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PANCE > High Yield Facts > Flashcards

High Yield Facts Flashcards

1
Q

Cardiac tamponade

A

Beck’s triad

HoTN + distant heart sounds + JVD

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2
Q

Drugs that slow heart rate

A

BB, CCB, digoxin, amiodarone, adenosine

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3
Q

HOCM murmur

A

systolic ejection murmur heard along the lateral sternal border, increases w/ decreased preload (Valsalva)

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4
Q

Aortic insufficiency

A

Austin Flint murmur, a disastolic decrescendo, low-pitched, blowing murmur that is best heard sitting up; increases with increased afterload (handgrip)

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5
Q

Aortic stenosis

A

Systolic crescendo/decrescendo; increases with increased preload (squatting)

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6
Q

Mitral Regurg

A

holosystolic murmur; increases with increased afterload (handgrip)

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7
Q

Mitral stenosis

A

diastolic mid-to-late low pitched. Opening snap

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8
Q

Tx afib or a flutter

A 
unstable = cardiovert
stable/chronic = rate ctrl BB or CCB
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9
Q

Dressler’s syndrome

A

autoimmune rxn w/ fever, pericarditis + high ESR

2-4 weeks post-MI

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10
Q

Pulsus paradoxus

A

decrease in SBP > 10 w/ inspiration

cardiac tamponade

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11
Q

Pericarditis EKG

A

low voltage diffuse ST segment elevation

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12
Q

Indications for surgical repair AAA

A

> 5.5 cm, rapidly enlarging, symptomatic, ruptured

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13
Q

Tx acute coronary syndrome

A

ASA, heparine, clopidogrel, morphine, O2, sublingual nitro, IV BB

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14
Q

Metabolic syndrome

A

1) abdominal obesity
2) high TG
3) low HDL
4) HTN
5) insulin resistance

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15
Q

Med used for phramacological stress test

A

dobutamine

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16
Q

Target LDL pt w/ diabetes

A

< 70

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17
Q

Signs of active ischemia during stress test

A

angina
ST changes
decrease BP

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18
Q

Anterior/septal wall MI artery

A

LAD

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19
Q

Inferior MI artery

A

RCA

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20
Q

Posterior/left MI artery

A

left circumflex

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21
Q

young pt + angina at rest + ST segment elevation w/ normal cardiac enzymes

A

Prinzmetal’s

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22
Q

Common sx associated w/ silent MIs

A

CHF, shock, AMS

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23
Q

Diagnostic test for pulmonary embolism

A

spiral CT + contrast

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24
Q

Heparin antidote

A

protamine

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25
Q

What lab check w/ warfarin

A

PT

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26
Q

MCC HTN young women

A

OCP

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27
Q

MCC HTN young men

A

Etoh

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28
Q

MC type of skin cancer

A

BCC

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29
Q

Pearly papule + translucent + telangiectasias

A

BCC

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30
Q

Nikolsky +
younger
mucous membranes + flaccid blisters

A

Pemphigus vulgaris

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31
Q

Nikolsky -
autimmune + elderly
tense blisters

A

Bullous pemphigoid

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32
Q

puritic, purple, polygonal, planar, papules/patches

A

Lichen planus

steroids

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33
Q

Iris-like target lesion

A

erythema multiforme

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34
Q

pink, scaling flat lesion

spaghetti/meatballs on KOH

A

Tinea versicolor

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35
Q

Premalignant lesion for SCC

A

actinic keratosis

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36
Q

dewdrops on a rose petal

A

varicella

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37
Q

Exophytic nodules on skin w/ varying degrees of scaling or ulceration

A

SCC

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38
Q

HA + weakness + fatigue + polyuria
exam shows HoTN + tetany
labs = HoK, metablic alkalosis

A

primary hyper-aldosteronism (from Conn’s syndrome or bilateral adrenal hyperplasia)

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39
Q

tachy + wild swings in BP + HA + diaphoresis + panic
tumor of chromaffin tissue
assoc MEN 2a and 2B
paroxysmal (short/frequent) sx

A

pheo
tumor of chromaffin tissue
assoc MEN 2a and 2B

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40
Q

alpha blockers for pheo

A

phentolamine

phenoxybenzamine

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41
Q

Hx lithium + copious dilute urine

A

nephrogenic diabetes insipidus

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42
Q

tx central DI

A

DDAVP + free water restriction

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43
Q

antidiabetic med associated w/ lactic acidosis

A

metformin

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44
Q

weakness + nausea + vomiting + weight loss
tan skin
HoNa + HypK

A

primary adrenal insufficiency - addisons

gluco + mineral corticoids

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45
Q

treatment DKA

A

fluids
insulin
K+

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46
Q

Risk factors cholelithiasis

A 
fat
female
fertile
forty
flatulent
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47
Q

MCC small bowel obstruction in pts w/ no hx abd surgery

A

hernia

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48
Q

Peritoneal signs + AXR shows free air under diaphragm. Management?

A

emergent laparotomy to repair perforation

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49
Q

Tx hepatic encephalopathy

A

decrease protein intake
lactulose
rifaximin

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50
Q

child w/ oliguria + petechiae + JAUNDICE

following illness w/ BLOODY DIARRHEA

A

HUS from e coli O157:H7

Hemolysis + uremia + THROMBOCYTOPENIA

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51
Q

causes of drug-induced hepatitis

A

TB meds (INH, rifampin, pryazinamide), acetaminphen, tetracycline

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52
Q

Tx IBD

A

5 ASA + steroids during acute exacerbations

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53
Q

extra intestinal manifestations of IBD

A 
uveitis
ank spnd
p. gangrenosum
erythema nodosum
PSC
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54
Q

