Step 3 Flashcards

1
Q

Radioactive iodine uptake of Subacute thyroiditis, iodine exposure, exogenous use

A

low

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2
Q

Trich features

A

Pear shaped, ph greater than 4.5

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3
Q

Number needed to treat

A

NNT= 1/control group event rate-experimental group rate

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4
Q

Treat TB pregnancy

A

INH, ridampin and ethambutol for 2 months then inh and rifampin for 7 months

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5
Q

Case control

A

Participants into groups based on WHO HAS DISEASE!!!. Then assessed for risk factors

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6
Q

Factorial study design

A

Study type that utilizes 2+ interventions and all combos of the interventions

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7
Q

Cushing syndrome sx

A

Hypertension, hyperglycemia, mood swings, osteopenia, hypokalemia and metabolic alkalosis

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8
Q

Screen for Cushing

A

Overnight dexamethasone suppression test or measurement of 24 hour urinary free cortisol

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9
Q

Ssri for adolescent

A

Fluoxetine

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10
Q

Sx for craniopharyngioma in adult vs child

A

Adult is sex dysfx and just is growth failure

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11
Q

Ppx for pertussis in household

A

Everyone even if vaxed. Azithro

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12
Q

Follow up for Barrett esophagus

A

No dysplasia 3-5 years, low grade dysplasia 6-12 mo. High grade eradication therapy

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13
Q

Polycythemia in newborns risk factors

A

Post term, SGA, infant of DM, monochorionic twins, and chromosome abnormalities

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14
Q

Primary hyperparathyroid labs

A

High calcium and low phosphate

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15
Q

PCA aneurysm findings

A

CN 3 palsy. Ptosis and anusocoria.

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16
Q

Erysipelas def and tx.

A

Caused by strep pyogenes. Fever with rapid erythema well demarcated borders. Tx with a penicillin

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17
Q

Treat tet spell

A

Increase SVR, Knee to chest position

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18
Q

VACTERL

A

vertebrae, anal, cardiac, trachea esophageal, renal, radial bone, limb defects

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19
Q

Treat tic paralysis

A

Remove tic

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20
Q

Previously vaccinated person exposed to rabies

A

Only a 2 dose booster of vaccine.

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21
Q

Complications of MRSA bacteremia

A

Metastatic infections: heart valves, lungs, osteoarticilar, particularly vertebral osteomyelitis

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22
Q

Indications for thrombolysis in Pe

A

Hemodynamic instability, severe right ventricular dysfx, large clot burden, free right side cardiac thrombus

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23
Q

Management of partial Kawasaki, fever for 5+ days and <=3 sx

A

Get CRP and ibuprofen and re examine next day

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24
Q

How long no live vaccines after tax Kawasaki

A

11 months

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25
Q

Scrombroid poisening def, sx, tx

A

Def: ingestion improperly stored seafood. Sx: flush, abdominal cramps, HA, palpitations, diarrhea. Tx: self limit

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26
Q

Hypoglycemia s/e diabetes Med

A

Sulfonureas and meglitinides

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27
Q

Rheumatic fever, good pasture, ITP, myasthenia gravis, graves, pemphigud vulgaris

A

Type II hypersensitivity

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28
Q

Transient erytheoblastopenia of childhood

A

Normocytic, normochromic anemia in healthy toddler. Tx supportive unless Hgb 5>

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29
Q

Size concerning for melanoma

A

6 mm

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30
Q

First step in eval hypercalcemia

A

PTH even if suspect malignancy

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31
Q

Initial test to determine if patient has excess androgen production due to adrenal neoplasm

A

DHEAS

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32
Q

What use prostaglandin E1 for and s/e

A

Used to keep PDA open in ductus dependent heart diseases. S/e apnea, bradycardia, hypotension

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33
Q

Prsentation of Guillian Barre

A

Ascending weakness and arreflexia

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34
Q

SAAG Formula and causes

A

SAAG=Serum albumin-ascitc albumin. Greater than 1.1: portal HTN: CHF, cirrhosis, alcoholic heptitis
Less than 1.1: no PH: peritonial carcinomastosis, peritoneal TB, nephrotic syndrome, pancreatitis

