Final Step Notecards - 1st 500 Flashcards
1
Q
A 16 year old has just moved schools. He is quiet, moody and not like himself at all. Within six months he seems to have completely changed back to his previous personality. What is the most likely diagnosis?
A
Adjustment disorder
2
Q
What is the prophylactic antibiotic most commonly given before a dental procedure if one is necessary?
A
Amoxicillin 2 grams po 1 hour before procedure
3
Q
Wilson’s disease is associated with a build up of what mineral?
A
There is a deficiency of the copper binding protein and therefore a buildup of copper.
4
Q
Name one oral medication that can be used for MRSA.
A
Linezolid (Zyvox) and Bactrim Digoxin
5
Q
Which cardiac medication is used to help with cardiac contractility after you have optimized most of the other cardiac medications?
A
Digoxin
6
Q
What medication used in hepatitis B infection helps prevent the need for liver transplant?
A
Lamivudine
7
Q
How is celiac disease most commonly diagnosed?
A
Endoscopic biopsy Mononucleosis
8
Q
A 14 year old field hockey player presents with prominent adenopathy, white purple exudates in the throat and a palpable spleen. What is the most likely diagnosis?
A
Wernicke’s aphasia
9
Q
A patient presents with what appears to be an inability to understand speech. Which aphasia should be at the top of your differential?
A
It is blood in the joint indicating a fracture even if the fracture line cannot be seen.
10
Q
A fat pad sign on a lateral x-ray of the elbow has what significance?
A
It is blood in the joint indicating a fracture even if the fracture line cannot be seen.
11
Q
A corkscrew appearance on barium study should make you think of what diagnosis?
A
Esophageal spasms
12
Q
What is the treatment for Turner’s syndrome?
A
Cyclical estrogen and progesterone
13
Q
What is the gold standard for diagnosing myocarditis?
A
Myocardial biopsy
14
Q
By what age should a child be able to hold up her head?
A
3 months
15
Q
On physical exam, you notice ulnar deviations and swan neck deformities. What is the most likely diagnosis?
A
Rheumatoid arthritis
16
Q
What is the most accurate way to diagnose urethritis?
A
Urine PCR
17
Q
You hear a loud harsh holosystolic murmur in a child. It is heard best at the LLSB. What is the most likely diagnosis?
A
Ventricular septal defect
18
Q
The accessory pathway known as the James bundle should make you think of what syndrome?
A
Lown-Ganong-Levine syndrome
19
Q
A Blalock procedure is used to correct what congenital heart condition?
A
Tetralogy of Fallot
20
Q
What medication can be used to control bleeding due to uterine atony?
A
Oxytocin (Pitocin)
21
Q
What is the most common cause of a folate deficiency?
A
Alcoholism
22
Q
List three risk factors for placental abruption.
A
HTN, smoking, AMA, cocaine use, PROM
23
Q
What ejection fraction is typical for a patient with CHF?
A
35-40%
24
Q
What is the major concern with using lithium?
A
It has a very narrow therapeutic window. Blood tests are needed every four weeks.
25
List the four most common places lung cancer will metastasize to.
Bone, brain, adrenals and liver
26
What is the main risk factor for esophagitis?
Immunocompromised patient
27
An EKG shows a regular rate of 50 beats per minute. The QRS is narrow and there is no visible P wave. What is the most likely diagnosis?
Junctional rythm
28
List two diagnoses which require antibiotic prophylaxis for "dirty procedures?"
Prosthetic valve, valve repair with any prosthetic material, prior endocarditis diagnosis, congential cyanotic heart defect
29
Does a patient with mitral valve prolapse require prophylactic antibiotics for dental work?
No, a recent change moves mitral valve prolapse from high risk to moderate risk.
30
A pregnant woman and cat litter should make you think of what diagnosis?
Toxoplasmosis
31
What two valvular issues do patients with Marfan's syndrome often have?
Aortic regurgitation and mitral valve prolapse (you can tell them apart by where they are heard).
32
What is the most common cause of sudden cardiac death?
Ventricular fibrillation
33
A positive straight leg test indicates what diagnosis?
Herniated disc
34
What two psychiatric issues are more common in males than females?
Autism and ADD, the rest are all either equal or more common in females.
35
How long must symptoms last before diagnosing ADD?
6 months
36
What are the two most common organisms responsible for cellulitis?
Strep and Staph
37
Does total lung capacity go up or down in COPD? What organism causes Lyme disease?
It goes up.
38
What organism is most commonly responsible for community acquired pneumonia?
Borrelia burgdorferi
39
An EEG showing focal rhythmic discharges at the onset of the seizure should make you think of what diagnosis?
Strep pneumoniae
40
What is the normal range for MCV?
Simple partial seizure
41
A patient's lab work shows positive Smith antibody and positive double-stranded DNA antibodies. What is the most likely diagnosis?
80-100 Lupus
42
You hear a continuous machine-like murmur. What is the most likely diagnosis?
Patent ductus arteriosus (PDA)
43
How do you administer the Weber hearing test?
Tuning fork placed in the middle of the forehead
44
By what age should a child be able to kick a ball?
24 months
45
A 6 year old boy seems to have all of the symptoms of ADD while at school, but at home he has no problems. Does he have ADD?
No, symptoms must occur in both settings for diagnosis.
46
Duchenne's and Becker's muscular dystrophy have what genetic characteristic?
X-linked recessive
47
Why is folic acid given as a prenatal vitamin?
Low folic acid can lead to neural tube defects.
48
Color blindness is transmitted through what genetic pattern?
Dominant X-linked
49
A patient presents with facial paresis, arm drift and abnormal speech. What are the first three tests to order?
Thinking of a stroke you order a non-contrast brain CT or MRI, serum glucose and oxygen saturation.
50
List 4 risk factors for endometrial cancer.
Chronic unopposed estrogen, nulliparity, early menarche, late menopause, tamoxifen, DM, obesity, HTN, breast CA, ovarian CA
51
Tall peaked P waves should make you think of what diagnosis?
Right atrial enlargement
52
What is the best test to check for H. pylori?
Urea breath test
53
What it is the recommended treatment for hepatitis C infection?
Pegylated interferon alpha-2
54
Is a nulliparous or mulitparous woman more likely to get preeclampsia?
Nulliparity is a risk factor for preeclampsia.
55
Name the condition in which the head of the penis curves downward or upward, at the junction of the head and shaft of the penis. (Hint: It is often associated with hypospadias.)
Chordee
56
Acute sinusitis is most commonly caused by which two pathogens?
Strep pneumoniae and haemophilus influenzae
57
A physical exam finding of egophony should make you think of what diagonsis?
