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STEP 2 > Rapid Review > Flashcards

Rapid Review Flashcards

1
Q

Sawtooth P waves

A

Classic ECG finding in atrial flutter.

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2
Q

Angina is new, is worsening, or occurs at rest

A

Definition of unstable angina.

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3
Q

ACEI

A

Antihypertensive for a diabetic patient with proteinuria.

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4
Q

Hypotension, distant heart sounds, and JVD

A

Beck’s triad for cardiac tamponade.

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5
Q

β-blockers, digoxin, calcium channel blockers

A

Drugs that slow AV node transmission.

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6
Q

Niacin

A

Hypercholesterolemia treatment that → flushing and pruritus.

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7
Q

Anticoagulation, rate control, cardioversion

A

Treatment for atrial fibrillation.

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8
Q

Immediate cardioversion

A

Treatment for ventricular fibrillation.

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9
Q

Dressler’s syndrome: fever, pericarditis, ↑ ESR

A

Autoimmune complication occurring 2-4 weeks post-MI.

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10
Q

Treat existing heart failure and replace the tricuspid valve

A

IV drug use with JVD and holosystolic murmur at the left sternal border. Treatment?

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11
Q

Echocardiogram (showing thickened left ventricular wall and outflow obstruction)

A

Diagnostic test for hypertrophic cardiomyopathy.

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12
Q

Pulsus paradoxus (seen in cardiac tamponade)

A

A fall in systolic BP of > 10 mmHg with inspiration.

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13
Q

Low-voltage, diffuse ST-segment elevation

A

Classic ECG findings in pericarditis.

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14
Q

BP > 140/90 on three separate occasions two weeks apart

A

Definition of hypertension.

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15
Q

Renal artery stenosis, coarctation of the aorta, pheochromocytoma, Conn’s syndrome, Cushing’s syndrome, unilateral renal parenchymal disease, hyperthyroidism, hyperparathyroidism

A

Eight surgically correctable causes of hypertension.

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16
Q

Abdominal ultrasound and CT

A

Evaluation of a pulsatile abdominal mass and bruit.

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17
Q

> 5.5 cm, rapidly enlarging, symptomatic, or ruptured

A

Indications for surgical repair of abdominal aortic aneurysm.

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18
Q

Morphine, O2, sublingual nitroglycerin, ASA, IV β-blockers, heparin

A

Treatment for acute coronary syndrome.

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19
Q

Abdominal obesity, high triglycerides, low HDL, hypertension, insulin resistance, prothrombotic or proinflammatory states

A

What is the metabolic syndrome?

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20
Q

Exercise stress treadmill with ECG

A

Appropriate diagnostic test? ■ A 50-year-old male with angina can exercise to 85% of maximum predicted heart rate.

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21
Q

Pharmacologic stress test (e.g., dobutamine echo)

A

Appropriate diagnostic test? ■ A 65-year-old woman with left bundle branch block and severe osteoarthritis has unstable angina.

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22
Q

Angina, ST-segment changes on ECG, or ↓ BP

A

Signs of active ischemia during stress testing.

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23
Q

ST-segment elevation (depression means ischemia), flattened T waves, and Q waves

A

ECG findings suggesting MI.

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24
Q

Prinzmetal’s angina

A

A young patient has angina at rest with ST-segment elevation. Cardiac enzymes are normal.

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25
Q

CHF, shock, and altered mental status

A

Common symptoms associated with silent MIs.

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26
Q

V/Q scan

A

The diagnostic test for pulmonary embolism.

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27
Q

Protamine

A

An agent that reverses the effects of heparin.

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28
Q

PT

A

The coagulation parameter affected by warfarin.

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29
Q

Hypertrophic cardiomyopathy

A

A young patient with a family history of sudden death collapses and dies while exercising.

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30
Q

Oral surgery—amoxicillin; GI or GU procedures—ampicillin and gentamicin before and amoxicillin after

A

Endocarditis prophylaxis regimens.

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31
Q

Pain, pallor, pulselessness, paralysis, paresthesia, poikilothermia

A

The 6 P’s of ischemia due to peripheral vascular disease.

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32
Q

Stasis, hypercoagulability, endothelial damage

A

Virchow’s triad.

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33
Q

OCPs

A

The most common cause of hypertension in young women.

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34
Q

Excessive EtOH

A

The most common cause of hypertension in young men.

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35
Q

Seborrheic keratosis

A

Stuck-on appearance.

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36
Q

Psoriasis

A

Red plaques with silvery-white scales and sharp margins.

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37
Q

Basal cell carcinoma

A

The most common type of skin cancer; the lesion is a pearly-colored papule with a translucent surface and telangiectasias.

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38
Q

Impetigo

A

Honey-crusted lesions.

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39
Q

Cellulitis

A

A febrile patient with a history of diabetes presents with a red, swollen, painful lower extremity.

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40
Q

Pemphigus vulgaris

A

ERROR!

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41
Q

Bullous pemphigoid

A
  • Nikolsky’s sign.
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42
Q

Acanthosis nigricans. Check fasting blood sugar to rule out diabetes

A

A 55-year-old obese patient presents with dirty, velvety patches on the back of the neck.

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43
Q

Varicella zoster

A

Dermatomal distribution.

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44
Q

Lichen planus

A

Flat-topped papules.

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45
Q

Erythema multiforme

A

Iris-like target lesions.

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46
Q

Contact dermatitis

A

A lesion characteristically occurring in a linear pattern in areas where skin comes into contact with clothing or jewelry.

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47
Q

Pityriasis rosea

A

Presents with a herald patch, Christmas-tree pattern.

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48
Q

Alopecia areata (autoimmune process)

A

A 16-year-old presents with an annular patch of alopecia with broken-off, stubby hairs.

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49
Q

Pityriasis versicolor

A

Pinkish, scaling, flat lesions on the chest and back. KOH prep has a “spaghetti-and-meatballs” appearance.

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50
Q

Asymmetry, border irregularity, color variation, large diameter

A

Four characteristics of a nevus suggestive of melanoma.

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51
Q

Actinic keratosis

A

Premalignant lesion from sun exposure that can → squamous cell carcinoma.

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52
Q

Lesions of 1° varicella

A

Dewdrop on a rose petal.

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53
Q

Seborrheic dermatitis. Treat with antifungals

A

Cradle cap.

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54
Q

Acne vulgaris

A

Associated with Propionibacterium acnes and changes in androgen levels.

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55
Q

Herpes simplex

A

A painful, recurrent vesicular eruption of mucocutaneous surfaces.

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56
Q

Lichen sclerosus

A

Inflammation and epithelial thinning of the anogenital area, predominantly in postmenopausal women.

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57
Q

Squamous cell carcinoma

A

Exophytic nodules on the skin with varying degrees of scaling or ulceration; the second most common type of skin cancer.

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58
Q

Hashimoto’s thyroiditis

A

The most common cause of hypothyroidism.

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59
Q

High TSH, low T4, antimicrosomal antibodies

A

Lab findings in Hashimoto’s thyroiditis.

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60
Q

Graves’ disease

A

Exophthalmos, pretibial myxedema, and ↓ TSH.

