PANCE Flashcards
philadelphia chromosome is pathognomonic of what type of leukemia
CML
Auer rods and Pancytopenia with circulating blast
AML
what type of lymphoma will most likely find epstein bar virus?
hodkins lymphoma
Reed-Sternberg cells =
= Hodgkins lymphoma
X-ray of the skull showing punched out lesions =
multiple myeloma
Thiazide diuretics is contraindicated in which patients?
Gout
what drugs can cause macular degeneration?
chloroquine or phenothazin
patient with strep pharyngitis allergic to penicillin, which abx?
Azithromycin
what is the name of a mass that develops in young adult following URI?
brachial cleft cyst -locateds away from the midline and anterior to the SCM
what is the treatment for oral trush?
nystatin or clotrimazole troches
what causes chronic otitits media?
P. aeuriginosa, H influenza, S. aureus
which type of conjuntivitis will present with pre-auricular lymphadenopathy?
viral conjunctivitis
what is the treatment for gonorrheae?
IM ceftriaxone or oral ceftixime
medications that causes ototoxicity?
aminoglycosides (gentamycin), loop diuretics, antineoplastic agents (cisplatin)
what is the treatment for aphthous ulcer?
liquid dihenhydramine
antacid
tetracycline
2% viscous xylocaine
what is the center criteria?
fever, tonsilar exudates, tender anterior lymphadenopathy, lack of cough
what is aphthous ulcer asssociated with ?
herper virus 6
what is the treatmement of aphthous ulcer?
liquid dihenhydramine
antacid
tetracycline
2% viscous xylocaine
what is prebyscus?
age related bilateral loss of high frequency hearing
what medication will help to relieve pain in the eye due to foreign object or substance?
proparocaine 0.5% opthalmic solution
sudden painless vision loss
cherry red stop on macula along with pallor to the retina, what is the DX?
Central retinal artery occlusion
what is the treatment for giant cell arhtritis?
high dose prednisone 60mg/day
characterized by blood and thunder fundus
mark hemmorrages
torturous vessel
central vein artery occlusion
what is cholesteatoma?
variety of chronic ottitis media
most common cause prolongerd eusthachian tube dysfunction with resultant chronic negative middle ear pressure that draws inward the upper flacid portion of the tympanic membrane
how do you monitored open angle glaucoma?
tonometry
gonioscopy
monitored dics to cup ration
visual field examination when monitoring
what is sialodenitis?
-acute bacterial mc s aureus
affect parotid or submandibular gland
acute swelling of the gland
increased pain and swelling with meals
tx for sialodenitis?
nafcillin
inclussion conjunctivitis fro chlamydial infection?
azithromycin 1g orally
what is herpes simplex keratitis?
causes acute ocular morbidity, virus colonizes trigeminal ganglion
positive D dimer is seen in
DIC
bite cells and heinz body are seen in this type of anemia
G6PD
should not eat fava beans
G6PD deficiency
t/f both hemophilia A&B are both x linked recessive
true
what is the main treatment acute management for anxiety?
SSRI-benzodiazepine (alprozalon or lorazepam)
what is the main treatment for the maintenace of anxiety?
benzodiazepine are tapered.
paroxetine is beneficial, fluoxetine, venlofaxine, sertraline
what is the treatment for schizoprenia?
serotonin and dopamine antagonist
what is clozapine and what is its side effect?
second line therapy to treat schizophrenia and can cause agranulocytosis
what is the difference between schizophenicform disorder and schizphrenia?
Schizophrenicform disorder last about 1-6 months
what is the treatment for body dysmorphic disorder?
serotonin modulator blocks (fluozetine, clomipraine), SSRI @ higher doses -treat for 10-12 weeks
when does pospartum depression occur and what is the tx?
4 weeks after delivery and tx is SSRI-sertraline and also hormone therapy might help
what should a patient be aware when started on MAOIs?
a tyramine free diet (no wine, beer, almost all cheeses, smoked meats , aged foods) to avoid side effects.
what is a side effect of MAOI when patient consumes foods containing tyramine?
hypertensive crisis
what is the treatment for mood disorder?
