Step 2 - Qbank

Front 1

How tx:

-Chlam
-Gonorr

Back 1

Chlam: 1 dose azithro OR 7d doxy

Gonorr: 1 dose CTX

Front 2

What CD4 count:

PCP

Back 2

<200

Front 3

PCP:

-uni/bilat?
-dry/wet cought?

Back 3

Diffuse bilat

Dry cough

Front 4

What specific PNA:

O2 saturation inconsistent w/Xray

Back 4

PCP PNA

(CD4 <200)

Front 5

PCP PNA: how tx? (aside from HIV)

Back 5

Bactrim & steroids

Front 6

What imaging test:

Aortic dissection

Back 6

TEE

(NOT TTE)

Front 7

Transtuzumab: what S/E?

Back 7

CARDIOTOXICITY

Get a baseline ECHO

Front 8

Her2/Neu breast cancer: why order ECHO?

Back 8

Transtuzumab is cardiotox

Front 9

What cancer?:

Transtuzumab

Back 9

Her2/neu breast

Front 10

Use what chemo agent:

Her2/neu breast cancer

Back 10

Transtuzumab

Front 11

What pathogen: acute epididymitis in:

-adol?
-elderly?

Back 11

Adol: G&C

Elderly: GNR (esp E coli)

Front 12

Gout prevention:

-Avoid smoke or EtOH?
-what diet proteins?
-what 2 drugs?

Back 12

Avoid:

-EtOH (converts to lactate --> competes w/urate excr)
-Purine
-Diuretics
-Pyrazinamide

Front 13

Micro/macro/normo anemia:

Multiple myeloma

Back 13

Normo Normo

Front 14

Mult myeloma: how lead to RF?

Back 14

Paraprotein casts OBSTRUCT DT/CT

Front 15

Pancreatitis: induce shock via what pathophysio?

Back 15

Necrosis --> release panc enzs --> INCREASE VASC PERM --> lose plasma into retroperitoneum

Front 16

SCFE: what part of growth plate is weak?

Back 16

Physis

Front 17

SCFE: how tx?

Back 17

Immed SURG PIN slipped epiphys in situ

(do NOT readjust)

Front 18

Next step:

>35yo preg & abn nuchal lucency

Back 18

CVS (more specific than markers)

Front 19

Hepatic encephalo: how tx? (4)

Back 19

Lactulose
Neomycin
Rifaximin
Laxatives

Front 20

Menarche: what % cycles in 1st year are anovulatory?

Back 20

90%

Front 21

Pedi VUR: M or F?

Back 21

F > M

Front 22

Pedi VUR: what image to dx?

Back 22

Voiding cystourethrogram

Front 23

What dz:

Increase Alk; normal Ca & Ph

Back 23

Paget's

Front 24

Paget's: how affect hydroxyproline?

Back 24

Increases

Front 25

Paget's dz: once confirm w/labs --> order what images?

Back 25

Full body bone scan --> then focus w/specific XRs

Front 26

Paget's: how tx asympto pts?

Back 26

NO TX--- only tx if bone pain, neuro s/sx, CHF or inv wt-bearing bones

Front 27

Paget's: how tx sympto pts? (meds & route)

Back 27

PO or IV bisphosphonates

Front 28

Rheumatic HD:

-what pathogen?
-main valve murmur?

Back 28

Strep pyogenes

Mitral stenosis

Front 29

Suspect what dz:

Foreign preg lady with new-onset A-fib, pulmonary edema

Back 29

Rheumatic HD --> mitral stenosis

Presents in preg 2/2 increased blood vol

Front 30

DEXA: T-scores compares to YOUNGER or SAME age?

Back 30

YOUNGER (same race, gender)

Front 31

DEXA scan: what age universal scan?

Back 31

>65yo

(60yo if risk factors)

Front 32

Angina pt: order what test if exercise stress test not possible?

Back 32

Myocardial perfusion scan

Front 33

Myocardial perfusion scan: uses what med? what is action?

Back 33

Dipyridamole --> coronary vasodilator

Front 34

Dipyridamole:

-use in what dx test?
-mxn of action?

Back 34

Myocardial perfusion

Coronary vasodilator --> redistrib blood to non-dz vessels --> angina

Front 35

What med:

CORONARY STEAL

Back 35

Dipyridamole

(utilizes in myocardial perfusion scan)

Front 36

What age:

1st vision screen

Back 36

0-5yo

Front 37

What dz:

Hyperparathyroid + peptic ulcer

Back 37

MEN1 (PPP: parathyroid, pit, panc)

(see ZES)

Front 38

What type of study:

Simultaneous measure exposure & outcome (e.g. genotype --> dz?)

Back 38

Cross-sectional study (prev)

Front 39

Vertebral fxs: can lead to what GI dz?

Back 39

Fxs --> retroperitoneal hemorr --> PARALYIC ILEUS

Front 40

What type of study:

Pick pts w/dz --> compares previous exposures (vs non-diseased)

Back 40

Case control
(retro)

Front 41

Immobilization:

-see hyperCa w/in how long?
-how affect phosphate? PTH?
-how tx?

Back 41

HyperCa2+ in few days

NORMAL phosph; DECREASED PTH

Tx: bisphosphonates

Front 42

Rhabdo: how affect Ca level?

Back 42

Muscle releases PHOSPHATE --> binds Ca (excreted) -->

HYPOCALCEMIA

Front 43

Hypoalbuminemia: how affect Ca?

Back 43

Ca binds alb;

Hyoalb --> HypoCa+

Front 44

ESRD: how affect:

-Ca?
-Phosp?
-PTH?

Back 44

Increase phosph

Decrease Ca2+

Increase PTH (to try to increase Ca2+)

Front 45

Randomization: decreases what bias?

Back 45

CONFOUNDING

Front 46

Increase or decrease fremitus?:

-CAP
-effusion

Back 46

CAP: increase fremitus

Effus: decrease

Front 47

Psoriatic arthritis: tx w/steroids?

Back 47

NO - relative contraI

Use anti-TNF, MTX

Front 48

Enteropathic arthritis:

-assoc what dz?
-present what joints?
-correl w/GI sxs?

Back 48

IBD

LEs & sacroiliac

Correl w/GI sxs

Front 49

RA: affects MCP, PIP and/or DIP?

Back 49

MCP & PIP

Front 50

What dz:

Child w/syncope (no posictal confusion) + HEARING LOSS + FHx SCD + normal phys exam

Back 50

Congenital Long QT synd

Front 51

Congenital Long QT synd:

-present as child or adult?
-how tx? (class)
-predisp what arryth?

Back 51

Presents as child w/syncope, bilat hearing loss

Tx: beta-blockers

Predisp: Torsades

Front 52

Bilat nasal polyps: r/o what dz?

Back 52

CF

Front 53

What pathogens (2):

Dental-induced endocarditis

Back 53

Strep mutans (caries)

Strep sanguis

(NOT S bovis)

Front 54

What is next step:

Isolate strep bovis in blood -->

Back 54

Colonoscopy
(S bovis assoc w/CRC)

Front 55

CRC: assoc with what pathogen (bactermia)?

Back 55

Strep bovis

Front 56

What MEDICATION:

S/E bilateral hearing loss

Back 56

Furosemide (loop)

(may also have tinnitus)
(ir/revers)

Front 57

What f/u labs:

Olanzapine

Back 57

Fasting BG
Lipids

(S/E hypergly, hyperchol)

Front 58

What GB disease:

May lead to GB adenocarcinoma

Back 58

Porcelain gallbladder

Front 59

Porcelain gallbladder: may lead to what cancer?

Back 59

GB adenoca

Front 60

#1 presenting sx in SCD

Back 60

Dactylitis

Front 61

What valve disease:

Brief CP at apex

Back 61

MVP

Front 62

MVP: murmur worsens or improves w/squat?

Back 62

Improves

Front 63

Splenectomy: lose what immune fxn?

Back 63

PHAGOCYTOSIS

(inability to opsonize)

Front 64

What bone: #1 carpal fx

Back 64

Scaphoid

Front 65

What fx:

Fall on outstretched hand

Back 65

Scaphoid

Front 66

What injury:

Tender snuffbox

Back 66

Scaphoid fx

Front 67

Scaphoid fx: how tx if:

-Non-displaced
-Displaced

Back 67

Non: immoblize 6-10w

Displaced: Open reduct & fix

Front 68

Nasopharyngeal cancer:

-Assoc what pathogen?
-what ethnicitis?
-mets?

Back 68

EBV

Asians, Medit

Late mets

Front 69

#1 leukemia 2-10yo

Back 69

ALL

Front 70

What dz:

Increase # cells w/PEROXIDASE POS GRANULES

Back 70

ALL

(lymphoblasts)

Front 71

If suspect hyperemesis --> r/o what dz first?

Back 71

GTD
(order a beta quant --> then pelvic U/S)

Front 72

If suspect GTD: 1st test? 2nd?

Back 72

Beta quant --> then pelvic U/S

Front 73

What bHCG see preg:

-TV-US
-TA-US

Back 73

TV: 1,500

TA: 6,500

Front 74

Pinworm: how tx? can you start empiric?

Back 74

Mebendazole

start empirically

Front 75

Heparin: affect the NUMBER OF PLATELETS?

Back 75

S/E may be DECREASED plts

(Heparin-induced thrombocytopenia = HIT)

type I: spont resolve
II: form Abs --> art thrombosis

Front 76

Chemo-induced n/v: what is 1st line med class?

Back 76

5HT antagonist (e.g. ondansetron)

Front 77

Toxo: how tx:

-patient
-ppx

Back 77

Patient: sulfadiazine-pyrimethamine

Ppx: sulfamethoxazole-trimethoprim

Front 78

How does tuberoinfundibular DA affect PRL release?

Back 78

DA --> inh PRL release

Front 79

What dz:

PAS-positive organism in small intestine

Back 79

T whipplei

Front 80

T whipplei: resides what part of GI tract?

Back 80

SMALL intestine

Front 81

What dz:

Chronic steat, abd distension, migratory arth, LAD, low fever

Back 81

Whipple's dz

(T whipplei)

Front 82

Gallstones: #1 imaging test

Back 82

U/S

Front 83

Kidney stone: what type of stone?:

Needle-shaped

Back 83

Uric acid

Front 84

Kidney stone: what shape are URIC ACID stones?

Back 84

Needle

Front 85

Kidney stone:

Uric acid opaque or lucent?

Back 85

Lucent --> req CT or IV pyelo

Front 86

Uric acid kidney stone:

Tx acidify or alkalinize urine

Back 86

Alkalinize >6.5

via potassium citrate or bicarb

Front 87

Kidney stone can induce SBO via what pathophysio mxn?

Back 87

Colic-pain --> vagal rxn --> ileus --> SBO

Front 88

Familial hypocalciuric hypercalcemia:

-how affect Ca, Phosph, PTH?
-what test to disting from hyperPTH?
-how inh?

Back 88

Increase PTH, increase Ca, decrease phosph

*LOW URINE Ca2+ (contrast hyperPTH)

AD inherit; benign

Front 89

Pregnancy: how do you evaluate if a cervix is incompetent?

Back 89

TV-US! (gold standard)

Front 90

Myocarditis: #1 pediatric etio

Back 90

ENTEROVIRUS

Front 91

What dz:

Kid w/flu-like sxs --> new mitral regurg, hepatomegaly --> CHF & pulm edema

Back 91

Viral-induced myocarditis

Front 92

Myocarditis: what is gold standard dx?

Back 92

Bx

Front 93

What dz:

ECHO w/global hypokinesia, LVH, pericardial effusion

Back 93

Myocarditis

Front 94

How tx:

Frostbite

Back 94

Submerge hot water

Front 95

Down's synd: assoc w/VSD or PDA?

Back 95

BOTH

Front 96

Turner: how prevent gonadoblastoma?

Back 96

Bilat gonadectomy (ppx)

Front 97

Next diagnostic test:

Recurrent vasovagal syncope

Back 97

Tilt table test

Front 98

Tilt Table Test: use in what type of syncope?

Back 98

Recurrent vasovagal

Front 99

How tx:

-mild hypoNa
-severe

Back 99

Mild: H2O restrict

Severe: 3% saline

Front 100

What specific dz:

Nighttime epigastric pain that resolves w/food

Back 100

H pylori duo ulcer

Front 101

BNP: how stimulate release?

Back 101

stretch LEFT VENT (e.g. CHF)

Front 102

Preg: when test Rh?

Back 102

Initial & 28w

Front 103

Prolactinoma: tx what 2 meds?

Back 103

Bromocrip
CABERGOLINE

Front 104

Cabergoline: what med class?

Back 104

DA agonist

Front 105

Metabolic alka: how affect Ca?

Back 105

DECREASES

(binds albumin)

Front 106

Restless leg: tx w/what med class?

Back 106

DA AGONIST (prampexole) or Levodopa

Front 107

DM nephropathy: if protein is present in urine --> what is best way to prevent further renal dz?

Back 107

BP CONTROL

(more effective that glucose control!)

Front 108

What leukemia:

Decreased leukocyte alkaline phosphatase

Back 108

CML

Front 109

Polycythemia vera: see EPO in urine?

Back 109

No

Front 110

What leukemia:

Tartrate resistant acid phosphatase

Back 110

Hairy cell

Front 111

#1 stroke risk factor

Back 111

HTN

Front 112

HIV w/PPD >5 but negative CXR: next step?

Back 112

Automatic isoniazid + pyridox x 9mos

(even if neg CXR?)

Front 113

Flash pulm edema 2/2 ant wall MI: how tx?

Back 113

Furosemid

(avoid beta-blocker)

Front 114

What dz:

Decrease conversion of androgens to E

Back 114

Aromatase deficiency

Front 115

Aromatase deficiency: decrease what levels?

Back 115

Estrogen levels

(cannot convert androgens --> E)

Front 116

What dz:

Virilized XX female with normal internal genitals

Back 116

Aromatase deficiency

(cannot convert androgens to E)

Front 117

Cephalohematoma OR caput succedaneum:

Subperiosteal

Back 117

Cephalohematoma (no discoloration)

Front 118

Cephalohematoma OR caput succedaneum:

Slow --> not notice until hrs after birth

Back 118

CPH

Front 119

Cephalohematoma OR caput succedaneum:

Diffuse, ecchymotic scalp swelling

Back 119

Succedaneum

(CPH is subperiosteal; does not cross suture line and do not see discolor)

Front 120

Cephalohematoma OR caput succedaneum:

VERTEX

Back 120

Caput succed

Front 121

Cephalohematoma OR caput succedaneum:

Crosses midline

Back 121

Succed

(CPH is subperiosteal & does not cross suture lines)

Front 122

#1 etio hyperCa+ in:

-ambulatory pts
-hosp

Back 122

Amb: 1' hyperPTH

Hosp: Malignancy

Front 123

Hered sphero:

-how inh?
-what protein defect?
-risk what GI dz?

Back 123

AD
Spectrin
Gallstones

Front 124

Hered sphero: ALWAYS supplement what vitamin?

Back 124

Folate

Front 125

Hered sphero: how tx?

Back 125

SPLENECTOMY

Front 126

Lye esophageal damage:

-give charcoal?
-give weak acid?
-first step in w/u?

Back 126

No charcoal or acid (damage is immed; if you give acid, may cause thermal damage)

1st step: EGD (assess perf)

Front 127

NORMAL:

-HCO3
-PCO2

Back 127

HCO3: 24

PCO2: 40

Front 128

G or C:

-mucopurulent
-purulent

Back 128

Mucopurulent: Chlam

Purulent: Gonorr

Front 129

What dz:

Absent tonsils/LN + lymphopenia (no Bs or Ts) + no thymic shadow

Back 129

Severe Combined Immunodef

Front 130

SCID: see tonsils?

Back 130

NO (absent)

Front 131

Organophosphate poison: admin what MED?

Back 131

ATROPINE
also remove clothes & wash

(NOT physostig)

Front 132

Organophosphate poisoin:

-how affect HR?
-pupil dilate or constrict?

Back 132

BRADYCARD

CONSTRICT

Front 133

What poisoin:

Bradycardic, miosis, bronchorrhea, saliva, lacrimate, diarrhea, urinate

Back 133

Organophophate

(deactivates acetylcholinesterase)

Front 134

What type of neuro deficit?:

Pronator drift

Back 134

UMN

(NOT impaired proprioR)

Front 135

Bacterial sinusitis: pathogens #1-3

Back 135

#1 Strep Pnuemo
2: non-typ H flu
3: Moraxella

Front 136

What murmur:

Harsh, holosystolic, lower LSB

Back 136

VSD

Front 137

#1 congenital HD

Back 137

VSD

Front 138

VSD: how tx if:

-small
-large

Back 138

Small: spont close --> no intervention; just give ppx abx pre-dental

Large: surg close to prevent lower resp infxns, CHF

Front 139

What med:

Keeps PDA open

Back 139

PGE1

Front 140

Effect on PDA:

PGE1

Back 140

Keeps open

Front 141

What TYPE of shock:

Normal mixed venous O2 concentration

Back 141

Septic

Front 142

Septic shock: hypo or hyperdynamic? How affect CO?

Back 142

Hyperdynamic --> increase CO

Front 143

Septic shock: how affect PCWP?

Back 143

Decreased

Front 144

What is next dx test:

Cold leg s/p MI

Back 144

ECHOCARDIOGRAM

(r/o LV thrombus)

Front 145

What dz:

Single, lytic long bone lesion that spontaneously resolves

Back 145

Langerhans histiocytosis

Front 146

Langerhans histiocytosis: how tx?

Back 146

Spontaneously resolves; sympto tx bone pain

Front 147

What PD med:

S/E hallucinations, agitation

Back 147

Levodopa

Front 148

Levodopa S/E: occur EARLY or LATE?:

-motor fluctations
-HA
-Hallucinations

Back 148

HALLUCINATIONS, HA: EARLY

Motor fluctuations: late

Front 149

What PD med:

S/E ankle edema, livedo reticularis

Back 149

Amantadine

Front 150

Admin what ANESTHETIC:

-liver dz
-renal dz

Back 150

Liver or renal dz: ATRACURIUM (metabolized in plasma)

Front 151

What ANESTHETIC:

Metab in plasma

Back 151

Atracurium

Front 152

Where metabolize?:

-Rocuronium
-Pancurium
-Atracurium

Back 152

Roc: liver
Pan: kidney
Atra: plasma

Front 153

Safe in renal failure?:

Succinycholine

Back 153

NO -- hyperK+, apnea

Front 154

Succinylcholine: S/E what lyte abn?

