FA High Yield Flashcards
1
Q
Disease associated with protein 14-3-3 (Galen)
A
Creuztfeld Jacob
2
Q
Classic EKG finding in atrial flutter
A
“Sawtooth” P waves
3
Q
Definition of unstable angina
A
Angina that is new, worsening, or occurs at rest
4
Q
Anti-hypertensive for a diabetic patient with proteinuria
A
ACE
5
Q
Beck’s triad of cardiac tamponade
A
Hypotension, JVD, distant heart sounds
6
Q
Drugs that slow heart rate
A
B-blockers, calcium channel blockers, digoxin, amiodarone
7
Q
Hypercholesterolemia treatment that leads to flushing and pruritus
A
Niacin
8
Q
Murmur of HOCM
A
Systolic ejection murmur heard along the lateral sternal border that increases with decreased preload (Valsalva)
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)
10
Q
Murmur of aortic stenosis
A
Systolic crescendo/decrescendo murmur that radiates to the neck; increases with increased preload (squatting)
11
Q
Murmur of mitral regurgitation
A
Holosystolic murmur that radiates to the axilla; increases with increased afterload (handgrip)
12
Q
Murmur of mitral stenosis
A
Diastolic, mid-to late, low pitched murmur preceded by an opening snap
13
Q
Treatment for atrial fibrillation and atrial flutter
A
If unstable, cardiovert
If stable or chronic, rate control with CCBs or BBs
14
Q
Treatment of ventricular fibrillation
A
Immediate cardioversion
15
Q
Dressler’s syndrome
A
An autoimmune reaction with fever, pericarditis, and increased ESR occurring 2-4 weeks post-MI
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
17
Q
Diagnostic test for hypertrophic cardiomyopathy
A
Echo (showing a thickened left ventricular wall and outflow obstruction)
18
Q
Pulsus paradoxus
A
A decrease in SBP > 10 mmHg with inspiration; seen in cardiac tamponade
19
Q
Classic EKG findings in pericarditis
A
Low voltage, diffuse ST elevation, PR depression
20
Q
Definition of HTN
A
BP > 140/90 on 3 separate occasions 2 weeks apart
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
22
Q
Evaluation of a pulsatile abdominal mass and bruit
A
Abdominal ultrasound and CT
23
Q
Indications for surgical repair of AAA
A
> 5.5 cm, rapidly enlarging, symptomatic, or ruptured
24
Q
Treatment for acute coronary syndrome
A
ASA, heparin, clopidogrel, morphine, O2, sublingual nitroglycerin, IV beta blockers
25
Metabolic syndrome
Abdominal obesity, high triglycerides, low HDL, HTN, insulin resistance, prothrombotic or proinflammatory states
26
Appropriate diagnostic test for a 50 year old man with stable angina and can exercise to 85% of max predicted HR
Exercise stress treadmill with EKG
27
Appropriate diagnostic test for a 65 year old woman with LBBB, severe osteoarthritis and has unstable angina
Pharmacologic stress test (dobutamine echo)
28
Target LDL in a patient with diabetes
29
Signs of active ischemia during stress testing
Angina, ST segment changes on EKG, or decreased BP
30
EKG findings suggestive of MI
ST segment elevation (depression means ischemia), flattened T waves, and Q waves
31
Coronary territories in an MI
Anterior wall (LAD/diagonal), inferior (PDA), posterior (left circumflex/oblique, RCA/marginal), septum (LAD/diagonal)
32
A young patient with angina at rest and ST segment elevation with normal cardiac enzymes
Prinzmeta's angina
33
Common symptoms associated with silent MIs
CHF, shock, and altered mental status
34
Diagnostic test for PE
Spiral CT with contrast
35
Use of protamine
Reverses effects of heparin
36
Use of prothrombin time
Coagulation parameter affected by warfarin
37
A young patient with a family history of sudden death collapses and dies while exercising
Hypertrophic cardiomyopathy
38
Endocarditis prophylaxis regimens
Oral surgery - amoxicillin for certain situations; GI or GU procedures - not recommended
39
Virchow's triad
Stasis, hypercoagulability, endothelial damage
40
The most common cause of HTN in a young women
OCPs
41
The most common cause of HTN in young men
Excessive EtOH
42
Figure 3 sign
Aortic coarctation
43
Water-bottle shaped heart
