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Step 2 CK > UWORLD NOTES > Flashcards

UWORLD NOTES Flashcards

1
Q

Anterior mediastinal mass ddx

A

thymoma
teratoma
thyroid
terrible lymphoma

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2
Q

Ovarian mass:

  • solid with thick septae
  • solid
  • calicifcations
  • ground glass/internal echo
A
  • solid with septae: malignancy
  • solid: luteoma/krukenburg
  • calcifications: teratoma
  • ground glass: endometrioma
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3
Q

What rules out retained placenta

A

thin endometrial stripe

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4
Q

Damage caused by clavicular fracture

A
  • subclavian artery

- brachial plexus

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5
Q

PSC findings on ERCP

A

bile duct fibrosis with “onion skinning”

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6
Q

Primary amenorrhea first step in dx

A

pelvic us
if there is a uterus –> check FSH
no uterus –> check karyotype

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7
Q

Cause of absent uterus with 46XX vs 46CY karyotype

A

46XX mullerian agenesis

46XY AIS

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8
Q

Breast feeding decreases which cancer risks

A

breast

ovarian

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9
Q

Causes of hyperandrogrenism in pregnancy

A

luteoma/theca lutein cyst

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10
Q

Splenectomy med treatment

A

vax weeks before when possible

penicillin px for 3-5 years

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11
Q

Tumor lysis labs

A

high uric acid
high K+
high PO4
low Ca

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12
Q

Treatment and risks assc with TLS

A

IVF, allopurinol

arrhythmia/renal failure

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13
Q

Lights criteria for exudative effusion

+cause

A

pleural/serum protein ratio more than 0.5; LDH ratio more than 0.6 or LDH greater than 2/3 ULN

cause is increased permeability

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14
Q

Transudative effusion cause

A

increased hydrostatic pressure or decreased oncotic pressure

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15
Q

Labs assc with hemolytic anemia

A

high indirect billi, high LDH, low haptoglobin (binds Hgb)

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16
Q

Three causes of low albumin

A

cirrhosis
nephrosis
protein wasting enteropathy

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17
Q

Pain + fever +hematuria esp when pt has membranous glomerulonephrosis=

A

renal vein thrombosis

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18
Q

Location of pain in:
IT band syndrome
patellofemoral syndrome
pes anserinus

A

IT band syndrome: lateral femoral condyle
patellofemoral syndrome: anterior knee
pes anserinus: opposite ITB (medial condyle)

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19
Q

CMV vs HSV retinitis

A

CMV- fluffy granular painless lesions
HSV- central retinal necrosis, painful
Both assc with AIDS

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20
Q

Normal ABG in pregnancy

A

respiratory alkalosis

high TV/MV/ PaO2

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21
Q

Cause of hepatorenal syndrome

A

splanchnic arterial dilation

low GFR with no other clear cause

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22
Q

Porphyria cutanea cause

A

low uroporphyrinogen decarboxylase = high prophyrins

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23
Q

Treatment PCT

A

phlebotomy and hydroxychloroquine

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24
Q

RAI needs to be combined with?

A

steroids or antithyroid meds to treat ophtalmopathy

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25
Q

Thyrotoxicosis effect on circulation

A

hyperdynamic state; increased contractility and HR

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26
Q

Obstructive lung disease cut off

A

FEV1/FVC under 0.7

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27
Q

MOS of nitroglycerin

A

systemic vasodilation –> decreased LV stress –> decreased MVO2

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28
Q

Liver abscess three types/ management

A
  • elederly/chronic med- bacterial must drain and give abx
  • asx/ animal contact- echinococcus must drain and give albendazle (calcified, daughter cysts)
  • sick/ endemic area- entamoeba = metronidazole no draining!
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29
Q

Strep viridans species

A 
MMMOSS
mutans 
milleri
mitis 
oralis
sobrinus
sanguinis
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30
Q

PCD vs CF cause of infertility

A

PCD immobile sperm

CF absent vas

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31
Q

Four causes thyroiditis +
which has +TPO

also: which is the only thyroid disease with increased RAIU?

A

painless/silent ++TPO (hyperthyroid state)
hashimoto ++TPO
subacute
graves- high RAIU

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32
Q

Soft S2 cause

A

severe aortic stenosis

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33
Q

Post op/partum fever not responsive to abx:

cause + treatment

A

septic thrombophlebitis

anticoag and broad spectrum abx

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34
Q

Two bone diseases that have normal Ca/PO4/PTH

A

pagets

osteoporosis

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35
Q

Management of placenta previa

A 
pelvic rest (no sex or exams)
CS at 36-37 weeks
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36
Q

MCC nephrotic syndrome in adults

A

FSGS

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37
Q

Clue to reactive arthritis vs gonococcal arthritis

A

reactive- enthesitis (gets nsaids while gonorrhea gets abx)

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38
Q

Polycythemia vera:
labs
treatment risk

A

all cell lines increased, JAK2 mutation
phlebotomy, hydroxyurea
clots and myelofibrosis

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39
Q

Two MCC prosthetic joint infections

A

early: aureus, acute pain and fever

late (3+ months): epi, indolent onset

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40
Q

Two smoke toxins

A

HCN and CO

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41
Q

Treatment for HCN tox (3)

A

hydroxycobalamin
thiosulfate
nitrates (FE3+ binds HCN)

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42
Q

PE finding that distinguishes hemothorax and PTX

A

hyperressonance seen with PTX

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43
Q

What distinguishes AIHA from SCA

A

look at the spleen

spleen large in AIHA, gone in SCA

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44
Q

When to give PEP after rabies

A

cant quarantine pet

high risk wild animal

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45
Q

Pernicious anemia risk

A

gastric cx

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46
Q

When is D-dimer an appropriate test?

A

less than 2 risks per wells criteria

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47
Q

phenytoin tox signs

A

ataxia

nystagmus

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48
Q

Polymyositis dx

A

biopsy first patchy necrosis
also have + ANA/Jo
treatment is steroids

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49
Q

PMR vs polymyositis

A

PMR is STIFFNESS and acute

Poly is weakness and indolent

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50
Q

Paradoxical chest wall motion after MVC =

A

flail chest

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51
Q

Sporotrix:
-bug type
-exposure
treatment

A

dimorphic fungus
decaying vegetation
3-6 months intraconazole

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52
Q

Menieres triad and cause

A

hearing loss
tinnitus
dizziness

increased endolymph pressure (poor absorption)

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53
Q

Joint mass with chalky white appearance

A

tophaceous hout

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54
Q

Delirium must have

A

fluctuating consciousness

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55
Q

Thyroid changes in pregnancy

A

total T4 &TBG which = normal free T4

low TSH

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56
Q

Contraindications to vaginal delivery

A

previa
prior classical CS
prior myomectomy

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57
Q

Reflex that is diminished with age

A

Achilles

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58
Q

Weight required for Hep B vaccine

A

2 kg/ 4.6 lbs

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59
Q

B2 agonists end in ?

A

erol

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60
Q

Arthrocentesis white count in:
OA
Septic

A

OA should be under 2k

Septic should be over 50k

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61
Q

Equilibrated cardiac pressures- clue for

A

tamponade

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62
Q

Vision changes + thickened eyelids=

A

atopic keratoconjunctivitis

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63
Q

Bacterial ocular discharge clue

A

comes back after cleaning off

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64
Q

MCC liver mets

A

GI lung breast

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65
Q

Treatment for Pagets

A

Bisphos and Ca/D

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66
Q

ESRD patient anticoagulation

A

just hep –> warf nothing fancy kidneys cant deal.

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67
Q

Supracondylar fracture assc injury

A

brachial artery/ median nerve

rarely compartment/volkman

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68
Q

Shingles trick

A

may have skin pain before shingles

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69
Q

Hemophilia A vs B + UA findings

A

both XR
A is factor 8
B is 9

hematuria with normal renal function

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70
Q

Which is screened for in all preggos: G or C

A

C, gonorrhea only under 25 or high risk

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71
Q

Constellation for Granulomatosis with Polyangitis

Assc ab

A

URI + LRTI + renal disease + skin findings

ANCA +

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72
Q

Staph vs TB cavitary lesion

A

staph is acute TB is indolent

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73
Q

MCC duodenal ulcer

A

almost always HPylori

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74
Q

What type of bias:

treatment regimen based on disease severity

A

selection bias (susceptibility)

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75
Q

Lab changes with PRBCs

A

citrate –> low calcium and mag

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76
Q

Cause of zenkers

A

dysmotility

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77
Q

Air in chest that is not improved with tube placement is

A

bronchial rupture

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78
Q

For every 1 decrease in albumin Ca changes by

A

down 0.8

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79
Q

Advanced ovarian mass next step

A

straight to lap

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80
Q
  • high gluc
  • skin pigment
  • LFTs high

is….

