Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Step 2 > Week 3 > Flashcards

Week 3 Flashcards

1
Q

Antibiotics if kid meets all CENTOR criteria?

A

No, must be confirmed on rapid stress or culture as opposed to adults

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Pneumatosis intestinalis in a neonate?

A

NEC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Treatment for enuresis

A

Behavior modification ->enuresis alarms (take 3-4months to be effective ->oral desmopressin for immediate help (not meant as monotherapy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

White granular patch on buccal mucosa of patient with tobacco and alcohol use? Leukoplakia - precancerous lesion

A

How to treat leukoplakia and when to biopsy? Stop tobacco and it will disappear in 2-3 weeks, biopsy if you see ulcers or induration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Large, painful liver mass in a young woman with signs of obstruction?

A

Hepatic adenoma, common with OCP vs. focal nodular hyperplasion, less common and will have arterial flow evidence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Prophylaxis for GBS in patient’s who have not been screened

A
  1. <37 weeks gestation
  2. Intrapartum fever
  3. ROM >18 hrs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Blurring of grey white matter interface after blunt trauma

A

Diffuse axonal injury - rotational force at area of decreased density results in vegetative state out of proportion to CT finding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Cause of hypogonadotropic hypogonadism

A

oss of pulsatile GnRH secretion precipitated by weight loss, stress, or chronic illness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

chronic anesthetic, macular (often hypopigmented) skin lesions with raised well-demarkated borders and nearby nodular and tender nerves (D/BT)

A

Leprosy (mycobacterium leprae) - full thickness biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Treatment for minimal lesion leprosy? Treatment with extensive lesions?

A

Limited - dapsone or rifampin, extensive dapsone/rifampin AND clofazimine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Treatment of rheumatic fever and follow up after?

A

Benzathine pen G until adulthood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Rapidly progressive cellulitis of submandibular space (D/P/serious complication/BT/Tr)

A

Ludwig angina - usually dental infection - polymicrobial, can result in airway compromise, CT scan of the neck, IV antibiotics and removal of inciting tooth - does not need drainage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Hemolytic anemia following sulfa drugs (D/P)

A

G6PD deficiency, X-linked genetics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Cape distribution sensory loss with preservation of vibration and proprioception neuro cause (D/P/associated disease). Why would there be areflexia?

A

Synringomyelia - fluid filled cavity that may represent dilation of central canal or separate cavity - Arnold Chiari type I - areflexia and weakness from compression of anterior horn gray matter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Affect of anesthesia on pheochromocytoma

A

Catecholamine surge - sudden huge hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Affect of b-blockers on pheochromocytoma-

A

unnopoosed alpha adrenergic stimulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Mild megaloblastic anemia on phenytoin, primidone, or phenobarbitol (Path)? Other causes of this deficiency?

A

Impaired folic acid absorption, folic acid supplementation. Other drugs - Trimethoprim and Methotrexate - dihydrofolate reductase inhibitors - need folinic acid (leucovorin) to reverse anti-folate effect of methotrexate)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Elevation in folate and cobalmin deficiency? Distinguishing elevation?

A

Elevation of homocysteine (decreased conversion to methionine), methylmalonic acid concentration elevated in cobalamin deficiency due to decreased conversion to succinyl coA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Biphasic respiratory distress in an infant which improves with neck extension

A

vascular ring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Differentiate vascular ring and laryngomalacia?

A

Place patient prone - laryngomalacia should improve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Why have ankylosing spondylitis patients do PFT’s?

A

To check for restritive pattern due to rib fixation - residual volume normal or increased due to rib fixation in inspiratory position

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

MRO chest injury from fall or blunt trauma?

A

Blunt aortic injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

anticoagulation, symptoms of weakness and dizziness, evidence of anemia and tachy with significant back pain -

A

> internal hemmorhage, consider retroperitoneal which can occur at normal INR’s spontaneously

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Hypertension in pregnancy after 20 weeks without nephropathy?

A

Gestational hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Chronic hypertension pregnancy risks?

A

Preeclampsia, PPH, GDM, placental abruption, fetal growht resitriction, perinatal mortality, preterm delivery, oligohydramnios

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Workup for sleep terrors?

A

None - typically resolve in 1-2 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Thyroid issue affecting 1/15 women after childbirth? Description?

A

Postpartum thyroiditis - brief hyperthyroid phase followed by hypothyroid phase with bradycardia, diastolic hypertension, lower extremity edema and possible coarse facies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Associated antibody with postpartum thyroiditis

A

anti-thyroid peroxidase - variant of Painless/silent thyroiditis - return to euthyroid state over several months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Syncope, hypotension, and new right bundle branch block when recovering from major operation?

A

Massive PE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Fetal nontender head swelling that does not cross suture lines?

A

Cephalohematoma - subperiostial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Fetal nontender head swelling that does cross suture lines?

A

Caput succedaneum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Treatment of tardive dyskinesia

A

d/c or switch drug - Clozapine has least EPS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

If suspicion is high enough for arterial occlusion, do what first?

A

Heparin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Cause of putaminal hemmorhage in chronic hypertension <60

A

Charcot-Bouchard aneurysms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Atopic dermatitis presentation difference in infants vs. children/adults?

A

Intant - itchy scaly crusted lesions on extensor surfaces, trunks, cheeks, scalp
Child/adult- Lichenified plaques in flexural creases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Stuttering episodes of nausea, vomitting, with pneumobillia

A

Gallstone ileus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Differentiate pneumobilia from gallstone ileus?

A

Hypoactive bowel sounds pneumobilia, hyperactive bowel sounds gallstone ileus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Can polymyositis cause dysphagia?

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Managing substance induced cardiac ischemia?

A

Benzo’s for blood pressure and anxiety, aspirin, nitro and calcium channel blockers fine, Beta-Blockers CONTRAINDICATED, unopposed alpha effect of cocaine, catheterization if needed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Risk of pulmonary toxicity with amiodarone correlates to what measure of drug intake?

A

Total cumulative dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

profound back pain, hematuria, hypotension, and coronary ischemia on EKG?

A

AAA rupture - gross hematuria from bladder venogongestion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Impaired taste, impaired wound healing, immune dysfunction, alopecia, skin rash for someone on parenteral nutrition

A

Zinc deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Fragile hair, skin depigmentation, neuro dysfunction like B12, and sideroblastic anemia

A

Copper deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Dermatitis (hyperpigmented), diarrhea, dementia (pellagra)

A

Niacin (B3) deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Deficiency leading to thyroid dysfunction and cardiomyopathy?

A

Selenium deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Pure hemisensory loss stroke location

A
  • Thalamus, VPL and VPN
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Ipsilateral face and contralateral body pain/temp loss, ipsilateral bulbar muscle weakness, vertigo, and horner’s (D/P)

A

Lateral medullary infarction, PICA occlusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Ipsilateral oculomotor palsy, ataxia, and contralateral hemiparesis

A

Midbrain stroke- ataxia from superior cerebellar peduncle, hemeparesis from cerebral peduncle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Signs that a stroke may be cortical?

A

Aphasia, agnosia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Contralateral hemiparesis, sensory loss, and conjugate gaze palsy

A

putaminal damage with corresponding internal capsule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Area responsible for spatial organization?

A

Non-dominant (usually right) parietal lobe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Fatigue, weight loss, hypotension, inability to breast feed after complicated pregnancy?

A

Sheehan’s syndrome - ischemic infarction and necrosis of pituitary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

What to check for after loss of consciousness

A

POSTICTAL STATE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Pulsus paradoxus after severe chest pain radiating to back and widened mediastinum?

