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USMLE Step 2 > UWorld First Pass > Flashcards

UWorld First Pass Flashcards

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USMLE® Step 1 flashcards
1
Q

What glomerulopathy is associated with HIV and African Americans?

A

Focal Segmental Glomerulosclerosis

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2
Q

What differentiates CML from a leukemia reaction?

A

Low Leukocyte Alkaline Phosphatase

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3
Q

What are the 5 P’s?

A 
Pain
Pallor
Pullselessness
Poikilothermia
Paresthesias
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4
Q

Which genital ulcers are associated with painful LAD?

A

HSV!
LGV is very large, very painful, and fluctuant
Chancroid has large nodes, but not as painful

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5
Q

What can you treat a pen-allergic pt with syphillis with?

A

Doxycycline (or ceftriaxone for tertiary). Desensitize in pregnancy.

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6
Q

What is a normal ABI result?

A

1.0 - 1.2

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7
Q

What is a defining feature of pseudoclaudication?

A

It is posture dependent (shopping cart sign)

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8
Q

What is the treatment for dermatitis herpeteformis?

A

Dapsone

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9
Q

How does INH differ from other drug induced liver injury?

A

It doesn’t usually have extra hepatic manifestations of drug reaction

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10
Q

What drugs cause Cholestasis?

A

Chlopromazine
Nitrofurantoin
Erythromycin
Anabolic Steroids

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11
Q

What drugs cause fatty liver?

A

Tetracycline
Valproate
Anti-Retrovirals

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12
Q

What drugs cause hepatitis?

A

Halothane
Phenytoin
INH
alpha-methyldopa

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13
Q

What drugs cause fulminant liver failure?

A

Carbon tetrachloride

Acetaminophen

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14
Q

What drugs cause granulomatous hepatitis?

A

Allopurinol

Phennylbutazone

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15
Q

What distinguishes anorexia from bulimia?

A

In anorexia, you don’t have a normal BMI while bulimics still maintain a low-normal BMI

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16
Q

What is the cortical findings in status epileptics?

A

Cortical laminar necrosis

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17
Q

What class of drugs can cause cerebellar atrophy?

A

Anti epileptic Drugs

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18
Q

What should be suspected in infants with bilateral bulbar palsies?

A

Botulism

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19
Q

What is the triad of McCune-Albright Syndrome?

A

Precocious puberty, cafe-au-alit spots and bone defects

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20
Q

What type of tumor can develop in Peutz-Jeghers syndrome?

A

Estrogen secreting tumors

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21
Q

What type of intracranial tumor can occur with McCune Albright?

A

Pituitary adenomas (e.g. Cushings, Prolactinoma, etc.)

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22
Q

True or false, low grade fever and leukocytosis are common in the first 24 hours postpartum?

A

True

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23
Q

Why does fat malabsorption increase incidence of oxalate stones?

A

Fatty acids chelate calcium and prevent it from binding with oxalateq

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24
Q

Why do alcoholics get hypokalemic?

A

poor intake and from vomiting

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25
Q

What ar the indications for carotid endarterectomy?

A

Men: 60%+ Stenosis if Asymptomatic.
Symptomatic: 50-69% (Grade IIA) 70%+ (Grade IA)
Women: 70%+ for both symptomatic and not

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26
Q

What is the cause of ED following pelvic fracture?

A

Parasympathetic nervous injury

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27
Q

What are the pleural effusion findings in Esophageal Rupture?

A

Exudative, low pH, very high amylase (>2,500 IU)

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28
Q

What intestinal finding can be caused by the vagal section to ureteral colic?

A

Illeus

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29
Q

What cells do non-functioning pituitary adenomas usually arrive from?

A

Gonadotrophs

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30
Q

What values is usually mildly elevated in gonadotroph adenomas?

A

Prolactin from disruption of the dopaminergic neural pathways

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31
Q

Which blistering disease has flaccid blisters?

A

Pemphigus Vulgaris

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32
Q

What are the interpretations for ABI?

A

1.3 Calcified vessels

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33
Q

In what populations are screening U/S for AAA recommended?

A

Men age 65-75 with a history of smoking

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34
Q

What is the difference between Hordeolum and Chalzion?

A

Hodreolum - Infection of a gland (abx and hot compress)

Chalazion - Granulomatous condition from obstruction of gland

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35
Q

What is the presentation of CO poisoning after a fire?

A

Confusion, wheezes, seizure

Carboxyhemoglobin (>15% in smokers, >3% in non smokers)

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36
Q

What vaccines are recommended for HIV patients?

A 
HAV
HBV
HPV
Influenza
Meningococcus
Pneumococcus
Tdap (once, then Td every 10 years)
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37
Q

What pulmonary fungal infection is associated with the “Halo Sign”?

