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1
Q

Cause of hemophilia A

A

Factor VIII

Hemophilia B is Factor IX

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2
Q

What is considered precocious puberty?

A

Girls 8 or younger

Boys 9 or younger

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3
Q

What causes precocious puberty in obese children?

A

Isolated premature adrenarche

Oily hair/skin, pubic/axillary hair, acne. Generally will not have menarche/thelarche.

Mediated by DHEA-S

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4
Q

Where does the abdomen begin with regard to penetrating injury?

A

Anything below the nipple is considered to involve abdomen and thorax until proven otherwise.

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5
Q

Indications for ex-lap after penetrating injury

A

Injury to abdomen or chest below nipples with:

  • HD instability
  • Peritoneal signs
  • Evisceration
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6
Q

Symptoms of Wilson’s Dz

A 
Liver disease (children/adolescents)
Neuropsych disturbances (tremor, rigidity, depression, catatonia)
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7
Q

Diagnosis of Wilson’s dz

A

Ceruloplasmin

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8
Q

What is seen on liver biopsy in A1AT deficiency?

A

Emphysema & early liver failure

PAS-positive and diastase-resistant granules

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9
Q

What drugs cause intersitial nephritis?

A 
Cephalosporins
Penicillins
Sulfa drugs
NSAIDs
Phenytoin
Allopurinol
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10
Q

Symptoms of drug-induced interstitial nephritis

A

Arthralgias
Rash
Acute renal failure
Eosinophilic casts in urine

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11
Q

How long for exclusive breastfeeding?

A

First 6mo of life

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12
Q

Maternal benefits of breastfeeding

A

Reduced risk of ovarian and breast cancer

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13
Q

Infant benefits of breastfeeding

A

Prevention of AOM, NEC, respiratory infx, UTI

Decreased risk of T1DM & childhood cancer

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14
Q

Contraindications to breastfeeding

A 
Galactosemia
Untreated maternal TB
Maternal HIV infection
Peripartum maternal varicella infx
Chemoradiation
Alcohol or drug abuse
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15
Q

Appearance of herpes lesions

A

Painful
Multiple, small, shallow, grouped ulcers
Tender LAD

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16
Q

Appearance of H. ducreyi infection

A

Single or multiple, painful
DEEP ulcers with ragged border
Base may have exudate
Matted LN’s can rupture

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17
Q

Which STI ulcers are painful vs. painless

A

Painful: Herpes, Chancroid (H. ducreyi)
Painless: Syphilis, Chlamydia, Klebsiella granulomatis

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18
Q

Presentation of acute syphilis infection

A

Single, well-circumscribed painless ulcer
Clean base
Nontender LAD

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19
Q

Presentation of Chlamydial ulcers L1-L3 serovars

A

Small shallow painless ulcers

Painful buboes

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20
Q

Immune complex-mediated nephritic syndromes

A

Postinfectious GN

IgA nephropathy

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21
Q

Diagnosis of post-infectious GN

A

Oliguria, edema, HTN, coca cola colored urine, recent pharyngitis
Low serum C3
ASO titer

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22
Q

Treatment of IgA nephropathy

A

Glucocorticoids

ACEi’s if proteinuria present

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23
Q

What are the types of nephritic syndrome?

A

Immune complex:

  • -Postinfectious GN
  • -IgA nephropathy

Pauci-immune:
–Wegener’s granulomatosis

Anti-GBM:

  • -Goodpasture’s syndrome
  • -Alport’s syndrome
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24
Q

