Pance Ob/gyn, Ortho

Front 1

Dx: adhesions and fibrosis in uterus causing secondary amenorrhea (does not respond to estrogen)

Back 1

Ashermans syndrome

Front 2

Dx: implantation of endometrial tissue in the myometrium, tender enlarged "boggy" uterus

Back 2

adenomyosis

Front 3

Diagnostic FSH value in menopause?

Back 3

<30

Front 4

Unopposed estrogen increases the risk of what?

Back 4

endometrial cancer

Front 5

Dx: firm enlarged irregular uterus, dysmenorrhea and abnormal menstrual bleeding

Back 5

Leiomyomata (fibroids)

Front 6

Meds which may reduce size of fibroids?

Back 6

GnRH agonists
mifepristone

Front 7

What types of endometrial cancer are found in younger pts? Which type in older pts?

Back 7

Younger: estrogen dependent
Older: estrogen independent

Front 8

Diagnosis that must be ruled out in post menopausal bleeding?

Back 8

endometrial cancer

Front 9

Dx: dysmenorrhea, dyspareunia, spotting, fixed uterus, associated with infertility?

Back 9

endometriosis

Front 10

Dx: amenorrhea, hirsutism, infertility, and insulin resistance

Back 10

polycystic ovary syndrome

Front 11

"String of pearls" seen on ultrasound?

Back 11

polycystic ovary syndrome

Front 12

HPV types associated with genital warts?

Back 12

6 and 11

Front 13

HPV types associated with cervical cancer?

Back 13

16 and 18

Front 14

Area involved in most cervical cancers?

Back 14

transformation zone

Front 15

Ductal carcinoma presenting with ezcematous lesion of nipple?

Back 15

pagets disease

Front 16

Gestational age when fundus reaches the umbilicus?

Back 16

20 wks

Front 17

Gestational age when fetal heart rate can be heard on doppler?

Back 17

10-12 wks

Front 18

Gestational age when quickening occurs?

Back 18

18-20 wks

Front 19

Blood levels in first trimester associated with increased risk of Trisomy 21?

Back 19

low PAPP-A
high free B-hCG

Front 20

Bluish discoloration of vagina and cervix?

Back 20

chadwicks sign

Front 21

Softening between fundus and cervix?

Back 21

hagars sign

Front 22

Procedure used to test for neural tube defects?

Back 22

amniocentesis (15-18 wks)

Front 23

Maternal Blood levels associated with increased risk of trisomy 21 in 2nd trimester?

Back 23

low unconjugated estriol
low AFP
high inhibin A

Front 24

What maternal blood level is abnormally high in neural tube defects?

Back 24

AFP (2nd trimester)

Front 25

Medication used to treat most ectopic pregnancies?

Back 25

methotrexate

Front 26

Criteria for using methotrexate in an ectopic pregnancy?

Back 26

hCG < 5,000
ectopic mass < 3.5 cm
hemodynamically stable patient
with ability to follow up

Front 27

Explain the 5 types of spontaneous abortions?

Back 27

threatened: vaginal bleeding, closed cervix, no products passed

inevitable: vaginal bleeding, open cervix, no products passed

incomplete: vaginal bleeding, open cervix, some products passed

complete: vaginal bleeding, open cervix, all products passed

missed: no vaginal bleeding, closed cervix, no products passed but fetus dead

Front 28

Findings on ultrasound with hydatiform moles?

Back 28

"grapelike vesicles"
"snowstorm pattern"

Front 29

HcG levels seen with hydatiform mole?

Back 29

> 100,000

Front 30

Birth defects seen in gestational diabetes?

Back 30

macrosomia
prematurity
fetal demise
delated fetal lung maturity

Front 31

What tocolytics are used in preterm labor?

Back 31

mag sulfate
Beta agonists: ridodrine, terbutaline
CCB

Front 32

Tests used to diagnose premature rupture of membranes?

Back 32

nitrazine paper
fern test

Front 33

What med is administered in preterm labor < 34 wks to enhance fetal lung maturity?

Back 33

betamethasone

Front 34

Pregnancy induced hypertension presents when?

Back 34

> 20 wks

Front 35

Medication treatment of choice for severe pregnancy induced hypertension?

Back 35

Methyldopa
labetalol

Front 36

Classic triad of preeclampsia?

Back 36

hypertension
edema
proteinuria

Front 37

What is HELLP syndrome?

Back 37

Hemolysis
Elevated Liver enzymes
Low
Platelets

+ severe preeclampsia

Front 38

Proteinuria seen in mild and severe preeclampsia?

