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1266 Cards in this Set
- Front
- Back
How tx:
-Chlam -Gonorr |
Chlam: 1 dose azithro OR 7d doxy
Gonorr: 1 dose CTX |
|
What CD4 count:
PCP |
<200
|
|
PCP:
-uni/bilat? -dry/wet cought? |
Diffuse bilat
Dry cough |
|
What specific PNA:
O2 saturation inconsistent w/Xray |
PCP PNA
(CD4 <200) |
|
PCP PNA: how tx? (aside from HIV)
|
Bactrim & steroids
|
|
What imaging test:
Aortic dissection |
TEE
(NOT TTE) |
|
Transtuzumab: what S/E?
|
CARDIOTOXICITY
Get a baseline ECHO |
|
Her2/Neu breast cancer: why order ECHO?
|
Transtuzumab is cardiotox
|
|
What cancer?:
Transtuzumab |
Her2/neu breast
|
|
Use what chemo agent:
Her2/neu breast cancer |
Transtuzumab
|
|
What pathogen: acute epididymitis in:
-adol? -elderly? |
Adol: G&C
Elderly: GNR (esp E coli) |
|
Gout prevention:
-Avoid smoke or EtOH? -what diet proteins? -what 2 drugs? |
Avoid:
-EtOH (converts to lactate --> competes w/urate excr) -Purine -Diuretics -Pyrazinamide |
|
Micro/macro/normo anemia:
Multiple myeloma |
Normo Normo
|
|
Mult myeloma: how lead to RF?
|
Paraprotein casts OBSTRUCT DT/CT
|
|
Pancreatitis: induce shock via what pathophysio?
|
Necrosis --> release panc enzs --> INCREASE VASC PERM --> lose plasma into retroperitoneum
|
|
SCFE: what part of growth plate is weak?
|
Physis
|
|
SCFE: how tx?
|
Immed SURG PIN slipped epiphys in situ
(do NOT readjust) |
|
Next step:
>35yo preg & abn nuchal lucency |
CVS (more specific than markers)
|
|
Hepatic encephalo: how tx? (4)
|
Lactulose
Neomycin Rifaximin Laxatives |
|
Menarche: what % cycles in 1st year are anovulatory?
|
90%
|
|
Pedi VUR: M or F?
|
F > M
|
|
Pedi VUR: what image to dx?
|
Voiding cystourethrogram
|
|
What dz:
Increase Alk; normal Ca & Ph |
Paget's
|
|
Paget's: how affect hydroxyproline?
|
Increases
|
|
Paget's dz: once confirm w/labs --> order what images?
|
Full body bone scan --> then focus w/specific XRs
|
|
Paget's: how tx asympto pts?
|
NO TX--- only tx if bone pain, neuro s/sx, CHF or inv wt-bearing bones
|
|
Paget's: how tx sympto pts? (meds & route)
|
PO or IV bisphosphonates
|
|
Rheumatic HD:
-what pathogen? -main valve murmur? |
Strep pyogenes
Mitral stenosis |
|
Suspect what dz:
Foreign preg lady with new-onset A-fib, pulmonary edema |
Rheumatic HD --> mitral stenosis
Presents in preg 2/2 increased blood vol |
|
DEXA: T-scores compares to YOUNGER or SAME age?
|
YOUNGER (same race, gender)
|
|
DEXA scan: what age universal scan?
|
>65yo
(60yo if risk factors) |
|
Angina pt: order what test if exercise stress test not possible?
|
Myocardial perfusion scan
|
|
Myocardial perfusion scan: uses what med? what is action?
|
Dipyridamole --> coronary vasodilator
|
|
Dipyridamole:
-use in what dx test? -mxn of action? |
Myocardial perfusion
Coronary vasodilator --> redistrib blood to non-dz vessels --> angina |
|
What med:
CORONARY STEAL |
Dipyridamole
(utilizes in myocardial perfusion scan) |
|
What age:
1st vision screen |
0-5yo
|
|
What dz:
Hyperparathyroid + peptic ulcer |
MEN1 (PPP: parathyroid, pit, panc)
(see ZES) |
|
What type of study:
Simultaneous measure exposure & outcome (e.g. genotype --> dz?) |
Cross-sectional study (prev)
|
|
Vertebral fxs: can lead to what GI dz?
|
Fxs --> retroperitoneal hemorr --> PARALYIC ILEUS
|
|
What type of study:
Pick pts w/dz --> compares previous exposures (vs non-diseased) |
Case control
(retro) |
|
Immobilization:
-see hyperCa w/in how long? -how affect phosphate? PTH? -how tx? |
HyperCa2+ in few days
NORMAL phosph; DECREASED PTH Tx: bisphosphonates |
|
Rhabdo: how affect Ca level?
|
Muscle releases PHOSPHATE --> binds Ca (excreted) -->
HYPOCALCEMIA |
|
Hypoalbuminemia: how affect Ca?
|
Ca binds alb;
Hyoalb --> HypoCa+ |
|
ESRD: how affect:
-Ca? -Phosp? -PTH? |
Increase phosph
Decrease Ca2+ Increase PTH (to try to increase Ca2+) |
|
Randomization: decreases what bias?
|
CONFOUNDING
|
|
Increase or decrease fremitus?:
-CAP -effusion |
CAP: increase fremitus
Effus: decrease |
|
Psoriatic arthritis: tx w/steroids?
|
NO - relative contraI
Use anti-TNF, MTX |
|
Enteropathic arthritis:
-assoc what dz? -present what joints? -correl w/GI sxs? |
IBD
LEs & sacroiliac Correl w/GI sxs |
|
RA: affects MCP, PIP and/or DIP?
|
MCP & PIP
|
|
What dz:
Child w/syncope (no posictal confusion) + HEARING LOSS + FHx SCD + normal phys exam |
Congenital Long QT synd
|
|
Congenital Long QT synd:
-present as child or adult? -how tx? (class) -predisp what arryth? |
Presents as child w/syncope, bilat hearing loss
Tx: beta-blockers Predisp: Torsades |
|
Bilat nasal polyps: r/o what dz?
|
CF
|
|
What pathogens (2):
Dental-induced endocarditis |
Strep mutans (caries)
Strep sanguis (NOT S bovis) |
|
What is next step:
Isolate strep bovis in blood --> |
Colonoscopy
(S bovis assoc w/CRC) |
|
CRC: assoc with what pathogen (bactermia)?
|
Strep bovis
|
|
What MEDICATION:
S/E bilateral hearing loss |
Furosemide (loop)
(may also have tinnitus) (ir/revers) |
|
What f/u labs:
Olanzapine |
Fasting BG
Lipids (S/E hypergly, hyperchol) |
|
What GB disease:
May lead to GB adenocarcinoma |
Porcelain gallbladder
|
|
Porcelain gallbladder: may lead to what cancer?
|
GB adenoca
|
|
#1 presenting sx in SCD
|
Dactylitis
|
|
What valve disease:
Brief CP at apex |
MVP
|
|
MVP: murmur worsens or improves w/squat?
|
Improves
|
|
Splenectomy: lose what immune fxn?
|
PHAGOCYTOSIS
(inability to opsonize) |
|
What bone: #1 carpal fx
|
Scaphoid
|
|
What fx:
Fall on outstretched hand |
Scaphoid
|
|
What injury:
Tender snuffbox |
Scaphoid fx
|
|
Scaphoid fx: how tx if:
-Non-displaced -Displaced |
Non: immoblize 6-10w
Displaced: Open reduct & fix |
|
Nasopharyngeal cancer:
-Assoc what pathogen? -what ethnicitis? -mets? |
EBV
Asians, Medit Late mets |
|
#1 leukemia 2-10yo
|
ALL
|
|
What dz:
Increase # cells w/PEROXIDASE POS GRANULES |
ALL
(lymphoblasts) |
|
If suspect hyperemesis --> r/o what dz first?
|
GTD
(order a beta quant --> then pelvic U/S) |
|
If suspect GTD: 1st test? 2nd?
|
Beta quant --> then pelvic U/S
|
|
What bHCG see preg:
-TV-US -TA-US |
TV: 1,500
TA: 6,500 |
|
Pinworm: how tx? can you start empiric?
|
Mebendazole
start empirically |
|
Heparin: affect the NUMBER OF PLATELETS?
|
S/E may be DECREASED plts
(Heparin-induced thrombocytopenia = HIT) type I: spont resolve II: form Abs --> art thrombosis |
|
Chemo-induced n/v: what is 1st line med class?
|
5HT antagonist (e.g. ondansetron)
|
|
Toxo: how tx:
-patient -ppx |
Patient: sulfadiazine-pyrimethamine
Ppx: sulfamethoxazole-trimethoprim |
|
How does tuberoinfundibular DA affect PRL release?
|
DA --> inh PRL release
|
|
What dz:
PAS-positive organism in small intestine |
T whipplei
|
|
T whipplei: resides what part of GI tract?
|
SMALL intestine
|
|
What dz:
Chronic steat, abd distension, migratory arth, LAD, low fever |
Whipple's dz
(T whipplei) |
|
Gallstones: #1 imaging test
|
U/S
|
|
Kidney stone: what type of stone?:
Needle-shaped |
Uric acid
|
|
Kidney stone: what shape are URIC ACID stones?
|
Needle
|
|
Kidney stone:
Uric acid opaque or lucent? |
Lucent --> req CT or IV pyelo
|
|
Uric acid kidney stone:
Tx acidify or alkalinize urine |
Alkalinize >6.5
via potassium citrate or bicarb |
|
Kidney stone can induce SBO via what pathophysio mxn?
|
Colic-pain --> vagal rxn --> ileus --> SBO
|
|
Familial hypocalciuric hypercalcemia:
-how affect Ca, Phosph, PTH? -what test to disting from hyperPTH? -how inh? |
Increase PTH, increase Ca, decrease phosph
*LOW URINE Ca2+ (contrast hyperPTH) AD inherit; benign |
|
Pregnancy: how do you evaluate if a cervix is incompetent?
|
TV-US! (gold standard)
|
|
Myocarditis: #1 pediatric etio
|
ENTEROVIRUS
|
|
What dz:
Kid w/flu-like sxs --> new mitral regurg, hepatomegaly --> CHF & pulm edema |
Viral-induced myocarditis
|
|
Myocarditis: what is gold standard dx?
|
Bx
|
|
What dz:
ECHO w/global hypokinesia, LVH, pericardial effusion |
Myocarditis
|
|
How tx:
Frostbite |
Submerge hot water
|
|
Down's synd: assoc w/VSD or PDA?
|
BOTH
|
|
Turner: how prevent gonadoblastoma?
|
Bilat gonadectomy (ppx)
|
|
Next diagnostic test:
Recurrent vasovagal syncope |
Tilt table test
|
|
Tilt Table Test: use in what type of syncope?
|
Recurrent vasovagal
|
|
How tx:
-mild hypoNa -severe |
Mild: H2O restrict
Severe: 3% saline |
|
What specific dz:
Nighttime epigastric pain that resolves w/food |
H pylori duo ulcer
|
|
BNP: how stimulate release?
|
stretch LEFT VENT (e.g. CHF)
|
|
Preg: when test Rh?
|
Initial & 28w
|
|
Prolactinoma: tx what 2 meds?
|
Bromocrip
CABERGOLINE |
|
Cabergoline: what med class?
|
DA agonist
|
|
Metabolic alka: how affect Ca?
|
DECREASES
(binds albumin) |
|
Restless leg: tx w/what med class?
|
DA AGONIST (prampexole) or Levodopa
|
|
DM nephropathy: if protein is present in urine --> what is best way to prevent further renal dz?
|
BP CONTROL
(more effective that glucose control!) |
|
What leukemia:
Decreased leukocyte alkaline phosphatase |
CML
|
|
Polycythemia vera: see EPO in urine?
|
No
|
|
What leukemia:
Tartrate resistant acid phosphatase |
Hairy cell
|
|
#1 stroke risk factor
|
HTN
|
|
HIV w/PPD >5 but negative CXR: next step?
|
Automatic isoniazid + pyridox x 9mos
(even if neg CXR?) |
|
Flash pulm edema 2/2 ant wall MI: how tx?
|
Furosemid
(avoid beta-blocker) |
|
What dz:
Decrease conversion of androgens to E |
Aromatase deficiency
|
|
Aromatase deficiency: decrease what levels?
