New Qs

Front 1

Axillary LN schema?

Back 1

Front 2

Algorithm of blunt chest trauma?

Back 2

Front 3

Rx of CRC in pts with Mets confined to liver?

Back 3

Surg resection of both primary tumor & liver met.

Front 4

Rx of adhesive capsulitis?

Natural hx?

Back 4

Front 5

Px of PAN?

Back 5

Front 6

Dx of PAN?

Back 6

Front 7

Rx of abdominal compartment syn?

Back 7

Front 8

Rx of an avulsed permanent tooth?

Back 8

1- until reimplantation=> tooth stored in cold milk, saliva or tooth culture media

2- tooth & socket gently rinsed with NS

3- Tooth handled by crown, placed in socket & splinted to adjacent teeth

4- discharged with ppx Abx eg doxy

Front 9

Rx of priapism?

Back 9

1- aspiration of corpora cavernosa

2- intracavernous injection of phenylephrine

Front 10

Management of traumatic brain injury?

Back 10

Front 11

Components of breast conserving therapy?

Back 11

1- partial mastectomy aka lumpectomy with neg lateral margins (re excised until margins are negitive)

2- SNLN Bx => ALND if ≥3 nodes positive

3- radiation therapy to eradicate any remaining tumor

Front 12

Modified radical mastectomy?

Back 12

1- whole mastectomy

2- ALND

Front 13

Rx of snake bite?

Back 13

Front 14

Cardiovascular CI to preg?

Back 14

Front 15

Criteria used for sepsis evaluation in ED?

Back 15

qSOFA score

1- RR >22/min

2- SBP ≤100 mmhg

3- confusion

≥2 shows septic

Front 16

Rx of sepsis in ED?

Back 16

1- blood culture

2- broad spectrum abx within 1 hr

3- aggressive fluid resuscitation within 3 hr

4- vasopressor NE => after >3L of IVF

Front 17

Empiric Abx used in sepsis?

Back 17

1- pip tazo/ meropenem/ cefepime PLUS

2- vanc

Front 18

1- Px of dialysis catheter associated bloodstream infections?

2- Rx?

Back 18

1- sepsis without any localizing signs

2- Abx=> vanc + ceftazidime

IVF

catheter removal

Front 19

Rfs for colon ca?

Back 19

Frequently=daily

Front 20

Rx of brown recluse spider?

Back 20

Front 21

Staging evaluation of rectal adenocarcinoma?

Back 21

Front 22

Rx of empyema?

Back 22

4- abx

Front 23

Rx of post hip dislocation?

Back 23

W/I 6 hrs to Dec risk of osteonecrosis of femoral head

1- dislocation without fx=> closed reduction

2- dislocation with fx=> open reduction

Front 24

CRC px if in

1- R colon

2- L colon

3- rectum

Back 24

1- occult bleeding + Fe def anemia

2- hematochezia + crampy/colicky abd pain+ change in bowel habits

3- hematochezia + narrow stools+ tenesmus+ sensation of mass in rectum

Front 25

Degrees of burns?

Back 25

Front 26

Rx of burns?

Back 26

1- superficial=> wound care (wash daily, apply moisturizer)

2- partial thickness=> gentle debridement with NS

3- full thickness => complete surg excision followed by skin grafting

Front 27

1- U/L diaphragmatic paralysis causes?

2- Px?

3- Dx?

Back 27

Front 28

Clinical scenario for AVN of humeral head?

Back 28

Shoulder joint dislocation PLUS

proximal humeral fx

Px=> pain with abduction

Front 29

Axillary N injured during ant shoulder dislocation

Px?

Back 29

deltoid & teres minor weakness => pain & weakness of abduction

Front 30

Diff between rotator Cuff injury & axillary N injury?

Back 30

Axillary N injury also causes sensory loss over lateral shoulder

Front 31

Fall on outstretched hand. Associated fxs?

Back 31

Front 32

Surveillance after colon ca resection?

Back 32

Front 33

Stages of colon cancer?

Back 33

1=> only involves mucosa & sub mucosa

2=> muscular & serosal layer

3=> LN involvement

Front 34

Breast cancer warning signs?

Back 34

Front 35

Intraductal papilloma px?

Back 35

U/L bloody discharge + no mass

Front 36

Rx of lung abscess?

