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UWorld Step 2 CK > NTK2 > Flashcards

NTK2 Flashcards

1
Q

Small Cell Lung Ca

A

Smoking

Centrally located

ACTH
SIADH

chemo/radiation

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2
Q

less than 1 year old

bilateral symmetrical limb jerking
not generalized
no fever

dx?

imaging?

tx?

associated condition?

A

infantile spasm

EEG interictal

tx: ACTH

can be associated with tuberous sclerosis

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3
Q

Narcolepsy associated with low CSF levels of what?

A

orexin-a, hypocretin-1

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4
Q

UNa and FeNa in pre-renal azotemia

A

UNa <20

FeNa <1%

why? - usually d/t hypotension = Aldosterone release = Na reabsorption = low UNa and FeNa

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5
Q

Indications for bacterial endocarditis prophylaxis

A 
prosthetic heart valve
previous IE
structural abnormality in TRANSPLANTED heart
unrepaired cyanotic CHD
repaired CHD with residual defect
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6
Q

Thready pulses that disappear with inspiration

A

pulsus paradoxus

cardiac tamponade

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7
Q

Characteristics of tuberculous effusions

A

very high protein levels (>4)

lymphocytic leukocytosis

low glucose

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8
Q

gallbladder wall - bluish color and brittle consistency

A

procelain gallbladder

gallbladder adenocarcinoma

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9
Q

Physical exam findings of aortic stenosis

A

pulsus parvus et tardus (diminished and elayed)

mid to late peaking systolic murmur

soft and single second heart sound S2

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10
Q

When do you add IV K with DKA

A

serum K less than or equal to 5.2

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11
Q

Right to Left shunts in peds (2)

A

Tetralogy

Transposition

cyanotic babies right away

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12
Q

Wilms tumor vs Neuroblastoma

A

WT - unilateral - 2 to 5 years old

Neuro - crosses midline - usually younger

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13
Q

What has been proven to prolong survival in COPD patients?

What hasn’t?

A

long term home oxygen therapy

vaccinations against influenza and pneumococcus

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14
Q

best preventive therapy for migraine

A

propranolol

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15
Q

Anti-social personality disorder diagnosed after what age?

A

18

with symptoms of conduct disorder beginning before age 15

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16
Q

Is metronidazole teratogenic?

A

No

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17
Q

Retinoblastoma is associated with what bone tumor?

A

osteosarcoma

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18
Q

spike differentiation between multiple myeloma and waldenstroms

A

waldenstroms is IgM specifically

MM - produces monoclonal IgG, IgA, or light chains

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19
Q

What electrolyte abnormality can occur with folate/B12 replenishment?

A

Hypokalemia

due to high cell production

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20
Q

Measles long term risk?

A

subacute sclerosing panencephalitis

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21
Q

most common pathogen of bartholin abscess

A

E. coli

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22
Q

MCC of bacterial tracheitis

A

staph aureus

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23
Q

Common murmur in infective endocarditis

A

Tricuspid regurgitation

Increases on inspiration

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24
Q

MCC of euvolemic hyponatremia

A

Pseudo (hyperglycemia)
Psychogenic polydipsia
Hypothyroid
SIADH

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25
Q

Target of Myasthenia graves

Lambert eaton

A

Post synaptic acetyl choline receptors

Pre synaptic Calcium channels

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26
Q

3 main causes of hyperbilirubinemia

A

pre-hepatic

intrahepatic

posthepatic

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27
Q

Biphasic stridor in an infant =

A

Vascular rings

vs

Laryngomalacia = INSPIRATORY stridor

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28
Q

Watery conjunctivitis 5 to 14 days after delivery

A

CHLAMYDIAL

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29
Q

two types of macular degeneration

A

dry - slow progressive, bilateral

wet - unilateral, aggressive

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30
Q

Triad of wisckott-aldrich

A

eczema

decreased platelets

infections

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31
Q

Cancers with VHL

A

hemangioblastoma
Clear cell renal carcinoma
Pheo

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32
Q

Measles = ?

infectious agent?

Prodrome?

fever and rash - timing and spread?

A

Rubeola

measles virus

rash on face - spreads to body (clears opposite direction)

Fever and rash at same time

Cough, Coryza, COnjunctivitis, Kopliks

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33
Q

What joints are NEVER involved in RA?

A

DIP’s

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34
Q

Effect of formula feeding on gastric emptying

A

Decreases it

Can be related to pyloric stenosis

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35
Q

what can differentiate transient synovitis from Legg-Calves-Perthes in a young boy who is of normal BMI?

A

length of pain

Months for LCP vs Up to 4 weeks for Transient synovitis

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36
Q

VSD murmur can be heard

A

Left Lower sternal border

Holosystolic

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37
Q

With increasing prevalence what happens to PPV?

A

increases

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38
Q

Natalizumab is associated with development of?

A

progressive multifocal leukoencephalopathy

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39
Q

What medications are associated with possibility of slowing progression of parkinsonism

A

MAO-B inhibitors

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40
Q

Ulcerative colitis associated with what gall bladder condition?

A

Primary sclerosing cholangitis

can have + p-ANCA

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41
Q

Primary adrenal insufficiency mcc?

significance of symptoms?

A

Autoimmune

more severe symptoms - hyperpigmentation, hypotension, hyperkalemia

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42
Q

Transposition of the great vessels associated with what maternal condition?

A

diabetes mellitus

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43
Q

Imiquimod

A

Locally applied immunostimulant

Leads to sloughing off of skin

Warts, BCC, actinic keratosis

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44
Q

Refractory cases of CLL tx

A

Cyclophosphamide

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45
Q

Cushing Syndrome

Initial work up tests (3)

A

24 hour urinary free cortisol

Late night salivary cortisol

Low dose dexamethasone suppression

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46
Q

High iron =

A

Sideroblastic anemia

alcoholic induced commonly

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47
Q

Triple or quad screen done when?

A

15-20 weeks

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48
Q

How logn does it take for cholestasis to develop with parenteral nutrition?

A

2 weeks or more

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49
Q

Anaphylactic egg allergy - which vaccine cannot be given?

A

Yellow fever

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50
Q

when can PUBS be done?

A

between 20 and 34 weeks gestation

benefit - can transfuse

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51
Q

Mild cases of CLL in the elderly tx?

A

Chlorambucil

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52
Q

intraplacental villous lakes

irregular placent

A

Placenta accreta

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53
Q

mechanism of decreased renal blood flow in hepatorenal syndrome

A

increased nitric oxide generation in splanchnic circulation secondary to portal HTN

NO reduces peripheral vascular resistance and blood pressure = decreased renal perfusion

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54
Q

3rd gen cephalosporins

A

ceftriaxone and cefotaxime

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55
Q

Complex vs simple seizures?

A

Complex = LOSS OF CONSCIOUSNESS

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56
Q

Where is Broca’s area located?

other associated findings with stroke?

A

posterior inferior FRONTAL lobe gyrus

DOMINANT side

right hemiparesis (face and upper limb)

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57
Q

Increasing pain, worsens at night

Relieved by NSAID’s

A

Osteoid osteoma

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58
Q

Ending -navir =?

Main adverse effect

A

Protease inhibitors

Hyperlipidemia, hyperglycemia

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59
Q

Carcinoid of the lungs

A

serotonin syndrome

5-HIAA in the URINE

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60
Q

Meds for Wolff Parkinson White

A

Procainamide or Ibutilide

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61
Q

Uncommon but specific sign of Graves Disease

A

digital clubbing thyroid acropathy

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62
Q

Specific therapy for hereditary angioedema

A

Ecallantide

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63
Q

What immunodeficiency may be associated with false negative serologic studies in celiac patients?

A

Selective IgA deficiency

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64
Q

Meckels is a remnant of what?

