Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Step 3 > Self asses 1 > Flashcards

Self asses 1 Flashcards

1
Q

Itchy rash, inbetween fingers, worse at night

A

Scabies

TOP permethrin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Differentiate between MDD and grief

A

Grief is a normal reaction; no SSRI needed but can benefit from counseling
MDD - feelings of worthlessness, excessive sadness, low-self esteem guilt, SI; SSRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Newborn hasn’t passed mec on DOL 3 and had aggressive expulsion on rectal exam. Dx and w/u?

A

c/f Hirschsprung
Caused - failure of neural crest cells to migrate to the distal colon
Dx - Rectal suction bx, demonstrates absence of ganglion cells and nerve hypertrophy
Can also use anorectal manometry as a screening test, but only acurate if >1 mo old

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Recent travel w/ diarrhea about 3-4 months ago
fever
RUQ pain
Ultrasound with hypoechogenic cyst
Aspiration - thick dark brown fluid, negative gram stain
Dx?

A 
Enatmoeba histolytica (protozoa)
Fecal oral transmission
90% asymptomatic but can get colitis or liver abscess
Dx - stool O&P or Serum test
Tx= Flagyl and paromomycin
"anchovy paste" liquid
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Guy in his 40s with UTI symptoms - be suspicious for?

A

Prostatitis
get a prostate exam to r/o hot tender prostate
Tx - Bactrim or fluoroquinolone (cipro) x 6 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Inidication for AAA repair

A

size > 5.5 cm

Growing faster than 0.5cm q6mo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q 
Hyperparathyroid
No constipation or urinary frequency
NL DEXA
Over >50 y/o
how do you manage?
A

Regular follow up with Sr calcium, Sr Cr and DEXA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

When do you recommend surgical resection of Parathyroid?

A

hyperparathyroid AND

  • Age <50
  • complication of hyperPTH (osteoporosis)
  • Frequent urination, constipation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Pt had a NSTEMI, < 75 y/o. What type of statin do they need?

A

Hi intensity - doesn’t matter what their lipid panel is

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Teenager with multiple erythematous plaques with centra clearing

A

Erythema multiform
HSV is the most common cause
Self limited in 1-2 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

When do you get an MRI of low back pain?

A

Neurologic deficit
suspect infection vs cancer
Pain persists 12+ weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Verrucocous ulcerated anal lesion

A

Anal carcinoma

Caused by HPV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Pt has syx c/f PE
CT shows a peripheral hemispherical consolidation near the pleura
Dx?

A

Pulmonary infarction
complication of a PE
can get hemoptysis d/t lung necrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

pt with Hep B
New liver mass
Dx?

A

Hepatic cel carcinoma
neoplasm of hepatocytes (liver parenchyma)
AFP can be NL or elevate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

teenager with a 20 min period of intoxication
Lethargy, stupor
Returns to BL within 20 min

A

inhalant abuse

Can have rash around mouth or nose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Tx for pertussis

A

Macrolides (Azithromycin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

4 months SOB
CT b/l reticular and linear opacities with irregular thickening of bronchovascular bundles in the upper lungs and enlarged mediastinal lymph nodes
Dx?

A

Sarcoid (Granulomatous lung disease)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How quickly should inguinal hernias be repaired in an infant?

A

In a few weeks, not emergent but urgent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

adult with new onset easing bring
Normal PT
prolonged aPTT

A

Acquired hemophilia

Presence of a coagulation factor inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

40ish y/o pt with new DOE, small joint pain, GERD, telangiectasis around his lips
Dx and w/u?

A

Scleroderma (interstitial pulmonary fibrosis, esophageal hypomotility
Anti-centromere antibodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Rapidly progressive breast pain, erythema, edema
Failed course of abx
c/f?

A

Inflammatory breast cancer

Need a core biopsy of LN or breast mass

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

when a pt has recurrent cellulitis whites a source you should consider?

A

Tinea pedis

Lymphedema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are your next options for treating acne that isn’t improving with TOP benzoyl peroxide and retinol?

A

moderate severe w/o scaring - po tetracycline

Severe nodulocystic w/ scaring - po isotretinoin. Need Upreg, LFTS routinely

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Pt with frequent abdominal pain and diarrhea gets frequent UTIs. C/f

A

IBD
can cause enterovesical fistula
Typically E. coli, bactericides fragilis
Can have pneumaturia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

When would you consider endometrial biopsy on a pre-menopausal female

A

Heavy intermenstrual bleeding to r/o endometrial cancer (especially if obese, HTN, T2DM)
Fibroids have heavy bleeding but should still be regular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Pt on AC with sudden RLQ pain and hypotensive. Scary for?

A

Retroperitoneal hemorrhage
Get a CT
Need rapid reversal of AC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Pt being treated for sepsis now with 2-3 loose stools and VS worsening. C/f?

