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PNCE > UWorld > Flashcards

UWorld Flashcards

1
Q

Delirium tremens

A

alcohol withdrawal >48h after last drink
Delirium, hyperthermia, HTN, tachycardia

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2
Q

Esophageal cancer subtypes

A

adenocarcinoma: distal esophagus, from Barretts
squamous cell carcinoma: proximal and mid esophagus

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3
Q

pertussis post exposure prophylaxis

A

<1 month: azithromycin
>1mo: azithromycin, clarithromycin, erythromycin

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4
Q

sigmoid volvulus

A

constipation, abd distension, no stool in rectal vault
colonic dilation, no air in rectum
elderly patient in nursing home

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5
Q

jones criteria

A

rheumatic fever
Joints
O (heart)
Nodules
Erythema nodosum
Sydenham chorea

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6
Q

acute rheumatic fever sx

A

Teen/young adult
fever, arthralgia, mitral regurgitation/stenosis
elevated ESR/CRP
prolonged QT interval
hx of recent URI

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7
Q

disseminated gonococcal infection

A

purulent monoarthritis or triad (tenosynovitis, dermatitis, migratory polyarthralgia)
pustular rash on trunk or extremity including palms and soles
tx 3rd gen cephalosporin

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8
Q

Abusive head trauma (shaken baby syndrome)

A

bilateral retinal hemorrhages
posterior rib fx
hx provided does not line of developmental age

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9
Q

DIC

A

schistocytes
bleeding from venipuncture sites

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10
Q

prolonged postoperative ileus

A

delayed return in bowel function >72h after surgery
conservative tx

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11
Q

primary open angle glaucoma sx

A

old age, DM, HTN, FHx
disk cupping, peripheral vision loss

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12
Q

HOCM presentation

A

Teenager syncope episode during sports game
systolic ejection murmur
LVH on EKG

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13
Q

pulmonary arterial HTN

A

progressive dyspnea, angina/syncope
loud P2 of S2
RVH

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14
Q

ethylene glycol poisoning

A

sudden flank pain, gross hematuria, oliguria
high ion gap metabolic acidosis
elevated osmolar gap

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15
Q

Conjunctivitis contact lens tx

A

pseudomonas
ciprofloxacin drops

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16
Q

rash in lyme disease

A

erythema migrans

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17
Q

MC sinus in orbital sinusitis

A

ethmoid

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18
Q

MC complication of Kawasaki dz

A

coronary artery aneurism

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19
Q

sarcoidosis sx

A

AA, hx of iritis
malaise, dyspnea, low grade fever
nodules on anterior lower legs
hepatomegaly
bilateral hilar lymphadenopathy

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20
Q

heart blocks that need pacemaker

A

2nd degree type 2 (mobitz)
3rd degree

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21
Q

Normal PR interval

A

0.12-0.20s
less than one big block

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22
Q

How to determine rate

A

300
150
100
75
60

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23
Q

Normal body temperature

A

98.6F (37C)

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24
Q

multifocal atrial tachycardia seen in

A

COPD

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25
Q

multifocal atrial tachycardia tx

A

CCB

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26
Q

WPW avoid

A

ABCD (adenosine, BB, CCB, digoxin)

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27
Q

WPW tx

A

Vagal
Procainamide
definitive: radio frequency ablation

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28
Q

ASD murmur

A

fixed split S2
crescendo decrescendo
systolic

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29
Q

ASD tx

A

surgery

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30
Q

coarctation of aorta seen in what condition

A

turners syndrome

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31
Q

when PDA becomes cyanotic

A

eisenmingers syndrome

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32
Q

tetralogy of fallot

A

pulmonary stenosis
RVH
VSD
overriding aorta

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33
Q

tetralogy of fallot sx

A

crescendo decrescendo holosystolic
LSB rad to back
tet spells
cyanotic

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34
Q

tetralogy of fallot dx and tx

A

boot shaped heart
IV PDE1 to keep open PDA

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35
Q

Cardiogenic shock sx

A

hypotension
tachycardia
cool extremities

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36
Q

niacin AE

A

flushing, HA
warm sensation, pruritus
Caution in gout and DM

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37
Q

Fibrate AE

A

myositis and myalgia
gallstones

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38
Q

endocarditis sx

A

Fever
roth spots
laneway lesions
splinter hemorrhages
osler nodes

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39
Q

pericarditis sx

A

pericardial knock
positional chest pain (better sitting up or leaning forward)
friction rub