|
Estrogen levels
(cannot convert androgens --> E) |
|
What dz:
Virilized XX female with normal internal genitals |
Aromatase deficiency
(cannot convert androgens to E) |
|
Cephalohematoma OR caput succedaneum:
Subperiosteal |
Cephalohematoma (no discoloration)
|
|
Cephalohematoma OR caput succedaneum:
Slow --> not notice until hrs after birth |
CPH
|
|
Cephalohematoma OR caput succedaneum:
Diffuse, ecchymotic scalp swelling |
Succedaneum
(CPH is subperiosteal; does not cross suture line and do not see discolor) |
|
Cephalohematoma OR caput succedaneum:
VERTEX |
Caput succed
|
|
Cephalohematoma OR caput succedaneum:
Crosses midline |
Succed
(CPH is subperiosteal & does not cross suture lines) |
|
#1 etio hyperCa+ in:
-ambulatory pts -hosp |
Amb: 1' hyperPTH
Hosp: Malignancy |
|
Hered sphero:
-how inh? -what protein defect? -risk what GI dz? |
AD
Spectrin Gallstones |
|
Hered sphero: ALWAYS supplement what vitamin?
|
Folate
|
|
Hered sphero: how tx?
|
SPLENECTOMY
|
|
Lye esophageal damage:
-give charcoal? -give weak acid? -first step in w/u? |
No charcoal or acid (damage is immed; if you give acid, may cause thermal damage)
1st step: EGD (assess perf) |
|
NORMAL:
-HCO3 -PCO2 |
HCO3: 24
PCO2: 40 |
|
G or C:
-mucopurulent -purulent |
Mucopurulent: Chlam
Purulent: Gonorr |
|
What dz:
Absent tonsils/LN + lymphopenia (no Bs or Ts) + no thymic shadow |
Severe Combined Immunodef
|
|
SCID: see tonsils?
|
NO (absent)
|
|
Organophosphate poison: admin what MED?
|
ATROPINE
also remove clothes & wash (NOT physostig) |
|
Organophosphate poisoin:
-how affect HR? -pupil dilate or constrict? |
BRADYCARD
CONSTRICT |
|
What poisoin:
Bradycardic, miosis, bronchorrhea, saliva, lacrimate, diarrhea, urinate |
Organophophate
(deactivates acetylcholinesterase) |
|
What type of neuro deficit?:
Pronator drift |
UMN
(NOT impaired proprioR) |
|
Bacterial sinusitis: pathogens #1-3
|
#1 Strep Pnuemo
2: non-typ H flu 3: Moraxella |
|
What murmur:
Harsh, holosystolic, lower LSB |
VSD
|
|
#1 congenital HD
|
VSD
|
|
VSD: how tx if:
-small -large |
Small: spont close --> no intervention; just give ppx abx pre-dental
Large: surg close to prevent lower resp infxns, CHF |
|
What med:
Keeps PDA open |
PGE1
|
|
Effect on PDA:
PGE1 |
Keeps open
|
|
What TYPE of shock:
Normal mixed venous O2 concentration |
Septic
|
|
Septic shock: hypo or hyperdynamic? How affect CO?
|
Hyperdynamic --> increase CO
|
|
Septic shock: how affect PCWP?
|
Decreased
|
|
What is next dx test:
Cold leg s/p MI |
ECHOCARDIOGRAM
(r/o LV thrombus) |
|
What dz:
Single, lytic long bone lesion that spontaneously resolves |
Langerhans histiocytosis
|
|
Langerhans histiocytosis: how tx?
|
Spontaneously resolves; sympto tx bone pain
|
|
What PD med:
S/E hallucinations, agitation |
Levodopa
|
|
Levodopa S/E: occur EARLY or LATE?:
-motor fluctations -HA -Hallucinations |
HALLUCINATIONS, HA: EARLY
Motor fluctuations: late |
|
What PD med:
S/E ankle edema, livedo reticularis |
Amantadine
|
|
Admin what ANESTHETIC:
-liver dz -renal dz |
Liver or renal dz: ATRACURIUM (metabolized in plasma)
|
|
What ANESTHETIC:
Metab in plasma |
Atracurium
|
|
Where metabolize?:
-Rocuronium -Pancurium -Atracurium |
Roc: liver
Pan: kidney Atra: plasma |
|
Safe in renal failure?:
Succinycholine |
NO -- hyperK+, apnea
|
|
Succinylcholine: S/E what lyte abn?
|
HyperK+
(not safe in RF) |
|
Suspect what dz:
Precoc puberty boy (severe acne, large testes) |
LATE-ONSET CAH
(more common than XYY; also XYY does not manifest as early puberty) |
|
Medication-induced serum sickness: occurs how long after admin abx?
|
1-2w
(NOT immed) |
|
Med-induced serum sickness:
-see LAD? -considered a true drug allergy? |
LAD
NOT a true allergy |
|
What dz:
Viral URI --> IgA mediated VASCULITIS --> arthralgia, purpura, abd pain, renal dysfxn |
HSP
|
|
HSP:
-what is trigger? -what type of Ig? |
Viral URI
IgA-med vasculitis |
|
TCA O/D: is the DURATION of QRS prolong correl w/risk of arryth
|
yes
|
|
Pancreatic cancer: located BODY/TAIL or HEAD?:
-Jaundice, steatorrhea -Pain & wt loss |
Jaundice: Head
Pain, wt loss: body/tail |
|
Orchitis 2/2 mumps:
-uni/bilat? -infertility common? |
Usu UNILAT
Infertility is rare |
|
Mumps: how tx?
|
Supportive (cold compress)
|
|
Epidural abscess: usu HEME or DIRECT EXTENS?
|
Heme
|
|
If suspect epidural abscess --> next step?
|
EMERGENCY MRI
(NEVER CT) THEN surgery |
|
How tx:
Eneuresis |
Desmopressin (1st) --> imipramine
|
|
HIV needlestick:
-when test serology (sequence) -how many ppx drugs? |
Sero: immed --> 6w --> 3mo --> 6mo
3 ppxs |
|
Clavicle fx: risk what artery? what is next step if audible bruit?
|
Subclavian
Angiogram |
|
1' dysmennorhea: menses pain 2/2 what pathophysio?
|
Increase prostaglandins
|
|
Inevitable abortion: tx of choice
|
Suction curretage
|
|
What pathogen & how tx:
Anaerobic, gram-positive, branching; cervicofacial infections |
Actinomycosis (A isrealli)
High-dose PCN x 6-12w |
|
What dz & how tx:
Yellow sulfur granules draining from pocket in neck |
Actinomycosis
Tx: high-dose PCN x 6-12w (NOT surg debride) |
|
Actinomycosis: how gram stain?
|
Gram-pos, branching, anaerobic
|
|
Chemo-induced anorexia: how tx?
|
PROGESTIN (megestrol, medroxyprogest acetate)
contrast n/v: tx w/5HT blocker NOT SSRI |
|
#1 pulm complication of systemic sclerosis
|
Interstitial fibrosis
|
|
Only DM drug that causes wt loss
|
Metformin
|
|
Myasthenic crisis w/resp distress: how tx? (steps)
|
Intubate --> withhold anticholinesterases a few days & give abx
--> reinitiate anticholn |
|
Next step:
Child w/torticollis |
C-spine XR (r/o trauma)
|
|
If suspect BPH: necessary to order UA, Cr?
|
YEs --> assess renal dysfxn
|
|
Choledochal cyst:
-intra or extra hepatic biliary dilation? -affect panc enzs? -affect cancer risk? |
Intra OR extraheptic
Increase amylase, lipase Increase risk cholangiocarcinoma |
|
What dz:
Mississippi + single lung nodule |
Histoplasmosis
|
|
Prazosin: GU S/e?
|
Priapism
|
|
TPN: pathophysio of S/E gallstones
|
Bypass GI tract --> decrease CCK release --> decrease GB contraction
|
|
Goal FIO2
|
40%
|
|
What dz:
anti-topoisomerase I |
Systemic sclerosis
|
|
Systemic sclerosis:
LH or RH fail? |
Lung fibrosis --> pulm art HTN --> RH failure
|
|
Systemic sclerosis:
Pathophysio of HTN |
renal art sclerosis
|
|
What dz:
Acral edema, flexion contractures; calcinosis cutis; masked facies; RH fail; HTN & GERD |
Systemic sclerosis
|
|
What dz:
Anti-SM Abs |
AI hepatitis
|
|
What dz:
Anti-mito Abs |
PBC
|
|
PBC: what Abs?
|
Anti-mito Abs
|
|
Malnutrition: physio of pitting edema?
|
Hypoalb --> decrease plasma oncotic pressure --> edema
|
|
#1 post-op electrolyte abn
|
HypoCa2+
(2/2 transfusions) |
|
What is etiology:
Post-op --> hyperactive DTRs, cramps, szs |
HypoCa2+ (2/2 transfusions)
|
|
Pyelo: what is next step?:
No respond abx 48-72h |
Renal U/S or CT (r/o abscess, obstruction)
|
|
What sinuses:
-present at birth -develop @ 1yo -develop @ 9yo |
Birth: Maxillary, ethmoid
1yo: sphenoid 9yo: frontal |
|
Acute bacterial sinusitis:
-#1 risk -best abx |
Viral URI
amox + clauv |
|
Suspect what dz:
LBP + low fever + increased ESR |
Vertebral OSTEOMYEL
|
|
Vertebral osteomyelitis:
-how affect ESR?: -what region SC? -heme or direct extens? |
Increased ESR
lumbar HEME |
|
Vertebral osteomyelitis:
-what dx imaging? |
MRI
|
|
#1 risk for variant angina
|
smoking
|
|
Variant angina: how tx? (2) avoid what 2 classes?
|
CEBs, nitrates
AVOID ASA & beta-blocker |
|
What is next step:
Proteinuria in asympto adol boy |
Repeat dip x 2
(ortho proteinuria common) |
|
Ank spond:
-#1 extraartic sx? how present? |
Ant uveitis (40% pts)
Painful monocular blur, photophob |
|
Zenkers: what dx imaging?
|
Barium esophagram
(NOT EGD -- may perf) |
|
Central cord synd: 2/2 flex or extens?
|
Hyperextens in elderly w/cervical degen
|
|
Central cord syndrome: lose what tracts?
|
Spinothalamic (pain, temp)
Corticospinal |
|
What SC dz:
2/2 hyperextension in elderly w/c-spine degen |
Central cord synd
|
|
Necrotizing post-op infxn: how tx?
|
Early debride
|
|
GDM:
-fetal hypo/hypergly? -what fetal lyte abn? -anemia or polycyth? |
Hypogly: maternal BG crosses placenta --> fetus pancreas releases insulin --> hypogly at birth
HYPOCALCEMIA Hypergly --> increase basal metab rate --> hypox --> polycyth |
|
Pseudomonas: tx what abx?
|
Cefepime + pip-tazo
NOT CTX |
|
What organ: #1 site of mets for:
-GI cancer -Lung cancer -Breast cancer |
LIVER (all)
|
|
If multiple liver masses --> order AFP?
|
No - only if solitary (suspect HCC)
Otherwise likely mets |
|
Osteomyelitis: #1 pathogen in infant/child
|
S aureus
|
|
BPAD & renal dz:
What meds? (2) |
VPA, carbamazepine
(NOT lithium) |
|
COPD exacerbation: what step should you always try before intubating?
|
Non-invasive PPV
|
|
What dz:
Abd pain + lower extrem rash + ankle/knee pain + proteinuria |
HSP
|
|
HSP:
-mediated by what type Ig? -follow URI? -How confirm dx? |
IgA
often s/p URI Immunoflu: IgA deposits in skin, renal |
|
What dz:
Linear deposit IgG on BM |
Goodpasture's
|
|
Goodpasture's: deposit what type of Ig on basement memb?
|
IgG
|
|
What dz:
HIV pt w/palate ulcers & hepatomeg |
Histoplasmosis
|
|
Lithium-induced DI: how tx (what med)?
|
AMILORIDE --> decrease Li accum in tubules
also give NS (not free H2O) |
|
What dz:
HA + low fever + periorbital edema |
Cav sinus thrombosis
|
|
Ascites: stepwise approach to LT tx
|
Na, H2O restrict --> SPIRONO --> LOOP (goal 1L/d) --> freq paracent (2-4L/d)
|
|
Cyclophosphamide: S/E what cancer/
|
Baladder cancer
|
|
Cyclophosphamide: affect fertility?
|
S/E sterility
|
|
#1 death in hemodial pt
#1 in renal transplant |
Heart disease (Mi, scd)
BOTH |
|
Alpha-1-antitrypsin def: how present in neonate?
|
NEONATAL HEPATITIS
|
|
Pseudotumor cerebri: need to order CT before therapeutic LP?
