COMLEX random Flashcards
Ligament that connects the uterus, fallopian tubes, and ovaries to the pelvic side wall; also contains the ovaries, fallopian tubes, and round ligament of uterus
Broad ligament
Ligament that connects the ovaries to the lateral pelvic wall and contains the ovarian vessels
Suspensory ligament of the ovaries (aka infundibulopelvic ligament)
Ligament that connects the cervix to the side wall of the pelvis and contains the uterine vessels
Cardinal ligament
LH stimulates the theca cells to do what?
Produce androgens, androstenedione, and testosterone
FSH stimulates the granulosa cells to do what?
Convert androstenedione to estriadol via aromatase
What is the funtion of the corpus luteum after implantation
Produce progesterone to maintain the pregnancy until the syncytiotrophoblast takes over around 8-10 weeks
Menorrhagia, dysmenorrhea, pelvic pain, ENLARGED UTERUS
adenomysiosis (endomotrium within the myometrium)
Ovarian tumor composed of thyroid-like follicles
Struma ovarii
Can partial moles have a heartbeat?
Yes
Drug that can treat both breast cancer and osteoporosis
Raloxifene
Bilateral adnexal cysts in someone with multiple gestations, trophoblastic disease, ovarian hyperstimulation, or pregnancy complicated by fetal hydrops is most likely what
Theca-lutein cysts
What causes the formation of theca-lutein cysts?
Leutinization and hypertrophy of the theca-interna cells due to excessive B-hCG stimulation
Ovarian tumor associated with ascites and pleural effusions
Fibromas; this is known as Meig’s syndrome
Are BRCA1 and 2 tumor suppressors or oncogenes?
Tumor suppressors
Serum levels of what are used to confirm menopause?
Increased FSH
Why is FSH increased in menopause?
Loss of negative feedback from decreased levels of estrogen
If someone has galactorrhea from antipsychotic medications, what is your first step in tx?
Adjust the doses of antipsychotics, don’t want to give DA agonists as that may worsen schizophrenia
What is a threatened abortion?
Uterine bleeding within the first 20 weeks of gestation
What is an inevitable abortion?
Uterine bleeding, lack of fetal heart tones, and a dilated cervix
In the 3 main congenital adrenal hyperplasias (17a-hydroxylase, 21-hydroxylase, and 11B-hydroxylase deficiencies), what hormone is decreased in all 3 cases?
Cortisol
Female neonate with masculinization and HTN
11B-hydroxylase deficiency
Lab values in 11B-hydroxylase deficiency
Decreased alsoterone, increased 11-deoxycorticosterone (what causes the HTN in this case), decreased cortisol, increased sex hormones (what causes the virilization)
Most common area to find boob cancer
Upper outer quadrant
Freely moveable, well marginated mass beneath the areola that produces a serous effusion from the nipple
Intraductal papilloma
How is an intraductal papilloma different from a fibroadenoma?
Fibroadenomas don’t produce discharge
Pregnancy category D
Risk to the fetus, but the risks of stopping drug therapy are greater than the risk to the fetus
Pregnancy category A
Have been studied in pregnant women and shown to have little affect on the fetus
Category B medications
Have not been shown to affect the fetus, but there are inadequate human studies
Category C medications
Have been shown to have adverse affects in animals but have not been studied in humans
Key difference between placenta abruption and placenta previa
Presence of pain (in abruption)
Endometriosis puts the patient at risk for what?
Infertility
Most common cause of 2ndary ammenorhea
Eggo is preggo
When is a fetus most susceptible to teratogens?
Weeks 3-8
Beta-waves are seen in which stage of sleep
Awake, eyes open AND REM
Alpha-waves are seen in which stage of sleep
Awake with eyes closed
Theta waves are associated with which sleep stage?
N1
Sleep spindles and K complexes are in what sleep stage
N2
Sleep-walking, night terrors and bedwetting occur in this stage of sleep
N3
Delta waves are seen in which stage of sleep.
