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Step 2 Flashcards

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
Q

Treatment of Goodpasture’s syndrome

A

Plasma exchange

Pulsed steroids

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26
Q

What is seen in Alport syndrome?

A

Hematuria
Sensorineural deafness
Eye disorders

Presents in boys 5-20y

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27
Q

Symptoms of nephritic syndrome

A 
Proteinuria
Hematuria
Azotemia
RBC casts
Oliguria
Hypertension
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28
Q

Symptoms of nephrotic syndrome

A

Proteinuria (>3.5g per day)
Albumin low
Lipids high
Edema

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29
Q

What are the causes of nephrotic syndrome?

A 
Minimal change disease
FSGS
Membranous nephropathy
Diabetic nephropathy
Lupus nephritis
Renal amyloidosis
Membranoproliferative nephropathy
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30
Q

Treatment of minimal change disease

A

Steroids

Most children have a full recovery

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31
Q

Things associated with FSGS

A

Black
IV drug use
HIV
Obesity

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32
Q

Histologic forms of diabetic nephropathy

A 
Diffuse hyalinization
Nodular glomerulosclerosis (Kimmelstiel-Wilson nodules)
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33
Q

Causes of renal amyloidosis

A

Primary: Multiple myeloma
Secondary: infectious/inflammatory (TB, RA, etc.)

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34
Q

Apple green birefringence on Congo red staining

A

Amyloidosis

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35
Q

Causes of membranoproliferative nephropathy

A

HCV
Cryoglobulinemia
SLE
Bacterial endocarditis

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36
Q

Treatment of nephrotic syndrome

A

Protein & salt restriction
Immunosuppression (for some forms)
ACEi’s
PPV23 immunization

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37
Q

Most common causes of acute unilateral lymphadenitis in children

A

Normally bacterial: Staph aureus or GAS

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38
Q

Symptoms of Vitamin A deficiency

A

Night blindness
Photophobia
Dry/scaly skin
Dry conjunctiva and cornea

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39
Q

Symptoms of Beriberi

A

Thiamine deficiency

Infantile: Cardiomegaly, cyanosis, dyspnea, vomiting
Dry adult: Symmetrical peripheral neuropathy
Wet adult: Neuropathy + cardiac involvement

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40
Q

Symptoms of hypervitaminosis A

A 
Pruritis
Alopecia
Fissuring of corners of the mouth
Increased ICP
Hepatomegaly
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41
Q

Crystals seen in pseudogout

A

Calcium pyrophosphate

Rhomboid, positive birefringence

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42
Q

Crystals seen in gout

A

Monosodium urate

Needle-shaped, negative birefringence

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43
Q

What immunizations are recommended in asplenic patients?

A

PCV13 then PPSV23
H. flu type B
Meningococcal

These should be given >2 weeks before or >2 weeks after splenectomy.

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44
Q

What are the primary humoral deficiencies?

A 
X-linked agammaglobulinemia
Common variable immunodeficiency
IgA deficiency
Hyper IgM syndrome
IgG subclass deficiency
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45
Q

Lab findings in X-linked agammaglobulinemia

A

Recurrent sinopulmonary infx

Decreased or absent B cells
Decreased Ig’s

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46
Q

Lab findings in CVID

A

Recurrent sinopulmonary infx

Normal B cells
Decreased Ig’s

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47
Q

Lab findings in hyper-IgM syndrome

A

Recurrent sinopulmonary infx

Normal B cells
Decreased IgG and IgA
Increased IgM

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48
Q

Causes of abnormal uterine bleeding

A

PALM-COEIN

Polyps
Adenomyosis
Leiomyoma
Malignancy and hyperplasia
Coagulopathy
Ovulatory dysfunction/anovulatory cycles
Endometrial
Iatrogenic
Not otherwise classified
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49
Q

Indications for endometrial biopsy

A

Women >45 with irregular menstrual bleeding

Any postmenopausal bleeding

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50
Q

Symptoms of thalamic stroke

A

Contralateral hemianesthesia
Dysesthesia (pain with light touch, aka thalamic phenomenon)
Transient hemiparesis, athetosis, or hemiballismus

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51
Q

Treatment of toxoplasma

A

Sulfadiazine and pyrimethramine

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52
Q

When do opioid abusers develop withdrawal?

What are the symptoms?

A

Begins 6-12h
Peaks 24-48h

n/v/d, restlessness, rhinorrhea, lacrimation, myalgias, dysphoria

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53
Q

Symptoms of constrictive pericarditis

A 
Peripheral edema
Ascites
Elevated JVP
Pericardial knock (mid-diastolic)
Pericardial calcifications on CXR
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54
Q

Symptoms of posterior limb of internal capsule CVA

A

Unilateral motor impairment

No sensory or cortical deficits

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55
Q

Symptoms of CVA in the MCA

A

Contralateral sensory and motor deficit (face, arm, and leg)
Aphasia (if dominant), Hemineglect (if nondominant)
Eye deviation toward lesion
Homonymous hemianopia

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56
Q

Symptoms of an ACA infarction

A

Sensory and motor deficit of contralateral lower extremity

Frontal lobe symptoms (apraxia, abulia, emotional disturbances)

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57
Q

Treatment for frostbite

A

Rapid rewarming with warm water

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58
Q

Side effects of amiodarone

A 
QT prolongation
Chronic interstitial pneumonitis
Hypo/hyperthyroidism
Transaminitis
Peripheral neuropathy
Optic neuropathy
Blue-gray skin discoloration
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59
Q

How is compartment syndrome diagnosed?

A

Compartment pressures > 30 mmHg

Delta pressure

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60
Q

ABG findings in CHF exacerbation

A

Hypoxia
Hypocapnea
Resp alkalosis

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61
Q

ABG findings in COPD exacerbation

A

Hypoxia
Hypercapnea
Resp acidosis

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62
Q

Prophylaxis in HIV patients

A

CD4

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63
Q

What is considered oliguria?

A
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64
Q

Treatment of wounds for tetanus

A

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
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65
Q

Timing of post-MI complications

A

Same day: CHF
2-4 days: Acute pericarditis, arrhythmia
5-10 days: Free wall rupture, papillary muscle rupture
Weeks-months: Ventricular aneurysm

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66
Q

Lipid levels considered to be dyslipidemia

A

LDL > 130
or
HDL

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67
Q

Indications for CABG

A

UnLimiTeD

Unable to perform PCI
Left main coronary artery
Triple vessel disease
Depressed ventricular function

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68
Q

Symptoms of TCA overdose

Treatment for TCA overdose

A

CNS depression, hypotension, anticholinergic (mydriasis, dry flushed skin, ileus), QRS prolongation

Tx: Sodium bicarb

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69
Q

What is seen with anterior cord syndrome?

A

Total loss of motor function below lesion
Loss of pain/temperature sensation
Preservation of proprioception

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70
Q

When is orchiopexy performed?

A

If testes still undescended by 6mo they are unlikely to do so

Should be performed before 1y

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71
Q

Complications of cryptorchidism

A

Inguinal hernia
Testicular torsion
Subfertility
Testicular cancer

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72
Q

Definition of menorrhagia

A

Prolonged or heavy menstruation

Longer than 7d or >80 cc

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73
Q

How is ectopic pregnancy diagnosed?

A

+hCG level

Empty uterus +/- fetus observed on adnexal US

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74
Q

What immunizations are routinely given during pregnancy?

A

Tdap

IPV

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75
Q

What immunizations are contraindicated during pregnancy?

A 
HPV
MMR (wait 4 weeks)
Varicella (wait 4 weeks)
Smallpox
Live-attenuated influenza (wait 4 weeks)
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76
Q

Side effects of cyclophosphamide

How to mitigate

A

Acute hemorrhagic cystitis (acrolein-mediated)
Bladder cancer (acrolein-mediated)
Sterility
Myelosuppression

Administer MESNA with cyclophosphamide along with lots of IVF.

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77
Q

What bacteria in the blood should raise suspicion for colorectal cancer?

A

Strep gallolyticus (Strep bovis Type 1)

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78
Q

What is the treatment for acute angle closure glaucoma?

A

IV Acetazolamide

Eventual laser peripheral iridotomy

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79
Q

What is seen with open angle glaucoma?

A

Insidious loss of peripheral vision resulting in tunnel vision

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80
Q

Clinical presentation of ankylosing spondylitis

How is it diagnosed?

A

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

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81
Q

What is the initial management of ruptured esophageal varices?

A

Volume resuscitation
IV octreotide
Antibiotics

Then endoscopic sclerotherapy or band ligation

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82
Q

Treatment of acute pancreatitis

A

Analgesics
IVF
NPO
NG tube

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83
Q

What are the secondary causes of HTN?

A 
Renal parenchymal disease
Renal artery stenosis
Primary hyperaldosteronism
Pheochromocytoma
Cushing syndrome
Hypothyroidism
Primary hyperparathyroidism
Coarctation of the aorta
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84
Q

Causes of Cushing’s syndrome

A

Exogenous glucocorticoids
Ectopic ACTH production (SCLC)
ACTH-producing pituitary adenomas

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85
Q

What are the types of tremors?

A

Essential
Parkinson’s dz
Cerebellar
Physiologic

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86
Q

Characteristics of essential tremor

A

Bilateral action tremor of the hands
Relieved with alcohol
No other neurologic signs

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87
Q

Clinical presentation of opioid intoxication

A

Decreased respiratory rate (most reliable sign)
Hypotension
Hypothermia
Obtunded

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88
Q

What Ig’s are associated with PBC?

A

Anti-mitochondrial Ab’s

Also high ALK, cholesterol, and IgM

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89
Q

What Ig’s are associated with autoimmune hepatitis?

A

Anti-smooth muscle Ab’s

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90
Q

What Ig’s are associated with SLE?

A

ANA

Anti-Smith Ab’s

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91
Q

How to differentiate exudative vs. transudative pleural effusion

A

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
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92
Q

What makes a parapneumonic effusion complicated?

A

pH empyema

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93
Q

Treatment of parapneumonic effusion

A

Uncomplicated –> abx
Complicated –> abx +/- chest tube drainage
Empyema –> abx + chest tube drainage

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94
Q

What drugs can cause drug-induced lupus?

A

HIPP: Hydralazine, Isoniazid, Procainamide, Phenytoin

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95
Q

Causes of transudative pleural effusion

A

CHF
Cirrhosis
Nephrotic syndrome

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96
Q

Causes of exudative pleural effusion

A 
Pneumonia (parapneumonic effusion)
TB
Malignancy
PE
RA/SLE
Pancreatitis
Trauma
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97
Q

Treatment of bacterial conjunctivitis

A

Erythromycin ointment
Polymixin-trimethoprim drops
Azithromycin drops
FQ drops (preferred if contacts are worn)

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98
Q

Most common cause of viral conjunctivitis

A

Adenovirus

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99
Q

Treatment for pinworm infection

A

Mebendazole

Confirm diagnosis with scotch tape test

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100
Q

Murmur heard from VSD

A

Holosystolic murmur at LLSB

Apical diastolic rumble

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101
Q

Murmur of ASD

A

Widely split, fixed S2

Systolic ejection murmur at LUSB

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102
Q

What is part of the tetralogy of fallot complex

A

VSD
Overriding aorta
RVH
RV outflow obstruction

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103
Q

What causes urinary retention 2/2 anticholinergics?

A

Decreased detrusor contraction

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104
Q

How is angle closure glaucoma diagnosed?

A

Tonometry

Gonioscopy

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105
Q

How is Boerhaave syndrome diagnosed

A

CT or Gastrografin esophagography
CXR: Pneumomediastinum and pleural effusions
Pleural fluid analysis has high amylase (>2500)

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106
Q

Prophylaxis in HIV patients

A 
200 = PCP = Bactrim
150 = Histoplasma = Itraconazole
100 = Toxoplasma = Bactrim
50 = MAC = Azithromycin
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107
Q

Prophylaxis in posttransplant patients

A

Bactrim for PCP

Immunize against Influenza, pneumococcus, and HBV

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108
Q

When to perform oral glucose tolerance test

A

24-28w

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109
Q

TSH, total T4, and free T4 levels in pregnancy

A

TSH down
Total T4 way up
Free T4 slightly up

Because beta-hCG has TSH-like activity and estrogen increases TBG

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110
Q

Paraneoplastic syndromes of SCLC

A

ACTH (Cushing’s)
ADH (SIADH)
Lambert-Eaton syndrome

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111
Q

Paraneoplastic syndromes of lung SCC

A

PTHrP (hypercalcemia)

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112
Q

Most common cause of urinary obstruction in newborn males

A

Posterior urethral valves

Can cause Potter’s sequence and hydronephrosis in-utero

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113
Q

Treatment for diabetic distal neuropathy

A

1) TCA’s

2) Gabapentin

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114
Q

EPS side effects of antipsychotics

A

Acute dystonic reaction (neck, mouth, tongue, EOM)
Akithisia (restlessness)
Parkinsonism
Tardive dyskinesia (after 1-6mo)

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115
Q

Which hereditary hyperbilirubinemias present with unconjugated hyperbili?
What is the difference?

A

Gilbert’s - mild and occurs with fasting and stress

Crigler-Najjar - Severe with early death

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116
Q

Which hereditary hyperbilirubinemias present with conjugated hyperbili?
What is the difference?

A

Rotor’s syndrome - normal appearing liver

Dubin-Johnson - Black liverf

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117
Q

Treatment of the hereditary hyperbilirubinemias

A

Crigler-Najjar I - Phenobarbital
Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant

Dubin-Johnson, Rotor’s, Gilbert’s do not require treatment.

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118
Q

Lab/vitals abnormalities of LBW infants

A 
Hypoxia
Hypothermia
Hypoglycemia
Hypocalcemia
Polycythemia
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119
Q

What electrolyte derangements are seen with significant emesis?

A

Hypochloremic, hypokalemic metabolic alkalosis

Loss of HCl in vomit
Angiotensin II –> HCO3 resorption
Aldosterone –> H+ secretion and K+ secretion

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120
Q

Superior sulcus tumor possible symptoms

A

Horner syndrome
Pancoast (ulnar pain distribution, shoulder weakness)
Hoarseness (RLN)
SVC syndrome

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121
Q

Divisions of mediastinum and their masses

A

Anterior: 4 T’s (thymoma, teratoma, thyroid, terrible lymphoma)
Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma
Posterior: Neurogenic tumors

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122
Q

Beck’s triad of cardiac tamponade

A

Hypotension
Distant heart sounds
Distended jugular veins

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123
Q

When can chorionic villous sampling be done?

Amniocentesis?

A

CVS: 9-14w
Amniocentesis: 15-22w

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124
Q

When to swab for GBS

A

35w

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125
Q

Quad screen results for Edwards syndrome

A

UNDERaged at 18

All are down

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126
Q

Quad screen results for Down syndrome

A

2up 2down at 21

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127
Q

Treatment of HIV in pregnancy

A

1) Zidovudine or Nevirapine during pregnancy
2) Elective c-section if viral load over 1000
3) Zidovudine for infant
4) No breastfeeding

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128
Q

Normal fetal heart rate

Causes for bradycardia or tachycardia

A

110-160 bpm

Brady - Congenital heart malformations, hypoxia
Tachy - Hypoxia, maternal fever, fetal anemia

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129
Q

Normal variability on FHT

A

6-25 bpm

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130
Q

What does sinusoidal variability on FHT indicate?

A

Serious fetal anemia

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131
Q

Treatment of hypercalcemia 2/2 malignancy

A

Short term: Normal saline, Calcitonin

Long term: Bisphosphonates

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132
Q

Mutation seen in cri-du-chat syndrome

A

5p deletion

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133
Q

Difference between gestational and chronic HTN

A

Chronic HTN if present before 20w or persists after 12w postpartum
Gestational HTN if presents after 20w

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134
Q

Definition of preeclampsia

A

1) New-onset HTN after 20w or worsened chronic HTN

2) Proteinuria of over 300mg/24h (3+ proteins)

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135
Q

Murmur of transposition of the great vessels

A

Single S2
+/- VSD murmur

Most common early cyanotic dz

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136
Q

Murmur of tetralogy of Fallot

A

Pulmonic stenosis murmur

VSD murmur

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137
Q

Treatment of transposition of the great vessels

A 
Prostaglandins early (to maintain PFO)
Emergent surgery
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138
Q

Treatment of impetigo

A

Non-bullous (honey crusts) - Topical mupirocin

Bullous - Oral abx

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139
Q

Symptoms of multiple myeloma

A

Calcium elevated
Renal dysfunction
Anemia
Bone lesions/Back pain

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140
Q

Indications for carotid endarterectomy

A

Symptomatic 70-99%

Men asymptomatic 60-99%

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141
Q

ESR and CK in glucocorticoid myopathy

A

Both normal

Painless weakness

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142
Q

ESR and CK in Polymyalgia Rheumatica

A

ESR elevated

CK normal

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143
Q

ESR and CK in statin-induced myopathy

A

ESR normal

CK elevated

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144
Q

How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis

A

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

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145
Q

What cancers are seen with HNPCC?

A

Colon cancer

Endometrial cancer

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146
Q

What cancers are associated with nephrotic syndromes?

A

Adenocarcinoma - membranous nephropathy

Lymphoma - Minimal change disease

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147
Q

Treatment of uric acid kidney stones

A

Oral potassium citrate

Citrate alkalinizes the urine and inhibits crystallization

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148
Q

Solitary pulmonary nodule workup

A

Nonsmoker - compare to old CXR. Q3mo CXR’s. If stable for 12mo considered benign.

Smoker:

  • Chest CT
  • FNA
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149
Q

Treatment for neonatal thyrotoxicosis

A

Methimazole + beta-blocker

Caused by maternal anti-TSH receptor Ab’s

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150
Q

Extrahepatic manifestations of HCV

A

Porphyria cutanea tarda
Essential mixed cryoglobulinemia
Membranoproliferative GN

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151
Q

Symptoms of mixed cryoglobulinemia

A

Purpura
Arthralgias
Weakness
Membranoproliferative GN

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152
Q

Symptoms of galactosemia

A

Newborn with:

  • FTT
  • Bilateral cataracts
  • Jaundice
  • Hypoglycemia
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153
Q

What is a normal AFI?

A

5-20

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154
Q

At what EFW would you deliver by planned c-section due to macrosomia?

A

No DM: 5,000g

DM: 4,500g

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155
Q

What maternal titer is considered Rh-sensitized?

A

1:16

So 1:20, 1:32, etc.

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156
Q

Definition of PROM and PPROM

A

PROM: Rupture 1h or more before onset of labor
PPROM: Rupture between 20-37w

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157
Q

What blood loss is considered postpartum hemorrhage?

A

500cc via vaginal delivery

1000cc via c-section

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158
Q

Causes of postpartum hemorrhage

A

Tone (atony)
Tissue (retained placental tissue)
Trauma (of genital tract)
Thrombin (coagulopathy)

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159
Q

Diagnosis of Polymyositis/Dermatomyositis

A

1) Anti-Jo-1 Ab’s

2) Muscle biopsy

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160
Q

What antibodies are associated with SLE?

A

ANA
Anti-dsDNA
Anti-Smith

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161
Q

What antibodies are associated with RA?

A

Anti-CCP

Rheumatoid factor

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162
Q

What antibodies are associated with CREST syndrome?

A

Anti-centromere

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163
Q

What antibodies are associated with drug-induced SLE?

A

Anti-histone

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164
Q

What antibodies are associated with PBC?

A

Antimitochondrial

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165
Q

What antibodies are associated with Scleroderma?

A

ANA
Anti-Scl-70
Anti-topoisomerase I

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166
Q

What antibodies are associated with autoimmune hepatitis?

A

Anti-smooth muscle

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167
Q

What antibodies are associated with Graves’ dz?

A

Anti-TSH receptor

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168
Q

What antibodies are associated with GPA?

A

c-ANCA

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169
Q

What antibodies are associated with microscopic polyangiitis?

A

p-ANCA

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170
Q

What antibodies are associated with MCTD?

A

U1RNP antibody

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171
Q

What does Prussian Blue staining detect?

A

Hemosiderin

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172
Q

What is seen in neurofibromatosis type 1?

A

Cafe-au-lait spots
Neurofibromas
Lisch nodules (iris hamartomas)
Optic glioma

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173
Q

Eye deviation in hemiparesis

A

Thalamic lesion - eyes deviate Toward hemiparesis

Cerebral lobe - eyes deviate Contralateral from hemiparesis

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174
Q

Symptoms of carcinoid syndrome

A

Flushing
Diarrhea
Bronchospasm

Usually tumor is found in small intestine

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175
Q

What is the classic brain lesion caused by status epilepticus?

A

Cortical laminar necrosis

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176
Q

What cancer rates are affected by COC’s?

A

COC’s reduce ovarian and endometrial cancer rates

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177
Q

Causes of primary amenorrhea with normal secondary sex characteristics

A

Pregnancy
Mullerian agenesis (2/3 of vagina and uterus missing)
Imperforate hymen
Androgen insensitivity (absent pubic hair)

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178
Q

How is bone age used to workup primary amenorrhea?

A

If bone age is 12+ and no development - likely a HPG axis problem

If bone age is under 12 - likely constitutional delay

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179
Q

Initial workup for secondary amenorrhea

A

Pregnancy test
TSH
Prolactin level

If all normal, proceed to progestin challenge

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180
Q

What to order if progestin challenge produces a withdrawal bleed

A

LH

If decreased –> idiopathic anovulation
If increased –> PCOS or premature menopause

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181
Q

What to order if no withdrawal bleed after progestin challenge

A

FSH

Elevated –> Hypergonadotropic hypogonadism
Decreased –> cyclic E2/Pr test to differentiate hypogonadotropic hypogonadism vs. endometrial/anatomic problem

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182
Q

Prophylaxis in HIV patients

A 
200 = PCP = Bactrim
150 = Histoplasma = Itraconazole
100 = Toxoplasma = Bactrim
50 = MAC = Azithromycin
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1
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183
Q

Prophylaxis in posttransplant patients

A

Bactrim for PCP

Immunize against Influenza, pneumococcus, and HBV

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1
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2
3
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5
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184
Q

When to perform oral glucose tolerance test

A

24-28w

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1
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2
3
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185
Q

TSH, total T4, and free T4 levels in pregnancy

A

TSH down
Total T4 way up
Free T4 slightly up

Because beta-hCG has TSH-like activity and estrogen increases TBG

How well did you know this?
1
Not at all
2
3
4
5
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186
Q

Paraneoplastic syndromes of SCLC

A

ACTH (Cushing’s)
ADH (SIADH)
Lambert-Eaton syndrome

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1
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3
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187
Q

Paraneoplastic syndromes of lung SCC

A

PTHrP (hypercalcemia)

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188
Q

Most common cause of urinary obstruction in newborn males

A

Posterior urethral valves

Can cause Potter’s sequence and hydronephrosis in-utero

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1
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2
3
4
5
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189
Q

Treatment for diabetic distal neuropathy

A

1) TCA’s

2) Gabapentin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
190
Q

EPS side effects of antipsychotics

A

Acute dystonic reaction (neck, mouth, tongue, EOM)
Akithisia (restlessness)
Parkinsonism
Tardive dyskinesia (after 1-6mo)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
191
Q

Which hereditary hyperbilirubinemias present with unconjugated hyperbili?
What is the difference?

A

Gilbert’s - mild and occurs with fasting and stress

Crigler-Najjar - Severe with early death

How well did you know this?
1
Not at all
2
3
4
5
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192
Q

Which hereditary hyperbilirubinemias present with conjugated hyperbili?
What is the difference?

A

Rotor’s syndrome - normal appearing liver

Dubin-Johnson - Black liverf

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193
Q

Treatment of the hereditary hyperbilirubinemias

A

Crigler-Najjar I - Phenobarbital
Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant

Dubin-Johnson, Rotor’s, Gilbert’s do not require treatment.

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194
Q

Lab/vitals abnormalities of LBW infants

A 
Hypoxia
Hypothermia
Hypoglycemia
Hypocalcemia
Polycythemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
195
Q

What electrolyte derangements are seen with significant emesis?

A

Hypochloremic, hypokalemic metabolic alkalosis

Loss of HCl in vomit
Angiotensin II –> HCO3 resorption
Aldosterone –> H+ secretion and K+ secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
196
Q

Superior sulcus tumor possible symptoms

A

Horner syndrome
Pancoast (ulnar pain distribution, shoulder weakness)
Hoarseness (RLN)
SVC syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
197
Q

Divisions of mediastinum and their masses

A

Anterior: 4 T’s (thymoma, teratoma, thyroid, terrible lymphoma)
Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma
Posterior: Neurogenic tumors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
198
Q

Beck’s triad of cardiac tamponade

A

Hypotension
Distant heart sounds
Distended jugular veins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
199
Q

When can chorionic villous sampling be done?

Amniocentesis?

A

CVS: 9-14w
Amniocentesis: 15-22w

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1
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3
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200
Q

When to swab for GBS

A

35w

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201
Q

Quad screen results for Edwards syndrome

A

UNDERaged at 18

All are down

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202
Q

Quad screen results for Down syndrome

A

2up 2down at 21

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203
Q

Treatment of HIV in pregnancy

A

1) Zidovudine or Nevirapine during pregnancy
2) Elective c-section if viral load over 1000
3) Zidovudine for infant
4) No breastfeeding

How well did you know this?
1
Not at all
2
3
4
5
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204
Q

Normal fetal heart rate

Causes for bradycardia or tachycardia

A

110-160 bpm

Brady - Congenital heart malformations, hypoxia
Tachy - Hypoxia, maternal fever, fetal anemia

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1
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3
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205
Q

Normal variability on FHT

A

6-25 bpm

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206
Q

What does sinusoidal variability on FHT indicate?

A

Serious fetal anemia

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3
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207
Q

Treatment of hypercalcemia 2/2 malignancy

A

Short term: Normal saline, Calcitonin

Long term: Bisphosphonates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
208
Q

Mutation seen in cri-du-chat syndrome

A

5p deletion

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209
Q

Difference between gestational and chronic HTN

A

Chronic HTN if present before 20w or persists after 12w postpartum
Gestational HTN if presents after 20w

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210
Q

Definition of preeclampsia

A

1) New-onset HTN after 20w or worsened chronic HTN

2) Proteinuria of over 300mg/24h (3+ proteins)

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1
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3
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211
Q

Murmur of transposition of the great vessels

A

Single S2
+/- VSD murmur

Most common early cyanotic dz

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1
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3
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212
Q

Murmur of tetralogy of Fallot

A

Pulmonic stenosis murmur

VSD murmur

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213
Q

Treatment of transposition of the great vessels

A 
Prostaglandins early (to maintain PFO)
Emergent surgery
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214
Q

Treatment of impetigo

A

Non-bullous (honey crusts) - Topical mupirocin

Bullous - Oral abx

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215
Q

Symptoms of multiple myeloma

A

Calcium elevated
Renal dysfunction
Anemia
Bone lesions/Back pain

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216
Q

Indications for carotid endarterectomy

A

Symptomatic 70-99%

Men asymptomatic 60-99%

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217
Q

ESR and CK in glucocorticoid myopathy

A

Both normal

Painless weakness

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218
Q

ESR and CK in Polymyalgia Rheumatica

A

ESR elevated

CK normal

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219
Q

ESR and CK in statin-induced myopathy

A

ESR normal

CK elevated

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220
Q

How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis

A

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

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221
Q

What cancers are seen with HNPCC?

A

Colon cancer

Endometrial cancer

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222
Q

What cancers are associated with nephrotic syndromes?

A

Adenocarcinoma - membranous nephropathy

Lymphoma - Minimal change disease

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223
Q

Treatment of uric acid kidney stones

A

Oral potassium citrate

Citrate alkalinizes the urine and inhibits crystallization

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224
Q

Solitary pulmonary nodule workup

A

Nonsmoker - compare to old CXR. Q3mo CXR’s. If stable for 12mo considered benign.

Smoker:

  • Chest CT
  • FNA
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225
Q

Treatment for neonatal thyrotoxicosis

A

Methimazole + beta-blocker

Caused by maternal anti-TSH receptor Ab’s

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226
Q

Extrahepatic manifestations of HCV

A

Porphyria cutanea tarda
Essential mixed cryoglobulinemia
Membranoproliferative GN

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227
Q

Symptoms of mixed cryoglobulinemia

A

Purpura
Arthralgias
Weakness
Membranoproliferative GN

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228
Q

Symptoms of galactosemia

A

Newborn with:

  • FTT
  • Bilateral cataracts
  • Jaundice
  • Hypoglycemia
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229
Q

What is a normal AFI?

A

5-20

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230
Q

At what EFW would you deliver by planned c-section due to macrosomia?

A

No DM: 5,000g

DM: 4,500g

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231
Q

What maternal titer is considered Rh-sensitized?

A

1:16

So 1:20, 1:32, etc.

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232
Q

Definition of PROM and PPROM

A

PROM: Rupture 1h or more before onset of labor
PPROM: Rupture between 20-37w

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233
Q

What blood loss is considered postpartum hemorrhage?

A

500cc via vaginal delivery

1000cc via c-section

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234
Q

Causes of postpartum hemorrhage

A

Tone (atony)
Tissue (retained placental tissue)
Trauma (of genital tract)
Thrombin (coagulopathy)

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235
Q

Diagnosis of Polymyositis/Dermatomyositis

A

1) Anti-Jo-1 Ab’s

2) Muscle biopsy

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236
Q

What antibodies are associated with SLE?

A

ANA
Anti-dsDNA
Anti-Smith

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237
Q

What antibodies are associated with RA?

A

Anti-CCP

Rheumatoid factor

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238
Q

What antibodies are associated with CREST syndrome?

A

Anti-centromere

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239
Q

What antibodies are associated with drug-induced SLE?

A

Anti-histone

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240
Q

What antibodies are associated with PBC?

A

Antimitochondrial

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241
Q

What antibodies are associated with Scleroderma?

A

ANA
Anti-Scl-70
Anti-topoisomerase I

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242
Q

What antibodies are associated with autoimmune hepatitis?

A

Anti-smooth muscle

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243
Q

What antibodies are associated with Graves’ dz?

A

Anti-TSH receptor

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244
Q

What antibodies are associated with GPA?

A

c-ANCA

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245
Q

What antibodies are associated with microscopic polyangiitis?

A

p-ANCA

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246
Q

What antibodies are associated with MCTD?

A

U1RNP antibody

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247
Q

What does Prussian Blue staining detect?

A

Hemosiderin

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248
Q

What is seen in neurofibromatosis type 1?

A

Cafe-au-lait spots
Neurofibromas
Lisch nodules (iris hamartomas)
Optic glioma

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249
Q

Eye deviation in hemiparesis

A

Thalamic lesion - eyes deviate Toward hemiparesis

Cerebral lobe - eyes deviate Contralateral from hemiparesis

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250
Q

Symptoms of carcinoid syndrome

A

Flushing
Diarrhea
Bronchospasm

Usually tumor is found in small intestine

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251
Q

What is the classic brain lesion caused by status epilepticus?

A

Cortical laminar necrosis

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252
Q

What cancer rates are affected by COC’s?

A

COC’s reduce ovarian and endometrial cancer rates

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253
Q

Causes of primary amenorrhea with normal secondary sex characteristics

A

Pregnancy
Mullerian agenesis (2/3 of vagina and uterus missing)
Imperforate hymen
Androgen insensitivity (absent pubic hair)

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254
Q

How is bone age used to workup primary amenorrhea?

A

If bone age is 12+ and no development - likely a HPG axis problem

If bone age is under 12 - likely constitutional delay

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255
Q

Initial workup for secondary amenorrhea

A

Pregnancy test
TSH
Prolactin level

If all normal, proceed to progestin challenge

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256
Q

What to order if progestin challenge produces a withdrawal bleed

A

LH

If decreased –> idiopathic anovulation
If increased –> PCOS or premature menopause

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257
Q

What to order if no withdrawal bleed after progestin challenge

A

FSH

Elevated –> Hypergonadotropic hypogonadism
Decreased –> cyclic E2/Pr test to differentiate hypogonadotropic hypogonadism vs. endometrial/anatomic problem

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258
Q

Prophylaxis in HIV patients

A 
200 = PCP = Bactrim
150 = Histoplasma = Itraconazole
100 = Toxoplasma = Bactrim
50 = MAC = Azithromycin
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259
Q

Prophylaxis in posttransplant patients

A

Bactrim for PCP

Immunize against Influenza, pneumococcus, and HBV

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260
Q

When to perform oral glucose tolerance test

A

24-28w

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261
Q

TSH, total T4, and free T4 levels in pregnancy

A

TSH down
Total T4 way up
Free T4 slightly up

Because beta-hCG has TSH-like activity and estrogen increases TBG

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262
Q

Paraneoplastic syndromes of SCLC

A

ACTH (Cushing’s)
ADH (SIADH)
Lambert-Eaton syndrome

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263
Q

Paraneoplastic syndromes of lung SCC

A

PTHrP (hypercalcemia)

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264
Q

Most common cause of urinary obstruction in newborn males

A

Posterior urethral valves

Can cause Potter’s sequence and hydronephrosis in-utero

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265
Q

Treatment for diabetic distal neuropathy

A

1) TCA’s

2) Gabapentin

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266
Q

EPS side effects of antipsychotics

A

Acute dystonic reaction (neck, mouth, tongue, EOM)
Akithisia (restlessness)
Parkinsonism
Tardive dyskinesia (after 1-6mo)

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267
Q

Which hereditary hyperbilirubinemias present with unconjugated hyperbili?
What is the difference?

A

Gilbert’s - mild and occurs with fasting and stress

Crigler-Najjar - Severe with early death

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268
Q

Which hereditary hyperbilirubinemias present with conjugated hyperbili?
What is the difference?

A

Rotor’s syndrome - normal appearing liver

Dubin-Johnson - Black liverf

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269
Q

Treatment of the hereditary hyperbilirubinemias

A

Crigler-Najjar I - Phenobarbital
Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant

Dubin-Johnson, Rotor’s, Gilbert’s do not require treatment.

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270
Q

Lab/vitals abnormalities of LBW infants

A 
Hypoxia
Hypothermia
Hypoglycemia
Hypocalcemia
Polycythemia
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271
Q

What electrolyte derangements are seen with significant emesis?

A

Hypochloremic, hypokalemic metabolic alkalosis

Loss of HCl in vomit
Angiotensin II –> HCO3 resorption
Aldosterone –> H+ secretion and K+ secretion

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272
Q

Superior sulcus tumor possible symptoms

A

Horner syndrome
Pancoast (ulnar pain distribution, shoulder weakness)
Hoarseness (RLN)
SVC syndrome

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273
Q

Divisions of mediastinum and their masses

A

Anterior: 4 T’s (thymoma, teratoma, thyroid, terrible lymphoma)
Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma
Posterior: Neurogenic tumors

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274
Q

Beck’s triad of cardiac tamponade

A

Hypotension
Distant heart sounds
Distended jugular veins

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275
Q

When can chorionic villous sampling be done?

Amniocentesis?

A

CVS: 9-14w
Amniocentesis: 15-22w

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276
Q

When to swab for GBS

A

35w

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277
Q

Quad screen results for Edwards syndrome

A

UNDERaged at 18

All are down

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278
Q

Quad screen results for Down syndrome

A

2up 2down at 21

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279
Q

Treatment of HIV in pregnancy

A

1) Zidovudine or Nevirapine during pregnancy
2) Elective c-section if viral load over 1000
3) Zidovudine for infant
4) No breastfeeding

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280
Q

Normal fetal heart rate

Causes for bradycardia or tachycardia

A

110-160 bpm

Brady - Congenital heart malformations, hypoxia
Tachy - Hypoxia, maternal fever, fetal anemia

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281
Q

Normal variability on FHT

A

6-25 bpm

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282
Q

What does sinusoidal variability on FHT indicate?

A

Serious fetal anemia

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283
Q

Treatment of hypercalcemia 2/2 malignancy

A

Short term: Normal saline, Calcitonin

Long term: Bisphosphonates

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284
Q

Mutation seen in cri-du-chat syndrome

A

5p deletion

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285
Q

Difference between gestational and chronic HTN

A

Chronic HTN if present before 20w or persists after 12w postpartum
Gestational HTN if presents after 20w

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286
Q

Definition of preeclampsia

A

1) New-onset HTN after 20w or worsened chronic HTN

2) Proteinuria of over 300mg/24h (3+ proteins)

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287
Q

Murmur of transposition of the great vessels

A

Single S2
+/- VSD murmur

Most common early cyanotic dz

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288
Q

Murmur of tetralogy of Fallot

A

Pulmonic stenosis murmur

VSD murmur

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289
Q

Treatment of transposition of the great vessels

A 
Prostaglandins early (to maintain PFO)
Emergent surgery
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290
Q

Treatment of impetigo

A

Non-bullous (honey crusts) - Topical mupirocin

Bullous - Oral abx

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3
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291
Q

Symptoms of multiple myeloma

A

Calcium elevated
Renal dysfunction
Anemia
Bone lesions/Back pain

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2
3
4
5
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292
Q

Indications for carotid endarterectomy

A

Symptomatic 70-99%

Men asymptomatic 60-99%

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293
Q

ESR and CK in glucocorticoid myopathy

A

Both normal

Painless weakness

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294
Q

ESR and CK in Polymyalgia Rheumatica

A

ESR elevated

CK normal

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295
Q

ESR and CK in statin-induced myopathy

A

ESR normal

CK elevated

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296
Q

How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis

A

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

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297
Q

What cancers are seen with HNPCC?

A

Colon cancer

Endometrial cancer

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4
5
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298
Q

What cancers are associated with nephrotic syndromes?

A

Adenocarcinoma - membranous nephropathy

Lymphoma - Minimal change disease

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2
3
4
5
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299
Q

Treatment of uric acid kidney stones

A

Oral potassium citrate

Citrate alkalinizes the urine and inhibits crystallization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
300
Q

Solitary pulmonary nodule workup

A

Nonsmoker - compare to old CXR. Q3mo CXR’s. If stable for 12mo considered benign.

Smoker:

  • Chest CT
  • FNA
How well did you know this?
1
Not at all
2
3
4
5
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301
Q

Treatment for neonatal thyrotoxicosis

A

Methimazole + beta-blocker

Caused by maternal anti-TSH receptor Ab’s

How well did you know this?
1
Not at all
2
3
4
5
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302
Q

Extrahepatic manifestations of HCV

A

Porphyria cutanea tarda
Essential mixed cryoglobulinemia
Membranoproliferative GN

How well did you know this?
1
Not at all
2
3
4
5
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303
Q

Symptoms of mixed cryoglobulinemia

A

Purpura
Arthralgias
Weakness
Membranoproliferative GN

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1
Not at all
2
3
4
5
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304
Q

Symptoms of galactosemia

A

Newborn with:

  • FTT
  • Bilateral cataracts
  • Jaundice
  • Hypoglycemia
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1
Not at all
2
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305
Q

What is a normal AFI?

