2-Full Faid

Front 1

Management of Afib

Back 1

ABCD (Anticoag, BB, Cardio/CCB, Dig)

Front 2

MCC 2nd dilated heart

Back 2

HTN and Ischemia

Front 3

S3 gallop means

Back 3

end of rapid ventricular filling in setting of fluid overload DT DILATED

Front 4

Paroxysmal atrial tach..MOA...rate...tx

Back 4

Rapid ectopic pace in atrium (not p)...rate>100, P wave unusual...adenosine can unmuask the underlying atrial activity

Front 5

Torsades usually DT

Back 5

QT syndrome, hypok...tx: tx hypok., give Mg then shock if unstable

Front 6

Atopic dermatitis aka and Moa

Back 6

eczema...seen in kids: scratch → lichenification...DT nongenitic trigges

Front 7

Atopic dermatitis assoc w....dx by?

Back 7

Asthma , allergic rhinitis...eosipho, IgE?...tx: non dry soaps, moisturizers

Front 8

contact dermatitis need? MOA...dx by

Back 8

previous sensiti (type 4)..,langerhans cell on skin pic up crap and go to LN, expose it to Tcells...dx by: PATCH TEST (shows causating allergen)

Front 9

Type 1 vs. type2.3.4

Back 9

2, 3, 4= All Ab mediated

Front 10

Type 2 MOA

Back 10

IgM / igG = ab/complem → MEMBR ATTACK COMPLEX

Front 11

Ty[es 3 MOA of immune cmplex and ex

Back 11

Ab-Ag--> activate complements → neutrophls--> release lysosome enz...ex: PAN, GN, RA

Front 12

Types 3 MOA for serum sickness

Back 12

Ab-Agforeign → deposit in embranes → damage to tissue...more common than Arthus rxn

Front 13

Type 3 MOA for Arthus rxn

Back 13

local, subacute ab vs the new prot → edema, necross (ex: hypersensitivy pneumonitis)

Front 14

Type 4 MOA

Back 14

sensitized T meets ag → complements (activates macrop): ex: transplant

Front 15

oily scaly, skin, diaper rash, “cradle cap”, dx

Back 15

Seborrheic dermaitis (bad in HIV pts)...tx: tar shapoo, topical KETOCO or steroids

Front 16

define seborrheic

Back 16

seborrha (oil glands)

Front 17

onycholysis seee in

Back 17

psoriasis

Front 18

whats seen in soriatic arthritis

Back 18

sausage fingers

Front 19

what has AUSPITZ sign

Back 19

bleeding capilaries when scale rubbed off in PSORIASIS

Front 20

what is MUNRO's abscess

Back 20

in psorisasis, small abscess w/ neutrophils in epiderm

Front 21

tx urticaria?

Back 21

aka hives...give systemic antiHist (topical doesnt work)

Front 22

when does drug eruption occur

Back 22

1-2 weeks later

Front 23

Toxic Epiderman Necrolysix vs. TSSS

Back 23

TEN: full thicknessof epidermis

Front 24

erythema multiform sx?

Back 24

itches!..MCC: HSV...look like target lesions

Front 25

MC pemphigous...moa

Back 25

pemphigus vulgaris...intra epid blisters--> widespread painful erosions...ab vs desmoglein....sx: MOST BLISTERS ARE BRKEN and in mucus too

Front 26

Pemp vulgaris also has

Back 26

Nikolsky sign and Acantholysis (intraepiderm spliit)....dx: ELISA for antiesmoglein ab

Front 27

Age btw Pem Vul and Bul PEM

Back 27

PV: 40-60...BP: 60-80

Front 28

MOA of Bull Pem

Back 28

MOA: ab. Vs ag that lie on Bmzone → separatesit (stable blisters DT roof of nearly nl epidermis), less mucuous membr...dx by: band Ig on BM...tx: systemic steroids

Front 29

chicken spared on

Back 29

palms and soles

Front 30

Molluscum contagiosum mc in

Back 30

young kids and AIDS...describe: small, waxy papules and central umbiliation, lesions are ASX...to dx: GIEMSA and WRIGHT (large inclusion or molluscum bodies)

Front 31

verrucae aka

Back 31

wart

Front 32

genital warts can be seen by

Back 32

ACETOWHITENING...tx: remove em

Front 33

honey crust on face...blisters

Back 33

IMPETIGO..tx: abx

Front 34

folliculitis vs. foruncle

Back 34

fol: small infl of hair root...foruncle: hair follicle abscess(harder, more painful)...

Front 35

what is a pilonidal cyst?

Back 35

abscess in sacrococcygeal region (20-40)...can be DT repetitive trauma

Front 36

Tinea Versicolor can be DT, sx, to dx, tx

Back 36

Pityrosporum or MALASSEZIA FURFUR... sx: hypo/per pigment lesion...to dx: SPAGHETTI and MEATBALL...tx: Selenium

Front 37

Where do dermatophytes live?

Back 37

tissue with KERATIN (skin, nail, hair)...sx: corporis, pedis, curis, capitis....to dx: koh = MOLD HYPHAE...tx: antiFugnal

Front 38

pubic lice bit with color?

Back 38

blue bites

Front 39

head lice tx w?

Back 39

PYRETHRIN

Front 40

tx scabes

Back 40

PERMETHRIN...oral IVERMECTIN

Front 41

dry gangrene DT

Back 41

insufficient blood flow to tissue (usually atherosclerosis)...sx: dull ache, cold, pallor of the flesh

Front 42

wet gangrene DT

Back 42

involves bacT inxn (skin flora)...bruise, swolen w/ pus

Front 43

sx: violaceous, flat topped, polygonal paupules, Whickahm's Striae (white stripes) in mucuous membr, (Koebner's phenomenom) lesion at site of trauma...dx

Back 43

LICHEN PLANUS

Front 44

to dx Lichen planus

Back 44

Tcells at dermal/epidermal jxn w. damage at basal layer...tx: mild steroid

Front 45

Rhinophyma and ocular keratitis in

Back 45

Rosacea (rhinophyma ...tx: mild steoids or mildMETRO

Front 46

whats herald patch ...tx

Back 46

initial lesion in Pytiriasis rosea...tx: self heal in 2-3weeks

Front 47

herald patch looks like

Back 47

tinea corporis

Front 48

cigarette paper

Back 48

pityriasis rosea

Front 49

pt with DM can ?

Back 49

antimelanocyte immune response → vitiligo

Front 50

MC type of skin tumor (almost everyone past 40 has it)

Back 50

Seborrheic keratosis

Front 51

if lots seborrheic keratosis at once. Think of

Back 51

paraneoplastic syndrome (tumors make epidermal GF)...sx: exophytic, waxy brown papules and plaques “LOOK AS IF THEY COULD BE SCRAPED OFF.”

Front 52

to dx seborrheic keratosis?

Back 52

histo: hyperplasia of benign basaloid epidermal cells with HORN PSEUDOCYTS (big follicular openings)..tx REMOVE

Front 53

Precursor to SCC in situ...tx

Back 53

Actinic keratosis...on sun surface (like ears)...tx: Cryotherapy or 5FU

Front 54

Actinic Keratoses vs. Bowen's

Back 54

B: precursor to SqCC from carcinogen exposure (ARSENIC)

Front 55

most sqCC on skin look...grade how

Back 55

exophytic nodules with erosion or ulceration...grades HISTOLOGICALLY

Front 56

RF for melanoma...all start at

Back 56

congenital melanocyic or dysplastic nevi...start: epidermal basal layer where melanocytes are

Front 57

malign melanoma show

Back 57

irreg pigment, contour, border, nodule and ulcer formatio....starts itching!....

Front 58

Lentigo maligna

Back 58

have ulcers and nodules...on sun damaged

Front 59

nodular melanoma bad?

Back 59

rapid vertical, and fast red-brown nodule with ulcers or hemorrhage

Front 60

Acral lengininous where

Back 60

hands and feet (Asian, AA)

Front 61

tx of melanoma

Back 61

LN excision not very helpful...malign CAN RELAPSE...

Front 62

HHV8 assoc with

Back 62

Kaposi Sarcoma

Front 63

Epidermic HIV assoc KS bad?

Back 63

aggressive, the MC HIV ASSOC MALIGN

Front 64

histo of KS...tx

Back 64

spindle (elongated tumor cells)...tx: local rads or cryo, NO SURG

Front 65

Cutaneous Tcell Lymphoma aka

Back 65

Mycosis Fungoides... histo: helper T cells to gather in the epidermis. ...RF: chemicas....CHRONIC

Front 66

Sezary or Lutzner histo...seen in?...typical pt

Back 66

cerebriform lcy... Mycosis Fungoides....pt: pt w/ dermatitis that is RESISTANT TO TX

Front 67

HLA DR3/ DR4

Back 67

DM1

Front 68

to dx DM? At least 1 of these

Back 68

1) Fast(8cm) >126 on 2 occastions... 2) random glc 200 + sx... 3) 2hr post >200 on 2 diff times

Front 69

how to tx retinal nevasc DT DM? DM retinopathy after how many yrs

Back 69

laser photocoag... DM retinopathy: 3-5yrs

Front 70

goal for DM pts on BP, LDL, TG,

Back 70

130/75... LDL = <100... TG = < 150, ASA

Front 71

SE Sulfonylureas

Back 71

hypoGlc, weight gain

Front 72

Sulfonulureas 3 types

Back 72

Glipizide, Glyburide, Glimepiride

Front 73

SE metformin

Back 73

dont' give to NEPHRO pts

Front 74

Glitazone SE

Back 74

hepatotox, weight...inc insulin sensitivity

Front 75

typical metablolic syndr pt

Back 75

abdomen fat, BP, Gly lipid

Front 76

give what to hyperthyr pts while waiting for result

Back 76

PROPRANOLOL

Front 77

MCC hypothyroidism

Back 77

HASHIMOTO

Front 78

tx Myxedema coma

Back 78

IV Levothyroxine

Front 79

tender thyroid ..tx

Back 79

subacute thyroiditis (or viral)...usually self limited (NSAID or oral steroid if bad)

Front 80

the Ps of Papillary thyroid CA

Back 80

Papillae, Palpable, Pupil nuclei (Orphan Anie), Psammomas, Posi Prog

Front 81

Medullary thyroid in

Back 81

MEN2

Front 82

hot nodules are

Back 82

NEVER CA so dont bx

Front 83

best way to assess malign of thyroid nodules...and tx

Back 83

FNA...1) if beningn FNA = FU US...2) Malignant FNA = SURGERY and RADIOABATION after surg

Front 84

follicualar thyroid CA good?

Back 84

yeah

Front 85

Medullary thyroid CA has

Back 85

calcitonin and vasc invovet

Front 86

VEMER syndr what

Back 86

MEN 1...(Parathyroid hyperplasia)

Front 87

Sippke syndr what

Back 87

MEN 2A...(Medullary carc, Parathyroid hyperplasia, Pheo)

Front 88

MEN 2B what

Back 88

Medulala cac, pheo, intestinal ganglioneuro (mucosal neuroma), Marfans

Front 89

hip fx + vertebral compression? RF?

Back 89

Osteoporosis...RF: SMOKING, StEROID USE

Front 90

osteomalacia vs. osteoporosis

Back 90

osteomalacia: BONE PAIN unrelated to fx

Front 91

estrogen therapy for osteoporosis?

Back 91

in psx perimenopausal period

Front 92

“Mosaic” lamellar bone pattern

Back 92

in Pagets dT inc bone turnover (xs resorp and x formation

Front 93

sx Paget...labs

Back 93

loss hearing, bone pain sometimes, fx....lab: NORMAL CA, inc ALKP, nl phosph...tx: most no need tx, no cure, Biphos/calcitonin/nsaids

Front 94

1% pagets become

Back 94

osteosarcoma

Front 95

MC 2nd cause of hyperPT DT

Back 95

inc Phosp DT CRF (→ renal osteodystrophy)

Front 96

3rd hyperPTH occur when

Back 96

chronic 2nd hyperPTH → unreg states → hyperCa

Front 97

tx acute hyperCa

Back 97

IV fluids (w/ loop), iV Biphsos, calcitonin

Front 98

MCC endogenous ACTH is

Back 98

pit adenoma (Cushin dz)

Front 99

sx of cushing

Back 99

depression, xs hair, sx DM, inc infxn

Front 100

dx cushing

Back 100

if overnight suppression of cortisol is not achieved (morning is always high)

Front 101

ACTH depent vs ACTH indepent source

Back 101

if late afternoon high ACTH = ectopic ACTH

Front 102

hwo to dx Acromegaly...tx

Back 102

try oral glc suppression test of GH (if still high after sugar, cancer)...tx: Transphenoidal surg or OCTREOTIDe (supress GH )

Front 103

serum PRL in prolactinoma...tx?

Back 103

>200...tx: DA agonist (dooooiitt!) = CABERGOLINE, BROMOCRIPTINE, PERGOLIDE

Front 104

MCC primary adrenal insuffiency

Back 104

ADDISON's (autoI vs. adrenal cortex)

Front 105

hyperpigment seen in

Back 105

Addison's (autoI vs. adrenal cortex)

Front 106

ACTH depent vs ACTH indepent source

Front 107

dx adrenal insuffi

Back 107

primary/secondary = eosinophilia + hypoNa... plasma cortisol low during period of stress is DX...ACTH stim also can test

Front 108

4S of adrenal crisis tx

Back 108

Salt (.9 NS), Steroid , Suport, Search underling cz

Front 109

tx primary adrenal insuffi

Back 109

Gluco + mineralo

Front 110

Pheo assoc w...usually found

Back 110

MEN2, VHL, NF...found: above kidney...tx: surgery but give ALPHA BLOCKER first before bb

Front 111

Conn's is? lab...tx

Back 111

unilateral adrenal adenoma → hyperaldo...lab: inc aldo/RENIN activity...tx: SPIRONOLACTONE (aldo antagonist) for bilateral hyperplasia

Front 112

CAH type...tx...sx if female

Back 112

AR...tx: immediate fluid and salt repletion!, CORTISOL to dec ACTH...female babies: amb genitalia

Front 113

MCC infxn esophagitis are in

Back 113

immuno pts = 1) Candida (PO FLUCONAZOLE), HSV(small, deep ulcers, ACYCLOVIR), CMV(large, superfic, GANCICLOVIR))

Front 114

tx diffuse esophageal spasm

Back 114

CCB, nitrates, surg (myotomy) if severe.

Front 115

define Achalasia

Back 115

DO of LES or distal 1/3 (nerve problem, also CA... and chagas)...tx: Nitrates, ccb, butolism

Front 116

tx GERD

Back 116

tx: first ) H2 antagonist (CIMETIDINE, RANITIDINE) or PPI (OMEPRAZOLE), surge (NISSEN)

Front 117

how to dx the hiatal hernia

Back 117

Barium swallow > CXR

Front 118

Type A vs Type B chronic gastritis?

Back 118

A: fundus, DT Ab vs. Parietal cells (other immuno dz), inc adenocarcinma...B: Antrum, DT NSAID/Hpylori, asx, inc PUD/gastricCA

Front 119

urease breath test for and what else can do it

Back 119

Hpylori...IgG...stool ag

Front 120

Type A chronic gastritis assoc w/

Back 120

Pernicious anemia

Front 121

Triple therapy is

Back 121

AMOX, CLARITH, OMEPRAZOLE

Front 122

Gastric CA types and good?

Back 122

INTESTINAL (gastric mucosa, nitries/low veg/Hpylori)....DIFFUSE TYPE (not Hpyli , unknown cz)...very bad, most die

Front 123

other cause of PUD

Back 123

Hpilory, NSAD, etoh, smoking, steroids

Front 124

dull pain that dec w/ food

Back 124

PUD

Front 125

pt with PUD who need NSAID (arthritis) can be given

Back 125

MISOPROSTOL

Front 126

ZE assoc w/...tx

Back 126

MEN1...tx: surgery, PPI, CLOSE FOLLOW UP

Front 127

if PUD for awole can do

Back 127

parietal cell vagotomy 9best)

Front 128

define diarrha

Back 128

>200 g feces /d with inc or dec consistency of stool

Front 129

winter, kid diarrhea, dx

Back 129

rota

Front 130

bloody diarrhea organisms

Back 130

E.cli, Shig, Salmo, Campylo

Front 131

#1 cz of infxn diarrea...tx

Back 131

Campylo....Erythro...last 7-10d

Front 132

this diarrhea can → TOXIC MEGACOLON

Back 132

C.diff....

Front 133

tx Entamaeba histolitca

Back 133

METRO

Front 134

salmonella last, osteomyelitis in, tx

Back 134

2-5d, sickle, BACTRIM

Front 135

can cause febrile seiz in young, fecal oral, tx ?

Back 135

Shigella...BACRIM

Front 136

tx diarrhea in acute, chronic, peds

Back 136

ACUTE (if not infxn = LOPERAMIDE, fluid...if infxn = no antidiara, abx instead)...CHRONIC (tx LOPERAMID...)...PEDS( if can't take PO, admit and give IV fluid)

Front 137

bile salt defic DT

Back 137

bact overgrowth, ileal disease

Front 138

to dx Lactose insuff

Back 138

Hydrogen breath test (give lactose = means metab of lactose by colon bacT

Front 139

wheezing, cardiac vave DT, loc, secretes, tx

Back 139

carcinoid (ENTEROCHROMAFFIN CELLS), loc: ileum, secrete: serotonin, substance P....tx: octreotide

Front 140

IBS sx and relief

Back 140

inc abd prob with stress...relief after bowel movement...tx: TCA, loperamide, antispasmodics (DICYCLOMINE), TEGASEROD (if constip)

Front 141

Crescendo-decresendo patter abd pain 5-10min, then vomit...dx

Back 141

SBO

Front 142

bowel sounds of Obstruc

Back 142

hight pitched tinkles and peristaltic rushes...later peristalsis may disappear

Front 143

tx SBO

Back 143

if partial = supportive...surg if: complete, sx >3d, w/ 2nd look 18-36hrs after surg

Front 144

ileus, next

Back 144

rectal to rule out obstr...XR: diffuse small and large dilated

Front 145

tx divertoculosis

Back 145

1) if uncomplic = high fiber diet, 2) if still bleed: wait it out or ablation

Front 146

Tx diverticulitis

Back 146

1) NPO, NG tube and 2nd or 3rd CEPHALO

Front 147

Apple core?

Back 147

usually mass on Left side of colon (CRC)

Front 148

SBO vs LgBO

Back 148

S: more severe sx....obstr in SBO = adhesion, in LBO = CA

Front 149

tx rectal lesion

Back 149

1) abdominoperineal resection (<10cm from anal verge) remove rectum/anus = permanent colostomy bag...2) low ant resection (anastamose colon and rectum)....3) wide local excision (small, low staged, well diff CA)

Front 150

radiation?

Back 150

not for colon but rectal CA

Front 151

XR Chrons vs UC

Back 151

C: deep transver fisure, ulcer....U: shortening of colon, loss of haustra (lead pipe)

Front 152

UC limited in, sx

Back 152

mucosa, submucosa...sx: bloody diarrhea...tx: 5ASA, Azathiorprine for relapse

Front 153

severe abd pain out of proportion of the exxam..to dx...to tx

Back 153

small bowel ischmeia...image: “thumbprinting”=bowel wall edema...todx: GOLD: ANGIOGRAPHY...tx: volume, fluid, anticoag, EARLY LAPAROTOMY for acute art occlusion dz

Front 154

MC area for ischemic colitis

Back 154

Left colon (water shaped area) at splenic flexure, seen in ELDERLY...to dx: scope to see extent...tx: basic

Front 155

MC Hernia in both genders

Back 155

indiret...DT: patent processus vaginalis

Front 156

Direct hernia on DT

Back 156

floor of Hasselbach's triangle DT:

Front 157

if pt is hemo stable with SIGN MED PROBLEMS (DM)...now acute cholecystitis, do what?

