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Rosh Review NBME > Missed Q's > Flashcards

Missed Q's Flashcards

1
Q

What complication is MC associated w/Bell’s palsy?

A

Corneal exposure keratitis

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2
Q

Pt w/suspected Bell’s Palsy that is able to wrinkle forehead on affected side indicates what?

If it does NOT spare the forehead, then what?

A

Central lesion

Bell’s Palsy

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3
Q

B/L facial nerve paralysis ddx?

A

Lyme
Infectious mono
HIV
Botulism

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4
Q

Rhabdo UA shows what?

Goal of therapy is what?

E- abnormalities?

A

3+ blood, no rbcs

Urine output of 3 mL/kg/hr

Hyper K and PO4, low Ca

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5
Q

What test in pts w/GBS correlates w/need for intubation?

A

Dec FVC

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6
Q

What characterizes a Galeazzi fracture?

A

Fracture of distal 1/3 of radial shaft

Disruption of distal radioulnar joint (DRUJJ)

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7
Q

Pt w/exquisite sensitivity to percussion or chewing w/acute pain, swelling and mild tooth elevation has what?

Common predisposing condition?

A

Periapical abscess

Cavities

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8
Q

What is alveolar osteitis?

A

Dry socket

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9
Q

ABD pain, bleeding, tenesmus in setting of active radiation therapy indicate what?

A

Acute radiation proctocolitis

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10
Q

MC cause of SVC syndrome?

MC presenting symptom?

A

Malignancy

Dyspnea from mediastinal compression

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11
Q

Liver Cirrhosis causes asterisks how?

A

Inc metabolism of ammonia leads to inc Glutamine in CNS

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12
Q

Cocaine OD is aka what?

Treat how?
Avoid?

A

Sympathomimetic toxidrome

Benzos
BBlockers

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13
Q

What cofactors need to be given with ethylene glycol poisoning?

A

B1, B6

Thiamine and pyridoxine

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14
Q

Pt w/eye exam showing superficial punctate epithelial surface irregularities which cover the entire cornea has what? Often seen in b/l eyes

Treatment?

A

UV keratitis

Topical NSAIDs +/- abx or cycloplegics

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15
Q

Treat klebsiella PNA how?

A

3rd gen cephalosporin + aminoglycoside

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16
Q

Pt w/organophosphate poisoning, how long do you keep giving atropine?

Why?

Dose and route?

A

Until respiratory secretions decrease

Mortality linked to ventilatory failure from severe secretions and bronchoconstriction

2-4 mg IM

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17
Q

Pt w/ankle pain needs xray when?

A

Tenderness to posterior edge of LATERAL Malleolus

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18
Q

A spiral fracture of the proximal 1/3 of the fibula assoc w/tear of the distal tibiofibular syndesmosis and the interosseous membrane is what?

A

Maisonneuve fracture

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19
Q

Treatment of acute sinusitis?

After 7-10 days treat how?

A

NSAID

Abx

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20
Q

Volar wrist refers to what?

A

Palmar aspect

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21
Q

Thyroid storm, what is the initial treatment? What does it do?

A

1) BB - blocks peripheral effects of hormone

2) dexamethasone - blocks peripheral conversion of T4 to T3 (steroids also help with any AI)

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22
Q

What layer of skin edema defines urticaria?

A

Dermis - via transvascular fluid extravasated

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23
Q

STEMI is differentiated from pericarditis how?

A

STEMI has reciprocal ST depression

If inferior MI, look for ST depression in leads aVL, V1, V2

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24
Q

What are the correct positions (2) for electrode pad placement for cardioversion?

A

Left Ant chest and left upper back
OR
Right upper chest and left midaxillary line

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25
Q

What causes barotitis (middle ear barotrauma)?

A

Descent barotrauma

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26
Q

Which lab studies are unreliable when drawn from an IO?

Which med takes longer to take effect when delivered through IO?

