UWorld First Pass Flashcards
What glomerulopathy is associated with HIV and African Americans?
Focal Segmental Glomerulosclerosis
What differentiates CML from a leukemia reaction?
Low Leukocyte Alkaline Phosphatase
What are the 5 P’s?
Pain Pallor Pullselessness Poikilothermia Paresthesias
Which genital ulcers are associated with painful LAD?
HSV!
LGV is very large, very painful, and fluctuant
Chancroid has large nodes, but not as painful
What can you treat a pen-allergic pt with syphillis with?
Doxycycline (or ceftriaxone for tertiary). Desensitize in pregnancy.
What is a normal ABI result?
1.0 - 1.2
What is a defining feature of pseudoclaudication?
It is posture dependent (shopping cart sign)
What is the treatment for dermatitis herpeteformis?
Dapsone
How does INH differ from other drug induced liver injury?
It doesn’t usually have extra hepatic manifestations of drug reaction
What drugs cause Cholestasis?
Chlopromazine
Nitrofurantoin
Erythromycin
Anabolic Steroids
What drugs cause fatty liver?
Tetracycline
Valproate
Anti-Retrovirals
What drugs cause hepatitis?
Halothane
Phenytoin
INH
alpha-methyldopa
What drugs cause fulminant liver failure?
Carbon tetrachloride
Acetaminophen
What drugs cause granulomatous hepatitis?
Allopurinol
Phennylbutazone
What distinguishes anorexia from bulimia?
In anorexia, you don’t have a normal BMI while bulimics still maintain a low-normal BMI
What is the cortical findings in status epileptics?
Cortical laminar necrosis
What class of drugs can cause cerebellar atrophy?
Anti epileptic Drugs
What should be suspected in infants with bilateral bulbar palsies?
Botulism
What is the triad of McCune-Albright Syndrome?
Precocious puberty, cafe-au-alit spots and bone defects
What type of tumor can develop in Peutz-Jeghers syndrome?
Estrogen secreting tumors
What type of intracranial tumor can occur with McCune Albright?
Pituitary adenomas (e.g. Cushings, Prolactinoma, etc.)
True or false, low grade fever and leukocytosis are common in the first 24 hours postpartum?
True
Why does fat malabsorption increase incidence of oxalate stones?
Fatty acids chelate calcium and prevent it from binding with oxalateq
Why do alcoholics get hypokalemic?
poor intake and from vomiting
What ar the indications for carotid endarterectomy?
Men: 60%+ Stenosis if Asymptomatic.
Symptomatic: 50-69% (Grade IIA) 70%+ (Grade IA)
Women: 70%+ for both symptomatic and not
What is the cause of ED following pelvic fracture?
Parasympathetic nervous injury
What are the pleural effusion findings in Esophageal Rupture?
Exudative, low pH, very high amylase (>2,500 IU)
What intestinal finding can be caused by the vagal section to ureteral colic?
Illeus
What cells do non-functioning pituitary adenomas usually arrive from?
Gonadotrophs
What values is usually mildly elevated in gonadotroph adenomas?
Prolactin from disruption of the dopaminergic neural pathways
Which blistering disease has flaccid blisters?
Pemphigus Vulgaris
What are the interpretations for ABI?
1.3 Calcified vessels
In what populations are screening U/S for AAA recommended?
Men age 65-75 with a history of smoking
What is the difference between Hordeolum and Chalzion?
Hodreolum - Infection of a gland (abx and hot compress)
Chalazion - Granulomatous condition from obstruction of gland
What is the presentation of CO poisoning after a fire?
Confusion, wheezes, seizure
Carboxyhemoglobin (>15% in smokers, >3% in non smokers)
What vaccines are recommended for HIV patients?
HAV HBV HPV Influenza Meningococcus Pneumococcus Tdap (once, then Td every 10 years)
What pulmonary fungal infection is associated with the “Halo Sign”?
Aspergillosis
What are the indications for statin therapy?
Atheroslerotic disease
LDL > 190
Age 40-75 with diabetes
10-year ASCVD risk > 7.5%
What are the indications for surgical revascularization in claudication?
Limb-threatening complications
Limitations of ADL
Non-response to exercise and pharmacologic program
What is the indication for home O2 therapy?
COPD with PaO2 55%
Awake PaO2 > 60/ SaO2 > 90 if hypoxic during sleep
What are the criteria for APGAR scoring?
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)
What is the interpretation of APGAR scoring?
