Rapid Review 2 Flashcards
The most common 1° malignant tumor of bone.
Multiple myeloma
Unilateral, severe periorbital headache with tearing and conjunctival erythema.
Cluster headache
Prophylactic treatment for migraine.
β-blockers, Ca2+ channel blockers, TCAs
The most common pituitary tumor. Treatment?
Prolactinoma. Dopamine agonists (e.g., bromocriptine)
A 55-year-old patient presents with acute “broken speech.” What type of aphasia? What lobe and vascular distribution?
Broca’s aphasia. Frontal lobe, left MCA distribution
The most common cause of SAH.
Trauma; the second most common is berry aneurysm
A crescent-shaped hyperdensity on CT that does not cross the midline.
Subdural hematoma—bridging veins torn
A history significant for initial altered mental status with an intervening lucid interval. Diagnosis? Most likely etiology? Treatment?
Epidural hematoma. Middle meningeal artery. Neurosurgical evacuation
CSF findings with SAH.
Elevated ICP, RBCs, xanthochromia
Albuminocytologic dissociation.
Guillain-Barré (↑ protein in CSF with only a modest ↑ in cell count)
Cold water is flushed into a patient’s ear, and the fast phase of the nystagmus is toward the opposite side. Normal or pathological?
Normal
The most common 1° sources of metastases to the brain.
Lung, breast, skin (melanoma), kidney, GI tract
May be seen in children who are accused of inattention in class and confused with ADHD.
Absence seizures
The most frequent presentation of intracranial neoplasm.
Headache
The most common cause of seizures in children (2–10 years).
Infection, febrile seizures, trauma, idiopathic
The most common cause of seizures in young adults (18–35 years).
Trauma, alcohol withdrawal, brain tumor
First-line medication for status epilepticus.
IV benzodiazepine
Confusion, confabulation, ophthalmoplegia, ataxia.
Wernicke’s encephalopathy due to a deficiency of thiamine
What % lesion is an indication for carotid endarterectomy?
Seventy percent if the stenosis is symptomatic
The most common causes of dementia.
Alzheimer’s and multi-infarct
Combined UMN and LMN disorder.
ALS
Rigidity and stiffness with resting tremor and masked facies.
Parkinson’s disease
The mainstay of Parkinson’s therapy.
Levodopa/carbidopa
Treatment for Guillain-Barre syndrome.
IVIG or plasmapheresis
Rigidity and stiffness that progress to choreiform movements, accompanied by moodiness and altered behavior.
Huntington’s disease
A six-year-old girl presents with a port-wine stain in the V2 distribution as well as with mental retardation, seizures, and leptomeningeal angioma.
Sturge-Weber syndrome. Treat symptomatically. Possible focal cerebral resection of affected lobe
Café-au-lait spots on skin.
Neurofibromatosis 1
Hyperphagia, hypersexuality, hyperorality, and hyperdocility.
Klüver-Bucy syndrome (amygdala)
Administer to a symptomatic patient to diagnose myasthenia gravis.
Edrophonium
1° causes of third-trimester bleeding.
Placental abruption and placenta previa
Classic ultrasound and gross appearance of complete hydatidiform mole.
Snowstorm on ultrasound. “Cluster-of-grapes” appearance on gross examination
Chromosomal pattern of a complete mole.
46,XX
Molar pregnancy containing fetal tissue.
Partial mole
Symptoms of placental abruption.
Continuous, painful vaginal bleeding
Symptoms of placenta previa.
Self-limited, painless vaginal bleeding
When should a vaginal exam be performed with suspected placenta previa?
Never
Antibiotics with teratogenic effects.
Tetracycline, fluoroquinolones, aminoglycosides, sulfonamides
Shortest AP diameter of the pelvis.
Obstetric conjugate: between the sacral promontory and the midpoint of the symphysis pubis
Medication given to accelerate fetal lung maturity.
Betamethasone or dexamethasone × 48 hours
The most common cause of postpartum hemorrhage.
Uterine atony
Treatment for postpartum hemorrhage.
Uterine massage; if that fails, give oxytocin
Typical antibiotics for group B streptococcus (GBS) prophylaxis.
IV penicillin or ampicillin
A patient fails to lactate after an emergency C-section with marked blood loss.
Sheehan’s syndrome (postpartum pituitary necrosis)
Uterine bleeding at 18 weeks’ gestation; no products expelled; membranes ruptured; cervical os open.