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61
Q

Iatrogenic steroid administration. The second most common cause is Cushing’s disease

A

The most common cause of Cushing’s syndrome.

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62
Q

Hypoparathyroidism

A

A patient presents with signs of hypocalcemia, high phosphorus, and low PTH.

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63
Q

Signs and symptoms of hypercalcemia

A

Stones, bones, groans, psychiatric overtones.

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64
Q

1° hyperaldosteronism (due to Conn’s syndrome or bilateral adrenal hyperplasia)

A

A patient complains of headache, weakness, and polyuria; exam reveals hypertension and tetany. Labs reveals hypernatremia, hypokalemia, and metabolic alkalosis.

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65
Q

Pheochromocytoma

A

A patient presents with tachycardia, wild swings in BP, headache, diaphoresis, altered mental status, and a sense of panic.

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66
Q

α-antagonists (phentolamine and phenoxybenzamine)

A

Should α- or β-antagonists be used first in treating pheochromocytoma?

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67
Q

Nephrogenic diabetes insipidus (DI)

A

A patient with a history of lithium use presents with copious amounts of dilute urine.

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68
Q

Administration of DDAVP ↓ serum osmolality and free water restriction

A

Treatment of central DI.

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69
Q

SIADH due to stress

A

A postoperative patient with significant pain presents with hyponatremia and normal volume status.

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70
Q

Metformin

A

An antidiabetic agent associated with lactic acidosis.

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71
Q

1° adrenal insufficiency (Addison’s disease). Treat with replacement glucocorticoids, mineralocorticoids, and IV fluids

A

A patient presents with weakness, nausea, vomiting, weight loss, and new skin pigmentation. Labs show hyponatremia and hyperkalemia. Treatment?

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72
Q
A

Goal hemoglobin A1c for a patient with DM.

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73
Q

Fluids, insulin, and aggressive replacement of electrolytes (e.g., K+)

A

Treatment of DKA.

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74
Q

They can mask symptoms of hypoglycemia

A

Why are β-blockers contraindicated in diabetics?

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75
Q

Observational bias

A

Bias introduced into a study when a clinician is aware of the patient’s treatment type.

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76
Q

Lead-time bias

A

Bias introduced when screening detects a disease earlier and thus lengthens the time from diagnosis to death.

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77
Q

Confounding variable

A

If you want to know if race affects infant mortality rate but most of the variation in infant mortality is predicted by socioeconomic status, then socioeconomic status is a _____.

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78
Q

Sensitivity

A

The number of true positives divided by the number of patients with the disease is _____.

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79
Q

Out

A

Sensitive tests have few false negatives and are used to rule _____ a disease.

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80
Q

Highly sensitive for TB

A

PPD reactivity is used as a screening test because most people with TB (except those who are anergic) will have a +PPD. Highly sensitive or specific?

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81
Q

Higher prevalence

A

Chronic diseases such as SLE—higher prevalence or incidence?

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82
Q

Higher incidence

A

Epidemics such as influenza—higher prevalence or incidence?

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83
Q

Prevalence

A

Cross-sectional survey—incidence or prevalence?

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84
Q

Incidence and prevalence

A

Cohort study—incidence or prevalence?

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85
Q

Neither

A

Case-control study—incidence or prevalence?

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86
Q

High reliability, low validity

A

Describe a test that consistently gives identical results, but the results are wrong.

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87
Q

Cohort studies can be used to calculate relative risk (RR), incidence, and/or odds ratio (OR). Case-control studies can be used to calculate an OR

A

Difference between a cohort and a case-control study.

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88
Q

The incidence rate (IR) of a disease in exposed − the IR of a disease in unexposed

A

Attributable risk?

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89
Q

The IR of a disease in a population exposed to a particular factor ÷ the IR of those not exposed

A

Relative risk?

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90
Q

The likelihood of a disease among individuals exposed to a risk factor compared to those who have not been exposed

A

Odds ratio?

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91
Q

1 ÷ (rate in untreated group − rate in treated group)

A

Number needed to treat?

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92
Q

Patients with IBD; those with familial adenomatous polyposis (FAP)/hereditary nonpolyposis colorectal cancer (HNPCC); and those who have first-degree relatives with adenomatous polyps (

A

In which patients do you initiate colorectal cancer screening early?

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93
Q

Prostate cancer is the most common cancer in men, but lung cancer causes more deaths

A

The most common cancer in men and the most common cause of death from cancer in men.

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94
Q

68%, 95.5%, 99.7%

A

The percentage of cases within one SD of the mean? Two SDs? Three SDs?

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95
Q

Number of live births per 1000 population

A

Birth rate?

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96
Q

Number of live births per 1000 women 15-44 years of age

A

Fertility rate?

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97
Q

Number of deaths per 1000 population

A

Mortality rate?

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98
Q

Number of deaths from birth to 28 days per 1000 live births

A

Neonatal mortality?

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99
Q

Number of deaths from 28 days to one year per 1000 live births

A

Postnatal mortality?

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100
Q

Number of deaths from birth to one year of age per 1000 live births (neonatal + postnatal mortality)

A

Infant mortality?

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101
Q

Number of deaths from 20 weeks’ gestation to birth per 1000 total births

A

Fetal mortality?

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102
Q

Number of deaths from 20 weeks’ gestation to one month of life per 1000 total births

A

Perinatal mortality?

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103
Q

Number of deaths during pregnancy to 90 days postpartum per 100,000 live births

A

Maternal mortality?

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104
Q

False. Patients may change their minds at any time. Exceptions to the requirement of informed consent include emergency situations and patients without decision-making capacity

A

True or false: Once patients sign a statement giving consent, they must continue treatment.

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105
Q

No. Parental consent is not necessary for the medical treatment of pregnant minors

A

A 15-year-old pregnant girl requires hospitalization for preeclampsia. Should her parents be informed?

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106
Q

Conflict of interest

A

A doctor refers a patient for an MRI at a facility he/she owns.

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107
Q

The patient is a danger to self, a danger to others, or gravely disabled (unable to provide for basic needs)

A

Involuntary psychiatric hospitalization can be undertaken for which three reasons?

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108
Q

False. Withdrawing and withholding life are the same from an ethical standpoint

A

True or false: Withdrawing life-sustaining care is ethically distinct from withholding sustaining care.

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109
Q

When there is no rationale for treatment, maximal intervention is failing, a given intervention has already failed, and treatment will not achieve the goals of care

A

When can a physician refuse to continue treating a patient on the grounds of futility?

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110
Q

Treat immediately. Consent is implied in emergency situations

A

An eight-year-old child is in a serious accident. She requires emergent transfusion, but her parents are not present.

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111
Q

Real threat of harm to third parties; suicidal intentions; certain contagious diseases; elder and child abuse

A

Conditions in which confidentiality must be overridden.

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112
Q

When treatment noncompliance represents a serious danger to public health (e.g., active TB)

A

Involuntary commitment or isolation for medical treatment may be undertaken for what reason?

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113
Q

Treat because the disease represents an immediate threat to the child’s life. Then seek a court order

A

A 10-year-old child presents in status epilepticus, but her parents refuse treatment on religious grounds.

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114
Q

A patient’s family cannot require that a doctor withhold information from the patient

A

A son asks that his mother not be told about her recently discovered cancer.