|
YES -- r/o mass
LP is safe in pseudotumor |
|
What dz:
Squatting improves cyanosis |
TOF
|
|
PPD: positive if >__:
HIV |
>5cm
|
|
PPD: positive if >__:
TB contact |
>5
|
|
PPD: positive if >__:
Transplant pt |
>5
|
|
PPD: positive if >__:
Immigrant |
>10
|
|
PPD: positive if >__:
IVDU |
>10
|
|
PPD: positive if >__:
Healthworker |
>10
|
|
PPD: positive if >__:
DM, CKD |
>10
|
|
PPD: positive if >__:
<4yo |
>10cm
|
|
PPD: positive if >__:
Healthy |
>15
|
|
What dz:
Defect collagen type I |
Osteogen imperfect
|
|
Osteogen imperfect:
-how inh? -defect what protein? -what lyte abn? |
AD
collagen type I HypoNa+ |
|
What dz:
Anosmia + 1' amenn |
Kallman's
|
|
Kallman's: abn karyotype? how affect GnRH level? FSH/LH?
|
Normal karyo
Decrease GnRH --> decrease FSH, LH |
|
#1 congen aplastic anemia
|
Fanconi's anemia
|
|
Fanconi's anemia: how inh or acq/
|
AR or X-linked
#1 congen aplastic anemia |
|
What dz:
AR/X-linked faulty DNA repair --> chromosomal breaks --> BM fail |
Fanconi's anemia
|
|
Fanconi's anemia:
Underlying genetic mxn |
Impaired DNA repair --> chromo breaks --> BM fail
|
|
Fanconi's anemia:
Micro/normo/macro anemia? |
MAcro
|
|
What dz:
Abn thumbs, hypogonad, hypo/hyperpigmented areas; low set ears, middle ear abns; macrocytic anemia |
Fanconi's anemia
|
|
Name for:
Severe infxn/inflamm --> increase WBC, increase leukocyte alk phosph (LAP) |
leukomoid rxn
|
|
Lyme: how tx if <9yo?
|
AMOX
|
|
What type of ovarian tumor:
Increase E --> precocous puberty & postmeno bleed |
Granulosa cell tumor
|
|
Granulosa cell ovarian tumor: increase what hormone?
|
E
|
|
Another name for:
Measles |
Rubeola
|
|
Another name for:
Rubeola |
Measles
|
|
HIV+: offer PCV to what ages?
|
ALL
|
|
Hemophilia: which more common:
Bruising or hemarth? |
Hemarth (#1 presenting)
|
|
Suspect what etio (pathogen & pathophys):
H/o IVDU --> presents w/pulm infection |
TV septic emboli --> S aureus
|
|
What pathogen:
UTI w/alkaline urine |
Proteus
|
|
Proteus UTI: acidic or alkaline urine?
|
ALKALINE
|
|
How explain?:
Pt appears HYPOthyroid but has ELEVATED T4, T3 |
Resistant to thyroid hormone
|
|
What dz:
Mild increase TSH, normal T4; asympto |
Subclinical hypothyroid
|
|
Subclinical hypothyroid: what lab abns?
|
Increased TSH; normal T4; asympto
|
|
How different (pathophysio):
-Osteomalacia -Osteoporosis |
Osteomalacia (vit D def): decreased Ca & phosph at mineralization sites --> weak bones
OP: normal mineralized but decreased density |
|
What dz:
-abn mineralization --> weak bones -normal mineralization; low bone density |
Abn mineralization: Osteomalacia
Low dens: OP |
|
HIV retinopathy: what fundo finding? (1)
|
Cotton wool (spont remit)
|
|
CMV or HIV retinopathy:
yellow-white opacific; retinal hemorrhages; decreased vision bilat |
CMV
(HIV: only see cotton wool) |
|
Asbestos: #1 lung cancer
|
BRONCHOGENIC CA (plaques, ground class)
NOT mesothelio |
|
Echinococcus: what animal transmits?
|
Sheep, dogs
|
|
What dz:
Hydatid cysts w/daughters |
Echinococc (sheep, dog)
Liver 60%, lung 25% |
|
Hydatid cysts: 2 most common locations?
|
Liver, lung
Echinococc |
|
Echinococcus: what histo finding?
|
Hydatid cysts
|
|
Nephrotic synd: how affect lipid panel?
|
Hyperlipidemia --> accel athero --> MI, CVA
|
|
CF: how lead to coagulpathy?
|
fat malabs --> decrease K --> decrease 2,7,9,10
|
|
What vitamin def:
Pellagra |
B3 (niacin)
|
|
Another name for:
Vit B3 |
niacin
|
|
Another name for:
Niacin (endog) |
B3
|
|
What dz:
Sunburn-like, tender rash + diarrhea + dementia in child |
Niacin (B3) def --> pellagra
|
|
What murmur:
Valsalva --> decrease preload --> INCREASE murmur |
HCOM
|
|
Nephrotic syndrome: req how much protein in 24h?
|
3g
(contrast severe preeclamp: 5g) |
|
HBV-induced nephrotic synd: what variant (histo)?
|
Membranoglomerulo
|
|
Post-op pt: should wait how long before start anti-coagulation?
|
Soon as 48h post-op!
|
|
What murmur:
Pan-systolic at LSB |
VSD
|
|
VSD: what diagnostic study?
|
ECHO w/bubble study
|
|
Supraventricular tachy: narrow or wide QRS?
|
NARROW
|
|
What arryth:
Tx cold H2O submersion, squat |
Supravent tachy (narrow qrs)
|
|
Supravent tachy:
-initial tx? next? -if unstable? |
Cold H2O immers, Valsalva --> ADENOSINE
Unstable: cardiovert |
|
NMS: tx what 2 drugs?
|
Dantro
Bromo |
|
Acute panc: #1 etio:
-M -F |
M: EtOH
F: gallstones |
|
Viral arthritis (parvo, hiV, hep, MMR):
-mono/poly artic? -a/symm? -resolves in what amt time? -may see what Abs? (false positives) |
Polyart
Symm Resolves 2 mos May see + ANA, RF |
|
Central retinal art or ven occlus:
See cherry red spot |
Central retinal art
|
|
Cherry red spot: may see in what INTOX?
|
Methanol
|
|
Infant colic: must be present how many hrs/d/wk/mo?
|
3hrs/d x 3d/w x 3w/m
|
|
Infant colic: resolve what age?
|
4mo
|
|
What dz:
Neonate >2d with vessicles surrounded by red halo; self-limited & benign |
Erythema toxicum
|
|
Erythema toxicum: presents what age/ how tx?
|
>2d
Benign; self-resolves |
|
What dz:
Neonate w/pustules --> EOSINOS in pustules |
Erythema toxicum
(diagnostic) |
|
Erythema toxicum: pustules contain what cell type?
|
eosinos
|
|
What dz:
Infant w/small pearly white cysts on skin |
Milia
|
|
What congenital dz:
Togavirus |
Rubella
|
|
Congenital rubella: highest risk in what weeks of preg? 1' infxn or reactivation?
|
0-4weeks preg
Only fetal risk if PRIMARY maternal infection |
|
What congenital dz:
IUGR + deaf + PDA/ASD + cataracts + microopthal + low plts + blueberry rash |
Rubella
|
|
ZES: fasting gastrin >____ is diagnostic
|
>1,000
|
|
ZES: w/u:
-when perform secretin stim test |
Only perform if fasting gastrin is non-diagnostic
|
|
Dermatomyo: M or F? what Ab? what % have underlying malig & which malig most common?
|
6x F > M
anti-Mi-2 (against helicase) 10% malig: OVARIAN, breast, lung |
|
What dz:
Anti-Mi-2 (anti-helicase) |
Dermatomyo
|
|
Tarsal tunnel synd:
-compress what nerve? -where is numbness? where radiate? |
Compress TIBIAL n --> numb/burning plantar toes --> radiates up calf
|
|
What dz:
Compress TIBIAL n --> numb/burning plantar toes --> radiates up calf |
Tarsal tunnel synd
|
|
What dz:
Aka congenital hypoplastic anemia |
Diamond-Blackfen synd
|
|
What dz:
Neonate with macrocytic anemia (w/out hypersegmented PMNs) + low retics + webbed neck/shield/cleft lip |
Diamond-Blackfen synd
(tricky!) Compared to megaloblastic anemia: no hyperseg |
|
What congen dz:
Intrinsic defect in erythroid precursor --> RBC apoptosis --> macro anemia + congen abns |
Diamond-Blackfen synd
|
|
Diamond-Blackfen synd: what is underlying pathophysio?
|
Intrins defect erythroid precursor --> increased RBC apopt
|
|
What dz:
Eczema + low plts + hypogammaglobulinemia |
Wiskott-Aldrich
|
|
Wiskott-Aldrich: how inh?
|
X
|
|
Fanconi anemia: how inh?
|
Ar
|
|
What dz:
8yo with progressive pancyto + cafe-au-lait + horseshoe kidney + absent thumbs |
Fanconi anemia
|
|
Fanconi anemia: see what renal abn?
|
Horseshoe kidney
|
|
What drug:
Blocks breast ER; stimulates endometrial ER |
Tamoxifen
|
|
Tamoxifen: blocks or stims:
-Breast ER -Endomet ER |
Blocks breast, stims endomet
|
|
Tamoxifen: increase risk what cancer?
|
Endometrial
(partial agonist at endomet ER) |
|
Tamoxifen: in/decrease risk OP?
|
Increased risk
(blocks ERs) |
|
HIT: occurs how long after heparin admin? see w/LMWH, enox?
|
5-10d
See with LMWH & enox |
|
HIT:
-how affect PLATELET count? -ven or art thrombi? -how tx/ |
decrease plts
paradoxic ven & art thrombi immed d/c hep --> anticoag w/direct thrombin inhibitor |
|
MCD: #1 what ages? (specific)
|
<16yo
|
|
MCD: how tx?
|
STEROIDS
|
|
What dz:
Corkscrew esoph |
DES
|
|
Diffuse esoph spasm: how tx?
|
Antispasmodic
Psych counsel (spasm assoc w/strong emotion) |
|
DES: LES able to relax?
|
normal relax
|
|
What dz:
No relax LES |
Achalasia
|
|
Achalasia:
What histo findings? |
Hypertrophy inner circ muscle; absent ganglion cells
|
|
What dz:
Birdbeak esoph |
Achalasia
|
|
Achalasia: resembles what other esoph dz?
|
Trypano cruzi!
|
|
Trypano cruzi: resembles what esoph dz?
|
Achalasia
|
|
HBV needlestick: how tx:
-vaccinated -unclear vaccin |
Vaccinated: reassur
Non: HBV IVIG + HBV vaccine series |
|
What dz:
Vaginal adenocarcinoma; T-shaped uterus |
DES-in uteru
|
|
DES in utero: what type of cancer?
|
Vaginal ADENOCA
(NOT SCC) |
|
DES in utero: what effects on male fetus?
|
Micropenis, hypogonad, cryptochord
|
|
Syph: w/u:
Positive Darkfield --> next dx step? |
NONE --- spirochetes in darkfield is dxtic --> next test for other STDs
|
|
Eichonococcus: see single or mult cysts?
|
SINgLE
|
|
What dz:
Hepatic cyst with EGGSHELL CALCIFICATIONS |
Hydatid (Eichonocc) -- dxistic!
|
|
Hydatid cyst: how tx?
|
NO FNA!