A

C. diff

probably abdominal tenderness on exam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what should you consider for a patient that reports normal BPs at home, but always high in the office

A

24 hour bp readings

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Syncopal episode
Electrical altercates on ekg
what caused the syncope?

A

Cardiac temponade

syncope d/t decreased cardiac pre-load (decreased filling of RA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Pt >50

b/l shoulder and neck pain (apparently can even have decreased ROM)

A

Polymyalgia Rhematica

Can give low dose steroids for comfort

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

At what point should we talk about transplant vs. HD in CKD pts?

A

When GFR <30

Apparently step considers ACEI/ARB protective

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Normocytic anemia
mild CKD
chronic back pain
Dx?

A

MM

Need a urine electrophoresis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Tortuous dilation of veins in pampiniform plexus

A

Varicocele
“bag of worms” on valsalva
Increases risk of infertility and testicular atrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q 
new born (hours old) gets cyanotic with feeds and improves with crying
next step in w/u?
A

Insert a NG tube
r/o choanal atresia
Narrowing or obstruction of posterior nasal passages preventing communication between nasal cavity and nasopharynx
So infant can’t breathe during feeds and can haver starter
If NG cannot pass into the pharynx it raises suspicion for an atresia which is then confirmed on CT
Need prompt pediatric ENT eval for surgical repair

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Cancer pt
Frequent pleural effusions that are exudative
What can you offer?

A

Chemical pleurodesis
Palliative effort to prevent future effusion
non small cell cancers with large effusions are considered incurable dz

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

kiddo with lead level > 70

A

severe

Needs IV dimercaprol and EDTA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Kiddo with lead level 45-69

A

Moderate

give po DMSA (succimer)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Kiddo with lead level < 44

A

Mild
No need for chelating agent
Contact public health to help mitigate exposure
Repeat blood level qmonth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

what increases risk of long QT

A 
Hypo mag
HypoK
Fluoroquinoloes
Antipsychotics
Increased risk of ventricular arrhythmia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

pt is s/p prostatectomy. How do you manage now?

A

Serial PSA’s
Level post-op should be close to 0
If it rises be concerned for recurrence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

1st line diagnostic test for pulmonary source of sepsis

A

Induced septum with hypertonic saline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

what should you get if you are thinking about adding steroids in PCP infection?

A

ABG

if PO2< 70 and a-a gradient > 35 should give steroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

If someone w/ a chronic foley has candida in their urine, what do you do?

A

Change the foley
More likely from colonization, Probably won’t need treatment
If they have urinary syx, neutropenic, or look infected can start fluconazole or amphotericin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

When do you image and Anke?

A

Pain near the malleoli OR
Unable to bear weight
OR pain at the malleoulous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Pt w/ h/o hodgkin lymphoma and big smoking hx has a large pulmonary mass. Why?

A

Lung cancer
Lymphoma presents as large lymph nodes, not a discrete mass
Hodgkin lymphoma does increase your risk of other malignancies, especially solid tumors (lung, breast, thyroid, bone, GI)
Smoking + h/o chemo or radiation = lung cancer

46
Q

Indications for abx prior to dental work

A

Prosthetic heart valve
Previous infective endocarditis
valve dz in pt with a heart transplant
Congenital heart dz (unprepared, cyanotic, anything prosthetic, or residual deficit)

47
Q

kiddo tried to od on TYL 6 hours ago but she looks fine. Now what?

A

Give N-acetylcysteine
Activated charcoal only works in first 4 hours
IF they present >4hours after ingestion –> empirically give NAC

48
Q

What is the greatest RF for pancreatic cancer?

A

Cigarette smoking

be suspicious with large mass in pancreases + weight loss

49
Q

CHF wit EF < 35% consider what intervention?

A

AICD (NOT pacemaker)

50
Q

When do you consider a biventricular pacemaker?

A

If EF < 35% and have a wide QRS (>120)

51
Q

Initial Tx for a symptomatic (vision loss, low libido, hyperprolactenemia) prolactinoma?

A

Dopamine agonist

Surgery is only indicated if they do not improve with medication alone

52
Q

Most common cause of inherited thrombophilia?

A

Factor V Leiden
On labs - activated protein C resistance
Will need life long AC

53
Q

Pt with OD of unknown’s medication has AMS, QRS prolongation >120, dilated pupils, dry MM, + Babinski. c/f?

A

Tricyclic antidepressant toxicity

Corrects QRS prolongation with Sodium Bicarb

54
Q

How to treat obestiy

A
  1. Dietary changes, exercise
  2. Orlistat
  3. Phentermine
    Phentermine mono therapy haas high rate of re-gain
55
Q

What’s the difference between delusional disorder and somatic syx disorder

A

Delusional - fixated on one specific delusion w/o any signs of hallucination or psychosis
Somatic symptom - anxiety about many physical symptoms, but not delusional
Illness anxiety - fear of an undiagnosed medical illness, but don’t fixate on any one thing and accept that they may not have a disease

56
Q

Afebrile kiddo with blood diarrhea

A

EHEC

look for beef ingestion or animal exposure

57
Q

Microcytic anemia, normal Hgb, NL RBC distribution width

A

Thalassemia

Target cells on smear

58
Q

Pt on MTX gets preggo
AFP high on quad screen
What do you do next?

