The Finals Step (Key Words to Know) Flashcards
1
Q
What age should patients begin getting DEXA scans? (male and female)
A
70 for males 65 for females
2
Q
Fracture that is the number one cause of compartment syndrome
A
Tibial shaft
3
Q
condition with positive smitha nitobdy and positive double stand DNA antibodies.
A
Lupus
4
Q
best diagnostics for osteomyelitits
A
Bone scan or MRI
5
Q
a painless mass in a wrist is most likely
A
ganglion cyst
6
Q
benign bone tumor often in males that presents with severe pain, often at night
A
osteoid osteoma
7
Q
what medication will help an osteoid osteoma?
A
ibuprofen
8
Q
clicking or locking of the knee suggests what dx?
A
meniscal tear
9
Q
if synvoial fluid contains positive bifingent crystals what condition does it inidcate?
A
pseudogout
10
Q
A patient with a history of hepatitis B presents
complaning of bilateral knee pain, fever and weight
loss. What is the most likely diagnosis?
A
polyarteritis nodosa
11
Q
Tx for polyarteritits nodosa
A
high dose steroids (confirm dx by biopsy)
12
Q
a positive neer’s test indicates what?
A
rotator cuff impingement
13
Q
What is the Schirmer test used for?
A
Sjogrens
14
Q
Tx for lupus
A
Systemic steroids
15
Q
There are 5 main characteristics of the limited form of scleroderma which are described by CREST. name these.
A
Calcinosis Raynaud's Esophageal motility Sclerodactyly Telangiectasia
16
Q
What ligament is most commonly injured in an ankle sprain?
A
anteriortalofibular
17
Q
mot common fracture in children
A
clavicle
18
Q
A patient presents with progressive neck and
proximal muscle weakness. On physical exam you
see a reddish purple maculopapular rash. Her lab
work shows an anti Jo 1 antibodies. What is the
most likely diagnosis?
A
Polymyositis
19
Q
which way does a colles fracture angulate?
A
dosrally
20
Q
which way does a smith fracture angulate?
A
vollarly
21
Q
A 15 year old boy presents complaining of night
pain in the pelvis. Since you have no idea what
to do you order an x-ray. The report comes back
with a description of a mass with an “onion skin
appearance.” What is the most likely diagnosis?
A
Ewing sarcoma
22
Q
A patient with HIV presents with severe groin pain.
What is the most likely diagnosis?
A
Avascular necrosis of the femoral
head. Antiretroviral medications put
patients at an increased risk of AVN.
23
Q
medical term for tennis elbow
A
lateral epicondylitits
24
Q
medical term for golf elbow
A
medial epicondylitits
25
most useful test for ACL tear
Lachman's
26
A 46 year old male comes into ER limping a little
on the right side. He states that it felt as though he
was kicked in the back of the leg during a soccer
game, but clearly no one was behind him. What is
the most likely diagnosis?
Achilles tendon rupture
27
a positive crossover test indicated what diagnosis?
Acromioclavicular joint injury (AC joint)
28
positive hawkins test indicates what diagnosis?
rotator cuff impingement
29
a positive straight leg test indicates what?
herniated disc
30
a positive straight leg test indicates what?
herniated disc
31
6 medications that can be used for migraine prophylaxis
Beta blockers, tricyclics, calcium
channel blockers, NSAIDs and
valproic acid.
32
A patient is brought in following a seizure in which
she did not lose consciousness. What is the most
likely diagnosis?
simple partial seizure
33
A patient presents with a painful ipsilateral third
| nerve palsy. What is the most likely diagnosis?
posterior communicating artery aneurysm (PCOM)
34
Decreased GABA and substance P should make you
| think of what diagnosis?
Huntington's
35
80% of strokes are ______
ischemic
36
You believe a patient has had a stroke. He presents
with aphasia, loss of hearing in one ear and loss of
vision in his left eye. Is the blockage likely in the
anterior or posterior circulation?
posterior
37
A patient who is asymptomatic should consider
having an endarterectomy at what percent
blockage of the carotid artery? How about in a
symptomatic patient?
70% in an asymptomatic patient and
greater than 60% in a symptomatic
patient.
38
Sign where When you lift the patient's head the
| patient bends his hips
Brudzinski's sign.
