S2 RR_4 Flashcards
Contraceptive methods that protect against PID.
OCP and barrier contraception
Unopposed estrogen is contraindicated in which cancers?
Endometrial or estrogen receptor- breast cancer
A patient presents with recent PID with RUQ pain.
Consider Fitz-Hugh-Curtis syndrome
Breast malignancy presenting as itching burning and erosion of the nipple.
Paget’s disease
Annual screening for women with a strong family history of ovarian cancer.
CA-125 and transvaginal ultrasound
A 50-year-old woman leaks urine when laughing or coughing. Nonsurgical options?
Kegel exercises estrogen pessaries for stress incontinence
A 30-year-old woman has unpredictable urine loss. Examination is normal. Medical options?
Anticholinergics (oxybutynin) or beta-adrenergics (metaproterenol) for urge incontinence.
Lab values suggestive of menopause.
inc’d serum FSH
The most common cause of female infertility.
Endometriosis
Two consecutive findings of atypical squamous cells of undetermined significance (ASCUS) on Pap smear. Follow-up evaluation?
Colposcopy and endocervical curettage
Breast cancer type that inc’s the future risk of invasive carcinoma in both breasts.
Lobular carcinoma in situ
Nontender abdominal mass associated with elevated VMA and HVA.
Neuroblastoma
The most common type of tracheoesophageal fistula (TEF). Diagnosis?
Esophageal atresia with distal TEF (85%). Unable to pass NG tube
Not contraindications to vaccination.
Mild illness and/or low-grade fever current antibiotic therapy and prematurity
Tests to rule out shaken baby syndrome.
Ophthalmologic exam CT and MRI
A neonate has meconium ileus.
CF or Hirschsprung’s disease
Bilious emesis within hours after the first feeding.
Duodenal atresia
A two-month-old presents with nonbilious projectile emesis. What are the appropriate steps in management?
Correct metabolic abnormalities. Then correct pyloric stenosis with pyloromyotomy
The most common 1Á immunodeficiency.
Selective IgA deficiency
An infant has a high fever and onset of rash as fever breaks. What is he at risk for?
Febrile seizures (roseola infantum)
Acute-phase treatment for Kawasaki disease.
High-dose aspirin for inflammation and fever; IVIG to prevent coronary artery aneurysms
Treatment for mild and severe unconjugated hyperbilirubinemia.
Phototherapy (mild) or exchange transfusion (severe)
Sudden onset of mental status changes emesis and liver dysfunction after taking aspirin.
Reye’s syndrome
A child has loss of red light reflex. Diagnosis?
Suspect retinoblastoma
Vaccinations at a six-month well-child visit.
HBV DTaP Hib IPV PCV
Tanner stage 3 in a six-year-old female.
Precocious puberty
Infection of small airways with epidemics in winter and spring.
RSV bronchiolitis
Cause of neonatal RDS.
Surfactant deficiency
What is the immunodeficiency? A boy has chronic respiratory infections. Nitroblue tetrazolium test is +.
Chronic granulomatous disease
What is the immunodeficiency? A child has eczema thrombocytopenia and high levels of IgA.
Wiskott-Aldrich syndrome
What is the immunodeficiency? A four-month-old boy has life-threatening Pseudomonas infection.
Bruton’s X-linked agammaglobulinemia
A condition associated with red currant-jelly stools.
Intussusception
A congenital heart disease that cause 2Á hypertension.
Coarctation of the aorta
First-line treatment for otitis media.
Amoxicillin x 10 days
The most common pathogen causing croup.
Parainfluenza virus type 1
A homeless child is small for his age and has peeling skin and a swollen belly.
Kwashiorkor (protein malnutrition)
Defect in an X-linked syndrome with mental retardation
Lesch-Nyhan syndrome (purine salvage problem with
gout self-mutilation and choreoathetosis.
HGPRTase deficiency)
A newborn female has continuous machinery murmur.
Patent ductus arteriosus (PDA)
First-line pharmacotherapy for depression.
SSRIs
Antidepressants associated with hypertensive crisis.
MAOIs
Galactorrhea impotence menstrual dysfunction and dec’d libido.
Patient on dopamine antagonist
A 17-year-old female has left arm paralysis after her boyfriend dies in a car crash. No medical cause is found.
Conversion disorder
Name the defense mechanism: A mother who is angry at her husband yells at her child.
Displacement
Name the defense mechanism: A pedophile enters a monastery.
Reaction formation
Name the defense mechanism: A woman calmly describes a grisly murder.
Isolation
Name the defense mechanism: A hospitalized 10-year-old begins to wet his bed.
Regression
Life-threatening muscle rigidity fever and rhabdomyolysis.
Neuroleptic malignant syndrome
Amenorrhea bradycardia and abnormal body image in a young female.
Anorexia
A 35-year-old male has recurrent episodes of palpitations diaphoresis and fear of going crazy.
Panic disorder
The most serious side effect of clozapine.
Agranulocytosis
A 21-year-old male has three months of social withdrawal worsening grades flattened affect and concrete thinking.
Schizophreniform disorder (diagnosis of schizophrenia requires _ 6 months of symptoms)
Key side effects of atypical antipsychotics.