A

5-20

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306
Q

At what EFW would you deliver by planned c-section due to macrosomia?

A

No DM: 5,000g

DM: 4,500g

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307
Q

What maternal titer is considered Rh-sensitized?

A

1:16

So 1:20, 1:32, etc.

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308
Q

Definition of PROM and PPROM

A

PROM: Rupture 1h or more before onset of labor
PPROM: Rupture between 20-37w

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309
Q

What blood loss is considered postpartum hemorrhage?

A

500cc via vaginal delivery

1000cc via c-section

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310
Q

Causes of postpartum hemorrhage

A

Tone (atony)
Tissue (retained placental tissue)
Trauma (of genital tract)
Thrombin (coagulopathy)

How well did you know this?
1
Not at all
2
3
4
5
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311
Q

Diagnosis of Polymyositis/Dermatomyositis

A

1) Anti-Jo-1 Ab’s

2) Muscle biopsy

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1
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2
3
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5
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312
Q

What antibodies are associated with SLE?

A

ANA
Anti-dsDNA
Anti-Smith

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5
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313
Q

What antibodies are associated with RA?

A

Anti-CCP

Rheumatoid factor

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314
Q

What antibodies are associated with CREST syndrome?

A

Anti-centromere

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315
Q

What antibodies are associated with drug-induced SLE?

A

Anti-histone

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316
Q

What antibodies are associated with PBC?

A

Antimitochondrial

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317
Q

What antibodies are associated with Scleroderma?

A

ANA
Anti-Scl-70
Anti-topoisomerase I

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318
Q

What antibodies are associated with autoimmune hepatitis?

A

Anti-smooth muscle

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319
Q

What antibodies are associated with Graves’ dz?

A

Anti-TSH receptor

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320
Q

What antibodies are associated with GPA?

A

c-ANCA

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321
Q

What antibodies are associated with microscopic polyangiitis?

A

p-ANCA

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322
Q

What antibodies are associated with MCTD?

A

U1RNP antibody

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323
Q

What does Prussian Blue staining detect?

A

Hemosiderin

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324
Q

What is seen in neurofibromatosis type 1?

A

Cafe-au-lait spots
Neurofibromas
Lisch nodules (iris hamartomas)
Optic glioma

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325
Q

Eye deviation in hemiparesis

A

Thalamic lesion - eyes deviate Toward hemiparesis

Cerebral lobe - eyes deviate Contralateral from hemiparesis

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326
Q

Symptoms of carcinoid syndrome

A

Flushing
Diarrhea
Bronchospasm

Usually tumor is found in small intestine

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327
Q

What is the classic brain lesion caused by status epilepticus?

A

Cortical laminar necrosis

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328
Q

What cancer rates are affected by COC’s?

A

COC’s reduce ovarian and endometrial cancer rates

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329
Q

Causes of primary amenorrhea with normal secondary sex characteristics

A

Pregnancy
Mullerian agenesis (2/3 of vagina and uterus missing)
Imperforate hymen
Androgen insensitivity (absent pubic hair)

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330
Q

How is bone age used to workup primary amenorrhea?

A

If bone age is 12+ and no development - likely a HPG axis problem

If bone age is under 12 - likely constitutional delay

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331
Q

Initial workup for secondary amenorrhea

A

Pregnancy test
TSH
Prolactin level

If all normal, proceed to progestin challenge

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332
Q

What to order if progestin challenge produces a withdrawal bleed

A

LH

If decreased –> idiopathic anovulation
If increased –> PCOS or premature menopause

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333
Q

What to order if no withdrawal bleed after progestin challenge

A

FSH

Elevated –> Hypergonadotropic hypogonadism
Decreased –> cyclic E2/Pr test to differentiate hypogonadotropic hypogonadism vs. endometrial/anatomic problem

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334
Q

Prophylaxis in HIV patients

A 
200 = PCP = Bactrim
150 = Histoplasma = Itraconazole
100 = Toxoplasma = Bactrim
50 = MAC = Azithromycin
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335
Q

Prophylaxis in posttransplant patients

A

Bactrim for PCP

Immunize against Influenza, pneumococcus, and HBV

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336
Q

When to perform oral glucose tolerance test

A

24-28w

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337
Q

TSH, total T4, and free T4 levels in pregnancy

A

TSH down
Total T4 way up
Free T4 slightly up

Because beta-hCG has TSH-like activity and estrogen increases TBG

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338
Q

Paraneoplastic syndromes of SCLC

A

ACTH (Cushing’s)
ADH (SIADH)
Lambert-Eaton syndrome

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339
Q

Paraneoplastic syndromes of lung SCC

A

PTHrP (hypercalcemia)

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340
Q

Most common cause of urinary obstruction in newborn males

A

Posterior urethral valves

Can cause Potter’s sequence and hydronephrosis in-utero

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341
Q

Treatment for diabetic distal neuropathy

A

1) TCA’s

2) Gabapentin

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342
Q

EPS side effects of antipsychotics

A

Acute dystonic reaction (neck, mouth, tongue, EOM)
Akithisia (restlessness)
Parkinsonism
Tardive dyskinesia (after 1-6mo)

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343
Q

Which hereditary hyperbilirubinemias present with unconjugated hyperbili?
What is the difference?

A

Gilbert’s - mild and occurs with fasting and stress

Crigler-Najjar - Severe with early death

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344
Q

Which hereditary hyperbilirubinemias present with conjugated hyperbili?
What is the difference?

A

Rotor’s syndrome - normal appearing liver

Dubin-Johnson - Black liverf

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345
Q

Treatment of the hereditary hyperbilirubinemias

A

Crigler-Najjar I - Phenobarbital
Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant

Dubin-Johnson, Rotor’s, Gilbert’s do not require treatment.

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346
Q

Lab/vitals abnormalities of LBW infants

A 
Hypoxia
Hypothermia
Hypoglycemia
Hypocalcemia
Polycythemia
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347
Q

What electrolyte derangements are seen with significant emesis?

A

Hypochloremic, hypokalemic metabolic alkalosis

Loss of HCl in vomit
Angiotensin II –> HCO3 resorption
Aldosterone –> H+ secretion and K+ secretion

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348
Q

Superior sulcus tumor possible symptoms

A

Horner syndrome
Pancoast (ulnar pain distribution, shoulder weakness)
Hoarseness (RLN)
SVC syndrome

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349
Q

Divisions of mediastinum and their masses

A

Anterior: 4 T’s (thymoma, teratoma, thyroid, terrible lymphoma)
Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma
Posterior: Neurogenic tumors

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350
Q

Beck’s triad of cardiac tamponade

A

Hypotension
Distant heart sounds
Distended jugular veins

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351
Q

When can chorionic villous sampling be done?

Amniocentesis?

A

CVS: 9-14w
Amniocentesis: 15-22w

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352
Q

When to swab for GBS

A

35w

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353
Q

Quad screen results for Edwards syndrome

A

UNDERaged at 18

All are down

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354
Q

Quad screen results for Down syndrome

A

2up 2down at 21

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355
Q

Treatment of HIV in pregnancy

A

1) Zidovudine or Nevirapine during pregnancy
2) Elective c-section if viral load over 1000
3) Zidovudine for infant
4) No breastfeeding

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356
Q

Normal fetal heart rate

Causes for bradycardia or tachycardia

A

110-160 bpm

Brady - Congenital heart malformations, hypoxia
Tachy - Hypoxia, maternal fever, fetal anemia

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357
Q

Normal variability on FHT

A

6-25 bpm

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358
Q

What does sinusoidal variability on FHT indicate?

A

Serious fetal anemia

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359
Q

Treatment of hypercalcemia 2/2 malignancy

A

Short term: Normal saline, Calcitonin

Long term: Bisphosphonates

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360
Q

Mutation seen in cri-du-chat syndrome

A

5p deletion

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361
Q

Difference between gestational and chronic HTN

A

Chronic HTN if present before 20w or persists after 12w postpartum
Gestational HTN if presents after 20w

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362
Q

Definition of preeclampsia

A

1) New-onset HTN after 20w or worsened chronic HTN

2) Proteinuria of over 300mg/24h (3+ proteins)

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363
Q

Murmur of transposition of the great vessels

A

Single S2
+/- VSD murmur

Most common early cyanotic dz

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364
Q

Murmur of tetralogy of Fallot

A

Pulmonic stenosis murmur

VSD murmur

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365
Q

Treatment of transposition of the great vessels

A 
Prostaglandins early (to maintain PFO)
Emergent surgery
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366
Q

Treatment of impetigo

A

Non-bullous (honey crusts) - Topical mupirocin

Bullous - Oral abx

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367
Q

Symptoms of multiple myeloma

A

Calcium elevated
Renal dysfunction
Anemia
Bone lesions/Back pain

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368
Q

Indications for carotid endarterectomy

A

Symptomatic 70-99%

Men asymptomatic 60-99%

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369
Q

ESR and CK in glucocorticoid myopathy

A

Both normal

Painless weakness

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370
Q

ESR and CK in Polymyalgia Rheumatica

A

ESR elevated

CK normal

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371
Q

ESR and CK in statin-induced myopathy

A

ESR normal

CK elevated

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372
Q

How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis

A

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

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373
Q

What cancers are seen with HNPCC?

A

Colon cancer

Endometrial cancer

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374
Q

What cancers are associated with nephrotic syndromes?

A

Adenocarcinoma - membranous nephropathy

Lymphoma - Minimal change disease

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375
Q

Treatment of uric acid kidney stones

A

Oral potassium citrate

Citrate alkalinizes the urine and inhibits crystallization

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376
Q

Solitary pulmonary nodule workup

A

Nonsmoker - compare to old CXR. Q3mo CXR’s. If stable for 12mo considered benign.

Smoker:

  • Chest CT
  • FNA
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377
Q

Treatment for neonatal thyrotoxicosis

A

Methimazole + beta-blocker

Caused by maternal anti-TSH receptor Ab’s

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378
Q

Extrahepatic manifestations of HCV

A

Porphyria cutanea tarda
Essential mixed cryoglobulinemia
Membranoproliferative GN

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379
Q

Symptoms of mixed cryoglobulinemia

A

Purpura
Arthralgias
Weakness
Membranoproliferative GN

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380
Q

Symptoms of galactosemia

A

Newborn with:

  • FTT
  • Bilateral cataracts
  • Jaundice
  • Hypoglycemia
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381
Q

What is a normal AFI?

A

5-20

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382
Q

At what EFW would you deliver by planned c-section due to macrosomia?

A

No DM: 5,000g

DM: 4,500g

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383
Q

What maternal titer is considered Rh-sensitized?

A

1:16

So 1:20, 1:32, etc.

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384
Q

Definition of PROM and PPROM

A

PROM: Rupture 1h or more before onset of labor
PPROM: Rupture between 20-37w

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385
Q

What blood loss is considered postpartum hemorrhage?

A

500cc via vaginal delivery

1000cc via c-section

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386
Q

Causes of postpartum hemorrhage

A

Tone (atony)
Tissue (retained placental tissue)
Trauma (of genital tract)
Thrombin (coagulopathy)

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387
Q

Diagnosis of Polymyositis/Dermatomyositis

A

1) Anti-Jo-1 Ab’s

2) Muscle biopsy

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388
Q

What antibodies are associated with SLE?

A

ANA
Anti-dsDNA
Anti-Smith

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389
Q

What antibodies are associated with RA?

A

Anti-CCP

Rheumatoid factor

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390
Q

What antibodies are associated with CREST syndrome?

A

Anti-centromere

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391
Q

What antibodies are associated with drug-induced SLE?

A

Anti-histone

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392
Q

What antibodies are associated with PBC?

A

Antimitochondrial

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393
Q

What antibodies are associated with Scleroderma?

A

ANA
Anti-Scl-70
Anti-topoisomerase I

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394
Q

What antibodies are associated with autoimmune hepatitis?

A

Anti-smooth muscle

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395
Q

What antibodies are associated with Graves’ dz?

A

Anti-TSH receptor

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396
Q

What antibodies are associated with GPA?

A

c-ANCA

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397
Q

What antibodies are associated with microscopic polyangiitis?

A

p-ANCA

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398
Q

What antibodies are associated with MCTD?

A

U1RNP antibody

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399
Q

What does Prussian Blue staining detect?

A

Hemosiderin

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400
Q

What is seen in neurofibromatosis type 1?

A

Cafe-au-lait spots
Neurofibromas
Lisch nodules (iris hamartomas)
Optic glioma

How well did you know this?
1
Not at all
2
3
4
5
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401
Q

Eye deviation in hemiparesis

A

Thalamic lesion - eyes deviate Toward hemiparesis

Cerebral lobe - eyes deviate Contralateral from hemiparesis

How well did you know this?
1
Not at all
2
3
4
5
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402
Q

Symptoms of carcinoid syndrome

A

Flushing
Diarrhea
Bronchospasm

Usually tumor is found in small intestine

How well did you know this?
1
Not at all
2
3
4
5
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403
Q

What is the classic brain lesion caused by status epilepticus?

A

Cortical laminar necrosis

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2
3
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5
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404
Q

What cancer rates are affected by COC’s?

A

COC’s reduce ovarian and endometrial cancer rates

How well did you know this?
1
Not at all
2
3
4
5
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405
Q

Causes of primary amenorrhea with normal secondary sex characteristics

A

Pregnancy
Mullerian agenesis (2/3 of vagina and uterus missing)
Imperforate hymen
Androgen insensitivity (absent pubic hair)

How well did you know this?
1
Not at all
2
3
4
5
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406
Q

How is bone age used to workup primary amenorrhea?

A

If bone age is 12+ and no development - likely a HPG axis problem

If bone age is under 12 - likely constitutional delay

How well did you know this?
1
Not at all
2
3
4
5
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407
Q

Initial workup for secondary amenorrhea

A

Pregnancy test
TSH
Prolactin level

If all normal, proceed to progestin challenge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
408
Q

What to order if progestin challenge produces a withdrawal bleed

A

LH

If decreased –> idiopathic anovulation
If increased –> PCOS or premature menopause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
409
Q

What to order if no withdrawal bleed after progestin challenge

A

FSH

Elevated –> Hypergonadotropic hypogonadism
Decreased –> cyclic E2/Pr test to differentiate hypogonadotropic hypogonadism vs. endometrial/anatomic problem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
410
Q

Prophylaxis in HIV patients

A 
200 = PCP = Bactrim
150 = Histoplasma = Itraconazole
100 = Toxoplasma = Bactrim
50 = MAC = Azithromycin
How well did you know this?
1
Not at all
2
3
4
5
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411
Q

Prophylaxis in posttransplant patients

A

Bactrim for PCP

Immunize against Influenza, pneumococcus, and HBV

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1
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2
3
4
5
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412
Q

When to perform oral glucose tolerance test

A

24-28w

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1
Not at all
2
3
4
5
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413
Q

TSH, total T4, and free T4 levels in pregnancy

A

TSH down
Total T4 way up
Free T4 slightly up

Because beta-hCG has TSH-like activity and estrogen increases TBG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
414
Q

Paraneoplastic syndromes of SCLC

A

ACTH (Cushing’s)
ADH (SIADH)
Lambert-Eaton syndrome

How well did you know this?
1
Not at all
2
3
4
5
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415
Q

Paraneoplastic syndromes of lung SCC

A

PTHrP (hypercalcemia)

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2
3
4
5
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416
Q

Most common cause of urinary obstruction in newborn males

A

Posterior urethral valves

Can cause Potter’s sequence and hydronephrosis in-utero

How well did you know this?
1
Not at all
2
3
4
5
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417
Q

Treatment for diabetic distal neuropathy

A

1) TCA’s

2) Gabapentin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
418
Q

EPS side effects of antipsychotics

A

Acute dystonic reaction (neck, mouth, tongue, EOM)
Akithisia (restlessness)
Parkinsonism
Tardive dyskinesia (after 1-6mo)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
419
Q

Which hereditary hyperbilirubinemias present with unconjugated hyperbili?
What is the difference?

A

Gilbert’s - mild and occurs with fasting and stress

Crigler-Najjar - Severe with early death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
420
Q

Which hereditary hyperbilirubinemias present with conjugated hyperbili?
What is the difference?

A

Rotor’s syndrome - normal appearing liver

Dubin-Johnson - Black liverf

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1
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3
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421
Q

Treatment of the hereditary hyperbilirubinemias

A

Crigler-Najjar I - Phenobarbital
Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant

Dubin-Johnson, Rotor’s, Gilbert’s do not require treatment.

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1
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5
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422
Q

Lab/vitals abnormalities of LBW infants

A 
Hypoxia
Hypothermia
Hypoglycemia
Hypocalcemia
Polycythemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
423
Q

What electrolyte derangements are seen with significant emesis?

A

Hypochloremic, hypokalemic metabolic alkalosis

Loss of HCl in vomit
Angiotensin II –> HCO3 resorption
Aldosterone –> H+ secretion and K+ secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
424
Q

Superior sulcus tumor possible symptoms

A

Horner syndrome
Pancoast (ulnar pain distribution, shoulder weakness)
Hoarseness (RLN)
SVC syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
425
Q

Divisions of mediastinum and their masses

A

Anterior: 4 T’s (thymoma, teratoma, thyroid, terrible lymphoma)
Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma
Posterior: Neurogenic tumors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
426
Q

Beck’s triad of cardiac tamponade

A

Hypotension
Distant heart sounds
Distended jugular veins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
427
Q

When can chorionic villous sampling be done?

Amniocentesis?

A

CVS: 9-14w
Amniocentesis: 15-22w

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1
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428
Q

When to swab for GBS

A

35w

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429
Q

Quad screen results for Edwards syndrome

A

UNDERaged at 18

All are down

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430
Q

Quad screen results for Down syndrome

A

2up 2down at 21

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431
Q

Treatment of HIV in pregnancy

A

1) Zidovudine or Nevirapine during pregnancy
2) Elective c-section if viral load over 1000
3) Zidovudine for infant
4) No breastfeeding

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432
Q

Normal fetal heart rate

Causes for bradycardia or tachycardia

A

110-160 bpm

Brady - Congenital heart malformations, hypoxia
Tachy - Hypoxia, maternal fever, fetal anemia

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433
Q

Normal variability on FHT

A

6-25 bpm

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434
Q

What does sinusoidal variability on FHT indicate?

A

Serious fetal anemia

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435
Q

Treatment of hypercalcemia 2/2 malignancy

A

Short term: Normal saline, Calcitonin

Long term: Bisphosphonates

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436
Q

Mutation seen in cri-du-chat syndrome

A

5p deletion

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437
Q

Difference between gestational and chronic HTN

A

Chronic HTN if present before 20w or persists after 12w postpartum
Gestational HTN if presents after 20w

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438
Q

Definition of preeclampsia

A

1) New-onset HTN after 20w or worsened chronic HTN

2) Proteinuria of over 300mg/24h (3+ proteins)

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439
Q

Murmur of transposition of the great vessels

A

Single S2
+/- VSD murmur

Most common early cyanotic dz

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440
Q

Murmur of tetralogy of Fallot

A

Pulmonic stenosis murmur

VSD murmur

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441
Q

Treatment of transposition of the great vessels

A 
Prostaglandins early (to maintain PFO)
Emergent surgery
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442
Q

Treatment of impetigo

A

Non-bullous (honey crusts) - Topical mupirocin

Bullous - Oral abx

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443
Q

Symptoms of multiple myeloma

A

Calcium elevated
Renal dysfunction
Anemia
Bone lesions/Back pain

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444
Q

Indications for carotid endarterectomy

A

Symptomatic 70-99%

Men asymptomatic 60-99%

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445
Q

ESR and CK in glucocorticoid myopathy

A

Both normal

Painless weakness

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446
Q

ESR and CK in Polymyalgia Rheumatica

A

ESR elevated

CK normal

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447
Q

ESR and CK in statin-induced myopathy

A

ESR normal

CK elevated

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448
Q

How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis

A

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

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449
Q

What cancers are seen with HNPCC?

A

Colon cancer

Endometrial cancer

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450
Q

What cancers are associated with nephrotic syndromes?

A

Adenocarcinoma - membranous nephropathy

Lymphoma - Minimal change disease

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451
Q

Treatment of uric acid kidney stones

A

Oral potassium citrate

Citrate alkalinizes the urine and inhibits crystallization

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452
Q

Solitary pulmonary nodule workup

A

Nonsmoker - compare to old CXR. Q3mo CXR’s. If stable for 12mo considered benign.

Smoker:

  • Chest CT
  • FNA
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453
Q

Treatment for neonatal thyrotoxicosis

A

Methimazole + beta-blocker

Caused by maternal anti-TSH receptor Ab’s

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454
Q

Extrahepatic manifestations of HCV

A

Porphyria cutanea tarda
Essential mixed cryoglobulinemia
Membranoproliferative GN

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455
Q

Symptoms of mixed cryoglobulinemia

A

Purpura
Arthralgias
Weakness
Membranoproliferative GN

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456
Q

Symptoms of galactosemia

A

Newborn with:

  • FTT
  • Bilateral cataracts
  • Jaundice
  • Hypoglycemia
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457
Q

What is a normal AFI?

A

5-20

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458
Q

At what EFW would you deliver by planned c-section due to macrosomia?

A

No DM: 5,000g

DM: 4,500g

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459
Q

What maternal titer is considered Rh-sensitized?

A

1:16

So 1:20, 1:32, etc.

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460
Q

Definition of PROM and PPROM

A

PROM: Rupture 1h or more before onset of labor
PPROM: Rupture between 20-37w

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461
Q

What blood loss is considered postpartum hemorrhage?

A

500cc via vaginal delivery

1000cc via c-section

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462
Q

Causes of postpartum hemorrhage

A

Tone (atony)
Tissue (retained placental tissue)
Trauma (of genital tract)
Thrombin (coagulopathy)

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463
Q

Diagnosis of Polymyositis/Dermatomyositis

A

1) Anti-Jo-1 Ab’s

2) Muscle biopsy

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464
Q

What antibodies are associated with SLE?

A

ANA
Anti-dsDNA
Anti-Smith

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465
Q

What antibodies are associated with RA?

A

Anti-CCP

Rheumatoid factor

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466
Q

What antibodies are associated with CREST syndrome?

A

Anti-centromere

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467
Q

What antibodies are associated with drug-induced SLE?

A

Anti-histone

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468
Q

What antibodies are associated with PBC?

A

Antimitochondrial

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469
Q

What antibodies are associated with Scleroderma?

A

ANA
Anti-Scl-70
Anti-topoisomerase I

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470
Q

What antibodies are associated with autoimmune hepatitis?

A

Anti-smooth muscle

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471
Q

What antibodies are associated with Graves’ dz?

A

Anti-TSH receptor

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472
Q

What antibodies are associated with GPA?

A

c-ANCA

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473
Q

What antibodies are associated with microscopic polyangiitis?

A

p-ANCA

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474
Q

What antibodies are associated with MCTD?

A

U1RNP antibody

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475
Q

What does Prussian Blue staining detect?

A

Hemosiderin

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476
Q

What is seen in neurofibromatosis type 1?

A

Cafe-au-lait spots
Neurofibromas
Lisch nodules (iris hamartomas)
Optic glioma

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477
Q

Eye deviation in hemiparesis

A

Thalamic lesion - eyes deviate Toward hemiparesis

Cerebral lobe - eyes deviate Contralateral from hemiparesis

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478
Q

Symptoms of carcinoid syndrome

A

Flushing
Diarrhea
Bronchospasm

Usually tumor is found in small intestine

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479
Q

What is the classic brain lesion caused by status epilepticus?

A

Cortical laminar necrosis

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480
Q

What cancer rates are affected by COC’s?

A

COC’s reduce ovarian and endometrial cancer rates

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481
Q

Causes of primary amenorrhea with normal secondary sex characteristics

A

Pregnancy
Mullerian agenesis (2/3 of vagina and uterus missing)
Imperforate hymen
Androgen insensitivity (absent pubic hair)

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482
Q

How is bone age used to workup primary amenorrhea?

A

If bone age is 12+ and no development - likely a HPG axis problem

If bone age is under 12 - likely constitutional delay

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483
Q

Initial workup for secondary amenorrhea

A

Pregnancy test
TSH
Prolactin level

If all normal, proceed to progestin challenge

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484
Q

What to order if progestin challenge produces a withdrawal bleed

A

LH

If decreased –> idiopathic anovulation
If increased –> PCOS or premature menopause

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485
Q

What to order if no withdrawal bleed after progestin challenge

A

FSH

Elevated –> Hypergonadotropic hypogonadism
Decreased –> cyclic E2/Pr test to differentiate hypogonadotropic hypogonadism vs. endometrial/anatomic problem

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486
Q

Prophylaxis in HIV patients

A 
200 = PCP = Bactrim
150 = Histoplasma = Itraconazole
100 = Toxoplasma = Bactrim
50 = MAC = Azithromycin
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487
Q

Prophylaxis in posttransplant patients

A

Bactrim for PCP

Immunize against Influenza, pneumococcus, and HBV

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488
Q

When to perform oral glucose tolerance test

A

24-28w

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489
Q

TSH, total T4, and free T4 levels in pregnancy

A

TSH down
Total T4 way up
Free T4 slightly up

Because beta-hCG has TSH-like activity and estrogen increases TBG

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490
Q

Paraneoplastic syndromes of SCLC

A

ACTH (Cushing’s)
ADH (SIADH)
Lambert-Eaton syndrome

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491
Q

Paraneoplastic syndromes of lung SCC

A

PTHrP (hypercalcemia)

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492
Q

Most common cause of urinary obstruction in newborn males

A

Posterior urethral valves

Can cause Potter’s sequence and hydronephrosis in-utero

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493
Q

Treatment for diabetic distal neuropathy

A

1) TCA’s

2) Gabapentin

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494
Q

EPS side effects of antipsychotics

A

Acute dystonic reaction (neck, mouth, tongue, EOM)
Akithisia (restlessness)
Parkinsonism
Tardive dyskinesia (after 1-6mo)

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495
Q

Which hereditary hyperbilirubinemias present with unconjugated hyperbili?
What is the difference?

A

Gilbert’s - mild and occurs with fasting and stress

Crigler-Najjar - Severe with early death

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496
Q

Which hereditary hyperbilirubinemias present with conjugated hyperbili?
What is the difference?

A

Rotor’s syndrome - normal appearing liver

Dubin-Johnson - Black liverf

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497
Q

Treatment of the hereditary hyperbilirubinemias

A

Crigler-Najjar I - Phenobarbital
Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant

Dubin-Johnson, Rotor’s, Gilbert’s do not require treatment.

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498
Q

Lab/vitals abnormalities of LBW infants

A 
Hypoxia
Hypothermia
Hypoglycemia
Hypocalcemia
Polycythemia
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499
Q

What electrolyte derangements are seen with significant emesis?

A

Hypochloremic, hypokalemic metabolic alkalosis

Loss of HCl in vomit
Angiotensin II –> HCO3 resorption
Aldosterone –> H+ secretion and K+ secretion

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500
Q

Superior sulcus tumor possible symptoms

A

Horner syndrome
Pancoast (ulnar pain distribution, shoulder weakness)
Hoarseness (RLN)
SVC syndrome

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501
Q

Divisions of mediastinum and their masses

A

Anterior: 4 T’s (thymoma, teratoma, thyroid, terrible lymphoma)
Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma
Posterior: Neurogenic tumors

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502
Q

Beck’s triad of cardiac tamponade

A

Hypotension
Distant heart sounds
Distended jugular veins

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503
Q

When can chorionic villous sampling be done?

Amniocentesis?

A

CVS: 9-14w
Amniocentesis: 15-22w

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504
Q

When to swab for GBS

A

35w

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505
Q

Quad screen results for Edwards syndrome

A

UNDERaged at 18

All are down

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506
Q

Quad screen results for Down syndrome

A

2up 2down at 21

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507
Q

Treatment of HIV in pregnancy

A

1) Zidovudine or Nevirapine during pregnancy
2) Elective c-section if viral load over 1000
3) Zidovudine for infant
4) No breastfeeding

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1
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3
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508
Q

Normal fetal heart rate

Causes for bradycardia or tachycardia

A

110-160 bpm

Brady - Congenital heart malformations, hypoxia
Tachy - Hypoxia, maternal fever, fetal anemia

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509
Q

Normal variability on FHT

A

6-25 bpm

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510
Q

What does sinusoidal variability on FHT indicate?

A

Serious fetal anemia

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511
Q

Treatment of hypercalcemia 2/2 malignancy

A

Short term: Normal saline, Calcitonin

Long term: Bisphosphonates

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2
3
4
5
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512
Q

Mutation seen in cri-du-chat syndrome

A

5p deletion

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513
Q

Difference between gestational and chronic HTN

A

Chronic HTN if present before 20w or persists after 12w postpartum
Gestational HTN if presents after 20w

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514
Q

Definition of preeclampsia

A

1) New-onset HTN after 20w or worsened chronic HTN

2) Proteinuria of over 300mg/24h (3+ proteins)

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1
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2
3
4
5
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515
Q

Murmur of transposition of the great vessels

A

Single S2
+/- VSD murmur

Most common early cyanotic dz

How well did you know this?
1
Not at all
2
3
4
5
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516
Q

Murmur of tetralogy of Fallot

A

Pulmonic stenosis murmur

VSD murmur

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517
Q

Treatment of transposition of the great vessels

A 
Prostaglandins early (to maintain PFO)
Emergent surgery
How well did you know this?
1
Not at all
2
3
4
5
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518
Q

Treatment of impetigo

A

Non-bullous (honey crusts) - Topical mupirocin

Bullous - Oral abx

How well did you know this?
1
Not at all
2
3
4
5
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519
Q

Symptoms of multiple myeloma

A

Calcium elevated
Renal dysfunction
Anemia
Bone lesions/Back pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
520
Q

Indications for carotid endarterectomy

A

Symptomatic 70-99%

Men asymptomatic 60-99%

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521
Q

ESR and CK in glucocorticoid myopathy

A

Both normal

Painless weakness

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1
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2
3
4
5
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522
Q

ESR and CK in Polymyalgia Rheumatica

A

ESR elevated

CK normal

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523
Q

ESR and CK in statin-induced myopathy

A

ESR normal

CK elevated

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3
4
5
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524
Q

How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis

A

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

How well did you know this?
1
Not at all
2
3
4
5
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525
Q

What cancers are seen with HNPCC?

A

Colon cancer

Endometrial cancer

How well did you know this?
1
Not at all
2
3
4
5
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526
Q

What cancers are associated with nephrotic syndromes?

A

Adenocarcinoma - membranous nephropathy

Lymphoma - Minimal change disease

How well did you know this?
1
Not at all
2
3
4
5
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527
Q

Treatment of uric acid kidney stones

A

Oral potassium citrate

Citrate alkalinizes the urine and inhibits crystallization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
528
Q

Solitary pulmonary nodule workup

A

Nonsmoker - compare to old CXR. Q3mo CXR’s. If stable for 12mo considered benign.

Smoker:

  • Chest CT
  • FNA
How well did you know this?
1
Not at all
2
3
4
5
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529
Q

Treatment for neonatal thyrotoxicosis

A

Methimazole + beta-blocker

Caused by maternal anti-TSH receptor Ab’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
530
Q

Extrahepatic manifestations of HCV

A

Porphyria cutanea tarda
Essential mixed cryoglobulinemia
Membranoproliferative GN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
531
Q

Symptoms of mixed cryoglobulinemia

A

Purpura
Arthralgias
Weakness
Membranoproliferative GN

How well did you know this?
1
Not at all
2
3
4
5
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532
Q

Symptoms of galactosemia

A

Newborn with:

  • FTT
  • Bilateral cataracts
  • Jaundice
  • Hypoglycemia
How well did you know this?
1
Not at all
2
3
4
5
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533
Q

What is a normal AFI?

A

5-20

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534
Q

At what EFW would you deliver by planned c-section due to macrosomia?

A

No DM: 5,000g

DM: 4,500g

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535
Q

What maternal titer is considered Rh-sensitized?

A

1:16

So 1:20, 1:32, etc.

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536
Q

Definition of PROM and PPROM

A

PROM: Rupture 1h or more before onset of labor
PPROM: Rupture between 20-37w

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537
Q

What blood loss is considered postpartum hemorrhage?

A

500cc via vaginal delivery

1000cc via c-section

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538
Q

Causes of postpartum hemorrhage

A

Tone (atony)
Tissue (retained placental tissue)
Trauma (of genital tract)
Thrombin (coagulopathy)

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539
Q

Diagnosis of Polymyositis/Dermatomyositis

A

1) Anti-Jo-1 Ab’s

2) Muscle biopsy

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540
Q

What antibodies are associated with SLE?

A

ANA
Anti-dsDNA
Anti-Smith

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541
Q

What antibodies are associated with RA?

A

Anti-CCP

Rheumatoid factor

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542
Q

What antibodies are associated with CREST syndrome?

A

Anti-centromere

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543
Q

What antibodies are associated with drug-induced SLE?

A

Anti-histone

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544
Q

What antibodies are associated with PBC?

A

Antimitochondrial

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545
Q

What antibodies are associated with Scleroderma?

A

ANA
Anti-Scl-70
Anti-topoisomerase I

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546
Q

What antibodies are associated with autoimmune hepatitis?

A

Anti-smooth muscle

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547
Q

What antibodies are associated with Graves’ dz?

A

Anti-TSH receptor

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548
Q

What antibodies are associated with GPA?

A

c-ANCA

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549
Q

What antibodies are associated with microscopic polyangiitis?

A

p-ANCA

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550
Q

What antibodies are associated with MCTD?

A

U1RNP antibody

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551
Q

What does Prussian Blue staining detect?

A

Hemosiderin

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552
Q

What is seen in neurofibromatosis type 1?

A

Cafe-au-lait spots
Neurofibromas
Lisch nodules (iris hamartomas)
Optic glioma

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553
Q

Eye deviation in hemiparesis

A

Thalamic lesion - eyes deviate Toward hemiparesis

Cerebral lobe - eyes deviate Contralateral from hemiparesis

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554
Q

Symptoms of carcinoid syndrome

A

Flushing
Diarrhea
Bronchospasm

Usually tumor is found in small intestine

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555
Q

What is the classic brain lesion caused by status epilepticus?

A

Cortical laminar necrosis

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556
Q

What cancer rates are affected by COC’s?

A

COC’s reduce ovarian and endometrial cancer rates

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557
Q

Causes of primary amenorrhea with normal secondary sex characteristics

A

Pregnancy
Mullerian agenesis (2/3 of vagina and uterus missing)
Imperforate hymen
Androgen insensitivity (absent pubic hair)

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1
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2
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558
Q

How is bone age used to workup primary amenorrhea?

A

If bone age is 12+ and no development - likely a HPG axis problem

If bone age is under 12 - likely constitutional delay

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559
Q

Initial workup for secondary amenorrhea

A

Pregnancy test
TSH
Prolactin level

If all normal, proceed to progestin challenge

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560
Q

What to order if progestin challenge produces a withdrawal bleed

A

LH

If decreased –> idiopathic anovulation
If increased –> PCOS or premature menopause

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561
Q

What to order if no withdrawal bleed after progestin challenge

A

FSH

Elevated –> Hypergonadotropic hypogonadism
Decreased –> cyclic E2/Pr test to differentiate hypogonadotropic hypogonadism vs. endometrial/anatomic problem

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562
Q

Prophylaxis in HIV patients

A 
200 = PCP = Bactrim
150 = Histoplasma = Itraconazole
100 = Toxoplasma = Bactrim
50 = MAC = Azithromycin
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563
Q

Prophylaxis in posttransplant patients

A

Bactrim for PCP

Immunize against Influenza, pneumococcus, and HBV

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564
Q

When to perform oral glucose tolerance test

A

24-28w

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565
Q

TSH, total T4, and free T4 levels in pregnancy

A

TSH down
Total T4 way up
Free T4 slightly up

Because beta-hCG has TSH-like activity and estrogen increases TBG

How well did you know this?
1
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2
3
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5
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566
Q

Paraneoplastic syndromes of SCLC

A

ACTH (Cushing’s)
ADH (SIADH)
Lambert-Eaton syndrome

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567
Q

Paraneoplastic syndromes of lung SCC

A

PTHrP (hypercalcemia)

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568
Q

Most common cause of urinary obstruction in newborn males

A

Posterior urethral valves

Can cause Potter’s sequence and hydronephrosis in-utero

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569
Q

Treatment for diabetic distal neuropathy

A

1) TCA’s

2) Gabapentin

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570
Q

EPS side effects of antipsychotics

A

Acute dystonic reaction (neck, mouth, tongue, EOM)
Akithisia (restlessness)
Parkinsonism
Tardive dyskinesia (after 1-6mo)

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571
Q

Which hereditary hyperbilirubinemias present with unconjugated hyperbili?
What is the difference?

A

Gilbert’s - mild and occurs with fasting and stress

Crigler-Najjar - Severe with early death

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572
Q

Which hereditary hyperbilirubinemias present with conjugated hyperbili?
What is the difference?

A

Rotor’s syndrome - normal appearing liver

Dubin-Johnson - Black liverf

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573
Q

Treatment of the hereditary hyperbilirubinemias

A

Crigler-Najjar I - Phenobarbital
Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant

Dubin-Johnson, Rotor’s, Gilbert’s do not require treatment.

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574
Q

Lab/vitals abnormalities of LBW infants

A 
Hypoxia
Hypothermia
Hypoglycemia
Hypocalcemia
Polycythemia
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575
Q

What electrolyte derangements are seen with significant emesis?

A

Hypochloremic, hypokalemic metabolic alkalosis

Loss of HCl in vomit
Angiotensin II –> HCO3 resorption
Aldosterone –> H+ secretion and K+ secretion

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576
Q

Superior sulcus tumor possible symptoms

A

Horner syndrome
Pancoast (ulnar pain distribution, shoulder weakness)
Hoarseness (RLN)
SVC syndrome

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577
Q

Divisions of mediastinum and their masses

A

Anterior: 4 T’s (thymoma, teratoma, thyroid, terrible lymphoma)
Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma
Posterior: Neurogenic tumors

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578
Q

Beck’s triad of cardiac tamponade

A

Hypotension
Distant heart sounds
Distended jugular veins

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579
Q

When can chorionic villous sampling be done?

Amniocentesis?

A

CVS: 9-14w
Amniocentesis: 15-22w

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580
Q

When to swab for GBS

A

35w

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581
Q

Quad screen results for Edwards syndrome

A

UNDERaged at 18

All are down

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582
Q

Quad screen results for Down syndrome

A

2up 2down at 21

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583
Q

Treatment of HIV in pregnancy

A

1) Zidovudine or Nevirapine during pregnancy
2) Elective c-section if viral load over 1000
3) Zidovudine for infant
4) No breastfeeding

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584
Q

Normal fetal heart rate

Causes for bradycardia or tachycardia

A

110-160 bpm

Brady - Congenital heart malformations, hypoxia
Tachy - Hypoxia, maternal fever, fetal anemia

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585
Q

Normal variability on FHT

A

6-25 bpm

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586
Q

What does sinusoidal variability on FHT indicate?

