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PPP ROSH- MSK/GI Flashcards

1
Q

Components of CREST Syndrome

What two PE findings may be seen w/ this condition

? monitoring is needed for Pts on DMARD therapy

A

Calcinosis Raynauds Esophageal dysmotility Sclerodactyly Telangiectasias

Madonna finger- distal finger tapering
Rat bit necrosis- distal ulcers

CBC- s/e of marrow suppression

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2
Q

Ottawa Ankle Rules

Define Maisonneuve Fx

MC soft tissue tumor of the hand

A

Bone pain posterior to distal 6cm of Lat/Med Malleolus
Inability to bear weight x 4 steps at evaluation
Navicular pain
Pain at base of fifth metatarsal

Spiral Fx of proximal 1/3 of fibula w/ tibiofibular syndesmosis and interosseous membrane tear

Ganglion- MC d/t repetitive movement

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3
Q

Define Myofascial Pain Syndrome

How are Pts Tx

Rotator impingements are associated w/ ? two positive PE findings

A

Trigger points w/ painful spots in palpable taut bands of muscle

Cyclobenzaprine- muscle relaxer

Hawkins, Neers

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4
Q

What are the muscles and movements of the rotator cuff

Pseudogout lab results

What x-ray finding is associated w/ this Dx

A

Supraspinatus- abduction
Ingraspinatus- external rotation
Teres minor- external rotation
Subscapularis- internal rotation

Pos birefringent Ca pyrophosphate dihydrate rhomboids

Chondrocalcinosis

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5
Q

Anti-SSA/Ro is associated w/ ? conditions

Anti-La/SS-B is associated w/ ? condition

Anticentromere is associated w/ ? condition

A

Lupus Sjogrens Neonate heart block

Sjogrens

CREST syndrome

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6
Q

Anti-dsDNA is associated w/ ? condition

Anit-Jo1 is associated w/ ? condition

Anti-Smith is associated w/ ? condition

A

Lupus

Inflammatory myopathy

Lupus

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7
Q

Antitopoisomerase SCL-70 is associated w/ ? condition

Antihistone is associated w/ ? conditions

What are the two ANCA autoantibodies associated w/

A

Systemic sclerosis

Drug induced lupus

cANCA- granulomatosis
pANCA- micro/eosinophilic polyangitis

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8
Q

Rheumatoid factor is associated w/ ? conditions

Anti-smooth muscle Ab is associated w/ ? condition

Antimitochondrial antibody is associated w/ ? condition

A

RA, Mixed CT d/o, Sjogrens

Chronic immune hepatitis

Primary biliary cholangitis

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9
Q

What are the three classifications of osteoporosis

What causes mallet finger

What condition occurs if this goes untreated

A

1: post-menopause d/t lack of estrogen
2: Age >75y/o, Loss Zinc/Ca
Secondary: chronic dz/meds (type seen in men)

Force DIP flexion rupturing extensor tendon at insertion on distal phalanx

Swan neck- PIP hyperextension, DIP flexion

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10
Q

Best initial screening test for SLE

What markers are Dx

What med is the best management for SLE

A

ANA

Anti-double strand DNA and Anti-Smith

Hydroxychloroquine- s/e retinal toxicity= annual Opto

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11
Q

What medication is used for active lupus nephritis

What marker is MC elevated w/ this form of lupus

S/Sxs of patellofemoral pain syndrome

A

Cyclophosphamide

Anti-double stranded DNA

Pain worse w/ loaded flexion: stair, jump, theater sign

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12
Q

Next step of knee OA after PO meds fail to control Sxs

First choice for mild-mod back pain

What is used for pain refractory to first choice

A

Intra-articular cortisone and lidocaine injections

NSAIDs

Muscle relaxors: Cyclobenzaprine

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13
Q

? Ab triad is seen w/ scleroderma

What are the three urate lowering meds for gout

What two meds are c/i during Tx

A

ANA w/ Anticentromere (limited) and Anti-SCL 70 (progressive)

