Memon Usmle Step 3 Flash Cards Deck 1

Front 1

Post-prandial fullness, hypoglycemia, sweating, dizziness, constipation in a DM patient. Diagnosis? Treatment?

Back 1

Gastroparesis (DM)

Rx = Metoclopramide, Erythromycin

Front 2

Drugs that lead to hypercalcemia

Back 2

Thiazides
Lithium

Front 3

Calcium greater than 12 or symptoms Rx

Back 3

NSS IV 3-6 l in 24 h

Furosemide if necessary

Front 4

Hypocalcemia post op removal of parathyroid adenoma Dx?

Back 4

Hungry bones syndrome

Front 5

Disease causing increased vitamin D levels?

Back 5

Sarcoidosis

Front 6

Confirmatory test for Dx of Familial hypocalciuric hypercalcemia?

Back 6

Low 24 h urine calcium

Front 7

Confirmatory test for Chronic thyroiditis (Hashimoto)

Back 7

Antimicrosomal Antibodies

Front 8

Drugs that lead to hypothyroidism

Back 8

Lithium
ASA

Front 9

Large nodule (cold) in multinodular goiter (hot) NEXT BEST STEP?

if follicular elements NEXT BEST STEP?

Back 9

Large nodule (cold) in multinodular goiter (hot) = FNA

if follicular elements = excision

Front 10

Graves disease Rx

Back 10

Bring the patient to euthyroid state, then: radioactive iodine, steroids for
ophtalmopathy

Front 11

Test for Thyroiditis

Back 11

low 24 h radioactive iodine uptake

Front 12

Graves disease Dx

Back 12

increased thyroid, "hot", proptosis, positive TSH Ig

Front 13

Nitroblue tetrazolium test

Back 13

chronic granulomatous disease; tests phagocyte function,
oxidative burst

Front 14

Cellular deficiency disease

Back 14

fatal infections after receiving live viral vaccines (MMR varicella)

Front 15

Ab deficiency disease symptoms and causes

Back 15

recurrent abscesses, lymphadenitis, periodontal infections, Gram negatives, catalase positives

e.g. CGD,
Chédiak-Higashi

Front 16

Increased ALP during pregnancy

Back 16

Can be a normal finding or stones...

Front 17

How to Dx Meconium ileus

Back 17

Barium enema

There are often many gas-filled bowel loops, but without air-fluid levels. Air-fluid levels are thought not to occur because the meconium does not provide a good air-fluid interface.

Front 18

Cystic fibrosis tests

Back 18

sweat test, nasal potential testing

Front 19

Can a heptatis B mother breast feed?

Back 19

YES! Hepatitis B mothers can breast feed!

Front 20

Graves in pregnancy Rx

Back 20

Propylthiouracil

Front 21

Clue cells
Dx?
Rx?
Counseling?

Back 21

DX = bacterial vaginosis

Rx = metronidazole

Counsel not to drink alcohol because of disulfiram-like reaction

Front 22

Pruritic urticarial papules and plaques of pregnancy. Which trimester?

Back 22

Third trimester = Pruritic urticarial papules and plaques of pregnancy

Front 23

Risk Factors for Ectopic Pregnancy?

Back 23

Age, PID, salpingitis, more than 3 pregnancies

Front 24

Pyloric stenosis

Dx?

Risk Factors?

Back 24

Non-bilious emesis, midepigastric olive:

Dx = USG

RF = erythromycin
use

Front 25

Rx of symptomatic biliary stones during pregnancy

Back 25

laparoscopic cholecystectomy

Front 26

N. gonorrhea
Histology & Rx

Back 26

Gram negative diplococci;

Rx = ceftriaxone + azithromycin (to cover
Chlamydia, which generally is there too)

Notify publc health authorities

Front 27

Trichomonas vaginalis
Histology

Back 27

motile flagellated microorganisms in vaginal wet mount

Front 28

Low grade squamous intraepithelial lesion (cervix)

Grade?

Treatment?

Back 28

CIN I; Rx = rescreen in 4-6 months

Front 29

Abnormal vaginal bleeding in woman older than 35 yo next step

Back 29

Office endometrial pipelle biopsy

Front 30

Menorrhagais, anovulatory bleeding - next step

Back 30

order a TSH!