A

Serious fetal anemia

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587
Q

Treatment of hypercalcemia 2/2 malignancy

A

Short term: Normal saline, Calcitonin

Long term: Bisphosphonates

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588
Q

Mutation seen in cri-du-chat syndrome

A

5p deletion

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589
Q

Difference between gestational and chronic HTN

A

Chronic HTN if present before 20w or persists after 12w postpartum
Gestational HTN if presents after 20w

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590
Q

Definition of preeclampsia

A

1) New-onset HTN after 20w or worsened chronic HTN

2) Proteinuria of over 300mg/24h (3+ proteins)

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591
Q

Murmur of transposition of the great vessels

A

Single S2
+/- VSD murmur

Most common early cyanotic dz

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592
Q

Murmur of tetralogy of Fallot

A

Pulmonic stenosis murmur

VSD murmur

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593
Q

Treatment of transposition of the great vessels

A 
Prostaglandins early (to maintain PFO)
Emergent surgery
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594
Q

Treatment of impetigo

A

Non-bullous (honey crusts) - Topical mupirocin

Bullous - Oral abx

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595
Q

Symptoms of multiple myeloma

A

Calcium elevated
Renal dysfunction
Anemia
Bone lesions/Back pain

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596
Q

Indications for carotid endarterectomy

A

Symptomatic 70-99%

Men asymptomatic 60-99%

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597
Q

ESR and CK in glucocorticoid myopathy

A

Both normal

Painless weakness

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598
Q

ESR and CK in Polymyalgia Rheumatica

A

ESR elevated

CK normal

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599
Q

ESR and CK in statin-induced myopathy

A

ESR normal

CK elevated

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600
Q

How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis

A

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

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601
Q

What cancers are seen with HNPCC?

A

Colon cancer

Endometrial cancer

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602
Q

What cancers are associated with nephrotic syndromes?

A

Adenocarcinoma - membranous nephropathy

Lymphoma - Minimal change disease

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603
Q

Treatment of uric acid kidney stones

A

Oral potassium citrate

Citrate alkalinizes the urine and inhibits crystallization

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604
Q

Solitary pulmonary nodule workup

A

Nonsmoker - compare to old CXR. Q3mo CXR’s. If stable for 12mo considered benign.

Smoker:

  • Chest CT
  • FNA
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605
Q

Treatment for neonatal thyrotoxicosis

A

Methimazole + beta-blocker

Caused by maternal anti-TSH receptor Ab’s

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606
Q

Extrahepatic manifestations of HCV

A

Porphyria cutanea tarda
Essential mixed cryoglobulinemia
Membranoproliferative GN

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607
Q

Symptoms of mixed cryoglobulinemia

A

Purpura
Arthralgias
Weakness
Membranoproliferative GN

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608
Q

Symptoms of galactosemia

A

Newborn with:

  • FTT
  • Bilateral cataracts
  • Jaundice
  • Hypoglycemia
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609
Q

What is a normal AFI?

A

5-20

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610
Q

At what EFW would you deliver by planned c-section due to macrosomia?

A

No DM: 5,000g

DM: 4,500g

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611
Q

What maternal titer is considered Rh-sensitized?

A

1:16

So 1:20, 1:32, etc.

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612
Q

Definition of PROM and PPROM

A

PROM: Rupture 1h or more before onset of labor
PPROM: Rupture between 20-37w

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613
Q

What blood loss is considered postpartum hemorrhage?

A

500cc via vaginal delivery

1000cc via c-section

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614
Q

Causes of postpartum hemorrhage

A

Tone (atony)
Tissue (retained placental tissue)
Trauma (of genital tract)
Thrombin (coagulopathy)

How well did you know this?
1
Not at all
2
3
4
5
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615
Q

Diagnosis of Polymyositis/Dermatomyositis

A

1) Anti-Jo-1 Ab’s

2) Muscle biopsy

How well did you know this?
1
Not at all
2
3
4
5
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616
Q

What antibodies are associated with SLE?

A

ANA
Anti-dsDNA
Anti-Smith

How well did you know this?
1
Not at all
2
3
4
5
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617
Q

What antibodies are associated with RA?

A

Anti-CCP

Rheumatoid factor

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3
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5
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618
Q

What antibodies are associated with CREST syndrome?

A

Anti-centromere

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619
Q

What antibodies are associated with drug-induced SLE?

A

Anti-histone

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620
Q

What antibodies are associated with PBC?

A

Antimitochondrial

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3
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621
Q

What antibodies are associated with Scleroderma?

A

ANA
Anti-Scl-70
Anti-topoisomerase I

How well did you know this?
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3
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5
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622
Q

What antibodies are associated with autoimmune hepatitis?

A

Anti-smooth muscle

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3
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623
Q

What antibodies are associated with Graves’ dz?

A

Anti-TSH receptor

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624
Q

What antibodies are associated with GPA?

A

c-ANCA

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625
Q

What antibodies are associated with microscopic polyangiitis?

A

p-ANCA

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626
Q

What antibodies are associated with MCTD?

A

U1RNP antibody

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627
Q

What does Prussian Blue staining detect?

A

Hemosiderin

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2
3
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628
Q

What is seen in neurofibromatosis type 1?

A

Cafe-au-lait spots
Neurofibromas
Lisch nodules (iris hamartomas)
Optic glioma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
629
Q

Eye deviation in hemiparesis

A

Thalamic lesion - eyes deviate Toward hemiparesis

Cerebral lobe - eyes deviate Contralateral from hemiparesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
630
Q

Symptoms of carcinoid syndrome

A

Flushing
Diarrhea
Bronchospasm

Usually tumor is found in small intestine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
631
Q

What is the classic brain lesion caused by status epilepticus?

A

Cortical laminar necrosis

How well did you know this?
1
Not at all
2
3
4
5
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632
Q

What cancer rates are affected by COC’s?

A

COC’s reduce ovarian and endometrial cancer rates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
633
Q

Causes of primary amenorrhea with normal secondary sex characteristics

A

Pregnancy
Mullerian agenesis (2/3 of vagina and uterus missing)
Imperforate hymen
Androgen insensitivity (absent pubic hair)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
634
Q

How is bone age used to workup primary amenorrhea?

A

If bone age is 12+ and no development - likely a HPG axis problem

If bone age is under 12 - likely constitutional delay

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
635
Q

Initial workup for secondary amenorrhea

A

Pregnancy test
TSH
Prolactin level

If all normal, proceed to progestin challenge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
636
Q

What to order if progestin challenge produces a withdrawal bleed

A

LH

If decreased –> idiopathic anovulation
If increased –> PCOS or premature menopause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
637
Q

What to order if no withdrawal bleed after progestin challenge

A

FSH

Elevated –> Hypergonadotropic hypogonadism
Decreased –> cyclic E2/Pr test to differentiate hypogonadotropic hypogonadism vs. endometrial/anatomic problem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
638
Q

Prophylaxis in HIV patients

A 
200 = PCP = Bactrim
150 = Histoplasma = Itraconazole
100 = Toxoplasma = Bactrim
50 = MAC = Azithromycin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
639
Q

Prophylaxis in posttransplant patients

A

Bactrim for PCP

Immunize against Influenza, pneumococcus, and HBV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
640
Q

When to perform oral glucose tolerance test

A

24-28w

How well did you know this?
1
Not at all
2
3
4
5
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641
Q

TSH, total T4, and free T4 levels in pregnancy

A

TSH down
Total T4 way up
Free T4 slightly up

Because beta-hCG has TSH-like activity and estrogen increases TBG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
642
Q

Paraneoplastic syndromes of SCLC

A

ACTH (Cushing’s)
ADH (SIADH)
Lambert-Eaton syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
643
Q

Paraneoplastic syndromes of lung SCC

A

PTHrP (hypercalcemia)

How well did you know this?
1
Not at all
2
3
4
5
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644
Q

Most common cause of urinary obstruction in newborn males

A

Posterior urethral valves

Can cause Potter’s sequence and hydronephrosis in-utero

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
645
Q

Treatment for diabetic distal neuropathy

A

1) TCA’s

2) Gabapentin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
646
Q

EPS side effects of antipsychotics

A

Acute dystonic reaction (neck, mouth, tongue, EOM)
Akithisia (restlessness)
Parkinsonism
Tardive dyskinesia (after 1-6mo)

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647
Q

Which hereditary hyperbilirubinemias present with unconjugated hyperbili?
What is the difference?

A

Gilbert’s - mild and occurs with fasting and stress

Crigler-Najjar - Severe with early death

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648
Q

Which hereditary hyperbilirubinemias present with conjugated hyperbili?
What is the difference?

A

Rotor’s syndrome - normal appearing liver

Dubin-Johnson - Black liverf

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649
Q

Treatment of the hereditary hyperbilirubinemias

A

Crigler-Najjar I - Phenobarbital
Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant

Dubin-Johnson, Rotor’s, Gilbert’s do not require treatment.

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650
Q

Lab/vitals abnormalities of LBW infants

A 
Hypoxia
Hypothermia
Hypoglycemia
Hypocalcemia
Polycythemia
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651
Q

What electrolyte derangements are seen with significant emesis?

A

Hypochloremic, hypokalemic metabolic alkalosis

Loss of HCl in vomit
Angiotensin II –> HCO3 resorption
Aldosterone –> H+ secretion and K+ secretion

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652
Q

Superior sulcus tumor possible symptoms

A

Horner syndrome
Pancoast (ulnar pain distribution, shoulder weakness)
Hoarseness (RLN)
SVC syndrome

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653
Q

Divisions of mediastinum and their masses

A

Anterior: 4 T’s (thymoma, teratoma, thyroid, terrible lymphoma)
Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma
Posterior: Neurogenic tumors

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654
Q

Beck’s triad of cardiac tamponade

A

Hypotension
Distant heart sounds
Distended jugular veins

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655
Q

When can chorionic villous sampling be done?

Amniocentesis?

A

CVS: 9-14w
Amniocentesis: 15-22w

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656
Q

When to swab for GBS

A

35w

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657
Q

Quad screen results for Edwards syndrome

A

UNDERaged at 18

All are down

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658
Q

Quad screen results for Down syndrome

A

2up 2down at 21

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659
Q

Treatment of HIV in pregnancy

A

1) Zidovudine or Nevirapine during pregnancy
2) Elective c-section if viral load over 1000
3) Zidovudine for infant
4) No breastfeeding

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660
Q

Normal fetal heart rate

Causes for bradycardia or tachycardia

A

110-160 bpm

Brady - Congenital heart malformations, hypoxia
Tachy - Hypoxia, maternal fever, fetal anemia

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661
Q

Normal variability on FHT

A

6-25 bpm

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662
Q

What does sinusoidal variability on FHT indicate?

A

Serious fetal anemia

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663
Q

Treatment of hypercalcemia 2/2 malignancy

A

Short term: Normal saline, Calcitonin

Long term: Bisphosphonates

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664
Q

Mutation seen in cri-du-chat syndrome

A

5p deletion

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665
Q

Difference between gestational and chronic HTN

A

Chronic HTN if present before 20w or persists after 12w postpartum
Gestational HTN if presents after 20w

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666
Q

Definition of preeclampsia

A

1) New-onset HTN after 20w or worsened chronic HTN

2) Proteinuria of over 300mg/24h (3+ proteins)

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667
Q

Murmur of transposition of the great vessels

A

Single S2
+/- VSD murmur

Most common early cyanotic dz

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668
Q

Murmur of tetralogy of Fallot

A

Pulmonic stenosis murmur

VSD murmur

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669
Q

Treatment of transposition of the great vessels

A 
Prostaglandins early (to maintain PFO)
Emergent surgery
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670
Q

Treatment of impetigo

A

Non-bullous (honey crusts) - Topical mupirocin

Bullous - Oral abx

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671
Q

Symptoms of multiple myeloma

A

Calcium elevated
Renal dysfunction
Anemia
Bone lesions/Back pain

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672
Q

Indications for carotid endarterectomy

A

Symptomatic 70-99%

Men asymptomatic 60-99%

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673
Q

ESR and CK in glucocorticoid myopathy

A

Both normal

Painless weakness

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674
Q

ESR and CK in Polymyalgia Rheumatica

A

ESR elevated

CK normal

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675
Q

ESR and CK in statin-induced myopathy

A

ESR normal

CK elevated

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676
Q

How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis

A

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

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677
Q

What cancers are seen with HNPCC?

A

Colon cancer

Endometrial cancer

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678
Q

What cancers are associated with nephrotic syndromes?

A

Adenocarcinoma - membranous nephropathy

Lymphoma - Minimal change disease

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679
Q

Treatment of uric acid kidney stones

A

Oral potassium citrate

Citrate alkalinizes the urine and inhibits crystallization

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680
Q

Solitary pulmonary nodule workup

A

Nonsmoker - compare to old CXR. Q3mo CXR’s. If stable for 12mo considered benign.

Smoker:

  • Chest CT
  • FNA
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681
Q

Treatment for neonatal thyrotoxicosis

A

Methimazole + beta-blocker

Caused by maternal anti-TSH receptor Ab’s

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682
Q

Extrahepatic manifestations of HCV

A

Porphyria cutanea tarda
Essential mixed cryoglobulinemia
Membranoproliferative GN

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683
Q

Symptoms of mixed cryoglobulinemia

A

Purpura
Arthralgias
Weakness
Membranoproliferative GN

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684
Q

Symptoms of galactosemia

A

Newborn with:

  • FTT
  • Bilateral cataracts
  • Jaundice
  • Hypoglycemia
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685
Q

What is a normal AFI?

A

5-20

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686
Q

At what EFW would you deliver by planned c-section due to macrosomia?

A

No DM: 5,000g

DM: 4,500g

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687
Q

What maternal titer is considered Rh-sensitized?

A

1:16

So 1:20, 1:32, etc.

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688
Q

Definition of PROM and PPROM

A

PROM: Rupture 1h or more before onset of labor
PPROM: Rupture between 20-37w

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689
Q

What blood loss is considered postpartum hemorrhage?

A

500cc via vaginal delivery

1000cc via c-section

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690
Q

Causes of postpartum hemorrhage

A

Tone (atony)
Tissue (retained placental tissue)
Trauma (of genital tract)
Thrombin (coagulopathy)

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691
Q

Diagnosis of Polymyositis/Dermatomyositis

A

1) Anti-Jo-1 Ab’s

2) Muscle biopsy

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692
Q

What antibodies are associated with SLE?

A

ANA
Anti-dsDNA
Anti-Smith

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693
Q

What antibodies are associated with RA?

A

Anti-CCP

Rheumatoid factor

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694
Q

What antibodies are associated with CREST syndrome?

A

Anti-centromere

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695
Q

What antibodies are associated with drug-induced SLE?

A

Anti-histone

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696
Q

What antibodies are associated with PBC?

A

Antimitochondrial

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697
Q

What antibodies are associated with Scleroderma?

A

ANA
Anti-Scl-70
Anti-topoisomerase I

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698
Q

What antibodies are associated with autoimmune hepatitis?

A

Anti-smooth muscle

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699
Q

What antibodies are associated with Graves’ dz?

A

Anti-TSH receptor

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700
Q

What antibodies are associated with GPA?

A

c-ANCA

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701
Q

What antibodies are associated with microscopic polyangiitis?

A

p-ANCA

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702
Q

What antibodies are associated with MCTD?

A

U1RNP antibody

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703
Q

What does Prussian Blue staining detect?

A

Hemosiderin

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704
Q

What is seen in neurofibromatosis type 1?

A

Cafe-au-lait spots
Neurofibromas
Lisch nodules (iris hamartomas)
Optic glioma

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705
Q

Eye deviation in hemiparesis

A

Thalamic lesion - eyes deviate Toward hemiparesis

Cerebral lobe - eyes deviate Contralateral from hemiparesis

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706
Q

Symptoms of carcinoid syndrome

A

Flushing
Diarrhea
Bronchospasm

Usually tumor is found in small intestine

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707
Q

What is the classic brain lesion caused by status epilepticus?

A

Cortical laminar necrosis

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708
Q

What cancer rates are affected by COC’s?

A

COC’s reduce ovarian and endometrial cancer rates

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709
Q

Causes of primary amenorrhea with normal secondary sex characteristics

A

Pregnancy
Mullerian agenesis (2/3 of vagina and uterus missing)
Imperforate hymen
Androgen insensitivity (absent pubic hair)

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710
Q

How is bone age used to workup primary amenorrhea?

A

If bone age is 12+ and no development - likely a HPG axis problem

If bone age is under 12 - likely constitutional delay

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711
Q

Initial workup for secondary amenorrhea

A

Pregnancy test
TSH
Prolactin level

If all normal, proceed to progestin challenge

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712
Q

What to order if progestin challenge produces a withdrawal bleed

A

LH

If decreased –> idiopathic anovulation
If increased –> PCOS or premature menopause

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713
Q

What to order if no withdrawal bleed after progestin challenge

A

FSH

Elevated –> Hypergonadotropic hypogonadism
Decreased –> cyclic E2/Pr test to differentiate hypogonadotropic hypogonadism vs. endometrial/anatomic problem

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714
Q

Prophylaxis in HIV patients

A 
200 = PCP = Bactrim
150 = Histoplasma = Itraconazole
100 = Toxoplasma = Bactrim
50 = MAC = Azithromycin
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715
Q

Prophylaxis in posttransplant patients

A

Bactrim for PCP

Immunize against Influenza, pneumococcus, and HBV

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716
Q

When to perform oral glucose tolerance test

A

24-28w

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717
Q

TSH, total T4, and free T4 levels in pregnancy

A

TSH down
Total T4 way up
Free T4 slightly up

Because beta-hCG has TSH-like activity and estrogen increases TBG

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718
Q

Paraneoplastic syndromes of SCLC

A

ACTH (Cushing’s)
ADH (SIADH)
Lambert-Eaton syndrome

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719
Q

Paraneoplastic syndromes of lung SCC

A

PTHrP (hypercalcemia)

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720
Q

Most common cause of urinary obstruction in newborn males

A

Posterior urethral valves

Can cause Potter’s sequence and hydronephrosis in-utero

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721
Q

Treatment for diabetic distal neuropathy

A

1) TCA’s

2) Gabapentin

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722
Q

EPS side effects of antipsychotics

A

Acute dystonic reaction (neck, mouth, tongue, EOM)
Akithisia (restlessness)
Parkinsonism
Tardive dyskinesia (after 1-6mo)

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723
Q

Which hereditary hyperbilirubinemias present with unconjugated hyperbili?
What is the difference?

A

Gilbert’s - mild and occurs with fasting and stress

Crigler-Najjar - Severe with early death

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1
Not at all
2
3
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5
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724
Q

Which hereditary hyperbilirubinemias present with conjugated hyperbili?
What is the difference?

A

Rotor’s syndrome - normal appearing liver

Dubin-Johnson - Black liverf

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725
Q

Treatment of the hereditary hyperbilirubinemias

A

Crigler-Najjar I - Phenobarbital
Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant

Dubin-Johnson, Rotor’s, Gilbert’s do not require treatment.

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726
Q

Lab/vitals abnormalities of LBW infants

A 
Hypoxia
Hypothermia
Hypoglycemia
Hypocalcemia
Polycythemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
727
Q

What electrolyte derangements are seen with significant emesis?

A

Hypochloremic, hypokalemic metabolic alkalosis

Loss of HCl in vomit
Angiotensin II –> HCO3 resorption
Aldosterone –> H+ secretion and K+ secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
728
Q

Superior sulcus tumor possible symptoms

A

Horner syndrome
Pancoast (ulnar pain distribution, shoulder weakness)
Hoarseness (RLN)
SVC syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
729
Q

Divisions of mediastinum and their masses

A

Anterior: 4 T’s (thymoma, teratoma, thyroid, terrible lymphoma)
Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma
Posterior: Neurogenic tumors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
730
Q

Beck’s triad of cardiac tamponade

A

Hypotension
Distant heart sounds
Distended jugular veins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
731
Q

When can chorionic villous sampling be done?

Amniocentesis?

A

CVS: 9-14w
Amniocentesis: 15-22w

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1
Not at all
2
3
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5
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732
Q

When to swab for GBS

A

35w

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1
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3
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5
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733
Q

Quad screen results for Edwards syndrome

A

UNDERaged at 18

All are down

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3
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5
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734
Q

Quad screen results for Down syndrome

A

2up 2down at 21

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735
Q

Treatment of HIV in pregnancy

A

1) Zidovudine or Nevirapine during pregnancy
2) Elective c-section if viral load over 1000
3) Zidovudine for infant
4) No breastfeeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
736
Q

Normal fetal heart rate

Causes for bradycardia or tachycardia

A

110-160 bpm

Brady - Congenital heart malformations, hypoxia
Tachy - Hypoxia, maternal fever, fetal anemia

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1
Not at all
2
3
4
5
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737
Q

Normal variability on FHT

A

6-25 bpm

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2
3
4
5
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738
Q

What does sinusoidal variability on FHT indicate?

A

Serious fetal anemia

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1
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2
3
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5
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739
Q

Treatment of hypercalcemia 2/2 malignancy

A

Short term: Normal saline, Calcitonin

Long term: Bisphosphonates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
740
Q

Mutation seen in cri-du-chat syndrome

A

5p deletion

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1
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2
3
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5
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741
Q

Difference between gestational and chronic HTN

A

Chronic HTN if present before 20w or persists after 12w postpartum
Gestational HTN if presents after 20w

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742
Q

Definition of preeclampsia

A

1) New-onset HTN after 20w or worsened chronic HTN

2) Proteinuria of over 300mg/24h (3+ proteins)

How well did you know this?
1
Not at all
2
3
4
5
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743
Q

Murmur of transposition of the great vessels

A

Single S2
+/- VSD murmur

Most common early cyanotic dz

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
744
Q

Murmur of tetralogy of Fallot

A

Pulmonic stenosis murmur

VSD murmur

How well did you know this?
1
Not at all
2
3
4
5
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745
Q

Treatment of transposition of the great vessels

A 
Prostaglandins early (to maintain PFO)
Emergent surgery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
746
Q

Treatment of impetigo

A

Non-bullous (honey crusts) - Topical mupirocin

Bullous - Oral abx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
747
Q

Symptoms of multiple myeloma

A

Calcium elevated
Renal dysfunction
Anemia
Bone lesions/Back pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
748
Q

Indications for carotid endarterectomy

A

Symptomatic 70-99%

Men asymptomatic 60-99%

How well did you know this?
1
Not at all
2
3
4
5
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749
Q

ESR and CK in glucocorticoid myopathy

A

Both normal

Painless weakness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
750
Q

ESR and CK in Polymyalgia Rheumatica

A

ESR elevated

CK normal

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1
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3
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5
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751
Q

ESR and CK in statin-induced myopathy

A

ESR normal

CK elevated

How well did you know this?
1
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2
3
4
5
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752
Q

How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis

A

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

How well did you know this?
1
Not at all
2
3
4
5
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753
Q

What cancers are seen with HNPCC?

A

Colon cancer

Endometrial cancer

How well did you know this?
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754
Q

What cancers are associated with nephrotic syndromes?

A

Adenocarcinoma - membranous nephropathy

Lymphoma - Minimal change disease

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755
Q

Treatment of uric acid kidney stones

A

Oral potassium citrate

Citrate alkalinizes the urine and inhibits crystallization

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756
Q

Solitary pulmonary nodule workup

A

Nonsmoker - compare to old CXR. Q3mo CXR’s. If stable for 12mo considered benign.

Smoker:

  • Chest CT
  • FNA
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757
Q

Treatment for neonatal thyrotoxicosis

A

Methimazole + beta-blocker

Caused by maternal anti-TSH receptor Ab’s

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758
Q

Extrahepatic manifestations of HCV

A

Porphyria cutanea tarda
Essential mixed cryoglobulinemia
Membranoproliferative GN

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759
Q

Symptoms of mixed cryoglobulinemia

A

Purpura
Arthralgias
Weakness
Membranoproliferative GN

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760
Q

Symptoms of galactosemia

A

Newborn with:

  • FTT
  • Bilateral cataracts
  • Jaundice
  • Hypoglycemia
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761
Q

What is a normal AFI?

A

5-20

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762
Q

At what EFW would you deliver by planned c-section due to macrosomia?

A

No DM: 5,000g

DM: 4,500g

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763
Q

What maternal titer is considered Rh-sensitized?

A

1:16

So 1:20, 1:32, etc.

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764
Q

Definition of PROM and PPROM

A

PROM: Rupture 1h or more before onset of labor
PPROM: Rupture between 20-37w

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765
Q

What blood loss is considered postpartum hemorrhage?

A

500cc via vaginal delivery

1000cc via c-section

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766
Q

Causes of postpartum hemorrhage

A

Tone (atony)
Tissue (retained placental tissue)
Trauma (of genital tract)
Thrombin (coagulopathy)

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767
Q

Diagnosis of Polymyositis/Dermatomyositis

A

1) Anti-Jo-1 Ab’s

2) Muscle biopsy

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768
Q

What antibodies are associated with SLE?

A

ANA
Anti-dsDNA
Anti-Smith

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769
Q

What antibodies are associated with RA?

A

Anti-CCP

Rheumatoid factor

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770
Q

What antibodies are associated with CREST syndrome?

A

Anti-centromere

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771
Q

What antibodies are associated with drug-induced SLE?

A

Anti-histone

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772
Q

What antibodies are associated with PBC?

A

Antimitochondrial

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773
Q

What antibodies are associated with Scleroderma?

A

ANA
Anti-Scl-70
Anti-topoisomerase I

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774
Q

What antibodies are associated with autoimmune hepatitis?

A

Anti-smooth muscle

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775
Q

What antibodies are associated with Graves’ dz?

A

Anti-TSH receptor

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776
Q

What antibodies are associated with GPA?

A

c-ANCA

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777
Q

What antibodies are associated with microscopic polyangiitis?

A

p-ANCA

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778
Q

What antibodies are associated with MCTD?

A

U1RNP antibody

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779
Q

What does Prussian Blue staining detect?

A

Hemosiderin

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780
Q

What is seen in neurofibromatosis type 1?

A

Cafe-au-lait spots
Neurofibromas
Lisch nodules (iris hamartomas)
Optic glioma

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781
Q

Eye deviation in hemiparesis

A

Thalamic lesion - eyes deviate Toward hemiparesis

Cerebral lobe - eyes deviate Contralateral from hemiparesis

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782
Q

Symptoms of carcinoid syndrome

A

Flushing
Diarrhea
Bronchospasm

Usually tumor is found in small intestine

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783
Q

What is the classic brain lesion caused by status epilepticus?

A

Cortical laminar necrosis

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784
Q

What cancer rates are affected by COC’s?

A

COC’s reduce ovarian and endometrial cancer rates

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785
Q

Causes of primary amenorrhea with normal secondary sex characteristics

A

Pregnancy
Mullerian agenesis (2/3 of vagina and uterus missing)
Imperforate hymen
Androgen insensitivity (absent pubic hair)

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786
Q

How is bone age used to workup primary amenorrhea?

A

If bone age is 12+ and no development - likely a HPG axis problem

If bone age is under 12 - likely constitutional delay

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787
Q

Initial workup for secondary amenorrhea

A

Pregnancy test
TSH
Prolactin level

If all normal, proceed to progestin challenge

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788
Q

What to order if progestin challenge produces a withdrawal bleed

A

LH

If decreased –> idiopathic anovulation
If increased –> PCOS or premature menopause

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789
Q

What to order if no withdrawal bleed after progestin challenge

A

FSH

Elevated –> Hypergonadotropic hypogonadism
Decreased –> cyclic E2/Pr test to differentiate hypogonadotropic hypogonadism vs. endometrial/anatomic problem

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790
Q

Prophylaxis in HIV patients

A 
200 = PCP = Bactrim
150 = Histoplasma = Itraconazole
100 = Toxoplasma = Bactrim
50 = MAC = Azithromycin
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1
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791
Q

Prophylaxis in posttransplant patients

A

Bactrim for PCP

Immunize against Influenza, pneumococcus, and HBV

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792
Q

When to perform oral glucose tolerance test

A

24-28w

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3
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793
Q

TSH, total T4, and free T4 levels in pregnancy

A

TSH down
Total T4 way up
Free T4 slightly up

Because beta-hCG has TSH-like activity and estrogen increases TBG

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1
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2
3
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794
Q

Paraneoplastic syndromes of SCLC

A

ACTH (Cushing’s)
ADH (SIADH)
Lambert-Eaton syndrome

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1
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3
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795
Q

Paraneoplastic syndromes of lung SCC

A

PTHrP (hypercalcemia)

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796
Q

Most common cause of urinary obstruction in newborn males

A

Posterior urethral valves

Can cause Potter’s sequence and hydronephrosis in-utero

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797
Q

Treatment for diabetic distal neuropathy

A

1) TCA’s

2) Gabapentin

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1
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2
3
4
5
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798
Q

EPS side effects of antipsychotics

A

Acute dystonic reaction (neck, mouth, tongue, EOM)
Akithisia (restlessness)
Parkinsonism
Tardive dyskinesia (after 1-6mo)

How well did you know this?
1
Not at all
2
3
4
5
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799
Q

Which hereditary hyperbilirubinemias present with unconjugated hyperbili?
What is the difference?

A

Gilbert’s - mild and occurs with fasting and stress

Crigler-Najjar - Severe with early death

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1
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2
3
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5
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800
Q

Which hereditary hyperbilirubinemias present with conjugated hyperbili?
What is the difference?

A

Rotor’s syndrome - normal appearing liver

Dubin-Johnson - Black liverf

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801
Q

Treatment of the hereditary hyperbilirubinemias

A

Crigler-Najjar I - Phenobarbital
Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant

Dubin-Johnson, Rotor’s, Gilbert’s do not require treatment.

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802
Q

Lab/vitals abnormalities of LBW infants

A 
Hypoxia
Hypothermia
Hypoglycemia
Hypocalcemia
Polycythemia
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1
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2
3
4
5
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803
Q

What electrolyte derangements are seen with significant emesis?

A

Hypochloremic, hypokalemic metabolic alkalosis

Loss of HCl in vomit
Angiotensin II –> HCO3 resorption
Aldosterone –> H+ secretion and K+ secretion

How well did you know this?
1
Not at all
2
3
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5
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804
Q

Superior sulcus tumor possible symptoms

A

Horner syndrome
Pancoast (ulnar pain distribution, shoulder weakness)
Hoarseness (RLN)
SVC syndrome

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805
Q

Divisions of mediastinum and their masses

A

Anterior: 4 T’s (thymoma, teratoma, thyroid, terrible lymphoma)
Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma
Posterior: Neurogenic tumors

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806
Q

Beck’s triad of cardiac tamponade

A

Hypotension
Distant heart sounds
Distended jugular veins

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807
Q

When can chorionic villous sampling be done?

Amniocentesis?

A

CVS: 9-14w
Amniocentesis: 15-22w

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808
Q

When to swab for GBS

A

35w

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809
Q

Quad screen results for Edwards syndrome

A

UNDERaged at 18

All are down

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810
Q

Quad screen results for Down syndrome

A

2up 2down at 21

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811
Q

Treatment of HIV in pregnancy

A

1) Zidovudine or Nevirapine during pregnancy
2) Elective c-section if viral load over 1000
3) Zidovudine for infant
4) No breastfeeding

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812
Q

Normal fetal heart rate

Causes for bradycardia or tachycardia

A

110-160 bpm

Brady - Congenital heart malformations, hypoxia
Tachy - Hypoxia, maternal fever, fetal anemia

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813
Q

Normal variability on FHT

A

6-25 bpm

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814
Q

What does sinusoidal variability on FHT indicate?

A

Serious fetal anemia

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815
Q

Treatment of hypercalcemia 2/2 malignancy

A

Short term: Normal saline, Calcitonin

Long term: Bisphosphonates

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816
Q

Mutation seen in cri-du-chat syndrome

A

5p deletion

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817
Q

Difference between gestational and chronic HTN

A

Chronic HTN if present before 20w or persists after 12w postpartum
Gestational HTN if presents after 20w

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818
Q

Definition of preeclampsia

A

1) New-onset HTN after 20w or worsened chronic HTN

2) Proteinuria of over 300mg/24h (3+ proteins)

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819
Q

Murmur of transposition of the great vessels

A

Single S2
+/- VSD murmur

Most common early cyanotic dz

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820
Q

Murmur of tetralogy of Fallot

A

Pulmonic stenosis murmur

VSD murmur

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821
Q

Treatment of transposition of the great vessels

A 
Prostaglandins early (to maintain PFO)
Emergent surgery
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822
Q

Treatment of impetigo

A

Non-bullous (honey crusts) - Topical mupirocin

Bullous - Oral abx

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823
Q

Symptoms of multiple myeloma

A

Calcium elevated
Renal dysfunction
Anemia
Bone lesions/Back pain

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824
Q

Indications for carotid endarterectomy

A

Symptomatic 70-99%

Men asymptomatic 60-99%

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825
Q

ESR and CK in glucocorticoid myopathy

A

Both normal

Painless weakness

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826
Q

ESR and CK in Polymyalgia Rheumatica

A

ESR elevated

CK normal

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827
Q

ESR and CK in statin-induced myopathy

A

ESR normal

CK elevated

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828
Q

How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis

A

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

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829
Q

What cancers are seen with HNPCC?

A

Colon cancer

Endometrial cancer

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830
Q

What cancers are associated with nephrotic syndromes?

A

Adenocarcinoma - membranous nephropathy

Lymphoma - Minimal change disease

How well did you know this?
1
Not at all
2
3
4
5
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831
Q

Treatment of uric acid kidney stones

A

Oral potassium citrate

Citrate alkalinizes the urine and inhibits crystallization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
832
Q

Solitary pulmonary nodule workup

A

Nonsmoker - compare to old CXR. Q3mo CXR’s. If stable for 12mo considered benign.

Smoker:

  • Chest CT
  • FNA
How well did you know this?
1
Not at all
2
3
4
5
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833
Q

Treatment for neonatal thyrotoxicosis

A

Methimazole + beta-blocker

Caused by maternal anti-TSH receptor Ab’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
834
Q

Extrahepatic manifestations of HCV

A

Porphyria cutanea tarda
Essential mixed cryoglobulinemia
Membranoproliferative GN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
835
Q

Symptoms of mixed cryoglobulinemia

A

Purpura
Arthralgias
Weakness
Membranoproliferative GN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
836
Q

Symptoms of galactosemia

A

Newborn with:

  • FTT
  • Bilateral cataracts
  • Jaundice
  • Hypoglycemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
837
Q

What is a normal AFI?

A

5-20

How well did you know this?
1
Not at all
2
3
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5
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838
Q

At what EFW would you deliver by planned c-section due to macrosomia?

A

No DM: 5,000g

DM: 4,500g

How well did you know this?
1
Not at all
2
3
4
5
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839
Q

What maternal titer is considered Rh-sensitized?

A

1:16

So 1:20, 1:32, etc.

How well did you know this?
1
Not at all
2
3
4
5
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840
Q

Definition of PROM and PPROM

A

PROM: Rupture 1h or more before onset of labor
PPROM: Rupture between 20-37w

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1
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2
3
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841
Q

What blood loss is considered postpartum hemorrhage?

A

500cc via vaginal delivery

1000cc via c-section

How well did you know this?
1
Not at all
2
3
4
5
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842
Q

Causes of postpartum hemorrhage

A

Tone (atony)
Tissue (retained placental tissue)
Trauma (of genital tract)
Thrombin (coagulopathy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
843
Q

Prophylaxis in HIV patients

A 
200 = PCP = Bactrim
150 = Histoplasma = Itraconazole
100 = Toxoplasma = Bactrim
50 = MAC = Azithromycin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
844
Q

Prophylaxis in posttransplant patients

A

Bactrim for PCP

Immunize against Influenza, pneumococcus, and HBV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
845
Q

When to perform oral glucose tolerance test

A

24-28w

How well did you know this?
1
Not at all
2
3
4
5
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846
Q

TSH, total T4, and free T4 levels in pregnancy

A

TSH down
Total T4 way up
Free T4 slightly up

Because beta-hCG has TSH-like activity and estrogen increases TBG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
847
Q

Paraneoplastic syndromes of SCLC

A

ACTH (Cushing’s)
ADH (SIADH)
Lambert-Eaton syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
848
Q

Paraneoplastic syndromes of lung SCC

A

PTHrP (hypercalcemia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
849
Q

Most common cause of urinary obstruction in newborn males

A

Posterior urethral valves

Can cause Potter’s sequence and hydronephrosis in-utero

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
850
Q

Treatment for diabetic distal neuropathy

A

1) TCA’s

2) Gabapentin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
851
Q

EPS side effects of antipsychotics

A

Acute dystonic reaction (neck, mouth, tongue, EOM)
Akithisia (restlessness)
Parkinsonism
Tardive dyskinesia (after 1-6mo)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
852
Q

Which hereditary hyperbilirubinemias present with unconjugated hyperbili?
What is the difference?

A

Gilbert’s - mild and occurs with fasting and stress

Crigler-Najjar - Severe with early death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
853
Q

Which hereditary hyperbilirubinemias present with conjugated hyperbili?
What is the difference?

A

Rotor’s syndrome - normal appearing liver

Dubin-Johnson - Black liverf

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
854
Q

Treatment of the hereditary hyperbilirubinemias

A

Crigler-Najjar I - Phenobarbital
Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant

Dubin-Johnson, Rotor’s, Gilbert’s do not require treatment.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
855
Q

Lab/vitals abnormalities of LBW infants

A 
Hypoxia
Hypothermia
Hypoglycemia
Hypocalcemia
Polycythemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
856
Q

What electrolyte derangements are seen with significant emesis?

A

Hypochloremic, hypokalemic metabolic alkalosis

Loss of HCl in vomit
Angiotensin II –> HCO3 resorption
Aldosterone –> H+ secretion and K+ secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
857
Q

Superior sulcus tumor possible symptoms

A

Horner syndrome
Pancoast (ulnar pain distribution, shoulder weakness)
Hoarseness (RLN)
SVC syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
858
Q

Divisions of mediastinum and their masses

A

Anterior: 4 T’s (thymoma, teratoma, thyroid, terrible lymphoma)
Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma
Posterior: Neurogenic tumors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
859
Q

Beck’s triad of cardiac tamponade

A

Hypotension
Distant heart sounds
Distended jugular veins

How well did you know this?
1
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2
3
4
5
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860
Q

When can chorionic villous sampling be done?

Amniocentesis?