A

hemochromatosis (risk KCC)

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81
Q

Meds for enuresis

A

1st line: desmopressin

2nd line: TCA

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82
Q

Turners risk and treatment

A

osteoporosis

HRT

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83
Q

Clue to angiodysplasia

A
  • missed on colonoscopy
  • painless bleeding and normocytic anemia
  • assc with CKD/AS/VWD
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84
Q

Treatment of acalculous chole

A

abx and perc cholecystostomy

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85
Q

First step in dx’ing cushings

A

dexa supression

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86
Q

Hemolysis AND thrombosis =

A

PNH

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87
Q

Clue to bacillary angiomatosis vs kaposcis

A

bacillary= systemic signs like fever

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88
Q

When to give progesterone for short cervix

A

if detected earlier than 24 wks GA

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89
Q

Enthesitis is seen in?

A

reactive arthritis

ank spon

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90
Q

What stress fracture requires treatment

A

5th metatarsal needs ORIF/casting

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91
Q

SIDs 3 risks

A

stomach sleeping
smoking
pacifier

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92
Q

Acute hep B is assc with what renal disease

A

membranous

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93
Q

Gross painless lower GI bleed

A

diverticulosis

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94
Q

RA treatment

A

start DMARDs (MTX) as soon as possible regardless of pain level

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95
Q

Ogilvies clue:

treatment:

A

distended colon on imaging

rectal tube

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96
Q

Presentation vs position in childbirth

A

presentation: butt vs head
position: part in relation to the pelvis
malposition = mcc second stage labor arrest

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97
Q

Signs of breast feeding failure jaundice

A

brick red crystals in diaper
dehydration
too many gaps between feeds

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98
Q

Treatment for BCC on face

A

Mohs

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99
Q

Nontender large salivary glands in alcoholic

A

sialadenosis

abnormal innervation

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100
Q

Cause of warfarin induced skin necrosis

A

protein C deficiency

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101
Q

MCC CAP in HIV pt

A

SP

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102
Q

Adjustment disorder time limit and treatment

A

3 months

therapy

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103
Q

How to dx ank spon

A

xray showing sacroilitis

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104
Q

NG tube in pulm cavity =

A

diaphragmatic rupture

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105
Q

Pseudogout + liver disease +DM =

A

hemochromatosis

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106
Q

Pt found unconscious and has hemiparalysis think…

A

Todds paralysis (post epileptic)

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107
Q

High risk pulm nodule size?
intermediate?
low?

A

2 cm+ high
0.8-2 med
less than 0.8 low risk

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108
Q

Ataxia
Nystagmus
Hammer Toes
Cardiomyopathy

What is THIS?

A

Freidreichs ataxia

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109
Q

Rash that looks like an oil spill

A

erythema marginatum of RF

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110
Q

Type of rash assc with serum sickness

A

urticarial

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111
Q

Intravascular cath MC infection

A

coag - staph

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112
Q

MC COD in PAD

A

MI

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113
Q

Fanconis vs Diamond Blackfan labs

A

Fanconis is aplastic

Diamond is pure red/macro (triphalangeal thumbs)

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114
Q

MCC neonatal sepsis

A

GBS

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115
Q

Lithium labs to monitor

A

LFTs
thyroid
Ca
level

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116
Q

Contraindications to vaginal labor are also contraindications to _____

A

contraction stress test

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117
Q

Cyanosis after topical anesthetic use is

A

methemoglobinemia

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118
Q

Tet squatting effect

A

LOUDER murmur but improved CYANOSIS

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119
Q

Components of BPP

A 
NST (2+ accels)
AFI (2x1 cm) 
Movement (3+) 
Tone (1 flexion/extension)
Breathing (1+ breathing episode)
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120
Q

Long QT treatment

A

BBer

Pacer

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121
Q

MC bug in acute parotitis following surgery

A

staph

prevent with hydration/hygiene

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122
Q

Peak Pressure = ____ + _____

A

plateau + airway resistance

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123
Q

Plateau pressure = ____ + ___

A

PEEP + elastic pressure

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124
Q

Elastic pressure = _____/ ____

A

TV/ compliance

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125
Q

Increase in peak pressure without a change in plateau pressure means

A

airway obstruction (mucus plug, biting tube, bronchospasm)

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126
Q

Cause of increasd plateau pressure

A

PTX/pulm edema/PNA/atelectasis/right sided intubation

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127
Q

Bilious emesis + small colon? big colon?

A

small colon- meconium ileus

big colon- toxic megacolon

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128
Q

Characterize hypercalemia assc with HCTZ

A

MILD, like 12 or less

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129
Q

How does viral illness lead to intussusception?

A

peyers patch hypertrophy

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130
Q

What determines severity of CHF

A

degree of hyponatremia

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131
Q

All pregnant patients should be screened for which STDs?

A

Chlamyida
Hep B
HIV
Syphillis

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132
Q

MC kidney stone type

A

calcium oxalate

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133
Q

Stone type assc with RTA & hyperparathyroidism

A

CaPO4

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134
Q

MC risk assc with prolonged pregnancy

A

oligo

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135
Q

Migratory superficial thrombophlebitis next step

A

CT to look for visceral malignancy

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136
Q

Central precocious puberty –> next step

A

bone age

normal: reassure
increased: MRI to r/o mass –> GNrH agonist

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137
Q

Two LSD with cherry red macula

A

Neiman Pick and Tay Sachs

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138
Q

How to distinguish neiman pick and tay sachs

A

neiman: HSM and arreflexia

tay sachs: normal spleen and reflexes

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139
Q

Krabbes disease typical finding + enzyme

A

vague… regression of milestones but no HSM, no cherry red macula

a galactosidase

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140
Q

Gauchers disease enzyme + findings

A

glucocerebrosidase

anemia/low platelets and HSM

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141
Q

Ovarian torsion must have

A

ovarian mass

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142
Q

Treatment for homocysteine elevation

A

B6/folate

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143
Q

MCC nonreactive NST

A

sleeping

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144
Q

Gilberts enzyme def

A

UDP glucuronosyltransferase

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145
Q

Palpable purpura in adult + renal disease =

A

cryoglobulinemia –> HCV

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146
Q

Fatigue + proximal muscle WEAKNESS + ^^CK =

A

thyroid myopathy (can be hypo or hyper)

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147
Q

What three yeasts present with skin and lung findings and how to tell these apart?

A

blasto- central US
histo- MS/Oh River valleys
coccidio- southwest us

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148
Q

What type of bug is aspergillus

A

mold

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149
Q

Costochondral joint enlargement=

A

rickets

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150
Q

myositis
periorbital edema
eosinophilia =

A

trichinellosis

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151
Q

Vision loss in mac degen (describe)

A

central vision gone

straight lines look wavy

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152
Q

Bilious emesis first step in evaluation after stabilizing

A

AXR
double bubble
dilated loops do contrast enema (MI, hirschsprungs)NG tube in duodenum = malrotation

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153
Q

Clubbing + sudden onset arthropathy

A

hypertrophic osteoarthropathy

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154
Q

Three clues to sickle trait

A

renal pap necrosis
splenic infarct
exertional rhabdo

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155
Q

Scrotal mass that is worse with standing

A

varicocele

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156
Q

What type of hernia is felt in the scrotum?

A

inguinal

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157
Q

Trauma –> delayed heart failure cause?

A

AVF

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158
Q

At what hgb are patients with GIBs transfused?

A

7 or less

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159
Q

SCA sudden drop in hgb and retics =

A

aplastic crisis

Splenic sequestration will not have low retics

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160
Q

Swelling at floor of mouth and submandibular area =

A

Ludwig angina

dental infection

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161
Q

MTX mc ADR

A

oral ulcers

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162
Q

Chorio must get what meds in addition to abx

A

Pitocin to speed up labor even if already in labor.