A

vitelline duct

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65
Q

Aldolase B deficiency =

A

hereditary fructose intolerance

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66
Q

three common causes of hyponatremia with hypervolemia

A

CHF
Nephrotic syndrome
Cirrhosis

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67
Q

Leuprolide

MOA?

A

GnRH agonist

given continuously suppresses estrogen

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68
Q

What is increased with both folate and B12 deficiency?

A

Homocysteine

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69
Q

delayed separation of cord + infections without pus?

A

Leukocyte adhesion deficiency

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70
Q

What RDW is associated with iron deficiency anemia?

A

> 20%

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71
Q

Treatment for chlamydial conjunctivits

A

ORAL erythromycin

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72
Q

Which source of vaginitis requires both partners to be treated?

A

Trichomonas

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73
Q

IgA nephropathy affects what part of the kidney?

A

glomerulus

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74
Q

Osteoarthritis is not associated with what type of anemia?

A

Anemia of chronic disease

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75
Q

Treatment of hyponatremia is based on?

A

Symptom severity (NOT the Na level)

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76
Q

Treatment for GBS

A

IVIG

OR

Plasmapharesis

NOT BOTH

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77
Q

firm hyperpigmented nodule

dimples in the center when pinched

A

dermatofibroma

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78
Q

Aplastic Anemia vs Aplastic crisis

A

Anemia = PANcytopenia

Crisis = ERYTHROpenia

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79
Q

RTA has positive or negative UAG?

A

Positive

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80
Q

Scabies treatment

A

Permethrin and Lindane

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81
Q

Treatment for Pertussis

A

erythromycin

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82
Q

4 of the most common complications of EPO therapy

A

Worsening of HTN

Headaches

Flu like syndrome

Red cell aplasia

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83
Q

Early decrescendo diastolic murmur

left sternal boarder (3rd/4th IC space)

with patient sitting up, leaning forward, and holding breath in full expiration

A

Aortic regurgitation

most commonly due to bicuspid aortic valve in the developed world

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84
Q

Increased Methylmalonic acid is associated with?

A

B12 deficiency

normal with folate

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85
Q

Complete androgen insensitivity syndrome

A

genetically male, phenotypically female

Cryptorchid testes

Orchiectomy after puberty

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86
Q

3 p’s of Mccune Albright

A

Precocious puberty

Pigmented spots

Polyostotic fibrous dysplasia

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87
Q

treatment for a-fib with RVR

A

beta blocker
diltiazem
digoxin

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88
Q

does long term use of OCP’s decrease breast cancer risk?

A

no , slight increase

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89
Q

Treatment options for non-ICU community acquired pneumonia

A

Fluoroquinolone

OR

Beta-lactam + Macrolide

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90
Q

what does mixed venous oxygen saturation tell you?

A

the amount of oxygen being extracted by tissues

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91
Q

flutamide mechanism of action

A

androgen blockade by binding to dihydrotestosterone receptors

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92
Q

Sevelamer and Lanthanum are?

A

phosphate binders

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93
Q

Diarrhea has positive or negative UAG?

A

Negative

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94
Q

Condyloma lata =

Condyloma acuminata =

A

Syphilis

Genital warts

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95
Q

When is post op atelectasis most comm?

A

Days 2-3

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96
Q

Renal changes in pregnancy

A

Increased risk of pyelonephritis

Increased GFR

Decreased BUN/creatinine

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97
Q

Methanol overdose is associated with what physical exam finding?

A

inflamed retina

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98
Q

Biliary atresia work up

A

U/S = no ducts

7 days of phenobarbital

HIDA scan

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99
Q

Patients with primary biliary cirrhosis are at increased risk of developing what?

A

Osteomalacia

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100
Q

Pulses parvus et tardus associated with what valve abnormality

A

Aortic stenosis

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101
Q

Accuracy

A

measures what it is supposed to measure

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102
Q

Periarticular osteopenia is a buzzword for?

A

Rheumatoid Arthritis

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103
Q

Tolcapone, Entacapone

MOI

A

COMT inhibitors

block metabolism of dopamine

Parkinsons

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104
Q

Most accurate imaging for adenomyosis?

A

MRI

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105
Q

Mild, irregular contractions with no cervical change =

A

braxton-hicks

reassure and send home

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106
Q

Medications that cause Acute interstitial nephritis are same drugs that cause what 4 other conditions?

A

Drug allergy/rash
Stevens-Johnson Syndrome
Toxic Epidermal Necrolysis
Hemolysis

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107
Q

Oligohydramnios

A

Single deepest pick of amniotic fluid <2cm or amniotic fluid index <5

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108
Q

MS patient with equivocal or non-diagnostic MRI

look for?

A

oligoclonal bands in CSF

not SPECIFIC to MS

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109
Q

what diuretic is associated with ototoxicity?

A

furosemide

damages hair cells of cochlea

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110
Q

Most commonly injured bronchus in chest trauma

A

Right main

RARE

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111
Q

SNRI’s

A

Venlafaxine

Desvenlafaxine

Duloxetine

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112
Q

what pharmacotherapy can be given with subarachnoid hemorrhage

A

CCB to prevent subsequent ischemic stroke from vasospasm

Phenytoin for seizure prophylaxis

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113
Q

preemie + GI bleed + air under diaphragm or pneumatosis intestinalis

A

NEC

NPO, IVF, TPN, IV abx

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114
Q

Common causes of priapism

A 
Sickle cell
Leukemia
Perineal or genital trauma
neurogenic lesions
meds - trazodone and prazosin
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115
Q

Adrenal medulla produces?

A

catecholamines

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116
Q

Swelling limited to surface of one cranial bone

A

cephalohematoma

caput crosses suture lines

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117
Q

Most common cause of labial fusion

A

21-B Hydroxylase deficiency

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118
Q

TInea capitis vs seborrheic dermatitis

A

TC doesn’t involve face, nasolabial folds, or eyebrows

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119
Q

Tx to prevent renal failure from tumor lysis

A

allopurinol

hydration

rasburicase

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120
Q

Three most common underlying causes of addisons

A

Autoimmune

TB

Anterior pituitary

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121
Q

Severe features for pre eclampsia

A

SBP >160 or DBP >110

Thrombocytopenia

Creatinine elevation

Elevated LFT’s

Pulmonary edema

Visual or cerebral symptoms

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122
Q

Which treatment for graves can cause worsening ophthalmopathy

A

Radioactive iodine

Due to increase in thyroid receptor antibodies

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123
Q

Male child

Decreased or absent tonsils, adenoids, lymph nodes, spleen

A

Brutons agammaglobulinemia

IVIG

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124
Q

dorsal column is responsible for?

A

vibration and proprioception

includes fasciculus cuneatus and fasciculus gracilis

posterior spinal artery

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125
Q

Sickle cell trait commonly results in ?

A

inability to concentrate urine

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126
Q

Hemodynamics in Septic shock

RA pressure
PCWP
cardiac index
sVR
MVO2
A

Normal or decreased

Normal or decreased

Increased

Decreased

Increased

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127
Q

3 general steps of bilirubin excretion

A

Uptake -

Conjugation -

Excretion -

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128
Q

Parkinsonism due to loss of cells where?

Neurotransmitter that is low?

A

Substantia Nigra

Dopamine

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129
Q

Which skin cancer can cause neuro symptoms due to neural invasion?

A

Squamous cell

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130
Q

What cell is most distinct abnormality in myelodysplastic syndrome?

A

Pelger-Huet

Bilobed nucleus

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131
Q

barking, seal like cough

inspiratory wheeze in between

dx?

A

croup

parainfluenza virus

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132
Q

most frequent type of delusion in delusional disorder

A

persecutory type

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133
Q

Cells of Hodkgkins?

A

Reed Sternberg

Owl-eyed cells

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134
Q

Cancers with Lynch Syndrome HNPCC

A

Colorectal
Endometrial
Ovarian

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135
Q

Treatment for intrauterine fetal demise >24 weeks?

