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A - Step II Secrets > Top 100 Facts > Flashcards

Top 100 Facts Flashcards

1
Q

the number one cause of preventable morbidity and mortality (e.g., atherosclerosis, cancer, chronic obstructive pulmonary disease) in the US

A

smoking

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2
Q

number two cause of preventable morbidity and mortality in the US

A

alcohol

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3
Q

What is the classic ratio of AST to ALT in alcoholic hepatitis?

A

AST:ALT ≥ 1:1, although both may be elevated

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4
Q

Give _____ to reproductive age women before pregnancy to prevent _____

What should you keep an eye out for and how should this be managed if it does present?

A

Folate, Neural tube defects

watch out for pernicious anemia (loss of gastric parietal cells/loss of IF production); treat with B12 to prevent permanent neurological deficits

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5
Q

what medication can cause B6/pyridoxine deficiency?

A

isoniazid

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6
Q

what should you treat alcoholic patients with and why?

A

Thiamine

prevent Korsakoff dementia

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7
Q

most common cause of anemia

A

IDA

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8
Q

which vitamin is a known teratogen?

in whom would you commonly see this vitamin used for?

A

A

reprodcutive-age women who is treating acne with vitamin A analog, isotretinoin

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9
Q

What are some complications of atherosclerosis?

What are the risk factors?

A

MI, heart failure, stroke, gangrene

age/sex, family history, smoking, HTN, DM, high LDL, and low HDL

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10
Q

Complications of DM? 6

A

DM leads to

  • atherosclerosis and its complications
  • retinopathy (a leading cause of blindness)
  • nephropathy (a leading cause of end-stage renal failure)
  • peripheral vascular disease (a leading cause of limb amputation)
  • peripheral neuropathy (sensory and autonomic)
  • increased incidence of infections
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11
Q

complications of severe HTN

A

hypertensive emergency:

headaches, dizziness, blurry vision, papilledema, cerebral edema, altered mental status, seizures, intracerebral hemorrhage (classically in the basal ganglia), renal failure/azotemia, angina, MI, and/or heart failure.

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12
Q

lifestyle modifications (diet, exercise, weightloss, cessation of alcohol/tobacco use) may be able to treat which disorders without the use of medications? 7

A

HTN, hyperlipidemia, DM, GERD, insomnia, obesity, and sleep apnea.

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13
Q

What does an ABG tell you?

A

pH = 1˚ event (acidosis vs alkalosis)

CO/HCO3 = cause (same direction as pH) and any compenstatory effect (opposite of pH)

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14
Q

exogenous causes of hyponatremia

A

narcotics

oxytocin

diuretics

IV fluids (excess)

anti-epileptic medications

NO-DIE

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15
Q

ECG findings in hyperkalemia

A

peaked T waves

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16
Q

ECG changes in hypokalemia

A

T-wave flattening and U waves

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17
Q

ECG changes in hypocalcemia

A

Qt prolongation

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18
Q

ECG changes in hypercalcemia

A

Qt shortening

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19
Q

Initial management of a patient in shock

A

O2

start IV line

set up pulse ox, ECG, vitals

give fluid bolus if patient does not have CHF

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20
Q

Virchow’s triad of DVTs

A

1) endothelial damange
2) venous stasis
3) hypercoagulable state

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21
Q

3 mainstay therapies for CHF

A

1) diuretics
2) ACEi
3) ß blockers

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22
Q

what is cor pulmonale?

A

Right-sided heart enlargement, hypertrophy, or failure caused by primary lung disease (usually COPD)

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23
Q

w/u for a patient with a-fib

A

assess for underlying etiology:

TSH

Electrolytes

ECHO

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24
Q

complications of a-fib

A
  1. ventricular rate and ischemia (if needed, slow the rate with medications)
  2. atrial clot formation/embolic disease (consider anticoagulation with warfarin)
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25
Q

management of v-fib or pulseless v-tach

A

immediate defibrillation followed by amiodarone, lidocaine, vasopressin, & epinephrine (ALiVE)

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26
Q

management of v-tach with a pulse

A

amiodarone and synchronized cardioversion

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27
Q

management of pulseless v-tach vs v-tach with a pulse

A

pulseless v-tach - immediate defibrillation followed by amiodarone, lidocaine, vasopressin, & epinephrine (ALiVE)

v-tach with a pulse - amiodarone and synchronized cardioversion

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28
Q

most important parameter on pulmonary function testing to distinguish between obstructive vs. restrictive lung disease

A

FEV1/FEV ratio

obstructive = FEV1/FEV ratio is less than normal

restrictive = FEV1/FEV ratio is often normal

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29
Q

most common type and cause of esophageal cancer

A

adenocarcinoma occurring as a result of long- standing reflux disease and the development of Barrett esophagus.

