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UWorld Flashcards

1
Q

What is the difference between pre-septal and orbital cellulitis in clinical presentation?

A 
orbital cellulitis has 
opthalmoplegia
pain with EOM
proptosis
vision impairment
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2
Q

what is the most common cause of congenital adrenal hyperplasia? (CAH)

A

21-hydroxylase deficiency

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3
Q

What is the clinical presentation of severe (classic) 21-hydroxylase deficiency?

A

presents in infancy
virilization
salt-losing crisis

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4
Q

What medical treatment is used for urge incontinence?

A

antimuscarinic

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5
Q

what medical treatment is used fro overflow incontinence?

A

cholinergic agonists

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6
Q

What deposits are found in parkinson’s disease and where are they located?

A

alpha-synuclein

substantia nigra pars compacta

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7
Q

What are the HACEK organisms?

A 
Haemophilus arprophilus
Aggregatibacter actinomycetemcomitans
Cardiobacterium hominis
E corrodens
Kingella kingae
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8
Q

what is the biggest risk factor for developing stroke (ischemic or hemorrhagic)?

A

hypertension

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9
Q

what is the treatment for postpartum endometritis?

A

clindamycin and gentamicin

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10
Q

what is the treatment for lactational mastitis?

A

dicloxacillin

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11
Q

what is the athletes triad?

A

amenorrhea
osteoprososis
eating disorder

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12
Q

at what ages are VZV vaccines administered?

A

1 and 4

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13
Q

What are potential masses in the anterior mediastinum?

A

Thymoma
retrosternal thyroid
teratoma
lymphoma

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14
Q

What are potential masses in the middle mediastinum?

A 
bronchogenic cyst
tracheal tumors
pericardial cysts
lymphoma
lymph node enlargement
aortic aneurysms of the arch
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15
Q

where are all neurogenic tumors located?

A

posterior mediastinum

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16
Q

what are neurogenic tumors?

A 
meningocele
enteric cysts
lymphoma
diaphragmatic nerhina
esophageal tumor
aortic aneurysm
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17
Q

what is the best treatment for cancer related cachexia?

A

progesterone analogues (megestrol acetate, medroxyprogresterone acetate)

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18
Q

what is the best treatment for HIV related cachexia?

A

synthetic cannabinoids (dronabinol)

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19
Q

what is the presentation of an erb-duchenne palsy? 5th and 6th cervical nerves

A

decreased moro and biceps reflexes
waiters tip (extended elbow, pronated arm, fixed wrist and fingers)
Intact grasp reflex

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20
Q

What is the presentation of Klumpke palsy? C8 and T1

A

Claw hand (extended wrist, hyperextended MCP, flexed IP, absent grasp reflex)
Horner syndrome
Intact moro and biceps reflex

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21
Q

what organisms predominates burn wounds in the first 5 days?

A

S. aureus

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22
Q

What organisms predominates burn wound after 5 days?

A

GN

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23
Q

What are the associated neoplasms with lynch syndrome

A

CRC
endometrial cancer
ovarian cancer

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24
Q

What are the associated neoplasms with familial adenomatous polyposis?

A

CRC
Desmoids and osetomas
brain tumors

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25
Q

What are the associated neoplasms with von hippel-lindau syndrome?

A

hemangioblastomas
clear cell renal carcinoma
pheochromocytoma

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26
Q

What are the associated neoplasms with MEN 1

A

parathrydoid adenoma
pituitary adenoma
pancreatic adenoma

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27
Q

What are the associated neoplasms with MEN2

A

medullary thyroid cancer
pheochromocytoma
parathyroid hyperplasia (type 2A)

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28
Q

What are the associated neoplasms associated with BRCA1 and BRCA2?

A

breast cancer

Ovarian cancer

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29
Q

Which histopathologicalfinding would require more intensive follow-up colonoscopic surveillance?

A

Villous adenoma is a bad polyp

sessile is bad too

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30
Q

what deficiency is associated with carcinoid syndrome?

A

niacin

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31
Q

what antibodies are positive in SLE?

A

ANA
anti-dsDNA
Anti-smith

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32
Q

what ar cyclic citrullinated peptide antibodies used to diagnose?