Back 36

Front 37

Clinda not 1st line for lung abscess due to?

Back 37

Inc risk of c diff infection

Front 38

Bronchiolitis obliterans px?

Back 38

Lung transplant pt develops:

1- progressive dyspnea & non productive cough

2- obstructive pattern on PFTs

Front 39

Px of pyogenic liver abscess?

Back 39

1- fever + RUQ pain + hepatomegaly

2- Inc WBCs + Inc liver enzymes esp ALP & bili

Front 40

Dx of liver abscess?

Rx?

Back 40

1- CT scan of abd, US

2- Blood culture, IV Abx, abscess drainage

Front 41

Components of balanced resuscitation/ damage control resuscitation?

Back 41

Front 42

S/Es of aggressive crystalloid resuscitation?

Back 42

Front 43

Main muscles responsible for

1- foot eversion

2- foot inversion

Back 43

1- peroneus muscles

2- tibialis ant & post muscles

Front 44

Can a pt with complete Achilles tendon rupture have normal plantar flexion?

Back 44

Yes due to plantaris, flexor hallucis longus & digitorum longus as they directly insert on foot (not via Achilles)

Front 45

Test used to id complete Achilles tendon rupture?

Back 45

Thompson aka calf squeeze test

Squeeze calf=> no passive plantar flexion= complete Achilles tendon rupture

Front 46

Dx of tarsal tunnel syn?

Rx?

Back 46

Positive Tinel test=> tapping in post medial malleolar area=> produces pain

Front 47

Features of effective teams in health care?

Back 47

Front 48

1- Technique used by high reliability organizatios to improve Psychological safety ?

2- Other examples?

Back 48

1-Team safety debriefings

2-A) teamwork simulation with teams practicing communication skills

B) Development of evaluation metrics rewarding members who id errors & safety risks

Front 49

Rx of burn associated infections?

Back 49

1- local wound infection ie no sepsis=> cefazolin, clindamycin

2- sepsis=> piptazo/ meropenem Plus vanc

Front 50

Li enhanced physiological tremors vs Li toxicity tremors?

Back 50

Enhanced=> symmetric, limited to hands & upper limbs

Toxicity=> irregular coarse tremors involving multiple parts of body

Front 51

Pathophys of Li associated tremors?

Back 51

Fe accumulation in substantia nigra

Front 52

CT scan in eclampsia?

Back 52

White matter edema

Front 53

Electrolyte abnormality associated with amphetamine intoxication?

Back 53

Hyponatremia possibly serotonin induced

Front 54

Amphetamine intoxication can be confirmed by?

Back 54

Urine drug testing

Front 55

Rx of recurrent cystitis in females?

Back 55

Front 56

Wu of presbycusis?

Back 56

1- careful hx of hearing changes

2- whispered voice test

3- for confirmation=> audiometric testing

Front 57

Gender Id?

Gender expression?

Gender variance?

Back 57

1- internal sense of being male, female

2- how a person expresses gender to outside world

3- when id/expression varies from social norms

Front 58

Gender dysphoria?

Back 58

Disagreement between gender id & assigned sex by birth

Front 59

1- Wt gain in preg on basis of pre preg BMI?

2- Associated calories in pts with normal wt?

Back 59

2nd trimester=> Inc calorie intake by 350 kcal/day

3 trimester=> Inc calorie intake by 450 kcal/day

Front 60

Supplementation in preg?

Harmful substances?

Food safety?

Back 60

Front 61

Indications for C section during 1st stage of labour?

Back 61

1- arrest of labor

2- category 3 FHR tracing

Front 62

Pts with intrapartum bleeding evaluated with?

Back 62

Front 63

Tocolytic use other than delaying delivery?

Back 63

Indicated for FHR abnormality caused by uterine tachysystole ie >5 contractions/Mon

Front 64

Causes of 2° PPH?

Back 64

2° PPH=> >24 Hrs after delivery

Front 65

Retained placenta vs retained POC px?

Back 65

Retained placenta=> immediate PPH

Retained POC=> late PPH

Front 66

Recognizing med non-adherence?

Back 66

Front 67

Typical feature of med discontinuation?

Back 67

dz worsening after years of good control

Front 68

Med discontinuation suspected. Nbsim?