Lobar pneumonia
58
A patient presents with erectile dysfunction and complains of some numbness in his feet. On second thought he has noticed significant polyuria and polydipsia. What diagnosis should you be thinking of?
Diabetic neuropathy
59
What percentage of diabetes in the US is type 2?
80-90%
60
What is the treatment for pneumocystis jiroveci pneumonia?
Bactrim
61
What will the bowel sounds be early on in a small bowel obstruction? What will they be later on?
Early they are hyperactive. Late they are absent.
62
A feathery border in an eye exam should make you think of what diagnosis?
Fungal infection
63
List six medications that can be used for migraine prophylaxis?
Beta blockers, tricyclics, calcium channel blockers, NSAIDs and valproic acid
64
What is the #1 cause of retinal artery occlusion?
Carotid atherosclerotic disease.
65
What is the formula for calculating estimated date of confinement or due date?
First day of last menstrual period + 7 days - 3 months
66
The pap smear results on a 23 year old patient come back as atypical squamous cell uncertain significance (ASCUS). What is your next step?
Repeat pap smear in 12 months although HPV test is acceptable.
67
What causes Mallory-Weiss tears?
Forced vomiting or retching (often involving alcohol)
68
Ghon or Ranke complexes on CXR should make you think of what diagnosis?
TB
69
During pregnancy which is the prefered treatment of hyperthyroidism PTU or methimazole?
PTU
70
What are three causes for a postpartum hemorrhage?
Uterine atony, genital laceration, retained placenta
71
What is the name of the test for dry eyes?
Schirmer's test
72
Will serum potassium be decreased or elevated in renal failure?
Elevated
73
Which lab should be tightly monitored in a patient taking an aldosterone antagonist?
Potassium, they may have hyperkalemia.
74
What is the definitive treatment for atrial flutter?
Radiofrequency catheter ablation
75
What medication is often used to treat postpartum depression in a woman who is breast feeding?
Sertraline (Zoloft)
76
A doughnut shaped burn should make you think of what issue?
Abuse either child or elder
77
A strawberry cervix with copious yellow/green discharge should make you think of what diagnosis?
Trichomonas vaginitis
78
During a physical exam of a child, you feel a tubular or sausage-shaped mass. What is the most likely diagnosis?
Intussusception
79
What is the first line treatment for carpal tunnel?
Night splint
80
What is the most common cause of a hip dislocation? Is it usually anterior or posterior?
MVA, posterior
81
Maltese crosses in the urine should make you think of what diagnosis?
Nephrotic syndrome Cystoscopy and biopsy Spermatocele
82
You place a patient on rifampin. What side effect should you warn her about?
Orange-red discoloration of body fluids
83
A patient believes that her 15 year old daughter is sleeping with the mailman. She has no evidence of this. She has confronted her daughter who denies it. It is not interfering with her daily activities, but she does spend time thinking about it. What is the most likely diagnosis?
Delusional disorder
84
What two leads do you use to determine the axis of the heart?
Lead I and AVF
85
What is the other term for Mobitz type I?
Wenckebach
86
List three possible treatments for stress incontinence in women.
Kegels, estrogen therapy, surgical placement of a urethral sling
87
A patient presents with unproductive retching, acute localized epigastric distention and inability to pass a nasogastric tube. What is the most likely diagnosis?
Gastric volvulus
88
How do you treat amebiasis?
Metronidazole (Flagyl)
89
Alcohol may be a major factor in which encephalopathy?
Wernicke's
90
List the three diagnosis you should be thinking of if a question includes Heinz bodies.
G6PD deficiency anemia, chronic liver disease, alpha thalassemia
91
A patient presents complaining of the worst headache of his life. What might you expect their blood pressure to be?
Typically this is the description for a subarachnoid hemorrhage. You would expect the blood pressure to be elevated.
92
What is the best patient position to hear aortic regurge and aortic stenosis?
Sitting up and leaning forward
93
List the six P's of an ischemic limb.
Pain, paresthesias, pallor, pulselessness, poikilothermia, paralysis
94
Fasting gastrin will be above what level with gastrinoma?
>150 pg/ml
95
How do you treat a Trichomonas infection?
Metronidazole
96
A Gram-positive organism in clusters should make you think of what diagnosis?
Staph
97
What is the most common cause of postpartum hemorrhage?
Uterine atony
98
An HIV patient with ground glass appearance on CXR should make you think of what diagnosis?
Pneumocystis jiroveci pneumonia (PJP used to be know as PCP)
99
Bat wing vessels or Kerley B lines on a CXR should make you think of what diagnosis?
CHF
100
Pale and boggy nasal mucosa should make you think of what diagnosis?
Allergic rhinitis Shortness of breath
101
What is the most common patient complaint with emphysema?
Conversion disorder
102
A patient complains of acute paralysis in his left arm. This does not seem to bother him, but his wife made him come in. There was no traumatic event. A complete neurologic workup is negative. What is the most likely diagnosis?
Ceftriaxone and doxycycline
103
How do you treat urethritis?
Catatonic depression
104
Posturing should make you think of what diagnosis?
When you lift the patient's head the patient bends his hips.
105
Describe Brudzinski's sign.
Systolic pressure of 140-159 and diastolic of 90-99
106
Define stage 1 hypertension according to JNC 7.
Trick question - NEVER do a physical exam on someone with presumed placenta previa.
107
What is the hallmark physical exam finding for placenta previa?
10-20 years old
108
How long should you wait for a swallowed marble to pass through the body before considering surgery?
24 hours
109
A fixed or consistent split S2 should make you think of what diagnosis?
Atrial septal defect
110
When does quickening occur?
Nulliparous 18-20 weeks, multiparous 14-16 weeks
111
Oval patches of hair loss should make you think of what diagnosis?
Alopecia areata
112
Under routine circumstances when should patients begin getting screening colonoscopies?
Age 50
113
The scotch tape test is used to diagnose what disease?
Pinworm
114
A child with a fever lasting longer than five days should make you think of what diagnosis?
Kawasaki syndrome
115
Which heart valve is most associated with rheumatic fever?
Mitral
116
What is the most common precipitating event for posttraumatic stress disorder in women?
Rape
117
Hampton's hump on CXR should make you think of what diagnosis?
Pulmonary embolism
118
Forchheimer spots are associated with what disease?
Rubella
119
A 15 year old boy presents complaining of night pain in the pelvis. Since you have no idea what to do, you order an x-ray. The report comes back with a description of a mass with an "onion skin appearance." What is the most likely diagnosis?
Ewing sarcoma
120
What ligament is most commonly injured in an ankle sprain?
Anterior talofibular ligament (ATFL)
121
What is the treatment for epiglottitis?
