Remember 2

Question 1

diastolic decescendo murmur with pain sudden onset radiating to back - define mumur and dx

Answer 1

murmur: AR (dt dissection extending to AV)
dx: ascending aortic dissection

Question 2

best test to dx aortic dissection

Answer 2

Transesophageal echocardiogram

Question 3

what nerve courses through parotid gland? what happens if it is disrupted?

Answer 3

facial nerve (CN7).

Facial droop.

Question 4

Name encapsulated organisms.

Answer 4

SpHiN

strep pneum
Hemoph influ
Neisseria mening

Question 5

SE of OCPs in 5% of users.

tx?

Answer 5

HTN - ML due to estrogen mediated increase in hepatic angiotensinogen synthesis or RAAS.
Tx: d/c OCPs

Question 6

does myasthenia gravis affect men or women first? ages?

Answer 6

women - 10-30

men - 40-60

Question 7

treat Myasthenia with __?

Answer 7

AChE inhibitor - i.e. pyridostigmine.

Question 8

treatment for routine frostbite. added intervention if limb-threatening.

Answer 8

Rapid rewarming with warm water.

In severe cases thrombolysis recommended.

Question 9

Mom of newborn is positive for HBeAg, HBsAg, and IgM anti-HBsAg. Do what for baby?

Answer 9

Mom is HepB positive, so give baby HepB Immune globulin FOLLOWED BY Hep B vaccine.

Question 10

thrombolysis of a stroke in what time frame?

Answer 10

before 3 hrs

Question 11

Mom is RhD-ab negative. Do what when?

Answer 11

Give D-immune globulin at 28-32 weeks and then AGAIN w/i 72hrs of D+ infant or after SAB.

Question 12

GBS screening done when during gestation?

Answer 12

35-37weeks.

Question 13

+ anti-smooth muscle ab and + ANCA

Answer 13

autoimmune hepatitis

Question 14

+ anti mitochondrial ab

Answer 14

primary biliary cholangitis

Question 15

hyperpigmentation of sunexposed areas and genitals

Answer 15

hemochromatosis

Question 16

harsh systolic ejectin murmur over LUSB in a child (and a single S2)

Answer 16

tet - dt pulmonary stenosis.

singel S2 due to stenotic pulmn valve

Question 17

MCC of megaloblastic anemia in chronic alcoholics

Answer 17

folate deficiency

Question 18

fasciculations - what motor neuron damage?

Answer 18

lower

Question 19

weakness and muscle wasting - what motor neuron damage?

Answer 19

upper and lower

Question 20

spasticity, bulbar sx - what motor neuron damage?

Answer 20

upper.

hyperreflexia as well.

Question 21

distortion of straight lines so that they appear wavy - this is the earliest finding of what eye pathology?

Answer 21

macular degeneration

Question 22

MCC of acute epididymitis (unilateral testicular pain)

Answer 22

e. coli

Question 23

cast finding in a person with ischemia to the kidneys after shock

Answer 23

acute tubular necrosis that causes muddy brown casts

Question 24

nephrotic syndrome casts (maltese cross)

Answer 24

fatty casts (hyaline casts with fat inclusions due to breakdown of lipid-rich epithelial cells)

Question 25

A person with chronic renal failure has what type of casts?

Answer 25

broad and waxy

Question 26

how do you prevent uric acid stones in the future?

Answer 26

alkalinize urine with potassium citrate

Question 27

Impaired vibratory and positional sense, gait ataxia, megaloblastic anemia v. oculomotor findings (nystagmus), wide based gait ataxia and confusion/AMS

Answer 27

1. B12 deficiency | 2. thiamine (B1) deficiency

Question 28

causes of INCREASED MATERNAL SERUM AFP SCREENING

Answer 28

neural tube defects abdominal wall defects multiple gestation

Question 29

causes of decreased maternal serum AFP screening

Answer 29

aneuploidies

Question 30

high riding porstate, blood at urehtral meatus, inability ot void post trauma - think what dx and do what next?

Answer 30

pelvic fracture causing urethral tearing. do a retrograde urethrogram to visualize.

Question 31

delayed and diminished carotid pulse -

Answer 31

AORTIC STENOSIS (pulsus parvus et tardus)

Question 32

jarisch herxheimer can follow what infection treatment (three examples)?

Answer 32

any spirochetes - syphilis, borrelia, bartonella

Question 33

tx for allergic rhinitis

Answer 33

inhaled GC

Question 34

hemineglect syndrome:

Answer 34

right parietal lobe

Question 35

MCC of orbital cellulitis

Answer 35

bacterial sinusitis

Question 36

what does reye syndrome look like in teh liver?

Answer 36

after ASA, MICROvesicular steatosis (fatty infiltration)

Question 37

Name of condition and cause: encephalopathy, ocular dysfunction (slow pupil reactiion time), gait ataxia

Answer 37

wernicke encephalopathy dt Vit B1 (thiamine) - alchohol OR HYPEREMESIS GRAVIDUM

Question 38

femoral artery or vein aneurysm MC

Answer 38

artery. 2MC after popliteal aneurysm

Question 39

oxytocin AE v. magnesium AE

Answer 39

Oxytocin: hyponatremia, hypotension, tachysystole = SEIZURES Mg: hyporeflexia, lethargy, HA, CARDIAC ARREST when >8

Question 40

PTSD timeline

Answer 40

>=1mo

Question 41

False postive = 1- ____ | False negative = 1-___

Answer 41

``` FP = 1-specificity FN = 1-sensitivity ```

Question 42

Defference between DM neuropathy - small v. large fibers

Answer 42

small n injury = POSITIVE sx (pain, paresthesia) | Large n injury = NEGATIVE sx (numbness, loss of prop/vibr, decreased ankle refelxes)

Question 43

tx for myasthenic crisis

Answer 43

plasmapheresis

Question 44

Sorethroat, mornign hoarsenses, cough worse at night, need for albuterol following meals, has asthma. Dx?

Answer 44

GERD that causes microaspiration of gastric ocntents, leading to incr vagal tone and bronchial reactivity

Question 45

old person with BP 175/75. Etiology

Answer 45

this is Isolated Systolic HTN caused by atrial stiffness or decr elasticity in elderly

Question 46

what three things are associated with idiopathic increased intracranial pressure?

Answer 46

obese women of child bearing age, tetracyclines (doxycycline, isoretinoin (vit A - think acne).