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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
What lab check w/ warfarin
PT
26
MCC HTN young women
OCP
27
MCC HTN young men
Etoh
28
MC type of skin cancer
BCC
29
Pearly papule + translucent + telangiectasias
BCC
30
Nikolsky + younger mucous membranes + flaccid blisters
Pemphigus vulgaris
31
Nikolsky - autimmune + elderly tense blisters
Bullous pemphigoid
32
puritic, purple, polygonal, planar, papules/patches
Lichen planus | steroids
33
Iris-like target lesion
erythema multiforme
34
pink, scaling flat lesion | spaghetti/meatballs on KOH
Tinea versicolor
35
Premalignant lesion for SCC
actinic keratosis
36
dewdrops on a rose petal
varicella
37
Exophytic nodules on skin w/ varying degrees of scaling or ulceration
SCC
38
HA + weakness + fatigue + polyuria exam shows HoTN + tetany labs = HoK, metablic alkalosis
primary hyper-aldosteronism (from Conn's syndrome or bilateral adrenal hyperplasia)
39
tachy + wild swings in BP + HA + diaphoresis + panic tumor of chromaffin tissue assoc MEN 2a and 2B paroxysmal (short/frequent) sx
pheo tumor of chromaffin tissue assoc MEN 2a and 2B
40
alpha blockers for pheo
phentolamine | phenoxybenzamine
41
Hx lithium + copious dilute urine
nephrogenic diabetes insipidus
42
tx central DI
DDAVP + free water restriction
43
antidiabetic med associated w/ lactic acidosis
metformin
44
weakness + nausea + vomiting + weight loss tan skin HoNa + HypK
primary adrenal insufficiency - addisons | gluco + mineral corticoids
45
treatment DKA
fluids insulin K+
46
Risk factors cholelithiasis
``` fat female fertile forty flatulent ```
47
MCC small bowel obstruction in pts w/ no hx abd surgery
hernia
48
Peritoneal signs + AXR shows free air under diaphragm. Management?
emergent laparotomy to repair perforation
49
Tx hepatic encephalopathy
decrease protein intake lactulose rifaximin
50
child w/ oliguria + petechiae + JAUNDICE | following illness w/ BLOODY DIARRHEA
HUS from e coli O157:H7 | Hemolysis + uremia + THROMBOCYTOPENIA
51
causes of drug-induced hepatitis
TB meds (INH, rifampin, pryazinamide), acetaminphen, tetracycline
52
Tx IBD
5 ASA + steroids during acute exacerbations
53
extra intestinal manifestations of IBD
``` uveitis ank spnd p. gangrenosum erythema nodosum PSC ```
54
MCC cause diarrhea
campy
55
camping diarrhea
giardia
56
traveler's diarrhea
ETEC
57
picnics/mayonnaise
s aureus
58
uncooked hamburgers
E O157:H7
59
poultry/eggs
salmonella
60
AIDs diarrhea
crytosporidium, MAC, isospora
61
pseudoappendicitis
Yersinia, Campy
62
post-HBV exposure tx
HBV immunoglobulin
63
40F, obese + itching + dark urine + clay colored stool | high bili, high alk phos
biliary tract obstruction
64
4 causes microcytic anemia
``` "TICS" Thalassemia Iron deficiency anemia of Chronic disease Sideroblastic anemia ```
65
precipitants of hemolytic crisis G6PD
sulfs, antimalaria drugs, fava beans
66
MC inherited hypercoagulability
Factor V
67
MC inherited bleeding d/o
von Willebrands
68
MC inherited hemolytic anemia
hereditary spherocytosis
69
Dx test for hereditary spherocytosis
osmotic fragility test
70
Meds/viruses that lead to aplastic anemia
``` Chloramphenicol Sulfonamides Radiation HIV Chemo hepatitis parvovirus B19 EBV ```
71
high hematocrit + high RBC mass + low EPO
polycythemia vera
72
TTP pentad
``` "FAT RN" fever anemia thrombocytopenia renal dysfunction neruo abnormalities ```
73
Tx TTP (thrombotic thrombocytopenic purpura)
emergent large volume plasmapheresis corticosteroids antiplatelets
74
what is CI in TTP
platelet transfusion
75
Tx ITP
resolves spontaneously | maybe IVIG/corticosteroids if unstable
76
which are elevated in DIC: fibrin split products, d-dimer, fibrinogen, platelets, hematocrit
high: fibrin split products + d-dimer low: platelets, fibrinogen, HCT
77
8y/o boy hemarthrosis + increased PTT normal PT + normal bleeding time
Hemophelia A or B | DDAVP, factor 8 or 9 supplements
78
14 y/o F prolonged bleeding normal PT increased bleeding time
vW disease | DDAVP, FFP or cryoprecipitate
79
Monoclonoal gammopathy Bence jones proteinuria punched out lesions on XR
multiple myeloma
80
Reed-Sternberg cells
Hodgkin's lymphoma
81
kid w/ fever, weight loss, night sweets | anterior mediastinal mass
non-hodgkin's lymphoma
82
Microcytic anemia low serum iron low TIBC normal/high ferritin
anemia of chronic disease
83
Microcytic anemia low serum iron high TIBC low ferritin
Fe deficiency anemia
84
old splenomegaly, lemphadenopathy lymphocytosis (super high)
CLL
85
Satiety, splenomgaly, bleeding | t(9,22)
CML
86
Heinz bodies
intracellular inclusions thalassemia G6PD postsplenectomy
87
virus assoc w/ aplastic anemia in sickle cell pts
parvoirus B19
88
Significant cause of morbidity in thalassemia pts: tx?