2nd or 3rd generation cephalosporin (ceftriaxone), macrolides may also be used (clindamycin)
122
In Cushing’s disease is ACTH elevated or decreased?
Elevated
123
What is the #1 cause of small bowel obstruction?
Postoperative adhesions
124
What Rh combination for mom and dad might cause the mother to create antiboides against the baby’s red blood cells?
Mom Rh-negative and dad Rh- positive
125
Which are painful and found on the fingers and toes, Osler nodes or Janeway lesions?
Osler nodes
126
What is the most common prophylactic antibiotic used preoperatively?
Cefazolin = Ancef, Keflex = Cefalexin, The answer is Cefazolin (Ancef)
127
What will an x-ray show in acute osteomyelitis?
Nothing - it will show bone destruction in chronic osteomyelitis.
128
You suspect mitral regurgitation. What is the most accurate way to prove your diagnosis?
Transesophageal echo
129
As it relates to diabetics, what is the dawn phenomenon?
Reduced insulin response between 5 and 8 am
130
If you hear crackles in the lung fields list three pulmonary issues that should be in your differential.
Pneumonia, fibrosis, CHF, Bronchitis
131
A pathology report comes back showing negatively birefringent crystals. What is the most likely diagnosis?
Gout
132
Cottage cheese discharge should make you think of what diagnosis?
Vaginal candidiasis
133
What is the most common organism causing pneumonia in COPD patients?
Haemophilus influenzae
134
What type of hearing loss would be caused by cerumen impaction?
Conductive
135
A christmas tree pattern should make you think of what diagnosis?
Pityriasis rosea
136
What is the age range for Duchenne's muscular dystrophy?
3-5 years old
137
A question about Prinzmetal's angina will often contain what key thing in the patient's history?
Cocaine use
138
Will unconjugated bilirubin be high or low in a patient with sickle cell disease?
High
139
The heart rate is irregular, so you can't count boxes between QRS waves to determine heart rate. What is another method you can use to determine rate on an EKG?
Count QRS waves in a six second strip and multiply by 10 to get beats per minute.
140
If you have a patient with positive blood cultures for candida what is the first line drug?
Amphotericin B
141
Would a B12 deficiency anemia most likely be microcytic, normocytic or macrocytic?
Macrocytic
142
What is the most serious complication of Kawasaki syndrome?
Aortic Aneurysm
143
Are one half of all adult hernias direct or indirect inguinal hernias?
Indirect inguinal hernias makeup 50% of all adult hernias.
144
Which way does a Colles fracture angulate: dorsal or volar? What about a Smith fracture?
Colles = Dorsal, Smith = Volar
145
A patient complains of seeing halos and rainbows around lights. She also complains of moderate photophobia? What is the most likely diagnosis?
Glaucoma
146
What is the appropriate treatment for a patent ductus arteriosus.
Indomethacin
147
What is the term for difficulty swallowing?
Dysphagia
148
An RSR prime in leads V1 or V2 should make you think of what diagnosis?
Right bundle branch block
149
What is the age range for osteosarcoma? Where are they most typically found in the body?
"Osteosarcoma usually occur in 15-25 year old males and are most commonly found around the knee."
150
What medication is used to increase surfactant levels and help with lung maturity if you are worried about preterm labor?
Betamethasone
151
What is the most specific diagnostic test for peptic ulcer disease?
Endoscopy
152
A patient complains of a rash on his palms and soles. He has a fever and chills. In conversation he mentions a strange painless chancre he had a few weeks ago. What is the most likely diagnosis?
Secondary syphilis. This is the most contagious stage.
153
A patient presents with watery bilateral discharge from the eyes and nontender preauricular adenopathy. What is the most likely diagnosis? What is the most common pathogen?
Viral conjunctivitis, adenovirus
154
What is the first line treatment for pertussis?
Erythromycin
155
A patient presents with a painful ipsilateral third nerve palsy. What is the most likely diagnosis?
Posterior communicating artery aneurysm (PComA)
156
Your attending asks you to come and see an excellent example of Hutchinson's sign. What diagnosis does the patient have?
Herpes zoster ophthalmicus
157
After 7 days of sinusitis what antibiotic would you start?
Amoxicillin or Bactrim
158
Is anorexia egosyntonic or ego-dystonic? What about bulimia?
Anorexia is egosyntonic. Bulimia is ego-dystonic.
159
What is the most common cause of CHF?
Coronary artery disease
160
What antibiotic class is the class of choice for chlamydia?
Macrolides
161
A surge in what hormone leads to ovulation?
Luteinizing hormone
162
As part of the antepartum testing a baby has a positive stress test. What does that mean?
They have had two heart rate accelerations in a 20 minute period of 15 beats above baseline for at least 15 seconds. This is a good thing.
163
What organism is the most common cause of pneumonia in a patient with cystic fibrosis?
Pseudomonas
164
Propranolol belongs to what class of medication?
Beta blockers
165
Grape-like vesicles or a sack of grapes on ultrasound should make you think of what diagnosis?
Hydatidiform mole
166
List three positive symptoms of schizophrenia.
Hallucinations, delusions, movement disorders
167
What is pertussis more commonly referred to as?
Whooping cough
168
Name three medication "classes" which are indicated for reduction in LDL?
Statins, ezetimibe, niacin and nicotinic acid
169
How do you treat a stasis dermatitis?
Compression stockings
170
A 95 year old female presents to ER after a fall in her home. Her left leg is shortened and externally rotated. What is the most likely diagnosis?
Hip fracture
171
What is the yellow, brown fleshy mass on the conjunctiva which usually does not interfere with vision?
Pinguecula
172
Is an upper respiratory infection which includes hoarseness most likely bacterial or viral?
Viral
173
Tenderness over the anatomical snuffbox is indicative of what fracture?
Scaphoid
174
If you have heartburn that does not improve with medication what is the most likely diagnosis?
Gastrinoma
175
Steatorrhea should make you think of what diagnosis?
Pancreatitis
176
Describe Barlow's test.
Adduct and internal rotation of the hips
177
What two viral hepatitis infections are self limiting?
Hepatitis A and hepatitis E
178
What is the most common organism that causes a bladder infection?
E. coli
179
Where are Heberden's nodes found?
Distal interphalangeal joint (DIP)
180
What is the leading cause of iron deficiency anemia?
E. coli
181
A 65 year old male presents with frequency. On digital rectal exam you feel an elastic moderately enlarged prostate. What is the most likely diagnosis?
BPH
182
What is the most common fracture in a patient with osteoporosis?
A compression fracture of a vertebral body followed by hip fractures.
183
At approximately how many weeks pregnant is the uterus at the level of the umbilicus?
