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1
Q

Where is the most common anatomical site for ectopic pregnancy?

A

Fallopian tubes (ampullary portion)

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2
Q

This STD is a gram negative diplococcus

A

Neisseria gonorrhoeae

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3
Q

Vaginal bleeding in a post menopausal female is what until proven otherwise?

A

Endometrial cancer

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4
Q

These two vaccinations are given at age 12-15 months and again at 4-6 years

A

MMR, Varicella

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5
Q

What is the tumor marker for colon cancer?

A

CEA (carcinoembryonic antigen)

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6
Q

What is the tumor marker for pancreatic cancer?

A

CA 19-9

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7
Q

What is the anti-dote for a beta blocker overdose?

A

Glucagon

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8
Q

What is the anti-dote for a coumadin overdose?

A

Vitamin K

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9
Q

This class of antibiotic has risks for tendon rupture as a side effect

A

Fluoroquinolones

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10
Q

What is the anti-dote for a benzodiazepine OD?

A

Flumazenil

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11
Q

Polycystic kidney disease is what type of inheritance?

A

Autosomal dominant

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12
Q

What is the causative agent, rash, and treatment for Lyme disease?

A

Borrelia burgdorferi
Erythema migrans
Doxy (< 12y or pregnant, give Amox)

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13
Q

What is the best test for pancreatitis?

A

Serum lipase

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14
Q

This antibiotic classically causes “red man syndrome”

A

Vancomycin

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15
Q

This anti-hypertensive medication causes erectile dysfunction in men

A

Beta blockers

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16
Q

This anti-hypertensive is classic for angioedema and hyperkalemia

A

ACEi

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17
Q

This sign (exam test) is classically positive in epididymitis, but negative in testicular torsion

A

Prehn sign
(relief of pain with elevation of testicle)

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18
Q

This type of pneumonia is classically associated with hot tubs and aeration systems

A

Legionella

  • classically presents with bradycardia and hyponatremia
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19
Q

This is the a1c level that is diagnostic for diabetes.

A

6.5% or more

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20
Q

True or false: mumps can cause pancreatitis

A

True

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21
Q

What level of elevation of LDL warrants a statin in patients with no other comorbidities other than hyperlipidemia?

A

160 mg/dL

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22
Q

When are patients eligible for the Shingrix vaccine?

A

at 50 years old
OR
at 19 years and older in pts who have weakened immune systems

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23
Q

Two side effects of spironolactone

A

Hyperkalemia, gynecomastia

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24
Q

10/10 foot pain with first few steps in the morning

A

Plantar fasciitis

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25
Q

This test comfortably rules out DVT in a low risk patient

A

D-dimer

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26
Q

This is contraindicated in acute diverticulitis

A

Colonoscopy

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27
Q

This type of thyroid cancer has the worst prognosis

A

Anaplastic

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28
Q

What is cranial nerve 9 called?

A

Glossopharyngeal

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29
Q

This murmur classically has unusual exam findings (think: uvula pulsation, head bobbing, and nail pulsations)

A

Aortic regurgitation

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30
Q

Which overdose classically has tinnitus as a notable symptom?

A

Salicylates (NSAIDs in high doses)

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31
Q

Which pancreatic cells secrete glucagon?

A

alpha cells of the islets of Langerhans

  • glucagon releases glucose from the liver and fatty acids from fat tissue. In turn, glucose and free fatty acids favour insulin release and inhibit glucagon release
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32
Q

What is the usual mechanism for PCL tear?

A

Anterior force onto knee
(classic ex: MVA where pt’s leg hits dashboard)

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33
Q

What is the usual mechanism for ACL tear?

A

Non-contact pivoting injury
(common in football)

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34
Q

Where is the Tzank smear useful?

A

HSV

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35
Q

Causative agent for syphilis

A

Treponema pallidum

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36
Q

PPI medications classically cause this electrolyte abnormality

A

Hypomagnesemia
(decreased magnesium)

Prolonged QT

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37
Q

Ascending paralysis post influenza vaccine

A

Guillain-Barré Syndrome

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38
Q

Antidote for Acetaminophen overdose

A

N-acetylcysteine (NAC)

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39
Q

This malignancy classically has “smudge cells” on peripheral smear

A

Chronic lymphocytic leukemia (CLL)

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40
Q

Initial treatment for stable patients presenting with SVT

A

Vagal maneuver

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41
Q

Subsequent treatment (medication) if vagal maneuvers fail in SVT

A

Adenosine

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42
Q

Causative agent for 5ths disease (erythema infectiosum)

A

parvovirus B19

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43
Q

Age for colonoscopy screening in asymptomatic patient with no FH (careful….)

