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Step 2 Qbank > Step 2 Rapid Review > Flashcards

Step 2 Rapid Review Flashcards

1
Q

Classic ECG finding in atrial flutter.

A

Sawtooth P waves

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2
Q

Definition of unstable angina.

A

Angina is new, is worsening, or occurs at rest

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3
Q

Antihypertensive for a diabetic patient with proteinuria.

A

ACEI

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4
Q

Beck’s triad for cardiac tamponade.

A

Hypotension, distant heart sounds, and JVD

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5
Q

Drugs that slow AV node transmission.

A

β-blockers, digoxin, calcium channel blockers

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6
Q

Hypercholesterolemia treatment that → flushing and pruritus.

A

Niacin

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7
Q

Treatment for atrial fibrillation.

A

Anticoagulation, rate control, cardioversion

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8
Q

Treatment for ventricular fibrillation.

A

Immediate cardioversion

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9
Q

Autoimmune complication occurring 2-4 weeks post-MI.

A

Dressler’s syndrome: fever, pericarditis, ↑ ESR

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10
Q

IV drug use with JVD and holosystolic murmur at the left sternal border. Treatment?

A

Treat existing heart failure and replace the tricuspid valve

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11
Q

Diagnostic test for hypertrophic cardiomyopathy.

A

Echocardiogram (showing thickened left ventricular wall and outflow obstruction)

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12
Q

A fall in systolic BP of > 10 mmHg with inspiration.

A

Pulsus paradoxus (seen in cardiac tamponade)

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13
Q

Classic ECG findings in pericarditis.

A

Low-voltage, diffuse ST-segment elevation

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14
Q

Definition of hypertension.

A

BP > 140/90 on three separate occasions two weeks apart

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15
Q

Eight surgically correctable causes of hypertension.

A

Renal artery stenosis, coarctation of the aorta, pheochromocytoma, Conn’s syndrome, Cushing’s syndrome, unilateral renal parenchymal disease, hyperthyroidism, hyperparathyroidism

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16
Q

Evaluation of a pulsatile abdominal mass and bruit.

A

Abdominal ultrasound and CT

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17
Q

Indications for surgical repair of abdominal aortic aneurysm.

A

> 5.5 cm, rapidly enlarging, symptomatic, or ruptured

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18
Q

Treatment for acute coronary syndrome.

A

Morphine, O2, sublingual nitroglycerin, ASA, IV β-blockers, heparin

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19
Q

What is the metabolic syndrome?

A

Abdominal obesity, high triglycerides, low HDL, hypertension, insulin resistance, prothrombotic or proinflammatory states

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20
Q

Appropriate diagnostic test? ■ A 50-year-old male with angina can exercise to 85% of maximum predicted heart rate.

A

Exercise stress treadmill with ECG

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21
Q

Appropriate diagnostic test? ■ A 65-year-old woman with left bundle branch block and severe osteoarthritis has unstable angina.

A

Pharmacologic stress test (e.g., dobutamine echo)

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22
Q

Signs of active ischemia during stress testing.

A

Angina, ST-segment changes on ECG, or ↓ BP

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23
Q

ECG findings suggesting MI.

A

ST-segment elevation (depression means ischemia), flattened T waves, and Q waves

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24
Q

A young patient has angina at rest with ST-segment elevation. Cardiac enzymes are normal.

A

Prinzmetal’s angina

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25
Q

Common symptoms associated with silent MIs.

A

CHF, shock, and altered mental status

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26
Q

The diagnostic test for pulmonary embolism.

A

V/Q scan

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27
Q

An agent that reverses the effects of heparin.

A

Protamine

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28
Q

The coagulation parameter affected by warfarin.

A

PT

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29
Q

A young patient with a family history of sudden death collapses and dies while exercising.

A

Hypertrophic cardiomyopathy

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30
Q

Endocarditis prophylaxis regimens.

A

Oral surgery—amoxicillin; GI or GU procedures—ampicillin and gentamicin before and amoxicillin after

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31
Q

The 6 P’s of ischemia due to peripheral vascular disease.

A

Pain, pallor, pulselessness, paralysis, paresthesia, poikilothermia

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32
Q

Virchow’s triad.

A

Stasis, hypercoagulability, endothelial damage

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33
Q

The most common cause of hypertension in young women.

A

OCPs

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34
Q

The most common cause of hypertension in young men.

A

Excessive EtOH

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35
Q

Stuck-on appearance.

A

Seborrheic keratosis

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36
Q

Red plaques with silvery-white scales and sharp margins.

A

Psoriasis

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37
Q

The most common type of skin cancer; the lesion is a pearly-colored papule with a translucent surface and telangiectasias.

A

Basal cell carcinoma

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38
Q

Honey-crusted lesions.

A

Impetigo

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39
Q

A febrile patient with a history of diabetes presents with a red, swollen, painful lower extremity.

A

Cellulitis

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40
Q

+ Nikolsky’s sign.

A

Pemphigus vulgaris

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41
Q
  • Nikolsky’s sign.
A

Bullous pemphigoid

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42
Q

A 55-year-old obese patient presents with dirty, velvety patches on the back of the neck.

A

Acanthosis nigricans. Check fasting blood sugar to rule out diabetes

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43
Q

Dermatomal distribution.

A

Varicella zoster

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44
Q

Flat-topped papules.

A

Lichen planus

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45
Q

Iris-like target lesions.

A

Erythema multiforme

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46
Q

A lesion characteristically occurring in a linear pattern in areas where skin comes into contact with clothing or jewelry.

A

Contact dermatitis

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47
Q

Presents with a herald patch, Christmas-tree pattern.

A

Pityriasis rosea

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48
Q

A 16-year-old presents with an annular patch of alopecia with broken-off, stubby hairs.

A

Alopecia areata (autoimmune process)

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49
Q

Pinkish, scaling, flat lesions on the chest and back. KOH prep has a “spaghetti-and-meatballs” appearance.

A

Pityriasis versicolor

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50
Q

Four characteristics of a nevus suggestive of melanoma.

A

Asymmetry, border irregularity, color variation, large diameter

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51
Q

Premalignant lesion from sun exposure that can → squamous cell carcinoma.

A

Actinic keratosis

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52
Q

Dewdrop on a rose petal.

A

Lesions of 1° varicella

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53
Q

Cradle cap.

A

Seborrheic dermatitis. Treat with antifungals

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54
Q

Associated with Propionibacterium acnes and changes in androgen levels.

A

Acne vulgaris

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55
Q

A painful, recurrent vesicular eruption of mucocutaneous surfaces.

A

Herpes simplex

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56
Q

Inflammation and epithelial thinning of the anogenital area, predominantly in postmenopausal women.

A

Lichen sclerosus

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57
Q

Exophytic nodules on the skin with varying degrees of scaling or ulceration; the second most common type of skin cancer.

A

Squamous cell carcinoma

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58
Q

The most common cause of hypothyroidism.

A

Hashimoto’s thyroiditis

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59
Q

Lab findings in Hashimoto’s thyroiditis.

A

High TSH, low T4, antimicrosomal antibodies

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60
Q

Exophthalmos, pretibial myxedema, and ↓ TSH.

A

Graves’ disease

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61
Q

The most common cause of Cushing’s syndrome.

