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COMLEX Level 2CE > HWK SB5 (-6) > Flashcards

HWK SB5 (-6) Flashcards

W# HWK blocks (74-85,B1-B3) Missing blocks 74,75,76,77,78,79

1
Q

what kidney condition will not improve w/ IVF?

A

hepatorenal synd

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2
Q

what do the labs look like in renal hypoperfusion?

A
  • AKI
  • decr uNa (<10 mEq/L)
  • no casts, protein or blood in urine
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3
Q

when should you suspect prerenal cause of AKI?

A
  • low BP
  • dehydrated state
  • BUN:Cr > 20
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4
Q

sudden onset resp distress (coughing, choking, wheezing) + air trapping on CXR are suspicious for what?

A

foreign body aspiration

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5
Q

what are the radiographical signs of air trapping?

A

unilat hyperinflation + mediastinal shift away from blocked side

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6
Q

what test confirms/tx foreign body aspiration?

A

immediate rigid bronchoscopy

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7
Q

how does fibromuscular dysplasia present on P/E?

A
  • abd bruit

- subauricular bruit

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8
Q

what are 2 common presenting s/s in fibromuscular dysplasia?

A
  • HA (2/2 internal carotid a. stenosis)

- 2* HTN (RAS)

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9
Q

what presents w/ internal male genitalia, external female genitalia, female phenotype @ birth and virulization @ puberty?

A

5-alpha-reductase def

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10
Q

why do m w/ 5-alpha-reductase def only develop internal male genitalia?

A

have T –> nL internal genitalia development

can’t make DHT –> no external genitalia or prostate development

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11
Q

what conditions can present w/ pulsus bisferiens (biphasic pulse)?

A
  • severe AR
  • HOCM
  • large PDA
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12
Q

viral myocarditis + large pericardial effusion 2/2 viral infx both present w/ h/o recent infx, fatigue, SOB, incr JVP and cardiomegally. how do you distinguish the 2 on p/e?

A

viral myocarditis –> S3 + vasc congestion on CXR

Lg pleural effusion –> clear lungs + nonpalp PMI

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13
Q

what is erythema toxicum neonatum?

A

-benign neonatal rash w/ blanching red papules/pustules

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14
Q

how do you tx erythema toxicum neonatum?

A

you don’t. it’s seld-limiting and w/ resolve w/in 2 wks of birth

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15
Q

what is enthesitis?

A

achilles tendon inflammation/pain

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16
Q

outside of the triad (can’t see, pee, or climb a tree), what symp are common in reactive arthritis?

A
  • enthesitis

- mucocutaneous lesions (oral ulcers)

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17
Q

when should you suspect reactive arthritis?

A

asymmetric oligoarthritis assoc w/ urethritis, conjunctivitis and/or mouth ulcers

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18
Q

what is the 1st line tx for reactive arthritis?

A

NSAIDS

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19
Q

how long does it usually take an MS flare to resolve?

A

days –> weeks

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20
Q

what LE condition can present like MS but resolves in a few hours?

A

common peroneal neuropathy (2/2 n. compression)

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21
Q

how does common peroneal neuropathy present?

A
  • foot drop + decr sensation of dorsal foot and lat. shin
  • decr dorsiflexion
  • decr big toe extension
  • nL plantar flexion
  • nL DTRs
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22
Q

chlordiazepoxide and diazepam are C/I in ____?

A

liver dz

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23
Q

what are the IV benzos?

A
  • lorazepam
  • diazepam
  • midazolam
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24
Q

what causes menieres dz?

A

incr vol or pressure of endolymph

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25
Q

how does menieres dz present?

A
  • episodic vertigo
  • sensorineural hearing loss
  • tinnitis or ear fullness
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26
Q

what causes benign positional vertigo?

A

Ca debris in semicircular canals

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27
Q

how do you tx SSRI induced mania?

A
  1. D/C the offending SSRI

2. tx underlying bipolar disorder if needed

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28
Q

meth use during pregnancy can cause ___.

A
  • spontaneous abortion
  • pre-term labor
  • IUGR
  • pre-eclampsia
  • placental abruption
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29
Q

randomization is use to control for what?

