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PANCE Prep > PANCE I > Flashcards

PANCE I Flashcards

1
Q

Barrett’s esophagus treatment

A
  • Indefinite use of PPIs

- EGD surveillance due to predisposition of esophageal adenocarcinoma

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2
Q

First diagnostic test for esophagitis

A

EGD

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3
Q

Types of esophagitis (5)

A
  • Reflux (MC)
  • Infectious
  • Eosinophilic
  • Pill-induced
  • Radiation
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4
Q

EGD finding and tx for reflux esophagitis

A
  • Mucosal breaks

- PPI

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5
Q

MC causes of infectious esophagitis

A
  • Candida; adherent white plaques

- Viral (CMV/HSV); MC in immunocompromised pts

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6
Q

EGD finding for eosinophilic esophagitis

A
  • Pt will have hx of atopy

- Stacked rings

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7
Q

Drugs that MC cause pill-induced esophagitis, and treatment

A
  • Bisphosphonates, iron supplements, NSAIDs

- Tx = PPI

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8
Q

Risk factors for 2 types of esophageal CA

A
  • SCC-smoking, ETOH, HPV

- Adeno-Barrett’s eso, smoking, obesity

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9
Q

Definition of Zenker’s diverticulum and symptoms

A
  • Outpouching of post laryngopharynx

- Regurgitation of undigested food or liquid into pharynx several hours after eating

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10
Q

GI complaint in patient with scleroderma

A
  • Decreased eso sphincter tone and peristalsis

- Predisposes pt to reflux esophagitis

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11
Q

Findings on two diagnostics for achalasia

A
  • Esophagram-dilation of esophagus and bird’s beak

- Esophageal manometry (confirmatory)-aperistalsis, no relaxation of LES

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12
Q

Symptoms of infant with pyloric stenosis

A
  • Post-prandial “projectile” vomiting
  • Always hungry baby
  • Palpable “olive shaped” mass in RUQ
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13
Q

Image of choice and finding for pyloric stenosis

A

UGI; “string sign”

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14
Q

MC association with gastroparesis, and treatment

A
  • Patients with diabetic autonomic neuropathy
  • Small frequent low-fat meals
  • Prokinetic agent (Metoclopramide)
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15
Q

Side effects of Metoclopramide (Reglan)

A

EPS/tardive dyskinesia

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16
Q

Complications of PUD (3)

A
  • Hemorrhage
  • Gastric outlet obstruction
  • Perforation
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17
Q

Perforation on KUB shows

A

Free air under diaphragm

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18
Q

Triple and quad therapy for H pylori

A
  • PPI, Amoxicillin, Clarithromycin

- PPI, Bismuth, Metronidazole, Tetracycline

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19
Q

Signs of metastatic spread in gastric adenocarcinoma

A
  • Virchow’s node-L supraclavicular lymph node

- Sister Mary Joseph node-umbilical nodule

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20
Q

Signs of and diagnostics for celiac disease

A
  • Villous atrophy on endoscopy
  • Tissue transglutaminase IgA
  • Dermatitis herpetiformis, FTT in children
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21
Q

2 main conditions that cause function constipation (MC)

A
  • Chronic idiopathic constipation

- IBS-C

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22
Q

3 groups of drugs and 2 supplements that cause med induced constipation

A
  • Calcium supp
  • Iron supp
  • Opioids
  • Antipsychotics
  • Anticholinergics
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23
Q

4 complications of constipation

A
  • Hemorrhoids
  • Anal fissures
  • Fluid/electrolyte abnormalities from laxative abuse
  • Fecal impaction –> obstruction
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24
Q

Why do you have to be careful with Miralax (polyethylene glycol) and Milk of magnesia and mag citrate?

A

Mg-containing laxatives in patients with renal insufficiency; can cause hypermagnesemia

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25
Q

Type of diarrhea in Vibrio cholerae

A

“rice water” diarrhea

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26
Q

Clostridium perfringens exposure

A
  • Home-canned goods

- Enterotoxin

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27
Q

Staphylococcus aureus exposure

A
  • Egg/potato salad
  • Creamy foods
  • Enterotoxin
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28
Q

Cryptosporidium is a serious disease in what group of patients?

A

Patients with AIDS

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29
Q

“Classic dysentery”

A

Shigella

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30
Q

EHEC complication

A
  • Enterohemorrhagic E coli 0157:H7
  • NO ABX
  • HUS
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31
Q

Complication of Clostridioides difficile

A

Toxic megacolon

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32
Q

Main point about Yersinia enterocolitica

A

Mimics appendicitis (RLQ pain)

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33
Q

Entamoeba histolytica can cause

A

-Intraluminal and disseminated disease (hepatic abscesses)

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34
Q

Medications that can cause chronic diarrhea (7)

A
  • Mg antacids
  • Metformin
  • Reglan
  • Laxatives
  • Abx
  • PPI
  • Colchicine
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35
Q

Difference between osmotic and secretory diarrhea

A
  • Osmotic (like from lactose intolerance) causes diarrhea that decreases with fasting
  • Secretory (like from neuroendocrine tumors) causes diarrhea that is unrelieved with fasting
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36
Q

Criteria for IBS

A

Rome IV criteria

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37
Q

Extra-intestinal manifestations of IBD (3)

A
  • Arthralgias
  • Erythema nodosum
  • Uveitis
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38
Q

Main diagnostic tool for Crohn’s

A

EGD, small bowel imaging

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39
Q

Curative treatment for UC

A

surgery

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40
Q

Crohn’s disease

A
  • Skip lesions
  • Transmural
  • Mouth to anus
  • Granulomas on biopsy
  • NSAIDs can worsen sxs
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41
Q

UC

A
  • Colon only
  • Mucosal layer only
  • NSAIDs can worsen sxs
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42
Q

Complications of Crohn’s disease (5)

A
  • Fistulas (chronic complication of abscess)
  • Fissures “passing glass”
  • Perianal abscess
  • Malabsorption
  • Colon CA
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43
Q

Complications of UC (3)

A
  • Toxic megacolon
  • Colon CA
  • Association with Primary Sclerosing Cholangitis
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44
Q

Most colorectal CA arise from

A

Adenomas (precancerous polyps)

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45
Q

“Pseudopolyps” (in colon) are associated with

A

IBD

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46
Q

Most common type of adenoma (colon polyp)

A

Tubular adenoma

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47
Q

What age to start colonoscopies

A
  • 50y
  • Begin screening at 40 or 10y younger than age at diagnosis of youngest relative affected and then every 5 years
  • IBD-q 1-2y beginning 8-10 years after diagnosis
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48
Q