A

vaginal delivery with labor induction

can be delayed until mother is ready

less than 24 weeks = dilation and evacuation

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136
Q

What milk intake can lead to folate deficiency?

A

Goats milk

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137
Q

Schizoaffective vs Major depression with psychotic features

A

Mood symptoms and psychotic symptoms occur together with MDD with psychotic features

Psychotic symptoms persist for >2 weeks by themslves in schizoaffective

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138
Q

Brown Sequard loss of?

A

pain and temp OPPOSITE SIDE

position and vibratory SAME SIDE

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139
Q

what medication should every stroke patient be given if they aren’t already on it?

A

Statin

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140
Q

2nd line treatment for Lyme

Treatment for neurologic infxn?

A

Amoxicillin

IV ceftriaxone

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141
Q

Pinworm =

A

itchy butt

scotch tape test

albendazole

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142
Q

Severe infections in CLL tx

A

IVIG

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143
Q

Tertiary prevention =

A

treatment of a given disease

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144
Q

What condition can present with bilateral trigeminal neuralgia

A

MS

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145
Q

agent of choice for prophylaxis of pasteurella?

A

amoxicillin/clavulanate

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146
Q

Rotavirus contraindicated in?

A

individuals with previous intussusception

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147
Q

corkscrew shaped and rightward displaced duodenum +

A

midgut volvulus

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148
Q

atypical glandular cells on pap smear

next step =

A

endometrial biopsy

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149
Q

Uric acid and BUN in SIADH are?

A

low

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150
Q

4 options for emergency contraception?

most effective?

A

Copper IUD
Ulipristal - antiprogestin
Levonorgestrel - progestin
OCP’s - progestin

Copper IUD most effective
OCP’s least effective for EMERGENCY contraception

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151
Q

Initial pharmacotherapy for pseudotumor cerebri

A

Acetazolamide

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152
Q

When do children need a renal and bladder ultrasound

A

with a first UTI between 2 and 24 months

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153
Q

Subacute combined degeneration = ?

loss of?

A

B12 deficiency or Neurosyphilis

position and vibratory sense

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154
Q

Autoimmune blistering disease

no mucosal involvement

linear IgG deposits on basement membrane

A

Bullous pemphigoid

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155
Q

when can you do a trans cranial doppler?

A

over 20 weeks

fetal anemia

increased velocity is a positive test

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156
Q

Exogenous glucocorticoid induced adrenal insufficiency doesn’t have what physical finding?

A

hyperpigmentation

central deficiency - steroids inhibit ACTH release

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157
Q

What kidney disease is associated with Hodgkin Lymphoma?

A

Minimal Change Disease

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158
Q

Normal nadir of maternal anemia in pregnancy

A

Hgb 10/ Hct 30

Reflex iron studies if less

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159
Q

gross hematuria 1 TO 2 DAYS AFTER URI

A

IgA nephropathy

most accurate test is kidney biopsy

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160
Q

common cause of complex partial seizures

A

temporal lobe epilepsy

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161
Q

Autoimmune thrombocytopenia or hemolysis in association with CLL tx?

A

Prednisone

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162
Q

Can you intubate patients with cervical spine trauma?

A

Yes

Only contraindication is significant facial trauma

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163
Q

what vitamin deficiency may present with hyperemesis gravidarum?

triad?

A

thiamine deficiency

AMS, ataxia, nystagmus

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164
Q

Cyanosis in an infant relived by crying = ?

A

Choanal atresia

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165
Q

Pregnant patient and possible DVT

A

1st step V/Q

Only a NORMAL v/q rules out PE

low probability v/q requires further testing - CT angio

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166
Q

Transudates tend to be high or low protein?

A

low protein

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167
Q

What infection is associated with membranous nephropathy in children?

A

Hep B

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168
Q

Graves vs painless thyroiditis

A

Graves has diffuse iodine uptake

Painless has low uptake

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169
Q

What curious thing occurs with Lymph nodes in Hodkgins?

A

EtOH causes tenderness

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170
Q

Best initial therapy for warm hemolytic anemia

A

Prednisone

IVIG if prednisone fails

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171
Q

SN-N-OUT

A

Sensative test - negative - rules out disease

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172
Q

Don’t use copper IUD as post birth contraception in what class of patients

A

Hypermenorrhea

Or

Anemic

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173
Q

When to switch to subQ insulin in DKA

A

able to eat

glucose <200

anion gap <12

serum HCO3 >15

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174
Q

what region of the brain does toxoplasmosis have a preference for?

A

basal ganglia

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175
Q

When to do C section for labor arrest

A

> 6 cm dilated

arrested for 4 to 6 hours

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176
Q

high arches, LE wasting, decreased DTR’s

A

Charcot-Marie-Tooth Disease

EMG

no tx

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177
Q

Normal iron studies =

A

Thalassemia

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178
Q

CSF findings in Guillain-Barre

A

Increased protein, normal cell counts

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179
Q

Unconjugated hyperbilirubinemia = patho or physio?

Steps of diagnosis
1, 2, 3, 4

A

physiologic

  1. Coombs test
  2. Hgb level
    - low = hemorrhagic
    - high = transfusion (twin-twin, delayed clamping)
  3. Retic
  4. Reabsorption
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180
Q

Contralateral somatosensory and motor deficit FACE, ARM, LEG

Eye deviation toward side of infarct

Aphasia (if dominant hemisphere)

Hemineglect (if non-dominant)

A

Middle Cerebral artery

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181
Q

Definitive diagnosis of CJD

A

Brain biopsy

Or

PRNP gene mutations

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182
Q

Type II RTA also known as?

Mechanism of impairment?

common side effect?

A

Proximal RTA

failure to reabsorb Bicarb in the PCT

osteomalacia (after chronic metabolic acidosis)

give bicarb then test urine

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183
Q

SAAG

A

subtract peritoneal albumin from serum albumin

ascites source determination

> 1.1 = portal

<1.1 = non-portal

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184
Q

First line treatment for OCD

A

exposure and response prevention

+/- SSRI

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185
Q

TYPE I RTA is also known as?

Mechanism of impairment?

common side effect?

initial step in work up?

A

Distal RTA

failure to generate new Bicarb in distal tubule - alkaline urine

nephrocalcinosis

UA for pH >5.5

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186
Q

Topical erythromycin is to prevent?

A

gonorrheal conjunctivits

2 to 7 days

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187
Q

persistent platelet elevations post infectious with a phx of abdominal trauma

A

splenectomy due to BAT

reactive thrombocytosis

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188
Q

Nontender lymphadenopathy - first step?

A

excisional biopsy

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189
Q

eosinophils on UA

what stain?

A

allergic or acute interstitial nephritis

Wright and Hansel

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190
Q

Polycythemia vera is caused by?

A

increased RBC production

NOT INCREASED EPO OR INCREASED EPO RESPONSIVENESS

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191
Q

PPV =

A

TP/(TP+FP)

patients want to know what a positive test means

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192
Q

Amniotic fluid

A

Ferning

Turns nitrazine paper blue

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193
Q

mechanism of action of hyperprolactinemia in hypothyroidism

A

TRH has some stimulation of lactotrophs = prolactin secretion

nipple discharge in hypothyroid patient

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194
Q

Sudden onset pain and redness in the MEDIAL CANTHAL region

Children or adults over 40

A

Dacrocystitis

Staph aureus, beta hemolytic strep

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195
Q

SP-P-IN

A

Specific test - positive - rules in disease

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196
Q

Bilateral pale gray nipple discharge

Guiac negative

Labs?

A

TSH and Prolactin level

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197
Q

What cbc findings can be found with EBV?

