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535 Cards in this Set
- Front
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akathisia treatment?
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beta blockers
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fluvoxamine
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SSRI
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phenelzine
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MAOI
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buspirone
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anti-anxiolytic
OCD GAD |
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Vit B3 deficiency
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3 D's:
diarrhea dermatitis dementia |
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PTSD Tx.
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SSRI + exposure
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Child with high fever and bloody diarrhea
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Shigella
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MC cause of atypical pneumonia and Tx.
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mycoplasma
tx: macrolide (ie - azithromycin) |
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EEG shows 3 per second spike and wave discharges
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absence seizure
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urine pH in calcium oxalate v. calcium phosphate stones
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calcium oxalate: acidic
calcium phosphate: alkalotic |
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radiolucent stones
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uric acid
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gout crystals
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needle shaped
strong neg. birefringence yellow / |
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c-ANCA
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Wegeners
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Wegeners
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c-ANCA
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anti-tissue transglutaminase
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Celiac Disease (gluten allergy)
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anti-mitochondrial
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primary biliary cirrhosis
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anti-topoisomerase
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systemic sclerosis
scleroderma |
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anti-centromere ab's
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CREST
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History of gardening and presentation with a painful, ulcerated nodule
Tx.? |
Sporotrichosis
Tx.: itraconazole |
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double bubble on xray
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intestinal atresia
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DEXA scan - what age?
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65
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most common cause of epididymitis in patients under 35
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chlamydia
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myokymia
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involuntary eyelid contractions caused by pressure on facial nerve
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______ bone somatic dysfunction results in pressure exerted on the facial nerve
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temporal
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Gastric ulcers are more common in what blood type?
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A
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duodenal ulcers are more commonly found in what blood type?
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O
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epidural hematomas are caused by rupture of _____
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middle meningeal artery
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head injury common in MVAs and blows to the head
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epidural hematoma
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head injury common in alcoholics and the elderly
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subdural hematoma (rupture of bridging veins)
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subdural hematoma caused by rupture of _______
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bridging veins
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Tx. epidural hematomas
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emergent surgery evacuation
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small cell lung carcinoma + proximal muscle weakness and hyporeflexia
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Lambert-Eaton Myasthenic Syndrome
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Classic triad:
1. vertigo 2. tinnitus 3. hearing loss |
Meniere's Disease
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Classic triad:
1. neutropenia 2. rheumatoid arthritis 3. splenomegaly |
Felty's Syndrome, often, thrombocytopenia and anemia too
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prolonged bleeding time and PTT
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von Willebrand's disease
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allergic rhinitis +
p-ANCA + astham + blood eosinophilia = |
Churg-Strauss
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infant born with clenched fists
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Trisomy 18 (Edward's)
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infant born with polydactyly
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Trisomy 13 (Patau's)
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most common cause of fever during the postpartum period
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endometritis
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when to start fertility workup?
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after trying for one year
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social phobia treatment: short term and long term
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short term: beta blockers
long term: ssri's |
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Classic triad:
1. nystagmus 2. ataxia 3. confusion |
Wernicke's encephalopathy
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BMI considered overweight
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>24.9
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Tx. for OCD
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CBT + clomipramine or SSRI
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flumazenil
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tx. for benzo OD
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malignant hyperthermia
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rxn to anesthetic agents
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congenital hearing and visual loss, petechiae, seizures, cerebral calcifications
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CMV
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congenital intracranial calcifications (basal ganglia), chorioretinitis, and hydrocephalus
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toxoplasma gondii
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Hutchinson's teeth, interstitial keratitis, and rash
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syphilis
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birth: cataracts, hearing loss and cardiac defects
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rubella
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linear reticular opacities and pleural plaques
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asbestosis
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nodular opacities in the upper lobes
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silicosis
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how to monitor heparin
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PTT (intrinsic)
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how to monitor warfarin
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PT (extrinsic)
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advantage of heparin over LMWH?
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heparin can be monitored with PTT; LMWH does not affect coags
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translucent, pearly papule with telangiectasias
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basal cell carcinoma
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most common lung cancer in the world
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pulmonary adenocarcinoma
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patients over 30, bone marrow biopsy reacts with myeloperoxidase and sudan black, associated with auer rods
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AML
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prophy for meningitis contacts
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rifampin or cipro - eradicate nasopharyngeal foci
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seborrheic dermatitis in newborns
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cradle's cap
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osteophytes seen at DIP
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Heberdeen's nodes
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osteophytes seen at PIP
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Bouchard's nodes
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ascitic fluid is found to have a polymorphonuclear (PMN) leukocyte count greater than 250/mm^3
Tx.? |
SBP - cefotaxime or another 3rd gen cephalosporin
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sialorrhea
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drooling
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Cullen's sign
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ecchymoses of periumbilically
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Fox's sign
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inguinal ecchymoses (hemorrhagic pancreatitis)
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Grey Turner's sign
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flank ecchymoses (hemorrhagic pancreatitis)
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Auspitz's sign
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psoriasis - pinpoint bleeding after removal of scale
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obturator sign
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appendicitis
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Courvoisier's sign
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non tender palpable GB - pancreatic CA
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Trousseau's syndrome
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migratory thrombophlebitis - pancreatic CA / lung CA
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What toxicity is associated with tremulousness, confusion, dysarthia, dystonia, hyperreflexia, and ataxia.
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Lithium
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When does scoliosis cause resp. compromise?
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> 50 degree angle
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When does scoliosis cause CV compromise
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> 75 degree angle
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dermatitis herpetiformis tx.
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dapsone
gluten-free diet |
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First line treatment for fibromyalgia
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desipramine and amitriptyline (TCA's)
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c-ANCA (Wegeners) are autoantibodies against _____.
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proteinase 3
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p-ANCA are autoantibodies against _____.
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myeloperoxidase
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hyper lipoproteinemia Type IIa
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increased LDL
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hyperlipoproteinemia Type IIb
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increased LDL + VLDL
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hyperlipoproteinemia Type IV
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increase VLDL
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Response to osteomyelitis is monitored with ________.
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ESR and CRP
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pathophys of myasthenia gravis
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auto-Ab's against nicotinic post-synaptic acetylcholine receptors
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white patches on the retina
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cotton wool spots - DM or HTN
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arteriovenous nicking
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HTN
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pallor of optic disc
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glaucoma
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optic disc margin blurring
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papilledema
intracranial mass |
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Tx. for uncomplicated PUD assoc. H. pylori
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omeprazole
metronidazole clarithromycin |
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CXR "egg-on-a-string"
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transposition of the great vessels
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Gottron's papules
|
erythematous, scaly papules found over the dorsum of the PIP and MCP joints
dermatomyositis |
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Apt test
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non-invasive test to differentiate fetal or neonatal blood from maternal blood by checking hemoglobin
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protamine
|
antidote for heparin
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flumazenil
|
antidote for benzodiazepines
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PAS-positive macrophages
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duodenum of pts. with Whipples disease
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quantitative test used to assess the severity of fetal-maternal hemorrhage so that the correct dosage of Rho(D) immune globulin may be administered
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Kleihauer-Betke
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What deficiency is associated with alopecia, dermatitis, nausea/vomiting, and depression?
