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300 Cards in this Set
- Front
- Back
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What is the treatment of cardiogenic shock?
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Vasopressor (Dobutamine)
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What systemic diseases can cause nephritis syndrome?
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DM
SLE Amyloidosis |
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Hypoxemia + pulmonary edema + normal pulmonary capillary wedge pressure =
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Acute respiratory distress syndrome
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What disorder is present in a teenager with a history of theft, vandalism, and violence toward family pets?
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Conduct disorder
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Continuous machine-like murmur
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Patent Ductus Arteriosis
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What would you suspect in a woman with preeclampsia in the first trimester?
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Hydatidiform mole
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What CSF findings would you see in a case of subarachnoid hemorrhage?
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Elevated CSF pressure
RBCs in 3+ tubes Xanthochromia (after a few days) |
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What acid-base disturbance is commonly seen in pregnant women?
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Respiratory alkalosis
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A husband asks that his wife not be told about her recently discovered lung cancer -> What do you do?
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Assess whether telling the patient will harm the patient, but in any case a relative cannot withhold information from a patient.
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Does a case-control study measure incidence or prevalence?
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Neither.
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What is the first-line treatment for a growth hormone-secreting pituitary adenoma?
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Transsphenoidal surgical resection
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What are the indications for surgical repair of an abdominal aortic aneurysm?
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Diameter > 5.5 cm
Rapidly enlarging Symptomatic or ruptured |
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What characteristics of a nevus suggest that it may actually be a melanoma?
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ABCD
Asymmetry Border irregularity Color variation Diameter (if larger than a pencil eraser) |
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Low urine specific gravity in the presence of high serum osmolality -> What is the diagnosis?
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Diabetes insipidus
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What is the treatment of atrial fibrillation of unknown duration?
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Rate control (beta-blockers, verapamil, digoxin)
Heparin + Warfarin |
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Which lung cancer is associated with SIADH?
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Small cell lung cancer
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What important side effects are common to many of the atypical antipsychotics?
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Weight gain
DM Type 2 |
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What is the most common location for an ectopic pregnancy?
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Ampulla of fallopian tube
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Uterine bleeding at 18 weeks' gestation + no products expelled + membranes ruptured + cervical os open = What diagnosis?
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Inevitable abortion
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ICU patient is awake and alert but cannot move anything but the eyes and eyelids. What is the diagnosis?
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Locked-in syndrome
(Involving the Basilar artery) |
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What type of shock causes a decreased cardiac output, decreased PCWP, and decreased peripheral vascular resistance?
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Septic shock
Anaphylactic shock Neurogenic shock |
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What is the most common form of nephritic syndrome?
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Membranous glomerulonephritis
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What is the initial treatment for child presenting with acute asthma attack?
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IV Steroids
Albuterol Oxygen |
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What type of psychotherapy is used in treating phobias, obsessive-compulsive disorder (OCD), and panic disorder?
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Cognitive behavioral therapy
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What is the underlying cause of neonatal respiratory distress syndrome?
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Surfactant deficiency (Lung immaturity)
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What is the first test in the assessment of a woman presenting with secondary amenorrhea?
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beta-hCG
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What are the components of HELLP syndrome?
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Hemolysis
Elevated LFTs Low Platelets |
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What medication is used to diagnose symptomatic myasthenia gravis?
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Edrophonium (Tinsilon test)
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An 11-year old obese, African-American boy presents with sudden onset of limp. What is the most likely diagnosis, and what imaging studies would confirm this?
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Slipped capital femoral epiphysis
Tests: X-Rays AP and frog-leg lateral |
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What organism is associated with dog or cat bites?
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Pasturella multocida
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How is polycythemia vera distinguishable from secondary polycythemia?
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Both have elevated Hb, RBC mass, Hct
Polycythemia vera is not due to low oxygen saturation or elevated EPO. You will have low or normal EPO, O2 sat is normal. |
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What is the medical treatment for hepatic encephalopathy?
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Lactulose
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A young child presents in status epilepticus, but her parents refuse treatment on religious grounds. What do you do?
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Treat anyways, seek court order after
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What percentage of values fall within one standard deviation of the mean? Two SDs? Three SDs?
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One SD: 68%
Two SDs: 95% Three SDs: 99.7% |
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In which endocrine disorder might weight loss completely eliminate the need for medication?
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Type 2 DM
PCOS |
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What rash is classically described as "dew drops on rose petals?"
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Primary varicella (chicken pox)
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What is the classic endocarditis prophylaxis regimen?
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Oral surgery: Amoxicillin (before and after)
GI/GU procedures: Ampicillin + Gentamycin before, Amoxicillin after |
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Cafe-au-lait spots on skin
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Neurofibromatosis Type I
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What is the treatment for mild unconjugated hyperbilirubinemia? Severe unconjugated hyperbilirubinemia?
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Mild unconjugated hyperbilirubinemia: Phototherapy
Severe unconjugated hyperbilirubinemia: Exchange transfusion |
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What number is needed on bacterial culture of a clean-catch specimen to diagnose a UTI?
