Notes Flashcards
Glucosuria is ____ in pregnancy
Glucosuria is normal in pregnancy
High levels of HbA2 + hypochromic anemia suggests _____
High levels of HbA2 + hypochromic anemia suggests Thalassemia
Mathe test:
Mathe test: kidney not moving in inspiration in a perinephric abscess.
Adjunctive Tx in resistant depression?
Lithium, 2nd gen antipsychotics, and triiodothyronine are adjunctive Tx in resistant depression.
Screening for ASx bacteuria is done in ____
Screening for ASx bacteuria is done in pregnant, renal transplant, and immunocompromised patients.
Immunization against HBV:
Immunization against HBV: Anti-HBs (+), all the rest are negative
Breast milk is deficient in _____
Breast milk is deficient in vitamin D
Freckling in the axila =
Freckling in the axila = neurofibromatosis type 1
Hakim triad:
- Neurocognitive disorder
- Urinary incontinence
- abnormal gait
Normal-pressure hydrocephalus
Management for chronic insomnia.
Cognitive behavioural stress management is the best management for chronic insomnia.
MTDZ and ceftriaxone are ______ in breastfeeding women
MTDZ and ceftriaxone are contraindicated in breastfeeding women
HLA-B27 –> PAIR
HLA-B27 –> PAIR Psoriatic arthritis, Ankylosis spondylitis, IBD, Reactive arthritis
Eczema + malabsorption syndrome =
Eczema + malabsorption syndrome = Celiac disease (dx IgA transglutaminase)
PPIs impair the absorption of ____
PPIs impair the absorption of Ca++
Neonate HR < 60 =
Neonate HR < 60 = compressions
Amenorrhea + hypergonadotropism + hypoestrogenism =
Amenorrhea + hypergonadotropism + hypoestrogenism = Premature ovarian failue
Differecnes between Oppositional defiant disorder and Conduct disorder
Oppositional defiant disorder fight authority DO NOT hurt peers. Conduct disorder fight authority AND hurt peers
If ischemic stoke while on ASA–> Tx with _____
If stoke while on ASA–> Add dipyridamole to ASA
Corticoid regimes that are more likely to suppress the axis?
Late night doses of corticoid are more likely to suppress the axis
Memory loss, changes in personality, changes in behaviour, aggression –>
Memory loss, changes in personality, changes in behaviour, aggression –> encephalitis
Nebulized ipratropium may cause blurred vision
Nebulized ipratropium may cause blurred vision
Alarm signs in irritable bowel is iron deficiency anemia
Alarm signs in irritable bowel is iron deficiency anemia
Medicine wheel:
Medicine wheel: mental, emotional, physical, spiritual
Most common inherited cause of intellectual disability in males. Long forehead, large ears, long face.
Fragile x
Topiramate –> Increase risk of ____
Topiramate –> Increase risk of kidney stones
______ doses of corticoids increase the risk of suppressed adrenal secretion
Late evening doses of corticoids increase the risk of suppressed adrenal secretion
GERD should be managed more aggressively in males because an increased incidence of Barret’s
GERD should be managed more aggressively in males because an increased incidence of Barret’s
____ levels should be normalized before hyperaldo investigations to avoid false-negative results.
K+ levels should be normalized before hyperaldo investigations to avoid false-negative results.
Mitral stenosis is a well-known cause of hemopthysis
Mitral stenosis is a well-known cause of hemopthysis
Management of 2nd or 3rd metatarsal fractures
2nd or 3rd metatarsal fractures are managed with ice, acetaminophen and resting.
Instrumental activities of daily living
Instrumental activities of daily living are not necessary for fundamental living but allow independence. E.g., taking meds, shopping groceries, driving.
Preeclampsia vs gestational HTN
- HTN after 20 weeks of gestation + poteinuria = preeclampsia
- HTN after 20 weeks of gestation - proteinuria = gestational HTN
Erythema nodosum + cough + travelling to wooded area =
Erithema nodosum + cough + traveling to wooded area = histoplasmosis
30% of turner syndrome patients have hypothyroidism.
30% of turner syndrome patients have hypothyroidism.
Thrombotic thrombocytopenic purpura treatment of choice is ____. Frist sign of improvement is ______
Thrombotic thrombocytopenic purpura treatment of choice plasma exchange. Frist sign of improvement is improvement of neuro sx.
Achilles tendon rupture –> tx with ______
Achilles tendon rupture –> tx with immobilization x 2 weeks, walking boot and physio
Multiple sclerosis –> detrusor hyperactivity
Multiple sclerosis –> detrusor hyperactivity
_______ are first line tx in asthma
Corticosteroids are first line tx in asthma
LSIL vs ASCUS
LSIL –> Colpo or repeat in 6 months ASCUS –> HPV-DNA or repeat in 6 months
Urethral syndrome
Urethral syndrome: dysuria + pyuria + negative culture. Tx: doxycycline, azithromycin, erythromycin, levofloxacin
Quaternary prevention:
Quaternary prevention: action taken to protect patients from medical interventions that can cause more harm than good. E.g., prevent overmedication and iatrogenic harm
Spherocytosis is treated with _____
Spherocytosis is treated with splenectomy
Avoid antibiotics in E.Choli diarrhea because of risk of release of shiga toxin
Avoid antibiotics in E.Choli diarrhea because of risk of release of shiga toxin
