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Step 2 Ck > Step2CK > Flashcards

Step2CK Flashcards

1
Q

Opening snap

A

Mitral stenosis

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2
Q

intraperitoneal extravasation
location
symptoms
tx

A

location - bladder dome
symptoms - chemical periotonitis (diffuse tenderness, guarding, rebound)
tx - ex lap & surgical repair

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3
Q

BAT: duodenal hematoma
symptoms -
timing -

A

kid, handle bar, SBO, epigastric pain & vom,

24-36 hours s/p injury

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4
Q

succussion splash

b/c -

A

retained gastric material b/c hollow viscus filled

b/c - gastric outlet obstruction

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5
Q

blunt trauma - abd pain, tachy, L chest wall pain, shoulder pain

A

splenic laceration

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6
Q

prerenal kidney injury BUN>Cr

A

BUN:Cr >20:1

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7
Q

emphysematous cholecystitis

A

air fluid levels in gallbladder & gas in gall bladder wall
also - fever & RUQ

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8
Q 
P.O.O.P 
increased pain with passive stretch
rapidly incr and tense swelling
parasthesia
tx =
A

compartment syndrome

tx = fasciotomy

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9
Q

BTT

esophageal rupture

A

s/p endoscopy

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10
Q

BTT

myocardial contusion

A

tachy, new BBB, arrythmia, +sternal fx

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11
Q

BTT

bronchial rupture

A

steering wheel

CXR - peristant pneumothorax, despite chest tube, pneumomediatinum, subcut emphysema

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12
Q

BTT

diaphragm rupture

A

bowel in chest (L), kehr sign

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13
Q

BTT

pulmonary contusion

A

white out within 48 hours

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14
Q

penile fracture

cause?

A

tear tunica albguinea –> rupture corpus cavernosum

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15
Q

two drugs that make long QRS

A

TCA & beta blocker

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16
Q

TCA overdose tx

A

sodium bicarb

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17
Q

beta blocker tx

A

glucagon

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18
Q

paralytic ileus - causes?

A
  1. incr splanchnic nerve sympathetic tone
  2. localized release of inflamm mediators
  3. opiod analgesics
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19
Q

peroneal nerve function

A

evert & dorsiflexion

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20
Q

SBO findings

A

dilated loop small bowel with air fluid levels

incr bowel sounds

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21
Q

myocardial contusion… PCWP?

A

incr PCWP bc CI shock

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22
Q

drug induced pancreatitis

A

thiazides and ACEi

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23
Q 
ICP lowering
head elevation - 
sedation - 
IV mannitol - 
hypervent - 
remove CSF
A

HE - venous outflow
sedation - decr metabolic demand
IV mannitol - extract free water from brain = osmotic diuresis
hypervent - CO2 washout = cerebral vasoconstriction
remove CSF - decr vol and press

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24
Q

initial hematuria

A

urethritis

trauma (cath)

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25
Q

punctate hem, gingivitis, corskscrew hair, delayed wound healing

A

Vit C (ascorbic acid) deficiency

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26
Q

megaloblastic anemia with neuro

A

B12 (cobalamin) def

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27
Q

megaloblastic anemia with NTD

A

B9 (folate) def

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28
Q

radial sublax

tx

A
  1. hyperpronate forearm

2. supinate forearm & flex elbow

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29
Q

aplastic crisis vs vaso-occlusive crisis

A

aplastic crisis : decr retic; norm platelets

vaso-occlusis: incr retic; decr platelets

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30
Q 
SCD osteomyelitits 
#1
#2
A 
#1 - S. Aureus
#2 - salmonella
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31
Q

CAH: 17alphahydroxylase def
which hormone increased?
features?

A

incr aldo

fx: HTN, fluid and Na retention

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32
Q

CAH: 11 B hydroxylase def
which hormone increased?
features?

A

incr: 11 deoxycortisol
fx: HTN, fluid and Na retention

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33
Q

decr MCV
norm RDW
incr retic

A

thalassemia minor

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34
Q

thalassemia minor (alpha) - Hg?

A

norm Hg electrophoresis

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35
Q

thalassemia mior (beta) - Hg?

A

incr HgA2

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36
Q 
Friedrich Ataxia
trinuc rpt?
decr neuro?
heart
endo
MSK
A 
GAA
neuro - dysarthria, ataxia, decr vib/proprio, decr DTR
heart - HOCM
endo - DM
MSK - scoliosis
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37
Q

Juvenille Idiopathic Arthritis

A 
symmetric arthritis x 6 weeks 
incr ferritin
incr Ig
thrombocytosis
anemia
* uveitis
tx = MTX
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38
Q

Spondylolithesis – Location?

A

L5 over S1

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39
Q

Sturge Weber Symptoms

A 
Sporadic portwine stain
Tram track Ca2
Unilateral
Retardation
Glaucoma/GNAQ
Epilepsy (phCo)
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40
Q

SBO Risks (GIGI Home)

A 
Prior Glsx
IBD 
Gallstoneileus
Intussception
Hernia
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41
Q

Hg Electrophorosis (HgA HgS HgF)
norm
SCD
SCT

A 
HgA       HgS        HgF
norm       99            0             1
SCD         0          85-95        15
SCT        50-60    35-45        <2%
^--hypostheuria, papnea/hemoturia
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42
Q

post MI - #1 cause of death

A

arrythmia - v fib

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43
Q

papillary muscle rupture - timing

A

acute or 3-5 days

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44
Q

new holosystolic murmur

severe pulmonary edema

A

papillary muscle rupture

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45
Q

inter ventricular septum rupture

A

acute or 3-5 days

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46
Q

increased O2 levels from RA to RV

A

inter ventricular septum rupture

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47
Q

new holosystolic murmur
shock
chest pain

A

inter ventricular septum rupture

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48
Q

free wall rupture - timing

A

5 days - 2 weeks

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49
Q
  • distant heart sounds

- shock

A

free wall rupture

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50
Q
  • stable angina

- ST elevations with deep Q

A

ventricular wall aneurysm

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51
Q

ventricular wall aneursym - timing

A

5 days to 3 months

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52
Q

infective endocarditis

- natiVe valve bug

A

strep Viridans

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53
Q

infective endocarditis

- Prosthetic valve bug

A

staph ePidermidis

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54
Q

infective endocarditis: intact valves

  • bug
  • virulence
  • acute/subacute?
A

iAHA

intact sAureus; hi viulence; acute

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55
Q

infective endocarditis: pre-existing lesions

  • bug
  • virulence
  • acute/subacute
A

VLS

s. Viridans; lo virulence; subacute

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56
Q

extraperitoneal extravasataion

  • locatin
  • symptoms
  • tx
A

loc - neck/ant wall
symptoms - loc pain, hematuria, urinary retention
tx - bed rest and foley