Allopurinol/Febuxostat: dec production
Probenacid: inc excretion
Pegloticase: converts uric acid to allantoin

ASA, Loops, Thiazides

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14
Q

MOA of Colchicine during gout Tx

MCC of acute compartment syndrome and where is the MC location

Dx criteria for Compartment Syndrome

A

Inhibits microtubule formation for neutrophil migration

Fxs- anterior leg, Volar forearm

30-40mmHg (norm: 0-10)
Delta: DBP - Compartment pressure= ≤30

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15
Q

What are the 6 Ps of Compartment Syndrome

How is Pseudogout Tx

How can Meniscus injury be detected on PE and what image is preferred

A

Paresthesia Pallor Pulse Poikilothermia Paralysis PooP
Pain Color Sensation Pulse Temp Paralyzed

NSAID (Colchicine if c/i)

+Thesally, pain on medial joint line; MRI

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16
Q

What is the “Unhappy Triad”

Suspected Ca mets to bone is imaged w/ ?

? type of c/c is common in autoimmune mediated inflammation

A

Medial meniscus, ACL, MCL

MRI > CT myelography

Pain worse w/ rest, improved w/ movement

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17
Q

EMED recs

A 
Know when to intubate
GCS- calculate
Sickle cell chest pain/occlusive crisis w/ dec Hgb
EENT
Anterior should dislocation- nerve damaged?
When to do Ex-Lap 
Dental emergency
Ectopic pregnancy
Spont abortion/Placenta preva
Emergency before/after 20wks gestation
Consults- OB GenSurg
Disposition- admit, IV ABX, serial exams
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18
Q

Define Dimple Sign

Why are these a surgical emergency

How are they Tx

A

Transverse groove at medial joint line indicating posterolateral knee dislocation

Irreducable w/ manual reducation: medial femoral condyle button holed through medial capsule, MC invaginated in joint

Surgical emergency: open reduction

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19
Q

? nerve/artery is MC damaged w/ tibiofemoral dislocations

Define Saturday Night Palsy

What sensory deficit is associated w/ this condition

A

N: Common Peronial/Fibular nerve
A: Popliteal artery

Prolonged external compression w/ wrist flexion causing inability to extend wrist against resistance