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100,000 (10^5) bacteria per ml
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What is the classic ECG appearance in atrial flutter?
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Saw-tooth pattern of P waves
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A 60-year old obese patient presents with dirty, velvety patches on the back of the neck. What is the diagnosis and what is the initial work-up?
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Acanthosis nigricans
Glucose to rule out DM, thorough H/P to look for signs of malignancy |
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What is the most common cause of hypothyroidism?
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Hashimoto's thyroiditis
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Which type of bias is introduced when screening detects a disease earlier and thus lengthens the time from diagnosis to death?
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Lead-time bias
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What are the exceptions to the requirement of informed consent?
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Emergencies
Patients without decision making capacity Patients that sign waivers to the right of informed consent |
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A 19 year old man presents with a palpable flank mass and hematuria. U/S shows bilateral enlarged kidneys with cysts. What brain anomaly is associated with this condition?
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Berry aneurysm
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What are the four main causes of microcytic anemia?
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Iron deficiency anemia
Anemia of chronic disease Thalassemias Lead poisoning |
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What are four signs and symptoms of streptococcal pharyngitis?
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Fever
Pharyngeal erythema Tonsillar exudates Lack of rhinorrhea Lack of cough |
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In which region of the US is Lyme disease endemic?
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American northeast
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Which joints in the hand are affected in rheumatoid arthritis?
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MCP and PIP
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Xerostomia + parotid enlargement + xerophthalmia + anti-La antibodies =
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Sjogren's syndrome
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What are the most common causes of seizures in young adults (ages 18-35)?
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Trauma
Alcohol withdrawal Brain tumors |
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What is the most common cause of non-obstetric post-partum death?
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Thromboembolic disease
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Uterine bleeding at 18 week's gestation + no products expelled + cervical os closed. What is the diagnosis?
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Threatened abortion
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Which immunodeficiency presents with eczema, thrombocytopenia, and high levels of IgA?
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Wiskott-Aldrich syndrome
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Which defense mechanism is displayed when a woman calmly describes a gory murder in great detail?
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Isolation
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What is the treatment for mild, persistent asthma?
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Albuterol + inhaled low dose corticosteroids
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EKG with peaked T waves and widened QRS?
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Hyperkalemia
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What is the treatment for iron overdose?
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Deferoxamine
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What is the acceptable minimum urine output in a stable patients?
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30cc/hour
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What method is used to calculate fluid repletion in burn patients?
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Parkland formula:
4 mL x kg (patient weight) x % body surface burned. |
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Salicylate ingestion results in what type of acid-base disorder?
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Mixed Respiratory alkalosis + Metabolic acidosis with elevated anion gap
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What medication is used most commonly to induce ovulation?
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Clomiphene citrate
Pulsatile leuprolide |
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Pyschiatric condition which a person travels a long distance, takes a new name, and has no memory of his prior life.
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Dissociative fugue
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Which congenital infection might present with a "blueberry-muffin" rash?
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Rubella
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Which type of breast cancer increases the future risk of invasive carcinoma in both breasts?
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Lobular carcinoma in situ
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What are the classic symptoms of placenta previa?
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Painless vaginal bleeding during 3rd trimester.
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An active 14-year old boy has anterior knee pain. What is the most likely diagnosis?
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Osgood-Schlatter disease
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Joint aspirate reveals rhomboid-shaped, positively birefringent crystals. What is the diagnosis?
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Pseudogout
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What type of oral infection has branching rods when examined microscopically?
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Actinomyces israeli
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What is the next step in the evaluation of a patient with two consecutive Pap smears with atypical squamous cells of undetermined significance (ASCUS)?
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Colposcopy with endocervical curetage
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A 45-year old obese female with pruritis, clay-colored stools, and dark urine has an elevated alkaline phosphate and elevated bilirubin. What is the most likely cause?
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Biliary tract obstruction
(ie.Gall stones) |
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What infection can cause diarrhea and pseudoappendicitis?
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Yersinia enterocolitica
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Which is more ethically unfavorable in a DNR patient: withdrawing life-sustaining care or withholding care?
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Does not matter. Both are the same.
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What is the most likely cause of acute lower GI bleeds in patients older than 40?
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Diverticulosis
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What is the most common underlying cause of pathologic fractures in elderly, thin women?
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Osteoporosis
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What is the causative agent in pityriasis versicolor?
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Malassezia furfur
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What is the cause of chest pain in a young patient that has angina at rest with ST-segment elevation but normal cardiac enzymes?
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Prinzmetal's angina
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Which hypercholesterolemia treatment causes flushing and pruritis?
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Niacin
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Target lesions with a red center, pale zone, and dark outer ring appearing on the palms and soles with a prodrome of malaise and myalgias.
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Erythema multiforme
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What autoimmune complication occurs 2-4 weeks after an MI?
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Dressler's syndrome
(Fever, pericarditis, increased ESR) |
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What name is given to stress-related hair loss? What is the treatment?
