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Notes Flashcards

1
Q

Glucosuria is ____ in pregnancy

A

Glucosuria is normal in pregnancy

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2
Q

High levels of HbA2 + hypochromic anemia suggests _____

A

High levels of HbA2 + hypochromic anemia suggests Thalassemia

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3
Q

Mathe test:

A

Mathe test: kidney not moving in inspiration in a perinephric abscess.

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4
Q

Adjunctive Tx in resistant depression?

A

Lithium, 2nd gen antipsychotics, and triiodothyronine are adjunctive Tx in resistant depression.

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5
Q

Screening for ASx bacteuria is done in ____

A

Screening for ASx bacteuria is done in pregnant, renal transplant, and immunocompromised patients.

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6
Q

Immunization against HBV:

A

Immunization against HBV: Anti-HBs (+), all the rest are negative

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7
Q

Breast milk is deficient in _____

A

Breast milk is deficient in vitamin D

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8
Q

Freckling in the axila =

A

Freckling in the axila = neurofibromatosis type 1

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9
Q

Hakim triad:

  • Neurocognitive disorder
  • Urinary incontinence
  • abnormal gait
A

Normal-pressure hydrocephalus

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10
Q

Management for chronic insomnia.

A

Cognitive behavioural stress management is the best management for chronic insomnia.

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11
Q

MTDZ and ceftriaxone are ______ in breastfeeding women

A

MTDZ and ceftriaxone are contraindicated in breastfeeding women

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12
Q

HLA-B27 –> PAIR

A

HLA-B27 –> PAIR Psoriatic arthritis, Ankylosis spondylitis, IBD, Reactive arthritis

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13
Q

Eczema + malabsorption syndrome =

A

Eczema + malabsorption syndrome = Celiac disease (dx IgA transglutaminase)

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14
Q

PPIs impair the absorption of ____

A

PPIs impair the absorption of Ca++

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15
Q

Neonate HR < 60 =

A

Neonate HR < 60 = compressions

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16
Q

Amenorrhea + hypergonadotropism + hypoestrogenism =

A

Amenorrhea + hypergonadotropism + hypoestrogenism = Premature ovarian failue

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17
Q

Differecnes between Oppositional defiant disorder and Conduct disorder

A

Oppositional defiant disorder fight authority DO NOT hurt peers. Conduct disorder fight authority AND hurt peers

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18
Q

If ischemic stoke while on ASA–> Tx with _____

A

If stoke while on ASA–> Add dipyridamole to ASA

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19
Q

Corticoid regimes that are more likely to suppress the axis?

A

Late night doses of corticoid are more likely to suppress the axis

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20
Q

Memory loss, changes in personality, changes in behaviour, aggression –>

A

Memory loss, changes in personality, changes in behaviour, aggression –> encephalitis

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21
Q

Nebulized ipratropium may cause blurred vision

A

Nebulized ipratropium may cause blurred vision

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22
Q

Alarm signs in irritable bowel is iron deficiency anemia

A

Alarm signs in irritable bowel is iron deficiency anemia

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23
Q

Medicine wheel:

A

Medicine wheel: mental, emotional, physical, spiritual

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24
Q

Most common inherited cause of intellectual disability in males. Long forehead, large ears, long face.

A

Fragile x

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25
Q

Topiramate –> Increase risk of ____

A

Topiramate –> Increase risk of kidney stones

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26
Q

______ doses of corticoids increase the risk of suppressed adrenal secretion

A

Late evening doses of corticoids increase the risk of suppressed adrenal secretion

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27
Q

GERD should be managed more aggressively in males because an increased incidence of Barret’s

A

GERD should be managed more aggressively in males because an increased incidence of Barret’s

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28
Q

____ levels should be normalized before hyperaldo investigations to avoid false-negative results.

A

K+ levels should be normalized before hyperaldo investigations to avoid false-negative results.

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29
Q

Mitral stenosis is a well-known cause of hemopthysis

A

Mitral stenosis is a well-known cause of hemopthysis

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30
Q

Management of 2nd or 3rd metatarsal fractures

A

2nd or 3rd metatarsal fractures are managed with ice, acetaminophen and resting.