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Biotin
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2cm hepatic tumor with central scar
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focal nodular hyperplasia - no worries!
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koilonychia
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spoon nails
iron deficiency |
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Deficiency of what essential trace element causes hyperglycemia?
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Chromium - insulin requires it
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________ deficiency is assoc esophageal webs.
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iron deficiency
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________ is mandatory after Strep bovis endocarditis.
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Colonoscopy, assoc colorectal cancer
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The combination of hyponatremia, low serum osmolality, and low urine volume is the hallmark of ______.
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SIADH - Tx. fluid restriction
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dacryocytes
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tear drop RBC's
seen in myelofibrosis and thalassemias |
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target RBC's
|
thalassemias
autosplenectomy 2 to SCD iron deficiency |
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singultus
|
hiccups
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xanthrochomia
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subarachnoid hemorrhage
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most common causes of drug induced lupus
|
hydralazine
procainamide quinidine isoniazid |
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most sensitive test for drug induced lupus
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anti-histone antibodies
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EMG showing high frequency action potentials along with fibrillations
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polymyositis
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glucagonomas
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necrotizing migratory erythemas
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necrotizing gastritis
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gangrenous infection of the stomach often caused by B. cereus
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spelunking
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histoplasmosis
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treatment of unstable angina and NSTEMI
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MONAH + B
Morphone O2 Nitrates ASA Heparin Beta blockers |
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dx. lactose intolerance
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hydrogen breath test
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night time perianal pruritus
cause dx tx |
enterobius vermicularis (pinworm)
dx.: scotch tape test tx. mebendazole |
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female puberty
|
thelarche
growth spurt -OR- adrenarche menarche |
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male puberty
|
adrenarche
testicular enlargement growth spurt |
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FHT sinusoidal pattern
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fetal anemia
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TCA SE's
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anticholinergic: dry mouth, drowsy, constipation, urine retention
sedating |
|
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first line treatment for ascites
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spironolactone and furosemide
|
|
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treatment for hepatic encephalopathy
|
lactulose
|
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prosopragnosia
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inability to recognize faces - PCA infarct
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MC cause of meningitis from
1. new born - 3 mos. 2. 3 mos - 9 years 3. teenagers |
1. GBS
2. S. pneumo 3. N. meningitis |
|
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test of choice for myasthenia gravis
|
acetylcholine receptor antibody test
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initial test for ALL patients presenting with syncope
|
EKG
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tx. for perforated peptic ulcers for people <70y/o and people >70y/o
|
conservative
surgery |
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tx. for aspiration pneumonia/abscess
|
clindamycin
|
|
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anti-insulin antibodies, decreased C-peptide, and decreased proinsulin levels
|
factitious hypoglycemia
|
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low risk mothers - amt of folic acid per day?
|
0.4 mg
|
|
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high risk mothers - amt of folic acid per day?
|
4 mg
|
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Hemodynamically unstable patients with V tach
|
DC cardioversion
|
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common causes of dilated cardiomyopathy
|
alcohol
cocaine doxorubicin |
|
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what vitamin can decrease m&m of measles?
|
A
|
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when is measles contagious?
|
5 days before and four days after the rash
|
|
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The most common cause of prosthetic valve endocarditis after 12 months of surgery
|
strep viridans
|
|
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gallstones, diabetes and steatorrhea
|
somatostatinoma
|
|
|
4 clinical features of VIPoma
|
1. water diarrhea (hypokalemia, acidosis)
2. achlorhydria (VIP inhibits gastric acid secretion) 3. hyperglycemia 4. hypercalcemia |
|
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"blue-dot" sign is present on the scrotum
|
torsion of the appendix testis
tx. bed rest, scrotal support |
|
|
most specific test for rheumatoid arthritis
|
x ray - joint space narrowing and erosions.
|
|
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What electrolyte abnormality causes prolonged QT interval?
|
hypocalcemia
|
|
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What electrolyte abnormality causes shortened QT interval?
|
hypercalcemia
|
|
|
most common cause of renal stenosis in 1. younger adults and 2. older adults
|
1. fibromuscular dysplasia
2. atherosclerosis |
|
|
gold standard in the diagnosis of endometriosis
|
laparoscopy
|
|
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Glucagonomas arise in the _____ cells of the pancreas.
|
alpha
(necrotizing migratory erythema!) |
|
|
pancreatic alpha cells
pancreatic beta cells pancreatic delta cells |
alpha: glucagonomas
beta: insulinomas delta: somatostatinomas |
|
|
Treatment of Generalized Anxiety Disorder (6 mos)
|
CBT with venlafaxine, buspirone, or SSRI's
|
|
|
MC fibroids
|
intramural
|
|
|
type of fibroids that leads to infertility
|
submucosal fibroids
|
|
|
Tx. of fibroids
|
1. GnRH agonists to reduce size
2. hysterectomy/myomectomy |
|
|
RhoGAM is administered to all Rh-negative women at ___ weeks' gestation
|
28
unless father is also Rh negative |
|
|
Diagnosis of small bowel obstruction
|
H&P
xray |
|
|
lymph node that is painless but alcohol may precipitate pain
|
Hodgkins lymphoma
|
|
|
Reed Sternberg cells
|
Hodgkins lymphoma
|
|
|
hyponatremia, low serum osmolality, and low urine volume
|
SIADH
|
|
|
Treat acute exacerbations of MS
|
high dose IV corticosteroids
|
|
|
neurological deficiencies separated by time
|
MS
|
|
|
most specific tests for systemic lupus erythematosus
|
anti-Sm Ab and anti-ds DNA
|
|
|
When is bed wetting not okay?
|
5
|
|
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Once a patient is ____ years of age or older, the minor may consent to his/her treatment of sexually transmitted disease or for abuse of alcohol or narcotic drugs.
|
12
|
|
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painless, bright red bleed per rectum and anal pruritis
|
external hemorrhoids
|
|
|
eczema, immunodeficiency, and thrombocytopenia
|
Wiskott-Aldrich - autoimmune defect in platelets
|
|
|
SBP ascitic fluid has a PMN count _____.