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Telogen Effluvium
Rx: Reassurance |
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What is the most common cause of Cushing's syndrome?
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Exogenous steroid use
(2nd most common is ACTH secreting tumor = Cushing's disease) |
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What is the most likely cause of galactorrhea, impotence (or menstrual dysfunction), and decreased libido in a patient with a history of schizophrenia?
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Anti-psychotic side effect: Dopamine antagonist (Haloperidol)
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What ethical problem exists when a doctor refers a patient for an MRI at a facility he owns?
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Conflict of interest
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Patient presents with sudden onset of severe, diffuse abdominal pain. AXR reveals free air under the diaphragm. What is the next step in management?
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Emergency laparotomy
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What are the two most common foodborne bacterial GI tract infections in the US?
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Salmonella
Campylobacter |
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What is the diagnostic test for hereditary spherocytosis?
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Osmotic Fragility test
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What bullous skin disease has a negative Nikolsky's sign?
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Bullous pemphigoid
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A 25 year old male presents with white plaques on his tongue and the back of his throat that scrape off with a tongue depressor. What is the diagnosis? What should he be screened for?
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Oral Candidiasis (Thrush)
Screen for HIV |
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Young male with hip and back pain along with stiffness that improves with activity and worsens at rest. What is the most likely diagnosis?
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Ankylosing Spondylitis
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Cold water is flushed into a patient's ear, and the fast phase of the nystagmus is towards the opposite side. Where is the lesion?
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No lesion. This is normal.
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What findings would you expect to see in a post-term pregnancy beyond 42 weeks gestation?
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Oligohydramnios
Passage of meconium in utero Dry peeling skin Placenta will be very mature with calcifications |
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What annual screening is recommended for women with strong family history of ovarian cancer?
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CA 125
Transvaginal ultrasound |
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A one year old is able to cruise, use two-finger pincer grasp, babble, and imitate actions. What part of his development is delayed.
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A 1 year old should be able to say a few words. His language is delayed.
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Which defense mechanism is a pedophile that enters a monastery using?
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Reaction formation
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What are some of the causes of an exudative pleural effusion?
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Cancer
TB Bacterial infections Pulmonary emboli Pancreatitis |
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What would you expect with eosinophilic casts found in the urine?
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Acute interstitial nephritis
(AKA Allergic interstitial nephritis) |
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What are the side effects of corticosteroids?
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Cushingoid symptoms (weight gain, buffalo hump)
Osteoporosis Immunosuppression Acne Insulin resistance Thin skin Mania Insomnia Cataracts |
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What is an acceptable urine output in a trauma patient?
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50cc/hour
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What is the treatment for ventricular fibrillation (VF)?
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Immediate cardioversion (360 J) Epinephrine or Vasopressin
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What skin blistering disease has a positive Nikolsky's sign?
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Pemphigus vulgaris
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What is the most common inherited cause of hypercoagulability?
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Factor V Leiden
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Which genetic disorder is associated with multiple fractures and is commonly mistaken for child abuse?
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Osteogenesis imperfecta
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What is the most common cause of bloody nipple discharge?
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Intraductal papilloma
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Which antibiotics should be avoided during pregnancy due to potential teratogenic effects?
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Fluoroquinolones
Tetracyclines Aminoglycosides, Sulfonamides (less concerning) |
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Antihistone antibodies
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Drug induced Lupus
(ie. Hydralazine) |
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Infectious cause of aplastic crisis in sickle cell disease
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Parvovirus B12
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Tachycardia + wild fluctuations in BP + headache + diaphoresis + panic attacks?
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Pheochromocytoma
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What should always be done prior to LP?
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Check for increased ICP (Check for papilledema)
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What is the next step in the diagnosis of cholecystitis when U/S is equivocal?
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HIDA scan
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What is the clinical definition of HTN?
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>140/90 for 3 separate visits at least 2 weeks apart
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What are the most common causes of fever of unknown origin?
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Infection
Cancer Autoimmune diseases |
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What is the most feared complication of a scaphoid fracture?
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Avascular necrosis
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Albuminocytologic dissociation (increased protein in CSF with only modest increase in cell count)
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Guillan-Barre
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What two disorders should come to mind when a neonate has meconium ileus?
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Cystic fibrosis
Hirshsprung disease |
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Immunodeficiency with a positive nitroblue tetrazolium test?
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Chronic granulomatous disease
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Pediatric patient with red "currant-jelly" stools?
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Intussusception
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A young female with amenorrhea, bradycardia, and abnormal body image.
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Anorexia nervosa
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What is the treatment for superior vena cava syndrome?
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Radiation of lung tumor
Steroids |
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What statistical calculation looks at true positives and divides them by the number of patients with the disease?
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Sensitivity
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A 15-year old pregnant girl requires hospitalization for preeclampsia. Should her parents be informed?