A

autoimmune hemolytic anemia

thrombocytopenia

elevated reticulocyte count

positive Coombs

due to IgM cold agglutinins

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198
Q

Work up of Addisons steps

A

early morning cortisol

cosyntropin stim test (no change = adrenal gland problem)

if adrenal gland - tx with cortisol + fludrocortisone

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199
Q

NPV =

A

TN/(TN+FN)

patients wants to know if the negative test is really negative

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200
Q

What immunosuppressant causes gingival hyperplasia and hirsutism

A

Cyclosporine

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201
Q

what is the other cause of floppy baby syndrome

A

Werdnig hoffman

AR degeneration of anterior horn cells and cranial nerve motor nuclei

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202
Q

What are the primary immune responses to PPSV23 vaccine and PCV 13 vaccine?

A

T-cell INDEPENDENT B cell response for PPSV23

T-cell DEPENDENT B cell response for PCV 13

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203
Q

Contrast induced renal failure lab values

A

LOW UNa
LOW FeNa
VERY HIGH spec grav

d/t spasm of afferent arteriole - renal tubular dysfunction and tremendous reabsorption of Na and Water

usual labs from toxin induced ATN would be the exact opposite

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204
Q

Untreated hyperthyroidism has increased risk for?

A

Bone loss

Osteoclast activity increased

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205
Q

Triple screen?

Quad?

A

Alpha fetoprotein
Estriol
Beta-hcg

Add inhibin A

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206
Q

Most common method of hep B transmission world wide

A

Perinatal

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207
Q

DTaP =

TdaP +

A

Kids

Adults

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208
Q

Proximal muscle weakness + hirsutism + weight gain

A

Cushing’s related MUSCULAR ATROPHY

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209
Q

EKG findings in tricuspid atresia

chest x ray findings

A

peaked P waves, Left axis deviation, small R waves

decreased pulmonary markings

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210
Q

headaches secondary to ICP are often worse when?

A

in the morning

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211
Q

Is BUN/Cr elevated or decreased in Upper GI Bleed?

A

elevated

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212
Q

Breast milk jaundice vs Breast feeding

A

Breast feeding = quanitity - not enough - bilirubin sits around due to lack of bowel movements - BEFORE DAY 7

Breast milk = quality - moms milk inhibits conjugation - AFTER DAY 7 - hydrolyzed formula

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213
Q

High radioactive iodine uptake scan = 3?

A

graves - diffuse pattern

toxic adenoma/multinodular goiter - nodular pattern

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214
Q

Hierarchy of growth in peds

A

Head
Height
Weight

(most to least important)

FTT leads to losses in the order of least to most important

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215
Q

Where is H and K excreted in the kidney?

A

cortical collecting tubule

216
Q

seizure stoppage in pregnancy

A

phenobarbital - relatively safe

217
Q

Nephrotic syndrome associated with what 3 physiologic responses?

A

edema

hyperlipidemia

thrombosis (hypercoagulable state)

218
Q

cogwheel rigidity

A

slowing of movement on passive flexion or extension of extremities

219
Q

VSD murmur

A

Holosystolic along left lower eternal border

With diastolic rumble at apex

220
Q

Chemical conjunctivits is associated with?

A

silver nitrate

within 24 hours

bilateral, nonpurulent

221
Q

Change in sensitivity and specificity with cutoff being decreased for a positive test

A

sensitivity increases

specificity decreases

222
Q

Nocardia pulmonary findings

A

nodular or cavitary lesions in the upper lobes

223
Q

cytologic findings of CSF with GBS

A

high protein, normal WBC’s

224
Q

Benztropin and Trihexylphenidyl

A

anti-cholinergic

Parkinsons

225
Q

When do you increase levothyroxine dose with pregnancy?

A

When the pregnancy is detected

226
Q

Asymmetric IUGR

A

Brain weigh is NOT decreased

After 20 weeks gestation

227
Q

First steps in SIADH

A

Fluid restriction

Salt tablets

228
Q

Erythema infectiosum = ?

infectious agent?

presentation?

A

fifths disease

parvovirus b19

fever and rash (SAME TIME)

229
Q

at what gestational age can you use a chorionic villous sampling?

A

over 10 weeks

230
Q

What test is more specific for Rheumatoid arthritis?

231
Q

painful, flaccid bullae, MUCOSAL EROSIONS

positive nikolsky sign

antibodies?

A

pemphigus vulgaris

antidesmoglein 1 and 3

chickenwire pattern on immunofluorescence - “intercellular deposits of IgG”

232
Q 
1 year
2year
3 year
4 year
5 year
A

walk

steps

tricycle

hop

skip

233
Q

Asymmetric growth in infants due to?

A

Uteroplacental abnormalities

Maternal malnutrition

234
Q

First line intervention for variable decels

A

maternal repositioning

235
Q

Effect of knee to chest positioning on cardiovascular system

A

Increases systemic vascular resistance

Decreases amount of R to L shunting in Tetralogy

236
Q

Hypertension, bilateral flank masses, micro he matures =

A

ADPKD

Berry aneurysms

237
Q

Only time you give tetanus immune globulin

A

Dirty wound

Uncertain vaccination history

OR

Less than 3 doses in history

238
Q

painless bleeding in 3rd trimester

A

placenta previa

transabdominal ultrasound to determine placental position

usually a patient with no prenatal care

239
Q

most common nutritional deficiency in infants?

240
Q

Central lytic lesion

Onion skinning

Moth eaten appearance

A

Ewings Sarcoma

241
Q

Specificity =

A

TN/ (TN+FP)

242
Q

2month

4month

6month

gross motor

A

lift head

roll over

sit up

243
Q

Enzyme to supplement with elevated homocysteine levels and DVT

A

Pyridoxine (B6)

244
Q

Meds for treatment of glaucoma

A

mannitol
acetazolamide
pilocarpine
timolol

245
Q

best treatment for absence seizures

A

ethosuximide

246
Q

X ray findings of rheumatoid arthritis

A

periarticular osteopenia and erosions of the joint margin

247
Q

Imaging needed for initial diagnosis of bronchiectasis

A

High resolution CT scan

248
Q

Prevention of passing measles accomplished by

A

Airborne precautions

249
Q

When does mittleschmerz occur?

A

At the time of ovulation

About halfway between periods

250
Q

CSF findings with Creutzfeld-Jacob

A

14-3-3 protein

Triphasic spikes on EEG

251
Q

Live attenuated vaccines

A

MMRV

Intranasal flu

252
Q

Increased level of what is diagnostic of Menopause?

253
Q

adequate contractions

A

> 200 montevideo units in 10 mins

IUPC measures

at least every 5 mins

254
Q

Sensitivity =

A

TP/ (TP+FN)

255
Q

Aortic dissection + elevated creatinine

Preferred imaging?

256
Q

Adenocarcinoma

A

non-smokers

asbestosis

peripherally located

no paraneoplastic syndrome

257
Q

In Brown Sequard hemisection loss of pain and temp occurs where approximately?

A

1 to 2 levels below the level of the transection

starting at umbilicus (T10) means injury occurred at T8

258
Q

Magnesium decreases the risk of what complication in preterm infants?

A

cerebral palsy

259
Q

Lab results of vomiting/nasogastric suctioning

A

hypochloremia, hypokalemia, metabolic alkalosis

elevated bicarb - for each H lost a bicarb is produced

260
Q

Pathophysiology behind toxic adenoma and multinodular goiter

A

autonomous production of thyroid hormone

261
Q

Two treatments for neuroleptic malignant syndrome

A

Dantrolene

Bromocriptine

262
Q

Pre-renal azotemia =

A

hypoperfusion

increased BUN and creatinine

BUN more

263
Q

gold standard for diagnosing vesicoureteral reflux?

A

voiding cystourethrogram

264
Q

predisposing condition of dementia patients to aspiration pneumonia

A

lack of cough reflex

265
Q

Best test to confirm Duchennes

A

Genetic testing

266
Q

Screening tests tend to be what?

A

high sensitivity

pap smear

267
Q

What anti-arrhythmic can cause dig toxicity when combined with dig?