Eisenmerger syndrome has the highest mortality rates for pregnant women.
Eisenmerger syndrome has the highest mortality rates for pregnant women.
Neonate should gain ____ grams per day
Neonate should gain 20-30 grams per day
Estrogen-progesterone challenge not resulting in bleeding =
Estrogen-progesterone challenge not resulting in bleeding = asherman
Pain in the scrotum that is relieved with elevation =
Pain in the scrotum that is relieved with elevation = epididymitis
College teenager with pneumonia =
College teenager with pneumonia = mycoplasma
Allopurinol vs Probenecid
Allopurinol for overproducers. Probenecid is for undersecretors.
Prevention of contrast-induced nephropathy
Hydration + HCO3 prevent contrast-induced nephropathy
Pruritus when taking a shower with hot water =
Pruritus when taking a shower with hot water = Polycythemia vera
Niacin increases _____
Niacin increases glucose
Young + hypertension + enlarged kidneys + family hx of early-onset hypertension =
Young + hypertension + enlarged kidneys + family hx of early-onset hypertension = polycystic kidney disease
Velvelt hyperpigmentation =
Velvelt hyperpigmentation = acanthosis nigricans
Clostridioides difficile =
Clostridioides difficile = clostridium difficile
“Frozen shoulder” =
“Frozen shoulder” = adhesive capsulitis
Stoll culture confirms the Dx of botulism
Stoll culture confirms the Dx of botulism
Maternal Varicella IgG protects the baby
Maternal Varicella IgG protects the baby
Azathriopine’s side effect is decrease of ___
Azathriopine’s side effect is decrease of WBC
____ is the most specific test to diagnose multiple myeloma
Bone marrow Bx is the most specific test to diagnose multiple myeloma
Secondary spontaneous pneumothorax occurs secondary to lung diseases like ___
Secondary spontaneous pneumothorax occurs secondary to lung diseases like COPD, asthma, sarcoidosis, TBC, cystic fibrosis
PID + sepsis/acute abdomen = Tx?
PID + sepsis/acute abdomen = surgery
Risk factors of transient tachypnea of the newborn.
Maternal diabetes, maternal asthma, smoking, prematurity are risk factors of transient tachypnea of the newborn.
Treatment of epiglotitis
Ceftriaxone is the treatment of epiglotitis
Tx of choise on back pain if NSAIDs don’t work
Cyclobenzaprina: Tx of choise on back pain if NSAIDs don’t work
Phase with highest drug failure rate?
Phase 2: Highest drug failure rate
Most common cause of lateral knee pain in athletes?
Most common cause of lateral knee pain in athletes is iliotibial band syndrome. Noble test (+)
Verapamil may cause hyperprolactinemia
Verapamil may cause hyperprolactinemia
Megacolon in a patient with ulcerative colitis = tx?
Megacolon in a patient with ulcerative colitis = urgent surgery!
Baby HR < 60 –> next step?
Baby HR < 60 –> compressions
_____ better than SSRIs in severe personality disorders
Lithium better than SSRIs in severe personality disorders
Take bilateral x-ray of clavicles when suspecting fracture
Take bilateral x-ray of clavicles when suspecting fracture
_______ are tx of choice in fistulizing Chron’s
Anti-TNF (e.g., infliximab) are tx of choice in fistulizing Chron’s
History of heart-lung transplantation + SOB, wheezing, crackles =
History of heart-lung transplantation + SOB, wheezing, crackles = Bronchiolitis obliterans
____ meniscus tears are more common than ____
Medial meniscus tears are more common than lateral
3-16 week-old baby with conjunctivitis and respiratory symptoms =
3-16 week-old baby with conjunctivitis and respiratory symptoms = Chlamydia
empiric tx for bacterial infection in neonates?
Ampi+Genta are empiric tx for bacterial infection in neonates.
SNRIs (e.g., Venlafaxine) are a good 2nd choice for depression
SNRIs (e.g., Venlafaxine) are a good 2nd choice for depression
Fixed splitting of S2 is Dx of _____
Fixed splitting of S2 is Dx of atrial septal defect
AAA < 5.5 are only treated conservatively.
AAA < 5.5 are only treated conservatively.
Levodopa/carvidopa dose is _____
Levodopa/carvidopa dose is 1 tab (25/100mg) TID
The immediate cause of death on a certificate:
The immediate cause of death on a certificate: Injury or complication directly producing death.
Anion gap =
Anion gap = Na - (Cl + HCO3)
Omeprazole side effects:
Omeprazole side effects: decreased vit B12 absorption, increased risk of C dif colitis, increased risk of pneumonia, atrophic gastritis, exacerbation of lupus
Brain tumor most common found in ventricular system =
Brain tumor most common found in ventricular system = ependymoma
______ has emerged as the tx of choice for social anxiety disorder
Paroxetina has emerged as the tx of choice for social anxiety disorder
Fothergill sign =
Fothergill sign = when an abdominal mass does not pass midline nor changes its shape with valsalva = rectus sheath hematoma
Antifreeze = ethylene glycol poisoning
Antifreeze = ethylene glycol poisoning
Antifreeze/Ethylene glycol poisoning. Acid-base abnormality
Anion gap metabolic acidosis
Normal anion gap =
Normal anion gap = 8-15
Most common cause of jaundice in pregnancy?
Viral hepatitis
Glasgow coma scale
Eye 4 Verbal 5 Movement 6

