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COMLEX 2 > Incorrect Questions > Flashcards

Incorrect Questions Flashcards

1
Q

acute MI on ECG

A

new development of ST-segment elevation or depression or the development of new T-wave changes such as hyper acute T waves or T wave inversions in two contiguous leads

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2
Q

posterior wall infarct ECG leads

A

V1-V4

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3
Q

posterior wall infarct vessels

A

left coronary artery
- circumflex branch
right coronary artery
- posterior descending branch

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4
Q

posterior wall ECG findings

A

tall R waves
ST-segment depression
upright T waves

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5
Q

inferior wall infarct ECG leads

A

II, III, aVf

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6
Q

inferior wall infarct vessels

A

right coronary artery

- posterior descending branch

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7
Q

inferior wall ECG findings

A

T-wave inversion

ST-segment elevation

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8
Q

lateral wall infarct ECG leads

A

I, aVl, V5, V6

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9
Q

lateral wall infarct vessels

A

left coronary artery

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10
Q

lateral wall infarct ECG findings

A

ST-segment elevation

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11
Q

septal wall infarct ECG leads

A

V1 and V2

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12
Q

septal wall infarct vessels

A

left anterior descending artery

- septal branch

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13
Q

septal wall infarct ECG findings

A

R wave disappears
ST-segment rises
T-wave inverts

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14
Q

anterior wall infarct ECG leads

A

V2-V4

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15
Q

anterior wall infarct vessels

A

left anterior descending artery

- diagonal branch

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16
Q

anterior wall infarct ECG findings

A

poor R-wave progression
ST-segment elevation
T-wave inversion

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17
Q

what causes neck stiffness (meningismus) after subarachnoid hemorrhage

A

breakdown of blood products within CSF

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18
Q

what is meningismus

A

neck stiffness indicating inflammation of the meninges

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19
Q

multiple endocrine neoplasia type 2

A

pheochromocytoma
thyroid carcinoma
hyperparathyroidism

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20
Q

cells for medullary thyroid cancer

A

thyroid parafollicular cells

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21
Q

what do thyroid parafollicular cells secrete

A

calcitonin

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22
Q

Atrial natriuretic peptide

A

seen in cardiac amyloidosis

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23
Q

ß-amyloid

A

accumulates in neurofibrillary tangles in Alzheimer’s disease

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24
Q

immunoglobulin light chain

A

amyloidosis associated with multiple myeloma

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25
Q

tuberous sclerosis genetics

A

autosomal dominant neurocutaneous disorder

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26
Q

presentation of tuberous sclerosis

A 
infants present with convulsive seizures (infantile spasms)
developmental delay
abnormal skin findings: 
- angiofibromas (sebaceous adenomas)
- ash-leaf spots best seen on Wood lamp
- shagreen patches
CNS: periventricular tubers
heart: rhabdomyoma
regina: mulberry tumors, phakomas, Regina hamartomas
kidneys: angiomyolipomas
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27
Q

most common kidney finding in tuberous sclerosis

A

angiomyolipomas

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28
Q

diagnosis of allergic dermatitis

A

patch testing

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29
Q

cells involved in allergic dermatitis

A

T cells, NOT IgE

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30
Q

O’Brien’s test is for

A

superior labral anterior to posterior tear

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31
Q

O’Brien’s test

A

passively flex patient’s shoulder to 90° then internally rotate shoulder

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32
Q

positive O’Brien’s test

A

pain and/or clicking when arm is in full internal rotation, but not when arm is in neutral rotation

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33
Q

Speed test for

A

irritation of the long head of the biceps tendon

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34
Q

α-1 antitrypsin deficiency (A1AD)

A

inherited condition characterized by genetic defect that causes configurational change in α-1 antitrypsin molecule that prevents its release from hepatocytes

