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Step 2 > Set 6 > Flashcards

Set 6 Flashcards

1
Q

MC breast tumor in pre-, peri- and post-menopausal women?

A 
pre = fibroadenoma (benign)
peri = intraductal papilloma (benign, unilateral bloody discharge)
pst = DCIS (+/- discharge)
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2
Q

HIV drug causing pancreatitis

A

didanosine (NRTI)

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3
Q

2 diseases associated with angiodysplasia in elderly?

A 
Aortic stenosis (called Heyde's Syndrome)
ESRD
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4
Q

obese diabetic with hepatomegaly and transaminitis? a/w? mechanism?

A

NASH, 2/2 insulin resistance causing increased rate of lipolysis and circulating insulin
a/w obesity, DM2, HLD and TPN

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5
Q

Immunocompromised pt with FOCAL neurologic deficits? Findings?

A

PML –> MRI w/ multiple demyelinating NON-enhancing lesions, no masses effect

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6
Q

Anserine Bursitis

A

anteromedial tibeal swelling/pain, normal xray, negative valgus stress test (vs. MCL injury)

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7
Q

HIV drug CLASS causing SJS

A

NNRTI

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8
Q

Dx and 2nd line Tx for lyme disease

A 
Dx = ELISA/WB
Tx = doxcycline 1st, amoxicillin 2nd
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9
Q

HIV drug causing liver failure

A

Nevirapine (NNRTI)

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10
Q

Hemorrhage vs. infarct on CT

A 
hemorrhage = HYPERdense
infarct = hypodense
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11
Q

Worst type of mutation in NF2, inheritance?

A 
Nonsense mutation (severe variant)
all are AD
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12
Q

photophobia, painful red eye, non-reactive mid-dilated pupil? dx, tx?

A

acute closed-angle glaucoma
dx = tonometry
tx = acetazolamide (decrease pressure) then pilocarpine (relieve obstruction)

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13
Q

deformed feet, joint effusions, osteophytes and bone fragments?

A

Charcot’s joint = neurogenic arthropathy 2/2 neuropathy and repeated wt-bearing trauma

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14
Q

What happens to levels of ACTH, aldosterone, cortisol and ADH if chronic steroid patient abruptly stops?

A

central, tertiary adrenal insufficiency
decreased ACTH, cortisol
increased ADH (normally suppressed by cortisol)
normal aldosterone

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15
Q

2 risks of tamoxifen use?

A 
VTE
cancer (endometrial CA, uterine sarcoma)
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16
Q

Acid-base disturbance in ASA overdose?

A

mixed respiratory alkalosis and AG metabolic acidosis (NOT a compensatory respiratory alkalosis though!)

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17
Q

conjunctivitis in neonate, 3 ddx and how to differentiate

A 
chemical = 1st 24hrs, no pus
gonococcal = 2-5 days with purulence
chlamydia = 5-15 days, less pus
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18
Q

When to do EGD in GERD

A

fail empiric tx OR

**complicated GERD = dysphagia, odynophagia, wt loss, bleeding or iron deficiency

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19
Q

3 MCC bacterial rhinosinusitis? tx?

A

S pneumo, H flu, M catarrhalis

Tx: augmentin

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20
Q

6 causes of drug-induced esophagitis

A

Tetracyclines, ASA/NSAIDs, Alendronate, KCl, Quinidine, Iron

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21
Q

urine/serum osmolality in osmotid diuresis

A

both elevated but urine > serum

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22
Q

3 dx features of Wilson’s Disease

A

Increased urinary copper
Decreased ceruloplasmin
Kayser-Fleischer rings on slit lamp eye exam

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23
Q

most and least malignant potential regarding colon polyps

A 
Most = sessile, villous adenoma >2.5cm
Least = hamartomatous and hyperplastic (~benign)
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24
Q

Iron, TIBC, ferritin, transferrin sat% in anemia of chronic disease

A

Decreased = iron, TIBC, transferrin, ~transferrin sat%

Increased ferritin

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25
Q

OI pathogenesis, PE findings (4)

A

type 1 collagen disorder

PE = blue sclera, hearing loss, hypermobile joints, dentinogenesis imperfecta

26
Q

Fall on oustretched hand resulting in Positive drop-arm test (can’t hold it up)

A

rotator cuff tear = supraspinatus injury which controls first 15 degrees of abduction

27
Q

Migratory thrombophlebitis indicates? W/u?

A

aka Trousseau’s Syndrome –> indicates likely underlying malignancy MCC adenocarcinoma (pancreas > lung > prostate > gastric)
Dx = CT abdomen

28
Q

Hemolytic anemia + hepatic vein thrombosis, think…pathogenesis?

A

Paroxysmal nocturnal hemoglobinuria –> ACQUIRED defect in GP1 anchor responsible for CD55/59 anchoring to RBCs to keep from being targeted by complement

29
Q

acute* symmetric, polyarticular arthritis

A

viral! MCC parvo B19

30
Q

location of axial skeletal involvement in RA

A

C1-C2 causing isntability +/- subaxial subluxation

31
Q

retinal hemorrhages vs. pale retina, which viruses?