N3
What neurotransmitter is key to initiating sleep
Serotonin in the raphe nucleus.
What will you see on a CT scan if someone has constrictive pericarditis
Calcifications around the heart
Common cause of constrictive pericarditis in immigrants
TB
What will you see in RA pressure tracing in constrictive pericarditis
Steep X and Y descents
MOA for Salmonella causing watery then bloody diarrhea
Direct activation of the immune response leading to increased cAMP
How many organisms does shigella need to cause illness
~10 (very virulent)
Injury to this nerve will cause weakness of the flexor carpi ulnaris, medial half of flexor digitorum profundus, medial 2 lumbricals, all interrossei, the lumbricals, and the ADductor pollicis
Ulnar nerve at the medial epidondial
What other conditions are vitiligo patients likely to experience?
Autoimmune conditions (remember, having one autoimmune dx, vitiligo, predisposes to having other autoimmune dxs)
In private practice, are doctors legally obligated to take new patients?
Nope
Difference between guttate and plaque psoriasis
Guttate is small salmon colored lesions, while plaque psoriasis is larger, well, plaques of pink lesions
When is a non-complete heart block at risk of progression to a complete (3rd degree) heart block
When it involves the His-purkinje conduction system, like Mobitz II block
Once you rule out reversible causes for a 3rd degree block, what do?
Put in an implantable pacemaker
Is medicare or medicaid for poor people?
Medicaid
Name a drug you can use for a prolactinoma besides bromocriptine
Cabergoline
Drugs that bind tubulin and block polymerization of microtubules
Vinblastine and vincristine
Drugs that STABILIZE microtubles, resulting in a failure of mitosis
Taxanes: paclitaxel
First generation sulfonylureas
Tolbutamide, chorpropamide
2nd gen sulfonylureas
Glyburide, glimepiride, glipizide
AE specific to 1st gen sulfonylureas
Disulfiram-like effects
AE of sulfonylureas in general
Hypoglycemia
Diabetes drug class that causes edema (can lead to HF), weight gain and hepatoxocity
Glitazones/thiazolidinediones
Graves dx is what type of hypersensitivity
Type II, non-toxic
Who carries pertussis and how is it spread
Pertussis is only carried by humans and is spread via respiratory droplets
What is better to screen for thyroid problems with? TSH or T4
TSH
Why is TSH better for screening for thyroid problems than T3 or T4
More sensitive; TSH levels show greater change before T3 and T4
What WBC is the key player in asthma
Eosinophils
Recurrent oral/genital ulcers, uveitis, erythema nodosum
Behcet syndrome
Proposed pathophysiology of Behcets
Immune complexes that attack large and small blood vessels in the body
Insidious onset of a limp and pain in the anterior hip or knee in boys 4-10 y/o
Legg-Calve-Perthes disease (avascular necrosis of the femoral head)
In Legg-Calve-Perthes disease, what will x-ray show?
Femoral head is wide and flat due to collapse
Findings in familial dysbetalipoproteinemia
Increased total cholesterol, chylomicron remnants and VLDL, xanthomas
Defect in what in familial dysbetalipoproteinemia
ApoE
Normal function of ApoE
Allows, along with ApoB48, for the LDL receptors on the liver to recognize chylomicrons and to be taken up into the liver and made into VLDL
What classification of hyperlipidemias is familial dysbetalipoproteinemia
Type III
Type IV hyperlipidemia is aka as
Hypertriglyceridemia
Hypertriglyceridemia is due to what?
Overproduction of VLDL
What 4 bones make up the pterion
Frontal, parietal, temporal, sphenoid
Woman on an anti-seizure med has a baby with cleft lip/palate, nail hypoplasia, growth retardation, mental deficiency and cardiac defects. What drug was she on and what is the syndrome
Phenytoin causing fetal hydantoin syndrome
What is the drug of choice to reduce inflammation in ulcerative colitis
Sulfasalazine
Where is the genetic defect in patients who are susceptible to malignant hyperthermia
Ryanodine receptors
Main symptom in diverticulosis
Painless rectal bleeding
Test of choice to diagnose diverticulosis
Barium enema
Bilateral tender breast lumps that change in size with menstrual period, usually decreasing in tenderness and size after menses
Fibrocystic changes
What is Leser-Trelat sign and what is it a sign of?
