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GK ROSH Summative Exam Review > Random Review > Flashcards

Random Review Flashcards

1
Q

What is patellofemoral syndrome (chondromalacia)

A

idiopathic softening/fissuring of the patellar articular cartilage

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2
Q

S/S of patellofemoral Syndrome

A

anterior knee pain “behind” or around the patella, worse with knee hyperflexion

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3
Q

Dx for patellofemoral syndrome

A

+ apprehension sign

(examiner applies pressure medial-lateral patella with pain or patient refuses test in anticipation of pain)

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4
Q

Mgmt of patellofemoral syndrome

A

NSAIDS

rest & rehab

strengthen vastus medialis obliquus of the quadriceps

weight loss

elastic knee sleeve

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5
Q

What is MOI for anterior cord syndrome?

A

MC after direct injurt: blowout vertebral body burst fractures (flexion)

indirect injury to anterior spinal artery

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6
Q

What deficits are present with anterior cord injury?

A

bilateral loss of motor function and pain and temperature sensation below the level of injury

vibration sense and proprioception are preserved

POOR PROGNOSIS!

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7
Q

What is the MCC of chlamydial cervicitis?

A

chlamydia trachomatis

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8
Q

Tx for chlamydia trachomatis

A

Azithromycin 1g single dose

Doxy 100mg BID x 7 days

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9
Q

What medication is known to reduce calcium absorption?

A

PPIs: decrease gastric acidity which leads to a decrease in calcium absorption. However, it is thought that calcium citrate does not have this same consequence when taken with omeprazole.

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10
Q

How does Botulinum Toxin cause paralysis?

A

It inhibits acetylcholine release at presynaptic receptors

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11
Q

What are the 3 ways someone can get botulism?

A
  1. ingestion of honey contaminated w/spores
  2. food-borne: inadequately preserved or undercooked foods
  3. wounds contaminated by spores
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12
Q

What are the S/S of Botulism?

A
  • descending, symmetric, flaccid paralysis (upper>lower)
  • Cranial Nerve deficits
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13
Q

Tx for Botulism

A

>1 y/o: equine serum antitoxin

<1 y/o: human-derived botulism Ig

abx for wounds

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14
Q

floppy baby

A

botulism

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15
Q

What labs should be ordered if suspecting acromegaly?

A

initial: IGF-1 (elevated), postprandial serum GH, TRH stimulation test

Secondary: oral glucose tolerance test (conclusive if failure to suppress serum GH to < 2 ng/mL after an oral load of 100 g glucose)

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16
Q

What is the MCC of acromegaly?

A

pituitary adenoma

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17
Q

Tx for acromegaly

A

ocreotide (a somatostatin analog)

transsphenoidal resection

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18
Q

What physical exam finding suggests globe perforation?

A

Hyphema

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19
Q

What is the most common type of knee dislocation?

A

anterior knee dislocation

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20
Q

“dimple” sign on PE w/ posterolateral dislocation

A

knee dislocation

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21
Q

Cause of knee dislocations

A

anterior: hyperextension of the knee
posterior: a direct blow to the anterior tibia w/knee flexed

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22
Q

What is the tx for anterior knee dislocation?

A

reductiona nd knee splint w/ 15-20 degree flexion

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23
Q

What nerve may be injured during anterior knee dislocation?

A

common peroneal nerve

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24
Q

What artery may be injured in an anterior knee dislocation?

A

popliteal artery

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25
Q

What are the 3 main types of polyps?

A
  1. hyperplastic (nonmalignant)
  2. adenomatous MC*
  3. malignant
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26
Q

AAFP routine colorectal cancer screening guidelines

A

Fecal occult blood testing, sigmoidoscopy, or colonoscopy in adults, beginning at 50 until 75

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27
Q

AAFP colorectal cancer screening guidelines if 1 relative w/colon cancer

A

colonscopy at 40

OR

10 yrs before the age at which relative was diagnosed

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28
Q

AAFP colorectal cancer screening guidelines if familial adenomatous polyposis

A

sigmoidoscopy at age 12, then every 1-2 years

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29
Q

What is volume of distribution?

A

describes how far a drug will partition from the bloodstream to the surrounding tissues.

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30
Q

Drugs with low volumes of distributions tend to stay in the ___________.

A

bloodstream

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31
Q

drugs with high volumes of distribution preferentially accumulate in ________ and ______.