Back 154

HyperK+

(not safe in RF)

Front 155

Suspect what dz:

Precoc puberty boy (severe acne, large testes)

Back 155

LATE-ONSET CAH

(more common than XYY; also XYY does not manifest as early puberty)

Front 156

Medication-induced serum sickness: occurs how long after admin abx?

Back 156

1-2w

(NOT immed)

Front 157

Med-induced serum sickness:

-see LAD?
-considered a true drug allergy?

Back 157

LAD

NOT a true allergy

Front 158

What dz:

Viral URI --> IgA mediated VASCULITIS --> arthralgia, purpura, abd pain, renal dysfxn

Back 158

HSP

Front 159

HSP:

-what is trigger?
-what type of Ig?

Back 159

Viral URI

IgA-med vasculitis

Front 160

TCA O/D: is the DURATION of QRS prolong correl w/risk of arryth

Back 160

yes

Front 161

Pancreatic cancer: located BODY/TAIL or HEAD?:

-Jaundice, steatorrhea
-Pain & wt loss

Back 161

Jaundice: Head

Pain, wt loss: body/tail

Front 162

Orchitis 2/2 mumps:

-uni/bilat?
-infertility common?

Back 162

Usu UNILAT

Infertility is rare

Front 163

Mumps: how tx?

Back 163

Supportive (cold compress)

Front 164

Epidural abscess: usu HEME or DIRECT EXTENS?

Back 164

Heme

Front 165

If suspect epidural abscess --> next step?

Back 165

EMERGENCY MRI

(NEVER CT)

THEN surgery

Front 166

How tx:

Eneuresis

Back 166

Desmopressin (1st) --> imipramine

Front 167

HIV needlestick:

-when test serology (sequence)
-how many ppx drugs?

Back 167

Sero: immed --> 6w --> 3mo --> 6mo

3 ppxs

Front 168

Clavicle fx: risk what artery? what is next step if audible bruit?

Back 168

Subclavian

Angiogram

Front 169

1' dysmennorhea: menses pain 2/2 what pathophysio?

Back 169

Increase prostaglandins

Front 170

Inevitable abortion: tx of choice

Back 170

Suction curretage

Front 171

What pathogen & how tx:

Anaerobic, gram-positive, branching; cervicofacial infections

Back 171

Actinomycosis (A isrealli)

High-dose PCN x 6-12w

Front 172

What dz & how tx:

Yellow sulfur granules draining from pocket in neck

Back 172

Actinomycosis

Tx: high-dose PCN x 6-12w (NOT surg debride)

Front 173

Actinomycosis: how gram stain?

Back 173

Gram-pos, branching, anaerobic

Front 174

Chemo-induced anorexia: how tx?

Back 174

PROGESTIN (megestrol, medroxyprogest acetate)

contrast n/v: tx w/5HT blocker

NOT SSRI

Front 175

#1 pulm complication of systemic sclerosis

Back 175

Interstitial fibrosis

Front 176

Only DM drug that causes wt loss

Back 176

Metformin

Front 177

Myasthenic crisis w/resp distress: how tx? (steps)

Back 177

Intubate --> withhold anticholinesterases a few days & give abx

--> reinitiate anticholn

Front 178

Next step:

Child w/torticollis

Back 178

C-spine XR (r/o trauma)

Front 179

If suspect BPH: necessary to order UA, Cr?

Back 179

YEs --> assess renal dysfxn

Front 180

Choledochal cyst:

-intra or extra hepatic biliary dilation?
-affect panc enzs?
-affect cancer risk?

Back 180

Intra OR extraheptic

Increase amylase, lipase

Increase risk cholangiocarcinoma

Front 181

What dz:

Mississippi + single lung nodule

Back 181

Histoplasmosis

Front 182

Prazosin: GU S/e?

Back 182

Priapism

Front 183

TPN: pathophysio of S/E gallstones

Back 183

Bypass GI tract --> decrease CCK release --> decrease GB contraction

Front 184

Goal FIO2

Back 184

40%

Front 185

What dz:

anti-topoisomerase I

Back 185

Systemic sclerosis

Front 186

Systemic sclerosis:

LH or RH fail?

Back 186

Lung fibrosis --> pulm art HTN --> RH failure

Front 187

Systemic sclerosis:

Pathophysio of HTN

Back 187

renal art sclerosis

Front 188

What dz:

Acral edema, flexion contractures; calcinosis cutis; masked facies; RH fail; HTN & GERD

Back 188

Systemic sclerosis

Front 189

What dz:

Anti-SM Abs

Back 189

AI hepatitis

Front 190

What dz:

Anti-mito Abs

Back 190

PBC

Front 191

PBC: what Abs?

Back 191

Anti-mito Abs

Front 192

Malnutrition: physio of pitting edema?

Back 192

Hypoalb --> decrease plasma oncotic pressure --> edema

Front 193

#1 post-op electrolyte abn

Back 193

HypoCa2+

(2/2 transfusions)

Front 194

What is etiology:

Post-op --> hyperactive DTRs, cramps, szs

Back 194

HypoCa2+ (2/2 transfusions)

Front 195

Pyelo: what is next step?:

No respond abx 48-72h

Back 195

Renal U/S or CT (r/o abscess, obstruction)

Front 196

What sinuses:

-present at birth
-develop @ 1yo
-develop @ 9yo

Back 196

Birth: Maxillary, ethmoid

1yo: sphenoid

9yo: frontal

Front 197

Acute bacterial sinusitis:

-#1 risk
-best abx

Back 197

Viral URI

amox + clauv

Front 198

Suspect what dz:

LBP + low fever + increased ESR

Back 198

Vertebral OSTEOMYEL

Front 199

Vertebral osteomyelitis:

-how affect ESR?:
-what region SC?
-heme or direct extens?

Back 199

Increased ESR

lumbar

HEME

Front 200

Vertebral osteomyelitis:

-what dx imaging?

Back 200

MRI

Front 201

#1 risk for variant angina

Back 201

smoking

Front 202

Variant angina: how tx? (2) avoid what 2 classes?

Back 202

CEBs, nitrates

AVOID ASA & beta-blocker

Front 203

What is next step:

Proteinuria in asympto adol boy

Back 203

Repeat dip x 2

(ortho proteinuria common)

Front 204

Ank spond:

-#1 extraartic sx? how present?

Back 204

Ant uveitis (40% pts)

Painful monocular blur, photophob

Front 205

Zenkers: what dx imaging?

Back 205

Barium esophagram

(NOT EGD -- may perf)

Front 206

Central cord synd: 2/2 flex or extens?

Back 206

Hyperextens in elderly w/cervical degen

Front 207

Central cord syndrome: lose what tracts?

Back 207

Spinothalamic (pain, temp)
Corticospinal

Front 208

What SC dz:

2/2 hyperextension in elderly w/c-spine degen

Back 208

Central cord synd

Front 209

Necrotizing post-op infxn: how tx?

Back 209

Early debride

Front 210

GDM:

-fetal hypo/hypergly?
-what fetal lyte abn?
-anemia or polycyth?

Back 210

Hypogly: maternal BG crosses placenta --> fetus pancreas releases insulin --> hypogly at birth

HYPOCALCEMIA

Hypergly --> increase basal metab rate --> hypox --> polycyth

Front 211

Pseudomonas: tx what abx?

Back 211

Cefepime + pip-tazo

NOT CTX

Front 212

What organ: #1 site of mets for:

-GI cancer
-Lung cancer
-Breast cancer

Back 212

LIVER (all)

Front 213

If multiple liver masses --> order AFP?

Back 213

No - only if solitary (suspect HCC)

Otherwise likely mets

Front 214

Osteomyelitis: #1 pathogen in infant/child

Back 214

S aureus

Front 215

BPAD & renal dz:

What meds? (2)

Back 215

VPA, carbamazepine

(NOT lithium)

Front 216

COPD exacerbation: what step should you always try before intubating?

Back 216

Non-invasive PPV

Front 217

What dz:

Abd pain + lower extrem rash + ankle/knee pain + proteinuria

Back 217

HSP

Front 218

HSP:

-mediated by what type Ig?
-follow URI?
-How confirm dx?

Back 218

IgA
often s/p URI

Immunoflu: IgA deposits in skin, renal

Front 219

What dz:

Linear deposit IgG on BM

Back 219

Goodpasture's

Front 220

Goodpasture's: deposit what type of Ig on basement memb?

Back 220

IgG

Front 221

What dz:

HIV pt w/palate ulcers & hepatomeg

Back 221

Histoplasmosis

Front 222

Lithium-induced DI: how tx (what med)?

Back 222

AMILORIDE --> decrease Li accum in tubules

also give NS (not free H2O)

Front 223

What dz:

HA + low fever + periorbital edema

Back 223

Cav sinus thrombosis

Front 224

Ascites: stepwise approach to LT tx

Back 224

Na, H2O restrict --> SPIRONO --> LOOP (goal 1L/d) --> freq paracent (2-4L/d)

Front 225

Cyclophosphamide: S/E what cancer/

Back 225

Baladder cancer

Front 226

Cyclophosphamide: affect fertility?

Back 226

S/E sterility

Front 227

#1 death in hemodial pt

#1 in renal transplant

Back 227

Heart disease (Mi, scd)

BOTH

Front 228

Alpha-1-antitrypsin def: how present in neonate?

Back 228

NEONATAL HEPATITIS

Front 229

Pseudotumor cerebri: need to order CT before therapeutic LP?

Back 229

YES -- r/o mass

LP is safe in pseudotumor

Front 230

What dz:

Squatting improves cyanosis

Back 230

TOF

Front 231

PPD: positive if >__:

HIV

Back 231

>5cm

Front 232

PPD: positive if >__:

TB contact

Back 232

>5

Front 233

PPD: positive if >__:

Transplant pt

Back 233

>5

Front 234

PPD: positive if >__:

Immigrant

Back 234

>10

Front 235

PPD: positive if >__:

IVDU

Back 235

>10

Front 236

PPD: positive if >__:

Healthworker

Back 236

>10

Front 237

PPD: positive if >__:

DM, CKD

Back 237

>10

Front 238

PPD: positive if >__:

<4yo

Back 238

>10cm

Front 239

PPD: positive if >__:

Healthy

Back 239

>15

Front 240

What dz:

Defect collagen type I

Back 240

Osteogen imperfect

Front 241

Osteogen imperfect:

-how inh?
-defect what protein?
-what lyte abn?

Back 241

AD
collagen type I
HypoNa+

Front 242

What dz:

Anosmia + 1' amenn

Back 242

Kallman's

Front 243

Kallman's: abn karyotype? how affect GnRH level? FSH/LH?

Back 243

Normal karyo

Decrease GnRH --> decrease FSH, LH

Front 244

#1 congen aplastic anemia

Back 244

Fanconi's anemia

Front 245

Fanconi's anemia: how inh or acq/

Back 245

AR or X-linked

#1 congen aplastic anemia

Front 246

What dz:

AR/X-linked faulty DNA repair --> chromosomal breaks --> BM fail

Back 246

Fanconi's anemia

Front 247

Fanconi's anemia:

Underlying genetic mxn

Back 247

Impaired DNA repair --> chromo breaks --> BM fail

Front 248

Fanconi's anemia:

Micro/normo/macro anemia?

Back 248

MAcro

Front 249

What dz:

Abn thumbs, hypogonad, hypo/hyperpigmented areas; low set ears, middle ear abns; macrocytic anemia

Back 249

Fanconi's anemia

Front 250

Name for:

Severe infxn/inflamm --> increase WBC, increase leukocyte alk phosph (LAP)

Back 250

leukomoid rxn

Front 251

Lyme: how tx if <9yo?

Back 251

AMOX

Front 252

What type of ovarian tumor:

Increase E --> precocous puberty & postmeno bleed

Back 252

Granulosa cell tumor

Front 253

Granulosa cell ovarian tumor: increase what hormone?

Back 253

E

Front 254

Another name for:

Measles

Back 254

Rubeola

Front 255

Another name for:

Rubeola

Back 255

Measles

Front 256

HIV+: offer PCV to what ages?

Back 256

ALL

Front 257

Hemophilia: which more common:

Bruising or hemarth?

Back 257

Hemarth (#1 presenting)

Front 258

Suspect what etio (pathogen & pathophys):

H/o IVDU --> presents w/pulm infection

Back 258

TV septic emboli --> S aureus

Front 259

What pathogen:

UTI w/alkaline urine

Back 259

Proteus

Front 260

Proteus UTI: acidic or alkaline urine?

Back 260

ALKALINE

Front 261

How explain?:

Pt appears HYPOthyroid but has ELEVATED T4, T3

Back 261

Resistant to thyroid hormone

Front 262

What dz:

Mild increase TSH, normal T4; asympto

Back 262

Subclinical hypothyroid

Front 263

Subclinical hypothyroid: what lab abns?

Back 263

Increased TSH; normal T4; asympto

Front 264

How different (pathophysio):

-Osteomalacia
-Osteoporosis

Back 264

Osteomalacia (vit D def): decreased Ca & phosph at mineralization sites --> weak bones

OP: normal mineralized but decreased density

Front 265

What dz:

-abn mineralization --> weak bones
-normal mineralization; low bone density

Back 265

Abn mineralization: Osteomalacia

Low dens: OP

Front 266

HIV retinopathy: what fundo finding? (1)

Back 266

Cotton wool (spont remit)

Front 267

CMV or HIV retinopathy:

yellow-white opacific; retinal hemorrhages; decreased vision bilat

Back 267

CMV

(HIV: only see cotton wool)

Front 268

Asbestos: #1 lung cancer

Back 268

BRONCHOGENIC CA (plaques, ground class)

NOT mesothelio

Front 269

Echinococcus: what animal transmits?

Back 269

Sheep, dogs

Front 270

What dz:

Hydatid cysts w/daughters

Back 270

Echinococc (sheep, dog)

Liver 60%, lung 25%

Front 271

Hydatid cysts: 2 most common locations?

Back 271

Liver, lung

Echinococc

Front 272

Echinococcus: what histo finding?

Back 272

Hydatid cysts

Front 273

Nephrotic synd: how affect lipid panel?

Back 273

Hyperlipidemia --> accel athero --> MI, CVA

Front 274

CF: how lead to coagulpathy?

Back 274

fat malabs --> decrease K --> decrease 2,7,9,10

Front 275

What vitamin def:

Pellagra

Back 275

B3 (niacin)

Front 276

Another name for:

Vit B3

Back 276

niacin

Front 277

Another name for:

Niacin (endog)

Back 277

B3

Front 278

What dz:

Sunburn-like, tender rash + diarrhea + dementia in child

Back 278

Niacin (B3) def --> pellagra

Front 279

What murmur:

Valsalva --> decrease preload --> INCREASE murmur

Back 279

HCOM

Front 280

Nephrotic syndrome: req how much protein in 24h?

Back 280

3g

(contrast severe preeclamp: 5g)

Front 281

HBV-induced nephrotic synd: what variant (histo)?

Back 281

Membranoglomerulo

Front 282

Post-op pt: should wait how long before start anti-coagulation?

Back 282

Soon as 48h post-op!

Front 283

What murmur:

Pan-systolic at LSB

Back 283

VSD

Front 284

VSD: what diagnostic study?

Back 284

ECHO w/bubble study

Front 285

Supraventricular tachy: narrow or wide QRS?

Back 285

NARROW

Front 286

What arryth:

Tx cold H2O submersion, squat

Back 286

Supravent tachy (narrow qrs)

Front 287

Supravent tachy:

-initial tx? next?
-if unstable?

Back 287

Cold H2O immers, Valsalva --> ADENOSINE

Unstable: cardiovert

Front 288

NMS: tx what 2 drugs?

Back 288

Dantro
Bromo

Front 289

Acute panc: #1 etio:

-M
-F

Back 289

M: EtOH
F: gallstones

Front 290

Viral arthritis (parvo, hiV, hep, MMR):

-mono/poly artic?
-a/symm?
-resolves in what amt time?
-may see what Abs? (false positives)

Back 290

Polyart
Symm
Resolves 2 mos
May see + ANA, RF

Front 291

Central retinal art or ven occlus:

See cherry red spot

Back 291

Central retinal art

Front 292

Cherry red spot: may see in what INTOX?

Back 292

Methanol

Front 293

Infant colic: must be present how many hrs/d/wk/mo?

Back 293

3hrs/d x 3d/w x 3w/m

Front 294

Infant colic: resolve what age?

Back 294

4mo

Front 295

What dz:

Neonate >2d with vessicles surrounded by red halo; self-limited & benign

Back 295

Erythema toxicum

Front 296

Erythema toxicum: presents what age/ how tx?

Back 296

>2d

Benign; self-resolves

Front 297

What dz:

Neonate w/pustules --> EOSINOS in pustules

Back 297

Erythema toxicum

(diagnostic)

Front 298

Erythema toxicum: pustules contain what cell type?

Back 298

eosinos

Front 299

What dz:

Infant w/small pearly white cysts on skin

Back 299

Milia

Front 300

What congenital dz:

Togavirus

Back 300

Rubella

Front 301

Congenital rubella: highest risk in what weeks of preg? 1' infxn or reactivation?

Back 301

0-4weeks preg

Only fetal risk if PRIMARY maternal infection

Front 302

What congenital dz:

IUGR + deaf + PDA/ASD + cataracts + microopthal + low plts + blueberry rash

Back 302

Rubella

Front 303

ZES: fasting gastrin >____ is diagnostic

Back 303

>1,000

Front 304

ZES: w/u:

-when perform secretin stim test

Back 304

Only perform if fasting gastrin is non-diagnostic

Front 305

Dermatomyo: M or F? what Ab? what % have underlying malig & which malig most common?

Back 305

6x F > M

anti-Mi-2 (against helicase)

10% malig: OVARIAN, breast, lung

Front 306

What dz:

Anti-Mi-2 (anti-helicase)

Back 306

Dermatomyo

Front 307

Tarsal tunnel synd:

-compress what nerve?
-where is numbness? where radiate?

