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Chings Notes > High Yield 2 > Flashcards

High Yield 2 Flashcards

1
Q

diarrhea, vomiting , weight loss and HYPERCALCEMIA

A

ZES

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2
Q

What is the initial test for a patient with suspected celiac disease?

A

TgT-IgA test - most sensitive test , the alternative is the anti-endomysial antibody test
Biopsy - the gold standard

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3
Q

Malabsorption, arthritis + lymphadenopathy
+ PAS-positive granules in lamina propria

A

Whipple Disease
Treat with long term antibiotics

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4
Q

Best initial test for Carcinoid Syndrome

A

Urine levels of 5- HIAA
while the CT scan and IN-111 octreotide scan is used to localize the tumor

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5
Q

flushing, diarrhea, abdominal cramps, right sided cardiac valvular lesions

A

Carcinoid Syndrome
tx: Octreotide and Surgical resection

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6
Q

What Vitamin deficiency does patients with carcinoid syndrome develop?

A

Vitamin B3 deficiency = ie Niacin deficiency
pellagra - Diarrhea, Dermatitis, Dementia

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7
Q

Most common cause of SBO in adults

A

Adhesions

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8
Q

Which condition is associated with the development of ileus

A

Diabetes Mellitus
hypokalemia

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9
Q

Most accurate test for mesenteric ischemia

A

CT angiography - gold standard
CT scan - best initial test

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10
Q

significant distention, tympany and tenderness, fever and signs of shock suggest perforation/peritonitis or ischemia / necrosis

A

Large Bowel Obstruction
(Colon Cancer)

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11
Q

Most common cause of Lower GI bleed in patients > 40

A

Diverticulosis - most common in sigmoid colon
risk factors: low fiber and high fat diet, older age and connective tissue disorder
- outpouching of the mucosa and submucosa that herniate the colonic muscle layers

Inv:
Colonoscopy - is for diverticulosis
while CT scan is for Diverticulitis

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12
Q

Pt with aortic valve endocarditis - given with Iv antibiotics - culture positive for S bovis . next step?

A

Colonoscopy

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13
Q

weight loss, anorexia, blood in stool, obstruction in left sided lesions, bright red in rectal lesions

A

Colorectal Cancer

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14
Q

Most commonly affected site in the Ischemic Colitis

A

Left Colon
Most commonly at the splenic flexure by the watershed area

Symptoms of Ischemic Colitis
lower abdominal pain, diarrhea after meals, exertion, fever may suggest bowel necrosis

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15
Q

upper GI bleed is classified as one above the

A

Jejunum

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16
Q

Transmural inflammation is seen in:
skip lesions

A

Crohn Disease

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17
Q

Treatment for gallstone ileus

A

Laparotomy with stone extraction

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18
Q

Elevated ALP and bilirubin is seen in

A

Cholestasis

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19
Q

Most common causes of Chronic Viral Hepatitis are

A

HBV, HCV

( busy - chronic viral hepatitis)

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20
Q

p-ANCA and onion skinning sclerosis

A

Primary Sclerosing Cholangitis

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21
Q

Which medication slows the disease of progression of Primary Biliary cholangitis

A

Ursodeoxycholic acid
(cholestyramine for pruritus)

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22
Q

Obese, diabetic patient who develops hepatomegaly with increased LFTS and hepatitis/ alcoholism

A

Insulin Resistance

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23
Q

Most common type of Primary Liver Cancer

A

Hepatocellular carcinoma

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24
Q

Autosomal recessive disorder that results in defective copper transport and subsequent accumulation and deposition of copper in the liver and the brain (psychosis, delusions)

A

Wilson Disease
tx: Penicillamine

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25
Q

highly malignant presents with watery diarrhea, dehydration, muscle weakness and flushing

A

VIPOma

tx: replace fluids and electrolyte losses
surgery to resect the tumor
and consider the octreotide

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26
Q

Sweating, anxiety and headache

A

Insulinoma

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27
Q

Courvoisier sign, palpable nontender gallbladder

A

Pancreatic cancer

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28
Q

D-xylose test

A

Celiac Disease

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29
Q

pain to back, worse after meals, no hepatomegaly

A

Pancreatitits

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30
Q

pain several hours after a meal
no hepatomegaly

A

Duodenal ulcer

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31
Q

weight loss, fatigue, anorexia, jaundice
common bile duct dilated

A

Pancreatic cancer

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32
Q

elevated aminotransferase levels, acute RUQ pain and thrombocytopenia in 3rd trimester

