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226 Cards in this Set
- Front
- Back
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dystonia
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neurological movement disorder, in which sustained muscle contractions cause twisting and repetitive movements or abnormal postures.
Drugs: antipsychotics (phenothiazines, chlorpromazine, haloperidol), antiemetics (metoclopramide), anticonvulsants Lesch±Nyhan syndrome Autosomal dominant, e.g. spinocerebellar degenerations, Huntington's disease Autosomal recessive, e.g. Wilson's disease Mitochondrial disease |
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vsd
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most common con heart defect
failure to thrive and recurrent respiratory infections Blowing holosystolic |
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cyanotic heart defects
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5 Ts
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phases of pertussis
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catarhall
paroxysmal convalescent |
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Treatment of RSV
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ribavirin
oxygen airway beta agonist |
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meningitis in 3 months to 10 years
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S. pneumoniae
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meningitis in 10 - 19 years
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N. meningitidis
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meningitis in 1-3 months
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Group B strep
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meningitis in older than 50-60 and immunocompromised
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listeria monocytogenes
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precipitating factors for cluster headaches
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Alcohol consumption, smoking and nitroglycerin can precipitate cluster headaches.
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hordeolum
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infection of external sebaceous gland (s. aureus)
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chalazion
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blocked internal meibomian gland
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olopatadine
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topical antihistamine
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MCC AOM
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s. pneumo
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giardia diarhea tx
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flagyl
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crohn's
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gradual onset
mouth to anus (mostly right sided) skip lesions trasmural depth diarrhea and pain fisutlas (common) toxic megacolon and cancer |
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Ulcerative colitis
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sudden or gradual onset
distal to proximal conitinuous only mucosal surface bloody puss-filled diarrhea, tenesmus toxic megacolon and cancer loss of haustral markings in colon |
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Questran (cholestyramine)
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bile acid sequestrant and is indicated in the treatment of postprandial diarrhea which may be a possible side effect following a laparoscopic cholecystectomy due to increased concentration of bile acids in the colon
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kyphosis
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n increase in the normal convex curvature of the thoracic spine (> 50 degrees, when measured with a modified Cobb angle
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lordosis
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Increased concave curvature of the lumbar spine
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scoliosis
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Abnormal shoulder and iliac crest heights due to horizontal curvature of the spine
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Galleazzi fracture
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A distal radius fracture with associated disruption of the distal radioulnar joint
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Monteggia fracture
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A distal ulnar fracture with associated distal radioulnar joint disruption
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Colles' fracture
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A distal radius fracture with dorsal displacement of the fracture fragments
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Smith's fracture
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A distal radius fracture with volar displacement of the fracture fragments
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Clomiphene
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Clomiphene is the first line medical therapy used in the treatment of infertility. It works to help induce ovulation by stimulating gonadotropin release, specifically LH. About 90% of patients given this type of therapy will ovulate, with a subsequently high rate of pregnancy. About 5% of patients treated with clomiphene will result in twin births
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wernicke's aphasia
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"Receptive aphasia") occurs when the area of the brain that organizes speech is affected. The patient retains the ability to produce speech, but is unable to organize it into comprehensive language.
When we want to speak, we formulate what we are going to say in Wernicke’s area, which then transmits our plan of speech to Broca’s area, where the plan of speech is carried out |
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broca's aphasia
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Expressive aphasia (non-fluent aphasia) is characterized by the loss of the ability to produce language (spoken or written)
speech is difficult to initiate, non-fluent, labored, and halting. |
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Mirtazapine
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remeron
This medication is generally used for depression with insomnia and decreased appetite |
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Paroxetine
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depression with anxiety
paxil |
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Sertraline
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zoloft
antidepressant which is activating helps get going in the morning |
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Duloxetine
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cymbalta
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drug class of choice in the treatment of diptheria
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penecillin
grayish pseudomembrane covering the tonsils. |
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malaria causing strains is associated with the highest morbidity and mortality
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Plasmodium falciparum
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Zidovudine
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idovudine, a nucleoside reverse transcriptase inhibitor has the common side effects of peripheral neuropathy and pancreatitis. Though they are infrequently concomitant, for the purposes of study, they have both been added to the clinical scenario.
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found on autopsy of animals with Rabies.
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Negri bodies
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ound on autopsy of patients with Alzheimer's disease
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Neurofibrillary tangles
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This finding is seen in Alcoholic hepatitis, and is described as clumps of eosiniphilic material in the liver
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Mallory bodies
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This is seen in patients with Multiple Sclerosis
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Periventricular plaques
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This is seen on peripheral smear of patients with Multiple Myeloma
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Rouleaux formation
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first line antibiotic therapy that is currently recommended in treating cholecystitis.