4-7: observe, stimulate, vent support
0-3: resuscitate
- HR
At what PaCO2 do you usually see CO2 narcosis?
> 60
What is the preferred treatment for hyperthyroidism?
Radioiodine ablation therapy
What is the deficiency/accumulation/symptom of Fabry’s Dz?
Deficiency: alpha-galactosidase A
Accumulates: Ceramide trihexoside
S/Sx: Limb pain, angiokeratomas, renal failure, thrombosis
What is the deficiency/accumulation/symptom of Krabbe’s Disease?
Deficiency: galactosylcermidase
Accumulates: galactrocerebroside
S/Sx: CNS degeneration, optic atrophy, death by 3
What physical findings are common in homocystinuria?
Fair hair, eyes, and marfanoid habitus
They get thromboembolic events
What is the triad of disseminated gonococci infection?
Tenosynovitis
Dermatitis
Migratory Polyarthritis
What are the synovial fluid findings in gonococci arthritis?
~ 50,000 WBC/mm^3
What injury should come to mind in the knee with significant hemarthrosis?
ACL injury
What is the formula for LR+?
sensitivity/1-specificity
What is the formula for LR-?
1-sensitivity/specificity
What type of study provides an exposure OR?
Case Control Studies
What type of study provides a prevalence OR?
Cross Sectional Studies
What are the live-attenuated vaccines?
Measles MumpsRubella Polio (Sabin) Yellow Fever Nasal Influenza
What are the 5 stages of behavioral change?
Precontemplation Contemplation Preparation Action Maintenance/Relapse
What differentiates MM and MGUS?
MM: Band > 3 mg/dL, anemia, renal disease, lytic lesions
MGUS: Band
What disease would you obtain and abdominal fat pad biopsy for?
Amyloidosis
What is the treatment for PID?
Inpatient: Cefotetan/Doxycycline
Outpatient: Ceftriaxone and Doxycycline
What interventions are useful for diabetic foot ulcers?
- Off-loading
- Debridement
- Wound Dressings
- Antibiotics
- Revascularization
- Amputation
Which immunosuppressant causes gum hypertrophy and hirsutism?
cyclosporine
What is the triad of wiskot-aldrich syndrome?
Eczema, Thrombocytopenia, recurrent infections with encapsulated organisms (X-linked Recessive)
High IgA/IgE levels, low IgM
When do you start surveillance in UC patients?
After disease has been present for 8 years
What does flattening of top and bottom of a flow-volume loop indicate?
Fixed-upper airway obstruction
Where does atrial flutter typically originate from?
The tricuspid annulus
What is the treatment for legionella?
Respiratory quinolone or new macrolide
What is the order of effectiveness of BP interventions?
- Weight loss (in overweight people)
- DASH diet
- Exercise
- Dietary sodium decreased
- Decrease EtOH intake
What is the formula for calculated osmolality?
2Na + Glu/18 + BUN/2.8
What are the findings in Beckwith-Wiedman syndrome?
Macrosomia, Macroglosia, Hemihyperplasia, Abdominal Wall Defects.
Monitor for hypoglycemia
What screening should kids with beckwith-wiedman syndrome get?
Abdominal U/S and AFP for Wilm’s Tumor and Hepatoblastoma
In what patients might you use stimulants to treat depression?
Those with short life expectancy as SSRIs can take 4 weeks for effect
What is the treatment for Lyme in a pregnant patient?
Amoxacillin
If allergic to amoxacillin, can use macrolide
If severe/disseminated, can do ceftriaxone
At which GA should pre-term labor be delayed?
23 weeks to 34 weeks
Highly increased risk of CP at
What age is mammography screening recommended?
50-75
What are the signs of Anorexia?
- Osteoporosis
- Elevated cholesterol/carotene
- Arhythmias (long QT)
- Euthyroid sick sinus syndrome
- HPA dysfunction
- Hyponatremia
- SGA babies (even if in remission from disease)
At what GA is conversion of breech presentation indicated?
37 Weeks
What condition has upward lens dislocation?
Marfans
What is the timeline for charcoal administration in acetomenophen poisoning?
Within 4 hours of ingestion
When are abx indicated in COPD exacerbation?
When there is > 1 cardinal symptom (SOB, increased cough, increased sputum purulence)
What age does gonococci and chlamydial conjunctivitis present at?
Gonoccocal: 2-5 days (ppx with erythromycin ointment)
Chlamydial: 5-14 days
What disease is associated with breath-holding spells?