A

Wbc, K, Ca, AST/ALT, blood O2

Succinylcholine

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27
Q

Cauda Equina syndrome is due to injury of what structures?

A

Lumbosacral nerve roots

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28
Q

What is the narrowest part of the airway in adults?

Children?

A

Vocal cords

Cricoid ring

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29
Q

Formula for predicting ET tube size in kids?

A

(Age + 16) / 4

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30
Q

What vascular structure can be injured w/proximal fibular fracture?

A

Anterior tibial artery

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31
Q

Pt w/high altitude cerebral edema, what is the treatment?

A

High-flow oxygen
Dexamethasone
Immediate descent

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32
Q

Pt that has a corneal abrasion, what is the management?

A

Lid eversion - looking for foreign body
Topical Abx
F/u with ophtho

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33
Q

What is Seidel’s sign?

Means what?

What is contraindicated?

A

Streaming of aqueous humor leaking from anterior chamber during fluorescein exam secondary to penetration of the cornea

Globe rupture

Measuring IOP

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34
Q

Jones fracture (transverse fracture in the diaphysis of the bone 1.5 cm distal to end of bone aka base of 5th metatarsal ) should be treated how?

A

Immobilized w/posterior splint

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35
Q

What traumatic injury to the eye will result in significantly increased IOP?

A

Retrobulbar hematoma

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36
Q

Treatment of otitis externa?

A

Mild - Acetic acid/hydrocortisone

Mod/Severe - Cipro/hydro

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37
Q

Pt with an AICD is getting frequent shocks d/t malfunction, what can you do?

What happens?

How is ICD different from pacemaker on Xray?

A

Place magnet over it

Paces only, no shocks

Thicker wire in distal lead

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38
Q

Pt with palpitations after getting Holliday heart but no other symptoms, what is the treatment?

A

Observation 24-48 hours

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39
Q

What is the MC form of botulism?

A

Infantile

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40
Q

What causes a Lisfranc injury?

Pain where?

What Xray shows it? What does it show?

A

Severe plantar flexion of foot usually by tripping

Tarsal metatarsal joint, dorsum of foot

AP view shows lateral shift of 2nd metatarsal off middle cunieform

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41
Q

Pt with acute pulmonary edema should be treated with what immediately?

What other interventions?

A

Nitroglycerin

BiPAP, furosemide, nesiritide

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42
Q

What artery is responsible for blood supply to the AV node?

Occlusion can result in what?

A

RCA

Complete heart block

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43
Q

What are the 2 techniques to correct nursemaid’s elbow?

A

Hyperpronation

Supination then elbow flexion

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44
Q

What does the inferior alveolar nerve block anesthetize?

A

All mandibular teeth to the midline, anterior 2/3 of tongue, floor of oral cavity

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45
Q

Intubated patients should be managed how on a ventilator?

A

I:E ratio of 1:3 or 1:4

Inspiratory flow rate inc > 100 L/min

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46
Q

Where does the spinal cord terminate in adults?

Infants?

What is the name of the terminal end of the spinal cord?

A

L1/L2

L3

Conus medullaris

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47
Q

What can happen to the eye after blunt trauma?

Treat how?

A

Iridocyclitis

Homatropine - dilates pupil

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48
Q

What are the 5 H’s in asystole?

A 
Hypoxia
Hypovolemia
Hypo/hyperkalemia
Hypothermia
H+ - acidosis
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49
Q

What are the 5 T’s in asystole?

A 
Thromboembolism (PE)
Thrombosis (MI)
Tension PTX
Tamponade - pericardial
Toxin
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50
Q

Treatment for serotonin syndrome?

A

Benzos

Cyprohepatidine

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51
Q

Treatment for NMS?

A

Bromocriptine

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52
Q

Patient that has frostbite, how do you treat?

A

WET rewarming, ideally a whirlpool

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53
Q

What otc drug is associated with serotonin syndrome?

A

Dextromethorphan

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54
Q

How long can digits survive ischemia when they are amputated?

