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STEP 2 CK Frequently Missed > USAW 2 = 265 > Flashcards

USAW 2 = 265 Flashcards

1
Q

Lady with Copper IUD post partum, lost 44 pounds, no periods since IUD, BMI 19, progesterone challenge no uterine bleeding. Cause?

A

Functional hypothalamic amenorrhea

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2
Q

Male age 15-35 with unliateral painless testicular nodule, dull lower abdominal pain, metastatic symptoms (SOB, low back pain, neck mass), exam shows firm oviod mass, fixed, hard, does not transilluminate, what is it?

A

Testicular germ cell tumor

workup: Get tumor markers and bilateral scrotal US
tx: radical orchiectomy with LN dissection

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3
Q

What tx for bulimia nervosa?

A

SSRI (fluoxetine), CBT, nutritional rehab

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4
Q

Parameters in Cardiogenic shock

A

RAP, PCWP (both preload) - increased
CO/CI - Decreased
SVR - Inreased
MVO2 - Decreased

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5
Q

Pruitic rash under breast, BMI 36 (also RF are excessive moisture, Immunocompromised, DM) - what is it?

A

Candida Intertrigo, it will culture growing pseudohyphae with budding yeast
Tx topical antifungal like nystatin, miconazole, good hygiene
(vs with tinea cruris would see septate hyphae)

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6
Q

All congenital infections can have

A

IUGR, HSM, Jaundice, Blueberry muffin spots

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7
Q

CMV also has

A

Periventricular calcifications, microcephaly, hearing loss

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8
Q

Toxo also has

A

Diffuse intracerebral calcifications, chorioretinitis, hydroecphalus

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9
Q

Syphilis

A

Rhinorrhea, notched teeth, saddle nose, short maxilla, saber shins, can have CN8 deafness, desquamating/bullous rash

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10
Q

Rubella

A

Cataracts, heart defects PDA, deafness

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11
Q

Tx sunburn

A

Cool compress, calamine lotion, aloe vera, NSAID

Severe: hospitalization, IV fluids, analgesia, wound care

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12
Q

Tx gout

Tx Gout if someone is taking anticoagulants

A

NSAIDS like Indomethacin, colchicine, steriods

If on anticoagulants then colchicine

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13
Q

Pregnant women with depression what do you do?

A

TX HER with SSRI and discuss risks and benefits

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14
Q

Guy with uncontrolled HTN and Crack Cocaine use found unresponsive, Right pupil dialted and unresponsive to light, extensor posturing, DTR 4+ Left, Babinski + left, what is cause?

A

Basal ganglia hemorrhage causing transtentorial herniation and compression occulomotor nerve

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15
Q

Tx endometritis

A

Clindamcin and gentamicin

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16
Q

21 mo boy with recurrent otitis media, 2 PNA, eczema, thrombocytopenia, small platelet size?

A

Wiskott Aldrich Syndrome
XLR is WAS protein gene, impaired cytoskeleton changes in leukocytes and platelets
tx Stem cell transplant

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17
Q

44 yo with fatigue, arthropathy, and hypogonadism?

A

Hereditary hemochromatosis

usually triad cirrhosis, DM, skin pig rare

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18
Q

33 week pregnant lady with regular contractions, no cervical change, what next?

A

FFN test, used to determine whether a patient at <34 weeks gestation with regular uterine contractions and no cervical change is in preterm labor
+ strong predictor delivery in next week, administer bethamethasone
- FFN can resume routine prenatal care

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19
Q

Labert Eaton vs MG

A

Labert Eaton has proximal muscle weakness L>A
Decreased or absent reflexes
Strength and reflexes improve with isometric contraction
Autonomic dysfunction
Associated with SCLC

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20
Q

Man with HIV not on antiretroviral meds, with rectal pain, bleeding, 3cm ulcer, bleeds easily

A

ANAL CANCER

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21
Q

Contraindications to Levonorgesterel IUD?

A

Active liver disease, breast cancer, acute pelvic infection

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22
Q

Contraindications to Copper IUD?

A

Wilson Disease, copper allergy, heavy menstrual bleeding, acute pelvic infection

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23
Q

Next step with acute mastoiditis?

A

Dx clinically in most cases, if needed CT scan or MRI w/contrast and IV abx and surgical drainage

24
Q

Consider COPD when?

A

> 40, tobacco use >30 pack years, chronic cough often with sputum, progressive dyspnea on exertion
w/u with spirometry

25
Q

Diabetic with nephrotic range proteinuria but has atypical features like hematuria, RBC casts, rapidly developing disease, what to do next for workup?

A

Kidney biopsy, looks like more GN picture

26
Q

Predictive of good prognosis in schizophrenia?

