Step 2- B

Front 1

How does RCC cause thrombocytosis and polycythemia?

Back 1

Increased EPO

Front 2

Blood streaked sputum and multiple lung cavities on CXR

Back 2

Acute necrotizing PNA with secondary pneumatoceles

Front 3

Which pathogen causes post-viral URI necrotizing pulmonary beonchopenumonia w/ multiple nodular infiltrates

Back 3

S. aureus

Front 4

Cause of gall stones in pts on TPN

Back 4

Decreased gallbladder contraction (b/c no stimulus from CCK)

Front 5

Why are women more predisposed to gall stones?

Back 5

Estrogen promotes formation by stimulating activity of HMG-CoA reductase

Front 6

Test for comparing two proportions (e.g. this number out of 100 have disease)

Back 6

Chi-square

Front 7

Test for comparing means

Back 7

Two sample t-test

Front 8

Nephrotic syndrome in pt with RA, enlarged kidneys, and hepatomegaly is most likely due to

Back 8

Amyloidosis

Front 9

Renal biopsy findings in amyloidosis

Back 9

Deposits w/ apple-green birefringence under polarized light after staining w/ congo red

Front 10

Renal biopsy w/ crescent formation on light microscopy

Back 10

RPGN

Front 11

Renal biopsy w/ linear immunoglobulin deposits on immunofluoresence

Back 11

Anti-GBM disease (e.g. Goodpasture's)

Front 12

Renal biopsy w/ granular deposits on immunofluoresence

Back 12

Immune complex glomerulonephritis (e.g. lupus or post-strep GN)

Front 13

Two areas most at risk in ischemic colitis

Back 13

Splenic flexure (between SMA and IMA)

Recto-sigmoid junction (supplied by narrow terminal branches of IMA)

Front 14

Hypopigmented plaque on skin w/o sensation, followed by muscle atrophy

Back 14

Leprosy

Front 15

How to diagnose leproxy

Back 15

Acid-fast bacilli on skin biopsy

Front 16

Asthma, chronic rhinosinusitis w/ nasal polyosis, and bronchospasm or congestion after aspirin or NSAIDs

Back 16

Aspirin exacerbated respiratory disease (AERD)

Front 17

Bland tasting food and recurrent nasal discharge/congestion

Back 17

Nasal polyps (bland tasting food is due to anosmia)

Front 18

Nasal discomfort and excess crusting/ bleeding

Back 18

Perforated nasal septum

Front 19

Risk factor for perforated nasal septum

Back 19

Intranasal cocaine

Front 20

Frequent cause of nose bleeds during pregnancy

Back 20

Increased incidence of pyogenic granulomas on anterior nasal septum

Front 21

Ductopenia (lack of bile ducts) is most commonly due to

Back 21

Primary biliary cirrhosis

Front 22

Liver w/ periductal portal tract fibrosis and segmental stenosis of extra/intra hepatic bile ducts

Back 22

Primary sclerosing cholangitis

Front 23

How to treat iron deficiency in dialysis pts

Back 23

IV (iron dextran)

Front 24

Clubbing in pt with COPD suggests

Back 24

Occult malignancy (clubbing is NOT a feature of simple COPD)

Front 25

Causes of clubbing (6)

Back 25

Pulmonary HTN and hypoxemia (from congenital heart disease, not COPD)
Lung abscess
Bronchiectasis
CF
Interstitial lung disease

Front 26

Why do pts with acromegaly develop acanthosis?

Back 26

They also have insulin resistance

Front 27

Sudden appearance of acanthosis may indicate

Back 27

GI malignancy

Front 28

Lung lesion that moves with position change

Back 28

Aspergilloma (fungus ball, lies free in the lung cavity)

Front 29

Lung lesion with an air fluid level

Back 29

Lung abscess

Front 30

CXR with calcified nodes in lung/mediastinum (or spleen/liver)

Back 30

Histoplasmosis

Front 31

EKG finding most specific for digitalis toxicity

Back 31

Atrial tachycardia (from ectopy) PLUS AV block

Front 32

Liver biopsy w/ macrovesicular steatosis, polymorphonuclear cellular infiltrates, and necrosis

Back 32

NASH or ASH

Front 33

Anti-mitochondrial antibodies

Back 33

Primary biliary cirrhosis

Front 34

Anti-smooth muscle Abs

Back 34

Autoimmune hepatitis

Front 35

Study with 2+ experimental interventions as well as multiple groups w/ different treatment endpoints (2+ variables studied independently)

Back 35

Factorial design study

Front 36

What is cluster analysis?