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163
Q

Appendicits longer than 5 ays is likely

A

abscess

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164
Q

Treatment of neonatal gonococcal conjunctivitis? chlamydial?

A

IM ceftriaxone- G

oral macrolide- C

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165
Q

Penile fracture is rupture of what structure?

Whats the first step?

A

corpus cavernosum

do retrograde urethrogram –> surgery

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166
Q

Histoplasma treatment

A

mild- itraconazole

widespread- amphotericin

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167
Q

Central cord syndrome is what deficit types

A

classic: pain and temp

but can also apparently be weakness

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168
Q

fluctuance is basically another word for

A

abscess

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169
Q

AVF (cranial) sx in the elderly is

A

amyloid

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170
Q

Carcinoid tumors cause what deficiency

A

niacin

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171
Q

whistling following rhinoplasty is

A

septal perforation

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172
Q

Postpartum bleeding + pulmonary infiltrates is?

A

chorio

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173
Q

Cholecystitis with stone at duct needs ____
cholecystitis without obstruction needs ____
biliary colic needs _____

A

with stone- ERCP
without- chole within 72 hours
colic- elective chole

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174
Q

Child with unilateral lymphadenitis has

A

staph aureus

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175
Q

Elderly man with irritative voiding –PSA – infxn:

ddx

A

chronic prostatitis- back pain

BPH- no back pain

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176
Q

Unstable aortic dissection gets

A

TEE

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177
Q

Acute agitation in dementia treatment

A

antipsychotics

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178
Q

Normal T4/TSH but change in T3 is

A

euthyroid sick syndrome

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179
Q

Lymphatic obstruction should have

A

thick/rigid skin

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180
Q

Amio ADRs

A 
-ocular 
blue skin
neuropathy 
pulm fibrosis
thyroid hyper or hypo
brady or QT long 
liver disease

(all organ systems)

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181
Q

1st line treatment for HE

A

lactulose

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182
Q

MCC orbital cellulitis

A

bacterial sinusitis

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183
Q

Recurrent hemarthrosis leads to

A

hemosiderin deposition/fibrosis/chronic pain

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184
Q

Microcytic anemia + GI sx + neuropsych sx + uric acid =

A

lead tox

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185
Q

Recurrent diffuse molluscum test for

A

HIV

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186
Q

Clotting in lupus is caused by

A

APL sx

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187
Q

Strongest stroke risk is

A

HTN

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188
Q

CDH first steps

A

intubate + gastric tube

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189
Q

Papullary thyroid cancer spread? Follicular?

A

Papillary is lymph

Follicular is blood

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190
Q

Amenorrhea in athletes stems from

A

hypothalamus

GnRH low

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191
Q

MC ADR assc with SERMS

A

hot flashes

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192
Q

How to treat uric acid stones

A

alkalinize urine with Pot citrate

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193
Q

Liver cyst + calcification + dogs =? treatment?

A

echinococcus

surg + albendazole

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194
Q

Capillary lead test is positive next step

A

confirm with venous & treat at 50+

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195
Q

Compensation in met acidosis?

A

Co2= 1.5(bicarb) + 8 +/-2

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196
Q

Compensation in met alk

A

1 bicarb = 0.7 Co2

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197
Q

Resp acid compensation

A

10 CO2 = 1 bicarb

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198
Q

Resp alkalosis compensation

A

10 CO2 = 2 bicarb

alkalosis compensation stronger

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199
Q

Which anti diabetic causes weight loss? weight gain?

A

weight loss- GLP1 (glutide)

gain- sulfonylurea, TZDs

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200
Q

Treatment of malignant otitis

A

IV Cipro

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201
Q

Treament of asx endometriosis

A

don’t

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202
Q

Attributable risk formula

A

RR-1/RR

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203
Q

Painless bloody stool, eczema, regurg=

A

milk protein enterocolitis

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204
Q

Neonatal dx:
respiratory distress
low glucose
high Hct

A

polycythemia vera

assc with delayed clamping and hypoxia

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205
Q

Inspiratory stridor that is worse when supine:

A

laryngomalacia
(collapse of supraglottic structure)
*self resolves

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206
Q

Solitary painful bone lesion with high Ca assume

A

malignancy

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207
Q

Always treat AOM under what age?

A

2

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208
Q

Cause of sudden death right after intubation

A

drop in rvp

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209
Q

succinylcholine MC ADR

A

K+ high –> arrhythmia

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210
Q

Halothane MC ADR

A

hepatotoxicity

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211
Q

Etomidate MC ADR

A

inhibits 11B hydroxylase (adrenal insufficiency)

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212
Q

NO MC ADR

A

inhibits B12 and methionine synthase –> neurotoxic

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213
Q

Growth at 12 months should be?

A

weight x3 and height up 50%

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214
Q

No fetal heart tones next step

A

must confirm with transabdominal US

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215
Q

Appropraite workup for IUFD

A

autopsy
karyotype
placental eval
maternal clotting eval

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216
Q

Treatment of LOCALZIED lyme in pregnancy

A

amoxicillin

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217
Q

Two year old appropriate speech

A

50+ words

two word phrases

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218
Q

Valgus stress tests

A

MCL

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219
Q

How does ZES lead to diarrhea?

A

acid inactivates lipase

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220
Q

Lynch cancers

A

colon
endometrial
ovary

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221
Q

FAP cancers

A

colon
brain
soft tissue

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222
Q

VHL cancers

A

clear cell renal
hemangioblastoma
pheos

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223
Q

MEN2A cancers

A

pheo
para
medullary

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224
Q

MEN2B masses

A

medullary
pheo
marfan habitus
neurofibromas

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225
Q

Lynch px screening

A

annual endometrial bx or hysterectomy

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226
Q

Papillary cancer cells + treatment

A

orphan annie, surg –> RAI

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227
Q

Reyes histo

A

microvesicular fatty infiltration

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228
Q

Toxo methods of acquiring

A

cat shit

undercooked meat

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229
Q

Only measure that is increased in hypovolemic shock

A

SVR

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230
Q

Prader willi is loss of ______ 15q11-q13

A

paternal

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231
Q

Mongolian spots what to do

A

not shit. they’ll go away. leave that shit alone. let the little babies eat their rice.

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232
Q

Acute rejection treatment

A

steroids.

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233
Q

Lacunar stroke:
presentation
cause
histo

A

pure motor
lipohyalinosis
HTN

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234
Q

When to give rhogam

A

28 wks

exposure to fetal blood

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235
Q

Treatment of postpartum psychosis

A

hospital

antipsychotics

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236
Q

Hydrocele in neonate management

A

surg at 1 year but usually resolves

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237
Q

Clue to AD complications

A

clear lungs: tamponade

crackles: AR

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238
Q

How to distinguish tinea from vitiligo

A

tinea: chest, back, some color
vitiligo: face/distal, complete loss of color

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239
Q

Inferior MI means patient may also have ____

A

RVI

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240
Q 
95% = within \_\_\_\_SDs 
99.7= within \_\_\_\_\_\_SDs 
68% = within \_\_\_\_\_ SDs
A

95-2
99-3
68-1

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241
Q

Dig arrhythmia

A

atrial tach with AV block

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242
Q

Baldness + skin findings = _____ Deficiency

A

zinc

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243
Q

Skin depigmentation
sideroblastic anemia

= _____ Deficiency

A

Cu

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244
Q

If you need to workup any pulm nodule you need to start with ___

A

CT

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245
Q

Loss to follow up is what bias type?

A

attrition –> selection

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246
Q

Reporting bias description

A

patient doesn’t report exposure due to fear of stigma

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247
Q

Normal liver span?

A

less than 12

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248
Q

McCune Albright constellation + cause

A

puberty early
pigmentation
polyostotic fibrous dysplasia

cAMP kinase g protein defect

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249
Q

PCOS infertility cause

A

failed follicular maturation

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250
Q

SCID infection types

A

viral + fungal + bacterial

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251
Q

RUL lesion? RLL lesion?

A

UL- TB

LL-Aspiration

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252
Q

LDL needs to be increased to start statin: T or F?

A

F

just need risk factors

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253
Q

MC complication Ank Spon

A

anterior uveitis

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254
Q

RA eye complication

A

episcleritis

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255
Q

Urine pH higher than 8 = what infections

A

klebsiella

proteus

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256
Q

Which trisomy is associated with midline defects? give some examples?