Numerous seborrheic keratosis (brown spots errwhere) and it is a sign of many different kinds of internal cancers
Treatment for Kawasaki’s disease
IVIG and ASA (yep, even in kids)
In severe diarrhea, what metabolic change are you likely to see
Hypovolemic hyponatremia
What does Medicare part A cover
In-patient hospital care, skilled nursing, hospice care, and home health care
What does medicare part B cover
Out-patient care, physical therapy, occupational therapy
What does medicare part C cover
Medicare advantage plan, covers parts of A and B
What does medicare part D cover
Prescription drugs (D=drugs)
Absence of what in paroxysmal nocturnal hemobloginuria
CD55 and 59
Lactose negative, H2S positive organisms
Proteus and salmonella
Lactose negative, H2S negative organism
Shigella
Hereditary fructose intolerance is due to a deficiency in what?
Aldolase B
What is necessary for the diagnosis of pre-eclampsia
2 serial BP readings of >140/90 6 hours apart and proteinuria >300 mg/24hrs
What do you do for the initial management of meniscal tears?
RICE and NSAIDs
Tanner stage 1
Childhood; no sexual development
Tanner stage 2
Pubic hair appears (pubarche) and breast bud forms (thelarche)
Tanner stage 3
Pubic hair darkens and gets curly; penis size/length increases; breast enlargens
Tanner stage 4
Penis width increases, darker scrotal skin, development of glands; raised areolae (i.e. 2ndary mound develops)
Tanner V
Adult; areolae are no longer raised
Tumor marker associated with pancreatic cancer
CA19-9
Sudden sexual dysfunction or fecal/urinary incontinence in someone with lower lumbar back pain raises suspicion of what?
Cauda equina syndrome
What is the cause of cauda equina syndrome?
Massive posterior disc herniation
Is cauda equina syndrome a medical emergency?
Yes!
Identity disturbance, impulsivity and suicidal behavior are signs of what personality disturbance?
Borderline personality disorder (Cluster B)
Attention seeking, inappropriate sexual conduct, and rapidly shifting emotions are a sign of what personality disorder
Histrionic (Cluster B)
What is the treatment of choice for someone with severe symptomatic aortic stenosis
Valve replacement
Presentation of squamous cell bladder cancer
Painless gross hematuria, suprapubic pain
What are some risk factors for squamous cell bladder cancer?
Smoking, shistosome infections, aniline dyes, petroleum byproducts
DOC for shistosomiasis
Praziquantel
Key to diagnosing thrombotic thrombocytopenic purpura
Unusually large monomers of vWF (due to lack of ADAMTS-13)
If someone needs a shock, do you do CPR before or after?
After (if you have already confirmed that the rhythm is shockable)
Tx for Guillain-Barre
Respiratory support, plasmaphoresis, IVIG
Will N. meningitidis ferment maltose?
Yes (gonorrhea is the one that doesn’t ferment maltose)
Attachments of the ulnar collateral ligament
Inferior medial epicondyle to the medial coronoid process
Ulnar collateral ligament resists what type of stress?
Valgus (medial)
Ways to measure cardiac output
CO=SVHR=(EDV-ESV)HR=MAP/TPR=O2 consumption/AV difference
Peripheral edema, holosystolic murmur at left sternal border
Tricuspid valve regurgitation
What do you treat a benzo OD with?
Flumazenil
What do you treat an opioid OD with
Naloxone/naltrexone
Electrolyte changes in renal failure
Hyperkalemia, metabolic acidosis, hyperphosphatemia, hypocalcemia, uremia
What else is located at the same level as the 4th cervical vertebrae
The carotid bifurcation
Sternal angle/angle of Luis is located at the same level as what mediastinal component
Carina (bifurcation of the trachea)
Most common ECG abnormality in PE
Non-specific ST-segment and T-wave changes
Diffuse ST-segment elevations describe what?