Pericardial effusion
| Look for pulsus paradoxus
44
"Stuck on appearance"
Seborrheic keratotis
45
Red plaques with silvery-white scales and sharp margins
Psoriasis
46
The most common type of skin cancer, the lesion is a pearly colored papule with a translucent surface and telangiectasias
Basal cell carcinoma
47
Honey crusted lesions
Impetigo
48
A febrile patient with a history of diabetes presents with a red, swollen, painful lower extremity
Cellulitis
49
(+) Nikolsky's sign
Pemphigus vulgaris
50
(-) Nikolsky's sign
Bullous pemphigoid
51
A 55 year old obese patient presents with dirty, velvety patches on the back of the neck
Acanthosis nigricans; check fasting glucose to rule out diabetes
52
Dermatomal distribution
Varicella zoster
53
Flat topped papules
Lichen planus
54
Iris-like target lesions
Erythema multiforme
55
A lesion characteristically occurring in a linear pattern in areas where skin comes into contact with clothing or jewelry
Contact dermatitis
56
Presents with a herald patch, Christmas-tree pattern
Pityriasis rosea
57
Pinkish, scaling, flat lesions on the chest and back; KOH prep has a "spaghetti and meatballs" appearance
Tina versicolor (caused by Malassezia furfur)
58
Four characteristics of a nevus suggestive of melanoma
Asymmetry, border irregularity, color variation, diameter > 6 mm
59
A premalignant lesion from sun exposure that can lead to squamous cell carcinoma
Actinic keratosis
60
"Dewdrops on a rose petal"
Lesions of primary varicella
61
"Cradle cap"
Seborrheic dermatitis; treat conservatively with bathing and moisturizing agents
62
Associated with Proprionibacterium acnes and changes in androgen levels
Acne vulgaris
63
A painful, recurrent vesicular eruption of mucocutaneous surfaces
Herpes simplex
64
Inflammation and epithelial thinning of the anogenital area, predominantly in postmenopausal women
Lichen sclerosis
65
Exophytic nodules on the skin with varying degrees of scaling or ulceration; the second most common type of skin cancer
Squamous cell carcinoma
66
The most common cause of hypothryoidism
Hashimoto's
67
Lab findings in Hashimoto's
High TSH, low T4, anti-TPO antibodies
68
Exophthalmos, pretibial myxedema, and low TSH
Grave's disease
69
The most common cause of Cushing's syndrome
Iatrogenic corticosteroids, the second most common cause is Cushing's disease
70
A patient presents with signs of hypocalcemia, high phosphorus, and low PTH
Hypoparathyroidism
71
"Stones, bones, groans, psychiatric overtones"
Signs of hypercalcemia
72
A patient complains of headache, weakness, and polyuria; exam reveals HTN and tetany; labs show hypernatremia, hypokalemia, and metabolic alkalosis
Primary hyperaldosteronism (Conn's syndrome or bilateral adrenal hyperplasia)
73
A patient presents with tachycardia, wild swings in BP, headache, diaphoresis, altered mental status, and a sense of panic
Pheochromocytoma
74
Which should be used first in treating pheochromotycoma, alpha or beta antagonists?
Alpha antagonists (phentolamine, phenoxybenzamine)
75
A patient with history of lithium use presents with copious amounts of dilute urine
Nephrogenic diabetes insipidus
76
Treatment of central DI
DDAVP and free water restriction
77
A postoperative patient with significant pain presents with hyponatremia and normal volume status
SIADH due to stress
78
An anti-diabetic agent associated with lactic acidosis
Metform
79
A patient presents with weakness, nausea, vomiting, weight loss, and new skin pigmentation; labs show hyponatremia and hyperkalemia. Treatment?
Primary adrenal insufficiency (Addison's disease)
Treat with glucocorticoids, mineralocorticoids, and IVF
80
Goal HbA1c for a patient with DM
81
Treatment of DKA
Fluids, insulin, and electrolyte repletion (K+)
82
Why are beta blockers contraindicated in diabetics
They can mask the symptoms of hypoglycemia
83
A patient presents with sudden onset of severe, diffuse abdominal pain. Exam reveals peritoneal signs, and AXR reveals free air under the diaphragm. Treatment?