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Ceftriaxone and Metronidazole
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Apprehension test
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Used to determine anterior instability of the shoulder, and though sometimes dislocation may lead to a SLAP injury, the O'Brien's test is more specific for SLAP injuries than the Apprehension test.
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Yergason's test
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Yergason's test is used in evaluation of biccipital tendonitis, and is pain in the biccipital groove with resisted supination
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O'Brien's test
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Though various sources have determined that no one technique can accurately diagnose a SLAP injury, O'Brien's test one of the more reliable tests used in the assessment of these shoulder injuries. A positive O'Brien's test produces pain when the arm is adducted across the chest with the thumb pointed inferiorly, but no pain with the thumb pointed superiorly. (If pain with both movements suspect an AC joint injury)
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Phalen's test
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This test is used to increase suspicion for carpal tunnel syndrome, and is a reproduction of symptoms after having the patient hold one or both wrists in the fully flexed position for 30-60 seconds
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Placenta Previa
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Painless vaginal bleeding in the 3rd trimester is most commonly secondary to this condition.
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Abruptio Placentae
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This would more likely present as painful vaginal bleeding in the 3rd trimester.
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Uterine Atony
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This is the most common cause of postpartum bleeding
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Which of the following immunoglobulins would you expect to be equal in both the mother and the fetus?
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IgG is the smallest of the immunoglobulins and easily crosses the placental barrier thus allowing mother and fetus to have equal share of this immunoglobulin.
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fundus at 12 weeks gestation
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Pubic symphysis
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fundus at 16 weeks gestation
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Half way between the symphysis and umbilicus
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fundus at 20 weeks gestation
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umbilicus
1 cm above umbilicus per week after 20 weeks |
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absolute contraindication to oral contraceptive medications
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History of deep vein thrombosis
B: >35 year old smoker C: Personal history of breast cancer D: Suspected pregnancy E: History of cerebrovascular accident |
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Meningitis Tx
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In cases of suspected meningitis, empiric antibiotic therapy should be initiated even before a lumbar puncture is obtained.
If CSF is not clear & colorless or yields positive results, continue with antibiotic therapy according to accepted antibacterial guidelines and repeat the LP in 24 hours. Current guidelines include: <3mo - ampicillin + cefotaxime 18-50y - cefotaxime + vancomycin + dexamethasone > 50 - ampicillin + ceftriaxone + vancomycin + dexamethasone |
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Adjustment disorder
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nxiety, depression, or a combination of the two is also associated with this disorder. Adjustment disorder is defined as development of anxiety, depression, or both within three months of an identified stressor such as finances, divorce, or illness in an individual's life. Impairment in
their job and relationships occur, but the condition usually resolves within six months. |
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Schizoaffective
disorder |
schizophrenia-type symptoms in addition to the depressive symptoms. For a diagnosis of Schizoaffective disorder to be made however, the patient must have delusions/hallucinations for two weeks without evidence of the mood changes
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Schizophreniform disorder
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Patients suffering from Schizophreniform disorder meet the criteria for schizophrenia for greater than 1 month, but less than 6 months.
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four "A's" used to describe symptoms associated with dementia
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A: Amnesia
B: Aphasia D: Apraxia E: Agnosia |
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the following tests is used to best evaluate the success of antiretroviral therapy in a patient with HIV?
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Serum viral load
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PATCH 4 MD for asystole
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Pulmonary embolus (thrombus)
Acidosis (hydrogen ions) Tension Pneumothorax Cardiac Tamponade Hypoxia Hypothermia Hypo/Hyperkalemia Hypovolemia (trauma) Massive MI (thrombus) Drug OD (toxins) |
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hypercalcemia and hyperparathyroidism
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stones (renal calculi)
bones (osteolysis) moans (psychiatric disorders) groans (PUD, pancreatitis, constipation) |
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most common type of hernia in the United States
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Indirect Hernia
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Sensation in which of the following places would indicate that sensory function is intact for median, radial, and ulnar nerve distributions?
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Dorsum of the hand, the thenar eminence, and the 5th digit
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recommended NSAIDs for the treatment of symptoms of dysmenorrhea.
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Mefenamic acid (Ponstel)
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most common presenting symptom of Dementia?
