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1
Q

acute bronchitis –> clinical presentation

A
  • 5day-3wk
  • productive cough
  • wheeze/rhonchi
  • tender chest wall
  • no systemic findings
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2
Q

definition of resistant HTN

A

persistent HTN despite >3 antiHTN agents

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3
Q

systolic-diastolic abd bruit –> condition?

A

renal A stenosis –> renovasc HTN

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4
Q

HBV infect –> how dx?

A
  • HBsAg

- IgM anti-HBc

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5
Q

pleural effusion –> findings?

  • breath sounds
  • tactile fremitus
  • percussion
A
  • decreased breath sounds
  • decreased tactile fremitus
  • dull to percussion
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6
Q

nonsmoker w/out pulm dz –> chronic cough –> 3 MC causes?

A
  • postnasal drip
  • GERD
  • asthma
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7
Q

suspect postnasal drip (upper airway cough synd) –> dx?

A

dx by empiric tx:

  • oral 1st gen antihist (chlorpheniramine)
  • combined antihist-decong (brompheniramine + pseudoephedrine)
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8
Q

gout d/t increased urate production –> cause (4)?

A
  • 1ary gout
  • myeloprolif/lymphoprolif dz
  • tumor lysis synd
  • hypoxanthine guanine phosphoribosyl transferase def
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9
Q

polycythemia vera –> ssx

A
  • aquagenic pruritis
  • HA
  • HSM
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10
Q

S4 –> represents what? indicates?

A

blood hit stiff/hypertrophic LV

LVH

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11
Q

ischemic stroke w no prior antiplatelet tx–> tx?

A

ASA w/in 24hr to reduce recur

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12
Q

stroke on ASA tx –> tx?

A

ASA + dipyridamole/clopidogrel

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13
Q

common variable immunodef –> pathophys?

A
  • impaired B cell diff
  • hypogammaglobulin
  • -> increased susceptibility to bact infect
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14
Q

CVID –> clinical manifestation

A
  • recurrent infect: resp, GI

- autoimmune dz

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15
Q

CVID –> dx?

A
  • quantitative measurement of Ig level –> sig decreased IgG, decreased IgA/IgM
  • no response to vaccine
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16
Q

adult –> recurrent bact infect –> condition?

A

common variable immunodef

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17
Q

warfarin –> excess anticoag –> tx?

A
  • IV vitK

- prothrombin complex concentrate

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18
Q

situational syncope –> pathophys

A

reflex or neurally-med syncope:

trigger –> micturition, defecation, cough –> alter autonomic response –> cardioinh/vasodepressor/mixed response

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19
Q

acute bact prostatitis –> ssx

A
  • UTI ssx
  • perineal pain
  • pronounced systemic ssx (fever, chills, acute illness)
  • tender, boggy prostate
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20
Q

acute bact prostatitis –> dx

A

mid-stream urine sample

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21
Q

acute bact prostatitis –> empiric tx

A
  • TMP/SMX

- fluoroquinolones

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22
Q

acute bact prostatitis –> trt for how long?

A

4-6wk

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23
Q

mult sclerosis –> acute exacerbation –> tx?

A
  • high dose IV glucocorticoids

- plasma exchange if not response to steroid

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24
Q

pit microadenoma –> galactorrhea –> tx?

A

symptomatic prolactinoma –> dopaminergic agonist (cabergoline, bromocriptine) –> lower prolactin level, reduce tumor size

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25
Q

RBC transfusion –> 2hr later –> chills, malaise –> condition?

A

febrile nonhemolytic transfusion rxn

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26
Q

febrile nonhemolytic transfusion rxn –> how long after RBC transfusion?

A

1-6hr

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27
Q

febrile nonhemolytic transfusion rxn –> what could have prevented this?

A

leukoreduction

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28
Q

S3 –> indicates?

A

heart fail

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29
Q

invasive pulm aspergillosis –> clinical presentation

A

classic triad:

  • fever
  • pleuritic chest pain
  • hemoptysis
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30
Q

invasive pulm aspergillosis –> CT finding

A

halo sign: nodules w surrounding ground glass opacity

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31
Q

invasive pulm aspergillosis –> tx

A

voriconazole + echinocandin (caspofungin)

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32
Q

invasive pulm aspergillosis –> RF?

A

immunocomp:
- neutropenia
- glucocorticoids
- HIV

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33
Q

curtain came down over eye –> condition?

A

retinal detach

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34
Q

retinal detach –> ssx

A
  • photopsia (flashes of light)
  • floaters (spots in visual light)
  • curtain coming down over eye
  • gray retina
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35
Q

1st deg AV heart block –> EKG finding

A

prolonged PR interval

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36
Q

abd aortic aneurysm –> RF assoc w aneurysm expansion & rupture (3)

A
  • lrg diameter
  • rate of expansion
  • current cigarette smoke
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37
Q

abd aortic aneurysm –> when endovasc repair?