Back 36

Randomization at level of groups rather than individuals

Front 37

Acute onset of back pain w/o obvious trauma + local tenderness on PEX

Back 37

Compression fracture of vertebrae

Front 38

Injury caused by less dramatic physical strain w/ paravertebral muscle tenderness (not spinal)

Back 38

Lumbago

Front 39

Rx for acne patient who has begun scarring

Back 39

Oral isotretinoin

Front 40

Best study type for calculating incidence

Back 40

Cohort

Front 41

Pt treated with a sulfa antibiotic who then presents with hemolysis

Back 41

G6PD deficiency

Front 42

Cause of hemolytic episodes in G^PD deficient pts

Back 42

Infections or meds (sulfa drugs, antimalarials, nitrofurantoin) that increase oxidative stress

Front 43

Finding on urine stain during G6PD hemolytic episode

Back 43

Prussian blue stain (indicating presence of hemosiderin)

Front 44

Pathophys of G6PD deficiency

Back 44

Can't catalyze reduction of NADP --> NADPH, which is necessary to form reduced glutathione, which protects RBCs from oxidative injury

Front 45

Pts with Strep bovis endocarditis or septicemia are at increased risk of

Back 45

Occult colorectal or upper GI cancer

Front 46

EKG: tachy w/ regular, narrow QRS complexes w/o definite p waves

Back 46

Supraventricular tachycardia

Front 47

Rx for SVT

Back 47

Adenosine

Front 48

Wide QRS complex tachycardia

Back 48

Ventricular tachy

Front 49

Rx for ventricular tachy (general)

Back 49

Amiodarone, lidocaine, etc.

Front 50

Management of pt about to undergo splenectomy (2)

Back 50

Anti-pneumococcal, Haemophilius, and meningococcal vaccines several weeks preop

Daily oral penicillin prophy for 3-5 yrs after surgery

Front 51

Lab test that can distinguish septic shock from other types of distributive shock (neurogenic, hypovolemic)

Back 51

MVO2: typically low in distributive, due to increased oxygen extraction by hypoperfused tissues, but normal in septic shock due to hyperdynamic circulation/ improper distribution of CO

Front 52

Excess immunoglobulins seen in multiple myeloma vs. Waldenstrom's

Back 52

IgG or IgA in multiple myeloma
IgM in Waldenstrom's

Front 53

Why do Waldenstrom's pts have dilated retinal veins?

Back 53

Hyperviscosity (not seen in multiple myeloma)

Front 54

Treating H pylori can help cure what type of GI cancer (specific)

Back 54

Gastric lymphoma (NOT gastric adenocarcinoma)

Front 55

Which pulmonary-renal syndrome requires emergency plasmapheresis to minimize the extent of kidney damage?

Back 55

Goodpasture's syndrome (take off anti-GBM antibodies)

Front 56

Rx for Wegener's

Back 56

Cyclophosphamide and steroids

Front 57

Another name for Wegener's?

Back 57

Granulomatosis with polyangitis

Front 58

Ganciclovir is most commonly used to treat

Back 58

CMV

Front 59

Pathophys of NASH

Back 59

Insulin resistance

Front 60

Weight loss, gynecomastia, testicular atrophy, impotence

Back 60

Chronic liver failure (latter three from hyperestrogenemia since estrogens aren't adequately cleared and there is decreased synthesis of SHBG)

Front 61

Cirrhosis can cause what endocrine problem?

Back 61

Hypothalamic-pituitary dysfunction (e.g. lack of TSH response to low thyroid hormone levels)

Front 62

A sudden aversion to smoking may indicate

Back 62

Hepatitis

Front 63

Rx for Hep A

Back 63

Supportive
Immune globulin for close contacts

Front 64

Rx for primary biliary cirrhosis

Back 64

Ursodeoxycholic acid (also MTX and colchicine)

Front 65

Rx for resistant PBC

Back 65

Liver transplant (once disease is advanced)

Front 66

Recurrent oral and genital ulcers, anterior uveitis, and erythema nodosum

Back 66

Behcet's Syndrome

Front 67

How is cysticercosis transmitted?

Back 67

NOT by eating infected pork. Rather, by ingesting the feces of someone who has eaten pork with Taenia solium eggs.

Front 68

Chem abnormality after a seizure?