Back 157

delay surgery until their acute infl resolves

Front 158

acute cholangitis DT

Back 158

gallstones or PSC (infl of billiary trree)...tx: ERCP

Front 159

multiple bile duct strictures with dilatiations betw them...on bx...inc risk?

Back 159

PSC...bx: “onion skin of ducts...risk: CHOLANGIOCARCINOMA

Front 160

hepatocellular injury: bili level?

Back 160

can be +- inc

Front 161

jaundice occurs when

Back 161

>2.5 total bili

Front 162

GC-C in hyperbili

Back 162

Gilbert, Crighleranaj = Conjugated defect

Front 163

Dubin's roots excrete poop

Back 163

DubJ,Rotor =Excretin defcec

Front 164

test for active HepA

Back 164

IgM HAV ab

Front 165

immunity to HepB

Back 165

Surface ab

Front 166

positive during window period of HB

Back 166

Ab to core ag

Front 167

what is cirsshosis of liver

Back 167

fibrosis and nodular regeneration

Front 168

to establish etiology of the ascites

Back 168

SAAG (serum ascites serum albumin): if >1.1 = DT portal HTN, if <1.1 – prot leak (nephrotic, TB, malign ovarian)

Front 169

SBP if neuto value or WBC value...tx

Back 169

N: 250, W=500..tx: 3rd gen cephalo vs (ecoli, kleb, entero)

Front 170

tx hepatic encephalopathy

Back 170

restrict prot, LACTULOSE, NEOMYCIN / METRO

Front 171

tx esopha varices

Back 171

med (BB), scope (BAND LIGATION), surg (Postcaval shunt)

Front 172

jaundice in middle age women, xhanthoma, fat malab...MOA..lab..dx...tx

Back 172

PBC ...MOA: autoI vs. INTRAHEP bile ducts...lab: alkP inc, AMA Ab, inc cholesterol..tx: URSODEOXYCHOLIC acid (slows dz), CHOLESTYRAMINE (for itch), TRANPLSANT

Front 173

biggest RF for HCC in usa

Back 173

Cirrhosis and Chronic hepatitis (HCV)....AFLATOXIN and HBV in other countries

Front 174

to dx HCC...lab...tx...

Back 174

dx: CT or US...lab: AFP, need bx....tx: surgery! (chemorad not very helpfuk)

Front 175

Dmsx, hypogonad, arthropathy of MCP, HF, cirrhosis...dx..lab..to dx...tx..complic

Back 175

Hemochromatosis...lab: DEC TRANSFERRIN, inc Fe and inc ferritin...to dx: Bx, HFE gene mut...complic: cardiomegaly

Front 176

best lab for Wilson's...type...age...sx/PE...tx...

Back 176

best: DEC CERULOPLASMIN...type: AR on chromo 13... sx: liver, tremor, psych/KEYSERFLEISHER...tx: dec cu in food (fish, liver), PENICILLAMINE

Front 177

Kayswer Fleisher in and what

Back 177

wilson's...(green/brown deposit in Descemet's)

Front 178

Penicillamine vs. Deferoxamine

Back 178

P: tx Cu...D: tx Fe

Front 179

RF for Acute vs. Chronic pancrea

Back 179

A: etoh/stone...C: etoh

Front 180

Ca in acute pancreatitis? In chronic?

Back 180

DEC if severe in A....C: calc of panreas (CHAIN OF LAKES in CT)

Front 181

complication of Acute vs. Chronic

Back 181

A: pseudocyst, fistula...C: CA

Front 182

MC pancreatic CA

Back 182

adenocarc of head (rf: smoke, first degree, high fat diet)

Front 183

Heparin decreases?

Back 183

fibrinogen levels (safe in preg)

Front 184

MOA heparin

Back 184

makes AntiThrombins better at stopping Thrombin

Front 185

what's hemophilia C?

Back 185

F9 defic (rare) = in Ash jews...MC: Hemophilia A

Front 186

type of Hemophilia A and B

Back 186

XR – mostly boys

Front 187

MC severe congenital clotting defi

Back 187

Hemphilia A

Front 188

age of Wilson's dz

Back 188

By 15 50% have sx...by 30, nearly all

Front 189

if PT is high in hemophilia...?

Back 189

Congenital F7 deficiency (it's nl in all other hemophilia)

Front 190

to dx a hemophilia...

Back 190

MIXING STUDY (mix pt's plasma w/ nl plasma, if this corrects PTT = factor DEFICIENCY is cz, if NOT = clot factor INHIBITOR), then do Factor assasys for F7,8,9,11,12

Front 191

tx mild hemophilia w/ but be careful

Back 191

DDAVP (desmopressin) but limit fluid = HYPONATREMIA

Front 192

purpose of RISTOCETIN COFACTOR ASSAY

Back 192

measures ability vWF to clot platelets in vitro in presesnce of ristocetin

Front 193

vWF type...sx...lab...to dx...to tx

Back 193

AD...sx: milder than hemophilia...lab: nl PT but PTT may be long DT F8...to dx: RSTOCEDIN TEST...DDAVP + OCP (for vag bleed), DONT GIVE ASA!!!!

Front 194

if family hx of bleed...

Back 194

vWF (it's AD)

Front 195

MC hereditary thrombotic dz..to dx...

Back 195

F5 Leyden...sx: recurrent DVT, PE, MI, stroke...to dx: 2 abn values while pt are asx and untx comp. To other family members

Front 196

tx DVT and PE

Back 196

Levanox + 3-6mo Coumadin for firs....2nd event = 6-12mon Coumadin, then lifelong

Front 197

DIC is 2 things

Back 197

1) THROMBOSIS (deposit fibrinin small bv), 2) BLEED (deplete clot factors and platelets)

Front 198

P in petechia for

Back 198

platelets

Front 199

bleed into C of Cavities for

Back 199

Clot factor defic

Front 200

DIC vs. LIVer dz

Back 200

can be similar....but F8 is low in DIC!!

Front 201

TTP

Back 201

HUS + AMS (delirium, seiz) + fever...can have SCHISTOCYTEs (broken up RBC)...NORMAL COAG FACTORS

Front 202

HUS vs TTP

Back 202

severe inc Cr is more HUS

Front 203

3 causes of Microves hemolytic anemia

Back 203

DIC, TTP, HUS

Front 204

tx. TTP

Back 204

steroid to dec thrombus + plasmapher...DONT GIVE PLATELETS

Front 205

ITP MOA

Back 205

IgG vs. platelets → inc platelet prod and inc MEGAKARYO in BM

Front 206

sx of ITP...to dx

Back 206

acute: kid after URI now bleeding...chronic: unleated to infxn, 20-40yo, w>m...to dx: exclusion

Front 207

tx ITP

Back 207

tx: steroids, IVIG, SPLENECTOMY....if prego: fetus can have severe dec platelets!....AntiD(Rh)Ig and RITUXIMAB are new

Front 208

glossitis, angular cheilitis and koilonychia(spoon nail) seen in

Back 208

Fe defic anemia

Front 209

TICS in microcytic anemia?

Back 209

Thal, Iron, Chrohic dz, Sideroblastic anemia

Front 210

tIBC/Transferrin level in Fe dev. Vs Chronic dz

Back 210

T: inc in Fe defic, dec in Chronic dz

Front 211

purpose of parietal cells

Back 211

make Intrinsic Factor for B12 absorp

Front 212

B12 defic →

Back 212

demyelination (motor, neuro, auto) AKA SubAcute Combine Degen of the cord = SCAD

Front 213

G6PD Defic type

Back 213

XR – mostly boys

Front 214

what is PNH

Back 214

blood cell sensitivity to complement activation is inc

Front 215

infxn, metab acidosis, fava, antimalarials, dapsone , sulfo, and NITROFURANTOIN

Back 215

oxidative stress in G6PDH

Front 216

sick cell in....type..

Back 216

Beta globin(qualitative defect)...type: AR

Front 217

autoI RBC destruct seen in

Back 217

EBV, mycoplasma, CLL, Rheumatic

Front 218

urobilinogen seen in

Back 218

urine and fecal for hemolytic

Front 219

Direct vs. Indirect Coomb;s test

Back 219

D: detect sensitized RBC...I: detect Ab vs RBC in pt's serum

Front 220

2 words explain Aplastic anemia...seen in

Back 220

destruction BM cells...in: FANCONI HIV...

Front 221

PE show: cafeaulai, short, radial/thumb hypoplasia

Back 221

FANCONI's anemia

Front 222

salmonellla infxn of osteo?

Back 222

Sickle cell pts

Front 223

types of Beta thal?

Back 223

2: Major (0 B)=severe first year and chronic transf....Minor: 1B = asx, but small cells

Front 224

types of Alpha thal?

Back 224

4...0=HYDROPS F...1/4= HbH dz (severe, inc reticulocyte, 1/3 bone changes DT expanded erythropeiesis)...2/4=trait (low mcv, asx)...3/4=silent carrier

Front 225

who should be transfure and given Fe chelators (deferoxamine)

Back 225

HbH and Bmajor

Front 226

true polycythemia vera is

Back 226

HIGH red cell mass...but increase in ALL CELLS (RBC, WBC, platelets)

Front 227

tx Polycythemia Vera

Back 227

phlebotomy...also cytoreducing rx like HYDROXYURIA and ASA, live 10yrs max

Front 228

3 types of transf rxn

Back 228

Nonhemolytic febrile....Minor allergic .... Hemolytic transfusion

Front 229

Nonhemolytic febrile MOA, tx

Back 229

cytokine during storage and WBC ab...STOP and give ACETAMINOPHEN

Front 230

minor allergic MOA, tx

Back 230

IgA usually vs. donor prot (usually after plasma containing product)...tx: STOP and give AntiHist, if severe = Epi

Front 231

Hemolytic transfuxion MOA, tx

Back 231

Ab. vs Donor RBC (DT ABO incomp or RH)...tx: stop, give NS, and maintain urine out

Front 232

all Porphyria of type and MOA

Back 232

AD (acute intermittent), AR(erythrooietic)...MOA: abn heme prod (→ build up porphyria)

Front 233

sx of Porphyria

Back 233

abd pain, seiz, psysch, photodermatitis...(red skin, blisters, dec reflex)

Front 234

college kid etoh and barb, next day abd pain and brown urine

Back 234

porphyria

Front 235

tx Porphyria

Back 235

avoid the triggers....sx: GLUCORSE → dec heme synth if mild, IV HEMATIN (neg feedback) for severe

Front 236

Acute leukemia MOA

Back 236

clone of early cells → rapid growht of immature cells (blast) → overwhelm BM so no more nl cells

Front 237

ALL and AML affect who, but?

Back 237

adults, but ALL = MCC kid CA

Front 238

ALL sx

Back 238

bone pain

Front 239

leukemia labs

Back 239

inc WBC but dont work → infxn, inc WBC → leukstasis (blast occlude vesels – CNS, pulmo edema..)

Front 240

dx Leukemia?

Back 240

BM aspir and bx (show >20-30% blast), if blast are myelo = AML, leuko = ALL

Front 241

tx Leukemia

Back 241

chemo, abx, etx...but should be HYDRATED and on ALLOPURINO prevent hyperuricemia

Front 242

tx LEUKOSTATIS

Back 242

HYDRXYURIA / LEUKOPHARESIS dec WBC fast

Front 243

85% ALL?

Back 243

complete cure with CHEMO

Front 244

AML type M3 (acute promyelo leuk) good?

Back 244

yes, tx with ATRA (all trans retinoic acid!!)

Front 245

myeloperoxidase see in

Back 245

myeloblast

Front 246

CLL is MC? Mainly? DT? Age

Back 246

MC type of Leukemia...mainly B cells, xcept for Tcell exist rarely...DT: unknown, some genetics...age: older >65

Front 247

sx CLL

Back 247

asx...big splen, LN...lab: inc wbc, smudge cells, small/nl lcy, pancytopenia DT BM infiltr, HYPOGAMMAGLOBIN because these cells dont work

Front 248

CD5?

Back 248

T cells leuk

Front 249

CD 20, 21

Back 249

B cells leuk

Front 250

tx CLL

Back 250

tx not until pts are sx (infxn, LN/spleen, pancyto)...tx: CHEMO, NOT CURABLE but can live long....can be complicated with AIHA

Front 251

age of CML

Back 251

MIDDLE AGE and generally asx

Front 252

what;st he 9,22 mtation...tx by

Back 252

tyr kinase...tx: IMATINIB

Front 253

CML lab

Back 253

very high WBC >100k, hyperviscocity syndr, LOW LEUK ALK PHOSPH, HIGH (B12, Uric acid, LDH)

Front 254

progression of CML – 3

Back 254

CHRONIC = no tx, 5 yrs long, no sx...ACCELERATED = toward blast crisis, inc peri/BM blood count, no sx really...BLAST: like acute Leukemia, die in 6mo

Front 255

tx CML

Back 255

Chornic = IMATINIB...acute: like acute leuk or stem cell

Front 256

What;s HAIRY CELL LEUKEMIA..cz..age...sx..dx...tx

Back 256

Blcy with no cz...rare...OLDER MEN...sx: pancytopenia (infxn with MAI), RARELY LN ...lab: LEUKOPENIA!!!, hairy cells (mononuclear cells with lots cytoplasm and cytoplasmic profections)....todx: TRAP (tartrate resistant acid phosphatase) stain of hair cells and FLOW CYTO..tx: 10% no tx needed, NUCLEOSIDE ANALOG to remit, splenectomy, IFNAlpha

Front 257

NHL affect which cell line, DT

Back 257

Bcells mostly...DT: t14,18, inh TSG, or some virus, or Hpylori for MALT

Front 258

NHL vs. HL

Back 258

NHL 5x more common

Front 259

NHL age...to dx...tx..

Back 259

50s, to dx: bx...tx: CHOP (cyclophosh, Adriamcin, Vincristine, Prednisone) and rads...if low grade NHL = bad, tx palliative, if high grade = cure with agrresive

Front 260

HL mainly and DT...age

Back 260

Bcells...DT: unknown (EBV! Maybe)...age: bimodal: 30s(nodular sclerosni), 60s(lcy depleted)

Front 261

sx of HL, loc

Back 261

CERVICAL LN, Bsx, itch, PEL-ELBSTEIN FEVER (1-2weeks fever, then 1-2weeks no), ETOH induced pain at nodes

Front 262

dx HL

Back 262

RS cells (large Bcells with eosnino nucli = owl's eyes)

Front 263

HL staging based on...tx/prog

Back 263

Bsx, #nodes, and if it cross diaphragm...tx: rads towards LN, good prog

Front 264

Anemia + bone pain

Back 264

MM

Front 265

MM vs. Pagets

Back 265

MM: hyperCa...P: nl Ca

Front 266

how many plasma in MM?...tx?

Back 266

>10% in BM...tx: CHEMO (Melphalan = oral alk agent)

Front 267

why would bone scan miss MM?

Back 267

Scans for OSTEOBLASTIC process, MM is an Osteroclastic

Front 268

Waldengstron Macroglobulinemia a type of

Back 268

clona BCEELL → inc IgM → (hypervisc, coag, cryoglobulinemia, cold agllt dz → AIHA, amyloidosis

Front 269

WM sx...to dx..tx

Back 269

Reynauld from cryoglobin, NEURO (AMS etc)...to dx: BM (small abn plasmacells w DUTCHER bodies (PAS+ IgM deposit around nucleus)..tx: plasmapher, chemo

Front 270

2 MCC amyloid forms of systemic amyloidosis and its tx

Back 270

Primary: AL....2ndary: AA...kidney,heart,liver

Front 271

AL what is it, loc...assoc w

Back 271

Plasma cell dstuff...deposit: Monoclonal Light Chain...MM, WM

Front 272

AA what is it..assoc

Back 272

Acute phase reacntant serym amyloid A...assoc: Chronic infl dz (RA), infxn, neoplasms

Front 273

dialysis amyloid?

Back 273

Beta 2 microglobulin

Front 274

senile amyloid ada

Back 274

deposit of actually NORMAL THRANSTHYRETIN

Front 275

dx amyloid

Back 275

tissue bx wth CONGO RED (= apple-green birefringent under polarized light)

Front 276

equation for AbsNeutrophiCount =

Back 276

WBC x ((%bands + % seg neutrophils)x.01)

Front 277

Fever + neutropena?

Back 277

ABX!!!

Front 278

nl abs eosinphils count?

Back 278

NEVER > 350

Front 279

time of HYPERACUTE, ACUTE and CHRONIC

Back 279

minus (prefomed ab, thrombi, ABO check, tx: cytotoxic stf)... 5d-3mo (Tcell, GGT/alkpos/LDH stuff that shows tissue destruction, tx: steroids, OKT3 antilcy, tacrolimus)... months to yrs (chronic immune → fibrosis, no tx)

Front 280

eosinophils in urine

Back 280

shistosoma

Front 281

eosinohiphils csf

Back 281

coccidiomycosis and helminths

Front 282

Down assoc w/ CA?

Back 282

ALL (we ALL go DOWN together)

Front 283

XP

Back 283

sq. c, basal c of skin

Front 284

pernicious anemia, atrophic gastratics

Back 284

gastric adenocarc

Front 285

facial angiofibroma, seiz, mr...dx.. assoc w/ CA?

Back 285

TS: astrocytoma/ cardiac rhabdo

Front 286

actinic keratosis

Back 286

sq. cc skin

Front 287

Plummer vinson

Back 287

sq. cc esophag

Front 288

UC

Back 288

colonic adenocarc

Front 289

immunodefic

Back 289

lymphoma

Front 290

AIDS

Back 290

aggressive NHL or KS

Front 291

acanthosis nigracans

Back 291

visceral cA (stomach, lung, booobs)

Front 292

define allogenic

Back 292

transplant btw diff gene people

Front 293

define syngenic

Back 293

transplant btw twins

Front 294

GVHD occur for, moa

Back 294

allogenic BM transpllant...MOA: donor T vs. host tissue (acute or chronic)..tx: sterods

Front 295

a form of GVHD is graft-vs-leuk-effect

Back 295

dec leukemia in transplant pts

Front 296

to dx legionella

Back 296

urine ag, sputum stain for ab

Front 297

to dx mycoplasma

Back 297

serum cold agglut, myco ab

Front 298

legionella PNA?

Back 298

atypical

Front 299

CF PNA?

Back 299

Pseudo

Front 300

tx for outpt CAP (<65, healty)

Back 300

MACROLIDE (Azithtro), DOXY or FLUORO

Front 301

tx for pt >65 or with comorbid PNA

Back 301

MACROLIDe or FLUORO (may need a 2nd gen CEPHALO or BETA LACTAM)

Front 302

CAP requiring hosp tx

Back 302

CEPHALO, BetaLACTAM, or FLUORO...+ MACROLIDE if atypical

Front 303

CAP needing ICU

Back 303

FLUORO, or extended spectrum CEPHALO or BETA LACTAM inh + MACROLIDE

Front 304

PNA critically ill, tanking

Back 304

Vanc or Linezolid

Front 305

if pt is >65 and or comorbid PNA, next

Back 305

Admit + IV abx

Front 306

tx TB

Back 306

4 rx (INH, pyrazinamide, rifam, etham)

Front 307

PPD test and result: + at 5 if, + at 10 if, + at 15 if

Back 307

5) HIV, close TB contact, CXR=TB...10) homless, 3rd world, IV rx, chnic, health care....15) if everyone else and no Rfl

Front 308

acute pharyngitis DT..tx..

