Medicine Shelf -Lag

Front 1

Pleural Effusions
(2)

Back 1

Malignant
Pneumo

Front 2

Secondary medical Tx for chronic stable angina after first 5 (2)

Back 2

1) If bp room add CCB
2) If refractory add Ranolazine

Front 3

Dx Irregularly irregular rhythm, with no P waves

Back 3

Afib

Front 4

Who should get coronary angiography?

Back 4

1) Lifestyle limiting angina despite medical tx
2) Markedly positive results on non-invasive stress testing
3) hx of Vtach
4) hx of Non specific CP with recurrent hospitalizations

Front 5

Who should get coronary Ca testing?

Back 5

Intermediate risk group (10-20% framingham risk score)

Front 6

Dx short PR and delta wave

Back 6

Wolf Parkinson White
(n.b. can become either orthodromic or antidromic AVRT)

Front 7

Dx Wide QRS tachycardia in setting of known hx of ischemic damage

Back 7

VTach

Front 8

Tx for Left NSTEMI

Back 8

Beta blocker

Front 9

Dx New murmur and respiratory after recent MI (2). Dx study? Tx?

Back 9

1) Acute MR
2) VSD
Dx study is Echo
Tx is IABP

Front 10

Dx STEMI, respiratory distress, hypotension, new systolic murmur, and thrill.

Back 10

Ventricular Septal defect

Front 11

Dx 1-4 days after MI, heart failure, tamponade or pulseless electrical activity.

Back 11

Ventricular free wall rupture

Front 12

Dx Afib or Aflutter spurts between a baseline of bradycardia

Back 12

Tachy-brady (a type of sick sinus sx)

Front 13

Dx Baseline bradycaria with dropped beats

Back 13

Sick sinus sx (sinoatrial node dysfunction)

Front 14

Dx Drug induced heart block

Back 14

Donepezil (ACh esterase inhibitor) causes increased vagal tone, bradycardia, and AV block

Front 15

Tx for Hemodynamically unstable patients with arrhythmia

Back 15

Electrical cardioversion

Front 16

Dx study for Aflutter or AVNRT

Back 16

Adenosine bolus

Front 17

Dx study for Sinus tachycardia

Back 17

Find underlying cause (e.g. TSH)

Front 18

What is the CHADS2 risk score?

Back 18

CHF
HTN
Age >75 years
Diabetes
Stroke or TIA (2 points)
-3 or greater get chronic anti-coagulation tx (warfarin)
*1-2 consider ASA vs warfarin

Front 19

Tx chronic Afib

Back 19

Beta blocker (or rhythm control e.g. verapamil) and Warfarin

Front 20

Dx study and tx for asymptomatic PVCs

Back 20

No studies or therapy needed

Front 21

Tx for symptomatic PVCs

Back 21

Beta blocker or CCB (e.g. verapamil)

Front 22

Indication for ICD in CHF

Back 22

EF less than 35%

Front 23

Indications for pacemaker

Back 23

1) Sick Sinus
2) symptomatic bradycardia due to 2nd or 3rd degree AV block

Front 24

Tx for Cardiac arrest (Ventricular arrhythmias)

Back 24

Medical management
1) ASA
2) Beta blocker
3) Statin
4) Plavix
5) ACE-I

Front 25

Dx Recurrent syncope with cardiac arrest with family history of sudden death

Back 25

Long QT syndrome
(cardiac arrest is in form of torsade de pointe)

Front 26

Indication for Digoxin tx

Back 26

Class III or IV heart failure (has no improved mortality, just keeps people out of hospital and makes them feel better)

Front 27

Dx Dyspnea, S3 or S4, displaced apical impulse, and EF less than 45% after delivery

Back 27

Peripartum cardiomyopathy

Front 28

Dx study for new onset CHF (DOE or orthopnea or edema) in the setting of angina (including stable) +/-abnormal EF

Back 28

Coronary angiography

Front 29

Dx study for New onset CHF

Back 29

Echo

Front 30

Tx for Class I or II CHF (2)
(even if asymptomatic)

Back 30

1) ACE-I
2) Beta blocker
3) Amlodipine only if refactory sx on 1 and 2

Front 31

Suitable substitute for spironolactone in Class III or IV CHF (bc they got gynecomastia)

Back 31

Epleronone

Front 32

Tx for Class III or IV CHF

Back 32

1) ACE-I
2) Beta blocker
3) Spironolactone

Front 33

Dx Aortic regurg in pt with prosthetic valve

Back 33

Prosthetic valve failure

Front 34

Dx split S2, right ventricular heave

Back 34

Atrial septal defect

Front 35

Dx opening snap, low pitched middiastolic murmur best heard over mitral valve

Back 35

Mitral stenosis

Front 36

Dx and Tx for Short, soft (less than 3), midsystolic murmur in elderly patient

Back 36

Usually aortic stenosis. No management needed.

Front 37

Diagnostic criteria for DM

Back 37

1) HbA1C greater than 6.5
2) Fasting glucose over 125
3) Random glucose over 200
4) 2 hour glucose tolerance test over 200

Hint 37

All of these have to be done twice except random BG with signs of hyperglycemia

Front 38

Tx Prediabetes

Back 38

Lifestyle modifications

Front 39

Dx chronic pancreatitis with diabetes

Back 39

Secondary diabetes

Front 40

Tx Initial for T2DM

Back 40

Metformin (and lifestyle modification)

Front 41

Tx Inpatient for controlling hyperglyecemia

Back 41

Long acting insulin with rapid acting insulin before meals (ISS)

Front 42

Tx for proliferative diabetic retinopathy or macular edema

Back 42

Laser photocoagulation

Front 43

Tx for chronic hypogycemia in DM

Back 43

Long acting and rapid acting prandial insulin

Front 44

Dx BG over 250, anion gap acidosis (less than 7.3), bicarb less than 15, and positive serum or urine ketones.

Back 44

Diabetic ketoacidosis (DKA)

Front 45

Dx BG over 600, ph more than 7.3, bicarb more than 15, serum osmolality greater than 320, and absent urine or serum ketones.

Back 45

Hyperglycemic hyperosmolar non-ketosis (HHNK)

Front 46

Tx HHNK

Back 46

IV fluids and identifying underlying cause

Front 47

Tx DKA

Back 47

Insulin drip

Front 48

Dx soft, non-tender, non-pruritic plaques on eyelids

Back 48

Xanthelasma (see in familial dyslipidemia)

Front 49

Tx for Isolated low HDL

Back 49

Lifestyle changes:
1) Exercise
2) Smoking cessation
3) Weight loss

Front 50

LDL goal for 0 or 1 CV risk factor

Back 50

Less than 160

Front 51

LDL goal for a diabetic

Back 51

Less than 100
(diabetes is a CVD equivalent)

Front 52

LDL goal for pts with hx of CVA or TIA

Back 52

Less than 100

Front 53

Mgmt for hypothyroidism

Back 53

Treat - Levothyroxine
Hashimoto disease is the most common cause of hypothyroidism, confirmation via TPO antibody unnecessary.

Front 54

Mgmt of Thyroid nodule

Back 54

If greater than 1 cm --> biopsy
If less than 1 cm, biopsy only if cancer risk hx

Front 55

Mgmt of Hypothyroidism in pregnacny

Back 55

Monitor, bc Thyroxine requirements go up 30-50%, want T4 1.5 normal

Front 56

Tx for Grave's disease

Back 56

Methimazole and Beta blocker
(better than radiation bc can achieve euthyroid. Also better than PTU)

Front 57

Mgmt of new Hyper or Hypothyroid post partum

Back 57

Recheck TSH and T4 to diagnose Postpartum Thyroiditis

Front 58

Mgmt abnormal thyroid studies in the setting of acute illness

Back 58

Recheck TSH and T4 to diagnose Euthyroid Sick Syndrome

Front 59

Mgmt of incidentally discovered adrenal adenoma in asymptomatic patient

Back 59

Get plasma-free metanephrine levels and overnight dexamethasone suppression test
(want to rule out hypersecretion of glucocorticoids and catecholamines)

Front 60

Dx study for Resistant HTN and hypokalemia

Back 60

Serum aldosterone to plasma renin activity ratio to diagnose Primary Hyperaldosteronism

Front 61

Dx study for High dose dexamethasone sensitive elevated ACTH

Back 61

MRI of pituitary

Front 62

Dx ACTH dependent hypercortisolism
1) High dose dexamethasone resistant
2) High dose dexamethasone sensitive

Back 62

1) Ectopic ACTH tumor
2) Pituitary tumor

Front 63

Mgmt of Palpitations, sweating, HA, HTN

Back 63

Abdominal CT scan to confirm Dx of Pheochyromocytoma

Front 64

Dx low ACTH, low cortisol, and high glucocorticoids in setting of exogenous corticosteroids

Back 64

Adrenal insufficiency due to exogenous corticosteroids

Front 65

Tx for Pts with adrenal insufficiency in setting of stress (as from illness or surgery)

Back 65

Stress level doses of corticostreroids (Hydrocortisone or Dexamethasone)

Front 66

Tx for Osteoporosis

Back 66

Vitamin D, Ca supplementation, Bisphosponates (or zoledronate annually if cannot tolerate bisphosphonates)

Front 67

When and with what to screen for osteoperosis

Back 67

Screen with DEXA in women over 65 or women 60-65 with increased risk of osteoperosis (i.e. weight below 154 lbs)

Front 68

Tx for Osteoporosis prevention

Back 68

Vit D and Ca

Front 69

Bone mineral density T score cutoffs for Osteopenia and Osteoperosis

Back 69

Osteopenia: -1 to -2.5
Osteoperosis: -2.5 or more

Front 70

Dx unilateral flank pain, n/v, gross or microscopic hematuria

Back 70

Nephrolithiasis

Front 71

Dx study for Nephrolithiasis

Back 71

Helical abdominal CT scan

Front 72

Dx study for Acute abdominal pain

Back 72

Supine and upright abdominal radiographs (to look for air fluid level --> bowel obstruciton, and free peritoneal air --> perforated bowel)

Front 73

Dx Abdominal pain, back pain, syncope

Back 73

Abdominal aortic aneurysm

Front 74

Dx Recurrent abdominal pain or discomfort, relieved with defecation, with diarrhea

Back 74

Irritable Bowel Syndrome

Front 75

Tx for Irritable bowel syndrome

Back 75

Fiber and/or polyethylene glycol with reassurance

Front 76

Dx crampy abdominal pain, with bloody stool, in eledery atherosclerotic patients

Back 76

Ischemic colitis

Front 77

Mgmt LLQ pain, fever, leukocytosis

Back 77

Contrast enhanced CT scan to confirm Diverticulitis

Front 78

Mgmt Chronic upper abdominal pain radiating to back, diabetes, steatorrhea, pancreatic calcifications

Back 78

Abdominal CT to look for pancreatic calcifications to confirm Chronic Pancreatitis

Front 79

Dx Thrombotic microangiopathy (schistocytes, elevated retic count, elevated LDH) and Thrombocytopenia

Back 79

Hemolytic Uremic Syndrome

Front 80

Dx Diarrhea and tenesmus within 6 weeks of radiation therapy

Back 80

Radiation proctitis

Front 81

Dx mid-epigastric abdominal pain, postprandial diarrhea, +/-DM

Back 81

Chronic pancreatitis

Front 82

Alarm criteria in IBS

Back 82

1) Fever
2) Weight loss
3) Blood in stool
4) Abnormal PE
5) FHx of IBD or Colon ca
6 Pain or diarrhea that interferes with sleep

Front 83

Dx 10-15 stool/day, lower abdominal pain, cramping, fever, leukocytosis in setting of Abx

Back 83

C Diff

Front 84

Tx for Salmonella gastroenteritis

Back 84

Self limiting, no tx

Front 85

Dx Anti-mitochondrial Ab

Back 85

Primary Biliary Cirrhosis

Front 86

Tx for Primary Billiary cirrhosis

Back 86

Ursodeoxycholic acid

Front 87

Which liver disease is associated with UC and Crohn's

Back 87

Primary sclerosing cholangitis

Front 88

Beading of the biliary duct

Back 88

PSC

Front 89

Pattern of bilirubin elevation
1) Prehepatic
2) Intrahepatic
3) Posthepatic

Back 89

1) Prehepatic - Unconjugated hi
2) Intrahepatic - Both hi
3) Posthepatic - Conjugated hi

Front 90

Dx Unconjugated hyperbilirubinemia with normal Hgb levels and otherwise normal LFTs

Back 90

Gilbert Syndrome

Front 91

Tx for Symptomatic gallstone disease

Back 91

Cholecystectomy

Front 92

Dx Elevated bilirubin and alkphos with IBD

Back 92

PSC

Front 93

Dx fever, jaundice, RUQ pain and common bile duct obstruction

Back 93

Acute cholangitis

Front 94

Dx biliary colic, Murphy sign, fever, leukocytosis, mild biliruibin and AST/ALT elevation, thickened gallbladder wall.

Back 94

Acute cholesystitis

Front 95

Tx for Gallstone pancreatitis

Back 95

ERCP with sphincterotomy and stone extraction

Front 96

Dx epigastric pain radiating to back, n/v, fever, tachycardia, abdominal distension, hypoactive bowel sounds.

Back 96

Acute pancreatitis

Front 97

Dx Stones in gallbladder, dilated bile duct, and elevated AST/ALT with acute pancreatitis.

Back 97

Acute pancreatitis due to gallstones

Front 98

Tx for Severe acute pancreatitis

Back 98

Enteral nutrition with nasojejunal feeding tube

Front 99

Mgmt GERD sx with dysphagia

Back 99

Upper endoscopy
(Dysphagia is an alarm sx)

Front 100

Tx Erosive Esophagitis

Back 100

PPI

Front 101

Dx study for gastric ulcer

Back 101

Biopsy
(all ulcers should be biopsied for possible malignancy)

Front 102

Mgmt of dyspepsia with NSAIDs

Back 102

Stop the NSAID

Front 103

Tx for Functional dyspepsia

Back 103

PPI
(i.e. dyspepsia/gastritis without visible organic pathology)

Front 104

Dx study for GI Bleed of unknown etiology after endoscopy and colonoscopy

Back 104

Repeat upper endoscopy

Front 105

Dx LLQ pain, urgent defecation, red or maroon rectal bleeding not requiring transfusion usually in older people

Back 105

Colonic ischemia

Front 106

Mgmt of Upper GI bleed after fluid resuscitation

Back 106

Upper endoscopy for Diagnosis, Prognosis, and possible therapy

Front 107

Tx for GI bleeding in hemodynamically unstable patients

Back 107

Fluid resuscitation

Front 108

Dx Painless lower GI bleeding

Back 108

Diverticulosis and vascular ectasia

Front 109

Dx BRBPR and pain with defecation

Back 109

Anal fissure

Front 110

Screening for chronic Hep B infection

Back 110

Liver ultrasound to look for hepatocellular ca

Front 111

Dx Acute hepatitis, fatigue, n/v, jaundice, AST/ALTs over 1000.

Back 111

Hepatitis A

Front 112

Dx AST;ALT ratio greater than 2, elevated alk phos

Back 112

Alcoholic hepatitis

Front 113

Dx Elevated AST/ALTs, hi GGT, mild bilirubinemia, mildly elevated alk phos, present of auto antibodies.

Back 113

Autoimmune hepatitis

Front 114

Dx Positive HBsAg and Anti-HBc IgM

Back 114

Acute HepB
(The IgM tells you its acute and not chronic infxn)

Front 115

Dx anti-hepatitis C Ab

Back 115

Exposure to Hep C or vaccine

Front 116

Dx Cirrhosis, obesity, T2DM, and hyperlipidemia

Back 116

Non-Alcoholic Steatohepatitis
NASH

Front 117

Dx UC and marked elevation in alk phos

Back 117

PSC

Front 118

Dx Ascitic fluid analysis showing serum to ascites albumin gradient greater than 1.1

Back 118

Portal hypertension
(caused by Liver disease, such as cirrhosis, right sided HF (congestive hepatopathy), or Budd-Chiari)

Front 119

Tx for Hepatic Encephalopathy

Back 119

Lactulose

Front 120

Dx kidney dysfunction in setting of portal htn after exclusion of prerenal azotemia, intra renal disease, and renal obstruction.

Back 120

Hepatorenal syndrome

Front 121

Dx small, exquisitely tender nodules on shins in IBD

Back 121

Erythema nodosum

Front 122

Dx Contiguous inflammation of rectum proximally

Back 122

UC (Ulcerative colitis)

Front 123

Tx for Ulcerative colitis

Back 123

Mesalamine

Front 124

Dx Chronic watery diarrhea without bleeding without findings on colonoscopy

Back 124

Microscopic colitis

Front 125

Which test characteristics are robust or sensitive to prevalence.