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Progressive impairment of intellectual functioning, with compromise in 2 of following: language, memory, visuospatial skills, emotional behavior, personality, cognition
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Cluster B includes:
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Borderline,
Antisocial, Histrionic, Narcissistic. Think "dramatic" or "aggressive". |
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Parathyroid adenoma
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most common cause of hyperparathyroidism. Buzz words include: "Bones, stones, abdominal groans, psychic moans, and fatigue overtones
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shortening of the QT interval
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Hyperparathyroidism with hypercalcemia
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lengthening of QT
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hypoparathyroid with hypocalcemia
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most common presenting symptom in diabetic gastroparesis?
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Vomiting several hours after meals
treat with metoclopromide |
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acute angle closure glaucoma medications
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A: Acetazolamide
B: Pilocarpine C: Timolol ophthalmic solution D: Mannitol |
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classic triad of intussusseption
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abdominal pain, vomiting, and currant jelly stools.
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antibody titers would you expect to be elevated in a patient with Primary Biliary Cirrhosis?
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Anti-mitochondrial antibody
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This antibody is associated with Antiphospholipid Antibody Syndrome (AAS)
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Anti-cardiolipin antibody
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antibody positive in many of the rheumatologic conditions
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Anti-nuclear antibodies
SLE, RA, or Scleroderma |
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antibody highly specific for a diagnosis of Systemic Lupus erythematosus (SLE)
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Anti-double stranded DNA
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antibodies are associated with Scleroderma,
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Anti-centromere antibodies
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skip lesions?
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Crohn's disease usually presents with possible ulcerative lesions from the mouth to the anus that are generally non-contiguous. The terminal ileum is the most common location for these lesions. The lesions in Ulcerative colitis are generally continuous areas of inflammation beginning distally.
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Which of the following is the gold standard diagnostic study in a patient with suspected Celiac disease?
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Small bowel biopsy via EGD
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Wrist drop in this patient with a humeral shaft fracture indicates
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radial nerve injury.
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poliomyelitis vaccine
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inactivated parenteral vaccine is now the standard vaccination technique used in the United States
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In cases of optic neuritis, which of the following testing parameters is most severely affected?
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Ishihara color vision testing
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10mm or greater of induration
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This is considered a positive test in patients with kidney disease, diabetes, healthcare workers, or someone exposed to active TB. It is the area of induration, not the erythema that determines a positive test.
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5mm or greater of induration
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his is a positive test in immunocompromised patients, such as HIV, Crohn's, Rheumatoid arthritis. (1) 5mm of induration is considered positive in persons who have confirmed exposures to TB.
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Which of the following is the most sensitive test for tuberculosis in this patient population?
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PPD test is the most sensitive test for tuberculosis in otherwise healthy individuals. (1) Remember that sensitive tests help to rule out conditions. A negative PPD effectively eliminates the possibility that this healthy patient has contracted TB.
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In a patient that is diagnosed with epiglottitis, which of the following antibiotic therapies is indicated?
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Ceftriaxone
3rd gen cephs |
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What is the most common type of thyroid neoplasm?
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Papillary carcinoma
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This is the type of thyroid cancer with the worst prognosis
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Anaplastic carcinoma
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You note a diffuse bronze-colored hyperpigmentation of the lower extremities. What is the gold standard diagnostic test for this patient's condition?
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Addison's disease, or adrenal insufficiency, is caused by destruction or dysfunction of the adrenal cortex. Autoimmune destrucion is the most common cause within the United States. ACTH produced at the pituitary causes the adrenal cortices to produce cortisol in healthy individuals; which explains the logic behind the Cosyntropin test. A rise in serum cortisol levels to 20 mcg/dL or more after administration of the synthetic ACTH indicates a normal functioning adrenal cortex. A suboptimal response to the Cosyntropin test confirms the presence of primary Addison's disease
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Which of the following is the most common cause of intestinal obstruction in an one year old child?
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Intussusception
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Which of the following antibiotic regimens is indicated in the treatment of a patient with suspected diverticulitis?
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Metronidazole and Ciprofloxacin
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In which of the following anatomical locations are peptic ulcers most likely to occur?
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Lesser curvature of the stomach and the duodenal bulb
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Rovsing's test
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Test used in evaluation of abdominal pain, and may be positive in patients with acute appendicitis
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Finklestein's test
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involves placing the thumb loosely inside the fingers and assessing pain with ulnar deviation of the wrist
evaluation of wrist pain due to DeQuervain's tenosynovitis. |
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Phalen's test
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This test is used to increase suspicion for carpal tunnel syndrome, and is a reproduction of symptoms after having the patient hold one or both wrists in the fully flexed position for 30-60 seconds
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most specific test used for detecting Sjögren's syndrome?