A

Iatrogenic steroid administration. The second most common cause is Cushing’s disease

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62
Q

A patient presents with signs of hypocalcemia, high phosphorus, and low PTH.

A

Hypoparathyroidism

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63
Q

Stones, bones, groans, psychiatric overtones.

A

Signs and symptoms of hypercalcemia

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64
Q

A patient complains of headache, weakness, and polyuria; exam reveals hypertension and tetany. Labs reveals hypernatremia, hypokalemia, and metabolic alkalosis.

A

1° hyperaldosteronism (due to Conn’s syndrome or bilateral adrenal hyperplasia)

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65
Q

A patient presents with tachycardia, wild swings in BP, headache, diaphoresis, altered mental status, and a sense of panic.

A

Pheochromocytoma

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66
Q

Should α- or β-antagonists be used first in treating pheochromocytoma?

A

α-antagonists (phentolamine and phenoxybenzamine)

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67
Q

A patient with a history of lithium use presents with copious amounts of dilute urine.

A

Nephrogenic diabetes insipidus (DI)

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68
Q

Treatment of central DI.

A

Administration of DDAVP ↓ serum osmolality and free water restriction

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69
Q

A postoperative patient with significant pain presents with hyponatremia and normal volume status.

A

SIADH due to stress

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70
Q

An antidiabetic agent associated with lactic acidosis.

A

Metformin

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71
Q

A patient presents with weakness, nausea, vomiting, weight loss, and new skin pigmentation. Labs show hyponatremia and hyperkalemia. Treatment?

A

1° adrenal insufficiency (Addison’s disease). Treat with replacement glucocorticoids, mineralocorticoids, and IV fluids

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72
Q

Goal hemoglobin A1c for a patient with DM.

A

< 7.0

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73
Q

Treatment of DKA.

A

Fluids, insulin, and aggressive replacement of electrolytes (e.g., K+)

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74
Q

Why are β-blockers contraindicated in diabetics?

A

They can mask symptoms of hypoglycemia

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75
Q

Bias introduced into a study when a clinician is aware of the patient’s treatment type.

A

Observational bias

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76
Q

Bias introduced when screening detects a disease earlier and thus lengthens the time from diagnosis to death.

A

Lead-time bias

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77
Q

If you want to know if race affects infant mortality rate but most of the variation in infant mortality is predicted by socioeconomic status, then socioeconomic status is a _____.

A

Confounding variable

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78
Q

The number of true positives divided by the number of patients with the disease is _____.

A

Sensitivity

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79
Q

Sensitive tests have few false negatives and are used to rule _____ a disease.

A

Out

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80
Q

PPD reactivity is used as a screening test because most people with TB (except those who are anergic) will have a +PPD. Highly sensitive or specific?

A

Highly sensitive for TB

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81
Q

Chronic diseases such as SLE—higher prevalence or incidence?

A

Higher prevalence

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82
Q

Epidemics such as influenza—higher prevalence or incidence?

A

Higher incidence

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83
Q

Cross-sectional survey—incidence or prevalence?

A

Prevalence

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84
Q

Cohort study—incidence or prevalence?

A

Incidence and prevalence

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85
Q

Case-control study—incidence or prevalence?

A

Neither

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86
Q

Describe a test that consistently gives identical results, but the results are wrong.

A

High reliability, low validity

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87
Q

Difference between a cohort and a case-control study.

A

Cohort studies can be used to calculate relative risk (RR), incidence, and/or odds ratio (OR). Case-control studies can be used to calculate an OR

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88
Q

Attributable risk?

A

The incidence rate (IR) of a disease in exposed − the IR of a disease in unexposed

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89
Q

Relative risk?

A

The IR of a disease in a population exposed to a particular factor ÷ the IR of those not exposed

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90
Q

Odds ratio?

A

The likelihood of a disease among individuals exposed to a risk factor compared to those who have not been exposed

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91
Q

Number needed to treat?

A

1 ÷ (rate in untreated group − rate in treated group)

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92
Q

In which patients do you initiate colorectal cancer screening early?

A

Patients with IBD; those with familial adenomatous polyposis (FAP)/hereditary nonpolyposis colorectal cancer (HNPCC); and those who have first-degree relatives with adenomatous polyps (< 60 years of age) or colorectal cancer

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93
Q

The most common cancer in men and the most common cause of death from cancer in men.

A

Prostate cancer is the most common cancer in men, but lung cancer causes more deaths

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94
Q

The percentage of cases within one SD of the mean? Two SDs? Three SDs?

A

68%, 95.5%, 99.7%

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95
Q

Birth rate?

A

Number of live births per 1000 population

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96
Q

Fertility rate?

A

Number of live births per 1000 women 15-44 years of age

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97
Q

Mortality rate?

A

Number of deaths per 1000 population

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98
Q

Neonatal mortality?

A

Number of deaths from birth to 28 days per 1000 live births

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99
Q

Postnatal mortality?

A

Number of deaths from 28 days to one year per 1000 live births

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100
Q

Infant mortality?

A

Number of deaths from birth to one year of age per 1000 live births (neonatal + postnatal mortality)

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101
Q

Fetal mortality?

A

Number of deaths from 20 weeks’ gestation to birth per 1000 total births

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102
Q

Perinatal mortality?

A

Number of deaths from 20 weeks’ gestation to one month of life per 1000 total births

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103
Q

Maternal mortality?

A

Number of deaths during pregnancy to 90 days postpartum per 100,000 live births

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104
Q

True or false: Once patients sign a statement giving consent, they must continue treatment.

A

False. Patients may change their minds at any time. Exceptions to the requirement of informed consent include emergency situations and patients without decision-making capacity

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105
Q

A 15-year-old pregnant girl requires hospitalization for preeclampsia. Should her parents be informed?

A

No. Parental consent is not necessary for the medical treatment of pregnant minors

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106
Q

A doctor refers a patient for an MRI at a facility he/she owns.

A

Conflict of interest

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107
Q

Involuntary psychiatric hospitalization can be undertaken for which three reasons?

A

The patient is a danger to self, a danger to others, or gravely disabled (unable to provide for basic needs)

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108
Q

True or false: Withdrawing life-sustaining care is ethically distinct from withholding sustaining care.

A

False. Withdrawing and withholding life are the same from an ethical standpoint

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109
Q

When can a physician refuse to continue treating a patient on the grounds of futility?

A

When there is no rationale for treatment, maximal intervention is failing, a given intervention has already failed, and treatment will not achieve the goals of care

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110
Q

An eight-year-old child is in a serious accident. She requires emergent transfusion, but her parents are not present.

A

Treat immediately. Consent is implied in emergency situations

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111
Q

Conditions in which confidentiality must be overridden.

A

Real threat of harm to third parties; suicidal intentions; certain contagious diseases; elder and child abuse

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112
Q

Involuntary commitment or isolation for medical treatment may be undertaken for what reason?

A

When treatment noncompliance represents a serious danger to public health (e.g., active TB)

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113
Q

A 10-year-old child presents in status epilepticus, but her parents refuse treatment on religious grounds.

A

Treat because the disease represents an immediate threat to the child’s life. Then seek a court order

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114
Q

A son asks that his mother not be told about her recently discovered cancer.