MC type of colorectal CA

A

Adenocarcinomas

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49
Q

CA marker for colorectal CA

A

CEA

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50
Q

Type of CA pts with Familial Adenomatous Polyposis (FAP) are risk of

A

Duodenal/Ampullary CA

-Need routine EGD

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51
Q

Type of CA pts with HNPCC (Lynch Syndrome) are at risk of

A

Extracolonic malignancies

-Endometrial MC

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52
Q

MC cause of intussusception, and ultrasound shows

A

Meckel’s diverticulum

-US shows “target sign”

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53
Q

Triad for intussusception

A
  • Colicky abd pain
  • Sausage-shaped and mass
  • “Currant jelly” stools
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54
Q

Complications (4) of diverticulitis

A
  • Abscess
  • Perforation
  • Obstruction
  • Fistula
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55
Q

Sign of diverticular bleeding

A
  • Painless hematochezia

- Common cause of overt LGIB

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56
Q
  • Pts at risk of acute mesenteric ischemia
  • Main PE sign
  • Diagnostic TOC
A
  • Atherosclerotic disease, valvular heart disease
  • Pain out of proportion to PE
  • CTA with IV contrast
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57
Q

2 main risk factors of getting toxic megacolon

A
  • Ulcerative colitis

- C diff

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58
Q

Main difference between internal and external hemorrhoids

A
  • Internal = painless

- External = painful

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59
Q

2 risk factors of anal CA, and MC type

A
  • Hx of HPV or HIV

- Squamous cell

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60
Q

Spectrum of alcoholic liver disease

A
  • Alcoholic steatosis (fatty liver)
  • Hepatitis (inflammation)
  • Cirrhosis
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61
Q

Difference between Non-alcoholic fatty liver dz (NAFLD) and non-alcoholic steatohepatitis (NASH)

A
  • NAFLD-secondary to Metabolic Syndrome

- NASH-fatty liver + inflammation

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62
Q

Main etiologies (3) of cirrhosis

A
  • Alcoholic liver disease
  • HBV
  • HCV
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63
Q

3 signs of cirrhosis

A
  • Jaundice
  • Spider telangiectasis
  • Palmar erythema
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64
Q

Complication of portal hypertension (from cirrhosis)

A
  • Caput medusae
  • Ascites
  • Splenomegaly
  • Encephalopathy (asterixis)
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65
Q

3 main risk factors of primary hepatocellular CA (HCC)

A
  • Hepatitis B
  • Hepatitis C
  • Cirrhosis
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66
Q

CA marker for Primary hepatocellular CA

A

AFP

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67
Q

Hemachromatosis

A
  • Disorder of iron metabolism; excess deposition

- Bronze pigmentation of skin

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68
Q

Wilson’s disease

A
  • Accumulation of copper in liver

- Kayser Fleischer rings in cornea

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69
Q

Ultrasound for pt with gallbladder CA shows

A

Porcelain gallbladder

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70
Q

Cholangiocarcinoma

A
  • Association with primary sclerosis cholangitis (pts with UC)
  • Jaundice, pruritus, Courvoisier sign
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71
Q

Primary Biliary Cholangitis

A

-Autoimmune destruction of intrahepatic bile ducts

+ antimitochondrial antibodies (AMA)

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72
Q

Primary Sclerosing Cholangitis

A

-Increased incidence in pts with UC

+ P ANCA

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73
Q

Gilbert Syndrome

A
  • Inherited
  • Deficiency in enzyme UGT that converts unconjugated bilirubin to conjugated in liver
  • Unconj hyperbilirubinemia in absence of hemolysis
  • Intermittent jaundice
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74
Q

When is pain worse in acute pancreatitis, and two signs

A
  • Worse with lying supine, and relieved by sitting and leaning forward
  • Cullen and Grey Turner’s sign
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75
Q

Criteria for acute pancreatitis

A

Ranson criteria

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76
Q

ERCP shows what for chronic pancreatitis

A

“Chain of lakes”

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77
Q

MC spot for pancreatic CA

A

Ductal adenocarcinoma involving head of the pancreas

-Courvoisier sign

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78
Q

Risk factors for pancreatic CA

A

Tobacco
Obesity
ETOH

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79
Q

CA marker for pancreatic CA

A

CA 19-9

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80
Q

MC hernia

A

indirect inguinal hernia

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81
Q

Lab value for Paget Disease, and treatment

A
  • Elevated serum Alk Phos

- Tx = Bisphosphonates and Calcitonin

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82
Q

PKU

A
  • Inability to convert phenyl aline to tyrosine

- Irreversible intellectual disability, seizures

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83
Q

Deficiency in Rickets

A

Ca, Vit D, and PO4

-Delayed closure of fontanelles, bow legs

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84
Q

Thiamine deficiency sign (2)

A

(B1)

  • Beriberi-motor/peripheral neuropathy
  • Wernicke-Korsakoff syndrome-neurologic
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85
Q

Riboflavin and Pyridoxine deficiency signs (3)

A

B2, B6

  • Cheilitis
  • Angular stomatitis
  • Glossitis
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86
Q

Niacin deficiency

A

B3

  • Pellagra (3 D’s)-dermatitis, dementia, diarrhea
  • Cheilitis
  • Angular stomatitis
  • Glossitis
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87
Q

2 risk factors for getting Cobalamin deficiency

A

B12

  • Post gastrectomy
  • Pernicious anemia
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88
Q

Vitamin A deficiency (4)

A
  • Night blindness
  • Bitot spots (on conjunctiva)
  • Poor wound healing
  • Dry skin
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89
Q

Vitamin D deficiency (2)

A
  • Rickets

- Osteomalacia

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90
Q

Main clinical presentation of vesicoureteral reflex, and diagnostic test

A
  • Recurrent UTIs

- VCUG is gold standard

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91
Q

Bladder CA

  • MC type
  • Risk factors
  • Clinical presentation
A
  • Transitional cell carcinoma
  • Smoking, Cyclophosphamide
  • Painless hematuria, irritative voiding sxs
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92
Q

Main diagnostic TOC and tx for bladder CA

A
  • Cystoscopy with bladder biopsy

- TURBT, cystectomy

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93
Q

Main treatment for urge urinary incontinence

A

Oxybutynin (antichol/antimuscarinics)

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94
Q

Main treatment for overflow incontinence

A

-osins (5 alpha reductase inhibitors)

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95
Q

Main causes of nephrolithiasis and diagnostic TOC

A
  • Calcium and uric acid

- CT A/P without contrast

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96
Q

3 main risk factors for renal cell carcinoma

A
  • Smoking
  • Obesity
  • Polycystic kidney disease
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97
Q

Prehn’s sign

A
  • Epididymitis/orchitis

- Alleviation of pain with scrotal elevation

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98
Q

Testicular CA

A
  • Painless, palpable mass
  • Serum protein markers (beta HG, AFP, LDH)
  • Radical orchiectomy
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99
Q

Hydrocele

A
  • Painless enlargement of one side of the scrotum

- Transillumination

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100
Q

Varicocele

A
  • “Bag of worms”

