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Boards First Aid and Kaplan > Practice Test 5 > Flashcards

Practice Test 5 Flashcards

1
Q

Molluscum contagiosum

A
  • Virus in the Poxvirus family
  • Self-limited epidermal infection
  • Characterized by flesh colored papules/vesicles that may be umbilicated
  • Common in children and sexually active adults (NOT an STI tho), kids in daycare or adolescents in team sports
  • Simply transmitted by body-to-body contact
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2
Q

Haemophilus ducreyi

A
  • Gram negative coccobacillus
  • Causes the STD called chancroid-painful sores on the genitalia and suppurative regional LAD
  • Increased risk of HIV transmission (test for HIV coinfx)
  • Grows on chocolate but not blood agar b/c it requires factor X (heme) to grow
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3
Q

Herpes simplex 2

A
  • dsDNA virus of the herpesviridae family
  • Causes genital herpes
  • Lesions appear as a cluster of vesicles/ulcerations with significant pain and regional LAD
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4
Q

What is the protocol for HIV testing?

A
  • Screen for HIV/AIDS with a highly sensitive test (ELISA)

- Confirm with a highly specific test (western blot)

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5
Q

Compare the V/Q ratios of the different parts of the lungs

A
  • Apex of the lung has a higher V/Q ratio, base of the lung has a lower V/Q ratio
  • Apex has both lower ventilation and perfusion
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6
Q

A pulmonary embolism would result in what V/Q ratio?

A

A pulmonary embolism would result in a high V/Q ratio (embolism blocks perfusion (flow) but not ventilation

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7
Q

Asthma would result in what V/Q ratio?

A

Asthma would cause a lower V/Q ratio because it only lowers ventilation

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8
Q

What is autonomy?

A
  • Respect for persons

- Respecting the informed decision-making of capacitated individuals

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9
Q

What is beneficence?

A

Acting to promote a patient’s interests or preferences

-Example-Doctor helping to facilitate consultation with another doctor

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10
Q

What is justice?

A

The fair treatment and distribution of medical goods and services

  • Patients with the same conditions should be treated equally
  • Example-providing appropriate medical care (such as a C-section) even if a patient does not have insurance
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11
Q

What is non-maleficence?

A

Avoidance of patient harm and/or what would be against a patient’s wishes

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12
Q

What is confounding bias?

A

Occurs when an unaccounted-for variable affects the dependent or independent variable

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13
Q

What is late-look bias?

A

Occurs when study design error causes info to be gathered at a time that skews results

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14
Q

What is lead-time bias?

A

Occurs when a test identifies a disease in an early stage and artificially predicts a longer survival period

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15
Q

What is recall bias?

A

When a study participant’s previous knowledge or opinion affects the result of the study

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16
Q

What is sampling bias?

A

Occurs when the group being studied does not represent the group about which the conclusions of the study are being made

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17
Q

What are characteristics of sarcoidosis?

A
  • Restrictive lung disease with bilateral hilar LAD seen on chest xray
  • Non-caseating granulomas
  • Commonly associated with Bell’s palsy, erythema nodosum, and Lofgren syndrome
  • Common for patients to have elevated ACE levels and hyperCa
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18
Q

What is Bell’s palsy?

A
  • Peripheral 7th nerve palsy
  • Presents with unilateral drooping of the eyelid and mouth
  • MC cranial nerve lesion assoc w/ sarcoidosis
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19
Q

What is the treatment for sarcoidosis?

A

Most patients do not require tx-spontaneous remission

-Severe disease-tx with glucocorticoids and other immunosuppressants

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20
Q

What is the triad for lofgren syndrome?

A
  • Bilateral hilar LAD
  • Erythema nodosum
  • Arthritis
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21
Q

What is myasthenia gravis?

A

Autoimmune dz

  • Abs against the nAchRs/NMJ on skeletal muscle tissue
  • Present with motor muscle weakness, severe dz can involve the diaphragm -> acute resp failure
  • Diagnosed with tensilon test (administer edrophonium, which will inhibit AchE inhibitor, and improve motor neuron strength)
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22
Q

If the tensilon test is negative and motor strength does not improve?

A

Lambert-Eaton myasthenic syndrome

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23
Q

What is the mnemonic to remember the signs/sx of sarcoidosis?

A

ABCDE

  • -A*CE (elevated)
  • -B*ilateral hilar LAD
  • -C*a (hyperCa)
  • -D*(elevated vitamin D)
  • -E*rythema nodosum
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24
Q

What is granulomatosis with polyangitis?