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Anti-La
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What is the treatment of choice for vaginal candidiasis in a pregnant patient?
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Miconazole nitrate vaginal cream
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The 3 D's: Dysmenorrhea, Dyspareunia, and Dyschezia are characteristic for
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endometriosis
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Results of a LP showing Viral infection would be:
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CSF - opening pressure normal, WBC < 1,000 with lymphocytes or monocytes, and protein, glucose normal
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Bacterial meningitis
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Meningitis will present with Fever, HA, vomiting, nuchal rigidity, AMS (petechial rash w/ N. meningitidis ), and possible Kernig & Brudzinski's on PE. LP will show (CSF turbid or purulent, ? pressure, WBC 1000-10000 with increased neutrophils, protein of 100-500, glucose < 40
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Which of the following diseases is most commonly associated with detection of intracellular Lewy bodies?
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Parkinson's Disease
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Which of the following is contraindicated in the treatment of cocaine overdose?
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While beta blockers are effective in treating the symptoms of cocaine withdrawal, they are contraindicated in cocaine overdose because they block only the beta receptors leaving alpha adrenergic receptors unopposed and available for increased stimulation by cocaine which can lead to hypertension, reduced coronary blood flow, reduced left ventricular function, and reduced cardiac output and tissue perfusion
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ou suspect thrombotic thrombocytopenic purpura (TTP). Which of the following is not commonly associated with this condition?
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Abnormal coagulation tests
Patients with TTP will have normal coagulation studies, separating this condition from DIC which may also be included on the differential. |
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vit k dependent clotting factors
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stayfree tends to nicely stop clots
7 10 2 9 S C |
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most common type of leukemia.
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CLL
smudge cells |
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Elongation of the PR interval until a QRS is dropped is characteristic of
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Second degree Type 1 block (wenkebach)
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In the treatment of pulmonary tuberculosis, what should be coadministered with isoniazid to reduce the risk of peripheral neuropathy?
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Vitamin B6
Isoniazid has a potential side effect of causing peripheral neuropathy. Patients should be routinely screened with a full neurologic exam. Vitamin B6 should be coadministered with isoniazid to prevent neuritis. |
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Which of the following types of anemia may be present in patients with Celiac disease?
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Iron deficiency anemia
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Which of the following is a recommended therapy in the treatment of Hepatitis C?
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ribavirin
his medication is indicated in the therapy of patients with Hepatitis C along with alpha-interferon if no contraindications exist. |
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This is the most common electrolyte abnormality seen in patients who are in the hospital.
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Hyponatremia
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safe UTI tx in pregnancy?
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nitrofurantoin
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Jefferson's fracture involves which of the following bones?
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Jefferson's fracture is a fracture of C1. Also referred to as an atlas fracture, this type of fracture is more commonly seen with axial load injuries such as direct blow to the top of the patients head, best detected with odontoid view xray or CT scan.
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fracture of both pedicles of C2 and is most commonly seen in an extension mechanism injury. It also may be seen in MVA secondary to deceleration increasing hyperextension forces.
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Hangman's fracture
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"5 P's": pulselessness, paralysis, paresthesias, poikilothermia, and pallor - and one could add pain out of proportion to visible injury
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Compartment syndrome
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Which of the following is the earliest sign seen in preeclampsia?
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Hypertension
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which of the following vaccines do you want to avoid giving during pregnancy?
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Rubella
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Which of the following types of HPV is the most severe and has the worse prognosis?
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Types 16, and 18 are associated with cervical cancer and type 18 has the worse prognosis; types 6 and 11 are associated with genital warts.
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strong musty breath odor. Lab tests are ordered. Which of the following labs is most helpful in determining this patient's condition?
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This patient most likely has hepatic encephalopathy which is due to failure of the liver to detoxify noxious agents especially ammonia. High levels of ammonia in the patient's blood may be expelled through the lungs and present with a musty breath odor; often referred to as "hepatic fetor".
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generally seen in patients with Schizophrenia - Catatonic type?
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A: Motoric immobility
B: Extreme negativism or mutism C: Peculiar voluntary movements D: Echolalia |
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treatment of choice in cases of Melasma.
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Topical hydroquinone
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erythematous plaques, and target lesions spread diffusely over both lower extremities.
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Erythema multiforme, most commonly recognized by its "target lesions" is commonly due to drug reactions, or may be due to recurrent HSV infection.
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Which of the following organisms is the most common cause of myocarditis?