Emergent laparotomy to repair a perforated viscus
84
Most likely cause of acute lower GI bleed in patients > 40 yo
Diverticulosis
85
Diagnostic modality used when ultrasound is equivocal for cholecystitis
HIDA scan
86
Risk factors for cholelithiasis
Fat, female, fertile, 40, flatulent
87
Inspiratory arrest during palpation of RUQ
Murphy's sign, seen in acute cholecystitis
88
The most common cause of SBO in patients with no history of abdominal surgery
Hernia
89
Most common cause of SBO in patients with history of abdominal surgery
Adhesions
90
Most common organism to cause diarrhea
Campylobacter
91
Most common cause of diarrhea after recent antibiotic use
C. diff
92
Most common cause of diarrhea after camping
Giardia
93
Most common cause of diarrhea in travelers
ETEC
94
Most common cause of diarrhea at church picnics/mayonnaise
Staph aureus
95
Most common cause of diarrhea after eating undercooked hamburgers
E. coli O157:H7
96
Most common cause of diarrhea after fried rice
Bacillus cereus
97
Most common cause of diarrhea after eating poulty/raw eggs
Salmonella
98
Most common cause of diarrhea after eating raw seafood
Vibrio, hepatitis A
99
Most common causes of diarrhea in AIDS patients
Isospora, Cryptosporidium, MAC
100
Most common cause of diarrhea that mimics appendicits
Yersinia
101
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.
Crohns
102
Inflammatory disease of the colon with an increased risk of colon cancer
Ulcerative colitis (greater risk than Crohns)
103
Extraintestinal manifestations of IBD
Uveitis, ankylosing spondylitis, pyoderma gangrenosum, erythema nodosum, primary sclerosing cholangitis
104
Medical treatment of IBD
5-ASA agents and steroids during acute exacerbations
105
Difference between Mallory-Weiss tears and Boerhaave tears
Mallory-Weiss - superficial tear in esophageal mucosa
Boerhaave - full thickness esophageal rupture
106
Charcot's triad
RUQ pain, jaundice, and fever/chills - signs of ascending cholangitis
107
Reynold's pentad
Charcot's triad plus shock and mental status changes - signs of suppurative ascending cholangitis
108
Medical treatment for hepatic encephalopathy
Decrease protein intake, lactulose, rifaximin
109
The first step in management of a patient with an acute GI bleed
Manage ABCs
110
A 4 year old child presents with oliguria, petechiae, and jaundice following an illness with bloody diarrhea. Most likely diagnosis and cause?
HUS due to E. coli O157:H7
111
Classic causes of drug-induced hepatitis
TB medications (INH, rifampin, pyrazinamide), acetaminophen, tetracycline
112
A 40 year old obese woman with elevated alkaline phosphatase, elevated bilirubin, dark urine, and clay colored stools
Biliary tract obstruction
113
Hernia with highest risk of incarceration - indirect, direct, or femoral?
Femoral
114
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?
Confirm the diagnosis of acute pancreatitis with elevated amylase and lipase. Make the patient NPO, and give IVF, O2, analgesia
115
Four causes of microcytic anemia
TICS - thalassemia, iron deficiency, anemia of chronic disease, sideroblastic anemia
116
AN elderly man with hypochromic, microcytic anemia is asymptomatic. Diagnostic tests?
FOBT and sigmoidoscopy, suspect colorectal cancer
117
Precipitants of hemolytic crisis in patients with G6PD deficiency
Sulfonamides, antimalarial drugs, fava beans
118
The most common inherited cause of hypercoagulability
Factor V Leiden mutation
119
The most common inherited bleeding disorder
von Willebrand's disease
120
The most common inherited hemolytic anemia
Hereditary spherocytosis
121
Diagnostic test for inherited hemolytic anemia
Osmotic fragility test
122
Pure RBC aplasia
Diamond-Blackfan anemia
123
Anemia associated with absent radii and thumbs, diffuse hyperpigmentation, cafe au lait spots, microcephaly, and pancytopenia
Fanconi's anemia
124
Medications and viruses that lead to aplastic anemia
Chloramphenicol, sulfonamides, radiation, HIV, chemotherapeutic agents, hepatitis, parvovirus B19, EBV
125
How to distinguish polycythemia vera from secondary polycythemia
Both have increased hematocrit and increased RBC mass, but polycythemia vera should have normal O2 saturation and low erythropoietin levels
126
TTP pentad?
FAT RN - fever, anemia, thrombocytopenia, renal dysfunction, neurologic abnormalities
127
HUS triad?
Anemia, thrombocytopenia, and acute renal failure
128
Treatment for TTP
Emergent large-volume plasmapheresis, corticosteroids, antiplatelet drugs.