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57
Q

terminal hematuria

A

lower collecting system

urothelial cancer, cystitis, BPH, prostate cancer

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58
Q

clavicle fracture

  • artery in danger
  • nerves in danger
  • tx for mid
  • tx for distal
A
  • subclavian artery
  • brachial plexus nerves
  • mid = non operative (brace)
  • distal = ORIF
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59
Q

tibial nerve

  • motor func
  • sensory innervation
A

flex knee, invert foot, plantar flx foot

sensory - lateral leg, plantar foot

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60
Q

hematuria throughout

A

upper collecting system

  • renal mass
  • glomerulonephritis
  • PCKD
  • urothelial cancer
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61
Q

on warfarin, need to reverse anticoagulant before surgery

A

FFP (to restore Vit K dependent factors)

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62
Q

long thoracic nerve

  • innervates
  • function
  • common injury
A

serratus anterior
rot scapula
bc penetrating trauma

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63
Q

Obturator nerve
motor -
sensory -

A

motor - adduction

sensory - medial thigh

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64
Q

BPP results
0-4
6
10

A 
0-4 = fetal hypoxia --> deliver
6 = equiv --> rpt 24 hours
10 = good --> rpt 1 week
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65
Q

chorionic villus sampling

  • timing
  • goal
A

10-13 weeks

definitive karyotype dx

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66
Q

amniocentesis

  • timing
  • goal
A

15-20 weeks

definitive karyotype dx

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67
Q 
maternal preggo changes
CO
plasma volume
SVR
BP
HR
Hg
TV
FRC
GFR
Cr
A 
CO incr
plasma volume incr
SVR decr
BP decr
HR incr
Hg decr
TV incr
FRC decr
GFR incr
Cr decr
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68
Q

tamoxifen
antag
agonist

A

antag - breast

agonist - uterus (incr uterine hyperplasia), bone (decr bone loss)

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69
Q

raloxifen
antag
agonist

A

antag - breast, uterus

agonist - bone (decr bone loss)

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70
Q

MOA for incr TH during pregnancy

A
  1. incr TBG bc estrogen stim TBG synthesis = incr total

2. hCG stim TSH receptors = decr TSH release

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71
Q

OCPs
incr risk
decr risk

A

decr risk - endometrial, ovarian
* ocp vowels = incr vowel cancer
incr risk - breast, cervical breast

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72
Q

kallman

FSH, LH

A

decr FSH & LH

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73
Q

Mg toxicity

A

decr DTR
somnolence
decr respiration

cause - usu b/c renal insufficiency

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74
Q

EBV - vs- gonorrhea

pharyngitis

A

EBV - exudative & tender cervical lymphadenpathy

gonorrhea - nontender cervical lymphadenopathy

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75
Q

pyelonephritis in pregnancy - tx

A

ceftriaxone

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76
Q

fibroids (leimyomata uteri)

A

proliferation of smooth muscle within myometrium

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77
Q

oxytocin toxicity

A

hypo natremia
hypo tension
tachy systole

bc sim to ADH = water retention –> H20 tox –> seizure

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78
Q

adenomyosis

A

proliferation of endometria glands within myometrium

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79
Q

GI complication of infective endocarditis

A

splenic abscess (LUQ pain)

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80
Q

cell free fetal DNA

  • timing
  • goal
A

timing - >/= 10 weeks
hi SN&SP for aneuploidy 13,18,21

  • use if F > 35 yo
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81
Q

granulosa cell

functions (2)
tumors effects (kid v adult)
histo
A
  1. secr aromatase (testosterone to estradiol)
  2. secr inhibin to inhibit FSH

tumor
kid - precocious pub
adult - AUB, postmen bleed bc endometrial hyperplasia

histo - call exner bodies

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82
Q

Acute Fatty Liver Pregnancy

  1. presentaion
  2. timing
  3. labs
A
  1. N/V, RUQ pain, enceph
  2. 3rd tmstr (early postpartum)
  3. hypo glycemia, mild incr AST/ALT, bili
    * incr PT incr PTT
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83
Q 
Tocolytics
Mg
 timing
 MOA
 CI
A

< 32 wks - neuroprotect
competitively competes inhibits Ca2+
dont give with CCB bc nifedipine will decr muscular contraction = respir depression

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84
Q 
Tocolytics 
Indomethicin
-timing
- MOA
- SE
- CI
A

< 32 weeks
NSAID (decr PG synth)
close ductus arterious, digoxin
CI = 3rd tmster

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85
Q 
tocolytics
Nifedipine
 - timing
 - MOA
 - SE
 - CI
A

32-34 weeks
CCB (inhibit Calciuum influx into smooth muscle
pulm edema, hypotension, flushing
CI = hypotension

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86
Q

TTP

  • pentad
  • dx? results?
  • LDH?
  • haptoglobin?
  • path?
  • tx?
A 
pentad: FATRN
dx - blood smear --> schistocytes &amp; microthrombi
ldh incr
haptoglobin - decr
path - decr ADAMTs13
tx - plasma xchng
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87
Q

incr PT only

A

vit K def

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88
Q

decr MCV

decr RDW

A

thalassemia

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89
Q

decr plateletes only

A

ITP

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90
Q

ITP tx
kid
adult

A 
kid 
 - cutaneous only = observe
 - bleeding = GC or IVIG
adult
 - skin + pltlt > 30k = observe
 - bleed + pltlt < 30k = GC or IVIG
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91
Q 
Immune Hemolytic Anemia
 IgG
warm v cold
destruction location
s/p?
tx
A

warm
spleen
PCN, ceph, sulfa, rifampin, cancer
tx - roids, splenectomy

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92
Q

decr MCV
incr Fe
decr TIBC
incr ferritin

A

sideroblastic anemia

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93
Q 
Immune Hemolytic Anemia
IgM
warm v cold
descruction location
associated with
tx
A

cold
liver
mono & mycoplasma
avoid cold; rituximab +/- fludrabine

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94
Q

incr BT

incr PTT

A

vWD

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95
Q 
vWD
- incr/decr
 inheritance
girls v boys
presentws
A

incr BT incr PTT
AD
females
recurr epistaxis, heavy meness, petechiae

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96
Q

decr MCV
decr Fe
decr TIBC
hi ferritin

A

ACD

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97
Q

decr MCV
decr Fe
incr TIBC
decr ferritin

A

Fe def

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98
Q

incr PTT only

A

hemophilia

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99
Q 
hemophilia
incr/decr
inheritance
boys or girls
presentation
A

incr PTT only
XLR
males
bruising, hematuria, hemarthrosis

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100
Q

dark urine in AM
path
complications
dx

A 
paroxysmal nocturnal hematuria
path - acquired defect myeloid stem cell 
 = absent GPI = complement destruction
dx - flow cytometry (-) CF55
complication - budd chiari
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101
Q

susceptible to oxidative stress
cells?
causes?

