Medical Jeopardy

Front 1

Alexander the Great refused to let his troops eat fish due to this toxin; Captain William Bligh described symptoms of this toxin among his sailors on an expedition in 1789.

Back 1

Ciguatera (mostly reef fish)

Front 2

Most common fish food poisoning in tropical coastal regions;

Back 2

Ciguatera; Ciguatera poisoning accounts for more than half of the fish-related foodborne disease outbreaks in the United States

Front 3

Symptoms of ciguatera toxin

Back 3

GI then neurologic

Front 4

In one highly publicized case, 26 employees developed this toxicity after eating blue marlin in the World Bank cafeteria in Washington, DC, in 1997

Back 4

Scombroid. Caused by ingestion of histamine in fish muscle

Front 5

Saxitoxin is associated with this ocean phenom.

Back 5

Red tide

Front 6

Consumption of saxitoxin in this type of seafood may result in perioral tingling, paralysis and resp failure

Back 6

Mussels, clams, and oysters, as well as by crabs and snails. PSP (paralytic shellfish poisons) toxins (saxitoxin is most common) block sodium ion channels

Front 7

Pufferfish (fugu) poisoning is caused by

Back 7

tetrodotoxin

Front 8

Treatment of pufferfish poisoning consists of

Back 8

Supportive care and intestinal decontamination with gut lavage and charcoal. Case reports suggest that anticholinesterases such as edrophonium may be effective

Front 9

INH toxicity antidote

Back 9

B6

Front 10

Dig toxicity

Back 10

Ovine Dig Fab

Front 11

cyanide toxicity

Back 11

amyl nitrite (inhalation), Na-nitrite (IV), na-thiosulfate IV

Front 12

which substance is metabolized to cyanide after ingestion –

Back 12

nail glue remover (acetotitrile)

Front 13

cyanide antidote kit

Back 13

Lilly Cyanide Antidote Package

Front 14

LMWH or heparin toxicity

Back 14

protamine

Front 15

TCA Toxicity

Back 15

Sodium Bicarb

Front 16

Salicylate toxicity (oil of wintergreen, peptobismol, alka seltzer)

Back 16

urine alkalinization, hemodialysis

Front 17

Bitter Almonds smell

Back 17

Cyanide

Front 18

Garlic smell

Back 18

Arsenic

Front 19

Pulmonary agent first used by the Germans in 1917, smells like newly mowed hay

Back 19

Phosgene gas (CG)

Front 20

fruity smell

Back 20

acetone, isopropyl alcohol, ethanol

Front 21

Iron toxicity

Back 21

Deferoxamine

Front 22

Lead toxicity treatment

Back 22

dimercaprol (British Anti-Lewisite or BAL), calcium disodium ethylenediaminetetraacetate (CaNA2EDTA), or meso-2,3-dimercaptosuccinic acid (DMSA); avoid dimercaprol in hepatic insufficiency or peanut allergy, cautious use in renal insufficiency or HTN

Front 23

Methemoglobin toxicity treatment (Fe in 3+ rather than 2+ results in inability to bind oxygen)

Back 23

methylene blue

Front 24

Ethylene glycol toxicity treatment

Back 24

Ethanol or fomepizole

Front 25

Organophosphate toxicity treatment

Back 25

atropine, pralidoxime

Front 26

Acetaminophen toxicity treatment

Back 26

N-Acetylcysteine oral 140mg/kg loading then 17 doses of 70mg/kg q4hr

Front 27

Narcotic antidote

Back 27

naloxone

Front 28

Benzodiazepine toxicity treatment

Back 28

Flumazenil

Front 29

Deadliest nerve agent known to man

Back 29

VX gas

Front 30

Pyridostigmine does not work as a pre-treatment for …

Back 30

VX gas and GB (sarin)

Front 31

Respiratory alkalosis, anion-gap metabolic acidosis, hyperpnea, tinnitus are al clinical clues of this overdose

Back 31

Salicylate poisoning

Front 32

Overdose with this substance typically causes an increased osmolar gap and ketosis without significant metabolic acidosis

Back 32

Isopropyl alcohol

Front 33

Antidote for nitrite overdose

Back 33

Methylene blue

Front 34

Three classes of medicines that are first-line treatment for anaphylaxis

Back 34

Epinephrine, antihistamines, steroids

Front 35

A patient with underlying hypertension goes into anaphylaxis that is refractory to epinephrine. In addition to standard measures, you should use this agent.

Back 35

Glucagon (pt may be on a B blocker and resistant to epinephrine

Front 36

Causes of clinical deterioration, lactic acidosis and altered mental status in a patient on nitroprusside

Back 36

cyanide toxicity

Front 37

AKA angel dust

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PCP

Front 38

AKA Special K or Kit Kats

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Ketamine

Front 39

AKA Georgia Home Boy

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GHB

Front 40

AKA Roffies or La Rocha

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Rohypnol

Front 41

Two most frequent symptoms of mild carbon monoxide poisoning

Back 41

Headache and nausea

Front 42

Accumulation of this gas is responsible for decompression illness

Back 42

Nitrogen

Front 43

Medical significance of N-acetyl-p-benzoquinoneimine (NAPQI)

Back 43

Toxic metabolite of acetominophen

Front 44

Intravenous treatment for cyanide poisoning

Back 44

Sodium thiosulfate

Front 45

Use this nomogram to assess tylenol toxicity at 4 and 24 hours after ingestion

Back 45

modified Rumack-Matthew nomogram

Front 46

Medical treatment for mild to moderate salicylate intoxication

Back 46

Alkalinization of the urine

Front 47

Treatment of choice for severe carbon monoxide toxicity with coma

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Hyperbaric oxygen

Front 48

Electrolyte abnormality classically associated with MDMA (3,4-methylenedioxymethamphetamine) intoxication

Back 48

Hyponatremia

Front 49

Delayed adverse reaction (that typically occurs 1-2 weeks after treatment) common in patients treated with antivenoms for Crotalinae bites (rattlesnakes, copperheads, and cottonmouths)?

Back 49

Serum sickness

Front 50

Metalloid chronic exposure associated with the hyperkeratosis pictured here as well as with a symmetric sensorimotor polyneuropathy, hepatic angiosarcoma, along with a variety of other CNS, CV, gastrointestinal, and pulmonary disorders

Back 50

Arsenic

Front 51

Symptoms of cholinergic excess

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SLUDGE = Salivation, lacrimation, urination, defecation, Gastric Emptying; BBB = bradycardia, bronchorrhea, bronchospasm

Front 52

2 drugs found in the Mark 1 kit

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Atropine and 2-PAM-Cl

Front 53

Of the three vesicants, this is the only one that does not cause immediate pain

Back 53

Mustard gas (Lewisite and phosgene oxide cause immediate pain)

Front 54

Lab findings in CN poisoning

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Severe anion-gap acidosis, bright red venous blood

Front 55

Optic neuritis, AG metabolic acidosis, osmolar gap from ingestion of this

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Methanol

Front 56

Ingestion of these 2 alcohols can cause a high anion gap

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Methanol, ethylene glycol

Front 57

Reason isopropyl alcohol does not have an increased anion gap

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Isopropyl alcohol is converted to acetone (neutral compound)

Front 58

The treatment of choice for lithium toxicity.

Back 58

Hemodialysis

Front 59

Red retinal veins after exposure to carbon monoxide

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Jett's sign

Front 60

Red as a beet, hot as a hare, dry as a bone, blind as a bat, mad as a hatter

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Anticholinergic syndrome

Front 61

Salivation, lacrimation, urination, defecation, GI upset, emesis

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Cholinergic syndrome/organophosphate poisoning

Front 62

Depressed mental status, depressed respiration, miosis

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Opiate toxiciity

Front 63

Depressed mental status, bradycardia, hypothermia, hypotension, pulmonary edema, areflexia

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Barbiturate toxicity

Front 64

CNS excitation, seizures, HTN, tachycardia, hallucinations, mydriasis

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Stimulant toxicity (amphetamines, cocaine)

Front 65

This neuromuscular junction disease is characterized by weakness that may improve with repetitive exercise

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Lambert-Eaton

Front 66

Term for a pink or yellow tint to centrifuged CSF in a patient with acute onset, severe HA

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Xanthochromia

Front 67

Spongiform encepholapathy in canabalistic tribes

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Kuru

Front 68

Flexion of the neck gives shock sensation down the spine in patients with MS (i.e. "Barber chair sign") - also seen in trauma, Behcet's disease, any transverse myelopathy or cord compression (disc, spondylarthropathy, Arnold-Chiari), Vit B12 def (sub-acute combined degeneration)

Back 68

Lhermitte's sign

Front 69

Three findings on exam that suggest an upper motor neuron lesion rather than a LMN lesion

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Hyperreflexia, Babinski's sign, and increased muscle tone.

Front 70

Wet, wacky, wobbly

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Normal pressure hydrocephalus

Front 71

In a patient with meningitis, massive neck flexion results in leg flexion

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Brudzinki's sign

Front 72

In a patient with meningitis, resistance to full extension of the knee with the hips flexed

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Kernig's sign

Front 73

Most common inheritied peripheral neuropathy

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Charcot-Marie-Tooth (Herditary motor sensory neuropathy)

Front 74

Impaired short term memory, confabulation, with normal cognition

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Korsakoff's syndrome

Front 75

Ipsilateral weakness, contralateral loss of pain and temperature sensation

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Brown-Sequard syndrome

Front 76

Confusion, ataxia, nystagmus

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Wernicke's encephalopathy (triad)

Front 77

Scanning speech, intention tremor, nystagmus

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Charcot's triad (for MS)

Front 78

Selective anterograde and retrograde amnesia in patients that have had Wernicke's

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Korsakoff's syndrome

Front 79

Frequent falls are associated with this particular seizure location

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Frontal lobe

Front 80

Lobe that is the site of 80% of partial seizures

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Temporal lobe

Front 81

name for stroke like symptoms following seizure

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Todd's paralysis

Front 82

Neurological symptoms seen first in B12 deficiency

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Loss of proprioception and vibrioception

Front 83

Miners of this element get Parkinson's disease

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Manganese

Front 84

Test associated wit NPH and shunting

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Miller-Fischer test (evaluate gait before and after removing 30 cc CSF)

Front 85

Cherry red spots

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Tay-Sachs or Nieman Pick

Front 86

Bilateral destruction of the temporal lobes that results in placidity, hypersexuality and loss of visual recognition.

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kluver-bucy

Front 87

plexus affected in Achalasia

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Auerbach's

Front 88

Plexus affected in Hirschprung's

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Meyer's plexus

Front 89

Rare condition that killed actor Dudley Moore

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Progressive supranuclear palsy (or, Parinaud's syndrome)

Front 90

This disease is similar to MS and is characterized by optic neuritis and transverse myelitis

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Devic's disease

Front 91

Lower plexus palsy affecting C8-T1 nerve roots

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Klumpke's palsy

Front 92

Protein found in Lewy Bodies (eosinophilic cytoplasmic inclusion bodies)

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synuclein

Front 93

Ratio of frontal horns of ventricle to maximal diameter of cranium

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0.4

Front 94

Confirmation of NPH criteria

Back 94

Improvement of gait with 30cc removal of CSF

Front 95

syndrome characterized by headaches, confusion, seizures and visual loss, common in the post transplant time period (2/2 tacrolimus/cyclosporine), with hypercalcemia or malignant HTN / eclampsia

Back 95

Posterior Reversible Encephalopathy Syndrome (PRES) or Reversible Posterior Leukoencephalopathy Syndrome (RPLS)

Front 96

Hypertension, bradycardia, irregular respirations seen with increased intracranial pressure

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Cushing's triad

Front 97

Hearing loss, tinnitus, vertigo

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Meniere's disease

Front 98

Ataxia, incontinence, mental status change

Back 98

Normal pressure hydrocephalus

Front 99

Non-drug treatment for benign positional vertigo

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Otolith repositioning maneuver such as the Epley maneuver; (Dix Hallpike for diagnosis)

Front 100

Diagnosis associated with acute onset of headache, vomiting, and ataxia

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Cerebellar infarction or hemorrhage (accept either)

Front 101

Name of condition characterized by rapidly flowing, dancing-like involuntary movements occurring in a chaotic, nonstereotypic fashion

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Chorea

Front 102

Syndrome characterized by frequent falls and vertical gaze paralysis

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Progressive supranuclear palsy (or, Parinaud's syndrome)

Front 103

Anticonvulsant drug associated with metabolic bone disease

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Phenytoin

Front 104

Rapidly progressive dementia in older person with prominent startle myoclonus is associated with this CSF protein

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14-3-3 protein in Creutzfeld-Jakob

Front 105

Name the symptom (not diagnosis) when an individual drops to the floor with complete muscle weakness after laughing

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cataplexy

Front 106

Diagnosis for extra-axial, calcified brain mass with overlying skull hyperostosis

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Meningioma

Front 107

Transient, acute memory loss lasting for minutes without loss of consciousness

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Transient global amnesia

Front 108

Auditory symptom associated with Bell's palsy

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Hyperacusis

Front 109

Most consistently effective treatment for spasmodic torticollis (cervical dystonia)

Back 109

bo-tox injections

Front 110

Syndrome characterized by dysautonomia, Parkinson's symptoms, corticospinal tract signs, and ataxia

Back 110

Multiple system atrophy (Shy Drager)

Front 111

Pupil with consensual but not direct response to light

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Marcus Gunn pupil (afferent pupillary defect)

Front 112

Ocular finding in hypercalcemia

Back 112

Band keratopathy

Front 113

Most common cause of conjunctivitis in adults

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viral conjunctiviitis

Front 114

Eye involvement associated with Crohn's disease

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Uveitis

Front 115

Most common malignant eye tumor

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Melanoma

Front 116

Eye finding often associated with abdominal straining

Back 116

Subconjunctival hemorrhage

Front 117

This physical exam finding can help differentiate iritis from benign conjunctivitis

Back 117

ciliary flush

Front 118

Most common presenting symptom in MS

Back 118

Optic neuritis

Front 119

Diagnostic procedure of choice for a patient with endophthalmitis

Back 119

Aspiration and culture of anterior chamber (accept either part of answer)

Front 120

Term for conjunctival edema

Back 120

Chemosis

Front 121

Disease associated with corkscrew conjunctival vessels

Back 121

Sickle cell

Front 122

Glaucoma diagnostic criteria (3)

Back 122

Progressive loss of peripheral vision, high intraocular pressure, abnormal cup/disc ratio

Front 123

Papilledema, high opening pressure, headache, and diplopia with a peripheral visual field loss is best treated with these medications

Back 123

Acetazolamide or furosemide (corticosteroids in severe cases) for pseudotumor cerebri

Front 124

Proliferation of opaque fibrovascular conjunctival tissue medial to iris

Back 124

Pterygium

Front 125

Unilateral large pupil with low reactivity to light and accomodation

Back 125

Adie's pupil

Front 126

Disease associated with "sausaging" of retinal veins

Back 126

Macroglobulinemia (accept Waldenstrom's, hyperviscosity syndrome)

Front 127

Adhesions that develop between the iris and lens capsule following iritis

Back 127

Synechiae

Front 128

Psychiatric disorder occuring commonly following stroke

Back 128

Depression

Front 129

Most common psychiatric disorder in women over the age of 65 years

Back 129

Generalized anxiety disorder

Front 130

Name of syndrome characterized by agitation, altered mental status, nausea, vomiting, diarrhea, dizziness, hypotension, fever, shivering and diaphoresis in a patient taking an SSRI and lithium

Back 130

Serotonin syndrome

Front 131

Syndrome characterized by the presence of four or more unexplained symptoms

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Abridged somatization

Front 132

Daily spiking fevers (quotidian), arthritis and an evenescent "salmon-colored" rash

Back 132

Adult Still's Disease

Front 133

Likely diagnosis in a 20 yo with recurrent R knee effusions and darkly pigmented fluid on joint aspiration containing hemosiderin-laden macrophages

Back 133

Pigmented Villonodular synovitis

Front 134

Pain at at the elbow is reproduced with the extension of the wrist against resistance

Back 134

Lateral epicondylitis (Tennis elbow)

Front 135

Leading cause of knee pain in pt <45

Back 135

Patellofemoral syndrome

Front 136

Most sensitive physical exam test to detect a patient's torn ACL

Back 136

Lachman's test

Front 137

Most common cause of foot pain (outpatient)

Back 137

Plantar fasciitis

Front 138

3 knee injuries that make up the Unhappy Triad

Back 138

ACL tear, MCL tear, medial meniscus tear

Front 139

In patient with RA, the name for the appearance of the index finger bent at 90 degrees

Back 139

boutonniere deformity (PIP hyperflexion with DIP hyperextension)

Front 140

Suspect this cause of proximal muslce weakness and elevated CK levels in a patient on chronic treatment for gout

Back 140

Colchicine myopathy

Front 141

4 seronegative spondyloarthropathies

Back 141

Reactive arthritis, IBD-associated, Psoriatic, Ankylosing spondylitis

Front 142

Infliximab and etanercept inhibit this mediator of the inflammatory response in RA

Back 142

TNF-alpha

Front 143

Infliximab

Back 143

human/mouse TNF alpha antibody

Front 144

Adalimumab

Back 144

human monoclonal antibody to TNF alpha

Front 145

Certolizumab

Back 145

pegylated humanized TNF alpha Fab

Front 146

Golimumab

Back 146

human monoclonal antibody to TNF alpha

Front 147

Etanercept

Back 147

fusion protein with TNF receptor and IgG

Front 148

3 components of Felty's syndrome

Back 148

Neutropenia, RA, splenomegaly

Front 149

Acute stridor and hoarseness in a patient with RA is a signal for involvement of this joint and is an emergent indication for steroids

Back 149

Cricoarythenoid synovitis

Front 150

This condition, known as 'pseudophlebitis,' can mimic a DVT

Back 150

Ruptured Baker's cyst

Front 151

2 large vessel vasculitidies

Back 151

Giant cell arteritis, Takayusu arteritis

Front 152

Suspect this diagnosis in a patient with active Hep B and vasculitis

Back 152

PAN (polyarteritis nodosa)

Front 153

Low complement levels are commonly seen in patients with these 2 types of vasculitis

Back 153

Cryoglobulinemia, SLE vasculitis

Front 154

Antibodies associated with systemic sclerosis

Back 154

Anti-Scl 70 or anti-centromere

Front 155

This antibody is associated with the absence of interstitial lung disease in patients with scleroderma

Back 155

Anti-centromere

Front 156

Myositis specific autoantibodies associated with interstitial lung disease, arthritis, and a hyperkeratotic rash on the hands

Back 156

Antihistidyl-tRNA synthetase

Front 157

Test for lacrimal function in patients with dry eyes

Back 157

Schirmer test

Front 158

Syndrome characterized by pain localized to the distal radius and a positive Finkelstein's test

Back 158

De Quervain's tenosynovitis

Front 159

What is Finkelsteins test?