A

confounders during study design

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30
Q

when does selective survival bias occur?

A
  • case control studies

- cases chosen from entire pop instead of newly dx cases only

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31
Q

how do simple renal cysts typically present?

A
  • asymp

- can cause HTN, flank pain, hematuria, or proteinuria if very Lg

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32
Q

how do simple renal cysts look on imaging?

A

boring (round, monochromatic, unilocular)

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33
Q

how do malig renal masses look on imaging?

A
  • multi-locular
  • irreg walls
  • thick septae
  • contrast enhancement
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34
Q

which benzos do you give an alcoholic w/ liver dz?

A

LOT
Lorazepam
Oxazepam
Temazepam

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35
Q

what do you not do if you suspect a pt is presenting w/ toxic megacolon?

A

-colonoscopy
-enema
(both incr risk of perforation)

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36
Q

what are the most likely causes of brain mets?

A

lung > breast > unknown 1* > melanoma > colon

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37
Q

which Ca –> mult lesion brain mets?

A
  • lung

- malig melanoma

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38
Q

what does lung Ca brain mets typically look like on imaging?

A

multiple well circumscribed lesions w/ vasogenic edema @ grey-white matter junction

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39
Q

how does toxic megacolon present?

A
  • systemic toxicity (incr HR, low BP, F)
  • bloody diarrhea
  • abd distension/ peritonitis
  • marked colonic distension on imaging
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40
Q

what is the MCC death in ESRD?

A

cardiovascular dz

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41
Q

cardiovascular dz vs infx account for what % of cause of mortality in ESRD?

A

cardiovasc = 50%

infx >20%

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42
Q

what cause of joint pain presents w/ F + D + wt loss + PAS+ staining mphages?

A

whipple’s dz

infx that causes malabsorption and arthritis

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43
Q

seeing straight gridlines are curved suggests what?

A

decr fine visual acuity 2/2 macular degeneration

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44
Q

when does the pt lose the right to refuse tx?

A

when doing so poses a serious threat to public health and wellbeing

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45
Q

which vessels are occluded if inferior MI?

A

RCA or LCX

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46
Q

STEMI leads 2, 3, avF. what additional findings would suggest RCA occlusion?

A

ST depression in leads 1 and avL

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47
Q

STEMI leads 2, 3, avF. what additional findings would suggest LCX occlusion?

A

ST elevations in leads 1 and avL

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48
Q

how do you distinguish between RCA and LCX occlusion w/ STE of leads 2, 3, avF?

A

look at leads 1 and avL

if elevated = LCX. if depressed = RCA

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49
Q

what clinical symp are associated w/ inf. STEMI?

A

low BP, low HR, AV block

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50
Q

what meds have been show to decr mortality in pts w/ severe PCP infx?

A

corticosteroids

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51
Q

when do you give corticosteroids in PCP?

A

paO2 < 70 mmHg on room air

A-a > 35 mmHg on room air

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52
Q

how do you manage uncomplicated low back pain?

A
  1. NSAIDS
  2. m. relaxers
    * *continue nL/moderate activities
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53
Q

what gifts are OK to accept from a 3rd party?

A

gifts that are non-monetary, low value and of direct benefit to pts

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54
Q

what is the most likely cause of pancytopenia if no splenomegally and no abn cells on peripheral smear?

A

aplastic anemia

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55
Q

what will be found on P/E if pancytopenia is 2/2 myelofibrosis (i.e. incr collagen or reticulin deposition in BM)?

A

hepatosplenomegally (2/2 extramedullary hematopoeisis)

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56
Q

when is prosthetic joint infx more likely to be caused by s. aureus than s. epidermidis?

A

< 3mos s/p implantation

> 12mos s/p implantation

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57
Q

clinically, how can you distinguish s. aureus prosthetic joint infx from s epidermidis infx?

A

s aureus = SICK (F + hot, red joint)

s epi = nL looking pt w/ chronic pain

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58
Q

what meds are associated w/ acute angle-closure glaucoma?

A

anti-cholinergics used for parkinson’s dz

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59
Q

what is trihexyphenidyl?

