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STEP 2 > Medicine > Flashcards

Medicine Flashcards

1
Q

what heme illness chromosome 22

A

CML: BCR-ABL

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2
Q

pt with clinical features of Ankylosing spondylitis, next best test to confirm dx?

A

X ray of SI joints

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3
Q

patient with kidney biopsy with intimal thickening nad luminal narrowing or renal arterioles with evidence of sclerosis–MCC?

A

HTN

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4
Q

when vaccinate patients undergoing splenectomy?

A

14 days before or after surgery

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5
Q

Tactile fremitus increase or decrease in pleural effusion?

A

Decrease!

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6
Q

who is at risk of anaphylaxis s/p transfusion?

A

pts who are IgA deficient because they have anti-IgA IgG antibodies

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7
Q

definitive dx of Wegener’s

A

bx of site of active disease

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8
Q

Thyroid cancer that spreads via lymph and has psammoma bodies

A

Papillary

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9
Q

The cancer that spread via blood, have to excise the whole thyroid

A

Follicular

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10
Q

Associate with and MEN2, amyloid and calcification

A

Medullary

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11
Q

What type of cancer does Hashimoto’s predispose to

A

Thyroid lymphoma

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12
Q

First best test for pheochromocytoma

A

urine and plasma free metanephrines

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13
Q

First best test for primary aldosteronism

A

Plasma aldosterone to renin ratio

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14
Q

First best test for adrenocortical carcinoma

A

urine 17-ketosteroids

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15
Q

First test for cushing syndrome

A

Overnight one mg dexamethasone test

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16
Q

Management of a less than five centimeter and nonfunctional adrenal nodule

A

Observing CT scans every six months

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17
Q

Management a greater than 6 cm or functional adrenal module

A

Surgical excision

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18
Q

how dx suspicious nodules for hyperPTH?

A

FNA or sestamibi

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19
Q

breast cysts that are painful and change with menses, dx?

A

fibrocystic change

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20
Q

mgmt fibrocystic change

A

restrict caffeine, take vit e, wear a supportive bra

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21
Q

mgmt DCIS

A

Excision With clear margins or simple mastectomy of multiple lesions [ no node sampling] and adjuvant radiation therapy

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22
Q

mgmt LCIS

A

More often bilateral. Consider bilateral mastectomy only if positive family history hormone sensitive or prior history of breast cancer

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23
Q

Mgmt IDC or lobular carcinoma

A

If small and away from nipple, can do a lumpectomy with axillary node sampling. Adjuvant radiation therapy. Chemo if node positive. Tamoxifen relaxes an estrogen receptor positive

Or

Modified radical mastectomy with axillary node sampling without adjuvant radiation therapy

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24
Q

Management for Paget’s disease of the breast

A

Mammogram to find the mass

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25
Q

Management of basal cell carcinoma

A

Shaver punch fancy that surgical removal Mohs

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26
Q

Management of squamous cell carcinoma

A

Excisional biopsy at Edge of lesion, then wide local excision. Can use radiation for tough locations

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27
Q

Management of melanoma

A

Treatment with excision, 1 cm margin if less than one millimeter thick, 2 cm margin if 1-4 mm thick. 3 cm margin if >4 millimeter thick

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28
Q

Sarcoma typically spread first

A

lungs, hematogenously

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29
Q

treatment for oral squamous cell cancer

A

XRT or radical dissection

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30
Q

tx laryngeal cancer

A

laryngoscope laser or resection

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31
Q

MC salivary gland tumor?

A

pleomorphic adenoma, benign but recurs

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32
Q

Dx diaphragmatic hernia prenatally, mgmt?

A

plan delivery at hospital with ECMO, let lungs mature 3-4 days and then do surgery

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33
Q

Baby is born w/ respiratory distress w/ excess drooling.

•Best diagnostic test?

A

TE-Fistula

Place feeding tube, take xray, see it coiled in thorax

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34
Q

Gastroschisis assoc with other disease?

A

not usually

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35
Q

Defect lateral (usually R) of the midline, no sac.

A

gastroschisis, see high maternal AFP

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36
Q

assoc with congenital umbilical hernias?