Fe deficiency anemia
What is the treatment for trypanosomes disease?
Benznidazole
What is the treatment for pinworms?
Albendazole
What disease does the D-xylose absorption test for?
celiac disease (test for small bowel mucosa functionality)
What are the back pain red flags to get XR and ESR?
Age > 50
Nighttime symptoms
> 1 month
Constitutional or Neuro Symptoms
What are the 5 Hs?
Hyperkalemia Hypothermia Hypoxia Hypovolemia Hydrogen Ions
What are the 5 T’s?
Tension Pneumo Tamponade Toxins Thrombosis Trauma
What type of solitary pulmonary nodule requires surveillance even if it’s appearance is stable?
GGO
What are the size-risk categories for solitary pulmonary nodules?
2.0 cm - High Risk
What is Charcot’s triad of cholangitis?
Fever
RUQ Pain
Jaundice
+Confusion/Hypotension = Reynaud’s Pentad
What should you suspect in back pain on anticoagulation?
Retroperitoneal Hematoma
What is the management of Alkali ingestion?
Decontamination, Irrigation, Endoscopy within 24 hours
Should you provoke vomiting in Alkali ingestion?
NO
What is the first test you should get for suspected adrenal insufficiency?
Morning cortisol/ACTH and Cosyntropin test
What is a sign of ventricular aneurysm post-MI?
Persistent ST elevation, signs of HF/mitral regurge (5days - 3 months)
What age is HPV vaccination indicated for?
9-26
At what age is bed-wetting normal until?
Until age 5
What is susceptibility bias?
Form of selection bias, treatment dictated by disease severity.
How might UC present in the acute setting?
Toxic Megacolon
What are the 5 causes of hypoxemia?
V/Q Mismatch Shunt Diffusion Barrier Decreased O2 Tension Hypoventilation
Which nephrotic syndrome is associated with HBV?
Membranous nephropathy (can have low C3)
What drugs can cause digoxin toxicity?
Amiodarone, Verapamil, Quinidine, Propafenone
Does trichomonas cause cervicitis?
No it is a vulvo-vaginitis
Is chlaymydia or gonorrhea a more common cause of mucopurulent cervicitis?
Chlamydia
What disease causes mild conjugated hyperbili with no enzyme elevation?
Rotor Syndrome
What is clomiphene citrate?
An estrogen analogue used in anovulatory disorders
What cancer is minimal change disease associated with?
Hodgkin’s Lymphoma
What is the role of ppx in rheumatic fever?
Penicillin, with cardiac involvement and valvular do it for 10 years or until age 40
Where does terminal hematuria localize?
Bladder
When is RhoGam intitially administered?
28-32 weeks
What lab must you check prior to starting lithium?
Renal function
What is winters formula?
15(bicarb) + 8 +/- 2
At what age is AAA screening indicated?
age 65-75 with smoking Hx. >5.5 cm repair
What nerve supplies the medial leg?
Saphenous, branch of femoral
What electrolyte abnormality occurs in Cushing’s syndrome?
Hypokalemia
What markers are elevated in non-seminomatous germ cell tumors?
bHCG and AFP
What electrolyte must be monitored with high-dose TMP?
Potassium, can cause hyperkalemia
Where is the anserine bursa located?
Antero-medially over the tibial plateau
What is a case of pleural fluid pH
Empyema
What is the INR threshold for FFP admin?
1.6
What nephrotic syndrome is associated with Renal vein thrombosis?
Membranous Glomerulopathy
What two diseases is HepC strongly correlated with?
Porphyria Cutanea Tarda
Mixed cryoglobulinemia
What are the symptoms of mixed cyroglobulinemia?
Immune complex deposits in small vessels. Palpable purport and possible membranoproliferazive glomerulonephritis
What is polyarteritis nodosa associated with?
HepB
What is erythema nodosum?
Painful nodules on anterior legs, associated with infections (e.g. strep and TB) and sarcoid
Should premature infants be vaccinated based on gestational or chronologic age?
Chronologic age (except hepB shouldn’t be given if less than 2 kg)
What are the three questions to ask in hypocalcemia?
- Low Mg?
- Due to a drug?
- Recent blood transfusion?
When did blood screening for hepC start?
1992
What drug should always be stopped in sepsis/kidney injury?
Metformin
What is first line treatment for Alzheimers disease?
