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Step 2 > Set 5 > Flashcards

Set 5 Flashcards

1
Q

hypopigmented spots, axillary freckles, skin nodules, lisch nodules

A

NF 1 or 2

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2
Q

heart sound in MI

A

4th heart sound = atrial gallop (diastolic dysfxn and stiff LV)

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3
Q

Tx bradycardia

A

IV atropine (muscarinic antagonist –> decreases vagal influence on SA node) then transcutaneous pacing

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4
Q

amylase in left-sided pleural effusion (3)

A

esophageal rupture, pancreatitis (or ruptured pseudocyst), or cancer

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5
Q

Tx prinzmetals angina

A

CCBs and/or nitrates

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6
Q

infant with central vs. peripheral cyanosis

A

central = hypoxemia in arteries suggesting CHD (ex perioral cyanosis but warm extremities)

peripheral = low cardiac output causing low blood flow/ excessive vasoconstriction –> normal PaO2, cold, cyanotic distal extremities

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7
Q

macrocytic anemia, leukopenia, thrombocytopenia and decreased segmentation of PMNs

A

myelodysplastic syndrome

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8
Q

Deficiency seen in carcinoid syndrome

A

Niacin (its precursor, tryptophan, gets all used up to make serotonin)

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9
Q

MRI shows butterfly appearance with central necrosis

A

GBM

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10
Q

MRI shows heterogenous, serpiginous contrast enhancement

A

high grade astrocytoma

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11
Q

SLE patient taking hydroxychloroquine, what test does she need to have?

A

eye exams q6mo looking for retinopathy and/or corneal damage

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12
Q

akathisia vs. dystonia vs. tics vs. myoclonus vs. chorea

A
  • akathisia - restlessness
  • dystonia - sustained muscle contraction - twisting, repetitive movements, or abn postures. focal or diffuse. ex. torticollis
  • athetosis - slow, writhing movements. ex. huntington’s. rett’s syndrome.
  • tics - repetitive movements or vocalizations. ex. tourette’s
  • myclonus - jerking movements
  • chorea - brief, irreg, flowing movements
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13
Q

What is a sestamibi scan for?

A

direct treatment in patients with hyperPTH either sx or asx with Ca>11, GFR<60 +/- osteoporosis

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14
Q

Esophageal tests algorithim for ordering if broad ddx

A

Barium esophagram then EGD then esophageal motility

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15
Q

Esophageal varices vs Mallory-Weiss Tears?

A

varices = VEINS (2/2 portal HTN)

MWT = ARTERIES (2/2 mucosal tears from heaving)

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16
Q

HIV drug causing hypersensitivity syndrome

A

abacavir (NRTI)

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17
Q

Eggshell calcification of hepatic cyst? Tx?

A

hydatid cyst = Echinococcus (via dog exposure)

Tx = Careful surgical drainage w/ albendazole

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18
Q

At what cutoff is it ok to give bicarb for metabolic acidosis?

A

pH <7.2, ie severe

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19
Q

Proximal muscle weakness + elevated CK? Tx?

A

dermato/polymyositis

Tx HIGH dose steroids (vs PMR)

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20
Q

CI of triptans (3)

A

uncontrolled HTN, CAD, Pregnancy

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21
Q

HIV drug causing hematuria w/ crystal-induced nephropathy

A

Indinavir (Protease Inhibitor)

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22
Q

Calcium levels in alkalosis, why?

A

decreased due to higher affinity of albumin for calcium

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23
Q

abnormality in coagulation profile in lupus

A

prolonged PTT 2/2 anticardiolipin Ab

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24
Q

Lip telangiectasias, epistaxis and polycythemia with normal WBC and plts

A

Hereditary telangiectasia aka Osler-Weber-Rendu

= AVMs occur primarily in mucus membranes, skin and GI tract but also liver, lung and brain

25
Q

Liver mass histology with atypically enlarged hepatocytes containing glycogen and lipid deposits

A

hepatic adenoma

26
Q

heberden nodes and bouchard nodes

A

OA = osteophyte formation in DIP and PIP respectively

27
Q

Tx cerebral hemorrhage while on warfarin

A

d/c warfarin, ASA and other anticoagulants

give FFP and Vit K

28
Q

Muscles+nerves involved in arm abduction

A

supraspinatous (suprascapular n) –> 1st 15 deg
deltoid (axillary n) –> 15-90 deg
trapezius (CN 11) and serratus anterior (LTN) –> lift above horizontal

29
Q

Calcified adrenal glands =

A

primary adrenal insufficiency caused by TB (granulomas cause hypercalcemia)

30
Q

Tx sarcoidosis

A

steroids (if sx)

31
Q

Tx Li-induced DI

A

amiloride and NS (nephrogenic DI, diuretic actually induces retention in other tubules)

32
Q

Elderly patient who is slow moving, depressed and signs of dementia? Dx?