A

Ultrasound
High suspicion for NTD
Can be seen as early as 6wk GA

59
Q

Recent renal transplant (weeks) present with:
Fevers, AKI, UA with RBCs
Renal bx - renal tubular damage and prominent basophilic intranuclear inclusions

A

BK virus
a type of polyomavirus
Well known cause of nephritis in immunosuppressed transplant recipients
Tx - reduce immunosuppression +/- antiviral therapy

60
Q

Most common demographic enrolled to medicaid?

A

Kids approx 50% - they’re also the cheapest

61
Q

When do you deliver a pt with adequately controlled DM?

A

39 wks

Attempts to avoid fetal respiratory stress

62
Q

At what size is there risk of social dystocia?

A

> 4.5kg, 9.9lb

63
Q

Pt presenting with proximal muscle aches exacerbated by exercise
Some weakness with ADL
non tender on exam
Elevated CK

A

Hypothyroid myopathy

Can look like an inflammatory myopathy (poly or dermato) but the hypothyroid pmts will not have TTP on exam

64
Q

Daily prophylactic meds for migraine

A

Beta blockers (metoprolol, propanolol)
TCAs (amitriptyline)
Anticonvulsants (valproate)

65
Q

Abortive medication for migraine

A

Ergotamines (Firocet)

Triptans

66
Q

Best way to avoid barotrauma on a vent and improve mortality?

A

Low TV

6-8cc/kg of ideal weight

67
Q 
Middle aged adult with Flexor surface Rash that is:
pruritic
planar
polygonal
purple
A

Lichen plants
unk etiology
Can also have white lace like pattern on the surface (Wicham striae)
Tx: TOP steroid, antihistamines

68
Q

Pt just put on a vent and gets hypotensive

A

2/2 increased intrathoracic pressure
Bolus her
Can also try to wean down PEEP

69
Q

Severe nephrotic syndrome increases risk of?

A

-Thrombotic events
especially in renal veins and DVTs, loss of anticoagulant factors in urine
- Infection

70
Q

Preggo gets Parvo. How does this change management?

A

Get periodic ultrasounds

Increased risk of fetal anemia, hydrops fetalis, fetal demise

71
Q

FHx of cirrhosis
presents with fatigue, poor libido
Mild transaminitis

A

Hereditary hemochromatosis

Get iron studies and genetic studies

72
Q

Pt taking doxycycline now with bad heart burn. Why?

A

Medication induced esophagitis
Common with doxycycline, NSAIDs, KCl, bisophophanates
Tx - avoid the causative medication and syx should improve in 1 week

73
Q

What are the advantages of NPPV in COPD?

A 
decreased:
mortality
Intubation
secondary bacterial PNA
Would have low threshold to give it
74
Q

Pt is having an NSTEMI, what med should be started in the next 24 hours?

A

ACEI
Start within 1-16 days
Improves LVEF, prohibits ventricular remodeling, and improve mortality

75
Q

Tx for bulimia?

A

CVT
If not successful SSRI, especially fluoxetine
NEVER BUPROPRION

76
Q

Tx options for candidate vaginitis while preggo?

A

TOP clotrimazole, miconazole, and nystatin

po fluconazole is teratogenic

77
Q

Causes of metabolic alkalosis w/ hypo K+ and what test can help you determine the etiology?

A

Vomiting - Low Urine Cl (trying to retain)
Diuretic use -High UR Na, Cl d/t receptors being blocked
Inherited salt wasting (Gitelman and Berterr) - High Ur sodium

78
Q

Pt with vascular dementia is having more behavioral agitation at home. Labs normal. Consider adding?

A

SSRI

safe for geriatric pop and no QTcc prolongation

79
Q

Tx for folliculitis (Furuncles, carbuncles)

A

po Clindamycin, Bactrim, doxycycline

basically the same as cellulitis

80
Q

If you suspect a biceps tendon rupture how do you treat?

A

Refer to Ortho

81
Q

IVDU with blood Cx positive for Staph aureus should raise concern for?

A

endocarditis

Vertebral osteomyelitis

82
Q

What is the common life-threatening complication of granulomatosis with polyangiitis

A

Diffuse alveolar hemorrhage

Pathology: systemic vasculitis that involves the upper respiratory tract, lower respiratory tract and kidneys

83
Q

Ulcerative colitis presenting with fatigue
Lab work with elevated bili, alk phos, and elevated INR
c/f?