A

drugs with high volumes of distribution preferentially accumulate in extravascular tissues and fluids.

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32
Q

What is a knee effusion?

A

A knee effusion is defined as fluid within the knee joint.

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33
Q

What abnormality can ethanol toxicity cause?

A

hypoglycemia

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34
Q

What is the mechanism of injurty for scaphoid fracture?

A

fall on an outstretched hand (FOOSH)

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35
Q

S/S of scaphoid fracture

A

dorsal radial wrist pain w/decreased ROM of wrist and thumb

tenderness to palpation of anatomic snuffbox

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36
Q

scaphoid fx tx

A

thumb spica splint

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37
Q

What are the live attenuated vaccines?

A
  • Herpes Zoster
  • Influenza
  • MMR
  • Rotavirus
  • Typhoid (bacterial)
  • Vaccinia (smallpox)
  • Yellow fever
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38
Q

What is the triad for Grave’s disease?

A
  1. Diffuse goiter
  2. exophthalmos
  3. pretibial myxedema
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39
Q

S/S of hyperthyroidism

A

Patient will be complaining of heat intolerance, palpitations, weight loss, tachycardia, and anxiety

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40
Q

What will PE of hyperthyroidism (graves dz) show?

A

hyperreflexia, goiter, exophthalmos, pretibial edema

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41
Q

Tx for hyperthyroidism

A

Methimazole or PTU

PTU if Pregnant

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42
Q

What is the 1st line tx for latent TB infection?

A

Isoniazid

43
Q

What will CXR for Primary TB show?

A

Ghon FOcus

44
Q

Tx for subarachnoid hemorrhage?

A

nimodipine

45
Q

S/S of retinal detachment

A

painless loss of vision, floaters, flashing lights, curtain lowering sensation

reduced brightness in involved eye

46
Q

Hydroxychloroquine is an anti-malarial drug used for which two diseases?

A

RA and Lupus

47
Q

S/S of systemic Lupus Erythematosus

A

fever, lymphadenopathy, weight loss, general malaise, or arthritis

48
Q

What will PE of Systemic Lupus Erythematosus show?

A

butterfly rash/malar rash

49
Q

What will labs of SLE show?

A

(ANA), anti-dsDNA antibodies, anti-smith antibodies, anti-histone antibodies

50
Q

Dx for osteoporosis

A

DEXA scan - T-score ≤ -2.5

51
Q

Tx for osteoporosis

A

bisphosphonates

52
Q

MC fractures associated w/osteoporosis

A

vertebral body compression fractures

53
Q

What electrolyte imbalance is a child with pyloric stenosis at most risk for?

A

hypokalemia

54
Q

hot potato voice

A

peritonsillar abscess

55
Q

Which medication is recommended for patients with atrophic vaginitis and dyspareunia who do not want to use a vaginal route of medication delivery?

A

The selective estrogen receptor modulator ospemifene

56
Q

What is stasis dermatitis and in what disease can you see it?

A

Stasis dermatitis occurs with venous insufficiency and valvular incompetency. The proximal skin appears thin and brown, and may occur with distal macules, papules, red irritation, skin thickening and edema.

57
Q

Dx for varicose veins

A

duplex ultrasound

58
Q

Tx for varicose veins

A

compression stocks + leg elevation

59
Q

What is the initial tx for hypercalcemia?

A

normal saline

60
Q

What does EKG for hypercalcemia show?

A

shortened QT interval

61
Q

What are most kidney stones composed of?

A

calcium oxalate or calcium phosphate

62
Q

Is peptic ulcer disease a risk factor for developing nephrolithiasis?

A

Yes, b/c pts with PUD usually ingest a lot of calcium to ease their symptoms.

63
Q

What are the clinical signs of Kawasaki Disease?

A
  • high fever for 5 days (necessary)
  • C/o of 4/5 of the following:
  1. bilateral bulbar conjunctival injection
  2. oral mucous membrane changes “strawberry tongue”
  3. peripher extremity changes (erythema/edema of hands or feet)
  4. Polymorphous rash
  5. Cervical lymphadenopathy
64
Q

CRASH and burn

A

Conjunctivitis

Rash

Adenopathy

Strawberry tongue

Hand/feet edema

BURN (uncontrolled high fever)

KAWASAKI DISEASE

65
Q

What is tx for Kawasaki Disease?