A

Aspergillosis

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38
Q

What are the indications for statin therapy?

A

Atheroslerotic disease
LDL > 190
Age 40-75 with diabetes
10-year ASCVD risk > 7.5%

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39
Q

What are the indications for surgical revascularization in claudication?

A

Limb-threatening complications
Limitations of ADL
Non-response to exercise and pharmacologic program

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40
Q

What is the indication for home O2 therapy?

A

COPD with PaO2 55%

Awake PaO2 > 60/ SaO2 > 90 if hypoxic during sleep

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41
Q

What are the criteria for APGAR scoring?

A

Score 0-2
Appearance (Blue central, central pink, all pink)
Pulse (0, 100)
Grimace (0, grimace, grimace and cough)
Activity (limp, some, active)
Respiratory Effort (0, irregular, regular)

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42
Q

What is the interpretation of APGAR scoring?

A

4-7: observe, stimulate, vent support
0-3: resuscitate
- HR

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43
Q

At what PaCO2 do you usually see CO2 narcosis?

A

> 60

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44
Q

What is the preferred treatment for hyperthyroidism?

A

Radioiodine ablation therapy

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45
Q

What is the deficiency/accumulation/symptom of Fabry’s Dz?

A

Deficiency: alpha-galactosidase A
Accumulates: Ceramide trihexoside
S/Sx: Limb pain, angiokeratomas, renal failure, thrombosis

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46
Q

What is the deficiency/accumulation/symptom of Krabbe’s Disease?

A

Deficiency: galactosylcermidase
Accumulates: galactrocerebroside
S/Sx: CNS degeneration, optic atrophy, death by 3

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47
Q

What physical findings are common in homocystinuria?

A

Fair hair, eyes, and marfanoid habitus

They get thromboembolic events

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48
Q

What is the triad of disseminated gonococci infection?

A

Tenosynovitis
Dermatitis
Migratory Polyarthritis

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49
Q

What are the synovial fluid findings in gonococci arthritis?

A

~ 50,000 WBC/mm^3

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50
Q

What injury should come to mind in the knee with significant hemarthrosis?

A

ACL injury

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51
Q

What is the formula for LR+?

A

sensitivity/1-specificity

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52
Q

What is the formula for LR-?

A

1-sensitivity/specificity

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53
Q

What type of study provides an exposure OR?

A

Case Control Studies

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54
Q

What type of study provides a prevalence OR?

A

Cross Sectional Studies

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55
Q

What are the live-attenuated vaccines?

A 
Measles
MumpsRubella
Polio (Sabin)
Yellow Fever
Nasal Influenza
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56
Q

What are the 5 stages of behavioral change?

A 
Precontemplation
Contemplation
Preparation
Action
Maintenance/Relapse
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57
Q

What differentiates MM and MGUS?

A

MM: Band > 3 mg/dL, anemia, renal disease, lytic lesions
MGUS: Band

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58
Q

What disease would you obtain and abdominal fat pad biopsy for?

A

Amyloidosis

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59
Q

What is the treatment for PID?

A

Inpatient: Cefotetan/Doxycycline
Outpatient: Ceftriaxone and Doxycycline

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60
Q

What interventions are useful for diabetic foot ulcers?

A
  1. Off-loading
  2. Debridement
  3. Wound Dressings
  4. Antibiotics
  5. Revascularization
  6. Amputation
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61
Q

Which immunosuppressant causes gum hypertrophy and hirsutism?

A

cyclosporine

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62
Q

What is the triad of wiskot-aldrich syndrome?

A

Eczema, Thrombocytopenia, recurrent infections with encapsulated organisms (X-linked Recessive)
High IgA/IgE levels, low IgM

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63
Q

When do you start surveillance in UC patients?

A

After disease has been present for 8 years

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64
Q

What does flattening of top and bottom of a flow-volume loop indicate?

A

Fixed-upper airway obstruction

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65
Q

Where does atrial flutter typically originate from?

A

The tricuspid annulus

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66
Q

What is the treatment for legionella?

A

Respiratory quinolone or new macrolide

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67
Q

What is the order of effectiveness of BP interventions?

A
  1. Weight loss (in overweight people)
  2. DASH diet
  3. Exercise
  4. Dietary sodium decreased
  5. Decrease EtOH intake
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68
Q

What is the formula for calculated osmolality?

A

2Na + Glu/18 + BUN/2.8

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69
Q

What are the findings in Beckwith-Wiedman syndrome?

A

Macrosomia, Macroglosia, Hemihyperplasia, Abdominal Wall Defects.
Monitor for hypoglycemia

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70
Q

What screening should kids with beckwith-wiedman syndrome get?