Fe overload | deferoxamine
89
What to do before LP
check for ICP via papilledema
90
Aplenic pts are susceptible to these organisms
``` encapulated organisms pneumococcus meningococcus H flu klebsiella ```
91
Pt from CA or AZ | fever + malaise + cough + night sweats
Coccidiodomycosis | Amp B
92
Blueberry muffin rash cataracts deafness mental retardation
Congenital rubella
93
CSF low glucose, mostly PMNs
bacterial meningitis
94
CSF normal glucose, mostly lymphocytes
viral meingitis
95
high ICP xanthochromia RBCs in serial CSF samples
subarachnoid hemorrhage
96
CSF w/ high gamma globulins
MS
97
3 syphilis findings
tabes dorsalis - loss coordination argyll roberson pupil - no reaction to light but ok accomodation aortic root aneurysms
98
lyme disease sx
``` erythema migrans arthralgia migratory polyarthropathies Bell's palsy myocarditis ```
99
Cold agglutinins
mycoplasma
100
Dog or cat bite
``` pasteurella multocida PCN augmentin Cipro Doxy ```
101
Gardener w/ bumps/sores slow to heal | "rose gardner's disease"
sporothrix schenckii | itraconazole
102
meningitis adults
N meningitidis
103
meningitis elderly
strep pneumo
104
Meningoencephalitis AIDS pt
cryptococcus neoformans
105
Red currant jelly sputum | alcoholic pneumonia
klebsiella
106
Infxn in burn victims
pseudomonas
107
smoker/drinker new cough + flu-like sx + diarrhea gram stain shows nothing silver stain sputum = gram- rods
Legionella pneumonea Macrolides Quinolones
108
Organisms for reactive arthritis
chlamydia campy shigella salmonella
109
pain/stiffness shoulders + hips anemia high ESR
polymyalgia rheumatica
110
MC primary malignant tumor of bone
multiple myeloma
111
"Broken speech" | type of aphasia, lobe, vessel
Broca's aphasia Frontal lobe Left MCA
112
MCC SAH
``` trauma #2 is berry aneurysm ```
113
Crescent shaped hyperdensity that does not cross midline
subdural hematoma | torn bridging veins
114
initial AMS then lucid interval
epidural hematoma | middle meningeal artery
115
albuminocytologic dissociation
Guillain Barre | high protein in CSF w/o significant increase in cell count
116
caloric response to water in ear
COWS is normal cold water = opposite warm = same
117
confusion + confabulation + opthalmoplegia (eye muscle paralysis) + ataxia (loss ctrl bodily mvmts)
Wernicke's
118
What % lesion is indication for CEA
70% if stenosis is symptomatic
119
combo UMN and LMN d/o
ALS
120
Tx Guillain Barre
IVIG or plasmapheresis | NO steroids
121
Complete hydatidiform mole on US
"snowstorm" | "cluster of grapes"
122
Abx w/ teratogenic effects
tetracycline fluoroquinolones aminoglycosides ("mycin") sulfonamides
123
Med to accelerate fetal lung maturity
Betamethasone or dexamethasone x 48H
124
Tx postpartum hemorrhage
uterine massage or oxytocin
125
Abx for GBS prophylaxis in pregnancy
IV PCN | ampicillin
126
heavy bleeding during and between periods
menometrorrhagia
127
amenorrhea w/ normal prolactin no response to estrogen/progesterone challenge hx D&C
Asherman's
128
Med to induce ovulation
clomiphene citrate
129
Tx for endometriosis
OCP danazol GnRH agonist (Lupron)
130
Chocolate cysts
endometriosis
131
Natural progression of leiomyoma
regress after menopause
132
Annual screening for F w/ strong FHx ovarian CA
CEA 125 | TVUS
133
unpredictable urine loss (urge incontinence) tx
``` anticholinergics (oxybutynin) B adrenergics (metroproterenol) ```
134
leakage urine w/ laughing/coughing (stress incontinence) tx
kegel estrogen pessaries
135
MCC female infertility
endometriosis
136
follow up for 2 consecutive finding ASCUS
colposcopy and endocervical curettage
137
Breast CA type that has high risk of invasive carcinoma in both breasts
Lobular carcinoma in situ
138
bilious emesis w/in hours after 1st feeding
duodenal atresia
139
neonate w/ meconium ileus
CF
140
failure to pass meconium for 48H
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
141
high fever + onset rash as fever breaks
Roseola HHV 6-7 risk for febrile seizures
142
Acute phase tx for Kawasaki disease
high dose ASA for inflammation/fever | IVIG to prevent coronary artery aneurysms
143
tx for mild and sever unconjugated hyperbilirubinemia
