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Step 2 CK > Second 100 > Flashcards

Second 100 Flashcards

1
Q

Pt with newly diagnosed diabetes, hepatomegaly and joint complaints - think what first?
Initial test?

A

Hemochromatosis

Serum iron studies

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2
Q

Theophylline -

  1. which 2 abx interacts, and how?
  2. Toxicity symptoms?
  3. Stimulates release of …?
A
  1. Cipro and erythromycin decreases clearance, raising levels
  2. HA, insomnia, N/V and arrhythmias
  3. Stimulates epinephrine release
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2
Q

Biggest risk factor for pancreatic cancer?

A

Smoking

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3
Q

Pt with splinter hemorrhages

  1. Most common diagnosis
  2. Secondary diagnosis - what sets it apart?
A
  1. Endocarditis

2. Trichinosis - if pt also has triad of periorbital edema, myositis and eosinophilia (peomeo?) - caused by roundworm

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4
Q

Timeline for alcoholic hallucinations?

A

Starts 12-24 hrs after last drink, stops 24-48hrs after

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5
Q

Treatment for bipolar disease (2)?

What side effects do they have?

A

Lithium or valproic acid

Lithium - nephrotoxicity (DI), hypothyroidism, Ebstein’s anomaly
Also psoriasis flares, hair loss, tremors

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6
Q

Kid with chronic middle ear infections and worsening hearing loss, granulation tissue and skin debris

A

Cholesteatoma

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7
Q

Hypertension, dilated pupils, psychosis, tachycardia - drug?

A

Amphetamines

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8
Q

Common kidney injury following shock?

What shows on UA?

A

ATN (acute tubular necrosis)

Muddy brown casts

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9
Q

What kidney injury goes with:

1) muddy brown casts
2) RBC casts
3) WBC casts
4) fatty casts
5) broad and waxy casts

A

1) ATN
2) glomeluronephritis
3) interstitial nephritis & pyelonephritis
4) nephrotic syndrome
5) chronic renal failure

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10
Q

Older patient presenting with gradual loss of CENTRAL vision
Diagnosis?
Results from ..?

A

1) Macular degeneration

2) Degen and atrophy of outer retina, pigment epithelium,bruch’s membrane and choriocapillaries

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11
Q

Sickle cell with bone pain

1) with fever - 2 causes
2) WITHOUT fever - most common cause

A

1) Salmonella or Staph

2) Avascular necrosis

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12
Q

Bleeding in the third trimester

1) without pain
2) with pain

A

1) no pain - placenta previa

2) painful - abruptio placentae

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13
Q

Contact dermatitis is what type of reaction?

A

Type FOUR, IV, 4

Not type 1

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14
Q

What is a high LAP (leukocyte alkaline phosphatase) indicative of?

Used to steer AWAY from what?

A

Leukomoid reaction

Steer away from leukemias, even with blast crises

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15
Q

DoC for syphilils? What if pt is allergic?

A

Penicillin G IM

If allergic, oral doxycycline

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16
Q

DoC for neurosyphilis?

A

IV aqueous crystalline penicillin

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17
Q

MCV <80 with:

1) Low iron & ferritin, high TIBC
2) Normal to high iron & ferritin
3) Low TIBC, normal ferritin

A

1) iron deficiency anemia
2) thalassemias OR sideroblastic anemia
3) anemia of chronic disease

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18
Q

Anaerobic, gram-positive,branching bacteria?

Treatment?

A

Actinomyces israelii

IV PCN

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19
Q

Motor and sensory function of femoral nerve

A

Hip flexion, knee extension

Medial thigh and knee

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20
Q

Motor and sensory innervation of superficial peroneal nerve

A

Foot eversion

Lateral lower leg and foot

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21
Q

Motor and sensory innervation of deep peroneal nerve

A

Foot dorsiflexion, toe extension

Area between big and 2nd toe

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22
Q

What does tocolysis do?

A

Used to delay preterm delivery

TOGO = NOGO

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23
Q

Lower limit of hemoglobin to maintain oxygentation?