MC organism? |
>250
MC organism : e. coli |
|
|
MC cause of acute pancreatitis:
|
gallstones
|
|
|
MC cause of chronic pancreatitis:
|
alcohol
|
|
|
diabetes, steatorrhea, and pancreatic calicifications on CT scan
|
chronic pancreatitis
|
|
|
are associated with rash development in patients with infectious mononucleosis
|
amoxicillin and ampicillin
|
|
|
First line treatment for allergic rhinitis
|
intranasal glucocorticoids
|
|
|
The most common causes of prosthetic valve endocarditis within 1 year of surgery are
|
Staph aureus
Staph epidermis |
|
|
the most common cause of native valve endocarditis
|
Strep viridans
|
|
|
slurred upstroke in the QRS complex
|
delta wave - WPW
|
|
|
Accidental ingestion may cause CNS depression bradycardia and heart block; usually include disturbances in color vision with a tendency towards yellow-green coloring
|
digoxin
|
|
|
causes Torsade de pointes and tinnitus, flushed skin, CNS disturbance,
Tx.? |
quinidine
Tx. IV mag |
|
|
CNS depression and respiratory/cardiac arrest, "an almond-like odor in the breath"
Tx.? |
cyanide
Reverse with amyl nitrite. |
|
|
Methanol and ethylene glycol poisoning are treated with
|
fomepizole
|
|
|
normal vaginal pH
|
3.8 - 4.5
|
|
|
elevated vaginal pH (alkalotic)
|
BV and trich
|
|
|
BPH + symptoms of urinary tract infection.
|
consider bladder diverticula
gold: voiding cystourethrography (VCUG) |
|
|
ankylosing spondylitis
|
IBD (Crohn's and UC)
|
|
|
prevents airway inflammation by inhibiting mast cell degranulation
|
cromolyn
|
|
|
Thiazide diuretics:
1. Ca 2. Na 3. K |
1. hypercalcemia
2. hyponatremia 3. hypokalemia |
|
|
mainstay treatments for variant (Prinzmetal's) angina
|
nitrates and CCB's (nifedipine, amlodipine, verapamil, and diltiazem)
|
|
|
IV medications that can be used to hypertensive emergencies include:
|
nitroprusside, nicardipine, clevidipine, labetalol, fenoldopam
|
|
|
tx. for sleep maintenance insomnia
|
estazolam, flurazepam (benzo)
|
|
|
tx. for sleep onset insomnia
|
zolpidem (hypnotic)
|
|
|
Elevated calcitonin is associated with
|
medullary carcinoma of the thyroid. Calcitonin lowers serum calcium levels
|
|
|
porcelain GB
|
GB cancer
|
|
|
postoperative patient who presents with hypotension, shock and hyperkalemia
|
secondary (iatrogenic) hypoadrenalism
|
|
|
positive birefringence
|
pseudo gout
|
|
|
negative birefringence
|
gout
|
|
|
the most important diagnostic tests in the emergency department setting for patients suspected of having tuberculosis.
|
sputum staining for acid-fast bacilli
CXR |
|
|
pulmonary lesions located:
- posterior seg of the right upper lobe - apicoposterior seg of the left upper lobe -apical segs of the lower lobes |
classic reactivation TB
|
|
|
CXR: lobar pneumonia with ipsilateral hilar adenopathy
|
primary active TB
|
|
|
presence of autoantibodies directed against adhesion molecules (specifically desmoglein 3) in the epidermis
|
pemphigus vulgaris
|
|
|
autoantibodies to the epidermal basement membrane
|
bullous pemphigoid
|
|
|
Hyperarrythmia EEG pattern
|
infantile spasms assoc. tuberous sclerosis
|
|
|
useful in the treatment of deep and aching pain associated with post-herpetic neuralgia.
|
amitriptyline
|
|
|
Vitamin B1
|
thiamine - Wernicke's
|
|
|
always give _____ prior to glucose as this condition can be elicited by high-dose glucose administration
|
thiamine - Wernicke's
|
|
|
prolonged PR intervals, depressed (scooped) ST segments, and alterations in T wave morphology
|
digitalis toxicity
|
|
|
Electrolyte abnormality useful as a predictor of morbidity and mortality in patients suffering from acute digitalis toxicity.
|
hyperkalemia
|
|
|
Perform _______ in children who aspirate foreign objects such as nuts and coins.
|
rigid bronchoscopy
|
|
|
anti-Saccharomyces cerevisiae antibodies
|
Crohn's disease
|
|
|
Crohn's v. UC: p-ANCA
|
UC
|
|
|
Salicylate toxicity initially manifests with
|
dizziness and tinnitus
|
|
|
salicylate toxicity: ABG would show?
|
mixed metabolic and respiratory acidosis
|
|
|
usually follows a viral illness and presents as a “stocking/glove” peripheral neuropathy which progresses from distal to proximal.
|
GBS
|
|
|
cause of hypercalcemia in sarcoidosis
|
high vit D
|
|
|
decreasing vagal tone in the bronchioles through antagonism of muscarinic receptors
|
ipratropium (atrovent)
|
|
|
works by potentiating exogenous catecholamines and stimulates release of endogenous catecholamines, causing diaphragmatic relaxation and bronchodilation
|
theophylline
|
|
|
Zafirlukast
|
“leukotriene receptor antagonists”; useful for the prophylaxis of exercise-induced asthma, as well as for the long-term treatment of asthma (as an alternative treatment to lose-dose corticosteroids)
|
|
|
corticosteroid that produces direct smooth muscle relaxation and alters inflammatory cell activity, resulting in decreased airway hyperresponsiveness.
|
budesonide (pulmcort)
|
|
|
AIDS patients exposed to turtles and chickens are at high risk for
|
Salmonella
|
|
|
gold standard diagnosis of urethral injury
|
retrograde urethrogram
|
|
|
________ toxicity can present as community-acquired pneumonia that is unresponsive to antibiotic therapy.
|
Amiodarone
|
|
|
Eustachian tube dysfunction in patients with acute otitis media is frequently associated with ____ rotation of the involved _____ bone.
|
internal
temporal |
|
|
First line prophylaxis for Traveler’s diarrhea is ?
|
Quinolones such as Ciprofloxacin or Norfloxacin.
|
|
|
Infections that would require reassignment of a pregnant worker include the following:
|
parvovirus B19,
measles, varicella, rubella |
|
|
most commonly elevated enzymes in patients with dermatomyositis.
|
creatinine kinase
aldolase |
|
|
The most common cause of sudden death in the first 24-hours following an acute MI is ?
|
arrhythmia.
|
|
|
____ is the first step in patients suspected of testicular torsion.
|
Ultrasound
|
|
|
erythema infectiosum
|
parvovirus B19
|
|
|
generalized lymphadenopathy, an erythematous and tender maculopapular rash, and polyarthritis
|
rubella
|
|
|
treatment of choice for a non-ruptured ectopic pregnancy.
|
laparoscopy
|
|
|
Surfactant ________ surface tension, preventing alveolar collapse
|
lowers surface tension
|
|
|
What secretes surfactant in the lungs?
|
Type II pneumocytes
|
|
|
MC cause of Addison's disease worldwide:
|
TB!