A

Amiodarone

268
Q

What value is most useful in differentiating anemias?

269
Q

Epilepsy and absence seizures carry increased risk of development of what?

A

ADHD

Anxiety

270
Q

Rasagiline, Selegiline

MOI

A

MAO inhibitors (MAO-B)

271
Q

Kidney biopsy in Goodpasture shows?

A

linear deposits

272
Q

Morning stiffness + C1 and C2

what to do next?

A

X-ray c spine

RA

273
Q

rituximab MOA

A

monoclonal antibody against cD20

CLL treatment

274
Q

Isolated onset of adrenarche (hair growth) in an obese young female

source of hormone?

A

Adrenals!!!!!!!

275
Q

Differentiation of PCOS from Cushing Syndrome

A

No skin atrophy, muscle weakness, or bruisability in PCOS

276
Q

Skin infection + recent ENT symptoms, + renal (glomerulonephritis)

A

GPA or Wegeners

277
Q

Cellular findings with Dementia with Lewy Body disease

A

round eosinophilic intracytoplasmic inclusions within neurons of substantia nigra

278
Q

Contralateral somatosensory and motor deficit predominantly in LOWER EXTREMITY

Abulia (lack of will)

URINARY INCONTINENCE

what area of stroke?

A

Anterior Cerebral Artery Occlusion

279
Q

Ranolazine mechanism of decreasing angina

A

Decreased myocardial calcium influx

280
Q

Epiglottitis cause

usual age?

A

Hib

3 to 7, with no vaccines

sick as shit - rapid onset, high spiking fever

tripod with drool

airway + IV abx

281
Q

How to determine if pancreatic pseudocyst needs drainage?

A

severity of symptoms

nausea/vomiting/abd pain - drainage

282
Q

pulsus bisferiens =

associated with what?

A

2 strong systolic peaks of aortic pulse

associated with significant aortic regurgitation

283
Q

Difference between euthyroid sick syndrome and subclinical hypothyroid

A

Euthyroid sick is LOW T3 Syndrome with normal TSH and T4

Subclinical has an elevated TSH, Normal T4

284
Q

D xylose test is used to diagnose what?

A

celiac

or malabsorption syndromes

low urinary excretion of d-xylose is a + test

285
Q

Bilious vomiting in neonate

X ray findings normal

Next test?

Likely diagnosis

A

Upper GI series

Volvulus

286
Q

Myotonic dystrophy typical age of onset?

Inheritance?

Vs DMD BMD

A

12-30

Autosomal dominant

287
Q

BP treatment in pre eclampsia

A

Labetalol

Hydralazine (if BRADYCARDIC)

288
Q

Timing of alcohol withdrawal symptoms

A

12 to 48 hours = seizures

2 to 4 days = Delirium tremens

289
Q

Rheumatoid arthritis patient with splenomegaly and neutropenia?

A

Felty syndrome

autoimmune

290
Q

powder burn lesions in the pelvis =

A

endometriosis

291
Q

Treatment for post partum endometritis

A

Clindamycin plus gentamycin

292
Q 
Associated nephrotic syndrome with:
Cancer?
Children?
IVDA and HIV
NSAID's
SLE
A

membranous

MCD

FSGS

MCD and Membranous

all of them

293
Q

Live attenuated vaccines (6)

A 
Polio (oral)
MMR
Rotavirus
Influenza (intranasal)
Yellow fever
Varicella/Zoster
294
Q

Recurrent sinopulmonary infections + AIDS related infections

A

Severe combined immunodeficiency

B and T cells

295
Q

Treatment for legionnaires

A

macrolide or fluoroquinolone

296
Q

Triamterene and Amiloride are?

A

K sparing diuretics

297
Q

Side effect of mirtazapine

A

Weight gain

May or may not be beneficial depending in patient

298
Q

UTI/asymptomatic bacteruria Treatment in pregnancy

A
  1. amoxicillin

2. nitrofurantoin

299
Q

Precision

A

ability to reproduce results

doesn’t necessarily measure what it intends to measure - just repeatable

300
Q

diverticulosis vs angiodysplasia

A

bright red blood due to arterial source with diverticulosis

maroon colored blood from right colon with angiodysplasia

301
Q

Blood gas findings in CHF

Vs COPD

A

Hypoxia
Hypocapnia
Respiratory Alkalosis

Respiratory acidosis and hypoxia in COPD

302
Q

Empiric treatment for bacterial meningitis in IMMUNOCOMPROMISED

A

Cefepime + Vanco + ampicillin

303
Q

Medication used for conceiving in PCOS patients?

A

Clomiphene

304
Q

Thrombosis of mesenteric or hepatic veins, think?

305
Q

Sensitivity =

A

TP/(TP+FN)

306
Q

Conditions associated with pulsus paradoxus

A

cardiac tamponade

asthma

COPD

307
Q

Estrogen effect on thyroid hormones

A

Increases thyroid hormone binding globulin levels

Requires and increase in thyroid hormone

308
Q

what does gabapentin bind to?

A

alpha-2-delta calcium channels

309
Q

Significant side effect of efavirenz

A

psychiatric symptoms

310
Q

Chorionic villus sampling timing

A

10-13 weeks

311
Q

Most common medications causing acute interstitial nephritis

A 
penicillins/cephalosporins
Sulfa drugs (including diuretics)
312
Q

Shy drager Syndrome

A

parkinson symptoms with Orthostasis

313
Q

at what gestational age can you use amniocentesis?

A

over 16 weeks

314
Q

Lice treatment

A

Permethrin

315
Q

Recurrent sinopulmonary infections in adult

Low IgG, IgM, IgA

B cells?

A

Common variable immunodeficiency

Normal, but ineffective at making Immunoglobulins

316
Q

exaggerated drop in systolic BP during inspiratin (>10 mmHg)

A

Pulsus paradoxus

317
Q

Preferred benzodiazepine for alcohol withdrawal

A

Lorazepam

no active metabolites

318
Q 
hyporeflexia
lethargy
headache
respiratory failure
cardiac arrest

female early post-partum w/pre-eclampsia or eclampsia

A

Magnesium toxicity

319
Q

Secondary prevention =

A

screening + intervention

320
Q

Oxytocin toxicity

A

Hyponatremia
Hypotension
Tachyarrhythmia

Seizures

321
Q

Important CYP 450 inducers

A 
Carbemazepine
Phenytoin
Ginseng
St John Wart
Oral Contraceptives
Phenobarbital
Rifampin
322
Q

Herpes simplex encephalitis imaging findings

A

FRONTOTEMPORAL region abnormalities

on CT, MRI, AND EEG!!!!

323
Q

Foamy macrophages and fat globules on breast biopsy

A

Fat necrosis

Benign

324
Q

What heart murmur is associated with ankylosing spondylitis?

A

aortic regurgitation

325
Q

What is the greatest risk of parenteral nutrition?

A

central line associated bloodstream infection

326
Q

Unilateral MOTOR involvement

no sensory, cortical deficits
no visual abnormalities

A

LACUNAR INFARCT

327
Q

What physical exam finding is associated with aortic regurgitation

A

Bounding pulses (water hammer pulse)

328
Q

At what gestation age is magnesium typically neuroprotective

A

Less than 32

329
Q

21 hydroxylase deficiency results in elevated levels of what?

A

17-hydroxyPROGESTERONE

not pregnenolone

330
Q

When can HIV patients receive live attenuated vaccines?

331
Q

Central vs Peripheral Bells Palsy

A

Central - PRESERVATION of forehead and eyebrow movements

Peripheral - loss of forehead and brow movement, inability to close eyes and drooping lids, drooping of lower lip

332
Q

Takayasu, GPA, Eosinophilic granulomatosis with polyangiities create what type of vasculitis

A

granulomatous

333
Q

Test for sideroblastic anemia

A

Prussian Blue

334
Q

Meds for fibromyalgia

335
Q

Cause of retinopathy of prematurity

A

high FiO2 in preemie with poor lung maturity

336
Q

Meds for trigeminal neuralgia

A

oxcarbazepine, carbamazepine

337
Q

Specificity =

A

TN/(TN+FP)

338
Q

Test for Cystinuria

urinalysis findings?