A

IVIG + ASA

66
Q

Hx of hyphema

A

hx of trauma to eye w/ foreign object

67
Q

s/s of hyphema

A

dec. vision, photophobia, pain, red reflex is absent

68
Q

PE of hyphema

A

blood in ant. chamber

69
Q

what PE sign shows globe perforation?

A

hyphema in anterior chamber

70
Q

what is a complication of tibial-femoral dislocations?

A

popliteal artery rupture

71
Q

which nerve is at most risk of direct damage with a tibial-femoral dislocation?

A

common peroneal nerve

72
Q

dx for tibial-femoral dislocation

A

arteriography (popliteal artery injury)

73
Q

tx tibial femoral dislocation

A

immediate orthopedic consult: severe limb threatening emergency

74
Q

pathophysiology of pulmonary hypertension

A

increased pulm vascular resistance –> RVH –> R-sided heart failure

75
Q

primary vs secondary pulm HTN

A

primary: BMPR2 gene idiopathic
secondary: COPD

76
Q

s/s of pulm htn

A

dyspnea on exertion

77
Q

PE findings pulm HTnqaccentuated S2 due to prominent P2

A

Increased JVD, peripheral edema, ascites

78
Q

dx of pulm HTN

A
  • CXR: enlarged pulm arteries
  • ECG: cor pulmonale: RVH, right axis deviation
  • GOLD STANDARD: right sided heart cath = def dx
  • CBC: polycythemia w/ increased hematocrit
79
Q

tx for pulm htn

A

primary: CCB 1st line

2nd line: sildenafil (PDE 5 blocker)

80
Q

s/s of acute pyelonephritis

A

fever, dysuria, frequency, urgency, flank pain, CVA tenderness, N/V

81
Q

tx acute pyelonephritis

A

FQ or bactrim

if inpatient/pregnant: ampicillin/gentamicin

82
Q

Where is leviteracetam eliminated through?

A

kidneys

caution in patients wCrCl of 30-50 mL/min

83
Q

Tx for bacterial conjunctivitis

A

ofloxacin topical eye drops

84
Q

Why should you avoid neomycin solutions in the eye?

A

hypersensitivity reactions

85
Q

What score is osteoporosis defined as on a bone density scan?

A

-2.5 or more standard deviations

86
Q

Tx for osteoporosis

A

bisphosphonates

87
Q

MC fx in pt with osteoporosis

A

vertebral body compression fractures

88
Q

s/s of idiopathic pulmonary fibrosis

A

chronic dry cough and dyspnea

smoking hx

89
Q

PFT for idiopathic pulm fibrosis

A

decreased FVC and FEV1

normal FEV1/FVC ratio

90
Q

PE of idiopathic pulm fibrosis

A

honeycombing

91
Q

Tx for pulseless electrical activity

A

CPR for 2 min

Epi q 3-5 min

check for shockable rhythm q 2 mins

92
Q

Dx (major/minor) for Duke’s Criteria

A

To confirm a diagnosis, 1 of the 3 must be:

  1. 2 major criteria
  2. 1 major, 3 minor
  3. 5 minor
93
Q

What are the major criterias for infective endocarditis?

A
  1. 2 positive blood cultures/hx of valve
  2. + echo showing vegetation (TTE)
  3. New murmur valvular regurgitation
94
Q

What are the minor criteria for infecive endocarditis? (Duke’s Criteria)

A
  1. Fever
  2. Vascular issues (petechiae, Roth spots in fundus, Jane Lesions)
  3. Immunologic issues (RA, Osler’s Nodes, nephrotic syndrome)
  4. Predisposition(IV drug user, prosthetic heart valve)
  5. Microbiology culture unlike major criteria
95
Q

If IV drug users get infectious endocarditis, which valvewill it most likely effect?

A

S aureus, Tricuspid

96
Q

What valve will you see infectious endocarditis in if pt has hx of native valve?

A

mitral valve

97
Q

What is the MC valve involved in infective endocarditis?

A

mitral EXCEPT if IVDA = tricuspid

98
Q

Tx for acute IE w/native valve

A

nafcillin OR vanco (MRSA) + gentamicin

99
Q

Tx for IE w/prosthetic valve

A

vanco + genta + rifampin

100
Q

Tx for fungal IE

A

amphotericin B

amphoterrible B

101
Q

Which abx are effective against gram +

A

Penicillin + vanco

102
Q

Which abx are effective against gram -

A

gentamicin

103
Q
A

GK ROSH Summative Exam Review (1 decks)

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