A

Aortic dissecion with cardiac tamponade

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Lab finding of antiphospholipid syndrome?

A

Paradoxical Prolonged PTT that does not correct when diluted with normal plasma as it binds the phospholipids used in assays

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

preferred long term oral anticoagulant in end-stage renal disease?

A

Warfarin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Intrauterine demise with multiple limb fractures and hypoplastic thoracic cavity (D/P)

A

Type II Osteogenesis Imperfecta - AD disorder related to type 1 collagn synthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

New onset spinal signs in a 6 yo girl with down syndrome?

A

Atlantoaxial instability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

First line bipolar medications?

A

Lithium, valproate, quetiapine, lamotrigine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Nausea, vomitting, weight loss, and signs of dehydration in gestational mom of twins? Differentiator from typical N/V of pregnancy?

A

Hyperemesis gravidarum - differentiate by presence of ketones in the urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Rapid onset <1 year hirsuitism with virilization (D/BT)?

A

Androgen-secreting neoplasm, get serum testosterone and DHEAS levels - elevated test normal DHEAS - ovarian source, DHEAS elevatedd - adrenal tumor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Fatigue, anorexia, hypoglycemia with testicular atrophy and cold intolerance, constipation, mild hyponatremia and hypotension.

A

Panhypopituitarism - fatigue, anorexia, hypoglycemia (low cortisol) testicular atrophy (hypogonadotropic hypogonadism) cold intolerance, constipation (hypothyroidism), hyponatremia/hypotension (ADH/decreased peripheral artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

What adrenal hormone is unaffected by panhypopituitarism?

A

Aldosterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Diagnosis of HIT type 2:

A

Heparin exposure >5 days AND

  1. Platelet count reduction >50%
  2. New thrombosis/expanding thrombosis
  3. Necrotic skin lesions
  4. Anaphylaxis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Diagnosis of Type 2 HIT

A

Serotonin release assay

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Alternatives to heparin in HIT:

A

Argatroban, fondiparinux, eventually warfarin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Antibodies for lupus (sensitive then specific)

A

ANA sensitive, anti-dsDNA and anti-Sm (specific)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Felty syndrome

A

RA PLUS splenomegaly and neutropenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

First test in alkali ingestion in absence of perf or respiratory distress?

A

Endoscopy to assess for esophageal damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Do studies show steroids help after esophageal damage?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

PCOS with normal testosterone?

A

Can appear normal due to decreased levels of sex hromone binding globulin,elevated free testosterone not measured

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

Second line for bipolar treatment

A

Lithium or valproate with a second gen antipsychotic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

Standard vitamin supplementation with measles?

A

Vitamin A - promotes antibody producing cells and regenteration of epithelium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

Vit E deficiency symptoms?

A

Hemolytic anemia, neuro complications like ataxia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

Phases of pertussis

A

Catarrhal (1-2 weeks) - mild cough, rhinitis
Paroxysmal (2-6 weeks) - whoop, postussive emesis
Covalescense (weeks - months) gradual resolutions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

Treatment for pertussis

A

Macrolides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

Blood findings with pertussis

A

marked lymphocytosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

Do you need pallor or pulselessness to diagnose compartment syndrome?

A

NO, unusual finding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

Metabolic abnormalities of hypothyroidism?

A

Hyperlipidemia, hyponatremia, assymptomatic elevations of CK and serum transaminases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

Painless, rapid, and transient vision loss with “curtain descending” (D/ most common cause)

A

Amaurosis fugax - most commonly caused by atherosclerotic emboli from ipilateral carotid artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

Age of onset of neonatal conjunctivits and treatment?

A

<24 hours -silver nitrate chemical - eye lubricant
2-5 days - gonococcal - IM ceftriax
5-14 days - chlamydial - PO macrolide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

Cause of Lesch-Nyhan syndrome?

A

X-linked recessive cause by deficiency of hypoxanthine guanine phosphoribosyltrasnsferase - accumulation of hypoxanthine and uric acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

6 mo girl regressing in speech and motor function with hand wringing?

A

Rett syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

Important cause of hypocalcemia in alcoholics (D/P)

A

Hypomagnesemia - decreased release of PTH but not associated with elevated phos levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

Correction for albumin level via calcium

A

0.8 for every 1 gm/L decrease in albumin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

Be careful giving sildenafil with what?

A

Alpha blocker (doxazosin) due to possibility of severe hypotension

Nitrates - severe hypotension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

Leading cause of euvolemic hyponatremia in someone taking lithium?

A

Diabetes insipidus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

Difference between complete and partial DI?

A

Complete - urine mOsm/kg <300 (often less than 100)

Partial - urine osmols from 300-600

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

Causes of nephrogenic DI?

A

Severe hypokalemia, hypercalcemia, meds (lithium, demeclocycline, foscarnet, cidofovir, amphotericin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

Treatment of nephrogenic DI due to lithium?

A

Salt restriction and d/c lithium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

Criteria for IBS

A

Recurrent abdominal pain/discomfort >3 days/month for 3 months with 2/3 of the following:

  1. Symptom improvement with bowel movement
  2. Change in stool frequency
  3. Change in form of stool
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

HIT rate higher with fractionated or unfractionated heparin? How to tell the difference?

A

unfractionated, markedly elevated aPPT with unfractionated heparin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

Why irregular cycles in adolescents?

A

Immature and insufficient - confirmed with menarche after exogenous progesterone administration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

target blood glucose levels in gestational DM

A

Fasting <=95, 1 hr postprandial <=140, 2 hr postprandial <=120

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

Managing shoulder dystocia

A

BE CALM - breathe (don’t push), elevate legs and flex hips, call for help, suprapubic pressure, enlarge vaginal opening with episiotomy, maneuvers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

McRoberts maneuver value in shoulder dystocia

A

relieves almost half

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

Cyanide toxicity mechanism of action?

A

potent inhibitor of cytochrome oxidase a3 and inhibits reduction to ferrous iron

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

Main toxins of smoke?

A

Hydrogen cyanide and carbon monoxide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

Treating cyanide toxicity

A

hydroxocobalamin or sodium thiosulfate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

Delusions, tactile hallucinations, aggression, poor dentition, excoriations

A

methamphetamine use disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

Severe GI symptoms, confusion, ataxia, and tremors with CNS irritability like seizures for bipolar patient? What medication change might have happened?

A

Lithium toxicity - Thiazide diuretics decrease secretion of lithium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

Meds that increase lithium levels

A

ACEi, NSAIDS, tetracyclines, metronydazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

Classic lab finding in poststreptococcal glomerulonephritis and related path

A

Immune complex deposition gets attacked by complement, leading to C3 in glomeruli and low complement C3 in serum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

Treatment of PGSN?

A

Supportive and blood pressure control

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

Most common cause of renal vein thrombosis and path?

A

Membranous glomerulonephropathy - loss of ATIII

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

Anemia, low haptoglobin, elevated bilirubin, elevated LDH - intravascular hemolysis

A

Hepatic vein thrombosis with hemolysis - paroxysmal nocturnal hemoglobinuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

BT for paroxysmal nocturnal hemoglobinuria and path?

