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Internal Medicine Flashcards

1
Q

What mediates the corneal reflex?

What specific nerve?

A

CN V1

Nasociliary n. off the ophthalmic branch

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2
Q

What is the MC cause of parietal lobe hemorrhage?

D/T what?

A

Amyloid angiopathy

Cerebral amyloid angiopathy —> AD

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3
Q

Pt w/elevated HTN after being on 3+ anti-HTN meds has what?

If they have ABD bruit?

A

Secondary HTN

Renovascular HTN

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4
Q

Tremor frequency of Parkinson’s?

What med to treat?

A

4-5 Hz

Trihexyphenidyl

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5
Q

Pt that has cough w/daily large volume (> 100 mL/day) mucopurulent sputum, rhinosinusitis, dyspnea, hemoptysis, crackles, wheezing has what?

Dx how?

A

Bronchiectasis

High Res CT

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6
Q

Risk is the probability of getting a disease over time, what is the equation?

A

disease / total # at risk

A / (A+C)

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7
Q

Pt w/increased JVP, Kussmaul’s sign, pulsus paradoxus, with a JVP tracing showing prominent x & y descents has what?

A

Constrictive pericarditis

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9
Q

Young female pt in 20s/30s w/conductive hearing loss and abnormal Rinne test has what?

A

Otosclerosis

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10
Q

Pt w/pigmented skin, increased LFTs, erectile dysfx, hyperglycemia and cardiomyopathy has what?

A

Hereditary hemochromatosis

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11
Q

EKG of pt w/hypokalemia?

A

Broad flat T waves, U waves, ST depression, Premature Ventricular beats

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12
Q

Pt w/Diplopia, tinnitus, HA, neuropathy and HSM, anemia, and thrombocytopenia has what?

A

Waldenstrom’s

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13
Q

Pt w/PMHx of Hodgkin Lymphoma can get what?

MC form with malignancy?

A

Minimal change disease

Membranous nephropathy

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14
Q

Pt that has CKD and taking EPO can have what occur?

A

HTN crisis

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15
Q

Pt having brain hemorrhage and is on warfarin, how to treat?

A

Prothrombin complex concentration and Vit K

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15
Q

What is the MC form of PSVT?

What increases Parasympathetic tone which can result in slowing of conduction in AV node?

A

AV nodal re-entrant tachycardia (AVNRT)

Vagaries maneuvers

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16
Q

How to Dx lactose intolerance?

Stool shows what?

Osmotic gap?

A

+ Hydrogen breath test

+ for reducing substances
low pH

Increased

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17
Q

Pt w/trigeminal neuralgia 3 months ago, uri 2 weeks ago may have what?

A

M.S.

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18
Q

What med SE causes diarrhea, leukopenia, hepatoxicity?

MOA?

A

Azathioprine

Inhibits purine synthesis (6-MP)

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20
Q

What causes peripheral edema, ascites, elevated JVP w/clear lungs?

D/t what?

What 2 special signs?

A

RHF

Constrictive pericarditis

Prominent y descent, Hepatojugular reflex

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21
Q

Pt on vent with ARDS, what is the goal PaO2?

Corresponds to what % O2 sat?

A

55-80

88-95

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22
Q

Narrowing of joint space and Osteophytes is found in what?

A

Osteoarthritis

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23
Q

What is characterized by proximal muscle weakness in the setting of hyperparathyroidism?

A

Chronic hyperthyroid myopathy

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24
Q

Pt has ruby colored papules on his lips that blanch with pressure, digital clubbin, nosebleeds, mucosal lesions in mouth has what?

What other sx?

A

Osler-Weber-Rendu

AVMs
Inc hematocrit

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25
Q

What causes progressive painless muscle weakness predom involving the proximal muscles?

D/t what?

A

Myopathy in Cushing syndrome

Muscle atrophy d/t catabolic effects of cortisol on skeletal m.

