Step 2 Facts

Front 1

hypovolemic hyponatremia is due to:

(4)

Back 1

1. dehydration

2. diuretics

3. DM

4. primary adrenal insufficiency

Front 2

hypervolemic hyponatremia ~~

(4)

Back 2

CHF
nephrotic syndrome
cirrhosis
renal failure

Front 3

SBP is usually due to:

(2)

Back 3

E. coli or Strep pneumo

Front 4

Tx PBC =

Back 4

liver transplant

Front 5

achalasia =

Back 5

incomplete relaxation of a hypertensive LES + loss of peristalsis

=> intermittent dysphagia, no reflux; bird beak on Barium

Front 6

DES and nutcracker esophagus =

Back 6

intermittent, painful spasms

Wx = corkscrew on Barium

Dx = manometry

Tx = CCB

Front 7

follow Barrett with:

Back 7

periodic bx’s

Front 8

you cannot use Barium in:

Back 8

suspected perforation

- give Gastrograffin, follow with Barium if perf excluded

Front 9

do NOT perform colonoscopy or Barium enema in:

Back 9

active lower GI bleed (that’s why Dx = CT)

Front 10

mc hernia for men or women =

Back 10

indirect

it’s scrotal (vs. abdominal of direct)

Front 11

femoral hernias are the ones most likely to:

Back 11

incarcerate/strangulate

Front 12

Tx open pneumothorax =

(2)

Back 12

1. tape 3 sides

2. intubate

Front 13

if cardiac tamponade pt is stable, perform:

Back 13

an Echo to confirm, then pericardiocentesis

- o/w, pericardiocentesis right away

Front 14

Tuberous Sclerosis ~~

(3)

Back 14

CNS hamartomas, rhabdos, and renal tumors

Front 15

Lesch-Nyhan ~~

Back 15

self-mutilating behaviors

Front 16

nodularities on broad ligament =

Back 16

endometriosis

==> retroverted uterus

Front 17

Tx adenomyosis =

(2)

Back 17

hysterectomy or leuprolide

- must r/o endometrial cancer with bx first

Front 18

anemia due to uterine fibroid = indication for:

Back 18

hysterectomy

- get bx to r/o endometrial cancer

Front 19

in a woman 35 or older you will never be faulted for performing:

Back 19

a bx on a breast mass

Front 20

first test for anemia =

Back 20

CBC

second = peripheral smear + retic count

Front 21

high retic count ~~

(2)

Back 21

HmA

or

blood loss

Front 22

HmA => pigmented stones =>

Back 22

cholecystitis

Front 23

you can see spherocytes in:

Back 23

AI HmA

Front 24

AI HmA ~~

Back 24

lupus, drugs

Front 25

teardrop cells ~~

Back 25

myelofibro dysplasia

Front 26

FFP for rapid reversal of:

(3)

Back 26

warfarin, DIC, or liver failure

- contains all clotting factors

Front 27

CryoPPT for:

(2)

Back 27

Hemophilias, vWF

= fibrinogen and F.8

Front 28

what blood type do you give if you can't wait for screen to come back?

Back 28

Type O-negative blood

universally accepted

Front 29

DIC is mcly seen in:

(4)

Back 29

1. pregnancy

2. obstetrics complications

3. malignancy

4. then sepsis

Front 30

features of TTP:

(4)

Back 30

1. normal PT and PTT

2. purpura

3. thrombocytopenia

4. HmA

Front 31

Tx TTP =

Back 31

PLEX with FFP

Front 32

Tx hypertensive urgency =

(3)

Back 32

PO Lasix or ACEI or clonidine

Front 33

Tx hypertensive Emergency =

(2)

Back 33

IV nicardopine or nitroprusside

Front 34

giving ACEI to an elderly pt with RAS (due to athero) can ppt:

Back 34

kidney failure

Front 35

do not give aspirin in:

(3)

Back 35

nasal polyps, chronic sinusitis, hemarthroses

Front 36

positive HIV test requires confirmation with:

