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Step 2 CK > May 12th > Flashcards

May 12th Flashcards

1
Q

What medications commonly cause urinary retention/overflow incont?

A

Anticholinergics, opiates, CCB

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2
Q

What is tolterodine? What is it used for?

A

Anticholinergic; indicated for urge incontinence or overactive bladder symptoms

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3
Q

What is superficial infantile hemangioma?

A

Aka strawberry hemangioma; vascular birthmark appears during first few weeks

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4
Q

What is a nevus flammeus?

A

AKA: Port wine stain

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5
Q

What is a nevus simplex?

A

“Stoke bite” or “angel kiss”; patch that most commonly occurs on eyelid and glabella and nape of neck

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6
Q

What is the most common cause of CF-related pneumonia in children?

A

S aureus

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7
Q

What is the most common CF-related pneumonia seen in adults?

A

Pseudomonas

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8
Q

What are Bitot spots and when do you see them?

A

Dry, silver-gray plaques on the bulbar conjunctiva; seen in Vit A def

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9
Q

What is Leriche syndrome?

A

Triad of bilateral hip, thigh and buttock claudication, absent or diminished femoral pulses, impotence; seen with aortoiliac occlusion

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10
Q

What is paroxysmal nocturnal hemoglobinuria?

A

Autoimmune hemolytic disorder with intra and extravascular hemolysis and hemoglobinuria; due to lack of glycosylphosphatidylinositol anchor

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11
Q

How is paroxysmal nocturnal hemoglobinuria diagnosed?

A

Flow cytometry - absence of CD55 and CD59

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12
Q

How is paroxysmal nocturnal hemoglobinuria treated?

A

Iron and folate supplementation; Eculizumab (mab that inhibits complement activation)

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13
Q

What is the pathophysiology of exophthalmos?

A

T cell activation and stimulation of orbital fibroblasts and adipocytes by TRAB, resulting in orbital tissue expansion and lymphocytic infiltration

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14
Q

Which vitamin can help lower homocysteine levels?

A

B6, folate and B12 may be helpful as well

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15
Q

What symptoms are seen in small fiber nerve injury of DM?

A

Positive sxs: pain, paresthesias, allodynia

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16
Q

What symptoms are seen in large fiber nerve injury in DM?

A

Negative sxs: numbness, loss of proprioception and vibration sense, diminished ankle reflexes

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17
Q

What is Legg-Calve-Perthes disease?

A

Idopathic avascular osteonecrosis of the femoral head; affects boys 3-12 (peak incidence is 6); dull, chronic LE pain and antalgic gait

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18
Q

How is acute dystonia treated?

A

Benztropine, diphenhydramine

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19
Q

How is the EPS akathisia treated?

A

Beta blocker, benzo, benztropine

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20
Q

How is parkinsonism EPS treated?

A

Benztropine, amantadine

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21
Q

What type of immune response is seen with the PPSV23 vaccine? Why?

A

T cell independent B cell response; vaccine contains 23 polysaccharides, which alone cannot be presented to T cells

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22
Q

What type of immune response is seen with PCV13 vaccine? Why?

A

T cell dependent B cell response; capsular polysaccharides have been covalently attached to inactivated diphtheria toxin protein

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23
Q

What type of vaccines produce a CD8+ T cell response?

A

Certain live attenuated vaccines (MMR), intranasal flu

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24
Q

What is a luteoma?

A

A benign, large ovarian mass that consists of lutein cells during pregnancy; results in hirsutism and acne during pregnancy; >10 cm in size, solid ovarian mass on US; expectant management - regress after delivery

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25
Q

What is a Krukenberg tumor?

A

Metastatic tumor to ovaries from primary GI tumor; can cause hirsutism in pregnancy

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26
Q

How is bronchiectasis diagnosed?

A

HRCT

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27
Q

How is vesicoureteral reflux diagnosed?

A

Voiding cystourethrogram

28
Q

What are the characteristics of restrictive PFTs?

A

Decreased TLC and normal FEV1/FVC ratio; decreased DLCO

29
Q

NF2 tumor suppressor gene codes for what protein?

A

Merlin

30
Q

NF2 tumor suppressor gene is on what chromosome?

A

22

31
Q

Nf1 tumor suppressor gene codes for what protein? And is on what chromosome?

A

Nuerofibromin; 17

32
Q

What are the key lab findings in hereditary spherocytosis?

A

Increased MCHC, neg Coombs, increased osmotic fragility, abnormal eosin-5-maleimide binding test; hemolytic anemia is seen

33
Q

Neonate presents with jaundice on first day of life and has persistent jaundice refractory to standard management; what should you think of?