Platelet transfusion is contraindicated
129
Treatment for ITP in children
Usually resolves spontaneously; may require IVIG and/or corticosteroids
130
Lab findings in DIC
Fibrin split products and D-dimer are elevated
Platelets, fibrinogen, and hematocrit are decreased
131
An 8 year old boy presents with hemarthrosis and increased PTT with normal PT and bleeding time. Diagnosis and treatment?
Hemophilia A or B; consider desmopressin (for hemophilia A) or factor VIII or IX supplements
132
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?
von Willebrand's disease, treat with desmopressin, FFP, or crycoprecipitate
133
A 60 year old black man presents with bone pain. What might a workup for multiple myeloma reveal?
Monoclonal gammopathy, Bence Jones proteinuria, and "punched out" lesions on x-ray of the skull and long bones
134
Reed-Sternberg cells
Hodgkin's lymphoma
135
A 10 year boy presents with fever, weight loss, and night sweats. Exam shows anterior mediastinal mass
Non-Hodgkins's lymphoma
136
Lab studies in anemia of chronic disease
Microcytic anemia with low serum iron, decreased TIBC, and normal or increased ferritin
137
Lab studies in iron deficient anemia
Microcytic anemia with decreased serum iron, decreased ferritin, and increased TIBC
138
An 80 year old man presents with fatigue, lymphadenopathy, splenomegaly, and isolated lymphocytosis. Diagnosis?
CLL
139
The lymphoma equivalent of CLL
Small lymphocytic lymphoma
140
A late, life-threatening complication of CML
Blast crisis (fever, bone pain, splenomegaly, pancytopenia)
141
Auer rods on blood smear
AML
142
AML subtype associated with DIC. Treatment?
M3. Retinoic acid
143
Electrolyte changes in tumor lysis syndrome
Hypocalcemia, hyperkalemia, hyperphosphatemia, hyperuricemia
144
A 50 year old man presents with early satiety, splenomegaly, and bleeding. Cytogenetics show t(9,22). Dx?
CML
145
Heinz bodies
Intracellular inclusions seen in thalassemia, G6PD deficiency, and postsplenomegaly
146
Virus associated with aplastic anemia in patients with sickle cell
Parvovirus B19
147
A 25 year old black man with sickle cell anemia has sudden onset of bone pain. Management of pain crisis?
O2, analgesia, hydration, and if severe, transfusion
148
A significant cause of morbidity in thalassemia patients. Treatment?
Iron overload, use deferoxamine
149
The 3 most common causes of fever of unknown origin
Infection, cancer, and autoimmune disease
150
Four signs and symptoms of strep pharnygitis
Fever, pharyngeal erythema, tonsillar exudate, lack of cough
151
A nonsuppurative complication of strep infection that is not altered by treatment of primary infection
Postinfectious glomerulonephritis
152
The most common predisposing factor for acute sinusitis
Viral URI
153
Asplenic patients are prone to these organisms
Encapsulated organisms - pneumococcus, meningococcus, H. influenza, Klebsiella
154
The number of bacteria needed on a clean-catch specimen to diagnose a UTI
10^5 bacteria/mL
155
Which healthy population is susceptible to UTIs?
Pregnant women, treat this group aggressively because of potential complications
156
A patient from Cali or Arizona presents with fever, malaise, cough and night sweats. Diagnosis and treatment
Coccidiodomycosis, treat with amphothericin B
157
Nonpainful chancre
Primary syphilis
158
A "blueberry muffin" rash is characteristic of what congenital infection
Rubella
159
Meningitis in neonates. Causes and Tx
GBS, E. coli, Listeria
Treat with ampicillin and gentamycin
160
Meningitis in infants. Causes and Tx
Pneumococcus, meningococcus, H. flu
Treat with cefotaxime and vanco
161
What should always be done prior to LP?
Check for increased ICP, look for papilledema
162
CSF findings in bacterial meningitis
Low glucose, PMN predominance
163
CSF findings in aseptic meningitis
Normal glucose, lymphocyte predominance
164
CSF findings in SAH
Numerous RBCs in serial CSF samples
165
CSF findings in multiple sclerosis
Increased gamma globulins
166
CSF findings in Guillain-Barre
Albuminocytologic dissociation, which is an elevation in CSF protein (>0.55 g/L) without an elevation in white blood cells
167
Initially presents with a pruritic papule with regional lymphadenopathy, evolves into a black eschar after 7-10 days. Tx
Cutaneous anthrax, treat with penicillin G or cipro
168
Findings in tertiary syphillis
Tabes dorsalis, general paresis, gummas, Argyll Robertson pupil, aortitis, aortic root aneurysms
169
Characteristics of secondary Lyme disease
Arthralgias, migratory polyarthropathies, Bell's palsy, mycoarditis
170
Cold agglutinins
Mycoplasma
171
A 24 year old man presents with soft white plaques on this tongue and back of throat. Dx? Workup? Tx?