A

Abdominal U/S and AFP for Wilm’s Tumor and Hepatoblastoma

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71
Q

In what patients might you use stimulants to treat depression?

A

Those with short life expectancy as SSRIs can take 4 weeks for effect

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72
Q

What is the treatment for Lyme in a pregnant patient?

A

Amoxacillin
If allergic to amoxacillin, can use macrolide
If severe/disseminated, can do ceftriaxone

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73
Q

At which GA should pre-term labor be delayed?

A

23 weeks to 34 weeks

Highly increased risk of CP at

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74
Q

What age is mammography screening recommended?

A

50-75

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75
Q

What are the signs of Anorexia?

A
  1. Osteoporosis
  2. Elevated cholesterol/carotene
  3. Arhythmias (long QT)
  4. Euthyroid sick sinus syndrome
  5. HPA dysfunction
  6. Hyponatremia
  7. SGA babies (even if in remission from disease)
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76
Q

At what GA is conversion of breech presentation indicated?

A

37 Weeks

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77
Q

What condition has upward lens dislocation?

A

Marfans

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78
Q

What is the timeline for charcoal administration in acetomenophen poisoning?

A

Within 4 hours of ingestion

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79
Q

When are abx indicated in COPD exacerbation?

A

When there is > 1 cardinal symptom (SOB, increased cough, increased sputum purulence)

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80
Q

What age does gonococci and chlamydial conjunctivitis present at?

A

Gonoccocal: 2-5 days (ppx with erythromycin ointment)
Chlamydial: 5-14 days

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81
Q

What disease is associated with breath-holding spells?

A

Fe deficiency anemia

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82
Q

What is the treatment for trypanosomes disease?

A

Benznidazole

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83
Q

What is the treatment for pinworms?

A

Albendazole

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84
Q

What disease does the D-xylose absorption test for?

A

celiac disease (test for small bowel mucosa functionality)

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85
Q

What are the back pain red flags to get XR and ESR?

A

Age > 50
Nighttime symptoms
> 1 month
Constitutional or Neuro Symptoms

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86
Q

What are the 5 Hs?

A 
Hyperkalemia
Hypothermia
Hypoxia
Hypovolemia
Hydrogen Ions
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87
Q

What are the 5 T’s?

A 
Tension Pneumo
Tamponade
Toxins
Thrombosis
Trauma
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88
Q

What type of solitary pulmonary nodule requires surveillance even if it’s appearance is stable?

A

GGO

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89
Q

What are the size-risk categories for solitary pulmonary nodules?

A

2.0 cm - High Risk

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90
Q

What is Charcot’s triad of cholangitis?

A

Fever
RUQ Pain
Jaundice
+Confusion/Hypotension = Reynaud’s Pentad

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91
Q

What should you suspect in back pain on anticoagulation?

A

Retroperitoneal Hematoma

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92
Q

What is the management of Alkali ingestion?

A

Decontamination, Irrigation, Endoscopy within 24 hours

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93
Q

Should you provoke vomiting in Alkali ingestion?

A

NO

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94
Q

What is the first test you should get for suspected adrenal insufficiency?

A

Morning cortisol/ACTH and Cosyntropin test

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95
Q

What is a sign of ventricular aneurysm post-MI?

A

Persistent ST elevation, signs of HF/mitral regurge (5days - 3 months)

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96
Q

What age is HPV vaccination indicated for?

A

9-26

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97
Q

At what age is bed-wetting normal until?

A

Until age 5

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98
Q

What is susceptibility bias?

A

Form of selection bias, treatment dictated by disease severity.

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99
Q

How might UC present in the acute setting?

A

Toxic Megacolon

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100
Q

What are the 5 causes of hypoxemia?

A 
V/Q Mismatch
Shunt
Diffusion Barrier
Decreased O2 Tension
Hypoventilation
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101
Q

Which nephrotic syndrome is associated with HBV?

A

Membranous nephropathy (can have low C3)

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102
Q

What drugs can cause digoxin toxicity?

A

Amiodarone, Verapamil, Quinidine, Propafenone

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103
Q

Does trichomonas cause cervicitis?

A

No it is a vulvo-vaginitis

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104
Q

Is chlaymydia or gonorrhea a more common cause of mucopurulent cervicitis?

A

Chlamydia

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105
Q

What disease causes mild conjugated hyperbili with no enzyme elevation?

A

Rotor Syndrome

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106
Q

What is clomiphene citrate?

A

An estrogen analogue used in anovulatory disorders

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107
Q

What cancer is minimal change disease associated with?

A

Hodgkin’s Lymphoma

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108
Q

What is the role of ppx in rheumatic fever?