A

Flow cytometry, shows abscence of CD 55 and CD 59 due to genetic defect in GPTD anchor - lack of complement inhibition allows membrane attack complex to form

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
108
Q

Mono-like illness with persisten fever, malaise, fatigue, absodlute lymphocytosis and >10% atypical lymphocytes

A

CMV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
109
Q

Differentiate CMV from EBV

A

Usually mild or absent pharyngitis, lymphadenopathy, and splenomegaly - supported by negative monospot and positive CMV IgM serology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
110
Q

what causes pain in primary amenorrhea?

A

Release of prostaglandins from endometrium causes uterine contractions - treat with NSAIDS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
111
Q

NMS non dantrolene management?

A

Bromocriptine or amantadine that can reverse dopamine block

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
112
Q

Treatment of severe serotonin syndrome?

A

Cryoheptadine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
113
Q

Treatment of antipsychotic dystonias and EPS?

A

Benztropine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
114
Q

Major causes of sudden death?

A

CAD, cardiomyopathy, arrhthmia, congenital heart defect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
115
Q

Difference between Stevens-Johnson syndrome and Toxic epidermal necrosis?

A

<10%, SJS, >30% body involvement, TEN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
116
Q

Causes of TEN?

A

Antibiotics, anticonvulsants, allopurinol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
117
Q

Loop diuretic sensory side effect? what primes this effect?

A

Ototoxicity, concurrent aminoglycosides or renal insufficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
118
Q

Monocular vision loss, afferent pupillary defect, and central sotoma in a young woman -

A

Optic neuritis often due to MS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
119
Q

When to perform antepartum fetal surveillance?

A

high risk pregnancies like maternal hypertension, DM, or fetal post-term pregnancy or growth restriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
120
Q

Common way to conduct antepartum fetal surveillance for gestational hypertension

A

Weekly BPP’s starting at 32 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
121
Q

BPP score of 6/10

A

Equivocal, repeat in 24 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
122
Q

Definition of latent Tb -

A

no signs on chest x-ray, nfiltrate, lymphadenopathy, or symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
123
Q

Treatement for latent TB

A

oniazid and Pyridoxine (to prevent isoniazid neuropathy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
124
Q

Mono plus mucocutaneous ulcers plus skin rahs plus diarrhea?

A

HIV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
125
Q

Genital warts medical name?

A

Condylomata acuminata

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
126
Q

HPV strains causing genital warts?

A

6 and 11

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
127
Q

Nonsurgical treatment for genital warts?

A

Podophyllin resin, trichloroccetic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
128
Q

Condylomata lata vs. acumunata?

A

Lata - syphillis, acuminata - warts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
129
Q

Most common complication for sickle cell trait?

A

Microscopic gross hematuria and hyposthenuria (impairment concentrating urine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
130
Q

Differential for liver abscess?

A

Entamoeba histolyica - young person with dyssentery
Echinoccocus - usually assymptomatic, frequent contact with animals, may have eosinophilia
Bacterial - older diabetic or liver disease patient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
131
Q

Test for entomoeba histolytica? Treatment?

A

Serologic testing (stool microscopy insensitive at liver stage) treatment with metronidazole AND a luminal agent like paromomycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
132
Q

Entamoeba vs echinococcus which to drain -

A

drain echinococcus and give albendazole, don’t drain entamoeba

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
133
Q

Murmur in aplastic crisis? Usually cause in sickle cell?

A

Functional systolic murmur due to hyperdynamic blood flow. Parvo B19, can happen even without preceding viral symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
134
Q

Pulmonary vasoocclusion and infection, fever, chest pain, and new radiographic infiltrate in sickle cell?

A

Acute chest syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
135
Q

After O2, best treatment for cluster headaches?

A

Subcutaneous sumatriptan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
136
Q

Hypertension, bradycardia, and respiratory depression in the face of head trauma?

A

Cushing’s reflex, elevated ICP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
137
Q

Signs of uncal herniation and cause?

A
  1. . Contralateral crus cerebri against tentorial edge - ipsilateral hemiparesis
  2. Compression of ipsilateral oculomotor nerve - Early mydriasis - late - down and out puil (unopposed trochlear and abducens)
  3. Contralateral homonymous heminopsia - compression of ipsi posterior cerebral artery
  4. Altered level of consciousness - reticular formation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
138
Q

Distinguished polymalgia rheumatica and fibromyalgA

A

PR has elevated ESR, CRP, PR usually only tender due to bursitis or synovitis, more commonly stiff shoulders and pelvic girdle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
139
Q

Major adverse effect of hydroxyurea?

A

Myelosuppression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
140
Q

Normal percentage of HbF in sickle cell patient?

A

5-15%, increases with hydroxyurea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
141
Q

Side effects of second gen antipsychotic olanzapine and clozapine?

A

Weight gain, dyslipidemia, hyperglycemia, increased risk for diabetes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
142
Q

Henoch Schonlein purura path and manifestations

A

IgA mediated leukocytoclastic vasculitis, gravity dependent palpable purpura, arthritis, and renal disease similar to IgA nephropathy
Normal platelet count and coag studies, commonly find hematuria +-RBC casts +- Proteinuriea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
143
Q

Treatment for HSP

A

Supportive unless severe, then glucocorticoids and hospitalization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
144
Q

thyroid changes in pregnancy?

A

Increased thyroxine binding globulin and increased thyroxine production resulting in total thyroid hormone level with minial increase to T4 = if already hypothyroid can worsen hypothyroid state

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
145
Q

Bartholin cyst location and presentation

A

Vulvar vestibule at 4 and 8 oclock - large cysts can cause vaginal pressure and discomfort with motion but clinically cyst is small, mobile, nontender, cystic mass behind the posterior labium majora with extension to vagina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
146
Q

Differentiate bartholin cyst vs bartholyn abscess?

A

Abscess indurated and tender

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
147
Q

What causes staph toxic shock syndrome?

A

Toxin 1- superantigen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
148
Q

High PTH, high calcium, low urine calcium excretion?

A

Familial hypercalcemic hypocalciuria, defect in calcium-sensing receptor, UCCR <0.01 comparedto >0.02 in HPTH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
149
Q

Workup for primary autoimmune insufficiency?

A

8 am serum cortisol and plasma ACTH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
150
Q

What is the ACTH stim test?

A

Cosyntropin given, should have a rapid rise of cortisol but will have low (central insufficiency) or insignificant rise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
151
Q

Basal cortisol low, ACTH high, minimal response to cosyntropin - primary adrenal insufficiency

A

Basal cortisol low, ACTH low, minimal response to cosyntropin - secondary or tertiary adrenal insufficienct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
152
Q

Difference between PPSV23 and PPCV13

A

PCV13 is conjugated and induces T-cell dependent B-cell response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
153
Q

Hypertonic and hyperrreflexia lower extremities in infant with lower extremity feet pointing inwards? Risk factors?

A

Cerebral palsy - prematurity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
154
Q

2-8 week old with regurgitation, painless bloody stools, and eczema

A

Milk/soy protein induced enterocolitis - eliminatie milk and soy from maternal diet or initiate hydrolyzed formula - spontaneously resolves in a year

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
155
Q

Sudden onset of vaginal bleeding in pregnant woman with high frequency, low-intesnity contractions and hypertonic, tender uterus?

A

Abruptio placentae - retroplacental bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
156
Q

Risk to mother of placental detachment? Risk to baby?

A

DIC and shock to mother, hypoxia and preterm delivery to baby

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
157
Q

Treatment for bullous pemphigoid?