Back 307

Compress TIBIAL n --> numb/burning plantar toes --> radiates up calf

Front 308

What dz:

Compress TIBIAL n --> numb/burning plantar toes --> radiates up calf

Back 308

Tarsal tunnel synd

Front 309

What dz:

Aka congenital hypoplastic anemia

Back 309

Diamond-Blackfen synd

Front 310

What dz:

Neonate with macrocytic anemia (w/out hypersegmented PMNs) + low retics + webbed neck/shield/cleft lip

Back 310

Diamond-Blackfen synd
(tricky!)

Compared to megaloblastic anemia: no hyperseg

Front 311

What congen dz:

Intrinsic defect in erythroid precursor --> RBC apoptosis --> macro anemia + congen abns

Back 311

Diamond-Blackfen synd

Front 312

Diamond-Blackfen synd: what is underlying pathophysio?

Back 312

Intrins defect erythroid precursor --> increased RBC apopt

Front 313

What dz:

Eczema + low plts + hypogammaglobulinemia

Back 313

Wiskott-Aldrich

Front 314

Wiskott-Aldrich: how inh?

Back 314

X

Front 315

Fanconi anemia: how inh?

Back 315

Ar

Front 316

What dz:

8yo with progressive pancyto + cafe-au-lait + horseshoe kidney + absent thumbs

Back 316

Fanconi anemia

Front 317

Fanconi anemia: see what renal abn?

Back 317

Horseshoe kidney

Front 318

What drug:

Blocks breast ER; stimulates endometrial ER

Back 318

Tamoxifen

Front 319

Tamoxifen: blocks or stims:

-Breast ER
-Endomet ER

Back 319

Blocks breast, stims endomet

Front 320

Tamoxifen: increase risk what cancer?

Back 320

Endometrial

(partial agonist at endomet ER)

Front 321

Tamoxifen: in/decrease risk OP?

Back 321

Increased risk

(blocks ERs)

Front 322

HIT: occurs how long after heparin admin? see w/LMWH, enox?

Back 322

5-10d

See with LMWH & enox

Front 323

HIT:

-how affect PLATELET count?
-ven or art thrombi?
-how tx/

Back 323

decrease plts

paradoxic ven & art thrombi

immed d/c hep --> anticoag w/direct thrombin inhibitor

Front 324

MCD: #1 what ages? (specific)

Back 324

<16yo

Front 325

MCD: how tx?

Back 325

STEROIDS

Front 326

What dz:

Corkscrew esoph

Back 326

DES

Front 327

Diffuse esoph spasm: how tx?

Back 327

Antispasmodic

Psych counsel (spasm assoc w/strong emotion)

Front 328

DES: LES able to relax?

Back 328

normal relax

Front 329

What dz:

No relax LES

Back 329

Achalasia

Front 330

Achalasia:

What histo findings?

Back 330

Hypertrophy inner circ muscle; absent ganglion cells

Front 331

What dz:

Birdbeak esoph

Back 331

Achalasia

Front 332

Achalasia: resembles what other esoph dz?

Back 332

Trypano cruzi!

Front 333

Trypano cruzi: resembles what esoph dz?

Back 333

Achalasia

Front 334

HBV needlestick: how tx:

-vaccinated
-unclear vaccin

Back 334

Vaccinated: reassur

Non: HBV IVIG + HBV vaccine series

Front 335

What dz:

Vaginal adenocarcinoma; T-shaped uterus

Back 335

DES-in uteru

Front 336

DES in utero: what type of cancer?

Back 336

Vaginal ADENOCA

(NOT SCC)

Front 337

DES in utero: what effects on male fetus?

Back 337

Micropenis, hypogonad, cryptochord

Front 338

Syph: w/u:

Positive Darkfield --> next dx step?

Back 338

NONE --- spirochetes in darkfield is dxtic --> next test for other STDs

Front 339

Eichonococcus: see single or mult cysts?

Back 339

SINgLE

Front 340

What dz:

Hepatic cyst with EGGSHELL CALCIFICATIONS

Back 340

Hydatid (Eichonocc) -- dxistic!

Front 341

Hydatid cyst: how tx?

Back 341

NO FNA!

Albendazole --> resect

Front 342

What pathogen:

Cysticercosis

Back 342

Taenia solium

Front 343

Taenia solium: where find cysts? (2)

Back 343

Brain
Muscle

Front 344

Simple liver cyst: see Ca2+?

Back 344

No

Front 345

LV diastolic dysfxn: how tx:

-pulm edema (dysp): ST, LT
-AfAm
-what meds increases LT survival?

Back 345

Pulm edema:
-ST: NITROGLYCERIN (decreases preload; know this)
-LT: Loop

AfAm: Hydralazine

LT survival: beta-blocker

Front 346

What dz:

Cystic expansion of 4th ventricle

Back 346

Dandy-Walker

Front 347

Dandy-Walker: expand which ventricle?

Back 347

4th

Front 348

Anterior shoulder dislocation: injure what nerve?

Back 348

Axillary n

Front 349

What nerve:

Deltoid, teres minor; upper arm sens

Back 349

Axillary n

Front 350

Axillary n: assoc w/what bony injury?

Back 350

Ant Shoulder Dislocat

Front 351

OCPs: in/decrease risk of:

-breast ca
-cervical ca
-endometrial ca
-ovarian ca

Back 351

Increase: breast, cervical

Decrease: endomet, ovarian

Front 352

OCPs: in/decrease risk of:

-HTN
-DM

Back 352

Increase both

Front 353

Short- or long-acting:

-Alprazolam
-Clonazepam

Back 353

Alpra: short

Clonaz: long (decreased risk of w/d)

Front 354

Palpable breast mass: next step:

-<30yo
->30yo

Back 354

<30yo: U/S --> needle asp if cyst, core bx if solid

>30yo: mammo + U/S

Front 355

HIV in preg: #1 intervention to prevent fetal transmit? #2?

Back 355

#1: ziduvidine mom & infant (decrease 70%)

#2: elective C/S (decrease 50%)

Front 356

Pre-renal or ATN:

BUN:Cr <20:1

Back 356

ATN

Front 357

Pre-renal or ATN:

Urine osm 300-350

Back 357

ATN

Front 358

Pre-renal or ATN:

FENa >2%

Back 358

ATN

Front 359

Hypovol shock: leads to what type of ARF?

Back 359

ATN

Front 360

What type of CAST:

ATN

Back 360

Muddy brown

Front 361

What type of CAST:

Glomerulonephritis

Back 361

RBC cast

Front 362

What type of CAST:

Vasculitis

Back 362

RBC cast

Front 363

What type of CAST:

Interstit nephritis

Back 363

WBC cast

Front 364

What type of CAST:

Pyelonephritis

Back 364

WBC cast

Front 365

What type of CAST:

Nephrotic synd

Back 365

Fatty cast

Front 366

What type of CAST:

chronic renal fail

Back 366

Broad, waxy cast

Front 367

What dz:

RBC cast

Back 367

Glomerulonephritis or vasculitis

Front 368

What dz:

Muddy brown cast

Back 368

ATN

Front 369

What dz:

Fatty cast

Back 369

Nephrotic synd

Front 370

What dz:

WBC cast

Back 370

Interstit nephritis, pyelo

Front 371

What dz:

Broad, waxy cast

Back 371

Chronic RF

Front 372

Anaphyl shock: SQ or IM epi?

Back 372

IM

Front 373

Post-chole pain: how tx if 2/2 sphincter Oddi dysfxn?

Back 373

ERCP sphincterectomy

Front 374

BPAD: % risk:

-gen pop
-1st deg

Back 374

Gen: 1%

FHx: 10%

Front 375

Next step in work-up:

Hyperlipidemia w/out clear etio

Back 375

THYROID FUNCTION

Front 376

Next step in work-up:

Unexplained hypoNa

Back 376

Thyroid function tests

Front 377

Porphyria cutanea tarda:

Assoc what infection?

Back 377

HCV

Front 378

What dz:

def uroporphyrinogen decarboxylase

Back 378

Porphyria cutanea tarda

Front 379

What dz:

Painless blisters + fragile skin on dorsal hands + facial hyperpig; triggered by EtOH & OCPs

Back 379

Porphyria cutanea tarda

Front 380

Porphyria cutanea tarda: 2 triggers?

Back 380

OCPs (discontinue)
ETOH

Front 381

Porphyria cutanea tarda: are blisters painful or painless?

Back 381

Painful

Front 382

Asthma-exacerbated resp dz: what sxs?

Back 382

Asthma; chronic rhinosinusitis w/polyps; bronchospasm

Front 383

What syndrome:

Contralat hemiplegia & vib/prop loss; ipsi tongue deviation

Back 383

MEDIAL medullary syndrome

Front 384

Medial medullary synd: ipsi or contra:

-hemipleg
-tongue dev

Back 384

Contra hemipleg

Ipsi tongue dev

Front 385

HSV-1 or -2:

HSV encephalitis

Back 385

HSV-1 (90%)

Front 386

Fungal mening: CSF glucose normal or decreased?

Back 386

Decreased glucose (contrast viral)

Front 387

Give all preg females what vaccine at initial visit?

Back 387

influenza

Front 388

What dz:

URI --> (2 weeks) --> s/sx CHF

Back 388

Viral myocarditis --> dilated cardiomyopathy

Front 389

Viral-induced cardiomyopathy: #1 pathogen

Back 389

Coxsackie B

Front 390

Dilated cardiomyopathy 2/2 viral myocarditis: what findings on ECHO?

Back 390

Dilated vents w/diffuse hypokinesis

Front 391

#1 etiology of COMMUNICATING hydroceph

(what is pathophysio?)

Back 391

SAH --> DESTROY ARACHNOID VILLI --> block CSF abs

(common in premat infants)

Front 392

Asc cholangitis: abx alone effective in what %? next step?

Back 392

abx --> cure 80%

next: ERCP

Front 393

GBS: when test in preg?

Back 393

35-37w

(NOT at initial)

Front 394

If preg has h/o GBS in prior preg --> retest in 2nd preg or ppx abx?

Back 394

ppx abx

Front 395

Sunscreen:

-apply how much earlier before expos?
-more effective than avoid midday sun?

Back 395

15-60 min pre-sun

Less effective

Front 396

DM: earliest renal abn/

Back 396

Glom hyperfiltration (occurs w/in days of dx) --> leads to glom HTN --> glom damage

Front 397

ACEI: decrease DM nephropathy via what mxn?

Back 397

Decrease glom HTN induced by hyperfilt

Front 398

Warm agglutins: what type of Ig? how tx?

Back 398

IgG

Tx pred --> splenect if innefective

Front 399

AI hemolytic anemia assoc w/lymphoprolif disorder: more likely warm or cold agglut?

Back 399

Warm (IgG)

Front 400

What subunit is unique to bHCG?

Back 400

beta

Front 401

What dz:

Meningococcemia --> adrenal hemorr --> sudden vasomotor collapse & purpura

Back 401

Waterhouse-Friderichson

Front 402

Waterhouse-Friderichson: what pathogen? what pathology?

Back 402

Meningococcemia --> adrenal hemorrhage --> vasocmotor collapse

Front 403

What pathogen:

DM pt w/malig otitis externa

Back 403

Pseudomonas

Front 404

Sarcoid:

-what lyte abn?

Back 404

HyperCa2+

Front 405

If see mediastinal adeno on CXR & suspect sarcoid --> next w/u step?

Back 405

BRONCHOSCOPY

Front 406

Sarcoid: how tx?

Back 406

Steroids

Front 407

How long after URI:

-post-strep glomerulonephritis
-IgA nephropathy

Back 407

post-strep: 10-20d

IgA: few days

Front 408

What dz:

Skin infection or URI --> swelling, hematuria, HTN , DECREASED COMPLEMENT

Back 408

Post-strep glomerulonephritis

Front 409

Post-strep glomerulo: how affect C3 level?

Back 409

DECREASED

(contrast IgA neprhopathy)

Front 410

IgA nephropathy: how affect complement levels?

Back 410

Normal

(contrast post-strep glomerulo)

Front 411

What med:

S/E idiosyncratic (not dose-dependent) liver injury that resembles viral hep

Back 411

Isoniazid

Front 412

Anorexia nervosa: how affect:

-cholesterol
-carotene level

Back 412

Increase cholesterol

INCREASE carotene

Front 413

Next step:

Elderly w/unexplained IDA & negative FOBT

Back 413

COLO

(could still be GIB despite 1 neg FOBT)

Front 414

Ventricular remodeling:

-how long after MI?
-Dilated or thickened LV?
-how prevent (med)?

Back 414

wks-mos s/p MI

Dilated LV

ACEI

Front 415

Do all pts w/central precoc puberty require brain MRI?

Back 415

yes

Front 416

NASH: underlying cell mxn? see stigmata of liver dz? how defin dx/

Back 416

Fat cells impaired response to insulin --> accum fat

Rarely see stigmata

Defin dx req bx

Front 417

Brady or tachy:

-Prolonged QRS
-Prolonged QT

Back 417

prolonged QRS: brady

prolonged QT: tachy

Front 418

Diaph rupture: dx via what study? (2)

Back 418

Barium swallow
CT w/con

(NOT CXR)

Front 419

What dz:

AR-inh degen ant horn cells & CN motor nuclei --> floppy baby

Back 419

Werndig-Hoffman

Front 420

Werndig-Hoffman: how inh? lose what cells?

Back 420

AR

Degen ant horn cells & CN motor nuclei --> floppy baby

Front 421

Myotonic congenital myopathy:

-how inh?

Back 421

AD

Front 422

Congenital hypothyroid: assoc w/what GI abn?

Back 422

Umb hernia

Front 423

#1 cause death in MI

Back 423

Isch --> heterogen condxn --> REENTRANT ARRYTH --> V-fib

Front 424

Marfan: increase risk what 2 heart abns?

Back 424

1. MVP
2. Ao dissectoin --> AR --> new early dia murmur

Front 425

What dz:

Marfan pt w/new early dia murmur

Back 425

Ao dissction --> Ao regurg

Front 426

PPROM: immed 1st step

Back 426

PCN (GBS ppx)

Front 427

At what week preg:

-Stop giving steroids for FLM

Back 427

32w

Front 428

What dz:

PEARLY skin cancer

Back 428

BCC

Front 429

#1 malignant tumor of eyelid

Back 429

BCC

Front 430

#1 non-traumatic etio of SAH (all ages)

Back 430

Aneurysm rupture (not AVM)

Front 431

Acute hemolytic transfusion reaction:

-occurs how long after transfusion?
-underlying etio?

Back 431

w/in 1h

ABO mismatch

Front 432

What dz:

Transfusion --> fever, DIC, BLEED AT IV SITE

Back 432

Acute hemolytic transfusion reaction

Front 433

What med class:

Enalapril

Back 433

ACEI

Front 434

What dz:

sore throat + jaundice/hepatosplenomeg + symm POST cervical LAD + tonsil exudate

Back 434

Mononucleosis

Front 435

EBV: how does infection --> anemia, thrombocytopenia? (mxn)

Back 435

EBV-induced Abs --> x-react w/RBCs & plts --> AI lyse

Front 436

Newly diagnosed cirrhosis: next step?

Back 436

EGD to look for esoph varices

Front 437

Esoph varices in newly dx cirrhotic: initial tx?

Back 437

beta-blocker

Front 438

DM: goal BP? 1st line antiHTN?

Back 438

130/80

ACEI

Front 439

DM: #1 CN neuropathy?

Back 439

CN III (down & out)

Front 440

Viral meningitis: most due to what 2 viruses?

Back 440

ENTEROVIRUSES: ECHO, Coxsackie

Front 441

Viral meningitis: more common infant or child?

Back 441

Infant; decrease w/age

Front 442

Anti-D immune globulin: adjust dose or fixed dose?

Back 442

Adjust dose based on event (e.g. abruption reqs higher dose)

Front 443

RTC tendintis: do ALL pts have impingement?

Back 443

Yes

Front 444

What dz:

Positive NEER test

Back 444

Rotator cuff impingement

(abd arm --> pain/guard)

Front 445

Rotator cuff impingment: improve w/lidocaine?

Back 445

Yes

(contrast tear)

Front 446

#1 testicular sex cord stromal tumor

Back 446

Leydig

Front 447

What testic tumor:

Increase T & E --> decrease FSH & LH

Back 447

Leydig

Front 448

Leydig cell tumor: in/decrease:

-T
-E
-FSH, LH

Back 448

Increase T & E

Decrease FSH, LH

Front 449

Testic seminoma: how affect tumor markers?

Back 449

All normal

Front 450

What testicular tumor type:

Increase AFP

Back 450

Yolk sac (endodermal sinus)

Front 451

Yolk sac (endodermal sinus) testicular cancer: increase what tumor marker?

Back 451

AFP

Front 452

What testicular tumor type:

Increase bHCG in man

Back 452

Choriocarcinoma

Front 453

Testicular choriocarcinoma: increase what tumor marker?

Back 453

betaHCG

Front 454

Normal:

If hyponatremia --> expect urine Na <___

Back 454

U Na <10

(dilute urine)

Front 455

What congenital dz:

Cutaneous lesions palms & soles; jaundice; anemia; RHINORRHEA; metaphyseal dystrophy & periostitis (Xray)

Back 455

Cong syph

Front 456

What dz:

bilat sensorineural hear loss + GROSS HEMATURIA + proteinuria

Back 456

Alport's

Front 457

What dz:

Alternating thick-thin cap lops w/splitting of glomerular BM

Back 457

Alport's

Front 458

NPH: increase CSF prod OR decrease abs?

Back 458

Decreased abs

Front 459

What dz:

HIV pt w/red, firm exophytic nodule

Back 459

Bacillary angiomatosis

Front 460

Bacillary angiomatosis:

how tx?

Back 460

Erythromycin

Front 461

Asympto pt: indication for parathyroidectomy if:

-<___ (what age)
-bone mineral dens <___

Back 461

<50yo

<2.5

Front 462

Pulsus paradoxus:

Insp --> decrease SBP by what amt?