Back 68

Non judgemental inquiry into use of med, focusing on when, how & how often do they use

Front 69

Insulinoma typical age of onset?

Back 69

> 40

Front 70

Typical feature of concealed placental abruption?

Back 70

Severe focal pain at location of placenta=> progresses to diffuse uterine tenderness

Front 71

Pathophys of placental abruption?

Back 71

Maternal vasoconstrictors=> cross into placenta => placental vasocons & ischemia=> necrosis & hemorrhage at UP interface=> detachment of placenta=> Inc intrauterine pressure=> uterine irritability => high frequency contractions

Front 72

MS risk associated with preg?

Back 72

1- preg protective for MS

2- INC risk in post partum period

Front 73

Tb screening should be considered in?

Back 73

1- close contact with known Tb

2- travel from endemic area

3- exposed to high risk setting homeless shelter, prisons

Front 74

Teratogenicity of ?

Back 74

Front 75

SIRS criteria?

Back 75

Front 76

Severe acute panc definition?

Predictors?

Back 76

Front 77

Labs in tertiary PTH?

Rx?

Back 77

Front 78

1- Acromioclavicular joint sprain pathophys?

2- P/E?

3- XRAY?

Back 78

1- direct trauma to superior or lateral shoulder

2- pain over AC joint & with addiction of arm across torso

3- can assess degree of sprain & concomitant clavicular or humeral fx

Front 79

Heme dzs associated with priapism?

Back 79

1- scd

2- Heme cancers eg CML

3- thalassemia

4- MM

Front 80

Sx of Inc abd pain/sepsis/ unstable vitals 7-10 days after acute panc.

1- Dx?

2- Wu?

Back 80

1- Infected panc necrosis

2- CT scan of abd=> gas within panc necrotic collection

Front 81

1- Alternative to 1:1:1 blood components transfusion in hemorrhagic shock?

2- adjunctive therapy?

Back 81

1- whole Blood

2-A tranexamic acid wi 3 hrs

B Topical hemostatic agents=> kaolin impregnated sponge, fibrin sealant dressing

Front 82

Cryoprecipitate is considered when?

Back 82

Fibrinogen <100

Front 83

1- Acute lung transplant rejection px?

2- WU?

3- Rx?

Back 83

1- wi 6 mon of transplant

Progressive dyspnea+ cough w/ low grade fever+ CXR =perihilar opacities & interstitial edema

2- BAL & lung bx to rule out infection

3- high dose glucocorticoids

Front 84

Root causes of errors related to transfers of care?

Back 84

Front 85

Preventive strategies for Root causes of errors related to transfers of care?

Back 85

Front 86

Rx of auricular hematoma?

Complications?

Back 86

Front 87

Complications of glenohumeral joint (shoulder) dislocation?

Back 87

4- axillary N injury

Front 88

A- Rfs for associated injuries in shoulder dislocation?

B- Nbsim?

Back 88

A

1- >40

2- first time dislocation

3- traumatic mechanism eg fall on outstretched hand

B- x-ray to rule out fx

Front 89

Mc fxs associated with shoulder dislocation?

Back 89

1- Hill-sachs defect=> avulsion fx of posterolat humeral head

2- Bankart lesions=> glenoid labrum disruption

Front 90

Mc fxs associated with shoulder dislocation?

Back 90

1- Hill-sachs defect=> avulsion fx of posterolat humeral head

2- Bankart lesions=> glenoid labrum disruption

Front 91

Rx of shoulder dislocation?

Back 91

1- no fx/ Hill-sachs/ Bankart=> closed reduction

2- if associated humeral neck fx=> open surg repair to Dec risk of AVN

Front 92

Rx of shoulder dislocation?

Back 92

1- no fx/ Hill-sachs/ Bankart=> closed reduction

2- if associated humeral neck fx=> open surg repair to Dec risk of AVN

Front 93

Human factors engineering strategies with highest reliability?

Back 93

Front 94

Human factors engineering strategies with high & medium reliability?

Back 94

Front 95

Reasons for hand hygiene non-compliance & their solutions?

Back 95

Front 96

1- Optimal hand hygiene in hospital setting?

2- if expo to spores eg infect diarr, c diff/ soiled?

3- Can Dec hosp acquired infections upto?

