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STEP 2 Review > FA High Yield > Flashcards

FA High Yield Flashcards

1
Q

Disease associated with protein 14-3-3 (Galen)

A

Creuztfeld Jacob

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2
Q

Classic EKG finding in atrial flutter

A

“Sawtooth” P waves

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3
Q

Definition of unstable angina

A

Angina that is new, worsening, or occurs at rest

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4
Q

Anti-hypertensive for a diabetic patient with proteinuria

A

ACE

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5
Q

Beck’s triad of cardiac tamponade

A

Hypotension, JVD, distant heart sounds

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6
Q

Drugs that slow heart rate

A

B-blockers, calcium channel blockers, digoxin, amiodarone

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7
Q

Hypercholesterolemia treatment that leads to flushing and pruritus

A

Niacin

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8
Q

Murmur of HOCM

A

Systolic ejection murmur heard along the lateral sternal border that increases with decreased preload (Valsalva)

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9
Q

Murmur of aortic insufficiency

A

Austin Flint murmur, a diastolic, decrescendo, low-pitched, blowing murmur that is best heard sitting up; increases with increased afterload (handgrip)

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10
Q

Murmur of aortic stenosis

A

Systolic crescendo/decrescendo murmur that radiates to the neck; increases with increased preload (squatting)

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11
Q

Murmur of mitral regurgitation

A

Holosystolic murmur that radiates to the axilla; increases with increased afterload (handgrip)

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12
Q

Murmur of mitral stenosis

A

Diastolic, mid-to late, low pitched murmur preceded by an opening snap

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13
Q

Treatment for atrial fibrillation and atrial flutter

A

If unstable, cardiovert

If stable or chronic, rate control with CCBs or BBs

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14
Q

Treatment of ventricular fibrillation

A

Immediate cardioversion

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15
Q

Dressler’s syndrome

A

An autoimmune reaction with fever, pericarditis, and increased ESR occurring 2-4 weeks post-MI

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16
Q

IV drug use with JVD and a holosystolic murmur at the left sternal border. Treatment?

A

Treat existing heart failure and replace the tricuspid valve

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17
Q

Diagnostic test for hypertrophic cardiomyopathy

A

Echo (showing a thickened left ventricular wall and outflow obstruction)

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18
Q

Pulsus paradoxus

A

A decrease in SBP > 10 mmHg with inspiration; seen in cardiac tamponade

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19
Q

Classic EKG findings in pericarditis

A

Low voltage, diffuse ST elevation, PR depression

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20
Q

Definition of HTN

A

BP > 140/90 on 3 separate occasions 2 weeks apart

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21
Q

Eight surgically correctable causes of HTN

A

Renal artery stenosis, coarctation of the aorta, pheochromocytoma, Conn’s syndrome, Cushing’s syndrome, unilateral renal parenchymal disease, hyperthyroidism, hyperparathyroidism

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22
Q

Evaluation of a pulsatile abdominal mass and bruit

A

Abdominal ultrasound and CT

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23
Q

Indications for surgical repair of AAA

A

> 5.5 cm, rapidly enlarging, symptomatic, or ruptured

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24
Q

Treatment for acute coronary syndrome

A

ASA, heparin, clopidogrel, morphine, O2, sublingual nitroglycerin, IV beta blockers

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25
Q

Metabolic syndrome

A

Abdominal obesity, high triglycerides, low HDL, HTN, insulin resistance, prothrombotic or proinflammatory states

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26
Q

Appropriate diagnostic test for a 50 year old man with stable angina and can exercise to 85% of max predicted HR

A

Exercise stress treadmill with EKG

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27
Q

Appropriate diagnostic test for a 65 year old woman with LBBB, severe osteoarthritis and has unstable angina

A

Pharmacologic stress test (dobutamine echo)

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28
Q

Target LDL in a patient with diabetes

A
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29
Q

Signs of active ischemia during stress testing

A

Angina, ST segment changes on EKG, or decreased BP

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30
Q

EKG findings suggestive of MI

A

ST segment elevation (depression means ischemia), flattened T waves, and Q waves

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31
Q

Coronary territories in an MI

A

Anterior wall (LAD/diagonal), inferior (PDA), posterior (left circumflex/oblique, RCA/marginal), septum (LAD/diagonal)

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32
Q

A young patient with angina at rest and ST segment elevation with normal cardiac enzymes