Back 462

>12mm

(see in asthma, tamponade)

Front 463

Name for:

Asthmatic takes deep insp --> SBP decreases by 15mm

Back 463

Pulsus paradoxus

(exagerrated decrease in preload)

Front 464

Paget's: underlying defect?

Back 464

Bone remodeling

Clast hyperfxn --> blast remodel --> disorganzed woven bone

Front 465

Hered sphero:

-how inh?
-what protein?
-most common presenting sx?
-what initiates anemia crisis?

Back 465

AD
spectrin
40% p/w gallstones
B19 --> anemic crisis

Front 466

Hered sphero: give what suppl? which pts?

Back 466

FOLATE suppl ALL pts (even if normocytic anemia)

Front 467

Hered sphero: cure?

Back 467

splenectomy

Front 468

Another name for:

1' adrenal failure

Back 468

Addison's

Front 469

What dz:

Fatigue, constipation, wt loss, HYPERPIGMENT, decreased BP

Back 469

1' adrenal failure (addison's)

Front 470

1' Adrenal failure: what lyte abns?

Back 470

HypoNa+ (#1), hyperK

Front 471

Micro/normo/macro anemia:

Order iron studies

Back 471

MICRO

Front 472

What dz:

Osler's nodes

Back 472

Infective endocard

Front 473

What dz:

Adult w/high fever (>39'), non-itchy rash on trunk & face during fever + arthritis

Back 473

Adult Still's dz

Front 474

PE: see on what % V/Q scans/

Back 474

50%

better test is ct-angio

Front 475

What dz:

Child w/subglottic narrowing

Back 475

Croup

Front 476

Croup: #1 pathogen

Back 476

Parainflu

Front 477

Hemophilia: what is mxn of joint pain s/p hemearth?

Back 477

Deposit Fe --> fibrosis & synovial thickening

Front 478

Neonatal chlamydia PNA:

Presents how long after birth?

Back 478

3-20w s/p birth

Front 479

Neonatal chlamydia PNA:

-fever?
-wheezing?

Back 479

no fever or wheezing (contrast RSV)

Front 480

Neonatal chlamydia PNA:

-how tx?

Back 480

PO erythro x 14d

Front 481

What drug O/D:

Anti-hist & anti-cholin effects --> drowsy, dry mouth, dilated pupils, blurry, AUR

Back 481

Diphenydramine

Front 482

Diphenhydramine O/D: how tx?

Back 482

PHYSOSTIGMINE

Front 483

Physostigmine: tx ANTI/CHOLINERGIC O/D?

Back 483

Txs anti-cholinergic O/D

e.g. diphenhydramine o/d

Front 484

HELLP: how tx if:

-<34w
>34w

Back 484

<34: dexa + wait until 34

>34: deliver immed

Front 485

HELLP: immed deliver if what week?

Back 485

>34w

Front 486

Steroid-induced acne: see comedones?

Back 486

No

see monomorphic follicular papules

Front 487

#1 indicator of liver fxn

Back 487

PT

Front 488

What dz:

Defective tyrosine kinase --> low CD19

Back 488

Bruton's (XLA)

Front 489

Bruton's (XLA): defect what enz? Decrease B and/or T cells?

Back 489

defect tyrosine kinase --> decrease B signal --> low B count

Front 490

XLA/Bruton's: resp infxns start what age? tonsils present?

Back 490

Resp infxns 6-18 mos

Absent tonsils

Front 491

24h urine Ca2+: differentiates what 2 diseases?

Back 491

1' hyperpara: 24h urine >200

Familial hypocalciuric hypercalcemia: <100

Front 492

What dz:

Sestamibi scan

Back 492

Parathyroid adenoma

Front 493

Parathyroid adenoma: localize via what imaging test?

Back 493

Sestamibi scan

Front 494

Pseudotumor: what CN palsy?

Back 494

CN VI

Front 495

Pseudotumor:

May be 2/2 what med class? (2)

Back 495

OCPs
Isoretinoin

Front 496

Pseudotumor:

Underlying pathophysio

Back 496

Decreased arachnoid CSF abs

Front 497

Pseudotumor:

#1 complication

Back 497

Blindness

Front 498

Pseudotumor:

What abns on imaging?

Back 498

All imaging normal

Front 499

Pseudotumor:

Very 1st tx

Back 499

Wt loss --> (then acetazol)

Front 500

Meningococcal meningitis:

-how tx contacts/healthcare workers?

Back 500

ppx RIFAMPIN or CIPRO

Front 501

Pseudotumor: what CN palsy?

Back 501

CN VI

Front 502

Pseudotumor:

May be 2/2 what med class? (2)

Back 502

OCPs
Isoretinoin

Front 503

Pseudotumor:

Underlying pathophysio

Back 503

Decreased arachnoid CSF abs

Front 504

Pseudotumor:

#1 complication

Back 504

Blindness

Front 505

Pseudotumor:

What abns on imaging?

Back 505

All imaging normal

Front 506

Pseudotumor:

Very 1st tx

Back 506

Wt loss --> (then acetazol)

Front 507

Meningococcal meningitis:

-how tx contacts/healthcare workers?

Back 507

ppx RIFAMPIN or CIPRO

Front 508

Multiple unexplained thromboses: next step in w/u if:

-young
-old

Back 508

Young: def protein C, S, AT-III

Old: CT for malig

Front 509

Flecainamide:

-what class anti-arryth?
-txs what type arryth?

Back 509

Class IC (blocks Na channel)

Txs SVT/tachy (inc afib)

Front 510

What antiarrythmic:

Use-dependence effect; e.g. increase HR (stress test) --> greater effect --> greater QRS prolong

Back 510

Flecainamide

Front 511

Reiter's arth: 1st line tx? (class)

Back 511

NSAIDS

(not abx)

Front 512

What dz:

Nontender palpable GB + jaundice + left supraclavicular LAD

Back 512

Pancreatic cancer

Front 513

What dz:

Virchow node

Back 513

Pancreatic cancer

(L supraclav node)

Front 514

#1 etio B12 def

Back 514

Pernicious anemia

Front 515

What is underlying pathophysio:

Epidural --> hypoT

Back 515

Block symp fibers --> VASODIL BVs in LE --> venous pooling in pelvic & LE

Front 516

HIV: #1 middle ear pathology

Back 516

NON-INFECTIOUS serous OM

(LAD or obstructing lymphoma --> eustachian tube dysfxn)

Front 517

What dz:

ONION-SKINNING; MOTH EATEN

Back 517

Ewing sarcoma

Front 518

What dz:

Critical lytic bone lesion w/adj sclerosis (Brodie's abscess)

Back 518

Osteomyelitis

Front 519

If suspect acute bact prostatitis --> next step?

Back 519

Mid-stream UA & Ucx

(do NOT massage prostate)

Front 520

tPA: must order what test 1st?

Back 520

non-con head CT (r/o hemorr stroke)

Front 521

What dz:

Neonatal cyanosis w/feed --> relieved w/crying

Back 521

Choanal atresia

(IMPORTANT)

Front 522

#1 congen nasal malformation

Back 522

Choanal atresia

Front 523

What dz:

Fail to pass catheter thru nose

Back 523

Choanal atresia

Front 524

Choanal atresia: how dx?

Back 524

Fail pass cath thru nose --> CT w/intranasal con

Front 525

Bordatella pertussis:

-does tx depend age? stage of dz?
-what abx?

Back 525

Erythro or azithro

REGARDLESS age or stage of dz

Front 526

Next step:

Dysphagia w/broad ddx

Back 526

Barium esophagram

(BEFORE EGD)

Front 527

#1 pediatric fx

Back 527

Supracondylar fx

(rare as adult)

Front 528

Supracondylar fx: #1 complication? how assess?

Back 528

Brachial art entrap

Check radial pulse before & after reduction

Front 529

What fx:

Risk entrapment of BRACHIAL ART (before & after reduction)

Back 529

Supracondylar fx
(#1 pedi fx)

Front 530

Proximal humerus fx: risk injury what nerve?

Back 530

Axillary nerve

Front 531

Axillary nerve: risk injury with what fx?

Back 531

Prox humerus

Front 532

What dz:

Schoolteacher with acute polyartic & symm arthritis in MCP, PCP, wrist, ankle

Back 532

Parvo B19 arthritis

Front 533

Parvo B19 induced arthritis: resolve after how long?

Back 533

2mos

Front 534

Parvo B19 induced arthritis: how dx? (what test)

Back 534

anti-B19 IgM

Front 535

ParvoB19 induced arthritis: how long does AM stiffness last?

Back 535

10minutes (compared RA: 30 minutes0

Front 536

RA: must have sxs for how long?

Back 536

6+mos

Front 537

What dz:

Painful recurrent oral & genital ulcers + ant uveitis + acneiform nodules + E nodosum

Back 537

Behcets

Front 538

Behcet's: what populations?

Back 538

Turk, Asian, Mid East

Front 539

Behcet's: how tx?

Back 539

Immed steroids

(progresses to blind, dementia)

Front 540

What dz:

Boy with self-mutilatin + dystonia + gout

Back 540

Lesh-Nyhan

Front 541

Lesh-Nyhan: risk what joint dz?

Back 541

gout

Front 542

Lesh-Nyhan: how inh?

Back 542

X

Front 543

What dz:

Hypoxanthine-guanine phosphoribosyl transferase (HPRT)

Back 543

Lesh-Nyhan

Front 544

Lesh-Nyhan: accum what substance in periph tissue?

Back 544

URIC ACID

Front 545

What CONGENITAL dz:

Accum uric acid in peripheral tissue

Back 545

Lesh-Nyhan

Front 546

Leprosy: how dx?

Back 546

bx: AFB

Front 547

What dz:

Hypopigmented plaque --> periph n damage --> nerve atrophy

Back 547

Leprosy

Front 548

PML (JC): do lesions enhance? see mass effect?

Back 548

Non-enhancing

No mass effect

Front 549

What dz:

HIV pt w/stroke-like hemiparesis, aphasia, ataxia, UMN sxs

Back 549

PML (JC virus)

Front 550

Cushing dz: in/decrease:

-glucose
-K
-BP

Back 550

Insulin resistance --> hypergly

hyperK

HTN

Front 551

Cushing dz: where is pathology? (what organ)

Back 551

Adrenal cortex

Front 552

What dz:

Pregnant AfAm woman w/bilat, multinodular SOLID ovarian masses

Back 552

Luteoma

Front 553

Luteoma of pregnancy: uni/bilat? cystic or solid?

Back 553

bilat, multinodular, solid

Front 554

Luteoma of pregnancy: how tx?

Back 554

Benign; no tx

Front 555

Pleural transudate:

Pleural protein:serum protein (what ratio?)

Back 555

<0.5

Front 556

Pleural transudate:

Pleural LDH:serum LDH (what ratio)?

Back 556

<0.6

Front 557

Empyema: what is pH of fluid? how tx/

Back 557

pH <7.2

Chest tube

Front 558

What dz:

Pleural exudate w/pH <7.2

Back 558

Empyema (insert chest tube)

Front 559

Pleural effusion: what is normal pH? what pH suspect empyema?

Back 559

normal <7.6

empyema <7.2

Front 560

Rosacea: how tx?

Back 560

TOPICAL metro

Front 561

Acute inf wall infarct:

-what BV?
-what leads?

Back 561

RCA

II, III, avF

Front 562

MI: what wall?:

Block RCA

Back 562

Inf wall

Front 563

MI: what wall?:

II, III, avF

Back 563

Inf wall

Front 564

MI: what wall?:

p/w hypoT, brady

Back 564

Inf wall (Rv)

Front 565

Safe in preg?:

Sumatriptan

Back 565

NO --- UPT before order triptan

Front 566

Sumatriptan: order what test before you admin to pt?

Back 566

urine preg test

Front 567

What O/D & how tx?:

Brady + AV block + hypoT + DIFFUSE WHEEZING

Back 567

beta-blocker

tx: IVF + ATROPINE --> GLUCAGON

Front 568

Beta-blocker O/D:

how tx? (steps)

Back 568

ATROPINE + IVF --> glucagon

Front 569

A-flutter: 2/2 what pathophysio? assoc w/what EKG finding?

Back 569

reentrant rhyth

2:1 heart block

Front 570

2:1 heart block: predisp to what arryth?

Back 570

A-flutter

Front 571

Buproprion:

Useful in eating disorder?

Back 571

ContraI

further increase risk of sz

Front 572

Buproprion:

Useful in EtOHic?

Back 572

contra-i

further increase risk of sz

Front 573

Buproprion:

Useful in ADHD?

Back 573

Yes

Front 574

Tetanus: what is next step if:

-Unimmunized & clean wound?
-Unimm & dirty wound?

Back 574

Clean: Td booster

Dirty: Td + TIG

(same as if not immunized in over 10 yrs)

Front 575

Tetanus: what is next step if:

-Last booster >10yrs ago & clean wound/
-Dirty wound?

Back 575

Clean: Td booster

Dirty: Td + TIG

(same as unimmunized)

Front 576

Tetanus: what is next step if:

-Booster <10 yrs & clean wound?
-Dirty?

Back 576

Clean: NOTHING

Dirty: booster only if 5-10yrs

Front 577

Cirrhotics: give what hepatitis vaccines?

Back 577

HAV & HBV both

Front 578

PBC: tx what med? txs symptos or increase survival?

Back 578

Ursodeoxycholic acid

Improves sxs AND prolongs survival

Front 579

Chemo-induced gout: how prevent?

Back 579

Allopurinol

Front 580

Cyclophosphamide: what med to prevent hemorr cystitis?

Back 580

Mesna

Front 581

Mesna: prevents what chemo-S/E?

Back 581

Cyclophosh-induced hemorrhagic cystitis

Front 582

What dz:

Adult w/HTN + bilat abd masses + microhematuria

Back 582

AD PCKD

Front 583

AD PCKD: risk what cerebral dz?

Back 583

Berry aneurysm (10% pts)

Front 584

AD PCKD: #1 extrarenal

Back 584

LIVER CYSTS

Front 585

AD PCKD: assoc what GI dz?

Back 585

Colon diverticula

Also abd wall & inguinal hernia

Front 586

What dz:

Hepatocytes w/inclusions that stain PAS+ and resist diastase

Back 586

A1-antitrypsin

Front 587

A1-antitrypsin: hepatocytes stain PAS pos or neg?

Back 587

Pos

Front 588

What dz:

Panacinar emphysema + cirrhosis

Back 588

A1-antitrypsin def

Front 589

A1-antitrypsin: lobar or panacinar emphysema?

Back 589

Panacinar

Front 590

A1-antitrypsin def: evaluate what organ (other than lung)?

Back 590

Liver (assoc w/cirrhosis)

Front 591

What dz:

Hyperseg PMNs + anisocytosis/poikilo + baso stippling

Back 591

Macro anemia (B12, folate)

Front 592

DKA: what is most reliable index to monitor response?

Back 592

serum anion gap

Front 593

Edwards: what heart defect?

Back 593

VSD

Front 594

Affect risk of osteporosis?:

-EtOH
-Smoking
-Vegetarian

Back 594

EtOH & smoking increase OP

Vegetarian not affect risk

Front 595

Tourette's: tx w/what class of med?

Back 595

TYPICALS

(haldol, PIMOZIDE)

Front 596

Panic disorder: assoc w/what other psych dx?

Back 596

mdd, substance abuse

(important)

Front 597

Neonatal sepsis: #1 pathogen

Back 597

GBS

Front 598

Renal stones:

-metabolic w/u after 1st stone?

Back 598

no - only if recurrent

Front 599

HIV: what CD4?:

Req MAC ppx

Back 599

<50

(azithro, clarithro)

Front 600

MAC ppx: what abx?

Back 600

Azithro, clarithro

Front 601

HIV w/CD4 <50: req antifungal?

Back 601

No

Front 602

EPO: how affect HTN?

Back 602

S/E WORSE HTN (30% pts)

more common if admin IV

often need to add antiHTN

Front 603

If admin IV EPO --> beware what S/E?

Back 603

Anti-HTN

often req add anti-htn

Front 604

ESRD: #1 etio anemia

Back 604

EPO deficiency

Front 605

ESRD: micro/normo/macro anemia?

Back 605

normo

Front 606

SCD: initiate hydroxyurea if how many episodes per year?

Back 606

>6 / yr

Front 607

What med:

Increase fetal Hgb --> prevents sickle crises

Back 607

Hydroxyurea

Front 608

Heat stroke: what body temp?

Back 608

>40.5

Front 609

Hypo or hyperthermia: see coagulopathic bleed

Back 609

Hyperthermia

(esp heat stroke > 40.5; see epistax)

Front 610

What dz:

-child w/hip pain
-fat adol w/hip pain
-athlete adol w/hip pain

Back 610

Child w/hip: Leg-Calve-Perth
Fat: SCFE
Athlete: Osgood-Schlatter

Front 611

What dz:

Traction apophysitis: quad tendon pulls tibial tubercle

Back 611

Osgood-Schlatter

Front 612

Osgood-Schlatter: mxn of inj?

Back 612

Traction apophysitis: quad tendon pulls tibial tubercle

Front 613

What SC synd:

assoc w/BURST fx

Back 613

Anterior cord syndrome

See loss of motor, pain, temp all levels below lesion

Front 614

Polycyth vera: affect HTN?

Back 614

Increase HTN 2/2 expanded blood vol (reversible)

Front 615

Polycythemia vera: low/normal/high EPO in urine?

Back 615

ABSENT EPO in urine

Front 616

Polycythemia vera: how affect ESR?

Back 616

Normal ESR

(contrast MM)

Front 617

To distinguish SEPTIC arth vs. transient synovitis:

-WBC > __
-ESR > ___

Back 617

WBC > 12k

ESR > 40

Front 618

What asthma med: S/E:

HA, insomnia, n/v, HTN, arryth

Back 618

Theophylline

Front 619

Theophylline toxicity: increased risk if co-admin what meds/

Back 619

Cipro, erythro

Front 620

What dz:

Asthmatic given cipro/erythro for UTI --> HTN, tachy, n/v, arryth

Back 620

Theophylline toxicity (increases w/abx0

Front 621

Hypercalcemia in malig: what is mxn:

-breast & lung cancer
-non-met solid tumor
-ovarian ca
-Hodgkin's

Back 621

Breast & lung: met to bone --> IL-1 & TNF --> lytic lesion

Non-met solid: PTHrP

Ovarian: ectopic PTH

Hodgkin: calcitriol

Front 622

Hypercalcemia in malig: what TYPE of tumor:

-local IL-1, TNF --> lytic lesions
-PTHrP
-Ectopic PTH
-Calcitriol

Back 622

Lytic lesions: lung & breast mets

PTHrP: solid non-met cancer

Ectopic PTH: ovarian & neuroecto

Calcitriol: Hodgkin's

Front 623

Nephrotic synd in child:

-how tx?
-req renal bx?