A

RA

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33
Q

What are anti-histone antibodies used to diagnose?

A

drug-induced lupus

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34
Q

What antibodies are used to diagnose scleroderma?

A

Anti-Scl-70 (anti-topoisomerase)

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35
Q

when are seizures most likely to occur from alcohol withdrawal?

A

12-48 hours

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36
Q

when does DT occur?

A

2-4 days after last drink

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37
Q

what is the clinical presentation of wernekes encephalopathy (thiamine deficiency)?

A

gait ataxia
oculomotor dysfunction (horizontal nystagmus)
encephalopathy

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38
Q

What is the hallmark of alcoholic cerebellar degeneration?

A

wide based gait with postural (truncal) instability (can’t perform heel-shin or tandem gait)
limb coordination intact (FNF)

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39
Q

What is legg-Clave-Perthes disease?

A

idiopathic avascular necrosis of the femoral capital epiphysis

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40
Q

what medication is contraindicated in cocaine abuse chest pain?

A

beta blockers

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41
Q

at what week should pre-eclampsia without severe features be delivered?

A

> 37 weeks

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42
Q

at what week should pre-eclampsia with severe features be delivered

A

> 34 weeks

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43
Q

what is the hallmark of euthyroid sick syndrome?

A

Normal TSH and T4, decreased T3

“Low T3 syndrome”

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44
Q

what is the gold standard test for diagnosis HIT?

A

serotonin release assay

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45
Q

what is the most common nephropathy associated with HIV?

A

Focal and segmental glomerulosclerosis (FSGS)

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46
Q

what is the treatment for Afib with RVR in a patient with WPW syndrome?

A

procainamide or ibutilide (AVOID AV nodal blockers)

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47
Q

what type of organisms are present with chronic granulomatous disease?

A

catalase positive pathogens (S. aureus, Serratia, Burkholderia, Aspergillus)

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48
Q

what are the tests for chronic granulomatous disease?

A

neutrophil function testing (dihydrohodamine 123 test, nitroblue tetrazolium test)

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49
Q

what opportunistic infections are most common with solid organ transplant?

A

PCP

CMV

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50
Q

What is the triad of aspirin exacerbated respiratory disease? (AERD)

A

asthma
chronic rhinosinusitis with nasal polyposis
bronchospasm or nasal congestion
all following ingestion of aspirin or NSAIDS

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51
Q

what is the likely causative organism in neutropenic fever?

A

pseudomonas

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52
Q

what is the best initial treatment for neutropenic fever?

A

anti-pseudomonad beta-lactam agent

cefepime, meropenem, pipperacillin-tazpobactam

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53
Q

what are the metabolic side effects of thiazide diuretics

A

hyperglycemia
increased LDL and triglycerides
hyperuricemia

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54
Q

What are the electrolyte abnormalities that can happen with thiazide diuretics?

A

hyponatremia
hypokalemia
hypomagnesemia
hyercalcemia

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55
Q

what are the classic findings of tricuspid atresia?

A

left axis deviation, decreased pulmonary markings on CXR, Minimal R waves, peaked p waves

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56
Q

what is the triad of congenital rubella disease?

A

cataracts, hearing loss, heart defect (PDA)

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57
Q

what is hyposthenuria and who is it most common in?

A

kidney damage leading to problems with concentrating urine

Caused by sickling of cells in sickle cell anemia/trait

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58
Q

what is the treatment for histoplasmosis in patients who are immunocompromised?

A

amphotericin B, after 1-2 weeks of clinical improvement, transitioned to oral itraconazole for 1 year

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59
Q

what is the clinical presentation of sporothrix schenckii

A

papule at the site of inoculation followed by spreading proximally along the lymphatic chain, common in landscapers

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60
Q

what disease is associated with primary sclerosing cholangitis?

A

ulcerative colitis

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61
Q

how do you diagnose primary biliary cholangitis?

A

anti-mitochondrial antibodies

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62
Q

if a patient is diagnosed with streptococcus gallolyticus (strep bovis) endocarditis what is the next best step?

A

colonoscopy to evaluate for CRC

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63
Q

what is the treatment for cyanide toxicity?

A

hydroxycobalamin or sodium thiosulfate

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64
Q

what is psuedocyesis?

