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COMLEX Level 2CE > QG SB1 (F) > Flashcards

QG SB1 (F) Flashcards

W1 QG blocks (1,2,4,6) Deck is full

1
Q

What type of hypersensitivity rxn is contact dermatitis?

A

Type 4

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2
Q

How does klienfelters present (s/s + labs)?

A
  • lack of 2* sex characteristics
  • bilat gynecomastia
  • small, firm testes
  • nL smell
  • labs: T = low. FSH = incr. LH = incr.
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3
Q

Lab values in Kallman’s?

A

T = low. FSH = low. LH = low.

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4
Q

Klienfelters karyotype

A

XXY

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5
Q

What distinguishing feature of kallman’s synd can skip generations due to incomplete penetrance?

A

anosmia

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6
Q

What causes cysticercosis?

A

T. soleum (pork ingestion)

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7
Q

Neurocysticercosis presentation?

A
  • siezures (MC)
  • HA
  • AMS
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8
Q

Tx HSV esophagitis vs CMV esophagitis

A

HSV (shallow ulcers) = acyclovir

CMV (deep ulcers) = gancyclovir (longer name txs bigger ulcers)

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9
Q

Which has a more favorable side effect profile ketoconazole or fluconazole?

A

fluconazole

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10
Q

Which can be applied topically ketoconazole or fluconazole?

A

ketoconazole

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11
Q

Cause of pseudotumor cerebri in young pts

A

tetracyclines
OCPs
obesity

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12
Q

What meds will cause rash in pt w/ h/o recent mono infection?

A

penicillins (esp. amoxicillin and ampicillin)

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13
Q

E+ R+ breast cancer tx=?

A

tamoxifen (SERM -E breast, +E uterus)

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14
Q

Her2/nue+ breast cancer tx=?

A

traztuzimab

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15
Q

What do you never to tx PEA?

A

cardiovert

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16
Q

Homocysteine & MMA levels in vitB12 vs folate deficiencies?

A

Homocysteine MMA
vitb12 : incr incr 9 so b12=both.
folate : incr nL

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17
Q

Presentation of Carcinoid

A 
BFDR
   Bronchospasm (wheezing)
   Flushing
   Diarrhea
   Right heart valve lesions

**NO s/s until liver mets

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18
Q

How does niacin (vitB3) deficiency present?

A

pellagra = 4Ds

Dermatitis, Diarrhea, Dementia, Death

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19
Q

HCV tx = ?

A 
1st = prevent further damage!! (No EtOH, HAV and HBV vaccinations)
2nd = Tx HCV = sofosbuvir-velpatasvir
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20
Q

Colonoscopy findings c diff vs laxative abuse?

A

c diff –Bx–> pseudomemranous colitis (red, thick fragile walls)
laxative abuse –Bx–> melanosis coli (dk brown wall w/ pale lymph patches)

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21
Q

What liver condition do you tx w/ prednisolone?

A

severe alcoholic hepatitis

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22
Q

What is lamivudine?

A

RT inhib used for HIV + HBV co-infec

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23
Q

MALT lymphoma MC pathogenesis

A

H. pylori infec

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24
Q

RF gastric adenocarcinoma

A
  • tobacco use
  • incr Na diet
  • N-nitrosamine compounds (smoked meats, aged cheeses)
  • pernicious anemia
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25
Q

Pernicious anemia associations

A

gastric adenocarcinoma

gastric carcinoid tumors

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26
Q

Best test dx acute HBV infec?

A

HBsAg + IgM anti-HBc

^infected ^earliest antibody formed

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27
Q

What two scenarios incr alk phos?

A
  1. biliary tree obstruction

2. condition w/ incr bone turn (eg paget’s dz)

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28
Q

Features of colon polyps w/ incr. malig potential?

A

HIGH potential - large, high dysplasia, villous, sessile

LOW potential - small, low dysplasia, tubular, pedunculated

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29
Q

Who gets lung cancer screening (LDCT)?

A

age 55-80
30+ pack year smoker
current smoker or quit within last 15 yr

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30
Q

What meds cause pill induced esophagitis?