A

Assoc w/ congenital hypo-thyroidism. (also big tongue)Repair not needed unless persists past age 2 or 3.

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37
Q

complications of pyloric stenosis

A

Hypochloremic, met alkalosis

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38
Q

tx pyloric stenosis

A

Immediate surg referral for myotomy

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39
Q

2wk old infant w/ bileous vomiting. The pregnancy was complicated by poly-hydramnios. dx? assoc with

A

Intestinal atresia or annular pancreas

assoc with downs

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40
Q

1 wk old baby w/ bileous vomiting, draws up his legs, has abd distension.

A

Malrotation and volvulus*Ladd’s bands can kink the duodenumDoesn’t rotate 270 ccw around SMA

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41
Q

A 3 day old newborn has still not passed meconium.

–DDX? (name 2)

A

Meconium ileus-consider CF if +FH*gastrograffin enema is dx & txHirschsprung’s-DRE explosion of poo. bx showing no ganglia is gold standard

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42
Q

A 5 day old former 33 weeker develops bloody diarrhea

A

NEC

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43
Q

A 2mo old baby has colicky abd pain and current jelly stool w/ a sausage shapend mass in the RUQ

A

Intussusception*Barium enema is dx and tx

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44
Q

Hyperacute Rejection-

A

Vascular thrombosis w/in minutes

–Caused by preformed antibodies

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45
Q

Acute Rejection-

A

Organ dysfunction (incrGGT or Cr depending on organ) w/in 5days –3mo. Due to T-lymphocytes.
–Technical problems common in Liver 1stcheck for biliary obstruction w/ U/S then check for thrombosis by Doppler.
–In heart, sxscome late, so check ventricular bxperiodically.
–Txw/ steroid bolus and antilymphocyteagent (OKT3)

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46
Q

Chronic Rejection

A

Occurs after years. Due to T-lymphocytes.

–Can’t treat it. Need re-transplantation.

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47
Q

Merperidine: side effects

A

Norperidine metabolite can lower seizure threshold esp in pts w/ renal failure.

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48
Q

Succinylocholine side effects

A

Can cause malignant hyperthermia, hyperK (not for burn or crush victim

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49
Q

Rocuronium side effects

A

Sometimes allergic rxn in asthmatics

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50
Q

Halothane side effects

A

Can cause malignant hyperthermia (dantroline Na), liver toxicity.

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51
Q

risk with raloxifene?

A

increases risk of DVT

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52
Q

MC heart defect in Downs

A

complete AV septal defect

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53
Q

treatment for extrapyramidal side effects

A

Benztropine or antihistamines

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54
Q

Abx for human bite

A

Amoxicillin-clavulonate

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55
Q

pt with back pain with red flags or sciatica, next step in mgmt

A

ESR and plain films

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56
Q

what type of thyroid cancer does mantle radiation predispose to?

A

papillary

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57
Q

HTN predisposes to what kind of intracerebral hemorrhage

A

basal ganglia

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58
Q

Contralateral hemiparesis and hemisensory loss, homonymous hemianopsia, gaze palsy

A

Basal ganglia hemorrhage

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59
Q

what is cardiac index, how is it changed in heart failure?

A

= cardiac output / body surface area, decreased in heart failure because of decreased forward flow

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60
Q

what type of anemia does lead poisoning cause?

A

microcytic

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61
Q

what does an inspiratory hold measure?

A

pulmonary compliance

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62
Q

patient who recently travelled to mexico with fever, double vision and painful swelling around his eyes, pain in neck and jaw muscles, eosinophilia–dx?

A

trichinellosis

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63
Q

pt with chondrocalcinosis, mild hepatomegaly and DM–dx?

A

hemochromatosis

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64
Q

leukocyte alkaline phosphatase score is usually high in what condition?

A

leukomoid reactions

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65
Q

strongest influence on long-term prognosis s/p STEMI is what?

A

time to return of coronary blood flow

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66
Q

what GI disorder that causes flatulance and malabsorption can be seen in patients with systemic sclerosis

A

SIBO

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67
Q

best mgmt of patient with fulminant liver failure

A

put on transplant list ASAP

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68
Q

pt with pancreatitis who likely has gallstones: what imaging modality

A

RUQ US!