A

Penicillin, with cardiac involvement and valvular do it for 10 years or until age 40

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109
Q

Where does terminal hematuria localize?

A

Bladder

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110
Q

When is RhoGam intitially administered?

A

28-32 weeks

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111
Q

What lab must you check prior to starting lithium?

A

Renal function

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112
Q

What is winters formula?

A

15(bicarb) + 8 +/- 2

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113
Q

At what age is AAA screening indicated?

A

age 65-75 with smoking Hx. >5.5 cm repair

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114
Q

What nerve supplies the medial leg?

A

Saphenous, branch of femoral

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115
Q

What electrolyte abnormality occurs in Cushing’s syndrome?

A

Hypokalemia

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116
Q

What markers are elevated in non-seminomatous germ cell tumors?

A

bHCG and AFP

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117
Q

What electrolyte must be monitored with high-dose TMP?

A

Potassium, can cause hyperkalemia

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118
Q

Where is the anserine bursa located?

A

Antero-medially over the tibial plateau

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119
Q

What is a case of pleural fluid pH

A

Empyema

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120
Q

What is the INR threshold for FFP admin?

A

1.6

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121
Q

What nephrotic syndrome is associated with Renal vein thrombosis?

A

Membranous Glomerulopathy

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122
Q

What two diseases is HepC strongly correlated with?

A

Porphyria Cutanea Tarda

Mixed cryoglobulinemia

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123
Q

What are the symptoms of mixed cyroglobulinemia?

A

Immune complex deposits in small vessels. Palpable purport and possible membranoproliferazive glomerulonephritis

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124
Q

What is polyarteritis nodosa associated with?

A

HepB

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125
Q

What is erythema nodosum?

A

Painful nodules on anterior legs, associated with infections (e.g. strep and TB) and sarcoid

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126
Q

Should premature infants be vaccinated based on gestational or chronologic age?

A

Chronologic age (except hepB shouldn’t be given if less than 2 kg)

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127
Q

What are the three questions to ask in hypocalcemia?

A
  1. Low Mg?
  2. Due to a drug?
  3. Recent blood transfusion?
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128
Q

When did blood screening for hepC start?

A

1992

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129
Q

What drug should always be stopped in sepsis/kidney injury?

A

Metformin

130
Q

What is first line treatment for Alzheimers disease?

A

Cholinesterase inhibitors

131
Q

What is the treatment for Tourett’s?

A

Antipsychotics

Alpha 2 Agonists: clonidine/guanfacine

132
Q

What cancer is associated with Hashimotos?

A

Thyroid Lymphoma

133
Q

In a child older than 2, what is most common cause of intussiception?

A

Meckel’s Diverticulum

134
Q

Must INH always be stopped with transaminitis?

A

No, not if mild and asymptomatic

135
Q

What is the formula for PAO2t?

A

FiO2(Patm-47)-PaCO2/R

136
Q

At what LN diameter should you consider a biopsy?

A

2.0 cm

137
Q

What is the treatment for restless leg syndrome?

A

Dopamine agonists (pramipexole, ropinirole)

138
Q

What is the DLCO in chronic bronchitis?

A

Normal

139
Q

When is cytology of fibrocystic aspirate indicated?

A

Bloody or foul smelling fluid

140
Q

At what time point should abortive seizure therapy be provided?

A

5 Minutes

141
Q

Which glomerular disease presents with deposits of C3 only?

A

MPGN Type II (dense deposit disease) due to C3 nephritic factor causing persistent alternative complement activation

142
Q

Is botulism ascending or descending?

A

Descending

143
Q

How does OA of the hip present?

A

Anterior hip pain worse with movement without TTP

144
Q

What is first line treatment for asymptomatic bacteuria in pregnancy?

A

Amoxicillin

145
Q

How does one differentiate AOM from OM with effusion?

A

OM with effusion lacks any acute infective symptoms

146
Q

What is characteristic of a cerebellar tremor?

A

Amplitude increases as the hand reaches its target

147
Q

What lab highly indicates empyema and mandates chest tube?

A

pH less than 7.2 (also glucose less than 60)

148
Q

What should you suspect in an AA patient with nocturne?

A

Hyposthenuria from sickle cell trait

149
Q

What characterizes HSV keratitis?

A

Corneal vesicles and dendritic ulcers

150
Q

What is the major contraindication to orotracheal intubation?

A

Significant facial trauma

151
Q

What may help differentiate abruption from previa?

A

Abruption is painful

152
Q

What is characteristic of vasa previa?

A

Significant fetal distress as it is fetal blood hemhorraging

153
Q

What food borne disease is associated with flushing and urticaria?

A

Scombroid

154
Q

How long must you wait after alpha-blocker for using sildenafil?

