Final mock SB (F) Flashcards
Final mock blocks (F2 B1-4) Deck is full
1
Q
what is a galactocele?
A
benign milk retention cyst
2
Q
when will a galactocele occur?
A
w/in a few mos of cessation of breast feeding
3
Q
how does galactocele present on p/e?
A
soft, mobile, nontender mass in the subareolar area
4
Q
why are fibroademonas unlikely in breastfeeding mothers?
A
they incr in size 2/2 high estrogen and breast feeding mothers are estrogen deficient
5
Q
why do pts w/ R sided heart failure require careful diuresis?
A
they are preload dependent
6
Q
what cortisol, ACTH and aldosterone levels are expected in 1* adrenal insufficiency?
A
cortisol = decr ACTH = incr aldosterone = decr
7
Q
what type of steroid is aldosterone?
A
mineralocorticoid
8
Q
what should make you suspicious for functional hypothalamic amenorrhea?
A
- pt has recent h/o significant wt loss
- low BMI
- progesterone challenge test fails to provoke bleeding (low estrogen state)
9
Q
pts w/ 1* ovary insufficiency present w/ what s/s and what FSH level?
A
- amenorrhea
- vasomotor s/s
- incr FSH
10
Q
pt develops F + n/v + vague abd pain 2-10 days s/p lap chole. bile ducts are nL on imaging. Dx = ?
A
bile leak
11
Q
how do you distinguish bile leak from retained gallstone s/p lap chole on imaging?
A
retained gallstone will have biliary dilation
12
Q
a wider CI indicates what?
A
wider range of possible effects
13
Q
how does lyme dz present other than the bulls-eye rash?
A
- systemic s/s = fatigue, malaise, arthralgias
- regional lymphadenopathy
- neurologic = meningitis, CN palsy (twisted face), radicoloneuritis
- cardiac = AV block
14
Q
what are infantile hemangiomas?
A
benign vasc tumors
15
Q
how do infantile hemangiomas present?
A
bright red, raised nodules that grow during 1st year of life and then shrink over the next 8-9 yrs (nL gone by age 10)
16
Q
what is the MC solid malignancy in young men?
A
germ cell tumors
17
Q
young man presents w/ painless, ovoid, unilateral testicular mass that does not transilluminate. dx = ?
A
germ cell tumor
18
Q
what is required to dx germ cell tumor in young men?
A
- radical orichectomy
- U/S and serum tumor markers are helpful but not diagnostic
19
Q
what is hematocele?
A
blood accumulation in the tunica vaginalis 2/2 testicular trauma
20
Q
are hematocele painful or painless?
A
painful
21
Q
what clinicla findings do all TORCH infx present w/?
A
- IUGR
- hepatosplenomegally
- jaundice
- blueberry muffin spots
22
Q
what does management of mild sunburn include?
A
cold compress + NSAIDs
23
Q
when are NSAIDs not 1st line tx for acute gout attack?
A
if the pt is on anti-coag
coadmin NSAID + anticoag = incr bleeding risk
24
Q
how does occular rosacea present?
A
- burning, foreign body sensation, blepharitits, keratitis, conjunctivitis, corneal ulcers and recurrent chalazia
- can involve cornea, conjunctiva and eyelids
25
what does viral conjunctivitis present w/ other than eye discomfort and watering?
URI s/s
26
what triad characterizes acute liver failure?
1. incr LFTs
2. hepatic encephalopathy
3. prolongued prothrombin time (elevated PT)
27
acute liver failure 2/2 wilson's dz will present w/ what lab in addition to the ALF triad?
decr ALP
28
GGT is a marker of liver damage. is it specific enough to dx acute liver failure?
no
29
when do you tx pregnant women for MDD?
when exhibiting mod-severe s/s
30
post-partum woman presents w/ 1 day high F + uterine fundal tenderness. dx = ?
post-partum endometritis
31
post-partum F fails to respond after 2 days of ABX. Ddx = ?
- pelvic abscess
| - superficial pelvic thrombophlebitis
32
how does post-partum endometritis present?