A

G6PD def
heinz bodies and bite cells
primaquine, sulfa, dapsone, nitrofurantoin

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102
Q

incr retic

incr MCHC

A

herediatry spherocytosis

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103
Q 
hereditary spherocytosis
 incr/decr
 path
2 complications
 dx
tx
A

incr retic, incr MCHC
path - AD defect RBC cytoskeleton ankrin and spctrin
complications
1. splenomegaly
2. bilirubin gallstones
dx - incr osm fragility with acidified glycerol
tx - splenectomy

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104
Q

multiple SAB & incr PTT
skin findings
tx

A

antiphospholipid/lupus anticoagulant
livedo reticularis, vascular thrombosis
tx - hep

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105
Q

post op –> decr platelets

A

HIT
path - IgG to heparin bound to PF4
tx - stop heparin and start leuprolife and argotroban

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106
Q 
#1 inheritied pro coaguable state
 path
A

F V Leiden

activated prot C resistance

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107
Q

CML vs leukamoid rxn

A

leuk count: CML >100k

LAP: CML decr

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108
Q

extrapulmonary sites for TB

A

liver, spleen, bone, adrenal gland

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109
Q

adrenal insufficiency

K? glucose? cells?

A

hyperkalemia
hypoglycemia
eosinophila

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110
Q

acid base
addison’s?
conn’s?

A

addisons - - normal gap met acidosis

conn’s - met alkalosis

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111
Q

when to start long term oxygen therapy

A
  1. PaO2 < 55 mmHg or SaO2 < 88%

2. PaO2 < 59 or SaO2 <89 if: cor pulomale, RHF, hematocrit > 55%

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112
Q

cobalamin deficiency
labs?
three causes?

A

labs - incr MCV, incr homocysteine, incr MMA
causes:
1. vegan
2. pernicious anemia (lack of intrinsic factor)
3. intestinal bacterial overgrowth (competes for cobalamin)

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113
Q

alpha-1-antitrypsin deficiency pathophys

A

loss of elastin in lung matrix

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114
Q

how to reverse warfarin?
rapid? 12-24 hours?
how to reverse heparin?

A 
warfarin
rapid: prothrombin complex concentrate
12-24 hours: vit K
heparin
protamine sulfate
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115
Q

Shy-Drager (Multiple system atrophy)

tx?

A
  1. parkinsonism
  2. autonomic dysfunction
  3. widespread neurological signs (cerebellar, pyramidal, LMN)
    * parkinsonism + orthosatic hypotension + impotence, incontence

tx? fluids + fludracortisone, salt, alpha-agonists

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116
Q

Riley-Day (familial dysautonomia)

A

gross dysfunction of autonomic nervous system with severe orthostatic hypotension

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117
Q

acute pyelonephritis with urine pH > 8

A

proteus mirabilis
or
klebsiella

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118
Q

CURB65

A 
Confusion 
Urea > 20
Respirations > 30
BP < 90/60
65+
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119
Q

CAP

Outpatient tx

A

Healthy -
macrolide or doxy
Comorbidities -
FQ or Blactam+macrolide

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120
Q

CAP

Inpatient (nonICU) tx

A

FQ
or
Blactam+macrolide

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121
Q

CAP

Inpatient (ICU) tx

A

Blactam+macrolide
Or
Blactam+FQ

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122
Q

Exudative effusion

Labs

A

LDH > 200
Pl:s LDH > 0.6
Pl:s protein > 0.5

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123
Q

TB pleural effusion

A

Hi lymphocytes
Hi protein
Li glucose

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124
Q

1 cancer in nonsmokers

A

Adenocarcinoma

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125
Q

Small cell lung cancer

3 manifestations:

A
  1. superior sulcus syndrome
  2. Lambert Eaton
  3. SIADH
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126
Q

Anterior mediastinal mass

A

Germ cell tumor (nonseminoma)
Thyroid (retrosternal)
Thymoma
Teratoma

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127
Q

Middle mediastinal masses

A

Tracheal tumor
Bronchogenic cyst
Aortic aneurysms
Pericardial cyst

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128
Q

Posterior mediastinal masses

A

Neurogenic cyst
Enteric cyst
Esophageal Tum
Diaphragmatic hernia

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129
Q

JVD, HA worse when leaving forward
Dx?
Assoc?
To?

A

SVC syndrome
Small cel lung cancer
Radiation and stent

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130
Q

3 cardinal symptoms of COPD exacerbation?
When do you give abx?
Which abx?

A
  1. Incr cough
  2. Incr dyspnea
  3. Sputum production (change in volume/color)

*need abx if:
2+ cardinal symptoms or mech vent

Abx:
Macrolide (azithromycin)
Respiratory FQ (levofloxacin)
Pen/Blactam (amox/clav)

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131
Q 
#1 type of kidney stone
tx? (med and diet changes
A 
calcium oxalate
tx= 
HCTZ 
decr Na, 
decr oxalate, 
incr citrate
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132
Q

calcium oxalate stone
opaque or lucent?
shape?

A

opaque

envelope shapes

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133
Q

kidney stone type in kid with family history

pathophys?

A

cysteine

cant resorb amino acid

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134
Q

cysteine stone
opaque or lucent?
shape?

A

lucent
hexagonal crystals

cysteine chapel is lucent and made of hexagonal window pieces

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135
Q

kidney stone type:
UTI or chronic indwelling catheter
alkaline pee

A

struvite stone

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136
Q

kidney stone type:
leukemia treated with chemo
tx =

A

uric acid stone

tx = potassium citrate, alkalinize urine, hydration

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137
Q

uric acid stones
opaque or lucent?
shape?

A

lucent
needle shaped
* acid is a clear drug you shoot up with needles*

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138
Q

kidney stone type

s/p volvulus, resection, chrons, fat malabsorption

A

pure oxalate stone

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139
Q

kidney stone treatment (general)

A

< 5 mm = hydrate
5mm to 2 cm = shockwave
> 2 cm = open.endoscopic surgical removal

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140
Q 
CP - worse with inspiration, better with leaning forward
dx?
EKG?
tx?
contraindications to each tx?
A

pericarditis
STelev and depressed PR
NSAIDS (ci = ckd); colchicine (ci = diarrhea)

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141
Q

chemical stress drugs

A

adenosine and dobutamine

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142
Q

anterior STEMI

vessel and leads

A

LAD – V1 - V4

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143
Q

lateral STEMI

vessel and leads

A

circumflex – I, aVL, V4-V6

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144
Q

inferior STEMI

vessel and leads

A

RCA – II, III, aVF

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145
Q

1st cardiac enzyme to rise?
when does it peak?
back to normal?
use?

