Medicine/step 2

Front 1

Next step if elevated anion gap

Back 1

Get ABG

Front 2

How would you manage pulmonary edema from systolic heart failure if lasix and nitro didn’t work

Back 2

Use an inotrope: dobutamine > reduces pre load and forces blood into vasculature

Front 3

Elevated urine coporphyrins dx

Back 3

Rotor syndrome

Front 4

How to tell the difference between gilberts and rotor/dubin johns

Back 4

Gilberts is unconjugated, rotor/dj are primarily conjugated

Front 5

When is mitral stenosis valve repaired with ballon

Back 5

Area of valve <1.5

Front 6

What is sipple syndrome

Back 6

MEN2A

Front 7

MEN 2A triad

Back 7

Medullary
Pheo
PTH

Front 8

MEN2B triad

Back 8

Medullary
Pheo
Skin neuromas

Front 9

MEN1 TRIAD

Back 9

Pituitary
Parathyroid
Pancreas

Front 10

How does amiodarone affect warfarin levels

Back 10

Increases the levels

Front 11

Major cause of morbity and death in polycythemia vera

Back 11

Thrombosis

Front 12

Back pain that is relieved by sitting forward

Back 12

Spinal stenosis

Front 13

Severe mitral stenosis with evidence of regurg tx

Back 13

Valve replacement

Front 14

Treatment of acute ulcerative colitits

Back 14

Topical mesalamine derivatives

Front 15

You are thinking VWF deficinecy but there is no correction with normal plasma

Back 15

Bernard soulier

Front 16

What tests will yield normal platelet aggregation in bernarnd soulier

Back 16

1. ADP
2. Epinephrine

Front 17

What is the tx in stable WPW

Back 17

First line : procainamide
Second: amiodarone

Front 18

How to tell the difference between DIC and TTP
l

Back 18

DIC ptt and pt are elevated
Ttp ptt and pt are normal

Front 19

Abx Tx for diverticulitis

Back 19

Quinolone with metro

Front 20

Cheapest way to test for eradication of h pylori

Back 20

Urea breath

Front 21

Sun exposed blistering of skin dx:

Back 21

Porphyria cutanea tardea

Front 22

Anemia, jaundice, splenomegaly triad dx

Back 22

Hereditary sphero

Front 23

Treatment for ttp:

Back 23

Plasampheresis to remove adams3 antibodies

Front 24

Anemia, low platelets, shistocytes, normal pt, ptt

Back 24

Ttp

Front 25

Anemia, low platelets, shistocytes, elevated pt, ptt

Back 25

Dic

Front 26

Anemia, low platelets, no shistocytes, normal pt, ptt 

Back 26

Itp

Front 27

Non alcoholic woman with pleural effusion and ascites dx

Back 27

Meigs syndrome

Front 28

Hepatomegaly, ascites and abdominal pain in a patient with polycythemia vera. Dx?

Back 28

Budd chiari due to thrombosis of hepatic vein

Front 29

tinnitus, decreased hearing, and vertigo

Back 29

menieres

Front 30

tinnitues, decreased hearing vertigo, facial weakness, numbness

Back 30

acoustic schwanoma

Front 31

65 y.o.
Dull, persistent abdominal pain with radiation to the back
20 lb weight loss in last three months Decreased appetite
Exam reveals mid epigastric tenderness
Swollen tender calf
Blood glucose 280 mg

Back 31

pancreatic cancer

Front 32

why swollen calf >

Back 32

cancer is hypercoag leading to dvt

Front 33

58 y.o. woman - Persistent joint aches affecting hands and hips in a asymmetric
distribution. Pain is aggravated by activity. She notes about 10 mins of morning
stiffness relieved by heat and movement

Back 33

osteoarthritis

Front 34

what is the key point >

Back 34

<10 minutes morning stiffness indicated non inflammatory

Front 35

21 y.o. man 4 months low back pain that improves with exercise and does not
improve with rest. Also notes posterior thigh pain. What’s the diagnosis?

Back 35

ankylosing sponylitis

Front 36

where can the sacroiliac pain be referred to>

Back 36

posterior thigh

Front 37

what will xr show:

Back 37

bamboo spine

Front 38

key point in ankylosing spondylitis

Back 38

> pain that gets better with excercise.

Front 39

what is the best test to order for rheumatoid factor:

Back 39

anti citriulinated protein (anti cccp)

Front 40

33 y.o. man presents with recurrent right knee pain and swelling of 4 years
duration. x-ray film shows speckling of the articular cartilage with increased joint
space. Joint tap shows pos birefringent, rhonboidal intracellular crystals. Whats the
diagnosis?

Back 40

pseudogout

Front 41

what are the 2p's of pseudogout

Back 41

1. postive bifringent
2. polygon crystals

Front 42

Older patients > 55, female, fever, anemia, and headaches, next step

Back 42

ESR THEN corticos if elevated

Front 43

Adult > 50 years old, Aching & Morning stiffness in neck, shoulders and hip
girdle. No evidence of destructive joint disease. Elevated sed rate. Rheum factor
negative. Diagnosis

Back 43

polymyalgia rheumatica
key point > hip and shoulder girdle stiffness, RH negative

Front 44

what vasculitis is pmr associated with:

Back 44

temporal arteritis

Front 45

cancer that stains with pap:

Back 45

squamous cell

Front 46

peripheral vascular disease, Severe mid abdominal pain 30 mins after eating

Back 46

mesenteric ischemia

Front 47

pain out of proportion to exam

Back 47

mesenteric ischemia

Front 48

chest pain underwent cardiac cath. 3 Hours later he developed severe mid
abdominal paincomplains of vomiting and diarrhea dx

Back 48

mesenteric ischemia due to emboli

Front 49

thumbprint sign of axr indicative of

Back 49

ischemic colitis

Front 50

45 y.o.with Chronic myelogenous leukemia develops renal failure after
chemotherapy.UA shows crystals. What is the cause of renal failure?

Back 50

tumor lysis syndrome

Front 51

what type of crystals in urine will you see in tumor lysis

Back 51

uric acid and calcium phosphate

Front 52

how would you prevent renal failure due to tumor lysis

Back 52

give allopurinal

Front 53

Draining sinus underneath chin – dental extraction of an abscess tooth 6 wks ago

Back 53

actinomyces
what are they famous for >
head and neck infection

Front 54

20 year old woman c/o dysuria, increased urinary frequency, suprapublic pain.
Dipstick negative for nitrites

Back 54

staph saprophyticus

Front 55

20 year old woman c/o dysuria, increased urinary frequency, suprapublic pain.
Dipstick positive for nitrites

Back 55

e coli

Front 56

56 y.o. woman whose hobby is gardening Presented with red swelling in right
middlle finger, dx and tx

Back 56

sporotrichosis, itraconazole

Front 57

dog bite <24 hours after gets with fever swelling dx

Back 57

pasturella

Front 58

dog bite >24 hours after gets with fever swelling dx

Back 58

capycytophagia carnivorous

Front 59

what 4 organisms are present in a human bite

Back 59

1. Strep
2. Staph
3. Eikenella
4. Fusobacterium

Front 60

obese pt has hip pain, is able to localize the pain with one finger is is worse when
lying on that side:

Back 60

trochanteric bursitis

Front 61

shoulder pain but normal shoulder exam should indicate:

Back 61

referred pain to shoulder

Front 62

what does xr show in RA?

Back 62

Marginal joint erosions

Front 63

Person has bloody diarrhea and arthritis

Back 63

Enteropathic arthritis

Front 64

Treatment of lupus nephritis

Back 64

High dose corticos

Front 65

What is the leading cause of death associated with dermatomyositis and
polymyositis

Back 65

Interstitial lung fibrosis

Front 66

How would neuromusclular weakness present on pft

Back 66

Rv  increased
Tlc  increased
fev/fvc  normal
dlco normal

Front 67

breathing that worsens when sitting up, better when lying down

Back 67

hepatopulmonary syndrome

Front 68

what is the pft finding in vocal cord dysfunction

Back 68

decreased lung volumes

Front 69

how to tell difference between pneumonia and pleural effusion on exam

Back 69

tactile fremitus increased in pneumonia

Front 70

how to distinguish mesenteric ischemia from ischemia colitis

Back 70

ischemia colitis > due to hypoperfusion > MI or cardiac failure
AMI > emboli and pain out of proportion to exam

Front 71

best screening test for aperson with cirrhosis for cancer

Back 71

ultrasound now, AFP later

Front 72

what two tests confirm primary biliary cirrhosis

Back 72

1. ama
2. way elevated ALK PHOS

Front 73

most common skin manifestation of IBS (crohsn or uc)

Back 73

erythema nodosum

Front 74

thinking viral meningitis, but high WBC, what organism

Back 74

cocksacki

Front 75

meningitis with lp pointing towards bacterial, but hx of rodent exposure

Back 75

lymphocytic choriomeningitis

Front 76

coved st in V1, v2, V3

Back 76

brugada syndrome

Front 77

how to dx radiation colitis

Back 77

flexible sigmoidoscopy

Front 78

person with UC, when doy ou do screening colonoscopy

Back 78

after 8-10 years

Front 79

cat scratch fever presentation but swollen painful lymph node

Back 79

Yersinia

Front 80

how to calculate A-a gradient;

Back 80

alveolar - arterial o2
alveolar o2 = FIo2*(Patm-pH2O) aka 150 - (Co2/.8)
arteriolar = the abg O2 level

Front 81

if person has neurofibromatosis, what other diease is linked to it

Back 81

pheochromocytoma

Front 82

what is a side effect of metformin and linezolid , isoniazid

Back 82

metabolic lactic acidosis

Front 83

tx for uremia platelet dysfunction

Back 83

ddavp

Front 84

how to dx vwf deficiency:

Back 84

1. ristocetin assay
2. vwf multimer distribution

Front 85

Best choice for uncontrolled diabetes in hospitalized pt

Back 85

Basal and short acting insulin

Front 86

What combination of drugs reduces the risk of hypoglycemia in a pt on insulin

Back 86

Basal and short acting combo

Front 87

What is required for the dx of dka

Back 87

Blood glucose > 250
Anion gap acidosis
Ketones in urine

Front 88

Woman has hypothyroid, on levothyroxine, at what level do you want the t4 to be

Back 88

1.5x normal

Front 89

Sick person with low TSH and free T3 levels with a free T4 level in the normal to
low-normal range, dx

Back 89

Sick euthyroid syndrome
Next step
Repeat tsh/t4 in 6 weeks

Front 90

What should you do with an incidentally found adrenal adenoma

Back 90

Investigate it always> VMA/MVA/overnight cortisol

Front 91

What is the best screening test for hyperaldo state

Back 91

Aldo:renin ratio (normal 20:to one)

Front 92

Pt has osteoporosis, cant tolerate oral bisphos, what to do next

Back 92

Iv biphoshonate

Front 93

One day after sustaining a laceration of the right hand. Temp 3.4 HR 110 RR 20
Intense pain, erythema and edema of upper extremity with epidermal necrosis and
desquamation. What’s the next step?

what is it

Back 93

surgical exploration

> necrotizing fascitis due to > group a strep

Front 94

how to tell primary sclerosing cholangitis from primaru biliary cirrhosis

Back 94

psc - ama negative
pbc -ama postive

Front 95

25 y.o. woman with recurrent sinopulmonary infection. eceives transfusion for post
partum hemorrhage. and goes into anaphylaxis, dx

Back 95

iga deficiency

Front 96

Pt with cirrhosis due to hepatitis C developed worsening jaundice, increased ascites,
encephalopathy and vague right upper quadrant pain. CT reveals presence of a
large tumor mass in the liver. next test to order

Back 96

afp

Front 97

what arteries are most commonly involved in htn hemorrhage

Back 97

lenticulostriate

Front 98

dizzyness, facial pain, trouble swallowing, dx

Back 98

lateral wallenburg syndrome

Front 99

what is the tx for svt

Back 99

1. valsalva
2. carotid massage
3. adenosine/verapimil/beta blocker

Front 100

68 y.o. unexplained falls (loss of balance while walking), vertical gaze palsy
(blurring of vision)
tremor, bradkinesia, rigidity. Diagnosis?

Back 100

psp

Front 101

how to tell from parkinsons

Back 101

no eye involvement in parkinsons

Front 102

flushing, diarrhea, murmur

Back 102

carcinoid syndrome

Front 103

Systolic murmur increased on inspiration. No evidence of pulmonary hypertension.
? Likely diagnosis?

Back 103

tricuspid regurg

Front 104

Sickle cell patient who works as a daycare worker. evelops Temp 38.1 C,
palpitations, dizziness, Hb 6.0 g/dL. Howell jolly bodies and absence of reticulocytes.
What is the Diagnosis & likely pathogen?

Back 104

transient aplastic crisis due to B19 infection

Front 105

acute illness, infiltrate and cavity in left LOWER LOBE >

Back 105

anaerobic abscess

Front 106

28 y.o. IV drug user presents with fever, chills, malaise, nausea, headaches. Exam
reveals loud holosytolic murmur. next step;

Back 106

1.blood cultures x2
2. echo
3. start antibiotics for endocarditis

Front 107

non stemi, what antiplatelet to give after

Back 107

1. aspirin
2. plavix

Front 108

bp 230/140 , optic disk edema, dipstick positve for protein, tx

Back 108

nitroprusside

Front 109

first line tx fo r gout

Back 109

indomethiacin

Front 110

22 y.o. C/O chronic weakness and fatigue. He notes dizziness when he stands up in
the morning. He notes cold intolerance, facial puffiness, coarsening of his hair and
hoarseness. Na 125, K 5.5, Bicarb 25, BUN 22 Glucose 380 and TSH 9.5, Diagnosis?

Back 110

polyglandular autoimmuine syndrome type 2

Front 111

what disease is specific to PAS type 1

Back 111

hypoparathyroid
and
candida

Front 112

what disease is specific to PAS type 2

Back 112

hypothyroid
no candida

Front 113

what age group to suspect pas type 1 and 2

Back 113

1 > kids
2 > older than kids

Front 114

Patient with inflammatory bowl disease develops a pustule on his skin that
progresses to an inflammatory ulcer with ulceration, necrosis and
purulence. Diagnosis? What do you expect to find on skin biopsy?

Back 114

pyoderma gangrenosum
will see neutrophilic infiltrate

Front 115

A patient with acute myelogenous leukemia whose disease has been stable
developed tender, inflamed papules, plaques and nodules on her arms and legs. She
notes a new lesion occurred at the site of a blood draw. She has also noted
irritation of her eyes. She has also developed fever to 39 degrees. Diagnosis? What
do you expect to find on skin biopsy.

Back 115

dx is > sweet syndrome
biopsy > neutrophilic infiltrate

Front 116

Sores on lip and scrotum. Photophobia.
Knee pain.
Elevated Sed Rate
Diagnosis?

Back 116

bechet disease
waht is it > vasculitis of all size blood vessels
will invovle:
1. eye ulcers
2. mouth/tongue ulcers
3. genital ulcers

Front 117

left pupil constricts with light on right, no constriction with light on left, dx

Back 117

left central retinal artery occlusion

Front 118

50 y.o. presents with 5 yr history of arthralgias who was suspected of having
rheumatoid arthritis. She now notes progressive dyspnea on exertion. On exam she
has erythematous patches over the knuckles, a mild malar rash andviolaceous discoloration to the eyelids. Crackles at lung bases. There are no joint
deformities. CXR show patchy infiltrates. What antibody do you expect to be in high
titer.

Back 118

anti ribonucleoprotein
its mixed connective tissue disease =

Front 119

mononucleosis, he asks when he can return to playing. On exam you detect
no splenomegaly. What do you tell him?

Back 119

4 weeks

Front 120

what ekg change will you see in a myeloma pt:

Back 120

qt shortneing due to hypercalcemia

Front 121

in May a boy scout who went camping in in Oklahoma last week is seen for C/O
fever, severe headache, malaise and nausea and a petechial rash involving palms
and soles.
What test for Dx before Tx?

Back 121

rocky mountain spotted fever - biopsy

Treatment
doxy

Front 122

A sheep and Goat farmer in Upstate NY with recent (2 wks ago) good fortune of
several births of lambs and kids presents with a flu like illness, pneumonia and
hepatitis. What zoonotic infection should be considered.

Back 122

q fever coxiella burnetti

Front 123

`
what are the indications for intubation in asthma

Back 123

1. acidosis
2. hypoxemia

Front 124

patient is younger than 45 years and has bilateral basilar emphysema, what to look for

Back 124

a1at

Front 125

what is similar between Cryptogenic organizing pneumonia and idiopathic
pulmonary fibrosis

Back 125

- both are in older patients with no smoking or exposure history

Front 126

how to tell the difference between COP and IPF

Back 126

COP  will be more acute, develops over 2 months or so,
- will basically resemble a pneumonia that hasn’t resolved with tx

IPF will be longer course, over months to yerars

Front 127

Leukocyte/wbc casts indicate what two things

Back 127

Acute interstitial nephritis
pyelonephritis

Front 128

How to tell blood in urine is from glomerular or other sources

Back 128

Glomerular dysmorphic RBC with casts
Non glomerular  regular RBC, no casts
Workup in non glomerular : cystoscopy

Front 129

Treatment of hypercalcemia due to sarcoid

Back 129

Prednisone

Front 130

Triad of right ventricle MI

Back 130

. hypotension
2. elevated central venous pressure
3. clear lung fields

Front 131

what is the tx of right ventricle MI

Back 131

fluids

Front 132

what type of heart block is associated with lyme

Back 132

3rd degree

Front 133

chronic stable angina that gets worsening symptoms tx

Back 133

increase bb dose

Front 134

presence of new murmur after MI could be 2 things:

Back 134

. Acute mitral regurg
2. vsd rupture

Front 135

treatment of lung abscess

Back 135

zosyn or unasyn

Front 136

tx of uncomplicated cystitis in non pregnant woman

Back 136

bactrim

Front 137

tx pyelo in non pregnant woman

Back 137

ciprofloxacin

Front 138

when to do ppx for mac in aids and
what to give

Back 138

<50 , azythromycin

Front 139

if a person gets recurrent zoster what do you have to look for

Back 139

hiv

Front 140

sinus bradycardian plus sinus arrests dx

Back 140

sick sinus syndrome

Front 141

when should dig be added to chf

Back 141

when ejection fraction worsens, stage 3 or 4 ny heart with limitations in activity

Front 142

pt has typical chest pain then develops chf like picture, best dx step

Back 142

angio

Front 143

what heart murmur will increase p2

Back 143

mitral stenosis

why -
increased pulmonary artery pressure

Front 144

how to dx familial mediterrian fever

Back 144

periods of 1-3 days of fever with serositis (can be mis dx as appendicitis)

Front 145

treatment for asymptomatic bacturia in non pregnant woman

Back 145

none

Front 146

treatment for asymptomatic bacturia in pregnant woman

Back 146

ampicillin or nitro

Front 147

Highly specific test when negative means what

Back 147

Rules disease in

Front 148

Highly sensitive test when postive means what

Back 148

Rules disease out

Front 149

What is the probability that a positive test result is a true positive result asking for

Back 149

Postive predicitive value

Front 150

Postive LR of 2, 5, 10 increase post test odds by how much

Back 150

15%,30%,45% respecitively

Front 151

Negative LR of .5,.2,.1 decrease post test odds by how much

Back 151

15%,30%,45% respecitively

Front 152

All pts with hemoptysis should receive

Back 152

Ct scan

Front 153

Pt with heavy menstrual bleeding tx

Back 153

Medroxyprogesterone

Front 154

The next step in the evaluation of this patient with secondary amenorrhea after stopping her oral contraceptive pill is

Back 154

a progestin withdrawal challenge

Front 155

progestin withdrawal challenge yields no bleeding, next step

Back 155

ultraasound to assess pevlic anatomy

Front 156

abnormal uterine bleeding in pt >35 next step

Back 156

endometrial biopsy

Front 157

demarcated, eczematous, crusted, erythematous papulovesicular plaques and excoriations that characteristically are pruritic and involve the antecubital and popliteal fossae and flexural wrists.

Back 157

Atopic dermatitis

Front 158

itchy, red, edematous, weepy, and crusted, sometimes with vesicles or bullae

Back 158

alllergic contact dermatitis

Front 159

Contact dermatitis can usually be differentiated from cellulitis by the

Back 159

presence of pruritus and the absence of fever

Front 160

itchy Lesions that are erythematous, with dry or greasy scales and crusts

Back 160

sebhorric dermatitis

Front 161

Erythema with telangiectasias, pustules, and papules

Back 161

Rosacea

Front 162

What infection is erythema multiform associated with

Back 162

Hsv

Front 163

Treatment of acute herpes zoster

Back 163

oral acyclovir, valacyclovir, or famciclovir

Front 164

elderly pt with htn, which drug to start off on
chlorthalidone
person found to have bp >160 on two occasions what to start on

Back 164

2 drugs!! Ace and diurtetic

Front 165

pt with fevers of unknown origin, low cd4 for a while, hv to check for what

Back 165

lymphoma
how: marrow biopsy

Front 166

sausage veins on fundoscopic exam, increased plasma cells in marrow dx

Back 166

waldenstrom

Front 167

person gets transfusion, then develops hypoxemia and respiratory distress, dx

Back 167

transfusion related acute lung injury

Front 168

how is trali different form transfusion rx ==>

Back 168

no hypoxemia in a regular transfusion rxn

Front 169

what is the tx for dvt in pregnancy

Back 169

heparin until 6 weeks post partum

Front 170

sustained v tac without symptoms tx

Back 170

1. Amio
or
2. lidocaine

Front 171

sustained v tact with symptoms tx

Back 171

synchronized cardiovert

Front 172

what type of insulin to give in dka

Back 172

regular

Front 173

when do you give k in dka

Back 173

when less than 5.3 and HAVE URINATED

Front 174

why do you give dextrose in dka

Back 174

to prevent cerebral edema

Front 175

person has mi, 4 weeks later develops jvd, ascites, shortness of breath, dx

Back 175

left ventricle aneurysm

Front 176

tx of right ventricle mi

Back 176

fluids

Front 177

what are the following in primary hypognonadism

Back 177

LH: increased
FSH: increased
Total testosterone: decreased
Free testosterone; decreased
Sex hormone binding globulin: increased

Front 178

Hexagonal crystals in ua indicate:

Back 178

Cysteine

Front 179

next test if cysteine crystals in urine

Back 179

Cyanide nitroprusside test

Front 180

Atypical lymphocytes seen in skin biopsy

Back 180

Either
1. Sezary
2. mycosis fungoides

Front 181

jvd, hepatomegaly, ascites, lvh with low voltage

Back 181

amyloidosis

Front 182

tx of primary amyloidosis

Back 182

steroids and lenolidomide

Front 183

transfusion, fever, no hemolysis, dx

Back 183

non allergic transfusion rxt
due to what:
cytokines in transfused blood

Front 184

transfusion, fever, hemolysis, what type of hypersensitivity

Back 184

type 2

Front 185

flu or mono like picture, rash two days later, have to look for what

Back 185

hiv

Front 186

what is hiv ppx <200 and for what

Back 186

Bactrim or, atovaqunoe, dapsone for PCP

Front 187

Hiv ppx <100 and for what

Back 187

Bactrim, or atovaqunoe, dapsone for toxo

Front 188

Hiv <50

Back 188

Azithromycin for mac

Front 189

Tx for familial mediterrranean fever and to prevent what

Back 189

Colchicine
amyloidosis

Front 190

tx of uncomplicated cystitis in non pregnant woman

Back 190

bactrim

Front 191

tx pyelo in non pregnant woman

Back 191

ciprofloxacin

Front 192

treatment of ascaris lumbricosides

Back 192

Mebendazole

Front 193

Treatment of chemotherapy related nausea 3 things:

Back 193

1. Zofran
2. dexamethasone
3. fosaprepitant

Front 194

what is the best test to identify enterameoba histolytica

Back 194

serology not stool

Front 195

best dx test for crohns

Back 195

COLONOSCOPy not sigmoidoscopy (terminal ileum is reached by colonoscopy)

Front 196

Person with gerd develops trouble swallowing due to what

Back 196

Esophageal stricture

Front 197

Best dx test to confirm ebv

Back 197

Heterophil antibody

Front 198

What are the indications for cabg

Back 198

1. Left main
2. triple vessel
3. two vessel and diabetic

Front 199

why are patients with nephrotic syndrome at increased risk for heptic vein thrombosis

Back 199

loss of antithrombin 3 in urine

Front 200

is raloxifen safe in hypercoag pts

Back 200

no ==>it increases risk

Front 201

pt with cd4 <50 who develops shock, hypotension, hyponatremia, hypokalemia, dx

Back 201

adrenal insufficiency due to CMV, MAC, or Kaposi

Front 202

in a person with pe, when is lmw heparin and unfractionated used

Back 202

lmw ==>uncomplicated
unfacrtionates ==>unstable pts

Front 203

how to tell the difference between pbc and psc if no anti mitochrondrial antibody result is given==>

Back 203

look for signs of associated symptoms
pbc ==>sjogresn ==>dry eyes, dry mouth artificial tears, xanthomas
psc ==>ulcerative colitis ==>bloody diarrhea, weight loss, erythema nodosum

Front 204

fever, cough, non bloody watery diarrhea dx

Back 204

legionella

Front 205

tx of legionella and when started

Back 205

ceftriaxone and azithromycin
empirically before culture comes back
once diagnosed legionella tx:
erythromycin or doxy

Front 206

microcytic anemia, normal rdw, normal iron

Back 206

thalesemia

Front 207

microcytic anemia, high rdw

Back 207

iron def

Front 208

necrotic pancreas tx:

Back 208

1. Antibiotics -imipenem/carbapenum
2. bowel rest

Front 209

if necrotic pancreas doenst improve with rest and abx

Back 209

aspirate the pancreas to rule out superinfection

Front 210

low sodium, high potassium , low bicarb, high bun dx

Back 210

addisons

Front 211

treatment of cll based on stage

Back 211

stage 0 ==> none
stage 1 ==> none
stage 2-4 ==>fludarabine

Front 212

immunosuppressed person, trouble swallowing, endoscopy shows white plaques

Back 212

candida

Front 213

immunosuppressed person, trouble swallowing, endo shows shallow ulcer with volcano

Back 213

hsv

Front 214

immunosuppressed person, trouble swallowing, endo shows deep ulcer

Back 214

cmv

Front 215

what does foamy macrophages on lung biopsy dx

Back 215

amiodarone toxicity

Front 216

B12 in urine after schilling dx

Back 216

Dietary deficiency (able to taken up to be excreted in urine)

Front 217

What do you do first in suspected temporal arteritis, prednisone or esr

Back 217

Esr

Front 218

Bad Side effect of ptu and methimazole

Back 218

Agranulocytosis (decreased all 3 cell lines)

Front 219

Positive ppd in at risk group (physician) next step

Back 219

Isoniazid and b6 for 9 months

Front 220

What is barter syndrome and tx

Back 220

Congentical loop diuretic
Nsaid and spironolactone

Front 221

Person is taking dig and has ekg depression, next step

Back 221

Echo to look for evidence of ischemia

Front 222

Pt with non tender palpable mass that is likely cancer, next step

Back 222

EXCISIONAL BIOPSY

Front 223

AAA is suspected, next dx step

Back 223

Ultrasound not CT

Front 224

when can abd us not be used to rule out aortic dissection

Back 224

obese

Front 225

Initial management with aortic dissection pt with htn

Back 225

Labetolol

Front 226

Person has early morning pre breakfast glucose level, next step

Back 226

Check at 3am

Front 227

Echo with thickened wall and speckled pattern

Back 227

Amyloidosis

Front 228

Calcified non enhancing cystic lesions on brain dx and tx

Back 228

Neurocystercosis
Albendazole

Front 229

Treatment to prevent meningeal relapse in ALL in kids

Back 229

Mtx ppx

Front 230

Tx of itp

Back 230

Steroids

if severe:
Ivig or rhogam

Front 231

What is the ddx for pancytopenia:

Back 231

1. Leukemia
2. aplastic anemia
3. b12 deficiency
4. myelofibrosis

Front 232

older person with elevated wbc with predominant lymphocytes dx

Back 232

chronic lymphocytic leukemia

Front 233

next step if a person has a positive fecal blood test

Back 233

colonoscopy

Front 234

small incidental nodule in non smoker follow up

Back 234

none

Front 235

small incidental nodule in high risk

Back 235

ct in 12 months

Front 236

when do we stop screening for prostate cancer

Back 236

75

Front 237

tx for mets prostate ca

Back 237

leuprolide

Front 238

when do you do colposcopy

Back 238

1. Ascus
and
2. positive hpv for 16 or 18

Front 239

how to tell the difference between squamous and melanoma

Back 239

squamous is scaly

Front 240

dark blue or berry like lesion on skin

Back 240

nodular melanoma

Front 241

rapid growth on skin with nodular crater

Back 241

keratoacanthoma.

Front 242

How to tell the difference between vfw deficiency and hemophilia a

Back 242

Bleeding time
Bleeding time is normal in ==>hemophilia a
Vfw ==>increased

Front 243

Common cause of cardo pulmonary disease in sickle cell

Back 243

Pulmonary htn

Front 244

Acute treatment in a sickler with acute chest syndrome

Back 244

Red cell exchange

Front 245

Slow rising carotid pulse dx

Back 245

Aortic stenosis

Front 246

Best diagnostic test for any heart valve issue

Back 246

Coronary angio

Front 247

Recurrent uti’s with stone, what is dx

Back 247

Proteus or pseudomonas

Front 248

Diabetic with foul smelling otorrhea, red mass lesion in external canal, dx and organsism

Back 248

Malignant external otitis, pseudomonas

Front 249

Pt has hyperPTH, gets adenoma removed, week later has decreased ca, dx

Back 249

Hungry bone syndrome

Front 250

What is the treatment of aspergillus

Back 250

Vorconazole

Front 251

Goal for mitral valve replacement INR

Back 251

2.5-3.5

Front 252

thinking alport, first dx test

Back 252

skin biopsy

Front 253

3 causes of nighttime chronic cough

Back 253

1 asthma
2. gerd
3. post nasal drip

Front 254

current tx for hcv

Back 254

peg interferon and ribavirin

Front 255

tx for oral thrush

Back 255

swish and spit nystatin
azole troche
oral azole

Front 256

platelet count over one million dx

Back 256

thrombocytosis
- can be primary (jak) or secondary as a reactive measure

Front 257

fixed split s2, young female, right BBB suggests

Back 257

atrial septal defect

Front 258

paradoxical or reverse splitting of S2, what 2 conditions

Back 258

aortic stenosis
hocm

Front 259

post mi, decreased ekg voltage, equalization of chambers dx

Back 259

cardiac tamponade

Front 260

jvd, hypotension, clear lung fields

Back 260

triad of right heart MI

Front 261

increased S one heart sound

Back 261

mitral stenosis

Front 262

how to calculate vent settting for copd

Back 262

7 times weight in kilo

Front 263

how does scleroderma lead to diarrhea

Back 263

dysmotility leads to buildup of bacteria and osmotic diarrhea

Front 264

how often to do pap in low risk

Back 264

every 3 years

Front 265

steps in the tx of heart failure

Back 265

o2
lasix
morphine
nitrates
dobutamine
hydralazine

Front 266

what will pulmonary cath show in pericarditis and tamponade

Back 266

equlaization of pressure in all 4 chambers (all are about the same)

Front 267

most common organisms to cause copd exacerbations

Back 267

strep
h flu
moraxella

Front 268

person post chemo has low neutrophils next step

Back 268

observe no treatment

Front 269

perosn post chemo has low neutros and develops fever, tx

Back 269

imipenem/carbapenem

Front 270

main complication of radioactive iodine tx

Back 270

hypothyroid

Front 271

mass on finger that does not transilluminate and drains fluid

Back 271

tophaceous gout

Front 272

person has mi, then develops jvd, rales/wheezing, no murmur, dx

Back 272

chf from mi

Front 273

perosn has mi, then gets jvd,clear lungs, pulsus paradoxicus dx

Back 273

cardaic tamponade

Front 274

ameobic abcess tx

Back 274

metro NO DRAINAGE

Front 275

at what age should dm be screened for

Back 275

45

Front 276

at what age in men and women should lipids be checked

Back 276

35, 45 respectively

Front 277

how to tell the difference between partially treated bacterial meningitis from aseptic

Back 277

cell count
partially treated bacterial: 20,000
aseptic: only about 2,000
both will have : lymphocyte predominance

Front 278

what is the preferred agent and alternative for malaria ppx in africa

Back 278

mefloquine is first choice
second is doxy

Front 279

what is malaria ppx in caribbean

Back 279

chloroquine

Front 280

as soon as dx of hyperthyroid is made, what should the pt be started on

Back 280

beta blocker

Front 281

what do you treat a person with previous staph infections and now suspecting mrsa pneumonia

Back 281

linezolid
or
vanco

Front 282

first line tx of hus

Back 282

plasmapheresis

Front 283

first line tx for ttp

Back 283

plasmapheresis

Front 284

person with upper gi bleed but no source can be identified

Back 284

dieulafoy lesion

Front 285

most common presentation of hocm

Back 285

dyspnea

Front 286

best initial treatment of kidney stone

Back 286

fluids and pain control

Front 287

do you give warfarin in HIT

Back 287

NO

Front 288

arteriopgraphy shows tortuous pattern of arterioles and pt is smoker, dx

Back 288

thromboangitis obliterans

Front 289

initial management of all sarcomas

Back 289

surgery to remove

Front 290

high leuk alk phos dx

Back 290

leukemoid reaction

Front 291

person undergoes surgery, then develops asymtpomatic jaundice, next step

Back 291

nothing, its post op cholestasis

Front 292

most sensitive tests for pheochromocytomas

Back 292

from best to worst
plasma metanephrines
urinary metanephrines
urinary vma

Front 293

how to calculate saag

Back 293

serum minus ascites albumin

Front 294

what tendon is involved in tennis elbow

Back 294

extensor carpi radialis brevis

Front 295

any patient with suspected silicosis should have what ruled out

Back 295

tb

Front 296

onion skinning of biliary duct dx

Back 296

psc

Front 297

mononuclear PERIDUCTAL infiltrate

Back 297

pbc

Front 298

mitral regurg pharm tx, 3 things

Back 298

reduce preload by: diurtetic
reduce afterload: ace
ionotrope: dig

Front 299

what is the ekg finding in PE

Back 299

s1
q3
t3

Front 300

fixed split s2 could be due to what 2 things

Back 300

1. ASD
2. RBBB

Front 301

what injfection can cuase RBBB

Back 301

chagas

Front 302

red crusted scaly rash

Back 302

psoriasis

Front 303

bowing of long bone, dx

Back 303

pagets

Front 304

adrenal mass, labs and workup negative, next step

Back 304

depends on size
>4 -surgery
<4: observe

Front 305

bloody diarrhea with day care

Back 305

shigella

Front 306

waxing and waning lymph nodes dx

Back 306

follicular lymphpoma

Front 307

blue sclera

Back 307

osteogenesis imperfecta

Front 308

low platelets, ezcema, recurrent infections

Back 308

wiskott aldrich

Front 309

dipstick positive, high ldh, no red cells in urine, dx

Back 309

myoglobinuria

Front 310

most common deficiency in bypass

Back 310

b12

Front 311

person has pe, platelts drop week later dx

Back 311

HIT

Front 312

howell jolly bodies mean what

Back 312

autosplenectomy

Front 313

what is polyglanular syndrome type 1 triad

Back 313

hypo PTH
mouth candida
kids

Front 314

waht is polyglandular syndrome type 2 triad

Back 314

thyroid
adrenal insuffiency
no mouth candida
adults

Front 315

nodules at needle stick called what

Back 315

pathergy

Front 316

what 3 diseases get pathergy

Back 316

1. bechets
2. pyoderma gangrenosum
3. sweet syndrome

Front 317

cherry red spot on fundus

Back 317

central retinal artery occlusion

Front 318

what drugs are avoided in glaucoma

Back 318

1. anticholinergics: tca, anti h
2. beta agonists

Front 319

what associations are there with restless leg

Back 319

1. iron deficiency
2. ckd
3. dm

Front 320

treatment of pulmonary hypertension

Back 320

vasodilator
then
calcium channel blocker

Front 321

solitary vesicle and punched out lesions dx

Back 321

kaposi varicellaform eruption

Front 322

hypertension with adrenal mass, should make you think of what 2 conditions

Back 322

pheo
conns

Front 323

person has elevated alk phos, normal ggt next step

Back 323

bone scan for increased turnover like pagets

Front 324

person has elevated alk phos, elevated ggt, next step

Back 324

abd ultrasound

Front 325

diarrhea, red eruption on skin, mouth ulcer, increased thirst, increased urination, dx

Back 325

glucagonoma

Front 326

how to treat htn in scleroderma pt

Back 326

ace

Front 327

firm, red, cord like structures in leg that come and go, dx

Back 327

migratory thrombophlebitis in pancreatic cancer

Front 328

what heart findings will you see in pulmonary htn

Back 328

right atrial enlargement
right ventricle enlargement
flattening of septa

Front 329

drug of choice to treat aspiration pneumonia

Back 329

clinda

Front 330

someone who has been exposed to hep a next step

Back 330

vaccinate

Front 331

bloody vomiting , normal upper gi series likely dx

Back 331

mallory weiss tear

Front 332

AIDS patient develops a scaling, oily erythema involving eyebrows, nasolabial folds and chest. Diagnosis?

Back 332

sebhorric keratosis

Front 333

55 y.o. man with progressive renal failure (Bun 100, Creatinine 10) presents with burning sensation and pain of the lower extremities. Exam reveals loss of position and vibration sense in the toes and decreased Achilles reflexes bilaterally. Hct 36%. MCV 94. Diagnosis?

Back 333

uremic neuropathy

Front 334

50 y.o. evaluated in the ED after twisting his knee while skiing. X-ray show increased bone density, cortical thickening, bowing and over growth.

Back 334

pagets

Front 335

elastic skin, hypermobile joints, thin skin

Back 335

ehlors danlos

Front 336

30 yo. is seen because of his urine becoming pink and recent DVT. Evaluation reveals HgB 11, indirect bilirubin of 1.1, total 1.5. UA shows dip stick Positive for blood,
0 RBC, LDH 400. combs is negative. What Test next?

Back 336

osmotic fragility looking for pnh

Front 337

tx for reactive arthritis

Back 337

nsaid

Front 338

treatment of suspected bacterial meningits

Back 338

amp if less than one month or >50yrs
vanco
ceftriaxone
dexamethasone

Front 339

tx of uncomplicated ebv

Back 339

nsaids or tylenol

Front 340

chronic vomiting will produce what pH condition

Back 340

hypochloremic metabolic alkalosis

Front 341

what is the most common and worst s/e of azt

Back 341

most common - myopathy and gi
worst - leukopenia/macrocytic anemia

Front 342

how to tell the difference between graves and exogenous thyroid admin

Back 342

raiu - radioactive iodine uptake
graves: increased
factitious: decreased

Front 343

how long to treat uti in men

Back 343

7 days

Front 344

initial tx of aml

Back 344

ara c
plus
a rubacin: either dauno/ida

Front 345

how to tell the difference between cryptosporidium and cmv and mac diarrhea in aids pt

Back 345

crytosporidum: non bloody, acid fast
cmv: bloody
mac: dx if nothing else is positive

Front 346

what drugs must be stopped prior to ekg stress test

Back 346

ones that lower HR
Beta blockers
calcium channel blockers

Front 347

when do you do stress echo instead of ekg

Back 347

left bundle branch block
baseline st elevations/depressions
curretnly on dig

Front 348

more oxygen in right ventricle than right atra post mi dx

Back 348

septal rupture

Front 349

acute severe hypotension post mi

Back 349

free wall rupture/tamponade

Front 350

systolic mitral regurg murmur, peristent st elevations one month later post mi, dx

Back 350

left ventricle aneurysm

Front 351

canon a waves indicate

Back 351

atria and ventricle no synchronized

Front 352

canon a waves can be due to

Back 352

3rd degree heart block
v fib

Front 353

ten weeks post mi, low grade fever, pleuritic chest pain dx

Back 353

dresslers

Front 354

young person, develops chf picture dx

Back 354

mycocaditis, prolly coxasckie

Front 355

how to tell the difference between chf and primary pulmonary htn

Back 355

pulmonary capillary wedge pressure
pulmonary htn: normal pcwp
chf: increased pcwp

Front 356

pleural effusion, transudative, low glucose

Back 356

rheumatoid arthritis

Front 357

pleural effusion, transudative, high lymphocytes

Back 357

tb

Front 358

pleural effusion, transudative, bloody

Back 358

pe or cancer (cancer can be transudative sometimes)

Front 359

how to define complicated pleural effusion

Back 359

grams stain postive or culture positive
PH less than 7.2
glucose less than 60

Front 360

how to determine if pleural effusion is transudative or exudative

Back 360

Lungs/serum
PRotein .5
LDH .6
LDH <2/3 of normal serum: transudative

Front 361

copd patient comes in with new onsent clubbing, next step and probable dx

Back 361

chest x ray looking for cancer
dx: hypertrophic osteoarthropathy

Front 362

nodule in upper lobe with egg shell calcifications

Back 362

silicosis

Front 363

reticulonodular plaques in lower lobes

Back 363

asbetosis

Front 364

important referral in pt with sarcoid

Back 364

optho

Front 365

hearing loss, increased hat size

Back 365

pagets

Front 366

what antibody is positive in autoimmune hepatitis

Back 366

anti smooth muscle

Front 367

who gets chemoprophylaxis in known tb exposure

Back 367

kids less than 4

Front 368

strep bovis bacteremia next step

Back 368

colonoscopy

Front 369

hiv pt, seizure, rbc's in lp, aura next step

Back 369

start acyclovir for HSV

Front 370

hiv, person starts developing focal neuro signs mimicking MS, best dx step

Back 370

biopsy for PML

Front 371

Absolute neutrophil count less than 500 and fever, dx

Back 371

neutropenic fever

Front 372

most common cause of fever in neutropenic

Back 372

mucositis from NORMAL gi flora

Front 373

most common bugs in neutropenic fever

Back 373

pseudomonas
staph

Front 374

what is first line tx for neutropenic fever

Back 374

3rd gen cephalo

Front 375

what drug is added to empiric tx for neutropenic fever if there is a port present

Back 375

vanco for staph coverage

Front 376

if neutropenic fever pt doesnt not improve within 5 days of empiric therapy, what is next step

Back 376

amphotericin for suspected fungal cause

Front 377

metabolic alkalosis with increased urine chloride >20, hypertensive

Back 377

conn syndrome

Front 378

metabolic alkalosis with increased urine chloride >20, normotensive

Back 378

barter/gittleman

Front 379

metabolic alkalosis with decreased urine chloride <20

Back 379

vomiting
ng suction

Front 380

most common cause of the rta

Back 380

type one: lithium
two: myeloma
four: diabetes

Front 381

treatment for the rta

Back 381

one: oral bicarb and potassium
two: thiazide and k
four: fludrocortisone

Front 382

enveloped shaped crystals on ua

Back 382

ethylene glycol

Front 383

what type of stone with alkaline pee

Back 383

struvite (mg po4 ammonia)

Front 384

family hx of stones, what type

Back 384

cysteine (cannot abs cysteine)

Front 385

nephrotic pt with flank pain dx

Back 385

renal vein thrombosis

Front 386

mcc nephrotic in adult

Back 386

membranous

Front 387

nephrotic plus iv drug use

Back 387

fsgs

Front 388

neprhotic, chronic hepatitis, low complement

Back 388

membrano proliferative

Front 389

first clotting factor depleted in liver failure

Back 389

7
therefore what test will increase first
pt

Front 390

initial step in multifocal atrial tacy workup

Back 390

o2 stats

Front 391

first test to order in pt with suspected acromelgaly

Back 391

somatomedin c aka igf one

Front 392

pt presents with cholelithiasis but only abnomality found is dilated bile duct, next step and likley dx

Back 392

ercp
sphincter of oddi dysfunction

Front 393

pt has itp, no evidence of bleeding, when to start steroids

Back 393

less than 30,000

Front 394

how to treat hyper PO4

Back 394

oral calcium acetate and carbonate

Front 395

birbeck granules pathomneumonic for

Back 395

eosoinophlic granulomatosis also called histiocytosis x

Front 396

arthritis plus nail pitting or nail changes

Back 396

psoriatic arthritis

Front 397

next step when aortic stenosis is found

Back 397

echo

Front 398

first line tx for hepatic encephalopathy

Back 398

lactulose

Front 399

zoster tx

Back 399

anti viral plus desipramine (tca)

Front 400

severe allergic rhinitis that doesnt respond to antihistamines

Back 400

ten day of steroid

Front 401

what murmur is present in aortic dissection

Back 401

aortic regurg

Front 402

treatment of wegners

Back 402

STEROIDS AND CYCLOPHOSPHAMIDE

Front 403

treatment of CAP in comorbid patients

Back 403

ceftriaxone and azythro
or
amox/clax
or
quinolone

Front 404

what are the risks for squamous cell Ca in esophagus other than smoking and alcohol

Back 404

lye ingestion
achalasia

Front 405

what is TLC and DLco in asthma

Back 405

TLC: increased
DLco: normal

Front 406

next step if positive stress test

Back 406

angio/cath

Front 407

what is tx for hepatorenal

Back 407

transplant

Front 408

pigmented macrophages in colon on colonoscopy

Back 408

chronic laxative use: melanosis coli

Front 409

drug that is most effective at reducing mortality in MI

Back 409

aspirin

Front 410

what valve abnormailty is associte with coart

Back 410

aortic stenois (bicuspid aortic)

Front 411

otherwise healthy immigrant with new onset seizure next step

Back 411

head ct for neurocystercosis

Front 412

person is taking EPO for CKD, hb/hct increases, then starts to decrease, next step

Back 412

stop epo
transfuse
treat underlying cause (eg infection)

Front 413

treatment of 2nd degree av block

Back 413

PACEMAKER

Front 414

treatment of 3rd degree av block

Back 414

PACEMAKER

Front 415

axr doesnt show stone, but ct does, what type of stone and treatment

Back 415

uric acid,
oral hydration, pain killers, potassium citrate

Front 416

air in renal parenchyma,
dx, what is organism, and who is susceptible

Back 416

emphesematous pyelonephritis
e coli
diabetics

Front 417

person has super therapeutic INR and has cranial bleed, next step

Back 417

transfuse FFP

Front 418

asthmatic with pulsus paradoxicus, next step

Back 418

intubation

Front 419

CD8 and diffuse

Back 419

poly

Front 420

autoantibodies and perifascilar

Back 420

dermato

Front 421

treatment of iga nephropathy

Back 421

ace inhibitors

Front 422

in patient with diabetes what is goal cholesterol

Back 422

<one hundred

Front 423

treatment of fibromyalgia

Back 423

first: tricyclics
next: nsaid
plus: exercise

Front 424

next step in blood in stool in pts less than 45, greater than 45

Back 424

<45: anoscopy and sigmoidoscopy
>45: colonoscopy

Front 425

person has raynauds and positive nail fold microscopy, what are the at risk for

Back 425

mixed connective tissue disease

Front 426

varicies in mid esophagus and facial edema

Back 426

svc syndrome

Front 427

varicies in distal esophagus and stomach

Back 427

portal htn

Front 428

what bug and what is the tx of peritoneal dialsysis infection

Back 428

staph
keflex and ceftazidime

Front 429

is malaria in brazil resistant or non

Back 429

resistant

Front 430

what is the tx of strep pneumo meningitis in order

Back 430

first: dexamthasone
next: vanco
next: ceftriaxone

Front 431

gram negative rod, looks like safety pin, bipolar wright stain

Back 431

yersinia pestis

Front 432

thickening of stomach folds, hypoproteinemia

Back 432

menetriers disease

Front 433

brain mass with tail

Back 433

meningioma

Front 434

huge dilation of intrahepatic dcuts

Back 434

caroli disease

Front 435

difference between lepromatous and tuberculoid leprosy

Back 435

lepromatous: good immune function, will have granulomas and postive AFB

tb: no granuloma, poor immune

Front 436

what electrolyte is deficient in alcholics and what other deficiency will it cause

Back 436

Mg, will cause hypoCa due to it being needed for PTH

Front 437

how to tell the difference between PCP and strep pnuemo in aids

Back 437

PCP: interstitial pneumonia, chronic, cough for a while, no f/c/s

strep pneumo: lobar pneumonia, acute, much sicker, f/c/s

Front 438

pseudohyphal mycelia and budding yeast dx

Back 438

candida

Front 439

person has recurrent candida infections, what do yuo have to rule out

Back 439

DM first, then HIV

Front 440

palpable mass in abd, flank pain,, hematuria dx

Back 440

renal cell carcinoma

Front 441

HTN, flank pain, hematuria dx

Back 441

PCKD

Front 442

multiple skin cancers in sun exposed area

Back 442

xeroderma pigmentosa

Front 443

tx for pericarditis

Back 443

nsaid

Front 444

fever, bone pain, effusion, conjunctival hemorrahge dx

Back 444

dengue

Front 445

next step in a person with barrets and has
no dysplasia
low grade
high

Back 445

no dysplasia: enod every 3 years
low: 6-twelve months
high: surgery

Front 446

bleomycin side effect

Back 446

pulmonary fibrosis

Front 447

busulfan side effect

Back 447

pulmonary fibrosis

Front 448

vincristine/vinblastine side effect

Back 448

peripheral neuropathy

Front 449

cyclophosphamide side effect

Back 449

hemorragic cystitis

Front 450

cisplatin side effects

Back 450

deafness
renal failure

Front 451

what do you have to check before starting doxo

Back 451

ejection fraction

Front 452

anti histone antibodies

Back 452

drug induced lupus

Front 453

anti jo antibodies

Back 453

dermatomyositis

Front 454

initial management of anemia of chronic disease

Back 454

treat underlying cause

Front 455

acd is initially treated but fails to improve what is next step and goal Hb

Back 455

EPO
twelve

Front 456

treatment of CAP that needs hospitlaization

Back 456

quinolone: levo or moxi
doxy
ceftriaxone plus azythromycin

Front 457

Rugae of stomach are hypertrophied and look like brain gyri

Back 457

menetriers disease

Front 458

Back 458

sideroblastic anemia

Front 459

Back 459

hereditary spherocytosis

Front 460

Back 460

burr cells
pk deficiency

Front 461

Back 461

heinz bodies, bite cells,
g6pd

Front 462

Back 462

sickle cell

Front 463

Back 463

basophilic stippling in lead

Front 464

Back 464

auer rod in PML/AML

Front 465

Back 465

smudge cell in CLL

Front 466

Back 466

reed sternburg cell in hodgkin lymphoma

Front 467

microcytic anemia, increased iron, increased ferritin

Back 467

sideroblastic anemia

Front 468

6 month old with growth failure, hepatospleno, bony deformities

Back 468

B major thalessemia

Front 469

1. Hemolytic anemia
2. Pancytopenia
3. Venous thrombosis

Back 469

pnh

Front 470

what is osteitis derformans also called

Back 470

pagets disease

Front 471

how to tell the difference between osteopenia, osteoporosis, and osteomalacia

Back 471

osteoporosis: decreased bone matrix and mineralization,
Lab values in osteoporosis: normal
osteomalacia: normal bone matrix, decreased mineralization,
lab values in osteomalacia: abnormal

Front 472

most common cancer to affect non smoker

Back 472

ADENO

Front 473

normal calcium, decreased phosphate, normal PTH, increased alk phos, normal ggt, dx

Back 473

hypophosphatemic rickets

Front 474

bradycardia alternating tacy, with a fib or a flutter
dx and tx

Back 474

sick sinus syndrome
ventricular pacemaker

Front 475

resting ekg shows st depressions, next step

Back 475

stress echo NOT excercise

Front 476

waht is the first test to do if suspecting ZES

Back 476

serum gastrin

Front 477

when is a secretin test done

Back 477

to differentiate between gastrin secreting conditions
- secretin should suppress gastrin normally, in ZES it does not lower the level

Front 478

tx of papillary muscle rupture after mi

Back 478

emergency surgery

Front 479

best initial test in acs workup in person with previous MI or LBBB

Back 479

echo

Front 480

fever, stridor, unwillingness to move neck, trouble swalloing, drooling, next dx step and dx

Back 480

lateral neck xr
retropharyngeal abcess

Front 481

iv drug user, enlarged kidneys, nephrotic

Back 481

amyloid kidney

Front 482

rash, conjunctival hemorrhage, watery diarrhea, muscle aches, fever, dx

Back 482

toxic shock syndrome

Front 483

how do ocp's affect endometrial and ovarian cancer risk

Back 483

decrease both

Front 484

tx of acute gout attack in renal insuficinecy

Back 484

steroids
- have to avoid using indomethiacin or colchicine

Front 485

which anti tb drug causes anemia, what type andhow

Back 485

isonizaid
causes B6 deficiency leading to sideroblastic anemia

Front 486

if person has hypothyroid and macrocytic anemia, what do you have to think of as the cause of anemia

Back 486

autoimmune - has a high association with hashimotos hypothyroid

Front 487

what is the tx of paget

Back 487

bisphosphonates

Front 488

workup of thyroid nodules

Back 488

first step: TSH
if TSH low: do scintiography
if tsh normal or high: FNA

Front 489

best thing to reduce breast cancer risk

Back 489

tamoxifen therapy

Front 490

what is the inheritance of G6PD

Back 490

x linked recessive

Front 491

what is the inheritance of PK deficiency

Back 491

autosomal recessive

Front 492

what is sickle cell inheritance

Back 492

autosomal recessive

Front 493

what is inhertance of NF one

Back 493

autosomal dominant

Front 494

what is inheritance of CF

Back 494

autosomal recessive

Front 495

tay sachs and niemann picks inheritance

Back 495

autosomal recessive

Front 496

air in wall of gallbladder, crepitus on exam
dx and tx

Back 496

emphysematous cholecystitis
cipro, metro and surgery

Front 497

orange colored tonsils

Back 497

tangiers disease

Front 498

mutliple angiokeratomas on lower half of body

Back 498

fabry disease

Front 499

grey brown pigmentation of forehead, hands, pretibial region

Back 499

gauchers

Front 500

intubation then black stool dx

Back 500

stress gastritis

Front 501

retinal pigmentation, osteomas, colonic polyps, skin cysts dx

Back 501

gardeners syndrome (FAP)

Front 502

colon cancer, cns cancer dx

Back 502

turcot syndrome

Front 503

what is the oral tx of onchomycosis

Back 503

terbinafine
or
itraconazole

Front 504

if suspecting SLE, what is the first initial antibody test to do

Back 504

anti nuclear antibody (ANA)

Front 505

cd22 or cd11 positive

Back 505

hairy cell

Front 506

first test to order for EBV and best test for EBV

Back 506

heterophile
IgM to VCA

Front 507

treatment of asymptomatic hereditary spherocytosis

Back 507

folate

Front 508

next step in cholecystitis workup if us is non diagnostic

Back 508

hida scan

Front 509

positive drop test dx

Back 509

supraspinatus tear

Front 510

nstemi, treated with all the appropriate drug, continues to have chest pain, next step

Back 510

cath

Front 511

person presents asymptiomatically with elevated lft's, what is dx

Back 511

non alcoholic steatohepatitis

Front 512

what is the association iwth non alcoholic steatohepatitis

Back 512

metaboloc syndrome

Front 513

what is the response to ristocetin and adp in:
vwf
bernarnd soulier
glanzman

Back 513

vwf
ristocetin: no response
ADP: no response

bernard soulier
ristocetin: none
ADP: aggregation

glanzman
ristocetin: aggregation
ADP: none

Front 514

treatment for perosn with MI due to volume/blood loss

Back 514

transfusion

Front 515

treatment of fap once polyps form

Back 515

total proctocolectomy

Front 516

tx with specific abx of ascending cholangitis

Back 516

fluids
ceftriaxone and metron
elective sphincterotomy 72 hours later

Front 517

treatment of graves disease versus thryoid adenoma

Back 517

graves: radioactive iodine ablation
thyroid adenoma: beta blocker, ptu or methi then ablation

Front 518

how to prevent tumor lysis syndrome

Back 518

fluids
allopurinol or rasburicase

Front 519

best initial test if suspecting RAS

Back 519

duplex

Front 520

treatment of asymptomatic aortic stenosis

Back 520

ace or arb

Front 521

cardiogenic shock tx

Back 521

inotropes like dobutamine

Front 522

increased range of motion in joint, redness, erythema, diabetic dx

Back 522

charcot joint

Front 523

new onset ascites in woman, must make you think of what dx

Back 523

ovarian cancer

Front 524

pregnant woman develops intense ithcing and increasing bili, next step

Back 524

deliver fetus since the increasing bili is toxic to it

Front 525

tingling of butt and butt pain, worsned by sitting down and bicyle ride, no low back pain, dx

Back 525

piriformis syndrome
if there was low abck pain : sciatica

Front 526

next step in evaluating person with HOCM after trans thoracic echo

Back 526

24 hour holter

Front 527

what type of testicular tumor is in an older man with signs of feminization

Back 527

leydig (makes lots of androgens)

Front 528

next step if new onset heart failure and chest pain

Back 528

angio

Front 529

loud P2 indicates

Back 529

increased pulmonary artery pressure or mitral stenosis

Front 530

what are FSH, LH and FSH/LH ratio in premature ovarian failure

Back 530

fsh: increased
LH: increased
fsh/lh: >1

Front 531

presence of bilirubin in urine indicates what type

Back 531

conjugated (able to be excreted, unconjugated not)

Front 532

how to tell the difference between breastfeeding failure jaundice and breast milk jaundice

Back 532

breastfeeing failure: will not be making enough wet diapers

breast milk: will be essentially normal but has jaundice

Front 533

what are the initial steps in esophageal varicies bleed

Back 533

first: fluids
next: octreotide
next: ceftriaxone abx ppx

Front 534

treatment of basic physiologic profile <4

Back 534

immediate delivery if >26 weeks

Front 535

treatment of bartonella

Back 535

azythromycin

Front 536

what is the step wise approach for the treatment of ascites

Back 536

first: salt and fluid restriction
next: spironolactone
next: furosemide
next: tap the ascites

Front 537

person has circumfrential burn, steps in management

Back 537

first: escarotomy
next: abx
if no relief: fasciotomy

Front 538

mobile cavitary lung lesion with hemoptysis

Back 538

aspergillous

Front 539

biggest risk of asymptomatic bacturia in pregnant pt

Back 539

pyelo leading to pre term birth

Front 540

baby hasnt moved in two days, no heart sounds on doppler, next step

Back 540

real time ultrasound

Front 541

management of preterm labor at:
24-34 weeks

Back 541

first: steroids
next: tocolysis to help get to 34 weeks

Front 542

which one is not covered in a membrane, gastrochesis or omphalocele

Back 542

gasrochesis

Front 543

fever, drooling, muffled voice, trouble swallowing, thumb sign on lateral xr

Back 543

epiglottitis

Front 544

fever, drooling, muffled voice, trouble swallowing, widened vertebral spacing on lateral xr

Back 544

retropharyngeal abscess

Front 545

solitary lytic bone lesion with hypercalcemia in peds pt

Back 545

langerhans histocytosis

Front 546

40yo woman, dysmenorrhea, menorrhagia, enlarged symmetrical uterus

Back 546

adenomyosis

Front 547

40yo woman, dysmenorrhea, menorrhagia, enlarged asymmetrical uterus

Back 547

leomyoma (fibroid)

Front 548

what vaccines should HIV get

Back 548

yearly flu
HBV
strep pneumo
HAV if men have sex with men

normal guidelines for: HPV, tDap, H flu

Front 549

first line management for idiopathic intracranial hypertension

Back 549

acetozolamine +/- furosemide

Front 550

what 2 infections can cause flaccid paralysis
(lmn lesion)

Back 550

polio
west nile

Front 551

most common causes of bacterial meningitis in these age groups:
0-1month
1month -2yr
2-18yr
18-60
60+

Back 551

0-1month: GBS, e coli, listeria
1month -2yr: S pneumo, neisseria
2-18yr: Neisseria, pneumo
18-60: pneumo, neisseria
60+: pneumo:, listeria, neiseria

Front 552

treatment of meningitis in these age groups:
0-1month
1month -2yr
2-18yr
18-60
60+

Back 552

0-1month: amp/gent, amp/ceftriaxone,
1month -2yr: ceftriaxone (maybe add vanco)
2-18yr: vanco, ceftriaxone, dexa
18-60: vanco, ceftriaxone, dexa
60+: ampicillin, ceftriaxone, dexa
TB meningitis: 4 drug regimen

Front 553

where is lesion if have:
eyes looking toward lesion

Back 553

FEF

Front 554

where is lesion if have:
eyes look away

Back 554

PPRF

Front 555

where is lesion if have:
upward gaze paralysis

Back 555

superior colliculus
(parinaud syndrome)

Front 556

where is lesion if have:
poor repetition

Back 556

arcuate fasiculus

Front 557

where is lesion if have:
dysarthria

Back 557

cerebellar vermis

Front 558

where is lesion if have:
agraphia and acalculia

Back 558

dominant parietal lobe

Front 559

what is the ppx for unvaccinated children exposed to Hib

Back 559

rifampin (same as neisseria)

Front 560

kid, hypoglycemia, encephalopahty, recent illness, dx

Back 560

reye syndrome
- hypoglycemia due to hepatic dysfunction

Front 561

suspecting a viral encephalitis, where would you see swelling in the brain

Back 561

thalamus

Front 562

dx, encephalitis with:
skin lesions, aura

Back 562

HSV

Front 563

dx, encephalitis with:
parotid swelling

Back 563

mumps

Front 564

dx, encephalitis with:
flaccid paralysis and maculopapular rash

Back 564

west nile

Front 565

what is the managemnt of brain abscess

Back 565

1. abx
2. STEROIDS
3. drainage

Front 566

young female with migraine with aura, what should she NOT be on

Back 566

oral contraceptives
increases risk of stroke

Front 567

1. Contralateral lower limb hemiparesis
2. Contralateral loss of proprioception
3. Ipsilateral tongue deviation
dx

Back 567

medial medullary syndrome

Front 568

what is medial medullary syndrome due to
what tracts are involved in
what tracts are spared

Back 568

anterior spinal artery occlusion
- LATERAL corticospinal (so lower limbs)
- Medial lemniscus carrying dorsal column
- Hypoglossal nerve

areas spared: spinothalamic

Front 569

what is lateral wallenburg due to
what area is involved
what deficits

Back 569

- PICA occlusion from vertebral
- lateral medulla

- hoarsness/dysphagia (nucleous ambiguous)
- vomiting vertigo
- horners
- loss of P&T to face

Front 570

what is lateral pontine syndrome due to
what area is involved
what deficits

Back 570

occlusion of AICA
- lateral pons

- FACIAL paralysis, decreased tearing (CN7 nucleus)
- hearing loss (CN8)
- horners
- n/v/vertigo

Front 571

facial weakness, dyarthria, dysphagia, weakness of one hand dx

Back 571

dysarthria clumsy hand syndrome
- type of lacunar stroke

Front 572

one sided full body weakness, combination of cranial nerve deficits dx

Back 572

basilar artery stroke

Front 573

what type of brain bleed gets seizure ppx

Back 573

parenchymal bleeds

Front 574

what 2 diseases most commonly cause NPH

Back 574

sub arachnoid
chronic meningitis

Front 575

increased afp on quad screen, think of what 2 defects and what 2 conditions

Back 575

most common: inaccurate age
defects:
neural tube
omphalocele/gastrochisis

could also be: multiple gestations

Front 576

decreased afp on quad screen

Back 576

down syndrome and turner

Front 577

the Rb gene mutation predisposes you to what two conditions

Back 577

retinoblastoma
osteosarcoma

Front 578

indications for cea

Back 578

symptomatic >60%
asymtomatic >80%

Front 579

biconvex lens hematoma

Back 579

epidural

Front 580

crescent shaped hematoma

Back 580

subdural

Front 581

treatment for tourette

Back 581

first line:
risperidone
guanfacine/clonidine

best overall:
haloperidol
pimozide

Front 582

what are the three most common causes of neonatal respiratory distress and what are they due to

Back 582

transient tacypnea of newborn
- all the mucus hasnt been cleared yet

neonatal respiratory distress
- deficient surfactant

persistent pulmonary HTN
-persistant shunting through pfo and pda in post term infants

Front 583

how to tell persistent pulmonary htn, respiratory distress and transient tacypnea from each other

Back 583

CXR
PP HTN: clear lung fields
RDS: ground glass opacities
TTNB: linear perihilar streaking

Front 584

first line tx for pin worm

Back 584

albendazole/mebendazole

Front 585

bilious vomiting in first days of life ddx

Back 585

biliary atresia
necrotizing enterocolitis

Front 586

what heart defects are associated with down

Back 586

complete AV canal - most common
vsd
asd

Front 587

what GI defects are associated with down

Back 587

biliary atresia
hirschprungs disease
imperforate anus

Front 588

mcc of asymptomatic vaginal discharge

Back 588

chlamydia

Front 589

orthostatic hypotension, impotence, rigidty, tremor, dx

Back 589

shy drager

Front 590

painful third semester bleeding dx

Back 590

abrupto placenta

Front 591

non painful third trimester bleeding

Back 591

placenta previa

Front 592

symmetrical arthritis involving wrist, mcp, pip, goes away after 20 min, no esr elevation, dx

Back 592

parvovirus arthirtis

Front 593

broad/waxy casts dx

Back 593

chronic renal failure

Front 594

ppx for cat bites

Back 594

amox/clav

Front 595

sudden loss of vision and floaters

Back 595

vitreous hemorrhage

Front 596

what causes the physiologic changes associated with pregnancy

Back 596

progesterone

Front 597

HIV pt, painless vision loss, fluffy granular lesions around vessels

Back 597

CMV

Front 598

HIV, painful vision loss, keratitis

Back 598

HSV

Front 599

first line tx for endometritis

Back 599

clindamycin and gent

Front 600

what are the three most common cdv anomalies in turner

Back 600

biscupid aortic (most common)
coarct (#2)
aortic root dilation (#3)

Front 601

how to tel the difference between legg calves perthes and SCFE

Back 601

legg: kids <10 and chronic pain
SCFE: fat teens, >10 and insiduous pain

Front 602

what arrythmia does dig cause

Back 602

Atrial tacy with AV block

Front 603

next test if elevated AFP

Back 603

us

Front 604

when is amniocentesis done

Back 604

after 16 weeks
abnormal quad screen
women >35

Front 605

when can cvs be done

Back 605

earlier than amnio
10-12 weeks
-has greater risk than amnio

Front 606

Normal breast, absent uterus/blind vagina, normal ovaries, normal axillary hair

Back 606

mullerian agenesis
normal breast = estrogen present
normal axillary hair = androgens present
ovaries present: NOT a mullerian structure

Front 607

Normal breast, absent uterus/blind vagina, no axillary/pubic hair, dx and complication

Back 607

dx: androgen insensitivity
complication: testicular cancer

Front 608

ddx of early post partum bleeding and how to tell apart

Back 608

1. Uterine atony – boggy uterus seen
2. Genital tract laceration - firm uterus yet bleeding
3. Uterine inversion – something sticking out of cervix
4. Placental accrete or retained placenta

Front 609

what cell type makes surfactant

Back 609

type 2 pneumocytes

Front 610

when is quad screen done

Back 610

16-18 weeks

Front 611

when is gbs screened for

Back 611

36 weeks

Front 612

increased nuchal translucency what 3 things

Back 612

down
turner
hear defect

Front 613

when does surfactant production begin

Back 613

24 weeks

Front 614

how does bp change in pregnancy

Back 614

decreases in first 2 trimesters, normalizes in third
- therefore any HTN is abnormal

Front 615

how are RV, FRC, and ERV, and minute ventilation changed in pregnancy

Back 615

RV: decreased
FRC: decreased
ERV: decreased
(all due to diaphram being pushed up)
minute vent: increased (due to increased TIDAL volume, not RR)

Front 616

how much weight should a woman gain in pregnacy if bmi:
<20
25-35
>35

Back 616

<20: 35lbs
25-35: 25lbs
>35: 15lbs

Front 617

increased inhibin A

Back 617

down syndrome or turner

Front 618

how to tell tri 21 from tri 18

Back 618

hcg
21: increased
18: decreased

Front 619

what other condition will have the same quad screen values as down

Back 619

turner

Front 620

what cardiac defect is seen in diabetic moms

Back 620

transpostion of great vessels

Front 621

epileptic woman gets pregnant, what to do with meds

Back 621

keep same anticonvulsants
-give folic acid and vitamin K in last trimester

Front 622

first line tx for hyperemesis gravidarum

Back 622

B6 pyridoxine
doxalamine

Front 623

how is normal n/v in pregnancy distinguished from hyperemesis

Back 623

weight loss >5%
ketones in urine

Front 624

how are migraines treated in pregnancy

Back 624

opioids
cant use any of the first line stuff

Front 625

ace/arb teratogen effect

Back 625

oligohydramnios
pulmonary hypoplasia
due to: renal agenesis

Front 626

aminoglycoside teratogen

Back 626

hearing loss

Front 627

CBZ teratogen

Back 627

FINGERNAIL hypoplasia
neural tube
facial abnormalities

Front 628

Diazepam teratogoen

Back 628

cleft palate

Front 629

DES teratogen

Back 629

clear cell adeno in vagina and cervix

Front 630

retinoids teratogen

Back 630

hydrocephalus
CNS defect
microtia ==> underdeveloped ear

Front 631

thalidomide teratogen

Back 631

limb shortening

Front 632

sulfa drugs teratogen

Back 632

kernicterus/bile issues

Front 633

valproate

Back 633

neural tube
HYPOSPADIA

Front 634

warfarin

Back 634

Abortion
LIMB HYPOPLASIA

Front 635

hydrocephalous, intracranial calcifications, chorioretinitis in newborn dx

Back 635

toxo

Front 636

hepatospleno, hemolytic anemia, jaundice, blood tinged nasal secretions in newborn dx

Back 636

syphilis

Front 637

deafness, cataracts, cardiac malformations, blueberry muffin rash in newborn

Back 637

rubella

Front 638

what cardiac abnormalities will be seen in rubella

Back 638

PDA
pulmonary artery stenosis

Front 639

unilateral hearing loss, microcephaly, intracranial calcifications, chorioretintis in newborn

Back 639

CMV

Front 640

conjunctivitis in newborn:
<24hours
2-5 days
>5 days

Back 640

<24 hrs; chemical from silver nitrate
2-5 days: gonococcal
>5 days: chlamydia

Front 641

encephalitis, pneumonia, choroioretinitis, scarring on skin in newborn, dx and tx

Back 641

VZV
VZV immune globin
scarrring will be in dermatomal pattern

Front 642

hydrops fetalis cause

Back 642

parvo b19

Front 643

what indications are for gbs ppx

Back 643

- if gbs is detected at 36 weeks
- gbs bacturia
- hx of gbs in previous birth
- prolonged rupture of membrane

Front 644

all pregnant women should be screened for what infections

Back 644

HIV
HBV
syphilis

Front 645

blunting of calyces and scarring on IVP dx

Back 645

chronic pyelo

Front 646

how to treat anorexia and cachexia due to cancer

Back 646

progesterone analogs like:
medroxyprogesterone
megestrol acetate

Front 647

elevation of alk phos in elderly and no symptoms, dx

Back 647

pagets

Front 648

decreased FEV/FVC ratio, normal DLCO
what 2 conditions

Back 648

chronic bronchitis
asthma

Front 649

big round cyst with daughter cyst
who is at risk and dx

Back 649

sheep farmers
echinococcus

Front 650

anterior shoulder dislocations can damage what nerve

Back 650

axillary

Front 651

one sided sensory loss with increased pain to touch, where was stroke

Back 651

thalamus

Front 652

strongest risk factor for stroke

Back 652

HTN

Front 653

what is the only contraindication to rotavirus vaccine

Back 653

prior hx of intussception

Front 654

us of kid shows abdominal circumference <10% for gestational age dx

Back 654

iugr

Front 655

most common causes of symmetric and asymmetric iugr

Back 655

symmetric: congenital infection, chromosomal
assymmetric: poor maternal health (more common than symmetric)

Front 656

what is oligohydramnios associated with in
first
second
third trimester

Back 656

first: spontaneous abortion
appears in second: renal abnormalities
appears in third: premature rupture of membranes

Front 657

treatment of polyhydramnios
<32 weeks
>32 weeks

Back 657

<32 weeks: indomethiacin + amnioreduction
>32 weeks: amnioreduction

Front 658

treatment of premature rupture of membranes:
<32 weeks

Back 658

<32:
- steroids
- tocolysis for 48 hours
- Penicillin ABX ppx

Front 659

treatment of premature rupture of membranes:
32-34 weeks

Back 659

depends on fetal lung maturity
- check amniotic fluid
- give steroids
- tocolysis
- ABX ppx

if mature:
- induce labor
- ABX ppx

Front 660

how is fetal lung maturity determined

Back 660

either
- L:S ratio >2
- presence of PG

Front 661

treatment of premature rupture of membranes:
>34 weeks

Back 661

- induce labor
- abx ppx

Front 662

what are the signs of mag tox

Back 662

first: loss of DTR
next: resp failure/pulmonary effusion
last: cardiac failure

Front 663

what is the surveillance for multiple gestations

Back 663

- weekly f/u starting at 24 weeks
- weekly non stress tests at 36

Front 664

what is considered a reactive fetal stress test

Back 664

2 or more 15bpm accels for at least 15 sec

Front 665

whqt are the steps in a non reassuring fetal HR

Back 665

1. O2, turn off pitocin, left lateral decubitus
2. give terbutaline
3. correct maternal hypotension (epidural commonly causes)
4. Vaginal exam
5. Fetal scalp electrode

Front 666

dx, due to, tx

Back 666

dx: early decel
due to: head compressrion
tx: none

Front 667

dx, due to, tx

Back 667

dx: late decel
due to: uteroplacental insufficiency, hypoxia
tx: prompt delivery

Front 668

dx, due to, tx

Back 668

dx: variable decel
due to: cord compression
tx: change mothers position

Front 669

sinusoidal fetal heart rhythm due to

Back 669

anemia

Front 670

definition and time to complete:
stage 1, latent phase

Back 670

def: start of contractions to 4cm
time to complete:
nulli: 20 hours
mutli: 14 hours

Front 671

definition and time to complete:
stage 1, active

Back 671

def: 4-10cm
>12 hours
nulli: 1.2/hour dilation
multi: 1.5/hour dilation

Front 672

definition and time to complete:
stage 2

Back 672

def: 10cm to delivery
nulli: <2 or 3 with epi
multi: <1 or 2 with epi

Front 673

definition and time to complete:
stage 3

Back 673

def: delivery until passage f placenta
time: 30 minutes

Front 674

what is arrest of descent

Back 674

prolonged stage 2

Front 675

treatment of uterine hyperstimulation

Back 675

terbutaline to slow conractions

Front 676

when are cephalic maneuvers offered for breech presenation

Back 676

36 weeks

Front 677

what is the most common type of breech presentation

Back 677

Frank: feet to face

Front 678

what is the definition of post partum bleeding

Back 678

vaginal: >500ml
c section: >1 liter

Front 679

treatment of post partum bleeding

Back 679

first: uterine massage
next: oxytocin
if not stopped: methergine or prostaglandin
if all else fails: embolization/ligation/hysterectomy

Front 680

when to supect endometritis

Back 680

fever post partum
uterine tenderness
foul smelling lochia
leukocytosis

Front 681

when can ocp's be started up after bitth

Back 681

6 weeks due to dvt risk

Front 682

hypoxia, shock, dic, immediately post partum dx

Back 682

AMNIOTIC FLUID EMBOLI

Front 683

what types of hyaditform moles exist and what are their genotypes

Back 683

complete: 46
incomplete: 69

Front 684

how to tell complete and incomplete moles apart

Back 684

HCG: much higher in complete
fetal parts: found in incomplete
preeclampsia, hyperemesis, or hyperthyroidism: complete

Front 685

when to suspected molar pregnancy

Back 685

- pre ecclampsia in first half of pregnancy
- hyperemeis gravid
- hyperthyroid
- B HCG higher than expected for age

Front 686

when to suspect choriocarcinoma

Back 686

- post partum bleeding past 6 weeks
- HCG levels do not do down or increases after delivery

Front 687

grape like vesicles coming from vagina dx

Back 687

molar pregnancy

Front 688

workup of single pulmonary nodule in :
low
intermediate
high risk

Back 688

low: serial ct
intermediate: <1 cm: serial ct
intermediate: >1 cm: PET scan then broch
high: resection

Front 689

how to tell the type of murmur in down sydrome

Back 689

AV canal: systolic regurg with loud S2
ASD: fixed split S2
VSD: holosystolic

Front 690

young woman, pain with climbing or going down stairs dx

Back 690

patello femoral

Front 691

treatment of pericarditis in renal failure

Back 691

dialysis

Front 692

kid with absent thymic shadow, tons of weird infections, dx

Back 692

scid

Front 693

when should birth weight double

Back 693

4 month

Front 694

when should birth weight triple

Back 694

12 mo

Front 695

when should birth weight quadruple

Back 695

24mo

Front 696

abnormal growth from birth should suggest

Back 696

prenatal cause

Front 697

normal weight at birth then starts to decline should suggest

Back 697

post natal cause

Front 698

consistently low normal growth suggests

Back 698

genetic short stature

Front 699

when is first dose of HBV given

Back 699

right after birth

Front 700

when does toilet training begin

Back 700

2-3 yr

Front 701

when can infant start eating solid food

Back 701

4-6mo

Front 702

when can infant drink whole milk

Back 702

1 year

Front 703

how may DTaP vaccines in total by 6yo

Back 703

5

Front 704

how many HiB by 18mo

Back 704

4

Front 705

when can a child tie shoe laces

Back 705

5

Front 706

next step if single umbilical artery

Back 706

renal ultrasound

Front 707

difference between caput succedaneum and cephalohematoma

Back 707

caput cross sutures

Front 708

next step if newborn female has bloody or white vaginal dishcharge

Back 708

nonthing, normal

Front 709

spider webbbing or marbling of newborn skin,
dx and tx

Back 709

dx: cutis marmorata
tx: none

Front 710

yellow pustules with red base with eosinophils on it on newborn
dx and tx

Back 710

erythema toxicum
leave alone

Front 711

intense reddening on gravity dependent side, blanching on opposite in newborn
dx and tx

Back 711

harlequin color change
leave alone

Front 712

bluish discoloration over buttoks and base of spine in newborn
dx and tx

Back 712

mongolian spot
DOCUMENT IT

Front 713

how to tell neonatal acne from infantile acne

Back 713

neonatal - occurs around 3 weeks
infantile - 3 months

Front 714

superficial pustules overlying hyperpigmented macules in newborn

Back 714

transient neontal pustular melanosis

Front 715

when is a child most at risk for sids

Back 715

2-4 months

Front 716

what to suspect when anterior fontanelle isnt closed by 2 years

Back 716

1. down
2. achondroplasia
3. rickets
4. hypothyroid
5. increased ICP

Front 717

soft occipital bone like ping pong ball classic for

Back 717

rickets

Front 718

white gray spots with red base on buccal mucosa, rash that starts on behind ears and spreads dx

Back 718

rubeola measles

Front 719

lymphadenopathy then rash that starts on face and spreads

Back 719

rubella german measles

Front 720

oral vesicles on mouth and tongue, with rash

Back 720

coxsackie

Front 721

ddx for desquamating of hands and feet

Back 721

1. scarlet fever
2. kawasaki
3. TSS

Front 722

high fever, kid is acting normal, bulging anterior fontanella, then develops rash

Back 722

roseola HHV6

Front 723

fever and mouth ulcers that keep reappearing every month dx

Back 723

periodic fever apthous ulcer pharyngitis and adenitis

Front 724

what kids need a workup for UTI

Back 724

any boy
girls <3
febrile UTI

Front 725

what is the workup for a child with UTI

Back 725

VCUG
renal US

Front 726

respiratory quotient >1 means

Back 726

excess carbs in diet

Front 727

fever, severe, morning headaches, focal neuro signs dx

Back 727

brain abscess

Front 728

should dystocia with clavicle irregularity

Back 728

fractured clavicle

Front 729

shoulder dystocia with crepitus over upper arm and irregularity

Back 729

humerus fracture

Front 730

shoulder dystocia with ptosis and miosis

Back 730

klumpke palsy
c8, t1

Front 731

shoulder dystocia, intact grasp reflex, decreased bicep and moro

Back 731

erb duchenne palsy

Front 732

battery is found in kids:
esophagus
distal to esophagus

Back 732

e: endoscopic removal
distal: wait for it to pass and f/u with xr

Front 733

hammer toes, ataxia, dysarthia, frequent falls, scoliosis

Back 733

friedrichs ataxia

Front 734

what are the leading causes of death in friedrichs ataxia

Back 734

hypertrophic cardiomyopathy
respiratory complications

Front 735

the more precise a study is the ____ the confidence interval

Back 735

smaller

Front 736

"dimorphic" (2 sizes of RBC on smear), normal iron studies, dx

Back 736

sideroblastic anermia

Front 737

mosaic pattern of lamellar bone

Back 737

paget

Front 738

what is the cause of the edema in a person with bilateral wheezes, jvd, no pulmonary edema, peripheral edema, ascites

Back 738

pulmonary artery HTN

Front 739

recurrent otitis media, pneumonia, diarrhea, no viral or fungal infections, no B cells on peripheral smear, dx

Back 739

Brutons Agamma globulinemia

Front 740

no thymic shadow ddx

Back 740

digeorge
scid

Front 741

kid with daily fevers, rash, arthritis, anemia, leukocytosis dx

Back 741

JRA or ALL

Front 742

if a child has a TE fistula what else do you have to look for

Back 742

VATER
Vertebral Abnormalities
Anal Imperforation
TE Fistula
Renal Anomalies

Front 743

treatment of kawasaki disease

Back 743

aspirin
IVIG

Front 744

male with features of turner syndrome

Back 744

noonan syndrome

Front 745

situs inversus, chronic sinusitis, otitis media

Back 745

kartagener syndrome

Front 746

painless rectal bleeding in early childhood, how to dx

Back 746

meckel
technetium scan

Front 747

infant between 4-10 months with colicky abd pain, normal behavior when pain goes away

Back 747

intussception

Front 748

bloody diarrhea + cns features

Back 748

shigella

Front 749

poor smooth pursuit of target with eyes, ataxia, rash on face, increased AFP

Back 749

Ataxia telangiectasia

Front 750

NBT test stays yellow dx

Back 750

chronic granulomatous disease

Front 751

albinism, recurrent skin infections, recurrent respiratory infections, giant cytoplasmic granules in MNs

Back 751

chediak higashi disease

Front 752

delayed separation of umbilicus

Back 752

leukocyte adhesion deficiency

Front 753

young kid with recurrent infections, doughy skin, two sets of teeth

Back 753

Jobs Hyper Ig E syndrome

Front 754

hypopigmented macules on woods lamps, leathery skin thickening, at risk for what tumors

Back 754

rhabdomyomas
brain hamartomas
renal angiolipomas

Front 755

lactic acidosis, hepatosplenomegaly, severe fasting hypoglycemia, increased glycogen in liver dx

Back 755

von gierke

Front 756

cardiomegaly, diaphragm weakness on young kid

Back 756

pompe

Front 757

hepatomegaly, hypoglycemia, normal lactate in kid

Back 757

cori

Front 758

painful muscle cramps in young kid with excercise

Back 758

mcardles

Front 759

vitamin or mineral deficiency:
increased RBC fragility

Back 759

vit E

Front 760

vitamin or mineral deficiency:
dermatitis, glossitis, cheilosis

Back 760

iron
or
B vitamins

Front 761

dermatitis, diarrhea, dementia

Back 761

Niacin B3

Front 762

headache and extraocular muscle palsies

Back 762

cavernous sinus thrombosis

Front 763

drug that causes gingival hyperplasia as side effect

Back 763

phenytoin

Front 764

what type of seizure has hallucinations, deja vu, and post ictal confusion

Back 764

complex partial

Front 765

what type of seizure has spike and wave pattern on eeg

Back 765

abscence

Front 766

treatment of serotonin syndrome

Back 766

1. stop drug
2. supportive
3. cyproheptadine

Front 767

treatment of TCA overdose

Back 767

sodium bicarb

Front 768

what are contraindications to buproprion

Back 768

1. seizure
2. alcoholics
3. eating disorders

Front 769

depression with poor appetite tx

Back 769

mirtazepine

Front 770

pt has sexual dysfunction from ssri, what is tx

Back 770

switch to buprioprion

Front 771

treatment of nephrogenic DI from lithium

Back 771

thiazide
PLUS
amiloride

Front 772

how are phobias treated

Back 772

CBT

Front 773

how to distinguish amphetamine intox from heroin withdraw

Back 773

heroin withdraw: patients appear agitated amphetamine: have psychotic sx

Front 774

Anxiety, auditory hallucinations, tremors, n/v withdrawing from what

Back 774

Benzo

Front 775

what are the 3 possible pharm tx for nms

Back 775

1. Dantrolene
2. bromocryptine
3. amantadine

Front 776

Nausea, vomiting, abd pain, muscle and joint aches, pupillary dilation

Back 776

Heroin withdraw

Front 777

first degree relatives of bipolar have what % of getting it

Back 777

25

Front 778

treatment of atypical depression

Back 778

phenelezine (MAOi)

Front 779

what drugs increase lithium levels

Back 779

nsaids
ace
thiazides

Front 780

person is being treated for depression, stops his med then feels depressed 2 days later what drug was he on

Back 780

paroxetine

Front 781

What part of the brain is wrong in tourettes

Back 781

Basal ganglia

Front 782

what other disorders are these drugs used for:
imipramine
desipramine

Back 782

imipramine: enuresis
deipramine: OCD

Front 783

torticolis or clenched jaw after starting new drug
dx and tx

Back 783

dx: acute dystonia
tx:
1. Benztropine
2. Diphenhydramine

Front 784

treatment of parkinsons symptoms after starting drug

Back 784

benztropine

Front 785

drug side effect of Feelings of restlessness, pacing, “engine inside me”
dx and tx

Back 785

dx: akasthesia
tx:
Short term tx: Benzos
Long term tx: Propranolol

Front 786

lip smacking, excess blinking, writhing movements of mouth months after starting new drug
dx and tx

Back 786

dx: tardive dyskinesia
tx:
Tx: Benzos, beta blockers

Front 787

Which two antipsychotics are weight neutral:

Back 787

1. Aripiprazole
2. Ziprasodone

Front 788

which two antipsychotics cause weight gain

Back 788

olanzapine
clozapine

Front 789

What side effects are seen with clozapine

Back 789

1. Prolonged QT
2. Agranulocytosis
3. Hyper PRL
4. myocarditis
5. seizures
6. most anticholinergic
7. bad metabolic

Front 790

which anti convulsant causes kidney stones

Back 790

topiramate

Front 791

who gets pertussis ppx for fourteen days

Back 791

everyone reguardless of immunization status

Front 792

hepatomegaly and inflammation and destruction of medium sized bile ducts

Back 792

PBC

Front 793

person with first unprovoked seizure, they will get what

Back 793

imaging
- either CT without or MRI

Front 794

workup of primary amenorrhea

Back 794

Pelvic US
- If no uterus: Karyotype and Testosterone
- If uterus: FSH
FSH high: Karyotype
FSH low: pituitary MRI

Front 795

throat infection, given amoxicillin/penicillin then develops rash

Back 795

EBV

Front 796

von gierkes deficient in what

Back 796

g6p enzyme

Front 797

pt has spleen removed, what to give afterwards

Back 797

vaccinations
daily penicillin ppx for 5 yrs after

Front 798

child who still has persistent ear discharge weeks after being treated

Back 798

cholesteatoma

Front 799

treatment of symptomatic and asymptomatic sarcoid

Back 799

asymptomatic: should go away on own
symptomatic: steroids

Front 800

prior to what year to pts need to be screened for both hbv and hcv if they received a blood transfusion,
only hcv?

Back 800

86
92

Front 801

sickler with drop in Hb, but no rise in retic count, dx and tx

Back 801

aplastic crisis
tx: transfusions

Front 802

how is aplastic crisis different from aplastic anemia

Back 802

aplastic crisis: only hb is down
aplastic anemia: pancytopenia

Front 803

fever, chest pain, infiltrates on cxr in sickler, dx

Back 803

acute chest syndrome

Front 804

what is the bug that causes endocarditis after urinary procedures

Back 804

enterococcus

Front 805

what endocrine issues will be associated with depression

Back 805

high cortisol - will not be suppressed by dexa
hypothyroid

Front 806

treatment of depression with psychotic features

Back 806

antipsychotic

Front 807

most common complication of supracondylar fracture

Back 807

brachial artery injury

Front 808

how to tell reactive arthritis from gonococcal

Back 808

reactive: has mouth ulcers, eye involvment
gonococcal: rash, fever

Front 809

ddx of delayed passage of meconium

Back 809

hirchsprungs disease
CF

Front 810

kid with webbed neck, short stature, cleft lip, shielded chest, macrocytic anemia, no retics being made, normal platelets, normal leukocytes

Back 810

diamond blackfan anemia
- key is only decreased hb, normal plt and leuks

Front 811

tick bite, leukopenia, thrombocytopenia, elevated liver enzymes dz

Back 811

ehlichiosis

Front 812

tick bite, rash, jaundice, dark urine, hemolysis

Back 812

babesia

Front 813

person making illegal drugs develops parkinsons, dx

Back 813

MPTP poisoning

Front 814

unilateral progressive motor weakness, intact sensation, fasiculations

Back 814

ALS

Front 815

what are the C's of HD

Back 815

CAG repeat
Caudate and Putamen Atrophy
AcH decrease
GABA decrease

Choreaoform
Crazy

Front 816

treatment of HD

Back 816

block dopamine with antipsychotics

Front 817

central vision loss, loss of eye aduction with nystagmus in other, eye pain

Back 817

MS
dx:
- optic neuritis
- INO

Front 818

best test to dx MS

Back 818

MRI

Front 819

dx of MG

Back 819

edrophonium tensilon test
postive AcH antibodies

Front 820

bilateral facial paralysis ddx

Back 820

lyme
GBS

Front 821

tx for bells palsy

Back 821

glucocorticoids
eye care

Front 822

symmetric muscle weakness, decreased reflexes, intact sensation dx

Back 822

GBS

Front 823

what finding is seen on LP for GBS

Back 823

increased protein, normal WBC
called: albumino cytological dissociation

Front 824

how to dx GBS

Back 824

EMG

Front 825

all pts with MG require what imaging

Back 825

CT chest for thymoma

Front 826

most common brain tumors in adults

Back 826

MGM Studios
1. Mets
2. GBM
3. Meningioma
4. Schwannoma

Front 827

Most common brain tumors in kids

Back 827

Astrocytoma
Medulloblastoma
Ependymoma

Front 828

next step in dx workup if brain cancer found

Back 828

full body scan for other primary malignancy

Front 829

treatment of hemiballismus

Back 829

block dopamine: Haloperidol

Front 830

obese person, hypersomnolent, polycythemia, facial redness, peripheral edema dx

Back 830

pickwickian syndrome
polycythema and redness from: hypoxemia
peripheral edema from: PULMONARY HTN***

Front 831

treatment of restless leg syndrome

Back 831

pramipexole
ropinerole

Front 832

coma large non reactive pupils dx

Back 832

uncal herniation/epidural bleed

Front 833

coma small reactive pupils

Back 833

thalamic involvement

Front 834

coma pinpoint pupils

Back 834

opioids, excessive cholinergic

Front 835

coma, eyes move toward water on caloric

Back 835

intact midbrain

Front 836

coma, eyes do not move with caloric

Back 836

CN 7 and 8 gone

Front 837

coma eyes nystagmus with caloric

Back 837

person is faking

Front 838

coma, decorticate positioning

Back 838

above red nucleus, cortical involvement

Front 839

coma, decerebrate

Back 839

beloe red nucleus by midbrain

Front 840

lesion of optic chiasm

Back 840

homonymous hemianopsia

Front 841

lesion of optic tract

Back 841

bitemporal hemianopsia

Front 842

temporal lobe lesion causes what visual defect

Back 842

upper quadrantopia

Front 843

optic radiation to lingual gyrus lesion

Back 843

upper quadrantopia

Front 844

optic radiation to cuneus lesion

Back 844

lower quadrantopia

Front 845

parietal lobe lesion causes what visual field defect

Back 845

lower quadrantopia

Front 846

occipital lobe lesion causes what visual field defect

Back 846

homonymous hemianopsia with macular sparing

Front 847

pink eye with:
diarrhea
or
upper respiratory cough

Back 847

adenovirus

Front 848

what are inflammatory and autoimmune causes of uveitis

Back 848

inlamm: UC and Crohns
AI: JRA, psoriatic, Ankylosing, Reactive arthritis

Front 849

peripheral vision loss with floaters dx

Back 849

glaucoma

Front 850

inflamed hard, dilated, non reactive pupil dx

Back 850

close angle glaucoma

Front 851

bilateral central vision loss

Back 851

macular degeneration

Front 852

painless loss of vision like a curtain pulled down with floaters

Back 852

retinal detachment

Front 853

flame hemorrhages, AV nicking, cotton wool spots dx

Back 853

HTN

Front 854

hemorrhages and microaneurysms with yellow exudates on fundoscopy

Back 854

Diabetic

Front 855

painful swollen ear with white discharge, red ear canal, normal TM
treatment

Back 855

polymyxin or neomycin

Front 856

treatment of meniere

Back 856

anticholinergics, anti Histamine

Front 857

non tender, unilateral eyelid swelling dx

Back 857

chalazion

Front 858

tender, red swellling at eyelid margin

Back 858

hordeolum

Front 859

red swollen eyelid margins and dandruff on lashes

Back 859

blepharitis

Front 860

- painless progressive decrease in vision
- trouble driving at night
- terrible glare from sunlight or headlights
dx

Back 860

cataracts

Front 861

how is orbital cellulitis different from periorbital

Back 861

orbital has:
- bulging eye (proptosis)
- limitation of eye movement
- painful eye movement
- decreased vision

Front 862

what is the treatment for orbital cellutitis

Back 862

vanco
and
cefotaxime

Front 863

large reddish vesicles on TM dx

Back 863

bullous maryngitis

Front 864

what is tx and what causes bullousmaryngitis

Back 864

mycoplasma
macrolid

Front 865

gray white pearly lesion in ear dx

Back 865

cholesteatoma

Front 866

sudden vertigo, nausea vomiting, normal hearing
- symptoms peak at 24hours

Back 866

vestibular neuritis

Front 867

vertigo, nausea vomiting, decreased hearing

Back 867

labyrinthitis

Front 868

brain tumor with calcifications and fried egg in BG or Thalamus

Back 868

oligodendroglioma

Front 869

tumor in 4th ventricle, solid

Back 869

medulloblastoma

Front 870

tumor in 4th ventricle, solid and cystic

Back 870

pilocytic

Front 871

what can be used to treat parkinsons tremor early on in disease

Back 871

anticholinergics

Front 872

what is amantidine good for in PD tx

Back 872

increased dopa so helps rigidity, movement

Front 873

falls, parkinsons, limitations of upgaze dx

Back 873

PSP

Front 874

head trauma, vertigo, tinnitus hearing loss

Back 874

labyrinth concussion

Front 875

patient hears "pop" in ear after sneezing, then develops vertigo dx

Back 875

perilymph fistula

Front 876

vertigo and fullness of ear sensation

Back 876

meniere

Front 877

- bilateral weakness
- Arreflexia
- cant move eyes
- Ataxic giat

Back 877

miller fisher GBS variant

Front 878

- Teen with symmetric slow progressive distal muscle atrophy of legs and feet
and has
1. Hammer toes
2. pes cavus

Back 878

charcot marie tooth
- Most common inherited polyneuropathy

Front 879

person with MG starts treatment, then develops trouble breathing, dx and next step

Back 879

Dx: MG crisis
Tx:
1. Stop pyridostigmine
2. Intubate
3. Steroids/IVIG/Plasma exchange

Front 880

Pupil is normal and reactive to light, but palsy of ocular muscles, dx

Back 880

Diabetes causing vascular issue

Front 881

pt cant look up, pupils constrict more to accomodation than light, dx and due to what

Back 881

parinaud
- pineal tumor

Front 882

what vaccines do alcoholics need

Back 882

pneumococcus
influenza
HAV
HBV

Front 883

treatment of intermittent explosive disorder

Back 883

mood stabilizers
- lithium, cbz, valproate

Front 884

treatment for anorexia

Back 884

food

Front 885

delirium + increased BP + papilledema

Back 885

malignant HTN

Front 886

delirium + tacy + tremor + thyromegaly

Back 886

thyrotoxicosis

Front 887

dementia + tremor + abnormal lfts

Back 887

wilsons

Front 888

person cannot remember traumatic event such as getting raped but can remember long term memoeries

Back 888

dissociative amnesia

Front 889

person found who cannot remember their identity and found in different location

Back 889

dissociative fugue

Front 890

Persistent or recurrent experiences of being detached from ones body

Back 890

depersonalization disorder

Front 891

What symptoms indicate dt instead of withdraw

Back 891

1. Autonomic instablility
2. visual hallucinations
3. delirium

Front 892

1. Fatigue/sleep alot
2. depression
3. constricted pupils
4. vivid dreams

Back 892

cocaine withdraw

Front 893

treatment of viral myocarditis

Back 893

supportive
inotropes

Front 894

who is at risk for herpetic whitlow

Back 894

dentist/healthccare worker

Front 895

who is at risk for a felon

Back 895

tailors

Front 896

2 biggest risks for neonatal respiratory distress

Back 896

prematurity
diabetic mother

Front 897

treatment of chlamydial conjunctivitis

Back 897

ORAL erythromycin

Front 898

ptx despite having chest tube in

Back 898

tracheobronchial rupture

Front 899

newborn is intially fine, at about one month develops diarrhea, failure to thrive, thrush, eczema dx

Back 899

hiv

Front 900

treatment of kleptomania

Back 900

CBT

Front 901

what type of organ failure should metformin not be given

Back 901

kidney

and

liver

Front 902

bilateral deafness newborn what infection

Back 902

rubella

Front 903

treatment of actinomycosis

Back 903

penicillin

Front 904

treatment of nocardia

Back 904

bactrim

Front 905

how to tell drug allergy vs rash from ebv

Back 905

drug allergy: appears minutes after
EBV: 24 hours after

Front 906

how to distinguish between somogyi effect from dawn effect

Back 906

2am glucose level

Front 907

what is the treatment for dawn phenomenon and somogyi effect

Back 907

dawn: increase evening NPH
somogyi effect:
1. decrease evening NPH
2. change NPH to before bed
3. eat snack before bed

Front 908

best diabetic tx choice in pts with renal failure

Back 908

thiolidazones

Front 909

diabetic tx with side effects of pancreatitis

Back 909

exenitide
liraglutide
(GLP1 agonists)

Front 910

treatment of diabetic neuropathy

Back 910

1. gabapentin
2. pregabalin
3. duloxetine

Front 911

how is diabetic gastroparesis DX

Back 911

gastric emptying studying with barium

Front 912

tx of diabetic gastroparesis

Back 912

1. erythromycin
2. metoclopramide
3. cisapride

Front 913

complications from thyroid surgery

Back 913

1. recurrent laryngeal nerve damage
2. hypocalcemia from PTH damage

Front 914

when do you perform surgical PTH removal of adenoma

Back 914

if any one of the following:
1. Ca >1 above normal
2. Creatinine decreased >30%
3. Age <50
4. Symptomatic
5. T score <-2.5

Front 915

what is the treatment of of hyper PTH due to renal disease

Back 915

1. Hyper PO4: gets protein (PO4) restriction
2. Calcium carbonate to bind PO4
3. Vitamin D analog like calcitriol

Front 916

first line tx in prolactinoma

Back 916

cabergoline

Front 917

what is the first s/s to appear in hyper PRL

Back 917

women: infertility, amenorrhea
men: decreased libido, impotence

Front 918

steps in tx of GH adenoma

Back 918

first: resection
if cannot be done: octreotide
if this doesnt work: cabergoline

Front 919

next step if person has empty sella syndrome

Back 919

if asymptomatic: reassurance that there is still tissue
sx: replace hormones

Front 920

what should diabetics do before and during exercise

Back 920

check blood sugar
- turn down pump if they are on one

Front 921

what pancreatic cells make insulin

Back 921

Beta cells

Front 922

how to tell HHS from DKA

Back 922

- no acidosis
- no ketones
- only Type 2 diabetics

Front 923

fever, painful neck mass, increased HR, heat intolerance dx

Back 923

subacute/de quervain thyroiditis

Front 924

person gets ct scan, develops, tacycardia, heat intolerance, diarrhea, sweating, anxiety, tremor, dx

Back 924

contrast induced hyperthyroidism

Front 925

what drugs can induce hyperthyroid

Back 925

1. amiodarone
2. contrast with iodine

Front 926

shortneing of 4th and 5th digits

Back 926

albright hereditary osteodystrophy (pseudo hypo PTH)

Front 927

what is death due to in acromegaly

Back 927

hypertrophic cardiomyopathy

Front 928

how are FSH/LH replaced in hypopituitarism

Back 928

PULSATILE leuoprolide

Front 929

treatment of cortisol producing tumor if unresectable

Back 929

1. Ketoconazole
2. metyrapone==> blocks cortisol synthesis

Front 930

treatment of hyper aldo due to hyperplasia

Back 930

spironolactone

Front 931

what is the presentation of 21oh deficiency in:
females
males
blood pressure
K

Back 931

females: virilization
males: none
bp: hypotensive
K: High

Front 932

what is the presentation of 11oh deficiency in:
females
males
bp
k

Back 932

females: virilization
males: none
bp: HTN
K: low

Front 933

what is the presentation of 17oh deficiency in
females
males
bp
k

Back 933

females: lacks secondary sex characteristics
males: ambiguous genitalia
bp: HTN
k: low

Front 934

how to tell secondary adrenal insufficiency from primary

Back 934

skin: no hyperpigment in secondary
K: normal in secondary, high in primary

Front 935

what diseases are associated with pheos

Back 935

NF1
MEN2A
MEN2B

Front 936

what are the cardiac manifestations of hyperCa

Back 936

1. Hypertension
2. QT shortening

Front 937

what are the renal manifestations of hyper Ca

Back 937

1. Nephrogenic DI ==>polyuria, polydipsia
2. Kidney stones

Front 938

If hypercalcemic and PTH level is low, what is the dx

Back 938

malignancy

Front 939

what to suspect when a person gets rapidly decreasing ca, mg, phosphate weeks after getting parathyroid removed?

Back 939

Hungry bones syndrome
Due to ==>increased osteoblast activity

Front 940

Amyloid Deposit in pancreas, which type of DM

Back 940

type 2

Front 941

leukcyte infiltrate in pancreas, which type of DM

Back 941

type 1

Front 942

what med will not work / should not be given once a T2DM requires insulin

Back 942

sulfonureas

Front 943

if suspecting prolactinoma, what is first test to do

Back 943

basal fasting prolactin levels

Front 944

Test to diagnose ACTH deficiency

Back 944

metyrapone

Front 945

test to dx GH deficiency

Back 945

arginine
or
insulin

Front 946

Fixed, rocklike painless goiter, hoarseness

Back 946

reidels thyroiditis

Front 947

fibrous tissue infiltrate found in thryoid, dx

Back 947

reidels thyroiditis

Front 948

treatment of thyroid storm

Back 948

First thing to give ==> antithyroid (PTU, methimazole)
Next ==>iodine ==>why ==>inhibits hormone release
Next ==>propranolol
Next ==>dexamethaxone ==>why ==> inhibits hormone release

Front 949

Giant cell granulomas on thryoid biopsy

Back 949

de quervains

Front 950

pain between third and fourth toes, clicking sound, who is at risk

Back 950

runners
dx: morton neuroma

Front 951

acute unilateral lymphadenitis in kid can be due to what 2 organsims

Back 951

staph
strep

Front 952

what do transplant pts receive as abx ppx

Back 952

bactrim

Front 953

older woman, vulvar itching, fused labia, likely dx and next step

Back 953

lichen sclerosus
biopsy

Front 954

woman is found to have ascus, what is next step depending on age

Back 954

<25: repeat pap in one year
>25: HPV tsting

Front 955

child with fever, conjunctivitis, rash, lip swelling dx

Back 955

kawasaki

Front 956

kid with hypopigmented spots, aplastic anemia, bent thumbs, pounding in ears dx

Back 956

fanconi anemia

Front 957

hallmark findings of nec on axr

Back 957

intramural air
air in portal veins