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35
Q

what does α-1 antitrypsin do

A

protects lung tissue from damage by proteases

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36
Q

ancestry for α-1 antitrypsin deficiency

A

Northern European

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37
Q

presentation of α-1 antitrypsin deficiency

A

emphysema - unchecked proteases cause damage to alveolar walls
liver disease

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38
Q

extra pulmonary manifestations of A1AD

A 
necrotizing panniculitis
vascular disease
vasculitis (c-ANCA positive)
inflammatory bowel disease
glomerulonephritis
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39
Q

common pathogens in meningitis for <1month

A

streptococcus agalactiae
escherichia coli
listeria monocytogenes

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40
Q

common pathogens in meningitis for 1 month to 23months

A 
streptococcus pneumonias
neisseria meningitidis
S. agalactiae
haemophilus influenza
E. coli
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41
Q

common pathogens in meningitis for 2 years to 50 years

A

N. meningitidis

S. pneumoniae

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42
Q

common pathogens in meningitis for > 50 years

A

S. pneumonias
N. meningitides
L. monocytogenes
Aerobic gram-negative bacilli

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43
Q

empiric antibiotic treatment for meningitis <1 month

A

ampicillin + cefotaxime
OR
ampicillin + aminoglycoside

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44
Q

empiric antibiotic treatment for meningitis 1 month to 23 months

A

vancomycin + third-generation cephalosporin

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45
Q

empiric antibiotic treatment for meningitis 2 years to 50 years

A

vancomycin + third generation cephalosporin

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46
Q

empiric antibiotic treatment for meningitis >50 years

A 
vancomycin
\+ 
ampicillin
\+ 
third-generation cephalosporin
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47
Q

why ceftriaxone for meningitis

A

provides good penetration into CSF

effective against most major causes of adult meningiits

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48
Q

why vancomycin for meningitis

A

increasing resistance of some bacteria to ß-lactams

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49
Q

why ampicillin for meningitis

A

increased risk of listeria in patients over 50

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50
Q

descriptions suspicious for malignancy in breast cancer

A

“linear branching micro calcifications”

“grouped irregular micro calcifications”

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51
Q

descriptions suspicious for benign breast changes

A

“vascular/skin calcifications”
“rim calcifications”
“large and coarse calcifications”
“smooth round and oval calcifications”

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52
Q

what is the next best step for suspected malignancy in breasts without a palpable mass?

A

stereotactic core biopsy

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53
Q

when is stereotactic core biopsy indicated?

A

non-palpable masses diagnosed on mammography

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54
Q

HELLP syndrome

A

Hemolysis
Elevated Liver
Low Platelets

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55
Q

Risk factors for HELLP syndrome

A 
African American 
extremes of age
multiple gestations
molar pregnancy
renal disease
chronic hypertension
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56
Q

another name for colonic pseudo-obstruction

A

Ogilvie syndrome

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57
Q

what is pseudo-obstruction

A

acute dilation of the colon with signs and symptoms of mechanical bowel obstruction without an actual mechanical or anatomic obstruction of flow

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58
Q

signs/symptoms of pseudo-obstruction

A 
abdominal distension
abdominal pain
nausea/vomiting
constipation
bowel sounds, hypoactive
abdominal tenderness, mild
abdominal tympani
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59
Q

who commonly gets pseudo-obstruction

A

severely ill or post surgical patients with certain medications (calcium channel blockers, narcotics, α-2 antagonists) and/or electrolyte imbalances (hypocalcemia, hypokalemia)

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60
Q

diagnosis of Ogilvie syndrome

A

clinical history and physical exam, abdominal radiography

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61
Q

abdominal x-rays in Ogilvie syndrome

A

colonic dilation, usually from cecum to splenic flexure

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62
Q

management of Ogilvie syndrome

A 
urgent NG decompression via NG tube
strict NPO
IV fluid resuscitation
labs to evaluate electrolyte abnormalities
abdominal imaging
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63
Q

complications of Ogilvie syndrome

A

colonic ischemia and/or perforation

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64
Q

sideroblastic anemia

A

acquired disease caused by an abnormality in iron metabolism

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65
Q

acquired causes of sideroblastic anemia

A 
lead
drugs
- isoniazid, alcohol, chloramphenicol
collagen vascular disease
neoplasm
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66
Q

labs in sideroblastic anemia

A

microcytic
hypo chromic
increased ferritin and iron
TIBC normal or elevated

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67
Q

peripheral smear of sideroblastic anemia

A

anisocytosis
target cells
poikilocytosis
occasional siderocytes

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68
Q

what is pathognomonic for sideroblastic anemia

A

siderocytes

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69
Q

what are siderocytes

A

hypo chromic red blood cells which have coarse basophilic granules visible via Wright or Wright-Giemsa stain

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70
Q

missed abortion

A

death of a fetus before 20wks with complete retention of products of conception and a closed cervical os

