Questions Misc Flashcards

1
Q

MCC mitral stenosis

A

rheumatic fever

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2
Q

mitral stenosis EKG

A

Afib

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3
Q

placental abruption RF

A

smoking
HTN

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4
Q

Cardiovascular d/o associated w/ argyll Robertson pupil

A

thoracic aortic aneurism

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5
Q

MCC mitral regurgitation

A

MVP

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6
Q

mitral regurgitation murmur

A

holosystolic
apex
radiates to axilla

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7
Q

MVP murmur

A

mid systolic click
rad to axilla

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8
Q

placental abruption lab

A

fibrinogen < 200

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9
Q

toxic megacolon TOC

A

abd xray: colon air and dilation > 6cm

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10
Q

GBS sx

A

URI/GI infx a few weeks ago
rapid symmetric ascending weakness of distal lower extremities
decreased or absent DTR

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11
Q

GBS dx

A

CSF: inc protein (albuminocytologic dissociation) normal WBC
EMG or nerve conduction study

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12
Q

Legionella pneumophilia hallmarks

A

diarrhea
hyponatremia, increased LFT
patchy unilobular infiltrate

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13
Q

Maisonneuve fracture

A

spiral fx proximal 1/3 of fibula
distal medial malleolar fx or deltoid ligament rupture

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14
Q

beefy red plaques

A

candidal diaper dermatitis
spares inguinal folds
nystatin ointment

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15
Q

Reynolds pentad

A

fever
jaundice
RUQ pain
AMS
hypotension

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16
Q

COPD EKG

A

MAT

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17
Q

cardinal manifestations of Parkinson’s dz

A

resting tremor
bradykinesia
cogwheel rigidity
postural instability

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18
Q

SCFE age

A

Teen

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19
Q

Legg calve Perthes age

A

child (4-8yo)

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20
Q

Drugs with increased risk of bladder cancer

A

phenacetin
chlornaphazine

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21
Q

3 Ds of endometriosis

A

dysmenorrhea, dyspareunia, dyschezia
fixed or retroverted uterus
adnexal mass

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22
Q

actinic keratosis tx

A

topical 5 fluorouracil

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23
Q

Thyroid storm tx sequence

A

BB (propranolol)
PTU/methimazole
iodide
CS

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24
Q

Crohns lab

A

pANCA negative
ASCA positive

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25
Q

Pagets dz of bone

A

imbalance in bone remodeling process, resulting in new bone that is abnormally weak or misshapen
cotton wool appearance
bisphosphonates TOC

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26
Q

budd chiari

A

hepatic vein obstruction
ascites, hepatomegaly, RUQ abd pain
US TOC

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27
Q

klinefelter syndrome karyotype

A

47XXY

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28
Q

Turner syndrome karyotype

A

45X

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29
Q

CD4 HIV dz

A

<200: PCP
<100: toxoplasmosis, cryptococcus
<50: mycobacterium avium

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30
Q

cardiovascular d/o associated w/ JVD and exophthalamos

A

massive tricuspid regurgitation

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31
Q

macular degeneration sx

A

gradual central vision loss
decreased detail and color vision
drusen bodies

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32
Q

jones fx

A

fx through diaphysis of 5th metatarsal

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33
Q

subarachnoid hemorrhage risk factors

A

cysts in liver and kidney (PKD)
MVP
diverticulosis
berry aneurism

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34
Q

stills murmur

A

early/mid-systolic musical
vibratory noisy twanging
high pitch
LLSB and apex

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35
Q

venous hum

A

harsh systolic ejection
LUSB

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36
Q

graham steell murmur

A

high pitch
early diastolic
L 2nd intercostal space w/ full inspiration
Assoc w/ pulmonary regurgitation

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37
Q

hypertensive crisis caused by tyramine containing foods (aged cheese, wine) can be caused by which med

A

MAOI (phenelzine, selegiline, isocarboxazid)