A

Small vessel vasculitis

  • Presents with fever, malaise, weight loss
  • Affects the lungs and kidneys too
  • C-ANCA (PR3) Abs
  • Tissue biopsy has necrotizing granulomatous vasculitis
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25
Q

Explain the pupillary light reflex

A

Tests both CN 2 and CN 3

  • When light enters the eye, the optic nerve sends that information to the brain (afferent pathway)
  • The signal to constrict the pupils travels from the cortex on the oculomotor nerve bilaterally so that the light entering one eye will cause pupil constriction in both eyes
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26
Q

What would the results of the pupillary light reflex be in a patient with a lesion of the right optic nerve?

A
  • When you shine the light in the left eye, both pupils constrict
  • When you shine the light in the right eye, both pupils dilate (right optic nerve is not transmitting the light to the brain, afferent pathway, afferent pupillary defect (APD))
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27
Q

What would the results of the pupillary light reflex be in a patient with a lesion of the left oculomotor nerve?

A

No pupil constriction in the left eye regardless of which eye the light is entering (efferent pathway is broken, pupil constriction signal is not being transmitted from the brain)

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28
Q

What are the most common causes of a lesion of the optic chiasm and what does it cause?

A

Lesion of the optic chiasm is typically from a pituitary tumor and causes a bilateral hemianopsia

29
Q

What does optic tract damage cause?

A

Homonymous hemianopsia
-May produce a relative afferent pupillary defect in the eye contralateral to the side of the lesion (defect of the right optic tract may cause left APD)

30
Q

For observational studies, if groups are organized by DISEASE STATUS, it is what type of study?

A

Case control (a retrospective study)

31
Q

What is the main problem in case control studies?

A

Recall bias

32
Q

For observational studies, if groups are organized by EXPOSURE STATUS, it is what type of study?

A

Cohort (a prospective study)

33
Q

What is the main problem in cohort studies?

A

Loss to follow-ups

34
Q

What is a cross sectional study?

A
  • A study that collects data from a group of people in order to assess the prevalence of disease and related risk factors as a particular point in time
  • No loss to follow-up (b/c no follow-up needed)
  • Associations to risk factors can be studied
  • Causality of the risk factors cannot be determined with this study type, only their prevalence with the dz
35
Q

What is the inheritance pattern of factor 7 deficiency?

A

Autosomal recessive

36
Q

Factor 13 deficiency

A
  • Autosomal dominant
  • AKA fibrin stabilizing factor-acts to cross-link fibrin to form an insoluble clot
  • Normal PT and PTT (factor 13 not technically in the clotting cascade)
  • Will cause abnormal clot formation though
37
Q

Von Willebrand disease

A
  • Autosomal dominant
  • Results in the characteristic platelet dysfx manifestations of mucocutaneous bleeding into the oral cavity, nasal cavity, and GI tract
  • Excessive bleeding after minor cuts and petechiae are common
  • Platelet count is normal
  • vWF plays an important role in primary hemostasis -> binds to the endothelium and causing plt activation
  • vWF is also a carrier protein for factor 8
  • Will have prolonged bleeding time and PTT
  • Patients should avoid aspirin
38
Q

What is the most sensitive test for vWF disease?

A

Ristocetin cofactor assay

39
Q

What is the treatment for vWF disease?

A

Desmopressin -> blood vessels release more vWF

40
Q

What is Berger’s disease?

A

AKA IgA nephropathy

  • Type 3 hypersensitivity AI disorder characterized by IgA deposits in the mesangium of kidney tissue, can progress to ESRD
  • Patients present with hematuria following a recent URI (synpharyngitic hematuria)
41
Q

What other diseases can Berger disease be associated with?

A
  • Celiac dz
  • Dermatitis herpetaformis
  • Akylosing spondylitis
  • T cell lymphomas/mycosis fungoides
42
Q

What is the tx for Berger disease?

A
  • Control risk factors such as HTN and proteinuria

- Glucocorticoids and immunosuppressants

43
Q

What is Graves’ disease?

A
  • Type 2 hypersensitivity AI disorder that involves IgG Abs against TSH receptors
  • MCC of hyperthyroidism
  • Patients present with sx related to increased metabolic rate such as anxiety, weakness, palpitations, unintentional weight loss, sweating, diarrhea, and amenorrhea
  • Hyperreflexia and goiter may also present
44
Q

What is the best initial laboratory test when you suspect Graves’ disease?

A

TSH level-will be LOW because the Abs are binding to the receptor instead of regular TSH

45
Q

What is the treatment for Graves’ disease?

A

Sx control
-Anti-thyroid medications-PTU and methimazole
-Beta blockers-propanolol and atenolol
Definitive tx
-Eliminate thyroid tissue via either radioactive iodine ablation or surgical removal

46
Q

What is courvoisier’s sign?

