Wrong Flashcards
Cognitive decline with disinhibition
Frontotemporal dementia
Pt with early satiety and pain with eating (dx)
Paraesophageal hernia
A test that can look for hemoglobinopathy like thalassemia
Hemoglobin electrophoresis
Most common longterm crohns complication
Bowel stricture
Are anal skin tags more common in crohns or colitis?
Crohns
Dx of patient with gradual onset pelvic and abdo pain and low grade fever
PID
Dx of pt with tender arm, fever and increase ESR
Osteomyelitis
A drug to stop bed wetting
Desmopressin
How to calculate osmolar gap
Osmolality = (2xNa) + glucose + urea
Gap = given Osmolality - calculated
Female athlete triad
Amenorrhea, disordered eating, low bone mass
Testicular cancer spreads to what lymph nodes
Para-aortic
New breast lump
Biopsy right away
Bowed legs and diet deficiency
Ricketts
Dx of pt with cytoplasmic antineutrophil antibodies, proteinuria, hematuria, CXR infiltrates bilat
Granulomatosis with polyangitis
Varicocoele is associated with
Infertility
Antibiotics that cause QT prolongation
Macrolides
Nurse had pertussis exposure
Give postexposure prophylaxis Abx
Signs of hyperaldosteronism
HTN and low K
Most common cause of fever 48 hours post op
Atelectasis
Where are bile acids reabsorbed
Terminal ileum
Where are fats reabsorbed
Jejunum
Tetanus exposure
Tetanus immune globulin and vaccine
Jaundice and anemia post new drug exposure
Autoimmune hemolytic anemia
Tremor treatment
Propanolol
Antipsychotic side effects
Impaired glucose tolerance and lipid disorders
Dx of pt with mild liver inflammation and malaise
Mono
Food poisoning within hours to 1 day of eating
Staph aureus
Signs of magnesium toxicity
Decreased patellar reflexes and resp depression
How to dx giant cell arteritis
Temporal artery biopsy
Looks like vitiligo but is scaly
Tinea versicolor
Worsens psychosis
Stimulants
Infant with jaundice and pale stool
Biliary atresia
Normal central venous pressure
8-12
Increased central venous pressure after surgery
Cardiogenic shock
Treatment for prostate ca
Antiandrogen therapy
Not chemo even with Mets
Neonate with no meconium in 72 hours and no vomiting
Congenital aganglionic megacolon (hirshsprungs)
Tx of polymyalgia rheumatica
Prednisone
Delusional disorder vs somatic symptom disorder
Delusional doesn’t affect day to day life and usually short term
Test for bladder, renal, prostate etc ca
Urine cytology
Associated with Tourette’s
OCD and adhd
Determining baby’s Rh status in utero
Cell free DNA /NIPT
Is valproate okay in pregnancy
No
Is carbamazepine okay in pregnancy
Yes
Dx of pt with pruritus, fatigue, mild hepatomegaly and increased ALP
Primary biliary cholangitis
Blood test for primary biliary cholangitis
Antimitochondrial antibodies
Generalized thickening and inflammation of colon with bloody diarrhea
Ischemic colitis
Rare side effect of molar pregnancy
Hyperthyroidism
Type of biopsy for BCC
Excisional. Not punch or shave
Appearance of klinefelter
Tall
How long after Zika country to conceive
3 months
Mechanism for quad tendon rupture
Going down stairs
Mechanism for meniscus tear
Trauma
Mechanism for ACL tear
Pivoting
Mechanism for PCL tear
Severe trauma. Rarely happens
Dx of pt with gait disturbance, urinary incontinence and cognitive impairment
Normal pressure hydrocephalus
Dx of pt with cog impairment, gait disturbance and psychiatric symptoms
Lewy body dementia
Pt is stiff 15 mins in the morning
OA
CT shows ?bronchogenic ca
Do broncoscopy next not Bx
Lithium side effects
Sedation, tremor, dry mouth, polyuria, hypothyroidism, increased WBC
Potential cause of recurrent SA
Lupus
Indication for urgent laparoscopy
Free air
Change in bowel habits
Colonoscopy
How soon before IUD works
1 week
Kids with tantrums
Ignore them
How many people can be at a delivery?