39
There is an MRI result of multiple foci of
demyelination in the white matter. What is the
most likely diagnosis?
multiple sclerosis
40
A patient presents to your office complaining of
a tremor in his right hand. He states after a beer
it goes away completely. What is the most likely
diagnosis?
benign essential tremor or familial tremor
41
A 35 year old patient comes to your office because
his wife made him. He has been increasingly
irritable and moody. She has also noticed that he
is very restless. You order a CT scan which shows
cerebral atrophy as well as atrophy of the caudate
nucleus. What is the most likely diagnosis?
Huntington's Disease
42
Med of choice for Tourette's
Haloperiodol
43
a slit lamp shows Kayser-Fleischer rings indicate what?
Wilson's disease
44
A lumbar puncture for a patient with bacterial
meningitis will show elevated or decreased wbc's?
Glucose? Protein?
Elevated wbc's, decreased glucose
| and elevated protein.
45
Duchenne's and Becker's muscular dystrophy have
| what genetic characteristic?
X linked recessive
46
Duchenne's and Becker's muscular dystrophy have
| what genetic characteristic?
X linked recessive
47
An EEG showing generalized spikes and associated
slow waves should make you think of what
diagnosis?
generalized or absence seizure
48
most common primary intracranial neoplasm
glioma
49
What are the most common primary cancer sites
| that metastasize to the brain?
lung, breast, and kidney
50
Weakness and numbness in the left hand might be
| a blockage in which carotid artery?
right
51
Which nerve root is responsible for the knee jerk
| reflex?
L3-L4
52
An EEG showing interictal spikes should make you
| think of what diagnosis?
complex partial seizure
53
most commonly herniated vertebral disc?
L4-L5 followed by L5-S1
54
What three symptoms are classic for a normal
| pressure hydrocephalus?
gait disturbance, dementia, and urinary incontinence
55
A patient complains of muscle weakness and
fatigability that improves with rest. What is the
most likely diagnosis?
myasthenia gravis
56
Lead pipe or cogwheel rigidity should make you
| think of what diagnosis?
parkinson's disease
57
Lead pipe or cogwheel rigidity should make you
| think of what diagnosis?
parkinson's disease
58
Type of hallucinations most common with schizoprhenia
auditory
59
what causes anorexic patients to have osteopenia
decrease in estrogen
60
3 positive symptoms of schizophrenia
hallucinations, delusions, movement disorders
61
med used to treat pospastrum women with depression
sertraline
62
A patient has very strange magical thinking. What
| is the most likely diagnosis?
schizotypal personality disorder
63
4 symptoms of serotonin syndrom
Hyperthermia
seizure
mental status change
tremor.
64
At what BMI should a patient be hospitalized for anorexia
BMI of
65
A patient of yours always craves attention, often
using sex as a tool to gain it. She often acts like a
child when she does not get her way? What is the
most likely diagnosis?
histrionic personality disorder
66
what is russell's sign?
abraded knuckles from forcing oneself to vomit
67
A psychiatric patient presents with confusion,
fever and lead pipe rigidity. What is the most likely
diagnosis?
Neuroleptic malignant syndrome,
this can occur with high dose
antipsychotics.
68
What is the time frame for the first symptoms of
| withdrawal from alcohol?
tremor in 8-18 hours
69
What is the time frame for the first symptoms of
| withdrawal from alcohol?
tremor in 8-18 hours
70
What are three things in your differential if you
| have a paradoxical pulse?
Cardiac tamponade, pericarditis and
| obstructive lung disease
71
normal size of aorta on palpation
72
a fix S2 should make you think of what?
ASD
73
a continuous, machine like murmur indicates what?