A

Prinzmeta’s angina

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33
Q

Common symptoms associated with silent MIs

A

CHF, shock, and altered mental status

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34
Q

Diagnostic test for PE

A

Spiral CT with contrast

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35
Q

Use of protamine

A

Reverses effects of heparin

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36
Q

Use of prothrombin time

A

Coagulation parameter affected by warfarin

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37
Q

A young patient with a family history of sudden death collapses and dies while exercising

A

Hypertrophic cardiomyopathy

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38
Q

Endocarditis prophylaxis regimens

A

Oral surgery - amoxicillin for certain situations; GI or GU procedures - not recommended

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39
Q

Virchow’s triad

A

Stasis, hypercoagulability, endothelial damage

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40
Q

The most common cause of HTN in a young women

A

OCPs

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41
Q

The most common cause of HTN in young men

A

Excessive EtOH

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42
Q

Figure 3 sign

A

Aortic coarctation

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43
Q

Water-bottle shaped heart

A

Pericardial effusion

Look for pulsus paradoxus

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44
Q

“Stuck on appearance”

A

Seborrheic keratotis

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45
Q

Red plaques with silvery-white scales and sharp margins

A

Psoriasis

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46
Q

The most common type of skin cancer, the lesion is a pearly colored papule with a translucent surface and telangiectasias

A

Basal cell carcinoma

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47
Q

Honey crusted lesions

A

Impetigo

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48
Q

A febrile patient with a history of diabetes presents with a red, swollen, painful lower extremity

A

Cellulitis

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49
Q

(+) Nikolsky’s sign

A

Pemphigus vulgaris

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50
Q

(-) Nikolsky’s sign

A

Bullous pemphigoid

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51
Q

A 55 year old obese patient presents with dirty, velvety patches on the back of the neck

A

Acanthosis nigricans; check fasting glucose to rule out diabetes

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52
Q

Dermatomal distribution

A

Varicella zoster

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53
Q

Flat topped papules

A

Lichen planus

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54
Q

Iris-like target lesions

A

Erythema multiforme

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55
Q

A lesion characteristically occurring in a linear pattern in areas where skin comes into contact with clothing or jewelry

A

Contact dermatitis

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56
Q

Presents with a herald patch, Christmas-tree pattern

A

Pityriasis rosea

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57
Q

Pinkish, scaling, flat lesions on the chest and back; KOH prep has a “spaghetti and meatballs” appearance

A

Tina versicolor (caused by Malassezia furfur)

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58
Q

Four characteristics of a nevus suggestive of melanoma

A

Asymmetry, border irregularity, color variation, diameter > 6 mm

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59
Q

A premalignant lesion from sun exposure that can lead to squamous cell carcinoma

A

Actinic keratosis

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60
Q

“Dewdrops on a rose petal”

A

Lesions of primary varicella

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61
Q

“Cradle cap”

A

Seborrheic dermatitis; treat conservatively with bathing and moisturizing agents

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62
Q

Associated with Proprionibacterium acnes and changes in androgen levels

A

Acne vulgaris

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63
Q

A painful, recurrent vesicular eruption of mucocutaneous surfaces

A

Herpes simplex

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64
Q

Inflammation and epithelial thinning of the anogenital area, predominantly in postmenopausal women

A

Lichen sclerosis

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65
Q

Exophytic nodules on the skin with varying degrees of scaling or ulceration; the second most common type of skin cancer

A

Squamous cell carcinoma

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66
Q

The most common cause of hypothryoidism

A

Hashimoto’s

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67
Q

Lab findings in Hashimoto’s

A

High TSH, low T4, anti-TPO antibodies

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68
Q

Exophthalmos, pretibial myxedema, and low TSH

A

Grave’s disease

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69
Q

The most common cause of Cushing’s syndrome

A

Iatrogenic corticosteroids, the second most common cause is Cushing’s disease

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70
Q

A patient presents with signs of hypocalcemia, high phosphorus, and low PTH

A

Hypoparathyroidism

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71
Q

“Stones, bones, groans, psychiatric overtones”

A

Signs of hypercalcemia

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72
Q

A patient complains of headache, weakness, and polyuria; exam reveals HTN and tetany; labs show hypernatremia, hypokalemia, and metabolic alkalosis

A

Primary hyperaldosteronism (Conn’s syndrome or bilateral adrenal hyperplasia)

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73
Q

A patient presents with tachycardia, wild swings in BP, headache, diaphoresis, altered mental status, and a sense of panic

A

Pheochromocytoma

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74
Q

Which should be used first in treating pheochromotycoma, alpha or beta antagonists?