A

13
holoprosencephaly
omphalocele
cutis aplasia

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257
Q

GFR, BUN, Cr, urine protein in pregnancy

A

low BUN/Cr
high GFR
high urine protein

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258
Q

Hgb, plts, fibrinogen, protein C in pregnancy

A

low hgb, plts, protein C

high fibrinogen

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259
Q

Contrast intellectualization and rationalization

A

intellectualization: turning something hard into just an intellectual puzzle
rationalization: making excuses for bad behavior

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260
Q

Cause of RUQ pain in HELLP

A

distention of glissons capsule

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261
Q

MCC SCD post infarction

A

re-reentrant vtach arrhythmia

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262
Q

MCC hypercoag with NORMAL labs

A

factor V leidein (protein C resistance)

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263
Q

Lab abnormality in APL

A

^PTT

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264
Q

Antithrombin deficiency causes

A

DIC, cirrhosis, nephrosis

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265
Q

MCC nepgrosis in hodgkins

A

minimal change

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266
Q

Mechanism of vagal maneuvers to stop PSVT/ANRT

A

increased parasympathetic tone, stops AV node

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267
Q

When and how to work up first UTI in peds

A

if under age of two, or recurrent

do first RUS –> VCUG

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268
Q

Post MI acute limb ischemia: check for?

A

LV thrombus (do echo)

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269
Q

How to treat post ictal lactic acidosis

A

don’t, itll go away on its own soon

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270
Q

Fall with object in mouth -

A

traumatic carotid injury

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271
Q

SCA hip issue

A

avascular necrosis

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272
Q

Mom holding baby gets what hand/wrist issue?

A

de quervains tendonitis

pain at side of wrist

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273
Q

Turners karyotype

A

45 XO

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274
Q

Klinefelters karyotype

A

47 XXY

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275
Q

Myelodysplastic syndrome labs

A

pancytopenia

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276
Q

How to distinguish adenomyosis from endometriosis

A

adeno should = tender UTERUS and HMB

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277
Q

Botulism clinical presentation + tx

A

descending paralysis (opposite GBS)
bilateral cranial neuropathies
equine antitoxin

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278
Q

NNT equation

A

1/ARR

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279
Q

When to workup delayed menarche

A

14 with no characteristics

16 if has secondary sex characteristics

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280
Q

How to deal with acute pulm hemorrhage

A

bleeding lung down and bronch

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281
Q

Meningitis management

A

focal deficits need CT otherwise:

LP –> abx

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282
Q

Targets for gestational DM

A

keep postprandial under 140

keep fasting under 95

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283
Q

Causes of ascending aortic aneurysm? descending?

dissection?

A

ascending- CMN/CT disorder
descending- atherosclerosis
dissection- HTN

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284
Q

Eye thing in rubella? toxo?

A

rubella- cataracts

toxo- chorioretinitis

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285
Q

FOOSH risk for?

A

rotator cuff tear

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286
Q

Pulsus bisiferens causes

A

AR PDA HOCM

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287
Q

Expressive aphasia lesion

A

Brocas, frontal

288
Q

How to treat pulm HTN

A

idiopathic- endothelin, PDEi, prostanoids

2/2 LV dysfxn- loop or ace

289
Q

Assymetric corneal light reflex =

A

strabismus patch the normal eye

290
Q

Uterine inversion first step

A

manual replacement

291
Q

Systemic sclerosis abs

A

scl/ topoisomerase

292
Q

RA ab

A

anti citrullinated peptide

293
Q

Retropharyngeal abscess is a risk for

A

acute necrotizing mediastinitis

294
Q

Valproate must monitor

A

LFTs and platelets

295
Q

Poor kidney function prevents use of what mood stabilizer

A

Depakote

296
Q

Prevent worsening diabetic nephropathy by decreasing _____

A

BP

297
Q

Sensitivity and Specificity equations

A

Sensitivity: TP/ TP+ FN
Specificity: TN/ TN+ FP

298
Q

Crepitus between 3rd and 4th toes is

A

mortons neuroma (conservative treatment)

299
Q

Treatment of Dresslers

A

NSAIDs

300
Q

Buproprion helps with? Buspirone?

A

Buproprion- smoking

Buspirone- anxiety

301
Q

HTN increases risk of?

A

Preterm labor but not PPROM

302
Q

Menopausul GU constellation + treatment

A

stress and urge incontinence
recurrent UTIs

vaginal estrogen

303
Q

Bacterial meningitis + immunocompromised =

A

vac, amp, cefepime

304
Q

Treatment of penetrating trauma to the skull

A

vanc and meropenem

305
Q

Swllowed battery when to intervene

A

in esophagus gotta get out

306
Q

HTN & bilateral palpable kidneys =

A

ADPKD

307
Q

Rapidly fatal neuro disease with brain scarring and atrophy

A

SSPE

308
Q

Multiple nonenhancing lesions on brain =

A

PML

309
Q

Posterior arm dislocation position

A

internal rotation

310
Q

Origin of afib location

A

pulmonary veins

311
Q

Origin of aflutter

A

tricuspid annulus

312
Q

Goal of O2 in advanced COPD

A

90-93%

313
Q

Intracerebral hemorrhage + patient on Coumadin what to do?

A

Prothrombin complex & K

314
Q

Persistent productive cough
linear atelectasis
blood tinged sputum

dx

A

bronchiectasis

315
Q

Herpangina (coxsackie) vs Herpetic Gingivostomatitis

A

Herp (cox)= posterior, gray

HSV- anterior, clusters, on gingiva

316
Q

Dx & tx of lichen sclerosis

A

bx of vulva

treat with steroids

317
Q

NF1 is chromosome ___ and called _____.

A

17; von Recklinghausen

318
Q

NF2 is chromosome ____ and has bilateral ______ and ______ on skin.

A

22; bilateral acoustic neuromas; café au lait

319
Q

Tuberous Sclerosis tumors + skin findings

A

cardiac/renal tumors; seizures; ash leaf spots

320
Q

face and arm swelling = _______ caused by ____ or ____.

A

SVC syndrome caused by NHL or small cell cancers most commonly

321
Q

GVHD cells implicated

A

donor T cells

322
Q

Bullous impetigo =

A

staph aureus

323
Q

Nocardia! That _____ ____ _____ needs to get ____!

A

acid fast aerobe needs to get BACK(trim)

324
Q

Finger movement and rhomberg test ______.

Pronator drift is a sign of ______.

A

Finger/rhombeg- proprioception

pronator drift- pyramidal tract disease

325
Q

Middle mediastinum masses

A

lymphoma

bronchogenic cyst

326
Q

Neutropenia
Arthritis
Spenomegaly
Ulcerating skin lesions

===

A

Felty

327
Q

How to protect lung when on vent

A

lower TV to prevent alveolar distention

SpO2 above 88

328
Q

A1AT biopsy findings

A

PAS+ globules

329
Q

Mallory Bodies assc

A

Wilsons or Alcoholic

330
Q

Granulosa Cell Tumor = need

A

endometrial bx

331
Q

Lithium + NSAID =

A

decreased renal clearance and high risk for lithium toxicity

332
Q

Vaccine refusal management

A

discuss and document

333
Q

How does ABO disease come about

A

Mom type O

Baby type A or B

334
Q

Dysgerminoma= elevated

A

HCG or LDH

335
Q

Chronic MR echo finding?

Acute?

A

Chronic LAE

Acute high LA/LV filling pressures = acute pulm Edema

336
Q

Gum hypertrophy and hirsutism are seen with what immunosupressant

A

cyclosporine

337
Q

When giving EPO you must also give

A

iron

338
Q

ACE mechanism is ____cellular and Statins are ___cellular

A

ACE- extra

Statins- intra

339
Q

Thalassemias smear finding

A

microcytic

targets

340
Q

Dietary recommendations for stones

A

increased fluids

low salt

341
Q

Achalasia in pt greater than 60 precaution

A

do scope, rule out cancer

342
Q

Management of atypical glandular cells

A

colposcopy
endometrial bx
endocervical curettage

343
Q

normal pupil size

A

2-5mm

344
Q

Treatment of acute mania

A

antipsychotics

345
Q

Hemolytic anemia, jaundice, pigmented gallstones, European =

A

Hereditary spherocytosis

346
Q

How to dx acute appendicitis in pregnancy

A

US not CT

347
Q

NAFLD pathogenesis

A

insulin resistance –> increased lipolysis –> FFA build up in liver.