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40
Q

pericarditis tx

A

NSAIDS (indomethacin, colchicine)

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41
Q

kussmaul sign seen in

A

cardiac tamponade

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42
Q

pulses alternans

A

cardiac tamponade

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43
Q

cardiac tamponade tx

A

pericardiocentesis

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44
Q

rheumatic fever presentation

A

Caused by GABHS
hx of strep pharyngitis

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45
Q

rheumatic fever tx

A

penicillin G
NSAID/ASA

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46
Q

MC valve rheumatic heart disease

A

mitral

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47
Q

systolic valve disorders

A

mitral regurg
aortic stenosis
tricuspid regurg
pulmonic stenosis

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48
Q

diastolic valve disorders

A

aortic regurgitation
mitral stenosis

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49
Q

meds that can be used in pregnancy

A

methyldopa
labetatol, hydralazine (acute)
nifedipine

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50
Q

folliculitis tx

A

topical mupirocin

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51
Q

Erythema multiforme reaction

A

type 4 hypersensitivity reaction

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52
Q

erythema multiforme etiology

A

HSV1

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53
Q

erythema multiforme major tx

A

PO prednisone

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54
Q

alopecia sx

A

exclamation mark hairs

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55
Q

paronychia nail biter tx

A

augmentin

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56
Q

hand foot and mouth disease complications

A

myocarditis
CNS dz

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57
Q

koplik spots

A

rubeola (measles)

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58
Q

MCC cellulitis

A

S. Pyogenes

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59
Q

erysipeloid tx

A

penicillin G or V

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60
Q

tinia capitus tx

A

griseofulvin PO

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61
Q

tinea versicolor tx

A

1st line: shampoo (selenium sulfide, ketoconazole)
2nd line: PO antifungals (fluconazole/itraconazole)

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62
Q

amphotericin B AE

A

nephrotoxic
cardiotoxic

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63
Q

condyloma acuminatum tx

A

TCA, podophyllin, imiquimod

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64
Q

verrucae tx

A

salicylic acid or cryotherapy

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65
Q

actinic keratosis sx

A

sandpaper
sum exposed areas (head, farmer, gardener)
easier to feel than see

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66
Q

seborrheic keratosis sx

A

benign
wart like
waxy greasy stuck on appearance

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67
Q

basal cell carcinoma sx

A

translucent pearly white shiny
pink papule or nodule w/ telanagiectasias
raised/rolled border

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68
Q

basal cell carcinoma tx

A

face: mohs

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69
Q

kaposki sarcoma etiology

A

HHV8

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70
Q

kaposki sarcoma sx

A

red/purple painless lesions
starts as oral lesion on feet/leg/hands and spread centripetally

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71
Q

kaposki sarcoma dx

A

skin bx: neoplastic spindle shaped cells

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72
Q

SCC of the skin sx

A

friable, bleeds w/ minimal trauma
firm, frequently ulcerates

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73
Q

pityriasis rosea sx

A

URI sx –> herald patch –> Christmas tree –> resolution

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74
Q

seborrheic dermatitis tx

A

anti dandruff shampoo
flares: TCS (desonide)

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75
Q

MC complication pressure ulcers

A

osteomyelitis

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76
Q

child with >6 cafe au lait spots

A

potential neurofibromatosis type 1

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77
Q

Jones criteria

A

acute rheumatic fever
Joint
O (heart)
Nodules
Erythema marginatum
Syndenham chorea
Minor: Fever, arthralgia, hx rheumatic fever, elevated ESR/CRP/Leukocytosis, prolonged PR interval

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78
Q

allergic conjunctivitis sx

A

cobblestone mucosa
bilateral
itching

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79
Q

MCC optic neuritis

A

MS

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80
Q

optic neuritis sx

A

swollen disk
Marcus gunn pupil
flame shaped hemorrhage
unilateral central vision loss
loss of color perception

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81
Q

optic neuritis tx

A

IV methylprednisolone
Oral CS

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82
Q

papilledema sx

A

flame hemorrhages
white cotton wool spots
blurred disc margins

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83
Q

periorbital cellulitis tx

A

no visual changes or EOM pain
augmentin or 1st gen cephalosporin

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84
Q

postseptal orbital cellulitis tx

A

hospital
IV ceftriaxone and vanco

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85
Q

retinopathy sx

A

hard exudates
cotton wool spots
flamed shaped, blot and dot
neovascularization
HTN: copper wiring, AV nicking

