Step 2- D

Front 1

Complication of mono

Back 1

Autoimmune hemolytic anemia and thrombocytopenia, due to cross reactivity of EBV-induced Abs against RBCs and platelets (cold agglutin Abs)

Front 2

Why are mono pts told to avoid contact sports for 3-4 wks

Back 2

Risk of splenic rupture w/ trauma

Front 3

Management of tylenol overdose (3 steps)

Back 3

Acetaminophen level (start at 4 hrs after ingestion)
Activated charcoal if early
N-acetylcysteine w/in 8hrs (based on the 4hr acetaminophen level)

Front 4

How does lactulose work?

Back 4

Bacteria acts on it --> acidification of colonic contents --> ammon converted into nonabsorbable ammonium ion (ammonia trap)

Front 5

Child w/ dyspnea, growth retardation, clubbing, and polycythemia

Back 5

Tetralogy of Fallot

Front 6

PDA is associated w/ what maternal infection

Back 6

Rubella

Front 7

When do ASDs become symptomatic (dyspnea, fatigue, palpitations)

Back 7

20s or 30s

Front 8

Pt w/ an aortic dissection who also has right sided weakness

Back 8

Ascending aorta dissection that extended into left carotid artery

Front 9

Rx for polymyositis

Back 9

High ose steroids

Front 10

UA that is positive for bilirubin indicates what type of hyperbilirubinemia

Back 10

Conjugated (unconjugated can't be excreted in urine)

Front 11

What is Rotor syndrome and how is it managed

Back 11

Conjugated hyperbili

Defect of hepatic storage of conjugated bilirubin, so it leaks into plasma

No treatment needed

Front 12

Decreased visual acuity, changes in color perception, and sluggish afferent pupillary reactions

Back 12

Optic neuritis

Front 13

Rx for PVCs after an MI (2 options)

Back 13

No treatment if asymptomatic
Beta blockers if symptomatic

Front 14

Angioysplasia is associated w/ what heart murmur?

Back 14

Aortic stenosis

Front 15

Most common cause of erythema nodosum

Back 15

Recent strep infection

Front 16

Work-up of erythema nodosum (3)

Back 16

Symptom-guided, but CXR, PPD, and ASO titer

Front 17

Isonazid can cause what type of anemia?

Back 17

Acquired sideroblastic anemia (microcytic hypochromic)

Like iron deficiency, but with decreased TIBC

Front 18

What is Beck's triad

Back 18

Hypotension, JVD, and muffled heart sounds

Cardiac tamponade

Front 19

Why is pulsus paradoxus seen in cardiac tamponade?

Back 19

Lower intrathoracic pressure during inspiration --> more blood into RV --> septum bows into LV, further reducing LV filling --> decreased CO on inspiration

Front 20

Squatting and straining do what to the HCOM murmur (different)

Back 20

Squatting: decrease (b/c increases preload)
Straining: increase (b/c decreases preload)

Front 21

Bitter almond breath

Back 21

Inhaled cyanide poisoning

Front 22

Pt w/ poisoning: cyanotic vs. pinkish-red skin hue

Back 22

Cyanotic: methemoglobinemia
Pinkish-red: CO

Front 23

2 abnormalities in HCOM pts --> outflow obstruction

Back 23

Hypertrophied IV septum
Systolic anterior motion abnormality in mitral valve leaflets

Front 24

Common trigger of asthma symptoms in adults

Back 24

GERD

Front 25

Pt w/ hematemesis and abd pain who reports a history of headaches for which he takes aspirin and drinks

Back 25

Acute erosive gastritis (development of hemorrhagic erosive lesions after exposure of gastric mucosa to injurious agents (or after a reduction of blood flow))

Front 26

70yo woman with unilateral headaches for 2mo and now unilateral vision loss; fundoscopy w/ swollen pale disc w/ blurred margins

Back 26

Temporal arteritis

Front 27

Mechanism of allopurinol

Back 27

Xanthine oxidase inhibitor (decreases uric acid production)

Front 28

MOA of probenecid

Back 28

Uricosuric drugs (increase urinary excretion of uric acid)