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30
Q

second most common type and cause of squamous cell carcinoma

A

smoking and alcohol abuse

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31
Q

patient presents with a gastric ulcer. what is the next best step in management?

A

get a biopsy OR follow it to resolution to exclude malignancy

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32
Q

best way to differentiate between upper vs lower GI bleed

A

test a nasogastric tube aspirate for blood

(although bright red blood via mouth or anus is a fairly reliable sign of a nearby bleeding source)

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33
Q

most common cause of GI complaints

A

IBS

(usually diagnosis of exclusion)

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34
Q

how does IBS classically present?

A

young woman with a history of chronic alternating constipation and diarrhea

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35
Q

type of pathology found on Crohns vs UC

A

Crohns = transmural inflammation

UC = mucosal/submucosal inflammation

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36
Q

bowel habit changes in Crohns vs UC

A

Crohns = obstruction, abdominal pain

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37
Q

classic lesions of Crohns vs UC

A

Crohns = fistulas, abscesses, cobblestoning, string sign on barium xray

UC = pseudopolyps, lead pipe colon on barium xray, toxic megacolon

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38
Q

which forms of hepatitis are transmitted parenterally and can lead to chronic infection, cirrhosis, and hepatocellular carcinoma?

A

BCD

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39
Q

most common known genetic disease in white people

how do they normally present?

how do you screen these patients?

how should these patients be managed?

A

Hereditary hemochromatosis

fatigue, impotence, hepatomeagly

transferrin saturation (serum iron/TIBC) and ferritin level

phlebotomy

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40
Q

sequelae of liver failure (many)

A

Coagulopathy that cannot be fixed with vitamin K

jaundice/ hyperbilirubinemia

hypoalbuminemia

ascites

portal hypertension

hyperammonemia/ encephalopathy

hypoglycemia

DIC

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41
Q

what is pancreatitis usually caused by?

management?

complications?

A

gallstones or alcohol

supportive treatment and pain control

pseudocyst formation, infection/abscess, ARDS (results from a systemic net pro-inflammatory response that causes endothelial and epithelial injury)

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42
Q

how do you determine if jaundice/hyperbilirubinemia is physiologic vs pathologic?

A

jaundice in neonates = physiologic

jaundice present at brith = pathologic

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43
Q

∆ between 1˚ and 2˚ endocrine disturbances

A

1˚ = gland malfunctions but the pituitary and another gland and the CNS responds appropriately

2˚ = gland is doing what it is told to do by other controlling forces (e.g., pituitary gland, hypothalamus, tumor, disease)

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44
Q

side effects of excess steroids

A

Weight gain, easy bruising, acne, hirsutism, emotional lability, depression, psychosis, menstrual changes, sexual dysfunction, insomnia, memory loss, buffalo hump, truncal/central obesity with wasting of extremities, moon facies, purplish striae, weakness (especially of the proximal muscles), HTN, peripheral edema, poor wound healing, glucose intolerance or diabetes, osteoporosis, and hypokalemic metabolic alkalosis (resulting from mineralocorticoid effects of certain corticosteroids). Growth can also be stunted in children.

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45
Q

most common cause of arthritis (≥75% of cases)

A

osteoarthritis

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46
Q

Sequelae of lung cancer 7

A

Hemoptysis

Horner syndrome

SVC syndrome

Phrenic nerve involvement/diaphragmatic paralysis

Recurrent laryngeal nerve involvement (hoarseness)

Hypercalcemia (PTHrP)

Paraneoplastic syndromes (Cushing syndrome, SIADH, hypercalcemia, Eaton-Lambert syndrome)

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47
Q

cause(s) of bitemporal hemianopsia

best diagnostic study?