Superficial branch numbness: dorsal first web space

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20
Q

? nerve is responsible for pinching movement between thumb and index finger

What is the function of the peroneal nerve

Anterior/Posterior hip dislocation presentations

A

Anterior Interosseous branch of median nerve

Superficial branch: Foot eversion
Deep branch: foot dorsiflexion, toe extension

P: internal rotation w/ shortening
A: external rotation w/ lengthening

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21
Q

Polymyalgia Rheumatica presentation

? other Dx is commonly co-existant

How are PR Pts Tx

A

Morning stiffness w/ shoulder/hip weakness and ESR >50

CGA

CCS

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22
Q

Best PE test for assessing ACL stability

Colchicine needs to be avoided in ? gout Pts

How is olecranon bursitis Tx

A

Lachman- bend 20-30*, pull tibia aneriorly

Dec GFR/renal failure

Compression, Ice, NSAIDs

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23
Q

How can olecranon bursitis be differed from a joint effusion on PE

How is osteomyelitis and septic arthritis differed on PE

What imaging modality is preferred to Dx osteomyelitis

A

Effusion: pain w/ full extension
Bursitis: normal PROM

Preserved ROM

MRI- shows defect 2wks prior to x-rays

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24
Q

MC microbe involed in cat bites

What ABX is used for Tx

? microbes MC lead to Reactive Arthritis

A

Pasteurella multocida

Amp-Sulbactam

Campylobacter, Shigella, Salmonella, Yersinia, Chlamydia

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25
How are stable ankle Fxs Tx What causes Cauda Equina to occur What is the most sensitive clinic sign for this condition
Weight bearing cast x 4-6wks Compression of conus medullaris Urine retention
26
How many pressure points for Fibromyalgia Dx Function of Flexor Digitorum Superficialis Function of Flexor Pollicus Longus
11 of 18 Medial humoral epicondyle to PIP/MCP for flexion Thumb flexion
27
Function of Palmaris Longus Function of Flexor Carpi Ulnaris Function of Flexor Digitorum Profundus
Wrist flexion Hand adduction DIP flexion
28
Function of Flexor Carpi Radialis What nerve innervates the FDS Bicep reflex nerve
Flexion and hand abduction Median C5/6
29
Tricep reflex nerve Brachioradialis reflex nerve Patellar reflex nerve
C7 C6 L4
30
Dorsal web of first/second toe innervated by ? Achilles reflex nerve What muscles insert at the Pes Anserinus
L5 S1 Goose foot: gracilus, sartorius, semitendinous
31
Gracilis origin, insertion, innervation What other knee injury needs to be r/o in a Pes Anserinus injury O'Brien test is AKA ? and tests for ?
Inferior ramus, Medial tibial shaft, L2-4 via obturator nerve MCL- insertion site near bursa Active Compression- SLAP/glenohumeral joint tears
32
? nutritional deficiency presents w/ malar rash like SLE What PE test is used to assess for Achilles rupture How are Pt managed prior to surgery
Pellagra- B3 deficiency Thompson squeeze- most reliable indicator Splint in plantar flexion w/ non-weight bearing
33
Lisfranc is ? type of injury How are these isolated for Dx on PE What type of mechanisms leads to this injury
Tarsometatarsal joint Fx/dislocation from cuneiform Stabilize hindfoot, forefoot rotation Plantar flexion
34
MCC of acute hemarthroses in sport injuries Joint aspirate w/ ? WBC levels indicate septic or inflammatory How does glucose content help differ
ACL tear Inflammation: 2-50K; Septic: >50K Inflammation: >25; Septic <25
35
What Dx causes tender, nodular lesions in starburst pattern w/ erythema on shins What types of plaques can Pt develop What is the preferred Tx for Polymyositis
Polyarteritis Nodosa: necrotizing vasculitis of small/medium arteries Livedo reticularis- starburst and pathognemonic Pred
36
What type of Ca is associated w/ dermatomysoitis in women How is Osgood-Schlatter Tx What causes Bankart Lesion