Front 29

Immunocompromised pt with PNA that on gram stain shows crooked, branching, beaded, gram-positive growth

Back 29

Nocardia

Front 30

Rx for nocardiosis

Back 30

Bactrim

Front 31

Pathophys of Goodpasture's

Back 31

Abs to the alpha-3 chain of type IV collagen, expressed in glomerular and alveolar basement membranes

Front 32

MOA of cyclosporine and tacrolimus

Back 32

Inhibits transcription of IL-2 (calcineurin inhibitors)

Front 33

Toxicities of cyclosporine (7)

Back 33

Nephrotoxicity
HTN
Neurotoxicity
Glucose intolerance
Infection
Malignancy (SCC and lymphoproliferative)
Gingival hypertrophy and hirsutism

Front 34

Difference in the toxicities of tacrolimus and cyclosporine

Back 34

Tacrolimus doesn't cause hirsutism or gum hypertrophy, and has a higher incidence of neurotoxicity, diarrhea, and glucose intolerance

Front 35

Main toxicity of mycophenolate

Back 35

Bone marrow suppression

Front 36

Main toxicity of azathioprine (3)

Back 36

Dose-related diarrhea
Leukopenia
Hepatotoxicity

Front 37

How does aortic stenosis cause angina?

Back 37

Creates large LV mass, which requires additional O2

Front 38

Path of diabetic nephropathy

Back 38

Increased ECM, GBM thickening, mesangial expansion, and fibrosis

Front 39

Ab in dermatomyositis

Back 39

anti-Mi-2 (Against helicase)

Front 40

Problem with HCTZ in a pt with metabolic syndrome

Back 40

Side effects include hyperglycemia and increased LDL/triglycerides

Front 41

Difference btwn type 1 and type 2 Mobitz heart block

Back 41

Type 1: progressive increase in PR interval until a ventricular beat is dropped

Front 42

What is first degree heart block

Back 42

Prolonged PR (>.2s)

Front 43

Dysphagia, glossitis, iron deficiency anemia

Back 43

Plummer-Vinson Syndrome

Front 44

Fitz-Hugh-Curtis syndrome

Back 44

Rare complication of PID w/ scar tissue on liver capsule

Front 45

Proximal myopathy, autonomic neuropathy, and areflexia

Back 45

Lambert-Eaton Syndrome

Front 46

Rx for Lambert Eaton Syndrome (and mechanism)

Back 46

3,4 diaminopyridine (blocks K+ channel so AP duration is longer)

Front 47

Pt from a developing country with dyspnea, nocturnal cough, and hemoptysis + a fib

Back 47

Rheumatic fever --> mitral stenosis --> increased pulmonary vascular pressures

Front 48

Nephrotic range proteinuria, hematuria, and dense intramembranous deposits that stain for C3

Back 48

Membranoproliferative glomerulonephritis, type 2 (dense deposit disease)

Front 49

Cause of MPGN type 2

Back 49

IgG Abs (C3 nephritic factor) directed against C3 convertase of alternative complment pathway --> persistent complement activation

Front 50

Cause of syncope in a pt with a prolonged PR interval

Back 50

Bradyarrhythmia

Front 51

Most important cause of torsades de pointes

Back 51

Hypomagnesemia

Front 52

Rx for PACs

Back 52

Remove risk factors (tobacco, alcohol, caffeine, stress)

Beta blockers only if symptomatic

Front 53

5 things that give points in CHADS2 score

Back 53

Age >75
CHF
HTN
DM
Prior stroke (2 points)

Front 54

Vomiting <6hrs after eating a particular food

Back 54

Rapid onset indicates due to a preformed exotoxin, e.g. either S. aureus or B. cereus

Front 55

How often should pts with high-risk polyps receive follow-up colonoscopies?

Back 55

Every 3-5yrs

Front 56

How does nitroglycerin decrease chest pain?

Back 56

Venodilation causes blood to pool in venous circulation --> decreased preload --> decreased LV volume and wall stress/stretch --> decreased myocardial oxygen demand

Front 57

Which types of renal stones are radiolucent?

