Random Subject Review Part II Flashcards
schizotypal
magical thinking, odd thoughts and appearances
schizophrenia
delusions, hallucinations > 6 months
schizoaffective
schizophrenia + mood disorder
schizoid
voluntary social isolation
schizophreniform
schizophrenia symptoms < 6 months
brief psychotic disorder
schizophrenia symptoms < 1 month
differential diagnosis for dislocation of the lens of the eye
marfan’s syndrome, homocystinuria, and alport syndrome
treatment for macular degeneration
anti-oxidants
treatment for retinal detachment
laser photocoagulation
second line: cryotherapy
females only, loss of previously acquired language and motor skills
ret disorder
impairements in social interactions, communications, play, repetitive behaviors
autism
impairment in social interaction but not avoidance, no language delay
aspergers
young girl with stereotyped midline hand movements
ret disorder
ignoring the basic rights of others
conduct disorder
characterized by hostility, annoyance, vindictiveness, disobedience, and resentfulness
oppositional defiant disorder
multiple motor and vocal tics
tourette’s
impulsive and inattentive
ADHD
7 year old who avoids going to school to stay home with parent
separation anxiety disorder
fever in postop period
atelectasis, pneumonia, DVT, UTI, wound infections, thrombophlebitis, wonder drugs, sinusitits
next step: pelvic fracture, DPL shows blood in the pelvis
emergency laparotomy
next step: pelvic fracture, DPL shows urine in the pelvis
urgent laparotomy (able to wait a few hours)
next step: pelvic fracture, DPL shows nothing, hemodynamic instability
retroperitoneal hematoma
angiography for diagnosis and embolization
next step: blunt abdominal trauma, unstable vital signs, FAST shows fluid in the pelvis
assume that is blood, urgent laparotomy
next step: blunt abdominal trauma, unstable vital signs, FAST shows no fluid in the pelvis
retroperitoneal hematoma
angiography for diagnosis and embolization
next step: blunt abdominal trauma, unstable vital signs, FAST inconclusive
perform DPL
next step: blunt abdominal trauma, stable vital signs
CT scan
next step: abdominal stab wound, hypotensive or with signs of peritonitis
laparotomy
diagnostic criteria for rheumatic fever
J - joint pain O - pancarditis N - subcutaneous nodules E - erythema marginatum S - sydenham's chorea
treatment for ventricular fibrillation
immediate electrocardioversion 360
if refractory, epinephrine + vasopressin following by epinephrine alone
skin blistering disease that has a positive nikolsky’s sign
pemphigus vulgaris
most common inherited cause of hypercoagulability
factor V leiden
genetic disorder associated with multiple fractures commonly mistaken for cihld abuse
osteogenesis imperfecta
most common cause of bloody nipple discharge
intraductal papilloma
antibiotics that should be avoided during pregnancy due to potential teratogenic effects
sulfonamdies, tetracyclines, aminoglycosides, fluoroquinolones,
antihistone antibodies
drug-induced lupus
infectious cause of aplastic crisis in sickle cell disease
parvo virus
tachycardia, wild fluctuations in blood pressure, headache, diaphoresis, and panic attacks
pheochromocytoma
what should always be done prior to LP
check for increased ICP, papilledema
next step in diagnosis of cholecystitis when U/S is equivocal
HIDA scan
clinical definition of hypertension
three separate sittings of blood pressure > 140/90 at least two weeks apart
most common causes of fever of unknown origin
cancer and autoimmune diseases
most feared complication of a scaphoid fracture
avascular necrosis of the scaphoid
albuminocytologic dissociation in CSF
guillain-barre syndrome
pathogenesis of neonate with meconium ileus
cystic fibrosis and hirschsprung’s disease
pediatric patient with red “currant-jelly” stools
intussusception
young female with amenorrhea, bradycardia, and abnormal body image
anorexia nervosa
treatment for superior vena cava syndrome
radiation +/- steroids
immunodeficiency with a positive nitroblue tetrazolium test
chronic granulomatous disease