A

pituitary tumor

get CT or MRI of brain

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48
Q

characteristics of a mole that should make you suspicious of a malignant transformation

management of such moles or if a mole starts to itch or bleed

A
  • Asymmetry
  • Borders (irregular)
  • Color (change in color or multiple colors)
  • Diameter (the bigger the lesion, the more likely it is malignant)
  • Evolving over time

Do an excisional biopsy

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49
Q

Potential risks/ADR of estrogen therapy

A

hepatic adenoma

glucose intolerance/diabetes

DVT/strokes

gallstones

fibroids/fibroadenomas

migraines/epilepsy

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50
Q

This type of birth control increases risk of CAD and breast cancer

A

combined estrogen + progesterone therapy

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51
Q

Children in these age groups are at risk of this particular illness

0-18 mo

1-2 yr

2-5 yr

common causes?

A

0-18 mo = bronchiolitis = RSV, parainfluenza, influenza (RIP)

1-2 yr = croup = parainfluenza, influenza

2-5 yr = epiglottitis = h. influenza, staph aureus, strep pneumo

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52
Q

X-ray findings of

bronchiolitis

croup (laryngotracheitis)

Epiglottitis

A

bronchiolitis = hyperinflation of lungs

croup (laryngotracheitis) = steeple sign (subglottic tracheal narrowing on frontal xray)

Epiglottitis = thumb sign (swollen epiglottis on lateral neck xray)

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53
Q

Treatment of

bronchiolitis

croup (laryngotracheitis)

Epiglottitis

A

bronchiolitis = humidified O2, bronchodilators, ribavirin (for RSV)

croup (laryngotracheitis) = dexamethasone, nebulized epinephrine, humidified O2

Epiglottitis = third gen cephalosporin + vanc or clindamycin (for MRSA), establish airway

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54
Q

Sequelae of streptococcal infection 3

which of thse can be prevented by antibiotics

A

Scarlet fever

Rheumatic fever (complication of scarlet fever)

Poststreptococcal glomerulonephritis.

Only the first two can be prevented by treatment with antibiotics

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55
Q

3 best diagnostic tests for multiple sclerosis

of these, which are the most sensitive?

A
  1. MRI = Most sensitive
  2. Lumbar Puncture (elevated IgG bands + MBP, mildly elevated lymphocytes and protein)
  3. Evoked potentials (slowed conduction in areas with myelin damage)
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56
Q

Top 3 ddx of an unconscious or delirious patient presenting to the ED with no history or evidence of trauma. How should these be managed?

A

hypoglycemia -> give glucose

opioid OD -> give naloxone

thiamine deficiency -> give thiamine, then glucose

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57
Q

∆ between delirium and dementia in terms of

onset

attention span

arousal level

A

delirium = acute onset, poor attention, fluctuating arousal

dementia = slow onset, unaffected attention, normal arousal

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58
Q

What should you consider in women between the ages of 15-50 before prescribing therapies or tests?

A

pregnancy

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59
Q

Initial management of patients with anaphylaxis

A

secure airway (intubation or cricothyroidotomy)

subcu or IV heparin

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60
Q

Colorectal screening recommendations

A

starting at age 50, but the frequency is determined by the type of procedure used

colonoscopy = q 10y if negative

flexible sigmoidoscopy = q 5y

FOBT = q 1y

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61
Q

prostate cancer screening recommendations

A

DRE = starting at age 40, annually

PSA = starting at age 50, annually *controversial*

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62
Q

Cervical cancer screening recommendations

A

Pap smear = start at age 21

  • if Pap only, then annual screening; after 3 consecutive negative, then test every 3 years
  • if Pap + HPV, then test every 3 years if both are negative
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63
Q

Pelvic exam screening recommendations

A

​Pelvic exam = start at age 21, and perform annually; after 3 consecutive negative, then perform every 2-3 years. If after 65, perform annually

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64
Q

Breast cancer screening recommendations

A
  • physical exam by MD - begin at 20, perform every 3 years until the age of 40, then perform annually
  • mammogram - begin at 40, then perform annually
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65
Q

lung cancer screening recommendations

A

sputum/CXR testing is NOT recommended for asymptomatic individuals, even if they are at high risk

Annual CT is controversial, but may be indicated for smokers/former smokers aged 55-74 who have at least a 30PY

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66
Q

what type of error does the p-value reflect?

