The Finals Step (Key Words to Know) Flashcards
What age should patients begin getting DEXA scans? (male and female)
70 for males 65 for females
Fracture that is the number one cause of compartment syndrome
Tibial shaft
condition with positive smitha nitobdy and positive double stand DNA antibodies.
Lupus
best diagnostics for osteomyelitits
Bone scan or MRI
a painless mass in a wrist is most likely
ganglion cyst
benign bone tumor often in males that presents with severe pain, often at night
osteoid osteoma
what medication will help an osteoid osteoma?
ibuprofen
clicking or locking of the knee suggests what dx?
meniscal tear
if synvoial fluid contains positive bifingent crystals what condition does it inidcate?
pseudogout
A patient with a history of hepatitis B presents
complaning of bilateral knee pain, fever and weight
loss. What is the most likely diagnosis?
polyarteritis nodosa
Tx for polyarteritits nodosa
high dose steroids (confirm dx by biopsy)
a positive neer’s test indicates what?
rotator cuff impingement
What is the Schirmer test used for?
Sjogrens
Tx for lupus
Systemic steroids
There are 5 main characteristics of the limited form of scleroderma which are described by CREST. name these.
Calcinosis Raynaud's Esophageal motility Sclerodactyly Telangiectasia
What ligament is most commonly injured in an ankle sprain?
anteriortalofibular
mot common fracture in children
clavicle
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?
Polymyositis
which way does a colles fracture angulate?
dosrally
which way does a smith fracture angulate?
vollarly
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?
Ewing sarcoma
A patient with HIV presents with severe groin pain.
What is the most likely diagnosis?
Avascular necrosis of the femoral
head. Antiretroviral medications put
patients at an increased risk of AVN.
medical term for tennis elbow
lateral epicondylitits
medical term for golf elbow
medial epicondylitits
most useful test for ACL tear
Lachman’s
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
a positive crossover test indicated what diagnosis?
Acromioclavicular joint injury (AC joint)
positive hawkins test indicates what diagnosis?
rotator cuff impingement
a positive straight leg test indicates what?
herniated disc
a positive straight leg test indicates what?
herniated disc
6 medications that can be used for migraine prophylaxis
Beta blockers, tricyclics, calcium
channel blockers, NSAIDs and
valproic acid.
A patient is brought in following a seizure in which
she did not lose consciousness. What is the most
likely diagnosis?
simple partial seizure
A patient presents with a painful ipsilateral third
nerve palsy. What is the most likely diagnosis?
posterior communicating artery aneurysm (PCOM)
Decreased GABA and substance P should make you
think of what diagnosis?
Huntington’s
80% of strokes are ______
ischemic
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
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.
Sign where When you lift the patient’s head the
patient bends his hips
Brudzinski’s sign.
There is an MRI result of multiple foci of
demyelination in the white matter. What is the
most likely diagnosis?
multiple sclerosis
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
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
Med of choice for Tourette’s
Haloperiodol
a slit lamp shows Kayser-Fleischer rings indicate what?
Wilson’s disease
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.
Duchenne’s and Becker’s muscular dystrophy have
what genetic characteristic?
X linked recessive
Duchenne’s and Becker’s muscular dystrophy have
what genetic characteristic?
X linked recessive
An EEG showing generalized spikes and associated
slow waves should make you think of what
diagnosis?
generalized or absence seizure
most common primary intracranial neoplasm
glioma
What are the most common primary cancer sites
that metastasize to the brain?
lung, breast, and kidney
Weakness and numbness in the left hand might be
a blockage in which carotid artery?
right
Which nerve root is responsible for the knee jerk
reflex?
L3-L4
An EEG showing interictal spikes should make you
think of what diagnosis?
complex partial seizure
most commonly herniated vertebral disc?
L4-L5 followed by L5-S1
What three symptoms are classic for a normal
pressure hydrocephalus?
gait disturbance, dementia, and urinary incontinence
A patient complains of muscle weakness and
fatigability that improves with rest. What is the
most likely diagnosis?
myasthenia gravis
Lead pipe or cogwheel rigidity should make you
think of what diagnosis?
parkinson’s disease
Lead pipe or cogwheel rigidity should make you
think of what diagnosis?
parkinson’s disease
Type of hallucinations most common with schizoprhenia
auditory
what causes anorexic patients to have osteopenia
decrease in estrogen
3 positive symptoms of schizophrenia
hallucinations, delusions, movement disorders
med used to treat pospastrum women with depression
sertraline
A patient has very strange magical thinking. What
is the most likely diagnosis?
schizotypal personality disorder
4 symptoms of serotonin syndrom
Hyperthermia
seizure
mental status change
tremor.
