Step 2 -- Day 3

Front 1

when to administer triple screen? what does it screen for?

Back 1

16-20 weeks
alpha-fetoprotein, estriol, hCG
(low, low, high in downs)

Front 2

snow storm on u/s. Dx?
Tx?
Complications?

Back 2

hydatiform mole
d&c
choriocarcinoma

Front 3

complete mole genotype

Back 3

46 XX

Front 4

incomplete mole genotype

Back 4

69 XXY

Front 5

What is a nonstress test?

Back 5

tests fetal well-being
20 min with mother at rest
need 2 accel for 15 bpm above baseline lasting 15 sec

Front 6

What is a BPP?

Back 6

used for high-risk preggers even if nothing wrong, 3rd trimester
nonstress test, amniotic fluid measurement, general fetal movements

Front 7

when is ASA acceptable in pregnancy?

Back 7

antiphospholipid syndrome

Front 8

prolonged gestation. ddx?

Back 8

inaccurate dating
anencephaly
placental sulfatase deficiency

Front 9

CVS vs amniocentesis

Back 9

CVS is done 9-12 weeks, for women with affected offspring or known genetic dz
amnio is 16-20 has less chance of miscarriage

Front 10

VZV in preggers. birth defects?

Back 10

limb hypoplasia, scarring of skin

Front 11

congenital syphilis. birth defects?

Back 11

rhinitis, saber shins, Hutchinson's teeth, interstitial keratitis, skin lesions

Front 12

CMV in preggers. birth defects?

Back 12

deafness, cerebral calcifications, micropthalmia

Front 13

When and how to treat VZV in preggers?

Back 13

mother contracts in last 5 days or within 2 days after delivery.
give immunoglobulin to infant

Front 14

fresh show of blood, lengthening of umbilical cord, rising fundus that becomes firm and globular. Dx?

Back 14

placenta previa

Front 15

No breastfeeding for...

Back 15

HIV
Hep
etOH/drugs

Front 16

When to treat GBS?

Back 16

during L&D with ampicillin

Front 17

protraction vs arrest. next step?

Back 17

labor progressing slowly
no change in dilation x 2 hrs, no change in descent x 1 hr
r/o abnl lie and CPD

Front 18

true labor vs false labor

Back 18

nl contractions q3min, regular, associated with cervical change
irregular contractions, no cerv change

Front 19

problems with oxytocin?

Back 19

uterine hyperstimulation, uterine rupture, FHR decel, hyponatremia

Front 20

problems with prostaglandin gel?

Back 20

used for cervical ripening
uterine hyperstimulation

Front 21

problems with amniotomy?

Back 21

route for infxn

Front 22

abortion requirements

Back 22

<20 weeks, <500 grams

Front 23

7yo with fatigue, pounding in ears, bleeding gums, hyperpigmented spots. Dx?
cause?

Back 23

Fanconi's syndrome
genetic, progressive bone marrow suppression, skin hypopigmentation, congenital abnormalities

Front 24

patient on sulfa or oxidant drugs with hemolysis. Dx?

Back 24

G6PD

Front 25

endometritis treatment?

Back 25

clindamycin and gentamicin

Front 26

hi CPK, cocaine abuse, immobilization. dx?

Back 26

rhabdo

Front 27

CAP treatment?

Back 27

levofloxacin or moxifloxacin

Front 28

adverse reactions to DTaP are attributed to which?
next step

Back 28

pertussis
next imz, DT only

Front 29

hypotonia, hyperactive DTR, learning disabilities, prolonged labor and low APGAR at birth. dx? cause?

Back 29

cerebral palsy
anoxia

Front 30

changes in lav values for SBO
complete vs partial?

Back 30

mild leukocytosis, and modest increases in amylase
LA levels

Front 31

strep pharyngitis in 10 yo, develops sandpaper rash on neck 12-48 hours later. dx? Tx?

Back 31

scarlet fever (GAS)
penicillin V

Front 32

GAS, 2-4 wks later carditis, migratory arthritis, sydenham chorea, SQ nodules, erythema marginatum

Back 32

rheumatic fever
"Jones criteria" -- 2 major or 1 major and 2 minor

Front 33

most common ASE in ACEi? MOA?

