Step 2- E

Front 1

Rx for dermatitis herpetiformis

Back 1

Dapsone

Front 2

Middle mediastinal masses (6)

Back 2

Bronchogenic cysts
Tracheal tumors
Pericardial cysts
Lymphoma
LN enlargement
Aortic arch aneurysm

Front 3

Where are neurogenic tumors found in the mediastinum?

Back 3

Posterior mediastinum

Front 4

Rx for localized Lyme disease in pregnant women

Back 4

Amoxicillin

Front 5

Rx for disseminated/ late Lyme disease

Back 5

IV 3rd generation cephalosporins (ceftriaxone and cefotaxime)

Front 6

Who needs the pneumococcal vaccine (2 groups)

Back 6

>65 (just once)
<65 w/ chronic medical condition + booster 5 yrs later

Front 7

Common cause of CHF in young pts

Back 7

Myocarditis (often from coxsackie B virus)

Front 8

Mechanism by which exudative ascites (SAAG <1.1) forms

Back 8

Increased capillary permeability

Front 9

Mechanism by which transudative ascites (SAAG >1.1) forms

Back 9

Portal HTN (increased capillary hydrostatic pressure)

Front 10

3 MI settings in which nitrates are not indicated (and why)

Back 10

RV infarction
Aortic stenosis
Recent phosphodiesterase inhibitor use

(b/c SV has decreased, impairing CO, so don't want to reduce preload)

Front 11

MI pt w/ JVD, hypotension, and clear lung fields indicates infarction is where?

Back 11

Right ventricular infarction (LV infarction will cause pulmonary edema if it is severe enough to cause hypotension)

Front 12

Pt w/ a history of Hodgkin's now w/ hepatomegaly, ascites, and increased JVP

Back 12

Constrictive pericarditis from radiation therapy

Front 13

3 common causes of respiratory alkalosis (hyperventilation)

Back 13

PNA
High altitude
Salicylate intoxication

Front 14

Manifestation of galactokinase deficiency

Back 14

Cataract development

Front 15

3 meds that should be held prior to exercise EKG

Back 15

Beta blockers (or others that slow heart)

Anti-ischemics

Digoxin

Front 16

New cardiac finding during an MI

Back 16

S4 (diastolic dysfunction and stiffened left ventricle --> atrial gallop)

Front 17

What pressure is measured at the end of an inspiratory hold in a ventilated pt

Back 17

Elastic/ plateau pressure (indicative of pulmonary compliance)

Front 18

Four metabolic abnormalities in tymor lysis syndrome

Back 18

Hyperkalemia and hyperphosphatemia from cell breakdown

Hypocalcemia (phos binds Ca)

Hyperuricemia (from degradation of cellular proteins)

Front 19

Increased PCWP with low CO and high SVR

Back 19

Cardiogenic shock

Front 20

Rx for needle stick in a HCW not vaccinated for HBV

Back 20

HBV vaccine
If source pt is positive for HbsAg, then give HB immune globulin too

Front 21

Most common underlying valve abnormality in a pt w/ infective endocarditis

Back 21

MR

Front 22

Which joints are affected in SLE and RA?

Back 22

MCP and PIP (but SLE is non-deforming)

Front 23

Pt w/ ascites and elevated creatinine

Back 23

Hepatorenal syndrome

Front 24

Cause of renal failure in hepatorenal syndrome

Back 24

Liver disease --> systemic vasodilation (2/2 generation of NO in sphlanchnic circulation from portal HTN) --> decreased vacular resistance --> renal hypoperfusion and pre-renal renal failure

Front 25

Pt w/ kidney failure and no protein and blood in the urine

Back 25

Unlikely to be intrinsic renal disease

Front 26

Rx for hepatorenal syndrome

Back 26

Midodrine and octreotide

Front 27

How to differentiate rotator cuff impingement/ tendonitis from rotator cuff tear?

