3-Fullfake

Front 1

Acyclovir toxicity

Back 1

--> crystalluria with obstr in high dose pt

Front 2

MCC primary adrenal inssuficiency

Back 2

80% DT autoImmune adrenatlitis in developed countries

Front 3

MCC adrenal insufficiency in 3rd work...HIV...

Back 3

TB (adrenal CALCIFICATION)...CMV in HIV... and Fungal

Front 4

adenemyosis vs. leomyomas

Back 4

L is softer in consisteny

Front 5

sx of endometritis and MCC

Back 5

FEVER post birth..Strept

Front 6

ADHD length

Back 6

>6month

Front 7

TOC for Adjustment DO

Back 7

Cognitive or psycho...not DX

Front 8

length of PTSD if less?

Back 8

1month … if less = Acute Stress Disorder

Front 9

other cause of Primary adrenal insuff

Back 9

Adrenoleukodystrophy

Front 10

all airway needed in? What if in field

Back 10

unconscious pt...needle cricoitd...ER: oro intubate / naso too long...

Front 11

tx of etoh withdrawal and can happen after surg when pt not drank in awhile

Back 11

CHLORDIAZEPOXIDE

Front 12

BUN>40 in nl Cr means...? 2 causes

Back 12

upper GI bleed -MOA: BacT break down HB in GIT and → reab of urea...also with STEROIDS

Front 13

ETOH liver dz 3 types, difference

Back 13

1) FATTY LIVER (DT short term) 2) ALCOHOLIC HEPATITIS and 3) ALCOHOLIC FIBROSIS ...upt to early fibrosis can be reversed if stopped

Front 14

if have alcoholic cirrhosis next?

Back 14

endoscope to see vacies

Front 15

Dx ALL

Back 15

25% lymphoblast in BM and + PAS(periodic acid shift) reaction...sx: nonspecific...dx: dec platelets, blast cells..need BM bx

Front 16

sx oh Hodgins

Back 16

painless, firm, cerivical adenopathy (like ALL but with without LYMPHOBLAST)

Front 17

AML age, dx

Back 17

Adult, 35% MYEloblast in bx

Front 18

Aplastic anemia in lab

Back 18

decreased ALL CELL LINES

Front 19

Kids with ITP sx and lab

Back 19

sudden bruising, petechiae, epistaxis...lab: only PLATELETs low and HUGE

Front 20

Atypical lcy on periphery and + monospot

Back 20

EBV

Front 21

high IgE, brownish plug in sputum, pulm infiltrates, asthmatic...dx...tx...

Back 21

ABPA...glucocorticoids...so asthmatic pt need test for ab to this...then IgE level..if <1000, no

Front 22

recurrent bacT + high IgE...infxn are staph and SKIN...neutrophils cant chemotax...sthma, allergic rhinitis...dx

Back 22

Job's, tx: ABX

Front 23

Tetrad: Excema, dec platelets, pyogenic infxn...A, E high...M low

Back 23

Wisckot Aldrich Xlinked

Front 24

MC eosinophilia in US

Back 24

Conic Esosinophilia PNA ...sx: fever, malaise, weight loss...lab: E >40%..tx: Glucocorticoid

Front 25

skin, kidney, vasculitis, many system (cns, GI, heart, asthma...lots eosinophila)

Back 25

churg strauss tx: steroid

Front 26

Contact dermatitis type

Back 26

type 4...ex: nickel, poison IV

Front 27

Atopic Dermatitis sx, loc, tx

Back 27

pruritic lesion in kid <6mo...diapier area spared...tx: prevention, warm bath, moisturizers...if acute: steroid

Front 28

Allergic Intersitial Nephritis DT and tye..triad

Back 28

Nafcillin...type 4...triad: fever, petechial rash, peripheral eosinohilia in azothemia pt (inc UREA)

Front 29

Common cz of ATN...lab

Back 29

Ischemia or nephrotox rx...MUDDY BROWN

Front 30

what is allergic shiners and seen in

Back 30

“dark puffy eyelids”...allergic rhinitis

Front 31

if rhinitis keeps happening...next

Back 31

nasal Cytology= if Neutrop = infxn, if Eosino= allergic

Front 32

if high AFP, next?

Back 32

US...then Amnio for AFP and AchE (AchE = inc only in NTD)

Front 33

AFP low in

Back 33

chromosomal dz

Front 34

triple and ALP done in

Back 34

16-18 week (4th mont)

Front 35

Alpha 1 antitrypsin Deficin cause what

Back 35

PANLOBULAR emphysema... sx in adult: Asx cirrhosis, maybe w/ HCC (liver cell have PAS _ and Diastase Resistnat)

Front 36

What else has PAS positive

Back 36

Whipple's (but no cirrhosis)

Front 37

recurrent hematuria, sensory deaf, renal dz

Back 37

Alport (split GBM)

Front 38

withdrawal of benzo

Back 38

seizure, confusion

Front 39

tx of ALS

Back 39

RILUZOLE (Glutamate inhibitor)...sx: muscle wasting throughout

Front 40

Alttered mental in elderly cause

Back 40

1) hypo/per Na 2)hypo/er Ca, 3)hypoMg, 4) hypoPhosph, 5) hypoGlc, 6) stroke, 7) cardiac, 8) infxn

Front 41

diff btw Altruism and Sublimation

Back 41

A: dec internal fears by helping others (AA alcoholic)...S: turn bad behavior into acceptable ones

Front 42

diffuse cortical atrophy and tx

Back 42

Alzheimer...tx: DONAZEPIN, TACRINE, RIVASTIGMINE, GALANTAMINE

Front 43

Allzheimer vs Picks

Back 43

Picks is more behavior change

Front 44

tx of Amaurosis Fugax

Back 44

Doppler...and dec athersclerosis Rfs

Front 45

Dx of amebic liver abscess...look like...tx

Back 45

CT of liver...aspiration: ANCHOVY paste...tx: Metro PO 1-2weeks

Front 46

cyst acqiure with contac with dogs...

Back 46

Hydatid cyst, Echinococcus

Front 47

2nd amenorrhea steps

Back 47

Preg, HyperPRL, or HypoThyr

Front 48

adequate Estrogen and hx intrauterine equiment

Back 48

ASHERMAN...dx: hysterosalpingogram

Front 49

2ndary ammenorrhea in athletes DT

Back 49

dec estrogen

Front 50

pt need rate control but pulmo fibrosis...dont give

Back 50

AMIODARONE

Front 51

DIGFAST in mania

Back 51

Distract, Insomnia, Grandio, Flightideas, Activ inc, Speech talktive, Thoughlessness

Front 52

sweating, lacrimation, N/V, diarrhea is

Back 52

Herion withdrawal

Front 53

Amyloidsis in heart means

Back 53

last stage = need transplant

Front 54

severe painful bright red blood during defeation

Back 54

anal fissures...tx: diet mod, stool softener, local anesthetics

Front 55

Analgesix nephropathy lab

Back 55

hematuria dT PAPILLARY NECROSIS and TUBULOINTERSTITIAL NEPHRITIS...early: polyuria sterile with WBC cast...later: protein and blood

Front 56

bee sting removal?

Back 56

if after 1 hr, dont remove, sc epi!...if after 1 min, remove sting first

Front 57

MCC anemia in premies (often seen in premies and low birth kids)

Back 57

dec RBC prod, short RBC life..tx: Fe sup doenst help and Fe defic not the case

Front 58

MCC aneurysm

Back 58

1) trauma do CT/MRI suspect because might not show up CXR...

Front 59

MCC descending aorta aneurysm

Back 59

atherosclerosis, pt has sign CAD

Front 60

if ascending aneursm and aortic regurg

Back 60

Marfan's

Front 61

Mycotic aneurysm MC location, MCC

Back 61

femoral art > ascending aorta..MCC: auerus and salmonella

Front 62

syphilis aneurysm where, sx, dx,

Back 62

ascending..chills and splinter hemorrhages!...do CT

Front 63

no CAD RF, wake up, transient ST elev, neg cardiac enz...dz? Tx?

Back 63

Prinzmetal...give Nitrates and CCB (DILTIAZAM)...dont give ASA and Propranolol

Front 64

ST depression

Back 64

subendocardial ischemia

Front 65

ST elevlation

Back 65

transmural infarct

Front 66

#1 test for stable angina...when do stress test? If can't? If test abn?

Back 66

EKG stress test...do stress echo instead if: Lbbb, WPW, ST depress >1mm at rest...DOBUTAMINE stress..if bad: Angiogram

Front 67

Dont give these rx before stress

Back 67

Dig, Bblocker

Front 68

tx stable pt with angina?

Back 68

BB! if cant...CCB!! both have antiAngina too...ACEI only has antiHTN

Front 69

define unstable angina

Back 69

Nitro only partially relieve...T invert...no cardiac enz...tx: IV hep, BB, Nitro...

Front 70

when thrombolysze then give

Back 70

LBBB...give: CLOPIDOGEL..not ticlodipine for prevent platelet aggr

Front 71

MCC painless GI bleed and how to diff

Back 71

Angiodysplasia: assoc with aortic stenosis/ renal failure...DX: scope to see diverticulosis

Front 72

angioedema MOA and tx

Back 72

ACE breaks Bradykinin...ACEI increases Bradykinin → substance P → inflammation...tx: ANTIHIST

Front 73

grey red mass in post nasophranx, young male, frequent nose bleed, dx? Lab?

Back 73

Angiofibroma (bening vasc tumor)...DX: CT and surg

Front 74

Winter formula

Back 74

PaCO2 = 1.5 (HCO3) + 8 = level that CO2 should be to compensate for Metab Acidosis

Front 75

Ankylosing Spond assoc w?..tx AS?...to dx?

Back 75

IBD....only tx to halt: EXERCISE...NSAID and SULFALAZINE just for sx...to dx: XR for SACROILITIS if cant see--> MRI!

Front 76

Yellow skin color in skinny person

Back 76

Anorexia Nervosa ..tx: hosp

Front 77

pain over medial tibia..sx of trauma XR nl?

Back 77

Anserine Bursitis

Front 78

Anterior Cord Syndrome can be DT and sx and tx...lab?

Back 78

MVA..sx: paralysis and analgesic below level...post column ok...tx: METHYLPRED...MRI is best

Front 79

Typical AntiPysch (3)

Back 79

Haloperidol, Chlorpromazine, Fluphenazine

Front 80

Atypical AntiPsy (2) and MOA

Back 80

Cloazapine, Risperdal (adds Serotonin inh! So dec EPS sx)

Front 81

if SSRI causes impotence, now?

Back 81

BUPROPION!

Front 82

antiD and insomnia?

Back 82

TRAZODONE

Front 83

Types of AntiPL Ab...tx?

Back 83

VDRL, Lupus, Anticardiolipin...Heparin+ ASA

Front 84

MCC AAA and cause

Back 84

Ascending aorta and is cystic medial necrosis...Descending is atherosclerosis

Front 85

if diarrhea and blood after AAA surgery...?

Back 85

Ischemic colitis!...do CT and if ok: SCOPE...f/u with abd US

Front 86

if CT shows rupted AAA?

Back 86

straight to laparotomy NOT laparascopy

Front 87

IF BP in different arms 30mmHg...next

Back 87

ICU + Nitro (dec BP) + BB (dec HR)...dont delay = ANTIHTN before imaging

Front 88

Water hammer pulse + pilstol shot femoral pulses...next..to dx

Back 88

Diuretics + ACEI + Dig = relieve Congestion of LV dxn..then change valve...dx: Aortic Regurg...to dx: ECHO

Front 89

tx for RECURRENT aortic coarct

Back 89

baloon angiography

Front 90

Exerption dyspnea...ejection systolic murmur rads to carotid..dx..to dx?

Back 90

Astenoss...in elderly DT Calcification...dx: ECHO and for F/U

Front 91

Bact endocarditis →

Back 91

AR not AS

Front 92

S4 means

Back 92

forceful atria contact vs. thick ventricle

Front 93

AorticSten and surgery?

Back 93

SAD (syncope, angina, dyspnea)

Front 94

to dx Aplastic anemia

Back 94

BM bx: hypocellular and fatty infiltrate

Front 95

pancytopenia, brown pigments, cafe' au lai, short, upper limb problem...first dec platelets...dec neutrophils..dec RBC...?

Back 95

FANCONI

Front 96

what is Diamond Blackfan Anemia

Back 96

congenital RBC aplasia...sx: first 3 months life: pallor poor feed...WBC/platelets nl

Front 97

if pt with appendicitis need surg and on warfarin, next?

Back 97

reverse with FFP NOT vit K then surg

Front 98

abx for complicated appendicitis

Back 98

CIPRO + VANC

Front 99

ARDS MCC is? And lab dx? If use mech vent, whats the best way?

Back 99

Sepsis (also acute pancreatitis)...need PaO2 = 55, and O2 by mask 60%...best way: PEEP inc

Front 100

CXR of ARDS

Back 100

bilateral flully with hypox and NO FEVER

Front 101

colles fx is what

Back 101

fall outstretched hand

Front 102

Chauffer;s fx is what

Back 102

radial styloid on drivers

Front 103

Galazzi's fx is what

Back 103

isolated fx along radius and also distal radial joint

Front 104

if arrest of labor with prominent ichial spine, what does it mean and next

Back 104

means midpevic contraction → Csection

Front 105

when can u use forcepts?

Back 105

when cervix fully dilated (10cm)

Front 106

what to do if shoulder dystocia?

Back 106

Zavanelli maneuver (push head back and do Csec)

Front 107

define enthesopathy and found in

Back 107

where muscle tendon insert into bones disease...reactive arthritie (spondyloathropathy...tx: NSAID...TETRA+ceft for GC

Front 108

pleural plaques

Back 108

absestosis

Front 109

if glass and pottery maker

Back 109

silicosis

Front 110

if work in high tech industry

Back 110

berylliosis

Front 111

tx ascending cholangitis?

Back 111

DT most likely obstr...need ERCP to remove stone...then abx

Front 112

tx cirrhotic ascites

Back 112

Diagnostic paracentesis...Restrict salt diet...SPIRONOLACTONE > lasix...else tap 2L/d with given Alb...

Front 113

where is Aspergillios found and how does it look

Back 113

SE USA: mobile mass

Front 114

PE what can see on EKG and CXR

Back 114

RVH, RBBB, T invert on anteriolead...CXR: dec pulmo markings

Front 115

MC fungal infxn in usa? On CXR

Back 115

Histop...CXR: Calcification

Front 116

Whats found on CXR of ABPA, dx, tx?

Back 116

central bronchiectasis...inc IgE and Eosinophilia...dx: skin test for ABPA ab..tx: ORAL Predno

Front 117

Fungal ball in lung cavity, hemptysis, what and how to treat

Back 117

Aspergiloma...lobectomy

Front 118

how to tx invasive Aspergiliosis

Back 118

IV AMPHOTERICIN

Front 119

ASA intox in 1) adult 2) kid

Back 119

1) MetabAcid with Resp Alk 2) init. Metab Acid..then Resp Alk

Front 120

how to tx ASA sensitivy Syndr

Back 120

Leuk recept inhibitor (DOC)..steroids, ASA, and desensi therapy...sx: bronchoconstrict/nasal polyps

Front 121

to test for Asthma...

Back 121

give B2agonist...if better → reversible, good dx (measure of FEV1)

Front 122

when give mast cell stabilizers

Back 122

CHROMOLYN – if other allergic DO

Front 123

tx exercise Asthma

Back 123

Bagonist + Chromolyn

Front 124

Asthma + crepitus →

Back 124

CXR to RO pneumothorax

Front 125

if persistent asthma...now tx w

Back 125

inh steroid (BECLOMETHASONE)

Front 126

if pt has nl CO2 and acute asthma attack?

Back 126

Bad...means lungs is not breathing much anymore

Front 127

tx atelectasis and sx

Back 127

bronch to remove mucus plug...seen post surgery...encourage coughing

Front 128

Arthero emoblic DZ vs. Gout?

Back 128

Gout = red toe...this: blue and pt has circulatory prob like pain

Front 129

Atopic Dermaitis sx and tx

Back 129

red, itchy skin...tx: PIMECROLIMUS (like TACRLIMUS = inh Tcell)

Front 130

Afib + WPW tx

Back 130

DOC: PROCAINAMIDE or DISOPYRAMIDE...don;t use slow AV like Dig or VERAPIMIL → arrhythmia

Front 131

if Afib witout hemo probl? Tx

Back 131

Amiodarone..also CCB

Front 132

Aflutter tx?

Back 132

Same..depnding on how stable pt is...long term tx: CCB or Bblocker

Front 133

Autism assoc with? Tx

Back 133

Berry...tx: special ed early like at 3

Front 134

Male DO where nl dev for 2 yrs...then lost acquired skils...autism sx...?

Back 134

Childhood Disintegrative DO

Front 135

good dev until 6 mo...loss hand coord and stereotype hand...?

Back 135

Rett...mainly girls

Front 136

orogressive hip pain without dec rom, nl xray, next? Dx?

Back 136

MRI!!!! Dx: avasc necrosis femoral head

Front 137

if vegeterian for <3ys and get B12 deficiency...? cause

Back 137

probably Pernicious Anemia (not diet...B12 last 3-4yrs in body)...if >4yrs = AbTest for IF

Front 138

MethylMalonic level diff?

Back 138

folate from B12

Front 139

Cut lesions, round, vascular, fever, HA, in HIV pts...dx?

Back 139

Bacilliary Angiomatosis DT Bartenella

Front 140

Skin lesion purpura + petechia and meningitis?

Back 140

BacT! (AMP used for Listeria)

Front 141

normotensive, hypoK, metab alk?

Back 141

Barter syndrome...early in life, polyuria, polydipsia, MR, grow slow...MOA: defect NaCl channel reap → hypovol → renin and problems...

Front 142

how to diff btw Primary hyperAldo vs. Renin secre tumor

Back 142

measure Renin level and aldo

Front 143

MCC hypok?

Back 143

diuretics...not Barters, Gilterman or vomit

Front 144

MC malign tumor eyelid?

Back 144

BCC (slow, pearly)...histo: clusters surrounded by palisading basal cells...can be upper lip, NEVER on lower...rarely met...

Front 145

tx of BCC

Back 145

1) cauterize 2) surg excision 3) cryo and rads

Front 146

Becet affect which pop?

Back 146

Males <20 asia and mideterranean...no tx..MOA: AutoI

Front 147

baby with: big tongue, big orgs, omphalocele, hypoGlc, hyperIns...dx

Back 147

Beckwith Widerman

Front 148

no hypoGlc, no hyperIns, umbilical hernia, no omphalocele....?

Back 148

Congenital Hypothyroid

Front 149

Wilm, Aniridia, Genitoruinary prob, MR...dx? MOA

Back 149

WAGR...gene WT1

Front 150

MOA Bell's palsy

Back 150

PERIPHERAL 7th nn palsy...no central DT central will have furrows still

Front 151

Sx of Acute hepatic failure

Back 151

inc PT, low alb, neuro DT hepatoencephalopathy

Front 152

Diff btw HALOTHANE type 1 and typ2 hepatotoxicity

Back 152

Type 1) mild inc liver enz and NO jaundice...type 2) Acute liver failure

Front 153

what is benign Intrahepatic cholestasis

Back 153

occer 2nd day post surgery..inc ALKP, but mild inc AST/ALT

Front 154

Giant platelets..ARecesive...mild dec platelets...16 yo girl period last 10 days and brother has bleed prob...dx

Back 154

Bernard Soulier...MOA: defect 1b receptor → lack vW attachment so platelet cant attach to endthe

Front 155

how to tx Bblocker toxicity

Back 155

Atropine to oppose vagal tone...else: ISOPROTERENOL...else: GLUCAGON...else temp pacemaker

Front 156

MCC AS in middle age adult

Back 156

Bicuspid...murmur: at Llsternal border rads to carotid (HCM cant hear at carotid)

Front 157

BPP has?

Back 157

NST + 4 others at 2 poins each...8-10 nl...if<4 deliver now

Front 158

Acute abd sx...skin necrosis like pyograngrene..deep skin ulcer...tx and dx

Back 158

CaGluconate and muscle relaxer...local exicision...give DAPSONE if G6PD defic...dx: BLACK WIDOW

Front 159

nonpalpable bladder, lower abd and perineal edema...dx and tx

Back 159

Bladder rupture...tx RETROGRADE CYSTOGRAM...in accident, intraperinal rupture more common

Front 160

skin, lung cavity and bone lytic lesion in ohio/missi

Back 160

blastomycosis

Front 161

when to transfuse blood in truma?

Back 161

if loss >1.5L...ex: if pelvic fracture → start IV crystaloid 2L in 10mins...if still hypovol, start blood transfusion

Front 162

if chest trauma with widened mediastinum...next?

Back 162

NEED ECHO or CT for dx

Front 163

XR of boerhaave show...dx with...

Back 163

subQ emphysema..dx with BARIIUM...need surg

Front 164

Tx Pertussis

Back 164

everyone gets 14d ERYTHRO no matter what

Front 165

Bowerl ischemia post surgery DT

Back 165

infarct of IMA

Front 166

if pt has bowel obstr without strangulation or perf..do?

Back 166

conservative: NG and Barium

Front 167

what kinda of stone DT bowel resect?

Back 167

Oxalate!! (DT xs oxalate reabsorp from GIT...the Ca is bound to fat in the GIT and unable to bind to oxalate)

Front 168

Prostate: Finasteride act on

Back 168

epithelium

Front 169

Prostate: alpha 1 blocker act on (DOXAZOSIN) act on....best one?

Back 169

smooth muscles...TAMSULOSIN

Front 170

What 2 tests done on all possible BPH?

Back 170

UA for infxn and Cr....if Cr inc: US of KUB!!!

Front 171

pt had OM and sinusitis...now HA, focal neuro..?

Back 171

brain absess! (CT or MRI = ring)

Front 172

What is braindead?

Back 172

clinical...means: abasent CORTICAL and BRAINSTEM...their DTR may still work...no pupil rxn, ATROPINE no accelarate heart...no vagal

Front 173

Occlusion of VERT art can →

Back 173

Medial Medullary Syndrome: contral paralysis/loss vibration/tong dev to same side

Front 174

Lesion in lateral pons can →

Back 174

LATERAL MID-PONTINE Syndr: impair sensory/motor of V

Front 175

lesion in Medial Midpon →

Back 175

MEDIAL MID-PONDINE SYNDR: ipsi limb ataxia, contralat eye dev, paralysis face, arm, leg

Front 176

Lesion of Lateral Medulla →

Back 176

WALLENBURG: ipsi Horner, loss pain/T face, weak palate/pharynx/vocal cord/cerebellar atax...no pain/T opposite side

Front 177

HER2/neu good or bad

Back 177

bad prognosis

Front 178

MCC metastatic skin CA in women

Back 178

Breast CA (erythema covered with necrotic skin)...tx: PALLIATIVE with wound care

Front 179

tx Breast CA in pregos

Back 179

no chemo in 1st Trimester and NEVER rads...no lumpectomy 1st (DT rads afterward)..so only tx for 1st = modified radical mastectomy

Front 180

if Breeech, next?

Back 180

if before 37 – leave alone, else cephalic version

Front 181

MOA bronchiectasis...sx..lab

Back 181

widening of med size airway → hemoptysis...”copious foul smelling sputum”...CXR: Tram track (inc vasc markings)..for dx: CT > Scope...next: AFB sputum

Front 182

Wheezing in winter, usually >2yo, inc chance of asthma later...WBC nl...CXR: air trappings..DT?