A

Primary sclerosis cholangitis
Confirm dx with ERCP - multifocal strictures and dilatations of the intra and extra hepatic bile ducts
Could consider MRCP

84
Q

Pt with a depression hx is c/o polydipsia, polyuria, NL Cr, elevated accucheck and HgA1c. What med caused this?

A

Second gen antipsychotic like olanzapine

Lithium can give similar syx but wouldn’t cause her hyperglycemia and weight gain

85
Q

New born with progressive respiratory distress develops shock that is symmetric on all limbs. Dx?

A

Hypoplastic L heart
PDA dependent and then crash when the PDA starts closing
Tx - prostaglandin E1 to keep PDA open and maintain systemic perfusion
Aortic coarctation looks similar but shock would only be seen in the lower extremities

86
Q

TNF alpha inhibitor increases risk of?

A

More severe infections. CAP with Staph aureus can progress to necrotizing pNA

87
Q

Preggo is RhD negative on prenatal labs. Somewhere along the way her RH(D) Ab titers go from 1:2 to 1:16. What do you do?

A

Nothing. She underwent alloimmunization at some point and it is too late to give rhogam
Just accept babe is likely to be Coombs positive and will be at risk of hemolytic dz, hyperbili

88
Q

Young pt with progressive DOE, JVD

CXR w/ enlargement of pulmonary arteries

A

C/f Pulmonary HTN

Get an ECHO

89
Q

standard initial prenatal labs

A 
Rheusus type and Ab screen (Rh+/-)
Hgb &amp; HCT
Rubella, Varicella serology
UA and culture
RPR, HIV, Hep B
Chlamydia
Pap (if due)
90
Q

Strongest correlation with OSA?

A

Neck circumference

91
Q 
young teenager
Leg fracture from a simple trip
hepatosplenomegaly
Anemia
Thrombocytopenia
Dx
A

Gaucher dz

Lysosomal storage disorder d/t glucocerebrosidase deficiency

92
Q

Diagnositic criteria for PCOS

A

2 orf 3:
Oligomenorrhea
Hypergonadenism
PCOS on TVUS

93
Q

Co-morbidities associated with PCOS?

A

T2DM
NASH
OSA
Endometrial cancer

94
Q

CA-125 is a tumor marker for?

A

Ovarian CA

95
Q

alpha fetoprotein is elevated in which CA?

A

Yolk sac germ cell cancer

96
Q

When is mitral valve repair or replacement indicated?

A

ECHO with severe MR and LVEF of 30-60%

LVEF is over-estimated with MR

97
Q

anatomic distinction of femoral hernia?

A

below inguinal ligament
medial to femoral n. a. v.
Indirect inguinal hernia - pass through he inguinal ring

98
Q

When to start infertility work up?

A

< 35 y/o F - after 12 months

>35 y/o F - after 6 months

99
Q

Key findings on GBS patients on exam?

A

Hyporeflexia

NL Babinski

100
Q

pt is hours s/p adrenalectomy (functional, elevated cortisol and low ACTH) then has adrenal crisis. Why?

A

adrenal gland atrophy

Leads to adrenal crisis because of the negative feedback of being in a high CRH ACTH state

101
Q

what is a pituitary apoplexy?

A

Pituitary infarction
Can also cause and adrenal crisis
Usually have HA and visual changes

102
Q

What can prevent long term disability in RA patients?

A

Cytotoxic medications

103
Q

cause of sick sinus syndrome

A

chronic SA node dysfunction
alternate between tacky and bradycardia
pacemaker placement is indicated if bradycardia is symptomatic

104
Q

PE findings c/w Parkinsons

A

Bradykinesia
Resting tremor
Rigidty
All are asymmetric and improve with dopaminergic therapy

105
Q

Recent cardiac Cath
“blue toe syndrome” (lived reticular)
Blood work with eosinophilia

A

Atherosclerotic emboli
Tends to go to lower limbs, kidney, retina, cerebrum, GI tract
can be seen after vascular or trauma surgery

106
Q

Hematuria
Flank pain
Palpable abdominal mass (firm nontender, moves with respiration)
Dx?

A

Renal cell carcinoma

CT to confirm

107
Q

When do you let pancreatitis patients eat?

A

Low res diet whenever they say they’re ready

108
Q

What causes hypotension after a PTX?

A

Decreased venous return

109
Q

Formula for NNT or NNH?

A

(incidnce/exposed pop) subtract (incidence/unexposed)

NNH =1/the difference

110
Q 
Polycythemia
Torturous veins
Thrombocytosis
low Epo
Dx?
A

Polycythemia vera

Mutation in JAK2

111
Q

Triphasic course of postpartum thyroiditis

A

Hyperthyroid phase
transient hypothyroidism
Recover to euthyroid state

Step 3 (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions