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Usmle กู อย่างละ 100ข้อ > USMLE 2 ชุด 8 > Flashcards

USMLE 2 ชุด 8 Flashcards

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USMLE® Step 1 flashcards
1
Q

คลอด Fat neonate Erb Ducheene
5th 6th waiter tip

TX?

A

massage PT
prevent contact
80% หายได้ลงใน 3 mo

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2
Q

หลังชนมี epigastric pain 20 after + coliky

A

Duodenal hematoma
ในเด็ก less abdominal tissue

IX CT scan

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3
Q

phynylketoneuria
- hypo pigmented blue eye fair hair seziure musty urine
IX?

A

AA analysis - AR fail chang ePHEN > tyrosin

tandem mass spectrometry

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4
Q

aldolase B

A

Fructose intolerance

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5
Q

condylomata acuminata

A

alot HPV 6+11

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6
Q

condylomata lata

A

2nd syphilis = grey white

late 2 nd

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7
Q

lower lip encrusted ulcer

DX?

A

SQ Ca= keratin peral

TX resection most no met @

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8
Q

hyperplasia นม
s/p reduction OR
now 3x3 spiculated mass + course calcified

TX?

A

reassure

foamy fat > benign breast mass = fat necrosis

from trauma/surgery/

no skin nipple retraction

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9
Q

fibrocystic change

A

multiple nodulocystic

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10
Q

fibroadenoma

A

1 mass

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11
Q 
neuroblastoma 
ไม่จำเป็นต้องแสดงตั้งแต่เกิด 2 yo start 
intermittent fever periorbital ecchymoses paravertebral mass +Droop 1 side face flush
constrict pupil
opoclonus myoclonus 
IX?
A

VMA

NMYC gene small O blue cell

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12
Q

Rape

A

suicide idea

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13
Q

patellofemoral pain

A

worse when sitting

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14
Q

infiltated after OR - aspirated gastric acid

TX?

A

supportibe

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15
Q

Aute Otitis Media 6-18 mo child
narrow straighter

chronic supperative 6 wk

serous otitis media no bulge no fever

A

dd

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16
Q

teenage 17 yo
no eat, picky eater not sleep well
+ erythema nasal mucosa
+ wt loss

DX?

A

Coccain _ avoid /restrict food

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17
Q

blunt abdominal trauma >8th rib โดน

MCC bleed =

A

hepatic laceration + rebound + gen guarding

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18
Q

APAS presentation

TX?

A

DVT
PR
TIA
STROKE

TX: ligfe loing anti coag +- hydroxycholoquine

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19
Q

neurosyphilis

A

artheritis CVS abnormal CSF inc lymp

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20
Q

post partum depression

TX when

A

+2 wk

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21
Q

ovarian failure
FSH
LH

A

inc FSH
inc LH

สามารถเกิดได้จาก chemo 5ปี ค่อยๆเป็น

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22
Q

henoch schonlein ?

A

IGA vasculitis ผื่น ข้อ abdominal intuss, renal +CAST

TX supportive + hospitalized + steroid

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23
Q

pccasional dizziness + palpation
dec PLT
IX?

A

HIV test 10% อาจจะมี
ITP
HEp C

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24
Q

Depression + suicide dont want SSRI?

TX?

A

dialectical behaviour therapy = psychotherapy first

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25
Q

BAT L ab pain
splenic injuty

FAST normal but high risk

IX?

A

CT scan

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26
Q

vaginal Ca + malorder vaginal discharge bleeding mass
risk 60yo + HPVm tobacco DES

TX?

A

biopsy

TX sx

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27
Q

TOF

A

brain abscess

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28
Q

pancreatic ca

TX?

A

stop smoking

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29
Q

pancreatitis

A

stop alcohol

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30
Q

NEC

A

เด็กไม่จำเป็นต้องมีไข้
foot ball sign
hypothermia

preterm formula milk blood in stool

TOF dec blood supply

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31
Q

ureter stone cut off

A

-1 cm dec discharge + stain + drink 2L/day

+1cm med alpha blocker, pain , strain, hydro neph

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32
Q 
Quad  chromosome 
AFP BHCG INHIBIN
trisomy
down
NT 
platau
A

trisomy- dec all except inhibin
down- inc BHCG + inhibin
NT - inc AFP
platau- in AFP

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33
Q

conduct HL female

A

otosclerosis - abnormal remodel ของ otic capsule from autoimmune

34
Q

lithium toxic

A

NV diarrhea ataxia confuse tremer

35
Q

risperidone

A

galactorrhea orthostasis

extrapyramidal

36
Q

ITP splenectomy when

A

+1 y
PLT <100,000

ทำBM Bx เมื่อ
1)แก่ อายุ>60ปี อันนี้เป็นแบบrelative 2)มีseries อื่นที่ผิดปกติด้วย หรือมีอาการอื่นที่ไม่อธิบายด้วยplt.ต่ำ 3)เจอunexplained organomegaly. 4)ไม่ตอบสนองต่อ steroid. 5)ก่อนsplenectomy

37
Q

ITP

A

แบ่งเป็นprimary(ส่วนใหญ่ประมาณ80%) คือไม่มีสาเหตุร่วม กับsecondary คือมีสาเหตุร่วม เช่น Autoimmune disease(SLE, Graves’, Evans syndrome, APS), infection(3H = HIV, HCV, H. Pylori) และviral infectionอื่นๆ เช่นCMV VZV, malignancy อย่าง lymphoproliferative disorderต่างๆ, สุดท้ายก็ยาที่ต้องหา(Rifampicin, quinine, abciximab, vancomycin, valproic acid)

-Lab เบื้องต้นที่ควรส่งทุกคนคือ CBC&Pbs, UA, LFT, antiHIV/antiHCV. อื่นๆ ที่อาจพิจารณาส่งเป็นรายๆ ไป เช่น ถ้าซีด/PbsแบบAIHA อาจต้องส่งdirect coombs test/reticulocyte countเพิ่ม, ถ้ามีdyspepsiaก็ต้องหาH.pylori, สงสัยAutoimm.ก็ ANA และต่างๆนานาตามที่สงสัย

38
Q

pregnancy hypothyroid

drug?