Back 182

Bronchiolitis...MOA: CMV!!!...tx: humidified O2 and bronchodilators

Front 183

MC lung CA after asbestosis exposure

Back 183

Bronchogenic Carcinoma > Malign Mesothelioma...BGC CAR inc with smoking

Front 184

damage to lateral spinothalamic tract → AKA

Back 184

Brown Sequard Syndr (sx: contralat loss pain and T beginning 2 levels below)

Front 185

Bruton's Agamma MOA, sx, tx

Back 185

Panhypogamma...IgG <100...infxn after 6 mo, recurent pyogenic...gene at Xq22 stops preB to become B...tx: lifelong Ig

Front 186

triad: abp pain, ascites, heptameg

Back 186

Budd Chiari (occlusion of hepatic vein)

Front 187

triad: occlusion disease of artery, migratory superficial thrombophlebitis + Reynauld in male smoker

Back 187

buerger

Front 188

definition of Bulimia Nervosa

Back 188

Binge >=2x /week, if not...”eatin DO NOS”

Front 189

Tense blisters, >60...what and MOA

Back 189

Bullous Pemphigous...MOA: Ab vs. BM, IgG/C3 at the epidermal/dermal jxn..tX: steroids

Front 190

MOA Pemphigous Vulgaris

Back 190

IgG deposit in dermis...HERPES has C3 in the BM

Front 191

Bupropion used for and watch out for

Back 191

Depression with smoking...can SEIZURE! (watch out for hx → give SSRI)

Front 192

best way to dx inhalation burn?tx?

Back 192

bronchscope!...tx: b-agonist, steroids, trach, abx

Front 193

burn that involve entire circumference...tx

Back 193

Escharectomy

Front 194

resuscitation dosage for burn PARKLAND formula

Back 194

4ml/kg/% body burn...half in 8hrs, rest in 16hrs

Front 195

MCC death DT burn is

Back 195

infxn

Front 196

first degree burn,what and tx

Back 196

epidermis...heals without scar (sunburn)

Front 197

2nd degree burn, what

Back 197

red, blisters

Front 198

tx for 3rd burn

Back 198

debridement and graft

Front 199

calanium fx DT fall, next?

Back 199

XRAY pelvic, neck, head and everything else too!

Front 200

Cancer rx causes anorx, tx that SE? Tx NV SE?

Back 200

1) MEGESTROL acetate 2) METOCLOPROPRAMIDE, ODANSETRON

Front 201

flush, diarrhea, valve dz...at risk of what?

Back 201

Carcinoid...CA make SEROTONIN and 5HIAA (need Trp for precursor...Trp used for NIACIN as well...so → NIACIN deficiency → PELLAGRA)

Front 202

triad of Pallagra and DT

Back 202

Diarrhea, dementia, dermatitis...deficiency of NIACIN

Front 203

if Carcinoid in Small bowel vs. appendix

Back 203

SB: sx, if appendix: asx

Front 204

cardiac contusion...next

Back 204

EKG!!! can be arrhythimia, dont do US

Front 205

difference btw Cardio tamponade vs. mediastinal hemorrhage

Back 205

CT show blood in cardiac sac instead of mediastinum

Front 206

MCC of myocarditis that result in dilated cardiomyopathy

Back 206

viral infxn (MC: Coxsackie)

Front 207

aortic stenosis lead to

Back 207

concentric hypertrophy

Front 208

regurg leads to

Back 208

Eccentric

Front 209

HCM how to dx?

Back 209

Echo is nonspecific...look at hx instead..tx: BB

Front 210

HCM inc mucmur by

Back 210

valsava and standing after squatting

Front 211

HCM dec mumur by

Back 211

Handgrip (inc Syste Art Resistance), leg elevation (inc LV vol)

Front 212

only tx for restrictive cardiomyopathy

Back 212

if pt has Hemochromatosis (phlebotomy and subQ deferoxime)

Front 213

speckled pattern on heart

Back 213

amyloidosis

Front 214

What is Caroli syndr

Back 214

congenital dilation biliary tree...seen in APKD

Front 215

cat bite TX

Back 215

AMOX/CLAVULANIC for 5d DT fear of PASTEURELA...sx start within 24hrs

Front 216

Cat scratch fever DT

Back 216

cat scratch sx after 3-10 d

Front 217

sx of Cat Scratch...lab...tx

Back 217

localized cutaneous and LN DO near inoculation site...dx: Hx and Ab to Bhenselia or + Warthin-Stary stain...tx: 5d of AZITHROMYcIN

Front 218

MCC white reflect in kid

Back 218

Cataracts

Front 219

to dx Caustic poisoning

Back 219

Endoscope

Front 220

sx of cavernous venous thrombosis...dx?...tx?

Back 220

HA, Fever...opthalmo, lat gaze palsy, nasal dc, blood...dx: CT of sinuses, brain, head...tx:

Front 221

pallor DT anemia, bone pain DT osteomalacia, brusing DT vitK, hyperkeratosis DT vit A defic...dx

Back 221

Celiac dz...dx: IgA ab to Gliadin and immunofluresent IgA ab endomysium, ab vs. Transglutaminase...confirm: bx Small intetestine

Front 222

dermitits herpidiformis, bloody diarrhea

Back 222

Celiac dz

Front 223

Central cord syndrome sx, age, loc

Back 223

sx: burning pain and paralysis upper extremities and spares lower...DT hyperextend of the neck

Front 224

if INR <5 and no bleed, INR 5-9, INR >9

Back 224

1) omit next wearfarin dose 2) stop it temporarily, 3)stop and give vitK

Front 225

Pap if shows dysplasia →

Back 225

Colpo

Front 226

if pap shows intl atypia spotting →

Back 226

repeat in 1 months...if pt comes with gross cervix → straight to punch biopsy

Front 227

MC finding in cervical spondylosis

Back 227

osteophyte... bony spurs are MC findings

Front 228

NADPH oxidase defici...defect in phagocytosis...dx and tx

Back 228

CGD...DT NitroBlue...tx: Bactrim and Gamma Interferon, BMT...

Front 229

Eczema, thrombocytopenia, recurrent infxn with encaps since birth...petechia and bloody stool

Back 229

Wiskott Aldrich

Front 230

dec granulation, chemotaxis, and grarunation...neutropenia, GIANT LYSOSOME il!!!

Back 230

tx: Bactrim

Front 231

recurrent chalazion

Back 231

squas. CC

Front 232

pleural effusion DT CHF

Back 232

transudate

Front 233

define exudate on pleural effusion

Back 233

if any of these: 1) Pleura/serum prot >.5, 2) pleural/serum LDH >.6...if pH <7.2 = empyema...if pH<7.3 = pleural inflammation

Front 234

aFib + CHF tx

Back 234

Dig

Front 235

Choanal Atresia dx by...

Back 235

kid cyanotic when feed...nasal tube cant pass...best dx: CT

Front 236

Cholescystitis...next

Back 236

1) USG 2) HIDA (good for acalculous especially)

Front 237

MCC acute cholecystitis

Back 237

stone blocks of cystic duct

Front 238

pain AFTER gallblader removal

Back 238

ERCP...if everyhtin clear and still pain...FXNAL pain so give analgesics

Front 239

acalculous cholecystitis occur in

Back 239

critically ill patient and imaging shows distended with fluid..remove it

Front 240

dilation of inta and extra hepatic ducts....RUQ pain or cholangitis...need US

Back 240

dx: Choldedochal cyst...

Front 241

tx of cholelithiasis

Back 241

1) if asx: no tx 2) surgery but if CI, then = URSODEOXYCHOLIC ACID → dec chol secretion from bile and

Front 242

Most gallbladder stones are

Back 242

radiolucent

Front 243

can cause conduction hearing loss in kids...not CA, what from? MOA

Back 243

Cholesteatoma: epithelial cyst that contain keratin...DT: OM or Eustachian tube dysfxn (Pseudomonas)... can destroy bone..best dx: CT and surg!

Front 244

painless redish blue mottling of skin of extremities

Back 244

Cholesterol embolization

Front 245

cholesterol profile done on kids who

Back 245

parents have total chol >240 or kid with risk of CAD

Front 246

MOA of CHOLESTYRAMINE

Back 246

sequest bile acid...lowers LDL and inc HDL...also reduces bioavail of other rx so need to inc those

Front 247

if baby has tach, uterine tenderness...dx and gold dx

Back 247

Chorioamnionitis... to dx: Amniotic fluid culture...tx: AMP + GENT

Front 248

postpartum woman with HEMOPTYSIS, SOB, CP...next

Back 248

CXR and serial HCG for chorocarcinoma

Front 249

to dx Chronic Mesensteic Ischemia

Back 249

Angio and US...pain after eating

Front 250

most pt with CRF also get

Back 250

HyperPT → renal osteodystrophy (dec Ca and retain Phosph)...Normo anemia (give Fe before erythropoitin)

Front 251

how to improve sx of CRF

Back 251

protein restriction and ACEI(this will worsen once cr keeps escalating)

Front 252

eosinophils pulmo infiltrate, peripheral pulmo infiltrate, peripheral blood eosinophilia, alergic granulomatosis...dx

Back 252

Churg Strauss

Front 253

tangentiality

Back 253

going from 1 topic to another

Front 254

if pt has esopha varices but no bleed...prophylactic tx?...if pt has recurrent variceal, ascites bleed, tx? TIPS

Back 254

Bblocker (dec future bleed...)

Front 255

MCC liver transplant

Back 255

HepC...Etoh MCC liver cirrhosis

Front 256

Clavicle fracture...risk damaging? Tx?

Back 256

subclavian artery and brachial plexus...if distal (ORIF), if near (CRIF wit figure 8)...if new born, no tx

Front 257

MCC leukemia in western world...sx...lab

Back 257

ClymphocyticLeukemia...asx...smudge cells

Front 258

C Lymphocytic Leukemia vs. Chronic Myelogenous Leukemia

Back 258

CML = LEUKOcytes (neutrophils)...ALL have

Front 259

MOA clomiphene

Back 259

AntiEstrogen → block hypothal, GNRH, inc LH FSH and inc ovulation...

Front 260

MOA Danozol

Back 260

androgen that inh gonads...for: endometriosis, fibroids, fibrocystic breast Dz

Front 261

Club foot tx

Back 261

aka (Talipus Equinovarus)...tx: 1) non surgical =stretch/manipulate of foot/splint/...tx:2) surgery at 3 and 6 months

Front 262

Clusters prophylaxis?

Back 262

VERAPAMIL, LI, ERGOTAMINE

Front 263

CML lab … BM...tx in crisis?...

Back 263

inc mature granulocyte like band forms and segmented neutrophils ... BM: hypercellular...tx in crisis: IMATINIB (Tyr K inhibitor) …

Front 264

CMV pneumonitis seen in

Back 264

in BM transplant … sx: dyspnea, cough, fever,

Front 265

Coarct CXR

Back 265

dilation ascending aorta and subclavian

Front 266

tx Coke OD

Back 266

EKG abn: st depression...tx: Benzo, Nitrates, Aspirine...if MI = cath!

Front 267

coccidomycosis vs blastomycosis

Back 267

C: cutaneous erythem multiform...B: cutaneous / verrucuous / ulcerative

Front 268

complex partial seizure sx

Back 268

brief loss impaired consciousness, AUTOMATISM (lip smacking) and post ictal...

Front 269

absence seizure has no?

Back 269

postictal

Front 270

HypoNa, HyperK, Hypoglc, Metab Acidosis...btw boy and girl babies?

Back 270

CAH (21 hydroxylaze deficiency)...AR.. boys may not go unnoticed for 2-4 weeks …

Front 271

tx of Congenital Diaphragmtic Hernia?

Back 271

NG tube to keep lung from further compression by stomach...tx before dx!...dont do bag mask → makes it worse

Front 272

Endocardial cushion defect seen in?

Back 272

Down's

Front 273

MCC congenital hypothyr and tx

Back 273

MCC 85% thyroid dysgenesis...baby sx: weak, hypotone, large tongue, umbilicial hernia...tx: levothyroxine

Front 274

triad: sensoneural deaf + cardiac (pda, asd) + cataracts

Back 274

Congenital Rubella...also: thrombocytopenia and purple skin lesion (BLUEBERRY MUFFIN spots)... maybe sx at 2 yo

Front 275

Triad: Chorioretinitis + hydrocephalus + intracranial calc

Back 275

TOXO congenital

Front 276

neonatal conjunctivitis

Back 276

MCC silver nitrate (to prevent gono)

Front 277

tx neonatal chlamydia conjunctivitis

Back 277

systmeic ERYTHRO

Front 278

constrictive pericarditis DT

Back 278

TB immigrants...

Front 279

MOA lactation and contraception

Back 279

inh GNRH → inh ovulation

Front 280

if woman wants contraception right after giving birth...give?

Back 280

PROGESTERONE (minipill)...dn't give combined OCP (Estrogen can dec milk production)

Front 281

to be qualified for home O2?

Back 281

PaO2 < 55, or SaO2 <88... (tx acute COPD: bronchodilators and prednisone)

Front 282

in pt with Multifocal TachyCardia

Back 282

Give O2 to stop arrhythia

Front 283

Chronic Bronhitis, DLCO? Puffer? O2 sat?

Back 283

nl DLCO, Blue Bloaters... O2 desat

Front 284

Emphysema, DLCO, O2 sat?

Back 284

MOA: destruction of alv walls...pink puffer (hyperInflation), and mod O2 sat

Front 285

tx COPD exacerbation

Back 285

Non Invasive Positive Pressure Vent

Front 286

Dx Craniopharyngioma

Back 286

MC in kids...retarded growth... adults hyposex... MRI: cystic calcified parasellar lesion...

Front 287

CREST syndr

Back 287

AntiCentromere ab... better prog than calcification

Front 288

Fast dementia, myoclonus, periodic bi and triphasic sharp wave on EEG...dx...to dx...?

Back 288

Creutzfeldt Jacob... bx: cortical spongiform changes, CSF nl...death in 1 yr... no tx

Front 289

non caseating granuloma

Back 289

UC

Front 290

tx coup?

Back 290

give Epi before intubate!

Front 291

caused by “sand box handling” and tropical travelers...dx and dx and tx

Back 291

Cutaneous Lava Migrans...sx: serperginous lesion on skin... tx: appying THIABENDAZOLE or MEBENDAZOLE

Front 292

MCC hemorrhagic CVA

Back 292

lateral stria arteries (aka Arteries of Stroke) a br of MCA

Front 293

SE Mycophenolate

Back 293

BM suppression

Front 294

SE Azothioprine

Back 294

leukopenia, liver tox

Front 295

SE Tacrolimus

Back 295

hirsu and gum hypertrophy

Front 296

to dx Cystic Fibrosis

Back 296

Sweat Chloride concentration >60... CXR: Tram track

Front 297

MOA of vit K

Back 297

is a cofactor of Gamma-Glutamil Carboxylase (adds carboxy group to glutamate residue of 2, 7, 9 10, C, S)

Front 298

Cystic Fibrosis pt need which vacc and not

Back 298

need INFLUENZA but not PNEUMOCOCCAL...

Front 299

tx of Pseudo for CF?

Back 299

Gent + Piper

Front 300

MC base pair mutation in CF ?

Back 300

Delta JO8 in CFTR gene in chromo 7

Front 301

how to screen for cystinuria?

Back 301

urinary Cyanide nitroprusside test... stones are hexagonal

Front 302

Dacryocystitis...where...DT...tx for acute and chronic

Back 302

MOA: inflammation of medial canthal (St. Aureus and strept)...tx: CEPHALEXIN and CEFAZOLIN (I&D if needed)...chronic: dilation of nasocralimal duct

Front 303

DeQuervain DT?

Back 303

abd of extensor of the tumb...tx: sx by rest or immobili (splinter cast) of tendon, application of heat for chronic infl or cold...NSAID...

Front 304

How to tx Dehydration and a good way to monitor it?

Back 304

NS...monitor: inc BU/Cr bad!

Front 305

Tx of Dermatomyositis Herperteformis

Back 305

DAPSONE (sx: malab, pruritic papules and vessicles over extensors)...lab: anti-Endomyosial Ab, Gluten sensitivity enteropathy and Celiac Sprue

Front 306

Grotton's sign what and seen in

Back 306

Skin on back of knuckles: nonscaly and violavious erythematous eruption...DERMATOMYOSITIS

Front 307

DES cause

Back 307

clear cell ADENOCARCINOMA of vag (usde for threatened abortion)

Front 308

uneven gluteal fold in babies:

Back 308

Development dysplasia of hip...dx: US if <6mo, lab: +Barlow +Ortolani...tx: Surgical reduction

Front 309

Dextrometorphan has rx toxicity with

Back 309

MAOI → hyperthermia

Front 310

intraabd organ lac...best dx procedure?

Back 310

Diagnostic Peritoneal Lavage... Angio is almost never done

Front 311

Pt likes cold beverage and urine osmolarity < serum osmolarity (xs amt of diluted urine) dx

Back 311

DI

Front 312

SAIDH seen in

Back 312

Lung CA and brain trauma

Front 313

Tx of Central DI

Back 313

intranasal Desmopressin

Front 314

if pt has nl AG metab acidosis in DM with GI prob...what and how to dx

Back 314

what: can lose NH4 through diarrhea or defective NH4 synth...so do urinary AG --> if (+) = nephropath, if (-) = Gastroenteritis

Front 315

fasting Glc for DM

Back 315

126..check again, if still >126 = DM or if px is Sx

Front 316

75 g of glc tolerance test level?

Back 316

200 or greater

Front 317

earliest renal prob in someone with DM

Back 317

glomerular hyperfiltration...first chance qunatified: thickening of GBM (ACEI is god)

Front 318

hyperK during DKA due to

Back 318

xchange K for H and inpaired insulin dependent reentry of K

Front 319

what is used to screen and confirm gestation DM

Back 319

1hr 50gm (<140 rules it out) for screen and 3hr 100 gm for confirm

Front 320

What's the best way to document delayed gastroemtying

Back 320

Nuclear medicine Scintigraphy after ingestion of radiolabeled food

Front 321

pt with NKHS... first check?

Back 321

Glc level

Front 322

MC type of DM neuropathy and how to dx

Back 322

symmetrical distal sensorimotor polyneuropathy (stocking glove)...dx: EMG and conduction studies

Front 323

DM is a RF for

Back 323

NASH

Front 324

infxn in uncontroleld DM?

Back 324

consider Candida

Front 325

Mucor Mycosis vs Rhizopus infxn

Back 325

in DM...M: eye/chemosis/diplopia... R: maxillary sinus...both necrotic infxn

Front 326

CC bacterial sinusitis

Back 326

H. Influenza and Moraxella Caterrhalis

Front 327

how to dx cystopathy

Back 327

Cystometry and Urodynamic studies...tx: strict volume control and Bethanoecol...then cath if not work

Front 328

Emphysematous pylon...DT...dx...tx

Back 328

DT Ecoli....dx by CT...tx: IV abx and possible emergency kidney removal...(this is an emergency)

Front 329

kid with macrocytic anemia (no megaloblastic, no hyperseg), low reticulocytes, congenital abn...short, webb neck...MOA

Back 329

tx: steroids and then transfusion if no work

Front 330

how to dx diaphragmitc herniation

Back 330

Barium swallow

Front 331

MCC bloody diarrhea in USA … watery as well

Back 331

Campylo (undercooked poultery)

Front 332

blod diearrha seen in daycare, institution

Back 332

Shigella

Front 333

MCC diarrhea in kids that cause acute gastroenteritis and tx

Back 333

Rotovirus...had a vaccine but took off DT cz intusseptin

Front 334

tx of DIC

Back 334

1) if pt bleed: FFP...if no bleed 2) IV abx + activated prot C

Front 335

how to dx Diffuse esophageal spasm

Back 335

mannometry: repetitive, non eipositic, high amp spont contraction

Front 336

DiGeorge sx

Back 336

HypoPT and impair cognitive

Front 337

Dig tox that needs and not need stop

Back 337

need: AV heart block, atrial tachy...

Front 338

SE of diphenhydramine

Back 338

seizure and anti-chol effects

Front 339

tx for disck herniation

Back 339

NSAID and early mobilization

Front 340

Biggest RF for diverticulosis

Back 340

chronic constipation...dx: Barium.

Front 341

XRAy of ischemic colitis

Back 341

thickening of colon walls

Front 342

lab for Down's

Back 342

Dec AFP, dec Estriol, inc HCG,

Front 343

Down kid with GI?

Back 343

duod atresia (MC), ASD (endocardium defect) (double bubble)... hirsprung, esoph atresia, pyloric stenosis,

Front 344

DOC for dressler

Back 344

NSAID

Front 345

drug induced pancreatitis

Back 345

1) diuretics/furesamide/thiazide 2) IBD/sulphalazine/5ASA...

Front 346

ACEI of CI

Back 346

hyperK

Front 347

CCB CI for

Back 347

2nd and 3rd degree Heart block and CHF

Front 348

DUBIN JOHNSON

Back 348

familial bile secretion (conjugated bili) can be aggravated by woman taking OCP...liver bx: dark granular pigments

Front 349

DUBIN vs ROTOR

Back 349

no dark granule

Front 350

Duchenne MD dx by

Back 350

bx

Front 351

test of choice for DVT

Back 351

Compression US...Venography is the GOLD but uncomfortable...

Front 352

test of choice for recurrent DVT

Back 352

plethysmography

Front 353

INR for prosthetic valves

Back 353

3.5-4.5

Front 354

dystonia define

Back 354

depressed mode for 2 yrs

Front 355

what's close contact with sheep

Back 355

ecchinococcus...(hepatomegaly, hydatid cyst in liver)...cyst has inner germinal layer

Front 356

neurocystercosis DT

Back 356

pig farmin, cyst in brain...kills fast

Front 357

assoc with atopic dermatitis...dx and DT

Back 357

eczema herpeticum...Herpes simplex... many umbilicate vessels around healing area...tx: life treat in kid = ACYCLOVIR asap

Front 358

closed fit, prominent occiput, microcephaly, overlapping fingers...

Back 358

EDWARDs (trisomy 18)

Front 359

t wave seen

Back 359

ischemia

Front 360

st depression seen in

Back 360

subendocardial infarct and unstable

Front 361

pt comes in with cold hand...next

Back 361

possibly emboli...tx: IMMEDIATE coag and possible surgery

Front 362

hx of neonatal jaundice and emphysema...

Back 362

Alpha 1 antitryptsin deficiency

Front 363

elderl DM man...infected gallbladder...crepitus...dx...lab..tx

Back 363

emphysematous Cholecystitis (acute DT gas forming bacT)...dx: abd xray gas line... lab: moderate unconj... tx: fluid, early cholecystectomy, abx)

Front 364

parapneumatic effusion can →

Back 364

empyema (PH< 7.2, 100k wBC)

Front 365

tx for endometriosis...gold std for dx:

Back 365

OCP...if fail: DANOZOLE (cause pseudomenopause SE: hirsu/deep voice)...dx: powder burn laparatomy

Front 366

tx vaginismus

Back 366

dilators

Front 367

when is endometritis and rF...MC bacT...tx

Back 367

2-3 d … prolonged labor/ PROM/repeated pelvic exam... MC: anaerobe … abx: Clinda + AMG or AMP

Front 368

best test to see if pt benefits from lung resection...