Gluconeogenesis is increased

348
Q

Rules for sunscreen

A

50 is max benefit

apply 15-30 mins before exposure

349
Q

EPO most common ADRs

A

worsening HTN, HA

350
Q

Spared eye (noninjured eye) disease

A

sympathetic ophtalmia = recognition of hidden antigens

351
Q

MCC death in dialysis patients

A

CV disease

352
Q

New preferred agents over warfarin for DVT

A

Xa inhibitors

353
Q

When Makenzie filled out jennas food log there was _____

A

hawthorne effect

354
Q

Treatment of diverticulitis with abscess

A

CT guided perc drainage

355
Q

Nasal discharge + anosmia =

A

polyp

356
Q

First trimester noninvasive testing is

A

cell free fetal DNA

357
Q

Three meds to hold during stress test

A

BB, CCB, Nitrates

358
Q

Negative RPR but clinical picture suggests syph what to do?

A

empirically treat

359
Q

Alternatives to heparin in HIT

A

agatroban, fonduparinux

360
Q

FTT, jaundice, cataracts in babe is suggestive of

A

galactosemia

361
Q

Mumps two most common complications

A

meningitis
orchitis
MOP (men, orch, parotitis)

362
Q

Enterotoxin is ingested to cause food poisoning with what two bugs?

A

staph

b cereus

363
Q

Toxin is made in gut for what three organisms

A

clostridium
vibrio
ETEC

364
Q

Which four bugs cause invasive diarrhea

A

listeria
salmonella
Yersinia
campy

365
Q

Periventricular enhancement =

A

CMV

366
Q

Subacute meningitis, papilledema, AIDS =

A

crypto

367
Q

HSV should have ____ on MRI

A

temporal lobe involvement

368
Q

Where is chloroquine an okay malaria px

A

central America and the caribbean

369
Q

When to add primaquine to treatment

A

vivax

370
Q

MCC symmetric IUFGR

A

chromosomal abnl

371
Q

Thyroid storm can be triggered by ____ In ____

A

stressful situations

undiagnosed patients

372
Q

Hypomania patient should be able to keep ____

A

working

373
Q

Globular mass below umbilicus =

A

fibroid uterus

374
Q

Isothenuria/nocturia is common in ____

A

SCA

375
Q

Hydroxyurea dose limiting ADR

A

myelosupression

376
Q

Oxytocin ADRs

A

tachysystole
hypoTN
hypoNa

377
Q

Folate and B12 def both increase

A

homocysteine

378
Q

Maternal weight loss = _____ —> __& __

A

IUGR —> Preterm, polycythemia

379
Q

Absent philtrum is clue to ____

A

FAS

380
Q

Causes of clubbing

A

R –> L shunts
CF
malignancy

381
Q

Carpal tunnel best test

A

nerve conduction

382
Q

Contact lens keratitis MC bug

A

pseudomonas

383
Q

COPD flat diaphragm leads to

A

increased WOB

384
Q

How does obesity increase endometrial cancer risk

A

increased peripheral conversion to estrogen

385
Q

How to treat hypothermeria

A

Mild 90-95 passive external cooling (blankets)
Mod 82-90 active external cooling
severe under 82 active internal cooling

386
Q

Endocarditis murmur should be at _____

A

apex or in IVDU RLSB

387
Q

How does PNA cause hypoxia?

A

R –> L shunting –> VQ mismatch –> low O2

388
Q

HTN young woman first step in treatment

A

stop OCP if taking any

389
Q

MG crisis treatment

A

IVIG, steroids

390
Q

Describe factorial design

A

2+ interventions with 2+ outcomes

391
Q

Cross over study design

A

similar to clinical trial but swap intervention mid way through

392
Q

Basic tests needed when diagnosing HTN

A

UA
chem panel
lipids
EKG

393
Q

Trachea/esophagus relationship

A

Trachea is anterior

394
Q

Complications of nephrotic syndrome

A

clotting
infection
loss of D
anemia

395
Q

Thyroid adenoma two MC complications

A

tachyarrythmias
bone loss!
(no eye issues with adenoma)

396
Q

How often to do colonoscopies in UC

A

q1-2

397
Q

FAP colonoscopy guidelines

A

start at 10; do q1

398
Q

Lynch/HNPCC colonoscopy guidelines

A

start at 20-25 do q1-2

399
Q

How does breast feeding lead to amenorrhea?

A

PRL —-I GnRH

400
Q

Schizophrenia MRI findings

A

enlargement of lateral ventricles

decreased hippocampal volume

401
Q

Baby with accelerated head growth is clue to

A

autism

402
Q

Abnormal orbitofrontal cortex/ basal ganglia is found in what psych disorder?

A

OCD

403
Q

MCC folate def

A

alcohol

404
Q

Thiazide lab changes

A

all electrolytes lost except ^ Ca

Increased gluc, LDL/TG, uric acid

405
Q

Meningitis type with ^^^^ opening pressure

A

cryptococcal

406
Q

TTP treatment

A

plasma exchange

407
Q

Weak, cataracts, tiny testicles, bald = what is the dx/inheritance pattern?

A

Myotonic Dystrophy; AD

408
Q

Duchenne & Becker inheritance pattern

A

XR

409
Q

Fragile X inheritance pattern

A

XD

410
Q

Acute liver failure with acetaminophen tox = need for ____

A

transplant! stat!

411
Q

Arm drop test looks for

A

rotator cuff tear

412
Q

Giardia treatment

A

metro

413
Q

Travelers diarrhea treatment

A

Cipro

414
Q

Renal failure + abdominal pain next step

A

place bladder catheter

415
Q

Abdominal pain/ NV should clue you to rule out

A

atypical cardiac

416
Q

Penetrating trauma + signs of peritonitis next step regardless of FAST

A

lap

do not do CT, do not do DPL, go straight to surgery

417
Q

Contrast somatic symptom and panic

A

panic disorder comes and goes, somatic constant symptoms

418
Q

Only indication for HRT

A

women under 60 with menopause within 10 years; vasomotor symptoms not improved with weight loss

419
Q

Radio-opaque tablets in kid’s stomach –> next step

A

deferoxamine

420
Q

Toxic megacolon treatment

A

start with fluids, abx, steroids –> surgery if no improvement

421
Q

Aside from PDA, what murmur may be continuous?

A

Aortic coarctation with collaterals through thorax

*May also have S4

422
Q

Muscular Dystrophy gold standard in diagnosis

A

muscle biopsy

423
Q

Chi squared measures what?

A

Proportions of categorized outcomes

424
Q

T tests measure what?

A

Two means

425
Q

ANOVA measures what?

A

Compares 3+ means

426
Q

When to image UTI of any sort?

A

After 3 days no improvement on abx

427
Q

HIT cause

A

antibodies to platelet components

428
Q

Trisomy 18 cardiac defect

A

VSD

429
Q

MCC zero puberty in female at 16+

A

Turners (low estrogen, increased FSH/LH)

430
Q

Hx of rheumatic fever requires _____

A

continuous abx px

if valve disease they need at least to age 40 and at least 10 years

431
Q

p value that is statistically significant

A

less than 0.05

432
Q

Osteoblastic lesion =

A

prostate cancer

433
Q

Cells that are PAS + and without granules

A

lymphoblasts

434
Q

Stop mammos at what age?

A

75

435
Q

SMH/WH symptoms

A

proximal muscle weakness lower more than upper

436
Q

Essential tremor = ____ tremor

A

intention

437
Q

MOA 13 valent vs 23 valent PNA Vax

A

13- T cell + B cell

23- B cell only

438
Q

1st step after pushing atropine in organophosphate poisoning

A

remove clothes

439
Q

Normal post void volume

A

under 12

440
Q

Dyschezia rules out _____

A

vaginismus

441
Q

ASA exacerbated respiratory disease reaction type

A

non IgE

442
Q

Dialted ventricles with diffuse hypokinesia is

A

dilated cardiomyopathy

443
Q

Concentric vs Eccentric cardiac hypertrophy causes

A

concentric- pressure overload

eccentric- volume overload

444
Q

Salvage therapy is given when?