A 
CMV = retinal hemorrhages (painless)
HSV/VSV = pale retina (+/- necrosis, painful)
32
Q

AMS and abnormal MRI in HIV patient, DDx and differentiation?

A

Toxo = multiple ring-enhancing round lesions, MC basal ganglia
PML = non-enhancing lesions
Primary CNS lymphoma = solitary, weakly ring-enhancing PERIVENTRICULAR mass (2/2 EBV)

33
Q

SE / complication of radioidone therapy, early vs. delayed?

A 
early = transient thyrotoxicosis/hyperthyroidism MC in elderly 2/2 excess thyroid hormone released from dying cells --> prevent with methimazole
later = hypothyroidism possible in all patients
34
Q

Major criteria for rheumatic fever (5)

A 
JONES:
Joints (migratory polyarthritis)
Heart (carditis)
Nodules (subcuticular)
Erythema marginatum
Sydenham chorea
35
Q

Minor criteria for rheumatic fever (5)

A 
PEACE:
Previous rheumatic fever
ECG w/ prolonged PR (ie 1st degree block)
Arthralgias
CRP/ESR elevation,
Elevated temp (fever)
36
Q

major and minor combos for dx rheumatic fever

A

2 major or 1 major + 2 minor

37
Q

Fever, tonsillar exudates, sore throat and erythema? Dx, Tx?

A

GAS pharyngitis
Dx = rapid strep test
Tx = oral PCN or amoxicillin (macrolide for penicillin allergy)

38
Q

Sore throat, conjunctivitis, rash, rhinorrhea

A

viral pharyngitis

39
Q

Early tx of strep throat prevents what?

A

rheumatic fever but NOT PSGN

40
Q

Peaked T waves

A

HYPERkalemia

41
Q

EKG findings in HYPOkalemia

A

U waves, flat and broad T waves, PVCs

42
Q

daily multiple seizures in kid <7yo, often at night? associated with? EKG findings?

A

Lennox-Gastaut Syndrome, associated with mental retardation, psychological and psychomotor delay.
EKG = interictal slow spike-and-wave complexes

43
Q

Suspected pancreatitis, what imaging to get?

A

if no h/o alcoholism, get RUQ US 1st to look for gallstones.

THEN get abdominal CT to confirm

44
Q

Female with pruritis, hypercholesterolemia, hyper alk phos, + IgM antibodies? Tx?

A

PBC

Tx = ursodeoxycholic acid ? MTX/colchicine

45
Q

W/u algorithm for erythema nodosum

A 
1st = anti-streptolysin-O titer (strep infxn MCC)
2nd = CXR (histo/sarcodiosis)
3rd = PPD
4th = h/o diarrhea/GI complaints (IBD)
46
Q

low leukocyte alkaline phosphatase seen in…(5)

A

CML, PNH, AML, aplastic anemia, pernicious anemia (its found in WBCs, indicates hematologic malignancy)

47
Q

high leukocyte alkaline phosphatase seen in…(4)

A

LEUKEMOID RXN! and Pvera, ET, myelofibrosis

48
Q

Tx MG crisis

A

intubate and D/C acetylcholinesterase inhibitors (possibly for days) +/- plasmapheresis or IVIG

49
Q

MG associated with (2)

A

thyrotoxicosis and thymomas

50
Q

Dx ZE syndrome

A

serum gastrin >1000

if non-dx, then secretin-stim test (if causes a rise in gastrin, then abnormal)

51
Q

70 yo with shoulder and hip pain with elevated ESR? Tx?

A

Polymyalgia Rheumatica

Tx LOW-dose steroids unless associated with giant-cell arteritis (then high dose)

52
Q

2 MCC AVN of femoral head? 2 dx tests?

A

Chronic steroids and alcohol abuse

Dx = MRI and scintography (detects earlier than MRI)

53
Q

anterior hip pain worse with activity and limited ROM +/- pain at rest

A

AVN of femoral head

54
Q

Ensthesitis associated with?

A

HLA-B27 Arthrophathies (AS, psoriatic and reactive arthritis)
MC achilles, tibal tuberosities, iliac crests

55
Q

Dx criteria for Lewy Body Dementia?

A

2+ of the following needed:

fluctuating cognition, recurrent visual hallucinations, parkinson-like motor features

56
Q

Rinne test is abnormal (BC>AC) on the Right, weber test lateralizes to the Left

A

Mixed hearing loss in the right ear (conductive and sensorineural)

57
Q

Tx seizure in the ER

A

Benzodiazepine (lorazepam), if fails then phenytoin

58
Q

Dx lactose intolerance

A

Hydrogen breath test

59
Q

3 Tx fibromyalgia

A

TCA (amitriptyline), exercise +/- muscle relaxant (cyclobenzaprine)

60
Q

HIV drug class causing lactic acidosis

A

NRTIs

Step 2 (20 decks)

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