Back 36

ELISA and Western blot

Front 37

CD4 count <200 =

Back 37

AIDS

Front 38

annual PPD only if HIV pt at high risk for:

Back 38

TB

Front 39

Tx CMV retinitis =

Back 39

val-ganciclovir

Front 40

Cryptosporidia or Isospora =>

Back 40

chronic watery diarrhea in AIDS only

Front 41

Bruton’s X-linked agamma ~~

Back 41

low to no B cells

(vs. CVID, which shows low Ig's but nl amounts of total B cells)

Front 42

CVID ~~

Back 42

normal amount of circulatingB-cells

- but dec. IG’s

(vs. Bruton’s, where *all* B-cells are low)

Front 43

Chronic Granulomatous Dz =

Back 43

X-linked recurrent infs to catalase-positive bugs

- positive nitrozine blue test indicates NADPH def.

Front 44

other space

Back 44

adsf

Front 45

hyper-IgE =>

Back 45

recurrent Staph skin infections

Front 46

Strep pneumo can be GP ___________

Back 46

DIPLOcocci

Front 47

aspiration PNA ~~

(2)

Back 47

E. coli or Klebsiella

Front 48

features of Kawasaki dz:

(8)

Back 48

1. <5 y/o

2. fever >5 days

3. bilateral injection

4. changes in lips/oral mucosa

5. swelling of hands and feet

6. truncal rash

7. cervical LAD

8. arthralagias

Front 49

Tx Kawasaki =

(2)

Back 49

1. aspirin + IVIG

2. follow with Echo

Front 50

subacute IE ~~

Back 50

*other* Staph

Front 51

good empiric Tx for Staph =

(2)

Back 51

PCN + aminoglycoside

Front 52

ribavirin for bronchiolitis only if:

Back 52

chronic health problems

Front 53

negative PPD =

Back 53

no treatment

Front 54

avoid contrast in:

Back 54

*all* renal issues, including DM

to e/o else, can give N-acetylcysteine to prevent AKI from contrast

Front 55

Goodpasture’s ~~

Back 55

anti-BM AB’s => linear IF

damages kidneys and lungs

Tx = IVIG

Front 56

***Tx acute MS =

Back 56

steroids

Front 57

***PPx of MS =

Back 57

interferon or glatiramer

Front 58

fasciculations or fibrillations ~~

Back 58

LMN’s

Front 59

in dementia, always r/o:

(2)

Back 59

B12 deficiency and hypothyroidism

Front 60

HA worse in the morning or wakes you up from sleep ~~

Back 60

IC mass

Front 61

damaged right optic tract ~~

Back 61

left homonymous hemianopsia

Front 62

“blown” pupil =

Back 62

serious cause of CN III palsy,

=> urgent CT or MRI

Front 63

facial nerve: LMN lesion ~~

Back 63

forehead affected ~~ Bell’s palsy or tumor

Front 64

PPx complex seizure =

(3)

Back 64

valproate or CBZ or lamotrigine

Front 65

benzo = 1st-line for:

Back 65

aborting a seizure

Front 66

avoid “heparin” as an answer for:

Back 66

Tx of stroke

- if past 4.5 hrs, give aspirin

Front 67

treat drug-induced Park’s with:

(2)

Back 67

anticholinergic or diphenhydramine

Front 68

Werndig-Hoffman =

Back 68

floppy baby due to degen of AHC’s

– occurs before 6 mths

Front 69

“ragged red fibers” =

Back 69

mitochondrial dz

~~ ophthalmoplegia

Front 70

causes of SAH:

Back 70

trauma > berry aneurysms

Front 71

2/3 of intracerebral hemorrhages occur in the:

Back 71

BG

- will see contralateral hemiplegia and sensory defects

Front 72

Tx inc. ICP =

(2)

Back 72

intubate in reverse Trendelenburg (head up) + hyperventilate to cerebral vasoconstriction

- mannitol if severe

Front 73

CPP = BP – ICP

Back 73

do NOT treat HTN immediately in someone who’s got ICP – you will ischemically stroke them out

Front 74

always give steroids in:

Back 74

spinal shock

Front 75

epidural spinal abscess in DM =

Back 75

Staph aureus

Front 76

syringomyelia starts out as:

Back 76

*loss of sensation* first,

then involves motor once it spreads

Front 77

Tx syringomyelia =

Back 77

shunt

Front 78

meningomyelocele ~~

Back 78

Arnold-Chiari, always

Front 79

Arnold-Chiari =

Back 79

herniation of cerebellum into SC

- ataxia, nausea, +/- hydrocephalus

- Dandy-Walker = cerebellum develops abnormally, esp. vermis

- hydrocephalus, ID, motor skill delay

Front 80

if BPP or CST are bad, consider:

Back 80

C-section

Front 81

next step with elevated aFP =

Back 81

repeat aFP

- then, U/S

Front 82

quadruple test =

Back 82

2nd Tri

aFP, B-hCG, estriol, inhibin A

Front 83

Toxo ~~

(2)

Back 83

intracranial calcifications and chorioretinitis (vs. CMV)

Front 84

Tx TB in preg. =

Back 84

RIE +/- P

Front 85

mag toxicity =

Back 85

respiratory and CNS depression

Front 86

oligo =

Back 86

AFI <5 or <500 mL

Front 87

polyhydramnios =

Back 87

AFI >25 or >2 L

Front 88

Braxxton-Hicks ~~

Back 88

no cervical changes

Front 89

misoprostol = PG =>

Back 89

uterine contraction

Front 90

incomplete abortion ~~

Back 90

POC’s

Front 91

for ectopic, Tx =

Back 91

salpingostomy if stable,

salpingectomy if HDUn

Front 92

turn mom over, O2, etc. then

Back 92

*measure scalp pH or fetal O2 sat*

pH >7.2 or O2 desat = immediate delivery
- o/w, continue to observe

Front 93

vaginal delivery is preferred for:

Back 93

abruption

Front 94

FIREERE

Back 94

spell it out

Front 95

Rhogam only if mom is:

Back 95

Rh *negative*

Front 96

if Rh AB screen is positive at 1st Tri,

Back 96

you’re too late for Rhogam – just monitor for hemolytic dz

Front 97

PROM =

Back 97

rupture of amniotic sac before onset of labor
positive nitrazine test
=> U/S to assess for volume

Front 98

spontaneous labor tends to follow:

Back 98

rupture of membranes

(that’s why AROM is done)

Front 99

induce labor in PROM if no labor after:

Back 99

8 hours

Front 100

physiologic resp. alkalosis of preg.

Back 100

is a thing

Front 101

acute fatty liver of pregnancy appears in:

Back 101

the 3rd Tri

- treat coagulopathies with FFP

Front 102

try to wait until 2nd Tri to:

Back 102

perform surgeries

Front 103

Tx endometritis =

(2)

Back 103

clinda + gent

Front 104

CML:

(3)

Back 104

1. Philadelphia 9:22 / BCR-ABL

2. blast crisis

3. WBC’s >50,000

Front 105

Hodgkin dz ~~

(3)

Back 105

night sweats, LAD, Reed-Sternburg

Front 106

Waldenstroms shows:

(2)

Back 106

Raynaud’s,

IgM spike

Front 107

Tx polycythemia =

Back 107

phlebotomy

Front 108

Tx mets to spine =

Back 108

MRI + steroids + radx or surgery if not radx-sensitive

Front 109

VHL ~~

(2)

Back 109

1. hemangioblastomas in cerebellum

2. cysts in liver or kidney

Front 110

you can treat non-small cell lung cancer confined to parenchyma with surgery; otherwise:

Back 110

chemo +/- radx

Front 111

fixed LN =

Back 111

cancerous

Front 112

CEA for:

Back 112

CRC

Front 113

glucagonoamas cause:

(2)

Back 113

HYPERglycemia, migratory necrotizing skin

Front 114

watch for ______ in all islet cell tumors

Back 114

MEN

Front 115

intracranial calcification ~~

Back 115

Craniopharyngioma

Front 116

testicular cancer does NOT ___________

Back 116

transluminate

Front 117

evaluate painless hematuria with:

(2)

Back 117

CT pelvis and cystoscopy

Front 118

aFP = screening for ______

Back 118

HCC

Front 119

hemangiomas of liver are:

Back 119

benign and left alone

Front 120

carcinoid tumors only symptomatic once they reach:

Back 120

the liver

- will see inc. urine 5-HIAA

Front 121

neuroblastomas show:

Back 121

calcification on CT

- Wilms doesn’t

Front 122

CA-125 ~~

Back 122

ovary

Front 123

S-100 ~~

Back 123

melanoma

Front 124

glaucoma =

Back 124

ophthalmic HTN

Front 125

Tx open-angle =

Back 125

BB’s or PG’s
cupping of the optic disc

Front 126

never give topical steroids to:

Back 126

the eye

Front 127

treat both chalazion (non-erythematous) and hordeolum with:

Back 127

warm compress

- add steroids to chalazion if nec.

Front 128

Tx dendritic keratitis =

Back 128

topical antiviral

Front 129

CRAO ~~

Back 129

cherry-red spot

Front 130

CRVO ~~

Back 130

also sudden, painless loss of vision

- torturous retinal veins

Front 131

optic neuritis *is*

Back 131

painful

Front 132

DM and HTN can cause isolated palsies of:

(3)

Back 132

CN 3, 4, and 6

– resolve

Front 133

w/ all open fractures, you should give:

(4)

Back 133

1. 4th-gen cephalosporin for both GP’s and GN’s

2. add vanc if MRSA

3. tetanus booster

4. then ORIF

Front 134

stress fracture =

Back 134

incomplete fracture

Front 135

herniation at L5-S1 is mc, affecting S1; ~~

(2)

Back 135

ankle reflex, weakness of plantar flexion

Front 136

L4-L5 second mc, affecting L5 – will see:

Back 136

weak ankle dorsiflexion

Front 137

reflexes and nerve roots:

(4)

Back 137

biceps ~~ C5,

triceps ~~ C7,

knee ~~ L3,

ankle ~~ S1

Front 138

Tx herniated disc =

Back 138

conservative (90% resolve)

Front 139

wound through foot ~~

Back 139

Pseudomonas osteomyelitis

Front 140

diabetic osteomyelitis =

Back 140

polymicrobial

Front 141

Dx AVN =

Back 141

MRI

Front 142

give screening and preventative care at EVERY encounter,

Back 142

not just well-child checks

Front 143

anticipatory guidance:

(4)

Back 143

1. keep water heater under 120 degrees

2. do not use infant walkers

3. no honey before 1 year of age

4. introduce solid foods gradually, starting at 6 mths

Front 144

screen for Iron-deficiency anemia with CBC if:

Back 144

rf’s present

Front 145

for kiddos, start iron supplementation at:

Back 145

4-6 mths if exclusively breast-fed

- at 2 mths if premie

Front 146

screen ALL females <25 for:

Back 146

chlamydia; include gonorrhea only if high-risk

Front 147

cavernous hemangiomas resolve, even if they get huge

Back 147

leave em be

Front 148

avoid BB’s in:

(3)

Back 148

DM, cocaine, CHF

- Beta-1-selective is better if need be

Front 149

SER syndrome =

(3)

Back 149

hyperthermia, rigidity, myoclonus

Front 150

get Mammography every:

and start at:

Back 150

TWO YEARS

starting at 50 y/o

Front 151

colonoscopy up to:

Back 151

75 y/o

Front 152

Pap Smears

Back 152

Once every 3 years

starting at 30 y/o, Pap + HPV every 5 years if both were initially negative

don’t test HPV until 30 (cus much more likely to clear it as a young person)

Front 153

screen for Lung cancer:

Back 153

Low-dose CT chest for ages 55-80

w/ 30+ pack-year history who quit <15 years ago

Front 154

screen for AAA:

Back 154

ONE time in men 65-75 who have ever smoked

Front 155

Tx acute dystonia = Tx Park’s =

(2)