Back 57

Uric acid stones

Front 58

Tests for pts diagnosed with HIV (8 categories)

Back 58

CBC and Chem
HIV RNA levels and CD4 count
VDRL
PPD
Anti-toxo Ab titer
MMSE
HAV and HBV vaccine if seronegative
Pneumococcal vaccine (unless CD4 count <200)

Front 59

Cancer on the lips (esp lower lip)

Back 59

SCC

Front 60

Appearance of aphthous ulcers

Back 60

Shallow, fibrin-coated ulcerations w/ underlying mononuclear infiltrates

Front 61

Cause of resistant HTN in a pt with cardiac stents, right thigh pain when walking, and asymmetrically increased BP in the left arm

Back 61

Atherosclerosis in multiple sites --> renal artery stenosis

Front 62

Rx for esophagitis in an HIV infected pt

Back 62

Fluconazole (to cover candida); if fail 3-5 day course, then further investigation

Front 63

Rx for HSV esophagitis

Back 63

Oral acyclovir

Front 64

Rx for CMV esophagitis

Back 64

Oral ganciclovir

Front 65

Immunocompromised pt w/ large, pedunculated exophytic scaly papules that hemorrhage when biopsied

Back 65

Bacillary angiomatosis, caused by Bartonella henselae and quintana

Front 66

Rx for frostbite injuries to extremities

Back 66

Rapid rewarming with warm water

Front 67

Best test for HSV encephalitis

Back 67

CSF PCR for HSV DNA (not viral culture)

Front 68

CSF findings in herpes encephalitis

Back 68

Lymphocytic pleocytosis and low glucose

Front 69

Rx for acute gout attack (2)

Back 69

Indomethacin
Colchicine

Front 70

Pts for whom indomethacin is contraindicated

Back 70

Renal failure
Hx for GI bleeding

Front 71

Winter's formula and what it is for

Back 71

PaCO2 = 1.5 (HCO3) + 8

to determine if there is adequate respiratory compensation for a metabolic acidosis

Front 72

Pathogen associated with subacute bacterial endocarditis in a pt with recent GU procedure

Back 72

Enterococci

Front 73

Cause of flushing and pruritis after starting niacin

Back 73

Peripheral vasodilation (drug-induced release of histamine and prostaglandins)

Front 74

Rx for niacin-induced flushing and pruritis

Back 74

Baby ASA 30 min before niacin
Usually improves after 2-4wks

Front 75

Young black male with painless hematuria

Back 75

Sickle cell trait (is due to papillary ischemia from low oxygen partial pressure)

Front 76

Why are HIV pts screened for toxoplasma at diagnosis?

Back 76

Cerebral toxoplasmosis is usually due to reactivation of a prior primary infection

Front 77

When do HIV pts need azithromycin prophylaxis, and for what?

Back 77

CD4 < 50
Mycobacterium avium complex

Front 78

Presentation of digoxin toxicity

Back 78

N/V, decreased appetite, confusion, weakness; sometimes visual symptoms

Front 79

What is observer bias?

Back 79

Investigator's decision is adversely affected by knowledge of the exposure status

Front 80

Intoxication w/ fever, tinnitus, and tachypnea

Back 80

Aspirin (salicylic acid)

Front 81

Acid-base abnormalities in salicyclic acid intoxication

Back 81

Mixed respiratory alkalosis and anion gap metabolic acidosis

Front 82

Why are dihydropyridine CCBs contraindicated in pts with ACS?

Back 82

Cause peripheral vasodilation and reflex tachycardia, so can worsen cardiac ischemia

Front 83

Pt with flank pain, hematuria, oliguria, acute renal failure, and anion gap metabolic acidosis

Back 83

Ethylene glycol poisoning

Front 84

Rx for ethylene glycol poisoning

Back 84

Fomepizole or ethanol (both inhibit alcohol dehydrogenase, so don't form the toxic metabolites)

Sodium bicarb for acidosis, hemodialysis if end-organ damage

Front 85

Rx for beta-blocker intoxication w/ bradycardia

Back 85

Glucagon

Front 86

Schilling Test (2 steps)

Back 86

Step 1: administer radiolabeled B12; if urinary excretion is normal, is dietary deficiency, if low, is poor absorption

Step 2: administer w/ intrinsic factor; if urinary excretion improves, is pernicious anemia, otherwise is malabsorption (pancreatic insufficiency or bacterial overgrowth)

Front 87

When do you rehydrate with colloid

Back 87

(e.g. albumin)

Burns or conditions accompanied by hypoproteinemia

Front 88

How to diagnose PE with a Swan-Ganz catheter?