A

the likelihood of making a type I error (claiming there is an effect or difference when none existed)

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67
Q

What are 6 ADRs of anti-psychotics and how are some of them managed?

A
  1. Acute dystonia –> anti-histamines or anticholinergics
  2. akathisia –> ß blocker
  3. tardive dyskinesia –> switch to a new agent
  4. parkinsonism –> anti-histamine or anticholinergics
  5. hyperprolactinemia
  6. autonomic nervous system-related effects
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68
Q

T/F asking about depression and/or suicidal ideation will cause patients to commit suicide

A

FALSE!

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69
Q

3 recreational drugs that can have fatal withdrawal effects

A

alcohol

barbituates

benzodiazepines

all incr. action of GABA/inhitory action

note that alcohol can inhibit NMDA receptor and result in release of other inhibitors (ie dopamine and serotonin), which can activate the reward centers

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70
Q

most common preventable cause of infertility in the US

A

Pelvic inflammatory disease (PID)

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71
Q

women who are heavy, amenorrheic and have hair on face, chest, abdomen, and lower back

how are these patients treated?

A

think PCOS - most common cause of dysfunctional uterine bleeding. Remember these folks have a dysfunctional HPO circuit, where desuppression occurs with too many GnRH pulses frequency and amplitude, resulting in an absent feedback mechanism to endogenous hormones; results in elevated LH (–> theca cells produce androgens) and slightly decreased FSH (recruit follicles + estrogen production)

lack of feedback system

  • long periods of unopposed estrogen
  • persistent endometrial proliferation
  • thick and unstable endometrium (not stabilized by progesterone) begins to outgrow vascular supply and breaks down into bits and pieces
  • dysfunctional uterine bleeding

treatment:

  • progesterone for endometrial protection
  • OCPs for hirsutism and acne
  • clomiphene for infertility
  • metformin to increase insulin insensitivity
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72
Q

women with PCOS are at risk of this malignancy

what should you give these patients to prevent this?

A

endometrial cancer due to unopposed estrogen

treat with cyclical progesterone

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73
Q

Fetal/neonatal macrosomia is caused by

how to prevent this?

A

maternal diabetes until proven otherwise

prevent wiht diet and insulin

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74
Q

when should maternal serum alpha-fetoprotein be measured?

Causes of low maternal serum alpha-fetoprotein?

Causes of high maternal serum alpha-fetoprotein?

A

between 16 - 20 weeks gestation.

LOW: Down syndrome, inaccurate dates (most common), and fetal demise.

HIGH: Neural tube defects, ventral wall defects (e.g., omphalocele, gastroschisis), inaccurate dates (most common), and multiple gestation.

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75
Q

pregnant woman presents with HTN and proteinuria

A

pre-eclampsia until proven otherwise

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76
Q

management of a woman who presents with a positive pregnancy test + vaginal bleeding + abdominal pain

A

ectopic pregnancy until proven otherwise

get a pelvic US

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77
Q

∆ between early, variable, and late decelerations

how should they be managed?

A
  • early - normal, caused by head compression
  • variable - caused by cord compression
    • turn mother on side, give O2 and fluids, stop oxytocin
  • late - caused by uteroplacental insufficiency
    • turn mother on side, give O2 and fluids, stop oxytocin, measure fetal O2 saturation or scalp pH, prepare for prompt delivery
78
Q

how should a third trimester bleeding be managed

A

pelvic US BEFORE pelvic exam (in case placenta previa is present)

79
Q

most common cause of postpartum bleeding

common etiologies?

A

uterine atony

etiologies: uterine overdistention (twins, polyhydramnios), prolonged labor, and/or oxytocin usage.

80
Q

acute abdomen pathology localized by physical exam

RUQ

LUQ

RLQ

LLQ

Epigastric area

A
  • RUQ - Gallbladder/biliary (cholecystitis, cholangitis) or liver (abscess)
  • LUQ - Spleen (rupture with blunt trauma)
  • RLQ - Appendix (appendicitis), PID
  • LLQ - Sigmoid colon (diverticulitis), PID
  • Epigastric area - Stomach (peptic ulcer) or pancreas (pancreatitis)
81
Q

Causes of post-op fever

A
  • water = UTI
  • wind = atelectasis, pneumonia
  • walk = DVT
  • wound = surgical wound infection
  • “wawa” = breast (post-partum)
  • weird drugs
82
Q

what should you consider in a patient with daily fever spikes that do not respond to antibiotics? what test should you order to confirm?