A

NSAIDS BATH +KCl

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31
Q

Celiac pts w/ what comorbid condtion will test neg for anti-TTG?

A

IgA deficiency

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32
Q

When to suspect SBP?

A

cirrhosis + ascites

Low fever, abdominal discomfort, or AMS

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33
Q

SBO presents w/

A

diffuse abd pain
n/v
incr bowel sounds
dialated loops sm bowel & nL lg bowel

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34
Q

D xylose test result interpretation

A 
positive = D xylose excreted in u. = pancreatic enzyme issue (you can absorb, so brush border is intact)
negative = not excreted = celiac's dz (damaged brush border fails to absorb)
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35
Q

Burning pain = ____ pain

A

nerve

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36
Q

Gamma-glutamyltransferase (GGT) = ____ marker

A

liver damage

37
Q

What is the purpose of ferratin?

A

Fe storage

38
Q

What is ferratin?

A

an acute phase reactant that is incr w/ liver damage

39
Q

Unilat pleural effusion = ____ until proven otherwise

A

CANCER

40
Q

What benign liver mass presents as young F on prolonged OCP?

A

hepatic adenoma

41
Q

How does the MC benign liver mass, _____, present?

A

hepatic hemangioma
nL = asymp
Lg mass = RUQ pain
**Rupture is rare, so not likely to see solid mass surrounded by free fluid.

42
Q

Acalculous cholecystitis is associated w/ what conditions?

A 
Trauma
Surgery
Burns
Sepsis
Prolonged parenteral nutrition
43
Q

SIBO presentation

A

Bloating, flatulence, watery diarrhea

+/- malabsorption s/s

44
Q

What conditions predispose to SIBO?

A

Conditions that alter gut motility, anatomy or GI sectretions

45
Q

How does dumping synd. present?

A

Incr s/s after high carb meals

Flushing, tachy, n/v/d, low BG

46
Q

What other than AI and infec causes massive LFT spikes?

A

liver damage 2/2 ischemic compromise

47
Q

Why does TPN incr risk of gallstones?

A

causes gall bladder stasis

48
Q

Which is more likely to lead to toxic megacolon obstructive colon ca or IBD?

A

IBD

49
Q

Tx toxic megacolon

A

IV steroids
NG decompression
ABX
IVF

50
Q

SAAG > 1.1 g/dL indicates what?

A

portal HTN etiology of ascites (cardiac, cirrhosis)

51
Q

SAAG < 1.1 g/dL indicates what?

A

non-portal HTN etiology of ascites (malignancy, TB, pancreatitis, nephrotic synd)

52
Q

What is the timeline for breast milk vs breast feeding jaundice?

A

Breast milk = starts day 3-5 and peaks @ 2 wks old

Breast feeding = starts 1st week of life

53
Q

What are the causes of breast milk vs breastfeeding jaundice?

A

Breast milk = enzymatic problem with breast milk

Breastfeeding = baby not getting enough milk

54
Q

3 causes of bright red blood per rectum and how much blood should you expect to see?

A
  1. hemorrhoids (streaks on TP)
  2. AVM (sm vol frank blood)
  3. diverticulosis (Lg vol frank blood)
55
Q

Drugs that induce hepatitis?

A

TB drugs (Rifampin, Isoniazid, Pyrazynamide)
Tetracyclines
Acetaminophen OD

56
Q

OCP affects on liver

A
  1. incr LFTs w/o necrosis

2. hepatic adenoma

57
Q

AFP is incr in what two cancer types?

A
  1. Liver

2. Yolk Sac

58
Q

How does multiple myeloma present on xray?

A

Bone LYTIC lesions. NO BLASTIC LESIONS.

59
Q

Cholangiocarcinoma tumor markers and labs?

A

CEA = incr
Ca19-9 = incr
alk phos = incr
AFP = nL

60
Q

What is P/E sign for temporal wasting suspicious for?

A

Immunosupression
AIDS
Cancer
Elderly

61
Q

Foreign people, immigrants, and pts w/ h/o recent travel abroad are suspicious for ___

A

Infectious process

62
Q

Which arthritis causes anemia of chronic dz?

A

RA

63
Q

Can an intubated pt receive an EGD?