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86
Q

amaurosis fugax sx

A

curtain descending then goes back up
unilateral, lasts minutes
acute vision loss

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87
Q

primary open angle glaucoma sx

A

gradual loss of peripheral vision `
cupping of optic disk

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88
Q

tx open angle glaucoma

A

BB (timolol)
latanoprost

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89
Q

malignant otitis externa tx

A

IV high dose cipro

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90
Q

acoustic neuroma sx

A

unilateral sensorineural hearing loss

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91
Q

labyrinthitis tx

A

CS

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92
Q

labyrinthitis sx

A

vertigo (continuous)
hearing loss
nystagmus
Hx of URI

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93
Q

BPPV dx

A

dix hall pike

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94
Q

BPPV tx

A

employ
meclizine

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95
Q

vestibular neuritis sx

A

continuous vertigo
no hearing loss

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96
Q

menière dz sx

A

episodic vertigo
hearing loss
ear fullness

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97
Q

tx mastoiditis

A

IV vancomycin and/or tympanostomy
mastoidectomy

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98
Q

anterior epistaxis tx

A

direct pressure, sitting and leaning forward
decongestants (afrin)
cautery (silver nitrate)
packing (after 24h failure)
arterial embolization or ligation

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99
Q

posterior epistaxis tx

A

posterior nasal packs
embolization or ligation

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100
Q

Vincents angina tx

A

trench mouth
penicillin VK/ clindamycin

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101
Q

Ludwig angina sx

A

Hx of dental caries
swelling upper neck and chin
muffled voice
tongue displacement
pus on floor of mouth

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102
Q

sialadenitis tx

A

nafcillin + flagyl or clindamycin

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103
Q

gas gangrene (myonecrosis) sx

A

hx traumatic injury of UVDU
brown/blood tinged watery exudates
crepitus/gas in tissue

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104
Q

gas gangrene tx

A

IV penicillin + IV clindamycin
debridement

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105
Q

listeriosis tx

A

ampicillin IV

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106
Q

anthrax tx

A

ciprofloxacin tx and exposure

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107
Q

campylobacter jejuni sx tx

A

F, frequency bloody watery diarrhea
supportive, azithromycin if severe

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108
Q

chlamydia conjunctivitis tx

A

PO erythromycin
erythromycin ointment if neonate

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109
Q

neonatal chlamydia pneumonia sx tx

A

azithromycin
staccato cough
afebrile

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110
Q

cholera sx tx

A

rice water stools
fever rare
doxy or azithromycin if mod-severe

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111
Q

diphtheria tx

A

hospital and isolation
airway support, ASAP antitoxin
IM penicillin G or IV erythromycin

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112
Q

hemolytic uremic syndrome labs

A

triad: hemolytic anemia, renal failure, thrombocytopenia

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113
Q

HUS sx and tx

A

E. coli O157:H7
bloody diarrhea
supportive n

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114
Q

salmonellosis sx

A

fever
bloody diarrhea

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115
Q

typhoid sx

A

relative bradycardia
hepatosplenomegaly
rose colored rash
pea soup

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116
Q

shigella sx

A

high fever
watery blood mucoid diarrhea
seizures
dehydration

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117
Q

shigella tx

A

FQ/cipro
azithromycin in kids
bactrim

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118
Q

Q fever tx

A

doxy

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119
Q

plague tx

A

streptomycin/gentamicin
doxycycline

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120
Q

tetanus sx

A

joker smile
arched back
lock jaw
descending paralysis

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121
Q

tetanus tx

A

metronidazole + IM tetanus IG

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122
Q

CD4 <100

A

cryptococcus
amphotericin B/ fluconazole

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123
Q

histoplasmosis tx

A

itraconazole or amphotericin B

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124
Q

CD4 <200

A

pneumocystis (PCP)

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125
Q

pneumocystis

A

fever
dry cough, wheezing
bilateral diffuse infiltrates (bat wing)
bactrim

126
Q

ehrlichiosis sx, lab, tx

A

ticks
7-10d sx start
high fever, myalgia, HA
no rash, splenomegaly
PBS: Buffy coat/ morale in WBC. mulberry shaped aggregates
tx w/ doxy