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115
Q

Emergent laparotomy to repair perforated viscus, likely stomach

A

Patient presents with sudden onset of severe, diffuse abdominal pain. Exam reveals peritoneal signs and AXR reveals free air under the diaphragm. Management?

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116
Q

Diverticulosis

A

The most likely cause of acute lower GI bleed in patients > 40 years old.

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117
Q

HIDA scan

A

Diagnostic modality used when ultrasound is equivocal for cholecystitis.

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118
Q

Acute pancreatitis

A

Sentinel loop on AXR.

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119
Q

Fat, female, fertile, forty, flatulent

A

Risk factors for cholelithiasis.

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120
Q

Murphy’s sign, seen in acute cholecystitis

A

Inspiratory arrest during palpation of the RUQ.

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121
Q

Campylobacter

A

Identify key organisms causing diarrhea: ■ Most common organism

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122
Q

Clostridium difficile

A

Identify key organisms causing diarrhea: ■ Recent antibiotic use

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123
Q

Giardia

A

Identify key organisms causing diarrhea: ■ Camping

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124
Q

ETEC

A

Identify key organisms causing diarrhea: ■ Traveler’s diarrhea

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125
Q

S. aureus

A

Identify key organisms causing diarrhea: ■ Church picnics/mayonnaise

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126
Q

E. coli O157:H7

A

Identify key organisms causing diarrhea: ■ Uncooked hamburgers

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127
Q

Bacillus cereus

A

Identify key organisms causing diarrhea: ■ Fried rice

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128
Q

Salmonella

A

Identify key organisms causing diarrhea: ■ Poultry/eggs

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129
Q

Vibrio, HAV

A

Identify key organisms causing diarrhea: ■ Raw seafood

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130
Q

Isospora, Cryptosporidium, Mycobacterium avium complex (MAC)

A

Identify key organisms causing diarrhea: ■ AIDS

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131
Q

Yersinia

A

Identify key organisms causing diarrhea: ■ Pseudoappendicitis

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132
Q

Crohn’s disease

A

A 25-year-old Jewish male presents with pain and watery diarrhea after meals. Exam shows fistulas between the bowel and skin and nodular lesions on his tibias.

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133
Q

Ulcerative colitis

A

Inflammatory disease of the colon with ↑ risk of colon cancer.

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134
Q

Uveitis, ankylosing spondylitis, pyoderma gangrenosum, erythema nodosum, 1° sclerosing cholangitis

A

Extraintestinal manifestations of IBD.

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135
Q

5-aminosalicylic acid +/− sulfasalazine and steroids during acute exacerbations

A

Medical treatment for IBD.

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136
Q

Mallory-Weiss—superficial tear in the esophageal mucosa Boerhaave—full-thickness esophageal rupture

A

Difference between Mallory-Weiss and Boerhaave tears.

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137
Q

RUQ pain, jaundice, and fever/chills in the setting of ascending cholangitis

A

Charcot’s triad.

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138
Q

Charcot’s triad plus shock and mental status changes, with suppurative ascending cholangitis

A

Reynolds’ pentad.

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139
Q

↓ protein intake, lactulose, neomycin

A

Medical treatment for hepatic encephalopathy.

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140
Q

Establish the ABCs

A

First step in the management of a patient with acute GI bleed.

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141
Q

Hemolytic-uremic syndrome (HUS) due to E. coli O157:H7

A

A four-year-old child presents with oliguria, petechiae, and jaundice following an illness with bloody diarrhea. Most likely diagnosis and cause?

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142
Q

HBV immunoglobulin

A

Post-HBV exposure treatment.

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143
Q

TB medications (INH, rifampin, pyrazinamide), acetaminophen, and tetracycline

A

Classic causes of drug-induced hepatitis.

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144
Q

Biliary tract obstruction

A

A 40-year-old obese female with elevated alkaline phosphatase, elevated bilirubin, pruritus, dark urine, and clay-colored stools.

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145
Q

Femoral hernia

A

Hernia with highest risk of incarceration—indirect, direct, or femoral?

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146
Q

Confirm the diagnosis of acute pancreatitis with elevated amylase and lipase. Make patient NPO and give IV fluids, O2, analgesia, and “tincture of time”

A

A 50-year-old man with a history of alcohol abuse presents with boring epigastric pain that radiates to the back and is relieved by sitting forward. Management?

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147
Q

TICS—Thalassemia, Iron deficiency, anemia of Chronic disease, and Sideroblastic anemia

A

Four causes of microcytic anemia.

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148
Q

Fecal occult blood test and sigmoidoscopy; suspect colorectal cancer

A

An elderly male with hypochromic, microcytic anemia is asymptomatic. Diagnostic tests?

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149
Q

Sulfonamides, antimalarial drugs, fava beans

A

Precipitants of hemolytic crisis in patients with G6PD deficiency.

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150
Q

Factor V Leiden mutation

A

The most common inherited cause of hypercoagulability.

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151
Q

Hereditary spherocytosis

A

The most common inherited hemolytic anemia.

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152
Q

Osmotic fragility test

A

Diagnostic test for hereditary spherocytosis.

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153
Q

Diamond-Blackfan anemia

A

Pure RBC aplasia.

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154
Q

Fanconi’s anemia

A

Anemia associated with absent radii and thumbs, diffuse hyperpigmentation, café-au-lait spots, microcephaly, and pancytopenia.

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155
Q

Chloramphenicol, sulfonamides, radiation, HIV, chemotherapeutic agents, hepatitis, parvovirus B19, EBV

A

Medications and viruses that → aplastic anemia.

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156
Q

Both have ↑ hematocrit and RBC mass, but polycythemia vera should have normal O2 saturation and low erythropoietin levels

A

How to distinguish polycythemia vera from 2° polycythemia.

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157
Q

Pentad of TTP—”FAT RN”: Fever, Anemia, Thrombocytopenia, Renal dysfunction, Neurologic abnormalities

A

Thrombotic thrombocytopenic purpura (TTP) pentad?

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158
Q

Anemia, thrombocytopenia, and acute renal failure

A

HUS triad?

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159
Q

Emergent large-volume plasmapheresis, corticosteroids, antiplatelet drugs

A

Treatment for TTP.

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160
Q

Usually resolves spontaneously; may require IVIG and/or corticosteroids

A

Treatment for idiopathic thrombocytopenic purpura (ITP) in children.

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161
Q

Fibrin split products and D-dimer are elevated; platelets, fibrinogen, and hematocrit are ↓.

A

Which of the following are ↑ in DIC: fibrin split products, D-dimer, fibrinogen, platelets, and hematocrit.

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162
Q

Hemophilia A or B; consider desmopressin (for hemophilia A) or factor VIII or IX supplements

A

An eight-year-old boy presents with hemarthrosis and ↑ PTT with normal PT and bleeding time. Diagnosis? Treatment?

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163
Q

von Willebrand’s disease; treat with desmopressin, FFP, or cryoprecipitate

A

A 14-year-old girl presents with prolonged bleeding after dental surgery and with menses, normal PT, normal or ↑ PTT, and ↑ bleeding time. Diagnosis? Treatment?