Back 368

PFT (esp FEV1 postop)

Front 369

MC helminth infxn in USA

Back 369

Enterobus Vermicularis...tx: Albendazole and Mebendazole

Front 370

tx for enuresis

Back 370

low dose IMIPRAMINE or DESMOPRESSIN...but RO UTI by urinalysis

Front 371

dx Epiglottitis

Back 371

dx: fiberoptic scope in OR, then → intubate...trach if cant... dn't need Epi first here

Front 372

some causes of Erectile dysfxn

Back 372

Venogenic ( tunical albuginea)... prolactinoma... don't give nitrates w/ sildenefil

Front 373

erysipelas is a type of … tx

Back 373

Cellulitis .. tx with: Pen V or Erythromycin 500 mg po >= 2 weeks...group A MCC

Front 374

how to tx DUBleed

Back 374

prolly DT anovulation...tx: Give Estro...then Prog...then withdrawal last few days

Front 375

erythema multiforme aka

Back 375

iris/target lesions

Front 376

erythema multiforme can be dT

Back 376

hespes...or Mycoplasma PNA & tx with TETRACYCLINE

Front 377

Erythema Nodosum can be DT

Back 377

TB...strepth throat...tx: bed rest

Front 378

new born, bening, self containing rash with red halos...eosinophils on skin...

Back 378

Erythema Toxicum... no fever, healthy

Front 379

tx esophareal varies acute

Back 379

1) IV fliuid...2) stop bleed by OCTREOTIDE or BAND LIGATION(less SE)...3) SCOPE if not avail--> balloon tamponade...if all else fails 4) TIPS surgery

Front 380

whats the indication for TIPS or sugery in ESOphageal Varies

Back 380

>= 5 units blood transfusion in 24 hrs

Front 381

Estrogen replacement therapy and Thyroid hormone?

Back 381

need more Lthyroxine...also same for pregnancy

Front 382

tx essential tremor

Back 382

BB > PRIMIDONE (SE: abd pain, acute intermittent porphyria: dx by urine prophobilinogen)... familial dz

Front 383

AG metab acidosis w/ rectangular envelope crystals...what is it and dx

Back 383

Calcium Oxalate...dx: ETHYLENE GLYCOL poisoning

Front 384

URI then hearing loss, full ear, pop when swallow...retracted and decreased movement tympanic...dx

Back 384

E tybe dysfxn...common...middle ear effusion

Front 385

Ewing sarcoma sx...and XR

Back 385

lower extremities pain in kids, swelling...very malignant...XR: ONION SKINNING periosteal retraction → moth eaten appearance...tx: everything...

Front 386

if XR: lytic bone defect with surrounding sclerosis..aka...seen in

Back 386

BRODIE's ABSCESS...in: osteomyelitis chronic

Front 387

diff btw factitious Diarrhea and IBS diarrhea...

Back 387

IBS not happen at night … (factitious cause is laxative, also rich nurses)

Front 388

define false labor

Back 388

painless, irregular... NO PROGRESSIVE cervical change (cervx shut)...tx: reassurance

Front 389

Arecessive, progressive pancytopen, macrocytosis...cafe au lai, small head, jaw...short, horshoekidney... NO THUMB...age 8...dx

Back 389

Fanconi's anemia

Front 390

tx of fat emboli

Back 390

HEPARIN... petechia, SOB

Front 391

assoc with surgery or trauma and mimics what? Dx?

Back 391

Mimics: Breast CA...dx: Fat necrosis... bx: foamy microphages and fat globules, bigcalcification=benign, microcalc=malignant...bx to dx...no tx xcept mammo

Front 392

dec platelets, fever >100 for 1 hr...next and dx

Back 392

FEBRILE NEUTROPENIA (emergency)... tx: admit, Blood cultures, IV CEFEPIME or CEFT, or IMEPENEM.... + VANC if skin or hypotensive (aureus)

Front 393

how to tx femur shalf fracture...how about if NECK of femur fractures

Back 393

closed intra medually fixation of shaft...then intramedullary nail insretion thhrough skin over greater trochanter... Closed nail > open nail... 2) if NECK = Int fixation with plates and screws

Front 394

fix intertrochanter fracture

Back 394

internal fixation with sliding screw with plate and early mobiliz

Front 395

sx femoral next fx...tx..

Back 395

elderly: short limb, rotated... if unstable (complete fx) = open reduction w/ internal fix or primary arthroplasty(reconstruction) when pt is stable... don't do surgery if pt needs mobiliszation asap

Front 396

epicanthal fold, long philtrum, small maxilla, thin upper lip...

Back 396

FAS

Front 397

if can't hear fetal heart beat..next...

Back 397

US

Front 398

Fetal hydantoin syndr

Back 398

small, small head, hypoplastic distal phalanx fingers/toes, low nasal bridge, cardiac murmur...NEUROBLASTOMA...

Front 399

Fever 3-5 days postop

Back 399

UTI

Front 400

Fever 3-7 days postop

Back 400

PE

Front 401

Fever 1-2 months post surg

Back 401

post spleenectomy sepsis (give pneumococcal vaccine after surg!_

Front 402

fever 6days postop

Back 402

PNA

Front 403

Fever 4-7

Back 403

wond infxn

Front 404

Female 35 with firm, rubbery mass, next

Back 404

MAMMO (fibroadenoma)

Front 405

fibrocystic breast...next and next

Back 405

1) aspirate = will go away...2) wait almost 1 yr = if come bac = BX... *******if fluid was smelly/bloody = cytology then!

Front 406

in FMD, which renal artery more likely affected...best tx?

Back 406

Right... angio: STRINGS OF BEADS … invertentional (stent placement) rather than medical better...

Front 407

dx for chronic fatique syndr

Back 407

6 months

Front 408

sx of Polymyalgia Rheumatica and age?

Back 408

pelvic and shoulder and >50, stiffness, not pain...fever..weight loss...ESR: elevated

Front 409

tx Fibromyalgia

Back 409

Amitriptyline or cyclobenzaprine

Front 410

SE of fluphenazine

Back 410

Hypothermia DT VD and inh of shivering

Front 411

HIV peeps get what type of glomerulonphritis

Back 411

focal segmental

Front 412

hard to perform simple task...low iq...lang prob, autism...large head, jaw, low set ears...dx...MOA

Back 412

Fragrile X DT mut FMR (CGG repeat inc..)

Front 413

ARecessive, trint repeat, poor prognosis...dx and best lab...

Back 413

Friedtrick Ataxia...tell parents to get genetic for next kid..lab: MRI brain/spinal = marked spinal atroph, minimal cerebral

Front 414

sx of Friedrich...MCC death?

Back 414

starts early 20s...atax, fall (degen spinocerebeallar, pyramidal, post tract)....nonneuro sx: HCM, DM, scoliosis, HAMMER toes...live 20 yrs...MCC death CV!!!!

Front 415

tx frost bite

Back 415

warm upbody with warm water

Front 416

rotator cuff dec what

Back 416

abd...ROM dec in active but nl in passive...arm drops at 90

Front 417

to dx tendinits from tear?

Back 417

inj lidocaine inc ROM in tendinitis but not in tear

Front 418

tinnitus?

Back 418

ASA

Front 419

ototox

Back 419

AMG, vanc, chloroquine

Front 420

newborn, bilat cataracts, jaundice, hypoGlc...

Back 420

dx: GALACTOSEMIA...tx: take out galactose..MOA: Uridyl Transferase def

Front 421

Galactosemia vs. Galactokinase def?

Back 421

Deficiency only has cataracts...nothing else

Front 422

chronic gallbladder stones →

Back 422

gallbladder carcinoma...XR: Porcelaine (DT Ca deposit)

Front 423

Acanthosis nigrans...blood vomiting...

Back 423

gastric carcinoma

Front 424

tx of MALT

Back 424

Gastric Mucosa assoc Lymphoid Tissue Lymphoma...tx: kill H.Pylori = usually takes care of it...if already met--> CHOP

Front 425

tx H. Pylori

Back 425

Omeprazole + chlarithromycin + Amox

Front 426

bowel not covered...dx...tx

Back 426

Gastroschisis= cover it, abx and fluid

Front 427

DT deficiency of Glucocerebrosidase...dx...sx

Back 427

Gaucher's dz...sx: big liver, anemia, dec WBC, dec platelets....NO CHERRY RED MACULA

Front 428

tx GAD

Back 428

Buspirone

Front 429

SE Gentamycin

Back 429

Nephro, ototox, vestibular tox (dizzy)

Front 430

how to dx Gerd

Back 430

24hr pH monitor of esophagus...

Front 431

to diff btw GERD and nocturnal asthma...

Back 431

give Omeprazole (PPI)...if better you kow

Front 432

complication of Giant Cell arteritis...lab

Back 432

Thoracic Aortic Aneurysm...lab: inc ESR, normo anemia

Front 433

partial absense of enzyme...nl liver enz...inc w/ stress...comes back to nl...dz

Back 433

Gilbert...UNCONJ

Front 434

Rotor syndrome bili?

Back 434

Conju

Front 435

Criggler Najjar type 1 vs Type 2

Back 435

both: uncon, Liver enz nl...type 1: kerniterus...type 2 dec bili with PHENOBARBITAL

Front 436

Glascow scale

Back 436

Minor >14, mod <13 >9, severe <9

Front 437

MCC bindness...how can u tell acute … dx tool

Back 437

Glaucoma... acute: non reactive, mid dilated pupil..dx: TONOMETRY

Front 438

open angle glaucoma sx...labs...last tx

Back 438

slow...PERIPHERAL affected first... high IO pressure...lab: cupping of disc... once defect found, map out where it is

Front 439

Acute closure glaucoma sx and tx

Back 439

svere pain,ant chamber shallow with inflammation...inc IOP...tx: ACETOZOLAMIDE, MANNITOL, PILOCARPINE...permenent tx: LASER PERIPHERAL IRIDOTOMY...avoid atropine

Front 440

acute open angle glaucoma sx and tx

Back 440

Blacks and DM...gradual loss PERIPHERAL... cupping of dis..tx: BB, TIMOLOL for init...def tx: TRABECULOPLASTY

Front 441

MOA: Glc 6 Phosphatase defic...dx?..sx..

Back 441

Von Gierke type 1 Glycogen storage dz...hypoGlc, lactic acid, hyper uric, hyperlipid...big liver, kidney... doll fase (fat cheeks), big abdomen, thn legs

Front 442

long term steroid →

Back 442

inc neutrophils, dec easino, dec wbc

Front 443

Type 2 and type 4 and type 1 glyc stor dz

Back 443

1: Von Gierke, 2: Pompe

Front 444

if suspected gonococcal arthritis go whee?

Back 444

urethral culture higher yield than synovium

Front 445

Arthritis + palm/soles necrosis

Back 445

Gonorrhea

Front 446

sputum has Fe in forms of hemosiderin...anermia, RBC case In urine...

Back 446

Ggood Pasture

Front 447

Good Pasture vs. Idiopathic pulmo hemosiderosis

Back 447

IPH: kids and more hemoptasis

Front 448

Wegner vs Good Pasture

Back 448

GP: lower (hemoptosis) + kidney...Wegener = GP + URI and CRESCENT

Front 449

tx Good pasture

Back 449

Plasmapheresis to remove Ab vs. GBM ASAP

Front 450

MOA: defic Acid Beta Glucosidase (lysozome)... sx... lab..

Back 450

Askhani Jew, tired, easy bruise, bone pain/fx... dx: XR: Erlenmeyer flask in distal femur.. BM: Gaucher cells wrinked paper

Front 451

If 24hr uric acid level show hyperuric (>800), tx?, if hypo tx?

Back 451

hyper: PROBENECID, hypo: ALLOPURINOL (xo)

Front 452

Gouty attacks DT? Tx for acute... chronic...

Back 452

Etoh ( → lactate and competes with urate for xcrete... inc urate → gout) 1) acute = oral INDOMETHACIN/ COLCHICINE/STEROIDS... 2)chronic: COLCHICINE

Front 453

MOA graft vs. host?

Back 453

activated donot Tlcy vs. organs → maculopaplar rash in palms/soles/face..

Front 454

rapid dev into painless ulcer... red beefy base... inguinal LN no Buboes... dx..lab...tx...if chronic?

Back 454

GRANULOMA INGUINALE dt Donovale Granulomatis... STD... dx: Donovan bodies (Giemsia or wright stain = red, encapsulated bipolar bacT in monocytes)...tx: TETRA...scarring

Front 455

describe ulcers of primary syphillis

Back 455

punched out base

Front 456

describe ulcer in Chanchroid

Back 456

PainFULL, buboes form and PAINFUL too

Front 457

describe ulcers in HERPES

Back 457

vesicles BEFORE → ulcers

Front 458

ulcers of Lymphogranuloma Venerum vs. Granuloma Inguinale

Back 458

both painless... Syphillis shallow and LN is inflammation and not same time as ulcers

Front 459

Tx Grave's

Back 459

Radioactive IODINE...

Front 460

Preg women suddenly Afib?

Back 460

hyperThyr

Front 461

MCC hyperthyr in pregos

Back 461

GRAVES

Front 462

Growing pain sx

Back 462

mostly at night...NSAID

Front 463

best way to monitor breathing in Guillan barre'? Lab

Back 463

besides serial VC (above 15ml/kg)...CMPYLO BACTER!...lab: alb-cyt dissociation (inc prot, nl cell count)...tx: IV Ig and plasmaphoresis

Front 464

whats another ascending paralysis?

Back 464

Tick borne paralysis

Front 465

what's descending paralysis

Back 465

butulism (antitoxin)

Front 466

injury below nipple line? (4th rib)

Back 466

laparotomy gunshot

Front 467

Tartrate resistant acid phosphatase stain? BM?

Back 467

Hairy Cell leukemia (type B lcy Chronic leuk)... BM: usually dried so no help

Front 468

tx NHL

Back 468

CHOP

Front 469

tx CLL

Back 469

Chlrambucil + prednisone

Front 470

Hashimoto lab.. seen in...imaging and to dx

Back 470

+ antithyroxyperoxidase ab...large rubbery goiter... thyroid lymphoma (60x!)...US: pseudocyst, uptake: dec...to dx: CORE BX (needle may miss)

Front 471

tx inc ICP?

Back 471

head elevated, hypervent, IV mannitol and diuresis

Front 472

Mobits type 2 can be DT

Back 472

MI

Front 473

Heat exhaustion vs. Heat stroke vs Cramp

Back 473

Stroke: CNS + >40 / MOA: thermoregulators failed...Cramps: pain DT dec salt

Front 474

tx Heat Stroke?

Back 474

evaporation cooling! (emerging in water hard to calc temp)

Front 475

Tx Acute Fatty liver disease

Back 475

supportive...deliver...

Front 476

HUS basics sx

Back 476

thrombosis glomerular arteries, in kids, after URI

Front 477

TTP basic sx and tx

Back 477

like HUS and with NEURO sx... tx: xchange transfusion or plasmaphoresis with FFP

Front 478

tx for HELLP

Back 478

If >34, deliver, give Mg to dec BP and vag

Front 479

Hemi neglect DT

Back 479

Right (non denominant) parietal lobe

Front 480

lab hemochromatosis... MC complication... inc risk of

Back 480

Transferrin sat >50%, Ferritin >1000.. MC complication HCC... inc risk of LISTERIA... first lab: CBC for fe level!

Front 481

big liver, hiperpig, DM, arthritis, HF and hypogonadism

Back 481

Hemochro

Front 482

Oliguric RF + MAHA (micro angiopathic hemolytic anemia) + dec platelets

Back 482

HUS

Front 483

HUS vs TTP

Back 483

TTP variant of HUS... T: thrombosis everywhere not just kidney / sx: fever AMS focal neuro renal MAHA (micro angio hemolytic anemia) and dec platelets... tx: xchange transf and plasmapheresis with FFP

Front 484

kid with diarrhea, now abd pain, inc bun/cr and triad: Uremia (renal fail), dec platelets, hemolytic anemia

Back 484

HUS... tx: supportive, if not work: plasmaphoresis/dialysis and steroids

Front 485

Solid tumor, xs estrogen → pubic hair, breat, uterus... bimodal young old, surg to remove..dx

Back 485

Granulosa tumor

Front 486

Dysgerminoma in what age

Back 486

young female, no hormone made

Front 487

mature teratoma aka

Back 487

dermoid cyst

Front 488

ovarian mass, abd pain...

Back 488

serous cystadenoma... MC cystic CA of ovaries

Front 489

Fe (HEMOSIDERIN) deposit and synovial thickening with fibrosis... bloody arthropathy..what...type...lab

Back 489

Hemophilia... X... PTT inc

Front 490

Hemothorax...first tx

Back 490

low tube to drain blood... if >1.5L = surgical thoracotomy or >600 mL after 6hrs

Front 491

males, URI, then → palpable purpura in buttocks, peripheral edema, scrotal swelling...hematuria/proteinuria...dx

Back 491

Henoch Schonlein tx..steroid ...MOA: IgA vasculitis of small vells → rash/abd pain/joint/renal... dx: Immuno = IgA deposit in kidneys

Front 492

how to tx IgA...

Back 492

if travel <4weeks → IgA, if more → Vaccine

Front 493

HIT seen how many days … labs...sx:

Back 493

3-15d and resolve 5d after stoppping... lab: BOTH PTT inc and PLATELETS dec... sx: Art/venous thrombosis + dec platelets

Front 494

liver ADENOMA

Back 494

OCP women

Front 495

Liver encephalopathy MOA and tx

Back 495

MOA: accum of ammonia → CNS... tx: Clear bowels w. anema/ dec prot / oral lactulose / oral Neomycin

Front 496

give cryoprecitpitate if

Back 496

coag factor defic like 8... packed RBC if <8

Front 497

tx Hep B after liver transplant v. Hep B infxn vs. vacc mult times with no response vs. exposed and never vacc before

Back 497

transplant: B IgG + Lamivudine... infxn: Interferon + Lamuvidine... vac useless: B IgG on exposure... never vac: B IgG and start vacc

Front 498

best test for acute hepB? How to tell if peson is vacc vs. infxn

Back 498

Anti core Ag, surface Ag... difference: vacc will have Anti surface Ag, but no surface Ag

Front 499

how to tell chronic HepB

Back 499

Surface Ag, eAg, and high hepB DNA titrs

Front 500

how to tell the tx for HepB

Back 500

ALT > 2x high = Lamivudine + inteferon (not useful if less)... if post exposure and had Vacc = just Ig, if no previous response: Ig _ vacc

Front 501

define fulminant hepatitis... lab...tx

Back 501

8 weeks post acute infxn... marked inc ALT, CNS... tx: put name on transplant list

Front 502

if pt depressed and choose btw Lamivudine or Interferon pick

Back 502

LAMIVUDINE (Inter is CI in psych pts)

Front 503

Hep E tx?

Back 503

none available

Front 504

HCC tx

Back 504

surgery..none avail...lab: AFP >500..tx: careful about volume so stop lasix and spironolactone

Front 505

how to dx hereditary spherocytosis... tx

Back 505

osmofragility test / MCV inc... AReces.. tx: give FOLIC ACID and transfusion during extreme anemia... worst: encaps bacT after splenectom = Pneumoc/Hinfl/daily Penicillin

Front 506

rhinorrhea, dilated pupils, sweat..dx

Back 506

heroin withrdrawal

Front 507

after abd hernia, bad for resp? Tx

Back 507

abd push up--> dec lung volume, so needlung exercise: blowing,

Front 508

CSF: lcy, low gl, inc prot. Bizzare behavior...dx..tx

Back 508

Herpes brain: Temporal lobe...dx: HSV PCR...tx: Acyclovir

Front 509

how to dx herpetic keratitis

Back 509

slit lamp

Front 510

tx herpetic witlow

Back 510

self gone

Front 511

hirshsprung, leukemia, duode atresia found in

Back 511

Down's

Front 512

if hirsutism DT ACTH tumor or adrenal adenoma?

Back 512

ACTH: bilateral adrenal hyperplasia... adnoma: focal

Front 513

white hairy lesion...DT..MOA in what

Back 513

Hairy Leukoplakia.. painless, DT EBV in HIV pts...

Front 514

all HIV pts shouuld get

Back 514

Chem, 2) CD4, plasma hiv RNA levels, VRDL, MMSE, Pneuc vac, HepA/B serology, HepA/B vaccine

Front 515

CD4 <50, abd pain, bloody dirrhea, bx?dx?tx?

Back 515

CMV colitis... bx: owl's eyes... tx: Gancyclovir/Foscarnet

Front 516

prophylax vs. MAI? CD4? How about tx?

Back 516

Prophylax: AZITHRO...<50... tx: CHLARITHRO + ETHAMBUTOL

Front 517

HIV prophylaxis vs. Histo at? With

Back 517

<100 … ITRACONAZOLE

Front 518

if pt has PCP SEVERE, add what?

Back 518

steroids to bactrim (esp. if PaO2 <70)

Front 519

tx Toxoplas in HIV

Back 519

SULfazadiazine and PYRIMETHAMINE... BACTRIM for propho

Front 520

HIV pt has collapsed vertebrae?

Back 520

TB

Front 521

diarrhea in HIV pt CD4 <80?

Back 521

1) Cryptosporidium (Modificed Acid Fast...ooocytes in stool, self gone)is MC 2) ISOSPORA (like #1 but not as common) 3) MICROSPORIDIA (SPORES in stool, not oocytes)

Front 522

multiple non-ring enhancing lesion in brain, CD4 <100...dx

Back 522

PML (DT: JC virus) = progressive Multifocal Leukoencephalopathy and NO MASS EFFECT

Front 523

TOXO vs. LYMphoma in HIV

Back 523

T: multiple ring lesion in basal ganglia...L: 1 ring and periventricular and EBV DNA in CSF

Front 524

Bartonella cause

Back 524

Bacilliary Angiomatosis...sx: red papules, fever, chills, anorexia...init: vascular, then crust over...tx: abx

Front 525

PCP pneumo sx

Back 525

DRY cough and NO EFFUSION

Front 526

TB vs Nocardia in HIV

Back 526

both cavitary lesion...N: PARTIALLY acid fast with branching rod / ppd small... tx: BACTRIM for N

Front 527

how to dx diarrhea in HIV

Back 527

NOT EMPIRIC...start with stool exam

Front 528

HIV user with dry cough and tx?

Back 528

PCP... give PENTAMIDINE if allergic to BACTRIM

Front 529

Condiloma Acuminata vs. Condyloma Lata

Back 529

A: (anogenital warts) pink/papiliform tx: PODOPHYLINE (antimitotic) but not in pregos... L: 2nd syphillis: Penicillin: flat and velvety

Front 530

HIV eye problems: CMV vs. Toxo vs. Herpes keratitis vs. Herpes Z Opthalmicus vs. HIV retinopathy

Back 530

C: CD4<50, retinal opaque/hemorrhage, yellow/white patch (GANC/FOSCAR)...T: >50% encephalitis, choroiditis, white fluffy lesion and necrosis of retina … HSK: pain, photophobia, dec vision, DENDRITIC ULCER... HZO: elderly, rash CN5...HIVR: benign cotton wool and self gone

Front 531

tx: Cryptococcus Meningitis in HIV pts

Back 531

IV. AMPHOTERICIN + FLUCYTOSINE

Front 532

bird and bat... if disseminated, sx:... tx

Back 532

Histo (ohio) is MC fungal infxn in usa... sx: oral ulcers, big spleen/liver, pancytopenia...tx: IV AMPHOTERICIN + lifelong ITRACONAZOLE

Front 533

Metastatic Breast CA can → and tx? By activating cytokine and TNF

Back 533

HyperCa … tx: if has bone lytic lesions and taking TAMOXIFEN give → PAMIDRONATE (biphosph)

Front 534

in acute hyperCa, give what? ...most common sx of HyperCa?