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69
Q

how long do patients with mono have to avoid contact sports?

A

at least 3 weeks

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70
Q

treatment for spinal epidural abscess

A

abx and emergent spinal decompression

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71
Q

methimazole side effect

A

agranulocytosis

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72
Q

pt with sickle cell with nocturia?

A

hyposthenuria

-can’t concentrate urine, 2/2 blood sickling in vasa recta

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73
Q

73 yo man recently started on amitriptyline with ab pain and suprapubic tenderness

A

do a urinary cath, likely urinary retention 2/2 amitriptyline

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74
Q

patient with RBC casts, proteinuria, palpable purpura, low complement, anti-HCV positive
dx?

A

mixed essential cryoglobulinemia

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75
Q

tx of patient with SIADH who is symptomatic

A

hypertonic saline

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76
Q

1st step in mgmt of patient with suspected variceal hemorrhage

A

volume resuscitation, IV octreotide and Abx

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77
Q

what are the best lifestyle modifications to decrease HTN?

A 
weight loss (#1)
DASH diet
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78
Q

pt with upper body edema and weight loss and plethoric, dark appearance, what should you think of?

A

SVC syndrome

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79
Q

cancer pt with pain who hasn’t taken narcotics, first line pain med?

A

short acting morphine

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80
Q

patient s/p stroke with hemianesthesia and athetosis: location of stroke?

A

thalamus

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81
Q

AIDS patient with widespread pale, peripheral lesions and central necrosis of the retina: dx?

A

HSV

CMV retinitis is PAINLESS

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82
Q

immigrant with weight loss, fever, cough, nausea and adrenal calcs bilaterally: dx

A

TB

MCC adrenal insufficiency in developing countries

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83
Q

what cranial nerve is responsible for corneal sensation?

A

trigeminal

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84
Q

ddx tinea corporis from secondary syphilis

A

tinea corporis: ring-shpaed scaly patches with central clearing and distinct borders

secondary syphilis is usually maculopapular and involves palms and soles

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85
Q

mgmt of premature atrial beats

A

observation

benign

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86
Q

L sided varicocele that fails to empty when the patient is recumbent: consider what diagnosis?

A

RCC

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87
Q

Dx: mediastinal mass with elevated bHCG and AFP

A

nonseminomatous germ cell tumors

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88
Q

first degree heart block mgmt?

A

if no QRS prolongation: no further eval

if QRS eval: conduction delay below AV node, need electrophys workup

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89
Q

do rimantadine and amantadine work against flu b?

A

no, only flu A

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90
Q

HA, fever, periorbital edema, vomiting: what should you worry about?

A

cavernous sinus thrombosis

ddx orbital cellulits, CST cellulitis extends beyond the orbital septum

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91
Q

facial swelling, bilateral lower-extremity edema, massive proteinuria, nephrotic syndrome

dx?

A

AA Amyloidosis

Colchicine for preventation and treatment

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92
Q

propylthiouracil (PTU) and methimazole (MMI) MC side effects

A

agranulocytosis

discontinue if pt has a fever and sore throat or WBC count less than

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93
Q

idiopathic intracranial hypertension Tx

A

Acetazolamide is first

inhibits choroid plexus carbonic anhydrase

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94
Q

what labs look at before starting someone on BP meds

A

UA
EKG
chemistry panel
lipid profile to risk stratify

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95
Q

genetic inheritance of HOCM

A

AD

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96
Q

hydatid cyst, what organism

A

echinococcus granulosus

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97
Q

pt with WPW who develops AFib–tx?

A

procainamide!

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98
Q

diabetic pt with elevated LFTs and normal serology, hepatic fullness: Dx?

A

NASH, 2/2 insulin resistance

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99
Q

pt with dysarthria and R hand weakness, likely etiology of stroke?

A

HTN

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100
Q

CURB-65

A

Confusion
Uremia (BUN >20)
Tachypnea RR >30
HYPOtension, BP 65

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101
Q

HIT immune mediated?

A

YES: type 2: antibodies against heparin-platelet factor 4 complexes

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102
Q

HOCM mitral valve abnormality

A

abnormal mitral leaflet motion

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103
Q

malignancy associated ACTH production associated with what kind of cancer?