A

somatization of pregnancy (you aren’t really pregnant, but stress from not being able to get pregnant makes you misinterpret symptoms of pregnancy for pregnancy despite a negative pregnancy test)

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65
Q

what is the treatment of choice for children <8 and pregnant women diagnosed with lyme disease?

A

amoxicillin or cefuroxime (don’t use doxycycline because it causes bone growth issues and tooth hypoplasia)

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66
Q

what is the difference between nightmare disorder and sleep terror disorder?

A

Nightmare disorder: Remember dream content, easily consolable, occur during REM, second half of night

Sleep terror disorder: Do not remember dream content, unresponsive to comfort, 1st third of night,non-REM sleep

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67
Q

what is the most common composition of kidney stones?

A

calcium oxalate

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68
Q

what are the causes of meningitis in children < 3 months old?

A

GBS
E. coli or GN
Listeria monocytogenes
HSV

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69
Q

What are the causes of meningitis in children 3 months to 10 years old?

A

Strep pneumo

niesseria meningitidis

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70
Q

What causes meningitis in children >11 years old?

A

N meningitidis

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71
Q

What is the pentad of thrombotic thrombocytopenic purpura (TTP)?

A 
thrombocytopenia
microangiopathic hemolytic anemia (MAHA)
renal insufficiency
neurologic changes
fever
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72
Q

what causes TTP?

A

acquired autoantibody to ADAMTS13

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73
Q

What does ADAMTS13 do?

A

cleaves VwF from endothelial surface

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74
Q

what is the treatment for TTP?

A

plasma exchange

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75
Q

what is the beast pharmacological treatment for anal fissures?

A

topical anesthetics (lidocaine) and vasodilators (nifedipine, nitroglycerine)

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76
Q

when is the meningococcal vaccine administered?

A

age 11-12 with booster at age 16

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77
Q

when is the rotavirus vaccine administered?

A

2-8 months

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78
Q

what is the formula for corrected serum sodium?

A

measured serum sodium + 2 (for every 100 glucose above 100)

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79
Q

what metabolic derangement is present in addison’s disease?

A

hyponatremic, hyperkalemic non-anion gap metabolic acidosis (lack of aldosterone leads to loss of sodium and retention of protons and k)

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80
Q

what is the formula for calculating sensitivity?

A

true positives/ (true positive + false negative)

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81
Q

what is the formula for calculating specificity?

A

TN/ (TN +FP)

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82
Q

what is the treatment for tine versicolor?

A

selenium sulfide

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83
Q

when should patients with placenta previa be delivered?

A

36-37 weeks via c-section

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84
Q

why do OCPs cause hypertension?

A

cause an increase in the production of angiotensinogen synthesis by estrogen during hepatic first-pass metabolism

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85
Q

what are the symptoms of anterior cord syndrome?

A

weakness below level of lesion
loss of pain and temp sensation 1-2 levels below lesion
retention of proprioception, vibration, and light touch

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86
Q

how do you differentiate between botulism and guillen-barre based on history?

A

botulism is descending flacid paralysis

guillen-barre is ascending flaccid paralysis

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87
Q

what are the side effects of cyclophosphamide?

A

acute hemorrhagic cystitis
bladder cancer
sterility
myelosupression

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88
Q

what is the best way to prevent the bladder side effects of cyclophosphamide?

A

drink plenty of water
urinate frequently
take MESNA

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89
Q

what is the triad of McCune-Albright syndrome? (3 ps)

A

precocious puberty
pigmentation (cafe au lait spots)
polyostotic fibrous dysplasia (multiple bone defects)

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90
Q

what are the side effects associated with second-generation anti-psychotics?

A 
metabolic syndrome (weight gain, dyslipidemia, hyperglycemia)
Olanzapine and clozapine most common
91
Q

what blood tests need to be done for patients taking lithium?

A

kidney and thyroid function

92
Q

what blood tests are needed when starting clozapine and why?

A

weekly blood counts to test for agranulocytosis for first 6 months of treatment

93
Q

what is the most common brain tumor in children?

A

pilocytic astrocytoma

94
Q

what is the formula for positive predictive value?

A

TP/TP + FP

95
Q

What is the formula for negative predictive value?