Back 534

IV NS before lasix (this will prevent renal failure DT dec volume)...sx: constipation

Front 535

MC sx in Sq CC of lung

Back 535

HyperCa

Front 536

hyperPTH lab?... criteria for surgery/removing

Back 536

inc Ca, dec Phosphate, inc PTH...requirements: 1) Ca >=1 above nl, 2) 24Ca urine >400, 3) <50yo, 4) BMD <2.5 SD, 5) if diff F/U

Front 537

Gout can → lab?

Back 537

HyperPTH (aspirate: rhomboid Ca Paraphosphate)

Front 538

Primary vs 2nd hyperPTH

Back 538

Ca: high in 1st, nl or low in 2nd (inc PTH is DT hypoCa)...

Front 539

dry, rough skin, horny plaques over surface of limb... dx... tx>

Back 539

ICHTHYOSIS VULGARIS (lizard skin)...tx: minimize bathing and oral vit A (CI in pregost)

Front 540

Pleurodesis used for

Back 540

recurrent pneumothorax and effusion

Front 541

tx Idiopathic Pulmonary Fibrosis

Back 541

Steroids... live 3yrs

Front 542

how to dx IgA deficiency...vs. CF?

Back 542

IgA <7, nl IgG and nl IgM... tx: BACTRIUM or AMOX prophy... if fail: IgA to nl amt...CF: does not cause anaphylaxis rxn in blood transfusion

Front 543

MCC glomerulonephritis in adult

Back 543

IgA.. sx: URI then 2-3 days later: gross hematuria, nl serum complements

Front 544

2-6yo kid... URI few days ago... petechia, purpura, hematuria, GI bleed...dx..tx

Back 544

ITP (ab vs platelets)...lab: nl xcept for dec platelets... if WBC <30k: steroid else, nothing

Front 545

how to tx local Impetigo?

Back 545

Mupirocin... if no help: systemic: CLOX or 1st gen CEPHALO....if allergic: ERYTHROMYCIN

Front 546

how to tx Afib in hyperThyroid?

Back 546

BB or

Front 547

SE of PTU or Methimazole

Back 547

agranulocytosis within 90 days (for hyperThyr)...sx: sore throat/fever..tx: STOP

Front 548

how to diff Graves from rest? And tx?

Back 548

24 hr RadioIodine reuptake... #1 initial=BB but always RadioIodine Ablation afterward...PTU used if pregos

Front 549

Nephrosclerosis is what?

Back 549

look like: hypertrophy and fibrosis of renal art... sx: pt present with ANEMIA

Front 550

histo of DM nephropathy

Back 550

inc EC matrix, thick BM, mesangial expansion and fibrosis

Front 551

isolated SYSTOLIC HTN seen in?...moa...tx

Back 551

elderly pts...DT dec elasticity → wide pulse pressure....tx: THIAZIDE

Front 552

tx HTN DT OCP

Back 552

stop..if not work: THIAZIDE

Front 553

HTN retinopathy histo

Back 553

spasm...sclerosis...narrowing...AVnicking..copper/nickel/exudates and hemorrhages

Front 554

Beta 2 agonist dec K by

Back 554

driving it into cells (so becareful if someone taking B starts muscle weak)...other SE: resting tremors and peripheral edema

Front 555

Perforation of esophagus need be tx

Back 555

by 6hrs (drain) and close

Front 556

HypoThyr assoc with

Back 556

myalgia, muscle hypertrophy... check CK and myopathy... hyperLipid and hypoNa... especially after Graves tx...so to dx: TSH level

Front 557

if pt has Major depression, chek?

Back 557

Hypothyroidism...so CHECK TSH

Front 558

MCC congenital hypothyr?

Back 558

Thyrdoid Dysgenesis

Front 559

postvoid cystometry in pt with stress incont? Tx

Back 559

nl... tx: KEGEL. Estrogen if postmenop, surg

Front 560

if pt has overflow, stop what

Back 560

NSAID = inhibits detrusor muscles, but give BETHANECHOL to improve detrusor, or self cath

Front 561

tx Urge incont

Back 561

OXYBUTYRIN

Front 562

if pt with EBV mono gets petechia/airway obstr/ autoI hemolytic anemia?

Back 562

Give Steroids

Front 563

rash after Ampicillin for URI? How to dx..?

Back 563

Infectious Mononucleosis...lab: atypical lcy (large basophilic lcy)..dx...Heterophil Ab may be neg, then do EBV Ab test

Front 564

Strept Bovis assoc with

Back 564

Colon CA

Front 565

infection edocarditis. MOA of ROTH spots / OSLER NODES

Back 565

ROTH: immune vasculitis → ovral retinal hemorrhae with pale centers... OSLER: deposits of complex... JANEWAY: nonpainful → DT septic emboli → small abscesses on palms and soles

Front 566

Condition that do not require prophylactic tx for IE

Back 566

MVP without regur, innocent murmurs, pacemakers and defibs

Front 567

Tricusp regurg murmur

Back 567

Holosystolic that worsen with inspiration... DT IV abx users st. aureus

Front 568

IE prophylacic for dental and GI

Back 568

Dental: if allergic to Amox: Clinda/Clarithro... if GI: AMP + GENTA / else: VANC + GENTA

Front 569

if fungal endocarditis tx?

Back 569

SURGERY, they are bad

Front 570

Erythema Nodosum + PANCA?

Back 570

IBD... vs: infectious diarrhea: painful anus.. todx: scope

Front 571

tx influenza A

Back 571

A: Amantidine....OSeltamivir for B and A

Front 572

Influenza vaccine for

Back 572

1) >65, 2) Nursing hom 3) chronic disease 4) 2nd trimester

Front 573

MOA of Alveolar Proteinosis

Back 573

accum of PL in alveoli... PFT: restricted.. dx: bx and PAS postive material... tx: total lung lavage

Front 574

what is Acute Interstitial Pneumonia

Back 574

acute and fatal...quickly → fibrosis (>40, fever, breathless, cough, hypoxia... need vent)

Front 575

Asbestos shows as

Back 575

obstructive and pleural fibrosis

Front 576

internal carotid occlusion →

Back 576

occular problem

Front 577

if pt comes in bwith bowel obstr, metab acidosis and shock> next

Back 577

Laparotomy (scope is CI)

Front 578

bloody nipple

Back 578

intraductal papilloma

Front 579

intra parenchymal hemorroage in pontine

Back 579

Deep coma, paraplegia

Front 580

Intrahepatic Cholestasis of pregnancy vs. Primary Biliary Cirrhosis Vs. Ulcerative Collitis

Back 580

ICP: pruritis, inc Bile Acid, fetal monitoring... PBC: intense pruritus, inc ALK PHOSPH and CHOL

Front 581

Intra ventricular hemorrhage of newborn... seen in? Sx? To dx

Back 581

low birth weight babies (premies)... hypoT, seizure, focal neuro, bulging fontanelle... US: transfontanel

Front 582

lab of Fe Defic Anemia...

Back 582

Dec Fe, inc TIBU and hypochromic... newborn at inc risk DT lack of Fe in milk!

Front 583

Define sidroblastic anemia

Back 583

Fe is increased but abn utiliz to make heme... sometimes can be helped with giving B6

Front 584

Giving milk to babies can →

Back 584

Fe defic anemia... so babies should be breast fed for 1 yr or given Fe supplements for 4-6 months

Front 585

High ferritin and signs of extramedullary hemopoiesis (spleen, bones...)

Back 585

Thalassemia

Front 586

sx: NVD, abd pain, GI bleed, Metab Acidosis...dx

Back 586

Fe poisoning → accumin mit –> cell damage... todx: serum Fe level... tx: IV DEFUROXAMINE

Front 587

MC site splenic flexure (watershed) btw... seen in

Back 587

SMA and IMA(this is the culprit)... careful if after AAA repair and bloody diarrhea... to dx: CT, if not Scope, do not do Barium → may perf.

Front 588

INH toxicity

Back 588

inc ALT / AST initially... will resolve

Front 589

Sx of ITP

Back 589

AutoI w/ isolated dec platelets...no fever/no big spleen/ skin or mucosal bleed/ coag studies normal... MOA: destroy platelets can be DT SLE, inflxn, CMV, toxo, hiv...tx: in kids, will go away, in adult: chronic!...to dx: check SLE, check BM....

Front 590

MC acquireed hemolytic dz in kids.. sx and lab

Back 590

ITP (after URI)... sx: easy bruise, petechiae... lab: dec platelets and nl PT PTT

Front 591

triad of HUS

Back 591

Microangioapathic hemolytic anemia, ARF, dec platelets

Front 592

IUGR define and type and DT

Back 592

<10 percentile... if symmetrical = <28 weeks (DT stuff like TORCH and congenital), if asym = >28weeks (abd small / DT: DM/HTN/PreE/CRF and better than symm)

Front 593

tx IUGR

Back 593

monitor with NST and BPP twice weekly... deliver at 34weeks or if lung mature... if onligo, try to deliver!.. inc risk of RDS, hypoGlc, meconium, MR, so TRY TO DELIVER VAG AsAP

Front 594

work up for jaundice (bili >1, normally direct is <10%of total)

Back 594

1) Conj ( direct >50%) or Unconj (indirect >90%) 2) Con causes (intrahepatic = etoh/rx/preg/vira or congenital=DJ/Rotor... Extrahepatic), 3) so Liver enz (AST/ALT = liver, ALKPHOSP= intra or extra) 4) Do US or CT to see extrahepatic obstr 5) ERCP or PTC last

Front 595

amenorrhea and no 2nd sex

Back 595

Kallman

Front 596

Kartagerner MOA

Back 596

Dynan abn...sx: sinusitis/bronchiectasis/Dextrocardia

Front 597

tx Kawasaki

Back 597

IV Ig and Asparin... sx: lips fissure, straw tongue and bulbar conjunctival injection

Front 598

tx Scarlett fever if pt is Penicillin allergic

Back 598

Erythromycin

Front 599

hand paralysis and ipsi Horner's.... DT and MOA

Back 599

Klumpke Paralysis (brachial plexus and injury CN 7 and 8th and T1)

Front 600

sx: hyperacusis, seizure, irritable...what and MOA

Back 600

Krabb's dz... MOA: Sphingolipidoses DT def in Galactocerebrosidase

Front 601

define labor

Back 601

contract q5 min and last .5-1 min

Front 602

2nd vs. 3rd vs. 4th stage labor

Back 602

2nd: complete dilation to deliver baby (.3-3hrs)... 3rd : deliver baby and end with delivery placenta... 4th: delivery placnta to 6hrs postpartum

Front 603

Define false labor

Back 603

there is no cervical DILATION

Front 604

MCC chronic inspiratory noise in kids... scope shows? Tx?

Back 604

Laryngomalacia...scope: flaccid larynx that collapse during inspiration... tx: self limited(hold baby in upright for ½ hr post feed and never feed while baby lying down)

Front 605

hypochromic anemia w/ basophilic stippling?

Back 605

lead poisoning

Front 606

femoral nn action and sensation

Back 606

extend thigh, flex hip... S: ant thigh, medial leg

Front 607

tibial nn action

Back 607

flex knee and digits, plantar flexion foot... S: leg and plantar foot

Front 608

Obturator nn

Back 608

Adduct thigh, S: medial thigh

Front 609

Common peroneal nn

Back 609

ant and lat leg thigh...

Front 610

12 yo, fat kid, wide joint space of jp and collapse femoral head, 1 side!, dx? Tx?

Back 610

Legg Calve Pertes... XR: diplaced femoral epiphysis (avsc necrosis)... tx: if <5 no, if >5 brace/surgery

Front 611

weird gait, adolescent kid

Back 611

slipped capitis femoral head

Front 612

PhD (Pneumonia, hypoNa, diarrhea) dx? Tx?

Back 612

Legionella...tx: ERYTHRO

Front 613

how to dx Leprosy

Back 613

acid fast bacilli in skin bx

Front 614

HGRT deficiency... sx and DT... tx

Back 614

Lesch-Nyhan... sx: mutilation, neuro, gouty arthritis (gout usually old, so if boy, thenTHIS!!!)... tx: ALLOPURINOL

Front 615

M5 leukemia (Acute Monocytic Leukemia)... lab

Back 615

“Alpha napthyl Esterase positive”... lab: lots of blast cells...sx: gingival hyperplasia

Front 616

M2 leukemia (Acute Myeloblastic Leukemia w maturation)...

Back 616

lost of myeloblast

Front 617

M3 lab

Back 617

promyeloblast... DIC!!!

Front 618

ALL (acute lymphoblastic Leuk)

Back 618

PAS + lymphoblast

Front 619

M6 Acute Erythro Leuk

Back 619

Erythroblast

Front 620

Leukemoid Reaction define... like what... how to differentiate

Back 620

lots inc leukocytes by severe infxn or inflm... like CML... Leukocyte Alkaline Phosphatase increase with LR!!...CML: Philadelphia chromosome

Front 621

epithelial lining inflammation and dry skin... in postmenop women... itch vag soreness... dx? Can-->? Tx

Back 621

Lichen Sclerosis... can → Vag CA... tx: steroid crea and wait for bx

Front 622

confusion, HA, GI, seizure, comma, hyperreflex... SE of what.. can precipate

Back 622

Lithium...--> Psoriasis!

Front 623

DI, Hypothyr, Ebstain...>

Back 623

Li...test for TFT, Cr, Preg before prescribe

Front 624

3 main fx of liver

Back 624

Synthesis (clot factors, chol, estrogen)... Metab (rx, steroids)/Detox... Excr bile

Front 625

how to tell if Liver is recovering or fulminant(dying)

Back 625

PT checks liver enz ability... so if dec TransAminase and Dec PT → BAD

Front 626

Acute liver failure vs. Fulminant liver failure... MCC of both

Back 626

ALF: failure within 8 weeks of hepatocellular injury.. FLF: ALF + encephalopathy... MCC: Acetaminophen... lab: AST/ALT 3000s

Front 627

work up for asx inc of Transaminase

Back 627

1) RO etoh and rx abuse and RF for viral 2) if only AST high check out extrahepatic cause for AST (ALT is more specific for liver)

Front 628

infxn of submaxilally and sublingual gland, dx? DT? Tx?

Back 628

LUDWIG angina... DT: tooth infextion (fever, diff swalloing)... tx: IV Pen + anaerobe

Front 629

CML pop, sx, lab

Back 629

>50, anorexia, low grade fever, bone pain, anemia... lab: leukocytosis, anemia, inc Granular like neutrop... BM: hypercell w/ lots granulocyte hyperplasia... LOW LEUK ALKALINE PHOSPHATASE

Front 630

Low Leukocyte Alkaline Phosphatase test seen in

Back 630

CML, Hypophosphatemia, PNH

Front 631

sx of Lumbosacral strain

Back 631

paravertebral tenderness after activity... neg straight leg...

Front 632

least assoc with Smoking

Back 632

lung adenocarcinoma

Front 633

if short period cycle, low level of mid leuteal progesterone?

Back 633

Luteal Phase defect... to dx: Endometrial bx (shows lag of 2 days or more).. to tx: Progest vag suppository first, if not--> CLOMIPHENE and HCG (both increase serum FSH)

Front 634

erythema migrams is in?

Back 634

Lime disease

Front 635

Reactive Arthritis occur when

Back 635

2-4weeks after GI or GU infxn...sx : symmetrical involvement

Front 636

lyme caused by and cross react with

Back 636

Ixodes Tick... w. T. Pallidum... tx: DOXY unless preg or kid, then AMOX

Front 637

Acute alcoholic hepatitis histo

Back 637

Balloon degen w/ polymorphic cellular infiltrate

Front 638

Histo of acute viral hepatitis

Back 638

Panlobular mononuclear infiltration w/ hepatic cell necrosis

Front 639

Histo of chronic hepatitis

Back 639

portal necrosis with piecemeal necrosis and bridging fibrosis

Front 640

histo of Primary biliary cirrhosis

Back 640

inflammatory destruction of small intrahepatic billiary duct

Front 641

histo: extensive fatty vaculorization of liver

Back 641

Reye's syndrome

Front 642

hepatojugular reflex used for

Back 642

differentiating lower extremety edema that is DT heart vs. liver

Front 643

visual hallucination, impairmen cognition, parkinsonism, dx

Back 643

LEWY BODY dementia... main pt: PROGRESSIVE cognitive decline

Front 644

HA, fever, then papules and ulcer in vulvovaginal region, PAINLESS...will go to LN if not tx now... dx DT

Back 644

Lymphogranuloma Venereum DT C. Trochomatis L1-L3... if untx: chronic ulcer, PROCTATITIS, rectal stricture/fistula... tx: DOXY or ERYTHRO

Front 645

ulcer and LN present same time... dx...histo...tx

Back 645

GRANULOMA INGUINALE dt Donovale Granulomatis... scrape: beefy red base...tx: AZI/ERYTHRO/DOXY

Front 646

LYNCH DO aka HNPCC and which extracolonic tumor

Back 646

Endometrial carcinoma

Front 647

progressive loss of Central vision... dx... MOA... tx

Back 647

Age related MACULAR DEGEN... MOA: Dgen/atrophy of outer retina... tx: LASER PHOTOCOAG

Front 648

ARMD vs. OAGlaucoma

Back 648

OAG: peripheral vision lost

Front 649

Prophylaxis vs. MALARIA? If rx resistant? Tx vivax and ovale?

Back 649

CHLOROQUINE... MEFLOQUINE... PRIMAQUINE... best dx: Giemsa stain thick smear

Front 650

Malignant HTN → what vasculitis?

Back 650

Fibrinoid necrosis of small arteries... 200/140...

Front 651

best bx for malign melanoma? MC type, least? Biggest RF

Back 651

excision bx with narrow margin... MC: superficial spreading, LEAST: Acral lentiginous... best tx: avoid 10am-4pm... strongest RF: recent change(size, color)

Front 652

tx for Bipolar with and without renal prob... tx for acute psychosis/mania

Back 652

Without: Li... with: Valproate >Carbama... acute: Haloperidol

Front 653

Marfan MOA and sx

Back 653

Fibrillin1... AD...Aortic root dilation / lens dislocation

Front 654

March fracture of stress fracture seen in and where

Back 654

young dancers... tibia

Front 655

burned skin w/ ulcer that has not healed yet?

Back 655

Marjoli's ulcer (SCC of skin)

Front 656

init tx of massive hemoptysis

Back 656

rigid scope (not flex)

Front 657

to inh lactation

Back 657

tight bra/ice packs.... NO BROMOCRIPT

Front 658

sx of lactose intolerance

Back 658

positive hydrogen test... stool for REDUCING substances

Front 659

The 4 types of Lacunar infarcts and MCC

Back 659

MCC: HTN...1) PURE MOTOR (post genu INT CAPSU) = unit lat deficit... 2) PURE SENSORY (VPL of nucleus of thalamus)... 3) ATAXIC HEMI (post limb of INT CAPSU)=weak lower extr/ispi arms and legs... 4)DYSARTHRIA (CLUMSY HAND SYNDR = pontine = mild motor aphasia, no sensory prob, weak hand)

Front 660

to dx knee injury

Back 660

1) MRI, if else, arthroscopy... surgery rare

Front 661

fxn of ACL

Back 661

prevent leg from gliding anteriorly

Front 662

meniscus injury DT? MC

Back 662

planting and twisting foot... bucket handle tear

Front 663

Juvenile RA aka? Sx? Lab?

Back 663

kid with systemic (fever, rash w/ central clearing, big spleen/ LN, pleuropericarditis, myocarditis, myocarditis)... lab: RF rarely positive...tx: NSAID, steroid if not respond or if myocarditis... aka: STILL'S DISEASE

Front 664

aka Congenital Q Syndrome...sx...dx...tx...

Back 664

sx: Syncopal episode without disorientation, nl PE, fx hx: Sudden cardiac death... dx: JERVEL LANG NEILSON... tx: BB

Front 665

work up for infertility in women

Back 665

1) check Basal Body Temp(for duration of luteal phase) / Mid Luteal Progesterone(level of luteal fxn)... to confirm: Endometrium BX to confirm luteal phase defect

Front 666

work up for infertility in men

Back 666

male coital factor (40% of time) responsible... first step: SPERM COUNT...2) if nl → endocrine (TFT = inc TSH → dec GnRH), testosterone level, GNRH, PRL level...

Front 667

the causes of women infertility

Back 667

1) Peritoneal (endometriosis/adhesions)... 2) Ovoluation(HPA axis) 3) cervical (structure and mucuous) 4) tubo-uterine (rare cause, fibroids..)...MCC is #1

Front 668

tx endometriosis

Back 668

GNRH, DANAZOL, MEDROXYPROGRESTERONE

Front 669

MOA of Clomiphene

Back 669

AntiEstrogen (comp inhibit Estrogen in hypothalams → inh the neg feedbac Estrogen has on GNRH -->inc LF/FSH)... can also use HCG

Front 670

MOA of DANAZOL

Back 670

androgen derivative... GNRH inhibition...for: endometriosis, fibroids, fibrocystic breast dz

Front 671

CT: dilation of all ventricle and enlargement of subarachnoid space over cortex...dx? Can -->? caused by?

Back 671

Infantile SAH (these CT show nonObstruction/Communicating hydrocephalus and this is the MCC)... can → destruction arachnoid villi and cistern...DT: hemorrhage common in premies

Front 672

Non-Communicating cystic expansion of 4th ventricle

Back 672

Dandy Walker

Front 673

sx of hypoCa... can be DT

Back 673

Crampy pain, paresthesia, carpopedal spasm... DT: hypervent--> alkalosis → more Ca bound to Alb → hypoCa

Front 674

hypoCa vs. hypoMg

Back 674

HypoCa: INC DTR, Mg: DEC DTR

Front 675

Hypertrophic osteoarthropahy, sx...DT

Back 675

Chronic prolif of Periostitis of long bone, clubbing of fingers and synovitis... Sq.CC and AdenoCar of lung

Front 676

MCC HyperK and MCC EKG change due to that...tx...

Back 676

DT: Rhabdo... EKG: peak T...tx: Calcium, B2 agonist, then Insulin, glc, kayexelate...