A

Alpha antagonists (phentolamine, phenoxybenzamine)

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75
Q

A patient with history of lithium use presents with copious amounts of dilute urine

A

Nephrogenic diabetes insipidus

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76
Q

Treatment of central DI

A

DDAVP and free water restriction

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77
Q

A postoperative patient with significant pain presents with hyponatremia and normal volume status

A

SIADH due to stress

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78
Q

An anti-diabetic agent associated with lactic acidosis

A

Metform

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79
Q

A patient presents with weakness, nausea, vomiting, weight loss, and new skin pigmentation; labs show hyponatremia and hyperkalemia. Treatment?

A

Primary adrenal insufficiency (Addison’s disease)

Treat with glucocorticoids, mineralocorticoids, and IVF

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80
Q

Goal HbA1c for a patient with DM

A
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81
Q

Treatment of DKA

A

Fluids, insulin, and electrolyte repletion (K+)

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82
Q

Why are beta blockers contraindicated in diabetics

A

They can mask the symptoms of hypoglycemia

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83
Q

A patient presents with sudden onset of severe, diffuse abdominal pain. Exam reveals peritoneal signs, and AXR reveals free air under the diaphragm. Treatment?

A

Emergent laparotomy to repair a perforated viscus

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84
Q

Most likely cause of acute lower GI bleed in patients > 40 yo

A

Diverticulosis

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85
Q

Diagnostic modality used when ultrasound is equivocal for cholecystitis

A

HIDA scan

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86
Q

Risk factors for cholelithiasis

A

Fat, female, fertile, 40, flatulent

87
Q

Inspiratory arrest during palpation of RUQ

A

Murphy’s sign, seen in acute cholecystitis

88
Q

The most common cause of SBO in patients with no history of abdominal surgery

A

Hernia

89
Q

Most common cause of SBO in patients with history of abdominal surgery

A

Adhesions

90
Q

Most common organism to cause diarrhea

A

Campylobacter

91
Q

Most common cause of diarrhea after recent antibiotic use

A

C. diff

92
Q

Most common cause of diarrhea after camping

A

Giardia

93
Q

Most common cause of diarrhea in travelers

A

ETEC

94
Q

Most common cause of diarrhea at church picnics/mayonnaise

A

Staph aureus

95
Q

Most common cause of diarrhea after eating undercooked hamburgers

A

E. coli O157:H7

96
Q

Most common cause of diarrhea after fried rice

A

Bacillus cereus

97
Q

Most common cause of diarrhea after eating poulty/raw eggs

A

Salmonella

98
Q

Most common cause of diarrhea after eating raw seafood

A

Vibrio, hepatitis A

99
Q

Most common causes of diarrhea in AIDS patients

A

Isospora, Cryptosporidium, MAC

100
Q

Most common cause of diarrhea that mimics appendicits

A

Yersinia

101
Q

A 25 year old Jewish man presents with pain and watery diarrhea after meals. Exam shows fistulas between the bowel and skin and nodular lesions on his tibias.

A

Crohns

102
Q

Inflammatory disease of the colon with an increased risk of colon cancer

A

Ulcerative colitis (greater risk than Crohns)

103
Q

Extraintestinal manifestations of IBD

A

Uveitis, ankylosing spondylitis, pyoderma gangrenosum, erythema nodosum, primary sclerosing cholangitis

104
Q

Medical treatment of IBD

A

5-ASA agents and steroids during acute exacerbations

105
Q

Difference between Mallory-Weiss tears and Boerhaave tears

A

Mallory-Weiss - superficial tear in esophageal mucosa

Boerhaave - full thickness esophageal rupture

106
Q

Charcot’s triad

A

RUQ pain, jaundice, and fever/chills - signs of ascending cholangitis

107
Q

Reynold’s pentad

A

Charcot’s triad plus shock and mental status changes - signs of suppurative ascending cholangitis

108
Q

Medical treatment for hepatic encephalopathy

A

Decrease protein intake, lactulose, rifaximin

109
Q

The first step in management of a patient with an acute GI bleed

A

Manage ABCs

110
Q

A 4 year old child presents with oliguria, petechiae, and jaundice following an illness with bloody diarrhea. Most likely diagnosis and cause?