A

TN/TN+FN

96
Q

what must an HIV person’s CD4 count be to be determined immunocompetent to receive a live attenuated vaccine?

A

> 200

97
Q

what do early decelerations indicate?

A

fetal head compression

98
Q

what do variable decelerations indicate?

A

umbilical cord compression

99
Q

what is the most common cause of isolated asymptomatic alkaline phosphatase elevation?

A

paget disease of bone

100
Q

what is the formula for number needed to treat?

A

1/ARR

101
Q

what is amaurosis fugax?

A

transient vision field defect progressing to monocular blindness

102
Q

what are contraindications to selective estrogen receptor modulators (SERM)? Roloxifene and tamoxifen

A

current or prior VTE disorder

103
Q

what are the lights criteria?

A

Exudative:
Pleural fluid protein/serum protein ratio >0.5
pleural fluid LDH/serum LDH ratio >0.6
Pleural fluid LDH >2/3 of the upper limit of normal for serum LDH

104
Q

which thyroid disorder comes on after viral illness with a diffuse enlarged, tender, goiter?

A

subacute (dequervains) thyroitiditis

105
Q

what is the most common cause of viral meningitis?

A

enterovirus (echovirus or coxsackie)

106
Q

guillen-barre affects which portion of the nervous system?

A

peripheral nerves

107
Q

vitamin B deficiency damages which structure of the spinal cord?

A

dorsal and lateral spinal columns

108
Q

what is the alternate treatment for syphillus in non-pregnant patients allergic to penicillin? What about pregnant patients?

A

doxycycline = non-pregnant

penicillin desensitization with administration = pregnant

109
Q

what is fetal hydantoin syndrome and what are the common causes?

A 
mid facial hypoplasia
microcephaly
cleft lip and palate
digital hypoplasia
hirsutism
developmental delay
(often caused by anti-convulsants such as phenytoin and carbamazepine)
110
Q

what is the classic presentation of congenital diaphragmatic hernia?

A

concave abdomen and barrel shaped chest, bowel sounds in chest, decreased lung sound where bowel is. Need to intubate

111
Q

what vitamin deficiency develops with chronic GI absorption problems (crohns, steatorrhea) and what electrolyte abnormalities occur because of that vitamin deficiency?

A

Vitamin D: leads to hypocalcemia, hypophosphatemia and subsequently secondary hyperparathyroidism

112
Q

what is the first step in management of hyper osmotic hyperglycemic state and why?

A

fluid repletion because HHS causes a osmotic diuresis which can lead to 8-10 liters of fluid loss.

113
Q

what is the classic organism for complement deficiency?

A

niesseria (encapsulated organisms)

114
Q

how do you test for complement deficiency?

A

CH50 assay

115
Q

what are pharmacotherapy options for calcium caused nephrolithiasis?

A

thiazide diuretic
urine alkalization (potassium citrate/sodium bicarb)
allopurinol (hyperurecemia caused stones)

116
Q

what is a requirement for hospice?

A

prognosis of less than 6 months (do not have to have a DNR signed)

117
Q

what blood pressure is considered hypertensive urgency and what distinguishes urgency from emergency?

A

> 180/120

Emergency has end organ dysfunction (retinal hemorrhages, papilledema)

118
Q

how do you diagnose carbon monoxide poisoning?

A

carboxyhemoglobin levels

119
Q

what is the classic finding for cyanide poisoning?

A

almond smelling breath

120
Q

What differentiates methemoglobinemia vs carbon monoxide poisoning?

A

CO = pinkish-red skin hue

methemoglobin: cyanosis and bluish discoloration

121
Q

what are the most common causing organisms of acute bacterial sinusitis?

A 
strep pneumo (30)
H influenza (30)
mortadella catarralis (10)
122
Q

where does the aspiration go with a patient who is lying supine?

A

posterior superior aspect of lower lobe

posterior inferior aspect of upper lobe

123
Q

what is the order of tests that should be performed to evaluate primary adrenal insufficiency?

A

8 AM cortisol, plasma ACTH, cosyntropin test (ACTH stimulation test)

124
Q

what are normal post void residual volumes?

A

Women: <150 ml
Men: <50 ml

125
Q

What is the morphology of nocardia and what is the treatment?