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25
Immunocompromised pt w/fever, pleuritic chest pain, hemoptysis has what? Treat how?
Invasive aspergillosis Voriconazole and echinocandin
26
What is hyposthenuria? Commin whom?
Inability to [ ] urine, causes nocturnal Sickle cell pt
27
What dietary recommendations for pts w/renal stones?
Inc fluids Dec Na Normal dietary Ca
28
What pts should get the PCV12 and PPSV23 if they are under 65 y/o?
Heart, lung, or liver disease | Or have DM, smoke, or EtOH user
30
How does acromegaly affect the structure of the heart? What else can it cause?
Concentric myocardial hypertrophic, LV dilation, global hypokinesis Flail mitral leaflet —> MR
31
What is another name for biliary colic? Lasts how long? What sx? What negative sx?
Hollow organ contraction and outlet obstruction < 6 hours, resolves completely Epigastric and Right shoulder pain, Vomitting NO fever, NO ABD pain, NO leukocytosis
32
OR equation?
Ad / bc
32
What is the path behind NPH?
Dec CSF absorption
35
What is Felty Syndrome? Dx how?
Inflammatory RA, neutropenia, splenomegaly Anti-CCP and RF +, ESR > 85
36
Pronator drift is a finding in what path? What disease?
UMN or pyramidal/corticospinal tract disease M.S.
37
Anorexic pt w/elevated urine Na w/ortho HoTN, HypoNa, hypoK is doing what?
Abusing diuretics
38
Pt w/vitiligo may also have what?
Pernicious anemia, primary AI, RA, Sjogren’s, Hashimoto’s, Graves
38
Colonoscopy that reveals dark brown mucosal pigment in the proximal colon has what? Caused by what? Histology shows what?
Melanosis coli Months of regular laxative ingestion Pigment in the macrophages of the LP
39
Pt w/ABD sx and cannot absorb D-xylose has what? Pt normal d-xylose test?
Celiac Chronic pancreatitis
40
What treats ethylene glycol poisoning? Labs show what?
Fomepizole HypoCa Calcium oxalate kidney stones
42
Pt w/a history of 1 year of foul-smelling diarrhea, weight loss, fatigue will have what? Can cause what?
Vit D deficiency Hypocalcemia, dec PO4 level
42
Old (senior citizen) w/dementia attack treat how?
Haldol Don’t use BENZO
43
Pt w/HIV, fever, cough, dyspnea most likely has what?
PCP
43
Cushing Syndrome can cause what ob-gyn irregularities?
Irregular periods
45
Glucocorticoid induced myopathy ESR level? CK?
Both normal
47
What is the MC cause of MVP?
Myxomatosis degen of mitral valve leaflets and chordate
48
PBC presents w/what clinical feature? Associated w/what diseases?
Eye xanthelasmas HCC Osteomalacia Osteoporosis
48
Carcinoid syndrome causes a deficiency of what vitamin?
Niacin
50
What is the #1 cause of Asymptomatic rise in ALP in old people? Path? What labs? Imaging?
Paget disease of bone Osteoclasts dysfx, inc bone turnover Elevated ALP, PINP, hydroxyproline Bone scan - focal increase uptake Xray - osteolytic or mixed lesions
51
Women on oral Estrogen therapy require more/less dose levothyroxine for hypothyroid? Why? What will be inc/Dec?
MORE Estrogen dec clearance of TBG —> inc TBG levels Dec free T4, Total T4 will be normal/inc Inc TSH
52
What presents w/acute, severe MR, HoTN, pulmonary edema, SOFT murmur?
Papillary muscle rupture
53
CHF presents w/what acid-base status? CO2 level?
Alkalosis Low CO2
54
Pain in the knee caused by abnormal gait, overuse or trauma is what? Located where?
Pes anserinus Bursa inflamed located anteromedially over the tibia plateau
56
Diabetic foot ulcers cause what kind of infection? How?
Polymicrobial Contiguous spread
57
Cancer-related anorexia/cachexia is a _______ state? What can treat it?
Hypercatabolic Progesterone analogs - megestrol acetate
57
Bitter almond odor = ?
CN toxicity
58
Anti-Phospholipid Ab Syndrome has what abnormal lab value? What specific tests?
Prolonged PTT Russell viper venom test, kaolin clothing time
59
Pt that has COPD and develops neurologic sx after admin of O2 has what as the cause?
CO2 retention
61
Hydroxychloroquine treats what? SE?
SLE Retinal toxicity
62
Travel to North Africa, what vaccines do you need? What about sub-Saharan Africa/South America?
HepA, HepB, Typhoid, polio booster Yellow fever
63
What meds can treat restless leg syndrome? MOA?
Pramipexole and gabapentin Dopamine agonists
63
EKG of HOCM looks like what?
Tall R wave in aVL, deep S wave in V3
64
Pt in their 30s or 40s w/HTN, hematuria, proteinuria, and progressive renal insufficiency has what?
ADPKD
65
Presbycusis causes what?
Sensorineural hearing loss
66
What DM drug causes weight loss?
GLP-1 agonists - the “tides”
67
HIV pt w/subacute-onset of low-grade fever, HA, inc ICP has what?
Cryptococcus
67
What can cause a false positive for VDRL testing for syphilis?
Anti-phospholipid Ab syndrome
68
What causes autoAbs directed against VG calcium channels in the presynaptic motor nerve terminal? Causes what sx?
Lambert-Eaton d/t small cell lung CA Symmetric proximal muscle weakness w/depressed DTRs
68
How do OCP’s effect TBG? total T4? free T4? TSH?
Inc TBG bc of inc estrogen Inc Same Same
69
What causes a cres-decrescendo murmur that INC on inspiration? Dx how? Treat how?
PV stenosis Echocardiogram Percutaneous balloon valvulotomy
70
How does AV fistula Cardiac preload? Causes what?
Inc High-output cardiac failure
70
Well-circumscribed, raised erythematous plaques, lesions can be oval or round w/intense pruritis that lasts for less than 6 weeks is what?
Acute uticaria
71
PCT assoc w/what other conditions?
HepC, HIV, EtOH, smoking, estrogens
72
How does polymyositis present?
Slowly progressive proximal muscle weakness of the LE then UE
73
PAS+ and anything to wit the stomach = ? Sx?
Whipple’s Arthralgia, weight loss, fever, diarrhea, ABD pain
74
Pt w/unilateral testicular pain, epididymal edema, dysuria has what? If > 35, d/t what? Under 35? Treatment?
Acute epididymitis E. Coli STI Ceftriaxone/Doxycycline
75
What is the earliest renal abnormality in pts w/DM? What is the 1st change that can be quantitated?
Glomerular hyperfiltration (ACE-i’s counteract this) Thickening of the GBM
75
Where does AFib originate MCly? Atrial flutter is a reentrant circuit around what?
PV Tricuspid annulus
76