A

High potency topical glucocorticoid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
158
Q

Saline responsive vs saline unresponsive metabolic alkalosis

A

Saline unresponsibe - typically hypervolumia (hyperaldosteronism, Cushing syndrome, excess black licorice) OR kidney issue (Barter’s, Gitelman’s) - not corrected by saline and elevated levels of urinary chloride
Saline unresponsive - loss of gastric secretions - volume depletion and low serum Cl/low urinary chloride

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
159
Q

Risk in infant <2 mo of bronchiolitis?

A

Apnea or recurrent wheezing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
160
Q

What to give exceptionally high risk kids with bronchiolitis?

A

Palivizumab

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
161
Q

Most common bacteria colonized in CF’r before age 20? After age 20?

A

Staph aureus, pseudomonas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
162
Q

Hypernatremia and dilute urine?

A

Think diabetes insipidus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
163
Q

Do central or nephrogenic DI patients compensate better?

A

Nephrogenic - no decreased thirst

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
164
Q

Cause of pericarditis in kidney failure? Treatment? Level at which it occurs?

A

Uremia, dialysis, usually BUN > 60mg/dL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
165
Q

Major gluconeogenic amino acid and what is it converted to?

A

Alanine to pyruvate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
166
Q

Main substrates of gluconeogenesis?

A

Alanine, glutamine, lactate, and glycerol 3-phosphate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
167
Q

Opsonization?

A

Antibody mediated phagocytosis conducted by the spleen - patients with asplenia at high risk of pneumococcal, meningococcal and Hib

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
168
Q

Umbillicus sensory level?

A

T10

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
169
Q

Low MCV, RDW, Mentzer index <13, target or teardrop cells:

A

thalassemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
170
Q

Differentiate iron deficiency anemia and thal minor

A

thal has higher reticulocyte count and normal RDW

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
171
Q

Parkinson’s symptoms on risperidone but can’t back down the dose?

A

Add benztropine (appropriate to switch to clozapine for tardive)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
172
Q

First or second generation antihistamines for postnasal drip causing cough?

A

First gen - who knows why, no response in 2-3 weeks warrants further workup

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
173
Q

Intraductal papilloma bening or malignant?

A

Benign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
174
Q

Differentiate intraductal papilloma and infiltrating ductal carcinoma?

A

Mass, microcalcification, and lymphadenopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
175
Q

Inflammatory arthritis, splenomegaly, and neutropenia

A

Felty syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
176
Q

what has a dose-dependent causal effect on breast cancer?

A

Alcohol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
177
Q

Is vaginal bleeding/fissures normal in menopause?

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
178
Q

Rett syndrome gene and major comorbidity

A

X-linked MECP2, seizures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
179
Q

Hyperandrogenism of pregnancy with bilateral cysts?

A

Either luteomas or theca lutein cysts, luteomas confer risk of virilization to female fetus but theca lutein cysts do not, both managed expectantly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
180
Q

Painless extensive bleeding during pregnancy?

A

Placenta previa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
181
Q

Differentiate placenta previa from vasa previa?

A

Vasa previa has rapid deterioration of fetal well being due to fetal bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
182
Q

Common bug in febrile neutropenia?

A

Pseudomonas and other gram positives due to disruption of mucosal barriers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
183
Q

Therapy for febrial neutropenia?

A

Antipseudomonal agent - cefepime, meropenam, pip-tazo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
184
Q

Mitral valve dysfunction in HOCM?

A

Systolic anterior motion of mitral valve contacts thickened septum and causes LVOT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
185
Q

Bacterial of fungal infection within the eye?

A

Endopthalmitis - usually postoperative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
186
Q

CML gene and translocation?

A

BCR-ABL between 9;22 - leukemogenesis due to constantly activated tyrosine kinase, inhibited by imatinib

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
187
Q

AML M3 variant treatment

A

Vitamin A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
188
Q

AML exposures:

A

Benzene, radiation, or past CML with blast crisis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
189
Q

Markers for ALL?

A

cALLA and Tdt

190
Q

Treatment for ALL? Test?

A

Chemo plus ARA-c for CNS prophylaxis +/- radiation. LP to see if CNS, then need radiation

191
Q

Leukemia you die with? Treatment?

A

CLL - chemo only for young (stem cell transplant) or old and symptomatic

192
Q

Cause of spider angiomas and palmar erythema in cirrhosis?

A

Hyperestronism - impaired metabolism of circulating estrogen - effects vascular wall dilation

193
Q

Cause of dupuytren contracture?

A

fibroblast proliferation and collagen deposition

194
Q

COPD and cirrhosis run in the family?

A

Alpha-1 antitrypsin disease

195
Q

AAT liver risk?

A

Hepatocellular carcinoma

196
Q

Bilateral lung infiltrates, confusion/ataxia, and diarrhea following travel? (D/Tr)

A

Legionella, treat with macrolides or fluoroquinolones

197
Q

Aortic stenosis signs in a young person and unequal blood pressures?

A

Supravalvular aortic stenosis due to congenital left ventricular outflow obstruction - palpable thrill in sternal notch

198
Q

Cause of Hyper-IgM syndrome

A

X-linked defect in CD40 - Tcells have trouble binding to B cells to induce class switching

199
Q

Differentiate hyper-IgM from Brutons X-linked agammaglobulinemia and Common variable immunodeficiency

A

Low B cells in bruton’s and low IgM, normal B-cells in common variable and low IgM

200
Q

Low IgG levels in 3-6 month old?

A

nadir of maternally derived antibody - transient

201
Q

Management of preterm labor by week period

A

<32 weeks - betamethasone, tocolytics, magnesium sulfate, penicillin if unknown GBS

32-<34 weeks - betamethasone, tocolytics, penicillin if unkown GBS

34-<37 weeks - maye betamethasone, penicillin if GBS unknown

202
Q

Why don’t we use tocolytics after 34 weeks?

A

Indomethacin - closure of DA and oligohydramnios, nifedipie - maternal hypotension, tachy

203
Q

Cause of nasopharyngeal carcinoma? Risk population?

A

EBV, southern china

204
Q

Aflatoxin cancer association?

A

Hepatocellular carcinoma

205
Q

Muscular dystrophy onsets:

A

Duchenne 2-3, gower sign and cal hypertrophy, X-linked recessive deletion of dystrophin, death by 20-30 from respiratory or heart failure

Becker 5-15- missing dystrophin, less severe Duchenne’s (decreased dystrophin, not absent)

Myotonic - 12-30 - facial weakness, hand grip, myotonia, dysphagia, autosomal dominant expansion of CTG in DMPK gene

206
Q

Wilms tumor associated syndrome

A

WAGR - wilm’s, aniridia, genitourinary, retardation
Beckwith-Wiedemann
Denys-Drash

207
Q

Treatment of Wilm’s

A

tumor excision and chemo, maybe radiation

208
Q

Mammography schedule?

A

women 50-75 every 2 years

209
Q

Pap schedule

A

21 to 65 every 3 years

210
Q

HLD screening?

A

Men 35+ lipid panel every 5 years

211
Q

Most common hypercoagulable disorder?

A

Factor V Leiden - does not respond to protein C - continued thrombin formation

212
Q

Ways to improve oxygenation

A

FiO2 or PEEP only

213
Q

Best strategy in improving ARDS survival?

214
Q

Resembles a DVT but has a medial malleoulus crescent sign?

A

Probably a popliteal cyst rupture but get an ultrasound just in case

215
Q

How to transfuse an IgA deficient individual?

A

Washed red cell products

216
Q

First line treatment for PMS?

A

Selective serotonin reuptake inhibitors

217
Q

Brief transient euphoria, loss of consciousness, dermatitis around the mouth

A

Inhalent abuse

218
Q

When to give hypertonic saline for hyponatremia?