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No. Parental consent is not necessary for treating pregnant minors (nor for STDs, contraception)
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A patient is unable to inspire completely due to pain during palpation of the RUQ. What is this sign? What is the diagnosis?
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Murphy's sign
Acute cholecystitis |
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What is the reversal agent for heparin?
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Protamine sulfate
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What substances are known to cause hemolysis in patients with G6PD Deficiency?
|
Sulfa drugs
Fava beans anti-malarials (primaquine) High dose aspirin Isoniazid Nitrofurantoin Dapsone |
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What medications can be given to a pregnant woman with cystitis?
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Amoxicillin
Nitrofurantoin 1st, 2nd gen ceph |
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A patient presents with limb pain on passive movement, pallor, poikilothermia, paresthesias, paralysis, and pulselessness. What is the treatment?
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Compartment syndrome:
Fasciotomy |
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What complication may arise from overly rapid correction of hyponatremia?
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Central pontine myelinolysis
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A 60 year old patient presents with an acute onset of broken speech. What type of aphasia is this? What lobe and vascular distribution has been affected? What is the first step in the workup?
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Broca's aphasia
Dominant frontal lobe lesion, via the Middle Cerebral Artery Workup requires CT scan to rule out hemorrhage |
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What are the most common primary sources of metastasis to the brain?
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Lung, breast, melanoma, renal and GI tract cancers
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What is the treatment for mastitis in a patient that is breast-feeding?
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Continue breast feeding
Oral antibiotics |
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What characteristics favor carcinoma in an isolated pulmonary nodule?
|
New nodule or increasing size
No calcifications (or irregular calcifications) History of smoking Age > 45 Size > 2 cm Irregular margins |
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In which disease would you find atrophy of the mammillary bodies?
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Wernicke's encephalopathy
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What term describes heavy bleeding during and between menstrual periods?
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Menometrorrhagia
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What is the most common type of tracheoesophageal fistula?
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Blind proximal esophagus, distal esophagus connected to trachea
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What is the treatment for Kawasaki disease in the acute phase?
|
High dose aspirin
IVIG |
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What is considered first-line pharmacotherapy for depression?
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SSRIs
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Which antidepressants are associated with hypertensive crisis? What substance can exacerbate this effect?
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MAOIs
Tyramine |
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A 40 year old black female is found to have noncaseating granulomas of the lung and hypercalcemia. What is the diagnosis?
|
Sarcoidosis
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In what disease might you find Curschmann's spirals (whorled mucous plugs)?
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Asthma
|
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Which type of renal tubular acidosis (RTA) is associated with abnormal H+ secretion and nephrolithiasis?
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Type I
|
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What are the causes of hypervolemic hyponatremia
|
CHF
Cirrhosis Nephrotic syndrome |
|
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A burn patient presents with cherry-red flushed skin and coma. O2 saturation is normal, but carboxyhemoglobin is elevated. What is the treatment?
|
This is CO poisoning.
100% O2 Hyperbaric oxygen |
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What is the treatment for delirium tremens?
|
This is caused by alcohol withdrawal
Benzodiazepines (Chlordiazepoxide) |
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What is the most common cause of postpartum hemorrhage?
|
Uterine atony
|
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Which drugs block transmission through the AV node?
|
Beta-blockers
Digoxin CCBs |
|
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What skin lesion causes a pearly-colored papule with a translucent surface and telangiectasias?
|
Basal cell carcinoma
|
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What type of infection causes honey-crusted lesions usually around the nose or mouth?
|
Impetigo (Staph aureus, Strep pyogenes)
|
|
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What causes hypocalcemia, high phosphorous, and low PTH?
|
Hypoparathyroidism
|
|
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What causes stones, bones, groans, and psychiatric overtones?
|
Hypercalcemia
Hyperparathyroidism |
|
|
What is the first-line treatment for acute otitis media?
|
Amoxicillin 10 days
|
|
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Does a cohort study identify incidence or prevalence?
|
Both
|
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When can a physician refuse to continue treating a patient on the grounds of futility?
|
No rationale for treatment
When maximal intervention has failed Treatment has not achieved goals of care |
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A violent patient with vertical and/or horizontal nystagmus has been exposed to what substance?
|
PCP
|
|
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What diarrheal illness is associated with church picnics/mayonnaise?
|
Pre-formed Staphylococcus aureus toxins
|
|
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What is a cause of congenital pure RBC aplasia?
|
Diamond-Blackfan anemia
|
|
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What is the pentad of thrombotic thrombocytopenic purpura (TTP)
|
Thrombocytopenia
Hemolytic anemia Uremia Fever Altered mental status |
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A patient that visited the SW US presents with fever, malaise, cough, and night sweats. What is the diagnosis and treatment?
|
Coccidioidomycosis
Rx: Fluconazole |
|
|
Ring-enhancing brain lesion on CT with seizures
|
Brain Abscess
Toxoplasmosis |
|
|
What are the classic physical findings in cases of endocarditis?