Lung tumor + PTH + keratine pearls =
SCC
Medication that increases risk for Achilles tendon rupture
Fluoroquinolones
“Snowman in storm” on CxR =
Total anomalous venous return
HTN in pregnancy. Tx?
Labetalol, methyldopa, nifedipine
Henosh-Scholein purpura aka ___
Henosh-Scholein purpura aka IgA vasculitis
Doxycycline is contraindicated in 2nd and 3rd trimester
Doxycycline is contraindicated in 2nd and 3rd trimester
Coag test in Von Willebrand
PT normal, PTT ↑/normal, BT ↑
Hematuria + hemoptisis =
Good-Pasteur syndrome (Dx. anti glomerular Antibodies)
HyperCa++, Renal failure, Anemia, Bone pain, multiple infections.
Dx and test?
Multiple myeloma; Test: Bone marrow Bx
Pneumonia + hypoNa + BCYE culture =
Legionella
Asbolute contraindication of OCPs
Migraine with aura
Liver anzimes in ETOH abuse
↑ALT, ↑↑AST (2 x ALT)
Primary amenorrhea + anosmia + normal anatomy =
Kallman syndrom (hypothalamic deficiency) Tx: GnRH
Kawasaki AKA ________
Kawasaki AKA necrotizing angiitis
Hypocalcemia on ECG
prolonged QT
Hypercalcemia on ECG
shortened QT
Irregularly enhancing mass on CT of brain =
glioblastoma multiforme
Ring-enhancing session on CT of brain =
brain abscess
Primary syphilis is dx with _____
Primary syphilis is dx with dark field microscopy
Right-lower abdominal pail + hyperCa =
ureterolithiasis
__________ are associated with higher than expected BNP levels
Female sex, old age, CKD, cirrhosis, hyperthyroidism, sepsis, HTN are associated with higher than expected BNP levels
Most concerning Clonazepine side effect
Agranulocytosis
Renal U/S is recommended in children with UTI when