127
Q

CD4 < 50

A

mycobacterium avium complex

128
Q

mycobacterium avium complex tx

A

clarithromycin + ethambutol

129
Q

Ghon complex

A

TB
Ghon focus (caseous necrosis) + hilarious lymph node

130
Q

PPD

A

> 5mm: HIV, recent TB contact, immunocomp
10mm: immigrants, IVDU, healthcare workers
15mm: anybody

131
Q

TB XCR

A

capillary lesions apical

132
Q

amebic liver abscess tx

A

metronidazole

133
Q

malaria tx

A

chloroquine
complicated: quinidine + doxy

134
Q

chloroquine AE

A

hemolytic anemia
G6PD

135
Q

malaria sx

A

cyclic fevers
night sweats
splenomegaly
jaundice
PBS + trophozoites (diamond ring appearance)

136
Q

ToRCH syndrome

A

toxoplasmosis
rubella
cytomegalovirus
HSV2
blueberry muffin rash (TTP)

137
Q

toxoplasmosis dx

A

ring enhancing lesion

138
Q

cytomegalovirus

A

CVM IgM
large atypical lymphocytes w/ owl eye appearance
tx w/ gancyclovir

139
Q

cat scratch dz tx

A

mild: symptomatic
azithromycin or doxy

140
Q

roseola sx

A

high fever w/ abrupt onset
rose colored rash starts on trunk

141
Q

scarlet fever sx

A

pharyngitis, F, chills
sandpaper rash, “burn w/ goosebumps”
flushed face w/ circumoral pallor and strawberry tongue
pastia lines

142
Q

tx scarlet fever

A

penicillin G/VK
macrolide if allergic

143
Q

zona glomerulosa

A

outer layer of cortex
aldosterone (Na balance)

144
Q

zona faciculata

A

cortisol
middle layer of cortex

145
Q

zona reticularis

A

estrogen/androgen
inner layer of cortex

146
Q

Primary adrenal insuffiency labs

A

CRH high
ACTH high
Cortisol low
CRH stim test: high ACTH

147
Q

secondary adrenal insufficiency labs

A

pituitary
CRH high
ACTH low
cortisol low
CRH stim test: absent/ low ACTH

148
Q

tertiary adrenal insufficiency labs

A

hypothalamus
CRH low
ACTH low
cortisol low
CRH stim test: prolonged

149
Q

primary adrenal insuffiency (Addisons) sx

A

hyperpigmentation
salt cravings
hypotension
hyperK, metabolic acidosis
hypoglycemia
loss libido

150
Q

Addisons BIT

A

AM serum cortisol level
if low, adrenal insufficiency

151
Q

GLP1 “tide” AE

A

pancreatitis

152
Q

SGLT2 “flozin” AE

A

UTI/yeast

153
Q

metformin AE

A

macrocytic anemia
renal impairment
metallic taste

154
Q

hyperosmolar hyperglycemic state

A

blood glucose 600-2400
serum osmy >320
hyponatremia
little ketones

155
Q

diabetic ketoacidosis

A

KETONURIA
blood glucose 250-600
fruity breath, kussmaul respiration
usually DMT1
hypokalemia, high anion gap

156
Q

pheochromocytoma tx

A

phenoxygenzamine
propranolol

157
Q

primary hyperaldosteronism (conn)

A

refractory HTN
hypokalemia, hypernatremia

158
Q

conn syndrome tx

A

adrenalectomy if adenoma
spironolactone

159
Q

SIADH labs

A

hyponatremia
high urine osmo
low serum osmo

160
Q

SIADH tx

A

fluid restriction
sx: furosemide, admit to ICU

161
Q

DI labs

A

increase volume dilute urine
decrease urine osmo
high serum osmo

162
Q

Tx DI central

A

DDAVP

163
Q

tx DI nephrogenic

A

thiazide

164
Q

thyroid storm tx

A

ABC
BB
PTU/methimazole
iodine and steroids (dexamethasone)

165
Q

hyperthyroidism tx

A

PTU
methimazole

166
Q

de quervain thyroiditis (subacute thyroiditis)