A

HUS due to E. coli O157:H7

111
Q

Classic causes of drug-induced hepatitis

A

TB medications (INH, rifampin, pyrazinamide), acetaminophen, tetracycline

112
Q

A 40 year old obese woman with elevated alkaline phosphatase, elevated bilirubin, dark urine, and clay colored stools

A

Biliary tract obstruction

113
Q

Hernia with highest risk of incarceration - indirect, direct, or femoral?

A

Femoral

114
Q

A 50 year old man with a history of alcohol abuse presents with boring epigastric pain that radiates to the back and is relieved by sitting forward. Management?

A

Confirm the diagnosis of acute pancreatitis with elevated amylase and lipase. Make the patient NPO, and give IVF, O2, analgesia

115
Q

Four causes of microcytic anemia

A

TICS - thalassemia, iron deficiency, anemia of chronic disease, sideroblastic anemia

116
Q

AN elderly man with hypochromic, microcytic anemia is asymptomatic. Diagnostic tests?

A

FOBT and sigmoidoscopy, suspect colorectal cancer

117
Q

Precipitants of hemolytic crisis in patients with G6PD deficiency

A

Sulfonamides, antimalarial drugs, fava beans

118
Q

The most common inherited cause of hypercoagulability

A

Factor V Leiden mutation

119
Q

The most common inherited bleeding disorder

A

von Willebrand’s disease

120
Q

The most common inherited hemolytic anemia

A

Hereditary spherocytosis

121
Q

Diagnostic test for inherited hemolytic anemia

A

Osmotic fragility test

122
Q

Pure RBC aplasia

A

Diamond-Blackfan anemia

123
Q

Anemia associated with absent radii and thumbs, diffuse hyperpigmentation, cafe au lait spots, microcephaly, and pancytopenia

A

Fanconi’s anemia

124
Q

Medications and viruses that lead to aplastic anemia

A

Chloramphenicol, sulfonamides, radiation, HIV, chemotherapeutic agents, hepatitis, parvovirus B19, EBV

125
Q

How to distinguish polycythemia vera from secondary polycythemia

A

Both have increased hematocrit and increased RBC mass, but polycythemia vera should have normal O2 saturation and low erythropoietin levels

126
Q

TTP pentad?

A

FAT RN - fever, anemia, thrombocytopenia, renal dysfunction, neurologic abnormalities

127
Q

HUS triad?

A

Anemia, thrombocytopenia, and acute renal failure

128
Q

Treatment for TTP

A

Emergent large-volume plasmapheresis, corticosteroids, antiplatelet drugs.

Platelet transfusion is contraindicated

129
Q

Treatment for ITP in children

A

Usually resolves spontaneously; may require IVIG and/or corticosteroids

130
Q

Lab findings in DIC

A

Fibrin split products and D-dimer are elevated

Platelets, fibrinogen, and hematocrit are decreased

131
Q

An 8 year old boy presents with hemarthrosis and increased PTT with normal PT and bleeding time. Diagnosis and treatment?

A

Hemophilia A or B; consider desmopressin (for hemophilia A) or factor VIII or IX supplements

132
Q

A 14 year old girl presents with prolonged bleeding after dental surgery and with menses, normal PT, normal or increased PTT, and increased bleeding time. Diagnosis and treatment?

A

von Willebrand’s disease, treat with desmopressin, FFP, or crycoprecipitate

133
Q

A 60 year old black man presents with bone pain. What might a workup for multiple myeloma reveal?

A

Monoclonal gammopathy, Bence Jones proteinuria, and “punched out” lesions on x-ray of the skull and long bones

134
Q

Reed-Sternberg cells

A

Hodgkin’s lymphoma

135
Q

A 10 year boy presents with fever, weight loss, and night sweats. Exam shows anterior mediastinal mass

A

Non-Hodgkins’s lymphoma

136
Q

Lab studies in anemia of chronic disease

A

Microcytic anemia with low serum iron, decreased TIBC, and normal or increased ferritin

137
Q

Lab studies in iron deficient anemia

A

Microcytic anemia with decreased serum iron, decreased ferritin, and increased TIBC

138
Q

An 80 year old man presents with fatigue, lymphadenopathy, splenomegaly, and isolated lymphocytosis. Diagnosis?