PDA (patent ductus arteriosus)
74
what type blocker do you use on someone with a pheo as they wait for surgery
alpha blocker
75
2 abx that are first line treatment for endocaritits
vanco and ceftriaxone
76
2 abx that are first line treatment for endocaritits
vanco and ceftriaxone
77
Tx for PDA
Indomethacin
78
subacute endocarditits is often caused by what organism?
strep viridans
79
most common place for an aortic aneurysm
in the abdomen below the renal arteries
80
giant cell arteritis is associated with what rheumatologic condition?
polymyalgia rheumatica
81
a bisphasic p wave should make you think of what?
left atrial enlargement
82
Lead I has a QRS that is up and the AVF lead has
a QRS complex that is down. Does this represent
normal axis, left axis deviation or right axis
deviation?
left axis deviation
83
first line medication for symptomatic bradycardia
atropine
84
Tx for polymyalgia rheumatic
low dose prednisone
85
An EKG shows a regular rate of fifty beats per
minute. The QRS is narrow and there is no visible
P wave. What is the most likely diagnosis?
junctional rhythm
86
An EKG shows a regular rate of fifty beats per
minute. The QRS is narrow and there is no visible
P wave. What is the most likely diagnosis?
junctional rhythm
87
common cause of a junctional rhythm?
digitoxin toxicity
88
medication class used to lower triglycerides
fibric acid derivatives
89
Tall peaked P waves should make you think of what
| diagnosis?
right atrial enlargement
90
1st line tx for genital warts?
imiquimod (aldara)
91
What two hormones are secreted by the posterior
| pituitary?
Oxytocin and antidiuretic hormone
| ADH, vasopressin
92
most common pituitary adenoma
prolactinoma
93
diabetes insipidus is a lack of what hormone?
antidiuretic hormone (vasopressin)
94
most common thyroid cancer
papillary
95
What medication might you use prior to
| thyroidectomy in a patient with hyperthyroidism?
Methimazole or propylthiouracil
| PTU
96
What is the most common cause of
| hypoparathyroid?
Post thyroidectomy with the
| complication of parathyroidectomy
97
Tap on facial nerve and get a twitch
| with low Ca.
Chvostek's sign
98
Inflate BP cuff and hold for 3
minutes. Patient with low Ca will get
carpel tunnel symptoms.
Trousseau's sign
99
Inflate BP cuff and hold for 3
minutes. Patient with low Ca will get
carpel tunnel symptoms.
Trousseau's sign
100
What is the most common cause of
| hyperparathyroidism?
Single parathyroid adenoma in 80%
| of cases.
101
In Cushing’s disease is ACTH elevated or
| decreased?
elevaged
102
ectopic tumors that may produce ACTH
| and give a patient Cushing's syndrome?
Small cell lung cancer, pancreatic
| islet cells, thymomas.
103
What is the test to begin with if you suspect
| pheochromocytoma?
24 hour urine for catecholamines.
104
Reduced insulin response between
| 5 and 8 am.
dawn phenomenon
105
How do sulfonylureas medications work?
stimulate inulin production
106
MOA of metformmin
Decreases the hepatic glucose
production and increases peripheral
glucose uptake.
107
5 criteria for metabolic syndrome
HDL 135/85, Triglycerides >150, Fasting
glucose >100, Waist >40 inches in
men >35 inches in women.
108
these findings make you think of what Moon face, buffalo hump, purple
strai, central obesity, supraclavicular
fat pads, easy bruising
cushing syndrome
109
What role does c-peptide play in the diagnosis of
| diabetes?
it is a marker of insulin production.
Elevated C-peptide points to DM 2.
Decreased c-peptide points towards
DM 1.
110
What role does c-peptide play in the diagnosis of
| diabetes?
it is a marker of insulin production.
Elevated C-peptide points to DM 2.
Decreased c-peptide points towards
DM 1.
111
What is a test for lactose intolerance?
hydrogen breath test
112
Sjogrens syndrome has what antibody markers?
Ro and Lo
113
acute sinusitits is most commonly caused by what 2 pathogens?
Strep pneumo and h. flu
114
List the time of year when each of the following
allergens is most prominent: pollen, grass, mold
and ragweed.
Pollen tree and flower = spring,
grasses are the summer, mold and
ragweed are fall.
115
List the four things that suggest group A beta
| hemolytic strep in a patient with pharyngitis.
Fever, tender anterior cervical
adenopathy, no cough and an
exudate in the throat.
116
tx for epiglottits
2nd or 3rd gen cephalopsorin (cefuroxime, ceftriaxone)
117
What virus causes mumps?
Paramyxovirus
118
Acute swelling and pain in the cheek that increases
| at meals. What is the most likely diagnosis?