Back 27

Only the former improves w/ a lidocaine injection

Front 28

Upper arm numbness, weakness, and swelling w/ weakened radial pulse

Back 28

Thoracic outlet syndrome (compression of subclavian vessels and lower trunk of brachial plexus)

Front 29

Throbbing pain in distal phalanx which is swollen, soft, and tender w/ non-purulent vesicles

Back 29

Herpetic whitlow (HSV)

Front 30

Electron microscopy findings in Alport's syndrome

Back 30

Alternating areas of thinned and thickened capillary loops w/ splitting of the GBM

Front 31

4 categories of asthma

Back 31

Intermittent (<2x/wk)

Mild persistent (symptoms >2x/wk but not daily, 3-4 awakenings/mo)

Moderate persistent (daily symptoms, weekly awakenings, FEV1 60-80% predicted)

Severe persistent (symptoms throughout day, frequent awakenings, FEV1 <60% predicted)

Front 32

Meds for each of the 4 classes of asthma

Back 32

Intermittent: short-acting beta-2 agonist (albuterol) inhaler

Mild persistent (add inhaled corticosteroids)

Moderate persistent (add long-acting inhaled beta-2 agonist inhaler)

Severe persistent (add oral prednisone)

Front 33

Cause of hypocalcemia/
hypophosphatemia in an alcoholic

Back 33

Malabsorption of Vitamin D 2/2 chronic pancreatitis

(acute pancreatitis can do the same thing)

Front 34

Three causes of avascular (aseptic) necrosis of the femoral head

Back 34

Chronid steroids
Alcoholism
Hemoglobinopathy

Front 35

Rx for pts who have had an episode of rheumatic fever

Back 35

Abx prophylaxis w/ penicillin to prevent further attacks (which can worsen valvular function)

Front 36

Management of CIN II/III after LEEP

Back 36

Pap smear +/- colpo q 6 mo until 3 negative tests obtained; then annual Paps until 3 negative tests; then q 3 yrs (like everyone else)

Front 37

Rx for first uncomplicated kidney stone

Back 37

CT, NSAIDs, fluids >2L/day
(don't need 24 hr urine collection until have recurrent stones)

Front 38

Soap bubble appearance on xray of distal epiphysis of femur

Back 38

Giant cell tumor of bone

Front 39

How to define a saline-responsive metabolic alkalosis, typical causes, and treatment

Back 39

Urine chloride <20

Hypovolemia or GI proton loss (e.g. vomiting)

IV saline

Front 40

Polyarthralgia, tenosynovitis, and painless vesiculopustular skin lesions

Back 40

Disseminated gonococcal infection

Front 41

Mechanism of warfarin-induced skin necrosis within a few days of starting treatment

Back 41

Protein C deficiency

Front 42

Immunocompromised pt w/ cultures growing gram-positive branching rod, partially acid fast

Back 42

Nocardia asteroides

Front 43

Rx for nocardiosis

Back 43

Bactrim

Front 44

3 ways to distinguish actinomyces and nocardia infections

Back 44

Actinomyces is anaerobic (nocardia is aerobic) and is more likely to cause cervicofacial disease and sinus tracts and may have sulfur granules

Front 45

Rx for actinomyces infection

Back 45

Penicillin G

Front 46

JAK2 mutation may be seen in

Back 46

Polycythemia vera

Front 47

Most common cause of isolated right-sided heart failure

Back 47

Pulmonary disease (cor pulmonale)

Front 48

Pathophys of hepatic encephalopathy (4)

Back 48

Accumulation of ammonia, production of false neurotransmitters, increased CNS sensitivity to inhibitory neurotransmitters, and zinc deficiency

Front 49

First step in aortic dissection pt w/ HTN

Back 49

Antihypertensive management (TEE is best diagnostic study, but comes afterward)

Front 50

Asymmetric oligoarthritis, urethritis, and mouth ulcers

Back 50

Reactive arthritis (Reiter syndrome)

Front 51

LAP, O2 sat, and EPO level in polycythemia vera

Back 51

Elevated
Normal
Low

Front 52

IVDU w/ pleuritic pain and cavitating lung nodules on CXR

Back 52

Septic emboli from tricuspid valve endocarditis (most often from S. aureus)

Front 53

Criteria for MGUS diagnosis

Back 53

Asymptomatic elevation of monoclonal protein <3

No anemia, lytic bone lesiosn, hypercalcemia, renal insufficiency, or anything else to suggest multiple myeloma

Front 54

Why is aggressive diuresis not recommended for treatment of ascites?