When will this be higher?

A

7g/L in normal people

In those with pre-existing heart disease, it is 10g/L

If the Hgb is lower than these, give packed red blood cells!

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24
Q

Which vitamin is used to treat measles?

A

Vit. A

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25
Q

How does mastitis differ from normal breast engorgement? (3 things)
How are plugged ducts different?
Treatment of mastitis?

A

Mastitis is 1. unilateral, with an 2. isolated, firm, tender erythematous area and a 3. Fever > 100
Plugged ducts are the same as mastitis, WITHOUT the fever

Treatment : anti-staph abx

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26
Q

How to interpret a BPP score?

A

<4 : immediate delivery
4 without oligohydramnios & mature lungs : consider delivery
4 without oligohydramnios and immature lungs : steroids
6 without oligo : contraction stress test
8-10 : normal

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27
Q

Wat skin condition is associated with parkinsons?

A

Seborrheic dermatitis

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28
Q

How does congenital rubella syndrome present? (5 things)

A

Deafness, cataracts, cardiac malformations, thrombocytopenia, hepatosplenomegaly

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29
Q

Treatment for toxoplasmosis?

Prophylactic treatment?

A

Treatment : Sulfadiazine-pyrimethamine

Prophylactic : TMP-SMX

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30
Q

HIV pt with single ring-enhancing brain lesion and NO fever - what is it? (treatment?)

What can it also be, and how would it be different?

A

Single without fever : CNS lymphoma (irradiation)

Multiple with fever : toxoplasmosis (sulfad-pyrim)

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31
Q

Most common cause of infectious neonatal conjunctivitis?

What is a positive and a negative finding?

A

Chlamydia

+ cough, no fever

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32
Q

50+ pt with mass that swells when swallowing liquids..?

Treatment?
Cause?

A

Zenker’s diverticulum

Surgical excision and cricopharyngeal myotomy
Motor dysfunction

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33
Q

Which diuretic can be used for prevention of calcium stones?

A

Thiazide

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34
Q

Iron deficiency - low or high retic count?

A

Low

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35
Q

Patient with end-stage liver disease develop kidney issues - next step?

A

Liver transplant 2/2 hepatorenal syndrome

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36
Q

Treatment for B. pertussis?

A

Erythromycin

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37
Q

Older female with painful blistering around thighs and breasts presents with some necrosis

Drug likely involved? Treatment?

A

Warfarin (warfarin-induced necrosis)

Stop drug, give vit. K. Use heparin in the meantime.

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38
Q

Purpura in kids with NO thrombocytopenia (plt > 100) - MCC?

A

Vsculitis - commonly HSP (look for recent infection)

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39
Q

Nikolsky’s sign - top diagnoses?

What differentiates them?

A

SSSS, TEN, SJS

Look for SSSS in kids < 6 with diffuse rash, other 2 older pts.
TEN is >30%TBSA, SJS is <10%

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40
Q

Baby with hx of eczema comes in with fever and overlying blisters - diagnosis? Treatment?

A

Eczema herpeticum

Acyclovir asap

41
Q

Recurrent painless, nodular rubbery lesion on eyelid - next step? Diagnosis?

A

Histopathalogical exam

Chalazion - concern for meibomian gland carcinoma or basal cell CA

42
Q

GVHD - pathophysiologic mechanism?

A

Activation of donor T-cells

43
Q

Pt with new and worsening pale patches on chest and in mouth?

Cause?

A

Vitiligo

Autoimmune destruction of melanocytes

44
Q

Pale, velvety pink macules that scale upon scratching

Lab shows?
Treatment?

A
  • Tinea versicolor - they DO NOT TAN
  • Lab shows: KOH prep - large, blunt hyphae with thick-walled budding spores (spaghetti&meatball)
  • Topical antifungals, ketokonazole shampoo for scalp
45
Q

Pink maculopapular rash that starts in the face and spreads down following a fever, malaise few days ago
Diagnosis?
Treatment?
Anything else?

