Random Stuffs Flashcards
1
Q
what medication is used for treatment of acute panic attack?
A
benzodiazepine e.g. lorazepam
2
Q
what are the clinical features for acute panic attack?
A
Shortness of breath Trembling Unsteady Depersonalization/ derealization Excessive heart rate Numbness Tingling Palpitation Abdominal pain Nausea Intense fear Chest pain
3
Q
what can be done for long term relief of panic disorder
A
SSRIs and/or CBT
4
Q
what are some of the instances that adolescents may be treated without parental consent and are entitled to strict patient confidentiality?
A
contraception
prenatal care
STDs
substance abuse
5
Q
What are the first line treatments for hypertensive encephalopathy?
A
Nitroprusside and labetalol
6
Q
What medication is effective in reducing risk of early recurrence of ischemic stroke? And how soon should it be given?
A
Aspirin
Given within 24hrs
7
Q
What is the most likely diagnosis and treatment when a patient has S3 sound + shortness of breath + tachypnea + hypoxia
A
Left ventricular failure
IV diuretics
8
Q
What is the difference between mobitz type 1 and type 2 in their level of block
A
Type 1: usually AV node
Type 2: below level of AV node
9
Q
On ECG findings what is the difference between Mobitz type 1 and Mobitz type 2
A
Type 1: progressive prolongation in PR interval until drop of QRS complex
Type 2: constant PR interval with sudden drop of QRS complex
10
Q
What is the difference in effect of exercise or atropine in Mobitz type 1 and Mobitz type 2
A
Type 1: improves
Type 2: worsens
11
Q
What is the difference of vagal maneuvers (carotid sinus massage) on Mobitz type 1 and Mobitz type 2?
A
Type 1: worsens type 1 AV block
Type 2: paradoxically improves type 2 AV block
12
Q
What is the difference in management of Mobitz type 1 and 2
A
Type 1: observation in asymptotic and correction of reversible causes
Type 2: pacemaker is indicated
13
Q
What is used as guide for conversion from IV insulin to subcutaneous insulin and how should it be done
A
Anion gap
Overlap subcutaneous insulin with IV insulin for 2 hours after anion gap has closed and then taper off IV insulin gradually
14
Q
A child with a first-degree relative who suffer from bipolar disorder has a …..-……..% risk of developing the condition in his/her lifetime
A
5-10%
15
Q
A child whose parents both suffer from bipolar disorder has a ….% risk of developing the condition
A
60%
16
Q
A monozygotic twin of an individual who suffers from bipolar disorder has a …..% risk of developing the condition
A
70%
17
Q
Lithium exposure in the first trimester of pregnancy is associated with an increased risk for ……………….
A
Cardiac malformations
18
Q
Lithium exposure during the second and third trimesters may cause …….. and ……….
A
Goiter and transient neonatal neuromuscular dysfunction
19
Q
Alarm symptoms indicating endoscopy include:
A
- anemia
- blood in stool
- weight loss
20
Q
In the esophagus, only ………….. and …………… are diagnosed by biopsy
A
Cancer and Barrett esophagus
21
Q
The single word “progressive” is the most important clue to diagnosis of ……………….
A
Esophageal cancer
22
Q
Dysphagia, halitosis and regurgitation of food particles is highly suggestive of ……………
A
Zenker diverticulum
23
Q
What muscles are involved in zenker’s diverticulum?
A
Posterior pharyngeal constrictor muscles
24
Q
Mention 3 paraneoplastic syndrome associated with small cell carcinoma
A
- SIADH
- Cushing syndrome
- Lambert-Eaton syndrome
25
Typical signs and symptoms of acute diverticulitis : .........,..............., ..........,
Fever, leukocytosis, LLQ location of pain
26
Stevens Johnson Syndrome up to _____of the body surface is involved whereas in Toxic epidermal necrolysis greater than ____ body surface area is involved.