|
Fever
Roth spots Osler nodes Murmur Janeway lesions Anemia Nail-bed (splinter) hemorrhages Emboli |
|
|
A 55 year old man has sudden onset of pain in his first metatarsophalangeal joint after a night of drinking red wine. What is the diagnosis, workup, and how can it be treated chronically?
|
Gout
Joint fluid aspiration shows needle shaped, negatively birefringent crystals Rx: Allopurinol, colchicine, Probenicid |
|
|
Patient with a history of lithium use presents with copious amounts of dilute urine
|
Nephrogenic diabetes insipidus
|
|
|
What is the most common pituitary tumor, and what is the treatment?
|
Prolactinoma
Dopamine agonists (bromocriptine) |
|
|
A male with a testicular mass is found to have an elevated beta-hCG. What is the diagnosis?
|
Testicular choriocarcinoma
|
|
|
What are the cardinal movements of labor?
|
Engagement
Descent Flexion Internal rotation Extension External rotation Expulsion |
|
|
50 year old female smoker presents with hematuria. What do you suspect?
|
Bladder cancer
|
|
|
30 year old female African immigrant presents with hematuria. What do you suspect?
|
Schistosomiasis
|
|
|
What therapies are used in treating polycystic ovarian syndrome?
|
Weight loss
Metformin Oral contraceptive pills (for estrogen regulation) Spironolactone (for hirsutism) |
|
|
What type of bone fracture is most likely to result from a fall on an outstretched hand?
|
Distal radius fracture (Colles fracture)
|
|
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A two month old presents with projectile, nonbilious, projectile emesis. What is the first step in the management?
|
Pyloric stenosis
Check for and correct metabolic abnormalities Diagnose with ultrasound Surgery for repair |
|
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A 16 year old female has left arm paralysis after her boyfriend dies in a car crash. No medical cause is found. What is the diagnosis?
|
Conversion disorder
|
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A patient presents to the ER after a MVA with hypertension, bradycardia, and abnormal respirations. After ABCs, what is the next step in management?
|
Cushing's triad of elevated ICP
- Raise head of bed - Hyperventilate - Mannitol - Neurosurgery consult |
|
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A normalizing PCO2 in a patient having an asthma exacerbation may indicate what problem?
|
Fatigue and impending respiratory failure
|
|
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A patient has dyspnea, hilar lymphadenopathy on CXR, and hypercalcemia. What is the diagnosis?
|
Sarcoidosis
|
|
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Which type of renal tubule acidosis is associated with abnormal HCO3- and rickets?
|
RTA type II
|
|
|
Chvostek's and Trousseau's sign
|
Hypocalcemia
|
|
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A young patient whose father died at age 30 in an MVA suddenly collapses and dies while exercising. What is the cause of death?
|
Hypertrophic obstructive cardiomyopathy
|
|
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Gyn exam of a postmenopausal woman reveals inflammation and epithelial thinning of the anogenital area. What is the diagnosis?
|
Lichen sclerosis
|
|
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An IV drug user has JVD and a holosystolic murmur at left sternal border. What is the treatment?
|
Tricuspid regurgitation
Vancomycin Treat heart failure, replace tricuspid valve |
|
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What is the classic ECG finding in pericarditis?
|
Low voltage diffuse ST-segment elevation
|
|
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What is the treatment for neuroleptic malignant syndrome?
|
Dantrolene
Dopamine agonist (Bromocriptine) |
|
|
A child has flesh-colored, umbilicated lesions on face. What are these lesions, and where do they appear in adults?
|
Molloscum contagiosum
Adults: Found in genital, perianal regions |
|
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Which medication is used more than any other in the treatment of Parkinson's?
|
Levadopa with carbidopa
|
|
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What diagnostic test differentiates central from nephrogenic diabetes insipidus?
|
Administer DDAVP
Measure urine osmolality |
|
|
A postop patient with significant pain presents with hyponatremia and normal volume status. What is the diagnosis?
|
SIADH due to stress
|
|
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An elderly female presents with pain and stiffness of the shoulders and hips. She cannot lift her arms above her head. Lab shows an elevated ESR. What is the diagnosis?
|
Polymyalgia rheumatica
|
|
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A child presents with oliguria, petechia, and jaundice following an illness with bloody diarrhea. What is the most likely diagnosis and infectious cause?
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Hemolytic Uremic Syndrome
E. coli 0157:H7 |
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An 11 year old boy presents with fever, weight loss, and night sweats. Radiology reveals an anterior mediastinal mass. What do you suspect? What is the patient was 30 years old?
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11 year old: Non-Hodgkin's lymphoma
30 year old: Hodgkin's lymphoma |
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What prophylactic medication is indicated in an HIV patient with a CD4 less than 100?
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TMP-SMX, Dapsone, Pentamidine (Toxoplasmosis, PCP)
Azithromycin (or Clarithromycin) for MAC |
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What is the most common testicular cancer?
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Seminoma
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A child presents with palpable purpura on the legs, abdominal pain, and arthritic pain in numerous joints. What is the diagnosis and treatment?