Back 159

MD grasps thumb and severely ulnar deviates wrist; + = sharp pain on top of forearm

Front 160

Syndrome of chelitis, dry mouth, and trouble chewing and swallowing food

Back 160

Xerostomia (Sjogren's syndrome)

Front 161

Essential serological finding in rheumatoid vasculitis

Back 161

High titers of Rheumatoid factor

Front 162

Most common extra-articular manifestation of ankylosing spondylitis

Back 162

Acute anterior uveitis

Front 163

candlewax appearance on back x-ray

Back 163

DISH (diffuse idiopathic skeletal hyperostosis)

Front 164

Autoimmune disorders that comprise Mixed connective tissue disorder

Back 164

SLE, scleroderma, polymyositis

Front 165

Mixed connective tissue disorder antibody

Back 165

anti-U1 RNP (spliceosomal component)

Front 166

Systemic Scleroderma staining pattern

Back 166

Nucleolar

Front 167

daily fever

Back 167

quotidian

Front 168

Idiopathic inflammatory myopathy that most commonly affects older men

Back 168

Inclusion body myositis

Front 169

2 types of arthritis that affect the DIP joints

Back 169

OA (Heberden's nodes), psoriatic arthritis

Front 170

name for hypersensitivity seen at sites of needle sticks in patient with Behcet's syndrome

Back 170

pathergy

Front 171

This class of drugs is the treatment of choice in patients with HTN crisis with scleroderma

Back 171

ACE-I

Front 172

Connective tissue disease in which wide mouthed colonic diverticuli are pathagnomonic

Back 172

Scleroderma

Front 173

This rare scleroderma-like syndrome results from ingestion of contaminated L-tryptophan supplements (interstitial infiltrates, eosinophilia, skin changes)

Back 173

Eosinophilia-Myalgia syndrome

Front 174

Antibody associated with neonatal lupus (congenital heart block)

Back 174

Anti-SSA (Ro)

Front 175

The most specific autoantibody for SLE

Back 175

Anti-Smith or anti-ds-DNA

Front 176

Antibody associated with psychosis and depression in SLE

Back 176

anti-ribosomal P

Front 177

Pulmonary complication of sjogren's syndrome predisposing to lymphoma

Back 177

Lymphocytic interstitial pneumonia, activation of B cells

Front 178

Apthous stomatitis, uveitis, genital ulcers

Back 178

Behcet's syndrome

Front 179

Blue sclera, hearing loss, brittle bones

Back 179

Osteogenesis imperfecta

Front 180

Lupus with renal involvement (antibody)

Back 180

anti ds DNA

Front 181

Primary biliary cirrhosis antibody

Back 181

Antimitochondrial

Front 182

Goodpasture's syndrome antibody

Back 182

Anti-glomerular basement membrane

Front 183

Antibody associated with drug induced lupus

Back 183

anti-histone antibody

Front 184

Drug used to treat Familial Mediterranean fever

Back 184

Colchicine (FMF characterized by paroxysmal attacks of fever and serosal inflammation)

Front 185

Major cause of mortality in patients with Familial Mediterranean Fever

Back 185

Secondary Amyloidosis

Front 186

The most common glycogen storage disease which can be associated with pain and weakness after exercise

Back 186

McArdle's disease (myophosphorylase deficiency)

Front 187

Patients of Middle Eastern descent with synovitis, erythema nodosum, sterile abscesses, and recurrent aphthous stomatitis and/or genital aphthous ulcers most likely have this disease (also a/w eye inflammatory sx and cutaneous pathergy - papular rxn persisting 24-48h after needle or skin prick)

Back 187

What is Behçet disease

Front 188

This HLA antigen is associated with aggressive rheumatoid arthritis

Back 188

HLA DR4 (RA also associated with DR1)

Front 189

This ANA pattern is typically seen in mixed connective tissue disease.

Back 189

speckled

Front 190

It is an inherited skeletal muscle disorder characterized by a hypermetabolic state precipitated by exposure to volatile inhalational anesthetics.

Back 190

What is malignant hyperthermia?

Front 191

These 2 HLA antigens have been associated with anti-glomerular basement membrane glomerulonephritis.

Back 191

HLA DR2 and B7

Front 192

HLA antigen associateed with ankylosing spondylitis, postgonococcal arthritis and acute anterior uveitis

Back 192

B27

Front 193

HLA antigens associated with Diabetes Mellitus Type 1

Back 193

HLA DR3, DR4

Front 194

HLA antigen associated with primary sjogren and autoimmune hepatitis

Back 194

HLA DR3

Front 195

HLA antigen associated with 21 hydroxylase deficiency

Back 195

HLA B47

Front 196

HLA antigen associated with Chronic Lyme Disease

Back 196

HLA DR2 and DR4

Front 197

17 year old girl with DM complaining of pain in the palmar surfaces of the first three fingers, thickening of finger skin (thick and waxy) and painful shoulders

Back 197

Limited joint mobility (Cheiroarthropathy)

Front 198

30 year old woman with acute onset of swelling redness and pain at the base of the big toe, amorphous calcification, normal labs, repeat x-ray 2 weeks later is normal

Back 198

Hydroxyapatite periarthritis

Front 199

Sign for thoracic outlet syndrome (eponym)

Back 199

Adson's sign

Front 200

30 year old woman with nonradiating lower back pain after delivery of her third child, trinagular sclerotic area of the ileum bilaterally, normal SI joint space, absent sclerotic changes in the sacrum

Back 200

osteitis condensas ilii

Front 201

The autoantibody most closely associated with Wegener's granulomatosis

Back 201

C-ANCA (anti-PR3)

Front 202

Congenital cystic dilatation of intrahepatic bile ducts associated with frequent bile stones

Back 202

Caroli's disease

Front 203

Acute colonoic pseudo-obstruction

Back 203

Ogilvie's syndrome

Front 204

Antibody is 95% sensitive and 98% specific for primary biliary cirrhosis

Back 204

Anti-mitochondrial AB

Front 205

Cause of an isolated elevation of serum alk phos in an asymptomatic woman in her 3rd trimester

Back 205

Increased placental alkaline phosphatase

Front 206

More common than Familial Adenomatous Polyposis, this syndrome is another hereditary form of cancer

Back 206

Hereditary Non-polyposis colorectal cancer (Lynch syndrome)

Front 207

Upper GI bleeding after retching

Back 207

Mallory Weiss tear

Front 208

Stress ulcers associated with severe burns or trauma due to ischemia of the gastric mucosa

Back 208

Curling's ulcers

Front 209

Erosions with incarcerated hiatal hernias, seen in 5.2% of patients with hiatal hernias

Back 209

Cameron lesions

Front 210

Eponym for esophageal rupture

Back 210

Boerhaave's syndrome

Front 211

Patient's pain out of proportion to abdominal exam findings in an elderly patient

Back 211

Ischemic bowel (Messenteric ischemia)

Front 212

Most common cause of an acute abdomen in a pregnant patient

Back 212

Acute appendicitis

Front 213

Most sensitive and specific test to diagnose acute cholecystitis

Back 213

HIDA scan

Front 214

Suspect this in neutropenic patient with abdominal pain

Back 214

Typhlitis (neutropenic necrotizing enterocolitis)

Front 215

Syndrome characterized by intestinal obstruction and pneumobilia

Back 215

Gallstone ileus

Front 216

Syndrome characterized by narrowing of the extra-hepatic bile duct from mechanical compression by a gallstone impacted in the cystic duct

Back 216

Mirizzi's syndrome

Front 217

Skin condition associated with inflammatory bowel disease but whose activity does not parallel that of the bowel disease

Back 217

Pyoderma Gangrenosum

Front 218

Syndrome of esophageal webs and iron deficiency anemia

Back 218

Plummer Vinson syndrome

Front 219

In patients with esophageal cancer, preferred non-invasive diagnostic test to determine extent of disease progression within esophageal wall and regional lymph nodes

Back 219

Endoscopic ultrasonography

Front 220

A cause of dysphagia that can be relieved in some patients by lifting their arms over the heads or with a Valsalva maneuver

Back 220

Achalasia

Front 221

Best test for suspected sclerosing cholangitis

Back 221

ERCP (accept MRCP)

Front 222

Gastrointestinal polyps and pigmented macules around mouth and lips

Back 222

Peutz-Jeghers' disease

Front 223

Drug for irritable bowel syndrome associated with ischemic colitis

Back 223

Alosetron (also Tegaserod)

Front 224

Drug used to treat bleeding associated with hereditary hemorrhagic telangiectasia

Back 224

Combination estrogen/progesterone (accept hormone therapy)

Front 225

Class of drugs causing regression of polyps in familial adenomatous polyposis

Back 225

NSAIDs

Front 226

Typical location of perforation in acute idiopathic intestinal obstruction

Back 226

Cecum

Front 227

Sudden loss of vision associated with hemorrhages confined to the optic disk and macula in acute pancreatitis

Back 227

Purtscher's retinopathy

Front 228

Best test to differentiate pancreatic insufficiency versus small bowel mucosal disease as a cause for malabsorption

Back 228

D-Xylose test

Front 229

Fe/TIBC percent consistent with hemochromatosis

Back 229

45%

Front 230

This monoclonal antibody reduces disease activity in both MS and Crohns disease

Back 230

What is natalizumab, an alpha-4 integrin antagonist?

Front 231

Stool finding with intussusception

Back 231

Currant-jelly stool

Front 232

Barrett's esophagus is associated with this type of abnormal cell metaplasia

Back 232

Abnormal intestinal columnar epithelium

Front 233

Patients with T cell mediated inflammatory rxn to gluten who present with itching may have this associated dermatologic condition

Back 233

Dermatitis herpetiformis

Front 234

Peutz-Jeghers syndrome is associated with these malignancies

Back 234

Stomach, duodenum, breast, ovary/testicular, pancreas

Front 235

Minimum Child-Pugh and MELD (Cr, INR, total bili) scores to consider liver transplantation

Back 235

7 and 10 respectively

Front 236

Indications for steroids and pentoxifylline in alcoholic hepatitis

Back 236

Discriminant function (4.6 x (PT-control) + total bili) >32 or enchepalitis without evidence of GIB or infection

Front 237

Benefit of pentoxifylline in alcoholic hepatitis

Back 237

Decreased hepatorenal syndrome and mortality

Front 238

Hepatotoxic mushroom

Back 238

Amanita phalloides

Front 239

Radiographic findings in mesenteric ischemia

Back 239

Submucosal hemorrhage and edema (thumbprinting)

Front 240

An elevated fecal osmotic gap suggests this type of diarrhea

Back 240

Osmotic diarrhea

Front 241

Formula for fecal osmotic gap

Back 241

Fecal osmotic gap = stool osmolality - 2(Na + K)

Front 242

Adults with acquired hypogammaglobulinemia or CVID associated with recurrent sinopulmonary infections are predisposed to malabsorption secondary to infection with this organism

Back 242

Giardia

Front 243

A patient with hemochromatosis develops abdominal pain, fever, and diarrhea. Stool has WBC and RBC. Infection with this organism is diagnosed.

Back 243

Yersinia enterocolitica

Front 244

This fundoplication operation is a surgical approach for the correction of GERD

Back 244

Nissen

Front 245

4 extra-esophageal manifestations of GERD

Back 245

cough, asthma/RAD, hoarseness/laryngitis, dental caries

Front 246

a mucosal ring at the gastro-esophageal junction that may cause dysphagia

Back 246

Schatzki's ring

Front 247

The appropriate treatment for ulcerative colitis with high grade dysplasia

Back 247

Proctocolectomy

Front 248

Eponym for syndrome with ETOH induced fatty liver, high triglycerides, and hemolysis

Back 248

Zieves syndrome

Front 249

This hepatic mass has been associated with the use of OCP

Back 249

Hepatocellular adenoma

Front 250

Bile duct cancer located at the bifurcation of the right and left hepatic ducts

Back 250

klatskin tumor

Front 251

In patients with varices (GI), treatment with this agent can reduce future bleeds

Back 251

Beta blockers

Front 252

4 well recognized causes of peptic ulcer disease

Back 252

H pylori, ZE syndrome, NSAIDs, Crohn's disease

Front 253

Suspect this class of diarrhea in a patient with large volume diarrhea, not relieved by fasting

Back 253

Secretory

Front 254

Most common cause of osmotic diarrhea

Back 254

lactase deficiency

Front 255

Associated with Fundal involvement of gastritis

Back 255

Pernicious anemia

Front 256

Associated with antral involvement of gastritis

Back 256

H. Pylori

Front 257

Superficial ectatic artery causing massive UGIB

Back 257

Dieulafoy's lesion

Front 258

RUQ pain on inspiration

Back 258

Murphy's sign

Front 259

A diagnostic test (not antibody) that can be used to test for celiac sprue

Back 259

D-Xylose test

Front 260

Extracolonic manifestiatations of Crohn's

Back 260

Pyoderma gangrenosum, erythema nodosum, iritis, episcleritis, aphhthous ulcers, thromboembolic events, auoimmune hemolytic anemia, chronic hepatitis, cirrhosis, sclerosiing cholangitis

Front 261

Antibody test for autimmune hepatitis

Back 261

Type I: antismooth muscle Type 2: anti liver/kidney microsome Type 3: anti soluble liver antigen

Front 262

5 components of child pugh classification

Back 262

Ascities, encephalopathy, bilirubin, albumin, PT

Front 263

RUQ pain, jaundice, fever/chills

Back 263

Charcot's triad

Front 264

RUQ pain, jaundice, fever/chills, MS change, hypotension

Back 264

Reynauld's pentad

Front 265

Syndrome where the colon is found between the liver and the diaphragm

Back 265

Chilaiditi syndrome

Front 266

Enlarged, palpable, nontender gallbladder seen with obstruction of the common bile duct

Back 266

Courvoisier's sign

Front 267

Right subscapular pain due to cholelithiasis

Back 267

Boas's sign

Front 268

Bluish discoloration of the periumbilical region

Back 268

Cullen's sign

Front 269

Hiatal hernia, gallstones, diverticulosis

Back 269

Saint's triad

Front 270

#1 cause of liver failure in the US

Back 270

Tylenol overdose

Front 271

Most common cause of asymptomatic ALT elevation

Back 271

Non-alcoholic fatty liver disease

Front 272

Top 3 causes of hepatitis with AST and ALT elevation greater than 5000

Back 272

viral, toxins, ischemia

Front 273

2 drug treatment for Hepatitis C

Back 273

Interferon and ribavirin

Front 274

Extrahepatic manifestions of hepatitis C

Back 274

Autoimmune thyroid disease, glomerulonephritis, lichen planus, porphyria cutanea tarda, mixed cryoglobulinemia, lymphoma

Front 275

Finding on colonoscopy in patient abusing laxatives

Back 275

melanosis coli

Front 276

This is a pancreatic islet tumor which manifests as mild diabetes, cholelithiasis, and diarrhea

Back 276

What is a somatatistatinoma?

Front 277

Chest pain, vomiting, cervicul subcutaneous emphysema

Back 277

Mackler triad

Front 278

acute hepatic or chronic biliary infection caused by eating watercress

Back 278

Fasciola hepatica

Front 279

Name for Intradermal antigen test for hydatid disease (echinococcus granulosus or multilocularis)

Back 279

Casoni

Front 280

Eponym for Hepatorenal syndrome

Back 280

Frerich Syndrome

Front 281

Eponym for aspiration of stomach juice

Back 281

Mendelson's

Front 282

Urine lab used to aid in the diagnosis of intestinal carcinoid tumor

Back 282

What is 5-HIAA (5-Hydroxyindoleacetic Acid)?