Sialadenitis (salivary gland infection)
| - Staph aureus.
119
A pateint with a history of smoking presents with
a new onset hoarsness. This has been persistant
for the past two weeks. What is the most likely
diagnosis?
Laryngeal squamous cell carcinoma
120
A patient presents with acute onset of continuous
severe vertigo for the past five days. He does have
a history of URI 2 weeks ago. What is the most
likely diagnosis?
Labrynthitis
121
Both testicles should be descended by what age?
3 months
122
Maltese crosses in the urine should make you think
| of what diagnosis?
nephrotic syndrome
123
What is the most likely diagnosis for a free floating,
painless, cystic mass found posterior and superior
to the testis?
spermatocele
124
tx for epididymitis?
ceftriaxone and doxycycline
125
1st line abx for prostatitis?
bactrim for 4-6 weeks
126
most common bladder cancer
transitional cell carcinoma
127
painless hematuria usually indicates what?
bladder cancer
128
painless hematuria usually indicates what?
bladder cancer
129
Name the condition in which the head of the penis
curves downward or upward, at the junction of
the head and shaft of the penis. (Hint: It is often
associated with hypospadias.)
Chordee
130
A 3 year old boy presents with hematuria and a
painless palpable abdominal mass. What is the
most likely diagnosis?
Wilms tumor
131
Muddy brown sediment in the urine should make
| you think of what diagnosis?
acute tubular necrosis
132
Tea colored urine with red cell casts should make
| you think of what diagnosis?
glomerularnephritis
133
A urine protein of >3.5 grams/day should make
| you think of what diagnosis?
nephrotic syndrome
134
A urine protein of >3.5 grams/day should make
| you think of what diagnosis?
nephrotic syndrome
135
At what age do you begin screening patients for
| prostate cancer? What two tests are used?
At age 50 an annual digital rectal
| exam and a PSA are recommended.
136
What is the most common type of testicular
| cancer?
Nonseminoma
137
What molecule binds iron in the blood stream?
Transferrin
138
A low retic count and a normal serum ferritin
| should make you think of what diagnosis?
anemia of chronic disease
139
How do you treat a sickle cell crisis?
Fluids, oxygen, pain medication,
| transfusion may be necessary
140
Will unconjugated bilirubin be high or low in a
| patient with sickle cell disease?
high
141
Which anemia should you think of if you see the
| term Howell-Jolly bodies?
Sickle cell due to the functional
asplenia, but it may also show up in
folic acid deficiency.
142
G6PD deficiency follows what pattern of
| inheritance?
x-linked
143
List the three diagnosis you should be thinking of if
| a question includes Heinz bodies.
G6PD deficiency anemia, chronic liver
| disease, alpha thalassemia.
144
What is Schilling's test used for?
test for cause of B12 deficiency
145
disease states with basophilic stippling
Lead poisoning, Beta or alpha
thalassemia, sideroblastic anemia,
arsenic poisoning.
146
disease states with basophilic stippling
Lead poisoning, Beta or alpha
thalassemia, sideroblastic anemia,
arsenic poisoning.
147
Owl eye inclusion bodies should make you think of
| what diagnosis?
Cytomegalovirus (CMV)
148
What is the treatment for pertussis?
erythromycin x 7 days
149
A leukemia patient has a CT of the liver which
shows punched out lesions. What diagnosis should
you be thinking of?
hepatsplenic candida
150
What disease does Rickettsia rickettsii cause?
Rocky mountain spotted fever
151
An inda ink stain showing cysts should make you
| think of what diagnosis?
Cryptococcosis
152
A COPD patient has apical cavities and calcified
nodes on his chest x-ray. You also discover he has
a pet bat and a few birds. What is the most likely
diagnosis?
Histoplasmosis
153
What type of organism causes botulism?
gram + rod clostrdium botulinum
154
tx for botulism
antitoxin
155
Rice water stool should make you think of what
| diagnosis?
cholera
156
A stuck on grey membrane in the pharynx should
| make you think of what diagnosis?
Diphtheria
157
What type of organism is tetanus?
A Gram + rod, Clostridium tetani
158
A patient ate out last night and today has cramping
and bloody diarrhea. What is the most likely
organism?