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71
Q

physiologic changes in pregnancy related to thyroid hormones

A

TBG increases
TSH no change
T4, total increases
T4, free no change

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72
Q

treatment for acute RV infarction

A

isotonic IV fluids (increase preload, cardiac output, and Pressure)
aspirin
cardiac catheterization

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73
Q

initial treatment of acute pericarditis

A

NSAIDs plus colchicine

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74
Q

gram stain of strep pyogenes

A

gram-positive cocci in chains

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75
Q

what is Peutz-Jeghers syndrome

A

autosomal dominant mutation in a tumor suppressor gene (STK11)

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76
Q

characteristic findings of PJS

A

2 of:

  • 2 or more Peutz-Jeghers-type hamartomatous polyps of the GI tract
  • mucocutaneous hyperpigmentation of the mouth, lips, nose, eyes, genitalia, and fingers
  • family history of PJS
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77
Q

most commonly increased GI cancer risks in patients with PJS

A

colorectal
gastric
small bowel
pancreatic

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78
Q

most commonly increased extra intestinal cancer risks in patients with PJS

A 
breast
ovary
cervix
Sertoli cell tumor of the testis
lung
thyroid
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79
Q

diphyllobothrium latum

A

cestode (tapeworm) from fish
acquired from ingesting infective larvae in fish, usually freshwater or spend most life in freshwater
larvae killed by flash freezing
causes vitamin B12 deficiency

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80
Q

most common causes of diphyllobothrium latum

A

salmon, trout, whitefish, herring, cod, freshwater squid, mackerel, and red snapper

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81
Q

sudden-onset severe chest pain that is ripping or tearing in nature, HTN, inter-arm pressure difference, asymmetric pulses

A

aortic dissection

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82
Q

aortic dissection - ascending

A

anterior chest

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83
Q

aortic dissection - aortic arch

A

neck and jaw

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84
Q

aortic dissection - descending

A

inter scapular area

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85
Q

mycosis fungoides

A

mc type of cutaneous T-cell lymphoma, a non-Hodgkin lymphoma

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86
Q

cutaneous T-cell lymphoma

A

malignant disease of helper T-cells within he skin and lymph nodes

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87
Q

clinical features of cutaneous T-cell lymphoma

A

initially, scaly plaques along with an erythematous, pruritic rash (often mis-dx)
may then progress to tumor stage with at least one tumor (lesion >5mm from skin)

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88
Q

threes phases of mycosis fungoides

A

1 - patches (nonspecific dermatitis-like patches)
2 - plaques (pruritic plaques and lymphadenopathy)
3 - tumors (likely to ulcerate)

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89
Q

tx of mycosis fungoides

A

topical (radiation, photochemotherapy, photodynamic therapy, and laser surgical excision)

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90
Q

back/flank pain, dark or cloudy urine, fever, and urinary incontinence or increased frequency

A

renal papillary necrosis (RPN)

91
Q

u/a in renal papillary necrosis (RPN)

A

necrotic tissue that has sloughed from the kidneys

92
Q

CT RPN

A

anatomical defects - medullary ring shadows and/or hydronephrosis

93
Q

risk factors for RPN

A

acetaminophen or NSAID use, sickle cell anemia (s/t ischemia of kidneys), urinary tract obstruction, and diabetes

94
Q

tx RPN

A

supportive

95
Q

CT hepatic hemangioma

A

well-defined hypotenuse mass with typical filling pattern for hemangioma - peripheral nodular enhancement followed by complete opacification on delayed images

96
Q

risk factors for anal cancer

A

HPV, receptive anal intercourse, and smoking

97
Q

mc type of anal cancer

A

squamous cell carcinoma

98
Q

liver cirrhosis immunization recommendations

A

HepA, HepB, influenza, and pneumococcal polysaccharide vaccine 23

99
Q

res ipsa loquitur

A

‘the thing speaks for itself’

  • no direct evidence of physician’s negligence
  • requires the accident must be of a kind which ordinarily does not occur in the absence of someone’s negligence and the patient did not contribute to the accident
100
Q

muscle strength grading

A

Grade 0 = no muscle movement
Grade 1 = trace muscle contraction but no joint movement
Grade 2 = joint and muscle movement with gravity and resistance eliminated
Grade 3 = joint and muscle movement against gravity, but not resistance
Grade 4 = joint and muscle movement against gravity and resistance, but less than normal
Grade 5 = normal joint and muscle movement against gravity and resistance