(in the West, autoimmune) |
|
|
hyperkalemia, hyponatremia, hypoglycemia and hypotension
|
adrenal failure / Addison's
|
|
|
euvolemic hyponatremia that most commonly presents without edema or changes in blood pressure.
|
SIADH
|
|
|
pleural effusion is assoc.
|
CHF
|
|
|
classical criteria for dx'ing ARDS
|
1. hypoxemia refractory to O2 therapy; PaO2/FiO2 < 200
2. b/l diffuse pulm infiltrates on CXR 3. no evidence of CHF: PCWP < 18 mmHg |
|
|
proptosis
pretibial myxedema |
Graves disease
|
|
|
Germinal centers in the thyroid gland
|
Hasimoto's thyroiditis
|
|
|
Chapman’s point for the urethra
|
superior margin of pubic ramus
|
|
|
Child with a palpable sausage-like mass on physical examination.
|
intussusception
|
|
|
bitter almonds
|
cyanide
|
|
|
most common ophthalmic complication in patients undergoing surgery under both general and MAC anesthesia
|
corneal abrasion
|
|
|
Treat impetigo empirically with _______, which will cover for both Staph and Strep.
|
a penicillin such as Dicloxacillin
|
|
|
All patients diagnosed with polyarteritis nodosa should also be worked up for _________.
|
hepatitis
|
|
|
chronic HTN
|
CHF
|
|
|
"onion skinning" of bone
|
Ewing Sarcoma
|
|
|
t(11;22) translocation
|
Ewing Sarcoma
|
|
|
Codman's Triangle
|
Osteosarcoma
|
|
|
childhood retinoblastoma is related to what bone problem?
|
osteosarcoma
|
|
|
"soap bubble" multiple lytic lesions in the bone
|
Giant cell tumor of the Bone
|
|
|
Heyde’s syndrome
|
characterized based on the combination of calcific aortic stenosis and GI bleeding due to colonic angiodysplasia
|
|
|
colonic angiodysplasia
|
calcified aortic stenosis
|
|
|
Medial tibial stress syndrome
|
shin splints
|
|
|
Whenever tympanic membrane perforation is suspected, ________ becomes the treatment of choice.
|
ofloxacin otic
|
|
|
Pneumonia in a 74-year-old male with metastatic lung cancer being treated with chemotherapy in the intensive care unit and on a ventilator for 10 days. Tx.?
|
Classic nosocomial pneumonia
Pseudomonas: imipenem + gent G+: vanc |
|
|
Pneumonia in a 52-year-old female with a history of chronic aspiration, producing foul smelling sputum. Tx.?
|
aspiration pneumonia
oral anaerobes: Clinda |
|
|
Pneumonia in an 88-year-old female who is a resident of a nursing home and has been hospitalized several times in the past year. Tx.?
|
Nosocomial infx.: imipenem, gent, vanc (G+)
Community acquired (mycoplasma): azithro |
|
|
Pneumonia in a 37 year old male with a history of IVDA, and foul smelling sputum.
|
Aspiration pneumo: clinda
IVDA: vanc |
|
|
bisacodyl
|
laxative
|
|
|
recurrent painless second-trimester spontaneous abortions due to Mullerian duct abnormalities
|
in utero exposure to DES
|
|
|
________ renal stones are caused by a genetic defect in amino acid transport and are associated with acidic urine.
|
Cystine
|
|
|
basic urine pre-disposes to what kind of stones?
|
calcium oxalate
struvite |
|
|
acidic urine pre-disposes to what kind of stones?
|
calcium phosphate
uric acid stones cystine stones |
|
|
___ and ___ are preferred in the treatment of isolated systolic hypertension (common in older ppl 2 to rigidity of arterial walls).
|
Thiazide diuretics and calcium-channel blockers
|
|
|
Wheezing after the ingestion of ASA is due to inhibition of _______, which increases _____ synth and results in _____.
|
Wheezing after the ingestion of aspirin is due to inhibition of COX enzyme, which increases leukotriene synthesis and results in bronchoconstriction.
|
|
|
a form of strabismus in which one, or both, eyes turn inward giving rise to a “cross-eyed” appearance.
|
esotropia
|
|
|
a condition where the eyes do not properly align, most commonly occurs due to imbalance of the EOMs, which prevents normal binocular vision and impedes proper depth of perception.
|
strabismus
|
|
|
bleeding into the anterior chamber most commonly due to blunt trauma of the eye.
|
hyphema
|
|
|
vaginal bleeding in between menstrual cycles.
heavy bleeding during menses |
metrorrhagia
menorrhagia |
|
|
Symptomatic abnormal uterine bleeding: Tx.?
|
should be treated with IV estrogen followed by admission to the hospital with subsequent D&C.
|
|
|
Innervation:
Tibialis anterior Peroneus Longus Gastrocnemius |
Tibialis Anterior: L4
Peroneus Longus: L5 Gastrocnemius: S1 |
|
|
most likely cause of esophagitis in AIDS patients & how to diagnose
|
Candida - pseudohyphae "branching filaments"
|
|
|
abnormal ristocetin assay
|
assay for platelet agglutination
von Willebrands |
|
|
pretibial myxedema
erythema nodosum |
pretibial myxedema - hyperthyroid
erythema nodosum - sarcoidosis |
|
|
2nd leading cause of Lung Cancer in US
|
radon gas
|
|
|
Ebstein’s anomaly is a cardiac abnormality of ____ and ____ and is commonly associated with maternal _____ therapy
|
Ebstein’s anomaly is a cardiac abnormality of the tricuspid valve and right ventricle and is commonly associated with maternal lithium therapy
|
|
|
the most commonly transmitted infectious disease acquired during the transfusion of blood products
|
hep B
|
|
|
treatment of Mycobacterium avium complex
|
oral clarithromycin
|
|
|
Tx. of CMV retinitis
|
oral ganciclovir
|
|
|
the treatment of Cryptococcal meningitis
|
IV fluconazole
|
|
|
When is chorionic villus sampling typically done?
What risk if done earlier? |
9-11 weeks
limb abnormalities |
|
|
The most common cause of postmenopausal vaginal bleeding is _____.
|
atrophic vaginitis
|
|
|
Alpha feto protein is a marker for ____
|
hepatocellular carcinoma (primary liver cancer)
germ cell tumors of the testes and ovary |
|
|
LDH is elevated in ______.
|
hemolysis and lymphoma
|
|
|
CA 19-9 is a marker for _____.
|
pancreatic cancer
|
|
|
CA-125 is a marker for _____.
|
ovarian cancer
|
|
|
CEA is a marker for ______.
|
colon cancer
|
|
|
The two most common causes of acute pancreatitis are
|
gallstones and alcoholism.
|
|
|
nephrotic syndrome
|
hypercoagulable state
|
|
|
sarcoidosis - lung manifestation
|
increased ACE
|
|
|
diabetes
estrogen increased TG's |
acute pancreatitis
|
|
|
cirrhosis, diabetes mellitus, and skin pigmentation
|
hemachromatosis
|
|
|
classic triad of hemachromatosis
|
cirrhosis, diabetes mellitus, and skin pigmentation
|
|
|
prokinetic agent that is 1st line in the treatment of diabetic gastroparesis
|
metoclopramide
|
|
|
Elevated levels of ______ result in prolonged REM and total sleep times.
|
acetylcholine
|
|
|
tender diffusely enlarged thyroid gland for several weeks
Dx? Tx? |
subacute thyroiditis
Tx: NSAIDS |
|
|
During a hysterectomy the most common location for ureter injury is the _____.
|
cardinal ligament (attaches the cervix to the pelvic wall). the ureter just lies below the uterine artery (water under the bridge).
|
|
|
_______ may present with abdominal pain, nausea, vomiting, a painful eye, and a fixed mid-dilated pupil that is nonreactive to light.
|
Acute angle glaucoma
|
|
|
_____ is a common sign of ovarian malignancy.
|
Ascites
|
|
|
best treatment for allergic rhinitis is _____
|
intranasal steroids
|
|
|
tall, thin male with hypogonadism and underdeveloped sexual characteristics.