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31
Q

Instrumental activities of daily living

A

Instrumental activities of daily living are not necessary for fundamental living but allow independence. E.g., taking meds, shopping groceries, driving.

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32
Q

Preeclampsia vs gestational HTN

A
  • HTN after 20 weeks of gestation + poteinuria = preeclampsia
  • HTN after 20 weeks of gestation - proteinuria = gestational HTN
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33
Q

Erythema nodosum + cough + travelling to wooded area =

A

Erithema nodosum + cough + traveling to wooded area = histoplasmosis

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34
Q

30% of turner syndrome patients have hypothyroidism.

A

30% of turner syndrome patients have hypothyroidism.

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35
Q

Thrombotic thrombocytopenic purpura treatment of choice is ____. Frist sign of improvement is ______

A

Thrombotic thrombocytopenic purpura treatment of choice plasma exchange. Frist sign of improvement is improvement of neuro sx.

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36
Q

Achilles tendon rupture –> tx with ______

A

Achilles tendon rupture –> tx with immobilization x 2 weeks, walking boot and physio

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37
Q

Multiple sclerosis –> detrusor hyperactivity

A

Multiple sclerosis –> detrusor hyperactivity

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38
Q

_______ are first line tx in asthma

A

Corticosteroids are first line tx in asthma

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39
Q

LSIL vs ASCUS

A

LSIL –> Colpo or repeat in 6 months ASCUS –> HPV-DNA or repeat in 6 months

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40
Q

Urethral syndrome

A

Urethral syndrome: dysuria + pyuria + negative culture. Tx: doxycycline, azithromycin, erythromycin, levofloxacin

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41
Q

Quaternary prevention:

A

Quaternary prevention: action taken to protect patients from medical interventions that can cause more harm than good. E.g., prevent overmedication and iatrogenic harm

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42
Q

Spherocytosis is treated with _____

A

Spherocytosis is treated with splenectomy

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43
Q

Avoid antibiotics in E.Choli diarrhea because of risk of release of shiga toxin

A

Avoid antibiotics in E.Choli diarrhea because of risk of release of shiga toxin

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44
Q

Eisenmerger syndrome has the highest mortality rates for pregnant women.

A

Eisenmerger syndrome has the highest mortality rates for pregnant women.

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45
Q

Neonate should gain ____ grams per day

A

Neonate should gain 20-30 grams per day

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46
Q

Estrogen-progesterone challenge not resulting in bleeding =

A

Estrogen-progesterone challenge not resulting in bleeding = asherman

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47
Q

Pain in the scrotum that is relieved with elevation =

A

Pain in the scrotum that is relieved with elevation = epididymitis

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48
Q

College teenager with pneumonia =

A

College teenager with pneumonia = mycoplasma

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49
Q

Allopurinol vs Probenecid

A

Allopurinol for overproducers. Probenecid is for undersecretors.

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50
Q

Prevention of contrast-induced nephropathy

A

Hydration + HCO3 prevent contrast-induced nephropathy

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51
Q

Pruritus when taking a shower with hot water =

A

Pruritus when taking a shower with hot water = Polycythemia vera

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52
Q

Niacin increases _____

A

Niacin increases glucose

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53
Q

Young + hypertension + enlarged kidneys + family hx of early-onset hypertension =

A

Young + hypertension + enlarged kidneys + family hx of early-onset hypertension = polycystic kidney disease

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54
Q

Velvelt hyperpigmentation =

A

Velvelt hyperpigmentation = acanthosis nigricans

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55
Q

Clostridioides difficile =

A

Clostridioides difficile = clostridium difficile

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56
Q

“Frozen shoulder” =

A

“Frozen shoulder” = adhesive capsulitis

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57
Q

Stoll culture confirms the Dx of botulism

A

Stoll culture confirms the Dx of botulism

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58
Q

Maternal Varicella IgG protects the baby

A

Maternal Varicella IgG protects the baby

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59
Q

Azathriopine’s side effect is decrease of ___

A

Azathriopine’s side effect is decrease of WBC

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60
Q

____ is the most specific test to diagnose multiple myeloma

A

Bone marrow Bx is the most specific test to diagnose multiple myeloma

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61
Q

Secondary spontaneous pneumothorax occurs secondary to lung diseases like ___

A

Secondary spontaneous pneumothorax occurs secondary to lung diseases like COPD, asthma, sarcoidosis, TBC, cystic fibrosis

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62
Q

PID + sepsis/acute abdomen = Tx?