Back 623

Assume MCD --> GIVE STEROIDS

no req bx

Front 624

#1 etio pelvic abscess in male

Back 624

ruptured appendix

Front 625

What dz:

Male w/abd pain --> days later: fluctuant mass on DRE + diarrhea + pain w/defecation

Back 625

ruptured appendix --> pelvic abscess

Front 626

Abscess 2/2 complicated diverticulitis: how tx?

Back 626

CT-guided perQ drain

(NOT laparotomy)

Front 627

How tx:

-gonorrhea
-chlam

Back 627

G: CTX

C: azithro/doxy x 7d

Front 628

Ao dissection: #1 risk

Back 628

HTN

Front 629

Trichoma: what serotypes?

Back 629

Chlam A-C

Front 630

What Chlamydia serotypes can lead to blindness?

Back 630

Sero A-C (trachoma): follicular conjunctivitis --> pannus (neovasc)

Front 631

Trachoma (chlam sero A-C): how tx/

Back 631

Topical tetracycline
OR
po azithro

Front 632

How tx (sequence):

Hypotensive pt requiring PEEP

Back 632

Volume resusc 1st --> then initiate PEEP

(PEEP can decrease preload --> worsen hypoT)

Front 633

What congen dz?:

Microcephaly + digit/nail hypoplasia + midface hypoplasia

Back 633

Fetal hydantoin synd (phenytoin)

Front 634

Chlamydia or Gonorrhea conjunctivitis:

d2-5; high purulent discharge

Back 634

Gonorrhea (hyperacute

(Chlam at d5-14)

Front 635

Chlamydia or Gonorrhea conjunctivitis:

Later appearance; congested conjunctivits w/scant discharge

Back 635

Chlamydia (d 5-14)

Contrast gonorr; d2-5 w/highly purulent discharge

Front 636

What dz:

Most destructive neonatal eye infxn

Back 636

GONORRHEAL conjunct

Front 637

Gonorrhea conjunctivits: how tx?

Back 637

ORAL CTX

Front 638

Chalmydia conjuncitivits: how tx?

Back 638

ORAL erythromycin

(not topical)
(prevents PNA)

Front 639

Female androgen prod:

Which androgen ONLY produced by adrenal?

Back 639

DHEA-S

Front 640

Female androgen prod:

Where produce DHEA-S?

Back 640

Adrenal only

Front 641

Female: what is most specific measure/marker for adrenal mass?

Back 641

DHEA-S

(ONLY produced in adrenal)

Front 642

Female androgen prod:

Where produce testosterone?

Back 642

Adrenal + ovary

Front 643

Female androgen prod:

Where produce DHEA?

Back 643

Adrenal + ovary

Front 644

Female androgen prod:

Where produce androstenedione?

Back 644

Adrenal + ovary

Front 645

Another name for:

Trousseau's syndrome

Back 645

Migratory thrombophlebitis

Front 646

Migratory thrombophlebitis: usu assoc with what other dz?

Back 646

occult adenocarcinoma (pancreas, lung, prostate)

Front 647

What dz:

Atypical thrombophlebitis of arm, chest

Back 647

Migratory thrombophlebitis (Trousseau's syndrome)

Front 648

Migratory thrombophlebitis: what is next step in w/u?

Back 648

Abdominal CT

(look for occult adenocarcinoma)

Front 649

Cirrhosis-induced esoph varices: what is 1st tx?

Back 649

beta-blockers (not sclero)

Front 650

What dz:

Young pt w/HTN + muscle weakness + nubmness

Back 650

1' hyperaldo

(hyperNA --> HTN)
(hypoK --> numb)

Front 651

1' hyperaldosteronism: in/decrease:

Aldo:renin ratio

Back 651

INCREASE

Aldo suppresses renin

Front 652

What dz:

Brown discolored colon w/shiny lymph follicles

Back 652

laxative abuse

Front 653

What segments of femoral vein are considered DEEP?

Back 653

all

Front 654

Which neck space:

Highest risk mediastinal inv

Back 654

Retropharyngeal

Front 655

Retropharyngeal abscess: most feared complication?

Back 655

Spread into mediastinum --> acute necrotizing mediastinitis

Front 656

Steroids: how induce osteonecrosis? (what mxn)

Back 656

Vascular disruption --> AVN

Front 657

Steroid-induced osteonecrosis; most sens dx test?

Back 657

MRI

Front 658

Avascular necrosis of bone: 2 most common causes

Back 658

EtOH, steroids

Front 659

What dz:

Neonate w/CXR fine reticular granularity

Back 659

Hyaline membrane dz

Front 660

Sickle cell trait: what pheno?

Back 660

AS

Front 661

What dz:

AS PHENOTYPE

Back 661

Sickle cell TRAIT

Front 662

Sickle cell TRAIT: #1 presenting sx

Back 662

Painless hematuria

Front 663

HIV: what % risk of reactivating TB?

Back 663

10%

Front 664

Hepatic hydrothorax: pleural transudate or exudate?

Back 664

Transudate

Front 665

What dz:

Cirrhotic pt w/pleural effusion but no cardio-pulm dz

Back 665

Hepatic hydrothorax

(2/2 diaph defects0

Front 666

Hepatic hydrothorax: how tx?

Back 666

Decrease salt --> diuretic --> TIPS

Front 667

Next step:

-Battery lodged in esoph
-Battery in stomach

Back 667

Esoph: immed EGD

Stomach: repeat CXRs

Front 668

Where in GI tract:

Abs Fe2+

Back 668

Duo

Front 669

Celiac sprue: affect Fe2+ abs?

Back 669

Decrease Fe2+ abs in duo --> IDA

Front 670

What dz:

Granular IgA deposits in upper dermis

Back 670

Derm herpatiformis (celiac sprue)

Front 671

Derm herpatiformis: what Ig subtype deposited in dermis?

Back 671

igA

Front 672

Acute hepatic failure: see HE in how many weeks?

Back 672

8w

Front 673

Another name for:

Hereditary Telangiectasia synd

Back 673

Osler-Weber-Rendu syndrome

Front 674

Another name for:

Osler-Weber-Rendu syndrome

Back 674

Hered Telangiectasia synd

Front 675

How inh:

Osler-Weber-Rendu (Hered Telangiect)

Back 675

AD

Front 676

What dz:

Diffuse telangiectasias + AVMS + epistax

Back 676

Osler-Weber-Rendu (Hered Telang)

Front 677

What hered dz:

AVM in lung --> R-to-L shunt --> chronic hypox --> reactive polycyth

Back 677

Osler-Weber-Rendu (hered telang)

Front 678

What dz:

CT: dilated bronchi w/thick walls

Back 678

Bronchiectasis

Front 679

What dz:

Increase IgM; decrease IgG, IgA, Bs, PMNs

Back 679

Hyper-IgM syndrome

Front 680

HyperIgM syndrome: affect level of B cells?

Back 680

decrease

(also decrease PMNs)

(contrast CVID: normal # circ Bs)

Front 681

HyperIgM or CVID:

Decrease IgG, IgA

Back 681

BOTH

Difference is that hyperIgM has high IgM; CVID has no IgM

Front 682

What dz:

-Increase IgM, decrease IgG, IgA, Bs
-Decrease IgM, IgG, IgA; normal # Bs
-Decrease IgM, IgG, IgA, Bs

Back 682

HyperIgM

CVID: normal # Bs

XLA (Bruton's): all decrease

Front 683

What pathogen:

DM pt w/malignant OM

Back 683

Pseudomonas

Front 684

What dz:

Ear granulation & drainage not responsive to abx

Back 684

Malignant OM

Front 685

What pathogen: DM pt with:

-malig OM
-sinus infxn extending into brain

Back 685

Malig OM: Pseudomonas

Sinus-brain infxn: Rhizopus

Front 686

Eneurisis: normal until what age?

Back 686

5yo

Front 687

What hearing test:

-Air vs. mastoid
-Forehead --> localize

Back 687

Air vs. mastoid: Rhine

Forehead: Weber

Front 688

Rhine test: which normal hear longer:

Air or mastoid?

Back 688

Air

if mastoid longer --> conductive hearing loss

Front 689

What type of hearing loss:

-Rhine: hear mastoid longer

Back 689

Conductive

Front 690

Weber test; louder in non/affected ear?

Back 690

affected (since not distracted by ambient noise)

Front 691

Otosclerosis:

-M or F?
-what ages?
-Conductive or sensorineural loss?

Back 691

F>M
20-30yo
Conductive: stapes fixes to oval window

Front 692

What dz:

AI; stapes fixes to oval window

Back 692

Otosclerosis

Front 693

What test:

-compares means in 2 SAMPLES
-compares means in 2 POPS
-compares categorical

Back 693

Samples: T

Pops: Z

Categorical: chi

Front 694

AAA repair: common complication

Back 694

Bowel ischemia --> pain, bloody diarhea, fever

Front 695

What dz:

Post-op AAA repair --> abd pain + bloody diarrhea + fever

Back 695

Bowel isch

Front 696

What dz:

Pt w/URI given amox --> polymorphous rash

Back 696

EBV

Front 697

Paget's disease of BREAST: assoc with what type of tumor

Back 697

underlying ADENOcarcinoma (85% pts)

Front 698

What type of breast cancer:

Cells retract from adj keratinocytes --> large cells w/clear halos

Back 698

Paget's disease of breast

(assoc w/underlying adenoca)

Front 699

Name for:

Hypogly at 3AM --> compens release E/N, glucagon --> hypergly at 7AM

Back 699

Somogyi

Front 700

Name for:

Cyclic release GH --> decreased insulin sens at 3AM --> hypergly at 7AM

Back 700

Dawn phenomenon

Front 701

Somogyi or Dawn:

-Hypergly at 3AM, hypergly at 7AM
-Hypogly at 3AM, hypergly at 7AM

Back 701

Dawn: hypergly at 3 & 7AM

Somogy: hypogly at 3AM (stims NE/E release) --> hypergly at 7AM

Front 702

What immuno-suppress agent: S/E:

Oral ulcers; n/v/abd pain; increased LFTs; BM suppression & anemia

Back 702

MTX

Front 703

MTX: coadmin what med to decrease S/E? affect med efficacy?

Back 703

Folate

(no disrupt MTX effect)

Front 704

What dz:

RA + splenomeg + decreased PMNs

Back 704

Felty Syndrome

Front 705

Felty syndrome: decrease what cell type?

Back 705

PMNs

Front 706

What dz:

Increase Alk; normal Ca, LFTs, bili

Back 706

Paget's dz bone

Front 707

Paget's dz of bone: in/decrease:

-Alk
-Bili
-Ca
-LFTs

Back 707

Increase Alk

(rest are normal)

Front 708

Can you ablate thyroid?:

-Preg
-Severe opthalmopathy

Back 708

NO

Front 709

Methylphenidate: approved in what ages?

Back 709

>7yo

(do not use to tx ADHD in 6yo)

Front 710

Ao stenosis: #1 etio:

->70yo
-<70yo

Back 710

>70: senile calcif

<70yo: BICUSPID AV

Front 711

WPW:

-short or long PR?
-wide or narrow QRS?

Back 711

Pre-excitation --> SHORT PR

Wide QRS

Front 712

Ao stenosis:

Sxs if valve <___ (area)

Back 712

<1cm

Front 713

What murmur:

Systolic murmur at right ICS 2

Back 713

Ao stenosis

Front 714

What murmur:

Parvus et tardus

Back 714

Ao sten

Front 715

What murmur:

Pulsus paradox

Back 715

Cardiac tamponade

Front 716

How tx:

PE w/hypoT, tachy, syncope

Back 716

thrombolytics

(evidence of RH fail)

Front 717

MAOI + tyramine --> monitor what vital sign?

Back 717

BP

(not fever)

Front 718

MAOI: avoid what diet?

Back 718

Tyramine

Front 719

SIADH: how tx:

-asympto pt
-last resort

Back 719

Asympto: fluid restrict

Last resort: hypertonic

Front 720

Goal INR:

-idiopathic DVT
-Prosthetic valve

Back 720

idiopathic: 2-3

Prosth: 2.5-3.5

Front 721

Acute bact sinusitis: how tx if <6yo?

Back 721

Empric amox (no req image)

Front 722

Variable decels: how tx? (sequence)

Back 722

Admin O2 + mother on side --> Trendleberg w/presenting part elevated --> amnioinfusion

Front 723

Colonic angiodysplasia:

-most common what part of colon?
-what age?
-#1 presenting sx?

Back 723

Cecum; >65yo; GIB (occult or episodic)

Front 724

Colonic angiodysplasia:

How dx (gold standard)

Back 724

ANGIOGRAPHY

(regularly miss on colo)

Front 725

Colonic angiodysplasia:

Assoc with what HEART dz?

Back 725

AO STENOSIS

Front 726

What dz:

Pt w/syst murmur at R 2nd ICS presents with a GIB

Back 726

colonic angiodysplasia (wierdly assoc w/ao sten)

Front 727

Acute cardiac tamponade: how appear on CXR?

Back 727

Often normal

Front 728

Creates pleural transudate or exudate?:

Infection

Back 728

Exudate

Front 729

Creates pleural transudate or exudate?:

Malig

Back 729

Exudate

Front 730

Creates pleural transudate or exudate?:

Pulmonary embolus

Back 730

Exudate

Front 731

EtOHIC w/anemia: more common folate or B12 def?

Back 731

Folate

Front 732

A-fib: may be 2/2 hypo or hyperthryoid?

Back 732

Hyper

Front 733

Fat necrosis of breast: how appear on:

-U/S
-mammo

Back 733

Same as breast cancer!

U/S: solid
Mammo: Ca2+

Front 734

How disting: fat necrosis of breast vs. cancer?

Back 734

Fat necrosis: bx shows fat globules + foamy histiocytes

Front 735

What dz:

Breast bx: fat globules + foamy histiocytes

Back 735

Fat necrosis of breast

Front 736

SJS: most common what 3 drug classes?

Back 736

Sulfa, NSAIDs, phenytoin

Front 737

Ovarian cancer: does pelvic exam count as screening?

Back 737

no

no screening measures

Front 738

Next step w/u:

Male w/hypogonad & low testosterone

Back 738

Measure PRL

(NOT estrogen)

Front 739

Guillan-Barre: serial monitor what pulmonary measurement?

Back 739

VITAL CAPACITY

(ETT if VC <15)

important!

Front 740

Guillan Barre: ETT if vital capacity <___?

Back 740

<15

Front 741

HIV esophagitis: 1st step? 2nd step?

Back 741

1st: empiric fluconazole
2nd (if no improve 3d): EGD w/bx

Front 742

What dz:

Surgery w/hypotension --> post-op abd pain, bloody diarrhea

Back 742

isch colitis

Front 743

Ischemic colitis: #1 site

Back 743

Splenic flexure

(not hepatic flex)

Front 744

HIV vaccine: give Td booster how often?

Back 744

q10 yrs (same)

Front 745

Schizo: which has better px?:

negative or positive sxs

Back 745

Positive (better tx w/typicals)

Front 746

Schizo: tx with A/TYPICAL?:

-Positive-predom
-Negative-predom

Back 746

Positive: TYPICAL

Neg: ATYPICAL

Front 747

Can you give a bolus of hypotonic fluid?

Back 747

Never hypo/hyper

Only give bolus of normo (LR, NS)

Front 748

Tzanck: disting HSV vs. VZV?

Back 748

no

Front 749

What dz:

Female w/chronic HA presents with painless hematuria

Back 749

Analgesic-induced nephropathy

Front 750

Analgesics: how induce nephropathy? (mxn)

Back 750

Tubulointerstital damage w/constrict vasa recta --> papillary necrosis

Front 751

CMV or EBV:

-pharyngitis
-cervical LAD

Back 751

EBV ONLY: pharyngitis, cervical LAD

Front 752

What dz:

X & Y descents on central venous tracing

Back 752

Constrictive pericarditis

Front 753

Constrictive pericarditis: #1 etio in developing world

Back 753

TB

Front 754

Chagas dz: DIA or SYST dysfxn?

Back 754

BOTH

also arryth, MR, TR

Front 755

Proximal or distal vein:

Ileal vein

Back 755

Prox

Front 756

Proximal or distal vein:

Femoral

Back 756

Prox

Front 757

Proximal or distal vein:

Popliteal

Back 757

Prox

Front 758

What dz:

Unexplained hemolytic anemia + thrombocytopenia + RF + neuro sxs

Back 758

TTP-HUS

Front 759

What dz:

Abs against ADAMTS-13 (vWF cleaving protease) --> accum vWF multimers

Back 759

TTP-HUS

Front 760

TTP-HUS: what Abs?

Back 760

Anti- ADAMTS-13

(accum vWF multimers --> plt agg)

Front 761

TTP-HUS: #1 tx

Back 761

Plasma exchange!

If no tx --> 80% fatal

Front 762

Breech: unlikely to spont convert after what week?

Back 762

36w

Front 763

Breech: attempt version at what week?

Back 763

37

Front 764

What dz:

Young adult M with proteinuria + ARF + RBC casts + SOB + hemoptysis

Back 764

Goodpastures

Front 765

What dz:

Abs to alpha3 chain of type IV collagen --> linear IgG on glomerular BM

Back 765

Goodpastures

Front 766

Goodpastures: how dx?

Back 766

Renal bx: linear IgG on glom BM

Front 767

Flail chest: use PPV?

Back 767

Yes

Front 768

Multiple sclerosis: what med SLOWS PROGRESSION?

Back 768

IFN-beta

(NOT steroids)

Front 769

IV ACV --> toxic to what organ? how prevent inj?