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38
Q

idiopathic pulmonary hypertension tx

A

CCB first line

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39
Q

Meckel’s diverticulum sx

A

painless rectal bleeding
from vitelline duct (yolk sac)
positive meckel’s scan

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40
Q

increased PTT, mixing study has no correction of PTT

A

antiphospholipid syndrome: factor inhibitors

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41
Q

tx for severe hypercalcemia

A

furosemide
IV NS
calcitonin
bisphosphonates

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42
Q

used to slow progression of macular degeneration

A

VitC
VitE
zinc

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43
Q

legg calve perthes sx

A

loss of abduction and internal rotation
painless limping
worse at the end of the day

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44
Q

cryptorchidism tx

A

orchiopexy >6mo

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45
Q

recurrent malignant pleural effusions tx

A

bleomycin
talc

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46
Q

silicosis presentation

A

sandblaster
eggshell classifications

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47
Q

asbestosis xray

A

pleural plaques

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48
Q

coal workers pneumoconiosis xray

A

small upper lobe nodules w/ hyperinflation of lower lobes

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49
Q

gas gangrene etiology

A

clostridium perfringens

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50
Q

anthrax etiology

A

bacillus anthracis

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51
Q

Q fever etiology

A

coxiella burnetii

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52
Q

hemolytic uremic syndrome can be caused by

A

enterohemorrhagic E. coli 0157:H7

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53
Q

GBS can come from

A

campylobacter jejuni

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54
Q

MCC travelers diarrhea

A

enterotoxigenic eccoli

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55
Q

Conns syndrome tx

A

spironolactone
ACE
CCB

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56
Q

schizophrenia tx w/ resistance to first line meds

A

clozapine

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57
Q

pseudotumor cerebri dx

A

CT w/o contrast first to r/o cranial tumor

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58
Q

sarcoidosis tx

A

AA w/ longstanding nonproductive cough and bilateral hilarity lymphadenopathy
oral prednisone

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59
Q

Dubin Johnson syndrome

A

causes isolated direct bilirubinemia

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60
Q

poison ivy sx and tx

A

fluid filled blisters in a straight line
diphenhydramine and topical CS

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61
Q

dawn phenomenon

A

decreased insulin sensitivity d/t nightly surge in glucagon and cortisol during nighttime fasting
normal evening glucose levels, increased levels during late night/early morning and upon awakening
tx by avoiding bedtime snack

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62
Q

somogyi effect

A

nocturnal hypoglycemia, rebound early morning hyperglycemia
normal evening glucose levels, late night/early morning hypoglycemia, hyperglycemia upon awakening
tx with decreasing bedtime NPH dose

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63
Q

pronator syndrome

A

median nerve compression at proximal forearm
hand and forearm sx

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64
Q

neuroleptic malignant syndrome tx

A

bromocriptine

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65
Q

serotonin syndrome tx

A

cyproheptadine
hyperthermia: diazepam

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66
Q

trigeminal neuralgia tx

A

carbamazepine

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67
Q

atrial flutter tx

A

verapamil
vagal
BB

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68
Q

mycobacterium avium complex tx

A

clarithromycin + ethambutol or rifampin

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69
Q

posterior cerebral artery occlusion

A

visual hallucinations
ipsilateral CN deficits (bells palsy)
contralateral muscle weakness
coma and drop attacks, nystagmus
contralateral homonymous hemianopsia

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70
Q

middle cerebral artery occlusion

A

contralateral hemiparesis, more prominent arm and face than lower extremities
aphasia
can raise both eyebrows

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71
Q

anterior cerebral artery occlusion

A

contralateral hemiparesis greater in leg than arm
urinary incontinence
abulia (lack of will)
personality changes

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72
Q

anterolateral MI sx

A

4th heart sound

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73
Q

inferior wall MI sx

A

sinus bradycardia

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74
Q

empiric management of bacterial meningitis when organism isn’t known

A

IV vancomycin + IV ceftriaxone

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75
Q

bowens disease

A

squamous cell carcinoma in situ
epidermal and dermal cells w/ large pleomorphic hyper chromatic nuclei

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76
Q

Caplan syndrome

A

RA in pts w/ coal workers pneumoconiosis

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77
Q

sezary dz

A

type of cutaneous lymphoma

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78
Q

peutz jegher’s syndrome

A

hereditary intestinal polyposis syndrome
assoc w/ hyper pigmented macules on lips and oral mucosa
colon cancer