Albendazole --> resect |
|
What pathogen:
Cysticercosis |
Taenia solium
|
|
Taenia solium: where find cysts? (2)
|
Brain
Muscle |
|
Simple liver cyst: see Ca2+?
|
No
|
|
LV diastolic dysfxn: how tx:
-pulm edema (dysp): ST, LT -AfAm -what meds increases LT survival? |
Pulm edema:
-ST: NITROGLYCERIN (decreases preload; know this) -LT: Loop AfAm: Hydralazine LT survival: beta-blocker |
|
What dz:
Cystic expansion of 4th ventricle |
Dandy-Walker
|
|
Dandy-Walker: expand which ventricle?
|
4th
|
|
Anterior shoulder dislocation: injure what nerve?
|
Axillary n
|
|
What nerve:
Deltoid, teres minor; upper arm sens |
Axillary n
|
|
Axillary n: assoc w/what bony injury?
|
Ant Shoulder Dislocat
|
|
OCPs: in/decrease risk of:
-breast ca -cervical ca -endometrial ca -ovarian ca |
Increase: breast, cervical
Decrease: endomet, ovarian |
|
OCPs: in/decrease risk of:
-HTN -DM |
Increase both
|
|
Short- or long-acting:
-Alprazolam -Clonazepam |
Alpra: short
Clonaz: long (decreased risk of w/d) |
|
Palpable breast mass: next step:
-<30yo ->30yo |
<30yo: U/S --> needle asp if cyst, core bx if solid
>30yo: mammo + U/S |
|
HIV in preg: #1 intervention to prevent fetal transmit? #2?
|
#1: ziduvidine mom & infant (decrease 70%)
#2: elective C/S (decrease 50%) |
|
Pre-renal or ATN:
BUN:Cr <20:1 |
ATN
|
|
Pre-renal or ATN:
Urine osm 300-350 |
ATN
|
|
Pre-renal or ATN:
FENa >2% |
ATN
|
|
Hypovol shock: leads to what type of ARF?
|
ATN
|
|
What type of CAST:
ATN |
Muddy brown
|
|
What type of CAST:
Glomerulonephritis |
RBC cast
|
|
What type of CAST:
Vasculitis |
RBC cast
|
|
What type of CAST:
Interstit nephritis |
WBC cast
|
|
What type of CAST:
Pyelonephritis |
WBC cast
|
|
What type of CAST:
Nephrotic synd |
Fatty cast
|
|
What type of CAST:
chronic renal fail |
Broad, waxy cast
|
|
What dz:
RBC cast |
Glomerulonephritis or vasculitis
|
|
What dz:
Muddy brown cast |
ATN
|
|
What dz:
Fatty cast |
Nephrotic synd
|
|
What dz:
WBC cast |
Interstit nephritis, pyelo
|
|
What dz:
Broad, waxy cast |
Chronic RF
|
|
Anaphyl shock: SQ or IM epi?
|
IM
|
|
Post-chole pain: how tx if 2/2 sphincter Oddi dysfxn?
|
ERCP sphincterectomy
|
|
BPAD: % risk:
-gen pop -1st deg |
Gen: 1%
FHx: 10% |
|
Next step in work-up:
Hyperlipidemia w/out clear etio |
THYROID FUNCTION
|
|
Next step in work-up:
Unexplained hypoNa |
Thyroid function tests
|
|
Porphyria cutanea tarda:
Assoc what infection? |
HCV
|
|
What dz:
def uroporphyrinogen decarboxylase |
Porphyria cutanea tarda
|
|
What dz:
Painless blisters + fragile skin on dorsal hands + facial hyperpig; triggered by EtOH & OCPs |
Porphyria cutanea tarda
|
|
Porphyria cutanea tarda: 2 triggers?
|
OCPs (discontinue)
ETOH |
|
Porphyria cutanea tarda: are blisters painful or painless?
|
Painful
|
|
Asthma-exacerbated resp dz: what sxs?
|
Asthma; chronic rhinosinusitis w/polyps; bronchospasm
|
|
What syndrome:
Contralat hemiplegia & vib/prop loss; ipsi tongue deviation |
MEDIAL medullary syndrome
|
|
Medial medullary synd: ipsi or contra:
-hemipleg -tongue dev |
Contra hemipleg
Ipsi tongue dev |
|
HSV-1 or -2:
HSV encephalitis |
HSV-1 (90%)
|
|
Fungal mening: CSF glucose normal or decreased?
|
Decreased glucose (contrast viral)
|
|
Give all preg females what vaccine at initial visit?
|
influenza
|
|
What dz:
URI --> (2 weeks) --> s/sx CHF |
Viral myocarditis --> dilated cardiomyopathy
|
|
Viral-induced cardiomyopathy: #1 pathogen
|
Coxsackie B
|
|
Dilated cardiomyopathy 2/2 viral myocarditis: what findings on ECHO?
|
Dilated vents w/diffuse hypokinesis
|
|
#1 etiology of COMMUNICATING hydroceph
(what is pathophysio?) |
SAH --> DESTROY ARACHNOID VILLI --> block CSF abs
(common in premat infants) |
|
Asc cholangitis: abx alone effective in what %? next step?
|
abx --> cure 80%
next: ERCP |
|
GBS: when test in preg?
|
35-37w
(NOT at initial) |
|
If preg has h/o GBS in prior preg --> retest in 2nd preg or ppx abx?
|
ppx abx
|
|
Sunscreen:
-apply how much earlier before expos? -more effective than avoid midday sun? |
15-60 min pre-sun
Less effective |
|
DM: earliest renal abn/
|
Glom hyperfiltration (occurs w/in days of dx) --> leads to glom HTN --> glom damage
|
|
ACEI: decrease DM nephropathy via what mxn?
|
Decrease glom HTN induced by hyperfilt
|
|
Warm agglutins: what type of Ig? how tx?
|
IgG
Tx pred --> splenect if innefective |
|
AI hemolytic anemia assoc w/lymphoprolif disorder: more likely warm or cold agglut?
|
Warm (IgG)
|
|
What subunit is unique to bHCG?
|
beta
|
|
What dz:
Meningococcemia --> adrenal hemorr --> sudden vasomotor collapse & purpura |
Waterhouse-Friderichson
|
|
Waterhouse-Friderichson: what pathogen? what pathology?
|
Meningococcemia --> adrenal hemorrhage --> vasocmotor collapse
|
|
What pathogen:
DM pt w/malig otitis externa |
Pseudomonas
|
|
Sarcoid:
-what lyte abn? |
HyperCa2+
|
|
If see mediastinal adeno on CXR & suspect sarcoid --> next w/u step?
|
BRONCHOSCOPY
|
|
Sarcoid: how tx?
|
Steroids
|
|
How long after URI:
-post-strep glomerulonephritis -IgA nephropathy |
post-strep: 10-20d
IgA: few days |
|
What dz:
Skin infection or URI --> swelling, hematuria, HTN , DECREASED COMPLEMENT |
Post-strep glomerulonephritis
|
|
Post-strep glomerulo: how affect C3 level?
|
DECREASED
(contrast IgA neprhopathy) |
|
IgA nephropathy: how affect complement levels?
|
Normal
(contrast post-strep glomerulo) |
|
What med:
S/E idiosyncratic (not dose-dependent) liver injury that resembles viral hep |
Isoniazid
|
|
Anorexia nervosa: how affect:
-cholesterol -carotene level |
Increase cholesterol
INCREASE carotene |
|
Next step:
Elderly w/unexplained IDA & negative FOBT |
COLO
(could still be GIB despite 1 neg FOBT) |
|
Ventricular remodeling:
-how long after MI? -Dilated or thickened LV? -how prevent (med)? |
wks-mos s/p MI
Dilated LV ACEI |
|
Do all pts w/central precoc puberty require brain MRI?
|
yes
|
|
NASH: underlying cell mxn? see stigmata of liver dz? how defin dx/
|
Fat cells impaired response to insulin --> accum fat
Rarely see stigmata Defin dx req bx |
|
Brady or tachy:
-Prolonged QRS -Prolonged QT |
prolonged QRS: brady
prolonged QT: tachy |
|
Diaph rupture: dx via what study? (2)
|
Barium swallow
CT w/con (NOT CXR) |
|
What dz:
AR-inh degen ant horn cells & CN motor nuclei --> floppy baby |
Werndig-Hoffman
|
|
Werndig-Hoffman: how inh? lose what cells?
|
AR
Degen ant horn cells & CN motor nuclei --> floppy baby |
|
Myotonic congenital myopathy:
-how inh? |
AD
|
|
Congenital hypothyroid: assoc w/what GI abn?
|
Umb hernia
|
|
#1 cause death in MI
|
Isch --> heterogen condxn --> REENTRANT ARRYTH --> V-fib
|
|
Marfan: increase risk what 2 heart abns?
|
1. MVP
2. Ao dissectoin --> AR --> new early dia murmur |
|
What dz:
Marfan pt w/new early dia murmur |
Ao dissction --> Ao regurg
|
|
PPROM: immed 1st step
|
PCN (GBS ppx)
|
|
At what week preg:
-Stop giving steroids for FLM |
32w
|
|
What dz:
PEARLY skin cancer |
BCC
|
|
#1 malignant tumor of eyelid
|
BCC
|
|
#1 non-traumatic etio of SAH (all ages)
|
Aneurysm rupture (not AVM)
|
|
Acute hemolytic transfusion reaction:
-occurs how long after transfusion? -underlying etio? |
w/in 1h
ABO mismatch |
|
What dz:
Transfusion --> fever, DIC, BLEED AT IV SITE |
Acute hemolytic transfusion reaction
|
|
What med class:
Enalapril |
ACEI
|
|
What dz:
sore throat + jaundice/hepatosplenomeg + symm POST cervical LAD + tonsil exudate |
Mononucleosis
|
|
EBV: how does infection --> anemia, thrombocytopenia? (mxn)
|
EBV-induced Abs --> x-react w/RBCs & plts --> AI lyse
|
|
Newly diagnosed cirrhosis: next step?
|
EGD to look for esoph varices
|
|
Esoph varices in newly dx cirrhotic: initial tx?
|
beta-blocker
|
|
DM: goal BP? 1st line antiHTN?
|
130/80
ACEI |
|
DM: #1 CN neuropathy?
|
CN III (down & out)
|
|
Viral meningitis: most due to what 2 viruses?
|
ENTEROVIRUSES: ECHO, Coxsackie
|
|
Viral meningitis: more common infant or child?
|
Infant; decrease w/age
|
|
Anti-D immune globulin: adjust dose or fixed dose?
|
Adjust dose based on event (e.g. abruption reqs higher dose)
|
|
RTC tendintis: do ALL pts have impingement?
|
Yes
|
|
What dz:
Positive NEER test |
Rotator cuff impingement
(abd arm --> pain/guard) |
|
Rotator cuff impingment: improve w/lidocaine?
|
Yes
(contrast tear) |
|
#1 testicular sex cord stromal tumor
|
Leydig
|
|
What testic tumor:
Increase T & E --> decrease FSH & LH |
Leydig
|
|
Leydig cell tumor: in/decrease:
-T -E -FSH, LH |
Increase T & E
Decrease FSH, LH |
|
Testic seminoma: how affect tumor markers?
|
All normal
|
|
What testicular tumor type:
Increase AFP |
Yolk sac (endodermal sinus)
|
|
Yolk sac (endodermal sinus) testicular cancer: increase what tumor marker?
|
AFP
|
|
What testicular tumor type:
Increase bHCG in man |
Choriocarcinoma
|
|
Testicular choriocarcinoma: increase what tumor marker?
|
betaHCG
|
|
Normal:
If hyponatremia --> expect urine Na <___ |
U Na <10
(dilute urine) |
|
What congenital dz:
Cutaneous lesions palms & soles; jaundice; anemia; RHINORRHEA; metaphyseal dystrophy & periostitis (Xray) |
Cong syph
|
|
What dz:
bilat sensorineural hear loss + GROSS HEMATURIA + proteinuria |
Alport's
|
|
What dz:
Alternating thick-thin cap lops w/splitting of glomerular BM |
Alport's
|
|
NPH: increase CSF prod OR decrease abs?
|
Decreased abs
|
|
What dz:
HIV pt w/red, firm exophytic nodule |
Bacillary angiomatosis
|
|
Bacillary angiomatosis:
how tx? |
Erythromycin
|
|
Asympto pt: indication for parathyroidectomy if:
-<___ (what age) -bone mineral dens <___ |
<50yo
<2.5 |
|
Pulsus paradoxus:
Insp --> decrease SBP by what amt? |
>12mm
(see in asthma, tamponade) |
|
Name for:
Asthmatic takes deep insp --> SBP decreases by 15mm |
Pulsus paradoxus
(exagerrated decrease in preload) |
|
Paget's: underlying defect?
|
Bone remodeling
Clast hyperfxn --> blast remodel --> disorganzed woven bone |
|
Hered sphero:
-how inh? -what protein? -most common presenting sx? -what initiates anemia crisis? |
AD
spectrin 40% p/w gallstones B19 --> anemic crisis |
|
Hered sphero: give what suppl? which pts?
|
FOLATE suppl ALL pts (even if normocytic anemia)
|
|
Hered sphero: cure?
|
splenectomy
|
|
Another name for:
1' adrenal failure |
Addison's
|
|
What dz:
Fatigue, constipation, wt loss, HYPERPIGMENT, decreased BP |
1' adrenal failure (addison's)
|
|
1' Adrenal failure: what lyte abns?