Front 283

Two conditions with Microvesicular fatty liver

Back 283

pregnancy, reyes syndrome

Front 284

Lynch 1

Back 284

HNPCC with colon only

Front 285

Lynch 2

Back 285

HNPCC with colon, ovary,breast, endometrial

Front 286

Antibody associated with ulcerative colitis

Back 286

P-ANCA (60-70%)

Front 287

Antibody associated with Crohn's

Back 287

anti-Saccharomyces cerevisiae (ASCA) in 60-70%

Front 288

Treatment of Hep B

Back 288

lamivudine, adefovir, telbivudine or entecavir (entacavir most potent)

Front 289

Screening tests for HCC indicated in Hep B

Back 289

serum AFP and hepatic US q6 months

Front 290

Suspect this diagnosis in a male patient with neuronal hearing loss and renal insufficiency

Back 290

Alport Syndrome (generally X linked, sometimes AR)

Front 291

The most common cause of nephrotic syndrome in patients < 15 years of age

Back 291

Minimal Change Disesae

Front 292

Path of kidneys in patients with diabetic nephropathy

Back 292

Kimmelstiel-Wilson nodules

Front 293

Drug of choice for hypertensive crisis due to preeclampsia

Back 293

Hydralazine

Front 294

This type of RTA is assoicated with nephrolithiasis

Back 294

Type I RTA (classic, distal)

Front 295

Winter's formula

Back 295

PCO2 = [1.5(HCO3 + 8) +/- 2

Front 296

In non-diabetic adults, these are the 2 most common causes of primary nephrotic syndrome

Back 296

Membranous nephropathy, FSGS

Front 297

Suspect this in a patient with nephritic syndrome who presents with flank pain, macroscopic hematuria and acute worsening of their renal function

Back 297

Renal vein thrombosis

Front 298

5 causes of low complement GN

Back 298

post infectious, SLE, cryoglobulinemia, MPGN, endocarditiis… also cholesterol emboli

Front 299

Most common cause of AKI in a hospitalized patient

Back 299

ATN

Front 300

Marked by acute renal failure, eosinophilia and livedo reticularis

Back 300

cholesterol emboli syndrome

Front 301

Most likely cause of hyperkalemia in diabetic patients with mild to moderate renal insufficiency

Back 301

Hyporeninemic hypoaldosteronism (accept type IV RTA)

Front 302

Diagnosis associated with hypokalemia and metabolic alkalosis

Back 302

Diuretic use or vomiting or Bartter's syndrome (any)

Front 303

Biological drug for acute renal failure secondary to hepatitis C associated cryoglobulinemia

Back 303

alpha-Interferon

Front 304

Hormone results in regression of left ventricular hypertrophy in dialysis patients

Back 304

Recombinant human erythropoietin

Front 305

Creatinine, sex, and age-based formula to estimate glomerular filtration rate

Back 305

Cockcroft-Gault formula (any part of name)

Front 306

Hydrocarbon exposure is a risk factor for this pulmonary/renal syndrome

Back 306

Goodpasture's syndrome

Front 307

Classes of Lupus Nephritis

Back 307

I Minimal Mesangial GN (normal on light, abnormal on electron) II Mesangial Proliferative nephritis - usu responds to corticosteroids III Focal Proliferative nephritis - usu responds to high doses of corticosteroids IV Diffuse Proliferative nephritis - corticosteroids + immunosuppressants V Membranous Nephritis - extreme edema and protein loss VI Glomerulosclerosis

Front 308

Anion gap represents these unmeasured anions

Back 308

Phosphorous, sulfate, organic acids, anionic proteins

Front 309

AG in patients with Waldenstrom's (lymphoplasmocytic lymphoma)

Back 309

Low

Front 310

Most common cause of secondary nephrotic syndrome

Back 310

Diabetes

Front 311

Most common cause of acute glomerulonephritis

Back 311

IgA nephropathy (Berger's disease)

Front 312

Nephrotic syndrome in heroin user with AIDS

Back 312

Focal segmental glomerulosclerosis

Front 313

Nephrotic syndrome in patient with chronic skin popping

Back 313

Secondary amyloidosis (AA)

Front 314

Aminoaciduria, phosphaturia, glycosuria

Back 314

Fanconi's syndrome

Front 315

Hyperreninemia hyperaldosteronism, hypokalemia, metabolic alkalosis, and/or hypomagnesemia with normal BP

Back 315

Bartter's syndrome (more severe) or Gittelman's syndrome (thiazide channel)

Front 316

4 primary types of kidney stones

Back 316

Calcium, cystine, uric acid (radiolucent), struvite

Front 317

This type of glomerulopathy is seen in Hepatitis B and C

Back 317

Membranous glomerulopathy

Front 318

RTA with hyporeninemic hypoaldosteronism

Back 318

Type IV RTA

Front 319

Most common urinary analysis abnormality in a patient with SLE

Back 319

Proteinuria

Front 320

The first sign of bladder cancer

Back 320

Hematuria

Front 321

Condition associated with dysmorphic red blood cells in the urine

Back 321

Glomerulonephritis

Front 322

Nutrient malabsorption causing hyperoxaluria

Back 322

Fat

Front 323

Renal vascular disease associated with angiographic "string of beads" appearance

Back 323

Fibromuscular disease (accept fibromuscular dysplasia)

Front 324

Periumbilical nodule representing metastatic abdominal (usually gastric) carcinoma

Back 324

Sister Mary Joseph's nodule

Front 325

Roleaux formation in a patient with anemia

Back 325

Multiple myeloma

Front 326

Most likely etiology of anemia in a woman with an MCV < 70 but only a mild anemia

Back 326

Beta thalessemia (minor)

Front 327

The first and most common clnical feature of acute and chronic graft vs host disease

Back 327

Skin rash

Front 328

This is the factor responsible for hypercalcemia seen in patients with multiple myeloma

Back 328

Osteoclast activating factor

Front 329

Most common cause of cancer death in women

Back 329

Lung CA

Front 330

This tumor marker may be elevated in patients with pancreatic cancer

Back 330

CA 19-9

Front 331

This neoplastic disease is the most common paraproteinemia

Back 331

MGUS

Front 332

Gene mutation associated with a 50-85% lifetime risk of developing breast CA

Back 332

BRCA1 or BRCA2

Front 333

In addition to other findings, multiple myeloma is defined by a BM bx containing greater than this % plasma cells

Back 333

10%; also presence of M spike and symptoms (CRAB)

Front 334

ISS Multiple Myeloma staging criteria

Back 334

What are I: Albumin GE 3.5, B2 MicroglobulinLT 3.5, III: B2 Microglobulin GE 5.5, II neither I nor III (if B2 microglobulin is 3.5 exactly than stage II)

Front 335

Most common inheritied bleeding disorder

Back 335

von Willebrand disease

Front 336

2 most common inheritied hypercoagulable states

Back 336

Factor V Leiden, PT 20210

Front 337

Syndrome of AHA and ITP

Back 337

Evan's syndrome

Front 338

least common and typically least aggressive of the 4 myeloproliferative syndromes

Back 338

Essential thrombocytopenia

Front 339

The 4 myeloproliferative syndromes

Back 339

CML, PV, primary Myelofibrosis, Essential thrombocytopenia

Front 340

Jackie onassis died of this disease after receiving CHOP therapy

Back 340

Non-hodgkin's lymphoma

Front 341

Bob Marley was at increased risk for this disease, from which he died

Back 341

Malignant melanoma

Front 342

This brutal warrior died of a nosebleed on his wedding night in AD453

Back 342

Attila the Hun

Front 343

Name 5 of the hemologic emergencies

Back 343

1. Acute tumor lysis syndrome 2. Hypercalcemia 3. SVC Syndrome 4. Spinal cord compression 5. Hyperviscosity syndrome/leukostasis 6. Neoplastic pericardial tamponade 7. Acute airway obstruction 8. Neutropenic fever

Front 344

mechanism of action - lepirudin, bivalirudin, argatroban

Back 344

Direct thromibin inhibitors; argatrobran (hepatic clearance), lepirudin (renal clearance)

Front 345

Autosomal Recessive Disease resulting in deficiency of glycoprotein IIb-IIIa complexes

Back 345

Glanzmann Thrombasthenia =aGGregation problem=inteGrillin function (fibrinogen receptor)

Front 346

Treatment for patient with splenomegaly, TRAP+ cells, dry bone marrow aspiration

Back 346

Cladribine (2-chlorodeoxyadenosine)

Front 347

Etiology of anemia in a 35 year old female with myasthenia gravis and a thymoma on CXR

Back 347

pure red cell aplasia

Front 348

Type of lung cancer associated with gynecomastia - due to production of bHCG

Back 348

Large Cell Lung CA

Front 349

Hypertrophric pulmonary osteoarthropathy (HOA) is most associated with this cell type of non-small cell lung CA

Back 349

adenocarcinoma

Front 350

Most common acute gastrointestinal complication of radiation therapy for prostate cancer

Back 350

acute proctitis

Front 351

This treatment is indicated for patients with recurrent MALT lymphoma

Back 351

chemotherapy or gastrectomy

Front 352

This drug is more effective than pentoxifylline in improving walking distance, functional status, and quality of life for patients with claudication

Back 352

Cilostazol

Front 353

Most frequent cause of transient aplastic crisis in patients with chronic hemolytic anemia

Back 353

Parvovirus B19

Front 354

Major use of cryoprecitate is to replace this blood component

Back 354

Fibrinogen

Front 355

Important cause of recurrent abdominal pain in patients with paroxysmal nocturnal hemoglobinuria

Back 355

Portal or mesenteric thrombosis

Front 356

Disease associated with "sausaging" of retinal veins

Back 356

Macroglobulinemia (accept Waldenstrom's aka lymphoplasmocytic lymphoma, hyperviscosity syndrome)

Front 357

Tests for PNH

Back 357

sucrose lysis test, Ham's acid hemolysis, Flow cytometry for low levels of CD55 and CD59

Front 358

CBC findings in adrenal insuff

Back 358

NC anemia, lymphocytosis, eosinophilia

Front 359

Absence/deficiency of Gp Ib/V/IX

Back 359

Bernard Soulier (vWF receptor) – will also have mild thrombocytopenia

Front 360

Chipmunk facies, microcytic anemia

Back 360

Beta thal major

Front 361

Anemia associated with Hydrops fetalis

Back 361

Hg Barts – alpha thal with all 4 alleles affected

Front 362

This disease can be ruled out by testing amniotic fluid for endonuclease Mst II cleavage pattern

Back 362

SS disease

Front 363

Lance armstrong's cancer

Back 363

GCT

Front 364

Relationship between carcinogen dose and tumor induction time

Back 364

Druckrey relationship

Front 365

Non-nutritive megaloblastic anemia in which malignant red cell precursors are particularly evident

Back 365

Di-Guglielmo disease (see M6 AML)

Front 366

Congenital pure red cell aplasia

Back 366

Diamond Blackfan anemia

Front 367

Severe immunodeficiency, MR, predisposition to cancers due to hypersensitivity to DNA damaging agents (ie CTX)

Back 367

Bloom’s syndrome

Front 368

Defect in primary homeostasis, prolonged PT, mechanism for translocating PS to the platelet membrane is defective, resulting in impaired thrombin formation

Back 368

Scott syndrome

Front 369

3 complications of massive RBC transfusion

Back 369

DIC, hypothermia, hypokalemia, hypocalcemia

Front 370

Pseudo Pelger Huet anomaly

Back 370

MDS or AML

Front 371

Unstable Hg and oxidant stress; precipitates of denatured Hg only visible with crystal violet stain

Back 371

Heinz bodies (think thallasemia, G6PD)

Front 372

Diseases with target cells on blood smear (3)

Back 372

Thalassemias, Liver disease, Alcoholism

Front 373

disease associated with a smudge cell

Back 373

CLL

Front 374

Chronic hematuria, iron deficiency anemia, DVT

Back 374

PNH

Front 375

Testing for presence of fetal blood cells in maternal circulation

Back 375

Kleihauer-Betke test

Front 376

AD condition with callous formation on palms and soles, esoph papillomas, 95% chance of developing esoph SCCA by 65yo

Back 376

Tylosis Palmaris

Front 377

In situ breast lesion that is not invasive but has inc risk for b/l involvement

Back 377

Lobular CIS

Front 378

CLL ->diffuse large cell lymphoma DLBCL) +fever, wt loss, LAD

Back 378

Richter’s Syndrome

Front 379

Sudden appearance and rapid increase in number and size of seborrheic keratoses with pruritis

Back 379

Sign of Leser trelat

Front 380

Carcinoma in situ of glans penis

Back 380

Erythroplasia of Queyrat

Front 381

Squamous cell CA in-situ, seen in sun exposed areas

Back 381

Bowens disease

Front 382

MCC malignancy

Back 382

Basal Cell CA

Front 383

Mutant p53 allele, predisposition towards breast carcinoma, sarcomas, and brain tumors (childhood and adult neoplasms)

Back 383

Li-Fraumeni Syndrome

Front 384

Left axillary node assoc with metastatic dz

Back 384

Irish node

Front 385

Tumor arising from CBD at confluence of right and left hepatic ducts, slow growing, sclerotic

Back 385

Klatskin tumor

Front 386

Carinomatous metastasis from primary site high up in peritoneal cavity; may be felt through anterior rectal wall as hard shelf

Back 386

Blumer’s shelf

Front 387

Metastatic GI neoplasia to ovaries

Back 387

Krukenburg tumor

Front 388

Hemochromatosis gene

Back 388

HFE gene, C282Y, H63D

Front 389

MC cancers causing malig pleural or pericardial effusions

Back 389

Breast, Lung, Lymphoma

Front 390

MC cancers met to bone

Back 390

Breast, Lung, Thyroid, Kidney, Prostate

Front 391

Cancer with thrombocytosis as associated paraneoplastic syndrome

Back 391

RCC

Front 392

Eponym for cholestasis with RCC

Back 392

Stauffer’s Syndrome

Front 393

4 Paraneoplastic syndromes associated with RCC

Back 393

Erythrocytosis, Thrombocytosis, Hypercalcemia, Cholestasis

Front 394

3 cancers associated with erythrocytosis

Back 394

RCC, hepatocellular, cerebellar hemangioblastoma

Front 395

4 cancers associated with hypercalcemia

Back 395

SqCLC, RCC, Ovarian CA, MM

Front 396

3 paraneoplastic syndromes associated with ovarian cancer

Back 396

Hypercalcemia, Cerebellar degeneration with loss of purkinje cells (anti-yo), sign of Leser Trelat

Front 397

Optic atrophy, contralateral papilledema, anosmia; occ assoc w/olfactory groove meningioma

Back 397

Foster-Kennedy Syndrome

Front 398

Papillary Cystadenoma lymphomatosum, parotid gland involved

Back 398

Warthin’s tumor

Front 399

Lymphedema following mastectomy leading to lymphangiosarcoma

Back 399

Stewart-Treve Syndrome

Front 400

Supraclavicular adenopathy usually on left side

Back 400

Virchow’s sentinel node

Front 401

Rare AD syndrome characterized by multiple hamartomas

Back 401

Cowden's Disease (PTEN gene); causes hamartomatous neoplasms of the skin and mucosa, GI tract (polyps), bones, CNS, eyes, and genitourinary tract. Skin is involved in 90-100% of cases, and the thyroid is involved in 66% of cases. Increased risk of breast and thyroid cancer as well as endometrial and RCC.

Front 402

Favorable cytogenetics in AML

Back 402

t(15;17), t(8;21), inv16, t(16:16)

Front 403

Poor cytogenetics in AML

Back 403

del (5q), del(7q), monosomies 5 or 7, trisomies 8 or 13, t(6:9), 3q21q26 abnormalities, 11q23 abnormaties, 12p abnormalities, 17p abnormalities, abnormalities with 3 or more genes

Front 404

Heavy chain disease with infiltration of lamina propria of small intestine with lymphoplasmacytoid cells

Back 404

Seligmanns Disease

Front 405

Special variant of cutaneous T cell lymphoma with generalized erythroderma, periph LAD; disseminated mycosis fungoides

Back 405

Sezary Syndrome (cerebriform nuclei)

Front 406

Light chains in plasma cell d/o

Back 406

Bence Jones proteins

Front 407

(t15;17)

Back 407

APL

Front 408

(t9;22)

Back 408

Philadelphia Chromosome

Front 409

(t8;14)

Back 409

Burkitt’s Lymphoma (c-myc and immunoglobulin)

Front 410

Isochromosome 12

Back 410

Germ cell tumors

Front 411

Broken ring of lymphoid tissue located in throat

Back 411

Waldeyer’s throat ring

Front 412

(t14;18)

Back 412

Follicular Lymphoma (immunoglobulin and bcl-2 genes)

Front 413

t(11:22)

Back 413

Ewing's sarcoma

Front 414

(t11;14)

Back 414

Mantle cell lymphoma (bcl-1 and immunoglobulin genes)

Front 415

burning pain in the feet or hands accompanied by erythema, pallor, or cyanosis, in the presence of palpable pulses (common in PV)

Back 415

Erythromelalgia (treat with aspirin)

Front 416

Best end-point for measuring the effect of a cancer screening intervention

Back 416

Cancer specific mortality

Front 417

Observational studies suggest that screening mammography is useful in women who have at least this number of years of life expectancy

Back 417

5 years

Front 418

Metastatic solid tumor cured with bleomycin, etoposide, and cisplatin

Back 418

Testicular cancer

Front 419

Best drug for warm-antibody autoimmune hemolytic anemia

Back 419

Corticosteroids

Front 420

Hydroxyurea re-activates expression of this developmentally silenced protein

Back 420

Fetal gamma globulin

Front 421

Most common neurological complication of systemic cancer

Back 421

Brain metastases

Front 422

Serum marker that is unique for nonseminomatous testicular cancer

Back 422

Alpha fetoprotein

Front 423

Relapsing (cyclical) fever of Hodgkin's disease

Back 423

Pel-Ebstein fever

Front 424

Test used to screen for anal intraepithelial neoplasia in high risk patients

Back 424

Pap smear

Front 425

Vulvar lichen sclerosis predisposes to this malignant condition

Back 425

Vulvar squamous cell carcinoma

Front 426

Best therapy for acute chest syndrome associated with sickle cell disease

Back 426

Partial exchange transfusion

Front 427

Most common cause of mild, asymptomatic thrombocytopenia in pregnancy

Back 427

Gestational thrombocytopenia

Front 428

Best test for paroxysmal nocturnal hemoglobinuria

Back 428

Flow cytometry

Front 429

Drug for acute aplastic anemia

Back 429

Antithymocyte globulin or cyclosporin (either)

Front 430

Name for acute lower limb ischemia caused by a massive ileofemoral DVT in which the leg is painful, swollen and blue

Back 430

phlegmasia cerulea dolens

Front 431

The systemic malignancy most commonly associated with erythroderma

Back 431

What is lymphoma (mycosis fungoides, cutaneous T-cell lymphoma, Sezary syndrome)?