A

when standard therapy fails

445
Q

When is neoadjuvant/adjuvant therapy given?

A

neo before standard

adjuvant with standard

446
Q

Treatment of AV Block/ meningitis in lyme disease- peds

A

IV rocephin

447
Q

Acute angle closure glaucoma is an ADR of what drug class?

A

anticholinergics

448
Q

Inpatient treatment of CAP

A

FQ or B lac + mac

449
Q

Outpatient treatment of CAP

A

mac/doxy or FQ if sick/ recent abx

450
Q

Treatment of decompensated heart failure

A

B agonist decreases LVESV (and also) LVEDV

451
Q

How to distinguish cardiac and liver edema?

A

hepatojugular reflux + only in cardiac

452
Q

Pain over tibial tubercle dx + xray findings

A

Osgood schlatter/ tibial apophysitis

xray shows lifting

453
Q

Pain at inferior pole of knee =

A

patellar tendonitis

454
Q

Horners and decreased gag reflex are seen in what brainstem stroke syndrome

A

laterally medullary (PICA/Vertebral)

455
Q

Tongue parlysis is seen in what brainstem stroke syndrome?

A

Medial Medullary (Vertebral/ ASA)

456
Q

Ipsilateral ataxia + nystagmus is caused by a stroke where?

A

cerebellum

457
Q

JVP should be less than ___

A

8

458
Q

Best way to reduce mortality in COPD

A

O2

459
Q

Polymyositis abs

A

ANA JO

460
Q

Why is HIT dangerous actually?

A

thrombogenic

arterial and venous clots

461
Q

Gluconeogenic amino acids are transformed into

A

pyruvate –> G3P –> glucose

462
Q

How long after pharyngitis until RF

A

2-4 weeks

463
Q

How to distinguish between absence and focal seizures

A

absence lasts seconds and is provoked by hyperventilation

464
Q

How to dx ectopic

A

have to do TVUS not transabdominal

465
Q

Recurrent nosebleeds hemoptysis and oral lesions dx

A

hereditary telangiectasia, osler weber rendu (pulmonary AVMs)

466
Q

Bicuspid aortic valve causes what type of aortic disease

A

AR or AS

467
Q

Seborrheic dermatitis can be on scalp or ____

A

face

468
Q

Nontender solitary node in neck is _____ until proven otherwise

A

squamous cell, biopsy and do panendoscopy

469
Q

How long of poor nutrition until person becomes vitamin K deficienct

A

1 week

470
Q

Melanosis coli is seen in what condition

A

laxative abuse

471
Q

WPW arrhythmia DOC

A

procainamide

avoid: CCB, dig, adenosine

472
Q

Reptile scale skin is called?

How to treat?

A

ichthyosis vulgaris

use emollients, keratlytics, retinoin

473
Q

How to treat overflow (constant dribbling) incontinence

A

cholinergics (bethanechol) & Cath

474
Q

Acute PCP treatment

A

steroids + Bactrim or pentamidine

475
Q

PCP and CMV PNA appearance

A

patchy/diffuse

476
Q

Bilateral trigeminal neuralgia is ____

A

MS

477
Q

Measles mechanism of spread

A

airborne

478
Q

Airway support for COPDE

A

first try NPPV

479
Q

PACs lifestyle modification

A

no cigarettes or beer

480
Q

Cross sectional study measures ____ and cohort study measures _____

A

cross sectional - prevalence

cohort - incidence; relative risk

481
Q

Common injury in peds BAT

A

duodenal hematoma

482
Q

Lab changes with Bactrim

A

increased Cr and K

483
Q

Insulin effect on K+

A

Drives into cells

484
Q

B agonist effect

A

Drives K+ into cells

485
Q

BBer effect on cells

A

Drive K+ out of cells

486
Q

Prednisone effect on K+

A

= mineralocorticoid –> increased excretion

487
Q

Neurocysticercosis bug

A

taenia solium

488
Q

Hemihypertrophy, macroglossia, umbilical hernia = ?

Pt needs what screening?

A

Beckwidth Wiedmin

US/AFP q3 months

489
Q

Bilateral periorbital cellulitis is ?

A

cavernous sinus thrombosis

490
Q

MC location hypertensive hemorrhagic stroke

A

putamen

491
Q

Treatment for bone pain in prostate cancer

A

radiation

492
Q

Labs in splenic sequestration

A

low RBC and platelets but high retics

493
Q

Miscarriage and patient is positive for VDRL –> think of

A

APL sx

494
Q

Management of peds vaginal foreign body

A

remove and irrigate

495
Q

DM type 1 and vesicular rash =

A

celiacs

496
Q

How to dx hyperemesis gravidarum

A

confirm with ketones

497
Q

How to distinguish between rotator cuff tear and adhesive capsulitis

A

adhesive- decreased passive and active ROM

tear- decreased active ROM only

498
Q

4 markers of lactose intolerance

A

+hydrogen breath
acidic stool
high stool osmol gap
+ stool reducing substances

499
Q

Vasovagal syncope management

A

teach counterpressure maneuvers

500
Q

How to treat antipsychotic parkinsonism

A

decrease dose or add amantadine/ benztropine

501
Q

Hydrozychloroquine requires what monitoring

A

regular eye exams

502
Q

Homocystinuria:
cause
stone shape
test

A

poor renal COLA transport
hexagonal
+cyanide nitroprusside test

503
Q

How to distinguish IDA from thal

A

thal has normal RDW/RBC count

504
Q

B thal has increased hb___

A

A2

505
Q

Penetrating wound with absent distal pulses next step

A

go to OR

506
Q

Gallstone ileus exam finding

A

absent bowel sounds

507
Q

Widened prevertebral space is clue to

A

retropharyngeal abscess

508
Q

Treatment of social anxiety disorder

A

SSRI

509
Q

RAI and IBD both predispose to

A

amyloidosis

510
Q

Hyalinosis is seen in what renal disease

A

diabetic nephropathy

511
Q

Randomization controls for

A

confounders

512
Q

Trisomy 18 finding on triple screen

A

normal inhibin rest low

513
Q

How are TP/FP on ROC curve related to sensitivity and specificity

A

1-FP= specificity

TP ~sensitivity

514
Q

Child with PCP And lymphadenopathy has

A

AIDS not CF or SCID

515
Q

Drugs that increase warfarin activitiy

A 
NSAIDs/ Tylenol 
abx 
amio
cimetidine and omeprazole 
SSRIs
516
Q

Drugs that decrease warfarin activity

A

phenobarb/phenytoin/carbamazepine
ginseng and st johns wart
rifampin

517
Q

BPPV cause

A

canaliths in semicircular canal

518
Q

How to distinguish lipoma and epidermal inclusion cyst

A

lipomas do not regress and reoccur

519
Q

Treatment for hypercalcemia of malignancy

A

bisphosphonates

520
Q

Obesity is the cause of amenorrhea when ____

A

LH/FSH

521
Q

When to give Tamiflu

A

less than 48 hours from onset

above 65 and chronic med patient

522
Q

Agitation and lower abdominal pain post op next step

A

do bladder us to check for AUR

523
Q

Scoliosis + joint laxity =

A

ehlers danlos

524
Q

joint laxity, clots, lens dislocation=

A

homocystinuria

525
Q

Corneal dystrophy, renal failure, clots, neuropathy=

A

Fabrys (a glucosidase)