Back 88

High RA pressure and pulmonary artery pressure, but normal PCWP (indicating secondary pulmonary HTN)

Front 89

Inheritance of hereditary spherocytosis

Back 89

AD

Front 90

3 common complications of hereditary spherocytosis

Back 90

Cholelithiasis (indirect hyperbilirubinemia) --> cholecystitis

Chronic leg ulcers

Aplastic crisis from parvovirus infection

Front 91

Pts w/ hereditary spherocytosis should receive what med prophylactically?

Back 91

Folic acid

Front 92

Work-up for SVC

Back 92

CXR

Front 93

Anticoagulant choice in pt with HIT (2)

Back 93

Danaparoid (factor Xa inhibitor)
Direct thrombin inhibitor (lepirudin or argatroban)

Front 94

Why should warfarin not be used in pts with HIT

Back 94

May increase the risk of venous limb gangrene in pts w/ DVT

Can start only when platelet count is >100,000

Front 95

Thick skin over fingers, GERD, and JVD

Back 95

Systemic sclerosis (GERD from esophageal dysmotility, right heart failure from pulmonary arterial hypertension)

Front 96

Abs in scleroderma pts (sensitive and specific)

Back 96

Sensitive: ANA
Specific: anti-topoisomerase-I

Front 97

Rx for severe hypercalcemia

Back 97

#1: IV normal saline
Also loop diuretics; last resort is hemodialysis

Front 98

Which type of lung cancer causes hypercalcemia?

Back 98

Squamous cell (sCa++mous)

Front 99

Which type of lung cancer causes ACTH production and SIADH?

Back 99

Small cell carcinoma

Front 100

Adenocarcinoma of the lung is often associated with what PNS?

Back 100

Hypertrophic pulmonary osteoarthropathy (digital clubbing associated w/ sudden-onset arthropathy)

Front 101

2 common non hepatobiliary complications of PBC

Back 101

Xanthelasmas/ xanthomas
Osteoporosis (due to reduced ability to absorb/store fat-soluble vitamins)

Front 102

Cardiac index and LVEDV in systolic heart failure

Back 102

Decreased
Increased

Front 103

LVEDV in pure diastolic heart failure

Back 103

May be normal

Front 104

What type of heart failure causes a normal cardiac index, elevated LVEDV, and decreased TPR?

Back 104

High-output heart failure

Front 105

Deposits in the fingers w/ a chalky white apperance

Back 105

Chronic tophaceous gout

Front 106

Indicators of severe asthma attack (1+5)

Back 106

Normal PaCO2 (should be decreased from hyperventilation; otherwise, have CO2 retention b/c of air trapping and/or respiratory muscle fatigue)

Speech difficulty, diaphoresis, altered sensorium, cyanosis, and silent lungs

Front 107

Nonhealing ulcer w/ polygonal cells w/ atypical nuclei at all levels of the epidermis w/ zones of keratinization

Back 107

SCC

Front 108

Acute angle closure glaucoma usually occurs following

Back 108

Pupillary dilation (e.g. dark movie theatres, during stress, etc.)

Front 109

Fundoscopic findings in angle closure glaucoma

Back 109

Red eye w/ steamy cornea and moderately dilated nonreactive pupil

Front 110

Rx for acute angle closure glaucoma (immediate and permanent)

Back 110

IV acetazolamide (later oral) to lower IOP

Laser peripheral iridotomy

Front 111

Why does TB reactivate in the apices of the lung?

Back 111

It is an aerobic organism, and oxygen tension is highest in the apices

Front 112

CXR in pneumocytis PNA

Back 112

Diffuse ground glass infiltrates

Front 113

Cirrhosis pt w/ weight loss and abdominal pain: top diagnosis and management

Back 113

Worry about HCC
Get an AFP, and then abdominal imaging

Front 114

Triad of Osler-Weber-Rendu syndrome

Back 114

Diffuse telangiectasies, recurrent epistaxis, and widespread AVMs

Front 115

Inheritance of Osler-Weber-Rendu syndrome

Back 115

AD

Front 116

Why do Osler-Weber-Rendu pts develop polycythemia?

