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3rd Year_Step 2 Rapid Review > S2 RR_2 > Flashcards

S2 RR_2 Flashcards

1
Q

Fetal mortality?

A

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

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2
Q

Perinatal mortality?

A

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

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3
Q

Maternal mortality?

A

Number of deaths during pregnancy to 90 days postpartum per 100000 live births

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4
Q

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

A

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

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5
Q

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

A

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

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6
Q

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

A

Conflict of interest

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7
Q

Involuntary psychiatric hospitalization can be undertaken for which three reasons?

A

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

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8
Q

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

A

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

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9
Q

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

A

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

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10
Q

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

A

Treat immediately. Consent is implied in emergency situations

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11
Q

Conditions in which confidentiality must be overridden.

A

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

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12
Q

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

A

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

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13
Q

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

A

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

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14
Q

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

A

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

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15
Q

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

A

Emergent laparotomy to repair perforated viscus likely stomach

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16
Q

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

A

Diverticulosis

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17
Q

Diagnostic modality used when ultrasound is equivocal for cholecystitis.

A

HIDA scan

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18
Q

Sentinel loop on AXR.

A

Acute pancreatitis

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19
Q

Risk factors for cholelithiasis.

A

Fat female fertile forty flatulent

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20
Q

Inspiratory arrest during palpation of the RUQ.

A

Murphy’s sign seen in acute cholecystitis

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21
Q

Identify key organisms causing diarrhea: Most common organism

A

Campylobacter

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22
Q

Identify key organisms causing diarrhea: Recent antibiotic use

A

Clostridium difficile

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23
Q

Identify key organisms causing diarrhea: Camping

A

Giardia

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24
Q

Identify key organisms causing diarrhea: Traveler’s diarrhea

A

ETEC

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25
Q

Identify key organisms causing diarrhea: Church picnics/mayonnaise

A

S. aureus

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26
Q

Identify key organisms causing diarrhea: Uncooked hamburgers

A

E. coli O157:H7

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27
Q

Identify key organisms causing diarrhea: Fried rice

A

Bacillus cereus

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28
Q

Identify key organisms causing diarrhea: Poultry/eggs

A

Salmonella

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29
Q

Identify key organisms causing diarrhea: Raw seafood

A

Vibrio HAV

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30
Q

Identify key organisms causing diarrhea: AIDS

A

Isospora Cryptosporidium Mycobacterium avium complex (MAC)

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31
Q

Identify key organisms causing diarrhea: Pseudoappendicitis

A

Yersinia

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32
Q

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.

A

Crohn’s disease

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33
Q

Inflammatory disease of the colon with inc’d risk of colon cancer.

A

Ulcerative colitis

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34
Q

Extraintestinal manifestations of IBD.

A

Uveitis ankylosing spondylitis pyoderma gangrenosum erythema nodosum 1Á sclerosing cholangitis

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35
Q

Medical treatment for IBD.

A

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

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36
Q

Difference between Mallory-Weiss and Boerhaave tears.

A

Mallory-Weisssuperficial tear in the esophageal mucosa Boerhaavefull-thickness esophageal rupture

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37
Q

Charcot’s triad.

A

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

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38
Q

Reynolds’ pentad.

A

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

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39
Q

Medical treatment for hepatic encephalopathy.

A

Decrease protein intake lactulose neomycin

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40
Q

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

A

Establish the ABCs

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41
Q

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

A

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

42
Q

Post-HBV exposure treatment.

A

HBV immunoglobulin

43
Q

Classic causes of drug-induced hepatitis.

A

TB medications (INH rifampin pyrazinamide) acetaminophen and tetracycline

44
Q

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

A

Biliary tract obstruction

45
Q

Hernia with highest risk of incarcerationindirect direct or femoral?

A

Femoral hernia

46
Q

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?

A

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

47
Q

Four causes of microcytic anemia.

A

TICSThalassemia Iron deficiency anemia of Chronic disease and Sideroblastic anemia

48
Q

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

A

Fecal occult blood test and sigmoidoscopy; suspect colorectal cancer

49
Q

Precipitants of hemolytic crisis in patients with G6PD deficiency.

A

Sulfonamides antimalarial drugs fava beans

50
Q

The most common inherited cause of hypercoagulability.

A

Factor V Leiden mutation

51
Q

The most common inherited hemolytic anemia.

A

Hereditary spherocytosis

52
Q

Diagnostic test for hereditary spherocytosis.

A

Osmotic fragility test

53
Q

Pure RBC aplasia.

A

Diamond-Blackfan anemia

54
Q

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

A

Fanconi’s anemia

55
Q

Medications and viruses that worsen aplastic anemia.