A

Rubella
Symptomatic
Beware pregnancy - CRS

46
Q

Key words: invasive cords of squamous cells with keratin pearls

A

Squamous cell carcinoma

47
Q

Key words: Invasive clusters of spindle cells surrounded by palisaded basal cells

A

Basal cell carcinoma

48
Q

Bullous impetigo - caused by?

Can evolve into?

A

S. aureus

SSSS

49
Q

WTF is Ludwig’s angina?

A

Bilateral cellulitis of the submental, -lingual and -maxillary spaces.
Presents with warm, red mouth, fever, drooling.
Can lead to death by asphyxiation

50
Q

Key words: Small, pink spots on trunk (‘rose spots’)

A

Salmonella typhi

51
Q

Key words: ‘sunburn with goosebumps’ with strawberry tongue

A

Scarlet fever (strep pyo) – PCN

52
Q

Small red patch on cheek that turns into a shiny, painful red plaque
Cause?
Treament?

A

Strep pyo (erysipelas)

PCN

53
Q

WTF is Fournier gangrene

A

Necrotizing fasciitis in the perianal / genital area

54
Q

2 abx that causes serious photosensitivity

A

Tetracycline and doxycycline

NOT erythromycin

55
Q

Key words: polygonal cells with atypical nuclei at all levels (on skin)

A

SCC

56
Q

Describe dermatitis herpitiformis

A

Pruritic papules
granular IgA deposits
circulating anti-endomysial antibodies
often with celiac disease

57
Q

Painless blisters on the back of the hands with increased fragility of the skin
What is the MCC?
What other signs will show? Next step?
What can cause this?

A

Porhyria cutanea tarda - deficiency of uroporphyrinogen decarboxylase
Look for hyperpigmentation on the face
Check urinary porphyrin (elevated)
Ethanol and estrogens can cause a flare-up

58
Q

Normal skin at birth, gradually becomes dryer no matter what

A

Ichthyosis vulgaris (lizard skin)

59
Q

Key words: waxy scale on a base of mild erythema

A

Seborrheic dermatitis

60
Q

Treatment for cellulitis with systemic signs

A

Nafcillin or cefazolin

61
Q

Chronology of rubell

A

Exposure (droplets)
Fever, malaise and adenitis after 2-3 weeks
Rash appears 1-5 days later, starts on face and spreads down, lasting less than 3 days

62
Q

Biopsy results with bullous pemphigoid?

A

IgG and C3 deposits at the dermal-epidermal junction

63
Q

Describe pityrasis rosea

A

Starts with herald patch, then many other itchy lesions
Look for christmas tree pattern on back
Treat with reassurance

64
Q

History of vomiting with crepitus in the suprasternal notch - most likely condition?

A

Boerhaaves - esophageal rupture

65
Q

Neonate with systic scrotal mass that transilluminates with light - what is is?
Treatment?
This is located within ..?

A

Hydrocele
Watch and wait
Processus vaginalis

66
Q

Twisting injury of the knee - most common injury?

What will show on xray?

A

Medial meniscus

Nothing

67
Q

Burning building/smoke inhalation pt - always think of what?

What other symptoms may that have?

A

CO inhalation

Confusion, seizure (with toxicity), agitation, HA, nausea

68
Q

When is diverticulitis complicated?

What are the treatment options?

A

With abscess formation, fistula, perf or obstruction

If abscess 3cm CT-guided percutaneous drainage. If this fails, surgery.

69
Q

WTF is Legg-Calvé-Perthes disease?

A

Idiopathic avascular necrosis of the femoral capital epiphysis
Common : boys aged 4-10 (peak 5-7)
Treat with obs and bracing, surgery for fem head not contained in acetabulum

70
Q

Newborn with palpable klunk in hips - next step?

A

Ultrasound of hips

71
Q

Charcot’s triad - what is it?
Diagnosis?
Next step?