Back 54

Risk of hepatorenal syndrome

Front 55

Most common cause of death in pts with acute MI

Back 55

Complex ventricular arrhythmia (partial block --> re-entrant arrhythmia, e.g. v fib)

Front 56

Elderly pt w/ tense bullae and urticarial plaques (+ pruritus)

Back 56

Bullous pemphigoid

Front 57

Pathophys of bullous pemphigoid

Back 57

IgG and C3 deposits at dermal-epidermal junction

Front 58

Tea and toast diet is associated w/ what dietary deficiency?

Back 58

Folic acid --> anemia

Front 59

Mechanism of a transudative pleural effusion

Back 59

Either increased hydrostatic pressure (e.g. CHF) or decreased oncotic pressure (e.g. liver failure)

Front 60

Common side effect of dihydropyridine Ca-channel antagonists (e.g. amlodipine)

Back 60

Peripheral edema

Front 61

Immigrant w/ high grade periodic fever, anemia, and splenomegaly

Back 61

Malaria

Front 62

Risk with HIT

Back 62

Paradoxically it is thrombogenic, so at risk for arterial and venous clots

Front 63

3 causes of postchole pain

Back 63

Sphincter of Oddi syfunction
CBD stone
Functional pain

Front 64

Risk factors for esophageal cancer: SCC vs. adenocarcinoma

Back 64

Squamous: smoking/alcohol
Adeno: GERD/ Barrett's

Front 65

HTN, mild hypernatremia, hypokalemia, metabolic alkalosis

Back 65

Primary hyperaldosteronism/ Conn's syndrome (excess aldosterone promotes reabsorption of sodium and secretion of K+ and H+ ions)

Front 66

Renin level in Conn's syndrome

Back 66

Decreased due to feedback inhibition from high aldosterone

Front 67

Management of HTN in a pt on OCPs

Back 67

D/c OCPs

Front 68

Short-term bloody diarrhea w/o travel history or fever

Back 68

EHEC O157:H7

Front 69

Pathophys of GVHD

Back 69

Recognition of host major and minor HLA antigens by donor T cells --> cell-mediated immune response

Front 70

Complication of temporal arteritis (other than vision loss)

Back 70

Aortic aneurysm

Front 71

Psoriatic arthritis most commonly involves which joints?

Back 71

DIP joints

Front 72

Potential complication of aortic dissection that can cause hypotension

Back 72

Cardiac tamponade

Front 73

Persistent nasal blockage and episodes of bronchoconstriction in a pt w/ chronic analgesic use for headaches

Back 73

Aspirin sensitivity syndrome

Front 74

Pathophys of aspirin sensitivity syndrome

Back 74

Pseudo-allergic reaction: exaggerated release of vasoactive and inflammatory mediators

Front 75

Rx for aspirin sensitivity syndrome

Back 75

Leukotriene inhibitors, topical steroids

Front 76

FEV1/FVC ratio in obstructive vs. restrictive disease

Back 76

Obstructive: <80%
Restrictive: >80%

Front 77

Frequent complication of nephrotic syndrome

Back 77

Hypercoagulability (multifactorial), most commonly leading to renal vein thrombosis (esp w/ membranous glomerulopathy)

Front 78

5 other complications of nephrotic syndrome

Back 78

Protein malnutrition

Microcytic hypochromic anemia (transferrin loss)

Vita D deficiency (loss of cholecalciferol-binding protein)

Decrease thyroxine (loss of TBG)

Increased susceptibility to infection

Front 79

Chronology of abdominal pain in acute appendicitis

Back 79

Visceral followed by somatic pain

Front 80

Rx for acute bleeding in pts with liver failure

Back 80

FFP (has all the clotting factors)

Front 81

What is the water bottle sign on CXR indicative of?

