Practice Exam topics Flashcards
Inherited protein C deficiency predisposes you to what?
Thrombosis
Preferred medication to decrease incidence of bed wetting episodes?
Imipramine/Tofranil
anticholinergic med that when given before bedtime can decrease incidence
what can you use Hyocyamine to treat?
overactive bladder
1st 2nd and 3rd line treatment for morton’s neuroma
1st- conservative metatarsal support, broad-toed shoes with firm soles
2nd- steroid injection
3rd- surgery if failed conservative tx (could have permanent numbness)
positive endomysial IgA antibodies during screening is indicative of what disease?
celiac sprue
when are face, scalp, trunk, and extremity sutures removed after placement?
face: 3-4 days
scalp: 5-7 days
trunk: 6-8 days
extremity: 7-14 days
which diagnostic test is most sensitive for an AIDS pt with toxoplasmosis who presents with AMS/neuro deficits?
MRI
which disease is diagnosed by an elevated sweat chloride test (TOC)?
cystic fibrosis
what is the most common cause of death in a patient with cystic fibrosis?
pulmonary infection (terminal CHRONIC resp failure)
CXR findings of “eggshell calcification of hilar lymph nodes” is suggestive of what disease?
silicosis
CXR findings of hyperinflation and flat diaphragms is suggestive of what disease?
long-standing chronic disease
which class of medications is contraindicated in pts using cocaine?
pure beta blockers (PROPRANOLOL)- can cause paradoxical hypertension (reverse effect causing more vasoconstriction and less blood flow to tissues)
first immunoglobulin to respond during acute exposure? immunoglobulin that responds during 2nd exposure?
first- IgM
2nd- IgG
(mom is faster than grandma)
what immunoglobulin responds during an allergic response or parasitic infection?
IgE
where is IgA antibody found?
colostrums and GI secretions
what is used to treat magnesium sulfate toxicity?
10% calcium gluconate
positive ANCA (antineutrophil cytoplasmic antibodies) are indicative of what disease
ulcerative colitis
positive ASCA (anti-saccharomyces cerevisiae antibodies) are indicative of what disease?
crohn’s disease
puncture wound with sxs suggestive of acute osteomyelitis is most likely infected with what bug?
pseudomonas
early and late XR findings of acute osteomyelitis
early- soft tissue swelling and PERIOSTEAL reaction
late- lucent areas of cortical destruction
mucosal bleeding (gingival bleeding) is seen in what heme disease?
von willebrand
migraines activate what nerve to cause pain sensation?
trigeminal
pt with metabolic acidosis due to methanol ingestion is treated with what?
ethanol
what are mild late decelerations on fetal non-stress test mostly likely due to?
uteroplacental insufficiency
variable decelerations on fetal non-stress test are most likely due to?
cord compression
early decelerations on fetal non-stress test are most likely due to?
head compression of fetus
deep late decelerations PLUS absent beat to beat variability on fetal non-stress test is most likely due to?
fetal hypoxia
which patient population is at highest risk to develop erythrasma?
people living in tropical climates
what is erythrasma?
superficial skin infection that causes brown scaly skin patches
sign for blue discoloration around umbilicus?
cullen’s sign hemorrhagic pancreatitis)
sign for green/brown discoloration of bilateral flanks ?
turner’s sign (acute pancreatitis)
what drug type is nedocromil and what can it help treat?
mast cell stabilizer (inhibits mast cell degranulation and can treat allergic rhinitis)
what are three lab findings typical for chronic renal failure pt?
hypocalcemia, metabolic acidosis and hyperkalemia
why are patients with chronic renal failure often anemic?
bc of low erythropoietin (broken kidneys cant make this anymore)
what are exudative pleural effusions due to?
increased production of fluid due to INFLAMMATION or MALIGNANT processes
what are transudative pleural effusions from?
increased hydrostatic or decreased oncotic pressures across normal capillaries
what is mittelschmerz
one-sided lower abdominal pain associated with OVULATION (occurs midway through cycle)
pain can alternate side to side
what is the organism for rocky mountain spotted fever?
rickettsia
what is the test to confirm diagnosis of rocky mountain spotted fever?
direct immunofluorescent assay (confirms antibodies to ricksettia)
what is test is used to detect antibodies to EBV?
heterophile agglutination
what does a prominent A wave of jugular venous pulsation represent?
atrial contraction against a closed tricuspid valve
how do you treat acute renal failure due to rhabdomyolysis/crush injury?
IV fluids and forced alkaline diuresis (IV sodium bicarb)
what is the common murmur associated with marfans syndrome
aortic regurgitation (connective tissue disorder or dilated aortic root) -diastolic murmur heard on right intercostal
which pneumonia vaccine do kids get at 2, 4, 6, and 12-18 months?