A

Chloramphenicol sulfonamides radiation HIV chemotherapeutic agents hepatitis parvovirus B19 EBV

56
Q

How to distinguish polycythemia vera from secondary polycythemia.

A

Both have dec’d hematocrit and RBC mass but polycythemia vera should have normal O2 saturation and low erythropoietin levels

57
Q

Thrombotic thrombocytopenic purpura (TTP) pentad?

A

Pentad of TTPFAT RN: Fever Anemia Thrombocytopenia Renal dysfunction Neurologic abnormalities

58
Q

HUS triad?

A

Anemia thrombocytopenia and acute renal failure

59
Q

Treatment for TTP.

A

Emergent large-volume plasmapheresis corticosteroids antiplatelet drugs

60
Q

Treatment for idiopathic thrombocytopenic purpura (ITP) in children.

A

Usually resolves spontaneously; may require IVIG and/or corticosteroids

61
Q

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

A

Fibrin split products and D-dimer are elevated; platelets fibrinogen and hematocrit are dec’d.

62
Q

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

A

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

63
Q

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

A

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

64
Q

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

A

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

65
Q

Reed-Sternberg cells

A

Hodgkin’s lymphoma

66
Q

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

A

Non-Hodgkin’s lymphoma

67
Q

Microcytic anemia with dec’d serum iron dec’d total iron-binding capacity (TIBC) and normal or inc’d ferritin.

A

Anemia of chronic disease

68
Q

Microcytic anemia with dec’d serum iron dec’d ferritin and inc’d TIBC.

A

Iron deficiency anemia

69
Q

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

A

Chronic lymphocytic leukemia (CLL)

70
Q

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

A

Blast crisis (fever bone pain splenomegaly pancytopenia)

71
Q

Auer rods on blood smear.

A

Acute myelogenous leukemia (AML)

72
Q

AML subtype associated with DIC.

A

M3

73
Q

Electrolyte changes in tumor lysis syndrome.

A

dec’d Ca2+; inc’d K+ phosphate uric acid

74
Q

Treatment for AML M3.

A

Retinoic acid

75
Q

A 50-year-old male presents with early satiety splenomegaly and bleeding. Cytogenetics show t(922). Diagnosis?

A

CML

76
Q

Heinz bodies?

A

Intracellular inclusions seen in thalassemia G6PD deficiency and postsplenectomy

77
Q

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

A

Glanzmann’s thrombasthenia

78
Q

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

A

Parvovirus B19

79
Q

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

A

O2 analgesia hydration and if severe transfusion

80
Q

A significant cause of morbidity in thalassemia patients. Treatment?

A

Iron overload; use deferoxamine

81
Q

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

A

Infection cancer and autoimmune disease

82
Q

Four signs and symptoms of streptococcal pharyngitis.

A

Fever pharyngeal erythema tonsillar exudate lack of cough

83
Q

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

A

Postinfectious glomerulonephritis

84
Q

Asplenic patients are particularly susceptible to these organisms.

A

Encapsulated organisms–pneumococcus meningococcus Haemophilus influenzae Klebsiella

85
Q

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

A

105 bacteria/mL

86
Q

Which healthy population is susceptible to UTIs?

A

Pregnant women. Treat this group aggressively because of potential complications

87
Q

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

A

Coccidioidomycosis. Amphotericin B

88
Q

Nonpainful chancre.

A

1Á syphilis

89
Q

A blueberry muffin rash is characteristic of what congenital infection?

A

Rubella

90
Q

Meningitis in neonates. Causes? Treatment?

A

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

91
Q

Meningitis in infants. Causes? Treatment?

A

Pneumococcus meningococcus H. influenzae. Treat with cefotaxime and vancomycin

92
Q

What should always be done prior to LP?

A

Check for inc’d ICP; look for papilledema

93
Q

CSF findings: Low glucose PMN predominance

A

Bacterial meningitis

94
Q

CSF findings: Normal glucose lymphocytic predominance

A

Aseptic (viral) meningitis

95
Q

CSF findings: Numerous RBCs in serial CSF samples

A

Subarachnoid hemorrhage (SAH)

96
Q

CSF findings: inc’d gamma globulins

A

MS

97
Q

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

A

Cutaneous anthrax. Treat with penicillin G or ciprofloxacin

98
Q

Findings in 3Á syphilis.

A

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

99
Q

Characteristics of 2Á Lyme disease.

A

Arthralgias migratory polyarthropathies Bell’s palsy myocarditis

100
Q

Cold agglutinins.

A

Mycoplasma

3rd Year_Step 2 Rapid Review (5 decks)

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