NBME 8 Flashcards
pt gets new liver then has eosinophils in the graft
allograft rejection (acute rejection)
non-fatigable weakness affecting eyes, proximal muscles, dry mouth, constipation, and loss of deep tendon reflexes
lambert-eaton
- dx with repetitive nerve stimulation
- improves with repetitive use AND has autonomic dysfunction
before knee or hip arthroplasty (ortho surgery) what do you give to the patient
IV cefazolin or cefuroxime
what is the ejection fraction cut off for surgery
less than 35%
what is a normal FEV1
about 3L (about 80%)
what is a contraindication to pts having a lung transplant
if their FEV1 after surgery will be less than 800mL then no surgery
3 infectious causes of rash on palms and soles
CaRS
Coxsackie A
Rocky Mountain Spotted Fever
Syphilis
young, fat, bad lipid panel and slightly elevated LFTs
Nonalcoholic steatohepatitis
whatre the requirements for tourette disorder
multiple motor tics AND at least 1 vocal tic for at least 1 year
at what age is sunscreen used
not commonly used in infants under 6 months
-keep them in shade and use protective clothing
unilateral bloody discharge from nipple but mammography shows no abnormalities
intraductal papilloma
-small fibroepithelial tumor within lactiferous ducts usually under the areola
if you see kerley B lines on chest x-ray what do you think of
pulmonary edema
if you see a pleural based hump shaped density on chest x-ray what do you think of
hampton hump = wedge shaped opacity due to pulmonary infarction
what is a major complication in pts with COPD
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
all neonates with sepsis should be empirically treated with what
amp and gent
what to give an MS patient and when
asymptomatic- Interferon beta
symptomatic (acute exacerbation)- glucocorticoids but if those dont work then do plasmapheresis
patient with type 2 diabetes and a glucose of 800 something then what do you think of
hyperosmolar hyperglycemic state
patient with asthma has what type of PFT pattern
obstructive
bowen disease
very early stage of skin cancer that is easily treatable
-red, scaly patch on the skin
how often should females with HIV have pap smears
annually
how to treat slipped capital femoral epiphysis
pin fixation to avoid avascular necrosis
what abx to use for aspiration pneumonia
aspiration = cover for anaerobes cause mouth and GI tract has them
- clindamycin
- metronidazole
- amox + clav
morning of back pain that gets better throughout the day and decreased range of motion means what
ankylosing spondylitis
-GET X-RAY TO CONFIRM
when would you need a bone scan
to help dx osteomyelitis, suspected fractures, and neoplasms
if you think someone has sjogrens whats the next best step
get an ANA
-then treat with symptomatic relief or hydroxychloroquine/methotrexate might also help
if you see exopthalmos what do you think of
graves disease
-pt will show sparing of the tendinous insertions (specific for graves eye muscle problems)
how to help with kidney function in someone with renal failure… diet-wise
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
part of the brain atrophied in huntingtons and what is the triad
caudate nucleus
- chorea (can also be facial tics and grimacing)
- dementia
- depression (many commit suicide)
how to treat uncomplicated vs complicated ectopic pregnancy
uncomplicated (no hemodynamic instability or signs of rupture): methotrexate
complicated: surgical exploration
what is seen in pts knees with osteoarthritis
osteophytes
what is chondrocalcinosis
pseudogout
only 2 diseases that involve the DIP joints
osteoarthritis and psoriatic arthritis
how to treat pt with positive PPD test but no symptoms of TB and nothing on cxr
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
biggest risk factor for superficial thrombophlebitis
varicose veins
what is superficial thrombophlebitis
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
what is pre-eclampsia and maternal htn a risk factor for
placental abruption
which biliary problem is associated with ulcerative colitis
primary sclerosing cholangitis
- beading of intra and extrahepatic bile ducts
- p-ANCA
midline mass in the neck that moves with swallowing
thyroglossal duct cyst
-use fine-needle aspiration to dx
baby is cyanotic an hour after birth and supplemental o2 doesnt help. baby has a murmur, what do you think
give prostaglandin to keep pda open till heart defect is fixed
what is a blighted ovum
anembryonic pregnancy
-fertilized egg attaches to uterine wall but nothing develops within the first trimester
how does ischemic colitis present
pain out of proportion to exam more than anything
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
turner syndrome (gonadal dysgenesis, 45 XO) -noonan syndrome is basically the male version of this
new mom 4-6 weeks post partum has hand pain when lifting up the baby
deQuervian tendinopathy
inflammation within the first dorsal extensor tendon compartment
-due to repetitive thumb abduction and wrist pain with ulnar deviation