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79
Q

storage weber syndrome

A

skin and neurologic dz assoc w/ port wine stain of the face, seizure, mental retardation, and cerebral tumors

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80
Q

metabolic syndrome sx

A

need 3/5
central obesity
HTN
elevated fasting plasma glucose
high serum triglycerides
low HDL

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81
Q

refractory ITP tx

A

splenectomy

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82
Q

sarcoidosis hallmark

A

bilateral hilar lymphadenopathy

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83
Q

Yersinia pestis

A

plague- safety pin appearance
bubonic: swollen extremely painful nodes
septicemic: DIC and gangrene
pneumonic: pulmonary infiltrates and pulmonary hemorrhage
infect using rodents and its fleas

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84
Q

prolactinoma tx

A

cabergoline or bromocriptine

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85
Q

med that causes T wave flattening and U waves on EKG (hypokalemia)

A

furosemide

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86
Q

lymphogranuloma venereum

A

genital/rectal lesions w/ suppuration from chlamydia
Tx w/ azithromycin or doxycycline

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87
Q

autoimmune hemolytic anemia dx

A

Coombs positive

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88
Q

hereditary spherycytotis dx

A

hyper chromic RBC
+ osmotic fragility test
increased RBCW
microcytic anemia

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89
Q

primary adrenocortical insufficiency labs

A

metabolic acidosis
isovolemic hypotonic hyponatremia
hyperkalemia
hypoglycemia
hypotension

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90
Q

clomiphene MOA

A

partial estrogen receptor agonist that stimulates ovulation

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91
Q

MMR vaccine CI

A

hx of HIV and CD4 count of 100

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92
Q

PCP tx

A

bactrim

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93
Q

too much mg causes

A

decreased DTR

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94
Q

skiers thumb

A

injury to ulnar collateral ligament (gamekeeper is chronic version)
increased laxity w/ valgus stress on thumb

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95
Q

MCC CAP

A

strep pneumo
2nd: H. flu

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96
Q

proteinuria test

A

spot urine albumin: creatinine ratio

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97
Q

neuroleptic malignant syndrome

A

AMS, fever, tachycardia
tachypnic, diaphoresis
stiffness on neck and arms (lead pipe rigidity)
decreased DTR, pupils normal
incontinence, hyper salivation, hyperthermia
Tx w/ bromocriptine or amantadine + dantrolene

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98
Q

amphetamine toxicity

A

HA, tremor, flushing
hyperthermia, cold sweat, N/V
seizures, sweating, tachycardia
pupil dilation, hypertension
potential MI

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99
Q

serotonin syndrome

A

tremor, hyperthermia, mydriasis
diarrhea, abdominal cramps

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100
Q

opioid toxicity

A

pupillary constriction, respiratory depression, bradycardia
hypotension, coma, N/V

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101
Q

acute dystonia

A

usually hours to days after admin 1st gen antipsychotics
intermittent spasms, trismus, protrusion of tongue
facial grimace, torticollis, difficulty speaking

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102
Q

1st line tx afib or aflutter

A

BB or CCB

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103
Q

CI in pts with myxedema coma

A

rapid warming: can cause shock

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104
Q

myxedema coma tx

A

IV dexamethasone
IV levothyroxine
IV NS
get TSH and free T4

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105
Q

erythema marginatum

A

rheumatic fever
recent throat infx
macular erythematous nonpruritic enlarging annular rash w/ rounded, sharply demarcated edges, no central clearing and blanches w/ pressure

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106
Q

erythema nodosum

A

from increased estrogen exposure, sarcoidosis, TB, coccidiomycosis
painful erythematous inflammatory nodules seen especially on anterior shins

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107
Q

erythema multiforme

A

type IV hypersensitivity reaction
dusty violet or red purpuric macule w/ vesicles or bullae in the center
classic target appearance