|
Klinefelter's syndrome, XXY
|
|
|
vomiting - hyper/hypokalemia?
|
hypokalemia
throwing "everything" up - including K+ ions kidneys reabsorbing Na+ |
|
|
toilet training?
|
18-24 months
|
|
|
the two most common etiologies of subarachnoid hemorrhage.
|
Rupture of berry aneurysms and A-V malformations
|
|
|
epidural hematoma is due to the rupture of what structure?
|
middle meningeal artery
|
|
|
subdural hematoma is due to rupture of what structure?
|
subcortical veins
|
|
|
MC cause of dysphagia in HIV pts.
|
Candidiasis
|
|
|
dysphagia v. odynophagia
|
dysphagia - DIFFICULTY swallowing
odynophagia - PAINFUL swallowing |
|
|
odynophagia is a specific symptom of?
|
esophagitis
|
|
|
main diagnostic tool used for esophagitis?
|
EGD
|
|
|
Tx. of sphenopalatine ganglion
|
enhances parasympathetic activity = decreased activity of goblet cells = thinned secretions of URI
|
|
|
Tx. of celiac ganglion
|
reduce sympathetic tone @ T5-T9 (upper GI)
|
|
|
Tx. of superior mesenteric ganglion
|
reduce sympathetic tone @ T10-T11 (jejunum to mid-transverse colon AND GU tract!)
|
|
|
Rigler sign
|
presence of both inner and outer walls of the bowel on abd xray
|
|
|
Tearing chest pain c mid-scapular radiation in an elderly patient with atherosclerosis and HTN carries a high index of suspicion for Type ___ aortic dissection.
|
III
|
|
|
What electrolyte abnormality can cause an ileus?
|
hypokalemia
|
|
|
MC cause of ACUTE endocarditis
|
S. aureus
|
|
|
2 MC causes of SUBACUTE endocarditis
|
Strep viridans
Staph epidermis |
|
|
More than 50% of cases of acute bacterial endocarditis in IV drug users lead to damage of the _____ valve.
|
tricuspid
|
|
|
Bilateral transudative pleural effusions are associated with _______.
|
CHF
|
|
|
Wermer’s syndrome
|
MEN I
|
|
|
Sipple’s syndrome
|
MEN II
|
|
|
normal anion gap metabolic acidosis
|
RTA
|
|
|
normal urine pH
|
5.3
|
|
|
Diarrhea leads to a ____ anion gap ____ with a _____ urine anion gap.
|
Diarrhea leads to a normal anion gap acidosis with a negative urine anion gap (kidneys compensate for the loss of bicarbonate with excess NH4+ and CL- excretion)
|
|
|
A creatinine level above ___ is a contraindication for metformin
|
1.5
|
|
|
________ (cholesterol meds) are known to have a very bad taste and are not tolerated well by patients.
|
Bile acid resins such as cholestyramine and colestipol
|
|
|
Emphysema can lead to _____ and eventually _____.
|
Emphysema can lead to pulmonary hypertension and eventually right-sided heart failure (cor pulmonale)
|
|
|
______ has been shown to be helpful in patients suffering form dysmenorrhea.
|
sacral inhibition
|
|
|
first line therapy for dysmenorrhea
|
NSAIDS
|
|
|
What Abx has been assoc. pyloric stenosis?
|
macrolides
|
|
|
rhinocerebral mucormycosis
Tx.? SE? |
amphotericin B - nephrotoxic
|
|
|
Paronychia
|
Paronychia: infections of the nail fold can occur secondary to bacterial, fungal or viral infection and are not seen in patients suffering from psoriasis.
|
|
|
painless separation of the nail from the nail-bed; assoc. psoriasis;white area of the nail plate due to a functional separation of the nail plate from its underlying attachment to the nail bed; the defect begins distally and progresses proximally, causing a traumatic uplifting of the distal nail plate.
|
onycholysis
|
|
|
spoon nails
|
koilonychia
|
|
|
koilonychia
|
spoon nails, iron deficiency
|
|
|
Onychorrhexis
|
refers to brittle nails that are split vertically, which generates vertical ridges and gives the nail a "peeled" appearance. usually not pathologic
|
|
|
Pterygium
|
Pterygium refers to the inward advance of skin over the nail plate, usually resulting from trauma to the nail matrix due to surgery or by a deep cut to the nail plate.
|
|
|
An omphalocele is a hernia through the umbilicus that is covered by peritoneum and commonly assoc.
|
Beckwith-Wiedemann syndrome: macroglossia, macrosomia, midline abd wall defects, ear creases and ear pits, neonatal hypoglycemia
|
|
|
Beckwith-Wiedemann Syndrome
|
macroglossia, macrosomia, midline abd wall defects, ear creases and ear pits, neonatal hypoglycemia
|
|
|
MC cause of traveler's diarrhea
|
enterotoxigenic e. coli
|
|
|
Most sensitive (thus, first to be ordered) test for Giardiasis?
|
ELISA
|
|
|
Afib in WPW syndrome tx.:
1. hemodynamically unstable patients 2. hemodynamically stable patients. |
1. cardioversion
2. IV procainamide (SE: SLE) |
|
|
____ is indicated for a patient evolving from stable to unstable angina.
|
Intravenous heparin
|
|
|
Adults suffering from severe salicylate toxicity will most likely present with ____. (acid-base disturbance)
|
metabolic acidosis with respiratory alkalosis.
|
|
|
_____ is given in patients suffering from hemorrhage secondary to von Willebrand’s disease.
|
Cryoprecipitate
|
|
|
Patients who are actively bleeding or who require emergency surgery should receive _____ to achieve immediate hemostasis.
|
fresh frozen plasma
|
|
|
The most common cause of death in pancreatitis is _____.
|
hypovolemic shock caused by excess fluid sequestration (third spacing)
|
|
|
Prinzmetal unstable angina Tx.?
|
nitrates
CCB's |
|
|
What does Corynebacterium diphtheriae look like?
|
non-motile, G+ bacilli
|
|
|
What does Staph look like?
|
G+ cocci in clusters
|
|
|
What does Group A Strep look like?
|
G+ diplococci
|
|
|
What does H. influenza look like?
|
small, pleomorphic, gram neg coccobacillus
|
|
|
Legionella pneumophila appears as ?
|
an aerobic, motile, and nutritionally fastidious pleomorphic gram-negative rod
|
|
|
Subcutaneous air is a classic radiographic finding assoc.:
|
necrotizing fasciitis
|
|
|
tx. for malignant hyperthermia
|
dantrolene
|
|
|
_____ reduces the risk of UTI in elderly patients suffering from neurogenic bladder.
|
Intermittent catheterization
|
|
|
marker to assess the likelihood of preterm labor between 22-34 weeks of pregnancy
|
FFN
|
|
|
series of indicators most specific for identifying the rupture of membranes includes:
|
Vaginal pooling
Ferning Nitrazine |
|
|
All patients who have suffered a penetrating cat bite should be treated with ___.
