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STEP2CK > Diagnostics > Flashcards

Diagnostics Flashcards

1
Q

Gold Standard Dx Malrotation

A

Upper GI Series

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2
Q

Intrauterine preg

A

@5 weeks or B-hCG 1000-1500 transvaginal US

Transabdominal Bhcg >6500

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3
Q

Extra workup in pregnant DM

A

EKG
24 hr urine for basline renal fct
HbA1c
Ophthalmologic exam

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4
Q

Toxic Megacolon

A

3+ diagnostic criterion
WBC: >10.5 K
tachy > 120 bpm
Fever >100.4

Definitive: Plain film x-ray

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5
Q

PCOS

A

Free T elevated
LH: FSH >3
Pelvic U/S: bilaterally enlarged cystic ovaries

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6
Q

Best initial test for pleural effusion?

A

Lateral chest xray (dx up as little as 50 mL fluid)

*PA film needs >200mL

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7
Q

Presumed bowel perforation?

A

UPRIGHT chest xray (NOT abdominal film)

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8
Q

Osteomyelitis

A

Bone Xray : FIRST
if it is negative (as osteo takes 2 weeks)..then
MRI or Bone Scan

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9
Q

Best first test for

  1. ) severe head trauma
  2. ) stroke
A

Non-Con head CT

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10
Q

Best first test for intracranial mass lesion?

A

Contrast head CT

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11
Q

Most accurate test for diverticulitis and kidney stones?

A

CT

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12
Q

Best test to look at the pancreas ? (and other retroperitoneal structures?)

A

Abdominal CT

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13
Q

Infective Endocarditis

A

Do blood cultures before starting antibiotics

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14
Q

Dig Toxity workup

A

EKG and potassium level

Get a digoxin level

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15
Q

Cystinuria

A

Urinary Cyanide Nitroprusside Test

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16
Q

Chronic Granulomatous Disease

A

Nitro-Blue tetrazolium test

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17
Q

Cryptococcal Meningitis

A

India Ink CSF, sabourad agar cx

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18
Q

Pulmonary HTN

A

Gold standard: Right heart catheterization (Swan-ganz)

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19
Q

Diagnosis of avascular necrosis

A

MRI

20
Q

Benign positional verticgo

A

Normal neuro exam

Dix-Hallpike maneuver yields nystagmus

21
Q

Herpes Encephalitis: Most accurate

A

PCR of CSF (better than BRAIN bx)

22
Q

Infectious Diarrhea

A

Best initial: fecal leukocytes (lactoferrin is actually better)
More accurate test: stool culture

23
Q

PID: most accurate test

A

Laparoscopy

24
Q

Hereditary Angioedema- Best initial test

A

Low C2, C4, c1 esterase inhibitor

25
Q

WPW: EKG

A
  1. wide QRS
  2. short PR
  3. delta waves
26
Q

Wilson’s Disease

A

Low serum Ceruloplasmin
High Urine Copper
DON’T GET A SERUM CU

27
Q

Hemtchromatosis

A

Ferritin

Bone marrow bx- definitive

28
Q

First-degree AV block + widened QRS

A

Electrophysiology Studies

29
Q

Suspected valve or septal rupture s/p MI, stable patient

A

Echo

30
Q

High-dose dexa- suppressible but negative MRI

A

Superior petrosal vein sample

31
Q

Bacterial antigen test for CNS infxn?

A

Do this when the patient got abx prior to LP and CSF cx might be falsely negative

32
Q

TB meningitis

A

Requires acid fast stain on 3 high-volume LPs
Centrifuge speciment to concentrate the organisms
[just one unspun CSF sample has a sensitivity of 10%]

33
Q

Lyme/Ricketsia

A

Serologies, ELISA, western blot, PCR

34
Q

Cryptococcus

A

India Ink (60-70% sensitive), Crypto antigen >95% sensitive

35
Q

Bacterial meningitis

A

TREATMENT BASED ON CSF CELL WBC COUNT

36
Q

Acyclovir-resistant herpes meningitis

A

Foscarnet?

37
Q

Best initial test for any hepatidites

A

IgM + IgG

38
Q

Drop arm test

A

Rotator Cuff Tear (common with falls on outstretched hands)

39
Q

Scabies

A

Scrape and magnify

40
Q

Definitive Dx of chicken pox

A

Tzanck smear - multinucleated Giant Cells

41
Q

E. hystolitica

A

Needs serologies, stool cx doesn’t work

42
Q

Cocaine Intox

A

Get an EKG first! R/o anything BAD

43
Q

Ischemic Bowel

A

CT abdomen- best initial

Angiography - most accurate

44
Q

Stress Fractures

A

CT/MRI (won’t show on xray)

45
Q

Hepatocellular Carcinoma

A

Triple Phase CT

46
Q

Cirrhosis pts

A

Get RUQ US and AFP, LFT, BMP, and coags for transplant elligibilites

STEP2CK (12 decks)

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