Front 677

EKG of hyperK

Back 677

peaked T, prolong PR / QRS...widening qrs

Front 678

tx for SLE and its SE

Back 678

HYDROXYCHLOROQUINE... SE: eye disase like Macular Degen so do frequent eye exam, MC: allergic skin

Front 679

Testosterome

Back 679

ovary

Front 680

Non communicating hydrocephalus examples

Back 680

Dandy Walker, Arnold Chiari

Front 681

diff btw hydrocele

Back 681

Non-communicating: DT remnant of processus vaginalis (most gone by 12 month)...Communicating: can't reach the upper limit and need surgery

Front 682

Echinococcus come from and cause

Back 682

Dogs... Hydatid cyst... sx: most asx... lab: CT = eggshell calc in liver...tx: DO NOT ASPIRATE (sepsis), but surgery unde A:LBENDAZOLE

Front 683

tx of hyaline membrane disease

Back 683

ventillation and surfactant... sx: resp distress and hypoxia NOT responding to O2

Front 684

whats tx for human bites

Back 684

Amox + Clavunic Acid

Front 685

tx for humeral fx

Back 685

closed reduction and hanging cast

Front 686

tx segmented fx (wat is it?_

Back 686

AKA open fx = open reduction and internal fixation

Front 687

HRT decrease what

Back 687

hip fx, colorectal CA, and vulvo atrophy

Front 688

Hodgkin's' tx and their SE

Back 688

ABVD... Adriamycin(cario), Bleomycin(pulmo), Vinblastin (neuro--> constipation), Davabrazine(ematogenic)

Front 689

sx of Homocyteinuria and tx

Back 689

Marfan + MR + thromboemboli + downward dislocaiton of lens...tx: high dose B6

Front 690

Staph abscess of eyelid aka and tx

Back 690

Hordeolum (stye)...tx: warm compress / I&D if no resolution in 2days

Front 691

The RF of HepC that makes it rapidly progress

Back 691

1) male, 2) if get it past 40, 3) with HepB or HIV 4) Etoh

Front 692

Complications of HepC

Back 692

1) Cryoglobulinemia (→ membranous glomerulonephritis)...2) B-cell Lymphoma... 3) Plasmacytosis...4) AutoI like Sjogren and thyroiditis 5) lichen planus 6) porphyrea cutanea tarda 7) ITP

Front 693

Whats the best way to screen HepC

Back 693

HepC RNA... if Chronic, need test for Hep A, B too and give vacc if need to (ok w/ pregos)...

Front 694

Mastitis MOA

Back 694

heavy, warm breast bilat... tx: tight bras, tx: oral DICLOXACILLIN... feed need stop but keep pumping breast

Front 695

Mastoiditis DT... sx..tx

Back 695

complication of acute OM... sx: fever, otalgia, tender mastitis... CT: fuild middle ear and demineralization of mastoid... tx: IV abx npw

Front 696

sx of methadone withdrawal

Back 696

seen 2-6th week... sx: seizure

Front 697

sx of coke mom

Back 697

IUGR, intracranial hemorrhage, premature labor

Front 698

etoh withdrawal

Back 698

tremors, agitation, lethargy and seizure

Front 699

The 3 P's seen in and tx

Back 699

McCune Albright (Precocious puberty, Pigment, Polyostitic Fibrous dysplasia)... tx: GnRH agonist

Front 700

Tx measles?

Back 700

Vit A can reduc sx

Front 701

Fifth disease aka

Back 701

erythema infectiosum by B19

Front 702

painless melena in 2yo DT ? MOA, how to dx?

Back 702

Meckel's...MOA: vitelline duct still open... todx: Tech99 scan...

Front 703

tx mediastenitis

Back 703

Thoracotomy for debride/ drain / abx... widerning mediastinum DT effusion (not pericardial flui)

Front 704

2 MCC post fossa tumor in kids

Back 704

1) Cerebellar astrocytoma, 2) medulloblastoma... MC location: VERMIS

Front 705

adult with recurrent UTI or renal stones...think of? To dx? Tx

Back 705

Medullary Cystic DZ (AD in adults)... need IVP (radial arrangement of cysts)... tx of stones: fluid/pain

Front 706

IgG vs. C3 convertase of the alt pathway can lead to-->

Back 706

MPGN (dense intramembranous deposits that stain for C3)

Front 707

Most likely kidney dz in someone with both HepB and nephritic dz

Back 707

Membranous GN

Front 708

HepC assoc with which kidney dz

Back 708

MPGN

Front 709

HIV assoc with which kidney dz

Back 709

FSGN

Front 710

SLE assoc with which kidney dz

Back 710

diffuse prolif GN1

Front 711

MEN1

Back 711

Pit, PT, Pancrease

Front 712

Men2a

Back 712

PT, THYROID MEDULLARY withdrawal, + pheo

Front 713

Thyroid C cell hyperplasia →

Back 713

Thyroid medullary carcinoma

Front 714

Men2b

Back 714

pheo, thyroid medullay, neuroma

Front 715

triad: rotation vertigo, sensori neural hearing loss, tinnitus, dx

Back 715

Meniere

Front 716

if vertigo is continuous and maybe ataxia

Back 716

acoustic neuroma

Front 717

meningitis w/ rash

Back 717

meningoccocemia

Front 718

MOA aromatase

Back 718

in peripheral FAT and converts Androgen ---> estrogen

Front 719

can lead to massive fluid sequestration in bowls → hypovol shock...dx...lab...

Back 719

Mesenteric thrombosis...lab: inc CK, diarrhea w/ blood, BP:60/0, CVP 0

Front 720

What is hyperchloric metab acidosis...

Back 720

nl AG metab acidosis (low HC03 but nl AG)... DT: 1) renal loss bicarb(RTA, CAI rx), 2) GI loss biarb(diarrhea)....to diff: Urine AG should tel

Front 721

uremia can lead to

Back 721

metab acidosis

Front 722

NG tube can →

Back 722

lots of aspiration acid → metab alk

Front 723

pt on dialysis who receive citrate?

Back 723

also metab alkalosis

Front 724

2 types of metab alkalosis

Back 724

1) cloride sensitive (Cl<20) = ECF contraction...also DT thiazide, loop, gastric secretion, acid ingestion, CF... tx by IV saline and K

Front 725

2nd type of metab alk

Back 725

2) cloride resitant (Cl >20) = DT continous mineralocorticoid stimulation and hypoL (ECF expansion)...HTN so NO IV FLUID... DT: primary hyperaldo, Cushin, Batter', Gilterman's

Front 726

MC acid base abn in hosp?

Back 726

metab alk... kayexelate can cause it too

Front 727

in first born only... 3 types... foot

Back 727

metatarsus adductus... typ1(feet correct both passive and actively)... 2(to neutral position with both)=need shoes or cast.... 3)rigid (first: serial cast and surg if not improve by 4)

Front 728

need check what before giving Metformin

Back 728

kidney status DT potential lactic acidosis SE... don't give if need Dye imaging

Front 729

sx of methanol tox... tx... assoc with

Back 729

BliNDNESS... tx: etoh... w: renal failure and crystallinuria (rectangular)

Front 730

Thrombolytics and MI...what are the indications

Back 730

yes if: 1) ST elev >1mm AFTER nitro rules out vasospasm, 2) new LBBB

Front 731

Thrombolytics and MI, what should not

Back 731

1) ST depression or unstable angina

Front 732

absolue CI for thrmbolytics

Back 732

strike withn 1 yr, intracranial neoplasm, int bleed, 180/110, AAA

Front 733

thrombolytics w/ tPA vs Streptokinase

Back 733

tPA needs heparin and ASA... streptokinase no

Front 734

After MI, when: 1) VSD&papillary rupture 2) ant wall MI need

Back 734

1) within first week, 2) need Hep and warfarin for 3 months, 3) Wall rupture within 1 week,

Front 735

MCC death in pt with acute MI

Back 735

Reentrrant Ventricular arrhthmia (Vfib)

Front 736

if pt has ST elevation MI, what needs to be done ASAP?

Back 736

PTCA or PCI > tPA

Front 737

What are (in sequence) the EKG findings in MI?

Back 737

1) peaked T... 2) ST elevation... 3) T inversion... 4) Qwaves

Front 738

Acute pericarditis vs. Dressler post MI

Back 738

time: Dressler is a >2weeks afer

Front 739

RV infarct leads →

Back 739

dec filling--> dec SV/CO/BP...so DO NOT GIVE ANY MEDS THAT dec PRELOAD (diuretics and preload)... so tx: IV NS to inc RV pressure, if not → DoBUTAMINE

Front 740

Inf wall infarct DT?

Back 740

RCA or LCA

Front 741

bradycardia and hypotT

Back 741

RV infarct (slow HR DT SA nodes)

Front 742

if cold leg after an MI... dx.. tx?

Back 742

emboli...tx: Angio and embolectomy

Front 743

tx Migraine

Back 743

1) NSAID, if not 2) Acetaminophen, not 3) ERGOTAMINE

Front 744

ERGOTAMINE for migraine, CI and for

Back 744

CI: in Pregos... give for migraine if >2d or recurrent

Front 745

Prophylactic migraine?... what if have asthma?

Back 745

BB … Amitryptypline!

Front 746

Trousseau syndrome seen in?

Back 746

Chronic DIC (Migratory Trombophebitis)...CA(especially if you see it on weird places like hands...)

Front 747

MC nephropathy assoc with carcinoma?... tx this nephro for kids?

Back 747

Minimal change... tx: in kids: straight to steroids, no need bx... dx: light electro nl, EM = effacement foot

Front 748

Midcycle abd pain in young girls (period 2 weeks ago) no fever

Back 748

Mittleschmertz

Front 749

MCC of isolated Mitral Regurg?

Back 749

MVP without regur, innocent murmurs, pacemakers and defibs

Front 750

other cz of Mitral Regurg

Back 750

#1 RHD, IE (leaflet or chordae), HCM, mitral calc (elderly), MI

Front 751

MC valve affected in IV drug users that is not tricuspid?

Back 751

Mitral valve

Front 752

The MCC of Mitral Regurg

Back 752

1) MVP is MCC, 2) MI, 3) RHD, 4) IE (feveR), 5) Mitral calc

Front 753

Mitral stenosis cz and ss

Back 753

1) Rheumatic HD, 2) R&L failure 3) HF... tx: diuretics, anticoag, dig, balloon angio

Front 754

murmur in Mitral stenosis

Back 754

Midsystolic rumble w/ opening snap at apex

Front 755

MVP tx

Back 755

1) BB for chestpain/palp 2) ASA if now have TIA...3) warfarin if not enough...4) repair

Front 756

mixed acid base DO how to find them

Back 756

look at ph (if acidic, and low HCO3 → metab, now look at CO2 and way too high, so it's resp acidosis too!!!)

Front 757

triad of Mixed CT dz

Back 757

SLE + Sclero + myositis... dx: antiRibonucleotide ab

Front 758

sx: palpable purpura, hematu, proteinuria, some peripheral neuro, hypoComplement..dx and assoc w

Back 758

Mixed Cryoglobulinemia... assoc w/ Hep C... MOA: Ig that clumps when plasa is cooled (cryoglobulin) while flowing through skin and tissue → smal vessels dz and purpura... to dx: clot blood at 98.6, incubate the separated serum at 39.2 and after 24 hrs look at it

Front 759

Mobitz type 1 seen in

Back 759

Dig tox, inc. Vagal tone, Inf Wall MI

Front 760

Assoc with AIDS when cd<100, gone in 1 yr, dx. tx.

Back 760

Moluscum Contagiosum... (a POXviurs)... tx: excistion and cryotherapy

Front 761

what is salmon patch and where and tx

Back 761

flat salmon colore (eyelid, neck, forehead (Glebella) = a vasc lesion in kids

Front 762

fx prox 1/3 ulna with ant disco of radial head...dx and assoc w

Back 762

Monteggia..can mess RADIAL nn so check

Front 763

radialf shalt fx asso w

Back 763

disruption of radial and ulna distal joint... GALEAZZO

Front 764

lab for Monoclonal Gammopathy of undetermined Significance

Back 764

only inc IgG, plasmac cell <10%, no anemia, no ss of MM (no lytic or bence jones prot)

Front 765

muculopurulent cervicitis dx

Back 765

C. Trachomatis (asx in 50% pts... no pain)

Front 766

murcor tx

Back 766

(in DM)...tx: debride w/ IV AMPHOTERICIN B

Front 767

Multiinfarct Dimentia need

Back 767

focal neuro deficit (else = alzheimer)

Front 768

MM MOA and lab

Back 768

MOA: prolif of Plasma cells (in BM) DT plasmacytoma in BM → inc intact Ig aka Bence Jones... sx: old, bone pain, anemia, renal failure, hyperCa, path fx osteolytic... to dx: electrophoresis

Front 769

to dx osteoporosis

Back 769

DEXA... DT dec bone density

Front 770

MOA of Paget's

Back 770

xs resorption by osteoclast (replace BM by fibrous CT)... lab: inc ALK PHOS, inc IgG, bone deform, large skull..HEARING LOSS NERVE PALSY

Front 771

lab for Essential Thrombocytopenia

Back 771

BM: inc cellularity with megakaryotic hyperplasia

Front 772

labs for aplastic anemia

Back 772

nl cells in BM but fat filled!

Front 773

aka Paraprotein

Back 773

Bence jones

Front 774

tx for MS

Back 774

intefergon B or Glatimavir... steroids for relapsing/remitting MS... dx: oligoclonal bands... MRI: Plaques in periventricular regions

Front 775

midsystolic sof mumur in young adult...tx

Back 775

no need to

Front 776

missense mutation moa

Back 776

Like 1 nt change

Front 777

Decreased Acetylcholine Receptors? Tx?

Back 777

MG... #1) Pyridostigmine (antiChoE)... immuno (Azothiprine, cyclosporine)... to dx: det level of Ab vs. Receptor (not Tensilon test anymore)

Front 778

MG crisis DT, tx

Back 778

infxn... tx: inbute the pt and withdraw from antiCholE for a few days (need bedside PFT)

Front 779

Define Myelodysplastic Syndrome

Back 779

clonal stem cell DO → acute leukemia... lab: PANCYTO

Front 780

muscles in dermato and polymyocitis

Back 780

PROximal weakness...ocular weakness not seen... tx: steroids, if not → METHOTREX

Front 781

myositis vs. scleroderma

Back 781

Myositis: striated msucles... S: smooth muscle...

Front 782

sx of Mixed CT dz

Back 782

swollen hands, synovitis, myositis and Reynauld

Front 783

The 2nd MCC muscular dystrophy... sx?

Back 783

Myotonic MD (#1 is DUCHENNE)...sx: ALL body atrophy (lips is a V)..AD...DELAYED muscle relax

Front 784

local mass that → bony erosion and epistaxis

Back 784

Angiofibroma

Front 785

Tx for nasoethmoidal fx

Back 785

Do not nasal pack → possible IC injury

Front 786

CSF from nose is and not

Back 786

fx base of skull...not ethmoid system

Front 787

Nasopharyngeal Carcinoma DT

Back 787

EBC... sx: painless neck mass, nasal

Front 788

Comon in smoker/drinkes.. palpable cervical node...dx and tx

Back 788

Neck Small CC... to tx: triple bx triple scooe

Front 789

neck trauma zone 1, zone 2, and tx

Back 789

1: clavicle to cricoid cartilate... 2: cricoid to angle of mandible...tx: ALL GUN tx / asx STAB can be observed... 3: mandible to base of skull

Front 790

neck trauma need?

Back 790

angiogram to RO CAROTID art damage... if intimal flap → surgery to prevent stroke

Front 791

duodenal atresia assoc w/?

Back 791

polyhydramnios

Front 792

tx for Necrotizing fasciitis

Back 792

AMP+ SULBACTAM / CLINDA

Front 793

what rx given t newborn

Back 793

Siver nitrate and vit K

Front 794

Neonatal cholestasis characterized by

Back 794

light color stool, big liver, lots direct bili...deficne >2 and NEED wORK up

Front 795

common cause of Ca oxalate stone

Back 795

fat malab and bile salts (→ inc aborsp of xalic acid)... #1 stones

Front 796

Uric acid stone seen in and tx

Back 796

very low pH urine (<4.5) (nl = 5.6)...DT: defet rnal ammonio secretion (need US or CT...XR wont see it)...2nd MCC...tx: hydration, alk urine, low purine diet

Front 797

if film NOT show stone in pt with typical sx

Back 797

1) radiolucent (Uric acid)...2) <1-3mm...3)non stone causes (obstr by blood clot or tumor)

Front 798

tx idiopathic hypercalciuria

Back 798

nc absorption in kidney by INC CA INTAKE, Thiazide, prevent precipitation in urine...1) inc fluid 2) nl or inc Ca intake 3) Restrict Na 4) restrict OXALATE (dark roughage, chocolate, vit C) 5) dec prot

Front 799

Cystinuria lab

Back 799

stones are radioOPAGUE, rhomboid … urine: positive CN nitroprusside

Front 800

Oxalate stone DT?

Back 800

(or IBD) small bowel resection → inc oxalate reabsorption... also if big diet of tea/coffee/beer/choco

Front 801

Calcium phosphate DT

Back 801

hyperciuria, sarcoid, cushing, RTN

Front 802

Cysteine stone can rarely cause

Back 802

staghorn

Front 803

Dx stone in preg!

Back 803

dont want to expose kid..soo → #1) US, if not 2)Transv US, if not 3) LIMITED IVP and Uteroscopy

Front 804

Nephrotic sx and inc what?

Back 804

sx (protein, hypoalbu, edema, hyperlipid, lipiduria)....inc risk of (HyperChol, HyperTG, HyperCoag)

Front 805

nephrotic dz DT amyloidosis how to dx

Back 805

renal bx: amyloid deposit that show apple green birefringent under polarized light after Congo Red staining...

Front 806

“crescent” GN?

Back 806

RPGN

Front 807

Granular deposit on microscope are

Back 807

SLE or PSGN

Front 808

FSGN MC in?

Back 808

blacks HIV, IV rx, morbid obese

Front 809

IgA after and sx

Back 809

URI and nephritic

Front 810

Hodgkins assoc w

Back 810

Nephrotic Syndr...

Front 811

MCC Nephrotic Syndr in Lymphoma is

Back 811

Minimal change

Front 812

Minimal change in kids...Membranous in

Back 812

Adults (also HBV and rx like god)

Front 813

MC extracranial tumor in kids..age...from...sit...sx...dx

Back 813

Neuroblastoma... 2yo...Neural Crest Cells (precursor of adrenal medulla)...MCsite: adrenal or retroperitoneal ganglia...sx: firm mass, calc or hemorrhage on xray or CT...lab: VMA, HMA, no fainting spells/HTN/palp like pheo

Front 814

MC parasite infxn of brain and see in?...sx

Back 814

Neurocysticercosis...pig farmers...sx:Neuro,HA die in 1 week

Front 815

optic gliomas, nodular swellings (hemartoma)..dx?

Back 815

NF

Front 816

what else has hemartoma

Back 816

TS and NF

Front 817

what else type 1 NS?

Back 817

Lisch nodules (iris) and neurofibroma, lytic bone lesions

Front 818

Type 2 NF from type 1? and tx

Back 818

bilateral acoustic neuroma... MRI to confirm then surgery

Front 819

malformation of brain, seizure, hemiparesis?

Back 819

Sturge Webber

Front 820

MR, ash leaf, cardia rhabdomyomas, kidney angiolyomopas seen in

Back 820

TS

Front 821

Neuroleptic Malign syndrome sx and DT

Back 821

AMS, muscle rigid, hyperthermia,CPK-->renal failure.... tx: DA(Brom)o and Dandrolin(relaxere) and alk urine of rhabdo)...DT: HALOPERIDOL SE

Front 822

Niacin SE DT and tx with

Back 822

Inc. Prostaglandin... give ASA

Front 823

Nieman Pick...MOA...sx...

Back 823

def Sphingomyelin (dead by 2)... big organs, cherry red spot

Front 824

lab finding for nocardia and organs and tx

Back 824

histo: abscess: acid fast: crooked, branching breaded, G+ filament on RED background... lung/brain...tx: BACTRIM

Front 825

diff btw NASH and alcoholic steatosis...NASH DT?

Back 825

same xcept AST/ALT not 2:!...tx: urodeoxycholic acid...DT: insulin resistance → accum fat in cells (inc lipolysis → inc insulin), intrahepatic fatty oxidation → ox stress → inflammation, fibrosis, cirrhosis...

Front 826

SE of this rx can make arms blue and cold so use in ICU only

Back 826

NE (for hypoT)

Front 827

lab for NPHydrochephalus

Back 827

MRI: dilated ventricle...CSF: nl pressure...tx: if tap helps, then shunt!

Front 828

MC nosocomial infxn

Back 828

E.Coli and S. Aureus... Noso PNA is MCC death from noso (PSEUDO!)

Front 829

Nursemaid: arm is and tx

Back 829

sublux of radial head..tx: passive elbow flexion and forearm supination

Front 830

Obstructive Jaundince MCC and labs

Back 830

cause: stones and pancreatic CA...labs: inc Alk Phosph...tx: US then CT

Front 831

to dx OSA?

Back 831

to dx: Nocturnal Polysomnography...do not give BENZO for them

Front 832

OCD DT? Tx

Back 832

Serotonin...Tx: SSRI > Clomipramine

Front 833

who should avoid OCT?

Back 833

1)SLE (inc risk thrombosis DT antiPL and nephritic)... 2) Migraine can → stroke... if start and irregular bleed, keep taking it

Front 834

Olanzapine vs. Clozapine SE

Back 834

O: weight gain... C: agranulo

Front 835

tx open fx

Back 835

don't close... dress it and plaster

Front 836

tx Opoiod tox

Back 836

Naloxone IV

Front 837

pain on eye movement, central scotoma (area of blindness in center), seen also in MS,

Back 837

Optic neuritis

Front 838

best way to tx OA?

Back 838

lose weight if obse

Front 839

xray finding in OA...tx?

Back 839

1) narrowing joint space 2) subchondral cyst 3) Heberden nodes 4) osteophytes...tx: ACETAMINOPHE first, next = INDOMETHACIN

Front 840

OA vs RA

Back 840

joint space narrowing but RA: juxta articular erosions

Front 841

gout vs psoriatic arthritis xray

Back 841

G: punched out erosion with a rim of cortical bone...P: marginal bony erosions and irreg joint destructioin

Front 842

DT collagen type 1 mutation

Back 842

Osteogenic imperfecta

Front 843

lab for osteosarcoma

Back 843

ESR nl, Alk PHOS INC!...XR: osteolytic lesion with periosteal reaction w/ may hx of trauma

Front 844

Osteomalacia MOA vs. Rickets

Back 844

defective mineralization bone in adult...Rickets in kids: defective mineraliz of bone AND cartilate

Front 845

MCC osteomyelitis if <1yo

Back 845

Group B

Front 846

MCC osteomyelitis DT puncture wound and tx

Back 846

Pseudo tx: quinolone

Front 847

if osteomyelitis of lumbar?

Back 847

careful..may need MRI DT if abscess formation → spinal cord compression

Front 848

MOA of osteomyelitis

Back 848

1) URI or whatever → 2)infxn lead to dead bone aka SEQUESTRIUM (fever, chill, esr)...to dx: XR, if not, bone scan, if not, bone bx is gold.

Front 849

imaging of osteomyelitis best? XR?

Back 849

XR nl for first 2-3 weeks... best: TECHNITIUM scan 3 phase

Front 850

tx for OsteoPorosis and Osteopenia

Back 850

Dx: 1000mg/d Ca 31-50, if >50: 1200 + Vit D...need stop etoh and smoking

Front 851

tx for osteoporosis pt w/ HTN?

Back 851

Thiazide (decreased urinary Ca excretion)

Front 852

Codman's triangle and seen in

Back 852

Sclerotic lesion in distal femur periosteal lifted and SUNBURST...

Front 853

Otitis Externa malign sx? DT...tx?

