Exam Cram Pack Flashcards
Type II error.
Missing the difference between two groups.
Type I error
Falsely finding difference between two groups.
Sensitivity formula
TP/(TP + FN)
Specificity formula
TN/(TN + FP)
Prevalence formula
(TP + FN)/(TP + FN + TN + FP)
Positive Predictive Value formula
TP/(TP + FP)
Negative Predictive Value
TN/(TN + FN)
Probability formula
Odds/ (1 + odds)
Odds formula
Probability/ (1 - probability)
Absolute Risk
Patients with event/ Total patients
Absolute Risk Reduction
Control event rate - experimental event rate
Absolute risk increase
Experimental event rate - control event rate
Relative Risk
Experimental event rate/ control event rate
Relative risk reduction or increase.
Absolute risk/ control event rate
Number needed to treat or harm
1/absolute risk
Mammogram age
50 - 74 years
AAA screen age
65 - 75
Bone density age
More than 65 years
Zoster vaccine age
60 years
Pneumococcus vaccine age
65 years
Do hip protectors prevent hip fractures?
No
Hyperbaric oxygen effective in treating pressure ulcers?
No
Pre-op before lung resection
Diagnostic spirometry.
OSA screen
Clopidogrel and surgery
Stop 5 - 7 days before surgery
Most important survival tool in cancer
Performance status
Duration of chronic cough and next step
> 8 weeks.
Chest radiograph.
Treatment of BPPV
Epley maneuver
Treatment of non self limiting vestibular neuritis
Steroid
Treatment of Meneire’s disease
Thiazide diuretics
HLD screening for males
> 35 years
HLD screening for females
> 45 years
Risk factors for heart disease
- Age: women over 55, men over 45
- HTN
- Smoking
- HDL < 40
- Family history: male less than 55, woman less than 65
Coronary disease or risk equivalent.
What LDL to treat?
100 mg/dl or more
0 - 1 risk factors.
LDL to treat
190 or more
Intermediate risk with 2 or more risk factors
LDL to treat
160 mg/dl or over
High risk; with 2 or more risk factors
LDL to treat
130 mg/dl or more
Defination of obesity
BMI over 30
Which obesity drug is contraindicated in hypertension?
Sibutramine
Name two obesity drugs
Orlistat
Sibutramine
What is pre-hypertension?
120-139/80-89
Stage 1 HTN
140-159/90-99
Stage 2 HTN
> 160/>100
GFR < 30
Which diuretic more effective as anti-HTN med?
Loop diuretic
LDL goal High risk (CHD or equivalent)
100 mg/dl or less
Intermediate (>2 risk factors)
LDL goal
130 mg/dl or less
Low risk (0-1 risk factors) LDL goal
160 mg/dl or less
How fast should you lose weight?
1-2 pounds per week
Absent cremasteric reflex.
Diagnosis likely?
Testicular torsion
Treatment of chronic prostatitis
Alpha blockers
Leading cause of infertility in males.
Varicocele
What’s the pro-drug for morphine?
Codeine
Weber test
Tuning fork on forehead
256 Hz
Rinne test
Tuning fork on mastoid process
512 Hz
Can presbycusis cause tinnitus
Yes
Rheumatic fever bacteria
Group A hemolytic streptococcus pyogenes
Lemierre’s disease
Infectious thrombophlebitis of jugular vein
Fusobacterium necrophorum
Pharyngitis with conjunctivitis
Adenovirus
Is post streptococcal glomerulonephritis preventable with antibiotics?
No
Treatment of strep throat
Penicillin G
Treatment of influenza
Oseltamivir
Zanamivir
Osler-Webb-Rendu
Hereditary hemorrhagic telangiectasias
Nasal packing in case of nose bleed.
What antibiotic coverage required to be in place?
Staphylococcus coverage.
Treatment of acute necrotizing ulcerative gingivitis.
Penicillin plus metronidazole.
Or
Clindamycin.
Treatment of Ludwig’s Angina.
Ampicillin/Sulbactam, penicillin, and metronidazole.
Treatment of Lemierre’s disease.
Penicillin or clindamycin.
Abcess drainage.
Anticoagulation recommended.
Oral cancer treatment.