526
Q

Stable patient with pericardial effusion next stap

A

do angio to r/o AD before doing pericardiocentesis

527
Q

Cords on histology is a buzzword for what cancer? palisading

A

cords- scc

palisading- bcc

528
Q

Timing of bowel perf 2/2 BAT

A

several days after

529
Q

AIS when to do gonadectomy

A

afer puberty

530
Q

Atopic dermatitis spares

A

genitals and groin

531
Q

Cold dying limb from AE next step

A

heparin before any testing

532
Q

Comedonal acne treatment

A

retinoid and topical acid

533
Q

inflammatory acne treatment

A

start with comedonal treatment –> add topical abx –> add oral abx

534
Q

Nodular/cystic acne treatment

A

start with topical retinoid, acid, and abx
add oral abx
add oral retinoin

535
Q

Acne pathogenesis

A

increased sebum and hyperkeratinzation
inflammation
p acne

536
Q

What rules out exogenous insulin as cause of hypoglycemia

A

elevated C peptide

537
Q

MC stone type

A

calcium oxalate

538
Q

Pedunculated red bleeding mass is

A

pyogenic granuloma

539
Q

Dermatofibroma clue

A

central area dimples when pinched

540
Q

DM neuropathy small vs large fiber

A

small- pain + symptoms

large- numbness - symptoms

541
Q

legionella treatment

A

mac or fq

542
Q

circulating hormone level=

A

total

543
Q

MC location bowel ischemia

A

splenic flexure

544
Q

Focal spinal tenderness treat as _____

A

osteo

545
Q

Abscesses with ^^^^^^ leukocytes=

A

LAD

546
Q

Catalase + bugs and lab findings in CGD

A

serratia
staph
burkholderia

labs are normal

547
Q

Papillary rupture presentation

Ventricular aneurysm presentation

A

rupture- acute MR within the first week

aneurysym- persistent STE several weeks after MI

548
Q

Lab clue to MAC infection

A

high alk phos

549
Q

Wiskott Aldrich inheritance/ cause

A

XR, cytoskeleton abnormality

550
Q

Alcoholic cerebellar degeneration presentation

A

truncal ataxia but normal limb coordination
(weird heel chin but normal finger nose)
*Finger-nose abnormal in B12

551
Q

Low albumin causes ____ ____.

A

low calcium

552
Q

Immobilization raises

A

Ca

553
Q

When to bx in abnormal uterine bleeding

A

above 45 or obese

554
Q

What lung path has increased breath sounds/ egophony?

A

consolidation, all others decreased

555
Q

When is tactile fremitus increased?

A

consolidation

fremitus ~breath sounds

556
Q

In lacunar stroke- which is effected more: arm or leg?

A

equal

557
Q

Clues to SCC

A

parasthesias

immunosuppressed

558
Q

Sheehan path

A

ischemic necrosis

559
Q

AML cell type

A

myeloblasts, acute symptoms

560
Q

CML LAP score and cell type

A

low LAP score; myelocytes

561
Q

Leukemoid reaction cell types

A

metamyelocytes; high LAP score

562
Q

Drug induced acne appearance

A

monomorphic papules on arms/upper back

common with steroids

563
Q

Clue to conus medullaris

A 
UMN signs, symmetric 
cauda equine (spinal nerve roots)= LMN
564
Q

SSRI sodium disorder

A

SIADH

565
Q

Clobetasol treats what skin disorder?

A

bullous pemphigoid

566
Q

Infection that mimics sarcoidosis

A

histoplasma

567
Q

Labs in JIA

A

increased ESR/CRP/ferritin
increased platelets, Igs
anemic

568
Q

Aminoglycosides most common tox

A

hearing and vestibulopathy

569
Q

NRDS two most common risks

A

prematurity

maternal DM

570
Q

Osteonecrosis xray findings

A

normal often

571
Q

When to give Td in adults

A

must confirm at least one TDaP can do Td after than q10

572
Q

If bilirubin is in urine it is ____

A

conjugated

573
Q

Craniophrayngioma presents with what systemic signs

A

pituitary deficiencies

574
Q

Confounding means the risk has ____ effect on disease.

A

Confounder- truly no effect

Effect mod means the risk has effect on disease only when combined with a second risk factor (compounds)

575
Q

Obstruction, air in small bowel and liver, no air in colon: dx

A

gallstone ileus

clues: no surgeries, gas in biliary tree

576
Q

“To and fro” murmur at Left ICS with bounding pulses=

A

PDA

577
Q

Cause of bruit in atherosclerosis

A

lipid accumulation, intimal thickening

578
Q

Peritoneal dialysis is risk for what infection

A

SBP

579
Q

Cause of RLL infiltrate in alzheimers

A

aspiration; decreased gag reflex

580
Q

In addition to nystagmus, what are clues to PCP intox

A

catatonic/coma; violent

581
Q

Jaundiced patient with dilation of biliary ducts needs:

A

ERCP

582
Q

Criteria for intubation

A

RR above 35

acidic

583
Q

Clearance for exercise includes

A

stress test

584
Q

Tip of thumb innervation

A

median nerve

585
Q

Sudden severe back pain=

A

compression fracture

586
Q

Rectal fissure treatment

A

anesthetics and stool softeners –> LIS those fail

587
Q

First step testicular torsion

A

dx by H&P then straight to surgery, no need for Doppler if its obvious

588
Q

Kidney stone- pain stops: assume?

A

stone is passed

589
Q

How is staph spread at picnics

A

poor refrigeration

590
Q

Anorexia with amenorrhea= risk of

A

osteoporosis

591
Q

Low K+ EKG findings

A

PVCs, flat T waves, ST depression

592
Q

Encapsulated bacteria assc with what deficiency?

A

B cell

593
Q

Post Op Aortic Coarctation BP maintenance

A

should be below 60 by managing pain

594
Q

Best way to prevent aspiration

A

elevate head of bed

595
Q

Eczema like rash effect only this nipple is

A

pagets

596
Q

Green discharge from nipple is

A

ductal ectasia

597
Q

draining abscess at nipple is

A

lactiferous fistula

598
Q

Achalsia pathogenesis

A

increased LES done and decreased peristalsis

599
Q

How do ACEi effect renal flow?

A

decreased GFR by constricting efferent arterioles

600
Q

Enzymes take how long to rise in MI?

A

as many as 6 so don’t assume normal enzymes= no heart attack

601
Q

Wide complex v tach may look similar to:

A

diffuse ST elevation

602
Q

Weakness in legs and bladder issues at time of birth is

A

spinal dysraphism

603
Q

TOA is ruled out how

A

U/S

604
Q

Lung cancer can cause what symptoms regardless of type

A

arthralgias

neuropathies

605
Q

Urine sodium above ____ is high.

A

40

606
Q

SIADH sodium is?

A

high because all fluid is retained

607
Q

Treatment of patient with both orthostatic hypotension and BPH

A

finasteride not alpa agonist

608
Q

Patient with gurgling sounds… what should you do?

A

get an airway. duh.

609
Q

Painful post void dribbling is?

A

urethral diverticulum

610
Q

ANA in JIA?

A

negative

611
Q

Acute lupus flare lab changes

A

decreased complement increased abs

612
Q

Sodium disorder common following head trauma

A

SIADH

613
Q

cohort vs case control study what is measures

A

cohort- rr

case control- or

614
Q

Odds ratio equation/ how to derive

A

use chart but instead of test result put intervention/risk for vertical column

(a/c)/(b/d)

615
Q

Relative Risk requation

A

use chart –> (a/a+b)/ (c/c+d)

relative risk ~PPV/NPV

616
Q

Attributable risk equation

A

(a/a+b) - (c/c+d)

relative risk but subtract instead of dividing

617
Q

RRR equation

A

1-RR

618
Q

ARR equation

A

(c/c+d)- (a/a+b)

619
Q

NNT equation n

A

1/ARR

620
Q

NNH equation

A

1/AR

621
Q

Type 1 error

A

false positive

622
Q

Type 2 error

A

false negative

increase power and decrease the risk of this error type by increasing sample size

623
Q

Vaccine given at birth

A

Hep B

624
Q

Vaccines given at 2 months

A

DR HIP + Hep B

DTaP, Rota, Hib, IPV, PCV13

625
Q

Vaccines given at 4 months

A

DR HIP

626
Q

Vaccines given at 6 months

A

DIP + flu PRN, 2 doses first season

627
Q

12-15 month vaccines

A 
MMRV 
DTaP
Hep A (x2)
PCV13 
Hib
628
Q

4-5 year vaccines

A

DIM
DTaP
IPV
MMRV

629
Q

11-12 year vaccines

A

meningococcal
TDaP
start HPV series

630
Q

16 year old vaccines

A

meningococcal

631
Q

Age to give zostavax

A

60, 1 dose

632
Q

HR change in all forms of shock

A

increased

633
Q

Which shock type has increased CO

A

septic

634
Q

Cardiac shock parameters

A

everything but CO increased

635
Q

Neurogenic shock parameters

A

everything but HR is decreased

636
Q

SVR is increased in what forms of shock?