A

PID + sepsis/acute abdomen = surgery

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63
Q

Risk factors of transient tachypnea of the newborn.

A

Maternal diabetes, maternal asthma, smoking, prematurity are risk factors of transient tachypnea of the newborn.

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64
Q

Treatment of epiglotitis

A

Ceftriaxone is the treatment of epiglotitis

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65
Q

Tx of choise on back pain if NSAIDs don’t work

A

Cyclobenzaprina: Tx of choise on back pain if NSAIDs don’t work

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66
Q

Phase with highest drug failure rate?

A

Phase 2: Highest drug failure rate

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67
Q

Most common cause of lateral knee pain in athletes?

A

Most common cause of lateral knee pain in athletes is iliotibial band syndrome. Noble test (+)

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68
Q

Verapamil may cause hyperprolactinemia

A

Verapamil may cause hyperprolactinemia

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69
Q

Megacolon in a patient with ulcerative colitis = tx?

A

Megacolon in a patient with ulcerative colitis = urgent surgery!

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70
Q

Baby HR < 60 –> next step?

A

Baby HR < 60 –> compressions

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71
Q

_____ better than SSRIs in severe personality disorders

A

Lithium better than SSRIs in severe personality disorders

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72
Q

Take bilateral x-ray of clavicles when suspecting fracture

A

Take bilateral x-ray of clavicles when suspecting fracture

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73
Q

_______ are tx of choice in fistulizing Chron’s

A

Anti-TNF (e.g., infliximab) are tx of choice in fistulizing Chron’s

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74
Q

History of heart-lung transplantation + SOB, wheezing, crackles =

A

History of heart-lung transplantation + SOB, wheezing, crackles = Bronchiolitis obliterans

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75
Q

____ meniscus tears are more common than ____

A

Medial meniscus tears are more common than lateral

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76
Q

3-16 week-old baby with conjunctivitis and respiratory symptoms =

A

3-16 week-old baby with conjunctivitis and respiratory symptoms = Chlamydia

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77
Q

empiric tx for bacterial infection in neonates?

A

Ampi+Genta are empiric tx for bacterial infection in neonates.

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78
Q

SNRIs (e.g., Venlafaxine) are a good 2nd choice for depression

A

SNRIs (e.g., Venlafaxine) are a good 2nd choice for depression

79
Q

Fixed splitting of S2 is Dx of _____

A

Fixed splitting of S2 is Dx of atrial septal defect

80
Q

AAA < 5.5 are only treated conservatively.

A

AAA < 5.5 are only treated conservatively.

81
Q

Levodopa/carvidopa dose is _____

A

Levodopa/carvidopa dose is 1 tab (25/100mg) TID

82
Q

The immediate cause of death on a certificate:

A

The immediate cause of death on a certificate: Injury or complication directly producing death.

83
Q

Anion gap =

A

Anion gap = Na - (Cl + HCO3)

84
Q

Omeprazole side effects:

A

Omeprazole side effects: decreased vit B12 absorption, increased risk of C dif colitis, increased risk of pneumonia, atrophic gastritis, exacerbation of lupus

85
Q

Brain tumor most common found in ventricular system =

A

Brain tumor most common found in ventricular system = ependymoma

86
Q

______ has emerged as the tx of choice for social anxiety disorder

A

Paroxetina has emerged as the tx of choice for social anxiety disorder

87
Q

Fothergill sign =

A

Fothergill sign = when an abdominal mass does not pass midline nor changes its shape with valsalva = rectus sheath hematoma

88
Q

Antifreeze = ethylene glycol poisoning

A

Antifreeze = ethylene glycol poisoning

89
Q

Antifreeze/Ethylene glycol poisoning. Acid-base abnormality

A

Anion gap metabolic acidosis

90
Q

Normal anion gap =

A

Normal anion gap = 8-15

91
Q

Most common cause of jaundice in pregnancy?