- Pain/heaviness

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101
Q

Prostatitis physical exam

A
  • Perineal pain
  • Dysuria, urgency, hematuria
  • Boggy, tender prostate
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102
Q

Strongest risk factors (2) for developing active TB

A
  • HIV

- Immunosuppressive therapy

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103
Q

Main symptoms of active TB infection

A
  • Fever, chills, night sweats
  • Bad cough >3 weeks (looks like bad PNA)
  • Weight loss
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104
Q

PE and CXR findings of active Tb

A
  • Post-tussive rales
  • Primary active infection-hilar adenopathy, middle lobe infiltrates, pleural effusions
  • Reactivation-upper lobe infiltrates and cavitation
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105
Q

Biopsy for active TB shows

A

Necrotizing (caveating) granulomas

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106
Q

TB skin testing

A

-BCG vaccine can give false positive
>5mm in HIV +, immunosuppressed pts, contacts with active TB
>10mm in everyone else (like hospital workers)
>15mm in people with no risk factors for TB

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107
Q

Drug treatment for active TB

A
  • 4 drug regimen for 2 months, then RIFxINH for 4-7 months
  • Rifampin
  • Isoniazid
  • Pyrazinamide
  • Ethambutol
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108
Q

TB drug side effects (5)

A
  • RIF-red orange excretions
  • INH-hepatic toxicity, peripheral neuropathy (co administer with Vitamin B6/Pyridoxine)
  • PZA-hepatic toxicity, hyperuricemia
  • EMB-optic neuritis
  • Strep-otoxicity, nephrotoxicity
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109
Q

Latent TB treatment

A
  • Treat only after active TB is ruled out (with hx and normal CXR)
  • INH and Rifapentine (RPT) once weekly for 12 weeks
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110
Q

What cells does HIV target?

A

T cells (particularly CD4 T cells/helper T cells); lymphocytes that enhance immune response

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111
Q

Early HIV infection

A
  • 2-6 weeks after exposure
  • Mono like or flu like illness
  • HIGHLY INFECTIOUS
  • Routine HIV Ab test will be negative
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112
Q

Signs/symptoms of early HIV infection

A
  • Rash (upper trunk, neck, face)
  • Mucocutaneous ulcers
  • Mono/flu like illness
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113
Q

Definition of AIDS

A

-CD4 T cell count <200
OR
-HIV + and 1 of 27 AIDS defining diseases

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114
Q

CXR and treatment for Pneumocystis jiroveci PNA (PCP)

A
  • MC opportunistic infection in pts with AIDS
  • Severe hypoxemia
  • CXR-perihilar infiltrates (“ground glass” appearance)
  • Bactrim
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115
Q

CT and treatment for toxoplasmosis in AIDS patients

A
  • Causes encephalitis
  • CT shows multiple contrast enhancing lesions
  • Sulfadiazine and Pyrimethamine
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116
Q

Main class of drugs for HIV treatment

A

Antiretroviral therapy (ART)

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117
Q

Organism for gonorrhea

A

(“OO”)

-Gram negative diplococci

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118
Q

Treatment for conjunctivitis of the newborn (ophthalmia neonatorum)

A

-Topical erythromycin applied ASAP after delivery for gonococcal prophylaxis

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119
Q

Organism for syphilis

A

Treponema pallidum

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120
Q

Primary syphilis sign

A

Painless chancre

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121
Q

3 MC clinical presentations of secondary syphilis

A
  • Non pruritic rash on palms and soles of feet (not contagious)
  • Condyloma lata (warts that are highly contagious)
  • Mucous patches
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122
Q

Diagnostic tests for syphilis

A
  • Bacteria from chancre visible under dark field microscopy
  • RPR or VDRL
  • Confirm RPR with treponema antibody test (FTA-ABS)
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123
Q

Tertiary syphilis

A

Can damage heart, vessels, brain, nervous system

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124
Q

Tzanck smear for herpes infection

A

(HSV, VZV, CMV)

-Multinucleated giant cells

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125
Q

Condyloma acuminata

A

HPV (genital warts)

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126
Q

Most important prognostic factor in diagnosing melanoma

A

Depth

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127
Q

Acral melanoma

A
  • MC in African Americans

- Worse prognosis

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128
Q

Lentigo maligna

A
  • Broad and thin melanoma on sun damaged skin
  • Not much color variation
  • Very slow growing
  • Mohs is tx
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129
Q

MC skin cancer in humans

A

-Basal cell carcinoma

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130
Q

Basal Cell Carcinoma

A
  • Rodent ulcer (ulcerated papule with rolled border0

- Friable

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131
Q

Actinic Keratosis

A
  • Pre skin cancer
  • Can transition to SCC
  • “Rough, dry skin”; sandpaper
  • Cryotherapy
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132
Q

Squamous cell carcinoma

A
  • Keratotic (scaly) plaques or nodules

- Biopsy and treat with Mohs/excision

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133
Q

Pityriasis rosea

A
  • Herald patch
  • Christmas tree pattern
  • Human herpes virus 6/7
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134
Q

Molluscum contagiosum virus

A

Pox virus

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135
Q

Sebaceous hyperplasia

A
  • Central del surrounding grape-like bumps
  • Adults with oily skin
  • Big sebaceous glands
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136
Q

Verrucae AKA

A

-HPV (warts)

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137
Q

Erythema migrans is associated with

A

Lyme disease from Borrelia burgdorferi

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138
Q

Lyme disease symptoms

A
  • Headache
  • Joint pain
  • Fatigue
  • Erythema migrans
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139
Q

Erythema nodosum

A
  • Swollen, tender nodules on shins
  • Usually young women
  • Associated with OCPs, sarcoidosis, cocci, UC, strep
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140
Q

Erythema Multiforme

A
  • Type IV hyperactivity response to trigger on palms and soles
  • HSV/viral or drug etiology
  • Target lesions on palms
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141
Q

Drugs that usually cause SJS/TEN

A
  • Sulfa
  • Anti convulsants (Carbamazepine, Phenytoin)
  • PCNs

Lids and eyes typical

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142
Q

Bullous pemphigoid

A
  • Autoimmune blistering disease
  • Intact bullae
  • Itchy
  • Tx with oral steroids
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143
Q

Dyshidrotic eczema

A
  • Itchy

- Tapioca like vesicles along fingers

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144
Q

Seborrheic keratosis

A
  • Waxy, stuck on appearance
  • Benign
  • Scaly plaques on scalp, torso, ankles
  • Tx with liquid nitrogen
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145
Q

3 main causes of acanthuses nigricans

A
  • Obesity
  • DM
  • Paraneoplastic
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146
Q

Lichen Planus

A

4 P’s

  • Pruritic
  • Purple
  • Polygonal
  • Papules

-Wickham striae-white lines in mouth

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147
Q

What don’t you want to give to a patient with psoriasis?