Inevitable abortion
Uterine bleeding at 18 weeks’ gestation; no products expelled; cervical os closed.
Threatened abortion
The first test to perform when a woman presents with amenorrhea.
β-hCG; the most common cause of amenorrhea is pregnancy
Term for heavy bleeding during and between menstrual periods.
Menometrorrhagia
Cause of amenorrhea with normal prolactin, no response to estrogen-progesterone challenge, and a history of D&C.
Asherman’s syndrome
Therapy for polycystic ovarian syndrome.
Weight loss and OCPs
Medication used to induce ovulation.
Clomiphene citrate
Diagnostic step required in a postmenopausal woman who presents with vaginal bleeding.
Endometrial biopsy
Indications for medical treatment of ectopic pregnancy.
Stable, unruptured ectopic pregnancy of < 3.5 cm at < 6 weeks’ gestation
Medical options for endometriosis.
OCPs, danazol, GnRH agonists
Laparoscopic findings in endometriosis.
“Chocolate cysts,” powder burns
The most common location for an ectopic pregnancy.
Ampulla of the oviduct
How to diagnose and follow a leiomyoma.
Ultrasound
Natural history of a leiomyoma.
Regresses after menopause
A patient has ↑ vaginal discharge and petechial patches in the upper vagina and cervix.
Trichomonas vaginitis
Treatment for bacterial vaginosis.
Oral or topical metronidazole
The most common cause of bloody nipple discharge.
Intraductal papilloma
Contraceptive methods that protect against PID.
OCP and barrier contraception
Unopposed estrogen is contraindicated in which cancers?
Endometrial or estrogen receptor– x0001 breast cancer
A patient presents with recent PID with RUQ pain.
Consider Fitz-Hugh–Curtis syndrome
Breast malignancy presenting as itching, burning, and erosion of the nipple.
Paget’s disease
Annual screening for women with a strong family history of ovarian cancer.
CA-125 and transvaginal ultrasound
A 50-year-old woman leaks urine when laughing or coughing. Nonsurgical options?
Kegel exercises, estrogen, pessaries for stress incontinence
A 30-year-old woman has unpredictable urine loss. Examination is normal. Medical options?
Anticholinergics (oxybutynin) or Beta-adrenergics (metaproterenol) for urge incontinence.
Lab values suggestive of menopause.
↑ serum FSH
The most common cause of female infertility.
Endometriosis
Two consecutive findings of atypical squamous cells of undetermined significance (ASCUS) on Pap smear. Follow-up evaluation?
Colposcopy and endocervical curettage
Breast cancer type that ↑ the future risk of invasive carcinoma in both breasts.
Lobular carcinoma in situ
Nontender abdominal mass associated with elevated VMA and HVA.
Neuroblastoma
The most common type of tracheoesophageal fistula (TEF). Diagnosis?
Esophageal atresia with distal TEF (85%). Unable to pass NG tube
Not contraindications to vaccination.
Mild illness and/or low-grade fever, current antibiotic therapy, and prematurity
Tests to rule out shaken baby syndrome.
Ophthalmologic exam, CT, and MRI
A neonate has meconium ileus.
CF or Hirschsprung’s disease
Bilious emesis within hours after the first feeding.
Duodenal atresia
A two-month-old presents with nonbilious projectile emesis. What are the appropriate steps in management?
Correct metabolic abnormalities. Then correct pyloric stenosis with pyloromyotomy
The most common 1° immunodeficiency.
Selective IgA deficiency
An infant has a high fever and onset of rash as fever breaks. What is he at risk for?
Febrile seizures (roseola infantum)
Acute-phase treatment for Kawasaki disease.
High-dose aspirin for inflammation and fever; IVIG to prevent coronary artery aneurysms
Treatment for mild and severe unconjugated hyperbilirubinemia.
Phototherapy (mild) or exchange transfusion (severe)
Sudden onset of mental status changes, emesis, and liver dysfunction after taking aspirin.
Reye’s syndrome
A child has loss of red light reflex. Diagnosis?
Suspect retinoblastoma
Vaccinations at a six-month well-child visit.
HBV, DTaP, Hib, IPV, PCV
Tanner stage 3 in a six-year-old female.
Precocious puberty
Infection of small airways with epidemics in winter and spring.
RSV bronchiolitis
Cause of neonatal RDS.
Surfactant deficiency