A

myoglobin
2 hours
24 hours
best for repeat diagnosis

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146
Q

cardiac enzyme, longest lasting?
peak?
back to normal?

A

troponin
24-48 hours
7-10 days

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147
Q

does systolic or diastolic have normal EF?

EF of other?

A 
diastolic = normal EF
systolic = EF < 55%
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148
Q

three meds that improve survival in diastolic HF

A
  1. ACEi - prevent remodeling by aldo
  2. beta blockers - prevent remodeling by epi/NE
  3. spirnolactone -
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149
Q

Hepatic encephalopathy
Symptoms?
TX?

A

AMS, Asterixis, Ataxia, Awake (sleep changes)

Tx = lactulose and rifaximin

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150
Q

Esophageal Dysphagia
Solid to liquid?
Solid and liquid?

A

TO = mechanical obstruction
Dx= barium swallow/upper endo
AND = motility disorder
dx = barium swallow +/- mammonetry

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151
Q

beta 2 agonist effect on electrolytes

A

reduce serum potassium levels by driving potassium into cells

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152
Q

dubin johnson?

liver color?

A

conjugated hyperbilirubinemia
bc defect in hepatic excretion
liver dark, lysosomal pigment

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153
Q

gilbert syndrome

A

unconjungated hyperbilirbinemia

bc decreased bilirubin glucuronidation

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154
Q

rotor syndrome?

liver color?

A

conjugated hyperbilirubinemia

normal liver color

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155
Q

crigler najar

A

unconjugated hyperbilirubinemia

bc total deficiency

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156
Q

SVT tx?

A
  1. vagal maneuivers
  2. adenosine
  3. shock
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157
Q

afib tx?
unstable?
stable?

A

unstable - cardiovert

stable - rate control ( CCB (diltazem/verapimil) or BBlkrs)

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158
Q

name (4) fast arrthymias?

which narrow and which wide QRS?

A 
narrow:
SVT 
Afib
wide:
Torsades
Vtach
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159
Q

torsades tx?

A

Mg; shock

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160
Q

Vtach tx?

A

shock then amiodarone

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161
Q

what to check if patient has afib?

A

CHA2DS2VASc

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162
Q

CHADSVASc
which count double?
acroncym stands for?

A

double = age and stroke

CHF, HTN, Age > 75, DM, Stroke, Vasc dz, Age (65-74), Sex category

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163
Q

indication for:
cardioversion?
defibrillation?

A

cardioversion - a fib (persistant tachyarrythmia)

defibr- v fib – provides random shock

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164
Q

(2) inherited long QT syndromes

A
  1. jervell & lange-nielsen = AR, hearing loss

2. romano-ward = AD

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165
Q

pulse difference btwn:
left and right?
UE and LE?

A

LandR = physiologic or aortic dissection

UE and LE = coarctation

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166
Q

pulse description for aortic stenosis

A

pulsus parvus et tardus =

delayed (slow rising) and diminished (weak) carotid pulse

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167
Q

pulse description for aortic regurgitation

A

widened pulse pressure (water hammer pulse)

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168
Q

pulse description in cardiac tamponade

A

pulsus paradoxus (decr SBP > 10mmHg with inspiration)

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169
Q

beta blockers contol angina via

A

reduce myocardial oxygen demand by

  1. decrease HR
  2. decrease myocardial contractility
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170
Q

asymptomatic carotid stenosis

A

asa and statin
only do CEA if:
symptomatic and >70% stenosis

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171
Q

JVD, hypotension, decr heart sounds

CXR?

A

pericardial tamponade

CXR clear lungs

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172
Q

fixed and split S2

A

ASD

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173
Q

dihydropyridine CCB

A

amlodipine

nifedipine

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174
Q

non-dihydropyridine CCB

A

diltiazem

verapamil

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175
Q

post MI

acute, severe hypotension, no pulse

A

ventricular free wall rupture

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176
Q

post MI

severe pulmonary edema

A

papillary muscle rupture

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177
Q

HOCM murmur

A

harsh, crescendo-decrescendo systolic murmur

heard at apex and LLSB

178
Q

afferent vs efferent arterioles

A

afferent - towards

efferent - away

179
Q

diffuse ST elevations, PR depression

A

pericarditis

180
Q

pericarditis with electrical alterans with sinus tachy

A

pericardial effusion

181
Q

diastolic CHF with pericardial knock

A

constrictive pericarditis

182
Q

causes of constrictive pericarditis

A

recurrant pericarditis
virus
radiation
TB

183
Q

constricitve pericarditis - echo findings

A

pericardial thickening and calcifications

184
Q

AIDs diarrhea
crypto?
MAC?
CMV?

A

crypto: <180 ; sevr water
MAC: < 50 ; watery, high fever (ppx = azithro)
CMV: < 50 ; small bloody
– tx = ganciclovie or foscarnet

185
Q

beta 1 receptor agonist

A

increase contractility via incr cAMP = incr calcium channel binding of actin myosin complex to tropnin C

186
Q

primary adrenal insufficiency
cortisol?
ACTH?
aldo?

A

cortisol - decr
ACTH - incr
aldo - decr

187
Q

central adrenal insufficiency
cortisol?
ACTH?
aldo?

A

cortisol - decr
ACTH - decr
aldo - normal

188
Q

1 cancer in asbestos exposure?

A

bronchogenic carcinoma

189
Q

only known cause of mesothelioma

A

asbestos

190
Q

reiculonodular processes in lower lobes with pleural plaques

A

asbestosis

191
Q

restrictive lung dz with eggshell calcifications

A

silicosis

192
Q

location of mesothelioma

A

unilateral

193
Q

bone pain, unilateral hearing loss, femoral bowing

A

paget dz of bone

194
Q

paget dz of bone: path?

A

increase in bone turnover

Oc –> oc/Ob –> Ob

195
Q

paget dz of bone: bone pattern?

A

disorganized mosaic pattern of lamellar bone

196
Q

osteomalacia: path?