A

Corticosteroids

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148
Q

Vitiligo

A
  • Autoimmune destruction of melanocytes
  • Depigmented macules/patches
  • Woods lamp to diagnose
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149
Q

Tinea versicolor

A
  • Malassezia furfur
  • Hypopigmented macule
  • KOH shows spores and pseudohyphae
  • Tx with selenium sulfide shampoo
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150
Q

Beefy red erosions, KOH shows spaghetti and meatballs

A

Candidiasis

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151
Q

Erythrasma

A
  • Corynebacterium
  • Dry, brown patches in axilla and web spaces
  • Woods lamp shows coral red fluorescence
  • Tx-topical Erythromycin/Clindamycin
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152
Q

Two main organisms for impetigo

A
  • Staph

- GAS (Strep pyogenes)

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153
Q

Erysipelas

A
  • Group A strep infection
  • Similar to cellulitis
  • Not itchy, but painful
  • Patient will feel ill and feverish
  • Tx-PCN
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154
Q

Rosacea

A
  • Complaints of acne and flushing in an adult patient

- Foods, heat, alcohol can be triggers

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155
Q

Hidradenitis suppurativa

A
  • Severe follicular dysfunction

- Smelly, cystic, scarring acne in intertriginous zones

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156
Q

MC cause of primary amenorrhea

A

Turner Syndrome

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157
Q

2 MC cause of secondary amenorrhea

A
  • Pregnancy

- Asherman’s syndrome (from previous instrumentation of the uterus)

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158
Q

PMS occurs during which part of the menstrual cycle

A

Second half (luteal)

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159
Q

PALM-COEiN (AUB)

A
  • Polyp
  • Adenomyosis
  • Leiomyoma
  • Malignancy
  • Coagulopathy
  • Ovulatory dysfunction
  • Endometrial
  • Iatrogenic
  • Not yet classified
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160
Q

MC gyn CA

A

Endometrial CA

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161
Q

Risk factors for endometrial CA

A
  • Obesity
  • Hx breast or ovarian CA
  • Lynch Syndrome
  • Early menarche
  • Late menopause
  • Nulliparity
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162
Q

Definitive diagnosis for endometriosis

A
  • Laparoscopy

- Chocolate cysts (endometriomas) on ovaries

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163
Q

Medical treatment for uterine fibroids

A
  • GnRH analogs (Depo)
  • Hormonal contraceptives
  • Fibroids will usually shrink once menopause hits
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164
Q

Benign adnexal mass (5)

A

-Thin walled
<3cm pre and <1cm postmenopausal (simple cysts)
-Hyperechoic nodule (teratoma)
-Network of linear pattern (hemorrhagic cyst)
-Homogenous echos (endometrioma)

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165
Q

MC type of ovarian cysts

A

Follicular, then corpus luteum

-Both regress after 1-2 menstrual cycles

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166
Q

Rotterdam Criteria for PCOS

A
  • Menstrual irregularities (oligo/amenorrhea)
  • Polycystic ovaries
  • Hyperandrogenism (hirsutisme, acne)

Causes infertility

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167
Q

Ultrasound for PCOS shows

A

String of pearls

168
Q

CA marker for epithelial ovarian CA

A

CA 125

169
Q

CA marker for germ cell ovarian CA

A

hCG, AFP, LDH

170
Q

MC types of cervical CA

A
  • Squamous cell-HPV 16

- Adenocarcinoma-HPV 18

171
Q

Top 3 etiologies for vaginitis

A
  • Gardnerella vaginalis
  • Candida albicans
  • Trichomonas vaginalis
172
Q

Amsel’s Criteria

A 
For bacterial vaginosis
-Homogenous, thin, grayish white discharge
-Vaginal pH >4.5
\+ whiff test 
-Clue cells
173
Q

MC type of vaginal CA

A
  • Squamous cell
  • Metastasis from uterus, cerix and ovary is MC cause of invasive disease
  • HPV has to be present
174
Q

Nageles Rule

A

For expected date of confinement

Add 7 days to LMP and subtract 3 months

175
Q

Abnormal AFP in maternal serum screen

A 
High = neural tube defects
Low = Down's syndrome
176
Q

What has to be present to be able to give Methotrexate for ectopic pregnancy?

A
  • HCG <5000
  • No cardiac activity
  • Sac <4cm
177
Q

MC type of gestational trophoblastic disease

A

Hydatiform Mole

178
Q

Clinical presentation of Hydatiform mole, and ultrasound finding

A
  • Uterine size greater than dates
  • Absent fetal heart tones

-“Snow storm” or “grape like clusters”

179
Q

Abruptio placentae

A
  • Abrupt painful vaginal bleeding

- Contractions

180
Q

Placenta previa

A
  • Abnormal location of the placenta in comparison to the cervical os
  • Painless bleeding after 20 weeks
  • DON’T PERFORM CERVICA EXAM
181
Q

HELLP Syndrome

A

For preeclampsia
Hemolysis
Elevated liver enzymes
Low platelet count

182
Q

When to give Rhogam

A

1st dose at 28w

2nd dose within 72 hours of a Rh+ infant

183
Q

MC type of breast CA

A

Infiltrating ductal carcinoma

MC in upper outer quadrant

184
Q

Definition hemoglobin and hematocrit

A
  • Hemoglobin-molecule that binds and transports O2

- Hematocrit-volume of packed RBCs

185
Q
  • Hypochromic, microcytic anemia etiologies
  • Normochromic, normocytic
  • Macrocytic
A
  • IDA
  • Thalassemia
  • Sideroblastic
  • Anemia of chronic disease
  • Aplastic anemia
  • Folate def
  • Vit b12 def
  • Hemolysis
186
Q

Treatment for anemia of chronic disease

A
  • Treat underlying disease

- EPO can help (if renal failure, CA, inflammatory disorders)

187
Q

Aplastic Anemia

A
  • All cell lines are decreased

- Most are idiopathic; others from drug exposure and viral illnesses (EBV, CMV, hepatitis)

188
Q

Etiologies of vitamin B12 deficiency

A
  • Pernicious anemia
  • Vegan diet
  • Gastric surgery
189
Q

Pernicious anemia

A
  • Deficiency of IF

- Autoantibodies against the gastric parietal cells

190
Q

Peripheral smear for vitamin B12 deficiency

A
  • Hypersegmented neutrophils
  • Anisocytosis
  • Macro-ovalocytes
191
Q

Intravascular vs extravascular hemolysis

A
  • Intra-destruction of RBCs within the blood stream (transfusion reactions, microangiopathy)
  • Extra-destruction of RBCs in the reticuloendothelial system, esp spleen (hereditary spherocytosis, sickle cell anemia, thalassemia)
192
Q

Hemolysis lab

A
  • Increase unconjugated bilirubin
  • Increase LDH
  • Decreased hemoglobin
193
Q

