FM COMAT Flashcards
Painless LAD, constitutional sx, no immunosuppression
Hodgkin Lymphoma
Rule of confinement for OB pt w/ regular 28 day cycle
From the date of last menses, add 7 days, minus 3 months Example: Last menses: July 17. Date of confinement: April 24th
EKG finding for PE
Sinus Tach
First step management of a Pt w/ Epiglottitis
Tracheal Intubation
Tx for C. diff
Acute: VancRecurrent: Fidaxomicin
Type and Tx – Headache w/ band like tension, front. Most often during stress
TensionNSAIDs
Non conducting P waveConsistent PR intervalNo QRSHis-Purkinjie dysfunction
Mobitz II
Incomplete SAB
Open CervixBleedingPartial POC delivered
Completed SAB
Closed CervixContracted UterusBleedingAll POC delivered
Inevitable SAB
Open CervixBleedingNo POC delivered
Missed SAB
<20 wksClosed CervixASx – no bleeding”Don’t ‘feel’ preggo anymore
Threatened SAB
Closed CervixBleeding Fetus still viable
Bloody, watery diarrheaNight SweatspANCAElevated ESR, CRPMucosal/Submucosal InflammationAbdominal Pain
UC
Benign flesh to erythematous colored annular plaques found on distal extremities of healthy adults and kids. Groups of 1-2 mm papule that coalesce into a >5cm plaque. Neg scale, KOH, fluid
Granuloma annulare
This will be increased on a CBC w/ a Hgb-SS Pt.
Reticulocytes
Fe studies: Chronic Dz
MicrocyticLow FeHigh FerritinNormal/Low TIBC
Fe studies: Fe Deficient Anemia
MicrocyticLow FeLow FerritinHigh TIBC
Fe studies: Fe Overload
NormocyticHigh FeHigh FerritinLow TIBC
Fe studies: Thalassemia
Microcytic nl Fe, Ferritin, TIBC
Pt has osteoarthritis along w/ CHF. His arthralgia should be Tx w/
Duoxetine
NSAID that blocks COX-2>COX-1
Meloxicam
Absence of esophageal peristalsisImpaired esophageal sprinter relaxationProgressive difficulty in eating foodsTest? Dx?
EndoscopyAchalasia
In areas w/o Fluoride in the water, Fluoride Tx may begin at
6mo
Rx to increase survival rate of ALS pts
Glutamine Release Inhibitor: Riluzole
Nerve DegenerationProgressive, asymmetric muscle weakness and wastingAffects upper and lower nervesTest? Dx?
ElectromyographyALS
Pt at 34 wk presents w/ upset stomach, nausea, diarrhea along w/ constitutional Sx, what GI medication is contraindicated
Bismuth Salicylate, Cat DAlong w/ other NSAIDs, causes premature closure of ductus arteriosus.
Tender thyromegaly following a viral prodrome
Subacute Thyroiditis Viral Illness»_space; Thyrotoxicosis»_space; Euthyroid»_space; Hypothyroid»_space; Recover
ADPulmonary AV malformations on contrast echoEpitaxis w/o apparent causeVisceral lesionTelengiectasiasCoag studies WNL
HHT/OWR Syn
Preggo and MDD, Tx?