Back 308

group A...tx: Penicillin x 10d, amox or azithro

Front 309

Lemiere syndrome

Back 309

thrombophlebitis of jugular vein DT FusobacT ( oral anaerobe)

Front 310

Acute sinusitisDT...chronic dt

Back 310

pneumo, Hinf, M. catar...c: obstr or anaerobe

Front 311

best lab for sinusitis

Back 311

CT but only if sx after tx

Front 312

tx acute sinusitis

Back 312

(most viral, no big deal), but: Amox/Clav or Chlarithro, azi, Bactrim

Front 313

tx coccidiomycosis

Back 313

rarely IV, but if so: AMPHOTERICIN B for severe PNA or disseminated, if mild: PO FLUCONA or ITRACO

Front 314

tx meningitis if close contact? Seteroids?

Back 314

RIFAMPIN + CEFt if close...steroids good in bacT menin if 20 min before abx

Front 315

intractable seizure?

Back 315

subdural empyema – drain

Front 316

MCC encephelitis

Back 316

HSV and Arbo

Front 317

RBC in CSF wihtout trauma?

Back 317

HSV encephelitis

Front 318

tx for neonatal MENING

Back 318

AMP + CEFOTAXIME or GENTA

Front 319

tx for 1-3mo MENIN

Back 319

VANC + CEFT or CEFOT

Front 320

tx for 3mo – adult MENIN

Back 320

same

Front 321

>60 MENIN tx

Back 321

AMP + VANC + CEFOT or CEFT

Front 322

to stain crypto meningitis...how about ameba

Back 322

india ink...Giemsa stain

Front 323

when to do PCR for menin

Back 323

HSV, CMV, EBV, VZV

Front 324

tx HSV encepheltitis vs CMV enceph

Back 324

IV ACYC, this is bad...C: GANC

Front 325

brain abscess: infxn vs. mass

Back 325

I: HA, Fever, focal neuro....M: if no fever

Front 326

MCC brain absess

Back 326

strept, staph, anaerobe

Front 327

comon cz of brain abcess

Back 327

OM, mastoiditis, MCA in graywhite

Front 328

inc ICP →

Back 328

CN 3 and 6 deficit

Front 329

tx brain abscess

Back 329

abx: Cephalo + METRO +/Vanc, drain, steroid if edema w/ mannitol

Front 330

CD4 vs. viral load

Back 330

C: degree of immunosuppr (guides therapy)...V: rate progression

Front 331

CD50 dz

Back 331

histo, CMV retinitis, CNS lymphoma

Front 332

CD 50-200 dz

Back 332

Fungus + toxo

Front 333

tx candida trush

Back 333

loca: Nystat, or Clotri, or PO Fluco

Front 334

how to dx cryptoco

Back 334

CSF + Ag, india ink stain...tx: IV Amph B

Front 335

pigeon dropping

Back 335

crypto

Front 336

rare fruiting bodies and 45degrees braching septate hyphae

Back 336

Aspergilus

Front 337

wide capssular halo, narrow base unequal budding

Back 337

crypto

Front 338

irregular, nonsepte hyphae

Back 338

mucor

Front 339

tx MAC in aids

Back 339

weekly AZITHRO or daily CHLARITHRO

Front 340

tx Toxo...cd?

Back 340

BacTRIM ...cd:<100

Front 341

candida esophag tx

Back 341

fluconazole (Nyst swish if oral)

Front 342

to dx HISTO...tx

Back 342

CXR: diffuse nodular, cavities, best: urine and serum polysac Ag test...if yeast form: SILVER STAIN....TX: AMPV

Front 343

when to use steroid for PCP

Back 343

PaO2<70, Aa gradient >35

Front 344

AIDs pt with cough and dyspna

Back 344

PCP

Front 345

CMV primary infxn? In CD of

Back 345

asx...CD: <100

Front 346

CMV retinitis has high rate of /sx

Back 346

retinal detachment (floaters)

Front 347

CMV pneumo

Back 347

bad!

Front 348

CMV encepheltis CD of

Back 348

<50

Front 349

HIV pt hit CD50, prophyx?

Back 349

Azithro for MAI

Front 350

to dx MAI?

Back 350

blood cult (postivie in 2-3weeks), inc serum Alk Phosphatiase, inc LDH, FOAMY macrophages with ACID FAST bacilli

Front 351

to dx Toxo?

Back 351

sero, PCR, MRI: MULTILE lesios...tx: PO PYRIMETHAMINE, SULFADIANZINE, BACTRIM for prophy if CD<100

Front 352

how to dx Chlamy...tx

Back 352

PCR in urine...GRAM STAIN: no bacT because its intracellular but show neutrohils..tx: DOXY or AZITHRO

Front 353

green yellow disharge in women, purulent urethral dc in men...

Back 353

gonorrhea

Front 354

gonnorrhea arthritis are

Back 354

MONOarticular septic arthritis

Front 355

syphillis is a

Back 355

spirochete

Front 356

2nd syphillis

Back 356

hands rashes, condyloma lat!

Front 357

3rd syphilis sx

Back 357

cardio (AORTIC ROOT ANEURYSM), argyll pupil, gummas

Front 358

TPPA> qhats that

Back 358

T.Pallidum particle agglu test = FTA like test for syphillis

Front 359

beefy red ulcer on genitals

Back 359

Granuloma inguinale-donovanosis

Front 360

regular, red shallow ulcer on genitals

Back 360

HSV

Front 361

irregular, deep , well demarc, necrotic

Back 361

H. Ducreyi (chanchroid)

Front 362

painful lesion on gonads

Back 362

H. Ducrei and HSV (both have ulcers!)

Front 363

painless lesions on gonads

Back 363

Granuloma inguinale, hpv, syphillis

Front 364

tx HPV warts

Back 364

remove

Front 365

tx Ducreyi chanchroid and Granuloma inguinale

Back 365

Doxy or azithro

Front 366

Jarisch Herxheimer rxn

Back 366

flu like sx after tx syphillis

Front 367

MC serious complic of preg

Back 367

pyelo

Front 368

recurrent pyelo, next

Back 368

if renal fine: do CT may show scar, else : try US may show stone

Front 369

tx pyelo

Back 369

FLUORO best

Front 370

define sepsis

Back 370

SIRS + documented infxn

Front 371

SIRS =

Back 371

fever, hypoThermia, tachypnea, leukocytosis, tachycard

Front 372

malaria mosquito nam

Back 372

Anopheles

Front 373

worse kind of malaira

Back 373

Falciparum (withing 24 hrs of sx)

Front 374

sx malaria...to dx

Back 374

periodic chills and fever..to dx: GIEMSA, or WRIGHT stained thick and thin blood fims get at 8hrs inteval

Front 375

which malaria can cz sx months to yrs later

Back 375

OVM

Front 376

uncomplicated malaria tx with

Back 376

Chloroquine

Front 377

whats blackwater fever

Front 378

posterior cervical LN?...do not give something for another dz

Back 378

Mono...don't give AMOX during EBV infxn → long, itchy, rash

Front 379

how to dx Mono

Back 379

heterophile monospot might be neg first few weeks...Mono Ab!...lab: >10% atypical Tlcy

Front 380

define Fever uknown origin

Back 380

>38.3 for >3weeks and undx (thicnk CA or ifxn, rheumatic in elderly)...tx: stop unnecessary meds!!!

Front 381

primary vs. 2nd vs 3rd lyme

Back 381

1: ERYTHEMA MIGRANS....2: MIGRATORY POLYART, bells', menin/myocarditis...3: arthritis and subacute encephelitis (memory/mood)

Front 382

to dx lyme

Back 382

ELISA and WESTERN

Front 383

bluebery muffin kid and what trimester...other sx?

Back 383

rubella...first trim...other: cataracts, MR, hearing loss

Front 384

MC congenital infxn?

Back 384

CMV (rash and PERIVENTRICULAR CALC)

Front 385

syphillis in pregos tx?

Back 385

penicillin

Front 386

during preg?

Back 386

consider abort if <20weeks...vacc mom afterward

Front 387

sandpaper skin rash, “snuffle” (mucupurulent sinusitis), saber shins, saddle nose, HUTCHINSON's triad (peg shaoed upper incisors, deaf and interstial keratitis_ what is it

Back 387

syphillis baby

Front 388

N.gono of cunjuntivitis?

Back 388

EM! can → blindness...IM ceft, PO cipro!

Front 389

tx chlamydia conjuntivitis

Back 389

Azithro, tetra, or erythro

Front 390

MCC viral conjunctivitis

Back 390

adenovirus (contagious)...tx: topical steroids under opthal suppervision

Front 391

orbital cellulitis usually DT, organisms, tx

Back 391

Paranasal sinuses...strept/staph/HInfluenza...

Front 392

otitis media vs. otitis externa

Back 392

pain w/ movement tragus/pinna

Front 393

otitis externa tx

Back 393

abx+steroid

Front 394

small tender nodules on finger and toe pads

Back 394

Osler's nodes

Front 395

small peripheral hemorrhages

Back 395

Janeway lesions

Front 396

JR=NO FAME for what

Back 396

endocarditis: Janeway, Roth, Nail bed splinter, Fever, Anemia, Murmur, emboi

Front 397

7d late, itchy papule, enlarges into ulcer → regional lymphadenopahy, 7d later → bLACK ESCHAR, dz

Back 397

Anthrax..to dx: CXR, clture and gram stain = short nonmotile baiccli, tx: CIPRO or DOXY (DO NOT GIVE PEN or AMOX as single line agent anymore)

Front 398

MRI of osteomyelitis show?

Back 398

inc signal in bone marrow and soft tissue prob...XR: show 2 weeks later: periosteal elevation

Front 399

osteo in Rx user

Back 399

Aureus or Pseudoh

Front 400

osteo in hip replacement

Back 400

s. epidermatitis

Front 401

osteo in foot puncture wound

Back 401

Pseudo

Front 402

what;s a MARJOLIN's ulcer

Back 402

long standing chronic osteomyelitis w/ draining sinus tract that may eventually →SqCC

Front 403

Volkman's contracture of wrist and fingers DT

Back 403

comp syndr DT supracondylar fx

Front 404

sx compartment syndr

Back 404

pain with PASSIVE moton...to dx: measure pressure (>30), delta pressure = (diastolic – compartment pressure)

Front 405

septic bursitis more common in

Back 405

superficial bursae (olecranon, prepatellar, infrapatellar

Front 406

do not inject steroid into

Back 406

septic bursitis

Front 407

L4 nn prob →

Back 407

foot dorsiflex (tib ant)

Front 408

L5 prob cant →

Back 408

big toe dorsi (extensor hallucis longus), foot eversion (peroneus muscles)

Front 409

S1 prob can't →

Back 409

plantar flex (gastrocnemius, soleus), gluteus max (hip extension)

Front 410

MC loc herniated disk..sx

Back 410

L4-L5, L5-S1...sx: Passive straght leg → pain, or cross leg

Front 411

to dx Cauda Equina Syndr

Back 411

MRI

Front 412

ant discloc, pt hold arm how...risk

Back 412

ext rot...risk: axillary aa and axillary nn

Front 413

post disloc pt hold arm and risk

Back 413

int rot..:risk: radial aa

Front 414

MC hip dislocation

Back 414

post...DT: post directed force (DASHBOARD injury)...risk: sciatic nn and avasc necrosis

Front 415

Ant hip disloc can

Back 415

injure obt nn

Front 416

tx colle's fx

Back 416

closed reduction, long arm cast

Front 417

when to tx scaphoid fx with open reduction...when necrosis

Back 417

if displacement or navicular nonalignment...necrosis if: prox 1/3 of scaphoid fx

Front 418

What's a Boxer's fx

Back 418

fist when hitting wall → fx of 5th metacarpal neck

Front 419

what's nightstick fx

Back 419

ulnar shaft fx DT self defense vs. Blunt object

Front 420

what's monteggia's fx

Back 420

diaphyseal fx of prox ulna w/ sublux of radial head

Front 421

what's Galeazzi's fx

Back 421

diaphyseal fx of radius w/ disloc of distal radioulnar joint (DT direct blow to radius)

Front 422

hip fx risk and presenation...tx

Back 422

osteoporosis...short and extern leg...tx: pinning of femoral head (if in elderly = hip replacement), then anticoag (DVT rsk)

Front 423

femoral fx DT and can cause...tx

Back 423

direct trauma...fat emboli...tx: nail of the femur (irrigate and debride if open)

Front 424

tibial fx DT, tx

Back 424

direct trauma...tx: cast vs. nailing

Front 425

open fx tx

Back 425

EM: go to OR = abx + tetanus

Front 426

how to dx archlle rupture

Back 426

Thompson's (squeeze gastrocnemus → foot can't plantar flex)...tx: long leg gast

Front 427

ACL dx by, DT

Back 427

+anterior drawer, + lachman test...DT: forced hyperextension or direct trauma to extended knee

Front 428

PCL dx by, DT

Back 428

+ poster drawer, DT: forced hyperextension

Front 429

MC fx long bones in kid...assoc with...where

Back 429

clavicle...brachial nn palsies..loc: prox 1/3 displaced sup (DT sternocleido)

Front 430

what's a greenstick fx

Back 430

incomplete fx (cortex only 1 side)...tx: red, cast, refilm at 14d

Front 431

pt refuse to bend elbow? Tx?

Back 431

nursemaid's elbow...tx: gentle sup elbow at 90 of flexion, no immobiliz

Front 432

supracondylar humerus fx risk...?

Back 432

prox to brachial art → inc risk of Volkmann's contracture (DT compartment syndrome of forearm)...tx: cast, closed red w/ pin if displaced a lot

Front 433

Duchenne sx start at, type

Back 433

4yo...type: XR...sx: prox>distal, clumsy, tired, MR...to dx: Dystrophin immunostatain, CK inc, muscle bx: necrosis fibers from degen/variable fiber size...complic: Pulmo congestion DT high output cardiac failure/cardiac-pulmo failures DT muscles

Front 434

age onset and death of DMD vs. Becker

Back 434

D: 5, dead teens...B: 15, dead: 40s

Front 435

MR and lab btw DMD and Becker

Back 435

D: MR, dec Dystrophin...B: no MR, Dystrophin #nl, but bad!

Front 436

Dysplasia of hip: which babies, sx

Back 436

first born girls in breech...sx: BARLOW (audible clunk when femur head post), ORTOLANI (thighs abd from midline = soft click = reduction of femoral head into acetabulum), GALEIZZI (knee are uneven height when hips and knees are flexed), asymm skin folds

Front 437

Dysplasia hip...how to dx, tx, complic

Back 437

US (can't see on XRAY until >4mo)...tx: splint w/ Pavlick harness (watch out for AVN)

Front 438

sx of Legg Calve' Perthes...tx...watch out for

Back 438

limited abd and int rotation, atrophy of affected leg...tx: brace...risk: AVN

Front 439

dx of Slipped capital femoral epiphysis...tx:

Back 439

AP/LAT xr: frog leg lateral views and post/med diplacement of femoral head...tx: no weight bearing until surg:

Front 440

Top 2 MC malign tumors of bone

Back 440

1: MM, 2: osterosarc

Front 441

MC loc osterosarc

Back 441

loc: metaphysis of distal femur...sx: pain all time...dx: CODMAN triangle (periosteal new bone formation at diaphysis) SUNBURST (onion skin in EWING)

Front 442

MCC scoliosis and defintion

Back 442

MC: idio...define: lateral curve > 10degrees

Front 443

tx of scolios: <20, 20-45, >50

Back 443

<20: regular obs....20-45: spinal brace (may keep getting worse)...>50: surgery

Front 444

pain w/ loss fxn and loss autonomic fx usually post trauma? And phases

Back 444

Reflex Sympathetic Dystrophy...3 phases: 1)acute sns denerv/underactivity 2) dystrophic 3) atrophic

Front 445

sx of RSD

Back 445

1) loss fxn of limb, pain, SNS prob (skin, soft tissue, bv), hair or nail growth

Front 446

tx RSD

Back 446

NSAIDs, steroids, low dose TCA, gabapentin, calcitonin, CHEM SNS blockage maybe

Front 447

If <11/18 tender points dx?

Back 447

Myofascial pain Syndrome....instead of Fibromyalgia

Front 448

yeLLow when paraLLel to condenser?

Back 448

gout crystals

Front 449

gout is ...sx...dx...

Back 449

MONOarticular...TOPHI(urate crystal depositis in soft tissue) seen in chronic dz...dx lab: NEEDLE shaped (elevated WBC too)

Front 450

what is seen in advanced gout?

Back 450

punched out erosions w/ overhanging cortical bone (“rat bite” erosions)

Front 451

Colchicine in gout?

Back 451

during acute attacks (has a limited therapeutic window)

Front 452

rhomboid shaped crystals

Back 452

pseudogout

Front 453

tx of gouts...how about MAINTENANCE THERAPY

Back 453

INDOmethacin...maintenance: ALLOPURINOL for overproducers and PROBENECID for undersecretors

Front 454

anterior uveitis and HEART block can be seen in ...tx

Back 454

ankylosing spondylitis...tx: NSAIDs, exercise, TNF inhibitors or Sulfazalaine

Front 455

what besides OA affects DIP

Back 455

psoriatic arthritis (w/ sausage shaped digits)

Front 456

Polymyositis sx

Back 456

prox muscle, SYMMETRICAL –> diff breathing/swallow

Front 457

SHAWL sign and GOTTRON papules in?

Back 457

Dermatomyositis...SHAWL (rash shoulder, chest, back), GOTTRON's papules (papular rash w/ scales on dorsa of hands over bony prominences)...CA: lung, breast

Front 458

EMG of poly and dermatomyositis show , other lab

Back 458

fibrillarion...muscle bx: inflammation and muscle fibers in necrosis/regen...other: inc CK...tx: high dose steroids

Front 459

triad: Big spleen, RA, dec platelets?

Back 459

FELTY's syndr

Front 460

tx RA:

Back 460

DMARDS like HYDROXYCHLORO, SULFAZALAZINE, METHOTREX

Front 461

nonmigratory, mono or polyarthritis w/ bony destruction and last >6weeks, 95% cases gone by puberty?...to dx: no labs...tx: NASAIDs, Methoxy

Back 461

Juvenile RA

Front 462

tx Scleroderma

Back 462

acute: Steroids, PENICILLAMINE for skin changes, CCB for Raynauld

Front 463

DOPAMINE RASH for?