Back 116

AVMs in lungs shunt blood --> chronic hypoxemia

Front 117

Med toxicity with CNS stimulation (headache, insomnia), N/V, and arrhythmia

Back 117

Theophylline toxicity

Front 118

What meds decrease the clearance of theophylline and therefore increase the risk of toxicity?

Back 118

Ciprofloxacin and erythromycin

Front 119

Pt w/ back and leg pain when walking (esp downhill; better when walking uphill), negative straight leg test

Back 119

Lumbar spinal stenosis

Front 120

What causes the pain of lumbar spinal stenosis to imrpove?

Back 120

Flexion of the spine (e.g. sitting and uphill walking)

Front 121

Rx for aortic regurg (2)

Back 121

Afterload reduction w/ CCBs or ACEIs

Front 122

Medication contraindicated in aortic regurg

Back 122

Beta blockers: slow HR so extend time during diastole when regurgitation can take place

Front 123

Manifestations of chronic HCV (5)

Back 123

Waxing/waning transaminase levels
Arthralgias/myalgias
Cryoglobulinemia
Porphyria cutanea tarda
Glomerulonephritis

Front 124

Rx for ankylosing spondylitis

Back 124

Pain relief
TNF-alpha antagonists

Front 125

2 diseases that predispose to calcium phosphate stones

Back 125

Primary hyperPTH
Rental tubular acidosis

Front 126

Best way to prevent contrast-induced nephropathy

Back 126

Pre-CT IV hydration

Front 127

Smudge cells

Back 127

CLL

Front 128

Rx for acute renal transplant rejection

Back 128

IV steroids

Front 129

How to differentiate acute rejection from cyclophosphamide toxicity?

Back 129

Latter doesn't have graft tenderness

Front 130

Drug associated with rhabdomyolysis

Back 130

Cocaine

Front 131

Difficulty concentrating, fatigue, dry skin, and weight gain while being treated for HTN and afib

Back 131

Amiodarone-induced hypothyroidism

Front 132

Management of SLE pt with elevated Cr or abnormal UA

Back 132

Renal biopsy (can have diff forms of nephritis which have diff treatments)

Front 133

Chronic recurrent cough w/ mucopurulent expectoration and occasional hemoptysis, responsive to Abx

Back 133

Bronchiectasis

Front 134

How to differentiate the cough of chronic bronchitis from bronchiectasis

Back 134

Chronic bronchitis: nonpurulent expectoration
Bronchiectasis: mucopurulent expectoration

Front 135

CXR findings in bronchiectasis

Back 135

Linear atelectasis (can sometimes see dilated airways)

Front 136

What is Dressler's syndrome

Back 136

Pericarditis weeks after MI; immunologic phenomenon; ESR is elevated

Front 137

Why is anticoagulation avoided in pts with pericarditis?

Back 137

Risk of hemorhagic pericardial effusion

Front 138

PNA in an alcoholic w/ capsulated gram negative bacilli and mucoid colonies

Back 138

Klebsiella

Front 139

Liver biopsy findings in alpha-1-antitrypsin deficiency?

Back 139

Hepatocyte inclusions that stain w/ periodic acid-Schiff (PAS) but resist digestion by diastase

Front 140

Rx for alpha-1 antitrypsin deficiency (2)

Back 140

Augment with purified human A1AT

Liver/lung transplant

Front 141

Location of BPH vs. prostate cancer

Back 141

BPH: central regions
Cancer: peripheral regions

Front 142

When is gonococcemia likely to disseminate?

Back 142

During menstrual periods

Front 143

Why are cultures often negative in disseminated gonococcemia?

Back 143

Specific growth requirements of the strain of N. gonorrhea

Front 144

Recurrent PNAs in the same anatomic region of the lung: ddx and work-up

Back 144

Bronchial obstruction (worry about bronchogenic carcinoma; also bronchiectasis, foreign body, bronchial stenosis)

Need chest CT

Front 145

What seizure drug can cause pancreatitis?