- 10%
| - 30 %
27
_________ is the preferred study for diagnosis of melanoma
Excisional biopsy with narrow margins
28
What is the best treatment for frostbite injuries?
Rapid reheating with warm water
29
What is the mode of transmission of herpes whitlow?
Direct inoculation of the virus through broken skin
30
________ are at increased risk of developing whitlow
Health care workers especially those who come in direct contact with orotracheal secretions
31
_________ is characterized by single or multiple rounded, dome-shaped papules with central umbilication
Molluscum contagiosum
32
What is the best form of treatment of molluscum contagiosum ?
Curettage or application of liquid nitrogen
33
_________ is characterized by painless blisters, increased skin fragility on the dorsal surfaces of the hands, facial hypertrichosis and hyperpigmentation
Porphyria cutanea Garda
34
Porphyria cutanea Tarda is associated with Hepatitis C infection. True / False
True
35
Suspect ____________ in 30-60 year old patients with telangiectasia over the cheeks, nose and chin.
Rosacea
36
What is the initial therapy for rosacea
Metronidazole
37
Warfarin-induced skin necrosis presents with ______ followed by ______ and _______
Pain
| Bullae formation and skin necrosis
38
What is the treatment of choice for cellulitis with systemic signs?
Intravenous nafcillin or cefazolin
39
Basal cell carcinoma presents as ________ with __________ and __________
Slow growing papule with
Pearly rolled border and
Overlying telangiectasia
40
______ is characterized by a pale, velvety pink or whitish, hypopigmented macules that do not tan and do not appear scaly but scale on scraping
Tinea versicolor
41
What is the topical treatment sir tinea versicolor?
Selenium sulfide lotion and ketoconazole shampoo
42
Maculae caerulea (hemosiderin-stained purpuric spots) is diagnostic of ____________
Body lice infestation
43
The characteristic lessons of scabies are pruritic vesicles and pustules in “runs” over the _________, ___________ and ___________
Finger webs, heels of palms, and wrist creases.
44
What is the treatment for scabies?
5% permethrin cream
45
What areas are usually spared in scabies?
Head, neck, palms and soles
46
Vitiligo is sometimes associated with other autoimmune conditions such as ___________, ____________, ____________, ______________, _________
```
Pernicious anemia
Autoimmune thyroid disease
Type 1 diabetes mellitus
Primary adrenal insufficiency
Hypopituitarism
Alopecia areata
```
47
In addition to a gluten-free diet, _________ is the treatment of choice for dermatitis herpetiformis.
Dapsone
48
The organs that are typically affected in GVHD include ______, _______ and _____
Skin
Intestines
Liver
49
__________ can help reduce the acute worsening of ophthalmopathy after radioactive iodine treatment?
Glucocorticoids
50
Transient vision loss, family history of stroke, and carotid bruit is highly suggestive of ______________
Fibromuscular dysplasia
51
Fibromuscular dysplasia most commonly affects ____________age__-____
Women age 15-50
52
Hypocalcemia, hyperphosphatemia and increased PTH are characteristic biochemical abnormalities of _________________
Secondary hyperparathyroidism in chronic renal failure
53
_____________ is the most common complication of peptic ulcer disease
Hemorrhage
54
All patients with cirrhosis regardless of etiology should undergo ____________________
Surveillance for hepatocellular carcinoma with ultrasound every 6 months
55
Characteristic findings in acute liver failure include: _________, ________ and __________
Acute onset of markedly elevated transaminases
Reduced hepatic synthetic function
Encephalopathy
56
What is the most common cause of hypomagnesemia?
Alcoholism
57
What is given for acute management of symptoms of hyperthyroidism (Graves)?