Back 463

SLE:...Discoid rash, Oral ulcers, Photosen, Arthritis, Malar rash, Immunologic, Neuro sx (seiz), Elev ESR, Renal dz, Ana+, Serositis, Hematologic abn

Front 464

labs for S:E

Back 464

dsDNA, antiSm....neonatal SLE: antiRo

Front 465

location of Temporarl arteritis

Back 465

granulomatous infl of large vessels (AORTA, EXT CAROTID especially TEMPORAL br)

Front 466

sx: pain and stiff shoulder and pelvic girdle (difficulty getting out of chair, other: fever, malaise, weight loss, NOT WEAK)...lab?...tx

Back 466

Polymyalgia Rheumatica...lab: inc ESR, anemia...tx: steroids

Front 467

CN3 fxn 3

Back 467

eye movment, constrict, eyelid opening

Front 468

CN5 fxn 2

Back 468

mastication, face sense

Front 469

CN7 fxn

Back 469

move face, tase ant 2/3, lacrimation, saliva (submax, sublingual), close eyelid

Front 470

UMN lesion of CN7 sx

Back 470

OPPOSITE paralysis LOWER FACE ONLY (lesion btw cortex and facial nucleus)

Front 471

LMN lesion of CN7 sx

Back 471

SAME SIDE upper AND lower paralysis

Front 472

3rd MCC death and #1 cz of disability in USA

Back 472

Stroke

Front 473

ischemic vs hemorrhagic stroke

Back 473

Ischemic >>> hemorrhagic

Front 474

lateral corticospina decuss at

Back 474

pyramid medulla

Front 475

DCML decuss at

Back 475

arcuate fibers at medulla

Front 476

Spinothalamic decuss at

Back 476

spinal cord

Front 477

UMN vs. LMN for 1)tone, 2) DTR 3) other

Back 477

U: inc tone, inc DTR...L: dec tone, dec DTR, atrophy/fasciculation

Front 478

neglect...where is stroke

Back 478

nondominant MCA

Front 479

coma, locked in, apnea, visual sx, where's the stroke

Back 479

Basilar artery

Front 480

Polio has same lesions as?

Back 480

Werdnig Hoffman (destroyed ant hor cells)

Front 481

syringomyelia lesion?

Back 481

crossing corticospinal fiber tracts (bilat loss pain and T sensation)

Front 482

dysarthria (clumsy hand syndrome) where's lesion

Back 482

Lacunar stroke

Front 483

tx acute ischemic stroke

Back 483

tPA

Front 484

when to give ASA for ischemic stroke

Back 484

if <48hrs

Front 485

tx these with acute stroke if exist

Back 485

fever and hyperGlc if exists

Front 486

for long term tx of stroke

Back 486

ASA, clopidogrel if anticoag CI

Front 487

tx SAH

Back 487

1) prevent rebleed (common first 2d) keep BP<150 until fixed...2) stop spasm by CCB, IV fluid, Pressors and PHENYTOIN (seiz prophylaxis)...3) inc ICP...4) SURGICAL clipping best tx

Front 488

contralateral hemiparesis and ipsi pupillary dilation

Back 488

subdural hematoma...CT: CRESCENT SHAPED

Front 489

Cingulate herniation located and DT

Back 489

under falx cerebri...dT: mass of frontal lobes

Front 490

downward transtentorial (central) herniation DT

Back 490

large supratentorial mass push midbrain inferiorly

Front 491

Uncal herniation DT

Back 491

mass in middle fossa (CN3 trapped → fixed and dilated SAME side)

Front 492

Migraine can be DT which nt?...duration...dec by?...tx?

Back 492

serotonin....2-2p4hrs duration...dec by: DARK, sleep

Front 493

unilateral with VISUAL aura?

Back 493

Classic migraine

Front 494

tx Migraine and Prophylactic

Back 494

tx: TRIPTANS and metoclopramide...prophylactic: BB, TCA, CCB, Valproic

Front 495

Tx Tension HA...special?

Back 495

#1= NSAIDs, #2/3= Triptans/Ergot...MC type of HA in adults

Front 496

Septic thrombosis of Cavernous sinus usually DT...MCC...sx...

Back 496

abscess in orbit, nasal sinuses, central face ...MCC Aureus...sx: anything

Front 497

2 types of partial seizures and to diff them

Back 497

1) simple: focal like motor WITHOUT change mentation...2) complex partial: usually temporal lobe w/ bilat spread of electrical (impaired mentation), automatism, postictal confusion

Front 498

sx of tonic clonic

Back 498

incontinence, tongue biting,loss consciousness, confused, mucle aches...lab: EEG 10hz tonic and slow wave clonic...tx: airway, PHENYTOIN/valproic

Front 499

status epilepticus last

Back 499

>10min...tx: stat CT, then when stable: EEG, Thiamine/glc/naloxone, IV BENZO

Front 500

What is west syndrome?

Back 500

infantile spasms: generalized epilepsy...sx: after 6mo, bilateral, symm jerk of head/trunk/extremities in clusters (by this time = ARREST OF PSYCHOMOTOR dev and → MR!)...lab: EEG: HYPSARRHYTHMIA, tx: ACTH, prednisone, clonazepam or valproic acid...tx: hormonal therapy with ACTH

Front 501

A common cause of recurrent peripheral vertigo from... sx:

Back 501

dislodged otolith → disturb in semicircular canals... sx: transient, episodic vertigo and torsional nystagmus triggered by changes in head position (like turning in bed)

Front 502

dx BPPV

Back 502

by Dix-Hallpike maneuver

Front 503

sx of acute labyrinthitiis...dx...tx

Back 503

sx: severe acute onset Nystagmus w/ N/V after VIRAL, <2weeks...dx...tx: selfgone in weeks, be careful of activities

Front 504

Recurrent severe vertigo, hearing losss, tinnitus or ear fullness...dx...tx?

Back 504

Meniere's...dx: need 2 episodes...tx: low Na, and diuretics!

Front 505

MOA of syncope

Back 505

LOC DT 2ndary drop in cerebral perf...

Front 506

tx syncope

Back 506

telemetry or holter monitor to eval cardiac causes

Front 507

sx myasthenic crisis

Back 507

resp compromise an aspiration

Front 508

dx Mgr

Back 508

Tensilon test, dec response to repetitive nn stimuli

Front 509

Tx Lambert Eaton

Back 509

1) the small cell 2) Guanidine Hydrochloride (main tx), and anticholinesterase

Front 510

MS MOA

Back 510

T-cell mediated

Front 511

pregos assoc w/ dec freq of

Back 511

MS

Front 512

Dawson's fingerS?

Back 512

periventricular white matter lesions in MS (especially in Corpus Callosum)

Front 513

Tx of relapsin/remitting or progressive MS?

Back 513

Mitoxantrone...baclofen for spasticity

Front 514

labs in guillan barre'

Back 514

lab: diffuse demyelination seen on EMG and nn conduction (shows dec nn conduction velocity), CSF prot >55mg/dL (little or no pleocytosis)

Front 515

RF for alzheimer's

Back 515

Age, fm hx, Down, neurofibrillary tangles, neuritic plaques w/ amyloid deposit

Front 516

first sx of alzheimer...MCC death in them..how to dx...

Back 516

first sign: mild cognitive impairment... MCC death: aspiration PNA...tx: AcEI (Donepezil, Rivastigmine), NMDA antagonist (galantamine), vit E to slow cognitive decline

Front 517

atrophy of frontotemporal lobe aka

Back 517

Pick's..to dx: PICK bodies (round intraneuronal inclusions)...sx: change in PERSONALITY...tx: only sx

Front 518

tx NPH

Back 518

surgical CSF shunt

Front 519

how to dx Creutizfield Jakob

Back 519

pyramidal signs, myoclonus, SHARP WAVES on EEG...also: protein 14-3-3..no tx

Front 520

sx of Hungtinton's... type... MOA...shows what kind of genetic

Back 520

HYPERkinetic...AD... CAG repeats on chromo 4...genetic: ANTICIPATION = more repeats, worse, live 20 yrs

Front 521

triad of huntington's

Back 521

triad: chorea, altered behavior, dementia (from forgetfulness to antisocial)

Front 522

tx huntingonton's

Back 522

NO CURE...for psychosis: HALDOL, for movement: RESERPINE...

Front 523

sx of Parkinsons'...lab:...

Back 523

HYPOkinetic...lab: LEWY BODIES (intraneuronal eosinophilic inclusions)...tx: ROPINIROLE or PRAMIPEXOLE (DA agonist), MAOIB (SELEGILENE)...surg: PALLIDOTOMY

Front 524

DA agonist used in Parkinsons

Back 524

PRAMIPEXOLE, ROPINIROLE

Front 525

SE of PRAMIPEXOLE

Back 525

uncontrolled gambling

Front 526

MCC CA in brain is

Back 526

met

Front 527

Met CA to brain located in

Back 527

grey/white border (many nodules)...from: lung, breast, kidney, GI, melanoma

Front 528

NV, HA worse in AM, dx?

Back 528

inc ICP

Front 529

met CA that cuase bleed in brain

Back 529

RCC, thyroid CA, choriocarcinoma, melanoma

Front 530

slow protracted course, may sx of unilat CN 5-7, 10

Back 530

Astrocytoma

Front 531

MC primary brain CA, prog?

Back 531

GBM (glioblastoma multiforme)...dead in 1 yr

Front 532

Meningioma from? Imaging, tx

Back 532

Dura or arachnoid...imaging: DURAL TAILS...tx: resect and rads if not possible

Front 533

sx of Acoustic neuroma

Back 533

no hear, ringing, spinning, cerebellar prob

Front 534

medulloblastoma from? Age? Prog

Back 534

from: FOURTH VENTRICLE → inc ICP... kids... prog: MALIGN

Front 535

another CA from 4th ventricle...age...

Back 535

EPENDYMOMA → obstruction...age: kids

Front 536

MC neurocutaneous DO

Back 536

NF

Front 537

NF1 aka

Back 537

VonRecklinhausen

Front 538

freckling in axilliary or inguinal region

Back 538

NF

Front 539

CA in NF (3)...2 other sx

Back 539

freckling, optic gliomas, Lisch nodules (pigmented iris hemartomas)... bone (scoliosis), MR

Front 540

TS type....affect which

Back 540

AD...affect many organs

Front 541

ash leaf aka...other sx in this dz

Back 541

hypopig spots...MR....(TS)

Front 542

What are sebaceous adenomas and what else seen

Back 542

SA: small red nodules on nose, cheeks in butterfly.... Shagreen patch: rough papule in lumbosacral w/ orange peel consistency... other: MR, cardio rhabdomyomas, kidney: angiomylo/RCC

Front 543

imaging in TS

Back 543

calcified tubers in cerebrum in periventricular area can ---> ASTROCYTOMAs

Front 544

define Aphasia and DT

Back 544

define: speech and language DO... DT: dominant hemisphere insult

Front 545

Broca's location... tx

Back 545

posterior inferior frontal (MCA) aka motor aphasia... tx: speech therapy

Front 546

Wernicke's location

Back 546

left posterior superior temporal lobe

Front 547

LOCKED in vs. PERSISTENT VEGETATIVE

Back 547

L: awake and alert, can only move EYES and EYELIDs, DT: central pontine myelinolysis/brain stem stroke/... P: nl wake sleep cycles, but unaware of SELF or ENVIRONMENT, DT: trauma w/ diffuse cortical injury or hypoxic event

Front 548

DONT stands for

Back 548

Dextrose, O2, Nalox, Thiamine

Front 549

Korsakoff =

Back 549

Wernicke + confab + amnesia

Front 550

aka cyanobobalamin

Back 550

B12...sx: gradual, progressive, symm paresthesia/stocking glove/ stiff legs/ dementia

Front 551

RF for closed angle glaucoma...sx:...tx

Back 551

RF: pupillary dilation (dark area, stress, meds), anterior uveitis, older age...sx: dilated eyes, red, painful...tx: ACETAZOLAMIDE then PILOCARPINE, laser IRIDOTOMY

Front 552

Pt >35, AA who needs frequent lens change, dx, first sx, fundo

Back 552

Open angle glaucoma...first sx: problem in the peripheral nasal fields... fundo: cupping of optic disk

Front 553

open vs. closed angle glaufoma

Back 553

open: bilateral... closed: unilateral

Front 554

optic nn vs. optic tract

Back 554

Nn = infront of chiasm... tract: below chiasm and before lateral geniculate bodies

Front 555

tx open angle

Back 555

topical BB (TIMOLOL, BETAXOLOL) = dec aquous prod, PILOCARPINE = inc outflow, CAI = inc outflow, surg: laser TRABECULOPLASTY (inc outflow)

Front 556

Macular degen sx

Back 556

painless

Front 557

Atrophic vs. Exudative macular dgen ...tx?

Back 557

A: gradual vision loss... E: faster and more severe....tx: for E: laser PHOTOCOAG delay loss central vision in E!!!

Front 558

age of retinal occlusion

Back 558

elderly

Front 559

Retinal vein vs. art occlusion

Back 559

A: sudden, CHERRY RED fovea, swelling, retinal artery pale...V: retinal hemorrhage, COTTON WOOL, edema of fundus

Front 560

tx retinal vs. art occulsion

Back 560

v: photocag maybe?....a: THROMBOLYSIS within 8 hrs, dec pressure,

Front 561

define gravity

Back 561

# preg

Front 562

define parity

Back 562

# preg that led to birth >20weeks or >.5kg

Front 563

HCG level in preg

Back 563

peak at 100k by 10th week, dec in 2nd trimester, level off in 3rd

Front 564

when is uterus palp above pubic

Back 564

12th week

Front 565

nl CV in preg: 1) CO, HR, SV...2) SVR.... 3) BP in first Trimester

Back 565

1) all inc (50%, 15bpm)... 2) dec (progesterone → relax SM)... 3) inc

Front 566

what murmur nl or abn in pregos

Back 566

systolic murmur OK...diastolic murmur BAD

Front 567

HPL for

Back 567

Human Placental Lactogen → inc lipolysis → inc FFA

Front 568

nl blood in pregos 1) anemia DT? 2) WBC?

Back 568

1) MOA: inc Plasma vol by 50% and inc RBC by 30%...2) WBC: inc throughout preg to 10k

Front 569

nl lung in pregos 1) TV, TLC/RV 2) RR 3) dyspnea DT

Back 569

1) TV inc (dec TLC /RV)....2)RR no change .... 3) dyspnea MOA: by inc TV and dec PCO2

Front 570

nl kidney in prgos 1) kidney 2) GFR 3) BUN/cr 4) Estro/progesterone

Back 570

1) dilates → hydronephrosis... 2) GFR: inc by 50% … 3)BUN/Cr dec by 25%... 4) E/P inc → inc RAS → inc ALDO → retain water and inc plasma vol

Front 571

how much weight pregos shuld gain and how much food

Back 571

25lbs...food: inc 100-300 cal/d

Front 572

give what to pregos

Back 572

1) FA, Fe

Front 573

prenatal vistis at 0-28, 29-36, 36-birth

Back 573

1) qmonth, 2) q2weeks, 3) qweek

Front 574

prenatal labs at 15-20w

Back 574

AFP, Quad sc (AFP, estriol, HcG, inhibin A)

Front 575

prenatal labs at 18-20w

Back 575

US to det GA if unknown

Front 576

Trisomy 18 quad screen

Back 576

ALL down

Front 577

Down quad screen

Back 577

AE down, BI up

Front 578

when to do AMNIO

Back 578

15-17w (enough amnio then): women >35, if abn quad, Rh to det baby, det lung maturity of baby

Front 579

CVS good vs. bad

Back 579

G: at 3 mo, as reliable as AMNIO...B: inc risk fetal loss and inc risk to not dx NTD...some limb defect maybe if <9w

Front 580

PUBS when and what for

Back 580

when: during 2 and 3rd tri when umbilical cord big enough...for fetal hemolysis dz and infxn... but AMNIO and CVS better

Front 581

FAS sx

Back 581

small, MR, midface hypoplasia, kidney, heart problem

Front 582

ACEI in babies

Back 582

renal agenisis, oligo, IUGR, cranial ossification

Front 583

Coumadin babies

Back 583

hypoplasia nose, stippled bone, dev delay, eyes problem

Front 584

carbamazepine babies

Back 584

NTD, small fingernail, small head, dev delay

Front 585

folic acid antagonist (methortexate) babies

Back 585

spont abortion inc

Front 586

lead babies

Back 586

inc spont

Front 587

mercury baby

Back 587

small head, atrophy brain, MR, seiz, blind

Front 588

streptomycin, kanamycin

Back 588

hearing loss and CN8 damage

Front 589

valproic acid

Back 589

NTD (spina bifida), small head/face defects

Front 590

bishop score for

Back 590

if cervix good enough to have baby

Front 591

MC congenital infxn

Back 591

CMV

Front 592

syphillis babies

Back 592

fetal hydrops, skin/teeth/bone prob

Front 593

skin scarring, chorio, cataracts, small head, hypoplasia hands/feet

Back 593

varicella

Front 594

diff btw the 2 phases of first stage of labor

Back 594

1) Latent (onset of labor at 3-4cm dilation) 2)active (4cm to complete dilation at 10cm)

Front 595

antepartum fetal surveillance for inc risk babies at?

Back 595

32-36w (or 26-28 if even more worried0

Front 596

what's umbilical artery doppler velocimetry for

Back 596

with IUGR, there is dec and even resrve of umbilical art diastolic flow (only use if IUGR might be)

Front 597

what's a bad oligohydramnios score

Back 597

AFI<5cm

Front 598

when doing BPP do what?

Back 598

Test the Baby MAN (Tone, Breathing, Movemet, Amniotic fluidvol, Nonstress test)

Front 599

to dec aspiration acid in preg?

Back 599

give Na Citrate (in both vag and Csec)

Front 600

When is gestational DM dx

Back 600

usually during LATE PREG

Front 601

if hyperGlc at <20w?

Back 601

preexisting undx DM and tx it like if GDM

Front 602

define large for gestation baby

Back 602

>10 percentile

Front 603

how to dx GDM

Back 603

ABN glc challenge test (24-28'th week)...if>140: do 3hr 100g (+ if at least 2): fasting >95, one hr>180, 2hr >155, 3hr>140

Front 604

GDM complications?

Back 604

50% get Glc intolerance or DM2 later in life

Front 605

what glc level should be for mothers who are DM

Back 605

fasting mornng: <90...2hr: <120

Front 606

DM mom now baby?

Back 606

heart, kidney defect... NTB (sacral agenesis)... polycythemia...hypoCa....hyperBili

Front 607

Gestational HTN protein level, when, complic

Back 607

mild proteinuria <300, usually >20weeks... ¼ → preeclampsia

Front 608

Chronic HTN present when, complic

Back 608

before concepton, <20w...--> preE

Front 609

define PreE (3)

Back 609

new HTN (140/90), proteinuria (>300), >20weeks gestation

Front 610

mild pre-E tx

Back 610

if close: induce w/ IV oxy, PG...if far: expectant management

Front 611

signs of severe preE

Back 611

persistent HA or other cerebral or visual, epigastric pain

Front 612

tx severe preE

Back 612

Mg and Mg 24hrs after

Front 613

how to dx placenta previa

Back 613

US! (transabd or transvag)

Front 614

define IUGR

Back 614

EFW < 10th percentile for GA

Front 615

define polyhydramnios

Back 615

AFI >20

Front 616

how to dx and tx mothers already sensitized Rh

Back 616

sensitized if Rh- mom with tiers >1:16...tx: close monitor w/ serioal US and Amnio for evidnce of fetal hemolysis

Front 617

define hydrops fetalis

Back 617

if Hb <7, fetal hypoxia, acidosis, kernicterus

Front 618

complete moles (GTD= gestational trophoblastic dz)MOA...sx...

Back 618

sperm fertilizaing empty ovum (46xx both from dad)...sx: first Trimester uterine bleed, hyperemesis gravidarum/early eclamp, big uterine size...CXR: may show lung mets...tx: DC and follow HCG for 1 yr

Front 619

molar pregnancies can →

Back 619

invasive moles and choriocarc to → pulmo or CNS

Front 620

MOA of incomplete moles...sx

Back 620

two sperm to 1 ovum (or 1 spurm duplicated)

Front 621

multiple gestations lab

Back 621

inc hCG, HPL, AFP

Front 622

Define PROM

Back 622

<1hr before onset of labor

Front 623

define PretermPROM

Back 623

<37weeks

Front 624

when having PROM do not?

