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Step 2 question review > Smartdeck, 6.8 start > Flashcards

Smartdeck, 6.8 start Flashcards

1
Q

most affective antipsychotic for treatment-resistant schizophrenia and schizoaffective disorder?

A

clozapine

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2
Q

most severe AEs of clozapine

A

agranulocytosis, seizures, myocarditis

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3
Q

compared to other antipsychotics, which one has the greatest risk of seizures?

A

clozapine

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4
Q

what actions are associated with risk reduction for long term rx opioid misuse?

A

state rx drug monitoring, random UDS, regular follow up

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5
Q

gold standard for evaluating risk in pt with hx of cervical surgery

A

transvaginal US

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6
Q

dysarthria, loss of DTRs, progressive gait and limb ataxia in adolescence

loss of position and vibratory senses

hypertrophic cardiomyopathy

A

friedreich ataxia

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7
Q

acute onset of ataxia, nystagmus, and dysarthria following an infection

A

acute cerebellar ataxia

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8
Q

musty odor urine

A

phenylketonuria

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9
Q

if PKU goes untreated…

A

intellectual disability and seizures

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10
Q

how to detect PKU

A

newborn screening

tandem mass spectrometry of dried blood spots

later in life - quantitative amino acid analysis

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11
Q

tx of PKU

A

dietary restriction of phenylalanine

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12
Q

how to differentiate hirschsprungs v meconium ileus

A

level of obstruction

Hirsh- rectosigmoid, normal consistency, positive squirt sign

mec ileus - ileum, inspissated consistency, negative squirt sign

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13
Q

bone pain and pancytopenia in a child

also fever, pallor, bruising, and hepatosplenomegaly

A

acute lymphoblastic leukemia

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14
Q

acute, unilateral cervical lymphadenitis in child is MCC by

A

S. aureus or S. pyogenes

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15
Q

pt has pna and developed signs of septic shock

airway is secure, what next?

A

IV normal saline

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16
Q

what is the MCC of community acquired bacterial meningitis

A

S. pneumo

can occur with or without concurrent pneumococcal pna

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17
Q

Vagal maneuvers will affect with node in the heart, AV or SA?

A

AV

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18
Q

High dose IV acyclovir can cause

A

crystalluria with renal tubular obstruction

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19
Q

diaphragmatic flattening in COPD caused by hyperinflation result in

A

increased work of breathing

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20
Q

intrinsic renal failure is commonly due to

A

acute tubular necrosis

high urine sodium

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21
Q

glomerulonephritis is characterized by

A

hematuria with RBCs

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22
Q

precocious puberty, normal bone age, really just increasing body hair

A

premature adrenarche

caused by early activation of adrenal androgens, more common in obsese children

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23
Q

profound hypoglycemia in pregnancy

A

acute fatty liver of pregnancy

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24
Q

management of acute fatty liver of pregnancy

A

immediate delivery

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25
Q

mucopurulent drainage with a friable cervix

A

acute cervicitis

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26
Q

management of hydatiform mole

A

DnC

serial bhCG post evacuation

contraception for 6 months

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27
Q

in adolescents, abnormal uterine bleeding is caused by

A

immature hypothalamic-pituitary-ovarian axis

causing irregular, heavy bleeding

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28
Q

in hemodynamically stable pt, acute uterine bleeding can be managed with

A

IV estrogen or high dose oral estrogen/progestin contraceptive pills

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29
Q

how long do you need pharmacotherapy for bipolar pt with multiple episodes?

A

likely life long

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30
Q

palpable lymph node, small/<2cm, soft, mobile nodes, localized to one area in a child or young adult

next step?