A

4 hours

155
Q

Which heart murmurs increase on expiration?

A

Only Left sided ones!

156
Q

What does a UTI with alkaline urine pH indicate?

A

Urease positive organism (proteus, klebsiela, morganella, psuedomonas, staph)

157
Q

How does polymyositis present?

A

Proximal muscle weakness, usually without pain

158
Q

What is the differential for T wave inversion?

A 
MI
Myocarditis
Old pericarditis
Myocardial contusion
Digoxin Toxicity
159
Q

What is the most predictive sign of opioid intoxication?

A

Depressed respiratory rate

160
Q

What are some P450 inhibitors?

A

Cimetidine, Ciprofloxacin, erythromycin, clarithromycin, verapamil

161
Q

How do you distinguish peripheral thrombosis from embolism?

A

Embolism is acute onset with diminished pulses unilaterally

162
Q

Which RTA is associated with fanconi syndrome?

A

Type 2 (impaired bicarbonate resorption)

163
Q

What lung parameter decreases in severe COPD?

A

VC

164
Q

Who needs a meningococcal booster?

A

vaccinated prior to age 16 needs one at age 16-21

165
Q

What is a hordeolum?

A

Staph abscess of the eyelid, treat with warm compresses.

166
Q

What is a chalazion?

A

Granulomatous inflame of the mebomium glands. treat with Incision and curettage

167
Q

What is the most important risk factor for stroke?

A

Hypertension

168
Q

What is first line therapy for symptomatic PVCs?

A

Beta Blockers

Amiodarone is second line

169
Q

What is the treatment for actinomyces?

A

Penicillin (12 weeks) or Clindamycin

170
Q

When does PNH usually manifest?

A

In the 30s with hemolysis, cytopenias, thrombosis

171
Q

At what age should non high-risk patients get PCV13?

A

Age 65, otherwise its just the PPSV 23

172
Q

What is eczema herpeticum?

A

Herpes infection that develops onto of eczema

173
Q

What is the cause of emphysematous cholecystitis?

A

Gas producing bacteria (cover GNRs and GPCs) (AFLs in the gallbladder or gas on U/S)

174
Q

Whistling noise after rhinoplasty?

A

Think septal perforation

175
Q

Does the living will take legal prescedence?

A

Yes!

176
Q

Which HIV drug causes crystal nephropathy?

A

Indinavir (a protease inhibitor)

177
Q

What are the common life threatening HAART complications?

A 
Didanosine - Pancreatitis
abacavir - hypersensitivity syndrome
NRTIs - Lactic Acidosis
NNRTIs - SJS
Neverapine - Liver Failure
178
Q

What lab abnormalities are seen with cholesterol embolization?

A

Eosinophilia

Hypocomplementemia

179
Q

What two syndromes result in unconjugated hyperbole?

A

Crigeler-Najar

Gilbert

180
Q

What screening tests should you do in infertility first?

A

TSH, FSH, Prolactin first

Unless prior uterine instrumentation, then image

181
Q

Who less than

A

Immunocompromised, CSF leak, Asplenia, cochlear implant

182
Q

Which patients should succinylcholine not be used in?

A

Those at risk for hyperkalemia:
Crush or burns > 8 hours old
Tumor lysis syndrome
Demyelinating syndromes

183
Q

What is the major division for cases of fetal growth restriction?

A

Is it asymmetrical (maternal factors) or symmetrical (fetal factors)

184
Q

What is lidocaine used for with ACS patients?

A

Can be used to ctrl vTach; however, should not be used prophylactically due to increased risk of systole

185
Q

What are the PE findings in fetal alcohol syndrome?

A

1 Small Palpebral Fissure
2 Smooth philthrum
3 Thin vermillion border

186
Q

What is the definition of arrested labor in the first stage?

A

> 6 cm dilated with:
No change in 4 hours with good contractions
or No change in 6 hours w/o good contractions

187
Q

What are rhonchi that clear with a cough suggestive of?

A

Bronchitis

188
Q

What is the treatment for Vaginismus?

A

Keigel exercises and gradual dilatation

189
Q

What differentiates galactokinase deficiency form galactose-1-phosphate uridyl transferase deficiency?

A

In the former, they only get cataracts, other also gets systemic manifestations

190
Q

What murmur is heard at the LSB with the patient leaning forward and holding exhalation?

A

Aortic Regurgitation (early diastolic murmur)

191
Q

What is an imaging finding with constrictive pericarditis?

A

Calcification along the heart border

192
Q

What should you think of with a mid-diastolic knock?

A

Constrictive pericarditis

193
Q

What are the top three causes of chronic cough?

A

GERD
Post-nasal Drip
Asthma - PFTs!!!