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Coxsackie Virus
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"PROVe"
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Tet of F
Pulmonary stenosis Right ventricular hypertrophy Overriding aorta Ventricular septal defect e |
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post op fever
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POD#1: Wind: Atelectasis or pneumonia
POD#3: Water: UTI, anastomotic leak POD#5: Wound: Wound infection, abscess POD#7: Walk: DVT/PE Wonder drugs - consider medication related fever |
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Theophylline works by this mechanism.
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Blockade of adenosine receptors leading to increase in cAMP and bronchiole smooth muscle relaxation
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his accurately describes the mechanism of action of ipratropium
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Blockade of muscarinic receptors resulting in bronchodilation
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Cromolyn sodium works by this mechanism.
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Inhibition of release of histamine from mast cells
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Montelukast works by this mechanism.
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Inhibits leukotriene receptors
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Beta agonists such as albuterol work by this mechanism of action.
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Activating adenylate cyclase and increase cAMP by stimulating beta receptors
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Which of the following medication classes should be avoided in patients experiencing hyperparathyroidism?
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Certain diuretics may cause an increase in serum calcium due to decreased renal excretion, thus worsening symptoms in hyperparathyroidism. Lithium has also been implicated in increasing serum calcium levels, and causing hyperparathyroidism in patients treated chronically
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Which of the following medication classes should be avoided in patients experiencing hyperparathyroidism?
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Bisphosphonates, calcium receptor antagonists, and beta blockers may be used in the treatment of primary hyperparathyroidism
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bump on her right eyelid. She admits to light sensitivity, lid heaviness, and increased tearing in the affected eye, but denies pain. Her vision is unaffected. On physical exam the lid appears swollen, but not erythematous and the mass is non-fluctuant
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chalazion
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Erythematous or pink annular lesions on the trunk or inner surface of the limbs
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Erythema marginatum
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A mildly erythematous ring surrounding a pale center
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Erythema multiforme, this describes the "target lesion".
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A fine erythematous, papular rash with a rough texture generally located on the torso
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Scarlet Fever, which is seen in infection with Group A ?-hemolytic strep
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Tender erythematous nodules generally seen on the anterior lower extremity
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Erythema nodosum
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A widespread maculopapular rash covering the trunk and extremities, but sparing the palms and soles
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Viral exanthem
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Celiac disease
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Dermatitis herpetiformis
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drug of choice, especially in elderly patients, when the patient presents with signs and symptoms of prostatitis.
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Fluoroquinolones
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Ulnar deviation at the wrist with the thumb held loosely in the fingers
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Finklestein's test for DeQuervain's tenosynovitis.
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This would produce pain in a patient with medial epicondylitis
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B: Resisted pronation with the elbow held at a 90° angle
C: Resisted flexion of the wrist |
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This would produce pain in a patient that had fractured their scaphoid
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Pressure applied just distal to the radial styloid
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A: Swan neck deformity
B: Boutonniere deformity |
RA
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C: Heberden's nodes
E: Bouchard's nodes |
OA
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Mallet finger
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caused by rupture of the extensor tendon as it inserts into the base of the distal phalanx
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No motion of the foot is observed when squeezing the gastrocnemius muscle
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This is the correct description of a positive Thompson test, used in evaluating for Achilles tendon rupture.
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A: No motion of the foot is observed when squeezing the gastrocnemius muscle
B: Pain in the right lower quadrant with deep palpation in the left lower quadrant C: Anteroposterior mobility of the patella when fluid is moved from suprapatellar area D: Pain when arm and forearm are held at 90° and internally rotated E: Laxity with anterior motion of the ankle |
Answer A: This is the correct description of a positive Thompson test, used in evaluating for Achilles tendon rupture.
Answer B: This is a positive Rovsing's test. See A Answer C: This is a positive Ballottement test. See A Answer D: This is a positive Hawkin's test. See A Answer E: This is a positive anterior drawer. See A |
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A: Intracellular Lewy bodies
B: Oligoclonal bands C: CT shows cerebral and caudate nucleus atrophy D: EEG shows generalized spikes and associated slow waves E: Increased serum ceruloplasmin concentration |
Answer A: Associated with Parkinson's disease. See B
Answer B: Oligoclonal bands, and myelin basic protein, found in the CSF would best confirm a diagnosis of MS. Answer C: Seen in Huntington's disease. See B Answer D: Seen in Non-convulsive seizures. See B Answer E: This test is associated with Wilson's disease. See B |
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Treatment with which of the following agents can lead to decreased serum lithium levels?