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Henoch-Schonlein Purpura
Rx: Self-limited Steroids for severe GI symptoms |
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Anticentromere antibodies
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CREST scleroderma
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Hyperphagia, hyperorality, hyperdocility, and hypersexuality
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Kluver-bucy syndrome
Bilateral amygdala lesion |
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After a minor car accident, a woman wears a neck brace and requests permanent disability. What is the most likely diagnosis?
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Malingering
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What medication is given to accelerate fetal lung maturity? For how long is it given? At what gestational age is it no longer necessary?
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IV Betamethasone or Dexamethasone
Given for 48 hours Gestational age < 34 weeks |
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Patients with silicosis are at higher risk for what type of infection?
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TB
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A patient has exophthalmos, pretibial myxedema, and a decreased TSH. What is the diagnosis?
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Graves disease
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PFTs show decreased FEV1/FVC. What is the diagnosis?
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Obstructive lung disease (Asthma, COPD, Emphysema)
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A postmenopausal female presents with vaginal bleeding for the last 5 days. What is the next step?
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Endometrial biopsy for suspected endometrial hyperplasia or carcinoma
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Which type of lung cancer is associated with hypercalcemia?
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Squamous cell (PTHrP secretion)
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What does a fall in systolic BP of > 10 mmHG with inspiration indicate?
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Pulsus paradoxus
Cardiac tamponade, Hyperinflation disorders (COPD, asthma) |
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What laparoscopic findings can be seen in endometriosis?
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Chocolate cysts
Powder burn lesions |
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Hypertension + hypernatremia + hypokalemia + metabolic alkalosis. What is the diagnosis?
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Hyperaldosteronism (Conn's or bilateral adrenal hyperplasia)
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What is the LDL goal in a patient with diabetes?
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LDL < 100
Any history of vessel disease LDL < 70 |
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An 8 year old child was in a motor vehicle accident and now requires emergency blood transfusion. Her parents are not present, but the child states she is a Jehovah's witness. What do you do?
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Treat anyways
Court order later |
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A 25 year old male presents with pain and watery diarrhea after meals. Exam shows fistulas between the bowel and skin and nodular lesions on his tibias. What is the diagnosis?
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Crohn's disease
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A 40 year old female presents with a discrete area of complete hair loss on the scalp that has worsened over weeks. What is the treatment?
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Alopecia arreata
Observation (resolves on its own) Intralesional steroids |
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CSF analysis shows low glucose, elevated neutrophils, and gram positive diplococci. What is the diagnosis?
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Streptococcus pneumonia meningitis
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What are the characteristic findings in tertiary syphilis?
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Tabes dorsalis
Positive Romberg sign Loss of proprioception Gamut formation Argyl-Robertson pupil Aortitis (tree barking of aorta) Aneurysm of aortic root |
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A young child presents with thigh muscle weakness, a waddling gait, and pronounced calf muscles. What is the diagnosis?
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Duchennes Muscular dystrophy
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A female who was born in breech position is found to have asymmetric inguinal and gluteal skin folds on her newborn exam. What is the diagnosis and treatment?
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Developmental dysplasia of the hip
Rx: Pavlik harness |
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Head injury -> initial altered mental status -> resolution of mental status for a few hours -> now with reemerging altered mental status. What is the diagnosis, underlying injury, and treatment?
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Epidural hematoma
Rupture of middle meningial artery Neurosurgical evacuation |
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What medication is given for seizure prophylaxis in sever preeclampsia?
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Magnesium sulfate
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What is the cause of erythroblastosis fetalis?
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Maternal antibodies against fetal Rh+ RBCs
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Describe the treatment of hypertension in cases of pheochromocytoma
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Alpha antagonist (phenoxybenzamine, phentolamine) FIRST
Beta-blockers after |
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A 7 year old boy presents with hemarthrosis. Lab-work shows increased PTT and normal PT and bleeding time. What is the diagnosis and treatment?
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Hemophila A or B
Rx: Supplement with deficient factors Desmopressin (Hemophilia A) |
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A tall, white male presents with shortness of breath. What diagnosis o you suspect? What is the treatment?
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Spontaneous pneumothorax
Spontaneous regression Pneumothorax > 15% requires chest tube placement |
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A 22 year old male has 4 months social withdrawal, worsening grades, decreased emotional expression, and concrete thinking. What is the diagnosis?
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Schizophreniform
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Honeycomb pattern on CT scan of the chest. What is the diagnosis and treatment?
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Diffuse interstitial pulmonary fibrosis
Steroids + azathioprine (or Cyclophosphamide) + N-acetylcysteine |
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A young child has loss of the red light reflex. What is the diagnosis?
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Retinoblastoma
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What is the first-line treatment for moderate hypercalcemia?
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IV Hydration
Loop diuretics |
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A 45-year old male presents with acute-onset flank pain and hematuria. What is the most likely etiology?
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Nephrolithiasis
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What test is used to rule out urethral injury?