A

urinary cyanide nitroprusside test

hexagonal crystals

339
Q

German Measles =?

prodrome?

fever and rash - timing and spread?

A

Rubella

fever and rash at same time

rash starts on face and spreads down body

generalized and tender lymphadenopthy

340
Q

How to determine what to do after oxytocin fails in stage 2 of labor

A

fetal station

if negative - c-section

if positive - forceps/vacuum

341
Q

Microcytic anemia non-responsive to iron supplementation

think?

A

Hemoglobinopathy

342
Q

Right Heart cath findings in septic shock (distributive shock)

A

decreased SVR
decreased/lownormal PCWP
elevated MvO2
Increased cardiac index

343
Q

Work up of Cushing’s

Steps

A

1 - low dose Dex test (failure to suppress) + 24 hour urine or late night salivary

2 - ACTH (normal = adrenal tumor) (elevated = ACTH dependent)

3 - High dose dex suppression test (suppression = cushings disease), (failure to suppress = ectopic tumor)

Low then high

344
Q

Apt test is for?

A

testing whether baby swallowed moms blood during delivery

345
Q

Meds to help 5-7mm renal stones pass

A

Nifedipine or Tamsulosin

346
Q

2nd Tri screen

A

Triple and Quad Screen

hCG, AFP, Estriol

quad + Inhibin A

Downs is up
Edwards is down down down

347
Q

Normal amniotic fluid index

348
Q

what two sensations are intact with anterior spinal artery infarct

A

position and vibratory

349
Q

What other electrolyte may need to be replaced if hypokalemia is resistant to correction?

A

Magnesium

can lead to INCREASED urinary loss of K

350
Q

omphalocele is usually located where?

351
Q

Should all Hep C patients be immunized against Hep A and B?

352
Q

Trichinellosis vs infective endocarditis

A

Eosinophilia and periorbital edema in trichinellosis

353
Q

Important CYP 450 inhibitors

A 
Acetaminophen
NSAIDs
Amiodarone
Antibiotics
Cimetidine
Cranberry juice, Gingo biloba
Omeprazole
Thyroid hormone
SSRIs
354
Q

Pathophysiology of uterine fibroids

A

Smooth muscle cell proliferation in myometrium

Irregularly enlarged uterus

355
Q

most common skin cancer of the lower lip?

A

squamous cell

356
Q

Anti smooth muscle antibodies is associated with what hepatic condition?

A

Autoimmune hepatitis

357
Q

HACEK organisms

Tx?

A 
Haemophilus 
Actinobacillus
Cardiobacterium
Eikenella
Kingella

Ceftriaxone

358
Q

most common cause of nephrotic syndrome in adults?

359
Q

Brain region involved with Huntingtons

A

Caudate nucleus

360
Q

Most common cause of sepsis in sickle cell disease

A

S. pneumoniae

prophylactic penicillin until age 5

361
Q

Most common sequelae of bacterial meningitis

A

Hearing loss

362
Q

Most common causes of acquired methemoglobinemia

A

Topical anesthetic

Dapsone

Nitrates in infants

363
Q

Symmetric growth restriction due to

A

Chromosomal anomalies

Congenital infections

364
Q

Lymph nodes with purple to drainage

Staph, burkholderia, nocardia, aspergillosis infections

A

Chronic granulomatous disease

365
Q

Rare but possible serious complication of Infectious Mono

A

Acute airway obstruction

366
Q

Eggshell calcification on liver cyst =

A

Hydatid cyst

Echinococcus granularis

367
Q

common side effect of roux-en-y bypass other than dumping syndrome

A

gall stones and cholecystitis

due to rapid weight loss

368
Q

Maneuvers that reduce blood return to the heart typically do what to innocent murmurs?

A

Reduce the intensity

369
Q

Macrosomia. Macroglossia, HEMIHYPERPLASIA

=

A

Beckwith Wiedmann

Abdominal ultrasound

370
Q

What occurs with uric acid levels in SiADH?

A

characteristically low

371
Q

Characteristics of RA to know

A

Small joints - hands and feet

Symmetric

Morning stiffness - greater than 60 mins to relieve

Cholesterol nodules

372
Q

Antipsychotic least likely to cause extrapyramidal symptoms

373
Q

Aldosterone mnemonic

ASSPP

A

Aldo saves sodium and pushes potassium out

374
Q

ACE-I causes what change in kidney blood flow?

A

efferent arteriole dilation

375
Q

1st Trimester Screen

A

U/S Nuchal translucency
PAPP-A
hCG

376
Q

vaccination, weight loss, decreased EtOH intake, decreased smoking are all forms of?

A

primary prevention

377
Q

Treatment for crabs

A

Permethrin

378
Q

Hemodynamics in Hypovolemic shock

RA pressure
PCWP
cardiac index
sVR
MVO2
A

Decreased

Decreased

Decreased

Increased

Decreased

379
Q

Antibody for primary biliary cholangitis

A

Anti-mitochondrial

380
Q

CHemo Man

A

Arms and Legs - Vincristine/Vinblastine = peripheral neurop

Heart - Doxi/Daunorubicin - dose dependent cardiomyopathy

Lungs - b shape - bleomycin - pulmonary fibrosis

kidneys and ears - platins - oto and renotoxic

Cystitis - hemorrhagic cystitis

381
Q

fragile X is commonly associated with what?

A

autistic behavior

382
Q

Pathophysiology behind breath sounds and tactile fremitus in pneumonia vs pleural effusion

A

Pneumonia = consolidation INSIDE lung = breath sounds fremitus traveling FASTER through liquid = INCREASED FREMITUS AND BREATH SOUNDS

Pleural effusion = fluid OUTSIDE lung = INSULATION of sounds = DECREASED FREMITUS AND BREATH SOUNDS

383
Q

Painful violaceous nodules on fingers tips and toes

A

Osler nodes

384
Q

Idiopathic precocious puberty is due to what?

A

Early activation of the HPA axis

385
Q

lung lobes affected with aspiration in supine patients

A

posterior segments of upper lobes

superior segments of lower lobes

386
Q

Envelope shaped crystals

A

Calcium oxalate

Ethylene glycol ingestion

387
Q

colonscopy for ulcerative colitis diagnosed early

A

start 8 years from diagnosis

q1year

388
Q

When is a Head CT needed prior to LP?

A

Papilledema
Seizures
Focal neurologic abnormalities
Confusion

389
Q

CD4 count for toxo

A

less than 100

390
Q

What tendon reflex decreases with age?

391
Q

Renal vein thrombosis most commonly associated with what kidney condition?

A

Membranous glomerulopathy

392
Q

ferning or positive nitro test with pregnant women =

A

rupture of membranes

393
Q

primary ovarian insufficiency is a form of?

A

HYPERGONADOTROPIC hypogonadism

elevated GnRH, FSH

decreased estrogen

394
Q

Mechanism of action of riluzole

tx for?

A

glutamate inhibitor

ALS

395
Q

Ring enhancing lesions in an HIV patient

A

Toxoplasmosis

TMP-SMX prophylaxis

396
Q

Lennox Gastaut Syndrome

A

children less than 7

array of seizure type s+ mental retardation

397
Q

Squamous cell

A

smoking

centrally located

PTH-RP

398
Q

grossly lipemic serum, palmar xanthomas, pancreatitis

first line tx

A

fenofibrate

familial dysbetalipoproteinemia

399
Q

Milk protein allergy presentation

due to?