A

observation

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31
Q

tx for body dysmorphic disorder

A

SSRI and CBT

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32
Q

prerenal AKI is characterized by

A

low urinary sodium (<20)

low fractional excretion of sodium (<1%)

elevated BUN:Cr >20:1

urine sediment is bland

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33
Q

stable pt with wide complex tachycardia can be initially managed with

A

antiarrhythmics like amiodarone

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34
Q

daily copious mucopurulent sputum in pt with chronic cough

A

bronchiectasis

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35
Q

test to determine if Crohns or UC

A

colonoscopy

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36
Q

older adult with progressive neck pain, gait disturbances, lower motor neuron signs in UE, and UMN signs in LE

A

cervical spondylotic myelopathy

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37
Q

persistent, eczematous, and/or ulcerating rash is localized to the nipple and spreads to the areola

A

paget disease of the breast

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38
Q

what kind of cancer is associated with Paget disease of the breast?

A

adenocarcinoma

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39
Q

does primary syphilis have associated adenopathy

A

yes

mild to moderate LAD is often present

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40
Q

what causes granuloma inguinale?

A

klebsiella granulomatis

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41
Q

extensive, progressive, painless genital ulcers, usually without LAD

A

granuloma inguinale

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42
Q

infection causing vaginal pH <4

A

candida

normal pH is 3.8 -4.5

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43
Q

initial evaluation of mixed urinary incontinence

A

voiding diary

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44
Q

first line tx for primary dysmenorrhea

A

NSAIDs

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45
Q

physiologic change of pregnancy associated with insulin

A

increased insulin resistance due to increased levels of placental somatomammotropin

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46
Q

what is placental somatomammotropin?

A

human placental lactogen

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47
Q

what is the cause of labial adhesion?

if symptomatic, what is the tx?

A

low estrogen production

topical estrogen cream

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48
Q

side effect of oxytocin

A

similar to ADH, hyponatremia, seizure

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49
Q

Pts in preterm labor at <32 weeks require:

A

betamethasone (decrease risk neonatal RDS)

tocolytics/indomethacin

mag sulfate for fetal neuroprotection

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50
Q

what age can get vulvar lichen sclerosus

A

prepubertal girls and perimenopausal or postmenopausal women

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51
Q

tx vulvar lichen slcerosus

A

superpotent corticosteroid tx

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52
Q

in what age pt would you see labial adhesions?

A

<2 yo

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53
Q

high risk pts in pregnancy require what in third tri?

A

repeat testing for STIs

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54
Q

pregnant lady with pruritis worse on hands and feet; markedly elevated total bile acids

A

intrahepatic cholestasis of pregnancy

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55
Q

absent coagulation factor carboxylation

A

vit K deficiency

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56
Q

rupture of emissiary veins upon scalp traction during delivery

A

subgalel hemorrhage

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57
Q

diffuse fluctuant swelling extending beyond suture line in neonates

A

subgaleal hemorrhage

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58
Q

subperiosteal vessel rupture

A

cephalohematoma

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59
Q

firm, non fluctuant swelling, does not cross suture line in neonate

no significant blood loss

A

cephalohematoma

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60
Q

pressure of presenting part of the scalp against a dilating cervix

A

caput succadaneum

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61
Q

moderately dehydrated normal kid

A

IV normal saline

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62
Q

neonate with bruising after a home birth

A

vit K deficiency

reduced coagulation factor carboxylation

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63
Q

multiple infxns, S. aureus, Serratia, Burkholderia cepacia (catalase positive)

A

chronic granulomatous disease

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64
Q

umbilical cord fails to separate, decrease immune system

A

leukocyte adhesion deficiency

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65
Q

preterm, leukocytosis, metabolic acidosis, bilious vomiting

A

necrotizing enterocolitis

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66
Q

cyanosis in infant, bounding peripheral pulses, harsh systolic murmur at lower left sternal border, loud S2

A

truncus arteriosus

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67
Q

cyanosis, tachypnea, single loud S2

A

transposition of great vessels

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68
Q

defect in NADPH oxidase

A

chronic granulomatous disease

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69
Q

infecting organisms are catalase positive (S. aureus, E. coli, candida, klebs, pseudo, aspergillus, nocardia, serratia)