20 weeks
184
Following a myocardial infarction, what medication should you be using to treat hypertension?
Beta blocker
185
A COPD patient has apical cavities and calcified nodes on his CXR. You also discover he has a pet bat and a few birds. What is the most likely diagnosis?
Histoplasmosis
186
Since a genetic cause is the number one reason for primary amenorrhea what is one very important test?
Karyotype
187
"What is the name for the triangular or wedge shaped growth on the conjunctiva that may interfere with vision?"
Pterygium
188
Scleroderma limited version has five main characteristics for which the CREST acronym is often used. What are those five things?
Calcinosis, Raynaud's, esophageal dysmotility, Sclerodactyly, Telangiectasia
189
What CXR finding might make you think of mesothelioma?
Pleural thickening, remember 80% are found in the pleura lining
190
You recommend bisphosphonates for a patient with osteoporosis. What instruction do you give her for immediately after taking the medication?
Remain upright for 30 minutes
191
With a gastric ulcer are the patient's symptoms exacerbated or relieved with food?
Exacerbated
192
Which EKG leads are used to diagnose an anterior wall MI?
V1, V2 and V3
193
A patient presents to the ER with chest pain. An EKG shows diffuse ST elevations in almost all of the leads. What is the most likely diagnosis?
Pericarditis
194
A 45 year old female complains of feeling the ground rolling under her feet at times. What is the most likely diagnosis?
Vertigo
195
At what BMI should a patient be hospitalized for anorexia?
BMI of <17.5 or 20% below appropriate body weight
196
How do fibrates work to affect the lipid profile? Describe Courvoisier's sign.
They inhibit synthesis of VLDL and elevate lipoprotein lipase.
197
Describe Courvoisier's sign.
Nontender, palpable gallbladder which may indicate pancreatic neoplasm.
198
When is the typical onset of Tourette's syndrome?
3-8 years old
199
You are treating a patient for TB. He has noticed that his body fluids now have an orange tint. What drug is most likely causing this?
Rifampin
200
Will evidence of TB be seen more frequently in the upper or lower lung lobes on CXR?
Upper
201
List three causes of decreased tactile fremitus.
COPD, Asthma, pleural effusion, pneumothorax
202
At approximately how many weeks pregnant is the uterus at the level of the symphysis pubis?
12 weeks
203
What are the ABC's of melanoma?
Asymmetry, border, color, diameter, elevation/irregularity, evolving
204
What life threatening side effect do statins have?
Rhabdomyolysis
205
What two hormones are secreted by the posterior pituitary?
Oxytocin and antidiuretic hormone (ADH, vasopressin)
206
Define paraphimosis.
Foreskin is retracted and cannot be reduced.
207
Borderline personality disorder is on the border of what two psychological disorders?
Neurosis and psychosis
208
Does FEV1 go up or down with asthma?
It goes down
209
A biphasic P wave should make you think of what diagnosis?
Left atrial enlargement
210
What is the treatment for a tetanus infections?
Penicillin, immune globulin and supportive care (especially respiratory support)
211
What are the genetic characteristics of Wilson's disease?
Autosomal recessive, chromosome 13
212
How does metformin work?
Decreases the hepatic glucose production and increases peripheral glucose uptake
213
Where is disease of the tricuspid valve best heard?
Along the left lower sternal border
214
Giant cells on a Tzanck smear should make you think of what diagnosis?
Herpes simplex virus
215
A positive Finkelstein's test indicates what diagnosis?
de Quervain's tenosynovitis
216
You have a patient with diagnosis of a pheochromocytoma. While waiting for surgery, should you use an alpha blocker or a beta blocker?
Alpha blocker. You should never use a pure beta blocker.
217
What medication is used for patients with lupus?
Systemic steroids
218
Bloody stool with cysts and trophozoites should make you think of what diagnosis?
Amebiasis
219
Pearly dome-shaped lesion with a central umbilication should make you think of what diagnosis?
Molluscum contagiousum
220
What is the x-ray finding that supports diagnosis of a slipped capital femoral epiphysis?
Ice cream falling of the cone
221
An opening snap on auscultation of the heart should make you think of what diagnosis?
Mitral Stenosis
222
Eggshell opacities on the CXR should make you think of what diagnosis?
Silicosis
223
How much fiber should you normally get in a day?
About 30 grams
224
How long must symptoms occur before diagnosing schizophrenia?
At least six months
225
What is the normal pH of the blood?
7.35-7.45
226
To be diagnosed with ADD patients must exhibit symptoms before what age?
7 years old
227
What are the three major criteria for endocarditis?
2 positive blood cultures, a positive transesophageal echocardiography, new murmur
228
What is the treatment for cholera?
Fluids
229
Which lipid medication may cause flushing?
Niacin
230
A patient believes she is pregnant. You notice that her cervix appears a little blue. What is the name of this sign?
Chadwick's Sign
231
A sudden thunderclap headache should make you think of what diagnosis?
Subarachnoid hematoma
232
What is the treatment for pertussis?
Erythromycin x 7 days
233
What are the two most common causes of epididymitis?
Neisseria gonorrhea and chlamydia
234
Under normal conditions at what hemoglobin level would you begin to consider a transfusion?
8
235
A patient presents with acute swelling and pain in the cheek that increases at meals. What is the most likely diagnosis?
Sialadenitis (salivary gland infection) - Staph aureus
236
What is the most common endometrial cancer?
75% are adenocarcinomas
237
What characteristic of pelvic inflammatory disease will help to differentiate it in a question stem from ectopic pregnancy, appendicitis, ovarian torsion and ovarian cyst?
It will be bilateral pain. Most other common abdominal complaints have unilateral pain.
238
A blockage of which artery causes a lateral wall MI?
Left circumflex artery
239
What are two tocolytic medications you should be aware of?
Magnesium sulfate and calcium channel blockers
240
Vision loss described as curtain coming down should make you think of what diagnosis?
Retinal detachment
241
Carpal tunnel affects what nerve and what parts of the hand?
Median nerve. Thumb, pointer and ring fingers. Thenar wasting is sign of advanced disease.
242
Define phimosis.
Foreskin can not be retracted.
243
An HIV patient presents with a nonproductive cough and a CXR showing diffuse interstitial infiltrates. What is the most likely diagnosis?
Pneumocystis jiroveci pneumonia (PCJ) formerly known as Pneumocystis pneumonia (PCP)
244
Do loop diuretics cause hyperkalemia or hypokalemia?
Hypokalemia
245
White blood cell casts should make you think of what diagnosis?
Pyelonephritis
246
A young boy comes into your office. He has elevated blood pressure when taken in his arm, but no femoral pulses can be palpated. What is the most likely diagnosis?