A

postsurgical abscess

Order a CT scan to locate, then drain the abscess if one is present.

83
Q

What are the ABCDEs of trauma?

A

airway, breathing, circulation, disability (either coma or convulsion), and exposure.

84
Q

6 thoracic injuries that must be recognized and treated immediately

A
  1. Airway obstruction (establish airway).
  2. Open pneumothorax (intubate and close defect on three sides).
  3. Tension pneumothorax (perform needle thoracentesis followed by chest tube).
  4. Cardiac tamponade (perform pericardiocentesis).
  5. Massive hemothorax (place chest tube to drain; thoracotomy if bleeding does not stop).
  6. Flail chest (occurs when rib is broken in two palces; consider intubation and positive pressure ventilation if oxygenation is inadequate).
85
Q

3 causes of neonatal conjunctivitis

when do they normall present?

A

chemical reaaction - first 12-24 hours of giving drops for prophylaxis

gonorrhea - 2-5 days after birth

chlamydial infection - 5-14 days after birth

86
Q

∆ between open angle and closed angle glaucoma?

A
  • open angle = painless, irreversible
    • usually due to optic disc atrophy with cupping, usually with increased IOP and progressive peripheral visual field loss
  • closed angle = painful, sudden vision loss with halos around eyes, frontal HA with rock-hard eye
    • if chronic, then it is often asymptomatic with damage to optic nerve and peripheral vision
    • usually due to enlargement or movement of lens against central iris
87
Q

how does uveitis present?

in what diseases do you commonly find them in?

A

remember, it is inflammation of the middle layer of tissue in the eye wall (uvea)

presents with photophobia, blurry vision, and eye pain

usually a marker for systemic conditions: juvenile rheumatoid arthritis, sarcoidosis, IBD, ankylosing spondylitis, reactive arthritis, MS, psoriasis, lupus

88
Q

3 causes of bilateral (although often asymmetric) painless gradual loss of vision

A

cataracts, macular degeneration, or glaucoma

89
Q

6 features of compartment syndrome

A
  1. Pain with passive movements, usually out of proportion to the injury
  2. Paresthesias (numbness, tingling, decreased sensation)
  3. Pallor (or cyanosis)
  4. Pressure (firm feeling muscle compartment, elevated pressure reading)
  5. Paralysis (late, ominous sign)
  6. Pulselessness (very late, ominous sign; treat with fasciotomy to relieve compartment pressure to prevent permanent neurologic damage)
90
Q

Name this nerve:

wrist extension

provides sensory to back of forearm, back of hand (first 3 digits)

clinical scenario usually is a humeral facture

A

radial n.

91
Q

Name this nerve:

finger abduction

provides sensory to front and back of last 2 digits

clinical scenario usually is an elbow dislocation

A

ulnar n.

92
Q

Name this nerve:

pronation, thumb opposition

provides sensory to palmar surface of hand (first 3 digits)

clinical scenario usually is carpal tunnel syndrome or humeral fracture

A

median n.

93
Q

Name this nerve:

abduction, lateral rotation

provides sensory lateral shoulder

clinical scenario upper humeral dislocation or fracture

A

axillary n.

94
Q

Name this nerve:

dorsiflexion, eversion

provides sensory to dorsal foot and lateral leg

clinical scenario usually is knee dislocation

A

peroneal (common fibular nerve)

95
Q

Which pediatric hip disorder is associated with female, firstborn, or breech delivery?

When does it first present?

What are some signs/symptoms associated with it?

What is the main treatment?

A

Congenital hip dysplasia

at birth

barlow and ortolani signs

harness

96
Q

Which pediatric hip disorder is associated with short male wiht delayed bone age?

When does it first present?

What are some signs/symptoms associated with it?

What is the main treatment?

A

Legg-Calvé-Perthes disease

4-10 years

knee, thigh, groin pain, limp

orthoses

97
Q

Which pediatric hip disorder is associated with overweight male adolescent?

When does it first present?

What are some signs/symptoms associated with it?

What is the main treatment?

A

slipped capital femoral epiphysis

9-13 years

knee, thigh, groin pain, limp

surgical pinning

98
Q

Why should you avoid lumbar puncture in a patient with head trauma or signs of increased intracranial pressure? What is an alternative option?