Back 81

Pericardial effusion

Front 82

Characteristics of a simple renal cyst that requires no follow-up

Back 82

Thin walls, no solid component, no enhancement

Front 83

4 worrisome findings of a renal mass

Back 83

Multilocular
Thickened, irregular walls
Thickened septae w/in the mass
Contrast enhancement

Front 84

How to diagnose allergic rhinitis

Back 84

Nasal cytology (for eosinophils; neutrophils would indictae infectious cause)

Front 85

Other causes of nasal eosinophilia (besides allergic rhintiis)

Back 85

Nasal polyposis (including aspiring sensitivity) and non-allergic rhinitis

Front 86

DLCO and pulmonary compliance in interstitial lung disease

Back 86

Both decreased

Front 87

Elderly pt w/ asymptomatic femoral bowing on xray

Back 87

Paget's disease

Front 88

Pathophys of Paget's

Back 88

Osteoclast hyperfunction --> mosaic pattern of lamellar bone

Front 89

Why do pts with obesity hypoventilation syndrome have respiratory acidosis?

Back 89

Decreaesd chest wall compliance --> increased work of breathing

Front 90

HIV pt taking all his meds and prophy drugs with hyperkalemia

Back 90

Likely 2/2 trimethoprim

Front 91

NPO postop pt who is bleeding is most likely due to

Back 91

Vitamin K deficiency (so give FFP)

Front 92

IBD w/ crypt abscess is most likely due to

Back 92

Ulcerative colitis

Front 93

Diarrhea w/ intestinal villous atrophy is likely due to

Back 93

Celiac sprue

Front 94

Afebrile pt w/ new-onset blood-tinged sputum, cold symptoms, and normal PEX

Back 94

Likely acute bronchitis (viral); just observe

Front 95

Pneumonia w/ GI symptoms and hyponatremia

Back 95

Legionella

Front 96

Pathophys of Baker cysts

Back 96

Excessive fluid produced by inflamed synovium (e.g. in RA, OA, and cartilage tears) that accumulates in the popliteal bursa

Front 97

5 most effective lifestyle ways to lower BP, in order

Back 97

Weight loss
DASH diet
Dietary sodium restriction
Exercise
Decrease alcohol intake

Front 98

4 causes of pulsus paradoxus (abnormally large drop in SBP w/ inspiration)

Back 98

Tamponade
Pericardial effusion
Tension pneumo
Severe asthma

Front 99

Rx for torsades de pointes

Back 99

Magnesium sulfate

Front 100

Pstop pt with syncope/ hypotension, JVD, and RBBB

Back 100

Massive PE --> cardiogenic shock

Front 101

Pt w/ hyperactive DTRs after multiple blood transfusions

Back 101

Hypocalcemia from citrate binding

Front 102

Acid-base disturbance in primary adrenal failure

Back 102

Normal AG hyperkalemic, hyponatremic metabolic acidosis (from aldosterone deficiency)

Front 103

Pathogens associated w/ acute epididymitis

Back 103

Younger pts w/ urethritis as well: chlamydia or neisseria

Older pts w/ UTI as well: E. coli

Front 104

Best way to improve survival in COP

Back 104

Supplemental O2 therapy

Front 105

Rx for an intubated pt who is persistently hypoxemic despite high FiO2 settings

Back 105

Add PEEP to prevent alveolar collapse

Front 106

Cause of hypoxia in pts with PNA

Back 106

Alveolar and interstitial inflammation --> areas of V/Q mismatch --> increased A-a oxygen gradient

Front 107

Potential cause of persistent/recurrent chalazion

Back 107

Meibomian gland carcinoma (sebaceous carcinoma), so needs biopsy

Front 108

Rx for renal artery stenosis 2/2 fibromuscular dysplasia

Back 108

Angioplasty w/ stent placement

Front 109

Which live vaccine can be given to HIV pts?