Salmonella
159
Diarrhea with blood and mucus should make you
| think of what diagnosis?
shigella
160
What is the best test to diagnose malaria?
peripheral blood smear
161
tx for shigella
Bactrim or fluoroquinolones and
| hydration.
162
What organism causes lyme disease?
Borrelia burgdorferi
163
What is the drug of choice to treat Lyme disease in
| kids or pregnant women?
amoxicillin
164
What drug is used for the treatment or prophylaxis
| of malaria?
chloroquine
165
A patient was camping a few days ago and now
has a rash that began on his wrists and ankles.
What is the most likely diagnosis?
rocky mountain spotted fever
166
DOC for rocky mountain spotted fever
doxycycline
167
Any reference to dark field microscopy should make
| you think of what organism?
treponema pallidus (syphillis)
168
A patient being treated with penicillin for a syphilis
infection develops fever, chills, muscle pain and
headaches. Do you stop treatment?
```
No this is Jarisch-Herxheimer
reaction. The patient must be closely
monitored, but it is a response to
released endotoxin from the death
of the spirochetes and not an allergic
reaction.
```
169
tx for cholera
fluids
170
What is the current drug of choice for the
| cytomegalovirus?
Ganciclovir
171
What is the current drug of choice for the
| cytomegalovirus?
Ganciclovir
172
What is the first symptom of a rabies infection?
pain and anesthesia at the site of the bite
173
Name three serious reactions a patient may have
| with the use of vancomycin??
Nephrotoxicity, ototoxicity and
| Stevens-Johnson syndrome.
174
What tests are done to screen for HIV?
ELISA and then if the positive
diagnosis is confirmed with a western
blot test.
175
What is the treatment for a tetanus infections?
Penicillin, immune globulin
and supportive care (especially
respiratory support)
176
How do hookworm larvae enter the body?
They penetrate the skin usually
| through the soles of the feet.
177
DOC for toxoplasmosis (ring enhancing lesions on CT scan in an HIV positive patient)
bactrim
178
What drug do you use to treat pinworm?
You treat everyone in the house with
albendazole. Two weeks later you
treat them again.
179
A Gram positive organism in chains should make
| you think of what diagnosis?
strep
180
A Gram negative diplococci should make you think
| of what diagnosis?
neisseria
181
What is the most common prophylactic antibiotic
| used preoperatively?
Cephalexin (Ancef)
182
What oral antibiotic can be used for pseudomonas?
ciprofloxacin
183
```
What class of antibiotics should you start with for
community acquired pneumonia?
```
macrolides (erythromycin, azithromycin, clarithrymycin)
184
Pizza pie retinopathy should make you think of
| what diagnosis?
cytomegalovirus (CMV)
185
A patient presents complaining of a metallic taste
in her mouth and dark brown urine. What antibiotic
might she be on?
metronidazole (flagyl)
186
Name one oral medication that can be used for
| MRSA.
linezolid and bactrim
187
Gummas or granulomatous nodules should make
| you think of what diagnosis?
tertiary syphillis
188
Community acquired carditis is most often caused
by one of the HACEK organisms. List the HACEK
organisms.
Haemophilus, Actinobacillus,
| Cardiobacterium, Eikenella, Kingella.
189
What is the best test for diagnosing rocky mountain
| spotted fever?
Indirect Immunofluorescent
| antibodies.
190
A Gram negative coccobaccili found in the sputum
of patient with pneumonia should make you think
of what diagonsis?
H. flu
191
A Gram negative coccobaccili found in the sputum
of patient with pneumonia should make you think
of what diagnosis?
H. flu
192
Purulent cervical discharge should make you think
| of what diagnosis?
N gonorrhea
193
What three labs should you order if you are
| considering secondary amenorrhea?
beta HCG, TSH, Prolactin
194
What is the most common uterine tumor?
Leiomyoma, also known as fibroids.
195
At what age is primary amenorrhea diagnosed?
Age 14 if no secondary sex
characteristics. Age 16 if some
secondary development.
196
What is the first line treatment for mastitis?
Dicloxacillin is fist line. Cephalexin or
| erythromycin are second line.
197
At how many weeks of pregnancy can an
| amniocentesis be done?
