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1
Q 
TTP
Path:
Sxs:
Labs:
Tx:
A

Path: Deficiency in ADAM TS13 (normally cleaves vWF into smaller pieces for degradation) due to an acquired autoantibody–> microthrombi

SXs: FAT RN
Fever
Anemia
Thrombocytopenia
Renal Failure
Neuro symptoms

Labs:

  • Increased bleeding time, but normal PT/PTT
  • Anemia with Schistocytes

Tx:
-Exchange transfusion (NEVER TRANSFUSE PLTS)

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2
Q 
DIC
Path:
Sxs:
Labs:
Tx:
A

Path: There are so sick the start to form clots where they shouldn’t, the use up the clotting materials and start to bleed

Sxs:
Septic

Labs:

  • Anemia with Schistocytes
  • Increased PT and PTT
  • Fibrinogen is decreased
  • D-dimer is increased

Tx:
Supportive
Fix Sepsis

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3
Q 
HIT
Path:
Sxs:
Dx:
Tx:
A

Path: antibodies to plts
Sxs: Plts drop after 7 to 14 days on heparin, normal PT/PTT
Dx: HIT antibodies
Tx: Stop heparin, put agatroban and bridge to warfarin

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4
Q 
ITP
path:
Sxs:
Dx:
Tx:
A

path: antibodies to plts
Pt: women with autoimmune disorder with low plt

Dx:*diagnosis of exclusion

Tx:
low plts–>steroids
critically low plts–> IgG to hide the Plts

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5
Q

Hemolytic anemia lab findings

A

Increased LDH
Decreased haptoglobin
Schistocytes on smear

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6
Q

Positive likelihood ratio
what?
Calculation?

A

what is it: the chance of finding an event in someone with the disease vs that someone without a disease

calculation:
+LR= (sens)/(1-spec)

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7
Q

negative likelihood ratio
what?
Calculation?

A

what is it: the chance of testing negative in someone with the disease vs that someone without a disease

calculation:
-LR= (1-sens)/(spec)

***The smaller the likelihood ratio the less likely the pt is to have to disease if they have a negative test

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8
Q

Esophageal cancer types and risk factors

A

Adenocarcinoma-chronic reflux and barrett’s esophagus
—distal to mid esophagus

Squamous cell carcinoma-smoking and alcohol
—upper esophagus

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9
Q

bacterial conjunctivitis Tx

A

Doesn’t wear contacts—>Erythromycin ointment or azithromycin drops

Wears contacts–> Fluoroquinolone drops (to cover for possibility of pseudomonas)

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10
Q

tx opioid withdrawal

A

-Methadone
OR
-In hospital may need to use clonidine (alpha 2 adrengeric agonist) due to availability

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11
Q

Scromboid poisoning

Sxs:

A

Sxs: Oral burning, flushing, headache, palpitations and diarrhea
-Start 10 to 30 minutes after eating fish, Sxs are self-limited

Path: IF fish is stored to hot, some of its products are broken down to histamine.

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12
Q

Thiazide effect on calcium

A

retains more calcium in the serum

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13
Q

Cerebral venous sinus thrombosis tx

A

Heparin or Low molecular weight heparin (if pregnant)

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14
Q

% of people within 1 SD

A

68%

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15
Q

% of people within 2 SDs

A

95%

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16
Q

% of people within 3 SDs

A

99.7%

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17
Q

At what bHCG does a pregnancy become visible on ultrasound

A

> 1,500

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18
Q

ARR

A

Control rate-treatment rate

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19
Q

NNT

A

1/ARR

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20
Q

Tick paralysis
vs
Guillane Barre

A

Tick paralysis- progresses over hours (start of sxs in 4 to 7 days after bite)
vs
Guillane Barre- hx of GI or URI sxs, the paralysis progressed over several days to weeks

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21
Q

Thyroid lymphoma

Pt:

A

Pt: suspect in a patient with a history of hashimoto’s thyroiditis with a rapidly enlarging thyroid gland and subsequent obstructive symptoms

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22
Q

Medullary thyroid cancer lab

A

Elevated calcitonin

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23
Q

Sxs of mixed cyroglobulinemia

A

Palpable purpura
Weakness
Arthralgia
-20% get glomerulonephritis

Labs:
hypocomplementemia
Rheumatoid factor

Path: secondary to an underlying inflammatory condition (MC is Hep C)

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24
Q

which is an intrinsic characteristic of the test?