CBT+SSRI»_space; SNRI
Pt is preggo, when do you do a PAP
First visit
Pt is preggo, initial visit you screen for
RhRuebellaABOSTIHIVHep B + CTB
Pt w/ SVT, Tx…
Vagal massage»_space; Adenosine»_space; Electric cardio version
Prophylaxis given after an animal bite
Amoxicilian + Clavulunate (Gr-/Anaerobe coverage)
When to give HD Amox for AOM
<6mo6mo-2yo w/ bacterial OM or Fever >102.2>2yo if bacterial OM AND Severe illnessHigh Risk f/u
Vaccines indicated for HIV Pt
TdapHep-BInfluenzaPneumococcal
Pt is a nonsmoker but has b/l panacinar bullae on CXR
Alpha 1 Antitrypsin Deficiency
Pt w/ CML has this finding on CBC
BasophilliaLeukocytosisThrombocytopeniaTx w/ Ty-K inhibitor, Imatinib
Wide QRS, Reg P-P, No conducted P-waves
3˚ Heart Block
Pt <45yo has thrombosis + FHx of PE. Most likely mutation of Factor
V
“Fasting” for a lab meaning
no caloric intake w/n last 12h no alcohol w/n last 24h
Dx test for cervical stenosis
MRI
Lab test for Paget Dz
Alk Phos
Pain b/t toes Tight ShoesMulder SignPain and numbness that radiates to proximal toes
Morton Neuroma
Mulder Sign
Palpable click on toes»_space; Morton Neuroma
Vitals worsen following an albuterol Tx d/t
VQ Mismatch
Pt w/ Struma ovarii will present as
Hyperthyroid d/t teratoma secreting free T4
AFP is elevated w/
Yolk Sac TumorHepatocellular Carcinoma
Ovarian Cancer marker
Ca125
Colorectal cancer marker
CEA
Pt is preggo at risk for HSV, Tx is
Tx recurrent episodes w/ acyclovir, begin daily Tx at 36wks.
Absence seizure Tx
Ethosuximide»_space; Valproate
Fixed non-tender testicular massSolid w/ necrotic centerIntratesticularSecretes Beta-hcg
Testicular choriocarcinoma
Pts on anti-virals should not take … for fear of hypotension
PDE-5 inhibitors
Pt presents in excruciating pain w/ external hemorrhoids w/n 72 hrs of onset, Tx w/
Surgical excision
Internal hemorrhoids that do not respond to Tx and do not protrude may be Tx w/
banding
When to Tx external hemorrhoids or low grade internal hemorrhoids w/ conservative Tx versus Surgery
w/n 72 hrs = Surgerybeyond 72hrs = Conservative
Baby has premature closure of fontanels, next step
XR»_space; CT
Microcephaly is
head circumference below 3rd percentile
Only medication used for asystole
Epi
Flat lesion, abnormal color/border, <4mmNext Step …
Punch Bx
Flat lesion, abnormal color/border, >4mmNext Step …
Excisional Bx
BCC larger than … gets excised
2mm
Raised, non-pigmented, superficial lesionNext Step …
Shave Bx
Adherent, greasy, scaly, stuck on appearance
Seborrheic KeratosisPt needs reassurance
Imaging for TIA
Diffusion-weighted MRI
Progressive prolonged PR, regular dropped QRS
Mobitz I (Wenckebach)
Tay-Sachs findings
ARCherry Red Spot Startle EasyHexosaminidase A DeficientGM2 ganglioside accumulationDeath by 4 by Pneumonia
Niemann Pick findings
ARCherry Red spotSphingomyelinase deficientSphingomyelin accumulationHepatosplenomegalyDeath by 3
Gaucher Dz findings
ARBeta Glucosidase deficientGlucocerebroside accumulationTissue paper MacsErlenmyer Flask femurs
Fabry findings
X-linkedAlpha-galactoside AGlycosphingolipidsDark Red/Blue/Black Non-blanching spotsIncreased clots
Wide QRS, Reg P-P, no conduction of P-wave
Third degree heart block
Narrow QRS, Reg/Irregular P-P, some conduction of P-wave
A-Flutterr
Wide QRS, Reg P-P, some conduction of P-wave
Mobitz II
Narrow QRS, Reg P-P, slow conduction of P-wave
Mobitz I (Wenckebach)
Narrow QRS, Irreg/Irregular P-P, some conduction of P-wave
A-Fib
Non-blanch, non- tender, raised vulvar lesion confirm Dx w/…
Punch Bx
Most common vulvar neoplasm
SSC
Vulvar neoplasms are often associated w/ longstanding
Lichen Sclerosis
Epigastric painHypotensionPain relieved by eatingDx and structure at risk …
