Grab Bag of Fun...not really Flashcards
Rib notching, “3-sign” of aorta
coarctation of aorta
Mittelschmerz
= “ovulation pain”
Lower abdominal/pelvic pain during ovulation
Physical symptoms involving more than 1 body part but symptoms are not associated w/ physical cause
Somatization disorder
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
1: C
2: E
3: A
4: D
5: B
Pericardial knock
constrictive pericarditis
D/t sudden cesation of ventricular filling by stiff pericardium
Speckled myocardium
Restrictive cardiomyopathy
Fat-pad sign in children
Supracondylar fracture
Mechanism” fall on outstretched hand (5-10 y/o)
Sail sign in adults
= abnormal anterior fat pad
OR posterior fat pad
–> Radial head fracture
MC complication of supracondylar fracture in children
Median nerve –> can’t abduct and oppose thumb
Brachial artery –> Volkmann’s ischemic contracture
Lateral epicondylitis = inflammation of tendon insertion of ____ d/t repetitive ___
Extensor carpi radialis brevis
Wrist extension
Ocular weakness and generalized weakness worse w/ repeated use of muscle
Myasthenia gravis
75% of pts w/ MS have ___
thymus gland abnormality (thymoma, hyperplasia)
Lambert-Eaton myasthenic syndrome is associated with ___.
Pathophysiology:
Symptoms:
Small cell lung cancer paraneoplastic syndrome
Auto anti-bodies that prevent PRE-synaptic release of acetylchoine
Weakness that IMPROVES with repeated use, abnormal DTR
Auto anti-bodies that prevent PRE-synaptic release of acetylchoine
Lambert-Eaton Myasthenic Syndrome
Auto antibodies against POST-synaptic acetylcholine receptors
Myasthenia gravis
Pancoast syndrome is associated with ___.
Symptoms:
Non small cell lung cancer
Miosis on side of tumor
Lichen planus described as ___
5 Ps: purple, polygonal, planar (plaques), pruitic, papular w/ fine scales
Intertrigo seen in ___
Described as ___
Pts w/ candida infection
Beefy red rash w/ scalloped borders in moist dark areas
Candida esophagitis
Upper endoscopy shows ___
Microscopy ___
1st line treatment:
Linear lesions **
Budding yeast w/ hyphae on KOH smear
Fluconazole
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
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)
Nephrotic syndrome = (3)
1st line tx:
Edema, proteinuria, hyperlipidemia
Prednisone –> Cyclophosphamide if resistant
Excess Acetylcholine causes:
“SLUDD-C”
Salivation, Lacrimation, Urination, Digestion, Defecation, pupillary Constriction
Chvostek’s sign =
Trousseau’s sign =
Associated w/ ___
Chvostek’s sign = facial spasms w/ tapping of facial nerve
Trousseau’s sign = carpal spasms w/ BP cuff inflated
Associated w/ HYPOcalcemia, HYPOmagnesemia
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
1: D
2: B
3: A
4: C
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
Pneumomediastinum seen in ___
Boerhaave’s syndrome = esophageal rupture
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)
Match the virus w/ its association
- Hantavirus
- Flavivirus
- Coronavirus
- Orthopox virus
- 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
Severe abdominal pain, painful uterine contractions and rigid uterus
Abruptio placentae = premature separation of placenta from uterine wall, MC in 3rd trimester
Anti-mitochondrial antibodies:
Anti-smooth muscle antibodies:
Anti-mitochondrial antibodies: Primary biliary cirrhosis
Anti-smooth muscle antibodies: Autoimmune hepatitis
Primary sclerosing cholangitis associated with ___, + ____ antibodies.
Inflammatory bowel disease (ulcerative colitis)
Perinuclear anti-neutrophil cytoplasmic antibodies (P-ANCA)
Most important prognostic factor of malignant melanoma
thickness of lesion
Matching:
- Low Hgb A, MUCH higher Hgb F, high Hgb A2
- 1 Hgb A: 1 Hgb F: 1 Hgb A2
- Low Hgb A, high Hgb F, high Hgb A2
- Hemoglobin S
- 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
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
Lhermitte’s sign =
Associated w/ ___
= electrical sensation that runs down the back and into the limbs
Associated w/ Multiple Sclerosis
Lack of tapering enlarged bronchi and bronchial wall thickening
___ appearance on imaging
Bronchiectasis
“tram-track”
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
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
Wide QRS complex w/ broad slurred R wave in V5 and V6 w/ deep S wave in V1
LBBB
MC cause of bacterial meningitis in pts < 18 y/o
Tx of choice:
Neisseria meningitidis
Tx: IV Penicillin G
Boas sign =
Referred right shoulder pain
Seen in acute cholecystitis
Kerr’s sign =
Left shoulder pain d/t irritation of phrenic nerve
Seen in splenic bleeding
Courvoisier’s sign =
palpable non tender, distended gallbladder
Seen in pancreatic cancer
Dance’s sign =
mass in RUQ/epigastrium w/ absence bowel in RLQ
Seen in intussusception
Idiopathic Thrombocytopenic Purpura treatment in children:
in adults:
Children: IV Immunoglobulin
Adults: Corticosteroids
Triple therapy of H. pylori peptic ulcer disease
PPI + amoxicillin 500 mg + clarithromycin 500 mg
MC indication for hysterectomy
Leiomyomas (uterine fibroids)
Name the type of kidney injury:
- White blood cell casts
- Epithelial cell casts/muddy brown casts
- RBC casts, dysmorphic red blood cells
- Acute interstitial nephritis
- Acute tubular necrosis
- Acute glomerulonephritis
Vesicles on the tip of the nose, or vesicles on the side of the nose = ___ sign
Associated w/ ___
Hutchinson’s sign
Herpes simplex Keratitis