A

soy protein allergy

failure to thrive despite adequate feeding

may present with bloody bowel movement

switch to cows milk or breast feeding

400
Q

Biomarker for epithelial ovarian carcinoma

A

CA-125

check level in postmenopausal woman with ovarian mass on pelvic ultrasound

401
Q

When do you add dextrose fluids in DKA?

A

glucose less than 250

402
Q

Jarisch-Herxheimer Reaction

A

Fever and worsening symptoms after treatment of syphilis

Give aspirin and antipyretic

403
Q

Symptoms of adrenal insufficiency

Initial work up

A

weakness, fatigue, hyponatremia, hyperkalemia

low-normal early cortisol

8am serum cortisol + Plasma ACTH

ACTH stim test in the meantime (plasma ACTH will take a few days)

404
Q

Dyskinesia in Huntingtons treated with?

A

tetrabenazine

405
Q

Can ACEi ARB be used with unilateral RAS?

406
Q

which type of colon polyp has the greatest malignant potential?

A

villous

VILLain

407
Q

Relief of pneumothorax allows restoration of what?

A

venous return

408
Q

CATCH

In catch 22 for digeorge

A 
Conotruncal defects
Abnormal facies
Thymic aplasia,hypoplasia
Cleft palate
Hypocalcemia
409
Q

Sudden loss of vision + floaters + difficulty visualizing fundus

A

Vitreous hemorrhage

410
Q

What 3 conditions is FSGS associated with?

A

HIV

Obesity

Heroin use

And African Americans

411
Q

inheritance of wiskott-aldrich

412
Q

what imaging should be done for individuals with myasthenia gravis

A

Chest

either X-ray, CT, or MRI

looking for THYMOMA

CT w/contrast is best

413
Q

Peds meningitis causes

A

<3 months = GBS, E. coli, listeria, HSV

3 months to 10 years = Strep pneumonia, Neisseria

> 11 years = Neisseria

414
Q

Only way to definitively diagnose adenomyosis?

A

Hysterectomy

415
Q

sodium correction in DKA

A

+ 2 Na for each 100 mg Glucose over 100

416
Q

Fine motor

3 year

4 year

5 year

A

circle

plus sign

triangle

417
Q

Common additional findings with Legionella

A

bradycardia

hyponatremia

mild hepatitis

CNS/GI involvement

418
Q

Giant granules in neutrophils, albinism

A

Chediak Higashi

419
Q

Differentiation of painless vaginal bleeding in pregnancy

A

Placenta Previa - no abnormalities other than bleeding

Vasa previa - Fetal heart tracing changes show deterioration

420
Q

What is the preferred treatment for adjustment disorder?

A

Psychotherapy

As opposed to meds for MDD

421
Q

Bupropion MOA

422
Q

What drugs for epilepsy are relatively safe for pregnancy?

A

leviteracitam

lamotrigine

423
Q

4th gen cephalosporin

424
Q

Why is the right kidney easier to palpate in ADPKD?

A

it lies lower than the left

due to the liver on the right

425
Q

Treatment for risperidone induced parkinsonism

A

add benztropine - anticholinergic

426
Q

Two types of periinfarct arrythmias

A

type Ia - within ten minutes - due to heterogenous conduction = reentrant

type Ib - 10 to 60 minutes post infarct - due to abnormal automaticity

427
Q

first line tocolytic at 32 to 34 weeks gestation

A

nifedipine

428
Q

Type IV RTA also known as?

mechanism of impairment

common underlying disease

Diagnostic test>

Tx?

A

Hypoaldosteronemia, Hyporeninemia

impaired aldosterone signaling

diabetes

Urine Na loss even with salt restricted diet

Fludrocortisone

429
Q

Genetic inheritance of Kallman

A

X linked recessive

congenital absence of GnRH

430
Q

Trinucleotide repeat for Huntingtons?

431
Q

differentiating nocardia from Actinomyces and Mycobaterium tuberculosis

A

weakly acid fast

not acid fast

strongly acid fast

432
Q

Most common organism associated with contact lens keratitis

A

Pseudomonas

433
Q

Glomerular disease + hearing loss + visual disturbance?

A

Alport

type IV collagen

434
Q

When can you observe and follow up dog/human bites

A

minor in nature

not located on hands, feet, or genitalia

immunocompetent

435
Q

hyperechoic nodules with calcifications - ovarian mass

A

dermoid ovarian cyst (CYSTIC TERATOMA)

benign

pre-menopausal women

436
Q

Most common side effect of excess oxytocin

A

Uterine tachysystole

437
Q

Immunodeficiency + thrombocytopenia + eczema

A

Wiskott-Aldrich

438
Q

why is strep pharyngitis less common udner age 3?

A

don’t have enough epithelial cell attachment sites

439
Q

Most common type of vulvar cancer?

A

Squamous cell

440
Q

Pathophysiology of Meckels diverticula

A

Incomplete obliteration of the vitelline (Omphalomesenteric) duct

441
Q

Symmetric IUGR

A

Brain in proportion with rest of body

Before 20 weeks

442
Q

What medication do you add to acute lymphocytic leukemia?

A

intrathecal methotrexate

443
Q

Infectious screens at initial prenatal visit

A 
HIV
VDRL/RPR
Hep B
Rubella
Varicella
Chlamydia (NOT GONORRHEA)
444
Q

Young, otherwise healthy female

Myalgias, proximal muscle weakness

Dx?

Labs?

A

Hypothyroid myopathy

TSH and free T4

445
Q

Bacterial tracheitis vignette

A

croup that doesn’t improve

more toxicity - fever/leukocytosis

racemic epi doesn’t work

tracheal culture

446
Q

Differentiating thalassemia minor from iron deficiency

A

Mentzer index

MCW/RBC

> 13 - Iron
<13 - thalassemia

447
Q

Zones of Adrenal

A

Glomerulosa - aldosterone

Fasciculata - cortisol

Reticularis - testosterone

448
Q

1 year

2 year

3 year

4 year

5 year

language

A

1 word

2 word

3 word

4 word

5 word sentences

449
Q

Pramipexole and Ropinirole

A

Dopamine agonists

Parkinsons

450
Q

macrocytic anemia

low retic

congenital anomalies

A

diamond blackfan anemia

triphalangeal thumbs

451
Q

what type of bili causes kernicterus?

A

unconjugated -> able to cross BBB

452
Q

currant jelly stool + sausage shaped mass + intermittent colicky abdominal pain with knees to chest (normal in between)

A

intussusception

KUB

U/S

Air enema

453
Q

Medication for ALS?

A

Riluzole

reduces glutamate buildup

454
Q

Meds for Tourettes

A

Fluphenazine, Clonazepam, Pimozide

455
Q

CD4 count for CMV disseminated

A

less than 50

456
Q

What type of cell on peripheral smear is most common with thalassemia

A

Target cells

457
Q

Inevitable abortion

A

Intrauterine bleeding + dilation of cervix

458
Q

Rheumatic fever is more often linked to ?

As opposed to glomerulonephritis being linked to?

A

group A strep throat

vs

impetigo

459
Q

Lewy Body dementia = Dementia +?

A

Parkinsonism

460
Q

Underlying pathophysiology of intussusception

A

Hypertrophy of Peyers Patches

461
Q

Seconary group of patients that Craniopharyngioma occurs in

A

55 to 65 years old

462
Q

mycosis fungoides =

A

cutaneous T cell lymphoma

463
Q

gastroschisis is usually located where?

A

to the right of the umbilicus

464
Q

fatigue + weight loss + normocytic anemia + renal insufficiency + hypercalcemia

A

multiple myeloma

465
Q

Hypnagogic hallucinations occur when?

A

Just prior to falling asleep

466
Q

mydriasis =

can worsen what condition?

A

dilation of the pupil

acute glaucoma

467
Q

Hyperventilation effect on CO2

Effect on cerebral blood flow

A

Decreases

Vasoconstriction

468
Q

Teenager with possible meckels - diagnostic test?