MCC cause diarrhea

A

campy

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55
Q

camping diarrhea

A

giardia

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56
Q

traveler’s diarrhea

A

ETEC

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57
Q

picnics/mayonnaise

A

s aureus

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58
Q

uncooked hamburgers

A

E O157:H7

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59
Q

poultry/eggs

A

salmonella

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60
Q

AIDs diarrhea

A

crytosporidium, MAC, isospora

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61
Q

pseudoappendicitis

A

Yersinia, Campy

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62
Q

post-HBV exposure tx

A

HBV immunoglobulin

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63
Q

40F, obese + itching + dark urine + clay colored stool

high bili, high alk phos

A

biliary tract obstruction

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64
Q

4 causes microcytic anemia

A 
"TICS"
Thalassemia
Iron deficiency
anemia of Chronic disease
Sideroblastic anemia
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65
Q

precipitants of hemolytic crisis G6PD

A

sulfs, antimalaria drugs, fava beans

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66
Q

MC inherited hypercoagulability

A

Factor V

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67
Q

MC inherited bleeding d/o

A

von Willebrands

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68
Q

MC inherited hemolytic anemia

A

hereditary spherocytosis

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69
Q

Dx test for hereditary spherocytosis

A

osmotic fragility test

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70
Q

Meds/viruses that lead to aplastic anemia

A 
Chloramphenicol
Sulfonamides
Radiation
HIV
Chemo
hepatitis
parvovirus B19
EBV
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71
Q

high hematocrit + high RBC mass + low EPO

A

polycythemia vera

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72
Q

TTP pentad

A 
"FAT RN"
fever
anemia
thrombocytopenia
renal dysfunction
neruo abnormalities
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73
Q

Tx TTP (thrombotic thrombocytopenic purpura)

A

emergent large volume plasmapheresis
corticosteroids
antiplatelets

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74
Q

what is CI in TTP

A

platelet transfusion

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75
Q

Tx ITP

A

resolves spontaneously

maybe IVIG/corticosteroids if unstable

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76
Q

which are elevated in DIC: fibrin split products, d-dimer, fibrinogen, platelets, hematocrit

A

high: fibrin split products + d-dimer
low: platelets, fibrinogen, HCT

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77
Q

8y/o boy
hemarthrosis + increased PTT
normal PT + normal bleeding time

A

Hemophelia A or B

DDAVP, factor 8 or 9 supplements

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78
Q

14 y/o F prolonged bleeding
normal PT
increased bleeding time

A

vW disease

DDAVP, FFP or cryoprecipitate

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79
Q

Monoclonoal gammopathy
Bence jones proteinuria
punched out lesions on XR

A

multiple myeloma

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80
Q

Reed-Sternberg cells

A

Hodgkin’s lymphoma

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81
Q

kid w/ fever, weight loss, night sweets

anterior mediastinal mass

A

non-hodgkin’s lymphoma

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82
Q

Microcytic anemia
low serum iron
low TIBC
normal/high ferritin

A

anemia of chronic disease

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83
Q

Microcytic anemia
low serum iron
high TIBC
low ferritin

A

Fe deficiency anemia

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84
Q

old
splenomegaly, lemphadenopathy
lymphocytosis (super high)

A

CLL

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85
Q

Satiety, splenomgaly, bleeding

t(9,22)

A

CML

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86
Q

Heinz bodies

A

intracellular inclusions
thalassemia
G6PD
postsplenectomy

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87
Q

virus assoc w/ aplastic anemia in sickle cell pts

A

parvoirus B19

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88
Q

Significant cause of morbidity in thalassemia pts: tx?

A

Fe overload

deferoxamine

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89
Q

What to do before LP

A

check for ICP via papilledema

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90
Q

Aplenic pts are susceptible to these organisms

A 
encapulated organisms
pneumococcus
meningococcus
H flu
klebsiella
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91
Q

Pt from CA or AZ

fever + malaise + cough + night sweats

A

Coccidiodomycosis

Amp B

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92
Q

Blueberry muffin rash
cataracts
deafness
mental retardation

A

Congenital rubella

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93
Q

CSF low glucose, mostly PMNs

A

bacterial meningitis

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94
Q

CSF normal glucose, mostly lymphocytes

A

viral meingitis

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95
Q

high ICP
xanthochromia
RBCs in serial CSF samples

A

subarachnoid hemorrhage

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96
Q

CSF w/ high gamma globulins

A

MS

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97
Q

3 syphilis findings

A

tabes dorsalis - loss coordination
argyll roberson pupil - no reaction to light but ok accomodation
aortic root aneurysms

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98
Q

lyme disease sx

A 
erythema migrans
arthralgia
migratory polyarthropathies
Bell's palsy
myocarditis
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99
Q

Cold agglutinins

A

mycoplasma

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100
Q

Dog or cat bite

A 
pasteurella multocida
PCN
augmentin
Cipro
Doxy
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101
Q

Gardener w/ bumps/sores slow to heal

“rose gardner’s disease”

A

sporothrix schenckii

itraconazole

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102
Q

meningitis adults

A

N meningitidis

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103
Q

meningitis elderly

A

strep pneumo

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104
Q

Meningoencephalitis AIDS pt

A

cryptococcus neoformans

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105
Q

Red currant jelly sputum

alcoholic pneumonia

A

klebsiella

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106
Q

Infxn in burn victims

A

pseudomonas

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107
Q

smoker/drinker
new cough + flu-like sx + diarrhea
gram stain shows nothing
silver stain sputum = gram- rods

A

Legionella pneumonea
Macrolides
Quinolones

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108
Q

Organisms for reactive arthritis

A

chlamydia
campy
shigella
salmonella

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109
Q

pain/stiffness shoulders + hips
anemia
high ESR

A

polymyalgia rheumatica

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110
Q

MC primary malignant tumor of bone

A

multiple myeloma

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111
Q

“Broken speech”

type of aphasia, lobe, vessel

A

Broca’s aphasia
Frontal lobe
Left MCA

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112
Q

MCC SAH

A 
trauma
#2 is berry aneurysm
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113
Q

Crescent shaped hyperdensity that does not cross midline

A

subdural hematoma

torn bridging veins

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114
Q

initial AMS then lucid interval

A

epidural hematoma

middle meningeal artery

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115
Q

albuminocytologic dissociation

A

Guillain Barre

high protein in CSF w/o significant increase in cell count

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116
Q

caloric response to water in ear

A

COWS is normal
cold water = opposite
warm = same

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117
Q

confusion + confabulation + opthalmoplegia (eye muscle paralysis) + ataxia (loss ctrl bodily mvmts)

A

Wernicke’s

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118
Q

What % lesion is indication for CEA

A

70% if stenosis is symptomatic

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119
Q

combo UMN and LMN d/o

A

ALS

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120
Q

Tx Guillain Barre

A

IVIG or plasmapheresis

NO steroids

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121
Q

Complete hydatidiform mole on US

A

“snowstorm”