1. F
2. purulent lochia
3. uterine fundal tenderness
33
young pt presents w/ indolent HA + malaise + F + persistent dry cough + pharyngitis + rash. CXR shows interstitial inflitrates. dx = ?
atypical PNA 2/2 m pneumoniae
34
how do you tx atypical PNA 2/2 m. pneumoniae?
- azythromycin (macrolide)
| - resp fluoroquinolone
35
what types of infx are commonly treated w/ clindamycin?
dental and skin infx (anaerobic + aerobic bugs)
36
will pre-op ABX reduce post-op resp compliations in pts w/o signs of active infx pre-operatively?
no
37
what are the effects of PO and inhaled corticosteroids on COPD pts post-operatively?
PO - some decr PNA
| inhaled - incr risk PNA
38
what is thromboangiitis obliterans (buerger's dz)?
nonartherosclerotic, inflam vaso-occlusive disorder of sm and med-sized vessles
39
how does thromboangiitis obliterans (buerger's dz) present?
ischemic ulcers + gangrene in young smokers
40
young F smoker presents w/ distal ulcers and gangrene. how do you distinguish btwn PAD and brueger's dz?
PAD will have compromised blood flow and decr pulses
41
pt w/ complex asthma or CF hx presents w/ severe PNA s/s + bronchiectasis on CXR + eosinophilia on labs. Dx = ?
allergic bronchopulmonary aspergillosis
42
how do you tx allergic bronchopulmonary aspergillosis?
long term PO corticosteroids + itraconazole
43
pt presents w/ mechanical heart valve + warfarin + INR = 1.5 + SOB + pulm crackles. Dx = ?
prosthetic valve thrombosis
44
what is bronchiectasis?
dz of bronchial damage and dilation triggered by decr host defense
45
what is not typically seen in emphysema?
recurrent bacterial resp. infx
46
what is labert eaton synd assoc w/?
small cell lung Ca
47
why is a chest CT usually obtained as part of the Lambert Eaton synd w/u?
close assoc w/ small cell lung Ca
48
how does dementia w/ lewy bodies present?
- fluctuating cognition/attention
- well-formed visual hallucinations
- motor manifestations of parkinsonism (bradykinesia, rigidity, postural instability)
49
when is amnioinfusion used?
to decr cord compression 2/2 ROM if baby is exhibiting recurrent variable decels
50
why is Mg given to pts @ risk of delivery < 32wks?
- fetal neuroprotection (ppx CP)
| - mild tocolytic
51
pts w/ unknown GBS status and expected to deliver @ < 37wks gestation require what?
GBS ppx (penicillin)
52
vit C def (scurvy) causes what?
- petichial and perifollicular hemorrhages
- mucosal bleeding
- peridontal dz
- corkscrew hair
- capillary wall fragility
- poor wound healing
53
how does chancroid present?
- PAINFUL genital ulcers
| - lymphadenitis (tender nodes)
54
how does anal cancer present?
- anal bleeding, pain, and fullness
- anal mass or ulcerated lesion (friable)
- painless lymphadenopathy
55
what are C/I for copper IUD?
- wilson's dz
- Cu allergy
- heavy menstrual bleeding
- acute pelvic infx
56
is current menstruation a C/I for IUD placement?
no
57
pregnant female presents w/ F and tachycardia. uterus is not tender. does she have chorioamnionitis?
not likely
58
how does acute pyelonephritis present in pregnancy?
F + flank pain +/- ARDS +/- preterm labor
59
pt presents w/ ear displacement + recent h/o OTM. dx = ?
mastoiditis
60
do you need imaging to dx mastoiditis?
not normally
61
what imaging might you get to confirm uncertain dx of mastoiditis or w/u intracranial complications?
CT or MRI
62
how do you tx mastoiditis?
IV ABX + surgical drainage
63
anti-B2-glycoprotein is used to dx APL synd. when is Beta-2 microgloulin incr?