A

risk of herniation

Perform CT scan without contrast instead.

99
Q

how do neck masses differ in children than do adults?

A

In children, 75% of neck masses are benign (lymphadenitis, thyroglossal duct cyst)

in adults, 75% of neck masses malignant (e.g., squamous cell carcinoma and/or metastases, lymphoma).

100
Q

Management of symptomatic carotid artery stenosis

A

depends on % occlusion

  • if occluded 70-99% –> carotid endarterectomy
  • if occluded 50-69% –> assess patient specific factors to determine appropriateness
  • if occluded <50% –> medical management with anti-hypertensive agents, statins, and antiplatelet therapy and addressing atherosclerotic risk factors
101
Q

Pulsatile abdominal mass + hypotension =

management?

A

ruptured AAA

ex-lap

102
Q

what are some conditions that are similar to angina? 3

A

TIA

claudication

chronic mesenteric ischemia (commonly due to atherosclerosis or a presence of a stenosis/occlusion of the mesenteric vessels; characterized by postprandial abdominal pain)

103
Q

main identifiable risk factor for testicular cancer

management?

A

Cryptorchidism

surgical retrieval and orchiopexy vs orchiectomy

104
Q

T/F BPH can present as acute renal failure

A

T

Patients have a distended bladder and bilateral hydronephrosis on ultrasound (neither is present with “medical” renal disease). Drain the bladder first (catheterize), then perform TURP

105
Q

Causes of Impotence?

A

physical (e.g., vascular, nervous system, drugs)

psychogenic (patients have normal nocturnal erections and a history of dysfunction only in certain settings).

106
Q

Which is more important in terms of assessing the development of a child: overall growth pattern or any one measurement?

A

overall growth pattern - a stable pattern is less worrisome and less likely to be correctable than a sudden change in previously stable growth

107
Q

what are some examples of suspicious findings for child abuse? 7

A
  • failure to thrive
  • multiple injuries in different stages of healing
  • retinal hemorrhages plus subdural hematomas (shaken baby syndrome)
  • sexually transmitted diseases
  • a caretaker story that does not fit the child’s injury or complaint
  • childhood behavioral or emotional problems
  • multiple personality disorder as an adult
108
Q

What is the APGAR score? When is it usually performed?

A

Appearance

Pulse

Grimace

Activity

Respiration

performed at 1 and 5 minutes after birth

109
Q

common cause of metabolic derangements

some examples of each?

A

diuretics

thiazide - hyperCa, hyperglycemia, hyperuricemia, hyperlipidemia, hyponatremia, hypokalemic metabolic alkalosis, hypovolemia

loop diuretics - hypokalemic metabolic alkalosis, hypovolemia (more potent than thiazides), ototoxicity, and calcium excretion

carbonic anhydrase inhibitors - metabolic acidosis, and potassium-sparing diuretics (e.g., spironolactone) may cause hyperkalemia.

110
Q

Antidote for Benzodiazepine OD

A

flumazenil

111
Q

Antidote for ß blocker OD

A

glucagon

112
Q

Antidote for carbon monoxide OD

A

oxygen

113
Q

Antidote for cholinesterase inhibitors OD

A

atropine or pralidoxime

114
Q

Antidote for copper or gold OD

A

penicillamine

115
Q

Antidote for digoxin OD

A

normalize K and other electrolytes

digoxin antibodies

116
Q

Antidote for Iron OD

A

deferoxamine

117
Q

Antidote for lead OD

A

EDTA (adults)

succimer (children)

118
Q

Antidote for methanol/ethylene glycol OD

A

fomepizole, ethanol

119
Q

Antidote for muscarinic blockers OD

A

physostigmine

120
Q

Antidote for opioids OD

A

naloxone

121
Q

Antidote for Quinidine or TCAs OD

A

Sodium bicarbonate (cardioprotective)

122
Q

Is the platelet dysfunction reversible or irreversible with NSAID? Aspirin?

A

NSAID = reversible

Aspirin = irreversible

123
Q

What type of renal damage would aspirin/NSAIDs cause?

A

interstitial nephritis, papillary necrosis

124
Q

Why should you never give aspirin to a child with a cold?

