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3rd Year_Step 2 Rapid Review > S2 RR_3 > Flashcards

S2 RR_3 Flashcards

1
Q

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

A

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

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2
Q

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

A

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

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3
Q

Risk factors for pyelonephritis.

A

Pregnancy vesicoureteral reflux anatomic anomalies indwelling catheters kidney stones

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4
Q

Neutropenic nadir postchemotherapy.

A

7-10 days

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5
Q

Erythema migrans.

A

Lesion of 1Á Lyme disease

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6
Q

Classic physical findings for endocarditis.

A

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

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7
Q

Aplastic crisis in sickle cell disease.

A

Parvovirus B19

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8
Q

Ring-enhancing brain lesion on CT with seizures

A

Taenia solium (cysticercosis)

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9
Q

Name the organism: Branching rods in oral infection.

A

Actinomyces israelii

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10
Q

Name the organism: Painful chancroid.

A

Haemophilus ducreyi

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11
Q

Name the organism: Dog or cat bite.

A

Pasteurella multocida

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12
Q

Name the organism: Gardener.

A

Sporothrix schenckii

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13
Q

Name the organism: Pregnant women with pets.

A

Toxoplasma gondii

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14
Q

Name the organism: Meningitis in adults.

A

Neisseria meningitidis

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15
Q

Name the organism: Meningitis in elderly.

A

Streptococcus pneumoniae

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16
Q

Name the organism: Alcoholic with pneumonia.

A

Klebsiella

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17
Q

Name the organism: Currant jelly sputum.

A

Klebsiella

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18
Q

Name the organism: Infection in burn victims.

A

Pseudomonas

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19
Q

Name the organism: Osteomyelitis from foot wound puncture.

A

Pseudomonas

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20
Q

Name the organism: Osteomyelitis in a sickle cell patient.

A

Salmonella

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21
Q

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?

A

Legionella pneumonia

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22
Q

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?

A

Lyme disease Ixodes tick doxycycline

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23
Q

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

A

S. aureus or S. epidermidis.

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24
Q

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

A

All-compartment fasciotomy for suspected compartment syndrome

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25
Q

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

A

Spinal stenosis

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26
Q

Joints in the hand affected in rheumatoid arthritis.

A

MCP and PIP joints; DIP joints are spared

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27
Q

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

A

Osteoarthritis

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28
Q

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

A

Osteogenesis imperfecta

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29
Q

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

A

Suspect ankylosing spondylitis. Check HLA-B27

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30
Q

Arthritis conjunctivitis and urethritis in young men. Associated organisms?

A

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

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31
Q

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

A

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

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32
Q

Rhomboid-shaped positively birefringent crystals on joint fluid aspirate.

A

Pseudogout

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33
Q

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 inc’d ESR.

A

Polymyalgia rheumatica

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34
Q

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

A

Osgood-Schlatter disease

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35
Q

Bone is fractured in fall on outstretched hand.

A

Distal radius (Colles’ fracture)

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36
Q

Complication of scaphoid fracture.

A

Avascular necrosis

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37
Q

Signs suggesting radial nerve damage with humeral fracture.

A

Wrist drop loss of thumb abduction

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38
Q

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

A

Duchenne muscular dystrophy

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39
Q

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

A

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

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40
Q

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

A

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

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41
Q

The most common 1Á malignant tumor of bone.

A

Multiple myeloma

42
Q

Unilateral severe periorbital headache with tearing and conjunctival erythema.

A

Cluster headache

43
Q

Prophylactic treatment for migraine.

A

beta-blockers Ca2+ channel blockers TCAs

44
Q

The most common pituitary tumor. Treatment?

A

Prolactinoma. Dopamine agonists (e.g. bromocriptine)

45
Q

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

A

Broca’s aphasia. Frontal lobe left MCA distribution

46
Q

The most common cause of SAH.

A

Trauma; the second most common is berry aneurysm

47
Q

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

A

Subdural hematomabridging veins torn

48
Q

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

A

Epidural hematoma. Middle meningeal artery. Neurosurgical evacuation

49
Q

CSF findings with SAH.

A

Elevated ICP RBCs xanthochromia

50
Q

Albuminocytologic dissociation.