Back 125

Robust - Sensitivity, Specificity, LR
Sensitive - PPV,. NPV

Front 126

What is the relationship between LRs and Post Test Probability

Back 126

LRs of 2, 5, and 10 increase Post test probability 15, 30, and 45% respectively

Front 127

Screening recommendation for AAA

Back 127

All men 65-75 who have ever smoked

Front 128

Flu vaccine recommendations for COPD

Back 128

All COPD patients regardless of age

Front 129

Pneumovax recommendations

Back 129

1) Anyone over 65
2) Smokers, COPD, or asthma can be younger
3) RE-Vaccination in everyone over 65 if last vaccination was more than 5 years ago AND before 65.
4) RE-Vaccination in immunosuppressed people if first vaccine more than 5 years ago

Front 130

What is the best end point for any trial?

Back 130

Mortality

Front 131

Zoster vaccine recommendations

Back 131

All patients over 60 regardless of prior varicella/zoster hx

Front 132

HPV vaccine recommendations

Back 132

All women 9-26

Front 133

Colon Ca screening recommendations

Back 133

Starting at age 50
1) Colonoscopy every 10 years
2) Flex sig every 5 years with home FOBT every 3 years
3) Annual home FOBT

Front 134

Dx Syncope in ischemic HF

Back 134

VTach

Front 135

How to diagnose orthostatic hypotension

Back 135

Drop in systolic BP of 20 or 10 diastolic after 3 minutes of standing

Front 136

Dx Syncope, nausea, lightheadedness, diaphoresis

Back 136

Vasovagal syncope (situational)

Front 137

Dx LOC irrespective of body position without preceding symptoms

Back 137

Cardiac arrhythmia

Front 138

Dx study for infrequent syncope

Back 138

Implantable loop recorder

Front 139

Tx for Depression after failing 1 antidepressant

Back 139

A different antidepressant

Front 140

Tx for Depressive sx of 2 weeks more than 8 weeks after death of loved one

Back 140

Pharmacologic antidepressants

Front 141

Tx for Acute cocaine intoxication

Back 141

Benzodiazepine

Front 142

Tx for short term alcohol dependence

Back 142

Naltrexone

Front 143

Tx for Acute opioid intoxication

Back 143

Naloxone (narcan)

Front 144

Tx for Spinal stenosis with neurologic deficits and pain refractory to NSAIDs and PT

Back 144

Surgery

Front 145

Dx study for Vertebral osteomyelitis

Back 145

MRI

Front 146

Tx for Acute non-specific low back pain

Back 146

NSAIDs or Acetaminophen

Front 147

Dx Back pain, muscle weakness, and bowel or bladder incontinence

Back 147

Spinal cord compression

Front 148

Dx study for Spinal cord compression

Back 148

MRI of spine

Front 149

Mgmt Cough variant asthma

Back 149

Albuterol inhaler trial for tx and dx

Front 150

Mgmt for Chronic cough in non-smoker

Back 150

Antihistamine/decongestant combination

Front 151

2 Most common causes of hemoptysis

Back 151

1) Bronchitis
2) Malignancy

Front 152

Dx study for Hemoptysis with and without alarms for malignancy

Back 152

1) CXR
2) If over 40, or more than 1 week, or 40 pyhx than Chest CT

Front 153

Tx Acute bronchitis

Back 153

Symptom management

Front 154

Effects of smoking cessation on lung function (2)

Back 154

1) Absolute improvement (minor)
2) Decreased rate of decline (major)

Front 155

Tx for Smoking cessation

Back 155

Varenicline
(Bupropion and nortriptyline effective but less so)

Front 156

Indications for bariatric surgery

Back 156

1) BMI over 40 regardless of comorbidities
2) BMI over 35 w/ comorbidities
When drug therapy was unsuccessful

Front 157

Tx for Obesity after diet and exercise fail

Back 157

Orlistat

Front 158

Dx Nausea and vomiting within months of bariatric surgery

Back 158

Stomal stenosis

Front 159

Mgmt Unintentional weight loss with negative labs and imaging

Back 159

Recheck in 6 months
(risk of ca low)

Front 160

Most common cause of unintentional weight loss in ca negative patients

Back 160

Depression

Front 161

Medication that can cause weight loss

Back 161

Bupropion

Front 162

Dx Unintentional weight loss, skeletal muscle dysfunction, osteoperosis, depression

Back 162

COPD

Front 163

Tx for Menorhagia

Back 163

Medroxyprogesterone for 10-21 days
(Menoroghia is heavy menstrual bleeding)

Front 164

Dx Oligomenorrhea, hirsutism, acne, alopecia

Back 164

PCOS

Front 165

Tx for Menopausal sx

Back 165

Estrogen replacement therapy

Front 166

Dx study for Amenorrhea after pregnancy rule out

Back 166

FSH, TSH, and Prolactin levels

Front 167

Dx study for Abnormal uterine bleeding in patients over 35

Back 167

Endometrial biopsy

Front 168

Dx Well-demarcated, rapidly spreading area of warmth, swelling, tenderness, and erythema +/- fever

Back 168

Cellulitis

Front 169

Dx Erythematous, dry or greasy scales and crusts

Back 169

Seborrheic dermatitis

Front 170

Dx Light pink to red papules and thin plaques with scaling, active borders and central clearing

Back 170

Tinea

Front 171

Dx Erythematous macules and plaques that progress to epidermal necrosis and sloughing on less than 10% of body

Back 171

Steven Johnson

Front 172

Dx Targetoid lesions of both skin and mucosal surfaces

Back 172

Erythema multiforme

Front 173

Tx for Zoster reactivation

Back 173

Oral antiviral if within 72 hours of onset of rash

Front 174

Dx Erythema, telangiectasias, papules, pustules, and sebaceous hyperlasia of the face and nasolabial folds

Back 174

Rosacea

Front 175

Dx brown to black, well demarcated, stuck on papules

Back 175

Seborrheic keratoses

Front 176

Tx Extensive or inflammatory acne

Back 176

Oral abx

Front 177

Dx Rapid appearance of wheal lasting less than 24 hrs

Back 177

Acute uriticaria

Front 178

Mgmt Solitary, mobile, LAD of less than 2 cm

Back 178

No mgmt needed

Front 179

Mgmt Enlarging, firm, axillary LAD in woman over 40

Back 179

Biopsy

Front 180

Screening for hearing loss in elderly

Back 180

Whispered voice test even if claiming asymptomatic

Front 181

Dx study for Fall in elderly patient

Back 181

Get up and go test

Front 182

Tx Urge urinary incontinence

Back 182

Tolterodine or Oxybutynin

Front 183

Mgmt of Non-specific dizziness in eldery patient

Back 183

PT

Front 184

Initial Tx for Stage I HTN

Back 184

Lifestyle modification for 6 to 12 months
(then you go to HCTZ)

Front 185

Initial Tx for HTN in eldergy pt

Back 185

HCTZ (more salt sensitive)

Front 186

BP Goal in diabetics or CKD

Back 186

130/80

Front 187

Dx HTN, radial to femoral artery delay, rib notching

Back 187

Coarctation of Aorta

Front 188

Initial Tx for Stage II HTN

Back 188

2 drugs, usually HCTZ and ACE-I

Front 189

Dx Serum ferritin levels lower than 100-120

Back 189

Iron deficiency anemia

Front 190

Dx Pancytopenia, low retic count, hypoplastic bone marrow (usually with fat)

Back 190

Aplastic anemia

Front 191

Tx Iron deficiency anemia

Back 191

Ferrous sulfate

Front 192

Dx bite or blister cells

Back 192

G6PDase Deficiency

Front 193

Dx Low MCV and target cells with normal iron studies

Back 193

Thalassemia minor

Front 194

Dx Macrocytic anemia, thrombocytopenia, elevated LDH

Back 194

Vitamin B12 deficiency

Front 195

Dx study for suspected Vit B12 deficiency with low normal Vit B12

Back 195

Methylmalonic acid and homocysteine

Front 196

Dx Elevated LDH, decreased serum haptoglobin, and elevated retic count

Back 196

Hemolytic anemia

Front 197

Dx Hemolytic anemia, schistocytes, in setting of prosthetic valve

Back 197

Prosthetic valve hemolytic anemia

Front 198

Dx Microcytic anemia, hypochromia, variable size, and variable shape

Back 198

Iron deficiency anemia

Front 199

Dx Spherocytes on blood smear

Back 199

Warm antibody-mediated hemolytic anemia

Front 200

Dx Long PT and PTT, high D-dimer, low serum fibrinogen and platelets, and microangiopathic hemolytic anemia

Back 200

Disseminated intravascular coagulation

Front 201

Dx Long bleeding time, borderline PTT, low factor VIII wit FHx of coagulopathy

Back 201

Von Willebrand

Front 202

Dx Transient aplastic crisis in patients with chronic hemolytic anemia (e.g. sickle cell disease)

Back 202

Parvovirus

Front 203

Dx Right sided heart failure in sickle cell anemia

Back 203

Pulmonary HTN
(common in sickle cell anemia)

Front 204

Tx Acute chest syndrome in sickle cell anemia

Back 204

Transfusion

Front 205

Dx study Osteonecrosis

Back 205

MRI of the hip

Front 206

Dx study for Sickle cell anemia

Back 206

Blood smear

Front 207

Dx Decreased platelets, thrombotic event in setting of recent heparin

Back 207

Heparin induced thrombocytopenia and thrombosis

Front 208

Dx Microangiopathic hemolytic anemia, thrombocytopenia with normal coagulation, CNS sx, renal failure, fever

Back 208

Thrombotic thrombocytopenic purpura

Front 209

Dx Large platelet clumps on stained blood film

Back 209

Pseudothrombocytopenia

Front 210

Tx for Immune thrombocytopenic purpura

Back 210

Corticosteroids

Front 211

Tx for Antiphospholipid syndrome after thrombus

Back 211

Warfarin for life

Front 212

Dx Lupus anti-coagulant or anticardiolipin or B2 glycoprotein antibodies

Back 212

Antiphospholipid

Front 213

Dx decreased AG with anemia, proteinuria, hypercalcemia, and renal failure

Back 213

Multiple myeloma

Front 214

Dx hypercalcemia, osteopenia, anemia, leukopenia, and renal insufficiency

Back 214

Multiple myeloma

Front 215

Dx M spike less than 3.0 with less than 10% plasma cells in bone marrow

Back 215

Monoclonal gammopathy of unknown significance

Front 216

Auer Rods

Back 216

AML

Front 217

Dx BCR/ABL oncogene, granulocytes with left shift, and myeloid proliferation in bone marrow

Back 217

CML

Front 218

Dx Blanching rythematous macules around wrists and ankles after tick exposure

Back 218

Rock mountain spotted fever

Front 219

Dx Very high or brief fever spikes and rapid defervescence without chills

Back 219

Factitious fever

Front 220

Dx Fever after inhaled anesthetics and depolarizing muscle relaxants

Back 220

Malignant hyperthermia

Front 221

Tx for Sepsis with hemodynamic instability

Back 221

Fluids

Front 222

Flu vaccine recommendations for COPD

Back 222

Annually regardless of age for everyone with COPD

Front 223

Dx Low MCV, low serum Fe, elevated TIBC, and low transferrin saturation

Back 223

Iron deficiency anemia

Front 224

Tx Rocky Mountain Spotted Fever

Back 224

Doxycycline

Front 225

Indication for Norepinephrine in septic shock

Back 225

If MAP is less than 65 after fluid resuscitation

Front 226

Criteria for Sepsis

Back 226

1) Positive BCx or visible infxn
2) Systemic response to infxn, at least 2: fever, tachycardia, tachypnea, leukocytosis
aka SIRS with positive BCx

Front 227

Criteria for Systemic inflammatory response syndrome (SIRS)

Back 227

At least 2 of:
Fever
HR over 90
Respiration greater than 20 (or PCO2 less than 32)
Leukocytosis (or Immature bands 10%)

Front 228

Criteria for Septic shock

Back 228

Sepsis with hypotension or evidence of perfusion abnormalities with adequate fluid resuscitation (or on vasopressors)

Front 229

Severe complications of Group A Strep (3)

Back 229

1) Peritonsillar abscess (quinsy)
2) Post-streptococcal glomerulonephritis
3) Rheumatic fever

Front 230

Tx for Acute otitis media

Back 230

Amoxicillin
(Amox-clav or Ceftriaxone if not improved within 3 days)

Front 231

Centor Criteria for Strep Throat (4)

Back 231

1) Fever
2) Tonsillar exudates
3) Tender LAD cervical
4) Absence of cough

Front 232

Mgmt according to Centor Criteria

Back 232

0-1 Nothing
2-3 Rapid strep antigen test
4 Empiric Abx tx

Front 233

Mgmt for Asymptomatic UTI in pregnant woman

Back 233

Ampicillin

Front 234

Dx
Prostatitis refractory to Abx

Back 234

Prostatic abscess

Front 235

Tx
Asymptomatic UTI

Back 235

No treatment

Front 236

Dx
Fever, chills, sweats, n/v, diarrhea, and flank pain

Back 236

Pyelonephritis

Front 237

Tx
Pyeloneophritis in non-pregnant woman

Back 237

Oral Fluoroquinolone

Front 238

Tx
Recurrent UTI in healthy women

Back 238

Trimethoprim sulfamethoxazole (bactrim) PRN for days with symptoms

Front 239

Dx
Mucoprurulent discharge or bleeding of os

Back 239

Cervicitis

Front 240

Tx
Cervicitis

Back 240

Ceftriaxone with doxy or azithromcyin

Front 241

Dx
Arthritis, tenosynovitis, sparese peripheral necrotic pustulues

Back 241

Gonorrhea

Front 242

Dx
Fever, HA, and painful, ulcerated vesicular lesions on junk

Back 242

Genital herpes

Front 243

Tx
Pelvic inflammatory disease

Back 243

Ceftriaxone and oral doxycycline

Front 244

Dx
CD4 less than 200, fever, dry cough, dyspnea for several days or weeks

Back 244

Pneumocystis jirovecii

Front 245

Tx
Pneumocystis jirovecii

Back 245

Bactrim
and Steroids if hypoxic

Front 246

HIV Abx prophylaxis by CD4 count and PPD

Back 246

1) Less than 200 - Bactrim for PJP and Toxo
2) Less than 50 - Azithromcyin for Mycobacterium Avium
3) PPD positive but lungs clear - Isoniazid

Front 247

Dx study for
Acute HIV infxn

Back 247

RNA viral load

Front 248

Dx
Ring enhancing lessions on MRI, neurologic deficits, in setting of HIV

Back 248

Toxoplasmosis

Front 249

How to reduce ventilator associated PNA

Back 249

Semi erect positioning of patient

Front 250

Infectious precautions for C Diff

Back 250

Barrier protection and soap and water

Front 251

Precautions for Meningoccocal meningitis

Back 251

Droplet precautions (surgical mask)

Front 252

Precautions for TB

Back 252

Airborne N95 mask

Front 253

Mgmt for
Positive PPD

Back 253

CXR

Front 254

PPD cutoffs by risk (3)

Back 254

5 mm Immunosuppressed or highest risk (close contact with TB)
10 mm Immigration form endemic country or prison worker
15 mm for healthy people

Front 255

What must you get tested before starting a TNF-alpha inhibitor

Back 255

TB tested with PPD (and treat if more than 5 mm)

Front 256

Dx
Severe, progressive PNA during flu season

Back 256

MRSA

Front 257

Tx
Community acquired PNA

Back 257

Azithromycin

Front 258

Tx
PE from valve endocarditis (Right heart valve)

Back 258

Vancomycin plus cefepime

Front 259

Tx
Left sided native endocarditis

Back 259

Penicillin plus gentamycin
or
Ceftriaxone plus gentamycin

Front 260

Dx
Positive BCx, vegetation on Echo, and new valvular regurg

Back 260

Endocarditis

Front 261

Dx study for
Suspected Vertebral osteomyelitis

Back 261

Spine MRI

Front 262

Dx study for
Osteomyelitis

Back 262

MRI

Front 263

Dx study for
Confirmed Osteomyelitis

Back 263

BCx or Bone culture

Front 264

Pneumovax is indicated in everyone after their 65th birthday or after 65 if there have been more than 5 years since last vaccine

Back 264

.

