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BOARD REVIEW > INTERNAL MEDICINE > Flashcards

INTERNAL MEDICINE Flashcards

1
Q

Inorganic dust causes mesothelioma

A

Asbestos

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2
Q

Inorganic dust causes Progressive Massive Fibrosis (PMF)

Multioke prominent calcified LN and multiple small pulmonary nodules throughout both lung fields with pleural thickening above both apices

A

Silica

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3
Q

Inorganic dust causes chronic granulomatous disease

A

Beryllium

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4
Q

Inorganic dust causes pneumoconiosis

A

Coal dust

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5
Q

Organic dust that causes Byssinosis or monday fever

A

Cotton dust

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6
Q

Organic dust causes hypersensitivity pneumonitis

A

Farmer’s lung

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7
Q

Chest radiographic hallmark of asbestosis

A

Indistict heart border with ground glass appearance

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8
Q

Most common cancer associated with asbestos exposure

A

Lung cancer or bronchogenic cancer

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9
Q

What occupation lung disease presents with characteristic HRCT pattern known as “crazy paving”?

A

Silicosis

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10
Q

Calcification of hilar nodes may occur in as 20% of cases and produces a characteristic pattern

A

Eggshell pattern

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11
Q

Combination of pneumoconiotic nodules and seropositive rheumatoid arthritis

A

Caplan syndrome

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12
Q

Rheumatoid arthritis + splenomegaly

A

Felty syndrome

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13
Q

Case:
Rigidity/ tremors
Parkinsonism
Dysautonomia

A

Shy- Drager Syndrome or Multiple Systems Atrophy (MSA)

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14
Q

Major cause of chest discomfort

A

Gastrointestinal

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15
Q

In adults, aortic stenosis occurs due to

A

Calcified degeneration

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16
Q

This drug stimulates K+ adenosine triphophate channels

A

Nicorandil

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17
Q

physical exam finding in patients with AORTIC STENOSIS. Auscultation at the cardiac apex reveals a murmur that sounds holosystolic and may mimic the murmur of MITRAL REGURGITATION.

A

Gallavardin effect

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18
Q

MC drug implicated in toxic cardiomyopathy

A

Doxorubicin

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19
Q

MC etiology of secondary hypertension

A

Primary renal disease

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20
Q

Irreversible inhibitor of cyclooxigenase

A

Acetylsalicylic acid

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21
Q

Time element defines chronic cough

A

> 8weeks

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22
Q

More than 12% and 200mL increase in FEV1 15 min after the inhaled short acting B2 agonist

2 to 4 week trial of oral corticosteroids

A

Reversibility ina asthma

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23
Q

Cyanosis and clubbing seen in

A

CHD with R to L shunt
Lung abscess
Pulmonary AV fistula
Lung cancer

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24
Q

Patients with CAP, how long will the symptoms resolve?

