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COMLEX Level 2CE > HWK SB1 (F) > Flashcards

HWK SB1 (F) Flashcards

W1 HWK blocks (3,5,7) Deck is full

1
Q

How does neuroleptic malignant syndrome present?

A
  • F > 104 F
  • confusion
  • muscle rigidity
  • autonomic instability (abn vitals, sweating)
  • rhabdomyolysis
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2
Q

How does serotonin syndrome present?

A
  • F > 104 F
  • tremor
  • incr DTR
  • myoclonus
  • V/D
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3
Q

How does hereditary spherocytosis present?

A
  • hemolytic anemia
  • jaundice
  • splenomegally
  • *indirect hyperbilirubinemia**
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4
Q

what is a common complication of hereditary spherocytosis?)

A

pigmented gallstones

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5
Q

What does the direct coombs test test for?

A
  • antibodies attached to RBC

- AI hemolytic anemia

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6
Q

what does the indirect coombs test test for?

A

-antibodies against foreign RBC

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7
Q

a 95% CI that does not span 1 corresponds to what p-value?

A

p < 0.05

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8
Q

What happens to CI when n= is increased?

A

CI narrows

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9
Q

what bacteria is a partially acid fast, filamentous branching rod on gram stain?

A

nocardia

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10
Q

What does nocardia cause?

A

pulm and/or disseminated (esp. neuro) nocardosis in IMMUNOCOMPROMISED pts

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11
Q

What is the 1st line tx for norcardosis?

A

trimethoprim-sulfamethoxazole

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12
Q

why does hemophilia cause joint pain?

A

-bleeding into the joint space –> hemosiderin deposition –> synovitis –> fibrosis

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13
Q

is arthritis 2/2 gonnococcal infec likely to last 6 mos?

A

NO (most infec are not likely to last that long)

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14
Q

How does acute mediastinitis present?

A
  • fever
  • chest pain
  • incr WBC
  • mediastinal widening on xray
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15
Q

What is the tx for acute mediastinitis?

A

-drainage, surgical debridement, prolonged ABX

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16
Q

what is post-pericardiotomy syndrome?

A
  • AI condition (usually)
  • occurs a few weeks s/p pericardial incision
  • presents w/ F, incr WBC, tachy, chest pain
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17
Q

MC locations arterial vs venous ulcers?

A 
arterial = tips of toes
venous = pretibial area, above medial maleolus
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18
Q

what is sheehan’s synd?

A

post-partum ischemic necrosis of anterior pituitary gland

= comp of massive post-partum hemorrhage

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19
Q

how does sheehan’s synd present?

A

lactation failure (decr prolactin), hypotension, anorexia

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20
Q

when do you treat HSV in pregnancy?

A
  • week 36 –> delivery (+/- lesions, +/- prodrome)
  • any time lesions are present
  • *c-sec if active infec @ time of delivery**
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21
Q

What are the causes of cyanotic heart dz in newborns?

A

5Ts

  1. Transposition of the great vessels
  2. ToF
  3. Tricuspid atresia
  4. Truncus arteriosus
  5. Total anomalous pulm venous return w/ obstruction
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22
Q

Which of the 5 causes of cyanotic heart dz in newborns DO NOT present w/ murmur?

A
  • total anomalous pulm venous return w/ obstruction

- transposition of the great vessels (+/- VSD)

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23
Q

which congenital heart defect presents w/ single loud S2? (hint: MC congenital cyanotic heart defect in neonatal period)

A

transposition of the great vessels

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24
Q

How do you dx pneumocystitis pneumonia?

A
  • Respiratory secretion (sputum sample/ broncoalveolar lavage specimen) analysis
  • special stains = toluidine blue, silver stain
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25
Q

Vit B12 def –> _______ –> ineffective erythropoesis presenting as megaloblastic anemia

A

defective DNA synthesis

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26
Q

what is the MOA of risperidone (2nd gen antipsychotic)?

A

serotonin 2A & dopamin D2 antagonist

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27
Q

why does risperidone cause fewer extrapyramidal s/e compared to gen1 antipsychotics?

A

antagonizes serotonin 2A receptors

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28
Q

what drug’s MOA = NE + dopamine reuptake inhib?

A

bupropion

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29
Q

anti-mitochondrial Ab is associated w/ what dz?

A

PBC

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30
Q

anti-smooth muscle Ab is associated w/ what dz?

A

AI hepatitis

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31
Q

anti-topoisomerase Ab is associated w/ what dz? (Bonus: what is the alt name of this Ab?)

A

diffuse scleroderma

Bonus: anti-Scl-70 Ab

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32
Q

pt presents after possible suicide attempt but denies attempted suicide. what do you do and why?

A
  • admit (voluntarily or involuntarily)

- even w/ denial risk of future attempt is HIGH and you must protect the pt

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33
Q

How does the timeline differ between chlamydial and gonococcal conjunctivitis?

A 
chlamydial = age 5-15 days
gonococcal = age 2-5 days (this is why we give ppx drops right after birth)
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34
Q

How does chlamydial vs gonococcal conjunctivitis present?

A 
chlamydial = watery drainage + sm. edema
gonococcal = pus + lg edema
35
Q

what heart rhythms can cause syncope?

A
  • afib
  • ventricular tachycardia
  • bradycardia w/ sinus arrest
36
Q

syncope that occurs suddenly and w/o prodrome is likely caused by what abn heart rhythms (if cause is cardiogenic)?

A
  • afib
  • ventricular tachycardia
  • *FAST RHYTHM = FAST ONSET = NO TIME FOR PRODROME**
37
Q

syncope that occurs after prodrome is likely caused by what abn heart rhythm (if cause is cardiogenic)?

A

-bradycardia w/ sinus arrest

38
Q

what s/s might the prodrome prior to a syncopal event include?

A
  • nause
  • diaphoresis
  • palor
  • light headednes
  • vision and/or hearing changes
39
Q

what is angiosarcoma?

A

malignant tumor of the lining of blood vessels and lymphatics

40
Q

what increases risk of angiosarcoma?

A
  1. local radiation exposure

2. chronic lymphadema

41
Q

why are ACEi useful post-MI?

A

they limit ventricular remodeling and decr ventricular dilation

42
Q

2* polycythemia vera exhibits ___ serum EPO

43
Q

how might materal parvovirus B19 infection cause fetal demise?

A

virus –> feral RBC precursor destruction –> anemia –> high output heart failure –> hydrops fatalis –> death

44
Q

what are the MC causes of 2* polycythemia vera?

A
  • renal cell ca (tumor produces EPO)

- chronic hypoxia (cardiopulm dz, OSA)

45
Q

What are the distinquishing features of the various TORCH infxns?

A 
CMV = periventricular calcifications
toxo = intracerebral calcifications
syphillis = desquam rash
rubella = cataracts, heart defects
46
Q

What are the MC causes of OTM vs OE?

A 
OTM = m caterhallis, s aureus, h influ (nontypable)
OE = psuedomonas
47
Q

What are the causes of telogen effluvium vs alopecia areata?

A

telogen effluvium = stress

alopecia areata = AI

48
Q

What location is affected by telogen effluvium vs alopecia areata?

A

telogen effluvium = diffuse

alopecia areata = patches

49
Q

What portion of the hair shaft is affected by telogen effluvium vs alopecia areata?

A

telogen effluvium = normal shaft

alopecia areata = hair shafts narrow @ surface

50
Q

On EKG, electrical alternans + sinus tach = very specific for what?

A

large pericardial effusion (b/c heart swings w/in the fluid filled pericardial sac)

51
Q

what is electrical alternans?

A

varying amplitude of QRS complex (seen w/ Lg pericardial effusions)

52
Q

What does rib notching on CXR suggest?

A

coarctation of the aorta

53
Q

What is coarctation of the aorta?

A

narrowing of the desc. aorta –> incr prox arterial pressure load

54
Q

how does coarctation of the aorta present?

A
  • UE BP > LE BP

- CXR shows inferior rib notching of ribs 3-8

55
Q

how does parovirus B19 infection present in the average adult?

A
  • MC = asymp or flu-like s/s

- can present like RA

56
Q

how does pneumocystic PNA present in pts w/o HIV?

A

F + dry cough + fulminant resp failure

57
Q

how does s aureus post-viral PNA present?

A
  • F + worsening resp s/s s/p initial improvement

- HIGH F + cough w/ hemoptysis + leukopenia + multilobar + cavitary infiltrates

58
Q

what is borderline personality disorder characterized by?

A
  • unstable relationships
  • unstable self-image
  • mood instability
  • impulsivity (ex. throwing/breaking things, binging, h/o mult MVA)
59
Q

when do you make a dx of intermittent explosive disorder?

A
  • aggressive outbursts that are out of proportion

* *ONLY MAKE THIS DX IF NO ADDED FEATURES THAT SUGGEST ANOTHER DX**

60
Q

when do you obtain an MRI as part of the headache w/u?

A
  • new or worsening HA

- high risk features including age >50, thunderclap onset, immunosuppression, h/o malig

61
Q

how do med overuse HA present?

A

= chronic, near-daily HA in setting of chronic HA med use w/ pre-existing HA disorder
-HA are often present upon waking and briefly remit before rebounding later in the day

62
Q

what is oligohydramnios a marker for and what must be done to tx it?

A
  • placental insufficiency

- immediate delivery

63
Q

when is amnioinfusion indicated?

A

to tx variable decels 2/2 oligohydramnios from ROM + fetal cord compressions

64
Q

what routine monitoring do late/post-term pregnancies receive?

A

routine NS test + AFI

65
Q

what is a nL AF volume?

A

single deepest pocket >= 2 cm and < 8 cm

66
Q

how does phenylketonuria present?

A
  • intellectual disability
  • fair complexion
  • eczema
  • musty/mousy odor
67
Q

what causes phenylketonuria?

A

phenylalanine hydroxylase def –> build-up of phenylalanine + neurotoxic metabolites

68
Q

how do you screen for PKU and how do you dx if pt skipped screeing?

A
  • screen = mass spec

- dx test = quantitative amino acid analysis

69
Q

how does galactosemia present?

A

jaundice, hepatomegally, FTT after consumption of breast milk or reg infant formula

70
Q

what causes galactosemia?

A

absence of galactose-1-phophate uridyl transferase activity in RBC

71
Q

what do the eyes do in stroke/hemorrhage of the Thalamus?

A

eyes look Toward the hemiparesis (away from lesion)

72
Q

what do the eyes do in stroke/hemorrhage of the cerebrAl lobe?

A

eyes look Away from hemiparesis (toward the lesion)

73
Q

what do the eyes do in stroke/hemorrhage of the Pons?

A

Pinpoint Pupils

74
Q

what is a common site of hypertensive intraparenchymal hemorrhage?

A

basal ganglia (putamen) w/ internal capsule involvement

75
Q

how do you tx neonatal clavicular fracture during deliver?

A
  • reassurance and education on how to handle gently (will heal in 7-10 d)
  • can imobilize arm by bending at the elbow and pinning long-sleeve to shirt
76
Q

when do you do EGD to remove a foreign body from the esophagus?

A

incr risk of perforation 2/2 ingestion of a sharp (or caustic) object

77
Q

how do you manage neonatal chicken pox?

A
  • isolate baby from sick contact (likely mom)

- give varicella-zoster IgG to baby if mom developed infx btwn 5d prior to thru 2d after delivery

78
Q

how do you passively immunize?

A

give antibody

79
Q

how can prosthetic valve thrombosis present?

A
  • new murmur
  • heart failure 2/2 valve stenosis or regurg
  • thromboembolic event (TIA or stroke)
80
Q

what should be considered the source of thromboembolism until proven otherwise?

A

prosthetic heart valve

81
Q

how does vertebral osteomyelitis present?

A 
\+ pain w/ gentle SP percussion = MC
\+/- incr ESR (COMMON)
\+/- incr plt (marker of inflam) (FAIRLY COMMON)
\+/- F (UNCOMMON)
\+/- leukocytosis (UNCOMMON)
82
Q

how does brown sequard synd present?

A
  • ipsilat hemiparesis
  • ipsilat loss of proprioception, vibratory and light touch sensation
  • contralat lost of pain and temp sens (2 levels below injury)
83
Q

how do you determine the level of spinal cord injury in brown sequard synd?

A

level of injury = 2 levels above start of contralat pain and temp loss

COMLEX Level 2CE (23 decks)

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