A

SCLC

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104
Q

how monitor HBV infection

A

ALT and HbEAg q 3-6 months

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105
Q

pt with an unexplained elevated CK level, next best test?

A

TSH

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106
Q

treatment for Sanford type B aortic dissection

A

Labetalol

do NOT give Heparin

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107
Q

MC complication with TPN

A

central line infection

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108
Q

Pt with non-Hodgkins lymphoma with painless ulcer on foot, recently had chemo: best tx?

A

anti-pseudomonal PCN because patient is immunosuppressed

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109
Q 
CSF
WBC 25
PMNs 5%
Glucose 65
RBC 700
Protein 120

Dx?

A

HSV encephalitis

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110
Q 
CSF
WBC 1100
PMNs 80%
Glucose 12
RBC 200
Protein 300

Dx?

A

Low glucose, elevated protein, PMNs

Acute bacterial meningitis

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111
Q 
CSF
WBC 120
PMNs 10%
Glucose 10
RBC 100 
Protein 80

Dx?

A

Lymphs, decreased glucose, increased protein

Chronic bacterial meningitis due to TB

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112
Q

1 cause of spinal stenosis

A

OA of the spine

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113
Q

pseudoclaudication

A

lower extremity pain that occurs with walking and does not improve with sitting or resting (this is how you differentiate it from true caludication)

MCC is spinal stenosis which is usually 2/2 OA

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114
Q

what kind of hormone is ACTH

A

polypeptide hormone

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115
Q

causes of labor protraction

A

power
passenger
pelvis

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116
Q

define labor arrest

A

once true labor has begun

no change in dilation over 2 hours or no change in descent in over 1 hour

tx = augment labor, then C section

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117
Q

active phase of labor, definition and times

A

3-4 cm to full dilation

dilated >1cm and hour

118
Q

thoracentesis with > 4gm protein, dx?

A

TB

119
Q

patient with cancer who has headache worse when they lean forward: dx?

A

SVC syndrome

120
Q

what level BUN in pts with uremia?

A

100 mg/dL

121
Q

diabetic moms: what risk to fetal lungs?

A

increased risk of respiratory distress because insulin causes cellular hypertrophy at the expense of cellular maturation

122
Q

what ABI values suggest peripheral arterial dz

A

0.4-0.9

123
Q

Calcium 14.1, phos 2.8 in old man with recent lethargy and weight loss

A

hypercalcemia of malignancy

124
Q

anti-mitochondrial antibodies

A

associated with PBC

125
Q

anti-smooth muscle antibodies

A

associated with autoimmune hepatitis

126
Q

tx neurogenic bladder

A

cholinergic agonist ex. bethanechol

127
Q

tx urge incontinence

A

muscarinic antagonist

oxybutynin

128
Q

SAAG cutoff for portal HTN

A

1.1

129
Q

pt with CHF sx s/p URI

A

myocarditis, can cause dilated cardiomyopathy

130
Q

unilateral upper lobe infiltrate and hilar adenopathy DX

A

TB

131
Q

A Fib associated with what thyroid dz

A

hyperthyroidism

132
Q

poor prognostic indicator for astrocytomas

A

anaplasia

133
Q

MC presentation of CLL

A

lymphocytosis and painless LAD
smudge cells

assoc with ITP and Autimmune hemolytic anemia

134
Q

tx CLL

A

Rituximab, anti CD 20

135
Q

who needs abx prior to dental procedures

A

prosthetic heart valves
prior history of un-repaired congenital heart dz
history of infective endocarditis

136
Q

best way to increase fertility in overweight PCOS patients

A

weight loss

137
Q

pancreatic cancer pt with elevated TBili and pruritis – tx?

A

endocopic stent placement

ursodeoxycholic acid only works in patients with INTRAhepatic bile duct obstruction

138
Q

multiple myeloma causes what kind of renal damage

A

renal tubule damage due to toxic effect of light chain casts

139
Q

tx for agitation due to delirium

A

haldol

NOT benzos, those increase delirium

140
Q

LGSIL and positive or uknown HPV status

A

colpo and bx

141
Q

LGSIL and negative for HPV 16 and 18

A

repeat cotesting in 1 year (preferred)
OR
colposcopy and biopsy

142
Q

vaginal normal ph

A

3.8-4.2

143
Q

vaginal irritation and pH of 4, dx?

A

Candida

BV and Trich elevate pH

144
Q

pt s/p MI who has a new holosystolic rupture

A

rupture of IV septum

145
Q

characteristics of DIC

A

thrombocytopenia
decreased fibrinogen
increased INR

146
Q

breast cancer screening recs

A

q 2 yrs over 50 yo

147
Q

cremasteric reflex: what is it? when useful?

A

elevation of testes in response to touching inner thigh

absent in almost all pts with testicular torsion

148
Q

pain relief with elevation of testicle associated with what dx?

A

Prehn’s sign

assoc with epididymitis

149
Q

Pancost tumor, what association?

A

SMOKING

not TB since TB doesn’t cause tumors!

150
Q

MCC AR

A

aortic root dilation or bicuspid aortic valve

151
Q

CSF
nml WBC
elevated portein
nml glucose

A

GBS

152
Q

presentation of oral herpes in a kid?

A

herpes gingivostomatitis

vesicular eruptions on the anterior oral mucosa and perioral region, kids are sick with a fever

153
Q

ovalo macrocytes and PMNs with reduced segmentation are associated with what illness?

A

myelodysplastic syndrome

154
Q

impetigo: bug, tx and MC complication

A

Staph A and group A strep
topical mupirocin
post-strep glomerulonephritis

155
Q

what drug hasten COPD exacerbation recovery

A

glucocorticoids

156
Q

chemo pt with WBC of 600, s/p transfusion 1 week prior dx?

A

bacterial infxn

157
Q

tx of diabetic ulcer that isn’t gangrenous but invades muscle

A

debridement

158
Q

mgmt DKA in kids

A

1: 10mL/kg isotonic fluid over one hour
2: insulin + isotonic fluids with K supplementation

159
Q

Efavirenz side effect

A

insomnia, vivid dreams

160
Q

lamivudine side effect

A

hepatotox

161
Q

initial tx of urge incontinence

A

bladder training

more freq urination

162
Q

leukocytoclastic vasculitis aka

A

HSP

163
Q

tx Barthoin gland abscess

A

I and D

164
Q

what migraine meds do you NOT want to use together

A

ergots and triptans

165
Q

KD tx

A

IVIG and ASA

166
Q

cause of carpal tunnel in hypothyroidism

A

accumulation of matrix substance

167
Q

cause of carpal tunnel in pregnancy

A

accumulation of fluid

168
Q

cause of carpal tunnel in RA

A

tenosynovial inflammation

169
Q

women at what weeks gestation are candidates for steroids

A

24-34 weeks

170
Q

kid with a 3-day fever followed by blanching, eryhtematous macular rash, dx?

A

roseola infantum HHV-6

171
Q

Tx for DIC

A

plasmapheresis

172
Q

what does sotalol predispose to?

A

torsades

173
Q

what complication is common s/p coil for SAH

A

rebleed in first 24 hours

vasospasm 3 days out

174
Q

mgmt of pt with NSCLC with a single brain met

A

resect the met

175
Q

tx Lewy body dementia

A

Rivastigmine or other Ach-ase inhibitors

176
Q

MC bug causing brain abscess s/p URI

A

viridans group strep

177
Q

Stroke location:

unilateral motor impairment
no sensory or cortical deficits
no visual field abnormalities

A

Posterior limb of internal capsule, lacunar infarct

178
Q

Stroke location:

contralateral somatosensory and motor deficit
conjugate eye deviation Toward side of infarct
homonymous hemianopsia
aphasia (dominant hemisphere)
hemineglect (non-dominant hemisphere)

A

MCA

179
Q

Stroke location

  • contralateral somatosensory adn motor deficit, predominantly in lower extremity
  • abulia (lack of will or initiative)
  • dyspraxia, emotional disturbance, urinary incontinence
A