A

chronic granulomatous disease

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70
Q

diagnostic test for chronic granulomatous disease

A

dihydroorhodamine test

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71
Q

defect in neutrophil chemotaxis/microtubule polymerization

A

chediak higashi

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72
Q

oculocutaneous albinism, peripheral neuropathy, neutropenia

A

chediak higashi

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73
Q

coarse facies, abscesses, retained primary teeth, hyper IgE, dermatologic

A

Jobs syndrome

Hyper IgE

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74
Q

tx of hyper IgE syndrome

A

penicillinase-resistant abx and IVIG

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75
Q

recurrent neisseria infxns, rarely lupus or glomerulonephritis

A

MAC deficiency

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76
Q

tx for spascity of cerebral palsy

A

diazepam, dantrolene, baclofen

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77
Q

sepsis work up

A

CBC, UA, blood/urine/CSF culture

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78
Q

tongue fasiculations and symmetric proximal muscle weakness, greater in LE than UE

A

spinal muscular atrophy

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79
Q

young child with cervical paravertebral sympathetic chain LAD, droopy eyelid, constricted pupil, abdominal mass

A

neuroblastoma

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80
Q

elevated vanillylmandelic acid and homovanillic acid

A

neuroblastoma

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81
Q

3 yo presents with gross hematuria and painless right sided abdominal mass

A

wilms tumor

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82
Q

claw sign on abdominal mass imaging in kid

A

wilms tumor

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83
Q

kidney mass crossing midline on imaging

A

neuroblastoma

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84
Q

osteosarcoma (aka osteogenic sarcoma) is also associated with

A

Rb and Paget disease

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85
Q

predominantly cortical small tumor, severe nocturnal pain

dx and tx

A

osteoid osteoma

NSAIDs

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86
Q

where is osteoblastoma located?

A

spine

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87
Q

bony overgrowth of the hard palate

A

torus palatinus

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88
Q

lytic lesions in the skull, in child

A

langerhans cell histiocytosis

immune cells, langerhan histiocytes, tennis-raquet, bierbeck granules

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89
Q

most likely site of injury of clavicular fx

A

middle third of clavicle

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90
Q

overuse apophysitis

A

osgood schlatter

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91
Q

SCFE pt that is less than 10th percentile for height, get

A

TSH

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92
Q

kid with diet of mostly cheese and yogurt and drinks ridiculous amounts of milk

A

Fe deficiency anemia

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93
Q

ambiguous genitalia, super high testosterone, 46, XX

A

CAH

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94
Q

5 alpha reductase deficiency will be in what karyotype?

A

46 XY

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95
Q

aromatase deficiency will present with

A

virilization in both the fetus and the mom

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96
Q

failure to thrive, jaundice, hepatomegaly, infantile cataracts, neuro symptoms

A

galactosemia

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97
Q

excess urination in sickle cell trait

A

hyposthenuria

kidney cant concentrate urine

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98
Q

pt with friederich ataxia is most likely to die from

A

cardiac issue

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99
Q

calcified lesion in sella turcica in kid

A

craniopharyngioma

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100
Q

jaundice, pale stools, and dark urine during 2-8 weeks old

A

biliary atresia

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101
Q

amylase rich, exudative pleural effusion

A

pancreaticopleural fistula

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102
Q

decreased air flow during both inspiration and expiration, flattening the top and bottom of a flow loop is likely caused by

A

fixed upper airway lesion

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103
Q

sudden onset respiratory distress following removal of a central venous catheter

A

venous air embolism

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104
Q

tx of venous air embolism

A

L lateral decubitus, in order to trap VAE on the lateral wall of the R ventricle

prevents RVOT obstruction and further embolization

105
Q

more than 2 years of numerous periods with hypomanic and depressive symptoms, but not meeting full criteria for hypomania or depressive symptoms

A

cyclothymic disorder

106
Q

depressed mood lasting most days for more than 2 years

A

persistent depressive disorder

107
Q

low urine osmolality and low urine specific gravity suggest dilute urine, as seen in

A

diabetes inspidus

108
Q

high urine osmolality and specific gravity suggest osmotic diuresis from conditions like

A

diabetes mellitus

109
Q

DVT following a surgery, pt has ESRD tx?

A

unfractionated heparin followed by warfarin

110
Q

heparin would be contraindicated in what pts?