African woman + cough + rales
Sarcoidosis
Skin manifestations of sarcoidosis
Skin papules
Erythema nodosum
Lupus pernio
Initial treatment of osteoarthritis
Initial treatment of osteoarthritis are oral NSAIDs (if renal function allows) and topical NSAIDs
The most common infection transmitted from person to person in wrestlers is _____
The most common infection transmitted from person to person in wrestlers is herpes gladiatorum
Dx of Meckel’s diverticulum
Technetium 99 radionucleotide scan
____ and ____ deficiency should be investigated in celic disease
Iron and vit D deficiency should be investigated in celic disease
Fever headache, sore throat, tonsillar swelling, adenopathies, splenomegaly
Dx? Diagnostic test?
Mononucleosis
Test: heterophile antibody
Body surface area calculation for burns

Parkland formula
[Kg x BSA burned (2nd or 3rd degree) x 4] cc of LR
50-50 8-16
- Give 50 % in 8 hrs
- Give 50% in the next 16 hrs

Osborn J wave
Associated with hypothermia
Centor criteria
Centor criteria:
- no Cough +1
- Exudates +1
- Nodes +1
- Temperature +1
- Age <14 -1; >14 +1
Interpretation:
- < 1: nothing it’s viral
- 2-3: rapid strep test
- > 4: treat with Ab
Screening of vit D deficiency.
The inactive form (25-hydroxy vit D) rather than the active form (1,25-hydroxy vit D) is used for screening of Vit D deficiency.
Antidote for beta-clocker toxicity
Glucagon
Result of a brain Bx in Alzheimer:
- Neurofibrillary tangles
- Amyloid plaques
- Tau proteins
When to intubate a patient with asthma exacerbation?
Peak expiratory flow (PEF) < 25%
PaCO2 > 42 mmHg
Altered mental status
Tetanus immunization and wound management

Tx of chlamydia urethritis
Single dose of azitromycin treats chlamydia urethritis
Most common long-term complication of bacterial meningitis is
Hearing loss
Displacement of tricuspid leaflets towards the apex resulting in enlarged right ventricle =
Ebstein’s abnormality
Courvoisier sign =
palpable gallbladder in a jaundiced patient (shows obstruction of the biliary tree generally due to reasons other than gallstones
Kariotype in turner =
45 X0
Large and coarse popcorn calcifications of mammography =
Fibroadenoma (benign)
Most varicoceles are ____-sided
Most varicoceles are left-sided
Tension headache may be associated with insomnia
Tension headache may be associated with insomnia
Overweight + fatigue + abnormal uterine bleeding –> Consider hypothiroidism as part of diferential
Overweight + fatigue + abnormal uterine bleeding –> Consider hypothiroidism as part of diferential
Cushing’s workup

Colon and breast screening guidelines
Colon
- Start: 50 yrs or 10 yrs before the Dx of a primary relative
- Stop: 75 yrs
- How: Flex sigmoidoscopy / 10 yrs; Or Fecal occult blood test / 2 yrs
Breast
- Start: 50 yrs
- Stop: 75 yrs
- How: Mamography / 2 yrs
Difference between schizophrenia, schizophreniform, brief psychotic episode, schizoid personality disorder, and schizoaffective

Late complication of epidural hematoma
Dural arteriovenous fistula
Lymphoma staging
Hydralazine is contraindicated in aortic dissection
Hydralazine is contraindicated in aortic dissection
Air Conduction > Bone Conduction
Webber lateralizes to the right
Dx?
Sensorial hearing loss of left ear

Bone Conduction > Air Conduction
Webber lateralizes to the right
Dx?
Conductive hearing loss of right ear