ACA

180
Q

Stroke location

  • alternate syndromes with contralateral hemiplegia and ipsilateral CN involvement
  • possible ataxia
A

vertebrobasilar system lesion supplying the brainstem

181
Q

site of hemorrhage

contralateral hemiparesis and hemisensory loss
homonymous hemianopsia
gaze palsy

A

basal ganglia

182
Q

site of hemorrhage

no hemiparesis
facial weakenss
ataxia and nystagmus
occipital headache and neck stiffness

A

cerebellum

183
Q

site of hemorrhage

deep coma and total paralysis within minutes
pinpoint reactive pupils

A

Pons

184
Q

etiology of normal pressure hydrocephalus

A

decreased CSF absorption

185
Q

treatment for restless leg syndrom

A

Dopamine agonist like pramipexole

186
Q

best diagnostic test for delirium in edlery

A

UA and serum electrolytes

187
Q

what is pronator drift specific for?

A

UMN lesion

188
Q

fixed dilated pupil: what type of injury to CN III

A

compression, can also cause parasympathetic injury.

due to P Comm aneurysm or uncal herniation

189
Q

Down and out pupil in a diabetic: what type of injury

A

ISCHEMIC injury to somatic fibers

normal light and accomodation reflexes

190
Q

best med to treat parkinson’s tremor

A

trihexyphenidyl (anticholinergic)

191
Q

what neuro test can you do in a brain dead pt

A

deep tendon reflexes because relate to spinal cord not brain

192
Q

patient has parkinsonism, autonomic dysfunction and diffuse neuro signs

dx?

A

multiple system atrophy
aka Shy Drager

Tx: IV volume expansion, anti-parkinsons drugs

Ddx: Familial Dysautonomia: autonomic dysfunction in jewish kids with severe orthostatic hypotension

193
Q

Tx for Lambert Eaton

A

plasmapheresis + immunosuppressive drug tx

194
Q

what type of drug is Selegine

A

MAO-B used to treat Parkinsons

195
Q

bilateral trigeminal neuralgia can be the first sign of what illness?

A

MS

196
Q

intense ipsilateral retroocular pain and Horner’s = what dx?

A

Cluster HA

197
Q

tx acute cluster HA attack

A

100% O2 and subQ sumatriptan

198
Q

tx opiod OD / delerium

A

naloxone

199
Q

medulloblastoma: infra or supra tentorial

A

supra

200
Q

when do endarterectomy

A

stenosis greater than 70%

201
Q

Ddx Werdnig Hoffman vs. infant botulinum

A

WHD: hypotonic at birth, affected by 6 months, + family history since AR. supportive tx

Botulism: often s/p honey, supportive tx and watch respiratory status

202
Q

tx organophosphate poisoning

A

Atropine and Pralidoxamine

203
Q

cause of charcot joint

A

nerve damage!

204
Q

Tx of hepatic encephalopathy

A

supportive tx first: K, electrolyte disturbances, albumin. Then lactulose to get rid of some of the ammonia

TIPS is for complications of portal HTN, not hepatic encephalopathy!

205
Q

AIDS patient with exophytic purpuric skin rash , and liver lesions that hemorrhage on bx

A

Bartonella

tx: ABX

206
Q

who gets PPSV23 first before PCV13?

A

heart or lung dz
diabetes
smoking
chronic liver disease

get PPSV23 first, then PCV 13 and PPSV23 at age 65

207
Q

dense, patchy lung infiltrates + abdominal tenderness in a patient who had a bone marrow transplant

A

CMV

208
Q

what tx for beta thal minor?

A

none

209
Q

patient with pale, voluminous, greasy and foul smelling stools

ddx

A

pancreatic insufficiency MCC 2/2 alcohol abuse
bile salt dysfunction
impaired intestinal epithelium

210
Q

side effect of bactrim

A

hyperkalemia

211
Q

urinary retention from anticholinergic drugs is a result of what?