A

50

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44
Q

What is the condition that pts can cause themselves by using nasal decongestants too much?

A

Rhinitis medicamentosa

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45
Q

This medication class commonly used for fungal infections prolongs the QT

A

-azoles

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46
Q

This is the most common EKG finding in pulmonary embolus (careful…)

A

T wave inversion
S1Q3T3
Sinus tachycardia

T wave inversion in the anterior leads represent reciprocal changes related to infero-posterior ischemia due to compression of the right coronary artery (RCA), caused by pressure overload in the right ventricle following an acute PE

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47
Q

This is the tumor marker for some liver cancers

A

Alpha-fetoprotein (AFP) blood test

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48
Q

What is CN 8 and how might an abnormality of it present?

A

Vestibulocochlear
Schwanomma tumor - hx usually is 40-50yo with hearing loss, speech discrimination issues, and pain

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49
Q

What does a U-wave on ECG represent?

A

Hypokalemia

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50
Q

What HTN med can cause hypokalemia?

A

HCTZ and furosemide (Lasix)

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51
Q

What HTN med can cause hyperkalemia?

A

ACEi, Spironolactone

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52
Q

What should we do to a patient who has pain over the anatomical snuffbox but normal x-ray?

A

Thumb spica cast

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53
Q

This TB drug classically causes alteration of color vision.

A

Ethambutol

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54
Q

This fracture classically has a “dinner fork deformity”

A

Colles fracture

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55
Q

X-ray of this disease shows a “pencil in a cup” deformity

A

Psoriatic arthritis

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56
Q

This specific medicine is treatment and prophylaxis for Pneumocystis jiroveci pneumonia in HIV/AIDs patients

A

Bactrim

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57
Q

What is the key exam finding for differentiating orbital cellulitis from pre-septal cellulitis (specific test)

A

Pain with EOM is present in orbital cellulitis

Pain with EOM is absent in preseptal cellulitis

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58
Q

This anti-hypertensive class is known for causing peripheral edema as a side effect

A

Calcium channel blockers

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59
Q

Sickle cell patients are more prone to develop infection with this organism

A

Salmonella, Strep pneumo, H influenze type b (Hib)

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60
Q

What is the probability that two individuals who are carriers of sickle cell trait produce an offspring who is autosomal recessive and therefore afflicted with sickle cell disease?

A

25%

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61
Q

Aspirin is used in Kawasaki disease for what reason?

A

To prevent coronary artery aneurysm

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62
Q

What disease classically impacts the terminal ileum?

A

Crohn’s disease

  • transmural inflammation (affects all layers of intestinal mucosa)
  • can affects anywhere from mouth to anus (discontinuous) – Rectum usually spared
63
Q

What cardiac enzyme is best for reinfarction?

A

CK-MB

  • unlike troponin, CK-MB quickly returns back to normal. b/c troponin will still be elevated (from 1st infarct), CK-MB makes it the best test for current infarction
64
Q

What triglyceride level puts you at risk for pancreatitis?

A

800-1000 mg/dL

65
Q

What are the 4 indications for statin therapy?

A
  1. Confirmed ASCVD (atherosclerotic cardiovascular disease): MI, angina, stroke, PAD, TIA, AAA
  2. LDL >190 mg/dL & age >21
  3. Diabetics age 40-75 with LDL >70
  4. Age 40-75 w/10-yr. ASCVD risk calculator >7.5%
66
Q

What causes Giardia?
How does it present?
How do you treat?

A

Someone who drank stream water that was not filtered
Foul smelling, floating stools described as sulphury
Tx w Metronidazole (Don’t forget pt edu: NO alcohol)

67
Q

2 common causes of hypercalcemia

A

Hyperparathyroidism
Malignancy

68
Q

What two hormones are produced by the posterior pituitary?

A

Oxytocin and ADH

69
Q

Best test for acromegaly?

What are pts with acromegaly at risk for?