A
  • an anticholinergic used to tx parkinson’s dz

- can cause glaucoma

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60
Q

what are the clinical features of GAD?

A
  • excessive, incontrollable worry (mult. issues) >= 6 mos

- physical s/s >=3 mos (restlessness, fatigue, irritability, decr concentration, muscle tension, sleep disturbance)

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61
Q

what are the physical manifestations of GAD?

A
  • restlessness
  • fatigue
  • irritability
  • decr concentration
  • m. tension
  • sleep disturbance
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62
Q

what is the sole focus of social anxiety disorder?

A

fear of negative evaluation by society

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63
Q

what do kids w/ GAD present w/ ?

A

GI upset

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64
Q

what is subconjunctival hemorrhage?

A
  • completely asymp red eye 2/2 minor injury/bruising

- MC self-resolves in 24-28 hrs

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65
Q

how does glaucoma present?

A
  • vision loss
  • dilated pupils
  • erythema
  • hard on palpation
  • incr IOP
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66
Q

in the 1st 2yrs s/p kidney transplant, what condition might occur leading to decr renal f(x)?

A

RAS of the allograft

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67
Q

how does RAS present?

A
  • HTN
  • decr renal f(x) w/ onset of ACEi use
  • abd bruit
  • recurrent flash pulm edema
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68
Q

how will pt present if kidney transplant rejection is occurring?

A

AKI + F + graft site tenderness

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69
Q

what are the steps for the precocious puberty w/u?

A
  1. xray (will see advanced bone age)
  2. check LH (incr LH = central PP)
  3. if decr LH, do GnRH stim test
    (incr LH = central PP. decr LH = peripheral PP)
  4. imaging (brain MRI for central. Abd CT/pelvic U/S for peripheral)
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70
Q

you should have high suspicion for what condition if pt has jejunal ulcers?

A

zollinger ellison synd

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71
Q

when should you suspect ZES?

A
  • multiple refrac duodenal ulcers
  • jejunal ulcers
  • ulcers + chronic diarrhea
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72
Q

what causes malabsorption in ZES?

A

incr stomach acid –> inactivation of pancreatic enzymes

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73
Q

how does Gilbert syndrome present?

A

jaundice provoked by stress

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74
Q

gilbert synd and G6PD def both present w/ jaundice provoked by stress. how do you distinguish between the two?

A

G6PD def = hemolytic anemia (low Hgb, incr LDH)

Gilbert synd = inability to conj bili (nL Hgb, nL LDH)

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75
Q

what are the labs for Gilbert synd?

A
  • incr total (unconj) bili
  • nL direct (conj) bili
  • nL LFTs
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76
Q

direct hyperbilirubinemias that present w/ nL AST, ALT, and ALP = ?

A
  • Dubin johnson synd

- rotor synd

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77
Q

elevated conj bili in urine suggests what?

A
  • defect in bilirubin excretion

- hepatobilliary dz

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78
Q

what is dubin johnson synd?

A
  • benign hereditary condition

- defect in hepatic excretion of conj bilirubin

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79
Q

how does hemochromotosis present?

A
  • fatigue, arthralgias, hyperglycemia, skin hyperpigmentation
  • abn LFTs
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80
Q

which chronic liver condition leads to black liver w/ pigments on bx?

A

dubin johnson synd

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81
Q

which organs are typically affected by graft vs host dz?

A

skin, intestine, liver

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82
Q

what causes graft vs host dz?

A

donor T cells attack recipient major and minor HLA antigens

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83
Q

how does acute interstitial nephritis present?

A
  • AKI + F + rash + pyuria
  • U/A = eosinophilia + WBC casts
  • WILL NOT SEE FLANK PAIN OR WT LOSS
84
Q

how will renal/perinephric abscesses present?

A
  • F + flank pain + wt loss

- h/o UTI (=< 1-2 mos ago)

85
Q

what features will 2* reynauds present w/ to distinguish it from 1* reynauds?

A

+ tissue injury (finger ulcers)

+ incr ANA and ESR

86
Q

how do you w/u 2* reynauds?