Back 33

angioedema
bradykinin increases

Front 34

low-birth weight infant with craniotabes, rachitic rosary, thickening wrists/ankles. dx?

Back 34

vitamin d deficiency rickets

Front 35

best treatment for chemo-vomiting?

Back 35

serotonin antagonist with CCS

Front 36

Hep C, on OCP... what is she at risk for?

Back 36

Porphyria cutanea tarda -- painless blisters, increased skin fragility on dorsum of hands
(also with alcohol ingestion)

Front 37

infantile spasms, hypsarrhythmia on EEG, hypopigmented lesions, cortical tubers on CT. Dx? Tx?

Back 37

tuberous sclerosis
ACTH

Front 38

LN biopsy vs observation?

Back 38

if > 2 cm or fever, chills, wt loss

Front 39

organs affected by hemachromotosis?

Back 39

liver, pancreas, heart, joints, and pit gland

Front 40

micrognathia, microcephaly, rocker bottom feet, overlapping fingers, vsd. Dx? Anomaly?

Back 40

Edward's Syndrome
18

Front 41

asd and endocardial cushion defects. dx? anomaly

Back 41

down's
21

Front 42

truncus arteriosus, tetralogy of fallot, interrupted aortic arch associated with?

Back 42

DiGeorge and velocardiofacial (CATCH 22)

Front 43

PDA associated with?

Back 43

congenital rubella

Front 44

coranary aneurysm associated with?

Back 44

Kawasaki

Front 45

rapid onset of non-inflammatory edema to face, limbs, genitalia, trachea and abdominal organs. dx? cause?

Back 45

C1esterase inhibitor deficiency
increase in C2b and bradykinin

Front 46

infertility. first step? next step?

Back 46

physical exam
mid-luteal progesterone level

Front 47

SAH. medical tx? cause of morbidity/mortality?

Back 47

CCB -- nimodipine
vasospasm

Front 48

cholecystitis diagnostic test?

Back 48

HIDA scan

Front 49

diagnostic test for chronic pancreatitis/pancreatic insufficiency?

Back 49

stool elastase

Front 50

child with rash, fever responding poorly to acetaminophen. dx?
Tx?

Back 50

Kawasaki
IVIg and ASA

Front 51

previous miscarriages, pos RPR, prolonged PTT, thrombocytopenia. Dx? Tx?

Back 51

antiphospholipid syndrome
LMWH

Front 52

child with macrocytic anemia, low retic count, congenital anomalies. dx? tx?

Back 52

Diamond-Blackfan syndrome (congenital hypoplastic anemia)
CCS

Front 53

thrombocytopenia, ecchymoses, petechiae, mucosal bleeding; no bm failure or splenomegaly. dx?

Back 53

autoimmune platelet destruction (ITP)

Front 54

direct vs indirect hyperbilirubinemia?

Back 54

conjugated = direct >50% total bili
unconjugated = indirect >90% total bili

Front 55

cirrhotic patient with transudative pleural effusion. Dx? tx?

Back 55

hepatic hydrothorax
liver transplant, diuretics, thoracentesis, TIPS

Front 56

large blood without RBCs in urine. dx?

Back 56

rhabdo

Front 57

chronic GERD predisposes...

Back 57

Barrett's
benign peptic esophageal strictures

Front 58

child with sensorineural deafness, PDA/ASD, catarracts. Dx?

Back 58

congenital rubella

Front 59

painless loss of monocular vision. dx? tx?

Back 59

central retinal artery occlusion
optic massage and hyperbaric oxygen

Front 60

light's criteria

Back 60

exudate =
Fprotein/Sprotein >0.5
FLDH/SLDH >0.6
FLDH >2/3 nlSLDH

Front 61

decrease in peristaltic waves and increased LES tone?

Back 61

achalasia

Front 62

sticking sensation in throat, dysphagia accompanied by heartburn, decrease peristaltic waves in lower 2/3, decrease in LES tone

Back 62

scleroderma

Front 63

HLA-B27 ...

Back 63

Psoriatic arthritis
ankylosing spondylitis
IBD, iritis/uveitis
reactive arthritis