Back 145

Valproic acid

Front 146

Classes of drugs associated with pancreatitis (6)

Back 146

Diuretics
Drugs for IBD
Immunosuppresants
AIDS meds
Antibiotics
Valproic acid

Front 147

Rx for amebic liver abscess

Back 147

Oral metronidazole (avoid needle aspiration)

Front 148

Postop jaundice with only an elevated bilirubin

Back 148

Postop cholestasis (from blood transfusions, brief hypoperfusion of liver, and decreased renal bili excretion from tubular necrosis)

Front 149

Immunocompromised pt w/ pneumonitis and colitis

Back 149

CMV

Front 150

Pt with GERD w/ improvement of heartburn symptoms but progressive dysphagia to solids

Back 150

Benign peptic esophageal stricture (caused by GERD; as it progresses, can improve reflux Sx)

Front 151

Management of peptic stricture seen on endoscopy in a pt with GERD and Barrett's esophagus

Back 151

Still need biopsy to r/o adenocarcinoma

Front 152

Test to order in an MI pt who develops a cold, pulseless leg

Back 152

Echo (to look for LV thrombus due to akinesis)

Front 153

When is non-invasive positive pressure ventilation contraindicated (3)

Back 153

Septic, hypotensive, or dysrhythmic pts

Front 154

Tumor cell marker produced by teratoma

Back 154

None!

Front 155

HIV pt w/ rapidly progressing b/l necrotizing retinitis (keratitis and conjunctivitis w/ eye pain and progressive visual loss)

Back 155

HSV retinitis

Front 156

Most common cause of corneal blindness in the US

Back 156

HSV infection of eye

Front 157

HIV pt w/ painless retinitis; fundoscopy w/ fluffy or granular lesions near vessels and associated hemorrhages

Back 157

CMV retinitis

Front 158

Fundoscopy appearance of HSV retinitis

Back 158

Widespread pale, peripheral lesions and central necrosis of retina

Front 159

HSV retinitis presents similarly to

Back 159

VZV retinitis

Front 160

What is sympathetic ophthalmia

Back 160

Spared eye injury: immune-mediated inflammation of one eye after a penetrating injury to the other

Front 161

Pathophys of sympathetic ophthalmia

Back 161

Uncovering of "hidden" antigens (breaking of barrier)

Front 162

Management of pt with lye (sodium hydroxide) ingestion (testing and concerning complication)

Back 162

Endoscopy; follow w/ serial AXR/CXR

Strongly alkaline, so can cause liquefactive necrosis of esophageal wall

Front 163

Surveillance for ulcerative colitis pt

Back 163

Colonoscopy at 8yrs after diagnosis and then every 1-2yrs thereafter

Front 164

Pathophys of atrial flutter

Back 164

Re-entrant rhythm in atria and variable AV node conduction

Front 165

Ulcerative colitis pt with an increased alk phos

Back 165

Primary sclerosing cholangitis

Front 166

What is De Quervain tenosynovitis?

Back 166

New moms who hold their infants with the thumb outstretched (abducted/extended) --> pain of abductor pollicis longus and extensor pollicis brevis

Front 167

How does hereditary spherocytosis cause cholecystitis?

Back 167

Chronic hemolysis --> pigmented (calcium bilirubinate) gallstones

Front 168

Best means of evaluating liver damage in chronic hepatitis

Back 168

Liver diopsy

Front 169

Erythematous papule w/ a central scale due to hyperkeratosis and sandpaper texture

Back 169

Actinic keratoses

Front 170

Pain exacerbated by eating

Back 170

Mesenteric angina

Front 171

Management of pt w/ Hx of prostate cancer and new onset back pain w/ tenderness on spinal palpation and neuro symptoms

Back 171

Needs back MRI, but give dexamethasone while waiting for results to attempt to preserve neuro function

Front 172

Diarrhea w/ 10-20 BMs/day; on colonic biopsy, dark brown discoloration of colon w/ lymph follicles shining thru as pale patches (melanosis coli)

Back 172

Factitious diarrhea (laxative abuse)

Front 173

Woman w/ mucopurulent urethral discharge, multiple sexual partners, and negative urine culture

Back 173

Chlamydial urethritis

Front 174

How to differentiate gonococcal and chlamydial urethritis?

