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PANCE > Grab Bag of Fun...not really > Flashcards

Grab Bag of Fun...not really Flashcards

1
Q

Rib notching, “3-sign” of aorta

A

coarctation of aorta

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2
Q

Mittelschmerz

A

= “ovulation pain”

Lower abdominal/pelvic pain during ovulation

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3
Q

Physical symptoms involving more than 1 body part but symptoms are not associated w/ physical cause

A

Somatization disorder

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4
Q

Match the symptom to location of lesion:

  1. Bitemporal heteronymous hemianopsia
  2. Contralateral homonymous hemianopsia
  3. Nasal hemianopsia
  4. Decreased vision in 1 eye
  5. Quadrantopia
A. Lateral to optic chiasm
B. Meyer's loop (lesion in temporal lobe)
C. Optic chiasm
D. Optic nerve or retina 
E. Optic tract/occipital lobe
A

1: C
2: E
3: A
4: D
5: B

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5
Q

Pericardial knock

A

constrictive pericarditis

D/t sudden cesation of ventricular filling by stiff pericardium

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6
Q

Speckled myocardium

A

Restrictive cardiomyopathy

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7
Q

Fat-pad sign in children

A

Supracondylar fracture

Mechanism” fall on outstretched hand (5-10 y/o)

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8
Q

Sail sign in adults

A

= abnormal anterior fat pad
OR posterior fat pad
–> Radial head fracture

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9
Q

MC complication of supracondylar fracture in children

A

Median nerve –> can’t abduct and oppose thumb

Brachial artery –> Volkmann’s ischemic contracture

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10
Q

Lateral epicondylitis = inflammation of tendon insertion of ____ d/t repetitive ___

A

Extensor carpi radialis brevis

Wrist extension

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11
Q

Ocular weakness and generalized weakness worse w/ repeated use of muscle

A

Myasthenia gravis

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12
Q

75% of pts w/ MS have ___

A

thymus gland abnormality (thymoma, hyperplasia)

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13
Q

Lambert-Eaton myasthenic syndrome is associated with ___.
Pathophysiology:
Symptoms:

A

Small cell lung cancer paraneoplastic syndrome
Auto anti-bodies that prevent PRE-synaptic release of acetylchoine
Weakness that IMPROVES with repeated use, abnormal DTR

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14
Q

Auto anti-bodies that prevent PRE-synaptic release of acetylchoine

A

Lambert-Eaton Myasthenic Syndrome

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15
Q

Auto antibodies against POST-synaptic acetylcholine receptors

A

Myasthenia gravis

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16
Q

Pancoast syndrome is associated with ___.

Symptoms:

A

Non small cell lung cancer

Miosis on side of tumor

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17
Q

Lichen planus described as ___

A

5 Ps: purple, polygonal, planar (plaques), pruitic, papular w/ fine scales

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18
Q

Intertrigo seen in ___

Described as ___

A

Pts w/ candida infection

Beefy red rash w/ scalloped borders in moist dark areas

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19
Q

Candida esophagitis
Upper endoscopy shows ___
Microscopy ___
1st line treatment:

A

Linear lesions **
Budding yeast w/ hyphae on KOH smear
Fluconazole

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20
Q

Match the DM medication w/ its side effect

  1. Lactic acidosis, macrocytic anemia, metallic taste
  2. Hypoglycemia
  3. Hepatitis, GI symptoms
  4. Thirst, abd pain, UTI
  5. Weight gain, cardiac dysrhythmia, hypoglycemia, GI upset, disulfuram reaction
A. Canogliflozin
B. Meglitinide
C. Acarbose
D. Metformin
E. Glyburide
A

1:D Metformin = Biguanide –> decreased hepatic glucose production
2: B Meglitinide –> Stimulate pancreatic beta cell insulin release
3: C Acarbose = alpha-glucosidase inhibitors –> delay intestinal glucose absorption
4 : A Canogliflozin = SGLT-2 inhibitor –> increase urinary glucose excretion
5 : E Glyburide = Sulfonylureas –> Stimulate pancreatic beta cell insulin release (non-glucose dependent)

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21
Q

Nephrotic syndrome = (3)

1st line tx:

A

Edema, proteinuria, hyperlipidemia

Prednisone –> Cyclophosphamide if resistant

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22
Q

Excess Acetylcholine causes:

A

“SLUDD-C”

Salivation, Lacrimation, Urination, Digestion, Defecation, pupillary Constriction

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23
Q

Chvostek’s sign =
Trousseau’s sign =
Associated w/ ___

A

Chvostek’s sign = facial spasms w/ tapping of facial nerve
Trousseau’s sign = carpal spasms w/ BP cuff inflated
Associated w/ HYPOcalcemia, HYPOmagnesemia

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24
Q

Match findings w/ responsible pathogen

  1. Peripheral buffy coat smear shows morulae in WBC
  2. Larvae in striated mm on biopsy
  3. Intracellular RBC parasites on peripheral thin and thick smears
  4. Pathognomic TETRAD INCLUSIONS seen in RBC

A. Malaria
B. Trichinosis
C. Babesiosis
D. Ehrlichiosis

A

1: D
2: B
3: A
4: C

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25
Q

Anti endomysial IgA antibodies:
Anti centromere antibodies:
Anti-Mi-2 antibodies:
Anti double-stranded DNA antibodies:

A

Anti endomysial IgA antibodies: CELIAC DISEASES –> dermatitis herpetiformis (vesicular rash on extensor surfaces, neck, trunk, scalp)
Anti centromere antibodies: SYSTEMIC SCLEROSIS
Anti-Mi-2 antibodies: DERMATOMYOSITIS –> malar rash that does NOT spare nasolabial folds
Anti double-stranded DNA antibodies: SLE –> malar rash SPARING nasolabial folds

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26
Q

Pneumomediastinum seen in ___

A

Boerhaave’s syndrome = esophageal rupture

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27
Q

Best at increasing HDL:
Best at lowering triglyceride levels:
Best at lowering LDL levels:

A

Best at increasing HDL: nicotinic acid (niacin)
Best at lowering triglyceride levels: Fenofibrate
Best at lowering LDL levels: Simvastatin (HMG-CoA reductase inhibitor)

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28
Q

Match the virus w/ its association

  1. Hantavirus
  2. Flavivirus
  3. Coronavirus
  4. Orthopox virus
  5. Rhabdovirus
A. Smallpox
B. Dengue fever
C. Severe Acute Respiratory Syndrome (SARS)
D. Rodent vector
E. Rabies
A

1: D Southwest US, Prodromal febrile phase (severe mylagias) –> severe cardiopulmonary phase, renal failure
2: B
3: C
4: A
5: E

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29
Q

Severe abdominal pain, painful uterine contractions and rigid uterus

A

Abruptio placentae = premature separation of placenta from uterine wall, MC in 3rd trimester

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30
Q

Anti-mitochondrial antibodies:

Anti-smooth muscle antibodies:

A

Anti-mitochondrial antibodies: Primary biliary cirrhosis

Anti-smooth muscle antibodies: Autoimmune hepatitis

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31
Q

Primary sclerosing cholangitis associated with ___, + ____ antibodies.

A

Inflammatory bowel disease (ulcerative colitis)

Perinuclear anti-neutrophil cytoplasmic antibodies (P-ANCA)

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32
Q

Most important prognostic factor of malignant melanoma

A

thickness of lesion

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33
Q

Matching:

  1. Low Hgb A, MUCH higher Hgb F, high Hgb A2
  2. 1 Hgb A: 1 Hgb F: 1 Hgb A2
  3. Low Hgb A, high Hgb F, high Hgb A2
  4. Hemoglobin S
  5. High % of homozygous S, increased Hgb F, no Hgb A
A. Sickle cell anemia
B. Beta thalassemia minor
C. Beta thalassemia major
D. Alpha thalassemia major
E. Sickle cell trait
A

1: C
2: D b/c all have alpha chains
3: B
4: E
5: A

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34
Q

Hemoglobin A = ___ + ____ chains
Hemoglobin F = ___ + ____ chains
Hemoglobin A2 = ___ + ____ chains

A

Hemoglobin A = 2 alpha + 2 beta chains
Hemoglobin F = 2 alpha + 2 gamma chains
Hemoglobin A2 = 2 alpha + 2 delta chains