194
Q

What empiric therapy for cervical lymphadenitis in children?

A

Clindamycin as it covers MRSA (+InD)

195
Q

What is the treatment for amebic liver abscess?

A

Oral Metronidazole with Paromomycin (luminal agent)

196
Q

What confirmatory test can be used if gastrin level is between 100 and 1000?

A

Secretin stim test, if gastrin elevated then it is a gastrinoma

197
Q

What should be avoided in Meinere’s disease?

A

High salt, EtOH, Caffeine, Nicotine

198
Q

After the dose at age 11-18 with Tdap, should patients get Td or Tdap?

A

Td unless pregnant

199
Q

Till what age should sickle cell patients take penicillin pox?

A

5

200
Q

For uncomplicated cystitis is a urine culture necessary?

A

No

201
Q

What factors make cystitis complicated?

A

Pregnancy, Diabets, CKD, UT obstruction, immunocompromised, hospital/procedure associated

202
Q

What do ST depressions in V1/V2 indicate?

A

Posterior wall MI

203
Q

How often is RV involved in an inferior infarct?

A

1/3 of the time, ST depression in I and AVL and indicate this

204
Q

What is cyclical vomiting syndrome associated with?

A

Migraine Headaches

205
Q

Which personality disorder has “magical thinking”?

A

Schizotypal Personality Disorder

206
Q

What is Ludwig Angina?

A

Progressive bilateral cellulitis of the submandibular and sublingual space

207
Q

What is the most common acute side effect of levodopa therapy?

A

Hallucinations

208
Q

In what group of elderly patients should typical neuroleptics not be used?

A

Those with lewy body dementia

209
Q

What is the treatment for chlamydial conjunctivitis or pneumonia in a newborn?

A

Oral Erythromycin

210
Q

What is the only segment of the bladder in contact with the peritoneum?

A

The dome of the bladder

211
Q

How is hypothermia classified?

A

Mild: 32-35
Moderate: 28-32
Severe: less than 28

212
Q

What type of arrhythmias usually resolve with warming in hypothermia?

A

Atrial arrhythmia

213
Q

What is acute stress disorder?

A

Like PTSD but symptoms are from 3 days to 1 month. A significant life threatening stressor is required for dx

214
Q

For who is the PPD cutoff value 10 mm?

A

Recent immigrants (within 5 years) from TB area
IVDU
Residents and employees of high risk settings
Comorbid (diabetes, ESRD, etc.)
Children less than 4

215
Q

What syndromes are associated with Wilm’s tumor?

A

WAGR
Beckwith-Wiedman
Denys-Drash

216
Q

What are indications for Hep C treatment?

A

Liver biopsy with at least bridging fibrosis
Compensated liver disease (INR not over 1.5, no ascites)
No MDD, EtOH, or IVDU

217
Q

What are the main side effects of sulfonylureas?

A

Weight gain and hypoglycemia

218
Q

What oral hypoglycemics cause weight loss?

A

GLP-1 receptor antagonists (exenatide)

219
Q

What oral hypoglycemics can be used in renal insuficiency?

A

Glitazones and DPP-IV inhibitors

220
Q

What is Beck’s triad of cardiac tamponade?

A

Hypotension
Distended Neck Veins
Muffled heart sounds

221
Q

What metabolic abnormality may result from thiazide treatment?

A

Hyperglycemia, Increased LDL, Hypertriglyceridemia, Hyperuricemia

222
Q

What should you think of with a mono like syndrome with LAD and Gi symptoms?

A

Acute HIV Infection

223
Q

What is required for the diagnosis of any psychiatric condition?

A

Interference with activities at work or home

224
Q

What should proximal muscle weakness, decreased reflexes, normal ESR, and elevated CK make you think of?

A

Hypothyroid Myopathy

225
Q

What is the inheritance pattern of myotonic dystrophy?

A

AD, trinucleotide repeat of CTG on Cr 19

226
Q

Which disease of the breast presents like eczema?

A

Pagets

227
Q

Is formula or breast milk associated with less colic?

A

Breast Milk

228
Q

What are the lesions of herpangina?

A

Gray vesicles on the posterior oropharynx and tonsilar pillars that progress to fibrin coated ulcerations

229
Q

In non-classical CAH, are there electrolyte disturbances?

A

No

230
Q

What are the screening recs for osteoporosis?

A

Dexa scan in all women > 65

231
Q

What is the management of endometrial hyperplasia without atypia?

A

Progestin therapy

232
Q

When can menopause be diagnosed clinically?

A

In women > 45 with 12 months of amenorrhea

233
Q

What is the treatment for nocardia?