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35
Q

Age to refer for orchiopexy for indescended testes

A

6 mo

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36
Q

Tx optic neuritis

A

IV steroids, oral has risk of recurrence

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37
Q

Tx muscle spacity in MS

A

Baclofen or tizanidine

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38
Q

Def and eval of delayed puberty in boys

A

Lack of testes enlargment by age 14; bone age and FSH, LH, Testosterone

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39
Q

Histrionic personality disorder

A

Excessive superficial emotion, attention seeking, secual behavior

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40
Q

Define second atage labor arrest

A

No fetal descent after nulli pushes for 3+ without or 4+ with epidural

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41
Q

Tx latent syphillis

A

3x weekyl pennicillin G

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42
Q

Tx of asymptomatic lead

A

5-44: nothing
45-69: meso-2,3-dime (DMSA)
70+: dimercaprol + EDTA

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43
Q

LH in central vs perioheral precocious puberty

A

High in central low in peripheral

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44
Q

Relative risk equation

A

Risk of outcome in exposed group/risk of outcome in nonexposed

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45
Q

SIADH assoc with which lung cancer

A

Small cell

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46
Q

Calcium-albumin correction

A

Calcium decrease 0.8 for every 1 decrease in albumin

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47
Q

Complications of hyperthyroid

A

Arrhythmia, cardiomyopathy, osteoporosis

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48
Q

Treat BV

A

Clinda or metro

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49
Q

What is raloxifene

A

Selective estrogen modulator for breast cancer chemo and osteoporosis

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50
Q

Treat mastitis

A

Dickoxacillin or cephalexin

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51
Q

Tx first line fir breast abscess

A

Fine needle aspiration

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52
Q

Positive predictive value equation

A

PPV= TP/(TP+FP)

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53
Q

Length time bias

A

When survival benefits of screening test are overstated cause of detection of lots of slowly progressive benign cases

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54
Q

Suspect PJP and Sputum negative

A

BAL

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55
Q

Abx for PPROM

A

Amp + azithro

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56
Q

Migrating polyarthalgia, tenosynovitis, dermatitis (pustular lesions)

A

Disseminated gonnococcal infection

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57
Q

Dyspepsia without other sx

A

H pylori testing

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58
Q

Proximal muscle weakness, high CK and inflammatory markers

A

Polymyositis

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59
Q

Pulm complications of polymyositis

A

Interstitial lung disease, infection, drug induced pneumonitis, resp muscle weakness

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60
Q

Abdominal pain, fat malabsorption, alcohol intake

A

Chronic pancreatitis, confirm with MRCP

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61
Q

Dx urethral diverticulum

A

MRI or tranvag Us

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62
Q

FOOSH fxs

A

Colles (distal radial)(deformity)

Scaphoid (pain in snuffbox)

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63
Q

When tx asymptomatic subclinical hypothyroid besides AB?

A

Abnormal lipids, sx, or menstrual dysfx

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64
Q

Relative risk reduction

A

(Risk in unexposed- risk in exposed)/ (risk in unexposed)

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65
Q

Eval gynecomastia

A

Look at photo

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66
Q

Mechanism of organophosphate poisening

A

Cholinergic tox by acetylcholinesterase inhib

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67
Q

Dialectal Behavioral therapy for…

A

Borderline

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68
Q

When get carotid endarterectomy

A

70+%, >5 yr life, symptomatic

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69
Q

Relative risk

A

Incidence in exposed/incidence in nonexposed

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70
Q

Cover for in CF

A

Pseudomonas

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71
Q

Complications of multiple myeloma

A

Hypercalcemia, renal insuff, infections, lytic lesions, thrombosis, hyoervoscity (rare)

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72
Q

Hypothyroid in pregnancy and tx

A

See pic

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73
Q

Midline neck mass moves with swallowing

A

Thyroglossal duct cyst

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74
Q

Parhophys and tx renal osteodystrophy from secondary hyperparathyroid

A

CKD cause less phos filtration and elevated phos snd low calcium, then elevated PTh. Tx wtih phos restrict