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108
Q

melasma tx

A

topical hydroquinone

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109
Q

Centor criteria

A

for strep pharyngitis
cervical lymphadenopathy
exudates
no cough
fever

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110
Q

cryptococcal meningitis CSF

A

decreased glucose
elevated WBC w/ lymphocytosis

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111
Q

cryptococcal meningitis dx

A

india ink
cryptococcal antigen examination

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112
Q

MC sign in PE

A

tachypnea

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113
Q

thoracic outlet syndrome

A

compression of brachial plexus, subclavian artery, or vein
adson test

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114
Q

pheochromocytoma labs

A

24h urine vanillylmandelic acid levels

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115
Q

oral hairy leukoplakia etiology

A

EBV

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116
Q

Young patient w/ early parkinsons. med to reduce tremor

A

benztropine

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117
Q

auspitz sign

A

punctate bleeding spots when the plaques of psoriasis are unroofed

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118
Q

guttate psoriasis rash

A

small erythematous discrete papules w/ fine scales

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119
Q

class II anti arrhythmic that antagonizes alpha 1, beta 2, and beta 2 receptors

A

carvedilol
labetalol

120
Q

definitive management of CAD if occlusion involves left main coronary artery

A

CABG

121
Q

tennis elbow sx

A

pain on lateral elbow with lateral epicondyle tenderness
inflammation of tendon insertion site of extensor carpi radials brevis

122
Q

first line TTP

A

plasmapheresis

123
Q

tumor lysis syndrome tx

A

allopurinol
agressive IV hydration

124
Q

pure seminomaqous germ cell tumor labs

A

normal AFP
normal bHcg

125
Q

organism w/ increased incidence of UTI in young sexually active women

A

staphylococcus saprophyticus
E. coli

126
Q

coccidioides immitus

A

fever, nonproductive cough, HA, joint pain
bilateral ankle and knee swelling
painful red rash oh both shine w/ no verrucous lesions present
elevated IgM precipitin ab test

127
Q

tests that help distinguish causes of Cushing syndrome

A

high dose dexamethasone suppression test
ACTH levels

128
Q

keep PDA open

A

prostaglandin

129
Q

PDA close w/

A

indomethacin

130
Q

risk factor bladder cancer

A

Hx of smoking
cyclophosphamide
pioglitazone
dye exposure

131
Q

BIT pyloric stenosis in children

A

US

132
Q

metformin AE

A

AKI, GI sx, lactic acidosis
megaloblastic anemia (elevated MCV)

133
Q

1st line schizophrenia

A

2nd gen antipsychotic (olanzapine)

134
Q

parkinson MOA

A

idiopathic depletion of dopamine in basal ganglia

135
Q

severe chronic bronchitis EKG

A

negative QRS complex in lead I
d/t hypoxemia –> pulmonary HTN –> RVH –> RAD –> RHF

136
Q

PPI (lansoprazole) AE

A

macrocytic anemia

137
Q

chronic hepatitis C tx

A

pegylated alpha interferon + ribavirin

138
Q

toxoplasmosis transmission

A

cat exposure
ring enhancing lesion

139
Q

fournier’s gangrene

A

necrotizing fasciitis of the penis and scrotom
impaired immunity

140
Q

physiopathology of psoriasis

A

keratin hyperplasia of stratum basale and spinosum due to T cell activation

141
Q

MC benign ovarian neoplasm

A

dermoid cystic teratomas

142
Q

MC clinical presentation of sickle cell

A

episodic hematuria

143
Q

DeQuervain’s thyroiditis

A

Viral illness sx w/ tender thyroid gland
increased ESR

144
Q

Celiac dz labs

A

endomysial antibodies

145
Q

P-ANCA

A

UC
microscopic polyangiitis
primary sclerosis cholangitis
charge-strauss

146
Q

primary biliary cirrhosis marker

A

anti-mitochondrial antibodies

147
Q

von willebrand marker

A

ADAMTS13

148
Q

streptomycin AE

A

ototoxicity
nephrotoxicity

149
Q

multiple sclerosis PE

A

lhermittes sign
increased DTR

150
Q

myasthenia gravis PE test

A

ice pack test: ice pack over eye can improve weakness

151
Q

SIADH labs

A

hyponatremia
urine sodium >20
decreased serum osmolarity
isovolemia

152
Q

dermatitis herpetiformis

A

assoc w/ celiac disease
papulovesicular rash on extensor surfaces
Tx w/ dapsone

153
Q

pyogenic granuloma

A

lobular capillary hemangioma
solitary glistening friable red nodule/papule
seen after trauma