SSRI (fluoxetine, paraxetine, sertraline)
what is the treatment for atypical depression?
MAOIs
what is serotonin syndrome?
when MAOI are used with SSRI
what is the treatment for bipolar disorder?
acute mania: lithium, antipsychotics, benzos, antisz
commonly lithium or valproate + antipsych
describe the different personality disorder clusters?
cluster A: mad
cluster B: Bad
Cluster C: Sad
what makes up cluster A?
paranoid, schizoid, schizotypal
what are the types of cluster B personality disorder?
Histrionic, Narcissistic, Borderline, Antisocial
what are the subtypes of cluster C?
avoidant
dependent
obsessive-compulsive
causes measles
paromyxovirus
causes rubella
togavirus??
causes foot hand mouth disease
coxsakie virus A16
causes erythema infectiousum
parvovirus b19
causes roseola infantum
HHV6 or 7
HIV, deep, purple, papular lessions
kaposi’s sarcoma
lession> 6mm
possible malignant melanoma
precursor of squames cell carcinoma
actinic keratosis
rouleaux formation seen
mutliple myeloma
autopsy of rabies shows
negri bodies
autops on alzeimers shows
neurofibrillary tangles
periventricular plaques is associated with
multiple sclerosis
slapped check
erythema infectosum
high fever then rash (starts on trunk spreads to face and extremeties)
Roseola
diagnostic test for malaria
peripheral blood smear with Giensa
coryza, cough, conjunctivities, koplik spots
measles-rubella
what is the drug of choice for cases of MRSA?
bactrum
what is herald patch?
salmon color -papular rash seen in pityriasis roseasea
what is the treatment of choice for urticaria caused by ABX
hydroxizine
what leukemia will present with Aeur rods?
AML
leukemia with CNS involvement
ALL
which leukemia will present with smudge cells
CLL
treatment for hemophilia IX
desmopresin
positive philadelphia chromosome seen in
CML
reed sterberg cells
hodkins lymphoma
howell-jolly bodies seen in
macrocytic anemia
ABX m/c to cause GERD
tetracycline
infectious esophagitis endoscopy with deep ulcers
CMV or HIV
infectious esophagitis with shallow ulcers agent
HSV
best initial test to visualized lession in esophagial neoplasm
biphasic barium esophagram
what is Budd Chiari syndrome?
may cause thrombosis of the portal vein leading to esophagial varices
treatment for h pilory
PPI+clarithromicin( or metronidazole) +amoxicillin or
Bismuth subsalicylate tetracycline + metronidazole+ PPI
what is prophylaxis treatment for h pylori
misoprostol or ppi
DX for ZES
secretin test 2 u/kg
tx for clostridium difficile
metronidazole, vancomycin, fidoxamicin
dx test for malabsorption
72 hrs fecal fat test
diagnostic test to distinguish between malabsorption from mladigestion (e.g pancreatic insufficiency)
D Xylose test
diagnostic test for celiac
IgA antiendothelial (EMA) antitissue transglutaminase ( Anti-TTG)
how is the dx confirmed in celiac
small bowel biopsy
what is the treatment for refractory case of celiac
prednisone
what is the treatment for chrons disease
prednisone for acute attacks with or w/o amino salicylates
tx for perianal disease in chrons
metrinadazole or cipro
best tx for maintanence of Chrons
mesalamine
TX for refractory cases of Crohn’s
infliximab
the tx for UC
total protecolectomy
currant jelly stool, sausage mass
intessuception
anal fissure is most likely location
posterior midlne
courvoiseur sign
jaundice and palpable gall bladder indicating pancreatic neoplasm
test to confirm dx of cholecysitis
HIDA scan
test to identify cause, location, extent of biliary obstruction
ERCP
Anti-HAV
onset of Hepatitis
HAV-IgG
resolved disease
HBs-AG
ongoin infection
Anti-HBs-
immunity due to past infection
anti-HBc
immunizatino or acute
c=core
HbeAG
e=envelope
active and contagious
anti-HBe
lower viral titer
HBsAG=
carrier or chronic infection
possible cause of liver abcess
entomoeba histolytica or coliform
direct hernia
hesselback triangle, no scrotum
indirect hernia
internal inguinal ring and scrotum
treatment for pyloric stenosis
riboflavin
failure to pass mecomiun first 48hrs what is the DD?