Treatment of Wegener’s GN

A

High dose corticosteroids & cytotoxic agents

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25
Treatment of Goodpasture's syndrome
Plasma exchange | Pulsed steroids
26
What is seen in Alport syndrome?
Hematuria Sensorineural deafness Eye disorders Presents in boys 5-20y
27
Symptoms of nephritic syndrome
``` Proteinuria Hematuria Azotemia RBC casts Oliguria Hypertension ```
28
Symptoms of nephrotic syndrome
Proteinuria (>3.5g per day) Albumin low Lipids high Edema
29
What are the causes of nephrotic syndrome?
``` Minimal change disease FSGS Membranous nephropathy Diabetic nephropathy Lupus nephritis Renal amyloidosis Membranoproliferative nephropathy ```
30
Treatment of minimal change disease
Steroids Most children have a full recovery
31
Things associated with FSGS
Black IV drug use HIV Obesity
32
Histologic forms of diabetic nephropathy
``` Diffuse hyalinization Nodular glomerulosclerosis (Kimmelstiel-Wilson nodules) ```
33
Causes of renal amyloidosis
Primary: Multiple myeloma Secondary: infectious/inflammatory (TB, RA, etc.)
34
Apple green birefringence on Congo red staining
Amyloidosis
35
Causes of membranoproliferative nephropathy
HCV Cryoglobulinemia SLE Bacterial endocarditis
36
Treatment of nephrotic syndrome
Protein & salt restriction Immunosuppression (for some forms) ACEi's PPV23 immunization
37
Most common causes of acute unilateral lymphadenitis in children
Normally bacterial: Staph aureus or GAS
38
Symptoms of Vitamin A deficiency
Night blindness Photophobia Dry/scaly skin Dry conjunctiva and cornea
39
Symptoms of Beriberi
Thiamine deficiency Infantile: Cardiomegaly, cyanosis, dyspnea, vomiting Dry adult: Symmetrical peripheral neuropathy Wet adult: Neuropathy + cardiac involvement
40
Symptoms of hypervitaminosis A
``` Pruritis Alopecia Fissuring of corners of the mouth Increased ICP Hepatomegaly ```
41
Crystals seen in pseudogout
Calcium pyrophosphate | Rhomboid, positive birefringence
42
Crystals seen in gout
Monosodium urate | Needle-shaped, negative birefringence
43
What immunizations are recommended in asplenic patients?
PCV13 then PPSV23 H. flu type B Meningococcal These should be given >2 weeks before or >2 weeks after splenectomy.
44
What are the primary humoral deficiencies?
``` X-linked agammaglobulinemia Common variable immunodeficiency IgA deficiency Hyper IgM syndrome IgG subclass deficiency ```
45
Lab findings in X-linked agammaglobulinemia
Recurrent sinopulmonary infx Decreased or absent B cells Decreased Ig's
46
Lab findings in CVID
Recurrent sinopulmonary infx Normal B cells Decreased Ig's
47
Lab findings in hyper-IgM syndrome
Recurrent sinopulmonary infx Normal B cells Decreased IgG and IgA Increased IgM
48
Causes of abnormal uterine bleeding
PALM-COEIN ``` Polyps Adenomyosis Leiomyoma Malignancy and hyperplasia Coagulopathy Ovulatory dysfunction/anovulatory cycles Endometrial Iatrogenic Not otherwise classified ```
49
Indications for endometrial biopsy
Women >45 with irregular menstrual bleeding | Any postmenopausal bleeding
50
Symptoms of thalamic stroke
Contralateral hemianesthesia Dysesthesia (pain with light touch, aka thalamic phenomenon) Transient hemiparesis, athetosis, or hemiballismus
51
Treatment of toxoplasma
Sulfadiazine and pyrimethramine
52
When do opioid abusers develop withdrawal? | What are the symptoms?
Begins 6-12h Peaks 24-48h n/v/d, restlessness, rhinorrhea, lacrimation, myalgias, dysphoria
53
Symptoms of constrictive pericarditis
``` Peripheral edema Ascites Elevated JVP Pericardial knock (mid-diastolic) Pericardial calcifications on CXR ```
54
Symptoms of posterior limb of internal capsule CVA
Unilateral motor impairment | No sensory or cortical deficits
55
Symptoms of CVA in the MCA
Contralateral sensory and motor deficit (face, arm, and leg) Aphasia (if dominant), Hemineglect (if nondominant) Eye deviation toward lesion Homonymous hemianopia
56
Symptoms of an ACA infarction
Sensory and motor deficit of contralateral lower extremity | Frontal lobe symptoms (apraxia, abulia, emotional disturbances)
57
Treatment for frostbite
Rapid rewarming with warm water
58
Side effects of amiodarone
``` QT prolongation Chronic interstitial pneumonitis Hypo/hyperthyroidism Transaminitis Peripheral neuropathy Optic neuropathy Blue-gray skin discoloration ```
59
How is compartment syndrome diagnosed?
Compartment pressures > 30 mmHg | Delta pressure
60
ABG findings in CHF exacerbation
Hypoxia Hypocapnea Resp alkalosis
61
ABG findings in COPD exacerbation
Hypoxia Hypercapnea Resp acidosis
62
Prophylaxis in HIV patients
CD4
63
What is considered oliguria?
64
Treatment of wounds for tetanus
If received 3+ doses of tetanus toxoid: - -Clean wound: vaccine if >10y since last dose - -Dirty wound: vaccine if >5y since last dose Unimmunized or Uncertain: - -Clean wound: vaccine only - -Dirty wound: vaccine plus tetanus Ig
65
Timing of post-MI complications
Same day: CHF 2-4 days: Acute pericarditis, arrhythmia 5-10 days: Free wall rupture, papillary muscle rupture Weeks-months: Ventricular aneurysm
66
Lipid levels considered to be dyslipidemia
LDL > 130 or HDL
67
Indications for CABG
UnLimiTeD Unable to perform PCI Left main coronary artery Triple vessel disease Depressed ventricular function
68
Symptoms of TCA overdose | Treatment for TCA overdose
CNS depression, hypotension, anticholinergic (mydriasis, dry flushed skin, ileus), QRS prolongation Tx: Sodium bicarb
69
What is seen with anterior cord syndrome?
Total loss of motor function below lesion Loss of pain/temperature sensation Preservation of proprioception
70
When is orchiopexy performed?
If testes still undescended by 6mo they are unlikely to do so Should be performed before 1y
71
Complications of cryptorchidism
Inguinal hernia Testicular torsion Subfertility Testicular cancer
72
Definition of menorrhagia
Prolonged or heavy menstruation | Longer than 7d or >80 cc
73
How is ectopic pregnancy diagnosed?
+hCG level | Empty uterus +/- fetus observed on adnexal US
74
What immunizations are routinely given during pregnancy?
Tdap | IPV
75
What immunizations are contraindicated during pregnancy?
``` HPV MMR (wait 4 weeks) Varicella (wait 4 weeks) Smallpox Live-attenuated influenza (wait 4 weeks) ```
76
Side effects of cyclophosphamide | How to mitigate
Acute hemorrhagic cystitis (acrolein-mediated) Bladder cancer (acrolein-mediated) Sterility Myelosuppression Administer MESNA with cyclophosphamide along with lots of IVF.
77
What bacteria in the blood should raise suspicion for colorectal cancer?
Strep gallolyticus (Strep bovis Type 1)
78
What is the treatment for acute angle closure glaucoma?
IV Acetazolamide Eventual laser peripheral iridotomy
79
What is seen with open angle glaucoma?
Insidious loss of peripheral vision resulting in tunnel vision
80
Clinical presentation of ankylosing spondylitis | How is it diagnosed?
10-30y male with spinal stiffness & low back pain for >3mo. Lasts >30 mins in the morning and better with activity. Tenderness over SI joints. Diagnose with spinal x-ray showing fused SI joints or bamboo spine
81
What is the initial management of ruptured esophageal varices?
Volume resuscitation IV octreotide Antibiotics Then endoscopic sclerotherapy or band ligation
82
Treatment of acute pancreatitis
Analgesics IVF NPO NG tube
83
What are the secondary causes of HTN?
``` Renal parenchymal disease Renal artery stenosis Primary hyperaldosteronism Pheochromocytoma Cushing syndrome Hypothyroidism Primary hyperparathyroidism Coarctation of the aorta ```
84
Causes of Cushing's syndrome
Exogenous glucocorticoids Ectopic ACTH production (SCLC) ACTH-producing pituitary adenomas
85
What are the types of tremors?
Essential Parkinson's dz Cerebellar Physiologic
86
Characteristics of essential tremor
Bilateral action tremor of the hands Relieved with alcohol No other neurologic signs
87
Clinical presentation of opioid intoxication
Decreased respiratory rate (most reliable sign) Hypotension Hypothermia Obtunded
88
What Ig's are associated with PBC?
Anti-mitochondrial Ab's Also high ALK, cholesterol, and IgM
89
What Ig's are associated with autoimmune hepatitis?
Anti-smooth muscle Ab's
90
What Ig's are associated with SLE?
ANA | Anti-Smith Ab's
91
How to differentiate exudative vs. transudative pleural effusion
Exudate has at least ONE of the following: - -Pleural fluid protein/serum protein ratio > 0.5 - -Pleural LDH/serum LDH > 0.6 - -Pleural LDH > 60
92
What makes a parapneumonic effusion complicated?
pH empyema
93
Treatment of parapneumonic effusion
Uncomplicated --> abx Complicated --> abx +/- chest tube drainage Empyema --> abx + chest tube drainage
94
What drugs can cause drug-induced lupus?
HIPP: Hydralazine, Isoniazid, Procainamide, Phenytoin
95
Causes of transudative pleural effusion
CHF Cirrhosis Nephrotic syndrome
96
Causes of exudative pleural effusion
``` Pneumonia (parapneumonic effusion) TB Malignancy PE RA/SLE Pancreatitis Trauma ```
97
Treatment of bacterial conjunctivitis
Erythromycin ointment Polymixin-trimethoprim drops Azithromycin drops FQ drops (preferred if contacts are worn)
98
Most common cause of viral conjunctivitis
Adenovirus
99
Treatment for pinworm infection
Mebendazole Confirm diagnosis with scotch tape test
100
Murmur heard from VSD
Holosystolic murmur at LLSB | Apical diastolic rumble
101
Murmur of ASD
Widely split, fixed S2 | Systolic ejection murmur at LUSB
102
What is part of the tetralogy of fallot complex
VSD Overriding aorta RVH RV outflow obstruction
103
What causes urinary retention 2/2 anticholinergics?
Decreased detrusor contraction
104
How is angle closure glaucoma diagnosed?
Tonometry | Gonioscopy
105
How is Boerhaave syndrome diagnosed
CT or Gastrografin esophagography CXR: Pneumomediastinum and pleural effusions Pleural fluid analysis has high amylase (>2500)
106
Prophylaxis in HIV patients
``` 200 = PCP = Bactrim 150 = Histoplasma = Itraconazole 100 = Toxoplasma = Bactrim 50 = MAC = Azithromycin ```
107
Prophylaxis in posttransplant patients
Bactrim for PCP Immunize against Influenza, pneumococcus, and HBV
108
When to perform oral glucose tolerance test
24-28w
109
TSH, total T4, and free T4 levels in pregnancy
TSH down Total T4 way up Free T4 slightly up Because beta-hCG has TSH-like activity and estrogen increases TBG
110
Paraneoplastic syndromes of SCLC
ACTH (Cushing's) ADH (SIADH) Lambert-Eaton syndrome
111
Paraneoplastic syndromes of lung SCC
PTHrP (hypercalcemia)
112
Most common cause of urinary obstruction in newborn males
Posterior urethral valves Can cause Potter's sequence and hydronephrosis in-utero
113
Treatment for diabetic distal neuropathy
1) TCA's | 2) Gabapentin
114
EPS side effects of antipsychotics
Acute dystonic reaction (neck, mouth, tongue, EOM) Akithisia (restlessness) Parkinsonism Tardive dyskinesia (after 1-6mo)
115
Which hereditary hyperbilirubinemias present with unconjugated hyperbili? What is the difference?
Gilbert's - mild and occurs with fasting and stress | Crigler-Najjar - Severe with early death
116
Which hereditary hyperbilirubinemias present with conjugated hyperbili? What is the difference?
Rotor's syndrome - normal appearing liver Dubin-Johnson - Black liverf
117
Treatment of the hereditary hyperbilirubinemias
Crigler-Najjar I - Phenobarbital Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant Dubin-Johnson, Rotor's, Gilbert's do not require treatment.
118
Lab/vitals abnormalities of LBW infants
``` Hypoxia Hypothermia Hypoglycemia Hypocalcemia Polycythemia ```
119
What electrolyte derangements are seen with significant emesis?
Hypochloremic, hypokalemic metabolic alkalosis Loss of HCl in vomit Angiotensin II --> HCO3 resorption Aldosterone --> H+ secretion and K+ secretion
120
Superior sulcus tumor possible symptoms
Horner syndrome Pancoast (ulnar pain distribution, shoulder weakness) Hoarseness (RLN) SVC syndrome
121
Divisions of mediastinum and their masses
Anterior: 4 T's (thymoma, teratoma, thyroid, terrible lymphoma) Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma Posterior: Neurogenic tumors
122
Beck's triad of cardiac tamponade
Hypotension Distant heart sounds Distended jugular veins
123
When can chorionic villous sampling be done? | Amniocentesis?
CVS: 9-14w Amniocentesis: 15-22w
124
When to swab for GBS
35w
125
Quad screen results for Edwards syndrome
UNDERaged at 18 | All are down
126
Quad screen results for Down syndrome
2up 2down at 21
127
Treatment of HIV in pregnancy
1) Zidovudine or Nevirapine during pregnancy 2) Elective c-section if viral load over 1000 3) Zidovudine for infant 4) No breastfeeding
128
Normal fetal heart rate | Causes for bradycardia or tachycardia
110-160 bpm Brady - Congenital heart malformations, hypoxia Tachy - Hypoxia, maternal fever, fetal anemia
129
Normal variability on FHT
6-25 bpm
130
What does sinusoidal variability on FHT indicate?
Serious fetal anemia
131
Treatment of hypercalcemia 2/2 malignancy
Short term: Normal saline, Calcitonin | Long term: Bisphosphonates
132
Mutation seen in cri-du-chat syndrome
5p deletion
133
Difference between gestational and chronic HTN
Chronic HTN if present before 20w or persists after 12w postpartum Gestational HTN if presents after 20w
134
Definition of preeclampsia
1) New-onset HTN after 20w or worsened chronic HTN | 2) Proteinuria of over 300mg/24h (3+ proteins)
135
Murmur of transposition of the great vessels
Single S2 +/- VSD murmur Most common early cyanotic dz
136
Murmur of tetralogy of Fallot
Pulmonic stenosis murmur | VSD murmur
137
Treatment of transposition of the great vessels
``` Prostaglandins early (to maintain PFO) Emergent surgery ```
138
Treatment of impetigo
Non-bullous (honey crusts) - Topical mupirocin | Bullous - Oral abx
139
Symptoms of multiple myeloma
Calcium elevated Renal dysfunction Anemia Bone lesions/Back pain
140
Indications for carotid endarterectomy
Symptomatic 70-99% | Men asymptomatic 60-99%
141
ESR and CK in glucocorticoid myopathy
Both normal Painless weakness
142
ESR and CK in Polymyalgia Rheumatica
ESR elevated | CK normal
143
ESR and CK in statin-induced myopathy
ESR normal | CK elevated
144
How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis
Saline-responsive: Urine chloride under 20 Saline-resistant: Urine chloride over 20 Saline responsive is 2/2 vomiting, diarrhea, diuretic abuse Saline resistant is 2/2 hyperaldosteronism, Cushing's, hypokalemia
145
What cancers are seen with HNPCC?
Colon cancer | Endometrial cancer
146
What cancers are associated with nephrotic syndromes?
Adenocarcinoma - membranous nephropathy Lymphoma - Minimal change disease
147
Treatment of uric acid kidney stones
Oral potassium citrate Citrate alkalinizes the urine and inhibits crystallization
148
Solitary pulmonary nodule workup
Nonsmoker - compare to old CXR. Q3mo CXR's. If stable for 12mo considered benign. Smoker: - Chest CT - FNA
149
Treatment for neonatal thyrotoxicosis
Methimazole + beta-blocker Caused by maternal anti-TSH receptor Ab's
150
Extrahepatic manifestations of HCV
Porphyria cutanea tarda Essential mixed cryoglobulinemia Membranoproliferative GN
151
Symptoms of mixed cryoglobulinemia
Purpura Arthralgias Weakness Membranoproliferative GN
152
Symptoms of galactosemia
Newborn with: - FTT - Bilateral cataracts - Jaundice - Hypoglycemia
153
What is a normal AFI?
5-20
154
At what EFW would you deliver by planned c-section due to macrosomia?
No DM: 5,000g | DM: 4,500g
155
What maternal titer is considered Rh-sensitized?
1:16 So 1:20, 1:32, etc.
156
Definition of PROM and PPROM
PROM: Rupture 1h or more before onset of labor PPROM: Rupture between 20-37w
157
What blood loss is considered postpartum hemorrhage?
500cc via vaginal delivery | 1000cc via c-section
158
Causes of postpartum hemorrhage
Tone (atony) Tissue (retained placental tissue) Trauma (of genital tract) Thrombin (coagulopathy)
159
Diagnosis of Polymyositis/Dermatomyositis
1) Anti-Jo-1 Ab's | 2) Muscle biopsy
160
What antibodies are associated with SLE?
ANA Anti-dsDNA Anti-Smith
161
What antibodies are associated with RA?
Anti-CCP | Rheumatoid factor
162
What antibodies are associated with CREST syndrome?
Anti-centromere
163
What antibodies are associated with drug-induced SLE?
Anti-histone
164
What antibodies are associated with PBC?
Antimitochondrial
165
What antibodies are associated with Scleroderma?
ANA Anti-Scl-70 Anti-topoisomerase I
166
What antibodies are associated with autoimmune hepatitis?
Anti-smooth muscle
167
What antibodies are associated with Graves' dz?
Anti-TSH receptor
168
What antibodies are associated with GPA?
c-ANCA
169
What antibodies are associated with microscopic polyangiitis?
p-ANCA
170
What antibodies are associated with MCTD?
U1RNP antibody
171
What does Prussian Blue staining detect?
Hemosiderin
172
What is seen in neurofibromatosis type 1?
Cafe-au-lait spots Neurofibromas Lisch nodules (iris hamartomas) Optic glioma
173
Eye deviation in hemiparesis
Thalamic lesion - eyes deviate Toward hemiparesis | Cerebral lobe - eyes deviate Contralateral from hemiparesis
174
Symptoms of carcinoid syndrome
Flushing Diarrhea Bronchospasm Usually tumor is found in small intestine
175
What is the classic brain lesion caused by status epilepticus?
Cortical laminar necrosis
176
What cancer rates are affected by COC's?
COC's reduce ovarian and endometrial cancer rates
177
Causes of primary amenorrhea with normal secondary sex characteristics
Pregnancy Mullerian agenesis (2/3 of vagina and uterus missing) Imperforate hymen Androgen insensitivity (absent pubic hair)
178
How is bone age used to workup primary amenorrhea?
If bone age is 12+ and no development - likely a HPG axis problem If bone age is under 12 - likely constitutional delay
179
Initial workup for secondary amenorrhea
Pregnancy test TSH Prolactin level If all normal, proceed to progestin challenge
180
What to order if progestin challenge produces a withdrawal bleed
LH If decreased --> idiopathic anovulation If increased --> PCOS or premature menopause
181
What to order if no withdrawal bleed after progestin challenge
FSH Elevated --> Hypergonadotropic hypogonadism Decreased --> cyclic E2/Pr test to differentiate hypogonadotropic hypogonadism vs. endometrial/anatomic problem
182
Prophylaxis in HIV patients
``` 200 = PCP = Bactrim 150 = Histoplasma = Itraconazole 100 = Toxoplasma = Bactrim 50 = MAC = Azithromycin ```
183
Prophylaxis in posttransplant patients
Bactrim for PCP Immunize against Influenza, pneumococcus, and HBV
184
When to perform oral glucose tolerance test
24-28w
185
TSH, total T4, and free T4 levels in pregnancy
TSH down Total T4 way up Free T4 slightly up Because beta-hCG has TSH-like activity and estrogen increases TBG
186
Paraneoplastic syndromes of SCLC
ACTH (Cushing's) ADH (SIADH) Lambert-Eaton syndrome
187
Paraneoplastic syndromes of lung SCC
PTHrP (hypercalcemia)
188
Most common cause of urinary obstruction in newborn males
Posterior urethral valves Can cause Potter's sequence and hydronephrosis in-utero
189
Treatment for diabetic distal neuropathy
1) TCA's | 2) Gabapentin
190
EPS side effects of antipsychotics
Acute dystonic reaction (neck, mouth, tongue, EOM) Akithisia (restlessness) Parkinsonism Tardive dyskinesia (after 1-6mo)
191
Which hereditary hyperbilirubinemias present with unconjugated hyperbili? What is the difference?
Gilbert's - mild and occurs with fasting and stress | Crigler-Najjar - Severe with early death
192
Which hereditary hyperbilirubinemias present with conjugated hyperbili? What is the difference?
Rotor's syndrome - normal appearing liver Dubin-Johnson - Black liverf
193
Treatment of the hereditary hyperbilirubinemias
Crigler-Najjar I - Phenobarbital Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant Dubin-Johnson, Rotor's, Gilbert's do not require treatment.
194
Lab/vitals abnormalities of LBW infants
``` Hypoxia Hypothermia Hypoglycemia Hypocalcemia Polycythemia ```
195
What electrolyte derangements are seen with significant emesis?
Hypochloremic, hypokalemic metabolic alkalosis Loss of HCl in vomit Angiotensin II --> HCO3 resorption Aldosterone --> H+ secretion and K+ secretion
196
Superior sulcus tumor possible symptoms
Horner syndrome Pancoast (ulnar pain distribution, shoulder weakness) Hoarseness (RLN) SVC syndrome
197
Divisions of mediastinum and their masses
Anterior: 4 T's (thymoma, teratoma, thyroid, terrible lymphoma) Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma Posterior: Neurogenic tumors
198
Beck's triad of cardiac tamponade
Hypotension Distant heart sounds Distended jugular veins
199
When can chorionic villous sampling be done? | Amniocentesis?
CVS: 9-14w Amniocentesis: 15-22w
200
When to swab for GBS
35w
201
Quad screen results for Edwards syndrome
UNDERaged at 18 | All are down
202
Quad screen results for Down syndrome
2up 2down at 21
203
Treatment of HIV in pregnancy
1) Zidovudine or Nevirapine during pregnancy 2) Elective c-section if viral load over 1000 3) Zidovudine for infant 4) No breastfeeding
204
Normal fetal heart rate | Causes for bradycardia or tachycardia
110-160 bpm Brady - Congenital heart malformations, hypoxia Tachy - Hypoxia, maternal fever, fetal anemia
205
Normal variability on FHT
6-25 bpm
206
What does sinusoidal variability on FHT indicate?
Serious fetal anemia
207
Treatment of hypercalcemia 2/2 malignancy
Short term: Normal saline, Calcitonin | Long term: Bisphosphonates
208
Mutation seen in cri-du-chat syndrome
5p deletion
209
Difference between gestational and chronic HTN
Chronic HTN if present before 20w or persists after 12w postpartum Gestational HTN if presents after 20w
210
Definition of preeclampsia
1) New-onset HTN after 20w or worsened chronic HTN | 2) Proteinuria of over 300mg/24h (3+ proteins)
211
Murmur of transposition of the great vessels
Single S2 +/- VSD murmur Most common early cyanotic dz
212
Murmur of tetralogy of Fallot
Pulmonic stenosis murmur | VSD murmur
213
Treatment of transposition of the great vessels
``` Prostaglandins early (to maintain PFO) Emergent surgery ```
214
Treatment of impetigo
Non-bullous (honey crusts) - Topical mupirocin | Bullous - Oral abx
215
Symptoms of multiple myeloma
Calcium elevated Renal dysfunction Anemia Bone lesions/Back pain
216
Indications for carotid endarterectomy
Symptomatic 70-99% | Men asymptomatic 60-99%
217
ESR and CK in glucocorticoid myopathy
Both normal Painless weakness
218
ESR and CK in Polymyalgia Rheumatica
ESR elevated | CK normal
219
ESR and CK in statin-induced myopathy
ESR normal | CK elevated
220
How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis
Saline-responsive: Urine chloride under 20 Saline-resistant: Urine chloride over 20 Saline responsive is 2/2 vomiting, diarrhea, diuretic abuse Saline resistant is 2/2 hyperaldosteronism, Cushing's, hypokalemia
221
What cancers are seen with HNPCC?
Colon cancer | Endometrial cancer
222
What cancers are associated with nephrotic syndromes?
Adenocarcinoma - membranous nephropathy Lymphoma - Minimal change disease
223
Treatment of uric acid kidney stones
Oral potassium citrate Citrate alkalinizes the urine and inhibits crystallization
224
Solitary pulmonary nodule workup
Nonsmoker - compare to old CXR. Q3mo CXR's. If stable for 12mo considered benign. Smoker: - Chest CT - FNA
225
Treatment for neonatal thyrotoxicosis
Methimazole + beta-blocker Caused by maternal anti-TSH receptor Ab's
226
Extrahepatic manifestations of HCV
Porphyria cutanea tarda Essential mixed cryoglobulinemia Membranoproliferative GN
227
Symptoms of mixed cryoglobulinemia
Purpura Arthralgias Weakness Membranoproliferative GN
228
Symptoms of galactosemia
Newborn with: - FTT - Bilateral cataracts - Jaundice - Hypoglycemia
229
What is a normal AFI?
5-20
230
At what EFW would you deliver by planned c-section due to macrosomia?
No DM: 5,000g | DM: 4,500g
231
What maternal titer is considered Rh-sensitized?
1:16 So 1:20, 1:32, etc.
232
Definition of PROM and PPROM
PROM: Rupture 1h or more before onset of labor PPROM: Rupture between 20-37w
233
What blood loss is considered postpartum hemorrhage?
500cc via vaginal delivery | 1000cc via c-section
234
Causes of postpartum hemorrhage
Tone (atony) Tissue (retained placental tissue) Trauma (of genital tract) Thrombin (coagulopathy)
235
Diagnosis of Polymyositis/Dermatomyositis
1) Anti-Jo-1 Ab's | 2) Muscle biopsy
236
What antibodies are associated with SLE?
ANA Anti-dsDNA Anti-Smith
237
What antibodies are associated with RA?
Anti-CCP | Rheumatoid factor
238
What antibodies are associated with CREST syndrome?
Anti-centromere
239
What antibodies are associated with drug-induced SLE?
Anti-histone
240
What antibodies are associated with PBC?
Antimitochondrial
241
What antibodies are associated with Scleroderma?
ANA Anti-Scl-70 Anti-topoisomerase I
242
What antibodies are associated with autoimmune hepatitis?
Anti-smooth muscle
243
What antibodies are associated with Graves' dz?
Anti-TSH receptor
244
What antibodies are associated with GPA?
c-ANCA
245
What antibodies are associated with microscopic polyangiitis?
p-ANCA
246
What antibodies are associated with MCTD?
U1RNP antibody
247
What does Prussian Blue staining detect?
Hemosiderin
248
What is seen in neurofibromatosis type 1?
Cafe-au-lait spots Neurofibromas Lisch nodules (iris hamartomas) Optic glioma
249
Eye deviation in hemiparesis
Thalamic lesion - eyes deviate Toward hemiparesis | Cerebral lobe - eyes deviate Contralateral from hemiparesis
250
Symptoms of carcinoid syndrome
Flushing Diarrhea Bronchospasm Usually tumor is found in small intestine
251
What is the classic brain lesion caused by status epilepticus?
Cortical laminar necrosis
252
What cancer rates are affected by COC's?
COC's reduce ovarian and endometrial cancer rates
253
Causes of primary amenorrhea with normal secondary sex characteristics
Pregnancy Mullerian agenesis (2/3 of vagina and uterus missing) Imperforate hymen Androgen insensitivity (absent pubic hair)
254
How is bone age used to workup primary amenorrhea?
If bone age is 12+ and no development - likely a HPG axis problem If bone age is under 12 - likely constitutional delay
255
Initial workup for secondary amenorrhea
Pregnancy test TSH Prolactin level If all normal, proceed to progestin challenge
256
What to order if progestin challenge produces a withdrawal bleed
LH If decreased --> idiopathic anovulation If increased --> PCOS or premature menopause
257
What to order if no withdrawal bleed after progestin challenge
FSH Elevated --> Hypergonadotropic hypogonadism Decreased --> cyclic E2/Pr test to differentiate hypogonadotropic hypogonadism vs. endometrial/anatomic problem
258
Prophylaxis in HIV patients
``` 200 = PCP = Bactrim 150 = Histoplasma = Itraconazole 100 = Toxoplasma = Bactrim 50 = MAC = Azithromycin ```
259
Prophylaxis in posttransplant patients
Bactrim for PCP Immunize against Influenza, pneumococcus, and HBV
260
When to perform oral glucose tolerance test
24-28w
261
TSH, total T4, and free T4 levels in pregnancy
TSH down Total T4 way up Free T4 slightly up Because beta-hCG has TSH-like activity and estrogen increases TBG
262
Paraneoplastic syndromes of SCLC
ACTH (Cushing's) ADH (SIADH) Lambert-Eaton syndrome
263
Paraneoplastic syndromes of lung SCC
PTHrP (hypercalcemia)
264
Most common cause of urinary obstruction in newborn males
Posterior urethral valves Can cause Potter's sequence and hydronephrosis in-utero
265
Treatment for diabetic distal neuropathy
1) TCA's | 2) Gabapentin
266
EPS side effects of antipsychotics
Acute dystonic reaction (neck, mouth, tongue, EOM) Akithisia (restlessness) Parkinsonism Tardive dyskinesia (after 1-6mo)
267
Which hereditary hyperbilirubinemias present with unconjugated hyperbili? What is the difference?
Gilbert's - mild and occurs with fasting and stress | Crigler-Najjar - Severe with early death
268
Which hereditary hyperbilirubinemias present with conjugated hyperbili? What is the difference?
Rotor's syndrome - normal appearing liver Dubin-Johnson - Black liverf
269
Treatment of the hereditary hyperbilirubinemias
Crigler-Najjar I - Phenobarbital Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant Dubin-Johnson, Rotor's, Gilbert's do not require treatment.
270
Lab/vitals abnormalities of LBW infants
``` Hypoxia Hypothermia Hypoglycemia Hypocalcemia Polycythemia ```
271
What electrolyte derangements are seen with significant emesis?
Hypochloremic, hypokalemic metabolic alkalosis Loss of HCl in vomit Angiotensin II --> HCO3 resorption Aldosterone --> H+ secretion and K+ secretion
272
Superior sulcus tumor possible symptoms
Horner syndrome Pancoast (ulnar pain distribution, shoulder weakness) Hoarseness (RLN) SVC syndrome
273
Divisions of mediastinum and their masses
Anterior: 4 T's (thymoma, teratoma, thyroid, terrible lymphoma) Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma Posterior: Neurogenic tumors
274
Beck's triad of cardiac tamponade
Hypotension Distant heart sounds Distended jugular veins
275
When can chorionic villous sampling be done? | Amniocentesis?
CVS: 9-14w Amniocentesis: 15-22w
276
When to swab for GBS
35w
277
Quad screen results for Edwards syndrome
UNDERaged at 18 | All are down
278
Quad screen results for Down syndrome
2up 2down at 21
279
Treatment of HIV in pregnancy
1) Zidovudine or Nevirapine during pregnancy 2) Elective c-section if viral load over 1000 3) Zidovudine for infant 4) No breastfeeding
280
Normal fetal heart rate | Causes for bradycardia or tachycardia
110-160 bpm Brady - Congenital heart malformations, hypoxia Tachy - Hypoxia, maternal fever, fetal anemia
281
Normal variability on FHT
6-25 bpm
282
What does sinusoidal variability on FHT indicate?
Serious fetal anemia
283
Treatment of hypercalcemia 2/2 malignancy
Short term: Normal saline, Calcitonin | Long term: Bisphosphonates
284
Mutation seen in cri-du-chat syndrome
5p deletion
285
Difference between gestational and chronic HTN
Chronic HTN if present before 20w or persists after 12w postpartum Gestational HTN if presents after 20w
286
Definition of preeclampsia
1) New-onset HTN after 20w or worsened chronic HTN | 2) Proteinuria of over 300mg/24h (3+ proteins)
287
Murmur of transposition of the great vessels
Single S2 +/- VSD murmur Most common early cyanotic dz
288
Murmur of tetralogy of Fallot
Pulmonic stenosis murmur | VSD murmur
289
Treatment of transposition of the great vessels
``` Prostaglandins early (to maintain PFO) Emergent surgery ```
290
Treatment of impetigo
Non-bullous (honey crusts) - Topical mupirocin | Bullous - Oral abx
291
Symptoms of multiple myeloma
Calcium elevated Renal dysfunction Anemia Bone lesions/Back pain
292
Indications for carotid endarterectomy
Symptomatic 70-99% | Men asymptomatic 60-99%
293
ESR and CK in glucocorticoid myopathy
Both normal Painless weakness
294
ESR and CK in Polymyalgia Rheumatica
ESR elevated | CK normal
295
ESR and CK in statin-induced myopathy
ESR normal | CK elevated
296
How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis
Saline-responsive: Urine chloride under 20 Saline-resistant: Urine chloride over 20 Saline responsive is 2/2 vomiting, diarrhea, diuretic abuse Saline resistant is 2/2 hyperaldosteronism, Cushing's, hypokalemia
297
What cancers are seen with HNPCC?
Colon cancer | Endometrial cancer
298
What cancers are associated with nephrotic syndromes?
Adenocarcinoma - membranous nephropathy Lymphoma - Minimal change disease
299
Treatment of uric acid kidney stones
Oral potassium citrate Citrate alkalinizes the urine and inhibits crystallization
300
Solitary pulmonary nodule workup
Nonsmoker - compare to old CXR. Q3mo CXR's. If stable for 12mo considered benign. Smoker: - Chest CT - FNA
301
Treatment for neonatal thyrotoxicosis
Methimazole + beta-blocker Caused by maternal anti-TSH receptor Ab's
302
Extrahepatic manifestations of HCV
Porphyria cutanea tarda Essential mixed cryoglobulinemia Membranoproliferative GN
303
Symptoms of mixed cryoglobulinemia
Purpura Arthralgias Weakness Membranoproliferative GN
304
Symptoms of galactosemia
Newborn with: - FTT - Bilateral cataracts - Jaundice - Hypoglycemia
305
What is a normal AFI?
5-20
306
At what EFW would you deliver by planned c-section due to macrosomia?
No DM: 5,000g | DM: 4,500g
307
What maternal titer is considered Rh-sensitized?
1:16 So 1:20, 1:32, etc.
308
Definition of PROM and PPROM
PROM: Rupture 1h or more before onset of labor PPROM: Rupture between 20-37w
309
What blood loss is considered postpartum hemorrhage?
500cc via vaginal delivery | 1000cc via c-section
310
Causes of postpartum hemorrhage
Tone (atony) Tissue (retained placental tissue) Trauma (of genital tract) Thrombin (coagulopathy)
311
Diagnosis of Polymyositis/Dermatomyositis
1) Anti-Jo-1 Ab's | 2) Muscle biopsy
312
What antibodies are associated with SLE?
ANA Anti-dsDNA Anti-Smith
313
What antibodies are associated with RA?
Anti-CCP | Rheumatoid factor
314
What antibodies are associated with CREST syndrome?
Anti-centromere
315
What antibodies are associated with drug-induced SLE?
Anti-histone
316
What antibodies are associated with PBC?
Antimitochondrial
317
What antibodies are associated with Scleroderma?
ANA Anti-Scl-70 Anti-topoisomerase I
318
What antibodies are associated with autoimmune hepatitis?
Anti-smooth muscle
319
What antibodies are associated with Graves' dz?
Anti-TSH receptor
320
What antibodies are associated with GPA?
c-ANCA
321
What antibodies are associated with microscopic polyangiitis?
p-ANCA
322
What antibodies are associated with MCTD?
U1RNP antibody
323
What does Prussian Blue staining detect?
Hemosiderin
324
What is seen in neurofibromatosis type 1?
Cafe-au-lait spots Neurofibromas Lisch nodules (iris hamartomas) Optic glioma
325
Eye deviation in hemiparesis
Thalamic lesion - eyes deviate Toward hemiparesis | Cerebral lobe - eyes deviate Contralateral from hemiparesis
326
Symptoms of carcinoid syndrome
Flushing Diarrhea Bronchospasm Usually tumor is found in small intestine
327
What is the classic brain lesion caused by status epilepticus?
Cortical laminar necrosis
328
What cancer rates are affected by COC's?
COC's reduce ovarian and endometrial cancer rates
329
Causes of primary amenorrhea with normal secondary sex characteristics
Pregnancy Mullerian agenesis (2/3 of vagina and uterus missing) Imperforate hymen Androgen insensitivity (absent pubic hair)
330
How is bone age used to workup primary amenorrhea?
If bone age is 12+ and no development - likely a HPG axis problem If bone age is under 12 - likely constitutional delay
331
Initial workup for secondary amenorrhea
Pregnancy test TSH Prolactin level If all normal, proceed to progestin challenge
332
What to order if progestin challenge produces a withdrawal bleed
LH If decreased --> idiopathic anovulation If increased --> PCOS or premature menopause
333
What to order if no withdrawal bleed after progestin challenge
FSH Elevated --> Hypergonadotropic hypogonadism Decreased --> cyclic E2/Pr test to differentiate hypogonadotropic hypogonadism vs. endometrial/anatomic problem
334
Prophylaxis in HIV patients
``` 200 = PCP = Bactrim 150 = Histoplasma = Itraconazole 100 = Toxoplasma = Bactrim 50 = MAC = Azithromycin ```
335
Prophylaxis in posttransplant patients
Bactrim for PCP Immunize against Influenza, pneumococcus, and HBV
336
When to perform oral glucose tolerance test
24-28w
337
TSH, total T4, and free T4 levels in pregnancy
TSH down Total T4 way up Free T4 slightly up Because beta-hCG has TSH-like activity and estrogen increases TBG
338
Paraneoplastic syndromes of SCLC
ACTH (Cushing's) ADH (SIADH) Lambert-Eaton syndrome
339
Paraneoplastic syndromes of lung SCC
PTHrP (hypercalcemia)
340
Most common cause of urinary obstruction in newborn males
Posterior urethral valves Can cause Potter's sequence and hydronephrosis in-utero
341
Treatment for diabetic distal neuropathy
1) TCA's | 2) Gabapentin
342
EPS side effects of antipsychotics
Acute dystonic reaction (neck, mouth, tongue, EOM) Akithisia (restlessness) Parkinsonism Tardive dyskinesia (after 1-6mo)
343
Which hereditary hyperbilirubinemias present with unconjugated hyperbili? What is the difference?
Gilbert's - mild and occurs with fasting and stress | Crigler-Najjar - Severe with early death
344
Which hereditary hyperbilirubinemias present with conjugated hyperbili? What is the difference?
Rotor's syndrome - normal appearing liver Dubin-Johnson - Black liverf
345
Treatment of the hereditary hyperbilirubinemias
Crigler-Najjar I - Phenobarbital Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant Dubin-Johnson, Rotor's, Gilbert's do not require treatment.
346
Lab/vitals abnormalities of LBW infants
``` Hypoxia Hypothermia Hypoglycemia Hypocalcemia Polycythemia ```
347
What electrolyte derangements are seen with significant emesis?
Hypochloremic, hypokalemic metabolic alkalosis Loss of HCl in vomit Angiotensin II --> HCO3 resorption Aldosterone --> H+ secretion and K+ secretion
348
Superior sulcus tumor possible symptoms
Horner syndrome Pancoast (ulnar pain distribution, shoulder weakness) Hoarseness (RLN) SVC syndrome