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Valproic acid
VPA when administered concurrently with lithium may lead to a decrease in lithium levels. These levels should be monitored closely to ensure efficacy when starting VPA, and to prevent lithium toxicity when stopping VPA. |
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A: Paramyxovirus
B: Coxsackie A16 virus C: Parvovirus B19 D: Human herpes virus 6 E: Pox virus |
Answer A: Measles is caused by a paramyxovirus, and Rubella (German measles) is caused by a Togavirus. See C
Answer B: This is the causative organism in Hand-foot-mouth disease. See C Answer C: This patient most likely has Erythema infectiosum, for which the most common causative agent is Parvovirus B19. Answer D: HHV 6 or 7 are causative agents in Roseola infantum. See C Answer E: The causative agent in Molluscum contagiosum. See C |
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Answer A: This organism causes cat scratch fever. See C
Answer B: This organism has been implicated in cases of rat-bite fever. See C Answer C: This is the chief pathogen of interest in dog bites. Answer D: This infectious organism can be transmitted with human bites if the individual is infected. See C Answer E: Typical of a human bite. |
A: Bartonella henselae
B: Streptobacillus moniliformis C: Pasteurella multocida D: Hepatitis B E: Actinomycosis |
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the most common type of thyroiditis and is generally an autoimmune type disease affecting females. They will generally have a non-tender gland, and positive anti-TPO, and anti-TGB antibodies. These patients should be treated with thyroid hormone replacement.
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Hashimoto's thyroiditis
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generally occurs in young to middle aged women secondary to a viral infection, and thus is self-limited. These patients will have a tender thyroid gland, and an elevated ESR. Anti-thyroid antibody levels will be low, but T3 & T4 may be high. These patients should be given symptomatic care, and you may consider adding a steroid to their treatment regimen
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Subacute thyroiditis
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may occur at any time during the first six months after delivery, is self-limited, and may last from 1-2 months
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Postpartum thyroiditis
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can be very serious because it is caused by an infectious process. The patient will present with fever, an extremely tender gland that may be swollen and fluctuant. These patients should be admitted to the hospital to receive IV antibiotics
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Suppurative thyroiditis
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has the classic descriptors such as "invasive woody, or fibrous thyroiditis
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Reidel's thyroiditis
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most common pathophysiology causing Addison's disease?
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Autoimmune destruction of the adrenal cortex
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gallbladder problems. Which of the following antibiotics is the best choice at this time?
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Ceftriaxone and metronidazole
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What is the recommended therapy for the close contacts of a patient recently diagnosed with Hepatitis A?
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Immune globulin
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The incidence of infection with Norwalk-like virus is most common in which of the following months?
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January
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Which of the following patient populations is not at high risk for urinary tract infections?
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Middle aged females
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most sensitive screening test for prostate cancer?
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PSA
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Which of the following represents the best test for acute renal failure?
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Fractional excretion of sodium
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Supracondylar fracture of the humerus generally results from which of the following mechanisms of injury?
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Hyperextension
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This is the mechanism of injury most commonly in Radial head subluxation (Nursemaid's elbow)
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Longitudinal traction of forearm
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hich of the following is the most common side effect of methotrexate?
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Stomatitis or gastritis are the most common side effects of methotrexate.
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This is a SE of hydroxychloroquine.
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Macular damage
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Esophageal irritation
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Think bisphosphonates
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May be SE of high dose aspirin or ototoxic drugs such as aminoglycosides.
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Tinnitus
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"Snowstorm appearance" and "grapelike clusters" on ultrasound is high suspicion for
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molar pregnancy. Also very important to check HCG levels and rule out choriocarcinoma.
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This is the study of choice that allows for differentiation between hemorrhagic stroke and ischemic stroke, and should be performed first in order to determine the best course of action in the patient's treatment plan.
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Head CT without contrast
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There is no definitive testing for Parkinson's disease. A thorough medical history and neurologic exam, a diagnosis can be made according to the following criteria:
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- At least two of the three cardinal signs of Parkinson's (tremor, slowing of motion, muscle rigidity)
- Unilateral onset - Tremor, worse at rest - Improvement with administration of levodopa |
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Heinz bodies are pathognomonic
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G6PD
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A: Virchow's node
B: Sister Mary Joseph node C: Blumer's shelf D: Palpable left supraclavicular node E: Palpable periumbilical node |
Answer A: This is a palpable left supraclavicular node. See C
Answer B: Palpable periumbilical node. See C Answer C: Palpable pelvic nodes on pelvic or rectal exam are termed Blumer's shelf, and may be a sign of metastatic cancer. Answer D: This is called Virchow's node. See C Answer E: This is called a Sister Mary Joseph node. See C |
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Which of the following medications is most important when treating a patient with dilated cardiomyopathy and an ejection fraction of 50%?