Front 265

Dx
Severe, progressive PNA during flu season

Back 265

MRSA

Front 266

Tx
Community acquired PNA

Back 266

Azithromycin

Front 267

Tx
PE from valve endocarditis (Right heart valve)

Back 267

Vancomycin plus cefepime

Front 268

Tx
Left sided native endocarditis

Back 268

Penicillin plus gentamycin
or
Ceftriaxone plus gentamycin

Front 269

Dx
Positive BCx, vegetation on Echo, and new valvular regurg

Back 269

Endocarditis

Front 270

Dx study for
Suspected Vertebral osteomyelitis

Back 270

Spine MRI

Front 271

Dx study for
Osteomyelitis

Back 271

MRI

Front 272

Dx study for
Confirmed Osteomyelitis

Back 272

BCx or Bone culture

Front 273

Dx
Confusion and agitation in setting of chronic dementia with recent anesthesia

Back 273

Postooperative delirium

Front 274

Tx
Acute delirium inpatient

Back 274

Haloperidol

Front 275

Dx
Mental status changes, nystagmus, ophthalmoplegia, unsteady gait

Back 275

Wernicke's encephalopathy

Front 276

Tx
Wernicke's encephalopathy

Back 276

Thiamine

Front 277

Dx
Smudge cells

Back 277

CML

Front 278

Dx
Proteinuria during day but not over night

Back 278

Orthostatic proteinuria

Front 279

Dx
AKI with sterile pyuria (PMNs in urine) and WBC casts

Back 279

AIN

Front 280

Dx study for
Persistent hematuria of non glomerular origin

Back 280

Cytoscopy

Front 281

Dx
Muscle pain, weakness, dark urine, elevated serum creatine kinase

Back 281

Rhabdomyolysis

Front 282

Dx
AKI, thrombocytopenia, microangiopathic hemolytic anemia

Back 282

Hemolytic uremic syndrome

Front 283

Dx
Muddy brown casts in setting of drugs or prolonged renal ischemia

Back 283

ATN

Front 284

Tx for
Diabetic nephropathy

Back 284

ACE-Is or ARBs

Front 285

Indications for dialysis in CKD (4)

Back 285

1) Hypervolemic
2) Hyperkalemic
3) Acidemic
4) Uremic

Front 286

Dx
Proteinuria, HTN, and decreasing GFR

Back 286

Diabetic nephropathy

Front 287

Dx study for
AKI with suprapubic tenderness

Back 287

Renal US

Front 288

Dx study for
Non diabetic nephropahty (hematuria) in a diabetic

Back 288

Renal biopsy

Front 289

Dx
Bone disease, elevated PTH, hypocalcemic, and hyperphosphatemic

Back 289

Bone disease 2/2 hyperparathyroidism in CKD

Front 290

What does the Urine anion gap (UAG) tell you? (3)

Back 290

If negative - Extra renal metabolic acidosis
If positive (30-50) - Normal
If positive in setting of metabolic acidosis - RTA

Front 291

Formula for Serum osmolality

Back 291

= Na*2 + BUN/2.8 + gluc/18

Front 292

Dx
Hypokalemia with low urine K

Back 292

Extra renal losses of K (laxatives or diarrhea)

Front 293

Dx
Hypocalcemia in setting of acute pancreatitis

Back 293

Free fatty acid chelation of Ca

Front 294

Tx for
Hypercalcemia in Sarcoidosis

Back 294

Corticosteroids (prednisone)
(decrease macrophages which produce 1alpha-hydroxylase which increases vit D)

Front 295

Most common cause of hypercalcemia outpatient

Back 295

Hyperparathyroidism

Front 296

Dx
Severe muscle weakness following glucose therapy in alcoholic

Back 296

Hypophosphatemia
(Insulin release from glucose moves phosphate into cells which is low bc of low oral intake)

Front 297

Risk for demented patients during surgery

Back 297

General anesthesia

Front 298

Tx for
Delirium inpatient

Back 298

Haloperidol

Front 299

Dx
MS changes, ophthalmoplegia, nystagmus and unsteady gait

Back 299

Wernicke's encephalopathy

Front 300

Cause of wenicke's encephalopathy

Back 300

Thiamine deficiency

Front 301

Dx
Neurologic sx including vision loss, hallucinations, numbness, tingling, weakness or confusion prior to HA

Back 301

Migraine with aura

Front 302

Dx
Dull, bilateral, diffuse headache described as squeezing

Back 302

Tension type headache

Front 303

Dx study
For sudden worst HA of life

Back 303

Non contrast Head CT

Front 304

Tx for
Migraine prophylaxis
(indication more than 2 per week)

Back 304

Amitrptyine (TCAs), Beta blockers, CCBs, valproic acid, topirmarate

Front 305

Abortive Tx for Migraine

Back 305

Triptans (5-HT1 agonists), NSAIDs, Ergotamine

Front 306

Dx
Prominent memory loss, anomia, impaired recognition of illness, variable degree of personality change

Back 306

Alzheimers

Front 307

Dx
Dementia of a few month onset with startle myoclonus

Back 307

Creutzfeldt-Jakob

Front 308

Dx
Parkinsonism, visual hallucinations, fluctuating symptoms, impaired learning and attention, less memory impairment

Back 308

Dementia with Lewy bodies

Front 309

Tx for
Mild Alzheimer's

Back 309

Donepezil
(ACh esterase inhibitor)

Front 310

Tx for
Moderate or advanced Alzheimer's

Back 310

Memantine

Front 311

Dx
Resting tremor, bradykinesia, rigidity, postural instability

Back 311

Parkinson Disease

Front 312

Dx
Tremor with voluntary movement that resolves with alcohol

Back 312

Essential tremor

Front 313

Tx for
Essential tremor

Back 313

Propanolol

Front 314

Dx
Meningitis with Gram positive bacilli in immunocompromised

Back 314

Listeria monocytogenes

Front 315

Dx
Fever, HA, myalgia, purpuric rash that begins on wrists and ankles and spreads centripetally

Back 315

Rocky mountain spotted fever

Front 316

Dx
Bacterial meningitis with Gram negative cocci

Back 316

Nisseria meningitidis

Front 317

Empiric Tx for bacterial meningitis in patients over 50

Back 317

Ceftriaxone + Vancomycin + Ampicillin

Front 318

Empiric Tx for bacterial meningitis in patients under 50

Back 318

Ceftriaxone + Vancomycin

Front 319

When should rehab begin after stroke?

Back 319

Immediately

Front 320

Tx for
Acute Stroke within 3 hrs of onset

Back 320

tPA
Hold ASA until 24 hours after tPA

Front 321

BP cutoffs to treat HTN in post ischemic stroke

Back 321

Over 220/120

Front 322

Dx study for
Sudden worst HA of life with negative non contrast Head CT

Back 322

LP

Front 323

Agent in Bell's palsy

Back 323

HSV-1

Front 324

Dx
Rapidly progressive Ascending extremity weakness, paresthesias, and areflexia.

Back 324

Guillaain-Barre

Front 325

Dx
Wrist pain sparing palm, numbness and tingling in the median nerve distribution, weakness of thenar muscles

Back 325

Carpal tunnel

Front 326

Dx
Stocking glove paresthesias or painful dysesthesias

Back 326

Diabetic neuropathy

Front 327

Positive Finkelstein test

Back 327

de Quervain tenosynovitis

Front 328

Dx study for
New small breast mass on mammography

Back 328

Ultrasound

Front 329

Dx
Persistent, scaling, eczematous, ulcerated lesion on breast around nipple

Back 329

Paget disease of breast
(indicates invasive or intraductal cancer)

Front 330

Dx study for
New breast mass

Back 330

Palpation, Mammography, and FNA

Front 331

Tx for
Small focal breast cancer tumor (3)

Back 331

Lumpectomy
Sentinel node dissection
Radiation

Front 332

Colonoscopy screening for 1st degree relative

Back 332

1) Starting at 40 or 10 years before relative
2) Every 5 years

Front 333

Dx study for
Single positive FOBT in asymptomatic pt

Back 333

Colonoscopy

Front 334

Screening for colon ca in IBD

Back 334

1) Starting 8 years after onset of disease
2) Every year

Front 335

Dx screening for lung ca

Back 335

None

Front 336

Dx study for
Pulmonary nodule less than 4 mm in low risk population

Back 336

No study necessary

Front 337

Dx study for
Diagnosed lung cancer

Back 337

Lymph node biopsy for staging

Front 338

Tx for
Small cell lung cancer

Back 338

Chemotherapy and radiation
(surgery is not effective)

Front 339

Indications for prostate biopsy (2)

Back 339

1) PSA over 4
2) Rising PSA

Front 340

Tx for
Prostate ca

Back 340

Leuprolide

Front 341

Dx study for
Atypical pap smear results

Back 341

Colposcopy with biopsy

Front 342

HPV vaccination recommendations

Back 342

Females and males 9-26

Front 343

Pap screening recommendations

Back 343

1) Start at 21 or 3 years after first sex
2) Annually for 21-30
3) Every 3 years after if normal in 30-65

Front 344

Dx
Berry like lesion

Back 344

Nodular melanoma

Front 345

Hyperkeratotic precursor to squamous cell carcinoma

Back 345

Actinic keratosis

Front 346

Dx
Pink, pearly, nodules with telangiectasias

Back 346

Basal Cell carcinoma

Front 347

Dx
Rapidly progressive, crater like firm nodule

Back 347

Keratoacanthoma

Front 348

Tx for
Keratoacanthoma

Back 348

Surgical excision
(can cause tissue damage or become malignant)

Front 349

How to treat cancer pain

Back 349

1) Non narcotics
2) Short acting narcotics
3) Then from that determine there long acting narcotic needs and Rx short acting for break through pain

Front 350

Tx for
Dyspnea in hospice ca care

Back 350

Opioids (short acting)

Front 351

Definition of unstable angina

Back 351

Angina is new, worsening, or occurring at rest

Front 352

Antihypertensive for a diabetic patient with proteinuria

Back 352

ACE-I

Front 353

Dx
Hypotension, distant heart sounds, JVD

Back 353

Cardiac tamponade

Front 354

Drugs that slow AV node conduction (3)

Back 354

1) Beta blockers
2) Digoxin
3) CCBs

Front 355

HOCM murmur

Back 355

Systolic ejection murmur along lateral sternal border that increases with Valsalva maneuver and standing

Front 356

Murmur aortic insufficiency

Back 356

Diastolic, decrescendo, high pitched, blowing murmur best heard when standing up

Front 357

Murmur aortic stenosis

Back 357

Systolic crescendo/decrescendo murmur that radiates to the neck, increases with increased preload

Front 358

Murmur mitral regurg

Back 358

Holosystolic murmur that radiates to the axilla or carotids

Front 359

Murmur mitral stenosis

Back 359

Diastolic, mild to late, low pitched rumble

Front 360

Tx for
Afib or Aflutter
1) If unstable
2) If stable

Back 360

1) If unstable - Cardiovert
2) If stable - Rate control with Beta blockers

Front 361

Tx for
Vfib

Back 361

Cardioversion

Front 362

Autoimmune complication 2-4 weeks post MI

Back 362

Dressler's syndrome: fever, pericarditis, elevated ESR

Front 363

Tx for
IV drug use with JVD and holosystolic murmur at left sternal border

Back 363

Treat existing HF and replace tricuspid valve

Front 364

Dx study for
Hypertrophic cardiomyopathy

Back 364

Echo

Front 365

Dx
Fall in systolic BP greater than 10 mm with inspiration

Back 365

Pulsus parodoxus --> Cardaic tamponade

Front 366

Classic EKG findings in pericarditis (2)

Back 366

1) Low voltage
2) Diffuse ST segment elevation

Front 367

Indications for surgical repair of AAA

Back 367

Greater than 5.5 cm
Rapidly enlarging
Symptomatic
or Ruptured

Front 368

EKG findings in MI (3)

Back 368

1) ST segment elevations
2) Flattened T waves
3) Q waves

Front 369

Dx
Young patient with angina at rest, ST segment elevation, nl cardiac enzymes

Back 369

Prinzmetal's angina

Front 370

Dx
CHF, shock, altered MS

Back 370

Silent MI

Front 371

Agent that reverses effect of heparin

Back 371

Protamine

Front 372

Endocarditis prophylaxis
1) Dental
2) GI or GU surgery

Back 372

1) Dental - Amoxicillin
2) GI or GU surgery - Ampicillin + Gentamicin

Front 373

Most common cause of HTN in young women

Back 373

OCPs

Front 374

Most common cause of HTN in young men

Back 374

EtOH

Front 375

Asplenic patients are susceptible to these organisms

Back 375

Encapsulated organisms
1) Strep pneumo
2) Nisseria meningitidis
3) H flu
4) Klebsiella

Front 376

Number of bac needed on urine sample to think UTI

Back 376

100,000
(100k)

Front 377

Dx
Fever, malaise, cough, night sweats recent SW US travel.
Tx?

Back 377

Dx - Cocciodomycosis
Tx - Amphotericin B

Front 378

Dx
Blueberry muffin rash

Back 378

Rubella

Front 379

What should always be done before LP?

Back 379

Check ICP with papilledema or head CT

Front 380

Dx
Gamma globulins in CSF

Back 380

Multiple sclerosis

Front 381

Dx
Initial pruritic papule with LAD progresses to eschar in 7-10 days
Tx?

Back 381

Dx - Cutaneous anthrax
Tx - Penicillin or Ciprofloxacin

Front 382

Dx
Tabes Dorsalis, general paresis, gummas, argyll robertson pupils, aortitis, aortic root aneurysm

Back 382

Tertiary syphilis

Front 383

Dx
Arthralgia, migratory polyarthropathies, Bell's palsy, myocarditis

Back 383

Secondary Lyme disease

Front 384

Dx
Cold agglutinins

Back 384

Mycoplasma

Front 385

Tx for
Candidal thrush

Back 385

Nystatin oral suppression

Front 386

When and what to begin in HIV opportunistic prophylaxis

Back 386

1) Less than 200 CD 4 count - Bactrim for Pneumocystis jiroveci
2) Less than 100 - Clarithromycin/Azithromycin for MAI

Front 387

Dx
Alcoholic and smoker with lung sx with no gram stain but positive silver stain

Back 387

Legionella pneumonia

Front 388

Dx
Acute onset monoarticular joint pain, bilateral bell's palsy.
Tx?

Back 388

Dx - Lyme disease
Tx - Doxycycline

Front 389

Main organisms in endocarditis (2)

Back 389

1) Stapy aureus
2) Strep epidermidis

Front 390

Dx
Branching rods in oral infection

Back 390

Actinomyces israelii

Front 391

Dx
Painful chancroid

Back 391

Haemophilus ducreyi

Front 392

Dx
Dog or cat bite

Back 392

Pasteurella

Front 393

Dx
Infection in gardner

Back 393

Sporothrix (sporotrichosis)

Front 394

Dx
Infxn pregnant with pets

Back 394

Toxoplasmosis

Front 395

Dx
Meningitis in adults

Back 395

Neisseria meningitidis

Front 396

Dx
Meningitis in elderly

Back 396

Strep pneumo

Front 397

Dx
Alcoholic with pneumonia

Back 397

Klebsiella

Front 398

Dx
Currant Jelly sputum

Back 398

Klebsiella

Front 399

Dx
Infxn in burn victims

Back 399

Pseudomonas

Front 400

Dx
Osteomyelitis from foot wound puncture

Back 400

Psuedomonas

Front 401

Dx
Osteomyelitis in sickle cell patient

Back 401

Salmonella

Front 402

Dx
HTN with hypokalemia
1) If renin activity low
2) If renin activity high

Back 402

1) If renin activity low - Primary Hyperaldosteronism
2) If renin activity high - Renovascular HTN (renal artery stenosis)

Front 403

Dx
Purpura in elderly on back of hands
Tx?

Back 403

Perivascular connective tissue atrophy
Tx - none

Front 404

Dx
Palpable purpura, low complement levels, glomerulonephritis, arthralgias, hepatosplenomegaly,

Back 404

Mixed Essential Cyroglobulinemia

Front 405

Dx
Muscle weakness (extreme) that resolves with rest

Back 405

Myasthenia gravis

Front 406

Tx for
Benign essential tremor

Back 406

Propanolol

Front 407

Dx
Tremor with planned, voluntary movement only, family hx

Back 407

Essential tremor

Front 408

The 4 criteria of Nephrotic Sx

Back 408

1) Proteinuria greater than 3 g/day
2) Hypoalbuminemia (less than 3.5)
3) Edema
4) HLD and lipiduria (waxy casts)
3)

Front 409

What kind of state is nephrotic sx?

Back 409

Hypercoagulable

Front 410

Pharmacologic agents that shift K into cells in acute hyperkalemia

Back 410

1) Insulin and glucose
2) Na bicarb
3) Beta 2 agonists

Front 411

Dx
Nephrotic sx in Blacks with obesity, heroin, or HIV hx

Back 411

Focal Segmental Glomerulosclerosis

Front 412

Most common cause of nephrotic sx in adults

Back 412

Membranous nephropathy

Front 413

Most common cause of nephrotic sx in children

Back 413

Minimal change disease

Front 414

Dx
Lung and GI involvement in immunocompromised pt

Back 414

CMV

Front 415

Dx
Fever, hives, arthralgias, and LAD after infection (usually 7-10 days later)

Back 415

Drug induced reaction (serum sickness)

Front 416

Dx
New clubbing in COPD pt

Back 416

Lung cancer

Front 417

Dx
Recurrent pain, itching, and red steaks in arms in setting of weight loss

Back 417

Trousseau's syndrome (migratory thrombophlebitis) caused by occult malignancy usually pancreatic or lung)

Front 418

Dx
New HA, jaw pain, scalp pain, visual loss.