Back 624

digital exam → inc infxn

Front 625

when can labor be induced

Back 625

34...when expectant: 32

Front 626

define preterm

Back 626

reg contr + <37w with cervical change....btw 20-37

Front 627

tx preterm

Back 627

unless CI: tocolysis (Beta-mimetics, Mg, CCB, PGI) and steroids...abx for GBS: pen or amp

Front 628

frank breech vs. flootling breech vs. complete breech

Back 628

Frank: MC, thigs flxed, knees extended...Foot: one foot straight...Complete: thighs and knees flexed

Front 629

tx breech

Back 629

followup...most ok by 38

Front 630

episiotomy types and complications

Back 630

types: median (midline) and mediolateral...complications: extension to anal sphincter (3rd degree), to rectum (4th)

Front 631

tx uterine atony by sequence if unsuccessfu

Back 631

1) masage 2) OXYTOCIN infusion 3) METHEGINE if not HTN 4) Prostin (PGF2a) it not asthmatic

Front 632

MCC postpartum infxn and define

Back 632

cz: endometrial infxn...edefne: >38 for at lest 2 of 10 post partum day (not including first 24hrs)

Front 633

tx endometritis

Back 633

admit, IV: clinda and gent until afebrile for 2 days or 1day for chorio

Front 634

MCC of ant pit insuf in adult female? MC sx?

Back 634

sheehans...MC sx: CANT LACTATE

Front 635

when not to lactate

Back 635

HIV, acute hepatitis, rx

Front 636

MOA of breast during preg

Back 636

inc ESTROGEN and PROG → breast hypertrophy and inh of PROLACTIN....after deliv, hormone dec → PRL release → milk prod

Front 637

MOA of suckling on milk

Back 637

Suckling → more PRL and OXYTOCIN

Front 638

what's colostrum and make up

Back 638

“early breast milk” = fat, prot, secretory IgA, minerals

Front 639

First trimester SAB RF and 2nd trimester

Back 639

first: chromosomal...2nd: cervical incomptenence nfxn, hypercoag, hypoThyr DM

Front 640

when can US detect sac, cardiac

Back 640

sac: 5-6w...heart:6-7w

Front 641

os is what in incomplete

Back 641

open

Front 642

anything expelled in threateneed?

Back 642

no (membrane is itact), uterine bleed, tx: pelvic rest 1-2d

Front 643

anything expelled in inevitable?

Back 643

no, but considered inevitable (os can be open or closed)

Front 644

anythign expelled in missed?

Back 644

no, tissue is still in but fetus is dead, no bleed...no sx...tx: D&C, PG suppositories. DIC risk inc

Front 645

recurrent spont abort define

Back 645

2 or more or 3 in a year...do karyotype, evaluate the uterus

Front 646

elective termination at first tri by

Back 646

oral Mifepristone low + vag/oral misoprostol... Methotrexate+Misoprostol...meds up to 50 days...or sugical (up to 13weeks)

Front 647

elective termination at 2nd tri by

Back 647

obstertric (ripening, amniototmy and oxytocin 13-24weeks...surgical

Front 648

tx mastitis...length post birth

Back 648

cont breast feed + abx (diclox)...usually 2-4 weeks postpartum

Front 649

MC benign breast condition and MOA..age...assoc w/

Back 649

FIBROSCYSTIC change...MOA: super stromal tissue response to hormones and GF ...age: 30-50, NOT IN POSTMENOP...asoc: trauma and coffe

Front 650

sx of fibrocystic change

Back 650

sx: cyclic bilateral mastalgia and swelling, sx JUST BEFORE MENSTRUATION, rapid FLUCTUATION of mass

Front 651

how to dx fibrocystic change...tx

Back 651

mammogram: no...US: can diff btw cystic/solid...FNA: if CELLULAR APLASIA or DUCTAL EPITH HYPERPLASIA = inc risk of CA...tx: OCP

Front 652

bloody nipple discharge

Back 652

intraductal papilloma

Front 653

what's a large fibroadenoma

Back 653

cystasarcoma phyllodes

Front 654

how to dx fibroadenoma

Back 654

US! then FNA...

Front 655

most breast CA occur?

Back 655

upper out quadrant

Front 656

breast CA staging 1-4

Back 656

1: <2cm...2: 2-5 cm... 3: Axillary node...4: distal mets

Front 657

prolonge unilateral scaling of nipple with or without discharge =

Back 657

Paget;s disease f nipple

Front 658

dx labs for breast ca results: mammogram, US, markers mets

Back 658

Mammogram: inc density w/ microcalc and irregular borders... US: solid mass vs. cystic...markers: CEA and CA15-3 or CA 27-29

Front 659

tx for HER/2neu receptor on the cancer cells =

Back 659

TRASTUZUMAB

Front 660

what are good factors for breast CA

Back 660

ER-, PR+, no aneuploidy

Front 661

CI to IUD

Back 661

more than 1 sex partner, prior ectopic, CA

Front 662

define primary amenorrhea

Back 662

none by 16 with 2nd sex characters or NO sex characters by 14

Front 663

define 2ndary amenorrhea

Back 663

none for 6 straight months w/ previous menarche

Front 664

diaphgram over cervix placed how

Back 664

fit by doctor and remain 6-8hrs aftrer sx

Front 665

2 types of IUD

Back 665

Copper (Paragard) (last 10yrs, inc bleed/perf/CI if mult partnert).... and Progesterone (Mirena) (5yrs, perf)

Front 666

types of OCT hormone (4)

Back 666

1) OCP (E + P)...2) P only (minipills)....3) DepoProvera (medroxyprogesterone)...4) morning after

Front 667

OCP MOA

Back 667

suppress FSH/LH → change consistency of cervical mucus...dec endometrial and ovarian CA... SE of E: breast tender, SE of P: depression, acne, HTN crisis

Front 668

Progestin only minipills MOA

Back 668

thickening of cervical mucus and making endometrium hostile. Can start immediate postpartum ...bad: high failure rate than OCP, need STRICT (pill same time each day)

Front 669

Depo-provera

Back 669

can be used by lactating women... reverse dec in bone mineral density (bad for osteo)

Front 670

MOA morning after pills

Back 670

P +/- E taken within 3 d

Front 671

MCC anatomincal cz of anemorrhea

Back 671

ASHERMAN's (DT scarring)

Front 672

what to order if BHCG is neg in amenorrhea? 5

Back 672

FSH (if inc = ovarian fail), LH, TSH, free T4, prolactin (stops LH/FSH)...chck testosterone level

Front 673

MOA of CABERGOLINE

Back 673

DA agonist

Front 674

tx Premature ovarian failure if 1) uterus present 2) uterus absent

Back 674

present: E + P....if absent: E

Front 675

tx anovulatory bleeding

Back 675

give Progeserin x14d → convert prolif endometrium to secretory

Front 676

tx Heavy bleeding

Back 676

Estrogen stabilizes the lining and stops the bleed...DANAZOL for intractable bleed...GNRH agonist (LEUPROLIDE or NAFARELIN)....OCP

Front 677

LEUPROLIDE moa...similar rx?

Back 677

GNRH agonist... similar: NAFARELIN

Front 678

tx Ovulatory bleed

Back 678

NSAIDs to dec blood loss...prolonged use of progesterone → intermittent bleed

Front 679

duration of pain of endometriosis

Back 679

begins 2-7d before onset of menses... severe until flow stops

Front 680

tx endometriosis

Back 680

1) stop ovulation for 5-10 mo: GnRH Analog (LEUPROLIDE), or inh midcycle FSH and LS surge (DANAZOL), or OCP

Front 681

define hypertrichosis

Back 681

xsess nonsex hair

Front 682

CAH sx in female babies

Back 682

ambiguous genitalia and life threateneing salt wasting

Front 683

lab of CAH

Back 683

inc ANDROGEN (Testosterone >2, DHEAS >7,

Front 684

cause of PCOS

Back 684

compensatory hyperinsulin → inc sex hormone-binding globulin (SHBG) & trophic to adrenals/ovaries

Front 685

What's a HAIR-AN syndrome

Back 685

(a variation of PCOS) = hyperandrogen, insulin resistance, acanthosis nigricans

Front 686

all PCOS ladies hsould be screen for

Back 686

glc intolerance (75mg 2 hr level) and for dyslipidemia

Front 687

tx PCOS...complications

Back 687

OCP or progesteron to dec risk of endometrial hyperplasia/CA... complications: DM2 and breast/endometrial CA

Front 688

menopause inc risk of

Back 688

osteoporosis and CAD...lab: inc FSH inc LH, DEXA scan, inc total chol dec HDL

Front 689

MCC infertility in males

Back 689

1) dec count and motility 2) primary test failure: inc FSH, inc LH, dec Testost 3) secondary testic failure (dec FSH, dec LH, dec Progesterone)

Front 690

tx syphillis?

Back 690

if allergic to Pen = tetra or dox...for 3rd trimester: NO ALTERNATIVE, need to desensitize Pen

Front 691

sx of chanchroid and by who

Back 691

painful, bloody, puss, painful inguinal LN....dx: H. Ducreyi

Front 692

primary vs. 2nd vs 3rd lymphogranuloma venereum

Back 692

primary: painless, shallow ulcer...second: inguinal LN hurts and infl, fever malaise... third: anogenital syndr (anal itch, discharge, …)

Front 693

firm red lesions in genitals DT? Tx

Back 693

Granuloma Inguinale...DT: CalymmatoBacterium Granulomatis... dx: Doxy

Front 694

how to dx molluscum contagiosum

Back 694

wright or giemsa stain...tx: cut out

Front 695

normal vag secretion due to

Back 695

1) midcycle Estrogen surge = clear, white, mucoid secretion... 2) luteal phase/pregnancy: thick/white attach to vag walls

Front 696

AMSEL's criteria for and for what

Back 696

¾ for vacT vaginosis.... 1) white/gray dc 2) pH >4.5... 3) + amine (whiff test)... 4) clue cells

Front 697

fish odor... mild vulvar irritation...

Back 697

Bact Vaginosis

Front 698

if vagina pH > 4.5

Back 698

Trichomonas or B Vaginosis

Front 699

yellow green dc vs grey white

Back 699

YG: Trichomonas (itchy and smelly, dc)...GW: B. Vaginosis (smelly, not really itchy)

Front 700

pH of vaginal candida...tx

Back 700

normal = 4...tx:uncomplic: fluconazole or topical...complic: more of it

Front 701

when not to take oral AZOLE

Back 701

pregos

Front 702

TSST sx...how to dx?

Back 702

diffuse macular erythematous rash, desquamation in palms and soles... to dx: culture neg because toxins

Front 703

to dx leiomyomas...to tx

Back 703

US to look at uterine mass...MRI to really determine boundary...tx: PROGESTerone or DANAZOLE (for bleed), GnRH (LEUPROLIDe or NAFARELIN = dec size of myomas, dec vascularity)

Front 704

precursor to endometrial CA and tx...dx test...tx...prevention

Back 704

1) endometrial hyperplasia (Tx by Progesterone)... dx test: bx (Pap not good)... tx: progesteroe, everything...prevent by: PROGESTERONE to oppose estrogen

Front 705

RF of Cervical CA...precursor lesions...dx test...tx...prevent...

Back 705

venereal warts... precursor: CIN common... tx: chem/rads/surg... prevent: smoking...histo: 5% sqcc, 15% adenocarcinoma

Front 706

MCC death in end stage cervica CA

Back 706

Uremia

Front 707

Vulvar CA: age...sx...exam:... RF... precursor lesion.. dx test... tx...histo

Back 707

age: postmenp... sx: itch, genital warts hx... exam: early like dermatitis, late: hard ulcer or cauliflower like... RF: HPV 16,18, 31, etc...precursor: VIN...dx test: punch bx = VIN1 or 2 = mild to mod risk of inc dysplasia, 3 = carcinoma in situ... tx: in situ (wide margin), invasice surg... histo: 90% sqcc, 6% melanoma

Front 708

ovarian CA: age, sx, exam, rf, dx test, tx, prevention, histo

Back 708

age: postmenop...sx: usually none... exam: early nl, later: mass, ASCITES...test: US, AFP, HCG...prevent: OCP, BSO if strong family hx

Front 709

MCC death in ovarian CA

Back 709

bowerl obstruc

Front 710

the two types of endometrial hyperplasia

Back 710

endometrial hyperplasia = changes in glandular and stroma....1) simple = no glandular crowding, 2) complex = glandular crowding

Front 711

what is hyperplasia + atypia called

Back 711

atypical simple or atypical complex(30% of → endometrial type 1 CA)

Front 712

The 2 types of endometrial CA

Back 712

Endometroid type 1..... Serous type 2

Front 713

Endometrial endometrioid CA DT...special... precursor of it?...reprod hx...metabolic syndr (HTN, DM, obesity)?...tumor grade... invasion of....tx...good or bad

Back 713

DT: unopposed E...special: MC female reprod CA in USA...precursor: hyperplasia and atypical...reprod hx: no babies...Metab: YES... tumor: low grade...invade: superficial myo...tx: stage 1 = high dose Progest for premenop, surg and rads for post...prog: good

Front 714

Serous endometrial CA DT...precursor of it...age...metab syndr...invade... tx...prog

Back 714

DT: unrelated to E, but P53 mutation...precursor: Endometrial Intraepithelial Carcinoma (EIC)... age: 67 (vs. 50's)... metab: none...grade: high... invade: deep myo...tx: TAH + staging...prog: bad

Front 715

MCC death of reprod tract CA?

Back 715

ovarian tumors (but most are benign)...RF: age, few babies, delayed childbearing

Front 716

BRCA and ovarian CA?

Back 716

BRACA1>BRACA2 for ovarian CA

Front 717

Ovarian CA also assoc w/

Back 717

LYNCH 2 (HNPCC = inc ovarian, endometrial and breast CA)

Front 718

tx of ovarian CA

Back 718

Premenarche if >2 cm = LAPAROTOMY...premenopause: if <10cm cystic = watch, most go away, if>10cm = surgery...postmenop: asx, unilat <5cm w/ nl CA125 = monitor w/ US

Front 719

more malignan pelvic mass finding of ovaries

Back 719

hard, fixed, bilateral, and nodular (not smooth)...if US: multilocular, bilat, ascites (vs. Calc)

Front 720

CA 125

Back 720

epith ovarian CA

Front 721

AFP in ovaries

Back 721

Endodermal sinus

Front 722

AFP, hCG in ovaries

Back 722

embryonal carcinoma

Front 723

hCG in ovaries

Back 723

choriocarcinoma

Front 724

LDH in ovaries

Back 724

dysgerminoma

Front 725

inhibin in ovaries

Back 725

granulosa

Front 726

tx urge

Back 726

Anticholinergic or TCAs, behavior traning (biofeedback)

Front 727

SPIRAL fx of humerus and femur

Back 727

strongly suggest abuse in kids <3yo

Front 728

shaken baby syndrome check for

Back 728

retinal hemorrhage and noncontrast CT for subdural

Front 729

3D's?

Back 729

acyanotic heart dx: vsD, asD, pDa

Front 730

5T's and 1P's

Back 730

cyanotic heart: P = pulmo atresia

Front 731

VSD fond in...tx

Back 731

Down, FAS, cri du chat, 13, 18...tx: if <1yo w. pulmo HTN, big VSD that dont close, ALL VSD need abx prphy before procedures

Front 732

ASD EKG

Back 732

Right axis dev, RVH

Front 733

PDA tx

Back 733

indomethacin...unless baby >6-8mo (then surgery)

Front 734

coarc assoc w/....sx

Back 734

berry aneurysm, 2/3 have bicuspid aortic valve...sx: asx HTN in kids (weak femoral pulses)

Front 735

“3” sign on CXR?

Back 735

pre and post dilation of the coarc segment with aortic wall indentation and rib notching

Front 736

CATCH 22 stands for

Back 736

Cardiac, Abn face, Thymic aplasia, Cleft palate, HypoCa

Front 737

MCC cyanotic congenital heart prob in newborn

Back 737

Transp of Great Vessels...need a septal defect to be alive

Front 738

MC cyanotic heard dz in kdis...sx when

Back 738

Tetralogy of fallot (MC in newborn is different)...RF: PKU and CATCH22...sx: not at birth but by first 2 yrs

Front 739

initial tx of both Tetralogy and Transposition

Back 739

PGE1

Front 740

Down sx

Back 740

flat face, epicanthal folds, simian crease, MR...heart: Atrioventricular canal (ASD, VSD, valve prob DT endocardial cushion defects)...C1-C2 instability too

Front 741

Edwards sx

Back 741

low set ears, clenched nands, prominent occiput...horseshoe kidney

Front 742

Patau sx

Back 742

MR, small head, CLEFT, abn forebrain (HOLOPrOENCEPHALY), puched out scalp, polydactyly...heart dz...death like edwards

Front 743

Klinefelter has? Sx

Back 743

XXY (bar Body)...sx: testicular atrophy, eunuchoid body, tall, long

Front 744

MCC primary amenorrhea

Back 744

Turner's...horseshoe kidney

Front 745

PKU MOA

Back 745

dec. phenylalanine hydroxylase or dec TH4... screend at bith (only valid after protein meal like milk) → tyrosine becomes essential and inc Phe...tx: inc TYR dec Phe in diet (if mom has it, needs to change her diet BEFORE comception)

Front 746

sx of PKU

Back 746

blond, blue eye, heat prob, MR, fair skin, mousy urine odor

Front 747

Fragile x MOA

Back 747

Xlinked (methylation and expression of FMR1 gene, triple repeat!) = 2nd MCC genetic MR

Front 748

Fabry's MOA...sx..type

Back 748

alphaGalactose A defic → inc Ceramide trihexose (heart, brain, kidney)...sx: renal fail, inc stroke and MI...type: XR

Front 749

Krabbe's dz MOA...sx..type

Back 749

no GALACTOSIDE and GALACTOSYLCERAMIDE → galactocerebroside in brain...sx: optic atrophy, spasticity, early death...AR

Front 750

Gaucher MOA, sx, type

Back 750

def. GLUCOCEREBROSIDASE → inc it brain, liver, BM (GOUCHER CELLS = crinkled paper)...sx: big organs, anemia, dec plastelets...MC type: 1 (nl life and no brain stuff)...AR

Front 751

Niemann Pick MOA, sx, type

Back 751

defic: SPHINGOMYELINASe → inc sphin cholesterol in RETICULOENDOTHELIAL and parenchymal...type A die by 3...AR (hehe: no man PICKS his nose with his SPHINGER)

Front 752

TaySac MOA, sx, type

Back 752

HEXOSAMINIDASE → GM2 Gang...sx: ok until 6mo, weak, slows , regress, dead by 3, CHERRY RED on MACULA...(hehe: taysaX, heXo)

Front 753

Metachromatic Leukodystrophy MOA, sx, type

Back 753

Arylsulfatase A → inc in brain, kidney, liver, PERIPHERAL NN...AR

Front 754

Hurler's , sx, type

Back 754

Alpha Iduronidase...sx: corneal cloud, MR...AR

Front 755

Hunter's, sx, type

Back 755

Iduronidase Sulfatase... sx: corneal couding, mild MR...XR (hehe: hunters need to see: no corneal blind to see X)

Front 756

Cystic Fibrosis MOA, sx, dx, tx

Back 756

MOA: CFTR channel in Chr 7...sx: meconium ileus, greasy stool, male infertility, ADEK defic...to dx: Sweat cloride >60, >80 for adult

Front 757

MCC bowel obstr in first 2 yrs life...and tx it

Back 757

intusseption....tx: aircontrast Barium, if unsuccessful: surgery

Front 758

the rules of Meckel's

Back 758

6 2s: 1) under 2, 2) males 2x, 3) pancreatic and gastric tissue 4) 2 in long within 2 ft ileocecal, 5) 2% pop

Front 759

MC congenital abn of small intestine

Back 759

Meckel's...sx: asx, painless rectal bleed, if pain → complications!...to dx: Meckle Scintigraphy scan...tx: if bleed: excise diverticulum, if asx: excise

Front 760

explosive discharge of stool after rectal exam:...to dx...tx

Back 760

Hirschprung...dx: plain film...tx: excise

Front 761

Malrotation with volvulus dx

Back 761

fibrous band (Ladd's bands)...to dx: if stable: Upper GI, US depends on tech...tx: NG to decompress, fluid, surg

Front 762

MC peds immuno DO...age...tx...