Back 769

Renal tox

Prevent w/adeq hydration

Front 770

What pathogen:

Encapsulated yeast

Back 770

Cryptococcus

Front 771

How tx:

Cryptococcal meningitis

Back 771

IV ampho + po flucytosine

Front 772

Histoplasmosis: use itraconazole in acute or maintenance tX?

Back 772

Maintenance only

Front 773

Renal stones: CON or NON-CON CT?

Back 773

Non-con spiral CT

Front 774

How affect ESR? CPK?:

-PMR
-PM/DM

Back 774

PMR: Increase ESR, normal CPK

PM/DM: younger pt; increase ESR & CPK

Front 775

What dz:

Neonate with epiglottis rolling in from side-to-side

Back 775

Laryngomalacia

Front 776

Raloxifene: tx what dz? contra-indicated in what dz?

Back 776

SERM; prevents osteopor

S/E DVT; contraI if h/o DVT

Front 777

Transposition of Great Vessels:

When see cyano?

Back 777

0-24h

Front 778

Maternal DM: increase risk of which cyanotic congen HD?

Back 778

Transposition of Great Vessels

Front 779

Transposition of Great Vessels:

M or F?

Back 779

M>F

Front 780

Transposition of Great Vessels:

Increased risk if what maternal dz?

Back 780

DM

Front 781

What congen HD:

Single loud S2

Back 781

Transposition of Great Vessels

Front 782

Transposition of Great Vessels:

How dx?

Back 782

ECHO

(normal CXR)

Front 783

Transposition of Great Vessels:

How tx?

Back 783

IV PGE1 --> surgery

Front 784

Turner Synd: what pathophysio mxn --> amenn?

Back 784

Ovarian dysgen --> decrease E --> amenn

Front 785

Turner: in/decrease FSH?

Back 785

Increase

(since ovarian dysgen leads to decreased E; compens FSH)

Front 786

Turner: in/decrease GH?

Back 786

Normal GH (despite short stature)

Front 787

JIA: non/migrat? arthritis for how long to dx?

Back 787

Non-migratory >6w

Front 788

Penile fx: tear what structure?

Back 788

Tunica albuginea

Front 789

Penile fx: how tx? (2 steps)

Back 789

Retro urethro --> surg

Front 790

MTX: micro/normo/macro anemia? check CBC how often?

Back 790

Macro; CBC q3mo

Front 791

What RA drug:

S/E hepatotox, interstitial lung dz, alopecia

Back 791

MTX

Front 792

MTX: how prevent some S/E?

Back 792

Coadmin folate (not interfere w/drug fxn)

Front 793

Meningitis: how w/u in:

-adult? (3 steps)
-child?

Back 793

Adult: abx --> CT --> LP

Child: LP FIRST --> vanco + CTX + dexamethasone
(no risk herniation since open fontanel)

Front 794

VPA: what S/E?

Back 794

pancreatitis

Front 795

What AED:

S/E pancreatitis

Back 795

VPA

Front 796

Med S/E:

What 2 diuretic classes S/E panceratitis

Back 796

Furosemide
Thiazide

Front 797

Med S/E:

What 2 antibiotics S/E pancreatitis

Back 797

Metronidazole
Tetracycline

Front 798

What dz:

Erythem papule with central scale & SANDPAPER texture

Back 798

Actinic keratotis (early)

Front 799

What dz:

Cutaneous horn

Back 799

Actinic keratosis

Front 800

What skin lesion:

Histo: acantholysis, parakeratosis, dyskeratosis

Back 800

Actinic keratosis

Front 801

What skin lesion:

Histo: thick epi; retain nuclei in stratum corneum

Back 801

Actinic keratosis

Front 802

Actinic keratosis: what % transform SCC?

Back 802

1%

Front 803

Offer hemodialysis?:

Severe dementia

Back 803

no (contrai)

Front 804

What dz:

Multiple somatic complaints (some NOT pain-related) & negative w/u

Back 804

Somatization disorder

Front 805

FAP:

-how inh?
-what gene?
-M or F?

Back 805

AD
APC gene
M=F

Front 806

What dz:

Hundreds of colon polyps --> 100% risk CRC

Back 806

FAP

Front 807

FAP: what is risk of CRC?

Back 807

100%

Front 808

FAP: if see polyps on colo --> how tx?

Back 808

Proctocolectomy (NOT serial colos)

Front 809

What HIV illness:

Fever, cough, dyspnea, hemoptysis

Back 809

Aspergillosis

Front 810

What HIV dz:

CXR single cavitary lesion w/rapid growth; CT pulm nodules with HALO SIGN

Back 810

Aspergillosis

Front 811

Aspergillosis: see single or multi lesions?

Back 811

Single cavitary lesion

Front 812

What dz:

CT scan shows pulmonary nodules w/halo signs (air crescent)

Back 812

Aspergillosis

Front 813

What dz:

Thrombocytopenia AND thrombosis (simultan!)

Back 813

Hep-induced thrombocytopenia (HIT)

Front 814

HIT: underlying mxn?

Back 814

Abs against heparin-platelet factor 4 complex

Front 815

What dz:

Abs against heparain-plt complex

Back 815

HIT

Front 816

MW tear: arteries in what layer?

Back 816

Submucosa

Front 817

MW tear: what % spont resolve? tx w/what MED?

Back 817

90% stop

Vasopressin (--> injxn --> caut)

Front 818

TCA O/D: inh what channel?

Back 818

Na channel --> QRS prolong

Front 819

TCA O/D: what antidote to decrease QRS?

Back 819

Sodium bicarb (sodium load)

Front 820

#1 cyanotic congen HD

Back 820

TOF

Front 821

TOF: what abn is the #1 determinant of sxs

Back 821

Pulmonary stenosis

Front 822

TOF: 4 findings

Back 822

1. Pulm stenosis
2. Overriding Ao
3. VSD
4. RVH

Front 823

Tet spell: see what change in hemodyn?

Back 823

Increase R-to-L shunt across VSD --> decrease pulm BF --> increase deoxy systemic blood

Front 824

TOF: what is effect of knee-to-chest?

Back 824

Increase syst vasc R --> increase BF from RV to pulm circ

Front 825

What dz:

Electrical alternans

Back 825

Tamponade

Front 826

Tamponade: how tx? (2)

Back 826

IVF + pericard

Front 827

What dz:

CP worse w/deep insp & improves when lean forward

Back 827

PERICARDITIS

Front 828

Pericarditis: CP better or worse when lean forward?

Back 828

Better

Front 829

What dz:

Diffuse ST elevation w/recip depresed AVR

Back 829

Pericarditis

Front 830

Pericarditis: ST elev or depress?

Back 830

Diffuse ST elevation

Front 831

Pericarditis: usu how long after MI?

Back 831

First few days

Front 832

Dressler synd:

-s/p what event? how long after?
-underlying mxn?
-how affect ESR?
-how tx?

Back 832

Weeks s/p MI; likely immun-med
Increase ESR
tx: NSAIDS ONLY (steroids if refract)

Front 833

What dz:

MI --> (wks later) malaise, fever, CP & increased ESR

Back 833

Dressler synd

Front 834

Ao aneurysm: type A or B:

Descending only

Back 834

B

Front 835

Ao aneurysm: type A or B:

Involves asc

Back 835

A

Front 836

Ao aneurysm: how tx:

-Type A
-Type B

Back 836

A: Iv beta-blocker + surg

B: IV b-b only

Front 837

Ao aneurysm: how tx type B in Af Am?

Back 837

Same - IV beta-blocker

Front 838

Sickle cell pt w/cholecystitis:

-should you be concerned about elev WBC?
-req emerg chole?

Back 838

elev WBC normal (not indicated cholangitis)

Tx same: conserv --> elective chole (not req emerg chole)

Front 839

Acute pericarditis: #1 etio

Back 839

Viral infection

Front 840

What is underlying dz:

Pericarditis + oliguria + HTN + red casts + proteinuria

Back 840

UREMIC pericarditis (2/2 nephrotic synd)

Front 841

Indication for hemodial?:

Uremic pericarditis

Back 841

Yes

Front 842

Next tx step:

Coagulopathy 2/2 renal failure

Back 842

Hemodial

Front 843

What med:

Increases HDL by 30%

Back 843

Niacin (nicotinic acid)

Front 844

PCOS: what test to assess insulin sens?

Back 844

2h glucose

(NOT fasting BG)

Front 845

What dz:

Brain cancer with BUTTERFLY appearance + central necrosis + heterogen contrast enhance

Back 845

GBM

Front 846

What dz:

Butterfly brain tumor

Back 846

GBM

Front 847

What dz:

s/p trauma: muscle pain worse w/passive ROM

Back 847

Compartment synd

Front 848

What menstrual phase:

Scant, thick, acidic mucus

Back 848

Early follicular

Front 849

Early follicular phase: acidic or alka mucus?

Back 849

Acidic (prevent sperm pen)

Front 850

What menstrual phase:

Profuse, thin, clear mucus; stretches 6cm; alkaline

Back 850

Ovulatory

(allows sperm pen)

Front 851

Ovulatory phase: acidic or alkaline mucus?

Back 851

Alkaline (>6.5)

Front 852

CLL: Bs or Ts?

Back 852

Bs

Front 853

What dz:

SMUDGE CELL

Back 853

CLL

Front 854

CLL: does presence of thrombocytopenia affect px?

Back 854

Thrombocytopenia --> poor px

(worse than splenomeg, anemia)

Front 855

CLL: #1 etio death

Back 855

infection

Front 856

CLL: what finding has worst px?

Back 856

Thrombocytopenia

(worse than splenomeg, anemia)

Front 857

What dz: spheros w/out central pallor and:

-Negative Coombs
-Positive Coombs

Back 857

Spheros + negative Coombs: hered sphero

Spheros + pos Coombs: AI hemolytic anemia

Front 858

What dz:

Sphero + neg Coombs

Back 858

Hered sphero

(if pos: AI hemolytic anemia)

Front 859

AI hemolytic anemia:

-pos or neg Coombs?
-warm or cold agglutins more common?

Back 859

Pos coombs

Warm > cold

Front 860

AI hemolytic anemia: warm or cold agglutins:

IgG

Back 860

Warm

(Georgia)

Front 861

AI hemolytic anemia: warm or cold agglutins:

IgM

Back 861

Cold

(Maine)

Front 862

AI hemolytic anemia: warm or cold agglutins:

more common

Back 862

Warm

Front 863

AI hemolytic anemia: warm or cold agglutins:

Tx steroids, splenectomy

Back 863

Warm

Front 864

AI hemolytic anemia: warm or cold agglutins:

Tx warm body, transfusion

Back 864

Cold

Front 865

What vitamin def:

increase homocysteine

Back 865

B12 & folate

Front 866

B12/folate def: in/decrease homocysteine?

Back 866

Increase homocysteine

(decrease conversion to methionine)

Front 867

DM nephropathy: most sensitive test?

Back 867

Random urine microalbumin:creatinine

Front 868

What dz:

order random urine microalbumin:creatinine

Back 868

DM nephropathy

Front 869

DM nephropathy: meas via urine dipstick?

Back 869

NO - only detects macroabluminuria

(miss early microalbumin)

Front 870

#1 intracardiac tumor

Back 870

Atrial myxedema

Front 871

Atrial myxedema: more common RA or LA?

Back 871

LA (80%)

Front 872

Post-term preg (>42w): what 2 tx options?

Back 872

1. Induce
2. BIWEEKLY eval oligo

Front 873

What vaginal infxn:

Thin, malodor, frothy

Back 873

Trich vag

Front 874

Trich vag: what is pH?

Back 874

ph 5-6

Front 875

Trich vag or BV:

Itchy, inflammed

Back 875

Trich

Front 876

What dz:

dyspnea + venous engorge face/chest + swelling H/N

Back 876

SVC syndrome

Front 877

SVC syndrome: most common what 2 cancers?

Back 877

Lung
NHL

Front 878

SVC syndrome: how dx?

Back 878

CXR

Front 879

EPS more common a/typical antipsych?

Back 879

Typical

Front 880

Typicals:

How tx EPS?

Back 880

Diphenydramine OR benztrop/trihexyphenadryl

Front 881

What dz:

(Triad) polyarth + tenosynovitis + painless vesicopapular rash

Back 881

Dissem gonorrhea

Front 882

Dissem gonorrhea: is rash painful?

Back 882

no

Front 883

What dz:

Developmental disorder; forward slip vert --> step off

Back 883

Spondylolithesis

Front 884

Spondylolithesis: what phys exam finding?

Back 884

Step off

Front 885

Spondylolithesis: see bladder dysfxn? sens findings?

Back 885

YES - if L5 slips forward over S1 --> bladder dysfxn & decreased sens perineum

Front 886

What complication:

Pt w/peptic ulcer surgery --> develops watery diarrhea

Back 886

BACT OVERGROWTH

(NOT short bowel synd -- see if sm intestine resect in CD)

Front 887

Follicular thyroid ca:

-early or late mets? spread via heme or lymph?

Back 887

EARLY; heme spread to lung, brain, bone

RARELY see LN inv

Front 888

What type of thyroid cancer:

Capsule + BV invasion

Back 888

Follicular

(papillary lacks capsule)

Front 889

Follicular or Papillary thyroid cancer:

Encapsulated

Back 889

Follicular

Front 890

Follicular or Papillary thyroid cancer:

LN involvement more common

Back 890

Papillary

Front 891

Follicular or Papillary thyroid cancer:

Hurthle cells

Back 891

BOTH

Front 892

What dz:

Hurthle cell

Back 892

Thyroid cancer (papp or follicular)

Front 893

DKA: how affect:

-serum K
-total body K

Back 893

H+ --> shift --> INCREASE serum K

GI loss/osm diuresis --> DECREASE total body K

Front 894

DKA: once give insulin --> increase or decrease serum K? initiate what tx?

Back 894

K shifts back into cells --> rapid decrease (beware)

Initiate K+ once serum K+ <4.5

Front 895

MG: how affect sens? reflexes?

Back 895

affects motor only

intact sens, reflex

Front 896

Syringomyelia: what SC syndrome?

Back 896

Central cord synd

(decrease motor & pain-temp in UE)

Front 897

Arnold-Chiari: what SC synd?

Back 897

Central cord synd

(sim syringomyelia)

Front 898

Herpes ophthalmicus or keratitis:

Skin rash

Back 898

Ophth

Front 899

RTC tear: what muscle most commonly torn?

Back 899

Supraspinat

2/2 repeated isch at insertion on humerus

Front 900

What dz:

Unable to abduct shoulder >90'

Back 900

RTC tear

Front 901

What nerve:

SERRATUS ANTERIOR

Back 901

Long thoracic

(Long serrated knife)

Front 902

Long thoracic n: what muscle?

Back 902

Serratus Anterior

(long serrated knife)

Front 903

What nerve injury?:

Winged scapula

Back 903

long thoracic n (serratus ant)

RLND

Front 904

Breast ca RLND:

-injure what nerve?
-what muscle?
-what classic finding?

Back 904

long thoracic n = serratus ant = winged scapula

Front 905

Atlantoaxial instab: what ligament is lax?

Back 905

Post transverse ligament

Front 906

What dz:

Down's synd with behav change, urine incontinence, vertigo/dizzy/diplop & UMN sxs

Back 906

Atlantoaxial instab

Front 907

Neonatal tetanus: hypo or hypertonic?

Back 907

Hyper

Front 908

What dz:

Hypertonic baby s/p umbilical stump infxn

Back 908

Neonatal tetanus

Front 909

Neonatal tetanus: #1 & #2 deaths

Back 909

1: apnea

2: septic

Front 910

#1 thyroid malig

Back 910

Papillary ca

Front 911

What thyroid cancer:

Psammoma bodies

Back 911

PAPILLARY

Front 912

What thyroid cancer:

Large cells w/ground glass cyto + pale nuclei + central grooving

Back 912

Papillary

(psammoma bodies)

Front 913

Papillary thyroid cancer with mets: good or bad ppx?

Back 913

GOOD (even w/mets)

Front 914

Social phobia: tx what med class?

Back 914

SSRI

Front 915

NMS: more common a/typical?

Back 915

Typical

Front 916

NMS: sxs w/in how long after initiate med?

Back 916

2w

Front 917

Acute mediastinitis: #1 risk

Back 917

Cardiac surg (intraop contamin)

Front 918

What dz:

Cardiac surg --> (14d) fever + tachy + CP + purulent drain

Back 918

Acute mediastinitis

Front 919

Acute mediastinitis: how tx?

Back 919

SURG + abx

Front 920

PCP PNA: how tx? (2)

Back 920

IV Bactrim + po pred

Front 921

What dz:

CD4 <200 + fever + dry cough + exertional dysp

Back 921

PCP PNA

Front 922

Malig HTN: dx reqs what finding?

Back 922

Papilledema

Front 923

Malign HTN: what histologic finding is responsible for end-organ damage?

Back 923

Fibrinoid necrosis of small arterioles

Front 924

DM gastroparesis: see post-meal hypo or hypergly?

Back 924

HYPO

(insulin has been injected BUT slow to absorb food)

Front 925

DM gastroparesis: how dx?

Back 925

Radionuclide scintigraphy

(radiolabeled meal)

Front 926

DM gastroparesis:

Can tx w/what abx?

Back 926

Erythro (stims motilin-R)

Front 927

DM: txs what complication?:

Metocloperamide

Back 927

DM gastroparesis

Front 928

DM: txs what complication?:

Bethanecol

Back 928

DM gastroparesis

Front 929

What dz:

Boy w/increased ICP + bitemp hemiano + calcified suprasellar

Back 929

Craniopharyngioma

Front 930

Craniopharyngioma: what type of cells nested in stroma?

Back 930

Squam cells

Front 931

Craniopharyngioma:

-p/w what visual disturb?
-calcified?
-how tx?

Back 931

Bitemp hemiano (sim pit)

Calcified suprasellar

resect

Front 932

What dz:

Concentric whorls + calcified psammoma bodies

Back 932

Meningioma

Front 933

What heart murmur:

Wide pulse pressure

Back 933

Ao regug

(water hammer)

Front 934

What heart murmur:

Sensation of pounding heartbeat (increases when lie on L side)

Back 934

Ao regurg

Front 935

Ao regurg: #1 etio:

-US
-world

Back 935

US: Ao root dilation, bicupsid AV

World: rheum HD

Front 936

What heart murmur:

Weak & late

Back 936

ao sten

Front 937

Zinc: essential or prod by body?