phototherapy (mild) exchange transfusion (severe) NO phototherapy for conjugated hyperbili
144
Sudden onset AMS + emesis + liver dysfunction + recent ASA intake
Reye's syndrome
145
child w/ loss of red reflex
retinoblastoma | increased risk osteosarcoma
146
Vaccinations for 6mon WCE (6 total)
``` HBV DTap Hib IPV PCV Rotavirus ```
147
Red currant jelly stool colicky abdominal pain bilious vomit sausage shaped mass
intussusception target on US air contrast barium enema = dx + tx
148
Croup cause
Parainfluenza virus
149
Peeling skin and swollen belly
Kwashiorkor (protein malnutrition)
150
Continous machinery murmur
PDA | tx w/ indomethacin
151
Webbed neck + shield chest Coarctation of aorta Lymphedema hands/feet as neonate high FSH
Turner (45 XO)
152
``` Inactivated X (Barr body) hypogonadism, testicular atrophy, tall, female hair ```
Klinefelters (47, XXY) | Tx w/ testosterone
153
Rocker-bottom feet overlapping 4-5 digits micrognathia Death w/in 1 year
Edward's (Trisomy 18)
154
Simian crease, upslanted eyes Duodenal atresia, Hirschsprung's, ASD/VSD/PDA increased risk ALL and Alzheimers
Down's | Meiotic nondisjunction
155
Erythema Infectiosum
parvovirus B 19 slapped check worse w/ sun exposure aplastic crisis for sickle cell
156
Measles (Rubeola)
paramyxovirus C's - conjunctivitis, cough, coryza, Koplik's Rash spreads from head to toe
157
Rubella (3 day measles)
rubella virus | non-ill looking kid w/ rash spreads down from head to toe
158
Roseola infantum
HHV 6-7 High fever + rash starting on TRUNK and spreads outward Febrile seizures
159
Varicella
VZV vesicles in different stages of healing infectious from 24H before eruption until crusted over Reye's Syndrome
160
symmetric proximal muscle weakness + difficulty breathing or swallowing red/purple maculopapular rash
polymyositis
161
``` heliotrope rash (violet periorbital rash) shawl sign (rash of upper chest/shoulders/back) Gottron's papules (papular rash w/ scales on dorsum hand) ```
dermatomyositis
162
high CK | anti-jo-1 ab
polymyositis, dermatomyositis
163
anticentromere ab
CREST syndrome
164
Anti dsDNA, Anti-Sm, ANA
``` SLE NSAID - joints Corticosteroids - acute exacerbations hydroxychloroquine - skin/joints cyclophosphamide - lupus nephritis ```
165
Antinuclear, Anti-Scl-70, Antitopoisomerase 1
Scleroderma
166
Anti CCP, RF factor
``` RA Tx: methrotrexate hydroxychloroquine sulfasalazine ```
167
Complication supracondylar humerus fx
MC pediatric elbow fx | brachial artery entrapment
168
Alli's/Galleazzi's sign
knees unequal heights when hips/knees flexed = developmental dysplasia of hip
169
may be administered to a symptomatic pt to dx myasthenia gravis
edrophonium
170
Antidepressant assoc w/ HTN crisis
MAOI
171
mother angry at husband yells at child
displacement
172
pedophile enters monastery
reaction formation
173
pt calmly describing a grisly murder
isolation
174
hospitalized 10y/o begins to wet bed
regression
175
violent pt + vertical/horizontal nystagmus
phencyclidine hydochloride intoxication (PCP)
176
pupillary dilation + "cocaine bugs" (formication) + "chest pain"
haldol | sx specific meds (for HTN, tachcardia, etc)
177
crash w/ hypersomnolence, depression, malaise, angina, increased appetite
cocaine w/d
178
crash w/ anxiety, HA, stomach cramps, depression/dysphoria, hunger, fatigue
amphetamines w/d
179
pupillary dilation, psychomotor agitation, prolonged wakefulness
haldol | sx specific meds (antiemetics, NSAIDS)
180
pupillary constriction, CNS/resp depression, constipation
Naloxone | naltrexone
181
myalgia, fever, lacrimation, diaphoresis, DILATED pupils, yawning, piloerection, NV, diarrhea
opioid w/d methadone w/d not life thretening
182
rx for bulemia
prozac
183
Honeycomb pattern CXR
diffuse interstitial pulmonary fibrosis | supportive +/- steroids
184
non-caseating granuloma + increased ACE + hyperCa + hilar lymph
Sarcoidosis
185
Lung CA assoc w/ SIADH
small cell lung CA
186
Lung CA from cigarette exposure
small cell lung CA
187
ARDS
hypoxemia + pulm edema + normal pulm capillary wedge pressure (PCWP)
188
Silicosis increases risk of?
mycobacterium TB
189
Westermark's sign, Hampton's hump | S1Q3invT
Pulm embolism
190
polycystic kidneys assoc w/?
