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32 Cards in this Set
- Front
- Back
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Your pt. presents w/ facial flushing, sweating, shortness of breath and abdominal pain.
Lab shows elevated 5-HIAA. What is the most likely diagnosis? CML Ovarian cancer Carcinoid syndrome Small cell lung cancer |
Carcinoid syndrome
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Your pt. presents w/ facial flushing, sweating, shortness of breath and abdominal pain.
She also suffers occasional diarrhea. Lab shows elevated 5-HIAA. Her lesion is most likely: In the adrenal medulla Metastatic to the liver In the appendix In the small intestine In the adrenal cortex |
Metastatic to the liver
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Your pt. presents w/ a severe headache and complains of diplopia, with a left eyeball w/ down and outward gaze.
The left pupil is also dilated. Where is the aneurysm likely located? Left anterior cerebral artery Right anterior cerebral artery Left anterior communicating Left posterior communicating Left posterior cerebral |
Left posterior communicating
aneurysm in the posterior communicating artery can compress CN III |
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A 60 yo. pt. who worked for 25 years in a shipyard presents w/ dyspnea and cough.
Chest X-ray shows pleural plaques. Which of the follwoing is likely true? Smoking will increase his risk of malignant mesothelioma Lung biopsy will show diffuse alveolar damage Lung biopsy will stain positive w/ Prussian blue He has an increased risk of developing tuberculosis He likely has distant metastasis |
Lung biopsy will stain positive w/ Prussian blue
This pt. has ASBESTOSIS Asbestos fibers become coated w/ protein and iron and form FERRUGINOUS BODIES |
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What are the two choice drugs for Absent Seizures?
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Ethosuximide
Valproic Acid |
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A woman has an attack of status epilepticus. Being discharged from the E.R. she is placed on a drug to prevent further attacks. What is this drug?
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Phenytoin
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A patient is placed on a drug for prophylaxis treatment of status epilepticus and develops large, swollen gums. What is the name of this side effect, and what drug is the most ikely cause
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Gingival Hyperplasia
Phenytoin |
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Patient comes to the ER via amberlamce having a status epilepticus attack. What are the two choice drugs for an acute attack?
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Benzodiazepines
Lorazepam |
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Patieint presents to the clinic complaining of severe pain on the right side of her head with tic dulerou' what is the drug of choice?
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Carbamazepine
This is also the drug of choice for Tonic-Clonic seizures. Main side effects are Agranulocytosis and Aplastic Anemia Carbamazepine is also a potent INDUCER of P-450 |
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What is the first line treatment for seizures in a pregnant woman?
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Carbamazepine
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A 25 yo. sickle cell pt. presents to your clinic.
Which of the following is most likely associated w/ his condition? Hydrogen bonding aggregates hemoglobin when oxygen is low An increased risk for malaria An increased risk for pneumococcal pneumonia Osteomyelitis of the hip Spleen infection |
An increased risk for pneumococcal pneumonia
Sickle cell pts. develop asplenia resulting in increased risk of capsulated bacterial infections (SHiN) |
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Your 45 yo chronic alcoholic pt. presents with massive hematemesis and epigastric pain after going on a drinking binge over the weekend.
He has been vomiting large amounts of blood and his pressure is now 80/60 mmHg. Which of the following is the most likely cause of his hematemesis? Portal hypertension Gastric inflammation Mallory-Weiss tears peptic ulcer disease Iron deficiency |
Portal hypertension
The key is the severe blood loss leading to a blood pressure of 80/60 |
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Your AIDS pt. presents w/ a CD4 count of 50.
A bone marrow biopsy reveals granulomas and a culture that grows budding yeast at 37 degrees Celsius and a mold with hyphae at 25 degrees Celsius. Which of the following infectious agents is most likely? Aspergillus Mucor species Cryptococcus neoformans Crypotsporidium parvum Histoplasma capsulatum |
Histoplasma capsulatum
This is the only form that is DIMORPHIC |
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A new study claims to diagnose people with colon cancer earlier.
