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Step 2 Stuff > Medicine stuff 2 > Flashcards

Medicine stuff 2 Flashcards

1
Q

Proximal muscle weakness PLUS anxiety, palpitations/tachycardia, weight loss - think?

A

hyperthryroidism

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2
Q

Treatment for PLT dysfunction?

A

DDAVP (desmopressin) - NOT platelet transfusion

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3
Q

Alopecia, irregular menses, obesity - think?

A

PCOS

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4
Q

Most common electrolyte abnormality in alcoholics?

Which can cause refractory what?

A

Hypomagnesiumemia

Hypokalemia

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5
Q

Hypertension, hyperglycemia, weight gain - think?

A

Cushing

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6
Q

Recurrent bacterial infections in ADULT - think?

Best test?

A

Common vaircable immunodeficinecy

Quant measurement of serum IgG showing sevrely reduced IgG and low IgA and/or IgM

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7
Q

Study that randomizes to different interventions with additional study of 2 or more variables is what type of study?

A

Factorial design

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8
Q

Two age range peaks for ulcerative colitis diagnosis?

A

15-40 and 50-80

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9
Q

Chronic Hep C diagnosis (2 steps)?

A

Positive serologic Ab test AND hep C viral RNA

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10
Q

Low platelets due to HIT - stop heparin and replace with what?

A

Alternate agent eg argabotran, fondaprinux, then when >150 go to warfarin

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11
Q

Immobilization: hypo or hyper-calcemia?

A

HYPER, increased osteoclast activity

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12
Q

ARP (attributable risk percent) equation?

A

ARP = (RR - 1)/RR

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13
Q

Erythema nodosum, suspected sarcoidosis, but no resp sx - best test?

A

CXR!! even tho no sx

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14
Q

What HgB level does Fe defic anemia become microcytic?

A

<10

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15
Q

Painless hematuria, smoking history - think?

A

bladder cancer

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16
Q

Most common extraskeletal complication of ankylosing spondylitis?

A

Anterior uveitis

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17
Q

First step in suspected PE (esp. if pt in distress)?

A

Start anti-coag (heparin)

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18
Q

Cardiolipin (anti-phospholipid) can give a false positive to what test?

A

RPR (syphilis)

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19
Q

Acute, uncomplicated low back pain - tx?

Chronic?

A

NSAIDs and normal activity

PT

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20
Q

Asymptomatic endometriosis - do what?

A

Observe

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21
Q

Lung problem in systemic sclerosis?

A

ILD

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22
Q

Numbness/pain in foot with clicking sensation between 3rd and 4th metatarsals?
Tx?

A

Morton neuroma

Conservative - metatarsal support and shoe inserts

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23
Q

Virus that causes a transient arthritis with similar sx to RA?

A

Parvovirus B19

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24
Q

GI sx and livedo reticularis post-vascular procedure - think?
If the GI prob is acute pancreatitis - tx?

A

Cholesterol embolism

Pain meds and IVF

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25
Q

COntact lens wearer with conjunctivitis sx BUT also has corneal involvement - think?
Organisms?

A 
Keratitis
usually GNs (esp pseudomonas or serratia)
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26
Q

RA with neutropenia and splenomegaly - think?

A

Felty’s syndrome (an autoimmune dz)

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27
Q

Name for when study population changes behaviour when they know they are being studied?

A

Hawthorne effect

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28
Q

Bite cells and Heinz bodies (RBC inclusions) - think?

A

G6PD defic

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29
Q

Elevated alk phos and mixed osteolytic and sclerotic bone lesions with focal enlargement of bones - think?
Tx?

A

Paget’s dz of the bone

Bisphosphonates

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30
Q

Age range for getting a statin with DM?

A

40-75

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31
Q

Most common casue of sudden cardiac arrest in immediate post MI period?

A

Reentrant ventricular arrythmias (v-Fib)

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32
Q

Ank spondy: HLA-B27 or x-ray to see sacroiliitis for diagnx?

A

Xray

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33
Q

LVV (low tidal volume vent) in ARDS avoids what?

A

overdistension of alveoli

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34
Q

Joints looks like inflammaorty arthritis but calcifcations seen on XRay - thikn?

A

pseudogout

calcium pyrophopsphate dihydrate crystals (CPPD)

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35
Q

Monocular vision loss - with cherry red spot on macula?
With floaters?
With diffuse hemorrhages?

A

retinal ARTERY occlusion
vitreous hemorrhage or retinal detachment (curtain here from periphery)
retinal VEIN occlsion

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36
Q

Odds ratio is very close to relative risk if outcome is common or uncommon in the population?

