Medicine In-Review Flashcards
Which area of the body is most frequently injured by runners?
Knee
Which neoplasm is Imiquod cream approved for?
Superficial basal cell carcinoma.
If a patient sustains an injury and has had a tetanus shot one year ago - does he need tetanus toxoid or immunoglobulin?
He does not need either of those.
What class if drugs does chlorpropamide belong to?
Sulfonylureas.
What effect does chlorpropamide have on warfarin?
Displaced warfarin from albumin leading to high levels and possibly bleeding.
How can aminoglycoside nephrotoxicity be attenuated?
By once daily dosing.
Is malignant ascites a portal hypertension mediated process or a non-portal hypertension mediated process?
Non-portal hypertension mediated.
What blood type is the universal donor?
O negative.
What medication is commonly used to treat precancerous actinic keratosis?
5-fluorouracil
What are less invasive treatment options for an old patient with comorbidities who has achalasia?
Bougienage or botulinum toxoid injections.
Which cancer is associated with malignant acanthosis nigricans?
Gastric cancer.
Is a PAP smear recommended in women who have has a hysterectomy because of benign causes?
No.
What is the next step if a patient has symptomatic bradycardia?
Permanent pacemaker implantation.
Management of mitral stenosis in a patient with hockey stick deformity of the anterior leaflet with restricted motion predominantly at the leaflet tips and minimal mitral regurgitation.
Balloon mitral valvoplasty.
Can hypokalemia cause hepatic encephalopathy?
Yes.
Bilateral ground glass opacities with low DLCO on pulmonary function tests.
Diagnosis?
Idiopathic pulmonary fibrosis.
Sudden cardiac death after being struck on the chest.
Diagnosis?
Commotio Cordis
Which marker of hepatitis B indicates prior infection with complete recovery?
Hepatitis B core antibody IgG.
Autosomal dominant condition with multiple keratocanthomas in sun exposed areas.
Ferguson-Smith syndrome
What effect do bile acid binding resins have on the lipid panel?
- Increase VLDL triglyceride production.
- Decease LDL cholesterol via increased hepatic LDL receptor activity.
- Increase HDL.
What is the best time to schedule elective surgery in a pregnant woman if the surgery cannot be postponed?
Second trimester.
What three common manifestations are common in patients with cryoglobulinemic vasculitis?
- Purpura
- Glomerulonephritis.
- Peripheral neuropathy.
How high does the Hepatitis B surface Antibody need to be to indicate immunity?
More than 12 mIU/mL
Pemphigus erythematosus (uncommon variant of pemphigus foliaceus with additional features of lupus erythematosus). Also known as...
Senear-Usher syndrome.
Elevated free T4 with normal TSH.
Next step?
MRI of pituitary gland.
Heyde’s syndrome…
Development of arteriovenous malformations in patients with…
Severe aortic stenosis.
Brachyonychia, eruptive keloids, and multiple pilomatricomas.
Diagnosis?
Rubinstein-Taybe syndrome.
What systemic disease is associated with generalized granuloma annulare?
Diabetes mellitus.
What is the most common cardiac disease diagnosed in pregnant women?
Congenital heart disease.
What metabolic disturbance occurs if ileum is used as a urinary conduit?
Non-anion gap metabolic acidosis.
Irregular heart rate, tachycardia, different morphologies for P waves…
Diagnosis?
Multifocal atrial tachycardia.
What eye problem do you suspect in a patient complaining if increased glare?
Cataracts.
What is the most prevalent gynecological disorder associated with chronic pelvic pain?
Endometriosis.
Patients with an inferior wall myocardial infarction should get a…
… Right sided ECG.
Girl with rounded face, obesity, short 4th and 5th fingers, area of subcutaneous calcification and evidence of hypocalcemia.
Diagnosis?
Pseudohypoparathyroidism type 1a.
Which body part has the highest per cutaneous absorption of topical steroids?
Scrotum.
Which antibody is the most specific for SLE?
Anti Smith Antibody.
What is the most common site if involvement of cicatricial pemphigoid?
Oral mucosa.
In dermatomyositis, which auto antibody is indicative of increased risk of pulmonary disease?
Anti-Jo-1 antibody.
When do you do aggressive suctioning in the setting of aspiration pneumonia?
When the patient is vomiting or it is an acute event.
What exposure would you expect in a car painter who develops lung disease?
Isocyanate
What does estrogen do to the HDL?
Increases it.
Are toll-like receptors (TLR) part of the innate or acquired immune system?
Innate immune system.
What organism causes (erosio interdigitalis blastomycetica) white stuff between fingers?
Candida albicans.
What kind of tumor do patients with Zollinger Ellison syndrome have?
Gastrinoma.
What is ectropion?
Eyelid margins turned away from the eye.
Is sickle cell disease an absolute contraindication to oral contraceptives?
Yes.
