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2CK Smartbook > USMLE World key info > Flashcards

USMLE World key info Flashcards

1
Q

mid diastolic rumble suggests what cardiac abnormality

A

mitral stenosis

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2
Q

how do you treat a patient who had rheumatic fever in year past but was not treated and why do you even treat?

A

prophylactic antibiotic regimen b/c of high risk of recurrence of RF w/ subsequent strep infections
=IM Penicillin G q4weeks
-for RF w/o carditis duration is 5 years or until age 21 (whichever is longer)
-for RF w/ carditis, but no residual valve disease duration is 10 years or until 21 (whichever is longer)
-for RF w/ persistent heart disease duration is 10 years or until 40 (whichever is longer)

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3
Q

top 3 cardiac diseases associated with Down’s syndrome listed in order of incidence

A
  1. complete atrioventricular septal defect (poorly formed AV valves + ASD + VSD)
  2. VSD
  3. ASD
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4
Q

5 P’s of limb ischemia

A

pulselessness, pallor, pain, parasthesias, paralysis (and hyPothermia)

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5
Q

widened pulse pressure and water hammer pulse suggest what valvular abnormality and why do these findings occur?

A

AR: widened pulse pressure due to open communication between aorta and LV after systole allowing back-leak of a portion of the stroke volume;
water hammer pulse occurs for the same reason, there is a strong SBP, but DBP drops significantly due to retrograde flow of some of the stroke volume

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6
Q

treat Wolf-Parkinson White with ________ and avoid _________ b/c ___________

A

treat WPW with antiarrhythmics like procainamide and avoid AV nodal blockers like CCB’s, digoxin and adenosine because they enhance accessory pathway conduction by slowing AV node conduction

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7
Q

treatment for infective endocarditis with PCN susceptible strep (2 options)

A

IV Penicillin G every 4-6 hours OR IV Ceftriaxone qd for 4 weeks

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8
Q

what is a cholesteatoma and how does it present

A

epithelial tumor of the middle ear that can disrupt the tympanic membrane
presentation: continued ear drainage despite abx and sudden onset of hearing loss; on ear exam a retraction pocket or granulation tissue on the TM may be seen

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9
Q

at what age should you start DEXA screening

A

do an initial screen for all woman over 65 years of age

T-score more negative than 2.5 is considered osteoporosis

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10
Q

ascites, JVP, LE edema and hepatomegaly in a patient s/p treatment for Hodgkin’s lymphoma should make you think of what etiologic condition

A

constrictive pericarditis due to radiation Tx resulting in right heart failure (JVP, ascites, peripheral edema, hepatomegaly)

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11
Q

a kid with bulging tympanic membranes and a middle ear effusion should be given what treatment

A

for acute otitis media 1st line therapy= amoxicillin

2nd line= amox-clavulanate

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12
Q

which 4 medications should be given for mortality benefit after myocardial infarction

A

beta blockers
statins
ACE-inhibitors
aspirin

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13
Q

what are the guidelines for ASA and clopidogrel after NSTEMI? after PCI?

A

after NSTEMI: clopidogrel for 12 months, ASA indefinitely

after PCI: clopidogrel for 30 after bare metal and 6-12 months after DES; ASA indefinitely

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14
Q

what hgb is considered anemic in pregnancy

A
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15
Q

at what age should you assume cryptoorchidism will not spontaneously resolve

A

if it persists at 6 months move to surgery

surgery should be done before 1 year

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16
Q

how do you treat a hairline fracture of the metatarsal

A

rest and analgesia (only casting if after time symptoms do not resolve; nonunion is uncommon due to natural splinting of adjacent bones)

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17
Q

nasal obstruction, visible nasal mass and recurrent epistaxis in a peds patients should make you think

A

juvenile angiofibroma

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18
Q

lifting of the tibial tubercle from the shaft or a break in the tibial tubercle seen on x-ray is suggestive of what condition

A

Osgood-Schlatter disease (traction apophysitis)

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19
Q

uveitis/conjunctivitis/inflammation of one eye after the other eye has suffered penetrating injury suggests what condition

A

sympathetic ophthalmia: uncovering of “hidden antigens” in the protected space of the eye leads to autoimmune attack on the other eye

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20
Q

until what age should most women get regular pap smears

A

until age 65

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21
Q

what is the drug of choice to treat malignant otitis externa

A

IV cipro (covers pseudomonas)

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22
Q

what is the age range and screening interval for breast cancer screening

A

ages 40-75, every 2 years

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23
Q

what is the age range and screening interval for cervical cancer

A

ages 21-65

21-29 pap every 3 years, then continue until 65 or switch to cotesting every 5 years until 65

24
Q

what is the age range and screening interval for colon cancer

A

age 50-75
colonoscopy every 10 years if normal
or FOBT yearly

25
Q

what is the age range and screening interval for hyperlipidemia

A

men over 35

lipid panel every 5 years

26
Q

what is the age range and screening interval for hypertension

A

after age 18

BP checks every 2 years

27
Q

otosclerosis is a conductive hearing disorder that involves overgrowth of what structure

A

the stapes

28
Q

what is the most common congenital cyanotic defect?

most common congenital heart defect overall?