A

pseudodementia (2/2 depression = psychomotor retardation)

Dx = dexamethasone suppression test, 50% are abnormal

33
Q

1st line tx osteoarthritis

A

TYLENOL (not NSAIDs due to higher SE profile)

34
Q

Older patient with AMS, muscle twitching and sharp waves on EEG

35
Q

Bacillary angiomatosis bug, type and tx

A

Bartonella henselae = gram - bacillus

Tx = erythromycin (macrolide)

36
Q

Tx ascitis

A

Na/H2O restriction –> spironolactone –> loop diuretic –> paracentesis

37
Q

Diabetic with ear drainage? Dx, tx?

A

malignant otitis media = pseudomonas
Can cause CN palsies –> requires CT/MRI
Tx = IV ciprofloxacin

38
Q

2 drugs that help with cachexia in cancer patients

A 
1st = progestin
2nd = steroids (more SE)
39
Q

Use of primidone? SE

A

mainly 2nd line tx for essential tremor (its an anticonvulsant)
SE = precipitates acute intermittent porphyria

40
Q

Pregnant mom at 30wks develops intense pruritis, skin lesions, hyperbilirubinemia, increased bile acids and transaminitis? Dx? Tx?

A

Intrahepatic Cholestasis of pregnancy
major = increased bile acids in serum
Tx = ursodeoxycholic acid > hydroxyzine or cholestyramine. Deliver baby when lungs are mature.

41
Q

high fevers, chills, tenosynovitis, migratory polyarthralgias, pustules on extremities and NEGATIVE blood cx

A

disseminated neisseria gonorrhea

42
Q

Tx PCP in AIDS

A

IV bactrim +/- oral steroids

43
Q

Tx strep throat

A

Penicillin or amoxicillin, if pcn allergy then erythromycin

44
Q

Ca, K, phos, uric acid in tumor lysis syndrome? por que? Tx?

A 
increased K, Phos and uric acid (protein degredation)
decreased Ca (released phos bind Ca)
Tx = allopurinol (decreased urate nephropathy)
45
Q

Elderly gets pneumonia after URI, CXR demonstrates multiple thin-walled cavities?

A

Staph aureus! only bug that causes post-viral URI necrotizing pulmonary bronchopneuonia with abscesses (cavities)

46
Q

Pencil in cup deformity

A

Psoriatic arthritis (distal phalangie resorption)

47
Q

fever, chills, sore throat, “hot potato” voic, deviated uvula? Tx?

A

Peritonsillar abscess

Tx = aspirate abscess and IV abx +/- sgy

48
Q

KID with sore throat gets abx, then 1 week later develops rash, arthralgias, LAD and fever?

A

Drug hypersensitivity (type 3) reaction similar to serum-sickness; can occur after treating viral infxn with abx

49
Q

Tx SIADH?

A

mild = water restriction, incr. salt intake (2nd line democlocycline)
severe (<120) = hypertonic saline (3%)

50
Q

Traztuzumab use? SE?

A

HER2/NEU antibody

SE = cardiotoxic –> get echo before starting

51
Q

2 immune-COMPLEX mediated nephropathies? which has a lower C3 level?

A

PSGN and MPGN

MPGN has lower C3 (seen in SLE, HIV, HBV, HCV)

52
Q

non-anion gap metabolic acidosis and hyperkalemia in diabetic with renal insufficiency

A

RTA type 4 = aldosterone deficiency or renal tubule insensitivity

53
Q

Tx giardia

A

metronidazole

54
Q

Iron, TIBC, ferritin and % transferrin sat in iron deficiency anemia?

A

Increased TIBC

All others decreased

55
Q

Tx human bite

A

Augmentin (amoxicillin+clavulanate)

56
Q

Hyperglycemia, necrotizing dermatitis and diarrhea/weight loss? Dx?

A

glucagonoma triad

dx = hyperglycemia and incr. glucagon, tumor on CT

57
Q

Difference b/w arthritis in SLE vs. RA

A

SLE arthritis is NOT deforming (and thus no permanent)

58
Q

Tx MS acute attack vs. relapsing-remitting vs. progressive?

A 
acute = steroids
relapse-remit = IFN-beta, glatiramer acetate
progressive = immunosuppressants (cyclosporine, MTX, mitoxantrone)

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