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164
Q

Monoclonal gammopathy, Bence Jones proteinuria, “punched-out” lesions on x-ray of the skull and long bones

A

A 60-year-old African-American male presents with bone pain. Workup for multiple myeloma might reveal?

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165
Q

Hodgkin’s lymphoma

A

Reed-Sternberg cells

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166
Q

Non-Hodgkin’s lymphoma

A

A 10-year-old boy presents with fever, weight loss, and night sweats. Examination shows anterior mediastinal mass. Suspected diagnosis?

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167
Q

Anemia of chronic disease

A

Microcytic anemia with ↓ serum iron, ↓ total iron-binding capacity (TIBC), and normal or ↑ ferritin.

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168
Q

Iron deficiency anemia

A

Microcytic anemia with ↓ serum iron, ↓ ferritin, and ↑ TIBC.

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169
Q

Chronic lymphocytic leukemia (CLL)

A

An 80-year-old man presents with fatigue, lymphadenopathy, splenomegaly, and isolated lymphocytosis. Suspected diagnosis?

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170
Q

Blast crisis (fever, bone pain, splenomegaly, pancytopenia)

A

A late, life-threatening complication of chronic myelogenous leukemia (CML).

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171
Q

Acute myelogenous leukemia (AML)

A

Auer rods on blood smear.

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172
Q

M3

A

AML subtype associated with DIC.

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173
Q

↓ Ca2+ , ↑ K− , ↑ phosphate, ↑ uric acid

A

Electrolyte changes in tumor lysis syndrome.

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174
Q

Retinoic acid

A

Treatment for AML M3.

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175
Q

CML

A

A 50-year-old male presents with early satiety, splenomegaly, and bleeding. Cytogenetics show t(9,22). Diagnosis?

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176
Q

Intracellular inclusions seen in thalassemia, G6PD deficiency, and postsplenectomy

A

Heinz bodies?

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177
Q

Glanzmann’s thrombasthenia

A

An autosomal-recessive disorder with a defect in the GPIIbIIIa platelet receptor and ↓ platelet aggregation.

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178
Q

Parvovirus B19

A

Virus associated with aplastic anemia in patients with sickle cell anemia.

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179
Q

O2, analgesia, hydration, and, if severe, transfusion

A

A 25-year-old African-American male with sickle cell anemia has sudden onset of bone pain. Management of pain crisis?

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180
Q

Iron overload; use deferoxamine

A

A significant cause of morbidity in thalassemia patients. Treatment?

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181
Q

Infection, cancer, and autoimmune disease

A

The three most common causes of fever of unknown origin (FUO).

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182
Q

Fever, pharyngeal erythema, tonsillar exudate, lack of cough

A

Four signs and symptoms of streptococcal pharyngitis.

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183
Q

Postinfectious glomerulonephritis

A

A nonsuppurative complication of streptococcal infection that is not altered by treatment of 1° infection.

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184
Q

Encapsulated organisms–pneumococcus, meningococcus, Haemophilus influenzae, Klebsiella

A

Asplenic patients are particularly susceptible to these organisms.

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185
Q

105 bacteria/mL

A

The number of bacterial culture on a clean-catch specimen to diagnose a UTI.

186
Q

Pregnant women. Treat this group aggressively because of potential complications

A

Which healthy population is susceptible to UTIs?

187
Q

Coccidioidomycosis. Amphotericin B

A

A patient from California or Arizona presents with fever, malaise, cough, and night sweats. Diagnosis? Treatment?

188
Q

1° syphilis

A

Nonpainful chancre.

189
Q

Rubella

A

A “blueberry muffin” rash is characteristic of what congenital infection?

190
Q

Group B strep, E. coli, Listeria. Treat with gentamicin and ampicillin

A

Meningitis in neonates. Causes? Treatment?

191
Q

Pneumococcus, meningococcus, H. influenzae. Treat with cefotaxime and vancomycin

A

Meningitis in infants. Causes? Treatment?

192
Q

Check for ↑ ICP; look for papilledema

A

What should always be done prior to LP?

193
Q

Bacterial meningitis

A

CSF findings: ■ Low glucose, PMN predominance

194
Q

Aseptic (viral) meningitis

A

CSF findings: ■ Normal glucose, lymphocytic predominance

195
Q

Subarachnoid hemorrhage (SAH)

A

CSF findings: ■ Numerous RBCs in serial CSF samples

196
Q

MS

A

CSF findings: ■ ↑ gamma globulins

197
Q

Cutaneous anthrax. Treat with penicillin G or ciprofloxacin

A

Initially presents with a pruritic papule with regional lymphadenopathy and evolves into a black eschar after 7-10 days. Treatment?

198
Q

Tabes dorsalis, general paresis, gummas, Argyll Robertson pupil, aortitis, aortic root aneurysms

A

Findings in 3° syphilis.

199
Q

Arthralgias, migratory polyarthropathies, Bell’s palsy, myocarditis

A

Characteristics of 2° Lyme disease.

200
Q

Mycoplasma

A

Cold agglutinins.

201
Q

Candidal thrush. Workup should include an HIV test. Treat with nystatin oral suspension

A

A 24-year-old male presents with soft white plaques on his tongue and the back of his throat. Diagnosis? Workup? Treatment?

202
Q

≤ 200 for PCP (with TMP); ≤ 50-100 for MAI (with clarithromycin/azithromycin)

A

Begin Pneumocystis carinii pneumonia (PCP) prophylaxis in an HIV-positive patient at what CD4 count? Mycobacterium avium-intracellulare (MAI) prophylaxis?

203
Q

Pregnancy, vesicoureteral reflux, anatomic anomalies, indwelling catheters, kidney stones

A

Risk factors for pyelonephritis.

204
Q

7-10 days

A

Neutropenic nadir postchemotherapy.

205
Q

Lesion of 1° Lyme disease

A

Erythema migrans.

206
Q

Fever, heart murmur, Osler’s nodes, splinter hemorrhages, Janeway lesions, Roth’s spots

A

Classic physical findings for endocarditis.

207
Q

Parvovirus B19

A

Aplastic crisis in sickle cell disease.

208
Q

Taenia solium (cysticercosis)

A

Ring-enhancing brain lesion on CT with seizures

209
Q

Actinomyces israelii

A

Name the organism: ■ Branching rods in oral infection.

210
Q

Haemophilus ducreyi

A

Name the organism: ■ Painful chancroid.

211
Q

Pasteurella multocida

A

Name the organism: ■ Dog or cat bite.

212
Q

Sporothrix schenckii

A

Name the organism: ■ Gardener.

213
Q

Toxoplasma gondii

A

Name the organism: ■ Pregnant women with pets.

214
Q

Neisseria meningitidis

A

Name the organism: ■ Meningitis in adults.

215
Q

Streptococcus pneumoniae

A

Name the organism: ■ Meningitis in elderly.

216
Q

Klebsiella

A

Name the organism: ■ Alcoholic with pneumonia.

217
Q

Klebsiella

A

Name the organism: ■ “Currant jelly” sputum.

218
Q

Pseudomonas

A

Name the organism: ■ Infection in burn victims.

219
Q

Pseudomonas

A

Name the organism: ■ Osteomyelitis from foot wound puncture.

