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37 Cards in this Set
- Front
- Back
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Retinoblastoma is associated w/ which other form of cancer (other than retinal)?
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Osteosarcoma
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A patient is stabbed in the chest at the right, 5th intercostal space.
The hemothorax is drained and 1500 ml of blood is collected. What is the most likely source of the bleeding? |
Intercostal Vessel
Intercostal laceration will generally result in 500 - 1500 or more ml of blood collecting in the thoracic cavity Lung parenchymal laceration will result in <500 ml of blood collecting |
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A pt. w/ chronic somatic dysfunction at T4 presents.
T4 is the anatomical landmark for which of the following: Inferior angle of the scapula Spine of the scapula Sternal angle Sternal notch Umbilicus |
Sternal angle
Inferior angle of the scapula = T7 Spine of the scapula = T3 Sternal angle = T2 Umbilicus = T10 |
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A 55 yo woman is being evaluated for protracted diarrhea.
She also complains of facial flushing and expiratory wheezing. She shows signs of JVD & a systolic murmur heard best over the xyphoid process. Which lab test would best confirm your diagnosis? Glucagon levels Gastrin levels 5-Hydroxy-indoleacetic acid (5-HIAA) Stool culture for TB Urinary catecholamines |
5-HIAA
This patient shows signs of Carcinoid Syndrome ("CDC BS" - Cutaneous flushing, Diarrhea, Colicky pain, Bronchospasm, Sweating) Glucagon levels would confirm a glucagonoma - which would produce severe necrolytic migratory dermatitis Gastrin levels would confirm a gastrinoma - which would show more signs of peptic ucler disease Stool TB would confirm interstitial TB which is very rare in the US Urinary catecholamines confirm the diagnosis of Pheochromocytoma (5 P's - palpitations, pallor, perspiration, pain, pressure) |
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A patient presents w/ wigns of Wilson's disease (splenomegaly, multiple neurologic deficits & grayish-green discoloration of the superior & inferior poles of the cornea).
Which transport protein could you test for to confirm the level of defect in this patient? |
Ceruloplasmin - Transport protein responsible for transporting Copper
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Which direction does the sacral base move during sacral nutation?
Which direction does the sacral base move during cranial flexion? |
Sacral base moves ANTERIOR during nutation (coccyx moves posterior)
Sacral base moves POSTERIOR during cranial flexion (coccyx moves anterior) |
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54 yo pt presents to the ER w/ bronze colored skin, chest pain, and diabetes mellitus.
What is the most likely diagnosis? |
Hemochromatosis
Characterized by Cirrhosis, DM, & skin pigmentation (bronze diabetes) Hemochromatosis is caused by iron deposition in the skin |
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A 45 yo woman is being treated for pancreatic cancer.
She now complains of sudden development of a sharp pain in her right calf, which is mildly enlarged, with slight warmth. She has a diminished dorsalis pedis pulse. What is the most likely diagnosis? |
DVT
DVT is characterized by: pain, warmth, and mild enlargement leading to diminshment of pulses Pancreatic cancer predisposes pts. to DIC |
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A 45 yo woman is being treated for pancreatic cancer.
She now complains of sudden development of a intense pain in her right calf, which is cool to the touch. She has a developed pulselessness of the dorsalis pedis pulse. What is the most likely diagnosis? |
Arterial embolus
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A pateint presents w/ ipsilateral miosis, ptosis, anhidrosis, and paralysis of the wrist and hand.
Where is the lesion likely located? What would be your diagnosis? |
Lesion location: C8-T1
Diagnosis: Klumpke's Palsy |
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What is the mnemonic for Rheumatic Fever?
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STREP PEACE
Sydenham's chorea Transient arthritis Rheumatoid nodules Erythema marginatum Pancarditis Prolonged PR Elevated ESR Arthralgia CRP Elevated temp |
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A woman presents in the ER after falling on her forearm.
X-rays are negative but physical exam reveals an increased carrying angle and resistance to lateral glide. What would be your diagnosis? |
Ulnar abduction (distal ulna)
Wrist/Hand adduction |
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Chapman point at L1 indicates what?
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Kidney pathology
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Chapman point at L2 indicates what?
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Abdominal or bladder pathology
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Chapman point at L3 indicates what?
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Urethral pathology
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Chapman point at T11 indicates what?
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Adrenal pathology
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Chapman point at T12 indicates what?
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Appendical pathology
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The temporal bone (and other paired bones) rotates about what axis?
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Vertical axis
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A patient complains of constant, high-pitched buzzing in their ear.
Which direction would you expect their temporal bone to be rotated? |
Internal rotation
Internal rotation of the temporal bones results in HIGH-PITCHED ringing External rotation results in low-pitched ringing |
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A patient complains of constant, low-pitched buzzing in their ear.
Which direction would you expect their temporal bone to be rotated? |
External rotation
External rotation of the temporal bones results in LOW-PITCHED ringing internal rotation results in high-pitched ringing |
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A patient presents following a motorcycle accident.
Examination of his ears reveals blood behind the eardrum (hemotympanum). Hemotympanum is a sign of what? |
Basilar skull fracture
Basilar skull fractures are fractures to the Temporal, Sphenoidal, Ethmoidal, or Occipital bones Basilar fractures may also demonstrate clear otorrhea (CSF), clear rhinorrhea, and racoon eyes (periorbital ecchymosis) |
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A 35 year old carpenter presents in your clinic complaining of pain in both of his hands after having them raised over his head for extended periods of time.