A

Viral hepatitis

92
Q

Glasgow coma scale

A

Eye 4 Verbal 5 Movement 6

93
Q

Lung tumor + PTH + keratine pearls =

A

SCC

94
Q

Medication that increases risk for Achilles tendon rupture

A

Fluoroquinolones

95
Q

“Snowman in storm” on CxR =

A

Total anomalous venous return

96
Q

HTN in pregnancy. Tx?

A

Labetalol, methyldopa, nifedipine

97
Q

Henosh-Scholein purpura aka ___

A

Henosh-Scholein purpura aka IgA vasculitis

98
Q

Doxycycline is contraindicated in 2nd and 3rd trimester

A

Doxycycline is contraindicated in 2nd and 3rd trimester

99
Q

Coag test in Von Willebrand

A

PT normal, PTT ↑/normal, BT ↑

100
Q

Hematuria + hemoptisis =

A

Good-Pasteur syndrome (Dx. anti glomerular Antibodies)

101
Q

HyperCa++, Renal failure, Anemia, Bone pain, multiple infections.

Dx and test?

A

Multiple myeloma; Test: Bone marrow Bx

102
Q

Pneumonia + hypoNa + BCYE culture =

A

Legionella

103
Q

Asbolute contraindication of OCPs

A

Migraine with aura

104
Q

Liver anzimes in ETOH abuse

A

↑ALT, ↑↑AST (2 x ALT)

105
Q

Primary amenorrhea + anosmia + normal anatomy =

A

Kallman syndrom (hypothalamic deficiency) Tx: GnRH

106
Q

Kawasaki AKA ________

A

Kawasaki AKA necrotizing angiitis

107
Q

Hypocalcemia on ECG

A

prolonged QT

108
Q

Hypercalcemia on ECG

A

shortened QT

109
Q

Irregularly enhancing mass on CT of brain =

A

glioblastoma multiforme

110
Q

Ring-enhancing session on CT of brain =

A

brain abscess

111
Q

Primary syphilis is dx with _____

A

Primary syphilis is dx with dark field microscopy

112
Q

Right-lower abdominal pail + hyperCa =

A

ureterolithiasis

113
Q

__________ are associated with higher than expected BNP levels

A

Female sex, old age, CKD, cirrhosis, hyperthyroidism, sepsis, HTN are associated with higher than expected BNP levels

114
Q

Most concerning Clonazepine side effect

A

Agranulocytosis

115
Q

Renal U/S is recommended in children with UTI when

A
116
Q

African woman + cough + rales

A

Sarcoidosis

117
Q

Skin manifestations of sarcoidosis

A

Skin papules

Erythema nodosum

Lupus pernio

118
Q

Initial treatment of osteoarthritis

A

Initial treatment of osteoarthritis are oral NSAIDs (if renal function allows) and topical NSAIDs

119
Q

The most common infection transmitted from person to person in wrestlers is _____

A

The most common infection transmitted from person to person in wrestlers is herpes gladiatorum

120
Q

Dx of Meckel’s diverticulum

A

Technetium 99 radionucleotide scan

121
Q

____ and ____ deficiency should be investigated in celic disease

A

Iron and vit D deficiency should be investigated in celic disease

122
Q

Fever headache, sore throat, tonsillar swelling, adenopathies, splenomegaly

Dx? Diagnostic test?

A

Mononucleosis

Test: heterophile antibody

123
Q

Body surface area calculation for burns

A
124
Q

Parkland formula

A

[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
125
Q
A

Osborn J wave

Associated with hypothermia

126
Q

Centor criteria

A

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
127
Q

Screening of vit D deficiency.