A

gram positive, partially acid-fast filamentous branching rods
Tx: Bactrim

126
Q

Since actinomyces and nocardia are both gram positive rods, how do you distinguish between the two?

A

actinomyces: anaerobic, not acid fast, sulfur granules

127
Q

what is the treatment for akathisia caused by anti-psychotics?

A

decrease the dose of the medication

add on beta blocker, benztorpine, or benzo

128
Q

What is the timing of first trimester combined test?

A

9-13 weeks

129
Q

What is the timing of cell free DNA test?

A

> or equal to 10 weeks

130
Q

What is the timing for chorionic villus sampling?

A

10-13 weeks

131
Q

when is the second trimester quadruple screen?

A

15-22 weeks

132
Q

When can amniocentesis be performed?

A

15-20 weeks

133
Q

When is the second trimester ultrasound for prenatal testing?

A

18-20 weeks

134
Q

what does immunofluroscopy show in pemphigus vulgaris?

A

netlike or chicken wire patter of IgG and C3 deposits

135
Q

What is the serology for pemphigus vulgaris?

A

anti desmoglein 1 and 3 antibodies

136
Q

What is the immunofluorescence of bullous pemphigoid?

A

linear IgG deposits at basement membrane

137
Q

Which disease has mucocutaneous blisters, bullous pemphigoid or pemphigus vulgaris?

A

pemphigus vulgaris

138
Q

What is the triad of felty syndrome?

A

inflammatory arthritis
splenomegaly
neutropenia

139
Q

what are the hallmark signs of riboflavin (B2) deficiency?

A 
angular chelitis
stomatitis
glossitis
normocytic-normochronic anemia
seborrheic dermatitis
140
Q

what is the initial test in hypercortisolism?

A

24 hour assay of urine free cortisol, late night salivary cortisol measurement, or low dose dexamethasone suppression test

141
Q

what causes a “down and out” gaze?

A

CN III palsy

142
Q

what are the features of CN III palsy/

A

down and out gaze
ptosis
preserved pupillary response

143
Q

what is serum sickness-like sickness?

A

type III hypersensitivity reaction occurring 1-2 weeks after beta-lactams or bactrum
fever, urticaria, polyarthralgia w/o mucosal involvement

144
Q

what is the definition of arrested second stage of labor?

A

no decent of fetus after 3 hours in nulliparous woman or more than 2 hours for multiparous woman

145
Q

what are the classic findings for cystic teratoma?

A

hyper echoic nodules and calcification

146
Q

what is the major pathogen in erysipelas?

A

group A strep (strep pyogenes)

147
Q

what are the symptoms of a glucagonoma?

A 
necrotizing migratory erythema (usually below the waist)
glossitis
stomatitis
mild DM
hyperglycemia with low amino acid levels
148
Q

which infection of the vagina has an elevated pH?

A

bacterial vaginosis (grey discharge, fish smell)

149
Q

what lung neoplasm is associated with SIADH?

A

Small cell carcinoma

150
Q

what is the treatment of malignant hypertensive emergency?

A

IV labetolol, nitroprusside, or nicardipine

151
Q

what neurological complication are patients with infective endocarditis and neurological changes at highest risk for?

A

brain abscess

152
Q

what are the screening guidelines for persons with family history of adenomatous polyps or CRC?

A

40 years old of 10 years prior to diagnosis in relative, whichever comes first
repeat every 3-5 years

153
Q

Colon cancer screening guidelines for persons with IBD?

A

begin 8 years after diagnosis

repeat every 1-2 years with biopsies

154
Q

Colon cancer screening guidelines for FAP

A

begin at age 10-12

repeat every year

155
Q

Colon cancer screening guidelines for hereditary nonpolyposis CRC (Lynch)

A

begin at 20-25 years

repeat ever 1-2 years

156
Q

where is blastomycosis usually found and what are the classic features?

A

Great lakes, mississippi and ohio river basins

Skin and bone lesions with pulmonary manifestations

157
Q

how does negative predictive value change with pre-test probability?

A

High pre-test probability = low NPV

low pre-test probability = high NPV

158
Q

what lineage of cells is CML from?