A

A patient’s family cannot require that a doctor withhold information from the patient

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115
Q

Patient presents with sudden onset of severe, diffuse abdominal pain. Exam reveals peritoneal signs and AXR reveals free air under the diaphragm. Management?

A

Emergent laparotomy to repair perforated viscus, likely stomach

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116
Q

The most likely cause of acute lower GI bleed in patients > 40 years old.

A

Diverticulosis

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117
Q

Diagnostic modality used when ultrasound is equivocal for cholecystitis.

A

HIDA scan

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118
Q

Sentinel loop on AXR.

A

Acute pancreatitis

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119
Q

Risk factors for cholelithiasis.

A

Fat, female, fertile, forty, flatulent

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120
Q

Inspiratory arrest during palpation of the RUQ.

A

Murphy’s sign, seen in acute cholecystitis

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121
Q

Identify key organisms causing diarrhea: ■ Most common organism

A

Campylobacter

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122
Q

Identify key organisms causing diarrhea: ■ Recent antibiotic use

A

Clostridium difficile

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123
Q

Identify key organisms causing diarrhea: ■ Camping

A

Giardia

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124
Q

Identify key organisms causing diarrhea: ■ Traveler’s diarrhea

A

ETEC

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125
Q

Identify key organisms causing diarrhea: ■ Church picnics/mayonnaise

A

S. aureus

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126
Q

Identify key organisms causing diarrhea: ■ Uncooked hamburgers

A

E. coli O157:H7

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127
Q

Identify key organisms causing diarrhea: ■ Fried rice

A

Bacillus cereus

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128
Q

Identify key organisms causing diarrhea: ■ Poultry/eggs

A

Salmonella

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129
Q

Identify key organisms causing diarrhea: ■ Raw seafood

A

Vibrio, HAV

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130
Q

Identify key organisms causing diarrhea: ■ AIDS

A

Isospora, Cryptosporidium, Mycobacterium avium complex (MAC)

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131
Q

Identify key organisms causing diarrhea: ■ Pseudoappendicitis

A

Yersinia

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132
Q

A 25-year-old Jewish male presents with pain and watery diarrhea after meals. Exam shows fistulas between the bowel and skin and nodular lesions on his tibias.

A

Crohn’s disease

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133
Q

Inflammatory disease of the colon with ↑ risk of colon cancer.

A

Ulcerative colitis

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134
Q

Extraintestinal manifestations of IBD.

A

Uveitis, ankylosing spondylitis, pyoderma gangrenosum, erythema nodosum, 1° sclerosing cholangitis

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135
Q

Medical treatment for IBD.

A

5-aminosalicylic acid +/− sulfasalazine and steroids during acute exacerbations

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136
Q

Difference between Mallory-Weiss and Boerhaave tears.

A

Mallory-Weiss—superficial tear in the esophageal mucosa Boerhaave—full-thickness esophageal rupture

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137
Q

Charcot’s triad.

A

RUQ pain, jaundice, and fever/chills in the setting of ascending cholangitis

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138
Q

Reynolds’ pentad.

A

Charcot’s triad plus shock and mental status changes, with suppurative ascending cholangitis

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139
Q

Medical treatment for hepatic encephalopathy.

A

↓ protein intake, lactulose, neomycin

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140
Q

First step in the management of a patient with acute GI bleed.

A

Establish the ABCs

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141
Q

A four-year-old child presents with oliguria, petechiae, and jaundice following an illness with bloody diarrhea. Most likely diagnosis and cause?

A

Hemolytic-uremic syndrome (HUS) due to E. coli O157:H7

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142
Q

Post-HBV exposure treatment.

A

HBV immunoglobulin

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143
Q

Classic causes of drug-induced hepatitis.

A

TB medications (INH, rifampin, pyrazinamide), acetaminophen, and tetracycline

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144
Q

A 40-year-old obese female with elevated alkaline phosphatase, elevated bilirubin, pruritus, dark urine, and clay-colored stools.

A

Biliary tract obstruction

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145
Q

Hernia with highest risk of incarceration—indirect, direct, or femoral?

A

Femoral hernia

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146
Q

A 50-year-old man with a history of alcohol abuse presents with boring epigastric pain that radiates to the back and is relieved by sitting forward. Management?

A

Confirm the diagnosis of acute pancreatitis with elevated amylase and lipase. Make patient NPO and give IV fluids, O2, analgesia, and “tincture of time”

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147
Q

Four causes of microcytic anemia.

A

TICS—Thalassemia, Iron deficiency, anemia of Chronic disease, and Sideroblastic anemia

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148
Q

An elderly male with hypochromic, microcytic anemia is asymptomatic. Diagnostic tests?

A

Fecal occult blood test and sigmoidoscopy; suspect colorectal cancer

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149
Q

Precipitants of hemolytic crisis in patients with G6PD deficiency.

A

Sulfonamides, antimalarial drugs, fava beans

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150
Q

The most common inherited cause of hypercoagulability.

A

Factor V Leiden mutation

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151
Q

The most common inherited hemolytic anemia.

A

Hereditary spherocytosis

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152
Q

Diagnostic test for hereditary spherocytosis.

A

Osmotic fragility test

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153
Q

Pure RBC aplasia.

A

Diamond-Blackfan anemia

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154
Q

Anemia associated with absent radii and thumbs, diffuse hyperpigmentation, café-au-lait spots, microcephaly, and pancytopenia.

A

Fanconi’s anemia

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155
Q

Medications and viruses that → aplastic anemia.

A

Chloramphenicol, sulfonamides, radiation, HIV, chemotherapeutic agents, hepatitis, parvovirus B19, EBV

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156
Q

How to distinguish polycythemia vera from 2° polycythemia.

A

Both have ↑ hematocrit and RBC mass, but polycythemia vera should have normal O2 saturation and low erythropoietin levels

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157
Q

Thrombotic thrombocytopenic purpura (TTP) pentad?

A

Pentad of TTP—”FAT RN”: Fever, Anemia, Thrombocytopenia, Renal dysfunction, Neurologic abnormalities

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158
Q

HUS triad?

A

Anemia, thrombocytopenia, and acute renal failure

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159
Q

Treatment for TTP.

A

Emergent large-volume plasmapheresis, corticosteroids, antiplatelet drugs

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160
Q

Treatment for idiopathic thrombocytopenic purpura (ITP) in children.

A

Usually resolves spontaneously; may require IVIG and/or corticosteroids

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161
Q

Which of the following are ↑ in DIC: fibrin split products, D-dimer, fibrinogen, platelets, and hematocrit.

A

Fibrin split products and D-dimer are elevated; platelets, fibrinogen, and hematocrit are ↓.

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162
Q

An eight-year-old boy presents with hemarthrosis and ↑ PTT with normal PT and bleeding time. Diagnosis? Treatment?

A

Hemophilia A or B; consider desmopressin (for hemophilia A) or factor VIII or IX supplements

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163
Q

A 14-year-old girl presents with prolonged bleeding after dental surgery and with menses, normal PT, normal or ↑ PTT, and ↑ bleeding time. Diagnosis? Treatment?

A

von Willebrand’s disease; treat with desmopressin, FFP, or cryoprecipitate

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164
Q

A 60-year-old African-American male presents with bone pain. Workup for multiple myeloma might reveal?