Cholinesterase inhibitors
What is the treatment for Tourett’s?
Antipsychotics
Alpha 2 Agonists: clonidine/guanfacine
What cancer is associated with Hashimotos?
Thyroid Lymphoma
In a child older than 2, what is most common cause of intussiception?
Meckel’s Diverticulum
Must INH always be stopped with transaminitis?
No, not if mild and asymptomatic
What is the formula for PAO2t?
FiO2(Patm-47)-PaCO2/R
At what LN diameter should you consider a biopsy?
2.0 cm
What is the treatment for restless leg syndrome?
Dopamine agonists (pramipexole, ropinirole)
What is the DLCO in chronic bronchitis?
Normal
When is cytology of fibrocystic aspirate indicated?
Bloody or foul smelling fluid
At what time point should abortive seizure therapy be provided?
5 Minutes
Which glomerular disease presents with deposits of C3 only?
MPGN Type II (dense deposit disease) due to C3 nephritic factor causing persistent alternative complement activation
Is botulism ascending or descending?
Descending
How does OA of the hip present?
Anterior hip pain worse with movement without TTP
What is first line treatment for asymptomatic bacteuria in pregnancy?
Amoxicillin
How does one differentiate AOM from OM with effusion?
OM with effusion lacks any acute infective symptoms
What is characteristic of a cerebellar tremor?
Amplitude increases as the hand reaches its target
What lab highly indicates empyema and mandates chest tube?
pH less than 7.2 (also glucose less than 60)
What should you suspect in an AA patient with nocturne?
Hyposthenuria from sickle cell trait
What characterizes HSV keratitis?
Corneal vesicles and dendritic ulcers
What is the major contraindication to orotracheal intubation?
Significant facial trauma
What may help differentiate abruption from previa?
Abruption is painful
What is characteristic of vasa previa?
Significant fetal distress as it is fetal blood hemhorraging
What food borne disease is associated with flushing and urticaria?
Scombroid
How long must you wait after alpha-blocker for using sildenafil?
4 hours
Which heart murmurs increase on expiration?
Only Left sided ones!
What does a UTI with alkaline urine pH indicate?
Urease positive organism (proteus, klebsiela, morganella, psuedomonas, staph)
How does polymyositis present?
Proximal muscle weakness, usually without pain
What is the differential for T wave inversion?
MI Myocarditis Old pericarditis Myocardial contusion Digoxin Toxicity
What is the most predictive sign of opioid intoxication?
Depressed respiratory rate
What are some P450 inhibitors?
Cimetidine, Ciprofloxacin, erythromycin, clarithromycin, verapamil
How do you distinguish peripheral thrombosis from embolism?
Embolism is acute onset with diminished pulses unilaterally
Which RTA is associated with fanconi syndrome?
Type 2 (impaired bicarbonate resorption)
What lung parameter decreases in severe COPD?
VC
Who needs a meningococcal booster?
vaccinated prior to age 16 needs one at age 16-21
What is a hordeolum?
Staph abscess of the eyelid, treat with warm compresses.
What is a chalazion?
Granulomatous inflame of the mebomium glands. treat with Incision and curettage
What is the most important risk factor for stroke?
Hypertension
What is first line therapy for symptomatic PVCs?
Beta Blockers
Amiodarone is second line
What is the treatment for actinomyces?
Penicillin (12 weeks) or Clindamycin
When does PNH usually manifest?
In the 30s with hemolysis, cytopenias, thrombosis
At what age should non high-risk patients get PCV13?
Age 65, otherwise its just the PPSV 23
What is eczema herpeticum?
Herpes infection that develops onto of eczema
What is the cause of emphysematous cholecystitis?
Gas producing bacteria (cover GNRs and GPCs) (AFLs in the gallbladder or gas on U/S)
Whistling noise after rhinoplasty?
Think septal perforation
Does the living will take legal prescedence?
Yes!
Which HIV drug causes crystal nephropathy?
Indinavir (a protease inhibitor)
What are the common life threatening HAART complications?
Didanosine - Pancreatitis abacavir - hypersensitivity syndrome NRTIs - Lactic Acidosis NNRTIs - SJS Neverapine - Liver Failure
What lab abnormalities are seen with cholesterol embolization?
Eosinophilia
Hypocomplementemia
What two syndromes result in unconjugated hyperbole?
Crigeler-Najar
Gilbert
What screening tests should you do in infertility first?