Back 937

Essential: animal protein, whole grain, bean

Front 938

Zinc: where abs?

Back 938

jejunum

Front 939

Zinc def: what 2 med conditions?

Back 939

IBD
TPN (some lacks zinc)

Front 940

What vitamin def:

Abnormal taste (everything tastes bad), alopecia, mouth pustules

Back 940

zinc

Front 941

If active HSV lesions at L&D --> next step?

Back 941

Emerg C/S

(NOT SVD w/ACV)

Front 942

What complication:

Pt with MI + ACUTE MR + holosyst murmur + LH failure

Back 942

Papillary muscle dysfxn

Front 943

Fibromyalgia: affected by exercise?

Back 943

Worsens

(contrast seroneg spondyl: improves w/exercise)

Front 944

Seroneg spondaryth: affect ESR?

Back 944

Increases

(contrast fibromyalgia: normal labs)

Front 945

Preg fem w/fetus in distress: does mother have right to deny C/S?

Back 945

Yes

Front 946

VUR: dx via what imaging? (2)

Back 946

Void cystourethro
OR
Radionuclide cystogram

(NOT U/S)

Front 947

HTN in preg: 1st line med

Back 947

Methyldopa

Front 948

Methyldopa: what CLASS in preg?

Back 948

B!

(although 1st line anti-HTN)

Front 949

What is next step in w/u:

Painless hematuria in adult

Back 949

Assume GU malig: perform both:

1. Con CT or IVP (assess upper)
2. Endoscopic eval of bladder

Front 950

AD PCKD: affect risk of:

-renal infection?
-stones?
-RCC?

Back 950

Increase all

Front 951

Guillan-Barre: how long after URI/gastroent?

Back 951

3-4w

Front 952

What dz:

CSF with increased protien but normal cell count

Back 952

Guillan-Barre

Front 953

What dz:

Albumino-cyto dissoc

Back 953

Guillan-Barre

Front 954

Guillan-Barre: how tx?

Back 954

IVIg + plasmaphar

NOT STEROIDS

Front 955

Toxo: reactivates when CD4 <___?

Back 955

<100

Front 956

Toxo: screen for Abs in ALL HIV pts?

Back 956

YES -- if positive --> prevent reactiv with ppx Bactrim

Front 957

Toxo: how tx?

Back 957

Bactrim

Front 958

HIV: initiate MAC ppx if CD4 <___

Back 958

<50

Front 959

What drug:

MAC ppx

Back 959

Azithro

Front 960

PID: screen for HCV?

Back 960

No - screen for HBV

Only screen HCV if h/o IVDU

Front 961

#1 atypical PNA in ambulatory setting

Back 961

Mycoplasma pneum

Front 962

Mycoplasma pneum: assoc w/what skin finding?

Back 962

E multiforme

Front 963

Mycoplasma pneum: how appear on G stain?

Back 963

No cell wall --> no appear on G stain

Front 964

Dissem gonorrh: mono or poly arth? migrat?

Back 964

Poly, migratory

Front 965

Psoas abscess: tx w/surg?

Back 965

NO --- increase m&m

abx, IVF, CT-guided drain

Front 966

What type of RTA:

Fail secrete H+

Back 966

I

Front 967

Type I RTA: alka or acidic urine?

Back 967

Alka

(fail to secrete H+)

Front 968

Type I RTA: more common child or adult?

Back 968

Child

Front 969

What type of RTA:

Decrease bicarb reabs

Back 969

2

Front 970

What type of RTA:

Fanconi syndrome

Back 970

2

Front 971

What type of RTA:

Defect Na+/K exchange in DT

Back 971

4

Front 972

What type of RTA:

HyperK, hyperCl acidosis

Back 972

4

Front 973

#1 inj knee ligament

Back 973

MCL

Front 974

What knee inj:

2/2 forceful abduction & torsion

Back 974

MCL

Front 975

What knee inj:

Dx valgus stress test

Back 975

McL

Front 976

MCL tear: how tx?

Back 976

Brace & early amb

Front 977

What dz:

Mutate type I collagen

Back 977

Osteogen imperfect

Front 978

Osteogenesis imperfecta: what protein mutated?

Back 978

Type I collagen

Front 979

A/typicals:

S/E tardive dyskinesia

Back 979

Typical

Also RISPERIDONE (atypical)

Front 980

Which atypical is most likely to produce tardive dyskinesia?

Back 980

Risperidone

Front 981

Which antipsychotic is least likely to produce tardive dyskinesia?

Back 981

Clozapine

Front 982

#1 source blood in hemothorax?

Back 982

Ao

Front 983

#1 bacterial pharyngitis

Back 983

Strep pharyngitis (GAS)

Front 984

Strep pharyngitis:

-LAD?
-tonsil exudate?

Back 984

Painful bilat LAD

Tonsil exud

Front 985

Strep pharyngitis:

How tx?

Back 985

PCN (decrease risk rheum fever)

Front 986

Hemochromatosis & cirrhosis: increase risk infection with what 3 pathogens?

Back 986

Listeria
Yersinia
Vibrio vulnificus

Front 987

Allergic rhinitis & PND: tx w/what med class?

Back 987

H1-R blocker

(chlorpheniramine)

Front 988

Chlorpheniramine: what drug class?

Back 988

H1-R blocker (tx allerg rhinitis, PND)

Front 989

What dz:

URI --> (few days) --> gross hematuria

Back 989

IgA nephropathy

Front 990

#1 glomerulonephritis in adult

Back 990

IgA nephropathy

Front 991

IgA nephropathy: how affect complement level?

Back 991

normal

Front 992

IgA nephropathy or Post-infectious glomerulonephritis?:

Few days s/p URI

Back 992

IgA

Front 993

IgA nephropathy or Post-infectious glomerulonephritis?:

10d after pharyngitis OR 20d after impetigo

Back 993

Post-infxn

Front 994

IgA nephropathy or Post-infectious glomerulonephritis?:

Low complement

Back 994

Post-infectious

Front 995

What dz:

Sore throat --> (2d) --> sandpaper blanching rash (starts neck & generalizes) + gray exudate throat + strawberry tongue

Back 995

Scarlet Fever

Front 996

Scarlet Fever:

-how long after sore throat?
-does rash blanch?

Back 996

2d s/p sore throat

Rash blanches

Front 997

Scarlet Fever: how tx?

Back 997

Pen V

Front 998

CF: what abx to tx lung infection?

Back 998

IV gent & CTX

Front 999

A/typical: olanzapine

Back 999

Atypical

Front 1000

Olanzapine: main S/E

Back 1000

wt gain (important)

Front 1001

What antipsychotic:

S/E wt gain

Back 1001

olanzapine

Front 1002

#1 etiology of increased MS AFP

Back 1002

Mis-dated

Front 1003

Chronic pancreatitis: how affect amy & lipase?

Back 1003

often normal

Front 1004

Chronic esterase: best test to dx?

Back 1004

Stool esterase (most sens & spec)

Front 1005

Dx what dz?:

Stool esterase

Back 1005

Chronic panc

Front 1006

Niacin: high- or low-dose to increase HDL?

Back 1006

HIGH

Front 1007

Niacin:

-does flushing improve?
-how prevent?

Back 1007

Flushing improves after 2-4w

Prevent via pre-tx ASA 30 minutes

Front 1008

What dz:

Abd distens + flatulence + CHF + migratory polyarth + dementia

Back 1008

Whipples dz

Front 1009

What dz:

PAS positive lamina propria

Back 1009

Whipples dz

Front 1010

Isoniazid w/out pyridox: what cell count abn?

Back 1010

Micro hypochromo anemia (sim IDA)

Front 1011

S/E what med?:

Dimorphic RBC pop: hypo- & normochromic

Back 1011

Isoniazid (w/out pyridox)

Front 1012

Isoniazid-anemia or IDA:

Increased serum Fe, decreased TIBC

Back 1012

Isoniazid

Front 1013

Hemochromatosis: see dilated or restrictive cardiomyopathy?

Back 1013

Either

Front 1014

Hemochromatosis: hyperpig 2/2 deposit what proteins?

Back 1014

Melanin + hemosiderin

Front 1015

Mitral stenosis:

-presents what age?
-#1 etio
-predisp what arryth?

Back 1015

30-50
Rheum hd
A-Fib

Front 1016

What heart murmur:

30-50yo with dysnea, pulm edema (worse w/exercise, preg)

Back 1016

mitral stenosis

Front 1017

What heart murmur:

Elevate L mainstem broncus

Back 1017

Mitral stenosis

Front 1018

Nocardia: how tx?

Back 1018

bactrim

Front 1019

What pathogen:

Gram +, weakly acid fast, filamentous branching rod

Back 1019

Nocardia

Front 1020

What type of delusion:

-special powers & mission from God
-one's thoughts control events

Back 1020

Grandiose

Magical thinking

Front 1021

What dz:

Adult with long bone bowing & fxs --> hip/knee arthritis

Back 1021

Pagets

Front 1022

If suspect EBV infect mono but heterophile negative --> next dx step?

Back 1022

repeat heterophile later

(negative early)

Front 1023

What vulva dz:

White polygonal patches; cigarette paper

Back 1023

Lichen sclerosis

Front 1024

Lichen sclerosis: predisp what cancer?

Back 1024

vulvar scc

Front 1025

Lichen sclerosis: how tx?

Back 1025

HIGH-potency topical steroid

Front 1026

What dz:

Neonate chokes + regurges + coughes during 1st feed

Back 1026

Esoph atresia

Front 1027

What dz:

Smoker w/small vol hemopt & chronic prod cough

Back 1027

Chronic bronchitis

Front 1028

Lost to f/u --> increase what bias?

Back 1028

Selection bias

Front 1029

Polycythemia vera: de/increase EPO?

Back 1029

Decrease EPO (compens)

Front 1030

P vera: increase risk what GI dz? what joint dz?

Back 1030

PUD

Gout

Front 1031

P vera: how tx?

Back 1031

Phlebotomy hct <45%

Front 1032

#1 extracranial pedi tumor

Back 1032

neuroblastoma

Front 1033

Neuroblastoma: presents what age?

Back 1033

2yo

Front 1034

Pedi neuroblastoma: arises what 2 extracranial locations?

Back 1034

1. Adrenal
2. Retroperitoneal ganglia

Front 1035

What dz:

2yo with adrenal mass with CALCIFIC & HEMORRH

Back 1035

Neuroblastoma

Front 1036

Pedi neuroblastoma:

-common mets?
-what urine tests?
-p/w catechol sxs?

Back 1036

70% have mets at dx (long bone, liver, LN)

Increase serum & urine MVA, HVA

NOT p/w catechol sxs (contrast pheo)

Front 1037

What dz:

2yo w/increased urine HVA, MVA

Back 1037

Neuroblastoma

Front 1038

Wilm's tumor: arises what embryo later?

Back 1038

Metanephros

Front 1039

CAH: in/decrease 17-alpha hydroxyprogesterone?

Back 1039

Increase

Front 1040

CAH: how affect Na? K?

Back 1040

Decreased production of mineralo/glucocorticoids -->

HypoNa
Hyperk

Front 1041

What dz:

Neonate with ambig genitalia & salt-wasting

Back 1041

Severe CAH (complete defs mineralo/glucocorticoids)

Front 1042

CAH: what dx test?

Back 1042

ACTH stim test

Front 1043

Esoph perf: 1st dx test to order

Back 1043

H2O-con esophagram

(NOT EGD)

Front 1044

Allergic conjunctivits vs. Atopic keratoconjunctivitis:

Thick mucus

Back 1044

Atopic keratoconjunct

Front 1045

Allergic conjunctivits vs. Atopic keratoconjunctivitis:

Photophobia, blurry vision

Back 1045

Atpoic keratoconjunc

Front 1046

What dz:

Obstruct nasolacrimal duct --> infect lacrimal sac --> pain, red, swell

Back 1046

Dacrocystitis

Front 1047

Dacrocystitis: obstruct what structure?

Back 1047

Nasolacrimal duct (infect lacrimal sac)

Front 1048

What antipsychotic:

S/E agranulo, decrease sz threshold

Back 1048

Clozapine

Front 1049

What antipsychotic:

S/E pigmentary retinopathy

Back 1049

Thioridazine

Front 1050

What antipsychotic:

S/E cataracts

Back 1050

Quetiapine

Front 1051

Premature ovarian failure: see in/decrease:

-LH
-FSH
-what is FSH:LH ratio?

Back 1051

compens increase both LH & FSH

FSH:LH >1

Front 1052

Meckle's: fail obliterate what structure?

Back 1052

Vitelline

Front 1053

How dx:

Gastric mucosa in Meckel's

Back 1053

technetium-99 pertechnate

Front 1054

Technetium-99 pertechnate: dx what dz?

Back 1054

Meckel's w/gastric tissue

Front 1055

Most sensitive lab measure to assess dehydration?

Back 1055

ratio BUN:Cr

Front 1056

Increase risk pancreas cancer?:

-DM
-EtOH
-Gallstones
-Smoke

Back 1056

Increase risk: DM, Smoke

NOT: ETOH, GALLSTONES

Front 1057

Goats milk: what vitamin def?

Back 1057

Folic acid def

Front 1058

NF-2: oncogene or TSG? what chromo?

Back 1058

TSG on chromo 22

Front 1059

What genetic dz:

TSG on chromo 22

Back 1059

NF-2

Front 1060

NF-2 variants: which more severe:

-Nonsense mutation (Wishert) or Gardner (missense/splice)

Back 1060

nonsense (Wishert)

Front 1061

Order WHICH cardiac enz:

Pt s/p MI re-presents with CP

Back 1061

CK-MB (decreases the fastest)

Front 1062

Which cardiac enz:

Most sens & specific to MI

Back 1062

Trop T

Front 1063

Which cardiac enz:

Takes 10d to normalize

Back 1063

Trop T

Front 1064

IV heroin: S/E vasospasm?

Back 1064

No

Front 1065

How tx:

Septic emboli

Back 1065

Abx

(not fibrinolytic)

Front 1066

How tx:

Nodulocystic acne

Back 1066

po isoretinoin

Front 1067

If suspect Ao dissection --> order what dx test?

Back 1067

TEE

(not arteriogram)

CONTROL BP FIRST

Front 1068

What dz:

Increase urine hydroxyproline, telopeptide

Back 1068

Pagets dz

Front 1069

Open or Closed angle glaucoma:

More common AfAm

Back 1069

Open

Front 1070

Open or Closed angle glaucoma:

Optic cupping + decreased periph vision

Back 1070

open

Front 1071

Open angle glauc: lose periph or central vision?

Back 1071

Periph --> tunnel vision

Front 1072

Open angle glaucoma: tx what med? surg?

Back 1072

Beta-blocker --> laser trabeculo

Front 1073

#1 acq blindness US

Back 1073

DM retinopathy

Front 1074

DM retinopathy: how present:

-early
-late

Back 1074

Early: asympto

Late: decrease night vision, curtain, floaters

Front 1075

What dz:

Decrease central vision first

Back 1075

Macular degen

Front 1076

What dz:

CXR thumbprint sign; obliterate vallecula

Back 1076

Epiglottitis

Front 1077

AVN hip: what dx imaging?

Back 1077

MRI

(normal XR)

Front 1078

What part of bladder:

Covered by peritoneum --> refers pain to shoulder

Back 1078

DOME

Front 1079

What part of bladder: most likely to rupture?

Back 1079

Dome

Front 1080

Dermatis herpetaformis: flexors or extensors?

Back 1080

Extensors

Front 1081

Dermatis herpetaformis: tx what med?

Back 1081

DAPSONE

Front 1082

Dapsone: txs what skin dz?

Back 1082

dermatis herpetaformis (celiac sprue)

Front 1083

Scabies: how tx?

Back 1083

1% lindane

Front 1084

Another name for:

Helmet cells

Back 1084

Schistocytes (fragmented RBCs)

Front 1085

Shistocytes: assoc w/increased or decreased haptoglobin?

Back 1085

2/2 valve dz or DIC/ttp/HUS

Shistos (fragmented RBCs) --> increase free hgb --> DECREASE HAPTOGLOBIN

Front 1086

Name for:

CPPD crystals

Back 1086

Pseudogout

Front 1087

#1 site pseudogout

Back 1087

Knee

Front 1088

Pseudogout:

-what shape crystals?
-neg or pos?

Back 1088

Rhomboid, pos

Front 1089

Pseudogout: what joint comp?

-if tap joint --> what CBC findigns?

Back 1089

Chondrocalcinosis

See LEFT SHIFT (tricky; resembles infxn)

Front 1090

Heparin: binds what protein? in/decreases activity?

Back 1090

Binds AT-III --> INCREASES activity --> prevent thrombus formation

Front 1091

What dz:

Reid-Sternberg cells

Back 1091

Hodgkins

Front 1092

#1 intervention to decrease SBP

Back 1092

Wt loss


#2: phys activity
(not smoking)

Front 1093

WPW: predisp what arryth?

Back 1093

a-fib

Front 1094

WPW: admin what med to convert to NSR?

Back 1094

Procainamide

Front 1095

WPW: admin beta-blocker? CEB? dig? adeno?

Back 1095

NO - all block AV node --> predisp WPW to V-fib

Front 1096

GSW: below what level --> assume intra-abd?

Back 1096

Below ICS 4

Front 1097

Preg: how dx renal stone?

Back 1097

U/S

NOT VP, CT, litho

Front 1098

What dz: Child with micro anemia and:

-normal RDW
-RDW >20%

Back 1098

normal RDW: thal

RDW >20%: IDA

Front 1099

GERD w/u:

1st step --> 2nd step

Back 1099

EGD --> 24hr pH (if EGD neg)

Front 1100

Hypothyroid: if start ERT --> in/decrease dose Synthroid?

Back 1100

ERT stims P450 metab --> req INCREASED DOSE Synthroid

Front 1101

Preg: increase or decrease req dose of Synthroid?