A

3 months

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25
Q

Exercise induced asthma
Tx

A

Prevent withinhaled corticosteroids

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26
Q

Ideal tidal volume ventilation for ARDS

A

6mL/kg predicted body weight

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27
Q

Causes ARDS through indirect lung injury

A

Flail chest

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28
Q

1st vasopressor administered to a patient with gram negative septic shock

A

Norepinephrine

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29
Q

Myasthenia gravis will lead to which type of respiratory failure

A

2

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30
Q

Main cell types harbor HIV in the CNS

A

Microglia

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31
Q

First line antibiotic for patients with leptospirosis

A

Ampicillin 0.5-1.0 q6 IV for 7 days

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32
Q

Characteristic of Influenza B of inability ro cause pandemos

A

Absence of REASSORTMENT with animal reservoir

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33
Q

Hallmark of acne vulgaris

A

(+) Comedone

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34
Q

Phenomenon where traumatized area often develop lesions of psoriasis

A

Isomorphic phenomenon

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35
Q

Strongest predisposing factor in contracting melanoma

A

(+) multiple benign nevi

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36
Q

Most common type of basal cell carcinoma

A

Nodular

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37
Q

This develops on lower extremity 2ndary to venous incompetence and chronic edema

Stasis ulcer is severe form

DVT and varicose veins are risk factors

A

Stasis dermatitis

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38
Q

Agents used for treatment in severe, widespread psoriatic disease

A

Acitretin
Cyclophosphamide
Methotrexate

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39
Q

TOC for Chronic Myelogenous Leukemia in chronic phase

A

Tyrosine inhibitor

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40
Q

Most cost effective test to evaluate patient with cobalamin deficiency

A

Serum cobalamin

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41
Q

Tumor lysis syndrome

A

Hyperkalemia
Hyperphosphatemia
Hyperuricemia
Metabolic acidosis

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42
Q

Marjolin ulcer an important risk factor to

A

Squamous cell CA

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43
Q

Most common gynecologic cancer in North America

A

Uterine cancer

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44
Q

MC environment risk factor for pancreatic CA

A

Smoking

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45
Q

Forrest classification for an ulcer — adherent clot

A

Type IIB

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46
Q

MC cause of LGIB

A

Hemorrhoids

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47
Q

Oral contraceptives are associated withincreased risk for

A

Crohn’s disease

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48
Q

Serologic marker present even at window period

A

IgM Anti-HBc

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49
Q

Similar pathogenesis in spider angiomas and in cirrhotic patient

A

Palmar erythema

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50
Q

Liver cirrhosis constitutes how many % as patients with ascites?

A

84%

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51
Q

Mainstay treatment of portosystemic encephalopathy

A

Lactulose

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52
Q

Loss of P wave seen in this level of potassium

A

6.5 - 7.5 mM

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53
Q

Loss of P wave seen in this level of potassium

A

6.5 - 7.5 mM

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54
Q

Renal tubular defect causes hypokalemia also presents with hypertension

A

Liddle syndrome

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55
Q

Hx recurrent UTI
Placed on antibiotics

Year later, complaining of progressive dyspnea
Cxr pulmonary fibrosis

What antibiotic?

A

Nitrofurantoin

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56
Q

+ carpopedal spasm after wering BP cuff inflated for 3 mins
What electrolyte abnormality

A

HypoMagnesemia

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57
Q

Hx of seizure
Now has excess facial hair and body hair
Drug?

A

Phenytoin

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58
Q

In management of thyroid storm, PTU is administered before SSKI to prevent which mechanism

A

Incorporation of iodine into new thyroid hormone

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59
Q

HbA1c goal of patient with DM2

A

<7.0%

60
Q

Patient apparently well but has hypoglycemia

A

Nesidioblastosis

61
Q

Amyloidosis from deposition of B2-microglobulin is associated with?

A

Patient on long term hemodialysis

62
Q

A soluble fusion protein consisting of the extracellular domain of human CTLA-4 linked to the modified portion of human IgG

A

Abatacept

63
Q

TB arthritis primarily affects what joint

A

Hips

64
Q

Serum antibody correlates with depression or psychosis due to CNS lupus

A

Anti-ribosomal P

65
Q

MC manifestation of diffuse CNS lupus

A

Cognitive dysfunction

66
Q

Earliest manifestation of colchicine toxicity

A

Diarrhea

67
Q

Malar skin rash
Generalized lymphadenopathy
Proteinuria
Joint pain
Nephritis and vasculitis
Antibody?

A

Anti-dsDNA

68
Q

MC primary immunodeficiency

A

IgA deficiency

69
Q

Major histocompatibility complex cobtains HLA class 1 and 2 genes whose products are critical for immunologic specificity and transplantation histocompatibiliyy. What chromosome?