Front 432

This study, published in June 2006, provided definitive evidence for the adequacy of CT-pulmonary angiography in the routine diagnosis of (outpatient) pulmonary embolism

Back 432

PIOPED II

Front 433

Cyclophosphamide metabolite that causes bladder cancer

Back 433

acrolein

Front 434

Criteria for APLAS

Back 434

Sapporo criteria: 1. Clinical - thrombosis (unequivocal) or pregnancy morbidity a. Thrombosis or b. Pregnancy morbidity 1) abortion after 10 weeks in a normal fetus 2) abortion prior to 34 weeks from preeclampsia, placental insufficiency or eclampsia 3) 3 abortions prior to 10 weeks not otherwise explained by chromosomal or anatomical abnormalities 2. Laboratory - anticardiolipin, anti B2-glycoprotein or lupus anticoagulant on 2 occasions > 6 weeks apart

Front 435

X-linked recessive disorder is characterized by immunodeficiency, severely dysfunctional platelets, and thrombocytopenia with microthrombocytes rather than macrothrombocytes

Back 435

Wiskott-Aldrich syndrome

Front 436

autosomal recessive disorder presenting with mild thrombocytopenia, circulating "giant" platelets, marked platelet dysfunction, and bleeding, absence of the platelet glycoprotein (GP) Ib-IX-V,

Back 436

Bernard-Soulier

Front 437

autosomal dominant trait characterized by giant platelets, mild to moderate thrombocytopenia, and leukocyte inclusions

Back 437

May-Hegglin anomaly

Front 438

a patient with anemia, thrombocytopenia, and large amounts of schistocytes on peripheral blood smear. 3 possible causes

Back 438

DIC, HUS, TTP, HELLP

Front 439

Causes increased risk of thrombosis with CA

Back 439

tissue factor

Front 440

Patients with lupus anticoagulant will bleed only if one of these two conditions are present

Back 440

Thrombocytopenia, prothrombin deficiency

Front 441

MALT lymphoma is associated with this infection

Back 441

H. Pylori

Front 442

The malignancy that often causes spinal cord compression is relatively radioresistant

Back 442

Renal cell carcinoma

Front 443

Syndrome of digital clubbing, chronic proliferative periostitis of long bones, and synovitis. Often seen in adenocarcinoma.

Back 443

Hypertrophic Pulmonary Osteoarthropathy (Bamberger-Marie disease)

Front 444

Thyroglobulin is a tumor marker for these 2 types of thyroid cancer

Back 444

Papillary and follicular

Front 445

GI polyps with oral papules, associated with thyroid CA, breast CA, and ovarian cysts

Back 445

Cowden's disease

Front 446

2 infectious causes of tropical sprue

Back 446

E coli, Klebsiella, Enterobacter cloacae

Front 447

Infectious cause of diarrhea that can mimic appendicitis or Crohn's disease

Back 447

Yersinia enterocolitica

Front 448

Auer rods on peripheral smear

Back 448

AML

Front 449

Tumor marker often seen in patients with ovarian cancer

Back 449

CA-125

Front 450

Leukemia with TRAP positive cells and dry bone marrow

Back 450

Hairy cell leukemia

Front 451

Autosomal dominant condition marked by hemangioblastomas, clearcell renal cell carcinomas, pheochromocytomas, endolymphic sac tumors of themiddle ear, serous cystadenomas and neuroendocrine tumors of the pancreas, and papillary cystadenomas of the epididymis and broad ligament

Back 451

von Hippel-Lindau disease

Front 452

an inherited neurocutaneous disorder that is characterized by pleomorphic features involving many organ systems, including multiple benign hamartomas of the brain, eyes, heart, lung, liver, kidney, and skin

Back 452

Tuberous Sclerosis

Front 453

Palmar fibromatosis (sometimes refererred to as palmar fasciitis) is a rare disorder most commonly associated with this neoplasm

Back 453

ovarian cancer

Front 454

Deficient in hereditary spherocytosis

Back 454

Spectrin

Front 455

Anemia, jaundice, splenomegaly, gallstones

Back 455

hereditary spherocytosis

Front 456

Congenital disorder of DNA repair is associateed with early and innumerable melanoma and nonmelanoma pigmentosa

Back 456

Xeroderma pigmentosa

Front 457

Microstaging method for melanoma

Back 457

Breslow's thickness

Front 458

4 types of cutaneous melanoma

Back 458

Superficial spreading, nodular, lentigo maligna melanoma, acral-lentiginous

Front 459

Histologic type of cutaneous melanoma, often found in subungual regions, occuring with equal frequency among whites and non-whites

Back 459

Acral-lentiginous melanoma

Front 460

Adjuvant biological therapy has ben shown to imporve relapse-free and overall survival in patients who are free of disease after surgical resection of high risk melanoma

Back 460

Interferon-alfa

Front 461

Ptosis, meiosis, anhydrosis

Back 461

Horner's syndrome

Front 462

Remnants of Rathke's pouch

Back 462

Craniopharyngioma

Front 463

Philadelphia chromosome

Back 463

CML

Front 464

Causes aplastic anemia in sickle cell patient

Back 464

Parvovirus B19

Front 465

Tender mass in left upper quadrant due to splenic hematoma (eponym)

Back 465

Balance's sign

Front 466

Left shoulder pain due to splenic rupture

Back 466

Kehr's sign (Kehr's sign can also refer to shoulder pain due to blood/irritants in the peritoneal cavity)

Front 467

Fever, neutropenia, rash

Back 467

Sweet's syndrome

Front 468

Side effect of 5-FU with stocking glove paresesthia, followed by painful erythema, swelling and desquamation

Back 468

palmoplantar erythrodysesthesia (Hand-Foot Syndrome)

Front 469

Treatment for patient with AIHA and TTP

Back 469

Plasma exchange

Front 470

Max dose of anthracyclines

Back 470

550 mg/m2

Front 471

Elevation in WBC diff in patient with myelodysplastic syndrome

Back 471

Monocytes

Front 472

Factor produced by the liver that is increased in anemia of chronic disease and leads to decresased release of iron from macrophages

Back 472

Hepcidin

Front 473

Endocrine disorders that can lead to anemia

Back 473

hypothyroidism, addison disease, hypogonadism, panhypopit (including decreased growth hormone)

Front 474

Expect this mass in a patient with pure red cell aplasia

Back 474

Thymoma (paraneoplastic)

Front 475

anticerebellar antibodie associated with small cell cancer

Back 475

Anti-Hu - antineuronal nuclear antibody Type 1

Front 476

anticerebellar antibodies associated with breast cancer and directed against Purkinje cells

Back 476

Anti-Yo (anti-purkinje cell antibody)

Front 477

Faggot cell

Back 477

AML M3 Subtype (Acute promyelocytic leukemia)

Front 478

"flame cell"

Back 478

Multiple myeloma

Front 479

"Lacunar cell"

Back 479

Hodgkin's lymphoma (usuually nodular sclerosing)

Front 480

Fever, retroorbital pain, "breakbone" aches and pains in a febrile traveler

Back 480

Dengue fever (flavivirus, + tourniquet test - 20 petechia/inch2, Aedes aegypti mosquito)

Front 481

Fever with bradycardia (pulse-temperature dissociation), abdominal pain & "rose" colored abdominal rash

Back 481

Typhoid fever (Salmonella Typhi), "nervous fever"

Front 482

Hot tub rash

Back 482

Pseudomonas aeurginosa

Front 483

The most important prognostic factor in a patient without an underlying comorbidity who has cryptococcal meningitis

Back 483

CSF opening pressure

Front 484

Most common cause of acute, nonepidemic encephalitis in the US

Back 484

HSV

Front 485

The three tic born illness endemic to Nantucket Island, and their treatments

Back 485

1. Babesiosis - IV clinda/ oral quinine, 2. Lyme - doxy, 3. Ehrlichiosis - doxy

Front 486

Human granulocytic anaplasmosis organism

Back 486

Anaplasma phagocytophilum

Front 487

Infection in asplenic/Martha's vineyard

Back 487

Babesia microti (Babesiosis)

Front 488

Drug used to eradicate liver hypnozoites in patient with malaria due to P. ovale or P. vivax

Back 488

primaquine ("prime the liver")

Front 489

The most direct method of diagnosing primary and secondary syphilis

Back 489

Darkfield microscopy

Front 490

Despite treatment, this test stays positive for life in patients with syphilis

Back 490

Fluorescent Treponemal antibodies

Front 491

4 criteria required for the diagnosis of bacterial vaginosis

Back 491

Homogeneous, thin, grayish-white discharge that smoothly coats the vaginal walls, vaginal pH greater than 4.5, positive whiff-amine test, clue cells on wet mount - need 3/4 Amsel criteria

Front 492

The virus contained in the smallpox vaccine

Back 492

Vaccinia virus

Front 493

This antiviral medication has shown antiviral activity against smallpox in animal models and may be employed in a smallpox (variola virus, poxviridae) oubreak

Back 493

Cidofovir (limited by renal toxicity)

Front 494

The most feared and often fatal complication of smallpox vaccination

Back 494

Vaccinia necrosum; tx with VIG (vaccinia immune globulin)

Front 495

Name of triad of ipsilateral facial nerve paralysis, ear pain and vesicles

Back 495

Ramsay-Hunt syndrome

Front 496

The reactivation of this virus causes PML (progressive multifocal leukoencephalopathy)

Back 496

JC virus (polyoma virus)

Front 497

Necrotizing fasciitis of the perineal and genital fascia

Back 497

Fournier's gangrene

Front 498

Umbilicated pearly papules

Back 498

Molluscum contagiosum

Front 499

Causative organism for tinea versicolor

Back 499

Malassezia furfur and globosa (also the most common cause of seborrheic dermatitis)

Front 500

In a patient with AIDS, disseminated (cutaneous) infection with this organism mimics molluscum

Back 500

Cryptococcus

Front 501

Rectal swab from a patient with suspected disseminated gonococcal infection should be plated on this agar

Back 501

Thayer-Martin agar

Front 502

The virus that causes Kaposi's sarcoma

Back 502

HHV-8

Front 503

AKA Valley Fever

Back 503

Coccidiodomycoses

Front 504

AKA Rabbit Fever

Back 504

Tularemia

Front 505

AKA Kala Azar

Back 505

Visceral Leishmaniasis

Front 506

AKA River Blindness

Back 506

Onchocerciasis ( Onchocerca volvulus transmitted by the black fly; tx: ivermectin)

Front 507

AKA Katayama Fever

Back 507

Acute Shistosomiasis (fever, lethargy, the eruption of pale temporary bumps associated with severe itching (urticarial) rash, liver and spleen enlargement, and bronchospasm)

Front 508

AKA Blackwater Fever

Back 508

Malaria with intravascular hemolysis, hemoglobinuria, and renal failure

Front 509

Eponym for severe form of leptospirosis including renal failure, hepatic failure and/or meningitis

Back 509

Weil's syndrome/disease

Front 510

Vector for Leishmaniasis

Back 510

Sand fly (Phlebotomous)

Front 511

Vector for African sleeping sickness (Trypanasoma Brucei)

Back 511

Tse Tse

Front 512

Vector for Chagas Disease (Trypanasoma Cruzi)

Back 512

Reduviid bug

Front 513

MC roundworm infection in the US

Back 513

Pinworm (Enterobius Vermicularis) - no eosinophils (no invasion)

Front 514

MC roundworm infection in the world

Back 514

Ascaris Lumbricoides (Largest nematode, Lung disease in Larval Stage (Loffler's),Tx: Mebendazole)

Front 515

Two diseases treated by ivermectin

Back 515

Onchocerciasis, filariasis

Front 516

Skin lesions after wading in water

Back 516

Vibrio vulnificus

Front 517

Bacterial agent causing pneumonia associated with the following risk factors: bronchiectasis, daily corticosteroid therapy, and malnutrition

Back 517

Pseudomonas

Front 518

Infection characterized by productive cough, hemoptysis, and cavitary pulmonary lesion in a patient with pulmonary silicosis

Back 518

Tuberculosis

Front 519

Diagnosis suggested by a severe CAP with pancytopenia in the setting of bird exposures

Back 519

Chlamidophila psitticai

Front 520

Class of drug useful in the treatment of both influenza A and influenza B

Back 520

Neuraminidase inhibitors (zanamavir and oseltamavir)

Front 521

Method of action for amantadine

Back 521

interference with a viral protein, M2 (an ion channel),[15][16] which is required for the viral particle to become "uncoated" once taken inside a cell by endocytosis.

Front 522

Preferred first-line antibiotic for the pneumonic form of tularemia

Back 522

Gentamicin or streptomycin

Front 523

Nasal mucosal atrophy and foul-smelling crusts in the nasal passages

Back 523

Ozena (klebsiella infection in atrophic rhinitis)

Front 524

Gram-stain finding in expectorated sputum from a chemotherapy patient

Back 524

Candida

Front 525

Class of anti-influenza drugs with activity against influenza B

Back 525

Neuraminidase inhibitors

Front 526

The two most common bacterial pathogens associated with bronchiectasis

Back 526

Pseudomonas and Staphylococcus

Front 527

Name of childhood illness caused by parvovirus B 19

Back 527

Erythema infectiosum (fifth disease)

Front 528

Etiological agent of fish tank granuloma

Back 528

Mycobacterium marinum

Front 529

Cutaneous anthrax location that is an indication for IV antibiotics

Back 529

Face and neck

Front 530

Causative organism for this skin finding

Back 530

Treponema pallidum (condyloma lata)

Front 531

Triad: arthritis, dermatitis, tenosynovitis

Back 531

Meltzer's triad (disseminated gonococcal infection)

Front 532

Acute necrotizing ulcerative gingivitis (eponym)

Back 532

Vincent's angina

Front 533

Two HIV drugs that cannot be used together

Back 533

AZT and d4T

Front 534

Bacteremia and sepsis in splenectomized patient bitten by dog

Back 534

Capnocytophaga canimorsis

Front 535

HIV drug may cause a hypersensitivity reaction consisting of a generalized rash and/or flu-like illness

Back 535

Abacavir

Front 536

The 2 bacteria associated with bacterial endocarditis and colon cancer

Back 536

Strepotoccus bovis and Clostridium septicum

Front 537

Organism responsible for whipple's disease

Back 537

Tropheryma whippelii

Front 538

Vector for HGA

Back 538

Ixodes tick

Front 539

Appearance of KOH prep in a patient with tinea versicolor

Back 539

spaghetti and meatball appearance

Front 540

Benign, recurrent aseptic meningitis

Back 540

Mollaret's meningitis

Front 541

Increased sebum production in patients with acne leads to proliferation of this organism

Back 541

Propionobacterium acne

Front 542

Most common cause of epididymitis in sexually active men aged < 35 years old

Back 542

N. gonorrhea (chlamydia second)

Front 543

This HIV medication can cause BM suppression

Back 543

Zidovudine

Front 544

Patient with HIV with foot drop and neg MRI

Back 544

mononeuritis multiplex

Front 545

Rickettsial infection with no insect vector. Presents with fever, headache, myalgias, nonproductive cough, and hepatitis

Back 545

Q fever (Coxiella burnetti)

Front 546

Causative organism for the plague

Back 546

Yersinia pestis

Front 547

This protease inhibitor is associated with kidney stones

Back 547

Indinavir

Front 548

CT head in HIV with ring enhancing lesions

Back 548

CNS toxoplasmosis or lymphoma

Front 549

2 indications to use steroids in PCP

Back 549

pO2 < 70 or AA gradient > 35

Front 550

CDC recommended medicine for leishmaniasis

Back 550

Pentavalent antimony (stibogluconate; Pentastam)

Front 551

Patients with cirrhosis and sepsis following raw oyster feast - suspect this bacteria

Back 551

Vibrio vulnificus

Front 552

Painful genital ulcer

Back 552

Haemophilus ducreyi

Front 553

Disease causing clue cells ona a wet prep

Back 553

Bacterial vaginosis (Gardnerella vaginalis)

Front 554

Strawberry cervix

Back 554

Trichomonas vaginalis

Front 555

Lymphogranuloma venereum (LGV)

Back 555

Chlamydia trachomatis (L1, L2, and L3 serovars)

Front 556

Caused by klebsiella grannulomatosis, this uncommon disease is characterized by horrible appearing genital ulcers

Back 556

Granuloma inguinale (Donovanosis)