|
HypoNa+ (#1), hyperK
|
|
Micro/normo/macro anemia:
Order iron studies |
MICRO
|
|
What dz:
Osler's nodes |
Infective endocard
|
|
What dz:
Adult w/high fever (>39'), non-itchy rash on trunk & face during fever + arthritis |
Adult Still's dz
|
|
PE: see on what % V/Q scans/
|
50%
better test is ct-angio |
|
What dz:
Child w/subglottic narrowing |
Croup
|
|
Croup: #1 pathogen
|
Parainflu
|
|
Hemophilia: what is mxn of joint pain s/p hemearth?
|
Deposit Fe --> fibrosis & synovial thickening
|
|
Neonatal chlamydia PNA:
Presents how long after birth? |
3-20w s/p birth
|
|
Neonatal chlamydia PNA:
-fever? -wheezing? |
no fever or wheezing (contrast RSV)
|
|
Neonatal chlamydia PNA:
-how tx? |
PO erythro x 14d
|
|
What drug O/D:
Anti-hist & anti-cholin effects --> drowsy, dry mouth, dilated pupils, blurry, AUR |
Diphenydramine
|
|
Diphenhydramine O/D: how tx?
|
PHYSOSTIGMINE
|
|
Physostigmine: tx ANTI/CHOLINERGIC O/D?
|
Txs anti-cholinergic O/D
e.g. diphenhydramine o/d |
|
HELLP: how tx if:
-<34w >34w |
<34: dexa + wait until 34
>34: deliver immed |
|
HELLP: immed deliver if what week?
|
>34w
|
|
Steroid-induced acne: see comedones?
|
No
see monomorphic follicular papules |
|
#1 indicator of liver fxn
|
PT
|
|
What dz:
Defective tyrosine kinase --> low CD19 |
Bruton's (XLA)
|
|
Bruton's (XLA): defect what enz? Decrease B and/or T cells?
|
defect tyrosine kinase --> decrease B signal --> low B count
|
|
XLA/Bruton's: resp infxns start what age? tonsils present?
|
Resp infxns 6-18 mos
Absent tonsils |
|
24h urine Ca2+: differentiates what 2 diseases?
|
1' hyperpara: 24h urine >200
Familial hypocalciuric hypercalcemia: <100 |
|
What dz:
Sestamibi scan |
Parathyroid adenoma
|
|
Parathyroid adenoma: localize via what imaging test?
|
Sestamibi scan
|
|
Pseudotumor: what CN palsy?
|
CN VI
|
|
Pseudotumor:
May be 2/2 what med class? (2) |
OCPs
Isoretinoin |
|
Pseudotumor:
Underlying pathophysio |
Decreased arachnoid CSF abs
|
|
Pseudotumor:
#1 complication |
Blindness
|
|
Pseudotumor:
What abns on imaging? |
All imaging normal
|
|
Pseudotumor:
Very 1st tx |
Wt loss --> (then acetazol)
|
|
Meningococcal meningitis:
-how tx contacts/healthcare workers? |
ppx RIFAMPIN or CIPRO
|
|
Pseudotumor: what CN palsy?
|
CN VI
|
|
Pseudotumor:
May be 2/2 what med class? (2) |
OCPs
Isoretinoin |
|
Pseudotumor:
Underlying pathophysio |
Decreased arachnoid CSF abs
|
|
Pseudotumor:
#1 complication |
Blindness
|
|
Pseudotumor:
What abns on imaging? |
All imaging normal
|
|
Pseudotumor:
Very 1st tx |
Wt loss --> (then acetazol)
|
|
Meningococcal meningitis:
-how tx contacts/healthcare workers? |
ppx RIFAMPIN or CIPRO
|
|
Multiple unexplained thromboses: next step in w/u if:
-young -old |
Young: def protein C, S, AT-III
Old: CT for malig |
|
Flecainamide:
-what class anti-arryth? -txs what type arryth? |
Class IC (blocks Na channel)
Txs SVT/tachy (inc afib) |
|
What antiarrythmic:
Use-dependence effect; e.g. increase HR (stress test) --> greater effect --> greater QRS prolong |
Flecainamide
|
|
Reiter's arth: 1st line tx? (class)
|
NSAIDS
(not abx) |
|
What dz:
Nontender palpable GB + jaundice + left supraclavicular LAD |
Pancreatic cancer
|
|
What dz:
Virchow node |
Pancreatic cancer
(L supraclav node) |
|
#1 etio B12 def
|
Pernicious anemia
|
|
What is underlying pathophysio:
Epidural --> hypoT |
Block symp fibers --> VASODIL BVs in LE --> venous pooling in pelvic & LE
|
|
HIV: #1 middle ear pathology
|
NON-INFECTIOUS serous OM
(LAD or obstructing lymphoma --> eustachian tube dysfxn) |
|
What dz:
ONION-SKINNING; MOTH EATEN |
Ewing sarcoma
|
|
What dz:
Critical lytic bone lesion w/adj sclerosis (Brodie's abscess) |
Osteomyelitis
|
|
If suspect acute bact prostatitis --> next step?
|
Mid-stream UA & Ucx
(do NOT massage prostate) |
|
tPA: must order what test 1st?
|
non-con head CT (r/o hemorr stroke)
|
|
What dz:
Neonatal cyanosis w/feed --> relieved w/crying |
Choanal atresia
(IMPORTANT) |
|
#1 congen nasal malformation
|
Choanal atresia
|
|
What dz:
Fail to pass catheter thru nose |
Choanal atresia
|
|
Choanal atresia: how dx?
|
Fail pass cath thru nose --> CT w/intranasal con
|
|
Bordatella pertussis:
-does tx depend age? stage of dz? -what abx? |
Erythro or azithro
REGARDLESS age or stage of dz |
|
Next step:
Dysphagia w/broad ddx |
Barium esophagram
(BEFORE EGD) |
|
#1 pediatric fx
|
Supracondylar fx
(rare as adult) |
|
Supracondylar fx: #1 complication? how assess?
|
Brachial art entrap
Check radial pulse before & after reduction |
|
What fx:
Risk entrapment of BRACHIAL ART (before & after reduction) |
Supracondylar fx
(#1 pedi fx) |
|
Proximal humerus fx: risk injury what nerve?
|
Axillary nerve
|
|
Axillary nerve: risk injury with what fx?
|
Prox humerus
|
|
What dz:
Schoolteacher with acute polyartic & symm arthritis in MCP, PCP, wrist, ankle |
Parvo B19 arthritis
|
|
Parvo B19 induced arthritis: resolve after how long?
|
2mos
|
|
Parvo B19 induced arthritis: how dx? (what test)
|
anti-B19 IgM
|
|
ParvoB19 induced arthritis: how long does AM stiffness last?
|
10minutes (compared RA: 30 minutes0
|
|
RA: must have sxs for how long?
|
6+mos
|
|
What dz:
Painful recurrent oral & genital ulcers + ant uveitis + acneiform nodules + E nodosum |
Behcets
|
|
Behcet's: what populations?
|
Turk, Asian, Mid East
|
|
Behcet's: how tx?
|
Immed steroids
(progresses to blind, dementia) |
|
What dz:
Boy with self-mutilatin + dystonia + gout |
Lesh-Nyhan
|
|
Lesh-Nyhan: risk what joint dz?
|
gout
|
|
Lesh-Nyhan: how inh?
|
X
|
|
What dz:
Hypoxanthine-guanine phosphoribosyl transferase (HPRT) |
Lesh-Nyhan
|
|
Lesh-Nyhan: accum what substance in periph tissue?
|
URIC ACID
|
|
What CONGENITAL dz:
Accum uric acid in peripheral tissue |
Lesh-Nyhan
|
|
Leprosy: how dx?
|
bx: AFB
|
|
What dz:
Hypopigmented plaque --> periph n damage --> nerve atrophy |
Leprosy
|
|
PML (JC): do lesions enhance? see mass effect?
|
Non-enhancing
No mass effect |
|
What dz:
HIV pt w/stroke-like hemiparesis, aphasia, ataxia, UMN sxs |
PML (JC virus)
|
|
Cushing dz: in/decrease:
-glucose -K -BP |
Insulin resistance --> hypergly
hyperK HTN |
|
Cushing dz: where is pathology? (what organ)
|
Adrenal cortex
|
|
What dz:
Pregnant AfAm woman w/bilat, multinodular SOLID ovarian masses |
Luteoma
|
|
Luteoma of pregnancy: uni/bilat? cystic or solid?
|
bilat, multinodular, solid
|
|
Luteoma of pregnancy: how tx?
|
Benign; no tx
|
|
Pleural transudate:
Pleural protein:serum protein (what ratio?) |
<0.5
|
|
Pleural transudate:
Pleural LDH:serum LDH (what ratio)? |
<0.6
|
|
Empyema: what is pH of fluid? how tx/
|
pH <7.2
Chest tube |
|
What dz:
Pleural exudate w/pH <7.2 |
Empyema (insert chest tube)
|
|
Pleural effusion: what is normal pH? what pH suspect empyema?
|
normal <7.6
empyema <7.2 |
|
Rosacea: how tx?
|
TOPICAL metro
|
|
Acute inf wall infarct:
-what BV? -what leads? |
RCA
II, III, avF |
|
MI: what wall?:
Block RCA |
Inf wall
|
|
MI: what wall?:
II, III, avF |
Inf wall
|
|
MI: what wall?:
p/w hypoT, brady |
Inf wall (Rv)
|
|
Safe in preg?:
Sumatriptan |
NO --- UPT before order triptan
|
|
Sumatriptan: order what test before you admin to pt?
|
urine preg test
|
|
What O/D & how tx?:
Brady + AV block + hypoT + DIFFUSE WHEEZING |
beta-blocker
tx: IVF + ATROPINE --> GLUCAGON |
|
Beta-blocker O/D:
how tx? (steps) |
ATROPINE + IVF --> glucagon
|
|
A-flutter: 2/2 what pathophysio? assoc w/what EKG finding?
|
reentrant rhyth
2:1 heart block |
|
2:1 heart block: predisp to what arryth?
|
A-flutter
|
|
Buproprion:
Useful in eating disorder? |
ContraI
further increase risk of sz |
|
Buproprion:
Useful in EtOHic? |
contra-i
further increase risk of sz |
|
Buproprion:
Useful in ADHD? |
Yes
|
|
Tetanus: what is next step if:
-Unimmunized & clean wound? -Unimm & dirty wound? |
Clean: Td booster
Dirty: Td + TIG (same as if not immunized in over 10 yrs) |
|
Tetanus: what is next step if:
-Last booster >10yrs ago & clean wound/ -Dirty wound? |
Clean: Td booster
Dirty: Td + TIG (same as unimmunized) |
|
Tetanus: what is next step if:
-Booster <10 yrs & clean wound? -Dirty? |
Clean: NOTHING
Dirty: booster only if 5-10yrs |
|
Cirrhotics: give what hepatitis vaccines?
|
HAV & HBV both
|
|
PBC: tx what med? txs symptos or increase survival?
|
Ursodeoxycholic acid
Improves sxs AND prolongs survival |
|
Chemo-induced gout: how prevent?
|
Allopurinol
|
|
Cyclophosphamide: what med to prevent hemorr cystitis?
|
Mesna
|
|
Mesna: prevents what chemo-S/E?
|
Cyclophosh-induced hemorrhagic cystitis
|
|
What dz:
Adult w/HTN + bilat abd masses + microhematuria |
AD PCKD
|
|
AD PCKD: risk what cerebral dz?
|
Berry aneurysm (10% pts)
|
|
AD PCKD: #1 extrarenal
|
LIVER CYSTS
|
|
AD PCKD: assoc what GI dz?
|
Colon diverticula
Also abd wall & inguinal hernia |
|
What dz:
Hepatocytes w/inclusions that stain PAS+ and resist diastase |
A1-antitrypsin
|
|
A1-antitrypsin: hepatocytes stain PAS pos or neg?
|
Pos
|
|
What dz:
Panacinar emphysema + cirrhosis |
A1-antitrypsin def
|
|
A1-antitrypsin: lobar or panacinar emphysema?
|
Panacinar
|
|
A1-antitrypsin def: evaluate what organ (other than lung)?
|
Liver (assoc w/cirrhosis)
|
|
What dz:
Hyperseg PMNs + anisocytosis/poikilo + baso stippling |
Macro anemia (B12, folate)
|
|
DKA: what is most reliable index to monitor response?
|
serum anion gap
|
|
Edwards: what heart defect?
|
VSD
|
|
Affect risk of osteporosis?:
-EtOH -Smoking -Vegetarian |
EtOH & smoking increase OP
Vegetarian not affect risk |
|
Tourette's: tx w/what class of med?
