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Step 2 > NBME 7 > Flashcards

NBME 7 Flashcards

1
Q

what is mupirocin

A

topical treatment for impetigo

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2
Q

what is triamcinilone

A

glucocorticoid topical treatment

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3
Q

how does a pt with diabetes insipidus present

A

hypernatremia with dilute urine and polyuria

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4
Q

what do you give to someone in an acute gout flare

A

you start with NSAIDs and try Celecoxib and then Indomethacin
if those dont work then move on glucocorticoids

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5
Q

pts with Crohns disease comes in with abdominal pain, n/v, and tender abdomen

A

likely due to stricture from crohns

-creating a small bowel obstruction

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6
Q

patient who looks like it might be pyelo but they have pain thats reponsive to morphine, what do you think of

A

kidney stone

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7
Q

what should you look at if an inpatient person suddenly has a decrease in renal function

A

check to see if they had any angiography or anything with contrast done cause this can mess up the kidney
-prevent kidney damage by these with extra hydration

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8
Q

what is becks triad and how do you treat it

A

becks triad: hypotension, JVD, muffled heart sounds (also electrical alternans)

  • this is for cardiac tamponade
  • treat it surgically by creating a pericardial window to drain the fluid
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9
Q

whatre the PAIR diseases (spondyloarthopathies)

A

Psoriatic arthritis: arthritis and nail pitting
Ankylosing spondylitis: back pain with morning stiffness relieved by exercise (bamboo spine)
IBD-related: enteroarthropathies, bilateral arthritis
Reactive arthritis: cant pee, climb a tree, see

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10
Q

what part of the aorta is most likely to get ruptured in a accel-decel MVA

A

thoracic aorta

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11
Q

baby to be born from someone who has herpes (no active lesions)

A
  • give acyclovir at 36 weeks
  • if they have active lesions then do c-section
  • if no active lesions then do vaginal birth
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12
Q

drug intoxication in a person with nystagmus… what drug do you think of

A

PCP

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13
Q

when a pt has an infection what happens to glucose

A

increases in the blood stream so you have a higher need for insulin (if diabetic)

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14
Q

any sort of dental work mentioned in a person with an artificial valve, what do you think of

A

strep viridans

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15
Q

what electrolyte abnormality can cause PVCs

A

hypokalemia

-especially in someone taking digoxin cause there is more digoxin binding to Na/K pump leading to cardiac dysfunction

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16
Q

just b/c a pt had a cholecystectomy doesnt mean they wont have a residual stone, what do you do if this person develops RUQ pain, fever, and jaundice?

A

this is charcots triad for acute cholangitis
-get ERCP

-if they also had altered mental status and hypotension that would be reynolds pentad

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17
Q

thoracostomy vs cricothyrotomy

A 
thoracostomy = chest tube 
cricothyrotomy =  throat tube to establish airway
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18
Q

how long does staph aureus food poisoning last

A

resolves within 24 hours

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19
Q

cramping abdominal pain and watery stool for 4 days with no pmns in the poop

A

ETEC

also possibly vibrio, cereus, or giardia depending on the story

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20
Q

patient with lyme disease and you want to protect the heart, what do you give

A

amoxicillin to treat the lyme disease

give doxy as first line unless its not an option or its a pregnant lady or child under 8

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21
Q

compare and contrast ABO vs Rh incompatibility in newborns with jaundice and high bilirubin levels

A

ABO incompatibility is not as severe as Rh cause ABO antibodies are IgM and dont cross the placenta but Rh is IgG and does cross the placenta
-if they say anything about an edematous baby then think Rh incompatibility cause it could be hydrops (caused by Rh)

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22
Q

sensation of bugs crawling on you (delusional paratosis) with skin picking or scratching is from what drug

A

methamphetamines

-treat w/ benzos

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23
Q

what do you think about in a boy pt who keeps getting sick with encapsulated organisms

A

x-linked brutons agammaglobulinemia
-problem with b-lymphocytes and plasma cells, you have none that can actually make the immunglobulins

SHiN for encapsulated organisms (strep pneumo, haemophilis influenza, neisseria)

24
Q

pt has a history of abscesses with catalase + organisms

A

chronic granulomatous disease

  • NADPH deficiency
  • problem with neutrophils
25
Q

what are the only 2 systolic murmurs

A

mitral regurg

aortic stenosis

26
Q

patients with multiple myeloma have increased risk of what types of infections

A

anything encapsulated

  • strep pneumo
  • H. influenza
  • neisseria
27
Q

acute stress disorder vs PTSD

A

same thing but acute stress disorder is 3 days to 1 month and PTSD is longer than 1 month

28
Q

pt presents with fever, RUQ pain, mild scleral icterus, and positive murphys sign with a normal sized common bile duct