berry aneurysms
191
waxy casts + maltese crosses + lipiduria
nephrotic syndrome
192
low urine specific gravity + high serum osmolality
DI
193
tx SIADH
fluid restriction | demeclocycline
194
MC type testicular CA
seminoma (type of germ cell tumor)
195
Testicular CA assoc w/ bhCG, AFP
choriocarcinoma
196
MC histology bladder CA
transitional cell CA
197
complication of overly rapid correction hyponatremia
central pontine myelinolysis
198
Salicylate ingestion causes what type of acid-base d/o
anion gap acidosis + resp alk
199
3 systemic diseases that lead to nephrotic syndrome
DM, SLE, amyloidosis
200
tx ARDS
CPAP
201
acetminophen OD
N acetylcysteine
202
BZD overdose
flumazenil
203
Tx for neuroleptic malignant syndrome (muscle rigidity, hyperthermia, autonomic instability, extrapyramidal sx)
dantrolene
204
signs neurogenic shock
HoTN + bradycardia
205
sx increased ICP (Cushing's triad)
HTN + bradycardia + abnormal respirations
206
low CO HIGH PCWP high peripheral vascular resistance
cardigenic shock
207
Test to r/o urethral injury
retrograde cystourethrogram
208
SVT tx
carotid massage | adenosine
209
Malignant htn tx
nitroprusside
210
HIGH CO low PCWP low peripheral vascular resistance
septic or anaphylactic shock
211
signs of air embolism
pt w/ chest trauma who was previously stable suddenly dies
212
sx cardiac tamponade
distended neck veins + HoTN + diminished heart sounds + pulsus paradoxus
213
absent breath sounds + dullness to percussion + shock + flat neck veins
massive hemothorax
214
Brown Sequard
same side motor/vib/prop | opp side pain/temp
215
Central cord
incomplete motor some sensory MCC - extension injury
216
Anterior cord
loss all motor loss pain and temp proprioception/vibration ok
217
Forchheimer spots
petechiae on the soft palate | rubella, measles, and scarlet fever
218
pattern of weight gain in kids: week 1, 6m, 12m, 3y, 4y
``` newborns lose 10% birth weight and back to weight at 10D 6m = 2x birth weight 12m = 3x 3y = 30lb, 30in 4y = 40lb, 40in ```
219
Barlow test
adduct + internal rotation
220
loud, harsh holosystolic murmur best at LLSB in child
VSD
221
musical/vibratory murmur at apex
Still's murmur
222
staccato cough w/o fever
chlamydia pneumo
223
most serious complication kawasaki
aortic aneurysm
224
lazy eye
amblyopia
225
type of CXR for foreign body
expiratory view looking for hyperinflation due to air trapping
226
child | painful ulcers in mouth, feet and hands
coxsackie virus
227
MCC upper resp tract infection
rhinovirus
228
hyaline membrane disease on CXR
bilateral atelectasis or ground glass appearance
229
distal esophagus CA
adenocarcinoma
230
frequency screening endoscopy pernicious anemia pts
Q5y looking for gastric CA
231
NSAID highest rate PUD
naproxen
232
MC vessel blocked with intestinal ischemia
superior mesenteric artery
233
supplement for pts on sulfasalazine for IBD
folate
234
MCC folate deficiency
alcoholism
235
Tx for gastrinoma
PPI
236
hernia most likely to pass into scrotum
indirect
237
air fluid levels on AXR
bowel obstruction
238
MC location colorectal CA
cecum
239
normal fiber requirements in 1 day
30g
240
blood tests celiac dz
IgA endomysial Ab | IgA TTG ab
241
psoas sign
raise right leg against resistance
242
obturator sign
flexion + internal rotation right hip
243
pancreatic CA tumor marker
CA 19-9
244
steatorrhea
pancreatitis
245
Ranson's criteria
``` 55y+ WBC > 16k gluc > 200 LDH > 350 AST > 250 ```
246
tumor marker liver CA
AFP
247
dysphagia to both liquids and solids
achalasia
248
med for hep B
lamivudine
249
tx hep C
pegylated interferon alpha2
250
hep B surface Ab?
recovery from infxn | or immunization to hep
251
hep B core Ab?
previous or going HIB infxn
252
viral hepatitis that is self limiting
Hep A and E
253
tx for gastric adenocarcinoma
surgery
254
Charcot vs Reynolds
``` Charcot = RUQ pain + fever + jaundice Reynolds = AMS + HoTN ```
255
PUD most common location
duodenum
256
tx for esophageal strictures
dilation | long term PPI
257
tx Mallory weiss tears
wait - typically resolve in 48H
258
to get Hep D must have?