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35
Q

Lhermitte’s sign =

Associated w/ ___

A

= electrical sensation that runs down the back and into the limbs
Associated w/ Multiple Sclerosis

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36
Q

Lack of tapering enlarged bronchi and bronchial wall thickening
___ appearance on imaging

A

Bronchiectasis

“tram-track”

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37
Q

Rapid fluid correction of HYPOnatremia causes ___

Rapid fluid correction of HYPERnatremia causes ___

A

Rapid fluid correction of hyponatremia causes CENTRAL PONINE MYELINOLYSIS
Rapid fluid correction of hypernatremia causes CEREBRAL EDEMA

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38
Q

McMurray’s test:
Ober test:
Lachman’s test:
Inability to raise straightened leg against gravity:

A

McMurray’s test: Meniscal tear
Ober test: Iliotibial band syndrome
Lachman’s test: ACL tear
Inability to raise straightened leg against gravity: Patellar tendon rupture

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39
Q

Wide QRS complex w/ broad slurred R wave in V5 and V6 w/ deep S wave in V1

A

LBBB

40
Q

MC cause of bacterial meningitis in pts < 18 y/o

Tx of choice:

A

Neisseria meningitidis

Tx: IV Penicillin G

41
Q

Boas sign =

A

Referred right shoulder pain

Seen in acute cholecystitis

42
Q

Kerr’s sign =

A

Left shoulder pain d/t irritation of phrenic nerve

Seen in splenic bleeding

43
Q

Courvoisier’s sign =

A

palpable non tender, distended gallbladder

Seen in pancreatic cancer

44
Q

Dance’s sign =

A

mass in RUQ/epigastrium w/ absence bowel in RLQ

Seen in intussusception

45
Q

Idiopathic Thrombocytopenic Purpura treatment in children:

in adults:

A

Children: IV Immunoglobulin
Adults: Corticosteroids

46
Q

Triple therapy of H. pylori peptic ulcer disease

A

PPI + amoxicillin 500 mg + clarithromycin 500 mg

47
Q

MC indication for hysterectomy

A

Leiomyomas (uterine fibroids)

48
Q

Name the type of kidney injury:

  1. White blood cell casts
  2. Epithelial cell casts/muddy brown casts
  3. RBC casts, dysmorphic red blood cells
A
  1. Acute interstitial nephritis
  2. Acute tubular necrosis
  3. Acute glomerulonephritis
49
Q

Vesicles on the tip of the nose, or vesicles on the side of the nose = ___ sign
Associated w/ ___

A

Hutchinson’s sign

Herpes simplex Keratitis

50
Q
  1. Triad of symptoms seen in Multiple Sclerosis =
  2. Med that decreases progression of relapsing-remitting form of disease =
  3. Med to treat acute exacerbation of MS =
  4. Med to help w/ fatigue symptoms of MS =
A
  1. Nystagmus, staccato speech, intentional tremor
  2. Glatiramer acetate or beta interferon
  3. High dose corticosteroids (2nd line = plasma exchange therapy)
  4. Amantadine
51
Q

MC cause of septic arthritis

A

Staphylococcus aureus

52
Q 
\+ Nikolysky sign =
Seen in all EXCEPT:
A. Toxic epidermal necrolysis
B. Bullous pemphigoid
C. Steven johnson syndrome
D. Pemphigus vulgaris
E. Staphylococcal scalded skin syndrome
A

= sloughing off of epidermis w/ slight pressure applied to skin
B. Bullous pemphigoid = chronic widespread autoimmune blistering skin disease seen in elderly

53
Q

Clozapine SE:

A

Agranulocytosis

Myocarditis

54
Q
  1. Pasturella multocida seen in ___

2. Bartonella henselae seen in ___

A
  1. Cat bite. Tx w/ Augmentin

2. Cat scratch disease

55
Q

Cold agglutinin test used to detect ___ (3)

A

Mycoplasma pneumonia
Infectious mononucleosis
Autoimmune hemolytic anemia

56
Q

____ should be used at least 2 weeks prior to surgery in PHEOCHROMOCYTOMA to prevent hypertension crisis during surgical removal of tumor.