Back 762

Bcells...sx: 6mo...tx: IV Ig (xcept for IgA defic)

Front 763

Bcells vs. Tcells immuno DO?

Back 763

Tcells: 1-3 mo (earlier) and infx: fungal, viral, IC, opportunistic...(Bcells: encaps bacT)

Front 764

3 ex of Bcells DO

Back 764

Xlinked Agamma (bruton's), Common variable Immunodef, IgA defic

Front 765

Bruton's peeps...infx...dx and tx

Back 765

peep: Bcell defic in BOYS only...infx: encaps, LIFE THREAT...to dx: quantify Ig, next see B or T cells levels, no tonsils or lymphoid tissue...tx: Abx + IV Ig

Front 766

Common Variable Immunodefic peeps, infx, tx

Back 766

peep: low Ig in 20-30s, B and T cells prob...sx: pus URI, Lymphoma and autoI inc...to dx: same as with Bruton's

Front 767

IgA defic sx...dx

Back 767

sx: Mild, common...sx: usually asx, anaphylactic rxn post transfusion...dx/tx: IgA level

Front 768

1 ex Tcells DO...sx..infxn...dx/tx

Back 768

Thymic aplasia (DiGeorge)...sx: tetany in first days, fungal and PCP...dx/tx: abs lcy count, delayed skin test...tx: BM, IVIg, PCP prophy, thymus transplant

Front 769

3 ex of Combined T and B DO

Back 769

Ataxia Telangiectasia.... SCID.... Wiskott Aldrich

Front 770

Atax Telangiectasia peep/moa...sx...dx/tx

Back 770

MOA: DNA repair defect...sx: OCULOCUTANEOUS TELANGIECTASIA and progressive CERBELLAR ATAXIA...infxn: inc NHL, Leuk, gastric CA...tx.dx: no specific

Front 771

SCID moa, sx, tx/dx

Back 771

moa: both T and C defic...sx: candida, everything...txdx: BM, stem cell, IV Ig, need PCP PROPHYLAX

Front 772

Wiskott-Aldrich MOA..infxn...txdx

Back 772

MOA: X- less bad B and T → dec IgM (hehe: WAM), dec platelets, inc E/A...sx: EXZEMA, Ig prob, DEC PLATELETS = recurrent... dxtx: IV Ig + abx, RARELY LIVE TO ADULTHOOD, bm

Front 773

3 ex of Phagocytic DO

Back 773

Chronic Granulomatous Dz....LAD...CHediak Higashi Syndrome

Front 774

CGD type...moa...sx..txdx

Back 774

type: XR, AR defic of superoxidase prod by PMN and Macrop...sx: chronic, granuloma of skin, LN...txdx..Abs neutrophil count, Nitroblue Tetrazolium, tx: daily BACTRIM, IFNgamma, BM

Front 775

LAD...sx...txdx

Back 775

sx: omphalitis in new born with delayed umb cord...txdx: no pus and minimum infl, lots WBC, tx: BM

Front 776

Chediak Higasi type..sx..txdx

Back 776

type: AR= neutrophil no chemotax...sx: oculocutaneous albinism, neuropathy, neutropenia, lots infxn bacT...tx: BM TOC!!!

Front 777

to dx C1 esterase defic

Back 777

total hemolytic complement (CH50) assess quantity and fxn of complement...tx: before surg: purified C1 esterase and FFP

Front 778

Juvenile Arthritis + systemic onst =

Back 778

Still's DZ (recurrent high fever, big organs, rash)...

Front 779

which vacc not to take in immunoins and pregos

Back 779

oral polio...(varicella...MMR = these 2 can be taken in HIV)

Front 780

these are not CI to vaccine

Back 780

premature, current abx therapy

Front 781

MCC bronchiolitis...to dx...to tx

Back 781

RSV...complic: resp failure...sx: tachypnea, wheez, crackle, rhinorrhea...to dx: CXR: hyperinflated, atelectasis, ELISA of nose washing...tx: fluid and nebulizers, RSV prophylaxis in winter for high risk pt <2

Front 782

MOA of croup (aka?)

Back 782

aka: laryngotraheobronchitis...MOA:viral infxn of Larynx, in subglottic...complic: bacT superinfxn → tracheitis...sx: URI, now stridor, barking cough...to dx: stridor, steeple DT subglottic...tx: if severe: EPI

Front 783

Epiglotitis area?

Back 783

supraglottic (epiglottis, and aryepiglottic folds)... sx: high fever, drool, muffled voice, dog position...to dx: do not examine throat, gold: fiberoptic: cherry red, swollen epiglottis...tx: true emergency: intubate and abx (ceft or cefurox) IV

Front 784

Stridor?

Back 784

croup

Front 785

Traheitis cause by...CXR

Back 785

s. aureus...sx: prodome then acute in 10hrs...CXR: subglottic narrowing

Front 786

Age / PE/position of Retropharyngeal abscess cs. Peritonsilar abscess

Back 786

R: 6 mo -6yrs, cervical LN unitlat/mass on posterior pharyangeal wall...P: >10yrs, no LN or mass outside..same bacT for both (group A MC)...R: like to be in a dog position

Front 787

like to be in Dog position

Back 787

retropharyngeal abscess and croup

Front 788

MCC viral meningitis

Back 788

Enteroviruses

Front 789

The 3 stages of BORDETELLA PERTUSSIS

Back 789

1) CATARRAL (mild URI sx = most contagious)...2) Paroxysmal (most common stage,, some insp woop. Emesis), 3) CONVALESCENT (dec sx)

Front 790

tx whooping cough

Back 790

if <6mo = hosp...else: ERYTHROMYCIN to everyone involved

Front 791

describe rash in 5th dz

Back 791

red, itchy, starts arm and spred to trunk

Front 792

measles DT and rare complication

Back 792

Paramyxovirus...complic: subacute sclerosing panencephalitis

Front 793

rubella describe rash

Back 793

red, tender rash starts face and goes out...less sx than measles

Front 794

Roseola infantum DT? Describe prodrome and rash and complic

Back 794

HHV6...prod: high fever then stop, then rash starts on trunk and spreads out and last <1d..complic: febrile seiz

Front 795

neonatal jaundice that is direct/conjugated hyperbili?

Back 795

always pathologic (unconju can be either)

Front 796

VACTERL?

Back 796

Vertbral, Anal, Cardiac, Tracheal, Esophageal, Renal, Limb

Front 797

Gastrochisis location

Back 797

next to umbilicus, no sac

Front 798

omphalocele

Back 798

covered by peritoneum and amniotic membrane...seen in: BECKWITH WIEDERMAN and trisomies

Front 799

pathologic vs. physiologic jaundice...time, %of direct bili and peaks

Back 799

Phys: not until 3 d, Path: first day...peak: Phys: <15, Path>15....%of direct in phys is <10%...length: in phys resolves in 1-2weeks, in path, not resolve in those time

Front 800

phototherapy of conjugated hyperbili →

Back 800

bronze skin

Front 801

sx Resp Distress Syndr

Back 801

MC resp failure in preterm infants...sx: fist 2-3 d, RR>60, hypoxemia, cyanosis, nasal flaring...

Front 802

Transient tachypnea of newborn MOA

Back 802

retained amniotic fluid → prominent perihilar streaking in interlobular fissures

Front 803

meconium aspirate newborn signs

Back 803

hyperexpansion and pneumothoraces

Front 804

tx RDS in kids

Back 804

CPAP or intubate and mechanical ventilation, surfactants

Front 805

MC movement DO in children...the types

Back 805

Cerebral palsy...1) PYRAMIDAL (spastic) = paresis of any or all limbs, MC, MR 90%...2) EXTRAPYRAMIDAL (dyskinetic) = ataxic, choreoathetoid, dystonic, abn worse during stress , less at sleep

Front 806

tx of Cerebral palsy

Back 806

Ed, PT, brace...tx spasticity: Diazepam, dandrolene, baclofen

Front 807

the types of febrile seiz

Back 807

1) simple (<15min, generalized seiz, high fever)...2) complex (>15min, focal, many seiz in 24hrs, low grade fever for days before seiz)...antipyretic does NOT dec amt of febrile seizure

Front 808

MC childhood malig? Age? Asoc with

Back 808

ALL...2-5yo white...assoc: Down, Fanconi, SCID, BM failures

Front 809

sx of ALL...to dx

Back 809

abrupt onset, can have weird CHLOROMA (greenish soft issue on skin or spinal cord)...to dx (lots of blast on peripheral)..tx: chemo (watch out for tumor lysis syndrome)

Front 810

sudden hyperK, hyperURICEMIA

Back 810

tumor lysis syndrome

Front 811

<2 yo, most have mets when found, mc loc: abd/thoracic/cervical...sx: NONTENDER abd mass (may cross midline), Horner, HTN or cord compression...dx...assoc w/...to dx...tx

Back 811

NEUROBLASTOMA...assoc: NF, Hirshsprung, N-myc... todx: CT, FNA, 24hr Cat (VMA, HVA)...tx: excise + chem/rads

Front 812

asyx, nontender abd mass, but 2-5 yo...assoc w...

Back 812

WILMs...assoc w: BeckWiderman (hemihypertrophy, macroglossia, visceromegaly), NF, WAGR (Wilms, Aniridia, Genitourinary abn, MR)

Front 813

Aniridia + hemihypertrophy..think

Back 813

WILMS

Front 814

From neuroectoderm...in bones...adolescent whites male...dx and chromo...loc...dx...

Back 814

Ewing's...Chromo 11:22 transloc...sx: swelling/pain in MIDSHAFT...lab: leuko, esr

Front 815

CA from osteoblasts of mesenchymal origin in young males...sx...dx...

Back 815

OSTEROSARC...sx: systemic sx RARE (vs. Ewing's), loc metaphyses of long bones, 20% mets to lung...lab: sunburst lytic, high LDH

Front 816

Generalized Anxiety Disorder length, tx

Back 816

>6 mo...tx: BUSPIRONE, venlafax, SSRI

Front 817

OCD pt know?

Back 817

that they are irrational and want to change...tx: SSRI and cognitive behavior therapy

Front 818

5 SSRI and first line for

Back 818

Sertraline, paroxetine, citalopram, escitalopram, fluox...tx: GAD, OCD, PTSD...se: sex

Front 819

Buspirone for...se

Back 819

same as SSRI...SE: SEIZURE w/ chronic use (no tolence, dependence or withdrawal)

Front 820

Flumazenil for...se

Back 820

tx BENZO intox (hehe: FLY in my BENZ)...SE: resedation, dizzy, vomit, pain

Front 821

OCD vs. OCDPersonality

Back 821

OCD: know they suck and want to change (ego-dystonic)...OCDP: do not recognize (Ego syntonic)

Front 822

tx phobias

Back 822

CBT

Front 823

PTSD length, tx

Back 823

>1mo...tx: SSRI, Buspirone, TCA and MAOI

Front 824

define DEMENTIA

Back 824

impair cognitive fxn with GLOBAL deficits, consciousness is STABLE, highest in >85

Front 825

Agnosia?

Back 825

cant recognize previously known object

Front 826

do not give what to elderly

Back 826

benzo

Front 827

define delirium

Back 827

consciouness CHANGE, cognity ALTERED

Front 828

type of hallucination in Dementia and Delirium

Back 828

Delirium: visual or tactile...Dementia: in 30% of peeps in very advanced dz

Front 829

SIG E CAPS for

Back 829

Sleep, Interest, Guilt, Energy, Concentration, appetite, psychomotor agitation/or retardation, suicide

Front 830

Bupropion SE

Back 830

dec. seizure treshold, few sexual side effects (CI in bulimics)

Front 831

trazodone SE

Back 831

pripaism, highly sedating

Front 832

TCA

Back 832

lethal arrhythmias

Front 833

MAOI...2 examples

Back 833

High-TYRAMINE foods (cheese, red wine), sex side effects... Phenelzine and tranylcypromine

Front 834

% of people with bipolar commit suicide

Back 834

10-15%

Front 835

define Bipolar 1

Back 835

at least 1 manic or mixed episode

Front 836

define Bipolar 2

Back 836

at least one MDE and one hypomanic episodes (less intense than mania)

Front 837

cyclothymic

Back 837

chronic and less severe

Front 838

DIG FAST

Back 838

Distract, Insomnia, Grandiosity, Flight of ideas, Activties/psychomotor, Sexual, Talkative

Front 839

how long is manic episodes

Back 839

>=1week

Front 840

Lamotrigine SE

Back 840

SJ

Front 841

SE of Thioridazine

Back 841

irreversible retinal pigmentation... type: Typical antipsychotics

Front 842

SE of atypical of

Back 842

NMS...tx: DANDROLENE or BROMOCRIPTINE

Front 843

Carbamazipine

Back 843

nausea, skin rash, leukopenia,

Front 844

Acute dystonia

Back 844

involuntary muscle contraction...tx: Benztroprine or Diphenhydramine

Front 845

Akathisia

Back 845

def: restlessness...tx: dec neuroleptic, try BB

Front 846

dysinesia def and tx

Back 846

def: pseudoparkinson like (shuffling gait, cogwheel rigid)

Front 847

tardive dyskinesia

Back 847

def: oral facial movements...tx: giving antichol or dec neuroleptics may initially worsen tardive dyskinesia

Front 848

Schizo earlier in males...which subtype is worse, best

Back 848

worse: disorganized... paranoid: prognosis

Front 849

Cluster A is?

Back 849

weird, (paranoid, schizoid, shizotypal)

Front 850

Cluster B is?

Back 850

wild (Borderline, histrionic, narcissistic, antisocial)

Front 851

Cluster C is?

Back 851

Worried and wimpy (OCD, avoidant, dependent)

Front 852

wht is schizoaffectiv

Back 852

Schizophrenia + major affective DO (Major depression or bipolar)

Front 853

Autism assoc w...age......sx..tx

Back 853

TS and Fragile X syndrome...before 3...no interest in relationship and abn devn in nl social behavior, stereotyped speech/behacior...tx: behavior management

Front 854

sx Asperger's

Back 854

Austim like in terms of relatinship...but NO LACK OF COGNITION OR LANGUAGE

Front 855

Retts MOA, age

Back 855

neurodegen in females..progressive impair after 5mo

Front 856

age of Childhood Disintegrative Disorder

Back 856

regress after 2yo

Front 857

MR IQ level

Back 857

<70...85% are mild (50-70), mod (35-49), severe (20-34), profound (<20)

Front 858

define Coproliala

Back 858

repetition of obscene words

Front 859

tx Tourette

Back 859

DA antagonist (HALOPERIDOL, PIMOZIDE)

Front 860

abuse vs. dependence

Back 860

Dependence is more dangerous....abuse: not fulfill responsibiilty...dependence: inc tolerance

Front 861

tx etoh abuse

Back 861

1) start benzo for withdrawal sx 2) vit, FA, thiamine, then Glc 3) long term AA

Front 862

anorexia vs. bulemia, who is more concerned and willing to get help

Back 862

bulemia (anorexics deny problem)

Front 863

define anorexia

Back 863

<85%, lanugo...

Front 864

etoh intox and withdrawal

Back 864

w: tremor, tachy

Front 865

opioids block by...withdrawal

Back 865

block by: NALOXONE, NALTREXONE...w: dilated pupils, cramps...

Front 866

PCP sx, tx for sever sx, withdrawal

Back 866

sx: assault/vert and horiz nystagmus)/seiz...tx: give benzo or Haloperidol if severe...w: RECURRENCE of INTOX DT reab in GI/sudden severe onset, random violence

Front 867

LSD sx

Back 867

flashbacks, delusion, visual hallucination

Front 868

2 types of anorexia

Back 868

1) restrictive 2) binge, purge

Front 869

pt with eating DO should not be prescribed

Back 869

BUPROPION (inc seiz)

Front 870

paraphilia...length...tx

Back 870

>6mo...tx: insight oriented psycho, behavior therpay

Front 871

define sexual sadism

Back 871

inflict on others

Front 872

define sexual masochism

Back 872

liked to be hurt

Front 873

tx insomnia

Back 873

good sleep hygiene...if using rx: Diphenhydramine, zolpidem, zalepllon, trazodone

Front 874

primary hypersomina length

Back 874

>1mo...tx: amphetamine

Front 875

tx narcolepsy

Back 875

scheduled daily naps + stimulant

Front 876

central vs. obstructive sleep apnea

Back 876

C: both airflow and respiratory effort decrease/MORNING HA/mood changes...O:airflow dec DT obstruction / SNORING/MALe/FAT

Front 877

tx CSA vs. OSA

Back 877

C: BPAP = mechanical...O: nasal continuous CPAP, weight loss, if kids = surg of tonsils

Front 878

tx jet lag

Back 878

2-7d self heal

Front 879

do somatoform pts know?

Back 879

no conscious control

Front 880

tx somatization DO

Back 880

multiple office visits

Front 881

tx conversion DO

Back 881

(ex: sudden loss vision)...tx: selfheal or psychotherapy

Front 882

tx Body dysmoorphic

Back 882

SSRI maybe

Front 883

tx pain DO

Back 883

rehab, TCA, venfalazine

Front 884

SAD PERSONS stand for

Back 884

risk factor of suicide: Sex male, Age, Depression, Previous attempt, Etoh, Rationa though, Sick, Organized plan, No spouse, Social support lacking

Front 885

3 MCC death in 15-24

Back 885

1) homicide 2) accidents 3) suicide

Front 886

some other sx of sarcoid...granulomas?

Back 886

gammaglobulinemia, negative TB, lymphadenopathy...noncaseating granulmas in LN!!!

Front 887

tx sarcoid

Back 887

steroids

Front 888

CXR of hypersensitivy pneumonitis acute and chronic

Back 888

acute: nl or miliary nodule infiltrate...chronic: fibrosis in upper lobes

Front 889

Abestosis...hx...age...CXR...complic

Back 889

hx: tile, brake, ships...20yrs later...CXR: calc pleural plaques (benign), linear opacities at base

Front 890

coal mine...cxr...complic

Back 890

cxr: small nodules in upper lobe...complic: fibrosis

Front 891

silicosis...sx...cxr...complic

Back 891

hx: glass, pottery...cxr: small nodule upper lobe, EGG SHELL CALC...comlic: inc risk TB, need yearly TB skin test/progressive massive fibrosis

Front 892

berylliosis..hx..dx..complic

Back 892

hx: high tech field, dental, dye...cxr: diffuse infltrate, HILAr adenopathy...complic: need CHRONIC steroid tx

Front 893

ABCT of obstr pulmo dz

Back 893

Asthma, Bronchiectasis, Cystic F, Tracheal/bronchial obstr

Front 894

5 things in Asthma

Back 894

1) reversible obstr 2) hyperreactivity 3) airway infl 4) mucuous plug 5) sm hyperreactive

Front 895

in kids withmany croup and URI?

