Getting closer... Flashcards
What is a common side effect of electroconvulsive therapy?
Amnesia (retrograde lasts longer than anterograde)
What is another name for Osgood-Schlatters Disease?
Traction apophysitis
What is the name of the disease that phagocytes cannot kill bacteria?
Chronic granulomatous disease
What is a cause of SCID?
Adenosine Deaminase Deficiency (auto recessive)
Funduscopic exam shows cupping of the optic disc. What is this?
Open-angle glaucoma
Are antibiotics required for all spontaneous abortions?
No…prophylactic for D&E and for septic abortion
What are the dietary recommendations for patients with multiple kidney stone episodes?
Low protein and oxalate
Low sodium
High fluids
High calcium
What should be checked when the initial diagnosis of HTN is made?
UA for occult hematuria and urine protein/creatinine ratio
CMP
Lipids
Baseline ECG
An infection in which neck space is most likely to spread to the mediastinum?
Retropharyngeal
What is the best initial therapy for febrile neutropenia?
Anti-pseudomonal beta-lactam agent (cefepime, meropenem, or piperacillin-tazobactam)
Kid has dextrocardia, recurrent sinusitis, and recurrent bronchiectasis. What is this? What can happen with males with this syndrome?
Kartagener Syndrome
An adult has persistent, high-spiking fevers, joint pain, and a salmon-colored rash. What should be considered?
Adult onset Still’s Disease
What is seen with type I glycogen storage disease (Glucose-6 phosphate deficiency…Von-Gierkes’)?
Hypoglycemia, lactic acidosis, hyperlipidemia, and hyperuricemia
Doll face, thin arms, short stature, protuberant belly (hepatomegaly and enlarged kidneys)
No splenomegaly and normal heart
What is seen with type III glycogen storage disease (debranching enzyme deficiency)?
Hypoglycemia, hyperlipidemia, elevated transaminases, fasting ketosis, and normal lactate and uric acid concentrations
Hepatomegaly, short stature, normal kidneys
Splenomegaly
A young kid (less than 3yo) has an abdominal mass that crosses midline and has systemic symptoms. What should be considered?
Neuroblastoma (third most common overall childhood cancer behind leukemia and brain tumors…most common in less than 1yo)
What does a SAAG >1.1 mean? Less than 1.1?
Greater = ascites is due to portal hypertension
Lesser = something other than portal hypertension
What can cause hypocalcemia after a transfusion?
Excess citrate –> calcium chelation
An Asian has a hypopigmented area that lacks sensation + muscle atrophy in muscles proximal to this area. What should be considered? What should be done?
Leprosy (Mycobacterium leprae)
Skin biopsy…look for acid-fast bacilli
Patient comes back from a cruise with respiratory and GI symptoms (and possibly neurological symptoms). What should be considered? How can it be diagnosed? What should be given?
Legionella
Urine antigen test
Fluoroquinolone or macrolide
Patient has a flat upper and lower flow/volume curve. What is going on?
Fixed upper-airway obstruction
A patient has endocarditis, and cultures grow strep gallolyticus. What should be checked?
Colonoscopy…increased risk of CRC
A patient with prolonged hypotension has bad renal panel. What is likely going on? What can be seen on microscopy?
ATN
Muddy brown casts
Which optical tumor is associated with NF1?
Optic glioma
Kid has many episodes of lymphadenopathy…sometimes diagnosed with aspergillosis, serratia marcescens, and/or Burkholderia cepacia. What should be expected? How can it be diagnosed?
Chronic granulomatous disease (resistant to coagulase + organisms)…prevent with daily TMP-SMX and gamma interferon 3x per week
Nitroblue tetrazolium
An older woman has an erythematous rash, violaceous periorbital edema, and proximal extensor muscle weakness. What does she have? What is she at increased risk of?
Dermatomyositis
Internal malignancy
How is diabetic neuropathy treated?
TCA
A person has a single episode of depression. How long should treatment last?
6months after patient’s response
How does CMV retinitis present?
Retinal opacification and hemorrhages
What causes non-pitting edema with Turner syndrome?
Dysgenesis of lymphatic network
What causes irregular menses in girls in first year or so after menarche?
Insufficient gonadotropin secretion
A 2-5 day old newborn gets conjunctivitis with eyelid swelling and purulent discharge. What is the likely cause? How should it be treated? What could have been done to prevent it?
Gonococcal conjunctivitis (ophthalmia neonatorum)
IV or IM ceftriaxone or cefotaxime
Erythromycin ointment shortly after birth
A 5-14 day old new born gets conjunctivitis with eyelid swelling and water or mucopurulent discharge (+/- blood). What is the likely cause and what else can it cause in the newborn? How should it be treated? How could it have been prevented?
Chlamydial conjunctivitis…pneumonia at 4-12 weeks old
Oral erythromycin…worry about hypertrophic pylorus
Screening and treating mom (1st trimester and 3rd in high risk)
What is interstitial cystitis?
Think fibromyalgia of the bladder…
A female transplant patient has facial hair, tremors, swollen gums, and bad renal panel. What med is likely causing this? What else can this drug cause?
Cyclosporine
Malignancy…squamous cell carcinoma and lymphoproliferative diseases
A patient has a medication or drug overdose and has symptoms of being drunk…but isn’t. What is the likely toxicity?
Benzodiazepine
How does lithium toxicity present?
Tremor, hyperreflexia, ataxia, and seizures
When should tetanus Ig be given in addition to the vaccine? When should the vaccine be given alone?
Dirty or severe wounds in people who are un/under-immunized or have an unknown immunization record
Clean or minor wounds when last immunization was more than 10yrs ago or if immunizations unknown; OR
Dirty or severe wounds when last immunization was more than 5yrs ago