Resection and radiotherapy
Treatment of squamous cell carcinoma at tongue base.
Chemoradiotherapy.
Treatment of glossadynia.
Alpha-lipoic acid.
Clonazepam.
Treatment oral lichen planus.
Reduce inflammation with corticosteroids, cyclosporine s, and retinoids.
Treatment of hairy cell leukoplakia (usually in HIV)
Zidovudine or Acyclovir.
What kind of hearing loss do you have in acoustic neuroma?
Sensorineural hearing loss.
If a patient presents with similar symptoms 7 days after being treated with IM ceftriaxone for gonorrhea, what should you suspect?
Re-infection.
Needs treatment again.
What kind of anesthesia is needed for cataract surgery?
MAC usually.
General surgery is rare.
What do you do with the anti-coagulation in cataract surgery?
Can usually be continued.
What kind of diabetic eye disease is the most common cause of visual impairment?
Diabetic maculopathy
When do you start screening for diabetic retinopathy in type 1?
3 - 5 years after diagnosis.
When do you start screening for diabetic retinopathy in type 2?
Immediately after diagnosis.
Most common infectious cause of corneal blindness.
Herpes simplex keratitis
Linear branching corneal ulcer on fluorescein stain.
Dendritic
Herpes simplex keratitis
Treatment for herpes simplex keratitis.
Topical ganciclovir
Most common opportunistic ocular infection in AiDS
CMV retinitis
Bilateral ocular discomfort, irritation, crusting of lashes, worse in the morning with remissions and exacerbations.
Diagnosis?
Blepharitis
Treatment of blepharitis
Oral tetracyclines
Topical antibiotics and steroids
Warm compresses and eyelid scrubs
Foreign body sensation, burning, tearing. Typically worse at end of day.
Corneal fluorescein staining shows fine diffuse erosions.
Diagnosis?
Keratoconjunctivitis sicca
Treatment of keratoconjunctivitis sicca.
Artificial tears
Topical cyclosporine
Precautions in viral conjunctivitis.
Avoid close contact with people 7 - 14 days.
Mucopurulent discharge from eye. And eyelashes sticking together.
Bacterial conjunctivitis.
S. pneumoniae
S. aureus
H. influenza
Papillae (red dots) on conjunctival lining of eyelid.
Diagnosis
Allergic conjunctivitis
Treatment of allergic conjunctivitis.
Topical antihistamine/mast cell stabilizers
Treatment of scleritis
Peri ocular steroid injections, systemic steroids or immunosuppressants.
Treatment of episcleritis.
Topical NSAIDS or steroids.
Anterior ischemic optic neuropathy.
Associated with?
Giant cell arteritis
Treatment of chemical burns to the eye.
Immediate copious irrigation.
Which oral medication can stop an attack of angle closure glaucoma?
Acetazolamide.
Medications that decrease efficacy of hormonal contraceptives.
Griseofulvin Rifampin Carbamazepine Phenobarbital Dilantin Oxycarbazepine Bosentan
Treatment of trichomoniasis.
Metronidazole.
Also treat partner.
Dyspareneuia + dysmenorrhea + infertility.
Diagnosis?
Endometriosis.
Bloody nipple discharge.
Diagnosis?
Intraductal papilloma.
Do most patients with atopic dermatitis have a food allergy?
No.
Topical treatment of psoriasis.
Vitamin D3 analogues.
Tazarotene.
Topical steroids.
What is the systemic treatment for psoriasis?
Methotrexate
Cyclosporine
Biologics: etanercept, infliximab
Treatment of seborrheic dermatitis
Topical steroids
Ketoconazole
Topical tacrolimus/pimecrolimus
Herald patch
Pityriasis Rosea
Christmas tree distribution
Pityriasis Rosea
Percentage of skin involvement in Steven Johnson’s syndrome.
10 - 30%
Percentage of skin involvement in toxic epidermal necrolysis.
More than 30%
Treatment of hidradenitis.
Acute painful lesion inject intralesional triamcinolone. Oral antibiotics (rifampin + clindamycin > tetracycline) Oral retinoids.
Which tetracycline can you use in renal failure?
Doxycycline
Difference between acne and rosacea.
Acne has comedones; rosacea does not.