Investigation for Meckel diverticulum
Scintigraphy with Technetium 99 radionucleotide scan
Animal bite treatment
Amoxa/clavulanato
Doxycycline (if PNC allergy)
HTN treatmen in postpartum
Nifedipine or labetalol
Dark urine after trauma, infraction or muscle disease.
Dx?
Myoglobinuria
Relationship between HbA1C and average blood glucose
Average blood glucose (mmol/L) = (1.6 x HbA1C) - 2.6
Organisms that causes hand, foot, mouth disease.
Coxsackie A
Loss of voice but whisper is maintained
Conversion aphonia
Sclerodermal renal crisis is associated with
Glucocorticoid use
HiB vaccine is recommented for
All children at age of 2 months
Most common cause of infective diarrhea
Campylobacter jejuni
Suspicion of epiglottitis in a patient without the typical symptoms. Next step?
xR of neck
First-line Tx in female pattern baldness
Topical minoxidil.
Second line: finasteride
Prevention of Sudden infant death syndrome (SIDS)
- Back to sleep (lay infant on their back on a firm mattress)
- Turn head to each side each night to prevent flatten occiput
- Front play (supervised play)
- Don’t share bed
- Smoking cessation
- Avoid overheating and overdressing
Best tests to diagnose a breast mass
Core needle Bx or FNA
Uncorrected coagulopathy is an absolute contraindication for laparoscopy
Uncorrected coagulopathy is an absolute contraindication for laparoscopy
Dx tests in Zollinger-Ellinson (gastrinoma)
- Gastrin level > 1600 (normal < 250)
- Between 250 and 1600 Secretin stimulation test
- To localize the tumor: Somatostatin receptor Scintigraphy (SRS)
NNT calculation
1/ absolute risk reduction (ARR)
Oral treatment for acne in a pregnant patient
Erythromycin or clindamycin
Severly ill patient with RUQ pain, high LFTs, normal U/S
Acalculous cholecystitis
Differentials of PCOS
- Cushing
- Adrenal hyperplasia
- Ovarian cancer
- Adrenal neoplasm
History of trauma/sinusitis/surgery
+
Bulging eye, visual disturbance, pain on eye movement
Orbital cellulits
Murmur characteristics that should tip you off for evaluation of structural heart condition
- Increased intensity when standing
- Holocystolic murmur
- Grade 3 or +
- Harsh quality
- Abnormal S2
- Maximal intensity in upper left sternal border
- Diastolic murmur
- Systolic click
Treatment of choice for fistulizing Chron’s
Anti-TNF (e.g., Infliximab)
Carbon monoxide toxicity tx
100% O2, Hyperbaric oxygen, obtain COHb
Tx of ADHD
Methylphenidate, anphethamine crystals
Constipation, weight loss, low pback pain, anemia, elevated ESR
Multiple myeloma
Hypoglycemia + Low Peptide C
Factitious
Pancreatic cancer classified as resectable on CT. Contraindicated test
Percutaneous aspiration Bx (risk of spreading cancer)
Pancreatic cancer classified as unresectable on CT. Next step
Percutaneous aspiration Bx (to directly confirm it is unresectable)
PID tx
Ceftraixone + azithromicin for patient and partner
Macular lesions, pale but not white, well defined but the edge is a little indistinct, rounded-oval,

Pityriasis alba (sub-acute form of dermatitis)
Evaluation of hearing loss in children according to age
- < 6 months: auditory brainstem response, tympanometry, evoked potentials
- 6 months–2.5 yrs: behaviour audiometry
- 2.5–5 yrs: play audiometry
- > 3 yrs: pure tone aidiometry
Rapid initial growth, then stabilization, then resolution. Presents in sun-exposed area, solitary lesion, dome-shaped, 1-2 cm, with central keratinous plug

Keratocanthoma
Abnormal uterine bleeding
+
U/S: globally enlarged uterus, with areas of decreased echogenicity, cystic spaces in myometrium
Adenomyosis
Delusion seen in schizophrenic patients when they believe a person has been replaced by a double
Capgras symdrome
Lofgren syndrome
Bilateral hilar lymphadenopathy
Erythema nodosum
Arthralgia
Cough
Plentiful, copious, foul-smelling sputum
cRx with peribronchial thickening
Bronchiectasis
Dx with High-res CT
Old patient, constipation, weight loss, bone pain, anemia, high ESR
Multiple myeloma
HIV+ patient with diarrhea. Next step?
Acid-fast stain of the stool to Dx cryptosporidium
HIV opportunistic infection prophylaxis

Patient with nephrotic syndrom who presents vomiting, flank pain, hematuria, worsening of hematuria, high LDH.
DX?
Renal vein trombosis
Most common microorganism causing otitis
Streptococcus penumoniae
Windlass test positive
Plantar fascitis
Tx of clostridoisdes difficile:
Stop antibioticas + oral vanco or oral fidaxomicin
Estimated date of term delivery by Naegele’s formula:
LMP + 7 days - 3 months
Natalizumab (tx for MS and Chron’s) may have leukoencephalopathy (cognitive impairment, behavioural changes, motor/visual disorders)
Natalizumab (tx for MS and Chron’s) may have leukoencephalopathy (cognitive impairment, behavioural changes, motor/visual disorders)