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Lisinopril
ACE inhibitors are considered the mainstay of therapy in dilated cardiomyopathy and may be given with a beta-blocker and a diuretic. Digoxin is second line therapy for this condition Studies have shown that CCB, such as diltiazem, should be avoided in most cases of DCM |
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This is the initial study of choice when a DVT is suspected.
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Venous Doppler ultrasound
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present with acute painless vision loss, but the retina will have the appearance of the classic "blood and thunder".
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Central retinal vein occlusion
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due to an embolic event, and patients may even have multiple transient occurrences of vision loss.
"pale retina with a cherry red spot". |
CRAO is usually due to an embolic event
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the sphenopalatine artery is the major branch, is located posteriorly and the most common site of posterior epistaxis. Posterior epistaxis is more difficult to control and may require consultation and management by ENT.
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Woodruff's plexus,
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Around 90% of nosebleeds arise from
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Kiesselbach's plexus (an area of the anterior nasal septum where three main vessels converge
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Children with a diagnosis of nasal polyps should be referred to ENT for removal and to rule out?
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cystic fibrosis
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Which of the following is the most common cause of Large bowel obstructions?
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carcinoma
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Yergason's test
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A patient's arm is flexed to 90°, and the patient resists while the practitioner attempts to supinate the forearm.
bicep tendonitis |
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What is the gold standard test for the diagnosis of carpal tunnel syndrome?
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Nerve conduction velocity
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most common knee complaint in primary care, and is most often caused by an imbalance in quadriceps strength. It is often seen in females, who tend to have a larger Q angle, resulting in a tendency for the patella to be pulled laterally and become worn and painful.
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Patellofemoral syndrome, or chondromalacia patella
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In which of the following skull fractures is surgical intervention required?
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Depressed
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Which of the following medications can be used in pregnant patients exhibiting manic characteristics?
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Haloperidol is a category C drug; meaning that no human studies have been conducted, or that benefits outweigh risks in treating this condition.
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Odd or eccentric behavior or appearance
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this is common with patients with Schizotypal personality disorder
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Bears grudges and feels socially isolated
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This characteristic is more commonly associated with Paranoid personality disorder. This disorder is more commonly seen in first degree relatives of schizophrenic patients.
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Lack of remorse for unacceptable activities
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Antisocial personality
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Patients with _______________ exhibit a pattern of social detachment and restricted affect, and may also have some of the following characteristics: doesn't enjoy or seek close relationships, chooses solitary activities or professions, shows little interest in sexual activity, has few friends besides first degree relatives, is emotionally detached and indifferent to praise or criticism.
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Schizoid personality disorder
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Magical thinking
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Schizotypal personality disorder
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What is the most common location affected by erysipelas?
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Legs
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The 3 D's: diplopia, dysarthria, and dysphagia in the absence of other CNS findings
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botulism
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ecchymosis around the umbilicus, which can sometimes be seen with acute pancreatitis.
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Cullen's sign
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ecchymosis of the flanks, which can sometimes be seen with acute pancreatitis
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Cullen's sign
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haracterized by behavioral changes that include apathy, assaultiveness, and impaired judgment. Physiological changes include nystagmus, slurred speech, psychomotor retardation and movement abnormalities such as incoordination, depressed reflexes, ataxic gait and tremor. Mood presentation can range from euphoria to stupor.
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inhalants
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characterized by behavioral changes that include euphoria followed by apathy, shortened attention span and memory dysfunction, psychomotor agitation or retardation, and poor judgment. Physiological changes that may present include slurred speech, drowsiness, and pupillary constriction.
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opioids
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disinhibition, aggressive behavior, anxiety, panic, rage, and impaired judgment. Physiological changes can include hyperthermia, elevated blood pressure, tachycardia, hyperacusis, nystagmus, diminished pain responsiveness, dysarthria, and seizures.
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pcp
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characterized by disinhibition, mood lability, and impaired judgment. Physiological symptoms may include slurred speech, poor coordination, nystagmus, impaired memory, and coma.
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benzos
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characterized by behavioral changes that include euphoria, hypervigilance and paranoia, interpersonal sensitivity, anxiety, and poor judgment. There are also possible physiological changes that include pupillary dilation, tachycardia or bradycardia, elevated or lowered blood pressure, psychomotor agitation, cardiac arrhythmias, seizures, and diaphoresis.
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cocaine
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chronic mood disorder lasting no less than 2 years with an absence of symptoms for no more than 2 months during the initial 2 years.