A

Monoclonal gammopathy, Bence Jones proteinuria, “punched-out” lesions on x-ray of the skull and long bones

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165
Q

Reed-Sternberg cells

A

Hodgkin’s lymphoma

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166
Q

A 10-year-old boy presents with fever, weight loss, and night sweats. Examination shows anterior mediastinal mass. Suspected diagnosis?

A

Non-Hodgkin’s lymphoma

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167
Q

Microcytic anemia with ↓ serum iron, ↓ total iron-binding capacity (TIBC), and normal or ↑ ferritin.

A

Anemia of chronic disease

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168
Q

Microcytic anemia with ↓ serum iron, ↓ ferritin, and ↑ TIBC.

A

Iron deficiency anemia

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169
Q

An 80-year-old man presents with fatigue, lymphadenopathy, splenomegaly, and isolated lymphocytosis. Suspected diagnosis?

A

Chronic lymphocytic leukemia (CLL)

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170
Q

A late, life-threatening complication of chronic myelogenous leukemia (CML).

A

Blast crisis (fever, bone pain, splenomegaly, pancytopenia)

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171
Q

Auer rods on blood smear.

A

Acute myelogenous leukemia (AML)

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172
Q

AML subtype associated with DIC.

A

M3

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173
Q

Electrolyte changes in tumor lysis syndrome.

A

↓ Ca2+ , ↑ K− , ↑ phosphate, ↑ uric acid

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174
Q

Treatment for AML M3.

A

Retinoic acid

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175
Q

A 50-year-old male presents with early satiety, splenomegaly, and bleeding. Cytogenetics show t(9,22). Diagnosis?

A

CML

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176
Q

Heinz bodies?

A

Intracellular inclusions seen in thalassemia, G6PD deficiency, and postsplenectomy

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177
Q

An autosomal-recessive disorder with a defect in the GPIIbIIIa platelet receptor and ↓ platelet aggregation.

A

Glanzmann’s thrombasthenia

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178
Q

Virus associated with aplastic anemia in patients with sickle cell anemia.

A

Parvovirus B19

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179
Q

A 25-year-old African-American male with sickle cell anemia has sudden onset of bone pain. Management of pain crisis?

A

O2, analgesia, hydration, and, if severe, transfusion

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180
Q

A significant cause of morbidity in thalassemia patients. Treatment?

A

Iron overload; use deferoxamine

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181
Q

The three most common causes of fever of unknown origin (FUO).

A

Infection, cancer, and autoimmune disease

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182
Q

Four signs and symptoms of streptococcal pharyngitis.

A

Fever, pharyngeal erythema, tonsillar exudate, lack of cough

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183
Q

A nonsuppurative complication of streptococcal infection that is not altered by treatment of 1° infection.

A

Postinfectious glomerulonephritis

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184
Q

Asplenic patients are particularly susceptible to these organisms.

A

Encapsulated organisms–pneumococcus, meningococcus, Haemophilus influenzae, Klebsiella

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185
Q

The number of bacterial culture on a clean-catch specimen to diagnose a UTI.

A

105 bacteria/mL

186
Q

Which healthy population is susceptible to UTIs?

A

Pregnant women. Treat this group aggressively because of potential complications

187
Q

A patient from California or Arizona presents with fever, malaise, cough, and night sweats. Diagnosis? Treatment?

A

Coccidioidomycosis. Amphotericin B

188
Q

Nonpainful chancre.

A

1° syphilis

189
Q

A “blueberry muffin” rash is characteristic of what congenital infection?

A

Rubella

190
Q

Meningitis in neonates. Causes? Treatment?

A

Group B strep, E. coli, Listeria. Treat with gentamicin and ampicillin

191
Q

Meningitis in infants. Causes? Treatment?

A

Pneumococcus, meningococcus, H. influenzae. Treat with cefotaxime and vancomycin

192
Q

What should always be done prior to LP?

A

Check for ↑ ICP; look for papilledema

193
Q

CSF findings: ■ Low glucose, PMN predominance

A

Bacterial meningitis

194
Q

CSF findings: ■ Normal glucose, lymphocytic predominance

A

Aseptic (viral) meningitis

195
Q

CSF findings: ■ Numerous RBCs in serial CSF samples

A

Subarachnoid hemorrhage (SAH)

196
Q

CSF findings: ■ ↑ gamma globulins

A

MS

197
Q

Initially presents with a pruritic papule with regional lymphadenopathy and evolves into a black eschar after 7-10 days. Treatment?

A

Cutaneous anthrax. Treat with penicillin G or ciprofloxacin

198
Q

Findings in 3° syphilis.

A

Tabes dorsalis, general paresis, gummas, Argyll Robertson pupil, aortitis, aortic root aneurysms

199
Q

Characteristics of 2° Lyme disease.

A

Arthralgias, migratory polyarthropathies, Bell’s palsy, myocarditis

200
Q

Cold agglutinins.

A

Mycoplasma

201
Q

A 24-year-old male presents with soft white plaques on his tongue and the back of his throat. Diagnosis? Workup? Treatment?

A

Candidal thrush. Workup should include an HIV test. Treat with nystatin oral suspension

202
Q

Begin Pneumocystis carinii pneumonia (PCP) prophylaxis in an HIV-positive patient at what CD4 count? Mycobacterium avium-intracellulare (MAI) prophylaxis?

A

≤ 200 for PCP (with TMP); ≤ 50-100 for MAI (with clarithromycin/azithromycin)

203
Q

Risk factors for pyelonephritis.

A

Pregnancy, vesicoureteral reflux, anatomic anomalies, indwelling catheters, kidney stones

204
Q

Neutropenic nadir postchemotherapy.

A

7-10 days

205
Q

Erythema migrans.

A

Lesion of 1° Lyme disease

206
Q

Classic physical findings for endocarditis.

A

Fever, heart murmur, Osler’s nodes, splinter hemorrhages, Janeway lesions, Roth’s spots

207
Q

Aplastic crisis in sickle cell disease.

A

Parvovirus B19

208
Q

Ring-enhancing brain lesion on CT with seizures

A

Taenia solium (cysticercosis)

209
Q

Name the organism: ■ Branching rods in oral infection.

A

Actinomyces israelii

210
Q

Name the organism: ■ Painful chancroid.

A

Haemophilus ducreyi

211
Q

Name the organism: ■ Dog or cat bite.

A

Pasteurella multocida

212
Q

Name the organism: ■ Gardener.

A

Sporothrix schenckii

213
Q

Name the organism: ■ Pregnant women with pets.

A

Toxoplasma gondii

214
Q

Name the organism: ■ Meningitis in adults.

A

Neisseria meningitidis

215
Q

Name the organism: ■ Meningitis in elderly.

A

Streptococcus pneumoniae

216
Q

Name the organism: ■ Alcoholic with pneumonia.

A

Klebsiella

217
Q

Name the organism: ■ “Currant jelly” sputum.

A

Klebsiella

218
Q

Name the organism: ■ Infection in burn victims.

A

Pseudomonas

219
Q

Name the organism: ■ Osteomyelitis from foot wound puncture.

A

Pseudomonas

220
Q

Name the organism: ■ Osteomyelitis in a sickle cell patient.