Albuminocytologic dissociation in CSF means what? With what Dx?
Elevated protein w/normal cell count GBS
76
Pressure necrosis occurs where? Arterial ulcer?
Bony prominences - sacrum, ischial tuberosity, Malleoli, 1st and 5th metatarsal head Tips of toes
77
Pt w/ACUTE onset odynophagia after an EGD most likely has what? Dx how?
Perforation - prob see bleeding Gastrografin (water-soluble) contrast esophagram
78
NAFLD pathophys d/t what? Have increased what?
Insulin resistance Peripheral lipolysis
79
Inflammatory arthritis = ?
Early RA
80
Post op patient w/HoTN, JVD, and new-onset RBBB that develops syncope has what?
Massive PE
81
Stroke pt w/Contralateral sensory loss, leg symptoms d/t what pathology?
Lacunar stroke of posterolateral thalamus (supplies PCA)
81
MPGN is d/t what path??
Persistent activation of the alternate complement pathway
82
ARP = ?
(RR - 1) / RR
83
What is the RA pressure (preload) in cardiogenic shock? PCWP? Cardiac index (pump fx)? SVR? MvO2?
Inc Inc Dec Inc Dec
84
What causes a mild, brief hyperthyroid, that is small nontender w/spontaneous recovery? + for what?
Painless thyroiditis TPO
84
Pt w/acute onset of HA, nausea, blurry vision, sluggish/dilated pupil has what? Caused by what?
Acute angle glaucoma Trihexyphenidyl (anti-ACh)
87
Polymyositis has what CK? What ESR?
Inc Inc
87
What presents w/acute, diffuse, non-inflammatory hair loss that is self limiting? What is the transformative phase? Rest/shedding phase?
Telogen effluvium Anagen Telogen
88
What can cause theophylline toxicity? Sx?
Cirrhosis, cholestasis, resp infection, ciprofloxacin CNS stimulation, N/V, cardiac toxicity
89
What does P mitrale look like on EKG?
Broad and notched P waves, RVH, atrial tachyarrhythmias
89
Pt that develops acute onset speech arrest and weakness has what? Imaging shows what? Treat how?
TIA NonCon CT of head will be - ASA, statin, BP control
90
Stool osmotic gap = ?
290 - [2*(Na + K)] > 50 means osmotic diarrhea
91
Female pt in her 30’s with optic neuritis and numbness/parasthesia w/motor paraparesis and spasticity has what? Dx how?
M.S. MRI brain or Oligoclonal IgG bands on CSF
92
How long does a fat embolism take to manifest?
12-24 hours
93
Pt that presents with STIFF shoulder, decreased passive and active ROM and POOP?
Adhesive capsulitis
93
Path behind sympathetic ophthalmia? What is it?
Uncovering hidden Ags Immune-mediated inflammation of 1 eye after a penetrating injury to the other eye
94
What can cause saline-unresponsive metabolic alkalosis? Presents how?
Self-induced vomiting Urinary chloride > 20 mEq/L
94
Zinc is absorbed where? Deficiency can be d/t what? Clinical features?
Duodenum and jejunum Crohn’s, bowel resection, gastric bypass Alopecia, hypogonadism, impaired wound healing, impaired taste
95
Pt that has pancytopenia, increased LDH, prolonged PT and PTT with fatigue has what?
AML
95
SAAH > 1.1 means what? < 1.1?
Portal HTN w/inc hydrostatic pressure Inc capillary permeability (pancreatitis, nephrotic syndrome, TB)
96
How to treat bacillary angiomatosis in HIV pts?
Doxycycline or erythromycin
97
Trastuzumab SE?
Cardiotoxicity - decline in LV EF
98
RR equation?
[a / (a+b)] / [c / (c+d)]
99
Does CML have a decreased or increased LAP score?
Dec
99
Acute phase of ASA intox? Chronic? CO2 level? HCO3 level? pH?
Resp alkalosis AG metabolic acidosis Low Low Close to normal bc mixed pic
101
Isolated systolic HTN defined how? PATH?
systolic BP > 140 w/diastolic BP < 90 Inc stiffness or dec elasticity of aortic end arterial walls
103
when does a LV aneurysm occur? Presents how?
5 days - 3 months Persistent ST elevation, Deep Q waves
104
MOA of sublingual nitro?
Decreased LV wall stress
105
What can you do to shift K+ into cells?
Insulin and glucose Calcium gluconate or CaCl
105
What can result from hyperextension in a MVA? CF?
Central cord syndrome Weakness in the UE > LE Localized deficit in pain/temp
106
Achalasia is d/t what path?
Loss of intramural neurons
106
Painless blisters, bullae, scarring, hypopigmentation on sun-exposed areas, and scarring is d/t what?
Porphyria cutanea tarda
107
Pain that is worse on an empty stomach, epigastric pain w/melena = ? D/t what?
Duodenal ulcer H pylori or NSAID
108
What causes a normocytic anemia, splenomegaly, reticulocytosis, jaundice w/elevated indirect bilirubin, inc LDH, dec haptoglobin?
Autoimmune hemolytic anemia
109
What causes excessive collagen deposition in the peri-alveolar tissues? DLCO is what? A-a gradient?
IPF Dec Inc
110
What presents w/fever, superficial dermis infection w/sharply demarcated raised edges that rapidly spreads? MC organism
Erysipelas Strep pyogenes
111
What can glucocorticoids cause? Describe?
Drug-induced acne Monomorphic papules w/out comedones, cysts, or nodules
111
Low-voltage EKG w/electrical alternans
Cardiac tamponade
111
What presents w/fever, rash that involves the palms and soles and is diffuse throughout the body, and HoTN?
Toxic shock syndrome
115
What vaccine works by relatively T-cell independent B cell response?
PPSV23 PNA vaccine Jordan is independent, don’t need no help
116
Pt w/fever, ABD distention, leukocytosis, HoTN, tachycardia has what? Dx how.
Toxic megacolon ABD xray shows colon distended > 6 cm
116
Cross sectional study is what kind? Estimates what? Examines what?
Observational Prevalence Associations bw RF
117
PCP treated how? Add steroids if?
Bactrim PaO2 = 70 or A-a gradient >/= 35
118
Pt with urinary retention can be confirmed how?
Bladder US w/urine > 300 mL
119
What is the RA pressure (preload) in hypovolemic shock? PCWP? Cardiac index (pump fx)? SVR? MvO2?
Dec Dec Dec Inc Dec
120
Systemic amyloidosis can effect the heart how?
Restrictive cardiomyopathy w/low voltage
120
Pt w/prolonged fever, malaise, exudative pharyngitis, HSM and generalized LAD has what? Can develop what after 2-3 weeks?
Infectious mono Autoimmune hemolytic anemia, thrombocytopenia
122
How do you treat cocaine OD?
IV Benzo
122
Pt w/DVT in the setting of elevated homocysteine needs to be on what?
Pyridoxine - B6
123
Pregnant mom’s get what MSK path? Effects what muscles?
De Quervain tenosynovitis APL and EPB