Back 109

MMR, if CD4 >200 (b/c measles is life-threatening in HIV pts)

Front 110

IBD w/ noncaseating granulomas

Back 110

Crohn's disease

Front 111

Lymphoblasts in ALL stain

Back 111

PAS-positive

Front 112

Palpable purpura, proteinuria, hematuria

Back 112

Mixed cryoglobulinemia

Front 113

Many pts w/ mixed cryoglobulinemia also have what infection?

Back 113

HCV

Front 114

Systemic vasculitis, upper and lower airway granulomatous inflammation, and glomerulonephritis

Back 114

Granulomatosis w/ polyangitis (Wegener's)

Front 115

Rx for Wegener's

Back 115

Cyclophosphamide

Front 116

Definitive and intermediate hosts for hydatid cysts (and the pathogen that causes them)

Back 116

Sheep and dogs, respectively

Echinococcosis

Front 117

What is anasarca?

Back 117

Generalized edema (pulm, ascites, swollen extremities)

Front 118

Size cut-off for worrisome LN

Back 118

>2cm

Front 119

Asymmetric polyarthritis before or after purulent monoarthritis

Back 119

Gonococcal septic arthritis

Front 120

Painless visual loss w/ optic disk swelling, retinal hemorrhage, dilated veins, and cotton wool spots

Back 120

CRVO

Front 121

Painless visual loss w/ optic disc pallor, cherry red fovea, and boxcar segmentation of blood in the retinal veins

Back 121

CRAO

Front 122

Temporary visual loss

Back 122

Amaurosis fugax

Front 123

Acid-base abnormality in PE

Back 123

Respiratory alkalosis (due to hyperventilation)

Front 124

Cholangiography showing beading (dilation) of the intrahepatic and/or extrahepatic bile ducts

Back 124

PSC

Front 125

Recent onset confusion, fever, muscle rigidity, and diaphoresis

Back 125

Neuroleptic malignant syndrome (drug-induced idiosyncratic reaction)

Front 126

Pathophys of anemia in SLE

Back 126

Warm autoimmune hemolysis

Front 127

Pathophys of SLE-associated thrombocytopenia and neutropenia

Back 127

Antibody mediated destruction

Front 128

Rx for bartonella

Back 128

Oral azithromycin

Front 129

Symmetric duskiness and coolness of all fingertips/ toes in an ICU pt

Back 129

Norepinephrine-induced vasospasm --> ischemia

Front 130

Best neuromuscular blocker for a pt with both liver and kidney failure

Back 130

Atracurium (degrades spontaneously in plasma)

Front 131

Rx for tick on skin

Back 131

Remove (ideally within 24hrs) by grabbing mouth w/ tweezers

Front 132

Cause of presbyopia

Back 132

Decreased lens elasticity, so can't focus on near objects

Front 133

Anion gap metabolic acidosis with optic disc hyperemia

Back 133

Methanol ingestion

Front 134

Best Rx for cancer-induced cachexia (no appetite)

Back 134

Progestin agents

Front 135

Pruritic vesicles and pustules in gray wavy runs over finger webs, heels of palms, and wrist creases + papules over nipples, areola, scrotum, penis

Back 135

Scabies

Front 136

Difficulty swallowing, lots of dental caries, enlarged/firm salivary glands

Back 136

Sjogren Syndrome (lack normal amount of saliva; lymhocytic infiltrate of saliva glands)

Front 137

Diabetes, hepatomegaly, arthropathy

Back 137

Hemochromatosis

Front 138

Pain over the anteromedial tibia just below the joint line, often worst at night (when touching)

Back 138

Anserine bursitis

Front 139

Young male with morning pain in his hands

Back 139

RA

Front 140

How to differentiate the thickening in hypertrophic vs. restrictive cardiomyopathy

Back 140

Hypertrophic: septum is thickest
Restrictive: symmetrical thickness

Front 141

Reversible cause of restrictive cardiomyopathy

Back 141

Hemochromatosis

Front 142

Atypical PNA with a skin rash (erythema multiforme: dusky red target shaped lesions)