A

Positive psychotic symptoms (hallucinations, delusions)

27
Q

Predictive of poor prognosis in schizophrenia?

A

early onset, no clear precipitant, prodromal phase, gradual onset

28
Q

Pathophysiology of chemotherapy induced cardiotoxicity?

A

Cardiomyocyte replacement by fibrous tissue 2/2 anthracyclines, less likely reversible VS
2/2 trastuzumab which has myocardial stuning/hibernation without myocyte destruction, more likely reversible

29
Q

Local complications of cardiac catherization

A

1) Hematoma - +/- mass, NO BRUIT
2) Psuedoaneurysm - bulding soft pulsatile mass, systolic bruit
3) AV fistula - NO MASS, continuous bruit

30
Q

Tx for patient with OA?

A

Exercises for strengthening the quadricep muscles

31
Q

Non painful, non itchy, lower eyelid swelling with previous occurences, no Temperature

A

Chalazion 2/2 occlusion of meibomian tear gland, resolves on own usually, but could also benefit from warm compress

32
Q

Acute inflammatory nodule from eyelash follice (stye) or from meiobomian gland under eye

A

Horedeolum, usually 2/2 staph a infection, usually painful and closer to lid margin

33
Q

Acute infection lacrimal sac sudden onset pain and redness at the medial canthal region

A

Dacryocystitis

34
Q

Constitutionally small infant life outcomes

A

Normal long term outcome

35
Q

Elevated intraocular pressure, atrophy of optic nerve head, progressive loss of peripheral vision, enlargement of optic cup with an increased cup:disc ratio

A

chronic open angle glaucome

36
Q

DRESS syndrome

A

drug reaction 2/2 allopurinol and antiepileptics (pheny, carba), have morbilliform eruption on face trunk and becomes diffuse and confluent, eosinophilia, systemic symtpoms, fever, malaise, LAD
take 2-8 weeks between drug intiation and manifestation

37
Q

Abdominal pain, distention, colonic dilation w/out radiographic evidence of an anatomic obstruction, can lead to colonic ischemia and perforation

A

Colonic psuedoobstruction (ogilvie syndrome)

38
Q

Dominant malaria outside of africa

A

P viviax, can have reactivation of dormant hypnozoites, tx with primaquine and chloroquine in non resitant areas

39
Q

Vaccines needed in pregnancy

A

TDAP, flu, RhoD IG

40
Q

Onycholysis, pitting, dermal plaques…

A

Psoriatic arthritis

41
Q

Harsh holosytolic murmur in the 4th L ICS

A

VSD

42
Q

Watery & nocturnal diarrhea for 6 months, fecal urgency, incontinence, female >50, smoking, NSAIDS?

A

Mircoscopic colitis, colonoscopy shows inflammatory infitrates with a monocytic predominance

43
Q

Akathisia caused by?

A

Antipsychotics or antiemetics (anti-DA)

Prochlorperazine, promethazine, metoclopramide (phenegran, reglan, compazine)

44
Q

MDS

A

Hematopoetic stem cell neoplasm, risk increasing age, previous Chemo/RT, may transform to acute leukemia
Pancytopenia
See dysplastic red and WBC (ovalomacrocytosis, neutrophil hyposegmentation/hypogranulatino)
Dx with BMBx

45
Q

Myelofibrosis

A

Pancytopenia with massive splenomegaly due to extramedullary hematopoesis

46
Q

Patients with symptomatic (exertional dyspnea, angina, presyncope/syncope) AS and valve area <1cm2 management?

A

Referral for valve replacement

47
Q

Mechanism of testicular torsion?

A

twisting of spermatic cord 2/2 inadequate fixation of the lower pole of the testis to the tunica vaginalis

48
Q

What to when older sibling reacts to birth of baby with regressive behavior and aggression toward infant?

A

Spend more time with older children

49
Q

How to diagnose leiomyomata?

A

saline infusion US

50
Q

Connection between Crohns disease and Uric acid stones?

A

Crohns –> chronic diarrhea –> Chronic HCO3 loss –> acidic hyper concentrated urine
Manage uric acid stones with urine alkanization and KHCO3, Kcitrate

51
Q

Hyperviscosity, bleeding, HSM, neuropathy, LAD

A

Waldenstrom macroglomulinemia IgM tx with plasma exchange

52
Q

PE cauues what to happen to heart?

A

decreased CO 2/2 RV dysfunction

53
Q

What will influence a teenager to be more adherent to using condoms?

A

Peer group uses them

54
Q

Upper load cavitary lung lesion in 45 pack year smoker?

A

SCCL (85% of malignant upper cavity lessions)

55
Q

1-3 weeks after viral infection child has disturbances with coordination and gait?

A

Acute cereballar ataxia

STEP 2 CK Frequently Missed (5 decks)

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