Hep B
259
Hep B surfance antigen
active hep B infxn
260
MC location anal fissure
posterior midline
261
TLC in COPD
increases
262
crackles in lung fields: ddx?
pneumonia, fibrosis, CHF, bronchitis
263
hyperresonance to percussion: ddx?
emphysema, pneumothroax, asthma
264
wheezing: ddx?
asthma, COPD, bronchitis
265
eggshell opacities
silicosis
266
older pt | PNA + diarrhea
legionella pneumonia
267
honeycombing + tram tracks
bronchiectasis | idiopathic pulm fibrosis
268
what is erythema nodosum
tender red nodules usually found on the shins
269
erythema nodosum + enlarged parotided gland = ?
sarcoidosis
270
4 MC places lung CA mets to
bone, brain, adrenals, liver
271
centrally located lung CA
small cell | squamous cell
272
peripherally located lung CA
adenocacinoma | large cell
273
type of laxative: polyethy glycol bisacodyl
``` poly = osmotic lax bisacodyl = stimulant lax ```
274
virus assoc w/ burkitt's lymphoma
EBV
275
Dx pertussis
PCR nasal secretion | tx w/ erythromycin
276
Premenstrual dysphoric disorder
anger/irritability | affects daily living
277
FB removal
rigid bronchoscopy
278
Rubulavirus
mumps
279
breakbone fever
Dengue | supportive
280
ARDS on CXR
diffuse infiltrates the spare costophrenic angles
281
MC cause bronchiectasis
CF
282
bullae and blebs on CXR
emphysema
283
FEV1 in asthma
decreases
284
MC cancers that mets to the lungs
breast, liver, colon
285
Asbestosis CXR
linear opacities at bases + pleural plaques
286
HACEK organisms most often cause what? list the organisms
``` community acquired carditis Haemophilus Actinobacillus Cardiobacerium Eikenella Kingella ```
287
Dullness to percussion
PNA
288
Dullness to percussion | rust colored sputum
PNA
289
Coal miner lung or silicosis CXR
nodular opacities in upper lung fields
290
Rust colored sputum
S. pneumo
291
MCC PNA in COPD pts
H flu
292
rats + PNA
yersinia pestis | aminoglycosides
293
college student + PNA
chlamydia or mycoplasma
294
gohn complex ranke complex caseating granuloma
TB | continue INH and RIF the longest
295
aerospace, nuclear plant workers | diffuse infiltrates + hilar adenopathy
berylliosis
296
MCC PNA in children < 1y
RSV
297
``` farsighted = ? nearsighted = ? ```
hyperopia; tx w/ convex lens | myopia; tx w/ concave lens
298
purulent d/c from eye: 2-5D after birth up to 2wks after birth +/- PNA
2-5D = neisseria | 2wks + PNA = chlamydia
299
hypopyon vs hyphema of the anterior chamber
``` hypopyon = WBC hypema = RBC ```
300
Hutchinson's sign
HSV vesicles on nose, assoc w/ zoster in eye
301
sudden PAINLESS complete unilateral vision loss opalescent retina + boxcarring cherry red spot
CRAO
302
MCC viral conjunctivits
adenovirus | bilateral watery d/c w/ nontender preauricular LAD
303
Halos + rainbows around lights moderate photophobia bowing of iris
glaucoma
304
metamorphopsia + central blind spot | drusen deposits on fundus
distorted vision of grid lines looking wavy macular degeneration check w/ Amsler grid
305
unilateral vision blurriness | blood and thunder fundus
CVO
306
5 parts biophysical profile
``` non-stress test fetal breathing 2 gross body mvmts fetal tone amniotic fluid indix ```
307
procidentia
uterine prolapse beyond the introitus
308
due date for baby
1st day LMP + 1 week - 3 mon
309
metritis
MC infection 10D after C-section
310
reproductive CA that carries the highest rates of death in women
ovarian CA
311
when give rhogam
28 wks | mom rh-, dad rh+
312
bhCG positive after how many days
8 days past conception
313
vaginal candida on KOH
pseudophyphae
314
2 meds to induce labor
Cervidil (prostaglandin) for cervical ripening | Oxytocin for urterine contractions
315
why tell pregnant pts to avoid deli meats and soft cheese
listeria
316
MC type endometrial CA
adenocarcinoma
317
wks to do chorionic villus sampling
10-13 wks
318
PID vs ectopic, appendicitis, ovarian torsion, ovarian cyst
PID described as bilateral pain. others typically unilateral
319
preterm labor
contractions that open cervix before 37wk
320
wks to do amniocentesis
15-20 wks
321
gold standard chlamydia
nucleic acid amplification test
322
what dx is associated w/ thymoma
myasthenia gravis
323
tx acute dystonic rxn after giving neurleptic med
benztropine diphenhydramine (anticholinergics)
324
fever, hyperreflexia, tremor, sweating, dilated pupils, diarrhea
serotonin syndrome | cyproheptadine (anticholinergic/antihistamine)
325
tx candida intertrigio
topical econazole
326