A

Enlarged non-tender gallbladder secondary to pancreatic disease or cancer
-Jaundice and palpable painless mass in the RUQ

47
Q

Definitive diagnosis of pancreatic cancer requires what test?

A

Abdominal CT

49
Q

What are the symptoms of primary biliary cirrhosis?

A
  • More common in women
  • Unexplained itching, fatigue, jaundice, unexplained weight loss, RUQ discomfort
  • Hyperpigmentation of skin (due to melanin deposition)
  • Extremely elevated ALP
  • Xanthomas-yellow lipid filled nodules in the skin, common near the eyelids (xanthelasma)
50
Q

What are the 4 antihypertensive agents that are safe during pregnancy?

A
  • Labetalol
  • Hydralazine
  • Nifedipine
  • Methyldopa
51
Q

Why are ACE inhibitors contraindicated in pregnancy?

A

Result in uterine ischemia and interfere with fetal kidney development

52
Q

Why are diuretics avoided in pregnancy?

A

Can aggravate low plasma volume to the point of uterine ischemia

53
Q

What is magnesium sulfate used for?

A

Seizure prophylaxis in patients with preeclampsia-trying to prevent progression to eclampsia

54
Q

Why is nitroprusside contraindicated in pregnancy?

A

Fetal cyanide poisoning

55
Q

Women with preeclampsia are at increased risk for life-threatening events such as?

A
  • Placental abruption
  • Acute renal failure
  • Cerebral hemorrhage
  • Liver failure
  • Pulmonary edema
  • DIC
  • Progression to eclampsia
56
Q

Diagnosis of DIC is based on what lab values?

A
  • Reduced levels of fibrinogen and plts

- Prolongation of thrombin, PT, and PTT

57
Q

What is hyperemesis gravidarum?

A
  • Severe form of morning sickness
  • Characterized by excessive pregnancy-related nausea and/or vomiting that prevents adequate intake of food and fluids
  • Associated with elevated beta-hCG
58
Q

What are the characteristics of HELLP syndrome?

A

Severe variant of preeclampsia (poor prognosis)

  • Hemolytic anemia
  • Elevated liver enzymes
  • Low plts
59
Q

What is the only cure for preeclampsia/eclampsia?

A

Delivery of the fetus

60
Q

What are the signs of Mg toxicity?

A
  • Loss of DTRs (hyporeflexia)-always appears first, continually test DTRs
  • Respiratory paralysis
  • Coma
61
Q

What is Ca gluconate used for?

A

Mineral supplement that can be used to reverse Mg poisoning

62
Q

What is polycystic ovarian syndrome?

A
  • Caused by abnormal function of the hypothalamus-pituitary-ovarian (HPO) axis -> deranged steroid synthesis by theca cells
  • Leads to inc LH, dec FSH, inc testosterone, inc, androgens, and inc estrogens
  • Manifests clinically as amenorrhea, infertility, obesity, and hirsutism
  • Also commonly assoc with T2DM/metabolic syndrome
63
Q

What is the treatment for PCOS?

A

Ovulatory stimulation with clomiphene +/- metformin

64
Q

What are the important hormone levels in Turner syndrome?

A
  • Dec estrogen

- Inc LH and FSH

65
Q

What are the signs and sx of Turner syndrome?

A
  • Ovarian dysgenesis-failure of gonad development
  • Primary amenorrhea (MCC), streak ovaries
  • Short stature, shield chest, bicuspid aortic valve, webbing of the neck (d/t cystic hygromas), and preductal coarctation of the aorta
66
Q

What are the characteristics of diffuse large B cell lymphoma (DLBCL)?

A
  • MC histologic subtype of non-Hodgkin lymphoma
  • Pts present with enlarging symptomatic mass (neck or abdomen) and systemic ‘B’ symptoms
  • Tumor cells ecpress B cell Ags-CD19, CD20, CD22, and CD79a
  • BCL-2 and BCL-6 protein expressions are common
  • Most follicular lymphomas have the 14;18 translocation -> BCL-2
67
Q

What are the systemic ‘B’ symptoms?

A
  • Fever
  • Weight loss
  • Drenching night sweats
68
Q

What is the equation for Fick’s principle?

A

CO = O2 consumption/(arterial O2 content-venous O2 content)

69
Q

Don’t understand #26

A

…

70
Q

What are the symptoms of acute cholecystitis?

A
  • RUQ pain (no palpable mass)
  • Positive murphy’s sign-inspiratory arrest during deep palpation of the RUQ
  • No jaundice-since the blockage occurs at the cystic duct (not common bile duct)

Boards First Aid and Kaplan (19 decks)

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