TSH, FSH, Prolactin first
Unless prior uterine instrumentation, then image
Who less than
Immunocompromised, CSF leak, Asplenia, cochlear implant
Which patients should succinylcholine not be used in?
Those at risk for hyperkalemia:
Crush or burns > 8 hours old
Tumor lysis syndrome
Demyelinating syndromes
What is the major division for cases of fetal growth restriction?
Is it asymmetrical (maternal factors) or symmetrical (fetal factors)
What is lidocaine used for with ACS patients?
Can be used to ctrl vTach; however, should not be used prophylactically due to increased risk of systole
What are the PE findings in fetal alcohol syndrome?
1 Small Palpebral Fissure
2 Smooth philthrum
3 Thin vermillion border
What is the definition of arrested labor in the first stage?
> 6 cm dilated with:
No change in 4 hours with good contractions
or No change in 6 hours w/o good contractions
What are rhonchi that clear with a cough suggestive of?
Bronchitis
What is the treatment for Vaginismus?
Keigel exercises and gradual dilatation
What differentiates galactokinase deficiency form galactose-1-phosphate uridyl transferase deficiency?
In the former, they only get cataracts, other also gets systemic manifestations
What murmur is heard at the LSB with the patient leaning forward and holding exhalation?
Aortic Regurgitation (early diastolic murmur)
What is an imaging finding with constrictive pericarditis?
Calcification along the heart border
What should you think of with a mid-diastolic knock?
Constrictive pericarditis
What are the top three causes of chronic cough?
GERD
Post-nasal Drip
Asthma - PFTs!!!
What empiric therapy for cervical lymphadenitis in children?
Clindamycin as it covers MRSA (+InD)
What is the treatment for amebic liver abscess?
Oral Metronidazole with Paromomycin (luminal agent)
What confirmatory test can be used if gastrin level is between 100 and 1000?
Secretin stim test, if gastrin elevated then it is a gastrinoma
What should be avoided in Meinere’s disease?
High salt, EtOH, Caffeine, Nicotine
After the dose at age 11-18 with Tdap, should patients get Td or Tdap?
Td unless pregnant
Till what age should sickle cell patients take penicillin pox?
5
For uncomplicated cystitis is a urine culture necessary?
No
What factors make cystitis complicated?
Pregnancy, Diabets, CKD, UT obstruction, immunocompromised, hospital/procedure associated
What do ST depressions in V1/V2 indicate?
Posterior wall MI
How often is RV involved in an inferior infarct?
1/3 of the time, ST depression in I and AVL and indicate this
What is cyclical vomiting syndrome associated with?
Migraine Headaches
Which personality disorder has “magical thinking”?
Schizotypal Personality Disorder
What is Ludwig Angina?
Progressive bilateral cellulitis of the submandibular and sublingual space
What is the most common acute side effect of levodopa therapy?
Hallucinations
In what group of elderly patients should typical neuroleptics not be used?
Those with lewy body dementia
What is the treatment for chlamydial conjunctivitis or pneumonia in a newborn?
Oral Erythromycin
What is the only segment of the bladder in contact with the peritoneum?
The dome of the bladder
How is hypothermia classified?
Mild: 32-35
Moderate: 28-32
Severe: less than 28
What type of arrhythmias usually resolve with warming in hypothermia?
Atrial arrhythmia
What is acute stress disorder?
Like PTSD but symptoms are from 3 days to 1 month. A significant life threatening stressor is required for dx
For who is the PPD cutoff value 10 mm?
Recent immigrants (within 5 years) from TB area
IVDU
Residents and employees of high risk settings
Comorbid (diabetes, ESRD, etc.)
Children less than 4
What syndromes are associated with Wilm’s tumor?
WAGR
Beckwith-Wiedman
Denys-Drash
What are indications for Hep C treatment?
Liver biopsy with at least bridging fibrosis
Compensated liver disease (INR not over 1.5, no ascites)
No MDD, EtOH, or IVDU
What are the main side effects of sulfonylureas?
Weight gain and hypoglycemia
What oral hypoglycemics cause weight loss?
GLP-1 receptor antagonists (exenatide)
What oral hypoglycemics can be used in renal insuficiency?
Glitazones and DPP-IV inhibitors
What is Beck’s triad of cardiac tamponade?
Hypotension
Distended Neck Veins
Muffled heart sounds
What metabolic abnormality may result from thiazide treatment?
Hyperglycemia, Increased LDL, Hypertriglyceridemia, Hyperuricemia
What should you think of with a mono like syndrome with LAD and Gi symptoms?