|
TYPICALS
(haldol, PIMOZIDE) |
|
Panic disorder: assoc w/what other psych dx?
|
mdd, substance abuse
(important) |
|
Neonatal sepsis: #1 pathogen
|
GBS
|
|
Renal stones:
-metabolic w/u after 1st stone? |
no - only if recurrent
|
|
HIV: what CD4?:
Req MAC ppx |
<50
(azithro, clarithro) |
|
MAC ppx: what abx?
|
Azithro, clarithro
|
|
HIV w/CD4 <50: req antifungal?
|
No
|
|
EPO: how affect HTN?
|
S/E WORSE HTN (30% pts)
more common if admin IV often need to add antiHTN |
|
If admin IV EPO --> beware what S/E?
|
Anti-HTN
often req add anti-htn |
|
ESRD: #1 etio anemia
|
EPO deficiency
|
|
ESRD: micro/normo/macro anemia?
|
normo
|
|
SCD: initiate hydroxyurea if how many episodes per year?
|
>6 / yr
|
|
What med:
Increase fetal Hgb --> prevents sickle crises |
Hydroxyurea
|
|
Heat stroke: what body temp?
|
>40.5
|
|
Hypo or hyperthermia: see coagulopathic bleed
|
Hyperthermia
(esp heat stroke > 40.5; see epistax) |
|
What dz:
-child w/hip pain -fat adol w/hip pain -athlete adol w/hip pain |
Child w/hip: Leg-Calve-Perth
Fat: SCFE Athlete: Osgood-Schlatter |
|
What dz:
Traction apophysitis: quad tendon pulls tibial tubercle |
Osgood-Schlatter
|
|
Osgood-Schlatter: mxn of inj?
|
Traction apophysitis: quad tendon pulls tibial tubercle
|
|
What SC synd:
assoc w/BURST fx |
Anterior cord syndrome
See loss of motor, pain, temp all levels below lesion |
|
Polycyth vera: affect HTN?
|
Increase HTN 2/2 expanded blood vol (reversible)
|
|
Polycythemia vera: low/normal/high EPO in urine?
|
ABSENT EPO in urine
|
|
Polycythemia vera: how affect ESR?
|
Normal ESR
(contrast MM) |
|
To distinguish SEPTIC arth vs. transient synovitis:
-WBC > __ -ESR > ___ |
WBC > 12k
ESR > 40 |
|
What asthma med: S/E:
HA, insomnia, n/v, HTN, arryth |
Theophylline
|
|
Theophylline toxicity: increased risk if co-admin what meds/
|
Cipro, erythro
|
|
What dz:
Asthmatic given cipro/erythro for UTI --> HTN, tachy, n/v, arryth |
Theophylline toxicity (increases w/abx0
|
|
Hypercalcemia in malig: what is mxn:
-breast & lung cancer -non-met solid tumor -ovarian ca -Hodgkin's |
Breast & lung: met to bone --> IL-1 & TNF --> lytic lesion
Non-met solid: PTHrP Ovarian: ectopic PTH Hodgkin: calcitriol |
|
Hypercalcemia in malig: what TYPE of tumor:
-local IL-1, TNF --> lytic lesions -PTHrP -Ectopic PTH -Calcitriol |
Lytic lesions: lung & breast mets
PTHrP: solid non-met cancer Ectopic PTH: ovarian & neuroecto Calcitriol: Hodgkin's |
|
Nephrotic synd in child:
-how tx? -req renal bx? |
Assume MCD --> GIVE STEROIDS
no req bx |
|
#1 etio pelvic abscess in male
|
ruptured appendix
|
|
What dz:
Male w/abd pain --> days later: fluctuant mass on DRE + diarrhea + pain w/defecation |
ruptured appendix --> pelvic abscess
|
|
Abscess 2/2 complicated diverticulitis: how tx?
|
CT-guided perQ drain
(NOT laparotomy) |
|
How tx:
-gonorrhea -chlam |
G: CTX
C: azithro/doxy x 7d |
|
Ao dissection: #1 risk
|
HTN
|
|
Trichoma: what serotypes?
|
Chlam A-C
|
|
What Chlamydia serotypes can lead to blindness?
|
Sero A-C (trachoma): follicular conjunctivitis --> pannus (neovasc)
|
|
Trachoma (chlam sero A-C): how tx/
|
Topical tetracycline
OR po azithro |
|
How tx (sequence):
Hypotensive pt requiring PEEP |
Volume resusc 1st --> then initiate PEEP
(PEEP can decrease preload --> worsen hypoT) |
|
What congen dz?:
Microcephaly + digit/nail hypoplasia + midface hypoplasia |
Fetal hydantoin synd (phenytoin)
|
|
Chlamydia or Gonorrhea conjunctivitis:
d2-5; high purulent discharge |
Gonorrhea (hyperacute
(Chlam at d5-14) |
|
Chlamydia or Gonorrhea conjunctivitis:
Later appearance; congested conjunctivits w/scant discharge |
Chlamydia (d 5-14)
Contrast gonorr; d2-5 w/highly purulent discharge |
|
What dz:
Most destructive neonatal eye infxn |
GONORRHEAL conjunct
|
|
Gonorrhea conjunctivits: how tx?
|
ORAL CTX
|
|
Chalmydia conjuncitivits: how tx?
|
ORAL erythromycin
(not topical) (prevents PNA) |
|
Female androgen prod:
Which androgen ONLY produced by adrenal? |
DHEA-S
|
|
Female androgen prod:
Where produce DHEA-S? |
Adrenal only
|
|
Female: what is most specific measure/marker for adrenal mass?
|
DHEA-S
(ONLY produced in adrenal) |
|
Female androgen prod:
Where produce testosterone? |
Adrenal + ovary
|
|
Female androgen prod:
Where produce DHEA? |
Adrenal + ovary
|
|
Female androgen prod:
Where produce androstenedione? |
Adrenal + ovary
|
|
Another name for:
Trousseau's syndrome |
Migratory thrombophlebitis
|
|
Migratory thrombophlebitis: usu assoc with what other dz?
|
occult adenocarcinoma (pancreas, lung, prostate)
|
|
What dz:
Atypical thrombophlebitis of arm, chest |
Migratory thrombophlebitis (Trousseau's syndrome)
|
|
Migratory thrombophlebitis: what is next step in w/u?
|
Abdominal CT
(look for occult adenocarcinoma) |
|
Cirrhosis-induced esoph varices: what is 1st tx?
|
beta-blockers (not sclero)
|
|
What dz:
Young pt w/HTN + muscle weakness + nubmness |
1' hyperaldo
(hyperNA --> HTN) (hypoK --> numb) |
|
1' hyperaldosteronism: in/decrease:
Aldo:renin ratio |
INCREASE
Aldo suppresses renin |
|
What dz:
Brown discolored colon w/shiny lymph follicles |
laxative abuse
|
|
What segments of femoral vein are considered DEEP?
|
all
|
|
Which neck space:
Highest risk mediastinal inv |
Retropharyngeal
|
|
Retropharyngeal abscess: most feared complication?
|
Spread into mediastinum --> acute necrotizing mediastinitis
|
|
Steroids: how induce osteonecrosis? (what mxn)
|
Vascular disruption --> AVN
|
|
Steroid-induced osteonecrosis; most sens dx test?
|
MRI
|
|
Avascular necrosis of bone: 2 most common causes
|
EtOH, steroids
|
|
What dz:
Neonate w/CXR fine reticular granularity |
Hyaline membrane dz
|
|
Sickle cell trait: what pheno?
|
AS
|
|
What dz:
AS PHENOTYPE |
Sickle cell TRAIT
|
|
Sickle cell TRAIT: #1 presenting sx
|
Painless hematuria
|
|
HIV: what % risk of reactivating TB?
|
10%
|
|
Hepatic hydrothorax: pleural transudate or exudate?
|
Transudate
|
|
What dz:
Cirrhotic pt w/pleural effusion but no cardio-pulm dz |
Hepatic hydrothorax
(2/2 diaph defects0 |
|
Hepatic hydrothorax: how tx?
|
Decrease salt --> diuretic --> TIPS
|
|
Next step:
-Battery lodged in esoph -Battery in stomach |
Esoph: immed EGD
Stomach: repeat CXRs |
|
Where in GI tract:
Abs Fe2+ |
Duo
|
|
Celiac sprue: affect Fe2+ abs?
|
Decrease Fe2+ abs in duo --> IDA
|
|
What dz:
Granular IgA deposits in upper dermis |
Derm herpatiformis (celiac sprue)
|
|
Derm herpatiformis: what Ig subtype deposited in dermis?
|
igA
|
|
Acute hepatic failure: see HE in how many weeks?
|
8w
|
|
Another name for:
Hereditary Telangiectasia synd |
Osler-Weber-Rendu syndrome
|
|
Another name for:
Osler-Weber-Rendu syndrome |
Hered Telangiectasia synd
|
|
How inh:
Osler-Weber-Rendu (Hered Telangiect) |
AD
|
|
What dz:
Diffuse telangiectasias + AVMS + epistax |
Osler-Weber-Rendu (Hered Telang)
|
|
What hered dz:
AVM in lung --> R-to-L shunt --> chronic hypox --> reactive polycyth |
Osler-Weber-Rendu (hered telang)
|
|
What dz:
CT: dilated bronchi w/thick walls |
Bronchiectasis
|
|
What dz:
Increase IgM; decrease IgG, IgA, Bs, PMNs |
Hyper-IgM syndrome
|
|
HyperIgM syndrome: affect level of B cells?
|
decrease
(also decrease PMNs) (contrast CVID: normal # circ Bs) |
|
HyperIgM or CVID:
Decrease IgG, IgA |
BOTH
Difference is that hyperIgM has high IgM; CVID has no IgM |
|
What dz:
-Increase IgM, decrease IgG, IgA, Bs -Decrease IgM, IgG, IgA; normal # Bs -Decrease IgM, IgG, IgA, Bs |
HyperIgM
CVID: normal # Bs XLA (Bruton's): all decrease |
|
What pathogen:
DM pt w/malignant OM |
Pseudomonas
|
|
What dz:
Ear granulation & drainage not responsive to abx |
Malignant OM
|
|
What pathogen: DM pt with:
-malig OM -sinus infxn extending into brain |
Malig OM: Pseudomonas
Sinus-brain infxn: Rhizopus |
|
Eneurisis: normal until what age?
|
5yo
|
|
What hearing test:
-Air vs. mastoid -Forehead --> localize |
Air vs. mastoid: Rhine
Forehead: Weber |
|
Rhine test: which normal hear longer:
Air or mastoid? |
Air
if mastoid longer --> conductive hearing loss |
|
What type of hearing loss:
-Rhine: hear mastoid longer |
Conductive
|
|
Weber test; louder in non/affected ear?
|
affected (since not distracted by ambient noise)
|
|
Otosclerosis:
-M or F? -what ages? -Conductive or sensorineural loss? |
F>M
20-30yo Conductive: stapes fixes to oval window |
|
What dz:
AI; stapes fixes to oval window |
Otosclerosis
|
|
What test:
-compares means in 2 SAMPLES -compares means in 2 POPS -compares categorical |
Samples: T
Pops: Z Categorical: chi |
|
AAA repair: common complication
|
Bowel ischemia --> pain, bloody diarhea, fever
|
|
What dz:
Post-op AAA repair --> abd pain + bloody diarrhea + fever |
Bowel isch
|
|
What dz:
Pt w/URI given amox --> polymorphous rash |
EBV
|
|
Paget's disease of BREAST: assoc with what type of tumor
|
underlying ADENOcarcinoma (85% pts)
|
|
What type of breast cancer:
Cells retract from adj keratinocytes --> large cells w/clear halos |
Paget's disease of breast
(assoc w/underlying adenoca) |
|
Name for:
Hypogly at 3AM --> compens release E/N, glucagon --> hypergly at 7AM |
Somogyi
|
|
Name for:
Cyclic release GH --> decreased insulin sens at 3AM --> hypergly at 7AM |
Dawn phenomenon
|
|
Somogyi or Dawn:
-Hypergly at 3AM, hypergly at 7AM -Hypogly at 3AM, hypergly at 7AM |
Dawn: hypergly at 3 & 7AM
Somogy: hypogly at 3AM (stims NE/E release) --> hypergly at 7AM |
|
What immuno-suppress agent: S/E:
Oral ulcers; n/v/abd pain; increased LFTs; BM suppression & anemia |
MTX
|
|
MTX: coadmin what med to decrease S/E? affect med efficacy?