A

cardiac and hypovolemic

637
Q

Symptomatic evidence of increased SVR

A

pale and cool skin

638
Q

HAP treatment

A

Must cover for pseudomonas

zosyn, carbapenem, or cefepime/ceftaz

639
Q

VAP treatment

A

THREE AGENTS

  • antipseudomonal from HAP
  • FQ or AG (AP)
  • Linezolid or Vanc (AS)
640
Q

Scaling lips/fissures and corneal vascularization = _____ deficiency

A

B2/ riboflavin

641
Q

rash, baldness, and adrenal insufficiency = ____ deficiency

A

B5/ pantothenic acid

642
Q

How can you become biotin (B7) deficient?

A

antibiotics, excess raw eggs

643
Q

Neuropathy + sideroblastic anemia = _____ deficiency

A

B6 (pyridoxine)

644
Q

Hemolytic anemia, weakness, spinocerebellar demyelination= ____ defi

A

vitamin E

645
Q

When should baby start saying “mama” “dada” etc?

A

9 months

it takes nine months to become a mama

646
Q

When should baby sit/roll/crawl/walk

A

sit unsupported and roll ~ 6 months
crawl by 9 months
walk by 12-14 months

647
Q

Stranger anxiety when?

Separation anxiety when?

A

Stranger- about 6 months

Separation- one year

648
Q

Words at one year?

A

about ten

649
Q

When should kid use complete sentences and understand most basic vocabulary?

A

age 3

650
Q

When does intentional smiling start?

A

2 months

651
Q

How many blocks should kid stack?

A

age in years x 3

652
Q

When do kids start group playing instead of parallel playing?

A

3

653
Q

Sideroblastic anemia:
macro or microcytic?
causes?
stain?

A

can be either
alcohol, lead, INH, B6
Prussian blue

654
Q

Only form of microcytic anemia with elevated circulating iron?

A

sideroblastic

655
Q

HbF is increased in what form of microcytic anemia

A

B thal minor

656
Q

What form of thalassemia has high reticulocytes?

A

three gene deletion a thal

657
Q

Like hemolytic anemia, B12/folate def high high ____ & ____.

A

LDH and indirect billi

658
Q

In addition to dietary/ alcohol causes what can cause B12 def (2)

A

pancreatic def

pernicious anemia

659
Q

Sickle Cell mutation

A

B6 valine –> glutamic acid

660
Q

Abx to be used in sickle crisis with high fever/ white count

A

rocephin or FQ

661
Q

Three prophylactic needs in sickle cell

A

hydroxyurea
folate
pneumovax

662
Q

Recurrent hemolysis + splenomegaly + family history=?

dx?

A

HS; osmotic fragility

put in hypotonic solution

663
Q

Causes of warm AIHA

A

CLL; lymphoma; SLE; drugs

664
Q

Exchange transfusion is used when in SCA?

A

ACS
priapism
stroke
retinal infarct

665
Q

Smear in AIHA ?

A

NO fragmented cells because hemolysis is extravascular

666
Q

Causes of cold AIHA

A

Mycoplasma
EBV
Waldenstroms

667
Q

Warm Agglutinin treatment?

Cold?

A

warm- steroids –> splenectomy

cold- rituximab –> plasmapheresis (NOT steroids)

668
Q

Cause of TTP/ HUS

A

ADAMSTS 13 Def

669
Q

Labs assc with HUS/TTP

A

normal PT/PTT/Coombs

low platelets, renal insufficiency, intravascular hemolysis

670
Q

Episodic dark urine + pancytopenia + clots in weird places = ? dx? tx?

A

PNH dx with flow cytometry

treatment is steroids

671
Q 
Splenomegaly 
Bleeding 
Thrombosis 
All cell lines up
Pruritis after warm shower

dx? tx?

A

Poly Vera

Phlebotomy and ASA –> hydroxyurea or allopurinol

672
Q

Pancytopenia + dry tap + tear drop cells = ?

treatment?

A

myelofibrosis

ruxolinitib (rux)

673
Q

Why are Auer Rods a big deal?

A

DIC risk

674
Q

ALL gets ____ _____

A

intrathecal MTX

675
Q

Ringed sideroblasts
pancytopenia
hypercellular marrow=

A

Myelodysplastic syndrome

leukemic precursor

676
Q

Abnormality assc with Myelodysplastic syndrome

A

5q deletion

677
Q

Bilobed nucleus cell is called? Assc with what d/o?

A

Pegler Huet

Myelodysplastic

678
Q

CLL special cell type”?

A

smudge cell

679
Q

Treatment CLL

A

chlorambucil simple –> cyclophospgamide refractory

680
Q

CML treatment?

A

TKI–> BMT

681
Q

Treatment of Hairy Cell

A

cladribine or pentostatin

682
Q

CBC in NHL?

Best initial test?

A

normal

do excisional bx

683
Q

Treatment of NHL?

A 
CHOP 
cyclophosphamide 
hydroxydaunorubicin 
oncovin (vincristine) 
prednisone

cyclo
dauno
vinc
prednisone

CHOP OUT LYMPHOMA

684
Q

Staging of NHL

A

I- one group
2- two groups
3- two sides diaphragm
4- widespread

685
Q

Treatment of HL

A

ABVD
A for Aunt Cindy

Adriamycin
Bleomycin
Vinblastine
Dacarbazine

686
Q

When should pt be screened for breast cancer after HL radiation?

A

within 8 years

687
Q

First test in MM

A

xray

688
Q

What distinguishes MGUS from MM?

A

normal BMBx

689
Q

What distinguishes Waldenstroms from MM?

A

Waldenstroms is IgM

MM is IgA/G

690
Q

Only cause of clotting with high PTT?

A

APL syndrome

691
Q

Wright and Hansel stains detect _______ which is seen in _____

A

eosinophilia
acute interstitial nephritis
*No eos in NSAID induced disease

692
Q

Dysmorphic red cells in urine =

A

glomerulonephritis

693
Q

Hyaline casts are caused by?

A

dehydration

Tamm Horsfall protein

694
Q

NSAIDs constrict the _____ while ACEi dilate the ____

A

NSAIDs constrict afferent arterioles

ACEi dilate efferent

695
Q

Post renal BUN:Cr

A

greater than 20:1 same as pre-renal

696
Q

FeNa/UNa in Pre/Post renal AKI

A

FeNa less than 1
UNa less than 20

because decreased perfusion increases ADH

697
Q

FeNa/UNa in ATN?

A

Isothenuria. Kidneys done broke.

698
Q

In pre-renal azotemia urine osm should be?

A

greater than 500 (this is considered concentrated)

699
Q

How long for a drug to cause renal tox ?

A

5-10 days.

don’t answer drug induced AKI on same day drug is started

700
Q

Treatment of rhabdoy

A

fluids
mannitol
bicarb

701
Q

Hepatorenal syndrome labs match?

Treatment?

A

match pre-renal

treatment is octreotide/ midodrine

702
Q

Labs assc with atheroemboli

A

eos

low complement

703
Q

Grossly visible necrotic material is?

Next step in dx?

A

renal papillary necrosis

CT scan

704
Q

Alport cause

A

type IV collagen

705
Q

PAN spares? It is assc with?

A

the lung; Hep B

706
Q

DI sodium level?

SIADH sodium level?

A

DI high sodium (water loss)

SIADH low sodium (water retention)

707
Q

Psychogenic polydipsia sodium levels?

A

high

708
Q

Best initial test in hypernatremia?

A

Water deprivation test –> ADH administration

709
Q

What are the three types of RTAs?

A

Type 1- distal
Type 2- proximal
Type 4- Hyporenin

710
Q

Which type of RTA is assc with stones?

A

Type 2

711
Q

What is the cause of type 1/distal RTA?

A

Tubule cant generate bicarb means acid cant be put into tubule means high urine pH above 5.5

712
Q

What is the cause of type 2/proximal RTA?

A

prevents bicarb from being reabsorbed

713
Q

Treatment types 1,2,4 RTA

A

Type 1-distal- bicarb
Type 2- proximal- thiazide
Type 4- steroids

714
Q

Urge incontinence treatment

A

oxybutynin

tolterodine

715
Q

Little boy with absent tonsil/lymph nodes and frequent sinopulmonary infections think?

A

Brutons

Step 2 CK (8 decks)

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