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dysthymia
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unjustified distrust and suspicion of others, the inability to confide in others, and the tendency to carry grudges and resent peers or colleagues for no founded reason. People with the disorder appear cold, calculating, and see suspicious meanings in everything. They usually have occupational difficulties, and they only do well if they have a solitary job.
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paranoid
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being lifelong loners, having a restricted emotional range, exhibiting unsociable behavior, appearing cold and reclusive, and enjoying few activities. Most people with the disorder do not marry or have romantic relationships. They often daydream and carry an unusual attachment to animals, but not to people. They are unaffected by praise or criticism, and they have no interest in sexual behavior.
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schizoid
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behavior that is influenced by magical thinking, telepathy, and/or aliens; unusual perceptions or bodily delusions; odd behavior and appearance; extreme anxiety in social situations; and an affect that is blunted or inappropriate to the topic at hand.
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schizotypal
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frequent bullying and threatening others, the tendency to start fights, and the tendency towards physical cruelty to animals and later humans. People with the disorder often steal and force sex on other individuals.
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antisocial
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unstable impulse control, early adult life instability in interpersonal relationships, frantic attempts to prevent abandonment, identity disturbance, self-damaging behavior, self-mutilating behavior, severe reactivity to moods, chronic feelings of being no good, and angry and paranoid behavior that may last for short or long periods of time.
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Borderline personality
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a tremor that is not accompagnied by any other neurologic symptoms. A family history of tremor may be present.
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Essential tremor
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Relative contraindications for the use of propranolol
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asthma, congestive heart failure, diabetes mellitus, and atrioventricular block
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a diffuse hazy appearance to the lungs that may be caused by idiopathic interstitial pneumonia, eosinophilic pneumonia, interstitial fibrosis, or some types of lung cancer.
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Ground glass shadowing
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Meconium ileus is associated with
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oth Hirschsprung’s disease (colonic aganglionosis) and cystic fibrosis. Rectal manometry and biopsy will provide the most information regarding the former, and sweat chloride analysis is the standard for the initial diagnosis of cystic fibrosis.
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Insulin secretagogues:
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Sulfonylureas and meglitinides
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Insulin sensitizers
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Metformin and thiazolidinediones
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With this injury, the ulnar collateral ligament is ruptured, which causes laxity when moving the thumb into abduction.
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gamekeepers thumb
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transferring of feelings to an inappropriate person, situation, or object (e.g., a man who has been yelled at by his boss takes out his anger on his wife).
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Displacement
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the attribution of one's own traits to someone else (e.g., a philandering husband accuses his wife of having an affair).
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Projection
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the unconscious changing of a feeling or idea to its opposite (e.g., a man acts very friendly toward a coworker when in fact he is unconsciously jealous).
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Reaction formation
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involves turning an unacceptable impulse into an acceptable one (e.g., someone with very aggressive impulses becomes a professional boxer).
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sublimation
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he following risk factors to initiate early screening of diabetes mellitus in pregnancy
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A history of previous gestational diabetes
A previous delivery of a macrosomic baby ( >4kg) A family history of type 2 diabetes mellitus Maternal obesity |
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selfish, callous, impulsive, associated with legal problems, and promiscuous.
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antisocial
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impulsive, have unstable interpersonal relationships, are suffused with anger and fear, lack self-control, are suicidal, and demonstrate aggressive behavior.
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borderline
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most positive indicator of polycystic ovarian syndrome
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LH:FSH ratio of 2:1 or greater
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Aniline dyes and aromatic amines are responsible for the higher risk
Organic chemicals and dyes are also known to increase risk of exposure. Therefore, dry cleaners, beauticians, paper industry workers, etc, are also at higher risk. |
bladder cancer
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Both gross and microscopic hematuria a couple of days after nonspecific upper respiratory tract infection and hypertension in male patients are highly suggestive on
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IgA nephropathy (Bergers disease).
IgA nephropathy is the most common chronic glomerular disease worldwide |
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Alport syndrome
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X-linked dominant hereditary nephritis that will also present with hematuria (asymptomatic or gross) 1-2 days after upper respiratory infection. This progressive hereditary nephritis will, however, be accompanied with bilateral sensorineural deafness and visual problems (patognomonical extrusion of central part of lenses into anterior ocular chamber).
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acute renal failure associated with non-immune (Coombs-negative) microangiopathic hemolytic anemia and thrombocytopenia. It is the most common cause of acute renal failure in children
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Hemolytic-uremic syndrome (HUS)
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