A

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.

128
Q

Antidote for beta-clocker toxicity

A

Glucagon

129
Q

Result of a brain Bx in Alzheimer:

A
  • Neurofibrillary tangles
  • Amyloid plaques
  • Tau proteins
130
Q

When to intubate a patient with asthma exacerbation?

A

Peak expiratory flow (PEF) < 25%

PaCO2 > 42 mmHg

Altered mental status

131
Q

Tetanus immunization and wound management

A
132
Q

Tx of chlamydia urethritis

A

Single dose of azitromycin treats chlamydia urethritis

133
Q

Most common long-term complication of bacterial meningitis is

A

Hearing loss

134
Q

Displacement of tricuspid leaflets towards the apex resulting in enlarged right ventricle =

A

Ebstein’s abnormality

135
Q

Courvoisier sign =

A

palpable gallbladder in a jaundiced patient (shows obstruction of the biliary tree generally due to reasons other than gallstones

136
Q

Kariotype in turner =

A

45 X0

137
Q

Large and coarse popcorn calcifications of mammography =

A

Fibroadenoma (benign)

138
Q

Most varicoceles are ____-sided

A

Most varicoceles are left-sided

139
Q

Tension headache may be associated with insomnia

A

Tension headache may be associated with insomnia

140
Q

Overweight + fatigue + abnormal uterine bleeding –> Consider hypothiroidism as part of diferential

A

Overweight + fatigue + abnormal uterine bleeding –> Consider hypothiroidism as part of diferential

141
Q

Cushing’s workup

A
142
Q

Colon and breast screening guidelines

A

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
143
Q

Difference between schizophrenia, schizophreniform, brief psychotic episode, schizoid personality disorder, and schizoaffective

A
144
Q

Late complication of epidural hematoma

A

Dural arteriovenous fistula

145
Q

Lymphoma staging

A
146
Q

Hydralazine is contraindicated in aortic dissection

A

Hydralazine is contraindicated in aortic dissection

147
Q

Air Conduction > Bone Conduction

Webber lateralizes to the right

Dx?

A

Sensorial hearing loss of left ear

148
Q

Bone Conduction > Air Conduction

Webber lateralizes to the right

Dx?

A

Conductive hearing loss of right ear

149
Q

Investigation for Meckel diverticulum

A

Scintigraphy with Technetium 99 radionucleotide scan

150
Q

Animal bite treatment

A

Amoxa/clavulanato

Doxycycline (if PNC allergy)

151
Q

HTN treatmen in postpartum

A

Nifedipine or labetalol

152
Q

Dark urine after trauma, infraction or muscle disease.

Dx?

A

Myoglobinuria

153
Q

Relationship between HbA1C and average blood glucose

A

Average blood glucose (mmol/L) = (1.6 x HbA1C) - 2.6

154
Q

Organisms that causes hand, foot, mouth disease.

A

Coxsackie A

155
Q

Loss of voice but whisper is maintained

A

Conversion aphonia

156
Q

Sclerodermal renal crisis is associated with

A

Glucocorticoid use

157
Q

HiB vaccine is recommented for

A

All children at age of 2 months

158
Q

Most common cause of infective diarrhea

A

Campylobacter jejuni

159
Q

Suspicion of epiglottitis in a patient without the typical symptoms. Next step?

A

xR of neck

160
Q

First-line Tx in female pattern baldness

A

Topical minoxidil.