15-20 weeks
198
list some risk factors for breast cancer
BRCA1 or BRCA2 positive, unopposed
estrogen, nulliparity, early menarche,
late menopause
199
List two medications commonly used for
| hypertension in pregnancy.
Methyldopa and labetalol
200
What is the classic triad of pre-eclampsia?
HTN, edema and proteinuria
201
preterm labor
20-37 weeks
202
A patient with primary amenorrhea and a low FSH
| should make you think of what diagnosis?
Hypothalamic pituitary insufficiency.
203
risk factors for ovarian cancer
BRCA1, Family history, Nulliparity,
| late menopause, caucasian, asian.
204
when does quickening occur
Nulliparous 18-20 weeks, multiparous
| 14-16 weeks.
205
RF for placental abruption
HTN, smoking, AMA, cocaine use,
| PROM.
206
RF for placental abruption
HTN, smoking, AMA, cocaine use,
| PROM.
207
What is the most common endometrial cancer?
75% are adenocarcinomas
208
A strawberry cervix with copious yellow/green
discharge should make you think of what
diagnosis?
trichomonas
209
What organism causes us to warn pregnant
patients to stay away from deli meats and soft
cheeses?
Listeria
210
What are two medications used to induce labor?
Cervidil (prostoglandin gel applied
to the cervix) which encourages
cervical rippening and oxytocin which
encourages uterine contractions.
211
As part of the antepartum testing a baby has a
| positive stress test. What does that mean?
```
They have had two heart rate
accelerations in a 20 minute period
of 15 beats above baseline for at
least 15 seconds. This is a good
thing.
```
212
What is the most common type of ovarian cyst?
Functional cyst - no treatment
| necessary.
213
risk factors for endometrial cancer.
Chronic unopposed estrogen,
nulliparity, early menarche, late
menopause, Tamoxifen, DM, obesity,
HTN, breast CA, ovarian CA
214
How many days after conception is a serum beta
| HCG positive?
8
215
Grape like vesicles or a sack of grapes on
ultrasound should make you think of what
diagnosis?
Hydatidiform mole
216
What medication is used to increase surfactant
levels and help with lung maturity if you are
worried about preterm labor?
betamethasone
217
What are two tocolytic medications you should be
| aware of?
Magnesium sulfate and calcium
| channel blockers
218
Gestational diabetes puts mom and baby at
| increased risk of for what three things?
Preeclampsia, macrosomia (traumatic
birth), slowing in fetal lung
development.
219
```
What medication(s) are used to treat a postpartum
metritis?
```
Clindamycin and gentamicin together
220
Define procidentia.
Uterine prolapse beyond the the
| introitus.
221
What is the formula for calculating estimated date
| of confinement or due date?
First day of last menstrual period + 7
| days - 3 months.
222
What is the formula for calculating estimated date
| of confinement or due date?
First day of last menstrual period + 7
| days - 3 months.
223
What is the #1 cause of retinal artery occlusion?
Carotid atherosclerotic disease.
224
A fundal exam shows a cherry red spot. What
| diagnosis should you be thinking of?
central retinal artery occlusion
225
What should a primary care provider do for
| presumed central retinal artery occlusion?
Ophthalmic emergency! Refer and
intermittent pressure and release of
the eye.
226
A patient presents with unilateral blurriness
developing over a few days. Fundal exam shows
a "blood and thunder" pattern. What is the most
likely diagnosis?
Central vein occlusion
227
What is appropriate treatment for central vein
| occlusion?
Typically self limited. Treat underlying
| disease.
228
Give two risk factors for glaucoma.
African American descent and
| diabetes
229
What is the yellow, brown fleshy mass on the
conjunctiva which usually does not interfere with
vision?
Pinguecula
230
A fundal exam shows a cup to disc ratio of >0.5.
There are also vessels bending over the disc. What
is the most likely diagnosis?
Glaucoma
231
A patient has metamorphopsia and a central blind
| spot. What is the most likely diagnosis?
Macular degeneration
232
What is the most likely quadrant for a retinal
| detachment?
Superior temporal
233
A patient presents with pain in one eye. The cornea
is hazy and the pupils are fixed. What is the most
likely diagnosis?