hirshsprings
cryptococcus causes & TX
fungal meningitis,amphoterecin B plus flucystosis
test for lyme disease
elisa
tx for lyme disease
IV ceftriaxone
boxer’s fracture to the mouth , treat for what organism?
Eikenella corrodens-organism specific to human mouth
gamekeeper’s thumb
sprain or tear of the ulnar collateral ligament of the thumb
compression of the median nerve
carpal tunnel
tennis elbow
lateral epicondylitis
golfer’s elbow
medial epicondylitis
dequervains thumb
overuse repetitive gripping
+ Finkestein test
posterior fat pad
radial fracture
septic bursitis mc organism
S. aureus
mc complication of scaphoid fracture
avascular necrosis and non union
what affected joint is required for diagnosis of ankylosis spondylitis
SI joint
what are other associated symptoms with ankylosing spondylitis
anterior uveitis, aortic insufficiency and 3rd degree heart block
what is found on AS in labs?
increase ESR
what is the treatment for AS
indomethacin #1
TNF
convex curvature of the thoracic spine
kyphosis
Scheuermann’s Disease
fixed kyphosis develops at the time of puberty
what are the x ray findings of Scheuermann’s disease
vertebrae wedging
end plate irregularity
Schmori’s nodules between T2 and T12
what is the most common scoliosis curvature
right thoracic turn
corveseur sign
seen in pancreatic cancer
palpable non tender gallbladder
triangle of callot
inferior border of the liver,cystic duct, common hepatic duct
treatment for H pilory
omeprazole + amoxicillin+clarithromicin
or
bismuth subcitrate+metronidazole+tetracycline+omeprazole
intessuception treatment
air enema
pyloric stenosis dx test
barium swallow, upper gi series
olive mass, string sign
exam findings associatedw with appendicities
Rovsing mckburneys psoas obturator blumberg (rebound tenderness)
histology findings of alcoholic hepatitis
mallory bodies
shigella infection tx
fluoroquinolones (levofloxacin, ciprofloxacin)
complication of acute pancreatitis
pseudocyst
diarrhea, dermatitis,dementia which vitamin deficiency
niacin=pellagra
niacin is b3 or should we say D3 se le pellagra la piel
ulcerative coltis
bloody diarhhea lost of haustral markings
positive drop arm test suggest
rotator cuff tear
what is the hawkins test for?
to evaluate impingement/bursitis
what test suggest inferior instability of the glenohumeral joint?
sulcus sign
what test is perform to evaluate anterior instability
apprehension test
what is the treatment for gameskeeper aka (skier thumb )
injury to the ulnar collateral ligament -immobilization for 4-6 weeks
what is the test is MOST SPECIFIC for detecting Sjondre syndrome?
anti-la test
what is the lab test used for the dx of scleroderma?
anti centromere antibody test
what nerve is associated with medical epicondylitis?
ulnar nerve
what are the findings of polyARTthritis Nodosa?
constitutional symptoms fever, anorexia, weight loss, palpable purpura , livido reticularis
related to hepatitis B
ANCA positive plus lungs and kidney findings suggest?
wegener’s granulomatosis
mr. WEGer is my ANCle
what is the hallmark of herniated disk disease
sciatica
what is the most SPECIFIC test to detect SLE?
anti-double stranded DNA
what vitamin deficiency is seen in cystic fibrosis?