|
Folate
(no disrupt MTX effect) |
|
What dz:
RA + splenomeg + decreased PMNs |
Felty Syndrome
|
|
Felty syndrome: decrease what cell type?
|
PMNs
|
|
What dz:
Increase Alk; normal Ca, LFTs, bili |
Paget's dz bone
|
|
Paget's dz of bone: in/decrease:
-Alk -Bili -Ca -LFTs |
Increase Alk
(rest are normal) |
|
Can you ablate thyroid?:
-Preg -Severe opthalmopathy |
NO
|
|
Methylphenidate: approved in what ages?
|
>7yo
(do not use to tx ADHD in 6yo) |
|
Ao stenosis: #1 etio:
->70yo -<70yo |
>70: senile calcif
<70yo: BICUSPID AV |
|
WPW:
-short or long PR? -wide or narrow QRS? |
Pre-excitation --> SHORT PR
Wide QRS |
|
Ao stenosis:
Sxs if valve <___ (area) |
<1cm
|
|
What murmur:
Systolic murmur at right ICS 2 |
Ao stenosis
|
|
What murmur:
Parvus et tardus |
Ao sten
|
|
What murmur:
Pulsus paradox |
Cardiac tamponade
|
|
How tx:
PE w/hypoT, tachy, syncope |
thrombolytics
(evidence of RH fail) |
|
MAOI + tyramine --> monitor what vital sign?
|
BP
(not fever) |
|
MAOI: avoid what diet?
|
Tyramine
|
|
SIADH: how tx:
-asympto pt -last resort |
Asympto: fluid restrict
Last resort: hypertonic |
|
Goal INR:
-idiopathic DVT -Prosthetic valve |
idiopathic: 2-3
Prosth: 2.5-3.5 |
|
Acute bact sinusitis: how tx if <6yo?
|
Empric amox (no req image)
|
|
Variable decels: how tx? (sequence)
|
Admin O2 + mother on side --> Trendleberg w/presenting part elevated --> amnioinfusion
|
|
Colonic angiodysplasia:
-most common what part of colon? -what age? -#1 presenting sx? |
Cecum; >65yo; GIB (occult or episodic)
|
|
Colonic angiodysplasia:
How dx (gold standard) |
ANGIOGRAPHY
(regularly miss on colo) |
|
Colonic angiodysplasia:
Assoc with what HEART dz? |
AO STENOSIS
|
|
What dz:
Pt w/syst murmur at R 2nd ICS presents with a GIB |
colonic angiodysplasia (wierdly assoc w/ao sten)
|
|
Acute cardiac tamponade: how appear on CXR?
|
Often normal
|
|
Creates pleural transudate or exudate?:
Infection |
Exudate
|
|
Creates pleural transudate or exudate?:
Malig |
Exudate
|
|
Creates pleural transudate or exudate?:
Pulmonary embolus |
Exudate
|
|
EtOHIC w/anemia: more common folate or B12 def?
|
Folate
|
|
A-fib: may be 2/2 hypo or hyperthryoid?
|
Hyper
|
|
Fat necrosis of breast: how appear on:
-U/S -mammo |
Same as breast cancer!
U/S: solid Mammo: Ca2+ |
|
How disting: fat necrosis of breast vs. cancer?
|
Fat necrosis: bx shows fat globules + foamy histiocytes
|
|
What dz:
Breast bx: fat globules + foamy histiocytes |
Fat necrosis of breast
|
|
SJS: most common what 3 drug classes?
|
Sulfa, NSAIDs, phenytoin
|
|
Ovarian cancer: does pelvic exam count as screening?
|
no
no screening measures |
|
Next step w/u:
Male w/hypogonad & low testosterone |
Measure PRL
(NOT estrogen) |
|
Guillan-Barre: serial monitor what pulmonary measurement?
|
VITAL CAPACITY
(ETT if VC <15) important! |
|
Guillan Barre: ETT if vital capacity <___?
|
<15
|
|
HIV esophagitis: 1st step? 2nd step?
|
1st: empiric fluconazole
2nd (if no improve 3d): EGD w/bx |
|
What dz:
Surgery w/hypotension --> post-op abd pain, bloody diarrhea |
isch colitis
|
|
Ischemic colitis: #1 site
|
Splenic flexure
(not hepatic flex) |
|
HIV vaccine: give Td booster how often?
|
q10 yrs (same)
|
|
Schizo: which has better px?:
negative or positive sxs |
Positive (better tx w/typicals)
|
|
Schizo: tx with A/TYPICAL?:
-Positive-predom -Negative-predom |
Positive: TYPICAL
Neg: ATYPICAL |
|
Can you give a bolus of hypotonic fluid?
|
Never hypo/hyper
Only give bolus of normo (LR, NS) |
|
Tzanck: disting HSV vs. VZV?
|
no
|
|
What dz:
Female w/chronic HA presents with painless hematuria |
Analgesic-induced nephropathy
|
|
Analgesics: how induce nephropathy? (mxn)
|
Tubulointerstital damage w/constrict vasa recta --> papillary necrosis
|
|
CMV or EBV:
-pharyngitis -cervical LAD |
EBV ONLY: pharyngitis, cervical LAD
|
|
What dz:
X & Y descents on central venous tracing |
Constrictive pericarditis
|
|
Constrictive pericarditis: #1 etio in developing world
|
TB
|
|
Chagas dz: DIA or SYST dysfxn?
|
BOTH
also arryth, MR, TR |
|
Proximal or distal vein:
Ileal vein |
Prox
|
|
Proximal or distal vein:
Femoral |
Prox
|
|
Proximal or distal vein:
Popliteal |
Prox
|
|
What dz:
Unexplained hemolytic anemia + thrombocytopenia + RF + neuro sxs |
TTP-HUS
|
|
What dz:
Abs against ADAMTS-13 (vWF cleaving protease) --> accum vWF multimers |
TTP-HUS
|
|
TTP-HUS: what Abs?
|
Anti- ADAMTS-13
(accum vWF multimers --> plt agg) |
|
TTP-HUS: #1 tx
|
Plasma exchange!
If no tx --> 80% fatal |
|
Breech: unlikely to spont convert after what week?
|
36w
|
|
Breech: attempt version at what week?
|
37
|
|
What dz:
Young adult M with proteinuria + ARF + RBC casts + SOB + hemoptysis |
Goodpastures
|
|
What dz:
Abs to alpha3 chain of type IV collagen --> linear IgG on glomerular BM |
Goodpastures
|
|
Goodpastures: how dx?
|
Renal bx: linear IgG on glom BM
|
|
Flail chest: use PPV?
|
Yes
|
|
Multiple sclerosis: what med SLOWS PROGRESSION?
|
IFN-beta
(NOT steroids) |
|
IV ACV --> toxic to what organ? how prevent inj?
|
Renal tox
Prevent w/adeq hydration |
|
What pathogen:
Encapsulated yeast |
Cryptococcus
|
|
How tx:
Cryptococcal meningitis |
IV ampho + po flucytosine
|
|
Histoplasmosis: use itraconazole in acute or maintenance tX?
|
Maintenance only
|
|
Renal stones: CON or NON-CON CT?
|
Non-con spiral CT
|
|
How affect ESR? CPK?:
-PMR -PM/DM |
PMR: Increase ESR, normal CPK
PM/DM: younger pt; increase ESR & CPK |
|
What dz:
Neonate with epiglottis rolling in from side-to-side |
Laryngomalacia
|
|
Raloxifene: tx what dz? contra-indicated in what dz?
|
SERM; prevents osteopor
S/E DVT; contraI if h/o DVT |
|
Transposition of Great Vessels:
When see cyano? |
0-24h
|
|
Maternal DM: increase risk of which cyanotic congen HD?
|
Transposition of Great Vessels
|
|
Transposition of Great Vessels:
M or F? |
M>F
|
|
Transposition of Great Vessels:
Increased risk if what maternal dz? |
DM
|
|
What congen HD:
Single loud S2 |
Transposition of Great Vessels
|
|
Transposition of Great Vessels:
How dx? |
ECHO
(normal CXR) |
|
Transposition of Great Vessels:
How tx? |
IV PGE1 --> surgery
|
|
Turner Synd: what pathophysio mxn --> amenn?
|
Ovarian dysgen --> decrease E --> amenn
|
|
Turner: in/decrease FSH?
|
Increase
(since ovarian dysgen leads to decreased E; compens FSH) |
|
Turner: in/decrease GH?
|
Normal GH (despite short stature)
|
|
JIA: non/migrat? arthritis for how long to dx?
|
Non-migratory >6w
|
|
Penile fx: tear what structure?
|
Tunica albuginea
|
|
Penile fx: how tx? (2 steps)
|
Retro urethro --> surg
|
|
MTX: micro/normo/macro anemia? check CBC how often?
|
Macro; CBC q3mo
|
|
What RA drug:
S/E hepatotox, interstitial lung dz, alopecia |
MTX
|
|
MTX: how prevent some S/E?
|
Coadmin folate (not interfere w/drug fxn)
|
|
Meningitis: how w/u in:
-adult? (3 steps) -child? |
Adult: abx --> CT --> LP
Child: LP FIRST --> vanco + CTX + dexamethasone (no risk herniation since open fontanel) |
|
VPA: what S/E?
|
pancreatitis
|
|
What AED:
S/E pancreatitis |
VPA
|
|
Med S/E:
What 2 diuretic classes S/E panceratitis |
Furosemide
Thiazide |
|
Med S/E:
What 2 antibiotics S/E pancreatitis |
Metronidazole
Tetracycline |
|
What dz:
Erythem papule with central scale & SANDPAPER texture |
Actinic keratotis (early)
|
|
What dz:
Cutaneous horn |
Actinic keratosis
|
|
What skin lesion:
Histo: acantholysis, parakeratosis, dyskeratosis |
Actinic keratosis
|
|
What skin lesion:
Histo: thick epi; retain nuclei in stratum corneum |
Actinic keratosis
|
|
Actinic keratosis: what % transform SCC?
|
1%
|
|
Offer hemodialysis?:
Severe dementia |
no (contrai)
|
|
What dz:
Multiple somatic complaints (some NOT pain-related) & negative w/u |
Somatization disorder
|
|
FAP:
-how inh? -what gene? -M or F? |
AD
APC gene M=F |
|
What dz:
Hundreds of colon polyps --> 100% risk CRC |
FAP
|
|
FAP: what is risk of CRC?
|
100%
|
|
FAP: if see polyps on colo --> how tx?
|
Proctocolectomy (NOT serial colos)
|
|
What HIV illness:
Fever, cough, dyspnea, hemoptysis |
Aspergillosis
|
|
What HIV dz:
CXR single cavitary lesion w/rapid growth; CT pulm nodules with HALO SIGN |
Aspergillosis
|
|
Aspergillosis: see single or multi lesions?
|
Single cavitary lesion
|
|
What dz:
CT scan shows pulmonary nodules w/halo signs (air crescent) |
Aspergillosis
|
|
What dz:
Thrombocytopenia AND thrombosis (simultan!) |
Hep-induced thrombocytopenia (HIT)
|
|
HIT: underlying mxn?
|
Abs against heparin-platelet factor 4 complex
|
|
What dz:
Abs against heparain-plt complex |
HIT
|
|
MW tear: arteries in what layer?
|
Submucosa
|
|
MW tear: what % spont resolve? tx w/what MED?
|
90% stop
Vasopressin (--> injxn --> caut) |
|
TCA O/D: inh what channel?
|
Na channel --> QRS prolong
|
|
TCA O/D: what antidote to decrease QRS?
|
Sodium bicarb (sodium load)
|
|
#1 cyanotic congen HD
|
TOF
|
|
TOF: what abn is the #1 determinant of sxs
|
Pulmonary stenosis
|
|
TOF: 4 findings
|
1. Pulm stenosis
2. Overriding Ao 3. VSD 4. RVH |
|
Tet spell: see what change in hemodyn?
|
Increase R-to-L shunt across VSD --> decrease pulm BF --> increase deoxy systemic blood
|
|
TOF: what is effect of knee-to-chest?
|
Increase syst vasc R --> increase BF from RV to pulm circ
|
|
What dz:
Electrical alternans |
Tamponade
|
|
Tamponade: how tx? (2)
|
IVF + pericard
|
|
What dz:
CP worse w/deep insp & improves when lean forward |
PERICARDITIS
|
|
Pericarditis: CP better or worse when lean forward?