what portion of bladder must be injured in order to develop chemical peritonitis
dome of the bladder (only portion covered by peritoneum)
next step in management of a woman with uncomplicated cystitis
3 day course of fluoroquinolones
diagnosis: newborn male with distended palpable bladder and oliguria
posterior urethral valves
treatment for epididymitis
< 35: treat for gonorrhea/chlamidya x 10 days
> 35 or history of anal intercourse: treat for enterobacter, fluoroquinolone x 10-14 days
lab work included in work-up for erectile dysfunction
nocturnal erection test, total testerone, PSA, LH, prolactin
recommended therapies for nocturnal enuresis
behavioral therapy, enuresis alarm
if refractory, consider imipramine or indomethacin suppositories
medications used in treatment of BPH
immediate relief: alpha-1 blocker
long-term relief: 5 alpha-reductase inhibitor
risk factors for bladder cancer
smoking, aniline dyes, schistosoma, petroleum byproducts, cyclophosphamide, recurrent UTIs
treatment for urethritis in men
ceftriaxone with doxycycline x 10 days
how do signs and symptoms of testicular torsion differ from epididymitis
E: subacute, relief with scrotal support
TT: acute, with some trauma/activity, absent cremasteric reflex
classic presentation of varicocele
most common on left, associated with infertility, transilluminates on U/S, shows retrograde flow
three year-old with abdominal mass, hematuria, and hypertension
wilm’s tumor
defining characteristic of hydrocele
transillumination
next step in management of testicular torsion confirmed with U/S
manually detorse, follow by bilateral orchiopexy
treatment for prostatitis
4-6 week course of antibiotics, TMP-SMX if no known association with STDs, standard STD medication if so
most common cause or aortic stenosis in 50 year old patient
congenital bicuspid aortic valves
most common cause of aortic regurgitation in 70 year old patient
senile or degenerative calcification
classic but rare EKG finding in pulmonary embolism
S1Q3invertedT3
most likely cause of secondary hypertension in arms but low pressure in legs
coarctation of the aorta
most likely cause of secondary hypertension with proteinuria
renal disease
most likely cause of secondary hypertension with hypokalemia
hyperaldosteronism
most likely cause of secondary hypertension with tachycardia, diarrhea, and heat intolerance
graves disease
most likely cause of secondary hypertension with hyperkalemia
renal artery stenosis or renal failure
most likely cause of secondary hypertension with episodic sweating and tachycardia
pheochromocytoma
elderly female with h/o cholelithiasis presents with 5 days of vague, recurrent abdominal pain and vomiting
gallstone ileus
management of ER patient with painful irreducible inguinal mass
surgery for incarcerated inguinal hernia
4 month-old child presents with nonbilious vomiting despite changing from milk-based formula to soy-based formula
pyloric stenosis
patient presents to second clinic visit with repeat reading of pressure > 140/90, what is the next step
confirm at third visit in 2-4 weeks before starting medication
glomerular disease suspected in patient with most common nephrotic syndrome in children
minimal change disease
glomerular disease suspected in patient with IF: granular pattern of immune complex deposition, LM: hypercellular glomeruli
post-streptococcal glomerlonephritis
glomerular disease suspected in patient with linear pattern of immune complex deposition
goodpasture’s syndrome
glomerular disease suspected in patient with kimmelstiel-wilson lesions
diabetic nephropathy
glomerular disease suspected in patient with most common nephrotic syndrome in adults
membranous glomerulonephritis
glomerular disease suspected in patient with EM: loss of epithelial foot processes
mimimal change disease
glomerular disease suspected in patient with nephrotic syndrome a/w hepatitis B
membranoproliferative glomerulonephritis
glomerular disease suspected in patient with nephrotic syndrome a/w HIV
focal segmental glomerulosclerosis
glomerular disease suspected in patient with anti-GBM antibodies, hematuria, and hemoptysis
goodpasture’s syndrome
glomerular disease suspected in patient with EM: subendothelial humps and tram-track appearance
membranoproliferative glomeruonephritis
glomerular disease suspected in patient with nephritis, deafness, cataracts
alport’s syndrome
glomerular disease suspected in patient with LM: crescent formation in glomeruli
idiopathic crescentic glomerulonephritis
glomerular disease suspected in patient with LM: segmental sclerosis and hyalinosis
focal segmental glomerulosclerosis
glomerular disease suspected in patient with purpura on back of arms and legs, abdominal pain, IgA nephropathy
henoch-schloein purpura
glomerular disease suspected in patient with positive ANCA
idiopathic crescentic glomerulonephritis or wegner’s glomerulonephritis
glomerular disease suspected in patient with anti-dsDNA antibodies
lupus nephritis
what statistical calculation looks at true positives and divides them by the number of patients with disease
sensitivity
15 year-old pregnant girl requires hospitalization for preeclampsia, should her parents be informed
no, pregnancy is empancipation
patient unable to inspire completely due to pain during palpation of the RUQ, what is the sign and diagnosis
positive murphy’s sign, cholecystitis
reversal agent for heparin
protamine sulfate
substances known to cause hemolysis in patients with G6PD deficiency
sulfa drugs, fava beans, primaquine, high dose aspirin, dapsone, nitrofurantoin, INH
medications given to a pregnant woman with cystitis
amoxicillin, ampicillin, nitrofurantoin, cephalosporins (ceflex)
patient presents with limb pain on passive movement, pallor, poikilothermia, paresthesias, paralysis, and pulselessness, what is the treatment
fasciotomy for compartment syndrome
complication that may arise for overly rapid correction of hyponatremia
central pontine myelinolosis
60 year-old patient presents with acute onset of broken speech, what type of aphasia is this and what lobe and vascular distribution has been affected? what is the first step in workup?
broca’s aphasia, middle cerebral artery, frontal lobe, CT scan w/o contrast
most common primary sources of metastasis to the brain
lung cancer, breast cancer, melanoma, renal cancer, GI tract cancer
treatment for mastitis in a patient that is breast-feeding
oral antibiotics and continue breast feeding
characteristics favoring carcinoma in an isolated pulmonary nodule
> 2 cm, smoker, age > 45, irregular margins, absence of calcification or irregular calcification
in what disease would you find atrophy of the mammillary bodies
wernicke’s encephalopathy
what term describes heavy bleeding during and between menstrual periods
menometormenorrhagia
most common type of tracheoesophageal fistula
blind upper esophageal pouch, trachea connects to lower esophagus and stomach
treatment for kawasaki disease in the acute-phase
high-dose aspirin, IVIG
no steroids for kawasaki
first-line pharmacotherapy for depression
SSRI
antidepressants associated with hypertensive crisis
MAO inhibitors
exacerbated by wine and soft cheeses
40 year-old black female is found to have noncaseating granulomas of the lung and hypercalcemia
sarcoidosis
what disease might you find curschmann’s spirals (whorled mucous plugs)
bronchial asthma
what is the platelet count, bleeding time, PT, and PTT for HUS or TTP
platelet count: decreased
bleeding time: increased
PT: normal
PTT: normal
what is the platelet count, bleeding time, PT, and PTT for hemophilia
platelet count: normal
bleeding time: normal
PT: normal
PTT: increased
what is the platelet count, bleeding time, PT, and PTT for von Willebrand disease
platelet count: normal
bleeding time: increased
PT: normal
PTT: increased (because of factor VIII)
what is the platelet count, bleeding time, PT, and PTT for DIC
platelet count: decreased
bleeding time: increased
PT: increased
PTT: increased
what is the platelet count, bleeding time, PT, and PTT for warfarin
platelet count: normal
bleeding time: normal
PT: increased
PTT: increased