vitamin A due to deficiency in fat soluble vitamins
diagnostic test to confirm polyarteritis nodosa
blood vessel biopsy
diagnostic test for polymyosistis
muscle biopsy
most common side effect of methotrexate
stomatitis/gastritis
what is the presentation of a patient with Ehlers Danlos syndrome?
type 1 varient, velvety skin, hyperflexibility of the joints, MVP
condition that presents with muscle weakness in upper leg muscles and hip girdle in young boy and elevated CPK and creatine
duchenne muscular dystrophy
what structure it is damage in gamekeeper’s thumb.
the ulnal collateral ligament which causes laxity when moving the thumg into abduction
vitamin recomendation for risk of osteoporosis
calcium 1200-1500 mg
vitamin D 800-1000u
what is the most common pathogen to cause osteomylitis
pseudomonas
what is the treatment for Ankylosis spondylitis
indomethacin/ NSAID
valgus testing it is for which ligament?
MCL
where is the pain felt most in polymyalgia rheumatica
girdle -
what lab is elevated in polymyalgia rheumatica
C reactive protein
describe each single Salter fracture
1=S=simple 2=A=above 3=L=lower 4=T=Through 5=E=egads!!
what location will most likely indicate morton’s neuroma
3rd and 4th digit fracture of foot
what is flinklesten’s test
evaluates wrist pain due to De Quervans’ tensynovitis
laxity with valgus stress testing
MCL
laxity with varus stress testing
LCL
mc sites of herniated disc
L4-5
L5-S1
the 5ps of compartemtn syndrome
pulseness parasthesias paralysis pallor poikilothermia
what is the treatment for epididymitis and mc agent
cipro, ecoli
negative prehn’s sign
testicular torsion
positive prehn’s sign
epididymitis
mc electrolyte abnormality in hospitalized patient
hyponatremia
acute bacterial prostatitis treatment
bactrum (TMX-sulfa)
fluoroquinolones (cipro)
delta waves in ECG
WPW
HTN treatment in pregnancy
hydralazine
hyperkalemia findings in EKG
hypokalemia findings in EKG
peaked T waves
broad flat T waves
hypercalcemia findings in EKG
hyppcalcemia findings in EKG
shortened QT waves
prolonged QT interval
treatment for priapism
phenylephrine
tx for gonorrhea
ceftriaxone
tx for chlamydia
doxycline or azythromycin
which testicular problem translumilates
hydrocele
DIP joints nodules
henderben
pip joints nodules
bouchards
what is the tetrad for reactive arthritis
urethritis, conjunctivitis, oligoarthritis, mucosal ulcer
diagnostic test for scleroderma
anti-centromere antibody
test for achiles tendon rupture
thompson test
wrist drop is due to what nerve injury
radial nerve
what psych medication can cause agranulocytosis
clozapine
cryptococcosis tx
amphoterecin B plus fleucytosin for CNS infection
treatment for ascities
spironolactone 100 mg qd
where is most likely to find direct hernia
hesselback triangle does NOT go to scrotum
agent that can cause liver abcess
entamoeba histolytica or coliform
diagnostic test for malabsorption
72 hrs fecal fat test
what test do you do to distinguish malabsorption for pancreatic insufficiency
D xylose test
pleural coin lession
hartoma
diagnostic test for syphilis
VRDL
what do you use for identification of post streptococcal glomeruloneprhitis
anti-DNAse B serology
treatmant for tension hemothrorax
large bore needle
do not give fava beans to
G6pd deficiency
bite cells and heinz bodies seen in
G6PD
what are lab findings of hepatic encephalopathy and the treatment
increase levels of NH3 and tx is lactulose
what medication is not indicated in the treatment of corneal abrassion?
topical antihistamine e.g =olapatadine
t/f extraocular muscle are affected in periorbital cellulits
false. extraocular movement likely to be intact
m/c causative agent of meningitis in neonate
group B strep- (screning done in pregnant women)
dilated tortuous vein, blood and thunder fundus vitrous hemorrages
central retinal vein occlusion
bone conduction > air conduction
louder sound in affected ear (weber lateralized to affected ear)
conductive hearing loss
air conduction> bone conduction
sound louder in better ear (weber lateralises to unaffected ear)
sensory hearing loss
what is the treatment for optic neuritis?