A

CVS: 9-14w
Amniocentesis: 15-22w

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861
Q

When to swab for GBS

A

35w

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862
Q

Quad screen results for Edwards syndrome

A

UNDERaged at 18

All are down

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863
Q

Quad screen results for Down syndrome

A

2up 2down at 21

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864
Q

Treatment of HIV in pregnancy

A

1) Zidovudine or Nevirapine during pregnancy
2) Elective c-section if viral load over 1000
3) Zidovudine for infant
4) No breastfeeding

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1
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2
3
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5
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865
Q

Normal fetal heart rate

Causes for bradycardia or tachycardia

A

110-160 bpm

Brady - Congenital heart malformations, hypoxia
Tachy - Hypoxia, maternal fever, fetal anemia

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866
Q

Normal variability on FHT

A

6-25 bpm

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867
Q

What does sinusoidal variability on FHT indicate?

A

Serious fetal anemia

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868
Q

Treatment of hypercalcemia 2/2 malignancy

A

Short term: Normal saline, Calcitonin

Long term: Bisphosphonates

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1
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2
3
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5
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869
Q

Mutation seen in cri-du-chat syndrome

A

5p deletion

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870
Q

Difference between gestational and chronic HTN

A

Chronic HTN if present before 20w or persists after 12w postpartum
Gestational HTN if presents after 20w

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871
Q

Definition of preeclampsia

A

1) New-onset HTN after 20w or worsened chronic HTN

2) Proteinuria of over 300mg/24h (3+ proteins)

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1
Not at all
2
3
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5
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872
Q

Murmur of transposition of the great vessels

A

Single S2
+/- VSD murmur

Most common early cyanotic dz

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3
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873
Q

Murmur of tetralogy of Fallot

A

Pulmonic stenosis murmur

VSD murmur

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874
Q

Treatment of transposition of the great vessels

A 
Prostaglandins early (to maintain PFO)
Emergent surgery
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3
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5
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875
Q

Treatment of impetigo

A

Non-bullous (honey crusts) - Topical mupirocin

Bullous - Oral abx

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1
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2
3
4
5
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876
Q

Symptoms of multiple myeloma

A

Calcium elevated
Renal dysfunction
Anemia
Bone lesions/Back pain

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2
3
4
5
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877
Q

Indications for carotid endarterectomy

A

Symptomatic 70-99%

Men asymptomatic 60-99%

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878
Q

ESR and CK in glucocorticoid myopathy

A

Both normal

Painless weakness

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879
Q

ESR and CK in Polymyalgia Rheumatica

A

ESR elevated

CK normal

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880
Q

ESR and CK in statin-induced myopathy

A

ESR normal

CK elevated

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3
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881
Q

How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis

A

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

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1
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5
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882
Q

What cancers are seen with HNPCC?

A

Colon cancer

Endometrial cancer

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2
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5
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883
Q

What cancers are associated with nephrotic syndromes?

A

Adenocarcinoma - membranous nephropathy

Lymphoma - Minimal change disease

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1
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2
3
4
5
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884
Q

Treatment of uric acid kidney stones

A

Oral potassium citrate

Citrate alkalinizes the urine and inhibits crystallization

How well did you know this?
1
Not at all
2
3
4
5
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885
Q

Solitary pulmonary nodule workup

A

Nonsmoker - compare to old CXR. Q3mo CXR’s. If stable for 12mo considered benign.

Smoker:

  • Chest CT
  • FNA
How well did you know this?
1
Not at all
2
3
4
5
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886
Q

Treatment for neonatal thyrotoxicosis

A

Methimazole + beta-blocker

Caused by maternal anti-TSH receptor Ab’s

How well did you know this?
1
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2
3
4
5
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887
Q

Extrahepatic manifestations of HCV

A

Porphyria cutanea tarda
Essential mixed cryoglobulinemia
Membranoproliferative GN

How well did you know this?
1
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2
3
4
5
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888
Q

Symptoms of mixed cryoglobulinemia

A

Purpura
Arthralgias
Weakness
Membranoproliferative GN

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1
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2
3
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889
Q

Symptoms of galactosemia

A

Newborn with:

  • FTT
  • Bilateral cataracts
  • Jaundice
  • Hypoglycemia
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1
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2
3
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890
Q

What is a normal AFI?

A

5-20

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891
Q

At what EFW would you deliver by planned c-section due to macrosomia?

A

No DM: 5,000g

DM: 4,500g

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892
Q

What maternal titer is considered Rh-sensitized?

A

1:16

So 1:20, 1:32, etc.

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893
Q

Definition of PROM and PPROM

A

PROM: Rupture 1h or more before onset of labor
PPROM: Rupture between 20-37w

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894
Q

What blood loss is considered postpartum hemorrhage?

A

500cc via vaginal delivery

1000cc via c-section

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1
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2
3
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5
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895
Q

Causes of postpartum hemorrhage

A

Tone (atony)
Tissue (retained placental tissue)
Trauma (of genital tract)
Thrombin (coagulopathy)

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1
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2
3
4
5
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896
Q

Prophylaxis in HIV patients

A 
200 = PCP = Bactrim
150 = Histoplasma = Itraconazole
100 = Toxoplasma = Bactrim
50 = MAC = Azithromycin
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1
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2
3
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897
Q

Prophylaxis in posttransplant patients

A

Bactrim for PCP

Immunize against Influenza, pneumococcus, and HBV

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1
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2
3
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5
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898
Q

When to perform oral glucose tolerance test

A

24-28w

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899
Q

TSH, total T4, and free T4 levels in pregnancy

A

TSH down
Total T4 way up
Free T4 slightly up

Because beta-hCG has TSH-like activity and estrogen increases TBG

How well did you know this?
1
Not at all
2
3
4
5
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900
Q

Paraneoplastic syndromes of SCLC

A

ACTH (Cushing’s)
ADH (SIADH)
Lambert-Eaton syndrome

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3
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901
Q

Paraneoplastic syndromes of lung SCC

A

PTHrP (hypercalcemia)

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3
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5
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902
Q

Most common cause of urinary obstruction in newborn males

A

Posterior urethral valves

Can cause Potter’s sequence and hydronephrosis in-utero

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1
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2
3
4
5
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903
Q

Treatment for diabetic distal neuropathy

A

1) TCA’s

2) Gabapentin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
904
Q

EPS side effects of antipsychotics

A

Acute dystonic reaction (neck, mouth, tongue, EOM)
Akithisia (restlessness)
Parkinsonism
Tardive dyskinesia (after 1-6mo)

How well did you know this?
1
Not at all
2
3
4
5
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905
Q

Which hereditary hyperbilirubinemias present with unconjugated hyperbili?
What is the difference?

A

Gilbert’s - mild and occurs with fasting and stress

Crigler-Najjar - Severe with early death

How well did you know this?
1
Not at all
2
3
4
5
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906
Q

Which hereditary hyperbilirubinemias present with conjugated hyperbili?
What is the difference?

A

Rotor’s syndrome - normal appearing liver

Dubin-Johnson - Black liverf

907
Q

Treatment of the hereditary hyperbilirubinemias

A

Crigler-Najjar I - Phenobarbital
Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant

Dubin-Johnson, Rotor’s, Gilbert’s do not require treatment.

908
Q

Lab/vitals abnormalities of LBW infants

A 
Hypoxia
Hypothermia
Hypoglycemia
Hypocalcemia
Polycythemia
909
Q

What electrolyte derangements are seen with significant emesis?

A

Hypochloremic, hypokalemic metabolic alkalosis

Loss of HCl in vomit
Angiotensin II –> HCO3 resorption
Aldosterone –> H+ secretion and K+ secretion

910
Q

Superior sulcus tumor possible symptoms

A

Horner syndrome
Pancoast (ulnar pain distribution, shoulder weakness)
Hoarseness (RLN)
SVC syndrome

911
Q

Divisions of mediastinum and their masses

A

Anterior: 4 T’s (thymoma, teratoma, thyroid, terrible lymphoma)
Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma
Posterior: Neurogenic tumors

912
Q

Beck’s triad of cardiac tamponade

A

Hypotension
Distant heart sounds
Distended jugular veins

913
Q

When can chorionic villous sampling be done?

Amniocentesis?

A

CVS: 9-14w
Amniocentesis: 15-22w

914
Q

When to swab for GBS

915
Q

Quad screen results for Edwards syndrome

A

UNDERaged at 18

All are down

916
Q

Quad screen results for Down syndrome

A

2up 2down at 21

917
Q

Treatment of HIV in pregnancy

A

1) Zidovudine or Nevirapine during pregnancy
2) Elective c-section if viral load over 1000
3) Zidovudine for infant
4) No breastfeeding

918
Q

Normal fetal heart rate

Causes for bradycardia or tachycardia

A

110-160 bpm

Brady - Congenital heart malformations, hypoxia
Tachy - Hypoxia, maternal fever, fetal anemia

919
Q

Normal variability on FHT

920
Q

What does sinusoidal variability on FHT indicate?

A

Serious fetal anemia

921
Q

Treatment of hypercalcemia 2/2 malignancy

A

Short term: Normal saline, Calcitonin

Long term: Bisphosphonates

922
Q

Mutation seen in cri-du-chat syndrome

A

5p deletion

923
Q

Difference between gestational and chronic HTN

A

Chronic HTN if present before 20w or persists after 12w postpartum
Gestational HTN if presents after 20w

924
Q

Definition of preeclampsia

A

1) New-onset HTN after 20w or worsened chronic HTN

2) Proteinuria of over 300mg/24h (3+ proteins)

925
Q

Murmur of transposition of the great vessels

A

Single S2
+/- VSD murmur

Most common early cyanotic dz

926
Q

Murmur of tetralogy of Fallot

A

Pulmonic stenosis murmur

VSD murmur

927
Q

Treatment of transposition of the great vessels

A 
Prostaglandins early (to maintain PFO)
Emergent surgery
928
Q

Treatment of impetigo

A

Non-bullous (honey crusts) - Topical mupirocin

Bullous - Oral abx

929
Q

Symptoms of multiple myeloma

A

Calcium elevated
Renal dysfunction
Anemia
Bone lesions/Back pain

930
Q

Indications for carotid endarterectomy

A

Symptomatic 70-99%

Men asymptomatic 60-99%

931
Q

ESR and CK in glucocorticoid myopathy

A

Both normal

Painless weakness

932
Q

ESR and CK in Polymyalgia Rheumatica

A

ESR elevated

CK normal

933
Q

ESR and CK in statin-induced myopathy

A

ESR normal

CK elevated

934
Q

How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis

A

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
Q

What cancers are seen with HNPCC?

A

Colon cancer

Endometrial cancer

936
Q

What cancers are associated with nephrotic syndromes?

A

Adenocarcinoma - membranous nephropathy

Lymphoma - Minimal change disease

937
Q

Treatment of uric acid kidney stones

A

Oral potassium citrate

Citrate alkalinizes the urine and inhibits crystallization

938
Q

Solitary pulmonary nodule workup

A

Nonsmoker - compare to old CXR. Q3mo CXR’s. If stable for 12mo considered benign.

Smoker:

  • Chest CT
  • FNA
939
Q

Treatment for neonatal thyrotoxicosis

A

Methimazole + beta-blocker

Caused by maternal anti-TSH receptor Ab’s

940
Q

Extrahepatic manifestations of HCV

A

Porphyria cutanea tarda
Essential mixed cryoglobulinemia
Membranoproliferative GN

941
Q

Symptoms of mixed cryoglobulinemia

A

Purpura
Arthralgias
Weakness
Membranoproliferative GN

942
Q

Symptoms of galactosemia

A

Newborn with:

  • FTT
  • Bilateral cataracts
  • Jaundice
  • Hypoglycemia
943
Q

What is a normal AFI?

944
Q

At what EFW would you deliver by planned c-section due to macrosomia?

A

No DM: 5,000g

DM: 4,500g

945
Q

What maternal titer is considered Rh-sensitized?

A

1:16

So 1:20, 1:32, etc.

946
Q

Definition of PROM and PPROM

A

PROM: Rupture 1h or more before onset of labor
PPROM: Rupture between 20-37w

947
Q

What blood loss is considered postpartum hemorrhage?

A

500cc via vaginal delivery

1000cc via c-section

948
Q

Causes of postpartum hemorrhage

A

Tone (atony)
Tissue (retained placental tissue)
Trauma (of genital tract)
Thrombin (coagulopathy)

949
Q

Prophylaxis in HIV patients

A 
200 = PCP = Bactrim
150 = Histoplasma = Itraconazole
100 = Toxoplasma = Bactrim
50 = MAC = Azithromycin
950
Q

Prophylaxis in posttransplant patients

A

Bactrim for PCP

Immunize against Influenza, pneumococcus, and HBV

951
Q

When to perform oral glucose tolerance test

952
Q

TSH, total T4, and free T4 levels in pregnancy

A

TSH down
Total T4 way up
Free T4 slightly up

Because beta-hCG has TSH-like activity and estrogen increases TBG

953
Q

Paraneoplastic syndromes of SCLC

A

ACTH (Cushing’s)
ADH (SIADH)
Lambert-Eaton syndrome

954
Q

Paraneoplastic syndromes of lung SCC

A

PTHrP (hypercalcemia)

955
Q

Most common cause of urinary obstruction in newborn males

A

Posterior urethral valves

Can cause Potter’s sequence and hydronephrosis in-utero

956
Q

Treatment for diabetic distal neuropathy

A

1) TCA’s

2) Gabapentin

957
Q

EPS side effects of antipsychotics

A

Acute dystonic reaction (neck, mouth, tongue, EOM)
Akithisia (restlessness)
Parkinsonism
Tardive dyskinesia (after 1-6mo)

958
Q

Which hereditary hyperbilirubinemias present with unconjugated hyperbili?
What is the difference?

A

Gilbert’s - mild and occurs with fasting and stress

Crigler-Najjar - Severe with early death

959
Q

Which hereditary hyperbilirubinemias present with conjugated hyperbili?
What is the difference?

A

Rotor’s syndrome - normal appearing liver

Dubin-Johnson - Black liverf

960
Q

Treatment of the hereditary hyperbilirubinemias

A

Crigler-Najjar I - Phenobarbital
Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant

Dubin-Johnson, Rotor’s, Gilbert’s do not require treatment.

961
Q

Lab/vitals abnormalities of LBW infants

A 
Hypoxia
Hypothermia
Hypoglycemia
Hypocalcemia
Polycythemia
962
Q

What electrolyte derangements are seen with significant emesis?

A

Hypochloremic, hypokalemic metabolic alkalosis

Loss of HCl in vomit
Angiotensin II –> HCO3 resorption
Aldosterone –> H+ secretion and K+ secretion

963
Q

Superior sulcus tumor possible symptoms

A

Horner syndrome
Pancoast (ulnar pain distribution, shoulder weakness)
Hoarseness (RLN)
SVC syndrome

964
Q

Divisions of mediastinum and their masses

A

Anterior: 4 T’s (thymoma, teratoma, thyroid, terrible lymphoma)
Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma
Posterior: Neurogenic tumors

965
Q

Beck’s triad of cardiac tamponade

A

Hypotension
Distant heart sounds
Distended jugular veins

966
Q

When can chorionic villous sampling be done?

Amniocentesis?

A

CVS: 9-14w
Amniocentesis: 15-22w

967
Q

When to swab for GBS

968
Q

Quad screen results for Edwards syndrome

A

UNDERaged at 18

All are down

969
Q

Quad screen results for Down syndrome

A

2up 2down at 21

970
Q

Treatment of HIV in pregnancy

A

1) Zidovudine or Nevirapine during pregnancy
2) Elective c-section if viral load over 1000
3) Zidovudine for infant
4) No breastfeeding

971
Q

Normal fetal heart rate

Causes for bradycardia or tachycardia

A

110-160 bpm

Brady - Congenital heart malformations, hypoxia
Tachy - Hypoxia, maternal fever, fetal anemia

972
Q

Normal variability on FHT

973
Q

What does sinusoidal variability on FHT indicate?

A

Serious fetal anemia

974
Q

Treatment of hypercalcemia 2/2 malignancy

A

Short term: Normal saline, Calcitonin

Long term: Bisphosphonates

975
Q

Mutation seen in cri-du-chat syndrome

A

5p deletion

976
Q

Difference between gestational and chronic HTN

A

Chronic HTN if present before 20w or persists after 12w postpartum
Gestational HTN if presents after 20w

977
Q

Definition of preeclampsia

A

1) New-onset HTN after 20w or worsened chronic HTN

2) Proteinuria of over 300mg/24h (3+ proteins)

978
Q

Murmur of transposition of the great vessels

A

Single S2
+/- VSD murmur

Most common early cyanotic dz

979
Q

Murmur of tetralogy of Fallot

A

Pulmonic stenosis murmur

VSD murmur

980
Q

Treatment of transposition of the great vessels

A 
Prostaglandins early (to maintain PFO)
Emergent surgery
981
Q

Treatment of impetigo

A

Non-bullous (honey crusts) - Topical mupirocin

Bullous - Oral abx

982
Q

Symptoms of multiple myeloma

A

Calcium elevated
Renal dysfunction
Anemia
Bone lesions/Back pain

983
Q

Indications for carotid endarterectomy

A

Symptomatic 70-99%

Men asymptomatic 60-99%

984
Q

ESR and CK in glucocorticoid myopathy

A

Both normal

Painless weakness

985
Q

ESR and CK in Polymyalgia Rheumatica

A

ESR elevated

CK normal

986
Q

ESR and CK in statin-induced myopathy

A

ESR normal

CK elevated

987
Q

How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis

A

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
Q

What cancers are seen with HNPCC?

A

Colon cancer

Endometrial cancer

989
Q

What cancers are associated with nephrotic syndromes?

A

Adenocarcinoma - membranous nephropathy

Lymphoma - Minimal change disease

990
Q

Treatment of uric acid kidney stones

A

Oral potassium citrate

Citrate alkalinizes the urine and inhibits crystallization

991
Q

Solitary pulmonary nodule workup

A

Nonsmoker - compare to old CXR. Q3mo CXR’s. If stable for 12mo considered benign.

Smoker:

  • Chest CT
  • FNA
992
Q

Treatment for neonatal thyrotoxicosis

A

Methimazole + beta-blocker

Caused by maternal anti-TSH receptor Ab’s

993
Q

Extrahepatic manifestations of HCV

A

Porphyria cutanea tarda
Essential mixed cryoglobulinemia
Membranoproliferative GN

994
Q

Symptoms of mixed cryoglobulinemia

A

Purpura
Arthralgias
Weakness
Membranoproliferative GN

995
Q

Symptoms of galactosemia

A

Newborn with:

  • FTT
  • Bilateral cataracts
  • Jaundice
  • Hypoglycemia
996
Q

What is a normal AFI?

997
Q

At what EFW would you deliver by planned c-section due to macrosomia?

A

No DM: 5,000g

DM: 4,500g

998
Q

What maternal titer is considered Rh-sensitized?

A

1:16

So 1:20, 1:32, etc.

999
Q

Definition of PROM and PPROM

A

PROM: Rupture 1h or more before onset of labor
PPROM: Rupture between 20-37w

1000
Q

What blood loss is considered postpartum hemorrhage?

A

500cc via vaginal delivery

1000cc via c-section

1001
Q

Causes of postpartum hemorrhage

A

Tone (atony)
Tissue (retained placental tissue)
Trauma (of genital tract)
Thrombin (coagulopathy)

1002
Q

Prophylaxis in HIV patients

A 
200 = PCP = Bactrim
150 = Histoplasma = Itraconazole
100 = Toxoplasma = Bactrim
50 = MAC = Azithromycin
1003
Q

Prophylaxis in posttransplant patients

A

Bactrim for PCP

Immunize against Influenza, pneumococcus, and HBV

1004
Q

When to perform oral glucose tolerance test

1005
Q

TSH, total T4, and free T4 levels in pregnancy

A

TSH down
Total T4 way up
Free T4 slightly up

Because beta-hCG has TSH-like activity and estrogen increases TBG

1006
Q

Paraneoplastic syndromes of SCLC

A

ACTH (Cushing’s)
ADH (SIADH)
Lambert-Eaton syndrome

1007
Q

Paraneoplastic syndromes of lung SCC

A

PTHrP (hypercalcemia)

1008
Q

Most common cause of urinary obstruction in newborn males

A

Posterior urethral valves

Can cause Potter’s sequence and hydronephrosis in-utero

1009
Q

Treatment for diabetic distal neuropathy

A

1) TCA’s

2) Gabapentin

1010
Q

EPS side effects of antipsychotics

A

Acute dystonic reaction (neck, mouth, tongue, EOM)
Akithisia (restlessness)
Parkinsonism
Tardive dyskinesia (after 1-6mo)

1011
Q

Which hereditary hyperbilirubinemias present with unconjugated hyperbili?
What is the difference?

A

Gilbert’s - mild and occurs with fasting and stress

Crigler-Najjar - Severe with early death

1012
Q

Which hereditary hyperbilirubinemias present with conjugated hyperbili?
What is the difference?

A

Rotor’s syndrome - normal appearing liver

Dubin-Johnson - Black liverf

1013
Q

Treatment of the hereditary hyperbilirubinemias

A

Crigler-Najjar I - Phenobarbital
Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant

Dubin-Johnson, Rotor’s, Gilbert’s do not require treatment.

1014
Q

Lab/vitals abnormalities of LBW infants

A 
Hypoxia
Hypothermia
Hypoglycemia
Hypocalcemia
Polycythemia
1015
Q

What electrolyte derangements are seen with significant emesis?

A

Hypochloremic, hypokalemic metabolic alkalosis

Loss of HCl in vomit
Angiotensin II –> HCO3 resorption
Aldosterone –> H+ secretion and K+ secretion

1016
Q

Superior sulcus tumor possible symptoms

A

Horner syndrome
Pancoast (ulnar pain distribution, shoulder weakness)
Hoarseness (RLN)
SVC syndrome

1017
Q

Divisions of mediastinum and their masses

A

Anterior: 4 T’s (thymoma, teratoma, thyroid, terrible lymphoma)
Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma
Posterior: Neurogenic tumors

1018
Q

Beck’s triad of cardiac tamponade

A

Hypotension
Distant heart sounds
Distended jugular veins

1019
Q

When can chorionic villous sampling be done?

Amniocentesis?

A

CVS: 9-14w
Amniocentesis: 15-22w

1020
Q

When to swab for GBS

1021
Q

Quad screen results for Edwards syndrome

A

UNDERaged at 18

All are down

1022
Q

Quad screen results for Down syndrome

A

2up 2down at 21

1023
Q

Treatment of HIV in pregnancy

A

1) Zidovudine or Nevirapine during pregnancy
2) Elective c-section if viral load over 1000
3) Zidovudine for infant
4) No breastfeeding

1024
Q

Normal fetal heart rate

Causes for bradycardia or tachycardia

A

110-160 bpm

Brady - Congenital heart malformations, hypoxia
Tachy - Hypoxia, maternal fever, fetal anemia

1025
Q

Normal variability on FHT

1026
Q

What does sinusoidal variability on FHT indicate?

A

Serious fetal anemia

1027
Q

Treatment of hypercalcemia 2/2 malignancy

A

Short term: Normal saline, Calcitonin

Long term: Bisphosphonates

1028
Q

Mutation seen in cri-du-chat syndrome

A

5p deletion

1029
Q

Difference between gestational and chronic HTN

A

Chronic HTN if present before 20w or persists after 12w postpartum
Gestational HTN if presents after 20w

1030
Q

Definition of preeclampsia

A

1) New-onset HTN after 20w or worsened chronic HTN

2) Proteinuria of over 300mg/24h (3+ proteins)

1031
Q

Murmur of transposition of the great vessels

A

Single S2
+/- VSD murmur

Most common early cyanotic dz

1032
Q

Murmur of tetralogy of Fallot

A

Pulmonic stenosis murmur

VSD murmur

1033
Q

Treatment of transposition of the great vessels

A 
Prostaglandins early (to maintain PFO)
Emergent surgery
1034
Q

Treatment of impetigo

A

Non-bullous (honey crusts) - Topical mupirocin

Bullous - Oral abx

1035
Q

Symptoms of multiple myeloma

A

Calcium elevated
Renal dysfunction
Anemia
Bone lesions/Back pain

1036
Q

Indications for carotid endarterectomy

A

Symptomatic 70-99%

Men asymptomatic 60-99%

1037
Q

ESR and CK in glucocorticoid myopathy

A

Both normal

Painless weakness

1038
Q

ESR and CK in Polymyalgia Rheumatica

A

ESR elevated

CK normal

1039
Q

ESR and CK in statin-induced myopathy

A

ESR normal

CK elevated

1040
Q

How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis

A

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
Q

What cancers are seen with HNPCC?

A

Colon cancer

Endometrial cancer

1042
Q

What cancers are associated with nephrotic syndromes?

A

Adenocarcinoma - membranous nephropathy

Lymphoma - Minimal change disease

1043
Q

Treatment of uric acid kidney stones

A

Oral potassium citrate

Citrate alkalinizes the urine and inhibits crystallization

1044
Q

Solitary pulmonary nodule workup

A

Nonsmoker - compare to old CXR. Q3mo CXR’s. If stable for 12mo considered benign.

Smoker:

  • Chest CT
  • FNA
1045
Q

Treatment for neonatal thyrotoxicosis

A

Methimazole + beta-blocker

Caused by maternal anti-TSH receptor Ab’s

1046
Q

Extrahepatic manifestations of HCV

A

Porphyria cutanea tarda
Essential mixed cryoglobulinemia
Membranoproliferative GN

1047
Q

Symptoms of mixed cryoglobulinemia

A

Purpura
Arthralgias
Weakness
Membranoproliferative GN

1048
Q

Symptoms of galactosemia

A

Newborn with:

  • FTT
  • Bilateral cataracts
  • Jaundice
  • Hypoglycemia
1049
Q

What is a normal AFI?

1050
Q

At what EFW would you deliver by planned c-section due to macrosomia?

A

No DM: 5,000g

DM: 4,500g

1051
Q

What maternal titer is considered Rh-sensitized?

A

1:16

So 1:20, 1:32, etc.

1052
Q

Definition of PROM and PPROM

A

PROM: Rupture 1h or more before onset of labor
PPROM: Rupture between 20-37w

1053
Q

What blood loss is considered postpartum hemorrhage?

A

500cc via vaginal delivery

1000cc via c-section

1054
Q

Causes of postpartum hemorrhage

A

Tone (atony)
Tissue (retained placental tissue)
Trauma (of genital tract)
Thrombin (coagulopathy)

1055
Q

Prophylaxis in HIV patients

A 
200 = PCP = Bactrim
150 = Histoplasma = Itraconazole
100 = Toxoplasma = Bactrim
50 = MAC = Azithromycin
1056
Q

Prophylaxis in posttransplant patients

A

Bactrim for PCP

Immunize against Influenza, pneumococcus, and HBV

1057
Q

When to perform oral glucose tolerance test

1058
Q

TSH, total T4, and free T4 levels in pregnancy

A

TSH down
Total T4 way up
Free T4 slightly up

Because beta-hCG has TSH-like activity and estrogen increases TBG

1059
Q

Paraneoplastic syndromes of SCLC

A

ACTH (Cushing’s)
ADH (SIADH)
Lambert-Eaton syndrome

1060
Q

Paraneoplastic syndromes of lung SCC

A

PTHrP (hypercalcemia)

1061
Q

Most common cause of urinary obstruction in newborn males

A

Posterior urethral valves

Can cause Potter’s sequence and hydronephrosis in-utero

1062
Q

Treatment for diabetic distal neuropathy

A

1) TCA’s

2) Gabapentin

1063
Q

EPS side effects of antipsychotics

A

Acute dystonic reaction (neck, mouth, tongue, EOM)
Akithisia (restlessness)
Parkinsonism
Tardive dyskinesia (after 1-6mo)

1064
Q

Which hereditary hyperbilirubinemias present with unconjugated hyperbili?
What is the difference?

A

Gilbert’s - mild and occurs with fasting and stress

Crigler-Najjar - Severe with early death

1065
Q

Which hereditary hyperbilirubinemias present with conjugated hyperbili?
What is the difference?

A

Rotor’s syndrome - normal appearing liver

Dubin-Johnson - Black liverf

1066
Q

Treatment of the hereditary hyperbilirubinemias

A

Crigler-Najjar I - Phenobarbital
Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant

Dubin-Johnson, Rotor’s, Gilbert’s do not require treatment.

1067
Q

Lab/vitals abnormalities of LBW infants

A 
Hypoxia
Hypothermia
Hypoglycemia
Hypocalcemia
Polycythemia
1068
Q

What electrolyte derangements are seen with significant emesis?

A

Hypochloremic, hypokalemic metabolic alkalosis

Loss of HCl in vomit
Angiotensin II –> HCO3 resorption
Aldosterone –> H+ secretion and K+ secretion

1069
Q

Superior sulcus tumor possible symptoms

A

Horner syndrome
Pancoast (ulnar pain distribution, shoulder weakness)
Hoarseness (RLN)
SVC syndrome

1070
Q

Divisions of mediastinum and their masses

A

Anterior: 4 T’s (thymoma, teratoma, thyroid, terrible lymphoma)
Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma
Posterior: Neurogenic tumors

1071
Q

Beck’s triad of cardiac tamponade

A

Hypotension
Distant heart sounds
Distended jugular veins

1072
Q

When can chorionic villous sampling be done?

Amniocentesis?

A

CVS: 9-14w
Amniocentesis: 15-22w

1073
Q

When to swab for GBS

1074
Q

Quad screen results for Edwards syndrome

A

UNDERaged at 18

All are down

1075
Q

Quad screen results for Down syndrome

A

2up 2down at 21

1076
Q

Treatment of HIV in pregnancy

A

1) Zidovudine or Nevirapine during pregnancy
2) Elective c-section if viral load over 1000
3) Zidovudine for infant
4) No breastfeeding

1077
Q

Normal fetal heart rate

Causes for bradycardia or tachycardia

A

110-160 bpm

Brady - Congenital heart malformations, hypoxia
Tachy - Hypoxia, maternal fever, fetal anemia

1078
Q

Normal variability on FHT

1079
Q

What does sinusoidal variability on FHT indicate?

A

Serious fetal anemia

1080
Q

Treatment of hypercalcemia 2/2 malignancy

A

Short term: Normal saline, Calcitonin

Long term: Bisphosphonates

1081
Q

Mutation seen in cri-du-chat syndrome

A

5p deletion

1082
Q

Difference between gestational and chronic HTN

A

Chronic HTN if present before 20w or persists after 12w postpartum
Gestational HTN if presents after 20w

1083
Q

Definition of preeclampsia

A

1) New-onset HTN after 20w or worsened chronic HTN

2) Proteinuria of over 300mg/24h (3+ proteins)

1084
Q

Murmur of transposition of the great vessels

A

Single S2
+/- VSD murmur

Most common early cyanotic dz

1085
Q

Murmur of tetralogy of Fallot

A

Pulmonic stenosis murmur

VSD murmur

1086
Q

Treatment of transposition of the great vessels

A 
Prostaglandins early (to maintain PFO)
Emergent surgery
1087
Q

Treatment of impetigo

A

Non-bullous (honey crusts) - Topical mupirocin

Bullous - Oral abx

1088
Q

Symptoms of multiple myeloma

A

Calcium elevated
Renal dysfunction
Anemia
Bone lesions/Back pain

1089
Q

Indications for carotid endarterectomy

A

Symptomatic 70-99%

Men asymptomatic 60-99%

1090
Q

ESR and CK in glucocorticoid myopathy

A

Both normal

Painless weakness

1091
Q

ESR and CK in Polymyalgia Rheumatica

A

ESR elevated

CK normal

1092
Q

ESR and CK in statin-induced myopathy

A

ESR normal

CK elevated

1093
Q

How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis

A

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
Q

What cancers are seen with HNPCC?

A

Colon cancer

Endometrial cancer

1095
Q

What cancers are associated with nephrotic syndromes?

A

Adenocarcinoma - membranous nephropathy

Lymphoma - Minimal change disease

1096
Q

Treatment of uric acid kidney stones

A

Oral potassium citrate

Citrate alkalinizes the urine and inhibits crystallization

1097
Q

Solitary pulmonary nodule workup

A

Nonsmoker - compare to old CXR. Q3mo CXR’s. If stable for 12mo considered benign.

Smoker:

  • Chest CT
  • FNA
1098
Q

Treatment for neonatal thyrotoxicosis

A

Methimazole + beta-blocker

Caused by maternal anti-TSH receptor Ab’s

1099
Q

Extrahepatic manifestations of HCV

A

Porphyria cutanea tarda
Essential mixed cryoglobulinemia
Membranoproliferative GN

1100
Q

Symptoms of mixed cryoglobulinemia

A

Purpura
Arthralgias
Weakness
Membranoproliferative GN

1101
Q

Symptoms of galactosemia

A

Newborn with:

  • FTT
  • Bilateral cataracts
  • Jaundice
  • Hypoglycemia
1102
Q

What is a normal AFI?

1103
Q

At what EFW would you deliver by planned c-section due to macrosomia?

A

No DM: 5,000g

DM: 4,500g

1104
Q

What maternal titer is considered Rh-sensitized?

A

1:16

So 1:20, 1:32, etc.

1105
Q

Definition of PROM and PPROM

A

PROM: Rupture 1h or more before onset of labor
PPROM: Rupture between 20-37w

1106
Q

What blood loss is considered postpartum hemorrhage?

A

500cc via vaginal delivery

1000cc via c-section

1107
Q

Causes of postpartum hemorrhage

A

Tone (atony)
Tissue (retained placental tissue)
Trauma (of genital tract)
Thrombin (coagulopathy)

1108
Q

Prophylaxis in HIV patients

A 
200 = PCP = Bactrim
150 = Histoplasma = Itraconazole
100 = Toxoplasma = Bactrim
50 = MAC = Azithromycin
1109
Q

Prophylaxis in posttransplant patients

A

Bactrim for PCP

Immunize against Influenza, pneumococcus, and HBV

1110
Q

When to perform oral glucose tolerance test

1111
Q

TSH, total T4, and free T4 levels in pregnancy

A

TSH down
Total T4 way up
Free T4 slightly up

Because beta-hCG has TSH-like activity and estrogen increases TBG

1112
Q

Paraneoplastic syndromes of SCLC

A

ACTH (Cushing’s)
ADH (SIADH)
Lambert-Eaton syndrome

1113
Q

Paraneoplastic syndromes of lung SCC

A

PTHrP (hypercalcemia)

1114
Q

Most common cause of urinary obstruction in newborn males

A

Posterior urethral valves

Can cause Potter’s sequence and hydronephrosis in-utero

1115
Q

Treatment for diabetic distal neuropathy

A

1) TCA’s

2) Gabapentin

1116
Q

EPS side effects of antipsychotics

A

Acute dystonic reaction (neck, mouth, tongue, EOM)
Akithisia (restlessness)
Parkinsonism
Tardive dyskinesia (after 1-6mo)

1117
Q

Which hereditary hyperbilirubinemias present with unconjugated hyperbili?
What is the difference?

A

Gilbert’s - mild and occurs with fasting and stress

Crigler-Najjar - Severe with early death

1118
Q

Which hereditary hyperbilirubinemias present with conjugated hyperbili?
What is the difference?

A

Rotor’s syndrome - normal appearing liver

Dubin-Johnson - Black liverf

1119
Q

Treatment of the hereditary hyperbilirubinemias

A

Crigler-Najjar I - Phenobarbital
Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant

Dubin-Johnson, Rotor’s, Gilbert’s do not require treatment.

1120
Q

Lab/vitals abnormalities of LBW infants

A 
Hypoxia
Hypothermia
Hypoglycemia
Hypocalcemia
Polycythemia
1121
Q

What electrolyte derangements are seen with significant emesis?

A

Hypochloremic, hypokalemic metabolic alkalosis

Loss of HCl in vomit
Angiotensin II –> HCO3 resorption
Aldosterone –> H+ secretion and K+ secretion

1122
Q

Superior sulcus tumor possible symptoms

A

Horner syndrome
Pancoast (ulnar pain distribution, shoulder weakness)
Hoarseness (RLN)
SVC syndrome

1123
Q

Divisions of mediastinum and their masses

A

Anterior: 4 T’s (thymoma, teratoma, thyroid, terrible lymphoma)
Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma
Posterior: Neurogenic tumors

1124
Q

Beck’s triad of cardiac tamponade

A

Hypotension
Distant heart sounds
Distended jugular veins

1125
Q

When can chorionic villous sampling be done?

Amniocentesis?

A

CVS: 9-14w
Amniocentesis: 15-22w

1126
Q

When to swab for GBS

1127
Q

Quad screen results for Edwards syndrome

A

UNDERaged at 18

All are down

1128
Q

Quad screen results for Down syndrome

A

2up 2down at 21

1129
Q

Treatment of HIV in pregnancy

A

1) Zidovudine or Nevirapine during pregnancy
2) Elective c-section if viral load over 1000
3) Zidovudine for infant
4) No breastfeeding

1130
Q

Normal fetal heart rate

Causes for bradycardia or tachycardia

A

110-160 bpm

Brady - Congenital heart malformations, hypoxia
Tachy - Hypoxia, maternal fever, fetal anemia

1131
Q

Normal variability on FHT

1132
Q

What does sinusoidal variability on FHT indicate?

A

Serious fetal anemia

1133
Q

Treatment of hypercalcemia 2/2 malignancy

A

Short term: Normal saline, Calcitonin

Long term: Bisphosphonates

1134
Q

Mutation seen in cri-du-chat syndrome

A

5p deletion

1135
Q

Difference between gestational and chronic HTN

A

Chronic HTN if present before 20w or persists after 12w postpartum
Gestational HTN if presents after 20w

1136
Q

Definition of preeclampsia

A

1) New-onset HTN after 20w or worsened chronic HTN

2) Proteinuria of over 300mg/24h (3+ proteins)

1137
Q

Murmur of transposition of the great vessels

A

Single S2
+/- VSD murmur

Most common early cyanotic dz

1138
Q

Murmur of tetralogy of Fallot

A

Pulmonic stenosis murmur

VSD murmur

1139
Q

Treatment of transposition of the great vessels

A 
Prostaglandins early (to maintain PFO)
Emergent surgery
1140
Q

Treatment of impetigo

A

Non-bullous (honey crusts) - Topical mupirocin

Bullous - Oral abx

1141
Q

Symptoms of multiple myeloma

A

Calcium elevated
Renal dysfunction
Anemia
Bone lesions/Back pain

1142
Q

Indications for carotid endarterectomy

A

Symptomatic 70-99%

Men asymptomatic 60-99%

1143
Q

ESR and CK in glucocorticoid myopathy

A

Both normal

Painless weakness

1144
Q

ESR and CK in Polymyalgia Rheumatica

A

ESR elevated

CK normal

1145
Q

ESR and CK in statin-induced myopathy

A

ESR normal

CK elevated

1146
Q

How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis

A

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
Q

What cancers are seen with HNPCC?

A

Colon cancer

Endometrial cancer

1148
Q

What cancers are associated with nephrotic syndromes?