Back 142

Mycoplasma

Front 143

Most common complication of inhaled corticosteroids

Back 143

Oropharyngeal candidiasis (oral thrush)

Front 144

Rx for CML and its mechanism

Back 144

Imatinib (Gleevec): tyrosine kinase inhibitor that binds the ATP binding site of BCR-ABL, preventing conformation change to its active form

Front 145

Mono symptoms + rash and diarrhea

Back 145

HIV

Front 146

Rx for Zenker's diverticulum

Back 146

Excision, usually with cricopharyngeal myotomy

Front 147

Rx for sphincter of Oddi dysfunction after chole

Back 147

ERCP with sphincterotomy

Front 148

Pathophys of ARDS

Back 148

Inflammatory mediators from tissue injury damage the alveoli --> alveolar capillary permeability --> fluid leaks into alveoli, causing pulmonary edema

Front 149

Rx for ARDS

Back 149

Mechanical ventilation w/ low tidal volumes and PEEP (may require up to 15 cm H2O of PEEP)

Front 150

Pathophys of statin induced myopathy

Back 150

Inhibiting HMG CoA also inhibits mevalonate production, which is also used in production of CoQ10 --> myopathy

Front 151

Tobacco induced white granular texture on mouth

Back 151

Leukoplakia

Front 152

Risk of leukoplakia

Back 152

Transformation into squamous cell carcinoma

Front 153

Vaccines for HIV pts

Back 153

Td booster, influenza, S. pneumo, hep A (if pt is MSM), and hep B

Front 154

Area w/ dullness to percussion and increased fremitus (but normal breath sounds)

Back 154

Likely consolidation/ PNA

Front 155

Exam findings with pneumothorax (air in pleural space)

Back 155

Decreased breath sounds, hyperresonance to percussion, decreased fremitus, transmitted voice sounds

Front 156

Exam findings w/ fluid in pleural space (effusion)

Back 156

Blocks sound transmission so dull to percussion, decreased breath sounds, decreased fremitus

Front 157

Abd pain, diarrhea, malabsorption w/ steatorrhea + migratory polyarthropathy, chronic cough, valvular regurgitation

Back 157

Whipple's disease

Front 158

Biopsy in Whipple's disease

Back 158

PAS-positive material in lamina propria of small intestine

Front 159

Swollen, pale arm after placement of subclavian line

Back 159

Subclavian vein thrombosis

Front 160

Rx for subclavian vein thrombosis

Back 160

Remove central line first! Then duplex, may need anticoagulation

Front 161

Management of solid testicular mass

Back 161

US; if suggestive, radical orchiectomy (don't biopsy! Could spill cancer cells, will diagnose after excision)

Front 162

Bilateral tearing, intense itching, hyperemia, tearing, and conjunctival/eyelid edema

Back 162

Allergic conjunctivitis

Front 163

Cause of aspiration PNA in demented pt

Back 163

Impaired epiglottic reflex/ swallowing

Front 164

Rx for hepatic hydrothorax (1st, 2nd, and 3rd line)

Back 164

Therapeutic thoracentesis + diuretics/ salt restricted diet

TIPS

Liver transplant

Front 165

Rx for hepatorenal syndrome

Back 165

Liver transplant

Front 166

Definition of hepatorenal syndrome

Back 166

Cirrhosis with renal failure that doesn't respond to volume resuscitation

Front 167

Hyperglycemia, weight loss, scaly papules on face

Back 167

Glucagonoma triad

Front 168

HIV pt w/ bright red, firm, friable, exophytic nodules

Back 168

Bacillary angiomatosis

Front 169

Pathogen causing bacillary angiomatosis

Back 169

Bartonella (gram negative)

Front 170

Rx for bacillary angiomatosis

Back 170

Oral erythromycin

Front 171

HIV pt w/ RUL cavity growing partially acid-fast, filamentous, branching rods

Back 171

Nocardia

Front 172

Rx for Nocardia

Back 172

Bactrim

Front 173

Criteria for long term O2 therapy in COPD pts (3)

Back 173

PaO2 <55 or SaO2 <88%

Cor pulmonale, evidence of pulm HTN, or hematocrit <55% change the cut-offs to 59 and 89%

Nocturnal hypoxia

Front 174

HIV pt w/ LAD, pancytopenia, hepatosplenomegaly, palatal ulcers, and interstitial pneumonitis

Back 174

Disseminated histoplasmosis

Front 175

Of histo, blasto, and coccidio, which is unlikely to infect i/c hosts?