Back 174

Gonococcal is purulent (vs. mucopurulent in chlamydial) and urine gram stain/culture will often grow organisms

Front 175

Asymptomatic thrombocytopenia w/ normal hematopoietic cell lines

Back 175

HIV

Front 176

Condyloma lata vs. condyloma acuminata

Back 176

Lata: syphilis, flat and velvety
Acuminata: HPV, verrucous, papilliform, skin-colored/pink

Front 177

Rx for condylomata acuminata (3 categories)

Back 177

Chemical agents (podophyllin, 5-FU gel, trichloroacetic acid)
Immune therapy (INF-alpha, imiquimod)
Surgery

Front 178

4 side effects of EPO

Back 178

Worsening of HTN (common, up to 10mmHg rise in diastolic BP)
Headaches
Flu-like symptoms
Red cell aplasia

Front 179

Firm, solitary submandibular LN in a smoker

Back 179

Concerning for squamous cell carcinoma of H&N; needs biopsy

Front 180

Polyarticular and symmetric arthritis + diarrhea in a pt who works at a day care

Back 180

Parvovirus

Front 181

Elevated blood test in parvovirus

Back 181

Anti-B19 IgM antibody

Front 182

4 potential side effects of compression from a superior sulcus (apical lung) tumor

Back 182

Sympathetic trunk (Horner)
Brachial plexus (Pancoast)
Recurrent laryngeal (hoarse voice)
SVC (SVC syndrome)

Front 183

Biopsy findings of HSV vs. CMV esophagitis

Back 183

HSV: multiple, well cicrumscribed ulcers w/ volcano-like (small and deep) appearance

CMV: large, shallow, and superficial ulcers

Front 184

Most common manifestation of hemophilia

Back 184

Hemarthroses (joint swelling)

Front 185

Best screening for acute HBV infection (2 tests)

Back 185

HBsAg (appears first)
anti-HBc (appears in window period before anti-HBs appears)

Front 186

3 causes of increased BUN/Cr ratio

Back 186

Prerenal ARF
GI bleeding (breakdown of Hb in GI tract w/ reabsorption of urea)
Steroid administration

Front 187

Infection where carries the highest risk of spread to the mediastinum?

Back 187

Retropharyngeal space

Front 188

What is Ludwig's angina?

Back 188

Infection in submandibular space

Front 189

Major complication of infection in parapharyngeal space

Back 189

Involvement of carotid sheath --> erosion of carotid artery and jugular thrombophlebitis

Front 190

First change in diabetic glomerulopathy that can be quantified

Back 190

Thickening of GBM (glomerular hyperfiltration is first but not quantified)

Front 191

Overdose w/ bradycardia, AV block, hypotension and diffuse wheezing (causative agent and remedy)

Back 191

Beta-blockers (give atropine and IV fluids, followed by glucagon)

Front 192

When do HIV pts need ganciclovir prophylaxis?

Back 192

CD4 <50 and serum CMV IgG positive (or a positive biopsy)

Front 193

Leukocytosis, anemia, and increased number of mature granulocytic forms (segmented neutrophils and band forms)

Back 193

CML

Front 194

Leukocyte alkaline phosphatase score in CML

Back 194

Low

Front 195

Two other diseases w/ low LAP

Back 195

Hypophosphatemia
Paroxysmal nocturnal hemoglobinuria

Front 196

Disease w/ elevated leukocyte alkaline phosphatase

Back 196

Leukemoid reaction

Front 197

Auer rods are diagnostic of

Back 197

AML

Front 198

Tartrate resistant acid phosphatase indicates

Back 198

Hairy cell leukemia

Front 199

Acute onset of leukocytosis w/ many monoblasts (peroxidase negative, esterase positive, no Auer rods), promonocytes, and monocytes and a positive alpha-naphthyl esterase test

Back 199

Acute monocytic leukemia (FAB M5)

Front 200

Acute promyelocytic leukemia has a high risk of

Back 200

DIC