220
Q

Salmonella

A

Name the organism: ■ Osteomyelitis in a sickle cell patient.

221
Q

Legionella pneumonia

A

A 55-year-old man who is a smoker and a heavy drinker presents with a new cough and flulike symptoms. Gram stain shows no organisms; silver stain of sputum shows gram-negative rods. What is the diagnosis?

222
Q

Lyme disease, Ixodes tick, doxycycline

A

A middle-aged man presents with acute-onset monoarticular joint pain and bilateral Bell’s palsy. What is the likely diagnosis, and how did he get it? Treatment?

223
Q

S. aureus or S. epidermidis.

A

A patient develops endocarditis three weeks after receiving a prosthetic heart valve. What organism is suspected?

224
Q

All-compartment fasciotomy for suspected compartment syndrome

A

A patient presents with pain on passive movement, pallor, poikilothermia, paresthesias, paralysis, and pulselessness. Treatment?

225
Q

Spinal stenosis

A

Back pain that is exacerbated by standing and walking and relieved with sitting and hyperflexion of the hips.

226
Q

MCP and PIP joints; DIP joints are spared

A

Joints in the hand affected in rheumatoid arthritis.

227
Q

Osteoarthritis

A

Joint pain and stiffness that worsen over the course of the day and are relieved by rest.

228
Q

Osteogenesis imperfecta

A

Genetic disorder associated with multiple fractures and commonly mistaken for child abuse.

229
Q

Suspect ankylosing spondylitis. Check HLA-B27

A

Hip and back pain along with stiffness that improves with activity over the course of the day and worsens at rest. Diagnostic test?

230
Q

Reactive (Reiter’s) arthritis. Associated with Campylobacter, Shigella, Salmonella, Chlamydia, and Ureaplasma

A

Arthritis, conjunctivitis, and urethritis in young men. Associated organisms?

231
Q

Gout. Needle-shaped, negatively birefringent crystals are seen on joint fluid aspirate. Chronic treatment with allopurinol or probenecid

A

A 55-year-old man has sudden, excruciating first MTP joint pain after a night of drinking red wine. Diagnosis, workup, and chronic treatment?

232
Q

Pseudogout

A

Rhomboid-shaped, positively birefringent crystals on joint fluid aspirate.

233
Q

Polymyalgia rheumatica

A

An elderly female presents with pain and stiffness of the shoulders and hips; she cannot lift her arms above her head. Labs show anemia and ↑ ESR.

234
Q

Osgood-Schlatter disease

A

An active 13-year-old boy has anterior knee pain. Diagnosis?

235
Q

Distal radius (Colles’ fracture)

A

Bone is fractured in fall on outstretched hand.

236
Q

Avascular necrosis

A

Complication of scaphoid fracture.

237
Q

Wrist drop, loss of thumb abduction

A

Signs suggesting radial nerve damage with humeral fracture.

238
Q

Duchenne muscular dystrophy

A

A young child presents with proximal muscle weakness, waddling gait, and pronounced calf muscles.

239
Q

Developmental dysplasia of the hip. If severe, consider a Pavlik harness to maintain abduction

A

A first-born female who was born in breech position is found to have asymmetric skin folds on her newborn exam. Diagnosis? Treatment?

240
Q

Slipped capital femoral epiphyses. AP and frog-leg lateral view

A

An 11-year-old obese, African-American boy presents with sudden onset of limp. Diagnosis? Workup?

241
Q

Multiple myeloma

A

The most common 1° malignant tumor of bone.

242
Q

Cluster headache

A

Unilateral, severe periorbital headache with tearing and conjunctival erythema.

243
Q

β-blockers, Ca2+ channel blockers, TCAs

A

Prophylactic treatment for migraine.

244
Q

Prolactinoma. Dopamine agonists (e.g., bromocriptine)

A

The most common pituitary tumor. Treatment?

245
Q

Broca’s aphasia. Frontal lobe, left MCA distribution

A

A 55-year-old patient presents with acute “broken speech.” What type of aphasia? What lobe and vascular distribution?

246
Q

Trauma; the second most common is berry aneurysm

A

The most common cause of SAH.

247
Q

Subdural hematoma—bridging veins torn

A

A crescent-shaped hyperdensity on CT that does not cross the midline.

248
Q

Epidural hematoma. Middle meningeal artery. Neurosurgical evacuation

A

A history significant for initial altered mental status with an intervening lucid interval. Diagnosis? Most likely etiology? Treatment?

249
Q

Elevated ICP, RBCs, xanthochromia

A

CSF findings with SAH.

250
Q

Guillain-Barré (↑ protein in CSF with only a modest ↑ in cell count)

A

Albuminocytologic dissociation.

251
Q

Normal

A

Cold water is flushed into a patient’s ear, and the fast phase of the nystagmus is toward the opposite side. Normal or pathological?

252
Q

Lung, breast, skin (melanoma), kidney, GI tract

A

The most common 1° sources of metastases to the brain.

253
Q

Absence seizures

A

May be seen in children who are accused of inattention in class and confused with ADHD.

254
Q

Headache

A

The most frequent presentation of intracranial neoplasm.

255
Q

Infection, febrile seizures, trauma, idiopathic

A

The most common cause of seizures in children (2-10 years).

256
Q

Trauma, alcohol withdrawal, brain tumor

A

The most common cause of seizures in young adults (18-35 years).

257
Q

IV benzodiazepine

A

First-line medication for status epilepticus.

258
Q

Wernicke’s encephalopathy due to a deficiency of thiamine

A

Confusion, confabulation, ophthalmoplegia, ataxia.

259
Q

Seventy percent if the stenosis is symptomatic

A

What % lesion is an indication for carotid endarterectomy?

260
Q

Alzheimer’s and multi-infarct

A

The most common causes of dementia.

261
Q

ALS

A

Combined UMN and LMN disorder.

262
Q

Parkinson’s disease

A

Rigidity and stiffness with resting tremor and masked facies.

263
Q

Levodopa/carbidopa

A

The mainstay of Parkinson’s therapy.

264
Q

IVIG or plasmapheresis

A

Treatment for Guillain-Barré syndrome.

265
Q

Huntington’s disease

A

Rigidity and stiffness that progress to choreiform movements, accompanied by moodiness and altered behavior.

266
Q

Sturge-Weber syndrome. Treat symptomatically. Possible focal cerebral resection of affected lobe

A

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.

267
Q

Neurofibromatosis 1

A

Café-au-lait spots on skin.

268
Q

Klüver-Bucy syndrome (amygdala)

A

Hyperphagia, hypersexuality, hyperorality, and hyperdocility.

269
Q

Edrophonium

A

Administer to a symptomatic patient to diagnose myasthenia gravis.

270
Q

Placental abruption and placenta previa

A

1° causes of third-trimester bleeding.

271
Q

Snowstorm on ultrasound. “Cluster-of-grapes” appearance on gross examination

A

Classic ultrasound and gross appearance of complete hydatidiform mole.

272
Q

46,XX

A

Chromosomal pattern of a complete mole.

273
Q

Partial mole

A

Molar pregnancy containing fetal tissue.

274
Q

Continuous, painful vaginal bleeding

A

Symptoms of placental abruption.

275
Q

Self-limited, painless vaginal bleeding

A

Symptoms of placenta previa.