|
oral course of prophylactic amoxicillin/clavulanate
|
|
|
GN and decreased C3/C4 levels.
|
cryoglobulinemia
|
|
|
ECG is not a reliable method to diagnose MI's in patients with a ____. ______ can be used instead.
|
ECG is not a reliable method to diagnose MI's in patients with a left bundle branch block. Echocardiogram can be used instead.
|
|
|
Preggers + Lyme Disease
|
oral amoxicillin
|
|
|
______ of the cervix and vagina is one of the earliest signs of pregnancy and is referred to as "______"
|
Bluish discoloration of the cervix and vagina is one of the earliest signs of pregnancy and is referred to as "Chadwick's sign."
|
|
|
Softening and cyanosis of the cervix at or after 4 weeks gestation.
|
Goodwell's sign
|
|
|
Softening of the uterus after 6 weeks gestation.
|
Ladin's sign
|
|
|
air/fluid levels, dilated loops of small bowel and no gas in the colon.
|
X-ray findings for SBO
|
|
|
____ commonly cause SBO when they rupture.
|
Mucinous ovarian tumors
|
|
|
Gastritis in patients with Hashimoto thyroiditis should make you think about ____.
|
pernicious anemia
|
|
|
Suspect ___ in pts c impaired lymphatic drainage who develop a localized rash with an "orange peel" appearance 1-2 days following initial symptoms of fever, chills and myalgias.
|
erysipelas
|
|
|
MC cause of erysipelas
|
Group A Strep/S. pyogenes
|
|
|
MC cause of cellulitis
|
S. aureus
|
|
|
hypotension, wheezing, diaphoresis and a rash from blood transfusion
|
anaphylaxis rxn from a blood transfusion - IgA deficiency should be considered
|
|
|
associated with “weird” behavior characterized by unconventional beliefs such as being convinced of having extra sensory abilities.
|
Schizotypal personality disorder
|
|
|
elevated FSH v. elevated LH/FSH ratio
|
elevated FSH: Turner Syndrome
elevated LH/FSH ratio: PCOS |
|
|
(A) result in permanent restriction of motion.
(B) involve temporary restrictions of movement that limit range of motion. |
(A) Pathologic
(B) Restrictive |
|
|
pt. with neurological impairment and pneumonia. cause?
|
anaerobes secondary to aspiration
|
|
|
sequence of ligamentous injury that occurs during inversion ankle injuries
|
1) Anterior talofibular
2) Calcaneofibular 3) Posterior talofibular |
|
|
The most common bacterial infection for a hydrocephalus shunt is ____.
|
Staphylococcus epidermidis which is coagulase-negative.
|
|
|
Staph epidermis - coag +/-?
|
coag negative
|
|
|
The ____ nerve runs posteriorly in close proximity to the proximal fibular head and is subject to injury with fracture of the fibula or with posterior dysfunction of the fibula.
|
common peroneal
|
|
|
most effective means of post-coital contraception
|
copper IUD
|
|
|
Most cases are diagnosed shortly after delivery of the infant by the presence of a bulging, yellow-gray mass at, or just beyond, the level of the vaginal introitus.
|
imperforate hymen
|
|
|
Best treatment for bacteriuria in pregnant patients?
|
Single 3 gram dose of amoxicillin
|
|
|
disease in which the optic nerve is damaged
|
Glaucoma
|
|
|
A high optic cup/disc ratio is the fundoscopic finding
|
chronic, open angle glaucoma
|
|
|
unilateral headache, blurry vision and a non-reactive pupil
|
closed angle glaucoma
|
|
|
What meds can exacerbate closed angle glaucoma?
|
anti-cholinergic meds
ie - urinary incontinence meds |
|
|
triad of substernal burning with odynophagia, oral ulcerations and the presence of intracellular inclusions.
|
CMV esophagitis
|
|
|
history of chronic inflammation presenting with nephrotic syndrome
|
renal amyloidosis
|
|
|
young males with chronic back stiffness, photosensitivity, oral ulcerations, and fatigue
|
ankylosing spondylitis
|
|
|
Commonly the first sign of Reiter's syndrome (Reactive Arthritis)
|
urethritis
|
|
|
newborns who develop jaundice, dark urine, and light colored stools several weeks following birth
|
biliary atresia
|
|
|
Ranitidine inhibits reduces gastric acid through
|
inhibition of parietal cell histamine receptor
|
|
|
first medication that should be used to treat status epilepticus
|
lorazepam
If a patient in status epilepticus does not respond to lorazepam, then phenytoin should be administered. |
|
|
The mainstay therapy for gonococcal infections
|
IM ceftriaxone
PO doxycycline or azithromycin |
|
|
Empiric treatment of meningitis
|
Ceftriaxone and vanco - covers N. meningitidis, S. pneumo
|
|
|
Pleural fluid with elevated amylase (3)
|
esophageal rupture
pacreatitis malignancy |
|
|
pleural fluid that is milky, opalescent fluid
|
chylothorax (lymph in the pleural space)
|
|
|
pleural fluid that is frankly purulent
|
empyema (pus in the pleural space)
|
|
|
pleural fluid that is bloody
|
malignancy
|
|
|
exudative pleural effusions that are primarily lymphocytic
|
TB
|
|
|
pleural fluid with pH <7.2 (2 possibilities)
|
parapneumonic effusion
empyema |
|
|
Treatment of empyema
|
complete drainage
antibiotics intrapleural fibrinolytic treatment |
|
|
diabetes mellitis
diarrhea/steatorrhea cholelithiasis hypochlorhydria weight loss |
somatostatinoma
|
|
|
gall stones
diabetes steatorrhea |
somatostatinoma
|
|
|
Histoplasmosis:
Pulm dz.: Tx.? Systemic dz.: Tx.? |
Pulm dz: no treatment
Systemic dz.: amphotericin B and itraconazole |
|
|
Lithium side effects include ____ and ___. Check ____ and ____.
|
nephrogenic DI and hypothyroidism
BUN/Cr and thyroid fx. (and beta hcg) |
|
|
What blood tests when taking Valproic Acid for bipolar?
|
platelets
LFTs |
|
|
What blood tests when taking carbamazepine?
|
CBC
LFTs |
|
|
Turner's syndrome is treated with
|
HGH and estrogen replacement therapy
|
|
|
Chronic pancreatitis has a classic triad of diabetes, steatorrhea, and ____.
|
pancreatic calicifications on CT scan
|
|
|
Which RTA presents with alkalotic urine?
|
Type I
|
|
|
Which RTA presents with hypokalemia?
|
Type II
|
|
|
Which RTA presents with hyperkalemia?
|
Type IV
|
|
|
Treatment order for NMS (Neuroleptic Malignant Syndrome)
|
1.) Stop medication
2.) IV fluids 3.) dantrolene/ bromocriptine/ amantadine (optional) |
|
|
pathophys of Myasthenia Gravis
|
autoAb's against post-synaptic nicotinic Ach receptors
|
|
|
EMG showing high frequency action potentials along with fibrillations
|
polymyositis
|
|
|
hip, shoulder and neck pain - often associated with temporal arteritis.