Ovarian Tylenol and activity as tolerated Posterior humeral head hitting anterior gleniod rim w/ arm abducted and externally rotated causing Fx
37
? biomarker is most specific for RA What 3 infections can present w/ elevated RF ? is the MC hand infection
Anti-cyclic citrullinated peptide Abs Hep C Malaria Rubella Paronychia- infection of lateral nail fold
38
What are two possible complications from paronychias Dx test for Sjogrens What lab markers may be positive in these pts
Progression to felon, Osteomyelitis of distal phalynx Schirmer Anti-Ro/La and RF
39
What is used to measure spinal deformities What test is used to r/o SLE Define De Quervain Tendinopathy
Cobb angle: top of first vertebrae involved, bottom of last vertebrae involved, >10*= Dx ANA Abductor pollicis longus/Extensor pollicis brevis inflammation d/t overuse/post-partum
40
? test is used for De Quervains Tendinopathy Dx How are Pts Tx What nerve innervates the ligaments involved
Finkelstein NSAIDs, thumb spica spint, steroid injections Deep branch of radial nerve
41
Kanavel Criteria for Flexor Tenosynovitis Triad characteristics of septic arthritis ? derm manifestation of reactive arthritis may be seen on PE
Tenderness along flexor tendon Finger swelling Pain w/ passive extension Flexed posture Pain Swelling Fever Brown/Red papules that become hyperkeratotic and crusted over on palm/soles after Chlamydia
42
? PE finding is a c/i to manually reduce a tibiofemoral dislocation ? lab marker is used as a marker of muscle injury during Rhabdo and used for Dx ? is the MC non-spine complication or Ankylosing Spondlyitis
Dimple sign Creatine kinase (CK-MB is more specific to cardiac muscle) Anterior Uveitis- unilateral pain, photophobia, blurred vision
43
How is Bipartite Patella differed from Patella Fx on x-ray ? body position leads to the MC type of shoulder dislocation ? nerve is MC injured during shoulder dislocations
Bipartitie- rounded/smooth edges Anterior: abducted, externally rotated, extended Axillary- lateral sensation, deltoid contraction
44
? two PE tests suggest rotator cuff injury ? TB med can induce Lupus-like syndrome ? drugs are used for the Tx of osteoporosis by slowing bone loss
Drop arm, Empty can Isoniazid BisPhos: -dronates Calcitonin SERM: Raloxifene Monoclonal: Denosumab
45
? med is used for osteoporosis Tx to reduce bone formation After initiating BisPhos therapy, when is the next f/u DEXA scan done Dupuytren contracture is associated w/ ? Dx
Teriparatide (PTH) 2yrs DM
46
# Define Syndesmotic Ankle Sprain What is seen on x-ray How are these Tx
High ankle sprain: pain w/ external rotation and dorsiflexion (Kleger test) w/ partial syndesmosis tear Diastasis between tib/fib Grade 1: immobilize, non-weight bearing 2/3: surgery
47
MC microbe seen w/ nail puncture induced osteomyelitis and how is it Tx Normally what is the MC microbe of osteomyelitis How is Lumbago Tx
Pseudomonas- Cipro Staph A Activity within pain limitations
48
# Define Boutonniere deformity Ankle sprain classifications by grade ? ABX is used for human bite infection prophylaxis
PIP flexion, DIP hyperextension 1: tender swelling, micro tears of colagen 2: dec ROM, possible instability; immobilize and PT 3: swelling, tenderness w/ instability e/ complete tear/rupture Augmentin
49
The MC microbes seen w/ dog bites ? medication is used for systemic stimulation in Pts w/ Sjogrens Two DDx for non-traumatic subungual hematomas
Staph A, Pasteurella multocida, Strep viridian Pilocarpine Melanoma, Kaposi
50
# Define HSP What are Pts at risk for What lab result aids w/ Dx
MC vasculitis of child hood; IgA mediated lower extremity palpable purpura, arthritis, abdominal pain and renal involvement Intussusception > Nephrotic syndrome Normal platelet count
51
Landmarks above/below snuff box Pos snuff box tenderness w/ negative x-ray needs w/ d/c education Scaphoid Fx are more likely to necrose w/ ? fx location
EPL/EPB/APL Repeat x-ray 10-14d, remain in thumb-spica splint Proximal, inc likelihood d/t blood supply via distal pole
52