A

myelogenous cell = neutrophils (promyelocytes, myelocytes)

159
Q

What are the characteristics of hairy cell leukemia?

A

splenomegaly

pancytopenia (including leukopenia)

160
Q

Does hodgkin lymphoma have a high, low, or normal leukocyte count?

A

normal

161
Q

what are the classic characteristics on blood smear of chronic lymphocytic leukemia?

A

leukocytosis with mature lymphocytes
smudge cells
age 70 is average

162
Q

what are the clinical features of interstitial cystitis?

A

bladder pain that is worse with filling and relieved with voiding

163
Q

what condition commonly presents with a cape like distribution of sensory changes?

A

syringomyelia

164
Q

what vaccinations should be given for a person with asplenia?

A

pneumococcal
meningococcal
HiB
given oral antibiotics in any febrile illness

165
Q

what hormones should be checked when suspecting PCOS and how do these levels help differentiate between ovarian etiology and adrenal etiology?

A

Testosterone and DHEAS
elevated T with normal DHEAS suggest ovary
Elevated DHEAS suggests adrenal tumor

166
Q

what is optic disc hyperemia associated with?

A

methanol poisoning

167
Q

whats the best way to differentiate between methanol poisoning and ethylene glycol poisoning?

A

methanol affects the eyes

ethylene glycol affects the kidneys

168
Q

what is the metabolic derangement seen in normal pregnancy and why?

A

respiratory alkalosis secondary to progresterone stimulating increased tidal volume and minute ventilation

169
Q

what is the most common immediate arrhythmia in MI and what causes it?

A

V fib

re-entry is the most common in immediate MI

170
Q

what is the treatment for bullous pemphigoid?

A

high potency topical glucocorticoids (clabetasol)

171
Q

what is dermatitis herpetiformis associated with and what is the treatment?

A

gluten allergy

tx with dapsone

172
Q

where is squamous cell cancer of the vagina most commonly found?

A

the posterior aspect of the upper 1/3 of the vagina

173
Q

where is clear cell carcinoma of the vagina most commonly found/

A

the anterior aspect of the upper 1/3 of the vagina

174
Q

how long must symptoms of PTSD be present to be considered PTSD and if they are shorter than that what is it characterized as?

A

> 1 month, if less it’s acute distress syndrome

175
Q

what is the best next step after positive beta-hCG with concern for ectopic pregnancy?

A

Transvaginal ultrasound

176
Q

what medications are contraindicated in acute angle closure glaucoma?

A

atropine (because it will cause dilation of the pupil worsening the obstruction)

177
Q

what is the treatment for acute dystonia?

A

benztropine or diphenhydramine

178
Q

what is the distinguishing feature of CVID?

A

all IG down, normal B cell count

179
Q

What is the distinguishing feature of x-linked agammaglobulinemia (bruton)

A

all IG down, B cell low

180
Q

What is the distinguishing feature of SCID?

A

decreased T cell and B cell concentrations with development of life threatening infection in infancy

181
Q

what are the lab findings associated with wilson’s disease?

A

low ceruloplasmin levels
increased urinary output of copper
kale-flesher rings on ophthalmologic exam

182
Q

what is the test name for checking for spherocytosis?

A

acidified glycerol test (osmotic fragility)

or abnormal eosin-5-maleimide binding test

183
Q

how do you diagnose paroxysmal nocturnal hemoglobinuria?

A

CH55 and CH59 testing

184
Q

which type of autoimmune hemolytic anemia is associated with antibiotics, URI, HIV?

A

warm IgG mediated

mycoplasma is cold IgM

185
Q

how does non-classical congenital adrenal hyperplasia present?

A

late onset, gonadotropin independent precocious puberty with normal electrolytes

186
Q

what is the best way to measure success in the treatment of DKA?

A

measure serum anion gap or direct assay of beta-hydroxybuterate

187
Q

what is the treatment for a prolactinoma?

A

bromocriptine or cabergoline

188
Q

what is the time frame for adjustment disorder?

A

symptoms starting after a specific inciting event occurring less than 3 months

189
Q

what is the classic finding of pityriasis rosea?

A

round ovoid patches on the trunk and upper extremities, christmas tree pattern
self-resolving aka no treatment

190
Q

what are the 4 Ps of lichen planus?