painful ulceration + inguinal lymphadenopathy
``` H ducreyi gram- coccobacillus Azith Rocephin Cipro Erythromycin ```
327
Dx criteria or diabetes
1. symptoms + random gluc > 200 2. fasting plasma > 126 twice 3. glucose > 200 2H after 75g glucose test
328
2 y/o | asx or painless rectal bleeding
Meckel's Diverticulum | Dx w/ 99m technetium scan (nuclear med scan)
329
Hemophilia A vs B
A (A'ight) = factor 8 | B (B-nine) = factor 9
330
ITCHING fatigue RUQ pain AMA Ab, high liver enzymes
Primary biliary cirrhosis
331
Causes core pulmonale
Pulm HTN = right ventricular dilation COPD, PE, fibrosis MG Sarcoid
332
hyperandrogenism high LH ovarian cysts
PCOS
333
same side sensorineural hearing loss + ataxia + tinnitus | poor word discrimination
Acoustic neuroma
334
when to check acetamiophen levels for toxicity
4H after reported time ingestion | 140mg N-acetylcysteine, then 70mg Q4H = total 17 doses
335
Tx hypercalcemia of malignancy
bisphosphonates | loops, IV fluid
336
``` SLUDGE Salivation Lacrimation Urination Diarrhea GI cramps Emesis ```
Organophosphate poison | Atropine, Pralidoxime (2-PAM)
337
relapse/remission 15-50y optic neuritis + fatigue
MS Lhermitte sign Periventricular plaques on T2 weighted MRI - demylination
338
Tx status epilepticus
1) IV lorazepam, diazepam, or midazolam 2) phenytoin or valproic acid 3) phenobarbital or propofol
339
young obese F papilledema + diplopia (CN6 palsy) + loss peripheral visual fields high opening pressure on LP
Idiopathic intracranial HTN (pseudotumor cerebri) | can be worsened w/ tetracycline, OCP, sulfonamides, macrobid
340
Diagnositic criteria gestational diabetes
1) 1h 50g glucose challened at 24-28 weeks | 2) 100g glucose challenge shows (2) = 95+ fasting, 180+ 1H, 155+ 2H, 140+ 3H
341
HCAP
within 90 days of hospitalization nursing home LTCF hemodialysis tx: cefepim, ceftazaidime, zosyn imipenem/cilastin,
342
gleason score
for prostate cancer (out of 10) lower number the better
343
Causes of transudative effusion
``` (intact capillaries) CHF cirrhosis Nephrotic syndrome PE ```
344
Vaccines C/I pregnancy
varicella MMR Zoster any live virus
345
``` bacterial/viral infxn followed by: bilateral LE palpable non-blanching macules/patches abdominal cramps/bloody stool knee/ankle aches hematuria ```
IgA vasculitis HSP supportive tx resolves in 6-8w
346
thick white curdy d/c | ph < 4.5
candida = pseudohyphae
347
frothy/green d/c
trich
348
thin, grey d/c | clue cells
BV
349
hx flu fever + productive cough + bloody sputum + SOB CXR: multiple cavitary lesions
post-viral PNA | MCC S aureus
350
MCC croup
parainfluenza virus | O2, IM steroids, neb epi
351
dx premature rupture of membranes
pooling test - amniotic fluid in fornix nitrazine test - amniotic fluid turns paper from orange (intact) to blue ferning (arborization)
352
2-6y/o child acute post viral infxn thrombocytopenia petechia/purpura/gingival bleeding
ITP corticosteroids IVIG splenectomy
353
2-10 y/o subacute scrotal pain dark blue dot upper pole
Torsion of appendix testis | MCC testicular pain boys 2-10
354
PNA + gram- coccobaccili
H flu
355
prophylasix menningococcal meningitis
rifampin
356
gram+ chains
strep | PCN, macrolides, cefs
357
tx toxoplasmosis
bactrim
358
is psudomanas gram + or gram - ?
pseudomonas = gram -
359
test for syphilis
dark field microsocpy/VRDL/RPR confirm w/ Ab test (FTA-ABS) treponema pallidum Jarish-Herxheimer rxn to PCN
360
low RTC+ normal iron
anemia chronic disease
361
peripheral zone vs transitional zone: BPH vs prostate CA
BPH = transition | prostate CA = peripheral
362
MC bladder CA type
transitional cell
363
phren sign
lifting relieves pain = epididymitis
364
swelling/pain in cheek worse w/ meals
sialadenitis | s. aureus
365
tx epiglotitis
3rd gen ceph - cephalosporin, rocephin
366
most aggressive thyroid CA type
anaplastic
367
insulins in order of peak efficacy
lispro (1-2H) regular (2-4H) NPH (5-7H) detemire/glargine (long axn - no peak)
368
tx dawn phenomenon
morning hyperglycemia from normal nighttime release of hormones (glucagon, cortisol, etc) increase NPH
369
tx somogyi effect
rebound hyperglycemia after overnight hypoglycemia | decrease NPH
370
HTN, T2D, obeses, hair grown, striae, moon facies
Cushings excess cortisol - check w/ dexamethasone suppression test and ACTH hyperglycemia, hypoK spironolactone or surgery
371
euvolemic hypoNa
SIADH - persistent ADH release, independent of serum osmolality urinary sodium > 20 restrict fluids!