A

Salmonella

221
Q

A 55-year-old man who is a smoker and a heavy drinker presents with a new cough and flulike symptoms. Gram stain shows no organisms; silver stain of sputum shows gram-negative rods. What is the diagnosis?

A

Legionella pneumonia

222
Q

A middle-aged man presents with acute-onset monoarticular joint pain and bilateral Bell’s palsy. What is the likely diagnosis, and how did he get it? Treatment?

A

Lyme disease, Ixodes tick, doxycycline

223
Q

A patient develops endocarditis three weeks after receiving a prosthetic heart valve. What organism is suspected?

A

S. aureus or S. epidermidis.

224
Q

A patient presents with pain on passive movement, pallor, poikilothermia, paresthesias, paralysis, and pulselessness. Treatment?

A

All-compartment fasciotomy for suspected compartment syndrome

225
Q

Back pain that is exacerbated by standing and walking and relieved with sitting and hyperflexion of the hips.

A

Spinal stenosis

226
Q

Joints in the hand affected in rheumatoid arthritis.

A

MCP and PIP joints; DIP joints are spared

227
Q

Joint pain and stiffness that worsen over the course of the day and are relieved by rest.

A

Osteoarthritis

228
Q

Genetic disorder associated with multiple fractures and commonly mistaken for child abuse.

A

Osteogenesis imperfecta

229
Q

Hip and back pain along with stiffness that improves with activity over the course of the day and worsens at rest. Diagnostic test?

A

Suspect ankylosing spondylitis. Check HLA-B27

230
Q

Arthritis, conjunctivitis, and urethritis in young men. Associated organisms?

A

Reactive (Reiter’s) arthritis. Associated with Campylobacter, Shigella, Salmonella, Chlamydia, and Ureaplasma

231
Q

A 55-year-old man has sudden, excruciating first MTP joint pain after a night of drinking red wine. Diagnosis, workup, and chronic treatment?

A

Gout. Needle-shaped, negatively birefringent crystals are seen on joint fluid aspirate. Chronic treatment with allopurinol or probenecid

232
Q

Rhomboid-shaped, positively birefringent crystals on joint fluid aspirate.

A

Pseudogout

233
Q

An elderly female presents with pain and stiffness of the shoulders and hips; she cannot lift her arms above her head. Labs show anemia and ↑ ESR.

A

Polymyalgia rheumatica

234
Q

An active 13-year-old boy has anterior knee pain. Diagnosis?

A

Osgood-Schlatter disease

235
Q

Bone is fractured in fall on outstretched hand.

A

Distal radius (Colles’ fracture)

236
Q

Complication of scaphoid fracture.

A

Avascular necrosis

237
Q

Signs suggesting radial nerve damage with humeral fracture.

A

Wrist drop, loss of thumb abduction

238
Q

A young child presents with proximal muscle weakness, waddling gait, and pronounced calf muscles.

A

Duchenne muscular dystrophy

239
Q

A first-born female who was born in breech position is found to have asymmetric skin folds on her newborn exam. Diagnosis? Treatment?

A

Developmental dysplasia of the hip. If severe, consider a Pavlik harness to maintain abduction

240
Q

An 11-year-old obese, African-American boy presents with sudden onset of limp. Diagnosis? Workup?

A

Slipped capital femoral epiphyses. AP and frog-leg lateral view

241
Q

The most common 1° malignant tumor of bone.

A

Multiple myeloma

242
Q

Unilateral, severe periorbital headache with tearing and conjunctival erythema.

A

Cluster headache

243
Q

Prophylactic treatment for migraine.

A

β-blockers, Ca2+ channel blockers, TCAs

244
Q

The most common pituitary tumor. Treatment?

A

Prolactinoma. Dopamine agonists (e.g., bromocriptine)

245
Q

A 55-year-old patient presents with acute “broken speech.” What type of aphasia? What lobe and vascular distribution?

A

Broca’s aphasia. Frontal lobe, left MCA distribution

246
Q

The most common cause of SAH.

A

Trauma; the second most common is berry aneurysm

247
Q

A crescent-shaped hyperdensity on CT that does not cross the midline.

A

Subdural hematoma—bridging veins torn

248
Q

A history significant for initial altered mental status with an intervening lucid interval. Diagnosis? Most likely etiology? Treatment?

A

Epidural hematoma. Middle meningeal artery. Neurosurgical evacuation

249
Q

CSF findings with SAH.

A

Elevated ICP, RBCs, xanthochromia

250
Q

Albuminocytologic dissociation.

A

Guillain-Barré (↑ protein in CSF with only a modest ↑ in cell count)

251
Q

Cold water is flushed into a patient’s ear, and the fast phase of the nystagmus is toward the opposite side. Normal or pathological?

A

Normal

252
Q

The most common 1° sources of metastases to the brain.

A

Lung, breast, skin (melanoma), kidney, GI tract

253
Q

May be seen in children who are accused of inattention in class and confused with ADHD.

A

Absence seizures

254
Q

The most frequent presentation of intracranial neoplasm.

A

Headache

255
Q

The most common cause of seizures in children (2-10 years).

A

Infection, febrile seizures, trauma, idiopathic

256
Q

The most common cause of seizures in young adults (18-35 years).

A

Trauma, alcohol withdrawal, brain tumor

257
Q

First-line medication for status epilepticus.

A

IV benzodiazepine

258
Q

Confusion, confabulation, ophthalmoplegia, ataxia.

A

Wernicke’s encephalopathy due to a deficiency of thiamine

259
Q

What % lesion is an indication for carotid endarterectomy?

A

Seventy percent if the stenosis is symptomatic

260
Q

The most common causes of dementia.

A

Alzheimer’s and multi-infarct

261
Q

Combined UMN and LMN disorder.

A

ALS

262
Q

Rigidity and stiffness with resting tremor and masked facies.

A

Parkinson’s disease

263
Q

The mainstay of Parkinson’s therapy.

A

Levodopa/carbidopa

264
Q

Treatment for Guillain-Barré syndrome.

A

IVIG or plasmapheresis

265
Q

Rigidity and stiffness that progress to choreiform movements, accompanied by moodiness and altered behavior.

A

Huntington’s disease

266
Q

A six-year-old girl presents with a port-wine stain in the V2 distribution as well as with mental retardation, seizures, and leptomeningeal angioma.

A

Sturge-Weber syndrome. Treat symptomatically. Possible focal cerebral resection of affected lobe

267
Q

Café-au-lait spots on skin.

A

Neurofibromatosis 1

268
Q

Hyperphagia, hypersexuality, hyperorality, and hyperdocility.

A

Klüver-Bucy syndrome (amygdala)

269
Q

Administer to a symptomatic patient to diagnose myasthenia gravis.

A

Edrophonium

270
Q

1° causes of third-trimester bleeding.

A

Placental abruption and placenta previa

271
Q

Classic ultrasound and gross appearance of complete hydatidiform mole.

A

Snowstorm on ultrasound. “Cluster-of-grapes” appearance on gross examination

272
Q

Chromosomal pattern of a complete mole.

A

46,XX

273
Q

Molar pregnancy containing fetal tissue.

A

Partial mole

274
Q

Symptoms of placental abruption.

A

Continuous, painful vaginal bleeding

275
Q

Symptoms of placenta previa.