PREVNAR (13)
what is the indication for pediatric pt to receive the 23 valent pneumo vaccine?
children 24-59 mo at high risk for invasive pneumo disease
treatment for polycythemia vera
phlebotomy
after starting synthroid, when do you recheck TSH level?
3-4 weeks
what lab test is best to determine immunity to Hep B?
Anti-HBs
circulating antibody that develops to surface antigen in response to past Hep B infection or Hep B immunization
what does a positive HBsAg mean?
shows an acute Hep B infection and NOT immunity
persistent ST elevation in corresponding leads of old MI (usually anterior) is diagnosis for what?
ventricular aneurysm
percussion, tactile fremitus, and lung sounds for lobar pneumonia
dullness to percussion
increased tactile fremitus
late inspiratory crackles
mastitis is most commonly caused by what bacteria?
staph aureus
what is the main difference between brown recluse and black widow spider bites?
back widow bites typically produce systemic sxs (bradycardia, htn, tachyarrhythmias, fever)
optimal INR for pt with mechanical mitral valve prosthesis or aortic mechanical valve?
MV- 2.5 to 3.5
AV- 2.0 to 3.0
leading cause of injury-related deaths in children between 1-15
motor vechicle injuries
a positive osmotic fragility test is seen in what disease?
hereditary spherocytosis
perfusion of the coronary arteries primarily occurs during what phase of heart activity?
diastole
what are three symptoms of a patient with interstitial lung disease?
progressive dyspnea on exertion, late inspiratory crackles, cough with minimal sputum production
four meds that are used for prophylaxis of traveler’s diarrhea
FQ: norfloxacin, ciprofloxacin, ofloxacin
bactrim
which two tests are specific tests for the diagnosis of syphilis?
FTA-ABS and MTA-TP
what is the initial study for a patient with amaurosis fugax?
carotid ultrasound
which trimester does maternal BP drop the lowest?
second
after insertion of a pacemaker, what is a common physical exam finding?
migratory ecchymosis: swollen, non tender arm with bluish discoloration along upper arm and forearm
what test do you do to confirm vitilago?
skin biopsy
pulmonary capillary wedge pressure indirectly measures what heart chamber pressure?
left atrial filling pressure
what disease can be caused by prescribing excessive doses of synthroid?
osteoporosis (increased bone turnover due to increased basal metabolic rate)
most effective tx for onychomycosis
terbinafine
which lifestyle recommendation most benefits a heart failure pt’s quality of life?
regular exercise program
which leukemia is auer rods present in?
AML
extracorporeal shock wave lithotripsy is indicated in patients with kidney stones larger than what size?
> 6 mm
which electrolyte should be most closely monitored when a pt is on loop diuretics?
potassium
what type of blood products do you have to give after 10 units of transfused packed RBCs?
fresh frozen plasma for clotting products
formications are associated with what two conditions?
delirium tremens from alcohol withdrawal and cocaine addiction
first line treatment for acute demyelinating polyneuropathy variant of guillain-barre syndrome?
IV immunoglobulin
most common PE finding for intestinal obstruction?
distention
which hormone inhibits GH secretion from pituitary?
somatostatin
first line medication for ankylosing spondylitis?
NSAIDS (indomethacin)
which bacteria causes diarrhea post ingestion of food contamination of dairy products, mayo, meats, eggs, salads?
S aureus
which medication class should be started to prevent progression of diabetic retinopathy?
ACEI
*concern with microalbuminemia/proteinuria = improve glomerular hemodynamics by decreasing glomerular pressure
which antiarrhythmic drug can be associated with hyper- or hypothyroidism following long-term use?
amiodarone: structurally related to thyroxine and contains iodine
what treatment should be initiated for insect in auditory canal with poorly visualized TM
Two percent lidocaine solution will paralyze the insect and provide topical anesthesia for suction or forceps
removal
which skin condition is characterized by epidermal hyperplasia and an increase in the epidermal turnover?
psoriasis: leads to classic scale pattern
what lung disease: diminished breath sounds over the right lower lobe with decreased tactile fremitus
and dullness to percussion
pleural effusion
pneumonia has increased tactile fremitus
what is ecthyma?
Ecthyma is a skin infection characterized by crusted sores beneath which ulcers form. It is a deep form of impetigo
what three medications are most useful in maintaining remission in a patient with ulcerative colitis?
Sulfasalazine, olsalazine, and mesalamine
treatment for child bitten by a black widow spider?
hospital admission for symptomatic care
What is the most accurate way to determine the exact degree of spinal curvature in a child with scoliosis?
the cobb angle
when would you use nebulized epi over oral dexamethasone in the treatment of croup?