154
Q

kawasaki tx

A

aspirin and IVIG

155
Q

marfan syndrome sx

A

MVP, tall
arachnoidactyly
precuts carinatum
joint laxity, ectopia lentes

156
Q

fragile X syndrome

A

MVP, tall, hyper extensible joints
long narrow face, print forehead and chin
large ears, macroorchidism

157
Q

MCC subacute endocarditis

A

strep viridian’s

158
Q

amiodarone AE

A

hypothyroid lab values

159
Q

esophageal adenocarcinoma

A

hx of GERD
dysphasia to solids, weight loss, anemia
no alcohol or smoking

160
Q

MCC AIN

A

penicillin

161
Q

MOA tamsulosin

A

alpha 1 blocker
provides rapid relief of sx by smooth muscle relaxation of prostate and bladder neck

162
Q

ATN sx

A

MC type of intrinsic kidney injury in hospital
oliguria
increase in BUN/Cr
epithelial cell or muddy brown casts

163
Q

AIN sx

A

usually assoc w/ allergic or inflammatory response in interstitium

164
Q

osteochondroma xray

A

pedunculate growth that grows away from growth plate

165
Q

chondrosarcoma xray

A

punctate or ring and arc appearance

166
Q

sulfonylurea MOA

A

glyburide, glimepiride, glipizide
stimulates pancreatic beta cell insulin release in a non-glucose dependent fashion

167
Q

biguanates MOA

A

metformin
decreases hepatic glucose production with no effect on pancreatic beta cells

168
Q

MOA alpha glucosidase inhibitors

A

acarbose, miglitol
delays intestinal absorption of glucose

169
Q

MOA thiazolidinedione

A

pioglitazone, rosiglitazone
increases insulin sensitivity at peripheral receptor sites of adipose and muscle tissues

170
Q

MOA glucagon like peptide 1 agonist

A

exenatide, liraglutide
lowers blood sugar by mimicking incretin

171
Q

hereditary hemochromatosis labs

A

increased serum iron
increased ferritin
increased transferrin saturation
positive hemosiderin deposition
C282Y HFE

172
Q

hereditary hemochromatosis sx

A

dilated cardiomyopathy
new onset DM
testicular atrophy
abdominal ascites w/ positive shifting dullness test
bronze colored skin

173
Q

babesiosis

A

fever, chills, arthralgia, hemolytic anemia (jaundice)
no rash
PBS: tetrads of organisms in RBC
from tick

174
Q

tx genital warts

A

from HPV
flesh colored lesion, cauliflower appearance
podophyllin

175
Q

hypersensitivity pneumonitis

A

from birds
rapid onset fever, chills, productive cough, chest tightness 4-8h post exposure
inspiratory crackles
lung bx: micro nodular interstitial involvement with poorly formed noncaseating granulomas

176
Q

asbestosis

A

ship builder or demolition repair
linear asbestos bodies w/ protein and iron deposition on lung bx

177
Q

rule of 9s

A

head and neck: 9
each arm: 9
anterior trunk: 18
Posterior trunk: 18
each leg: 18
groin: 1

178
Q

Borderline personality disorder

A

failed long term relationships
mood swings, black and white thinking with no middle ground
reckless activity, may self harm

179
Q

ankylosing spondylitis tests

A

xray: squaring of vertebral bodies (bamboo spine)

180
Q

psoriatic arthritis xray

A

pencil in cup deformity

181
Q

narrow complex SVT tx

A

adenosine

182
Q

streptococcus agalactiae bacteremia

A

group B streptococcus, can cause bacteremia and meningitis in newborn
vaginal delivery
gram positive cocci

183
Q

cutaneous anthrax

A

widening of mediastinum
painless black eschar
flu like sx

184
Q

TTP labs

A

decreased ADAMTS 13 serum levels
positive neurologic sx
shistocytes on PBS
normal PT and PTT

185
Q

nephritic syndrome labs

A

HTN
sudden increase in BUN/Cr
RBC casts
hypercellularity of glomerulus on bx

186
Q

Ludwig angina

A

swelling and erythema to upper neck and chin
pus on floor of the mouth

187
Q

Vincents angina

A

trench mouth
acute necrotizing ulcerative gingivitis causing profuse gingival bleeding, pain, and interdental papilla with ulcerative necrosis