A

CLL

139
Q

The lymphoma equivalent of CLL

A

Small lymphocytic lymphoma

140
Q

A late, life-threatening complication of CML

A

Blast crisis (fever, bone pain, splenomegaly, pancytopenia)

141
Q

Auer rods on blood smear

A

AML

142
Q

AML subtype associated with DIC. Treatment?

A

M3. Retinoic acid

143
Q

Electrolyte changes in tumor lysis syndrome

A

Hypocalcemia, hyperkalemia, hyperphosphatemia, hyperuricemia

144
Q

A 50 year old man presents with early satiety, splenomegaly, and bleeding. Cytogenetics show t(9,22). Dx?

A

CML

145
Q

Heinz bodies

A

Intracellular inclusions seen in thalassemia, G6PD deficiency, and postsplenomegaly

146
Q

Virus associated with aplastic anemia in patients with sickle cell

A

Parvovirus B19

147
Q

A 25 year old black man with sickle cell anemia has sudden onset of bone pain. Management of pain crisis?

A

O2, analgesia, hydration, and if severe, transfusion

148
Q

A significant cause of morbidity in thalassemia patients. Treatment?

A

Iron overload, use deferoxamine

149
Q

The 3 most common causes of fever of unknown origin

A

Infection, cancer, and autoimmune disease

150
Q

Four signs and symptoms of strep pharnygitis

A

Fever, pharyngeal erythema, tonsillar exudate, lack of cough

151
Q

A nonsuppurative complication of strep infection that is not altered by treatment of primary infection

A

Postinfectious glomerulonephritis

152
Q

The most common predisposing factor for acute sinusitis

A

Viral URI

153
Q

Asplenic patients are prone to these organisms

A

Encapsulated organisms - pneumococcus, meningococcus, H. influenza, Klebsiella

154
Q

The number of bacteria needed on a clean-catch specimen to diagnose a UTI

A

10^5 bacteria/mL

155
Q

Which healthy population is susceptible to UTIs?

A

Pregnant women, treat this group aggressively because of potential complications

156
Q

A patient from Cali or Arizona presents with fever, malaise, cough and night sweats. Diagnosis and treatment

A

Coccidiodomycosis, treat with amphothericin B

157
Q

Nonpainful chancre

A

Primary syphilis

158
Q

A “blueberry muffin” rash is characteristic of what congenital infection

A

Rubella

159
Q

Meningitis in neonates. Causes and Tx

A

GBS, E. coli, Listeria

Treat with ampicillin and gentamycin

160
Q

Meningitis in infants. Causes and Tx

A

Pneumococcus, meningococcus, H. flu

Treat with cefotaxime and vanco

161
Q

What should always be done prior to LP?

A

Check for increased ICP, look for papilledema

162
Q

CSF findings in bacterial meningitis

A

Low glucose, PMN predominance

163
Q

CSF findings in aseptic meningitis

A

Normal glucose, lymphocyte predominance

164
Q

CSF findings in SAH

A

Numerous RBCs in serial CSF samples

165
Q

CSF findings in multiple sclerosis

A

Increased gamma globulins

166
Q

CSF findings in Guillain-Barre

A

Albuminocytologic dissociation, which is an elevation in CSF protein (>0.55 g/L) without an elevation in white blood cells

167
Q

Initially presents with a pruritic papule with regional lymphadenopathy, evolves into a black eschar after 7-10 days. Tx

A

Cutaneous anthrax, treat with penicillin G or cipro

168
Q

Findings in tertiary syphillis

A

Tabes dorsalis, general paresis, gummas, Argyll Robertson pupil, aortitis, aortic root aneurysms

169
Q

Characteristics of secondary Lyme disease

A

Arthralgias, migratory polyarthropathies, Bell’s palsy, mycoarditis

170
Q

Cold agglutinins

A

Mycoplasma

171
Q

A 24 year old man presents with soft white plaques on this tongue and back of throat. Dx? Workup? Tx?

A

Candidal thrush, workup should include HIV testing, treat with oral nystatin

172
Q

At what CD4 count should PCP pneumonia prophylaxis be given in an HIV + patient. MAC prophylaxis?