“cluster of grapes”

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122
Q

Abx w/ teratogenic effects

A

tetracycline
fluoroquinolones
aminoglycosides (“mycin”)
sulfonamides

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123
Q

Med to accelerate fetal lung maturity

A

Betamethasone or dexamethasone x 48H

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124
Q

Tx postpartum hemorrhage

A

uterine massage or oxytocin

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125
Q

Abx for GBS prophylaxis in pregnancy

A

IV PCN

ampicillin

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126
Q

heavy bleeding during and between periods

A

menometrorrhagia

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127
Q

amenorrhea w/ normal prolactin
no response to estrogen/progesterone challenge
hx D&C

A

Asherman’s

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128
Q

Med to induce ovulation

A

clomiphene citrate

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129
Q

Tx for endometriosis

A

OCP
danazol
GnRH agonist (Lupron)

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130
Q

Chocolate cysts

A

endometriosis

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131
Q

Natural progression of leiomyoma

A

regress after menopause

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132
Q

Annual screening for F w/ strong FHx ovarian CA

A

CEA 125

TVUS

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133
Q

unpredictable urine loss (urge incontinence) tx

A 
anticholinergics (oxybutynin)
B adrenergics (metroproterenol)
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134
Q

leakage urine w/ laughing/coughing (stress incontinence) tx

A

kegel
estrogen
pessaries

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135
Q

MCC female infertility

A

endometriosis

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136
Q

follow up for 2 consecutive finding ASCUS

A

colposcopy and endocervical curettage

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137
Q

Breast CA type that has high risk of invasive carcinoma in both breasts

A

Lobular carcinoma in situ

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138
Q

bilious emesis w/in hours after 1st feeding

A

duodenal atresia

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139
Q

neonate w/ meconium ileus

A

CF

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140
Q

failure to pass meconium for 48H

A

Hirschsprung dz
barium enema - narrowed distal colon w/ proximal dilation
rectal bx = no myenteric (Aurebach’s plexus) or submucosal (Meissner’s) plexus
tx: surgery colostomy then “pull through” procedure

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141
Q

high fever + onset rash as fever breaks

A

Roseola
HHV 6-7
risk for febrile seizures

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142
Q

Acute phase tx for Kawasaki disease

A

high dose ASA for inflammation/fever

IVIG to prevent coronary artery aneurysms

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143
Q

tx for mild and sever unconjugated hyperbilirubinemia

A

phototherapy (mild)
exchange transfusion (severe)
NO phototherapy for conjugated hyperbili

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144
Q

Sudden onset AMS + emesis + liver dysfunction + recent ASA intake

A

Reye’s syndrome

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145
Q

child w/ loss of red reflex

A

retinoblastoma

increased risk osteosarcoma

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146
Q

Vaccinations for 6mon WCE (6 total)

A 
HBV
DTap
Hib
IPV
PCV
Rotavirus
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147
Q

Red currant jelly stool
colicky abdominal pain
bilious vomit
sausage shaped mass

A

intussusception
target on US
air contrast barium enema = dx + tx

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148
Q

Croup cause

A

Parainfluenza virus

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149
Q

Peeling skin and swollen belly

A

Kwashiorkor (protein malnutrition)

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150
Q

Continous machinery murmur

A

PDA

tx w/ indomethacin

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151
Q

Webbed neck + shield chest
Coarctation of aorta
Lymphedema hands/feet as neonate
high FSH

A

Turner (45 XO)

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152
Q 
Inactivated X (Barr body)
hypogonadism, testicular atrophy, tall, female hair
A

Klinefelters (47, XXY)

Tx w/ testosterone

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153
Q

Rocker-bottom feet
overlapping 4-5 digits
micrognathia
Death w/in 1 year

A

Edward’s (Trisomy 18)

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154
Q

Simian crease, upslanted eyes
Duodenal atresia, Hirschsprung’s, ASD/VSD/PDA
increased risk ALL and Alzheimers

A

Down’s

Meiotic nondisjunction

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155
Q

Erythema Infectiosum

A

parvovirus B 19
slapped check
worse w/ sun exposure
aplastic crisis for sickle cell

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156
Q

Measles (Rubeola)

A

paramyxovirus
C’s - conjunctivitis, cough, coryza, Koplik’s
Rash spreads from head to toe

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157
Q

Rubella (3 day measles)

A

rubella virus

non-ill looking kid w/ rash spreads down from head to toe

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158
Q

Roseola infantum

A

HHV 6-7
High fever + rash starting on TRUNK and spreads outward
Febrile seizures

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159
Q

Varicella

A

VZV
vesicles in different stages of healing
infectious from 24H before eruption until crusted over
Reye’s Syndrome

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160
Q

symmetric proximal muscle weakness + difficulty breathing or swallowing
red/purple maculopapular rash

A

polymyositis

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161
Q 
heliotrope rash (violet periorbital rash)
shawl sign (rash of upper chest/shoulders/back)
Gottron's papules (papular rash w/ scales on dorsum hand)
A

dermatomyositis

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162
Q

high CK

anti-jo-1 ab

A

polymyositis, dermatomyositis

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163
Q

anticentromere ab

A

CREST syndrome

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164
Q

Anti dsDNA, Anti-Sm, ANA

A 
SLE
NSAID - joints
Corticosteroids - acute exacerbations
hydroxychloroquine - skin/joints
cyclophosphamide - lupus nephritis
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165
Q

Antinuclear, Anti-Scl-70, Antitopoisomerase 1

A

Scleroderma

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166
Q

Anti CCP, RF factor

A 
RA
Tx:
methrotrexate
hydroxychloroquine
sulfasalazine
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167
Q

Complication supracondylar humerus fx

A

MC pediatric elbow fx

brachial artery entrapment

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168
Q

Alli’s/Galleazzi’s sign

A

knees unequal heights when hips/knees flexed = developmental dysplasia of hip

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169
Q

may be administered to a symptomatic pt to dx myasthenia gravis

A

edrophonium

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170
Q

Antidepressant assoc w/ HTN crisis

A

MAOI

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171
Q

mother angry at husband yells at child

A

displacement

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172
Q

pedophile enters monastery

A

reaction formation

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173
Q

pt calmly describing a grisly murder

A

isolation

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174
Q

hospitalized 10y/o begins to wet bed

A

regression

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175
Q

violent pt + vertical/horizontal nystagmus

A

phencyclidine hydochloride intoxication (PCP)