Back 38

mild: >300 mg /24 hr

severe: 5g in 24 hr

Front 39

DIP and PIP joints associated with osteoarthritis?

Back 39

DIP: heberdens
PIP: Bouchards

Front 40

Dx: Morning stiffness lasting >1 hr, symmetric arthritis with positive RF?

Back 40

rheumatoid arthritis

Front 41

Dx: polyarthralgias, salmon pink rash appearing daily in the evening associated with fever, <16 yo?

Back 41

Juvenile idiopathic arthritis

Front 42

Uveitis that may lead to blindness is associated with what positive lab value in juvenile idiopathic arthritis?

Back 42

ANA

Front 43

Most common bacteria involved in septic arthritis?

Back 43

staph aureus

Front 44

Sausage finger appearance is seen in what type of arthritis?

Back 44

psoriatic

Front 45

Xray findings of psoriatic arthritis?

Back 45

pencil in cup (proximal phalanx)

Front 46

Tetrad of conditions in reactive arthritis (reiters syndrome)?

Back 46

urethritis
conjunctivitis
oligoarthritis (asymmetric)
mucosal ulcers

Front 47

Common causes of reactive arthritis?

Back 47

sexually transmitted infection
(chlamydia)

gastroenteritis
(shigella, salmonella, yersinia, campylobacter)

Front 48

Common positive antigen blood level in reactive arthritis?

Back 48

HLA-B27 (50-80%)

Front 49

Name for first MTP joint, most common site of gout?

Back 49

podagra

Front 50

Deposits of urate crystals adjacent to joint, seen in chronic gout?

Back 50

tophi

Front 51

Gout findings on fluid aspiration?

Back 51

rod shaped negatively birefringent urate crystals

Front 52

Causes of hyperuremia?

Back 52

Primary: idiopathic overproduction or over excretion

Secondary:
-Overproduction due to purine intake, myelo/lympho proliferative, drugs, hemolytic anemia

Front 53

Tx of choice for acute gout?

Back 53

indomethacin 25-50mg TID

steroids if renal insufficiency

Front 54

Side effects of colchicine?

Back 54

n/v, diarrhea

Front 55

What causes of pseudogout should be ruled out in younger patients?

Back 55

Hemochromatosis
Hypothyroidism
Hyper parathyroidism

Front 56

Joint aspiration findings in pseudogout?

Back 56

rhomboid calcium pyrophosphate crystals, positively birefringent

Front 57

Systemic sx and findings in lupus?

Back 57

malar rash
discoid rash
photosensitivity
oral ulcers
arthritis
serositis (heart lungs)
renal disease
Heme disorders
Neuro disorders (seizures, psychosis)

Front 58

Lab value that is very sensitive for SLE?

Back 58

ANA

Front 59

Besides ANA, what lab tests are very specific for SLE?

Back 59

Ro
La
ds-DNA
Smith
histone (usually drug induced SLE)
U1-RNP

Front 60

What meds cause SLE?

Back 60

procainamide
hydralazine
penicillamine
minocycline
INH
methyldopa
quinidine
chlorpromazine
diltiazem

Front 61

Dx: inflammatory disease affecting proximal limb, neck and pharynx muscles

Sx: weakness, syphagia, poyarthralgias

Back 61

polymyositis

Front 62

Clinical findings in dermatomyositis?

Back 62

polymyositis +
malar (shawl sign) or heliotrope rash

Front 63

What muscular inflammatory condition is associated with occult malignancy?

Back 63

polymyositis

Front 64

Scaly purple plaque found over finger/elbow joints in dermatomyositis?

Back 64

gottrons papules

Front 65

Elevated lab values in polymyositis?

Back 65

ANA
CPK
aldolase
anti Jo1
anti Mi2

Front 66

Dx: pain and stiffness in neck, shoulders, pelvic girdle. Accompanied by fever, fatigue, weight loss, depression

Back 66

polymyalgia rheumatica

Front 67

What condition is polymyalgia associated with?

Back 67

temporal arteritis

Front 68

Polyarteritis nodosa is associated with what infection?

Back 68

HepB

Front 69

Dx: vasculitis causing fever, wt loss, abd pain, neuropathy, arthralgias, arthritis, HTN , uremia

Back 69

polyarteritis nodosa

Front 70

Skin lesions seen in polyarteritis nodosa?

Back 70

livedo reticularis
palpable purpura

Front 71

What is CREST syndrome?

Back 71

seen in limited scleroderma

Calcinosis
Raynauds
Esophageal dysfunction
Sclerodactyly
Telangiectasias

Front 72

Lab value associated with Limited scleroderma?