- Triad of symptoms seen in Multiple Sclerosis =
- Med that decreases progression of relapsing-remitting form of disease =
- Med to treat acute exacerbation of MS =
- Med to help w/ fatigue symptoms of MS =
- Nystagmus, staccato speech, intentional tremor
- Glatiramer acetate or beta interferon
- High dose corticosteroids (2nd line = plasma exchange therapy)
- Amantadine
MC cause of septic arthritis
Staphylococcus aureus
\+ 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
Clozapine SE:
Agranulocytosis
Myocarditis
- Pasturella multocida seen in ___
2. Bartonella henselae seen in ___
- Cat bite. Tx w/ Augmentin
2. Cat scratch disease
Cold agglutinin test used to detect ___ (3)
Mycoplasma pneumonia
Infectious mononucleosis
Autoimmune hemolytic anemia
____ 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)
Name the cause of the following fundoscopic exam:
- Blurring optic disc and cup
- Venous compresion at artery-venous junction
- Yellow spots w/ sharp margins that are circinate
- Fluffy gray-white spots on retina (cotton-wool spots)
- = Papilledema –> malignant HTN
- = AV nicking–> Stage II and above HTN
- = Hard exudates –> Diabetic retinopathy
- = Soft exudates –> Stage III HTN
Amenorrhea, hirsutism, obesity = Triad associated w/ ___
Tx:
Polycystic Ovarian Syndrome (PCOS) –> elevated FSH:LH ratio, insulin resistance, increased androgen levels
Tx: Combination oral contraception
Gingival hyperlasia is a SE seen in ___
phenytoin
Gottron’s papules =
Pathognomonic for ____
= raised, violaceous eruptions on knuckles
Dermatomyositis
Purple, heliotrope rash around eyelids is pathognomonic for ___
Dermatomyositis
Presence of bullae and sloughing off of epidermis =
Associated w/ (2)
Koebner’s phenomenon
Psoriasis
Pemphigus vulgaris
Tx of nephrogenic diabetes insipidus
Indomethacin
Match the pathophysiology w/ the disorder:
- Ab against ADAMTS 13 –> Von Willebrand multimers causing platelet activation
- Auto-ab against glycoprotein IIb/IIIa receptor on platelets following viral infection –> platelet destruction by spleen, isolated thrombocytopenia
- Pathologic activation of coagulation system causing microthrombi and subsequent thrombocytopenia
- 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
Virus that can precipitate aplastic crisis in sickle cell disease
Parvovirus B-19
1st line treatment of Malaria
Chloroquine
If resistance: Atovaquone + Doxycycline or clindamycin
S/E of spironolactone (good and bad)
causes gynecomastia
can help acne
decreases hirsutism (like in PCOS)
cause of guillain barre syndrome
Campylobacter - infection with nausea and vomiting. gram negative comma or S shaped rods
Difference between PMS and Premenstrual Dysphoric disorder
Severe Functional impairment (missing school, can’t work, etc…)
what is given with isoniazid (TB treatment) to prevent neurologic symptoms (peripheral neuropathy, parasthesias)?
Pyridoxine, B6
Candidal esophagitis: what is the first line treatment?
Fluconazole
Can chvostek’s and trousseau sign be seen with hypomagnesia?
Yes! Its still caused by hypocalcemia but hypocalcemia is often seen with hypomagnesia
Where is ehrlichiosis seen?
Babesiosis?
E: Morulae in WBC
B: tetrad in RBC is pathognomonic
Looser zones seen in ____
Osteomalacia d/t Vit D deficiency
= associated w/ demineralization of bone
Kaposi sarcoma caused by ____
Seen in ___
Human herpes virus 8
HIV pts and other immunosuppressive d/o
Dendritic leisons on slit lamp indicates ___
Tx:
herpes ophthalmic keratitis
Tx: trifluridine ophthalmic drops and acyclovir orally
Red Man Syndrome
occurs when ___
= histamine-induced flushing
Rapid IV administration of VANCOMYCIN
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
MC thyroid malignancy
papillary thyroid carcinoma (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
____ should be suspected in pts w/ microcytic anemia w/ normal serum iron
Dx with ___
Thalassemia
Hemoglobin electrophoresis
Organophosphate poisoning is caused by ____
Tx:
Acetylcholinesterase inhibition –> HA, mm spasms, convulsions, diffuse wheezing, increased sweating, lacrimation
Atropine (anticholinergic) + Pralidoxime (increases acetylcholine breakdown)
MC cause of myocarditis
Enterovirus (echovirus, Coxsackie viruses)
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
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%
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%
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%
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
Hemolytic anemia, venous thrombosis of large vessels, pancytopenia = hallmark of ____
Paroxysmal nocturnal hemoglobinuria
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
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
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
What kind of breathing?
Deep rapid continuous respiration
Seen in ____
Kussmaul’s respiration
Metabolic acidosis
MC chronic manifestation of Q fever
Culture negative endocarditis
Hallmark of Wegener’s granulomatosis (3)
+ for ___ antibodies
Necrotic sinusitis
Lower respiratory tract involvement
Rapidly progressing glomerulonephritis
C-ANCA
1st line treatment of Heparin Induced Thrombocytopenia
Long term management:
Direct thrombin inhibitor: argatroban, bivalirudin
Long term management: Warfarin
Preferred method of evaluating severity of proteinuria
spot urine albumin: creatinine ratio
