Wrong Question Flashcards
what over the counter medication can cause hepatotoxcitiy
NIACIN tablet
Red yeast rice what blood should be moinotored
LIVER ENZYMS
ovarian cancer screening
No recommendation is recommended
Tx wandering in a patient with ALZIEMERS
anticohlinergics
DO not give benzos unless agitated incoming etc
Zollinger Ellison syngrome
peptic ulcers increase GASTRIN SECRETION and a tumour in the pancreas (gastronome) also get HYPERCALCEMIA
Dx Zollinger Ellison syngrome
measure gastrin levels
most frequent cause of ventricular rupture
Necrosis due to artery obstruction
Increase PTT, normal INR , bleeding from nose and bruising both male and female members of the family
von Hillebrand disease
hypoglycemic agent that acts on both alpha and beta blockers used with Metformin
SITAGLIPTIN
prophylaxis for meningococcus for close contacts and pregnant women
Close contact - 4 doses of rifampin every 12 hours
Pregnant women - IM ceftriaxone
inability to birng teeth together properly, visual disturbances and clear nasal discharge due to what fracture
MAXILLARY FRActure
Perioperative ventricular arrhythmia GREATEST risk factor
congestive heart failure
feeling of dread and apprehensive expectations
ANXIety
Treatment of acute gout
Indometocin (DO NOT TAKE IF ON WAFARIN)
OR
Colchicine
herpes gential infection transmission
Suppressive therapy can REDUCE transmission to sexual partner (acyclivir, famciclovir)
tennis elbow dx
lateral epicondylitits best DX PHYSICAL EXAM AND HISTORY
no lactation after birth
SHEEHAN SYNDROME
- all pituitary hormones decreased
Aldosterone = uneffective
Megestrol what is it?
it is a progesterone analogue
USED In breast cancer and ALSO can be used as an appetite stimulant
MOA: results in adrenal SUPPRESION
COMMON risk factor for retinal detachment
Posterior detachment of the virtuous
what eye condition will NOT require ophthalmology appointment
BACTERIAL CONGUnctiVITIS
type of nonthrombocytopenia purpura
hSp
MOST common cause of fistula in an
Rectal absecess
treadmill arterial flow study showing a 20 mmHG decrease in ankle systolic blood pressure immediately following exercise
PVD
decrease in ABI
PVD
LOUD SOUNDS without ear protection clinical
Sensory hearing loss and tinnitus
How many hours or days will antibiotics help prevent thematic fever after having Group a strep throat
9 DAYS
what symptom is not produced with antipsychotic drugs
tremor at rest
pauci articular juvenille arteritis is ass. w/
UVEITIS
Tx SVT
Verapamil
What headache is ALWAYS UNILATERAL
cluster headache
MOA respiradone
Dopamine receptor antagonist
hypertrophic cardiomyopathy
cause of sudden death
Flumazenil used for
Benzodiazepine
Overdose is acute and there is NO chronic dependance in alcoholic
treatment RSV
OXYGEN
what do you give to prevent contrast induced nephropathy
isotonic bicarbonate infusion
SOB and cough HTN digital clubbig , fine bisilar inspiratory crackles
Idiopathic pulm fibrosis
1 treatment of PVD
STRICT EXERCISE PROGRAM
What is NOT a Dx of viral labyrinths
Otorrhea
Guttate psoriasis
You get after Group A beta streptococcal infection
dark urine and foot edema THINK
GN - therefore red blood cell cast
Starvation anionion gap
INCREASE ANION GAP
Diarhearra anion gap
metabolic acidosis
asthma - uses SABA once per week - what treatment should she get now
NO CHANGE IN MEDS - only mild asthma
multiple tender shotty nodules that are immovable in the breast
Fibrocystic disease of the breast
highly movable non tender masses in breast
FIRBOADENOMA
1 cm ulceration on exocervix - What treatment do u do
punch biopsy
feeding tube in Alzhiemers - benefit
NONe has been shown
what test do you do for the initial test for ALzhiemers
TSH
- b/c hyper or hypo thyroids can mimic alshimers in elderly patients
duration of anticoagulant treatment in each case :
First DVT w/ transient risk factor
First episode DVT with ongoing risk factor such as cancer pr antiphosphlipid antibiody or more than one risk factor
recurrent DVT
first episode with no identifiable risk factors or inherited risk factor (FVL)
First Dvt w/ transient risk factor - 3 month
First episode DVT with ongoing risk factor such as cancer pr antiphosphlipid antibiody or more than one risk factor - LIFELONE
recurrent DVT - idenfinite
first episode with no identifiable risk factors or inherited risk factor (FVL) - 6-12 month
leading cause of eyrsipela
GROUP A SSTREP PYROGEN
initial dose of Ldopa in Parkinsons
100mg tablet THREE times a day = 300mg per day
best test to determine if patient has denentia or not
Mini mental state exam
2.5-15 hypoechoic cyst
NORMAL _ recheck 8 months
flashing lights in one eye - 74 year old healthy man what does he have?