Glaucoma
234
You notice drusen deposits on fundal exam. What
| is the most likely diagnosis?
macular degeneration
235
type of distorted vision in which a grid of straight lines appears wavy and parts of the grid may appear blank. It is mainly associated with macular degeneration,
metamorphopsia
236
What is the most common way of testing for
| metamorphopsia?
Amsler grid
237
A patient presents with irritated, burning and
tearing eyes. You notice some scurf and scales.
Where do you begin treatment?
This is blepharitis. Treatment begins
with good hygiene and moves on to
topical antibiotics if necessary.
238
A fundal exam shows an opalescent retina and
boxcarring of arterioles. What is the most likely
diagnosis?
Central retinal artery occlusion.
239
What is the most common preceding event for
| orbital cellulitis?
URI
240
You notice a bowing of the iris on exam. What is
| the most likely diagnosis?
glaucoma
241
A patient presents with watery bilateral discharge
from the eyes and nontender preauricular
adenopathy. What is the most likely diagnosis?
What is the most common pathogen?
Viral conjunctivitis. Adenovirus.
242
What is the name for the the triangular or wedge
shaped growth on the conjunctiva that may
interfere with vision?
Pterygium
243
A patient having recently undergone cataract
surgery presents complaining of vision loss in the
operative eye. What is the most likely diagnosis?
retinal detachment
244
A patient presents with sudden painless complete
unilateral vision loss. What is the most likely
diagnosis?
Central retinal artery occlusion
245
Which nerve is involved in herpes zoster
| ophthalmicus?
Trigeminal nerve, CN 5
246
A patient presents with a dense corneal infiltrate
and an epithelial defect seen with fluorescein stain.
What diagnosis should you be thinking of?
corneal ulcer
247
A feathery border in an eye exam should make you
| think of what diagnosis?
fungal infection
248
What is the first thing you should be thinking of if a
pediatric patient comes in with blood in the anterior
chamber of the eye (hyphema).
child abuse
249
What is the term for being nearsighted? What type
| of lens do you use to correct it?
Myopia, concave lenses
250
What is the first line treatment for orbital cellulitis?
IV antibiotics, followed by 2 weeks of
| oral antibiotics
251
What is the term for being farsighted? What type
| of lens do you use to correct it?
Hyperopia, convex
252
What is the term for being farsighted? What type
| of lens do you use to correct it?
Hyperopia, convex
253
A patient without a functioning spleen is more
| susceptible to what type of organisms?
Encapsulated organisms most
commonly Strep pneumoniae and
H. Flu.
254
What occupations are associated with berylliosis?
Aerospace and nuclear plant
| workers.
255
A noncaseating granuloma should make you think
| of what diagnosis?
Sarcoidosis
256
A pearl formation on CXR should make you think of
| what diagnosis?
squamous cell lung cancer
257
Mesothelioma is most commonly found in what
| lung location?
80% are found in the pleural lining
258
What organism is the most common cause of
| pneumonia in a patient with cystic fibrosis?
Pseudomonas
259
A college student presents with pneumonia. What
| two organisms should you be thinking of?
Chlamydia and Mycoplasma
260
You suspect a pneumothorax. What instructions
| should go along with the order for a chest x-ray?
It should be an end expiratory view
in order to look for visceral pleural
air.
261
Nodular opacities in the upper lung fields should
| make you think of what diagnosis?
Silicosis
262
Caseating granulomas should make you think of
| what diagnosis?
TB
263
What is the best test to diagnose bronchiectasis?
CT
264
What are the main side effects of isoniazid?
Hepatitis and peripheral neuropathy
265
Ethambutol has what major side effects?
Optic neuritis, red green vision loss
266
If you see a question with anything to do with rats
and the patient has pneumonia, what organism
should you be thinking of?
Yersinia pestis
267
If you see a question with anything to do with rats
and the patient has pneumonia, what organism
should you be thinking of?
Yersinia pestis
268
What is the most common organism causing
| pneumonia in COPD patients?
Haemophilus influenzae
269
A patient has pneumonia with rust colored sputum.
| What is the most likely diagnosis?
Strep pneumonia
270
Any question about rabbits and pneumonia should
| make you think of what diagnosis?
Tularemia
271
List six extrapulmonary complications of lung
| cancer.