A

Acute Fatty Liver of Pregnancy

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33
Q

elevated aminotransferase levels, elevated total bilirubin levels, generalized pruritus that is worse on palms and soles

A

Intrahepatic Cholestasis of pregnancy

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34
Q

Central stellate scar

A

Focal Nodular hyperplasia

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35
Q

bilateral infarcts and several microaneurysms of abdominal arteries

transmural inflammation of arterial walls, fever, joint pain , tissue ischemia affecting primarily the kidneys

A

Polyarteritis nodosa

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36
Q

persistent bloody ascites

A

Hepatocellular carcinoma

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37
Q

presents at age 3-5 weeks with non bilious vomiting after every feed

A

Pyloric Stenosis

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38
Q

a non-IgE mediated food allergy that presents in infancy with Non-bilious vomiting after ingestion of a trigger food like milk

A

Food protein induced enterocolitis

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39
Q

chronic episodic bilious vomiting
No blood in the stool
abdominal pain and irritability

A

Intestinal malrotation (volvulus)

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40
Q

A patient with cirrhosis that develops confusion and asterixis should be treated with

A

Lactulose

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41
Q

obesity, hepatomegaly, elevated AST and ALT

A

Non-Alcoholic Fatty Disease

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42
Q

self-induced vomiting _ chest / back pain + Pleural effusion

A

Boerhaave Syndrome
or Esophageal Perforation with pleural effusion

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43
Q

Proper management for a button battery lodged in the esophagus of a baby

A

Endoscopy

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44
Q

photophobia, dry skin, Bitot spots
what vit def?

A

Vitamin A

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45
Q

sore throat, cheilitis, glossitis
What vit deficieny?

A

Vit B12

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46
Q

What Vit Def if there is ecchymoses, petechiae and bleeding gums?

A

Vitamin C2

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47
Q

thickened intestinal loops floating free in the amniotic fluid

A

Gastroschisis

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48
Q

prune belly

A

Omphalocoele

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49
Q

distant infection (eg endocarditis) + high fever + tender splenomegaly

A

Splenic abscess

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50
Q

rebound and guarding

A

Appendicitis

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51
Q

Free air in the abdominal imaging
anorexia, abdominal discomfort and constipation
fever and peritonitis

A

Diverticular perforation

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52
Q

diagnostic markers most appropriate to diagnose acute hepatitis B infection

A

HbsAg and IgM anti-HBc

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53
Q

A person undergoes surgery and several days later develops RUQ pain, fever and leukocytosis
Distended gallbladder with no gallstones

A

Acalculous Cholecystitis

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54
Q

painful, erythema nodules on the shins

A

IBD

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55
Q

A pregnant woman presents with hematochieza, abdominal pain and tenesmus (fecal urgency followed by straining and an inability to defecate)

A

Ulcerative Colitis

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56
Q

porcellain gallbladder

A

gallbladder adenocarcinoma

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57
Q

crushing, substernal chest pain with ST elevations in V1, V2, V3 with shortness of breath, crackles and LE edema

A

STEMI

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58
Q

Unrestrained passenger in motor vehicle accident presents with unilateral diminished breath sounds and dullness to percussiom

A

Hemothorax

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59
Q

Young person with unilateral upper extremity swelling, pain erythema following vigorous exercise

A

Deep Venous thrombosis

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60
Q

An older man with a recent history of abdominal surgery presents with severe abdominal pain, constipation and irreducible mass in the left lower quadrant

A

Incarcerated Inguinal Hernia

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61
Q

Immediately after completing a marathon, a runner collapses without loss of consciousness and minimally elevated temperature

A

Exercise Associated Postural Hypotension

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62
Q

young patient with moderate chest pain and worsened with palpation

A

Costochondritis

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63
Q

Miner presents with ataxia, irritability, gingival inflammation and excess salivation

A

Mercury poisoning

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64
Q

Sudden onset severe headache in an elderly patient

A

Subarachnoid hemorrhage

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65
Q

Sudden-onset, severe, unilateral periorbital headache with tearing and conjunctival injection

A

Cluster headache

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66
Q

Elderly patient with extensive smoking history presents with fatigue, malaise, bilateral upper extremity edema, headache worse with supine positioning

A

SVC Syndrome (Pancoast Tumor)