A

detrusor inactivity

212
Q

what drug to stimulate appetite in cancer patients

A

progesterone analog

213
Q

mgmt of Hep C in pregnancy

A

give Hep A and B vaccine

214
Q

side effect of isoniazid

A

acute hepatitis`

215
Q

drugs of choice for hypercalcemia of malignancy

A

bisphosphonates like zolendronic acid or pamidronate

216
Q

treatment of dermatitis herpetiformis

A

dapsone

217
Q

side effect of HCTZ

A

hyperglycemia
increased LDL cholesterol
plasma triglycerides
hypoK, hypoNa, increased Ca

218
Q

how ddx chlamydia vs. gonorrhea urethritis in men

A

gram stain

won’t see chlamydia, will see neisserria

219
Q

name 3 causes of increased BUN/Cr ratio

A

renal failure
GI bleed
steroid administration

220
Q

symmetric and circumferential narrowing of the esophagus with dysphagia for solids, no weight loss: DX

A

stricture

221
Q

tiotroprium and ipratroprium are what kinds of drugs?

A

muscarinic antagonist

222
Q

next step if FAST inconclusive

A

DPL

223
Q

mgmt of hypercalemia if >14

A

normal saline and calcitonin

NO furosemide unless CHF bc can worsen volume depletion

224
Q

hepatojugular reflex reflects what?

A

failing R heart

225
Q

do pts with sickle cell trait have findings on a peripheral smear?

A

NO

226
Q

heinz bodies, what dz

A

oxidated hemoglobin from G6PD

227
Q

tx for diabetic gastroparesis

A

metoclopramide

228
Q

what do WBC casts indicate?

A

interstitial nephritis and pyelo

229
Q

what do broad and waxy casts indicate?

A

chronic renal failure

230
Q

tx for TCA toxicity

A

if QRS >100, give sodium bicar

231
Q

when prophylax HIV patients against MAC

A

CD4

232
Q

next best step Gastric adenocarcinoma found on bx

A

CT scan for staging

233
Q

Hep C is associated with what skin disorder?

A

porphyria cutanea tarda

234
Q

tx cellulitis

A

nafcillin or cefazolin

235
Q

mgmt hyperplastic colon polyps

A

non-neoplastic

no further workup

236
Q

what abx can cause acute renal failure

A

aminoglycosides: amikycin, gent, tobra

237
Q

tx acute vs chronic prostatitis

A

acute: bactrim or cipro x4-6 weeks
chronic: cipro

238
Q

gum hypertrophy in a transplant pt, what drug?

A

cyclosporine

239
Q

diarrhea, leukopenia and hepatotox in a transplant pt, caused by what drug?

A

azathioprine

240
Q

bone marrow suppression in a transplant pt, drug cause?

A

mycophenolate

241
Q

erythematous lesions with sandpaper texture: dx?

A

actinic keratoses

242
Q

Ddx for anterior mediastinal mass

A

thymoma
teratoma
thryoid neoplasm
terrible lymphoma

243
Q

what vaccinations do HIV positive pts need?

A

Hep A and B
flu
pneumococcus

244
Q

what bug causes erysipelas

A

Group A beta hemolytic strep

245
Q

pyoderma gangrenosum is associated with what illness?

A

IBD, esp crohn’s

246
Q

what do you have to test for before starting a patient on methotrexate?

A

hep B
hep C
TB

247
Q

best test to demonstrate volume depletion

A

elevated BUN: Cr ratio (not Hct, because that could actually be elevated in a dehydration state due to hemoconcentration)

248
Q

tx for type IV RTA

A

Fludrocortisone

249
Q

tx for Goodpasture’s nephritic

A

plasmapheresis to get off excess antibodies

250
Q

who gets amyloid nephrotic syndrome

tx?

A

pts with chronic inflammatory diseases like RA, IBD

tx is transplant bc otherwise it recurs

251
Q

Aspirin leads to what acid base disorder? what’s the pH?

A

respiratory alkalosis and then anion gap metabolic acidosis (lactate)

pH is close to 7.40

252
Q

what electrolyte changes would you see in a patient with Addison’s

A 
hyper K (bc no aldo)
hypo Na (because no mineralcorticoids)--look this up
253
Q

carotid endarterecomy recommended with carotid stenosis of what levels?

A

symptomatic men and women: 70-99% stenosis

men with asymptomatic stenosis of 60-99%

254
Q

most important prognostic indicator in acute liver failure

A

PT

255
Q

bradycardia, hypotension, wheezing, hypoglycemia, delirium, seizures, cardiogenic shock: dx? tX?