A

hx URI
hyperthyroid then hypothyroid state
HLA B35
high ESR

167
Q

subacute thyroiditis tx

A

self limiting
NSAIDS and BB
steroids

168
Q

Basal long acting insulin

A

glargine
getemir
deluded
once daily

169
Q

basal intermediate acting insulin

A

NPH
twice daily

170
Q

preprandial short acting

A

Regular: best for IV use DKA. peak 2-5h
lispro, aspart, glulisine: peak 30m-3h. best for postal hyperglycemia

171
Q

DM meds that cause hypoglycemia

A

sulfonylureas (glyburide, glipizide)
meglitinides (repaglinidide, nateglinidide)
insulin (regular, lispro, aspart, NPH, glargine)

172
Q

cholecystitis sx

A

fat female fertile forty
murpheys sign
fever

173
Q

cholangitis sx

A

charcots triad: F, RUQ pain, jaundice
Reynolds pentad: + septic shock, AMS
emergency

174
Q

cholelithiasis sx

A

fat, forty, female, fertile, fair
pain after meal
no tx if asx

175
Q

choledocholithiasis

A

jaundice, RUQ pain

176
Q

primary biliary cholangitis

A

jaundice, RUQ pain, pruritus
+anti mitochondrial antibodies
tx w/ ursodiol. cholestyramine for pruritus

177
Q

primary sclerosing cholangitis sx, lab

A

male w/ hx of IBS/UC
itchy hands, jaundice, hepatomegaly
increased ALK, increased GGT
+ pANCA
onion skin on liver bx

178
Q

constipation tx

A

psyllium
Senna, bisacodyl
enema

179
Q

diverticulosis sx

A

painless rectal bleeding

180
Q

diverticulosis sx

A

fever, LLQ pain, leukocytosis
no bleeding

181
Q

diverticulitis dx

A

CT w/ oral and IV contrast
CI: barium enema and colonoscopy (risk of perforation)

182
Q

diverticulitis tx

A

zosyn, cipro, bactrim + metronidaozole

183
Q

fecal impaction tx

A

digital disimpaction and evacuation

184
Q

Hirschsprung dz sx

A

no passed meconium within 48h of birth
poor feeding, abd distention

185
Q

hirschsprung dx

A

anorectal manometry BIT
xray: complete bowel obstruction
bx definitive

186
Q

hirschsprung tx

A

surgery

187
Q

hemorrhoids tx

A

2nd line: rubber band ligation (internal). elliptical excision (thrombosed)
3rd line: hemorrhoidectomy

188
Q

smoking and IBD

A

Crohn: smoking harmful
UC: smoking protective

189
Q

crohns

A

transmural, cobblestone appearance, skip lesions
RLQ, N/V/D, no gross blood
+ASCA, high ESR/CRP
string sign

190
Q

Tx crohns

A

mesalamine

191
Q

UC sx

A

continuous
LLQ pain, hematochezia, tenesmus
sigmoidoscopy/colonoscopy
+PANCA, stovepipe sign (dec haustral marking)
total colectomy curative

192
Q

toxic megacolon

A

fever, tachycardia, leukocytosis
bloody diarrhea, vomiting
Xray: >6cm loss of haustral markings
ICU: colectomy if >24h

193
Q

boerhaave syndrome

A

severe retrosternal chest pain
crunching (hammens sign)
XR: widened mediastinum, pleural effusion, emphysema)
contrast esophogram definitive
NPO, surgical

194
Q

diffuse esophageal spasm tx

A

nitrates, CCB, TCA

195
Q

Zenker diverticulum

A

halitosis
barium swallow
surgery 1st line

196
Q

tx esophageal varices

A

vasopressin
banding and IV octeotide
chronic: BB and ligation

197
Q

H. pylori tx

A

clarithromycin
amoxicillin
PPI

198
Q

duodenal atresia

A

bilious vomiting first 2 days of life
double bubble sign

199
Q

gastroporesis dx and tx

A

upper endoscopy BIT
confirm: scintigraphic gastric emptying study
metoclopramide

200
Q

direct inguinal hernia

A

hesselbachs triangle
medial to inferior epigastric vessels

201
Q

indirect inguinal hernia

A

lateral to inferior epigastric vessels

202
Q

travelers diarrhea tx

A

cipro
azithromycin (preg/child)
bismuth

203
Q

C. diff tx

A

metronidazole
vancomycin

204
Q

hemolytic uremic syndrome caused by

A

shiga toxin
E. coli 1057:H7

205
Q

HUS sx

A

bloody diarrhea, petechiae, oliguria
schistocytes
thrombocytopenia, AKI
Tx fluids, transfusion, dialysis