349
Divisions of mediastinum and their masses
Anterior: 4 T's (thymoma, teratoma, thyroid, terrible lymphoma) Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma Posterior: Neurogenic tumors
350
Beck's triad of cardiac tamponade
Hypotension Distant heart sounds Distended jugular veins
351
When can chorionic villous sampling be done? | Amniocentesis?
CVS: 9-14w Amniocentesis: 15-22w
352
When to swab for GBS
35w
353
Quad screen results for Edwards syndrome
UNDERaged at 18 | All are down
354
Quad screen results for Down syndrome
2up 2down at 21
355
Treatment of HIV in pregnancy
1) Zidovudine or Nevirapine during pregnancy 2) Elective c-section if viral load over 1000 3) Zidovudine for infant 4) No breastfeeding
356
Normal fetal heart rate | Causes for bradycardia or tachycardia
110-160 bpm Brady - Congenital heart malformations, hypoxia Tachy - Hypoxia, maternal fever, fetal anemia
357
Normal variability on FHT
6-25 bpm
358
What does sinusoidal variability on FHT indicate?
Serious fetal anemia
359
Treatment of hypercalcemia 2/2 malignancy
Short term: Normal saline, Calcitonin | Long term: Bisphosphonates
360
Mutation seen in cri-du-chat syndrome
5p deletion
361
Difference between gestational and chronic HTN
Chronic HTN if present before 20w or persists after 12w postpartum Gestational HTN if presents after 20w
362
Definition of preeclampsia
1) New-onset HTN after 20w or worsened chronic HTN | 2) Proteinuria of over 300mg/24h (3+ proteins)
363
Murmur of transposition of the great vessels
Single S2 +/- VSD murmur Most common early cyanotic dz
364
Murmur of tetralogy of Fallot
Pulmonic stenosis murmur | VSD murmur
365
Treatment of transposition of the great vessels
``` Prostaglandins early (to maintain PFO) Emergent surgery ```
366
Treatment of impetigo
Non-bullous (honey crusts) - Topical mupirocin | Bullous - Oral abx
367
Symptoms of multiple myeloma
Calcium elevated Renal dysfunction Anemia Bone lesions/Back pain
368
Indications for carotid endarterectomy
Symptomatic 70-99% | Men asymptomatic 60-99%
369
ESR and CK in glucocorticoid myopathy
Both normal Painless weakness
370
ESR and CK in Polymyalgia Rheumatica
ESR elevated | CK normal
371
ESR and CK in statin-induced myopathy
ESR normal | CK elevated
372
How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis
Saline-responsive: Urine chloride under 20 Saline-resistant: Urine chloride over 20 Saline responsive is 2/2 vomiting, diarrhea, diuretic abuse Saline resistant is 2/2 hyperaldosteronism, Cushing's, hypokalemia
373
What cancers are seen with HNPCC?
Colon cancer | Endometrial cancer
374
What cancers are associated with nephrotic syndromes?
Adenocarcinoma - membranous nephropathy Lymphoma - Minimal change disease
375
Treatment of uric acid kidney stones
Oral potassium citrate Citrate alkalinizes the urine and inhibits crystallization
376
Solitary pulmonary nodule workup
Nonsmoker - compare to old CXR. Q3mo CXR's. If stable for 12mo considered benign. Smoker: - Chest CT - FNA
377
Treatment for neonatal thyrotoxicosis
Methimazole + beta-blocker Caused by maternal anti-TSH receptor Ab's
378
Extrahepatic manifestations of HCV
Porphyria cutanea tarda Essential mixed cryoglobulinemia Membranoproliferative GN
379
Symptoms of mixed cryoglobulinemia
Purpura Arthralgias Weakness Membranoproliferative GN
380
Symptoms of galactosemia
Newborn with: - FTT - Bilateral cataracts - Jaundice - Hypoglycemia
381
What is a normal AFI?
5-20
382
At what EFW would you deliver by planned c-section due to macrosomia?
No DM: 5,000g | DM: 4,500g
383
What maternal titer is considered Rh-sensitized?
1:16 So 1:20, 1:32, etc.
384
Definition of PROM and PPROM
PROM: Rupture 1h or more before onset of labor PPROM: Rupture between 20-37w
385
What blood loss is considered postpartum hemorrhage?
500cc via vaginal delivery | 1000cc via c-section
386
Causes of postpartum hemorrhage
Tone (atony) Tissue (retained placental tissue) Trauma (of genital tract) Thrombin (coagulopathy)
387
Diagnosis of Polymyositis/Dermatomyositis
1) Anti-Jo-1 Ab's | 2) Muscle biopsy
388
What antibodies are associated with SLE?
ANA Anti-dsDNA Anti-Smith
389
What antibodies are associated with RA?
Anti-CCP | Rheumatoid factor
390
What antibodies are associated with CREST syndrome?
Anti-centromere
391
What antibodies are associated with drug-induced SLE?
Anti-histone
392
What antibodies are associated with PBC?
Antimitochondrial
393
What antibodies are associated with Scleroderma?
ANA Anti-Scl-70 Anti-topoisomerase I
394
What antibodies are associated with autoimmune hepatitis?
Anti-smooth muscle
395
What antibodies are associated with Graves' dz?
Anti-TSH receptor
396
What antibodies are associated with GPA?
c-ANCA
397
What antibodies are associated with microscopic polyangiitis?
p-ANCA
398
What antibodies are associated with MCTD?
U1RNP antibody
399
What does Prussian Blue staining detect?
Hemosiderin
400
What is seen in neurofibromatosis type 1?
Cafe-au-lait spots Neurofibromas Lisch nodules (iris hamartomas) Optic glioma
401
Eye deviation in hemiparesis
Thalamic lesion - eyes deviate Toward hemiparesis | Cerebral lobe - eyes deviate Contralateral from hemiparesis
402
Symptoms of carcinoid syndrome
Flushing Diarrhea Bronchospasm Usually tumor is found in small intestine
403
What is the classic brain lesion caused by status epilepticus?
Cortical laminar necrosis
404
What cancer rates are affected by COC's?
COC's reduce ovarian and endometrial cancer rates
405
Causes of primary amenorrhea with normal secondary sex characteristics
Pregnancy Mullerian agenesis (2/3 of vagina and uterus missing) Imperforate hymen Androgen insensitivity (absent pubic hair)
406
How is bone age used to workup primary amenorrhea?
If bone age is 12+ and no development - likely a HPG axis problem If bone age is under 12 - likely constitutional delay
407
Initial workup for secondary amenorrhea
Pregnancy test TSH Prolactin level If all normal, proceed to progestin challenge
408
What to order if progestin challenge produces a withdrawal bleed
LH If decreased --> idiopathic anovulation If increased --> PCOS or premature menopause
409
What to order if no withdrawal bleed after progestin challenge
FSH Elevated --> Hypergonadotropic hypogonadism Decreased --> cyclic E2/Pr test to differentiate hypogonadotropic hypogonadism vs. endometrial/anatomic problem
410
Prophylaxis in HIV patients
``` 200 = PCP = Bactrim 150 = Histoplasma = Itraconazole 100 = Toxoplasma = Bactrim 50 = MAC = Azithromycin ```
411
Prophylaxis in posttransplant patients
Bactrim for PCP Immunize against Influenza, pneumococcus, and HBV
412
When to perform oral glucose tolerance test
24-28w
413
TSH, total T4, and free T4 levels in pregnancy
TSH down Total T4 way up Free T4 slightly up Because beta-hCG has TSH-like activity and estrogen increases TBG
414
Paraneoplastic syndromes of SCLC
ACTH (Cushing's) ADH (SIADH) Lambert-Eaton syndrome
415
Paraneoplastic syndromes of lung SCC
PTHrP (hypercalcemia)
416
Most common cause of urinary obstruction in newborn males
Posterior urethral valves Can cause Potter's sequence and hydronephrosis in-utero
417
Treatment for diabetic distal neuropathy
1) TCA's | 2) Gabapentin
418
EPS side effects of antipsychotics
Acute dystonic reaction (neck, mouth, tongue, EOM) Akithisia (restlessness) Parkinsonism Tardive dyskinesia (after 1-6mo)
419
Which hereditary hyperbilirubinemias present with unconjugated hyperbili? What is the difference?
Gilbert's - mild and occurs with fasting and stress | Crigler-Najjar - Severe with early death
420
Which hereditary hyperbilirubinemias present with conjugated hyperbili? What is the difference?
Rotor's syndrome - normal appearing liver Dubin-Johnson - Black liverf
421
Treatment of the hereditary hyperbilirubinemias
Crigler-Najjar I - Phenobarbital Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant Dubin-Johnson, Rotor's, Gilbert's do not require treatment.
422
Lab/vitals abnormalities of LBW infants
``` Hypoxia Hypothermia Hypoglycemia Hypocalcemia Polycythemia ```
423
What electrolyte derangements are seen with significant emesis?
Hypochloremic, hypokalemic metabolic alkalosis Loss of HCl in vomit Angiotensin II --> HCO3 resorption Aldosterone --> H+ secretion and K+ secretion
424
Superior sulcus tumor possible symptoms
Horner syndrome Pancoast (ulnar pain distribution, shoulder weakness) Hoarseness (RLN) SVC syndrome
425
Divisions of mediastinum and their masses
Anterior: 4 T's (thymoma, teratoma, thyroid, terrible lymphoma) Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma Posterior: Neurogenic tumors
426
Beck's triad of cardiac tamponade
Hypotension Distant heart sounds Distended jugular veins
427
When can chorionic villous sampling be done? | Amniocentesis?
CVS: 9-14w Amniocentesis: 15-22w
428
When to swab for GBS
35w
429
Quad screen results for Edwards syndrome
UNDERaged at 18 | All are down
430
Quad screen results for Down syndrome
2up 2down at 21
431
Treatment of HIV in pregnancy
1) Zidovudine or Nevirapine during pregnancy 2) Elective c-section if viral load over 1000 3) Zidovudine for infant 4) No breastfeeding
432
Normal fetal heart rate | Causes for bradycardia or tachycardia
110-160 bpm Brady - Congenital heart malformations, hypoxia Tachy - Hypoxia, maternal fever, fetal anemia
433
Normal variability on FHT
6-25 bpm
434
What does sinusoidal variability on FHT indicate?
Serious fetal anemia
435
Treatment of hypercalcemia 2/2 malignancy
Short term: Normal saline, Calcitonin | Long term: Bisphosphonates
436
Mutation seen in cri-du-chat syndrome
5p deletion
437
Difference between gestational and chronic HTN
Chronic HTN if present before 20w or persists after 12w postpartum Gestational HTN if presents after 20w
438
Definition of preeclampsia
1) New-onset HTN after 20w or worsened chronic HTN | 2) Proteinuria of over 300mg/24h (3+ proteins)
439
Murmur of transposition of the great vessels
Single S2 +/- VSD murmur Most common early cyanotic dz
440
Murmur of tetralogy of Fallot
Pulmonic stenosis murmur | VSD murmur
441
Treatment of transposition of the great vessels
``` Prostaglandins early (to maintain PFO) Emergent surgery ```
442
Treatment of impetigo
Non-bullous (honey crusts) - Topical mupirocin | Bullous - Oral abx
443
Symptoms of multiple myeloma
Calcium elevated Renal dysfunction Anemia Bone lesions/Back pain
444
Indications for carotid endarterectomy
Symptomatic 70-99% | Men asymptomatic 60-99%
445
ESR and CK in glucocorticoid myopathy
Both normal Painless weakness
446
ESR and CK in Polymyalgia Rheumatica
ESR elevated | CK normal
447
ESR and CK in statin-induced myopathy
ESR normal | CK elevated
448
How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis
Saline-responsive: Urine chloride under 20 Saline-resistant: Urine chloride over 20 Saline responsive is 2/2 vomiting, diarrhea, diuretic abuse Saline resistant is 2/2 hyperaldosteronism, Cushing's, hypokalemia
449
What cancers are seen with HNPCC?
Colon cancer | Endometrial cancer
450
What cancers are associated with nephrotic syndromes?
Adenocarcinoma - membranous nephropathy Lymphoma - Minimal change disease
451
Treatment of uric acid kidney stones
Oral potassium citrate Citrate alkalinizes the urine and inhibits crystallization
452
Solitary pulmonary nodule workup
Nonsmoker - compare to old CXR. Q3mo CXR's. If stable for 12mo considered benign. Smoker: - Chest CT - FNA
453
Treatment for neonatal thyrotoxicosis
Methimazole + beta-blocker Caused by maternal anti-TSH receptor Ab's
454
Extrahepatic manifestations of HCV
Porphyria cutanea tarda Essential mixed cryoglobulinemia Membranoproliferative GN
455
Symptoms of mixed cryoglobulinemia
Purpura Arthralgias Weakness Membranoproliferative GN
456
Symptoms of galactosemia
Newborn with: - FTT - Bilateral cataracts - Jaundice - Hypoglycemia
457
What is a normal AFI?
5-20
458
At what EFW would you deliver by planned c-section due to macrosomia?
No DM: 5,000g | DM: 4,500g
459
What maternal titer is considered Rh-sensitized?
1:16 So 1:20, 1:32, etc.
460
Definition of PROM and PPROM
PROM: Rupture 1h or more before onset of labor PPROM: Rupture between 20-37w
461
What blood loss is considered postpartum hemorrhage?
500cc via vaginal delivery | 1000cc via c-section
462
Causes of postpartum hemorrhage
Tone (atony) Tissue (retained placental tissue) Trauma (of genital tract) Thrombin (coagulopathy)
463
Diagnosis of Polymyositis/Dermatomyositis
1) Anti-Jo-1 Ab's | 2) Muscle biopsy
464
What antibodies are associated with SLE?
ANA Anti-dsDNA Anti-Smith
465
What antibodies are associated with RA?
Anti-CCP | Rheumatoid factor
466
What antibodies are associated with CREST syndrome?
Anti-centromere
467
What antibodies are associated with drug-induced SLE?
Anti-histone
468
What antibodies are associated with PBC?
Antimitochondrial
469
What antibodies are associated with Scleroderma?
ANA Anti-Scl-70 Anti-topoisomerase I
470
What antibodies are associated with autoimmune hepatitis?
Anti-smooth muscle
471
What antibodies are associated with Graves' dz?
Anti-TSH receptor
472
What antibodies are associated with GPA?
c-ANCA
473
What antibodies are associated with microscopic polyangiitis?
p-ANCA
474
What antibodies are associated with MCTD?
U1RNP antibody
475
What does Prussian Blue staining detect?
Hemosiderin
476
What is seen in neurofibromatosis type 1?
Cafe-au-lait spots Neurofibromas Lisch nodules (iris hamartomas) Optic glioma
477
Eye deviation in hemiparesis
Thalamic lesion - eyes deviate Toward hemiparesis | Cerebral lobe - eyes deviate Contralateral from hemiparesis
478
Symptoms of carcinoid syndrome
Flushing Diarrhea Bronchospasm Usually tumor is found in small intestine
479
What is the classic brain lesion caused by status epilepticus?
Cortical laminar necrosis
480
What cancer rates are affected by COC's?
COC's reduce ovarian and endometrial cancer rates
481
Causes of primary amenorrhea with normal secondary sex characteristics
Pregnancy Mullerian agenesis (2/3 of vagina and uterus missing) Imperforate hymen Androgen insensitivity (absent pubic hair)
482
How is bone age used to workup primary amenorrhea?
If bone age is 12+ and no development - likely a HPG axis problem If bone age is under 12 - likely constitutional delay
483
Initial workup for secondary amenorrhea
Pregnancy test TSH Prolactin level If all normal, proceed to progestin challenge
484
What to order if progestin challenge produces a withdrawal bleed
LH If decreased --> idiopathic anovulation If increased --> PCOS or premature menopause
485
What to order if no withdrawal bleed after progestin challenge
FSH Elevated --> Hypergonadotropic hypogonadism Decreased --> cyclic E2/Pr test to differentiate hypogonadotropic hypogonadism vs. endometrial/anatomic problem
486
Prophylaxis in HIV patients
``` 200 = PCP = Bactrim 150 = Histoplasma = Itraconazole 100 = Toxoplasma = Bactrim 50 = MAC = Azithromycin ```
487
Prophylaxis in posttransplant patients
Bactrim for PCP Immunize against Influenza, pneumococcus, and HBV
488
When to perform oral glucose tolerance test
24-28w
489
TSH, total T4, and free T4 levels in pregnancy
TSH down Total T4 way up Free T4 slightly up Because beta-hCG has TSH-like activity and estrogen increases TBG
490
Paraneoplastic syndromes of SCLC
ACTH (Cushing's) ADH (SIADH) Lambert-Eaton syndrome
491
Paraneoplastic syndromes of lung SCC
PTHrP (hypercalcemia)
492
Most common cause of urinary obstruction in newborn males
Posterior urethral valves Can cause Potter's sequence and hydronephrosis in-utero
493
Treatment for diabetic distal neuropathy
1) TCA's | 2) Gabapentin
494
EPS side effects of antipsychotics
Acute dystonic reaction (neck, mouth, tongue, EOM) Akithisia (restlessness) Parkinsonism Tardive dyskinesia (after 1-6mo)
495
Which hereditary hyperbilirubinemias present with unconjugated hyperbili? What is the difference?
Gilbert's - mild and occurs with fasting and stress | Crigler-Najjar - Severe with early death
496
Which hereditary hyperbilirubinemias present with conjugated hyperbili? What is the difference?
Rotor's syndrome - normal appearing liver Dubin-Johnson - Black liverf
497
Treatment of the hereditary hyperbilirubinemias
Crigler-Najjar I - Phenobarbital Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant Dubin-Johnson, Rotor's, Gilbert's do not require treatment.
498
Lab/vitals abnormalities of LBW infants
``` Hypoxia Hypothermia Hypoglycemia Hypocalcemia Polycythemia ```
499
What electrolyte derangements are seen with significant emesis?
Hypochloremic, hypokalemic metabolic alkalosis Loss of HCl in vomit Angiotensin II --> HCO3 resorption Aldosterone --> H+ secretion and K+ secretion
500
Superior sulcus tumor possible symptoms
Horner syndrome Pancoast (ulnar pain distribution, shoulder weakness) Hoarseness (RLN) SVC syndrome
501
Divisions of mediastinum and their masses
Anterior: 4 T's (thymoma, teratoma, thyroid, terrible lymphoma) Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma Posterior: Neurogenic tumors
502
Beck's triad of cardiac tamponade
Hypotension Distant heart sounds Distended jugular veins
503
When can chorionic villous sampling be done? | Amniocentesis?
CVS: 9-14w Amniocentesis: 15-22w
504
When to swab for GBS
35w
505
Quad screen results for Edwards syndrome
UNDERaged at 18 | All are down
506
Quad screen results for Down syndrome
2up 2down at 21
507
Treatment of HIV in pregnancy
1) Zidovudine or Nevirapine during pregnancy 2) Elective c-section if viral load over 1000 3) Zidovudine for infant 4) No breastfeeding
508
Normal fetal heart rate | Causes for bradycardia or tachycardia
110-160 bpm Brady - Congenital heart malformations, hypoxia Tachy - Hypoxia, maternal fever, fetal anemia
509
Normal variability on FHT
6-25 bpm
510
What does sinusoidal variability on FHT indicate?
Serious fetal anemia
511
Treatment of hypercalcemia 2/2 malignancy
Short term: Normal saline, Calcitonin | Long term: Bisphosphonates
512
Mutation seen in cri-du-chat syndrome
5p deletion
513
Difference between gestational and chronic HTN
Chronic HTN if present before 20w or persists after 12w postpartum Gestational HTN if presents after 20w
514
Definition of preeclampsia
1) New-onset HTN after 20w or worsened chronic HTN | 2) Proteinuria of over 300mg/24h (3+ proteins)
515
Murmur of transposition of the great vessels
Single S2 +/- VSD murmur Most common early cyanotic dz
516
Murmur of tetralogy of Fallot
Pulmonic stenosis murmur | VSD murmur
517
Treatment of transposition of the great vessels
``` Prostaglandins early (to maintain PFO) Emergent surgery ```
518
Treatment of impetigo
Non-bullous (honey crusts) - Topical mupirocin | Bullous - Oral abx
519
Symptoms of multiple myeloma
Calcium elevated Renal dysfunction Anemia Bone lesions/Back pain
520
Indications for carotid endarterectomy
Symptomatic 70-99% | Men asymptomatic 60-99%
521
ESR and CK in glucocorticoid myopathy
Both normal Painless weakness
522
ESR and CK in Polymyalgia Rheumatica
ESR elevated | CK normal
523
ESR and CK in statin-induced myopathy
ESR normal | CK elevated
524
How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis
Saline-responsive: Urine chloride under 20 Saline-resistant: Urine chloride over 20 Saline responsive is 2/2 vomiting, diarrhea, diuretic abuse Saline resistant is 2/2 hyperaldosteronism, Cushing's, hypokalemia
525
What cancers are seen with HNPCC?
Colon cancer | Endometrial cancer
526
What cancers are associated with nephrotic syndromes?
Adenocarcinoma - membranous nephropathy Lymphoma - Minimal change disease
527
Treatment of uric acid kidney stones
Oral potassium citrate Citrate alkalinizes the urine and inhibits crystallization
528
Solitary pulmonary nodule workup
Nonsmoker - compare to old CXR. Q3mo CXR's. If stable for 12mo considered benign. Smoker: - Chest CT - FNA
529
Treatment for neonatal thyrotoxicosis
Methimazole + beta-blocker Caused by maternal anti-TSH receptor Ab's
530
Extrahepatic manifestations of HCV
Porphyria cutanea tarda Essential mixed cryoglobulinemia Membranoproliferative GN
531
Symptoms of mixed cryoglobulinemia
Purpura Arthralgias Weakness Membranoproliferative GN
532
Symptoms of galactosemia
Newborn with: - FTT - Bilateral cataracts - Jaundice - Hypoglycemia
533
What is a normal AFI?
5-20
534
At what EFW would you deliver by planned c-section due to macrosomia?
No DM: 5,000g | DM: 4,500g
535
What maternal titer is considered Rh-sensitized?
1:16 So 1:20, 1:32, etc.
536
Definition of PROM and PPROM
PROM: Rupture 1h or more before onset of labor PPROM: Rupture between 20-37w
537
What blood loss is considered postpartum hemorrhage?
500cc via vaginal delivery | 1000cc via c-section
538
Causes of postpartum hemorrhage
Tone (atony) Tissue (retained placental tissue) Trauma (of genital tract) Thrombin (coagulopathy)
539
Diagnosis of Polymyositis/Dermatomyositis
1) Anti-Jo-1 Ab's | 2) Muscle biopsy
540
What antibodies are associated with SLE?
ANA Anti-dsDNA Anti-Smith
541
What antibodies are associated with RA?
Anti-CCP | Rheumatoid factor
542
What antibodies are associated with CREST syndrome?
Anti-centromere
543
What antibodies are associated with drug-induced SLE?
Anti-histone
544
What antibodies are associated with PBC?
Antimitochondrial
545
What antibodies are associated with Scleroderma?
ANA Anti-Scl-70 Anti-topoisomerase I
546
What antibodies are associated with autoimmune hepatitis?
Anti-smooth muscle
547
What antibodies are associated with Graves' dz?
Anti-TSH receptor
548
What antibodies are associated with GPA?
c-ANCA
549
What antibodies are associated with microscopic polyangiitis?
p-ANCA
550
What antibodies are associated with MCTD?
U1RNP antibody
551
What does Prussian Blue staining detect?
Hemosiderin
552
What is seen in neurofibromatosis type 1?
Cafe-au-lait spots Neurofibromas Lisch nodules (iris hamartomas) Optic glioma
553
Eye deviation in hemiparesis
Thalamic lesion - eyes deviate Toward hemiparesis | Cerebral lobe - eyes deviate Contralateral from hemiparesis
554
Symptoms of carcinoid syndrome
Flushing Diarrhea Bronchospasm Usually tumor is found in small intestine
555
What is the classic brain lesion caused by status epilepticus?
Cortical laminar necrosis
556
What cancer rates are affected by COC's?
COC's reduce ovarian and endometrial cancer rates
557
Causes of primary amenorrhea with normal secondary sex characteristics
Pregnancy Mullerian agenesis (2/3 of vagina and uterus missing) Imperforate hymen Androgen insensitivity (absent pubic hair)
558
How is bone age used to workup primary amenorrhea?
If bone age is 12+ and no development - likely a HPG axis problem If bone age is under 12 - likely constitutional delay
559
Initial workup for secondary amenorrhea
Pregnancy test TSH Prolactin level If all normal, proceed to progestin challenge
560
What to order if progestin challenge produces a withdrawal bleed
LH If decreased --> idiopathic anovulation If increased --> PCOS or premature menopause
561
What to order if no withdrawal bleed after progestin challenge
FSH Elevated --> Hypergonadotropic hypogonadism Decreased --> cyclic E2/Pr test to differentiate hypogonadotropic hypogonadism vs. endometrial/anatomic problem
562
Prophylaxis in HIV patients
``` 200 = PCP = Bactrim 150 = Histoplasma = Itraconazole 100 = Toxoplasma = Bactrim 50 = MAC = Azithromycin ```
563
Prophylaxis in posttransplant patients
Bactrim for PCP Immunize against Influenza, pneumococcus, and HBV
564
When to perform oral glucose tolerance test
24-28w
565
TSH, total T4, and free T4 levels in pregnancy
TSH down Total T4 way up Free T4 slightly up Because beta-hCG has TSH-like activity and estrogen increases TBG
566
Paraneoplastic syndromes of SCLC
ACTH (Cushing's) ADH (SIADH) Lambert-Eaton syndrome
567
Paraneoplastic syndromes of lung SCC
PTHrP (hypercalcemia)
568
Most common cause of urinary obstruction in newborn males
Posterior urethral valves Can cause Potter's sequence and hydronephrosis in-utero
569
Treatment for diabetic distal neuropathy
1) TCA's | 2) Gabapentin
570
EPS side effects of antipsychotics
Acute dystonic reaction (neck, mouth, tongue, EOM) Akithisia (restlessness) Parkinsonism Tardive dyskinesia (after 1-6mo)
571
Which hereditary hyperbilirubinemias present with unconjugated hyperbili? What is the difference?
Gilbert's - mild and occurs with fasting and stress | Crigler-Najjar - Severe with early death
572
Which hereditary hyperbilirubinemias present with conjugated hyperbili? What is the difference?
Rotor's syndrome - normal appearing liver Dubin-Johnson - Black liverf
573
Treatment of the hereditary hyperbilirubinemias
Crigler-Najjar I - Phenobarbital Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant Dubin-Johnson, Rotor's, Gilbert's do not require treatment.
574
Lab/vitals abnormalities of LBW infants
``` Hypoxia Hypothermia Hypoglycemia Hypocalcemia Polycythemia ```
575
What electrolyte derangements are seen with significant emesis?
Hypochloremic, hypokalemic metabolic alkalosis Loss of HCl in vomit Angiotensin II --> HCO3 resorption Aldosterone --> H+ secretion and K+ secretion
576
Superior sulcus tumor possible symptoms
Horner syndrome Pancoast (ulnar pain distribution, shoulder weakness) Hoarseness (RLN) SVC syndrome
577
Divisions of mediastinum and their masses
Anterior: 4 T's (thymoma, teratoma, thyroid, terrible lymphoma) Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma Posterior: Neurogenic tumors
578
Beck's triad of cardiac tamponade
Hypotension Distant heart sounds Distended jugular veins
579
When can chorionic villous sampling be done? | Amniocentesis?
CVS: 9-14w Amniocentesis: 15-22w
580
When to swab for GBS
35w
581
Quad screen results for Edwards syndrome
UNDERaged at 18 | All are down
582
Quad screen results for Down syndrome
2up 2down at 21
583
Treatment of HIV in pregnancy
1) Zidovudine or Nevirapine during pregnancy 2) Elective c-section if viral load over 1000 3) Zidovudine for infant 4) No breastfeeding
584
Normal fetal heart rate | Causes for bradycardia or tachycardia
110-160 bpm Brady - Congenital heart malformations, hypoxia Tachy - Hypoxia, maternal fever, fetal anemia
585
Normal variability on FHT
6-25 bpm
586
What does sinusoidal variability on FHT indicate?
Serious fetal anemia
587
Treatment of hypercalcemia 2/2 malignancy
Short term: Normal saline, Calcitonin | Long term: Bisphosphonates
588
Mutation seen in cri-du-chat syndrome
5p deletion
589
Difference between gestational and chronic HTN
Chronic HTN if present before 20w or persists after 12w postpartum Gestational HTN if presents after 20w
590
Definition of preeclampsia
1) New-onset HTN after 20w or worsened chronic HTN | 2) Proteinuria of over 300mg/24h (3+ proteins)
591
Murmur of transposition of the great vessels
Single S2 +/- VSD murmur Most common early cyanotic dz
592
Murmur of tetralogy of Fallot
Pulmonic stenosis murmur | VSD murmur
593
Treatment of transposition of the great vessels
``` Prostaglandins early (to maintain PFO) Emergent surgery ```
594
Treatment of impetigo
Non-bullous (honey crusts) - Topical mupirocin | Bullous - Oral abx
595
Symptoms of multiple myeloma
Calcium elevated Renal dysfunction Anemia Bone lesions/Back pain
596
Indications for carotid endarterectomy
Symptomatic 70-99% | Men asymptomatic 60-99%
597
ESR and CK in glucocorticoid myopathy
Both normal Painless weakness
598
ESR and CK in Polymyalgia Rheumatica
ESR elevated | CK normal
599
ESR and CK in statin-induced myopathy
ESR normal | CK elevated
600
How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis
Saline-responsive: Urine chloride under 20 Saline-resistant: Urine chloride over 20 Saline responsive is 2/2 vomiting, diarrhea, diuretic abuse Saline resistant is 2/2 hyperaldosteronism, Cushing's, hypokalemia
601
What cancers are seen with HNPCC?
Colon cancer | Endometrial cancer
602
What cancers are associated with nephrotic syndromes?
Adenocarcinoma - membranous nephropathy Lymphoma - Minimal change disease
603
Treatment of uric acid kidney stones
Oral potassium citrate Citrate alkalinizes the urine and inhibits crystallization
604
Solitary pulmonary nodule workup
Nonsmoker - compare to old CXR. Q3mo CXR's. If stable for 12mo considered benign. Smoker: - Chest CT - FNA
605
Treatment for neonatal thyrotoxicosis
Methimazole + beta-blocker Caused by maternal anti-TSH receptor Ab's
606
Extrahepatic manifestations of HCV
Porphyria cutanea tarda Essential mixed cryoglobulinemia Membranoproliferative GN
607
Symptoms of mixed cryoglobulinemia
Purpura Arthralgias Weakness Membranoproliferative GN
608
Symptoms of galactosemia
Newborn with: - FTT - Bilateral cataracts - Jaundice - Hypoglycemia
609
What is a normal AFI?
5-20
610
At what EFW would you deliver by planned c-section due to macrosomia?
No DM: 5,000g | DM: 4,500g
611
What maternal titer is considered Rh-sensitized?
1:16 So 1:20, 1:32, etc.
612
Definition of PROM and PPROM
PROM: Rupture 1h or more before onset of labor PPROM: Rupture between 20-37w
613
What blood loss is considered postpartum hemorrhage?
500cc via vaginal delivery | 1000cc via c-section
614
Causes of postpartum hemorrhage
Tone (atony) Tissue (retained placental tissue) Trauma (of genital tract) Thrombin (coagulopathy)
615
Diagnosis of Polymyositis/Dermatomyositis
1) Anti-Jo-1 Ab's | 2) Muscle biopsy
616
What antibodies are associated with SLE?
ANA Anti-dsDNA Anti-Smith
617
What antibodies are associated with RA?
Anti-CCP | Rheumatoid factor
618
What antibodies are associated with CREST syndrome?
Anti-centromere
619
What antibodies are associated with drug-induced SLE?
Anti-histone
620
What antibodies are associated with PBC?
Antimitochondrial
621
What antibodies are associated with Scleroderma?
ANA Anti-Scl-70 Anti-topoisomerase I
622
What antibodies are associated with autoimmune hepatitis?
Anti-smooth muscle
623
What antibodies are associated with Graves' dz?
Anti-TSH receptor
624
What antibodies are associated with GPA?
c-ANCA
625
What antibodies are associated with microscopic polyangiitis?
p-ANCA
626
What antibodies are associated with MCTD?
U1RNP antibody
627
What does Prussian Blue staining detect?
Hemosiderin
628
What is seen in neurofibromatosis type 1?
Cafe-au-lait spots Neurofibromas Lisch nodules (iris hamartomas) Optic glioma
629
Eye deviation in hemiparesis
Thalamic lesion - eyes deviate Toward hemiparesis | Cerebral lobe - eyes deviate Contralateral from hemiparesis
630
Symptoms of carcinoid syndrome
Flushing Diarrhea Bronchospasm Usually tumor is found in small intestine
631
What is the classic brain lesion caused by status epilepticus?
Cortical laminar necrosis
632
What cancer rates are affected by COC's?
COC's reduce ovarian and endometrial cancer rates
633
Causes of primary amenorrhea with normal secondary sex characteristics
Pregnancy Mullerian agenesis (2/3 of vagina and uterus missing) Imperforate hymen Androgen insensitivity (absent pubic hair)
634
How is bone age used to workup primary amenorrhea?
If bone age is 12+ and no development - likely a HPG axis problem If bone age is under 12 - likely constitutional delay
635
Initial workup for secondary amenorrhea
Pregnancy test TSH Prolactin level If all normal, proceed to progestin challenge
636
What to order if progestin challenge produces a withdrawal bleed
LH If decreased --> idiopathic anovulation If increased --> PCOS or premature menopause
637
What to order if no withdrawal bleed after progestin challenge
FSH Elevated --> Hypergonadotropic hypogonadism Decreased --> cyclic E2/Pr test to differentiate hypogonadotropic hypogonadism vs. endometrial/anatomic problem
638
Prophylaxis in HIV patients
``` 200 = PCP = Bactrim 150 = Histoplasma = Itraconazole 100 = Toxoplasma = Bactrim 50 = MAC = Azithromycin ```
639
Prophylaxis in posttransplant patients
Bactrim for PCP Immunize against Influenza, pneumococcus, and HBV
640
When to perform oral glucose tolerance test
24-28w
641
TSH, total T4, and free T4 levels in pregnancy
TSH down Total T4 way up Free T4 slightly up Because beta-hCG has TSH-like activity and estrogen increases TBG
642
Paraneoplastic syndromes of SCLC
ACTH (Cushing's) ADH (SIADH) Lambert-Eaton syndrome
643
Paraneoplastic syndromes of lung SCC
PTHrP (hypercalcemia)
644
Most common cause of urinary obstruction in newborn males
Posterior urethral valves Can cause Potter's sequence and hydronephrosis in-utero
645
Treatment for diabetic distal neuropathy
1) TCA's | 2) Gabapentin
646
EPS side effects of antipsychotics
Acute dystonic reaction (neck, mouth, tongue, EOM) Akithisia (restlessness) Parkinsonism Tardive dyskinesia (after 1-6mo)
647
Which hereditary hyperbilirubinemias present with unconjugated hyperbili? What is the difference?
Gilbert's - mild and occurs with fasting and stress | Crigler-Najjar - Severe with early death
648
Which hereditary hyperbilirubinemias present with conjugated hyperbili? What is the difference?
Rotor's syndrome - normal appearing liver Dubin-Johnson - Black liverf
649
Treatment of the hereditary hyperbilirubinemias
Crigler-Najjar I - Phenobarbital Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant Dubin-Johnson, Rotor's, Gilbert's do not require treatment.
650
Lab/vitals abnormalities of LBW infants
``` Hypoxia Hypothermia Hypoglycemia Hypocalcemia Polycythemia ```
651
What electrolyte derangements are seen with significant emesis?
Hypochloremic, hypokalemic metabolic alkalosis Loss of HCl in vomit Angiotensin II --> HCO3 resorption Aldosterone --> H+ secretion and K+ secretion
652
Superior sulcus tumor possible symptoms
Horner syndrome Pancoast (ulnar pain distribution, shoulder weakness) Hoarseness (RLN) SVC syndrome
653
Divisions of mediastinum and their masses
Anterior: 4 T's (thymoma, teratoma, thyroid, terrible lymphoma) Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma Posterior: Neurogenic tumors
654
Beck's triad of cardiac tamponade
Hypotension Distant heart sounds Distended jugular veins
655
When can chorionic villous sampling be done? | Amniocentesis?
CVS: 9-14w Amniocentesis: 15-22w
656
When to swab for GBS
35w
657
Quad screen results for Edwards syndrome
UNDERaged at 18 | All are down
658
Quad screen results for Down syndrome
2up 2down at 21
659
Treatment of HIV in pregnancy
1) Zidovudine or Nevirapine during pregnancy 2) Elective c-section if viral load over 1000 3) Zidovudine for infant 4) No breastfeeding
660
Normal fetal heart rate | Causes for bradycardia or tachycardia
110-160 bpm Brady - Congenital heart malformations, hypoxia Tachy - Hypoxia, maternal fever, fetal anemia
661
Normal variability on FHT
6-25 bpm
662
What does sinusoidal variability on FHT indicate?
Serious fetal anemia
663
Treatment of hypercalcemia 2/2 malignancy
Short term: Normal saline, Calcitonin | Long term: Bisphosphonates
664
Mutation seen in cri-du-chat syndrome
5p deletion
665
Difference between gestational and chronic HTN
Chronic HTN if present before 20w or persists after 12w postpartum Gestational HTN if presents after 20w
666
Definition of preeclampsia
1) New-onset HTN after 20w or worsened chronic HTN | 2) Proteinuria of over 300mg/24h (3+ proteins)
667
Murmur of transposition of the great vessels
Single S2 +/- VSD murmur Most common early cyanotic dz
668
Murmur of tetralogy of Fallot
Pulmonic stenosis murmur | VSD murmur
669
Treatment of transposition of the great vessels
``` Prostaglandins early (to maintain PFO) Emergent surgery ```
670
Treatment of impetigo
Non-bullous (honey crusts) - Topical mupirocin | Bullous - Oral abx
671
Symptoms of multiple myeloma
Calcium elevated Renal dysfunction Anemia Bone lesions/Back pain
672
Indications for carotid endarterectomy
Symptomatic 70-99% | Men asymptomatic 60-99%
673
ESR and CK in glucocorticoid myopathy
Both normal Painless weakness
674
ESR and CK in Polymyalgia Rheumatica
ESR elevated | CK normal
675
ESR and CK in statin-induced myopathy
ESR normal | CK elevated
676
How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis
Saline-responsive: Urine chloride under 20 Saline-resistant: Urine chloride over 20 Saline responsive is 2/2 vomiting, diarrhea, diuretic abuse Saline resistant is 2/2 hyperaldosteronism, Cushing's, hypokalemia
677
What cancers are seen with HNPCC?
Colon cancer | Endometrial cancer
678
What cancers are associated with nephrotic syndromes?
Adenocarcinoma - membranous nephropathy Lymphoma - Minimal change disease
679
Treatment of uric acid kidney stones
Oral potassium citrate Citrate alkalinizes the urine and inhibits crystallization
680
Solitary pulmonary nodule workup
Nonsmoker - compare to old CXR. Q3mo CXR's. If stable for 12mo considered benign. Smoker: - Chest CT - FNA
681
Treatment for neonatal thyrotoxicosis
Methimazole + beta-blocker Caused by maternal anti-TSH receptor Ab's
682
Extrahepatic manifestations of HCV
Porphyria cutanea tarda Essential mixed cryoglobulinemia Membranoproliferative GN
683
Symptoms of mixed cryoglobulinemia
Purpura Arthralgias Weakness Membranoproliferative GN
684
Symptoms of galactosemia
Newborn with: - FTT - Bilateral cataracts - Jaundice - Hypoglycemia
685