- lymphoproliferative disorders (mult myeloma)
| - conditions w/ incr cell turnover
64
what vasculitic disorders can exhibit livedo reticularis?
- polyarteritis nodosa
| - SLE
65
what vasoocclusive disorders can exhibit livedo reticularis?
- cholesterol embolization
- APL synd
- cryoglobulinemia
66
which hemolytic anemia can present w/ livedo reticularis?
cold-agglutinin dz
67
adv stage cervical Ca can present how?
back pain + edema + pelvic mass + hydronephrosis
68
how do you tx hypoparathyroidism?
vit D + Ca2+ supplementation
69
why must you closely monitor Ca2+ and phos levels during hypoparathyroidism tx?
high levels can lead to soft tissue calcification
70
what Ca/Phos levels are concerning for incr risk of soft tissue calcification?
(s. Ca x s. Phos) > 55
71
how might pt present if calcification of the basal ganglia has occurred?
extrapyramidal s/s (movement disorders)
72
is vit D toxicity assoc w/ incr or decr Ca2+?
hypercalcemia
73
anthracycline induced cardiotoxicity is due to what?
myocyte necrosis and destruction (fibrosis)
74
what are the anthracyclines?
| hint: cardiotoxic chemo drugs
- doxoRUBICIN
- daunoRUBICIN
- epiRUBICIN
- idraRUBICIN
75
how does doxyrubicin damage the heart?
causes myocyte necrosis and destruction (fibrosis)
76
cardiomyocyte hypertrophy and disarray are seen in what heart condition?
hypertrophic cardiomyopathy
77
yound child (< 6yo) worries about her parents dying and has recently been fixated on death. she has friends at school and no diff going to school. does she have separation anxiety?
no
78
severe COPD is often accompanied by what?
pulmonary cachexia
79
what is pulmonary cachexia characterized by?
loss of mean muscle mass 2/2 energy imbalance and systemic inflammation
80
lung Ca advanced enough to cause cachexia (incr wt loss + muscle wasting) will present w/ what finding on CXR?
lung mass
81
how does viral pleuritis present?
- viral prodrome (F, cough, rhinorrhea)
- pleuritic CP
- SOB
- pleuritic friction rub
- NO pleural effusion
82
what is pleuritis?
inflammation of the parietal pleura
83
if pleuritis is 2/2 bacterial PNA, what will typically be seen on CXR?
consolidatioin
84
what is a hordeolum?
acute inflammatory nodule 2/2 infx of eyelash folicle (stye) or meibomian gland (internal hordeolum) w/ staph aureus
85
what is a chalazeon?
granulomatous rxn to a blocked meibomian tear gland
86
how do you distinguish hordeolum from chalazeon?
hordeolum = PAINFUL and closer to lid margin
87
how does chalazeon present?
solitary, PAINLESS, rubbery, nodular lesion below the eye
88
pulm HTN in pts w/ L heart dz is caused by what?
incr LA and pulm venous pressures
89
what are common causes of pulm HTN 2/2 incr LA or pulm venous HTN?
- LV systolic/diastolic dysf(x)
- mitral or aortic valve dz
- congenital cardiomyopathies
90
what is diastolic heart failure
HFrEF
91
1* pulm arterial HTN is characterized by what?
vasc proliferation w/ intimal hyperplasia
92
how does chronic open-angle glaucoma present?
- progressive peripheral vision loss
- incr IOP
- incr cup: disc ratio
93
retinal exam in diabetic retinopathy reveals what?
vascular proliferation +/- vitreos hemorrhage
94
retinal exam reveals cherry red fovea. pt presented w/ sudden monocular vision loss. dx = ?
central retinal artery occlusion
95
retinal exam reveals arteriovenous nicking, cotton wool spots (fuzzy yellow spots), ateriolar narrowing, and hard exudates (discrete yellow spots). dx = ?
hypertensive retinopathy
96
what are common complications of maternal hyperglycemia?
