Grab Bag of Fun...not really Flashcards
1
Q
Rib notching, “3-sign” of aorta
A
coarctation of aorta
2
Q
Mittelschmerz
A
= “ovulation pain”
Lower abdominal/pelvic pain during ovulation
3
Q
Physical symptoms involving more than 1 body part but symptoms are not associated w/ physical cause
A
Somatization disorder
4
Q
Match the symptom to location of lesion:
- Bitemporal heteronymous hemianopsia
- Contralateral homonymous hemianopsia
- Nasal hemianopsia
- Decreased vision in 1 eye
- 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
5
Q
Pericardial knock
A
constrictive pericarditis
D/t sudden cesation of ventricular filling by stiff pericardium
6
Q
Speckled myocardium
A
Restrictive cardiomyopathy
7
Q
Fat-pad sign in children
A
Supracondylar fracture
Mechanism” fall on outstretched hand (5-10 y/o)
8
Q
Sail sign in adults
A
= abnormal anterior fat pad
OR posterior fat pad
–> Radial head fracture
9
Q
MC complication of supracondylar fracture in children
A
Median nerve –> can’t abduct and oppose thumb
Brachial artery –> Volkmann’s ischemic contracture
10
Q
Lateral epicondylitis = inflammation of tendon insertion of ____ d/t repetitive ___
A
Extensor carpi radialis brevis
Wrist extension
11
Q
Ocular weakness and generalized weakness worse w/ repeated use of muscle
A
Myasthenia gravis
12
Q
75% of pts w/ MS have ___
A
thymus gland abnormality (thymoma, hyperplasia)
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
14
Q
Auto anti-bodies that prevent PRE-synaptic release of acetylchoine
A
Lambert-Eaton Myasthenic Syndrome
15
Q
Auto antibodies against POST-synaptic acetylcholine receptors
A
Myasthenia gravis
16
Q
Pancoast syndrome is associated with ___.
Symptoms:
A
Non small cell lung cancer
Miosis on side of tumor
17
Q
Lichen planus described as ___
A
5 Ps: purple, polygonal, planar (plaques), pruitic, papular w/ fine scales
18
Q
Intertrigo seen in ___
Described as ___
A
Pts w/ candida infection
Beefy red rash w/ scalloped borders in moist dark areas
19
Q
Candida esophagitis
Upper endoscopy shows ___
Microscopy ___
1st line treatment:
A
Linear lesions **
Budding yeast w/ hyphae on KOH smear
Fluconazole
20
Q
Match the DM medication w/ its side effect
- Lactic acidosis, macrocytic anemia, metallic taste
- Hypoglycemia
- Hepatitis, GI symptoms
- Thirst, abd pain, UTI
- 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)
21
Q
Nephrotic syndrome = (3)
1st line tx:
A
Edema, proteinuria, hyperlipidemia
Prednisone –> Cyclophosphamide if resistant
22
Q
Excess Acetylcholine causes:
A
“SLUDD-C”
Salivation, Lacrimation, Urination, Digestion, Defecation, pupillary Constriction
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
24
Q
Match findings w/ responsible pathogen
- Peripheral buffy coat smear shows morulae in WBC
- Larvae in striated mm on biopsy
- Intracellular RBC parasites on peripheral thin and thick smears
- Pathognomic TETRAD INCLUSIONS seen in RBC
A. Malaria
B. Trichinosis
C. Babesiosis
D. Ehrlichiosis
A
1: D
2: B
3: A
4: C
25
Anti endomysial IgA antibodies:
Anti centromere antibodies:
Anti-Mi-2 antibodies:
Anti double-stranded DNA antibodies:
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
26
Pneumomediastinum seen in ___
Boerhaave's syndrome = esophageal rupture
27
Best at increasing HDL:
Best at lowering triglyceride levels:
Best at lowering LDL levels:
Best at increasing HDL: nicotinic acid (niacin)
Best at lowering triglyceride levels: Fenofibrate
Best at lowering LDL levels: Simvastatin (HMG-CoA reductase inhibitor)
28
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
```
1: D Southwest US, Prodromal febrile phase (severe mylagias) --> severe cardiopulmonary phase, renal failure
2: B
3: C
4: A
5: E
29
Severe abdominal pain, painful uterine contractions and rigid uterus
Abruptio placentae = premature separation of placenta from uterine wall, MC in 3rd trimester
30
Anti-mitochondrial antibodies:
| Anti-smooth muscle antibodies:
Anti-mitochondrial antibodies: Primary biliary cirrhosis
| Anti-smooth muscle antibodies: Autoimmune hepatitis
31
Primary sclerosing cholangitis associated with ___, + ____ antibodies.