Retintal detachment
when do you get mirgraine syndrome
8th decade - where you get virtuous floaters and ARE referred to as SPOTS (not lights - cause that would be retinal detachment )
meripenime
decreases 5HT release
suspect an MI
get EKG and troponin levels
Dx of renal agenesis
Renal doppler US
Smoking withdrawal symptoms
Insomnia
impaired conecntration
testies pain improves when elevated
epididymis
extensor tendon injury
patient can not actively extended the joint but passive extension is possible
treatment of extensor tendon injury
Splinting for 6 weeks
If not treated correctly or delayed then a boutonniere deformity can result
After treatment of H.pylori how many months does it take for the results of urea breath test to be negative
6-12 months to turn negative
Phaeochromocytome usually occurs in …
THIN PATIENTS
xerosis
Pathological dryness of the skin
In elederly
worse in winter time , low humidity and low temperature
PAIN IN BIG TOE BUT NOT GOUT THINK
Sesamoid bone fracture
verterbal compression fracture
- measured conservatively - DECREASE IN ACTIVITY until pain is gone
- IF PAIN does not go in 2 weeks… then you want to do vertebroblast
Side effect of timolol for glaucoma
BRONCHOSPASM
respiratory use
Some medical conditions are adversely affected by respiratory use
ISOLATED SYSTOLIC HTN TX
hydrochlorothiazide
cotyledons - how to Dx
inspect maternal placenta
How to Dx succenturiate placenta
inspect the fetal placenta aide (this means an entire lobe
buckle fractures have a high incidence of on union
FALSE
OCP with continuous bleeding
ADD NSAID
hypertenssion secondary to pseudoephedrine and MAO inhibitor how go treat
STOP PSEUDOEPHEDRINE
patient that remains hypotensive after fluids are administered
YOU wANT TO TREAT WITH NOREPINEPHRINE infusion then correct whatever clinically is causing it (ex. PE)
saddle shaped extension into both pulmonary arteries with widen mediastinum TX
think its a PE
want to do an embolectomy
bright light therapy is good for what sleep disorder
shift night insomnia
tourettes
is a tic disorder that begins in childhood
what has the greatest risk of endometrial carcinoma
THINK PCOS
what vitamin is produced endogneously
VIT D and K
what cardiac cause can chronic alcohol abuse lead to
DILATED CARDIOPMYOPATHY
what drug can cause a false decrease PSA level
finasteride
recurrent pneumonia in 3 year old … think
CYSTIC FIBROSIS
Fournier gangrene Tx
THIS IS an example of necrotizing facts of the perineal peianal or genital area best treatment with IV CIPROFLOXACIN
loss of vaiablitiy on CTG .. what next
DO A biophySIcAL PROFILE
IBS tx
Loperamide
past Hx of schizophrenia … what makes u re-evaluate the patient
ELATED MOOD
Long term complication of heamochromatosis leads to cirrhosis which leads to
PORTAL HTN Schistosomiasis and hepatic vascular abnormalitis
Mode of adheradace of Huntigtons
What % will male children will be affected if dad has
ADOSOMAL DOMINANT
50% chance they will have sons and then a 50% chance they will get the disease
0.5X 0.5 = 25%
How to distinguish depressive symptoms from metastatic disease
WITHDRAWAL FROM FAMILY
grandmother has TB and dies… what test do you do in family
PPD testing in rest of family
Flattening of inspiratory loop of the flow volume loop but NORMAL expiratory phase
THINK vocal cord disfunction
treatment hypercalcemia
normal saline iV
postpartum urinary retension
discharge with caterer in place and close follow up
what is not ass. w/ psychogenic amnesia …
Moderate to devere anterograde amnesia
opisthotonus in newborn - is when the body is held in an abnormally extended position how do you tx
this is due to pathological jaundice - UCB - and therefore you want to initial exchange transfusion
Does Conjugated (direct) bilirubin cause BIND - bilirubin induced neurologic dysfunction - >340 mol/l known as vigitiphobia because of its concerning association with neurologic disorder
NO