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67
Q

Fall into an outstretched hand now with arm in adduction and internal rotation, Xray with widening of glenohumeral joint space

A

Posterior Shoulder dislocation

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68
Q

Repeated bilateral lower extremity pain and swelling after strenuous exercise with spontaneous resolution

A

Chronic Exertional compartment syndrome

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69
Q

Young patient with no PMH, presents with encephalopathy, anion gap metabolic acidosis, hyperglycemia

A

Diabetic Ketoacidosis

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70
Q

Fall from roof with spinal tenderness, spinal Xray with decreased vertebral height at T8

A

Vertebral compression fracture

71
Q
A
72
Q

Skin dimpling

A

Inflammatory breast carcinoma

73
Q

Hx of Pcos presents with post menopausal bleeding for 1 month

A

Endometrial carcinoma

74
Q

Beefy protrusion of tissue of the urethral meatus

A

Urethral prolapse

75
Q

Nintendo abdominal bulge in post-partum patient with no facial defect on palpation

A

Rectum abdominal diastasis

76
Q

Amenorrhoea and cyclic abdominal pain in each month

A

Impersonate hymen

77
Q

Breast mass posterior to the nipple

A

Physi8logic thelarcge

78
Q

History of multiple miscarriages, positive Vdrl and elevates PTT

A

Antiphospholipid syndrome

79
Q

Pregnant with fever, dysuria and flank.pai n

A

Pyelonephritis
Treat with caftriaxone

80
Q

Pregnant woman 10 wks with uterine size larger than estimated dates, severe nausea ans Vomiting BP 155/95 , elevated Bhcg

A

Complete hydatidiform mole

81
Q

Pregnant patient with twins on ultrasound
One twin has dysmorphic limbs and a flattened face the other has polyhydramnios and polycythrmia

A

Twin to twin transfusion syndrome

82
Q

What type of pregnancy his the previous scenario

A

Monochorionic diamniotic

83
Q

Pregnant woman with severe nausea, Vomiting, orthosthatic hypotension, ketone in urine

A

Hyper3mesis gravidarum look for thiamine b1 Def

84
Q

Pregnant woman with anaemia, thrombocytopenia, lfts elevated

A

HELLP SYNDROME

85
Q

Pregnant woman with severe RUQpain, thrombocytopenia, profound hypoglycaemia, elevated LFTS, DIC

A

Acute fatty liver of pregnancy

86
Q

Newborn male single s2 sound
Blowing holosystolic murmur
Egg ona string appearance on chest x ray

A

Transposition of the great vessels

87
Q

Failure of aorticopulmonary septation
Associated with Digeorge syndrome

A

Truncus arteriosus

88
Q

Displac3ment of infundibular septum
Leads to PROV abdomalities
Associated with Digeorge Syndrome
Leads ti PROV abnormalities - pulmonary stenosis, RVH , overriding of the aorta

A

Tetralogy of Fallot

89
Q

Young person
No family hx and ischaemic stroke

A

PATENT FORAMEN OVALE

90
Q

Holosystolic murmur at the left lower sternly border

A

VSD

91
Q

Wide, fixed splitting S2

A

ASD

92
Q

Double bubble sign

A

Duodenal atresia

93
Q

Triple bubble sigb

A

Jejunal atresia

94
Q

Corkscrew or misplaced ligament of tretz

A

Malrotstion + volvulis

95
Q

Tonsillitis + strawberry tongue + morbiliform rash

A

Scarlet fever
Tx: penicillin

96
Q

Crash and burn
Conjunctivitis, rash, adenopathy, strawberry tongue, hand and foot erythema + fever for 5 days

A

Kawasaki disease
Tx: aspirin + IVIG

97
Q

Posterior lymphadenopathy
Abdominal.pain from splenomegaly

A

Infectious Mononucleosis

98
Q

Cough absent
Exudate on tonsils

A

GAS pharyngitis

99
Q

Fever, lovk jaw (trismus)
Ear pain, uvula deviation

A

Peritonsillar abscess

100
Q

Anterior LAD, unable to move ecj

A

Retropharynge abscess

101
Q

Fever, dysphagia, drooling

A

Epiglottitis

102
Q

Harsh, cough , inspiratory stridor

A

Laryngotracheitis

103
Q

Inspiratory chronic stridor
Improves with prone position

A

Laryngomalacia

104
Q

Biphasic ins and ex chronic stridor
Improves with neck extension

A

Vascular ring

105
Q

Expiratory chronic stridor
History of prolonged intubation

A

Tracheomalacia

106
Q

Prematurity, insufficient surfactant
Alveoli collapse
Resp distress, grunting, nasal flaring
Ground glass appearance + air bronchograms