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75
Q

Analgesic nephropathy sx

A

Hematuria, pyuria, proteinuria, renal colic

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76
Q

Normal caloric response

A

Deviation of eye to side of stimulus, saccadic correction to midline

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77
Q

Risk for reactive arthritis

A

Greater in HLA B27 And also salmonella and chlamydia

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78
Q

Management if NSTEMI/Unstable angina

A

See photo

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79
Q

bilateral polyspike and slow wave activity

A

juvenile myclonic epilepsy

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80
Q

sx of endometriosis

A

pelvic pain, DEEP dyspareunia, dysmennorrhea, dyschezia

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81
Q

when do c/s for HIV

A

viral load >1000

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82
Q

define allergic bronchopulm aspergillosis

A

hypersensitivity disorder in asthma and CF; reccurent fleeting infiltrates and central bronchiectasis

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83
Q

acute, monocular vision loss, cherry red macula on fundoscopy

A

central artery occlusion

84
Q

size of nodule that needs mangament or surveilence

A

> 0.8 cm

85
Q

screening for diabetic kidney disease

A

urine albumin/creatinine ratio

86
Q

Rule of 10s for reconstruction of cleft lip

A

10 lbs, 10 weeks, 10g hemoglobin

87
Q

Sx of HIT

A

Thrombocytopenia and arterial and venous thrombus

88
Q

Switch to for HIT

A

Direct thrombin inbunitor (argatroban, bivalirudin) or fondaparinux

89
Q

Right ventricular strain on EKG

A

RBBB, atrial arrythmias, Qwaves or St change in infeior leads

90
Q

tx catatonia

A

benzos

91
Q

AKI in TLS

A

Ca-Phos stone formation

92
Q

when get cold agglutinin hemolytic anemia

A

after a viral infection

93
Q

boy with hemolytic anemia

A

G6PD

94
Q

early systolic murmur at appex

A

mitral regurg

95
Q

MOA of loop diuretics

A

block Na-K-2Cl transporter in loop of Henle

96
Q

calcium and thiazide

A

reabsorb more so more in serum less in urine

97
Q

sx of aspirin OD

A

n/v, tachypnea, lactic acid, hyperthermia, AMS

98
Q

death in tuberous sclerosis

A

seizure, aspiration pneumonia, obstructive hydrocephalus

99
Q

what is pyelophlebitis

A

infection of portal vein thrombosis, complication of appendicitis

100
Q

tx pagets

A

bisphosphates

101
Q

presbycusis

A

hearing loss elderly

102
Q

3+ months of dysuria, pain with ejac, perianal pain and tx

A

chronic prostatitis (tx with tamsulosin)

103
Q

what screen for in patients with primary biliary sclerosis

A

osteoporosis

104
Q

what is scleroderma renal crisis and tx?

A

severe HTN and renal failure, ACE and nitropruside

105
Q

psych med complications

A

see pic

106
Q

Exam findings for severe AS

A

Soft single heart sound, delayed and dimished carotid pulse, loud and late peak systolic murmur.

107
Q

Rate ratio

A

Incidence in intervention/incidence in control

108
Q

Number needed to harm

A

1/(rate in treatment-rate in placebo)

109
Q

Tx post op a fib after cardiac surgery

A

Most spont convert. However can reccur

110
Q

asymmetry in a funnel plot suggests…

A

publication bias

111
Q

positive and negative likelihood ratio

A

+LR= sensitivity/(1-specificity)

-LR=(1-sensitivity)/specificity

112
Q

korsacoff MRI finding

A

mammilary body atrophy

113
Q

when switch to subQ insulin in DKA

A

able to eat, glc <200, anion gap <12, and bicarb >15

114
Q

who gets ppx for n. mening

A

household, roomates, child care, directly exposed to secretions, seated next to for >8 hr

115
Q

calcifications in nodule that raise susp for malignancy

A

eccentric, reticular, punctate

116
Q

Proximal muscle weakness, CK, skin

A

Dermatomysostis

117
Q

Extrarenal manifestations of ADPKD

A

Cerebral aneurysms, helatic and pancreatic cysts, mitral valve prolapse, aortic tegurg, colonic diverticula, ventral and inguinal hernias

118
Q

Screen for ADPKD

A

US for patients above 18

119
Q

Soinal cord level of cremasteric reflex

A

L1-2

120
Q

supra INR

A

<4.5 nothing
4.5-10: low dose oral vit K
10+: high dose oral vit K
Bleeding: iv vit K and PCC

121
Q

1st step for pancreatic cyst

A

US with aspiration

122
Q

what fluids non infectious for HIV

A

stool, urine, vomit,vtears as long as not bloody

123
Q

When treat with fibrates for hypertrigly.