BIND is tx with exchange transfusion (caused by UCB )
what antibiotic causes esophagitis in elderly
TETRACYCLINE
what animal do you not need to protect against if concerned about rabies
any small rodents (rats, mice or squirls)
Chronic adominal pain is ass. w/
type A personality with chronic ado pain - stress related
lower limb deem, bilateral basilar lung crackles, SOB and diaphoresis Hx of diabetes and 2 MI what do you treat him with
He is having pulmonary oedema - due to the increase capillary hydrostatic pressure secondary to the elevated pulmonary venous pressure
tx with nitroglycerin - preload reduction, after load reduction and ionotropic support
Never give what during an acute exacerbation of negative ionotropism
BETA BLOCKERS
toddlers diarrhea is NOT ass. w/
failure to thrive
Marphans - what screening
ECHO - every 6 months
placed on a b-blocker
history of shingles 3 weeks ago… and the patient has recurrent pain how do you t
think it is postherpetic neuralgia and therefore tx with nortriptyline
sleep problem that occurs in second half of sleep
NIGHTMARES
When are tears produced …
tears are not produced till 3 months of age and therefore a blocked nasolacimal duct usually becomes apparent after 1 month of age
what gender is at higher risk of developing tardive dyskinesia
FEAMLE GENDER (males can get it to though just at lower risk)
empirical treatment of osteomylitits
IV VANCOMYCIN (not naficillin)
solitary node in lung - next step
take biopsy
acute bronchitis how long does cough last for
2 weeks and up to 20 days
1 test for urolithiasis
unenhanced helical CT scan of the abdomen and pelvis
acceptable chemoprophylaxis indicated for n.mennigitids
Ciprofloxacin (not okay if
in elderly what is the number one cause of incontinence
DETRUSOR INSTABILITY
77 year old man with urinary incontinence - no change with cough sneeze, has a smooth large prostate without irregularity what is the cause of incontinince
detrusor instability
most serve sign of pancreatitis is
HYPOCALCEMIA - because means saponification is caused by release of fatty acids
treatment of condylomata acuminated
CRYOTHERAPHY
PPD test without clinical X-ray finding tx with
menas latent TB
treat with 9 months of isoniazid
PSA test
best used for seeing disease progression and recurrence after post-operatively
Short stature case that may need further evaluation
prepubescent testicular soze
peak level of BHCG
Week 8-10
cray of neonate RSV
Air broncograms
absolute contraindication to HRT
Acute / severe liver disease
elevate levels of what is ass. w/ increase risk of atherosclerosis
homocysteine
what drug can cause hyperthyroidism
Amiodarone
tx of ankle sprain
semi rigid stirup brace
MIBI scan what is it
Thallium and technetium Tc 99 sestamibi scan that - GOOD FOR PATIENTS WITH LIMITATIONG IN EXERCISE with normal ECG and chest pain
why treat strep pharyngitis
want to decrease risk of getting scalet fever
bite by someone who suspected to have HIV
you should draw blood and test HIV
nicotine leads to an increase in
GLUCOSE
HDL
nicotine tends to lover
serum cholesterol LDL serum TG
What Sx has a highest risk of MI post sx
FEMOROPOPLITEAL Bypass
if patient has high calcium… what lab value would diagnose a cause other than hyperparathyroidism
Low 24 hour urine calcium
this would be a finding in familial hypocalciutic hypercalcemia
What test does not need to be done for turners
MRI of brain
IV oral chelation
only wheh >70
ORAL CHELATION
45-69
WHEN DOES VIRAL SHEEDING occur in norwalk
viral sheeding occurs long after acute illness
suspected pneumonia in neonate 1st test
Oxygen saturation by pulse oximetry
crying fussy child
flurescein strip should be performed to exclude corneal abration
anxiety towards strangers happens at what age
6 months
proteinuria and puffy eyes kids
NEPHROTIC SYNDROME
they will also have high cholesterol
MCC of neonatal death if mom had diabetes before pregnancy
Congenital abnormalitis