Coarctation of the aorta
247
Oral herpes is best treated with systemic or topical antivirals?
Topical is the first line. Systemic antivirals will help but are only indicated for severe cases.
248
What medication class is used to lower triglycerides?
Fibric acid derivatives
249
List the four cluster B personality disorders.
Bad antisocial, borderline, histrionic and narcissistic
250
An 82 year old patient complains of headaches and jaw claudication. What is the most likely diagnosis?
Giant cell (temporal) arteritis
251
What specific breathing pattern is associated with diabetic ketoacidosis?
Kussmaul respirations
252
What is Reynold's pentad and why does it matter?
Charcot's triad + hypotension + altered mental status. It indicates high risk of sepsis.
253
What class of antibiotics is sometimes prescribed specifically for its effects on increasing GI motility?
Macrolides
254
A Gram-negative coccobaccili found in the sputum of patient with pneumonia should make you think of what diagonsis?
Kussmaul respirations
255
A patient presents to the ER in acute CHF. What drug class will likely be the first choice?
Loop diuretics
256
Define priapism
Painful persistent erection
257
Are ulcers from arterial insufficiency painful or painless?
Painful
258
An African American female presents with malar rash and a positive double-stranded DNA antibody. What is the most likely diagnosis?
Lupus
259
A patient presents with a ruptured Achilles tendon. He states he that he was recently in the hospital for a "blood infection and on a ton of antibiotics." What antibiotic class may he have been on?
Fluoroquinolones
260
Clue cells should make you think of what diagnosis?
Bacterial vaginosis
261
Which medication is worse to give to a pediatric patient, tetracycline or an aminoglycoside?
Tetracycline
262
How long after a radiant energy burn do symptoms typically show?
6-12 hours
263
What dermatologic finding is associated with insulin insensitivity?
Acanthosis nigricans
264
White curd like vaginal discharge should make you think of what diagnosis?
Vaginal candida infection
265
Is sickle cell microcytic, macrocytic or normocytic?
Microcytic
266
Tapioca blisters should make you think of what diagnosis?
Dyshidrosis - these are usually on the hands and feet
267
A college student presents with a little purulent drainage from one eye and nontender preauricular lymphadenopathy. What diagnosis and pathogen should you be thinking of?
Chlamydia conjunctivitis
268
When is it recommended to begin pap smears?
Guidelines suggest beginning at age 21 regardless of sexual history.
269
At what age is primary amenorrhea diagnosed?
Age 14 if no secondary sex characteristics. Age 16 if some secondary development.
270
What is the name for the 4th and 5th metacarpal fractures that often result from throwing a punch?
Boxer's fracture
271
What is the medical term for lazy eye?
Amblyopia
272
What tests are done to screen for HIV?
ELISA and then if the positive diagnosis is confirmed with a Western blot test
273
A herald patch should make you think of what diagnosis?
Pityriasis rosea
274
Oseltamivir (Tamiflu) may be given to children above what age?
1 year old
275
A 30 year old female presents with pustules on her face that spare the vermilion border. In her history she has been using topical steroids. What is the most likely diagnosis?
Perioral dermatitis
276
What does ERCP stand for?
endoscopic retrograde cholangiopancreatography
277
Define pellagra?
Niacin (B3) deficiency Cytomegalovirus
278
Where is disease of the mitral valve best heard?
At the apex
279
At how many weeks of pregnancy can chorionic villus sampling be done?
10-13 weeks
280
What is the most common infection following a C-section?
Metritis
281
You have a patient with PCOS who would like to get pregnant. What are two medications you may start her on?
Metformin and Clomid
282
What is the most useful physical exam test for diagnosing an ACL tear?
Lachman's, followed by anterior drawer
283
The term Philadelphia chromosome should make you think of what diagnosis?
Chronic myeloid leukemia
284
What two lung cancers are typically found centrally on CXR?
Small cell and squamous cell
285
Honey and babies should make you think of what diagnosis?
Botulism
286
Anatomically where are 80% of clavicle fractures located?
Middle third
287
What molecule binds iron in the blood stream?
Transferrin
288
What is the medical term for cross-eyed?
Strabismus
289
Fruity breath should make you think of what diagnosis?
Diabetic ketoacidosis
290
An RSR prime in leads V5 or V6 should make you think of what diagnosis?
Left bundle branch block
291
What dermatologic finding is associated with asthma?
Atopic dermatitis
292
A child presents with painful ulcers in his mouth. On physical exam you find more of the same type of ulcers on his feet and hands. What virus is most likely causing these symptoms?
Coxsackie virus
293
An endoscopy for presumed esophagitis shows multiple shallow ulcers. What is the most likely diagnosis?
Herpes simplex virus
294
A snowstorm appearance on ultrasound should make you think of what diagnosis?
Hydatidiform mole
295
List two risk factors for prostate cancer.
Advancing age, African American, positive family history, high fat diet
296
Zanamivir (Relenza) may be giv to children above what age?
7 years old
297
At what age should a child begin to feed himself?
6 months
298
What type of mosquitoes carry malaria?
Anopheles
299
What is the most likely diagnosis for a young man who experiences sudden death while playing sports?
Hypertrophic cardiomyopathy
300
What is the treatment for a bad brown recluse spider bite?
Debridement, the venom causes tissue necrosis.
301
What antibiotic is the first line treatment for mycoplasma pneumonia?
A macrolide (azithromycin or erythromycin)
302
Decreased GABA and substance P should make you think of what diagnosis?
Huntington's
303
What is the most common thyroid cancer?
Papillary makes up about 80% of thyroid cancers.
304
Currant jelly stool should make you think of what diagnosis?
Intussusception
305
Melasma is most often found in what patient population?
Women of childbearing age
306
Paradoxical pulses may be found in what pulmonary disorder?
Asthma
307
Currant jelly stool should make you think of what diagnosis?
Intussusception
308
A barrel chest should make you think of what diagnosis?
Emphysema
309
A physical exam revealing a retroverted uterus or uterosacral ligament nodularity should make you think of what diagnosis?
Endometriosis
310
Dullness to percussion should make you think of what diagonsis?
Lobar pneumonia
311
A positive Auspitz sign should make you think of what diagnosis?
Psoriasis
312
What is the best test for diagnosing Rocky Mountain spotted fever?
Indirect immunofluorescent antibodies
313
A dendritic lesion is seen with fluorescein stain. What is the most likely diagnosis?
Herpes keratitis
314
A fluid filled painless mass found in the scrotum which transilluminates should make you think of what diagnosis?
Hydrocele
315
Tea-colored urine with red cell casts should make you think of what diagnosis?