A

Adenocarcinoma - membranous nephropathy

Lymphoma - Minimal change disease

1149
Q

Treatment of uric acid kidney stones

A

Oral potassium citrate

Citrate alkalinizes the urine and inhibits crystallization

1150
Q

Solitary pulmonary nodule workup

A

Nonsmoker - compare to old CXR. Q3mo CXR’s. If stable for 12mo considered benign.

Smoker:

  • Chest CT
  • FNA
1151
Q

Treatment for neonatal thyrotoxicosis

A

Methimazole + beta-blocker

Caused by maternal anti-TSH receptor Ab’s

1152
Q

Extrahepatic manifestations of HCV

A

Porphyria cutanea tarda
Essential mixed cryoglobulinemia
Membranoproliferative GN

1153
Q

Symptoms of mixed cryoglobulinemia

A

Purpura
Arthralgias
Weakness
Membranoproliferative GN

1154
Q

Symptoms of galactosemia

A

Newborn with:

  • FTT
  • Bilateral cataracts
  • Jaundice
  • Hypoglycemia
1155
Q

Prophylaxis in HIV patients

A 
200 = PCP = Bactrim
150 = Histoplasma = Itraconazole
100 = Toxoplasma = Bactrim
50 = MAC = Azithromycin
1156
Q

Prophylaxis in posttransplant patients

A

Bactrim for PCP

Immunize against Influenza, pneumococcus, and HBV

1157
Q

When to perform oral glucose tolerance test

1158
Q

TSH, total T4, and free T4 levels in pregnancy

A

TSH down
Total T4 way up
Free T4 slightly up

Because beta-hCG has TSH-like activity and estrogen increases TBG

1159
Q

Paraneoplastic syndromes of SCLC

A

ACTH (Cushing’s)
ADH (SIADH)
Lambert-Eaton syndrome

1160
Q

Paraneoplastic syndromes of lung SCC

A

PTHrP (hypercalcemia)

1161
Q

Most common cause of urinary obstruction in newborn males

A

Posterior urethral valves

Can cause Potter’s sequence and hydronephrosis in-utero

1162
Q

Treatment for diabetic distal neuropathy

A

1) TCA’s

2) Gabapentin

1163
Q

EPS side effects of antipsychotics

A

Acute dystonic reaction (neck, mouth, tongue, EOM)
Akithisia (restlessness)
Parkinsonism
Tardive dyskinesia (after 1-6mo)

1164
Q

Which hereditary hyperbilirubinemias present with unconjugated hyperbili?
What is the difference?

A

Gilbert’s - mild and occurs with fasting and stress

Crigler-Najjar - Severe with early death

1165
Q

Which hereditary hyperbilirubinemias present with conjugated hyperbili?
What is the difference?

A

Rotor’s syndrome - normal appearing liver

Dubin-Johnson - Black liverf

1166
Q

Treatment of the hereditary hyperbilirubinemias

A

Crigler-Najjar I - Phenobarbital
Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant

Dubin-Johnson, Rotor’s, Gilbert’s do not require treatment.

1167
Q

Lab/vitals abnormalities of LBW infants

A 
Hypoxia
Hypothermia
Hypoglycemia
Hypocalcemia
Polycythemia
1168
Q

What electrolyte derangements are seen with significant emesis?

A

Hypochloremic, hypokalemic metabolic alkalosis

Loss of HCl in vomit
Angiotensin II –> HCO3 resorption
Aldosterone –> H+ secretion and K+ secretion

1169
Q

Superior sulcus tumor possible symptoms

A

Horner syndrome
Pancoast (ulnar pain distribution, shoulder weakness)
Hoarseness (RLN)
SVC syndrome

1170
Q

Divisions of mediastinum and their masses

A

Anterior: 4 T’s (thymoma, teratoma, thyroid, terrible lymphoma)
Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma
Posterior: Neurogenic tumors

1171
Q

Beck’s triad of cardiac tamponade

A

Hypotension
Distant heart sounds
Distended jugular veins

1172
Q

When can chorionic villous sampling be done?

Amniocentesis?

A

CVS: 9-14w
Amniocentesis: 15-22w

1173
Q

When to swab for GBS

1174
Q

Quad screen results for Edwards syndrome

A

UNDERaged at 18

All are down

1175
Q

Quad screen results for Down syndrome

A

2up 2down at 21

1176
Q

Treatment of HIV in pregnancy

A

1) Zidovudine or Nevirapine during pregnancy
2) Elective c-section if viral load over 1000
3) Zidovudine for infant
4) No breastfeeding

1177
Q

Normal fetal heart rate

Causes for bradycardia or tachycardia

A

110-160 bpm

Brady - Congenital heart malformations, hypoxia
Tachy - Hypoxia, maternal fever, fetal anemia

1178
Q

Normal variability on FHT

1179
Q

What does sinusoidal variability on FHT indicate?

A

Serious fetal anemia

1180
Q

Treatment of hypercalcemia 2/2 malignancy

A

Short term: Normal saline, Calcitonin

Long term: Bisphosphonates

1181
Q

Mutation seen in cri-du-chat syndrome

A

5p deletion

1182
Q

Difference between gestational and chronic HTN

A

Chronic HTN if present before 20w or persists after 12w postpartum
Gestational HTN if presents after 20w

1183
Q

Definition of preeclampsia

A

1) New-onset HTN after 20w or worsened chronic HTN

2) Proteinuria of over 300mg/24h (3+ proteins)

1184
Q

Murmur of transposition of the great vessels

A

Single S2
+/- VSD murmur

Most common early cyanotic dz

1185
Q

Murmur of tetralogy of Fallot

A

Pulmonic stenosis murmur

VSD murmur

1186
Q

Treatment of transposition of the great vessels

A 
Prostaglandins early (to maintain PFO)
Emergent surgery
1187
Q

Treatment of impetigo

A

Non-bullous (honey crusts) - Topical mupirocin

Bullous - Oral abx

1188
Q

Symptoms of multiple myeloma

A

Calcium elevated
Renal dysfunction
Anemia
Bone lesions/Back pain

1189
Q

Indications for carotid endarterectomy

A

Symptomatic 70-99%

Men asymptomatic 60-99%

1190
Q

ESR and CK in glucocorticoid myopathy

A

Both normal

Painless weakness

1191
Q

ESR and CK in Polymyalgia Rheumatica

A

ESR elevated

CK normal

1192
Q

ESR and CK in statin-induced myopathy

A

ESR normal

CK elevated

1193
Q

How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis

A

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
Q

What cancers are seen with HNPCC?

A

Colon cancer

Endometrial cancer

1195
Q

What cancers are associated with nephrotic syndromes?

A

Adenocarcinoma - membranous nephropathy

Lymphoma - Minimal change disease

1196
Q

Treatment of uric acid kidney stones

A

Oral potassium citrate

Citrate alkalinizes the urine and inhibits crystallization

1197
Q

Solitary pulmonary nodule workup

A

Nonsmoker - compare to old CXR. Q3mo CXR’s. If stable for 12mo considered benign.

Smoker:

  • Chest CT
  • FNA
1198
Q

Treatment for neonatal thyrotoxicosis

A

Methimazole + beta-blocker

Caused by maternal anti-TSH receptor Ab’s

1199
Q

Extrahepatic manifestations of HCV

A

Porphyria cutanea tarda
Essential mixed cryoglobulinemia
Membranoproliferative GN

1200
Q

Symptoms of mixed cryoglobulinemia

A

Purpura
Arthralgias
Weakness
Membranoproliferative GN

1201
Q

Symptoms of galactosemia

A

Newborn with:

  • FTT
  • Bilateral cataracts
  • Jaundice
  • Hypoglycemia
1202
Q

Prophylaxis in HIV patients

A 
200 = PCP = Bactrim
150 = Histoplasma = Itraconazole
100 = Toxoplasma = Bactrim
50 = MAC = Azithromycin
1203
Q

Prophylaxis in posttransplant patients

A

Bactrim for PCP

Immunize against Influenza, pneumococcus, and HBV

1204
Q

When to perform oral glucose tolerance test

1205
Q

TSH, total T4, and free T4 levels in pregnancy

A

TSH down
Total T4 way up
Free T4 slightly up

Because beta-hCG has TSH-like activity and estrogen increases TBG

1206
Q

Paraneoplastic syndromes of SCLC

A

ACTH (Cushing’s)
ADH (SIADH)
Lambert-Eaton syndrome

1207
Q

Paraneoplastic syndromes of lung SCC

A

PTHrP (hypercalcemia)

1208
Q

Most common cause of urinary obstruction in newborn males

A

Posterior urethral valves

Can cause Potter’s sequence and hydronephrosis in-utero

1209
Q

Treatment for diabetic distal neuropathy

A

1) TCA’s

2) Gabapentin

1210
Q

EPS side effects of antipsychotics

A

Acute dystonic reaction (neck, mouth, tongue, EOM)
Akithisia (restlessness)
Parkinsonism
Tardive dyskinesia (after 1-6mo)

1211
Q

Which hereditary hyperbilirubinemias present with unconjugated hyperbili?
What is the difference?

A

Gilbert’s - mild and occurs with fasting and stress

Crigler-Najjar - Severe with early death

1212
Q

Which hereditary hyperbilirubinemias present with conjugated hyperbili?
What is the difference?

A

Rotor’s syndrome - normal appearing liver

Dubin-Johnson - Black liverf

1213
Q

Treatment of the hereditary hyperbilirubinemias

A

Crigler-Najjar I - Phenobarbital
Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant

Dubin-Johnson, Rotor’s, Gilbert’s do not require treatment.

1214
Q

Lab/vitals abnormalities of LBW infants

A 
Hypoxia
Hypothermia
Hypoglycemia
Hypocalcemia
Polycythemia
1215
Q

What electrolyte derangements are seen with significant emesis?

A

Hypochloremic, hypokalemic metabolic alkalosis

Loss of HCl in vomit
Angiotensin II –> HCO3 resorption
Aldosterone –> H+ secretion and K+ secretion

1216
Q

Superior sulcus tumor possible symptoms

A

Horner syndrome
Pancoast (ulnar pain distribution, shoulder weakness)
Hoarseness (RLN)
SVC syndrome

1217
Q

Divisions of mediastinum and their masses

A

Anterior: 4 T’s (thymoma, teratoma, thyroid, terrible lymphoma)
Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma
Posterior: Neurogenic tumors

1218
Q

Beck’s triad of cardiac tamponade

A

Hypotension
Distant heart sounds
Distended jugular veins

1219
Q

When can chorionic villous sampling be done?

Amniocentesis?

A

CVS: 9-14w
Amniocentesis: 15-22w

1220
Q

When to swab for GBS

1221
Q

Quad screen results for Edwards syndrome

A

UNDERaged at 18

All are down

1222
Q

Quad screen results for Down syndrome

A

2up 2down at 21

1223
Q

Treatment of HIV in pregnancy

A

1) Zidovudine or Nevirapine during pregnancy
2) Elective c-section if viral load over 1000
3) Zidovudine for infant
4) No breastfeeding

1224
Q

Normal fetal heart rate

Causes for bradycardia or tachycardia

A

110-160 bpm

Brady - Congenital heart malformations, hypoxia
Tachy - Hypoxia, maternal fever, fetal anemia

1225
Q

Normal variability on FHT

1226
Q

What does sinusoidal variability on FHT indicate?

A

Serious fetal anemia

1227
Q

Treatment of hypercalcemia 2/2 malignancy

A

Short term: Normal saline, Calcitonin

Long term: Bisphosphonates

1228
Q

Mutation seen in cri-du-chat syndrome

A

5p deletion

1229
Q

Difference between gestational and chronic HTN

A

Chronic HTN if present before 20w or persists after 12w postpartum
Gestational HTN if presents after 20w

1230
Q

Definition of preeclampsia

A

1) New-onset HTN after 20w or worsened chronic HTN

2) Proteinuria of over 300mg/24h (3+ proteins)

1231
Q

Murmur of transposition of the great vessels

A

Single S2
+/- VSD murmur

Most common early cyanotic dz

1232
Q

Murmur of tetralogy of Fallot

A

Pulmonic stenosis murmur

VSD murmur

1233
Q

Treatment of transposition of the great vessels

A 
Prostaglandins early (to maintain PFO)
Emergent surgery
1234
Q

Treatment of impetigo

A

Non-bullous (honey crusts) - Topical mupirocin

Bullous - Oral abx

1235
Q

Symptoms of multiple myeloma

A

Calcium elevated
Renal dysfunction
Anemia
Bone lesions/Back pain

1236
Q

Indications for carotid endarterectomy

A

Symptomatic 70-99%

Men asymptomatic 60-99%

1237
Q

ESR and CK in glucocorticoid myopathy

A

Both normal

Painless weakness

1238
Q

ESR and CK in Polymyalgia Rheumatica

A

ESR elevated

CK normal

1239
Q

ESR and CK in statin-induced myopathy

A

ESR normal

CK elevated

1240
Q

How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis

A

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
Q

What cancers are seen with HNPCC?

A

Colon cancer

Endometrial cancer

1242
Q

What cancers are associated with nephrotic syndromes?

A

Adenocarcinoma - membranous nephropathy

Lymphoma - Minimal change disease

1243
Q

Treatment of uric acid kidney stones

A

Oral potassium citrate

Citrate alkalinizes the urine and inhibits crystallization

1244
Q

Solitary pulmonary nodule workup

A

Nonsmoker - compare to old CXR. Q3mo CXR’s. If stable for 12mo considered benign.

Smoker:

  • Chest CT
  • FNA
1245
Q

Treatment for neonatal thyrotoxicosis

A

Methimazole + beta-blocker

Caused by maternal anti-TSH receptor Ab’s

1246
Q

Extrahepatic manifestations of HCV

A

Porphyria cutanea tarda
Essential mixed cryoglobulinemia
Membranoproliferative GN

1247
Q

Symptoms of mixed cryoglobulinemia

A

Purpura
Arthralgias
Weakness
Membranoproliferative GN

1248
Q

Symptoms of galactosemia

A

Newborn with:

  • FTT
  • Bilateral cataracts
  • Jaundice
  • Hypoglycemia
1249
Q

Prophylaxis in HIV patients

A 
200 = PCP = Bactrim
150 = Histoplasma = Itraconazole
100 = Toxoplasma = Bactrim
50 = MAC = Azithromycin
1250
Q

Prophylaxis in posttransplant patients

A

Bactrim for PCP

Immunize against Influenza, pneumococcus, and HBV

1251
Q

When to perform oral glucose tolerance test

1252
Q

TSH, total T4, and free T4 levels in pregnancy

A

TSH down
Total T4 way up
Free T4 slightly up

Because beta-hCG has TSH-like activity and estrogen increases TBG

1253
Q

Paraneoplastic syndromes of SCLC

A

ACTH (Cushing’s)
ADH (SIADH)
Lambert-Eaton syndrome

1254
Q

Paraneoplastic syndromes of lung SCC

A

PTHrP (hypercalcemia)

1255
Q

Most common cause of urinary obstruction in newborn males

A

Posterior urethral valves

Can cause Potter’s sequence and hydronephrosis in-utero

1256
Q

Treatment for diabetic distal neuropathy

A

1) TCA’s

2) Gabapentin

1257
Q

EPS side effects of antipsychotics

A

Acute dystonic reaction (neck, mouth, tongue, EOM)
Akithisia (restlessness)
Parkinsonism
Tardive dyskinesia (after 1-6mo)

1258
Q

Which hereditary hyperbilirubinemias present with unconjugated hyperbili?
What is the difference?

A

Gilbert’s - mild and occurs with fasting and stress

Crigler-Najjar - Severe with early death

1259
Q

Which hereditary hyperbilirubinemias present with conjugated hyperbili?
What is the difference?

A

Rotor’s syndrome - normal appearing liver

Dubin-Johnson - Black liverf

1260
Q

Treatment of the hereditary hyperbilirubinemias

A

Crigler-Najjar I - Phenobarbital
Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant

Dubin-Johnson, Rotor’s, Gilbert’s do not require treatment.

1261
Q

Lab/vitals abnormalities of LBW infants

A 
Hypoxia
Hypothermia
Hypoglycemia
Hypocalcemia
Polycythemia
1262
Q

What electrolyte derangements are seen with significant emesis?

A

Hypochloremic, hypokalemic metabolic alkalosis

Loss of HCl in vomit
Angiotensin II –> HCO3 resorption
Aldosterone –> H+ secretion and K+ secretion

1263
Q

Superior sulcus tumor possible symptoms

A

Horner syndrome
Pancoast (ulnar pain distribution, shoulder weakness)
Hoarseness (RLN)
SVC syndrome

1264
Q

Divisions of mediastinum and their masses

A

Anterior: 4 T’s (thymoma, teratoma, thyroid, terrible lymphoma)
Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma
Posterior: Neurogenic tumors

1265
Q

Beck’s triad of cardiac tamponade

A

Hypotension
Distant heart sounds
Distended jugular veins

1266
Q

When can chorionic villous sampling be done?

Amniocentesis?

A

CVS: 9-14w
Amniocentesis: 15-22w

1267
Q

When to swab for GBS

1268
Q

Quad screen results for Edwards syndrome

A

UNDERaged at 18

All are down

1269
Q

Quad screen results for Down syndrome

A

2up 2down at 21

1270
Q

Treatment of HIV in pregnancy

A

1) Zidovudine or Nevirapine during pregnancy
2) Elective c-section if viral load over 1000
3) Zidovudine for infant
4) No breastfeeding

1271
Q

Normal fetal heart rate

Causes for bradycardia or tachycardia

A

110-160 bpm

Brady - Congenital heart malformations, hypoxia
Tachy - Hypoxia, maternal fever, fetal anemia

1272
Q

Normal variability on FHT

1273
Q

What does sinusoidal variability on FHT indicate?

A

Serious fetal anemia

1274
Q

Treatment of hypercalcemia 2/2 malignancy

A

Short term: Normal saline, Calcitonin

Long term: Bisphosphonates

1275
Q

Mutation seen in cri-du-chat syndrome

A

5p deletion

1276
Q

Difference between gestational and chronic HTN

A

Chronic HTN if present before 20w or persists after 12w postpartum
Gestational HTN if presents after 20w

1277
Q

Definition of preeclampsia

A

1) New-onset HTN after 20w or worsened chronic HTN

2) Proteinuria of over 300mg/24h (3+ proteins)

1278
Q

Murmur of transposition of the great vessels

A

Single S2
+/- VSD murmur

Most common early cyanotic dz

1279
Q

Murmur of tetralogy of Fallot

A

Pulmonic stenosis murmur

VSD murmur

1280
Q

Treatment of transposition of the great vessels

A 
Prostaglandins early (to maintain PFO)
Emergent surgery
1281
Q

Treatment of impetigo

A

Non-bullous (honey crusts) - Topical mupirocin

Bullous - Oral abx

1282
Q

Symptoms of multiple myeloma

A

Calcium elevated
Renal dysfunction
Anemia
Bone lesions/Back pain

1283
Q

Indications for carotid endarterectomy

A

Symptomatic 70-99%

Men asymptomatic 60-99%

1284
Q

ESR and CK in glucocorticoid myopathy

A

Both normal

Painless weakness

1285
Q

ESR and CK in Polymyalgia Rheumatica

A

ESR elevated

CK normal

1286
Q

ESR and CK in statin-induced myopathy

A

ESR normal

CK elevated

1287
Q

How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis

A

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
Q

What cancers are seen with HNPCC?

A

Colon cancer

Endometrial cancer

1289
Q

What cancers are associated with nephrotic syndromes?

A

Adenocarcinoma - membranous nephropathy

Lymphoma - Minimal change disease

1290
Q

Treatment of uric acid kidney stones

A

Oral potassium citrate

Citrate alkalinizes the urine and inhibits crystallization

1291
Q

Solitary pulmonary nodule workup

A

Nonsmoker - compare to old CXR. Q3mo CXR’s. If stable for 12mo considered benign.

Smoker:

  • Chest CT
  • FNA
1292
Q

Treatment for neonatal thyrotoxicosis

A

Methimazole + beta-blocker

Caused by maternal anti-TSH receptor Ab’s

1293
Q

Extrahepatic manifestations of HCV

A

Porphyria cutanea tarda
Essential mixed cryoglobulinemia
Membranoproliferative GN

1294
Q

Symptoms of mixed cryoglobulinemia

A

Purpura
Arthralgias
Weakness
Membranoproliferative GN

1295
Q

Symptoms of galactosemia

A

Newborn with:

  • FTT
  • Bilateral cataracts
  • Jaundice
  • Hypoglycemia
1296
Q

Prophylaxis in HIV patients

A 
200 = PCP = Bactrim
150 = Histoplasma = Itraconazole
100 = Toxoplasma = Bactrim
50 = MAC = Azithromycin
1297
Q

Prophylaxis in posttransplant patients

A

Bactrim for PCP

Immunize against Influenza, pneumococcus, and HBV

1298
Q

When to perform oral glucose tolerance test

1299
Q

TSH, total T4, and free T4 levels in pregnancy

A

TSH down
Total T4 way up
Free T4 slightly up

Because beta-hCG has TSH-like activity and estrogen increases TBG

1300
Q

Paraneoplastic syndromes of SCLC

A

ACTH (Cushing’s)
ADH (SIADH)
Lambert-Eaton syndrome

1301
Q

Paraneoplastic syndromes of lung SCC

A

PTHrP (hypercalcemia)

1302
Q

Most common cause of urinary obstruction in newborn males

A

Posterior urethral valves

Can cause Potter’s sequence and hydronephrosis in-utero

1303
Q

Treatment for diabetic distal neuropathy

A

1) TCA’s

2) Gabapentin

1304
Q

EPS side effects of antipsychotics

A

Acute dystonic reaction (neck, mouth, tongue, EOM)
Akithisia (restlessness)
Parkinsonism
Tardive dyskinesia (after 1-6mo)

1305
Q

Which hereditary hyperbilirubinemias present with unconjugated hyperbili?
What is the difference?

A

Gilbert’s - mild and occurs with fasting and stress

Crigler-Najjar - Severe with early death

1306
Q

Which hereditary hyperbilirubinemias present with conjugated hyperbili?
What is the difference?

A

Rotor’s syndrome - normal appearing liver

Dubin-Johnson - Black liverf

1307
Q

Treatment of the hereditary hyperbilirubinemias

A

Crigler-Najjar I - Phenobarbital
Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant

Dubin-Johnson, Rotor’s, Gilbert’s do not require treatment.

1308
Q

Lab/vitals abnormalities of LBW infants

A 
Hypoxia
Hypothermia
Hypoglycemia
Hypocalcemia
Polycythemia
1309
Q

What electrolyte derangements are seen with significant emesis?

A

Hypochloremic, hypokalemic metabolic alkalosis

Loss of HCl in vomit
Angiotensin II –> HCO3 resorption
Aldosterone –> H+ secretion and K+ secretion

1310
Q

Superior sulcus tumor possible symptoms

A

Horner syndrome
Pancoast (ulnar pain distribution, shoulder weakness)
Hoarseness (RLN)
SVC syndrome

1311
Q

Divisions of mediastinum and their masses

A

Anterior: 4 T’s (thymoma, teratoma, thyroid, terrible lymphoma)
Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma
Posterior: Neurogenic tumors

1312
Q

Beck’s triad of cardiac tamponade

A

Hypotension
Distant heart sounds
Distended jugular veins

1313
Q

When can chorionic villous sampling be done?

Amniocentesis?

A

CVS: 9-14w
Amniocentesis: 15-22w

1314
Q

When to swab for GBS

1315
Q

Quad screen results for Edwards syndrome

A

UNDERaged at 18

All are down

1316
Q

Quad screen results for Down syndrome

A

2up 2down at 21

1317
Q

Treatment of HIV in pregnancy

A

1) Zidovudine or Nevirapine during pregnancy
2) Elective c-section if viral load over 1000
3) Zidovudine for infant
4) No breastfeeding

1318
Q

Normal fetal heart rate

Causes for bradycardia or tachycardia

A

110-160 bpm

Brady - Congenital heart malformations, hypoxia
Tachy - Hypoxia, maternal fever, fetal anemia

1319
Q

Normal variability on FHT

1320
Q

What does sinusoidal variability on FHT indicate?

A

Serious fetal anemia

1321
Q

Treatment of hypercalcemia 2/2 malignancy

A

Short term: Normal saline, Calcitonin

Long term: Bisphosphonates

1322
Q

Mutation seen in cri-du-chat syndrome

A

5p deletion

1323
Q

Difference between gestational and chronic HTN

A

Chronic HTN if present before 20w or persists after 12w postpartum
Gestational HTN if presents after 20w

1324
Q

Definition of preeclampsia

A

1) New-onset HTN after 20w or worsened chronic HTN

2) Proteinuria of over 300mg/24h (3+ proteins)

1325
Q

Murmur of transposition of the great vessels

A

Single S2
+/- VSD murmur

Most common early cyanotic dz

1326
Q

Murmur of tetralogy of Fallot

A

Pulmonic stenosis murmur

VSD murmur

1327
Q

Treatment of transposition of the great vessels

A 
Prostaglandins early (to maintain PFO)
Emergent surgery
1328
Q

Treatment of impetigo

A

Non-bullous (honey crusts) - Topical mupirocin

Bullous - Oral abx

1329
Q

Symptoms of multiple myeloma

A

Calcium elevated
Renal dysfunction
Anemia
Bone lesions/Back pain

1330
Q

Indications for carotid endarterectomy

A

Symptomatic 70-99%

Men asymptomatic 60-99%

1331
Q

ESR and CK in glucocorticoid myopathy

A

Both normal

Painless weakness

1332
Q

ESR and CK in Polymyalgia Rheumatica

A

ESR elevated

CK normal

1333
Q

ESR and CK in statin-induced myopathy

A

ESR normal

CK elevated

1334
Q

How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis

A

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
Q

What cancers are seen with HNPCC?

A

Colon cancer

Endometrial cancer

1336
Q

What cancers are associated with nephrotic syndromes?

A

Adenocarcinoma - membranous nephropathy

Lymphoma - Minimal change disease

1337
Q

Treatment of uric acid kidney stones

A

Oral potassium citrate

Citrate alkalinizes the urine and inhibits crystallization

1338
Q

Solitary pulmonary nodule workup

A

Nonsmoker - compare to old CXR. Q3mo CXR’s. If stable for 12mo considered benign.

Smoker:

  • Chest CT
  • FNA
1339
Q

Treatment for neonatal thyrotoxicosis

A

Methimazole + beta-blocker

Caused by maternal anti-TSH receptor Ab’s

1340
Q

Extrahepatic manifestations of HCV

A

Porphyria cutanea tarda
Essential mixed cryoglobulinemia
Membranoproliferative GN

1341
Q

Symptoms of mixed cryoglobulinemia

A

Purpura
Arthralgias
Weakness
Membranoproliferative GN

1342
Q

Symptoms of galactosemia

A

Newborn with:

  • FTT
  • Bilateral cataracts
  • Jaundice
  • Hypoglycemia
1343
Q

Prophylaxis in HIV patients

A 
200 = PCP = Bactrim
150 = Histoplasma = Itraconazole
100 = Toxoplasma = Bactrim
50 = MAC = Azithromycin
1344
Q

Prophylaxis in posttransplant patients

A

Bactrim for PCP

Immunize against Influenza, pneumococcus, and HBV

1345
Q

When to perform oral glucose tolerance test

1346
Q

TSH, total T4, and free T4 levels in pregnancy

A

TSH down
Total T4 way up
Free T4 slightly up

Because beta-hCG has TSH-like activity and estrogen increases TBG

1347
Q

Paraneoplastic syndromes of SCLC

A

ACTH (Cushing’s)
ADH (SIADH)
Lambert-Eaton syndrome

1348
Q

Paraneoplastic syndromes of lung SCC

A

PTHrP (hypercalcemia)

1349
Q

Most common cause of urinary obstruction in newborn males

A

Posterior urethral valves

Can cause Potter’s sequence and hydronephrosis in-utero

1350
Q

Treatment for diabetic distal neuropathy

A

1) TCA’s

2) Gabapentin

1351
Q

EPS side effects of antipsychotics

A

Acute dystonic reaction (neck, mouth, tongue, EOM)
Akithisia (restlessness)
Parkinsonism
Tardive dyskinesia (after 1-6mo)

1352
Q

Which hereditary hyperbilirubinemias present with unconjugated hyperbili?
What is the difference?

A

Gilbert’s - mild and occurs with fasting and stress

Crigler-Najjar - Severe with early death

1353
Q

Which hereditary hyperbilirubinemias present with conjugated hyperbili?
What is the difference?

A

Rotor’s syndrome - normal appearing liver

Dubin-Johnson - Black liverf

1354
Q

Treatment of the hereditary hyperbilirubinemias

A

Crigler-Najjar I - Phenobarbital
Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant

Dubin-Johnson, Rotor’s, Gilbert’s do not require treatment.

1355
Q

Lab/vitals abnormalities of LBW infants

A 
Hypoxia
Hypothermia
Hypoglycemia
Hypocalcemia
Polycythemia
1356
Q

What electrolyte derangements are seen with significant emesis?

A

Hypochloremic, hypokalemic metabolic alkalosis

Loss of HCl in vomit
Angiotensin II –> HCO3 resorption
Aldosterone –> H+ secretion and K+ secretion

1357
Q

Superior sulcus tumor possible symptoms

A

Horner syndrome
Pancoast (ulnar pain distribution, shoulder weakness)
Hoarseness (RLN)
SVC syndrome

1358
Q

Divisions of mediastinum and their masses

A

Anterior: 4 T’s (thymoma, teratoma, thyroid, terrible lymphoma)
Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma
Posterior: Neurogenic tumors

1359
Q

Beck’s triad of cardiac tamponade

A

Hypotension
Distant heart sounds
Distended jugular veins

1360
Q

When can chorionic villous sampling be done?

Amniocentesis?

A

CVS: 9-14w
Amniocentesis: 15-22w

1361
Q

When to swab for GBS

1362
Q

Quad screen results for Edwards syndrome

A

UNDERaged at 18

All are down

1363
Q

Quad screen results for Down syndrome

A

2up 2down at 21

1364
Q

Treatment of HIV in pregnancy

A

1) Zidovudine or Nevirapine during pregnancy
2) Elective c-section if viral load over 1000
3) Zidovudine for infant
4) No breastfeeding

1365
Q

Normal fetal heart rate

Causes for bradycardia or tachycardia

A

110-160 bpm

Brady - Congenital heart malformations, hypoxia
Tachy - Hypoxia, maternal fever, fetal anemia

1366
Q

Normal variability on FHT

1367
Q

What does sinusoidal variability on FHT indicate?

A

Serious fetal anemia

1368
Q

Treatment of hypercalcemia 2/2 malignancy

A

Short term: Normal saline, Calcitonin

Long term: Bisphosphonates

1369
Q

Mutation seen in cri-du-chat syndrome

A

5p deletion

1370
Q

Difference between gestational and chronic HTN

A

Chronic HTN if present before 20w or persists after 12w postpartum
Gestational HTN if presents after 20w

1371
Q

Definition of preeclampsia

A

1) New-onset HTN after 20w or worsened chronic HTN

2) Proteinuria of over 300mg/24h (3+ proteins)

1372
Q

Murmur of transposition of the great vessels

A

Single S2
+/- VSD murmur

Most common early cyanotic dz

1373
Q

Murmur of tetralogy of Fallot

A

Pulmonic stenosis murmur

VSD murmur

1374
Q

Treatment of transposition of the great vessels

A 
Prostaglandins early (to maintain PFO)
Emergent surgery
1375
Q

Treatment of impetigo

A

Non-bullous (honey crusts) - Topical mupirocin

Bullous - Oral abx

1376
Q

Symptoms of multiple myeloma

A

Calcium elevated
Renal dysfunction
Anemia
Bone lesions/Back pain

1377
Q

Indications for carotid endarterectomy

A

Symptomatic 70-99%

Men asymptomatic 60-99%

1378
Q

ESR and CK in glucocorticoid myopathy

A

Both normal

Painless weakness

1379
Q

ESR and CK in Polymyalgia Rheumatica

A

ESR elevated

CK normal

1380
Q

ESR and CK in statin-induced myopathy

A

ESR normal

CK elevated

1381
Q

How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis

A

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
Q

What cancers are seen with HNPCC?

A

Colon cancer

Endometrial cancer

1383
Q

What cancers are associated with nephrotic syndromes?

A

Adenocarcinoma - membranous nephropathy

Lymphoma - Minimal change disease

1384
Q

Treatment of uric acid kidney stones

A

Oral potassium citrate

Citrate alkalinizes the urine and inhibits crystallization

1385
Q

Solitary pulmonary nodule workup

A

Nonsmoker - compare to old CXR. Q3mo CXR’s. If stable for 12mo considered benign.

Smoker:

  • Chest CT
  • FNA
1386
Q

Treatment for neonatal thyrotoxicosis

A

Methimazole + beta-blocker

Caused by maternal anti-TSH receptor Ab’s

1387
Q

Extrahepatic manifestations of HCV

A

Porphyria cutanea tarda
Essential mixed cryoglobulinemia
Membranoproliferative GN

1388
Q

Symptoms of mixed cryoglobulinemia

A

Purpura
Arthralgias
Weakness
Membranoproliferative GN

1389
Q

Symptoms of galactosemia

A

Newborn with:

  • FTT
  • Bilateral cataracts
  • Jaundice
  • Hypoglycemia
1390
Q

Prophylaxis in HIV patients

A 
200 = PCP = Bactrim
150 = Histoplasma = Itraconazole
100 = Toxoplasma = Bactrim
50 = MAC = Azithromycin
1391
Q

Prophylaxis in posttransplant patients

A

Bactrim for PCP

Immunize against Influenza, pneumococcus, and HBV

1392
Q

When to perform oral glucose tolerance test

1393
Q

TSH, total T4, and free T4 levels in pregnancy

A

TSH down
Total T4 way up
Free T4 slightly up

Because beta-hCG has TSH-like activity and estrogen increases TBG

1394
Q

Paraneoplastic syndromes of SCLC

A

ACTH (Cushing’s)
ADH (SIADH)
Lambert-Eaton syndrome

1395
Q

Paraneoplastic syndromes of lung SCC

A

PTHrP (hypercalcemia)

1396
Q

Most common cause of urinary obstruction in newborn males

A

Posterior urethral valves

Can cause Potter’s sequence and hydronephrosis in-utero

1397
Q

Treatment for diabetic distal neuropathy

A

1) TCA’s

2) Gabapentin

1398
Q

EPS side effects of antipsychotics

A

Acute dystonic reaction (neck, mouth, tongue, EOM)
Akithisia (restlessness)
Parkinsonism
Tardive dyskinesia (after 1-6mo)

1399
Q

Which hereditary hyperbilirubinemias present with unconjugated hyperbili?
What is the difference?

A

Gilbert’s - mild and occurs with fasting and stress

Crigler-Najjar - Severe with early death

1400
Q

Which hereditary hyperbilirubinemias present with conjugated hyperbili?
What is the difference?

A

Rotor’s syndrome - normal appearing liver

Dubin-Johnson - Black liverf

1401
Q

Treatment of the hereditary hyperbilirubinemias

A

Crigler-Najjar I - Phenobarbital
Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant

Dubin-Johnson, Rotor’s, Gilbert’s do not require treatment.

1402
Q

Lab/vitals abnormalities of LBW infants

A 
Hypoxia
Hypothermia
Hypoglycemia
Hypocalcemia
Polycythemia
1403
Q

What electrolyte derangements are seen with significant emesis?

A

Hypochloremic, hypokalemic metabolic alkalosis

Loss of HCl in vomit
Angiotensin II –> HCO3 resorption
Aldosterone –> H+ secretion and K+ secretion

1404
Q

Superior sulcus tumor possible symptoms

A

Horner syndrome
Pancoast (ulnar pain distribution, shoulder weakness)
Hoarseness (RLN)
SVC syndrome

1405
Q

Divisions of mediastinum and their masses

A

Anterior: 4 T’s (thymoma, teratoma, thyroid, terrible lymphoma)
Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma
Posterior: Neurogenic tumors

1406
Q

Beck’s triad of cardiac tamponade

A

Hypotension
Distant heart sounds
Distended jugular veins

1407
Q

When can chorionic villous sampling be done?

Amniocentesis?

A

CVS: 9-14w
Amniocentesis: 15-22w

1408
Q

When to swab for GBS

1409
Q

Quad screen results for Edwards syndrome

A

UNDERaged at 18

All are down

1410
Q

Quad screen results for Down syndrome

A

2up 2down at 21

1411
Q

Treatment of HIV in pregnancy

A

1) Zidovudine or Nevirapine during pregnancy
2) Elective c-section if viral load over 1000
3) Zidovudine for infant
4) No breastfeeding

1412
Q

Normal fetal heart rate

Causes for bradycardia or tachycardia

A

110-160 bpm

Brady - Congenital heart malformations, hypoxia
Tachy - Hypoxia, maternal fever, fetal anemia

1413
Q

Normal variability on FHT

1414
Q

What does sinusoidal variability on FHT indicate?

A

Serious fetal anemia

1415
Q

Treatment of hypercalcemia 2/2 malignancy

A

Short term: Normal saline, Calcitonin

Long term: Bisphosphonates

1416
Q

Mutation seen in cri-du-chat syndrome

A

5p deletion

1417
Q

Difference between gestational and chronic HTN

A

Chronic HTN if present before 20w or persists after 12w postpartum
Gestational HTN if presents after 20w

1418
Q

Definition of preeclampsia

A

1) New-onset HTN after 20w or worsened chronic HTN

2) Proteinuria of over 300mg/24h (3+ proteins)

1419
Q

Murmur of transposition of the great vessels

A

Single S2
+/- VSD murmur

Most common early cyanotic dz

1420
Q

Murmur of tetralogy of Fallot

A

Pulmonic stenosis murmur

VSD murmur

1421
Q

Treatment of transposition of the great vessels

A 
Prostaglandins early (to maintain PFO)
Emergent surgery
1422
Q

Treatment of impetigo

A

Non-bullous (honey crusts) - Topical mupirocin

Bullous - Oral abx

1423
Q

Symptoms of multiple myeloma

A

Calcium elevated
Renal dysfunction
Anemia
Bone lesions/Back pain

1424
Q

Indications for carotid endarterectomy

A

Symptomatic 70-99%

Men asymptomatic 60-99%

1425
Q

ESR and CK in glucocorticoid myopathy

A

Both normal

Painless weakness

1426
Q

ESR and CK in Polymyalgia Rheumatica

A

ESR elevated

CK normal

1427
Q

ESR and CK in statin-induced myopathy

A

ESR normal

CK elevated

1428
Q

How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis

A

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
Q

What cancers are seen with HNPCC?

A

Colon cancer

Endometrial cancer

1430
Q

What cancers are associated with nephrotic syndromes?