A
  • aneurysm size >5.5cm
  • rapid rate of aneurysm expansion
  • presence of ssx: abd/back/flank pain, limb ischemia
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38
Q

MC drug that cause priapism

A

prazosin

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39
Q

appearance: squamous cell carcinoma vs basal cell carcinoma

A

SCC: nodule –> keratinized (thick, rough) or ulcerate w crusting/bleeding

BCC: pearly flesh/pink nodule w telangiectatic vessels

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40
Q

organ transplant –> chronic immunosupp tx –> #1 skin malig?

A

SCC

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41
Q

asplenia –> why at risk for infect w encapsulated bact?

A

deficit in:

  • Ab-med phagocytosis
  • Ab-med complement activation
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42
Q

raise cutoff level of dx test –> what happens to:

  • false neg
  • true pos
  • true neg
  • false pos
  • sens
  • specificity
A 
FN: increase
TP: decrease 
sens: decrease 
TN: increase
FP: decrease
spec: increase
43
Q

young F –> ant knee pain –> condition?

A

patellofemoral pain synd

44
Q

patellofemoral pain synd –> cause

A
  • chronic overuse

- malalignment

45
Q

patellofemoral pain synd –> tx

A
  • activity modification
  • NSAID
  • stretch, strengthen exercise: quad, knee extensor, hip abductor
46
Q

patellofemoral pain synd –> positive for what test?

A

patellofemoral compression test

47
Q

vasospastic angina –> tx?

A
  • smoking cessation

- CCB (diltiazem)

48
Q

common abx options for anaerobe coverage (3)

A
  • metronidazole w amoxicillin
  • amoxi-clavulanate
  • clindamycin
49
Q

solid organ transplant –> systemic illness involving mult organ systems –> pneumonitis, hepatitis, gastroenteritis –> condition?

A

CMV viremia

50
Q

CMV –> dx?

A

PCR

51
Q

brain death: charact findings

A
  • absent cortical & brainstem fxs

- spinal cord may still be fxing –> normal DTR

52
Q

when? 13-valent pneumococcal vaccine. 23-valent?

A

> 65yo: 13-valent 1x –> then 23-valent

If <65yo –> current smoke, chronic med condition –> 23-valent

53
Q

recurrent nose bleed + oral lesions –> must think of what vasc condition?

A

hereditary telangiectasia (Osler-Weber-Rendu synd)

54
Q

hereditary telangiectasia (Osler-Weber-Rendu synd) –> characteristics (3)

A
  • diffuse telangiectasia
  • recur epistaxis
  • widespread AVM
55
Q

hereditary telangiectasia (Osler-Weber-Rendu synd) –> pulm AVM –> manifests as?

A
  • hemoptysis (can be fatal)

- R to L shunt –> chronic hypoxemia –> reactive polycythemia

56
Q

external hordeolum –> MC org?

A

staph aureus (but can be sterile)

57
Q

external hordeolum –> tx?

A

warm compress

58
Q

adult –> #1 cause of gross lower GI bleed

A

diverticulosis

59
Q

HIV –> fever, HA, bilat papilledema –> condition?

A

cryptococcal meningitis

60
Q

cryptococcal meningitis –> how dx?

A

CSF:

  • cryptococcal antigen
  • org isolation
61
Q

cushing synd –> 3 main charact

A
  • wt gain
  • muscle weak
  • HTN
62
Q

cushing synd –> catabolic effect on connective tissue –> leads to what ssx (3)?

A
  • easy bruise
  • dermal atrophy
  • striae
63
Q

cushing synd –> hyperandrogenism –> why?

A

co-secretion of adrenal androgens w cortisol

64
Q

cushing synd –> co-secrete adrenal androgens –> leads to what ssx (3)?

A

hyperandrogenism:

  • menstrual irreg
  • acne
  • hirsutism
65
Q

what is severe hyperCa?

A

> 14mg/dL

66
Q

severe or symptomatic hyperCa –> immed tx?

A

aggressive NS hydration + calcitonin

67
Q

severe or symptomatic hyperCa –> longterm tx?

A

bisphosphonate (zoledronate)

68
Q

severe hyperCa –> vol depletion –> why?

A
  • hyperCa induced nephrogenic DI –> polyuria

- GI distress –> decreased oral intake

69
Q

hyperCa –> main charact (3)?