A
  • CBC, CMP
  • U/A
  • ANA, RF
  • ESR, C3/C4
87
Q

rare pts w/ cirrhosis may develop what condition?

A

cirrhosis –> ascites + sm defects in diaphragm –> hepatic hydrothorax

88
Q

what pts are at low risk (<10%) for CAD?

A
  • asymp (all ages)

- atypical chest pain F < 50 yo

89
Q

what pts are at high risk (>90%) for CAD?

A
  • typical angina M > 40 yo

- typical angina F >= 60 yo

90
Q

what are the 3 features of classic angina?

A
  • typical pain (substernal, dull ache/pressure, duration)
  • provoked by exercise or emotional stress
  • relieved by rest/nitroglycerin use
91
Q

what electrolyte abn are common in chronic EtOH?

A
  • low Mg
  • low K
  • low phos
92
Q

how does Mg affect management of K?

A

inhibits renal K excretion

so low Mg –> incr K excretion and low serum K

93
Q

low K that is difficult to replenish w/ K replacement is likely 2/2 what?

94
Q

type 1 and 2 RTA cause low K and are typically assoc w/ what metabolic derangement?

A

met acidosis

95
Q

in met acidosis what do you expect bicarb level to be?

A

decr HCO3-

96
Q

what is likely causing the esophagitis in an HIV pt if there is NO dysphagia and NO oral thrush seen on exam?

A

viral cause = CMV or HSV

97
Q

what should be suspected if infective endocarditits pt developes an AV block?

A

perivalvular abscess

98
Q

how does renal vein thrombosis present?

A

flank pain + hematuria + scrotal edema

99
Q

why might you see scrotal edema in a M pt w/ nephropathy?

A

nephropathy –> decr antithrombin 3 –> hypercoag state –> renal v. thrombosis

100
Q

what are the CI for the rotavirus vaccine?

A
  • anaphylaxis to active ingredient
  • h/o intussusception
  • h/o uncorrected GI malformation
  • SCID
101
Q

can vaccines be given safely during minor infx (URI)?

102
Q

sudden onset SOB + CP + tachy w/ NO consolidation on CXR = ?

103
Q

what lung condition can cause unilat/bilat pleural effusions (typically sm. exudative and bloody)

104
Q

how do malig pulm effusions typically present?

A
  • large volume
  • progressive SOB
  • take days–> wks to develope (subacute)
105
Q

what are vascular rings?

A

congenital anomaly where the aortic arch vessels wrap around the trachea and/or esophagus

106
Q

GERD predisposes to what 3 complaints?

A
  1. barrett’s esophagus
  2. erosive esophagitis
  3. esophageal stricture formation
107
Q

how does PCKD present?

A
  • HTN
  • polyuria
  • flank pain
  • renal dysf(x)
  • liver cysts
  • cerebral aneurysms
108
Q

what unilat flank mass typically presents w/ hematuria, F, and wt loss?

109
Q

how does cryptosporidium infx present?

A
  • large volume watery diarrhea
  • no blood in diarhea
  • low fever
  • wt loss
110
Q

how does MAC diarrhea present?

A
  • watery diarrhea
  • HIGH fever (>102.2)
  • wt loss
111
Q

what systems does CMV typically attack in AIDS pts CD4 < 50?

A
  • retina
  • neuro
  • GI
112
Q

how does GI CMV infx present in AIDS pt?

A
  • freq sm vol bloody diarrhea
  • abd pain
  • low fever
  • wt loss
113
Q

which organism will cause bloody diarrhea in an AIDs pt?

114
Q

how do you tx cervicofacial actinomyces?

A
  • penicillin 2-6 mos

- sx (severe dz only)

115
Q

what types of infx are tx w/ metronidazole?

A
  • anaerobic infx

- parasitic infx

116
Q

what is the tx for TCA OD?

A
  • NaHCO3- (for heart)

- Benzos (for seizures)

117
Q

why is nL/incr K seen in HHS/DKA despite total body K deficit?

A

intracellular K shifts into s in an attempt t replace the K being peed out (looks deceptively high)

118
Q

why do HSS/DKA pts develop total body K deficit?

A

glucosuria induced osmotic diuresis –> incr u K

119
Q

in HSS, will ADH be incr or decr?