Glomerulonephritis
316
When is watchful waiting with a diagnosis of acoustic neuroma an appropriate plan?
This tumor is very slow growing. Watching a small tumor in an elderly patient is appropriate treatment.
317
Strict vegans are at risk for what type of anemia?
B12 deficiency anemia
318
What are the most common colors lost in color blindness?
Red and green
319
A patient presents with unilateral blurriness developing over a few days. Fundal exam shows a "blood and thunder" pattern. What is the most likely diagnosis?
Central vein occlusion
320
What might happen if you infuse vancomycin too fast?
Red Man syndrom
321
A 60 year old male presents to the ER with severe dizziness and back pain. His blood pressure is dropping, and you can feel an abdominal pulsatile mass on physical exam. What is the most likely diagnosis?
Ruptured aortic aneurysm
322
Give the DEXA score for osteopenia and osteoporosis.
Osteopenia = 1 to 2.4 standard deviations, osteoporosis = 2.5 standard deviations or greater
323
Will ACTH be elevated or decreased in Addison's disease?
Elevated if the problem is at the adrenal glands.
324
What is the definitive treatment for a patient with recurrent ventricular tachycardia?
Implanted defibrillator
325
A patient is brought in following a seizure in which she did not lose consciousness. What is the most likely diagnosis?
Ruptured aortic aneurysm
326
Both lead I and AVF have positive QRS complexes. Does this represent normal axis, left axis deviation or right axis deviation?
Normal axis
327
What is the most common cause of dementia?
Alzheimer's disease, it may be as high as 80%.
328
HLA-DR gene is a marker for what endocrine disorder?
DM type 1
329
At what age do symptoms of Huntington's disease appear?
Around 30 years old
330
You hear a loud, harsh pulmonary murmur along the left sternal border. What is the most likely diagnosis?
Ventricular septal defect
331
White oral lesions which can be scraped off leaving punctate bleeding should make you think of what diagnosis?
Oral candida
332
A unilateral, single, mobile, firm, nontender solid breast mass should make you think of what diagnosis?
Fibroadenoma
333
What is the most common cause of DM type 1?
Autoimmune destruction of the islet cells in the pancreas
334
What is a cystocele?
A herniation of the bladder into the vagina.
335
What is the term for eyelids that turn in?
Entropion
336
Are target cells seen in mild or severe iron deficiency anemia?
Severe, they are also seen in alpha thalassemia, chronic liver disease and asplenia.
337
An Osborn or J wave on EKG should make you think of what diagnosis?
Hypothermia
338
Name three medications used to break a seizure?
Diazepam, lorazepam, phenytoin or fosphenytoin.
339
What organism causes toxoplasmosis?
Toxoplasma gondii
340
Giant cell arteritis is associated with what other disease?
Polymyalgia rheumatica
341
A patient presents with a painless mass in her right wrist. What is the most likely diagnosis?
Ganglion cyst
342
What is the first line treatment for mastitis?
Dicloxacillin is first line. Cephalexin or erythromycin are second line.
343
What is the diagnostic test of choice for Zenker's diverticulum?
Barium swallow will show the diverticulum.
344
What are the two most common predisposing factors in the development of chronic renal failure?
HTN and DM
345
A child with bulky greasy stool should make you think of what diagnosis?
Cystic fibrosis
346
Describe how to perform the psoas sign.
The patient is supine and attempts to raise the right leg against resistance.
347
What is the most common uterine tumor?
Leiomyoma, also known as fibroids
348
What location within the pelvis is endometriosis most commonly found?
On an ovary
349
What is the initial treatment for a myocardial infarction?
MONA - morphine, oxygen, nitroglycerin and aspirin
350
A stuck on grey membrane in the pharynx should make you think of what diagnosis?
Diphtheria
351
An abdominal exam with pain out of proportion to the exam should make you think of what diagnosis?
Intestinal ischemia
352
A patient presents with sudden painless complete unilateral vision loss. What is the most likely diagnosis?
Central retinal artery occlusion
353
What is tonometry used for?
Determining intraocular pressure
354
Muddy-brown sediment in the urine should make you think of what diagnosis?
Acute tubular necrosis
355
Are patients with specific phobias aware they are strange?
Yes
356
Name one abortive drug for migraines.
Triptans (sumatriptan, zolmitriptan), ergotamine
357
During an interview a patient states "I have been anxious for as long as I can remember." This statement should make you think of what diagnosis?
Generalized anxiety disorder
358
A patient presents to your office complaining of a tremor in his right hand. He states after a beer it goes away completely. What is the most likely diagnosis?
Benign essential tremor or familial tremor
359
What CXR finding might make you think of berylliosis?
Diffuse infiltrates with hilar adenopathy
360
Vaginal infection with motile flagellated protozoa should make you think of what diagnosis?
Trichomonas vaginitis
361
What siezure medication may cause overgrowth of the gums?
Phenytoin
362
Tympany to percussion should make you think of what diagonsis?
Large pneuomthorax
363
A patient presents with pain in one eye. The cornea is hazy and the pupils are fixed. What is the most likely diagnosis?
Glaucoma
364
What is the treatment for a patient with a Mobitz II AV block?
Pacemaker
365
You see regular P waves and regular QRS complexes, but they do not seem to have any correlation to each other. What is the diagnosis?
Third degree AV block
366
Where do most aortic dissections occur?
The ascending or descending thoracic aorta
367
What medical treatment is given for a gastrinoma?
Proton pump inhibitors
368
What is the clinical name for whooping cough?
Pertussis
369
What two labs do you want to monitor in a patient on an ACEI?
Serum creatinine and serum potassium
370
In what age range do you expect to most commonly find amaurosis fugax?
Patients older than 50
371
An involuntary loss of urine during coughing or laughing is what type of incontinence?
Stress incontinence
372
Which thyroid cancer is the most aggressive?
Anaplastic
373
Define threatened abortion.
Vaginal bleeding, closed cervix, products of conception are still inside
374
How much more potent is T3 than T4?
3-4x
375
List four disease states in which you may find basophilic stippling.
Lead poisoning, beta or alpha thalassemia, sideroblastic anemia, arsenic poisoning
376
What is the most common cause of hyperparathyroidism?
Single parathyroid adenoma in 80% of cases.
377
Is staph gram (+) or gram (-)?
Gram (+)
378
What are the two main causes of aortic stenosis?
Congenital bicuspid valve and calcification of the valve secondary to coronary artery disease
379
You notice drusen deposits on fundal exam. What is the most likely diagnosis?
Macular degeneration
380
List the 5 insulins in order of peak efficacy?