A

CNS symptoms (signalling risk of cerebral edema)

219
Q

Rate of increase of sodium?

A

<8meq/L over 24 hours

220
Q

Night blindness, photophobia, dry scaly kin, dry eye, wrinkled, cloudly cornea -

A

vitamin A deficiency

221
Q

Symptoms of early pregnancy, belief to be pregnant, no evidency on ultrasound or urine

A

pseudocyesis - somatization of stress- often will interpret negative pregnancy tests to be positive

222
Q

Typical place for brain cancer metastasis?

A

white gray matter junction

223
Q

Percentage of lung cancer patients presenting first with brain mets?

224
Q

Ugly duckling sign (appearance different than the other) of a mole?

A

90% sensitive for melanoma

225
Q

Painless purpura, fatigue, weakness, fleeting joint pains, low C4 factor

A

Cryoglobulinemia

226
Q

Differentiate mixed cryoglobulinemia from TTP

A

TTP has much more severe anemia and thrombocytopenia, non-palpable purpura

227
Q

Anti-cyclic citrullinated peptide and RF

A

Rheumatoid arthritis

228
Q

3-4 month old with doll-like face, thin extremities, short stature, protuberant abdomen?

A

Glucose-6-phosphatase deficiency (Von Gierke’s) - cannot convert glycogen to glucose - get glycogen buildup, seizures, lactic acidosis, hyperuricemia

229
Q

MS worsening factor of environment?

A

High temperature weather

230
Q

LP finding in MS?

A

Oligoclonal IgG bands

231
Q

Cause of Prader-Wili - deletion of parental copy of chromosome 15q11

A

Cause of Angelman syndrome - paternal uniparental disomy (mamma’s boy, daddy’s girl)

232
Q

Thiazide effect on those with diabetes and metabolic syndrome

A

Hyperglucose, hypertriglyceride

233
Q

Hemolytic anemia, increased mean corpuscular hemoglobin, jaundice, splenomegaly?

A

Hereditary spherocytosis

234
Q

Fatigue, weakness, GI symptoms but no vomitting or diarrhea, and low BP?

A

Primary adrenal insufficiency

235
Q

Signs of AS:

A

Weak slow rising pulse (parvus and tardus), single soft S2, mid-tolate peaking systolic murmur

236
Q

abdominaal pain worse at night, weight loss and fatigue, migratory thrombophlebitis

A

Pancreatic cancer

237
Q

Cushing ulcer typical presentation?

A

prominent gastric bleeding, acute onset

238
Q

RA hot swollen single joint with fever?

A

Septic arthritis, RA is more at risk

239
Q

Sail sign in child <3

240
Q

Treating bradycardia in hypothermia?

A

Active rewarming

241
Q

What is tachysystole?

A

> 5 contractions in 10 minutes, usually induced by labor inducers which can also cause tetanic contractions

242
Q

Side effect of tachysystole

A

fetal heart rate trace abnormalities due to less blood flow 2/2 less relaxation, generally well tolerated

243
Q

Side effects of oxytocin?

A

Tachysystole, hyponatremia, hypotension

244
Q

Achalasia with slowly worsening symptoms and B signs?

A

Psuedoachalasia due to esophageal cancer

245
Q

Back pain/perineal pain for >-3 months with irritative voiding symptoms and unidentifiable cause and normal urine culture?

A

Chronic prostatitis/chronic pelvic pain syndrome, inflammatory if leukocytes in urinalysis - diagnosis of exclusion, treat with antibiotics and usual antiprostate drugs

246
Q

Eczematous ulcerating rash of the nipple -

A

Paget’s disease of the breast - usually due to adenocarcinoma

247
Q

5 days post-MI for anterior infarction be watching for?

A

Ventricular free wall rupture

248
Q

Common manifestation of Lyme carditis?

A

AV node conduction block

249
Q

How to diagnose Lyme?

A

B burgdorferi serology (ELISA and western blot

250
Q

Subacute to chronic lateral elbow pain with history of repetitive or forceful wrist extension, pain with passive wrist flexion

A

Lateral epicondylitis “tennis elbow” - normal treatment + counterforce bracing

251
Q

Goodpasture antibody target?

A

Type IV collagen

252
Q

Arteries affected by fibromuscular dysplasia?

A

Renal and internal carotid arteries

253
Q

Subauricular systolic bruit?

A

nternal carotid artery - usually not affected by atherosclerosis like the carotid bulb

254
Q

Livideo reticularis, blue toes, kidney injury, ocular spots, eosinophilia in urine post cardiac catheterization

A

Cholesterol crystal syndrome

255
Q

Preferred diagnostic study for aortic dissection in patient with renal failure

A

transesophageal echocardiography

256
Q

Test of choice for aortic dissection in hemodynamically stable patients?

A

Transesophageal echo

257
Q

What to check in potential hypertensive emergency?

A

Check for retinal hemmorhages, papilledema

258
Q

Worst case scenario in a posterior oropharyngeal injury?

A

Internal carotid artery dissection

259
Q

Most common cause of congenital aplastic anemia? Short stature, hypopigmentation, hypoplastic thumbs (D/P)

A

Fanconi anemia - DNA repair defect

260
Q

Vaccines for premes with chronilogical or gestational age? Exception?

A

Chronilogical. Exception is hep B, should be >=2 kg before

261
Q

Goal age of delivery for PPROM?

A

34 weeks EGA

262
Q

Goal date for delivery with preeclampsia with severe features?

A

> =34 weeks

263
Q

Severe hypertensive crisis in pregnant mother treatment?

A

Hydralazine or labetalol - don’t use labetalol if bradycardic or nifedipine (oral)

264
Q

Viral prodrome followed by chest pain, respiratory distress, S3 gallop, and holosystolic murmur?

A

Myocarditis resulting in dilated cardiomyopathy

265
Q

Acute fevers chills and myalgias 6-48 hrs after treatment for early syphillis, lyme, or leptospirosis?

A

Jarish-Herxheimer - support with IV fluids, acetaminophen, NSAIDS

266
Q

Carcinoid secretions?

A

Histamine, serotonin, VIP

267
Q

Deficiency in carcinoid and mechanism?

A

All cellular tryptohan used for production of serotonin, tryptophan is also used for niacin - can result in pellagra (diarrhea, dermatitis, glossitis, angular stomatitis, dementia)

268
Q

Nephrotic syndrome in AA or Hispanic obese IV drug user?

269
Q

Nephrotic syndrome in pt. with hx of hep b or c and lipodystrophy?

A

Membranoproliferative glomerulonephritis

270
Q

Most common cause of acute epidydimitis in patients >35?

A

E. Coli/coliform ascending bacteria related to bladder outlet obstruction

271
Q

Treatment for coliform epidydimits?

A

Levofloxacin

272
Q

Afib and pleuritic chest pain?

273
Q

Progressive ataxia in adolescence with kyphoscholiosis and pes cavus?

A

Fredereich ataxia - GAA tinucleotide repeat in frataxin gene

274
Q

Cuase of ataxia-telangectasia and risks?

A

DNA repair deficits, malignancy

275
Q

Does GBS affect vibratory or position senses?

276
Q

Most common cause of inherited intellectual disability and genetics?

A

Fragile X, CGG trinucleotide repeats in X chromosome

277
Q

SUPER high white count and hepatosplenomegaly in a pneumonia patient?

A

Check for CLL with flow cytometry

278
Q

Hepatic encephalopathy acidosis or alkalosis?