A

malabsorpbtion of calcium and vitamin D = ababnormal mineralization

197
Q

insulin effect on potassium

A

drives potassium into cels = hypokalemia

198
Q

HHS tx

A

normal saline

199
Q

estrogen effect on TBG

A

estrogen decrease clearance of TBG = increaesed TBG

200
Q 
myopathies ESR; CK
glucocorticoid
statin
polymyalgia rheumatica
inflammatory
hypothyroid
A 
GC - norm, norm
statin - norm; incr
PR - incr; norm
inflamm - incr; incr
hypothy - norm; incr
201
Q

three drugs that improve quality of life in alzehimers pts and MOA

A

cholinesterase inhibitors:
donepezil
rivastigmine
galantamine

202
Q

absent CD55

A

PNH

203
Q

most common origins of PE

A

proximal thigh - femoral, iliac, popliteal

204
Q

arterial ulcer manifestiations

A

ulcer at tips of digits
diminished pulses
loss of hair
intermittent claudication

205
Q

pulsus parvus et tardus

A

aortic stenosis

= delayed and diminished carotid pulse

206
Q

harsh ejection (crescendo-decresecndo) systolic ejection m urmur

A

aortic stenosis

207
Q

disseminated gonoccocal triad

A
  1. polyarthragia
  2. tenosynovitis
  3. painless vesiculopustular skin lesions
208
Q

common age for SSSS?

bug?

A

<6yo

s aureus

209
Q

wilson dz - what mineral accumulates? and where? old or young?

A

copper
Liver, BG, cornea
younger

210
Q

two diseases with mallory hyaline

A
  1. wilsons

2. alcohol liver injury

211
Q

two diseases with mallory hyaline

A
  1. wilsons

2. alcohol liver injury

212
Q

constricitive pericarditis

causes?

A

radiation, recurrent pericarditis, TB

213
Q

constricitive pericarditis

echo findings?

A

thickened pericardium and calcifications

214
Q

nocardia gram stain

A

partially acid fast filamentous branching rods

215
Q

nocardia tx

A

TMP-SMX

216
Q

actinomyces gram stain

A

gram postive, filamentous
NOT acid fast
NOT branching

217
Q

actinomyces unique characteristic

A

sulfur granules

218
Q

actinomyces tx

A

penicillin G

219
Q

bowel ischemia - 2 common signs

A

abd pain and bloody diarrhea

220
Q

BMI to hospitlize an anorexic?

A

<15

221
Q

dendritic ulcer around eye?

dendriform ulcer around eyye?

A

dendritic - herpes simplex keratitis

dendridform - herpes zoster opthlmicus

222
Q

three factors predisposing postpartum patients to thrombosis

A
  1. hypercoaguable state of preggo
  2. pelvic venous stsis and dilation
  3. endothelial damage from infection and/or trauma during delivery
223
Q

persistant fever unresponsive to abx and negative infectious postpartum

A

septic pelvic thrombophlebitis

224
Q

septic pelvic thrombophlebitis tx

A

broad abx and anticoagulant

225
Q

OCPs decrease risk of which cancers?

A

endometiral and ovarian

226
Q

NF1

A 
cafe au lait
clustered freckles (axilla, inguinal)
lisch nodules
neurofibromas
optic glioma
227
Q

tetraology of fallort vs choalnal atresia

A

tet - fine at rest; cyanotic with crying

choanal - cyanotic at rest; better with cry

228
Q

case control

RR or OR?

A

OR

229
Q

cohort

RR or OR?

A

RR

230
Q

acute pancreatitis causes

A 
ethos
gallstone
hyperTG
drugs (valproic acid, thiazide)
infections (CMV, legionella)
iatrogenic (post ERCP)
231
Q

CVID tx

A

IVIG

232
Q

WAS tx

A

stem cell transplant

233
Q

congential, recurrent skin abscesses

A

CGD

234
Q

CGD tx

A

interferon gamma

235
Q

ARDS

mechanically improve oxygenation by?

A

incr FiO2

incr PEEP

236
Q

chronic prostatitis tx

A
  1. alpha blockers (tamulosin)
  2. antibiotics (cipro)
  3. 5alphareducatse inhibitors (finesterade)
237
Q

irritative voiding symptoms, meatospermia, pain with ejaction
NO UTI sx
NO tender prostate

A

chronic prostatitis/chronic pelvic pain syndrome

238
Q

long term intervention for:
asthma?
COPD?

A

asthma - inhaled corticosteroids

copd - long acting antichol inhaler

239
Q

fever, leukocytosis, LUQ pain

A

splenic abscess

240
Q

violent behavior
horizontal and vertical nystagmus
dissociation
hallucination

A

PCP intox

241
Q

visual halucinations
euphoria
panic
tachy/htn

A

LSD intox

242
Q

chest pain
mydriasis
seizures
tachy/htn

A

cocaine intox

243
Q

incr appt
hypersomnia
pschomotor retardation
severe depression

A

cocaine withdrawl

244
Q

violent behavior
tooth decay
choreform mvmnt
psychosis

A

meth intox

245
Q 
incr appt
slow reflexes
conjunctival injection
dry mouth
tachy!
A

MJ intox

246
Q

depressed
miosis
respir depression

A

heroine/opiod intox

247
Q

N/V/D/cramp
muscle aches
druggie

A

heroine withdrawl

248
Q

opiod overdose tx

A

naloxone

249
Q

dilated pupils
yawnlacrimation
piloerection
hyperactive bowel sounds

A

heroine withdrawl

250
Q

alcohol withdrawl tx

A

lorazepem

251
Q

tremor
delirium
insomnia

A

alchol withdrawl

252
Q

BZ overdose tx

A

flumazenil

253
Q

tremor
anxiety
perceptual disturbances
insomnia

A

BZ withdrawl

254
Q

three stages of alchol withdrawl (with timing)

A

6-24 hours - mild
12-48 hours - seizures and alc hallucinastions
48-96 hours - DT

255
Q 
dysphagia to solids
vs 
dysphagia to solids and liquids
vs 
dysphagia to liquids
A

solids - esophageal stricture
solids and liquids - achalasia
liquids - diffuse esophageal spasm

256
Q

vascular ring
vs
laryngomalacia

A

VR - better with neck extension; biphasi stridor

laryng - better when prone; inspiratory stridor

257
Q

locations of hypertensive hemorrhages

A

basal ganglia (putamen)
cerebellar nuclei
thalamus
pons

258
Q

SLE test..

SN? SP?

A

SN - anti nuclear

SP - anti ds dna

259
Q

multiple areas of increased T2 weighted density in periventricular areas

A

multi-infarct dementia

260
Q

antibodies for
limited cutaneous sclerosis
vs
diffuse cutaneous

A

limited - anticentromere

diffuse - anti scl 70 (topo1)

261
Q

MOA of finasteride

A

5-alpha-reductase inhibitor

blocks conversion of testosterone to dihydrotestosterone

262
Q

abd pain with fever and subtle mental changes

A

think spontaneous bacterial peritonitis!