A

BB overdose

tx: IV fluids and atropine, then IV glucagon if profound or refractory hypotension

256
Q

how dx C Diff

A

stool toxin

257
Q

RA drug that can cause oral ulcers

A

methotrexate

258
Q

1st line tx for OA

A

acetaminophen

259
Q

what kind of drug is ondansetron

A

serotonin antagonist

260
Q

how treat anemia of chronic disease

A

treat underlying illness

261
Q

MC complication of peptic ulcer dz

A

hemorrhage

262
Q

tx febrile neutropenia in a cancer pt

A

pip-taxo, cefepime, meropeneum

need an anti-pseudomonal

263
Q

Dx Hep B tests during window period

A

HBsAg and Anti-HBc

264
Q

all patients with chronic liver dz should be immunized against

A

Hep A and B

265
Q

patient with h/o asthma or chronic rhinosinusitis with nasal polyposis: dx?

A

aspirin-exacerbated respiratory disease

pseudo-allergic drug reaction

266
Q

what kind of kidney injury does acyclovir cause

A

renal tubular obstruction

2/2 crystals that precipitate

267
Q

pt with MGUS, next step

A

skeletal survey to rule out multiple myeloma

268
Q

abnormal D xylose test indicates what illness

A

Celiac

269
Q

Cause of systemic HTN in throtoxicosis

A

hyperdynamic circulation from increased myocardial contractility and HR

270
Q

Meniere’s is a dz of what part of the ear?

A

INNER ear

271
Q

MC underlying valve abnormality associated with patients with infective endocarditis?

A

MR

272
Q

dendritic corneal ulcer is due to what

A

VZV

273
Q

how ddx methanol vs. ethylene glycol poisoning

A

both cause AGMA with increased serum osms

methanol–> blurry vision
ethylene glycol–> kidney damage (stones)

274
Q

tx for ethylene glycol poisoning

A

Fomepizole

275
Q

treatment for Hep B

A

Tenofavir or entecavir

276
Q

osteomalacia: what pathophys?

A

impaired osteoid matrix mineralization

277
Q

how does acute pancreatitis cause hypotension

A

increased vascular permability

278
Q

is it okay to practice procedures on dead patients?

A

yes as long as you get family’s permission

279
Q

patient with a painful red eye and opacification and ulceration of the cornea

A

contact lens associated keratitis, mostly due to pseudomonas or serratia

medical emergency, broad spectrum Abx

280
Q

MC site of spinal arthritis in RA

A

C-spine

281
Q

middle ear effusion without an acute infection: dx?

A

serous otitis media

sx: dull tympanic membrane, hypomobile

282
Q

L hemipleiga

R ptosis and eye deviation to R and down: what kind of stroke?

A

Webber’s aka PCA paramedian branch stroke to midbrain

283
Q

Falling to the left

R ptosis and eye deviation to R and down: what kind of stroke?

A

Benedikt’s

PCA or paramedian branches of basilar artery to tegmentum of midbrain

284
Q

pure motor or pure sensory stroke

A

basal ganglia lacunar stroke

ex: clumsy hand syndrome, ataxic hemiparesis

285
Q

toxo treatment

A

sulfadiazine and pyrimethamine

286
Q

meningitis vaccine: what age?

booster?

A

11-12

16-21

287
Q

unilateral motor deficit
mild dysarthria
no visual, sensory or higher cortical dysfunction

A

pure motor hemiparesis

lacunar infarct in the posterior limb of the internal capsule

288
Q

unilateral numbness, parasthesias, and hemisensory deficit involving the face, arm, trunk and leg

A

pure sensory stroke

stroke int eh VPL nucleus of the thalamus

289
Q

weakness that is more prominent in the lower extremity, along with ipsilateral arm and leg incoordination

A

ataxic-hemiparesis

lacunar infarct in the anterior limb of the internal capsule

290
Q

hand weakness, mild motor aphasia, no sensory abnormalities

A

dysarthria clumsy hand syndrome

lacunar stroke at the basis pontis

291
Q

hemisensory loss with severe dysesthesia of the affected area: lesion in what side of the brain?

A

thalamus

292
Q

medical tx for descending aortic dissection

A

labetalol NOT nifedipine

STEP 2 (8 decks)

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