Propranolol
58
What are the most common initial symptoms of myasthenia gravis?
ptosis, diplopia, blurred vision
59
symptoms of myasthenia gravis worsens during the day. T/F
True
60
what is the test of choice for diagnosis of myasthenia gravis?
acetylcholine receptor antibody test
61
______ is generally characterized by a ratio of AST to ALT >2, elevated GGT and elevated ferritin
Alcoholic hepatitis
62
____________ is a major cause of chronic diarrhea in HIV-infected patients with CD4 counts less than 180 cells/mm3
Cryptosporidium parvum
63
What are the two watershed areas of the colon?
Splenic flexure
| Recto-sigmoid junction
64
The most common cause of iron deficiency anemia in an elderly patient is _________
GI blood loss
65
What is the drug of choice for primary biliary cirrhosis?
Ursodeoxycholic acid
66
Suspect ___________ in patients with malabsorption, along with a history of living in endemic areas for more than one month.
Tropical sprue
67
______________ is characterized by very frequent watery, nocturnal diarrhea.
Laxative abuse
68
The diagnosis of __________ can be confirmed with the characteristic biopsy finding of dark brown discoloration of the colon with lymph follicles shining through as pale patches
Laxative abuse
69
____________ can worsen or even precipitate tics in patients.
Stimulants or dopamine agonists
70
Current guidelines recommend treating all confirmed or suspected influenza within ______ of symptom onset.
48 hours
71
splenic abscess often presents with the classic triad of ________
fever, leukocytosis and left upper quadrant abdominal pain
72
For patients with profound metformin-induced lactic acidosis use of __________ or _____ is recommended
Hemodialysis or sodium bicarbonate
73
The treatment of choice for trichomoniasis vaginitis is __________
One 2-mg dose of metronidazole
74
Medication for us heroin intoxication is _________
Naloxone
75
Classic triad of spinal epidural abscess:
- fever
- severe focal back pain
- neurologic deficits
76
causes of abnormal uterine bleeding
```
Polyps
Adenomyosis
Leiomyoma
Malignancy/hyperplasia
Coagulopathy
Ovarian dysfunction
Endometrium
Iatrogenic/Infection/Inflammation
Not yet specified
```
77
What does transient tachypnea of the new born show on CXray
Bilateral perihilar linear streaking
78
________ should be susceptibility when a premature infant presents with grunting, flaring and retractions immediately after birth.
Respiratory distress syndrome
79
What is the characteristic findings on CXR in respiratory distress syndrome
Fine reticular granularity of the lungs
80
What is the treatment for respiratory distress syndrome of premature origin?
Early continuous positive air pressure ventilation
81
______ due to ________ and _______ due to _______ are common presentations of fibromuscular dysplasia.
Headaches due to internal carotid artery stenosis and secondary hypertension due to renal artery stenosis
82
Adenosine is primarily used for the __________________
Acute termination of paroxysmal supraventricular tachycardia
83
___________ is the first-line therapy for stable patients with recurrent episodes of Torsades de pointes
Intravenous magnesium
84
The majority of infants with congenital toxoplasmosis are asymptomatic at birth but experience __________ in adulthood due to reactivation of their infection
Chorioretinitis
85
How is congenital toxoplasmosis diagnosed?
Serology: the presence of infant IgM or IgA
86
Treatment for congenital toxoplasmosis
Pyrimethamine, sulfadiazine and folate
87
Nonresponders to bladder training and pelvic floor muscle exercises in urgency incontinence can use _____
An antimuscarinic agent to decrease detrusor activity likeoxybutynin
88
___________ is a common cause of chronic anterior knee pain in women
Patellofemoral pain syndrome
89
Treatment of patellofemoral pain syndrome includes _______ and _____
Strengthening the quadriceps and hip abductors
90
Contraindications to breastfeeding that include _________, _____________, ______________, ___________ and ____________
Untreated tuberculosis, varicella infection, herpetic breast lesions, current chemotherapy and active substance use (eg, cocaine, phencyclidine)
91
An arteriovenous fistula allows blood to bypass the high-resistance systemic capillaries, resulting in ________ SVR (afterload), ________ VR (preload) and ______ CO
Decreased
Increased
Increased
92
_____________ is a serious postoperative complication that can present with fever, abdominal pain, tachypnea, and tachycardia, usually within the first week after bariatric surgery.