Preterm <37wks
Tx: positive pressure ventilation ,may need intubation *follow paediatric ACLS algorithm)

A

Neonatal Resp distress Syndrome

107
Q

Rapid expulsion - inability to exhale pulmonary fluid
Brief, tachypnea, resolves by day 2
Xray findings : erihilar streaking + fluid in fissures
C section or rapid vaginal delivery

A

Transient Tachypnea of the newborn

108
Q

Cause post -term fetus > more likely infant has passed meconium - risk to aspirate
Green coloured amniotic fluid
Treatment:intubation + suction beneath trachea

A

Meconium aspiration syndrome

109
Q

Obese or tall adolescents 10-16yi
May have knee pain
Flexing of the hips causes external rotation
Treatment : surgical pinning

A

SCFE

110
Q

Younger 4-10 yo child, limited to internal rotation and abduction *both cause femur -acetabulum space to narrow

A

Legg Calve Perthes Disease

111
Q

I’ll, fever, elevated WBC count, inability to bear weight, elevated ESR and CRP

A

Septic arthritis
Tx,: arthrocentesis + IV antibiotics

112
Q

Bloody stool
Painless
Eczema, mildly fussy but consolable, painless, hematochezia + loose stool
Treatment for breast

A

Milk allergic proctoenterocolitis

113
Q

Bloody stool
Painless
Rule of 2s: 2yo, 2 more common in males, 2 feet from ileocecal valve + 2 inches long
Painless hematochezia or melena

A

Meckels diverticulum

114
Q

History of straining, hard, or pellet like stools +/- anal fissures very painful
Bloody stool

A

Constipation

115
Q

Bloody stool
Painful , intermittent episodes of painful Bloody stool in between they are seen playing normally, sausage shaped mass on RLQ or RUQ, currant jelly

A

Intussusception

116
Q

Dilated small.bowel

A

Meconium.ileus

117
Q

Narrow point at rectosigmoid

A

Hirschsprung disease

118
Q

Hypotonia, jaundice, dry skin

A

Hypothyroidism

119
Q

Slanted epicantyal folds, single pmar crews, sandal toe (gap between 1st and 2nd toe brush field spots on iris

A

Trisomy 21

120
Q

Happy demeanour, seizures, gap between teeth, intellectual disability

A

Angel man

121
Q

History of hypotonia as infant, obesity, short stature, behavioural problems

A

Prader Willi

122
Q

Friendliness qith strangers, elfin face, supravalvular aortic stenosis

A

Williams syndrome

123
Q

High oitched cry, microcephaly

A

Cri du chat

124
Q

Midline defects, cleft lip, aphasia cuts of scalp, polydactyly,holoprosencephaly

A

Palau
Trisomy 13

125
Q

Prominent occipital, clenched and overlapping fingers, micrognathia, or retronathia

