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Step 2 > USMLE Missed Qs > Flashcards

USMLE Missed Qs Flashcards

1
Q

Most common malignant bone tumor of childhood

A

Ewing Sarcoma

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2
Q

Localized pain and swelling + tumor in diaphysis or pelvis + moth eaten or onion skinning

A

Ewing Sarcoma

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3
Q

Management of child < 2 yo with first febrile UTI

A

Renal and Bladder US

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4
Q

EPO levels in polycythemia vera

A

Low

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5
Q

No cervical change for >/= 4 hours w/ adequate contraction or no cervical change for >/= 6 hours without adequate contractions

A

active phase arrest

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6
Q

Cervical change slower than expected (<1 cm/2 hours)

A

Protracted Active Phase

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7
Q

Management of active phase arrest

A

C-Section

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8
Q

Treatment of tremor in Parkinson’s in a younger patient

A

Trihexyphenidyl

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9
Q

Time frame for febrile nonhemolytic transfusion reaction in patients receiving blood during surgery

A

1-6 hours

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10
Q

What labs to get when starting a patient on lithium

A

BMP (BUN, Cr), UA, Calcium, pregnancy tests, and thyroid function tests

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11
Q

ECG Monitoring before and during a vasovagal syncopal episode

A

Sinus bradycardia and Asystole

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12
Q

Reason for sinus bradycardia and asystole in vasovagal syncope

A

Cardioinhibitory response due to increased parasympathetic activity

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13
Q

Elevated JVD + R ventricular 3rd heart sound + Tricuspid regurg murmur + hepatomegaly w/ pulsatile liver + lower extremity edema, ascites or pleural effusions

A

signs of R ventricular failure and cor pulmonale due to lung disease

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14
Q

Increased R heart pressure of pulmonary artery systolic pressure > 25 mmHg

A

signs of R ventricular failure and cor pulmonale due to lung disease

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15
Q

Study design best for determining the incidence of a disease

A

cohort study design

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16
Q

loss of normal action of the pyloric sphincter due to injury or surgical bypass leading to rapid emptying of hypertonic gastric contents

A

dumping syndrome

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17
Q

abdominal pain, nausea, diarrhea, HoTN, tachy, dizziness, confusion, fatigue, diaphoresis after gastric bypass surgery

A

dumping syndrome

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18
Q

Initial management of dumping syndrome

A

dietary modifications

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19
Q

consume frequent, small meals
avoid simple sugars
increase fiber and protein
drink fluids between rather than during meals

A

dietary modifications to counter dumping syndrome

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20
Q

Most common location of a VIPoma

A

pancreatic tail

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21
Q

watery diarrhea, + muscle cramps/weakness + hypo/achlorydia

A

VIPoma syndrome

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22
Q

Anorexia, Nausea, vomiting, early say tidy, post prandial fullness, and impaired glycemic control.

A

Diabetic Gastroparesis

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23
Q

Management of diabetic gastroparesis

A

Prokinetic agents like metoclopramide, erythromycin, cisapride

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24
Q

Initial treatment of sciatica

A

Short term relief of symptoms with nonsteroidal anti-inflammatory drugs or acetaminophen

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25
Q

Paraneoplastic syndrome characterized by symmetrical proximal muscle weakness and erythematous rash over the door some of the fingers and/or upper eyelids

A

Dermatomyositis

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26
Q

A common cause of a wide confidence interval:

A

A small sample size

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27
Q

Symptoms of disseminated gonococcal infection:

A

Triad of polyarthralgias, tenosynovitis, and vesiculopustular skin lesions

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28
Q

Factorial design studies:

A

Involve randomization to different interventions (2 or more) with additional study of two or more variables/outcomes

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29
Q

Definitive treatment for SCID

A

Stem cell transplant

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30
Q

Clinical features of neurofibromatosis type 1:

A

Multiple café au-lait macules, axillary and inguinal freckling, lisch nodules, neurofibromas, Optic gliomas

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31
Q

Inheritance pattern of neurofibromatosis type 1:

A

Autosomal dominant

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32
Q

Diagnostic test for chronic granulomatous disease:

A

Dihydrorhodamine 123 or nitroblue tetrazolium test

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33
Q

When do you see acalculous cholecystitis?