372
autoimmune adrenal cortical destruction weakness, fatigue salt craving + HoTN hyperpigmentation
Addisons = cortical adrenal insufficiency HoNa HyperK, HyperCa am cortisol < 3, confirm w/ Cosyntropin stimulation cortisol doesn't raise >18 glucocorticoids and mineralocoritcoids (aldo)
373
young pt w/ HTN w/o RF or FamHx | HTN + HA + polyuria + muscle weakness
``` Hyperaldo - Conn's syndrome if there's an adrenal adenoma HypoK, HyperNa HypoMag aldo/renin activity ratio high CT/MRI spironolactone ```
374
Kussmal breathing
a deep and labored breathing pattern often associated with severe metabolic acidosis,
375
teardrop lesion after strep throat
guttate psoriasis
376
tx for high TG
fibric acid
377
left axis deviation
L1 up AVF down L = leaving each other
378
right axis deviation
L1 down AVF up R = heading right for each other
379
ddx w/ pulses paradoxus
pericarditis pericardial effusion obstructive lung disease
380
biphastic P wave
LAE
381
MCC subacute endocarditits
strep viridans
382
Balock procedure corrects what heart condition
tetralogy of fallot
383
Tx PDA vs VSD
PDA - indomethacin | VSD - surgery
384
MCC atrial septal defect
patent foramen ovale
385
MCC acute endocarditis
s aureus | vanc
386
how long to be on aspirin or clopidogrel after stent
1 yr
387
PMI from aortic stenosis
laterally displaced b/c LVH
388
tietze syndrome
costochondritis
389
best way to hear aortic regurge and stenosis
sitting up and leaning forwards
390
pulsus alternans
EKG waveform changes from beat to beat | large pericardial effusion
391
first line IV inotropic agent for cardiogenic shock
dopamine
392
INR: mechanical valve replacement organic valve
mechanical valve: 2.5-3.5 | organic valve: 2-3
393
MCC CHF
coronary artery disease
394
after MI what med to tx HTN
BB
395
behavioral tx for borderline pts
dialectical behavior therapy
396
2 psych issues more common in M > F
autism | ADD
397
Cluster B
antisocial borderline - neurotic + psychosis histrionic narcissistic
398
Cluster C
avoidant obsessive compulsive dependent
399
Cluster A
paranoid schizoid - prefers to be alone schizotypal - magical thinking
400
tx depression ok w/ breast feeding
zoloft
401
muscle weakness | fatigability that improves w/ rest
myasthenia gravis | ACh receptor Ab
402
intracranial neoplasm causing auditory illusions, olfactory hallucinations, and emotional changes: which lobe?
temporal
403
MC primary intracranial neoplams
glioma
404
tx tourette's
haldol, fluphenazine: block DA
405
tx essential tremor
propanolol | primidone
406
stroke w/ aphasia, loss of hearing 1 hear, loss of vision 1 eye: what artery?
anterior cerebral artery
407
GABA and substance P
Huntington's
408
3 tx cluster HA
O2 sumatriptan stadol (butorphanol)
409
painful ipsilateral 3rd nerve palsy
posterior communicating artery (PCA) aneurysm
410
MC knee injury
medial meniscal tear
411
inability to extend knee after trauma
patellar fx
412
MC rotator cuff muscle injured
supraspinatus
413
elderly w/ leg shorted and externally rotated after fall
hip fx
414
HIV pt has severe groin pain
AVN of femoral head due to antiretroviral meds
415
MC fracture in a pt w/ osteoporosis
compression fx vertebral body, then hip fx
416
angulation Colles vs Smith
``` Colles = dorsal Smith = volar ```
417
hx Hep B bilateral knee pain fever + wt loss
polyarteritis nodosa
418
severe night bone pain
osteoid osteoma - benign bone tumor MC in femur and tibia | pain tx w/ ibuprofen
419
MCC compartment syndrome
tibia fracture
420
age to order DEXA scans
70 M | 65 F
421
Austin flint murmur
low-pitched rumbling heart murmur which is best heard at the cardiac apex mid-diastolic or presystolic murmur assoc with severe aortic regurg
422
tx myasthenia gravis
pyridostigmine (anticholinesterase)
423
tx multiple sclerosis
``` steroids immunomodulators cylophosphamide IVIG plasmapheresis ```
424
nephritic ssx + coughing up blood
anti-glomerular basement membrane (Goodpasture syndrome) | tx plasmapheresis, corticosteroids, cyclophosphamide
425
MC primary glomerulonephritis
IgA nephropathy (Berger disease) can be associated w/ URI tx: ACEI/ARB or steroids
426
young male, black/hispanic HTN + anemia + antiphospholipid Ab Proetinuria > 500
lupus nephritis | Tx: ACE/ARB
427
7-10D after pharyngitis/impetigo
Post-infectious glomerulonephritis Group A strep IgG and C3 along basement membrane ASO titers
428
rapid decline in kidney func | Crescents on microscopy
rapidly progressive glomerulonephritis
429
Types of nephritic syndromes (edema + HTN + coke/tea colored urin) UNa > 2%
Rapidly progressive Post-infectious Berger disease (IgA) Goodpasture's
430
Types of nephrotic syndromes (proteinuria > 3 + hypoalbuminemia + hyperlipidemia)
minimal change disease focal segmental glomerulosclerosis membranous nephropathy
431
MC proteinuria renal disease in children may follow URI assoic w/ Hodkins
Minimal change disease | tx: steroids 8-16 wks
432
MCC nephrotic syndrome in adults that leads to ESRD | Black + overweight + HTN
Focal segmental glomerulosclerosis | tx: ACEI/ARB/statin, immunosuppressives, steroids
433
nephrotic syndrom associated w/ Hep B, CA, syphilis | Kidney bx = "spike and dome"
Membranous nephropathy | tx: ACE/ARB/statin, steroid, immunosuppressives
434
pre-renal AKI
hypoperfusion - dehydration Na < 1% BUN/Cr > 20 tx w/ IV saline
435
post-renal AKI
flow obstruction - pelvic tumors, radiation, prostate enlargement, stones
436
types of intrinsic renal disease
ATN AIN nephritc syndrome vasculitis
437
Na > 2% | RF1 > 1
ATN
438
``` WBC casts (eosinophiluria) fever, rash ```
AIN
439
male child w/ infection PALPABLE PURPURA on LE joint aches abdominal ssx - nausea, colic, melena
Henoch-Schonlein Purpura (WITHOUT thrombocytopenia) self-resolves
440
adenosine vs atropine
``` adenoSine = Slows (AV conduction via K+ channel activation) aTropine = Triggers the Ticker ```
441
rx tx for tachy in WPW
adenosine or CCB to block AV node
442
what med must be withheld 48H after contrast?