As many as mom wants
Gentamicin and kidney disease
Decrease the dose
Newborn with seizures - what tests to order
Blood Glucose and calcium
Gastric ulcer not improved with PPI
Go gastroscopy and bx
Tx for infectious diarrhea
Don’t give Abx until after stool sample
Choledoco/cholangitis tx
Admit and give IV Abx and order endoscopic sphincterotomy
Child depression tx
CBT before meds
Stridor after intubation
Laryngospasm
Rib # tx
Encourage normal ADLs
When you need to know the blood type write
Type and cross match
Info needed for colon ca screening
FH of polyps and adenomatous polyposis and cancer, and personal hx of colitis
Bradycardia and hypotension tx
External pacer pads
Dystonia tx
Benztropine IM or diphenhydramine IM
Preventing dystonia in future
Anticholinergics
Tb meds - oral or IV
Oral
Upper arm weakness dx
Spinal cord injury
Tests for ?esophageal cancer
OGD and barium swallow
Rotator cuff tendinopathy dx and tx
No investigations needed
Tx is nsaids and physio
Tests needed with cocaine use
EKG
Is warfarin okay in pregnancy
No
Is low molecular weight heparin okay in pregnancy
Yes
Pt with meningococcal meningitis
Treat family with rifampin
Acute onset vertigo, nausea and hearing loss in one ear
Internal auditory artery infarction
Why is relative risk confusing to pts
They don’t know baseline risk
Blood exposure but the person with blood source refuses to give blood test results
Manage as if she was exposed
Dx of pt with fatigue, weight loss, N and V, hypotension and electrolyte disturbance
Adrenal insufficiency
Test to confirm adrenal insufficiency
ACTH stimulation test
When to do bone densitometry
Age 65+
Biggest risk of suicide in transgender pt
Lack of family support
Consent laws
12-13 2 year’s difference
14-17 5 year’s difference
Pt with chronic progressive edema
It can’t be a blood clot if it’s chronic
Just needs physio
Dx of pt with slow growth, low IQ, small hands and feet, hypogonadism, obesity
Prader-Willi
Pt doesn’t want you to disclose their HIV status to surgeon
Don’t disclose
Pt has peptic ulcer
Gastroscopy and biopsy
Pt with recurrent UTI
Postcoital Abx
Incidental finding of enlarged uterus and fibroids. No bleeding
Just reassure - likely leiomyomas
Child has a suspicious fracture
Do full body x-ray
This murmur is always pathological
Wide split S2
Signs it’s growing pains
The pain wakes you from your sleep
Pt has low K not improving with supplementation
Check for hypomagnesium
Hallucinations not often associated with schizophrenia
Olfactory (smell)
Pt has incidental finding of large prostate on imaging
Do DRE
An antidepressant associated with SIADH
Citalopram
What is primary dysmenorrhea
Regular period cramps
Besides GI issues, what else can Crohns have
Joint pain
Patient has high calcium, low Hgb, kidney failure and bone pain
Multiple myeloma
Before pregnancy screening
Do protest counselling
Does O2 CO2 or HCO3 cause decreased LOC
Increased CO2
Pt has mass in arm sus for cancer
Do X-ray to check for bone involvement
This disease is associated with contractures
Diabetes
Pt has FHx of 3rd trimester loss
Do CBC and Hgb electrophoresis of the couple
Firstline rec for bipolar
Olanzapine
This drug is known to decrease sodium
Carbamazepine
When locuming and using a medical record
Have your own account and password
Pt had a measles exposure
Give them the measles vaccine
At what age is reversing letters when writing normal
Until 7
PCOS - what test would be off
Abnormal glucose tolerance test
Pt has adrenal incidentiloma and HTN
Do plasma aldosterone to renin ratio
Pt is wondering about lead exposure
Do blood lead level
Absolute risk reduction of 5% treatment and 3% placebo
2%
Pt has hot flashes and cervical cancer
Combined hormonal is fine. Cervical cancer not related to estrogen
Pt has cancer and needs an antithrombotic following surgery
SQ unfractionated heparin
Pt has suspected cause of infertility and has been trying to conceive for 6 months
Refer for infertility assessment even though it’s under a year
Gout tophi
Nodular urate crystal deposits on pinnae, hands etc
Pt has PMDD
Stress reduction
What does eschorotomy mean?
Pt has severe burns of their chest and they go into resp distress so cut open the burn
CF and lung function
Lung function is worse in pts who don’t exercise
Child with midline thyroid lump
Likely thyroglossal duct cyst. Excise
What age to stop colonoscopy
75
Tx for hyperprolactinemia
Dopamine agonist
Pt has vertigo, tinnitus, unilateral hearing loss
Menieres
Pt is on lithium and can’t eat or drink post op
Dc lithium
Postmenopausal pt with solid pelvic mass, bloating, urgency, pelvic pain and vaginal discharge
Epithelial ovarian cancer
Pt has SBO - physical exam
DRE and palpate inguinal area
Prevention in COPD
Annual flu and pneumococcal vaccine
What disease is known to worsen asthma
GERD
A patient has new ADHD symptoms in their 20s
Provide ADHD screening regardless of having issues in childhood
Child with back pain and pain in areas where muscles, tendons, ligaments attach to bone
Juvenile ankylosing spondylitis
E. Coli source
Contaminated well
Flu vaccine in children
Do dose number 2 28 days after first
Imaging for enlarged prostate
CT pelvis
Low amniotic fluid and IUGR at 38 weeks
Induce labour
condition that occurs when monochorionic twins share unequal portions of the placenta
Selective intrauterine growth restriction
Pt has been on Ativan for 30 years and is saying she is having worsening sleep and wants a higher dose
Decline to increase
Making up words
Neologisms
the production or creation of false or erroneous memories without the intent to deceive
Confabulation
a mode of speech characterized by association of words based upon sound rather than concepts. For example, this may include compulsive rhyming or alliteration without apparent logical connection between words.