125
AR has what Inc/dec LV EDV? LV ED pressure? What signs and symptoms?
Inc Inc Diastolic decrescendo murmur, widened PP
125
What is an abscess over the eyelid d/t staph aureus and appears localized red w/tender swelling?
Hordeolum
127
NON-healing, painless, bleeding skin ulcer suggests what? Do what?
SCC Biopsy
128
Cryptosporidium parvum can cause what in non-HIV pts?
Traveler’s diarrhea, found in lakes and streams
128
Right ventricle MI supplied by what vessel? EKG changes?
RCA ST elevation in V4-V6
130
What presents w/deep dermal infection w/no fever at the beginning, flat edges, over a few days? MC organism?
Cellulitis S pyogenes, MSSA
131
What is electrical alternans mean on EKG?
QRS in the SAME lead is of different amplitude
131
Wernicke’s area is located where?
Superior temporal gyrus of temporal lobe
132
Humoral hypercalcemia of malignancy is the MC of what? Presents how?
PTHrP secretion Ca > 14 with smoking pmhx
133
Direct renin inhibitor causes what? Effects angiotensin II how? Aldosterone?
Enhanced natriuresis Dec Dec
133
What is a very bad sign in a pt with acute asthma exacerbation? What should they have?
Normal PaCO2 Very low bc of hyperventilation
133
What deficiency is common after partial or total gastrectomy? Causes what?
B12 Defective DNA synthesis
134
Paget disease of bone alternate name?
Osteitis deformans
134
What presents w/alternating hypoglossal hemiplegia w/c/L paralysis of arm and leg and tongue deviation towards the lesion and loss of c/L tactile and position sensation? D/t what?
Medial medullary syndrome Vertebral or anterior spinal artery occlusion
134
Burr cell seen in what?
ESRD and liver disease
135
Bicuspid aortic valve in young pt can cause what? Murmur sounds what?
AR Diastolic decrescendo, widened PP, water hammer pulse
136
Cross sectional study is used to determine what?
Prevalence of disease, or to examine associations bw RF CrAP
137
What causes erysipelas? Treat how?
Strep pyogenes Ceftriaxone, cefazolin
137
What is located in anterior mediastinum? Middle mediastinum? Post?
Thymoma Bronchogenic cyst Leiomyoma, all neurogenic tumors, hernia, AA
138
Pt w/1st time seizure in adult do what workup?
UDS, labs MRI and CT EEG
138
What causes hemi-neglect?
Infarct of the non-dominant (MC right) parietal cortex
139
Pt w/dec FEV1/FVC ratio and normal DLCO has what? With Dec DLCO?
Chronic bronchitis or asthma Emphysema
140
Treatment for pulmonary HTN?
Diuretics and ACE-i
141
Exudate pleural effusion has what pathophys?
Inc capillary or pleural membrane permeability
142
Pt that is in the hospital w/UTI then gets IE, what organism?
Enterococcus
142
Path behind tarsal tunnel syndrome? sx?
Compression of Tibial n. As it passes through ankle Burning, numbness, aching of DISTAL plantar surface
143
Marian pt w/acute chest pain that causes early decrescendo murmur diastolic murmur along the Left sternal border at the 3rd and 4th ICS has developed what?
Acute AR from aortic dissection
143
Pt w/vomiting and upper ABD pain w/rapid progression to odynophagia, dyspnea, and septic shock with a widened mediastinum? Diagnose how?
Esophageal rupture = Boerhaave Syndrome CT or contrast EGD w/gastrograffin
145
What can cause acute erosive gastropathy? Characterized how?
ASA, cocaine, alcohol Severe hemorrhagic lesions
146
What can cause abrupt increases in RA pressure to > 10 mmHg and PA pressure to > 40 mmHg? This leads to what?
Massive PE Dec CO, HoTN, obstructive shock
148
What are the top 5 things to do to lower systolic BP?
``` 1 - weight loss if BMI > 25 DASH diet Exercise Dec dietary Na EtOH ```
149
What are the sx of thyrotoxicosis? How does it affect myocardial contractility? SVR?
Weight loss, tachycardia, tremor, lid retraction Inc Dec
150
Pt that has recurrent DVTs must be checked for what?
Cancer
152
Sudden onset of multiple seborrheic keratosis indicates what? Means what?
Lesar-Trelat sign Cancer
153
What is the best indicator for cardiac cause of edema?
+ hepatojugular reflex
160
What presents as gastric folds protruding above the diaphragm?
Hiatal hernia
161
What is the MOA of BB and Non-DHP on the heart? DHP CCB MOA?
Decrease myocardial contractility Decrease afterload
162
What causes symmetric, migratory, nonerosive w/brief morning stiffness of a pt’s joints?
SLE
163
What is the MC type of esophagitis in HIV pts?
Infectious
165
Pt that has diverticulitis can develop what? Presents how?
Fistula Bubbles in the urine —> pneumaturia or fecaluria
166
What categorizes SJS? TEN?
Skin involvement of < 10% > 30%
167
What is endemic mycosis of central and midwestern US? Sx? Dx? treat?
Histo capsulatum Pancytopenia, febrile, pulm mucocutaneous and reticuloendothelial manifestations Serum/urine Ag Immunoassay Amp B, switch to itraconazole after 1-2 weeks
168
What qualifies as acute liver failure
LFT > 1000 Hepatic encephalopathy INR >/= 1.5 1 of the 3
169
How to treat HOCM?
BB | Non-DHP CCBs
170
Adult w/erythema infectiousum, symmetric arthralgia, and works in a day care center has what?
Parvo B19
172
Pt w/avascular necrosis of hip has MRI showing what?
Subchondral lucency -> crescent sign
173
If IIH is not treated, what can it cause?
Blindness
174
Guatemalan farmer w/HM, RUQ pain and liver cysts has what? Comes from what? Treat how?
Echinococcus granulosas Dog tapeworm Albendazole
176
What medications you need to hold prior to stress testing? For how long
BB CCB Nitrates 48 hours
177
Acute MR d/t papillary m. Rupture w/acute MI causes what?
Excess volume overload Inc LA pressure Inc ventricular filling pressure Acute Pulm Edema
178
What are the SE of methotrexate?
Macrocytosis Pancytopenia - Bone marrow suppression Stomatitis Hepatotoxicity
179
Otoscelerosis causes what? Otoscopic exam appears how?
Progressive CONDUCTIVE hearing loss Normal
180
Orthostatic HoTN is d/t what?
Dec baroreceptor responsiveness
183
What is the RA pressure (preload) in septic shock? PCWP? Cardiac index (pump fx)? SVR? MvO2?
Dec or normal Dec or normal Inc Dec Inc
185
What is the most sensitive screen for neuropathy in diabetic pts?
Random urine for microalbumin/Cr ratio