A

risk of Reyes Syndrome - encephalopathy and/or liver failure

125
Q

metabolic derangements with aspirin OD

A

metabolic acidosis and respiratory alkalosis

126
Q

Central pontine myelinolysis can be caused by:

A

overly rapid correction of hypOnatremia

127
Q

Low levels of this can make hypocalcemia and hypokalemia unresponsive to replacement therapy

A

HypoMg

128
Q

What are examples of scenarios that can cause abnormal lab results? (4 major ones)

A

Hemolysis (hyperkalemia)

Pregnancy (elevated ESR and alkaline phosphatase)

hypoalbuminemia (hypocalcemia)

hyperglycemia (hyponatremia)

129
Q

What are some ECG findings of MI?

A

flipped/flattened T waves

ST-elevation

Q waves in a patterned distribution (ie leads II, III, aVF for inferior infarct)

130
Q

When would you institute interventions for cholesterol?

A
131
Q

What are the differences between Type I and Type II DM in terms of:

age of onset

body habitus

development of ketoacidosis

levels of endogenous insulin

response to oral hypoglycemics

antibodies to insulin

A
132
Q

How is HTN classified?

A
133
Q

Rapid Associations: friction rub

A

pericarditis

134
Q

Rapid Associations: Kussmaul breathing (deep rapid breathing)

A

DKA

135
Q

Rapid Associations: Kayser-Fleischer ring in the eye

A

Wilson disease

136
Q

Rapid Associations: Bitot spots

A

Vitamin A deficiency

137
Q

Rapid Associations: Dendritic corneal ulcers on fluorescein stain of the eye

A

herpes keratitis

138
Q

Rapid Associations:

Cherry-red spot on the macula without hepatosplenomegaly

Cherry-red spot on the macula with hepatosplenomegaly

A

W/O HSM: Tay-Sachs

W/ HSM: Niemann-Pick (niemann picks which organs)

139
Q

Rapid Associations: Bronze skin plus diabetes

A

Hemochromatosis

140
Q

Rapid Associations: Malar rash on the face

A

Systemic lupus erythematosus

141
Q

Rapid Associations: Heliotrope rash (purplish rash on the eyelids)

A

Dermatomyositis

142
Q

Rapid Associations: Clue cells

A

Gardnerella vaginalis infection

143
Q

Rapid Associations: Meconium ileus

A

Cystic fibrosis

144
Q

Rapid Associations: Rectal prolapse

A

Cystic fibrosis

145
Q

Rapid Associations: Salty-tasting infant

A

Cystic fibrosis

146
Q

Rapid Associations:

Café-au-lait spots with normal IQ

Café-au-lait spots with mental retardation

A

normal IQ: Neurofibromatosis

mental retardation: McCune-Albright syndrome or tuberous sclerosis

147
Q

Rapid Associations: Worst headache of the patient’s life

A

Subarachnoid hemorrhage

148
Q

Rapid Associations: Abdominal striae

A

Cushing syndrome or pregnancy

149
Q

Rapid Associations: Honey ingestion

A

botulism

150
Q

Rapid Associations: LLQ tenderness w/ rebound

A

Diverticulitis

151
Q

Rapid Associations: Children who torture animals

A

conduct d/o

152
Q

Rapid Associations: Currant jelly stools in children

A

Intussusception

153
Q

Rapid Associations: Ambiguous genitalia and hypotension

A

21-Hydroxylase deficiency in girls

154
Q

Rapid Associations: Catlike cry in an infant

A

Cri-du-chat syndrome

155
Q

Rapid Associations: Infant weighing more than 10 lb

A

maternal diabetes

156
Q

Rapid Associations: Anaphylaxis from immunoglobulin therapy

A

IgA deficiency

157
Q

Rapid Associations: Postpartum fever unresponsive to broad-spectrum antibiotics

A

Septic pelvic thrombophlebitis

158
Q

Rapid Associations: Increased hemoglobin A2 and anemia

A

thalassemia

159
Q

Rapid Associations: Heavy young woman with papilledema and negative CT/ MR scan of head

how are these patients usually managed?