A

yes (you dummy!)

64
Q

NS in management in pt w/ acute liver failure 2/2 drug OD?

A

liver transplant (esp if LFTs trending up)

65
Q

How does gastric outlet syndrome present?

A
  • early satiety
  • nasuea
  • nonbillous vomiting
  • weightloss
66
Q

What are the s/s vit A def?

A 
Eyes:
  -decr adaptation to darkness
  -photophobia
  -xerosis conjunctiva
  -xerosis cornea
Skin:
  -keratomalacia
  -folicular hyperkeratosis and bitot spots (shoulders, butt, extensor surfaces)
  -dry scaley skin
67
Q

what causes biliary colic?

A

intermittent incr pressure when gallstone obstructs cystic duct –> colicky pain

68
Q

How does stress fracture of the foot present?

A

+ point tendernesss
+/- edema
- redness/bruising
**HAIRLINE fracture on xray

69
Q

when does the w/u of an ankle injury include xray?

A
  • pt unable to weightbear

- tenderness over boney landmarks

70
Q

what types of pts present w/ stress fractures?

A
  • sudden incr in exercise
  • long distance runners
  • low BMI
  • *look out for F w/ the athlete’s traid (oligomeorrhea, osteoporosis, decr caloric intake)
71
Q

what is podagra?

A

gout of the big toe. often begins at night

72
Q

How to tx stress fracture?

A
  • REST and NSAIDs

- Sx if s/s not resolving

73
Q

What are the osteoporosis screening guidelines?

A

1x DEXA scan F age>=65

DEXA scan F age<65 if high risk

74
Q

why might celiac pts fracture easily?

A

celiacs = malabsorptive dz. malabsorption –>vit ADEK def. vit D def –> osteoporosis –> fragility fractures

75
Q

What are the 5 causes of high output heart failure? (Bonus: why?)

A
  1. severe anemia (low O2 carrying capacity –> heart pumps faster to deliver O2)
  2. hyperthyroidism (incr metabolism –> incr O2 demand –> heart works harder)
  3. AV fistula (diverted blood –> heart works harder to feed body)
  4. Beriberi (incr metabolism –> incr O2 demand –> heart works harder)
  5. Paget’s disease (abn bone –> abn vasc grows –> heart works harder to compensate)
76
Q

How does paget’s dz of the bone present?

A
  • skeletal deformities (thick skull, bowed legs)
  • bone pain
  • fractures (make lots of poor quality bone)
77
Q

what does pt feel w/ meniscal tear?

A

popping sensation

78
Q

what does dr feel on P/E of pt w/ meniscal tear?

A

locking sensation w/ IR

79
Q

MC mechanism of injury meniscal tear = ?

A

sudden twisting on a planted foot

80
Q

What conditions are associated w/ gout?

A
  • idiopathic gout
  • tumor lysis syndrome
  • lesch-nyhan (hypoxanthine oxidase def)
  • myeloproliferative
81
Q

How does polycythemia vera present?

A
  • headache (high blood viscosity)
  • itchy after hot bath
  • hepatosplenomegaly
82
Q

If gout presents w/ self-mutilation, what is the dz?

A

Lesch-nyhan

83
Q

What causes gout in Lesch-nyhan?

A

hypoxanthine-guanine phosphoribosyl transferase def

84
Q

How does AVN present on xray?

A 
Early = no changes
Late = boney remodeling
85
Q

Anti-U1 RNA (ribonucleoprotein) is associated w/ what condition?

A

MCTD

86
Q

MCTD includes features of what 3 conditions?

A
  1. SLE
  2. Systemic sclerosis
  3. Polymyositis
87
Q

What should you have decr index of suspicion for in dermatomyositis pts?

A

malignancy

88
Q

What are the s/s of hypercalcemia?

A 
BONES (bone pain)
STONES (kidney stones)
GROANS (fatigue)
MOANS (constip)
PSYCH OVERTONES
89
Q

What is the typical presentation of polymyalgia rheumatica?

A
  • F age>50
  • > =1 mos STIFF/painful neck, shoulders, pelvic girdle
  • ESR > 40

COMLEX Level 2CE (23 decks)

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