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176
Q

pupillary dilation + “cocaine bugs” (formication) + “chest pain”

A

haldol

sx specific meds (for HTN, tachcardia, etc)

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177
Q

crash w/ hypersomnolence, depression, malaise, angina, increased appetite

A

cocaine w/d

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178
Q

crash w/ anxiety, HA, stomach cramps, depression/dysphoria, hunger, fatigue

A

amphetamines w/d

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179
Q

pupillary dilation, psychomotor agitation, prolonged wakefulness

A

haldol

sx specific meds (antiemetics, NSAIDS)

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180
Q

pupillary constriction, CNS/resp depression, constipation

A

Naloxone

naltrexone

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181
Q

myalgia, fever, lacrimation, diaphoresis, DILATED pupils, yawning, piloerection, NV, diarrhea

A

opioid w/d
methadone
w/d not life thretening

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182
Q

rx for bulemia

A

prozac

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183
Q

Honeycomb pattern CXR

A

diffuse interstitial pulmonary fibrosis

supportive +/- steroids

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184
Q

non-caseating granuloma + increased ACE + hyperCa + hilar lymph

A

Sarcoidosis

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185
Q

Lung CA assoc w/ SIADH

A

small cell lung CA

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186
Q

Lung CA from cigarette exposure

A

small cell lung CA

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187
Q

ARDS

A

hypoxemia + pulm edema + normal pulm capillary wedge pressure (PCWP)

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188
Q

Silicosis increases risk of?

A

mycobacterium TB

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189
Q

Westermark’s sign, Hampton’s hump

S1Q3invT

A

Pulm embolism

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190
Q

polycystic kidneys assoc w/?

A

berry aneurysms

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191
Q

waxy casts + maltese crosses + lipiduria

A

nephrotic syndrome

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192
Q

low urine specific gravity + high serum osmolality

A

DI

193
Q

tx SIADH

A

fluid restriction

demeclocycline

194
Q

MC type testicular CA

A

seminoma (type of germ cell tumor)

195
Q

Testicular CA assoc w/ bhCG, AFP

A

choriocarcinoma

196
Q

MC histology bladder CA

A

transitional cell CA

197
Q

complication of overly rapid correction hyponatremia

A

central pontine myelinolysis

198
Q

Salicylate ingestion causes what type of acid-base d/o

A

anion gap acidosis + resp alk

199
Q

3 systemic diseases that lead to nephrotic syndrome

A

DM, SLE, amyloidosis

200
Q

tx ARDS

A

CPAP

201
Q

acetminophen OD

A

N acetylcysteine

202
Q

BZD overdose

A

flumazenil

203
Q

Tx for neuroleptic malignant syndrome (muscle rigidity, hyperthermia, autonomic instability, extrapyramidal sx)

A

dantrolene

204
Q

signs neurogenic shock

A

HoTN + bradycardia

205
Q

sx increased ICP (Cushing’s triad)

A

HTN + bradycardia + abnormal respirations

206
Q

low CO
HIGH PCWP
high peripheral vascular resistance

A

cardigenic shock

207
Q

Test to r/o urethral injury

A

retrograde cystourethrogram

208
Q

SVT tx

A

carotid massage

adenosine

209
Q

Malignant htn tx

A

nitroprusside

210
Q

HIGH CO
low PCWP
low peripheral vascular resistance

A

septic or anaphylactic shock

211
Q

signs of air embolism

A

pt w/ chest trauma who was previously stable suddenly dies

212
Q

sx cardiac tamponade

A

distended neck veins + HoTN + diminished heart sounds + pulsus paradoxus

213
Q

absent breath sounds + dullness to percussion + shock + flat neck veins

A

massive hemothorax

214
Q

Brown Sequard

A

same side motor/vib/prop

opp side pain/temp

215
Q

Central cord

A

incomplete motor
some sensory
MCC - extension injury

216
Q

Anterior cord

A

loss all motor
loss pain and temp
proprioception/vibration ok

217
Q

Forchheimer spots

A

petechiae on the soft palate

rubella, measles, and scarlet fever

218
Q

pattern of weight gain in kids: week 1, 6m, 12m, 3y, 4y

A 
newborns lose 10% birth weight and back to weight at 10D
6m = 2x birth weight
12m = 3x
3y = 30lb, 30in
4y = 40lb, 40in
219
Q

Barlow test

A

adduct + internal rotation

220
Q

loud, harsh holosystolic murmur best at LLSB in child

A

VSD

221
Q

musical/vibratory murmur at apex

A

Still’s murmur

222
Q

staccato cough w/o fever

A

chlamydia pneumo

223
Q

most serious complication kawasaki

A

aortic aneurysm

224
Q

lazy eye

A

amblyopia

225
Q

type of CXR for foreign body

A

expiratory view looking for hyperinflation due to air trapping

226
Q

child

painful ulcers in mouth, feet and hands

A

coxsackie virus

227
Q

MCC upper resp tract infection

A

rhinovirus

228
Q

hyaline membrane disease on CXR

A

bilateral atelectasis or ground glass appearance

229
Q

distal esophagus CA

A

adenocarcinoma

230
Q

frequency screening endoscopy pernicious anemia pts

A

Q5y looking for gastric CA

231
Q

NSAID highest rate PUD

A

naproxen

232
Q

MC vessel blocked with intestinal ischemia

A

superior mesenteric artery

233
Q

supplement for pts on sulfasalazine for IBD

A

folate

234
Q

MCC folate deficiency

A

alcoholism

235
Q

Tx for gastrinoma

A

PPI

236
Q

hernia most likely to pass into scrotum

A

indirect

237
Q

air fluid levels on AXR

A

bowel obstruction

238
Q

MC location colorectal CA

A

cecum

239
Q

normal fiber requirements in 1 day

A

30g

240
Q

blood tests celiac dz

A

IgA endomysial Ab

IgA TTG ab

241
Q

psoas sign

A

raise right leg against resistance

242
Q

obturator sign

A

flexion + internal rotation right hip

243
Q

pancreatic CA tumor marker

A

CA 19-9

244
Q

steatorrhea

A

pancreatitis

245
Q

Ranson’s criteria

A 
55y+
WBC > 16k
gluc > 200
LDH > 350
AST > 250
246
Q

tumor marker liver CA

A

AFP

247
Q

dysphagia to both liquids and solids

A

achalasia

248
Q

med for hep B

A

lamivudine

249
Q

tx hep C

A

pegylated interferon alpha2

250
Q

hep B surface Ab?