186
Pt w/Localized chest pain that worsens w/movement and deep inspiration or coughing that is Tender to palpation and is sharp has what? Treat?
Costochondritis Reassurance
191
Pt w/HTN Emergency treated with what? potential SE? Sx?
Nitroprusside CN toxicity AMS, lactic acidosis, seizure, coma
192
Pt w/septic shock and 1 day later develops AST/ALT elevations has what?
Ischemic hepatic injury —> shock liver
193
Lateral epicondylitis has pain with what passively? Actively?
Passive wrist flexion Active wrist extension
197
B12 deficiency causes what? Common in what?
Glossitis, peripheral neuropathy Pernicious anemia, gastric cancer
198
What skin lesion arises de novo and will have a central punctum that resolves spontaneously but can recur?
Epidermal inclusion cyst (epidermal cyst)
199
What is Cushing’s reflex? Indicates what?
HTN, bradycardia, resp depression Brain stem compression
201
SE of levodopa/carbidopa?
Hallucination, confusion, somnolence...much later dyskinesia
202
What causes tenosynovitis, dermatitis, asymmetric migratory polyarthralgia?
Disseminated gonococcal infection
203
Massive PE defined how?
HoTN w/Right heart strain Syncope RBBB Elevated RA and PA pressure with normal PCWP
204
Case control studies determine what first? Retrospective cohorts?
Outcome RF exposure
207
Milk-alkali syndrome causes what changes?
Renal vasoconstriction and decreased GFR Renal loss of Na + H20
208
What are the signs of RV Failure? What does it cause?
``` Elevated JVP RV S3 TR murmur HM w/pulsatile liver LE edema, ascites ``` Cor Pulmonale
209
Complicated parapneumonic effusion, describe the following: pH? Glucose? Wbc?
< 7.2 < 60 > 50,000
210
Lynch syndrome is what?
CEO Colon Endometrial Ovarian
212
What kind of gait does Parkinsonism have?
Hypokinetic gait
214
HIV pt w/SM and elevated ALP level, normal CXR, fever, cough, ABD pain, D, night sweats has what?
Disseminated MAC
216
What causes cardiogenic shock physiologically?
Impaired LV contractility
218
Pt w/Proximal symmetric muscle weakness in UE and LOE w/inc CK, inc aldolase, inc LDH has what?
Dermatomyositis
220
Alanine gets converted to _____ in gluconeogenesis?
Pyruvate
221
Pt that presents w/chest pain and dysphagia and manometry showing multiple simultaneous contractions of the middle and lower esophagus has what? Treat?
DES CCBs
222
Dec breath sounds in the lower lobes = ? If pt is < 45 then most likely what?
COPD alpha 1 anti-trypsin
223
Strawberry hemangioma occurs when? Treat how? Cherry hemangioma?
1st weeks of life, regresses spontaneously by age 5-8 Old people
225
What causes weight loss, diarrhea, anemia, and neurologic migratory erythema?
Glucagonoma
226
Pt w/advanced cirrhosis, portal HTN, edema, w/renal hypoperfusion has what? Path? Treat how?
Hepatorenal syndrome Splanchnic arterial dilation, dec vascular resistance Splanchnic vasoconstrictors (midodrine, octreotide, NE)
227
Pt comes in w/DKA, when do you give them bicarbonate? When to give them PO4?
pH < 6.9 < 1.0
228
Pt that has pruritis, elevated Hg, low EPO, HTN and bleeding has what? Complications? Treatment?
PV Thrombosis, AML, gout Phlebotomy, Hydroxyurea
231
What is the path behind osteomalacia? Seen in what common disease? ALP is what? PTH? Vit D?
Impaired osteoid matrix mineralization Celiac spruce Inc Inc Dec
232
Correcting hypernatremia too quickly can cause what?
Cerebral edema
233
What is characterized by rapidly progressive ascending paralysis, absence of fever or sensory abnormalities and normal CSF exam in a pt that was in Colorado?
Tick-borne paralysis
235
Episodic, painless GI bleeding dark maroon in color in an older pt w/AS has what?
Angio dysplasia
237
Pulsus paradoxus during inspiration can indicate what?
Severe asthma or COPD
238
Pt w/HTN that is old and suddenly presents w/weakness aka pure motor hemiparesis has what?
Lacunar stroke
240
What disease predispose to Kidney Amyloidosis? See what symptoms? What histology on imaging?
R.A. And IBD Enlarged kidneys, hepatomegaly Glomerular deposits after special staining
241
What is the pathology behind Graves ophthalmopathy?
Activated T cells and Thyrotropin Receptor Antibodies
244
S3 d/t what? S4?
Heart Failure, restrictive cardiomyopathy Atrial Gallup, d/t acute MI, LV stiffening
245
Hard, nontender, u/L in the neck are very suspicious for what?
SCC of neck
246
Mucus plugging = ? Breath sounds? Mediastinal shift?
Atelectasis Dec Towards atelectasis
247
Dermatitis herpetiformis may occur where on body?
Elbow, knee, back, butt
248
COPD home oxygen supplementation if what?
PaO2 is 55 and lower OR SaO2 is 88 and lower SaO2 is 89 in pts w/Cor pulmonale, RHF or Hct > 55
252
What presents w/triad of fever, leukocytes, LUQ pain w/left-sided pleuritic chest pain? MC cause?
Splenic abscess IE
253
Renal V thrombosis is a complication of what? MC d/t what?
nephrotic syndrome Membranous glomerulopathy
254
SE of Amantadine?
Ankle edema | Livedo reticularis
256
What is the #1 RF for stroke?
HTN
257
Cor Pulmonale is diagnosed definitively by what?
Elevated PA systolic pressure > 25
258
What presents w/nonhealing ulcers, livedo reticularis, recurrent sinusitis/otitis and lung nodules?
Wegener’s
259
Acute DVT/PE can be treated w/what alternate therapy? Onset?
Apixaban or Rivaroxaban 2-4 hours
260
How long does a subacute cough last for? Path? Treat?
3-8 weeks PND 1st gen antihistamine
261
When does febrile nonhemolytic transfusion reaction occur? Sx? How to prevent?
1-6 hours Fever, chills, malaise, NO hemolysis Leukoreduction
262
Cortical laminar necrosis indicates what?
Prolonged seizures
263
What presents w/a new harsh holosystolic murmur w/palpable thrill at the Left sternal border and pt has HoTN? Occurs when?
Rupture of IV septum 3-5 days post Acute MI
265
Pt w/extreme pain after surgery and not responding to toradol give what? When is toradol’s peak effectiveness?
Morphine 3 hours
266
What meds for migraine prophylaxis?
Topiramate - blocks VG Na and Ca channels Divalproex Na TCA Propanolol
267
What presents w/LAD, pancytopenia, HSM, common in Mississippi?
Histoplasmosis
268