A

Self-limited, painless vaginal bleeding

276
Q

When should a vaginal exam be performed with suspected placenta previa?

A

Never

277
Q

Antibiotics with teratogenic effects.

A

Tetracycline, fluoroquinolones, aminoglycosides, sulfonamides

278
Q

Shortest AP diameter of the pelvis.

A

Obstetric conjugate: between the sacral promontory and the midpoint of the symphysis pubis

279
Q

Medication given to accelerate fetal lung maturity.

A

Betamethasone or dexamethasone × 48 hours

280
Q

The most common cause of postpartum hemorrhage.

A

Uterine atony

281
Q

Treatment for postpartum hemorrhage.

A

Uterine massage; if that fails, give oxytocin

282
Q

Typical antibiotics for group B streptococcus (GBS) prophylaxis.

A

IV penicillin or ampicillin

283
Q

A patient fails to lactate after an emergency C-section with marked blood loss.

A

Sheehan’s syndrome (postpartum pituitary necrosis)

284
Q

Uterine bleeding at 18 weeks’ gestation; no products expelled; membranes ruptured; cervical os open.

A

Inevitable abortion

285
Q

Uterine bleeding at 18 weeks’ gestation; no products expelled; cervical os closed.

A

Threatened abortion

286
Q

The first test to perform when a woman presents with amenorrhea.

A

β-hCG; the most common cause of amenorrhea is pregnancy

287
Q

Term for heavy bleeding during and between menstrual periods.

A

Menometrorrhagia

288
Q

Cause of amenorrhea with normal prolactin, no response to estrogen-progesterone challenge, and a history of D&C.

A

Asherman’s syndrome

289
Q

Therapy for polycystic ovarian syndrome.

A

Weight loss and OCPs

290
Q

Medication used to induce ovulation.

A

Clomiphene citrate

291
Q

Diagnostic step required in a postmenopausal woman who presents with vaginal bleeding.

A

Endometrial biopsy

292
Q

Indications for medical treatment of ectopic pregnancy.

A

Stable, unruptured ectopic pregnancy of < 3.5 cm at < 6 weeks’ gestation

293
Q

Medical options for endometriosis.

A

OCPs, danazol, GnRH agonists

294
Q

Laparoscopic findings in endometriosis.

A

Chocolate cysts, powder burns

295
Q

The most common location for an ectopic pregnancy.

A

Ampulla of the oviduct

296
Q

How to diagnose and follow a leiomyoma.

A

Ultrasound

297
Q

Natural history of a leiomyoma.

A

Regresses after menopause

298
Q

A patient has ↑ vaginal discharge and petechial patches in the upper vagina and cervix.

A

Trichomonas vaginitis

299
Q

Treatment for bacterial vaginosis.

A

Oral or topical metronidazole

300
Q

The most common cause of bloody nipple discharge.

A

Intraductal papilloma

301
Q

Contraceptive methods that protect against PID.

A

OCP and barrier contraception

302
Q

Unopposed estrogen is contraindicated in which cancers?

A

Endometrial or estrogen receptor- breast cancer

303
Q

A patient presents with recent PID with RUQ pain.

A

Consider Fitz-Hugh-Curtis syndrome

304
Q

Breast malignancy presenting as itching, burning, and erosion of the nipple.

A

Paget’s disease

305
Q

Annual screening for women with a strong family history of ovarian cancer.

A

CA-125 and transvaginal ultrasound

306
Q

A 50-year-old woman leaks urine when laughing or coughing. Nonsurgical options?

A

Kegel exercises, estrogen, pessaries for stress incontinence

307
Q

A 30-year-old woman has unpredictable urine loss. Examination is normal. Medical options?

A

Anticholinergics (oxybutynin) or β-adrenergics (metaproterenol) for urge incontinence.

308
Q

Lab values suggestive of menopause.

A

↑ serum FSH

309
Q

The most common cause of female infertility.

A

Endometriosis

310
Q

Two consecutive findings of atypical squamous cells of undetermined significance (ASCUS) on Pap smear. Follow-up evaluation?

A

Colposcopy and endocervical curettage

311
Q

Breast cancer type that ↑ the future risk of invasive carcinoma in both breasts.

A

Lobular carcinoma in situ

312
Q

Nontender abdominal mass associated with elevated VMA and HVA.

A

Neuroblastoma

313
Q

The most common type of tracheoesophageal fistula (TEF). Diagnosis?

A

Esophageal atresia with distal TEF (85%). Unable to pass NG tube

314
Q

Not contraindications to vaccination.

A

Mild illness and/or low-grade fever, current antibiotic therapy, and prematurity

315
Q

Tests to rule out shaken baby syndrome.

A

Ophthalmologic exam, CT, and MRI

316
Q

A neonate has meconium ileus.

A

CF or Hirschsprung’s disease

317
Q

Bilious emesis within hours after the first feeding.

A

Duodenal atresia

318
Q

A two-month-old presents with nonbilious projectile emesis. What are the appropriate steps in management?

A

Correct metabolic abnormalities. Then correct pyloric stenosis with pyloromyotomy

319
Q

The most common 1° immunodeficiency.

A

Selective IgA deficiency

320
Q

An infant has a high fever and onset of rash as fever breaks. What is he at risk for?

A

Febrile seizures (roseola infantum)

321
Q

Acute-phase treatment for Kawasaki disease.

A

High-dose aspirin for inflammation and fever; IVIG to prevent coronary artery aneurysms

322
Q

Treatment for mild and severe unconjugated hyperbilirubinemia.

A

Phototherapy (mild) or exchange transfusion (severe)

323
Q

Sudden onset of mental status changes, emesis, and liver dysfunction after taking aspirin.

A

Reye’s syndrome

324
Q

A child has loss of red light reflex. Diagnosis?

A

Suspect retinoblastoma

325
Q

Vaccinations at a six-month well-child visit.

A

HBV, DTaP, Hib, IPV, PCV

326
Q

Tanner stage 3 in a six-year-old female.

A

Precocious puberty

327
Q

Infection of small airways with epidemics in winter and spring.

A

RSV bronchiolitis

328
Q

Cause of neonatal RDS.

A

Surfactant deficiency

329
Q

What is the immunodeficiency? ■ A boy has chronic respiratory infections. Nitroblue tetrazolium test is +.

A

Chronic granulomatous disease

330
Q

What is the immunodeficiency? ■ A child has eczema, thrombocytopenia, and high levels of IgA.

A

Wiskott-Aldrich syndrome

331
Q

What is the immunodeficiency? ■ A four-month-old boy has life-threatening Pseudomonas infection.

A

Bruton’s X-linked agammaglobulinemia

332
Q

A condition associated with red “currant-jelly” stools.

A

Intussusception

333
Q

A congenital heart disease that cause 2° hypertension.

A

Coarctation of the aorta

334
Q

First-line treatment for otitis media.

A

Amoxicillin × 10 days

335
Q

The most common pathogen causing croup.

A

Parainfluenza virus type 1

336
Q

A homeless child is small for his age and has peeling skin and a swollen belly.

A

Kwashiorkor (protein malnutrition)

337
Q

Defect in an X-linked syndrome with mental retardation,

A

Lesch-Nyhan syndrome (purine salvage problem with

338
Q

gout, self-mutilation, and choreoathetosis.