|
polymyalgia rheumatica
|
|
|
Screening test for Sjogren's
|
anti-SSB/La
|
|
|
Tx. of C. Diff (2)
|
1. metronidazole
2. oral vanc |
|
|
the following must be met for medical malpractice:
|
Dereliction of a Duty Directly causing Damages
|
|
|
PCWP in:
1. ARDS 2. cardiogenic pulmonary edema |
1. <18 mmHg
2. >18mm Hg |
|
|
autoimmune condition causing progressive destruction of the small bile ducts in the liver leading to fibrosis and scarring
|
primary biliary cirrhosis
|
|
|
First line treatment for panic disorder
|
SSRI
|
|
|
anxiolytic agent used for general anxiety disorder and OCD.
|
buspirone
|
|
|
stricturing and dilatation of intrahepatic and extrahepatic bile ducts in a bead like fashion
|
primary sclerosing cholangitis
|
|
|
projectile vomiting, papilledema, and morning headaches
|
intracranial mass
|
|
|
white patches on the retina
|
cotton wool spots
damage to nerve fibers diabetes and HTN |
|
|
arteriovenous nicking
|
HTN retinopathy
|
|
|
pallor of the optic disc
|
glaucoma
|
|
|
optic disc margin blurring
|
papilledema
|
|
|
erythroblasts with stainable deposits of iron in cytoplasm
Tx.? |
sideroblastic anemia
Tx.: pyridoxine |
|
|
Leukemoid reaction is ?
What is a classic lab finding? |
Leukemoid reaction is leukocytosis secondary to infection.
Increased leukocyte alkaline phosphatase is the classic lab finding. |
|
|
CML v. Leukemoid rxn
|
CML - decreased leukocyte alkaline phosphatase (LAP)
Leukemoid - increased LAP |
|
|
CLL - classic finding on lab
|
increased lymphocytes
|
|
|
Nikolsky's sign - positive in pemphigus vulgaris or bullous pemphigoid
|
pemphigus vulgaris
|
|
|
abd pain
elevated urine aminolevulinic acid |
acute intermittent porphyria:
porphobilinogen deaminase deficiency |
|
|
postprandial pain
weight loss atherosclerotic disease abd bruit |
chronic intestinal ischemia
|
|
|
hepatic tumor with central scar
|
focal nodular hyperplasia
don't worry about it |
|
|
intestinal biopsy - PAS positive macrophage inclusions
|
Whipple's Disease
|
|
|
malabsorption + joint pain
|
possibly Whipple's
|
|
|
The pheochromocytoma 10% rules are as follows:
|
10% recurrence rate after surgery
10% are familial 10% are bilateral 10% are extra-adrenal 10% are malignant 10% occur in children |
|
|
How to distinguish betw. ASD and VSD
|
ASD - asymptomatic until adult
VSD - symptomatic in childhood |
|
|
What is the ABI in PVD
|
<1.0
|
|
|
Calf pain is exacerbated by standing, walking, and extension at the waist and relieved with sitting, flexing, and lying flat
|
spinal stenosis
|
|
|
Cut off for AAA
|
6 cm
|
|
|
four or more episodes of major depression, mania, hypomania, or mixed symptoms within 12 months.
|
rapid cycling bipolar
|
|
|
episodes of hypomania that shift back and forth with mild depression for at least two years.
|
cylothymic discorder
|
|
|
pattern of major depressive episodes shifting back and forth with hypomanic episodes
|
bipolar II
|
|
|
occurrence of at least one manic or mixed episode. Although not required for diagnosis, depression is usually present. Therefore, mania alone is sufficient for this diagnosis.
|
bipolar I
|
|
|
milder, but chronic form of depression that lasts at least 2 years. Symptoms occur most of the day, more days than not. Patients may have a symptom-free period that lasts 2 months or less.
|
dysthymia
|
|
|
used to augment therapy when MDD is resistant to monotherapy with antidepressants.
|
lithium
|
|
|
The hip-drop test is a commonly used test to evaluate
|
sidebending of the lumbar spine.
|
|
|
Post-exposure prophylaxis for rabies in patients previously vaccinated consists of ____.
|
irrigation and repeat vaccinations
|
|
|
Patients over 50 and/or with alarming symptoms such as weight loss, dysphagia, new-onset anemia, hemorrhage, and early satiety should _____.
|
received upper endoscopy with biopsy.
|
|
|
Symptomatic HCM should be treated with______.
|
a beta-blocker or verapamil.
|
|
|
CK-MB v. Troponin
|
CK-MB appears 4-6 hours after symptom onset, peaks at 24 hrs., returns to normal in 3 days.
Troponin appears 4-6 hrs. too but stays elevated for 14 days |
|
|
SOB + myasthenia gravis
|
thymoma - surgical resection
|
|
|
Drugs that exacerbate myasthenia gravis are
|
aminoglycosides
tetracyclines beta blockers quinidine procainamide lidocaine |
|
|
methylmalonic acid level and homocysteine levels in VitB12 deficiency and folic acid deficiency
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Vit B12 - increased in both
Folic Acid - increased in homocysteine |
|
|
darkening plaque with wart-like, velvety texture; stuck on appearance
|
seborrheic keratosis
|
|
|
crusty lesion in sun-exposed areas
|
actinic keratosis - squamous cell carcinoma
|
|
|
MC Type of gastric ulcer
|
Type I - lesser curvature of the stomach
|
|
|
Type of PUD where there are 2 ulcers present: one gastric and one duodenal
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Type II
|
|
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PUD type III
|
prepyloric ulcer
|
|
|
PUD type IV
|
proximal gastroesophageal ulcer
|
|
|
diagnostic test of choice for thyroid nodules
|
fine needle aspiration
|
|
|
Treatment of choice for idiopathic bilateral hyperplasia causing hyperaldosteronism is ____.
|
spironolactone
|
|
|
congenital intracranial calcifications of the basal ganglia
|
toxoplasmosis
|
|
|
Tx. of toxoplasmosis
|
pyrimethamine and sulfadiazine
|
|
|
causes a shiny skin on the nipple with peeling at the areola
breastfeeding mom |
candidiasis
|
|
|
gold standard in the diagnosis of endometriosis
|
laparoscopy
|
|
|
The most common presentation is pain and paresthesias in the ulnar nerve distribution due to C8 and T1 involvement.
|
Thoracic Outlet Syndrome
|
|
|
Questions that mention cough usually indicate that it is NOT ____.