276
Q

Never

A

When should a vaginal exam be performed with suspected placenta previa?

277
Q

Tetracycline, fluoroquinolones, aminoglycosides, sulfonamides

A

Antibiotics with teratogenic effects.

278
Q

Obstetric conjugate: between the sacral promontory and the midpoint of the symphysis pubis

A

Shortest AP diameter of the pelvis.

279
Q

Betamethasone or dexamethasone × 48 hours

A

Medication given to accelerate fetal lung maturity.

280
Q

Uterine atony

A

The most common cause of postpartum hemorrhage.

281
Q

Uterine massage; if that fails, give oxytocin

A

Treatment for postpartum hemorrhage.

282
Q

IV penicillin or ampicillin

A

Typical antibiotics for group B streptococcus (GBS) prophylaxis.

283
Q

Sheehan’s syndrome (postpartum pituitary necrosis)

A

A patient fails to lactate after an emergency C-section with marked blood loss.

284
Q

Inevitable abortion

A

Uterine bleeding at 18 weeks’ gestation; no products expelled; membranes ruptured; cervical os open.

285
Q

Threatened abortion

A

Uterine bleeding at 18 weeks’ gestation; no products expelled; cervical os closed.

286
Q

β-hCG; the most common cause of amenorrhea is pregnancy

A

The first test to perform when a woman presents with amenorrhea.

287
Q

Menometrorrhagia

A

Term for heavy bleeding during and between menstrual periods.

288
Q

Asherman’s syndrome

A

Cause of amenorrhea with normal prolactin, no response to estrogen-progesterone challenge, and a history of D&C.

289
Q

Weight loss and OCPs

A

Therapy for polycystic ovarian syndrome.

290
Q

Clomiphene citrate

A

Medication used to induce ovulation.

291
Q

Endometrial biopsy

A

Diagnostic step required in a postmenopausal woman who presents with vaginal bleeding.

292
Q

Stable, unruptured ectopic pregnancy of

A

Indications for medical treatment of ectopic pregnancy.

293
Q

OCPs, danazol, GnRH agonists

A

Medical options for endometriosis.

294
Q

Chocolate cysts, powder burns

A

Laparoscopic findings in endometriosis.

295
Q

Ampulla of the oviduct

A

The most common location for an ectopic pregnancy.

296
Q

Ultrasound

A

How to diagnose and follow a leiomyoma.

297
Q

Regresses after menopause

A

Natural history of a leiomyoma.

298
Q

Trichomonas vaginitis

A

A patient has ↑ vaginal discharge and petechial patches in the upper vagina and cervix.

299
Q

Oral or topical metronidazole

A

Treatment for bacterial vaginosis.

300
Q

Intraductal papilloma

A

The most common cause of bloody nipple discharge.

301
Q

OCP and barrier contraception

A

Contraceptive methods that protect against PID.

302
Q

Endometrial or estrogen receptor- breast cancer

A

Unopposed estrogen is contraindicated in which cancers?

303
Q

Consider Fitz-Hugh-Curtis syndrome

A

A patient presents with recent PID with RUQ pain.

304
Q

Paget’s disease

A

Breast malignancy presenting as itching, burning, and erosion of the nipple.

305
Q

CA-125 and transvaginal ultrasound

A

Annual screening for women with a strong family history of ovarian cancer.

306
Q

Kegel exercises, estrogen, pessaries for stress incontinence

A

A 50-year-old woman leaks urine when laughing or coughing. Nonsurgical options?

307
Q

Anticholinergics (oxybutynin) or β-adrenergics (metaproterenol) for urge incontinence.

A

A 30-year-old woman has unpredictable urine loss. Examination is normal. Medical options?

308
Q

↑ serum FSH

A

Lab values suggestive of menopause.

309
Q

Endometriosis

A

The most common cause of female infertility.

310
Q

Colposcopy and endocervical curettage

A

Two consecutive findings of atypical squamous cells of undetermined significance (ASCUS) on Pap smear. Follow-up evaluation?

311
Q

Lobular carcinoma in situ

A

Breast cancer type that ↑ the future risk of invasive carcinoma in both breasts.

312
Q

Neuroblastoma

A

Nontender abdominal mass associated with elevated VMA and HVA.

313
Q

Esophageal atresia with distal TEF (85%). Unable to pass NG tube

A

The most common type of tracheoesophageal fistula (TEF). Diagnosis?

314
Q

Mild illness and/or low-grade fever, current antibiotic therapy, and prematurity

A

Not contraindications to vaccination.

315
Q

Ophthalmologic exam, CT, and MRI

A

Tests to rule out shaken baby syndrome.

316
Q

CF or Hirschsprung’s disease

A

A neonate has meconium ileus.

317
Q

Duodenal atresia

A

Bilious emesis within hours after the first feeding.

318
Q

Correct metabolic abnormalities. Then correct pyloric stenosis with pyloromyotomy

A

A two-month-old presents with nonbilious projectile emesis. What are the appropriate steps in management?

319
Q

Selective IgA deficiency

A

The most common 1° immunodeficiency.

320
Q

Febrile seizures (roseola infantum)

A

An infant has a high fever and onset of rash as fever breaks. What is he at risk for?

321
Q

High-dose aspirin for inflammation and fever; IVIG to prevent coronary artery aneurysms

A

Acute-phase treatment for Kawasaki disease.

322
Q

Phototherapy (mild) or exchange transfusion (severe)

A

Treatment for mild and severe unconjugated hyperbilirubinemia.

323
Q

Reye’s syndrome

A

Sudden onset of mental status changes, emesis, and liver dysfunction after taking aspirin.

324
Q

Suspect retinoblastoma

A

A child has loss of red light reflex. Diagnosis?

325
Q

HBV, DTaP, Hib, IPV, PCV

A

Vaccinations at a six-month well-child visit.

326
Q

Precocious puberty

A

Tanner stage 3 in a six-year-old female.

327
Q

RSV bronchiolitis

A

Infection of small airways with epidemics in winter and spring.

328
Q

Surfactant deficiency

A

Cause of neonatal RDS.

329
Q

Chronic granulomatous disease

A

What is the immunodeficiency? ■ A boy has chronic respiratory infections. Nitroblue tetrazolium test is +.

330
Q

Wiskott-Aldrich syndrome

A

What is the immunodeficiency? ■ A child has eczema, thrombocytopenia, and high levels of IgA.

331
Q

Bruton’s X-linked agammaglobulinemia

A

What is the immunodeficiency? ■ A four-month-old boy has life-threatening Pseudomonas infection.

332
Q

Intussusception

A

A condition associated with red “currant-jelly” stools.

333
Q

Coarctation of the aorta

A

A congenital heart disease that cause 2° hypertension.

334
Q

Amoxicillin × 10 days

A

First-line treatment for otitis media.

335
Q

Parainfluenza virus type 1

A

The most common pathogen causing croup.

336
Q

Kwashiorkor (protein malnutrition)

A

A homeless child is small for his age and has peeling skin and a swollen belly.

337
Q

Lesch-Nyhan syndrome (purine salvage problem with

A

Defect in an X-linked syndrome with mental retardation,

338
Q

HGPRTase deficiency)

A

gout, self-mutilation, and choreoathetosis.