A

inc levothyroxine

39
Q

sheehan

FSH
TSH

A

dec FSH
dec TSH

แต่ adhesion = normal

40
Q

aortic dissection

IX?

A

CT i contrast - type A = emergency Sx

unstable = TE echo

41
Q

hypersensitivity

1 2 3 4

A

1-igE
2- IgA- good pasteure, AIHA
3 - AB AG PSGN lupus nephritis
4- T cell contact derm TB

42
Q

Gambling disorder

TX

A

CBT + naltrexone opiod antagonist

43
Q

acute diver

IX

A

abdomen CT i contrast LLQ fever ileus

44
Q

Preterm premature rupture of membrane

A

<34 wk infect? atb corticosteroid Mg
>34 wk ATB cortico delivery

IV penicillin - GBS

45
Q

Thyroid strome

s/p OR @@@

A

fever tachycardia AF hypotension agitate seizure guiter n/v

malignant hypertnermia= inc crea, in K, muscle rigid

46
Q

Iron poisoning

A

NV shock hypotension met acidosis hematemesis

IX: radioplaque
TX: whole bowel irregation

CC
2D- hepatic necerosis
2-8wk pyloric stenosis

47
Q

Aspirin

A

tinnitus fever met acidosis hyperapnea, inc depth + rate inspiration

48
Q

BCA then biopsy now purple papule firm
+R arm edema

DX?

A

angisarcoma

IX biopsy again

lining blood vessel lymph

49
Q

mittle schemerz

A

mid cycle pain

50
Q

somatic symptom

A

+1 problem +6 months

51
Q

coversion disorder

A

neuro symptom

52
Q

brown macule

cafe spot

A

NF 1
Lish nodule

CC nerve shelf tumor
cluster freckles axillary groin

53
Q

down

A

brushfield spot =ALL

54
Q

tuberous sclerosis

A

hypopigmented facial angiofibroma

55
Q

CPPD

A

meniscial calcified
Rhomboid shape
+ bifringence
chrondrocalcinosis

56
Q

PEEP

A

inc intra thoracic pressure

dec right preload

57
Q

2 MDS drug

A

apriprazole quetapine

Bupropion = NE d reuptake inhibitor

58
Q

Gen AD TX

A

Buspirone

59
Q

baby blue
+ holosystolic
LAD
P pulmonale ‘

DX?

A

Tricuspid atresia hyperplastic RV = ASD VSD

60
Q

TOF

A

RAD

61
Q

TAPVR

A

RAD + right vent hypertrophy

62
Q

TA

A

normal EEG

inc pulmonary marking

63
Q 
child infraorbital ecchymosis 
jerky movement 
flank mass
dumbbel tremor - spinal cord compression
opsclonus myoclonus

DX?

A

neuroblastoma - adrenal medulla sympathetic

NMYC

64
Q 
withdrawal
alcohol
heroin
opioid
coccain + amph
nicotine
A 
alcohol - delirium
heroin - yawn dilate pupil lacrimation
opioid - dilate pupil, myalgia, hyperactive bowel
coccain + amph- dlow crash vivid dream
nicotine - inc appetite
65
Q

normal PP

A

uterine at umbilicus + - 2 cm

66
Q

TOA

TX?

A

emperic Azithro + ceftri

gonococcal

67
Q

intrauterine synechiae

A

ashermas syndrome > cut out basalis

68
Q

vaginal Ca

A

smoking most important

age +60 HPV DES

69
Q

gartnerduct cyst

A

lateral to anterior vagina (wolffian duct)

70
Q

skene gland

A

bilat paraurethral in anterior vaginal vestibule

71
Q

valvular excoriation + erythema + abnormal pap

intermittant bleeding dyspareunia

A

vulvular CA

72
Q

endometrial hyperplasia

A

from peripheral aromatization of androgen to estrogen

androstenedine > estrone

73
Q

neonatal thyrotoxicosis from

A

transplancental TSH receptor AB _ bind to TSH receptor
low birth wt, tachy, warm skin,

TX: self resolving 3 mo
symptomatic : MMZ, bblocker

74
Q

hyperandrogen

A

ovarian cyst , inc BHCG- leuteomas bilateral

tx expectant

virilization inc testosterone = sertoli- leydig

75
Q

chronic HT in preg

MCC complication

A

preterm labor , oligo

76
Q

PPROM

A

chorioamnionitis UTI

77
Q

placenta precia

A

prior CS

78
Q

valvular firm white plaque + excoriation
IX

candida = white discharge + symmetric

A

biopsy
lichen sclerosis
risk for vulvular CA

Benigh tx steroid
malignant : imiquimode laser

79
Q

microenceph + hypotonia baby
travel + mosquito
+ multiple intracranial cal + close anteriro frantanelle

A

ZIKA syndrome = flavivirus, transplacental

IX RNA detection, ADES

80
Q

Lysteric

A

intracranial cal + hydrocephalus

81
Q

alcohol

A

micro encep แต่ไม่มี craniosynosis

82
Q

endometriosis

IX

A

laparoscopy
ดูว่ามีที่ uterosacral ligament ?

if yes = sacral pain

Usmle กู อย่างละ 100ข้อ (10 decks)

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