Back 853

pain on traction of pinna... Pseudomonas... tx: cipro... in DM / immuno... IF white fibers in canal = fungal infxn

Front 854

Tx for Otitis Media

Back 854

Amox... acute: S. Pneumo, Hinfl, Moraxella...

Front 855

Serous OM DT

Back 855

prolonged blockag (membrane dull and hypomobile, air bubbles seen)

Front 856

hearing loss by 30s...dx...type...MOA... tx

Back 856

Otosclerosis...AD...osseous dyscrasia limited to Temporal Bone

Front 857

inhibin action

Back 857

inhibits FSH...so dec inhibin in ovarian falure → in FSH

Front 858

hearing loss, hat size, inc alk phosph...MOA...

Back 858

Pagets...eventually → sclerotic bone

Front 859

increased osteoid deposit DT?

Back 859

Vit D deficiency

Front 860

bone demineralization DT

Back 860

Osteoporosis

Front 861

fibrous replacement of bon

Back 861

primary hyperPTH

Front 862

MCC inc Alk Phopsh in elderly

Back 862

Pagets...tx: BiPhosphonate (inh bone resorption), Calcitonin (inh osteoclast) (Ca and Vit D has no effect)...osteosarcoma

Front 863

red, ooozing custy breast lesion not responding to Abx or steroids...bx?

Back 863

large cells surrounded by halo like area ivading the epidermis...BREAST CARCINOMA present (infiltrating Ductal cell carc and sometimes ductal carci in situ)

Front 864

smoker, arm pain, cough and weight loss

Back 864

Pancost tumor

Front 865

RF pancreatic CA... labs?

Back 865

Fat, smoking, family, chronic pancretitis, DM, high fat diet... NOT ALCOHOL...lab: first US, then CT better, then ERCP assess duct...amylase not useful here

Front 866

Acute pancreatitis... can be DT

Back 866

HyperTG (>1000), if DT gallbladder=remove it afterward

Front 867

palpable abd mass 4 weeks post acute pancreatitis

Back 867

pancreatic cyst (not true cyst = no epithelial)...leaks amylase so inc amylase..to dx: US...tx: drain if >6weeks or >5cm... tx: lipase/amylase level, USG, HIDA for calculus and acalculus

Front 868

tx pancreatic abscess

Back 868

Drain externally

Front 869

Best lab for chronic pancreatitis

Back 869

weight loss...best dx test: 24 hr fat in stool >7g...

Front 870

tx panic DO

Back 870

tx: benzo affects right now, long term: SSRI or TCA w. therapy

Front 871

pt on rx for panic DO now has seizure...DT?

Back 871

Alprazolam (shorter acting)...Diazepam is longer, less likely of seizure withdrawal

Front 872

lab level of PTHr by sq. cc

Back 872

inc Ca, dec Phosph

Front 873

Paraneoplastic Syndrome can sx (Besides Ca)

Back 873

Myopathy = prox muscle dec symmetrically....nl reflex...lab: inc CK, abn EMG

Front 874

10 yr w/facial hair, vertical gaze and Collier sign...dx? vs. Craniopharyngioma

Back 874

Parinaud (Collier sign is Eyelid retraction)...MCC: pinealoma...Cranyo: no Collier sign

Front 875

tx tremor and rigidity of parkinsons

Back 875

Benztropine

Front 876

Parkinson assoc w/?

Back 876

subborrheic dermatitis

Front 877

tx PSVT

Back 877

Adenosine

Front 878

PNH MOA

Back 878

hemolysis at night when serum is more acidic...sx: morning urine = red DT lysis...cc of death: thrombosis of hepatic v...lab: inc LDH, bili, reticulocyte...test: sugar warter and Acidified Hemolytic test (HAM), DAF is gone...CD59 absent through flow cy

Front 879

Hypocellular BM but no abn peripheral blood smear, no splenomeg

Back 879

Aplasti anemia

Front 880

pain in sym joints wrist, knee, feet (small), females, rash sometimes

Back 880

Parvo virus infxn (school teacher(... to dx: antiB19 IgM

Front 881

LSD vs PCP

Back 881

similar (aggresion, violent) but PCP more...LSD: visual flashbacks

Front 882

IgM hyper Syndrome lab

Back 882

high IgM, low IgG/A... poor response to vac...sx: recurent sinopulmo/PCP, dec neutrophils...recurrent opportunistic

Front 883

X-Linked Agamma aka, 4 findings

Back 883

Brutton's...1) recurrent bacT infxn first 5yrs, 2) IgGMA very low (poor to vac), 4)<2% B19 Bcells in periphery

Front 884

Common variable ID...lab...sx and diff than others

Back 884

lab: Low IgGMA, NORMAL Bcells...sx: like XLA but 15-35yo (not at 1-5)

Front 885

IgA deficiency affect

Back 885

resp, GI and GU... lab: all ok xcept for A

Front 886

Selective Subclass IgG def sx

Back 886

recurrent pulmo but NORMAL IgG!

Front 887

Severe Combine ID

Back 887

sx: life threat, recurrent, oral candida, diarrhea, viral and opportunistic... dx by: NO LN and NO TONSILS, no thymic shadow, abn B and T

Front 888

Wiskot Aldrich...type...age...sx...lab

Back 888

young boy: eczema/thrombocytopenia/recurrent encaps infxn since birth, bleeding...XR...lab: Low IgG, high IgAE, dec T and platelets

Front 889

Chronic Granulomatous DZ...prob? MOA

Back 889

defect in fagocytosis DT NADPH ox → recurrent catalase + (klep, aspergillo, staph...), ok with cat – (Strpeptneumo and Hinfl)...sx: abscess and lymphanenitis skin and visca... to dx: NitroBlue...tx: Daily BACTRIM or Interferon or BM

Front 890

Transient HypoGamma...lab...

Back 890

Dec IgG, nl IgA, varialbe IgM....tx: no, become ok by .5 to 1 yr

Front 891

Chediak Higashi: 2 sx...lab dx...tx

Back 891

sx: dec granulation and chemotaxis → multisyste/neuro/plancyto/albnini/aureus... lab: dec platelets and giantlysozome in neutrophils..tx: bacTrim and daily ascorbic acid

Front 892

Leuk Adh Defi...assoc with

Back 892

delayed separation of umbilical cord, necrotic skin, gingivitis

Front 893

HyperIgE

Back 893

chronic itchy, staph inxn (resp/skin), IgE

Front 894

Hinfl meningitis...age and lab dx

Back 894

.5-2yr...CSF: antigen

Front 895

Listeria meningitis...moa

Back 895

fin milk or DM mom through vag delivery

Front 896

New born meningitis

Back 896

Group B – Listeria – S. Pneumo

Front 897

1 month – 2 yrs meningitis

Back 897

S. Pneum – Nisseria – Group B

Front 898

2-18 yrs

Back 898

Neisseria – S. Pneu – Hinfl

Front 899

Adults >18

Back 899

S. Pneumo

Front 900

Rheumatic fever

Back 900

SubQ nodules, Erythema Marginatum...tx: Pen G (if chorea=antiEpilieptic, if pericarditis=ASA, Arthritis=codeine)

Front 901

Inc PeeP →

Back 901

dec Venous return → Dec output → hypoT

Front 902

so pt on vent and hypoT?

Back 902

DEC PEEP!

Front 903

if on PEEP need?

Back 903

Swan Ganz monitor (DT dec CO)

Front 904

tx: if tidal vol is high (800), next?

Back 904

dec PP and inc Vent rate to not inc PC02

Front 905

Pediatric jaundice first 24 hrs good?

Back 905

no, immediate tx...possible cause: Erythro fetalis, hemorrhage, sepsis, ifxn

Front 906

jaundice first 24hrs vs. 2nd-3rd d vs. 3rd-1week

Back 906

2nd/3rd: physiology... 3rd: bact sepsis or TI and prompt tx by blood culture and LP

Front 907

pt wth corn fed have what defi? Aka? Sx?

Back 907

Pellagra... 4D: diar/dementia/derm (rash on sun) and death

Front 908

Pelvic trauma need

Back 908

XR not CT

Front 909

flaccid bulla, dx? Lab? Tx

Back 909

Pemphigus Vulgaris... lab: IgG in dermis, ab vs. Desmoglyen...sx: first in oral, easy sep of epidermis w/ pressure (NIKOLSKY)..tX: steroid

Front 910

Pemp Vulg vs. Bullous Pemphigous

Back 910

BP: tense, IgG and C3 in dermal/epider jxn

Front 911

penile fracture...next?

Back 911

urethrogram, then surg exploration

Front 912

whenever you do NG suction...do what

Back 912

give K

Front 913

how to tx pericardial cyst.. which imaging...other mediastinal mass

Back 913

CT and drain...no surgery needed...other mass: Bronchogenic cyst, Lymphoma, AA

Front 914

Renal fail + acute pericarditis

Back 914

Nephritic syn → uremic pericarditis → dialysis

Front 915

sx acute pericarditis

Back 915

sx that is relieved by sitting up or leaning forward...MCC: Coxakie ( hx current viral illness)...PR depression

Front 916

Absolute indication for dialysis... CI?

Back 916

1) fluid overload not dec w/ tx 2) hyperK not responding. 3) pH< 7.2, 4) Uremic pericarditis/enchpalo 5) coag dT liver fail..CI: debilitating chronic dz, severe irreversible dementia

Front 917

MC Peripheral aortic aneurysm

Back 917

Femoral and Popliteal...all have atherosclerotic RF

Front 918

MCC of peritonitis...to dx?

Back 918

2nd to paralytic ileus...if shifting dullness: do dx needle!

Front 919

Pernicious anemia vs. lead poisoning

Back 919

Both: basophilic stippling...Lead: very much like Fe defic anemia=microcytic..PA: megaloblastic, very high LDH

Front 920

tx strept?

Back 920

IM PenG, not IV PenG

Front 921

Phenelzine CI?

Back 921

Not with SSRI...this is an MOAI...else → Serotonin syndrome (high T, rigid, mental status)...2) w/wine → HTN crisis

Front 922

to tx Pheo surgery

Back 922

alpha blocker...then BB

Front 923

physio vs. Neonatal sepsis vs. Breast Milk vs. first 24 hrs time wise

Back 923

P: 2-3d, gone in 1 week...NS: starts 5th...BM: after first week but within first week... first 24Hrs: Erythroblastosis fetalis

Front 924

1) Picks Dz...aka...sx...VS. 2) LEWY body VS 3) MultiInfarct VS. 4) Neurosyphillis

Back 924

1) FrontoTemporal...sx: personality change, compulsive, memory... 2)L: flux cognitive/visual hallucination/parkinsonism... 3) MI: cognitive w/ motorand sensensory prob... 4)N: Psychotic and personality change but NO fam Hx(like in Picks)

Front 925

tx PID

Back 925

Ceft + Doxy

Front 926

Sx of PKU... to dx... to tx

Back 926

Sx: fair skin, blue eyes, rash, musty odor 1 month old... to dx: Guthri test shows metab of Phe... tx: low prot low Phe

Front 927

Placenta Previa dx by... tx?

Back 927

Transabd US > Transvag... if bleeding keeps going, Csection

Front 928

Pleural effusion...next?

Back 928

1) diagnostic thoracocentesis to see exudate/transudate XCEPT if pt is CHF, then use diuretics...2) if exudate: further workup (exudate can be CA)... 3) if fluid inconclusive → BRONCH

Front 929

MCC pleural effusion?

Back 929

CHF (transudate)

Front 930

pleural pH nl? Inflm? Transudate?

Back 930

Nl: 7.46... infl: <7.3... transudate 7.35

Front 931

how to dx PMS...tx

Back 931

menstrual diary... tx: SSRI maybe?

Front 932

Pneumococcus vacc MOA

Back 932

T cell independent B cell response

Front 933

Frielander affects

Back 933

upper lobe

Front 934

if after 2 weeks, PNA still there even after abx...next

Back 934

Broncho for CA

Front 935

Mycoplasma pneumona has a rash?

Back 935

sometimes: Erythema Multiforme (target).... this has no membrane so will not stain

Front 936

Paraneumonic effusion sterile?

Back 936

at first andwill go away w/ abx... if sx not go away, consider tube: if Glc <60 = ALWAYS TUBE, but best lab os pH...if pH<7.2, TUBE!!!!!

Front 937

Pnemomediastitum tx

Back 937

Dt: air from pneumothorax into hila and mediastinum...put a tube...if mediastinitis, then surgery

Front 938

Tension pneumothorax vs. Spontaneous?

Back 938

Spontaneous require no trauma...S: main problem is oxygenation, CV 2nd...T: CV first!

Front 939

car accident now w/ Tension and hemothorax...next

Back 939

chest tube, not O2 mask! It won't help

Front 940

Can peep cause Pneumothorax?

Back 940

Yes, tension → collapse lung → RV fills up → HypoT

Front 941

Insulin resistant hyperinsulin found in

Back 941

PCOD (can → DM2)...so? Need glucose tolerance test: 2hr >140 = dx.

Front 942

MOA Metformin in PCOS

Back 942

1) prevent DM, 2) causes anorexa dec obesity 3) Correct hirsu 4) correct menstrual irreg

Front 943

ninc H&H and big spleen/liver?... typical sx? ...lab?

Back 943

Polycythemia Vera... risk: Budd Chiari (hepatic v. → tender/big liver)... sx: itch, thrombosis (DT inc platelets and their impaired fxn)... BM: hypercellular...lab: inc Leuk Alk Phosh, nl O2 sat, lOW Erythropoiein

Front 944

Prox stiffness (NOT PAIN) >1 mo at least 30min in AM, elev ESR...dx

Back 944

Polymyalgia Rheumatica... tx: low Steroids

Front 945

sx: difficulty going up/down stairs, combing, dysphagia..dx...to dx?

Back 945

Polymyositis...inflammatory dz...to dx: muscle bx = ENDOMYSIAL infiltration (dysphagia DT weak striated muscle)

Front 946

The 3 types of polyps and difference

Back 946

1) Hyperplastic (MC non neoplastic – no FU)... 2) HEMARTOMATOUs (inc Juvenile polyps and Peutz Jeghers – non malig)... 3) ADENOMA (MC polyp in colon, 1% malig, malig based on histo and apprearance)

Front 947

Types of adenoma polyps

Back 947

1) Sessile (CA more)...2) STALKED=pedunculated...

Front 948

histo of adenoma polyps

Back 948

Villus (sessile inc CA)... tubular(least)... tubulovillu

Front 949

painless blisters, hypertrichosis and hyperPig, inc skin fragility of hands... assoc w? ...can be trig by?...tx?

Back 949

Porphyria Cutanea Tarda... assoc w/ Hep C... trig: OCP (estrogen) and ethanol... lab: Inc urine Porphyria.. tx: Phlebotomy or HYDROXYCHLOROQUINE

Front 950

Post exposure prophylaxis for chicken pox?

Back 950

VZIg if wihing 3 days...if no, tell mom it's too late, baby will get it

Front 951

PTSD vs ASD...tx?

Back 951

ASD: less than 4 weeks...both: dont give them benzo (hx of abuse), SSRI and Cogn instead

Front 952

>42 weeks DT?

Back 952

Anencephaly and Trisomy 18 (follow biweek w/ NST and BPP

Front 953

MCC endopthalmitis?

Back 953

post op btw 1-6 weeks... need abx

Front 954

low C3, low CH50, complement in serum...RBC ast and proteinuria

Back 954

Post Strepth GN...C3, CH50, ASO all go back nl eventually

Front 955

Post Strepth GN vs Drug Induced Interstitial Nephritis

Back 955

DIIN: eaosinophila, hematuria, pyuria, rash, arthralgia...

Front 956

MOA is genomic imprinting...dx?...sx...

Back 956

Deletion arm 15...Prader Willi... sx: diamond eyes, down turn mouth, eat a lot, hypogonad

Front 957

Pseudopuberty vs True?

Back 957

Pseudo is very fast...so pt pt has severe acne + acccelerated growth = pseudo!

Front 958

Precocious PUBarche DT

Back 958

sever androgen xs (like from 21-oh def)

Front 959

how to test for true precocious pub?

Back 959

give GnRH...if inc LH,then yes

Front 960

Prednisone can → acidosis, how?

Back 960

by dec pulmo fxn...so do PFT

Front 961

Tx Mg toxicity

Back 961

Stop it and give Ca Gluconate

Front 962

what's proteinuria for PreEcclampsia?

Back 962

>300mg/24hr

Front 963

MCC death from PreEclam

Back 963

Hemorrhagic stroke DT HTN and thrombocytopenia

Front 964

tx PreE...?

Back 964

1) Mild: if at term, deliver, if btw 24-34w= give steroids and once mature deliver... 2)Severe: eval, if >160/110 give antiHTN, ...HTN tx: if close, give Hydralazine/Labetolol, if far=MEthylDopa...CCB are 2nd choice

Front 965

If BP very high, give nitro?

Back 965

Not if near term... may make baby cyanosis

Front 966

time frame: CVS, Amnio, Cordo/Percut Umb Blood Sampling

Back 966

C: 2.5-3 mo... A: 4-4.5 mo... Cordo: for rapid karyo or Rh iso... AFB done in 2nd trimester

Front 967

when is Group B tested on pregos and tx with

Back 967

36week... PenG durin labor even if no risk

Front 968

lower back pain 3rd trimester DT?

Back 968

lordosis and relax of lig

Front 969

xs ocytocin →

Back 969

water retention, hypoNa and seizure DT water intox

Front 970

tx sugar in pregos?

Back 970

stop oral and give insulin

Front 971

Pt 6 weeks preg, +FTA...allergic to Penicillin...next?

Back 971

Try to Desensitize her

Front 972

neonates of pts w/ graves tx with surgery may get?

Back 972

thyrotoxicosis

Front 973

epidural anesthesis can →

Back 973

hypoT DT pooling and LE redistribution

Front 974

Edema lower extremities in pregos?

Back 974

ok unless proteinuria or HTN

Front 975

HTN post 20 weeks DT?

Back 975

PreE (prot >300mg/d), or Transient HTN (no proteinuria)

Front 976

how can baby and mom have diff blood type and be ok?

Back 976

IgM for ABO doesnt cross blood

Front 977

Premature Adrenarche DT?

Back 977

adrenal gland androgen... Pubarche is 50% CNS

Front 978

Tx premature labor

Back 978

MG!!! (and give steroid to speed up maturity)

Front 979

MCC premature ovarian failure

Back 979

Adhesion, Hashi, Rads or Chemo...sx: Amenorrhea, atrophy vag... tx: egg donation

Front 980

PPROM, next?

Back 980

Amniotic to measure lung indices...US to measure amnio vol and fetal anomalies..if babies has anomaly: let vag deliveries...if ok, prolong to mature lung, then deliver

Front 981

Tx Premature Ventricular Contraction?

Back 981

no tx

Front 982

Define Presbycusis?

Back 982

hard to hear high freq in older both ears (speech differentiation)

Front 983

define preterm labor

Back 983

1) <37weeks, 2) cervical 80% or 2cm.... define 20-37weeks..

Front 984

tx Preterm labor

Back 984

1) bed rest and hydration (hydration actually inh oxy and--> dec contraction), 2) tocolytics Mg 3) culture Group B and Ab 4) if btw 24-34 give steroids

Front 985

DRE and hemocult at what age

Back 985

50, yearly

Front 986

Colonosopy

Back 986

50, q 10yrs

Front 987

mammogram

Back 987

Yearly 50-75

Front 988

Chlamydia screen

Front 989

LDL?

Back 989

100 in a DM...start lifestyle

Front 990

CIN 2 or 3

Back 990

yearly pap if even negative 3years in a row

Front 991

best tx for osteop for postmenop

Back 991

ORT

Front 992

TD booster?

Back 992

q 15yrs

Front 993

DTP for adults?

Back 993

not really if >5yrs, adults dont get it

Front 994

Hep A vacc?

Back 994

if travel

Front 995

Yellow Fever vac?

Back 995

Africa or South America

Front 996

if kid has seizure after DTP, next?

Back 996

next time only give DT (no pertussis)

Front 997

if surgery for UC?

Back 997

Scope 8 yrs post surg, then q1-3

Front 998

rx that cause priapism

Back 998

Trazodone > Prazosin

Front 999

tx the sx of Primary Biliary Cirrhosis

Back 999

Ursodeoxycholic dec itch and progression...end tx: Liver transplant

Front 1000

Histo of PBC and assoc w/

Back 1000

histo: granulomatous destruction of bile ducts in in portal triad... assoc w: Sjogrean, RA and CREST

Front 1001

Primary Dysmenorrhea

Back 1001

appears .5-1yr post menarche... few hrs before menses, last 3-4 d... tx: NSAID, OCP (DT inc Prostaglandin)

Front 1002

when is inc / low renin?

Back 1002

hi: in Renal Vascular HTN... low: Primary HypeAldo (adenoma = hypoK)

Front 1003

MOA of aldosterone and why NO EDEMA

Back 1003

Aldo → inc salt and h2o retention...--> natruiresis (aka ALDO ESCAPE PHENOMENOM), therefore = Mild HyperNA and NO EDEMA

Front 1004

Primary ovarian failure: Estrogen and inhibin?

Back 1004

both decrease → loss feedback → inc LH and FSH (inhibin only for FSH)

Front 1005

Primary Polydypsia can be dT

Back 1005

PHENOTHIAZINE (antiChol) that cause dry mouth... or hypothalamic lesion affecting thirst

Front 1006

Define Primary Sclerosing Cholangitis MOA... sx... can progress -->...to dx...

Back 1006

Infl destruction of of intra/extra ducts...sx: itch, jaundice, RUQ pain or acute cholangitis... progress: complete obstr, wnday cirrosis, liver fail... to dx: ERCP! BEADING DT strict, LFT: very HIGH ALK PHOS, TA<300, PANCA, hyperGamma, inc IgM

Front 1007

Cholangiocarcinoma can be DT...sx

Back 1007

PSC (especially smoker)... sx: SEVER stricture of tree → cholangitis...tx: ERCP , then bx of stricture...tx: URSOdeoxy to dec liver enz

Front 1008

aka lactotroph adenoma..sx in men/women

Back 1008

prolactinoma... men: hypogonadism, women: galactorrhea... tx: CARBEGOLINE, if no, then MRI and surg

Front 1009

SE of PTU MC and Worst

Back 1009

MC: allergies...worse: agranulo(most recover)

Front 1010

tx bone pain post Prostatectomy CA

Back 1010

Rads...

Front 1011

work up for spinal cord compression DT CA (cauda equina)

Back 1011

1) steroids, 2) MRI or CT angio if MRI CI, 3)rads

Front 1012

work up for Prostate CA

Back 1012

if PSA >4, USG...next: needle bx, next staging, ast : bone scan

Front 1013

if late prostate CA, tx

Back 1013

palliative: AntiAndrogen! (LEUPROLIDE)> flutamide

Front 1014

Work up for acute bacT prostatitis

Back 1014

1) midstream catch...2) empiric abx

Front 1015

sx nonBacT prostatitis

Back 1015

no fever, irritabe, UA nl, excretion of prostate: WBC10, cult negative... need to RO CA

Front 1016

Prostatodynia...what is it and lab

Back 1016

inflammation prostate with no known cause... afebrile, void irritation... prostate secretion: nl...no hx UTI

Front 1017

woman complain pregnancy but all labs negative

Back 1017

Pseudocyesis...need psych

Front 1018

tx pseudodementia

Back 1018

SSRI

Front 1019

high Ca, low Phosph, rhomboid shaped crystals, dx

Back 1019

Pseudogout... Ca pyrophosphate w/ postive birefringent

Front 1020

needle shape

Back 1020

gout

Front 1021

coffin lid

Back 1021

struvite

Front 1022

tx pseudomembranous

Back 1022

IV/oral Metro....or ORAL ONLY vanc

Front 1023

only MRI abn in pseudotumor cerebri, tx if LP not dec ICP?

Back 1023

Dilated ventricle DT inc ICP...tx: Acetazolamide (inh Choroid plexus CA inhibitors)

Front 1024

RUQ pain, fever, + psoas sign, and Furuncles (pus filled sore)...dx...to dx:...tx

Back 1024

Psoas abscess... need CT...if cant find and still suspicious → laparotomy and drain

Front 1025

Psoriasis can precipitated by? Sx? Location? vs. OA...vs RA

Back 1025

Lithium...pitting nails, asymmetric...DIP...OA not infl...RA not DIP

Front 1026

Define Puerperal fever... MCC?... if not sx not improve with abx?

Back 1026

>38 for 2d within 10d postpartum....MCC: endometritis...tx: if not improve, add Heparin for 2-3 weeks in case of thrombophebitis or something...if not = abscess!

Front 1027

Trauma, hypoxic, chest wall bruising...dx...lab

Back 1027

Pulmonary contusion...ABG: hypoxia

Front 1028

PE RF

Back 1028

Antithrombin 3, C, S defic

Front 1029

PE labs?

Back 1029

arterial hypoxia ALWAYS...tx: O2 and anticoag

Front 1030

if reccurent DVT and now PE?

Back 1030

Factor 5 leiden (MOA: mut to coag 5 → resistant to inact by prot C

Front 1031

PE tx

Back 1031

1) if pt hemo unstable and clot in main pulmo artery → embolectomy (give him heparin but still surg)...2) fibrolytic BEST if hemo unstable but not in post pt is good...

Front 1032

PE sx

Back 1032

sudden SOB with clear lungs

Front 1033

best dx for DVT

Back 1033

Doppler US

Front 1034

Very first step in tx PE?

Back 1034

Anticoa start!!!

Front 1035

Pulmo HTN CXR?

Back 1035

enlarged pulmo art and RV

Front 1036

Pulmo regurg more prominent w

Back 1036

inspiration

Front 1037

nitrites for

Back 1037

enterobacT

Front 1038

esterases

Back 1038

pyuria

Front 1039

Chronic Pyelo seen w?

Back 1039

Focal parenchyma scarring and blunting of calyces in IVP

Front 1040

tx Pyloric stenosis

Back 1040

1) #1=hydrate + K! 2) US then 3) surgery

Front 1041

RA needs tx?

Back 1041

DMARD (dz mod anti-rheum drugs)= METHOTREX/ HYDROXYCHLOROQUINE /SULFASALAZINE /AZATHIOPRINE...SE of Methotrex? Microcytic anemia DT inh DHF reductase

Front 1042

SE HYDROXYCHLOROQUINE

Back 1042

1) GI, 2)visual 3) hemolysis w/ G6pDH

Front 1043

SE AZATHIOPRINE

Back 1043

1) pancreatitis, 2) liver tox, 3) BM suppr...

Front 1044

CYCLOSPORINE used for and SE

Back 1044

transplant... Kidney bad

Front 1045

bit by dog, now what

Back 1045

1) if cant catch dog: active and passive 2) catch and bx brain, if nl, still give both

Front 1046

tx fx of isolated humeral

Back 1046

tx: closed reduction and cast

Front 1047

SERM used for osteop?

Back 1047

RALOXIFENE (no inc rsk of Endometrial CA!!! unlike estrogen)...problem: inc PE and CI in pt with recurrent DVT

Front 1048

ramsey hunt

Back 1048

CN5

Front 1049

Woman who hates foreigners now voluteer to help them

Back 1049

reaction formation

Front 1050

rape victim open clinic for other rape victims?

Back 1050

altruism (calm her own fears)

Front 1051

Pain, swelling and vasomotor prob dx? Loc? Imaging? Tx

Back 1051

Reflex Sympathetic Dystrophy... loc: shoulder restriction... XR: osteopenia...tx: PT and steroid if need

Front 1052

Keratoderma Blenorrhagium on palms and soles, dx?

Back 1052

Reactive arthitis... clear vesicle w/ red bases... painful shallow ulcers...lab: B27

Front 1053

tx chlamydia arthritis?

Back 1053

NSAID and Tetracyclin

Front 1054

Renal artery stenosis...1) RF, 2)lab

Back 1054

RF for athero (DM...)... Resistant HTN!... lab: continuous murmur (syst and diast) in periumbilical

Front 1055

if VARICOCELE fail to empty in recumbent? Dx and next

Back 1055

Renal CC... Abd CT

Front 1056

pt comes in with low pH but no HCO3 compensation...MCC

Back 1056

RTA

Front 1057

RTA acid base?

Back 1057

nl AG metab acidosis (DT dec renal acid secretion)

Front 1058

Type 1 RTA: aka, MOA, labs

Back 1058

type 1: DISTAL RENAL ACIDOSIS (cant make more bicarb) lab: urine pH >5.5, LOW K,

Front 1059

Type 2 RTA: aka, MOA, labs

Back 1059

Proximal Tubular Acidosis: (can't reab HCO3 → urine HCO3) lab: urine pH <5.5, K ok or low...assoc w/ Osteomalacia

Front 1060

RTA typ4?

Back 1060

HyperK RTA: MC in adults (DT Aldo resistance or deficiency)...lab: hyperK (asx)

Front 1061

Renal vein thrombosis can be DT

Back 1061

Nephrotic syndrome, antiThrombin 3 lost in urine... MCC: MEMBRANUS (abd pain, hematuria sudden)

Front 1062

MCC of ocular stroke...fundo...tx

Back 1062

emboli from retinal artery...painless...fundo: retinal whitening/red cherry spot...tx: do not delay (massage the oculi) and high )2

Front 1063

sx of retinal detach...tx...

Back 1063

one side, floaters, “curtain coming down”...tx: LASER CRYO

Front 1064

Retinal necrosis acute DT

Back 1064

HSC or VZV in HIV...(keratitis, uveitis)

Front 1065

CMV retinitis sx...fundo...seen in

Back 1065

painless (no keratitis or conjunctivitis)...fundo: fluffy/bleed around retinal vessels, yellow plaques, opaque retia...in: HIV w. CD4<50..tx: Gang

Front 1066

Retinoblast can met to...sx..

Back 1066

brain, liver....sx: strabismusl pain, dec vision, glaucoma

Front 1067

MCC white reflex

Back 1067

Congenital cataracts

Front 1068

POSTERIOR pharyngeal edema and nuchal rigid?

Back 1068

Retro pharyngeal abscess

Front 1069

MCC rhabdo...lab

Back 1069

etoh...cr inc a lot → ATN..tx: Fluid and Alkalize urine and osmotic diuresis (mannitol).

Front 1070

Purpose of RhoGam

Back 1070

AntiDgamma → prevent contact mom and baby blood by dec fetal RBC in mom's circulation...good if mom not sensitized (ab <1:6)...

Front 1071

rhoGam given at

Back 1071

28th and within 3 days of delivery

Front 1072

MCC Mitral stenosis?

Back 1072

Reumatic Fever...complic: LA gets huge and can push on left main stem bronchus or phrenic (cough)... dx by Echo and PenG prophylaxis (IM monthly)...

Front 1073

rib fx can be deadlty in elderly DT →

Back 1073

Pain → hypovent DT atelectasis/pneumonia...main tx: PAIN MANAGEMENT even w/ nn block

Front 1074

RITORDINE SE

Back 1074

a B2agonist (tocolytic) → inc water retention (edema), and heart workload...inc glucose from liver/muscle so inc need insulin also

Front 1075

complication of rocky mountain if not tx

Back 1075

shock (need IV) then tetra

Front 1076

light skin, 30-60, telangiectasia cheeks,nose,chin.... flush caused by hot, heat,...dx

Back 1076

rosacea and tx: topical metro for papules/erythema

Front 1077

Rotor

Back 1077

conj bili in urine

Front 1078

arthritis in adult female, w/ rash, post auricular LN, fever 15d...

Back 1078

rubella! Rash is same as measles...

Front 1079

vesicular rash

Back 1079

chickenpox

Front 1080

erythema infectiosum

Back 1080

slapped cheek

Front 1081

roseola infantum

Back 1081

HHV 6 (no longer febrile when rash comes)

Front 1082

rubella at begin of preg worse!...infxn dx by

Back 1082

IgM or IgG..tx: vac all ladies, if unsure hx, obtain titer at 1st tri (dont give vac to pregos)

Front 1083

hydrocepha, cerebral calc, chorioretinitis, small head in

Back 1083

cmv and toxo

Front 1084

salmon patch location

Back 1084

eyelid/neck...selfgone

Front 1085

tx sarcoid

Back 1085

steroids if sx

Front 1086

tx scabies

Back 1086

permetrin for adults

Front 1087

scaphoid tx

Back 1087

even if XR neg … tx: all nondisplaced fx = cast, if displaced open reduction and int fix

Front 1088

Schizo + mood

Back 1088

schizoaffective (hear voices, not violent, want to be alone)

Front 1089

if schizo non compliant?

Back 1089

FLUPHENAZINE and HALOPERIDOL (both injectible q2mo)

Front 1090

detached and limited emoitino

Back 1090

schizoid

Front 1091

schizotypal

Back 1091

magic

Front 1092

schizo btw 1-6 mo

Back 1092

schizofreniform

Front 1093

brain of schizo

Back 1093

inc ventricles, dec cerebral mass, temporal mass, no change in cerebellar mass

Front 1094

tx catatonic schizo

Back 1094

Benzo – lorazepam

Front 1095

CREST

Back 1095

Scl 70

Front 1096

Wegener

Back 1096

CANCA

Front 1097

dermatomyo

Back 1097

antiJo, ANA

Front 1098

types of scoliosis

Back 1098

type1: idiopathic (infantile, juvenile, adult)...type2: neuromuscular....type3: congenital

Front 1099

to dx scoliosis ...and tx

Back 1099

bend over and Cobb's angle...tx: <20: f/u, >30=brace, >40=surgery

Front 1100

dry scales of scap, inrecaspular umbilius, body folds...dx..seen in...

Back 1100

Seborrheic dermatitis...seen in: Parkinson, HIV!, Hep C (if w. lichen planus)

Front 1101

bening, warty, greasy, stuck on...anywher xcept palms/soles...dx...dx by...tx

Back 1101

Seborrheic keratosis...dx by shave bx...tx remove to look good

Front 1102

to find spina mets

Back 1102

Technitum 99 scan

Front 1103

Tonic clonic describe and type

Back 1103

general....aura (lights)...stiffness and loc

Front 1104

absence is

Back 1104

generalilzed as well

Front 1105

complex partial seizure

Back 1105

focal then transient or incomplete impaired consciousness

Front 1106

leukocytes in septic arthritis

Back 1106

>50k or >100k...tx: SURGERY NOW! Abx kid: Nafcillin + 3rd gen...adult: Nafcillin

Front 1107

both septic arthritis and osteomyelitis from

Back 1107

URI blood

Front 1108

MC ear path in hiv pts

Back 1108

serous OM

Front 1109

Serous OM vs. Chronic

Back 1109

Chronic: purulant aural dc, t. membrane thick and calcified, perf....

Front 1110

absense of stapedial reflex in 3rd decade...dx...loc

Back 1110

Otosclerosis...temporal bone

Front 1111

no b, t, nk cells, no ln or tonsils

Back 1111

SCID (life threat)

Front 1112

Common variable ID vs. Brutton's Xlinked Agamma

Back 1112

CV: older 15-35, less severe, AGME may be dec but B cells ok!... B: asx until 6mo then pyogenic infxn, dec AGME AND B CELLS!!!

Front 1113

young bo, ezcema, dec platelets, inc infxn w/ caps...at bith petechia, bleed from circumcision...dx...lab

Back 1113

Wiskott Aldrich (Xlinked)... lab: low MAE Ig, dec T, dec platelets

Front 1114

impair ADH → DI, DT?

Back 1114

sheehan (ischemic necrosis of pit)

Front 1115

how to wok up shock

Back 1115

1) CO < 5? → PCWP <18 = hypovolemic, if >18 = cardiogenic...2) if CO>5 = sepsis, or neurogenic

Front 1116

The 4 classes of hypovol define

Back 1116

1) class 1 = 10%, tachy, thats it...2)class2 = 20% confused and combative, cold... 3) class 3 = 35-50% BP cannot maintain, HR keeps going ip, mental bad....4)class 4>40% = coma, BP incompatible with life

Front 1117

MOA septic shock

Back 1117

Systemic VD → inc CO (dec RA and pulmo pressure)

Front 1118

MOA neurogenic

Back 1118

has low Mixed Venous O2 concentration DE inc O2 extraction by hypoperfused tissues

Front 1119

if no JVD?

Back 1119

NO TAMPONADE

Front 1120

if pt unstable with supsected intraabd bleed, best dx procedure?

Back 1120

Peritoneal lavage!...if pt stable: CT...Ultrasound before PL maybe

Front 1121

tonic clonic seizure →

Back 1121

post disloc shoulder (presents w. int rotated arm and cant ext rotate...good sensory and reflex) ....vs Ant disloc (sensory loss and pt has arm ext rotated)

Front 1122

Parkinson pt with postural hypoT, impotence, incont...dx and MOA, tx

Back 1122

Shy-Dragger (park + auto like bladder prob)... tx: antiPark not hep, need IV volume expansion

Front 1123

how to tx SIADH induced hypoNa

Back 1123

1) mild (asx 120-130): fluid restrict, 2) mod (asx 110-120): loop+NS, 3) severe (CNS sx)= hypertonic saline (3%)

Front 1124

SIADH lab

Back 1124

hypoNa, hypoTonic, euvolimic

Front 1125

chronic tx of SAIDH?

Back 1125

Li or Demeclocycline = inh ADH action

Front 1126

MC in submandibular gland...dx? Sx..tx

Back 1126

sialolithiasis...sx: pain post food DT stone seen on xr...tx: dilate and remove

Front 1127

MC pattern of sick euthyroid synx

Back 1127

fall in total and free T3, nl T4 and TSH

Front 1128

MC sx in sickle

Back 1128

painless hematuria

Front 1129

aplastic crisis DT in sick?

Back 1129

1) folate defic (GIVE EM) 2) Parvo infxn

Front 1130

how to tx painful crisis in sickle?

Back 1130

O2, fluid and HYDROXYUREA...MOA: vasoocclusion

Front 1131

5 yo AAM present with high fever, hypoT, AMS, inc WBC wth bands...DT?

Back 1131

S. Pneumonia DT sickle cell asplenia

Front 1132

what is aplastic crisi?... vs Spenic Sequestration

Back 1132

transient arrest of erythropoieisis DT infxn → Hb and no reticulocytes... tx: transfuse...SPLENIC SEQ: pooling of blood in spleen (those who still have them) → dec Hb but RETICULOCYTES ARE STILL THERE → hypoT shock, tx: remove spleen

Front 1133

Sideroblastic anemia DT?

Back 1133

impair heme ( like B6 impair...so look out for INH pts!)...lab: hypochromic like Fe def but lab--> inc Fe and inc TIBC...tx: B6...MCC chronic etoh

Front 1134

sideroblastic anemia histo

Back 1134

Fe granules in blue around nucleus

Front 1135

MCC death 1mo-1yr

Back 1135

SIDS

Front 1136

sx: dental carries, diff swallow, talk, keratoconjuntivitis...dx..moa..lab..

Back 1136

Sjogen...MOA: autoI vs. exocrine gland--> salivary insuff...lab: anemia, leukopenia, eosinophilia, inc ESR...to dx: lip bx

Front 1137

MCC in sle?

Back 1137

CRF

Front 1138

MOA kidney damage in SLE

Back 1138

Type 2=immune complex deposit (good pasture is type 3

Front 1139

5 patterns of renal involvement w SLE

Back 1139

1,2 no tx....3,4 = immuno...

Front 1140

renal involvementin SLE

Back 1140

1) mesengial first and least bad...2)focal (getting worse, areas of necrosis)...3) diffuse proliferative (MC and worst, hematuria, dsDNA ab)... 4)Membranous GN (renal fx fine, thick BM, subepithelial deposist).... 5) Sclerosing ( healing of previous damage, urine nl, no infl so immunotx no help)

Front 1141

antismith?

Back 1141

Only 40% of sle pts

Front 1142

SLE + muscle, skin , pulmo, kidney....dx

Back 1142

mixed CT dz DT antiRNP

Front 1143

scarring alopecia

Back 1143

in SLE pts (skin)

Front 1144

sleep terror vs. nightmare

Back 1144

sleep terror : dont remember....N: remember

Front 1145

MOA of Slipped capital femoral epiphysis

Back 1145

failure of growth plate btw fem neck and fem head → displacement (in fat kid)...dx by XR (bone cyst and sclerosis and collapse if advance)...surgery (fix hip w/ screws)

Front 1146

tx somatization DO

Back 1146

repeat clinic visit

Front 1147

specifc phobia tx

Back 1147

systemic desensitization

Front 1148

tx acute anxiety

Back 1148

benzo

Front 1149

big spleen vs levels of haptoglobin

Back 1149

spleen: vasclar hemolysis... hapto: intravas hemolysis...

Front 1150

hereditary sphericytosis

Back 1150

AD... has extravascular hemolysis... osmofragility test positive

Front 1151

osmofragility test positive in? How to diff

Back 1151

Hereditary spherocy (fm hx) and AHA (no fm sx)

Front 1152

sx of Black Widow Spider bites and tx

Back 1152

Sx: acute abdomen...tx: Muscle relaxant and Ca Giuconatek

Front 1153

sx Brown reclusive spider bite and tx

Back 1153

Sx: like extensive localized skin necrosis (like Pyoderma Gangrenosum)... tx: Dapsone (dec necrosis)

Front 1154

describe brown reclusive spider wound

Back 1154

deep ulcer with necrotic center and red halo...tx: local incisioj

Front 1155

Burst fracture of vertebra →

Back 1155

Anterior Cord Syndrome (total loss of motor fxn below level of lesion w/ loss pain and T)... best dx method: MRI

Front 1156

sx CENTRAL CORD LESION

Back 1156

purning pain paralysis of UE... in elderly DT hyperetension neck injury

Front 1157

Calf pain when standing up and walks...DT?

Back 1157

Neurogenic claudication from spinal stenosis...POSITIONAL (no pain at rest)...dx: MRI

Front 1158

Splenic contusion often DT

Back 1158

rib fracture

Front 1159

define Spondylolesthesis

Back 1159

dev DO...forward slip of vertebra...sx: “step off”, neuro (urine incont), back pain...

Front 1160

MCC peritonitis

Back 1160

E. Coli...lab: 250 neutrophils, SAAG (serum to ascites albumin gradient) >1.1...if worse 2 days later: 2ndary peritonitis...tx: CEFOTAXIM or AMP+AMG... recurrent very common

Front 1161

sporothrix pain?

Back 1161

painless

Front 1162

hilar lung mass

Back 1162

Sq. CC

Front 1163

Biggest RF for SqCC of skin..assoc loc?

Back 1163

sunlight...assoc: LEUKOPLAKIA (need bx) and ulcer not heal in LOWER LIP.

Front 1164

Ulcers that never heal aka?

Back 1164

MARJOLIN's (sq. CC)... need a PUNCH bx and WIDE excision

Front 1165

Precursor to SqCC

Back 1165

Actinic Keratosis

Front 1166

tx Status epilepticus

Back 1166

EMERGENCY...1) pt on lateral with mandible pushed out, 2) meds, if not work in 30 min 3) general anesthesia w. intubation

Front 1167

RA + salmon rash _ fever in 20-30 yo

Back 1167

STILL's dz

Front 1168

itchy rash, abd pain, rash lower legs and buttt

Back 1168

Henoch Sholein

Front 1169

Only CA that has decreased

Back 1169

Stomach CA

Front 1170

MCC of amblyopia (dec visual acuity) is

Back 1170

strabismus (MC type = esodeviation = medial dev)...tx: cover the eye

Front 1171

Stranger anxiety vs. Seperation Anxiety

Back 1171

Stranger: younger 6mo – 18mo...Sep: older kids

Front 1172

bone pain at rest, worse with excercise, XR negative rght now...dx..next

Back 1172

Stress fx...need MRI...tx: dec weight bearing with cast (takes 1 month)...DANCERs LEG

Front 1173

2 vertebral arteries →

Back 1173

Basilar → posterior

Front 1174

Anterior Cerebral artery stroke sx

Back 1174

lower limb problem, urinary incont, atax

Front 1175

MCA stroke sx

Back 1175

more upper limb... homonomos hemianopia...if left (dominant lobe) = aphasia, if nonD (right) = neglect and anosognosia

Front 1176

PCA stroke sx

Back 1176

ataxia, visual hallucination (Calcarine Cortex), sensory (thalamus), 3rd n palsy (mid brain)

Front 1177

Lacunar infarcts sx

Back 1177

very define sx (not both sensory and motor)

Front 1178

Within 3 hours of a stroke and CT is neg, next>

Back 1178

Thrombolytics w/ tPA (NOT streptokinase)

Front 1179

Thalamic stroke where

Back 1179

VPL of thalamus (sensory from opposite side)

Front 1180

Diff btw not understanding what is said to speech difficulty

Back 1180

Speech difficulty: Expressive Aphasia (DT dominant fronta)...Cant understand: Parietal (Dyscalculi, dysgraphia)

Front 1181

Caverness unilateral hemangioman, in skull XR?

Back 1181

gyriform intracranial calcification look like tramline...tx: control seizure and dec ICP, laser to remove skin lesoins

Front 1182

Neer sign, what is it, dx? And sx... imaging...tx

Back 1182

Subacromial bursitis...pain absent at rest...N: pain passive int rot and forward flex shoulder...MRI...tx: NSAID, PT

Front 1183

MCC SAH in kids?

Back 1183

AVM malform (hx seizure and migrained like HA)

Front 1184

MCC death in SAH? And tx

Back 1184

vasospasm!...tx: CCB (Nimodipine)

Front 1185

SAH aka

Back 1185

Cerebral salt wasting syndrome (SAIDH inc water retention → hypoNa (tx: water restriction)

Front 1186

subdural hematomy without midline shift on CT...tx?

Back 1186

Dec ICP by hypervent, head elev...if need: acetazolamide/mannitol...if midline shift = craniotomy

Front 1187

biconvex

Back 1187

epidural

Front 1188

man with fiery temper channels anger toward running

Back 1188

sublimation

Front 1189

CI to sumatriptan

Back 1189

Prinzmetal, CAD, preg!!