A

Chromosome 6

70
Q

MC site of angioedema

A

Periorbital area
Lips

71
Q

Halesdache characterized by daily bouts of 1-2 attacks of relatively short-duration unilateral pain with at least 1 attack recurring at about the same hour each day

A

Cluster headache

72
Q

Causes of dementia

A

Normal pressure hydrocephalus with triad of
Ataxic gait
Dementia
Urinary incontinence

73
Q

Harvard criteria for definition of irreversible coma

A

Unreceptivity
No breathing
No reflexes with further delineation of brainstem reflexes
No movement

74
Q

Chemoattractant for leukocytes
Degranulation of mast cells
Increase production and release of inflammatory mediators
Vasodilation

A

Substance P

75
Q

Difference of hyperthermia and fever

A

Fever - increased hypothalamic temperature setting
Hyperthermia - unchanged

76
Q

Anatomical structure of the system is unaque because the afferent projections bypass the thalamus and synapse directly with the primary olfactory cortex

A

Olfactory system

77
Q

Hyponatremia
Suppression of circulating antidiuretic hormone levels
Dx?

A

Psychogenic polydipsia

78
Q

Condition contraindicated to smallpox vaccination

A

Eczema

79
Q

Most common drug induced skin reaction

A

Diffuse morbiliform rash

80
Q

Laboratory tests helpful in determining the cause of photosemsitivity in a patient

A

Antinuclear antibody (ANA)
Anti-La
Anti-Ro
Plasma porphyrins

81
Q

Drugs associated with photosensitivity reaction

A

Hydrochlorothiazide

82
Q

A normal red blood cell is approximately the size of

A

Normal lymphocytes

83
Q

Most abundant receptor on platelet amd therefore a target for antiplatelet therapy

A

Glycogen IIb/IIIa

84
Q

Prevention of development of risk factors for disease

A

Primordial prevention

85
Q

Attempts to reduce the risk of incident disease among individual with a risk factor

A

Primary prevention

86
Q

Avoiding recurrence of disease and death in an individual who is already affected

A

Secondary prevention

87
Q

Requires rapid action to prevent imminent death in the setting of acute illness

A

Tertiary prevention

88
Q

Opioid overdose?
Tx

A

Nalaxone

89
Q

Benzodiazepine overdose?
Tx

A

Flumazenil
(GABA receptor antagonist)

90
Q

Acetaminophen overdose?

A

N-acetylcysteine

91
Q

Acute
Maximal in <5mins
Severe headache laating >5mins
Stiff neck no fever
Dx?

A

Subarachnoid hemorrhage
– lumbar puncture

92
Q

Narrowed lumbas spinal canal

Neurogenic claudication
Back and buttock or leg pain induced by walking or standing and relieved by sitting

A

Lumbas spinal stenosis

93
Q

German measles

A

RuBella

94
Q

Measles

A

RubeOLA

95
Q

Koplik spot

A

Pathognomonic for measles
1 -2 mm white or bluish lesions with an erythematous halo on the buccal mucosa

96
Q

Fordyce spots

A

Ecropic sebaceous glands
No erythematous halos
Found in healthy individual’s mouth

97
Q

Feared complication of measles

A

Subacute sclerosing Panencephalitis

98
Q

Mosquito bite in tropical and subtropical region
Maculopapular eruption
Severe polyarticular small joint arthralgia

A

Chikungunya fever

99
Q

Caused by Coxsackie A16 or Enterovirus71
Tender vesicles distributed on hand, feet and mouth

A

Hand foot and mouth disease

100
Q

Generalized rash
Prominent on palms and soles
Caused by treponema pallidum

A

Secondary syphilis

101
Q

Rash begins at wrist and ankles and spread centripetal
Blanchable macules to petechiae
Rash in palms and soles later in the disease
Spread by ticks

A

Rocky mountain spotted fever
Rickettsia rickettsii

102
Q

Septic shock
No positive blood cultures
Diffuse rash
Lack of primary infected site
STAPHYLOCOCCUS AUREUS
retained tampon

A

Toxic shock syndrome

103
Q

Erythema migrans
Erythematous annular patch
Central erythematous focus at tick bite
Affects CNS, articular and cardiac – COMPLETE HEART BLOCK