A

In hospital patients who are critically ill (Recent surgery, severe trauma, extensive burns, sepsis or shock, prolonged fasting or total parenteral nutrition, critical illness requiring mechanical intubation)

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34
Q

Modifiable risk factors for Breast cancer:

A

Hormone replacement therapy
Nulliparity
Increased age at first live birth
Alcohol consumption

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35
Q

First line treatment of vulvar lichen sclerosus:

A

Superpotent topical corticosteroids (clobetasol)

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36
Q

One of the most common causes of fetal tachycardia:

A

Maternal fever due to intramniotic infection

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37
Q

Most sensitive test for diagnosis of hiatal hernia:

A

Barium swallow

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38
Q

The best test for diagnosis of hemodynamically stable patients with suspected AAA:

A

Abdominal CT

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39
Q

What type of ingestion causes dysphasia, severe pain, heavy salvation, and mouth burns?

A

Caustic ingestion

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40
Q

The top three risk factors for preterm labor:

A

Preterm labor in a prior pregnancy
Multiple gestation
A history of cervical surgery

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41
Q

What is the first step in evaluating the risk of preterm labor?

A

Transvaginal ultrasound to measure the cervical length in the second trimester

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42
Q

How do ingested eggs that hatch from Taenia Solium sprayed in the body?

A

Hematogenously

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43
Q

Vitamin B2 deficiency:

A

Chelitis, glossitis, stomatitis, normocytic anemia, seborrheic dermatitis

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44
Q

Most common cause of rectovaginal fistula?

A

Obsetric injury (3rd or 4th degree laceration)

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45
Q

Preferred modality for diagnosing a ureteral stone?

A

US or non-con spiral CT of abdomen and pelvis

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46
Q

Indications for exploratory laparotomy:

A

Peritonitis
AAA
abdominal trauma

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47
Q

When is a HIDA scan indicated?

A

In patients with acute cholecystitis and US cannot definitively demonstrate obstruction at the GB neck

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48
Q

Causes of multifocal atrial tachycardia

A

R atrial enlargement
Catecholamine surge (sepsis)
Electrolyte imbalances

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49
Q

Treatment of multifocal atrial tachycardia

A

Management if the inciting disturbance

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50
Q

Howell-Jolly bodies

A

Nuclear remnants within RBCs typically removed by spleen suggesting asplenia

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51
Q

Which SSRI causes dose dependent hypertension?

A

Venlafaxine

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52
Q

Sexual assault victims are at increased lifetime risk for what?

A

Major depression and contemplation of suicide or actual suicide attempts

53
Q

Patient presenting with irritability, agitation, and psychosis. Physical signs include tachycardia, hypertension, hyper thermia, diaphoresis, and mydriasis. Symptoms resolve spontaneously:

A

Amphetamine intoxication

54
Q

The best approach to the psychotic patient with no insight:

A

A nonjudgmental stance that acknowledges the patient experience and perspective without endorsing specific delusions or hallucinations

55
Q

Indications for ECT

A

Treatment resistant depression
Depression with psychotic features
Emergency conditions (pregnancy, refusal to eat or drink, imminent risk for suicide)

56
Q

The most common psychiatric complication of multiple sclerosis:

A

Depression

57
Q

Withdrawal symptoms of a short acting benzodiazepine (alprazolam):

A

Generalized seizures and confusion

58
Q

Dream enhancement that occurs during REM sleep if muscle atonia is absent

A

REM Sleep behavior disorder

59
Q

Recurrent episodes of impulsive verbal or physical aggression that are unplanned and out of proportion to the provocation. Diagnosed after age 10

A

Intermittent explosive disorder

60
Q

Come in early side affect of SSRI:

A

Nausea, diarrhea, headache, increased anxiety, insomnia or somnolence

61
Q

Why should patients with anxiety disorders be started at lower doses of anti-depressant?