Back 68

Lactic acidosis from the seizure --> post-seizure anion gap metabolic acidosis that resolves w/in 60-90 min

Front 69

Abx choice for emphysematous cholecystitis

Back 69

Coverage for Clostridium (amp-sulbactam, zosyn, or an aminoglycoside + clinda)

Front 70

High fever, jaundice, and RUQ pain

Back 70

Charcot's triad (acute cholangitis)

Front 71

Localize the lesion for cauda equina syndrome

Back 71

Nerve root injury

Front 72

Pts with hemochromatosis and cirrhosis are at increased risk of infection with what 3 bacteria?

Back 72

Listeria, Yersinia, and Vibrio vulnificus

Front 73

What test is required before starting trastuzumab adjuvant treatment for breast cancer?

Back 73

Echo (b/c risk of cardiac toxicity, esp in combo w/ chemo, and pts w/ EF <55% are at higher risk)

Front 74

Rx for SVT in a pt with unstable vitals or refractory chest pain

Back 74

DC cardioversion

Front 75

Pt with sickle cell trait and nocturia

Back 75

Hyposthenuria

Front 76

What is hyposthenuria?

Back 76

Impaired ability to concentrated urine (likely from RBC sickling in vasa rectae of medulla)

Front 77

Dreaded complication of retropharyngeal abscess and 2 measures to prevent it

Back 77

Spread into mediastinum
IV Abx and urgent drainage

Front 78

What is herpangina and what virus causes it?

Back 78

Formation of vesicles on the tonsils and soft palate

Coxsackie A virus

Front 79

Rx for a pt w/ uremic pericarditis 2/2 renal failure

Back 79

Hemodialysis

Front 80

6 indications for hemodialysis

Back 80

1) Refractory hyperK
2) Volume overload/pulm edema refractory to diuretics
3) Refractory metabolic acidosis (pH <7.2)
4) Uremic pericarditis
5) Uremic encephalopathy/ neuropathy
6) Coagulopathy due to renal failure

Front 81

Immunocompromised host w/ bilateral difffuse interstitial infiltrates

Back 81

Pneumocystis jiroveci

Front 82

Zofran (ondansetron)'s mechanism

Back 82

Serotonin (5HT3) antagonist

Front 83

2 most common causes of cellulitis

Back 83

Staph aureus and beta-hemolytic strep

Front 84

Rx for cellulitis w/ systemic signs (high fevers, confusion, etc.)

Back 84

IV nafcillin or cefazolin

Front 85

Common nidus for LE cellulitis

Back 85

Tinea pedia

Front 86

Rx for organophosphate poisoning

Back 86

Atropine (anticholinergic) and wash whole body

Front 87

Two non-renal risks of nephrotic syndrome

Back 87

Lipid abnormalities (high LDL/low HDL: risk of atherosclerosis) and hypercoagulability

Front 88

Chloride and bicarb in pt w/ obesity hypoventilation syndrome

Back 88

Compensate for respiratory acidosis by retaining bicarb (high), which causes chloride excretion (low)

Front 89

Rx for hemochromatosis pts who can't udnergo phlebotomy

Back 89

Deferoxamine

Front 90

Hypercalcemia w/ recurrent peptic ulcers

Back 90

MEN1 (hyperparathyriodism and pnacreatic gastrinoma)

Front 91

Rx for acute COPD flare (4)

Back 91

Bronchodilator (beta-adrenergic agonist e.g. albuterol), antimuscarinic (ipratropium), broad spectrum Abx, 2wk steroid taper

Front 92

Chem-7 abnormality in Cushing's

Back 92

Hypokalemic alkalosis

Front 93

Rash of Lyme vs. secondary syphilis

Back 93

Erythema migrans is on arms, abdomen, or moist areas and has central clearing

Syphilis is scaly red papules on trunk/extremities (incl palms/soles)

Front 94

Difference between 2 sample t test and z test?

Back 94

T: two groups
Z: two populations

Front 95

Anaphylaxis to blood transfusion may indicate

Back 95

IgA deficiency

Front 96

Rx for anaphylaxis from blood transfusion (4)

Back 96

Stop transfusion, epi, IV fluids, vasopressors

Front 97

Pt w/ bacterial endocarditis w/ hemoptysis, chest pain, and numerous round alveolar infiltrates on CXR

Back 97

Septic pulmonary emboli

Front 98

Pt w/ bacterial endocarditis w/ proteinuria

Back 98

Septic emboli to kidneys

Front 99

Tricuspid endocarditis causes what murmur?