Inflammatory bowel disease (ulcerative colitis)
| Perinuclear anti-neutrophil cytoplasmic antibodies (P-ANCA)
32
Most important prognostic factor of malignant melanoma
thickness of lesion
33
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
```
1: C
2: D b/c all have alpha chains
3: B
4: E
5: A
34
Hemoglobin A = ___ + ____ chains
Hemoglobin F = ___ + ____ chains
Hemoglobin A2 = ___ + ____ chains
Hemoglobin A = 2 alpha + 2 beta chains
Hemoglobin F = 2 alpha + 2 gamma chains
Hemoglobin A2 = 2 alpha + 2 delta chains
35
Lhermitte's sign =
| Associated w/ ___
= electrical sensation that runs down the back and into the limbs
Associated w/ Multiple Sclerosis
36
Lack of tapering enlarged bronchi and bronchial wall thickening
___ appearance on imaging
Bronchiectasis
| "tram-track"
37
Rapid fluid correction of HYPOnatremia causes ___
| Rapid fluid correction of HYPERnatremia causes ___
Rapid fluid correction of hyponatremia causes CENTRAL PONINE MYELINOLYSIS
Rapid fluid correction of hypernatremia causes CEREBRAL EDEMA
38
McMurray's test:
Ober test:
Lachman's test:
Inability to raise straightened leg against gravity:
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
39
Wide QRS complex w/ broad slurred R wave in V5 and V6 w/ deep S wave in V1
LBBB
40
MC cause of bacterial meningitis in pts < 18 y/o
| Tx of choice:
Neisseria meningitidis
| Tx: IV Penicillin G
41
Boas sign =
Referred right shoulder pain
| Seen in acute cholecystitis
42
Kerr's sign =
Left shoulder pain d/t irritation of phrenic nerve
| Seen in splenic bleeding
43
Courvoisier's sign =
palpable non tender, distended gallbladder
| Seen in pancreatic cancer
44
Dance's sign =
mass in RUQ/epigastrium w/ absence bowel in RLQ
| Seen in intussusception
45
Idiopathic Thrombocytopenic Purpura treatment in children:
| in adults:
Children: IV Immunoglobulin
Adults: Corticosteroids
46
Triple therapy of H. pylori peptic ulcer disease
PPI + amoxicillin 500 mg + clarithromycin 500 mg
47
MC indication for hysterectomy
Leiomyomas (uterine fibroids)
48
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
1. Acute interstitial nephritis
2. Acute tubular necrosis
3. Acute glomerulonephritis
49
Vesicles on the tip of the nose, or vesicles on the side of the nose = ___ sign
Associated w/ ___
Hutchinson's sign
| Herpes simplex Keratitis
50
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 =
1. Nystagmus, staccato speech, intentional tremor
2. Glatiramer acetate or beta interferon
3. High dose corticosteroids (2nd line = plasma exchange therapy)
4. Amantadine
51
MC cause of septic arthritis
Staphylococcus aureus
52
```
+ 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
```
= sloughing off of epidermis w/ slight pressure applied to skin
B. Bullous pemphigoid = chronic widespread autoimmune blistering skin disease seen in elderly
53
Clozapine SE:
Agranulocytosis
| Myocarditis
54
1. Pasturella multocida seen in ___
| 2. Bartonella henselae seen in ___
1. Cat bite. Tx w/ Augmentin
| 2. Cat scratch disease
55
Cold agglutinin test used to detect ___ (3)
Mycoplasma pneumonia
Infectious mononucleosis
Autoimmune hemolytic anemia
56
____ should be used at least 2 weeks prior to surgery in PHEOCHROMOCYTOMA to prevent hypertension crisis during surgical removal of tumor.
Nonselective alpha-blocker (phenoxybenzamine, phentolamine)
57
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)
1. = Papilledema --> malignant HTN
2. = AV nicking--> Stage II and above HTN
3. = Hard exudates --> Diabetic retinopathy
4. = Soft exudates --> Stage III HTN
58
Amenorrhea, hirsutism, obesity = Triad associated w/ ___
| Tx:
Polycystic Ovarian Syndrome (PCOS) --> elevated FSH:LH ratio, insulin resistance, increased androgen levels
Tx: Combination oral contraception
59
Gingival hyperlasia is a SE seen in ___
phenytoin
60
Gottron's papules =
| Pathognomonic for ____
= raised, violaceous eruptions on knuckles
| Dermatomyositis
61
Purple, heliotrope rash around eyelids is pathognomonic for ___
Dermatomyositis
62
Presence of bullae and sloughing off of epidermis =
| Associated w/ (2)
Koebner's phenomenon
Psoriasis
Pemphigus vulgaris
63
Tx of nephrogenic diabetes insipidus
Indomethacin
64
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
1: D
2: C
3: B
4: A
65
Virus that can precipitate aplastic crisis in sickle cell disease
Parvovirus B-19
66
1st line treatment of Malaria
Chloroquine
| If resistance: Atovaquone + Doxycycline or clindamycin
67
S/E of spironolactone (good and bad)
causes gynecomastia
can help acne
decreases hirsutism (like in PCOS)
68
cause of guillain barre syndrome
Campylobacter - infection with nausea and vomiting. gram negative comma or S shaped rods
69
Difference between PMS and Premenstrual Dysphoric disorder
Severe Functional impairment (missing school, can't work, etc...)