Back 96

1- cleansing & disinfecting hands with soap or antiseptic hand rub (preferred) until dry (~20 sec)

2- washed thoroughly with soap & water ~20 sec

3- up to 70%

Front 97

>2500 m ascent wi days.

1- Dx?

2- Other features/ how to diff it from PNA?

Back 97

1- high altitude pul edema

2-

Front 98

Pathophys of high altitude pul edema?

Back 98

1- Normally=>Hypoxia at Inc altitudes=> vasoconstriction

2- In HAPE=> genetic predisposition unevenly distributed hypoxic vasocon=> expo of less vasocons pul capillaries to high perfusion pressure=> disruption of alveolar -capillary interface=> b/l pul edema

Front 99

CKD associated Tb risk?

Associated finding related to PPD?

Back 99

1- 6 to 50 fold Inc in reactivation

2- PPD is FN due to immunocompromise

Front 100

Rx of olecranon bursitis?

Back 100

Front 101

Px of local large reactions?

Rx?

Back 101

Front 102

Type of rxns in response to a sting?

Back 102

1- wheal & flare rxns

2- large local rxns

3- systemic rxns (anaphylaxis like)

Front 103

1- Mononeuritis multiplex?

2- Mcly triggered by?

Back 103

1- neuropathy of ≥2 non-contiguous peripheral nerves

2- underlying vasculitis esp PAN

Front 104

Antibody associated with PAN?

Wu?

Back 104

1- not typically associated

2- tissue bx

Front 105

Triggers of GBS?

Back 105

1- GIT infection

2- URTI

3- Acute HIV infection

Front 106

1- Px of hereditary hemochromatosis associated arthropathy?

2- x-ray?

3- Rx?

Back 106

Front 107

1- epidemic of Tb meningitis

2- px?

3- dx?

Back 107

Front 108

Tb meningitis px over,

Back 108

Weeks

Front 109

1- CAP px in immunosuppred?

2- finding on CXR

3- Alternative?

Back 109

1- septic + sx localizing infection to lungs eg hypoxia+ crackles

2- normal

3- HRCT=> can id subtle pul infiltrates

Front 110

Pathophys of X linked agammaglobulinemia?

Back 110

Front 111

Px of X linked agammaglobulinemia?

Back 111

Front 112

1- Labs of X linked agammaglobulinemia?

2- Rx?

Back 112

Front 113

H influenzae type b infection in a fully immunized child.

Dx?

Back 113

X linked agammaglobulinemia

Front 114

Acute distal symmetric polyneuropathy raises concern for?

Back 114

1- toxins

2- medication SEs

Front 115

Meds associated with distal symmetric polyneuropathy?

Back 115

1- MTZ

2- FQs

3- dapsone

4- amiodarone

5- digoxin

Front 116

1- Pathophys of coarctation of aorta?

2- Px?

Back 116

Front 117

1- Complications of coarctation of aorta?

2- Rx?

Back 117

Front 118

1- Bronchial carcinoid epidemiology?

2- px?

3- dx?

Back 118

Front 119

Mc lung CA in young non-smokers?

Back 119

Bronchial carcinoid tumors

Front 120

1- Patient with which risk factor need to be started on earlier screening for CRC?

2- Screening method?

Back 120

A

1- abd-pelvic radiation

2- UC

3- Hereditary ca syn=> FAP, Lynch

4- Personal/ fhx of adenomatous polyps, colon ca

B - at earlier age 30-40

Colonoscopy is preferred. Alt FOBT, fecal DNA testing

Front 121

1- Px of lateral epicondylitis?

2- dx?

3- Rx?

Back 121

Front 122

Main muscles affected in lateral epicondylitis?

Back 122

Conjoined tendons of extensor carpi radialis brevis & extensor digitorum at lateral epicondyle of humerus=> max pain 1cm distal to lateral epicondyle

Front 123

Causes of neonatal sepsis?

Px?

Dx?

Rx?

Back 123

Acyclovir often added to cover HSV

RAJPT C

Front 124

Neonates with sepsis are often brought in for?

Back 124

LIP

1- lethargy

2- irritability

3- poor feeding

Front 125

Finding?

Dx?

Back 125

1- epidural fluid collection with rim enhancement

2- epidural abscess

Front 126

Management of colles fx?