Back 99

Tricuspid regurg (systolic murmur that increases w/ inspiration)

Front 100

Systolic murmur that increases w/ standing

Back 100

HOCM

Front 101

Paradoxical splitting of S2

Back 101

LBBB (due to delayed closure of aortic valve)

Front 102

Pleural fluid protein count in exudates vs. transudates

Back 102

Higher in exudates

Front 103

Low pH pleural fluid: diagnosis and management

Back 103

Likely empyema
Needs drainage

Front 104

Management of pleural fluid w/ glucose <60

Back 104

Needs drainage

Front 105

Milky white pleural effusion is likely due to

Back 105

Ruptured thoracic duct

Front 106

How to differentiate hereditry spherocytosis from autoimmune hemolytic anemia (both have spherocytes)

Back 106

+ osmotic fragility test vs. + Coomb's test

Front 107

Two types of autoimmune hemolytic anemia

Back 107

Warm-agglutin (IgG)
Cold-agglutin (IgM)

Front 108

Heinz bodies on peripheral smear indicate

Back 108

G6PD deficiency

Front 109

D-xylose absorption test

Back 109

Requires only intact mucosa, so normal in pancreatic insufficiency and terminal ileal disease

Decreased in bacterial overgrowth but improves w/ Abx

Decreased in celiac disease

Front 110

Inpatient CAP Rx

Back 110

Levofloxacin or moxifloxacin

Front 111

Outpatient CAP Rx

Back 111

Azithromycin or doxycycline

Front 112

Rx for hairy cell leukemia

Back 112

Cladribine (purine analog)

Front 113

Rx for non-Hodgkin's lymphoma

Back 113

CHOP

Front 114

Rx for CLL

Back 114

Chlorambucil and prednisone

Front 115

Common bone marrow aspiration finding in hairy cell leukemia pts and why

Back 115

Dry tap: fibrotic BM

Front 116

What is use dependence and what anti-arrhythmics display it?

Back 116

More effective at higher HRs b/c med has less time to dissociate from receptosr

Class I and IV anti-arrhythmics

Front 117

Diabetic pt w/ necrotic nasal turbinates

Back 117

Mucormycosis (usually from fungus Rhizopus)

Front 118

Rx for Mucormycosis

Back 118

Surgical debridement + IV amphotericin B (only effective drug)

Front 119

Characteristics of the arthritis in SLE (2)

Back 119

Very painful
Non-deforming

Front 120

Young pt w/ neuro abnormalities (incl extensor weakness), abdominal pain, renal disease, and anemia

Back 120

Lead poisoning

Front 121

Tick borne illness w/ leukopenia/ thrombocytopenia and elevated LFTs, but no rash

Back 121

Ehrlichiosis ("spotless RMSF")

Front 122

Rx for erlichiosis

Back 122

Doxycycline

Front 123

Rx for tinea versicolor (2)

Back 123

Selenium sulfide lotion and ketoconazole shampoo

Front 124

Cause of pseudogout

Back 124

Release of calcium pyrophosphate dehydrate (CPPD) crystals from sites of chondrocalcinosis in joint space

Front 125

Best intervention to prevent enlargement of AAA

Back 125

Smoking cessation

Front 126

Rx for HTN in pt with AAA

Back 126

Beta blocker

Front 127

Retrosternal chest pain with aortic regurg

Back 127

Aortic dissection

Front 128

Diagnostic test for suspected aortic dissection

Back 128

TEE

Front 129

HIV drug associated w/ nepropathy

Back 129

Indinavir (protease inhibitor) --> crystal-induced nephropathy

Front 130

HIV drug associated w/ pancreatitis

Back 130

Didanosine

Front 131

HIV drug associated w/ hypersensitivity

Back 131

Abacavir

Front 132

HIV drug associated w/ liver failure

Back 132

Nevirapine

Front 133

HIV drug class associated w/ lactic acidosis

Back 133

NRTIs

Front 134

HIV drug class associated w/ Stevens-Johnson syndrome

Back 134

NNRTIs

Front 135

Widened mediastinum on CXR in Marfan's pt

Back 135

Aortic dissection

Front 136

Splenomegaly and pruritis after showering

Back 136

Polycythemia vera

Front 137

Myeloproliferative disorder with painful swollen toe

Back 137

Gout (MPDs cause uric acid overproduction from increased purine turnover)

Front 138

How does chronic kidney disease cause gouty attacks?