Pericarditis
ASA poisoning causes what acid-base changes
Initial metabolic acidosis (via uncoupling of the ETC) which then progresses to a mixed metabolic acidosis/respiratory alkalosis due to excessive hyperventilation by the patient
hCG can mimic what other hormones
TSH, FSH and LH
Excessive hCG can cause what other unexpected problems
Hyperthyroid like symptoms (due to TSH mimicry) and gynecomastia (via LH mimicry)
Hydrogen ion secretion in renal tubules is linked with what ion
Potassium (so if K+ increases, H+ increases and vice-versa)
Metabolic changes caused by excessive aldosterone
Hypernatremia, hypokalemia, metabolic alkalosis
How does renal artery stenosis lead to metabolic alkalosis
Decreased perfusion>increased renin release>increased ATII>increased aldosterone>sodium retention, K+ and H+ secretion (remember, these two are coupled in the kidney)
Rhabdomyolysis leads to what acid-base disturbance
Metabolic acidosis
Complete absence of UDP-glucoronyltransferase
Crigler-Najar
How do you treat Crigler-Najar
Plasmaphoresis and phototherapy
Jaundice during stress
Gilbert syndrome
Cause of Gilbert syndrome
Decreased amounts of UDP-glucoronysyltransferace
How can you confirm diagnosis of Gilbert syndrome
Genetic testing
Red-man syndrome is associated with what drug
Vancomycin
What do you measure to ensure safe delivery vaginally of a child
Obstetric conjugate
MI in leads V1-4 most likely caused by occlusion of what artery
LAD
Developmental delay, gargoylism, airway obstruction, corneal clouding, hepatosplenomegaly
Hurler syndrome
Hurler syndrome caused by what?
alpha-L-iduronidase deficiency
What builds up in Hurler syndrome
Heparan sulfate, dermatan sulfate
Will changes in respiratory rate change the rate of uptake in inhaled anaesthetics
Yes
Most commonly affected nerve in pseudotumor cerebri and why
Abducens nerve because of it long intracranial course
What foramen does the middle meningeal artery pass through?
Foramen spinosum
Possible skin manifestation of primary sclerosing cholangitis
Pyoderma gangrenosum
Will you seen anti-mitochondrial antibodies in primary sclerosing cholangitis
No, you will see them in primary BILIARY CIRRHOSIS
What is defective in hereditary non-polyposis colorectal cancer
DNA mismatch repair
Why shouldn’t you drink the juice while on treatment for giardia
Metronidazole causes a disulfiram-like reaction
1st line treatment for acute sinusitis
Amoxicillin/clavulanate
Describe granuloma annulare
Smooth, shiny dermal papules located in a circle or ring
When might you see granuloma annulare
DM type 1, thyroid dx, lupus, other autoimmune dx
Use and MOA for danazol
Often used to treat endometriosis and blocks the production of FSH and LH from the anterior pituitary
Inheritance of leukocyte adhesion deficiency
AR
Describe condyloma acuminata
Pearly, fungating, cauliflower like verrucous papule lesions on the external vagina
What causes condyloma acuminata
HPV 6 and 11
Blood thing changes in warfarin OD
PT increase, PTT increase, normal bleeding time
What is it called when a doctor overrides a patients autonomy if the patients decision is unreasonable or dangerous.
Paternalism
Res ipsa loquitur
“The thing speaks for itself”, obvious negligence by the doctor like leaving a scalpel inside a patient during surgery
Serum levels of what are increased in Duchenne muscular dystrophy
Creatine phosphokinase
Most common cause of pyelonephritis
E. coli
If you have an older women with longstanding untreated hypothyroidism, what is she at risk for?