A

Because they are sensitive to the activating effects of antidepressants

62
Q

First line treatment for specific phobia?

A

Exposure —based cognitive behavioral therapy

63
Q

Hyperactivity of the hypothalamic-pituitary – adrenal axis is associated with what?

A

Major depressive disorder

64
Q

Age less than 45, psychiatric disorder, personal or family history of substance disorder, or a legal history…

A

Risk factors for prescription opioid miss use

65
Q

Alcohol withdrawal at 6 to 24 hours

A

Mild withdrawal

66
Q

Alcohol withdrawal within 12 to 48 hours:

A

Seizures in alcoholic hallucinosis

67
Q

Alcohol withdrawal in 48 to 96 hours:

A

Delirium tremens

68
Q

Long acting benzodiazepines used to treat alcohol withdrawal

A

Diazepam and Chlordiazepoxide

69
Q

What intermediate acting benzodiazepine is used to treat alcohol withdrawal

A

Lorazepam

70
Q

Impatience treated with anti-Parkinson’s medications who develop psychotic symptoms…

A

Dose reduction should be considered

71
Q

Two times in which vulvar lichen sclerosus presents:

A

Pre-pubertal girls and peri/postmenopausal women

72
Q

A BPP of 04/10 indicates…

A

Fetal hypoxia —> urgent delivery

73
Q

A BPP of 6/10 is…

A

Equivocal —> repeat testing in 1 week

74
Q

Normal BPP score

A

8-10/10

75
Q

When does a patient with gestational hypertension need to begin weekly BPP?

A

32 weeks gestation

76
Q

What two antepartum surveillance tests are equivalent?

A

BPP and CST

77
Q

Severe, long-standing (>10 yrs) RA characterized by neutropenia splenomegaly

A

Felty Syndrome

78
Q

All nonpregnant patients >25 yo with CIN 3 require:

A

Excision of the transformation zone (cone biopsy) due to the risk of progression to invasive squamous cell carcinoma

79
Q

Pulmonary contusion results in…

A

Inter-alveolar hemorrhage and Edema

80
Q

Characteristic features of pulmonary contusion following blunt thoracic trauma:

A

Tachypnea, tachycardia, and hypoxia with rails and decreased breath sounds developing less than 24 hours after blunt thoracic trauma

81
Q

Exaggerated unconjugated hyperbilirubinemia in the first week of life caused by insufficient intake of breast milk:

A

Breastfeeding jaundice

82
Q

How often should exclusively breast-fed newborns feed

A

Greater than or equal to 10 to 20 minutes per breast every 2 to 3 hours

83
Q

When does breast-feeding jaundice occur?

A

1st week of life

84
Q

When does breast milk jaundice occur?

A

Starts at age 3-5 days, peaks at 2 weeks.

85
Q

How many wet diapers should a newborn baby produce?

A

1 per how many days old ( for the first week)

86
Q

Spherocytes with no central pallor is seen in:

A

Hereditary spherocytosis and autoimmune hemolytic anemia

87
Q

Fetal ultrasound findings in toxoplasmosis

A

Bilateral ventriculomegaly

Diffuse intracranial calcification (especially basal ganglia)

88
Q

Breath holding spells:

A

An episode of apnea precipitated by frustration anger or pain

89
Q

Fever, skin rash, polyarthralgia occurring 1 to 2 weeks after exposure two antibiotics.

A

Serum-sickness like reaction

90
Q

Most common complication of influenza

A

Secondary bacterial pneumonia (S. Pneumo or S. Aureus)

91
Q

Patients with known of suspected measles infection should be isolated and placed on what precautions?

A

Airborne precautions

92
Q

Post-exposure prophylaxis for pertussis:

A

Macrolides for all close contacts

93
Q

Early satiety, nausea, nonbilious vomiting, weight loss

A

Gastric outlet obstruction

94
Q

Pyloric stricture is seen in patients with a history of…

A

Acid ingestion

95
Q

What measure of central tendency is most affected by an outlier?

