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Internal Medicine > General Medicine > Flashcards

General Medicine Flashcards

1
Q

If nystagmus with Dix-Hallpike maneuver is vertical what type of vertigo is it? Peripheral or central?

A

Central

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2
Q

What is the triad for Meniere Disease?

A
  1. Vertigo
  2. Low frequency hearing loss
  3. Tinnitus
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3
Q

What is cause of shoulder pain if Apley scratch test (touch superior and inferior aspects of opposite scapula) is positive?

A

Rotator cuff problem

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4
Q

What is cause of shoulder pain is Neer test is positive (forced flexion of pronated arm)?

A

Subacromial impingement

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5
Q

What is cause of shoulder pain if Hawkins test is positive (forward flexion of the shoulder to 90 degrees and internal rotation)?

A

Supraspinatous tendon impingement

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6
Q

What is cause of shoulder pain if patient has positive drop-arm test (attempted slow lowering of arm to waist)?

A

Rotator cuff tear

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7
Q

What is the cause of shoulder pain if positive cross-arm test (forward elevation to 90 degrees and active adduction)?

A

Acromioclavicular joint arthritis

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8
Q

What is the cause of shoulder pain if positive Spurling test (spine extended with head rotated to affected shoulder while axially loaded)?

A

Cranial nerve root disorder

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9
Q

What is the cause of shoulder pain if positive apprehension test (anterior pressure on the humerus with external rotation)?

A

Anterior glenohumeral instability

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10
Q

What is the cause of shoulder pain if positive relocation test (posterior force on the humerus while externally rotating the arm)?

A

Anterior glenohumeral instability

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11
Q

What is the cause of shoulder pain if positive sulcus sign (pulling down on elbow or wrist)?

A

Inferior glenohumeral instability

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12
Q

What is the cause of shoulder pain if positive yergason sign (elbow flexed to 90 degrees with forearm pronated)?

A

Biceps tendonitis or instability

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13
Q

What is the cause of shoulder pain if positive speed maneuver (elbow flexed to 20 to 30 degrees and forearm supinated)?

A

Biceps tendonitis or instability

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14
Q

What is the cause of shoulder pain if positive “clunk” sign (rotation of loaded shoulder from extension to forward flexion)?

A

Label tear/disorder

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15
Q

Do testicular torsion or epididymal pain improve with raising the affected testicle?

A

Epididymitis

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16
Q

What is the length of treatment for epididymitis?

A

21 days

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17
Q

Do varicoceles occur more on the right or left?

A

Left

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18
Q

What is diagnostic test of choice for breast mass if age

A

Ultrasound

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19
Q

What is diagnostic test of choice for breast mass if woman > age 35?

A

Diagnostic mammogram

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20
Q

What form of biopsy is best for solid breast lesions?

A

Core needle biopsy

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21
Q

What is only medication approved for treatment of cyclic mastalgia?

A

Danazol

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22
Q

What are contraindications to using OCPs?

A 
H/o thrombosis
Liver disease
Breast cancer
Migraine with aura
Uncontrolled hypertension
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23
Q

A copper IUD can be implanted within how many days to act as emergency contraception?

A

5 days

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24
Q

How far after intercourse can Plan b (levonorgestrel) be taken for emergency contraception?

A

72 hrs, may be efficacious up to 5 days

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25
Q

How long after sexual intercourse call Ella (ulipristal) be used for emergency contraception?

A

120 hrs (5 days)

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26
Q

Which SSRIs are potentially teratogenic?

A

Fluoxetine

Paroxetine

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27
Q

How long should a person have amenorrhea to be considered to have gone through menopause?

A

12 months

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28
Q

What are absolute contraindications to hormonal therapy for menopausal symptoms?

A 
Pregnancy
Thrombosis
CVA
Coronary artery disease
Unexplained vaginal bleeding
Breast or endometrial cancer
Hypertriglyceridemia
Immobilization
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29
Q

What defines oligomenorrhea?

A

> every 35 days

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30
Q

What defines polymenorrhagia?

A

Bleeding more frequent that every 24 days

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31
Q

What endometrial stripe thickened requires further eval for endometrial cancer?

A

5 mm

32
Q

How many candidal vaginitis infections in a year is considered recurrent?

A

> 4 in a year - treat with topical imidazole x 7-14 days or PO fluconazole q3 days x 3 followed by weekly x 6 months

33
Q

What is the most common viral etiology of conjunctivitis?

A

Adenovirus

34
Q

What is the most common bacterial etiology of conjunctivitis?

A

S aureus

35
Q

What is severe complication of Neisseria gonorrhea conjunctivitis?

A

Corneal perforation

36
Q

What underlying conditions are associated with scleritis?

A

Rheumatoid arthritis
Tuberculosis
Syphilis

37
Q

What antibiotic should be used for blepharitis with associated rosacea?