Hereditary spherocytosis

A
  • Splenectomy

- Though splenectomy increases risk of infection from encapsulated organisms (like Pneumococcus)

194
Q

Homozygous vs heterozygous sickle cell anemia

A
  • Homo (Hb SS)-sickle cell disease

- Hetero (Hb S + Hb A)-sickle cell trait

195
Q

Main etiologies for acute bronchitis

A
  • MC viral (influenza, adenovirus, rhinovirus)

- Bacteria include Streptococcus pneumonia, H flu, M cat

196
Q

CXR on acute bronchitis

A

Normal

197
Q

Etiology on bronchiolitis

A

RSV

198
Q

Main difference between influenza and URI

A
  • Severity of presentation for influenza

- Flu has abrupt onset of fever and chills

199
Q

MC etiology for croup

A

Parainfluenza

200
Q

Top 3 etiologies for hospital acquired PNA

A
  • Pseudomonas
  • Staph aureus
  • Enterobacter
201
Q

CXR findings for PNA

A
  • Presence of an infiltrate is “gold standard” for diagnosing PNA
  • Lobar PNA = Strep pneumonia, H influenza
  • Interstitial PNA = atypical, viral, PCP
202
Q

3 stages of pertussis

A
  • Catarrhal-prodrome
  • Paroxysmal-intense coughing with inspiratory whoop
  • Convalescent-cough subsides
203
Q

Treatment for pertussis

A

Erythromycin for 2 weeks

204
Q

CXR for viral PNA

A

Diffuse or patchy infiltrates

205
Q

Histoplasmosis

A
  • Bird and bat droppings

- Single or multiple patchy or nodular infiltrates in lower lung fields on CXR and hilarious adenopathy

206
Q

Treatment for histoplasmosis

A

Amphotericin B

207
Q

Clinical presentation of cocci

A
  • Rash (erythema multiforme or erythema nodosum)
  • HA, fever, arthralgias
  • Fever, cough, etc

-Eosinophilia

208
Q

Treatment of cocci

A

Fluconazole and Amphotericin B

209
Q

CXR for HIV related PNA

A

Interstitial infiltrates

-Elevated LDH

210
Q

3 types of non-small cell lung cancer, and location

A
  • Adenocarcinoma (MC)-peripheral
  • Squamous cell-central
  • Large cell-peripheral
211
Q

MC symptom for lung cancer

A

-Cough

212
Q

MC cause of hemoptysis

A

Bronchitis (NOT lung CA)

213
Q

MC cause of transudative pleural effusion

A

CHF

214
Q

Location for small cell lung cancer

A

Central

215
Q

Leukemia definition

A

Unrestrained proliferation of leukocytes and leukocyte precursors

216
Q

Possible etiologies of Acute Lymphoblastic Leukemia (ALL)

A
  • Most idiopathic
  • Genetics-Down’s, Klinefelter’s
  • Viruses
217
Q

Clinical presentation of ALL

A

Child presents with fatigue

  • Abrupt onset of fever
  • Bone pain (limp)
218
Q

Diagnostics for ALL

A

-CBC shows leukocytosis with decreased ANC
-Circulating lymphoblasts on blood smear
>20% blasts on bone marrow

219
Q

Risk factors for AML

A
  • Environmental exposures (pesticides, radiation)

- Prior chemo

220
Q

Diagnostics for AML

A

-WBC >50,000 with decreased ANC
-Platelets <100,000
-Myeloid blasts on smear
-Auer rods
>20% blasts on bone marrow

221
Q

Tumor Lysis Syndrome

A

Intracellular products are released

  • Hyperuricemia
  • Hyperkalemia
  • Hypocalcemia
  • Hyperphos
  • Acute renal failure

Tx-Allopurinol

222
Q

Diagnostics for CLL

A

-Autoimmune hemolytic anemia
-Thrombocytopenia
-Smudge cells
>30% B cell lymphocytes

223
Q

Diagnostics for CML

A
  • WBC >150,000 (markedly elevated)
  • Philadelphia chromosome
  • Elevated uric acid
  • Elevated LDH
  • Increased serum vitamin B12
224
Q

Hodgkin’s Lymphoma

A
  • B cell lymphoma
  • Arises from single node
  • Can have extra nodal involvement in spleen and liver
225
Q

Risk factors for Hodgkin’s lymphoma

A
  • EBV

- Smokers

226
Q

Multiple Myeloma

A

Malignancy of the plasma cells

227
Q

MC acquired coagulopathy

A

Vitamin K deficiency

  • Warfarin
  • Malnutrition/absorption

Prolonged PT and PTT

228
Q

MC inherited bleeding disorder

A

Von Willebrand Disease

  • Prolonged PTT
  • Tx with Desmopressin
229
Q

Lab findings with hemophilia A

A
  • Increased PTT

- Decreased factor VIII

230
Q

ITP

A
  • MC in children after viral infection
  • Self limited autoimmune disorder
  • Isolated thrombocytopenia with petechiae and purport
231
Q

Decreased ADAMTS13

A

TTP

232
Q

Etiologies for DIC

A

-Malignancies
-Obstetrics
-Sepsis
-Trauma
(MOST)

233
Q

Labs for DIC

A

-Elevated PT and PTT
-Decreased fibrinogen and platelets
+ D Dimer
-Microangiopathic hemolytic anemia with schistocytes

234
Q

MC genetic cause of VTE in women

A

Factor V Leiden Mutation

235
Q

CO =

A

HR X SV

Decrease in SV, increase in HR to compensate

236
Q

Systolic HF =

A

HFrEF (LVEF <40%)

-Chamber dilation

237
Q

Diastolic dysfunction =

A

HFpEF

-Hypertrophy with impaired relaxation

238
Q

MC cause of heart failure

A

CAD

239
Q

Left HF

A
  • Decreased CO

- Pulmonary congestion

240
Q

Two main treatment goals for CHF

A

Vasodilate and diurese

241
Q

Cardio specific BB (3)

A

Carvedilol
Bisoprolol
Metroprolol

242
Q

Normal S1 and S2 heart sounds

A

S1-Closing of mitral/tricuspid valves during ventricular systole
S2-Closing of aortic/pulm valves during early diastole

243
Q

S3 and S4

A

S3-suspect HFrEF; displaced PMI; immediately following S2

S4-suspect HFpEF

244
Q

Aortic stenosis murmur

A
  • Harsh
  • Crescendo-decrescendo
  • Radiates to neck
245
Q

Mitral stenosis murmur

A
  • Low pitch rumble
  • Opening snap after S2
  • Mid late diastolic
  • Heard in left lateral decubitus position
246
Q

Mitral regurgitation murmur

A
  • High pitched blowing murmur

- Massive LAE

247
Q

Murmur with rheumatic fever

A

Aortic stenosis

248
Q

HCM murmur heard worse at… treatment

A
  • Louder if patient stands or valsalvas

- Tx-CCB (Verapamil), BB (Propranolol)