Clanging
a condition in which the heart becomes thickened without an obvious cause.
Hypertrophic cardiomyopathy
High percentage of hemoglobin S
Sickle cell disease
Treatment of sickle cell disease
Hydroxyurea
Hard palate mass - long-standing
Benign bony growth
Is Tdap safe in pregnancy
Yes
Is MMR vaccine safe in pregnancy?
No
Is chicken pox vaccine safe in pregnancy
No
Child with familiar hypercholesterolemia
Will likely have xanthelasma
Pt comes in with wrist laceration bandaged up
Before removing bandage, assess hand function
Sore throat with severe pain worse when swallowing, uvula swollen and displaced, tonsil swollen and displaced
Peritonsillar abscess
Peritonsillar abscess tx
Refer to surgeon for drainage
a neurological condition experienced by individuals with epilepsy, in which a seizure is followed by a brief period of temporary paralysis
Todd paralysis
Projectile vomiting in infant after eating diagnostic test
Abdominal ultrasound
Test for amenorrhea - not pregnant
Serum FSH
Recurrent swelling of face and lips and resp distress
C1 esterase inhibitor
You are concerned that a physician has lost their clinical skills
Meet with the physician and recommend an audit of their practice
Risk factor for OA
Obesity
Name for Spanking a child, etc.
Corporal punishment
Capillary refill of 4 seconds
Admit to hospital
Mass in RUQ and microhematuria of young child
Nephroblastoma (Wilms tumour)
Presence of schistocytes
Traumatic hemolytic anemia
Age of delivery for gestational diabetes
39 weeks
4 year old with ADHD symptoms
Recommend a structured routine
Displaced supracondylar fracture of humerus with pale pulse less hand
Traction and splinting of arm first
Sleep apnea can cause/worsen
HTN
a response to chronic hypoxemia, which triggers increased production of erythropoietin by the kidneys
Polycythemia secondary to hypoxemia
Pt with cervical cancer who had radiation and is now having constant vaginal discharge
Vesicovaginal fistula
Vesicovaginal fistula
an abnormal opening between the bladder and the vagina that results in continuous and unremitting urinary incontinence
Pt with longstanding diarrhea and lethargy
Micronutrient deficiency - likely malabsorption
10 year old with 1 week of light vaginal bleeding but no breast
Foreign body
Pharmaceutical company wants you to do a presentation and will pay all your expenses
Accept but disclose the compensation
Post MI. Patient fully conscious and alert but HR 50
Monitored observation
3 episodes of asthma attacks in 1 year for 2 year old
Prescribe daily inhaled steroids (indefinitely)
Pseudomonas aeruginosa is associated with
Cystic fibrosis
5 month old with accessory muscle use, crackles and wheezing tx
Nasal suctioning
Postmenopausal bleeding but you aren’t able to do endometrial biopsy
Transvaginal US
Unilateral pleuritic chest pain and hemoptysis
PE
Can fibromyalgia be treated with opioids
Nope
Pt keeps missing appts
Ask them why
Joint pain, dactylitis, nail pitting with no rash
Psoriatic arthritis
Stress incontinence
Pelvic floor exercises before pessary
Besides smoking, this can increase lung ca in northern communities
Radon gas
Closed fracture following MVA, ;4 hours later hypotension
Blood loss
Heavy periods tx when OCP is contraindicated
NSAIDs
Molar pregnancy tx
Dilatation, suction and curettage
Young man with recent pneumonia and moderately sized pleural effusion
Do diagnostic thoracentesis
Arthritis blood test
CRP better than Rheumatoid factor?
Best anti hypertensive in pregnancy
Nifedipine
An antipsychotic that makes antidepressants more effective
Aripiprazole
Best way to reduce sugar intake of kids
Take away soft drinks in places where kids learn, play, etc
A 3 year old can’t get to sleep
Recommend bedtime stories
Forgetfulness, weakness, falls, peripheral neuropathy
Pernicious anemia
Excessive menstrual bleeding and shortening of days between periods
Do CBC
Teenager with parents getting divorced
Recommend a mediator looking at the best interest of the teen and parents
Teen boy with gynecomastia
Idiopathic - reassure
Who should explain an injury to a patient? The person who caused the injury or the person who noticed
The one who caused it
Going from angry to sad affect
Labile
an official who is usually appointed by the government or by parliament to investigate complaints and attempt to resolve them, usually through recommendations or mediation.
Ombudsperson
This drug can cause bruising
Valproate
Pt in MVA with many fractures. Before putting in a catheter do this
DRE
45 year old with irregular heavy bleeding and endometrial biopsy showing benign hyperplasia
IUD
This antipsychotic can cause myocarditis
Clozapine
Antipsychotic that can cause stiffness and falls
Risperidone
Child with high glucose, high lipids and high BMI
Do urine albumin to creatinine ratio
Pregnant woman exposed to parvovirus
Order serum parvovirus immunoglobulin G and M