He states the pain goes away when he hangs his hands at his sides. What is the most likely diagnosis? |
Thoracic outlet syndrome
Nerve root impingement would not be relieved by lowering the arms. The diagnosis can be confirmed by hyperabduction testing The Pec. Minor may be hypertonic leading to the numbness sensation in the hands |
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Describe a claw toe
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Claw toe has a flexed PIP & DIP w/ a hyperextended metatarsophalangeal joint
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Describe a hammer toe
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Hammer toe has a flexed PIP & extended DIP w/ a hyperextended metatarsophalangeal joint
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A 17 year old boy complains of RUQ pain and high fever.
He has emergency surgery to remove his gallbladder. Gall stones are noted to be dark brown & faceted. What would cause these gall stones? |
Dark brown gallstones are caused by hemolytic diseases (sickle cell etc.)
Yellow gallstones are caused by cholesterol issues |
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A mother presents w/ her 4 year old child and complains that she has noticed that the child experiences brief staring spells, during which time she does not respond to stimuli.
Each spell lasts about 30 seconds. If ethosuximide is not an option to treat this child, which other agent would be your top choice? |
Valproic Acid
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A 26 week G1P1 patient presents to the ER complaining of excruciating pain and vaginal bleeding.
What is your initial diagnosis? |
Abruptio placentae or premature seperation of the placenta from the uterine wall
Only 2 things cause 3rd trimester bleeding - Abruptio Placentae & Placenta Previa PAIN distinguishes the two (Abruptio presents w/ pain & Previa does NOT) |
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A football player sustains a fracture to the proximal half of his radius.
He holds the arm in the pronated position, but care must be taken to supinate it before casting it. Why is this important? |
A fracture at the proximal site of the radius seperates the pronator muscles (pronator teres & quadratus) & the supinator muscles (biceps brachii & supinator).
The distal pronators will pronate the arm w/ out opposition & the proximal supinators will supinate the arm w/ out opposition. Thus it is crucial to supinate the distal forearm before casting it to ensure correct alignment |
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Which of the following parasites would cause intense skin itching & a serpingous eruption?
Ancylostoma braziliense Ascaris lumbrcoides Enterobius vermicularis Necator americanus |
Ancylostoma braziliense
Necator causes pneumonitis |
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Which of the following parasites is described as a filariform larva that penetrates intact skin of bare feet & causes pneumonitis?
Ancylostoma braziliense Ascaris lumbrcoides Enterobius vermicularis Necator americanus |
Necator americanus
Ancylostoma causes intense itching & a serpingous eruption |
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A 10 month old is brought into your clinic by his mother who complains of a pruiritic skin lesion that has a chronic fluctuating coarse.
The lesions are erythematous, papulovesicular & exudative. The infant continuously scratches the lesions which has exacerbated it. Corticosteroids provided moderate relief. Where else would you expect to find these lesions: Back Cheeks Scalp Chest Groin |
Cheeks
The child is suffering from atrophic dermatitis (i.e. eczema) Atrophic dermatitis affects the extensor surfaces and cheeks first |
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Your patient presents complaining of discomfort in her legs when she tries to sleep at night.
She can't describe it well but says she finds temporary relief by moving her legs. Which of the following would be best to treat her: Chloral hydrate Clomipramine Dextroamphetamine Pramipexol Quinine sulfate |
Pramipexol - Dopamine agonist
Cabergoline is another D agonist that may be an option Chloral hydrate = hypnotic for insomnia Clomipramine = antidepressant for narcolepsy Dextroamphetamine = stimulant for narcolepsy Quinine sulfate = treatment for leg cramps |
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A student athlete presets for an annual sports physical.
Normal sagittal plane postural findings would include which of the following: Plumb line passes anterior to the apex of the coronal suture Plumb line passes anterior to the axis of the hip joint Plumb line passes posterior to the knee joint Plumb line passes posterior to the lateral malleolus Plumb line passes through the auditory meatus |
Plumb line passes through the auditory meatus
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A 60 yo male complains of fatigue, low back pain, and pain at specific places on several bones.
X-ray films show multiple sharply defined lytic lesions throughout the skeleton. Which of the following would most likely be expected on further tests: Bence-Jones proteins in the urine Cytlogic evidence of Ewing sarcoma Cytlogic evidence of osteosarcoma Elevated serum levels of prostatic specific antigen High serum levels of acid phosphatase |
Bence-Jones protein in the urine
Bence-Jones proteins are found in Multiple Myeloma and Lymphocytic Leukemias & Lymphomas Primarily pathomnemonic for Multiple Myeloma Think Multiple Myeloma whenever you read multiple lytic bone lesions Ewing sarcoma & osteosarcoma are wrong because both of these occur in younger people Elevated PSA & Acid Phosphatase are associated w/ widespread metastatic prostatic cancer |
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Your patient was recently diagnosed w/ Multiple Myeloma.
What would be your next step in your evaluation: Lymph node biopsy MRI of the lumbar spine Radionuclide bone scan Serum protein electrophoresis Transrectal prostate biopsy |
Serum protein electrophoresis
This is the hallmark test for multiple myeloma This would show monoclonal spikes at the beta or gamma globulin region |
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Which of the following would be of great concern in your patient w/ Multiple Myeloma:
Anuria Avascular necrosis of bone Hepatic failure Peripheral neuropathy Renal failure |
Renal failure
Anuria is associated w/ an enlarged prostate Avascular necrosis would be associated w/ osteosarcoma, Ewing sarcoma or other bone malignancies Hepatic failure is not a complication of multiple myeloma Peripheral neuropathy may develop if you treated the patient w/ methotrexate but it is not a direct complication of the disease itself |
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Your patient's CBC and peripheral blood smear suggest that he has myeloproliferative disorder.
He will have the greatest probability of progressing to AML if he is diagnosed w/ which of the following: Agnogenic myeloid metaplasia Chronic myelofibrosis Chronic myeloid leukemia Essential thrombocytopenia Polycythemia vera |
Chronic myeloid leukemia
Pts. w/ CML have a 70% chance of developing AML |
