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Questions1 Flashcards

1
Q

What is Heyde’s syndrome?

A

Aortic stenosis + GIB 2/2 angiodysplasia

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2
Q

Preferred form of hormonal contraception for lactating mothers:

A

progestin-only

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3
Q

Forgetfulness and dissociation assoc w travel:

A

dissociative fugue

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4
Q

Treatment for simple or partial seizure:

A

carbamazepine (first line), lamotrigine, oxcarbazepine, levetiracetam

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5
Q

Treatment for complex partial seizures:

A

carbamazepine (1st line), valproate, lamotrigine, levetiracetam

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6
Q

Treatment for absence seizure:

A

ethosuximide (first line), valproate

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7
Q

Treatment for tonic-clonic seizure:

A

phenytoin (first line), carbamazepine (1st line), valproate (1st line), lamotrigine, levetiracetam

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8
Q

Children are more likely to have a febrile seizure in the future if…

A

1) less than 18 months at first seizure
2) FH of febrile convulsions in first-degree relatives
3) short time before fever and seizure
4) low degree fever before seizure
5) seizure history of abnormal neuro signs or developmental delay

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9
Q

In children with cerebellar findings, consider which diseases?

A

1) cerebellar astrocytoma, medulloblastoma
2) hydrocephalus (arnold-chiari or dandy-walker malformations)
3) Friedreich ataxia (AR, areflexia, loss of bivration/position sense, cardiomyopathy=HCM)
4) ataxia-telangiectasia (progressive cerebelalr ataxia, oculocutaneous telangiectasias, immune deficiency)

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10
Q

What are the two classic causes of “floppy” baby?

A

Wernig-Hoffmann disease (FH–autosomal recessive, congenital degeneration of anterior horns of spinal cord (LMN lesion) long slowly progressive disease; all affected by 6 months)

Botulism: sudden onset, honey or home-canned foods; spontaneous recovery within 1 week

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11
Q

What can ethambutol cause?

A

optic neuritis

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12
Q

Polio is caused by destruction cells where?

A

anterior horn of spinal cord (LMN death)

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13
Q

Toxicities of carbamazepine:

A

blood dyscrasias (agranulocytosis/aplastic anemia), liver toxicitiy

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14
Q

P450 inducers:

A

Momma Barb Steals Phen-phen and refuses greasy carbs chronically

Modafinil
Barbiturates
St. John's wort
Phenytoin
Rifampin
Griseofulvin
Carbamazepine
Chronic alcohol abuse
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15
Q

P450 inhibitors

A

MAGIC RACKS in GQ

Macrolides
Amiodarone
Grapefruit juice
Isoniazid
Carbamazepine
Ritonavir
Acute alcohol
Ciprofloxacin
Ketoconazole
Sulfa

Gemfibrozil
Quinidine

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16
Q

Which muscls are spared in Lambert-Eaton but almost always involved in MG?

A

extraocular

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17
Q

How do you treat organophosphate poisoning?

A

atropine, pralidoxime (antidote to organophosphate)

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18
Q

Which antibiotics given in high doses can cause MG-like muscular weakness or prolong effects of muscular blockade after anesthesia?

A

aminoglycosides

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19
Q

Inability to relax grip or release a handshake, mental retardation, baldness, ovarian/testicular dystrophy:

A

myotonic dystrophy. Autosomal dominant

20
Q

Both Duchenne and Becker muscular dystrophy show what kind of inheritance?

A

XLR

21
Q

What glycogen storage disease (autosomal recessive) can cause muscular weakness that may resemble muscular dystrophy?

A

McArdle disease (deficiency in glycogen phosphorylase)

22
Q

What is the MOA of memantine?

A

acts on the glutamatergic system by blocking NMDA receptors

23
Q

What are acetylcholinesterase inhibitors used to treat dementia?

A

donepezil, rivastigmine, galantamine, tacrine

24
Q

What is ropinirole/pramiprexole?