101
Q

radial nerve palsy

A

C5-T1
most often fx at mid-humerus or compression of nerve by crutches
paralysis of wrist extensors, digits, and forearm supinators (‘wrist drop’)

102
Q

axillary nerve injury

A

C5-C6
fx of surgical neck of humerus
motor of deltoid and sensory overlying deltoid

103
Q

long thoracic nerve injury

A

serrates anterior

winged scapula

104
Q

median nerve injury

A

pronation, flexion of the hand at wrist joint, and thumb opposition
‘ape hand’ deformity

105
Q

ulnar nerve injury

A

fx of medial epicondyle

pinpoint pain, loss of sensation over medial hand, decreased grip strength

106
Q

hydrosalpinx

A

collection of fluid inside Fallopian tube and is almost always a complication of acute salpingitis/pelvic inflammatory disease

107
Q

pelvic ultrasound of hydrosalpinx

A

sausage-like, cystic lesions filled with clear fluid

108
Q

radioactive iodine uptake scan in dequervain thyroiditis

A

decreased uptake

d/t stored hormones being released from the inflamed gland, not from overproduction

109
Q

Grave’s disease antibody

A

thyroid-stimulating hormone receptor antibody (TRAb)

110
Q

kallman syndrome

A

hypogonadotropic hypogonadism and impaired ability to smell

111
Q

lab findings in Kallman syndrome

A

low LH, low FSH, low testosterone, progesterone, and estrogen

112
Q

lichen planus

A

immune-mediated skin disorder in middle aged adults
five p’s : pruritic, purple, polygonal, and papules or plaques
commonly found on ectremities

113
Q

viewing of lichen planus

A

fine white lines (Wickham striae)

114
Q

TCA toxicity

A

CNS depression, coma, seizures, cardiac dysrhythmias, and respiratory depression

115
Q

mc EKG findings in TCA toxicity

A

sinus tachycardia
prolonged PR interval
widening of QRS complex
QTc interval prolongation

116
Q

what can be used to reduce incidence of PUD associated with NSAIDs

A

misoprostal - prostaglandin

117
Q

arsenic poisoning

A 
acute = GI symptoms - watery diarrhea, abdominal pain, and vomiting
chronic = polyneuropathy and skin pigmentation changes
118
Q

tx arsenic poisoning

A

chelation therapy with dimercaprol (BAL) to speed excretion

119
Q

mc hematologic complication with nephrotic syndrome

A

venous thrombosis and pulmonary embolism

120
Q

rib movements

A

ribs 1-5: pump handle
ribs 6-10: bucket-handle
ribs 11-12: caliper

121
Q

muscles used for rib tx

A 
rib 1: anterior scalene
rib 2: posterior scalene
ribs 3-5: pectoralis minor
ribs 6-9: serratus anterior
ribs 11-12: quadrates lumborum
122
Q

odds ratio

A

determining the different levels of risk attributable to the exposure

123
Q

calculation of odds ratio

A 
= ad/bc 
a = exposure &amp; disease
b = exposure &amp; no disease
c = no exposure &amp; disease
d = no exposure &amp; no disease
124
Q

LVH on ekg

A

increased in amplitude of QRS complexes and left deviation

125
Q

causes of LVH

A

uncontrolled htn, cvd, aortic stenosis, and aortic insufficiency

126
Q

tx LVH

A

if reversible, target cause of disease

ex: HTN? tx ACE-i, ARB, direct renin inhib, CCBs

127
Q

minor pelvic fx

A

located within pubic rami

128
Q

consider minor pelvic fx in pt with:

A

leg length discrepancy, abnormal positioning of leg, focal bony tenderness of hip or pelvis, reluctance to move leg, and inability to lift leg

129
Q

granulomatosis with polyangiitis

A

necrotizing vasculitis that primarily affects lungs and kidneys

130
Q

nephritic syndrome

A

hematuria, oliguria, and mild proteinuria

131
Q

granulomatosis with polyangiitis

A

rhinitis and hemoptysis
positive c-ANCA
cxr: interstitial lung disease, infiltrates, cavitary nodules
IF negative for antibodies