A

uncommon

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37
Q

4 meds classes to think about with pill esophagitis?

A

tetracyclines, KCl, bisphosphonates, NSAIDs

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38
Q

How does sodium bicarb help TCA overdose?

A

alleviates depressant action on heart muscle sodium channels (NOT aiding excretion of TCA like acetaminophen)

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39
Q

Ho to work out number needed to treat from ARR?

A

NNT = 1/ARR

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40
Q

Abx for legionella?

A

FQs or Macrolides

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41
Q

Resp distress with NEURO abnormalities and PETECHIAL RASH 12-72 hours (and LONG BONE fracture)?
But more rapid onset and WITHOUT NEURO sx, patchy alveolar infiltrates?

A

Fat embolism

Pulmonary contusion

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42
Q 
DI vs SIADH
Hyponatremia and concentrated urine?
Hypernatremia and dilute urine?
Next step for DI?
Tx?
A

SIADH
DI (these findings rule out primary polydipsia)
Water deprviation test for DI for central vs nephro, if central then corrects 50% with desmopressin, no change if nephro
Intranasal desmopressin

43
Q

Diagnostic imaging for suspected ureteral stones (pain on flank or abd radiating to groin with n/v)?

A

US or noncontrast CT

44
Q

Kidney: increased ECM, BM thickening, mesangial expansion, fibrosis - caused by what underlying dz?
And if it were sclerosis of arterioles and glomerular capillary tufts - caused by?

45
Q

H pylori associated cancers?

A

Gastric adenocarcinoma and MALT lymphoma

46
Q

Very common GI prob found on endoscopy and associated with chronic constipation?
Best dietary intervention/lifestye mod?

A

Diverticulosis

More fiber

47
Q

HIV: CD4 count where live vaccines (MMR, varicella, zoster) are contraindicated?
So what vaccines for HIV pt with CD4 <200?

A

<200

annual flu, Td if nec time-wise, varicella, pneumoccal PCV13 THEN PPSV23) and HBV

48
Q

More likely to embolize to PE - distal/calf clots or proximal (femoral/popliteal/iliacs)?

49
Q

Fever in PE?

Low O2 sat and Afib with PE are good or bad for prognosis?

A

Yes, low grade

BAD

50
Q

Latent TB in HIV positive: what size PPD induration?

Tx?

A 
>5mm
Isoniazid and pyridoxine for 9 mo
If active (sx) then 4 drug tx
51
Q

Electrolyte abnormality that is an indicator of how bad CHF is?

A

hyponatremia

52
Q

Reaction to nickel (like posion ivy) is what type of reaction?

A

Type IV hypersensitivity

Low to mid -potency topical steroid

53
Q

Do you need fever and/or leukocytosis for (lumbar) osteomyelitis?

54
Q

Urge incontinence - 1st line then 2nd line?

A

PFEs and bladder training

Then oxybutynin

55
Q

Psedomonas coverage …

A

FQs (cipro)

Pip-taz (zosyn), ceftazidime cefepime

56
Q

Boerhave (esophageal tear) vs Mallory Weiss presentation?

A

Crepitus (pneumomediastium) in Boerhave and hematemesis in MW (MW only partial tear of mucosa at GE jxn)

57
Q

Malaria prophylaxis - drugs and timing?

A

Chlorogquine, but if resistant area (likely) then mefloquine or others
2 weeks before until 4 weeks after trip

58
Q

The marine bacteria associated with the ocean causing food borne illness in oysters and wound infections?
Disease of which organ increased risk?

A

vibrio vulnificus

Liver

59
Q

Actinic keratosis looks like (and can progress to) this skin cancer (scaly plaques)?

60
Q

Hyperthyroid sx. Low RAIU hwo do you tell exogenous intake vs thyroidtits or iodide expsoure?

A

Get a serum thyroglobulin. Low in exogeonous use, high in others

61
Q

Contraction alkalosis - from loss of fluid/acid/NaCL form vomiting - treat with?

62
Q

High output heart failure - think possibly?

A

AVF, can be result of trauma

63
Q

COPD exacerbation tx (4 big ones)

A 
O2 (target sats 88-92)
Inhaled bronchodilators
Systemic glucocorticoids
ABX (if 2 or more cardinal sx)
Tamiflu if flu
NPPV or intubation if fails
64
Q

HIV:

AMC prophylaxis - what CD4 count and what drug?

A

<50, azithro

65
Q

Bloody diarrhea with no travel history (3)?