A

ESRD pts

111
Q

respiratory distress, neuro dysfunction, and petechial rash after a femur fx

A

fat embolism syndrome

112
Q

dx of gastric cancer is established with

A

EGD

113
Q

patchy, nonscarring hairloss, autoimmune

A

alopecia areata

114
Q

tx of alopecia areata

A

topical or intralesional corticosteroids

topical triamcinolone

115
Q

laryngomalacia has an

A

inspiratory stridor

116
Q

drug fever from antibiotics (typically beta lactams) is dx of exclusion and generally accompanied by

A

rash and peripheral eosinophilia

117
Q

eczema, microthrombocytopenia, and recurrent infections

A

wiskott aldrich syndrome

118
Q

why do turner syndrome babies have swollen hands and feet

A

lymphatic network dysgenesis

119
Q

bupivacaine systemic toxicity

A

CNS overactivity - perioral numbness, metallic taste, tinnitus

generalized tonic clonic seizure

120
Q

within 2 standard deviations of the mean is what percentage?

A

95% of data

121
Q

greatest risk related to parenteral nutrition

A

central line associated bloodstream infection

122
Q

thready pulses over both radial arteries that disappear with deep inspiration

A

pulsus paradoxus

cardiac tamponade

123
Q

characteristic CSF findings in herpes simplex virus encephalitis

A

lymphocytic pleocytosis, increased erythrocytes, and elevated protein, normal glucose

124
Q

mass causing Cushings is secreting what?

A

ACTH, ectopic corticotropin, polypeptide hormone

125
Q

tx for nonvalvular AF

A

options include: rivaroxaban, dabigatran, apixaban, and endoxaban

126
Q

exudative effusion with very elevated protein

A

Tuberculosus

127
Q

flu vaccines in HIV

MMR and varicella zoster vaccines in HIV

A

never give LAIV

live MMR and VZ vaccines CI if <200 CD4 ct

128
Q

HA worse when leaning forward, JVD but no peripheral edema

A

superior vena cava syndrome

129
Q

fever, ascites, diffuse abdominal pain, tachycardia, AMS

A

spontaneous bacterial peritonitis

130
Q

subepidermal blisters

A

bullous pemphigoid

131
Q

intraepidermal cleavage

A

pemphigus vulgaris

132
Q

what enzymes are elevated in polymyositis

A

CK, aldolase, AST

133
Q

with a tension pneumo, the high intrathoracic pressure will

A

impede venous return to the R atrium by compressing the vena cava

134
Q

what do you see on CT of chronic pancreatitis?

A

calcifications

135
Q

what happens to lipase in chronic pancreatitis?

A

doesn’t have to be elevated

also, alcohol doesn’t always cause liver elevation

136
Q

Pt just had roux en y gastric bypass, and they are likely developing symptomatic gallstones. Why does this happen?

A

due to rapid weight loss, promoting gallstone formation, likely from increased bile concentrations of mucin and calcium

137
Q

elevated phosphate level and low calcium in setting of CKD is characteristic of …

the resulting elevation in PTH can cause…

A

secondary hyperparathyroidism

renal osteodystrophy

138
Q

hypocalcemia and hyperphosphatemia stimulate release of PTH to maintain normal electrolyte levels. overtime, this will result in

A

parathyroid gland hyperplasia

139
Q

high nitrogen states that could cause hepatic encephalopathy

A

GI bleeding or dietary changes

140
Q

suicidal pt, hematemesis, green/black diarrhea, severe abdominal pain.

what did she take?

A

acute iron poisoning

141
Q

new onset AF, unintentional wt loss

what test do you get?

A

TSH

142
Q

the prognosis of astrocytomas is most affected by

A

tumor grade, with increased atypia, mitoses, neovascularity, or necrosis conveying a worse prognosis

143
Q

multi-chain LAD, splenomegaly, mild cytopenias, and marked lymphocytic predominant leukocytosis

A

CLL

144
Q

first line tx of CLL

A

rituximab, mab v CD20 antigen expressed on B lymphocytes

145
Q

what is the relationship, generally speaking, between sensitivity and specificity?