Myxedema coma
S&S of myxedema coma
Depressed state of consciousness, profound hypothermia, and respiratory depression
S&S of growth hormone deficiency
Decreased muscle mass, hypoglycemia, decreased gluconeogenesis
Most common etiology of hyperthyroidism
Graves dx
Lab values in primary hyperthyroidism
Decreased TSH, increased free and total T4, increased T3
Drug used for gastroparesis
Metoclopramide
Is there a painful thyroid gland in Graves dx?
No
Major difference between case-control study and cohort study
Case-control is retrospective (in the past) and cohort is prospective (follow subjects into future)
Delta-cells in the pancreas secrete what?
Somatostatin
S&S of somatostatinoma
Diabetes mellitus(somatostatin inhibits insulin release), hypochlorhydia (decreased gastrin secretion), cholelithiasis (decreased CCK release), steatorrhea
First line drug for DM II
Metformin
Why is metformin first line for DM II
Does not cause hypoglycemia
How do thyroid related proteins change during pregnancy
Thyroid binding globulin increases, total T4 increases, free T3 and T4 are normal and TSH is normal
DM drugs that inhibit dipeptidyl peptidase 4 (DPP-4) from breaking down incretins
The -gliptin’s; Linagliptin, saxagliptin, sitagliptin
How does insulin lower serum potassium
Drives K+ into cells by increasing the activity of Na/K ATPase
What are most thyroid nodules?
Benign adenomas (NOT papillary adenomas)
Mild diabetes, venous thrombosis, anemia, severe infections, NECROTIZING MIGRATORY ERYTHEMA
Glucagonoma
What is the drug of choice for gestational diabetes
Insulin!
What type of casts do you see in chronic renal failure
Waxy
DOC for legionella
Levofloxacin
Contralateral loss of pain and temp in the body, ipsilateral loss of pain and temp in the face, ipsilateral Horner’s syndrome, hoarseness, dysphagia, decreased gag reflex, vertigo, nystagmus, diplopia, vertigo, ipsilateral ataxia
Lateral medullary or “Wallenburg” syndrome caused by an infarct of the posterior inferior cerebellar artery
Dementia like Alzheimer’s plus movement disorder like Parkinsons=…
Lewy Body dementia
Specific finding for Lewy body dementia that you won’t see in Alzheimer’s or Parkinsons
Visual hallucinations
Orientation of the superior facets in the thoracic spine
Backwards, upwards and lateral
Orientation of the superior facets in the cervical spine
Backwards, upwards, and medial
Orientation of the superior facets in the lumbar spine
Backwards and medial
AEs of long-term heparin use
Alopecia and osteoporosis
What is the best sample (besides culture) to diagnose Legionella
Urine sample (contains Legionella antigens)
What will be increased in a patient population with increased prevalence of disease
Positive predictive value
Does prevalence affect sensitivity or specificity?
No
Mild-moderate conjugated hyperbilirubinemia that occurs after fasting states
Rotor’s syndrome
Pt travels to Africa and develops eye pain, iriditis, anterior uveitis and eventually blindness
Onchocerca volvulus
How is onchocerca volvulus transmitted?