Back 895

think asthma

Front 896

ASTHMA for asthma tx

Back 896

Abuterol, Steroids, Theophyline, Humidified O2, Mg, Antichol

Front 897

acute vs chronic tx asthma

Back 897

A: O2, Bdilatr (short acting), Ipratropium (never use alone), systemic STEROIDs...C: Bdila(long), inh steroids, systemic steroids, cromolyn or theophyllin

Front 898

2 ex of B2Agonist

Back 898

Albuterol (short) , Salmeterol (long)

Front 899

1 ex of Methylxanthines and MOA

Back 899

THEOPHYLLINE (inh Phosphodiesterase → inc cAMP → dilate lung...SE: narrow margin safety (CARDIO and NEUROTOX)

Front 900

1 ex of muscarinic antagnoist

Back 900

IPRATROPIUM

Front 901

CROMOLYN MOA...for...usage....SE

Back 901

stops stuff from MAST CELLs...for EXERCISE spasms...use: mainly for PROPHYLAXIS, not for acute...SE: rare

Front 902

inh steroids used for

Back 902

first line tx for long term asthma

Front 903

severe persisten asthma..sx...meds

Back 903

continous...tx: High dose inh steroids + long inh B2 + possible PO steroids + PRN short bronchodilators

Front 904

mod persistent asthma..sx..meds

Back 904

daily, >1x nightweek...tx: med inh steroids + long inh B2 + PRN short B2

Front 905

Mild persistent asthma...sx..meds

Back 905

>2weekday but <1/d, >2nightmonth...tx: low inh steroids + PRN short B2

Front 906

mild intermittent asthma...sx..meds

Back 906

<=2day.week, <=2night.month...tx: NO daily + PRN short B2

Front 907

Bronchiectasis to dx..tx

Back 907

CXR: inc marking, TRAM LINES (parallel lines outlining dilated bronchi DT infl and fibrosis), CT: dilated bronchi

Front 908

The 2 types of enphysema, cause and loc

Back 908

1) SMOKING (centrilobular) 2) Alpha1 antitrypsin (panlobular)...E: terminal airway destruction and dilation

Front 909

in COPD pt with chronic hyoxia...be careful?

Back 909

give them lots of O2 will stop their breathing drive

Front 910

COPD tx for COPD

Back 910

Corticosteroids, O2, Prevention (smoke, pneumovax, influvax), Dilators (B2, antichol)...

Front 911

dyspnea and pursed lips....CXR: parenchymal BULLAE or subpleural BLEBS!!!!...abg?...tx

Back 911

emphysema...ABG: hpoxia, and chronic resp acidosis...tx: acute (O2, inh B2, antichol, IV steroids, abx), chronic (stop smoking, O2, inh B, antichol, steroids, pneumovax/fluvax)

Front 912

only thing that inc survival in COPD?

Back 912

supplemental O2

Front 913

pulse ox in hypoxemia...ABG for...if inc Aa gradient

Back 913

pulse ox: dec HbO2 sat...ABG: eval PaO2, calc Alveo-Art (A-a) O2 gradient...inc Aa gradient = V/Q mismatch or diffusion impaired

Front 914

tx hypoxia

Back 914

1) give O2 before eval 2) if pt on vent = inc O2 sat by inc FiO2, inc PEEP or Inc I/E ratio...3)HyperCO2 pt = Inc minute vent

Front 915

ARDS dx or ARDS

Back 915

Acute onset, Ratio (PaO2/FiO2 <=200), Diffuse infiltra, Swanz Ganz <18mmHg

Front 916

triad of ARDS

Back 916

hypoxia, dec lung complicance, noncardio PE

Front 917

tx ARDS

Back 917

vent at LOW TIDAL VOLUME (reduces mech vent injury), PEEP to get collapse bronchi, change PEEP and FiO2 to get enough O2...goal: PaO2>60, or SaO2 <90 on FiO2 <.6

Front 918

define pulmo HTN

Back 918

>25mmHg

Front 919

dyspnea, tachy, nl CXR...tx

Back 919

PE....tx: 1) Hepatrin 2) thromboylsis (if severe DVT or PE → RHF and heme unstable, CI in recent surg)

Front 920

wedge shaped infarct lung on CXR

Back 920

Hampton's hump

Front 921

oligemia in embolized lung zone CXR

Back 921

Westermark's sign

Front 922

ECK of PE

Back 922

Swave on 1, Q in 3, inverted T in 3

Front 923

best way for DVT prophylaxis

Back 923

early ambulation

Front 924

factors favoring lung CA...tx low risk CA

Back 924

>45, smoke, no calc, irregular calc, irregular margin...tx low risk: re image 3-6 mo

Front 925

BLAB for lung CA location

Back 925

bone, liver, adrenal, brain

Front 926

smCC of lung assoc w, loc, origin

Back 926

assoc: cigarette, loc: center, origin: neuroendocrine

Front 927

MC lung CA, loc, types,

Back 927

Adenocarcinoma, loc: periphery, a type: BRONCHOALVEOLAR CARCINOMA (lots of sputum, prolif)

Front 928

Least common and worst lung CA

Back 928

large cell

Front 929

MOA of primary pneumothorax

Back 929

Rupture of bleb in tall, thin, young guys

Front 930

MOA of 2nd pneumotohax

Back 930

DT: COPD, TB, trauma, PCP, line...

Front 931

MOA tension pneumo

Back 931

wall defect –> one way valve (inc inside)...sx:

Front 932

HyperNa can be DT

Back 932

hypertonic saline/feed or INC ALDO

Front 933

hypotonic fluid loss DT

Back 933

diureticcs, renal dz, diarrhea, burn

Front 934

pure water loss

Back 934

DI

Front 935

sx of central pontine myelinolysis and DT

Back 935

quadriplegic and pseudobulbar palsy...DT: correcting hypoNa too fast (>1mEq/L/hr)

Front 936

hyperK DT

Back 936

Type 4 RTA, NSAIDs, mineralocorticoid defic

Front 937

C BIG K for tx hyperK

Back 937

Calcium, Bicarb or insulin w/ sugar, Keyexalate

Front 938

4 cz of hypervol and tx

Back 938

RF, Nephrotic, Cirrhosis, CHF...tx: restirct water

Front 939

7 cz euvolemia and tx

Back 939

SAIDH, hypoThyr, RF, rx, psychogenic polydipsia, adrenal insufficiency...tx: restrict water

Front 940

6 cz hypovolemia and tx

Back 940

diuretics, vomit, diarrhea, third space, dehydration...tx: give NS

Front 941

EKG for hyperK

Back 941

1) peak T, 2) long PR 3) wide QRS

Front 942

B2 agonist and K?

Back 942

inc cell uptake K

Front 943

hypoK can be DT

Back 943

renal, GI, Barters, hypoMg, Type 1 RTA, mineralocort xs

Front 944

sx hypoK

Back 944

weak, cramps, hyporeflex, paralysis...EKG: flat T, U wave, ST depression

Front 945

MCC hypoK

Back 945

renal, GI loss

Front 946

MCC hyperCa

Back 946

hyperPT and CA (breast, MM, sqcc, xs vit A/D, MEN1)

Front 947

level of Ca

Back 947

8.5-10.2

Front 948

hypoCa sx

Back 948

abd cramps, tenaty, PERIORAL and ACRAL PARESTHESIA

Front 949

pt dev cramps and tetany after thyroid surg

Back 949

hypoCa

Front 950

low alb?

Back 950

can cause false low Ca!

Front 951

MUDPILES for

Back 951

AG! Methanol, Uremia, DKA, Paraldehyde, Intox, Lactic acidosis, Ethylene Glycol, Salicylates

Front 952

MOA ARF

Back 952

sudden dec fluid → retention BUN/Cr

Front 953

Renal ischemia, toxins, hemoglobinuria or myoglobinuria →

Back 953

ATN

Front 954

if FeNa<1%, meaning

Back 954

Kidney trying to retain Na...so problem is prerenal!

Front 955

Methicillin and kidne?

Back 955

AIN

Front 956

hyaline cast means

Back 956

volume depletion

Front 957

Granular cast, renal tubular cells, “muddy brown cast” see in

Back 957

ATN

Front 958

SE of carbonic anhydrase inhibitors

Back 958

hyperCl, Metab acidosis, sulfa allergy

Front 959

Ethacrinic acid, Bumetanide are?

Back 959

loop agents

Front 960

what is nephritic syndrome 2 words...to dx...

Back 960

inflammation of glomerular...HTN, dec GFR → inc BUN/Cr, proteinuria, hematuria

Front 961

“lumpy-bumpy” on immunoFluorescence

Back 961

Post-strept GN

Front 962

IgA nephropath can been seen in

Back 962

(aka Berger's)...with Henoch Sholein purpura...20%--> enstage

Front 963

tx Wagener vs. Good pasture

Back 963

G: plasmaph + some steroids...W: high steroids

Front 964

Alport age, sx, histo, prog

Back 964

5-20yomen...sx: deaf, asx hematuria...histo: GBM SPLIT...prog: esrd

Front 965

minimal change can be 2nd to...hx...tx

Back 965

2nd to NSAIDs, blood CA...hx: infxn and clot hx... tx: steroid, GREaT!

Front 966

young black male with uncontrolled HTN...dx? Assoc w/...tx

Back 966

FSGN...assoc: IV rx, DM, HIV...tx: steroids

Front 967

Membranous..assoc w...histo

Back 967

assoc: HBV, syphylis, gold...histo: SPIKE AND DOME dt deposit IgG and C3 at BM

Front 968

DM Nephro 2 types...histo..

Back 968

types: Diffuse hyaline and Nodular glomerulosclerosis (Kimmelstein wilson lesions)...histo: thick GBM and inc MESANGIAL MATRIX

Front 969

Lupus nephritis histo

Back 969

mesangial proliferation, subendothelial immune complex deposition

Front 970

renal amyloiddosis DT?..hx...histo

Back 970

DT primary (plasma cell dyscrasia), 2nd (infxn, infl)...hx: MM or chronic infla dz...histo: Congo red stain, apple green birefringen

Front 971

Membranoproliferative assoc..histo..tx

Back 971

assoc: HCV, Cryoglobulemia, lupus, subacute bacterial endocarditis...hx: slow progress to renal failure...histo: double layer BM, subendothelial deposit

Front 972

pts with DI like...dx test

Back 972

ice cold beverages...Water deprivation test: excrete lots of diluted urine...

Front 973

tx SAIDH

Back 973

restrict water

Front 974

SAIDH can be DT...how does DEMECLOCYCLINE help

Back 974

CNS (injury, tumor), pulmo (sarcoid), drugs (antipsych, antiD) or surgery....DEME: antagonizes ADH in tuberal

Front 975

urinary of Na >20 means?

Back 975

pt is not hypovolemic

Front 976

kidney stone size and prog

Back 976

<.5cm can pass...<3cm =litho

Front 977

MCC calcium kidney stone

Back 977

80% idiopahtic

Front 978

which kidney stones have alk urine

Back 978

Cacium, Struvite

Front 979

Which kidney stone has acidic urine

Back 979

Uric Acid...tx by alk urine with CITRATE

Front 980

hexagonal kidney stone

Back 980

cystine

Front 981

APKD assoc w

Back 981

liver cyst, berry aneurysms...esrd eventually

Front 982

what age worry if first UTI

Back 982

<7yo...need voiding cystourethrogram

Front 983

labs to check for erectile dysfxn

Back 983

Testosterone, gonadotropin...PRL also can dec androgen

Front 984

BPH most common age...mc location...tx:

Back 984

>50...loc: periurethral...DRE: rubbery (if hard = CA)...tx: TERAZOSIN (alpha block), FINASETRIDE (5alpha reductase inhibitors)

Front 985

prostate CA PSA? Histo scale...tx metastatic prostate CA

Back 985

PSA>4!....GLEASON: 1-5 of 2 samples = 10 is highest...tx mets: ANDROGEN ABLATION (GnRH agonist, orchiectomy, flutamide)

Front 986

how to dx bladder CA

Back 986

cystoscope w/ bx

Front 987

tx bladder CA

Back 987

1) CARCINOMA IN SITU: chemo, 2) SUPERFICIAL: complete transurethral resect or chemo w/ mitomycinC or BCG (vaccine for TB?!) 2) LARGE/HIGH GRADE: chemo 3) INVASIVE without MET: radical removal 4) INVASIVE WITH METS: chemo only

Front 988

RCC from and RF

Back 988

from: tubular epith cells...RF: male, smoking, fat, VHL..tx: surgery usualy good if local

Front 989

MC testucular CA are and prog...RF...to dx...

Back 989

germ cells 95% and almost all: malign...RF: cryptor and klinefelter...to dx: US, marker

Front 990

Tx seminomas? Nonseminomas?

Back 990

RADIO!!!...NS: Platinum chemo

Front 991

never delay airway DT

Back 991

cervical injury

Front 992

how to do A in ABCDE

Back 992

1) O2 cannula or face mask 2) intubate 3) trach

Front 993

B in ABCDE

Back 993

breathing: the 5 cz immediate death: T pneumothorax, C Tamponade, O pnemothorax, hemothorax, airway obstr

Front 994

C in ABCDE

Back 994

1) 16 gave in each antecubal fossa 2) 3:1 fluid to blood loss of NS (start with 1-2 L bolus)

Front 995

D/E in ABCDE

Back 995

Disability(cns = glascow) / exposure (take off close and assess)

Front 996

chest injury: unstable and pentrating..next

Back 996

intubate and bilateral chest tubes

Front 997

tx contiminated wound

Back 997

early irrigation and debridement >>>> abx!!!!

Front 998

aortic prob assoc w/

Back 998

Ribs 1 and 2, scapular, sternal fx...decel injury

Front 999

direct epigastric blow can →

Back 999

aka handlebar injury = pancreatic rupture

Front 1000

MC organ damage in abd trauma

Back 1000

liver, spleen

Front 1001

MC GU damage in rauma

Back 1001

kidneys

Front 1002

tx pelvic fractures

Back 1002

need SUGEON NOW if in field, can use MAST (military antishock trousers) to maintain BP

Front 1003

pelvic injuries assoc with urethral injury if...next

Back 1003

1) blood at urethral meatus 2) high riding prostate or lack of one....tx: retrograde urethrogram before folate

Front 1004

sharp vs dull abd pain

Back 1004

sharp: peritoneal...dull: organs

Front 1005

tx asystole

Back 1005

Epi and Atropine

Front 1006

tx PEA

Back 1006

Epi + atropine and now search for cz

Front 1007

SVT tx

Back 1007

1) unstable = DC, 2) stable = rate with maneuvers (like cold) 3) if cant maneuver = ADENOSINE

Front 1008

Afib/flutter tx

Back 1008

1) unstable = DC 2) stable = rate with DILTIAZEM or BB, now rhythm = (if <2d = DC, if >2d = anticoag and TEE before DC), then anticoag

Front 1009

PNA can present as

Back 1009

right or left UQ pain

Front 1010

psoas sign

Back 1010

extend hips → RLQ pain

Front 1011

Obturator sign

Back 1011

int rot of flexed hip → RLQ pain

Front 1012

Rovsing's sign

Back 1012

palpate LLQ → RLQ pain

Front 1013

2nd MCC death in kids, det the 3 types

Back 1013

first degree burn (epidermis – pain, no blisters)...2nd degree (part of dermis – pain and blisters)...3rd (full dermis and beyond – painless, white, charred)

Front 1014

rule of 9's for Body Surface Area

Back 1014

head, each arm = 9% each...back and chest = 18% each...leg = 18% each...perineum 1%

Front 1015

tx burns

Back 1015

for 2nd and 3rd degree = PARKLAND formula = fluids for first 24 hrs = (4 x pt's weight in kg x %BSA) & 50% fluid first 8 hrs, rest next 16hrs

Front 1016

5Ws of postop fever

Back 1016

Wind, Water, Walking, Wounds, Wonder rx...dec by: spirometry, abx, short term foley, early amb and dvt prophylaxis...fever at 3rd d unlikely infxn unless Cdiff or Beta strept

Front 1017

dx labs for CO poisoning

Back 1017

ABG and serum carboxyHb (nl <5% in nonsmokers, <10% in smokers), maybe scope...tx: 1) 100% O2 until unsx 2) HYPERBARIC if prgos, unresponsive, neuro sx 3) if smoke INHALATION may need intub DT potential airway EDEMA

Front 1018

tx acid / alk ingestion

Back 1018

scope for stricture

Front 1019

tx organophosphate (and anticholE too)

Back 1019

2pam (atropine, pralidoxime)

Front 1020

tx arsenic, mercury, gold

Back 1020

succimer, dimercaprol

Front 1021

tx BB

Back 1021

glucagon

Front 1022

tx barb (phenobarbital)

Back 1022

urine alk, dialysis, charcoal

Front 1023

tx black widow

Back 1023

Ca, methocarbamol

Front 1024

tx CO

Back 1024

100% O2, hyperbaric

Front 1025

tx cu, arsenic, lead, gold

Back 1025

penicillamine

Front 1026

tx cyanide

Back 1026

amyl nitrate, Na nitrate, Na thiosulfate

Front 1027

tx Dig

Back 1027

stop Dig, normalize K, lidocaine (for torsades), antiDig Fab

Front 1028

tx lead

Back 1028

sucimer, EDTA, Dimercaprol

Front 1029

tx Methanol, etylene glycol

Back 1029

etOH, fomepizole, dialysis, Ca

Front 1030

tx Methemoglobin

Back 1030

methylene blue

Front 1031

tx opioids

Back 1031

naloxone

Front 1032

tx PCP

Back 1032

NG

Front 1033

tx salicylates

Back 1033

urine alk, dialysis, charcoal

Front 1034

tx TCA

Back 1034

NaHCO3 for QRS prolong, diazepam for seiz

Front 1035

tx Theophylline

Back 1035

charcoa

Front 1036

tx tPA, streptokindase

Back 1036

Amiocaproic acid

Front 1037

SE AMG

Back 1037

ATN (and otox)

Front 1038

SE amantadine

Back 1038

ataxia, LIVEDO RETICULARIS (net like lesions on LE on skin)

Front 1039

SE amiodarone

Back 1039

thyroid prob

Front 1040

SE Amphotericin

Back 1040

kidney, BM, anemia

Front 1041

SE antipsych

Back 1041

acute dystonia, akathisia, parkinso, TD, NMS

Front 1042

SE azoles (fluconazole)

Back 1042

inh P450

Front 1043

SE BB

Back 1043

worsesns asthma, mask hypoGlc

Front 1044

SE CCB

Back 1044

constipation

Front 1045

SE carbamazepine

Back 1045

inc P450, AGRANULO, liver tox

Front 1046

SE cisplatin

Back 1046

kidney, acoustic nn damage

Front 1047

SE Clonidine

Back 1047

rebound HA /HTN

Front 1048

SE clozapine

Back 1048

agranulo

Front 1049

SE steroids acute

Back 1049

mania

Front 1050

SE cyclophosphamide

Back 1050

Hemorrhagic cystitis

Front 1051

SE Dig

Back 1051

yellow vision, arrhythmia (jxn tachy or SVT)

Front 1052

SE doxorubicin

Back 1052

CARDIOTOX

Front 1053

SE halothane

Back 1053

liver tox, MALIGNANT HYPERTHERMIA (neuro malign synd for = neuro or antipsych, not this)