A

as sensitivity increases, specificity decreases

and vice versa

146
Q

tx for advanced pancreatic cancer causing jaundice an pruritis by obstructing the CBD

A

palliative - endoscopic CBD stent placement

147
Q

amlodipine or metoprolol for controlling AF

A

metoprolol

amlo is DHP, causing vasodilation, not affecting conduction rate

148
Q

wenckebach is a

A

Mobitz type I

149
Q

why does renal insufficiency happen in multiple myeloma?

A

light chain cast nephropathy with resultant renal tubular injury

150
Q

trinucleotide CGG repeat on FMR1 gene on the X chromosome

A

Fragile X syndrome

exhibit features of autism

151
Q

3-5 days s/p MI; acute hemodynamic compromise and a holosystolic murmur at the left sternal border

A

ventricular septum rupture

152
Q

meckel diverticulum pathophys

A

ectopic gastric mucosa

153
Q

anemia seen in patients with DIC is often due to

A

microangiopathic hemolysis

154
Q

mitral stenosis murmur

A

mid diastolic murmur at the cardiac apex

155
Q

when do you monitor Lipids?

A

If 10 year ASCVD is >7.5%

156
Q

hemothorax will do what to preload

A

decrease preload, blood is pooling elsewhere

157
Q

nonlobular infiltrate on chest CT

A

pulmonary contusion

158
Q

central obesity, proximal muscle weakness, HTN, and easy bruising

A

Cushing syndrome

159
Q

upper GI series shows a cork-screw shaped duodenum that is abnormally located in the R abdomen

A

midgut volvulus

160
Q

common bug causing immunocomprised (like on chronic glucocorticoids) pt to have bacterial meningitis in pt >50 yo

A

listeria

161
Q

what can you tell a pt who gets a ton of gout attacks

A

drink less alcohol

162
Q

oral vesicles in a kid

A

herpangina, coxsackie A

163
Q

peripheral blood smear shoing signs of dysplasia, oval macrocytes, and hyposegmented/hypogranulated neutrophils

next step?

dx?

A

bone marrow biopsy

myelodysplastic syndrome

164
Q

MC complication of neutropenia

A

bacterial infxn

165
Q

what causes symptoms of DKA physiologically

A

fatty acid breakdown in the liver, generating ketones

166
Q

V/Q scan can be used to rule out PE in pregnancy if…

A

it is normal

if low probability, get CTA

167
Q

tx for urinary urgency

A

lifestyle mods, bladder training, antimuscarinic

168
Q

vaginal bleeding in pt >20 weeks, next step?

A

US to find placenta location

169
Q

blunt trauma, XR shows widened mediastinum, next step?

A

CTA chest

170
Q

chronic loss of visual acuity, excessive glare, and halos around bright lights

A

cataracts

171
Q

advanced cases of cataracts may show

A

loss of red reflex

172
Q

what beta blockers have been shown to improve symptoms and overall long term survival in stable patients with heart failure and LV systolic dysfunction?

A

metoprolol succinate

carvedilol

bisoprolol

173
Q

first line tocolytic at 32-34 weeks gestation

A

nifedipine

174
Q

tocolytic to use prior to 32 weeks

A

indomethacin

175
Q

what causes central cyanosis

A

low arterial oxygen saturation

176
Q

urine findings in rhabdo

A

dark red urine

positive blood

absence of RBC

AKI

177
Q

use of OCPs is associated with decreased risk of

A

ovarian and endometrial cancer

178
Q

sotalol side effect

A

torasdes

179
Q

low grade fever, LAD (suboccipital, posterior auriculuar, and posterior cervical), descending rash in child

A

rubella

180
Q

carditis, chorea, and elevated ESR; also could have erythema marginatum, subcutaneous nodules, and migratory arthritis

A

acute rheumatic fever

181
Q

best intervention to minimize AAA progression

A

smoking cessation

182
Q

inability to recall important personal information, usually of traumatic or stressful nature; not explained by another disorder