A

incr (triggered by low BP and incr K 2/2 shift)

120
Q

what metabolic derangement is to be expected w/ ASA OD?

A

anion gap metabolic acidosis + resp alkalosis (comp)

121
Q

what are the clinical features of OCD?

A

obsessions + compulsions

122
Q

what are the obsessions that are seen in OCD?

A

recurrent, intrusive, anxiety producing urges or images (can mimic psychosis)

123
Q

what are compulsions? (hint: think OCD)

A
  • response to obsessions w/ repeated behaviors or mental acts
  • behaviors won’t realistically prevent the feared event but still serve to calm anxiety
124
Q

what are the 1st and 2nd line pharm tx for OCD?

A
  1. SSRI

2. gen 2 antipsychotics

125
Q

what is the 1st line tx for OCD?

A

exposure and response prevention based CBT

126
Q

what is the tx for severe low Na w/o seizures?

A

NS + freq Na level rechecks

127
Q

when would you give 3% hypertonic saline for low Na?

A
  • pt presents w/ seizures

- low Na 2/2 SIADH

128
Q

what is the tx for severe low Na in SIADH?

A

3% hypertonic saline

129
Q

why do you give 3% saline for low Na 2/2 SIADH?

A

IVF [electrolyte] > urinary [electrolyte] to correct problem

130
Q

what are the approx osm of NS and 1/2 NS?

A
  • NS ~300 mOSM / kg H20

- 1/2 NS ~150 mOSM / kg H2O

131
Q

when do you suspect HIT?

A
  • on day 5-10 of heparin therapy

- pt presents w/ low plt + thrombus + > 50% reduc in plt from pre-heparin tx baseline

132
Q

which is more likely to cause HIT enoxaparin or unfractionated heparin?

A

unfractionated heparin

133
Q

what labs will be seen 2/2 cell lysis in tumor lysis synd?

A
  • incr K, incr phos, incr uric acid

- decr Ca (2/2 phosphate binding)

134
Q

pain w/ ejaculation suggests what?

A

chronic prostatitis

135
Q

how does chronic prostatitis present?

A
  • pain w/ ejaculation
  • recurrent UTI
  • tender prostate (+/-)
136
Q

what is GGT?

A

marker of liver and bile duct damage

137
Q

what is GGT used for?

A
  • to detect liver and bile duct damage

- to r/o bone source of incr ALP

138
Q

what GGT values are expected if cause of incr ALP is boney vs liver/biliary?

A 
boney = nL ALP
liver/biliary = incr GGT
139
Q

what is LFCN compression called and how does it present?

A
  • meralgia parasthetica
  • lateral thigh pain, numbness, or parasthesia.
  • NO weakness
140
Q

what are some causes of incr maternal serum AFP?

A
  • mult. gestation pregnancy
  • open neural tube defect (anencephally and open spina bifida)
  • ventral wall defects (omphalocele and gastroschesis)
141
Q

what are some causes of low maternal serum AFP?

A

aneuploides (trisomy 18 and 21)

142
Q

when do you check maternal AFP and what do you do if its elevated?

A
  • wks 15-20 (ideal = wks 16-18)

- if elevated do thorough U/S looking for anatomical defects

143
Q

what is the underlying pathological process/state of wegner’s?

A

vasculitis of sm and med-sized vessels

144
Q

how does wegner’s present?

A

upper and lower resp tract granulomatous inflam + rapidly progressive glomerulonephritis

145
Q

what is gluconeogenesis and why is it important?

A
  • process by which alanine, glutamine, lactate and G3-phosphate are converted to glucose
  • after 24 hrs of fasting, gluconeogenesis is the body’s sole source of glucose production
146
Q

why are benzos C/I in elderly pts?

A
  • incr risk s/e (withdrawal, dependence, motor impairment)
  • can worsen aggitation
  • very long lasting (old ppl metabolize benzos slowly)
147
Q

how does cryptosporidium diarrhea present?

A
  • self-limited if CD4 > 180. chronic if CD4 < 180.
  • large volume watery diarrhea
  • low fever
  • wt loss
  • NO blood in stool. NO pain
148
Q

what ABX = 1st line in suspected pneumococcal PNA?