A

Alkalosis - promotes conversion from ammonium to ammonia which can enter CNS and drives down potassium - treate with potassium repletion and IV volume repletion

279
Q

New mother with a thumb issue?

A

De Quervain tenosynovitis, inflammation of abductor pollicis longus and extensor pollicis brevis

280
Q

Patent ductus arteriousus, sensineural hearing loss, and cataracts in an infant?

281
Q

Chorioretinitis, hydrocephalus, and diffuse intracranial calcifications in an infant?

A

Congenital toxo

282
Q

Chorioretinitis with periventricular calcifications in a newborn?

283
Q

Hepatomegaly, nasal discharge,osteoarticular destruction, and maculopapular rash in newborn?

A

Congenital syphillis

284
Q

Postgastrectomy nausea, diarrhea, cramping, sweating, palpitations after eating?

A

Dumping sndrome - rapid emptying of gastric contents into duodenum

285
Q

Treatment for aspiration pneumonia?

A

Clindamycin, amoxicillin-clavulanate

286
Q

Cause of Zenker diveticulum?

A

Eosophageal dysmotility leads to posterior herniation above the upper esophageal sphincter

287
Q

Where to start for infertility workup?

A

Semen analysis

288
Q

AFP in gastroischesis?

A

Elevataed, passes through the exposed bowel wall into amniotic fluid

289
Q

Isolated or comorbid gastroischesis usually?

290
Q

Positive RPR workup?

A

Need fluorescent treponemal antibody test - postive tests require confirmation from other method

291
Q

Hydrophobia, aerophobea, pharygneal spasm, spastic paralysis, agitation, and ascending flaccid paralysis?

A

Rabies - most common in bats in US, dogs in developing world, need rabies immune globulin and vaccine immediately

292
Q

Why are CF men infertile?

A

Inspissated mucus obstructs development of vas deferens, resulting in congenital absence

293
Q

What causes the peripheral insulin resistance of increased pancreatic B cell hyperplasia of pregnancy?

A

Human placental lactogen (hPL), a somatomammotropin

294
Q

Fever, rash, or arthralgia with peripheral eosinophilia, hematuria, sterile pyura, eosinophiluria?

A

Drug induced interstitial nephritis

295
Q

Delayed bleeding after minimal trauma in 3 yo, especially hemarthrosis (D/P/BT)

A

Hemophilia, A is VIII deficiency and B is IX deficiency, X-linked recessive disorder, BT is coagulation study which will show elevated PTT, normal PT, absent or lowered factors

296
Q

How to treat hemophilia for extensive bleeding

A

Factor replacement, desmopressin for mild hemophilia

297
Q

Patient got a tan and has hypopigmented mildly itchy lesions (D/Path finding)

A

Tinea versicolor due to malazessia, KOH shows budding yeast (spaghetti and meatballs), treat topically with selenium sulfide or ketoconazole

298
Q

PBC relationship to Lipids?

299
Q

Asbestosis carcinoma cancer risk multiplier?

300
Q

Location of emphysematous changes in COPD and AAT

A

COPD - centriacinar selective to upper lobes, AAT panacinar of lower lobes

301
Q

Common side effect of medroxyprogesterone (the contraceptive shot?)

A

weight gain

302
Q

How to test for lactose intolerance?

A

Rise of hydrogen in breath test indicating carb metabolism

303
Q

Which dystophy is autosomal dominant trinucleotide expansion?

A

Myotonic dystrophy, DMD and Becker’s are X-linked

304
Q

Symptoms of myotonic dystrophy?

A

Dysphagia (most dangerous), myotonia, cardiac conduction problems, cataracts, testicular atrophy, frontal baldness, insulin resistance

305
Q

Screening with BWS?

A

Abdominal ultrasound and AFP for Wilms and hepatoblastoma

306
Q

How does thyrotoxicosis cause hypertension?

A

Leads to positive inotropic and chroniotropic changes leadign to tachycardia, systolic hypertension, widened pulse pressure, afib adn aflutter

307
Q

Thyrotoxic effects on heart?

A

Rhythm issues, systolic hypertension, heart failure, angina symptoms

308
Q

Middle mediastinal mass w/o warning signs?

A

Bronchogenic cyst, tracheal tuor, pericardial cyst

309
Q

Where are neurogenic mediastinal masses located?

A

Posterior mediastinum

310
Q

Indications for home O2 in COPD’r

A

PaO2<55 mmHg, SaO2 <88%, slightly higher in those with cor pulmonale

311
Q

Diarrhea occuring even during fasting or sleep?

A

Secretory diarrhea

312
Q

Distinguish osmotic from secretory diarrhea?

A

Stool osmotic gap

313
Q

Typical finding of SCC biopsy

A

keratin pearls

314
Q

Bladder part injury that leads to peritonitis?

A

Bladder dome

315
Q

Is HFpEF the same as high output heart failure?

A

No, high output heart failure occurs ins severe anemia, hyperthyroidism, beri beri, and Paget’s

316
Q

Part of bowel resection that can contribute to gallstone?

317
Q

Most common predisposing factor for acute bacterial sinusitis in a child?

A

Viral infection

318
Q

Fluid of choice for hypernatremia?

319
Q

How long to d/c SSRI before starting MAOI?

320
Q

Mental status changes, autonomic dysregulation, and neuro hyperactivity in psych patient?

A

Check serotonin syndrome

321
Q

New onset GI symptoms, confusion, ataxia, tremor in hospitalized schizoaffective patient?

A

Think lithium toxicity from some other given drug reducing renal clearanc

322
Q

Insomnia, fatigue, weight gain in a woman of childbearing years

A

Expect pregnancy

323
Q

Where is Dxylose absorbed? Does it need enzymes?

A

Functional proximal intestines, no enzymes needed

324
Q

Treatment for toxo?

A

Sufadiazine and pyrimethamine plus leucovorin to prevent hemmorhage - initiate ART 2 weeks after beginning treatment

325
Q

Treatment of MAC GI/pulm

A

clarithromycin and ethambutol

326
Q

Vaginal bleeding, pelvic pain, nausea, vomitting?

A

Think ectopic pregnancy

327
Q

Peritoneal irritation from ovulation follicular fluid?

A

Mittelscmirtz

328
Q

Active panic attack acute treatment?

A

Benzodiazepine

329
Q

Diverticular abscess in stable patient?

A

CT percutaneous drainage

330
Q

First line treatment for cognitive AD symptoms?

A

Cholinesterase inhibitors - donepezil, rivastigmine

331
Q

Methimazole side effects:

A

Agranulocytosis, teratogen in 1st trimester

332
Q

Propylthiouracil side effects:

A

Hepatic fialure, ANCA-vasculitis

333
Q

Radiodine side effects

A

worsening of opthalmopathy

334
Q

Preferred treatment for nephrogenic DI?

335
Q

Right sided motor and sensory issues predominant in lower extremity WITH urinary incontinence and WITHOUT visual defects?

A

ACA stroke, urinary incontinence unlikely in lacunar stroke, visual defects likely in MCA stroke

336
Q

Ammenorhea with negative BhCG workup?

A

Prolactin, TSH, FSH

337
Q

Severe auditory canal infection and base of skull infection with granulation tissue and an edematous external auditory canal

A

Pseudomonas aeruginosa

338
Q

IV drug of choice for pseudomonal MOE?

A

Ciprofloxacin

339
Q

Adult-onset disral muscular weakness and atrophy with dysphagia?