- macrosomia
- hypoglycemia
- hypocalcemia
- polycythemia (2/2 chronic hypoxia in utero)
97
how does cecal volvulus present?
abd pain + cramping
98
what is cecal volvulus?
torsion of cecum and asc colon
99
pt presents w/ decr Na + severely incr glucose. what type of hyponatremia is this?
hypertonic hypoNa
100
why does severely high blood glucose lead to hyponatremia?
glucose pulls H2O out of cells and this dilutes Na
101
other than UE SBP> LE SBP, how can a pt w/ coarctation of the aorta present?
- HA, epistaxis (2/2 incr upper body BP)
- LE claudication
- brachial-femoral pulse delay
102
pt presents w/ pulsatile mass + SYSTOLIC bruit s/p left heart cath. dx = ?
pseudoaneurysm
103
pr presents w/ continuous bruit s/p left heart cath. dx = ?
AV fistula
104
what are some of the facial abnormalities seen in DiGeorge synd?
- low set ears
- small jaw
- cleft palate
105
a cortisol producing adenoma can cause what?
cushing synd
106
what labs do you expect in cushing synd (cortisol producing adenoma)?
- cortisol = incr
- ACTH = decr
- DHEAs = decr
- dexamethasone suppression test = negative (b/c tumor does what it wants)
107
how does DRESS synd present?
- diffuse, confluent, morbiliform rash + eosinophilia + systemic s/s (F, malaise, lympadenopathy)
- onset = 2-8 wks s/p starting allopurinol or anti-epileptic therapy
108
which malaria is assoc w/ dormant liver infx?
p. vivax infx
109
how do you tx p. vivax malaria?
chloroquine (kill 1* infx) + primaquine (kill liver hypnozoites)
110
how does choriocarcinoma present?
- recent pregnancy (mole, kid, spontaneous abortion)
- abn bleeding, pelvic pressure, big uterus
- vagina mets w/ red friable lesions
111
what nail findings are assoc w/ psoriasis?
- onycholysis
| - pitting
112
what is onycholysis?
distal separation of nail plate from the nail bed
113
what dz is caused by exocrine gland dysf(x)?
sjogrens synd
114
what are the dermal manifestations of sjogren's synd?
- reynaud phenom
- cutaneous vasculitis
- chronic urticaria
115
what causes septic arthritis in kids?
hematogenous spread of bacteria into the joint space
116
how does legionella PNA present?
- HIGH fever
- preceeded by GI s/s
- typical PNA s/s
117
how do you tx legionella PNA?
- levofloxacin
| - newer macrolide (azithromycin)
118
what is lochia?
nL shedding of blood and decidua after delivery
119
what does lochia look like?
- red/brown for several days
| - pink for several weeks
120
in non-lactating women, when do ovulation and menses resume?
ovulation @ 6-12 wks post-partum
| menses @ 8-14 wks post-partum
121
what predisposes to uric acid stones?
- incr s. uric acid
| - acidic urine
122
why might a pt w. chronic diarrhea present w/ uric acid stones?
diarrhea --> HCO3- loss --> acidic urine --> uric acid stones
123
how can you prevent uric acid stone precipitation?
urine alkalization w/ KHCO3- and/or KCitrate
124
how do you alkalize the urine?
- KHCO3-
| - KCitrate
125
what is most likely to influence adolescents adherence s/ safe sex practices?
use of condoms by their peers
126
presence of a cavitary lesion on CXR of a pt suspected of lung Ca is highly suggestive of what?
SCC
127
how is thyroid function affected by pregnancy?
1. estrogen --> incr TBG --> incr bound thyroid hormone
2. BHCG --> TSH receptor stimulation --> incr T3/T4 and decr TSH
**both have to happen to balance out and keep things working
128
what is another name for anogenital warts?
chondyloma acuminata
129
what is the 1st line tx of chondyloma accuminata in pregnancy?
topical trichloroacetic acid
130
what tx for choldyloma acuminata are avoided during pregnancy and why?
- imiquimod (teratogenic potential)
- podophyllin resin (teratogenic potential)
- excisional biopsy (risks assoc w/ anesthesia and sx)