A

> 880

124
Q

Type 1 error=

A

False positivie

125
Q

Late in life depression at risk for

A

Alzheimers

126
Q

Herbal meds and their side effects

A

See pic

127
Q

Labor cannot progress without

A

Adequate contractions every 2-3 mins

128
Q

Antipsychotics with worst parkinson risk

A

Haloperidol-risoeridone-olanzipine

129
Q

Schistosomiasis sx and tx

A

Dysuria, urinary freq, hematuria, perioheral eosinophillia, praxiquantel

130
Q

how does octreotide help variceal bleed

A

lower elevated portal venous pressure that causes varcieals

131
Q

primary and secondary prevention of variceal hemmorrhage

A

propanolol

132
Q

physical activity and insulin

A

reduce prior to activity

133
Q

LCIS if found on FNA next step and why

A

excisional bx because could be DCIS or other cancer

134
Q

meds cause pseudo tumor and findings on fundoscope

A

isotretinoin and minocycline; flame hemmorrhages, venous engorge, hard exudates

135
Q

gram stain for G vs C

A

G: leukocytes with intracellular gram neg diplococci
C: leukocytes with no organisms

136
Q

CHD risk equivalent

A

Noncoronary athersclerosis, DM, CKD

137
Q

Relative risk

A

Risk exposed/risk unexposed

138
Q

Attributable risk percent

A

ARP=(RR-1)/RR

139
Q

Population attributable risk percent

A

PARP=(risk in total pop-risk in unexposed)/risk in total

140
Q

Most common parhogen of nec fasc

A

Group A strep

141
Q

Tx CAP

A

Ctx and azitrho, no anaerobic coverage even if aspiration

142
Q

____ challenge for asthma

A

methacholine

143
Q

what NOT to use orally for tinea versicolor

A

terbinafine and grisefulvin

144
Q

When total thyroidextomy for papilary thryroid cancer

A

> 1 cm, tukor extension, distant met, or radiation exposure

145
Q

Clinical benefit of medication equation

A

Possible benefit-possible harm

146
Q

Intention to trrat primciple

A

Participants analyzed in groups they were randomized even if dropped out or fucked up

147
Q

CKD cardio findings

A

LVH and anemia

148
Q

Pempjigoid gestationis def

A

Automimmune urticarial papules and plaques vesicles and bullar. Periumbilical

149
Q

Hematuria, abdominal mass, erythrocytsosis

A

RCC

150
Q

Tx tines pedis

A

Topical terbinafine, azole or oral terbinafine or azole

151
Q

Erythetamous mass from rectum with concentruc rings

A

Rectal prolapse

152
Q

What hematoma not good in head injury <2 yeats

A

Nonfrontal scalp hematoma

153
Q

Good prognostic factors for schizophrenia

A

Late onset, female, acute onset with precipitant, positive sx, no fam hx

154
Q

def of neg and pos likelihood ratios

A

-: probability neg result in cancerous tissue compared to normal
+: probability of pos result in cancerous tissue compared to normal

155
Q

reflexes and electrolytes

A

hypocalcemia=hyperactive
hypermagnesemia=hypoactive
hypophos= hypoactive

156
Q

sensitivity help

A

rule out disease

157
Q

tsh in hypothyroid

A

high

158
Q

pregnancy complications for subclinical hypothyroid

A

recurrent miscariges, PEC, preterm birth, low birth weight, and placenta abruption