Sens and spec
Or
Positive and Negative predictive values

A

Sens and spec

Likelihood ratios are also not affected by prevelance

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25
Q

Tourette syndrome
criteria:
Tx:

A

Criteria: More than one motor tic plus one or more vocal tics for over a year

Tx:2nd gen antipsychotics (aripiprazole, risperidone)
Or
Alpha-2 adrenergic receptor antagonists (clonidine, guanfacine)

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26
Q

criteria for spontaneous bacterial peritonitis

A

PMNs>250/mm3
SAAG(serum ascites albumin gradient) >1.1 g/dl
Protein <1 g/dl
Positive culture

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27
Q

Neurofibromatosis type 1 symptoms:

A 
Symptoms:
Cafe-au-lait macules
Optic glioma
Axillary and Inguinal freckling
Nuerofibromas
Pseudoarthrosis
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28
Q

Drugs for STEMI

A 
Aspirin and clopidogrel
Nitrates 
beta blockers
statin
anticoagulation
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29
Q

ratio for traumatic tap

A

RBC:WBC–>(750-1000):(1)

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30
Q

Tuberous sclerosis

Sxs:

A

Sxs:
Ash-leaf spots
Shagreen patches
Angiofibromas of the malar region

Cognitive delays
Autism
Epilepsy

Rhambdomyomas

Angiomyolipomas (renal)

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31
Q

Cancer associated with Sjogren’s

A

B- cell non hodgkins lymphoma

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32
Q

Location of lesion causing
Construction apraxia
(can’t copy a drawing)

A

Non dominant (right sided) parietal lobe lesion

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33
Q

Location of lesion causing

acalculia and agraphia

A

Dominant (left sided) parietal lobe

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34
Q

Location of lesion causing

Homonymous upper quadranopia and impaired perception of complex sounds (auditory agnosia)

A

Nondominant (right sided) temporal lobe

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35
Q

Location of lesion causing

Homonymous upper quadranopia and wernicke’s aphasia (trouble understanding)

A

Dominant(left sided) temporal lobe

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36
Q

Dementia with Lewy Bodies
Sxs:
Tx:

A

Sxs:
Fluctuating cognition
Visual hallucinations
Parkinsonism features

***Dementia appears first and then Parkinsonism

Tx: cholinesterase inhibitors(donepezil, Rivastigmine) for cognitive impairment,

carbidopa-levodopa for parkinsonism

melatonin for REM sleep behavior disorder

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37
Q

Vascular dementia

Sxs:

A

Early executive dysfn, focal neurologic findings

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38
Q

Tinea versicolor tx

A

topical ketoconazole

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39
Q

small cell carcinoma

A

Associated with SIADH (normovolemic hyponatremia)

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40
Q

Mesothelioma

Chest XRay

A

Nodular thickening of the pleura and/or obscuring of the diaphragm

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41
Q

Squamous cell carinoma

A

Cavitary lesion in the bronchus

Parathyroid hormone like production can lead to hypercalcemia

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42
Q

PCP presentation

A

Subacute presentation
Chest Xray shows: INTERSITIAL infiltrate

(S. pneumoniae shows lobar infiltrate)

TMP-SMX is prophylaxis for PCP when CDC<200

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43
Q

Light criteria

A

Exudate if:
Pleural protein/serum protein>0.5

Pleural LDH/serum LDH>0.6

Pleural LDH >2/3 upper limit of normal of serum LDH

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44
Q

Scarlet fever
Sxs:
Tx:

A

Sxs:
sandpaper rash, strawberry tongue, circumoral palor

Tx:
Amoxicillin

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45
Q

Kawasaki Disease
Sxs:
Tx:

A 
Sxs:
Conjunctivitis
Mucositis
Cervical lymphadenopathy
Rash
Erythema and edema of hands/feet

Tx:
Aspirin
IVIG

46
Q

lab workup for initial dementia eval

A

TSH(hyponatremia can be a clue for hypothyroidism), B12

also screen for depression

47
Q

Gout aspirate

A

shows negatively birefringent crystals

48
Q

Cushing’s syndrome

Sxs:

A

Hypertension, hyperglycemia, osteoporosis, mood swings, Diabetes, hypokalemia, and metabolic alkalosis

Dx: Dexamethasone suppression test of measurement of 24 hour urinary free cortisol level

49
Q

Prerenal vs ATN labs

A

Prerenal:
BUN:Cr->20
FEN: <1%
Urine Osmolality: >500mOsm/kg

ATN:
BUN:Cr-10-15
FEN: >2%
Urine Osmolality: ~300mOsm/kg

50
Q

Familial hypocalciuric hypercalcemia

Labs:

A

High PTH
High calcium
Urine Ca is low (if it is high with the other two labs, they have primary hyperparathyroidism)

51
Q

MEN 1

A

Pituitary adenomas
Primary hyperparathyroidism
Pancreatic/gastrointestinal neuroendocrine tumors

52
Q

origin of DHEAS vs testosterone for females

A

DHEAS-Adrenal gland

Testosterone-Ovaries

53
Q

PCOS

A

Usually for the 1st half of cycle estrogen predominates, after that progesterone takes over (but these patients don’t ovulate)

Labs:
increased testosterone
Normal DHEAS
LH/FSH ratio of >3:1
U/S shows excessive follicles

Tx:
Exercise and weight-loss
Metformin
OCPs

54
Q

Sertoli-Leydig Tumor

A

Sxs:
virilization

Labs:
Testosterone-drastically increased
DHEAS-normal

Tx:
Resection

55
Q

Adrenal tumor

A

Sxs:
virilization

Labs:
Testosterone-normal
DHEAS-very elevated

Tx:
Resection (first need to do an adrenal vein sampling, because it is not always the side with the mass)

56
Q

CAH

A

pt: Hirsuitism

Labs:
Testosterone-normal
DHEAS-elevated
17-OH-progesterone in the urine

Tx:
Cortisol
Fludrocortisone

57
Q

Prolactinoma

labs to check:

A

TSH(hypothyroidism can cause increased prolactin)
Prolactin-high

Tx: carbergoline or bromocriptine

58
Q

Acromegaly

labs to check:

A

insulin-like growth factor-1 (positive)

Glucose suppression test (does not suppress Growth hormone))

59
Q

SIADH

tx

A 
Labs:
UrineOsm-increased
UrineNA-increased
Tx: water restriction 
or 
Demeclocycline if that fails
60
Q

Nephrotic syndrome

A

Urine protein >3.5 g/day
Increased cholesterol
edema

61
Q

Folic acid vs B12 deficiency test labs

A

Methyl malonic acid will be increased in B12 deficiency but not folic acid deficiency

62
Q

prenatal labs

A

Blood type, antibody screen, Rhesus type, CBC with diff, BMP, Pap smear, Rubella status, syphilis screen, UA and urine culture, hepatitis B surface antigen, HIV testing and counseling, chlamydia testing

63
Q

Nephrotic syndrome criteria

A

proteinuria
hypoalbuminemia (pitting edema)
hypogammaglobulinemia
Hypercoagulable state (loss of antithrombin III0
Hyperlipidemia (b/c the blood is so thin, so the body throws stuff in to beef it up)

***No hematuria

64
Q

Types of Nephrotic Syndrome

A 
minimal change disease
Focal segmental glomerulosclerosis
membranour nephropathy
membranoproliferative glomerulonephritis
DM
Systemic Amyloidosis
65
Q

Nephritic syndrome is characterized by

A 
glomerular inflammation and bleeding
limited proteinuria (<3.5 g/day)
Oliguria and azotemia
Salt retention with periorbital edema and HTN
RBC cases and dysmorphic RBCs in urine
66
Q

screening for celiac

A

tTG-IgA

if under 2 add:
Deamidated Gliandin IgA and IgG

67
Q

SAAG >1.1=

A

portal HTN

think CHF, hepatitis, cirrhosis

68
Q

Type 2 error

A

failure to reject the null hypothesis when it is false

69
Q

Type 1 error

A

Rejecting the null hypothesis uncorrectly

70
Q

Somatic symptom disorder

A

preoccupation with > or = 1 unexplained symptom

71
Q

Illness anxiety disorder

A

fear of have an illness WITH FEW OR NO SYMPTOMS even after excessive workups have returned negative