Front 557

Usual cause of traveler's diarrhea

Back 557

ETEC

Front 558

Enteritis with this organism is associated with Guillian-Barre syndrome

Back 558

Campylobacter Jejuni

Front 559

E. coli O157:H7 must be grown on this media

Back 559

MacConkey-Sorbital agar

Front 560

Lyme disease vector

Back 560

Ixodes tick

Front 561

TB vaccine name

Back 561

Bacille Calmette-Guerin

Front 562

Toxin from clostridium tetanus

Back 562

Tetanospasm

Front 563

Impetigo

Back 563

Streptococcus

Front 564

Rose spots

Back 564

Salmonella typhi

Front 565

Fever, flu-like symptoms, tachycardia, hypotension during syphilis treatment

Back 565

Jarisch-Herxheimer reaction

Front 566

Organism associated with chronic diarrhea and eosinophilia in an AIDS patient

Back 566

Isospora Belli

Front 567

Treatment for Toxoplasmosis

Back 567

Sulfadiazine, Pyrimethamime, folic acid

Front 568

Bullous myringitis associated with this organism

Back 568

Mycoplasma pneumoniae

Front 569

Mycoplasma pneumoniae may cause this hematologic abnormality

Back 569

Hemolysis (60%; secondary to cold agglutinin)

Front 570

Mycoplasma is most commonly treated with this antibiotic

Back 570

Azithromycin

Front 571

Infection that is the leading cause of adult onset seizures

Back 571

Taenia solium (from eating undercooked pork; larval stage metacestode causes cysticercosis)

Front 572

Tapeworm infection associated with eating undercooked beef

Back 572

Taenia saginata

Front 573

Tapeworm infection associated with eating fish

Back 573

Diphyllobothrium latum

Front 574

2 medications used in the treatment of measles

Back 574

Ribavirin and Vitamin A

Front 575

1st disease

Back 575

Rubeola

Front 576

2nd disease

Back 576

Streptococcal spotted fever

Front 577

3rd disease

Back 577

Rubella

Front 578

4th disease

Back 578

Filator-Duke's disease

Front 579

5th disease

Back 579

Erythema infectiosum (Parvo)

Front 580

6th disease

Back 580

Exanthem Subitum (HHV 6)

Front 581

Koplik's spots

Back 581

Measles

Front 582

Rocky mounted spotted fever organism

Back 582

Rickettsia rickettsii

Front 583

Horder spots

Back 583

Psittacosis

Front 584

Jugular vein thrombophlebitis secondary to Fusobacterium

Back 584

lemierre's syndrome

Front 585

Eponym for posterior cervical lymphadenopathy in Trypanosomiasis

Back 585

Winter bottom sign

Front 586

Rash in disseminated pseudomonas

Back 586

Ecthyma Gangrenosum

Front 587

HIV drug associated with nightmares

Back 587

Efavirenz

Front 588

HIV drug associated with Fanconi's syndrome

Back 588

Tenofovir

Front 589

Most common cause of eosinophilic meningitis in the world

Back 589

Angiostrongylus Cantonensis

Front 590

Strain of e coli causing recent outbreak in 2010

Back 590

O145

Front 591

findings on exam suggestive of severe aortic insufficiency

Back 591

severity proportional to DURATION of murmur (except in acute and severe late disease)

Front 592

Rapid rise and fall of pulse (AR sign)

Back 592

Corrigan’s (or Watson's) water-hammer pulse

Front 593

A systolic and diastolic bruit heard when the femoral artery is partially compressed (sign of AI)

Back 593

Duroziez’s sign

Front 594

A pistol shot pulse (systolic and diastolic sounds) heard over the femoral arteries, esp with distal compression (sign of AI)

Back 594

Traube’s sound

Front 595

Pulsating cervix (sign of AI)

Back 595

Shelly’s sign

Front 596

Visible pulsations of the retinal arteries and pupils (sign of AI)

Back 596

Becker’s sign

Front 597

Splenic pulsation (sign of AI)

Back 597

Gerhard’s sign

Front 598

Head-bobbing with heartbeat (sign of AI)

Back 598

de Musset’s sign

Front 599

Systolic pulstations of the liver (sign of AI)

Back 599

rosenbach's sign

Front 600

More than a 15 mmHg decrease in diastolic blood pressure with arm elevation from the value obtained with the arm in the standard position. (AI sign)

Back 600

Mayne's sign

Front 601

Popliteal cuff systolic pressure exceeding brachial pressure by more than 20 (60?) mmHg (AI sign)

Back 601

Hill's sign

Front 602

Systolic pulsation of uvula (AI sign)

Back 602

Mueller’s sign

Front 603

Subungal capillary pulsations (AI sign)

Back 603

Quincke’s pulses

Front 604

findings on exam suggestive of severe aortic stenosis

Back 604

pulsus parvus et tardus, late peaking murmur, inaudible A2, single or paradoxically split S2, LV heave, S4

Front 605

Pulse of severe aortic stenosis

Back 605

Pulsus parvus et tardus

Front 606

echo classification of AS

Back 606

1.) gradient: mild < 25, moderate 25-40, severe >40; 2.) Velocity > 4 m/s (severe) 3.) AoVA (cm2): mild 1.5-2, moderate 1.0-1.5, severe < 1.0

Front 607

hematologic abn a/w more severe AS

Back 607

acquired von Willebrand disease (destruction of vWF by shear forces)

Front 608

Notching in the ascending limb of the S wave in leads V3 and V4 in a pt with MI and known LBBB

Back 608

Cabrera's sign

Front 609

Notching of the ascending limb of the R wave in lead V5 or V6 in a pt with MI and known LBBB

Back 609

Chapman’s sign

Front 610

A clenched fist pressed against the center of the chest in a patient with angina

Back 610

Levine’s sign

Front 611

Which finding is most highly suggestive of significant ischemic heart disease on exercise ECT testing

Back 611

An S3 heart sound heard during the test

Front 612

Duke Treadmill Score

Back 612

Exercise time - 5 (ST segment deviation) - 4xangina (1 nonlimiting, 2 limiting) Low GE 5 Moderate -10 to +4 High LE -11

Front 613

Pleuritic chest pain alleviated in pericarditis when bending to a chest on knee position

Back 613

Pins’ sign

Front 614

Exaggeration of pulmonary sounds in acute pericarditis.

Back 614

Warthin’s sign

Front 615

Most common cancers causing Pericardial effusions

Back 615

Lung, breast, NHL, RCC

Front 616

Dullness at the angle of the left scapula caused by pericardial effusion

Back 616

Ewart’s sign

Front 617

A paradoxical increase in venous distention and pressure during inspiration seen in constrictive pericarditis

Back 617

Kussmaul’s sign (sign of RV dysfunction, also seen in effusion w/ tamponade, restrictive CMP, RV failure/infarct, tricuspid stenosis)

Front 618

Physical exam finding in hypertrophic cardiomyopathy, this ‘sign’ is characterized by a large atrial kick, a sustained left ventricular impulse, and an S3.

Back 618

The triple ripple

Front 619

Pulse of HOCM

Back 619

Pulsus bisferians

Front 620

The jugular venous pulse wave caused by bulging upward of the closed tricuspid valve during RV contraction

Back 620

C-wave

Front 621

Brockenbrough phenomenon

Back 621

Paradoxically diminished pulse occurring after a premature beat in HOCM

Front 622

Severe left ventricular failure EKG finding

Back 622

Pulsus alternans

Front 623

cyclic crescendo-decrescendo respiratory effort and airflow during wakefulness or sleep (associated with heart failure)

Back 623

Cheyne-Stokes

Front 624

HACEK

Back 624

Haemophilus (Haemophilus parainfluenzae, Haemophilus aphrophilus, and Haemophilus paraphrophilus)[3] Actinobacillus actinomycetemcomitans (now called Aggregatibacter actinomycetemcomitans) Cardiobacterium hominis Eikenella corrodens Kingella kingae

Front 625

Name these pathognmonic, (typically) distal, nontender, erythematous/hemorrhagic, macular/nodular lesions and associated condition

Back 625

Janeway lesions; infective endocarditis

Front 626

Name these painful, red lesions on the palms of the hands and soles of feet c/w immune complex deposition and the classic associated disease states

Back 626

Osler's nodes; infective endocarditis; also seen in SLE, maranatic endocarditis, disseminated gonococcal infection, infected arterial catheters (distal to catheter)

Front 627

JONES criteria

Back 627

Joints, Carditis, Nodes (subcutaneous), Erythema marginatum, Sydenham's chorea

Front 628

Antibiotics for endocarditis prophylaxis

Back 628

Amoxicillin/Ampicillin 2 grams Clindamycin 600 mg PO/IV

Front 629

The 2 bacteria associated with bacterial endocarditis and colon cancer

Back 629

Strepotoccus bovis and Clostridium septicum

Front 630

Activation of receptors in the atria, great veins, and left ventricle may lead to this reflex causing neurocardiogenic syncope

Back 630

Bezold-Jarisch reflex

Front 631

Venous waveform letters

Back 631

a = atrial contraction c = closure of TV with early ventricular contraction - bulging of TV back into RA x = atrial relaxation, downard movement of ventricle during contraction v = venous filling against a closed valve y = opening of TV

Front 632

Lenegre-Lev syndrome

Back 632

An acquired complete heart block due to idiopathic fibrosis and calcification of the electrical conduction system of the heart (His bundle, or bundle branches with corresponding conduction blocks). Both sexes affected; onset over 50 years of age. It is often described as senile or sclerodegenerative degeneration of the conduction system.

Front 633

anti-hypertensive that raises ICP (avoid in neuro HTN emergency)

Back 633

nitroprusside

Front 634

The ejection fraction or systolic left ventricle internal diameter used as in indication for surgical intervention in severe mitral regurgitation

Back 634

Left ventricular ejection fraction < 60% or left ventricular internal diameter in systole > 45 mm

Front 635

dig toxicity

Back 635

digi FAB,

Front 636

These 2 agents are first line anti-anginal therapies for patients with cocaine induced angina an EKG changes

Back 636

Nitroglycerin and calcium antagonists

Front 637

EkG findings in a patient with a low body temperature

Back 637

Osborne waves

Front 638

ECG changes found in patients with massive PE that may correlate with more severe RV strain

Back 638

Anterior T wave inversions

Front 639

Consider witholding calcium as a treatment of hyperkalemia in patients on this drug

Back 639

Digoxin

Front 640

ECG changes with hypercalcemia

Back 640

shortened QT interval

Front 641

Abnormality associated with fixed splitting of S2

Back 641

ASD

Front 642

Diastolic murmur with opening snap

Back 642

Mitral stenosis

Front 643

Eponym applied to physical examination sign describing an increased intensity of a heart murmur during inspiration

Back 643

Carvallo's sign

Front 644

Diagnosis associated with equalization of diastolic pressures in right atrium, right ventricle, wedge pressure, and left ventricle

Back 644

Tamponade or constrictive pericarditis

Front 645

Drug reduces risk for aortic valve replacement for chronic aortic regurgitation

Back 645

Nifedipine

Front 646

Eponym associated with systolic plethora and diastolic blanching in the nail

Back 646

Quincke’s pulse

Front 647

Most important factor determining prognosis following myocardial infarction

Back 647

Left ventricular ejection fraction

Front 648

Coronary artery most often responsible for ischemic papillary muscle rupture

Back 648

Posterior descending artery (accept RCA)

Front 649

Diagnosis associated with bradycardia and variable intensity of S1

Back 649

Complete heart block

Front 650

Presence of this drug is a contraindication to calcium gluconate in the treatment of hyperkalemia

Back 650

Digitalis

Front 651

Drugs used for "pill-in-the-pocket" treatment of atrial fibrillation

Back 651

Flecainide and propafenone

Front 652

Cardiac auscultatory finding associated with acute ischemia that disappears with relief of the ischemia

Back 652

Mitral regurgitant murmur (accept holosystolic murmur), paradoxical splitting of S2, and an S4 (any one answer accepted)

Front 653

Phase of respiration when pericardial friction rubs are best heard

Back 653

Inspiration

Front 654

Meaning of each of the 1st three letters in NBG pacing code

Back 654

Chamber paced, chamber sensed, response to sensing

Front 655

When placing a temporary TV pacer, these are the 3 things that you must set on the device

Back 655

HR, output (mA), sensitivity

Front 656

Result of placing a magnet over a DDD pacemaker

Back 656

Failure of sensing (function asynchronously), reverts to factory settings

Front 657

Feared complication that can occur in asynchronous (AOO) pacing

Back 657

R-on-T phenomenon causing Torsades

Front 658

Syndrome charactererized by long QT and congenital deafness

Back 658

Jerville-Lange-Nielson Syndrome

Front 659

Preferred treatment for RV-outflow tract ventricular tachycardia

Back 659

Catheter ablation

Front 660

S2 in a patient with LBBB

Back 660

Paradoxical splitting

Front 661

Refractory tachycardia in a patient on theophylline

Back 661

Multifocal Atrial Tachycardia (MAT)

Front 662

5 causes of PEA

Back 662

Hypovolemia, Hypoxia, Hydrogen ion (acidosis), Hyper/hypokalemia, Hypothermia, Hypoglycemia Tablets or Toxins, Trauma, Tension Pneumo, Tamponade, Thombosis (coronary), Thrombosis (pulmonary)

Front 663

Sensitivity of TTE/TEE

Back 663

65%/>90%

Front 664

An appropriate antiarrhythmic for a fib in patients with CRF

Back 664

quinidine

Front 665

Single most common cause of culture negative endocarditis

Back 665

Prior antibiotic use

Front 666

Feared complication of inserting a PA catheter in a patient with LBBB

Back 666

RBBB (trifascicular block, LBBB + RBBB)

Front 667

Causes of high output heart failure

Back 667

Thyrotoxicosis, anemia, AV fistula, Paget's, Carcinoid, thiamine deficiency (Beriberi)

Front 668

Valvular lesion that occurs in 70% of patients with coarctation of the aorta

Back 668

Bicuspid aortic valve

Front 669

Classic EKG findings in patients with intracerebral hemorrhage

Back 669

Diffuse T wave inversions, prolonged QT, bradycardia

Front 670

Cardiac drug causing pneumonitis, thyroid dysfunction, and proarrhythmia

Back 670

Amiodarone

Front 671

ASD leading to right to left shunting

Back 671

Eisenmenger syndrome

Front 672

Most common adult congenital heart disease

Back 672

Bicuspid aortic valve

Front 673

Most common cyanotic congenital heart disease

Back 673

Tetrology of Fallot

Front 674

Disorder characterized by transient dysfunction of the apical portion of the LV, with compensatory hyperkinesis of the basal walls, prducing ballooning of the apex with systole in the absence of coronary artery disease

Back 674

Takotsubo cardiomyopathy

Front 675

JVD, decreased heart sounds, hypotension

Back 675

Beck's triad (cardiac tamponade)

Front 676

3 causes of holosystolic murmur

Back 676

MR, TR, VSD

Front 677

short PR with no delta wave

Back 677

Lown-Ganong-Levine

Front 678

Long QT (AD; without deafness)

Back 678

Romano Ward

Front 679

Association between bleeding from gatrointestinal angiodysplasia and severe aortic stenosis which may resolve with aortic valve replacement; may also be explained by acquired type Iia von Willebrand's syndrome

Back 679

Heyde's syndrome

Front 680

Chronic ergotism (historically from consumption of rye contaminated with ergot fungus); characterized by intense burning pain of the feet, hands, and whole limbs due to vasoconstrictive properties of ergot

Back 680

st anthony's fire

Front 681

Sydenham's chorea (eponym)

Back 681

st vidus's dance

Front 682

Aortic insufficiency like murmur in early diastole found in anemia

Back 682

Cabot-Locke

Front 683

Rapid xy descent

Back 683

Constrictive pericarditis

Front 684

Left vocal cord paralysis secondary to LAE secondary to mitral stenosis

Back 684

Ortner's syndrome

Front 685

Valvular abnormality associated with Ankylosing spondylitis

Back 685

Aortic regurgitation

Front 686

RBBB, persistent ST elevations in leads V1 and V2 without evidence of structural heart disease

Back 686

Brugada's syndrome

Front 687

High Risk Cardiac contraindications to pregnancy

Back 687

Eisenmenger's, severe pulm HTN, complex cyanotic heart dz, marfan's with aortic root or valve involvement, severe AS, aortic or mitral valve dz with EF < 40%, NYHA class III or IV, prior peripartum cardiomyopathy

Front 688

Continuous LTOT would be indicated with a pO2 56-59 in these patients

Back 688

dependent edema, cor pulmonale with p pulmonale on ECG (>3mv in inferior leads), or Hct>56

Front 689

Findings comprising Bergman's Triad and associated disease state

Back 689

petechia, dyspnea, MS changes; a/w Fat Emboli syndrome

Front 690

Eponym for high-pitched, blowing murmur that may be found in a patient with pulmonary regurgitation resulting from pulmonary HTN

Back 690

Graham-Steell

Front 691

Endocarditis with cancer

Back 691

Marantic Endocarditis

Front 692

2 possible causes of hypercalcemia in a patient with a high PTH-intact level

Back 692

1. primary hyperparathyroidism, 2. Familial Hypocalciuric Hypercalcmia, Lithium use

Front 693

The drug used to treat hyperthyroidism in pregnancy, is associated with a small risk of agranulocytosis

Back 693

PTU

Front 694

Hypotension, gingival and palmar crease hyperpigmentation is seen in this disease

Back 694

Addison's disease (primary adrenal insufficiency)

Front 695

Most common type of secretory pituitary mass

Back 695

Prolactinoma

Front 696

Failure of lactation following a complicated C-section delivery

Back 696

Sheehan's syndrome

Front 697

Sudden onset of severe headache, visual changes and hypotension in a patient with a known pituitary macroadenoma

Back 697

Pituitary apoplexy (pituitary hemorrhage)

Front 698

Hemochromatosis, when involving the pituitary, most commonly results in deficiency of this pituitary hormones

Back 698

Gonadotropin deficiency (LH, FSH)