Black fly
Treatment for onchocerca volvulus
Ivermectin
Trypanosome bruceii gambiense and rhodesiense cause what and are transmitted by what
African sleeping sickness and are transmitted by the tsetse fly
Kala-azar (visceral leishmeniasis) symptoms and transmission (and where is it found)
Fevers, hepatosplenomegaly, transmitted by the sandfly, and is often found in India
How do you treat visceral leishmaniasis
Sodium stibogluconate
If you see an adenoma with a stalk in the GI tract, what is it’s histology
Tubular adenoma (villous adenomas do not have a stalk)
What lab value changes will you see in a patient with carnitine palmitoyltransferase deficiency
Elevated creatine kinase and myoglobin (due to rhabdomyolysis)
The only cells of the CNS derived from mesoderm
Microglia
What might you find on auscultation if someone has an esophageal rupture
Crackles with each heart beat (pneumomediastinum, this is known as Hamman crunch)
Explain the odds ratio again
Odds that the group with the disease was exposed to the risk factor compared to those without the disease (if you visualize the square you draw for these problems, you divide down the columns not across the rows (across rows if for relative risk factor)
Antibody in scleroderma (NOT the CREST variant)
anti-topoisomerase
What’s the difference between arthritis in Reiter’s syndrome (reactive arthritis) and septic arthritis
Septic arthritis typically only occurs in one joint, whereas reactive arthritis occurs in many joints
Triad of Reiter’s syndrome (Reactive arthritis)
Conjunctivitis, urethritis, arthritis (Can’t see, can’t pee, can’t climb a tree)
What is primary prevention
Interventions that decrease disease in healthy people (vaccination, healthy lifestyle, antibiotic prophylaxis, aspirin)
What is secondary prevention
Do not prevent diseases themselves, but allow for intervention when needed (eg. screening tests)
Strong fibrous ligament that connects the apices of the spinous processes from C7 down to sacrum
Supraspinous ligament
Anatomical barrier
Point to where a physician can move a patients joint
Physiologic barrier
Point to where the PATIENT can actively move their own joint
Classic presentation of intussusception
Colicky abdominal pain, vomiting, and passage of blood through the rectum (currant jelly stools)
Laryngotracheobronchitis is also known as…
croup (barking seal cough)
What causes croup
Parainfluenza virus
AP neck x-ray may show what in croup?
Steeple sign from sublottic narrowing
Hyperphagia, nonspecific hypothalamic dysfunction, hypogonadism in an infant
Prader-Willi syndrome
Defect in Prader-Willi syndrome
Loss of gene on the paternal copy (imprinting) of chromosome 15
If someone has a bleeding defect with elevated prothrombin time but normal PTT and bleeding time, what is the likely defect
Factor VII deficiency (external pathway)
Skin infections located in skin folds (intertriginous areas)
Intertrigo caused by candida
Explain how leuprolide can function as both an agonist and an antagonist of GnRH
It is a GnRH analog that if given in a pulsatile manner (like GnRH) it will cause the release of FSH/LH. If given continuously, leuprolide will decrease both of these
What drug can you use to shrink fibroid tumors
Leuprolide
Bloody diarrhea, liver abscess, RUQ pain, flask-shaped ulcer
Entamoeba histolytica
Tx for entamoeba hisolytica
Metronidazole
Tx for t. brucei gambiense/rhodosiense
Suramin for blood born disease, melarsoprol
Maltese cross
Babesia microti
S&S of babesiosis
Fever, hemolytic anemia
Basesia is transmitted by
Ixodes tick
Babesia often coinfects with what and why?
Borrelia burgdorferi because that are both transmitted by the same vector, the ixodes tick
Tx for babesia
Atovaquone + azithromycin
T. cruzi causes what?
Chaga’s disease
What is T. cruzi transmitted by?
Reduviid (kissing bug)
Tx for enterobius vermicularis (pinworm)
Mebendazole
Intestinal infection, vomiting, diarrhea, anemia, rhabditiform larvae in the stool
Strongyloides stercoralis
Tx for strongyloides
Ivermectin or albendazole
Skin, inflammation, ulceration with a worm in the skin
Dracunculus medinensis
How do you treat dracunculus medinensis?
Slow extraction of worm
Swelling in skin, worm in the conjunctiva
Loa loa
How is Loa Loa transmitted
Deer fly, horse fly, mango fly
Diethylcarbamazine can be used to treat what infections
Loa Loa and wucheria bancrofti
Taenia solium is transmitted how
Ingestion of larvae in undercooked pork
Tx for taenia solium
Praziquantel
Cysts in liver that can lyse and cause anaphylaxis if antigens are released
Echinococcus granulosus
Histology of echinococcus granulosus
“Egg-shell” calcifications
This tapeworm causes B12 deficiency
Diphyllobothrium latum
Tx for diphyllobothrium latum
Praziquantel
This fluke can cause biliary tract inflammatin leading to pigmented gallstones
Clonorchis sinensis
How do you get clonorchis sinensis?
Eating undercooked fish
What cancer is clonorchis sinensis associated with?