249
Q

Murmurs on R side of heart increases with

A

inspiration

250
Q

Aortic regurgitation murmur

A
  • Austin flint murmur (functional MS murmur)
  • Low diastolic
  • Widened pulse pressure
251
Q

Mitral valve prolapse

A
  • Murmur heard louder with standing and valsalva

- Mid late systolic click

252
Q

MC cause of mitral stenosis

A

Rheumatic heart disease

-Atrial fibrillation

253
Q

Medication for stress echo

A

Dobutamine

254
Q

Gold standard for diagnosing CAD

A

Coronary angiography

255
Q

Medications (3) to decrease O2 demand in stable angina

A
  • Nitrates (preload reduction)
  • BB (decrease HR, BP, contractility)
  • CCB (vasodilation, decrease BP, contractility)
256
Q

Medications (2) to increase O2 supply

A
  • Nitrates (preload reduction)

- CCB (vasodilation, decrease BP, contractility)

257
Q

Indications for CABG

A
  • Left main stenosis

- Triple vessel disease

258
Q

Prinzmetal angina

A
  • Ischemic symptoms secondary to vasospasm
  • Younger patients
  • Tx-nitrates, CCBs
259
Q

EKG changes in ischemia

A
  • Inverted T wave

- Depressed ST segment

260
Q

EKG changes in infarct

A

-Pathologic Q waves

261
Q

STEMI on EKG locations

A
  • Anterior-V1-4 (LAD)
  • Lateral-Lead I, aVL, V5/6
  • Interior-Lead II, III, aVF
  • Posterior-Reciprocal changes in V1/2, tall R waves with ST depression
262
Q

Dressler Syndrome with treatment

A

-1-2 weeks post MI

  • Pericarditis
  • Fever
  • Leukocytosis
  • Pericardial effusion

-ASA/NSAIDs for 3-4 weeks

263
Q

Primary hyperaldosteronism

A
  • Hypokalemia

- Metabolic alkalosis

264
Q

Triad for Cushing Syndrome

A
  • Skin atrophy
  • Striae
  • Proximal mm weakness
265
Q

Triad for pheochromocytoma

A
  • HA
  • Sweating
  • Tachycardia
266
Q

Difference between thiazide diuretics and loop diuretics

A

Thiazide causes hypercalcemia, and loops cause hypocalcemia

267
Q

Difference between non-dihydropyridines and dihydropyridines (CCBs)?

A
  • Non (Verapamil, Diltiazem)-more of a cardiac depressant

- Dihy (Amlodipine, Nifedipine)-more selective as vasodilators

268
Q

What two drug classes can cause hyperlipidemia?

A
  • Atypical antipsychotics

- Diuretics

269
Q

High intensity statins (2) and low intensity statin (1)

A 
High = Atorvastatin, Rosuvastatin
Low = Simvastatin
270
Q

Statins:
Lipid effects
Side effects

A

-Decrease LDL

  • Hepatotoxicity
  • Myalgias
  • Rhabdo
271
Q

Fibrates (Gemfibrozil, Fenofibrate):
Lipid effects
Side effects

A

-Decrease TAGs

  • Don’t use with statins
  • Hepatitis
  • Myositis
272
Q

Niacin lipid effects

A
  • Increase HDL

- Decrease TAGs

273
Q

Resin (Cholestyramine):
Lipid effects
Side effects

A
  • Only lipid med safe in pregnancy
  • Decrease LDL
  • May increase TAGs

-Don’t use in its with hypertriglyceridemia

274
Q

Difference between obstructive and restrictive lung disease (and FEV1/FVC ratio)

A

Obstructive = difficulty exhaling air; FEV1/FVC decreased

Restrictive = difficulty expanding; FEV1/FVC normal or high

275
Q

SABA, LABA examples

A 
SABA = Albuterol 
LABA = Salmeterol
276
Q

Inhaled corticosteroids examples

A
  • Beclomethasone
  • Fluticasone
  • Budesonide
277
Q

Leukotriene modifying drugs (for lungs) examples

A

Montelukast (Singulair)

278
Q

Lung exam for chronic bronchitis and emphysema

A 
CB = rhonchi, wheezing, prolonged expiration
Emphysema = distant BS, hyper resonance
279
Q

Treatment for COPD

A 
Oxygen
Inhaled bronchodilators (SABAs, LABAs)
Anticholinergics 
-SAMAs-Ipratropium bromide (Atrovent)
-LAMAs-Tiotropium bromide (Spiriva)
280
Q

3 treatments for acute exacerbation of COPD

A
  • Systemic steroids
  • Antibiotics
  • Increase bronchodilator therapy (SABA +/- SAMA)
281
Q

Main cause of bronchiectasis

A

-Cystic fibrosis

Leads to recurrent pulm infections

282
Q

CXR findings for bronchiectasis

A

Tram tracks

283
Q

CXR findings for idiopathic pulmonary fibrosis

A
  • Reticular infiltrates
  • Honeycombing

Patients are usually former smokers

284
Q

Treatment for sarcoidosis

A

Steroids

285
Q

What can asbestosis lead to?

A
  • Bronchogenic carcinoma
  • Malignant mesothelioma

Smoking increases risk of bronchogenic CA

286
Q

Asbestosis CXR findings, jobs

A
  • Thickened pleura
  • Pleural plaques

Pipefitter

287
Q

Silicosis CXR findings, job

A
  • Numerous small round opacities
  • Hilar node enlargement and calcification (eggshell)

Mining

288
Q

Rotator cuff order

A

Supraspinatus
Infraspinatus
Teres minor
Subscapularis

289
Q

Eustachian tube dysfunction (with tympanogram results)

A
  • Ear fullness
  • Recurrent middle ear effusions
  • Hearing loss
  • Type C on tympanogram
290
Q

MC cause of tympanic membrane perforation

A

Otitis media

291
Q

Etiologies for chronic otitis media (2)

A
  • Gram neg (Pseudomonas)
  • Staph aureus
  • Anaerobes
292
Q

Tympanogram types

A
  • Type A = normal
  • Type B = restricted TM mobility (“everything else”)
  • Type C = negative middle ear pressure (Eustachian tube dysfunction)
293
Q

Acute sensorineural hearing loss etiologies (4) and treatment

A
  • Viral
  • Autoimmune
  • Drug induced ototoxicity
  • Acoustic neuroma

-Oral steroids

294
Q

Etiology and definition for vestibular neuritis

A
  • Acute onset after URI

- Spont vertigo lasting days without hearing loss

295
Q

Etiology and definition for vestibular labyrinthitis

A
  • Acute onset after URI

- Vertigo lasting days with hearing loss

296
Q

Gold standard for diagnosing acute sinusitis

A

CT of the sinuses

297
Q

Smear for oral herpes simplex

A

Tzank Smear; shows multinucleated giant cells

298
Q

Etiology for sialadenitis/parotitis

A

Staph aureus

299
Q

Blepharitis definition

A
  • Eyelid inflammation due to Meibomian gland dysfunction
  • Chronic itching, burning
  • No vision change
300
Q

Presentation for orbital cellulitis

A
  • Eyelid swelling and erythema
  • Impaired and painful ocular movements
  • Fever
301
Q

Chemosis is a part of which etiology of conjunctivitis?