What is a normal AFI?
5-20
686
At what EFW would you deliver by planned c-section due to macrosomia?
No DM: 5,000g | DM: 4,500g
687
What maternal titer is considered Rh-sensitized?
1:16 So 1:20, 1:32, etc.
688
Definition of PROM and PPROM
PROM: Rupture 1h or more before onset of labor PPROM: Rupture between 20-37w
689
What blood loss is considered postpartum hemorrhage?
500cc via vaginal delivery | 1000cc via c-section
690
Causes of postpartum hemorrhage
Tone (atony) Tissue (retained placental tissue) Trauma (of genital tract) Thrombin (coagulopathy)
691
Diagnosis of Polymyositis/Dermatomyositis
1) Anti-Jo-1 Ab's | 2) Muscle biopsy
692
What antibodies are associated with SLE?
ANA Anti-dsDNA Anti-Smith
693
What antibodies are associated with RA?
Anti-CCP | Rheumatoid factor
694
What antibodies are associated with CREST syndrome?
Anti-centromere
695
What antibodies are associated with drug-induced SLE?
Anti-histone
696
What antibodies are associated with PBC?
Antimitochondrial
697
What antibodies are associated with Scleroderma?
ANA Anti-Scl-70 Anti-topoisomerase I
698
What antibodies are associated with autoimmune hepatitis?
Anti-smooth muscle
699
What antibodies are associated with Graves' dz?
Anti-TSH receptor
700
What antibodies are associated with GPA?
c-ANCA
701
What antibodies are associated with microscopic polyangiitis?
p-ANCA
702
What antibodies are associated with MCTD?
U1RNP antibody
703
What does Prussian Blue staining detect?
Hemosiderin
704
What is seen in neurofibromatosis type 1?
Cafe-au-lait spots Neurofibromas Lisch nodules (iris hamartomas) Optic glioma
705
Eye deviation in hemiparesis
Thalamic lesion - eyes deviate Toward hemiparesis | Cerebral lobe - eyes deviate Contralateral from hemiparesis
706
Symptoms of carcinoid syndrome
Flushing Diarrhea Bronchospasm Usually tumor is found in small intestine
707
What is the classic brain lesion caused by status epilepticus?
Cortical laminar necrosis
708
What cancer rates are affected by COC's?
COC's reduce ovarian and endometrial cancer rates
709
Causes of primary amenorrhea with normal secondary sex characteristics
Pregnancy Mullerian agenesis (2/3 of vagina and uterus missing) Imperforate hymen Androgen insensitivity (absent pubic hair)
710
How is bone age used to workup primary amenorrhea?
If bone age is 12+ and no development - likely a HPG axis problem If bone age is under 12 - likely constitutional delay
711
Initial workup for secondary amenorrhea
Pregnancy test TSH Prolactin level If all normal, proceed to progestin challenge
712
What to order if progestin challenge produces a withdrawal bleed
LH If decreased --> idiopathic anovulation If increased --> PCOS or premature menopause
713
What to order if no withdrawal bleed after progestin challenge
FSH Elevated --> Hypergonadotropic hypogonadism Decreased --> cyclic E2/Pr test to differentiate hypogonadotropic hypogonadism vs. endometrial/anatomic problem
714
Prophylaxis in HIV patients
``` 200 = PCP = Bactrim 150 = Histoplasma = Itraconazole 100 = Toxoplasma = Bactrim 50 = MAC = Azithromycin ```
715
Prophylaxis in posttransplant patients
Bactrim for PCP Immunize against Influenza, pneumococcus, and HBV
716
When to perform oral glucose tolerance test
24-28w
717
TSH, total T4, and free T4 levels in pregnancy
TSH down Total T4 way up Free T4 slightly up Because beta-hCG has TSH-like activity and estrogen increases TBG
718
Paraneoplastic syndromes of SCLC
ACTH (Cushing's) ADH (SIADH) Lambert-Eaton syndrome
719
Paraneoplastic syndromes of lung SCC
PTHrP (hypercalcemia)
720
Most common cause of urinary obstruction in newborn males
Posterior urethral valves Can cause Potter's sequence and hydronephrosis in-utero
721
Treatment for diabetic distal neuropathy
1) TCA's | 2) Gabapentin
722
EPS side effects of antipsychotics
Acute dystonic reaction (neck, mouth, tongue, EOM) Akithisia (restlessness) Parkinsonism Tardive dyskinesia (after 1-6mo)
723
Which hereditary hyperbilirubinemias present with unconjugated hyperbili? What is the difference?
Gilbert's - mild and occurs with fasting and stress | Crigler-Najjar - Severe with early death
724
Which hereditary hyperbilirubinemias present with conjugated hyperbili? What is the difference?
Rotor's syndrome - normal appearing liver Dubin-Johnson - Black liverf
725
Treatment of the hereditary hyperbilirubinemias
Crigler-Najjar I - Phenobarbital Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant Dubin-Johnson, Rotor's, Gilbert's do not require treatment.
726
Lab/vitals abnormalities of LBW infants
``` Hypoxia Hypothermia Hypoglycemia Hypocalcemia Polycythemia ```
727
What electrolyte derangements are seen with significant emesis?
Hypochloremic, hypokalemic metabolic alkalosis Loss of HCl in vomit Angiotensin II --> HCO3 resorption Aldosterone --> H+ secretion and K+ secretion
728
Superior sulcus tumor possible symptoms
Horner syndrome Pancoast (ulnar pain distribution, shoulder weakness) Hoarseness (RLN) SVC syndrome
729
Divisions of mediastinum and their masses
Anterior: 4 T's (thymoma, teratoma, thyroid, terrible lymphoma) Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma Posterior: Neurogenic tumors
730
Beck's triad of cardiac tamponade
Hypotension Distant heart sounds Distended jugular veins
731
When can chorionic villous sampling be done? | Amniocentesis?
CVS: 9-14w Amniocentesis: 15-22w
732
When to swab for GBS
35w
733
Quad screen results for Edwards syndrome
UNDERaged at 18 | All are down
734
Quad screen results for Down syndrome
2up 2down at 21
735
Treatment of HIV in pregnancy
1) Zidovudine or Nevirapine during pregnancy 2) Elective c-section if viral load over 1000 3) Zidovudine for infant 4) No breastfeeding
736
Normal fetal heart rate | Causes for bradycardia or tachycardia
110-160 bpm Brady - Congenital heart malformations, hypoxia Tachy - Hypoxia, maternal fever, fetal anemia
737
Normal variability on FHT
6-25 bpm
738
What does sinusoidal variability on FHT indicate?
Serious fetal anemia
739
Treatment of hypercalcemia 2/2 malignancy
Short term: Normal saline, Calcitonin | Long term: Bisphosphonates
740
Mutation seen in cri-du-chat syndrome
5p deletion
741
Difference between gestational and chronic HTN
Chronic HTN if present before 20w or persists after 12w postpartum Gestational HTN if presents after 20w
742
Definition of preeclampsia
1) New-onset HTN after 20w or worsened chronic HTN | 2) Proteinuria of over 300mg/24h (3+ proteins)
743
Murmur of transposition of the great vessels
Single S2 +/- VSD murmur Most common early cyanotic dz
744
Murmur of tetralogy of Fallot
Pulmonic stenosis murmur | VSD murmur
745
Treatment of transposition of the great vessels
``` Prostaglandins early (to maintain PFO) Emergent surgery ```
746
Treatment of impetigo
Non-bullous (honey crusts) - Topical mupirocin | Bullous - Oral abx
747
Symptoms of multiple myeloma
Calcium elevated Renal dysfunction Anemia Bone lesions/Back pain
748
Indications for carotid endarterectomy
Symptomatic 70-99% | Men asymptomatic 60-99%
749
ESR and CK in glucocorticoid myopathy
Both normal Painless weakness
750
ESR and CK in Polymyalgia Rheumatica
ESR elevated | CK normal
751
ESR and CK in statin-induced myopathy
ESR normal | CK elevated
752
How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis
Saline-responsive: Urine chloride under 20 Saline-resistant: Urine chloride over 20 Saline responsive is 2/2 vomiting, diarrhea, diuretic abuse Saline resistant is 2/2 hyperaldosteronism, Cushing's, hypokalemia
753
What cancers are seen with HNPCC?
Colon cancer | Endometrial cancer
754
What cancers are associated with nephrotic syndromes?
Adenocarcinoma - membranous nephropathy Lymphoma - Minimal change disease
755
Treatment of uric acid kidney stones
Oral potassium citrate Citrate alkalinizes the urine and inhibits crystallization
756
Solitary pulmonary nodule workup
Nonsmoker - compare to old CXR. Q3mo CXR's. If stable for 12mo considered benign. Smoker: - Chest CT - FNA
757
Treatment for neonatal thyrotoxicosis
Methimazole + beta-blocker Caused by maternal anti-TSH receptor Ab's
758
Extrahepatic manifestations of HCV
Porphyria cutanea tarda Essential mixed cryoglobulinemia Membranoproliferative GN
759
Symptoms of mixed cryoglobulinemia
Purpura Arthralgias Weakness Membranoproliferative GN
760
Symptoms of galactosemia
Newborn with: - FTT - Bilateral cataracts - Jaundice - Hypoglycemia
761
What is a normal AFI?
5-20
762
At what EFW would you deliver by planned c-section due to macrosomia?
No DM: 5,000g | DM: 4,500g
763
What maternal titer is considered Rh-sensitized?
1:16 So 1:20, 1:32, etc.
764
Definition of PROM and PPROM
PROM: Rupture 1h or more before onset of labor PPROM: Rupture between 20-37w
765
What blood loss is considered postpartum hemorrhage?
500cc via vaginal delivery | 1000cc via c-section
766
Causes of postpartum hemorrhage
Tone (atony) Tissue (retained placental tissue) Trauma (of genital tract) Thrombin (coagulopathy)
767
Diagnosis of Polymyositis/Dermatomyositis
1) Anti-Jo-1 Ab's | 2) Muscle biopsy
768
What antibodies are associated with SLE?
ANA Anti-dsDNA Anti-Smith
769
What antibodies are associated with RA?
Anti-CCP | Rheumatoid factor
770
What antibodies are associated with CREST syndrome?
Anti-centromere
771
What antibodies are associated with drug-induced SLE?
Anti-histone
772
What antibodies are associated with PBC?
Antimitochondrial
773
What antibodies are associated with Scleroderma?
ANA Anti-Scl-70 Anti-topoisomerase I
774
What antibodies are associated with autoimmune hepatitis?
Anti-smooth muscle
775
What antibodies are associated with Graves' dz?
Anti-TSH receptor
776
What antibodies are associated with GPA?
c-ANCA
777
What antibodies are associated with microscopic polyangiitis?
p-ANCA
778
What antibodies are associated with MCTD?
U1RNP antibody
779
What does Prussian Blue staining detect?
Hemosiderin
780
What is seen in neurofibromatosis type 1?
Cafe-au-lait spots Neurofibromas Lisch nodules (iris hamartomas) Optic glioma
781
Eye deviation in hemiparesis
Thalamic lesion - eyes deviate Toward hemiparesis | Cerebral lobe - eyes deviate Contralateral from hemiparesis
782
Symptoms of carcinoid syndrome
Flushing Diarrhea Bronchospasm Usually tumor is found in small intestine
783
What is the classic brain lesion caused by status epilepticus?
Cortical laminar necrosis
784
What cancer rates are affected by COC's?
COC's reduce ovarian and endometrial cancer rates
785
Causes of primary amenorrhea with normal secondary sex characteristics
Pregnancy Mullerian agenesis (2/3 of vagina and uterus missing) Imperforate hymen Androgen insensitivity (absent pubic hair)
786
How is bone age used to workup primary amenorrhea?
If bone age is 12+ and no development - likely a HPG axis problem If bone age is under 12 - likely constitutional delay
787
Initial workup for secondary amenorrhea
Pregnancy test TSH Prolactin level If all normal, proceed to progestin challenge
788
What to order if progestin challenge produces a withdrawal bleed
LH If decreased --> idiopathic anovulation If increased --> PCOS or premature menopause
789
What to order if no withdrawal bleed after progestin challenge
FSH Elevated --> Hypergonadotropic hypogonadism Decreased --> cyclic E2/Pr test to differentiate hypogonadotropic hypogonadism vs. endometrial/anatomic problem
790
Prophylaxis in HIV patients
``` 200 = PCP = Bactrim 150 = Histoplasma = Itraconazole 100 = Toxoplasma = Bactrim 50 = MAC = Azithromycin ```
791
Prophylaxis in posttransplant patients
Bactrim for PCP Immunize against Influenza, pneumococcus, and HBV
792
When to perform oral glucose tolerance test
24-28w
793
TSH, total T4, and free T4 levels in pregnancy
TSH down Total T4 way up Free T4 slightly up Because beta-hCG has TSH-like activity and estrogen increases TBG
794
Paraneoplastic syndromes of SCLC
ACTH (Cushing's) ADH (SIADH) Lambert-Eaton syndrome
795
Paraneoplastic syndromes of lung SCC
PTHrP (hypercalcemia)
796
Most common cause of urinary obstruction in newborn males
Posterior urethral valves Can cause Potter's sequence and hydronephrosis in-utero
797
Treatment for diabetic distal neuropathy
1) TCA's | 2) Gabapentin
798
EPS side effects of antipsychotics
Acute dystonic reaction (neck, mouth, tongue, EOM) Akithisia (restlessness) Parkinsonism Tardive dyskinesia (after 1-6mo)
799
Which hereditary hyperbilirubinemias present with unconjugated hyperbili? What is the difference?
Gilbert's - mild and occurs with fasting and stress | Crigler-Najjar - Severe with early death
800
Which hereditary hyperbilirubinemias present with conjugated hyperbili? What is the difference?
Rotor's syndrome - normal appearing liver Dubin-Johnson - Black liverf
801
Treatment of the hereditary hyperbilirubinemias
Crigler-Najjar I - Phenobarbital Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant Dubin-Johnson, Rotor's, Gilbert's do not require treatment.
802
Lab/vitals abnormalities of LBW infants
``` Hypoxia Hypothermia Hypoglycemia Hypocalcemia Polycythemia ```
803
What electrolyte derangements are seen with significant emesis?
Hypochloremic, hypokalemic metabolic alkalosis Loss of HCl in vomit Angiotensin II --> HCO3 resorption Aldosterone --> H+ secretion and K+ secretion
804
Superior sulcus tumor possible symptoms
Horner syndrome Pancoast (ulnar pain distribution, shoulder weakness) Hoarseness (RLN) SVC syndrome
805
Divisions of mediastinum and their masses
Anterior: 4 T's (thymoma, teratoma, thyroid, terrible lymphoma) Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma Posterior: Neurogenic tumors
806
Beck's triad of cardiac tamponade
Hypotension Distant heart sounds Distended jugular veins
807
When can chorionic villous sampling be done? | Amniocentesis?
CVS: 9-14w Amniocentesis: 15-22w
808
When to swab for GBS
35w
809
Quad screen results for Edwards syndrome
UNDERaged at 18 | All are down
810
Quad screen results for Down syndrome
2up 2down at 21
811
Treatment of HIV in pregnancy
1) Zidovudine or Nevirapine during pregnancy 2) Elective c-section if viral load over 1000 3) Zidovudine for infant 4) No breastfeeding
812
Normal fetal heart rate | Causes for bradycardia or tachycardia
110-160 bpm Brady - Congenital heart malformations, hypoxia Tachy - Hypoxia, maternal fever, fetal anemia
813
Normal variability on FHT
6-25 bpm
814
What does sinusoidal variability on FHT indicate?
Serious fetal anemia
815
Treatment of hypercalcemia 2/2 malignancy
Short term: Normal saline, Calcitonin | Long term: Bisphosphonates
816
Mutation seen in cri-du-chat syndrome
5p deletion
817
Difference between gestational and chronic HTN
Chronic HTN if present before 20w or persists after 12w postpartum Gestational HTN if presents after 20w
818
Definition of preeclampsia
1) New-onset HTN after 20w or worsened chronic HTN | 2) Proteinuria of over 300mg/24h (3+ proteins)
819
Murmur of transposition of the great vessels
Single S2 +/- VSD murmur Most common early cyanotic dz
820
Murmur of tetralogy of Fallot
Pulmonic stenosis murmur | VSD murmur
821
Treatment of transposition of the great vessels
``` Prostaglandins early (to maintain PFO) Emergent surgery ```
822
Treatment of impetigo
Non-bullous (honey crusts) - Topical mupirocin | Bullous - Oral abx
823
Symptoms of multiple myeloma
Calcium elevated Renal dysfunction Anemia Bone lesions/Back pain
824
Indications for carotid endarterectomy
Symptomatic 70-99% | Men asymptomatic 60-99%
825
ESR and CK in glucocorticoid myopathy
Both normal Painless weakness
826
ESR and CK in Polymyalgia Rheumatica
ESR elevated | CK normal
827
ESR and CK in statin-induced myopathy
ESR normal | CK elevated
828
How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis
Saline-responsive: Urine chloride under 20 Saline-resistant: Urine chloride over 20 Saline responsive is 2/2 vomiting, diarrhea, diuretic abuse Saline resistant is 2/2 hyperaldosteronism, Cushing's, hypokalemia
829
What cancers are seen with HNPCC?
Colon cancer | Endometrial cancer
830
What cancers are associated with nephrotic syndromes?
Adenocarcinoma - membranous nephropathy Lymphoma - Minimal change disease
831
Treatment of uric acid kidney stones
Oral potassium citrate Citrate alkalinizes the urine and inhibits crystallization
832
Solitary pulmonary nodule workup
Nonsmoker - compare to old CXR. Q3mo CXR's. If stable for 12mo considered benign. Smoker: - Chest CT - FNA
833
Treatment for neonatal thyrotoxicosis
Methimazole + beta-blocker Caused by maternal anti-TSH receptor Ab's
834
Extrahepatic manifestations of HCV
Porphyria cutanea tarda Essential mixed cryoglobulinemia Membranoproliferative GN
835
Symptoms of mixed cryoglobulinemia
Purpura Arthralgias Weakness Membranoproliferative GN
836
Symptoms of galactosemia
Newborn with: - FTT - Bilateral cataracts - Jaundice - Hypoglycemia
837
What is a normal AFI?
5-20
838
At what EFW would you deliver by planned c-section due to macrosomia?
No DM: 5,000g | DM: 4,500g
839
What maternal titer is considered Rh-sensitized?
1:16 So 1:20, 1:32, etc.
840
Definition of PROM and PPROM
PROM: Rupture 1h or more before onset of labor PPROM: Rupture between 20-37w
841
What blood loss is considered postpartum hemorrhage?
500cc via vaginal delivery | 1000cc via c-section
842
Causes of postpartum hemorrhage
Tone (atony) Tissue (retained placental tissue) Trauma (of genital tract) Thrombin (coagulopathy)
843
Prophylaxis in HIV patients
``` 200 = PCP = Bactrim 150 = Histoplasma = Itraconazole 100 = Toxoplasma = Bactrim 50 = MAC = Azithromycin ```
844
Prophylaxis in posttransplant patients
Bactrim for PCP Immunize against Influenza, pneumococcus, and HBV
845
When to perform oral glucose tolerance test
24-28w
846
TSH, total T4, and free T4 levels in pregnancy
TSH down Total T4 way up Free T4 slightly up Because beta-hCG has TSH-like activity and estrogen increases TBG
847
Paraneoplastic syndromes of SCLC
ACTH (Cushing's) ADH (SIADH) Lambert-Eaton syndrome
848
Paraneoplastic syndromes of lung SCC
PTHrP (hypercalcemia)
849
Most common cause of urinary obstruction in newborn males
Posterior urethral valves Can cause Potter's sequence and hydronephrosis in-utero
850
Treatment for diabetic distal neuropathy
1) TCA's | 2) Gabapentin
851
EPS side effects of antipsychotics
Acute dystonic reaction (neck, mouth, tongue, EOM) Akithisia (restlessness) Parkinsonism Tardive dyskinesia (after 1-6mo)
852
Which hereditary hyperbilirubinemias present with unconjugated hyperbili? What is the difference?
Gilbert's - mild and occurs with fasting and stress | Crigler-Najjar - Severe with early death
853
Which hereditary hyperbilirubinemias present with conjugated hyperbili? What is the difference?
Rotor's syndrome - normal appearing liver Dubin-Johnson - Black liverf
854
Treatment of the hereditary hyperbilirubinemias
Crigler-Najjar I - Phenobarbital Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant Dubin-Johnson, Rotor's, Gilbert's do not require treatment.
855
Lab/vitals abnormalities of LBW infants
``` Hypoxia Hypothermia Hypoglycemia Hypocalcemia Polycythemia ```
856
What electrolyte derangements are seen with significant emesis?
Hypochloremic, hypokalemic metabolic alkalosis Loss of HCl in vomit Angiotensin II --> HCO3 resorption Aldosterone --> H+ secretion and K+ secretion
857
Superior sulcus tumor possible symptoms
Horner syndrome Pancoast (ulnar pain distribution, shoulder weakness) Hoarseness (RLN) SVC syndrome
858
Divisions of mediastinum and their masses
Anterior: 4 T's (thymoma, teratoma, thyroid, terrible lymphoma) Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma Posterior: Neurogenic tumors
859
Beck's triad of cardiac tamponade
Hypotension Distant heart sounds Distended jugular veins
860
When can chorionic villous sampling be done? | Amniocentesis?
CVS: 9-14w Amniocentesis: 15-22w
861
When to swab for GBS
35w
862
Quad screen results for Edwards syndrome
UNDERaged at 18 | All are down
863
Quad screen results for Down syndrome
2up 2down at 21
864
Treatment of HIV in pregnancy
1) Zidovudine or Nevirapine during pregnancy 2) Elective c-section if viral load over 1000 3) Zidovudine for infant 4) No breastfeeding
865
Normal fetal heart rate | Causes for bradycardia or tachycardia
110-160 bpm Brady - Congenital heart malformations, hypoxia Tachy - Hypoxia, maternal fever, fetal anemia
866
Normal variability on FHT
6-25 bpm
867
What does sinusoidal variability on FHT indicate?
Serious fetal anemia
868
Treatment of hypercalcemia 2/2 malignancy
Short term: Normal saline, Calcitonin | Long term: Bisphosphonates
869
Mutation seen in cri-du-chat syndrome
5p deletion
870
Difference between gestational and chronic HTN
Chronic HTN if present before 20w or persists after 12w postpartum Gestational HTN if presents after 20w
871
Definition of preeclampsia
1) New-onset HTN after 20w or worsened chronic HTN | 2) Proteinuria of over 300mg/24h (3+ proteins)
872
Murmur of transposition of the great vessels
Single S2 +/- VSD murmur Most common early cyanotic dz
873
Murmur of tetralogy of Fallot
Pulmonic stenosis murmur | VSD murmur
874
Treatment of transposition of the great vessels
``` Prostaglandins early (to maintain PFO) Emergent surgery ```
875
Treatment of impetigo
Non-bullous (honey crusts) - Topical mupirocin | Bullous - Oral abx
876
Symptoms of multiple myeloma
Calcium elevated Renal dysfunction Anemia Bone lesions/Back pain
877
Indications for carotid endarterectomy
Symptomatic 70-99% | Men asymptomatic 60-99%
878
ESR and CK in glucocorticoid myopathy
Both normal Painless weakness
879
ESR and CK in Polymyalgia Rheumatica
ESR elevated | CK normal
880
ESR and CK in statin-induced myopathy
ESR normal | CK elevated
881
How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis
Saline-responsive: Urine chloride under 20 Saline-resistant: Urine chloride over 20 Saline responsive is 2/2 vomiting, diarrhea, diuretic abuse Saline resistant is 2/2 hyperaldosteronism, Cushing's, hypokalemia
882
What cancers are seen with HNPCC?
Colon cancer | Endometrial cancer
883
What cancers are associated with nephrotic syndromes?
Adenocarcinoma - membranous nephropathy Lymphoma - Minimal change disease
884
Treatment of uric acid kidney stones
Oral potassium citrate Citrate alkalinizes the urine and inhibits crystallization
885
Solitary pulmonary nodule workup
Nonsmoker - compare to old CXR. Q3mo CXR's. If stable for 12mo considered benign. Smoker: - Chest CT - FNA
886
Treatment for neonatal thyrotoxicosis
Methimazole + beta-blocker Caused by maternal anti-TSH receptor Ab's
887
Extrahepatic manifestations of HCV
Porphyria cutanea tarda Essential mixed cryoglobulinemia Membranoproliferative GN
888
Symptoms of mixed cryoglobulinemia
Purpura Arthralgias Weakness Membranoproliferative GN
889
Symptoms of galactosemia
Newborn with: - FTT - Bilateral cataracts - Jaundice - Hypoglycemia
890
What is a normal AFI?
5-20
891
At what EFW would you deliver by planned c-section due to macrosomia?
No DM: 5,000g | DM: 4,500g
892
What maternal titer is considered Rh-sensitized?
1:16 So 1:20, 1:32, etc.
893
Definition of PROM and PPROM
PROM: Rupture 1h or more before onset of labor PPROM: Rupture between 20-37w
894
What blood loss is considered postpartum hemorrhage?
500cc via vaginal delivery | 1000cc via c-section
895
Causes of postpartum hemorrhage
Tone (atony) Tissue (retained placental tissue) Trauma (of genital tract) Thrombin (coagulopathy)
896
Prophylaxis in HIV patients
``` 200 = PCP = Bactrim 150 = Histoplasma = Itraconazole 100 = Toxoplasma = Bactrim 50 = MAC = Azithromycin ```
897
Prophylaxis in posttransplant patients
Bactrim for PCP Immunize against Influenza, pneumococcus, and HBV
898
When to perform oral glucose tolerance test
24-28w
899
TSH, total T4, and free T4 levels in pregnancy
TSH down Total T4 way up Free T4 slightly up Because beta-hCG has TSH-like activity and estrogen increases TBG
900
Paraneoplastic syndromes of SCLC
ACTH (Cushing's) ADH (SIADH) Lambert-Eaton syndrome
901
Paraneoplastic syndromes of lung SCC
PTHrP (hypercalcemia)
902
Most common cause of urinary obstruction in newborn males
Posterior urethral valves Can cause Potter's sequence and hydronephrosis in-utero
903
Treatment for diabetic distal neuropathy
1) TCA's | 2) Gabapentin
904
EPS side effects of antipsychotics
Acute dystonic reaction (neck, mouth, tongue, EOM) Akithisia (restlessness) Parkinsonism Tardive dyskinesia (after 1-6mo)
905
Which hereditary hyperbilirubinemias present with unconjugated hyperbili? What is the difference?
Gilbert's - mild and occurs with fasting and stress | Crigler-Najjar - Severe with early death
906
Which hereditary hyperbilirubinemias present with conjugated hyperbili? What is the difference?
Rotor's syndrome - normal appearing liver Dubin-Johnson - Black liverf
907
Treatment of the hereditary hyperbilirubinemias
Crigler-Najjar I - Phenobarbital Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant Dubin-Johnson, Rotor's, Gilbert's do not require treatment.
908
Lab/vitals abnormalities of LBW infants
``` Hypoxia Hypothermia Hypoglycemia Hypocalcemia Polycythemia ```
909
What electrolyte derangements are seen with significant emesis?
Hypochloremic, hypokalemic metabolic alkalosis Loss of HCl in vomit Angiotensin II --> HCO3 resorption Aldosterone --> H+ secretion and K+ secretion
910
Superior sulcus tumor possible symptoms
Horner syndrome Pancoast (ulnar pain distribution, shoulder weakness) Hoarseness (RLN) SVC syndrome
911
Divisions of mediastinum and their masses
Anterior: 4 T's (thymoma, teratoma, thyroid, terrible lymphoma) Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma Posterior: Neurogenic tumors
912
Beck's triad of cardiac tamponade
Hypotension Distant heart sounds Distended jugular veins
913
When can chorionic villous sampling be done? | Amniocentesis?
CVS: 9-14w Amniocentesis: 15-22w
914
When to swab for GBS
35w
915
Quad screen results for Edwards syndrome
UNDERaged at 18 | All are down
916
Quad screen results for Down syndrome
2up 2down at 21
917
Treatment of HIV in pregnancy
1) Zidovudine or Nevirapine during pregnancy 2) Elective c-section if viral load over 1000 3) Zidovudine for infant 4) No breastfeeding
918
Normal fetal heart rate | Causes for bradycardia or tachycardia
110-160 bpm Brady - Congenital heart malformations, hypoxia Tachy - Hypoxia, maternal fever, fetal anemia
919
Normal variability on FHT
6-25 bpm
920
What does sinusoidal variability on FHT indicate?
Serious fetal anemia
921
Treatment of hypercalcemia 2/2 malignancy
Short term: Normal saline, Calcitonin | Long term: Bisphosphonates
922
Mutation seen in cri-du-chat syndrome
5p deletion
923
Difference between gestational and chronic HTN
Chronic HTN if present before 20w or persists after 12w postpartum Gestational HTN if presents after 20w
924
Definition of preeclampsia
1) New-onset HTN after 20w or worsened chronic HTN | 2) Proteinuria of over 300mg/24h (3+ proteins)
925
Murmur of transposition of the great vessels
Single S2 +/- VSD murmur Most common early cyanotic dz
926
Murmur of tetralogy of Fallot
Pulmonic stenosis murmur | VSD murmur
927
Treatment of transposition of the great vessels
``` Prostaglandins early (to maintain PFO) Emergent surgery ```
928
Treatment of impetigo
Non-bullous (honey crusts) - Topical mupirocin | Bullous - Oral abx
929
Symptoms of multiple myeloma
Calcium elevated Renal dysfunction Anemia Bone lesions/Back pain
930
Indications for carotid endarterectomy
Symptomatic 70-99% | Men asymptomatic 60-99%
931
ESR and CK in glucocorticoid myopathy
Both normal Painless weakness
932
ESR and CK in Polymyalgia Rheumatica
ESR elevated | CK normal
933
ESR and CK in statin-induced myopathy
ESR normal | CK elevated
934
How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis
Saline-responsive: Urine chloride under 20 Saline-resistant: Urine chloride over 20 Saline responsive is 2/2 vomiting, diarrhea, diuretic abuse Saline resistant is 2/2 hyperaldosteronism, Cushing's, hypokalemia
935
What cancers are seen with HNPCC?
Colon cancer | Endometrial cancer
936
What cancers are associated with nephrotic syndromes?
Adenocarcinoma - membranous nephropathy Lymphoma - Minimal change disease
937
Treatment of uric acid kidney stones
Oral potassium citrate Citrate alkalinizes the urine and inhibits crystallization
938
Solitary pulmonary nodule workup
Nonsmoker - compare to old CXR. Q3mo CXR's. If stable for 12mo considered benign. Smoker: - Chest CT - FNA
939
Treatment for neonatal thyrotoxicosis
Methimazole + beta-blocker Caused by maternal anti-TSH receptor Ab's
940
Extrahepatic manifestations of HCV
Porphyria cutanea tarda Essential mixed cryoglobulinemia Membranoproliferative GN
941
Symptoms of mixed cryoglobulinemia
Purpura Arthralgias Weakness Membranoproliferative GN
942
Symptoms of galactosemia
Newborn with: - FTT - Bilateral cataracts - Jaundice - Hypoglycemia
943
What is a normal AFI?
5-20
944
At what EFW would you deliver by planned c-section due to macrosomia?
No DM: 5,000g | DM: 4,500g
945
What maternal titer is considered Rh-sensitized?
1:16 So 1:20, 1:32, etc.
946
Definition of PROM and PPROM
PROM: Rupture 1h or more before onset of labor PPROM: Rupture between 20-37w
947
What blood loss is considered postpartum hemorrhage?
500cc via vaginal delivery | 1000cc via c-section
948
Causes of postpartum hemorrhage
Tone (atony) Tissue (retained placental tissue) Trauma (of genital tract) Thrombin (coagulopathy)
949
Prophylaxis in HIV patients
``` 200 = PCP = Bactrim 150 = Histoplasma = Itraconazole 100 = Toxoplasma = Bactrim 50 = MAC = Azithromycin ```
950
Prophylaxis in posttransplant patients
Bactrim for PCP Immunize against Influenza, pneumococcus, and HBV
951
When to perform oral glucose tolerance test
24-28w
952
TSH, total T4, and free T4 levels in pregnancy
TSH down Total T4 way up Free T4 slightly up Because beta-hCG has TSH-like activity and estrogen increases TBG
953
Paraneoplastic syndromes of SCLC
ACTH (Cushing's) ADH (SIADH) Lambert-Eaton syndrome
954
Paraneoplastic syndromes of lung SCC
PTHrP (hypercalcemia)
955
Most common cause of urinary obstruction in newborn males
Posterior urethral valves Can cause Potter's sequence and hydronephrosis in-utero
956
Treatment for diabetic distal neuropathy
1) TCA's | 2) Gabapentin
957
EPS side effects of antipsychotics
Acute dystonic reaction (neck, mouth, tongue, EOM) Akithisia (restlessness) Parkinsonism Tardive dyskinesia (after 1-6mo)
958
Which hereditary hyperbilirubinemias present with unconjugated hyperbili? What is the difference?
Gilbert's - mild and occurs with fasting and stress | Crigler-Najjar - Severe with early death
959
Which hereditary hyperbilirubinemias present with conjugated hyperbili? What is the difference?
Rotor's syndrome - normal appearing liver Dubin-Johnson - Black liverf
960
Treatment of the hereditary hyperbilirubinemias
Crigler-Najjar I - Phenobarbital Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant Dubin-Johnson, Rotor's, Gilbert's do not require treatment.
961
Lab/vitals abnormalities of LBW infants
``` Hypoxia Hypothermia Hypoglycemia Hypocalcemia Polycythemia ```
962
What electrolyte derangements are seen with significant emesis?
Hypochloremic, hypokalemic metabolic alkalosis Loss of HCl in vomit Angiotensin II --> HCO3 resorption Aldosterone --> H+ secretion and K+ secretion
963
Superior sulcus tumor possible symptoms
Horner syndrome Pancoast (ulnar pain distribution, shoulder weakness) Hoarseness (RLN) SVC syndrome
964
Divisions of mediastinum and their masses
Anterior: 4 T's (thymoma, teratoma, thyroid, terrible lymphoma) Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma Posterior: Neurogenic tumors
965
Beck's triad of cardiac tamponade
Hypotension Distant heart sounds Distended jugular veins
966
When can chorionic villous sampling be done? | Amniocentesis?
CVS: 9-14w Amniocentesis: 15-22w
967
When to swab for GBS
35w
968
Quad screen results for Edwards syndrome
UNDERaged at 18 | All are down
969
Quad screen results for Down syndrome
2up 2down at 21
970
Treatment of HIV in pregnancy
1) Zidovudine or Nevirapine during pregnancy 2) Elective c-section if viral load over 1000 3) Zidovudine for infant 4) No breastfeeding
971
Normal fetal heart rate | Causes for bradycardia or tachycardia
110-160 bpm Brady - Congenital heart malformations, hypoxia Tachy - Hypoxia, maternal fever, fetal anemia
972
Normal variability on FHT
6-25 bpm
973
What does sinusoidal variability on FHT indicate?
Serious fetal anemia
974
Treatment of hypercalcemia 2/2 malignancy
Short term: Normal saline, Calcitonin | Long term: Bisphosphonates
975
Mutation seen in cri-du-chat syndrome
5p deletion
976
Difference between gestational and chronic HTN
Chronic HTN if present before 20w or persists after 12w postpartum Gestational HTN if presents after 20w
977
Definition of preeclampsia
1) New-onset HTN after 20w or worsened chronic HTN | 2) Proteinuria of over 300mg/24h (3+ proteins)
978
Murmur of transposition of the great vessels
Single S2 +/- VSD murmur Most common early cyanotic dz
979
Murmur of tetralogy of Fallot
Pulmonic stenosis murmur | VSD murmur
980
Treatment of transposition of the great vessels
``` Prostaglandins early (to maintain PFO) Emergent surgery ```
981
Treatment of impetigo
Non-bullous (honey crusts) - Topical mupirocin | Bullous - Oral abx
982
Symptoms of multiple myeloma
Calcium elevated Renal dysfunction Anemia Bone lesions/Back pain
983
Indications for carotid endarterectomy
Symptomatic 70-99% | Men asymptomatic 60-99%
984
ESR and CK in glucocorticoid myopathy
Both normal Painless weakness
985
ESR and CK in Polymyalgia Rheumatica
ESR elevated | CK normal
986
ESR and CK in statin-induced myopathy
ESR normal | CK elevated
987
How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis
Saline-responsive: Urine chloride under 20 Saline-resistant: Urine chloride over 20 Saline responsive is 2/2 vomiting, diarrhea, diuretic abuse Saline resistant is 2/2 hyperaldosteronism, Cushing's, hypokalemia
988
What cancers are seen with HNPCC?
Colon cancer | Endometrial cancer
989
What cancers are associated with nephrotic syndromes?
Adenocarcinoma - membranous nephropathy Lymphoma - Minimal change disease
990
Treatment of uric acid kidney stones
Oral potassium citrate Citrate alkalinizes the urine and inhibits crystallization
991
Solitary pulmonary nodule workup
Nonsmoker - compare to old CXR. Q3mo CXR's. If stable for 12mo considered benign. Smoker: - Chest CT - FNA
992
Treatment for neonatal thyrotoxicosis
Methimazole + beta-blocker Caused by maternal anti-TSH receptor Ab's
993
Extrahepatic manifestations of HCV
Porphyria cutanea tarda Essential mixed cryoglobulinemia Membranoproliferative GN
994
Symptoms of mixed cryoglobulinemia
Purpura Arthralgias Weakness Membranoproliferative GN
995
Symptoms of galactosemia
Newborn with: - FTT - Bilateral cataracts - Jaundice - Hypoglycemia
996
What is a normal AFI?
5-20
997
At what EFW would you deliver by planned c-section due to macrosomia?
No DM: 5,000g | DM: 4,500g
998
What maternal titer is considered Rh-sensitized?
1:16 So 1:20, 1:32, etc.
999
Definition of PROM and PPROM
PROM: Rupture 1h or more before onset of labor PPROM: Rupture between 20-37w
1000
What blood loss is considered postpartum hemorrhage?
500cc via vaginal delivery | 1000cc via c-section
1001
Causes of postpartum hemorrhage
Tone (atony) Tissue (retained placental tissue) Trauma (of genital tract) Thrombin (coagulopathy)
1002
Prophylaxis in HIV patients
``` 200 = PCP = Bactrim 150 = Histoplasma = Itraconazole 100 = Toxoplasma = Bactrim 50 = MAC = Azithromycin ```
1003
Prophylaxis in posttransplant patients
Bactrim for PCP Immunize against Influenza, pneumococcus, and HBV
1004
When to perform oral glucose tolerance test
24-28w
1005
TSH, total T4, and free T4 levels in pregnancy
TSH down Total T4 way up Free T4 slightly up Because beta-hCG has TSH-like activity and estrogen increases TBG
1006
Paraneoplastic syndromes of SCLC
ACTH (Cushing's) ADH (SIADH) Lambert-Eaton syndrome
1007
Paraneoplastic syndromes of lung SCC
PTHrP (hypercalcemia)
1008
Most common cause of urinary obstruction in newborn males
Posterior urethral valves Can cause Potter's sequence and hydronephrosis in-utero
1009
Treatment for diabetic distal neuropathy
1) TCA's | 2) Gabapentin
1010
EPS side effects of antipsychotics
Acute dystonic reaction (neck, mouth, tongue, EOM) Akithisia (restlessness) Parkinsonism Tardive dyskinesia (after 1-6mo)
1011
Which hereditary hyperbilirubinemias present with unconjugated hyperbili? What is the difference?
Gilbert's - mild and occurs with fasting and stress | Crigler-Najjar - Severe with early death
1012
Which hereditary hyperbilirubinemias present with conjugated hyperbili? What is the difference?
Rotor's syndrome - normal appearing liver Dubin-Johnson - Black liverf
1013
Treatment of the hereditary hyperbilirubinemias
Crigler-Najjar I - Phenobarbital Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant Dubin-Johnson, Rotor's, Gilbert's do not require treatment.
1014
Lab/vitals abnormalities of LBW infants