188
Q

MOA zofran

A

serotonin antagonist

189
Q

SJS vs TEN

A

SJS: <10%
TEN: >30%

190
Q

acute stress disorder vs PTSD

A

acute stress disorder: <1mo
PTSD: >1mo

191
Q

serotonin syndrome

A

tachycardia, BP fluctuations, hyperthermia
hyperreflexia, myoclonus, dilated pupils
agitation, hyperactive GI tract
tx w/ cyproheptidine

192
Q

multiple sclerosis CSF

A

increased oligoclonal bands

193
Q

vibrio cholera sx

A

raw shellfish
stools are grey with no fecal blood or pus

194
Q

jersey finger

A

inability to flex DIP due to avulsion of flexor tendon

195
Q

TOC mycoplasma pneumoniae and empiric tx for CAP

A

macrolide (azithromycin) <– only choice for kids
doxycycline

196
Q

pneumothorax >30% tx

A

chest tube thoracostomy

197
Q

MC cardiac abnormality seen with coarctation of the aorta

A

bicuspid aortic valve

198
Q

cyclophosphamide AE

A

used for cancer
hemorrhagic cystitis
increase risk of bladder cancer
SIADH

199
Q

cimetidine AE

A

CP450 inhibition
gynecomastia
impotence

200
Q

screening test SLE

A

ANA (antinuclear antibody)

201
Q

drug induced lupus lab

A

anti histone ab

202
Q

primary biliary cirrhosis lab

A

anti-mitochondrial ab

203
Q

complex regional pain syndrome sx

A

pain out of proportion
post fracture or trauma
early: swelling, extremity color changes, increased nail and hair growth
late: atrophic skin, hair, nail, muscle growth

204
Q

mononeuritis multiplex

A

painful asymmetrical peripheral neuropathy affecting at least 2 nerve areas either simultaneously or sequentially
eventually becomes symmetrical

205
Q

meds that exacerbate myesthinia gravis

A

BB
FQ
aminoglycosides (gentamicin)

206
Q

ARDS hallmark

A

unresponsiveness to oxygen therapy and low PaO2/FiO2 ratio (<200)
bilateral pulmonary infiltrates

207
Q

post streptococcus glomerulonephritis lab

A

anti-streptolysin titer
color colored urine
puffiness to eyes

208
Q

Janeway lesions

A

in endocarditis
painless macule on palms and soles

209
Q

oslers nodes

A

tender painful nodules on pads of digits
infective endocarditis

210
Q

keratoderma blenorrhagicum

A

hyperkeratotic lesions on palms and soles
reactive arthritis

211
Q

Roth spots

A

retinal hemorrhages with pale centers
endocarditis

212
Q

erythema marginatum

A

macular annular rashes
rheumatic fever

213
Q

diphtheria tx

A

diphtheria antitoxin + penicillin

214
Q

herpetic gingivostomatosis

A

HSVI in children
sudden onset fever, anorexia, gingivitis and yellow grey vesicles on oral mucosa, tongue, and lips

215
Q

monteggia fracture

A

proximal ulnar shaft with anterior radial head dislocation

216
Q

galleazzi fracture

A

mid distal radial shaft fx with dislocation of distal radioulnar joint

217
Q

nightstick fx

A

isolated mid shaft ulnar fx

218
Q

endometrial cancer risk factors

A

estrogen replacement therapy
nulliparity
chronic anovulation
tamoxifen therapy

219
Q

haloperidol AE

A

1st gen antipsychotic
galactorrhea
decreased libido
amenorrhea

220
Q

organophosphate poisoning sx and tx

A

HA, muscle spasms, convulsions, diffuse wheezing,
diaphoresis, lacrimation
Atropine + pralidoxime