A

HGPRTase deficiency)

339
Q

A newborn female has continuous “machinery murmur.”

A

Patent ductus arteriosus (PDA)

340
Q

First-line pharmacotherapy for depression.

A

SSRIs

341
Q

Antidepressants associated with hypertensive crisis.

A

MAOIs

342
Q

Galactorrhea, impotence, menstrual dysfunction, and ↓ libido.

A

Patient on dopamine antagonist

343
Q

A 17-year-old female has left arm paralysis after her boyfriend dies in a car crash. No medical cause is found.

A

Conversion disorder

344
Q

Name the defense mechanism: ■ A mother who is angry at her husband yells at her child.

A

Displacement

345
Q

Name the defense mechanism: ■ A pedophile enters a monastery.

A

Reaction formation

346
Q

Name the defense mechanism: ■ A woman calmly describes a grisly murder.

A

Isolation

347
Q

Name the defense mechanism: ■ A hospitalized 10-year-old begins to wet his bed.

A

Regression

348
Q

Life-threatening muscle rigidity, fever, and rhabdomyolysis.

A

Neuroleptic malignant syndrome

349
Q

Amenorrhea, bradycardia, and abnormal body image in a young female.

A

Anorexia

350
Q

A 35-year-old male has recurrent episodes of palpitations, diaphoresis, and fear of going crazy.

A

Panic disorder

351
Q

The most serious side effect of clozapine.

A

Agranulocytosis

352
Q

A 21-year-old male has three months of social withdrawal, worsening grades, flattened affect, and concrete thinking.

A

Schizophreniform disorder (diagnosis of schizophrenia requires ≥ 6 months of symptoms)

353
Q

Key side effects of atypical antipsychotics.

A

Weight gain, type 2 DM, QT prolongation

354
Q

A young weight lifter receives IV haloperidol and complains that his eyes are deviated sideways. Diagnosis? Treatment?

A

Acute dystonia (oculogyric crisis). Treat with benztropine or diphenhydramine

355
Q

Medication to avoid in patients with a history of alcohol withdrawal seizures.

A

Neuroleptics

356
Q

A 13-year-old male has a history of theft, vandalism, and violence toward family pets.

A

Conduct disorder

357
Q

A five-month-old girl has ↓ head growth, truncal dyscoordination, and ↓ social interaction.

A

Rett’s disorder

358
Q

A patient hasn’t slept for days, lost $20,000 gambling, is agitated, and has pressured speech. Diagnosis? Treatment?

A

Acute mania. Start a mood stabilizer (e.g., lithium)

359
Q

After a minor fender bender, a man wears a neck brace and requests permanent disability.

A

Malingering

360
Q

A nurse presents with severe hypoglycemia; blood analysis reveals no elevation in C peptide.

A

Factitious disorder (Munchausen syndrome)

361
Q

A patient continues to use cocaine after being in jail, losing his job, and not paying child support.

A

Substance abuse

362
Q

A violent patient has vertical and horizontal nystagmus.

A

Phencyclidine hydrochloride (PCP) intoxication

363
Q

A woman who was abused as a child frequently feels outside of or detached from her body.

A

Depersonalization disorder

364
Q

A man has repeated, intense urges to rub his body against unsuspecting passengers on a bus.

A

Frotteurism (a paraphilia)

365
Q

A schizophrenic patient takes haloperidol for one year and develops uncontrollable tongue movements. Diagnosis? Treatment?

A

Tardive dyskinesia. ↓ or discontinue haloperidol and consider another antipsychotic (e.g., risperidone, clozapine)

366
Q

A man unexpectedly flies across the country, takes a new name, and has no memory of his prior life.

A

Dissociative fugue

367
Q

Risk factors for DVT.

A

Stasis, endothelial injury and hypercoagulability (Virchow’s triad)

368
Q

Criteria for exudative effusion.

A

Pleural/serum protein > 0.5; pleural/serum LDH > 0.6

369
Q

Causes of exudative effusion.

A

Think of leaky capillaries. Malignancy, TB, bacterial or viral infection, pulmonary embolism with infarct, and pancreatitis

370
Q

Causes of transudative effusion.

A

Think of intact capillaries. CHF, liver or kidney disease, and protein-losing enteropathy

371
Q

Normalizing PCO2 in a patient having an asthma exacerbation may indicate?

A

Fatigue and impending respiratory failure

372
Q

Dyspnea, lateral hilar lymphodenopathy on CXR, noncaseating granulomas, increased ACE, and hypercalcemia.

A

Sarcoidosis

373
Q

PFT showing ↓ FEV1/FVC.

A

Obstructive pulmonary disease (e.g., asthma)

374
Q

PFT showing ↑ FEV1/FVC.

A

Restrictive pulmonary disease

375
Q

Honeycomb pattern on CXR. Diagnosis? Treatment?

A

Diffuse interstitial pulmonary fibrosis. Supportive care. Steroids may help

376
Q

Treatment for SVC syndrome.

A

Radiation

377
Q

Treatment for mild, persistent asthma.

A

Inhaled β-agonists and inhaled corticosteroids

378
Q

Acid-base disorder in pulmonary embolism.

A

Hypoxia and hypocarbia

379
Q

Non-small cell lung cancer (NSCLC) associated with hypercalcemia.

A

Squamous cell carcinoma

380
Q

Lung cancer associated with SIADH.

A

Small cell lung cancer (SCLC)

381
Q

Lung cancer highly related to cigarette exposure.

A

SCLC

382
Q

A tall white male presents with acute shortness of breath. Diagnosis? Treatment?

A

Spontaneous pneumothorax. Spontaneous regression. Supplemental O2 may be helpful

383
Q

Treatment of tension pneumothorax.

A

Immediate needle thoracostomy

384
Q

Characteristics favoring carcinoma in an isolated pulmonary nodule.

A

Age > 45-50 years; lesions new or larger in comparison to old films; absence of calcification or irregular calcification; size > 2 cm; irregular margins

385
Q

Hypoxemia and pulmonary edema with normal pulmonary capillary wedge pressure.

A

ARDS

386
Q

↑ risk of what infection with silicosis?

A

Mycobacterium tuberculosis

387
Q

Causes of hypoxemia.

A

Right-to-left shunt, hypoventilation, low inspired O2 tension, diffusion defect, V/Q mismatch

388
Q

Classic CXR findings for pulmonary edema.

A

Cardiomegaly, prominent pulmonary vessels, Kerley B lines, “bat’s-wing” appearance of hilar shadows, and perivascular and peribronchial cuffing

389
Q

Renal tubular acidosis (RTA) associated with abnormal H+ secretion and nephrolithiasis.

A

Type I (distal) RTA

390
Q

RTA associated with abnormal HCO3 − and rickets.

A

Type II (proximal) RTA

391
Q

RTA associated with aldosterone defect.

A

Type IV (distal) RTA

392
Q

Doughy skin.

A

Hypernatremia

393
Q

Differential of hypervolemic hyponatremia.

A

Cirrhosis, CHF, nephritic syndrome

394
Q

Chvostek’s and Trousseau’s signs.

A

Hypocalcemia

395
Q

The most common causes of hypercalcemia.