A

E Coli (EHEC) - MOST COMMON
Shigella
Campy

66
Q

Which thyroid cancer involves calcitonin?

67
Q

Which thyroid cancer has psammoma bodies?

68
Q

Which thyroid cancer spread by blood?

A

follicular

69
Q

Steven Johnsons vs TENs - differentiated by area of body affected but what numbers?

A

<10 SJS
10-30 overlap
>30 TENS

70
Q

Aortic dissection - next steps if HD stable, then unstable?

A

If stable, CT angiography, if unstable then pericardioecentesis

71
Q

Tighter the confidence interval the more ______ the result.

72
Q

Strep sanguinis is a type of strep _______?

73
Q

Involvement of mouth mucosa - Crohn’s or UC?

74
Q

Fever, tinnitus, tachypnea - OD of what?

75
Q

Non-EtOH fatty liver disease associated with what?

A

insulin resistance

76
Q

Mild DM, rash, weight loss - think?

A

glucagonoma

77
Q

Trypanosoma cruzi causes what dz?
Sx?
What continent?

A

Chagas
megaesophaus, megacolon, cardiac dysfunction
Latin America

78
Q

Definitive diagnostic test for polymyositis?

Showing what?

A

Muscle biopsy

Mononuclear infiltrate surrounding necrotic and regenerating muscle fibers (yeah, whatever)

79
Q

Elbow pain, reproducible on passive flexion or resisted extension - think?

A

lateral epicondylitis

80
Q

Which meds to hold prior to stress test?

A

B-blockers, CCBs, nitrates

81
Q

Painful monocular vision loss with a centrla “smudge”, changes in color - think?
Associated with what dz?

A

Optic neuritis

MS

82
Q

Endocarditis associated with nosocomail UTI - bug?

A

enterococcus

83
Q

Where’s the birds beak in achalasia?

A

right next to the LES!

84
Q

Ring enhancing lesions on MRI, HIV patient suggests?

Prophylactic med?

A

toxo

bactrim (like PCP)

85
Q

Neutropenic fever - empiric abx choice?

A

make sure you conver GN and pseudomonas so pip-taz, cefepime or meropenem etc.

86
Q

Uremia - diagnosed by clinical sx and also a high?

87
Q

Cystic heptaic lesion with eggshell calcification and contact with dogs - think?
Organism?
Tx?

A

Hydatid cyst
Ecchinococcus granulosus
Surgery with abendazole

88
Q

2 classes of drugs that can cause unsafe hypertension with sildenafil?

A

nitrates and a-blockers

89
Q

D-xylose test used to test for what?

And what result would you see?

A

Celiac dz

Low urine output of D-xylose

90
Q

acute diverticulitis imaging?

A

CT abd contrast

91
Q

acute liver failure - 2 things required for diagnosis?

A

encephalopathy and impaired synthetic fxn (INR >1.5 or = 1.5)

92
Q

devleoped countries, 80% of adrenal insufficinecy is casued by what?

A

autoimmune adrenalitis

93
Q

Nephrtoic syndrome increases risk of what?

A

Atherosclerosis and thrombosis

Hypoproteinemia causes liver to increase production of proteins AND lipids leading to hyperlipidemia

94
Q

Drug to reverse antichlolinergic toxicity?

A

physostigmine, a cholinesterase inhinitor

95
Q

Effect of raising a cutoff point on specigicity and sensitivity?

A

Spec up

Sens down

96
Q

Blood in the joint after ACL injury (T/F)?

97
Q 
Timing and vessel for these MI complications:
RV failure?
Pap muscle rupture?
Septum problem?
Free wall rupture?
A

acute (RCA)
acute and 3-5 days (RCA)
acute and 3-5 days (LAD apical, RCA basal)
5 days - 2 weeks (LAD)

98
Q

Symptomatic primary hyperparathyroidism in a pt <50 - next step?

A

Surgery (parathyroidectomy)

99
Q

Deformed feet, pain, effusion, in a patient with neuropathy (or high risk for neuropathy eg DM)?

A

Charcot joint (neurogenic arthropathy)

100
Q

Diabetic neuropathy is an axonopathy of nerve fibers:
Large or small cause pain/parasthesias?
Large or small cause loss numbness, proprioception loss, relfex decr?

A

Small

Large

101
Q

Fever and sore throat in anthithyroid drug patient - what side effect?
Next steps?

A

Agranulocytosis

Stop drug get WBC

102
Q

Hep A vaccination recommended for which groups (3)?

A

MSMs, travelers, chronic liver dz

103
Q

Hereditary hemochromatosis associated with what kind of joint pain?

A

pseudogout

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