Front 31

Group B strep prophylaxis

Back 31

penicillin or ampicillin to mother during active labor, CBC and blood culture on the newborn

Front 32

Bleeding in pregnancy tests to order:

Back 32

Blood type
Rh
Atypical antibodies

Front 33

Bilious vomiting in infant

And what to do with no peritoneal signs?

Back 33

Malrotation with volvulus

If no peritoneal signs: flexible
sigmoidoscopy is diagnostic and treatment at the same time

Front 34

High grade intraepithelial lesion (cervix) management

Back 34

colposcopy + endocervical curetage
+ biopsy

Front 35

Following a molar pregnancy

Back 35

1) contraceptives for 1 year
2) monitor beta HCG, if it goes up, it could be choriocarcinoma

Front 36

Tuboovarian abscess Rx

Back 36

IV antibiotics

surgery only if necessary - it's one of the few cases of
abscess that are cured without incision

Front 37

Prostate cancer Dx

Back 37

USG guided needle biopsy with 6-12 specimens

Front 38

Metastatic prostate cancer Rx

Back 38

GnRh agonists (flutamide), orchiectomy + chem

Front 39

Staging for testicular cancer and treatment

Back 39

Serum LDH, AFP, beta HCG
CT chest/abd/pelvis

Rx = radical inguinal orchiectomy + spermatic cord ligation

Front 40

Most common sites of melanoma

Back 40

Trunk for Men

Legs for Women

Front 41

Basophilic palisiding cells, pearl appearance, upper 1/3 of the face

Back 41

Basal cell ca

Front 42

Moh's micrographic surgery

Back 42

for squamous cell ca (lower 1/3 of the face), makes 1-2 mm
margins

Front 43

Most common causes of encephalitis in adults, diagnostic findings and treatment

Back 43

HSV;

meningeal signs + focal neurological signs, temporal
lobe changes on CT

Rx = IV Acyclovir 14-21 days

Front 44

Listeria monocytogenes meningitis Rx

Back 44

Ampicillin; NB, elderly

Front 45

Chronic sinusitis definition, diagnosis, and rx

Back 45

Longer than 3 months

Clinical Dx, but if something is going to be ordered
= CT sinus

Rx = amoxicillin +/- clavulanate +/-clindamycin for 21 days, nasal steroid sprays, endoscopic surgery if necessary

Front 46

Otitis media, ac. sinusitis Rx

Back 46

TMP/SMX

or

Amoxicillin +/- clavulanate

Front 47

Chronic carriers of group A strep Rx

Back 47

Clindamycin

Front 48

Smoker with pneumonia, diarrhea, increased LDH

Diagnosis?

What to order?

Treatment?

Back 48

Diagnosis: Legionella

Dx = Urine Ag

Rx = Doxycycline

Front 49

Cystic fibrosis pneumonia Rx and Most Common Cause

Back 49

IV ceftazidime + IV levofloxacine = IV aminoglycoside;

MCC = Pseudomonas

Front 50

PCP pneumonia Dx & Rx?

When do you add prednisone

Back 50

Dx = silver stain of sputum, bronchial lavage

Rx = IV TMP/SMX or
inhaled pentamidine

Add prednisone if: PaO2 less than 70 orA-a gradient more than 35

Front 51

TB Rx

Back 51

RIPE for 8 w., then INH + rifampin for 16 w. more

Add vit. B6 for INH

Front 52

Lab value to monitory in TB patients given Pyrazinamide

Back 52

Uric Acid

Front 53

What do TB patients on Ethambutol need?

Back 53

Order ophtalmologic evaluation

Front 54

Latent TB Rx

Back 54

nine months of INH (+ B6)

Front 55

TB + HIV, how to modify drugs?

Back 55

use Rifabutin instead of Rifampin because of possible drug interaction

Front 56

Ac. prostatitis Rx

Back 56

TMP/SMX or fluoroquinolone for 14 d

Front 57

Chronic prostatitis Rx

Back 57

Fluoroquinolone 1 m. or TMP/SMX 3 m.

Front 58

Primary/secondary syphilis Rx

Back 58

Penicillin G 2.4 million U IM; if disease present for more than 1 year = three doses with 1 w. intervals; notify health department

Front 59

Neurosyphilis Rx

Back 59

Penicillin G IV for 14 days

Front 60

DM Dx =

Back 60

1))) random glucose test >200 + symptoms

2))) Twice fasting glucose > 126


3))) 75g GTT > 200 at 2 h.

4))) 50g GTT > 146 at 2 h

Front 61

Annual influenza vaccine recommendation:

Back 61

Patients older than 50 yo, healthcare workers

Front 62

Do OCP decrease risk for gonococcal PID?

Back 62

YES! OCP decrease risk for gonococcal PID!

Front 63

Osteoporosis Rx

Back 63

With drugs, not only calciumm is indicated when = T-score < 1.5 OR < 2.5 + RF

Front 64

Elderly + fall, what do you need to do?

Back 64

do a home safety evaluation

avoid narcotics

Front 65

Woman sexually active, younger than 25 yo or with RF screen for?

Back 65

Screen for Chlamydia

Front 66

how many readings for HTN Dx =

Back 66

3 separate readings

Front 67

Post exposure TB prophylaxis

Back 67

2 drugs chosen according to bug susceptibility

Front 68

Smallpox Rx

Back 68

Cidofovir

Front 69

Anthrax Rx and prophylaxis

Back 69

Ciprofloxacin (adults)

Penicillin (children)

Front 70

Pneumococcal vaccine

Back 70

Q5 y for >50 yo with chronic disease

Front 71

Td vaccine

Back 71

q10 y or once at age 50 yo

Front 72

Woman with relative with breast ca recommendation

Back 72

Mammogram 10 y before the affected person age + self breast examination

Front 73

Men with relative with prostate cancer recommendations

Back 73

annual PSA + DRE after 40 yo

Front 74

Autism suspicion must order which test?

Back 74

hearing test

Front 75

Gingko biloba + warfarin

Back 75

increased risk of bleeding

Front 76

1 yo vaccines

Back 76

Hib

MMR

Varicella

PCV

Front 77

ERCP complications

Back 77

Acute pancreatitis
Infected pancreatic pseudocyst formation
Cholangitis
Perforation

Front 78

Disrupted/transected urethra suspicion next step

Back 78

retrograde urethrogram;

blood at meatus + high riding prostate

Front 79

Leaking CSF (ears)

-Diagnoses
-Contraindications

Back 79

cribiform fracture

blind nasogastric or nasal intubations are contraindicated!

Front 80

Radial head fracture (outstretched hand, Cole's fracture) Rx

Back 80

sling 2-3 days, early exercises

Front 81

New onset serous discharge, means?

Back 81

Wound dehiscence

Front 82

How do you take CXR in pneumothorax

Back 82

Take CXR at maximal expiration

Front 83

Compartment syndrome suspicion confirmation and treatment?

Back 83

measure compartment pressures

emergent fasciotomy if confirmed

Front 84

What is CI in In burn patients

Back 84

Succinylcholine due to the risk of hyperkalemia

Front 85

Diuretic given to sulfa alergic patients

Back 85

Etacrinic acid

Front 86

Increased ICP first steps in management

Back 86

Intubation + hyperventilation

Front 87

Anterior spinal arterial occlusion symptoms

Back 87

Decreased motor function, decreased sensation, decreased pinprick, preserved proprioception

Front 88

Painful Chancroid unilateral lymphadenopathy and lesion with
purulent base

Rx?

Back 88

Haemophilus ducreyi

Rx = ceftriaxone, azithromycin

Front 89

PSA > 4 next step

Back 89

Prostate Biopsy

Front 90

Metastatic prostate ca Rx

Back 90

Leuprolide
Goserelin
Bilateral orchiectomy

Front 91

Hydrocele how to dx and rx?

Back 91

Dx with USG
no Rx required

Front 92

Tumors that increase HCG?

Back 92

seminomas and nonseminomas

Front 93

Tumors that increase AFP?

Back 93

Embryonal, Yolk sac elements (nonseminomas)

Front 94

HTN + BPH Rx

Back 94

Terazosin, Doxazosin

Front 95

Epididimoorchitis Rx =

Back 95

Doxycycline 100 mg PO bid for 10 d + ceftriaxone 250 mg IM

Front 96

Amytriptiline S.E.

Back 96

constipation, ac. glaucoma, urinary retention, dry mouth, paralytic

Front 97

Methanol toxicity

Effects
Orders
RX

Back 97

Effects: vision changes

Order: ABG, electrolytes, osmolality

Rx = IV ethanol, dyalisis

Front 98

Testicular torsion Rx and treatments S.E

Back 98

Ketorolac

S.E. = gastric ulceration, GI bleeding

Front 99

Thioridazine S. E.

Back 99

prolonged QT