A

dopamine agonists used to treat PD

25
Q

RMSF spreads from head to palms/soles or from palms/soles to center of body?

A

spreads centripedally from palms/soles to center of body. THrombocytopenia, increased LFTs

26
Q

What is the BP threshold for those eligible for thrombolysis?

A

185/110

27
Q

T/F: Triptans are contraindicated in patients with stroke and uncontrolled hypertension.

A

True

28
Q

After exposure to varicella, patients only need the vaccine (and not the IG) if…

A

they are older than 1 and immunocompetent (and asymptomatic)

29
Q

The most serious side effect of hydroxychloroquine is

A

retinopathy

30
Q

Antibiotic tx needed in salmonella diarrhea when

A

severe disease or immunocompromised patients

31
Q

Which diarrheal pathogens cause bloody diarrhea?

A

e coli, shigella (travel), campylobacter (raw/under cooked meats)

32
Q

Persistent ST-segment elevation after a recent MI and deep Q waves in the same leads might suggest

A

ventricular aneursym

33
Q

Indications for oxygen therapy in COPD:

A

PaO2 55%, evidence of cor pulmonale

34
Q

Which blood test should you order for necrotizing vasclitis with GRANULOMAs in the lung and necrotizing glomeruloneprhitis?

A

c-ANCA for Wegners. Treat with cyclophosphamide and steroids.

**no granulomas with the same clinical picture would be p-Anca for microscopic polyangiitis. But if there are granulomas AND eosinophilia, consider Churg-Strauss, esp if also peripheral neuropathy = that is pANCA, too

35
Q

A stroke in the putamen or the cerebellum will have eyes FACING the lesion?

A

cerebellum! FEF usually pushes eyes to opposite side.

putamen stroke will have eyes facing opposite since PPRF pulls eyes

36
Q

Diffuse proliferative glomerulonephritis is due to

A

SLE or membranoproliferative glomerulonephritis

37
Q

Which testicular tumor results in an increase in AFP?

A

Yolk sac (note that all of the germ cell, except seminoma which is the most common, produce increased hCG)

38
Q

What is the pregnancy quad screen for Downs?

What is it for Edwards syndrome?

A

Increased Bhcg and inhibin. Decreased estriol and AFP

Edwards: normal Inhibin. Decreased everything else

39
Q

Rockerbottom feet, polydactyly w/ flexed fingers, congenital heart disease, holoprosencephaly

A

Patau’s (chromosome 13)

40
Q

Index finger overlapping third and fourth fingers, prominent occiput, rocker bottom feet, congenital heart problems, micrognathia

A

Edwards (chromosome 18)

41
Q

GI sx, splinter hemorrhages, conjunctival hemorrhages, PERIORBITAL EDEMA, MYOSITIS, EOSINOPHILIA:

A

trichinellosis

42
Q

How can you distinguish between Tay-Sachs and Niemann Pick? Which enzyme is deficient in each?

A

Niemann Pick = sphingomyelinase. Cherry red spot AND HEPATOSPLENOMEGALY

Tay-Sachs = hexosaminidase. No hsm.

43
Q

Both interventricular wall rupture and papillary muscle rupture occur 3-5 days after infarction and cause new holosystolic murmurs. How do you tell them apart?

A

Interventricular wall rupture: murmur best heard at LLSB

Papillary muscle rupture: murmur best heard at apex

44
Q

A buccal smear in Turner Syndrome will show (absent/numerous) Barr bodies.

A

ABSENT

45
Q

Describe the clinical findings of tuberous sclerosis:

A

AD, hypopigmented skin macules (“ash leaf spots”), seizures, CNS hamartomas (tubers) and increased risk of cardiac rhabdomyomas and renal tumors=angiomyolipomas, adenoma sebaceum, thick leathery skin at nape of neck/back (“shagreens patches”)

UWorld (4 decks)

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