What’s the number 1 cause of tinea versicolor?
Malassezia globosa.
Spaghetti and meatballs.
Diagnosis?
Tinea versicolor
Treatment of tinea versicolor.
Topical antifungals
Selenium sulfide-containing shampoos.
Hypo or hyperpigmented macules on the trunk and arms (spares face)
Wood’s lamp yellow.
Diagnosis?
Tinea versicolor.
Treatment of tinea nigra
Topical -azole
Treatment of severe tinea capitis with kerion (boggy, oozing inflammatory reaction).
Oral fluconazole and prednisone.
Immunosuppressed patient with papules and pustules in hair-bearing areas. Indurated, pink plaque.
Diagnosis?
Majocchi granuloma.
T. rubrum and T. Tonsurans
Treatment of majocchi granuloma.
Systemic antifungals.
Treatment of anthrax.
Penicillin
Ciprofloxacin or Doxycycline.
Treatment of Borrelia/Lyme
Doxycycline
Borrelia/Lyme in children and pregnant women.
Treatment.
Amoxicillin
What immune problem predisposes to meningococcemia?
Complement deficiencies.
C3 - C5
Treatment of meningococcemia.
IV penicillin or ceftriaxone.
Plaques on external nares.
Mikulicz cells on pathology.
Diagnosis?
Klebsiella pneumoniae rhinoscleromatis
Treatment of rhinoscleromatis.
Ciprofloxacin
Organism causing ecthyma gangrenosum.
P. aeruginosa.
Green nails.
Organism?
Pseudomonas aeruginosa.
Hot tub folliculitis.
Organism?
Pseudomonas aeruginosa.
Q fever.
Organism?
Coxiella burnetii
Treatment of rickettsial diseases.
Tetracyclines.
Doxycycline preferred.
Treatment for leprosy.
Dapsone
Rifampin
Clofazimime
Name rapid growing atypical mycobacterium.
M. abscessus.
M. chelonei.
M. fortuitum
Treatment of Mycobacterium marinum.
Minocycline.
Sharply erythematous marginated patches. Wood’s lamp shows coral red florescence.
Diagnosis.
Organism.
Treatment.
Erythrasma.
Corynebacterium minutissimum.
Topical benzoyl peroxide gel and macrolide/tetracycline.
Honey colored crusts.
Diagnosis.
Organism.
Treatment.
Impetigo
Strep pyogenes / Staph aureus
Benzyl peroxide, dicloxacillin / vancomycin.
Very ill patient: necrotic ulcer with erythematous rim. Associated with hot tub folliculitis. Diagnosis. Organism. Treatment.
Ecthyma gangrenosum.
Pseudomonas aeruginosa.
Ciprofloxacin, meropenem, imipenem, piperacillin.
Explosive superinfection around central face with swelling and erythema.
Diagnosis
Organism
Treatment
Erysipelas.
Strep pyogenes
Erythromycin, clarithromycin, cephalosporin and clindamycin.
What organism cause infectious mononucleosis.
EBV
Treatment of primary syphilis.
Penicillin.
Treatment of chancroid.
Azithromycin
Ceftriaxone
Ciprofloxacin
Erythromycin
“School of fish” on gram or giemsa stain.
Soft, painful, tender chancre.
Diagnosis?
Chancroid.
H. ducreyi.
Donnovan bodies - safety pin shaped intracytoplasmic inclusions in macrophages.
Diagnosis and treatment.
Granuloma Inguinale
TMP-SMX, doxycycline, erythromycin, ciprofloxacin.
Painless, soft lesion that heals spontaneously.
Secondary inguinal adenopathy, fluctuant, tender nodes.
Diagnosis and treatment.
Lymphogranuloma venereum (Chlamydia trachomatis) Doxycycline.
Treatment of gonorrhea.
Ceftriaxone.
Treatment of leishmaniasis.
Pentavalent antimony/sodium stibogluconate.
What’s the number 1 cause of acquired blindness worldwide?
River blindness.
Onchocerciasis
Treatment of scabies.
Permethrin cream 5%
Ivermectin oral
Which antibody is associated with Annular SLE?
Anti-Ro antibody
What are the two top causes of mortality in scleroderma?
- Lung disease.