``` Hypoxia Hypothermia Hypoglycemia Hypocalcemia Polycythemia ```
1015
What electrolyte derangements are seen with significant emesis?
Hypochloremic, hypokalemic metabolic alkalosis Loss of HCl in vomit Angiotensin II --> HCO3 resorption Aldosterone --> H+ secretion and K+ secretion
1016
Superior sulcus tumor possible symptoms
Horner syndrome Pancoast (ulnar pain distribution, shoulder weakness) Hoarseness (RLN) SVC syndrome
1017
Divisions of mediastinum and their masses
Anterior: 4 T's (thymoma, teratoma, thyroid, terrible lymphoma) Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma Posterior: Neurogenic tumors
1018
Beck's triad of cardiac tamponade
Hypotension Distant heart sounds Distended jugular veins
1019
When can chorionic villous sampling be done? | Amniocentesis?
CVS: 9-14w Amniocentesis: 15-22w
1020
When to swab for GBS
35w
1021
Quad screen results for Edwards syndrome
UNDERaged at 18 | All are down
1022
Quad screen results for Down syndrome
2up 2down at 21
1023
Treatment of HIV in pregnancy
1) Zidovudine or Nevirapine during pregnancy 2) Elective c-section if viral load over 1000 3) Zidovudine for infant 4) No breastfeeding
1024
Normal fetal heart rate | Causes for bradycardia or tachycardia
110-160 bpm Brady - Congenital heart malformations, hypoxia Tachy - Hypoxia, maternal fever, fetal anemia
1025
Normal variability on FHT
6-25 bpm
1026
What does sinusoidal variability on FHT indicate?
Serious fetal anemia
1027
Treatment of hypercalcemia 2/2 malignancy
Short term: Normal saline, Calcitonin | Long term: Bisphosphonates
1028
Mutation seen in cri-du-chat syndrome
5p deletion
1029
Difference between gestational and chronic HTN
Chronic HTN if present before 20w or persists after 12w postpartum Gestational HTN if presents after 20w
1030
Definition of preeclampsia
1) New-onset HTN after 20w or worsened chronic HTN | 2) Proteinuria of over 300mg/24h (3+ proteins)
1031
Murmur of transposition of the great vessels
Single S2 +/- VSD murmur Most common early cyanotic dz
1032
Murmur of tetralogy of Fallot
Pulmonic stenosis murmur | VSD murmur
1033
Treatment of transposition of the great vessels
``` Prostaglandins early (to maintain PFO) Emergent surgery ```
1034
Treatment of impetigo
Non-bullous (honey crusts) - Topical mupirocin | Bullous - Oral abx
1035
Symptoms of multiple myeloma
Calcium elevated Renal dysfunction Anemia Bone lesions/Back pain
1036
Indications for carotid endarterectomy
Symptomatic 70-99% | Men asymptomatic 60-99%
1037
ESR and CK in glucocorticoid myopathy
Both normal Painless weakness
1038
ESR and CK in Polymyalgia Rheumatica
ESR elevated | CK normal
1039
ESR and CK in statin-induced myopathy
ESR normal | CK elevated
1040
How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis
Saline-responsive: Urine chloride under 20 Saline-resistant: Urine chloride over 20 Saline responsive is 2/2 vomiting, diarrhea, diuretic abuse Saline resistant is 2/2 hyperaldosteronism, Cushing's, hypokalemia
1041
What cancers are seen with HNPCC?
Colon cancer | Endometrial cancer
1042
What cancers are associated with nephrotic syndromes?
Adenocarcinoma - membranous nephropathy Lymphoma - Minimal change disease
1043
Treatment of uric acid kidney stones
Oral potassium citrate Citrate alkalinizes the urine and inhibits crystallization
1044
Solitary pulmonary nodule workup
Nonsmoker - compare to old CXR. Q3mo CXR's. If stable for 12mo considered benign. Smoker: - Chest CT - FNA
1045
Treatment for neonatal thyrotoxicosis
Methimazole + beta-blocker Caused by maternal anti-TSH receptor Ab's
1046
Extrahepatic manifestations of HCV
Porphyria cutanea tarda Essential mixed cryoglobulinemia Membranoproliferative GN
1047
Symptoms of mixed cryoglobulinemia
Purpura Arthralgias Weakness Membranoproliferative GN
1048
Symptoms of galactosemia
Newborn with: - FTT - Bilateral cataracts - Jaundice - Hypoglycemia
1049
What is a normal AFI?
5-20
1050
At what EFW would you deliver by planned c-section due to macrosomia?
No DM: 5,000g | DM: 4,500g
1051
What maternal titer is considered Rh-sensitized?
1:16 So 1:20, 1:32, etc.
1052
Definition of PROM and PPROM
PROM: Rupture 1h or more before onset of labor PPROM: Rupture between 20-37w
1053
What blood loss is considered postpartum hemorrhage?
500cc via vaginal delivery | 1000cc via c-section
1054
Causes of postpartum hemorrhage
Tone (atony) Tissue (retained placental tissue) Trauma (of genital tract) Thrombin (coagulopathy)
1055
Prophylaxis in HIV patients
``` 200 = PCP = Bactrim 150 = Histoplasma = Itraconazole 100 = Toxoplasma = Bactrim 50 = MAC = Azithromycin ```
1056
Prophylaxis in posttransplant patients
Bactrim for PCP Immunize against Influenza, pneumococcus, and HBV
1057
When to perform oral glucose tolerance test
24-28w
1058
TSH, total T4, and free T4 levels in pregnancy
TSH down Total T4 way up Free T4 slightly up Because beta-hCG has TSH-like activity and estrogen increases TBG
1059
Paraneoplastic syndromes of SCLC
ACTH (Cushing's) ADH (SIADH) Lambert-Eaton syndrome
1060
Paraneoplastic syndromes of lung SCC
PTHrP (hypercalcemia)
1061
Most common cause of urinary obstruction in newborn males
Posterior urethral valves Can cause Potter's sequence and hydronephrosis in-utero
1062
Treatment for diabetic distal neuropathy
1) TCA's | 2) Gabapentin
1063
EPS side effects of antipsychotics
Acute dystonic reaction (neck, mouth, tongue, EOM) Akithisia (restlessness) Parkinsonism Tardive dyskinesia (after 1-6mo)
1064
Which hereditary hyperbilirubinemias present with unconjugated hyperbili? What is the difference?
Gilbert's - mild and occurs with fasting and stress | Crigler-Najjar - Severe with early death
1065
Which hereditary hyperbilirubinemias present with conjugated hyperbili? What is the difference?
Rotor's syndrome - normal appearing liver Dubin-Johnson - Black liverf
1066
Treatment of the hereditary hyperbilirubinemias
Crigler-Najjar I - Phenobarbital Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant Dubin-Johnson, Rotor's, Gilbert's do not require treatment.
1067
Lab/vitals abnormalities of LBW infants
``` Hypoxia Hypothermia Hypoglycemia Hypocalcemia Polycythemia ```
1068
What electrolyte derangements are seen with significant emesis?
Hypochloremic, hypokalemic metabolic alkalosis Loss of HCl in vomit Angiotensin II --> HCO3 resorption Aldosterone --> H+ secretion and K+ secretion
1069
Superior sulcus tumor possible symptoms
Horner syndrome Pancoast (ulnar pain distribution, shoulder weakness) Hoarseness (RLN) SVC syndrome
1070
Divisions of mediastinum and their masses
Anterior: 4 T's (thymoma, teratoma, thyroid, terrible lymphoma) Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma Posterior: Neurogenic tumors
1071
Beck's triad of cardiac tamponade
Hypotension Distant heart sounds Distended jugular veins
1072
When can chorionic villous sampling be done? | Amniocentesis?
CVS: 9-14w Amniocentesis: 15-22w
1073
When to swab for GBS
35w
1074
Quad screen results for Edwards syndrome
UNDERaged at 18 | All are down
1075
Quad screen results for Down syndrome
2up 2down at 21
1076
Treatment of HIV in pregnancy
1) Zidovudine or Nevirapine during pregnancy 2) Elective c-section if viral load over 1000 3) Zidovudine for infant 4) No breastfeeding
1077
Normal fetal heart rate | Causes for bradycardia or tachycardia
110-160 bpm Brady - Congenital heart malformations, hypoxia Tachy - Hypoxia, maternal fever, fetal anemia
1078
Normal variability on FHT
6-25 bpm
1079
What does sinusoidal variability on FHT indicate?
Serious fetal anemia
1080
Treatment of hypercalcemia 2/2 malignancy
Short term: Normal saline, Calcitonin | Long term: Bisphosphonates
1081
Mutation seen in cri-du-chat syndrome
5p deletion
1082
Difference between gestational and chronic HTN
Chronic HTN if present before 20w or persists after 12w postpartum Gestational HTN if presents after 20w
1083
Definition of preeclampsia
1) New-onset HTN after 20w or worsened chronic HTN | 2) Proteinuria of over 300mg/24h (3+ proteins)
1084
Murmur of transposition of the great vessels
Single S2 +/- VSD murmur Most common early cyanotic dz
1085
Murmur of tetralogy of Fallot
Pulmonic stenosis murmur | VSD murmur
1086
Treatment of transposition of the great vessels
``` Prostaglandins early (to maintain PFO) Emergent surgery ```
1087
Treatment of impetigo
Non-bullous (honey crusts) - Topical mupirocin | Bullous - Oral abx
1088
Symptoms of multiple myeloma
Calcium elevated Renal dysfunction Anemia Bone lesions/Back pain
1089
Indications for carotid endarterectomy
Symptomatic 70-99% | Men asymptomatic 60-99%
1090
ESR and CK in glucocorticoid myopathy
Both normal Painless weakness
1091
ESR and CK in Polymyalgia Rheumatica
ESR elevated | CK normal
1092
ESR and CK in statin-induced myopathy
ESR normal | CK elevated
1093
How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis
Saline-responsive: Urine chloride under 20 Saline-resistant: Urine chloride over 20 Saline responsive is 2/2 vomiting, diarrhea, diuretic abuse Saline resistant is 2/2 hyperaldosteronism, Cushing's, hypokalemia
1094
What cancers are seen with HNPCC?
Colon cancer | Endometrial cancer
1095
What cancers are associated with nephrotic syndromes?
Adenocarcinoma - membranous nephropathy Lymphoma - Minimal change disease
1096
Treatment of uric acid kidney stones
Oral potassium citrate Citrate alkalinizes the urine and inhibits crystallization
1097
Solitary pulmonary nodule workup
Nonsmoker - compare to old CXR. Q3mo CXR's. If stable for 12mo considered benign. Smoker: - Chest CT - FNA
1098
Treatment for neonatal thyrotoxicosis
Methimazole + beta-blocker Caused by maternal anti-TSH receptor Ab's
1099
Extrahepatic manifestations of HCV
Porphyria cutanea tarda Essential mixed cryoglobulinemia Membranoproliferative GN
1100
Symptoms of mixed cryoglobulinemia
Purpura Arthralgias Weakness Membranoproliferative GN
1101
Symptoms of galactosemia
Newborn with: - FTT - Bilateral cataracts - Jaundice - Hypoglycemia
1102
What is a normal AFI?
5-20
1103
At what EFW would you deliver by planned c-section due to macrosomia?
No DM: 5,000g | DM: 4,500g
1104
What maternal titer is considered Rh-sensitized?
1:16 So 1:20, 1:32, etc.
1105
Definition of PROM and PPROM
PROM: Rupture 1h or more before onset of labor PPROM: Rupture between 20-37w
1106
What blood loss is considered postpartum hemorrhage?
500cc via vaginal delivery | 1000cc via c-section
1107
Causes of postpartum hemorrhage
Tone (atony) Tissue (retained placental tissue) Trauma (of genital tract) Thrombin (coagulopathy)
1108
Prophylaxis in HIV patients
``` 200 = PCP = Bactrim 150 = Histoplasma = Itraconazole 100 = Toxoplasma = Bactrim 50 = MAC = Azithromycin ```
1109
Prophylaxis in posttransplant patients
Bactrim for PCP Immunize against Influenza, pneumococcus, and HBV
1110
When to perform oral glucose tolerance test
24-28w
1111
TSH, total T4, and free T4 levels in pregnancy
TSH down Total T4 way up Free T4 slightly up Because beta-hCG has TSH-like activity and estrogen increases TBG
1112
Paraneoplastic syndromes of SCLC
ACTH (Cushing's) ADH (SIADH) Lambert-Eaton syndrome
1113
Paraneoplastic syndromes of lung SCC
PTHrP (hypercalcemia)
1114
Most common cause of urinary obstruction in newborn males
Posterior urethral valves Can cause Potter's sequence and hydronephrosis in-utero
1115
Treatment for diabetic distal neuropathy
1) TCA's | 2) Gabapentin
1116
EPS side effects of antipsychotics
Acute dystonic reaction (neck, mouth, tongue, EOM) Akithisia (restlessness) Parkinsonism Tardive dyskinesia (after 1-6mo)
1117
Which hereditary hyperbilirubinemias present with unconjugated hyperbili? What is the difference?
Gilbert's - mild and occurs with fasting and stress | Crigler-Najjar - Severe with early death
1118
Which hereditary hyperbilirubinemias present with conjugated hyperbili? What is the difference?
Rotor's syndrome - normal appearing liver Dubin-Johnson - Black liverf
1119
Treatment of the hereditary hyperbilirubinemias
Crigler-Najjar I - Phenobarbital Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant Dubin-Johnson, Rotor's, Gilbert's do not require treatment.
1120
Lab/vitals abnormalities of LBW infants
``` Hypoxia Hypothermia Hypoglycemia Hypocalcemia Polycythemia ```
1121
What electrolyte derangements are seen with significant emesis?
Hypochloremic, hypokalemic metabolic alkalosis Loss of HCl in vomit Angiotensin II --> HCO3 resorption Aldosterone --> H+ secretion and K+ secretion
1122
Superior sulcus tumor possible symptoms
Horner syndrome Pancoast (ulnar pain distribution, shoulder weakness) Hoarseness (RLN) SVC syndrome
1123
Divisions of mediastinum and their masses
Anterior: 4 T's (thymoma, teratoma, thyroid, terrible lymphoma) Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma Posterior: Neurogenic tumors
1124
Beck's triad of cardiac tamponade
Hypotension Distant heart sounds Distended jugular veins
1125
When can chorionic villous sampling be done? | Amniocentesis?
CVS: 9-14w Amniocentesis: 15-22w
1126
When to swab for GBS
35w
1127
Quad screen results for Edwards syndrome
UNDERaged at 18 | All are down
1128
Quad screen results for Down syndrome
2up 2down at 21
1129
Treatment of HIV in pregnancy
1) Zidovudine or Nevirapine during pregnancy 2) Elective c-section if viral load over 1000 3) Zidovudine for infant 4) No breastfeeding
1130
Normal fetal heart rate | Causes for bradycardia or tachycardia
110-160 bpm Brady - Congenital heart malformations, hypoxia Tachy - Hypoxia, maternal fever, fetal anemia
1131
Normal variability on FHT
6-25 bpm
1132
What does sinusoidal variability on FHT indicate?
Serious fetal anemia
1133
Treatment of hypercalcemia 2/2 malignancy
Short term: Normal saline, Calcitonin | Long term: Bisphosphonates
1134
Mutation seen in cri-du-chat syndrome
5p deletion
1135
Difference between gestational and chronic HTN
Chronic HTN if present before 20w or persists after 12w postpartum Gestational HTN if presents after 20w
1136
Definition of preeclampsia
1) New-onset HTN after 20w or worsened chronic HTN | 2) Proteinuria of over 300mg/24h (3+ proteins)
1137
Murmur of transposition of the great vessels
Single S2 +/- VSD murmur Most common early cyanotic dz
1138
Murmur of tetralogy of Fallot
Pulmonic stenosis murmur | VSD murmur
1139
Treatment of transposition of the great vessels
``` Prostaglandins early (to maintain PFO) Emergent surgery ```
1140
Treatment of impetigo
Non-bullous (honey crusts) - Topical mupirocin | Bullous - Oral abx
1141
Symptoms of multiple myeloma
Calcium elevated Renal dysfunction Anemia Bone lesions/Back pain
1142
Indications for carotid endarterectomy
Symptomatic 70-99% | Men asymptomatic 60-99%
1143
ESR and CK in glucocorticoid myopathy
Both normal Painless weakness
1144
ESR and CK in Polymyalgia Rheumatica
ESR elevated | CK normal
1145
ESR and CK in statin-induced myopathy
ESR normal | CK elevated
1146
How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis
Saline-responsive: Urine chloride under 20 Saline-resistant: Urine chloride over 20 Saline responsive is 2/2 vomiting, diarrhea, diuretic abuse Saline resistant is 2/2 hyperaldosteronism, Cushing's, hypokalemia
1147
What cancers are seen with HNPCC?
Colon cancer | Endometrial cancer
1148
What cancers are associated with nephrotic syndromes?
Adenocarcinoma - membranous nephropathy Lymphoma - Minimal change disease
1149
Treatment of uric acid kidney stones
Oral potassium citrate Citrate alkalinizes the urine and inhibits crystallization
1150
Solitary pulmonary nodule workup
Nonsmoker - compare to old CXR. Q3mo CXR's. If stable for 12mo considered benign. Smoker: - Chest CT - FNA
1151
Treatment for neonatal thyrotoxicosis
Methimazole + beta-blocker Caused by maternal anti-TSH receptor Ab's
1152
Extrahepatic manifestations of HCV
Porphyria cutanea tarda Essential mixed cryoglobulinemia Membranoproliferative GN
1153
Symptoms of mixed cryoglobulinemia
Purpura Arthralgias Weakness Membranoproliferative GN
1154
Symptoms of galactosemia
Newborn with: - FTT - Bilateral cataracts - Jaundice - Hypoglycemia
1155
Prophylaxis in HIV patients
``` 200 = PCP = Bactrim 150 = Histoplasma = Itraconazole 100 = Toxoplasma = Bactrim 50 = MAC = Azithromycin ```
1156
Prophylaxis in posttransplant patients
Bactrim for PCP Immunize against Influenza, pneumococcus, and HBV
1157
When to perform oral glucose tolerance test
24-28w
1158
TSH, total T4, and free T4 levels in pregnancy
TSH down Total T4 way up Free T4 slightly up Because beta-hCG has TSH-like activity and estrogen increases TBG
1159
Paraneoplastic syndromes of SCLC
ACTH (Cushing's) ADH (SIADH) Lambert-Eaton syndrome
1160
Paraneoplastic syndromes of lung SCC
PTHrP (hypercalcemia)
1161
Most common cause of urinary obstruction in newborn males
Posterior urethral valves Can cause Potter's sequence and hydronephrosis in-utero
1162
Treatment for diabetic distal neuropathy
1) TCA's | 2) Gabapentin
1163
EPS side effects of antipsychotics
Acute dystonic reaction (neck, mouth, tongue, EOM) Akithisia (restlessness) Parkinsonism Tardive dyskinesia (after 1-6mo)
1164
Which hereditary hyperbilirubinemias present with unconjugated hyperbili? What is the difference?
Gilbert's - mild and occurs with fasting and stress | Crigler-Najjar - Severe with early death
1165
Which hereditary hyperbilirubinemias present with conjugated hyperbili? What is the difference?
Rotor's syndrome - normal appearing liver Dubin-Johnson - Black liverf
1166
Treatment of the hereditary hyperbilirubinemias
Crigler-Najjar I - Phenobarbital Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant Dubin-Johnson, Rotor's, Gilbert's do not require treatment.
1167
Lab/vitals abnormalities of LBW infants
``` Hypoxia Hypothermia Hypoglycemia Hypocalcemia Polycythemia ```
1168
What electrolyte derangements are seen with significant emesis?
Hypochloremic, hypokalemic metabolic alkalosis Loss of HCl in vomit Angiotensin II --> HCO3 resorption Aldosterone --> H+ secretion and K+ secretion
1169
Superior sulcus tumor possible symptoms
Horner syndrome Pancoast (ulnar pain distribution, shoulder weakness) Hoarseness (RLN) SVC syndrome
1170
Divisions of mediastinum and their masses
Anterior: 4 T's (thymoma, teratoma, thyroid, terrible lymphoma) Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma Posterior: Neurogenic tumors
1171
Beck's triad of cardiac tamponade
Hypotension Distant heart sounds Distended jugular veins
1172
When can chorionic villous sampling be done? | Amniocentesis?
CVS: 9-14w Amniocentesis: 15-22w
1173
When to swab for GBS
35w
1174
Quad screen results for Edwards syndrome
UNDERaged at 18 | All are down
1175
Quad screen results for Down syndrome
2up 2down at 21
1176
Treatment of HIV in pregnancy
1) Zidovudine or Nevirapine during pregnancy 2) Elective c-section if viral load over 1000 3) Zidovudine for infant 4) No breastfeeding
1177
Normal fetal heart rate | Causes for bradycardia or tachycardia
110-160 bpm Brady - Congenital heart malformations, hypoxia Tachy - Hypoxia, maternal fever, fetal anemia
1178
Normal variability on FHT
6-25 bpm
1179
What does sinusoidal variability on FHT indicate?
Serious fetal anemia
1180
Treatment of hypercalcemia 2/2 malignancy
Short term: Normal saline, Calcitonin | Long term: Bisphosphonates
1181
Mutation seen in cri-du-chat syndrome
5p deletion
1182
Difference between gestational and chronic HTN
Chronic HTN if present before 20w or persists after 12w postpartum Gestational HTN if presents after 20w
1183
Definition of preeclampsia
1) New-onset HTN after 20w or worsened chronic HTN | 2) Proteinuria of over 300mg/24h (3+ proteins)
1184
Murmur of transposition of the great vessels
Single S2 +/- VSD murmur Most common early cyanotic dz
1185
Murmur of tetralogy of Fallot
Pulmonic stenosis murmur | VSD murmur
1186
Treatment of transposition of the great vessels
``` Prostaglandins early (to maintain PFO) Emergent surgery ```
1187
Treatment of impetigo
Non-bullous (honey crusts) - Topical mupirocin | Bullous - Oral abx
1188
Symptoms of multiple myeloma
Calcium elevated Renal dysfunction Anemia Bone lesions/Back pain
1189
Indications for carotid endarterectomy
Symptomatic 70-99% | Men asymptomatic 60-99%
1190
ESR and CK in glucocorticoid myopathy
Both normal Painless weakness
1191
ESR and CK in Polymyalgia Rheumatica
ESR elevated | CK normal
1192
ESR and CK in statin-induced myopathy
ESR normal | CK elevated
1193
How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis
Saline-responsive: Urine chloride under 20 Saline-resistant: Urine chloride over 20 Saline responsive is 2/2 vomiting, diarrhea, diuretic abuse Saline resistant is 2/2 hyperaldosteronism, Cushing's, hypokalemia
1194
What cancers are seen with HNPCC?
Colon cancer | Endometrial cancer
1195
What cancers are associated with nephrotic syndromes?
Adenocarcinoma - membranous nephropathy Lymphoma - Minimal change disease
1196
Treatment of uric acid kidney stones
Oral potassium citrate Citrate alkalinizes the urine and inhibits crystallization
1197
Solitary pulmonary nodule workup
Nonsmoker - compare to old CXR. Q3mo CXR's. If stable for 12mo considered benign. Smoker: - Chest CT - FNA
1198
Treatment for neonatal thyrotoxicosis
Methimazole + beta-blocker Caused by maternal anti-TSH receptor Ab's
1199
Extrahepatic manifestations of HCV
Porphyria cutanea tarda Essential mixed cryoglobulinemia Membranoproliferative GN
1200
Symptoms of mixed cryoglobulinemia
Purpura Arthralgias Weakness Membranoproliferative GN
1201
Symptoms of galactosemia
Newborn with: - FTT - Bilateral cataracts - Jaundice - Hypoglycemia
1202
Prophylaxis in HIV patients
``` 200 = PCP = Bactrim 150 = Histoplasma = Itraconazole 100 = Toxoplasma = Bactrim 50 = MAC = Azithromycin ```
1203
Prophylaxis in posttransplant patients
Bactrim for PCP Immunize against Influenza, pneumococcus, and HBV
1204
When to perform oral glucose tolerance test
24-28w
1205
TSH, total T4, and free T4 levels in pregnancy
TSH down Total T4 way up Free T4 slightly up Because beta-hCG has TSH-like activity and estrogen increases TBG
1206
Paraneoplastic syndromes of SCLC
ACTH (Cushing's) ADH (SIADH) Lambert-Eaton syndrome
1207
Paraneoplastic syndromes of lung SCC
PTHrP (hypercalcemia)
1208
Most common cause of urinary obstruction in newborn males
Posterior urethral valves Can cause Potter's sequence and hydronephrosis in-utero
1209
Treatment for diabetic distal neuropathy
1) TCA's | 2) Gabapentin
1210
EPS side effects of antipsychotics
Acute dystonic reaction (neck, mouth, tongue, EOM) Akithisia (restlessness) Parkinsonism Tardive dyskinesia (after 1-6mo)
1211
Which hereditary hyperbilirubinemias present with unconjugated hyperbili? What is the difference?
Gilbert's - mild and occurs with fasting and stress | Crigler-Najjar - Severe with early death
1212
Which hereditary hyperbilirubinemias present with conjugated hyperbili? What is the difference?
Rotor's syndrome - normal appearing liver Dubin-Johnson - Black liverf
1213
Treatment of the hereditary hyperbilirubinemias
Crigler-Najjar I - Phenobarbital Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant Dubin-Johnson, Rotor's, Gilbert's do not require treatment.
1214
Lab/vitals abnormalities of LBW infants
``` Hypoxia Hypothermia Hypoglycemia Hypocalcemia Polycythemia ```
1215
What electrolyte derangements are seen with significant emesis?
Hypochloremic, hypokalemic metabolic alkalosis Loss of HCl in vomit Angiotensin II --> HCO3 resorption Aldosterone --> H+ secretion and K+ secretion
1216
Superior sulcus tumor possible symptoms
Horner syndrome Pancoast (ulnar pain distribution, shoulder weakness) Hoarseness (RLN) SVC syndrome
1217
Divisions of mediastinum and their masses
Anterior: 4 T's (thymoma, teratoma, thyroid, terrible lymphoma) Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma Posterior: Neurogenic tumors
1218
Beck's triad of cardiac tamponade
Hypotension Distant heart sounds Distended jugular veins
1219
When can chorionic villous sampling be done? | Amniocentesis?
CVS: 9-14w Amniocentesis: 15-22w
1220
When to swab for GBS
35w
1221
Quad screen results for Edwards syndrome
UNDERaged at 18 | All are down
1222
Quad screen results for Down syndrome
2up 2down at 21
1223
Treatment of HIV in pregnancy
1) Zidovudine or Nevirapine during pregnancy 2) Elective c-section if viral load over 1000 3) Zidovudine for infant 4) No breastfeeding
1224
Normal fetal heart rate | Causes for bradycardia or tachycardia
110-160 bpm Brady - Congenital heart malformations, hypoxia Tachy - Hypoxia, maternal fever, fetal anemia
1225
Normal variability on FHT
6-25 bpm
1226
What does sinusoidal variability on FHT indicate?
Serious fetal anemia
1227
Treatment of hypercalcemia 2/2 malignancy
Short term: Normal saline, Calcitonin | Long term: Bisphosphonates
1228
Mutation seen in cri-du-chat syndrome
5p deletion
1229
Difference between gestational and chronic HTN
Chronic HTN if present before 20w or persists after 12w postpartum Gestational HTN if presents after 20w
1230
Definition of preeclampsia
1) New-onset HTN after 20w or worsened chronic HTN | 2) Proteinuria of over 300mg/24h (3+ proteins)
1231
Murmur of transposition of the great vessels
Single S2 +/- VSD murmur Most common early cyanotic dz
1232
Murmur of tetralogy of Fallot
Pulmonic stenosis murmur | VSD murmur
1233
Treatment of transposition of the great vessels
``` Prostaglandins early (to maintain PFO) Emergent surgery ```
1234
Treatment of impetigo
Non-bullous (honey crusts) - Topical mupirocin | Bullous - Oral abx
1235
Symptoms of multiple myeloma
Calcium elevated Renal dysfunction Anemia Bone lesions/Back pain
1236
Indications for carotid endarterectomy
Symptomatic 70-99% | Men asymptomatic 60-99%
1237
ESR and CK in glucocorticoid myopathy
Both normal Painless weakness
1238
ESR and CK in Polymyalgia Rheumatica
ESR elevated | CK normal
1239
ESR and CK in statin-induced myopathy
ESR normal | CK elevated
1240
How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis
Saline-responsive: Urine chloride under 20 Saline-resistant: Urine chloride over 20 Saline responsive is 2/2 vomiting, diarrhea, diuretic abuse Saline resistant is 2/2 hyperaldosteronism, Cushing's, hypokalemia
1241
What cancers are seen with HNPCC?
Colon cancer | Endometrial cancer
1242
What cancers are associated with nephrotic syndromes?
Adenocarcinoma - membranous nephropathy Lymphoma - Minimal change disease
1243
Treatment of uric acid kidney stones
Oral potassium citrate Citrate alkalinizes the urine and inhibits crystallization
1244
Solitary pulmonary nodule workup
Nonsmoker - compare to old CXR. Q3mo CXR's. If stable for 12mo considered benign. Smoker: - Chest CT - FNA
1245
Treatment for neonatal thyrotoxicosis
Methimazole + beta-blocker Caused by maternal anti-TSH receptor Ab's
1246
Extrahepatic manifestations of HCV
Porphyria cutanea tarda Essential mixed cryoglobulinemia Membranoproliferative GN
1247
Symptoms of mixed cryoglobulinemia
Purpura Arthralgias Weakness Membranoproliferative GN
1248
Symptoms of galactosemia
Newborn with: - FTT - Bilateral cataracts - Jaundice - Hypoglycemia
1249
Prophylaxis in HIV patients
``` 200 = PCP = Bactrim 150 = Histoplasma = Itraconazole 100 = Toxoplasma = Bactrim 50 = MAC = Azithromycin ```
1250
Prophylaxis in posttransplant patients
Bactrim for PCP Immunize against Influenza, pneumococcus, and HBV
1251
When to perform oral glucose tolerance test
24-28w
1252
TSH, total T4, and free T4 levels in pregnancy
TSH down Total T4 way up Free T4 slightly up Because beta-hCG has TSH-like activity and estrogen increases TBG
1253
Paraneoplastic syndromes of SCLC
ACTH (Cushing's) ADH (SIADH) Lambert-Eaton syndrome
1254
Paraneoplastic syndromes of lung SCC
PTHrP (hypercalcemia)
1255
Most common cause of urinary obstruction in newborn males
Posterior urethral valves Can cause Potter's sequence and hydronephrosis in-utero
1256
Treatment for diabetic distal neuropathy
1) TCA's | 2) Gabapentin
1257
EPS side effects of antipsychotics
Acute dystonic reaction (neck, mouth, tongue, EOM) Akithisia (restlessness) Parkinsonism Tardive dyskinesia (after 1-6mo)
1258
Which hereditary hyperbilirubinemias present with unconjugated hyperbili? What is the difference?
Gilbert's - mild and occurs with fasting and stress | Crigler-Najjar - Severe with early death
1259
Which hereditary hyperbilirubinemias present with conjugated hyperbili? What is the difference?
Rotor's syndrome - normal appearing liver Dubin-Johnson - Black liverf
1260
Treatment of the hereditary hyperbilirubinemias
Crigler-Najjar I - Phenobarbital Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant Dubin-Johnson, Rotor's, Gilbert's do not require treatment.
1261
Lab/vitals abnormalities of LBW infants
``` Hypoxia Hypothermia Hypoglycemia Hypocalcemia Polycythemia ```
1262
What electrolyte derangements are seen with significant emesis?
Hypochloremic, hypokalemic metabolic alkalosis Loss of HCl in vomit Angiotensin II --> HCO3 resorption Aldosterone --> H+ secretion and K+ secretion
1263
Superior sulcus tumor possible symptoms
Horner syndrome Pancoast (ulnar pain distribution, shoulder weakness) Hoarseness (RLN) SVC syndrome
1264
Divisions of mediastinum and their masses
Anterior: 4 T's (thymoma, teratoma, thyroid, terrible lymphoma) Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma Posterior: Neurogenic tumors
1265
Beck's triad of cardiac tamponade
Hypotension Distant heart sounds Distended jugular veins
1266
When can chorionic villous sampling be done? | Amniocentesis?
CVS: 9-14w Amniocentesis: 15-22w
1267
When to swab for GBS
35w
1268
Quad screen results for Edwards syndrome
UNDERaged at 18 | All are down
1269
Quad screen results for Down syndrome
2up 2down at 21
1270
Treatment of HIV in pregnancy
1) Zidovudine or Nevirapine during pregnancy 2) Elective c-section if viral load over 1000 3) Zidovudine for infant 4) No breastfeeding
1271
Normal fetal heart rate | Causes for bradycardia or tachycardia
110-160 bpm Brady - Congenital heart malformations, hypoxia Tachy - Hypoxia, maternal fever, fetal anemia
1272
Normal variability on FHT
6-25 bpm
1273
What does sinusoidal variability on FHT indicate?
Serious fetal anemia
1274
Treatment of hypercalcemia 2/2 malignancy
Short term: Normal saline, Calcitonin | Long term: Bisphosphonates
1275
Mutation seen in cri-du-chat syndrome
5p deletion
1276
Difference between gestational and chronic HTN
Chronic HTN if present before 20w or persists after 12w postpartum Gestational HTN if presents after 20w
1277
Definition of preeclampsia
1) New-onset HTN after 20w or worsened chronic HTN | 2) Proteinuria of over 300mg/24h (3+ proteins)
1278
Murmur of transposition of the great vessels
Single S2 +/- VSD murmur Most common early cyanotic dz
1279
Murmur of tetralogy of Fallot
Pulmonic stenosis murmur | VSD murmur
1280
Treatment of transposition of the great vessels
``` Prostaglandins early (to maintain PFO) Emergent surgery ```
1281
Treatment of impetigo
Non-bullous (honey crusts) - Topical mupirocin | Bullous - Oral abx
1282
Symptoms of multiple myeloma
Calcium elevated Renal dysfunction Anemia Bone lesions/Back pain
1283
Indications for carotid endarterectomy
Symptomatic 70-99% | Men asymptomatic 60-99%
1284
ESR and CK in glucocorticoid myopathy
Both normal Painless weakness
1285
ESR and CK in Polymyalgia Rheumatica
ESR elevated | CK normal
1286
ESR and CK in statin-induced myopathy
ESR normal | CK elevated
1287
How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis
Saline-responsive: Urine chloride under 20 Saline-resistant: Urine chloride over 20 Saline responsive is 2/2 vomiting, diarrhea, diuretic abuse Saline resistant is 2/2 hyperaldosteronism, Cushing's, hypokalemia
1288
What cancers are seen with HNPCC?
Colon cancer | Endometrial cancer
1289
What cancers are associated with nephrotic syndromes?
Adenocarcinoma - membranous nephropathy Lymphoma - Minimal change disease
1290
Treatment of uric acid kidney stones
Oral potassium citrate Citrate alkalinizes the urine and inhibits crystallization
1291
Solitary pulmonary nodule workup
Nonsmoker - compare to old CXR. Q3mo CXR's. If stable for 12mo considered benign. Smoker: - Chest CT - FNA
1292
Treatment for neonatal thyrotoxicosis
Methimazole + beta-blocker Caused by maternal anti-TSH receptor Ab's
1293
Extrahepatic manifestations of HCV
Porphyria cutanea tarda Essential mixed cryoglobulinemia Membranoproliferative GN
1294
Symptoms of mixed cryoglobulinemia
Purpura Arthralgias Weakness Membranoproliferative GN
1295
Symptoms of galactosemia
Newborn with: - FTT - Bilateral cataracts - Jaundice - Hypoglycemia
1296
Prophylaxis in HIV patients
``` 200 = PCP = Bactrim 150 = Histoplasma = Itraconazole 100 = Toxoplasma = Bactrim 50 = MAC = Azithromycin ```
1297
Prophylaxis in posttransplant patients
Bactrim for PCP Immunize against Influenza, pneumococcus, and HBV
1298
When to perform oral glucose tolerance test
24-28w
1299
TSH, total T4, and free T4 levels in pregnancy
TSH down Total T4 way up Free T4 slightly up Because beta-hCG has TSH-like activity and estrogen increases TBG
1300
Paraneoplastic syndromes of SCLC
ACTH (Cushing's) ADH (SIADH) Lambert-Eaton syndrome
1301
Paraneoplastic syndromes of lung SCC
PTHrP (hypercalcemia)
1302
Most common cause of urinary obstruction in newborn males
Posterior urethral valves Can cause Potter's sequence and hydronephrosis in-utero
1303
Treatment for diabetic distal neuropathy
1) TCA's | 2) Gabapentin
1304
EPS side effects of antipsychotics
Acute dystonic reaction (neck, mouth, tongue, EOM) Akithisia (restlessness) Parkinsonism Tardive dyskinesia (after 1-6mo)
1305
Which hereditary hyperbilirubinemias present with unconjugated hyperbili? What is the difference?
Gilbert's - mild and occurs with fasting and stress | Crigler-Najjar - Severe with early death
1306
Which hereditary hyperbilirubinemias present with conjugated hyperbili? What is the difference?
Rotor's syndrome - normal appearing liver Dubin-Johnson - Black liverf
1307
Treatment of the hereditary hyperbilirubinemias
Crigler-Najjar I - Phenobarbital Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant Dubin-Johnson, Rotor's, Gilbert's do not require treatment.
1308
Lab/vitals abnormalities of LBW infants
``` Hypoxia Hypothermia Hypoglycemia Hypocalcemia Polycythemia ```
1309
What electrolyte derangements are seen with significant emesis?
Hypochloremic, hypokalemic metabolic alkalosis Loss of HCl in vomit Angiotensin II --> HCO3 resorption Aldosterone --> H+ secretion and K+ secretion
1310
Superior sulcus tumor possible symptoms
Horner syndrome Pancoast (ulnar pain distribution, shoulder weakness) Hoarseness (RLN) SVC syndrome
1311
Divisions of mediastinum and their masses
Anterior: 4 T's (thymoma, teratoma, thyroid, terrible lymphoma) Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma Posterior: Neurogenic tumors
1312
Beck's triad of cardiac tamponade
Hypotension Distant heart sounds Distended jugular veins
1313
When can chorionic villous sampling be done? | Amniocentesis?
CVS: 9-14w Amniocentesis: 15-22w
1314
When to swab for GBS
35w
1315
Quad screen results for Edwards syndrome
UNDERaged at 18 | All are down
1316
Quad screen results for Down syndrome
2up 2down at 21
1317
Treatment of HIV in pregnancy
1) Zidovudine or Nevirapine during pregnancy 2) Elective c-section if viral load over 1000 3) Zidovudine for infant 4) No breastfeeding
1318
Normal fetal heart rate | Causes for bradycardia or tachycardia
110-160 bpm Brady - Congenital heart malformations, hypoxia Tachy - Hypoxia, maternal fever, fetal anemia
1319
Normal variability on FHT
6-25 bpm
1320
What does sinusoidal variability on FHT indicate?
Serious fetal anemia
1321
Treatment of hypercalcemia 2/2 malignancy
Short term: Normal saline, Calcitonin | Long term: Bisphosphonates
1322
Mutation seen in cri-du-chat syndrome
5p deletion
1323
Difference between gestational and chronic HTN
Chronic HTN if present before 20w or persists after 12w postpartum Gestational HTN if presents after 20w
1324
Definition of preeclampsia
1) New-onset HTN after 20w or worsened chronic HTN | 2) Proteinuria of over 300mg/24h (3+ proteins)
1325
Murmur of transposition of the great vessels
Single S2 +/- VSD murmur Most common early cyanotic dz
1326
Murmur of tetralogy of Fallot
Pulmonic stenosis murmur | VSD murmur
1327
Treatment of transposition of the great vessels
``` Prostaglandins early (to maintain PFO) Emergent surgery ```
1328
Treatment of impetigo
Non-bullous (honey crusts) - Topical mupirocin | Bullous - Oral abx
1329
Symptoms of multiple myeloma
Calcium elevated Renal dysfunction Anemia Bone lesions/Back pain
1330
Indications for carotid endarterectomy
Symptomatic 70-99% | Men asymptomatic 60-99%
1331
ESR and CK in glucocorticoid myopathy
Both normal Painless weakness
1332
ESR and CK in Polymyalgia Rheumatica
ESR elevated | CK normal
1333
ESR and CK in statin-induced myopathy
ESR normal | CK elevated
1334
How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis
Saline-responsive: Urine chloride under 20 Saline-resistant: Urine chloride over 20 Saline responsive is 2/2 vomiting, diarrhea, diuretic abuse Saline resistant is 2/2 hyperaldosteronism, Cushing's, hypokalemia
1335
What cancers are seen with HNPCC?
Colon cancer | Endometrial cancer
1336
What cancers are associated with nephrotic syndromes?
Adenocarcinoma - membranous nephropathy Lymphoma - Minimal change disease
1337
Treatment of uric acid kidney stones
Oral potassium citrate Citrate alkalinizes the urine and inhibits crystallization
1338
Solitary pulmonary nodule workup
Nonsmoker - compare to old CXR. Q3mo CXR's. If stable for 12mo considered benign. Smoker: - Chest CT - FNA
1339
Treatment for neonatal thyrotoxicosis
Methimazole + beta-blocker Caused by maternal anti-TSH receptor Ab's
1340
Extrahepatic manifestations of HCV
Porphyria cutanea tarda Essential mixed cryoglobulinemia Membranoproliferative GN
1341
Symptoms of mixed cryoglobulinemia
Purpura Arthralgias Weakness Membranoproliferative GN
1342
Symptoms of galactosemia
Newborn with: - FTT - Bilateral cataracts - Jaundice - Hypoglycemia
1343
Prophylaxis in HIV patients
``` 200 = PCP = Bactrim 150 = Histoplasma = Itraconazole 100 = Toxoplasma = Bactrim 50 = MAC = Azithromycin ```
1344
Prophylaxis in posttransplant patients
Bactrim for PCP Immunize against Influenza, pneumococcus, and HBV
1345
When to perform oral glucose tolerance test
24-28w
1346
TSH, total T4, and free T4 levels in pregnancy
TSH down Total T4 way up Free T4 slightly up Because beta-hCG has TSH-like activity and estrogen increases TBG
1347
Paraneoplastic syndromes of SCLC
ACTH (Cushing's) ADH (SIADH) Lambert-Eaton syndrome
1348
Paraneoplastic syndromes of lung SCC
PTHrP (hypercalcemia)
1349
Most common cause of urinary obstruction in newborn males
Posterior urethral valves Can cause Potter's sequence and hydronephrosis in-utero
1350
Treatment for diabetic distal neuropathy
1) TCA's | 2) Gabapentin
1351
EPS side effects of antipsychotics
Acute dystonic reaction (neck, mouth, tongue, EOM) Akithisia (restlessness) Parkinsonism Tardive dyskinesia (after 1-6mo)
1352
Which hereditary hyperbilirubinemias present with unconjugated hyperbili? What is the difference?
Gilbert's - mild and occurs with fasting and stress | Crigler-Najjar - Severe with early death
1353
Which hereditary hyperbilirubinemias present with conjugated hyperbili? What is the difference?
Rotor's syndrome - normal appearing liver Dubin-Johnson - Black liverf
1354
Treatment of the hereditary hyperbilirubinemias
Crigler-Najjar I - Phenobarbital Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant Dubin-Johnson, Rotor's, Gilbert's do not require treatment.
1355
Lab/vitals abnormalities of LBW infants
``` Hypoxia Hypothermia Hypoglycemia Hypocalcemia Polycythemia ```
1356
What electrolyte derangements are seen with significant emesis?
Hypochloremic, hypokalemic metabolic alkalosis Loss of HCl in vomit Angiotensin II --> HCO3 resorption Aldosterone --> H+ secretion and K+ secretion
1357
Superior sulcus tumor possible symptoms
Horner syndrome Pancoast (ulnar pain distribution, shoulder weakness) Hoarseness (RLN) SVC syndrome
1358
Divisions of mediastinum and their masses
Anterior: 4 T's (thymoma, teratoma, thyroid, terrible lymphoma) Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma Posterior: Neurogenic tumors
1359
Beck's triad of cardiac tamponade
Hypotension Distant heart sounds Distended jugular veins
1360
When can chorionic villous sampling be done? | Amniocentesis?
CVS: 9-14w Amniocentesis: 15-22w
1361
When to swab for GBS
35w
1362
Quad screen results for Edwards syndrome
UNDERaged at 18 | All are down
1363
Quad screen results for Down syndrome
2up 2down at 21
1364
Treatment of HIV in pregnancy
1) Zidovudine or Nevirapine during pregnancy 2) Elective c-section if viral load over 1000 3) Zidovudine for infant 4) No breastfeeding
1365
Normal fetal heart rate | Causes for bradycardia or tachycardia
110-160 bpm Brady - Congenital heart malformations, hypoxia Tachy - Hypoxia, maternal fever, fetal anemia
1366
Normal variability on FHT
6-25 bpm
1367
What does sinusoidal variability on FHT indicate?
Serious fetal anemia
1368
Treatment of hypercalcemia 2/2 malignancy
Short term: Normal saline, Calcitonin | Long term: Bisphosphonates
1369
Mutation seen in cri-du-chat syndrome
5p deletion
1370
Difference between gestational and chronic HTN
Chronic HTN if present before 20w or persists after 12w postpartum Gestational HTN if presents after 20w
1371
Definition of preeclampsia
1) New-onset HTN after 20w or worsened chronic HTN | 2) Proteinuria of over 300mg/24h (3+ proteins)
1372
Murmur of transposition of the great vessels
Single S2 +/- VSD murmur Most common early cyanotic dz
1373
Murmur of tetralogy of Fallot
Pulmonic stenosis murmur | VSD murmur
1374
Treatment of transposition of the great vessels
``` Prostaglandins early (to maintain PFO) Emergent surgery ```
1375
Treatment of impetigo
Non-bullous (honey crusts) - Topical mupirocin | Bullous - Oral abx
1376
Symptoms of multiple myeloma
Calcium elevated Renal dysfunction Anemia Bone lesions/Back pain
1377
Indications for carotid endarterectomy
Symptomatic 70-99% | Men asymptomatic 60-99%
1378
ESR and CK in glucocorticoid myopathy
Both normal Painless weakness
1379
ESR and CK in Polymyalgia Rheumatica
ESR elevated | CK normal
1380
ESR and CK in statin-induced myopathy
ESR normal | CK elevated
1381
How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis
Saline-responsive: Urine chloride under 20 Saline-resistant: Urine chloride over 20 Saline responsive is 2/2 vomiting, diarrhea, diuretic abuse Saline resistant is 2/2 hyperaldosteronism, Cushing's, hypokalemia
1382
What cancers are seen with HNPCC?
Colon cancer | Endometrial cancer
1383
What cancers are associated with nephrotic syndromes?
Adenocarcinoma - membranous nephropathy Lymphoma - Minimal change disease
1384
Treatment of uric acid kidney stones
Oral potassium citrate Citrate alkalinizes the urine and inhibits crystallization
1385
Solitary pulmonary nodule workup
Nonsmoker - compare to old CXR. Q3mo CXR's. If stable for 12mo considered benign. Smoker: - Chest CT - FNA
1386
Treatment for neonatal thyrotoxicosis
Methimazole + beta-blocker Caused by maternal anti-TSH receptor Ab's
1387
Extrahepatic manifestations of HCV
Porphyria cutanea tarda Essential mixed cryoglobulinemia Membranoproliferative GN
1388
Symptoms of mixed cryoglobulinemia
Purpura Arthralgias Weakness Membranoproliferative GN
1389
Symptoms of galactosemia
Newborn with: - FTT - Bilateral cataracts - Jaundice - Hypoglycemia
1390
Prophylaxis in HIV patients
``` 200 = PCP = Bactrim 150 = Histoplasma = Itraconazole 100 = Toxoplasma = Bactrim 50 = MAC = Azithromycin ```
1391
Prophylaxis in posttransplant patients
Bactrim for PCP Immunize against Influenza, pneumococcus, and HBV
1392
When to perform oral glucose tolerance test
24-28w
1393
TSH, total T4, and free T4 levels in pregnancy
TSH down Total T4 way up Free T4 slightly up Because beta-hCG has TSH-like activity and estrogen increases TBG
1394
Paraneoplastic syndromes of SCLC
ACTH (Cushing's) ADH (SIADH) Lambert-Eaton syndrome
1395
Paraneoplastic syndromes of lung SCC
PTHrP (hypercalcemia)
1396
Most common cause of urinary obstruction in newborn males
Posterior urethral valves Can cause Potter's sequence and hydronephrosis in-utero
1397
Treatment for diabetic distal neuropathy
1) TCA's | 2) Gabapentin
1398
EPS side effects of antipsychotics
Acute dystonic reaction (neck, mouth, tongue, EOM) Akithisia (restlessness) Parkinsonism Tardive dyskinesia (after 1-6mo)
1399
Which hereditary hyperbilirubinemias present with unconjugated hyperbili? What is the difference?
Gilbert's - mild and occurs with fasting and stress | Crigler-Najjar - Severe with early death
1400
Which hereditary hyperbilirubinemias present with conjugated hyperbili? What is the difference?
Rotor's syndrome - normal appearing liver Dubin-Johnson - Black liverf
1401
Treatment of the hereditary hyperbilirubinemias
Crigler-Najjar I - Phenobarbital Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant Dubin-Johnson, Rotor's, Gilbert's do not require treatment.
1402
Lab/vitals abnormalities of LBW infants
``` Hypoxia Hypothermia Hypoglycemia Hypocalcemia Polycythemia ```
1403
What electrolyte derangements are seen with significant emesis?
Hypochloremic, hypokalemic metabolic alkalosis Loss of HCl in vomit Angiotensin II --> HCO3 resorption Aldosterone --> H+ secretion and K+ secretion
1404
Superior sulcus tumor possible symptoms
Horner syndrome Pancoast (ulnar pain distribution, shoulder weakness) Hoarseness (RLN) SVC syndrome
1405
Divisions of mediastinum and their masses
Anterior: 4 T's (thymoma, teratoma, thyroid, terrible lymphoma) Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma Posterior: Neurogenic tumors
1406
Beck's triad of cardiac tamponade
Hypotension Distant heart sounds Distended jugular veins
1407
When can chorionic villous sampling be done? | Amniocentesis?
CVS: 9-14w Amniocentesis: 15-22w
1408
When to swab for GBS
35w
1409
Quad screen results for Edwards syndrome
UNDERaged at 18 | All are down
1410
Quad screen results for Down syndrome
2up 2down at 21
1411
Treatment of HIV in pregnancy
1) Zidovudine or Nevirapine during pregnancy 2) Elective c-section if viral load over 1000 3) Zidovudine for infant 4) No breastfeeding
1412
Normal fetal heart rate | Causes for bradycardia or tachycardia
110-160 bpm Brady - Congenital heart malformations, hypoxia Tachy - Hypoxia, maternal fever, fetal anemia
1413
Normal variability on FHT
6-25 bpm
1414
What does sinusoidal variability on FHT indicate?
Serious fetal anemia
1415
Treatment of hypercalcemia 2/2 malignancy
Short term: Normal saline, Calcitonin | Long term: Bisphosphonates
1416
Mutation seen in cri-du-chat syndrome
5p deletion
1417
Difference between gestational and chronic HTN
Chronic HTN if present before 20w or persists after 12w postpartum Gestational HTN if presents after 20w
1418
Definition of preeclampsia
1) New-onset HTN after 20w or worsened chronic HTN | 2) Proteinuria of over 300mg/24h (3+ proteins)
1419
Murmur of transposition of the great vessels
Single S2 +/- VSD murmur Most common early cyanotic dz
1420
Murmur of tetralogy of Fallot
Pulmonic stenosis murmur | VSD murmur
1421
Treatment of transposition of the great vessels
``` Prostaglandins early (to maintain PFO) Emergent surgery ```
1422
Treatment of impetigo
Non-bullous (honey crusts) - Topical mupirocin | Bullous - Oral abx
1423
Symptoms of multiple myeloma
Calcium elevated Renal dysfunction Anemia Bone lesions/Back pain
1424
Indications for carotid endarterectomy
Symptomatic 70-99% | Men asymptomatic 60-99%
1425
ESR and CK in glucocorticoid myopathy
Both normal Painless weakness
1426
ESR and CK in Polymyalgia Rheumatica
ESR elevated | CK normal
1427
ESR and CK in statin-induced myopathy
ESR normal | CK elevated
1428
How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis
Saline-responsive: Urine chloride under 20 Saline-resistant: Urine chloride over 20 Saline responsive is 2/2 vomiting, diarrhea, diuretic abuse Saline resistant is 2/2 hyperaldosteronism, Cushing's, hypokalemia
1429
What cancers are seen with HNPCC?
Colon cancer | Endometrial cancer
1430
What cancers are associated with nephrotic syndromes?
Adenocarcinoma - membranous nephropathy Lymphoma - Minimal change disease
1431
Treatment of uric acid kidney stones
Oral potassium citrate Citrate alkalinizes the urine and inhibits crystallization
1432
Prophylaxis in HIV patients
``` 200 = PCP = Bactrim 150 = Histoplasma = Itraconazole 100 = Toxoplasma = Bactrim 50 = MAC = Azithromycin ```
1433
Prophylaxis in posttransplant patients
Bactrim for PCP Immunize against Influenza, pneumococcus, and HBV
1434
When to perform oral glucose tolerance test
24-28w
1435
TSH, total T4, and free T4 levels in pregnancy
TSH down Total T4 way up Free T4 slightly up Because beta-hCG has TSH-like activity and estrogen increases TBG
1436
Paraneoplastic syndromes of SCLC
ACTH (Cushing's) ADH (SIADH) Lambert-Eaton syndrome
1437
Paraneoplastic syndromes of lung SCC
PTHrP (hypercalcemia)
1438
Most common cause of urinary obstruction in newborn males
Posterior urethral valves Can cause Potter's sequence and hydronephrosis in-utero
1439
Treatment for diabetic distal neuropathy
1) TCA's | 2) Gabapentin
1440
EPS side effects of antipsychotics
Acute dystonic reaction (neck, mouth, tongue, EOM) Akithisia (restlessness) Parkinsonism Tardive dyskinesia (after 1-6mo)
1441
Which hereditary hyperbilirubinemias present with unconjugated hyperbili? What is the difference?
Gilbert's - mild and occurs with fasting and stress | Crigler-Najjar - Severe with early death
1442
Which hereditary hyperbilirubinemias present with conjugated hyperbili? What is the difference?
Rotor's syndrome - normal appearing liver Dubin-Johnson - Black liverf
1443
Treatment of the hereditary hyperbilirubinemias
Crigler-Najjar I - Phenobarbital Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant Dubin-Johnson, Rotor's, Gilbert's do not require treatment.
1444
Lab/vitals abnormalities of LBW infants
``` Hypoxia Hypothermia Hypoglycemia Hypocalcemia Polycythemia ```
1445
What electrolyte derangements are seen with significant emesis?
Hypochloremic, hypokalemic metabolic alkalosis Loss of HCl in vomit Angiotensin II --> HCO3 resorption Aldosterone --> H+ secretion and K+ secretion
1446
Superior sulcus tumor possible symptoms
Horner syndrome Pancoast (ulnar pain distribution, shoulder weakness) Hoarseness (RLN) SVC syndrome
1447
Divisions of mediastinum and their masses
Anterior: 4 T's (thymoma, teratoma, thyroid, terrible lymphoma) Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma Posterior: Neurogenic tumors
1448
Beck's triad of cardiac tamponade
Hypotension Distant heart sounds Distended jugular veins
1449
When can chorionic villous sampling be done? | Amniocentesis?
CVS: 9-14w Amniocentesis: 15-22w
1450
When to swab for GBS
35w
1451
Quad screen results for Edwards syndrome
UNDERaged at 18 | All are down
1452
Quad screen results for Down syndrome
2up 2down at 21
1453
Treatment of HIV in pregnancy
1) Zidovudine or Nevirapine during pregnancy 2) Elective c-section if viral load over 1000 3) Zidovudine for infant 4) No breastfeeding
1454
Normal fetal heart rate | Causes for bradycardia or tachycardia
110-160 bpm Brady - Congenital heart malformations, hypoxia Tachy - Hypoxia, maternal fever, fetal anemia
1455
Normal variability on FHT
6-25 bpm
1456
What does sinusoidal variability on FHT indicate?
Serious fetal anemia
1457
Treatment of hypercalcemia 2/2 malignancy
Short term: Normal saline, Calcitonin | Long term: Bisphosphonates
1458
Mutation seen in cri-du-chat syndrome
5p deletion
1459
Difference between gestational and chronic HTN
Chronic HTN if present before 20w or persists after 12w postpartum Gestational HTN if presents after 20w
1460
Definition of preeclampsia
1) New-onset HTN after 20w or worsened chronic HTN | 2) Proteinuria of over 300mg/24h (3+ proteins)
1461
Murmur of transposition of the great vessels
Single S2 +/- VSD murmur Most common early cyanotic dz
1462
Murmur of tetralogy of Fallot
Pulmonic stenosis murmur | VSD murmur
1463
Treatment of transposition of the great vessels
``` Prostaglandins early (to maintain PFO) Emergent surgery ```
1464
Treatment of impetigo
Non-bullous (honey crusts) - Topical mupirocin | Bullous - Oral abx
1465
Symptoms of multiple myeloma
Calcium elevated Renal dysfunction Anemia Bone lesions/Back pain
1466
Indications for carotid endarterectomy
Symptomatic 70-99% | Men asymptomatic 60-99%
1467
ESR and CK in glucocorticoid myopathy
Both normal Painless weakness
1468
ESR and CK in Polymyalgia Rheumatica
ESR elevated | CK normal
1469
ESR and CK in statin-induced myopathy
ESR normal | CK elevated
1470
How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis
Saline-responsive: Urine chloride under 20 Saline-resistant: Urine chloride over 20 Saline responsive is 2/2 vomiting, diarrhea, diuretic abuse Saline resistant is 2/2 hyperaldosteronism, Cushing's, hypokalemia
1471
What cancers are seen with HNPCC?
Colon cancer | Endometrial cancer
1472
What cancers are associated with nephrotic syndromes?
Adenocarcinoma - membranous nephropathy Lymphoma - Minimal change disease
1473
Treatment of uric acid kidney stones
Oral potassium citrate Citrate alkalinizes the urine and inhibits crystallization
1474
Prophylaxis in HIV patients
``` 200 = PCP = Bactrim 150 = Histoplasma = Itraconazole 100 = Toxoplasma = Bactrim 50 = MAC = Azithromycin ```
1475
Prophylaxis in posttransplant patients
Bactrim for PCP Immunize against Influenza, pneumococcus, and HBV
1476
When to perform oral glucose tolerance test
24-28w
1477
TSH, total T4, and free T4 levels in pregnancy
TSH down Total T4 way up Free T4 slightly up Because beta-hCG has TSH-like activity and estrogen increases TBG
1478
Paraneoplastic syndromes of SCLC
ACTH (Cushing's) ADH (SIADH) Lambert-Eaton syndrome
1479
Paraneoplastic syndromes of lung SCC
PTHrP (hypercalcemia)
1480
Most common cause of urinary obstruction in newborn males
Posterior urethral valves Can cause Potter's sequence and hydronephrosis in-utero
1481
Treatment for diabetic distal neuropathy
1) TCA's | 2) Gabapentin
1482
EPS side effects of antipsychotics
Acute dystonic reaction (neck, mouth, tongue, EOM) Akithisia (restlessness) Parkinsonism Tardive dyskinesia (after 1-6mo)
1483
Which hereditary hyperbilirubinemias present with unconjugated hyperbili? What is the difference?
Gilbert's - mild and occurs with fasting and stress | Crigler-Najjar - Severe with early death
1484
Which hereditary hyperbilirubinemias present with conjugated hyperbili? What is the difference?
Rotor's syndrome - normal appearing liver Dubin-Johnson - Black liverf
1485
Treatment of the hereditary hyperbilirubinemias
Crigler-Najjar I - Phenobarbital Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant Dubin-Johnson, Rotor's, Gilbert's do not require treatment.
1486
Lab/vitals abnormalities of LBW infants
``` Hypoxia Hypothermia Hypoglycemia Hypocalcemia Polycythemia ```
1487
What electrolyte derangements are seen with significant emesis?
Hypochloremic, hypokalemic metabolic alkalosis Loss of HCl in vomit Angiotensin II --> HCO3 resorption Aldosterone --> H+ secretion and K+ secretion
1488
Superior sulcus tumor possible symptoms
Horner syndrome Pancoast (ulnar pain distribution, shoulder weakness) Hoarseness (RLN) SVC syndrome
1489
Divisions of mediastinum and their masses
Anterior: 4 T's (thymoma, teratoma, thyroid, terrible lymphoma) Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma Posterior: Neurogenic tumors
1490
Beck's triad of cardiac tamponade
Hypotension Distant heart sounds Distended jugular veins
1491
When can chorionic villous sampling be done? | Amniocentesis?
CVS: 9-14w Amniocentesis: 15-22w
1492
When to swab for GBS
35w
1493
Quad screen results for Edwards syndrome
UNDERaged at 18 | All are down
1494
Quad screen results for Down syndrome
2up 2down at 21
1495
Treatment of HIV in pregnancy
1) Zidovudine or Nevirapine during pregnancy 2) Elective c-section if viral load over 1000 3) Zidovudine for infant 4) No breastfeeding
1496
Normal fetal heart rate | Causes for bradycardia or tachycardia
110-160 bpm Brady - Congenital heart malformations, hypoxia Tachy - Hypoxia, maternal fever, fetal anemia
1497
Normal variability on FHT
6-25 bpm
1498
What does sinusoidal variability on FHT indicate?
Serious fetal anemia
1499
Treatment of hypercalcemia 2/2 malignancy
Short term: Normal saline, Calcitonin | Long term: Bisphosphonates
1500
Mutation seen in cri-du-chat syndrome
5p deletion
1501
Difference between gestational and chronic HTN
Chronic HTN if present before 20w or persists after 12w postpartum Gestational HTN if presents after 20w
1502
Definition of preeclampsia
1) New-onset HTN after 20w or worsened chronic HTN | 2) Proteinuria of over 300mg/24h (3+ proteins)
1503
Murmur of transposition of the great vessels
Single S2 +/- VSD murmur Most common early cyanotic dz
1504
Murmur of tetralogy of Fallot
Pulmonic stenosis murmur | VSD murmur
1505
Treatment of transposition of the great vessels
``` Prostaglandins early (to maintain PFO) Emergent surgery ```
1506
Treatment of impetigo
Non-bullous (honey crusts) - Topical mupirocin | Bullous - Oral abx
1507
Symptoms of multiple myeloma
Calcium elevated Renal dysfunction Anemia Bone lesions/Back pain
1508
Indications for carotid endarterectomy
Symptomatic 70-99% | Men asymptomatic 60-99%
1509
ESR and CK in glucocorticoid myopathy
Both normal Painless weakness
1510
ESR and CK in Polymyalgia Rheumatica
ESR elevated | CK normal
1511
ESR and CK in statin-induced myopathy
ESR normal | CK elevated
1512
How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis
Saline-responsive: Urine chloride under 20 Saline-resistant: Urine chloride over 20 Saline responsive is 2/2 vomiting, diarrhea, diuretic abuse Saline resistant is 2/2 hyperaldosteronism, Cushing's, hypokalemia
1513
What cancers are seen with HNPCC?
Colon cancer | Endometrial cancer
1514
What cancers are associated with nephrotic syndromes?
Adenocarcinoma - membranous nephropathy Lymphoma - Minimal change disease
1515
Treatment of uric acid kidney stones
Oral potassium citrate Citrate alkalinizes the urine and inhibits crystallization
1516
Prophylaxis in HIV patients
``` 200 = PCP = Bactrim 150 = Histoplasma = Itraconazole 100 = Toxoplasma = Bactrim 50 = MAC = Azithromycin ```
1517
Prophylaxis in posttransplant patients
Bactrim for PCP Immunize against Influenza, pneumococcus, and HBV
1518
When to perform oral glucose tolerance test
24-28w
1519
TSH, total T4, and free T4 levels in pregnancy
TSH down Total T4 way up Free T4 slightly up Because beta-hCG has TSH-like activity and estrogen increases TBG
1520
Paraneoplastic syndromes of SCLC
ACTH (Cushing's) ADH (SIADH) Lambert-Eaton syndrome
1521
Paraneoplastic syndromes of lung SCC
PTHrP (hypercalcemia)
1522
Most common cause of urinary obstruction in newborn males
Posterior urethral valves Can cause Potter's sequence and hydronephrosis in-utero
1523
Treatment for diabetic distal neuropathy
1) TCA's | 2) Gabapentin
1524
EPS side effects of antipsychotics
Acute dystonic reaction (neck, mouth, tongue, EOM) Akithisia (restlessness) Parkinsonism Tardive dyskinesia (after 1-6mo)
1525
Which hereditary hyperbilirubinemias present with unconjugated hyperbili? What is the difference?
Gilbert's - mild and occurs with fasting and stress | Crigler-Najjar - Severe with early death
1526
Which hereditary hyperbilirubinemias present with conjugated hyperbili? What is the difference?
Rotor's syndrome - normal appearing liver Dubin-Johnson - Black liverf
1527
Treatment of the hereditary hyperbilirubinemias
Crigler-Najjar I - Phenobarbital Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant Dubin-Johnson, Rotor's, Gilbert's do not require treatment.
1528
Lab/vitals abnormalities of LBW infants
``` Hypoxia Hypothermia Hypoglycemia Hypocalcemia Polycythemia ```
1529
What electrolyte derangements are seen with significant emesis?
Hypochloremic, hypokalemic metabolic alkalosis Loss of HCl in vomit Angiotensin II --> HCO3 resorption Aldosterone --> H+ secretion and K+ secretion
1530
Superior sulcus tumor possible symptoms
Horner syndrome Pancoast (ulnar pain distribution, shoulder weakness) Hoarseness (RLN) SVC syndrome
1531
Divisions of mediastinum and their masses
Anterior: 4 T's (thymoma, teratoma, thyroid, terrible lymphoma) Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma Posterior: Neurogenic tumors
1532
Beck's triad of cardiac tamponade
Hypotension Distant heart sounds Distended jugular veins
1533
When can chorionic villous sampling be done? | Amniocentesis?
CVS: 9-14w Amniocentesis: 15-22w
1534
When to swab for GBS
35w
1535
Quad screen results for Edwards syndrome
UNDERaged at 18 | All are down
1536
Quad screen results for Down syndrome
2up 2down at 21
1537
Treatment of HIV in pregnancy
1) Zidovudine or Nevirapine during pregnancy 2) Elective c-section if viral load over 1000 3) Zidovudine for infant 4) No breastfeeding
1538
Normal fetal heart rate | Causes for bradycardia or tachycardia
110-160 bpm Brady - Congenital heart malformations, hypoxia Tachy - Hypoxia, maternal fever, fetal anemia
1539
Normal variability on FHT
6-25 bpm
1540
What does sinusoidal variability on FHT indicate?
Serious fetal anemia
1541
Treatment of hypercalcemia 2/2 malignancy
Short term: Normal saline, Calcitonin | Long term: Bisphosphonates
1542
Mutation seen in cri-du-chat syndrome
5p deletion
1543
Difference between gestational and chronic HTN
Chronic HTN if present before 20w or persists after 12w postpartum Gestational HTN if presents after 20w
1544
Definition of preeclampsia
1) New-onset HTN after 20w or worsened chronic HTN | 2) Proteinuria of over 300mg/24h (3+ proteins)
1545
Murmur of transposition of the great vessels
Single S2 +/- VSD murmur Most common early cyanotic dz
1546
Murmur of tetralogy of Fallot
Pulmonic stenosis murmur | VSD murmur
1547
Treatment of transposition of the great vessels
``` Prostaglandins early (to maintain PFO) Emergent surgery ```
1548
Treatment of impetigo
Non-bullous (honey crusts) - Topical mupirocin | Bullous - Oral abx
1549
Symptoms of multiple myeloma
Calcium elevated Renal dysfunction Anemia Bone lesions/Back pain
1550
Indications for carotid endarterectomy
Symptomatic 70-99% | Men asymptomatic 60-99%
1551
ESR and CK in glucocorticoid myopathy
Both normal Painless weakness
1552
ESR and CK in Polymyalgia Rheumatica
ESR elevated | CK normal
1553
ESR and CK in statin-induced myopathy
ESR normal | CK elevated
1554
How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis
Saline-responsive: Urine chloride under 20 Saline-resistant: Urine chloride over 20 Saline responsive is 2/2 vomiting, diarrhea, diuretic abuse Saline resistant is 2/2 hyperaldosteronism, Cushing's, hypokalemia
1555
What cancers are seen with HNPCC?
Colon cancer | Endometrial cancer
1556
What cancers are associated with nephrotic syndromes?
Adenocarcinoma - membranous nephropathy Lymphoma - Minimal change disease
1557
Treatment of uric acid kidney stones
Oral potassium citrate Citrate alkalinizes the urine and inhibits crystallization
1558
Prophylaxis in HIV patients
``` 200 = PCP = Bactrim 150 = Histoplasma = Itraconazole 100 = Toxoplasma = Bactrim 50 = MAC = Azithromycin ```
1559
Prophylaxis in posttransplant patients
Bactrim for PCP Immunize against Influenza, pneumococcus, and HBV
1560
When to perform oral glucose tolerance test
24-28w
1561
TSH, total T4, and free T4 levels in pregnancy
TSH down Total T4 way up Free T4 slightly up Because beta-hCG has TSH-like activity and estrogen increases TBG
1562
Paraneoplastic syndromes of SCLC
ACTH (Cushing's) ADH (SIADH) Lambert-Eaton syndrome
1563
Paraneoplastic syndromes of lung SCC
PTHrP (hypercalcemia)
1564
Most common cause of urinary obstruction in newborn males
Posterior urethral valves Can cause Potter's sequence and hydronephrosis in-utero
1565
Treatment for diabetic distal neuropathy
1) TCA's | 2) Gabapentin
1566
EPS side effects of antipsychotics
Acute dystonic reaction (neck, mouth, tongue, EOM) Akithisia (restlessness) Parkinsonism Tardive dyskinesia (after 1-6mo)
1567
Which hereditary hyperbilirubinemias present with unconjugated hyperbili? What is the difference?
Gilbert's - mild and occurs with fasting and stress | Crigler-Najjar - Severe with early death
1568
Which hereditary hyperbilirubinemias present with conjugated hyperbili? What is the difference?
Rotor's syndrome - normal appearing liver Dubin-Johnson - Black liverf
1569
Treatment of the hereditary hyperbilirubinemias
Crigler-Najjar I - Phenobarbital Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant Dubin-Johnson, Rotor's, Gilbert's do not require treatment.
1570
Lab/vitals abnormalities of LBW infants
``` Hypoxia Hypothermia Hypoglycemia Hypocalcemia Polycythemia ```
1571
What electrolyte derangements are seen with significant emesis?
Hypochloremic, hypokalemic metabolic alkalosis Loss of HCl in vomit Angiotensin II --> HCO3 resorption Aldosterone --> H+ secretion and K+ secretion
1572
Superior sulcus tumor possible symptoms
Horner syndrome Pancoast (ulnar pain distribution, shoulder weakness) Hoarseness (RLN) SVC syndrome
1573
Divisions of mediastinum and their masses
Anterior: 4 T's (thymoma, teratoma, thyroid, terrible lymphoma) Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma Posterior: Neurogenic tumors
1574
Beck's triad of cardiac tamponade
Hypotension Distant heart sounds Distended jugular veins
1575
When can chorionic villous sampling be done? | Amniocentesis?
CVS: 9-14w Amniocentesis: 15-22w
1576
When to swab for GBS
35w
1577
Quad screen results for Edwards syndrome
UNDERaged at 18 | All are down
1578
Quad screen results for Down syndrome
2up 2down at 21
1579
Treatment of HIV in pregnancy
1) Zidovudine or Nevirapine during pregnancy 2) Elective c-section if viral load over 1000 3) Zidovudine for infant 4) No breastfeeding
1580
Normal fetal heart rate | Causes for bradycardia or tachycardia
110-160 bpm Brady - Congenital heart malformations, hypoxia Tachy - Hypoxia, maternal fever, fetal anemia
1581
Normal variability on FHT
6-25 bpm
1582
What does sinusoidal variability on FHT indicate?
Serious fetal anemia
1583
Treatment of hypercalcemia 2/2 malignancy
Short term: Normal saline, Calcitonin | Long term: Bisphosphonates
1584
Mutation seen in cri-du-chat syndrome
5p deletion
1585
Difference between gestational and chronic HTN
Chronic HTN if present before 20w or persists after 12w postpartum Gestational HTN if presents after 20w
1586
Definition of preeclampsia
1) New-onset HTN after 20w or worsened chronic HTN | 2) Proteinuria of over 300mg/24h (3+ proteins)
1587
Murmur of transposition of the great vessels
Single S2 +/- VSD murmur Most common early cyanotic dz
1588
Murmur of tetralogy of Fallot
Pulmonic stenosis murmur | VSD murmur
1589
Treatment of transposition of the great vessels
``` Prostaglandins early (to maintain PFO) Emergent surgery ```
1590
Treatment of impetigo
Non-bullous (honey crusts) - Topical mupirocin | Bullous - Oral abx
1591
Symptoms of multiple myeloma
Calcium elevated Renal dysfunction Anemia Bone lesions/Back pain
1592
Indications for carotid endarterectomy
Symptomatic 70-99% | Men asymptomatic 60-99%
1593
ESR and CK in glucocorticoid myopathy
Both normal Painless weakness
1594
ESR and CK in Polymyalgia Rheumatica
ESR elevated | CK normal
1595
ESR and CK in statin-induced myopathy
ESR normal | CK elevated
1596
How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis
Saline-responsive: Urine chloride under 20 Saline-resistant: Urine chloride over 20 Saline responsive is 2/2 vomiting, diarrhea, diuretic abuse Saline resistant is 2/2 hyperaldosteronism, Cushing's, hypokalemia
1597
What cancers are seen with HNPCC?
Colon cancer | Endometrial cancer
1598
What cancers are associated with nephrotic syndromes?
Adenocarcinoma - membranous nephropathy Lymphoma - Minimal change disease
1599
Treatment of uric acid kidney stones
Oral potassium citrate Citrate alkalinizes the urine and inhibits crystallization
1600
Prophylaxis in HIV patients
``` 200 = PCP = Bactrim 150 = Histoplasma = Itraconazole 100 = Toxoplasma = Bactrim 50 = MAC = Azithromycin ```
1601
Prophylaxis in posttransplant patients
Bactrim for PCP Immunize against Influenza, pneumococcus, and HBV
1602
When to perform oral glucose tolerance test
24-28w
1603
TSH, total T4, and free T4 levels in pregnancy
TSH down Total T4 way up Free T4 slightly up Because beta-hCG has TSH-like activity and estrogen increases TBG
1604
Paraneoplastic syndromes of SCLC
ACTH (Cushing's) ADH (SIADH) Lambert-Eaton syndrome
1605
Paraneoplastic syndromes of lung SCC
PTHrP (hypercalcemia)
1606
Most common cause of urinary obstruction in newborn males
Posterior urethral valves Can cause Potter's sequence and hydronephrosis in-utero
1607
Treatment for diabetic distal neuropathy
1) TCA's | 2) Gabapentin
1608
EPS side effects of antipsychotics
Acute dystonic reaction (neck, mouth, tongue, EOM) Akithisia (restlessness) Parkinsonism Tardive dyskinesia (after 1-6mo)
1609
Which hereditary hyperbilirubinemias present with unconjugated hyperbili? What is the difference?
Gilbert's - mild and occurs with fasting and stress | Crigler-Najjar - Severe with early death
1610
Which hereditary hyperbilirubinemias present with conjugated hyperbili? What is the difference?
Rotor's syndrome - normal appearing liver Dubin-Johnson - Black liverf
1611
Treatment of the hereditary hyperbilirubinemias
Crigler-Najjar I - Phenobarbital Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant Dubin-Johnson, Rotor's, Gilbert's do not require treatment.
1612
Lab/vitals abnormalities of LBW infants
``` Hypoxia Hypothermia Hypoglycemia Hypocalcemia Polycythemia ```
1613
What electrolyte derangements are seen with significant emesis?
Hypochloremic, hypokalemic metabolic alkalosis Loss of HCl in vomit Angiotensin II --> HCO3 resorption Aldosterone --> H+ secretion and K+ secretion
1614
Superior sulcus tumor possible symptoms
Horner syndrome Pancoast (ulnar pain distribution, shoulder weakness) Hoarseness (RLN) SVC syndrome
1615
Divisions of mediastinum and their masses
Anterior: 4 T's (thymoma, teratoma, thyroid, terrible lymphoma) Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma Posterior: Neurogenic tumors
1616
Beck's triad of cardiac tamponade
Hypotension Distant heart sounds Distended jugular veins
1617
When can chorionic villous sampling be done? | Amniocentesis?
CVS: 9-14w Amniocentesis: 15-22w
1618
When to swab for GBS
35w
1619
Quad screen results for Edwards syndrome
UNDERaged at 18 | All are down
1620
Quad screen results for Down syndrome
2up 2down at 21
1621
Treatment of HIV in pregnancy
1) Zidovudine or Nevirapine during pregnancy 2) Elective c-section if viral load over 1000 3) Zidovudine for infant 4) No breastfeeding
1622
Normal fetal heart rate | Causes for bradycardia or tachycardia
110-160 bpm Brady - Congenital heart malformations, hypoxia Tachy - Hypoxia, maternal fever, fetal anemia
1623
Normal variability on FHT
6-25 bpm
1624
What does sinusoidal variability on FHT indicate?
Serious fetal anemia
1625
Treatment of hypercalcemia 2/2 malignancy
Short term: Normal saline, Calcitonin | Long term: Bisphosphonates
1626
Mutation seen in cri-du-chat syndrome
5p deletion
1627
Difference between gestational and chronic HTN
Chronic HTN if present before 20w or persists after 12w postpartum Gestational HTN if presents after 20w
1628
Definition of preeclampsia
1) New-onset HTN after 20w or worsened chronic HTN | 2) Proteinuria of over 300mg/24h (3+ proteins)
1629
Murmur of transposition of the great vessels
Single S2 +/- VSD murmur Most common early cyanotic dz
1630
Murmur of tetralogy of Fallot
Pulmonic stenosis murmur | VSD murmur
1631
Treatment of transposition of the great vessels
``` Prostaglandins early (to maintain PFO) Emergent surgery ```
1632
Treatment of impetigo
Non-bullous (honey crusts) - Topical mupirocin | Bullous - Oral abx
1633
Symptoms of multiple myeloma
Calcium elevated Renal dysfunction Anemia Bone lesions/Back pain
1634
Indications for carotid endarterectomy
Symptomatic 70-99% | Men asymptomatic 60-99%
1635
ESR and CK in glucocorticoid myopathy
Both normal Painless weakness
1636
ESR and CK in Polymyalgia Rheumatica
ESR elevated | CK normal
1637
ESR and CK in statin-induced myopathy
ESR normal | CK elevated
1638
How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis
Saline-responsive: Urine chloride under 20 Saline-resistant: Urine chloride over 20 Saline responsive is 2/2 vomiting, diarrhea, diuretic abuse Saline resistant is 2/2 hyperaldosteronism, Cushing's, hypokalemia
1639
What cancers are seen with HNPCC?
Colon cancer | Endometrial cancer
1640
What cancers are associated with nephrotic syndromes?
Adenocarcinoma - membranous nephropathy Lymphoma - Minimal change disease
1641
Treatment of uric acid kidney stones
Oral potassium citrate Citrate alkalinizes the urine and inhibits crystallization
1642
Prophylaxis in HIV patients
``` 200 = PCP = Bactrim 150 = Histoplasma = Itraconazole 100 = Toxoplasma = Bactrim 50 = MAC = Azithromycin ```
1643
Prophylaxis in posttransplant patients
Bactrim for PCP Immunize against Influenza, pneumococcus, and HBV
1644
When to perform oral glucose tolerance test
24-28w
1645
TSH, total T4, and free T4 levels in pregnancy
TSH down Total T4 way up Free T4 slightly up Because beta-hCG has TSH-like activity and estrogen increases TBG
1646
Paraneoplastic syndromes of SCLC
ACTH (Cushing's) ADH (SIADH) Lambert-Eaton syndrome
1647
Paraneoplastic syndromes of lung SCC
PTHrP (hypercalcemia)
1648
Most common cause of urinary obstruction in newborn males
Posterior urethral valves Can cause Potter's sequence and hydronephrosis in-utero
1649
Treatment for diabetic distal neuropathy
1) TCA's | 2) Gabapentin
1650
EPS side effects of antipsychotics