Acute HIV Infection
What is required for the diagnosis of any psychiatric condition?
Interference with activities at work or home
What should proximal muscle weakness, decreased reflexes, normal ESR, and elevated CK make you think of?
Hypothyroid Myopathy
What is the inheritance pattern of myotonic dystrophy?
AD, trinucleotide repeat of CTG on Cr 19
Which disease of the breast presents like eczema?
Pagets
Is formula or breast milk associated with less colic?
Breast Milk
What are the lesions of herpangina?
Gray vesicles on the posterior oropharynx and tonsilar pillars that progress to fibrin coated ulcerations
In non-classical CAH, are there electrolyte disturbances?
No
What are the screening recs for osteoporosis?
Dexa scan in all women > 65
What is the management of endometrial hyperplasia without atypia?
Progestin therapy
When can menopause be diagnosed clinically?
In women > 45 with 12 months of amenorrhea
What is the treatment for nocardia?
TMP-SMX for pulmonary
Add carbapenem for CNS disease
What is the typical pH in salicylate overdose?
It is usually near normal
What is the clinical presentation of osteoid osteoma?
Increasing pain worse at night better with NSAIDs
Hypodense lesion on x-ray
What should be given to decrease homocysteine levels?
B6 and Folate
What are the sfx of EPO administration?
Worsening HTN
Headaches
Flu-like syndrome
Red cell aplasia
What are the indications for steroid use in PCP treatment?
PaO2 less than 70
A-a gradient greater than 35 on RA
What is the triad of Wernicke’s?
Encephalopathy
Oculomotor dysfunction
Gain disturbances
What cancers do OCPs reduce the risk of?
Endometrial and Ovarian
Decreased benign breast dz risk
What is a common side effect of OCPs?
HTN
What is the definition of primary amenorrhea?
Absence of menstruation in someone age 15 with normal growth
How does glucagonoma present?
With DM, necrolytic migratory erythema, weight loss, diarrhea, anemia
When does common variable immunodefficiency present?
Usually not till after age 15 and the B cells are present
What is Kehr’s sign?
LUQ pain radiating to the L shoulder from diaphragmatic irritation
Which cell lines are up in polycythemia vera?
All three, but red cells most
What condition causing hand pain affects new mothers?
De Querveins Tenosynovitis
What Ca abnormality prolongs the QT interval?
hypocalcemia
What should recurrent epistaxis and AVMs make you think of?
Hereditary Hemhorragic Telengectasia
What is the most common complication of a supracondylar fracture?
Brachial Artery Injury (also median nerve and cubitus varus deformity)
What parasite might give you subungual hemorrhages, periorbital edema, chemosis?
Trichinella Spiralis
What infectious disease causes fever, headache, retro-orbital pain, myalgia?
Dengue
Which disease has chery-red macula and areflexia?
Nieman-Pick, also has HSM
Which disease had chery-red macula and hyperreflexia?
Tay-Sachs
What ist he deficiency in Nieman-Pick?
Sphingomyelinase
What is the deficiency in Tay-Sachs?
Beta Hexosaminidase A
What disease has anemia, thrombocytopenia, and HSM?
Gauchers (glucocerebrosidase deficiency)
What is the threshold for lead treatment in a child?
45-69 mcg - DMSA
over 70 - Dimercapol and EDTA
What are flat and broad T waves a sign of?
Hypokalemia
What signs indicate a Morton Neuroma?
Numbness and Pain between 3rd and 4th toes, clicking sensation when placating while squeezing metatarsal joints
What are signs of ischemia in an SBO?
fever, tachycardia, leukocytosis, metabolic acidosis
What are the findings in trichomonas vaginits?
Motile pear-shaped organisms
What are the indications for bladder and renal US in peds?
First febrile UTI before 24 months
What is the initial workup for an ovarian mass in post-menopausal women?
US and CA 125
Do OCPs cause weight gain?
NO
Which deficits are most severe early on in multi-infarct dementia?
Executive Function deficits
Why does IUGR decrease RDS incidence?
Stress in uterus causes lungs to mature early
What cardiac defects is most common in Trisomy 18?
VSD
What two things can be added to the classic triad of reactive arthritis?
Mucosal ulcers and enthesitis of the achiles
What is the appropriate test in primary syphilis?
Dark Field Microscopy
What should you think with non-anion gap metabolic acidosis and hyperkalemia?
