Mehl. PED bullets general nr 3 Flashcards
16F + thin, grey, watery discharge + Dx is made by wet mount; Dx? Tx?
bacterial vaginosis
clue cells seen on wet mount
Tx with topical metronidazole gel.
16F + yellow-green discharge + Dx made by wet mount; Dx? Tx?
Trichomonas vaginalis
wet mount shows flagellated protozoa; strawberry cervix (punctate hemorrhages) or erythematous vaginal canal might be seen;
Tx with topical metronidazole for patient AND partner (high risk of reinfection).
Strawberry cervix (punctate hemorrhages) or erythematous vaginal canal might be see in what????????
trichomonas vaginalis
18M + positive Romberg sign + sexually active; Dx?
Answer on Neuro NBME = neurosyphilis
Can also present with Argyll-Robertson pupil.
17M + skin-colored papules on penile shaft; Tx?
answer = podophyllum resin
Tx for HPV (this is also the answer on the Obgyn NBME for vulvar condylomata acuminata).
17M + went to Uganda over summer vacation + has painful crater on base of penile shaft; Dx?
haemophilus ducreyi
Tx = azithromycin.
17F + BMI 28 + erythematous and itchy vulva + no mention of discharge but Q asks for organism; Dx? Tx?
candidiasis; classically curd-like, white discharge.
Tx = first: topical nystatin first; then oral fluconazole
16M + sexually active + left knee pain + fever + S. aureus not listed as answer; Dx?
gonococcal arthritis
16M + redness of both eyes + rash over extremities + mucopurulent urethral discharge; Dx? Cause?
Reactive arthritis
due to chlamydia; gonococcus does not cause reactive arthritis.
16M + polyarthritis + positive Finkelstein test + cutaneous papules over the wrist; Dx?
gonococcal arthritis
will present either as monoarthritis of large joint, such as the knee, or as a triad of polyarthritis, tenosynovitis, and cutaneous papules.
Caput succedaneum?
CROSS SUTURE
Poorly defined soft tissue edema on the scalp; caused by pressure of
fetal scalp against cervix during parturition, leading to transient decreased blood flow and reactive edema; crosses suture lines; can be purplish in color similar to cephalohematoma
(i.e., don’t use color to distinguish); complications rare; disappears in hours to few days.
Cephalohematoma?
DOES NOT CROSS SUTURE
Well-defined, localized, fluctuant swelling; caused by subperiosteal
hemorrhage (answer on Peds NBME = “blood under periosteum of parietal bone”); does not cross suture lines; may be associated with underlying skull fracture, clotting disorders, jaundice; disappears in weeks to months.
8M + non-productive cough worse at night + SoB during the day + CXR shows mild hyperinflation; next best step in Dx?
What can be esophageal disease?
Spirometry
Dx = asthma.
Dysphagia to solids +/- weight loss +
upper endoscopy shows many concentric rings; Dx? eosinophilic esophagitis. ,,Trachealisation”
17F + HTN + low K + high bicarb; next best step?
MR angiogram of renal arteries; Dx = fibromuscular dysplasia; another answer = “increased renin production.”