A

Lyme disease
Borrelia burgdorferi

104
Q

Individual who cannot detoxify arene oxides present in anticonvulsants (PHENOBARBETAL)
Desquamative rash
Eosinophilia
Hepatic involvement
Facial edema
Hypotension

A

Drug Reaction with Eosinophilia and Systemic Symptoms Syndrome (DRESS)

105
Q

Erythematous indurated plaque with pseudovesicular border

A

Sweet syndrome /
Acute Febrile Neutrophilic Dermatosis

106
Q

Fever of Unknown Origin

A

Fever >=38.3°C (>=101F) on at least 2 occasions
Illness duration of >=3weeks
No known immunocompromised state
Dx remains uncertain after a thorough hx taking, PE and following obligatory investigations

107
Q

Deficiency of ______ may play a key role in pathogenesis of delirium

A

Acetylcholine

108
Q

Prominent memory deficit
Family hx of dementia
(+) apolipoprotein E4 allele
Small hypocampal volumes
AD-like signature of cortical atrophy
Low CSF AB and elevated tau
(+) brain amyloid deposition

A

Alzheimer’s disease

109
Q

Alpha-synuclein neuronal inclusions

A

Lewy bodies

110
Q

Neurofibrillary tangles -hyperphosphorylated tau filaments
Accumulation of amyloid in blood vessel walls in cortex and leptomeninges

A

Alzheimer’s diasease

111
Q

Bilateral disorder of parietofrontal area of the brain
Inability to orderly scan the environment (oculomotor apraxia)
Inacurate manual reaching for objects (optic apraxia)
Inability to integrate info in center of gaze w peripheral info (Simultanagnosia)

A

Balint syndrome

112
Q

Left/ right relative afferent pupilary defect

A

Marcus gunn pupil

113
Q

Asymmetric sizes of pupil

A

Anisocoria

114
Q

Defect in the direct response. It is due to damage in the inoptic nerve or severe retinal disease.

Affected pupil WILL NOT CONSTRICT to light when light is shone in the that pupil
However, it will constrict if light is shone in the other eye (consensual response)

A

Relative Afferent Pupillary Defect (RAPD, Marcus Gunn Pupil)

115
Q

Common in women in the 3rd/4th decade of life (but also can be present in men)

Either no or sluggish response to light (both direct and consensual responses)

A

Adie’s (Tonic) Pupil

116
Q

Hallmark of tertiary neurosyphillis

Pupils will NOT constrict to light but they WILL constrict with accommodation

A

Argyll Robertson Pupil

117
Q

Results from injury of cochlear apparatus or disruption of neural pathways from the inner ear to the brain

Site of damage: hair cells of the inner ear

A

Semsoryneural hearing loss

118
Q

Impairment of external ear and auditory canal to transmit and amplify spund through the middle ear to the cochlea

A

Conductive hearing loss

119
Q

Tuning fork at mastoid process then front of external ear

Conductive - intensity of sound is louder when placed on BONE

Sensoryneural - louder at external ear

A

Rinne test

120
Q

Tuning fork at midline of head

Unilateral conductive - intensity of sound at affected ear

Unilateral sensoryneural - loudest at UNaffected ear

A

Weber test

121
Q

Test for evaluation of dry eyes to quantify adequate tear production

A

Schirmer test

122
Q

Rapidly progressive
Potentially fulminant form of cellulitis
Bilateral sublingual and submandibular spaces
Hx recent extracted tooth (lower 2nd/3rd molar)
Woody edema of sublingual
Hot potato voice

A

Ludwig angina

123
Q

Thumbprint sign
Edematous epiglottis
Cellulitis of epiglotis and adjacent structures

Group A Streptococcus
Strep pneumonia
Haemophilus influenza
Staph aureus

A

Acute epiglottitis

124
Q

Type of Cyanosis
Etiology- reduced oxygen saturation or abnormal hemoglobin
Bluish discoloration of both mucous membrane and skin