What RA presentation differs it from OA RA induced effusions will have ? results What is needed to confirm a Dx of scoliosis
Constitutional Sxs Low glucose, low pH, high LDH Radiographs to measure Cobb angle
53
? lab result will be almost universally elevated in Pts w/ osteomyelitis What radiographic finding indicates this Dx MC Fx carpal bone
Inc ESR Periosteal elevation w/ inflammation Scaphoid
54
? joints of the hand are spared w/ RA Define Colles Fx Plantar fasciitis is common w/ ? foot abnormality
DIP spared Distal radial Fx from FOOWrist Cavus foot
55
# Define Tarsal Tunnel Syndrome What lab results will be seen in UA during rhabdo What two carpals bone articulate w/ radius
Posterior tibial nerve entrapment under flexor retinaculum Inc K, Ph; Dec Ca- MC Scaphoid, Lunate
56
If Pt presents w/ L4-L5 herniation, what nerve root is compressed ? hyperlipid medicine can exacerbate gout This med is also an exacerbation to ? population Dx
One above- L4 Niacin DM- hyperglycemia
57
Lab results seen after muscle biopsy to Dx polymyositis How are Frozen Shoulder's Tx Urate crystals are the product of ? metabolism
Inc aldolase and Creatine Kinase PT, NSAID, injections Purines
58
MC cause of hip disability in adolescents What c/c can Pts present w/ What PE finding will be seen
SCFE M: 12-16y/o F: 10-14y/o Hip pain referred to thigh/knee Dec internal rotation
59
Name of x-ray line used for Dx SCFE Fasciotomy's are most effective if done w/in ? time frame First step in ganglion cyst management
Klein line <6hrs from injury Aspiration
60
? drug is safe for RA Tx during pregnancy MC presenting complaint for men w/ osteoporosis Pos anterior drawer test after ankle injury means ?
Hydroxychloroquine Vertebral compression Fx Grade 3: tear of anterior talofibular ligament
61
Chronic use of ? meds place Pts at risk for vertebral compression Fxs outside of a Dx of osteoporosis What is the straight leg raise test AKA ? ? PE test assesses the meniscus of the knee
CCS Lasegue sign McMurray
62
How are Pts w/ Greater Trochanteric Pain Syndrome Tx in sequence Pts w/ this condition who do not respond to conservative Tx need to have ? Dx r/o What causes GTP Syndrome
1st: NSAIDs, PT 2nd: CCS injection to bursa Medial glute tear Overloading of glute medius/minimus
63
Scleroderma Pts will most likely test positive for ? biomarker MC joint for septic arthritis Lab results seen w/ this Dx
+ ANA Knee WBC >50K, low glucose
64
What PE finding aids w/ Dx of Ankylosing Spondylitis Medical Tx options for Raynauds Allopurinol can be used to avoid acute gout attacks except for ? type
Tenderness over spine/SI joint CCBs Sildenafil Fluoxetine Diuretic induced gout
65
Mainstay of Tx for Reactive Arthritis Three PE findings associated w/ Dermatomyositis How are Pts Tx
High dose NSAIDs Heliotrop rash: violet erythema around eyes Gottron papules: thickened knuckle skin Shawl sign Pred, Methotrexate, Cyclophosphamide
66
Joint aspiration WBC results for Normal, Non-Inflamm, Inflamm, Septic and Hemorrhagic Red flags of back pain
``` N: <150 Non-In: <3K Inflamm: >3K Septic: >50K Hemorrhagic; n/a ``` ``` IVDA F/C/S- infection AM tenderness >30min- seroneg spondyl Retention/Anesthesia- cauda equina Tenderness- Fx Night pain/Weight loss- tumor ImmDef- infection Coagulopathy- hematoma Extremes of age Recent instrumentation- hematoma/abscess ```
67
? x-ray view should be ordered for patellofemoral instability w/ catching Frog leg view is used to view ? Grashey view is used to view ?
Axial/sunrise Hip Glenohumeral joint
68
Swimmers view x-ray is used to view ? Most sensitive imaging for radiculopathy What does xanthochromia indicate in CSF
Cervicothoracic junction MRI > CT w/ contrast RBCs in subarachnoid space
69
? underlying condition is commonly associated w/ fibromyalgia Sxs in males What are the MC positive autoantibodies for myositis What other two results will can also be positive
OSA Anti-Jo 1 ANA, RF
70
Ottawa Ankle Rules apply to injuries that occurred ? long ago ? is the MC sprained ankle ligament What are the Sxs associated w/ Sjogrens called and how are they Tx