|
Strep
|
|
|
Cluster HA prophy
|
verapamil
prednisone valproic acid topiramate ergotamine |
|
|
most common form of brachial plexus injury caused by difficult labor
|
Erb-Duchenne palsy - C5/C6 nerve roots
|
|
|
disease of hemangiomas in the brain, spinal cord and retina. It is associated with renal cell carcinoma, pheochromocytoma and renal angiomas. (children)
|
von Hippel - Lindau
|
|
|
causes absent deep tendon reflexes, atrophied muscles, and muscle weakness (children)
|
polymyelitis
|
|
|
Acute tubular necrosis:
BUN/Cr ? urine sodium ? FENa ? urine osmolality ? |
BUN:Cr ratio will be <20:1
urine sodium >40 mEq/L FENa >2% urine osmolality <350 mosm/kg. |
|
|
Pre-renal acute renal failure:
BUN/Cr ? FENa ? Urine Na ? Urine Osmolality ? |
BUN:Cr ratio over 20
FENa<1% Urine Na <20mEq/L urine osmolality >500mosm/kg. |
|
|
Hemolytic Uremic Syndrome (HUS) v. Thrombotic Thrombocytopenic Purpura (TTP)
|
HUS:
microangiopathic anemia thrombocytopenia acute renal failure TTP: HUS + fever + neurologic signs |
|
|
Tx. of polycythemia vera
|
chronic phlebotomy
hydroxyurea |
|
|
Right sided v. Left sided colon cancer
|
Right side bleeds, Left side obstructs
Right: melena, occult blood Left: hematochezia BRBPR, pencil stools |
|
|
Tx. of perforated peptic ulcer?
|
if <70 y/o, conservative, IV fluids, suction, etc.
if >70 y/o, open laparotomy |
|
|
Pt. with high cortisol level and low ACTH level - What next?
|
Cushing's syndrome: order CT scan of adrenals
|
|
|
VIPomas cause:
|
watery diarrhea (hypokalemia)
hypochlorhydria hyperglycemia |
|
|
parasternal lift
|
RV dilatation
|
|
|
diffuse upsloping ST elevations with PR depressions.
|
acute pericarditis
|
|
|
child with hyperphagia and obesity after difficulty eating as infant
|
Prader-Willi
|
|
|
Meckel's Diverticulum Rule of 2's:
|
(A) Occurs in 2% of the population (B) Only 2% are symptomatic
(C) Located 2 ft proximal to the ileocecal valve (D) The diverticulum is 2 in. long (E) Sx. manifest at 2 years of age. |
|
|
Meckel's Diverticulum: Dx. and Tx.?
|
Dx: tech 99 scan
Tx: surgical excision |
|
|
cherry red macular spot
|
Neimann-Pick OR Tay Sachs (no HSM)
|
|
|
deficiency in sphingomyelinase
|
Neimann-Pick
|
|
|
deficiency in hexosaminidase A
|
Tay-Sachs
|
|
|
deficient in glucocerebrosidase
|
Gauchers
|
|
|
deficient in galactosidase A
|
Fabry's
|
|
|
Fabry's Disease
|
neuro and renal disease
skin lesions in groin area |
|
|
Gaucher's Disease
|
Neurological symptoms
HSM hypersplenism (thrombocytopenia/anemia) osteoporosis |
|
|
levels of MSAFP are _____ with trisomy.
|
decreased
|
|
|
Neural tube defects have increase/decreased _____ (3) activity
|
increased MSAFP, AFAFP, and AchE
|
|
|
painless anal bleeding and anal pruritis
|
hemorrhoids - internal and external
become painful when thrombosed |
|
|
confusion, ataxia, and nystagmus.
|
Wernicke's encephalopathy - vit B1 (thiamine) deficiency
|
|
|
Glucose and thiamine?
|
NEVER give glucose before thiamine - causes thiamine deficiency
|
|
|
positive Trendelenberg test
|
When the patient lifts one leg, the pelvis will fall on the opposite side of the weak gluteus medius muscle
|
|
|
First line treatment for ascites is ____ and/or _____.
|
spironolactone
furosemide |
|
|
PE on EKG
|
tachycardia
|
|
|
Most specific test for RA
|
xray - joint space narrowing and erosions
|
|
|
non-anion gap, hyperchloremic metabolic acidosis.
|
RTA
|
|
|
What kind of electrolyte abnormality is found in multiple myeloma?
|
Hypercalcemia - decreased anion gap
|
|
|
CNS malignancy associated with familial adenomatous polyposis
|
Turcot's Syndrome
|
|
|
adenomatous polyps - plus osteomas, lipomas, fibromas,cysts, and dental abnormalities
|
Gardners Syndrome
|
|
|
SBP Tx.
|
3rd generation cephalosporin: cefotaxime
|
|
|
Treatment of choice for H. pylori is triple therapy:
|
amoxicillin, clarithromycin, and a proton pump inhibitor
|
|
|
pseudohypoparathyroidism
|
end organ resistance to PTH: hypocalcemia, hyperphosphatemia but high PTH
|
|
|
Indications for long term oxygen therapy for patients with COPD are:
|
1.) SaO2 < 89%
2.) PaO2 < 55%, 3.) PaO2 55-59 right-sided heart failure or erythrocytosis is present |
|
|
What bug is assoc. reactive arthritis/Reiter's?
|
Campylobacter
|
|
|
Campylobacter may cause what two autoimmune disease?
|
reactive arthritis
Guillain Barre |
|
|
RF for endometrial carcinoma (4)
|
1. Age
2. excess estrogen 3. FamHx 4. Diabetes |
|
|
weakness of finger adductors and abductors?
|
T1 nerve impingement
|
|
|
Treatment of Choice for dermatitis herpetiformis
|
dapsone
gluten-free diet |
|
|
Chest x-ray of silicosis will show
|
nodular opacities in the upper lobe
|
|
|
CXR of berylliosis will show
|
unilateral hilar lymphadenopathy
|
|
|
CXR of asbestosis will show
|
b/l opacities with pleural plaques
|
|
|
Tx. of focal segmental glomerulosclerosis
|
prednisone and cyclophosphamide
|
|
|
most common cause of nephrotic syndrome in adults
|
membranous glomerulonephritis
|
|
|
granular deposits of IgG and C3 at the basement membrane, sometimes referred to as "spike-and-dome" appearance
|
membranous glomerulonephritis
|
|
|
fusion of epithelial foot processes
|
minimal change disease
|
|
|
most common cause of nephrotic syndrome in children
|
minimal change disease
|
|
|
nephrotic syndrome caused by immune complexes depositing in the kidney
|
membranoproliferative glomerulonephritis
|
|
|
C3 levels are low in pts with this condition: a characteristic "tram-track" appearance on microscopy due to capillary basement membranes thickening by interposition of mesangial cells and matrix into the capillary wall
|
membranoproliferative glomerulonephritis
|
|
|
___ or ___ may be used concurrently with NSAIDs to reduce the incidence of ulcers
|
Misoprostol or PPI's
|
|
|
type of thyroid cancer that causes an increase in calcitonin
|
medullary
|
|
|
MC type of thyroid cancer
|
papillary
|
|
|
hyponatremia, low serum osmolality, and low urine volume is the hallmark of ____? Tx.?
|
SIADH
Tx.: fluid restriction |
|
|
continuous machine like murmur
|
Patent ductus arteriosus
|
|
|
mood reactivity + weight gain, hypersomnia, leaden paralysis, or sensitivity to rejection
|
atypical depression
|
|
|
patient with dysthymia experiences an episode of major depression
|
double depression
|
|
|
melancholic depression
|
lack of mood reactivity, early morning awakening / insomnia, and weight loss / anorexia
|
|
|
defect in the pars interarticularis
|
spondylolysis
|
|
|
degenerative change of the vertebrae
|
spondylosis
|