Limbs?

A

8 hours

4-6

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55
Q

Patient w/skull fracture that is linear, what is the disposition?

Who should get antibiotics?

A

Admission for observation

Open, depressed skull fracture

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56
Q

Jellyfish sting, what is treatment?

A

Salt water then hot water

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57
Q

What is the treatment for bupivacaine poisoning?

What else does this treat?

A

Intralipid

Local anesthetics (lidocaine), BBs, CCBs, TCAs

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58
Q

Where do you place chest tubes?

A

4/5th ICS at midaxillary line

59
Q

What is the earliest US finding of cardiac tamponade?

How will the IVC appear in pericardial tamponade?

A

RA diastolic collapse

Plethoric (dilated and noncollapsable w/respiration)

60
Q

What is Mallet finger?

If it gets worse can become what?

Treatment?

A

Forced hyperflexion of DIP, cannot extend DIP

Swan neck deformity (hyperextension of PIP and flexion of DIP)

Splinting of DIP in full extension or slight hyperextension

61
Q

Why do bodybuilders use GHB?

Who else uses it?
PE shows what?

A

Elevates HGH

Nightclub goer
Agitation, bradycardia, respiratory depression

62
Q

How to treat hydrofluoric acid burn?

A

Irrigation and calcium gluconate

63
Q

What is the narrowest part of the airway in peds?

A

Cricoid cartilage

64
Q

What is the main difference in epiglottis bw adults and peds?

A

Peds is longer, narrower, omega shaped

65
Q

What is HHV-6?

A

Roseola

66
Q

Patient that overdosed on Benzos that now has a fever, why?

Dx how?

A

Aspiration PNA from passing out

CXR

67
Q

How do you treat a SALTER Harris type 1 fracture of the ankle?

A

Immobilize, non weight bearing

68
Q

Why do you give BB’s in acute MI?

A

Dec risk of ventricular dysrhythmia if given w/in 24 hours

69
Q

Le Fort fracture 1, 2, 3: describe

A

1 - speak no evil (lower face)
2 - see no evil (around the eyes)
3 - hear no evil (to the ears) —> can have rhinorrhea and cribriform plate disruption

70
Q

UNILATERAL disc herniation bw L4/L5 compresses which root?

A

L4

71
Q

Outpatient tx of PID?

A

Ceftriaxone 250mg IM

Doxy 100mg PO BID x 14 days

72
Q

When should you do a thoracotomy?

A

Chest tube output of > 20 mL/kg (or 1500 mL) or > 200 mL/hr

73
Q

Where do you perform needle decompression of the chest?

A

2nd ICS at midclavicular line

74
Q

What drugs in adults can be given via ET tube?

A 
NAVEL
Naloxone 
Atropine
Vasopressin
Epinephrine
Lidocaine
75
Q

What level of carboxyhemoglobin level indicates need for hyperbaric therapy?

What else?

A

> 25%

Syncope, coma, seizure, FND, confusion

76
Q

What causes bleeding into the anterior chamber of the eye secondary to blunt trauma?

A

Hyphema

77
Q

What is a Clay shoveler’s fracture?

Describe it?

A

Avulsion to SP of C6/C7

Stable

78
Q

Dementia patient has what kind of memory?

A

Good long-term recall

NO recall of immediate events

79
Q

What is the MC visceral artery aneurysm?

Dx how?

A

Splenic artery

Angiogram

80
Q

What is trephination?

A

Cutting a hole in the nail to release blood in subungual hematoma

81
Q

What occurs 1st in compartment syndrome?

Next?

A

Sensory deficit

Loss of pulses

82
Q

What are the Kanavel Criteria?

A

Tenderness along course of flexor tendon
Fusiform or symmetrical swelling of the finger
Pain w/passive extension
Flexed finger

83
Q

GHB main complications?

A

Respiratory depression

Rhabdomyolysis

84
Q

What is the MC abnormal vital sign in pt with a PE?