what is the platelet count, bleeding time, PT, and PTT for end stage liver disease
platelet count: decreased or normal
bleeding time: increased or normal
PT: increased
PTT: increased
what is the platelet count, bleeding time, PT, and PTT for aspirin use
platelet count: normal
bleeding time: increased
PT: normal
PTT: normal
medications necessary in patient with end stage renal disease
diuretics, dialysis, kayexelate, vitamin D, epo (Hgb < 12), statins, phosphate binders
treatment for hyperkalemia
calcium gluconate, D50 with insulin, sodium bicarbonate, albuterol nebulizer, kayexalate, furosemide
4 potassium sparing diuretics
spironolactone (causes gynecomastia)
eplenaranone
amiloride
triamterene
deep palpation of RUQ –> arrest of inspiration due to pain
murphy’s sign with cholecystitis
charcot’s triad (fever, jaundice, RUQ pain) + hypotension and altered mental status
reynold’s pentad a/w cholangitis
RLQ pain on passive extension of the hip
psoas sign, appendicitis
RLQ pain on passive internal rotation of the hip
obturator sign, appendicitis
LUQ pain and referred left shoulder pain
kerr’s sign seen with splenic rupture
ecchymosis of the skin overlying the flank
grey turner’s sign a/w pancreatitis
ecchymosis of the skin overlying the periumbilical area
cullen’s sign a/w pancreatitis
CXR finding indicative of croup
steeple sign
CXR finding indicative of epiglotitis
tongue sign
treatment for RSV bronchiolitis
albuterol or racemic epinephrine
oxygen for hypoxia
no steroids, ribavirin only as a last resort
beck’s triad
hypotension, distended neck veins, distant heart sounds a/w cardiac tamponade
typical initial post-op fever work-up
CBC, U/A, CXR, blood culture, urine culture
claw hand
ulnar nerve injury
ape hand
median nerve injury
wrist drop
radial nerve injury
scapular winging
long thoracic nerve injury
unable to wipe bottom
thoracodorsal nerve injury
loss of forearm pronation
median nerve
cannot abduct or adduct fingers
ulnar nerve
loss of arm abduction
axillary nerve
weak lateral rotation of arm
suprascapular nerve or axillary nerve
loss of arm and forearm flexion
musculocutaneous nerve
loss of forearm extension
radial nerve
trouble initially arm abduction
suprascapular nerve
unable to abduct arm beyond 10 degrees
axillary nerve
unable to raise arm above horizontal
long thoracic nerve and spinal accessory nerve
what type of renal tubular acidosis is associated with abnormal H+ secretion and nephrolithiasis
RTA I
causes of hypervolemic hyponatremia
CHF, nephrotic syndrome, liver failure
burn patient presents with cherry-red flushed skin and coma, oxygen saturation is normal but carboxyhemoglobin is elevated, what is the treatment
100% hyperbaric oxygen
treatment for delerium tremends
benzos, chlordiazepoxide
most common cause of postpartum hemorrhage
uterine atony
give IV oxytocin after delivery
drugs that block transmission through the AV node
beta-blockers, digoxin, CCBs
skin lesion causes a pearly-colored papule with a translucent surface and telangectasias
basal cell carcinoma
infection causes honey-crusted lesions usually around nose or mouth
impetigo
what causes hypocalcemia, high phosphorus, and low PTH
hypoparathyroidism
what causes stones, bones, groans, and psychiatric overtones
hyperparathyroidism
first-line treatment for acute otitis media
amoxicillin x10 days
does a cohort study identify incidence or prevalence
incidence AND prevalence
a violent patient with vertical and/or horizontal nystagmus has been exposed to hat substance
PCP
what diarrheal illness is associated with church picnics/mayonnaise
staph aureus
cause of congenital pure RBC aplasia
diamond-blackfan anemia
pentad of TTP
hemolytic anemia, thrombocytopenia, renal failure, fever, neurological symptoms
patient who visited the southwest US presents with fever, malaise, cough, and night sweats, what is the diagnosis and treatment
coccidiomycoses
ring-enhancing brain lesion on CT with seizures
toxoplasmosis
classical physician finds in case of endocarditis
fever, osler’s nodes, janeway lesions, heart murmur, splinter hemorrhages, roth spots in the eye