A

Malignancy and hyperparathyroidism

396
Q

T-wave flattening and U waves.

A

Hypokalemia

397
Q

Peaked T waves and widened QRS.

A

Hyperkalemia

398
Q

First-line treatment for moderate hypercalcemia.

A

IV hydration and loop diuretics (furosemide)

399
Q

Type of ARF in a patient with FeNa < 1%.

A

Prerenal

400
Q

A 49-year-old male presents with acute-onset flank pain and hematuria.

A

Nephrolithiasis

401
Q

The most common type of nephrolithiasis.

A

Calcium oxalate

402
Q

A 20-year-old man presents with a palpable flank mass and hematuria. Ultrasound shows bilateral enlarged kidneys with cysts. Associated brain anomaly?

A

Cerebral berry aneurysms (AD PCKD)

403
Q

Hematuria, hypertension, and oliguria.

A

Nephritic syndrome

404
Q

Proteinuria, hypoalbuminemia, hyperlipidemia, hyperlipiduria, edema.

A

Nephrotic syndrome

405
Q

The most common form of nephritic syndrome.

A

Membranous glomerulonephritis

406
Q

The most common form of glomerulonephritis.

A

IgA nephropathy (Berger’s disease)

407
Q

Glomerulonephritis with deafness.

A

Alport’s syndrome

408
Q

Glomerulonephritis with hemoptysis.

A

Wegener’s granulomatosis and Goodpasture’s syndrome

409
Q

Presence of red cell casts in urine sediment.

A

Glomerulonephritis/nephritic syndrome

410
Q

Eosinophils in urine sediment.

A

Allergic interstitial nephritis

411
Q

Waxy casts in urine sediment and Maltese crosses (seen with lipiduria).

A

Nephrotic syndrome

412
Q

Drowsiness, asterixis, nausea, and a pericardial friction rub.

A

Uremic syndrome seen in patients with renal failure

413
Q

A 55-year-old man is diagnosed with prostate cancer. Treatment options?

A

Wait, surgical resection, radiation and/or androgen suppression

414
Q

Low urine specific gravity in the presence of high serum osmolality.

A

DI

415
Q

Treatment of SIADH?

A

Fluid restriction, demeclocycline

416
Q

Hematuria, flank pain, and palpable flank mass.

A

Renal cell carcinoma (RCC)

417
Q

Testicular cancer associated with β-hCG, AFP.

A

Choriocarcinoma

418
Q

The most common type of testicular cancer.

A

Seminoma—a type of germ cell tumor

419
Q

The most common histology of bladder cancer.

A

Transitional cell carcinoma

420
Q

Complication of overly rapid correction of hyponatremia.

A

Central pontine myelinolysis

421
Q

Salicylate ingestion → in what type of acid-base disorder?

A

Anion gap acidosis and 1° respiratory alkalosis due to central respiratory stimulation

422
Q

Acid-base disturbance commonly seen in pregnant women.

A

Respiratory alkalosis

423
Q

Three systemic diseases → nephrotic syndrome.

A

DM, SLE, and amyloidosis

424
Q

Elevated erythropoietin level, elevated hematocrit, and normal O2 saturation suggest?

A

RCC or other erythropoietin-producing tumor; evaluate with CT scan

425
Q

A 55-year-old man presents with irritative and obstructive urinary symptoms. Treatment options?

A

Likely BPH. Options include no treatment, terazosin, finasteride, or surgical intervention (TURP)

426
Q

Class of drugs that may cause syndrome of muscle rigidity, hyperthermia, autonomic instability, and extrapyramidal symptoms.

A

Antipsychotics (neuroleptic malignant syndrome)

427
Q

Side effects of corticosteroids.

A

Acute mania, immunosuppression, thin skin, osteoporosis, easy bruising, myopathies

428
Q

Treatment for DTs.

A

Benzodiazepines

429
Q

Treatment for acetaminophen overdose.

A

N-acetylcysteine

430
Q

Treatment for opioid overdose.

A

Naloxone

431
Q

Treatment for benzodiazepine overdose.

A

Flumazenil

432
Q

Treatment for neuroleptic malignant syndrome.

A

Dantrolene or bromocriptine

433
Q

Treatment for malignant hypertension.

A

Nitroprusside

434
Q

Treatment of AF.

A

Rate control, rhythm conversion, and anticoagulation

435
Q

Treatment of supraventricular tachycardia (SVT).

A

Rate control with carotid massasge or other vagal stimulation

436
Q

Causes of drug-induced SLE.

A

INH, penicillamine, hydralazine, procainamide

437
Q

Macrocytic, megaloblastic anemia with neurologic symptoms.

A

B12 deficiency

438
Q

Macrocytic, megaloblastic anemia without neurologic symptoms.

A

Folate deficiency

439
Q

A burn patient presents with cherry-red flushed skin and coma. SaO2 is normal, but carboxyhemoglobin is elevated. Treatment?

A

Treat CO poisoning with 100% O2 or with hyperbaric O2 if severe poisoning or pregnant

440
Q

Blood in the urethral meatus or high-riding prostate.

A

Bladder rupture or urethral injury

441
Q

Test to rule out urethral injury.

A

Retrograde cystourethrogram

442
Q

Radiographic evidence of aortic disruption or dissection.

A

Widened mediastinum (> 8 cm), loss of aortic knob, pleural cap, tracheal deviation to the right, depression of left main stem bronchus

443
Q

Radiographic indications for surgery in patients with acute abdomen.

A

Free air under the diaphragm, extravasation of contrast, severe bowl distention, space-occupying lesion (CT), mesenteric occlusion (angiography)

444
Q

The most common organism in burn-related infections.

A

Pseudomonas

445
Q

Method of calculating fluid repletion in burn patients.

A

Parkland formula

446
Q

Acceptable urine output in a trauma patient.

A

50 cc/hour

447
Q

Acceptable urine output in a stable patient.

A

30 cc/hour

448
Q

Cannon “a” waves.

A

Third-degree heart block

449
Q

Signs of neurogenic shock.

A

Hypotension and bradycardia

450
Q

Signs of ↑ ICP (Cushing’s triad).

A

Hypertension, bradycardia, and abnormal respirations

451
Q

↓ CO, ↓ pulmonary capillary wedge pressure (PCWP), ↑ peripheral vascular resistance (PVR).

A

Hypovolemic shock

452
Q

↓ CO, ↑ PCWP, ↑ PVR.

A

Cardiogenic shock

453
Q

↑ CO, ↓ PCWP, ↓ PVR.

A

Septic or anaphylactic shock

454
Q

Treatment of septic shock.

A

Fluids and antibiotics

455
Q

Treatment of cardiogenic shock.

A

Identify cause; pressors (e.g., dobutamine)

456
Q

Treatment of hypovolemic shock.

A

Identify cause; fluid and blood repletion

457
Q

Treatment of anaphylactic shock.

A

Diphenhydramine or epinephrine 1:1000

458
Q

Supportive treatment for ARDS.

A

Continuous positive airway pressure

459
Q

Signs of air embolism.

A

A patient with chest trauma who was previously stable suddenly dies

460
Q

Trauma series.

A

AP chest, AP/lateral C-spine, AP pelvis

Step 2 Qbank (4 decks)

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