Front 699

President George H. Bush

Back 699

Possible TSH-receptor antibodies

Front 700

According to the WHO, a T score of this value is the definition of osteoporosis

Back 700

T-score < or = to 2.5

Front 701

Suspect this dx in a male with premature osteoporosis and loss of libido

Back 701

Hypogonadism

Front 702

Most important initial therapy in patients with significant hypercalcemia

Back 702

Volume expansion

Front 703

Suspect this diagnosis in a patient with significant diuretic induced hypokalemia

Back 703

Primary hyperaldosteronism

Front 704

95% of cases of congenital adrenal hyperplasia are due to deficiency of this enzyme

Back 704

21-hydroxylase deficiency

Front 705

2 most common etiologies seen in single adrenal masses

Back 705

Adrenal Adenoma Metastasis to adrenal glands

Front 706

3 drugs used to treat a patient in thyroid storm

Back 706

Beta blockers, PTU/Methimazole, iodine, steroids

Front 707

Jane Austen is believed to have died of this, brought on by TB of a particular organ system

Back 707

Primary adrenal insufficiency (Addison's disease)

Front 708

Best test to distinguish thyroiditis from factitious hyperthyroidism in a patient with a low RAIU

Back 708

thyroglobulin

Front 709

Osteitis fibrosa cystica - chronic hyperparathyroidism eponym

Back 709

Von Recklinghausen disease of the bone

Front 710

Diabetic syndrome of symmetric proximal leg weakness and pain

Back 710

Diabetic amyotrophy

Front 711

Preferred imaging test for insulinoma

Back 711

Endoscopic ultrasonography

Front 712

Sign associated with contraction of the facial muscles after tapping facial nerve

Back 712

Chvostek's sign

Front 713

Facial plethora as a sign of increased thoracic inlet pressure/obstruction with the raising of the patient's arms

Back 713

Pemberton's sign; can be caused by retrosternal thyroid gland

Front 714

This hormone deficiency is associated with kallman's syndrome

Back 714

Gonadatropin-releasing hormone

Front 715

Non-insulin hormone responsible for storing body fat

Back 715

Leptin

Front 716

Severe hypertension, metabolic acidosis, hypokalemia and suppressed plasma renin activity and plasma aldosterone

Back 716

Liddle's syndrome

Front 717

Metabolic disease that is associated with patient smelling like putrid fish

Back 717

Trimethylaminuria

Front 718

Acromegaly screening/confirmatory tests

Back 718

IGF-1 (somatomedin C), 100 gram glucose load challenge

Front 719

Most sensitive test for primary adrenal insufficiency

Back 719

ACTH stim test

Front 720

Screening test for patient with glucose intolerance, several skin tags, and who on colonoscopy has multiple polyps

Back 720

IGF-1 (Glucose tolerance test is confirmatory)

Front 721

PCOS eponym

Back 721

Stein Leventhal syndrome

Front 722

Order this test to follow a patient with secondary hypothyroidism

Back 722

Free T4

Front 723

Thyroid cancer associated with MEN2

Back 723

Medullary thyroid cancer

Front 724

Feared complication of PTU and methimatazole

Back 724

Agranulocytosis

Front 725

The 2 tests that distinguish Grave's disease, factitious thyrotoxicosis and subacute thyroiditis

Back 725

RAIU and TG (or ESR)

Front 726

In a patient with subacute hypothyroidism, this test is the best predictor if overt hypothyroidism will develop over time

Back 726

Anti-TPO antibodies

Front 727

Adrenal insufficiency may have these CBC abnormalities

Back 727

eosinphilia, normocytic anemia, lymphocytosis

Front 728

Polyglandular autoimmune syndrome I

Back 728

Parathyroid insufficency, adrenal insuficiency, mucocutaneous candidiasis

Front 729

Hyperkalemia is seen in this type of adrenal insufficiency

Back 729

Primary adrenal insufficiency

Front 730

Polyglandular autoimmune syndrome II

Back 730

adrenal insufficiency,autoimmune thyroid disease, Diabetes Mellitus I

Front 731

Polyglandular autoimmune syndrome III

Back 731

autoimmune thyroiditis with another autoimmune disease that is not autoimmune adrenalitis

Front 732

This substance can give hypokalemia and HTN

Back 732

Licorice

Front 733

Genetic disorder affecting the Na channel in the renal tubule

Back 733

Liddle's syndrome

Front 734

AB present in Hashimoto's

Back 734

Thyroid peroxidase (TPO) antibody

Front 735

Components of Sipple's syndrome

Back 735

Medullary thyroid cancer, pheochromocytoma, hyperparathyroidism

Front 736

Components of Wermer syndrome

Back 736

Hyperpara, hyperpit, pancreatic tumor

Front 737

Hyperpigmentation in adrenal insufficiency is caused by this

Back 737

ACTH

Front 738

Hyperthyroidism following iodine contrast

Back 738

Jod-Basedow phenomenon

Front 739

Sudden exposure to excess serum iodide inhibits organification of iodide, thereby diminishing hormone biosynthesis

Back 739

Wolf-Chaikoff effect

Front 740

Genetics of MEN1

Back 740

Chromosome 11, MEN 1 gene

Front 741

Genetics of MEN2

Back 741

Chromosome 10, ret-proto oncogene

Front 742

Hyperthyroidism drug not given to women

Back 742

Methimazole (causes aphasia cutis in newborns)

Front 743

3 endocrine disorders that can cause carpal tunnel syndrome

Back 743

Acromegaly, hypothyroidism, diabetes

Front 744

First manifestation of iodine deficiency

Back 744

Goiter

Front 745

Most common thyroid cancer

Back 745

Papillary carcinoma

Front 746

Found on FNA of papillary thyroid cancers

Back 746

Psammoma bodies

Front 747

2 hormones from posterior pituitary

Back 747

oxytocin and ADH

Front 748

Hypogonadic hypogonadism (Low GnRH with low FSH and LH), anosmia, and color blindness

Back 748

Kallman syndrome

Front 749

Antibody to test in Diabetes Type I

Back 749

Glutamic acid decarboxylase

Front 750

Diabetes, hirsutism, post-menopausal women

Back 750

Achard-Thiers

Front 751

Disappearing bone disease

Back 751

Gorhams Disease

Front 752

Osmolality equation

Back 752

2Na +Glucose/18 + BUN/2.8

Front 753

Osmolality when thirst begins

Back 753

295

Front 754

Time of peak for ACTH

Back 754

3-4 am

Front 755

Two hormones controlling GH

Back 755

GHRH, Somatostatin

Front 756

Two hormones controlling TSH

Back 756

TRH, Somatostatin

Front 757

Most common cause(s) of pituitary macroadenoma

Back 757

lactotrophs, gonadotrophs

Front 758

Most common presentation of gonadotroph tumo

Back 758

non-functional mass (can test for alpha subunits to help diagnose; TRH stimulation test can also be used)

Front 759

Treatment for empty sella syndrome

Back 759

usually none - 90%+ function normally

Front 760

Threshold of prolactin when prolactinoma very likely

Back 760

>200

Front 761

PRL Levels correlate with tumor size in macroadenomas - true or false

Back 761

TRUE

Front 762

Treatment for prolactinoma

Back 762

Bromocriptine (safe in pregnancy) and cabergoline (better tolerated, more expensive)

Front 763

Contraindications to cabergoline

Back 763

known lung, heart valve, and retroperitoneal fibrotic disease (Parkinson's at increased risk for diseased heart valve)

Front 764

Postpartum infarct of pituitary that results in anterior hypopit and sometimes central diabetes insipidus

Back 764

Sheehan's syndrome

Front 765

Other causes of pituitary mass

Back 765

craniopharyngioma, cns lymphoma, 1% metastatic cancer (Breast and lung)

Front 766

Definition of pituitary incidentaloma

Back 766

<10 mm; asymptomatic - requires work-up for PRL only

Front 767

Variable onset with severeheadache, N/V, meningismus, vertigo, visual defects, fluctuating consciousness

Back 767

Pituitary apoplexy (pituitary hemorrhage) - can occur immediately or over 1-2 days

Front 768

Diabetes mellitus, hypogonadism, large hands and feet, large head with a lowering brow and course features

Back 768

acromegaly

Front 769

Most common endocrine conditions that cause carpal tunnel syndrome

Back 769

DM, acromegaly, hypothyroidism

Front 770

Screening and confirmatory test for GH excess

Back 770

IGF-1 (>3 u/ml), 100 gm oral glucose suppression test

Front 771

Treatment for somatotroph adenoma

Back 771

Always treat even if symptomatic -> transphenoidal surgery, irradiaiton. Bromocriptine can be used paradoxically. Can also use octreotide/lanreotide or pegvisomant (GH R antag)

Front 772

What can mimic partial nephrogenic DI

Back 772

polydipsic DI

Front 773

Alternate treatment choices for DI

Back 773

Desmopressin, Thiazide diuretics

Front 774

adipsic hypernatremia

Back 774

occurs when thirst and adh osmoreceptors are damaged - hypernatremic dehydration without thirst

Front 775

Treatment for refractory SIADH

Back 775

Demeclocycline (adverse rxn: photosensitivity and nephrotoxicity)

Front 776

ADH antagonists

Back 776

Conivaptan, Tolvaptan

Front 777

RAIU result in hCG secreting tumor

Back 777

increased

Front 778

Amiodarone effect on thyroid

Back 778

hyper or hypo; decreased T4 to T3 conversion; low RAIU (saturated with iodine)

Front 779

Most common cause of hypothyroidism

Back 779

Chronic Autoimmune thyroiditis ("Hashimoto")

Front 780

Causes of tongue enlargement

Back 780

Hypothyoroid, Amyloid …

Front 781

CBC finding in hypothyroidism

Back 781

Normochromic normocytic anemia (except when associated with pernicious anemia)

Front 782

Most common TSH/T4 in euthyroid sick

Back 782

low tsh, normal t4 (should check this answer)

Front 783

Biliary cirrhosis, hepatitis, clofibrate and narcotic effect on thyroid function tests

Back 783

increase TBG

Front 784

Meds that block t4 to t3 conversion

Back 784

propranolol, glucocorticoids, propylthiouracil, amiodarone

Front 785

Adrenal insufficiency affect on thyroid hormones

Back 785

increased TSH

Front 786

Test to differentiate secondary and tertiary hypothyroidism

Back 786

sella imaging

Front 787

medical comorbidity requiring slow titration of Thyroxine

Back 787

CAD (especially elderly)

Front 788

mortality of myxedema coma

Back 788

30-40%

Front 789

Two classic signs of myxedema coma

Back 789

Decreased mentation and hypothermia

Front 790

Eponym for automimmune adrenalitis and thyroiditis

Back 790

Schmidt syndrome (suspect with hypoglycemia and hypothyroid)

Front 791

Treatment for myxedema coma

Back 791

passive rewarming, ivf, normalizing serum sodium, t3, intravenous t4 or both t3 and t4; stress dose steroids if any suspicion for adrenal insufficiency; empiric broad spectrum abx until infection excluded

Front 792

Most common cause of thyrotoxicosis

Back 792

Graves disease

Front 793

Cause of abnormal ACTH stim test in hyperthyroidism

Back 793

low cortisol binding protein; hyperthyroid patients usually don't have true adrenal dysfunction

Front 794

buzzword for hyperthyroidism in the elderly

Back 794

apathetic hyperthyroidism - "failure to thrive" picture

Front 795

2 immune mediated hematologic abnormalities associated with Graves

Back 795

pernicious anemia and ITP

Front 796

Lab finding associated with reduced incidence of relapse of Graves after treatment

Back 796

absence of stimulatory immunoglobulins

Front 797

treatment of graves with history of prior radiation

Back 797

surgery; give ptu or methimazole +/- beta blockers before surgery

Front 798

Precipitating events (3) for thyroid storm

Back 798

surgery, infections, iodine load

Front 799

Treatment of thyroid storm (6)

Back 799

1. IV propranolol or esmolol 2. high dose thionamide 3. iodine solution (blocks release of preformed hormone 4. iodinated contrast and glucocorticoids (blocks peripheral conversion) 5. empiric broad spectrum abx until infection excluded 6. supportive care in ICU (volume status, temperature, heart rate)

Front 800

Cause of acute thyroiditis

Back 800

Bacterial infection

Front 801

Cause of subacute thyroiditis

Back 801

Virus (also called granulomatous); PAIN - very tender neck, becomes fibrotic, returns to normal months later

Front 802

Cause of chronic thyroiditis

Back 802

autoimmune -mediated (Hashimoto's), painless, postpartum

Front 803

TX of subacute (granulomatous) thyroiditis

Back 803

ASA or NSAIDS; glucocorticoids in refractory (8 week taper); frequent reevaluation until thyroid fxn normalizes (1 week - most - to 12 months)

Front 804

Percent of patients with painless thyroiditis that eventually develop Hashimoto's

Back 804

50%

Front 805

Eponym for thyroid tissue in an ovarian teratoma

Back 805

Struma Ovarii

Front 806

Percent of cold thyroid nodules that are benign

Back 806

85%

Front 807

nonmalignant thyroid nodule after neck radiation

Back 807

colloid adenoma

Front 808

Two diagnostic tests done after finding a palpable nodule

Back 808

tsh and thyroid ultrasound; FNA if high low TSH and cold nodule, high TSH with concerning ultrasound, or normal TSH

Front 809

Size criteria for FNA of incidentaloma (thyroid) with normal TSH

Back 809

1 cm

Front 810

principle cell involved with medullary thyroid cancer

Back 810

parafollicular C cells

Front 811

Gene involved in MEN2

Back 811

RET protoncogene - tyrosine kinase, transduces signals for cell growth

Front 812

Serum marker for medullary thyroid cancer

Back 812

calcitonin

Front 813

Spread of folllicular cancer is by what route and to what tissue

Back 813

hematogenous; bone, lungs, CNS

Front 814

spread of papillary cancer is by what route and to what tissue

Back 814

lymphatics; bone, lungs

Front 815

treatment of thyroid cancer

Back 815

near-total thyroidectomy; posterior capsule often left in place to minimize the risk of recurrent laryngeal nerve damage; TSH allowed to rise to >30 then high dose radioactive iodine

Front 816

follow-up studies for thyroid cancer in "remission"

Back 816

neck ultrasound, total body scans, and/or thyroglobulin (interferred with by anti-TPO)

Front 817

Concern when hashimoto's develops fast growing thyroid mass

Back 817

Thyroid lymphoma

Front 818

Vegetables that act as goitrogen

Back 818

cassava root, Brussel sprouts, cauliflower, cabbage

Front 819

3 main indications for treatment of nontoxic multinodular goiter

Back 819

Compression of trachea, venous outflow obstruction, growth into intrathoracic area

Front 820

Treatment of toxic multinodular goiter

Back 820

usually ablative (I131)

Front 821

3 zones of adrenal cortex

Back 821

Zona Glomerulosa (salt), Zona Fasciculata (sugar - cortisol), Zona Reticularis (sex)

Front 822

Product of chromaffin cells in adrenal medulla

Back 822

mainly epinephrine

Front 823

most common cause of CAH and resultant increased precursor

Back 823

21 hydroxylase deficiency and 17 hydroxy progesterone

Front 824

Enzyme deficient in late-onset CAH with hypertension and hyperkalemia

Back 824

11 hydroxylase - causes increase in 11 deoxycortisol and 11 deoxycorticosterone (an active mineralocorticoid) in addition to testosterone

Front 825

Cancers associated with ectopic ACTH

Back 825

bronchogenic, pancreatic, thymic … carcinoid (if age > 60, then small cell lung cancer is the most common cause of Cushing's)

Front 826

1st and 2nd most common cause of Cushing syndrome

Back 826

exogenous steroids and pituitary adenoma (Cushing disease)

Front 827

Causes of pseudo-cushing's

Back 827

obesity, alcoholism, depression

Front 828

What distinguishes Cushing disease and adrenal carcinomas from adrenal adenomas

Back 828

Presence of increased androgens (adrenal DHEA) and hirsutism and acne

Front 829

Failure of high dose dex to suppress cortisol production

Back 829

Ectopic production of ACTH -> image with CT and check 5-hydroxyindoleacetic acid

Front 830

Causes of Addison's disease

Back 830

Autoimmune, granulomatous, HIV, CMV, amyloid, sarcoid

Front 831

chronic mucocutaneous candidiasis, adrenal/pituitary insufficiencies +/- pernicious anemia, hepatitis, allopecia, Hashimoto's and premature ovarian failure

Back 831

Polyglandular Autoimmune Syndrome I

Front 832

>= 2 of the following Addison disease, hashimoto's, premature ovarian failure, type I diabetes +/- pernicious anemia, vitiligo, alopecia, sprue, myasthenia

Back 832

Polyglandular Autoimmune Syndrome II

Front 833

Most common cause of secondary AI

Back 833

rapid withdrawal of chronic glucocorticoids

Front 834

Primary adrenal insufficiency and hypothyroidism

Back 834

Schmidt syndrome - give cortisol first; thyroid replacement first can worsen shock

Front 835

Electrolyte that impacts aldosterone secretion

Back 835

potassium

Front 836

Most common cause of hypoaldosteronism

Back 836

decreased production of renin in diabetic patients

Front 837

Drugs that suppress aldosterone (directly or indirectly)

Back 837

ACE inhibitors, NSAIDs, chronic heparin

Front 838

Medications that interfere with work-up for primary and secondary hyperaldosteronism

Back 838

ACEI/ARBs

Front 839

Imaging test for pheo if CT/MRI normal

Back 839

metaiodobenzylguanidine scintigraphy

Front 840

Medication that interferes with urine metanephrines and catecholamines

Back 840

TCA2 - wean two weeks prior to surgery, etc.