Back 138

Decreases amount of uric acid excreted in urine

Front 139

HIV pt with chronic bloody diarrhea, abdominal pain, and normal stool culture

Back 139

CMV colitis

Front 140

Rx for CMV colitis

Back 140

Ganciclovir

Front 141

Colonic biopsy with large cells w/ eosinophilic intranuclear and basophilic intracytoplasmic inclusions

Back 141

Owl's eyes: CMV colitis

Front 142

Irregular vaginal bleeding, pelvic pain, and an enlarged uterus postpartum

Back 142

Gestational trophoblastic disease

Front 143

Rx for aortic dissection

Back 143

BP control w/ IV labetalol (beta blockers simultaneously lower HR and BP)

Front 144

Which type of dissections require surgery in addition to medical therapy

Back 144

Type A (involve ascending aorta)
(Type B doesn't: descending aorta only)

Front 145

Most common pathogen in osteomyelitis from a nail puncture wound

Back 145

Pseudomonas

Front 146

Painless blisters, increased skin fragility on dorsal hands, facial hypertrichosis and hyperpigmentation

Back 146

Porphyria cutanea tarda

Front 147

2 substances that can trigger porphyria cutanea tarda

Back 147

Ethanol
Estrogens

Front 148

Pathophys of porphyria cutanea tarda

Back 148

Deficiency of uroporphyrinogen decarboxylase (part of heme synthesis pathway)

Front 149

Common infection that co-occurs w/ porphyria cutanea tarda

Back 149

HCV

Front 150

Rx for porphyria cutanea tarda (3)

Back 150

Phlebotomy or hydroxychloroquine

Interferon-alpha in pts w/ HCV

Front 151

Where is lung ventilation and perfusion the greatest?

Back 151

Most dependent location (usually lung bases; when on their side, pts lower lung)

Front 152

What is susceptibility bias?

Back 152

Type of selection bias

Treatment regimen selected for a pt depends on severity of their condition

Front 153

S/p angiography w/ blue skin on the toes, livedo reticularis, acute renal fialure, and nausea/abd pain

Back 153

Cholesterol embolization

Front 154

Two lab abnormalities in cholesterol embolization

Back 154

Increased eosinophils
Decreased complement levels

Front 155

Pathophys of edema in heart failure

Back 155

Decreased circulating blood volume --> renal hypoperfusion --> renal arteriolar constriction --> sodium reabsorption --> water retention

Front 156

How to distinguish anemia of chronic disease from iron deficiency anemia?

Back 156

TIBC is decreased in anemia of chronic disease and elevated in iron deficiency

Front 157

MOA of osteltamivir and zanamivir

Back 157

Neuraminidase inhibitors (latter is only for treatment, not prevention, of influenza)

Front 158

When should antivirals be administered in influenza pts?

Back 158

Within 48 hrs, otherwise not effective

Front 159

TPN pt w/ alopecia, abnormal taste, bullous lesions around orifices, impaired wound healing

Back 159

Zinc deficiency

Front 160

Rx for gallstone pt who isn't a surgical candidate (2)?

Back 160

Avoidance of fatty foods
Ursodeoxycholic acid (bile salt that decreases cholesterol content of bile by reducing enterohepatic circulation)

Front 161

Hypothyroid Sx + carpal tunnel Sx

Back 161

Generalized myxedema --> deposition of acid mucopolysaccharides in skin, heart, and nerves (incl. median nerve)

Front 162

Cause of carpal tunnel in pregnancy

Back 162

Accumulation of fluid

Front 163

Hematuria, HTN, RBC casts, and mild proteinuria 2 wks after infection and Abx

Back 163

PSGN

Front 164

Complement finding in PSGN

Back 164

Low serum C3

Front 165

Hematuria 5 days after URI w/ normal complement

Back 165

IgA nepropathy

Front 166

Hematuria, peripheral eosinophilia, WBC casts in urine after infection and Abx

Back 166

Drug-induced acute interstitial nephritis

Front 167

Diagnostic test for suspected achalasia in pt >60yo or with weight loss

Back 167

Endoscopy to r/o pseudoachalasia (from malignancy)

Front 168

Skin condition associated w/ Parkinson's

Back 168

Seborrheic dermatitis

Front 169

Electrolyte side effects of loop diuretics

Back 169

Metabolic alkalosis
Hypokalemia
Prerenal renal failure

Front 170

Rx for erythema migrans

Back 170

Is pathognomonic for Lyme disease, so no need to test, just treat with doxycycline