<48hrs Anterior talofibular Sicca Sxs: pilocarpine
71
Non-puncture foot osteomyelitis is MCC by ? microbes and Tx w/ ? Criteria for adolescent scoliosis How are Pts managed
Staph/Strep: Clinda/Cephalexin Cobb angle ≥10* and onset ≥10y/o 10-19*: observed w/ f/u q6-9mon until skeletal maturity 20-29*: possible brace 30-39*: brace ≥40*: surgery
72
What is the name of the grading system for assessing skeletal maturity ? two PE tests are done for suspected carpal tunnel MC radiograph finding for Salter-Harris type 5
Risser classificaiton Most sensitive: median compression test Tinel tap test, Phalen compression x 60sec Normal
73
Legg Calve Pertheses Dz ages compared to SCFE ages Define Colchicine toxicity ? DMARD is preferred for Ankylosing non-responsive to NSAIDs
LCPD: 4-10, SCFE: 12-16 Automn crocus/Glory lily alkaoids- severe GI upset w/in first 24hrs of use Infliximab
74
# Define Sever Dz Tx of choice for disseminated N gonorrhoeae septic arthritis What are the main Sxs of bone maligancy
Calcaneal apophysitis- inflammed calcaneal growth plate causing pos compression test after cleat-wearing sport participation, self resolves Ceftriaxone Constant, deep ache at night unrelieved by rest
75
Primary bone tumors of 20-30y/o Primary bone tumors of 30-50y/o Primary bone tumors of >50y/o
``` Osteo-chondroma/sarcoma Osteoid osteoma Adamantinoma Giant cell Enchodondroma ``` Chondrosarcoma Fibrosarcoma Malignant histiocytoma Lymphoma MMyeloma
76
What is the next step needed for Pts w/ proximal humerus Fxs What 3 rotator muscle insert on the greater tuberosity When is it appropriate to refer spinal claudication/stenosis to Ortho
Distal neurovascular supply assessment Supraspinatus Infraspinatus Teres Neuroclaudication >12wks
77
What two PE tests are positive if ankle instability is present Straight leg raise tests for radiculopathy at ? level How is this test done
Anterior Drawer, Talar tilt L5-S1 Sx leg raised straight; Pos= pain in back radiating past knee when raised 30-70*
78
Reverse straight leg raise tests for radiculopathy at ? level How is this test done Pos Galeazzi test indicates ? issue
L3-L4 Passive extension of hip w/ Pt prone Development hip dysplasia d/t femoral shortening
79
Developmental dysplasia of the hips is more common in Pts w/ ? cervical condition Involvement of ? structure indicates inoperable gastric Ca Three PE signs of gastric Ca mets
Congenital torticollis, "wry neck" Hepatic artery encasement Virchow node Iris node- L axillary node Sister Mary Joseph- periumbilicular
80
MCC of infectious diarrhea in AIDS Pts Primary anal fissure location and causes Secondary anal fissure location and causes
Crypto when CD4 <100 Posterior midline: Trauma Constipation/Diarrhea Delivery Lateral midline: Crohns Malignancy Communicable/Granulomatous dz
81
Marker of Hepatic Encephalopathy How is this Tx MC type of pancreatic Ca
Ammonia Laculose, Rifaximin Adenomacarcinoma- worst prognosis
82
How do pancreatic Cas present What serum marker is associated w/ this MCC of intestinal obstruction in Pts <2y/o
Painless jaundice Courvoisier sign Trousseau syndrome- hypercoagulability seen as migratory thrombophlebitis 19-9 Inussusception- cyclic cramping pain w/ vomiting and bloody stool w/ palpable mass
83
MC type of colorectal Ca MC type of Ca and MCC of death in M/W
Adenocarcinoma- ab pain, bowel changes, weight loss, dec appetite and hematochezia Men MC: Prostate Lung Colorectal Men MC death: Lung Prostate Colorectal Women MC: Breast Lung Colorectal Women MC death: Lung Breast Colorectal
84
MC emergent surgery in pregnancy How is pancreatitis Dx How are esophageal varices Tx
Appendicitis Lipase inc 3x- most specific US to evaluate for biliary etiology Ligation Banding Sclerotherapy
85
? infectious Dz can cause esophageal varices When does candidiasis induced esophagitis occur and how is it Tx Female athlete triad
Schistosomiasis (trematode) CD4 <200; First line: fluconazole D/o eating Amenorrhea Osteopenia