70
what is given with isoniazid (TB treatment) to prevent neurologic symptoms (peripheral neuropathy, parasthesias)?
Pyridoxine, B6
71
Candidal esophagitis: what is the first line treatment?
Fluconazole
72
Can chvostek's and trousseau sign be seen with hypomagnesia?
Yes! Its still caused by hypocalcemia but hypocalcemia is often seen with hypomagnesia
73
Where is ehrlichiosis seen?
| Babesiosis?
E: Morulae in WBC
B: tetrad in RBC is pathognomonic
74
Looser zones seen in ____
Osteomalacia d/t Vit D deficiency
= associated w/ demineralization of bone
75
Kaposi sarcoma caused by ____
| Seen in ___
Human herpes virus 8
| HIV pts and other immunosuppressive d/o
76
Dendritic leisons on slit lamp indicates ___
Tx:
herpes ophthalmic keratitis
Tx: trifluridine ophthalmic drops and acyclovir orally
77
Red Man Syndrome
occurs when ___
= histamine-induced flushing
Rapid IV administration of VANCOMYCIN
78
```
Corynebacterium diphtheria
Gram ____
Transmitted by ____
Presents classically as ____
Tx ____
```
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
MC thyroid malignancy
papillary thyroid carcinoma (80%)
80
1st generation antipsychotics (Haloperidol) work by ____
May cause ____
blocking CNS dopamine receptors
--> increased prolactin levels d/t lack of dopamine inhibition of prolactin--> galactorrhea, decreased libido, amenorrhea
81
____ should be suspected in pts w/ microcytic anemia w/ normal serum iron
Dx with ___
Thalassemia
Hemoglobin electrophoresis
82
Organophosphate poisoning is caused by ____
Tx:
Acetylcholinesterase inhibition --> HA, mm spasms, convulsions, diffuse wheezing, increased sweating, lacrimation
Atropine (anticholinergic) + Pralidoxime (increases acetylcholine breakdown)
83
MC cause of myocarditis
Enterovirus (echovirus, Coxsackie viruses)
84
Neurogenic shock presents with (hyper/hypo)tension with (tachy/brady)cardia, (increased/decreased) pulmonary capillary wedge pressure.
Hypotension w/ bradycardia ***
| Decreased pulmonary capillary wedge pressure
85
```
Moderate persistent asthma defined as:
Frequency of symptoms
Frequency of use of short term beta 2 agonists
Frequency of nighttime awakening
Forced expiratory volume
```
Daily symptoms
Daily use of short term beta 2 agonists
Nighttime awakening > 1 x week
Forced expiratory volume 60-80%
86
```
Mild persistent asthma defined as:
Frequency of symptoms
Frequency of use of short term beta 2 agonists
Frequency of nighttime awakening
Forced expiratory volume
```
>2 days /week of symptoms
>2 days/week of beta 2 agonist use
Nighttime awakening 3-4 x/month
FEV > 80%
87
```
Severe persistent asthma defined as:
Frequency of symptoms
Frequency of use of short term beta 2 agonists
Frequency of nighttime awakening
Forced expiratory volume
```
Symptoms throughout the day
Several times a day of beta 2 agonist
Nightly awakening
FEV <60%
88
Multiple Myeloma
Caused by:
Hallmark manifestations: (5)
Dx:
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
Hemolytic anemia, venous thrombosis of large vessels, pancytopenia = hallmark of ____
Paroxysmal nocturnal hemoglobinuria
90
Tx of Hyperosmolar hyperglycemic syndrome (HHS)
IV 0.9% NaCl solution --> promote renal excretion of glucose, reduce serum osmolarity, restore hydration
IV insulin p saline therapy is initiated
91
What kind of breathing?
Quick, shallow breaths of equal depth w/ irregular periods of apnea
Seen in ___
Biot's breathing
Seen in opioid-induced respiratory depression
92
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 ____
Cheyne-Stokes
HF, uremia, brain damage, respiratory depression
93
What kind of breathing?
Deep rapid continuous respiration
Seen in ____
Kussmaul's respiration
Metabolic acidosis
94
MC chronic manifestation of Q fever
Culture negative endocarditis
95
Hallmark of Wegener's granulomatosis (3)
+ for ___ antibodies
Necrotic sinusitis
Lower respiratory tract involvement
Rapidly progressing glomerulonephritis
C-ANCA
96
1st line treatment of Heparin Induced Thrombocytopenia
Long term management:
Direct thrombin inhibitor: argatroban, bivalirudin
Long term management: Warfarin
97
Preferred method of evaluating severity of proteinuria
spot urine albumin: creatinine ratio
