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Step 2 CK > May 10th > Flashcards

May 10th Flashcards

1
Q

Hypoketotic hypoglycemia during fasting

A

MCAD - inability to break down fatty acid chains

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2
Q

4 month old presenting with hypoglycemia, lactic acidosis, hyperuricemia, hyperlipidemia, doll-like face and hepatomegaly

A

Glucose 6 phosphatase def (type I glycogen storage dz, Von Gierke disease)

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3
Q

What cancer is associated with pernicious anemia?

A

Gastric cancer (due to atrophic gastritis)

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4
Q

Patient with HIV, presents with floaters and blurred vision of right eye, photophobia, with fundoscopy showing yellow-white exudates immediately adjacent to the fovea and retinal vessels. Diagnosis?

A

CMV retinitis

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5
Q

What is the proper work up for a palpable breast mass in a 36 yo F?

A

Mammogram (+/- US); mammo first in anyone >/= 30 years; if under 30 US firstline

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6
Q

How is lichen sclerosus definitively diagnosed?

A

Punch biopsy

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7
Q

How is lichen sclerosus treated?

A

Topical steroids (high potency)

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8
Q

What are the treatment options for chlamydia/gonorrhea in women?

A

Empiric: azithromycin + ceftriaxone; confirmed chlamydia: azithromycin; confirmed gonorrhea: azithromycin + ceftriaxone

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9
Q

Pseudogout is associated with what diseases?

A

Hyperparathyroidism, hypothyroidism, and hemochromatosis

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10
Q

What is the genetic abnormality in CML?

A

BCR-ABL fusion

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11
Q

What are the criteria for initiating long term home oxygen therapy in COPD?

A

Resting arterial oxygen tension (PaO2) = 55 mmHg or pulse oxy = 88% on room air; PaO2 = 59 or pulse ox = 89% in patients with cor pulmonale, RHF or Hct > 55%

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12
Q

MCHC in hereditary spherocytosis?

A

Increased

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13
Q

Methylmalonic acid level in B12 deficiency?

A

Elevated

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14
Q

Parkinson’s disease is due to loss of what?

A

Dopaminergic neurons in the basal ganglia

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15
Q

Prior to starting trastuzumab, patients need what type of work up?

A

Baseline echocardiography

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16
Q

What is the pathophysiology of bone loss in hyperthyroidism?

A

Thyroid hormones result in increased osteoclast activity, resulting in increased bone resorption

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17
Q

Elevated 24 hour urinary excretion of 5-HIAA is seen in what tumor?

A

Carcinoid

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18
Q

What is the treatment for carcinoid syndrome?

A

Octreotide for sxs/prior to surgery; surgery definitive

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19
Q

Patients with carcinoid syndrome can become depleted in what?

A

Niacin

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20
Q

PAS + material in laminia propria

A

Whipple’s disease - Tropheryma whippelii (bacillus)

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21
Q

What is first line treatment for tinea corporis?

A

Topical antifungal (eg clotrimazole, terbinafine); second line is oral antifungals (eg terbinafine and griseofulvin)

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22
Q

What medications cause granulomatous liver injury?

A

Allopurinol and phenylbutazone

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23
Q

What drugs cause cholestasis type drug-induced liver disease?

A

Chlorpromazine, nitrofurantoin, erythromycin, anabolic steroids

24
Q

What medications cause fattyliver disease?

A

Tetracycline, valproate, anti-retrovirals

25
Q

Halothane, phenytoin, isoniazid, and alpha-methyldopa cause what type of liver disease?

A

Hepatitis

26
Q

Carbon tetrachloride and acetaminophen result in what type of liver disease?

A

Fulminant liver failure

27
Q

Variable decels on FHR monitor are due to what?

A

Cord compression, oligohydramnios, cord prolapse

28
Q

What are the causes of meningitis in children <3 months?

A
  1. GBS 2. E coli 3. L monocytogenes 4. HSV
29
Q

What is the most common cause of meningitis in children age 3 months to 10 years?

A
  1. S pneumo 2. N meningitidis
30
Q

What is the MOA of pramipexole?

A

Dopamine agonist

31
Q

What channel does gabapentin work on?

A

It is a Alpha-2-delta calcium channel ligand

32
Q

What is the treatment for Tourette disorder?

A

Antipsychotics (eg risperidone), alpha-2 adrenergic agonists (clonidine, guanfacine), habit reversal therapy

33
Q

How is a dystonic reaction treated?

A

Dystonic reaction resulting from a dopamine antagonist - give Benztropine or diphenhydramine

34
Q

What cardiac index is seen in hypovolemic shock?

A

Low cardiac index

35
Q

What are the risk factors for placenta previa?

A

Prior placenta previa, prior Cesarean delivery/uterine surgery, multiple gestation, smoking

36
Q

How is PAO2 calculated?

A

150 - (PaCO2/0.8) if at sea level breathing room air

37
Q

How does a glucagonoma present?

A

DM (easily controlled with diet/one oral med), necrolytic migratory erythema (erythematous plaques with central clearing and eroded boarders), weight loss, diarrhea, anemia

38
Q

How is MS exacerbation treated?

A

IV steroids; plasmapharesis if refractory to steroids

39
Q

What are the prophylaxis medications for HIV opportunistic infections?

A

TMP SMX at CD4 200 for PCP; TMP SMX at CD4 100 for Toxo; Azithromycin at CD4 50 for MAC; itraconazole at CD4 150 for histo

40
Q

What diseases are associated with erythema nodosum?

A

Strep infection, sarcoid, TB, endemic fungal infections (eg histo), IBD, and Behcet disease

41
Q

What are the most common causes of death in Friedreich ataxia?

A

Cardiomyopathy (causes concentric hypertrophic cardiomyopathy) and respiratory complications

42
Q

What are the common manifestations of Friedreich ataxia?

A

Neuro (ataxia, dysarthria), skeletal (scoliosis, hammer toes), cardiomyopathy - concentric hypertrophy

43
Q

What are Howell-Jolly bodies and when do you see them?

A

Nuclear remnants of RBCs; seen in asplenia (eg Sickle Cell)

44
Q

What is basophilic stippling and when is it seen?

A

Ribosomal precipitates; seen in thalassemia and lead/heavy metal poisoning

45
Q

What are Heinz bodies and when are they seen?

A

Denatured aggregates of Hgb; seen in G6PD def (and thalassemia)

46
Q

Renal vein thrombosis is most common in what nephrotic syndrome?

A

Membranous glomerulopathy

47
Q

What is an abnormal 50 g oral glucose tolerance test?

A

BS >/= 140 one hour after glucose load

48
Q

What is the clinical presentation of milk-protein induced entercolitis?

A

Age 2-8 weeks, regurgitation or vomiting, painles bloody stools, eczema

49
Q

What is the treatment for milk protein induced colitis?

A

Mother eliminate all soy and dairy products from diet; or switch to hydrolyzed formula

50
Q

Parotid gland enlargement can be seen in alcohol use, why?

A

Thought to be due to fatty infiltration from chronic alcohol use

51
Q

How often should patients with cirrhosis have an US?

A

Q6 months

52
Q

Urinary alkalization in a UTI is concerning for what?

A

Urease-producing bacteria (P mirabilis most common; K pneumo)

53
Q

What thyroid nodule US findings are suspicious?

A

Hypoechogeneity, microcalcifications, internal vascularity

54
Q

How is panic disorder treated?

A

Acute sxs: benzo; start SSRI and CBT for longterm management

55
Q

How is the Reitan trail test useful?

A

Its a timed connect the numbers test that helps detect subtle mental status changes; useful with SBP

Step 2 CK (19 decks)

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