A

recovery from infxn

or immunization to hep

251
Q

hep B core Ab?

A

previous or going HIB infxn

252
Q

viral hepatitis that is self limiting

A

Hep A and E

253
Q

tx for gastric adenocarcinoma

A

surgery

254
Q

Charcot vs Reynolds

A 
Charcot = RUQ pain + fever + jaundice
Reynolds = AMS + HoTN
255
Q

PUD most common location

A

duodenum

256
Q

tx for esophageal strictures

A

dilation

long term PPI

257
Q

tx Mallory weiss tears

A

wait - typically resolve in 48H

258
Q

to get Hep D must have?

A

Hep B

259
Q

Hep B surfance antigen

A

active hep B infxn

260
Q

MC location anal fissure

A

posterior midline

261
Q

TLC in COPD

A

increases

262
Q

crackles in lung fields: ddx?

A

pneumonia, fibrosis, CHF, bronchitis

263
Q

hyperresonance to percussion: ddx?

A

emphysema, pneumothroax, asthma

264
Q

wheezing: ddx?

A

asthma, COPD, bronchitis

265
Q

eggshell opacities

A

silicosis

266
Q

older pt

PNA + diarrhea

A

legionella pneumonia

267
Q

honeycombing + tram tracks

A

bronchiectasis

idiopathic pulm fibrosis

268
Q

what is erythema nodosum

A

tender red nodules usually found on the shins

269
Q

erythema nodosum + enlarged parotided gland = ?

A

sarcoidosis

270
Q

4 MC places lung CA mets to

A

bone, brain, adrenals, liver

271
Q

centrally located lung CA

A

small cell

squamous cell

272
Q

peripherally located lung CA

A

adenocacinoma

large cell

273
Q

type of laxative:
polyethy glycol
bisacodyl

A 
poly = osmotic lax
bisacodyl = stimulant lax
274
Q

virus assoc w/ burkitt’s lymphoma

A

EBV

275
Q

Dx pertussis

A

PCR nasal secretion

tx w/ erythromycin

276
Q

Premenstrual dysphoric disorder

A

anger/irritability

affects daily living

277
Q

FB removal

A

rigid bronchoscopy

278
Q

Rubulavirus

A

mumps

279
Q

breakbone fever

A

Dengue

supportive

280
Q

ARDS on CXR

A

diffuse infiltrates the spare costophrenic angles

281
Q

MC cause bronchiectasis

A

CF

282
Q

bullae and blebs on CXR

A

emphysema

283
Q

FEV1 in asthma

A

decreases

284
Q

MC cancers that mets to the lungs

A

breast, liver, colon

285
Q

Asbestosis CXR

A

linear opacities at bases + pleural plaques

286
Q

HACEK organisms most often cause what? list the organisms

A 
community acquired carditis
Haemophilus
Actinobacillus
Cardiobacerium
Eikenella
Kingella
287
Q

Dullness to percussion

A

PNA

288
Q

Dullness to percussion

rust colored sputum

A

PNA

289
Q

Coal miner lung or silicosis CXR

A

nodular opacities in upper lung fields

290
Q

Rust colored sputum

A

S. pneumo

291
Q

MCC PNA in COPD pts

A

H flu

292
Q

rats + PNA

A

yersinia pestis

aminoglycosides

293
Q

college student + PNA

A

chlamydia or mycoplasma

294
Q

gohn complex
ranke complex
caseating granuloma

A

TB

continue INH and RIF the longest

295
Q

aerospace, nuclear plant workers

diffuse infiltrates + hilar adenopathy

A

berylliosis

296
Q

MCC PNA in children < 1y

A

RSV

297
Q 
farsighted = ? 
nearsighted = ?
A

hyperopia; tx w/ convex lens

myopia; tx w/ concave lens

298
Q

purulent d/c from eye:
2-5D after birth
up to 2wks after birth +/- PNA

A

2-5D = neisseria

2wks + PNA = chlamydia

299
Q

hypopyon vs hyphema of the anterior chamber

A 
hypopyon = WBC
hypema = RBC
300
Q

Hutchinson’s sign

A

HSV vesicles on nose, assoc w/ zoster in eye

301
Q

sudden PAINLESS complete unilateral vision loss
opalescent retina + boxcarring
cherry red spot

A

CRAO

302
Q

MCC viral conjunctivits

A

adenovirus

bilateral watery d/c w/ nontender preauricular LAD

303
Q

Halos + rainbows around lights
moderate photophobia
bowing of iris

A

glaucoma

304
Q

metamorphopsia + central blind spot

drusen deposits on fundus

A

distorted vision of grid lines looking wavy
macular degeneration
check w/ Amsler grid

305
Q

unilateral vision blurriness

blood and thunder fundus

A

CVO

306
Q

5 parts biophysical profile

A 
non-stress test
fetal breathing
2 gross body mvmts
fetal tone
amniotic fluid indix
307
Q

procidentia

A

uterine prolapse beyond the introitus

308
Q

due date for baby

A

1st day LMP + 1 week - 3 mon

309
Q

metritis

A

MC infection 10D after C-section

310
Q

reproductive CA that carries the highest rates of death in women

A

ovarian CA

311
Q

when give rhogam

A

28 wks

mom rh-, dad rh+

312
Q

bhCG positive after how many days

A

8 days past conception

313
Q

vaginal candida on KOH

A

pseudophyphae

314
Q

2 meds to induce labor

A

Cervidil (prostaglandin) for cervical ripening

Oxytocin for urterine contractions

315
Q

why tell pregnant pts to avoid deli meats and soft cheese

A

listeria

316
Q

MC type endometrial CA

A

adenocarcinoma

317
Q

wks to do chorionic villus sampling

A

10-13 wks

318
Q

PID vs ectopic, appendicitis, ovarian torsion, ovarian cyst

A

PID described as bilateral pain. others typically unilateral

319
Q

preterm labor

A

contractions that open cervix before 37wk

320
Q

wks to do amniocentesis

A

15-20 wks

321
Q

gold standard chlamydia

A

nucleic acid amplification test

322
Q

what dx is associated w/ thymoma

A

myasthenia gravis

323
Q

tx acute dystonic rxn after giving neurleptic med

A

benztropine
diphenhydramine
(anticholinergics)