206
Q

phenylketonuria

A

excessive phenylalanine
light complexion, musty/mousey urine
tx w/ tyrosine, avoid high proteins and phenylalanine

207
Q

MC gastric cancer

A

adenocarcinoma

208
Q

colorectal cancer

A

CEA

209
Q

cholangiocarcinoma

A

tumor of intra extra hepatic bile duct
clay colored stool, dark urine, jaundice

210
Q

pancreatic cancer

A

Ca 19-9
CEA
painless jaundice, pale stools
palpable gallbladder

211
Q

thiamine deficiency

A

B1
from alcoholism
wernicke encephalopathy

212
Q

Beriberi sx

A

dry: peripheral neurologic deficits from B1 deficiency. stocking glove distribution
wet: myocardial dz due to B1 deficiency

213
Q

Riboflavin

A

B2
oral ocular genital syndrome
magenta tongue, angular chelitis

214
Q

niacin deficiency

A

B3 (pellagra)
raw skin
4Ds: diarrhea, dementia, dermatitis, death (if not tx)
tx: meat, fish, liver, whole grains, green leafy veggies

215
Q

scurvy

A

vitamin C deficiency
3H: hyperkeratitis, hemorrhage, hematologic

216
Q

vitamin D deficiency labs

A

loser lines
low Ca, low P, high ALP

217
Q

acute pancreatitis sx

A

epigastric pain rad to back
N/V/F leukocytosis, hypotension
Cullen sign, grey turner sign, fox sign

218
Q

acute pancreatitis labs

A

CT
Xray/US: colon cut off sign, sentinel loop
high serum amylase, lipase (specific), low calcium

219
Q

chronic pancreatitis

A

triad: calcifications, steatorrea, DM
CT, ERCP (gold)
amylase lipase normal

220
Q

acute mesenteric ischemia

A

pain out of proportion
lactic acidosis, metabolic acidosis
CTA BIT, mesenteric angiography gold
barium enema (thumb printing)

221
Q

intussusception sx, dx, tx

A

palpable sausage shaped mass
currant jelly stool
XR BIT (target sign)
reduction via enema (stable)
surgical if unstable

222
Q

SBO labs

A

XR: ladder pattern, string of pearls

223
Q

paralytic ileus

A

RF: opioids, post op
abscent/no Bowel sounds
resolves w/ time

224
Q

volvulus

A

bilious vomiting, blood streaked stools
double bubble sign
corkscrew/beaked appearance

225
Q

Kayser Fleischer ring

A

Wilsons dz
decreased ceruloplasmin
tx w/ D. penicillamine, zinc

226
Q

compartment syndrome 5 Ps

A

pulselessness
pallor
paresthesia
paralysis
pain out of proportion
poikilothermic

227
Q

OA tx

A

NSAIDs
acetaminophen for elderly w/ bleed risk

228
Q

osteomyelitis sx tx

A

Codman’s triangle (CT)
high WBC, high ESR/CRP
bone aspiration gold
tx: ampicillin-sublbactam, surgery to remove dead bone

229
Q

avascular necrosis xray

A

joint space narrowing, subchondral sclerosis

230
Q

salter Harris fx

A

I: Slipped epiphysis
II: Above fx
III: L below fx
IV: Through fx
V: ERasure of growth plate

231
Q

pes anserinus pain syndrome

A

pain medial knee just below joint line
tenderness over medial tibial condyle

232
Q

medial ankle injury gold

A

screw fixation

233
Q

osteosarcoma presentation

A

young adult, adolescent
long bones
hair on end, starburst
Codman triangle

234
Q

Ewing sarcoma sx, dx

A

children
+ fever, palpable mass
lytic lesion, onion peel, moth eaten, codman triangle

235
Q

fibromyalgia tx

A

amitriptyline or duloxetineor pregabalin

236
Q

1st line gout tx

A

NSAIDs

237
Q

juvenile RA

A

uveitis, salmon colored macular rash, joint pain
high CRP, high ESR, + ANA
opthalmologic exams
NSAID, MTX