A

transposition of the great vessels

most common overall=VSD

29
Q

what is the difference between validity and accuracy

A

trick question! there is no difference

validity=accuracy

30
Q

what treatment is indicated for a GSW to the abdomen who is hemodynamically unstable and has an indeterminate FAST

A

emergent laparotomy; this is a penetrating trauma and anything below the 4th intercostal space is considered abdomen

31
Q

what infection is erythema multiforme often associated with

A

herpes simplex virus

32
Q

a whistling sound in the nose on inspiration after rhinoplasty is likely

A

nasal septal perforation

33
Q

what are the typical x-ray findings for cervical spondylosis

A

osteophytes (bony spurs) and sclerotic facet joints

34
Q

a dome shaped painless nodule with a central punctum that regresses and recurs is likely

A

epidermal inclusion cyst

35
Q

what is Ramsey Hunt syndrome

A

Herpes zoster that causes Bell’s palsy

36
Q

what is serous otitis media and how does it present

A

commonly seen in AIDS, serous otitis media is a non-infectious inflammation and effusion of the middle ear
presentation= hearing loss, dull and hypomobile tympanic membrane

37
Q

how do you treat tinea capitis (the scalp fungal infection that causes bald spots)

A

oral griseofulvin

selenium sulfide or ketoconazole shampoo for household contacts

38
Q

what is the treatment for hydrocoele in an infant

A

reassurance and observe; most resolve by 1 year of age (no imaging needed)

39
Q

a patient has a firm testicular mass and ultrasound suggests cancer; what is the next best step

A

radiacal orchiectomy
KILL FIRST AND INVESTIGATE LATER
biopsies are contraindicated due to spillage of highly invasive cells

40
Q

by 1 year of age a child’s weight should increase by how much

A

weight should triple, height should increase by half

41
Q

what can a patient do to decrease risk of Meniere’s disease

A

low salt diet, avoiding triggers like alcohol, caffeine and nicotine which increase endolymphatic retention

42
Q

a knee injury during athletic activity resulting in rapid hemarthrosis should make you think of what

A

ACL injury (tends to present more commonly with more rapid hemarthrosis than other ligament tears)

43
Q

pain at the knee that is pretibial and medial with negative x-ray with no swelling and valgus stress test is likely

A

anserine bursitis (the anserine bursa is just medial to the infrapatellar bursa and causes pain, but no swelling when inflamed)

44
Q

cancers on the lip are usually basal cell or squamous cell carcinoma?

A

squamous cell carcinoma

45
Q

initial drug of choice for pain in mild to moderate osteoarthritis?

A

acetaminophen (can’t use NSAIDs because chronic use would increase GI toxicity risk)

46
Q

nasopharyngeal carcinoma (an undifferentiated cancer of squamous origin) is associated with what risk factors

A

EBV, smoking, nitrosamines (salted fish)

47
Q

what is Felty syndrome

A

splenomegaly and neutropenia in a patient with rheumatoid arthritis

48
Q

what are the side effects of MTX?

A

hepatotoxicity, stomatitis, cytopenias

49
Q

how do sulfasalazine and hyroxychloroquine work (mechanism of action)?

A

TNF and IL-1 suppression

50
Q

acute otitis media vs. otitis media with effusion

A

both involve middle ear effusion however acute otitis media has signs of acute infection such as fever, bulging TM

51
Q

what intervention is most effective in reducing medication reconcilliation errors during transitions of care from different facilities/institutions

A

interventions that target pharmacists and high-risk patients

52
Q

what is torus palatinus

A

a congenital benign bony mass located in the central suture of the hard palate

53
Q

what renal side effect do patients with diffuse scleroderma develop

A

scleroderma renal crisis (involves renal failure, malignant hypertension, thrombocytopenia and microangiopathic hemolytic anemia)

54
Q

when do you see Burr cells (RBCs with serrated edges)

A

liver disease and ESRD

55
Q

when do you have to add tetanus immunoglobulin to post-exposure ppx toxoid vaccine?

A

when the wound is dirty or severe

56
Q

what is the treatment for cat-scratch disease

A

oral azithromycin

57
Q

which kind of neurologic condition involves a lucid interval after trauma

A

EPIDURAL hematoma

2CK Smartbook (18 decks)

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