A

Pseudotumor cerebri (increased ICP without clear etiology)

managed with acetazolamide +/- lasix, migraines Rx, and weight loss

160
Q

Rapid Associations: Low-grade fever in the first 24 hr after surgery

A

atelectasis

161
Q

Rapid Associations: vietnam veteran

A

PTSD

162
Q

Rapid Associations: Bilateral hilar adenopathy in an African American patient

A

Sarcoidosis

163
Q

Rapid Associations: Sudden death in a young athlete

A

Hypertrophic obstructive cardiomyopathy

164
Q

Rapid Associations: Fractures or bruises in different stages of healing in a child

A

child abuse

165
Q

Rapid Associations: Absent breath sounds in a trauma patient

A

pneumothorax

166
Q

Rapid Associations: Constant clearing of throat in a child or teenager

A

Tourette syndrome

167
Q

Rapid Associations: Shopping sprees

A

mania

168
Q

Rapid Associations: Intermittent bursts of swearing

A

Tourette syndrome

169
Q

Rapid Associations: Koilocytosis

A

HPV or cytomegalovirus

170
Q

Rapid Associations: Rash develops after administration of ampicillin or amoxicillin for sore throat

A

Epstein-Barr virus infection

171
Q

Rapid Associations: Daytime sleepiness and occasional falling down (cataplexy)

A

Narcolepsy

172
Q

Rapid Associations: Facial port wine stain and seizures

A

Sturge-Weber Syndrome

173
Q

What is this sign? Babinski sign

What is it an indication of?

A

Stroking the bottom of the foot yields extension of the big toe and fanning of other toes (UMN lesion)

174
Q

What is this sign? Beck triad

What is it an indication of?

A

Jugular venous distention, muffled heart sounds, and hypotension (cardiac tamponade)

175
Q

What is this sign? Brudzinski sign

What is it an indication of?

A

Pain on neck flexion with meningeal irritation (meningitis)

176
Q

What is this sign? Charcot triad

What is it an indication of?

A

Fever/chills, jaundice, and right upper quadrant pain (cholangitis)

177
Q

What is this sign? Chvostek sign

What is it an indication of?

A

Tapping on the facial nerve elicits tetany (hypocalcemia)

178
Q

What is this sign? Courvoisier sign

What is it an indication of?

A

Painless, palpable gallbladder plus jaundice (pancreatic cancer)

179
Q

What is this sign? Cullen sign

What is it an indication of?

A

Bluish discoloration of periumbilical area (pancreatitis with retroperitoneal hemorrhage)

180
Q

What is this sign? Cushing reflex

What is it an indication of?

A

Hypertension, bradycardia, and irregular respirations (high intracranial pressure)

181
Q

What is this sign? Grey Turner sign

What is it an indication of?

A

Bluish discoloration of flank (pancreatitis with retroperitoneal hemorrhage)

182
Q

What is this sign? Homans sign

What is it an indication of?

A

Calf pain on forced dorsiflexion of the foot (DVT)

183
Q

What is this sign? Kehr sign

What is it an indication of?

A

Pain in the left shoulder (ruptured spleen)

184
Q

What is this sign? Leriche syndrome

What is it an indication of?

A

Claudication and atrophy of the buttocks with impotence (aortoiliac occlusive disease)

185
Q

What is this sign? McBurney sign

What is it an indication of?

A

Tenderness at McBurney point (appendicitis)

186
Q

What is this sign? Murphy sign

What is it an indication of?

A

Arrest of inspiration during palpation under the rib cage on the right (cholecystitis)

187
Q

What is this sign? Ortolani sign/test

What is it an indication of?

A

Abducting an infant’s flexed hips causes a palpable/audible click (congenital hip dysplasia)

188
Q

What is this sign? Prehn sign

What is it an indication of?

A

Elevation of a painful testicle relieves pain (epididymitis vs. testicular torsion)

189
Q

What is this sign? Rovsing sign

What is it an indication of?

A

Pushing on left lower quadrant then releasing your hand produces pain at McBurney point (appendicitis)

190
Q

What is this sign? Tinel sign

What is it an indication of?

A

Tapping on the volar surface of the wrist elicits paresthesias (carpal tunnel syndrome)

191
Q

What is this sign? Trousseau sign

What is it an indication of?

A

Pumping up a blood pressure cuff causes carpopedal spasm (tetany from hypocalcemia)

192
Q

What is this sign? Virchow triad

What is it an indication of?

A

Stasis, endothelial damage, and hypercoagulability (risk factors for DVT)

A - Step II Secrets (40 decks)

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