At what BMI should a patient be hospitalized for anorexia
BMI of
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
what is russell’s sign?
abraded knuckles from forcing oneself to vomit
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.
What is the time frame for the first symptoms of
withdrawal from alcohol?
tremor in 8-18 hours
What is the time frame for the first symptoms of
withdrawal from alcohol?
tremor in 8-18 hours
What are three things in your differential if you
have a paradoxical pulse?
Cardiac tamponade, pericarditis and
obstructive lung disease
normal size of aorta on palpation
a fix S2 should make you think of what?
ASD
a continuous, machine like murmur indicates what?
PDA (patent ductus arteriosus)
what type blocker do you use on someone with a pheo as they wait for surgery
alpha blocker
2 abx that are first line treatment for endocaritits
vanco and ceftriaxone
2 abx that are first line treatment for endocaritits
vanco and ceftriaxone
Tx for PDA
Indomethacin
subacute endocarditits is often caused by what organism?
strep viridans
most common place for an aortic aneurysm
in the abdomen below the renal arteries
giant cell arteritis is associated with what rheumatologic condition?
polymyalgia rheumatica
a bisphasic p wave should make you think of what?
left atrial enlargement
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
first line medication for symptomatic bradycardia
atropine
Tx for polymyalgia rheumatic
low dose prednisone
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
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
common cause of a junctional rhythm?
digitoxin toxicity
medication class used to lower triglycerides
fibric acid derivatives
Tall peaked P waves should make you think of what
diagnosis?
right atrial enlargement
1st line tx for genital warts?
imiquimod (aldara)
What two hormones are secreted by the posterior
pituitary?
Oxytocin and antidiuretic hormone
ADH, vasopressin
most common pituitary adenoma
prolactinoma
diabetes insipidus is a lack of what hormone?
antidiuretic hormone (vasopressin)
most common thyroid cancer
papillary
What medication might you use prior to
thyroidectomy in a patient with hyperthyroidism?
Methimazole or propylthiouracil
PTU
What is the most common cause of
hypoparathyroid?
Post thyroidectomy with the
complication of parathyroidectomy
Tap on facial nerve and get a twitch
with low Ca.
Chvostek’s sign
Inflate BP cuff and hold for 3
minutes. Patient with low Ca will get
carpel tunnel symptoms.
Trousseau’s sign
Inflate BP cuff and hold for 3
minutes. Patient with low Ca will get
carpel tunnel symptoms.
Trousseau’s sign
What is the most common cause of
hyperparathyroidism?
Single parathyroid adenoma in 80%
of cases.
In Cushing’s disease is ACTH elevated or
decreased?
elevaged
ectopic tumors that may produce ACTH
and give a patient Cushing’s syndrome?
Small cell lung cancer, pancreatic
islet cells, thymomas.
What is the test to begin with if you suspect
pheochromocytoma?
24 hour urine for catecholamines.
Reduced insulin response between
5 and 8 am.
dawn phenomenon
How do sulfonylureas medications work?
stimulate inulin production
MOA of metformmin
Decreases the hepatic glucose
production and increases peripheral
glucose uptake.
5 criteria for metabolic syndrome
HDL 135/85, Triglycerides >150, Fasting
glucose >100, Waist >40 inches in
men >35 inches in women.
these findings make you think of what Moon face, buffalo hump, purple
strai, central obesity, supraclavicular
fat pads, easy bruising
cushing syndrome
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.
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.
What is a test for lactose intolerance?
hydrogen breath test
Sjogrens syndrome has what antibody markers?
Ro and Lo
acute sinusitits is most commonly caused by what 2 pathogens?
Strep pneumo and h. flu
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.
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.
tx for epiglottits
2nd or 3rd gen cephalopsorin (cefuroxime, ceftriaxone)
What virus causes mumps?
Paramyxovirus
Acute swelling and pain in the cheek that increases
at meals. What is the most likely diagnosis?
Sialadenitis (salivary gland infection)
- Staph aureus.
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
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
Both testicles should be descended by what age?
3 months
Maltese crosses in the urine should make you think
of what diagnosis?
nephrotic syndrome
What is the most likely diagnosis for a free floating,
painless, cystic mass found posterior and superior
to the testis?
spermatocele
tx for epididymitis?
ceftriaxone and doxycycline
1st line abx for prostatitis?
bactrim for 4-6 weeks
most common bladder cancer
transitional cell carcinoma
painless hematuria usually indicates what?
bladder cancer
painless hematuria usually indicates what?
bladder cancer