A

dissociative amnesia

183
Q

feelings of detachment from, or being an outside observer of, one’s self

A

depersonalization

184
Q

experiencing surroundings as unreal

A

derealization

185
Q

in depersonalization/derealization disorder, reality testing will be …

A

intact

186
Q

irregular patchy hair loss, uneven hair growth and absence of other findings

A

trichotillomania

187
Q

bloating, steatorrhea, and macrocytic anemia in setting of RYGB surgery

A

SIBO

188
Q

test to dx symptomatic diverticulitis

A

abdominal CT with con

189
Q

initial tx for anterior spinal cord injury

A

disrupted autonomic function - causing urinary retention - put in a bladder catheter

190
Q

membranous nephropathy is a nephrotic syndrome and that means this person is also…

A

hypercoaguable

191
Q

3 months constipation in older person and pain unrelated to bowel movements is suspicious for

A

malignancy

192
Q

irregular abdominal protuberance in an acute pregnant lady

A

fetal parts - uterine rupture

193
Q

antiemetics that are dopamine antagonists?

what are their side effects?

A

metoclopramide and prochlorperazine

extrapyramidal symptoms

194
Q

IBD is frequently complicated by … and this can be exacerbated by NSAIDs

A

arthritis

195
Q

how do you confirm central venous catheter placement?

A

chest XR

196
Q

how do kidneys repsond to OSA?

A

increasing epo, resulting in erythrocytosis

197
Q

tx of chemo related diarrhea

A

loperamide

198
Q

tx of beta blocker toxicity

A

glucagon

199
Q

retracted TM

A

eustachian tube dysfunction

200
Q

tumor markers from nonseminomatous germ cell tumors

A

AFP and hCG both elevated

201
Q

erythema of the central face, facial flushing, telangiectasias, and burning discomfort

A

erythematotelangiectatic rosacea

202
Q

pregnant pt positive for GBS, needs intrapartum ppx, has low risk penicillin allergy

A

give cefazolin

203
Q

tx of anaerobic/aspiration lung infection options

A

amoxicillin, amox-clauv, and clinda

204
Q

before starting MTX, what do you need to check on the pt?

A

liver labs

205
Q

unstable pt, unknown AAA, next step?

A

FAST exam

206
Q

TCA overdose and is having cardiac abnormalities, tx?

A

sodium bicarb

sodium load will alleviate depressant action on myocardial sodium channels

207
Q

short term hyperventilation helps lower ICP by causing

A

cerebral washout of CO2, leading to vasoconstriction and decreased cerebral blood flow

208
Q

bacterial meningitis in neonate with increased ICP, next step?

A

LP to properly dx

209
Q

why does cushing syndrome have myopathy??

A

due to direct catabolic effects of cortisol on skeletal muscle, leading to muscle atrophy

210
Q

AIDs pt with increased ICP, progressive HA, N/V and confusion

A

cryptococcal meningitis

211
Q

rapid onset episodes of tachycardia, hypertension, and tachypnea often associated often accompanied by fever and diaphoresis after a TBI

A

paroxysmal sympathetic hyperactivity

212
Q

injury to hip, adduction and internal rotation at the hip

A

posterior hip rotation

213
Q

indomethacin tocolysis can cause …. and …. although benefits outway risks

A

oligohydraminos and premature closure of fetal ductus arteriosus

214
Q

where on the bone does pediatric acute osteomyelitis occur?

A

metaphysis of long bones

215
Q

multiple gastric folds and thickened gastric folds on endoscopy

A

gastrinoma

216
Q

SBO in crohns disease

A

fibrotic stricture

217
Q

initial mgmt of frostbite

A

rapid rewarming in water bath

218
Q

heat exhaustion v heat stroke

A

exhaustion - mentation remains normal

stroke - AMS

219
Q

parapneumonic effusions with pH <7.2, glucose <60, neutro-predominant lymphocytes >50k

A

empyema

220
Q

Type A aortic dissection suspected, next step?

what is contraindicated?