221
Q

restrictive cardiomyopathy echo

A

diastolic dysfunction w/ dilation of both atria

222
Q

efaviranz

A

HIV med
AE: vivid dreams, neurologic disturbances

223
Q

zidovudine AE

A

bone marrow suppression
myopathy
hepatomegaly
pancreatitis

224
Q

MC inherited cause of hyper coagulability

A

factor v leiden

225
Q

MC inherited cause of bleeding

A

von willebrand dz

226
Q

hallmark neurogenic shock

A

hypotension w/ bradycardia
decreased pulmonary capillary wedge pressure

227
Q

empyema tx

A

abx and pleural fluid drainage

228
Q

tx hyperkalemia

A

insulin w/ glucose
IV calcium gluconate
oral sodium polstyrene sulfonate
neb albuterol

229
Q

MC premalignant skin condition

A

actinic keratosis

230
Q

crohns dz classic association

A

granulomas and fistulas

231
Q

TOC esophageal variceal bleeding

A

endoscopic ligation

232
Q

acute dystonia

A

from diphenhydramine
trismus, protruding of tongue, facial grimacing
torticollis
difficulty speaking

233
Q

paroxysmal nocturnal hemoglobinuria triad

A

hemolytic anemia
venous thrombus of large vessels
pancytopenia

234
Q

Step process hyperosmolar hyperglycemic syndrome

A

IV NS
IV insulin bolus
IV insulin drip
Glu 250: 5DNS

235
Q

methimazole AE

A

hepatotoxicity
myelosupression (agranulocytosis)

236
Q

myasthenia gravis tx and lab

A

acetylcholine receptor ab
acute crisis: plasmapheresis
long term management: pyridostigmine or neostigmine

237
Q

doxorubicin indication and AE

A

used for AML, ALL
dilated cardiomyopathy. bone marrow suppression, GI AE, alopecia

238
Q

carotid endarterectomy indication

A

internal or common carotid artery stenosis >70%

239
Q

meds CI in tx of cocaine induced MI

A

BB

240
Q

Biot’s respiration

A

morphine/opioid OD
irregular respirations of quick shallow breaths of equal depth with irregular periods of apnea

241
Q

cheyne stokes breathing

A

HF, respiratory depression, uremia, brain damage
periods of deep breathing alternating with periods of apnea. smooth increases in rate of breathing with smooth gradual decrease in rate of breathing with period of apnea

242
Q

kussmaul breathing

A

metabolic acidosis
deep rapid continuous respirations

243
Q

clinical manifestation of Q fever

A

culture negative endocarditis

244
Q

pyoderma gangrenosum

A

inflammatory diseases
inflammatory nodule/pustule –> painful necrotic ulcer with irregular purple or violet undermined borders and purulent base

245
Q

erythema multiforme major vs minor

A

major: involves mucus membranes (oral, genital, ocular)

246
Q

PID tx

A

doxycycline + ceftrixone

247
Q

hallmark neisseria meningitidis

A

petechia rash
MCC meningitis in children 1mo- 18yo

248
Q

hemophilia B labs

A

Christmas tree
increase in PTT

249
Q

myocarditis sx

A

conjunctivitis
urethral discharge
arthralgia

250
Q

rotator cuff tendinitis

A

younger patients
anterior shoulder pain when doing overhead movements
tx: subacromial lido

251
Q

wegener’s granulomatosis (granulomatosis w/ polyangiitis)

A

necrotic sinusitis
lower respiratory tract infection (honeycombing)
rapidly progressing glomerulonephritis (RBC casts)
+ C-ANCA

252
Q

C. diff colitis

A

strikingly increased lymphocytes, pseudomembrane appearance in colon
oral metronidazole

253
Q

vitamin C deficiency sx

A

perifollicular hemorrhages and purpura
hyperkeratosis

254
Q

CI to flu vaccine

A

egg allergy

255
Q

CI MMR and varicella

A

gelatin allergy
neomycin allergy

256
Q

hep B vaccine CI

A

bakers yeast

257
Q

Lambert eaton syndrome

A

seen with small cell carcinoma
ab against presynaptic Ca gated channels that release Ach
Hallmark: improves w/ repeated use

258
Q

acute exacerbations of COPD tx

A

ipratropium + albuterol

259
Q

percutaneous nephrolithotomy

A

large stones >10mm
struvite and stag horn calculi

260
Q

heparin induced thrombocytopenia tx

A

tx w/ direct thrombin inhibitor (argatroban, bivalirudin)
thrombocytopenia and thrombosis