72
Q

catatonia tx

A

benzodiazepines

73
Q

NMS tx

A

Dantrolene

NMS-recent exposure to antipsychotics, autonomic instability, generalized muscular rigidity, fever

74
Q

postitive predictive value

A

a/(a+b)

75
Q

negative predictive value

A

d/(c+d)

76
Q

Sensitvity

A

a/(a+c)

77
Q

specificity

A

d/(d+b)

78
Q

tx of hyperthyroidism

A

propranolol and methimazole

Propylthiouracil when pregnant

79
Q

Acute dystonia

tx:

A

tx:Benztropine, diphenhydramine

80
Q

tortocollis

A

valbenzine

81
Q

tx for postpartum endometritis

A

Clindamycin (aerobic gram positive cocci and penicillin resistant anerobes)
AND
Gentamicin (gram negatives and some gram positives)

82
Q

PID treatment

A

Doxycycline and Cefoxitin

83
Q

Probability vs odd

A

Probability: (events)/(events+non-events)

Odds: (events)/(non-events)

***approximate each other when there is a rare disease

84
Q

relative risk

A

(PROBABILITY in people exposed)/(PROBABILITY in people non-exposed)

*** used in cohort study

85
Q

odds ratio

A

(ODDS of having the exposure in people with the disease)/(ODDS of having the exposure in people without the disease)

***used in case control study

86
Q

ARR vs AR

A

ARR=(PROBABILITY of disease in people exposed)-(PROBABILITY in people non-exposed)

AR=(PROBABILITY in people non-exposed)-(PROBABILITY of disease in people exposed)

87
Q

NNT

A

1/ARR

88
Q

NNH

A

1/AR

89
Q

RRR

A

1-RR

90
Q

Parkinson’s tremor
pt:
tx:

A

pt: tremor plus bradykinesia plus rigidity
tx: levodopa or pramipexole

91
Q

Essential tremor
pt:
tx:

A

pt: bilateral, worse with fine motor activity
tx: propranolol

92
Q

when to use anova

A

when you are analyzing the MEAN value of a continuous variable in SEVERAL groups

93
Q

when to use chi squared test

A

association between CATEGORICAL variables

94
Q

when to use a t squared test

A

different between two MEANS
patient serve as their own control group

(ex comparing mean blood pressure before and after tx)

95
Q

Labs in iron deficiency anemia

A

Iron-low
transferrin-high
Ferritin-low
TIBC-low

96
Q

Multiple myeloma symptoms

A

CRAB

Calcium elevation
Renal dysfunction
Anemia
Bone lesions (can see fractures)

97
Q

MEN 1

A

diamond

pituitary
parathyroid
pancreas

98
Q

MEN 2A

A

Square

medullary thyroid
parathyroid
pheochromocytoma

99
Q

MEN2B

A

Triangle

medullary thyroid
pheochromocytoma
intestinal
Marfanoid

100
Q

SLE arthritis vs rheumatoid arthritis

A

SLE arthritis is usually transient, migratory and associated with only brief morning stiffness

Rheumatoid arthritis is chronic, symmetrical synovitis most commonly in small joints of hands and wrists (spares DIP)

101
Q

Classic Urine NA

and Urine osmolality for SIADH

A

Urine Na>50

Urine osmolality>100

102
Q

tx for impetigo

A

topical mupirocin

103
Q

Tinnitus, vertigo not related to postion and hearing loss is most likely caused by:

A

meniere’s disease

Salcylates-don’t usually have hearing loss

BPV- doesn’t usually have hearing loss and vertigo is induced by position change

104
Q

Bilateral deafness is associated with?

A

NF-2

105
Q

Tx for ADH deficient

A

DDAVP

106
Q

TX for SIADH

A

demeclocycline

107
Q

Side effect for Ginkgo biloba

A

Bleeding and plt dysfunction

108
Q

Marker for ovarian cancer

A

CA 125

109
Q

Anticoagulation in pregnancy

A

low molecular weight heparin

110
Q

High dexamethasone suppression test for excess cortisol

A

suppresses-pituitary adenoma

no suppression- atopic ACTH production

111
Q

normal anion gap

A

10 to 14

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