SPHERE - SVC syndrome, Pancoast
tumor, Horner's syndrome, Endocrine
problems, Recurrent laryngeal
symptoms, Effusions (exudative)
272
What will the likely findings be on a CXR of a
| patient with asbestosis?
Linear opacities at the bases with
| pleural plaques.
273
What are the three most common cancers to
| metastasize to the lungs?
Breast, liver and colon
274
Post tussive rales should make you think of what
| diagnosis?
TB
275
Parenchymal metastasis and blebs on CXR should
| make you think of what diagnosis?
emphysema
276
What two lung cancers are typically found centrally
| on chest x-ray?
Small cell lung cancer and squamous
| cell
277
What two lung cancers are typically found
| peripherally on chest x-ray?
adenocarcinoma and Large cell
278
What two lung cancers are typically found
| peripherally on chest x-ray?
adenocarcinoma and Large cell
279
Pertussis is most commonly treated with what
| antibiotic?
erythromycin
280
List the four most common lung cancer will
| metastasize to.
Bone, brain, adrenals and liver
281
If you come across a question where the patient
has erythema nodosum and an enlarged parotid
gland what is the most likely diagnosis?
Sarcoidosis
282
What is erythema nodosum?
Tender red nodules usually found on
| the shins.
283
Paradoxical pulses may be found in what
| pulmonary disorder?
asthma
284
An older patient presents with pneumonia and
| diarrhea. What is the most likely diagnosis?
Legionella pneumonia
285
Eggshell opacities on the CXR should make you
| think of what diagnosis?
Silicosis
286
List three causes of decreased tactile fremitus.
COPD, Asthma, pleural effusion,
| pneumothorax
287
CXR shows vascular redistribution and blurred
| vascular outlines. What is the most likely diagnosis?
CHF
288
most common location for an anal fissure?
posterior midline
289
what does hep b surface antigen (HBsAG) indicate?
active hep B infection
290
treatment for mallory weiss tear?
watchful waiting
291
2 treatments for esophageal strictures (from long term GERD)
PPIs, dilation of the esophagus
292
where is peptic ulcer disease most common
duodenum
293
with a gastric ulcer does food make the symptoms better or worse
worse
294
what levels will be elevated with gastrinoma
gastrin level >150
295
most gallstones are what type?
cholesterol
296
what is charcot's triad? what does it suggest?
RUQ pain, fever, jaundice; cholangitis
297
what is reynolds pentad?
charcots triad + HPOTN and altered mental status. indicates high risk of sepsis
298
most common cause of peptic ulcer disease
H pylori
299
what does anti-HBc (hep B core antibody) indicate?
previous or ongoing Hep B infection
300
what antibody indicates immunization against Hep B?
Anti-HBs (hep B surface antibody)
301
what antibody indicates immunization against Hep B?
Anti-HBs (hep B surface antibody)
302
good beta blocker to reduce portal HTN
propranolol
303
umbilical ecchymosis often related to pancreatitis
Cullen sign
304
tumor marker for panceatric cancer
CA 19-9
305
term for painful swallowing
odynophagia
306
amoutn of fiber one should eat each day
30 grams
307
most common cause of a lower GI bleed
diverticulosis
308
is a direct or indirect hernia more likely to pass thorugh the scrtu
indirect
309
what does a string sign on barium swallow indicate?
pyloric stenosis
310
a patient on sulfasalazine for IBD should also receive what vitamin?
folate
311
most common cause of folate deficiency
alcoholism
312
most common cause of folate deficiency
alcoholism
313
other name for german measles
rubella
314
premature infant w/ hylaine membrane disease will have what on chet x-ray
atelectasis or ground glass appearance
315
seizures + mouse like urine odor =
PKU
316
pink rings on the trunk and inner surface of the limbs seen in rheumatic fever
eryethema marginatum
317
another names for measles
rubeola
318
staccato cough and no fever indicates what type of pneumona
chlamydia pneumo
319
what age should a child be able to use a spoon and stack 3-4 blocks?
18 months
320
by what age should a child be able to roll over?
4 months
321
adduct and internal rotation of the hips to check for hip dysplasia in a infant (name of test)
Barlow
322
medical term for crossed eyes
strabismus