261
Q

hemolytic anemia labs

A

increased indirect bili
increased LDH
shistocytes
increased reticulocytes
decreased haptoglobin

262
Q

thiazolidinedione AE

A

rosiglitazone
cardio toxicity (chest pain), CHF (fluid retention, edema)
hepatotoxicity, fx

263
Q

osteomalacia xray

A

looser zones

264
Q

renal osteodystrophy xray

A

osteomalacia in chronic renal dz
salt and pepper appearance

265
Q

multiple myeloma xray

A

punched out lesions of skull

266
Q

Paget dz of bone xray

A

cotton wool appearance of skull

267
Q

kaposki sarcoma etiology

A

HHV8

268
Q

erythromycin AE

A

prolonged QT
CP450 inhibition
diarrhea
increased risk of muscle toxicity with statin

269
Q

erysipelothriz rhusiopathiae

A

follows skin abrasion or puncture from raw fish, shellfish, raw meat, and poultry
localized cutaneous lesion limited to hand, finger, and web spaces
Nonpitting edema and purplish erythema with sharp irregular margins extending peripherally while clearing centrally

270
Q

BB AE

A

fatigue, depression, impotence, hypotension, bradycardia
2nd/3rd degree heart block, bronchospasm

271
Q

primary vs secondary adrenal insufficiency

A

primary has skin hyperpigmentation

272
Q

naegele’s rule

A

3 months + 7 days

273
Q

membranous neuropathy

A

MCC primary nephrotic syndrome in adults
caused by viral hepatitis or penicillamine
basement membrane thickening on kidney bx
can cause exudative pleural effusion

274
Q

Berger’s disease

A

IgA deposition in glomerulus
associated with glomerulonephritis

275
Q

DM induced neuropathy

A

kimmelstiel wilson lesion
nodular glomerulonephritis with pink hyaline material around glomerular capillaries

276
Q

meniere’s disease 4 cardinal sx

A

episodic peripheral vertigo (horizontal nystagmus)
ear fullness
hearing loss
tinnitus

277
Q

syphilis dx with chancre or. condyloma

A

dark field microscopy

278
Q

chronic mesenteric ischemia sx

A

dull abdominal pain worse w/ meals and weight loss

279
Q

schizophrenia vs mania

A

flat blunted emotional affect in schizophrenia

280
Q

alpha 1 antitrypsin deficiency

A

young patient w/ emphysema, nonsmoker

281
Q

increased CSF opening pressure xanthochromia that does not diminish from tube 1 to 4

A

subarachnoid hemorrhage

282
Q

staghorn and struvite stones associated with

A

proteus mirabilis

283
Q

low AFP
high bHcg
low estradiol

A

trisomy 21

284
Q

low AFP
low bHcg
low estradiol

A

trisomy 18

285
Q

latent TB infx tx

A

isoniazid + pyridoxine for 9mo

286
Q

whipples disease

A

diarrhea
joint pain
Fever
twitching of eye muscle while chewing
positive PAS macrophage
dilation of lacteals

287
Q

sickle cell disease xray

A

H shaped vertebrae with central endplate depression

288
Q

warm antibody autoimmune hemolytic anemia tx

A

CS

289
Q

amiodarone AE

A

pulmonary fibrosis
thyroid disorders

290
Q

tx Lyme disease with neurological and cardiac disease

A

IV ceftriaxone

291
Q

seborrheic keratosis PE

A

small papule or plaque with velvety warty stuck on appearance

292
Q

myoclonus

A

brief sporadic single repetitive jerks or twitching of 1+ muscle groups

293
Q

tularemia

A

camping, tick or insect bite or handling rodent/rabbit tissue
HA, F, N
ulcerated papule with central eschar and tender regional lymphadenopathy
splenomegaly, diarrhea

294
Q

medullary thyroid carcinoma test

A

calcitonin

295
Q

cholinergic crisis

A

excess Ach
N/V, salivation, diarrhea, mitosis, bradycardia,
respiratory failure, sweating
edrophonium worsens sx

296
Q

Crohns dz sx

A

string sign
non bloody diarrhea
RLQ pain
saccharomyces cerevisiae ab positive
B12 deficiency

297
Q

complication of B12 replacement therapy

A

hypokalemia