Hepatojugular reflex is used to differentiate bw what?
Cardiac v liver causes of LE edema Cardiac = + HJ reflex
270
CHF d/t dilated cardiomyopathy Echo will show?
Dilated ventricles and diffuse hypokinesia —> Low EF
274
Brain abscess w/SINGLE ring-enhancing lesion DDx?
Staph aureus | Viridans Streptococci
275
Meth use is assoc w/what? Causes what sx? Treat?
Cardiomyopathy HF, HoTN, low pulses, low CO, cool UE/LE Dobutamine
279
Pt that has a HA, Low-grade fever, periorbital edema, vomiting, papilledema, after an insect bite may have what?
Cavernous sinus thrombosis
281
High dose acyclovir can cause what?
Crystalluria w/renal tubular obstruction
282
What technique used in case-control studies is designed to eliminate confounding?
Matching
283
Plateau pressure = what?
Elastic pressure + PEEP
284
Pt w/jaundice, icterus, + urine bilirubin assay has what build up? If + urine urobilinogen assay then what?
Conjugated bili Unconjugated
287
What can cause a stone to be stuck in the common BD? Treat how?
Postcholecystectomy syndrome ERCP
288
Inferior MI supplied by what vessel? Sx?
RCA HoTN, bradycardia, AV block
289
What causes b/l hemiparesis/weakness, diminished b/l pain and temp 1-2 levels below injury and INTACT b/l 2pt proprioception?
Anterior spinal cord syndrome
291
Pt w/caustic ingestion needs what w/in 24 hours?
Upper EGD w/water soluble contrast
293
SE of radioactive iodine? PTU? Methimazole?
Worsens ophthalmopathy, permanent hypoT Hepatic failure, ANCA-Vasculitis Cholestasis
294
Ethylene glycol damages what organ? Methanol?
Kidney Eyes - optic disc hyperemia
295
WPW causes what on EKG?
``` Short PR interval (< .12s) Delta wave QRS widening (> .12s) ```
296
Pt w/symmetrically enlarged NonTender thyroid w/elevated TSH and normal T4 has what? Path?
Subclinical hypothyroid Anti-TPO Abs Can cause recurrent pregnancy loss
297
Pt w/LE that has pain, pallor, paresthesia, no pulse, and paralysis has what? D/T what? Treat how?
Acute arterial occlusion AFib - thrombus Heparin drip
298
Polymyalgia rheumatica CK level? ESR? Sx?
Normal Elevated STIFFNESS, esp in the morning, lasts > 1 hour
299
Posterior MI supplied by what vessel? What on ekg?
LCX ST depression in V1-V3 ST elevation in I and aVL
300
HTN vasculopathy causes what?
Bleed in the basal ganglia
304
What causes retinal hemorrhages, papilledema, or encephalopathy?
Malignant HTN
306
What med SE causes nephrotoxicity, hyperK, HTN, tremor? MOA?
Tacrolimus Inhibits IL-2
307
Diuretics, baby ASA, surgery, trauma, recent hospitalization puts pt at risk for what?
Gout
308
Pt w/PCN allergy should be treated with what? Unless what?
Doxycycline Pregnancy or tertiary syphilis
309
Pt w/anemia, leukopenia, thrombocytopenia, low complement levels and joint pain has what?
SLE
310
What causes LE swelling that is worse in the evening and prolonged standing, is improved w/leg elevation and after walking, will see pitting edema? Treat?
Chronic venous insufficiency causes venous HTN in deep veins of legs RICE
311
Causes of glomerular hematuria? Which is greater: microscopic or gross?
Post-strep, IgA nephropathy, Alports Microscopic
312
Treat Raynaud’s phenomenon?
CCB - amlodipine / nifedipine
313
What are some things that can trigger thyroid storm?
``` Surgery Infection Trauma Iodine contrast Childbirth ```
314
HIV pt that gets acute retinal necrosis w/pain, keratitis, uveitis and peripheral pale lesions has what?
HSV
315
Type 4 RTA has what K+? Common in what pts>
Hyperkalemia Poorly controlled diabetes, HTN
316
If a disease has low prevalence, what is the incidence?
Low
317
Pt w/ophthalmic exam that shows grey, elevated retina and sx of photopsia, floaters and “curtain coming down” has what?
Retinal detachment
318
Inability to lift the skin on the dorsum of the second toe is called what? Specific for what?
+ Stemmer sign Lymphedema
319
Does TR increase or decrease on inspiration?
Inc
320
What causes nontender enlargement of the submandibular glands that is non inflammatory?
Sialadenitis
321
Hemochromatosis can cause what joint problems?
Pseudogout —> chondrocalcinosis
323
What is peak airway pressure aka? = what?
Max TV being delivered Resistive pressure (flow x resistance) + Plateau pressure
324
MC skin cancer in immunosuppressed? 2nd?
SCC Melanoma
327
Upright CXR w/free air under the diaphragm means what?
Perforation
328
Pt that presents w/PNA, fever, bradycardia and GI symptoms has what? Treat how?
Legionella Resp FQ - Levaquin or moxifloxacin
329
Elevated testosterone and normal DHEAS indicates what? Elevated DHEAS?
Ovarian source Adrenal source
331
What can cause venous compression w/distended neck veins and facial plethora? What is this called?
Retrosternal extension —> thyroid lymphoma Pemberton sign
332
Cell-mediated important in what kidney path? Non-immune kidney damage for what?
Crescent GN Diabetic and HTN nephropathy
333
Pathophys of S4 heart sound?
Stiff LV, restrictive cardiomyopathy, LVH, prolonged HTN
334
Pt on warfarin with back pain and hemodynamic instability at risk for what?
Retroperitoneal hematoma
335
Protein of 3+ on dipstick means how much in urine?
300-1000 mg/dL
336
2nd degree type 1 AV block is what? Describe
Wencekbach Prolonged PR interval and dropped beat
337
Treatment for a disease when standard therapy fails is called what? Example?
Salvage therapy Radiation therapy for prostate recurrence after prostatectomy for cancer
339
Pt w/pmhx of total Nephrectomy can get what?
U/L obstructive uropathy d/t renal calculus
343
What is euthyroid sick syndrome?
Normal TSH Normal T4 Low T3
344
What causes a holosystolic murmur which is the result of a permanent pacemaker?
TR
346
GVHD is d/t activation of what?
Donor T lymphocytes
347
What presents w/rapid dementia and MYOCLONUS? What special sign on EEG?
CJD Triphasic synchronous discharge on EEG
348
What is the Path of DM? What type of symptoms does this path produce?
Axonopathy of LARGE nerve fibers - sx (numbness, loss of proprioception and vibration, diminished ankle reflexes)
351
What types of strep belong to the viridans group?
``` Sanguinis Sobrinus Mitis Milleri Mutans Oralis ```
353