A

acute cholecystitis

-cholangitis would have negative murphys and a dilated common bile duct with a high alk phos

29
Q

patient at a summer camp or dorm or some closed off space with people then gets sick and has altered mental status

A

think meningococcemia

30
Q

what could the following things cause:

  • sepsis
  • aminoglycosides
  • ischemia/hypotension
  • heavy metals, radiocontrast
  • ethylene glycol
  • rhabdomyolysis
A

acute tubular necrosis

31
Q

what do you look for to see if its aspirin toxicity

A

fast respirations, tinnitus, kidney damage (increased creatinine)
-otherwise you can try to look for a mixed anion gap metabolic acidosis with significant respiratory alkalosis

32
Q

young boy with tibial tubercle pain, what do you think of

A

osgood shlatter (repeated microfractures at tendon insertion site)

33
Q

patient has nipple peeling, scaling, cracking but no mass

A

pagets disease of breast

-50% have negative mammogram and no calcifications

34
Q

a little breast discharge that is non-spontaneous, non-bloody with minimal discharge and normal physical exam and images

A

physiologic discharge

35
Q

history of increased activity, localized pain to anterior chest that worsens with deep movement and coughing, there is tenderness to palpation of the affected area

A

costochondritis

-self-limiting and will resolve within weeks to a year

36
Q

how to treat mom with + GBS if she is(nt) allergic to penicillin

A

no allergy: IV penicillin G
mild allergy: cefazolin
severe allergy: clindamycin/erythromycin

37
Q

how to treat lead poisoning

A

chelation or EDTA (calcium disodium edetate)

38
Q

young pt with recurrent facial swelling (angioedema) with a family history of the same thing
-also presents with colicky abdominal pain and GI symptoms

A

C1 esterase inhibitor deficiency

-leads to impaired bradykinin breakdown

39
Q

what arteries are you concerned about for each of these areas if the pt presents with claudication

foot only

calf only

thigh and calf

butt, thigh, calf, with possible impotence

A

foot only: tibulofibular

calf claudication: femoropopliteal artery

thigh and calf claudication: external iliac artery

gluteal/thigh/calf claudication (possible impotence): aortoiliac artery

40
Q

what does wernicke-korsakoffs look like

A

Classic triad

  1. Ataxia
  2. Confusion
  3. Ophthalmoplegia

If you see confabulation, personality change, memory loss then its Korsakoffs and the memory loss is permanent

41
Q

patient with panic attack in MRI, how to help them…

A

give them a benzo before going in again

42
Q

compare and contrast arterial vs venous stasis/insufficiency

A

arterial

  • claudication
  • shiny hairless legs
  • necrosis at the tips of the toes

venous

  • ulcers on the medial aspect of the legs
  • lower extremity edema
  • pulses still palpable even if weak
43
Q

when to give a newborn varicella prophylaxis

A

only if the mother developed varicella less than 5 days before delivery or even up to 2 days after delivery
-if so then prophylax the newborn with immunglobin

44
Q

what is spondylolithesis

A

palpable step-off and lateral x-ray shows forward slippage of one of the key vertebral bodies
pain with spinal extension

45
Q

right subclavian catheter placed… what is on your mind

A

pneumothorax

46
Q

cerebral palsy vs spinal dysraphism

A

cerebral palsy

  • presents in childhood with missed milestones
  • comorbid seizures and intellectual disability
  • abnormal muscle tone

spinal dysraphism

  • presents at birth with foot deformities
  • lower limb paralysis and numbness with a full bladder
  • spinal cord injury affecting lower extremities –> neural tube defect
47
Q

next step if pt isnt responding to iv fluids and is bleeding

A

give them blood products

48
Q

supraclavicular node plus splenomegaly, what do you think of

A

hodgkins lymphoma

-associated with pruritis on NBME exams cause of increased lactate dehydrogenase

49
Q

how does retinal detachment present

A

flashes and floaters, curtain drawn down then monocular vision loss

50
Q

how does macular degeneration present

A

older pt with loss of central vision and a straight line appears curved

51
Q

how does disseminated gonococcemia present

A

dermatitis, oligoarthritis, enthesitis OR monoarticular septic arthritis

52
Q

what to think of when a pt has cervical motion tenderness

A

PID or ectopic pregnancy

-if PID think of fever, pharyngeal erythema, RLQ and cervical motion tenderness- will a negative pregnancy test

53
Q

what are propylthiouracil and methimazole used for

A

they are used to treat hyperthyroidism by clocking thyroid peroxidase

54
Q

how does a zinc deficiency present

A

alopecia, dermatitis, scaly skin around eyes and mouth, abnormal taste, impaired wound healing

55
Q

how does copper deficiency present

A

hematologic abnormalities (microcytic anemia, leukopenia) and myeloneuropathy

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