Back 126

1- check neurovascular compromise

2- if compromised (Dec radial pulse/ Dec median N sensation) => immediate close reduction

3- if compromise improves=> wrist splinting with Ortho consult

If doesn't improve=> emergent orthopedic consultation

Front 127

Lactose intolerance pathogen?

Px?

Back 127

Front 128

Dx of lactose intolerance?

Rx?

Back 128

Front 129

Strategies to improve health care communication?

Back 129

SCITT

1- standardized handoff

2- closed loop communication

3- interdisciplinary rounds

4- team Huddles & debriefings

5- team based training

Front 130

Standardized hand off description?

Benefits?

Back 130

Front 131

Closed loop communication description?Benefits?

Back 131

Front 132

Interdisciplinary rounds description?Benefits?

Back 132

Front 133

Team Huddles & debriefings description?Benefits?

Back 133

Front 134

Team based training description?Benefits?

Back 134

Front 135

1- Primary goal in management of drowning?

2- methods?

Back 135

1- correction of hypoxia

2- supplemental O²

3- not responding to O2 & can protect airway=> NPPV eg CPAP

4- not responding to O2 & can't protect airway (somnolent)=> endotracheal intubation with mechanical ventilation

5- bronchodilators to Rx bronchospasm

Front 136

Characteristics of physiological thelarche?

Back 136

1- normal in girls ≥8

2- often tender,breast buds posterior to nipple

3- can U/L in early puberty

Front 137

Rx of molluscum contagiosum

1- in children

2- in adults

Back 137

1- reassurance

2-

Front 138

Typical location of Molluscum contagiosum lesions.

1- children

2- adults?

Back 138

Front 139

Genital molluscum contagiosum in children is due to?

Back 139

Auto inoculation

Front 140

Management of hemorrhage due to trauma?

Back 140

Front 141

Massive transfusion protocol?

Back 141

Massive transfusion is Required if ≥2 are positive & they should be given in 1:1:1 =FFP:pRBCs: Platelets

1- SBP ≤90

2- Pulse ≥120

3- positive FAST

4- penetrating mechanism of injury

Front 142

Time needed for type & cross-matching blood?

Back 142

>20 min

Front 143

Type of blood group that is given in hemorrhagic shock without type & cross matching?

Back 143

1- females of reproductive age=> Gp O, Rh D neg (to dec risk of HDN)

2- In females beyond reproductive age & Males=> either can be used

Gp O, Rh D neg,

Gp O, Rh D posi

Front 144

Chronic enteroviral meningitis+ recurrent PNA by encapsulated organisms+

Recurrent diarrheal illness.

Dx?

Back 144

Bruton agammaglobulinemia

Front 145

Weber syn?

Back 145

Occlusion of PCA => Midbrain infarction=> ch by CN 3 dysfunction

Front 146

Drowning/ cardiac arrest=> Cushing reflex.

Mechanism?

Back 146

Drowning/ cardiac arrest=> Hypoxic-ischemic brain injury=> neuronal cell death wi minutes=> widespread necrosis=> cerebral edema=> Inc ICP & compresses small arterioles=> Dec blood flow

Front 147

1- Cushing reflex prognostic sign?

2- it shows?

Back 147

1- poor prognostic sign

2- cerebral herniation is imminent

Front 148

Rfs for atraumatic spleen rupture?

Back 148

Front 149

1- Alarm sx of IBS?

2- NBSIM?

Back 149

1- NGO WIPE FU

2- colonoscopy

Front 150

Rfs for severe life threatening asthma?

Back 150

Front 151

Objective measures in severe life threatening asthma?

Back 151

Front 152

Exam findings in severe life threatening asthma?

Back 152

Front 153

1- Pathophys of congenital dacryostenosis?

2- px?

Back 153

Front 154

1- Rx of congenital dacryostenosis?

2- complications?

Back 154

Front 155

VACTERL screening?

CHARGE?

Back 155

For both

1- Echo

2- Renal US

Above plus these For VACTERL

3- contrast enema for anal atresia

4- limb radiographs

Front 156

Microcephaly definition?

Back 156

1- >2 SD below mean

2- <2 percentile for age

Front 157

Benign familial microcephaly?

Back 157

Genetically small head circumference that typically occurs in an infant who has normal height & weight & has a parent with a similarly small head

Front 158

1- Features suggestive of benign microcephaly ?