A

Adenocarcinoma - membranous nephropathy

Lymphoma - Minimal change disease

1431
Q

Treatment of uric acid kidney stones

A

Oral potassium citrate

Citrate alkalinizes the urine and inhibits crystallization

1432
Q

Prophylaxis in HIV patients

A 
200 = PCP = Bactrim
150 = Histoplasma = Itraconazole
100 = Toxoplasma = Bactrim
50 = MAC = Azithromycin
1433
Q

Prophylaxis in posttransplant patients

A

Bactrim for PCP

Immunize against Influenza, pneumococcus, and HBV

1434
Q

When to perform oral glucose tolerance test

1435
Q

TSH, total T4, and free T4 levels in pregnancy

A

TSH down
Total T4 way up
Free T4 slightly up

Because beta-hCG has TSH-like activity and estrogen increases TBG

1436
Q

Paraneoplastic syndromes of SCLC

A

ACTH (Cushing’s)
ADH (SIADH)
Lambert-Eaton syndrome

1437
Q

Paraneoplastic syndromes of lung SCC

A

PTHrP (hypercalcemia)

1438
Q

Most common cause of urinary obstruction in newborn males

A

Posterior urethral valves

Can cause Potter’s sequence and hydronephrosis in-utero

1439
Q

Treatment for diabetic distal neuropathy

A

1) TCA’s

2) Gabapentin

1440
Q

EPS side effects of antipsychotics

A

Acute dystonic reaction (neck, mouth, tongue, EOM)
Akithisia (restlessness)
Parkinsonism
Tardive dyskinesia (after 1-6mo)

1441
Q

Which hereditary hyperbilirubinemias present with unconjugated hyperbili?
What is the difference?

A

Gilbert’s - mild and occurs with fasting and stress

Crigler-Najjar - Severe with early death

1442
Q

Which hereditary hyperbilirubinemias present with conjugated hyperbili?
What is the difference?

A

Rotor’s syndrome - normal appearing liver

Dubin-Johnson - Black liverf

1443
Q

Treatment of the hereditary hyperbilirubinemias

A

Crigler-Najjar I - Phenobarbital
Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant

Dubin-Johnson, Rotor’s, Gilbert’s do not require treatment.

1444
Q

Lab/vitals abnormalities of LBW infants

A 
Hypoxia
Hypothermia
Hypoglycemia
Hypocalcemia
Polycythemia
1445
Q

What electrolyte derangements are seen with significant emesis?

A

Hypochloremic, hypokalemic metabolic alkalosis

Loss of HCl in vomit
Angiotensin II –> HCO3 resorption
Aldosterone –> H+ secretion and K+ secretion

1446
Q

Superior sulcus tumor possible symptoms

A

Horner syndrome
Pancoast (ulnar pain distribution, shoulder weakness)
Hoarseness (RLN)
SVC syndrome

1447
Q

Divisions of mediastinum and their masses

A

Anterior: 4 T’s (thymoma, teratoma, thyroid, terrible lymphoma)
Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma
Posterior: Neurogenic tumors

1448
Q

Beck’s triad of cardiac tamponade

A

Hypotension
Distant heart sounds
Distended jugular veins

1449
Q

When can chorionic villous sampling be done?

Amniocentesis?

A

CVS: 9-14w
Amniocentesis: 15-22w

1450
Q

When to swab for GBS

1451
Q

Quad screen results for Edwards syndrome

A

UNDERaged at 18

All are down

1452
Q

Quad screen results for Down syndrome

A

2up 2down at 21

1453
Q

Treatment of HIV in pregnancy

A

1) Zidovudine or Nevirapine during pregnancy
2) Elective c-section if viral load over 1000
3) Zidovudine for infant
4) No breastfeeding

1454
Q

Normal fetal heart rate

Causes for bradycardia or tachycardia

A

110-160 bpm

Brady - Congenital heart malformations, hypoxia
Tachy - Hypoxia, maternal fever, fetal anemia

1455
Q

Normal variability on FHT

1456
Q

What does sinusoidal variability on FHT indicate?

A

Serious fetal anemia

1457
Q

Treatment of hypercalcemia 2/2 malignancy

A

Short term: Normal saline, Calcitonin

Long term: Bisphosphonates

1458
Q

Mutation seen in cri-du-chat syndrome

A

5p deletion

1459
Q

Difference between gestational and chronic HTN

A

Chronic HTN if present before 20w or persists after 12w postpartum
Gestational HTN if presents after 20w

1460
Q

Definition of preeclampsia

A

1) New-onset HTN after 20w or worsened chronic HTN

2) Proteinuria of over 300mg/24h (3+ proteins)

1461
Q

Murmur of transposition of the great vessels

A

Single S2
+/- VSD murmur

Most common early cyanotic dz

1462
Q

Murmur of tetralogy of Fallot

A

Pulmonic stenosis murmur

VSD murmur

1463
Q

Treatment of transposition of the great vessels

A 
Prostaglandins early (to maintain PFO)
Emergent surgery
1464
Q

Treatment of impetigo

A

Non-bullous (honey crusts) - Topical mupirocin

Bullous - Oral abx

1465
Q

Symptoms of multiple myeloma

A

Calcium elevated
Renal dysfunction
Anemia
Bone lesions/Back pain

1466
Q

Indications for carotid endarterectomy

A

Symptomatic 70-99%

Men asymptomatic 60-99%

1467
Q

ESR and CK in glucocorticoid myopathy

A

Both normal

Painless weakness

1468
Q

ESR and CK in Polymyalgia Rheumatica

A

ESR elevated

CK normal

1469
Q

ESR and CK in statin-induced myopathy

A

ESR normal

CK elevated

1470
Q

How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis

A

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
Q

What cancers are seen with HNPCC?

A

Colon cancer

Endometrial cancer

1472
Q

What cancers are associated with nephrotic syndromes?

A

Adenocarcinoma - membranous nephropathy

Lymphoma - Minimal change disease

1473
Q

Treatment of uric acid kidney stones

A

Oral potassium citrate

Citrate alkalinizes the urine and inhibits crystallization

1474
Q

Prophylaxis in HIV patients

A 
200 = PCP = Bactrim
150 = Histoplasma = Itraconazole
100 = Toxoplasma = Bactrim
50 = MAC = Azithromycin
1475
Q

Prophylaxis in posttransplant patients

A

Bactrim for PCP

Immunize against Influenza, pneumococcus, and HBV

1476
Q

When to perform oral glucose tolerance test

1477
Q

TSH, total T4, and free T4 levels in pregnancy

A

TSH down
Total T4 way up
Free T4 slightly up

Because beta-hCG has TSH-like activity and estrogen increases TBG

1478
Q

Paraneoplastic syndromes of SCLC

A

ACTH (Cushing’s)
ADH (SIADH)
Lambert-Eaton syndrome

1479
Q

Paraneoplastic syndromes of lung SCC

A

PTHrP (hypercalcemia)

1480
Q

Most common cause of urinary obstruction in newborn males

A

Posterior urethral valves

Can cause Potter’s sequence and hydronephrosis in-utero

1481
Q

Treatment for diabetic distal neuropathy

A

1) TCA’s

2) Gabapentin

1482
Q

EPS side effects of antipsychotics

A

Acute dystonic reaction (neck, mouth, tongue, EOM)
Akithisia (restlessness)
Parkinsonism
Tardive dyskinesia (after 1-6mo)

1483
Q

Which hereditary hyperbilirubinemias present with unconjugated hyperbili?
What is the difference?

A

Gilbert’s - mild and occurs with fasting and stress

Crigler-Najjar - Severe with early death

1484
Q

Which hereditary hyperbilirubinemias present with conjugated hyperbili?
What is the difference?

A

Rotor’s syndrome - normal appearing liver

Dubin-Johnson - Black liverf

1485
Q

Treatment of the hereditary hyperbilirubinemias

A

Crigler-Najjar I - Phenobarbital
Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant

Dubin-Johnson, Rotor’s, Gilbert’s do not require treatment.

1486
Q

Lab/vitals abnormalities of LBW infants

A 
Hypoxia
Hypothermia
Hypoglycemia
Hypocalcemia
Polycythemia
1487
Q

What electrolyte derangements are seen with significant emesis?

A

Hypochloremic, hypokalemic metabolic alkalosis

Loss of HCl in vomit
Angiotensin II –> HCO3 resorption
Aldosterone –> H+ secretion and K+ secretion

1488
Q

Superior sulcus tumor possible symptoms

A

Horner syndrome
Pancoast (ulnar pain distribution, shoulder weakness)
Hoarseness (RLN)
SVC syndrome

1489
Q

Divisions of mediastinum and their masses

A

Anterior: 4 T’s (thymoma, teratoma, thyroid, terrible lymphoma)
Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma
Posterior: Neurogenic tumors

1490
Q

Beck’s triad of cardiac tamponade

A

Hypotension
Distant heart sounds
Distended jugular veins

1491
Q

When can chorionic villous sampling be done?

Amniocentesis?

A

CVS: 9-14w
Amniocentesis: 15-22w

1492
Q

When to swab for GBS

1493
Q

Quad screen results for Edwards syndrome

A

UNDERaged at 18

All are down

1494
Q

Quad screen results for Down syndrome

A

2up 2down at 21

1495
Q

Treatment of HIV in pregnancy

A

1) Zidovudine or Nevirapine during pregnancy
2) Elective c-section if viral load over 1000
3) Zidovudine for infant
4) No breastfeeding

1496
Q

Normal fetal heart rate

Causes for bradycardia or tachycardia

A

110-160 bpm

Brady - Congenital heart malformations, hypoxia
Tachy - Hypoxia, maternal fever, fetal anemia

1497
Q

Normal variability on FHT

1498
Q

What does sinusoidal variability on FHT indicate?

A

Serious fetal anemia

1499
Q

Treatment of hypercalcemia 2/2 malignancy

A

Short term: Normal saline, Calcitonin

Long term: Bisphosphonates

1500
Q

Mutation seen in cri-du-chat syndrome

A

5p deletion

1501
Q

Difference between gestational and chronic HTN

A

Chronic HTN if present before 20w or persists after 12w postpartum
Gestational HTN if presents after 20w

1502
Q

Definition of preeclampsia

A

1) New-onset HTN after 20w or worsened chronic HTN

2) Proteinuria of over 300mg/24h (3+ proteins)

1503
Q

Murmur of transposition of the great vessels

A

Single S2
+/- VSD murmur

Most common early cyanotic dz

1504
Q

Murmur of tetralogy of Fallot

A

Pulmonic stenosis murmur

VSD murmur

1505
Q

Treatment of transposition of the great vessels

A 
Prostaglandins early (to maintain PFO)
Emergent surgery
1506
Q

Treatment of impetigo

A

Non-bullous (honey crusts) - Topical mupirocin

Bullous - Oral abx

1507
Q

Symptoms of multiple myeloma

A

Calcium elevated
Renal dysfunction
Anemia
Bone lesions/Back pain

1508
Q

Indications for carotid endarterectomy

A

Symptomatic 70-99%

Men asymptomatic 60-99%

1509
Q

ESR and CK in glucocorticoid myopathy

A

Both normal

Painless weakness

1510
Q

ESR and CK in Polymyalgia Rheumatica

A

ESR elevated

CK normal

1511
Q

ESR and CK in statin-induced myopathy

A

ESR normal

CK elevated

1512
Q

How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis

A

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
Q

What cancers are seen with HNPCC?

A

Colon cancer

Endometrial cancer

1514
Q

What cancers are associated with nephrotic syndromes?

A

Adenocarcinoma - membranous nephropathy

Lymphoma - Minimal change disease

1515
Q

Treatment of uric acid kidney stones

A

Oral potassium citrate

Citrate alkalinizes the urine and inhibits crystallization

1516
Q

Prophylaxis in HIV patients

A 
200 = PCP = Bactrim
150 = Histoplasma = Itraconazole
100 = Toxoplasma = Bactrim
50 = MAC = Azithromycin
1517
Q

Prophylaxis in posttransplant patients

A

Bactrim for PCP

Immunize against Influenza, pneumococcus, and HBV

1518
Q

When to perform oral glucose tolerance test

1519
Q

TSH, total T4, and free T4 levels in pregnancy

A

TSH down
Total T4 way up
Free T4 slightly up

Because beta-hCG has TSH-like activity and estrogen increases TBG

1520
Q

Paraneoplastic syndromes of SCLC

A

ACTH (Cushing’s)
ADH (SIADH)
Lambert-Eaton syndrome

1521
Q

Paraneoplastic syndromes of lung SCC

A

PTHrP (hypercalcemia)

1522
Q

Most common cause of urinary obstruction in newborn males

A

Posterior urethral valves

Can cause Potter’s sequence and hydronephrosis in-utero

1523
Q

Treatment for diabetic distal neuropathy

A

1) TCA’s

2) Gabapentin

1524
Q

EPS side effects of antipsychotics

A

Acute dystonic reaction (neck, mouth, tongue, EOM)
Akithisia (restlessness)
Parkinsonism
Tardive dyskinesia (after 1-6mo)

1525
Q

Which hereditary hyperbilirubinemias present with unconjugated hyperbili?
What is the difference?

A

Gilbert’s - mild and occurs with fasting and stress

Crigler-Najjar - Severe with early death

1526
Q

Which hereditary hyperbilirubinemias present with conjugated hyperbili?
What is the difference?

A

Rotor’s syndrome - normal appearing liver

Dubin-Johnson - Black liverf

1527
Q

Treatment of the hereditary hyperbilirubinemias

A

Crigler-Najjar I - Phenobarbital
Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant

Dubin-Johnson, Rotor’s, Gilbert’s do not require treatment.

1528
Q

Lab/vitals abnormalities of LBW infants

A 
Hypoxia
Hypothermia
Hypoglycemia
Hypocalcemia
Polycythemia
1529
Q

What electrolyte derangements are seen with significant emesis?

A

Hypochloremic, hypokalemic metabolic alkalosis

Loss of HCl in vomit
Angiotensin II –> HCO3 resorption
Aldosterone –> H+ secretion and K+ secretion

1530
Q

Superior sulcus tumor possible symptoms

A

Horner syndrome
Pancoast (ulnar pain distribution, shoulder weakness)
Hoarseness (RLN)
SVC syndrome

1531
Q

Divisions of mediastinum and their masses

A

Anterior: 4 T’s (thymoma, teratoma, thyroid, terrible lymphoma)
Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma
Posterior: Neurogenic tumors

1532
Q

Beck’s triad of cardiac tamponade

A

Hypotension
Distant heart sounds
Distended jugular veins

1533
Q

When can chorionic villous sampling be done?

Amniocentesis?

A

CVS: 9-14w
Amniocentesis: 15-22w

1534
Q

When to swab for GBS

1535
Q

Quad screen results for Edwards syndrome

A

UNDERaged at 18

All are down

1536
Q

Quad screen results for Down syndrome

A

2up 2down at 21

1537
Q

Treatment of HIV in pregnancy

A

1) Zidovudine or Nevirapine during pregnancy
2) Elective c-section if viral load over 1000
3) Zidovudine for infant
4) No breastfeeding

1538
Q

Normal fetal heart rate

Causes for bradycardia or tachycardia

A

110-160 bpm

Brady - Congenital heart malformations, hypoxia
Tachy - Hypoxia, maternal fever, fetal anemia

1539
Q

Normal variability on FHT

1540
Q

What does sinusoidal variability on FHT indicate?

A

Serious fetal anemia

1541
Q

Treatment of hypercalcemia 2/2 malignancy

A

Short term: Normal saline, Calcitonin

Long term: Bisphosphonates

1542
Q

Mutation seen in cri-du-chat syndrome

A

5p deletion

1543
Q

Difference between gestational and chronic HTN

A

Chronic HTN if present before 20w or persists after 12w postpartum
Gestational HTN if presents after 20w

1544
Q

Definition of preeclampsia

A

1) New-onset HTN after 20w or worsened chronic HTN

2) Proteinuria of over 300mg/24h (3+ proteins)

1545
Q

Murmur of transposition of the great vessels

A

Single S2
+/- VSD murmur

Most common early cyanotic dz

1546
Q

Murmur of tetralogy of Fallot

A

Pulmonic stenosis murmur

VSD murmur

1547
Q

Treatment of transposition of the great vessels

A 
Prostaglandins early (to maintain PFO)
Emergent surgery
1548
Q

Treatment of impetigo

A

Non-bullous (honey crusts) - Topical mupirocin

Bullous - Oral abx

1549
Q

Symptoms of multiple myeloma

A

Calcium elevated
Renal dysfunction
Anemia
Bone lesions/Back pain

1550
Q

Indications for carotid endarterectomy

A

Symptomatic 70-99%

Men asymptomatic 60-99%

1551
Q

ESR and CK in glucocorticoid myopathy

A

Both normal

Painless weakness

1552
Q

ESR and CK in Polymyalgia Rheumatica

A

ESR elevated

CK normal

1553
Q

ESR and CK in statin-induced myopathy

A

ESR normal

CK elevated

1554
Q

How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis

A

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
Q

What cancers are seen with HNPCC?

A

Colon cancer

Endometrial cancer

1556
Q

What cancers are associated with nephrotic syndromes?

A

Adenocarcinoma - membranous nephropathy

Lymphoma - Minimal change disease

1557
Q

Treatment of uric acid kidney stones

A

Oral potassium citrate

Citrate alkalinizes the urine and inhibits crystallization

1558
Q

Prophylaxis in HIV patients

A 
200 = PCP = Bactrim
150 = Histoplasma = Itraconazole
100 = Toxoplasma = Bactrim
50 = MAC = Azithromycin
1559
Q

Prophylaxis in posttransplant patients

A

Bactrim for PCP

Immunize against Influenza, pneumococcus, and HBV

1560
Q

When to perform oral glucose tolerance test

1561
Q

TSH, total T4, and free T4 levels in pregnancy

A

TSH down
Total T4 way up
Free T4 slightly up

Because beta-hCG has TSH-like activity and estrogen increases TBG

1562
Q

Paraneoplastic syndromes of SCLC

A

ACTH (Cushing’s)
ADH (SIADH)
Lambert-Eaton syndrome

1563
Q

Paraneoplastic syndromes of lung SCC

A

PTHrP (hypercalcemia)

1564
Q

Most common cause of urinary obstruction in newborn males

A

Posterior urethral valves

Can cause Potter’s sequence and hydronephrosis in-utero

1565
Q

Treatment for diabetic distal neuropathy

A

1) TCA’s

2) Gabapentin

1566
Q

EPS side effects of antipsychotics

A

Acute dystonic reaction (neck, mouth, tongue, EOM)
Akithisia (restlessness)
Parkinsonism
Tardive dyskinesia (after 1-6mo)

1567
Q

Which hereditary hyperbilirubinemias present with unconjugated hyperbili?
What is the difference?

A

Gilbert’s - mild and occurs with fasting and stress

Crigler-Najjar - Severe with early death

1568
Q

Which hereditary hyperbilirubinemias present with conjugated hyperbili?
What is the difference?

A

Rotor’s syndrome - normal appearing liver

Dubin-Johnson - Black liverf

1569
Q

Treatment of the hereditary hyperbilirubinemias

A

Crigler-Najjar I - Phenobarbital
Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant

Dubin-Johnson, Rotor’s, Gilbert’s do not require treatment.

1570
Q

Lab/vitals abnormalities of LBW infants

A 
Hypoxia
Hypothermia
Hypoglycemia
Hypocalcemia
Polycythemia
1571
Q

What electrolyte derangements are seen with significant emesis?

A

Hypochloremic, hypokalemic metabolic alkalosis

Loss of HCl in vomit
Angiotensin II –> HCO3 resorption
Aldosterone –> H+ secretion and K+ secretion

1572
Q

Superior sulcus tumor possible symptoms

A

Horner syndrome
Pancoast (ulnar pain distribution, shoulder weakness)
Hoarseness (RLN)
SVC syndrome

1573
Q

Divisions of mediastinum and their masses

A

Anterior: 4 T’s (thymoma, teratoma, thyroid, terrible lymphoma)
Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma
Posterior: Neurogenic tumors

1574
Q

Beck’s triad of cardiac tamponade

A

Hypotension
Distant heart sounds
Distended jugular veins

1575
Q

When can chorionic villous sampling be done?

Amniocentesis?

A

CVS: 9-14w
Amniocentesis: 15-22w

1576
Q

When to swab for GBS

1577
Q

Quad screen results for Edwards syndrome

A

UNDERaged at 18

All are down

1578
Q

Quad screen results for Down syndrome

A

2up 2down at 21

1579
Q

Treatment of HIV in pregnancy

A

1) Zidovudine or Nevirapine during pregnancy
2) Elective c-section if viral load over 1000
3) Zidovudine for infant
4) No breastfeeding

1580
Q

Normal fetal heart rate

Causes for bradycardia or tachycardia

A

110-160 bpm

Brady - Congenital heart malformations, hypoxia
Tachy - Hypoxia, maternal fever, fetal anemia

1581
Q

Normal variability on FHT

1582
Q

What does sinusoidal variability on FHT indicate?

A

Serious fetal anemia

1583
Q

Treatment of hypercalcemia 2/2 malignancy

A

Short term: Normal saline, Calcitonin

Long term: Bisphosphonates

1584
Q

Mutation seen in cri-du-chat syndrome

A

5p deletion

1585
Q

Difference between gestational and chronic HTN

A

Chronic HTN if present before 20w or persists after 12w postpartum
Gestational HTN if presents after 20w

1586
Q

Definition of preeclampsia

A

1) New-onset HTN after 20w or worsened chronic HTN

2) Proteinuria of over 300mg/24h (3+ proteins)

1587
Q

Murmur of transposition of the great vessels

A

Single S2
+/- VSD murmur

Most common early cyanotic dz

1588
Q

Murmur of tetralogy of Fallot

A

Pulmonic stenosis murmur

VSD murmur

1589
Q

Treatment of transposition of the great vessels

A 
Prostaglandins early (to maintain PFO)
Emergent surgery
1590
Q

Treatment of impetigo

A

Non-bullous (honey crusts) - Topical mupirocin

Bullous - Oral abx

1591
Q

Symptoms of multiple myeloma

A

Calcium elevated
Renal dysfunction
Anemia
Bone lesions/Back pain

1592
Q

Indications for carotid endarterectomy

A

Symptomatic 70-99%

Men asymptomatic 60-99%

1593
Q

ESR and CK in glucocorticoid myopathy

A

Both normal

Painless weakness

1594
Q

ESR and CK in Polymyalgia Rheumatica

A

ESR elevated

CK normal

1595
Q

ESR and CK in statin-induced myopathy

A

ESR normal

CK elevated

1596
Q

How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis

A

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
Q

What cancers are seen with HNPCC?

A

Colon cancer

Endometrial cancer

1598
Q

What cancers are associated with nephrotic syndromes?

A

Adenocarcinoma - membranous nephropathy

Lymphoma - Minimal change disease

1599
Q

Treatment of uric acid kidney stones

A

Oral potassium citrate

Citrate alkalinizes the urine and inhibits crystallization

1600
Q

Prophylaxis in HIV patients

A 
200 = PCP = Bactrim
150 = Histoplasma = Itraconazole
100 = Toxoplasma = Bactrim
50 = MAC = Azithromycin
1601
Q

Prophylaxis in posttransplant patients

A

Bactrim for PCP

Immunize against Influenza, pneumococcus, and HBV

1602
Q

When to perform oral glucose tolerance test

1603
Q

TSH, total T4, and free T4 levels in pregnancy

A

TSH down
Total T4 way up
Free T4 slightly up

Because beta-hCG has TSH-like activity and estrogen increases TBG

1604
Q

Paraneoplastic syndromes of SCLC

A

ACTH (Cushing’s)
ADH (SIADH)
Lambert-Eaton syndrome

1605
Q

Paraneoplastic syndromes of lung SCC

A

PTHrP (hypercalcemia)

1606
Q

Most common cause of urinary obstruction in newborn males

A

Posterior urethral valves

Can cause Potter’s sequence and hydronephrosis in-utero

1607
Q

Treatment for diabetic distal neuropathy

A

1) TCA’s

2) Gabapentin

1608
Q

EPS side effects of antipsychotics

A

Acute dystonic reaction (neck, mouth, tongue, EOM)
Akithisia (restlessness)
Parkinsonism
Tardive dyskinesia (after 1-6mo)

1609
Q

Which hereditary hyperbilirubinemias present with unconjugated hyperbili?
What is the difference?

A

Gilbert’s - mild and occurs with fasting and stress

Crigler-Najjar - Severe with early death

1610
Q

Which hereditary hyperbilirubinemias present with conjugated hyperbili?
What is the difference?

A

Rotor’s syndrome - normal appearing liver

Dubin-Johnson - Black liverf

1611
Q

Treatment of the hereditary hyperbilirubinemias

A

Crigler-Najjar I - Phenobarbital
Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant

Dubin-Johnson, Rotor’s, Gilbert’s do not require treatment.

1612
Q

Lab/vitals abnormalities of LBW infants

A 
Hypoxia
Hypothermia
Hypoglycemia
Hypocalcemia
Polycythemia
1613
Q

What electrolyte derangements are seen with significant emesis?

A

Hypochloremic, hypokalemic metabolic alkalosis

Loss of HCl in vomit
Angiotensin II –> HCO3 resorption
Aldosterone –> H+ secretion and K+ secretion

1614
Q

Superior sulcus tumor possible symptoms

A

Horner syndrome
Pancoast (ulnar pain distribution, shoulder weakness)
Hoarseness (RLN)
SVC syndrome

1615
Q

Divisions of mediastinum and their masses

A

Anterior: 4 T’s (thymoma, teratoma, thyroid, terrible lymphoma)
Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma
Posterior: Neurogenic tumors

1616
Q

Beck’s triad of cardiac tamponade

A

Hypotension
Distant heart sounds
Distended jugular veins

1617
Q

When can chorionic villous sampling be done?

Amniocentesis?

A

CVS: 9-14w
Amniocentesis: 15-22w

1618
Q

When to swab for GBS

1619
Q

Quad screen results for Edwards syndrome

A

UNDERaged at 18

All are down

1620
Q

Quad screen results for Down syndrome

A

2up 2down at 21

1621
Q

Treatment of HIV in pregnancy

A

1) Zidovudine or Nevirapine during pregnancy
2) Elective c-section if viral load over 1000
3) Zidovudine for infant
4) No breastfeeding

1622
Q

Normal fetal heart rate

Causes for bradycardia or tachycardia

A

110-160 bpm

Brady - Congenital heart malformations, hypoxia
Tachy - Hypoxia, maternal fever, fetal anemia

1623
Q

Normal variability on FHT

1624
Q

What does sinusoidal variability on FHT indicate?

A

Serious fetal anemia

1625
Q

Treatment of hypercalcemia 2/2 malignancy

A

Short term: Normal saline, Calcitonin

Long term: Bisphosphonates

1626
Q

Mutation seen in cri-du-chat syndrome

A

5p deletion

1627
Q

Difference between gestational and chronic HTN

A

Chronic HTN if present before 20w or persists after 12w postpartum
Gestational HTN if presents after 20w

1628
Q

Definition of preeclampsia

A

1) New-onset HTN after 20w or worsened chronic HTN

2) Proteinuria of over 300mg/24h (3+ proteins)

1629
Q

Murmur of transposition of the great vessels

A

Single S2
+/- VSD murmur

Most common early cyanotic dz

1630
Q

Murmur of tetralogy of Fallot

A

Pulmonic stenosis murmur

VSD murmur

1631
Q

Treatment of transposition of the great vessels

A 
Prostaglandins early (to maintain PFO)
Emergent surgery
1632
Q

Treatment of impetigo

A

Non-bullous (honey crusts) - Topical mupirocin

Bullous - Oral abx

1633
Q

Symptoms of multiple myeloma

A

Calcium elevated
Renal dysfunction
Anemia
Bone lesions/Back pain

1634
Q

Indications for carotid endarterectomy

A

Symptomatic 70-99%

Men asymptomatic 60-99%

1635
Q

ESR and CK in glucocorticoid myopathy

A

Both normal

Painless weakness

1636
Q

ESR and CK in Polymyalgia Rheumatica

A

ESR elevated

CK normal

1637
Q

ESR and CK in statin-induced myopathy

A

ESR normal

CK elevated

1638
Q

How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis

A

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
Q

What cancers are seen with HNPCC?

A

Colon cancer

Endometrial cancer

1640
Q

What cancers are associated with nephrotic syndromes?

A

Adenocarcinoma - membranous nephropathy

Lymphoma - Minimal change disease

1641
Q

Treatment of uric acid kidney stones

A

Oral potassium citrate

Citrate alkalinizes the urine and inhibits crystallization

1642
Q

Prophylaxis in HIV patients

A 
200 = PCP = Bactrim
150 = Histoplasma = Itraconazole
100 = Toxoplasma = Bactrim
50 = MAC = Azithromycin
1643
Q

Prophylaxis in posttransplant patients

A

Bactrim for PCP

Immunize against Influenza, pneumococcus, and HBV

1644
Q

When to perform oral glucose tolerance test

1645
Q

TSH, total T4, and free T4 levels in pregnancy

A

TSH down
Total T4 way up
Free T4 slightly up

Because beta-hCG has TSH-like activity and estrogen increases TBG

1646
Q

Paraneoplastic syndromes of SCLC

A

ACTH (Cushing’s)
ADH (SIADH)
Lambert-Eaton syndrome

1647
Q

Paraneoplastic syndromes of lung SCC

A

PTHrP (hypercalcemia)

1648
Q

Most common cause of urinary obstruction in newborn males

A

Posterior urethral valves

Can cause Potter’s sequence and hydronephrosis in-utero

1649
Q

Treatment for diabetic distal neuropathy

A

1) TCA’s

2) Gabapentin

1650
Q

EPS side effects of antipsychotics

A

Acute dystonic reaction (neck, mouth, tongue, EOM)
Akithisia (restlessness)
Parkinsonism
Tardive dyskinesia (after 1-6mo)

1651
Q

Which hereditary hyperbilirubinemias present with unconjugated hyperbili?
What is the difference?

A

Gilbert’s - mild and occurs with fasting and stress

Crigler-Najjar - Severe with early death

1652
Q

Which hereditary hyperbilirubinemias present with conjugated hyperbili?
What is the difference?

A

Rotor’s syndrome - normal appearing liver

Dubin-Johnson - Black liverf

1653
Q

Treatment of the hereditary hyperbilirubinemias

A

Crigler-Najjar I - Phenobarbital
Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant

Dubin-Johnson, Rotor’s, Gilbert’s do not require treatment.

1654
Q

Lab/vitals abnormalities of LBW infants

A 
Hypoxia
Hypothermia
Hypoglycemia
Hypocalcemia
Polycythemia
1655
Q

What electrolyte derangements are seen with significant emesis?

A

Hypochloremic, hypokalemic metabolic alkalosis

Loss of HCl in vomit
Angiotensin II –> HCO3 resorption
Aldosterone –> H+ secretion and K+ secretion

1656
Q

Superior sulcus tumor possible symptoms

A

Horner syndrome
Pancoast (ulnar pain distribution, shoulder weakness)
Hoarseness (RLN)
SVC syndrome

1657
Q

Divisions of mediastinum and their masses

A

Anterior: 4 T’s (thymoma, teratoma, thyroid, terrible lymphoma)
Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma
Posterior: Neurogenic tumors

1658
Q

Beck’s triad of cardiac tamponade

A

Hypotension
Distant heart sounds
Distended jugular veins

1659
Q

When can chorionic villous sampling be done?

Amniocentesis?

A

CVS: 9-14w
Amniocentesis: 15-22w

1660
Q

When to swab for GBS

1661
Q

Quad screen results for Edwards syndrome

A

UNDERaged at 18

All are down

1662
Q

Quad screen results for Down syndrome

A

2up 2down at 21

1663
Q

Treatment of HIV in pregnancy

A

1) Zidovudine or Nevirapine during pregnancy
2) Elective c-section if viral load over 1000
3) Zidovudine for infant
4) No breastfeeding

1664
Q

Normal fetal heart rate

Causes for bradycardia or tachycardia

A

110-160 bpm

Brady - Congenital heart malformations, hypoxia
Tachy - Hypoxia, maternal fever, fetal anemia

1665
Q

Normal variability on FHT

1666
Q

What does sinusoidal variability on FHT indicate?

A

Serious fetal anemia

1667
Q

Treatment of hypercalcemia 2/2 malignancy

A

Short term: Normal saline, Calcitonin

Long term: Bisphosphonates

1668
Q

Mutation seen in cri-du-chat syndrome

A

5p deletion

1669
Q

Difference between gestational and chronic HTN

A

Chronic HTN if present before 20w or persists after 12w postpartum
Gestational HTN if presents after 20w

1670
Q

Definition of preeclampsia

A

1) New-onset HTN after 20w or worsened chronic HTN

2) Proteinuria of over 300mg/24h (3+ proteins)

1671
Q

Murmur of transposition of the great vessels

A

Single S2
+/- VSD murmur

Most common early cyanotic dz

1672
Q

Murmur of tetralogy of Fallot

A

Pulmonic stenosis murmur

VSD murmur

1673
Q

Treatment of transposition of the great vessels

A 
Prostaglandins early (to maintain PFO)
Emergent surgery
1674
Q

Treatment of impetigo

A

Non-bullous (honey crusts) - Topical mupirocin

Bullous - Oral abx

1675
Q

Symptoms of multiple myeloma

A

Calcium elevated
Renal dysfunction
Anemia
Bone lesions/Back pain

1676
Q

Indications for carotid endarterectomy

A

Symptomatic 70-99%

Men asymptomatic 60-99%

1677
Q

ESR and CK in glucocorticoid myopathy

A

Both normal

Painless weakness

1678
Q

ESR and CK in Polymyalgia Rheumatica

A

ESR elevated

CK normal

1679
Q

ESR and CK in statin-induced myopathy

A

ESR normal

CK elevated

1680
Q

How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis

A

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
Q

What cancers are seen with HNPCC?

A

Colon cancer

Endometrial cancer

1682
Q

What cancers are associated with nephrotic syndromes?

A

Adenocarcinoma - membranous nephropathy

Lymphoma - Minimal change disease

1683
Q

Treatment of uric acid kidney stones

A

Oral potassium citrate

Citrate alkalinizes the urine and inhibits crystallization

1684
Q

Prophylaxis in HIV patients

A 
200 = PCP = Bactrim
150 = Histoplasma = Itraconazole
100 = Toxoplasma = Bactrim
50 = MAC = Azithromycin
1685
Q

Prophylaxis in posttransplant patients

A

Bactrim for PCP

Immunize against Influenza, pneumococcus, and HBV

1686
Q

When to perform oral glucose tolerance test

1687
Q

TSH, total T4, and free T4 levels in pregnancy

A

TSH down
Total T4 way up
Free T4 slightly up

Because beta-hCG has TSH-like activity and estrogen increases TBG

1688
Q

Paraneoplastic syndromes of SCLC

A

ACTH (Cushing’s)
ADH (SIADH)
Lambert-Eaton syndrome

1689
Q

Paraneoplastic syndromes of lung SCC

A

PTHrP (hypercalcemia)

1690
Q

Most common cause of urinary obstruction in newborn males

A

Posterior urethral valves

Can cause Potter’s sequence and hydronephrosis in-utero

1691
Q

Treatment for diabetic distal neuropathy

A

1) TCA’s

2) Gabapentin

1692
Q

EPS side effects of antipsychotics

A

Acute dystonic reaction (neck, mouth, tongue, EOM)
Akithisia (restlessness)
Parkinsonism
Tardive dyskinesia (after 1-6mo)

1693
Q

Which hereditary hyperbilirubinemias present with unconjugated hyperbili?
What is the difference?

A

Gilbert’s - mild and occurs with fasting and stress

Crigler-Najjar - Severe with early death

1694
Q

Which hereditary hyperbilirubinemias present with conjugated hyperbili?
What is the difference?

A

Rotor’s syndrome - normal appearing liver

Dubin-Johnson - Black liverf

1695
Q

Treatment of the hereditary hyperbilirubinemias

A

Crigler-Najjar I - Phenobarbital
Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant

Dubin-Johnson, Rotor’s, Gilbert’s do not require treatment.

1696
Q

Lab/vitals abnormalities of LBW infants

A 
Hypoxia
Hypothermia
Hypoglycemia
Hypocalcemia
Polycythemia
1697
Q

What electrolyte derangements are seen with significant emesis?

A

Hypochloremic, hypokalemic metabolic alkalosis

Loss of HCl in vomit
Angiotensin II –> HCO3 resorption
Aldosterone –> H+ secretion and K+ secretion

1698
Q

Superior sulcus tumor possible symptoms

A

Horner syndrome
Pancoast (ulnar pain distribution, shoulder weakness)
Hoarseness (RLN)
SVC syndrome

1699
Q

Divisions of mediastinum and their masses

A

Anterior: 4 T’s (thymoma, teratoma, thyroid, terrible lymphoma)
Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma
Posterior: Neurogenic tumors

1700
Q

Beck’s triad of cardiac tamponade

A

Hypotension
Distant heart sounds
Distended jugular veins

1701
Q

When can chorionic villous sampling be done?

Amniocentesis?

A

CVS: 9-14w
Amniocentesis: 15-22w

1702
Q

When to swab for GBS

1703
Q

Quad screen results for Edwards syndrome

A

UNDERaged at 18

All are down

1704
Q

Quad screen results for Down syndrome

A

2up 2down at 21

1705
Q

Treatment of HIV in pregnancy

A

1) Zidovudine or Nevirapine during pregnancy
2) Elective c-section if viral load over 1000
3) Zidovudine for infant
4) No breastfeeding

1706
Q

Normal fetal heart rate

Causes for bradycardia or tachycardia

A

110-160 bpm

Brady - Congenital heart malformations, hypoxia
Tachy - Hypoxia, maternal fever, fetal anemia

1707
Q

Normal variability on FHT

1708
Q

What does sinusoidal variability on FHT indicate?

A

Serious fetal anemia

1709
Q

Treatment of hypercalcemia 2/2 malignancy

A

Short term: Normal saline, Calcitonin

Long term: Bisphosphonates

1710
Q

Mutation seen in cri-du-chat syndrome

A

5p deletion

1711
Q

Difference between gestational and chronic HTN

A

Chronic HTN if present before 20w or persists after 12w postpartum
Gestational HTN if presents after 20w

1712
Q

Definition of preeclampsia

A

1) New-onset HTN after 20w or worsened chronic HTN

2) Proteinuria of over 300mg/24h (3+ proteins)

1713
Q

Murmur of transposition of the great vessels

A

Single S2
+/- VSD murmur

Most common early cyanotic dz

1714
Q

Murmur of tetralogy of Fallot

A

Pulmonic stenosis murmur

VSD murmur

1715
Q

Treatment of transposition of the great vessels

A 
Prostaglandins early (to maintain PFO)
Emergent surgery
1716
Q

Treatment of impetigo

A

Non-bullous (honey crusts) - Topical mupirocin

Bullous - Oral abx

1717
Q

Symptoms of multiple myeloma

A

Calcium elevated
Renal dysfunction
Anemia
Bone lesions/Back pain

1718
Q

Indications for carotid endarterectomy

A

Symptomatic 70-99%

Men asymptomatic 60-99%

1719
Q

ESR and CK in glucocorticoid myopathy

A

Both normal

Painless weakness

1720
Q

ESR and CK in Polymyalgia Rheumatica

A

ESR elevated

CK normal

1721
Q

ESR and CK in statin-induced myopathy

A

ESR normal

CK elevated

1722
Q

How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis

A

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
Q

What cancers are seen with HNPCC?