A

Fever, RUQ pain and jaundice !!!!! NB!!!!!
Ascending cholangitis (infection of the common bile duct)
Ultrasound and broad-spectrum abx – for unstable pts, ERCP for biliary drainage

72
Q

Most common neoplasm of liver?

A

Mets (20x more than local)

73
Q

Child with nocturnal vulvar itching - mcc?
Test?
Treatment?

A

Pinworm
Scotch tape
Mebedazole

74
Q

Complaints of dizziness and ‘fullness of ear’ - mcc?

Pathology?

A

Meniere’s disease

Abnormal accumulation of endolymph in the INNER ear

75
Q

How to interpret the L/S ratio of a pregnancy?

A

Indication of lung maturity

A ratio of less than 2:1 shows immature lungs - treat with steroids

76
Q

Normal AFI?

A

5-25 is normal for amniotic fluid index

Less than 5 - amnioinfusion

77
Q

WTF is McCune-Albright?

A

Look for precocious female puberty!
3 P’s - pigmentation (cafe-au-lait spots), polyostotis fibrous dysplasia (bone defects) and precocious puberty
Often assoc. with other autoimmune disorders

78
Q

Amonorrhea is athletes - deficiency of proges or estrogen?

A

Estrogen

79
Q

Turners is at risk for developing?

A

Osteoporosis

80
Q

Trastuzumab with chemo can lead to?

A

Cardiotoxicity

81
Q

Most sens and spec test for chronic pancreatitis?

A

Stool elastase

82
Q

Therapy for non-bleeding varicies in stable patients?

A

Propranolol

83
Q

Bloody discharge from nipple with no mass?

A

Intraductal papilloma

84
Q

Most common cause of acute pancreatitis?

Diagnostic test?

A

Alcohol and gallstones

Ultrasound, NOT CT scan (cannot see stones)

85
Q

When to give tetanus-diphteria toxoid and/or tetanus Ig?

A

Always give toxoid, except for minor/clean wounds with 10years

86
Q

Which drug is good for anxiety, as well as an appatite stimulNt?

A

Mirtazapine (TCA)

87
Q

Side effect of citalopram

A

Impotence

88
Q

What are the most common complications of anorexia nervosa?

A

Osteoporosis #1

Also IUGR, prolonged QT interval, hypercholesterolemia, hyperemesis gravidarum,

89
Q

Most significant side effect with olanzapine?

A

Weight gain (olifant-zapine)

90
Q

Treatment for nocturnal bedwetting?

A

Enuresis - give desmopressin first, no dice, try imipramine

91
Q

Firstline treatment for general anxiety disorders?

A

Buspirone

92
Q

Patient is poisoned - description includes ‘optic disc hyperemia’
What is it?
What else will they have?

A

Methanol poisoning - it goes for the eyes

Also: metabolic acidosis, blurred vision, epigastric pain

93
Q

Describe farmer’s poisoning (sluds)

A

Organophosphate poisoning = acetylcholinesterase inhibitor, leading to cholineric excess
Treatment = atropine & pralidoxine
Side note - atropine/pralidoxine OD treated with physostigmine, which will WORSEN sluds

94
Q

What type of drug causes hypothermia?

A

Typical antipsychotics - fluphenazine more than others

95
Q

What is naloxone used for?

A

Opiod OD

96
Q

How does diphenhydramine (benadryl) OD show up?

Treatment?

A

Dilated pupils, blurred vision, decreased bowel sounds, urinary retention (anti-histamine and anti-cholinergic effects)

Treat the same as atropine OD - physostigmine

97
Q

How does serotonin syndrome present?

A

Tachycardia, dilate pupils, HTN and hyperthermia

Look for MAOI with another serotonin drug interaction

98
Q

Drug of choice for alcohol withdrawel?

A

Chlordiazepoxide (benzo)

99
Q

Pt receives the following - what was the OD?

  1. Glucagon
  2. Flumazenil
  3. Naloxone
A
  1. Beta blocker OD
  2. Benzodiazepine OD
  3. Opioid OD

Step 2 CK (6 decks)

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