324
Q

fever, hyperreflexia, tremor, sweating, dilated pupils, diarrhea

A

serotonin syndrome

cyproheptadine (anticholinergic/antihistamine)

325
Q

tx candida intertrigio

A

topical econazole

326
Q

painful ulceration + inguinal lymphadenopathy

A 
H ducreyi
gram- coccobacillus
Azith
Rocephin
Cipro 
Erythromycin
327
Q

Dx criteria or diabetes

A
  1. symptoms + random gluc > 200
  2. fasting plasma > 126 twice
  3. glucose > 200 2H after 75g glucose test
328
Q

2 y/o

asx or painless rectal bleeding

A

Meckel’s Diverticulum

Dx w/ 99m technetium scan (nuclear med scan)

329
Q

Hemophilia A vs B

A

A (A’ight) = factor 8

B (B-nine) = factor 9

330
Q

ITCHING
fatigue
RUQ pain
AMA Ab, high liver enzymes

A

Primary biliary cirrhosis

331
Q

Causes core pulmonale

A

Pulm HTN = right ventricular dilation
COPD, PE, fibrosis
MG
Sarcoid

332
Q

hyperandrogenism
high LH
ovarian cysts

A

PCOS

333
Q

same side sensorineural hearing loss + ataxia + tinnitus

poor word discrimination

A

Acoustic neuroma

334
Q

when to check acetamiophen levels for toxicity

A

4H after reported time ingestion

140mg N-acetylcysteine, then 70mg Q4H = total 17 doses

335
Q

Tx hypercalcemia of malignancy

A

bisphosphonates

loops, IV fluid

336
Q 
SLUDGE
Salivation
Lacrimation
Urination
Diarrhea
GI cramps
Emesis
A

Organophosphate poison

Atropine, Pralidoxime (2-PAM)

337
Q

relapse/remission
15-50y
optic neuritis + fatigue

A

MS
Lhermitte sign
Periventricular plaques on T2 weighted MRI - demylination

338
Q

Tx status epilepticus

A

1) IV lorazepam, diazepam, or midazolam
2) phenytoin or valproic acid
3) phenobarbital or propofol

339
Q

young obese F
papilledema + diplopia (CN6 palsy) + loss peripheral visual fields
high opening pressure on LP

A

Idiopathic intracranial HTN (pseudotumor cerebri)

can be worsened w/ tetracycline, OCP, sulfonamides, macrobid

340
Q

Diagnositic criteria gestational diabetes

A

1) 1h 50g glucose challened at 24-28 weeks

2) 100g glucose challenge shows (2) = 95+ fasting, 180+ 1H, 155+ 2H, 140+ 3H

341
Q

HCAP

A

within 90 days of hospitalization
nursing home LTCF
hemodialysis
tx: cefepim, ceftazaidime, zosyn imipenem/cilastin,

342
Q

gleason score

A

for prostate cancer (out of 10) lower number the better

343
Q

Causes of transudative effusion

A 
(intact capillaries)
CHF
cirrhosis
Nephrotic syndrome
PE
344
Q

Vaccines C/I pregnancy

A

varicella
MMR
Zoster
any live virus

345
Q 
bacterial/viral infxn followed by:
bilateral LE palpable non-blanching macules/patches
abdominal cramps/bloody stool
knee/ankle aches
hematuria
A

IgA vasculitis
HSP
supportive tx
resolves in 6-8w

346
Q

thick white curdy d/c

ph < 4.5

A

candida = pseudohyphae

347
Q

frothy/green d/c

A

trich

348
Q

thin, grey d/c

clue cells

A

BV

349
Q

hx flu
fever + productive cough + bloody sputum + SOB
CXR: multiple cavitary lesions

A

post-viral PNA

MCC S aureus

350
Q

MCC croup

A

parainfluenza virus

O2, IM steroids, neb epi

351
Q

dx premature rupture of membranes

A

pooling test - amniotic fluid in fornix
nitrazine test - amniotic fluid turns paper from orange (intact) to blue
ferning (arborization)

352
Q

2-6y/o child
acute post viral infxn
thrombocytopenia
petechia/purpura/gingival bleeding

A

ITP
corticosteroids
IVIG
splenectomy

353
Q

2-10 y/o
subacute scrotal pain
dark blue dot upper pole

A

Torsion of appendix testis

MCC testicular pain boys 2-10

354
Q

PNA + gram- coccobaccili

A

H flu

355
Q

prophylasix menningococcal meningitis

A

rifampin

356
Q

gram+ chains

A

strep

PCN, macrolides, cefs

357
Q

tx toxoplasmosis

A

bactrim

358
Q

is psudomanas gram + or gram - ?

A

pseudomonas = gram -

359
Q

test for syphilis

A

dark field microsocpy/VRDL/RPR
confirm w/ Ab test (FTA-ABS)
treponema pallidum
Jarish-Herxheimer rxn to PCN

360
Q

low RTC+ normal iron

A

anemia chronic disease

361
Q

peripheral zone vs transitional zone: BPH vs prostate CA

A

BPH = transition

prostate CA = peripheral

362
Q

MC bladder CA type

A

transitional cell

363
Q

phren sign

A

lifting relieves pain = epididymitis

364
Q

swelling/pain in cheek worse w/ meals

A

sialadenitis

s. aureus

365
Q

tx epiglotitis

A

3rd gen ceph - cephalosporin, rocephin

366
Q

most aggressive thyroid CA type

A

anaplastic

367
Q

insulins in order of peak efficacy

A

lispro (1-2H)
regular (2-4H)
NPH (5-7H)
detemire/glargine (long axn - no peak)

368
Q

tx dawn phenomenon

A

morning hyperglycemia from normal nighttime release of hormones (glucagon, cortisol, etc)
increase NPH

369
Q

tx somogyi effect

A

rebound hyperglycemia after overnight hypoglycemia

decrease NPH

370
Q

HTN, T2D, obeses, hair grown, striae, moon facies

A

Cushings
excess cortisol - check w/ dexamethasone suppression test and ACTH
hyperglycemia, hypoK
spironolactone or surgery

371
Q

euvolemic hypoNa

A

SIADH - persistent ADH release, independent of serum osmolality
urinary sodium > 20
restrict fluids!