A
  • weak
  • GI distress
  • neuropsych ssx
70
Q

indications for cystoscopy (6)

A
  • gross hematuria –> but no glomerular dz/infect
  • microscopic hematuria + bladder CA RF
  • recurrent UTI
  • obstruct ssx –> suspect stricture, stone
  • irritative ssx –> but no urinary infect
  • abnormal bladder image, urine cytology
71
Q

thrombotic thrombocytopenic purpura –> classic pentad

A
  • thrombocytopenia
  • microangiopathic hemolytic anemia
  • renal insuff
  • neuro change
  • fever
72
Q

thrombotic thrombocytopenic purpura –> pathophys

A

hereditary or acq (autoAb) –> low ADAMTS13 –> lrg vWF multimers –> small vessel thrombi –> shear RBC, end organ damage (renal, CNS)

73
Q

thrombotic thrombocytopenic purpura –> tx

A

emergent plasma exchange

74
Q

bronchiectasis –> pathophys

A

infect + impaired bact clearance –> recurrent infect, inflamm, tissue damage –> bronchial wall damage –> airway thicken & dilation

75
Q

bronchiectasis –> ssx

A

similar to chronic bronchitis:

  • cough
  • daily mucopurulent sputum
  • rhinosinusitis
  • dyspnea
  • hemoptysis
  • crackles, wheeze
76
Q

bronchiectasis –> how dx?

A

high res chest CT

77
Q

acyclovir –> can cause what kind of renal AE?

A

crystalluria –> renal tubular obstruct –> crystal induced acute kidney injury

78
Q

modified wells criteria –> likely PE –> next step?

A

1) anticoag (LMW or unfract hep)

2) confirmatory diag test

79
Q

neurofibromatosis type 1 –> eye complication?

A

optic glioma

80
Q

immunocomp –> bact meningitis –> common org (4)

A
  • S pneumo
  • N meningitidis
  • Listeria
  • G- rods
81
Q

immunocomp –> bact meningitis –> tx?

A

empiric abx + dexamethasone

82
Q

immunocomp –> bact meningitis –> empiric abx

A

vancomycin + ampicillin + cefepime

83
Q

immunocomp –> bact meningitis –> trt w dexamethasone –> why?

A

prevent neurologic comp of S pneumo meningitis (deaf, focal deficit) –> d/c when r/o pneumococcal meningitis

84
Q

bact meningitis –> empiric abx –> vancomycin + cephalosporin –> why vancomycin?

A

cover cephalosporin-resistant pneumococci

85
Q

SLE –> renal comp?

A
  • glomerulonephritis –> nephritic synd

- membranous glomerulonephritis –> nephrotic synd

86
Q

SLE –> glomerulonephritis –> pathophys? significant lab result?

A

ds-DNA/Ab immune complex –> deposit in mesangium/subendo space –> intense inflamm rxn –> activate complement –> low C3, C4

87
Q

fever, back pain, focal spinous tenderness –> condition?

A

vertebral osteomyelitis

88
Q

vertebral osteomyelitis –> workup?

A
  • blood culture
  • ESR/CRP
  • XR
89
Q

vertebral osteomyelitis –> how dx? how confirm dx?

A

MRI –> CT-guided bone bx

90
Q

adult –> parvovirus B19 –> arthritis –> where?

A

symm polyarticular: hand, wrist, knee, feet

91
Q

mult myeloma –> renal involvement –> pathophys?

A

excessive monoclonal protein –> deposit in renal tubule –> renal insuff

92
Q

myasthenia gravis –> pyridostigmine –> still symptomatic –> next step?

A

add chronic immunosupp therapy (corticosteroid, azathioprine, mycophenalate mofetil)

93
Q

61yo –> low back pain –> nocturnal pain, wt loss –> next step?

A

XR

94
Q

LBP –> when do XR (3)?

A
  • osteoporosis/compression fx
  • suspected malig
  • ankylosing spondylitis
95
Q

ankylosing spondylitis –> LBP charact (3)?

A
  • insidious onset
  • nocturnal pain
  • better w mvmt
96
Q

LBP –> when do MRI (3)?

A
  • sensory/motor deficit
  • cauda equina synd
  • suspected epidural abscess/infect
97
Q

chikungunya fever –> presentation

A
  • flu-like illness
  • symm polyarthralgia
  • limb & trunk –> macular or maculopapular rash
  • peripheral edema
  • cervical LAD
98
Q

chikungunya fever –> lab results

A
  • lymphopenia
  • thrombocytopenia
  • elevated LFT
99
Q

chikungunya fever –> transmission?

A

mosquito-borne viral illness

100
Q

aging adult –> small, red, cutaneous papule –> condition?

A

cherry hemangioma

101
Q

what produces early decrescendo diastolic murmur?

A

AR

102
Q

bicuspid aortic valve –> can lead to what in young pt? old pt?

A

young: AR
old: AS

103
Q

how can bicuspid aortic valve lead to sudden death?

A

bicuspid aortic valve –> aortic root or ascending aorta dilation –> aortic aneurysm –> dissection –> sudden death

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