238
Q

starburst livedo

A

polyarteritis nodosa: skin ulcers, nodules on lower legs,
high ESR/CRP
definitive: deep wedge bx of nodules
-ANCA
prednisone, cyclophosphamide

239
Q

polymyalgia rheumatica

A

assoc w/ giant cell arteritis
morning stiffness better throughout the day (proximal)
high ESR/CRP
low dose prednisone w/ taper

240
Q

eosinophilic granulomatosis w/ polyangitis

A

triad: asthma, hypereosinophilia, chronic rhino sinusitis
eosinophilia hallmark, + panca, high ESR/CRP, inc BUN/Cr
CS

241
Q

polymyositis markers and tx

A

anti-jo-1
anti SRP
high dose CS

242
Q

dermatomyositis

A

anti MI 2 ab
heliotrope (blue/purple eyelid discoloration)
gottrons papules: knuckles raised violaceous scaly eruptions
malar rash
shawl/ V sign

243
Q

reactive arthritis tx

A

NSAID
supportive

244
Q

RA

A

+RF
anti CCP

245
Q

sjrogens

A

+ ANA, + RF
schemer test
antiSSa (ro)
anti SSb (la)
tx: pilocarpine

246
Q

+ anticardiolipin ab

A

antiphospholipid syndrome

247
Q

SLE tx

A

hydroxychloroquine

248
Q

scleroderma markers

A

anti SCL 70
anticentromere ab

249
Q

ankylosing spondylitis tx

A

NSAIDS, PT
TNF

250
Q

brown sequared syndrome

A

ipsilateral hemiplegia
ipsilater loss of motor, vibratory, and proprioception
contralateral loss of pain and temp sensation

251
Q

anterior cord syndrome

A

loss of motor, pain, temp below injury
proprioception and vibratory maintained

252
Q

MC clavicle fx

A

middle 1/3

253
Q

humeral head fx avascular necrosis

A

axillary nerve
brachial plexus
axillary artery

254
Q

fat pad sail sign

A

radial head fx

255
Q

galeazze fx

A

distal radius fx
radioulnar joint dislocation

256
Q

Monteggia fx

A

ulna fx
radial head dislocation

257
Q

MC mandibular fx

A

body
condyle
angle

258
Q

lateral rectus palsy

A

SO4, LR6: abducens nerve
horizontal diplopia, estropia

259
Q

trigeminal neuralgia tx

A

carbamazepine

260
Q

pseudotumor cerebri tx

A

acetazolamide

261
Q

alzheimers tx

A

anticholinergics (donepezil, rivastigmine)
memantine late stages

262
Q

Creutzfeldt-Jakob disease

A

dementia at early age
seizures, myoclonic jerks
LP: 14-3-3 proteins in CSF
no current tx

263
Q

frontotemporal dementia

A

+ palmomental and palmar grasp reflexes
personality changes
tx: SSRI, supportive

264
Q

normal pressure hydrocephalus

A

wet, weird, wobbly: urinary incontinence, dementia, shuffling/wide based gait
MRI: ventriculomegaly
Tx w/ shunt

265
Q

vascular dementia

A

sudden or stepwise decline
temporal: memory problems
parietal: loss of speech (aphasia)
frontal: personality changes
Tx by preventing another stroke: anticoagulant (ASA, clopidogrel, statin, ACE)

266
Q

cerebral palsy sx

A

spastic: increase muscle tone, high DTR

267
Q

MS tx

A

exacerbation: Methylpred
plasmapheresis
maintenance: Beta interferon

268
Q

myasthenia gravis dx

A

AChr ab test, MuSK ab
tension test

269
Q

myasthenia gravis tx

A

pyridostigmine
thymectomy if thymoma

270
Q

GBS tx

A

high dose IVIG, plasmapheresis, CS

271
Q

central cord syndrome

A

upper extremities more affected than lower

272
Q

subarachnoid hemorrhage gold standard

A

LP: xanthochromia

273
Q

intracranial hemorrhage tx

A

nitroprusside

274
Q

ACA

A

feet and legs

275
Q

MCA

A

hands
arms
face
language center in dominant hemisphere

276
Q

PCA

A

visual
blindness

277
Q

lacunar CVA

A

hemiparesis (contralateral)