Front 841

three familial cancer syndromes with pheos

Back 841

MEN2, VHL, neuofibromatosis

Front 842

new name for pheo outside the adrenals

Back 842

extraadrenal paraganglioma

Front 843

Pre-op med for pheo

Back 843

Phenoxybenzamine then propranolol

Front 844

incidentaloma not requiring a work-up

Back 844

Myelolipoma

Front 845

3 indications for removing adrenal incidentaloma

Back 845

tests indicate a functioning tumor, mass is >6 cm, prior was <4 and evidence of growth on 6 month repeat

Front 846

parathyroid hyperplasia, pituitary adenoma, pancreatic islet cell tumors (insulin, gastrin)

Back 846

MEN1 (Wermer's)

Front 847

(cardiac) myxomas, spotty pigmentation, and endocrine overactivity

Back 847

Carney complex

Front 848

Pheo, C cell hyperplasia -> medullary thyroid cancer, parathyroid hyperplasia

Back 848

Men2a (sipple's)

Front 849

Pheo, medullary thyroid, mucosal neuromas ("blubbery lips"), marfanoid body type

Back 849

Men2b (or MEN III) - no consistent eponym

Front 850

Diagnosis represented by "bilateral symmetric pseudofractures"; presenting symoms of bone pain and proximal muscle weakness

Back 850

osteomalacia - commonly caused by vitamin d deficiency; usually caused by malabsorption

Front 851

Test to diagnose osteomalacia

Back 851

25(OH)D (not 1,25) - also marked by increased iPTH and alk phos, decreased Ca and decreased Phos

Front 852

Effect of Magnesium on Calcium and MOA

Back 852

Hypomagnesemia decreases PTH causing hypocalcemia

Front 853

hypocalcemia with normal or elevated PTH and absence of 4th and 5th knuckles

Back 853

pseudohypoparathyroidism - genetic mutation in PTH receptor

Front 854

Drug of choice for myeloma-associated hypercalcemia

Back 854

pamidronate

Front 855

Guidelines for parathyroidectomy for Hyperparathyroidism (2008 guidelines)

Back 855

Serum calcium 1.0 mg/dl above ULN, creatinine clearance < 60 ml/min, T-score < 2.5 at any site and/or previous fragility fracture, Age <50

Front 856

Causes of hypercalcemia other than PTH (5+)

Back 856

Vitamin D excess, Vitamin A excess, thiazide diuretics, lithium (increases PTH setpoint), benign familial hypocalciuric hypercalcemia, PTHrP, granulomatous diseases, bone mets, MM, immobilization *in setting of high turnover - thyroid, pagets, adolescence)

Front 857

Mottled-looking band stretching horizontally across the center of the cornea

Back 857

Band keratopathy in hypercalcemia

Front 858

Subperiosteal bone resorption with a moth-eaten appearance to phalangeal cortex on finger radiographs

Back 858

osteitis fibrosa cystica with prolonged PTH excess

Front 859

Most common cause of vitamin d deficiency

Back 859

malabsorption

Front 860

Whipple's triad

Back 860

hypoglycemic signs and symptoms, low glucose level, relief of symptoms with glucose administration

Front 861

Two main categories of hypoglycemia symptoms

Back 861

neuroglycopenic and autonomic

Front 862

postrprandial hypoglycemia found in T2DM and in some post-GI surgical patients (when gastric contents get dumed into the small intestine too quickly with a brisk release of incretins)

Back 862

Idiopathic reactive hypoglycemia

Front 863

Four tests usined in the work-up of confirmed, nonreactive hypoglycemia

Back 863

serum insulin, serum proinsulin (increased to >20% with insilunoma), c-peptide,urinary/plasma sulfonylurea test

Front 864

Hormone that both increases osteoblasts (like corticosteroids) and inhibits osteoclasts (like calcitonin)

Back 864

Estrogen

Front 865

Autoantibodies in type 1 DM

Back 865

anti-islet, -insulin, -glutamic acid decarboxylase, -tyrosine phosphatases IA-2 and IA-2beta

Front 866

HLA (on chromosome 6) associated with DM

Back 866

DR3 and DR4

Front 867

Ketoacids in diabetes

Back 867

Beta-hydroxybutyrate and acetoacetate (only one detected by Acetest)

Front 868

Etiologies of brittle DM

Back 868

gastroparesis, poor communication, malingering, increased growth hormone in puberty (increased insulin resistance)

Front 869

Improvement of hyperglycemia after diagnosis and institution of treatment

Back 869

Honeymoon effect

Front 870

Increased blood glucose between 4 and 7 am with no preceding hypoglycemia

Back 870

Dawn phenomenon (early morning rise in cortisol and GH)

Front 871

Increased blood glucose with preceding hypoglycemia

Back 871

Somogyi effect (classically at night with associate headaches and nightmares)

Front 872

Triad of carbohydrate intolerance, glossitis, and erythematous rash

Back 872

Glucagonoma

Front 873

red, blistering rash that spreads across the skin, particularly the lower abdomen, buttocks, perineum, and groin

Back 873

Necrolytic migratory erythema

Front 874

analogue to amylin which is secreted by the pancreatic beta cells

Back 874

Pramlintide - cut the insulin dose by 50% when using

Front 875

sitagliptin moa

Back 875

dipeptidyl peptidase 4 inhibitor

Front 876

act by stimulating insulin release, inhibiting prostprandial glucagon release, slowing nutrient absorption, and accelerating satiety

Back 876

byetta (glucagon-like peptide 1)

Front 877

Nerves most often involved in diabetic mononeuropathy

Back 877

CN 3 and 6, peroneal nerve (foot drop) and radial nerve (wrist drop)

Front 878

glucose goals in pregnancy

Back 878

60-90; <120 postprandial (note that pregnant patients require 50% more insulin)

Front 879

Syndrome characterized by clinical and biochemical evidence of thyrotoxicosis, low 24-hour radioactive iodine uptake, nontender thyroid gland, and normal sedimentation rate

Back 879

Silent (lymphocytic) thyroiditis or factitious (exogenous) thyrotoxicosis

Front 880

Oral hypoglycemic agent that should discontinued prior to contrast imaging studies

Back 880

metformin

Front 881

Diagnosis suggested by high insulin, proinsulin, C-peptide levels and hypoglycemia

Back 881

insulinoma

Front 882

Long-acting, irreversible nonselective alpha-blocker used for pheochromocytoma

Back 882

Phenoxybenzamine

Front 883

Drug stimulates new bone formation by increasing osteoblast activity

Back 883

Teriparatide (accept recombinant human parathyroid hormone)

Front 884

This is a feared complication of removal of > 1 liter of fluid in a patient with a large pleural effusion

Back 884

Reexpansion pulmonary edema

Front 885

Light's criteria

Back 885

protein ratio > 0.5, LDH ratio > 0.6, LDH fluid > 2/3 upper limit of normal

Front 886

In a 24 y.o. pt with asthma and freq night symptoms, these 2 drugs are the mainstay of chronic therapy

Back 886

Inhaled corticosteroids (#1) and long acting B agonists (#2)

Front 887

Frequent asthma exacerbations, eosinophilia, elevated IgE and proximal bronchiectasis

Back 887

Allergic Bronchopulmonary Aspergillosiss

Front 888

Refractory asthma, pulmonary infiltrates, eosinophilia, and fever

Back 888

Churg-Strauss Disease

Front 889

Seen on CXR , this pleural based wedge shaped defect from infarction just above the diaphragm

Back 889

Hamptom's Hump

Front 890

Located near the hilum, this may be seen on CXR from a patient with confirmed PE

Back 890

Westermark's sign

Front 891

Extremely low values of this are seen in pleural effusions of patients with RA

Back 891

Low glucose

Front 892

Pleural effusion, LE edema, yellow nails

Back 892

Yellow Nail Syndrome (2/2 disorder of lymphatics, pleural effusion can persist > 1 year); a history of bronchiectasis, bronchitis, or sinusitis in association with chronic pleural effusion should suggest the diagnosis.

Front 893

Spirally twisted mucous plugs of shed epithelium that occur in the sputum of asthmatics

Back 893

Curschmann's spirals

Front 894

According to the ACCP, chest tube drainage is indicated in pleural effusions with a pH of this value

Back 894

pH < 7.2; also glucose <60 or positive gram stain

Front 895

Exudative criteria with better specificity than Light's

Back 895

Serum-effusion albumin gradient LE 1.2; cholesterol effusion > 45 and LDHeff > 200

Front 896

Markers for exudative effusion when concern for heart failure pseudoexudate

Back 896

albumin gradient LE 1.2 and cholesterol >60

Front 897

These 3 diseases are in the differential of an effusion with glucose <60

Back 897

RA, malignancy, infection

Front 898

Marker of chylothorax

Back 898

Triglyceries > 110

Front 899

The test used to distinguisha chylothorax with triglycerides from 50-110

Back 899

Lipoprotein analysis to check for chylomicrons

Front 900

Marker of urinothorax

Back 900

Creatinine effusion/serum ratio GT 1

Front 901

Aneurysmal dilation of a pulmonary artery that results from the local inflammation due to cavitary TB

Back 901

Rasmussen's aneurysm

Front 902

Mental status changes, petechiae (often in the axilla/thorax) and dyspnea

Back 902

Bergman's triad (fat emboli syndrome)

Front 903

Syndrome of pulmonary rheumatoid nodules in patient with co-existing coal worker's pneumoconiosis

Back 903

Caplan's syndrome

Front 904

Interstitial lung disease characterized by upper lobe masses in patient with known silicosis

Back 904

Progressive massive fibrosis

Front 905

Slowly progressive pulmonary syndrome associated with cystic changes in the lungs occurring almost exclusively in smokers

Back 905

Pulmonary Langerhans Cell Histiocytosis

Front 906

The earliest pleural manifestation of asbestos exposure

Back 906

benign asbestos pleural effusion

Front 907

Neck circumference measurement associated with an increased risk of obstructive sleep apnea

Back 907

> 17 inches (43 cm)

Front 908

Disease with chest CT findings described as "crazy paving"

Back 908

Pulmonary alveolar proteinosis

Front 909

Shortness of breath in the erect position

Back 909

Platypnea

Front 910

Laryngeal finding associated with vocal cord dysfunction

Back 910

Adduction of vocal cords (or paradoxical motion of vocal cords)

Front 911

Inhaled drug that is effective for bronchoconstriction due to propranolol

Back 911

Ipratropium

Front 912

Cystic lung disease in women of childbearing age

Back 912

Lymphangioleiomyomatosis

Front 913

Late, severe complication of silo filler's disease

Back 913

Brochiolitis obliterans

Front 914

Upper airway complication of prolonged intubation

Back 914

Tracheal stenosis (or tracheomalacia)

Front 915

Syndrome characterized by quadriplegia, paralysis of horizontal eye movements with preservation of vertical eye movements, and inability to speak

Back 915

Locked in syndrome

Front 916

Smoke inhalation victim with coma, hypotension, profound anion-gap metabolic acidosis unresponsive to volume replacement and oxygen

Back 916

Cyanide poisoning

Front 917

Three things that move oxyhemoglobin curve to the right

Back 917

decreased pH, increased temp, increased 2,3 DPG (diphosphoglycerate)

Front 918

Wool Sorter's disease (causative organism)

Back 918

Bacillus anthracis

Front 919

Continuous LTOT would be indicated with a pO2 56-59 in these patients

Back 919

Those with resting pO2 56-59 with edema, cor pulmonale, or Hct>56

Front 920

Interventions that increase oxygenation in an intubated patient

Back 920

increased FiO2, increased PEEP, increased I/E ratio

Front 921

cyclic crescendo-decrescendo respiratory effort and airflow during wakefulness or sleep (associated with heart failure)

Back 921

Cheyne-Stokes

Front 922

Fat Emboli Syndrome

Back 922

Bergman's Triad - petechia, dyspnea, MS changes

Front 923

Besides ABCs and aggressive fluid resuscitation, these are 4 additional treatment options in CCB overdose patients

Back 923

IV calcium, IV glucagon, IV insulin and glucose (high dose 1u/kg insulin bolus), cardiopulmonary bypass? (May also accept pressors, pacemaker, atropine, phosphodiesterase inhibitors, aortic balloon pump, activated charcoal)

Front 924

Description of mediastinum LN in sarcoid

Back 924

Potato nodes

Front 925

Patient with SLE admitted for SOB. DLCO elevated. DX?

Back 925

Diffuse Alveolar hemorrhage

Front 926

Feared complication from too rapidly correctin a patients significant hypernatremia

Back 926

Cerebral edema

Front 927

Hemoptysis and tram-tracking on CXR

Back 927

Bronchiectasis

Front 928

Components of Samter's triad

Back 928

ASA sensitivity, nasal polyps, asthma

Front 929

Histologic findings in Hamman-rich syndrome

Back 929

Organizing diffuse alveolar damage

Front 930

Mode of mechanical ventilation wher there is a set tidal volume and rate and the patient gets the set tidal volume with every breath

Back 930

AC

Front 931

The TV in ARDS patients should not exceed this

Back 931

6 ml/kg of predicted weight

Front 932

Acute sarcoid with anterior uveitis, parotid enlargement, fever, and facial nerve palsy

Back 932

Heerfordt Waldenstrom Syndrome

Front 933

Suspect his as a cause if patient's hypoxia does not correct with 100% FiO2

Back 933

Shunt

Front 934

5 general causes of hypoxemia

Back 934

Decreased FiO2, hypoventilation, shunt, VQ mismatch, decreased diffusion

Front 935

Causes of increased DLCO

Back 935

asthma, L to R cardiac shunting, diffuse alveolar hemorrhage, polycythemia, obesity

Front 936

Over 90% of massive hemoptysis comes from these arteries

Back 936

Bronchial arteries

Front 937

Dyspnea occuring only in upright position

Back 937

Platypnea (associated with hepatopulmonary syndrome)

Front 938

Desaturation in the upright position but better in the supine position

Back 938

Orthodeoxia (associated with hepatopulmonary syndrome)

Front 939

Oxygen saturation gap is associated with this

Back 939

methemoglobinemia (cyanosis with a normal PaO2)

Front 940

Congenital central hypoventilation syndrome associated with this GI disease

Back 940

Hirschprung's disease (also associated with neuroblastoma and dysphagia)

Front 941

Congenital disease with decreased autonomic control of ventilation, central sleep apnea (eponym)

Back 941

Ondine's curse

Front 942

2 causes of heme-negative hemoptysis

Back 942

Serratia marcecens, INH treatment

Front 943

Microscopic findings in Langerhans Cell Histiocytosis

Back 943

Staining for S100 and CD1a or anti-langerin. Also birbeck granules may be seen

Front 944

Spontaneous pneumothorax now with chylous effusion

Back 944

Lymphangioleiomyomatosis

Front 945

Lymphangioleiomatosis can be associated with a higher incidence of this neuro malignancy

Back 945

Meningioma

Front 946

Treatment for LAM

Back 946

Hormonal manipulation but of unproven benefit; also sirolimus or lung transplantation (Oophorectomy not recommended, progestin, tamoxifen, GnRH analogs)

Front 947

Cartilage disorder and bronchiectasis (eponym)

Back 947

william Campbell

Front 948

eponym for hyperpigmented patches on thighs proximal to the knees, from chronic elbow pressure as the emphysematous patient rests leaning forward to improve breathing

Back 948

Dahl's sign

Front 949

The age at which medicare takes effect

Back 949

65

Front 950

This part of Medicare pays for physician office visits, ambulanc rides, and outpatient treatments administered in a doctor's office

Back 950

Part B

Front 951

This part of Medicare covers inpatient treatment

Back 951

Part A

Front 952

Medicare Advantage plans (privatized)

Back 952

Part C

Front 953

Prescription Drug Plan

Back 953

Part D

Front 954

BMI values

Back 954

Obesity if >30, Overweight if 25-30

Front 955

Metabolic syndrome

Back 955

three or more of the following: 1. Blood pressure equal to or higher than 130/85 mmHg 2. Blood sugar (glucose) equal to or higher than 100 mg/dL 3. Large waist circumference (length around the waist): Men - 102 cm or more Women - 88 cm or more 4. Low HDL cholesterol: Men - under 40 mg/dL Women - under 50 mg/dL 5. Triglycerides equal to or higher than 150 mg/dL

Front 956

President W. Henry Harrison

Back 956

Pneumonia

Front 957

President Kennedy's tan

Back 957

Addison's disease

Front 958

President George Washington

Back 958

epiglottitis

Front 959

President Andrew Jackson

Back 959

Heart Failure

Front 960

Risk factors for developing preeclampsia

Back 960

1. Nulliparity 2. Chronic HTN 3. family history 4. renal disease 5. diabetes 6. obesity

Front 961

Name applied to decision making for a patient whose preferences are not known but are based upon the best evidence of what the patient would have wanted

Back 961

Substituted Judgement

Front 962

Federal law requiring health care institutions participating in Medicare/Medicaid to ask if a patient has an advance directive, to provide information about advance directives, and incorporate advance directives into the medical record

Back 962

Patient Self-Determination Act of 1990

Front 963

In 50% of women with contraceptive associated hypertension, the blood pressure will return to normal within this time span

Back 963

3 months

Front 964

Diagnosis suggested by dyspareunia and punctate ulcers in the vestibule located primarily around the Bartholin's glands

Back 964

Vulvar vestibulitis

Front 965

Pregnancy complication of untreated Trichomonas vaginitis

Back 965

PROM or preterm delivery

Front 966

Federal Act of 1996 contains rules about privacy of medical records

Back 966

Health Insurance Portability and Accountability Act (HIPAA)

Front 967

An advance directive appointing a surrogate who will make decisions if the patient is unable to do so

Back 967

Durable power of attorney (for health care)

Front 968

Name describing generalized swelling of an entire digit

Back 968

Dactylitis

Front 969

Eponym for a bruise over the mastoid, indicating a basal skull fracture

Back 969

Battle's sign

Front 970

Chronic renal failure increases risk for this third trimester pregnancy complication

Back 970

Preeclampsia

Front 971

Vasodilator of choice for peripartum cardiomyopathy

Back 971

Hydralazine

Front 972

Treatment of gestational hypertension improves this renal outcome

Back 972

Decreased proteinuria

Front 973

Probability of a positive test in a patient with disease compared to the probability in a patient without disease

Back 973

Positive likelihood ratio

Front 974

Breast cancer prediction model based upon personal and family risk factors

Back 974

Gail model

Front 975

Best trimester to perform "semi-elective" abdominal surgery

Back 975

2nd trimester

Front 976

Normal PCO2 level during pregnancy

Back 976

28-32 mm Hg (accept any answer within range)

Front 977

Major fetal effect of maternal ACE inhibitor use

Back 977

Renal tubular dysgenesis

Front 978

In pregnant patients with a normal fasting glucose, what screening test at 24-28 weeks is recommended for the detection of gestational diabetes

Back 978

What is 50-g glucose tolerance test at 24-28 weeks gestation?