Cholangiocarcinoma
Disease caused by paragonimus westermani
Lung inflam w/ 2ndary bacterial infection and hemoptysis
How do you get paragonimus westermani?
Eating undercooked crab meat
Animal bite leading to osteomyelitis
Pasteurella multocida (not just cat bites!)
Why do you give cilistatin with imipenem
To decrease the renal excretion rate of imipenem
MOA of cilistatin
Dehydropeptidase 1 inhibitor
DOC for lyme disease
Doxycycline
DOC for lyme disease IN KIDS
amoxicillin (doxycycline isn’t used in kids due to risk of bone and teeth malformations
Most common hepatitis virus associated with IV drug use
HCV (HBV can infect via this route too, but HCV is more common)
Out of the enterically transmitted hepatitis viruses (A and E) which one is not typically found in the USA
HEV
Serious sequelae of measles infection
subacute sclerosing panencephalitis (SSPE)
CSF findings in Guillain-Barre caused by C. jejuni infection
Normal cell count with increased protein
Most common presentation of 2ndary syphillis
Macular and papular rash on the palms and soles
Should you expect Kaposi sarcoma if the patient doesn’t have a low CD4 count?
No way Jose!
Hiker presents with fever for 3 days and a relapse for 2 days, then it occurs again
Colorado tick fever
Colorado tick fever is caused by what virus?
A coltivirus from the reoviridae family (DS DNA virus)
Colorado tick fever is transmitted by what vector
Dermacentor andersoni
Ehrlichiosis infections target what type of cells
WBC
Most common infection causing ehrlichiosis
Ehrlichiosis chafeensis (obligate intracellular gram negative bacteria from the rickettsia family)
Ehrlichiosis chafeensis is transmitted by what vector
Ixodes tick
Presentation of someone with ehrlichiosis
Fever, headaches, malaise, myalgias, rigors
What should you do first in a bacterial endocarditis patient
Blood cultures so you know which organism to treat
Can a patient refuse HIV testing, even if pregnant?
Yes
High fever (>40) that breaks and the a rash appears on a patients trunk and spreads to the face and the extremities
Roseola
What is roseola caused by?
HHV6 and 7
Viral rash that worsens in the sun
Erythema infectiosum caused by parvovirus B19
Rubella is aka
German measles
Rubeola is aka
Actual measles
Adenovirus structural characteristics
Double stranded, linear, non-enveloped DNA virus
Classification of enterobius vermicularis
Nematodes and diecious (distinct male and female organisms)
Progressive multifocal leukoencephalopthy is caused by what virus
JK polyomavirus
Is JK polyomavirus widespread in the US population?
Yes, it just doesn’t cause symptoms most of the times because it needs to host to be immunocompromised
What is the study of choice to determine disease prevalence in a population
Cross-sectional study
What type of birefringence will fluid aspiration of a joint show in gout?
Negative birefringence
What are the chalky-white lesions often seen under the skin in gout?
Tophi (uric acid crystals under the skin that produce an inflammatory response)
What is the initial drug of choice for ACUTE gout attacks, and why is it not colchicine?
Indomethacin. Colchicine is not used because of it’s GI AEs
How do OCP decrease chances of being pregnant
Main MOA is by blocking the release of the ovum via suppression of gonadotropins during the time of the LH surge.
Main difference between a manic and a hypomanic state
Hypomanic isn’t severe enough to affect the patients daily life.
If a patient has strep throat and is allergic to penicillin, what is the 2nd line drug you use?
Macrolides (erythromycin and azithromycin)
Most severe AE of macrolides
QT prolongation (especially azithromycin)
Bone cancer associated with retinoblastoma
Osteosarcoma
What lab test would allow you to visualize a chromosomal defect (eg in deletions like in Prader-Willi)
Flourescent in situ hybridization
Why is a stool culture not useful when diagnosing C. dif infections
C. dif can be part of the normal flora
What antibiotics are mostly associated with causing C. dif
Ampicillin and clindamycin