Back 418

Temporal arteritis

Front 419

Tx for
Temporal arteritis

Back 419

High dose prednisone
(to prevent damage to retinal artery and other vessels)

Front 420

Dx
Weakness, fatigue, hypotension, cold intolerance, brittle nails, bradycardia

Back 420

Pituitary tumor causing secondary adrenocortical deficiency

Front 421

Dx
Hyperpigmentation, amenorrhea in young adult

Back 421

Congenital adrenal hyperplasia

Front 422

Most common deficiency in Congential adrenal hyperplasia

Back 422

21-hydroxylase deficiency

Front 423

Dx study for
CP in young woman with no risk factors for CAD

Back 423

None

Front 424

Dx study for
Newly diagnosed Myasthenia gravis

Back 424

Chest CT (to look for thymoma)

Front 425

Tx for
Kidney stones in acidic urine

Back 425

Potassium citrate

Front 426

Dx
Palpable mass in RUQ with hyperbilirubinemia in child

Back 426

Choledochal cyst

Front 427

Tx for
Cocaine induced CP

Back 427

Benzos
(also nitrates and aspirin)

Front 428

Dx
Epigastric pain with voluminous pale foul smelling diarrhea

Back 428

Chronic pancreatitis

Front 429

Dx
EKG shows flat and broad T waves, PVCs

Back 429

Hypokalemia

Front 430

Dx
Fever, ns, LAD, arthralgias, diarrhea

Back 430

Acute HIV

Front 431

Dx
New onset diabetes, arthropathy, and hepatomegaly

Back 431

Hemochromatosis

Front 432

Dx
No pulses but telemetry shows beats

Back 432

Pulseless electrical activity (PEA)

Front 433

Tx for
PEA (pulseless electrical activity)

Back 433

Chest compressions, ventilation with 100% oxygen

Front 434

Door to therapy time for PCTA and fibrinolysis in MI

Back 434

PTCA - 90 minutes
Fibrinolysis - 30 minutes

Front 435

Most common cause of uncomplicated UTI in women

Back 435

Ascending infection of urethra usually from sex (honeymoon cystitis)

Front 436

Dx
Hazy lung fields, cough, dyspnea, fever, malaise in setting of farming or bird care

Back 436

Hypersenstivity pneumonitis (bird fancier's lung or famer's lung)

Front 437

Tx for
Hypersensitivity pneumonitis

Back 437

Avoidance of antigen

Front 438

Dx
Arthritis, lesions on shins, bloody diarrhea, P-ANCA positive

Back 438

UC (IBD)

Front 439

Ankylosing spondylitis and Ulcerative colitis share this HLA type

Back 439

HLA-B27

Front 440

Most common sites of thrombus for PE

Back 440

1) Iliac
2) Femoral
3) Popliteal

Front 441

Dx
Elevated alk phos and bowed legs on xray

Back 441

Paget's disease

Front 442

Dx
RUQ pain, mildly elevated liver enzymes, firm hepatomegaly.

Back 442

Mets to the liver (usually from GI)

Front 443

Dx
High fever, chills, tenosynovitis, migratory polyarthralgias and pustular lesions on extremities, negative BCx

Back 443

Disseminated gonococcus

Front 444

Dx
4th and 5th finger decreased sensation and weakened grip

Back 444

Ulnar nerve syndrome
(medial elbow compression)

Front 445

Dx
Heel pain, +/- shoulder, hip, and shin pain

Back 445

Enthesitis due to Ankylosing spondylitis

Front 446

Blood lab findings in Vit D malabsorption (3)

Back 446

1) V. Low phosphate
2) Low Ca
3) High PTH

Front 447

Which vitamin increases INR

Back 447

Vitamin E

Front 448

Dx
High Ca, low Phosphate, abdominal pain, constipation, fatigue, excessive urination, urinary stones

Back 448

Hyperparathyroidism

Front 449

Hyperparathyroidism predisposes to what arthralgia?

Back 449

Pseudogout

Front 450

Which joint does pseudogout usually affect

Back 450

Knee

Front 451

Dx
Intermittent abdominal distension, flatulence, greasy stools, iron deficiency anemia

Back 451

Celiac sprue

Front 452

Skin condition associated with celiac sprue

Back 452

Dermatitis herpetiform

Front 453

Dx study for
BRBPR under 50 with no risk factors for colon cancer

Back 453

Anoscopy

Front 454

Most common causes of osteomyelitis in sicke cell (2)

Back 454

1) Salmonella
2) Staph

Front 455

Dx
Smudge cells

Back 455

CLL

Front 456

Dx
Cause of erectile dysfunction following urethral surgery

Back 456

Neurogenic

Front 457

Mechanism of fatty liver

Back 457

Insulin resistance increases lipolysis leading to fat accumulation in hepatocytes

Front 458

Dx
High PaCO2 and low PaO2

Back 458

Alveolar hypoventilation

Front 459

Dx
COPD with sudden onset of catastrophic worsening of respiratory sx

Back 459

Pneumothorax (dilated alveolar blebs rupture in the pleural space)

Front 460

Most common cause of osteomyelitis in children

Back 460

Staph aureus

Front 461

Dx
Air fluid levels in the gall bladder in elderly diabetic male

Back 461

Emphysematous cholecystitis

Front 462

Dx
Slow onset hazy visual loss

Back 462

Cataracts

Front 463

Dx
Focal site of increased radio active iodine uptake with otherwise decreased uptake in the thyroid

Back 463

Toxic nodule

Front 464

Dx
HAs worse in morning, n/v early in day, vision changes, somnolence, confusion, hypertension and bradycardia

Back 464

Increase intracranial pressure

Front 465

Dx
Bilateral lower extremity weakness following termporal arteritis tx

Back 465

Steroid induced myopathy

Front 466

Dx study for
New onset dyspepsia in
1) Over 55
2) Alarm sx of weight loss, dysphagia, vomiting
3) All others

Back 466

1) Upper endoscopy
2) Upper endoscopy
3) PPI or H Pylori serology

Front 467

Dx
Insidious onset dry cough in absence of constitutional sx, also with skin lesions and uveitis in african american women

Back 467

Sarcoid

Front 468

Dx
Lower leg discomfort at night relieved by massage or movement of them

Back 468

Restless leg syndrome

Front 469

Tx for
Restless leg syndrome

Back 469

Dopamine agonists

Front 470

Dx study for
Adult with recurrent bacterial infections

Back 470

Serum Ig levels to consider humoral immunity deficiency

Front 471

Dx study for
Cancer patient with back pain and neurologic sx particularly bowel or bladder incontinence

Back 471

MRI of spine

Front 472

Tx for
Cancer patient with back pain and neurologic sx particularly bowel or bladder incontinence

Back 472

Dexamethasone to decrease swelling on spine
(while awaiting MRI results)

Front 473

Tx for
Lactic acidosis from septic shock (3)

Back 473

1) Fluids
2) Vasopressors if necessary
3) Abx

Front 474

In patients refractory to HTN tx always treat their lifestyle problems before adding more therapeutics

Back 474

.

Front 475

Dx
HA, n/v with enclosed air space occupation

Back 475

Carbon monoxide poisoning

Front 476

Dx study for
Elderly pt with new onset delirium

Back 476

Urinalysis and electrolytes

Front 477

Dx
Elderly male with dysphagia, regurgitation, foul-smelling breath, aspiration, possibly palpable mass

Back 477

Zenker's diverticulum

Front 478

Dx
Chest scan showing primary nodules with a halo sign

Back 478

Aspergillosis

Front 479

Dx
Acute pneumonia, cough, fever malaise, hilar lymphadenopathy on CXR, recent travel to Southeastern, mid Atlantic, and central US

Back 479

Histoplasmosis

Front 480

Dx
Pneunomia with arthralgias recent travel to SW US

Back 480

Coccidio

Front 481

Dx
Liver cysts with multiple cysts inside of the cysts.
What exposure?

Back 481

Hydatid cysts from Echinococcosis.
Sheep exposure

Front 482

Dx
Right sided effusion with cirrhosis

Back 482

Hepatic hydrothorax

Front 483

Tx for
Hepatic hydrothorax

Back 483

Tx Thoracentesis and diuretics
If refractory, TIPS

Front 484

Common drugs that cause hyperkalemia

Back 484

1) ACE-Is
2) NSAIDs
3) K sparing diuretics (spironolactone and amiloride)

Front 485

Dx
Hematemesis following multiple episodes of non-bloody vomiting

Back 485

Mallory Weiss tear (ruptured submucosal arteries of distal esophagus)

Front 486

Which HepB serology is most useful to determine acute Hep B infection? (2)

Back 486

ABsAg and anti-HBc antibody

Front 487

Dx
Corneal vesicles and dendritic ulcers

Back 487

Herpes simplex keratitis

Front 488

Mgmt
New onset lupus

Back 488

Get kidney biopsy then start methylprednisone

Front 489

Dx
Verrucuous, skin colored or pink papules around anus

Back 489

Anogenital warts (HPV)

Front 490

Tx for
Anogenital warts (HPV)

Back 490

Podophyllin

Front 491

Tx for
Prolactinoma

Back 491

Dopamine agonists (bromocriptine or cabergoline)

Front 492

Mgmt
GERD with dysphagia, weight loss, odynophagia

Back 492

Upper endoscopy

Front 493

Prophylaxis for MAC when CD 4 count less than 50

Back 493

Azithromycin for Mycobacterium avium complex

Front 494

Most common type of thyroid malignancy

Back 494

Papillary carcinoma of the thyroid

Front 495

Dx
Normocytic anemia, hypercalcemia, renal failure, elevated total protein

Back 495

Multiple myeloma

Front 496

Dx study for
Multiple myeloma

Back 496

Serum immunoelectrophoresis

Front 497

Which compound is increased in androgen producing adrenal tumors?

Back 497

DHEA

Front 498

Dx
FEV1/FVC ratio decreased and normal DLCO

Back 498

Bronchitis

Front 499

Potential fatal side effect of succinylcholine

Back 499

Hyperkalemia

Front 500

Dx
Ca low and Phos low

Back 500

Vit D deficiency

Front 501

Dx
Ca low but Phos high.
1) If If PTH v high
2) If PTH high
3) If PTH low

Back 501

1) If If PTH v high - Pseudohypoparathyroidism
2) If PTH high - Renal failure
3) If PTH low - Hypoparathyroidism

Front 502

Pronator drift localizes the lesion to where?

Back 502

Upper motor neuron

Front 503

What happens to Ca in alkalemia

Back 503

It binds better to albumin causing effective hypocalcemia despite normal total serum Ca levels

Front 504

Dx
Post partum woman fails to lactate with pituitary hormonal deficiency

Back 504

Sheehan's syndrome (ischemic necrosis of pituitary gland following shock from childbirth)

Front 505

Dx
Tender regional LAD, following cat laceration

Back 505

Azithromycin for cat scratch disease (bartonella)

Front 506

Dx
Hypercalcemia, constipation, abdominal pain, weight loss, polyuria, polydipsia

Back 506

Vit D toxicity

Front 507

Dx
Pruritic, papules and plaques on face, scalp, chest, and extensor surface of baby sparing diaper area

Back 507

Atopic dermatitis

Front 508

Dx
Very high Ca, low PTH, high Phosphate

Back 508

Hypercalcemia of malignancy

Front 509

Dx study for
Curtain drop loss of vision

Back 509

Dx is amaurosis fugax and is usually caused by carotid embolization.
Get carotid artery doppler.

Front 510

Dx
Ring shaped scaly patch with central clearing and distinct border
Tx?

Back 510

Dx - Tinea corporis
Tx - Antifungal cream (e.g. terbinafine)

Front 511

Tx for
Myasthenia crisis

Back 511

Endotracheal intubation and withdrawal of anti-cholinesterases

Front 512

Dx
Pneumonia with targetoid lesions on extremities

Back 512

Lesions are erythema multiform and the patient has mycoplasma pneumonia

Front 513

Dx
Partially acid fast, filamentous, branching rods on sputum exam

Back 513

Nocardia

Front 514

Mgmt for
Severe symptomatic hyponatremia.
And what to watch out for...

Back 514

1) Hypertonic saline
2) Central pontine myelinosis from too rapid increase in serum osmolality

Front 515

Dx
What is low in macrocytic anemia when there is peripheral neuropathy?

Back 515

Cobalmin (Vit B12)
id est not Folate which can correct the anemia but not the neuropathy

Front 516

Dx
Progressive dyspnea and hypoxia in AIDS patient

Back 516

Pneumocystis jiroveci

Front 517

Dx
Vertigo, tinnitus, vomiting, nystagmus

Back 517

Meniere's disease

Front 518

Tx for
Meniere's disease

Back 518

Salt restriction and caffeine, nicotine, and alcohol avoidance

Front 519

Dx
Loud S1 and mid diastolic rumble

Back 519

Mitral stenosis

Front 520

Dx
Clotting history with lupus signs

Back 520

Antiphospholipid antibody sx (lupus anticoagulant positive which is actually a hypercoagulable state)

Front 521

Dx study for
Lupus anticoagulant

Back 521

Russel viper venom test

Front 522

Which way does PTT move in lupus anticoagulant

Back 522

PTT increases (paradoxically bc hypercoagulable)

Front 523

Drug whose side effect profile is
Nephrotoxicity, hyperkalemia, hypertension, gum hypertrophy, hirsutism

Back 523

Cyclosporine

Front 524

Drug whose side effect profile is
Nephrotoxicity, hyperkalemia, hypertension,

Back 524

Tacrolimus

Front 525

Drug whose side effect profile is diarrhea, leukopenia, hepatotoxicity

Back 525

Azathioprine

Front 526

Drug whose side effect profile is bone marrow suppression

Back 526

Mycophenolate

Front 527

Tx for
Aortic dissection

Back 527

Antihypertensives

Front 528

Mgmt for
Targetoid lesions and malaise, HA, muscle pain, and joint pain

Back 528

Doxycycline for Lyme (not testing necessary)

Front 529

Dx
Weight loss, gynecomastia, testicular atrophy, telangiectasias

Back 529

Chronic liver disease
(hyperestrogen state due to reduced clearance by ****** liver)

Front 530

Dx
Hx of sudden cardiac death with syncopal episodes and hearing impairment

Back 530

Long QT

Front 531

Tx for
Long QT

Back 531

Beta blockers

Front 532

Dx
Hypercalcemia and stomach ulcer

Back 532

Hyperparathyroidism and zollinger-ellison sx suggestive of MEN1

Front 533

Diagnostic criteria for ARDS

Back 533

1) Acute respiratory distress in setting of predisposing condition sepsis, pneumonia etc
2) Bilateral infiltrates
3) Normal PCWP

Front 534

Dx
Normal FEV1/FVC with decreased DLCO

Back 534

Interstitial lung disease

Front 535

Clopidogreal indications post STEMI

Back 535

1) Post UA/NSTEMI for 12 months
2) Post PCI 30 days for bare metal and 12 months for DES

Front 536

Dx
Contralateral half body pain and temperature loss with cranial nerve defect

Back 536

Lateral medulla

Front 537

Dx
Contralateral half body paralysis and proprioception and vibratory loss

Back 537

Medial medulla

Front 538

Dx study for
Cough, mucopurulent sputum, hemoptysis that responds to abx

Back 538

High resolution CT scan for Bronchiectasis

Front 539

Terrible T's of anterior mediastinal mass (4)

Back 539

1) Thymoma
2) Teratoma
3) Thyroid cancer
4) Terrible Lymphoma

Front 540

Dx
Anterior mediastinal mass with elevated alpha feto protein and elevated beta human chorionic gonadotropin

Back 540

Nonseminomatous germ cell tumor

Front 541

Dx
Anterior mediastinal mass with elevated beta human chorionic gonadotropin

Back 541

Seminoma

Front 542

Dx
Prolonged PT before a prolonged PTT

Back 542

Vit K deficiency

Front 543

Dx
Grid test looks like curved lines

Back 543

Macular degeneration

Front 544

Dx
Parkinson like rigidity, psychosis, hallucinations, confusions, REM disorder, parkinson sx worse with neuroleptic (anti-psychotics)

Back 544

Lewy body dementia

Front 545

Dx
Early diastolic murmur

Back 545

Aortic regurg

Front 546

DEXA screening recs

Back 546

1) Women over 65
2) Women 60-64 if risk of fracture

Front 547

Yellow fever vaccine is for what countries

Back 547

Sub saharan africa and S America

Front 548

Vaccines in HIV

Back 548

1) Tdap every 10 years
2) Pneumovax (revaccinate in 5 years)
3) Flu annually
4) Hep A and B
5) Meningococcus if asplenic or in college/military
6) HPV (only in high risk individuals)
7) H Flu (only if not given in infancy)
8) MMR and varicella if CD4 over 200

Front 549

Recs for treated cervical neoplasia

Back 549

1) Pap smear +/- colposcopy +/- curretage every 6 months until 3 negative results in a row
2) Then resume normal screening for age

Front 550

AAA rec

Back 550

ULTRASOUND OF ABDOMEN in all men 65-75 who ever smoked

Front 551

Pressure ulcer preventino

Back 551

Repositioning every 2 hours

Front 552

Mammography frequency

Back 552

Every 2 years from 50-75 years old

Front 553

Pneumovax recommendations

Back 553

1) Everyone over 65
2) Adults under 65 with cardiovascular, pulmonary, hepatic, renal, diabetes, or immunosuppressin
2a) Under 65 need a booster over 65

Front 554

When colonoscopy starts for 1st degree relative

Back 554

10 years before their onset

Front 555

Give hep B vaccine and Ig if exposed with no known immunization history

Back 555

.