What should you expect in patients with hemoptysis who are homeless?
Tuberculosis.
What is the most common endocrine abnormality found in adrenal incidentalomas?
Autonomous cortisol hypersecretion.
Patient with recurrent infections, eczema, and thrombocytopenia.
Diagnosis?
Wiskott-Aldrich syndrome.
What are the risk factors for developing ARDS in trauma patients?
- Female sex.
- Chronic Alcohol Abuse.
- Cigarette smoking.
- Advanced age
If the calcium containing phosphate binding drugs used in chronic kidney disease cause hyperkalemia; then what phosphate binders can be used?
Lanthanum carbonate.
Sevelamer.
What is the most common cause of nephrotic syndrome in adults?
Membranous glomerulonephritis.
Is hyperlipidemia a possible metabolic abnormality with long term systemic glucocorticosteroid therapy?
Yes
Which site of squamous cell carcinoma has the greatest risk of metastasis?
Lip.
What kind of therapy do you need to give for transitional cell carcinoma of the bladder?
Intravesical therapy.
Young patient with persistent isolated asymptomatic microhematuria.
Diagnosis?
Thin basement membrane nephropathy.
If someone has a high grade dysplasia on biopsies obtained with EGD for Barrett’s esophagus then what is the longest time they can wait before getting an EGD if they don’t want to get surgery or endoscopic resection at this time?
3 months
Does propranolol disrupt sleep structure?
Yes.
What medication can be used to medically treat recurrent obscure GI bleeding likely secondary to angioectasias?
Thalidomide.
Compared to non smokers, how much greater is the risk of stroke in active smokers?
Four fold.
Compared to nonsmokers, what is the risk of stroke in former smokers?
Two fold.
Compared to non-smokers, what is the risk of stroke of smokers with hypertension?
Twenty fold.
What disease is pseudofolliculitis barbae associated with?
End stage renal disease.
What is the first step if a patient ingests a caustic substance causing burns to the throat and upper airway?
Emergent laryngoscopy.
Which subtype of HPV has been implicated in giant conduloma of Buschke and Lowenstein and anogenital condyloma?
HPV type 6.
What antibody immune complexes are expected to be found on direct immunoflorescence in Henoch-Schonlein purpura?
IgA.
Do pleural effusions from nephrotic syndrome usually cause dyspnea at rest?
No.
If a serrated adenoma is found during colonoscopy; when does the patient need to have the next colonoscopy?
After one year.
What is the target range of hemoglobin in dialysis patients?
10 - 11 g/dl
What system is involved in most women with chronic pelvic pain?
Gastrointestinal system.
What’s an MDCT of the chest?
CT PE protocol.
What is the potency of Halobetasol propionate cream 0.05%?
Super potent Class 1 topical steroid.
What should you try to do in a patient with subclinical hyperthyroidism and osteoporosis?
Investigate the cause by a radioactive iodine uptake scan.
What disease is associated with pterygium like formations on the nails?
(Hint: patient has arthritis)
Systemic sclerosis.
How do you treat jelly bean stings?
5% acetic acid.
What state is angiosarcoma related to?
Chronic lymphadematous states.
What cardiovascular defect is associated with Turner’s syndrome?
Coarctation of aorta and aortic dissection.
Which disease is herpes gestationis associated with?
Grave’s disease.
Generally when is an MRI breast done?
Evaluating breast implants.
Metastasis where the breast may have the occult primary.
Does jaundice cause confusion?
No.
What is adrenal hemorrhage most frequently associated with?
Heparin induced thrombocytopenia.
Can nephrogenic systemic fibrosis be fatal?
Yes
What is the optimal initial therapy for severe symptomatic hypercalcemia?
Intravenous hydration and calcitonin.
Which malignancy commonly cause ectopic vitamin 1,25 OH D production?
Hodgkin’s lymphoma
Which joint disease is para-articular osteopenia seen in?
Rheumatoid Arthritis
Does papillary muscle rupture and acute mitral regurgitation cause palpable thrill?
No.
If a heart failure patient with a low ejection fraction has symptoms on maximal medical therapy, what can be done to improve symptoms, functional capacity and survival rate?
Biventricular pacemaker.
What differentiates NSAID induced interstitial nephritis from other kinds of interstitial nephritis?
Absence of urine eosinophils in NSAID induced interstitial nephritis.
What happens to the heart sounds in first degree block?
S1 decreases in intensity
Where can a DVT best be investigated by compression ultrasound?
The superficial femoral vein.
How do you manage necrotizing pancreatitis with no evidence of infection?
IV hydration continued. If not better in 2 - 3 weeks the surgical debridement considered.
Are prophylactic antibiotics recommended for procedures such as bronchoscopies?
No.
Which anti-scabies medication interferes with GABA function?
Lindane.
What happens if you don’t treat tuberculous pleural effusions?
Most resolve spontaneously within 4 - 16 weeks.