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Retrograde cystourethrogram
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A 75 year old man presents with fatigue, lymphandeopathy, splenomegaly, and isolated lymphocytosis. What diagnosis do you suspect?
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Chronic Lymphocytic Leukemia
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Meningitis is diagnosed in a neonate. What are the most likely organisms, and what is the empiric treatment?
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Group B strep
Listeria E. coli Ampicillin + Gentamycin |
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What pathology causes an onion-skin appearance of the bone on x-ray?
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Ewing's sarcoma
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Which skin cancer classically presents with varying degrees of scaling or ulcerations?
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Squamous cell carcinoma
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What is the treatment for the premalignant lesion from sun exposure that can lead to squamous cell skin cancer?
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Actinic keratosis
5-FU or cryoablation |
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What is the general treatment of DKA?
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IV Fluids
Insulin + dextrose Electrolyte balance (Potassium, Bicarbonate, Magnesium, Phosphate) |
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A patient presents with weakness, nausea, vomiting, weight loss, and new skin pigmentation. Labs show hyponatremia and hyperkalemia. What is the treatment?
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Addison's disease
Glucocorticoids and mineralcorticoids (Fludrocortisone) |
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What diagnosis would you consider in a patient with sacroilitis?
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Ankylosing spondylitis
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A child presents with a midline neck mass. What do you suspect?
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Thyroglossal duct cyst
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A child presents with a lateral neck mass. What do you suspect?
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Brachial cleft cyst
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What is the medical treatment for inflammatory bowel disease?
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5-ASA +/- Sulfasalazine
Steroids |
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What is the difference between Mallory-Weiss and Boerhaave tears?
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Mallory-Weiss is a superficial tear in the esophagus.
Boerhaave is a perforated esophagus. This is life threatening. |
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What is the treatment for TTP?
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Plasmapharesis
Steroids |
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Which of the following are elevated in DIC: fibrin split products, D-dimer, fibrinogen, platelets, and Hct?
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Fibrin split products, D-dimer are increased
Platelets, Hct, fibrinogen are decreased |
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What EKG finding is a/w hypothermia?
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J wave
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What infection is classically a/w cold agglutinins?
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Mycoplasma pneumoniae
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What are the signs suggesting radial nerve damage with a humeral fracture?
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Wrist drop
Loss of thumb abduction |
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What is the first-line treatment for pediculosis pubis and pediculosis capitis?
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Permethrin
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Which immunodeficiency would you suspect in a patient with recurrent infections, thrombocytopenia, and eczema?
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Wiskott-Aldrich syndrome
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What causes a child to have mental retardation, microcephaly, microphthalmia, short palpebral fissures, midfacial hypoplasia, and cardiac defects?
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Fetal alcohol syndrome
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An 18 year old female with no history of abnormal pap smears now has a first time ASCUS pap. How should this be managed?
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Re pap smear in 12 months.
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What are the management options of a first time ASCUS pap in a non-adolescent?
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1. Reflex HPV
Low risk: Re pap in 6-12 months High risk: Colposcopy 2. Re pap in 6 months 3. Colposcopy |
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What is the treatment for a clavicle fracture?
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Conservative management
If at birth, do not treat. Figure of eight or sling |
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A 40 year old female has persistent erythema on her nose and cheeks and recurrent facial flushing especially with alcohol and spicy foods. What is the diagnosis?
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Rosecea
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A patient with cirrhosis presents again to the ER to have his ascites drained. Analysis of the ascites fluid reveals an absolute neutrophil count greater than 250 cells/mm3. What is the diagnosis?
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Spontaneous bacterial peritonitis
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Otoscopy in a child presenting with acute onset of ear pain reveals large, reddish vesicles on the TM. What is the diagnosis, typical organism, and treatment?
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Bullous myringitis
Mycoplasma Rx: Macrolides |
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What is the treatment for a pilonidal cyst?
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Incision and drainage
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What is the treatment for a rectal fistula?
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Fistulotomy
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A patient on isotretinoin for acne begins to develop daily, persistent, pulsatile headaches. Exam reveals papilledema. What is the diagnosis?
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Pseudotumor cerebri caused by Tetracycline drug interaction
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An 18 year old male is found to have a systolic heart murmur heard at the apex and left lower sternal border that increases in intensity while standing after squatting. What diagnosis do you suspect?
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Hypertrophic obstructive cardiomyopathy
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What disorder classically presents with the triad of cognitive impairment, urinary incontinence, and abnormal gait?
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Normal pressure hydrocephalus
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What is the underlying cause of late fetal decelerations on contraction stress test?
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Utero-Placental insufficiency
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A middle-aged man presents for knee pain and x-ray reveals bilateral calcifications of the articular cartilage. What is the treatment?
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Pseudogout
Colchicine and NSAIDs |
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What is the next step in the management of a positive PPD?
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Chest X-ray
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A 25 year old male is diagnosed with a solid testicular mass by ultrasound. What is the next step in the management?