A

Colon cancer

Endometrial cancer

1724
Q

What cancers are associated with nephrotic syndromes?

A

Adenocarcinoma - membranous nephropathy

Lymphoma - Minimal change disease

1725
Q

Treatment of uric acid kidney stones

A

Oral potassium citrate

Citrate alkalinizes the urine and inhibits crystallization

1726
Q

Prophylaxis in HIV patients

A 
200 = PCP = Bactrim
150 = Histoplasma = Itraconazole
100 = Toxoplasma = Bactrim
50 = MAC = Azithromycin
1727
Q

Prophylaxis in posttransplant patients

A

Bactrim for PCP

Immunize against Influenza, pneumococcus, and HBV

1728
Q

When to perform oral glucose tolerance test

1729
Q

TSH, total T4, and free T4 levels in pregnancy

A

TSH down
Total T4 way up
Free T4 slightly up

Because beta-hCG has TSH-like activity and estrogen increases TBG

1730
Q

Paraneoplastic syndromes of SCLC

A

ACTH (Cushing’s)
ADH (SIADH)
Lambert-Eaton syndrome

1731
Q

Paraneoplastic syndromes of lung SCC

A

PTHrP (hypercalcemia)

1732
Q

Most common cause of urinary obstruction in newborn males

A

Posterior urethral valves

Can cause Potter’s sequence and hydronephrosis in-utero

1733
Q

Treatment for diabetic distal neuropathy

A

1) TCA’s

2) Gabapentin

1734
Q

EPS side effects of antipsychotics

A

Acute dystonic reaction (neck, mouth, tongue, EOM)
Akithisia (restlessness)
Parkinsonism
Tardive dyskinesia (after 1-6mo)

1735
Q

Which hereditary hyperbilirubinemias present with unconjugated hyperbili?
What is the difference?

A

Gilbert’s - mild and occurs with fasting and stress

Crigler-Najjar - Severe with early death

1736
Q

Which hereditary hyperbilirubinemias present with conjugated hyperbili?
What is the difference?

A

Rotor’s syndrome - normal appearing liver

Dubin-Johnson - Black liverf

1737
Q

Treatment of the hereditary hyperbilirubinemias

A

Crigler-Najjar I - Phenobarbital
Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant

Dubin-Johnson, Rotor’s, Gilbert’s do not require treatment.

1738
Q

Lab/vitals abnormalities of LBW infants

A 
Hypoxia
Hypothermia
Hypoglycemia
Hypocalcemia
Polycythemia
1739
Q

What electrolyte derangements are seen with significant emesis?

A

Hypochloremic, hypokalemic metabolic alkalosis

Loss of HCl in vomit
Angiotensin II –> HCO3 resorption
Aldosterone –> H+ secretion and K+ secretion

1740
Q

Superior sulcus tumor possible symptoms

A

Horner syndrome
Pancoast (ulnar pain distribution, shoulder weakness)
Hoarseness (RLN)
SVC syndrome

1741
Q

Divisions of mediastinum and their masses

A

Anterior: 4 T’s (thymoma, teratoma, thyroid, terrible lymphoma)
Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma
Posterior: Neurogenic tumors

1742
Q

Beck’s triad of cardiac tamponade

A

Hypotension
Distant heart sounds
Distended jugular veins

1743
Q

When can chorionic villous sampling be done?

Amniocentesis?

A

CVS: 9-14w
Amniocentesis: 15-22w

1744
Q

When to swab for GBS

1745
Q

Quad screen results for Edwards syndrome

A

UNDERaged at 18

All are down

1746
Q

Quad screen results for Down syndrome

A

2up 2down at 21

1747
Q

Treatment of HIV in pregnancy

A

1) Zidovudine or Nevirapine during pregnancy
2) Elective c-section if viral load over 1000
3) Zidovudine for infant
4) No breastfeeding

1748
Q

Normal fetal heart rate

Causes for bradycardia or tachycardia

A

110-160 bpm

Brady - Congenital heart malformations, hypoxia
Tachy - Hypoxia, maternal fever, fetal anemia

1749
Q

Normal variability on FHT

1750
Q

What does sinusoidal variability on FHT indicate?

A

Serious fetal anemia

1751
Q

Treatment of hypercalcemia 2/2 malignancy

A

Short term: Normal saline, Calcitonin

Long term: Bisphosphonates

1752
Q

Mutation seen in cri-du-chat syndrome

A

5p deletion

1753
Q

Difference between gestational and chronic HTN

A

Chronic HTN if present before 20w or persists after 12w postpartum
Gestational HTN if presents after 20w

1754
Q

Definition of preeclampsia

A

1) New-onset HTN after 20w or worsened chronic HTN

2) Proteinuria of over 300mg/24h (3+ proteins)

1755
Q

Murmur of transposition of the great vessels

A

Single S2
+/- VSD murmur

Most common early cyanotic dz

1756
Q

Murmur of tetralogy of Fallot

A

Pulmonic stenosis murmur

VSD murmur

1757
Q

Treatment of transposition of the great vessels

A 
Prostaglandins early (to maintain PFO)
Emergent surgery
1758
Q

Treatment of impetigo

A

Non-bullous (honey crusts) - Topical mupirocin

Bullous - Oral abx

1759
Q

Symptoms of multiple myeloma

A

Calcium elevated
Renal dysfunction
Anemia
Bone lesions/Back pain

1760
Q

Indications for carotid endarterectomy

A

Symptomatic 70-99%

Men asymptomatic 60-99%

1761
Q

ESR and CK in glucocorticoid myopathy

A

Both normal

Painless weakness

1762
Q

ESR and CK in Polymyalgia Rheumatica

A

ESR elevated

CK normal

1763
Q

ESR and CK in statin-induced myopathy

A

ESR normal

CK elevated

1764
Q

How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis

A

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
Q

What cancers are seen with HNPCC?

A

Colon cancer

Endometrial cancer

1766
Q

What cancers are associated with nephrotic syndromes?

A

Adenocarcinoma - membranous nephropathy

Lymphoma - Minimal change disease

1767
Q

Treatment of uric acid kidney stones

A

Oral potassium citrate

Citrate alkalinizes the urine and inhibits crystallization

1768
Q

Prophylaxis in HIV patients

A 
200 = PCP = Bactrim
150 = Histoplasma = Itraconazole
100 = Toxoplasma = Bactrim
50 = MAC = Azithromycin
1769
Q

Prophylaxis in posttransplant patients

A

Bactrim for PCP

Immunize against Influenza, pneumococcus, and HBV

1770
Q

When to perform oral glucose tolerance test

1771
Q

TSH, total T4, and free T4 levels in pregnancy

A

TSH down
Total T4 way up
Free T4 slightly up

Because beta-hCG has TSH-like activity and estrogen increases TBG

1772
Q

Paraneoplastic syndromes of SCLC

A

ACTH (Cushing’s)
ADH (SIADH)
Lambert-Eaton syndrome

1773
Q

Paraneoplastic syndromes of lung SCC

A

PTHrP (hypercalcemia)

1774
Q

Most common cause of urinary obstruction in newborn males

A

Posterior urethral valves

Can cause Potter’s sequence and hydronephrosis in-utero

1775
Q

Treatment for diabetic distal neuropathy

A

1) TCA’s

2) Gabapentin

1776
Q

EPS side effects of antipsychotics

A

Acute dystonic reaction (neck, mouth, tongue, EOM)
Akithisia (restlessness)
Parkinsonism
Tardive dyskinesia (after 1-6mo)

1777
Q

Which hereditary hyperbilirubinemias present with unconjugated hyperbili?
What is the difference?

A

Gilbert’s - mild and occurs with fasting and stress

Crigler-Najjar - Severe with early death

1778
Q

Which hereditary hyperbilirubinemias present with conjugated hyperbili?
What is the difference?

A

Rotor’s syndrome - normal appearing liver

Dubin-Johnson - Black liverf

1779
Q

Treatment of the hereditary hyperbilirubinemias

A

Crigler-Najjar I - Phenobarbital
Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant

Dubin-Johnson, Rotor’s, Gilbert’s do not require treatment.

1780
Q

Lab/vitals abnormalities of LBW infants

A 
Hypoxia
Hypothermia
Hypoglycemia
Hypocalcemia
Polycythemia
1781
Q

What electrolyte derangements are seen with significant emesis?

A

Hypochloremic, hypokalemic metabolic alkalosis

Loss of HCl in vomit
Angiotensin II –> HCO3 resorption
Aldosterone –> H+ secretion and K+ secretion

1782
Q

Superior sulcus tumor possible symptoms

A

Horner syndrome
Pancoast (ulnar pain distribution, shoulder weakness)
Hoarseness (RLN)
SVC syndrome

1783
Q

Divisions of mediastinum and their masses

A

Anterior: 4 T’s (thymoma, teratoma, thyroid, terrible lymphoma)
Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma
Posterior: Neurogenic tumors

1784
Q

Beck’s triad of cardiac tamponade

A

Hypotension
Distant heart sounds
Distended jugular veins

1785
Q

When can chorionic villous sampling be done?

Amniocentesis?

A

CVS: 9-14w
Amniocentesis: 15-22w

1786
Q

When to swab for GBS

1787
Q

Quad screen results for Edwards syndrome

A

UNDERaged at 18

All are down

1788
Q

Quad screen results for Down syndrome

A

2up 2down at 21

1789
Q

Treatment of HIV in pregnancy

A

1) Zidovudine or Nevirapine during pregnancy
2) Elective c-section if viral load over 1000
3) Zidovudine for infant
4) No breastfeeding

1790
Q

Normal fetal heart rate

Causes for bradycardia or tachycardia

A

110-160 bpm

Brady - Congenital heart malformations, hypoxia
Tachy - Hypoxia, maternal fever, fetal anemia

1791
Q

Normal variability on FHT

1792
Q

What does sinusoidal variability on FHT indicate?

A

Serious fetal anemia

1793
Q

Treatment of hypercalcemia 2/2 malignancy

A

Short term: Normal saline, Calcitonin

Long term: Bisphosphonates

1794
Q

Mutation seen in cri-du-chat syndrome

A

5p deletion

1795
Q

Difference between gestational and chronic HTN

A

Chronic HTN if present before 20w or persists after 12w postpartum
Gestational HTN if presents after 20w

1796
Q

Definition of preeclampsia

A

1) New-onset HTN after 20w or worsened chronic HTN

2) Proteinuria of over 300mg/24h (3+ proteins)

1797
Q

Murmur of transposition of the great vessels

A

Single S2
+/- VSD murmur

Most common early cyanotic dz

1798
Q

Murmur of tetralogy of Fallot

A

Pulmonic stenosis murmur

VSD murmur

1799
Q

Treatment of transposition of the great vessels

A 
Prostaglandins early (to maintain PFO)
Emergent surgery
1800
Q

Treatment of impetigo

A

Non-bullous (honey crusts) - Topical mupirocin

Bullous - Oral abx

1801
Q

Symptoms of multiple myeloma

A

Calcium elevated
Renal dysfunction
Anemia
Bone lesions/Back pain

1802
Q

Indications for carotid endarterectomy

A

Symptomatic 70-99%

Men asymptomatic 60-99%

1803
Q

ESR and CK in glucocorticoid myopathy

A

Both normal

Painless weakness

1804
Q

ESR and CK in Polymyalgia Rheumatica

A

ESR elevated

CK normal

1805
Q

ESR and CK in statin-induced myopathy

A

ESR normal

CK elevated

1806
Q

How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis

A

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
Q

What cancers are seen with HNPCC?

A

Colon cancer

Endometrial cancer

1808
Q

What cancers are associated with nephrotic syndromes?

A

Adenocarcinoma - membranous nephropathy

Lymphoma - Minimal change disease

1809
Q

Treatment of uric acid kidney stones

A

Oral potassium citrate

Citrate alkalinizes the urine and inhibits crystallization

1810
Q

Prophylaxis in HIV patients

A 
200 = PCP = Bactrim
150 = Histoplasma = Itraconazole
100 = Toxoplasma = Bactrim
50 = MAC = Azithromycin
1811
Q

Prophylaxis in posttransplant patients

A

Bactrim for PCP

Immunize against Influenza, pneumococcus, and HBV

1812
Q

When to perform oral glucose tolerance test

1813
Q

TSH, total T4, and free T4 levels in pregnancy

A

TSH down
Total T4 way up
Free T4 slightly up

Because beta-hCG has TSH-like activity and estrogen increases TBG

1814
Q

Paraneoplastic syndromes of SCLC

A

ACTH (Cushing’s)
ADH (SIADH)
Lambert-Eaton syndrome

1815
Q

Paraneoplastic syndromes of lung SCC

A

PTHrP (hypercalcemia)

1816
Q

Most common cause of urinary obstruction in newborn males

A

Posterior urethral valves

Can cause Potter’s sequence and hydronephrosis in-utero

1817
Q

Treatment for diabetic distal neuropathy

A

1) TCA’s

2) Gabapentin

1818
Q

EPS side effects of antipsychotics

A

Acute dystonic reaction (neck, mouth, tongue, EOM)
Akithisia (restlessness)
Parkinsonism
Tardive dyskinesia (after 1-6mo)

1819
Q

Which hereditary hyperbilirubinemias present with unconjugated hyperbili?
What is the difference?

A

Gilbert’s - mild and occurs with fasting and stress

Crigler-Najjar - Severe with early death

1820
Q

Which hereditary hyperbilirubinemias present with conjugated hyperbili?
What is the difference?

A

Rotor’s syndrome - normal appearing liver

Dubin-Johnson - Black liverf

1821
Q

Treatment of the hereditary hyperbilirubinemias

A

Crigler-Najjar I - Phenobarbital
Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant

Dubin-Johnson, Rotor’s, Gilbert’s do not require treatment.

1822
Q

Lab/vitals abnormalities of LBW infants

A 
Hypoxia
Hypothermia
Hypoglycemia
Hypocalcemia
Polycythemia
1823
Q

What electrolyte derangements are seen with significant emesis?

A

Hypochloremic, hypokalemic metabolic alkalosis

Loss of HCl in vomit
Angiotensin II –> HCO3 resorption
Aldosterone –> H+ secretion and K+ secretion

1824
Q

Superior sulcus tumor possible symptoms

A

Horner syndrome
Pancoast (ulnar pain distribution, shoulder weakness)
Hoarseness (RLN)
SVC syndrome

1825
Q

Divisions of mediastinum and their masses

A

Anterior: 4 T’s (thymoma, teratoma, thyroid, terrible lymphoma)
Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma
Posterior: Neurogenic tumors

1826
Q

Beck’s triad of cardiac tamponade

A

Hypotension
Distant heart sounds
Distended jugular veins

1827
Q

When can chorionic villous sampling be done?

Amniocentesis?

A

CVS: 9-14w
Amniocentesis: 15-22w

1828
Q

When to swab for GBS

1829
Q

Quad screen results for Edwards syndrome

A

UNDERaged at 18

All are down

1830
Q

Quad screen results for Down syndrome

A

2up 2down at 21

1831
Q

Treatment of HIV in pregnancy

A

1) Zidovudine or Nevirapine during pregnancy
2) Elective c-section if viral load over 1000
3) Zidovudine for infant
4) No breastfeeding

1832
Q

Normal fetal heart rate

Causes for bradycardia or tachycardia

A

110-160 bpm

Brady - Congenital heart malformations, hypoxia
Tachy - Hypoxia, maternal fever, fetal anemia

1833
Q

Normal variability on FHT

1834
Q

What does sinusoidal variability on FHT indicate?

A

Serious fetal anemia

1835
Q

Treatment of hypercalcemia 2/2 malignancy

A

Short term: Normal saline, Calcitonin

Long term: Bisphosphonates

1836
Q

Mutation seen in cri-du-chat syndrome

A

5p deletion

1837
Q

Difference between gestational and chronic HTN

A

Chronic HTN if present before 20w or persists after 12w postpartum
Gestational HTN if presents after 20w

1838
Q

Definition of preeclampsia

A

1) New-onset HTN after 20w or worsened chronic HTN

2) Proteinuria of over 300mg/24h (3+ proteins)

1839
Q

Murmur of transposition of the great vessels

A

Single S2
+/- VSD murmur

Most common early cyanotic dz

1840
Q

Murmur of tetralogy of Fallot

A

Pulmonic stenosis murmur

VSD murmur

1841
Q

Treatment of transposition of the great vessels

A 
Prostaglandins early (to maintain PFO)
Emergent surgery
1842
Q

Treatment of impetigo

A

Non-bullous (honey crusts) - Topical mupirocin

Bullous - Oral abx

1843
Q

Symptoms of multiple myeloma

A

Calcium elevated
Renal dysfunction
Anemia
Bone lesions/Back pain

1844
Q

Indications for carotid endarterectomy

A

Symptomatic 70-99%

Men asymptomatic 60-99%

1845
Q

ESR and CK in glucocorticoid myopathy

A

Both normal

Painless weakness

1846
Q

ESR and CK in Polymyalgia Rheumatica

A

ESR elevated

CK normal

1847
Q

ESR and CK in statin-induced myopathy

A

ESR normal

CK elevated

1848
Q

How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis

A

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
Q

What cancers are seen with HNPCC?

A

Colon cancer

Endometrial cancer

1850
Q

What cancers are associated with nephrotic syndromes?

A

Adenocarcinoma - membranous nephropathy

Lymphoma - Minimal change disease

1851
Q

Treatment of uric acid kidney stones

A

Oral potassium citrate

Citrate alkalinizes the urine and inhibits crystallization

1852
Q

Prophylaxis in HIV patients

A 
200 = PCP = Bactrim
150 = Histoplasma = Itraconazole
100 = Toxoplasma = Bactrim
50 = MAC = Azithromycin
1853
Q

Prophylaxis in posttransplant patients

A

Bactrim for PCP

Immunize against Influenza, pneumococcus, and HBV

1854
Q

When to perform oral glucose tolerance test

1855
Q

TSH, total T4, and free T4 levels in pregnancy

A

TSH down
Total T4 way up
Free T4 slightly up

Because beta-hCG has TSH-like activity and estrogen increases TBG

1856
Q

Paraneoplastic syndromes of SCLC

A

ACTH (Cushing’s)
ADH (SIADH)
Lambert-Eaton syndrome

1857
Q

Paraneoplastic syndromes of lung SCC

A

PTHrP (hypercalcemia)

1858
Q

Most common cause of urinary obstruction in newborn males

A

Posterior urethral valves

Can cause Potter’s sequence and hydronephrosis in-utero

1859
Q

Treatment for diabetic distal neuropathy

A

1) TCA’s

2) Gabapentin

1860
Q

EPS side effects of antipsychotics

A

Acute dystonic reaction (neck, mouth, tongue, EOM)
Akithisia (restlessness)
Parkinsonism
Tardive dyskinesia (after 1-6mo)

1861
Q

Which hereditary hyperbilirubinemias present with unconjugated hyperbili?
What is the difference?

A

Gilbert’s - mild and occurs with fasting and stress

Crigler-Najjar - Severe with early death

1862
Q

Which hereditary hyperbilirubinemias present with conjugated hyperbili?
What is the difference?

A

Rotor’s syndrome - normal appearing liver

Dubin-Johnson - Black liverf

1863
Q

Treatment of the hereditary hyperbilirubinemias

A

Crigler-Najjar I - Phenobarbital
Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant

Dubin-Johnson, Rotor’s, Gilbert’s do not require treatment.

1864
Q

Lab/vitals abnormalities of LBW infants

A 
Hypoxia
Hypothermia
Hypoglycemia
Hypocalcemia
Polycythemia
1865
Q

What electrolyte derangements are seen with significant emesis?

A

Hypochloremic, hypokalemic metabolic alkalosis

Loss of HCl in vomit
Angiotensin II –> HCO3 resorption
Aldosterone –> H+ secretion and K+ secretion

1866
Q

Superior sulcus tumor possible symptoms

A

Horner syndrome
Pancoast (ulnar pain distribution, shoulder weakness)
Hoarseness (RLN)
SVC syndrome

1867
Q

Divisions of mediastinum and their masses

A

Anterior: 4 T’s (thymoma, teratoma, thyroid, terrible lymphoma)
Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma
Posterior: Neurogenic tumors

1868
Q

Beck’s triad of cardiac tamponade

A

Hypotension
Distant heart sounds
Distended jugular veins

1869
Q

When can chorionic villous sampling be done?

Amniocentesis?

A

CVS: 9-14w
Amniocentesis: 15-22w

1870
Q

When to swab for GBS

1871
Q

Quad screen results for Edwards syndrome

A

UNDERaged at 18

All are down

1872
Q

Quad screen results for Down syndrome

A

2up 2down at 21

1873
Q

Treatment of HIV in pregnancy

A

1) Zidovudine or Nevirapine during pregnancy
2) Elective c-section if viral load over 1000
3) Zidovudine for infant
4) No breastfeeding

1874
Q

Normal fetal heart rate

Causes for bradycardia or tachycardia

A

110-160 bpm

Brady - Congenital heart malformations, hypoxia
Tachy - Hypoxia, maternal fever, fetal anemia

1875
Q

Normal variability on FHT

1876
Q

What does sinusoidal variability on FHT indicate?

A

Serious fetal anemia

1877
Q

Treatment of hypercalcemia 2/2 malignancy

A

Short term: Normal saline, Calcitonin

Long term: Bisphosphonates

1878
Q

Mutation seen in cri-du-chat syndrome

A

5p deletion

1879
Q

Difference between gestational and chronic HTN

A

Chronic HTN if present before 20w or persists after 12w postpartum
Gestational HTN if presents after 20w

1880
Q

Definition of preeclampsia

A

1) New-onset HTN after 20w or worsened chronic HTN

2) Proteinuria of over 300mg/24h (3+ proteins)

1881
Q

Murmur of transposition of the great vessels

A

Single S2
+/- VSD murmur

Most common early cyanotic dz

1882
Q

Murmur of tetralogy of Fallot

A

Pulmonic stenosis murmur

VSD murmur

1883
Q

Treatment of transposition of the great vessels

A 
Prostaglandins early (to maintain PFO)
Emergent surgery
1884
Q

Treatment of impetigo

A

Non-bullous (honey crusts) - Topical mupirocin

Bullous - Oral abx

1885
Q

Symptoms of multiple myeloma

A

Calcium elevated
Renal dysfunction
Anemia
Bone lesions/Back pain

1886
Q

Indications for carotid endarterectomy

A

Symptomatic 70-99%

Men asymptomatic 60-99%

1887
Q

ESR and CK in glucocorticoid myopathy

A

Both normal

Painless weakness

1888
Q

ESR and CK in Polymyalgia Rheumatica

A

ESR elevated

CK normal

1889
Q

ESR and CK in statin-induced myopathy

A

ESR normal

CK elevated

1890
Q

How to differentiate saline-responsive vs. saline-resistant metabolic alkalosis

A

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
Q

What cancers are seen with HNPCC?

A

Colon cancer

Endometrial cancer

1892
Q

What cancers are associated with nephrotic syndromes?

A

Adenocarcinoma - membranous nephropathy

Lymphoma - Minimal change disease

1893
Q

Treatment of uric acid kidney stones

A

Oral potassium citrate

Citrate alkalinizes the urine and inhibits crystallization

1894
Q

Prophylaxis in HIV patients

A 
200 = PCP = Bactrim
150 = Histoplasma = Itraconazole
100 = Toxoplasma = Bactrim
50 = MAC = Azithromycin
1895
Q

Prophylaxis in posttransplant patients

A

Bactrim for PCP

Immunize against Influenza, pneumococcus, and HBV

1896
Q

When to perform oral glucose tolerance test

1897
Q

TSH, total T4, and free T4 levels in pregnancy

A

TSH down
Total T4 way up
Free T4 slightly up

Because beta-hCG has TSH-like activity and estrogen increases TBG

1898
Q

Paraneoplastic syndromes of SCLC

A

ACTH (Cushing’s)
ADH (SIADH)
Lambert-Eaton syndrome

1899
Q

Paraneoplastic syndromes of lung SCC

A

PTHrP (hypercalcemia)

1900
Q

Most common cause of urinary obstruction in newborn males

A

Posterior urethral valves

Can cause Potter’s sequence and hydronephrosis in-utero

1901
Q

Treatment for diabetic distal neuropathy

A

1) TCA’s

2) Gabapentin

1902
Q

EPS side effects of antipsychotics

A

Acute dystonic reaction (neck, mouth, tongue, EOM)
Akithisia (restlessness)
Parkinsonism
Tardive dyskinesia (after 1-6mo)

1903
Q

Which hereditary hyperbilirubinemias present with unconjugated hyperbili?
What is the difference?

A

Gilbert’s - mild and occurs with fasting and stress

Crigler-Najjar - Severe with early death

1904
Q

Which hereditary hyperbilirubinemias present with conjugated hyperbili?
What is the difference?

A

Rotor’s syndrome - normal appearing liver

Dubin-Johnson - Black liverf

1905
Q

Treatment of the hereditary hyperbilirubinemias

A

Crigler-Najjar I - Phenobarbital
Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant

Dubin-Johnson, Rotor’s, Gilbert’s do not require treatment.

1906
Q

Lab/vitals abnormalities of LBW infants

A 
Hypoxia
Hypothermia
Hypoglycemia
Hypocalcemia
Polycythemia
1907
Q

What electrolyte derangements are seen with significant emesis?

A

Hypochloremic, hypokalemic metabolic alkalosis

Loss of HCl in vomit
Angiotensin II –> HCO3 resorption
Aldosterone –> H+ secretion and K+ secretion

1908
Q

Superior sulcus tumor possible symptoms

A

Horner syndrome
Pancoast (ulnar pain distribution, shoulder weakness)
Hoarseness (RLN)
SVC syndrome

1909
Q

Divisions of mediastinum and their masses

A

Anterior: 4 T’s (thymoma, teratoma, thyroid, terrible lymphoma)
Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma
Posterior: Neurogenic tumors

1910
Q

Beck’s triad of cardiac tamponade

A

Hypotension
Distant heart sounds
Distended jugular veins

1911
Q

When can chorionic villous sampling be done?

Amniocentesis?

A

CVS: 9-14w
Amniocentesis: 15-22w

1912
Q

When to swab for GBS

1913
Q

Quad screen results for Edwards syndrome

A

UNDERaged at 18

All are down

1914
Q

Quad screen results for Down syndrome

A

2up 2down at 21

1915
Q

Treatment of HIV in pregnancy

A

1) Zidovudine or Nevirapine during pregnancy
2) Elective c-section if viral load over 1000
3) Zidovudine for infant
4) No breastfeeding

1916
Q

Normal fetal heart rate

Causes for bradycardia or tachycardia

A

110-160 bpm

Brady - Congenital heart malformations, hypoxia
Tachy - Hypoxia, maternal fever, fetal anemia

1917
Q

Normal variability on FHT

1918
Q

What does sinusoidal variability on FHT indicate?

A

Serious fetal anemia

1919
Q

Prophylaxis in HIV patients

A 
200 = PCP = Bactrim
150 = Histoplasma = Itraconazole
100 = Toxoplasma = Bactrim
50 = MAC = Azithromycin
1920
Q

Prophylaxis in posttransplant patients

A

Bactrim for PCP

Immunize against Influenza, pneumococcus, and HBV

1921
Q

When to perform oral glucose tolerance test

1922
Q

TSH, total T4, and free T4 levels in pregnancy

A

TSH down
Total T4 way up
Free T4 slightly up

Because beta-hCG has TSH-like activity and estrogen increases TBG

1923
Q

Paraneoplastic syndromes of SCLC

A

ACTH (Cushing’s)
ADH (SIADH)
Lambert-Eaton syndrome

1924
Q

Paraneoplastic syndromes of lung SCC

A

PTHrP (hypercalcemia)

1925
Q

Most common cause of urinary obstruction in newborn males

A

Posterior urethral valves

Can cause Potter’s sequence and hydronephrosis in-utero

1926
Q

Treatment for diabetic distal neuropathy

A

1) TCA’s

2) Gabapentin

1927
Q

EPS side effects of antipsychotics

A

Acute dystonic reaction (neck, mouth, tongue, EOM)
Akithisia (restlessness)
Parkinsonism
Tardive dyskinesia (after 1-6mo)

1928
Q

Which hereditary hyperbilirubinemias present with unconjugated hyperbili?
What is the difference?

A

Gilbert’s - mild and occurs with fasting and stress

Crigler-Najjar - Severe with early death

1929
Q

Which hereditary hyperbilirubinemias present with conjugated hyperbili?
What is the difference?

A

Rotor’s syndrome - normal appearing liver

Dubin-Johnson - Black liverf

1930
Q

Treatment of the hereditary hyperbilirubinemias

A

Crigler-Najjar I - Phenobarbital
Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant

Dubin-Johnson, Rotor’s, Gilbert’s do not require treatment.

1931
Q

Lab/vitals abnormalities of LBW infants

A 
Hypoxia
Hypothermia
Hypoglycemia
Hypocalcemia
Polycythemia
1932
Q

What electrolyte derangements are seen with significant emesis?

A

Hypochloremic, hypokalemic metabolic alkalosis

Loss of HCl in vomit
Angiotensin II –> HCO3 resorption
Aldosterone –> H+ secretion and K+ secretion

1933
Q

Superior sulcus tumor possible symptoms

A

Horner syndrome
Pancoast (ulnar pain distribution, shoulder weakness)
Hoarseness (RLN)
SVC syndrome

1934
Q

Divisions of mediastinum and their masses

A

Anterior: 4 T’s (thymoma, teratoma, thyroid, terrible lymphoma)
Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma
Posterior: Neurogenic tumors

1935
Q

Beck’s triad of cardiac tamponade

A

Hypotension
Distant heart sounds
Distended jugular veins

1936
Q

When can chorionic villous sampling be done?

Amniocentesis?

A

CVS: 9-14w
Amniocentesis: 15-22w

1937
Q

When to swab for GBS

1938
Q

Quad screen results for Edwards syndrome

A

UNDERaged at 18

All are down

1939
Q

Quad screen results for Down syndrome

A

2up 2down at 21

1940
Q

Treatment of HIV in pregnancy

A

1) Zidovudine or Nevirapine during pregnancy
2) Elective c-section if viral load over 1000
3) Zidovudine for infant
4) No breastfeeding

1941
Q

Normal fetal heart rate

Causes for bradycardia or tachycardia

A

110-160 bpm

Brady - Congenital heart malformations, hypoxia
Tachy - Hypoxia, maternal fever, fetal anemia

1942
Q

Normal variability on FHT

1943
Q

What does sinusoidal variability on FHT indicate?

A

Serious fetal anemia

1944
Q

Prophylaxis in HIV patients

A 
200 = PCP = Bactrim
150 = Histoplasma = Itraconazole
100 = Toxoplasma = Bactrim
50 = MAC = Azithromycin
1945
Q

Prophylaxis in posttransplant patients

A

Bactrim for PCP

Immunize against Influenza, pneumococcus, and HBV

1946
Q

When to perform oral glucose tolerance test

1947
Q

TSH, total T4, and free T4 levels in pregnancy

A

TSH down
Total T4 way up
Free T4 slightly up

Because beta-hCG has TSH-like activity and estrogen increases TBG

1948
Q

Paraneoplastic syndromes of SCLC

A

ACTH (Cushing’s)
ADH (SIADH)
Lambert-Eaton syndrome

1949
Q

Paraneoplastic syndromes of lung SCC

A

PTHrP (hypercalcemia)

1950
Q

Most common cause of urinary obstruction in newborn males

A

Posterior urethral valves

Can cause Potter’s sequence and hydronephrosis in-utero

1951
Q

Treatment for diabetic distal neuropathy

A

1) TCA’s

2) Gabapentin

1952
Q

EPS side effects of antipsychotics

A

Acute dystonic reaction (neck, mouth, tongue, EOM)
Akithisia (restlessness)
Parkinsonism
Tardive dyskinesia (after 1-6mo)

1953
Q

Which hereditary hyperbilirubinemias present with unconjugated hyperbili?
What is the difference?

A

Gilbert’s - mild and occurs with fasting and stress

Crigler-Najjar - Severe with early death

1954
Q

Which hereditary hyperbilirubinemias present with conjugated hyperbili?
What is the difference?

A

Rotor’s syndrome - normal appearing liver

Dubin-Johnson - Black liverf

1955
Q

Treatment of the hereditary hyperbilirubinemias

A

Crigler-Najjar I - Phenobarbital
Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant

Dubin-Johnson, Rotor’s, Gilbert’s do not require treatment.

1956
Q

Lab/vitals abnormalities of LBW infants

A 
Hypoxia
Hypothermia
Hypoglycemia
Hypocalcemia
Polycythemia
1957
Q

What electrolyte derangements are seen with significant emesis?

A

Hypochloremic, hypokalemic metabolic alkalosis

Loss of HCl in vomit
Angiotensin II –> HCO3 resorption
Aldosterone –> H+ secretion and K+ secretion

1958
Q

Superior sulcus tumor possible symptoms

A

Horner syndrome
Pancoast (ulnar pain distribution, shoulder weakness)
Hoarseness (RLN)
SVC syndrome

1959
Q

Divisions of mediastinum and their masses

A

Anterior: 4 T’s (thymoma, teratoma, thyroid, terrible lymphoma)
Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma
Posterior: Neurogenic tumors

1960
Q

Beck’s triad of cardiac tamponade

A

Hypotension
Distant heart sounds
Distended jugular veins

1961
Q

When can chorionic villous sampling be done?

Amniocentesis?

A

CVS: 9-14w
Amniocentesis: 15-22w

1962
Q

When to swab for GBS

1963
Q

Quad screen results for Edwards syndrome

A

UNDERaged at 18

All are down

1964
Q

Quad screen results for Down syndrome

A

2up 2down at 21

1965
Q

Treatment of HIV in pregnancy

A

1) Zidovudine or Nevirapine during pregnancy
2) Elective c-section if viral load over 1000
3) Zidovudine for infant
4) No breastfeeding

1966
Q

Normal fetal heart rate

Causes for bradycardia or tachycardia

A

110-160 bpm

Brady - Congenital heart malformations, hypoxia
Tachy - Hypoxia, maternal fever, fetal anemia

1967
Q

Normal variability on FHT

1968
Q

What does sinusoidal variability on FHT indicate?

A

Serious fetal anemia

1969
Q

Prophylaxis in HIV patients

A 
200 = PCP = Bactrim
150 = Histoplasma = Itraconazole
100 = Toxoplasma = Bactrim
50 = MAC = Azithromycin
1970
Q

Prophylaxis in posttransplant patients

A

Bactrim for PCP

Immunize against Influenza, pneumococcus, and HBV

1971
Q

When to perform oral glucose tolerance test

1972
Q

TSH, total T4, and free T4 levels in pregnancy

A

TSH down
Total T4 way up
Free T4 slightly up

Because beta-hCG has TSH-like activity and estrogen increases TBG

1973
Q

Paraneoplastic syndromes of SCLC

A

ACTH (Cushing’s)
ADH (SIADH)
Lambert-Eaton syndrome

1974
Q

Paraneoplastic syndromes of lung SCC

A

PTHrP (hypercalcemia)

1975
Q

Most common cause of urinary obstruction in newborn males

A

Posterior urethral valves

Can cause Potter’s sequence and hydronephrosis in-utero

1976
Q

Treatment for diabetic distal neuropathy

A

1) TCA’s

2) Gabapentin

1977
Q

EPS side effects of antipsychotics

A

Acute dystonic reaction (neck, mouth, tongue, EOM)
Akithisia (restlessness)
Parkinsonism
Tardive dyskinesia (after 1-6mo)

1978
Q

Which hereditary hyperbilirubinemias present with unconjugated hyperbili?
What is the difference?

A

Gilbert’s - mild and occurs with fasting and stress

Crigler-Najjar - Severe with early death

1979
Q

Which hereditary hyperbilirubinemias present with conjugated hyperbili?
What is the difference?

A

Rotor’s syndrome - normal appearing liver

Dubin-Johnson - Black liverf

1980
Q

Treatment of the hereditary hyperbilirubinemias

A

Crigler-Najjar I - Phenobarbital
Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant

Dubin-Johnson, Rotor’s, Gilbert’s do not require treatment.

1981
Q

Lab/vitals abnormalities of LBW infants

A 
Hypoxia
Hypothermia
Hypoglycemia
Hypocalcemia
Polycythemia
1982
Q

What electrolyte derangements are seen with significant emesis?

A

Hypochloremic, hypokalemic metabolic alkalosis

Loss of HCl in vomit
Angiotensin II –> HCO3 resorption
Aldosterone –> H+ secretion and K+ secretion

1983
Q

Superior sulcus tumor possible symptoms

A

Horner syndrome
Pancoast (ulnar pain distribution, shoulder weakness)
Hoarseness (RLN)
SVC syndrome

1984
Q

Divisions of mediastinum and their masses

A

Anterior: 4 T’s (thymoma, teratoma, thyroid, terrible lymphoma)
Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma
Posterior: Neurogenic tumors

1985
Q

Beck’s triad of cardiac tamponade

A

Hypotension
Distant heart sounds
Distended jugular veins

1986
Q

When can chorionic villous sampling be done?

Amniocentesis?

A

CVS: 9-14w
Amniocentesis: 15-22w

1987
Q

When to swab for GBS

1988
Q

Quad screen results for Edwards syndrome

A

UNDERaged at 18

All are down

1989
Q

Quad screen results for Down syndrome

A

2up 2down at 21

1990
Q

Treatment of HIV in pregnancy

A

1) Zidovudine or Nevirapine during pregnancy
2) Elective c-section if viral load over 1000
3) Zidovudine for infant
4) No breastfeeding

1991
Q

Normal fetal heart rate

Causes for bradycardia or tachycardia

A

110-160 bpm

Brady - Congenital heart malformations, hypoxia
Tachy - Hypoxia, maternal fever, fetal anemia

1992
Q

Normal variability on FHT

1993
Q

What does sinusoidal variability on FHT indicate?