132
Q

contact dermatitis (diaper)

A

erythema and maceration on convex skin surfaces that are in direct contact with the diaper

133
Q

comedonal or noninflammatory acne

A

multiple open and closed comedones and small papules and pustules without significant erythema or inflammation

134
Q

tx comedonal acne vulgars w/o inflammatory component

A

topical retinoid

135
Q

topical retinoid MOA

A

reduce follicular hyper proliferation resulting in reduced follicular occlusion and reduced comedones formation

136
Q

four main pathogenic factors of acne

A
  1. increased sebum production (triggered by presence of androgens)
  2. follicular hyper proliferation (excessive keratinization which blocks the sebum from exiting the follicles)
  3. proliferation of Cutibacterium acnes, part of the normal skin lora, within the sebum-clogged follicles
  4. inflammation (trigged by proliferation of C. acnes)
137
Q

Galeazzi fracture

A

fx of distal third of the radius in conjunction with dislocation of the distal radioulnar joint

138
Q

nerve affected in Galeazzi fx

A

anterior interosseous nerve (branch of the median nerve) is damaged
-> paralysis of the flexor policies longs and flexor digitorum profundus -> loss of ability to pinch between the thumb and index finger

139
Q

tricuspid stenosis murmur

A

significant diastolic pressure gradient -> low pitched diastolic rumble heard at lower left sternal border that enhances with insporation
mc cause is rheumatic fever

140
Q

what can be used to increase breast milk production

A

metoclopramide, dopamine antagonist

141
Q

hx of travel to tropical/subtropical, eosinophilia, pruritic skin lesion f/b transient cough and later GI

A

parasites

Strongyloides stercoralis

142
Q

Echniococcus granulosus

A

‘hydatid cysts’
mc - lung, liver, and CNS
chest pain, hemoptysis and HA or disorientation d/t increased ICP
NO GI

143
Q

onchocerciasis volvulus

A

transmitted by blackfly, common in africa
‘river blindness’
dx: skin snip test and microscopic exam, slit lamp

144
Q

Schistosoma haematobium

A

‘swimmer’s itch’
fever, urticaria, nausea, and abdominal pain
mc cause of squamous cell carcinoma of the urinary bladder

145
Q

trypanosoma brucei

A

African trypanosomiasis, or African sleeping sickness
no GI manifestations
fever, malaise, chancre at site of tsetse fly bite f/b meningoencephalitis and daytime somnolence

146
Q

Strongyloides stercoralis

A

penetrate skin in foot from soil
penetrate colonic mucosa, travel hematogenously to other organ systems -> hyper infection syndrome in immunocompromised host
pneumonitis, abdominal apin, severe fever, meningitis/encephalitis

147
Q

radial head somatic dysfunction muscle energy

A

physician supinates the arm to move the radial head anterior while the patient resists by pronating the arm

148
Q

pulmonary fibrosis

A

chronic inflammation of the lung parenchyma -> fibroblast activation and proliferation
slow onset with dyspnea on exertion, chronic cough, wheezing, and chest pain

149
Q

physical exam of pulmonary fibrosis

A

inspiratory rales

signs of right heart failure: elevated JVD, S3 heart sounds, RV heave, digital clubbing

150
Q

pulmonary fibrosis on xray

A

reticular, nodular, or ground-glass pattern

severe: cystic space in the lung periphery d/t destruction of lung parenchyma

151
Q

causes of pulmonary fibrosis

A

idiopathic, irritation with cigarettes, medications (amiodarone), environmental allergens, environmental pollutants, recurrent aspiration, and reflux

152
Q

pulmonary fibrosis PFT

A

decreased diffusion capacity

153
Q

management of fibromyalgia

A

duloxetine, milnacipran, and pregabalin

154
Q

eligibility for mechanical thrombectomy

A

initiated within 6hrs of symptom onset, imaging without hemorrhage and minimal signs of ischemic change

155
Q

thiazide diuretics

A

hydrochlorothiazide and chlorthalidone

156
Q

Henoch Schonlein Purpur (HSP)

A

inflammation of small to medium blood vessels

157
Q

fever, palpable purpura on LE and buttocks, migratory polyarthritis of large joints, glomerulonephritis, abdominal pain in peds pt