Lispro 1-2 hrs, Regular 2-4 hrs, NPH 5-7 hrs, Lente 4-8 hrs, Ultralente 8-14 hrs
381
What would you expect to see on a KOH prep if the patient had vaginal candidiasis?
Pseudohyphae
382
Will a hemolytic anemia generally have an elevated or decreased retic count?
Elevated
383
Define the third stage of labor.
Delivery of baby to delivery of placenta
384
How do you treat alcohol withdrawal
Benzodiazepines
385
What is the treatment for myxedema?
Levothyroxine and slow warming
386
What is the therapeutic range for INR following an organic valve replacement?
2 to 3
387
What would you expect the WBC count to be in the joint fluid of an infected knee?
>50,000 at a minimum and probably much higher.
388
A 34 year old presents with symptoms which are relapsing and remitting over the past few weeks. These include visual problems and weakness in her right arm. What is the most likely diagnosis?
Multiple sclerosis
389
List the four things that suggest group A beta- hemolytic strep in a patient with pharyngitis.
Fever, tender anterior cervical adenopathy, no cough and an exudate in the throat
390
A patient exhibits splitting, seeing others as all good or all bad. What is the most likely diagnosis?
Borderline personality disorder
391
What is the medical treatment for gout?
Allopurinol, colchicine
392
In order to contract hepatitis D what must you already have?
Hepatitis B
393
A CXR finding of notched ribs in a child should make you think of what diagnosis?
Coarctation of the aorta
394
A leukemia patient has a CT of the liver which shows punched out lesions. What diagnosis should you be thinking of?
Hepatosplenic candida
395
What two main causes should you be thinking of in a macrocytic anemia?
Malnutrition and severe blood loss
396
Where are Bouchard's nodes found?
Proximal interphalangeal joint (PIP)
397
What is the first line treatment for tinea corporis?
Topical azoles
398
Which of the four rotator cuff muscles is most commonly injured?
Supraspinatus
399
What three symptoms are classic for a normal pressure hydrocephalus?
Gait disturbance, dementia and urinary incontinence
400
What is the treatment of choice for strep throat? List 4 medications which may cause asthma.
Penicllin, amoxicillin, erythromycin
401
A patient has metamorphopsia and a central blind spot. What is the most likely diagnosis?
Beta blockers, NSAIDS, ACEI, ASA
402
A PSA above what level should start to make you concerned?
Topical azoles
403
A patient has an intracranial neoplasm causing auditory illusions, olfactory hallucinations and emotional changes. What lobe is the lesion likely in?
>4.0 Temporal
404
What is the first line medical treatment for pericarditis?
Aspirin and NSAIDS
405
A 35 year old patient comes to your office because his wife made him. He has been increasingly irritable and moody. She has also noticed that he is very restless. You order a CT scan which shows cerebral atrophy as well as atrophy of the caudate nucleus. What is the most likely diagnosis?
Topical azoles
406
A diaper rash with satellite lesions should make you think of what diagnosis?
Candida
407
A patient complains of severe crushing chest pain. EKG shows ST segment elevations. All labs including troponins and CK-MB are negative. What is the most likely diagnosis?
Prinzmetal's angina
408
Coal miners lung often shows nodular opacities in what lung fields?
Upper lung fields
409
What is the gold standard for diagnosing coronary artery disease?
Cardiac catheterization
410
What are two treatments you should consider for esophageal strictures?
Dilation of the esophagus and long term PPIs.
411
Community acquired carditis is most often caused by one of the HACEK organisms. List the HACEK organisms.
Haemophilus, Actinobacillus, Cardiobacterium, Eikenella, Kingella
412
When treating herpes keratitis should you use topical antiviral, topical steroid or both?
Don't use steroids. Topical antiviral and refer!
413
List four symptoms of serotonin syndrome.
Hyperthermia!, seizure, mental status change, tremor
414
What is the karyotype for patient with Turner's syndrome?
(45, X) They are missing one sex chromosome.
415
What happens to total lung capacity in sarcoidosis?
It goes down
416
Which hyperlipidemia medication may cause flushing?
Niacin
417
A double comedone is indicative of what diagnosis?
Hidradenitis suppurativa
418
A positive crossover test indicates what diagnosis?
Acromioclavicular joint injury (AC joint)
419
Silvery scales should make you think of what diagnosis?
Psoriasis
420
A patient presents with acute onset of continuous severe vertigo for the past five days. He does have a history of URI 2 weeks ago. What is the most likely diagnosis?
Labrynthitis
421
What tumor marker may be used for liver cancer?
alpha-Fetoprotein
422
A patient complains of an aching headache which feels like a band around his head. What is the most likely diagnosis?
Tension Headache
423
What is considered a normal PCO2? What is the best lab test for scabies?
40mmHG Respiratory - CO2 is elevated
424
Nasal polyps should make you think of what diagnosis?
Microscopic examination under oil immersion
425
A new mother presents with pain over the radial wrist. She has a positive Finkelstein's test. What is the most likely diagnosis?
Cystic fibrosis
426
What is erythema nodosum?
de Quervain's tenosynovitis
427
What is the most common anorectal problem affecting patients over 50?
Tender red nodules usually found on the shins.
428
You should be thinking alpha thalassemia if the question stem includes which four geographic areas?
Hemorrhoids
429
What is the most common cause of an upper respiratory tract infection?
Southeast Asia, China, Middle East, Africa
430
What is the drug of choice to treat a urethritis caused by neisseria?
Rhinovirus
431
What is the medical treatment for an early ectopic pregnancy?
Ceftriaxone (Rocephin)
432
A Salter-Harris type III fracture affects what area of the bone?
Methotrexate
433
What is the treatment for Addison's disease?
The physis (growth plate) as well as the epiphysis
434
What is the term for a chronic mild depression which has lasted greater than two years?
Hydrocortisone or prednisone Dysthymia
435
Which NSAID has the highest rate of peptic ulceration?
Naproxen
436
What is the only curative therapy for gastric adenocarcinoma?
Surgical resection
437
What should a primary care provider do for presumed central retinal artery occlusion?
Ophthalmic emergency! Refer and intermittent pressure and release of the eye.
438
What is a good beta blocker to reduce portal HTN?
Propranolol
439
A waxy stuck on appearance should make you think of what diagnosis?
Seborrheic keratosis
440
A sawtooth pattern on EKG should make you think of what diagnosis?
Atrial flutter
441
Ethambutol has what two major side effects?
Optic neuritis, red green vision loss
442
How does levothyroxine work?
It is a synthetic T4
443
How do you treat pityriasis rosea?
Reassurance
444
How long does menstration need to be absent before secondary amenorrhea can be diagnosed?