What can cause methemoglobinemia? Treat how?
Dapsone or anesthetic agent Methylene blue
354
How are the breath sounds on consolidation (lobar PNA)? Tactile fremitus? Percussion?
INCREASED Increased Dull
355
Pearly nodule on face w/elevated or rolled border w/central ulceration is what?
BCC
356
What causes widened pulse pressure, strong peripheral arterial pulsation, systolic flow murmur, tachycardia, flushed extremities? Causes?
AV fistula PDA, angioma, trauma, cancer, etc
357
Pt that presents w/fever, fatigue, myalgia, arthralgia, dyspnea w/normocytic anemia and inc ESR has what?
IE
358
What causes alveolar Hypoventilation? AA gradient is what? PH status?
PE, atelectasis, Pleural effusion, Pulmonary edema all cause a V/Q mismatch Elevated Resp alkalosis
359
What is the Path of Meneire’s?
Elevated endolymphatic pressure and volume d/t defective resorption of endolymph
361
What meds lower uric acid levels? What can increase risk of gout?
Loser tan, CCBs Thiazides, loops, ASA, BB’s
362
Pt that is in the post-MI period is most at risk for what?
Re-entrant ventricular arrhythmia (VFib)
363
How do you treat aortic dissection?
Morphine IV BB Na Nitroprusside if SBP > 120
364
Pt w/sudden onset paralysis and speech impairment has what? What brain location?
Broca’s Frontal lobe - inferior gyrus BFIG
367
What is the #1 change in vascular dementia? What sx?
Executive functioning Pronator drift
368
Pt that has nosocomial UTI then gets IE, what bug?
Enterococcus
370
Conn’s syndrome causes what to renin? Aldosterone? Bicarbonate? Why?
Low High High, hypoK causes increased renal bicarbonate resorption
371
When does a ventricular septal rupture occur?
Hours - 1 week
372
Liver problems w/elevated titers of ANA and ASMA is d/t what? Treat how?
Autoimmune hepatitis PO glucocorticoids
374
When do you give IV bicarbonate in pt w/metabolic acidosis?
pH < 7.1
376
Pt that has stent placement is likely to have a stent thrombosis if what?
Non-compliant w/their medication
377
What is Charcot join? Complication of what? Caused by what?
Neurogenic arthropathy Neuropathy and repeated joint trauma B12 def, DM, syphilis
378
What causes back pain radiating to the foot?
Spinal nerve root entrapment
380
MC causes of liver failure/infection < 1 month? 1-6 months? > 6 months?
Bacterial Opportunistic infxn - CMV, Aspergillus, Myco TB Normal pathogens
381
Mono can have what?
High false negative rate in the beginning of the illness (1st week)
382
What does a Tc-99m test measure? Also called what?
Perfusion of the heart Single photon emission CT
383
Adult Pt that has a chronic cough primary at night may have what?
Asthma
384
Bactrim causes what ion SE?
Hyperkalemia
385
Pt that has chronic epigastric ABD pain that radiates to the back and gets better w/leaning forward has what?
Chronic pancreatitis
386
Diabetes pt that has anorexia, N/V, early satiety and postprandial fullness has what? Treat how?
Diabetic autonomic neuropathy of the GI tract reglan or erythromycin
387
Pt w/poorly controlled HTN, occipital HA, neck stiffness, N/V, and Ipsilateral hemiataxia of the trunk has what?
Right cerebellar hemisphere hemorrhage
389
Pt that has severe agitation, combativeness, psychosis, delerium, myoclonus w/a prolonged duration lasting days has what?
Bath salts intoxication
390
What is Ludwig angina?
Rapidly progressive cellulitis of the submandibular space, MC from dental infections
391
CSF finds of Gillian Barre?
Inc protein | Everything else normal
392
Pt that has VFib or pulseless VT, treat how?
Immediate defibrillator
394
HIV pts can receive the varicella LIVE vaccine when?
CD4 > 200
395
What is livedo reticularis?
Mottled reticulated vascular pattern that appears as lace-like purple discoloration of the skin
397
What causes lid discomfort, CG inflammation of the meibomian gland, and is hard and painless lid nodule?
Chalazion
398
Pt w/pancreatitis has what kind of blood flow? This causes what? Renin is? Aldosterone?
Dec Dec GFR Inc Inc
399
What causes a single subcapsular cyst in the right hepatic lobe?
Amebic liver abscess
400
What is the antidote for CN poisoning?
Sodium thiosulfate
401
Uric acid stones are what? Can bee seen how? How to make soluble?
Radiolucent on Xray US or CT Potassium citrate —> 6-6.5 pH
404
What is the MC cause of death in dialysis pts? What %?
Cardiovascular disease 50%
408
What is a complication of cardiac CATH that can manifest as blue toe syndrome, intestinal ischemia, AKI? Treat how?
Atheroembolism (cholesterol embolism) Supportive, statin
409
What is the treatment algorithm in pt w/symptomatic bradycardia?
1st - atropine Then IV Epi or dopamine Or transcutaneous pacing
412
SIADH will have what volume and sodium status?
Hyponatremia and euvolemia
419
Pt w/spontaneous pain, odynophagia for hot and cold precipitated by stress that resolves w/nitrates and CCBs is what? Dx how?
DES Esophageal motility studies
421
Controlling blood glucose below 6.5 A1c reduces what risk?
Diabetic retinopathy | Neuropathy
422
Pt w/pyelonephritis and pmhx of CKD that suddenly develops Renal failure, what happened?
Amikacin SE
423
What is the initial workup for essential HTN?
Lipid panel Chem panel UA EKG
424
MC complications of SAH? Prophylax how?
Re-bleed in 24 hours Vasospasm after 3 days Nimodipine
426
Pt that is 29 y/o w/elevated BP and EKG showing high voltage QRS w/downsloping ST-segment depression w/T-wave inversion in leads V5 and V6 w/symptoms of epistaxis, HA, LE claudication has what? Dx how?
Coarctation of aorta B/L arm and leg BP measurements
427
What presents w/elevated TSH, normal T4 and T3?
Subclinical hypothyroidism
429
What is Dacryocystitis? Caused by what?
Inflammatory change in the medial canthal region of the eye Staph aureus and strep
434
Pt w/solid organ transplantation requires what to prevent organ rejection? Dx how?
High dose immunosuppressive Sputum w/special stain or BAL
436
Pt w/intraocular foreign body is common in pts w/high-velocity injuries may have what negative exam? Need to get what?
Pen-light exam Fluorescein exam
437
