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21 Cards in this Set

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In which plane, around which axis does sidebending occur?
Coronal plane around an Anterior-Posterior axis
If your patient were to rupture their extensor tendon in their finger and he/she was unable to extend their distal phalanx, what type of deformity would they be suffering from?
Mallet Finger
A 6 year old boy presents in your clinic with decreased motion of his hip and knee pain.
Passive motion of his hip is guarded, but extension of the knee is normal.
What is the most likely cause of his problems?
Avascular necrosis of the capital femoral epiphysis

Avascular necrosis occurs typically in this age group and has a preference for boys
A chubby 13 yo boy comes to your clinic with hip pain.
He is unable to internally rotate the hip.
What is the most likely cause?
Slipped capital femoral epiphysis
What is the mechanism of the antipyretic properties of acetaminophen?
Prostaglandin inhibition
Pt. presents with painful ulcerations in her mouth as well as flaccid blisters of the scalp & trunk.
Nikolsky sign is positive.
Vesicles are shown in the epidermis slightly above the basal layer.

What is the diagnosis?
Pemphigus vulgaris
Pt. presents with painful ulcerations over his scalp & trunk.
Nikolsky sign is negative.
Vesicles are shown below the basal layer.

What is the diagnosis?
Bullous pemphigoind
Your patient presents with massive splenomegaly & a peripheral smear stains positive for tartrate-resistant acid phosphatase.

What are the most likely causes of splenomegaly in this case?

What is the most likely diagnosis?
Splenomegaly causes in this patient:

CML or Hairy Cell Leukemia (HCL)

Most likely diagnosis:

HCL
Tartrate-resistant acid phosphate is pathomnemonic for HCL
A pt. presents to the ER w/ suspected OD on acetaminophen.
What are the phases of respiratory/metabolic acidosis/alkalosis involved w/ OD?

Early respiratory or metabolic acidosis or alkalosis followed by late respiratory or metabolic acidosis or alkalosis?
Early respiratory alkalosis followed by late metabolic acidosis

Salicylates stimulate the central respiratory pathways causing an initial respiratory alkalosis whici is later follwed by a metabolic acidosis due to the ketosis which develops due to overwhelming CYP450 metabolism
A 2 year old boy presents in your clinic 10 days after a respiratory infection.
Physical exam reveals a petechial rash over his trunk, back and all extremities.
Labs reveal a Hgb of 11.6, WBC of 9,000, Lymphocytes of 65% & PLTs of 11,000.

What is the most likely diagnosis?
ITP

ITP often follows a viral infection and is characterized by low PLT count w/ a normal WBC count
Where would you apply pressure (angle, midaxillary line, midclavicular line) and for what period of time would you hold for an inhalation dysfunction to rib 6?
Angle of the rib for 2 minutes

Inhalation dysfunctions require pressure to the angle

Exhalation dysfunctions require pressure to the midaxillary line
What is the drug of choice for a pt. whose chest X-ray reveals diffuse infiltrates bilateraly?
Erythromycin

Diffuse infiltrates bilateraly is a BUZZ for Alveolar Pneumonia

Causative agent = M. Pneumonia
What is the drug of choice for a pt. whose chest X-ray reveals lobular infiltrates in a single field?
Penicillin

Lobular pneumonia is a BUZZ for Bacterial Pneumonia

Causative agent = S. Pneumonia
A 35 yo female presents w/ a cough for several days and no other symptoms. Which of the following would be the most appropriate antitussive drug?

Codeine
Diphenoxylate
Fentanyl
Methadone
Morphine
Codeine

Codeine is an opioid
Opioids are classified as analgesic, antitussive or antidiarrheal
Codeine has antitussive & analgesic effects, leading to abuse

Dextromethorphan is an opioid which has only antitussive effects and no abuse side effects
A 40 yo black female presents w/ shortness of breath w/ exertion.
A chest X-ray reveals bilateral hilar lucencies.
Lab studies show elevated serum ACE and elevated serum calcium.

What is her likely diagnosis and what might you see on a lung biopsy?
Diagnosis = Sarcoidosis
Biopsy = Noncaseating Granulomas

Sarcoid BUZZ words:
Black female
Widespread noncaseating granulomas containing calclium and "Schaumann bodies", and asteroid bodies
Elevated serum ACE & hypercalcemia
Erythema nodosum
Bell's palsy
Bilateral hilar adenopathy
What is ibuprofan's MOA?
Inhibits COX-1&2 resulting in decreased PG synthesis
What is Celecoxib's MOA?
Inhibits ONLY COX-2 thus inhibiting the inflammatory effects of PG but not causing any GI adverse effects
What is the MOA of Zafirlukast & Zilueton?
Zileuton inhibits 5-Lipoxygenase, resulting in decreased LT synthesis

Zafirlukast (& Montelukast) inhibits CytLT1 resulting in decreased Bronchoconstriction
How do Corticosteroids accomplish their anti-inflammatory effects?
By inhibiting Phospholipase A2, resulting in decreased Arachadonic Acid production from membrane lipids
A 17 year old boy who has suffered chronic middle ear infections his entire life presents to your clinic.
On examination of his ear you now notice a small mass behind his eardrum.
What is the most likely diagnosis?
Cholesteatoma

Pts. who have chronic middle ear infections are prone to the development of abnormal skin-like tissue through the eardrum, termed cholestatoma.

This can eventually lead to damage to the bones & tissue of the middle ear, causing hearing loss
Which feature of the urine dipstick would you expect to be positive in a patient w/ suspected UTI?

Bili
Nitrite
Protein
Ketone
Glucose
Nitrite