Weight gain type 2 DM QT prolongation
A young weight lifter receives IV haloperidol and complains that his eyes are deviated sideways. Diagnosis? Treatment?
Acute dystonia (oculogyric crisis). Treat with benztropine or diphenhydramine
Medication to avoid in patients with a history of alcohol withdrawal seizures.
Neuroleptics
A 13-year-old male has a history of theft vandalism and violence toward family pets.
Conduct disorder
A five-month-old girl has dec’d head growth truncal dyscoordination and dec’d social interaction.
Rett’s disorder
A patient hasn’t slept for days lost $20000 gambling is agitated and has pressured speech. Diagnosis? Treatment?
Acute mania. Start a mood stabilizer (e.g. lithium)
After a minor fender bender a man wears a neck brace and requests permanent disability.
Malingering
A nurse presents with severe hypoglycemia; blood analysis reveals no elevation in C peptide.
Factitious disorder (Munchausen syndrome)
A patient continues to use cocaine after being in jail losing his job and not paying child support.
Substance abuse
A violent patient has vertical and horizontal nystagmus.
Phencyclidine hydrochloride (PCP) intoxication
A woman who was abused as a child frequently feels outside of or detached from her body.
Depersonalization disorder
A man has repeated intense urges to rub his body against unsuspecting passengers on a bus.
Frotteurism (a paraphilia)
A schizophrenic patient takes haloperidol for one year and develops uncontrollable tongue movements. Diagnosis? Treatment?
Tardive dyskinesia. Decrease or discontinue haloperidol and consider another antipsychotic (e.g. risperidone clozapine)
A man unexpectedly flies across the country takes a new name and has no memory of his prior life.
Dissociative fugue
Risk factors for DVT.
Stasis endothelial injury and hypercoagulability (Virchow’s triad)
Criteria for exudative effusion.
Pleural/serum protein > 0.5; pleural/serum LDH > 0.6
Causes of exudative effusion.
Think of leaky capillaries. Malignancy TB bacterial or viral infection pulmonary embolism with infarct and pancreatitis
Causes of transudative effusion.
Think of intact capillaries. CHF liver or kidney disease and protein-losing enteropathy
Normalizing PCO2 in a patient having an asthma exacerbation may indicate?
Fatigue and impending respiratory failure
Dyspnea lateral hilar lymphodenopathy on CXR noncaseating granulomas increased ACE and hypercalcemia.
Sarcoidosis
PFT showing dec’d FEV1/FVC.
Obstructive pulmonary disease (e.g. asthma)
PFT showing inc’d FEV1/FVC.
Restrictive pulmonary disease
Honeycomb pattern on CXR. Diagnosis? Treatment?
Diffuse interstitial pulmonary fibrosis. Supportive care. Steroids may help
Treatment for SVC syndrome.
Radiation
Treatment for mild persistent asthma.
Inhaled beta-agonists and inhaled corticosteroids
Acid-base disorder in pulmonary embolism.
Hypoxia and hypocarbia
Non-small cell lung cancer (NSCLC) associated with hypercalcemia.
Squamous cell carcinoma
Lung cancer associated with SIADH.
Small cell lung cancer (SCLC)
Lung cancer highly related to cigarette exposure.
SCLC
A tall white male presents with acute shortness of breath. Diagnosis? Treatment?
Spontaneous pneumothorax. Spontaneous regression. Supplemental O2 may be helpful
Treatment of tension pneumothorax.
Immediate needle thoracostomy
Characteristics favoring carcinoma in an isolated pulmonary nodule.
Age > 45-50 years; lesions new or larger in comparison to old films; absence of calcification or irregular calcification; size > 2 cm; irregular margins
Hypoxemia and pulmonary edema with normal pulmonary capillary wedge pressure.
ARDS
inc’d risk of what infection with silicosis?
Mycobacterium tuberculosis
Causes of hypoxemia.
Right-to-left shunt hypoventilation low inspired O2 tension diffusion defect V/Q mismatch
Classic CXR findings for pulmonary edema.
Cardiomegaly prominent pulmonary vessels Kerley B lines bat’s-wing appearance of hilar shadows and perivascular and peribronchial cuffing
Renal tubular acidosis (RTA) associated with abnormal H+ secretion and nephrolithiasis.
Type I (distal) RTA
RTA associated with abnormal HCO3 & rickets.
Type II (proximal) RTA
RTA associated with aldosterone defect.
Type IV (distal) RTA
Doughy skin.
Hypernatremia
Differential of hypervolemic hyponatremia.
Cirrhosis CHF nephritic syndrome
Chvostek’s and Trousseau’s signs.
Hypocalcemia
The most common causes of hypercalcemia.
Malignancy and hyperparathyroidism
T-wave flattening and U waves.
Hypokalemia
Peaked T waves and widened QRS.
Hyperkalemia
First-line treatment for moderate hypercalcemia.
IV hydration and loop diuretics (furosemide)
Type of ARF in a patient with FeNa < 1%.
Prerenal
A 49-year-old male presents with acute-onset flank pain and hematuria.
Nephrolithiasis