2. Scleroderma renal crisis.
Which antibody is positive in mixed connective tissue disease?
Anti U1-RNP
First disease - Rubeola/measles.
Virus?
Paramyxovirus.
Second disease - Scarlet fever
Organism?
Streptococcus.
Third disease - Rubella/German measles
Virus?
Togavirus
Fourth disease - Duke’s disease.
Virus?
Not specific
Fifth disease - Erythema infectiosum
Virus?
Parvovirus B19
Sixth disease - Roseola/Exanthem subitum.
Virus?
HHV - 6/7
What medications cause psoriasis flares?
Withdrawal of systemic steroids.
Interferon.
ACE inhibitors.
Antimalarial drugs
What is eruptive seborrheic keratosis (Lesar Trelat) associated with?
Gastric carcinoma.
What kind of MRI image do multiple sclerosis flares show up on?
T2 FLAIR
What kind of MRI image does a stroke show up well on?
Diffusion weighted imaging.
Parkinson’s disease + autonomic features.
Multiple system atrophy.
Parkinson’s disease + difficulty with upward gaze.
Progressive supra nuclear palsy.
Parkinson’s disease + alien hand syndrome (they think their limb is not theirs)
Corticobasal degeneration.
Wacky, wobbly, wet.
Normal pressure hydrocephalus.
Anti-Ri antibody
Opsoclonus-myoclonus syndrome
Anti-Yo antibody
Subacute cerebellar cortical degeneration syndrome
Treatment of amyotrophic lateral sclerosis.
Riluzole
Concussion - Loss of consciousness.
Return to play in?
1 - 2 weeks
Concussion - no loss of consciousness.
Return to play in?
1 week
Concussion - symptoms resolve in less than 15 seconds.
Return to play in?
Immediately.
Is photosensitivity a feature of chlorpromazine?
Yes.
How long after cessation of alcohol does delirium tremens usually begin?
72 hours after cessation of drinking.
How much does sodium fall with every 100 mg/dl rise in blood glucose?
1.6 meq/l
What should you suspect if the urine pH is above 5.5 in the setting of metabolic acidosis?
Renal tubular acidosis.
What medication can be used to treat SIADH?
Conivaptan
Contraindications for conivaptan.
Heart failure.
Cirrhosis.
Formula for free water deficit.
TBW x ((plasma sodium/140) - 1)
Easy formula for metabolic acidosis compensation.
PCO2 = HCO3 + 15.
Or
Last digits of pH
Easy formula for metabolic alkalosis compensation.
PCO2 = HCO3 + 15.
pCO2 increases 7 mmHg for each 10 meq/l bicarb increase
Respiratory acidosis compensation
Acute: HCO3 increases by 1 meq/l for each 10 mmHg in pCO2
Chronic: HCO3 increases by 4 meq/l for each 10 mmHg in pCO2
Respiratory alkalosis compensation.
Acute: HCO3 decreases by 2 meq/l for each 10 mmHg increase in pCO2.
Chronic: HCO3 decreases by 4 meq/l for each 10 mmHg increase in pCO2.
Calculated osmolality formula.
2 x Na + glucose/18 + BUN/2.8
Negative urine anion gap.
Etiology?
Extra-renal cause.
Positive urine anion gap.
Etiology?
Renal tubular disorders.
Kidney stones in acidic urine?
Uris acid
Cystine
Kidney stones in alkaline urine?
Struvite
Calcium phosphate
Hemoglobin goal in CKD.
10 - 11 g/dl
Treatment of steroid resistant focal segmental glomerulosclerosis.
Cyclosporine and tacrolimus.
Treatment of IgA nephropathy.
ACE inhibitors.
ARBs
Fish oil
If severe then corticosteroids
Treatment of post-streptococcal glomerulonephritis.
Supportive; fluid, salt restriction.
Diuretics
Treatment of anti-glomerular basement membrane antibody disease.
Plasmapheresis.
Cyclophosphamide and prednisone.
How much proteinuria for nephrotic syndrome?
More than 3.5g/24h
Philadelphia chromosome
Chronic Myeloid Leukemia
What factors protect against ovarian cancer?
Pregnancy
OCPs
Oophorectomy
Lactation