A

Tachypnea

85
Q

MC Primary brain tumor?

MC malignant tumor?

HA w/brain tumor worse when? Why?

A

Meningioma

Glioma

morning, ICP is highest

86
Q

Infant that presents w/sudden onset abdominal distention and bilious emesis has what?

Correct how?

A

Malrotation w/midgut volvulus

Ladd’s procedure

87
Q

What is the standard energy level for cardioversion?

Peds?

A

100 joules

.5-1 J/kg

88
Q

What is the San Fran criteria for syncope high risk?

A 
CHESS
CHF
Hct < 30%
ECG abnormal 
SOB
Systolic BP < 90
89
Q

What classifies to moderate persistent asthma?

A

Night awakenings > 1x/wk, aka 5 or more a month

90
Q

What drugs can cause asthma exacerbation?

A

ASA

BBlocker

91
Q

MC complication of basilar skull fracture?

A

CN entrapment: CN 7 - facial droop

92
Q

McRoberts maneuver uses what type of pressure?

A

Suprapubic

93
Q

What is the MC cause of dysentery in the US?

A

Shigella sonnei

94
Q

When is proper irrigation of chemical burn achieved?

A

PH between 7.0-7.2

95
Q

What nerve is MC injured in perilunate dislocation?

A

Median nerve

96
Q

Earliest neuro finding of heat stroke?

A

Ataxia

97
Q

How to treat Croup?

A

Dexamethasone and racemic Epi

98
Q

Treatment for isolate pubic ramus fracture (nondisplaced)?

A

Conservative treatment w/PT and weight bearing exercises

99
Q

What is a hematoma above inguinal ligament called?

Indicates what?

A

Destot’s sign

Pubic ramus fracture

100
Q

HIV exposure prophylaxis should be started when?

A

W/in 2 hours improves transmission prevention

101
Q

How does anticholinergic poisoning present?

Antidote?

A

Mad as a hatter, blind as a bat, red as a beet, hot as a hare, dry as a bone

Physostigmine - AChE-i

102
Q

What is a luxatio erecta?

A

Inferior GH dislocation, least common

Assoc w/axillary artery injury

103
Q

What causes diarrhea that was initially profuse and watery and then LATER becomes bloody?

A

Yersinia

104
Q

Clinical signs of epididymitis?

A

Increasing, dull, UNILATERAL scrotal pain
Erythematous, painful, swollen scrotum
Relief w/testicular elevation (Prehn’s sign)

105
Q

What is an Amp of D50?

A

25 grams of dextrose = 100 calories

Aka 25 grams / 50 mL

106
Q

50% dextrose means what?

A

50 grams / 100 mL

107
Q

ACLS epinephrine dose?

A

1mg (10 mL of 1:10,000)

108
Q

Anterior STEMI will have what reciprocal changes?

A

ST depression in III and aVF

109
Q

Acute ST elevation in lead aVR can indicate what?

A

Left main coronary artery

110
Q

What formula do you use for the DEPTH of an ET tube in pediatric pt?

A

(Age in yrs/2) + 12 OR 3x tube size

In centimeters

111
Q

What artery is indicated in a TIA that causes hemiplegia/quadriplegia, sensory changes, blindness, vertigo, difficulty speaking, etc?

A

Vertebrobasilar artery

112
Q

What is there early respiratory alkalosis in ASA poisoning?

A

ASA directly stimulates the respiratory center of the brain to cause hyperventilation

113
Q

Axial load falls directly on pt head, at risk for what fracture?

A

Jefferson Burst fracture of C1

114
Q

What causes vesicular rash around the ear canal, facial paralysis, and hearing loss?

A

Ramsay hunt syndrome caused by zoster

115
Q

Hypotensive patient with VTach what is the treatment?

A

Synchronized cardioversion

116
Q

What are the 5 treatments for HPV warts?