159
Q

acute cholangitis sx

A

fever, RUQ pain, jaundice, confusion

160
Q

odds ratio equation

A

see pic

161
Q

clinical features of cervical insufficiency

A

2+ prior painless 2nd trimester pregnancy losses, painless cervical dilation

162
Q

interpret hazard ratio

A

<1 means less likely to occur in treatment than event group

>1 means more liekly

163
Q

Hirschaprung dx

A

Suction bx

164
Q

Primary hyperparathyroid indications for surgery

A

Age <50, symptomatic, calcium >1 above normal, urine >400

165
Q

High dose statins

A

Atorvastatin 40-80 or rosuvastatin 20-40

166
Q

Palpable breast mass

A

Photo

167
Q

Hyperkalemia EKG

A

See pic

168
Q

Tx pertusis

A

Macrolides

169
Q

Bleeding from fibroids

A

Regular and heavy

170
Q

Hyoercalcemia EKG

A

Short QT

171
Q

What is electrical alternans and when does it happen

A

Cardiac tamponade, alternating amplitude in QRS complexes

172
Q

Pain and stiff without weakness

A

PMR

173
Q

When initiate discussion about renal replacement therapy

A

GFR <30

174
Q

What can Factor V ledien lead to

A

Protein C resistance

175
Q

When bariatric surgery

A

BMI more than 40

176
Q

myopathies and ESR and CK

A

see pic

177
Q

urine chloride distinguish causes of metabolic alkalosis

A
low= gastric losses
high= diuretic use
178
Q

cohort vs case control

A

cohort prospective, case control retrospective

179
Q

erythropoetin and polycythemia

A

if low: primary/PV

if high: secondary

180
Q

autoimmune metaplastic atrophic gastritis caused by and lead to

A

caused by: autoimmune aggression against gastric mucosa

lead to: pernicious anemia

181
Q

warfarin effected by meds increase INR and decrease

A

increase INR “a”s + flagyl + quinolones

182
Q

MOA of carbidopa

A

decrease peripheral conversion of levodopa to dopamine

183
Q

tx allergic bronchopulmonary aspergillosis

A

prednisone and if not work itraconazole or voriconazole

184
Q

selection bias

A

inappropriate selection or poor retention of subjects

185
Q

what is sheehan syndrome

A

pan hypopituitarism due to ishcemic necrosis after a postpartum hemmorrhage

186
Q

drugs affect lithium levels

A

thiazides, NSAIDs, ACE and ARB,tetracycline, Flagyl

187
Q

when do dialysis for lithium

A

> 4

188
Q

schizoaffective

A

2+ weeks psychotic sx without mod sx

189
Q

Mentzer index and significance

A

MCV/RBC; >13 is iron def anemia, less is thalassemia

190
Q

target for treating graves in pregnancy

A

hyperthyroid state

191
Q

markers for autoimmune hepatits

A

ANA and anti-smooth muscle AB

192
Q

traumatic LP ratio

A

1 WBC per 750-1000 RBCs

193
Q

toxic nodule characteristics

A

increased idioine uptake in nodule, decreased in rest

194
Q

valve for IV drug user endocarditis

A

tricuspid

195
Q

first line therapy for MDD with psychotic features

A

Electroconvulsive therapy

196
Q

meds for heart failure during preg

A

BB, digoxin, hydralyzine, nitrates, loop diuretics

197
Q

erythema infectiosum

A

parvo reticulated rash

198
Q

low T4 and normal/low TSH

A

central hypothyroidism

199
Q

silicosis in what lobes of lung

A

upper

200
Q

hyperchloremia, hypokalemia non anion gap met acidosis, hypercalciuria

A

Distal RTA Type 1

201
Q

painful vs painless genital ulcers

A

painful: HSV, chanchroid (H. ducry)
painless: Syphillis charcre, lymphavenereum-chlamydia (then turn painful buboes)

202
Q

manifestations of stongyliodes

A

pulm: cough and wheeze, GI: n/d, skin: linear erythetamous

203
Q

AIN drugs

A

PPI, NSAIDs, penicillins, diuretics

204
Q

lights criteria

A

pleural/serum protein >0.5
pleural/ serum LDH >0.6
pleural LDH >2/3 upper lim normal serum

205
Q

chronic open angle glaucoma presentation

A

progressive loss of peripheral vision and increased cup to disk ratio

206
Q

fever cough rhinorrhea, then cephalocaudal rash and conjunctivia

A

measles

207
Q

criteria for BiV pacer

A

LVEF <35%, CHF sx, and left bundle branch block >150 ms