Front 1054

SE HCTZ

Back 1054

hypo: K and Na.....hyper: Uric acid, Glc, Ca

Front 1055

SE hydroxychloroquine

Back 1055

retinopathy

Front 1056

SE MAOI

Back 1056

hypertensive

Front 1057

SE methanol

Back 1057

blind

Front 1058

SE methyldopa

Back 1058

+ coomb, SLE

Front 1059

SE nitroglycein

Back 1059

HypoT, tachy, HA, tolerance

Front 1060

SE penicillamine

Back 1060

Sle

Front 1061

SE phenytoin

Back 1061

hirsutism, atax

Front 1062

SE Prazosin

Back 1062

first dose hypoT

Front 1063

SE PTU

Back 1063

agranulo, aplasic

Front 1064

SE quinidine

Back 1064

cinchonism (HA, tinnitus), dec platlets, arrhythmia (torsades)

Front 1065

SE succinylcholine

Back 1065

Malign HTN, hyperK

Front 1066

SE tetracycline

Back 1066

photosensitivy, Fanconi

Front 1067

SE valproic acid

Back 1067

NT defect, rare fatal liver tox

Front 1068

SE Vanc

Back 1068

kidney, otox, red man (DT hist release)

Front 1069

SE Vinblastine

Back 1069

severe myelosuppr

Front 1070

SE vincristine

Back 1070

peripheral neuropathy

Front 1071

etoh house

Back 1071

10 hrs = tremor...in 2d = seiz...in a week = DT (hallucination

Front 1072

tx barb

Back 1072

benzo

Front 1073

tx benzo

Back 1073

benzo

Front 1074

tx coke

Back 1074

avoid pure BB

Front 1075

tx opiods

Back 1075

mod sx: clonidine or buprenorphine....if severe: methadone....if drug free for week: naltrexone

Front 1076

vit A defic

Back 1076

night blind

Front 1077

vit B1 defic

Back 1077

(thiamine)...BERIBERI (polyneuritis, dilated heart, high output CHF, edema), WK

Front 1078

vit B2 defic

Back 1078

(riboflavin)....stomatits, corneal vasc

Front 1079

Vit B3 defic

Back 1079

(niacin)...3Ds

Front 1080

vit B12 defic

Back 1080

neuro (optic, SCD)

Front 1081

vit C defic

Back 1081

scurvy (bleeding gums poor wound healing, bruising)

Front 1082

vit D defic

Back 1082

rickets in kids (bending of bone), osteomalacia in adult (soft bone), hypoCa tetany

Front 1083

vit E defic

Back 1083

rbc fragile

Front 1084

kit K defic

Back 1084

neonatal hemorrhages

Front 1085

defic biotin

Back 1085

demattis...can be DT eatin RAW EGGS or abx

Front 1086

FA defic

Back 1086

MC defic in USA...sprue, anemia wo neuro sx

Front 1087

Mg defic

Back 1087

weak, cramp, inc tetany DT hypoCa, tremors

Front 1088

Selenium Defic

Back 1088

Keshan disease (cardiomyopathy)

Front 1089

define unstable angina

Back 1089

new, worsening or at rest

Front 1090

rx that slows AV

Back 1090

BB, Dig, CCB

Front 1091

tx hyperchol

Back 1091

Niacin

Front 1092

a fall of systolic >10 w/ inspiration

Back 1092

Pulsus paradoxus (in cardiac tamponade)

Front 1093

LDL in pt with DM

Back 1093

<70

Front 1094

ST elev vs. ST depess

Back 1094

Elev = MI (along with Q wave and flat T)...depres = ischemia

Front 1095

endocarditis prophylaxis

Back 1095

Oral = amox....GI or GU = AMP + GENT before and AMOX after

Front 1096

MCC HTN in young guys

Back 1096

xs ETOH

Front 1097

Stuck on look

Back 1097

seborrheic keratosis

Front 1098

pearly papule with talengiectasia

Back 1098

basalcc

Front 1099

honey crust lesion

Back 1099

impetigo

Front 1100

+ vs. - Nikolsky

Back 1100

+ = P Vulgaris...- = B. Pemphigoid

Front 1101

flat topped papules

Back 1101

lichen planus

Front 1102

lesion linear pattern where skin contact cloth

Back 1102

contact dermatitis

Front 1103

herald patch (christmas like)

Back 1103

pityriasis rosea

Front 1104

16yo annular patch of alopecia w/ broken off stubby hairs

Back 1104

aplopecia areata (autoI)

Front 1105

spaghetti and meatballs

Back 1105

pityriasis versicolor

Front 1106

premaling lesion → sqcc

Back 1106

actinic keratosis

Front 1107

cradle cap

Back 1107

seborrheic dermatitis (tx w/ antifungal)

Front 1108

painful, recurrent vesicular eruption of mucocutaneous surfaces

Back 1108

Herpes simplex

Front 1109

inflmmation and epith thinning of the anogenital area, in postmenop women

Back 1109

lichen slerosus

Front 1110

exophytic nodules with scales and ulcers....2nd MCC skin CA

Back 1110

sqcc

Front 1111

antimicrosomal ab

Back 1111

hashimotos

Front 1112

hypoCa, high phosph, low tsh

Back 1112

hypoPTH

Front 1113

HA, weak, polyuria...HTN, tetany..hyperNa, hypoK, Metab Alk

Back 1113

primary hyperaldo

Front 1114

tx cental DI

Back 1114

DDAVP

Front 1115

post op pt with sign pain with hypoNa and nl vol status

Back 1115

SAIDH

Front 1116

pt weak, weight loss, new skin pigm...hypoNa, hyperK..tx

Back 1116

(addison's = primary adrenal insuff)...tx: gluco, mineralocor, IV fluid

Front 1117

A1c goal for DM

Back 1117

<7=

Front 1118

girl with preE, should tell parents?

Back 1118

no, no need to for pregos

Front 1119

diff btw withdrawaing life sustaining care and witholdind sustatining care

Back 1119

same

Front 1120

10 yo with status epilepticus, parents say no, u?

Back 1120

do it (DT immediate threat to her life), get court oder afterward

Front 1121

if US doesnt reeveal much about gallbladder

Back 1121

HIDA

Front 1122

sentinel loop on AXR

Back 1122

acute pancreatitis

Front 1123

MCC diarrhea

Back 1123

campylo

Front 1124

fried rice diarrhea

Back 1124

B. cereus

Front 1125

raw seafood diarrhea

Back 1125

vibrio, HAV

Front 1126

AIDS diareh

Back 1126

Isospora, crypto, MAI

Front 1127

Pseudoappendicitis

Back 1127

Yersinia

Front 1128

pain and diarrhea...fistula btw bowel and skin, nodules on tibia

Back 1128

Chron's

Front 1129

extraintestinal sx of IBD

Back 1129

uveitis...AnkSpond... Pyoderma Gangrenosum... Erythema Nodosum...PSC

Front 1130

tx IBD

Back 1130

5ASA and steroids

Front 1131

Reynaulds for

Back 1131

asc cholangitis now pus...Charcot + shock + AMS

Front 1132

tx hepatic encephalopathy

Back 1132

dec prot...lactulose...neomycin

Front 1133

4 yo, oliguria / petechia/ jaundice after bloody diarrhea

Back 1133

HUS

Front 1134

rx induced Hepatitis

Back 1134

TB (INH, rifampin, pyrazinamide), acetaminophen, tetracyclin

Front 1135

4 causes of Microcytic anemia

Back 1135

TICS (Thal, Iron defic, Chronic dz, Sideroblastic)

Front 1136

MC inherited cz of hypercoag

Back 1136

Factor 5

Front 1137

MC inherited hemolytic anemia

Back 1137

hereditary sphero

Front 1138

dx test for hereditary sphero

Back 1138

ofmotic fragility test

Front 1139

pure RBC aplasia

Back 1139

Diamond-Blackfan anemia

Front 1140

anemia... no radii or thumb, diffuse hyperpig, cafe'aulait, small head, pancytopenia

Back 1140

Fanconi

Front 1141

polycythemia vera vs. 2nd poly

Back 1141

both inc mass...PV = nl O2 and low erythropoitin

Front 1142

TTP pentad?

Back 1142

FAT RN (Fever, Anemia, thrombocytopenia, Renal dz, Neurologic

Front 1143

HUS triad

Back 1143

anemia, thrombocytopenia, ARF

Front 1144

tx ITP in kids

Back 1144

selfheal...may need IV Ig or steroids

Front 1145

whats inc in DIC

Back 1145

Fibrin split prod and Ddimers

Front 1146

girl with longer bleed after dental and mense...nl everthing xcpet nl/inc PTT

Back 1146

vWF (give desmopressin, FFP, or cryo)

Front 1147

10yo, weight loss, fever, night sweats, ant mass

Back 1147

NHL

Front 1148

80 ym, LN, tired, isolated lymphocytosi

Back 1148

CLL (lymphocytic leuk)

Front 1149

life treat cond of CML

Back 1149

blast crisis (fever, bone pain, big organs, pancytopenia)

Front 1150

auer rods

Back 1150

AML

Front 1151

AML + DIC

Back 1151

M3

Front 1152

50 yo male, big spleen, bleed, 9,22,

Back 1152

CML

Front 1153

AR, defect G2b3a, dec platelet aggr

Back 1153

Glanzmann's thromboblasthenia

Front 1154

significant cz of morbidity in thal pts, tx

Back 1154

Fe overload, use deferoxamine

Front 1155

which are encapsulated bugs

Back 1155

Pneumococcus, meningococcus, H. flu, Kleb

Front 1156

tx coccio

Back 1156

Ampho B

Front 1157

tx neonates meningitis

Back 1157

Genta + Amp

Front 1158

tx kids meningitis

Back 1158

Vanc + Cefo

Front 1159

CSF w/ inc gamma globulins

Back 1159

MS

Front 1160

first itchy papules, then LN then black eschar after a week

Back 1160

cut anthrax...tx: PenG or Cipro

Front 1161

24yo with white plaques back of throat, work up, tx

Back 1161

Candida trush...workup: HIV...tx Nystating oral

Front 1162

prophylax for MAI in HIV

Back 1162

Azithro/clarithro

Front 1163

ring enhancing on CT with seiz

Back 1163

Taenia solium (cysticercosis)

Front 1164

branching rods in oral infxn

Back 1164

Act. Israelli

Front 1165

Painful chancroid

Back 1165

h. ducreyi

Front 1166

meningitis in elderly

Back 1166

s. pneumo

Front 1167

osteomyelitis from foot puncture

Back 1167

pseudo

Front 1168

osteomye in sc

Back 1168

salmonella

Front 1169

55 yo smoker, drinker, flu like, stain nothing, silver = gram neg

Back 1169

legionella

Front 1170

acute onset monoarticular joint pain and Bell's

Back 1170

lyme

Front 1171

pain pallor, paresthesia, paralysis, pulselesness, tx

Back 1171

fasciotomy

Front 1172

back pain worse by stand/walk, better with sit and flex

Back 1172

spinal stenosis

Front 1173

genetic dz, mistaken for child abuse

Back 1173

osterogenic imperfecta

Front 1174

arthritis, conjunvitivitis, urethritis, org?

Back 1174

reiter's (campylo, shigell, salmo, chlamy, ureaplasma)

Front 1175

chronic tx gout

Back 1175

allopurinol or probenecid

Front 1176

rhomboid shape

Back 1176

pseudogout

Front 1177

old lady, pain stiff shoulder and hip, cant lift her arms above head, anemia and inc esr

Back 1177

polymyalgia rheumatica

Front 1178

bone fx fall outstretched hand

Back 1178

colle's (distal radius)

Front 1179

youn kid, prox muscle weak, waddling gait, calf muscl

Back 1179

duchenne

Front 1180

first born female, breech, asx skin fold

Back 1180

dev dysplasia of hip...if severe = PAVLIK harness to maintain abduction

Front 1181

MC primary tumor of bone

Back 1181

MM

Front 1182

prophylactic tx migraine 3

Back 1182

BB, CCB, TCA

Front 1183

sudden broken speech, dx, lobe and vasc

Back 1183

broca...frontal, MCA

Front 1184

MCC SAH

Back 1184

trauma, 2nd = berry

Front 1185

albuminocytologic dissociation

Back 1185

Guillain Barre' (inc prot in CSF w/ a little inc cell)

Front 1186

cold water into ear and fast part of nystag → opposite, good?

Back 1186

yes

Front 1187

MCC primary source met to brain

Back 1187

L, B, S (melanoma), K

Front 1188

MCC sx of intracranial tumor

Back 1188

HA

Front 1189

MCC seiz in kids 2-10

Back 1189

infxn...febrile...trauma...idopathic

Front 1190

MCC seiz in young adults 18-35

Back 1190

trauma...etoh withdrawal...brain tumor

Front 1191

first line med for status epilept

Back 1191

IV benzo

Front 1192

confuse, make up, eyes, atax

Back 1192

Wernicke

Front 1193

% for carotid endarectomy

Back 1193

70 IF SX!!!!!!!!

Front 1194

tx Guillain

Back 1194

IV Ig or Plasmaph

Front 1195

rigid, stiff ....then dance like, mood

Back 1195

Hunting

Front 1196

6yo, stain on V2, MR, seiz, leptomendial angioma

Back 1196

SW (tx sx! Possible resection of affected lobe)

Front 1197

hypersex

Back 1197

Kluver Bucy (amygdala)

Front 1198

primary cz of 3rd trim bleed

Back 1198

p previa, p abruptio

Front 1199

continuous painful vag bleed

Back 1199

p abuptio

Front 1200

abx with that are terato

Back 1200

Tetracycline, fluoroquiolones, AMG, sulfa

Front 1201

shortest AP diameter of pelvis

Back 1201

obstetric conjugate (sacral promontory and midpt of pubic symphysis)

Front 1202

tx postpart heorrhage

Back 1202

hands...if not, OXYTOCIN

Front 1203

GBS prophlaxctic

Back 1203

penci...of AMP

Front 1204

heavy bleed during and btw menses aka

Back 1204

menometrorrhagia

Front 1205

amenorrhea, nl PRL, no response to E and P, hx DC

Back 1205

ashermans

Front 1206

TX PCOS

Back 1206

weight loss and OCP

Front 1207

postmenop with vag bleed, next

Back 1207

endometrial bx

Front 1208

when to tx ectopic with meds

Back 1208

<3.5cm, stable at <6weeks

Front 1209

tx endometriosis 3

Back 1209

OCP, DANAZOL, GNRH

Front 1210

MC loc for ectopic

Back 1210

ampulla

Front 1211

dx and follow leiomyoma

Back 1211

US

Front 1212

inc vag dc and petechaie patch on uppervag and cervix

Back 1212

Trichomonas

Front 1213

Contraceptive that protes against PID

Back 1213

OCP and barrier

Front 1214

strong fx ovarian CA yearly wahat

Back 1214

US and CA125

Front 1215

leaks urine when laugh tx

Back 1215

Kegel, Estrogen, Pessaries

Front 1216

pees unexpectedly, tx

Back 1216

Anticho (oxybutyrin) or B adrenegic (metaproterenol) for urge

Front 1217

MCC female infertility

Back 1217

endometriosis

Front 1218

2 straight finding of ASCUS on pap, next

Back 1218

Colpo and Endocervical curettage

Front 1219

type br CA that inc risk of invasive ca in both breast

Back 1219

LOBULAR carcinoma in situ

Front 1220

nontender abd mass with inc VMA and HMA

Back 1220

Neuroblastoma

Front 1221

baby with meconium ileus

Back 1221

hirsprung or CF

Front 1222

bilius with FIRST feed

Back 1222

duod atresia

Front 1223

hgh fever...then rash as fever breaks, risk for

Back 1223

febrile seiz (roseola infantum)

Front 1224

kid has eczema, thrombocytopenia and inc IgA

Back 1224

Wiskott Alrich

Front 1225

4 month old with life threat pseudo

Back 1225

Bruton X Agamma

Front 1226

tx for mild or sever unconj bili

Back 1226

phototherapy or xchange if severe

Front 1227

Tanner 3 at 6yo

Back 1227

precocious

Front 1228

infxn small airway with epidemics in winter and spring

Back 1228

RSV bronchiolitis

Front 1229

congenital heart dz → 2ndary HTN

Back 1229

coarct

Front 1230

first line for OM

Back 1230

amox

Front 1231

homeless kid small for age has peeling skin and swollen belly

Back 1231

Kwarshorkor (prot malnutrition)

Front 1232

defec in xlink w/ MR, gout, self mutilation, choreo

Back 1232

Lesch Nyhan (purine salvage prob w/ HGPRTase defic)

Front 1233

galatorrhea, impotense, menstrual dysfxn, and dec sex

Back 1233

DA antagonist

Front 1234

17 yo blind after bf died car crash

Back 1234

conversion

Front 1235

mom angry at husband yell at baby

Back 1235

displacement

Front 1236

pedophile enters monastery

Back 1236

reaction formation

Front 1237

20 yo wet his bed

Back 1237

regression

Front 1238

life threat muscle rigid, fever, rhabdo

Back 1238

NMS

Front 1239

SE of atypical

Back 1239

DM1, weight gain, QT prolonged

Front 1240

young weight lifter given HALOPERIDOL now yes deviate sideway dx, tx

Back 1240

acute dystonia (oculogyric crisis), tx: BENZTROPINE or DIPHENHYDRAMINE

Front 1241

5 mo, dec head growth, social interaxct

Back 1241

Retts

Front 1242

takes haloperidol for schizo, now tongue comes out, dx, tx

Back 1242

Tardive Dyskinesia...dec or stop haldol, change to another

Front 1243

honeycomb on CXR, dx, tx

Back 1243

Diffuse INTERSTITIAL pulmo FIBROSIS...tx: supportive...steroid maybe

Front 1244

tx for SVC syndrome

Back 1244

rads

Front 1245

acid base in PE

Back 1245

hypoxia and hypocarbia (resp Alkalosis)

Front 1246

lung CA DT smoking

Back 1246

SCLC

Front 1247

inc risk infxn w. silicosis

Back 1247

TB

Front 1248

RTA + abn H seretion and kidney stones

Back 1248

Type 1 distal

Front 1249

RTA + rickets + abn HCO3

Back 1249

Type 2 prox

Front 1250

dought skin

Back 1250

hyperna

Front 1251

tx mod hyperCa

Back 1251

Loop + NS

Front 1252

red cell cast

Back 1252

Nephritic or glomerulonephritis

Front 1253

waxy casts and maltese cross (seen with lipiduria)

Back 1253

Nephrotic

Front 1254

low urine spec grav + high serum osmolal

Back 1254

DI

Front 1255

MC type of testicular CA

Back 1255

Seminoma (a germ cell)

Front 1256

3 systemic dz → nephrotic

Back 1256

DM, SLE, amyloid

Front 1257

inc erythropitin and nl O2

Back 1257

RCC or nother CA

Front 1258

rx that cause rigid msucle, hyperthermia, auto instab, extrapyraid

Back 1258

Antipsych (NMS)

Front 1259

tx NMS

Back 1259

dandrolene or bromocriptine

Front 1260

tx for Malign HTN

Back 1260

nitroprusside

Front 1261

acceptable urine out in trauma

Back 1261

50cc/hr

Front 1262

accepte untrine in stable pt

Back 1262

30cc/hr

Front 1263

cannon 'a' wave

Back 1263

3rd degree heart block

Front 1264

tx septic shock

Back 1264

Fluid + abx

Front 1265

tx cardiogenic shock

Back 1265

find cause...pressors (dopamine)

Front 1266

tx hypovolemic shock

Back 1266

fluid and blood

Front 1267

anaphylactic shock

Back 1267

diphenhydramine or epi

Front 1268

tx for ARDS

Back 1268

CPAP

Front 1269

trauma series

Back 1269

AP chest...AP/Lat C spine...AP pelvis