3 day course of iv methylprednisone followed by an oral taper
pale retina and cherry red spot on fundoscopy
central retinal artery occlusion
difference between dacroadenytis and dacrocystitis
dacroadenitis= inflammation/ infection of lacrimal gland (eyelid area ) dacrocystitis= acute infection of the NASOlacrimal gland( nose area)
steamy cornea, fixed mid dilated pupil, crescent shadow
acute angle closure glaucoma
neovascularization is a fundoscopic finding of
diabetic retinopathy
treatment for trigeminal neuralgia (tic douloureax)
carbamazepine
age related hearing bilateral hearing loss of high frequeancy hearing and decrease word recognition
prebyscusis
what other medication spiranolactone should NOT be combined for possible cause of death?
oral potasium as it could cause hyperkalemia and die
what are digoxin side effects?
dizziness, headaches, diarrhea, nausea, vomiting, weakness, palpitations, and change in vision with yelowish to blue tint to the vision
what are side effect of allopurinol?
rash and fever
what are the side effect of hydralazine?
it is a vasodilator use to treat hypertention and SE are takycardia, headache, nausea, lupus like syndrome
what is the side effect of spironolactone?
hyperkalemia and gynecomastia
a genetic defect in fibrillin gene
marfan syndrome
genetic defect in collagen characterized by joint laxity and hypertensibility
Ehlers-Danlos syndrome
major and minor criteria for rheumatic fever
Jones fear No1 J=joints=polyarthritis migrator O=shape heart =carditis =new onset murmur N=nodules=subcutaneous,extensor surface E=erythema marginatum S=sydenham's chorea
F=fever E=ESR raised CRP increased A=arthralgia R=rheumatic fever No-1=1st degree heart block on ECG/PR interval prolonged
must have 2 major or 1 major 2 minor
tx for patient with hypotention and bradycardia
atropine
what medication should be discontinued in torsade de pointes
amiodorone could cause ST segment elevation
treatment for hypertensive emergency
labetalol- it is a combined alpha and beta blocker and will decrease systemic vascular resistence
High speed Motor vehicle accident with chest pain and back pain
Aortic dissection
Crescendo decresendo murmur heard best at the right second intercostal space and radiates to the carotids
Aortic stenosis
Suspected ingestion of antifreeze , what should be the DX of choice ?
Evaluate the urine under woods lamp for fluorescense
Triad of ptosis,miosis,and anhydrosis in smoker patient
Horner syndrome -lung cancer
Medication used for benzodiazepine overdose
Flumazenil ( romazicon)
Medication used in opiod detoxification
Naltrexone ( revia)
Type ii hypersensitive reaction
Myasthenia gravis
Painless obstructive jaundice and weight loss
Pancreatic adenoma
Anti-DNA topoisomerase I ( anti-Scl-70)
Scleroderma
Mc type of cancer in smoker
Squamos cell carcinoma
Mc lung cancer in nonsmoker
Bronchogenic adenocarcinoma
Having mechanical ventilation with positive pressure increases the risk of what ?
Pneumothorax
IgM anti-HBc indicates
Actively infected with hepatitis B
Alcoholic presenting with dementia,ataxia, ophtalmoplegia
Wernicke encephalopathy
Due to thiamine deficiency
Peripheral neuropathy,memory loss, paresthesia, gait disturbance ,and glossitis what is the deficiency ?