tx celiac skin problem
Daspone
What should injury is most serious and life threatening
SC joint
1 cause of pneumonia in 6 month old
RSV
when is tocolysis contraindicatied
when the cervix is dilated 3cm
after delivery when does a mother get her menstrual cycle if she is not breast feeding
3 months
tc hirtuisim in PCOS
spirolactone
left lower ado pain, pelvic US best diagnosis what
Adnexal torsion
if last period was April 17 when is the patient due
negate rule = 9 months + 7 days =- JANUARY 24
treatment of pyelonephritis in pregnancy
IV Ceftriaxone
AGUS - most likely what
CIN
unilateral varoceile on the right
requires more investigation
high INR slightly high aPTT with normal bleeding time
vit K disorder
INR always slightly higher
perforation of the apendendix ten days later fever, pain
pelvic absess
tenderness of radial head without swelling - FOSH
radial fracture - put in posterior split and rex-ray 1-2 weeks
patient with a previous postoperative venous thromboembolism is at risk of another after another Sx therefore what do u do
Start subcutaneous enoxaparin (Lovenox) 1-2 hour prior to surgery and once a day after surgery
4mm stone but the patient is vomitting what do you do
Admit and hospital medical management
fluroscenin staining is negative with tearing and blurry vision
Think intraocular foreign body
not corneal abrasion - would have a positive fluroscein test
treatment of choice for massive heamatesis
Ensocopic ligation
nissen fundoplication is the treatment of choice for
GERD
extensor tendon injury when do you recommend sx
know as mallet finger
if they lack passive extension of DIP joint
flexor tendon injury - unable to flex at distal IPJ - what do you do
(know as jersey finger)
splint the finger
slightlu flexed position and urgerly refer hi to a hand surgery
treatment of ankle sprain
early range of motion exercise to maintain flexibility
best screening test for hemochromatosis
serum transferrin saturation
varicella vaccine recommendation
in anyone >60 to prevent PAIN and RECURRENCE of Shingles
what is the purpose of randimization in trails
to minimize bias between 2 groups
16 year old girl … does not live with her parents and has no contact with them who does consent
the girl does
hyperplastic polyp when to screen
10 years - they are concidered to have a normal colposcopy finding and therefore normal .
3 or more adenomatous polyps > 1cm how many years
3 years
1-2 adenomatous polyps
5 years
if sessile adenoma removed piecemeal should be re-examined when
6-12 month
face to face time with patients
concelling and coordinating care
age 50 – went to doctor for routine screening what test should he get first
stool for occult blood - every year
colposcopy 10 years
sigmoidotomy 5 years
screening at age 40
diabetest
screening at age 30
cholesterol
diverticulitis is recommended to increase fiber what other recommendations
NONE
relapses
usually recurrent and part of the change process
who should be screened for hepC
individuals with recurrent abnormal ALT
somatiziation disorder does not need to include
hx of depression or anxiety
what tx should be avoided in panic symptoms
buporpion
hx of narcolepsy what do you ass. w/ it
hallucination
what is the least likely hx of having in conversion disorder
childhood of stammering disorder
if patient is on benzo and she stops them
educate her on the importance of taking medication as percibed
buying impulsively plus history of depression
bipolar 11
acute delrium is treatmed with
IV haloperiodol in increasing doses every 30 mintues
recent hanging themself then get a history of long and short term memory loss think..
cerebral anoxia
bipolar diosry has psychosis despite treatment for depression or mania what is the dx
schizoaffective disorder
depression in elderly what do you have to do first
rule our secondary cause of depression
treatment of delirium
haloperiodol - may lessen agitation or pschyotic symptoms