A
  1. macrolides
  2. fluoroquinolones
  3. doxycycline
149
Q

how does s pneumo PNA present?

A

F + pleuritic CP + SOB + productive cough w/ rusty sputum

150
Q

which congenital heart defect exhibits a heart that looks like a boot on CXR?

151
Q

is K incr/decr in met alkalosis 2/2 extensive emesis?

152
Q

pt presents w/ 5/7 of the MDD dx criteria. what is your 1st Q?

A

are they suicidal

153
Q

what is the tx for PID?

A 
outpt = IM ceftriaxone + PO doxy
inpt = IV cefoxitin or cefotetan + PO doxy
154
Q

why can gastrectomy –> vit B12 def?

A

decr parietal cells –> decr intrinsic factor –> decr vit B12 absorption

155
Q

how does SAH present?

A
  • HA (sudden onsent = thunderclap)
  • neck pain/stiffness (meningeal irritation)
  • FND = uncommon
156
Q

what is diabetic nephropathy?

A

incr GFR (hyperfiltration) –> decr GFR w/ incr Cr + incr u. protein

157
Q

how do you tx diabetic nephropathy?

A
  • ACEi / ARB (slow progression)

- strict BG control (target HgA1c < 7%)

158
Q

which presents w/ skin findings ehlers danlos or marfans?

A

ehlers danlos = stretchy skin that bruises easily +/- velvety w/ atrophy/scarring
(marfans only presents w/ striae)

159
Q

what are the distinguishing MSK features of ehlers danlos vs marfans?

A 
ED = high arched palate
marfans = tall w/ long extremities
160
Q

which presents w/ eye issues, aortic root dilation and spontaneous PTX, marfans or ehlers danlos?

161
Q

which presents w/ hernias +/- uterine prolapse, marfans or ehlers danlos?

A

ehlers danlos

162
Q

what is selection bias?

A

nonrandom sampling/tx allocation –> study population that is not representative of target pop

163
Q

what is power?

A

= the probability that the test rejects the null hypothesis appropriately
= likelihood of avoiding a type 2 error

164
Q

what is a type 1 error?

A
  • FALSE POS conclusion
  • diff in tx where there is not
  • rejecting the null hypoth when you shouldn’t
165
Q

what is a type 2 error?

A
  • FALSE NEG conclusion
  • no diff in tx when there is
  • not rejecting the null hypoth when you should
166
Q

what statistical value = % of T1 error occuring in a particular study?

167
Q

power = ?

A

1 - type 2 error (B)

168
Q

what is the defect in Dubin Johnson synd?

A

liver can’t excrete conj bilirubin into the biliary system

169
Q

what are the expected labs in dubin johnson?

A
  • incr direct (conj) bili
  • nL LFTs
  • nL ALP
170
Q

what is the defect in Gilberts?

A

can’t conjugate bilirubin

171
Q

what are the expected labs in gilberts?

A

-incr total (unconj) bilirubin

172
Q

what will the synovial fluid look like in gouty arthritis?

A
  • crystals (neg birefringent needle shaped)
  • nonpurulent
  • neg G stain
173
Q

what is alcoholic ketoacidosis?

A

an acute metabolic acidosis 2/2 recent binge drinking + little/no nutritional intake

174
Q

what reproductive system abn is seen in CF?

A

infertility (M > 95%, F ~20%)

175
Q

what vit def = common in CF?

A

vit ADEK def

2/2 pancreatic insufficiency

176
Q

why are most M w/ CF infertile?

A

absent vas deferens (azospermia)

177
Q

how do you distinguish 1* ciliary dyskinesia from CF considering they present w/ the same resp s/s?

A

1* CD - 50 % situs invertus + immotile sperm + nL growth

CF - pancreatic inuff + azospermia + FTT

178
Q

how does pheochromocytoma present?

A
  • paroxysmal severe HTN
  • HA
  • pallor
  • sinus tachy
179
Q

what can trigger pheochromocytoma s/s?

A
  • sx
  • induction of anesthesia
  • nonselective BB
  • incr intrabd pressure (tumor palpation, positional changes)
180
Q

how do you tx kawasaki dz?

A

ASA + IVIG

181
Q

what is another name for NG tube placement?

A

nasogastric intubation

182
Q

what are the s/e of thiazide diuretics?

A 
HyperGLUC + decr Na/K/Mg
   High BG
   High lipids
   High uric acid
   High Ca
   Decr Na
   Decr K
   Decr Mg
183
Q

what is migratory superficial thrombophlebitis (trousseau synd)?

A

hypercoag disorder that presents w/ unexplained superficial venous thrombosis @ unusual sites (arm and chest = common)

184
Q

what is migratory superficial thrombophlebitis (trousseau synd) commonly assoc w/ ?

A

pancreatic ca > acute leukemias, lung, prostate, stomach, and colon ca

185
Q

how does peripheral septic thrombophlebitis present?

A
  • F + pain + edema @ infected site

- recent h/o catheter, venipuncture or IV injections

186
Q

what are the MCCs of sinus infx?

A
  • *s pneumo**
  • h influ
  • m caterhallis
187
Q

what caues a hydrocele?

A
  1. patent processus vaginalis

2. failure of fluid w/in the tunica vaginalis to reabsorb after obliteration of the processus vaginalis

188
Q

what does a patent processus vaginalis lead to?

A

communicating hydrocele

189
Q

pt presents w/ decr ulnar n. distribution sensation + pain @ elbow. dx = ?

A

ulnar n. entrapment @ elbow

190
Q

what is the MC sire of ulnar n. entrapment?

A

elbow (@ medial epicondylar groove)&raquo_space; wrist > forearm

191
Q

what comorbidity increases the likelihood of ulnar n entrapement in the forearm?

A

diabetes melitus

192
Q

what lab abnormalities can hypothyroidism cause?

hint: think lipids

A
  • incr total cholesterol
  • incr LDL
  • incr TG
193
Q

your trauma pt is declared brain dead. what do you do?

A
  • inform the family (empathetically) and answer any questions they may have. mention organ donation
  • contact organ donor ppl to get them on board ASAP
194
Q

what is the tx for menigococcal meningitis?

A
  • Gen3 cephalosporin (ceftriaxone) + vanc

- NO steroids (WILL NOT help)

195
Q

how should resp contacts be ppx for meningococcal meningitis?

A

rifampin + ciprofloxacin + ceftriaxone

196
Q

how do you tx asymp UTI in pregnancy?

A
  • nitrofurantoin
  • amoxicillin
  • cephalexin
197
Q

how do you tx IBS?

A
  1. TCA (amitriptyline, nortriptyline)
  2. SSRI
    * *add on anti-diarrheal meds and/or anti-constipation meds as needed
198
Q

how does hereditary hemachromatosis present?

A
  • bronze diabetes
  • joint pain
  • incr LFTs –> cirrhosis –> HCC
  • 2* hypogonadism
  • 2* hypothyroidism
  • restrictive/dilated cardiomyopathy and conduction abn
  • incr listeria, vibrio vulnificus and yersinia enterolitica infx
199
Q

how do you decr risk of cirrhosis and HCC in hemachromatosis pts?

A

serial phlebotomy (drain excess Fe)

200
Q

what is the best test for dx diverticulosis/diverticulitis?

201
Q

when is colonoscopy used to dx diverticulosis/itis?

A
  • incidentally

- to find source of a GI bleed

202
Q

what is toxic epidermal necrolysis?

A

severe synd w/ sudden onset mucocutaneous lesions + skin sloughing + systemic toxicity

203
Q

what most commonly triggers TEN?

A
  • ABX (sulfonamides)
  • anticonvulsants
  • allopurinol
204
Q

which anticonvulsants trigger TEN?

A
  • carbemazepine
  • lamotrigine
  • phenytoin
205
Q

how do you distinguish between steven-johnson synd and toxic epidermal necrolysis?

A

SJS < 10% BSA affected
overlap synd = 10-30% BSA affected
TEN > 30% BSA affected

COMLEX Level 2CE (23 decks)

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