A

Allergic

302
Q

Acute angle glaucoma definition and presentation

A
  • Acute rise of IOP due to outflow obstruction
  • Acute decreased vision
  • Halos around lights
  • Steamy cornea
  • Mid dilated pupil
  • Firm globe
303
Q

Treatment for acute angle glaucoma

A
  • BB, alpha 2 agonists oph drops

- Oral/IV osmotic agents (Mannitol)

304
Q

Definition open angle glaucome

A

-Chronic painless visual field loss (peripheral, then central)

305
Q

Definition macular degeneration

A
  • Metamorphopsia (wavy/ distorted vision)

- Central scotoma (blind spot)

306
Q

Dry vs wet macular degeneration

A

Dry: druse deposits, vision loss slow, one/both eyes

Wet: me-vascular degeneration, rapid vision distortion, loss of central vision, MC in one eye

307
Q

Definition retinal detachment

A
  • Floaters
  • Photopsias (light flashes)
  • Loss of vision
  • Curtain-like
308
Q

Central Retinal Artery Occlusion (CRAO)

A
  • Embolic
  • Acute, total, painless loss of vision (black as night)
  • “cherry red spot”
309
Q

Central Retinal Vein Occlusion (CRVO)

A
  • Thrombotic
  • Acute, variable, painless loss of vision
  • “blood and thunder”
310
Q

Painful monocular vision loss with central scotoma

A

Optic Neuritis

Associated with multiple sclerosis

311
Q

Corneal light reflex abnormal in…

A

Strabismus

Cover-uncover test can reveal latent strabismus

312
Q

Blowout fracture

A
  • Blunt trauma with fracture of orbital floow
  • Inability to look up
  • Double vision common
313
Q

What can ophthalmic drops cause?

A

Glaucoma and cataracts

314
Q

Initial therapy for child <5 years with ADHD

A

Behavior

-Ritalin only if needed

315
Q

Which disorder can turn into ASPD?

A

Conduct disorder

316
Q

Two medications used for pts with eating disorders

A
  • Prozac for bulimia

- Vyvanse for binge eating disorder

317
Q

TCA used in treatment of OCD

A

Anafranil (Clomipramine)

318
Q

First line med for PTSD

A

Paroxetine (Paxil)

319
Q

Adjustment disorder definition

A

Psychological response to an identifiable stressor

320
Q

How long do symptoms have to be present for definition of MDD?

A

At least 2 weeks

SIG-E-CAPS

321
Q

How long do symptoms have to be present for definition of persistent depressive disorder?

A

2 years

322
Q

Bipolar I definition

A

1 manic episode

323
Q

Bipolar II definition

A

1 hypomanic episode and 1 MDD episode

NO manic episode

324
Q

Cluster A PD (3)

A

Paranoid
Schizoid
Schizotypal

325
Q

Cluster B PD (4)

A

Antisocial
Borderline
Histrionic
Narcissistic

326
Q

Cluster C PD (3)

A

Avoidant
Dependent
Obsessive compulsive

327
Q

Borderline PD definition

A
  • Pattern of unstable interpersonal relationships
  • Unstable self image
  • Unstable affects
  • Poor impulse control
  • Fear of abandonment
328
Q

Brief psychotic disorder

A
  • 1 day to 1 month

- Full return to full level of functioning

329
Q

Delusional disorder

A
  • Non bizarre delusions for at least 1 month

- Functioning not impaired

330
Q

Schizophreniform disorder duration

A

1 month to 6 months

331
Q

Schizophrenia duration

A

6 months +

332
Q

Top 2 first generation antipsychotics

A

D2 receptor blockers

  • Chlorpromazine (Thorazine)
  • Haloperidol (Haldol)
333
Q

Top 2nd generation antipsychotics (7)

A 
Aripiprazole (Ability)
Clozapine (Clozaril)
Lurasidone (Latuda)
Olanzapine (Zyprexa)
Quetiapine (Seroquel)
Risperisdone (Risperdal)
Ziprasidone (Geodon)
334
Q

Two somatic disorders where patient intentionally produces symptoms

A
  • Factitious disorder (“sick role”)

- Malingering (external gain)

335
Q

Multiple complaints with multiple organ systems

A

Somatic symptom disorder

336
Q

Most effective treatment for unintentional somatic symptom disorders

A

CBT

337
Q

Diphtheria etiology

A

Corynebacterium diphtheria

338
Q

Treatment for diphtheria

A

Abx-Erythromycin or Pen G

339
Q

Infants <1 month are at risk of what if prescribed a macrolide?

A

Pyloric stenosis

340
Q

3 main complications for measles (rubeola)

A
  • Myocarditis
  • PNA
  • Encephalitis
341
Q

Presentation for rubella

A

-Fever + maculopapular rash (“blueberry muffin rash”; head to toe progression

342
Q

Complications (3) for rubella

A
  • Deafness
  • Cataracts
  • Cardiac defects

Congenital rubella can be lethal, esp in first trimester

343
Q

Dew drops on a rose petal

A

Varicella (chicken pox)

344
Q

Pregnant women contracting erythema infectiosum

A

“Fifth disease”

Miscarriage, hydrous fettles

345
Q

Kawasaki disease presentation

A 
Conjunctivitis (b/l)
Rash (morbilliform)
Adenopathy (cervical)
Strawberry tongue (red lips, fissuring)
Hands (swollen and red) 
Fever not responsive to antipyretics
346
Q

Treatment for Kawasaki disease

A

IVIG and high dose ASA

347
Q

Complications for Kawasaki disease

A
  • Coronary aneurysms
  • Carditis

Patient needs echo

348
Q

Criteria for acute rheumatic fever (5)

A

(Major criteria)

  • Polyarthritis
  • Carditis
  • Syndenham chorea
  • SQ nodules
  • Erythema marginatum (on trunk/limbs)
349
Q

Complication of acute rheumatic fever

A

-Rheumatic heart disease (affecting mitral valve; mitral stenosis)

350
Q

Top two causes of bilious vomiting in children

A
  • Malrotation

- Congenital atresia

351
Q

Top three causes of bloody vomit in children

A
  • Maternal ingestion
  • Esophageal varices
  • FB
352
Q

Finding on abd ultrasound for intussusception

A

Target sign

353
Q

Difference between indirect and direct inguinal hernia

A
  • Indirect-abd contents herniate through int inguinal ring into inguinal canal; lateral
  • Direct-abd contents do not go through canal
354
Q