Back 155

Benadryl or anticholinergic

- BB for akathisia

Front 156

1st-line for phobias =

Back 156

behavioral therapy

Front 157

Tx narcolepsy =

Back 157

modafinil or stimulants

Front 158

Tx ADHD =

Back 158

stimulants

Front 159

Tx Tourette’s =

Back 159

antipsychotics

- can be unmasked by stimulants in ADHD

Front 160

cocaine WD =

(3)

Back 160

sleepy, hungry, depressed

Front 161

opioid WD ~~

(4)

Back 161

goose pimples, diarrhea, insomnia, cramping, pain

- methadone or buprenorphine can reduce WD symps

Front 162

RSV bronchiolitis =>

Back 162

wheezing

Front 163

RSV and parainfluenza (croup) can both cause:

Back 163

PNA

Front 164

infant RDS ~~

Back 164

immature lungs

Tx = O2, intubate if necessary, surfactant if severe

Front 165

phosphatodylglyceride in the amniotic fluid means:

Back 165

the lungs are*mature*

Front 166

causes of epistaxis:

(5)

Back 166

1. nose-picking

2. trauma

3. local tumor (angiofibroma)

4. leukemia (=> pancytopenia)

5. ITP, etc.

Front 167

branchial cleft cysts are _________ to the midline

Back 167

lateral to the midline, and often become infected

Front 168

common causes of Cervical Lymphadenitis =

(4)

Back 168

GAS, EBV, cat-scratch, or mycobacteria

Front 169

Wx for unknown cancer of the neck =

(2)

Back 169

triple endoscopy + triple bx

Front 170

Tx OE =

Back 170

topical abx

Front 171

Tx infectious myringitis =

Back 171

macrolide (vesicles on TM)

Front 172

Tx otosclerosis =

(2)

Back 172

hearing aid or surgery

Front 173

1st-line for burns =

Back 173

Lactated Ringers

Front 174

burned skin infection is usually due to:

(2)

Back 174

Staph aureus or Pseudomonas

Front 175

be ready to give tons of IVF in any:

Back 175

muscle breakdown/rigidity question

Front 176

Heberden and Bouchard ~~

Back 176

*osteo*arthritis

Front 177

Gout: colcichine or NSAIDs acutely,

Back 177

allopurinol or probenecid for prevention

Front 178

Psoriatic arthritis looks like RA, but:

Back 178

RF is negative

1st-line = NSAIDs

Front 179

Tx Ank Spond =

Back 179

NSAIDs, MTX, etc.

Front 180

polyarteritis nodosa ~~ positive ________

Back 180

ANCA

Dx = vessel bx

Front 181

pulseless ~~ Takayasu ~~

Back 181

aorta or major branches ~~ steroids

Front 182

painful oral and genital ulcers in young man ~~

Back 182

Bechet ~~ uveitis, arthritis ~~ steroids

Front 183

after 2 fluid boluses that did nothing, insert:

Back 183

Swan-Ganz catheter to m. hemodynamic numbers

Front 184

TSS ~~

Back 184

Staph aureus *toxin*

Front 185

seminoma ~~

Back 185

B-hCG, never aFP

Front 186

struvite stones ~~

Back 186

Proteus ~~ staghorn

Front 187

allow testes to descend in:

Back 187

the 1st year of life, then surgery if not

Front 188

hyperacute organ rejection ~~

Back 188

preformed AB’s, acute organ rejection ~~ T-cells

Front 189

chronic rejection is mediated by:

Back 189

AB's *or* T-cells

Front 190

Potter syndrome is:

Back 190

incompatible with life

Front 191

carotid stenosis in asymp pts >

Back 191

>60% occluded => carotid endarterectomy

Front 192

mcc of death during vascular surgery =

Back 192

MI

Front 193

Dx mesenteric ischemia =

Back 193

angiography
Tx = revascularization

Front 194

“thumbprinting” of bowel walls ~~

Back 194

bowel infarction

Front 195

cervical rib or inc. muscle mass =>

Back 195

thoracic outlet syndrome