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Step 2 > NBME 8 > Flashcards

NBME 8 Flashcards

1
Q

pt gets new liver then has eosinophils in the graft

A

allograft rejection (acute rejection)

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2
Q

non-fatigable weakness affecting eyes, proximal muscles, dry mouth, constipation, and loss of deep tendon reflexes

A

lambert-eaton

  • dx with repetitive nerve stimulation
  • improves with repetitive use AND has autonomic dysfunction
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3
Q

before knee or hip arthroplasty (ortho surgery) what do you give to the patient

A

IV cefazolin or cefuroxime

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4
Q

what is the ejection fraction cut off for surgery

A

less than 35%

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5
Q

what is a normal FEV1

A

about 3L (about 80%)

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6
Q

what is a contraindication to pts having a lung transplant

A

if their FEV1 after surgery will be less than 800mL then no surgery

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7
Q

3 infectious causes of rash on palms and soles

A

CaRS
Coxsackie A
Rocky Mountain Spotted Fever
Syphilis

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8
Q

young, fat, bad lipid panel and slightly elevated LFTs

A

Nonalcoholic steatohepatitis

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9
Q

whatre the requirements for tourette disorder

A

multiple motor tics AND at least 1 vocal tic for at least 1 year

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10
Q

at what age is sunscreen used

A

not commonly used in infants under 6 months

-keep them in shade and use protective clothing

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11
Q

unilateral bloody discharge from nipple but mammography shows no abnormalities

A

intraductal papilloma

-small fibroepithelial tumor within lactiferous ducts usually under the areola

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12
Q

if you see kerley B lines on chest x-ray what do you think of

A

pulmonary edema

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13
Q

if you see a pleural based hump shaped density on chest x-ray what do you think of

A

hampton hump = wedge shaped opacity due to pulmonary infarction

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14
Q

what is a major complication in pts with COPD

A

In most capillary beds of the body, decreased oxygen leads to vasodilation in order to facilitate more bloodflow to the area to maintain perfusion, but the lungs are the one exception in which decreased oxygen leads to constriction of blood vessels feeding that area so that blood is preferentially sent to well-oxygenated portions of the lung to minimize V/Q mismatch, but can lead to cor pulmonale in patients with COPD because their entire lungs are poorly oxygenated, leading to diffuse vasoconstriction and increased afterload on right ventricle

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15
Q

all neonates with sepsis should be empirically treated with what

A

amp and gent

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16
Q

what to give an MS patient and when

A

asymptomatic- Interferon beta

symptomatic (acute exacerbation)- glucocorticoids but if those dont work then do plasmapheresis

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17
Q

patient with type 2 diabetes and a glucose of 800 something then what do you think of

A

hyperosmolar hyperglycemic state

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18
Q

patient with asthma has what type of PFT pattern

A

obstructive

19
Q

bowen disease

A

very early stage of skin cancer that is easily treatable

-red, scaly patch on the skin

20
Q

how often should females with HIV have pap smears

A

annually

21
Q

how to treat slipped capital femoral epiphysis

A

pin fixation to avoid avascular necrosis

22
Q

what abx to use for aspiration pneumonia

A

aspiration = cover for anaerobes cause mouth and GI tract has them

  • clindamycin
  • metronidazole
  • amox + clav
23
Q

morning of back pain that gets better throughout the day and decreased range of motion means what

A

ankylosing spondylitis

-GET X-RAY TO CONFIRM

24
Q

when would you need a bone scan

A

to help dx osteomyelitis, suspected fractures, and neoplasms

25
Q

if you think someone has sjogrens whats the next best step

A

get an ANA

-then treat with symptomatic relief or hydroxychloroquine/methotrexate might also help

26
Q

if you see exopthalmos what do you think of

A

graves disease

-pt will show sparing of the tendinous insertions (specific for graves eye muscle problems)

27
Q

how to help with kidney function in someone with renal failure… diet-wise

A

restrict phosphorous cause a broken kidney can’t handle it then it will build up and be higher in serum

  • will take calcium out of bone
  • cause metastatic calcifications
28
Q

part of the brain atrophied in huntingtons and what is the triad

A

caudate nucleus

  1. chorea (can also be facial tics and grimacing)
  2. dementia
  3. depression (many commit suicide)
29
Q

how to treat uncomplicated vs complicated ectopic pregnancy

A

uncomplicated (no hemodynamic instability or signs of rupture): methotrexate

complicated: surgical exploration

30
Q

what is seen in pts knees with osteoarthritis

A

osteophytes

31
Q

what is chondrocalcinosis

A

pseudogout

32
Q

only 2 diseases that involve the DIP joints

A

osteoarthritis and psoriatic arthritis

33
Q

how to treat pt with positive PPD test but no symptoms of TB and nothing on cxr

A

treat for latent TB!!!

(1) Isoniazid and rifapentine weekly for 3 months
(2) Isoniazid for 6-9 months and give with Vitamin B6 if needed
(3) Rifampin for 4 months

34
Q

biggest risk factor for superficial thrombophlebitis

A

varicose veins

35
Q

what is superficial thrombophlebitis

A

usually on the back of the leg

  • tenderness, induration, erythema, and thickening in a linear distribution on the extremities
  • biggest risk factor is varicose veins so if they have that then really go for this
36
Q

what is pre-eclampsia and maternal htn a risk factor for

A

placental abruption

37
Q

which biliary problem is associated with ulcerative colitis

A

primary sclerosing cholangitis

  • beading of intra and extrahepatic bile ducts
  • p-ANCA
38
Q

midline mass in the neck that moves with swallowing

A

thyroglossal duct cyst

-use fine-needle aspiration to dx

39
Q

baby is cyanotic an hour after birth and supplemental o2 doesnt help. baby has a murmur, what do you think

A

give prostaglandin to keep pda open till heart defect is fixed

40
Q

what is a blighted ovum

A

anembryonic pregnancy

-fertilized egg attaches to uterine wall but nothing develops within the first trimester

41
Q

how does ischemic colitis present

A

pain out of proportion to exam more than anything

42
Q

baby born with excessive skin around neck with swelling of hands and feet plus a murmur that goes to the back, what do you think of

A 
turner syndrome (gonadal dysgenesis, 45 XO)
-noonan syndrome is basically the male version of this
43
Q

new mom 4-6 weeks post partum has hand pain when lifting up the baby

A

deQuervian tendinopathy
inflammation within the first dorsal extensor tendon compartment
-due to repetitive thumb abduction and wrist pain with ulnar deviation

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