Presentation for Hirschsprung disease

A
  • Congenital ganglionic megacolon
  • Failure to pass meconium in first 48 hours of life
  • Ribbon like stools
355
Q

Diagnostic test for Hirschsprung disease

A

Rectal biopsy

356
Q

Presentation for botulism

A
  • Descending weakness

- Hypotonia, loss of DTRs

357
Q

Treatment for botulism

A

-Botulism immune globulin

358
Q

Hyaline membrane disease

A
  • Neonatal RDS
  • More common in <32 weeks gestation
  • Deficiency of surfactant in immature lungs
359
Q

MC cause of speech delay

A

Conductive hearing loss from a middle ear effusion

360
Q

Four tests for rotator cuff

A

Drop arm (complete tear)
Empty can
Neer’s impingement sign
Hawkin’s

361
Q

Two tests for biceps tendonitis

A

Yergason’s

Speed’s

362
Q

Test for adhesive capsulitis

A

Apley scratch test

363
Q

Bankart lesion

A

Detachment of ant inferior labrum from glenoid rim

364
Q

Hill Sachs lesion

A

Cortical depression of the posterolateral humeral head

365
Q

Nerve consideration for anterior shoulder dislocation

A

Axillary nerve

Decreased sensation lateral aspect of shoulder (mid deltoid) and decreased deltoid function

366
Q

Nerve consideration for humeral shaft fracture

A

Radial nerve; wrist drop

367
Q

Cubital tunnel

A

Compression of ulnar nerve

368
Q

Number one symptom for compartment syndrome

A

Pain

369
Q

Colles vs Smiths wrist fracture

A 
Colles = dorsal displacement
Smiths = volar displacement
370
Q

Jersey finger

A

Flexor tendon rupture; inability to flex DIP joint

371
Q

Mallet finger

A

Rupture of extensor tendon (DIP); inability to extend DIP joint

372
Q

Boutonniere vs swan neck deformity

A

Boutonniere = flexion of PIP joint, hyperextension at DIP

Swan neck = hyperextension of PIP, flexion of DIP

373
Q

Boxer’s fracture

A

Neck of 5th metacarpal

374
Q

Bennett’s fracture

A

Fracture at the base of the 1st metacarpal

375
Q

Classic patient with dupuytren’s contracture

A

Male, Northern European, >40y, ETOH abuse

376
Q

DTRs

A 
Biceps-C5
Brachioradialis-C6
Triceps-C7
Knee-L4
Achilles-S1
377
Q

Spinal stenosis presentation

A

Pain relief with leaning forward while standing; pain increases with walking

378
Q

+ straight leg raise

A

Herniated nucleus pulposus

Majority occur at L4-L5 and L5-S1

379
Q

Gold standard diagnosing pelvic fractures

A

CT scan

380
Q

Presentation for hip fracture

A
  • Will hold leg in external rotation/abduction

- Leg will appear shorter

381
Q

Hip dislocation

A
  • Posterior MC
  • Adduction and internally rotated
  • Leg will appear shorter
382
Q

Two tests for meniscus

A

McMurray’s

Apley’s

383
Q

ACL tear presentation

A

-Pop sensation with instability
-Hemarthrosis
+ Lachman’s

384
Q

What fracture is at high risk for compartment syndrome?

A

Tibial shaft fractures

385
Q

Stress fracture of foot

A

Midshaft 3rd MT

386
Q

Lisfranc fracture

A

Fracture/dislocation of 1st and 2nd TMT

387
Q

Septic hip Kocher criteria

A
  • Holds leg in flexion, abduction, ext rotation
  • Walks with limp or refusal to bear weight
WBC >12,000
ESR >40
Fever >101.3
NWB
2/4
388
Q

MC mechanism for proximal tibia fractures

A

Trampolines

389
Q

Focal tenderness to tibial tubercle

A

Osgood-Schlatter’s disease

390
Q

Metastatic tumors to the bone

A 
Pb KTL ("lead kettle")
Prostate
Breast
Kidney
Thyroid
Lung
391
Q

MC benign tumor in bone

A

Unicameral bone cyst (simple bone cyst)

392
Q

Blood filled cyst in the bone

A

Aneurysmal bone cyst

393
Q

Osteoid osteoma

A
  • Worsening pain at night
  • NSAIDs relieve pain
  • Benign bone tumor
394
Q

Fixed mass near joints

A

Osteochondroma

395
Q

MC malignant bone tumor in children

A

Osteosaroma

396
Q

Complex regional pain syndrome etiology and presentation

A
  • POOP to injury involving extremities, usually following an injury (months later)
  • Tx-pain management, NSAIDs
397
Q

LP on Guillain barre syndrome, treatment

A

Elevated CSF protein with normal WBCs

Tx-IVIG or plasmapheresis

398
Q

Diagnostic and treatment for trigeminal neuralgia

A
  • MRI to r/o multiple sclerosis

- Tx-Carbamazepine (Tegretol)

399
Q

Increase risk for Bell’s palsy (4)

A
  • Idiopathic
  • Pregnancy
  • DM
  • HSV/zoster
400
Q

Petechial rash with meningitis

A

Neisseria meningitidis

401
Q

Bacterial meningitis LP results

A
  • High opening pressure
  • Very high WBC count
  • Decreased glucose
  • Increased protein
402
Q

Etiologies and treatment for encephalitis

A
  • MC viral
  • Enteroviruses (coxsackie)
  • West nile
  • HSV

Tx with Acyclovir

403
Q

Diagnostics for multiple sclerosis

A 
MRI = periventricular white matter changes
CSF = oligoclonal IgG bandds
404
Q

Tx for myasthenia gravis

A

AchE Inhibitor-Pyridostigmine

405
Q

Essential tremor

A

Action tremor

Tx-Propranolol

406
Q

Tremor in Parkinson disease

A

Resting tremor

407
Q

MC primary benign brain tumor

A

Meningioma

408
Q

MC malignant brain tumor

A
  • From metastases

- MC malignant primary brain tumor = glioblastoma

409
Q

Cushing’s triad

A

Htn
Bradycardia
Irregular respirations

410
Q

4 reversible causes of dementia

A

Hypothyroidism
Vitamin B12 def
Hydrocephalus
Neurosyphilis

411
Q

Cognitive fluctuations, visual hallucinations, REM sleep behavior disorder

A

Dementia with Lewy bodies

412
Q

MC cause of SAH

A

Berry aneurysm

413
Q

Epidural hematomas MC involve

A

Middle meningeal artery

Convex bleed on CT

414
Q

Subdural hematomas MC involve

A

Bridging veins

415
Q

Artery involved in ischemic strokes

A

MC form of stroke; middle cerebral artery

PANCE Prep (2 decks)

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