Front 556

Vaccines for hepatic disease

Back 556

1) Tdap
2) Flu
3) Pneumovax
4) Hep A and B

Front 557

Bladder cancer screening in at risk population

Back 557

Not recommended ever

Front 558

Dx
Onion skin appearance with moth eaten mottled appearance on bone xray

Back 558

Ewing's sarcoma

Front 559

Which metal causes type IV hypersensitivity

Back 559

Nickel

Front 560

Auto-Antibodies in scleroderma (2)

Back 560

1) Anti-Topoisomerase
2) ANA

Front 561

Mgmt for
Familial colonic polyposis

Back 561

Procto-colectomy

Front 562

Dx
Hematuria, deafness, and fhx of renal failure

Back 562

Alport's syndrome

Front 563

Pain mgmt in past drug abuser

Back 563

Opioids (do not deny despite history)

Front 564

Most common complication of PUD

Back 564

Hemorrhage

Front 565

Dx
Dysphagia, CP, food regurgitation, dilated esophagus, bird's beak deformity

Back 565

Achalasia

Front 566

Dx
Normal Ca, normal alk phos, low phosphate, and normal vit D with rickets

Back 566

X-linked hypophosphatemic rickets
(phosphate wasting)

Front 567

Aphasia localized an infarct to where?

Back 567

Cortex usually on the Left side (dominant side given R handed)

Front 568

Dx
Back pain, anemia, renal dysfunction, elevatd ESR

Back 568

Multiple myeloma

Front 569

Dx
High alk phos, normal liver tests, hearing loss

Back 569

Paget's disease

Front 570

Dx
Intense, focal back pain without neurological symptoms not relieved by rest

Back 570

Vertebral compression

Front 571

Dx
Apophyseal joint arthritis

Back 571

Ankylosing sponylitis

Front 572

Dx
Intervertebral disc degereneration

Back 572

OA of the spine

Front 573

Dx
Falling into chairs, can't raise arms above head, light tremors

Back 573

Hyperthyroid

Front 574

Most common type of kidney stone

Back 574

Calcium oxalate

Front 575

Dx
Hip pain in setting of corticosteroids
Mgmt?

Back 575

Avascular necrosis of femoral head
Mgmt - needs MRI

Front 576

Dx
Circumferential narrowing of distal esophagus with dysphagia

Back 576

Peptic stricture

Front 577

Dietary recs for kidney stones (4)

Back 577

1) decreased protein and oxalate
2) Decreased Na
3) Increased fluid
4) Increase Ca

Front 578

Dx
PAinful, rubbery nodule on eyelid
Mgmt?

Back 578

Chalazion
Mgmt - Biopsy

Front 579

Dx
Mucoid, Gram negative rod

Back 579

Klebsiella

Front 580

Dx
Weakness, weight loss, skin color changes

Back 580

Hemachromatosis

Front 581

How to diagnose follicular cancer of thyroid from just adenoma

Back 581

Invasion of capsule

Front 582

Dx
Mucopurulent urethral discharge, no bacteria on culture

Back 582

Chlamydia
(think gonorrhea if purulent discharge)

Front 583

Dx
Hypersegmented neutrophil

Back 583

Megaloblastic anemia

Front 584

Increased metabolite differences in Vit B12 and Folate deficinecy

Back 584

Vit B 12 deficiency: Increased homocysteine AND methlymalonic acid
Folate deficiency: Just Homocysteine elevated

Front 585

Dx
Motor hemiparesis of face, arm, and leg without other neurologic deficits

Back 585

Internal capsule

Front 586

Dx
Hemiplegia, aphasia, hemineglect

Back 586

Middle cerebral artery

Front 587

Dx
Contralateral weakness of lower extremities mostly, emotional disturbance

Back 587

Anterior cerebral artery

Front 588

Dx
Contralateral hemiplegia with Ispilateral cranial nerve involvement

Back 588

Vertebrobasilar system (brain stem)

Front 589

Most likely cancer in asbestosis

Back 589

Bronchogenic carcinoma
(Not mesothelioma!)

Front 590

Dx
Ascending paralysis, areflexia, 3-4 weeks after URI or gastroneteritis, CSF shows albumino-cytologic dissociation

Back 590

Guillan barre

Front 591

Tx
Guillain Barre

Back 591

IV Immunoglobulins and plasmapharesis

Front 592

Dx
Pruritis, tense bullae, uriticarial plaques, with IgG and C3 along basement membrane zone

Back 592

Bullous pemphigoid

Front 593

Dx
Follicular conjunctivitis with neovascularization of conjunctiva

Back 593

Trachoma (chlamydia thrachomatis infection)

Front 594

Side effect of Anti thyroid meds in grave's disease

Back 594

Agranulocytosis and allergy

Front 595

What causes orthostatic hypotension in elderly?

Back 595

Decreased sensitivity of baroreceptors

Front 596

Mgmt
AKI due to possible urinary retention

Back 596

Straight cath (not US for residual volume)

Front 597

Mgmt
Esophagitis in HIV

Back 597

Fluconazole empiric tx for candidiasis
If refractory then upper endoscopy for CMV

Front 598

Mgmt
Solid testicular mass

Back 598

Radical removal of testis and cord

Front 599

Prophylaxis for splenectomy

Back 599

1) Pneumovax, h flu, meningococcus vaccines before surgery
2) Daily oral PCN for 3-5 years after

Front 600

Dx
Painless hematuria

Back 600

Bladder mass

Front 601

People with hemachromatosis are suscpetible to what organism

Back 601

Listeria

Front 602

Dx
Progressive proximal weakness with elevated serum creatinine kinase

Back 602

Myositis and dermatomyositis

Front 603

Tx for
Myositis

Back 603

Steroids

Front 604

Tx for
Gastroparesis

Back 604

Metoclopramide (prokinetic)

Front 605

Mgmt
Rapidly developing (over 3 months) male characteristics in woman

Back 605

Hormone producing tumor
Serum testosterone --> ovarian source
Serum Testosterone and DHEAS --> Adrenal source

Front 606

Dx
Fever, rash, occipital or posterior cervical LAD, and arthritis

Back 606

Rubella

Front 607

Findings in OA

Back 607

1) Crepitus
2) Bony enlargment
3) Bony tenderness
4) Stiffness without warmth
5) Over 50 yo
Need 3 for a diagnosis

Front 608

Strongest risk factor for stroke

Back 608

HTN
then smoking and DM

Front 609

Traveler's diarrhea

Back 609

E coli

Front 610

Dx
Back pain on trauma with ankylosing spondylitis

Back 610

Vertebral fracture

Front 611

Tx
Parkinson's

Back 611

Trihexyphenidyl

Front 612

How to diagnose parkinson's

Back 612

Physical exam:
Tremor
Rigidity
Bradykinesia

Front 613

Dx
HCG and AFP elevated

Back 613

Nonseminomatous tumor

Front 614

Acute Migraine tx

Back 614

Prochlorperazine, chlorpromazine, or metoclopramide

Front 615

Auto antibody in Primary biliary sclerosis

Back 615

Anti-mitochondrial Ab

Front 616

Dx
Autoimmune destruction of intrahepatic bile ducts with cholestasis

Back 616

Primary biliary sclerosis

Front 617

Lite's criteria for Exudate

Back 617

1) Total protein ratio more than 0.5
2) LDH ratio more than 0.6
3) LDH greater than 2/3 of upper limit of normal

Front 618

Dx
Decreased breath sounds on left after intubation

Back 618

Accidental intubation of tight main stem bronchus

Front 619

Renal complication of Hepatitis

Back 619

Membranoproliferative glomerulonephritis

Front 620

Causes of pulsus paradoxus (3)

Back 620

1) Cardiac tamponade
2) Tension pneumothorax
3) Severe asthma

Front 621

Dx
Vertigo, vomiting, and occipital headache

Back 621

Cerebellar stroke

Front 622

Mgmt
Hot potato voice and deviated uvula

Back 622

Aspiration of abscess

Front 623

Dx
Large basophilic cells (atypical lymphocytes) with negative monospot

Back 623

CMV

Front 624

Dx
Down and out eye with ptosis in diabetic

Back 624

Ischemic CNIII palsy

Front 625

Mgmt
Pyelonephritis

Back 625

BCx Then empiric Abx then if refractory US

Front 626

Dx
Wedge shaped consolidation on CT scan of lungs

Back 626

Pulmonary embolism

Front 627

Respiratory monitoring in Guillain barre

Back 627

Bedside Vital Capacity

Front 628

Dx
40 yo male with back pain that is worse in morning and improves during the day

Back 628

Ankylosing spondylitis

Front 629

Tx for
Acute cholangitis

Back 629

Supportive care and Abx
Then
ERCP for biliary drainage and or to remove stone

Front 630

Dx
Chronic hematomas and joint swelling

Back 630

Hemophilia

Front 631

Dehydration: Crystalloids or colloids

Back 631

Crystalloids

Front 632

Tx for
Cellulitis with systemic signs

Back 632

IV Nafcillin

Front 633

Tx for
Multiple sclerosis

Back 633

Interferon-beta

Front 634

Dx
Seizure without LOC or amnesia

Back 634

Simple partial seizure

Front 635

Dx
Seizure with LOC, aura, and autamatisms

Back 635

Complex partial seizure

Front 636

Dx
Seziure with LOC, tonic clonic activity

Back 636

Partial seizure with secondary generalization

Front 637

Mgmt for
Cat bite

Back 637

Amox clav for pasteurella

Front 638

Dx
Polyuria in sickle cell trait or disease

Back 638

Hyposthenuria

Front 639

3 Mechanical complications post MI

Back 639

1) MR due to papillary muscle rupture
2) LV free wall rupture
3) Interventricular septal rupture

Front 640

Dx
Hypothyroidism, HAs, bitemporal blindness

Back 640

Craniopharyngioma

Front 641

Dx
ST elevation in II, III, and AVF

Back 641

Right Coronary Artery occlusion

Front 642

There are no pathologic changes in IBD!!

Back 642

!

Front 643

PPD cutoffs

Back 643

1) Healthy people: 15 mm
2) 10mm for immigrants, drug users, high risk employees, diabetics
3) 5 mm for HIV, recent exposure to TB, TB on CXR, immunosuppressed PTs

Front 644

Tx for
Latent TB

Back 644

Isoniazid for 6 months

Front 645

Tx for
Active TB

Back 645

Iszoniazid, INH, rifampin, pyrazinamide for 8 weeks then 4 more months of isoniazid and rifampin

Front 646

Essential tremor

Back 646

Absent at rest but present with intentional movement

Front 647

Tx for
Essential tremor

Back 647

Beta blockers

Front 648

Urinary side effects of antihistamines

Back 648

Anticholinergic effect causes detrussor inactivity

Front 649

Tx for
Gastric MALT without metastases

Back 649

Triple H pylori regimen
(omeprazole, clarithromycin, and amoxicillin)

Front 650

Dx
Dyspnea, fatigue, and peripheral edema following viral infection

Back 650

Dilated cardiomyopathy due to viral myocarditis

Front 651

Mgmt
For 1st degree heart block

Back 651

No tx

Front 652

Dx
Medial knee pain without positive valgus stress test

Back 652

Anserine bursitis

Front 653

Mgmt
Recurrent attcks of focal neurological sx at non predicatable intervals

Back 653

MRI for MS

Front 654

Dx
Initial presentation of impaired gait, dementia, and urinary incontinence

Back 654

Normal pressure hydrocephalus
(Alzheimer's will have more memory and visuospatial impairments)

Front 655

Dx
Nephrotic syndrome in children with Hep B

Back 655

Membranous glomerulonephritis

Front 656

Electrolyte impairments in alcoholism

Back 656

Hypokalemia with exacerbating hypomagnesemia
also hyphophosphatemia

Front 657

Dx
Pain and stiffness in the neck, shoulders, and pelvic girdle with morning stiffness and elevated ESR

Back 657

Polymyalgia rheumatica

Front 658

Tx for
Polymyaglia rheumatica without giant cell arteritis

Back 658

Low dose prednisone

Front 659

What drug to avoid in preexisting lung disease

Back 659

Amiodarone (causes lung toxicity)

Front 660

Dx study for
Suspected vasovagal syncope

Back 660

Tilt table testing

Front 661

Dx
Thin walled cavities on CXR in pneumonia

Back 661

Staph aureus

Front 662

Dx study for
Aortic dissection

Back 662

Trans Esophageal echo (Not TTE)
or CT with contrast

Front 663

If anemia despite EPO tx in CKD what's the Tx?

Back 663

Iron supplements

Front 664

Tx for
Hepatic fulminant failure (defined as hepatic encephalopathy within 8 weeks of onset of acute liver failure)

Back 664

Liver transplant

Front 665

Tx for
Hep C with detectable viral load and evidence of damage (LFTs)

Back 665

Combined interferon and Ribvarin

Front 666

Dx
Vague, headache, n/v and closed air space

Back 666

Carbon monoxide poisoning

Front 667

Dx
High bp, hypokalemia, metabolic alkalosis, mild hypernatremia, and very low plasma renin activity

Back 667

Primary Hyperaldosteronism

Front 668

Indications for Aortic valve replacement

Back 668

1) Symptomatic AS
2) Pts with AS that need CABG
3) AS patients with LV systolic function or valve area less than 0.6

Front 669

Dx
Large amount of blood in urine on dipstick by few RBCs on microscopy

Back 669

Rhabdomyloysis

Front 670

Dx
Chronic hepatitis, grey green rings in eyes

Back 670

Wilson's disease aka
Hepatolenticular disease

Front 671

Dx
Pain radiating to back, Leukocytosis, markedly elevated serum amylase and lipase

Back 671

Acute pancreatitis

Front 672

Tx for
Acute pancreatitis

Back 672

Conservative tx of analgesics, fluids, and NPO

Front 673

Mgmt
Aseptic meningitis of suspected HSV

Back 673

Start acyclovir and get cultures later

Front 674

Mgmt
Acute GI bleed with ABC jeopardy

Back 674

1) Fluids
2) Protect airway with intubation
3) Upper GI endoscopy to find/stop bleeding

Front 675

Dx
Fever, lethargy in settin of chirrhosis and ascites

Back 675

Spontaneous bacterial peritonitis
(usually superimposed on liver failure from cirrhosis)

Front 676

Mgmt
Fever, lethargy in settin of chirrhosis and ascites

Back 676

Paracentesis
(positive fluid culture and PMNs more than 250 = Spontaneous bacterial peritonitis)

Front 677

Dx
Arteriosclerotic lesions of afferent and efferent renal arterioles

Back 677

HTN

Front 678

Dx
Increased intracellular matrix, basement membrane thickening, and fibrosis

Back 678

Diabetic microangiopathy (nephropathy)

Front 679

Dx
Leukemia with nonspecific esterase positive

Back 679

Acute monocytic leukemia

Front 680

Dx
Hypercalcemia in a patient bedridden with truama
Tx?

Back 680

Immobilization and high bone turnover in healing lead to osteoclast activity
Tx - bisphosphonates

Front 681

Dx
Curtain fall vision loss, flashes of light, and floaters

Back 681

Retinal detachment

Front 682

Dx
Shin rash with bilateral lympadenopathy of lungs

Back 682

Inflammatory granulomas (sarcoid)

Front 683

Tx for
Strep viridans bacterial endocarditis

Back 683

Ceftriaxone or IV penicillin

Front 684

Side effect of Herceptin (trastuzumab)

Back 684

Cardiotoxicity

Front 685

Dx
Renal disease in diabetes

Back 685

Microangiopathy

Front 686

Dx
Blood and thunder fundoscopic exam: optic disc swelling, retinal hemorrhage, dilated veins, cotton wool spots

Back 686

Retinal vein occlusion

Front 687

Dx
Curtain fall vision loss, pallor of optic disc, cherry red fovea, boxcar segmentation of retinal veins

Back 687

Central artery occlusion (amareurosis fugax)

Front 688

Dx
Small cell lung cancer, with muscle weakness

Back 688

Eaton lambert syndrome (autoantibodies to voltage gated Ca channels)

Front 689

Dx
IV drug user with mutliple nodules in lungs

Back 689

Staph aureus vegetation embolizations

Front 690

Mgmt
Bleeding in liver failure

Back 690

Fresh frozen plasma

Front 691

Mgmt
Suspected melanoma

Back 691

Excisonal biopsy
(if deeper than 1 mm on biopsy need sentinel lymph node study)

Front 692

Dx
Painless hematuria in young black male

Back 692

Sicke cell trait

Front 693

Microcytic anemia with low ferritin

Back 693

Iron deficiency anemia

Front 694

Most common cause of low iron deficiency

Back 694

GI Bleed

Front 695

Low TIBC in the setting of normal ferritin

Back 695

Anemia of chronic disease

Front 696

Tx Iron deficiency anemia

Back 696

Ferrous sulfate

Front 697

Acute tenosynovitis

Back 697

Gonorrhea (gonnococcal arthritis)

Front 698

Poly joint swelling with flexio

Back 698

Tenosynovitis

Front 699

Sheeps, dogs Infection

Back 699

Echinococcosis

Front 700

Biliary obstruction (infection)

Back 700

Ascariasis

Front 701

Severe granulomatous rxn, hepatosplenomegaly, portal htn

Back 701

Schistosomiasis

Front 702

Popcorn calcifications in round solitary nodule

Back 702

Hamartoma

Front 703

Temporal headache, scalp tenderness, sisx of giant cel arteritis

Back 703

Temporal arteritis

Front 704

Hives with jaundice

Back 704

Hep B

Front 705

Asymptomatic low grade hi PTH and hi Ca

Back 705

No Tx

Front 706

Iatrogenic Hemolysis in G6PD deficiency

Back 706

Sulfa drugs (e.g. trimethoprim sulfa)

Front 707

Most common cause of UTI

Back 707

E. coli

Front 708

Dermatitis, dementia, diarrhea (vitamin deficiency)

Back 708

Pellagra aka niacin deficiency

Front 709

CV dz (high output failure), neurologic (wernicke-korsakoff sx) Vitamin deficiency

Back 709

Beriberi aka Thiamine (B1) deficiency

Front 710

Macrocytic anemia. Vitamin deficiency

Back 710

B12 deficiency. Etio pernicious anemia, gastrectomy, ileal abnormalities

Front 711

Osteomalacia in adults, rickets in children. Vitamin Deficiency

Back 711

Vitamin D deficiency

Front 712

Ecchymotic rashes around hair follicles, bledding gums

Back 712

Vitamin C deficiency

Front 713

Microcytic anemia with low ferritin

Back 713

Iron deficiency anemia

Front 714

Most common cause of low iron deficiency

Back 714

GI Bleed

Front 715

Low TIBC in the setting of normal ferritin

Back 715

Anemia of chronic disease

Front 716

Tx Iron deficiency anemia

Back 716

Ferrous sulfate

Front 717

Acute tenosynovitis

Back 717

Gonorrhea (gonnococcal arthritis)

Front 718

Poly joint swelling with flexio

Back 718

Tenosynovitis

Front 719

Sheeps, dogs Infection

Back 719

Echinococcosis

Front 720

Biliary obstruction (infection)

Back 720

Ascariasis

Front 721

Severe granulomatous rxn, hepatosplenomegaly, portal htn

Back 721

Schistosomiasis

Front 722

Popcorn calcifications in round solitary nodule

Back 722

Hamartoma

Front 723

Temporal headache, scalp tenderness, sisx of giant cel arteritis

Back 723

Temporal arteritis

Front 724

Hives with jaundice

Back 724

Hep B

Front 725

Asymptomatic low grade hi PTH and hi Ca

Back 725

No Tx

Front 726

Iatrogenic Hemolysis in G6PD deficiency

Back 726

Sulfa drugs (e.g. trimethoprim sulfa)

Front 727

Most common cause of UTI

Back 727

E. coli

Front 728

Dermatitis, dementia, diarrhea (vitamin deficiency)

Back 728

Pellagra aka niacin deficiency

Front 729

CV dz (high output failure), neurologic (wernicke-korsakoff sx) Vitamin deficiency

Back 729

Beriberi aka Thiamine (B1) deficiency

Front 730

Macrocytic anemia. Vitamin deficiency

Back 730

B12 deficiency. Etio pernicious anemia, gastrectomy, ileal abnormalities

Front 731

Osteomalacia in adults, rickets in children. Vitamin Deficiency

Back 731

Vitamin D deficiency

Front 732

Ecchymotic rashes around hair follicles, bledding gums

Back 732

Vitamin C deficiency

Front 733

Drinking vitamin deficiencies

Back 733

Vit C and B1 (thiamine)

Front 734

Elevated amylase, elevated lipase, pain radiating to back, “sentinel loo” (air in small bowel LUQ)

Back 734

Acute Pancreatitis

Front 735

Fever, tonsilar exudate, cervical LAD, no cough

Back 735

Strep Infection (usually pyogenes)

Front 736

Most common causes of exudative (bacterial) URI

Back 736

Strep pyogenes

Front 737

50% of AIDS patients have this electolyte abnormality

Back 737

Hyponatremia

Front 738

Acute Tx of hemorrhage

Back 738

1st Saline, 2nd place large bore catheters while blood matching

Front 739

Diarrhea in AIDs, Eti and Dx

Back 739

Cryptosporidium or Isospora, AFB stain of stool

Front 740

Gram positive diplococci in PNA

Back 740

Strep Pneumo (pnemococcus)

Front 741

Reduced breath sounds, decreased tactile fremitus

Back 741

Effusion

Front 742

Reduced breath sounds, increased tactile fremitus

Back 742

Consolidation

Front 743

Tx for migraine

Back 743

Ergotamine or -Triptans

Front 744

Prophlaxis for migraines

Back 744

CCBs

Front 745

Tx Tension headache (normal headache)

Back 745

NSAIDs

Front 746

Cause of kidney stone with pyloneprhritis

Back 746

Proteus mirabilis (makes urine basic leading to stone), Tx is acidic diet, urease inhibitor, and abx

Front 747

Most common GI sx of Scleroderma

Back 747

Esophageal dysfunction (densely fibrotic esphagus)

Front 748

Lung kidney things

Back 748

Goodpastures, Wegners, or Churg-strauss

Front 749

Lung-kidney dz, with C-ANCA or P-ANCA

Back 749

Wegners C-ANCA, and Churg-Struass = P-ANCA

Front 750

Lung-kidney dz, with hemoptysis, and linear desposition of IgG in glomerulus

Back 750

Good pastures

Front 751

Most common precipitating factor in status epilepticus

Back 751

Drug Non-compliance

Front 752

Hypoxemia, hypoglycemia hypotenstion, hyperthermia

Back 752

Status epilepticus

Front 753

Sleep apnea with CO2 retention

Back 753

Pickwickian (obesity hypoventilation syndrome)

Front 754

Morbid obesity, HIV infection, or heroin abuse with nephrotic syndrome

Back 754

Focal segmental glomerulosclerosis

Front 755

Diabetic nephropathy

Back 755

Kimmelstiel wilson disease

Front 756

Childhood nephrotic sx

Back 756

Minimal change diease

Front 757

Crescent shaped cells accumulate in bowman’s capsule

Back 757

Crescentic glomerulonephritis

Front 758

Frank proteinuria

Back 758

Nephrotic Syndrome

Front 759

RBCs and protein in urine

Back 759

Nephritic Syndrome

Front 760

When to use cryoprecipitate

Back 760

DIC, von Willebrand,"", and Hemophilia A

Front 761

Most common cause of pericarditis

Back 761

Renal failure (when BUN over 100), treat with HD

Front 762

Hep A IgM and IgG tells you what

Back 762

IgM acute infection, IgG chronic infxn

Front 763

Mitral obstruction by mass in atria

Back 763

Myxoma

Front 764

Oral ulcers, genital ulcers, arthritis

Back 764

Bechet’s Sx

Front 765

Medullary carcinoma thryoid RF

Back 765

MEN

Front 766

Papillary carcinoma thryoid RF

Back 766

Radiation

Front 767

Prolonged QT Tx

Back 767

Alkalemic process (like hyperventilation) or bicarb

Front 768

Cheesy white exudate on oropharynx in AIDS

Back 768

Thrush from Candida albicans

Front 769

Most common cause of HIV retinitis

Back 769

CMV

Front 770

Human bite infection

Back 770

Mixed aerobic and anaerobic bacteria

Front 771

Dog bite infection

Back 771

Pasteurella multocida (penicilin sensitive)

Front 772

Most associated with polymyalgia rheumatica

Back 772

Temporal arteritis

Front 773

Giving nitroprussides causes hypoxia why?

Back 773

V/Q mismatch from non-specific pulm vasculature dilation, preventing vasoconstriction of poorly perfused areas

Front 774

Rapidly progressive respiratory distress

Back 774

ARDS

Front 775

Neurologic findings separated by time and location.

Back 775

Multiple Sclerosis

Front 776

Sensory hearing loss, facial nerve palsy, cerebellar dysfunction, headache

Back 776

Acoustic neuroma

Front 777

Initial Tx for Endocarditis

Back 777

Get BCx first, then broad spectrum Abx (to not screw up BCx)

Front 778

Tx severe aplastic anemia

Back 778

Bone marrow transplant

Front 779

Hives with pigmented spots, that wheal with blunt object stroking.

Back 779

Systemic mastocytosis (too many mast cells)

Front 780

Tx for Supraventricular arrhythmia

Back 780

Verapamil (or Class III)

Front 781

Most common cause of ring enhancing lesions in AIDS in brain

Back 781

Toxoplamosis and Lymphoma (if abx resistant)

Front 782

Acute angled, branching septated fungus

Back 782

Aspergillus

Front 783

Pseudohyphal mycelia with budding yeast cells

Back 783

Candida

Front 784

Owl Eyes

Back 784

Hodgkins lymphoma

Front 785

Owl eyes + intranuclear and cytoplasmic inclusion bodies

Back 785

CMV

Front 786

Fever, headache, anemia, elevated ESR

Back 786

Temporal Arteritis

Front 787

Tx Arterial Temporitis

Back 787

Prednisone

Front 788

Most common cause of chronic pancreatitis

Back 788

Alcoholism

Front 789

Anti mitochondrial Antibodies

Back 789

.

Front 790

If no EKG changes with angina, do it with exercisez

Back 790

.

Front 791

Every diabetic should be on what besides insulin

Back 791

ACE-i

Front 792

Ectopic production ACTH causing cushing

Back 792

Small cell carcinoma of lung

Front 793

Side effects of amiodarone

Back 793

Pulmonary fibrosis (10%), Prolonged QT (1%), skin discoloration common

Front 794

MS CSF findings

Back 794

Oligoclonal IgG bands, mildly increased protein

Front 795

Tx for cerebral edema following stroke

Back 795

Prednisone

Front 796

Tx to increase penumbra salvage after stroke

Back 796

CCBs, Barbiturates, and NMDA antagonists

Front 797

Cause of abx associated pseudomembranous colitis

Back 797

C Diff

Front 798

Complication of C Diff pseudomembranous colitis

Back 798

Colonic perforation

Front 799

Linear burrow holes

Back 799

Scabies, mineral oil Tx

Front 800

Phenytoin

Back 800

Folate deficiency

Front 801

Vanillymandeic acid

Back 801

Pheochromocytoma

Front 802

Rapid shift of Na with fluids causing neurologic damage

Back 802

Central pontine myelinolysis

Front 803

Stress (hospitilzation) gastritis

Back 803

Acute erosive gastritis with ulcers

Front 804

Acute htn crisis Tx

Back 804

Nitroprusside

Front 805

Main complication of hepatic adenoma

Back 805

Rupture into peritoneal cavity

Front 806

Initial Tx for acute Gout

Back 806

Indomethacin (NSAID) or colchicine (2ndary), prednisone if refractory, and allopurinol long term

Front 807

Sinus, lung, skin, and kidney dz

Back 807

Wegners

Front 808

Days of rest for musculoskeletal injury

Back 808

3 days at most

Front 809

Which Abx cause ATN/AIN

Back 809

Aminoglycosides (e.g. gentamycin) cause ATN, Penicillins cause AIN

Front 810

RNP

Back 810

Mixed connective tissue dz

Front 811

c-ANCA

Back 811

Wegner’s

Front 812

dsDNA

Back 812

Lupus

Front 813

p-ANCA

Back 813

microscopic polyarteritis

Front 814

Scl-70

Back 814

Systemic sclerosis

Front 815

Traumatic brain bleed, lucid interval

Back 815

Epidural bleed

Front 816

LOC, worst headache of life, vomiting

Back 816

Subarachnoid

Front 817

Putamenal or caudate lobe, basal ganglia, LOC, vomiting

Back 817

Hypertensive bleed

Front 818

Flat emotional affect, language disturbances with dementia

Back 818

Pick dementia

Front 819

44. Pseudogout= positive bifrengint rhomboids whereas negative befringent needle is gout

Back 819

.

Front 820

45. lepromatous leprosy (aggresive) is diff from tb leprosy (milder form, treated w depsone)

Back 820

.

Front 821

46. severe sharp chest pain radiating to back and shoulder is classic symptom for aortic dissection

Back 821

.

Front 822

47. homeless, alcoholic (aspiration pneumonia) is classically anaerobic (TB is classically in upper lung lobes)

Back 822

.

Front 823

48. MRI of brain for not typical cerebral problem s

Back 823

.

Front 824

49. pneumonia: decreased tactile fremitus over the right hemithorax

Back 824

.

Front 825

50. sarcoid

Back 825

.

Front 826

Mononucleosis

Back 826

Splenomegaly + LAD, Heterophil is another name for monospot test, which is positive. Atypical lymphocytes on on blood smears

Front 827

CLL

Back 827

B lymphocytosis, lymphadenopathy, if only those two, no treatment. First line treatment is chlorambucil. If that fails use fludarabine. Bone marro transplant is reserved for very young patient.

Front 828

DM I

Back 828

Associated w HLA DR3 and DR4

Front 829

Alcoholic Hepatitis

Back 829

AST/ALT is greater than 2

Front 830

Huntington

Back 830

Familial, irritiablity, restessness, diff. concentration, and onset between 30-50. Autosomal Dominant

Front 831

Hypervolemia

Back 831

Can cause hyponatremia

Front 832

Narrow Angle Glaucoma

Back 832

Red Eye, extreme pain, blurred vision with halos most frequent in Asians. Test this with tonometry to test pressure.

Front 833

Pneumonia in AIDS patients

Back 833

Bacterial pneumonia is the most common form if AIDS patients. MAI causes a wasting systemic disease not like pneumonia. TB has crhonic or subactue, with cough fever and drenching night sweats. PCP only in severe CD4 count depression.

Front 834

Membranous Glomerulopathy

Back 834

Hep B is the most common infection cause, with syphyillis a second. Most common renal complication in AIDS is focal segmental. C3 refers to IgG which is found in membranoproliferative. IgA is in Berger disease, with flu like symptoms.

Front 835

Acromegaly

Back 835

Tested after a glucose supression test. People have fluctuating baselines, so you want to try and balance that out by supressing glucose. THEN you do MRI and or CT.

Front 836

Secondary amenohrea

Back 836

Most Common Pregnancy. Once rule out pregnancy, then CT.

Front 837

Renal Cell Carcinoma

Back 837

Flank Pain, Hemature, and Abdomina mass. Can cause hematurea, weigh loss. and history cigarette smoking.

Front 838

Charcot Triad

Back 838

Jaundice, fever, RUQ: cholangitis, Cholecystitis rarely give you fever.

Front 839

Indirect Billirubinemia

Back 839

Hemolysis (, spherocytosis etc). Cihhrosis only causes diret.

Front 840

Diabetes and Hypertension

Back 840

Give them an ACE is first line

Front 841

Hypercholesterolemia

Back 841

most common cause ia defect in the LDL receptor (look up class scheme for memorizing the rest).

Front 842

Trichinosis

Back 842

Is the nematode, common from boar, bear, pork, or horse. You get muscle invasion, intestinal stage with diarrhea, and blood eosinophilia, elevated creatine kinase. Chagas is caused by trypanosomiasis.

Front 843

Metabolic Acidosis

Back 843

Need to have Ph standards and also responding appropriately with a respiratory alkalosis.

Front 844

Aluminum hydroxidde

Back 844

Caused by aluminium containing antacids. Calcium carbonate can cause a hyperphosphatemia.

Front 845

Alcoholism

Back 845

Associated with carbohydrate deficient transferrin levels.

Front 846

NSAID use

Back 846

misoprostal supposedly helps, questionable

Front 847

Mycoplama Pneumonia

Back 847

Erythematous painful papules on the tympanic membranes, and cold agglutinins which precipitate on colloing is pathognomonic for Mycoplasma. Treatment is erytromycin.

Front 848

Meniere’s Disease

Back 848

Vertigo, Tinnitus, and feeling of swelling.

Front 849

CREST syndrome

Back 849

only have thicknede skin on theri hadn and face, as opposed to more diffuse.

Front 850

Reflex Esophagitis

Back 850

Squamous to Columnar metaplasis and goblet cells, is a garrets esophagus. Long fingers is also Barrets.

Front 851

HOCM

Back 851

Initial therapy is beta blockers, or CCBs.

Front 852

Central Pontine Myelonlysis

Back 852

demylenination from volume shifts

Front 853

Hypeparathyroidism

Back 853

Most common casue of hypercalcemia in patients.

Front 854

Erythema Multiforme

Back 854

Variety of morphologies, sudden onset, also target lesion.

Front 855

Erythema Migrans

Back 855

Lyme

Front 856

Suspected Biliary obtruction

Back 856

Start with ultrasound

Front 857

Ankylosing Spondylitis

Back 857

Early onset, before 40, and involvemtn of sacroilliac joints.

Front 858

Why would Bacterial endocarditis blood screen be negative

Back 858

BC they got antibiotics before doing teh culture

Front 859

Steatosis

Back 859

Most common causes are alcohol use, obesity, or DM.

Front 860

Radial Palsy

Back 860

Triceps, brachioradialsi, wrists, and finger and thumb extensors

Front 861

PBC

Back 861

Assocaited with antimicrobial autoantibodies

Front 862

PSC

Back 862

Most associated with Ulcerative Cholitis.

Front 863

Anti Smooth Muscle

Back 863

Autoimmune chronic hepatitis

Front 864

Clinically Following Ascites

Back 864

Follow their PT, which is a proxy for synthetic capability. Bleeding time is a marker of platelet function.

Front 865

Hypothermia

Back 865

helps chances for better outcomes. Sedation is also useful, but only if hypothermia doesnt work. Hyperventilation is only indicated by if there is ICP.

Front 866

Malignant Hyperthermia

Back 866

Patient was given succinylcholine, which can cause muscular contracture.

Front 867

Takayasu Arteritis

Back 867

Inflammation of aortic arch or branches, frequently pulseless, can cause ischemia to brain

Front 868

Wegeners

Back 868

C-Anca

Front 869

Atopic Dermatitis

Back 869

Is Eczema

Front 870

Nummular Eczema

Back 870

Coin Shaped Lesions, scaly crust

Front 871

Seborrheic Dermatitis

Back 871

Scaly oily dandruss rash on the scalp and eyebrows.

Front 872

Paget Disease

Back 872

Mostly older, Heavy osteoclastic and osteopblastic, coarsely woven, thrick, heavily cacifed but weak. Frontal bossing, bow legs

Front 873

Schistosomiasis

Back 873

Infective larvae are excreted by snails and penetrate through skin or mucous membrane. Recurrent hematuria and predisposes to squamous cell carcionma. Search for OVA.

Front 874

Pyelonephritis

Back 874

Start IV ampicillin and gentamycin

Front 875

Von Willebrand disease

Back 875

Factor VIII deficiency, will extend PTT. Factor VII extend PT. Factor IX will extend PTT, is hemophila B. Hemophilia A is also a IIX deficiency, prolongs PTT< and is x linked.

Front 876

Fat Emobolism

Back 876

Dyspnea, tachypnea, tachycardia, with diffuse bilateral inflitrates consistent with ARDS and a self limiting petechial rash.

Front 877

DKA

Back 877

Osmolar diueres: leads to volume depletion, need volume, need insulin, and D5W.

Front 878

AtlantoAxial joint

Back 878

Upper motor neuron symptoms, so it must be above the heart.

Front 879

Digoxin Toxicity

Back 879

DIG is renally excreted

Front 880

Scurvy

Back 880

Vit C deficiency: bleeding from teh gums, capillary fragility, petehia, eccymoses, poor wound healing,

Front 881

External Otitis- necrotizing/malignant

Back 881

Most Commonly caused by pseudomonal aeruginosa. Cipro is the treatment of choice.

Front 882

Anti-centromere antibodies

Back 882

Specficially to the CREST variant of systemic sclerosis. Calcinosis, Reynauds, Esophageal dysmotility, Sclerdacyly, telangectasia

Front 883

Rebound Tendernes and rigid abdomen

Back 883

Describing perforation or its in the peritoneal space.

Front 884

Pseudogout

Back 884

rhomboidal positive birefringent crystals , Gout is negative needles

Front 885

Burkitts Scan

Back 885

Starry SKy, Africa

Front 886

Follicular Small Cleaved Cell lymphoma

Back 886

Waxing and Waning lymphadenopathy,

Front 887

Ankylosing Spondylitis

Back 887

Seronegative spondyloarthropathy, make sex, young, sacroillitis, large joing arthritis, aortic regurgitattion, low back pain

Front 888

Menetrier Disease

Back 888

Thickened Gastric folds, low acid secretion, protein loss and edema, weight loss

Front 889

Scrufulla

Back 889

TB infection in the neck

Front 890

Positive TB

Back 890

On isoniazid if seropositive for 6 months and have contacts with people with TB

Front 891

Acute Gout Therapy

Back 891

NSAIDS, then colchicine, then steroids

Front 892

Caroli Disease

Back 892

Associated wtih biliary cirrhosis, adn can develop hepatic fibrosis. Dilation of intrahepatic bile ducts

Front 893

Crigler Najjar

Back 893

Inherited enzymatic abnormality of the liver that causes hyperbilirubinemia

Front 894

Dubin Johnson

Back 894

Enzymatic disorder that causes dark grey liver and hyperbilirubinemia

Front 895

Gilbert Syndrome

Back 895

Asymptomic hyperbilirubinemia

Front 896

Rotor Syndrome

Back 896

hyperbilirubinemia without liver discoloration

Front 897

Malaria

Back 897

Should be looked for in blood smears. They have waxing and waning fevers (three day disease), blood smears should be examined every 8 hours during and between febrile attacks Treatment for malaria is chloroquine.

Front 898

Myelophthisic Anemia

Back 898

Small schistocytes, fragment, red cells. Happens when your bone marrow cavity is taken over by tumor, fibrosis, or other things.

Front 899

Hypochromic Macrocytes

Back 899

Folate defiency, vitamin B12, and thalassemia

Front 900

Ringed Sideroblasts

Back 900

Sideroblastic anemia, problem with erythrocyt maturation adn utilization iron

Front 901

Cholecystitis

Back 901

Symptomatic, treat with lap coli

Front 902

Anal Cancer

Back 902

HPV

Front 903

Neutrophilic predominant

Back 903

Baterial, Lymphocytic (less bacterial)

Front 904

CEA

Back 904

Colon Cancer. AFP liver, ovary, and testicular Cancer.

Front 905

Atypical Pneumonia

Back 905

Mycoplasma pneumoniae, chlamydia, coxiella burnetti. THe interstial patter is what characteristics.

Front 906

Magnesium Deficiency

Back 906

Malabsorption, or kwashiorker, . CHronic alcoholism is another cause of magnesium deficiency.

Front 907

Hemochromatosis

Back 907

hepatomegaly, arthlargias, skin hyperpigmentation. HFE protein mutation.

Front 908

Treatment of Prolactinoma

Back 908

is bromocriptine

Front 909

Hypertensive Hemorrhage

Back 909

MOst common in putamen, but if the symptoms are cerebellar, then its cerebellum. Putamenal hemorrhage usually leads to contralaeral hemiparesis, hemianesthesia, and hemianopia

Front 910

Basal Cell Carcinoma

Back 910

Most common cause, pearly, rolled edges. Melanoma pigmentation. For squamous stuck on appearance, not ulcerated.

Front 911

OSA

Back 911

Poor nightitme sleeping, day time sleepiness

Front 912

Prostatic Hyperplasia

Back 912

If IV contrast posioning, its going to be within 24 hours, not a week.

Front 913

Alcoholic aspiration pneumonia

Back 913

Klebsiella

Front 914

Inferior MI

Back 914

RCA occlusion

Front 915

Coffee ground emesis, pain killers

Back 915

gastric ulcers

Front 916

quick onset food poisoning

Back 916

Staph aureus, B cereus

Front 917

most common cause of hemoptysis in adults

Back 917

chronic bronchitis

Front 918

Vit K def.

Back 918

Abx can cause Vit K def, but also TPN

Front 919

Hyperpigmentation and hypocortisol

Back 919

Addisons

Front 920

Constrictive Pericarditis

Back 920

Increased venous distension on inspiration (kussmaul’s sign)

Front 921

Radioactive Iodine Scan

Back 921

only needed if there are symptoms of thyrotoxicosis. If there are no symptoms and there is a nodule for FNA to make sure its benign.

Front 922

Brain Abscess

Back 922

Afebrile, and can exhibit progressive neurologic symptoms

Front 923

Psyllium

Back 923

A bulking agent that you use before laxatives.

Front 924

Aplastic Anemia

Back 924

Fat in bone marrow.

Front 925

Ramsay Hunt

Back 925

Cranial Nerve 8 with shingles. Vesicles in the ear. Facial Palsay

Front 926

Menieres Disease

Back 926

One sided Tinnitus, Deaffness, and vertigo. Fullness

Front 927

Pityriasis Rosea

Back 927

Scaly lesion that involves the trunk, sometimes a christmas tree appearance

Front 928

Pityrisasis Rubra pilaria

Back 928

involves the hands and soles and does not produce a herald patch

Front 929

Scabies

Back 929

Small skin burrows in addition to papules, itching is prominent

Front 930

Rovsing Sign

Back 930

Acute pendicitis

Front 931

Htn

Back 931

Confirm within two months

Front 932

Hypoparathyroidism

Back 932

Feedback inhibition

Front 933

Hungry Bone syndrom

Back 933

Will happen days or weeks, with patients with hyperparathyroidism

Front 934

Syphillis

Back 934

Use penicillin, if theyre allergic use doxycycline.

Front 935

alcohol cardiomyopathy

Back 935

Leads to dilated. S3 is also indicative of dilated.

Front 936

Antiphospholipid Antibody

Back 936

Hypercoagulable (or anticardiolipin), can lead to thrombosis

Front 937

Acute adrenal insufficiancy

Back 937

It happens when you remove steroids, treate w IV hydrocortisone, adn then confirm diagnosis by measuring. confirm by measuring cortisol levels

Front 938

Mesothelioma

Back 938

Smoking is not a risk factor, Asbestos.

Front 939

Tear Drop

Back 939

Idiopathic myelofibrosis. The bone marrow is crying, also wil have bone marrow fibrosis `

Front 940

Increased RBC mass

Back 940

PVERA

Front 941

Acetaminophen Entoxication

Back 941

7 grams is necessary, unless you already have liver dysfunction

Front 942

Medullary Carcinoma

Back 942

Men 2a associated with medullary cancer, treat!

Front 943

paracetomol

Back 943

aspirin.

Front 944

Antirheumatics

Back 944

For disease progression, use Nsaids and steroids for symptom control

Front 945

Neomycin

Back 945

Lactulose is given classically to wash out the bateria, and neomycin, a poorly absorbed aminoglycoside, that allows it to destory the ammonia producing bacteria

Front 946

Dig Toxicity

Back 946

yellow green cast to the vision, also known as xanthopsia/verdopsia, bradycardia

Front 947

Conn Disease

Back 947

Primary hyperaldosteronism

Front 948

Hashimoto thyroiditis

Back 948

Goiter, antibodies against thyroglobulin, and with lymphocytes.

Front 949

B thall

Back 949

Do electrophoresis. RDW is less than 15%. In iron def. there is more deficiency, and RDW is greater than 15%

Front 950

Kidneys plus HTN

Back 950

ace inhibitor

Front 951

Sickle Cell

Back 951

Hydration and Narcotics

Front 952

Howell Jolly Body

Back 952

rbcs with their nucleus

Front 953

Nephrotic syndrome

Back 953

you lose anticoagulant proteins

Front 954

Hodkins (stage IV)

Back 954

Treat with chemo

Front 955

G6PD

Back 955

fava bean, done, heinz bodies, makes cells vuln. to cell damage

Front 956

Pancreatic CAncer

Back 956

Look at amylase, lipase

Front 957

EPO in the setting of CKD, dialysis

Back 957

can cause hypertension in 20% of cases

Front 958

Effect on dexamethasone test and what it tells you.

Back 958

Decrease ACTH secretion by pituitary only, so if ACTH or cortisol remains high, non pituitary source.

Front 959

Startle myoclonus (jerks causes by loud noises)

Back 959

Creutzfeld Jakob

Front 960

Why is lung cancer screening not effective?

Back 960

Even when primary tumors are detected, bc high rates of metastasis are usually already present

Front 961

First treatment in hypercalemia

Back 961

Restore volume. Hypercalemic pts are dehydrated, restoring improves GFR and Ca clearance.

Front 962

Cough, fever, and yellow sputum in healthy person. Dx?

Back 962

Acute bronchitis

Front 963

First imaging in Diverticular Disease?

Back 963

You want to do a barium enema, but you need an x-ray first to make sure there are no perforations first.

Front 964

Insulin high, C-peptide low, insulin AB

Back 964

Exogenous source of insulin.

Front 965

Exposure to plants, chain of lesions. Dx?

Back 965

Sporotrichosis

Front 966

Tapping causes facial twitch. Dx?

Back 966

Hypocalcemia (Chvostek sign)

Front 967

Hyperpigmented, sharply marginates lesions on healthy person. Dx?

Back 967

Melasma

Front 968

Signs of cholestasis + antimitochondrial Ab. Dx?

Back 968

Primary biliary cirrhosis

Front 969

% HCV infection that becomes chronic

Back 969

75% (HBV, 5-10%)

Front 970

Patchy hypopigmentation of skin. Dx?

Back 970

Vitiligo

Front 971

Antihypertensive med that causes hyperkalemia

Back 971

ACE inhibitors

Front 972

Painful thyroid gland. DDx?

Back 972

Subacute thyroiditis

Front 973

Delayed carotid upstroke

Back 973

Aortic stenosis

Front 974

Hyperbilirubinemia with otherwise normal lab values & no other symptoms. Dx?

Back 974

Gilbert’s syndrome

Front 975

Slowly developing nodular lesion with central ulceration. Dx?

Back 975

Basal cell carcinoma

Front 976

Most important factor affecting long-term success of TIPS or liver transplant

Back 976

Abstinence from alcohol

Front 977

Diagnostic test for suspected pituitary adenoma

Back 977

Serum prolactin (before head MRI)

Front 978

Fungus in the Southwest US

Back 978

Coccidioides immitis

Front 979

Elderly patient with subacute onset of dementia, urinary incontinence, gait disturbance

Back 979

Normal pressure hydrocephalus

Front 980

Procollagen I deficiency

Back 980

Osteogenesis imperfecta

Front 981

Cryptococcal meningitis tx

Back 981

Amphotericin B (the oral fluconazole)

Front 982

Proximal weakness & elevated CPK

Back 982

Polymyositis

Front 983

Polymyositis tx

Back 983

Corticosteroids

Front 984

Cause of black pigment gallbladder stones

Back 984

Hemolysis

Front 985

Cause of brown pigment gallbladder stones

Back 985

Infected bile

Front 986

Elevated urinary 5-hydroxyindoleacetic acid (5-HIAA)

Back 986

Carcinoid syndrome (5-HIAA = serotonin metabolite)

Front 987

Elevated urinary vanillylmandelic acid (VMA)

Back 987

Pheo (VMA = catecholamine metabolite)

Front 988

MALT lymphoma tx

Back 988

Antibiotics (to eradicate H pylori)

Front 989

Positive direct Coombs test

Back 989

Autoimmune hemolytic anemia (detects C’ or Ab on RBC)

Front 990

Cold agglutinins

Back 990

#ERROR!

Front 991

Loss of speech discrimination + tinnitus

Back 991

Schwannoma of CN VIII (aka acoustic neurinoma)

Front 992

Ascending paralysis

Back 992

Guillain-Barre

Front 993

2,5, and 10 LRs correlate to what additional post test probabilities

Back 993

15%, 30% and 45%

Front 994

Triple AAA screening

Back 994

Male between 65 and 75 and ever smoked.

Front 995

When to get pneumovax?

Back 995

Everyone over 65. If active smoker, COPD, or asthma they should get it earlier.

Front 996

Who can get live attenuated flu vaccine intranasally?

Back 996

Less than 50, immuncompetent with no immunosuppressed contacts.

Front 997

Who definitely needs Flu vaccine?

Back 997

Everyone. And can be dead or attenuated unless immunosuprressed.

Front 998

Who should get zoster vaccine?

Back 998

All immunocompetent 60 and older regardless of prior hx.

Front 999

Who gets Tdap?

Back 999

All between 19-64 who haven’t gotten booster.

Front 1000

When to give Tdap immunoglobulin.

Back 1000

Patients with wound who do not have reliable Tdap hx.

Front 1001

Who doesn’t need Tdap?

Back 1001

If they had Tdap within 5 years, or have a clear wound and a Tdap within 10 years.

Front 1002

Who should get HVP vaccine?

Back 1002

All girls 9-26

Front 1003

Acceptable Colorectal screening options (4)

Back 1003

1. Colonoscopy every 10 years starting at 50

Front 1004

Syncope in heart failure with ischemia. Dx?

Back 1004

Vtach

Front 1005

Common cause of syncope, must check this test especialy in diabetics.

Back 1005

Orthostatics

Front 1006

Syncope with prodrome of nausea, light-headedness, and diaphoresis. Dx?

Back 1006

Vasovagal (situational/neurocardiogenic) syncope

Front 1007

Syncope with lack of prodrome. Dx?

Back 1007

Arrhythmia

Front 1008

Best diagnostic study for infrequent but recurrent syncope.

Back 1008

Loop recorder

Front 1009

Tx if first anti-depressant fails.

Back 1009

Another antidepressant.

Front 1010

Tx for suicidal ideation

Back 1010

Urgent inpatient admission

Front 1011

When bereavement becomes inappropriate and should be considered for SSRI

Back 1011

At least 2 consecutive weeks of depression 8 weeks after death of loved one

Front 1012

Hx of self harm, dysfuntional relationships, intense anger. Dx?

Back 1012

Borderline personality disorder

Front 1013

First line Tx for acute alcohol withdrawal.

Back 1013

Lorazepam (ativan)

Front 1014

Tx for acute cocaine intoxication

Back 1014

Benzos (lorazepam)

Front 1015

Why can’t you give B blockers to coacine ODs?

Back 1015

Selective beta blockers will block the sympathetic effects on heart, while the cocaine alpha vasoconstricts the vasculature. Can give non-selective beta blockers.

Front 1016

When to give haloperidol?

Back 1016

When psychosis present

Front 1017

Tx for drug induced seizure

Back 1017

Benzo (not anti-epileptic)

Front 1018

Tx to prevent relapse in alcoholism?

Back 1018

Naltrexone (also can be used for opioid addiction)

Front 1019

Tx for acute opioid overdose

Back 1019

Naloxone (narcan)

Front 1020

Tx for long term opiate addiction

Back 1020

Suboxone (buprenorphine)

Front 1021

Screening for alcoholism

Back 1021

CAGE

Front 1022

Initial tx for spinal stenosis. Refractory tx especially if neurologic impairment.

Back 1022

NSAIDs. Surgery for refractory.

Front 1023

Diagnostic study for back pain, with possible infection.

Back 1023

MRI bc can detect acute osteomyelitis changes that CT and x-ray can’t

Front 1024

Tx for acute non-specific low back pain.

Back 1024

NSAIDs or acetaminophen

Front 1025

Dx back pain, muscle weakness, bowel or bladder incontinence.

Back 1025

Spinal cord compression

Front 1026

Dx study Cancer patients with possible spinal cord compression

Back 1026

MRI of spine

Front 1027

Tx for cough variant asthma

Back 1027

Albuterol inhaler trial

Front 1028

Tx for chronic cough without CXR findings

Back 1028

Anti-histamine and decongestant

Front 1029

Diagnostic study for hemoptysis in healthy and cancer suspicion

Back 1029

Healthy - CXR

Front 1030

Tx for acute bronchitis

Back 1030

Symptom management (if over 3 weeks, get CXR)

Front 1031

Lung function improvement in COPD following smoking cessation.

Back 1031

Improved lung function (2%) and decreased rate of decline by half

Front 1032

Cardiovascular risk relation to smoking status

Back 1032

Pack years are irrelevant, but stopping smoking rapidly improves outcome within 5 years of cessation.

Front 1033

Tx for smoking cessation

Back 1033

First line - Verenicline

Front 1034

Indications for bariatric surgery

Back 1034

BMI over 35 with co-morbidities, or over 40 without comorbidities AND unsuccessful weight loss with diet and drugs.

Front 1035

Tx for pharmacologic treatment of obesity

Back 1035

Orlistat

Front 1036

Dx Nausea and vomiting following bariatric surgery

Back 1036

Stomal stenosis

Front 1037

Dx study Stomal Stenosis suspicion after bariatric surgery

Back 1037

Upper endoscopy

Front 1038

Dx for weight loss, lack of focal sx, lack of f/c/ns, and normal labs and imaging.

Back 1038

Re-evaluate in 6 months

Front 1039

Dx systemic weight loss, skeletal muscle dysfunction, osteoporosis, and depression with trouble breathing.

Back 1039

COPD

Front 1040

Tx for excessive menstrual bleeding

Back 1040

If considerable - medroxyprogesterone

Front 1041

If less - Oral contraceptives

Back 1041

.

Front 1042

Dx Oligomenorrhea, hirsutism, acne, alopecia

Back 1042

PCOS

Front 1043

Tx for menopausal sx

Back 1043

Estrogen replacement therapy

Front 1044

Dx for secondary ammenorrhea

Back 1044

Progestin withdrawal study

Front 1045

Initial Dx study for amenorrhea

Back 1045

FSH, TSH, and prolactin levels

Front 1046

Dx study for Abnormal uterine bleeding in over 35

Back 1046

Endometrial biopsy to diagnose most likely cause (endometriosis) and rule out cancer or hyperplasia

Front 1047

Dx well demarcated, rapidly spreading area of warmth, swelling, tenderness, and erythema.

Back 1047

Cellulitis

Front 1048

Dx erythematous, dry or greasy scales and crusts.

Back 1048

Seborrheic dermatitis (dandruff)

Front 1049

Dx Pink/red papules and thin plaques with scaling active borders and central clearing.

Back 1049

Tinea cruris

Front 1050

Acute, severe, reaction after drug use with erythematous macules and plaques involving mucus membranes but less than 10% of body.

Back 1050

Steven Johnson syndrome

Front 1051

Red Man Sx rxn to what?

Back 1051

Vancomycin

Front 1052

Dx targetoid lesions, with skin and mucusoal involvement

Back 1052

Erythema multiforme

Front 1053

Dx Spreading ring of erythema

Back 1053

Erythema migrans (Lyme)

Front 1054

Dx Subtle, fine, pink Blanching macules and papules that spreads centripetally

Back 1054

Rocky mountain spotted fever

Front 1055

Tx for shingles

Back 1055

Oral valcyclovir or famcyclovir

Front 1056

Dx erythema, telangiectasias, pustules, and sebaceous hyperplasia, that does not spare nasolabial folds.

Back 1056

Rosacea

Front 1057

Dx common, benign neoplasms that are black or brown, well demarcated, stuck on with waxy surface.

Back 1057

Seborrheic keratosis

Front 1058

Tx for non-inflammatory acne, mild inflammatory, or gross inflammatory

Back 1058

1) Benzoyl peroxide, salicylic acid, or retinoids

Front 1059

Dx acute, rapid wheal, superficial, itchy, discrete swelling, lasting less than 24 hours

Back 1059

Acute urticaria (chronic if more than 24 hours)

Front 1060

Dx study for isolated axillary lymphadenopathy that is immobile

Back 1060

Lymph node biopsy

Front 1061

New onset urinary incontince causes (DIAPERS)

Back 1061

Drugs

Front 1062

Dx study for Elderly hearing impairment

Back 1062

Whispered voice test

Front 1063

Dx study for Gait and balance problems

Back 1063

Get up and Go test

Front 1064

Tx for Urge urinary incontinence

Back 1064

Tolterodine or Oxybutynin (anticholinergics)

Front 1065

Dx Slow urinary stream, urinary hesitancy, and nocturia

Back 1065

BPH

Front 1066

Chlorthalidone is what class?

Back 1066

Hydrochlorothiazide diuretic

Front 1067

Target bp for T2DM?

Back 1067

130/80

Front 1068

Dx systemic htn, radial to femoral artery delay, and rib notching.

Back 1068

Coarctation of aorta

Front 1069

Stages of HTN and initial Tx

Back 1069

Stage 1 - 140/90 (HCTZ)

Front 1070

Lateral epicondylitis (tennis elbow)

Back 1070

lateral elbow pain on wrist extension.

Front 1071

Rheumatoid

Back 1071

PIP is always rheumatoid. Heberdeens nodes are DIP, bouchards are PIP

Front 1072

Trochanteric Bursitis

Back 1072

Localized hip pain, and resisted abduction of the hip worsens the pain

Front 1073

Positive McMurray Test

Back 1073

Meniscal Tear

Front 1074

Anserine Bursitis

Back 1074

Focal tenderness on the upper, inner tibia, about 5 cm distal to the medial articular line of the knee

Front 1075

Rotator Cuff Tendinitis

Back 1075

Think baseball pitcher, subacromial tenderness, pain reaching overhead or lying on shoulder

Front 1076

Adhesive capsulitis

Back 1076

decreased ROM, stiffness not pain or weakness

Front 1077

Torn Rotator Cuff

Back 1077

positive drop arm test (cant smoothly drop arm)

Front 1078

Polymyalgia Rheumatica

Back 1078

15% of people w this have temporal arteritis. 50% of people with temporal arteritis have polymyalgia rheumatica. Pain with neck shoulders and hips. Treat w methotrexate as a steroid sparing agent.

Front 1079

Tx for Community acquired septic arthritis with G+ cocci

Back 1079

Vancomycin (cover for possible MRSA)

Front 1080

Tx for Gonoccocal septic arthritis (G- cocci)

Back 1080

Ceftriaxone

Front 1081

Acute monoarthritis

Back 1081

Is septic until proven otherwise. Need to do arthrocentesis.

Front 1082

Dx Pain in the absence of fever and leukocytes in patient with prosthetic joint

Back 1082

Prosthetic joint infection (sic)

Front 1083

Treatment of GOUT

Back 1083

Indomethacin (is an NSAID), then colchicine and steroids

Front 1084

Changing Gout therapy

Back 1084

Initiating or changing allopurinol levels must be done w prophylactic nsaids, colchicine, or steroids to avoid an acute attack

Front 1085

Pseudogout

Back 1085

Positive birefringent rhomboids

Front 1086

OA

Back 1086

pain that worsens w activity, relieved by rest, key is that thereis no erythema or warmth. First line therapy is PT

Front 1087

De quervain tenosynovitis

Back 1087

pain on palpation of distal aspect of radial styloid. finkelstein test is positive.

Front 1088

Dx Chronic pain at base of thumb with positive grind test

Back 1088

OA of thumb

Front 1089

OA

Back 1089

First line is acetaminophen + PT, if that fails, then use NSAIDS

Front 1090

Dx joint space narrowing, subchondral sclerosis, osteophyte formation

Back 1090

OA

Front 1091

Dx study for suspected RA (best sensitivity)

Back 1091

X-ray, look for erosions of cartilage, joint space narrowing

Front 1092

Start TNF alpha, then what?

Back 1092

Check tuberculin skin test. Why? Reactive TB

Front 1093

Tx for RA (3)

Back 1093

1) Initially NSAIDs and DMARDs (methotrexate) hepatoxicity is possible, use hydroxychloroquine then

Front 1094

HLA-B27

Back 1094

Ankylosing Spondylitis

Front 1095

Dx oligoarticular arthritis involving lower extremities in setting of IBD

Back 1095

Enteropathic arthritis

Front 1096

When there is an explosive onset of psoriasis

Back 1096

Think the Hivvy

Front 1097

Most commonly systemic illness in pts. with anterior uveitis

Back 1097

reactive arthritis, ankylosing spondyltitis, and sarcoidosis

Front 1098

Dx of Ankylosing spondylitis

Back 1098

MRI of sacroilliac joints

Front 1099

Anti DS DNA

Back 1099

SLE

Front 1100

Antiribonucleoprotein antibody

Back 1100

Mixed connective tissue diease

Front 1101

AntiSSA SSB (ro-la)

Back 1101

sjogrens, (also in subactute cutaneous lupus)

Front 1102

Anti topoisomerase (anti scl 70),

Back 1102

scleraderma

Front 1103

Drug Induced lupus treatment

Back 1103

Seen with methotrexate use, stop the drug, treat w prednisone to control pleuritis and synovitis associated

Front 1104

Lupus Nephritis

Back 1104

Treat with high dose corticosteroids, and ACE inhibitors

Front 1105

Comorbidities of polymyositis and dermatomyositis

Back 1105

ILD with progressive fibrosis and secondary PAH.

Front 1106

Dx Diffuse pain on both sides of body, above and below waist, as well as axial skeletal pain.

Back 1106

Fibromylagia

Front 1107

Tx of Raynauds

Back 1107

CCBs (amlodipine)

Front 1108

Polyarteritis Nodosa

Back 1108

Necrotizing inflammation of the medium sized or small arteries. Fever, msk, affects the kidneys, causes htn,

Front 1109

Dx HA, temporal artery tenderness, acute visual loss, dever, milad anemia.

Back 1109

Giant cell arteritis

Front 1110

Tx for Giant cell arteritis

Back 1110

Immediate corticosteroid Tx even before diagnostic testing

Front 1111

Abdominal Fat pad aspiration

Back 1111

AL amyloidosis diagnosis

Front 1112

Dx CP with exertion, Trop negative, EKG negative

Back 1112

Stable angina

Front 1113

Dx CP even at rest or unpredictable/increasing, Trop negative, no ST elevation

Back 1113

Unstable angina

Front 1114

Dx CP even at rest or unpredictable/increasing, Trop positive, no ST elevation

Back 1114

NSTEMI

Front 1115

Dx CP even at rest or unpredictable/increasing, Trop positive, ST elevation

Back 1115

STEMI

Front 1116

Need 2 of 3 of these to Dx acute pericarditis

Back 1116

1) Pleuritic CP (worst when supine)

Front 1117

Tx for STEMI

Back 1117

Percutaneous angioplasty and stent placement (unless PCI more than 3 hrs away, then do thrombolysis within 12 hrs)

Front 1118

Dx CP with predictable relation to exercise relieved with nitroglycerin

Back 1118

Stable Angina pectoris

Front 1119

Dx Acute hypotension, clear lung fields, elevated central venous pressure (Right precordial ST elevations)

Back 1119

Right ventricular MI

Front 1120

Tx for Esophageal noncardiac CP

Back 1120

Empiric proton pump inhibitor

Front 1121

Most common cause of marked bradycaria and manifests as absence of atrial ventricular association

Back 1121

3rd degree heart block

Front 1122

Dx palpitations, sweating, tremulousness, dyspnea, CP, nausea, dizziness, numbnees.

Back 1122

Panic attack

Front 1123

Tx for recurrent panic attacks

Back 1123

SSRI (paroxetine) and CBT

Front 1124

Dx Severe headache, diaphoresis, palpitations

Back 1124

Pheochromocytoma

Front 1125

Dx Progressive prolongation of PR interval

Back 1125

Mobitz type I (2nd degree AV block)

Front 1126

Tx for Stable angina (initial medical)

Back 1126

1) ASA

Front 1127

Dx CP, dyspnea, leg edema, elevated CVP, tachypnea, and tachycardia

Back 1127

PE

Front 1128

Dx study for suspected PE

Back 1128

CT Pulmonary angiography (PE protocol)

Front 1129

What does normal wall motion on ECHO during CP allow you to do?

Back 1129

Exclude coronary ischemia and infarction.

Front 1130

Dx study for atypical CP with normal resting EKG

Back 1130

Exercise stress EKG test

Front 1131

Dx Narrow complex, regular tachycardia, absent p waves, but sawtooth baseline

Back 1131

Aflutter

Front 1132

Dx Either symptomatic sinus bradycaria, OR tachy-brady sx

Back 1132

Sick sinus syndrome

Front 1133

Dx PR interval greater than 200 ms

Back 1133

1st Degree AV Block

Front 1134

1. Tactile fremitus decreased and dullness to percussion over area; rales, crackles or bronchial breath sounds; egophony, bronchophony, and whispered pectoriloquy: Pneumonia PE findings

Back 1134

.

Front 1135

2. Fever, productive cough, elevated WBCs, hypoxemia, new lung infiltrate → Pneumonia

Back 1135

.

Front 1136

3. Lobar consolidation in pneumonia → Strep pneumo

Back 1136

.

Front 1137

4. Interstitial infiltrates in pneumonia → Mycobacterium pneumia or Pneumocystis carinii

Back 1137

.

Front 1138

5. Cavitary pneumonia → anaerobes, gram negative, or tuberculous pneumonia

Back 1138

.

Front 1139

6. Pleural effusion → Strep pneumo

Back 1139

.

Front 1140

Dx
Pruritis after bathing

Back 1140

Polycythemia vera

Front 1141

Leukesterase means what?
Nitries mean what?

Back 1141

Leukesterase = infection of UTI
Nitrites = enterobacter infection

Front 1142

Dx
Spasticity, bulbar symptoms, hyperreflexia, fasciculations

Back 1142

ALS

Front 1143

Tx for
HA, nausea, eye pain, vision loss, redness in eye

Back 1143

Dx is acute glacucoma
Tx is Mannitol, acetozolamide, pilocarpine, +/- Timolol

Front 1144

Dx
Fever, hypotension, generalized erythema, desquamation

Back 1144

Toxic shock syndrome