Acute dystonic reaction (neck, mouth, tongue, EOM) Akithisia (restlessness) Parkinsonism Tardive dyskinesia (after 1-6mo)
1651
Which hereditary hyperbilirubinemias present with unconjugated hyperbili? What is the difference?
Gilbert's - mild and occurs with fasting and stress | Crigler-Najjar - Severe with early death
1652
Which hereditary hyperbilirubinemias present with conjugated hyperbili? What is the difference?
Rotor's syndrome - normal appearing liver Dubin-Johnson - Black liverf
1653
Treatment of the hereditary hyperbilirubinemias
Crigler-Najjar I - Phenobarbital Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant Dubin-Johnson, Rotor's, Gilbert's do not require treatment.
1654
Lab/vitals abnormalities of LBW infants
``` Hypoxia Hypothermia Hypoglycemia Hypocalcemia Polycythemia ```
1655
What electrolyte derangements are seen with significant emesis?
Hypochloremic, hypokalemic metabolic alkalosis Loss of HCl in vomit Angiotensin II --> HCO3 resorption Aldosterone --> H+ secretion and K+ secretion
1656
Superior sulcus tumor possible symptoms
Horner syndrome Pancoast (ulnar pain distribution, shoulder weakness) Hoarseness (RLN) SVC syndrome
1657
Divisions of mediastinum and their masses
Anterior: 4 T's (thymoma, teratoma, thyroid, terrible lymphoma) Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma Posterior: Neurogenic tumors
1658
Beck's triad of cardiac tamponade
Hypotension Distant heart sounds Distended jugular veins
1659
When can chorionic villous sampling be done? | Amniocentesis?
CVS: 9-14w Amniocentesis: 15-22w
1660
When to swab for GBS
35w
1661
Quad screen results for Edwards syndrome
UNDERaged at 18 | All are down
1662
Quad screen results for Down syndrome
2up 2down at 21
1663
Treatment of HIV in pregnancy
1) Zidovudine or Nevirapine during pregnancy 2) Elective c-section if viral load over 1000 3) Zidovudine for infant 4) No breastfeeding
1664
Normal fetal heart rate | Causes for bradycardia or tachycardia
110-160 bpm Brady - Congenital heart malformations, hypoxia Tachy - Hypoxia, maternal fever, fetal anemia
1665
Normal variability on FHT
6-25 bpm
1666
What does sinusoidal variability on FHT indicate?
Serious fetal anemia
1667
Treatment of hypercalcemia 2/2 malignancy
Short term: Normal saline, Calcitonin | Long term: Bisphosphonates
1668
Mutation seen in cri-du-chat syndrome
5p deletion
1669
Difference between gestational and chronic HTN
Chronic HTN if present before 20w or persists after 12w postpartum Gestational HTN if presents after 20w
1670
Definition of preeclampsia
1) New-onset HTN after 20w or worsened chronic HTN | 2) Proteinuria of over 300mg/24h (3+ proteins)
1671
Murmur of transposition of the great vessels
Single S2 +/- VSD murmur Most common early cyanotic dz
1672
Murmur of tetralogy of Fallot
Pulmonic stenosis murmur | VSD murmur
1673
Treatment of transposition of the great vessels
``` Prostaglandins early (to maintain PFO) Emergent surgery ```
1674
Treatment of impetigo
Non-bullous (honey crusts) - Topical mupirocin | Bullous - Oral abx
1675
Symptoms of multiple myeloma
Calcium elevated Renal dysfunction Anemia Bone lesions/Back pain
1676
Indications for carotid endarterectomy
Symptomatic 70-99% | Men asymptomatic 60-99%
1677
ESR and CK in glucocorticoid myopathy
Both normal Painless weakness
1678
ESR and CK in Polymyalgia Rheumatica
ESR elevated | CK normal
1679
ESR and CK in statin-induced myopathy
ESR normal | CK elevated
1680
How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis
Saline-responsive: Urine chloride under 20 Saline-resistant: Urine chloride over 20 Saline responsive is 2/2 vomiting, diarrhea, diuretic abuse Saline resistant is 2/2 hyperaldosteronism, Cushing's, hypokalemia
1681
What cancers are seen with HNPCC?
Colon cancer | Endometrial cancer
1682
What cancers are associated with nephrotic syndromes?
Adenocarcinoma - membranous nephropathy Lymphoma - Minimal change disease
1683
Treatment of uric acid kidney stones
Oral potassium citrate Citrate alkalinizes the urine and inhibits crystallization
1684
Prophylaxis in HIV patients
``` 200 = PCP = Bactrim 150 = Histoplasma = Itraconazole 100 = Toxoplasma = Bactrim 50 = MAC = Azithromycin ```
1685
Prophylaxis in posttransplant patients
Bactrim for PCP Immunize against Influenza, pneumococcus, and HBV
1686
When to perform oral glucose tolerance test
24-28w
1687
TSH, total T4, and free T4 levels in pregnancy
TSH down Total T4 way up Free T4 slightly up Because beta-hCG has TSH-like activity and estrogen increases TBG
1688
Paraneoplastic syndromes of SCLC
ACTH (Cushing's) ADH (SIADH) Lambert-Eaton syndrome
1689
Paraneoplastic syndromes of lung SCC
PTHrP (hypercalcemia)
1690
Most common cause of urinary obstruction in newborn males
Posterior urethral valves Can cause Potter's sequence and hydronephrosis in-utero
1691
Treatment for diabetic distal neuropathy
1) TCA's | 2) Gabapentin
1692
EPS side effects of antipsychotics
Acute dystonic reaction (neck, mouth, tongue, EOM) Akithisia (restlessness) Parkinsonism Tardive dyskinesia (after 1-6mo)
1693
Which hereditary hyperbilirubinemias present with unconjugated hyperbili? What is the difference?
Gilbert's - mild and occurs with fasting and stress | Crigler-Najjar - Severe with early death
1694
Which hereditary hyperbilirubinemias present with conjugated hyperbili? What is the difference?
Rotor's syndrome - normal appearing liver Dubin-Johnson - Black liverf
1695
Treatment of the hereditary hyperbilirubinemias
Crigler-Najjar I - Phenobarbital Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant Dubin-Johnson, Rotor's, Gilbert's do not require treatment.
1696
Lab/vitals abnormalities of LBW infants
``` Hypoxia Hypothermia Hypoglycemia Hypocalcemia Polycythemia ```
1697
What electrolyte derangements are seen with significant emesis?
Hypochloremic, hypokalemic metabolic alkalosis Loss of HCl in vomit Angiotensin II --> HCO3 resorption Aldosterone --> H+ secretion and K+ secretion
1698
Superior sulcus tumor possible symptoms
Horner syndrome Pancoast (ulnar pain distribution, shoulder weakness) Hoarseness (RLN) SVC syndrome
1699
Divisions of mediastinum and their masses
Anterior: 4 T's (thymoma, teratoma, thyroid, terrible lymphoma) Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma Posterior: Neurogenic tumors
1700
Beck's triad of cardiac tamponade
Hypotension Distant heart sounds Distended jugular veins
1701
When can chorionic villous sampling be done? | Amniocentesis?
CVS: 9-14w Amniocentesis: 15-22w
1702
When to swab for GBS
35w
1703
Quad screen results for Edwards syndrome
UNDERaged at 18 | All are down
1704
Quad screen results for Down syndrome
2up 2down at 21
1705
Treatment of HIV in pregnancy
1) Zidovudine or Nevirapine during pregnancy 2) Elective c-section if viral load over 1000 3) Zidovudine for infant 4) No breastfeeding
1706
Normal fetal heart rate | Causes for bradycardia or tachycardia
110-160 bpm Brady - Congenital heart malformations, hypoxia Tachy - Hypoxia, maternal fever, fetal anemia
1707
Normal variability on FHT
6-25 bpm
1708
What does sinusoidal variability on FHT indicate?
Serious fetal anemia
1709
Treatment of hypercalcemia 2/2 malignancy
Short term: Normal saline, Calcitonin | Long term: Bisphosphonates
1710
Mutation seen in cri-du-chat syndrome
5p deletion
1711
Difference between gestational and chronic HTN
Chronic HTN if present before 20w or persists after 12w postpartum Gestational HTN if presents after 20w
1712
Definition of preeclampsia
1) New-onset HTN after 20w or worsened chronic HTN | 2) Proteinuria of over 300mg/24h (3+ proteins)
1713
Murmur of transposition of the great vessels
Single S2 +/- VSD murmur Most common early cyanotic dz
1714
Murmur of tetralogy of Fallot
Pulmonic stenosis murmur | VSD murmur
1715
Treatment of transposition of the great vessels
``` Prostaglandins early (to maintain PFO) Emergent surgery ```
1716
Treatment of impetigo
Non-bullous (honey crusts) - Topical mupirocin | Bullous - Oral abx
1717
Symptoms of multiple myeloma
Calcium elevated Renal dysfunction Anemia Bone lesions/Back pain
1718
Indications for carotid endarterectomy
Symptomatic 70-99% | Men asymptomatic 60-99%
1719
ESR and CK in glucocorticoid myopathy
Both normal Painless weakness
1720
ESR and CK in Polymyalgia Rheumatica
ESR elevated | CK normal
1721
ESR and CK in statin-induced myopathy
ESR normal | CK elevated
1722
How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis
Saline-responsive: Urine chloride under 20 Saline-resistant: Urine chloride over 20 Saline responsive is 2/2 vomiting, diarrhea, diuretic abuse Saline resistant is 2/2 hyperaldosteronism, Cushing's, hypokalemia
1723
What cancers are seen with HNPCC?
Colon cancer | Endometrial cancer
1724
What cancers are associated with nephrotic syndromes?
Adenocarcinoma - membranous nephropathy Lymphoma - Minimal change disease
1725
Treatment of uric acid kidney stones
Oral potassium citrate Citrate alkalinizes the urine and inhibits crystallization
1726
Prophylaxis in HIV patients
``` 200 = PCP = Bactrim 150 = Histoplasma = Itraconazole 100 = Toxoplasma = Bactrim 50 = MAC = Azithromycin ```
1727
Prophylaxis in posttransplant patients
Bactrim for PCP Immunize against Influenza, pneumococcus, and HBV
1728
When to perform oral glucose tolerance test
24-28w
1729
TSH, total T4, and free T4 levels in pregnancy
TSH down Total T4 way up Free T4 slightly up Because beta-hCG has TSH-like activity and estrogen increases TBG
1730
Paraneoplastic syndromes of SCLC
ACTH (Cushing's) ADH (SIADH) Lambert-Eaton syndrome
1731
Paraneoplastic syndromes of lung SCC
PTHrP (hypercalcemia)
1732
Most common cause of urinary obstruction in newborn males
Posterior urethral valves Can cause Potter's sequence and hydronephrosis in-utero
1733
Treatment for diabetic distal neuropathy
1) TCA's | 2) Gabapentin
1734
EPS side effects of antipsychotics
Acute dystonic reaction (neck, mouth, tongue, EOM) Akithisia (restlessness) Parkinsonism Tardive dyskinesia (after 1-6mo)
1735
Which hereditary hyperbilirubinemias present with unconjugated hyperbili? What is the difference?
Gilbert's - mild and occurs with fasting and stress | Crigler-Najjar - Severe with early death
1736
Which hereditary hyperbilirubinemias present with conjugated hyperbili? What is the difference?
Rotor's syndrome - normal appearing liver Dubin-Johnson - Black liverf
1737
Treatment of the hereditary hyperbilirubinemias
Crigler-Najjar I - Phenobarbital Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant Dubin-Johnson, Rotor's, Gilbert's do not require treatment.
1738
Lab/vitals abnormalities of LBW infants
``` Hypoxia Hypothermia Hypoglycemia Hypocalcemia Polycythemia ```
1739
What electrolyte derangements are seen with significant emesis?
Hypochloremic, hypokalemic metabolic alkalosis Loss of HCl in vomit Angiotensin II --> HCO3 resorption Aldosterone --> H+ secretion and K+ secretion
1740
Superior sulcus tumor possible symptoms
Horner syndrome Pancoast (ulnar pain distribution, shoulder weakness) Hoarseness (RLN) SVC syndrome
1741
Divisions of mediastinum and their masses
Anterior: 4 T's (thymoma, teratoma, thyroid, terrible lymphoma) Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma Posterior: Neurogenic tumors
1742
Beck's triad of cardiac tamponade
Hypotension Distant heart sounds Distended jugular veins
1743
When can chorionic villous sampling be done? | Amniocentesis?
CVS: 9-14w Amniocentesis: 15-22w
1744
When to swab for GBS
35w
1745
Quad screen results for Edwards syndrome
UNDERaged at 18 | All are down
1746
Quad screen results for Down syndrome
2up 2down at 21
1747
Treatment of HIV in pregnancy
1) Zidovudine or Nevirapine during pregnancy 2) Elective c-section if viral load over 1000 3) Zidovudine for infant 4) No breastfeeding
1748
Normal fetal heart rate | Causes for bradycardia or tachycardia
110-160 bpm Brady - Congenital heart malformations, hypoxia Tachy - Hypoxia, maternal fever, fetal anemia
1749
Normal variability on FHT
6-25 bpm
1750
What does sinusoidal variability on FHT indicate?
Serious fetal anemia
1751
Treatment of hypercalcemia 2/2 malignancy
Short term: Normal saline, Calcitonin | Long term: Bisphosphonates
1752
Mutation seen in cri-du-chat syndrome
5p deletion
1753
Difference between gestational and chronic HTN
Chronic HTN if present before 20w or persists after 12w postpartum Gestational HTN if presents after 20w
1754
Definition of preeclampsia
1) New-onset HTN after 20w or worsened chronic HTN | 2) Proteinuria of over 300mg/24h (3+ proteins)
1755
Murmur of transposition of the great vessels
Single S2 +/- VSD murmur Most common early cyanotic dz
1756
Murmur of tetralogy of Fallot
Pulmonic stenosis murmur | VSD murmur
1757
Treatment of transposition of the great vessels
``` Prostaglandins early (to maintain PFO) Emergent surgery ```
1758
Treatment of impetigo
Non-bullous (honey crusts) - Topical mupirocin | Bullous - Oral abx
1759
Symptoms of multiple myeloma
Calcium elevated Renal dysfunction Anemia Bone lesions/Back pain
1760
Indications for carotid endarterectomy
Symptomatic 70-99% | Men asymptomatic 60-99%
1761
ESR and CK in glucocorticoid myopathy
Both normal Painless weakness
1762
ESR and CK in Polymyalgia Rheumatica
ESR elevated | CK normal
1763
ESR and CK in statin-induced myopathy
ESR normal | CK elevated
1764
How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis
Saline-responsive: Urine chloride under 20 Saline-resistant: Urine chloride over 20 Saline responsive is 2/2 vomiting, diarrhea, diuretic abuse Saline resistant is 2/2 hyperaldosteronism, Cushing's, hypokalemia
1765
What cancers are seen with HNPCC?
Colon cancer | Endometrial cancer
1766
What cancers are associated with nephrotic syndromes?
Adenocarcinoma - membranous nephropathy Lymphoma - Minimal change disease
1767
Treatment of uric acid kidney stones
Oral potassium citrate Citrate alkalinizes the urine and inhibits crystallization
1768
Prophylaxis in HIV patients
``` 200 = PCP = Bactrim 150 = Histoplasma = Itraconazole 100 = Toxoplasma = Bactrim 50 = MAC = Azithromycin ```
1769
Prophylaxis in posttransplant patients
Bactrim for PCP Immunize against Influenza, pneumococcus, and HBV
1770
When to perform oral glucose tolerance test
24-28w
1771
TSH, total T4, and free T4 levels in pregnancy
TSH down Total T4 way up Free T4 slightly up Because beta-hCG has TSH-like activity and estrogen increases TBG
1772
Paraneoplastic syndromes of SCLC
ACTH (Cushing's) ADH (SIADH) Lambert-Eaton syndrome
1773
Paraneoplastic syndromes of lung SCC
PTHrP (hypercalcemia)
1774
Most common cause of urinary obstruction in newborn males
Posterior urethral valves Can cause Potter's sequence and hydronephrosis in-utero
1775
Treatment for diabetic distal neuropathy
1) TCA's | 2) Gabapentin
1776
EPS side effects of antipsychotics
Acute dystonic reaction (neck, mouth, tongue, EOM) Akithisia (restlessness) Parkinsonism Tardive dyskinesia (after 1-6mo)
1777
Which hereditary hyperbilirubinemias present with unconjugated hyperbili? What is the difference?
Gilbert's - mild and occurs with fasting and stress | Crigler-Najjar - Severe with early death
1778
Which hereditary hyperbilirubinemias present with conjugated hyperbili? What is the difference?
Rotor's syndrome - normal appearing liver Dubin-Johnson - Black liverf
1779
Treatment of the hereditary hyperbilirubinemias
Crigler-Najjar I - Phenobarbital Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant Dubin-Johnson, Rotor's, Gilbert's do not require treatment.
1780
Lab/vitals abnormalities of LBW infants
``` Hypoxia Hypothermia Hypoglycemia Hypocalcemia Polycythemia ```
1781
What electrolyte derangements are seen with significant emesis?
Hypochloremic, hypokalemic metabolic alkalosis Loss of HCl in vomit Angiotensin II --> HCO3 resorption Aldosterone --> H+ secretion and K+ secretion
1782
Superior sulcus tumor possible symptoms
Horner syndrome Pancoast (ulnar pain distribution, shoulder weakness) Hoarseness (RLN) SVC syndrome
1783
Divisions of mediastinum and their masses
Anterior: 4 T's (thymoma, teratoma, thyroid, terrible lymphoma) Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma Posterior: Neurogenic tumors
1784
Beck's triad of cardiac tamponade
Hypotension Distant heart sounds Distended jugular veins
1785
When can chorionic villous sampling be done? | Amniocentesis?
CVS: 9-14w Amniocentesis: 15-22w
1786
When to swab for GBS
35w
1787
Quad screen results for Edwards syndrome
UNDERaged at 18 | All are down
1788
Quad screen results for Down syndrome
2up 2down at 21
1789
Treatment of HIV in pregnancy
1) Zidovudine or Nevirapine during pregnancy 2) Elective c-section if viral load over 1000 3) Zidovudine for infant 4) No breastfeeding
1790
Normal fetal heart rate | Causes for bradycardia or tachycardia
110-160 bpm Brady - Congenital heart malformations, hypoxia Tachy - Hypoxia, maternal fever, fetal anemia
1791
Normal variability on FHT
6-25 bpm
1792
What does sinusoidal variability on FHT indicate?
Serious fetal anemia
1793
Treatment of hypercalcemia 2/2 malignancy
Short term: Normal saline, Calcitonin | Long term: Bisphosphonates
1794
Mutation seen in cri-du-chat syndrome
5p deletion
1795
Difference between gestational and chronic HTN
Chronic HTN if present before 20w or persists after 12w postpartum Gestational HTN if presents after 20w
1796
Definition of preeclampsia
1) New-onset HTN after 20w or worsened chronic HTN | 2) Proteinuria of over 300mg/24h (3+ proteins)
1797
Murmur of transposition of the great vessels
Single S2 +/- VSD murmur Most common early cyanotic dz
1798
Murmur of tetralogy of Fallot
Pulmonic stenosis murmur | VSD murmur
1799
Treatment of transposition of the great vessels
``` Prostaglandins early (to maintain PFO) Emergent surgery ```
1800
Treatment of impetigo
Non-bullous (honey crusts) - Topical mupirocin | Bullous - Oral abx
1801
Symptoms of multiple myeloma
Calcium elevated Renal dysfunction Anemia Bone lesions/Back pain
1802
Indications for carotid endarterectomy
Symptomatic 70-99% | Men asymptomatic 60-99%
1803
ESR and CK in glucocorticoid myopathy
Both normal Painless weakness
1804
ESR and CK in Polymyalgia Rheumatica
ESR elevated | CK normal
1805
ESR and CK in statin-induced myopathy
ESR normal | CK elevated
1806
How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis
Saline-responsive: Urine chloride under 20 Saline-resistant: Urine chloride over 20 Saline responsive is 2/2 vomiting, diarrhea, diuretic abuse Saline resistant is 2/2 hyperaldosteronism, Cushing's, hypokalemia
1807
What cancers are seen with HNPCC?
Colon cancer | Endometrial cancer
1808
What cancers are associated with nephrotic syndromes?
Adenocarcinoma - membranous nephropathy Lymphoma - Minimal change disease
1809
Treatment of uric acid kidney stones
Oral potassium citrate Citrate alkalinizes the urine and inhibits crystallization
1810
Prophylaxis in HIV patients
``` 200 = PCP = Bactrim 150 = Histoplasma = Itraconazole 100 = Toxoplasma = Bactrim 50 = MAC = Azithromycin ```
1811
Prophylaxis in posttransplant patients
Bactrim for PCP Immunize against Influenza, pneumococcus, and HBV
1812
When to perform oral glucose tolerance test
24-28w
1813
TSH, total T4, and free T4 levels in pregnancy
TSH down Total T4 way up Free T4 slightly up Because beta-hCG has TSH-like activity and estrogen increases TBG
1814
Paraneoplastic syndromes of SCLC
ACTH (Cushing's) ADH (SIADH) Lambert-Eaton syndrome
1815
Paraneoplastic syndromes of lung SCC
PTHrP (hypercalcemia)
1816
Most common cause of urinary obstruction in newborn males
Posterior urethral valves Can cause Potter's sequence and hydronephrosis in-utero
1817
Treatment for diabetic distal neuropathy
1) TCA's | 2) Gabapentin
1818
EPS side effects of antipsychotics
Acute dystonic reaction (neck, mouth, tongue, EOM) Akithisia (restlessness) Parkinsonism Tardive dyskinesia (after 1-6mo)
1819
Which hereditary hyperbilirubinemias present with unconjugated hyperbili? What is the difference?
Gilbert's - mild and occurs with fasting and stress | Crigler-Najjar - Severe with early death
1820
Which hereditary hyperbilirubinemias present with conjugated hyperbili? What is the difference?
Rotor's syndrome - normal appearing liver Dubin-Johnson - Black liverf
1821
Treatment of the hereditary hyperbilirubinemias
Crigler-Najjar I - Phenobarbital Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant Dubin-Johnson, Rotor's, Gilbert's do not require treatment.
1822
Lab/vitals abnormalities of LBW infants
``` Hypoxia Hypothermia Hypoglycemia Hypocalcemia Polycythemia ```
1823
What electrolyte derangements are seen with significant emesis?
Hypochloremic, hypokalemic metabolic alkalosis Loss of HCl in vomit Angiotensin II --> HCO3 resorption Aldosterone --> H+ secretion and K+ secretion
1824
Superior sulcus tumor possible symptoms
Horner syndrome Pancoast (ulnar pain distribution, shoulder weakness) Hoarseness (RLN) SVC syndrome
1825
Divisions of mediastinum and their masses
Anterior: 4 T's (thymoma, teratoma, thyroid, terrible lymphoma) Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma Posterior: Neurogenic tumors
1826
Beck's triad of cardiac tamponade
Hypotension Distant heart sounds Distended jugular veins
1827
When can chorionic villous sampling be done? | Amniocentesis?
CVS: 9-14w Amniocentesis: 15-22w
1828
When to swab for GBS
35w
1829
Quad screen results for Edwards syndrome
UNDERaged at 18 | All are down
1830
Quad screen results for Down syndrome
2up 2down at 21
1831
Treatment of HIV in pregnancy
1) Zidovudine or Nevirapine during pregnancy 2) Elective c-section if viral load over 1000 3) Zidovudine for infant 4) No breastfeeding
1832
Normal fetal heart rate | Causes for bradycardia or tachycardia
110-160 bpm Brady - Congenital heart malformations, hypoxia Tachy - Hypoxia, maternal fever, fetal anemia
1833
Normal variability on FHT
6-25 bpm
1834
What does sinusoidal variability on FHT indicate?
Serious fetal anemia
1835
Treatment of hypercalcemia 2/2 malignancy
Short term: Normal saline, Calcitonin | Long term: Bisphosphonates
1836
Mutation seen in cri-du-chat syndrome
5p deletion
1837
Difference between gestational and chronic HTN
Chronic HTN if present before 20w or persists after 12w postpartum Gestational HTN if presents after 20w
1838
Definition of preeclampsia
1) New-onset HTN after 20w or worsened chronic HTN | 2) Proteinuria of over 300mg/24h (3+ proteins)
1839
Murmur of transposition of the great vessels
Single S2 +/- VSD murmur Most common early cyanotic dz
1840
Murmur of tetralogy of Fallot
Pulmonic stenosis murmur | VSD murmur
1841
Treatment of transposition of the great vessels
``` Prostaglandins early (to maintain PFO) Emergent surgery ```
1842
Treatment of impetigo
Non-bullous (honey crusts) - Topical mupirocin | Bullous - Oral abx
1843
Symptoms of multiple myeloma
Calcium elevated Renal dysfunction Anemia Bone lesions/Back pain
1844
Indications for carotid endarterectomy
Symptomatic 70-99% | Men asymptomatic 60-99%
1845
ESR and CK in glucocorticoid myopathy
Both normal Painless weakness
1846
ESR and CK in Polymyalgia Rheumatica
ESR elevated | CK normal
1847
ESR and CK in statin-induced myopathy
ESR normal | CK elevated
1848
How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis
Saline-responsive: Urine chloride under 20 Saline-resistant: Urine chloride over 20 Saline responsive is 2/2 vomiting, diarrhea, diuretic abuse Saline resistant is 2/2 hyperaldosteronism, Cushing's, hypokalemia
1849
What cancers are seen with HNPCC?
Colon cancer | Endometrial cancer
1850
What cancers are associated with nephrotic syndromes?
Adenocarcinoma - membranous nephropathy Lymphoma - Minimal change disease
1851
Treatment of uric acid kidney stones
Oral potassium citrate Citrate alkalinizes the urine and inhibits crystallization
1852
Prophylaxis in HIV patients
``` 200 = PCP = Bactrim 150 = Histoplasma = Itraconazole 100 = Toxoplasma = Bactrim 50 = MAC = Azithromycin ```
1853
Prophylaxis in posttransplant patients
Bactrim for PCP Immunize against Influenza, pneumococcus, and HBV
1854
When to perform oral glucose tolerance test
24-28w
1855
TSH, total T4, and free T4 levels in pregnancy
TSH down Total T4 way up Free T4 slightly up Because beta-hCG has TSH-like activity and estrogen increases TBG
1856
Paraneoplastic syndromes of SCLC
ACTH (Cushing's) ADH (SIADH) Lambert-Eaton syndrome
1857
Paraneoplastic syndromes of lung SCC
PTHrP (hypercalcemia)
1858
Most common cause of urinary obstruction in newborn males
Posterior urethral valves Can cause Potter's sequence and hydronephrosis in-utero
1859
Treatment for diabetic distal neuropathy
1) TCA's | 2) Gabapentin
1860
EPS side effects of antipsychotics
Acute dystonic reaction (neck, mouth, tongue, EOM) Akithisia (restlessness) Parkinsonism Tardive dyskinesia (after 1-6mo)
1861
Which hereditary hyperbilirubinemias present with unconjugated hyperbili? What is the difference?
Gilbert's - mild and occurs with fasting and stress | Crigler-Najjar - Severe with early death
1862
Which hereditary hyperbilirubinemias present with conjugated hyperbili? What is the difference?
Rotor's syndrome - normal appearing liver Dubin-Johnson - Black liverf
1863
Treatment of the hereditary hyperbilirubinemias
Crigler-Najjar I - Phenobarbital Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant Dubin-Johnson, Rotor's, Gilbert's do not require treatment.
1864
Lab/vitals abnormalities of LBW infants
``` Hypoxia Hypothermia Hypoglycemia Hypocalcemia Polycythemia ```
1865
What electrolyte derangements are seen with significant emesis?
Hypochloremic, hypokalemic metabolic alkalosis Loss of HCl in vomit Angiotensin II --> HCO3 resorption Aldosterone --> H+ secretion and K+ secretion
1866
Superior sulcus tumor possible symptoms
Horner syndrome Pancoast (ulnar pain distribution, shoulder weakness) Hoarseness (RLN) SVC syndrome
1867
Divisions of mediastinum and their masses
Anterior: 4 T's (thymoma, teratoma, thyroid, terrible lymphoma) Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma Posterior: Neurogenic tumors
1868
Beck's triad of cardiac tamponade
Hypotension Distant heart sounds Distended jugular veins
1869
When can chorionic villous sampling be done? | Amniocentesis?
CVS: 9-14w Amniocentesis: 15-22w
1870
When to swab for GBS
35w
1871
Quad screen results for Edwards syndrome
UNDERaged at 18 | All are down
1872
Quad screen results for Down syndrome
2up 2down at 21
1873
Treatment of HIV in pregnancy
1) Zidovudine or Nevirapine during pregnancy 2) Elective c-section if viral load over 1000 3) Zidovudine for infant 4) No breastfeeding
1874
Normal fetal heart rate | Causes for bradycardia or tachycardia
110-160 bpm Brady - Congenital heart malformations, hypoxia Tachy - Hypoxia, maternal fever, fetal anemia
1875
Normal variability on FHT
6-25 bpm
1876
What does sinusoidal variability on FHT indicate?
Serious fetal anemia
1877
Treatment of hypercalcemia 2/2 malignancy
Short term: Normal saline, Calcitonin | Long term: Bisphosphonates
1878
Mutation seen in cri-du-chat syndrome
5p deletion
1879
Difference between gestational and chronic HTN
Chronic HTN if present before 20w or persists after 12w postpartum Gestational HTN if presents after 20w
1880
Definition of preeclampsia
1) New-onset HTN after 20w or worsened chronic HTN | 2) Proteinuria of over 300mg/24h (3+ proteins)
1881
Murmur of transposition of the great vessels
Single S2 +/- VSD murmur Most common early cyanotic dz
1882
Murmur of tetralogy of Fallot
Pulmonic stenosis murmur | VSD murmur
1883
Treatment of transposition of the great vessels
``` Prostaglandins early (to maintain PFO) Emergent surgery ```
1884
Treatment of impetigo
Non-bullous (honey crusts) - Topical mupirocin | Bullous - Oral abx
1885
Symptoms of multiple myeloma
Calcium elevated Renal dysfunction Anemia Bone lesions/Back pain
1886
Indications for carotid endarterectomy
Symptomatic 70-99% | Men asymptomatic 60-99%
1887
ESR and CK in glucocorticoid myopathy
Both normal Painless weakness
1888
ESR and CK in Polymyalgia Rheumatica
ESR elevated | CK normal
1889
ESR and CK in statin-induced myopathy
ESR normal | CK elevated
1890
How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis
Saline-responsive: Urine chloride under 20 Saline-resistant: Urine chloride over 20 Saline responsive is 2/2 vomiting, diarrhea, diuretic abuse Saline resistant is 2/2 hyperaldosteronism, Cushing's, hypokalemia
1891
What cancers are seen with HNPCC?
Colon cancer | Endometrial cancer
1892
What cancers are associated with nephrotic syndromes?
Adenocarcinoma - membranous nephropathy Lymphoma - Minimal change disease
1893
Treatment of uric acid kidney stones
Oral potassium citrate Citrate alkalinizes the urine and inhibits crystallization
1894
Prophylaxis in HIV patients
``` 200 = PCP = Bactrim 150 = Histoplasma = Itraconazole 100 = Toxoplasma = Bactrim 50 = MAC = Azithromycin ```
1895
Prophylaxis in posttransplant patients
Bactrim for PCP Immunize against Influenza, pneumococcus, and HBV
1896
When to perform oral glucose tolerance test
24-28w
1897
TSH, total T4, and free T4 levels in pregnancy
TSH down Total T4 way up Free T4 slightly up Because beta-hCG has TSH-like activity and estrogen increases TBG
1898
Paraneoplastic syndromes of SCLC
ACTH (Cushing's) ADH (SIADH) Lambert-Eaton syndrome
1899
Paraneoplastic syndromes of lung SCC
PTHrP (hypercalcemia)
1900
Most common cause of urinary obstruction in newborn males
Posterior urethral valves Can cause Potter's sequence and hydronephrosis in-utero
1901
Treatment for diabetic distal neuropathy
1) TCA's | 2) Gabapentin
1902
EPS side effects of antipsychotics
Acute dystonic reaction (neck, mouth, tongue, EOM) Akithisia (restlessness) Parkinsonism Tardive dyskinesia (after 1-6mo)
1903
Which hereditary hyperbilirubinemias present with unconjugated hyperbili? What is the difference?
Gilbert's - mild and occurs with fasting and stress | Crigler-Najjar - Severe with early death
1904
Which hereditary hyperbilirubinemias present with conjugated hyperbili? What is the difference?
Rotor's syndrome - normal appearing liver Dubin-Johnson - Black liverf
1905
Treatment of the hereditary hyperbilirubinemias
Crigler-Najjar I - Phenobarbital Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant Dubin-Johnson, Rotor's, Gilbert's do not require treatment.
1906
Lab/vitals abnormalities of LBW infants
``` Hypoxia Hypothermia Hypoglycemia Hypocalcemia Polycythemia ```
1907
What electrolyte derangements are seen with significant emesis?
Hypochloremic, hypokalemic metabolic alkalosis Loss of HCl in vomit Angiotensin II --> HCO3 resorption Aldosterone --> H+ secretion and K+ secretion
1908
Superior sulcus tumor possible symptoms
Horner syndrome Pancoast (ulnar pain distribution, shoulder weakness) Hoarseness (RLN) SVC syndrome
1909
Divisions of mediastinum and their masses
Anterior: 4 T's (thymoma, teratoma, thyroid, terrible lymphoma) Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma Posterior: Neurogenic tumors
1910
Beck's triad of cardiac tamponade
Hypotension Distant heart sounds Distended jugular veins
1911
When can chorionic villous sampling be done? | Amniocentesis?
CVS: 9-14w Amniocentesis: 15-22w
1912
When to swab for GBS
35w
1913
Quad screen results for Edwards syndrome
UNDERaged at 18 | All are down
1914
Quad screen results for Down syndrome
2up 2down at 21
1915
Treatment of HIV in pregnancy
1) Zidovudine or Nevirapine during pregnancy 2) Elective c-section if viral load over 1000 3) Zidovudine for infant 4) No breastfeeding
1916
Normal fetal heart rate | Causes for bradycardia or tachycardia
110-160 bpm Brady - Congenital heart malformations, hypoxia Tachy - Hypoxia, maternal fever, fetal anemia
1917
Normal variability on FHT
6-25 bpm
1918
What does sinusoidal variability on FHT indicate?
Serious fetal anemia
1919
Prophylaxis in HIV patients
``` 200 = PCP = Bactrim 150 = Histoplasma = Itraconazole 100 = Toxoplasma = Bactrim 50 = MAC = Azithromycin ```
1920
Prophylaxis in posttransplant patients
Bactrim for PCP Immunize against Influenza, pneumococcus, and HBV
1921
When to perform oral glucose tolerance test
24-28w
1922
TSH, total T4, and free T4 levels in pregnancy
TSH down Total T4 way up Free T4 slightly up Because beta-hCG has TSH-like activity and estrogen increases TBG
1923
Paraneoplastic syndromes of SCLC
ACTH (Cushing's) ADH (SIADH) Lambert-Eaton syndrome
1924
Paraneoplastic syndromes of lung SCC
PTHrP (hypercalcemia)
1925
Most common cause of urinary obstruction in newborn males
Posterior urethral valves Can cause Potter's sequence and hydronephrosis in-utero
1926
Treatment for diabetic distal neuropathy
1) TCA's | 2) Gabapentin
1927
EPS side effects of antipsychotics
Acute dystonic reaction (neck, mouth, tongue, EOM) Akithisia (restlessness) Parkinsonism Tardive dyskinesia (after 1-6mo)
1928
Which hereditary hyperbilirubinemias present with unconjugated hyperbili? What is the difference?
Gilbert's - mild and occurs with fasting and stress | Crigler-Najjar - Severe with early death
1929
Which hereditary hyperbilirubinemias present with conjugated hyperbili? What is the difference?
Rotor's syndrome - normal appearing liver Dubin-Johnson - Black liverf
1930
Treatment of the hereditary hyperbilirubinemias
Crigler-Najjar I - Phenobarbital Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant Dubin-Johnson, Rotor's, Gilbert's do not require treatment.
1931
Lab/vitals abnormalities of LBW infants
``` Hypoxia Hypothermia Hypoglycemia Hypocalcemia Polycythemia ```
1932
What electrolyte derangements are seen with significant emesis?
Hypochloremic, hypokalemic metabolic alkalosis Loss of HCl in vomit Angiotensin II --> HCO3 resorption Aldosterone --> H+ secretion and K+ secretion
1933
Superior sulcus tumor possible symptoms
Horner syndrome Pancoast (ulnar pain distribution, shoulder weakness) Hoarseness (RLN) SVC syndrome
1934
Divisions of mediastinum and their masses
Anterior: 4 T's (thymoma, teratoma, thyroid, terrible lymphoma) Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma Posterior: Neurogenic tumors
1935
Beck's triad of cardiac tamponade
Hypotension Distant heart sounds Distended jugular veins
1936
When can chorionic villous sampling be done? | Amniocentesis?
CVS: 9-14w Amniocentesis: 15-22w
1937
When to swab for GBS
35w
1938
Quad screen results for Edwards syndrome
UNDERaged at 18 | All are down
1939
Quad screen results for Down syndrome
2up 2down at 21
1940
Treatment of HIV in pregnancy
1) Zidovudine or Nevirapine during pregnancy 2) Elective c-section if viral load over 1000 3) Zidovudine for infant 4) No breastfeeding
1941
Normal fetal heart rate | Causes for bradycardia or tachycardia
110-160 bpm Brady - Congenital heart malformations, hypoxia Tachy - Hypoxia, maternal fever, fetal anemia
1942
Normal variability on FHT
6-25 bpm
1943
What does sinusoidal variability on FHT indicate?
Serious fetal anemia
1944
Prophylaxis in HIV patients
``` 200 = PCP = Bactrim 150 = Histoplasma = Itraconazole 100 = Toxoplasma = Bactrim 50 = MAC = Azithromycin ```
1945
Prophylaxis in posttransplant patients
Bactrim for PCP Immunize against Influenza, pneumococcus, and HBV
1946
When to perform oral glucose tolerance test
24-28w
1947
TSH, total T4, and free T4 levels in pregnancy
TSH down Total T4 way up Free T4 slightly up Because beta-hCG has TSH-like activity and estrogen increases TBG
1948
Paraneoplastic syndromes of SCLC
ACTH (Cushing's) ADH (SIADH) Lambert-Eaton syndrome
1949
Paraneoplastic syndromes of lung SCC
PTHrP (hypercalcemia)
1950
Most common cause of urinary obstruction in newborn males
Posterior urethral valves Can cause Potter's sequence and hydronephrosis in-utero
1951
Treatment for diabetic distal neuropathy
1) TCA's | 2) Gabapentin
1952
EPS side effects of antipsychotics
Acute dystonic reaction (neck, mouth, tongue, EOM) Akithisia (restlessness) Parkinsonism Tardive dyskinesia (after 1-6mo)
1953
Which hereditary hyperbilirubinemias present with unconjugated hyperbili? What is the difference?
Gilbert's - mild and occurs with fasting and stress | Crigler-Najjar - Severe with early death
1954
Which hereditary hyperbilirubinemias present with conjugated hyperbili? What is the difference?
Rotor's syndrome - normal appearing liver Dubin-Johnson - Black liverf
1955
Treatment of the hereditary hyperbilirubinemias
Crigler-Najjar I - Phenobarbital Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant Dubin-Johnson, Rotor's, Gilbert's do not require treatment.
1956
Lab/vitals abnormalities of LBW infants
``` Hypoxia Hypothermia Hypoglycemia Hypocalcemia Polycythemia ```
1957
What electrolyte derangements are seen with significant emesis?
Hypochloremic, hypokalemic metabolic alkalosis Loss of HCl in vomit Angiotensin II --> HCO3 resorption Aldosterone --> H+ secretion and K+ secretion
1958
Superior sulcus tumor possible symptoms
Horner syndrome Pancoast (ulnar pain distribution, shoulder weakness) Hoarseness (RLN) SVC syndrome
1959
Divisions of mediastinum and their masses