Candidal thrush, workup should include HIV testing, treat with oral nystatin
172
At what CD4 count should PCP pneumonia prophylaxis be given in an HIV + patient. MAC prophylaxis?
173
Risk factors for pyelonephritis
Pregnancy, vesicoureteral reflux, anatomic abnormalities, indwelling catheters, kidney stones
174
Neutropenic nadir postchemotherapy
7-10 days
175
Erythema migrans
Lesion of primary Lyme disease
176
Classic physical findings of endocarditis
Fever, heart murmur, Osler's nodes, splinter hemorrhages, Janeway lesions, Roth spots
177
Aplastic crisis in sickle cell disease
Parvovirus B19
178
Ring enhancing brain lesion on CT with a patient presenting with seizures
Taenia solium (cysticercosis)
179
Name the organism: branching rods in oral infection
Actinomyces
180
Name the organism: weekly gram positive, partially acid-fast in lung infection
Nocardia
181
Name the organism: painful chanchroid
H. ducreyi
182
Name the organism: dog or cat bite
Pasteurella
183
Name the organism: gardener
Sporothrix
184
Name the organism: raw pork and skeletal muscle cysts
Trichinella spiralis
185
Name the organism: sheep herders with liver cysts
Echinococcus
186
Name the organism: perianal itching
Enterobius vermicularis
187
Name the organism: pregnant women with pets
Toxoplasmosis
188
Name the organism: meningitis in adults
Neisseria
189
Name the organism: meningitis in elderly
Strep pneumo
190
Name the organism: meningoencephalitis in AIDS patients
Cryptococcus
191
Name the organism: alcoholic with pneumonia
Klebsiella
192
Name the organism: currant jelly sputum
Klebsiella
193
Name the organism: malignant otitis externa
Pseudomonas
194
Name the organism: Infection in burn victims
Pseudomonas
195
Name the organism: osteomyelitis from a foot wound puncture
Pseudomonas
196
Name the organism: osteomyelitis in a sickle cell patient
Salmonella
197
Name the organism: Endocarditis in a native valve after having a dental cleaning
Strep viridans
198
Back pain that is worse with standing and walking and relieved with sitting and hyperflexion of the hips
Spinal stenosis
199
Joints in the hand affected in RA
MCP and PIP joints, DIPs are spared
200
Joint pain and stiffness that worsen over the course of the day and are relieved by rest
Osteoarthritis
201
A genetic disorder associated with multiple fractures and blue sclerae
Osteogenesis imperfecta
202
Hip and back pain along with stiffness that improves with activity over the day and worsens with rest. Diagnostic test?
Ankylosing spondylitis, Check HLA-B27
203
Arthritis, conjunctivitis, and urethritis in a young man. Associated organisms?
Reactive (Reiter's) arthritis. Most commonly with Chlamydia, also consider Campylobacter, Shigella, Salmonella and Ureaplamsa
204
Crystal characteristics of gout
Needle-shaped, negatively birefringent
205
Crystal characteristics of pseudogout
Rhomboid-shaped, positively birefringent
206
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
Polymyalgia rheumatica
207
Active 13 year old boy with anterior knee pain
Osgood-Schlatter
208
Bone that is fractured in FOOSH
Distal radius (Colles fracture)
209
Complication of scaphoid fracture
Avascular necrosis
210
Sign suggesting radial nerve damage with humeral fracture
Wrist drop, loss of thumb abduction
211
Young child presents with proximal muscle weakness, waddling gait and big ass calfs
Duchenne muscular dystrophy
212
First born female born in breech presentation, asymmetric skin folds
Developmental dysplasia of the hip
If severe, consider a Pavlik harness to maintain abduction
213
11 year old fat black boy presents with sudden onset of limp. Dx? Workup?
Slipped capital femoral epiphysis. AP and frog-leg lateral X-rays
214
Most common primary malignant tumor of bone
Multiple myeloma