86
Small intestine infarctions MC occurs d/t ? If surgical intervention is performed on the left lower quadrant, ? was the issue Shigella infections can cause ? Dx and ? extraintestinal manifestation
Superior mesenteric artery emoli Inferior mesenteric artery Dysentery: Reactive arthritis, Seizure, Hallucinations
87
Lactose intolerance is d/t ? What lab results may be seen What causes achalasia
No lactase- glucose to galactose Stool osmotic gap >125, pH <6 Degeneration of ganglion cells in the myenteric plexus of esophagus wall
88
MCC of upper GI bleeds MCC of lower GI bleeds Define Hamman Sign
PUDz Diverticulosis- painless rectal bleeding Crunching on chest auscultation d/t esophageal perf
89
? microbe causes ileocecitis What is the Dx AKA ? What post-infectious issues can develop
Yersinia enterocolitica from pigs Pseudoappendicitis Erythema nodosum, Reactive arthritis
90
Most effective Tx of esophageal strictures What type of laxative is first line Tx for chronic constipation Phenyketonuria needs life long diet of ?
Dilation and PPIs Bulks- psyllium, methylcellulose High veggie, low meat/starch- inability to convert phyalanine to tyrosine
91
What sweetner is avoided during PKU Heinz bodies is associated w/ ? micro/macrocytic anemias What lab result would show Heinz bodies
Aspartame Micro: A-thalassemia macro: G6PD deficiency- no glutathione (radical destroyer) Neg Coombs test- non-immune
92
# Define Cholecystitis Gold standard to Dx PUD Ascending Cholangitis Sxs
Infected gallbladder d/t stones obstructing the cystic duct Endoscopy Charcots: RUQ pain, Jaundice, Fever Reynolds: +shock and AMS
93
Four classifications of hemorrhoid Diverticulitis out-Pt Tx ABX Viral hepatitis lab results
1: no protrusion 2: spontaneous reduction 3: manual reduction 4: non-reduceable, possible strangulation Cipro w/ Metronidazole/TMP-SMX ALT>AST
94
Acute Hep B infection characterized by ? Immunization is noted by ? result
Anti-HBc-IgM Anti-HBsAg IgG
95
Bulk laxative Stool softener laxatives Stimulant laxatives
Psyllium, Methylcellulose Docusate Senna Bisacodyl Castor oil
96
? lab result are most significant for re-feeding syndrome Complication that can arise from UC How is this complication Tx
Hypo-phosphatemia HypoK Thiamine deficieny and CHF Toxic megacolon Bowel rest and NG tube
97
MC type of gastric Ca and Dx method What is the MC RF What tumor marker will be inc in 50% of Pts w/ gastric Ca
Adenocarcinoma Dx w/ EGD H pylori Carcinoembryonic Ag (CEA)
98
# Define Mallory Weiss What is a pre-disposing RF Define Positive Dance Sign
Longitudinal tear in distal esophagus mucosal layer Hiatal hernia Empty RLQ in US significant for intussusception
99
What causes intussusception in adults How is ascites 2/2 P-HTN/cirrhosis Tx What causes un/conjugated bili to rise
Malignancy Spironolactone (reverses Na retention, conserves K and diuresis fluid), then Furosemide, then centesis Un: hemolysis, liver dz, Con: biliary obstruction
100
MCC of acute gastritis What heme abnormality may be seen What can/not be eaten w/ Celiac dz
H pylori Pernicious anemia d/t parietal cell destruction, IF destruction Can: rice, corn, potato, soybeans No: wheat, barley, rye
101
? GI med decreases Ca absorption How is a Dx of lactose intolerance confirmed Recommended Ca per day
PPIs Lactose hydrogen breath test 1200mg/day
102
EGD needs to be done on all Pts w/ dyspepsia over ? age MCC of VGE ? population has a high mortality rate d/t Hep E
≥60 Norwalk virus from cruise ships Pregnancy 2-3rd trimester
103
How is cholelithiasis Tx during pregnancy Zollinger Ellison is associated w/ ? genetic syndrome MC PE finding for PUDz and what is the MC complication to arise from this Dz
Pain control, support MEN-1 Epigastric tenderness; GI bleeds
104
Colon Ca bleeding comes from ? side while diverticulitis comes from ? side Acute management for variceal bleeds Chronic management includes ?
Ca: R, Diver: L Octreotide, Banding/Sclerotherapy, Ceftriax BB, ligation
105
Crohns biomarkers Crohns derm manifestation Crohns is AKA ?