A

Oral tetracycline

38
Q

What eye condition has deposits of drusen?

A

Dry macular degeneration

39
Q

What type of macular degeneration is more vision threatening - wet or dry?

A

Wet

40
Q

What is treatment of dry macular degeneration?

A

Antioxidants - vit C or E and beta carotene
Zinc
Laser therapy
VEGF inhibitor

41
Q

What is leading cause of irreversible blindness in the world?

A

Primary open angle glaucoma

42
Q

What cup to disc ratio is a finding of glaucoma?

A

> 0.5

43
Q

What complication occurs if acute angle closure glaucoma is not treated?

A

Optic nerve atrophy

44
Q

What is leading cause of blindness globally (reversible)?

A

Cataracts

45
Q

What is epiphora?

A

Excessive tearing of eyes due to impaired drainage of the lacrimal duct system

46
Q

What eye disorder presents with sudden unilateral vision loss, cotton wool spots, tortuous retinal veins?

A

Central retinal vein occlusion (CRVO)

47
Q

What eye condition presents with sudden loss of vision in one eye, pale retina, cherry red fovea and afferent pupillary defect?

A

Central retinal artery occlusion

48
Q

What is endophthalmitis?

A

Inflammation of the aqueous and vitreous humors - usually from infection or after eye surgery

49
Q

What is Hutchinson sign?

A

Herpes zoster infection that involves the tip of the nose - usually indicates corneal involvement

50
Q

What dietary change can precipitate worsening of Ménière’s disease?

A

High salt intake

51
Q

Which tuning fork is used for Rinne test - 256 or 512 hz?

A

512 Hz

52
Q

Which hearing test places a 512 hz running fork against the mastoid?

A

Rinne test - if sound can be heard better on the mastoid then likely conductive hearing loss

53
Q

Which type of hearing loss (conductive vs sensorineural) in the Weber test be louder in the affected ear?

A

Conductive

54
Q

What conditions can cause pulsatile tinnitus?

A

AV malformation
Carotid artery stenosis
Paraganglioma (glomus tumor)

55
Q

What are the 2 most common bacterial causes of acute otitis externa?

A

Pseudomonas

Staph aureus

56
Q

Acute otitis externa with presence of white or black fungal balls indicate what organism?

A

Aspergillus

57
Q

What post strep complication can NOT be caused by group C or G streptococci?

A

Acute rheumatic fever

58
Q

What bacteria is know to cause lemierre syndrome (septic thrombosis of IJ)?

A

Fusobacterium necrophorum

59
Q

What vitamin deficiency is associated with atropic glossitis?

A

B12

60
Q

Which type of vertigo, central or peripheral, habituates with Dix-Halpike maneuver?

A

Peripheral

61
Q

What is Russell sign?

A

Scarring on dorsum of the hand from recurrent purging in bulimia

62
Q

What MMSE score is mild dementia?

A

19-24

63
Q

What pharmacological therapy can help with stress incontinence if pelvic floor exercises don’t work?

A

Duloxetine

64
Q

What pressure ulcer stage has full thickness breakdown with visible subq fat but no tendons, bone or ligament seen?

A

Stage 3

65
Q

Which lipid lowering agent needs to be held prior to surgery?

A

Cholestyramine

66
Q

What dose of steroids a patient is taking requires stress dosing?

A

If taking >10 mg/day for 3 weeks or more

67
Q

When should estrogen be discontinued before surgery?

A

Several weeks- increased risk of thrombosis

68
Q

What psychiatric medication class needs to be discontinued prior to surgery?

A

MAOIs

69
Q

Which patients require DVT prophylaxis for 5 weeks after surgery?

A

Orthopedic surgeries
Abdominal or gynecological surgery for malignancy
History of VTE

70
Q

What CHADS2 score for a fib requires bridging therapy for surgery?

A

> 4

71
Q

What medication can be given for platelet dysfunction due to underlying kidney/liver disease prior to surgery to decrease bleeding?

A

Desmopressin 1 hr prior to surgery

72
Q

Which hormone LH or FSH is responsible for ovulation?

A

LH

73
Q

What vitamin deficiency presents with skin pigmentation cracking and crusting?

A

Niacin

74
Q

What vitamin deficiencies present with glossitis?

A

Niacin folate and vitamin b12

75
Q

What condition should be considered if a person faints while doing upper extremity exercise?

A

Subclavian steal syndrome

76
Q

What is Ramsey hunt syndrome?

A

Zoster infection of the external ear canal of facial nerve. May also have facial paralysis and sensorineural hearing loss

77
Q

What cause of conjunctivitis is associated with giant papillary conjunctivitis with itchy, watery discharge and preauricular LAD?

A

Chlamydial conjunctivitis

Internal Medicine (12 decks)

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