2- NBSIM?

Back 158

2- measure parental head circumferences

Front 159

Microcephaly+ early closure of fontanelle.

Dx?

Back 159

Underlying genetic disorder

Front 160

1- Hypertrophic CM in infants of diabetic mothers pathogen?

2- px?

3- imaging?

4- Rx?

5- prognosis?

Back 160

Front 161

1- Causes

2- px

3- Rx

of community acquired PNA in school age children

1- if lobar

2- if B/L

Back 161

Front 162

Typical age of onset of CVID?

Back 162

1- adolescence (around puberty)

2- early adulthood 20-40

Front 163

Clinical features suggesting Dec likelihood of MI despite Inc troponins?

Back 163

1- mild troponins elevation in context of CKD => Dec clearance of troponins

2- hx of chronically Inc troponins in prev hospitalizations

3- absence of clinical signs or findings suggestive of myocard ischemia eg ECG changes, new murmur

Front 164

1- Rfs for hypoglycemia in insulin therapy?

2- px?

Back 164

Pts with dec glucagon response eg in pancreatogenic diabetes => rapid, severe hypoglycemia with little warning

Front 165

Rx of hypoglycemia in insulin therapy?

Back 165

Front 166

Metabolic abnormalities associated with hypovolemic shock?

Back 166

1- hypernatremia/ hyponatremia

2- hyperkalemia

3- metabolic acidosis

Front 167

Progressive ECG changes in hyperkalemia?

Back 167

Peaked T waves=> loss of P waves=> widened QRS=> sine wave pattern => asystole

Front 168

NSAIDs effect on CHF?

Back 168

Often exacerbates it due to Na retention

Front 169

CXR infiltrate of PNA due to Bacteria/virus VS that of CHF?

Back 169

1- CXR infil of PNA=> Takes several wks to months to resolve despite clinical improvement after Abx

2- CXR infil of CHF resolves rapidly after diuretic therapy

Front 170

RTA typical px?

Back 170

1- Non-anion gap metabolic acidosis

2- FTT

Front 171

Typical associations of RTA?

Back 171

Type 1=> often a genetic DO & commonly associated with nephrolithiasis

Type 2=> commonly component of fanconi

Type 4=> obstructive uropathy & Aldo Insufficiency are common in children

Front 172

Pathophys of variable deceleration?

Back 172

UC Compression & Occlusion of umbilical vessels=> Inc in fetal SVR & BP => reflexive rapid Dec in FHR ie variable deceleration

Front 173

1- Cf s of hyerandrogenism?

2- DD?

Back 173

Front 174

Dx criteria of PCOS?

Back 174

2 of following 3 :

1- clinical or lab evidence of hyerandrogenism

2- menstrual irregularities

3- PCOS on US

Front 175

Normal fetal activity in 3rd trimester?

Ie >28 wks

Back 175

≥10 movements in 2 hrs

Front 176

Proteinuria definitions considered in preeclampsia?

Back 176

1- ≥300 mg/24 hr OR

2- protein/Cr ratio ≥0.3 OR

3- dipstick ≥1+

Front 177

Communication failure between physicians during pt handoff results in?

Back 177

1- Medical errors

2- adverse pt outcomes

Front 178

Rx of medical errors due communication failure between physicians during handoff?

Back 178

Implementing a sign out checklist

Front 179

Essential components of an effective sign out checklist?

Back 179

1- DNR/ don't intubate status

2- hospital course & recent events

3- current condition & anticipatory info

Front 180

Tobacco smoking Dec risk of which gyne ca?

Back 180

Endometrial ca

Front 181

1- Hypospadias px?

2- Rx?

Back 181

Front 182

1- Photokeratitis rfs?

2- px?

Back 182

Front 183

1- Dx of Photokeratitis?

2- Rx?

3- prevention?

Back 183

Front 184

Eye conditions associated with damage caused by UV light ?

Back 184

1- Photokeratitis

2- pterygium

3- cataracts

Front 185

Hyphema?

Back 185

After trauma

1- pain

2- vision loss

3- blood in anterior chamber

Front 186

Ischemic colitis is a common complication of ?

Back 186

Vascular surgery eg aortic aneurysm repair

Front 187

Px of microscopic colitis?

Triggers

Dx?

Rx?

Back 187