278
Q

basilar CVA

A

CN abnormalities
vertigo

279
Q

TPA/Alteplase

A

w/in 4.5h of onset

280
Q

vertebral CVA

A

vertigo, nystagmus, diplopia

281
Q

MC CVA

A

MCA

282
Q

outpatient tx pneumonia

A

amoxicillin
doxycycline

283
Q

inpatient tx pneumonia

A

ceftriaxone and azithromycin
FQ (levo)
pseudomonas: piperacillin tazo

284
Q

MCC atypical pneumonia

A

mycoplasma (young college)

285
Q

CXR atypical pneumonia

A

mycoplasma: reticulonodular infiltrates

286
Q

blastomycosis

A

east of Mississippi
F, cutaneous papules
pulmonary sx
round broad budding yeast w/ thick double walls
itraconazole

287
Q

coccidiomycosis

A

California
mild lung infx, bone granulomas, meningitis, erythema nodosum
self limiting, itraconazole

288
Q

histoplasmosis

A

Mississippi River valley, Ohio
dimorphic oval yeast

289
Q

cryptococcosis

A

encapsulated budding yeast on India ink stain
USA, MC fungal meningitis

290
Q

aspergillosis sx tx

A

soil
mold grow in lungs
septa hyphae w/ regular branching, wide angle
fungus ball on xray
need surgery, itraconazole

291
Q

rifampin AE

A

orange discoloration of urine/tears
hepatotoxic

292
Q

isoniazid + pyroxidine AE

A

peripheral neuropathy (combo w/ B6)
hepatotoxic

293
Q

pyrazinamide AE

A

hepatotoxic
hyperuricemia
photosensitive dermatologic rash
can use on pregnancy

294
Q

ethambutol AE

A

optic neuropathy
red/green color blindness
hyperuricemia
gout

295
Q

superior vena cava syndrome

A

complication of lung cancer
SVC obstructed by tumor, venous congestion to head, neck and UE
facial fullness, face/arm edema, dilated veins anterior chest/arm/face JVD

296
Q

horners syndrome

A

apical tumor presses on cervical sympathetic chain
ptosis
miosis
anhidrosis

297
Q

lung cancer nerve compression

A

recurrent laryngeal nerve: hoarseness
phrenic nerve: diaphragmatic elevation and dyspnea

298
Q

small cell lung cancer location

A

central

299
Q

mesothelioma dx

A

pleural thickening
bx of tumor definitive
immunostained w/ calretinin: fried egg shape

300
Q

pulmonary carcinoid tumor

A

dysfunction of neuroendocrine cells leading to tumor production
serotonin synthesis
diarrhea, skin flushing, asthma-like attacks, hemoptysis
well vascularized central tumor (pink/purple)
best: 24h urine w/ 5-HIAA: high serotonin levels
TOC: surgery, octreotide

301
Q

pulmonary HTN sx

A

dyspnea, chest pain, and syncope on exertion
tricuspid regurgitation (holosystolic murmur)
loud P2 during S2
right heart Cath gold, echo BIT
tx underlying

302
Q

coal worker pneumoconiosis CXR

A

small apical opacities upper lobs

303
Q

berylliosis

A

aerospace, dental, lightbulbs
berrylium lymphocyte upper lobe
noncaseating granulomas on bx
glucocorticoid therapy for acute and chronic
MTX if nonresponsibe

304
Q

byssinosis sx

A

cotton dust, textile
Monday chest tightness

305
Q

ARDS sx and xray

A

failure to respond to 100% O2
bilateral infiltrates, spares costophrenic angles

306
Q

Stages of asthma tx

A

Intermittent: <2d/wk, night sx <2/mo (SABA prn)
Mild persistent: >2d/wk, night sx 4x/mo (SABA + low dose ICS, fluticasone)
moderate persistent: daily sx, night sx >1/wk (SABA + low ICS +LABA)
severe persistent: multiplex/d night >7x/wk (SABA+med/hi ICS+LABA)

307
Q

bronchiectasis

A

MCC CF
chronic cough, mucopurulent foul smelling sputum
Chest CT: tram track, signet ring sign
zosyn for pseudomonas coverage

308
Q

MC site FB lung

A

main right bronchus

309
Q

hyaline membrane dz

A

insuffiency of surfactant
diffuse ground glass appearance
antenatal CS for mom 24h before

310
Q

3 auditory ossicles

A

malleus
incus
stapes: smallest bone in body

PNCE (33 decks)

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