A

IGF-1

At risk for CAD, CHF, and colon cancer

70
Q

What might a pt with acromegaly have in their history?

A

Increasing hat, glove or ring size

71
Q

Treatment for acromegaly

A

Dopamine agonist, such as bromocriptine

72
Q

52yo with unexplained iron deficiency anemia — what should you be thinking?

A

Colon cancer
(slow bleeding loss in stool over time)
—–> get colonoscopy

73
Q

Ovarian cancer tumor marker

74
Q

Pancreatic cancer tumor marker

75
Q

Young, healthy female with balance issues, trouble holding urine, and eye color changes?

A

Multiple sclerosis

76
Q

How does atropine affect the pupil?

A

It causes dilation bc it’s an anticholinergic

77
Q

Initial treatment for acute angle closure glaucoma

A

Acetazolamide
(diuretic that helps lower intraocular pressure)

78
Q

Buildup of aqueous humor causes what?

A

Increased IOP and pupil dilation

79
Q

1 cause of Torsades

#2 cause of Torsades

A

1 Hypomagnesemia

#2 Hypokalemia

80
Q

What medication keeps ductus arteriosus open?

A

Prostaglandin E

81
Q

What medications closes ductus arteriosus?

A

Indomethacin

82
Q

This diagnosis is an emergency and presents with eye pain/redness, a fixed mid-dilated pupil, nausea and vomiting

83
Q

This disease causes severe pruritus in the web spaces and is classically worse at night

84
Q

This hematologic disorder is classically associationed with the Philadelphia chromosome

85
Q

This must be ruled out in all nasal trauma, given that missing the diagnosis can result in septum necrosis

A

Septal hematoma

86
Q

This anti-hypertensive classically causes peripheral edema

87
Q

This anti-hypertensive is relatively contraindicated in asthma and COPD, given its ability to cause bronchospasm

88
Q

This murmur classically radiates to the axillary region

A

Mitral regurgitation

89
Q

This exam can help differentiate scleritis from episcleritis

A

Cotton tip maneuver

Episcleritis is the movable vessels

90
Q

This infectious disorder presents with laryngospasm

A

Rabies/Epiglottitis

91
Q

TM rupture due to barotrauma most likely presents on what part of an airplane flight

A

Descending

92
Q

This class of anti-hypertensives classically causes cough, angioedema, and hyperkalemia

93
Q

This diuretic causes ototoxicity and hypokalemia

A

Furosemide (Lasix)

94
Q

This test, when positive, shows an involuntary flexion of the hips/knees with passive neck flexion

A

Brudzinski

95
Q

This antibiotic is most classically associated with causing Clostridium difficile diarrhea

A

Cephalosporin

Esp. Clindamycin

96
Q

This antibiotic causes Red Man Syndrome

A

Vancomycin

97
Q

This is the imaging test of choice to rule out acute stroke in the ED

98
Q

An actinic keratosis is a precursor to what malignancy?

99
Q

This dermatome level is at the umbilicus

100
Q

Koplik spots are associated with what preventable disease?

A

Measles aka Rubeola

101
Q

What is the first-line antibiotic for acute otitis media (assuming to allergies)?

A

Amoxicillin

102
Q

This is the name for the flapping tremor in the hands seen in advanced cirrhosis/liver disease?

103
Q

This is the organism responsible for cat-scratch fever

A

Bartonella henselae

104
Q

This is the first-line antibiotic for cat-scratch fever

A

Azithromycin

105
Q

This “machine-like” murmur can be closed with indomethacin

A

Patent Ductus Arteriosus

106
Q

This is the electrolyte abnormality commonly seen as a side effect of Spironolactone

A

Hyperkalemia

107
Q

This common over-the-counter medication can cause tinnitus as a side effect when taken in excess

108
Q

This structure is classically spared in benign eye conditions (episcleritis, conjunctivitis) but typically shows erythema in deeper eye pathology

109
Q

Cherry red spots seen on funoscopy

A

Central Retinal Artery Occlusion

110
Q

If you saw papilledema on funoscopy, which diagnostic procedure is contraindicated?

A

Lumbar puncture

111
Q

Which has higher propensity to progress to malignancy, leukoplakia or erythroplakia?

A

Erythroplakia

112
Q

Which murmurs increase on inspiration? And on expiration?