RTA Type 4 (often older patient with poorly ctrld DM)
What should patients with precocious puberty with high LH undergo?
Brain MRI with contrast
What should be used for AF in WPW syndrome?
Procainamide
What organ might hydroxychloroquine damage?
Eyes
Where is the lesion in dysarthria-clumsy hand syndrome?
Lacunar infarct at the basis points
What is the workup for a simple renal cyst?
None - reassurance only
Which immunosupressant has gum hypertrophy and hirsutism?
Cyclosporine
What does thrombocytopenia, hemolytic anemia, and renal failure =?
TTP!!!!
How do you differentiate CMV and HSV retinitis?
CMV does not cause initial keratitis and has fluffy retinal lesions
What is the most common cardiac abnormality in Down Syndrome?
Complete AV Septal Defect
What is focal proliferative glomerulonephritis a subset of?
SLE nephritis
Where is the anserine bursa located?
Anteromedially below the knee joint line
A headache in which location in a child should raise concern?
Occipital headaches
What do you do intrapartum if HIV > 1,000 copies / ml?
Intrapartum zidovudine and C-section
When are live vaccines contraindicated in HIV?
when CD4 count is less than 200
When does endometriosis pain peak?
Prior to menses not during menses
What should you suspect in an infant with left axis deviation and tall peaked T waves?
Tricuspid Atresia
What is the treatment for restless leg syndrome?
Fe supplementation, dopamine agonists (pramipexole)
What is the treatment for cocaine intoxication and ischemia?
IV Benzodiazepines
What is the treatment for cancer cachexia?
Progesterone analogues
When is the RBC count useful?
In Fe deficiency it is down, thalasemias it is normal
What do recurrent chalazions require?
Histopathologic examination for carcinoma
What are normal values for FEV1 and FEV1/FVC?
80 to 120% of predicted
What are the normal values of RA pressure?
0-8
What are the normal values of RV pressure?
15-25/3-12
What are the potential side effects of abacavir?
Lactic Acidosis, Hepatits, hypersensitivity reaction
What are the side effects of effevirenz?
Insomnia with vivd or bizarre dreams
What eye disease is described as having a glare worse at night?
Cataracts
What is the most effective treatment for slowing the progression of diabetic nephropathy?
Blood pressure ctrl
What might elevate glucose in a burn patient indicate?
Sepsis
What does pronator drift signify?
An upper motor neuron lesion
What is the most common PNA causing organism in young patients with CF?
S Aureus
What is the Tx for duodenal hematoma?
NG tube and parenteral nutrition
What is the preferred regimen for penicillin sensitive viridians endocarditis?
IV Penicillin G or IV Ceftriaxone
What is a defining feature of the attacks in panic disorder?
They are UNEXPECTED
What are fusion beats with wide QRS diagnostic of?
Sustained Monomorphic Ventricular Tachycardia
What is the Tx for uric acid stones?
K Citrate to alkalinize the urine
What HIV drug causes crystal nephropathy?
Indinavir (protease inhibitor)
What contraceptive should be used when breastfeeding?
Progestin-only pills
What is the gait of parkinsonism?
Hypokinetic narrow-based gait
How should you follow up an RAI scan with low uptake?
Measure thyroglobulin
Ulcer with a purulent base and ragged violacious border?
Pyoderma Gangrenosum
What does hepatojugular reflux indicate?
A failing RV that can’t accommodate the increased fluid
When is an AR murmur best heard along the LSB?
When it is due to valvular disease (as opposed to aortic root disease)
What murmur does tricuspid endocarditis present with?
Tricuspid Regurgitation i.e. a systolic murmur accentuated with inspiration
What is the presentation of Type I glycogen storage disease?
3-4 month old with doll like face, hypoglycemia, lactic acidosis, hyperuricemia. Transaminase are normal
What is the presentation of Type III GSD?
Similar to type one but normal uric acid and lactate levels and elevated transaminases
What are some P450 inhibitors?
Acetomenophin Antibiotics Amiodarone Cimetidine Cranberry Juice, Ginko Omeprazole Thyroid Hormone SSRIs
What are some P450 inducers?
Carbamazepine Ginseng OCPs Phenobarbitol Rifampin St. Johns Wort
What causes isolated systolic hypertension?
Decreased arterial wall elasticity
What antiarythmatic class exhibits the most “use dependence?
class IC drugs (flecanide, morcizine, propafenone)