Front 171

6 common drugs that cause esophagitis

Back 171

Tetracyclines
Aspirin
NSAIDs
Alendronate
Potassium
Iron

Front 172

Rx for pancreatic pseudocyst

Back 172

Usually just watch; drain only if last >6wks, are >5cm, or become secondarily infected

Front 173

Rx for hyperkalemia (5)

Back 173

IV calcium gluconate (to stabilize cardiac membrane)
Shift potassium intracellularly w/ insulin, glucose, sodium bicarb, and beta-2 agonists (albuterol)

Front 174

Asymmetric breath sounds immediately after intubation

Back 174

Have likely intubated right mainstem bronchus: pull back

Front 175

Intermittent flank pain, hematuria, recurrent UTIs/nephrolithiasis, and palpable mass

Back 175

Autosomal dominant polycystic kidney disease

Front 176

Why is an enlarged right kidney easier to palpate than on the left?

Back 176

Lies lower

Front 177

2 most common electrolyte abnormalities in primary adrenal insufficiency

Back 177

Hyponatremia
Hyperkalemia

Front 178

HBV is associated with what type of nephrotic syndrome?

Back 178

Membranous glomerulonephritis

Front 179

COPD pt with worsening symptoms, chest pain, and unilateral decreased breath sounds

Back 179

Secondary pneumothorax

Front 180

Cause of secondary pneumothorax in COPD pts?

Back 180

Destruction of alveolar sacs --> formation of alveolar blebs, which can rupture and leak air into pleural space

Front 181

Mobitz type I AV block implies dysfunction where and what type of pattern?

Back 181

AV node
PR intervals that grow progressively longer until a beat is dropped

Front 182

Tachycardia-bradycardia syndrome on EKG might indicate?

Back 182

Sick sinus syndrome (impaired SA node automaticity from fibrosis or SA node arterial disease)

Front 183

Common cause of respiratory acidosis

Back 183

Alveolar hypoventilation

Front 184

What decreases the risk of febrile transfusion reaction?

Back 184

Leukocyte depletion techniques (e.g. cell washing)

Front 185

Cause of edema in a severe COPD pt?

Back 185

Hypoxemia --> pulmonary arterial constriction --> pulmonary HTN, RVH, and right heart failure

Front 186

Who requires yearly influenza vaccines?

Back 186

All adults (IM if elderly or comorbid conditions)

Front 187

Who needs a Td vs. a TdaP vaccine?

Back 187

All adults need a Td vaccine every 10 yrs

One time TdaP booster for adults >18yo due to waning immunity against pertussis

Front 188

Overdose w/ dilated pupils, seizures, QRS prolongation, and hypotension

Back 188

TCA overdose

Front 189

Rx for severe TCA overdose

Back 189

Sodium bicarb

Front 190

Rx for afib w/ RVR in a pt with Wolf Parkinson White

Back 190

Because they have accessory pathway conduction, don't want to block the AV node further (which typical afib drugs do); so instead, convert to sinus rhythm with cardioversion or antiarrhythmics like procainamide

Front 191

Common cause of anemia in a pt with a malignant lymphoproliferative disorder

Back 191

Warm autoimmune hemolytic anemia

Front 192

Rx for warm autoimmune hemolytic anemia (first and second line)

Back 192

Prednisone (if ineffective, splenectomy)

Front 193

Cause of UTI in a pt with alkaline urine and why

Back 193

Proteus (produces urease, which alkalinizes urine)

Front 194

Reactivation of TB causes what CT findings

Back 194

Upper lobe cavitary lesions (+/- surrounding alveolar infiltration)

Front 195

Chest pain, severe N/V, widened mediastinum, and unilateral pleural effusion w/ high amylase and low pH

Back 195

Esophageal rupture (Boerhaave's syndrome)

Front 196

Rx for any chemical contact with eye

Back 196

Run under water for at least 15 min

Front 197

Rx for pt with high homocysteine (3) and why

Back 197

Vitamin B6 (pyridoxine) which is a cofactor of cystathionine Beta-synthase (which metabolizes homocysteine into cystathionine

Also, folate and B12

Front 198

Rx for hepatic adenoma

Back 198

Resect if symptomatic
Otherwise, can watch with imaging and serial AFP measurements

Front 199

Concern with hepatic adenoma (2)

Back 199

Hemorrhage
Malignant transformation

Front 200

Most common asymptomatic isolated elevation of alk phos in the elderly

Back 200

Paget's disease of bone (osteitis deformans)