A

Nonselective alpha-blocker (phenoxybenzamine, phentolamine)

57
Q

Name the cause of the following fundoscopic exam:

  1. Blurring optic disc and cup
  2. Venous compresion at artery-venous junction
  3. Yellow spots w/ sharp margins that are circinate
  4. Fluffy gray-white spots on retina (cotton-wool spots)
A
  1. = Papilledema –> malignant HTN
  2. = AV nicking–> Stage II and above HTN
  3. = Hard exudates –> Diabetic retinopathy
  4. = Soft exudates –> Stage III HTN
58
Q

Amenorrhea, hirsutism, obesity = Triad associated w/ ___

Tx:

A

Polycystic Ovarian Syndrome (PCOS) –> elevated FSH:LH ratio, insulin resistance, increased androgen levels

Tx: Combination oral contraception

59
Q

Gingival hyperlasia is a SE seen in ___

A

phenytoin

60
Q

Gottron’s papules =

Pathognomonic for ____

A

= raised, violaceous eruptions on knuckles

Dermatomyositis

61
Q

Purple, heliotrope rash around eyelids is pathognomonic for ___

A

Dermatomyositis

62
Q

Presence of bullae and sloughing off of epidermis =

Associated w/ (2)

A

Koebner’s phenomenon

Psoriasis
Pemphigus vulgaris

63
Q

Tx of nephrogenic diabetes insipidus

A

Indomethacin

64
Q

Match the pathophysiology w/ the disorder:

  1. Ab against ADAMTS 13 –> Von Willebrand multimers causing platelet activation
  2. Auto-ab against glycoprotein IIb/IIIa receptor on platelets following viral infection –> platelet destruction by spleen, isolated thrombocytopenia
  3. Pathologic activation of coagulation system causing microthrombi and subsequent thrombocytopenia
  4. Platelet activation by exotoxins

A. Hemolytic Uremic Syndrome
B. Disseminated Intravascular Coagulation
C. Idiopathic Thrombocytopenic Purpura
D. Thrombotic Thrombocytopenic Purpura

A

1: D
2: C
3: B
4: A

65
Q

Virus that can precipitate aplastic crisis in sickle cell disease

A

Parvovirus B-19

66
Q

1st line treatment of Malaria

A

Chloroquine

If resistance: Atovaquone + Doxycycline or clindamycin

67
Q

S/E of spironolactone (good and bad)

A

causes gynecomastia
can help acne
decreases hirsutism (like in PCOS)

68
Q

cause of guillain barre syndrome

A

Campylobacter - infection with nausea and vomiting. gram negative comma or S shaped rods

69
Q

Difference between PMS and Premenstrual Dysphoric disorder

A

Severe Functional impairment (missing school, can’t work, etc…)

70
Q

what is given with isoniazid (TB treatment) to prevent neurologic symptoms (peripheral neuropathy, parasthesias)?

A

Pyridoxine, B6

71
Q

Candidal esophagitis: what is the first line treatment?

A

Fluconazole

72
Q

Can chvostek’s and trousseau sign be seen with hypomagnesia?

A

Yes! Its still caused by hypocalcemia but hypocalcemia is often seen with hypomagnesia

73
Q

Where is ehrlichiosis seen?

Babesiosis?

A

E: Morulae in WBC
B: tetrad in RBC is pathognomonic

74
Q

Looser zones seen in ____

A

Osteomalacia d/t Vit D deficiency

= associated w/ demineralization of bone

75
Q

Kaposi sarcoma caused by ____

Seen in ___

A

Human herpes virus 8

HIV pts and other immunosuppressive d/o

76
Q

Dendritic leisons on slit lamp indicates ___

Tx:

A

herpes ophthalmic keratitis

Tx: trifluridine ophthalmic drops and acyclovir orally

77
Q

Red Man Syndrome

occurs when ___

A

= histamine-induced flushing

Rapid IV administration of VANCOMYCIN

78
Q 
Corynebacterium diphtheria 
Gram \_\_\_\_
Transmitted by \_\_\_\_
Presents classically as \_\_\_\_
Tx \_\_\_\_
A

Gram + rod
Inhalation of respiratory secretions

  • Pseudomembranes (gray/white membranes on posterior pharynx that bleeds when scraped off)
  • Bull neck d/t enlarged cervical lymphadenopathy
  • Myocarditis