Doudenal ulcersGastroduodenal artery at risk
Give this to have rapid control of hyperthyroid Sx
Beta-blockers
Hyperthyroid first line med
Methimazole
Hyperthyroid first line med, pt preggo 1st trimester
5-PU
Hyperthyroid first line med, pt preggo 2nd/3rd trimester
Methimazole
Rash that is hyper pigmented, scaly, thick, scaly, edematous papule and plaques.Hx of Eczema/Psoriasis
Lichen Simplex Chronicus
Herald Patch
salmon colored patch on the truck w/ central clearing
Pityriasis Rosea findings
herald patchOval shaped macule in christmas tree patternb/l and Symm, spares hands feet and face
Nevus Flammus, aka
port wine stain
Nevus Simplex on newborn b/t eyes or on the nape of the neck
Nevus Simplex
Severe pre-eclampsia should deliver by
34 wks
Mild/mod pre-eclampsia should deliver by
37 wks
Stages of CKD
> 90 = 160-89 = 230-59 = 315-29 = 4<15 = 5
Painless thyroid that does not move w/ swallowingMass effect+/- abnl TSHDx by …
Open Bx, Riedel Thyroiditis
When to perform a FNA on a goiter
TSH is nl
GAD first list
SSRI/SNRIBuspirone (partial 5HT antagonist)
Most potent risk factor for TIA and stroke
HTN
Smooth, rubber, mobile, solitary, well-circumscribed, painless breast mass
Fibroadenoma
Initial Dx test of AD-PKD
Renal U/S
Most likely complication of Nephrotic syndrome
Venous thrombosis
Biliary Atresia of newborn presents as …
1-8wk oldjaundicepale stooldark urine elevated direct bili (>20% total/>2 mg/dl)
Breastfeeding jaundice d/t
inadequate milk supply
Breastmilk jaundice d/t
milk quality, removes glucuronic of direct bili
Colorectal Ca Screening
50 yoColonscopy q 10rFOBT AnnualFlexisigmoidoscopy q 5yr
Joint pain in elderly that is b/l and resolves w/n 30 min
Osteoarthritis
Clots w/ gross hematuria in a child, next step is a …
U/S of kidney and bladder
Pt w/ dyspnea has a flattened inspiratory loop and normal FVC and FE1/FVC ratio
Vocal Cord Dysfxn
Most common cause of 2nd HTN
Renal Stenosis
Adjustment disorder timeframe
If Sx don’t resolve w/n 3 months of the stressor being removed
Expressive language disorder Sx
No babble at 1yrNo ords by 15 monthsNo intelligible words at 2yr
Gr- Diplococcus3rd leading Cz of Bacterial OM and rhinosinusitis
Morexella Catarrhalis
Gr+, Cat-, Capsule, DiplococcusComplement DependentPneumolysin releases TNF-alpha and IL-1
S. Pneumo.
Pt Dx w/ SBP, Tx w/
Cefotaxime
Vaccines for pts >56yo + immunocompromised
Mening Poly (MCV-4)Pneumo -13 (PCV13)HiB
Pt at 26wk, perform
DM ScreenCBCRhogam Vacc - Flu/Tdap
Contradictions for tetracyclines
Pregnant or <9yo
Sizes of AAA and what to do
<4cm = Nothing4-5.4cm = Follow>5.4cm = Surgery
Marker for increased metabolic activity in the liver, bone or placenta
Alk Phos
Lytic lesions corticol thickeninghearing losselevated al phos
Pagets
Pt suspected of Mono, you run these tests
CBCHeterophileRapid Group A
Newborn rashSystemic SxBx shows eosinophilsSpares palms/soles
Erythema toxicum neonatorum
Releases PTH-like hormone and can cause hypercalcemia
SCC
Pt w/ IBD has calcium oxalate stones. The stones are caused by …
decreased absorption of fatty acids and bleeding salts
Bilious, non-projectile, non-bloody emesis in a neonate <1 month old
Abdominal malrotation – get an upper GI Barium Series
Testicular torsion mechanism
congenital malformation of process vaginalis
This condition(s) causes inaccurate A1c readings
CKD– any condition that disrupts the nl lifespan of a RBC
Pt 18mo-3yr has patella point forward but pt is pigeon toed, b/lCz…
Internal Tibial Rotation
Pigeon toe <18 months, cz…
Metatarsus adductus
NSAIDS damage kidneys by …
reducing prostaglandins»_space;> reversible Renal ischemia