372
Q

autoimmune adrenal cortical destruction
weakness, fatigue
salt craving + HoTN
hyperpigmentation

A

Addisons = cortical adrenal insufficiency
HoNa
HyperK, HyperCa
am cortisol < 3, confirm w/ Cosyntropin stimulation cortisol doesn’t raise >18
glucocorticoids and mineralocoritcoids (aldo)

373
Q

young pt w/ HTN w/o RF or FamHx

HTN + HA + polyuria + muscle weakness

A 
Hyperaldo - Conn's syndrome if there's an adrenal adenoma
HypoK, HyperNa
HypoMag
aldo/renin activity ratio high
CT/MRI
spironolactone
374
Q

Kussmal breathing

A

a deep and labored breathing pattern often associated with severe metabolic acidosis,

375
Q

teardrop lesion after strep throat

A

guttate psoriasis

376
Q

tx for high TG

A

fibric acid

377
Q

left axis deviation

A

L1 up
AVF down
L = leaving each other

378
Q

right axis deviation

A

L1 down
AVF up
R = heading right for each other

379
Q

ddx w/ pulses paradoxus

A

pericarditis
pericardial effusion
obstructive lung disease

380
Q

biphastic P wave

A

LAE

381
Q

MCC subacute endocarditits

A

strep viridans

382
Q

Balock procedure corrects what heart condition

A

tetralogy of fallot

383
Q

Tx PDA vs VSD

A

PDA - indomethacin

VSD - surgery

384
Q

MCC atrial septal defect

A

patent foramen ovale

385
Q

MCC acute endocarditis

A

s aureus

vanc

386
Q

how long to be on aspirin or clopidogrel after stent

A

1 yr

387
Q

PMI from aortic stenosis

A

laterally displaced b/c LVH

388
Q

tietze syndrome

A

costochondritis

389
Q

best way to hear aortic regurge and stenosis

A

sitting up and leaning forwards

390
Q

pulsus alternans

A

EKG waveform changes from beat to beat

large pericardial effusion

391
Q

first line IV inotropic agent for cardiogenic shock

A

dopamine

392
Q

INR:
mechanical valve replacement
organic valve

A

mechanical valve: 2.5-3.5

organic valve: 2-3

393
Q

MCC CHF

A

coronary artery disease

394
Q

after MI what med to tx HTN

A

BB

395
Q

behavioral tx for borderline pts

A

dialectical behavior therapy

396
Q

2 psych issues more common in M > F

A

autism

ADD

397
Q

Cluster B

A

antisocial
borderline - neurotic + psychosis
histrionic
narcissistic

398
Q

Cluster C

A

avoidant
obsessive compulsive
dependent

399
Q

Cluster A

A

paranoid
schizoid - prefers to be alone
schizotypal - magical thinking

400
Q

tx depression ok w/ breast feeding

A

zoloft

401
Q

muscle weakness

fatigability that improves w/ rest

A

myasthenia gravis

ACh receptor Ab

402
Q

intracranial neoplasm causing auditory illusions, olfactory hallucinations, and emotional changes: which lobe?

A

temporal

403
Q

MC primary intracranial neoplams

A

glioma

404
Q

tx tourette’s

A

haldol, fluphenazine: block DA

405
Q

tx essential tremor

A

propanolol

primidone

406
Q

stroke w/ aphasia, loss of hearing 1 hear, loss of vision 1 eye: what artery?

A

anterior cerebral artery

407
Q

GABA and substance P

A

Huntington’s

408
Q

3 tx cluster HA

A

O2
sumatriptan
stadol (butorphanol)

409
Q

painful ipsilateral 3rd nerve palsy

A

posterior communicating artery (PCA) aneurysm

410
Q

MC knee injury

A

medial meniscal tear

411
Q

inability to extend knee after trauma

A

patellar fx

412
Q

MC rotator cuff muscle injured

A

supraspinatus

413
Q

elderly w/ leg shorted and externally rotated after fall

A

hip fx

414
Q

HIV pt has severe groin pain

A

AVN of femoral head due to antiretroviral meds

415
Q

MC fracture in a pt w/ osteoporosis

A

compression fx vertebral body, then hip fx

416
Q

angulation Colles vs Smith

A 
Colles = dorsal
Smith = volar
417
Q

hx Hep B
bilateral knee pain
fever + wt loss

A

polyarteritis nodosa

418
Q

severe night bone pain

A

osteoid osteoma - benign bone tumor MC in femur and tibia

pain tx w/ ibuprofen

419
Q

MCC compartment syndrome

A

tibia fracture

420
Q

age to order DEXA scans

A

70 M

65 F

421
Q

Austin flint murmur

A

low-pitched rumbling heart murmur which is best heard at the cardiac apex
mid-diastolic or presystolic murmur
assoc with severe aortic regurg

422
Q

tx myasthenia gravis

A

pyridostigmine (anticholinesterase)

423
Q

tx multiple sclerosis

A 
steroids
immunomodulators
cylophosphamide
IVIG
plasmapheresis
424
Q

nephritic ssx + coughing up blood

A

anti-glomerular basement membrane (Goodpasture syndrome)

tx plasmapheresis, corticosteroids, cyclophosphamide

425
Q

MC primary glomerulonephritis

A

IgA nephropathy (Berger disease)
can be associated w/ URI
tx: ACEI/ARB or steroids

426
Q

young male, black/hispanic
HTN + anemia + antiphospholipid Ab
Proetinuria > 500

A

lupus nephritis

Tx: ACE/ARB

427
Q

7-10D after pharyngitis/impetigo

A

Post-infectious glomerulonephritis
Group A strep
IgG and C3 along basement membrane
ASO titers

428
Q

rapid decline in kidney func

Crescents on microscopy

A

rapidly progressive glomerulonephritis

429
Q

Types of nephritic syndromes (edema + HTN + coke/tea colored urin)
UNa > 2%

A

Rapidly progressive
Post-infectious
Berger disease (IgA)
Goodpasture’s

430
Q

Types of nephrotic syndromes (proteinuria > 3 + hypoalbuminemia + hyperlipidemia)