A

Right-sided murmurs increase on inspiration
Left-sided murmurs increase on expiration

113
Q

Parotid gland enlargement, orchitis, and possible pancreatitis can be caused by what?

114
Q

What virus causes mumps?

A

Paramyxovirus

115
Q

What virus causes erythema infectiosum aka Fifths disease?

A

Parvovirus B19

116
Q

What malignancy may present with hoarseness/dysphonia?

A

Laryngeal cancer

117
Q

Giant cell arteritis is associated with what disorder

A

Polymyalgia Rheumatica

118
Q

This is the term for normal age-related vision changes

A

Presbyopia

119
Q

Tall, peaked T waves on ECG are earliest finding of what electrolyte abnormality?

A

Hyperkalemia

120
Q

A patient with tall, peaked T waves is most likely on what medication?

A

Spironolactone, ACEi

121
Q

Nasal polyps, low growth curves and frequent URIs should make you think of what disease?

122
Q

This type of brain injury impacts the “bridging veins”

A

Subdural hematoma

123
Q

A tall, skinny male presents with acute onset SOB and chest pain

A

Pneumothorax

124
Q

This dermatologic problem classically is seen in the summer, starts with a herald patch and then ultimately lasts 3-8 weeks in a Christmas tree pattern

A

Pityriasis rosea

125
Q

Prognosis in melanoma typically relates to what?

A

Depth/thickness of lesion

126
Q

A patient using a beta agonist too frequently or more than prescribed is at risk for what electrolyte abnormality?

A

Hyperkalemia

127
Q

What is an Osborn J wave and what condition will it be seen on EKG?

A

Notched downstroke QRS; reversed delta waves
Hypothermia

128
Q

This type of thyroid cancer is most common and carries the best prognosis?

129
Q

This disease classically has bilateral hilar lymphadenopathy

A

Sarcoidosis

130
Q

This is the somewhat unusual/not commonly ordered lab test that is elevated in sarcoidosis

131
Q

Special test most sensitive for ACL tear?

132
Q

Best abortive option for acute cluster headache

133
Q

14yo unvaccinated make with gray pseudomembranes in throat?

A

Diphtheria

134
Q

A 14 year old male presents after a syncopal episode during a football game. His EKG shows deep septal Q Waves. What is the diagnosis?

135
Q

What is the treatment for 1st degree heart block?

A

Nothing
if symptomatic, can give 0.5mg Atropine

136
Q

A 62 year old male with BPH and inability to urinate will most likely have what type of renal injury (pre-renal, intrinsic, or post-renal) if obstruction is not relieved?

A

Post-renal

137
Q

Use of strong topical steroids should be avoided in thin skinned areas for what reason?

A

It causes skin thinning/atrophy

138
Q

What disorder has “exclamation point hairs” viewed under microscopy?

A

Alopecia areata

139
Q

A strawberry cervix corresponds with what disorder?

A

Trichomonas

140
Q

Best abortive option for an acute cluster headache

A

100% O2, subq sumatriptan

140
Q

Best abortive option for an acute cluster headache

A

100% O2, subq sumatriptan

141
Q

This cholesterol medication classically causes facial flushing

142
Q

What is the Chvostek sign and what does it indicate?

A

Spasm of the facial nerve area caused by tapping
Hypocalcemia

143
Q

Which Salter Harris fracture is the most common?

144
Q

Which Salter Harris fracture is associated with a crush injury?

145
Q

Criteria to diagnose DM

A

FBG > 126
or
Random glucose > 200 WITH symptoms
or
A1C > 6.5

146
Q

Mid-fixed, dilated pupil and a steamy cornea

A

Acute angle closure glaucoma

147
Q

Presentation and Tx for acute angle closure glaucoma

A

Pt usually was in an environment with a change of light (ex movie theater) and suddenly have severe eye pain, N/V

PE show a mid-fixed, dilated pupil and a steamy cornea

1st line: Azetazolamide + topical BB to reduce IOP

148
Q

Dx Menopause

149
Q

Best test to dx acromegaly

150
Q

Tx for acromegaly

A

Dopamine agonist, such as bromocriptine

151
Q

Which is louder at the apex… S1 or S2?

152
Q

Cold shocks

A

Hypovolemic
Cardiogenic

153
Q

Warm shocks

A

Anaphylactic
Septic

Pearls from Dan (1 decks)

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