339
Q

Patent ductus arteriosus (PDA)

A

A newborn female has continuous “machinery murmur.”

340
Q

SSRIs

A

First-line pharmacotherapy for depression.

341
Q

MAOIs

A

Antidepressants associated with hypertensive crisis.

342
Q

Patient on dopamine antagonist

A

Galactorrhea, impotence, menstrual dysfunction, and ↓ libido.

343
Q

Conversion disorder

A

A 17-year-old female has left arm paralysis after her boyfriend dies in a car crash. No medical cause is found.

344
Q

Displacement

A

Name the defense mechanism: ■ A mother who is angry at her husband yells at her child.

345
Q

Reaction formation

A

Name the defense mechanism: ■ A pedophile enters a monastery.

346
Q

Isolation

A

Name the defense mechanism: ■ A woman calmly describes a grisly murder.

347
Q

Regression

A

Name the defense mechanism: ■ A hospitalized 10-year-old begins to wet his bed.

348
Q

Neuroleptic malignant syndrome

A

Life-threatening muscle rigidity, fever, and rhabdomyolysis.

349
Q

Anorexia

A

Amenorrhea, bradycardia, and abnormal body image in a young female.

350
Q

Panic disorder

A

A 35-year-old male has recurrent episodes of palpitations, diaphoresis, and fear of going crazy.

351
Q

Agranulocytosis

A

The most serious side effect of clozapine.

352
Q

Schizophreniform disorder (diagnosis of schizophrenia requires ≥ 6 months of symptoms)

A

A 21-year-old male has three months of social withdrawal, worsening grades, flattened affect, and concrete thinking.

353
Q

Weight gain, type 2 DM, QT prolongation

A

Key side effects of atypical antipsychotics.

354
Q

Acute dystonia (oculogyric crisis). Treat with benztropine or diphenhydramine

A

A young weight lifter receives IV haloperidol and complains that his eyes are deviated sideways. Diagnosis? Treatment?

355
Q

Neuroleptics

A

Medication to avoid in patients with a history of alcohol withdrawal seizures.

356
Q

Conduct disorder

A

A 13-year-old male has a history of theft, vandalism, and violence toward family pets.

357
Q

Rett’s disorder

A

A five-month-old girl has ↓ head growth, truncal dyscoordination, and ↓ social interaction.

358
Q

Acute mania. Start a mood stabilizer (e.g., lithium)

A

A patient hasn’t slept for days, lost $20,000 gambling, is agitated, and has pressured speech. Diagnosis? Treatment?

359
Q

Malingering

A

After a minor fender bender, a man wears a neck brace and requests permanent disability.

360
Q

Factitious disorder (Munchausen syndrome)

A

A nurse presents with severe hypoglycemia; blood analysis reveals no elevation in C peptide.

361
Q

Substance abuse

A

A patient continues to use cocaine after being in jail, losing his job, and not paying child support.

362
Q

Phencyclidine hydrochloride (PCP) intoxication

A

A violent patient has vertical and horizontal nystagmus.

363
Q

Depersonalization disorder

A

A woman who was abused as a child frequently feels outside of or detached from her body.

364
Q

Frotteurism (a paraphilia)

A

A man has repeated, intense urges to rub his body against unsuspecting passengers on a bus.

365
Q

Tardive dyskinesia. ↓ or discontinue haloperidol and consider another antipsychotic (e.g., risperidone, clozapine)

A

A schizophrenic patient takes haloperidol for one year and develops uncontrollable tongue movements. Diagnosis? Treatment?

366
Q

Dissociative fugue

A

A man unexpectedly flies across the country, takes a new name, and has no memory of his prior life.

367
Q

Stasis, endothelial injury and hypercoagulability (Virchow’s triad)

A

Risk factors for DVT.

368
Q

Pleural/serum protein > 0.5; pleural/serum LDH > 0.6

A

Criteria for exudative effusion.

369
Q

Think of leaky capillaries. Malignancy, TB, bacterial or viral infection, pulmonary embolism with infarct, and pancreatitis

A

Causes of exudative effusion.

370
Q

Think of intact capillaries. CHF, liver or kidney disease, and protein-losing enteropathy

A

Causes of transudative effusion.

371
Q

Fatigue and impending respiratory failure

A

Normalizing PCO2 in a patient having an asthma exacerbation may indicate?

372
Q

Sarcoidosis

A

Dyspnea, lateral hilar lymphodenopathy on CXR, noncaseating granulomas, increased ACE, and hypercalcemia.

373
Q

Obstructive pulmonary disease (e.g., asthma)

A

PFT showing ↓ FEV1/FVC.

374
Q

Restrictive pulmonary disease

A

PFT showing ↑ FEV1/FVC.

375
Q

Diffuse interstitial pulmonary fibrosis. Supportive care. Steroids may help

A

Honeycomb pattern on CXR. Diagnosis? Treatment?

376
Q

Radiation

A

Treatment for SVC syndrome.

377
Q

Inhaled β-agonists and inhaled corticosteroids

A

Treatment for mild, persistent asthma.

378
Q

Hypoxia and hypocarbia

A

Acid-base disorder in pulmonary embolism.

379
Q

Squamous cell carcinoma

A

Non-small cell lung cancer (NSCLC) associated with hypercalcemia.

380
Q

Small cell lung cancer (SCLC)

A

Lung cancer associated with SIADH.

381
Q

SCLC

A

Lung cancer highly related to cigarette exposure.

382
Q

Spontaneous pneumothorax. Spontaneous regression. Supplemental O2 may be helpful

A

A tall white male presents with acute shortness of breath. Diagnosis? Treatment?

383
Q

Immediate needle thoracostomy

A

Treatment of tension pneumothorax.

384
Q

Age > 45-50 years; lesions new or larger in comparison to old films; absence of calcification or irregular calcification; size > 2 cm; irregular margins

A

Characteristics favoring carcinoma in an isolated pulmonary nodule.

385
Q

ARDS

A

Hypoxemia and pulmonary edema with normal pulmonary capillary wedge pressure.

386
Q

Mycobacterium tuberculosis

A

↑ risk of what infection with silicosis?

387
Q

Right-to-left shunt, hypoventilation, low inspired O2 tension, diffusion defect, V/Q mismatch

A

Causes of hypoxemia.

388
Q

Cardiomegaly, prominent pulmonary vessels, Kerley B lines, “bat’s-wing” appearance of hilar shadows, and perivascular and peribronchial cuffing

A

Classic CXR findings for pulmonary edema.

389
Q

Type I (distal) RTA

A

Renal tubular acidosis (RTA) associated with abnormal H+ secretion and nephrolithiasis.

390
Q

Type II (proximal) RTA

A

RTA associated with abnormal HCO3 − and rickets.

391
Q

Type IV (distal) RTA

A

RTA associated with aldosterone defect.

392
Q

Hypernatremia

A

Doughy skin.

393
Q

Cirrhosis, CHF, nephritic syndrome

A

Differential of hypervolemic hyponatremia.

394
Q

Hypocalcemia

A

Chvostek’s and Trousseau’s signs.

395
Q

Malignancy and hyperparathyroidism

A

The most common causes of hypercalcemia.