Second line: finasteride

161
Q

Prevention of Sudden infant death syndrome (SIDS)

A
  • 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
162
Q

Best tests to diagnose a breast mass

A

Core needle Bx or FNA

163
Q

Uncorrected coagulopathy is an absolute contraindication for laparoscopy

A

Uncorrected coagulopathy is an absolute contraindication for laparoscopy

164
Q

Dx tests in Zollinger-Ellinson (gastrinoma)

A
  • Gastrin level > 1600 (normal < 250)
    • Between 250 and 1600 Secretin stimulation test
  • To localize the tumor: Somatostatin receptor Scintigraphy (SRS)
165
Q

NNT calculation

A

1/ absolute risk reduction (ARR)

166
Q

Oral treatment for acne in a pregnant patient

A

Erythromycin or clindamycin

167
Q

Severly ill patient with RUQ pain, high LFTs, normal U/S

A

Acalculous cholecystitis

168
Q

Differentials of PCOS

A
  • Cushing
  • Adrenal hyperplasia
  • Ovarian cancer
  • Adrenal neoplasm
169
Q

History of trauma/sinusitis/surgery

+

Bulging eye, visual disturbance, pain on eye movement

A

Orbital cellulits

170
Q

Murmur characteristics that should tip you off for evaluation of structural heart condition

A
  • Increased intensity when standing
  • Holocystolic murmur
  • Grade 3 or +
  • Harsh quality
  • Abnormal S2
  • Maximal intensity in upper left sternal border
  • Diastolic murmur
  • Systolic click
171
Q

Treatment of choice for fistulizing Chron’s

A

Anti-TNF (e.g., Infliximab)

172
Q

Carbon monoxide toxicity tx

A

100% O2, Hyperbaric oxygen, obtain COHb

173
Q

Tx of ADHD

A

Methylphenidate, anphethamine crystals

174
Q

Constipation, weight loss, low pback pain, anemia, elevated ESR

A

Multiple myeloma

175
Q

Hypoglycemia + Low Peptide C

A

Factitious

176
Q

Pancreatic cancer classified as resectable on CT. Contraindicated test

A

Percutaneous aspiration Bx (risk of spreading cancer)

177
Q

Pancreatic cancer classified as unresectable on CT. Next step

A

Percutaneous aspiration Bx (to directly confirm it is unresectable)

178
Q

PID tx

A

Ceftraixone + azithromicin for patient and partner

179
Q

Macular lesions, pale but not white, well defined but the edge is a little indistinct, rounded-oval,

A

Pityriasis alba (sub-acute form of dermatitis)

180
Q

Evaluation of hearing loss in children according to age

A
  • < 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
181
Q

Rapid initial growth, then stabilization, then resolution. Presents in sun-exposed area, solitary lesion, dome-shaped, 1-2 cm, with central keratinous plug

A

Keratocanthoma

182
Q

Abnormal uterine bleeding

+

U/S: globally enlarged uterus, with areas of decreased echogenicity, cystic spaces in myometrium

A

Adenomyosis

183
Q

Delusion seen in schizophrenic patients when they believe a person has been replaced by a double

A

Capgras symdrome

184
Q

Lofgren syndrome

A

Bilateral hilar lymphadenopathy

Erythema nodosum

Arthralgia

185
Q

Cough

Plentiful, copious, foul-smelling sputum

cRx with peribronchial thickening

A

Bronchiectasis

Dx with High-res CT

186
Q

Old patient, constipation, weight loss, bone pain, anemia, high ESR

A

Multiple myeloma

187
Q

HIV+ patient with diarrhea. Next step?

A

Acid-fast stain of the stool to Dx cryptosporidium

188
Q

HIV opportunistic infection prophylaxis

A
189
Q

Patient with nephrotic syndrom who presents vomiting, flank pain, hematuria, worsening of hematuria, high LDH.

DX?

A

Renal vein trombosis

190
Q

Most common microorganism causing otitis

A

Streptococcus penumoniae

191
Q

Windlass test positive

A

Plantar fascitis

192
Q

Tx of clostridoisdes difficile:

A

Stop antibioticas + oral vanco or oral fidaxomicin

193
Q

Estimated date of term delivery by Naegele’s formula:

A

LMP + 7 days - 3 months

194
Q

Natalizumab (tx for MS and Chron’s) may have leukoencephalopathy (cognitive impairment, behavioural changes, motor/visual disorders)

A

Natalizumab (tx for MS and Chron’s) may have leukoencephalopathy (cognitive impairment, behavioural changes, motor/visual disorders)

Notes (4 decks)

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