A

TMP-SMX for pulmonary

Add carbapenem for CNS disease

234
Q

What is the typical pH in salicylate overdose?

A

It is usually near normal

235
Q

What is the clinical presentation of osteoid osteoma?

A

Increasing pain worse at night better with NSAIDs

Hypodense lesion on x-ray

236
Q

What should be given to decrease homocysteine levels?

A

B6 and Folate

237
Q

What are the sfx of EPO administration?

A

Worsening HTN
Headaches
Flu-like syndrome
Red cell aplasia

238
Q

What are the indications for steroid use in PCP treatment?

A

PaO2 less than 70

A-a gradient greater than 35 on RA

239
Q

What is the triad of Wernicke’s?

A

Encephalopathy
Oculomotor dysfunction
Gain disturbances

240
Q

What cancers do OCPs reduce the risk of?

A

Endometrial and Ovarian

Decreased benign breast dz risk

241
Q

What is a common side effect of OCPs?

A

HTN

242
Q

What is the definition of primary amenorrhea?

A

Absence of menstruation in someone age 15 with normal growth

243
Q

How does glucagonoma present?

A

With DM, necrolytic migratory erythema, weight loss, diarrhea, anemia

244
Q

When does common variable immunodefficiency present?

A

Usually not till after age 15 and the B cells are present

245
Q

What is Kehr’s sign?

A

LUQ pain radiating to the L shoulder from diaphragmatic irritation

246
Q

Which cell lines are up in polycythemia vera?

A

All three, but red cells most

247
Q

What condition causing hand pain affects new mothers?

A

De Querveins Tenosynovitis

248
Q

What Ca abnormality prolongs the QT interval?

A

hypocalcemia

249
Q

What should recurrent epistaxis and AVMs make you think of?

A

Hereditary Hemhorragic Telengectasia

250
Q

What is the most common complication of a supracondylar fracture?

A

Brachial Artery Injury (also median nerve and cubitus varus deformity)

251
Q

What parasite might give you subungual hemorrhages, periorbital edema, chemosis?

A

Trichinella Spiralis

252
Q

What infectious disease causes fever, headache, retro-orbital pain, myalgia?

A

Dengue

253
Q

Which disease has chery-red macula and areflexia?

A

Nieman-Pick, also has HSM

254
Q

Which disease had chery-red macula and hyperreflexia?

A

Tay-Sachs

255
Q

What ist he deficiency in Nieman-Pick?

A

Sphingomyelinase

256
Q

What is the deficiency in Tay-Sachs?

A

Beta Hexosaminidase A

257
Q

What disease has anemia, thrombocytopenia, and HSM?

A

Gauchers (glucocerebrosidase deficiency)

258
Q

What is the threshold for lead treatment in a child?

A

45-69 mcg - DMSA

over 70 - Dimercapol and EDTA

259
Q

What are flat and broad T waves a sign of?

A

Hypokalemia

260
Q

What signs indicate a Morton Neuroma?

A

Numbness and Pain between 3rd and 4th toes, clicking sensation when placating while squeezing metatarsal joints

261
Q

What are signs of ischemia in an SBO?

A

fever, tachycardia, leukocytosis, metabolic acidosis

262
Q

What are the findings in trichomonas vaginits?

A

Motile pear-shaped organisms

263
Q

What are the indications for bladder and renal US in peds?

A

First febrile UTI before 24 months

264
Q

What is the initial workup for an ovarian mass in post-menopausal women?

A

US and CA 125

265
Q

Do OCPs cause weight gain?

A

NO

266
Q

Which deficits are most severe early on in multi-infarct dementia?

A

Executive Function deficits

267
Q

Why does IUGR decrease RDS incidence?

A

Stress in uterus causes lungs to mature early

268
Q

What cardiac defects is most common in Trisomy 18?

A

VSD

269
Q

What two things can be added to the classic triad of reactive arthritis?

A

Mucosal ulcers and enthesitis of the achiles

270
Q

What is the appropriate test in primary syphilis?

A

Dark Field Microscopy

271
Q

What should you think with non-anion gap metabolic acidosis and hyperkalemia?

A

RTA Type 4 (often older patient with poorly ctrld DM)

272
Q

What should patients with precocious puberty with high LH undergo?

A

Brain MRI with contrast

273
Q

What should be used for AF in WPW syndrome?

A

Procainamide

274
Q

What organ might hydroxychloroquine damage?

A

Eyes

275
Q

Where is the lesion in dysarthria-clumsy hand syndrome?

A

Lacunar infarct at the basis points

276
Q

What is the workup for a simple renal cyst?

A

None - reassurance only

277
Q

Which immunosupressant has gum hypertrophy and hirsutism?