A

minimal change disease
focal segmental glomerulosclerosis
membranous nephropathy

431
Q

MC proteinuria renal disease in children
may follow URI
assoic w/ Hodkins

A

Minimal change disease

tx: steroids 8-16 wks

432
Q

MCC nephrotic syndrome in adults that leads to ESRD

Black + overweight + HTN

A

Focal segmental glomerulosclerosis

tx: ACEI/ARB/statin, immunosuppressives, steroids

433
Q

nephrotic syndrom associated w/ Hep B, CA, syphilis

Kidney bx = “spike and dome”

A

Membranous nephropathy

tx: ACE/ARB/statin, steroid, immunosuppressives

434
Q

pre-renal AKI

A

hypoperfusion - dehydration
Na < 1%
BUN/Cr > 20
tx w/ IV saline

435
Q

post-renal AKI

A

flow obstruction - pelvic tumors, radiation, prostate enlargement, stones

436
Q

types of intrinsic renal disease

A

ATN
AIN
nephritc syndrome
vasculitis

437
Q

Na > 2%

RF1 > 1

A

ATN

438
Q 
WBC casts (eosinophiluria)
fever, rash
A

AIN

439
Q

male child w/ infection
PALPABLE PURPURA on LE
joint aches
abdominal ssx - nausea, colic, melena

A

Henoch-Schonlein Purpura
(WITHOUT thrombocytopenia)
self-resolves

440
Q

adenosine vs atropine

A 
adenoSine = Slows (AV conduction via K+ channel activation)
aTropine = Triggers the Ticker
441
Q

rx tx for tachy in WPW

A

adenosine or CCB to block AV node

442
Q

what med must be withheld 48H after contrast?

A

metformin

443
Q

atrophy caudate and putamen of the basal ganglia

A

Huntington

tx w/ BZD, or DA antagonists (reglan)

444
Q

what med class exacerbate huntingtons sx

A

dopamine agonists - worsens sx

445
Q

erysipelas caused by?

A

strep pyogens
amoxicillin
keflex
rocephin

446
Q

which is more sensitive: phalen vs tinel?

A

Phalen

447
Q

imaging for congenital hip dysplasia before 6mon

A

US

448
Q

Barlow vs Ortolani

A

Barlow - ADDuct = dislocate

Ortalani - ABDuct = reduction

449
Q 
anticholinergic sx:
hot hare
dry bone
blind bat
mad hatter
red beet
cause by what OD?
A

TCA

450
Q

sudden onset unilateral (R > L) abd/pelvic pain
leukocytosis
W 15-30 or postmenopause

A

Ovarian Torsion
Dx TVUS
Gold standard: laparoscopy
MCC cyst or tumor

451
Q

AV dissociation, wide complex, rate 150-200

A

VTach

pulseless: defibrilate
unstable: sync cardiovert
stable: meds

452
Q

Med tx for stable V tach

A

amiodarone

procainamide

453
Q

Bite
Neurotoxin
severe muscle cramping + CNS excitation

A 
black widow (red hourglass)
supportive (opioids, bzds)
454
Q

Bite
Cytotoxin
tissue destruction

A 
Brown recluse (brown fiddle)
local wound care
455
Q

MCC hyperosmolar hyperglycemic state

A

glucose 600+ without ketones

dehydration - tx w/ IVF

456
Q

biphasic T waves V2-3

A

stenosis LAD

457
Q

Coved ST seg elevation followed by negative T waves in V1-3

A

Brugada

AICD

458
Q

horizontal ST depression with tall, broad R waves and upright T waves in leads V1-3

A

posterior MI

459
Q

1) ST elevation in aVR > 1mm; or
2) aVR ST elevation > ST elevation in V1
3) ST depression in leads 1-2 and V4-6

A

left main coronary artery occlusion

460
Q

bulge lateral to inferior epigastic vessels
can pass into scrotum or labia majora
M > F; congenital

A

indirect hernia

461
Q

bulge thru weakened fascia of abdominal wall
behind superficial inguinal ring
medial to inferior epigastric vesels

A

direct hernia

462
Q

Weber results

A

conductive loss = lateralization to affected side

sensorineural loss = lateralization to normal/better hearing side

463
Q

Rinne test results

A

Normal = AC > BC

Conductive loss = BC > AC

464
Q

difference in 1st-3rd degree burns

A

1st: superficial, epidermis
2nd: superficial partial - papillary dermis
2nd: deep partial - reticular dermis (white/leathery/painless)
3rd: hypodermis (subq - charred)

465
Q

nephroblastoma

A

wilms tumor

good prognosis after surgery/chemo/radiation

466
Q

what is S3 vs S4 assoc w/

A 
CAD = systolic HF - S3
HTN = diastolic heart failure - S4
467
Q

floppy ventricle

A

S3

468
Q

stiff ventricle

A

S4

HTN, aortic stenosis

469
Q

RF aortic aneurysm vs dissection

A

aneurysm - atherosclerosis

dissection - HTN, cocaine, bicuspid valve, collagen d/o

470
Q

MCC bacterial trachitis

A

s aureus
kids 3-5y/o
looks like croup but TOXIC appearing

471
Q

inverted P wave afer QRS

A

premature junctional contraction

472
Q

flushing + diarrhea + pulm ssx

A

carcinoid tumor

24-hour excretion of 5-hydroxyindoleacetic acid (5-HIAA)

473
Q

what is a carcinoid tumor

A

neuroendocrine tumors of the digestive tract, lungs, and less commonly of the kidneys and ovaries
secrete serotonin, histamine, catecholamine, prostaglandins

474
Q

diastolic murmur (rumble)
left sternal border 4th
louder w/ inspiration

A

tricuspid stenosis

475
Q

MC ekg finding in PE

A

sinus tachy

476
Q

juvenile idiopathic arthritis tx

A

NSAIDs
methotrexate
steroids

477
Q

diabetes insipidus lab values

A

low urine osmolality

high serum osmolality

478
Q

tx diabetes insipidus

A

central: DDAVP
nephrogenic: HCTZ, amilioride, indomethacin

479
Q

diarrhea, steatorrhea, gas, weight loss

IgA, anti tTG antibodies

A

Celiac disease
bx small bowel
dermatitis herpetiformis

PANCE (7 decks)

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