Pt w/sudden-onset odynophagia w/retrosternal pain that can cause difficulty swallowing? D/t what? EGD shows what?
Pill-induced esophagitis Tetracyclines, NSAIDs, Bisphosphonates, KCl, Fe Discrete ulcers
438
MEN1?
Parathyroid Pituitary Pancreatic
440
What is ichthyosis vulgaris? Caused by what? Treat?
Chronic, inherited skin disorder characterized by diffuse dermal scaling Mutation in filaggrin Emollient, keratolytics, topical retinoids
442
What presents w/HA, N/V, ABD discomfort, confusion, coma and a pinkish-red skin hue? Treat?
CO poisoning Hyperbaric O2
446
What kind of tumor affects young pts and makes AFP and hCG?
Nonseminomatous germ cell tumor
450
What med causes SE of gingival hypertrophy, nephrotoxicity, hyperK, HTN, hirsuitism? MOA?
Cyclosporine inhibits transc. Of IL-2
454
Tumor lysis syndrome causes what abnormal lab values?
HypoCa HyperPO4 HyperK
455
What causes recurrent painful oral aphthous ulcers and genital ulcers? What other sx?
Behcet disease Eye/skin lesions, thrombosis
457
What presents w/loss of pain/temp in I/L face and c/L trunk and limbs w/dysarthria, dysphoria, hoarseness? D/t what?
Wallenberg syndrome Lateral medulla lesion
460
What does a lesion of the lateral mid pons affect?
i/L trigeminal nerve, diminished jaw jerk reflex, muscles of mastication
462
Loss-to-follow up in prospective studies is what type of bias?
Selection
464
Mono lasts how long? | What other special feature?
Longer than 2 weeks | Generalized LAD
465
Secretory diarrhea has what kind of osmotic gap? Hallmarks?
Small, < 50 Large daily stool volumes, diarrhea that occurs during fasting and at night
466
Diffuse CREST syndrome can cause what? Leading to what?
Systemic sclerosis ILD
472
What pain med to give in cancer pt w/bony METS and Severe pain?
Short acting - morphine or hydro morphine
473
What causes punctuate lesions w/surrounding erythema?
Bed bugs
474
Electrical alternans + Sinus tachycardia = ?
Pericarditis
478
HepC pt w/palpable purpura, proteinuria, hematuria, glomerularnephritis and HM has what?
Mixed cryoglobulinemia
481
What causes cauda equina syndrome? What sx? Treatment?
Compression of spinal n roots LMN paralysis IV steroids, emergency MRI
482
Thalassemia is considered what?
Hemoglobinopathy
484
Fibromyalgia CK level? ESR? Sx?
Normal Normal Widespread pain
485
CMV retinitis described how?
Painless | Fundoscopy shows fluffy or glandular lesions
486
What is a poor prognostic factor in systolic HF? Why>
Hyponatremia w/CHF Inc levels of renin, NE, ADH
492
Serous OM is characterized how? Common in whom?
Middle ear effusion w/out acute infection AIDS pt
498
Pt w/organ transplant w/pneumonitis, hepatitis, and gastroenteritis has what?
CMV
499
What causes dactylitis? What else can it cause?
Psoriatic arthritis Nail pitting, onycholysis
504
Mycophenolate SE? MOA?
BM suppression Reversible IMPDH inhibitor
509
What causes significantly lower brachial systolic BP in 1 arm and a systolic bruit in the supraclavicular fossa w/S4 heart sound? Dx how?
Subclavian steal syndrome Doppler US w/MRA
515
How does PCV13 PNA vaccine work?
Capsular polysaccharide conjugate to protein Ag
517
Ascending aortic dissection can cause what abnormality?
Acute AR
518
TCAs inhibit ______ in the His-Purkinje system and myocardium? Affects the arrhythmiticity of the heart how? If overdose treat how?
Fast Na channels Dec conduction velocity, increases duration of repol, prolongs absolute refractory period Sodium bicarbonate
521
Treatment for toxoplasmosis encephalitis?
Sulfadiazine and pyrimethamine + Luecovorin
522
Pleural effusion breath sounds? Tactile fremitus? Mediastinal shift?
Dec Dec Away from effusion
525
Pt that receives solid organ transplantation needs what med? To protect against what?
Bactrim PCP, listeria, Toxo
527
Wedge shaped infarct on CT means what? Will see what on CXR?
PE Hampton Hump
529
PMHx of depression, dilated pupils, intestinal ileus w/QRS prolongation indicates what? Tx?
TCA overdose Sodium bicarbonate
536
Exudate pleural fluid/serum ratio? LDH? pH? Glucose?
> .5 > .6 7.3 - 7.45 < 60
538
Painless, sudden, loss of vision in right eye in pt w/lots of RFs most likely has what?
Central retinal artery occlusion
540
TPN as food can cause what symptoms? Leads to what?
GB stasis, predisposes to gallstone formation and bile sludge get Cholecystitis
542
Kidney stones can cause what?
Ileus
561
Cardiac tamponade affects volumes of the heart how?
Dec LV preload
565
Pt w/warlike lesions, violaceous nodules, skin ulcers w/acute PNA and osteomyelitis has what? Treat?
Blastomycosis Mod - PO itraconazole Severe - IV Amph B
578
Upper GI bleed that needs transfusion, give what?
Packed red blood cells
583
Pt w/diabetes neuropathy but has hyperactive reflexes and Babinski sign means what? Get what?
UMN problem MRI spine
604
Pt w/cirrhosis and portal HTN can develop what? What pathology?
Hepatic hydrothorax, MC on the right Fluid passage through diaphragmatic defects
617
What is the PATH behind senile purpura? Brown color d/t what?
Perivascular CT atrophy Hemosiderin deposition
620
Sick sinus syndrome path?
Sinuses pauses, can have inc PR or QRS interval
643
Pt w/hypercalcemia, 24 hour hx of pain in swelling in knee has what? Mc d/t what?
Pseudogout Hyperparathyroidism w/chronic hypercalcemia
644
Pt w/acute cocaine intoxication, treat how? What is contraindicated?
IV benzo and oxygen BBlockers
645
Pts w/+ hepatojugular reflex have what etiology? - Hepatojugular reflex?
Peripheral edema d/t HF w/elevated JVP Edema from primary hepatic disease and cirrhosis
646
Exudative effusions are d/t what pathology?
Cytokines released during inflammation or infection INCREASE CAPILLARY PERMEABILITY
647
How is central retinal artery occlusion treated?
Ocular massage and high flow O2
648
What are the MC inciting factors of hepatorenal syndrome? HRS occurs as what progresses? Pts develop what?
SBP and GI bleed Cirrhosis Splanchnic arterial dilation and dec in vascular resistance
649
What will causes pleural fluid to have a low pH and very high amylase (> 2500)?
Ruptured esophagus

UWorld Step 2 (17 decks)

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