Front 1190

MCC superior vena cava syndrome

Back 1190

bronchogenic carcinoma (small cell tumor) smokers...tx: angioplasty with stent

Front 1191

triad of SVT

Back 1191

narrow QRS, HR>140, reg, loss P...tx: same, unstab=DC, stable=Vegal and adenosine...2nd: VERAPAMIL

Front 1192

supraclav fx can →

Back 1192

brachial artery pulse loss

Front 1193

sx Bradycardia tx

Back 1193

Atropine, then transcutaneous pace...if brady and hypo = EPI

Front 1194

Exerptional syncope define and DT

Back 1194

cardiac flow obstr (AS)

Front 1195

Syncope DT cardiac sx

Back 1195

end and start suddenly...DT arrhythmia

Front 1196

Vasovagal syncope DT

Back 1196

stimuli like fright (dx by tilt table and carotid massage)

Front 1197

situational syncope DT

Back 1197

autonomic dysregulation (like pee then pass out)

Front 1198

primary syphilis

Back 1198

painless, shallow chancre ulcer with punched out base... painless bilateral LN

Front 1199

Condyloma lata contagenous

Back 1199

yes

Front 1200

if syryngomyelia + arnold chiari... watch out for

Back 1200

caudal displacement cerebellar tonsils

Front 1201

tx of systemic sclerosis for skin thickening and renal dz

Back 1201

1) Penicillamine, 2) ACEI

Front 1202

Dig for

Back 1202

atrial tach

Front 1203

tx Vtach

Back 1203

Amio if not, lido...unstable=DC

Front 1204

Tamoxifen used for and SE

Back 1204

breast CA...SE: 2 CA 1) endometrial, 2) Uterine sarcoma

Front 1205

Hexosaminase def → GM2 gang accum...dx...sx

Back 1205

Tay Sachs...(MR, seiz, cherry red macula, hyperacus, NO big spleen NO LN)

Front 1206

MCC constrictive pericarditis in immigrants?

Back 1206

TB (hx JVD and previous exposure)

Front 1207

tx for TCA intox

Back 1207

tx: Na HCO3 → prevents arrhtymia...tox: QRS widening....if seiz = diazepam

Front 1208

inc placental Alk phosph and testical pain

Back 1208

SEMINOMA

Front 1209

inc AFP and testis

Back 1209

EMBRYONAL

Front 1210

inc BHCG and testis

Back 1210

choriocarcinoma (next: US then orchiectomy...do not do a bx!)

Front 1211

MC testicular sex cord stromal CA?

Back 1211

Leydig cell

Front 1212

AFP?

Back 1212

yolk sac tumor

Front 1213

breast dev from?

Back 1213

periphery estrogen...ax/pubic hair does not

Front 1214

toxoid boooster?

Back 1214

q10yrs

Front 1215

TOF vs VSD/ASD

Back 1215

TOF: early cyanosis

Front 1216

Theophyllin SE

Back 1216

CNS (insomnia), GI( NV), Cardio (arrhythmia)

Front 1217

THIORIDAZINE what and SE

Back 1217

antipsych... SE: cardiac arrhythmia, prolong QRS (need NaHCO3)...also inc PRL dt inh of DA

Front 1218

Thoracic outlet syndrome, next

Back 1218

CXR...MRI and angio to det compression

Front 1219

in threatened abort, cervix?

Back 1219

closed

Front 1220

inevitable abortion

Back 1220

cervix dilated, USG=sac is ruptured and no fetal cardiac

Front 1221

cerclage is for

Back 1221

1st trimester DT incompetent cervix

Front 1222

location of Thymoma

Back 1222

anterior mediastinum

Front 1223

location neurogenic tumors and which ones

Back 1223

Posterior mediastinum (neuroblastoma, esoph lyomyoma)

Front 1224

location of pericardial cyst

Back 1224

middle mediastinum

Front 1225

MC thyroid CA...pt hx...histo

Back 1225

Papillary Carcinoma...hx of rads... histo: hurtle cells, psammoma bodies, large cells/pale nuclei with central bodies...prog: GREAT even if mets

Front 1226

#2 MC thyroid CA..

Back 1226

Follicular CARCINOMA...elderly...vs. ADENOMA (not invade capsule and BV)...prog: more malig than papillary (blood spread)

Front 1227

#3 MC Thyroid CA

Back 1227

Medullary (solid) carcinoma = sporadic or familial...type: AD...path: prolif of paraFollicular cells (Ccells)--> lots of calcitonin (→ dec Ca dec Phosph)...tx: TOTAL removal

Front 1228

$4 Anaplastic

Back 1228

sx: fast and painful (die in 1 yr)

Front 1229

Types of thyroid nodules and work up

Back 1229

MC: COLLOID (benign) > FOLLICULAR adenoma (benign)...w: 1) TSH (then T3, T4 based on that)

Front 1230

Follicular adenoma histo

Back 1230

invade capsule and blood

Front 1231

Follicular vs. Papillary CA

Back 1231

Follicular = encapsulated and not LN like Papillary

Front 1232

Subacute lcy thyroiditis

Back 1232

sx: painless, thyrotoxicosis = leak of hormones

Front 1233

Subacute granulomatous thyroiditis aka and sx

Back 1233

De Quervain's... sx: intense pain thyroid...tx: NSAID

Front 1234

sx of embolic TIA...imaging...tx

Back 1234

hours...EKG: aFib or MI... tx: dec RF: smoke, htn, choles...antcoag? If emboli from heart (hep, then war)

Front 1235

embolic TIA vs. atherothrombotic TIA?

Back 1235

embolic: hours...athero: minutes(if no CI, give anticoag – ASA is initial...or CLOPIDOGREL if ASA CI)...

Front 1236

tx thromboembolic TIA?

Back 1236

always anticoag if no CI (ASA >CLOPIDOGREL>TICLOPIDINE)

Front 1237

What is Reversible Ischemic Neuro Deficit and duration

Back 1237

TIA then resolve in 1-7d

Front 1238

Babiosis sx

Back 1238

splenectomized...enter RBC-> hemolysis → jaundice, renal fail, death...NO RASH...dx by blood smear

Front 1239

tx tinea corporis

Back 1239

lotion (TERBINAFINE)...systemic (GRISEOFULVIN)

Front 1240

“spagetti and meatball dx?

Back 1240

tinea versicolor..tx: topical SELENIUM or Ketoconazole shampoo

Front 1241

tx of Tourette

Back 1241

typical like antipscy

Front 1242

Tx Torsades

Back 1242

1) stop med (Quinidine) 2) Mg

Front 1243

Outgrowth of the hard palate aka

Back 1243

Torus palatinus...tx: none...(fleshy immobile mass on hard palatine)

Front 1244

Toxic adenoma vs. Grave's

Back 1244

Adenoma: RadioI uptake in 1 lobe...Grave: diffuse uptake AND exopthalmos...Multinodular: patchy uptake...

Front 1245

hyperthyr have inc risk of

Back 1245

bone loss (DT inc osteoclast resoprtion)

Front 1246

Toxic epidermal necrolysis DT

Back 1246

Sulfa, barbiturates, Phenytoin, NSAID...tx: supportive

Front 1247

MCC blindness in world...tx

Back 1247

Trachoma...dx by: lymphoid follicles in conjunctiva...tx: TETRACY

Front 1248

tx to prevent PCP in transplant pt

Back 1248

BACTRIM

Front 1249

MCC cyanosis w/n first 24 hrs

Back 1249

Transposition of great vessels... TOF few yrs later

Front 1250

pear shaped, has flagella, malodorous

Back 1250

dx: microscope...T.Vaginallis

Front 1251

Sx of Tricuspid atresia

Back 1251

Cyanotic heart dz early....most have VSD

Front 1252

mid diastolic rumble

Back 1252

tricusp stenosis

Front 1253

TCA tox

Back 1253

antichol, vc, neuro sx... CV(prolong QRS and AV block)...best predictor of TCA tox? QRS INTERVAL

Front 1254

MOA of Trigeminal Neuralgia

Back 1254

Art > vein compressing CN5 root...tx: CARBAMAZEPINE

Front 1255

rx that cause hemolysis

Back 1255

BACTRIM and PRIMAQUINE DT G6PD def

Front 1256

blunting of villi and hx is travel...dx...triad...to dx

Back 1256

Tropical Sprue... sx: triad (sore tongue, diarrhea, weight loss)... malab: steatorrhea,to dx: Dxylose absorp nl >90% case... histo (shot villi, lengthed cryps, changes in surface epith, infl cell infiltrate of lcy, plasma and eosinophils)...tx: TETRACYCLINE

Front 1257

TTP pentad? Lab

Back 1257

1) severe dec platelets, 2) Microangiopathic hemolytic anemia (RBC fragments), 3) neuro signs, 4) renal failure, 5) fever... lab: inc : LDH; PT/PTT nl

Front 1258

HUS vs TTP

Back 1258

HUS like TTP without neuro...tx: both PLASMAPHESIS

Front 1259

dx ITP

Back 1259

isolated dec in platelet count...

Front 1260

init sx of TS... on CT...tx

Back 1260

seizure... sx: cutaneous anomaly: ADENOMA SEBACEUM (5-10yrs)... first yrs of life: symmetrical infantile spasms...ash leaf (hyperpig) and cortical tubers...tx: IM ACTH!!

Front 1261

tx broad spectrum abx

Back 1261

GENTAMYCIN + CLINDAMYCIN + AMP...if not work = laparotomy possible abscess

Front 1262

tx Tumor Lysis syndrome?...lab?

Back 1262

allopurinol... lab: hypoCa, hyperPhosph (from inside cell cause dec extracellCa), hyperK, hyperUric

Front 1263

turcot assoc with...type...assoc

Back 1263

BRAIN (meduloblastoma, gliomas), FAP or HNPCC...AR and in teens...

Front 1264

GARDNER … assoc … type

Back 1264

AD...

Front 1265

Peutz Jegher type... assoc w/

Back 1265

AD... cutaneous melanocytic macules

Front 1266

Multiple Hemartoma syndr assoc w/

Back 1266

GIT hematoma, breast CA, thyroid CA, gingiva hyperplasia

Front 1267

no fxnal ovaries or estrogen...DT

Back 1267

Turner syndrome (streaked ovaries)

Front 1268

if Turner with XY, next?

Back 1268

bilateral gonadectomy (inc risk of gonadoblastoma)

Front 1269

Toxic megacolon seen in and tx

Back 1269

UC...tx with: IV steroids, NG decompress, and fluid....if remove colon, need scope 8 yrs later

Front 1270

MCC esophageal ulceration in HIV? vs. Herpes?

Back 1270

CMV...triad (substernal burn w/ odynophagia, shallow ulcers, IC inclusion) / Gang tx...HERPES: many, well circumscribed like volacnoes

Front 1271

variable decel DT

Back 1271

umbilical cord compression... FETAL head compression: early decel

Front 1272

Umbilical hearnia tx?

Back 1272

most gone by 1yr... when to surg? If 3-4yo, >2cm, sx, strangulation

Front 1273

Triad of urethral injury

Back 1273

1) blood at meatus 2) can't void 3) distended bladder..

Front 1274

anterior vs. posterior urethral injury

Back 1274

A: (ant to perineal membr) / DT: trauma like saddle / tx: surgery now...P: (prostate urethra and membr urethra) / high riding prostate/pevic fracture/tx: RETROGRADE URETHROGRAM then SUPRAPUBIC cath

Front 1275

tx URETHRAL vs. BLADDER injury

Back 1275

urethral (post) = suprapubic cath after retrograde urethrogram...Bladder: urethrogram with post void film

Front 1276

what makes urine alkali?

Back 1276

Proteus (makes urease)

Front 1277

if female uti not better with BACTRIM, dx?

Back 1277

C. Trachomatis (friable cervix and dc)

Front 1278

Chlamydia urethritis discovered how?

Back 1278

dysuria for 7d and not better with tx for chlamydia CYSTITIS

Front 1279

MCC red eye in akylo spond

Back 1279

UVEITIS

Front 1280

Vaginismus DT?

Back 1280

mental...tx: relax, KEGEL, gradual dilation (penetration)

Front 1281

vag candida can be DT, lab, tx

Back 1281

besides stuff like DM...Alkali pH of vag during menses (favors Candida growth)... tx: cottage cheese appearance...lab: NO SMELL, ph 4-5.5... dx by wet KOH... tx: IMIDAZOLE cream or FLUCONAZOLE

Front 1282

Vericose vein → ulcers where

Back 1282

medial malleolus

Front 1283

varicose v. VS Art Insuff

Back 1283

AI: pain worse by leg elev (V: if leg raise, it goes away)...AI: ulcers are deep and more distal , NO SWELLING, but loss hair/muscle atrophy

Front 1284

Art Insuf vs. DM ulcers

Back 1284

DM: at pressure points

Front 1285

DVT ulcers vs. others

Back 1285

D: takes years to dev and UNLIKLEY in ACTIVE pts

Front 1286

Vasa Preva lab, to dx, tx

Back 1286

Hemarrage → baby HR tach to brady → sinosoidal.... high death rate... dx w/ Transvag US w/ Doppler...tx: CSECTION

Front 1287

pt with Vtach, next?

Back 1287

1) Amiodarone...2) if recurrent look for cz...MCC: DIURETICS (lasix → hyPOK) 3) oder electrolytes and correct them! (K)

Front 1288

Vfib tx

Back 1288

1) defib, if not 2) lidocaine or amiodarone 3) EPI can be tried to lower treshold for conversion

Front 1289

VERAPAMIL tox and tx

Back 1289

Bradycardia and hypoT, AV block, cardiac arrest... tx: IV saline first, Ca Cl to reverse CBB effects

Front 1290

what is vesicourethral reflux

Back 1290

Urine → bladder and ureter and pelvis (uti and scar)...Renal scar is MCC RENAL FAIL in kids...dx: voiding cystourethrogram

Front 1291

diarrhea, hypoK → leg cramp, dec acid in stomach...wight loss, face flush...dx

Back 1291

VIPoma...dx: VIP in blood high...tx: IV for dehydra, OCTREOTIDE for diarrhea, surg

Front 1292

vit K lab

Back 1292

dec PT and coag factors

Front 1293

vWF lab

Back 1293

Bleed inc, PTT inc...PT ok... low F8

Front 1294

liver dz labs

Back 1294

PT inc...everythin ok

Front 1295

ITP labs

Back 1295

dec platelets...everything ok

Front 1296

MCC vit D def Vs. HyperPTH and PseudoPTH

Back 1296

MCC Malab → dec Ca and dec Phosph... H&P: dec Ca but dec Phosph...

Front 1297

sx of vitD def in kids, path

Back 1297

soft and deformed bone... low birth weight, dark skin, breast fed kid...path: defective MINERALIZ

Front 1298

costochondral jxn, wrist/ankle thick...XR: cupping and frying distan ulnar /rad, dx?

Back 1298

rickets (vit D)

Front 1299

Photophobia, dermatitis, anemia

Back 1299

B2 deficiency riboflavin

Front 1300

3D

Back 1300

Niacin

Front 1301

kid and adult BeriBeri

Back 1301

B1 (thiamine)

Front 1302

sx wet beriberi

Back 1302

Neuro + cardiac

Front 1303

sx dry beriberi

Back 1303

sym periph neuro with sensory and motor prob

Front 1304

pale mough and areola... assoc with

Back 1304

Vitiligo:...assoc: Pernicious, Graves, DM1, alopecia areata

Front 1305

sudden no vision, floaters, hard to see fundus...dx...assoc w/

Back 1305

Vitreous Hemrrhage...MCC: DM retinopathy

Front 1306

3 types of eye bleed and diff

Back 1306

1) conjunctiva (small trauma like sneeze, no tx gone in 2weeks)...2)Vitreous (black reflex, retinal v occlusion)... 3) Retinal Hemorrhage (flame shaped in HTN, dot/blot in DM or septic)

Front 1307

Whats on the radio of supracondylar fx

Back 1307

displaced ant fat pad

Front 1308

Volkdman's ischemic contracture define

Back 1308

Volkmann's contracture results from acute ischaemia of the muscles of the forearm. It is caused by pressure on the brachial artery, possibly from improper use of a tourniquet, improper use of a plaster cast or from compartmental syndrome. It is commonly described in supracondylar fracture of the humerus where it results in injury/occlusion of the brachial artery.

Front 1309

If <1 mo, billious vomit, blood stool, abd distended

Back 1309

Volvulus midgut...sx: irritable but NO PAIN

Front 1310

Hirrschprung vs. meconium ileus

Back 1310

H: no stool (Down)...M: no meconium

Front 1311

VSD closure?

Back 1311

40% close by 3yrs, 70% by 10... need IE prophy...permanent if large (soft murmur) so need surg now or else irreversible

Front 1312

Describe Vulvur Hypertrohphy dystrophy and peeps

Back 1312

thick, hyperkeratotic...DT long term scratching... in PM women

Front 1313

Vulvar Papillomatosis aka and DT

Back 1313

aka Condyloma Acuminata... DT: HPV 6,11 (cauliflower)

Front 1314

Waldernstrum Macroglobulinemia...MOA...lab...sx..

Back 1314

Chronic plasma cell neoplasm...MOA: mult and invade BM, spleen, LN-> xs IgM → viscosity...sx: ing size spleen, liver, LN, tired

Front 1315

Walden Vs. MM

Back 1315

MM: Ig A/G not IgM / no hyperviscosity....W: IgM

Front 1316

Warfarin induced skin necrosis DT and occur when

Back 1316

prot C deficiency...w/n weeks...tx: give viK and stop warfarin if worsen, now give heparin until lesions heal

Front 1317

pt on warfarin now need emergency surgery, next

Back 1317

FFP

Front 1318

Febrile rxn DT...and tx

Back 1318

transfusion rxn DT ab in pt's plasma vs. Donor's leukocytes...prevent by: leuk dec technique like CELL WASHING...this is a NON-hemolytic rxn

Front 1319

sudden vasomotor collapse and rash

Back 1319

Waterouse friedricksen--> adrenal just hemorrhaged

Front 1320

Wegener triad...assoc...lab...XR...

Back 1320

bloody pee, bloody vomit, sinusiti...MOA: necrotizing vasculitis w/ granuloma... CANeutrophilicCA...XR: nodular cavities...

Front 1321

Wednig Hoffman...type...MOA...like what

Back 1321

AR...degen ant hor cells and CN nuclei...floppy baby

Front 1322

COAT stands for

Back 1322

confu, opthal, atax, thiamine defic

Front 1323

cheilosis and glossitis DT

Back 1323

riboflavin (B2)

Front 1324

Cz of Whipple dz...sx...to dx...if unx...tx?

Back 1324

T. Whippelli...joint pain/stomachpain/diarrhea/lose weight/skin hyperpig...todx: PAS+ microphage w. glycoprot seen in bx of small int...if untx: progressive and fatal...tx: Procaine PenG then TETRA

Front 1325

diff btw bact overgrowth and Whipple dz

Back 1325

Xylose absorb dec in both... but becomes nl after abx

Front 1326

pneumothorax, subconjuntival hemorrage, prolapse...dx

Back 1326

Whopping...tx: ERYTHRO + anticough

Front 1327

MC primary kidney tumor in kids..dx and age

Back 1327

Wilms...2-5yr...80% big abd mass...tx: nephrectomy

Front 1328

Wilms vs. Neuroblastoma

Back 1328

N: <1 yo, usually have HTN, crosses midline and dx w/ urine catechol products, from NEURAL CREST CELLS... W: 2-5yo, from METANEPHRONS

Front 1329

lab for Wilson's

Back 1329

dec CERULOPLASMIN, inc URINE copper, SLIT LAMP of eye...liver: MALLORY hyaline...basal ganglia (HEPATOLENTICULAR)..dx after 1yo (most kids have high Copper first 3 months)..tx: PENICILLAMINE, fulminant need LIVER TRANSPLANT

Front 1330

age for Wiskott Aldrich

Back 1330

within first year...sx: first bleeding episodes then pyogenic infxn...low IgM but AG nl...bad: can't make response vs. polysacc Ag...

Front 1331

Wisckott Aldrich predisposed to

Back 1331

ALL and Hodgkins

Front 1332

Age of Chronic GD and dx?

Back 1332

<2...dx NEGATIVE nitroblue test means you HAVE THE DZ

Front 1333

partial albinism, neuropathies and nystagmus

Back 1333

Wiskott aldrich

Front 1334

Smith fractur

Back 1334

reverse of Colles (MC fx of distal radius in outstreteched hand)

Front 1335

MOA of Zenker

Back 1335

herniation of mucosa through CRICOPHARYNREAL muscle...to dx: BARIUM esophaGRAPHY, NOT ENDOSCPE

Front 1336

pathognomic for ZE

Back 1336

ulcers in jejunum! (even mult duod)...tx: PPI (Omeprazole) indefinitely until surg, if med fail = TOTAL GASTRECTOMY... assoc w: MEN1(HyperPTH, Pit tumors)

Front 1337

Placenta Prev. VS. Abruptia placenta

Back 1337

PP: if no bleed, can't be...AP: if no blood, CAN be and PAIN

Front 1338

MCC DIC in preg

Back 1338

Placenta Abruptio (DT replease thromboplastin)

Front 1339

RITODRINE CI in?

Back 1339

HTN peeps (esp pregos)...moa: it's a B2 agonist, a tocolytic

Front 1340

best for AIRWAY

Back 1340

in ER: orotrachial intubation...in field: needle crico...if unconscious = chin lift

Front 1341

if can't do IV, next

Back 1341

Saphenous cutdown...interosseous in kid

Front 1342

Gingival hyperplasia, LN, hirsu...SE of

Back 1342

Valproic Acid

Front 1343

EEG symmetric 3hz spike and wave

Back 1343

Abasense seiz

Front 1344

SE is Stephven johnson?

Back 1344

Phenytoin and Carbamazepine

Front 1345

Cough is SE of and DT?

Back 1345

ACEI...DT: inc Kenin (are degraded by ACE)

Front 1346

if acute acetaminophen tox, can use?

Back 1346

ETOH (competes for same liver enz) → less toxic metabolites

Front 1347

Chronic etoh users inc acetaminophen tox DT

Back 1347

dec Glutathione (metabolizes acetaminohen)

Front 1348

how to tx ACETAMINOPHEN tox

Back 1348

1-4hrs: AA levels.....if>7.5 grams and level not avail for 8hrs...tx with NAC

Front 1349

ACETAZOLAMINDE tox (acid base)?

Back 1349

NAG metab acidosis (DT renal loss bicarb)

Front 1350

gliding tibia under femur?

Back 1350

ACL (hyperextension injury)

Front 1351

Lachman test for

Back 1351

ACL

Front 1352

Valgus test for

Back 1352

Medial collateral ligament

Front 1353

McMurray

Back 1353

Meniscus injury

Front 1354

Yellow sulfur granules, NO PAIN, mass that drain...dx, DT, tx

Back 1354

Actinomycosis...DT Actinomycosis Israellii...tx: IV Pen for 6-12 weeks, surgery debride after abx

Front 1355

ingest lye, next

Back 1355

Upper GI CONTRAST ASAP to see if perf!!!

Front 1356

dx Angiodysplasia?

Back 1356

painless...labeled RBC scintigraphy

Front 1357

Acute rejection of kidney histo... tx

Back 1357

histo:lcy and vasc swellng, inc Bun/Cr, oliguria...tx: high dose STEROIDS IV

Front 1358

prolonged hypoT →

Back 1358

ATN (Muddy brown granular cast)...

Front 1359

RBC cast

Back 1359

GN

Front 1360

WBC cast

Back 1360

Interstitial Nephritis....Pyelonephritis

Front 1361

Fatty cast

Back 1361

Nephrotic syndr

Front 1362

Broad and waxy cast

Back 1362

CRF