A

CT scan is better than Tech-99 scan

469
Q

Purulent conjunctivitis 2 to 5 days after delivery

A

GONOCOCCAL

470
Q

Roseola =?

what infectious agent?

fever and rash - timing and spread

A

HHV 6

HIGH spiking fever

fever, then rash, not together

rash starts on trunk and spreads outward

471
Q

Pathophysiology of Hepatorenal syndrome

A

Splanchnic arterial dilation

Decreased GFR in absence of other clear cause

472
Q

Amniocentesis timing

A

15-20 weeks

473
Q

Inheritance of hemophilia A and B

A

X linked recessive

474
Q

Urine anion gap = ?

helps determine between?

A

Na - Cl-

between RTA and diarrhea

475
Q

Threatened abortion

A

Intrauterine bleeding + NO CERVICAL DILATION

476
Q

Gold standard tx for pertussis

A

Macrolides

477
Q

Bacterial meningitis empiric treatment

2 to 50 years

over 50

A

2 to 50 = vanco + 3rd gen cephalosporin

over 50 = vanco + 3rd fgen ceph + ampicillin

478
Q

Which cancer has the highest ability to transform into acute leukemia?

479
Q

Drug used for HIV transmission prevention in baby

A

Zidovudine

480
Q

What defines a positive water deprivation test

A

Urine osmolality stays low

Urine volume stays high

481
Q

Left to Right shunts in peds (3)

A

ASD

VSD

PDA

482
Q

clotting changes with pregnancy

A

increased vWF, increased 7,8,10

decreased protein C and S

increased fibrinogen

483
Q

Child
High fever
Knee pain/Swelling (Unilateral)
refusal to bear weight

leukocytosis + elevated CRP and ESR

Recent URI or skin infection

A

Septic arthritis

next step: Arthrocentesis

484
Q

Glucose levels low in pleural effusion usually due to

A

White blood cells in the effusion

485
Q

Patients with gonococcal infection should be screened for?

A

HIV, Syphilis, Hep B

486
Q

Polyarteritis nodosa creates what type of vasculitis

A

necrotizing

487
Q

Indications for retrograde urethrogram

A

blood at meatus
dysuria
urinary retention

488
Q

foot tapping, lip smacking, tongue protrusions in a patient on antipsychotics

A

tardive dyskinesia

when dose reduction isn’t possible switch to CLOZAPINE

489
Q

maternal diabetes associated with what congenital heart defect

A

transposition

490
Q

Draw the diagram for determining NPV, PPV, SNS, SPC

A

TP FP PPV
FN TN NPV

SNS SPC

491
Q

Diptheria steps of treatment

A

intubate

anti-toxin

IV abx

pseudomembrane - do not try to remove it

492
Q

Melanosis coli

A

Dark brown discoloration of the colon with pale patches of lymphoid follicles

Associated with laxative abuse

493
Q

Preferred pharmacotherapy for a prolonged QT

A

Beta blockers

Blunts increases in HR and shortens QT

494
Q

Mupirocin

A

Topical antibiotic

Localized impetigo

495
Q

What three things are commonly affected by allergenic substances?

A

skin
kidney
red cells

496
Q

Rusty or dark brown lesions on laparoscopy

Chocolate cyst on ovary

A

Endometriosis

497
Q

diffus breast erythema, edema, p’eau d’orange

A

inflammatory breast carcinoma

498
Q

Lung destruction from smoking vs AAT deficiency

A

upper lobes for smoking

lower lobes for AAT deficiency

Centriacinar vs Panacinar respectively

499
Q

At what age can you stop mammo screening?

500
Q

Recurrent skin infections with staph

A

Hyper-IgE syndrome

501
Q

Hemodynamics in Cardiogenic shock

RA pressure
PCWP
cardiac index
sVR
MVO2
A

Increased

Increased

DECREASED

Increased

Decreased

502
Q

Dysmorphic red cells on UA =

A

glomerulonephritis

503
Q

Where is Wernicke’s area located?

other associated findings with stroke?

A

Superior posterior TEMPORAL lobe

right superior visual field defect

504
Q

Pertussis post exposure prophylaxis

A

Azithromycin for 5 days

Or the other macrolides

505
Q

Patient with stroke already on aspirin, next pharmacologic step

A

add Dipyridamole

OR

switch to Clopidogrel

506
Q

Confirmatory tests tend to be ?

A

high specificity

colposcopy

507
Q

Tolvaptan and Conivaptan are?

A

ADH Antagonists

for acute severe SIADH

Demeclocycline for chronic SIADH

508
Q

Stroke or MI in a young person = look for?

viral infection associated?

best initial test?

A

Polyarteritis Nodosa

Hep B

Angiography

509
Q

2 months

6 months

1 year

social development

A

social smile

stranger anxiety

separation anxiety

510
Q

Mild vs Severe Concussion

4 factors

A

FND
LOC
HA
Amnesia

511
Q

Important equation for determining pH

A

H+ = {pCO2}/{HCO3-}

512
Q

Treatment for toxoplasmosis

A

Sulfadiazine + Pyrimethamine

TMP-SMX for prophylaxis

513
Q

what is the type of rash with fat embolism?

A

petechial

12 to 24 hours after injury

514
Q

condyloma acuminata =

condyloma lata =

A

HPV

syphilis

515
Q

Low ferritin + High TIBC =

RDW?

A

Iron deficiency anemia

Increased RDW

516
Q

What imaging can induce thyrotoxic crisis

A

CT with contrast

Contrast is iodinated

517
Q

Change in sensitivity and specificity if cutoff point is increased for a positive test

A

sensitivity decreases

specificity increases

518
Q

Mono like illness in mom

brain calcifications
ventriculomegaly
seizures

A

toxoplasmosis

519
Q

abx for gallbladder diseases (cystitis, docholithiasis, cholangitis)

A

cipro/metro

amp/gent/metro

520
Q

Three A diseases associated with eosinophilic esophagitis

A

asthma

allergies

atopy

521
Q

esophageal cancer vs esophageal stricture

A

barium swallow

stricture = symmetric

cancer = asymmetric

522
Q

nocturnal asthma =

523
Q

Stool osmolar gap

A

Measured - calculated

290 - (2x(Na + K))

524
Q

Stool osmolar gap

A

Measured - calculated

290 - (2x(Na + K))

525
Q

attributable risk percent =

A

ARP = (RR-1)/RR

so if a given risk factor causes 4 times the risk of getting a disease the RR = 4 and the ARP = 75%

526
Q

do sensitivity and specificity depend on disease prevalence at all?

527
Q

What is factorial study design

A

2 or more interventions each with 2 or more variables studied independently

528
Q

what value of hazard ratio indicates no significant difference in adverse event outcomes between two itnerventions?

A

the closer to 1, the more equal they are

529
Q

wider confidence interval including the null value of RR=1

most likely cause?

A

small sample size

decreases power

530
Q

Subtypes of Selection bias

A

ascertainment

nonresponse

Berkson

Prevalence (Neyman)

Attrition

531
Q

Subtypes of Observational Bias

A

Recall

Observer

Reporting

Surveillance (detection)

532
Q

Case Control study

A

analytical observational study

retrospective

selecting cases with an outcome then controls without that outcome

then look back for risk factors

533
Q

when can odds ratio be assumed to be representative of the relative risk?

A

rare diseases

tampon use and toxic shock syndrome

TSS has very low prevalence

534
Q

research study to do to investigate incidence

A

cohort study

535
Q

Mode, median, mean

in a positive skew

in a negative skew

A

positive
Mode> Median > mean

negative Mode < median < mean

536
Q

a tight confidence interval =

A

a precise study

537
Q

moving upward on an ROC cruve =

moving to the right on an ROC curve =

A

increased sensitivity

decreased specificity

UWorld Step 2 CK (3 decks)

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