A

Hereditary spherocytosis

34
Q

Intensive glycemic control in t2dm reduces the risk of what complications?

A

Microvascular complications: nephropathy and retinopathy

35
Q

Phosphodiesterase-5 inhibitors should be used with caution in what combination with what other medications?

A

Nitrates and alpha blockers

36
Q

If a patient has h/o CIN2 or higher, what is the appropriate pap screening end point?

A

Continues for another 20 years after detection (past age 65 if indicated)

37
Q

When is pap testing stopped?

A

Age 65 (with other factors met)

38
Q

What is the cause of HELLP syndrome?

A

Systemic inflammation and activation of coagulation system and plt consumption

39
Q

Mirtazapine is a good antidepressant choice when what symptoms accompany depression?

A

Weight loss and decreased appetite and insomnia

40
Q

How is acute infection with parvovirus B19 diagnosed?

A

B19 IgM antibodies if immunocompetent; NAAT for B19 if immunocompromised

41
Q

What are common chemotherapy-induced peripheral neuropathy drugs?

A

Vincristine, platinum-baed meds, taxanes

42
Q

What organisms are covered by ciprofloxacin?

A

Gram negatives; NOT anaerobes or gram positives

43
Q

What are good antibiotic options in aspiration pneumonia?

A

Clindamycin + azithromycin; metronidazole with amoxicillin, amoxicillin + clavulanate, or carbapenem

44
Q

What organisms cause emphysematous cholecystitis?

A

Clostridium spp; some E coli

45
Q

What is ziprasidone?

A

Secon gen antipsychotic with low metabolic risk profile (aripiprazole and lurasidone also have low metabolic profile)

46
Q

What is fomepizole?

A

Competitive Alcohol dehydrogenase inhibitor; useful in methanol and ethylene glycol ingestions

47
Q

Nephrotic syndrome associated with African American and Hispanic ethnicity; obesity, HIV and heroin use?

A

FSGS

48
Q

Nephrotic syndrome associated with adenocarcinoma (breast and lung); NSAIDs, HBV, SLE?

A

Membranous nephropathy; HBV also associated with membranoproliferative glomerulonephritis; NSAIDs also associated with MCD

49
Q

Nephrotic syndrome associated with HBV, HCV, lipodystrophy?

A

Membranoproliferative glomerulonephritis

50
Q

Nephrotic disease associated with NSAIDs and lymphoma?

A

MCD; NSAIDs also associated with Membranous

51
Q

Most common nephrotic syndrome in patients with Hodgkin lymphoma?

A

MCD

52
Q

What is seen in MEN2B?

A

Medullary thyroid cancer, pheo, mucosal neuromas/marfanoid habitus

53
Q

What is seen in MEN2A?

A

Medullary thyroid cancer, pheo, parathyroid hyperplasia

54
Q

What is seen in MEN 1?

A

Primary hyperparathyroidism, pituitary tumors, pancreatic tumors

55
Q

Small shallow painless genital ulcers with large, painful lymphadenopathy (buboes)

A

Lymphogranuloma venerum; associated with chlamydia trachomatis L1-L3

56
Q

What is the next best step in a patient with suspected posterior urethral injury?

A

Retrograde urethrogram

57
Q

What is conduct disorder?

A

Violation of major societal norms and rights of others (cruelty toward animals, destruction of property, lying, stealing)

58
Q

How is conduct disorder treated?

A

CBT, family therapy

59
Q

What is oppositional defiant disorder?

A

Angry/irritable mood, argumentative/defiant behavior toward authority; less severe and do not include stealing or aggression toward people

60
Q

What is the most common GI complication of Henoch-Schonlein purpura?

A

Intussusception; usually ileoileal which does not response to air or contrast enema and usually needs surgical management

61
Q

How is PCP treated?

A

TMP-SMX and glucocorticoids in patients with impaired oxygenation; treatment of PCP can cause worsening of oxygenation

62
Q

What is the mechanism behind CCB causing edema?

A

Preferential dilation of precapillary vessels —> increased capillary hydrostatic perssure

63
Q

Contact dermatitis is what type of HSR?

A

Type IV, delayed, T cell mediated

64
Q

What is scleroderma renal crisis?

A

Acute onset renal failure and malignant hypertension (headache, blurry vision, nausea); can see schistocytes and thrombocytopenia

65
Q

When are Burr cells seen?

A

Liver disease and ESRD

66
Q

When are spur cells seen?

A

Liver disease

67
Q

What is the outpatient treatment for PID?

A

IM ceftriaxone + doxycycline

Step 2 CK (19 decks)

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