A

Serious fetal anemia

1994
Q

Prophylaxis in HIV patients

A 
200 = PCP = Bactrim
150 = Histoplasma = Itraconazole
100 = Toxoplasma = Bactrim
50 = MAC = Azithromycin
1995
Q

Prophylaxis in posttransplant patients

A

Bactrim for PCP

Immunize against Influenza, pneumococcus, and HBV

1996
Q

When to perform oral glucose tolerance test

1997
Q

TSH, total T4, and free T4 levels in pregnancy

A

TSH down
Total T4 way up
Free T4 slightly up

Because beta-hCG has TSH-like activity and estrogen increases TBG

1998
Q

Paraneoplastic syndromes of SCLC

A

ACTH (Cushing’s)
ADH (SIADH)
Lambert-Eaton syndrome

1999
Q

Paraneoplastic syndromes of lung SCC

A

PTHrP (hypercalcemia)

2000
Q

Most common cause of urinary obstruction in newborn males

A

Posterior urethral valves

Can cause Potter’s sequence and hydronephrosis in-utero

2001
Q

Treatment for diabetic distal neuropathy

A

1) TCA’s

2) Gabapentin

2002
Q

EPS side effects of antipsychotics

A

Acute dystonic reaction (neck, mouth, tongue, EOM)
Akithisia (restlessness)
Parkinsonism
Tardive dyskinesia (after 1-6mo)

2003
Q

Which hereditary hyperbilirubinemias present with unconjugated hyperbili?
What is the difference?

A

Gilbert’s - mild and occurs with fasting and stress

Crigler-Najjar - Severe with early death

2004
Q

Which hereditary hyperbilirubinemias present with conjugated hyperbili?
What is the difference?

A

Rotor’s syndrome - normal appearing liver

Dubin-Johnson - Black liverf

2005
Q

Treatment of the hereditary hyperbilirubinemias

A

Crigler-Najjar I - Phenobarbital
Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant

Dubin-Johnson, Rotor’s, Gilbert’s do not require treatment.

2006
Q

Lab/vitals abnormalities of LBW infants

A 
Hypoxia
Hypothermia
Hypoglycemia
Hypocalcemia
Polycythemia
2007
Q

What electrolyte derangements are seen with significant emesis?

A

Hypochloremic, hypokalemic metabolic alkalosis

Loss of HCl in vomit
Angiotensin II –> HCO3 resorption
Aldosterone –> H+ secretion and K+ secretion

2008
Q

Superior sulcus tumor possible symptoms

A

Horner syndrome
Pancoast (ulnar pain distribution, shoulder weakness)
Hoarseness (RLN)
SVC syndrome

2009
Q

Divisions of mediastinum and their masses

A

Anterior: 4 T’s (thymoma, teratoma, thyroid, terrible lymphoma)
Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma
Posterior: Neurogenic tumors

2010
Q

Beck’s triad of cardiac tamponade

A

Hypotension
Distant heart sounds
Distended jugular veins

2011
Q

When can chorionic villous sampling be done?

Amniocentesis?

A

CVS: 9-14w
Amniocentesis: 15-22w

2012
Q

When to swab for GBS

2013
Q

Quad screen results for Edwards syndrome

A

UNDERaged at 18

All are down

2014
Q

Quad screen results for Down syndrome

A

2up 2down at 21

2015
Q

Treatment of HIV in pregnancy

A

1) Zidovudine or Nevirapine during pregnancy
2) Elective c-section if viral load over 1000
3) Zidovudine for infant
4) No breastfeeding

2016
Q

Normal fetal heart rate

Causes for bradycardia or tachycardia

A

110-160 bpm

Brady - Congenital heart malformations, hypoxia
Tachy - Hypoxia, maternal fever, fetal anemia

2017
Q

Normal variability on FHT

2018
Q

What does sinusoidal variability on FHT indicate?

A

Serious fetal anemia

2019
Q

Prophylaxis in HIV patients

A 
200 = PCP = Bactrim
150 = Histoplasma = Itraconazole
100 = Toxoplasma = Bactrim
50 = MAC = Azithromycin
2020
Q

Prophylaxis in posttransplant patients

A

Bactrim for PCP

Immunize against Influenza, pneumococcus, and HBV

2021
Q

When to perform oral glucose tolerance test

2022
Q

TSH, total T4, and free T4 levels in pregnancy

A

TSH down
Total T4 way up
Free T4 slightly up

Because beta-hCG has TSH-like activity and estrogen increases TBG

2023
Q

Paraneoplastic syndromes of SCLC

A

ACTH (Cushing’s)
ADH (SIADH)
Lambert-Eaton syndrome

2024
Q

Paraneoplastic syndromes of lung SCC

A

PTHrP (hypercalcemia)

2025
Q

Most common cause of urinary obstruction in newborn males

A

Posterior urethral valves

Can cause Potter’s sequence and hydronephrosis in-utero

2026
Q

Treatment for diabetic distal neuropathy

A

1) TCA’s

2) Gabapentin

2027
Q

EPS side effects of antipsychotics

A

Acute dystonic reaction (neck, mouth, tongue, EOM)
Akithisia (restlessness)
Parkinsonism
Tardive dyskinesia (after 1-6mo)

2028
Q

Which hereditary hyperbilirubinemias present with unconjugated hyperbili?
What is the difference?

A

Gilbert’s - mild and occurs with fasting and stress

Crigler-Najjar - Severe with early death

2029
Q

Which hereditary hyperbilirubinemias present with conjugated hyperbili?
What is the difference?

A

Rotor’s syndrome - normal appearing liver

Dubin-Johnson - Black liverf

2030
Q

Treatment of the hereditary hyperbilirubinemias

A

Crigler-Najjar I - Phenobarbital
Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant

Dubin-Johnson, Rotor’s, Gilbert’s do not require treatment.

2031
Q

Lab/vitals abnormalities of LBW infants

A 
Hypoxia
Hypothermia
Hypoglycemia
Hypocalcemia
Polycythemia
2032
Q

What electrolyte derangements are seen with significant emesis?

A

Hypochloremic, hypokalemic metabolic alkalosis

Loss of HCl in vomit
Angiotensin II –> HCO3 resorption
Aldosterone –> H+ secretion and K+ secretion

2033
Q

Superior sulcus tumor possible symptoms

A

Horner syndrome
Pancoast (ulnar pain distribution, shoulder weakness)
Hoarseness (RLN)
SVC syndrome

2034
Q

Divisions of mediastinum and their masses

A

Anterior: 4 T’s (thymoma, teratoma, thyroid, terrible lymphoma)
Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma
Posterior: Neurogenic tumors

2035
Q

Beck’s triad of cardiac tamponade

A

Hypotension
Distant heart sounds
Distended jugular veins

2036
Q

When can chorionic villous sampling be done?

Amniocentesis?

A

CVS: 9-14w
Amniocentesis: 15-22w

2037
Q

When to swab for GBS

2038
Q

Quad screen results for Edwards syndrome

A

UNDERaged at 18

All are down

2039
Q

Quad screen results for Down syndrome

A

2up 2down at 21

2040
Q

Treatment of HIV in pregnancy

A

1) Zidovudine or Nevirapine during pregnancy
2) Elective c-section if viral load over 1000
3) Zidovudine for infant
4) No breastfeeding

2041
Q

Normal fetal heart rate

Causes for bradycardia or tachycardia

A

110-160 bpm

Brady - Congenital heart malformations, hypoxia
Tachy - Hypoxia, maternal fever, fetal anemia

2042
Q

Normal variability on FHT

2043
Q

What does sinusoidal variability on FHT indicate?

A

Serious fetal anemia

2044
Q

Prophylaxis in HIV patients

A 
200 = PCP = Bactrim
150 = Histoplasma = Itraconazole
100 = Toxoplasma = Bactrim
50 = MAC = Azithromycin
2045
Q

Prophylaxis in posttransplant patients

A

Bactrim for PCP

Immunize against Influenza, pneumococcus, and HBV

2046
Q

When to perform oral glucose tolerance test

2047
Q

TSH, total T4, and free T4 levels in pregnancy

A

TSH down
Total T4 way up
Free T4 slightly up

Because beta-hCG has TSH-like activity and estrogen increases TBG

2048
Q

Paraneoplastic syndromes of SCLC

A

ACTH (Cushing’s)
ADH (SIADH)
Lambert-Eaton syndrome

2049
Q

Paraneoplastic syndromes of lung SCC

A

PTHrP (hypercalcemia)

2050
Q

Most common cause of urinary obstruction in newborn males

A

Posterior urethral valves

Can cause Potter’s sequence and hydronephrosis in-utero

2051
Q

Treatment for diabetic distal neuropathy

A

1) TCA’s

2) Gabapentin

2052
Q

EPS side effects of antipsychotics

A

Acute dystonic reaction (neck, mouth, tongue, EOM)
Akithisia (restlessness)
Parkinsonism
Tardive dyskinesia (after 1-6mo)

2053
Q

Which hereditary hyperbilirubinemias present with unconjugated hyperbili?
What is the difference?

A

Gilbert’s - mild and occurs with fasting and stress

Crigler-Najjar - Severe with early death

2054
Q

Which hereditary hyperbilirubinemias present with conjugated hyperbili?
What is the difference?

A

Rotor’s syndrome - normal appearing liver

Dubin-Johnson - Black liverf

2055
Q

Treatment of the hereditary hyperbilirubinemias

A

Crigler-Najjar I - Phenobarbital
Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant

Dubin-Johnson, Rotor’s, Gilbert’s do not require treatment.

2056
Q

Lab/vitals abnormalities of LBW infants

A 
Hypoxia
Hypothermia
Hypoglycemia
Hypocalcemia
Polycythemia
2057
Q

What electrolyte derangements are seen with significant emesis?

A

Hypochloremic, hypokalemic metabolic alkalosis

Loss of HCl in vomit
Angiotensin II –> HCO3 resorption
Aldosterone –> H+ secretion and K+ secretion

2058
Q

Superior sulcus tumor possible symptoms

A

Horner syndrome
Pancoast (ulnar pain distribution, shoulder weakness)
Hoarseness (RLN)
SVC syndrome

2059
Q

Divisions of mediastinum and their masses

A

Anterior: 4 T’s (thymoma, teratoma, thyroid, terrible lymphoma)
Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma
Posterior: Neurogenic tumors

2060
Q

Beck’s triad of cardiac tamponade

A

Hypotension
Distant heart sounds
Distended jugular veins

2061
Q

When can chorionic villous sampling be done?

Amniocentesis?

A

CVS: 9-14w
Amniocentesis: 15-22w

2062
Q

When to swab for GBS

2063
Q

Quad screen results for Edwards syndrome

A

UNDERaged at 18

All are down

2064
Q

Quad screen results for Down syndrome

A

2up 2down at 21

2065
Q

Treatment of HIV in pregnancy

A

1) Zidovudine or Nevirapine during pregnancy
2) Elective c-section if viral load over 1000
3) Zidovudine for infant
4) No breastfeeding

2066
Q

Normal fetal heart rate

Causes for bradycardia or tachycardia

A

110-160 bpm

Brady - Congenital heart malformations, hypoxia
Tachy - Hypoxia, maternal fever, fetal anemia

2067
Q

Normal variability on FHT

2068
Q

What does sinusoidal variability on FHT indicate?

A

Serious fetal anemia

2069
Q

Prophylaxis in HIV patients

A 
200 = PCP = Bactrim
150 = Histoplasma = Itraconazole
100 = Toxoplasma = Bactrim
50 = MAC = Azithromycin
2070
Q

Prophylaxis in posttransplant patients

A

Bactrim for PCP

Immunize against Influenza, pneumococcus, and HBV

2071
Q

When to perform oral glucose tolerance test

2072
Q

TSH, total T4, and free T4 levels in pregnancy

A

TSH down
Total T4 way up
Free T4 slightly up

Because beta-hCG has TSH-like activity and estrogen increases TBG

2073
Q

Paraneoplastic syndromes of SCLC

A

ACTH (Cushing’s)
ADH (SIADH)
Lambert-Eaton syndrome

2074
Q

Paraneoplastic syndromes of lung SCC

A

PTHrP (hypercalcemia)

2075
Q

Most common cause of urinary obstruction in newborn males

A

Posterior urethral valves

Can cause Potter’s sequence and hydronephrosis in-utero

2076
Q

Treatment for diabetic distal neuropathy

A

1) TCA’s

2) Gabapentin

2077
Q

EPS side effects of antipsychotics

A

Acute dystonic reaction (neck, mouth, tongue, EOM)
Akithisia (restlessness)
Parkinsonism
Tardive dyskinesia (after 1-6mo)

2078
Q

Which hereditary hyperbilirubinemias present with unconjugated hyperbili?
What is the difference?

A

Gilbert’s - mild and occurs with fasting and stress

Crigler-Najjar - Severe with early death

2079
Q

Which hereditary hyperbilirubinemias present with conjugated hyperbili?
What is the difference?

A

Rotor’s syndrome - normal appearing liver

Dubin-Johnson - Black liverf

2080
Q

Treatment of the hereditary hyperbilirubinemias

A

Crigler-Najjar I - Phenobarbital
Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant

Dubin-Johnson, Rotor’s, Gilbert’s do not require treatment.

2081
Q

Lab/vitals abnormalities of LBW infants

A 
Hypoxia
Hypothermia
Hypoglycemia
Hypocalcemia
Polycythemia
2082
Q

What electrolyte derangements are seen with significant emesis?

A

Hypochloremic, hypokalemic metabolic alkalosis

Loss of HCl in vomit
Angiotensin II –> HCO3 resorption
Aldosterone –> H+ secretion and K+ secretion

2083
Q

Superior sulcus tumor possible symptoms

A

Horner syndrome
Pancoast (ulnar pain distribution, shoulder weakness)
Hoarseness (RLN)
SVC syndrome

2084
Q

Divisions of mediastinum and their masses

A

Anterior: 4 T’s (thymoma, teratoma, thyroid, terrible lymphoma)
Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma
Posterior: Neurogenic tumors

2085
Q

Beck’s triad of cardiac tamponade

A

Hypotension
Distant heart sounds
Distended jugular veins

2086
Q

When can chorionic villous sampling be done?

Amniocentesis?

A

CVS: 9-14w
Amniocentesis: 15-22w

2087
Q

When to swab for GBS

2088
Q

Quad screen results for Edwards syndrome

A

UNDERaged at 18

All are down

2089
Q

Quad screen results for Down syndrome

A

2up 2down at 21

2090
Q

Treatment of HIV in pregnancy

A

1) Zidovudine or Nevirapine during pregnancy
2) Elective c-section if viral load over 1000
3) Zidovudine for infant
4) No breastfeeding

2091
Q

Normal fetal heart rate

Causes for bradycardia or tachycardia

A

110-160 bpm

Brady - Congenital heart malformations, hypoxia
Tachy - Hypoxia, maternal fever, fetal anemia

2092
Q

Normal variability on FHT

2093
Q

What does sinusoidal variability on FHT indicate?

A

Serious fetal anemia

2094
Q

Prophylaxis in HIV patients

A 
200 = PCP = Bactrim
150 = Histoplasma = Itraconazole
100 = Toxoplasma = Bactrim
50 = MAC = Azithromycin
2095
Q

Prophylaxis in posttransplant patients

A

Bactrim for PCP

Immunize against Influenza, pneumococcus, and HBV

2096
Q

When to perform oral glucose tolerance test

2097
Q

TSH, total T4, and free T4 levels in pregnancy

A

TSH down
Total T4 way up
Free T4 slightly up

Because beta-hCG has TSH-like activity and estrogen increases TBG

2098
Q

Paraneoplastic syndromes of SCLC

A

ACTH (Cushing’s)
ADH (SIADH)
Lambert-Eaton syndrome

2099
Q

Paraneoplastic syndromes of lung SCC

A

PTHrP (hypercalcemia)

2100
Q

Most common cause of urinary obstruction in newborn males

A

Posterior urethral valves

Can cause Potter’s sequence and hydronephrosis in-utero

2101
Q

Treatment for diabetic distal neuropathy

A

1) TCA’s

2) Gabapentin

2102
Q

EPS side effects of antipsychotics

A

Acute dystonic reaction (neck, mouth, tongue, EOM)
Akithisia (restlessness)
Parkinsonism
Tardive dyskinesia (after 1-6mo)

2103
Q

Which hereditary hyperbilirubinemias present with unconjugated hyperbili?
What is the difference?

A

Gilbert’s - mild and occurs with fasting and stress

Crigler-Najjar - Severe with early death

2104
Q

Which hereditary hyperbilirubinemias present with conjugated hyperbili?
What is the difference?

A

Rotor’s syndrome - normal appearing liver

Dubin-Johnson - Black liverf

2105
Q

Treatment of the hereditary hyperbilirubinemias

A

Crigler-Najjar I - Phenobarbital
Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant

Dubin-Johnson, Rotor’s, Gilbert’s do not require treatment.

2106
Q

Lab/vitals abnormalities of LBW infants

A 
Hypoxia
Hypothermia
Hypoglycemia
Hypocalcemia
Polycythemia
2107
Q

What electrolyte derangements are seen with significant emesis?

A

Hypochloremic, hypokalemic metabolic alkalosis

Loss of HCl in vomit
Angiotensin II –> HCO3 resorption
Aldosterone –> H+ secretion and K+ secretion

2108
Q

Superior sulcus tumor possible symptoms

A

Horner syndrome
Pancoast (ulnar pain distribution, shoulder weakness)
Hoarseness (RLN)
SVC syndrome

2109
Q

Divisions of mediastinum and their masses

A

Anterior: 4 T’s (thymoma, teratoma, thyroid, terrible lymphoma)
Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma
Posterior: Neurogenic tumors

2110
Q

Beck’s triad of cardiac tamponade

A

Hypotension
Distant heart sounds
Distended jugular veins

2111
Q

When can chorionic villous sampling be done?

Amniocentesis?

A

CVS: 9-14w
Amniocentesis: 15-22w

2112
Q

When to swab for GBS

2113
Q

Quad screen results for Edwards syndrome

A

UNDERaged at 18

All are down

2114
Q

Quad screen results for Down syndrome

A

2up 2down at 21

2115
Q

Treatment of HIV in pregnancy

A

1) Zidovudine or Nevirapine during pregnancy
2) Elective c-section if viral load over 1000
3) Zidovudine for infant
4) No breastfeeding

2116
Q

Normal fetal heart rate

Causes for bradycardia or tachycardia

A

110-160 bpm

Brady - Congenital heart malformations, hypoxia
Tachy - Hypoxia, maternal fever, fetal anemia

2117
Q

Normal variability on FHT

2118
Q

What does sinusoidal variability on FHT indicate?

A

Serious fetal anemia

2119
Q

Prophylaxis in HIV patients

A 
200 = PCP = Bactrim
150 = Histoplasma = Itraconazole
100 = Toxoplasma = Bactrim
50 = MAC = Azithromycin
2120
Q

Prophylaxis in posttransplant patients

A

Bactrim for PCP

Immunize against Influenza, pneumococcus, and HBV

2121
Q

When to perform oral glucose tolerance test

2122
Q

TSH, total T4, and free T4 levels in pregnancy

A

TSH down
Total T4 way up
Free T4 slightly up

Because beta-hCG has TSH-like activity and estrogen increases TBG

2123
Q

Paraneoplastic syndromes of SCLC

A

ACTH (Cushing’s)
ADH (SIADH)
Lambert-Eaton syndrome

2124
Q

Paraneoplastic syndromes of lung SCC

A

PTHrP (hypercalcemia)

2125
Q

Most common cause of urinary obstruction in newborn males

A

Posterior urethral valves

Can cause Potter’s sequence and hydronephrosis in-utero

2126
Q

Treatment for diabetic distal neuropathy

A

1) TCA’s

2) Gabapentin

2127
Q

EPS side effects of antipsychotics

A

Acute dystonic reaction (neck, mouth, tongue, EOM)
Akithisia (restlessness)
Parkinsonism
Tardive dyskinesia (after 1-6mo)

2128
Q

Which hereditary hyperbilirubinemias present with unconjugated hyperbili?
What is the difference?

A

Gilbert’s - mild and occurs with fasting and stress

Crigler-Najjar - Severe with early death

2129
Q

Which hereditary hyperbilirubinemias present with conjugated hyperbili?
What is the difference?

A

Rotor’s syndrome - normal appearing liver

Dubin-Johnson - Black liverf

2130
Q

Treatment of the hereditary hyperbilirubinemias

A

Crigler-Najjar I - Phenobarbital
Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant

Dubin-Johnson, Rotor’s, Gilbert’s do not require treatment.

2131
Q

Lab/vitals abnormalities of LBW infants

A 
Hypoxia
Hypothermia
Hypoglycemia
Hypocalcemia
Polycythemia
2132
Q

What electrolyte derangements are seen with significant emesis?

A

Hypochloremic, hypokalemic metabolic alkalosis

Loss of HCl in vomit
Angiotensin II –> HCO3 resorption
Aldosterone –> H+ secretion and K+ secretion

2133
Q

Superior sulcus tumor possible symptoms

A

Horner syndrome
Pancoast (ulnar pain distribution, shoulder weakness)
Hoarseness (RLN)
SVC syndrome

2134
Q

Divisions of mediastinum and their masses

A

Anterior: 4 T’s (thymoma, teratoma, thyroid, terrible lymphoma)
Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma
Posterior: Neurogenic tumors

2135
Q

Beck’s triad of cardiac tamponade

A

Hypotension
Distant heart sounds
Distended jugular veins

2136
Q

When can chorionic villous sampling be done?

Amniocentesis?

A

CVS: 9-14w
Amniocentesis: 15-22w

2137
Q

When to swab for GBS

2138
Q

Quad screen results for Edwards syndrome

A

UNDERaged at 18

All are down

2139
Q

Quad screen results for Down syndrome

A

2up 2down at 21

2140
Q

Treatment of HIV in pregnancy

A

1) Zidovudine or Nevirapine during pregnancy
2) Elective c-section if viral load over 1000
3) Zidovudine for infant
4) No breastfeeding

2141
Q

Normal fetal heart rate

Causes for bradycardia or tachycardia

A

110-160 bpm

Brady - Congenital heart malformations, hypoxia
Tachy - Hypoxia, maternal fever, fetal anemia

2142
Q

Normal variability on FHT

2143
Q

What does sinusoidal variability on FHT indicate?

A

Serious fetal anemia

2144
Q

Prophylaxis in HIV patients

A 
200 = PCP = Bactrim
150 = Histoplasma = Itraconazole
100 = Toxoplasma = Bactrim
50 = MAC = Azithromycin
2145
Q

Prophylaxis in posttransplant patients

A

Bactrim for PCP

Immunize against Influenza, pneumococcus, and HBV

2146
Q

When to perform oral glucose tolerance test

2147
Q

TSH, total T4, and free T4 levels in pregnancy

A

TSH down
Total T4 way up
Free T4 slightly up

Because beta-hCG has TSH-like activity and estrogen increases TBG

2148
Q

Paraneoplastic syndromes of SCLC

A

ACTH (Cushing’s)
ADH (SIADH)
Lambert-Eaton syndrome

2149
Q

Paraneoplastic syndromes of lung SCC

A

PTHrP (hypercalcemia)

2150
Q

Most common cause of urinary obstruction in newborn males

A

Posterior urethral valves

Can cause Potter’s sequence and hydronephrosis in-utero

2151
Q

Treatment for diabetic distal neuropathy

A

1) TCA’s

2) Gabapentin

2152
Q

EPS side effects of antipsychotics

A

Acute dystonic reaction (neck, mouth, tongue, EOM)
Akithisia (restlessness)
Parkinsonism
Tardive dyskinesia (after 1-6mo)

2153
Q

Which hereditary hyperbilirubinemias present with unconjugated hyperbili?
What is the difference?

A

Gilbert’s - mild and occurs with fasting and stress

Crigler-Najjar - Severe with early death

2154
Q

Which hereditary hyperbilirubinemias present with conjugated hyperbili?
What is the difference?

A

Rotor’s syndrome - normal appearing liver

Dubin-Johnson - Black liverf

2155
Q

Treatment of the hereditary hyperbilirubinemias

A

Crigler-Najjar I - Phenobarbital
Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant

Dubin-Johnson, Rotor’s, Gilbert’s do not require treatment.

2156
Q

Lab/vitals abnormalities of LBW infants

A 
Hypoxia
Hypothermia
Hypoglycemia
Hypocalcemia
Polycythemia
2157
Q

What electrolyte derangements are seen with significant emesis?

A

Hypochloremic, hypokalemic metabolic alkalosis

Loss of HCl in vomit
Angiotensin II –> HCO3 resorption
Aldosterone –> H+ secretion and K+ secretion

2158
Q

Superior sulcus tumor possible symptoms

A

Horner syndrome
Pancoast (ulnar pain distribution, shoulder weakness)
Hoarseness (RLN)
SVC syndrome

2159
Q

Divisions of mediastinum and their masses

A

Anterior: 4 T’s (thymoma, teratoma, thyroid, terrible lymphoma)
Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma
Posterior: Neurogenic tumors

2160
Q

Beck’s triad of cardiac tamponade

A

Hypotension
Distant heart sounds
Distended jugular veins

2161
Q

When can chorionic villous sampling be done?

Amniocentesis?

A

CVS: 9-14w
Amniocentesis: 15-22w

2162
Q

When to swab for GBS

2163
Q

Quad screen results for Edwards syndrome

A

UNDERaged at 18

All are down

2164
Q

Quad screen results for Down syndrome

A

2up 2down at 21

2165
Q

Treatment of HIV in pregnancy

A

1) Zidovudine or Nevirapine during pregnancy
2) Elective c-section if viral load over 1000
3) Zidovudine for infant
4) No breastfeeding

2166
Q

Normal fetal heart rate

Causes for bradycardia or tachycardia

A

110-160 bpm

Brady - Congenital heart malformations, hypoxia
Tachy - Hypoxia, maternal fever, fetal anemia

2167
Q

Normal variability on FHT

2168
Q

What does sinusoidal variability on FHT indicate?

A

Serious fetal anemia

2169
Q

Prophylaxis in HIV patients

A 
200 = PCP = Bactrim
150 = Histoplasma = Itraconazole
100 = Toxoplasma = Bactrim
50 = MAC = Azithromycin
2170
Q

Prophylaxis in posttransplant patients

A

Bactrim for PCP

Immunize against Influenza, pneumococcus, and HBV

2171
Q

When to perform oral glucose tolerance test

2172
Q

TSH, total T4, and free T4 levels in pregnancy

A

TSH down
Total T4 way up
Free T4 slightly up

Because beta-hCG has TSH-like activity and estrogen increases TBG

2173
Q

Paraneoplastic syndromes of SCLC

A

ACTH (Cushing’s)
ADH (SIADH)
Lambert-Eaton syndrome

2174
Q

Paraneoplastic syndromes of lung SCC

A

PTHrP (hypercalcemia)

2175
Q

Most common cause of urinary obstruction in newborn males

A

Posterior urethral valves

Can cause Potter’s sequence and hydronephrosis in-utero

2176
Q

Treatment for diabetic distal neuropathy

A

1) TCA’s

2) Gabapentin

2177
Q

EPS side effects of antipsychotics

A

Acute dystonic reaction (neck, mouth, tongue, EOM)
Akithisia (restlessness)
Parkinsonism
Tardive dyskinesia (after 1-6mo)

2178
Q

Which hereditary hyperbilirubinemias present with unconjugated hyperbili?
What is the difference?

A

Gilbert’s - mild and occurs with fasting and stress

Crigler-Najjar - Severe with early death

2179
Q

Which hereditary hyperbilirubinemias present with conjugated hyperbili?
What is the difference?

A

Rotor’s syndrome - normal appearing liver

Dubin-Johnson - Black liverf

2180
Q

Treatment of the hereditary hyperbilirubinemias

A

Crigler-Najjar I - Phenobarbital
Crigler-Najjar II - Plasmapheresis, phototherapy, liver transplant

Dubin-Johnson, Rotor’s, Gilbert’s do not require treatment.

2181
Q

Lab/vitals abnormalities of LBW infants

A 
Hypoxia
Hypothermia
Hypoglycemia
Hypocalcemia
Polycythemia
2182
Q

What electrolyte derangements are seen with significant emesis?

A

Hypochloremic, hypokalemic metabolic alkalosis

Loss of HCl in vomit
Angiotensin II –> HCO3 resorption
Aldosterone –> H+ secretion and K+ secretion

2183
Q

Superior sulcus tumor possible symptoms

A

Horner syndrome
Pancoast (ulnar pain distribution, shoulder weakness)
Hoarseness (RLN)
SVC syndrome

2184
Q

Divisions of mediastinum and their masses

A

Anterior: 4 T’s (thymoma, teratoma, thyroid, terrible lymphoma)
Middle: Bronchogenic cyst, tracheal tumor, pericardia cyst, lymphoma
Posterior: Neurogenic tumors

2185
Q

Beck’s triad of cardiac tamponade

A

Hypotension
Distant heart sounds
Distended jugular veins

2186
Q

When can chorionic villous sampling be done?

Amniocentesis?

A

CVS: 9-14w
Amniocentesis: 15-22w

2187
Q

When to swab for GBS

2188
Q

Quad screen results for Edwards syndrome

A

UNDERaged at 18

All are down

2189
Q

Quad screen results for Down syndrome

A

2up 2down at 21

2190
Q

Treatment of HIV in pregnancy

A

1) Zidovudine or Nevirapine during pregnancy
2) Elective c-section if viral load over 1000
3) Zidovudine for infant
4) No breastfeeding

2191
Q

Normal fetal heart rate

Causes for bradycardia or tachycardia

A

110-160 bpm

Brady - Congenital heart malformations, hypoxia
Tachy - Hypoxia, maternal fever, fetal anemia

2192
Q

Normal variability on FHT

2193
Q

What does sinusoidal variability on FHT indicate?

A

Serious fetal anemia

2194
Q

Prophylaxis in HIV patients

A 
200 = PCP = Bactrim
150 = Histoplasma = Itraconazole
100 = Toxoplasma = Bactrim
50 = MAC = Azithromycin
2195
Q

Prophylaxis in HIV patients

A 
200 = PCP = Bactrim
150 = Histoplasma = Itraconazole
100 = Toxoplasma = Bactrim
50 = MAC = Azithromycin
2196
Q

Prophylaxis in HIV patients

A 
200 = PCP = Bactrim
150 = Histoplasma = Itraconazole
100 = Toxoplasma = Bactrim
50 = MAC = Azithromycin
2197
Q

Prophylaxis in HIV patients

A 
200 = PCP = Bactrim
150 = Histoplasma = Itraconazole
100 = Toxoplasma = Bactrim
50 = MAC = Azithromycin
2198
Q

Prophylaxis in HIV patients

A 
200 = PCP = Bactrim
150 = Histoplasma = Itraconazole
100 = Toxoplasma = Bactrim
50 = MAC = Azithromycin
2199
Q

Prophylaxis in HIV patients

A 
200 = PCP = Bactrim
150 = Histoplasma = Itraconazole
100 = Toxoplasma = Bactrim
50 = MAC = Azithromycin
2200
Q

Prophylaxis in HIV patients

A 
200 = PCP = Bactrim
150 = Histoplasma = Itraconazole
100 = Toxoplasma = Bactrim
50 = MAC = Azithromycin
2201
Q

Pathogens that cause Guillan-Barre

A 
Campylobacter
Herpes viruses
Mycoplasma
H. flu
HIV
Immunizations
Lymphoma/Sarcoid/SLE
2202
Q

Treatment of mastitis

A

Continue breastfeeding

Abx that cover staph

2203
Q

Where does breast cancer metastasize to?

A

Bone
Lung
Liver

2204
Q

Initial workup of a breast mass

A

Over 30 - mammogram
Under 30 - US

Can follow with FNA, core needle, or open biopsy

2205
Q

Medical treatment of breast cancer

A

If hormone receptor positive - Tamoxifen
HER2/neu positive - Trastuzumab
ER- patients - chemo

These will all be accompanied by lumpectomy or modified radical mastectomy

2206
Q

Treatment of mastitis

A

Continue breastfeeding

Abx that cover staph

2207
Q

Where does breast cancer metastasize to?

A

Bone
Lung
Liver

2208
Q

Initial workup of a breast mass

A

Over 30 - mammogram
Under 30 - US

Can follow with FNA, core needle, or open biopsy

2209
Q

Medical treatment of breast cancer

A

If hormone receptor positive - Tamoxifen
HER2/neu positive - Trastuzumab
ER- patients - chemo

These will all be accompanied by lumpectomy or modified radical mastectomy

2210
Q

List of X-linked recessive disorders

A

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
Q

Findings in Down syndrome

A 
Mental retardation
Prominent epicanthal folds
Simian crease
Duodenal atresia
ASD
Increased risk of ALL and Alzheimer's
2212
Q

Down syndrome quad screen results

A

AFP, b-hCG, Estriol, Inhibin A

Down Up Down Up

2213
Q

Edwards’ syndrome quad screen results

A

AFP, b-hCG, Estriol, Inhibin A

Down Down Down Normal

2214
Q

What is the CHA2DS2VASc score?

A

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
Q

Pure motor hemiparesis CVA

A

Lacunar stroke in the posterior limb of the internal capsule

2216
Q

Causes of increased maternal serum AFP

A

Neural tube defects
Ventral wall defects
Multiple gestation

2217
Q

Cephalohematoma vs. Caput succedaneum

A

Cephalohematoma - subperiosteal bleeding. Does not cross suture lines

Caput succedaneum - Scalp swelling. Diffuse across suture lines.

2218
Q

How is endometrial hyperplasia managed?

A

Without atypia - Progestin therapy and repeat biopsy at 3mo

With atypia - Hysterectomy (if no future children planned)

2219
Q

Treatment of caustic ingestion

A

ABC’s
Decontaminate skin/clothes
Endoscopy within 24h

2220
Q

Differential of delayed passage of meconium (48h)

A 
Hirschsprung dz - Rectosigmoid
Meconium ileus (CF) - Ileum
2221
Q

When to administer vaccines to preterm infants

A

According to chronologic age.

Only exception is wait on HBV at birth if infant is under 2kg.

2222
Q

Treatment of PNH

A

Iron and Folate

Eculizumab (complement inhibitor)

2223
Q

Murmur of HOCM

A

Systolic at LUSB

2224
Q

Treatment of HOCM

A

Beta blockers

Allow more time for diastolic filling

2225
Q

What opening pressure is diagnostic of pseudotumor cerebri?

A

Over 250 mm H20 in the right clinical setting

2226
Q

Most common causes of chronic cough (8+ weeks)

A

Postnasal drip
Asthma
GERD

2227
Q

How to distinguish Cobalamin and Folate deficiency

A

MMA levels

Increased MMA - Cobalamin deficiency
Normal MMA - Folate deficiency

2228
Q

What is increased/decreased with Folate or B12 deficiency?

A

Homocysteine is increased

Methionine is decreased

2229
Q

Skin manifestation associated with IBD

A

Pyoderma gangrenosum

2230
Q

Skin manifestation of Pseudomonas bacteremia

A

Ecthyma gangrenosum

2231
Q

Treatment of MS

A

Corticosteroids for acute exacerbations

Interferons

2232
Q

Test used to detect cysteinuria

A

Urinary cyanide nitroprusside test

Blue = cysteine present

2233
Q

Treatment of absence seizures

A

Ethosuximide

2234
Q

Side effects of phenytoin

A

Gingival hypertrophy
Hirsutism
Rash
LAD

2235
Q

Most common causes of osteomyelitis

A

Staph aureus is most common

Pseudomonas if a puncture wound through shoe

Salmonella or Staph aureus in sickle cell patients

2236
Q

What proteins does warfarin inhibit?

A

Factors II, VII, IX, X
Protein C and S

All are vitamin K-dependent

2237
Q

What cancer are PCOS women at risk for?

A

Endometrial (androgens converted to estrogens peripherally)

2238
Q

Treatment for a PPD positive HIV patient

A

PPD is positive if 5mm+ of induration

Tx: INH and Pyridoxine for 9mo

2239
Q

Side effects of INH

A

Injures Neuronsand Hepatocytes

Neuropathy
Hepatitis

Pyridoxime can prevent neuropathy but not hepatitis

2240
Q

What is considered a positive PPD?

A

5mm - HIV or other risk factors, close TB contacts
10mm - Homeless, developing countries, IVDA, healthcare workers, inmates
15mm - Everyone else

2241
Q

When is bedwetting abnormal?

A

Over age 5y

2242
Q

When do you give Anti-D Ig?

A

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
Q

When do you screen for GBS?

2244
Q

Symptoms of Behcets syndrome

A

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
Q

Symptoms of reactive arthritis

A

Urethritis
Conjunctivitis
Mucocutaneous lesions
Arthritis

2246
Q

Facial dysmorphisms of fetal alcohol syndrome

A

Small palpebral fissures
Smooth philtrum
Thin vermilion border

2247
Q

Body dysmorphisms of Fragile X syndrome

A

Long narrow face
Large ears
Prominent forehead and chin
Macroorchidism

2248
Q

Congenital CMV symptoms

A 
SNHL
Blindness
Jaundice and HSM
Petechiae
Developmental delay
2249
Q

Congenital Rubella symptoms

A 
SNHL
Cataracts
HSM
Purpura
Developmental delay
2250
Q

Lead points for intussusception

A

Under 2y: Peyer’s patch
Children over 2: Meckels diverticulum, HSP
Adults:Tumor

2251
Q

Treatment for Trigeminal Neuralgia

A

Carbamazepine

2252
Q

What are the mature defense mechanisms?

A

SASH

  • Suppression
  • Altruism
  • Sublimation
  • Humor
2253
Q

Where to perform needle thoracostomy

A

Midclavicular line 2nd intercostal space

2254
Q

Treatment for Tinea versicolor

A

Topical selenium sulfide or ketoconazole

2255
Q

Symptoms of hereditary angioedema

A

Rapid-onset edema of the face, limbs, larynx, and genitals

Colicky abdominal pain

2256
Q

Drug usedto treat tremor in Parkinson’s

A

Trihexyphenidyl (anticholinergic)

2257
Q

Which anemia has increased MCHC?

A

Hereditary spherocytosis

2258
Q

What are the microcytic anemias?

A

Iron deficiency
Lead intoxication
Thalassemia
Sideroblastic anemia

2259
Q

Causes of postop fever

A 
Wind - pneumonia, PE, aspiration POD3
Water- UTI POD5
Walking - DVT POD7
Wound - POD 7-10
Wonderdrugs - Drug fever, IV sites, blood - Any time
2260
Q

Difference between intermittent and recurrent variable decels

A

Over 50% of contractions show a decel

Intermittent - expectant mgmt
Recurrent - O2, change maternal position, +/- amnioinfusion

2261
Q

What lung cancers are peripheral vs central?

A

Peripheral: Adenocarcinoma, Large cell carcinoma
Central: SCC, SCLC

2262
Q

Differential for anterior mediastinal mass

A

4T’s: Thymoma, Teratoma, Thyroid neoplasm, Terrible lymphoma

*Teratoma includes other germ cell tumors

2263
Q

Serum markers in germ cell tumors

A

Seminoma = beta-hCG

Other germ cell tumors = AFP and beta-hCG

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