NBME 7 Flashcards by Nava Lalehzari

what is mupirocin

topical treatment for impetigo

How well did you know this?

Not at all

Perfectly

what is triamcinilone

glucocorticoid topical treatment

How well did you know this?

Not at all

Perfectly

how does a pt with diabetes insipidus present

hypernatremia with dilute urine and polyuria

How well did you know this?

Not at all

Perfectly

what do you give to someone in an acute gout flare

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

How well did you know this?

Not at all

Perfectly

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

likely due to stricture from crohns

-creating a small bowel obstruction

How well did you know this?

Not at all

Perfectly

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

kidney stone

How well did you know this?

Not at all

Perfectly

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

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

How well did you know this?

Not at all

Perfectly

what is becks triad and how do you treat it

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

How well did you know this?

Not at all

Perfectly

whatre the PAIR diseases (spondyloarthopathies)

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

How well did you know this?

Not at all

Perfectly

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

thoracic aorta

How well did you know this?

Not at all

Perfectly

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

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

How well did you know this?

Not at all

Perfectly

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

PCP

How well did you know this?

Not at all

Perfectly

when a pt has an infection what happens to glucose

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

How well did you know this?

Not at all

Perfectly

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

strep viridans

How well did you know this?

Not at all

Perfectly

what electrolyte abnormality can cause PVCs

hypokalemia

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

How well did you know this?

Not at all

Perfectly

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?

this is charcots triad for acute cholangitis
-get ERCP

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

How well did you know this?

Not at all

Perfectly

thoracostomy vs cricothyrotomy

thoracostomy = chest tube 
cricothyrotomy =  throat tube to establish airway

How well did you know this?

Not at all

Perfectly

how long does staph aureus food poisoning last

resolves within 24 hours

How well did you know this?

Not at all

Perfectly

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

ETEC

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

How well did you know this?

Not at all

Perfectly

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

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

How well did you know this?

Not at all

Perfectly

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

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)

How well did you know this?

Not at all

Perfectly

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

methamphetamines

-treat w/ benzos

How well did you know this?

Not at all

Perfectly

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

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)

pt has a history of abscesses with catalase + organisms

chronic granulomatous disease

NADPH deficiency
problem with neutrophils

what are the only 2 systolic murmurs

mitral regurg | aortic stenosis

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

anything encapsulated - strep pneumo - H. influenza - neisseria

acute stress disorder vs PTSD

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

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

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

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

think meningococcemia

what could the following things cause: - sepsis - aminoglycosides - ischemia/hypotension - heavy metals, radiocontrast - ethylene glycol - rhabdomyolysis

acute tubular necrosis

what do you look for to see if its aspirin toxicity

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

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

osgood shlatter (repeated microfractures at tendon insertion site)

patient has nipple peeling, scaling, cracking but no mass

pagets disease of breast | -50% have negative mammogram and no calcifications

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

physiologic discharge

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

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

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

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

how to treat lead poisoning

chelation or EDTA (calcium disodium edetate)

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

C1 esterase inhibitor deficiency | -leads to impaired bradykinin breakdown

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

foot only: tibulofibular calf claudication: femoropopliteal artery thigh and calf claudication: external iliac artery gluteal/thigh/calf claudication (possible impotence): aortoiliac artery

what does wernicke-korsakoffs look like

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

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

give them a benzo before going in again

compare and contrast arterial vs venous stasis/insufficiency

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

when to give a newborn varicella prophylaxis

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

what is spondylolithesis

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

right subclavian catheter placed... what is on your mind

pneumothorax

cerebral palsy vs spinal dysraphism

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

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

give them blood products

supraclavicular node plus splenomegaly, what do you think of

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

how does retinal detachment present

flashes and floaters, curtain drawn down then monocular vision loss

how does macular degeneration present

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

how does disseminated gonococcemia present

dermatitis, oligoarthritis, enthesitis OR monoarticular septic arthritis

what to think of when a pt has cervical motion tenderness

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

what are propylthiouracil and methimazole used for

they are used to treat hyperthyroidism by clocking thyroid peroxidase

how does a zinc deficiency present

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

how does copper deficiency present

hematologic abnormalities (microcytic anemia, leukopenia) and myeloneuropathy