Anterior: 4 T's (thymoma, teratoma, thyroid, terrible lymphoma) Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma Posterior: Neurogenic tumors
1960
Beck's triad of cardiac tamponade
Hypotension Distant heart sounds Distended jugular veins
1961
When can chorionic villous sampling be done? | Amniocentesis?
CVS: 9-14w Amniocentesis: 15-22w
1962
When to swab for GBS
35w
1963
Quad screen results for Edwards syndrome
UNDERaged at 18 | All are down
1964
Quad screen results for Down syndrome
2up 2down at 21
1965
Treatment of HIV in pregnancy
1) Zidovudine or Nevirapine during pregnancy 2) Elective c-section if viral load over 1000 3) Zidovudine for infant 4) No breastfeeding
1966
Normal fetal heart rate | Causes for bradycardia or tachycardia
110-160 bpm Brady - Congenital heart malformations, hypoxia Tachy - Hypoxia, maternal fever, fetal anemia
1967
Normal variability on FHT
6-25 bpm
1968
What does sinusoidal variability on FHT indicate?
Serious fetal anemia
1969
Prophylaxis in HIV patients
``` 200 = PCP = Bactrim 150 = Histoplasma = Itraconazole 100 = Toxoplasma = Bactrim 50 = MAC = Azithromycin ```
1970
Prophylaxis in posttransplant patients
Bactrim for PCP Immunize against Influenza, pneumococcus, and HBV
1971
When to perform oral glucose tolerance test
24-28w
1972
TSH, total T4, and free T4 levels in pregnancy
TSH down Total T4 way up Free T4 slightly up Because beta-hCG has TSH-like activity and estrogen increases TBG
1973
Paraneoplastic syndromes of SCLC
ACTH (Cushing's) ADH (SIADH) Lambert-Eaton syndrome
1974
Paraneoplastic syndromes of lung SCC
PTHrP (hypercalcemia)
1975
Most common cause of urinary obstruction in newborn males
Posterior urethral valves Can cause Potter's sequence and hydronephrosis in-utero
1976
Treatment for diabetic distal neuropathy
1) TCA's | 2) Gabapentin
1977
EPS side effects of antipsychotics
Acute dystonic reaction (neck, mouth, tongue, EOM) Akithisia (restlessness) Parkinsonism Tardive dyskinesia (after 1-6mo)
1978
Which hereditary hyperbilirubinemias present with unconjugated hyperbili? What is the difference?
Gilbert's - mild and occurs with fasting and stress | Crigler-Najjar - Severe with early death
1979
Which hereditary hyperbilirubinemias present with conjugated hyperbili? What is the difference?
Rotor's syndrome - normal appearing liver Dubin-Johnson - Black liverf
1980
Treatment of the hereditary hyperbilirubinemias
Crigler-Najjar I - Phenobarbital Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant Dubin-Johnson, Rotor's, Gilbert's do not require treatment.
1981
Lab/vitals abnormalities of LBW infants
``` Hypoxia Hypothermia Hypoglycemia Hypocalcemia Polycythemia ```
1982
What electrolyte derangements are seen with significant emesis?
Hypochloremic, hypokalemic metabolic alkalosis Loss of HCl in vomit Angiotensin II --> HCO3 resorption Aldosterone --> H+ secretion and K+ secretion
1983
Superior sulcus tumor possible symptoms
Horner syndrome Pancoast (ulnar pain distribution, shoulder weakness) Hoarseness (RLN) SVC syndrome
1984
Divisions of mediastinum and their masses
Anterior: 4 T's (thymoma, teratoma, thyroid, terrible lymphoma) Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma Posterior: Neurogenic tumors
1985
Beck's triad of cardiac tamponade
Hypotension Distant heart sounds Distended jugular veins
1986
When can chorionic villous sampling be done? | Amniocentesis?
CVS: 9-14w Amniocentesis: 15-22w
1987
When to swab for GBS
35w
1988
Quad screen results for Edwards syndrome
UNDERaged at 18 | All are down
1989
Quad screen results for Down syndrome
2up 2down at 21
1990
Treatment of HIV in pregnancy
1) Zidovudine or Nevirapine during pregnancy 2) Elective c-section if viral load over 1000 3) Zidovudine for infant 4) No breastfeeding
1991
Normal fetal heart rate | Causes for bradycardia or tachycardia
110-160 bpm Brady - Congenital heart malformations, hypoxia Tachy - Hypoxia, maternal fever, fetal anemia
1992
Normal variability on FHT
6-25 bpm
1993
What does sinusoidal variability on FHT indicate?
Serious fetal anemia
1994
Prophylaxis in HIV patients
``` 200 = PCP = Bactrim 150 = Histoplasma = Itraconazole 100 = Toxoplasma = Bactrim 50 = MAC = Azithromycin ```
1995
Prophylaxis in posttransplant patients
Bactrim for PCP Immunize against Influenza, pneumococcus, and HBV
1996
When to perform oral glucose tolerance test
24-28w
1997
TSH, total T4, and free T4 levels in pregnancy
TSH down Total T4 way up Free T4 slightly up Because beta-hCG has TSH-like activity and estrogen increases TBG
1998
Paraneoplastic syndromes of SCLC
ACTH (Cushing's) ADH (SIADH) Lambert-Eaton syndrome
1999
Paraneoplastic syndromes of lung SCC
PTHrP (hypercalcemia)
2000
Most common cause of urinary obstruction in newborn males
Posterior urethral valves Can cause Potter's sequence and hydronephrosis in-utero
2001
Treatment for diabetic distal neuropathy
1) TCA's | 2) Gabapentin
2002
EPS side effects of antipsychotics
Acute dystonic reaction (neck, mouth, tongue, EOM) Akithisia (restlessness) Parkinsonism Tardive dyskinesia (after 1-6mo)
2003
Which hereditary hyperbilirubinemias present with unconjugated hyperbili? What is the difference?
Gilbert's - mild and occurs with fasting and stress | Crigler-Najjar - Severe with early death
2004
Which hereditary hyperbilirubinemias present with conjugated hyperbili? What is the difference?
Rotor's syndrome - normal appearing liver Dubin-Johnson - Black liverf
2005
Treatment of the hereditary hyperbilirubinemias
Crigler-Najjar I - Phenobarbital Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant Dubin-Johnson, Rotor's, Gilbert's do not require treatment.
2006
Lab/vitals abnormalities of LBW infants
``` Hypoxia Hypothermia Hypoglycemia Hypocalcemia Polycythemia ```
2007
What electrolyte derangements are seen with significant emesis?
Hypochloremic, hypokalemic metabolic alkalosis Loss of HCl in vomit Angiotensin II --> HCO3 resorption Aldosterone --> H+ secretion and K+ secretion
2008
Superior sulcus tumor possible symptoms
Horner syndrome Pancoast (ulnar pain distribution, shoulder weakness) Hoarseness (RLN) SVC syndrome
2009
Divisions of mediastinum and their masses
Anterior: 4 T's (thymoma, teratoma, thyroid, terrible lymphoma) Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma Posterior: Neurogenic tumors
2010
Beck's triad of cardiac tamponade
Hypotension Distant heart sounds Distended jugular veins
2011
When can chorionic villous sampling be done? | Amniocentesis?
CVS: 9-14w Amniocentesis: 15-22w
2012
When to swab for GBS
35w
2013
Quad screen results for Edwards syndrome
UNDERaged at 18 | All are down
2014
Quad screen results for Down syndrome
2up 2down at 21
2015
Treatment of HIV in pregnancy
1) Zidovudine or Nevirapine during pregnancy 2) Elective c-section if viral load over 1000 3) Zidovudine for infant 4) No breastfeeding
2016
Normal fetal heart rate | Causes for bradycardia or tachycardia
110-160 bpm Brady - Congenital heart malformations, hypoxia Tachy - Hypoxia, maternal fever, fetal anemia
2017
Normal variability on FHT
6-25 bpm
2018
What does sinusoidal variability on FHT indicate?
Serious fetal anemia
2019
Prophylaxis in HIV patients
``` 200 = PCP = Bactrim 150 = Histoplasma = Itraconazole 100 = Toxoplasma = Bactrim 50 = MAC = Azithromycin ```
2020
Prophylaxis in posttransplant patients
Bactrim for PCP Immunize against Influenza, pneumococcus, and HBV
2021
When to perform oral glucose tolerance test
24-28w
2022
TSH, total T4, and free T4 levels in pregnancy
TSH down Total T4 way up Free T4 slightly up Because beta-hCG has TSH-like activity and estrogen increases TBG
2023
Paraneoplastic syndromes of SCLC
ACTH (Cushing's) ADH (SIADH) Lambert-Eaton syndrome
2024
Paraneoplastic syndromes of lung SCC
PTHrP (hypercalcemia)
2025
Most common cause of urinary obstruction in newborn males
Posterior urethral valves Can cause Potter's sequence and hydronephrosis in-utero
2026
Treatment for diabetic distal neuropathy
1) TCA's | 2) Gabapentin
2027
EPS side effects of antipsychotics
Acute dystonic reaction (neck, mouth, tongue, EOM) Akithisia (restlessness) Parkinsonism Tardive dyskinesia (after 1-6mo)
2028
Which hereditary hyperbilirubinemias present with unconjugated hyperbili? What is the difference?
Gilbert's - mild and occurs with fasting and stress | Crigler-Najjar - Severe with early death
2029
Which hereditary hyperbilirubinemias present with conjugated hyperbili? What is the difference?
Rotor's syndrome - normal appearing liver Dubin-Johnson - Black liverf
2030
Treatment of the hereditary hyperbilirubinemias
Crigler-Najjar I - Phenobarbital Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant Dubin-Johnson, Rotor's, Gilbert's do not require treatment.
2031
Lab/vitals abnormalities of LBW infants
``` Hypoxia Hypothermia Hypoglycemia Hypocalcemia Polycythemia ```
2032
What electrolyte derangements are seen with significant emesis?
Hypochloremic, hypokalemic metabolic alkalosis Loss of HCl in vomit Angiotensin II --> HCO3 resorption Aldosterone --> H+ secretion and K+ secretion
2033
Superior sulcus tumor possible symptoms
Horner syndrome Pancoast (ulnar pain distribution, shoulder weakness) Hoarseness (RLN) SVC syndrome
2034
Divisions of mediastinum and their masses
Anterior: 4 T's (thymoma, teratoma, thyroid, terrible lymphoma) Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma Posterior: Neurogenic tumors
2035
Beck's triad of cardiac tamponade
Hypotension Distant heart sounds Distended jugular veins
2036
When can chorionic villous sampling be done? | Amniocentesis?
CVS: 9-14w Amniocentesis: 15-22w
2037
When to swab for GBS
35w
2038
Quad screen results for Edwards syndrome
UNDERaged at 18 | All are down
2039
Quad screen results for Down syndrome
2up 2down at 21
2040
Treatment of HIV in pregnancy
1) Zidovudine or Nevirapine during pregnancy 2) Elective c-section if viral load over 1000 3) Zidovudine for infant 4) No breastfeeding
2041
Normal fetal heart rate | Causes for bradycardia or tachycardia
110-160 bpm Brady - Congenital heart malformations, hypoxia Tachy - Hypoxia, maternal fever, fetal anemia
2042
Normal variability on FHT
6-25 bpm
2043
What does sinusoidal variability on FHT indicate?
Serious fetal anemia
2044
Prophylaxis in HIV patients
``` 200 = PCP = Bactrim 150 = Histoplasma = Itraconazole 100 = Toxoplasma = Bactrim 50 = MAC = Azithromycin ```
2045
Prophylaxis in posttransplant patients
Bactrim for PCP Immunize against Influenza, pneumococcus, and HBV
2046
When to perform oral glucose tolerance test
24-28w
2047
TSH, total T4, and free T4 levels in pregnancy
TSH down Total T4 way up Free T4 slightly up Because beta-hCG has TSH-like activity and estrogen increases TBG
2048
Paraneoplastic syndromes of SCLC
ACTH (Cushing's) ADH (SIADH) Lambert-Eaton syndrome
2049
Paraneoplastic syndromes of lung SCC
PTHrP (hypercalcemia)
2050
Most common cause of urinary obstruction in newborn males
Posterior urethral valves Can cause Potter's sequence and hydronephrosis in-utero
2051
Treatment for diabetic distal neuropathy
1) TCA's | 2) Gabapentin
2052
EPS side effects of antipsychotics
Acute dystonic reaction (neck, mouth, tongue, EOM) Akithisia (restlessness) Parkinsonism Tardive dyskinesia (after 1-6mo)
2053
Which hereditary hyperbilirubinemias present with unconjugated hyperbili? What is the difference?
Gilbert's - mild and occurs with fasting and stress | Crigler-Najjar - Severe with early death
2054
Which hereditary hyperbilirubinemias present with conjugated hyperbili? What is the difference?
Rotor's syndrome - normal appearing liver Dubin-Johnson - Black liverf
2055
Treatment of the hereditary hyperbilirubinemias
Crigler-Najjar I - Phenobarbital Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant Dubin-Johnson, Rotor's, Gilbert's do not require treatment.
2056
Lab/vitals abnormalities of LBW infants
``` Hypoxia Hypothermia Hypoglycemia Hypocalcemia Polycythemia ```
2057
What electrolyte derangements are seen with significant emesis?
Hypochloremic, hypokalemic metabolic alkalosis Loss of HCl in vomit Angiotensin II --> HCO3 resorption Aldosterone --> H+ secretion and K+ secretion
2058
Superior sulcus tumor possible symptoms
Horner syndrome Pancoast (ulnar pain distribution, shoulder weakness) Hoarseness (RLN) SVC syndrome
2059
Divisions of mediastinum and their masses
Anterior: 4 T's (thymoma, teratoma, thyroid, terrible lymphoma) Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma Posterior: Neurogenic tumors
2060
Beck's triad of cardiac tamponade
Hypotension Distant heart sounds Distended jugular veins
2061
When can chorionic villous sampling be done? | Amniocentesis?
CVS: 9-14w Amniocentesis: 15-22w
2062
When to swab for GBS
35w
2063
Quad screen results for Edwards syndrome
UNDERaged at 18 | All are down
2064
Quad screen results for Down syndrome
2up 2down at 21
2065
Treatment of HIV in pregnancy
1) Zidovudine or Nevirapine during pregnancy 2) Elective c-section if viral load over 1000 3) Zidovudine for infant 4) No breastfeeding
2066
Normal fetal heart rate | Causes for bradycardia or tachycardia
110-160 bpm Brady - Congenital heart malformations, hypoxia Tachy - Hypoxia, maternal fever, fetal anemia
2067
Normal variability on FHT
6-25 bpm
2068
What does sinusoidal variability on FHT indicate?
Serious fetal anemia
2069
Prophylaxis in HIV patients
``` 200 = PCP = Bactrim 150 = Histoplasma = Itraconazole 100 = Toxoplasma = Bactrim 50 = MAC = Azithromycin ```
2070
Prophylaxis in posttransplant patients
Bactrim for PCP Immunize against Influenza, pneumococcus, and HBV
2071
When to perform oral glucose tolerance test
24-28w
2072
TSH, total T4, and free T4 levels in pregnancy
TSH down Total T4 way up Free T4 slightly up Because beta-hCG has TSH-like activity and estrogen increases TBG
2073
Paraneoplastic syndromes of SCLC
ACTH (Cushing's) ADH (SIADH) Lambert-Eaton syndrome
2074
Paraneoplastic syndromes of lung SCC
PTHrP (hypercalcemia)
2075
Most common cause of urinary obstruction in newborn males
Posterior urethral valves Can cause Potter's sequence and hydronephrosis in-utero
2076
Treatment for diabetic distal neuropathy
1) TCA's | 2) Gabapentin
2077
EPS side effects of antipsychotics
Acute dystonic reaction (neck, mouth, tongue, EOM) Akithisia (restlessness) Parkinsonism Tardive dyskinesia (after 1-6mo)
2078
Which hereditary hyperbilirubinemias present with unconjugated hyperbili? What is the difference?
Gilbert's - mild and occurs with fasting and stress | Crigler-Najjar - Severe with early death
2079
Which hereditary hyperbilirubinemias present with conjugated hyperbili? What is the difference?
Rotor's syndrome - normal appearing liver Dubin-Johnson - Black liverf
2080
Treatment of the hereditary hyperbilirubinemias
Crigler-Najjar I - Phenobarbital Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant Dubin-Johnson, Rotor's, Gilbert's do not require treatment.
2081
Lab/vitals abnormalities of LBW infants
``` Hypoxia Hypothermia Hypoglycemia Hypocalcemia Polycythemia ```
2082
What electrolyte derangements are seen with significant emesis?
Hypochloremic, hypokalemic metabolic alkalosis Loss of HCl in vomit Angiotensin II --> HCO3 resorption Aldosterone --> H+ secretion and K+ secretion
2083
Superior sulcus tumor possible symptoms
Horner syndrome Pancoast (ulnar pain distribution, shoulder weakness) Hoarseness (RLN) SVC syndrome
2084
Divisions of mediastinum and their masses
Anterior: 4 T's (thymoma, teratoma, thyroid, terrible lymphoma) Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma Posterior: Neurogenic tumors
2085
Beck's triad of cardiac tamponade
Hypotension Distant heart sounds Distended jugular veins
2086
When can chorionic villous sampling be done? | Amniocentesis?
CVS: 9-14w Amniocentesis: 15-22w
2087
When to swab for GBS
35w
2088
Quad screen results for Edwards syndrome
UNDERaged at 18 | All are down
2089
Quad screen results for Down syndrome
2up 2down at 21
2090
Treatment of HIV in pregnancy
1) Zidovudine or Nevirapine during pregnancy 2) Elective c-section if viral load over 1000 3) Zidovudine for infant 4) No breastfeeding
2091
Normal fetal heart rate | Causes for bradycardia or tachycardia
110-160 bpm Brady - Congenital heart malformations, hypoxia Tachy - Hypoxia, maternal fever, fetal anemia
2092
Normal variability on FHT
6-25 bpm
2093
What does sinusoidal variability on FHT indicate?
Serious fetal anemia
2094
Prophylaxis in HIV patients
``` 200 = PCP = Bactrim 150 = Histoplasma = Itraconazole 100 = Toxoplasma = Bactrim 50 = MAC = Azithromycin ```
2095
Prophylaxis in posttransplant patients
Bactrim for PCP Immunize against Influenza, pneumococcus, and HBV
2096
When to perform oral glucose tolerance test
24-28w
2097
TSH, total T4, and free T4 levels in pregnancy
TSH down Total T4 way up Free T4 slightly up Because beta-hCG has TSH-like activity and estrogen increases TBG
2098
Paraneoplastic syndromes of SCLC
ACTH (Cushing's) ADH (SIADH) Lambert-Eaton syndrome
2099
Paraneoplastic syndromes of lung SCC
PTHrP (hypercalcemia)
2100
Most common cause of urinary obstruction in newborn males
Posterior urethral valves Can cause Potter's sequence and hydronephrosis in-utero
2101
Treatment for diabetic distal neuropathy
1) TCA's | 2) Gabapentin
2102
EPS side effects of antipsychotics
Acute dystonic reaction (neck, mouth, tongue, EOM) Akithisia (restlessness) Parkinsonism Tardive dyskinesia (after 1-6mo)
2103
Which hereditary hyperbilirubinemias present with unconjugated hyperbili? What is the difference?
Gilbert's - mild and occurs with fasting and stress | Crigler-Najjar - Severe with early death
2104
Which hereditary hyperbilirubinemias present with conjugated hyperbili? What is the difference?
Rotor's syndrome - normal appearing liver Dubin-Johnson - Black liverf
2105
Treatment of the hereditary hyperbilirubinemias
Crigler-Najjar I - Phenobarbital Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant Dubin-Johnson, Rotor's, Gilbert's do not require treatment.
2106
Lab/vitals abnormalities of LBW infants
``` Hypoxia Hypothermia Hypoglycemia Hypocalcemia Polycythemia ```
2107
What electrolyte derangements are seen with significant emesis?
Hypochloremic, hypokalemic metabolic alkalosis Loss of HCl in vomit Angiotensin II --> HCO3 resorption Aldosterone --> H+ secretion and K+ secretion
2108
Superior sulcus tumor possible symptoms
Horner syndrome Pancoast (ulnar pain distribution, shoulder weakness) Hoarseness (RLN) SVC syndrome
2109
Divisions of mediastinum and their masses
Anterior: 4 T's (thymoma, teratoma, thyroid, terrible lymphoma) Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma Posterior: Neurogenic tumors
2110
Beck's triad of cardiac tamponade
Hypotension Distant heart sounds Distended jugular veins
2111
When can chorionic villous sampling be done? | Amniocentesis?
CVS: 9-14w Amniocentesis: 15-22w
2112
When to swab for GBS
35w
2113
Quad screen results for Edwards syndrome
UNDERaged at 18 | All are down
2114
Quad screen results for Down syndrome
2up 2down at 21
2115
Treatment of HIV in pregnancy
1) Zidovudine or Nevirapine during pregnancy 2) Elective c-section if viral load over 1000 3) Zidovudine for infant 4) No breastfeeding
2116
Normal fetal heart rate | Causes for bradycardia or tachycardia
110-160 bpm Brady - Congenital heart malformations, hypoxia Tachy - Hypoxia, maternal fever, fetal anemia
2117
Normal variability on FHT
6-25 bpm
2118
What does sinusoidal variability on FHT indicate?
Serious fetal anemia
2119
Prophylaxis in HIV patients
``` 200 = PCP = Bactrim 150 = Histoplasma = Itraconazole 100 = Toxoplasma = Bactrim 50 = MAC = Azithromycin ```
2120
Prophylaxis in posttransplant patients
Bactrim for PCP Immunize against Influenza, pneumococcus, and HBV
2121
When to perform oral glucose tolerance test
24-28w
2122
TSH, total T4, and free T4 levels in pregnancy
TSH down Total T4 way up Free T4 slightly up Because beta-hCG has TSH-like activity and estrogen increases TBG
2123
Paraneoplastic syndromes of SCLC
ACTH (Cushing's) ADH (SIADH) Lambert-Eaton syndrome
2124
Paraneoplastic syndromes of lung SCC
PTHrP (hypercalcemia)
2125
Most common cause of urinary obstruction in newborn males
Posterior urethral valves Can cause Potter's sequence and hydronephrosis in-utero
2126
Treatment for diabetic distal neuropathy
1) TCA's | 2) Gabapentin
2127
EPS side effects of antipsychotics
Acute dystonic reaction (neck, mouth, tongue, EOM) Akithisia (restlessness) Parkinsonism Tardive dyskinesia (after 1-6mo)
2128
Which hereditary hyperbilirubinemias present with unconjugated hyperbili? What is the difference?
Gilbert's - mild and occurs with fasting and stress | Crigler-Najjar - Severe with early death
2129
Which hereditary hyperbilirubinemias present with conjugated hyperbili? What is the difference?
Rotor's syndrome - normal appearing liver Dubin-Johnson - Black liverf
2130
Treatment of the hereditary hyperbilirubinemias
Crigler-Najjar I - Phenobarbital Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant Dubin-Johnson, Rotor's, Gilbert's do not require treatment.
2131
Lab/vitals abnormalities of LBW infants
``` Hypoxia Hypothermia Hypoglycemia Hypocalcemia Polycythemia ```
2132
What electrolyte derangements are seen with significant emesis?
Hypochloremic, hypokalemic metabolic alkalosis Loss of HCl in vomit Angiotensin II --> HCO3 resorption Aldosterone --> H+ secretion and K+ secretion
2133
Superior sulcus tumor possible symptoms
Horner syndrome Pancoast (ulnar pain distribution, shoulder weakness) Hoarseness (RLN) SVC syndrome
2134
Divisions of mediastinum and their masses
Anterior: 4 T's (thymoma, teratoma, thyroid, terrible lymphoma) Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma Posterior: Neurogenic tumors
2135
Beck's triad of cardiac tamponade
Hypotension Distant heart sounds Distended jugular veins
2136
When can chorionic villous sampling be done? | Amniocentesis?
CVS: 9-14w Amniocentesis: 15-22w
2137
When to swab for GBS
35w
2138
Quad screen results for Edwards syndrome
UNDERaged at 18 | All are down
2139
Quad screen results for Down syndrome
2up 2down at 21
2140
Treatment of HIV in pregnancy
1) Zidovudine or Nevirapine during pregnancy 2) Elective c-section if viral load over 1000 3) Zidovudine for infant 4) No breastfeeding
2141
Normal fetal heart rate | Causes for bradycardia or tachycardia
110-160 bpm Brady - Congenital heart malformations, hypoxia Tachy - Hypoxia, maternal fever, fetal anemia
2142
Normal variability on FHT
6-25 bpm
2143
What does sinusoidal variability on FHT indicate?
Serious fetal anemia
2144
Prophylaxis in HIV patients
``` 200 = PCP = Bactrim 150 = Histoplasma = Itraconazole 100 = Toxoplasma = Bactrim 50 = MAC = Azithromycin ```
2145
Prophylaxis in posttransplant patients
Bactrim for PCP Immunize against Influenza, pneumococcus, and HBV
2146
When to perform oral glucose tolerance test
24-28w
2147
TSH, total T4, and free T4 levels in pregnancy
TSH down Total T4 way up Free T4 slightly up Because beta-hCG has TSH-like activity and estrogen increases TBG
2148
Paraneoplastic syndromes of SCLC
ACTH (Cushing's) ADH (SIADH) Lambert-Eaton syndrome
2149
Paraneoplastic syndromes of lung SCC
PTHrP (hypercalcemia)
2150
Most common cause of urinary obstruction in newborn males
Posterior urethral valves Can cause Potter's sequence and hydronephrosis in-utero
2151
Treatment for diabetic distal neuropathy
1) TCA's | 2) Gabapentin
2152
EPS side effects of antipsychotics
Acute dystonic reaction (neck, mouth, tongue, EOM) Akithisia (restlessness) Parkinsonism Tardive dyskinesia (after 1-6mo)
2153
Which hereditary hyperbilirubinemias present with unconjugated hyperbili? What is the difference?
Gilbert's - mild and occurs with fasting and stress | Crigler-Najjar - Severe with early death
2154
Which hereditary hyperbilirubinemias present with conjugated hyperbili? What is the difference?
Rotor's syndrome - normal appearing liver Dubin-Johnson - Black liverf
2155
Treatment of the hereditary hyperbilirubinemias
Crigler-Najjar I - Phenobarbital Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant Dubin-Johnson, Rotor's, Gilbert's do not require treatment.
2156
Lab/vitals abnormalities of LBW infants
``` Hypoxia Hypothermia Hypoglycemia Hypocalcemia Polycythemia ```
2157
What electrolyte derangements are seen with significant emesis?
Hypochloremic, hypokalemic metabolic alkalosis Loss of HCl in vomit Angiotensin II --> HCO3 resorption Aldosterone --> H+ secretion and K+ secretion
2158
Superior sulcus tumor possible symptoms
Horner syndrome Pancoast (ulnar pain distribution, shoulder weakness) Hoarseness (RLN) SVC syndrome
2159
Divisions of mediastinum and their masses
Anterior: 4 T's (thymoma, teratoma, thyroid, terrible lymphoma) Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma Posterior: Neurogenic tumors
2160
Beck's triad of cardiac tamponade
Hypotension Distant heart sounds Distended jugular veins
2161
When can chorionic villous sampling be done? | Amniocentesis?
CVS: 9-14w Amniocentesis: 15-22w
2162
When to swab for GBS
35w
2163
Quad screen results for Edwards syndrome
UNDERaged at 18 | All are down
2164
Quad screen results for Down syndrome
2up 2down at 21
2165
Treatment of HIV in pregnancy
1) Zidovudine or Nevirapine during pregnancy 2) Elective c-section if viral load over 1000 3) Zidovudine for infant 4) No breastfeeding
2166
Normal fetal heart rate | Causes for bradycardia or tachycardia
110-160 bpm Brady - Congenital heart malformations, hypoxia Tachy - Hypoxia, maternal fever, fetal anemia
2167
Normal variability on FHT
6-25 bpm
2168
What does sinusoidal variability on FHT indicate?
Serious fetal anemia
2169
Prophylaxis in HIV patients
``` 200 = PCP = Bactrim 150 = Histoplasma = Itraconazole 100 = Toxoplasma = Bactrim 50 = MAC = Azithromycin ```
2170
Prophylaxis in posttransplant patients
Bactrim for PCP Immunize against Influenza, pneumococcus, and HBV
2171
When to perform oral glucose tolerance test
24-28w
2172
TSH, total T4, and free T4 levels in pregnancy
TSH down Total T4 way up Free T4 slightly up Because beta-hCG has TSH-like activity and estrogen increases TBG
2173
Paraneoplastic syndromes of SCLC
ACTH (Cushing's) ADH (SIADH) Lambert-Eaton syndrome
2174
Paraneoplastic syndromes of lung SCC
PTHrP (hypercalcemia)
2175
Most common cause of urinary obstruction in newborn males
Posterior urethral valves Can cause Potter's sequence and hydronephrosis in-utero
2176
Treatment for diabetic distal neuropathy
1) TCA's | 2) Gabapentin
2177
EPS side effects of antipsychotics
Acute dystonic reaction (neck, mouth, tongue, EOM) Akithisia (restlessness) Parkinsonism Tardive dyskinesia (after 1-6mo)
2178
Which hereditary hyperbilirubinemias present with unconjugated hyperbili? What is the difference?
Gilbert's - mild and occurs with fasting and stress | Crigler-Najjar - Severe with early death
2179
Which hereditary hyperbilirubinemias present with conjugated hyperbili? What is the difference?
Rotor's syndrome - normal appearing liver Dubin-Johnson - Black liverf
2180
Treatment of the hereditary hyperbilirubinemias
Crigler-Najjar I - Phenobarbital Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant Dubin-Johnson, Rotor's, Gilbert's do not require treatment.
2181
Lab/vitals abnormalities of LBW infants
``` Hypoxia Hypothermia Hypoglycemia Hypocalcemia Polycythemia ```
2182
What electrolyte derangements are seen with significant emesis?
Hypochloremic, hypokalemic metabolic alkalosis Loss of HCl in vomit Angiotensin II --> HCO3 resorption Aldosterone --> H+ secretion and K+ secretion
2183
Superior sulcus tumor possible symptoms
Horner syndrome Pancoast (ulnar pain distribution, shoulder weakness) Hoarseness (RLN) SVC syndrome
2184
Divisions of mediastinum and their masses
Anterior: 4 T's (thymoma, teratoma, thyroid, terrible lymphoma) Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma Posterior: Neurogenic tumors
2185
Beck's triad of cardiac tamponade
Hypotension Distant heart sounds Distended jugular veins
2186
When can chorionic villous sampling be done? | Amniocentesis?
CVS: 9-14w Amniocentesis: 15-22w
2187
When to swab for GBS
35w
2188
Quad screen results for Edwards syndrome
UNDERaged at 18 | All are down
2189
Quad screen results for Down syndrome
2up 2down at 21
2190
Treatment of HIV in pregnancy
1) Zidovudine or Nevirapine during pregnancy 2) Elective c-section if viral load over 1000 3) Zidovudine for infant 4) No breastfeeding
2191
Normal fetal heart rate | Causes for bradycardia or tachycardia
110-160 bpm Brady - Congenital heart malformations, hypoxia Tachy - Hypoxia, maternal fever, fetal anemia
2192
Normal variability on FHT
6-25 bpm
2193
What does sinusoidal variability on FHT indicate?
Serious fetal anemia
2194
Prophylaxis in HIV patients
``` 200 = PCP = Bactrim 150 = Histoplasma = Itraconazole 100 = Toxoplasma = Bactrim 50 = MAC = Azithromycin ```
2195
Prophylaxis in HIV patients
``` 200 = PCP = Bactrim 150 = Histoplasma = Itraconazole 100 = Toxoplasma = Bactrim 50 = MAC = Azithromycin ```
2196
Prophylaxis in HIV patients
``` 200 = PCP = Bactrim 150 = Histoplasma = Itraconazole 100 = Toxoplasma = Bactrim 50 = MAC = Azithromycin ```
2197
Prophylaxis in HIV patients
``` 200 = PCP = Bactrim 150 = Histoplasma = Itraconazole 100 = Toxoplasma = Bactrim 50 = MAC = Azithromycin ```
2198
Prophylaxis in HIV patients
``` 200 = PCP = Bactrim 150 = Histoplasma = Itraconazole 100 = Toxoplasma = Bactrim 50 = MAC = Azithromycin ```
2199
Prophylaxis in HIV patients
``` 200 = PCP = Bactrim 150 = Histoplasma = Itraconazole 100 = Toxoplasma = Bactrim 50 = MAC = Azithromycin ```
2200
Prophylaxis in HIV patients
``` 200 = PCP = Bactrim 150 = Histoplasma = Itraconazole 100 = Toxoplasma = Bactrim 50 = MAC = Azithromycin ```
2201
Pathogens that cause Guillan-Barre
``` Campylobacter Herpes viruses Mycoplasma H. flu HIV Immunizations Lymphoma/Sarcoid/SLE ```
2202
Treatment of mastitis
Continue breastfeeding | Abx that cover staph
2203
Where does breast cancer metastasize to?
Bone Lung Liver
2204
Initial workup of a breast mass
Over 30 - mammogram Under 30 - US Can follow with FNA, core needle, or open biopsy
2205
Medical treatment of breast cancer
If hormone receptor positive - Tamoxifen HER2/neu positive - Trastuzumab ER- patients - chemo These will all be accompanied by lumpectomy or modified radical mastectomy
2206
Treatment of mastitis
Continue breastfeeding | Abx that cover staph
2207
Where does breast cancer metastasize to?
Bone Lung Liver
2208
Initial workup of a breast mass
Over 30 - mammogram Under 30 - US Can follow with FNA, core needle, or open biopsy
2209
Medical treatment of breast cancer
If hormone receptor positive - Tamoxifen HER2/neu positive - Trastuzumab ER- patients - chemo These will all be accompanied by lumpectomy or modified radical mastectomy
2210
List of X-linked recessive disorders
GOLD FOB Holds His Watch ``` G6PD deficiency Ocular albinism Lesch-Nyhan syndrome Duchenne's muscular dystrophy Fabry's disease OTC deficiency Bruton's agammaglobulinemia Hemophilia Hunter's syndrome Wiskott-Aldrich syndrome ```
2211
Findings in Down syndrome
``` Mental retardation Prominent epicanthal folds Simian crease Duodenal atresia ASD Increased risk of ALL and Alzheimer's ```
2212
Down syndrome quad screen results
AFP, b-hCG, Estriol, Inhibin A Down Up Down Up
2213
Edwards' syndrome quad screen results
AFP, b-hCG, Estriol, Inhibin A Down Down Down Normal
2214
What is the CHA2DS2VASc score?
For nonvalvular AF ``` CHF HTN Age 75+ (2 points) DM Stroke/TIA/Thromboembolism (2 points) Vascular dz Age 65-74 Sex category (females) ``` ``` 0 = nothing 1 = ASA or anticoagulation 2+ = anticoagulation ```
2215
Pure motor hemiparesis CVA
Lacunar stroke in the posterior limb of the internal capsule
2216
Causes of increased maternal serum AFP
Neural tube defects Ventral wall defects Multiple gestation
2217
Cephalohematoma vs. Caput succedaneum
Cephalohematoma - subperiosteal bleeding. Does not cross suture lines Caput succedaneum - Scalp swelling. Diffuse across suture lines.
2218
How is endometrial hyperplasia managed?
Without atypia - Progestin therapy and repeat biopsy at 3mo | With atypia - Hysterectomy (if no future children planned)
2219
Treatment of caustic ingestion
ABC's Decontaminate skin/clothes Endoscopy within 24h
2220
Differential of delayed passage of meconium (48h)
``` Hirschsprung dz - Rectosigmoid Meconium ileus (CF) - Ileum ```
2221
When to administer vaccines to preterm infants
According to chronologic age. Only exception is wait on HBV at birth if infant is under 2kg.
2222
Treatment of PNH
Iron and Folate | Eculizumab (complement inhibitor)
2223
Murmur of HOCM
Systolic at LUSB
2224
Treatment of HOCM
Beta blockers Allow more time for diastolic filling
2225
What opening pressure is diagnostic of pseudotumor cerebri?
Over 250 mm H20 in the right clinical setting
2226
Most common causes of chronic cough (8+ weeks)
Postnasal drip Asthma GERD
2227
How to distinguish Cobalamin and Folate deficiency
MMA levels Increased MMA - Cobalamin deficiency Normal MMA - Folate deficiency
2228
What is increased/decreased with Folate or B12 deficiency?
Homocysteine is increased | Methionine is decreased
2229
Skin manifestation associated with IBD
Pyoderma gangrenosum
2230
Skin manifestation of Pseudomonas bacteremia
Ecthyma gangrenosum
2231
Treatment of MS
Corticosteroids for acute exacerbations | Interferons
2232
Test used to detect cysteinuria
Urinary cyanide nitroprusside test Blue = cysteine present
2233
Treatment of absence seizures
Ethosuximide
2234
Side effects of phenytoin
Gingival hypertrophy Hirsutism Rash LAD
2235
Most common causes of osteomyelitis
Staph aureus is most common Pseudomonas if a puncture wound through shoe Salmonella or Staph aureus in sickle cell patients
2236
What proteins does warfarin inhibit?
Factors II, VII, IX, X Protein C and S All are vitamin K-dependent
2237
What cancer are PCOS women at risk for?
Endometrial (androgens converted to estrogens peripherally)
2238
Treatment for a PPD positive HIV patient
PPD is positive if 5mm+ of induration Tx: INH and Pyridoxine for 9mo
2239
Side effects of INH
Injures Neuronsand Hepatocytes Neuropathy Hepatitis Pyridoxime can prevent neuropathy but not hepatitis
2240
What is considered a positive PPD?
5mm - HIV or other risk factors, close TB contacts 10mm - Homeless, developing countries, IVDA, healthcare workers, inmates 15mm - Everyone else
2241
When is bedwetting abnormal?
Over age 5y
2242
When do you give Anti-D Ig?
1) 28-32w gestation 2) Within 72h of delivery (if infant is Rh+) or abortion 3) Chorionic villous sampling or amniocentesis 4) 2nd or 3rd trimester bleeding 5) Ectopic or molar pregnancy
2243
When do you screen for GBS?
35-37w
2244
Symptoms of Behcets syndrome
Recurrent oral ulcers (required) Recurrent genital ulcers Uveitis Skin lesions - erythema nodosum or pustular lesions Can involve GI, skeletal, vascular systems Most often seen in Turkish, Asian, and Middle Eastern
2245
Symptoms of reactive arthritis
Urethritis Conjunctivitis Mucocutaneous lesions Arthritis
2246
Facial dysmorphisms of fetal alcohol syndrome
Small palpebral fissures Smooth philtrum Thin vermilion border
2247
Body dysmorphisms of Fragile X syndrome
Long narrow face Large ears Prominent forehead and chin Macroorchidism
2248
Congenital CMV symptoms
``` SNHL Blindness Jaundice and HSM Petechiae Developmental delay ```
2249
Congenital Rubella symptoms
``` SNHL Cataracts HSM Purpura Developmental delay ```
2250
Lead points for intussusception
Under 2y: Peyer's patch Children over 2: Meckels diverticulum, HSP Adults:Tumor
2251
Treatment for Trigeminal Neuralgia
Carbamazepine
2252
What are the mature defense mechanisms?
SASH - Suppression - Altruism - Sublimation - Humor
2253
Where to perform needle thoracostomy
Midclavicular line 2nd intercostal space
2254
Treatment for Tinea versicolor
Topical selenium sulfide or ketoconazole
2255
Symptoms of hereditary angioedema
Rapid-onset edema of the face, limbs, larynx, and genitals | Colicky abdominal pain
2256
Drug usedto treat tremor in Parkinson's
Trihexyphenidyl (anticholinergic)
2257
Which anemia has increased MCHC?
Hereditary spherocytosis
2258
What are the microcytic anemias?
Iron deficiency Lead intoxication Thalassemia Sideroblastic anemia
2259
Causes of postop fever
``` Wind - pneumonia, PE, aspiration POD3 Water- UTI POD5 Walking - DVT POD7 Wound - POD 7-10 Wonderdrugs - Drug fever, IV sites, blood - Any time ```
2260
Difference between intermittent and recurrent variable decels
Over 50% of contractions show a decel Intermittent - expectant mgmt Recurrent - O2, change maternal position, +/- amnioinfusion
2261
What lung cancers are peripheral vs central?
Peripheral: Adenocarcinoma, Large cell carcinoma Central: SCC, SCLC
2262
Differential for anterior mediastinal mass
4T's: Thymoma, Teratoma, Thyroid neoplasm, Terrible lymphoma *Teratoma includes other germ cell tumors
2263
Serum markers in germ cell tumors
Seminoma = beta-hCG | Other germ cell tumors = AFP and beta-hCG

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