ANCA, ASCA Erythema nodosum- tender, erythematous nodules on bilateral shins Regional enteritis
106
PE finding suggesting B12/Cobalamin deficiency What lab results will be pos How are UTIs in G6PD Pts Tx
Enlarged, red tongue Inc methylmalonic acid and homocysteine Cephalexin
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What is seen on smears of G6PD blood What tropical dz are they protected from MCCs of SCC/Adeno Ca in esophagus
Heinz bodies, Bite cells Malaria SCC: Smoking, Alcohol, Adeno: Barrets
108
Vit A toxicity What is the result of this toxicity Post-hernia surgery w/ beltline numbness is d/t ? nerve
Inc ICP, Oily skin, Alopecia, Dec appetite/weight loss Suppress osteoblast, Stims osteoclast Iliohypogastric
109
What is a neuro complication arising form thiamine deficiency How is this Tx/prevented Ranson Criteria
Wernicke Korsakoff Syndrome- Encephalopathy Ocular dysfunction Ataxia Thiamine before glucose GA LAW: Glucose>200 AST>250 LDH>350 Age>55y/o WBC>16K CHOBBS: Ca<8 Hct dec >10% O2<60 Base deficit >4 BUN inc >5 Sequesters fluid >6L
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What E+ needs to be monitored after admission for pancreatitis Triad of Disulfuram Reaction Perforation of ? GI structure has the highest mortality and MC d/t ?
Ca Flushing Tachycardia HOTN Esophagus MC d/t iatrogenic cause
111
4Hs of Scurvy Define IgA Vasculitits presentation What will be seen on lab results
Hemorrhage- gum/petechiea Hperkeratosis- rough skin, loose teeth Hypochondriasis- irritable emotional changes Heme abnormals- easy bruising AKA Henoch Schonlen purpua- arthritis/arthralgia and palpable but non-blanching red/purple macules w/ abdominal cramps and bloody stools Guiac pos stool, proteinuria, inc BUN/Cr
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Histopathologic term for gastric malignancy cells Borders of inguinal hernias Celiac Dz can cause Pts to become ? deficient
Signet ring cell Hesselbach Triangle: abdominus rectus, inguinal ligament, epigastric vessels Fe
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Nexus criteria MC presentation for acute small bowel obstruction How does the presentation of an ileus or pseudo-obstruction present differ
``` Neuro deficit, no focal deficit Spinal tenderness, midline AMS, normal Intoxicated Distracting injury ``` Colicky pain w/ distension and emesis; No colicky pain or N/V
114
? vitamin deficiency presents w/ dermatitis, diarrhea and dementia? MCC of esophageal varices in USA How is H Pylori Tx
Niacin, Pellagra Cirrhosis Triple: Clarithromycin Amox (or Metro) and PPI Quad: Bismuth Metro Tetracycline PPI
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INH Tx leads to ? deficiency Folic acid production depends on ? vitamin First line Tx for Crohns
B6- pyridoxine B9- folate Mesalamine (ileitis) or Sulfasalazine (ileocolitis, colitis)
116
What lab results are seen w/ pyloris stenosis Indications for H Pylori quad therapy Lab results seen w/ Rickets
HypoCl/K w/ metabolic alkalosis Recent macrolide use, Area w/ clarithromycin resistance, Triple therapy eradication ≤85% Inc AlkPhos, low phosphorus/Ca
117
3 MCC of small bowel obstructions in order Define Ogilvie Syndrome How is this Tx
Adhesion, Ca, Incarcerated hernia Pseudo-obstruction w/ dilated colon d/t autonomic dysfunction Cecal diameter >12cm: Neostigmine- aetylcholinesterase inhibitor Opioid induced: methylnaltrexone
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S/e of using neostigmine for Tx of Ogilvie Syndrome Hallmark histology result for celiac dz ? med is c/i in Pts w/ NSAID induced ulces
Bradycardia, Asystole Villous atrophy Misoprostol
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? acid base d/o does salicylate toxicity cause What medication is used to trap the aspirin and promote excretion External PE finding suggesting IBDz
Metabolic acidosis, Resp alkalosis Na bicarbonate Anal skin tags

IPAP (212 decks)

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