A

Cyclosporine

278
Q

What does thrombocytopenia, hemolytic anemia, and renal failure =?

A

TTP!!!!

279
Q

How do you differentiate CMV and HSV retinitis?

A

CMV does not cause initial keratitis and has fluffy retinal lesions

280
Q

What is the most common cardiac abnormality in Down Syndrome?

A

Complete AV Septal Defect

281
Q

What is focal proliferative glomerulonephritis a subset of?

A

SLE nephritis

282
Q

Where is the anserine bursa located?

A

Anteromedially below the knee joint line

283
Q

A headache in which location in a child should raise concern?

A

Occipital headaches

284
Q

What do you do intrapartum if HIV > 1,000 copies / ml?

A

Intrapartum zidovudine and C-section

285
Q

When are live vaccines contraindicated in HIV?

A

when CD4 count is less than 200

286
Q

When does endometriosis pain peak?

A

Prior to menses not during menses

287
Q

What should you suspect in an infant with left axis deviation and tall peaked T waves?

A

Tricuspid Atresia

288
Q

What is the treatment for restless leg syndrome?

A

Fe supplementation, dopamine agonists (pramipexole)

289
Q

What is the treatment for cocaine intoxication and ischemia?

A

IV Benzodiazepines

290
Q

What is the treatment for cancer cachexia?

A

Progesterone analogues

291
Q

When is the RBC count useful?

A

In Fe deficiency it is down, thalasemias it is normal

292
Q

What do recurrent chalazions require?

A

Histopathologic examination for carcinoma

293
Q

What are normal values for FEV1 and FEV1/FVC?

A

80 to 120% of predicted

294
Q

What are the normal values of RA pressure?

A

0-8

295
Q

What are the normal values of RV pressure?

A

15-25/3-12

296
Q

What are the potential side effects of abacavir?

A

Lactic Acidosis, Hepatits, hypersensitivity reaction

297
Q

What are the side effects of effevirenz?

A

Insomnia with vivd or bizarre dreams

298
Q

What eye disease is described as having a glare worse at night?

A

Cataracts

299
Q

What is the most effective treatment for slowing the progression of diabetic nephropathy?

A

Blood pressure ctrl

300
Q

What might elevate glucose in a burn patient indicate?

A

Sepsis

301
Q

What does pronator drift signify?

A

An upper motor neuron lesion

302
Q

What is the most common PNA causing organism in young patients with CF?

A

S Aureus

303
Q

What is the Tx for duodenal hematoma?

A

NG tube and parenteral nutrition

304
Q

What is the preferred regimen for penicillin sensitive viridians endocarditis?

A

IV Penicillin G or IV Ceftriaxone

305
Q

What is a defining feature of the attacks in panic disorder?

A

They are UNEXPECTED

306
Q

What are fusion beats with wide QRS diagnostic of?

A

Sustained Monomorphic Ventricular Tachycardia

307
Q

What is the Tx for uric acid stones?

A

K Citrate to alkalinize the urine

308
Q

What HIV drug causes crystal nephropathy?

A

Indinavir (protease inhibitor)

309
Q

What contraceptive should be used when breastfeeding?

A

Progestin-only pills

310
Q

What is the gait of parkinsonism?

A

Hypokinetic narrow-based gait

311
Q

How should you follow up an RAI scan with low uptake?

A

Measure thyroglobulin

312
Q

Ulcer with a purulent base and ragged violacious border?

A

Pyoderma Gangrenosum

313
Q

What does hepatojugular reflux indicate?

A

A failing RV that can’t accommodate the increased fluid

314
Q

When is an AR murmur best heard along the LSB?

A

When it is due to valvular disease (as opposed to aortic root disease)

315
Q

What murmur does tricuspid endocarditis present with?

A

Tricuspid Regurgitation i.e. a systolic murmur accentuated with inspiration

316
Q

What is the presentation of Type I glycogen storage disease?

A

3-4 month old with doll like face, hypoglycemia, lactic acidosis, hyperuricemia. Transaminase are normal

317
Q

What is the presentation of Type III GSD?

A

Similar to type one but normal uric acid and lactate levels and elevated transaminases

318
Q

What are some P450 inhibitors?

A 
Acetomenophin
Antibiotics
Amiodarone
Cimetidine
Cranberry Juice, Ginko
Omeprazole
Thyroid Hormone
SSRIs
319
Q

What are some P450 inducers?

A 
Carbamazepine
Ginseng
OCPs
Phenobarbitol
Rifampin
St. Johns Wort
320
Q

What causes isolated systolic hypertension?

A

Decreased arterial wall elasticity

321
Q

What antiarythmatic class exhibits the most “use dependence?

A

class IC drugs (flecanide, morcizine, propafenone)

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