A

Inclusion body myositis

340
Q

Typical symptoms of GBS?

A

Ascending flaccid paralysis with distal parethesias

341
Q

typical finding of CSF in GBS?

A

Albuminocytologic dissociation - normal WBC, high protein

342
Q

Immunocompromised, febrile, productive cough, low PO2, 2/6 Left upper border HM?

A

Pneumonia, fever causes hyperdynamic heart state

343
Q

Preferred enema style for intussuception?

A

Air enema - safer cleaner than contrast enema

344
Q

Action tremor with no additional signs?

A

Essential tremor

345
Q

Marked hypertension and acute kidney injury in setting of systemic schlerosis? (D/Path)

A

Scleroderma renal crisis - upt to 20% of patients with diffuse cutaneous sclerosis. Increased vascular permeability, activation of coagulation cascade, increased renin along with microangiopathic hemolytic anemia - schizocytes and thrombocytopenia

346
Q

Burr cell meaning?

A

End stage renal disease, liver disease

347
Q

Howell-Jolly body meaning?

A

Asplenia or splenectomy

348
Q

Target cell meaning?

A

Thalasemmia or chronic liver disease

349
Q

Pyrexia, tachy, delirium, and vomitting on hyperthyroidism after CT?

A

Thyroid storm due to iodine load from contrast

350
Q

How to treat boodborne botulism?

A

Horse-derived antitoxin

351
Q

What does botulin toxin inhibit?

A

Presynaptic acetylcholine release at NMJ

352
Q

Tetanus infection or toxin?

A

Toxin - blocks release of GABA and glycine

353
Q

Cut down on alcohol craving?

A

Naltrexone or acamprosate

354
Q

Basic lab analysis for suspected essential hypertension?

A

Urinalysis, chemistry panel, lipid profile, baseline EKG

355
Q

MEN1 three P’s

A

Parathyroid adenoma/hyperplasia, gastrointenstinal/pancreatic tumors (ZE), pituitary adenomas

356
Q

Smudge cells?

A

Pathognomoic for CLL

357
Q

Cause of gilberts?

A

UDPglucuronosyltransferase

358
Q

If pet is available for quarantine, does dog bite require prophylaxis for rabies?

A

No, dogs develop full symptoms in 5-10 days vs humans for 1-3 months

359
Q

When to give tetanus immunoglobulin? Unimmunized, dirty wound

A

Dirty wound last tetanus update? Within 5 years

360
Q

Infant chronic diarrhea, lymphadenopathy, and failure to trhive PLUS opportunitstic infections?

A

Consider T lymphocyte deficiency

361
Q

Differentiate HIV infection with ADA deficiency in infant?

A

ADA deficiency has profound lymphopenia

362
Q

Recurrent severe infections from staph A., serratia, and aspergillus?

A

chronic granulomatous disease, impaired phagocytosis means catalase + infections proliferat

363
Q

Path of toxic megacolon in UC?

A

Subset get inflammation to smooth muscle layer leading to colonic dilation

364
Q

Treatment for IBD toxic megacolon?

A

IVF, broad spectrum antibiotics, bowel rest, and IBD specific corticosteroids

365
Q

Hemolysis, bite cells, Heinz bodies

A

G6PD deficiency

366
Q

Right sided pleural effusion with moderate lymphocytosis and elevated protein?

A

Suggestive for TB

367
Q

Key enzyme to produce estrone/estogren from androstenedione?

368
Q

Hormones in Kallmann syndrome

A

hypogonadotropic hypogonadism

369
Q

Why avoid prolonged high FiO2?

A

Oxygen toxicity

370
Q

Brain complication of ADPKD?

A

Cerebral aneurysms

371
Q

Preferred med for ADPKD hypertension?

372
Q

vWD have bleeding into tissue?

A

No, normally mucosa, think hemophilia for tissue bleeding or hemarthrosis

373
Q

Herpangina vs. HSV

A

Herpangina, Coxackie A, summer/early fall, gray vesicles on tonsillar pillars and posterior oropharynx

374
Q

HSV

A

mostly oropharynx and lips

375
Q

Age cut off for likey sjogren’s

A

middle age, unusual for initial presentation after 65

376
Q

> 65 sjogren’s presentation but no antibodies?

A

Age-related sicca syndrome due to decreased exocrine output from glands

377
Q

How quickly does RAI therapy ablate thyroid follicles?

A

weeks to months

378
Q

Why does lymphedema transition from pittingto nonpitting?

A

Deposition of subcutaneous collagen and adipose tissue

379
Q

Inability to lift skin off of dorsum of foot?

A

Stemmer sign, highly specific for lymphedema

380
Q

Differentiate RDS of newborn vs transient tachypnea?

A

Lung volumes - low lung volumes in RDS

381
Q

Path cause of TTN? Delayed resoprtion of alveolar fluid

A

Chest x-ray finding of transient tachypnea of newborn?

Fluid in interlobar fissures

382
Q

Highly sensitive syphillis test?

A

FTA-ABS (treponemal)

383
Q

Drugs that cause a phototoxic drug reaction -

A

Tetracyclines - exagerated sunburn reactions with erythema,edema, and vesicles

384
Q

Hard to visual fundus, dark red hue, sudden loss of vision

A

Vitreous hemorrhage - treat with upright position during sleep

385
Q

Pancytopenia, spenomegaly due to clonal B-cell neoplasm?

A

Hairy cell leukemia - look for “hairy cell projections””, dx with bone marrow biopsy

386
Q

Differentiating test between CML and leukmoid reaction?

A

Decreased leukocyte alkaline phosphatase score in CLL

387
Q

Auer rods in all myelocytic leukemias?

A

No, only AML

388
Q

Rapidly progressing dementia and myoclonus?

A

Creutzfelt-Jacob

389
Q

CSF fluid finding for Creutzfelt-Jakob disease?

A

14-3-3 regulatory proteins

390
Q

Dermatomyositis classic violaceous poikiloderma locations

A

Heliotrope, shawl, and gottron’s (on knuckles)

391
Q

Gottron’s papules?

A

Scaly papules over joints pathognomonic for dermatomyositis

392
Q

Classic autoantibodies for dermatomyositis?

A

Anti-Jo, anti-Mi-2

393
Q

Common comorbidity with dermatomyositis?

A

Internal malignancies

394
Q

Risk factor for hypergonadotropic hypogonadism -

A

hypothyroidism

395
Q

Limited upward gaze, upper eyelid retraction, prostitutes pupil?

A

Parinaud syndrome - pineal gland mass (can also add obstructive hydrocephalus signs)

396
Q

Length of QT interval?

A

2 big boxes

397
Q

Elongated QT interval treatment?

A

Maintain levels of calcium, potassium, and magnesium pharmacotherapy, Beta blockers, may need pacemaker

398
Q

CD19 and CD3 association?

A

19-Bcells, 3-T cells

399
Q

Differentiate breastfeeding jaundice and breast milk jandice

A

Breastfeeding - insufficient intake with suboptimal breastfeeding and dehydration around 1 week - causes less bilirubin output
Breastmilk - 3-5 days to 2 weeks, high levels of B-glucoronidase in breast milk - everything else normal

400
Q

Cause of Kaposi sarcoma?

401
Q

Bone pain worse at night relieved by NSAIDS with a small round lucency on Xray

A

Osteoid osteoma

402
Q

Ewing sarcoma finding on Xray?

A

Extensive bony involvmenet and onion skinning

403
Q

HIV dementia has what sort of dysfunction along with apathy and impaired attention?