A

Central cyanosis

125
Q

Type of cyanosis
Normal O2 sat but slowing of blood flow and increased fraction of oxygen extraction from blood
Only in skin and extremities

A

Peripheral cyanosis

126
Q

Loss of 10pounds (4.5kg) or >5% of one’ body weight over a period kf 6-12 months

A

Clinically important weight loss

127
Q

Yellowing of skin due to ingestion of excess amount of vegetables and fruits that contain carotene (carrots, leafy veg, squash, peach, orange)

Palms, soles, forehead, nasolabial folds

A

Carotenoderma

128
Q

“6Fs”
Causes of abdominal swelling

A

Fluid
Fetus
Fat
Feces
Flatus
Fatal mass

129
Q

Coexistence of hyponatremia with a normal or increased plasma tonicity

A

Pseudohyponatremia

130
Q

Border of untreated active ulcer – undermined necrotic violaceohs edge and a peripheral erythematous halo

Associated with UC and Crohns

A

Pyoderma gangrenosum

131
Q

Non scarring hair loss due to synchronus hair growth cycle
Normal in postpartum
High fever, infection, medication or chabges in hormone

A

Telogen effluvium

132
Q

Subepidermal blisters with dense eosinophilic-rich infiltrate
Autoimmune cutaneous disease
Tense blisters on either a normal or erythematous base
Linesr deposits of IgG and/or C3 in epidermal basement membrane

A

bullous pemphigoid

133
Q

Severe pruritus
Skin lesion symmetrically distributed along extensor surface, buttocks, back, scalp, posterior neck
Papular, papulovesicular, utricarial plaques
Burning and stinging
Gluten sensitive
Neutrophilic inflammatory infiltrate in dermal papillae
Granular deposits of IgA found in papillary dermis and alongepidermal basement membrane

A

Dermatitis herpetiformis (DH) / Celiac disease

Tx- Dapsone

134
Q

Hypersegmented neutrophils (multilobed polymorphonuclear leukocytes) commonly seen in

A

Folic acid or Vit B12 deficiency

135
Q

Vacuolated neutrophils or bands
(Immature neutrophils that have not completed nuclear condensation and have a U-shaped nucleus)

A

Sign of bacterial sepsis

136
Q

Uniform population of primitive myeloblasts with immature chromatin, nucleoli in some cells and primary cytoplasmic granules

A

Acute myeloid leukemia

137
Q

Increased number of small lymphocytes, many are ruptured in making the blood smear leaving a smudge of nuclear naterial without surrounding cytoplasm or cell membrane (SMUDGE CELLS)

A

Chronic Lymphoid Leukemia

138
Q

Microcytic hypochromic red cells with marked variation ib size (anisocytisis) and shape (poikilocytosis)

A

Iron deficiency anemia

139
Q

Microcytic or normkcytic normochromic anemia
Sickling of RBC in capillaries
Howell-jolly bodies

A

Sickle cell disease

140
Q

Burr cells - multiple spiny projections

A

Uremia

141
Q

Schistocytes - helmet shaped cells that reflect microangiopathic hemolytic anemia or fragmentation on an artificial heart valve

A

Disseminated intravascular coagulation

142
Q

Spherocytes - small dense RBCs that lack central pallor and biconcavity

A

Hereditaru spherocytosis
Autoimmune hemolytic anemias

143
Q

Target cells
Bulls eye appearance

A

Thalassemia
Liver disease

144
Q

Large granules in neutrophils
Defect in lysosomal transport protein LYST, encoded by gene CHSI at 1q42
Nystagmus
Partial oculocutabeous albinism
Infection

A

Chediak-Higashi syndrome

145
Q

Bilobed granulocytes
Nucleus has spectacle-like or pince-nez configuration

A

Pelger-huet anomaly

146
Q

(Neutrophil <100/uL)
Near complete absence of neutrophils and neutrophil precursors
Fatal
Mutation in gene HAX-1

A

Kostmann syndrome

BOARD REVIEW (19 decks)

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