Their sample population included both men and women between 50 and 60 w/ a family history of colon cancer. The results concluded that people w/ colon cancer who underwent the test lived up to 5 years longer than those who did not. This study is invalid because: Confounding bias Selection bias Low statistical power Lead-time bias Experimenter expectancy |
Lead-time bias
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A 4 year old boy presents w/ a rash on his buttocks and extensor surface of his legs.
He also complains of severe abdominal pain. History reveals that he suffered an upper respiratory tract infection last week. Urine is positive for red blood cells. Renal biopsy would most likely show which of the following? Subepithelial deposits Spike and dome IgG deposits in the basement membrane Interstitial inflammation with eosinophils Normal findings IgA deposits in the mesangium |
IgA deposits in the mesangium
This child is suffering from HSP |
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A 52 yo female has a 3 year history of depression.
As the sypmtoms progress treatment is initiated which results in GI distress and anorgasmia. What medication was most likely prescribed? Amitryptiline Venlafaxine Buspirone Citralopram Trazadone |
Citralopram
Citalopram is an SSRI inhibitor It can cause ANORGASMIA!! |
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A 14 yo girl w/ CP is given Baclofen to help control her spasms.
Which of the following best describes the MOA of Baclofen? It blocks the release of calcium from the SR It is a competitive inhibitor at the neuromuscular junction It blocks sodium channels It binds GABA-a receptros and opens chloride channels It binds GABA-b receptors and reduces the release of excitatory neurotransmitters |
It binds GABA-b receptors and reduces the release of excitatory neurotransmitters
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A 4 yo child is brought to your clinic w/ complaints of poor ambulation and loss of fine motor skills.
Examination shows bitemporal hemianopia. An MRI reveals enamel-like calcifications and a benign tumor that is located supratentorally. What statement best describes the tumor? It is composed of Rosenthal fibers Solid rosettes of small blue cells are present The tumor contains foamy cells that are highly vascular There appears to be a "fried egg" appearance on histology The tumor is a remnant of Rathke's pouch |
The tumor is a remnant of Rathke's pouch = Craniopharyngioma
A = Pilocytic astrocytoma B = Medulloblastoma C = Hemangioblastoma D = Oligodendroglioma |
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A 55 yo man presents w/ dull epigastric pain that worsens 2 hours after meals.
Stool is positive for occult blood. Antacids slightly improve his symptoms. Which of the following drugs is contraindicated? Corticosteroids Sucralfate Acetaminophen ACE inhibitors Meperidine |
Corticosteroids
Acetaminophen is a very weak COX inhibitor and would be 2nd in line |
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A pt. presents w/ pain patterns classic of kidney stones.
A CT scan reveals a stone in the ureter. Analysis of the stone shows it to contain magnesium-ammonium-phosphate. Which of the following organisms would have most likely caused this? E. Coli Neisseria Enterococcus faecalis Bacteroides fragilis Proteus mirabilis |
Proteus mirabilis
Protease-producing organisms can produce radiopaque (radiodense) stones at high pHs (>7.2) Protease bugs include: Proteus, Pseudomonas, Klebsiella, Staph, & Mycoplasma Radiolucent stones are NOT produced by urease positive bugs They are produced by hyperuricemia and high cell turnover (cancer) |
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Name the drugs which can cause Steven's Johnson Syndrome?
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"SAPPLE"
Sulfa drugs Allopurinol Phenobarbital Phenytoin Lamotrigene Ethosuximide |
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A Hep B pt presents w/ complaints of abdominal pain.
Ultrasound shows enlarged lymph nodes in the hepatoduodenal ligament. The structure at the highest risk for being affected is the: Remnant of the umbilical vein Portal triad Hepatic vein Recurrent laryngeal nerve Hepatic bile duct |
Portal triad
The portal triad is housed within the hepatoduodenal ligament |
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Your patient presents w/ leg pain.
Which of the following drugs would be most helpful? Naproxen Nitroglycerine Propranolol Diazepam Cilostazol |
Cilostazol
Cilostazol is a phosphodiesterase inhibitor thus increasing cAMP. It also decreases platelet aggregation. |
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Your AIDS patient develops influenza A.