263
Q

spontaneous bacterial peritonisits tx and ppx

A

TX - 3rd gen cheph (cefotaxime)

ppx - FQ

264
Q

PE EKG findign

A

S1 Q3 T3

265
Q 
polycythemia vera 
lab findings?
Hg?
WBC?
EPO?
JAK2?
A

Hg - hi
wbc - leukocytosis and thrombocytosis
epo - low
jak2 - (+)

266
Q

liver cirrhosis
path of:
esophageal varices, splenomegaly, acites, caput medusae, anorectal varices

A

portal htn

267
Q

liver cirrhosis
path of:
spider angiomata, gynecomastia, loss of sexy hair, testicular atroph, palmar erythema

A

hyper estrinism

268
Q

liver cirrhosis
path of:
ecchymosis, edema

A

hepatic synthetic dysfunction

269
Q

erythema multiform after which infection?

A

herpes simplex

270
Q

CSF
bacterial meningits
cells? glucose? protein?

A

cells - PMN
glucose - decr
protein - incr

271
Q

CSF
viral meningitis
cells? glucose? protein?

A

cells - lymphocytes
glucose - norm
protein - norm

272
Q

CSF
fungal meningitis
cells? glucose? protein?

A

cells - lympphocytes
glucose - decr
protein - incr

273
Q

dermatophytosis and onchymosis tx?

A

griseofulvin

274
Q

complement levels in PSGN and why?

A

low C3 in serum bc C3 accumulates in glomerular deposits

275
Q

calcium gluconate tx for what?

A

hyperkalemia

276
Q

pneumoconioses with:
parenchymal nodules?
pleural plaques?

A

nodules - silicosis

plaques - asbestosis

277
Q

lumbar punture of GBS

A

incr prot

albuminocytologic dissociation

278
Q

nephrotic syndrome:

hep B and SLE?

A

membranous nephropathy

279
Q

nephrotic syndrome:

NSAIDs and lymphoma

A

MCD

280
Q

infective endocarditis
vascular lesions?
immunologic lesions?

A

vascular - janeway (nontender on palms and soles)

immunologic - osler nodes (painful on tips) and roth spots ( retinal hem)

281
Q

tinea corporis (ringworm)
tx for:
first line/ local?
second/extensive?

A 
first - 
topical antifungal =  clomtrimazole, terbinfine)
second - 
oral antifungal = 
griseofulvin, terbinifine
282
Q

water hammer pulse and widened pulse pressure

A

aortic regurgitation

283
Q

raised sharp red borders

strep pyogenes

A

erysipelas

284
Q

muddy brown casts

A

ATN

285
Q

RBC casts

A

glomerulonephritis

286
Q

WBC casts

A

interstitial nephritis and pyelo

287
Q

fatty casts

A

nephrotic syndrome

288
Q

broad waxy casts

A

chronic renal failure

289
Q

hyaline casts

A

hypovolemia/dehydration

290
Q

LDH level in PCP

A

incr

291
Q

LAP level in CML and leukamoid rxn?

A

CML - low

leuk rxn - high

292
Q

peripheral smear cells in CLL

A

smudge cells

293
Q

CML tx?

MOA?

A

imatinib

moa = inhibits TyrKin

294
Q

LDH level in AML?

A

incr

295
Q

peripheral smear cells in AML

A

auer rods

296
Q 
bacterial meningitis
empiric abx for anyone?
2-50?
>50?
immunocomp?
neurosurg?
A 
all - vanc
2-50 = + ceftriaxone
> 50 = + ceftriaxone + amp
immuncomp = +cefepime + amp
neurosurg = + cefepime
297
Q

for syphillis, which test quantitiate and which test qualitiative?

A

quant - nontrep (RPR, VDRL)

qual - trep (FTA-abs)

298
Q

mirtazapine MOA

A

alpha 2 antag

299
Q

which ulcer is worse with food? better with food?

A

worse? gastric

better? duod

300
Q

two class 1C antiarrythmics

A

flecainide and propafenone

301
Q

why is kidney damaged in DM?

A

glomerular hyperfiltration

302
Q

MOA of riluzole

A

glutamate (excitatory) inhibitor

303
Q 
wegeners:
real name?
three effects
ANCA?
tx?
A

name - granulomatosis with polyangitis

  1. upper repir - sinusitis/otitis, saddle nose deformity
  2. lower respir - lung nodules/cavitation
  3. renal - RPGN

cANCA (PR3)

tx = MTX and cyclophosphamide

304
Q

loop diruretics:
inhibit which channel?
also decreases?
also increases?

A

inhibits NaKCl2
also decreases - Mg, Ca
also increase = urate, Li

305
Q

thiazide diuretics:
inhibit which channel?
also increases?

A

inhibits NaCl

also increases - glucose, uric acid, Ca

306
Q

allergic conjunctivitis

A

bilateral

vs viral and bacterial which are unilateral

307
Q

normal:
rhinne?
weber?

A

rhinne - A>B

weber - midline

308
Q

SNHL
rhinne?
weber?

A

rhinne - A > B

weber - lat to unaffected

309
Q

conductive
rhinne?
weber?

A

rhinne - B>A

weber - lat to affected

310
Q

case control

A

compare risk factor frequency

311
Q

cohort (retrospective)

A

compare dz incidence

312
Q

diffuse esophageal spasm manometry

A

periodic, high amplitude, non-peristaltic contractions

313
Q

systemic sclerosis manometry

A

hypomobility and incompetence of LES

smooth muscle atrophy and fibrosis

314
Q

decrease GFR and lack of improvement with volume resuscitation

A

hepatorenal syndrome

315
Q

low TSH

high RAIU

A

diffuse - graves

nodular - toxic adenoma

316
Q

toxic adenoma path

A

produce own TH

317
Q

low TSH

low RAIU

A

hi TG - thyroiditis

lo TG - exogenous TH

318
Q

thyroiditis path

A

preformed TH

319
Q

bullous pemphigoid
IgG against?
pattern?
tx

A

against hemidesmosomes
linear
tx = topical clobestol

320
Q

pemphigus vulgaris
IgG against?
pattern?

A

against desmosomes

fish net

321
Q

violaceous heaped up verrucoud or nodular lesions

A

disseminated blastomycosis

322
Q

seborrheic dermatitis assoc with which two diseases?

A

parkinsons

HIV

323
Q

which post MI complication can occurs months s/p MI

A

ventricular aneurysm

324
Q

TTP tx

A

plasma exchange

325
Q

interstitial lung dz path

A

alveolar spaces filled with fibroblasts

326
Q

bronchiectasis path

A

brochical wall thickening with mucus plugs

327
Q

hyponatemia with Sosm < 275

three main categories

A

hypo, eu, and hypervolemic

328
Q

hypovolemic hyponatremia

A

Una<40 = NONRENAL
- vom, diarrhea, dehyd
Una>40 = RENAL
- diuretics, primary adl insuff

329
Q

euvolemic hyponatremia

A 
Uosm <100 
- psych
- beer
Uosm >100
- SIADH
330
Q

SIADH - what is Una?