A

Subcortical dysfunction such as slow movement and difficulty with movement

404
Q

Common lung manifestation of systemic sclerosis

A

Pulmonary artery hypertension

405
Q

Mechanism of PAH in systemic sclerosis

A

hyperplasia of intimal smooth muscle ratio and unaffected lungs

406
Q

Method of action of dobutamine in meth cardiomyopathy?

A

Increase myocardial contractility/decrease in left ventricular end-systolic volume - primarily B1 action

407
Q

Psych symptoms with neuro symptoms in a child with abnormal liver function test?

A

Wilson’s disease

408
Q

Other places fibromuscular dysplasia occurs outside of renal arteries?

A

Carotid, vertebral (amaurosis fugax, Horner’s, TIA)

409
Q

Dx for fibromuscular dysplasia?

A

CT angiogram or duplex ultraosound

410
Q

Which diabetes medication can aid in weight loss?

A

GLP-1 agonists (exenatide, liraglutide

411
Q

GLP-1 risk?

A

Acute pancreatitis

412
Q

Irregular vaginal bleeding, englarged uterus, and chest pain 6 mo after pregnancy (D/BT)

A

Choriocarcinoma, quantitative B-hCG

413
Q

Management of postictal lactic acidosis if seizures are controlled?

A

Recheck after 2 hours, lactic acid AGMA due to skeletal muscle hypoxia

414
Q

Findings from central retinal artery occlusion?

A

Whitened retina (edam) and red fovea (cherry red spot) as well as defect in afferent pupil reflex

415
Q

Hypokalemia alkalosis and normotension differential?

A
  1. Surreptitious vomiting
  2. Diuretic abuse
  3. Bartter syndrome
  4. Gitelman’s syndrome
416
Q

Nontender 2x2 chronic hard palate mass in a young healthy patient?

A

Congenital torus palatinus - bony growth that only has intervention if symptomatic

417
Q

What agents to avoid in glaucoma?

A

Atropine - further dilates the pupil and can worsen glaucoma

418
Q

How does Guillain Barre syndrome cause damage?

A

Demyelination of peripheral nerve fibers

419
Q

What neuromuscular illnesses involve the anterior horn cells?

A

Spinal muscular atrophy (infants), poliomyelitis, and ALS

420
Q

where is Broca’s area located?

A

Frontal lobe

421
Q

How soon to become vitamin K deficient in acutely ill person with reduced liver stores?

422
Q

subacute fever, chills, malaise, headache with bilateral hilar lymphadenopathy and granulomas with narrow based budding yeast?

A

Histoplasmosis

423
Q

Emperic treatment of choice for menningococcal meningitis?

A

Ceftriaxone and vanc, dexamethasone does NOT help

424
Q

RMSF manifestation of CSF?

A

Seems like viral meningitis

425
Q

Parkinsons med that can cause acute closure glaucoma?

A

Trihexyphenadyl - anticholinergic

426
Q

Symptoms of refeeding syndrome? Primary deficiency electrolyte?

A

Pancreatic insulin surge after starvation, shift of magnesium, potassium into cells causing cardiac arythmias, congestive heart failure, and seizures, potassium is primary deficiency due to need for ATP

427
Q

Risk of inverted uterus?

A

Hemorrhagic shock and lower abdominal pain

428
Q

Path of aortic coarctation?

A

Thickening of tunica media of aortic arch

429
Q

Physiological findings in depression?

A

Increased cortisol from hyperactivity of hypothalamic-pituitary-adrenal axis, decreased hippocampal and frontal lobe volumes

430
Q

Nonspecific symptoms with splenomegaly and elevated alk phos and very low CD4 count?

A

Think dissemeinated MAC

431
Q

Prophylaxis for MAC

A

Azithromycin

432
Q

Concave abdomen, barrel shaped chest, pulmonary distress in infant?

433
Q

Treatment for bony tumors outside of chemo to prevent pathologic fractures and malignant hypercalcemia?

A

Bisphosphonates

434
Q

Unexplained superficial venous thrombosis and upper GI issues?

A

Think trousseau’s syndrome (migratory superficial thrombophlebitis) related to pancreatic carcinoma

435
Q

PTHrP cancer producer:

A

sCa++amous - squamous cell carcinoma

436
Q

SIADH from cancer type?

A

Small cell carcinoma

437
Q

ectopic ACTH production?

A

Suspect small cell carcinoma

438
Q

Most important predisposing factor to aortic dissection?

A

Systemic hypertension

439
Q

weakness and tremors after asthma attack?

A

Albuterol potassium shifts

440
Q

First line treatment for blood pressure control in aortic dissection?

A

IV beta blockers - reduce cardiac and aortic wall stress

441
Q

Treatment for TCA toxicity with QRS>100 msec?

A

Sodium bicarb

442
Q

How does late gestation cause oligohydramnios?

A

Preferential redistrubtion during placental insufficient shunts blood to brain

443
Q

Signficant air leak after chest tube placement post chest trauma?

A

Tracheobronchial rupture

444
Q

Hx of RA with enlarged kidneys and hepatomegaly nephropathy cause?

A

Amyloid deposition - stain apple-green birefringent with Congo red

445
Q

Most common cause of AA amyloidosis in US?

446
Q

Leukopenia, thrombocytopenia, and elevated aminotransferases ofter tic bite?

A

Ehrlichosis

447
Q

Periorbital edama, myositis, and eosinophilia?

A

Trichonillosis

448
Q

Diagnosis of celiac?

A

Anti IgA transglutaminase and IgA anti-endomysial antibodies

449
Q

Blackfan association?

A

Only red cell line underdevelopment

450
Q

Fanconi anemia

A

pancellular failure

451
Q

Cyclosporine mechanism of action and side effects?

A

Inhibiting transcription of IL-2 - nephrotoxicity, hypertension, nuerotoxicity, glucose intolerance, gingival hypertrophy and hisuitism

452
Q

Distinguish cyclosporine vs tacrolimus side effects?

A

Tacrolimus does not cause hisutism or gingival hyperplasia

453
Q

Azathiaprine mech of action and side effects?

A

Purine analog converted to 6-mercaptopurine inhibiting purine synthesis - dose related diarrhea, leukopenia, and hepatotoxicity

454
Q

Mycophenolate mech of action and side effect?

A

Reversible inhibitor of inosine monophosphate - inhibits purines - depresses MARROW

455
Q

Drug stimulant with seizures and hyponatremia?

456
Q

Treatment of PBC?

A

Ursodeoxycholic acid - decreases biliary injury by bile acids

457
Q

Aortic stenosis patient has GI bleeding?

A

Angiodisplasia related to acquied vW factor deficieny

458
Q

Treatment for norcadia?

A

TMP-SMX and carbapenems if brain involvement

459
Q

Anticentromere antibody?

A

Limited cutaneous systemic sclerosis

460
Q

Anti-RNA polymerase II antiboday

A

Diffuse cutaneous sclerosis

461
Q

Elevated homocysteine?

A

Give B6 and folate

462
Q

Anti CCP

463
Q

Anticentromere

464
Q

anti dsDNA

465
Q

Antihistone

A

Drug induced lupus

466
Q

AntiJo1

A

Polymyositis/dermatomyositis

467
Q

Antimitocondrial

468
Q

Anti-Scl-70

A

Systemic sclerosis

469
Q

Anti Sm

470
Q

Anti smooth muscle

A

Autoimmune hepatitis

471
Q

Antitopoisomerase I

A

Systemic sclerosis

Step 2 (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions