Mm Step 3 - 1

Front 1

MALT associated with?

Back 1

H.pylori infection

Front 2

Paget's dz of VULVA can lead to what cancer?

Back 2

Adenocarcinoma

Front 3

What autoimmune dz of mother can lead to complete heart block in newborns?

Back 3

SLE

Front 4

What are 5 antibiotics that cover pseudomonas?

Back 4

Tobramycin, Ceftazidime IV, Ciprofloxacin PO, Levofloxacin PO, Gentamicin IV

Front 5

What is sevelamer?

Back 5

phosphate binder

Front 6

What is pamidronate?

Back 6

bisphosphonate - slows destruction of bone (use: osteoporosis)

Front 7

Fever, AMS, diffuse abdominal pain, orthostatic hypotension, hypoNa, hyperK, dx? tx?

Back 7

Addisonian crisis (acute adrenal insufficiency). tx:steroids (hydrocortisone & fludrocortisone). Causes: autoimmune, mets, hemorrhagic infarct, Tb/Sarcoid

Front 8

What is carcinoid syndrome caused by? Marker? Can cause tricuspic & pulmonary valve fibrosis

Back 8

5-HIAA. Neuroendocrine tumor secreting serotonin & kallikrein. Originates appendix/term ileum. Can be bronchogenic.

Front 9

Gout: acute attack tx? In pt w CRI? Long-term tx?

Back 9

NSAIDs, Colchicine IV (also po can prevent acute flares in recovery phase), Steroids (in pts with CRI); Long-term: allopurinol (can precipitate attacks if given in recovery phase) probenicid.

Front 10

What labs needs to be followed if a patient is taking Linezolid?

Back 10

CBC - can cause bone marrow suppression

Front 11

What labs should be followed when a patient is taking gentamicin?

Back 11

Creatinine. Nephrotoxicity

Front 12

What labs should be followed when a patient is taking tetracycline?

Back 12

LFTs & creatinine. Hepatic and renal dysfunction

Front 13

Painless, indurated penile lesion; dz? tx?

Back 13

Primary syphilis; penicillin (tetracycline alt)

Front 14

Painful, penile lesion w pus-filled inguinal lymphadenopathy; dx? tx?

Back 14

H. ducreyi; CTX or azithromycin

Front 15

Contraceptive for patient with migraine with aura?

Back 15

Depo shot IM; OCPs contraindicated

Front 16

In what 3 clinical situations does a CNS infection merit the use of systemic steroids?

Back 16

1.Infant with H.flu meningitis (not Strep); 2.Tuberculous meningitis (severely ill adult); 3.Neurocysticercosis & increased ICP

Front 17

Gout: acute attack tx? In pt w CRI? Long-term tx?

Back 17

NSAIDs, Colchicine IV, Steroids (in pts with CRI); Long-term: allopurinol or probenicid.

Front 18

What laboratory tests do you need to monitor for clozapine (schizophrenia antipsychotic)?

Back 18

CBC (agranulocytosis)

Front 19

What laboratory tests do you need to monitor for clozapine (schizophrenia antipsychotic)?

Back 19

CBC (agranulocytosis)

Front 20

What is Zollinger Ellison syndrome?

Back 20

Malignant gastrinomas (pancreatic islet cell); dx gastrin>1000, or secretin stim test. [MEN I assoc]

Front 21

Duration of sxs (perceived threat to safety, relive traumatic event, sxs of anxiety) to dx PTSD: __ months.

Back 21

>1 month; acute stress disorder is 2 days to 4 weeks.

Front 22

Pt p/w back pain, anemia and renal insufficiency; need to include this on ddx:

Back 22

Multiple myeloma: overproduction of monoclonal Ig, kappa, lambda chains

Front 23

Hirsutism; labs to order?

Back 23

LH>FSH - PCOS. Elevated testosterone & DHEA-S - androgen-secreting tumor (if nml DHEA, but high test, then ovarian source (v. adrenal)); TSH to r/o hypothyroid -> hyperprolactin -> inc adrogen

Front 24

Headache, scalp tenderness, & vision problems; dx? tx? Major dangerous complication

Back 24

Giant cell arteritis; steroids; aortic aneurysm

Front 25

Macroglossia, one body side bigger than other, hepatomegaly; dx? assoc malignancy?

Back 25

Beckwith-Wiedemann syndrome; nephroblastoma (Wilm's tumor)

Front 26

Statin; what labs to order prior to starting? also be aware of proximal muscle weakness

Back 26

LFTs

Front 27

Viral URI followed by hematuria in a young man 1-2d later. ML dx? tx?

Back 27

IgA nephropathy. (poss HTN, post infectious GN usually follows 7-21d after infection); Tx: lisinopril (reduces proteinuria, BP, progression)

Front 28

Chromosome structure of complete mole (hydatiform mole)?

Back 28

46XX. empty egg w fertilization & replication by 23X sperm

Front 29

Chromosome structure of partial mole?

Back 29

69XXX or 69XXY. egg fertilized by two sperm

Front 30

After a hydatiform mole forms, the woman risks developing what? No pregancy for one year after mole D&C'd.

Back 30

gestational trophoblastic neoplasia (elevated hcg)

Front 31

triple screen, dec AFP, dec beta hCG, dec unconj estriol -- nml or abn? if abn, condition assoc?

Back 31

abnormal. Trisomy 18 - Edwards syndrome

Front 32

triple screen, dec AFP, inc beta hCG, dec unconj estriol -- nml or abn? if abn, condition assoc?

Back 32

abnormal Trisomy 21 - Down syndrome

Front 33

SN Hearing loss, enlarged skull, elevated alk phosphate, hip pain; dx?

Back 33

Paget's dz of bone; associated neoplasm is osteosarcoma; inc in osteoblastic (build) and osteoclastic (chew) activity leading to weaker bones w abn architecture

Front 34

Hashimoto thyroiditis; tx?

Back 34

If no compressive sxs, conservative mgmt w LEVOTHYROXINE

Front 35

What is the most common thyroid malignancy?

Back 35

Papillary (popular)

Front 36

What is the most common thyroid malignancy?

Back 36

Papillary (popular)

Front 37

Dysphagia, elevated calcium, diarrhea, proteinuria; dx? likely cause of death?

Back 37

Scleroderma (limited CREST calcinosis, Raynaud's, Esophageal dysmotility, Sclerodactyly, Telangiectasias); Likely cause of death d/t renal failure. Also malabsorption, cardiac fibrosis, pulmonary fibrosis. Et: collagen deposition

Front 38

What is hemochromatosis? dx? autosomal recessive (HFE)

Back 38

iron overload; inc transferrin saturation (>60% men, >50% women) iron/(transferrin or TIBC)

Front 39

Best anti-HTN med for pts with gout?

Back 39

ACEi. thiazides may inc gout flares

Front 40

Methotrexate; sulfas, pyrimethamine (abx used for pcp infxn) can both cause BMS. What should be given to reverse BMS?

Back 40

Leucovorin (folinic acid)

Front 41

Dysarthria, dysphagia, tongue fasciculations, hyperreflexic jaw jerk; next step in mgmt?

Back 41

Head MRI to r/o ischemic/hemorrhagic stroke. Possibly may have ALS too.

Front 42

Diastolic heart murmur, with fixed split S2; dx?

Back 42

ASD. fixed S2 from delayed PV closure.

Front 43

Diffuse abdominal pain, low-grade fever, ascites, AMS, h/o cirrhosis, elevated ammonia, next step?

Back 43

paracentesis for possible Spontaneous Bacterial Peritonitis (PMN>250)

Front 44

Initial treatment of status epilepticus?

Back 44

Lorazepam

Front 45

Anemia with low platelets, low-grade fever, seizures, ARI; dx?

Back 45

TTP

Front 46

Patient s/p CABG, now w redness of sternotomy wound. crunching with systole, SOB, CP dx?

Back 46

Mediastinitis

Front 47

Pt with pheochromocytoma; prior to surgical resection start on what anti-HTN med?

Back 47

alpha blocker (phenoxybenzamine) & fluid LOADED to prevent hypotension when med is stopped during surgery

Front 48

Tx of amoebic colitis (Entamoeba histolytica) with cysts seen?

Back 48

Metronidazole & iodoquinol

Front 49

3yo boy w fever for 5days, conjunctivitis, cervical LAD, red tongue; dx? tx? CV complication?

Back 49

Kawasaki (fever >5d + 4-5 of 5 other sxs Conjuctivitis, Rash, Adenopathy, Strawberry tongue, Hand/foot swelling + BURN fever); tx: high-dose ASA (NSAIDs), IVIg to prevent coronoary artery aneurysms

Front 50

How do you test for ACL tear?

Back 50

Lachman test. Anterior force on tibia while knee bent at 30deg

Front 51

How do you test for PCL tear?

Back 51

Posterior force on tibia while knee bent at 90deg

Front 52

Rash, recent DM dx, weight loss, anemia, what type of endocrine tumor?

Back 52

Glucagonoma

Front 53

Cetirizine; type of med?

Back 53

Zyrtec. 2nd gen anti-H2. (fexofenadine=Allegra)

Front 54

Fexofenadine, type of drug?

Back 54

Allegra, 2nd gen anti-H2. (Zyrtec = cetirizine)

Front 55

Singulair, type of drug?

Back 55

Montelukast, leukotriene inhibitor

Front 56

21M w itchy, red vesicles on extensor surfaces in pt w diarrhea w wheat; dx of rash? dx of GI issues?

Back 56

Celiac sprue & dermatitis herpetiformis

Front 57

How to measure for orthostatic hypotension? How much must SBP drop? DBP? Important cause other than hypovolemia, prolonged bed rest, drugs?

Back 57

5min supine BP. BP at 1 & 3 min standing. SBP drop >20 or DBP drop >10. If HR inc <10 then possible autonomic dysfunction.
Adrenal insufficiency

Front 58

When should you cardiovert someone in new-onset Afib? After how many days of Afib, should you give 3w anticoagulation first?

Back 58

when HD unstable. >48h, risk of thromboembolism goes up.

Front 59

G2P1 female, 26wk gestation, w low-grade fever, tachycardia, elev WBC w contractions, cervix 6cm, what med? why not steroids? why not indomethacin?

Back 59

Ampicillin for Strep B prophylaxis given imminent delivery. Likely intra-amniotic infxn so no time >12h for steroids (for preterm RDS). No indomethacin (tocolytic) b/c of infxn

Front 60

Right ear pain with severe sharp pain when tapping on tooth; dx?

Back 60

Tooth abscess; need emergent extraction due to possibility of dissemination

Front 61

Tx of trichomoniasis, inflamed vaginal mucosa, red friable cervix, flagellated protozoa, +whiff test?

Back 61

Metronidazole (ok in pregnancy)

Front 62

Risk factors for endometrial cancer? (highest risk)

Back 62

1.Estrogen, 2.Obesity, 3.Nulliparity, 4.Early menarche, 5.High fat diet

Front 63

G2P1 female, 26wk gestation, w low-grade fever, tachycardia, elev WBC w contractions, cervix 6cm, what med? why not steroids? why not indomethacin?

Back 63

Ampicillin for Strep B prophylaxis given imminent delivery. Likely intra-amniotic infxn so no time >12h for steroids (for preterm RDS). No indomethacin (tocolytic) b/c of infxn

Front 64

Right ear pain with severe sharp pain when tapping on tooth; dx?

Back 64

Tooth abscess; need emergent extraction due to possibility of dissemination

Front 65

Tx of trichomoniasis, inflamed vaginal mucosa, red friable cervix, flagellated protozoa, +whiff test?

Back 65

Metronidazole (ok in pregnancy)

Front 66

Risk factors for endometrial cancer? (highest risk)

Back 66

1.Estrogen, 2.Obesity, 3.Nulliparity, 4.Early menarche, 5.High fat diet

Front 67

8yo boy hx mental retardation, seizures, retinal lesions, and angiomyolipomas of the kidneys; dx? assoc brain tumor?

Back 67

Tuberous sclerosis. Ependymoma (cells line ventricles & produce CSF) occurs in 4th ventricle

Front 68

First line of treatment for pericarditis (viral, idiopathic, post-MI)?

Back 68

ASA, NSAIDs

Front 69

Patient w family members w pheochromocytoma, thyroid cancer, & parathyroid tumor; thyroid labs nml; dx? Mgmt of thyroid?

Back 69

MEN II - MPP - Medullary carcinoma of thyroid, pheo, parathyroid. Total thyroidectomy

Front 70

HIV pt with CD4<50, blurred vision; likely infectious cause? tx?

Back 70

CMV retinitis; ganciclovir (foscarnet 2nd line)

Front 71

Ganciclovir, must monitor what labs?

Back 71

CBC (due to myelosuppression)