Step3 17 Flashcards

1
Q

Appearance of benign calcification on CT (4)

A

Diffuse
Laminar
Central
Popcorn

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2
Q

Common causes of decreased vision in the elderly and management

A

Cataracts
Age-related macular degeneration

Screen for macular degeneration in a patient with a cataract. Surgery may worsen or cause acute macular degeneration

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3
Q

Management of Bells’ Palsy

A

Corticosteroids
Artificial tears
Eye patch

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4
Q

Facial paralysis in Lyme diseased

A

Bilateral

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5
Q

Difference between arrythmias due to Anterior wall MI vs. Inferior wall MI

A

Anterior wall MI:
Usually due to damage of the system below the AV node.
Bradycardia - AV block does not respond to atropine

Inferior wall MI:
Due to increase in vagal tone. Usually responds to Atropine

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6
Q

Symptomatic bradycardia presentation and management

A
Bradycardia
Hypotension
Dizziness
Heart failure
Syncope

Atropine
Pacemaker if not responding to atropine

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7
Q

Risk factors for pelvic inflammatory disease (5)

A

Multiple sexual partner (most significant)
Inconsistent use of condoms
Previous episode of PID
Partner with a sexual transmitted disease
15-25 years of age

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8
Q

Extrapelvic complication of pelvic inflammatory disease

A

Peri hepatitis (Fitz-Hugh-Curtis Sd.)

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9
Q

Clinical manifestations of Diphteria

A

Fever, malaise, sore throat

Pharyngitis (pseudomembranous)

Toxin-mediated myocarditis, peripheral or cranial neuropathies, and renal damage

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10
Q

Guillian-Barre happens after what?

A

2-4 weeks after

Pneumonia (usually mycoplasma)

GI infection: Campylobacter

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11
Q

STOP BANG Questionnaire for sleep apnea

A
Snores
Tiredness during the day
Observe apnea episodes
Pressure (Elevated BP)
BMI >35
Age >50
Neck circumference: >17cm  male, >16 cm female
Gender (male)

<3 excludes disease (High specificity)
>3 requires more studies

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12
Q

Lifestyle modifications to reduce snoaring

A

Stop alcohol before bedtime
Stop smoking
Weight loss

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13
Q

Diagnosis for adrenal insufficiency

A

8am cortisol level: low

ACTH level and ACTH stimulation test

Suboptimal response:

  • –ACTH Low: central adrenal insufficiency
  • –ACTH high: primary adrenal insufficiency

Normal response:

  • – High suspicion for central AI?: Metyrapone or insulin-induce hypoglycemia test
  • – Low suspicion: rule out
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14
Q

Recommended medications for alcohol abuse

A

Naltrexone: mu opioid receptor antagonist
Contraindicated in liver failure, hepatitis or taking opioids

Acamprosate: glutamate

Disulfiram: highly motivated patients in abstinence

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15
Q

What is chlordiaxepozide?

A

A benzo

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16
Q

Alarm symptoms for dysphagia (6). What do you do next

A
>60
Iron deficiency anemia
Odynophagia
Progresive dysphagia
Adenopathy
Persistent vomiting
Family hx
17
Q

ECG findings for STEMI

A

> 1mm ST elevation in two consecutive leads except for V2 and V3

> 1.5mm in women, >2cm in men >40 and 2.5 in men <40 in V2 and V3

18
Q

Medication that causes Photosenstivity

A

Think acne treatment

Tetracyclines (doxy and minocycline)
Benzil
Retinoids

19
Q

Treatment for moderate sunburn

A

NSAIDs
Calamine lotion
Aloe vera

20
Q

Side effects of retinoids for acne and prevention

A

Teratogen (need 2 pregnancy test)
Pseudo tumor cerebri with concomitant tetracyclines
Dry mucus membranes
Myalgias

2 negative pregnancy test before treatment
2 contraceptive methods
Stop other acne treatment

21
Q

Clinical manifestations of Henoch-Scholein Purpura

A

Palpable purpura
Arthritis/Arthralgias
Abdominal Pain
Renal disease (Nephritic sd)

22
Q

Management of Henoch-Schonlein Purpura

A

Supportive (Hydration and NSAIDs for most patients)

Hospitalization and steroids for severe disease

23
Q

Cannabis intoxication presentation

A
Tachycardia
Tachypnea
Conjunctival injection
Increased appetite
Dry mouth
24
Q

Severe combined immunodeficiency

Pathology
Type of defect

A

Low adenosine deaminase
Low quantitive inmmunoglobulins
Combine B and T cell

Severe frequent bacterial infections, chronic candidiasis, opportunistic organisms

Presents within first few months of life

25
Q

Most common organism involved in

Erysipelas
Celulitis
Abscess

A

Erysipelas: S. pyogenes

Celulitis: S. pyogenes, MSSA

Abscess: MSSA and MRSA

26
Q

Dxx diagnosis:

Breastfeeding failure jaundice vs. Breastmilk jaundice

A

Timing:
BFJ: first week of life
BJ: 2-5 days and peaks at 2 weeks

Presentation:
BFJ: Insufficient breastfeeding and signs of dehydration
BJ: Normal physical exam

Pathology:
BFJ: Failure to breastfeed. Increase enterohepatic circulation
Mother B-glucuronidase conjugates breast milk, increased enterohepatic circulation