Back 72

anticentromere antibody

Front 73

Lab value associated with Diffuse scleroderma?

Back 73

anti-Scl-70

Front 74

Dx: dry mouth, dry eyes, enlarged parotid glands

Back 74

sjogrens syndrome
(autoimmune destruction of salivary and lacrimal glands)

Front 75

Test to evaluate tear secretions in sjogrens syndrome?

Back 75

schirmers test
(filter paper placed in lower eyelid)

Front 76

Sickle cell patients are at risk for developing what kind of osteomyelitis?

Back 76

salmonella

Front 77

Sarcoma found in diaphyses of long bones/ribs/flat bones found in pts age 5-25?

Back 77

Ewings sarcoma

Front 78

Sarcoma found in metaphyseal area of long bones, ages 10-20?

Back 78

osteosarcoma

Front 79

Most common fracture sites in type 1 osteoporosis?

Back 79

vertebrae
hip
distal radius

Front 80

Classification system for childrens fractures involving the epiphyseal plate?

Back 80

salter harris

Front 81

Stretching or tearing of a ligament?

Injury to muscle near muscle-tendon junction?

Back 81

sprain

strain

Front 82

Cause of rheumatoid arthritis?

Back 82

hyperplastic synovial tissue (pannus) erodes cartilage, bone, capsule and ligaments

Front 83

Hand findings in rheumatoid arthritis?

Back 83

ulnar deviation

subluxation of MCP joint

swan-neck deformity (flexion of DIP, extension of PIP)

boutonnieres deformity

Front 84

Most common benign bone neoplasm of the hand?

Back 84

enchondroma

Front 85

Most common primary malignancy of bone?

Back 85

multiple myeloma

Front 86

Most common shoulder dislocation, fall on an outstretched arm?

Back 86

anterior glenohumoral

Front 87

2 Tests for shoulder impingement?

Back 87

1: Neers sign: flexion to fully overhead
2: Hawkins sign: passive abduction to 90 degrees then internal rotation

Front 88

Exam tests for rotator cuff problems?

Back 88

apley scratch test (touch opposite scapula)

drop arm test

empty can test (thumb pointing down, raises arm against force)

Front 89

Xrays findings of calcium deposits under supraspinatus?

Back 89

calcific tendonitis

Front 90

Inflammation of joint after injury or idiopathically, common in diabetics, pain with restricted ROM

Back 90

Adhesive capsulitis

Front 91

Most common nerve injured in humeral shaft fracture?

Back 91

radial nerve

Front 92

Xray finding in supracondylar humerus fracture?

Back 92

fat pad sign (joint capsule distended with blood)

Front 93

Dx: subluxation of head of radius, usually child that was lifted at wrist

Back 93

nursemaids elbow

Front 94

Site of lateral epicondylitis (tennis elbow)?

Back 94

extensor carpi radialis brevis tendon

Front 95

Site of medial epicondylitis (golfers elbow)?

Back 95

flexor carpi radialis tendon

Front 96

Radial shaft Fracture associated with distal radioulnar dislocation?

Back 96

galeazzi

Front 97

Fracture of ulnar shaft associated with radial head subluxation?

Back 97

monteggia fracture

Front 98

Dx: fall on outstretched hand, diner fork deformity, dorsal displacement of wrist?

Back 98

colles fracture (distal radius fx)

Front 99

Dx: Tenosynovitis inhibiting flexion/extension of finger joint, thickening of A1 pulley?

Back 99

Trigger finger

Front 100

Dx: hyperabduction and radial deiation to 1st MCP joint?

Back 100

gamekeepers thumb
(skiers thumb)

Front 101

Sign seen in flexor tenosynovitis:
-tendernes over sheath
-symmetric enlargement of whole finger
-pain on passive ROM
-flexed rested position

Back 101

Kanavel's sign

Front 102

Dx: LE pain exacerbated with walking, relieved with bending forward

Back 102

neurogenic claudication (from spinal stenosis)

Front 103

Dx: young male with stiffness and back/hip pain which improves with activity, associated with uveitis

Back 103

ankylosing spondylitits

Front 104

Lumbar film findings in ankylosing spondylitis?

Back 104

bamboo spine (fusion of spine)

Front 105

Condition in children associated with avascular necrosis of the femoral head?

Back 105

legg-calve perthes disease

Front 106

Displacement of femoral neck caused by weakening of epiphyseal plate of femur?

Back 106

slipped capital femoral epiphysis

Front 107

MC nerve injury in humeral shaft fracture?

Back 107

radial nerve