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Orchiectomy of that testicle
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A teenage on antibiotics for acne presents with a severe sunburn. What antibiotic is he most likely taking?
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Tetracycline
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What is the next step in the management of a female with poor uterine tone after delivery of the placenta?
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Uterine massage
Oxytocin |
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What is Beck's triad for cardiac tamponade?
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Elevated JVP
Distant heart sounds Hypotension |
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What lab findings are diagnostic of Hashimoto's thyroiditis?
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Increased TSH
Decreased T4 Anti-microsomal antibodies |
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If you want to know if maternal age affects infant mortality rate but most of the variation in infant mortality is predicted by socioeconomic status, then socioeconomic status is a _____.
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Confounding variable
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What are the 3 reasons for involuntary psychiatric hospitalization?
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Danger to self
Danger to others Patient is gravely disabled |
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What is Charcot's triad in cases of gallbladder disease?
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Charcot's triad for ascending cholangitis
RUQ pain Jaundice Fever/chills |
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What is the treatment for ITP in children?
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Usually resolves spontaneously
IVIG Corticosteroids |
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What infection causes aplastic crisis in sickle cell disease?
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Parvovirus B12
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Elderly male complains of bony pain and adds that his favorite hat no longer fits.
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Paget's disease
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What test is used in the tenth week of gestation to screen for chromosomal abnormalities?
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Chorionic villus sampling
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What is the cause of secondary amenorrhea in a patient with normal prolactin + no response to estrogen-progesterone challenge + a history of D&C?
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Asherman's syndrome
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What causes a crescent-shaped hyperdensity on CT scan that does not cross the midline?
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Subdural hematoma
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Most common pathogen causing croup
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Parainfluenza virus
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What causes a transudative pleural effusion?
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CHF
Liver or kidney disease Protein-losing enteropathy |
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Immunodeficiency with doughy skin
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Job's syndrome (Hyper IgE syndrome)
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What is the treatment for opioid overdose?
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Naloxone, naltrexone
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What is the treatment for septic shock?
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IV fluids
Antibiotics Norepinephrine (Pressor) |
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Most serious side effect of clozapine?
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Agranulocytosis
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What are the 5 basic criteria for metabolic syndrome?
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Abdominal obesity
Insulin resistance High TG Low HDL Hypertension |
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What type of bias is present when a clinician is aware of the type of treatment his patient has received?
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Observer bias
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Sentinel loop on abdominal x-ray
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Acute pancreatitis
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What would you suspect in an ER patient with blood in the urethral meatus or a high-riding prostate?
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Urethral injury
Bladder injury |
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What type of acute renal failure would you suspect in a patient with FENa < 1%?
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Prerenal failure
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What are the protein and LDH criteria for an exudative effusion?
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Pleural protein to serum protein ratio > 0.5
Pleural LDH to serum LDH > 0.6 |
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What is the cause of muscle rigidity, fever, and rhabdomyolysis in a schizophrenic patient?
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Neuroleptic malignant syndrome
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What is the cause of bilious emesis in a newborn within hours after the first feeding?
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Duodenal atresia
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A 60 year old woman leaks urine when laughing or coughing. What are her nonsurgical options?
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Stress incontinence
Kegel exercises Estrogen (oral or cream) Pesary |
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What are the most common causes of seizures in children aged 2-10?
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Febrile seizure
Infections Trauma Idiopathic |
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Positive p-ANCA
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Pauci-immune glomerulonephritis
Microscopic polyangitis Churg-strauss syndrome |
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What organism is known for causing infection in burn victims?
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Pseudomonas
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What is the most common cause of HTN in young women?
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Oral contraceptive pills
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A patient presents with a painless, pruritic papule with regional lymphadenopathy that evolves over 7-10 days into a necrotic ulcer with a black eschar. What is the diagnosis and treatment?
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Cutaneous anthrax
Penicillin V or G Ampicillin Doxycycline |
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What is the late, life-threatening complication of chronic myelogenous leukemia (CML)?
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Blast crisis: Fever, bone pain, splenomegaly, pancytopenia
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Which hernia carries the highest risk of incarceration: indirect, direct, or femoral?
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Femoral hernia
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What cause of aplastic anemia is associated with thumb abnormalities, diffuse hypo- or hyperpigmentation, cafe-au-lait spots, and short stature?
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Fanconi's anemia
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What biostatistic calculation looks at individuals with and without a disease and determines the likelihood of exposure to a risk factor?
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Odd's ratio
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Which antidiabetic agent is associated with lactic acidosis?
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Metformin
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What is "cradle cap" and what is the treatment?
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Seborrheic dermatitis
Rx: Selenium sulfide shampoo, topical antifungals |
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What diseases causes glomerulonephritis with deafness?
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Alport's syndrome
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What is the preferred diagnostic test for a pulmonary embolism?
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CT w/ IV contrast
If unavailable: V/Q scan |
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What rash presents with herald-patch followed by a Christmas-tree pattern?
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Pityriasis rosea
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