Anastomotic leak
93
The diagnosis of anastomotic leak is best confirmed by
The diagnosis is best confirmed by oral contrast–enhanced imaging (either abdominal CT scan or upper gastrointestinal series)
94
Unfavorable metabolic side effects of thiazide diuretics include ___________, _________________, and ____________.
hyperglycemia, increased LDL cholesterol and plasma triglycerides, and hyperuricemia.
95
Associated hypokalemia suggests severe hypercortisolism and is most often seen with _____________
ectopic ACTH-producing tumors
96
Those with CD4 counts >200/mm3 are immunocompetent enough to clear attenuated infections and should receive varicella and MMR vaccinations if titers are low. True/ False
True
97
_______ are virtually pathognomonic for gout
Uric acid tophi
98
in the absence of microscopic confirmation of crystals, the diagnosis of gout can be made provisionally in patients with _________ and ________
Visible tophi and history of episodic monoarthritis
99
________ is the procedure of choice in a patient with massive hemoptysis and what is the purpose
Bronchoscopy
| Identify the site and attempt early therapeutic intervention
100
Sudden- onset severe abdominal pain with peritonitis and subdiaphragmatic free air on upright CXR is a classic presentation of ________________
Perforated viscus (eg. perforated peptic ulcer)
101
_________ is characterized by increased hemoglobin A2 and hgF on electrophoresis
Beta-thalassemia major
102
Patients with beta-thalassemia are transfusion- independent. T/F
False
103
_________ in children presents with fever, dysphagia, muffled voice and pain with neck extension
Retropharyngeal abscess
104
PCOS patients may have infertility due to ______
Anovulation from failed follicular maturation
105
_________ antipsychotic medication has a high frequency of prolactin elevation
Risperidone
106
__________ is both an antagonist as well as a partial agonist of dopamine D2 receptors
Aripiprazole
107
The most common adverse effect of inhaled corticosteroids is __________
Oropharyngeal thrush (oral candidiasis)
108
Older patients with a history of chronic antacid use are at risk for __________
Vit B12 deficiency
109
___________ have analgesic properties that can be helpful in treating patients with comorbid depression and chronic pain including painful diabetic neuropathy.
Serotonin and norepinephrine reuptake inhibitor eh. Duloxetine
110
The diagnosis of _______________ should be suspected in patients with unexplained chronic abdominal pain, weight loss and food aversion
Chronic mesenteric ischemia
111
_____ is the most common nutritional deficiency in children
iron deficiency
112
children should not be started on cow's milk until what age?
1 year
113
The development of clubbing and sudden-onset joint arthropathy in a chronic smoker is suggestive of _______________
Hypertrophic osteoarthropathy
114
A large mediastinal with associated elevations of AFP and beta-hCG is virtually diagnostic of _____________
A nonseminomatous germ cell tumor
115
___________ has been found in up to two-thirds of patients with MS and is the most common psychiatric complication.
Depression
116
Rapid compression of the duodenum against the vertebral column during blunt abdominal trauma may result in a _____________
duodenal hematoma.
117
Splenic sequestration Laboratory testing demonstrates _____________, ______________, and ______________.
Normocytic anemia, reticulocytosis and thrombocytopenia
118
__________ is a self-limited disorder of the vestibulocochlear nerve (CN VIII) that sometimes follows a viral upper respiratory infection
Vestibular neuritis
119
Vestibular neuritis with unilateral hearing loss is termed __________
Labyrinthitis
120
The characteristic ultrasound finding of a ___________________ is an endometrium with a "Swiss cheese" or "snowstorm" appearance.