Back 1101

increase

(meas TSH q4-6w)

Front 1102

#1 PNA in HIV

Back 1102

Strep pneumo

Front 1103

What HIV PNA:

dry cough, dysp, bilateral diffuse infiltrates w/out effusoin

Back 1103

Pcp

Front 1104

#1 risk native valve endocarditis

Back 1104

mvp (not Rheum HD)

Front 1105

Which valve:

Endocard --> SPLINTER HEMMS

Back 1105

MV

Front 1106

IUGR: most sensitive U/S measure? (which part of body)

Back 1106

Abdom circum

(NOT head)

Front 1107

Warfarin: risk hypercoag if what underlying dz?

Back 1107

protein C def

Front 1108

Mongolian spot: melanocytes in what layer?

Back 1108

Dermis

Front 1109

What dz:

Parkinsonism + ED + ortho hypoT

Back 1109

Multisystem Atrophy (Shy-Drager)

Front 1110

Multisystem Atrophy (Shy-Drager):

-how present?
-how tx?

Back 1110

PD + ANS dysfxn (ED, ortho hypoT) + widespread neuro sx

NO tx pd drugs
Give fludrocortisone

Front 1111

Familial dysautonomia: how inh? what population?

Back 1111

AR; Ashkenazi; ANS dysfxn

Front 1112

What dz:

B-glucosidase

Back 1112

Gaucher

Front 1113

What dz:

Erlenmeyer flask femur; BM shows wrinkled paper cells

Back 1113

Gaucher

Front 1114

Gaucher: present child or adol?

Back 1114

adol

Front 1115

MI: which better outcome:

PCTA or fibrinolytic

Back 1115

PCTA

Front 1116

What murmur:

Narrow pulse pressure

Back 1116

Ao sten

Front 1117

What dz:

Chronic granuloma of Meibomian gland

Back 1117

Chalazion

Front 1118

Episcleritis: eye pain?

Back 1118

Pain, photophobia, watry eye

Front 1119

SLE: req renal bx?

Back 1119

RENAL BX ALL PATIENTS (determine tx)

*BX even before start tx!

Front 1120

SBP: req PMN > ___

Back 1120

>250

Front 1121

#1 H/N cancer

Back 1121

SCC (hard unilat non-tender ln)

Front 1122

What dz:

IgG & C3 linear at hemidesmo BM

Back 1122

Bullous pemphigoid

Front 1123

What dz:

Abs against demogleins

Back 1123

Pemphigus vulgaris

Front 1124

CD: in/decrease abs oxalate?

Back 1124

increase --> oxalate kidney stones

Front 1125

What dz:

Delete 5p

Back 1125

Cri-du-chat

Front 1126

Suspect what dz:

back pain & hypoT s/p cardiac cath

Back 1126

Retroperitoneal bleed --> order abd CT w/out contrast

Front 1127

What dz:

FAP/HPNCC + brain tumor (GBM, medulloblastoma)

Back 1127

Turcot syndrome

Front 1128

Turcot syndrome: what 2 tumor types

Back 1128

HPNCC/FAP + brain GBM/medulloblastoma

Front 1129

What dz:

Colon polyps + desmoid tumors + epidermal cysts + MANDIBLE OSTEOMA + supernumerary teeth

Back 1129

Gardner's

Front 1130

What dz:

Bite cells, Heinz bodies

Back 1130

G6PD

hgb denatures --> Heinz --> disrupts RBC membrane

Front 1131

What dz:

hgb denatures --> Heinz --> disrupts RBC membrane

Back 1131

G6PD

Front 1132

RA:

-avg age onset
-increase risk what bone dz?

Back 1132

30-50yo

Increase OP

Front 1133

What dz:

Sticking in throat + absent peristal lower 2/3 esoph

Back 1133

Scleroderma

Front 1134

DJD: pain limits ACTIVE or PASSIVE ROM?

Back 1134

both

Front 1135

Meralgia paresthetica: compress what nerve?

Back 1135

Lat fem cutaneous

Front 1136

What dz:

2/2 friction b/w gluteus medius & tensor fascia lata

Back 1136

Trochanteric bursitis

Front 1137

Trochanteric bursitis: friction b/w what 2 structures?

Back 1137

Glut med + TFL

Front 1138

Pain worse w/palpation?:

-Hip OA
-Meralgia parasthetica
-Trochanteric bursitis

Back 1138

Hip OA, meralg: not affected by palp

Trochanteric: pain worse w/palp (worse w/sleep)

Front 1139

What dz:

Decrease color vision

Back 1139

Optic neuritis

Front 1140

What dz:

Eye pain/red/blurry + prelimbal injection + keratic precipitates

Back 1140

Ant uveitis

Front 1141

What dz:

Gradual decrease periph vision (tunnel vision)

Back 1141

Open angle glaucoma

Front 1142

Open or closed glaucoma:

Optic cupping

Back 1142

Open

Front 1143

Neutropenic fever:

-what pathogen
-what abx

Back 1143

Pseudomonas

IV ceftax/cefep or mero or imipenem

Front 1144

Beta-thals: responsive to iron?

Back 1144

NO

(contrast ida)

Front 1145

CHF: what lyte abn indicates severe dz?

Back 1145

HypoNa

Front 1146

CHF: in/decrease NE?

Back 1146

Increase renin --> increase NE

Front 1147

What age:

Stranger understands 1/2 speech

Back 1147

2yo

Front 1148

If suspect HCC:

-what is 1st test?
-2nd test?

Back 1148

SERUM AFP --> then CT!

(never ascites fluid - low yield)

Front 1149

Preg: what acid-base abn?

Back 1149

Resp alka

Progest stims resp center

Front 1150

Chronic bronch or ephysema:

Increase pulm marks

Back 1150

Chronic bronch

(emph: decrease vasc marks)

Front 1151

Chronic bronch or ephysema:

Normal DLCO

Back 1151

Chronic bronch

Front 1152

Chronic bronch or ephysema:

Decrease DLco

Back 1152

Emphys (destroy alv)

Front 1153

Emphysema: centriacinar or pan?:

COPD

Back 1153

Centri

Front 1154

Emphysema: centriacinar or pan?:

alpha-antitryp

Back 1154

Pan

Front 1155

What drug class:

Indinavir

Back 1155

protease inh

s/e needle crystals

Front 1156

What etiology?:

HIV pt develops needle crystals in urine

Back 1156

Indinavir (protease inhibitor)

Front 1157

What HIV med: S/E:

Pancreatitis

Back 1157

Didanosine

Front 1158

What HIV med: S/E:

Urine needle crystals

Back 1158

Idinavir

Front 1159

What HIV med: S/E:

Hypersens rxn

Back 1159

Abacavir

Front 1160

NRTI or NNRTI:

S/E lactic acidosis

Back 1160

NRT

Front 1161

NRTI or NNRTI:

S/E SJS

Back 1161

NNRTI

Front 1162

What HIV med: S/E:

Liver failure

Back 1162

nevirapine

Front 1163

S/p MI: discharge with what meds? what if s/p PCI?

Back 1163

ASA
ACEI
Beta-blocker
Statin

If PCI: also add clopidogrel

Front 1164

Clopidogrel: admin how long if:

-bare metal stent
-drug-eluting stent

Back 1164

Bare metal: 30d
Drug: 1yr

Front 1165

ASA sensitivity synd: how tx?

Back 1165

D/C ASA --> initiate leukotriene inhibitor

Front 1166

MCL inj: valgus or varus test?

Back 1166

Valgus

Front 1167

#1 px indicator in breast cancer

Back 1167

TNM stage

(not hormone/her R status)

Front 1168

What type of nephrotic synd:

Assoc obesity, HIV, heroin

Back 1168

Focal segmental glomerulosclerosis

Front 1169

What type of nephrotic synd:

>50% nephrotic synd in AfAms

Back 1169

Focal segmental glomerulosclerosis

Front 1170

What dz:

URI --> hematuria

Back 1170

IgA nephropathy

Front 1171

#1 risk abruption

Back 1171

HTN

Front 1172

Reye's syndrome: how affect:

-PT
-LFTs

Back 1172

Increase all

Front 1173

Reye's: how tx?

Back 1173

Supportive

Front 1174

What dz:

URI --> scrotal swelling + purpura on butt + periph edema + hematuria

Back 1174

HSP

Front 1175

HSP: increases risk what GI dz?

Back 1175

Intuss

Front 1176

HSP: how tx?

Back 1176

Steroids

Front 1177

What congen defect: LITHIUM in:

-TM1
-TM3

Back 1177

TM1: Ebsteins

TM3: goiter, transient neonatal motor dysfxn

Front 1178

What congen defect:

Atrialized RV (small)

Back 1178

Ebsteins (lithium)

2/2 inf & small TV

Front 1179

What dz:

Pt w/abd pain & bloody diarrhea --> (1-2d) --> hemolytic anemia + swollen face + increased Cr

Back 1179

HUS (E coli)

Front 1180

Adol w/dysfxnl uterine bleed: how tx:

-moderate loss but no active bleed
-mod + active

Back 1180

No active: progestin only

Active: high-dose E

Front 1181

Dysfxnl uterine bleed: req bx if what age?

Back 1181

>35yo

Front 1182

What dz:

White reflex in infant (assume what dz)

Back 1182

Retinoblastoma

Front 1183

Retinoblastoma: lwo or high malig?

Back 1183

Highly malig --> mets liver, brain

Front 1184

Retinoblastoma: proto-onco or TSG?

Back 1184

Rb TSG

Front 1185

What dz:

Spheros + Negative Coombs

Back 1185

hered sphero

Front 1186

Hered sphero: pos or neg Coombs?

Back 1186

Neg

Front 1187

What dz:

DX osmotic fragility test

Back 1187

hered sphero

Front 1188

What dz:

Dx via SUGAR WATER TEST

Back 1188

Paroxys noct hemoglobinuria

Front 1189

What type of lung cancer:

Least assoc w/smoking

Back 1189

Adenoca

Front 1190

What type of lung cancer:

#1 type

Back 1190

Adenoca

Front 1191

What type of lung cancer:

Peripheral

Back 1191

Adenoca

Front 1192

Central or periph:

Lung adenoca

Back 1192

Periph

Front 1193

What type of lung cancer:

Columnar cells growing along septa

Back 1193

Adenoca

Front 1194

What type of lung cancer:

2/2 pulmonary scars (e.g. pulm fibrosis)

Back 1194

ADENOca

mets early to bone, adrenal, CNS

Front 1195

#1 malig of eyelid

Back 1195

BCC

Front 1196

What murmur:

Mid-diast rumble at apex

Back 1196

MS

Front 1197

Rheum fever: give all pts <18yo ppx?

Back 1197

PCN

Front 1198

What dz:

New mother + pain on radial wrist

Back 1198

DeQuervain tenosynovitis

Front 1199

What dz:

2/2 holding baby w/thumb outstretched

Back 1199

DeQuervain tenosynovitis

Front 1200

DeQuervain tenosynovitis: tender if palp wrist?

Back 1200

Yes

Front 1201

What dz:

inflamm APL & EPB as pass through fibrous sheath at radial styloid

Back 1201

DeQuervain tenosynovitis

Front 1202

What dz:

Pain palmar aspect of 1st MCP

Back 1202

Trigger thumb

Front 1203

Trigger thumb: pain at what joint?

Back 1203

1st MCP

Front 1204

Chronic hepatitis: best measure of dz severity

Back 1204

BX (not LFTs)

Front 1205

What pathogen:

Bullous impetigo

Back 1205

staph

Front 1206

MM: affect ESR?

Back 1206

Increase

Front 1207

Ca2+ kidney stones: recommended fluid intake

Back 1207

>3L/d

Front 1208

Ca2+ kidney stones:

Tx w/what diuretic?

Back 1208

Thiazide (decrease Ca2+ excretion into urine)

Front 1209

In/decrease Ca2+ excretion into urine:

-thiazide
-furesomide

Back 1209

Thiazide: decrease Ca2+ excret (S/E mild hyperCa)

Furosemide: increase Ca2+ excret

Front 1210

Hairy: B or T?

Back 1210

B

Front 1211

What leukemia:

Fibrotic BM --> dry tap

Back 1211

Hairy (B)

Front 1212

What leukemia:

TRAP

Back 1212

hairy (B)

Front 1213

What infection:

Bloody diarrhea & afebrile

Back 1213

EHEC

Front 1214

What infection:

Shiga toxin

Back 1214

EHEC

Front 1215

Down's: #1 heart defect

Back 1215

Endocardial cushion defect of AV canal

Front 1216

Down's cushion defect: how tx?

Back 1216

Early surg --> prevent pulm HTN

Front 1217

What abx:

S/E sunburn

Back 1217

Tetracycline (esp DOXYCYCLIN)

Front 1218

Fight-bite: what abx?

Back 1218

Amox-clav

Front 1219

Hyperparathyroid: how affect BP?

Back 1219

Hypertension

Front 1220

Renal vein thrombosis:

Assoc what type of nephrotic synd?

Back 1220

Membranous glomerulonephritis

Front 1221

Renal vein thrombosis:

2/2 loss of what protein?

Back 1221

Memb glomerulonephrosis --> lose AT-III --> renal v thrombus

Front 1222

PTU: if pt develops sore throat --> next step?

Back 1222

S/E agranulo

D/C PTU --> check CBC

Front 1223

PTU: are S/E dose dependent?

Back 1223

NO - dose-independent

(contrast methimazole -- dose-dependent)

Front 1224

Next step:

Pt on Coumadin develops back pain

Back 1224

Abd CT (r/o retroperitoneal hemm)

Front 1225

Sjogren: what histo?

Back 1225

Lymphos invade salivary glands --> enlarged, firm

Front 1226

What dz:

-anti-SSA
-anti-SSB

Back 1226

Sjogren's

(both)

Front 1227

What dz:

-anti-Ro
-anti-La

Back 1227

Sjogrens

(both)

Front 1228

Supravent tachy: how does Valsalva/carotid massage break the arryth?

Back 1228

INCREASE vagal tone

Front 1229

Txs what arryth:

Valsalva, carotid, cold immers

Back 1229

Parox Supravent Tachy

-increases vagal tone --> decreases AV condxn

Front 1230

Txs what dz;

Riluzole

Back 1230

ALS

Front 1231

Clubfoot (talipes equinovarus):

-how tx

Back 1231

Tx immed: stretch --> serial cast --. surg & 3-6mos

Front 1232

#1 etio congen hypothyroid:

-US
-World

Back 1232

US: thyroid dysgen

world: endemic goiter

Front 1233

What dz:

Admin X-lyose before & after abx --> no excrete xylose in urine

Back 1233

Celiac dz

(contrast bact overgrowth: excrete s/p abx)

Front 1234

What dz:

Anti-TPO

Back 1234

Hashimoto (90%)

Front 1235

Safe to co-admin Sildenafil & prazosin?

Back 1235

Space 4h apart

Front 1236

#1 tx for DM-induced ED

Back 1236

Sildenafil

Front 1237

HIT-I or -II:

occurs 0-2d s/p initiate

Back 1237

hit-I

Front 1238

HIT-I or -II:

non-immune; hep directly activates platelets

Back 1238

I

Front 1239

HIT-I or -II:

Imm; Abs against hep platelet factor 4

Back 1239

II

Front 1240

HIT-I or -II:

occurs 4-10d s/p initiate hep

Back 1240

HIT-II

Front 1241

What dz:

Anti-desmoglein IgGs in epidermis

Back 1241

Pemphigus vulgaris

Front 1242

Pemphigus vulgaris: how tx?

Back 1242

pred + MTX + azathio

Front 1243

Impetigo: how tx?

Back 1243

Topical mupirocin

Front 1244

EPO admin: leads to what mineral def?

Back 1244

Fe def 2/2 over-rapid RBC prolif

(pre-tx w/suppl Fe2+)

Front 1245

DM neuropathy: how tx?

Back 1245

TCA
Gabapentin
NSAID

Front 1246

Lead poison: what #?:

-remove child from house
-chelate

Back 1246

>10 --> remove house

>45 --> chelate

Front 1247

Celiac dz: affect coag?

Back 1247

Fat malabs --> decreaes vit K --> increase PT

Front 1248

What dz:

IgA anti-gliadin

Back 1248

Celiac

Front 1249

What dz:

Anti-endomysial

Back 1249

Celiac

Front 1250

What dz:

Anti-transglutaminase

Back 1250

Celaic

Front 1251

What dz:

Anti-centromere

Back 1251

CREST

Front 1252

What dz:

Anti-mitochondria

Back 1252

PBC

Front 1253

DKA: admin what type of insulin? what route?

Back 1253

IV regular insulin

Front 1254

Factor V leidin: pro- or anti-coag? Factor V resists what protein?

Back 1254

CLOTS --- DVTs

Resists protein C

Front 1255

Hyperparathyroid: increase what joint dz?

Back 1255

Increase Ca --> increase CPPD --> increase pseudogout

Front 1256

what stone:

Coffin lids

Back 1256

Struvite kidney stone (urease)

Front 1257

LE synd:

-what cancer?
-how tx?
-affect DTRs?

Back 1257

Small cell (oat)

tx: plasmaphar & immunosupp

DECREASE DTRs (contrast MG)

Front 1258

LE or MG:

Normal DTRs

Back 1258

MG

(LE --> decrease DTRs)

Front 1259

What dz:

Osmo fragility test

Back 1259

Hered sphero

Front 1260

What dz:

Jaundiced infant of N European descent

Back 1260

Hered sphero

Front 1261

What dz:

Envelope crystals

Back 1261

Calcium oxalate in ETHYLENE GLYCOL --> RF

Front 1262

What dz:

Snowfield vision & acute pancreatitis

Back 1262

Methanol

Front 1263

Methanol or Ethylene glycol:

Acute pancreatitis

Back 1263

Methanol

Front 1264

RV infarct:

-give nitrates prn pain?
-if see JVD --> admin fluid?

Back 1264

No nitrates (decrease preload)

Always give IVF to increase preload

Front 1265

Septic joint:

-what 2 pathogens?
-heme or contig spread?
-how tx?

Back 1265

Strep & staph aureus

HEME SPREAD

IV abx & immed surg

Front 1266

Thiazide: how affect

-K
-Na
-Ca
-LDL
-TG
-HDL

Back 1266

Decrease K, Na

Increase Ca

Increase LDL, TG

n/a HDL