A

pruritic
polygonal
purple
flat-toppedpaules

191
Q

at what age should patients get the shingles vaccine?

A

over age 60

192
Q

what are the indications to start statin therapy?

A

secondary prevention for ASCVD
LDL >190
Diabetes ages 40-75 with LDL 70-189
Risk score of >7.5% ages 40-75

193
Q

what cancers are associated with osteoblastic metastasis?

A

prostate

breast

194
Q

Which cancers are associated with osteoclastic metastasi?

A

lung
kidney
thyroid
multiple myeloma

195
Q

what are the PFTs of COPD? (FEV1/FVC, FEV1, TLC)

A

FEV1/FVC ratio < 0.7
FEV1 decreased
TLC increased

196
Q

What are PFTs in asthma? (FEV1/FVC, FEV1, TLC)

A 
FEV1 decreased
FVC decreased
FEV1/FVC ratio decreased
FEV1 increase by 12% with albuterol
FEV1 decrease by 20% with methacholine or histamien
197
Q

what is the criteria for persistent depressive disorder?

A

depressed mood with 2 of SIGECAPS for more than 2 years

198
Q

what are the criteria for diagnosing depression?

A

5 of 9 SIGECAPS plus depressed mood

199
Q

what is a distinguishing feature between methamphetamine intoxication and PCP intoxication?

A

there is nystagmus in PCP intox

200
Q

What is the major side effect of anti-thyroid medications (methimazole and propylthiouracil)? What are the presenting symptoms?

A

agranulocytosis

sore throat and fever

201
Q

persons from mediterannian decent are most likely to have which blood problem?

A

beta-thalassemia

202
Q

what clinical presentation distinguishes between beta thalassemia minor vs major?

A

major is associated with requirement of transfusions at an early age

203
Q

at what gestational age should pre-mature delivering mothers receive magnesium sulfate?

A

<32 weeks

204
Q

in a positively skewed distribution what is true about the mean compared to the median? negatively skewed?

A

mean > median = positively skewed

mean < median = negatively skewed

205
Q

what medication is associated with medication-induced psychosis?

A

glucocorticoids

206
Q

what is a factorial design study?

A

patients are divided into different groups and within these groups they are further divided into different groups

207
Q

What are the risk factors for C. diff?

A

recent abs use
hospitalization
PPI

208
Q

what trisomy is rocker bottom feet associated with?

A

trisomy 18

209
Q

how do you diagnose acute lymphoblastic leukemia?

A

> 25% lymphoblasts
periodic acid schiff positive
terminal deoxynueclotidyltransferase (TdT) positive

210
Q

what is the microscopic finding of AML?

A

Auer rods

211
Q

what is the step for secondary amenorrhea?

A

UPT followed by prolactin, TSH, and FSH levels

212
Q

what is the triad and treatment of hereditary spherocytosis?

A

anemia, jaundice, elevated MCHC

Tx is splenectomy

213
Q

if there is a widened mediastinum after heart surgery what is the next step?

A

surgical exploration with debridement for suspected infection

214
Q

what does a patient have when they have a grossly positive PPD with negative CXR findings and negative sputum samples?

A

latent TB

215
Q

what electrolyte abnormality is associated with sarcoidosis?

A

hypercalcemia

216
Q

what electrolyte derangements are found in chronic alcoholism and why?

A

hypomagnesmia leading to decreased PTH secretion leading to decreased calcium

217
Q

what anatomic structure is responsible for acne?

A

pilosebaceous follicles

218
Q

what is the best next step in evaluating a patient with aplastic crisis?

A

bone marrow biopsy or peripheral smear

219
Q

what is the morphology of H influenza?

A

gram negative bacilli

220
Q

what are the most common causes of post viral pneumonia?

A

H flu and S pneumo

221
Q

what are the EMG findings of ALS?

A

fibrillation potentials in multiple muscles in multiple extremities

222
Q

metastatic breast cancer to bones causes what electrolyte abnormality?

A

hypercalcemia

223
Q

what are the classic features of wiskott-aldrich syndrome?

A

eczema
thrombocytopenia
immunodeficiency
easy bleeding (diarrhea, nose, pensi)

Step 2 (4 decks)

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