A

Una >40

331
Q

hypervolemic hyponatremia

A

CHF
hepatic failure
nephrotic syndrome

332
Q

hyponatremia with normal Sosm

A

pseudohypo (incr lipids)

333
Q

hyponatremia with Sosm >295

A 
hyperglcemia
expgenous solutes (mannitol)
334
Q

drugs that cause SIADH

A

carbamazepine
SSRI
NSAIDs

335
Q

area of atrophy in Alzhimers

A

temporal and parietal lobe

336
Q

c diff - 3 risk factors

A

abx
hospital
ppi

337
Q

path of c diff

A

orgnaism noninvasive but released exotoxin (enterotox a and cytotox B) that penetrate colonic epithelial cells
= apoptosis of tight junctions

338
Q

how to dx TTP

A

peripheral blood smear

339
Q

SLE vs rosacea – which gets in nasolabial folds?

which is affected by alcohol?

A

rosacea

340
Q

polymyositis vs polymyalgia rheumatica

symptoms

A

polymyosists - more pain/weakness

PR - more stiffness

341
Q

polymyositis dx

A

muscle biopsy = mononuclear infiltrate surrounding necrotic and regernating muscle fibers

342
Q

argyll roberston pupil

pupils constrict with ___ but not ___

A

constrict with accomodation but not light

343
Q

pearly, flesh coloroed nodule

A

basal cell carcinoma

344
Q

most common skin cancer

A

basal cell carcinoma

345
Q

ZE syndrome -describe tumor

A

gastrin secretin pancreatic tumor

346
Q

symptoms of

focal nodular hyperplasia vs hepatic adenoma

A

FNH - asymptomatic

HA - RUQ pain, assoc with OC

347
Q

aortic dissection diagnosis if:
renal insufficiency or hemodynamic instability?
hemodynamic stable?

A

renal insuff/unstable - TEE

table - CT angio

348
Q

CLL dx?

A

flow cytometry

349
Q

acutely elevated creatinine.. next best test?

A

renal u/s

350
Q

causes of gout

A
  1. incr urate production
    - idiopathic
    - myeloprliferative dz
    - tumor lysis
    - HGPRT def
  2. decr urate clearance
    - CKD
    - thiazide and loop diuretics
351
Q

digital clubbing with painful joint enlargement, periostosis of long bones, synovial effusions

A

hypertrophic osteoarthropathy

352
Q

which liver problem, if rupture, can cause anaphylaxis?

A

echinoccocal cyst

353
Q

FEV1/FVC

changes in each and overall for restrictive lung dz

A 
FEV1 = decr
FVC = decr decr
FEV1/FVC = incr
354
Q

dilated cardiomyopathy
path?
sys or dys?
echo?

A

path - virus, etoh, wet beri beri
systolic CHF
echo = dilated ventricle with diffuse hypokinesia

355
Q

aortic valve vegetation –> what murmur?

A

aortic regurgitation

356
Q

clostridium botulinum

A

inhibits PREsynaptic Ach release

357
Q

boutlism tx

A

equine serum heptavalent botulinum antitoxin

358
Q

myasthenia gravis

A

autoantibodies to ACh receptors on postsynaptic

359
Q

lambert eaton

A

autoantibodies to Ca channles at PREsynaptic

360
Q

CMV retinitis vs HSV retinits
pain?
retinal findings?

A

CMV - painless; fluffy/granular lesions

HSV - painful; keratitis, central necrosis of retina

361
Q

condyloma
acunimata?
lata?

A

acuminata - HPV (verrucous,papilliform, pink/skin colored)

lata - syphilis (flat pink/gray)

362
Q

preventative meds for migraines

A

beta blockers
topiramate
TCA (amytriptaline)
divalpoex

363
Q

decr DLCO in:
obstructive?
restrictive?

A

obstructive - COPD

restrictive - ILD

364
Q 
amiodarone side effects
cardiac?
pulm?
GI?
ocular?
derm?
neruo?
A 
cardiac - QT prolong
pulm - chronic interstitial pneumonitis
GI - elev LFT, hepatitis
ocular -  corneal microdeposits, optic neuropathy
derm - blue-grey skin discoloration
neruo - periph neuropathy
365
Q

kidney issue in:
sarcoidosis?
wegeners?

A

sarcoid - interstitial nephritis

wegeners - glomerulonephritis

366
Q

clostridium tetani MOA

A

blocks release of inhibitory nt (glycine and GABA)

367
Q

atrophy of lenticular nucleus

A

wilsons dz

368
Q

hyperviscosity, HSM, neuropathy, bleeding

A

waldenstrom macroglobilinemia

369
Q

bone marrow biopsy for:

waldenstrom vs MM?

A

walden - >10% clonal B cells

MM - >10% clonal plasma cells

370
Q

EKG of LVH

A

high voltage QRS, lateral ST depression, lateral T wave inversion

371
Q

EKG of coarctation

A

LVH

372
Q

which repiratory acid/base disturbance is becuase of:
hypovent?
hypervent?

A

hypovent - respir acidosis

hypervent - respir alkalosis

373
Q

4 causes of cor pulmonale

A

1 COPD

  • ILD
  • pulm vasc
  • OSA
374
Q

antithyroid drugs (MMZ, PTU) SE?

A

both - agranulocytosis
MMZ - 1st tmstr teratogen, cholestasis
PTU - hepatic failulre, ANCA vasc

375
Q

radioactive iodine SE

A

permanent hypothy

worsen opthalmopathy

376
Q

thyroid surgery risks

A

permanent hypothy
recurr laryngeal nerve dmg
hypoparathy

377
Q

brocas area location?

associtated features?

A

lateral left frontal lobe

assoc - right hemiparesis (face and upper limb)

378
Q

ischemia of CN III effects?

nerve compression of CN III effects?

A

ischemia - EOM muscles ( down and out)

compression - abnormla pupil respone (mydriasis)

379
Q

drugs that cause hearing loss

A

cisplatin
aminoglycosides
loops
vancomycin

380
Q

palpable purpura, arthralgias, glomerulonephritis in someone with HepC

A

mixed cryoglobulinemia

381
Q

short systolic murmur at apex that disappears with squatting

A

MVP

382
Q

rapid tx for hyperkalemia?

to stabilize heart/.

A

insulin and glucose

heart - calcium gluconate

383
Q

difference in mumur between interventricular septal rupture and papillary muscle rupture?

A

intervent rupture - harsh holosystolic with palpable thrill

papillary muscle rupt - soft, MR

384
Q

adenocarcinoma, nsaids, hepB, sle

which nephrotic?

A

membranous

385
Q

salicylate intoxication acid/base disturb

tx?

A

1st - respiratory alkalosis
2nd - anion gap metabolic acidosis

tx = alkalinization or dialysis

386
Q

which aa can make niacin?