Front 979

Therapy indicated in a 28 yo gravid female at 10 weeks with a low TSH and normal T4 that was found on routine testing

Back 979

What is no therapy is necessary? HCG during the 1st trimester is in high concentration and acts as a partial TSH agonist. Recheck later in pregnancy.

Front 980

Diagnostic criteria for preeclampsia

Back 980

What is systolic blood pressure > 140 mmHg or diastolic blood pressure > 90 mmHg (on two separate occasions with prior normal BP after 20 weeks gestation) and proteinuria of 300mg or greater in a 24-hour urine specimen?

Front 981

Ingredients in lactated ringer

Back 981

chloride, potassium ,calcium, lactate, sodium,water

Front 982

5 As for quitting smoking

Back 982

Ask, Advise, Assess, Assist, Arrange

Front 983

Deficiency of this vitamin results in cardiomyopathy and muscle pain

Back 983

Selenium

Front 984

Most likely deficiency in person with anemia, cheilosis, and seborrheic dermatitis who takes a tricyclic antidepressant

Back 984

Riboflavin (Vitamin B2)

Front 985

Most common cause of jaundice during 1st and 2nd trimesters

Back 985

Acute viral hepatitis

Front 986

Stunted growth, loss of adipose tissue, generalized wasting of protein mass, no edema

Back 986

Marasmus (protein and energy deficiency)

Front 987

Growth failure, edema, hypoalbuminemia, fatty liver, preservation of subcutatneous fat

Back 987

Kwashiorkor (protein deficiency

Front 988

Dermatitis, dementia, diarrhea

Back 988

Pellagra (niacin deficiency)

Front 989

High output heart failure, peripheral neuropathy, Wernicke's encephalopathy, Korsakoff syndrome

Back 989

Beriberi (thiamine deficiency)

Front 990

Perifollicular hyperkeratotic papules, purpura, poor wound healing, hemorrhages

Back 990

Scurvy (vitamin C deficiency)

Front 991

Location of surgeries associated with greatest risk in patients with COPD

Back 991

Upper abdominal or thoracic

Front 992

Duration of prophylactic antibiotics for uncomplicated surgical procedures

Back 992

24 hours

Front 993

Recommended preoperative screening prior to cataract surgery

Back 993

None

Front 994

Percentage of patients with a negative history but abnormal bleeding tests that require preoperative treatment

Back 994

0.3% (Less than 1% acceptable)

Front 995

General surgery may be safely performed if the INR is below this level

Back 995

1.5

Front 996

Vitamin deficiency noted bby dwarfism, gonadal atrophy, severe dermatitis, alopecia

Back 996

Zinc

Front 997

Vitamin deficiency noted by cardiomyopathy, proximal muscle weakness, macrocytosis, pseudoalbinism

Back 997

Selenium (Keshan disease)

Front 998

Enzyme deficiency in Tay-sachs

Back 998

hexosiminadase A

Front 999

Enzyme deficiency in Niemann Pick

Back 999

Sphingomyelinase

Front 1000

5 Kubler-Ross stages of grief

Back 1000

Denial, Anger, Bargaining, Depression, Acceptance

Front 1001

Name all of the clinical competencies

Back 1001

1. Medical Knowledge,2. Professionalism, 3. Practice Based Learning and Improvement, 4. Systems based learning/practice, 5. Interpersonal/communication skills, 6. patient care

Front 1002

Formula for relative risk

Back 1002

RR = pexposed/pnotexposed = [a/(a+b)]/[c/(c+d)]; used in cohort and randomized/prospective studies

Front 1003

Formula for odds ratio

Back 1003

ad/bc (used in case control and retrospective studies)

Front 1004

Marfanoid habitus, increased risk of strokes, and CAD is seen in this congenital syndrome

Back 1004

Homocysteinuria syndrome

Front 1005

2008 Guidelines for surgery for asymptomatic hyperpara

Back 1005

Age < 50, Creatinine > 1mg/dl over ULN, creatinine clearance < 60 ml/min, T score < 2.5

Front 1006

He was a US Army chemist and surgeon credited with originating the technique of liquid chlorination of drinking water. It has been plausibly asserted that more lives have been saved and more disease prevented by this contribution to sanitation than by any other single achievement in medicine or public health.

Back 1006

Dr. Carl Rogers Darnall

Front 1007

Nobel awardee for development of electrocardiogram

Back 1007

Willem Einthoven

Front 1008

First to provide experimental proof that blood was pumped through a closed circulatory system

Back 1008

William Harvey

Front 1009

The 1910 report that revolutionized medical education and established current system of education

Back 1009

Flexner report

Front 1010

First to use mecury in a thermometer to measure temperature

Back 1010

Gabriel Daneil Fahrenheit

Front 1011

Persian physician who gave first accurate description of measles and smallpox

Back 1011

Rhazes (Razi)

Front 1012

first to describe angina pectoris

Back 1012

heberden

Front 1013

Invented blood storage and the first blood bank; started Red closs blook bank; mobile blood stations in WWII

Back 1013

Charles Drew

Front 1014

Highest DO rank, commander WRAMC

Back 1014

LTG Ronald Blanck

Front 1015

1st true surgeon general, weather records, started library

Back 1015

Joseph Lovell

Front 1016

The first surgeon general of the air force; achievements included developing body armor to protect combat crews; devloping electrically heated clothing, device to protect gunners from windblast, etc.

Back 1016

Malcolm Grow

Front 1017

assistant army surgeon during the Apache wars who was the first Medal of Honor award winner (chronologically by date of action)

Back 1017

Bernard Irwin

Front 1018

American neurologist and surgeon general who founded the Army Medical museum and co-founded the American neurological Associatoin

Back 1018

William Hammond

Front 1019

Typhoid vaccine

Back 1019

MAJ Frederick Russell

Front 1020

first meningitis polysaccharide vaccine

Back 1020

MAJ Ronald Gold

Front 1021

Army nurse corps chief, 1st female general in Army history

Back 1021

Anna Hays

Front 1022

Promoted immediately after Anna Hays, the 2nd female general in Army history

Back 1022

Hoisington

Front 1023

This former Walter Reed and Tripler-based Army physician is credited with recognizing the entity of agammaglobulinemia most often seen in young boys

Back 1023

Ogden Bruton

Front 1024

Under the guidance of this former Army surgeon general, Army hospitals became training institutions for the first time in history by offering residency training programs to the career officer

Back 1024

Raymond Bliss

Front 1025

Preferred treatment for acute episodes of angioedema in hereditary angioedema

Back 1025

C1-INH (inhibitor) concentrate (accept danazol or stanzolol)

Front 1026

Complement level that typically remains low between attacks of hereditary angioedema

Back 1026

C4

Front 1027

3 rare but severe side effects of IVIG administration

Back 1027

anaphylaxis, volume overload, renal failure, aseptic meningitis

Front 1028

Patients with this immune deficiency should not receive IVIG

Back 1028

IgA deficiency

Front 1029

The MMR vaccine contains a small amount of this antibiotic

Back 1029

Neomycin (avoid MMR if patient is allergic to neomycin

Front 1030

Low IgM, high IgA and IgE

Back 1030

Wiskot-aldrich syndrome

Front 1031

Patient becomes pregnant despite daily OCPs

Back 1031

antibiotics, phentyoin, rifampin

Front 1032

Patient with elevated LDL and triglycerides develops rhabdomyolysis while taking simvastatin

Back 1032

Gemfibrozil

Front 1033

Patient with well treated hyperlipdemia, a-fib, and hypertension develops rhabdo while taking Zocor

Back 1033

Diltiazem or verapamil (Ca channel blocker)

Front 1034

Patient with GERD and anemia fails treaatment with Levaquin for their CAP

Back 1034

antacids, iron or Zn

Front 1035

Hypothyroid patient with heavy menses remains hypothyroid despite escalating her synthroid dose

Back 1035

iron, calcium

Front 1036

Aspirin MOA

Back 1036

irreversible cyclooxygenase inhibitor (platelets)

Front 1037

Plavix MOA

Back 1037

Inhibits binding of ADP to platelets

Front 1038

Integrillin (eptifibitide) MOA

Back 1038

blocks the GP Iia/IIIb platelet receptor

Front 1039

Heparin MOA

Back 1039

Antibthrombin III activator

Front 1040

This chemotherapy can cause auditory toxicity

Back 1040

Cisplatin

Front 1041

This chemotherapy can cause HUS

Back 1041

Mitomycin C

Front 1042

This cancer treatment can cause an ARDS like presentation

Back 1042

All trans retinoic acid

Front 1043

Lipid lowering agent that is least likely to interact with antiretrovirals

Back 1043

Pravastatin

Front 1044

This antiepileptic is structurally similar to TCAs

Back 1044

Carbemazipine

Front 1045

Risk of giving pentamidine IV

Back 1045

Torsades des pointes

Front 1046

Dose limiting toxicity of vincristine

Back 1046

peripheral neuropathy

Front 1047

Treatment of TB with this medicine may aggravate gouty symptoms

Back 1047

Pyrazinamide

Front 1048

Estrogen found in most OCPs

Back 1048

Ethinyl estradiol

Front 1049

Androgen used in hereditary angioedema

Back 1049

Danazol

Front 1050

Overdose of this causes CNS depression, tachycardia, QT prolongation

Back 1050

TCA

Front 1051

AIDs medication that can cause bluish discoloration of the nails

Back 1051

AZT

Front 1052

Herbal antidote to deathcap mushrooms

Back 1052

Milk thistle

Front 1053

Nmbing sensation on tongue when taken orally

Back 1053

Echinacea

Front 1054

High doses can decrease blood levels of some anti-convulsants

Back 1054

Ginko biloba

Front 1055

Can cause premature contractions

Back 1055

Black cohosh

Front 1056

used for migraine treatment

Back 1056

Feverfew

Front 1057

Treatment for eczema or arthritis

Back 1057

Evening primrose

Front 1058

Urology medicine associated with pulmonary fibrosis

Back 1058

Nitrofurantoin

Front 1059

Gardasil

Back 1059

6/16/2018

Front 1060

indications for AoVR

Back 1060

1.) symptomatic AS, 2.) asx severe with LVEF <50%, 3.) asx severe with AoVA <0.6, gradient >60, jet >5 m/s or high likelihood of rapid progression, 4.) also c/w patients in mod-sev asx AoS undergoing CABG, valvular or Ao root surgery

Front 1061

natural progression for AS

Back 1061

"ASK (actually ASC) 532", angina 5yr mean survival, syncope 3yr mean survival, CHF 2 yr mean survival; typically 0.1cm per yr decrease in AoVA; follow with TTE q1-2y in mod, q3-5y in mild

Front 1062

medical Rx for AoS

Back 1062

HTN control, caution with diuresis, maintenance of NSR, statin, avoiding venodilators and negative ionotropes in more severe disease

Front 1063

hematologic abn a/w more severe AS

Back 1063

acquired von Willebrand disease (destruction of vWF by shear forces)

Front 1064

Class I recommendation for GXT

Back 1064

1. intermediate pretest probability of CHD 2. prognosis and managment of patients with prior CHD including stable angina or prior MI 3. Screen for CHD in high risk asymptomatic populations (not routine screening for DM or CKD) 4. Eval exercise capacity and response to therapy in heart transplant list patients 5. Assist in differentiation between cardiac and pulmonayry causes of dyspnea 6. Identify appropriate settings in patients with rate adaptive pacemakers 7. Eval patients with congenital complete heart block prior to sports/increased activity

Front 1065

Contraindications to GXT

Back 1065

1. Acute MI within last 2 days 2. Unstable angina 3. Uncontrolled arrhythmias causing symptoms/hemodynamic 4. Symptomatic severe AS 5. Uncontrolled symptomatic HF 6. Active endocarditis/myocarditis/pericarditis 7. Acute aortic dissection 8. Acute embolism 9. Acute noncardiac disorders that may affect exercise 10. Baseline ECG abnormalities including preexcitation, complete LBBB, more than 1 mm ST depression at rest, paced ventricular rhythm, use of digoxin

Front 1066

Positive exercise stress test

Back 1066

60 to 80 ms of 1mm or greater horizontal or downsloping ST depression or elevation (lead V5 most diagnostic) Others: 1. Poor exercise capacity (< 5 Mets) 2. exercise induced angina 3. Low peak systolic blood pressure (<130) or fall in blood pressure 4. Chonotropic incompetence 5. New S3

Front 1067

Absolute Fibronylitic Contraindications

Back 1067

1. any prior intracranial hemorrhage known structural cerebral vascular lesion (AVM) 2. Known malignant intracranial neoplasm Ischemic stroke within 3 months (except if within 3 hours) 4. Suspected aortic dissection 5. Active bleeding or bleeding diathesis (not menses) 6. Significant closed head trauma or facial trauma within 3 months

Front 1068

Relative Fibrinolytic Contraindications

Back 1068

1. History of chronic, severe, poorly controlled HTN 2. Severe uncontrolled HTN on presentation (SBP > 180 or DBP > 110) 3. History of prior ischemic stroke > 3 months, dementia or known intracranial pathology 4. Traumatic or prolonged (>10 mintes) CPR or major surgery (<3weeks) 5. Recent (within 2-4 weeks) internal bleeding 6. Noncompressible vascular punctures 7. Pregnancy 8. Active peptic ulcer 9. Current use of anticoagulant (worse the higher the INR) For streptokinase/anistreplase: prior exposure (>5 days ago) or prior allergic rx to these agents

Front 1069

a

Back 1069

a

Front 1070

Venous waveform letters

Back 1070

a = atrial contraction c = closure of TV with early ventricular contraction - bulging of TV back into RA x = atrial relaxation, downard movement of ventricle during contraction v = venous filling against a closed valve y = opening of TV

Front 1071

Cardiac output

Back 1071

Q=SVxHR

Front 1072

O2 extraction ratio-

Back 1072

SaO2-SvO2/SaO2

Front 1073

O2 delivery-

Back 1073

Q x CaO2

Front 1074

FICKS equation for oxygen consumption

Back 1074

VO2 = Q(Ca -Cv) (volume of oxygen used = cardiac output (difference in oxygen content)

Front 1075

Oxygen content

Back 1075

(1.34 x HB x SaO2) + (0.0031 x PaO2)

Front 1076

Causes of Complete Heart Block

Back 1076

Medication Ischemia CNS - Cushing's reflex (increased intracranial pressure) Metabolic - Hyperkalemia (usually greater than 6.3) Hypo/hyperthyroid Infection - Lyme Rheum - SLE, dermatomyositis Sarcoid High Vagal tone Lenegre-Lev syndrome

Front 1077

The ejection fraction or systolic left ventricle internal diameter used as in indication for surgical intervention in severe mitral regurgitation

Back 1077

Left ventricular ejection fraction < 60% or left ventricular internal diameter in systole > 45 mm

Front 1078

amiodarone toxicity

Back 1078

1. CARDIAC: hypotension with rapid infusion, prolonged QT, torsades 2. NEUROLOGIC problems occur in 20-40%, including malaise, ataxia, and peripheral neuropathies 3. ENDOCRINE: hypothyroidism and hyperthyroidism 4. GI problems occur in 25% 5. OPHTHALMOLOGIC disturbances include optic neuropathy, papilledema, and photosensitivity 6. SKIN: blue grey pigmentation 7. PULMONARY: pulmonary fibrosis

Front 1079

Indications for IE prophylaxis

Back 1079

1. Previous IE 2. Prosthetic heart valve 3. Unrepaired cyanotic heart disease (including palliative shunts and conduits); 4. Completely repaired congenital heart defects with prosthetic material or device, whether placed by surgery or by percutaneous catheter intervention, during the six months after the procedure; 5. Repaired congenital heart disease with residual defects at the site, or adjacent to the site, of a prosthetic patch or prosthetic device (which inhibit endothelialization); and 6. Previous cardiac transplantation with subsequent cardiac valvulopathy (substantial leaflet pathology and regurgitation).

Front 1080

HPV strongly associated with cervical cancer

Back 1080

16, 18, 31, 45

Front 1081

Vector for ehrlichiosis

Back 1081

HME - Ambyomma americanum, dermacentor variabilis HGA - Ixodes

Front 1082

Organism for spotless RMSF

Back 1082

Erhlichiosis chaffeensis - human monocytic erlichiosis Also: Anaplasma phagocytophilum - Human granulocytic anaplasmosis