If cycles have been previously normal: 3 months. If cycles have been previously irregular: 6 months.
445
A patient is arrogant with an inflated self image. He feels he is special and should be treated that way. What is the most likely diagnosis?
Narcissistic personality disorder
446
Will the serum ferritin be high or low in a patient with iron deficient anemia?
It will almost always be low
447
A patient presents with several episodes of vertigo over the past few weeks. He has had intermittent unilateral hearing loss and a “blowing” in his ears. What is the most likely diagnosis?
Meniere's disease
448
What organism is the most common cause of an uncomplicated urinary tract infection?
E. Coli
449
Is the ankle jerk reflex of lumbar or sacral origin? What is the best test to diagnose bronchiectasis?
Sacral
450
Koplik spots are white clustered lesions on the buccal mucosa. What virus are they pathognomonic for?
CT Measles/Rubeola
451
Air fluid levels on abdominal x-ray should make you think of what diagnosis?
Bowel obstruction
452
Typically what is the first medication started in type 2 DM?
Metformin
453
What is the first step in treating atopic dermatitis?
Behavioral modifications - reduce bathing, only use soap on face and genitals, use natural breathable fabrics
454
A patient being treated with penicillin for a syphilis infection develops fever, chills, muscle pain and headaches. Do you stop treatment?
No this is Jarisch-Herxheimer reaction. The patient must be closely monitored, but it is a response to released endotoxin from the death of the spirochetes and not an allergic reaction.
455
Subacute endocarditis is most commonly caused by what organism?
Strep Viridans
456
What is the treatment for Shigella?
Bactrim or fluoroquinolones and hydration.
457
On auscultation, you hear a harsh blowing pansystolic murmur at the apex. What is the most likely diagnosis?
Mitral regurgitation
458
What lab result will increase the risk of digoxin toxicity?
Hypokalemia or hypercalcemia
459
Which nerve is involved in herpes zoster ophthalmicus?
Trigeminal nerve, CN 5
460
Describe the pattern of weight gain in an infant over the following time periods: week one, 6 months, 12 months, 3 years old and 4 years old.
Newborns lose 10% of their birth weight initially but are back to birth weight at 10 days, 6m = 2x birth weight, 12m = 3x birthweight,3 y/o= 30 lbs & 30 inches, 4 y/o = 40 lbs & 40 inches
461
Why is ovarian cancer so hard to diagnose?
There are no good markers and the symptoms are very vague.
462
Stocking glove paresthesias should make you think of what two diagnoses?
B12 deficiency neuropathy and diabetic neuropathy
463
Describe Cullen's sign.
Umbilical ecchymosis often related to pancreatitis.
464
A 35 year old female presents with heat intolerance, weight loss and palpitations. What is the most likely diagnosis?
Hyperthyroidism
465
A patient exhibits all of the characteristics of antisocial personality disorder, but he is only 14 years old. What is the most likely diagnosis?
Conduct disorder
466
What is the most common cause of an atrial septal defect?
Patent foramen ovale
467
A widely split fixed S2 should make you think of what diagnosis?
Atrial septal defect
468
Waxy flexibility should make you think of what diagnosis?
Catatonic schizophrenia
469
Weakness and numbness in the left hand might be a blockage in which carotid artery?
Right
470
A patient with a history of herpes now presents with a target lesion. What is the most likely diagnosis?
Erythema multiforme
471
A patient in the ER has no pulse; but on EKG, there are wide irregular "complexes" which are at an irregular rate. They all appear very different from one another. What is the treatment for this patient?
He is in ventricular fibrillation. The treatment is defibrillation.
472
If you hear a midsystolic click you should immediately be thinking about what diagnosis?
Mitral valve prolapse
473
A shuffling gait should make you think of what diagnosis?
Parkinson's disease
474
What is the most common microcytic anemia?
Iron deficiency anemia
475
Nodular opacities in the upper lung fields should make you think of what diagnosis?
Silicosis
476
If you see a question with anything to do with rats and the patient has pneumonia, what organism should you be thinking of?
Yersinia pestis
477
Purple, pruritic, polygonal, papules on physical exam should make you think of what diagnosis?
Lichen planus
478
A patient is bitten by a rabies infected raccoon. On what days do you give human diploid cells?
0, 3, 7, 14, 28
479
What is the initial treatment for a chemical burn to the eyes?
Irrigate, irrigate, irrigate
480
Clot busting drugs should be used within 3 hours of which two cardiac events?
STEMI and new left bundle branch block
481
Positive antithyroid peroxidase and antithyroglobulin antibodies should make you think of what diagnosis?
Hashimoto's
482
Is pseudomonas gram (+) or gram (-)?
Gram (-)
483
Early on in pregnancy serial beta-HCG should double over what time period?
every 48-72 hours
484
Mesothelioma is most commonly found in what lung location?
80% are found in the pleural lining
485
A patient presents with a hot potato or muffled voice. What is the most likely diagnosis?
Peritonsillar abscess
486
A patient presents to the ER with acute progessive weakness, diplopia and a very dry mouth. What organism may be causing this?
Clostridium botulinum
487
What role does C-peptide play in the diagnosis of diabetes?
It is a marker of insulin production. Elevated C-peptide points to DM 2. Decreased C-peptide points towards DM 1.
488
What is the first line treatment for genital warts?
Imiquimod (Aldara)
489
What side effect might make a patient stop taking an ACEI?
Cough
490
At how many weeks of pregnancy can an amniocentesis be done?
15-20 weeks
491
What is the term for being nearsighted? What type of lens do you use to correct it?
Myopia, concave lenses
492
You are counting boxes from the peak of a QRS wave on an EKG in order to determine the heart rate. What would the heart rate be if the next QRS wave peak were three boxes away? What numbers are associated with the first five boxes?
The answer is 100. The heart rates by counting boxes are 300, 150, 100, 75, 60.
493
A young child presents to ER and you see him waiting in tripod position. What is the most likely diagnosis?
Epiglottitis
494
A patient with HIV presents with severe groin pain. What is the most likely diagnosis?
Avascular necrosis of the femoral head. Antiretroviral medications put patients at an increased risk of AVN.
495
List 4 physical exam findings for Cushing's syndrome.
Moon face, buffalo hump, purple striae, central obesity, supraclavicular fat pads, easy bruising
496
What medicaton classes are prescribed in order to help prevent chronic renal failure in diabetic patients?
ACEIs or ARBs
497
What is the best imaging for a thyroid nodule?
Ultrasound
498
Salmon-colored scales should make you think of what diagnosis?
Psoriasis
499
A colonoscopy that shows cobblestone or skip lesions should make you think of what diagnosis?
Crohn's disease