Vitamin b12
Patient on long term of isoniazid , what vitamin deficiency
B6, pyridoxine - presents with peripheral neuropathy
Need to give pyridoxine supplementation
Acetomenaphen poisoning treatment
N acetylcysteine
Salicylates toxicity tx
Gastric lavage with airway protection
Give activated charcoal
Intravenous bicarbonate and aggressive IV fluids
Tx for ulcerative colitis
Mesalamine ( asacol,pestasa)
Treatment of choice for stress incontinence
Urethrocystometry
Chronic tension headache treatment
Tricyclic antidepressant eg amitriptyline
What is fat embolism?
History of trauma to long bones ,respiratory insufficiency,neurologic impairment ,petechial rash over the upper body
What does HBeAG indicates
Patient does not have active replication at this time
Which medication could cause torsades de pointes and should be discontinued ?
Amiodarone ( cordarone)
Causes prolongation of the QT interval
What is the complications of long term corticosteroid use?
Osteopenia with vertebral compression factors , give oral calcium,vitamin d,and biphosphonate
What are the changes in blood gases during barbiturate overdose ?
Causes respiratory depression resulting in carbon dioxide retention and hypoxemia
Low pO2, high pCO2=’respiratory acidosis
Barbituates are sedative
What is the initial test that should be performed when lupus is suspected?
Antinuclear antibody
Vitamin deficiency with poor wound healing?
Scurvy vitamin C deficiency . It presents with poor wound healing,show petechia,bleeding gums and loose teeth
Virchow triad
Venous stasis, hypercoagulability, vascular injury
Ptosis,miosis,anhydrosis, dilated vein necks related to respiratory tumor
Pancoast tumor presenting with horners syndrome
What is schwachmans disease
Hereditary cause of chronic pancreatitis
Mallory bodies in histology of liver indicates
Alcoholic hepatitis
Contraindications to anticoagulation therapy
Hx of ULcers, positive hemoccult test,resent surgery, HX of hemorrhagic stroke, significant active or known bleeding
Diagnostic test for delta waves on ecg?
Electrophysiology study
Hirschprungs disease dx test
Rectal biopsy
Foot drop due to which affected nerve
Deep peroneal
Triamterene could most likely cause this complications
Hyperkalemia - it is a potasium sparing diuretic
Where do you find pseudo polyps? Chrons or UC
UC
Bowell wall thickening and transmutation lession, cobblestone appearence mucosa
Chrons
Complication of long term use of corticosteroids
Osteopenia
Hypertensive emergency diastolic pressure
Greater than 130
What additional supplementation might be need it for patients taking thiazide diuretics
Potassium supplementation
Treatment for aortic disection
Nitroprusside,b blocker labetalol or esmolol and urgent surgery
Treatment for hypertention in setting of acute renAl failure
Fenoldopam
What is the role in atherosclerosis ?
Inflamation and elevation of c reactive protein
What are the three common patterns of UA?
Angina at rest (m/c)
New onset of angina symptoms
Incresing pattern of pain in previously stable patients
What is considered a positive stress test?
St depression of 1mm (0.1mV)
What is the definitive diagnostic procedure for angina?
Coronar you angiography and should be use selectively because of cost and invasive ness
What septal defect is common in Down syndrome ?
AV septal defect
What is holiday heart?
A fib cause by excessive alcohol use or withdrawal
Treatment of unstable bradycardia
Vagolytic = atropine
Or Positive chronotropic =epinephrine or dopamine
Medical Treatment for psvt
Adenosine IV push
Preferred Treatment for chronic atrial flutter
Dofetilide
What is it called the condition of Erectile disfunction due to PAD in ileac artery?
Leriche syndrome
What is the first line of treatment for raynauds phenomenom
CCB ege nifedipine
When would you use inplantable cardioverter defibrillator in patient with CHF ?
When EF is less than 35
What is the most common symptom of tb?
Cough
What is the cornerstone of DX for pneumocystic jiroveci ?
CXR with diffuse and perihilar infiltrate no effusions seen
Pneumonia with lactase dehydrogenase and bilateral interstitial infiltrates ?
Pneumocystic jeruvici tx is bactrum
What is the definitive diagnosis of lung cancer ?
Cytologic examination of the sputum