Nebulized racemic epinephrine is only indicated in the treatment of croup in cases of moderate to severe
rest stridor, respiratory distress, or hypoxia
describe what drusen bodies look like and what disease they are from
Drusen are tiny to small yellowish round spots with hard or soft edges that are often seen in age-related
macular degeneration
Which class of diuretics is considered the treatment of choice as first-line therapy in a failing kidney due to its improved sodium clearance in pts with heart failure?
Loop diuretics remain active in severe renal insufficiency and are the most effective type of diuretics used in the management of heart failure symptoms. These agents have a rapid onset and result in natriuresis due to their activity in the ascending limb in the Loop of Henle.
two most common treatments for neuroleptic malignant syndrome
dantrolene (Dantrium) and bromocriptine (Parlodel)
Which finding on CXR would most likely be seen in a patient with hypersensitivity
pneumonitis?
diffuse nodular densities
What is the recommendation for primary prevention of stroke in a patient under sixty years of age with atrial
fibrillation?
no therapy
what side of the penis does epispadias occur on?
THE DORSAL side (top of penis)
hypospadias is the ventral side (bottom of penis)
what is the next medication to add to asthma therapy after PRN albuterol?
ICS
after that is the long acting bronchodilator
difference between schizophrenia and schizophreniform disorder
Schizophrenia is greater than six months duration.
Schizophreniform disorder is characterized by the same features except the total duration of the illness is at least one month and less than six months
A patient with adrenal insufficiency is taking hydrocortisone 25 mg daily. What should the patient do with the hydrocortisone dose when they develop a minor illness such as a cold?
To better mimic the normal physiologic response the baseline dose should be doubled for the duration of the illness. Doses should be increased 5-10 fold with major events such as surgery
Common symptoms of fatigable weakness, ptosis, diplopia, and proximal muscle
weakness are found in what disease?
myasthenia gravis
two ABX used for treatment of bacterial conjunctivitis in contact lens wearers
Topical aminoglycoside or fluoroquinolones are indicated in contact lens wearers to cover Pseudomonas infection
What laboratory test must be monitored frequently in patients who are taking clozapine (Clozaril)?
white blood count: Leukopenia, granulocytopenia, and agranulocytosis occur in approximately 1% of patients on this medication
what is IgA nephropathy due to?
IgA nephropathy presents after an upper respiratory illness with deposition of IgA within the mesangium of the glomerulus
what is considered a risk factor for retinopathy of prematurity?
low birth weight
what medication inhibits prostaglandin synthesis in a patient with rheumatoid arthritis
aspirin
Which disease state results from hypersecretion of growth hormone in a 27 year-old patient?
acromegaly
what three medications can be used to tx absence seizures?
Ethosuximide, valproic acid, and clonazepam
what is a tzanck smear used for?
herpes simplex
next step in treatment for patient with allergic rhinitis who is not responsive to allergy avoidance or medical therapy of antihistamines and nasal steroids
immunotherapy
What laboratory test should be followed routinely every six to twelve months in patients taking lithium?
TSH
Which of the following conditions is most closely associated with an increased intensity of the P2 heart sound?
ASD
what test should be done to evaluate the urinary system in a pt with blood at the urethral
meatus and suspected of having a pelvic fracture?
urethrogram is the only procedure that should be done to evaluate this type of injury as urethral integrity may have been compromised secondary to the pelvic fracture
which medication should be used for a hypertension control in a pt with pheochromocytoma?
Phenoxybenzamine is an alpha-blocker
A 21 year-old male with a diagnosis of type 1 von Willebrand disease undergoes dental extraction of his wisdom teeth. The patient comes to the clinic with continued oozing of the dental sockets despite packing. Treatment should begin with which of the following?
DDVAP = causes the release of vWF and factor VIII from storage sites significantly which is needed to complete
hemostasis
(vWF used in patients with type 2 or 3)
what is treatment of choice for posterior nose bleed?
posterior nasal packing
which med class is contraindicated in pts with CAD to treat migraines?
triptans
what is the cause of syncope brought on by change in positions?
atrial myxomas
which heme disease is caused by a disorder in the red blood cell membrane
cell membrane defect of spherocytosis leads to hemolysis due to trapping of the cells by the spleen
Patients who undergo percutaneous angioplasty or who have coronary artery revascularization often are treated with glycoprotein IIb/IIIa inhibitors. What is the major side effect associated with these agents?
bleeding
medication to treat PCP in HIV + pts?
bactrim (also used for prophylactic PCP when CD4 is less than 200)
what elevated lab value is associated with sarcoidosis?
ACE
imaging findings that suggest mesothelioma?
pleural thickening and plaque formation (doesn’t involve parenchyma)
pleural effusion
medication type that should not be given in pts with hyperparathyroidism?
thiazides (increase serum calcium)