A

tryptophan

387
Q

zenker’s diverticulum
path?
dx?

A

path - motor dysfunction

dx contrast./barium esophagram

388
Q

ZE syndrome
path?
tumor location?

A

path = gastrin producting tumor in pancreas or duodenum
uncontrolled gastrin secretion = pariteal cell hyperplasia = excessive production gastric acind = inactivate pancreatic enzymes = diarrhea and steatorrhea

389
Q

preseptal cellulits tx

A

oral doxy

390
Q 
hyperaldosteronism
main features?
diagnostic test?
primary ratio?
secondary ratio?
A

fx - HTN + hypokalemia
diag - renin to aldo ratio
primary = decr renin incr aldo
secondary = incr renin incr aldo

391
Q

differnce in presentation btwn
methanol ?
ehylene glycol?

A

methanol - visual blurring, centl scotomoa, APD, ams

ethylene glycol - flank pain, hematuria, CN palsy, calcium oxalate crystals

392
Q

antibody for primary biliary cholanfitis

A

ant mitochondrial an

393
Q

lesion that dimples in center when pinched

A

dermatofibroma

394
Q

PE tx if:
normal GFR?
GFR < 30?

A

normal GFR - LMWH

GFR < 30 - unfractionated hep

395
Q

most common valvular dz with infective endocarditis

A

MR and MVP

396
Q

attributable risk percent

A

ARP = (risk in exposed - risk in unexposed)/risk in exposed
or
ARP = (RR-1)/RR

397
Q

replacement for sever coagulopathy ( liver dz, DIC)

A

FFP

398
Q

ways other than poor diet and alcohol to get folic acid deficiency?

A

drugs!
phenytoin (impair folic acid absorption)
MTX, TMP-SMX (antag folic )

399
Q

tx for med and large sized varices
ppx?
tx of actively bleeding?

A

ppx - nonselective beta blocker (propranolo, nadolol)

active - octreotide ( somatostatin analogue)

400
Q

path of ascending vs descending aortic aneursyms?

A

asc - cyctic medial necrosis (agin) or CT disorders

desc - atherosclerosis (htn, smoking, hi cholesterol)

401
Q

when to add corticosteroids to PCP tx

A

pulse ox < 92%
PaO2 < 70
Art-Alv >35

402
Q

hi calcium algorithm:

A
  1. check PTH
  2. hi PTH = PTH dpndnt = primary hyperPTH or familial
  3. Lo PTH - PTH independent –> check PTHtp and VitD == malig, vit d rox, thiazides, thyrotoxicosis, immobilization
403
Q

lipid panel

when to start and how often

A

M > 35
F > 45
Q5y

404
Q

INH – two SE

A

hepatotox and periph neuropathy

405
Q

BZ overdose vs opiod overdose

A

BZ - not as severe respir depression and normal pupil size ( btwn 2-4 mm)

406
Q

esophageal cancer:
two subtypes?
location of each?

A

adenocarcinoma - distal (bc barretts)

squamous cell - anywhere

407
Q

histoplasmosis - diagnosis?

A

urinary antigen testing

408
Q

risk factors for MS

A 
genetic
vit D def
geographic location (USA, europe) cold places
409
Q

three complications of ankylosing spondylitis

A

OP/vertebral fractures
aoritic regurgiation
cauda equina

410
Q

dx giardia

tx?

A

stool antigen testing (elisa)

tx = metronidazole

411
Q

azathioprine - major toxicity?

A

dose related diarrhea, leukopenia, hepatotx

412
Q

mycophenolate - major toxicity?

A

bon emarrow suppression

413
Q

immunosuprresent with gingival hypertorphy an dhirsuitism?

which other immunosppresent works similarly but doesnt have these SE?

A

cyclosporine

other - tacolimus

414
Q

test for pheochromocytoma

A

plasma fractionated metanephrine assay

415
Q

three things that are PAS(+)

whats the difference?

A

whipples and MAC
MAC - acid fast bacilli
and ALL

416
Q

drug to stabilize bony tumors?

MOA

A

bisphosphonates (-ate)

inhibit osteoclasts

417
Q

asymptomatic liver cyst

A

echinoccocus (hydatic cyst)

418
Q

echinoccocus cyst tx

A

albendazole and surgery to remove whole cyst

rupture = anaphylaxis

419
Q

liver cyst with RUQ pain, fever,

A

entaemoeba histolyticsa

420
Q

entamaeba histolytica tx

A

metronizaole (do not drain)

421
Q

bug of acute epidiymitis
<35
>35

A

<35 STC (gc/chlam

>35 bladder outlet obstuction with e.coli

422
Q

brown sequard

A

ipsi hemiparesis
ipsi decr vib/proprio
contra decr P/t two levels below

423
Q

cotton wool spots

A

central retinal vein hemorrhage

424
Q

acid fast hyphae

A

aspergillus

425
Q

scabies tx

A

topical 5% permethrin
OR
oral ivermectin

426
Q

buzzwords for:
actinitc keratosis
seborrheic keratosis

A

AK - premalignant

SK - stuck on

427
Q

three main findings of glucagonoma

A
  1. necrolytic migratory erythema (face, perineum, extremities)
  2. DM
  3. GI – diarrhea
428
Q

sensory findings for lateral medullary syndrome

A

ipsi P/T face

contr body

429
Q 
carcinoid syndrome
skin?
GI?
cardiac?
pulm?
misc?
A 
skin - flushing, telangiectasias
GI - diarhea, cramping
vardiac - valvular (R>L)
pulm - bronchospasm
misc- niacin deficiency
430
Q

carcinoid syndrome
diagnosis?
why?

A

elev 24 hours urinary excretion of 5HIAA

bc incr conversion of tryptophan to serotnin and 5HIAA

431
Q

tx for agitated older patient?

what drugs are contraindicated?

A

tx = haldol

CI - bz

432
Q

euthyroid sick syndrome -

TSH? T3? T4?

A

TSH - lo
T3 - lo
T4 - norm

433
Q

sulfonylurea - side effects?

A

weight gain and hypoglycemia

434
Q

pioglitazones - side effects?

A

CHF
bone fracture
bladder cancer
weight gain and edema

435
Q

diabetes med best for weight loss

A

GLP-1 receptor agonist

exentide

436
Q

ulnar nerve entrapment location

A

at elbow where ulnar nerve meets medial epicondyle

437
Q

optic disc pallor
cherry red fovea
boxcar segmentation of blood in retinal vein

A

CRAO

438
Q

curtain coming down

A

retinal detachment

439
Q

pancreatic cancer

location that presents with jaundice?

A

head of pancreas

440
Q

dx for pancreatic caner

A

CT with contrast

Step 2 Ck (3 decks)

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