metformin
443
atrophy caudate and putamen of the basal ganglia
Huntington | tx w/ BZD, or DA antagonists (reglan)
444
what med class exacerbate huntingtons sx
dopamine agonists - worsens sx
445
erysipelas caused by?
strep pyogens amoxicillin keflex rocephin
446
which is more sensitive: phalen vs tinel?
Phalen
447
imaging for congenital hip dysplasia before 6mon
US
448
Barlow vs Ortolani
Barlow - ADDuct = dislocate | Ortalani - ABDuct = reduction
449
``` anticholinergic sx: hot hare dry bone blind bat mad hatter red beet cause by what OD? ```
TCA
450
sudden onset unilateral (R > L) abd/pelvic pain leukocytosis W 15-30 or postmenopause
Ovarian Torsion Dx TVUS Gold standard: laparoscopy MCC cyst or tumor
451
AV dissociation, wide complex, rate 150-200
VTach pulseless: defibrilate unstable: sync cardiovert stable: meds
452
Med tx for stable V tach
amiodarone | procainamide
453
Bite Neurotoxin severe muscle cramping + CNS excitation
``` black widow (red hourglass) supportive (opioids, bzds) ```
454
Bite Cytotoxin tissue destruction
``` Brown recluse (brown fiddle) local wound care ```
455
MCC hyperosmolar hyperglycemic state
glucose 600+ without ketones | dehydration - tx w/ IVF
456
biphasic T waves V2-3
stenosis LAD
457
Coved ST seg elevation followed by negative T waves in V1-3
Brugada | AICD
458
horizontal ST depression with tall, broad R waves and upright T waves in leads V1-3
posterior MI
459
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
left main coronary artery occlusion
460
bulge lateral to inferior epigastic vessels can pass into scrotum or labia majora M > F; congenital
indirect hernia
461
bulge thru weakened fascia of abdominal wall behind superficial inguinal ring medial to inferior epigastric vesels
direct hernia
462
Weber results
conductive loss = lateralization to affected side | sensorineural loss = lateralization to normal/better hearing side
463
Rinne test results
Normal = AC > BC | Conductive loss = BC > AC
464
difference in 1st-3rd degree burns
1st: superficial, epidermis 2nd: superficial partial - papillary dermis 2nd: deep partial - reticular dermis (white/leathery/painless) 3rd: hypodermis (subq - charred)
465
nephroblastoma
wilms tumor | good prognosis after surgery/chemo/radiation
466
what is S3 vs S4 assoc w/
``` CAD = systolic HF - S3 HTN = diastolic heart failure - S4 ```
467
floppy ventricle
S3
468
stiff ventricle
S4 | HTN, aortic stenosis
469
RF aortic aneurysm vs dissection
aneurysm - atherosclerosis | dissection - HTN, cocaine, bicuspid valve, collagen d/o
470
MCC bacterial trachitis
s aureus kids 3-5y/o looks like croup but TOXIC appearing
471
inverted P wave afer QRS
premature junctional contraction
472
flushing + diarrhea + pulm ssx
carcinoid tumor | 24-hour excretion of 5-hydroxyindoleacetic acid (5-HIAA)
473
what is a carcinoid tumor
neuroendocrine tumors of the digestive tract, lungs, and less commonly of the kidneys and ovaries secrete serotonin, histamine, catecholamine, prostaglandins
474
diastolic murmur (rumble) left sternal border 4th louder w/ inspiration
tricuspid stenosis
475
MC ekg finding in PE
sinus tachy
476
juvenile idiopathic arthritis tx
NSAIDs methotrexate steroids
477
diabetes insipidus lab values
low urine osmolality | high serum osmolality
478
tx diabetes insipidus
central: DDAVP nephrogenic: HCTZ, amilioride, indomethacin
479
diarrhea, steatorrhea, gas, weight loss | IgA, anti tTG antibodies
Celiac disease bx small bowel dermatitis herpetiformis

PANCE (7 decks)

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