Complete hydatidiform mole
121
The first-line agents for management of essential hypertension during pregnancy are _____________ and ___________
Labetalol and methyldopa
122
Atypical glandular cells (AGC) on a Pap test may be due to either ________ or _________
cervical or endometrial adenocarcinoma.
123
Evaluation of Atypical Glandular Cells requires ______, _______, _______
colposcopy, endocervical curettage, and endometrial biopsy.
124
Once GBS is suspected in a hemodynamically stable patient, the next step in management is to ____________
Assess pulmonary function with spirometry
125
_______ should be administered in emergency setting for opioids intoxication
Naloxone
126
The primary anti-ischemic and antianginal effects of nitrates are due to _____________
Systemic vasodilation
127
Systemic venodilation _______ preload and left ventricular end-diastolic volume, ________ wall stress and myocardial oxygen demand
Lowers
| Reducing
128
Typical features of ________ include a happy disposition, jerky gait and hand flapping
Angelman syndrome
129
Features of ______ include self-mutilating behavior, gout and nephrolithiasis
Lesch-Nyhan syndrome
130
___________ is characterized by the regression of language skills due to severe epileptic attacks.
Landau-Kleffner syndrome
131
Language skill deterioration in Landau-Kleffner syndrome is at age _-_ years
3-6 years
132
Management of Pityriasis rosea includes________
Reassurance alone and symptomatic management of pruritus
133
___________ is a self-limited exanthem that classically begins with a solitary, large herald path followed by clusters of smaller oval lesions oriented in a “Christmas tree” pattern.
Pityriasis rosea
134
Stridor, dysphagia, voice changes and “tripod positioning “ are all signs of _____
Increasing upper airway obstruction
135
Invasive pulmonary aspergillosis is characterized by the classic triad of ________, __________, _____________
Fever, pleuritic chest pain and hemoptysis
136
CT scan of the chest of a patient with invasive pulmonary aspergillosis usually reveals
Nodules with surrounding ground-glass opacities
137
Management of invasive pulmonary aspergillosis
1-2 weeks of IV voriconazole + an echinocandin (eg. Caspofungin) and prolonged therapy with oral voriconazole alone
138
______ is a common opportunistic infection that may cause pneumonitis marked by dyspnea, nonproductive cough lo grade fever and (usually) patchy or diffuse ground-glass opacities on CT scan.
CMV
139
Muddy brown granular cast is seen in
Acute tubular necrosis
140
Broad casts and waxy casts are seen in ___
Patients with chronic renal failure
141
RBC casts are indicative of
Glomerular disease or vasculitis
142
WBC casts are seen in
Cases of interstitial nephritis, pyelonephritis
143
Fatty cast are seen in
Conditions causing nephrotic syndrome
144
___________ is the most common malignancy diagnosed in patients exposed to asbestos
Bronchogenic carcinoma
145
___________ is a genetic disorder leading to poor platelet-endothelial binding and reduced factor VII levels
Von Willebrand disease
146
_______ is an antidepressant with mild stimulant properties that can be particularly helpful for depressed patients with low energy, impaired concentration, hypersomnia and weight gain
Bupropion
147
Pt presents with sweating, generalized itching, headaches for 6 wks with weight loss. Hct = 58%; plt 568,00/mm3. Most likely diagnosis and cause
Polycythemia Vera
| Increased production of erythrocytes
148
Treatment for PCP infection in HIV patient
TMP-SMX
149
Best initial test for mastoiditis
CT or MRI
150
What confirms the diagnosis of chronic mesenteric ischemia?
Mesenteric arteriography
151
What is the definitive treatment of chronic mesenteric ischemia
Surgical revascularization
152
___________ typically presents with postmenopausal bleeding and a uterine mass that causes bulk symptoms (eg, pelvic pressure, constipation)
Uterine sarcoma
153
Side effect of thiazide diuretics
```
Hyperglycemia
Hyperuricemia
Hyperlipidemia
Hypercalcemia
Hyponatremia
```