Back 175

Blasto

Front 176

Red eye w/ leukocytes in anterior chamber

Back 176

Anterior uveitis

Front 177

Young pt w/ chest pain and short systolic murmur at apex that disappears w/ squatting

Back 177

Mitral valve prolapse (squatting increases preload, which decreases murmur)

No explanation for why MVP pts have chest pain

Front 178

SIADH is most commonly associated w/ what kind of lung cancer?

Back 178

Small cell carcinoma

Front 179

What to tell pts who are starting warfarin

Back 179

Many foods have vitamin K and will decrease its efficacy

Many meds will decrease its efficacy as a side effect

Front 180

Mechanism of varencicline

Back 180

Partial agonist of nicotinic acetylcholine receptor

Front 181

Post eye operation, pt w/ pain, decreased visual acuity, swollen eyelids and conjunctiva, corneal edema and infection

Back 181

Postop endophthalmitis (infection w/in vitreous of eye)

Front 182

Rx for postop endophthalmitis

Back 182

Intravitreal antibiotic injection or vitrectomy

Front 183

Dx and management of urinary urgency, hesitancy, and nocturia w/ smoothly enlarged prostate w/ elevated creatinine

Back 183

BPH

Need abd US to r/o hydronephrosis (if so, need Foley and likely a TURP)

Front 184

Pt with diverticulitis who isn't improving on Abx

Back 184

CT scan to r/o complications like abscess or fistula

Front 185

Drugs to avoid in HOCM

Back 185

Nitrates (or anything that reduces preload: worsens obstruction)

Front 186

2 cancers tamoxifen places pts at risk of

Back 186

Uterine endometrial cancer and sarcoma

Front 187

Other risk of tamoxifen

Back 187

Venous thrombosis

Front 188

What do leukocyte esterase and nitrates indicate

Back 188

LE: pyuria
Nitrates: enterobacteriaceae

Front 189

Non-tender, indurated neck mass which is draining fluid w/ Gram positive, branching bacteria

Back 189

Actinomyces

Front 190

Rx for Actinomyces

Back 190

High dose IV penicillin for 6-12 wks

Front 191

Dev't of fever, hemolysis and DIC 30 min after blood transfusion

Back 191

Acute hemolytic transfusion reaction from ABO or minor antigen mismatched blood

Front 192

Mono presentation w/ negative heterophile Ab test

Back 192

Test may be negative early in illness; should repeat

Front 193

Best test for lactose intolerance

Back 193

Hydrogen breath test (increase in hydrogen after ingestion of lactose indicates bacterial carb metabolism, i.e. positive test)

Front 194

Stool tests in lactose intolerance (3)

Back 194

Low pH, increased osmotic gap, positive test for reducing substances

Front 195

Which type of ulcers are worse on an empty stomach and why?

Back 195

Duodenal (unopposed acidic fluid empties into duodenum)

Front 196

Rx for duodenal ulcer

Back 196

Abx (90% have H pylori) and PPIs

Front 197

3 classes of drugs that should be taken w/ folic acid

Back 197

Anti-epileptics, MTX, TMP

Front 198

Axillary freckling and cafe au lait spots

Back 198

Neurofibromatosis, type 1

Front 199

Ophtho risk w/ neurofibromatosis

Back 199

Optic glioma

Front 200

Presentation of optic glioma

Back 200

Slowly progressive unilateral vision loss, dyschromatopsia, exophthalmos