Tx: Diphtheria antitoxin + PCN/erythromycin x 2 weeks

79
Q

MC thyroid malignancy

A

papillary thyroid carcinoma (80%)

80
Q

1st generation antipsychotics (Haloperidol) work by ____

May cause ____

A

blocking CNS dopamine receptors

–> increased prolactin levels d/t lack of dopamine inhibition of prolactin–> galactorrhea, decreased libido, amenorrhea

81
Q

____ should be suspected in pts w/ microcytic anemia w/ normal serum iron

Dx with ___

A

Thalassemia

Hemoglobin electrophoresis

82
Q

Organophosphate poisoning is caused by ____

Tx:

A

Acetylcholinesterase inhibition –> HA, mm spasms, convulsions, diffuse wheezing, increased sweating, lacrimation

Atropine (anticholinergic) + Pralidoxime (increases acetylcholine breakdown)

83
Q

MC cause of myocarditis

A

Enterovirus (echovirus, Coxsackie viruses)

84
Q

Neurogenic shock presents with (hyper/hypo)tension with (tachy/brady)cardia, (increased/decreased) pulmonary capillary wedge pressure.

A

Hypotension w/ bradycardia ***

Decreased pulmonary capillary wedge pressure

85
Q 
Moderate persistent asthma defined as: 
Frequency of symptoms
Frequency of use of short term beta 2 agonists
Frequency of nighttime awakening
Forced expiratory volume
A

Daily symptoms
Daily use of short term beta 2 agonists
Nighttime awakening > 1 x week
Forced expiratory volume 60-80%

86
Q 
Mild persistent asthma defined as: 
Frequency of symptoms
Frequency of use of short term beta 2 agonists
Frequency of nighttime awakening
Forced expiratory volume
A

> 2 days /week of symptoms
2 days/week of beta 2 agonist use
Nighttime awakening 3-4 x/month
FEV > 80%

87
Q 
Severe persistent asthma defined as: 
Frequency of symptoms
Frequency of use of short term beta 2 agonists
Frequency of nighttime awakening
Forced expiratory volume
A

Symptoms throughout the day
Several times a day of beta 2 agonist
Nightly awakening
FEV <60%

88
Q

Multiple Myeloma
Caused by:
Hallmark manifestations: (5)
Dx:

A

Malignancy of single clone of plasma cells –> increase in monoclonal ab production

Bone pain, anemia, recurrent infections, renal failure, hypercalcemia
-“punched out” lesions of skull

Kappa or lambda light chain proteins on urine electrophoresis

89
Q

Hemolytic anemia, venous thrombosis of large vessels, pancytopenia = hallmark of ____

A

Paroxysmal nocturnal hemoglobinuria

90
Q

Tx of Hyperosmolar hyperglycemic syndrome (HHS)

A

IV 0.9% NaCl solution –> promote renal excretion of glucose, reduce serum osmolarity, restore hydration

IV insulin p saline therapy is initiated

91
Q

What kind of breathing?
Quick, shallow breaths of equal depth w/ irregular periods of apnea

Seen in ___

A

Biot’s breathing

Seen in opioid-induced respiratory depression

92
Q

What kind of breathing?

  • Periods of deep breathing alternating w/ periods of apnea
  • Smooth increases in rate of breathing w/ smooth gradual decrease in rate of breathing

Seen in ____

A

Cheyne-Stokes

HF, uremia, brain damage, respiratory depression

93
Q

What kind of breathing?
Deep rapid continuous respiration

Seen in ____

A

Kussmaul’s respiration

Metabolic acidosis

94
Q

MC chronic manifestation of Q fever

A

Culture negative endocarditis

95
Q

Hallmark of Wegener’s granulomatosis (3)

+ for ___ antibodies

A

Necrotic sinusitis
Lower respiratory tract involvement
Rapidly progressing glomerulonephritis

C-ANCA

96
Q

1st line treatment of Heparin Induced Thrombocytopenia

Long term management:

A

Direct thrombin inhibitor: argatroban, bivalirudin

Long term management: Warfarin

97
Q

Preferred method of evaluating severity of proteinuria

A

spot urine albumin: creatinine ratio

PANCE (20 decks)

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