Which of the following is true regarding antiviral treatment for influenza? Amantadine is effective against influenza A and B Antiviral treatment is only effective if initiated in the first 16 hours Rimantadine is contraindicated in liver failure Amantadine is a neuraminidase inhibitor Amantadine is contraindicated in liver failure |
Rimantadine is contraindicated in liver failure
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A 50 yo pt. presents w/ a unilateral, periorbital headache that came on suddenly.
Physical exam reveals a constricted right pupil and dry, flushed facial skin on the right. In which of the following foramina can the nerve(s) responsible for his symptoms be found? Jugular foramen Superior orbital fissure Internal auditory meatus Foramen spinosum Carotid canal |
Carotid canal
Horner's syndrome involves a lesion to the nerve as it passes through the carotid canal to cause damage that covers a larger area than just the eye |
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A 27 yo black male presents w/ a painful vesicular lesion on his penis and his intergluteal cleft.
Which of the following best describes the mechanism of the drug of choice? Binding to the 30s ribosomal subunit Inhibition of cell wall synthesis Binding to DNA-dependent RNA polymerase Binding to the 50s ribosomal subunit Inhibiting DNA polymerase |
Inhibiting DNA polymerase
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A 65 yo female presents w/ anorexia, nausea, and confusion.
She has had poorly controlled diabetes for 35 years. PE shows HTN and pitting edema. Labs show potassium of 5.8, creatinine of 5.5, and hemoglobin of 10.0. Which of the following will most likely be found on urinalysis? Broad, waxy casts Red blood cell casts Hematuria Brown muddy casts White blood cell casts |
Broad, waxy casts
This pt. is in chronic renal failure as indicated by her lab results Poorly controlled diabetes can lead to renal failure |
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A 25 yo female presents w/ ptosis, diplopia and weakness.
Repetitive nerve stimulation shows increased muscle fatigue. A diagnosis of MG is suspected. Which of the following additional findings is most likely? Elevated TSH Hyperplasia of the thymus Lung mass Neck mass Antibodies against calcium channels |
Hyperplasia of the thymus
Lung mass is associated w/ Lambert-Eaton syndrome |
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A 32 yo male comes to your office complaining of weakness of both of his legs symmetrically.
He says it started with his toes and over the past 48 hours it has spread upwards and he is concerned. What type of hypersensitivity is this? Type 1 Type 2 Type 3 Type 4 |
Type 4
Guillain Barre is a type 4 delayed type reaction Guillain Barre is caused by an initial exposure to Campylobacter Jejuni which is going to sensitize CD4 T Cells, which leads to a Type 4 hypersensitivity |
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A G2P2 23 yo black female presents with menorrhagia for 2 months duration.
Ultrasound reveals uterine fibroids. The pt. elects myomectomy because she still wishes to have children. Which of the following meds would be best to help reduce the size of her fibroids prior to surgery? Leuprolide Estrogen Medication is contraindicated Tamoxifen Progestins |
Leuprolide
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A 65 yo male w/ a 50 pack year history of ciagrette smoking presents w/ hemoptysis and dyspnea.
Chest X-ray shows a lung mass. Labs show hyponatremia and elevated corticosteroids. Which of the following can be used to manage his hyponatremia? Carbamazepine Lithium Desmopressin Spironolactone Democlocycline |
Democlocycline
This pt. is suffering from SIADH. Demococycline is a Tetracycline which has the side effect of blocking the ADH receptor Lithium is another option for SIADH treatment; however it is rarely used since it is too toxic |
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An 8 yo black girl presents w/ severe pain in her arms, legs, fingers and toes.
The pain started 2 days ago without any relief. Which of the following would be most suitable in treating her disease? Fresh frozen plasma Hydroxyurea Erythropoeitin Vitamin K Clopidogrel |
Hydroxyurea
Hydroxyurea is the DOC for Sickle Cell |