A
173
Q

Risk factors for pyelonephritis

A

Pregnancy, vesicoureteral reflux, anatomic abnormalities, indwelling catheters, kidney stones

174
Q

Neutropenic nadir postchemotherapy

A

7-10 days

175
Q

Erythema migrans

A

Lesion of primary Lyme disease

176
Q

Classic physical findings of endocarditis

A

Fever, heart murmur, Osler’s nodes, splinter hemorrhages, Janeway lesions, Roth spots

177
Q

Aplastic crisis in sickle cell disease

A

Parvovirus B19

178
Q

Ring enhancing brain lesion on CT with a patient presenting with seizures

A

Taenia solium (cysticercosis)

179
Q

Name the organism: branching rods in oral infection

A

Actinomyces

180
Q

Name the organism: weekly gram positive, partially acid-fast in lung infection

A

Nocardia

181
Q

Name the organism: painful chanchroid

A

H. ducreyi

182
Q

Name the organism: dog or cat bite

A

Pasteurella

183
Q

Name the organism: gardener

A

Sporothrix

184
Q

Name the organism: raw pork and skeletal muscle cysts

A

Trichinella spiralis

185
Q

Name the organism: sheep herders with liver cysts

A

Echinococcus

186
Q

Name the organism: perianal itching

A

Enterobius vermicularis

187
Q

Name the organism: pregnant women with pets

A

Toxoplasmosis

188
Q

Name the organism: meningitis in adults

A

Neisseria

189
Q

Name the organism: meningitis in elderly

A

Strep pneumo

190
Q

Name the organism: meningoencephalitis in AIDS patients

A

Cryptococcus

191
Q

Name the organism: alcoholic with pneumonia

A

Klebsiella

192
Q

Name the organism: currant jelly sputum

A

Klebsiella

193
Q

Name the organism: malignant otitis externa

A

Pseudomonas

194
Q

Name the organism: Infection in burn victims

A

Pseudomonas

195
Q

Name the organism: osteomyelitis from a foot wound puncture

A

Pseudomonas

196
Q

Name the organism: osteomyelitis in a sickle cell patient

A

Salmonella

197
Q

Name the organism: Endocarditis in a native valve after having a dental cleaning

A

Strep viridans

198
Q

Back pain that is worse with standing and walking and relieved with sitting and hyperflexion of the hips

A

Spinal stenosis

199
Q

Joints in the hand affected in RA

A

MCP and PIP joints, DIPs are spared

200
Q

Joint pain and stiffness that worsen over the course of the day and are relieved by rest

A

Osteoarthritis

201
Q

A genetic disorder associated with multiple fractures and blue sclerae

A

Osteogenesis imperfecta

202
Q

Hip and back pain along with stiffness that improves with activity over the day and worsens with rest. Diagnostic test?

A

Ankylosing spondylitis, Check HLA-B27

203
Q

Arthritis, conjunctivitis, and urethritis in a young man. Associated organisms?

A

Reactive (Reiter’s) arthritis. Most commonly with Chlamydia, also consider Campylobacter, Shigella, Salmonella and Ureaplamsa

204
Q

Crystal characteristics of gout

A

Needle-shaped, negatively birefringent

205
Q

Crystal characteristics of pseudogout

A

Rhomboid-shaped, positively birefringent

206
Q

An old lady presents with pain and stiffness in the shoulders and hips; cannot lift her arms above her head, labs show anemia and increased ESR

A

Polymyalgia rheumatica

207
Q

Active 13 year old boy with anterior knee pain

A

Osgood-Schlatter

208
Q

Bone that is fractured in FOOSH

A

Distal radius (Colles fracture)

209
Q

Complication of scaphoid fracture

A

Avascular necrosis

210
Q

Sign suggesting radial nerve damage with humeral fracture

A

Wrist drop, loss of thumb abduction

211
Q

Young child presents with proximal muscle weakness, waddling gait and big ass calfs

A

Duchenne muscular dystrophy

212
Q

First born female born in breech presentation, asymmetric skin folds

A

Developmental dysplasia of the hip

If severe, consider a Pavlik harness to maintain abduction

213
Q

11 year old fat black boy presents with sudden onset of limp. Dx? Workup?

A

Slipped capital femoral epiphysis. AP and frog-leg lateral X-rays

214
Q

Most common primary malignant tumor of bone

A

Multiple myeloma

STEP 2 Review (4 decks)

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