A

Henoch-Schonlein Purpura

aka IgA vasculitis

158
Q

IgA nephropathy

A

primary glomerulonephritis

recurrent episodes of macroscopic hematuria, mild flank pain, and low-grade fever

159
Q

peds pt with tuberculosis

A

several days to weeks of fever, cough, night sweats, and weight loss
cxr - hilar adenopathy
foreign born, visited endemic area, or adult contact

160
Q

iodine deficiency

A

hypothyroidism goiter

161
Q

tx actinic keratoses

A

5-FU in diffuse areas

cryo for isolated lesions

162
Q

pancreas posterior chapman’s point

A

between transverse process of T7 and T8 on right

163
Q

pancreas anterior chapman’s point

A

7th ICS right

164
Q

complication of acute diverticulitis

A

pneumaturia

165
Q

number needed to treat

A

1/absolute risk reduction

ex:
0. 8% -> 1/0.008 = 125

166
Q

Berger’s disease

A

presents within days of URI

caused by deposition of IgA antibody in glomerulus

167
Q

trichuris trichiura

A

whipworm

diarrhea, mucus or bloody, worse at night, abdominal pain

168
Q

brugia malayi

A

filarial nematode transmitted by mosquitoes

inhabits lymphatics -> lymphadenitis and lymphedema

169
Q

dipylidium caninum

A

dog tapeworm, transmitted to humans via flea ingestion

asymptomatic, but can have abdominal pain or diarrhea

170
Q

enterobius vermicularis

A

pin worm, common nematode in children

intense pruritus of ani, particularly at night

171
Q

loa loa

A

African eye worm
transmitted by chrysoprase fly
soft tissue swelling sand ocular migration

172
Q

TB pleural effusion

A

lymphocytes >80%, greatly increased total protein
adenosine deaminase <40 r/o TB
glucose is low (30-50)

173
Q

CHF pleural effusion

A

transudative bilateral

174
Q

rheumatoid arthritis pleural effusion

A

extremely low glucose (< 30)

extremely low glucose also found in empyema and malignancy

175
Q

lymphoma pleural effusion

A

chylothorax = white and milky pleural fluid with TG > 110

176
Q

PE pleural effusion

A

bloody

bloody also seen in malignancy

177
Q

dawn phenomenon

A

result of early morning growth hormone secretion

GH is an antagonist to insulin, so may cause hyperglycemia in the middle of the night and early morning

178
Q

initial step in management if pt has increased morning glucose

A

measure blood glucose again at 3am prior to making any change to insulin regimen

179
Q

inability to tolerate oral intake and obstipation in first few days after an abdominal operation

A

postoperative ileus
normal intestinal structure on CT
self-limited

180
Q

positively skewed distribution

A

mean > median

mean, median > mode

181
Q

bimodal distribution

A

two distinct modes

182
Q

negatively skewed distribution

A

mean < median, mode

183
Q

normal (gaussian) distribution

A

classic symmetric bell curve

mean = median = mode

184
Q

management for isolated cleft lip in otherwise healthy infant

A

surgically manage at 3-6mo of age

185
Q

SAAG > 1.1

A

portal HTN likely to be cause of ascites

may be portal vein thrombosis, cirrhosis, or CHF

186
Q

diagnostic test to confirm thoracic outlet syndrome

A

arteriography

187
Q

superficial thrombophlebitis

A

localized extremity pain and redness
cordlike area of induration, erythema
tx: NSAIDs, elevation, heat, and support stockings

188
Q

hypersensitivity pheumonitis PFT

A

decreased diffusing capacity of the lungs for carbon monoxide

189
Q

hypersensitivity pneumonitis cause

A

associated with bird or pigeon breeding

190
Q

generalized weakness, easy fatiguability, depression, HTN, recurrent episodes of pseudo gout, nausea, vomiting, and abdominal pain

A

hypercalcemia

191
Q

pt < 5y/o with fever, bull formation, and sheetlike desquamation of the skin

A

staph scalded skin syndrome

192
Q

chi-square

A

best statistical test for analyzing studies where results are 2 proportions

193
Q

tx of narrow QRS tachycardia in unstable pt

A

sedation and synchronized cardioversion

194
Q

chronic urticaria

A

antihistamines- diphenhydramine or cetirizine

195
Q

Creutzfeldt-Jakob disease

A

rapidly progressive dementia accompanied by at least 2 of the four findingS:

  • myoclonus
  • visual or cerebellar disturbance
  • pyramidal/extrapyramidal dysfunction
  • akinetic mutism (lack of motor activity)
196
Q

tests in CJD

A

EEG: sharp wave complex
MRI: putamen and head of caudate
CSF: elevated protein, normal glucose, no cells

197
Q

biopsy in CJD

A

gliosis (increased size and number of astrocytes)
neuronal loss
spongiform change (tissue replaced with vacuoles)
abnormal protein buildup (using prion protein immunoperoxidase)

198
Q

myxoma

A

mc primary tumor of heart in adults

connective tissue in right or left atria

199
Q

symptoms of myxoma

A

weight loss, fatigue, dyspnea, syncope

ball-valve obstruction of mitral valve -> ‘tumor plop’ with early diastolic thud f/b diastolic murmur

200
Q

diagnostic test of choice for diverticulitis

A

CT scan

201
Q

treatment of neuroleptic malignant syndrome

A

bromocriptine

202
Q

tx cyanide poisoning

A

from sodium nitroprusside

hydroxocobalamin - binds cyanide to facilitate urinary excretion

203
Q

altered mental status, autonomic hyperactivity, seizures, and tactile/visual hallucinations

A

delirium tremens - lorazepam tx

204
Q

folliculitis

A

pruritic, erythematous pustules

staph aureus

205
Q

Ewing sarcomas

A

primary malignant bone tumors affecting children and adolescents

206
Q

Ewing sarcoma xray

A

destructive lesion with a periosteal reaction causing layers of reactive bone to form, giving a so-called ‘onion-skin’ appearance

207
Q

bone pain, skeletal deformities, hearing loss, elevated alk phos, enlargement of skull, jaw, or clavicle

A

Paget disease of the bone

208
Q

Paget disease of bone xray

A

thick bone cortices with bony deformities

prominent radimdense peripheral contours of vertebrae common

209
Q

fat embolism

A 
respiratory changes (dyspnea, tachypnea, cough, hypoxia)
neurologic abnormalities (mental status change)
petechial rash 1-3d after insult
210
Q

serum glucose >600, bicarb >/= 15, serum pH >/= 7.30; no ketonuria, profound dehydration, alteration of consciousness

A

Hyperglycemic Hyperosmolar State (HHS)

effective serum osmolality >320

211
Q

polyarteritis nodosa

A

necrotizing arteritis of medium-sized vessels

affects skin, cardiovascular, renal/mesenteric, and nervous systems

212
Q

derm manifestations of polyarteritis nodosa

A

livedo reticular, subcutaneous nodules, digital gangrene, and ulcers

213
Q

polyarteritis nodosa test

A

hepatitis B

negative p-ANCA

214
Q

polyarteritis nodosa findings

A

dermatologic
hypertension caused by renal artery involvement
abdominal pain assoc with meals d/t mesenteric ischemia

215
Q

dx polyarteritis nodosa

A

biopsy or mesenteric angiography

216
Q

cariogenic shock

A

causes increased pulmonary capillary wedge pressure and JVD
cxr & lung: pulmonary congestion
low cardiac output, high systemic vascular resistance (SVR)

217
Q

neurogenic shock

A

disruption of autonomic nervous system control over vasoconstriction
peripheral vasodilation -> warm, flushed skin
low cardiac output, pulmonary capillary wedge pressure, AND SVR

218
Q

septic shock

A

hx recent infection
peripheral vasodilation -> warmed, flushed skin
decreased SVR -> increased cardiac output
low pulmonary capillary wedge pressure

219
Q

hypovolemic shock

A

trauma, diarrhea, vomiting, GI bleeding, SBO, or burns
decreased preload -> decreased cardiac output -> increase SVR to compensate
low pulmonary capillary wedge pressure

220
Q

H&P cardiogenic shock

A

MI, CHF, chest pain.

cold clammy skin, JVD, and pulmonary congestion

221
Q

H&P hypovolemic shock

A

History of fluid loss

Cold clammy skin, pallor

222
Q

H&P septic shock

A

Recent infection, fever, leukocytosis, warm flushed skin

223
Q

H&P anaphylactic shock

A

inciting exposure

224
Q

H&P neurogenic shock

A

severe CNS trauma or hemorrhage

COMLEX 2 (37 decks)

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