A

Mean

96
Q

Women with a history of HSV get what and when?

A

Antiviral ppx at 36 weeks

97
Q

Strongest single factor predictive of suicide

A

Personal history of suicide attempt

98
Q

Blood pressure medications associated with drug induced pancreatitis

A

Guys are diuretics and ACE inhibitors

99
Q

When is ERCP indicated?

A

In patients with gallstone pancreatitis who have cholangitis, visible common bile duct dilation/obstruction, or increasing liver enzyme levels

100
Q

Fasting blood glucose level target for gestational diabetes

A

Less than or equal to 95 mg/dL

101
Q

1-hr postprandial glucose target for gestational diabetes:

A

Less than or equal to 140 mg/dL

102
Q

2-hr post prandial blood glucose goals in gestational diabetes

A

Less than or equal to 120 mg/dL

103
Q

Initial management of shoulder dystocia:

A

McRoberts maneuver (flexion of hips backward toward the abdomen) and the application of suprapubic pressure

104
Q

Initial management of placenta previa:

A

Pelvic rest, abstinence from intercourse, and routine obstetric care

105
Q

Definition of a short cervix:

A

Less than or equal to 2.5 cm

106
Q

Where is the lesion located in hemi neglect syndrome

A

The right (non-dominant) parietal lobe

107
Q

Risk factors for uterine rupture

A

Prior uterine surgery, induction of labor/prolonged labor, congenital uterine anomalies, fetal macrosomia

108
Q

Clinical presentation of Uterine rupture:

A

Vaginal bleeding, intra-abdominal bleeding, fetal heart decelerations, loss of fetal station, palpable fetal parts or an abdominal examination, loss of intrauterine pressure

109
Q

What does the biophysical profile assess?

A

Fetal Oxygenation

110
Q

What defines oligohydramnios

A

A single deepest pocket less than 2 centimeters or an amniotic fluid index less than five

111
Q

Agents used to reduce the risk of systemic thromboembolism in patients with afib and moderate to high risk thromboembolic events:

A

Warfarin or NOACs (apixiban, dabigatran, rivaroxaban)

112
Q

Initial step in management of epidural spinal cord compression:

A

IV glucocorticoids

113
Q

Most common cause of active phase protraction:

A

Cepahlopelvic disproportion

114
Q

How to contract infantile botulism:

A

Ingestion of spores

115
Q

Sine wave pattern on EKG indicates:

A

Hyperkalemia

116
Q

Emergent treatment of hyperkalemia:

A

IV calcium (chloride or gluconate) to stabilize the cardiac myocyte

117
Q

First prenatal screening labs:

A

HIV, HBV, chlamydia, syphilis

118
Q

Risk factors for avascular necrosis of the femoral head:

A

Steroid use, alcohol use, Lupus, Antiphospholipid syndrome, sickle cell, infections, renal transplant, decompression sickness

119
Q

Treatment of minimal change disease:

A

Corticosteroids

120
Q

Multiple stomach ulcers and thickened gastric folds:

A

Zollinger Ellison Syndrome

121
Q

Most common pathogenic organism in young patients with CF

A

Staphylococcus Aureus

122
Q

Mulder sign:

A

Eliciting pain on the plantar surface of the foot and crepitus between the 3rd and 4th toe when squeezed

123
Q

Most common cause of nutritional folic acid deficiency in the US:

A

Alcohol abuse

124
Q

Most common neoplasm to metastasize to the brain:

A

Lung Cancer

125
Q

Appearance of lung mets on MRI:

A

Multiple, well-circumscribed lesions with vasogenic edema at the gray and white matter junction

126
Q

Causes of scurvy:

A

Alcoholism, drug abuse, psychiatric illness

127
Q

Manifestations of scurvy:

A

Ecchymoses, follicular hyperkeratosis, petechiae, gingivitis, poor wound healing

128
Q

How does raising the cutoff point affect sensitivity and specificity?

A

Decreases sensitivity

Increases specificity

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