A

Edward’s
Trisomy 18

126
Q

Narrow epicanthal folds,smooth phltrum, thin upper vermilion bordsr

A

Fetal alcohol syndrome

127
Q

O.phalocoele, large tongue, right arm and leg enlargement, Wilmslow tumkr

A

Beckwith - Wiedemann syndrome

128
Q

Chordal artesian, heart defects, ear anomalies

A

CHARGE Syndrome

129
Q

Tracheoesophageal fistula, anal abnormalities, scoliosis

A

VACTERL

130
Q

Hypotonia, jaundice, umbilical hernia, large tongue

A

Congenital hypothyroidism

131
Q

Self aggression, crystals found in diaper, poor tone

A

Lesch Nyhan Syndrome

132
Q

Long head, large ears, intellectual disability

A

Fragile X syndrome

133
Q

Nephritis syndrome gwnitourinary abnormalities
Wilms tumor

A

Denys Drash Syndrome

134
Q

Hearing loss, microcephaly, periventricular calcifications

A

Congenital CMV

135
Q

Hydrocephalus, microcephaly, perivwntricular calcifications

A

Congenital CMV

136
Q

Hydrocephalus, chorioretinitis, diffuse intracranial calcifications

A

Toxoplasma

137
Q

Soin scars, cataracts, limb hyperplasia

A

Varicella

138
Q

Jaundice, cataracts, deafness, continuous murmur

A

Rua

139
Q

Rhinorrhea, skinr ash, teeth and bone abnormalities

A

SYPHILIS

140
Q

Hydrops fetalis

A

Parvovirus B19

141
Q

Neonatal sepsis, widespread abscesses

A

Listeria

142
Q

Encephalitis, sepsis, vesicular skin lesions

A

Herpes Simolex

143
Q

Harsh, hilosystolic murmur at the lower left sternal border

A

VSD

144
Q

Wide, fixed split S2 + soft systolic murmur

A

ASD

145
Q

Continuous murmur in interscapular region

A

Coarctation

146
Q

Continuous “machine-like” murmur in infraclavicular region

A

PDA

147
Q

Continuous murmur in right infraclavicular region, disappears with compression of internal.jugular vein

A

Central venous hum

148
Q

Holosystolic murmur at lower sternal border + systolic murmur at upper left sternal border in a patient with Trisomy 21

A

Common Av canal (endocardial cushion defect in Down syndrome)

149
Q

Systolic murmur at lower left sternal border, increased intensity with Valsalva

A

Hypertrophic cardiomyopathy

150
Q

Most sensitive Laboratory test to confirm abuse of Alcohol

A

GGT or
gamma Glutamyl Transferase

151
Q

All of a sudden half of my vision is black

A

Central Retina Artery Ischemia

152
Q

Placed on face mask with )2 flowing at 10 L/min, remains cyanotic and pulse oximetry reading does not chanfe.
Bilateral breath sounds are present, no murmur. breathing deeply and quickly but not retracting.
While waiting fo the transport to the nearby hospital, what will you initiate?

A

Prostaglandin E1 Infusion

153
Q

Diagnostic imaging test to diagnose osteoporosis

A

DEXA scan

154
Q

CMV infections may produce what retinal disturbance

A

Chorioretinitis

155
Q

poppling sound when he bends his knees

A

Medial Meniscus tear

156
Q

When LLQ is palpated and there is tendernes in RLQ

A

Rovsing Sign

157
Q

Is the aign when there is an occurrence of sharp pain when the examiner presses his or her hand over the Mcburner Point and then releases the hand pressure suddenly.

A

Blumber Sign

158
Q

Increase of pain when the psoas muscle is stretched as the patient extends his or her hips.

A

Psoas Sign

159
Q

Elicitatiin of pain as the hip is flexed and internally rotated

A

Obturator Sign

160
Q

is a condition marked by symmetrical cyanosis of the extremities with persistent, uneven, mottled blue or red discoloration of the skin of the digits, wrists and ankles along with profuse sweating and coldness of the fingers and toes.

A

Raynaud sign

161
Q

Which statements about Cholangitis is true

A

Charcot triad: fever, jaundice and pain in the RUQ

162
Q

Fracture of the left temporal lobe
Suddenly loses consiousness and dilation of the left pupil
What is the diagnosis?

A

An Epidural hematoma

163
Q

You suspect a Meckel’s diverticulum as the possible cause what s the best test to confirm the diagnosis?

A

Technetium 99m pertechnetate scintigraphic study

164
Q

Which HPV types are associated with benign condyloma

A

HPV 6 and 11

165
Q

Which HPV are associated with cervical neoplasia

A

HPV 16, 18 and 21

166
Q

How to confirm epilepsy
descibes as eye fluttering for several seconds

A

Electroencephalogram

167
Q

Fluttering in her chest

A

Atrial Fibrillation

168
Q

Thrombocytopenia
Eczema and increased susceptibility to infection

A

Wiskot Aldrich Sydnrome

169
Q

The reactivation is not a risk to the fetus

A

Shingles

170
Q

which of the ff is true with ADHD

A

Children diagnosed with ADHD commonly continue to have symptoms into the adulthood

171
Q

several weeks of abdominal pain and black stools
inv?

A

Upper GI endoscopy

172
Q

cough and chest pain for 2 months
she complains of coughing up hair
CXR reveals mediastinal mass
Which mediastinal tumor is most likely associated with

A

Cystic Teratoma

173
Q

Cause phy Hypotension

A

Gram negative sepsis

174
Q

Progressive pain in his knees
tenderness, swollen and prominent tibial tuberlcle

A

Osgood Schlatter disease

Chings Notes (39 decks)

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