A

Guillain-Barre (inc’d protein in CSF with only a modest increase in cell count)

51
Q

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

A

Normal

52
Q

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

A

Lung breast skin (melanoma) kidney GI tract

53
Q

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

A

Absence seizures

54
Q

The most frequent presentation of intracranial neoplasm.

A

Headache

55
Q

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

A

Infection febrile seizures trauma idiopathic

56
Q

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

A

Trauma alcohol withdrawal brain tumor

57
Q

First-line medication for status epilepticus.

A

IV benzodiazepine

58
Q

Confusion confabulation ophthalmoplegia ataxia.

A

Wernicke’s encephalopathy due to a deficiency of thiamine

59
Q

What % lesion is an indication for carotid endarterectomy?

A

Seventy percent if the stenosis is symptomatic

60
Q

The most common causes of dementia.

A

Alzheimer’s and multi-infarct

61
Q

Combined UMN and LMN disorder.

A

ALS

62
Q

Rigidity and stiffness with resting tremor and masked facies.

A

Parkinson’s disease

63
Q

The mainstay of Parkinson’s therapy.

A

Levodopa/carbidopa

64
Q

Treatment for Guillain-Barr_ syndrome.

A

IVIG or plasmapheresis

65
Q

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

A

Huntington’s disease

66
Q

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.

A

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

67
Q

Caf_-au-lait spots on skin.

A

Neurofibromatosis 1

68
Q

Hyperphagia hypersexuality hyperorality and hyperdocility.

A

KlÙver-Bucy syndrome (amygdala)

69
Q

Administer to a symptomatic patient to diagnose myasthenia gravis.

A

Edrophonium

70
Q

1Á causes of third-trimester bleeding.

A

Placental abruption and placenta previa

71
Q

Classic ultrasound and gross appearance of complete hydatidiform mole.

A

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

72
Q

Chromosomal pattern of a complete mole.

A

46XX

73
Q

Molar pregnancy containing fetal tissue.

A

Partial mole

74
Q

Symptoms of placental abruption.

A

Continuous painful vaginal bleeding

75
Q

Symptoms of placenta previa.

A

Self-limited painless vaginal bleeding

76
Q

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

A

Never

77
Q

Antibiotics with teratogenic effects.

A

Tetracycline fluoroquinolones aminoglycosides sulfonamides

78
Q

Shortest AP diameter of the pelvis.

A

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

79
Q

Medication given to accelerate fetal lung maturity.

A

Betamethasone or dexamethasone x 48 hours

80
Q

The most common cause of postpartum hemorrhage.

A

Uterine atony

81
Q

Treatment for postpartum hemorrhage.

A

Uterine massage; if that fails give oxytocin

82
Q

Typical antibiotics for group B streptococcus (GBS) prophylaxis.

A

IV penicillin or ampicillin

83
Q

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

A

Sheehan’s syndrome (postpartum pituitary necrosis)

84
Q

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

A

Inevitable abortion

85
Q

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

A

Threatened abortion

86
Q

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

A

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

87
Q

Term for heavy bleeding during and between menstrual periods.

A

Menometrorrhagia

88
Q

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

A

Asherman’s syndrome

89
Q

Therapy for polycystic ovarian syndrome.

A

Weight loss and OCPs

90
Q

Medication used to induce ovulation.

A

Clomiphene citrate

91
Q

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

A

Endometrial biopsy

92
Q

Indications for medical treatment of ectopic pregnancy.

A

Stable unruptured ectopic pregnancy of < 3.5 cm at < 6 weeks’ gestation

93
Q

Medical options for endometriosis.

A

OCPs danazol GnRH agonists

94
Q

Laparoscopic findings in endometriosis.

A

Chocolate cysts powder burns

95
Q

The most common location for an ectopic pregnancy.

A

Ampulla of the oviduct

96
Q

How to diagnose and follow a leiomyoma.

A

Ultrasound

97
Q

Natural history of a leiomyoma.

A

Regresses after menopause

98
Q

A patient has inc’d vaginal discharge and petechial patches in the upper vagina and cervix.

A

Trichomonas vaginitis

99
Q

Treatment for bacterial vaginosis.

A

Oral or topical metronidazole

100
Q

The most common cause of bloody nipple discharge.

A

Intraductal papilloma

3rd Year_Step 2 Rapid Review (5 decks)

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