A

CT angiography

CI - anticoagulation

221
Q

edema and narrowing of the proximal trachea in 18 mo old with inspiratory stridor

A

croup

222
Q

unilateral wheezing in a kid, unresponsive to albuterol

A

FB ingestion

223
Q

giant coffee bean on XR

A

sigmoid volvulus

224
Q

tx of uncomplicated sigmoid volvulus

A

flex sig

225
Q

pt with hx of breast cancer and now has mets to at least her spine; abnl labs and hypotension

dx and first test

A

primary adrenal insufficiency

cosyntropin stimulation test

226
Q

eye complications of Sjogrens

A

decreased visual acuity, infection, corneal ulceration, corneal perforation

227
Q

migratory, symmetric, polyarticular arthralgias, accompanied by brief morning stiffness; XR shows no evidence of joint destruction

A

SLE

228
Q

first line tx nummular eczema

A

topical glucocorticoids

229
Q

bright, sharply demarcated erythema over perianal/perineal area in school aged children

A

perianal streptococcus

230
Q

beefy red rash involving skin folds with satellite lesions in kids

A

candida dermatitis

231
Q

tx of papulopustular rosacea

A

topical metronidazole

232
Q

tx of erythematotelangiectatic rosacea

A

topical brimonidine

233
Q

sudden onset of psoriasis - test for?

A

HIV

234
Q

first line tx of OCD

A

CBT and/or SSRI

235
Q

complication of hyperemesis gravidarum, symptoms of encephalopathy, oculomotor dyfunction, and gait ataxia

A

wernicke encephalopathy, thiamine deficiency

236
Q

oliguria definition by numbers

A

<250 mL urine in 12 hours

237
Q

pt with oliguria and AKI, next step

A

urgent bladder scan and cath

238
Q

elevated intraocular pressure, optic disc rim thinning, increased cup:disc ratio, otherwise asymptomatic

A

open angle gluacoma

239
Q

first line tx open angle glaucoma

A

topical agent to lower IOP, topical prostaglandin (latanoprost, bimatoprost)

240
Q

if prostaglandins are ineffective tx of open angle gluacoma, what is next step?

A

topical beta blocker like timolol

241
Q

hypercalcemia in setting of metastatic cancer to bone, tx?

A

bisphosphonates

242
Q

crescendo-decrescedno murmur along L sternal border without carotid radiation

A

HOCM

243
Q

CXR shows extensive bilateral alveolar opacities

A

ARDS

244
Q

ARDS pt with insufficient oxygenation, FiO2 is at 70% and PEEP is at 5, what do you change?

A

increase PEEP because we try to wean to <60% FiO2 as quickly as possible

245
Q

tx of BCC on trunk or extremities

A

surgical excision bx with narrow margins

246
Q

postexposure HIV ppx for high risk occupational exposure

A

3 drug antiretroviral therapy for 4 weeks, start ASAP

247
Q

initial step in evaluation of Cushings syndrome to confirm hypercortisolism

A

late-night salivary cortisol

24 hour urine free cortisol

overnight low dose dexamethasone test

248
Q

MC testicular malignancy in prepubertal males

A

yolk sac tumor

249
Q

tx of MVP

A

reassure and echos on occasion

250
Q

tx of severe mitral stenosis

A

percutaneous balloon valvuloplasty

251
Q

status epilepticus tx

A

lorazepam

lorazepam

fosphenytoin

phenytoin

valproic acid

levetiracetam

252
Q

travel to mexico, now has RUQ abd pain, diarrhea and weakness, next step?

A

RUQ ultrasound

253
Q

only established risk factor for acne

A

family hx

254
Q

new dx of HTN in pt with fhx of HTN and DM, next step?

A

EKG

255
Q

MC long term sequelae of untreated bacterial menigitis

A

eighth cranial nerve/ hearing loss

256
Q

dilated high output cardiomyopathy and heart failure

dx and what vitamin deficiency?

A

wet beri beri

thiamine

257
Q

3 drugs that could tx community acquired MRSA

A

TMP-SMX, doxy, clinda

258
Q

tx of cardiogenic shock

A

NE or DA

259
Q

control exacerbations of Bechet disease with

A

prednisone

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