A 
Podofilox
Imiquimod
Cryotherapy
Trichloroacetic acid
Surgical removal
117
Q

Old pt that is constipated w/lots of comorbitidites and CT shows no obstruction has what?

Treat how?

A

Ogilvie syndrome

Neostigmine (SE: Bradycardia, asystole)

118
Q

MC fracture involving the elbow in children under 8 years old?

What nerve is injured?

A

Supracondylar fracture

Anterior interosseous - branch of median n.
Check w/“ok” sign

119
Q

Primary blast injury causes what injury?

Secondary?

Tertiary?

Quart?

A

TM rupture, pulmonary contusion

Injury via flying object

Victim flying through air and hit stuff

Burns, radiation, other injures

120
Q

Burns from military white PO4 munitions produces what lab abnormalities?

A

HypoCalcemia

HyperPO4

121
Q

What vessel is located at the commissure of the lip?

A

Labial artery

122
Q

How to manage acute COPD exacerbation?

A

Duoneb
PO Prednisone (60mg)
BiPAP
Abx

123
Q

Def in what vitamin causes anemia and peripheral neuropathy?

A

Vit B12

124
Q

Person going through opiate withdrawal what med to give for symptomatic relief?

A

Clonidine

125
Q

IT CRIES mneumonic?

A 
Infection
Trauma, tourniquet 
Cardiac disease 
Reflux, rxn to meds, rectal fissure
Intussusception 
Eye (corneal abrasion)
Strangulation, hernia
126
Q

Treatment for epididymitis in pts < 35?

> 35?

A

Ceftriaxone + Doxycycline

Bactrim or Levo/ciprofloxacin

127
Q

What is Hutchinson sign?

Means what?

A

Blistering at tip of nose

Shingles - herpes zoster

128
Q

Forced hyperextension causes what kind of injuries?

Called what?

Prognosis?

A

Sensory and motor, deficit UE > LE

Central cord

Average

129
Q

EKG changes d/t hyperkalemia other than peaked T waves?

A

Bradycardia, wide QRS, dropped/absent P waves

130
Q

GHB is used to treat what medical condition?

A

Narcolepsy

131
Q

What is AV-Nodal Reentrant Tachycardia?

Treat how?

A

MC cause of paroxysmal SVT

Adenosine if stable

132
Q

What is a classic symptom of PUD?

A

Pain that wakes pt up in the middle of the night bc acid production peaks at 2am

133
Q

What crown-rump length is a heartbeat expected on US?

A

5mm

134
Q

What is the inability to reduce the foreskin back to an atomic position called?

A

Paraphimosis

135
Q

What is phimosis?

A

Inability to retract the foreskin

136
Q

What can happen if septal hematoma left untreated?

What is the consequence of a septal hematoma?

How to determine if it is a septal hematoma?

A

Necrosis and septal perforation

Abscess, saddle nose deformity

Size will NOT change with administration of oxymetazoline

137
Q

What classes are local anesthetics divided into?

A

Esters - procaine (Aka Novocain)
Amides - lido, bupivacaine

All the amides have 2 “I’s” in their name, the esters only have 1!!!

138
Q

Pt that comes from the Caribbean and has severe, diffuse myalgia and arthralgia has what?

A

Dengue fever

139
Q

Old pt with abdominal pain and distention with nausea but NO vomiting often has what?

Treat how?

A

Sigmoid volvulus

Sigmoidoscopy

140
Q

What is splenic sequestration crisis?

Causes what?

A

Rapid splenic sequestration of RBCs

SM, severe anemia

141
Q

Acute chest syndrome has what CF?

CXR shows what?

A

Fever, CP

Pulmonary infiltrate

142
Q

What radiographic finding of a COPD pt suggest inc risk of a PTX?

A

Bullae

143
Q

What is normal compartment pressure?

What P is assoc w/ischemic necrosis?
What else to look for?

A

0-10 mmHg

30-40 mmHg
HoTN

Rosh Review NBME (1 decks)

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