396
Q

Hypokalemia

A

T-wave flattening and U waves.

397
Q

Hyperkalemia

A

Peaked T waves and widened QRS.

398
Q

IV hydration and loop diuretics (furosemide)

A

First-line treatment for moderate hypercalcemia.

399
Q

Prerenal

A

Type of ARF in a patient with FeNa

400
Q

Nephrolithiasis

A

A 49-year-old male presents with acute-onset flank pain and hematuria.

401
Q

Calcium oxalate

A

The most common type of nephrolithiasis.

402
Q

Cerebral berry aneurysms (AD PCKD)

A

A 20-year-old man presents with a palpable flank mass and hematuria. Ultrasound shows bilateral enlarged kidneys with cysts. Associated brain anomaly?

403
Q

Nephritic syndrome

A

Hematuria, hypertension, and oliguria.

404
Q

Nephrotic syndrome

A

Proteinuria, hypoalbuminemia, hyperlipidemia, hyperlipiduria, edema.

405
Q

Membranous glomerulonephritis

A

The most common form of nephritic syndrome.

406
Q

IgA nephropathy (Berger’s disease)

A

The most common form of glomerulonephritis.

407
Q

Alport’s syndrome

A

Glomerulonephritis with deafness.

408
Q

Wegener’s granulomatosis and Goodpasture’s syndrome

A

Glomerulonephritis with hemoptysis.

409
Q

Glomerulonephritis/nephritic syndrome

A

Presence of red cell casts in urine sediment.

410
Q

Allergic interstitial nephritis

A

Eosinophils in urine sediment.

411
Q

Nephrotic syndrome

A

Waxy casts in urine sediment and Maltese crosses (seen with lipiduria).

412
Q

Uremic syndrome seen in patients with renal failure

A

Drowsiness, asterixis, nausea, and a pericardial friction rub.

413
Q

Wait, surgical resection, radiation and/or androgen suppression

A

A 55-year-old man is diagnosed with prostate cancer. Treatment options?

414
Q

DI

A

Low urine specific gravity in the presence of high serum osmolality.

415
Q

Fluid restriction, demeclocycline

A

Treatment of SIADH?

416
Q

Renal cell carcinoma (RCC)

A

Hematuria, flank pain, and palpable flank mass.

417
Q

Choriocarcinoma

A

Testicular cancer associated with β-hCG, AFP.

418
Q

Seminoma—a type of germ cell tumor

A

The most common type of testicular cancer.

419
Q

Transitional cell carcinoma

A

The most common histology of bladder cancer.

420
Q

Central pontine myelinolysis

A

Complication of overly rapid correction of hyponatremia.

421
Q

Anion gap acidosis and 1° respiratory alkalosis due to central respiratory stimulation

A

Salicylate ingestion → in what type of acid-base disorder?

422
Q

Respiratory alkalosis

A

Acid-base disturbance commonly seen in pregnant women.

423
Q

DM, SLE, and amyloidosis

A

Three systemic diseases → nephrotic syndrome.

424
Q

RCC or other erythropoietin-producing tumor; evaluate with CT scan

A

Elevated erythropoietin level, elevated hematocrit, and normal O2 saturation suggest?

425
Q

Likely BPH. Options include no treatment, terazosin, finasteride, or surgical intervention (TURP)

A

A 55-year-old man presents with irritative and obstructive urinary symptoms. Treatment options?

426
Q

Antipsychotics (neuroleptic malignant syndrome)

A

Class of drugs that may cause syndrome of muscle rigidity, hyperthermia, autonomic instability, and extrapyramidal symptoms.

427
Q

Acute mania, immunosuppression, thin skin, osteoporosis, easy bruising, myopathies

A

Side effects of corticosteroids.

428
Q

Benzodiazepines

A

Treatment for DTs.

429
Q

N-acetylcysteine

A

Treatment for acetaminophen overdose.

430
Q

Naloxone

A

Treatment for opioid overdose.

431
Q

Flumazenil

A

Treatment for benzodiazepine overdose.

432
Q

Dantrolene or bromocriptine

A

Treatment for neuroleptic malignant syndrome.

433
Q

Nitroprusside

A

Treatment for malignant hypertension.

434
Q

Rate control, rhythm conversion, and anticoagulation

A

Treatment of AF.

435
Q

Rate control with carotid massasge or other vagal stimulation

A

Treatment of supraventricular tachycardia (SVT).

436
Q

INH, penicillamine, hydralazine, procainamide

A

Causes of drug-induced SLE.

437
Q

B12 deficiency

A

Macrocytic, megaloblastic anemia with neurologic symptoms.

438
Q

Folate deficiency

A

Macrocytic, megaloblastic anemia without neurologic symptoms.

439
Q

Treat CO poisoning with 100% O2 or with hyperbaric O2 if severe poisoning or pregnant

A

A burn patient presents with cherry-red flushed skin and coma. SaO2 is normal, but carboxyhemoglobin is elevated. Treatment?

440
Q

Bladder rupture or urethral injury

A

Blood in the urethral meatus or high-riding prostate.

441
Q

Retrograde cystourethrogram

A

Test to rule out urethral injury.

442
Q

Widened mediastinum (> 8 cm), loss of aortic knob, pleural cap, tracheal deviation to the right, depression of left main stem bronchus

A

Radiographic evidence of aortic disruption or dissection.

443
Q

Free air under the diaphragm, extravasation of contrast, severe bowl distention, space-occupying lesion (CT), mesenteric occlusion (angiography)

A

Radiographic indications for surgery in patients with acute abdomen.

444
Q

Pseudomonas

A

The most common organism in burn-related infections.

445
Q

Parkland formula

A

Method of calculating fluid repletion in burn patients.

446
Q

50 cc/hour

A

Acceptable urine output in a trauma patient.

447
Q

30 cc/hour

A

Acceptable urine output in a stable patient.

448
Q

Third-degree heart block

A

Cannon “a” waves.

449
Q

Hypotension and bradycardia

A

Signs of neurogenic shock.

450
Q

Hypertension, bradycardia, and abnormal respirations

A

Signs of ↑ ICP (Cushing’s triad).

451
Q

Hypovolemic shock

A

↓ CO, ↓ pulmonary capillary wedge pressure (PCWP), ↑ peripheral vascular resistance (PVR).

452
Q

Cardiogenic shock

A

↓ CO, ↑ PCWP, ↑ PVR.

453
Q

Septic or anaphylactic shock

A

↑ CO, ↓ PCWP, ↓ PVR.

454
Q

Fluids and antibiotics

A

Treatment of septic shock.

455
Q

Identify cause; pressors (e.g., dobutamine)

A

Treatment of cardiogenic shock.

456
Q

Identify cause; fluid and blood repletion

A

Treatment of hypovolemic shock.

457
Q

Diphenhydramine or epinephrine 1:1000

A

Treatment of anaphylactic shock.

458
Q

Continuous positive airway pressure

A

Supportive treatment for ARDS.

459
Q

A patient with chest trauma who was previously stable suddenly dies

A

Signs of air embolism.

460
Q

AP chest, AP/lateral C-spine, AP pelvis

A

Trauma series.

STEP 2 (3 decks)

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