|
Better
|
|
What dz:
Diffuse ST elevation w/recip depresed AVR |
Pericarditis
|
|
Pericarditis: ST elev or depress?
|
Diffuse ST elevation
|
|
Pericarditis: usu how long after MI?
|
First few days
|
|
Dressler synd:
-s/p what event? how long after? -underlying mxn? -how affect ESR? -how tx? |
Weeks s/p MI; likely immun-med
Increase ESR tx: NSAIDS ONLY (steroids if refract) |
|
What dz:
MI --> (wks later) malaise, fever, CP & increased ESR |
Dressler synd
|
|
Ao aneurysm: type A or B:
Descending only |
B
|
|
Ao aneurysm: type A or B:
Involves asc |
A
|
|
Ao aneurysm: how tx:
-Type A -Type B |
A: Iv beta-blocker + surg
B: IV b-b only |
|
Ao aneurysm: how tx type B in Af Am?
|
Same - IV beta-blocker
|
|
Sickle cell pt w/cholecystitis:
-should you be concerned about elev WBC? -req emerg chole? |
elev WBC normal (not indicated cholangitis)
Tx same: conserv --> elective chole (not req emerg chole) |
|
Acute pericarditis: #1 etio
|
Viral infection
|
|
What is underlying dz:
Pericarditis + oliguria + HTN + red casts + proteinuria |
UREMIC pericarditis (2/2 nephrotic synd)
|
|
Indication for hemodial?:
Uremic pericarditis |
Yes
|
|
Next tx step:
Coagulopathy 2/2 renal failure |
Hemodial
|
|
What med:
Increases HDL by 30% |
Niacin (nicotinic acid)
|
|
PCOS: what test to assess insulin sens?
|
2h glucose
(NOT fasting BG) |
|
What dz:
Brain cancer with BUTTERFLY appearance + central necrosis + heterogen contrast enhance |
GBM
|
|
What dz:
Butterfly brain tumor |
GBM
|
|
What dz:
s/p trauma: muscle pain worse w/passive ROM |
Compartment synd
|
|
What menstrual phase:
Scant, thick, acidic mucus |
Early follicular
|
|
Early follicular phase: acidic or alka mucus?
|
Acidic (prevent sperm pen)
|
|
What menstrual phase:
Profuse, thin, clear mucus; stretches 6cm; alkaline |
Ovulatory
(allows sperm pen) |
|
Ovulatory phase: acidic or alkaline mucus?
|
Alkaline (>6.5)
|
|
CLL: Bs or Ts?
|
Bs
|
|
What dz:
SMUDGE CELL |
CLL
|
|
CLL: does presence of thrombocytopenia affect px?
|
Thrombocytopenia --> poor px
(worse than splenomeg, anemia) |
|
CLL: #1 etio death
|
infection
|
|
CLL: what finding has worst px?
|
Thrombocytopenia
(worse than splenomeg, anemia) |
|
What dz: spheros w/out central pallor and:
-Negative Coombs -Positive Coombs |
Spheros + negative Coombs: hered sphero
Spheros + pos Coombs: AI hemolytic anemia |
|
What dz:
Sphero + neg Coombs |
Hered sphero
(if pos: AI hemolytic anemia) |
|
AI hemolytic anemia:
-pos or neg Coombs? -warm or cold agglutins more common? |
Pos coombs
Warm > cold |
|
AI hemolytic anemia: warm or cold agglutins:
IgG |
Warm
(Georgia) |
|
AI hemolytic anemia: warm or cold agglutins:
IgM |
Cold
(Maine) |
|
AI hemolytic anemia: warm or cold agglutins:
more common |
Warm
|
|
AI hemolytic anemia: warm or cold agglutins:
Tx steroids, splenectomy |
Warm
|
|
AI hemolytic anemia: warm or cold agglutins:
Tx warm body, transfusion |
Cold
|
|
What vitamin def:
increase homocysteine |
B12 & folate
|
|
B12/folate def: in/decrease homocysteine?
|
Increase homocysteine
(decrease conversion to methionine) |
|
DM nephropathy: most sensitive test?
|
Random urine microalbumin:creatinine
|
|
What dz:
order random urine microalbumin:creatinine |
DM nephropathy
|
|
DM nephropathy: meas via urine dipstick?
|
NO - only detects macroabluminuria
(miss early microalbumin) |
|
#1 intracardiac tumor
|
Atrial myxedema
|
|
Atrial myxedema: more common RA or LA?
|
LA (80%)
|
|
Post-term preg (>42w): what 2 tx options?
|
1. Induce
2. BIWEEKLY eval oligo |
|
What vaginal infxn:
Thin, malodor, frothy |
Trich vag
|
|
Trich vag: what is pH?
|
ph 5-6
|
|
Trich vag or BV:
Itchy, inflammed |
Trich
|
|
What dz:
dyspnea + venous engorge face/chest + swelling H/N |
SVC syndrome
|
|
SVC syndrome: most common what 2 cancers?
|
Lung
NHL |
|
SVC syndrome: how dx?
|
CXR
|
|
EPS more common a/typical antipsych?
|
Typical
|
|
Typicals:
How tx EPS? |
Diphenydramine OR benztrop/trihexyphenadryl
|
|
What dz:
(Triad) polyarth + tenosynovitis + painless vesicopapular rash |
Dissem gonorrhea
|
|
Dissem gonorrhea: is rash painful?
|
no
|
|
What dz:
Developmental disorder; forward slip vert --> step off |
Spondylolithesis
|
|
Spondylolithesis: what phys exam finding?
|
Step off
|
|
Spondylolithesis: see bladder dysfxn? sens findings?
|
YES - if L5 slips forward over S1 --> bladder dysfxn & decreased sens perineum
|
|
What complication:
Pt w/peptic ulcer surgery --> develops watery diarrhea |
BACT OVERGROWTH
(NOT short bowel synd -- see if sm intestine resect in CD) |
|
Follicular thyroid ca:
-early or late mets? spread via heme or lymph? |
EARLY; heme spread to lung, brain, bone
RARELY see LN inv |
|
What type of thyroid cancer:
Capsule + BV invasion |
Follicular
(papillary lacks capsule) |
|
Follicular or Papillary thyroid cancer:
Encapsulated |
Follicular
|
|
Follicular or Papillary thyroid cancer:
LN involvement more common |
Papillary
|
|
Follicular or Papillary thyroid cancer:
Hurthle cells |
BOTH
|
|
What dz:
Hurthle cell |
Thyroid cancer (papp or follicular)
|
|
DKA: how affect:
-serum K -total body K |
H+ --> shift --> INCREASE serum K
GI loss/osm diuresis --> DECREASE total body K |
|
DKA: once give insulin --> increase or decrease serum K? initiate what tx?
|
K shifts back into cells --> rapid decrease (beware)
Initiate K+ once serum K+ <4.5 |
|
MG: how affect sens? reflexes?
|
affects motor only
intact sens, reflex |
|
Syringomyelia: what SC syndrome?
|
Central cord synd
(decrease motor & pain-temp in UE) |
|
Arnold-Chiari: what SC synd?
|
Central cord synd
(sim syringomyelia) |
|
Herpes ophthalmicus or keratitis:
Skin rash |
Ophth
|
|
RTC tear: what muscle most commonly torn?
|
Supraspinat
2/2 repeated isch at insertion on humerus |
|
What dz:
Unable to abduct shoulder >90' |
RTC tear
|
|
What nerve:
SERRATUS ANTERIOR |
Long thoracic
(Long serrated knife) |
|
Long thoracic n: what muscle?
|
Serratus Anterior
(long serrated knife) |
|
What nerve injury?:
Winged scapula |
long thoracic n (serratus ant)
RLND |
|
Breast ca RLND:
-injure what nerve? -what muscle? -what classic finding? |
long thoracic n = serratus ant = winged scapula
|
|
Atlantoaxial instab: what ligament is lax?
|
Post transverse ligament
|
|
What dz:
Down's synd with behav change, urine incontinence, vertigo/dizzy/diplop & UMN sxs |
Atlantoaxial instab
|
|
Neonatal tetanus: hypo or hypertonic?
|
Hyper
|
|
What dz:
Hypertonic baby s/p umbilical stump infxn |
Neonatal tetanus
|
|
Neonatal tetanus: #1 & #2 deaths
|
1: apnea
2: septic |
|
#1 thyroid malig
|
Papillary ca
|
|
What thyroid cancer:
Psammoma bodies |
PAPILLARY
|
|
What thyroid cancer:
Large cells w/ground glass cyto + pale nuclei + central grooving |
Papillary
(psammoma bodies) |
|
Papillary thyroid cancer with mets: good or bad ppx?
|
GOOD (even w/mets)
|
|
Social phobia: tx what med class?
|
SSRI
|
|
NMS: more common a/typical?
|
Typical
|
|
NMS: sxs w/in how long after initiate med?
|
2w
|
|
Acute mediastinitis: #1 risk
|
Cardiac surg (intraop contamin)
|
|
What dz:
Cardiac surg --> (14d) fever + tachy + CP + purulent drain |
Acute mediastinitis
|
|
Acute mediastinitis: how tx?
|
SURG + abx
|
|
PCP PNA: how tx? (2)
|
IV Bactrim + po pred
|
|
What dz:
CD4 <200 + fever + dry cough + exertional dysp |
PCP PNA
|
|
Malig HTN: dx reqs what finding?
|
Papilledema
|
|
Malign HTN: what histologic finding is responsible for end-organ damage?
|
Fibrinoid necrosis of small arterioles
|
|
DM gastroparesis: see post-meal hypo or hypergly?
|
HYPO
(insulin has been injected BUT slow to absorb food) |
|
DM gastroparesis: how dx?
|
Radionuclide scintigraphy
(radiolabeled meal) |
|
DM gastroparesis:
Can tx w/what abx? |
Erythro (stims motilin-R)
|
|
DM: txs what complication?:
Metocloperamide |
DM gastroparesis
|
|
DM: txs what complication?:
Bethanecol |
DM gastroparesis
|
|
What dz:
Boy w/increased ICP + bitemp hemiano + calcified suprasellar |
Craniopharyngioma
|
|
Craniopharyngioma: what type of cells nested in stroma?
|
Squam cells
|
|
Craniopharyngioma:
-p/w what visual disturb? -calcified? -how tx? |
Bitemp hemiano (sim pit)
Calcified suprasellar resect |
|
What dz:
Concentric whorls + calcified psammoma bodies |
Meningioma
|
|
What heart murmur:
Wide pulse pressure |
Ao regug
(water hammer) |
|
What heart murmur:
Sensation of pounding heartbeat (increases when lie on L side) |
Ao regurg
|
|
Ao regurg: #1 etio:
-US -world |
US: Ao root dilation, bicupsid AV
World: rheum HD |
|
What heart murmur:
Weak & late |
ao sten
|
|
Zinc: essential or prod by body?
|
Essential: animal protein, whole grain, bean
|
|
Zinc: where abs?
|
jejunum
|
|
Zinc def: what 2 med conditions?
|
IBD
TPN (some lacks zinc) |
|
What vitamin def:
Abnormal taste (everything tastes bad), alopecia, mouth pustules |
zinc
|
|
If active HSV lesions at L&D --> next step?
|
Emerg C/S
(NOT SVD w/ACV) |
|
What complication:
Pt with MI + ACUTE MR + holosyst murmur + LH failure |
Papillary muscle dysfxn
|
|
Fibromyalgia: affected by exercise?
|
Worsens
(contrast seroneg spondyl: improves w/exercise) |
|
Seroneg spondaryth: affect ESR?
|
Increases
(contrast fibromyalgia: normal labs) |
|
Preg fem w/fetus in distress: does mother have right to deny C/S?
|
Yes
|
|
VUR: dx via what imaging? (2)
|
Void cystourethro
OR Radionuclide cystogram (NOT U/S) |
|
HTN in preg: 1st line med
|
Methyldopa
|
|
Methyldopa: what CLASS in preg?
|
B!
(although 1st line anti-HTN) |
|
What is next step in w/u:
Painless hematuria in adult |
Assume GU malig: perform both:
1. Con CT or IVP (assess upper) 2. Endoscopic eval of bladder |
|
AD PCKD: affect risk of:
-renal infection? -stones? -RCC? |
Increase all
|
|
Guillan-Barre: how long after URI/gastroent?
|
3-4w
|
|
What dz:
CSF with increased protien but normal cell count |
Guillan-Barre
|
|
What dz:
Albumino-cyto dissoc |
Guillan-Barre
|
|
Guillan-Barre: how tx?
|
IVIg + plasmaphar
NOT STEROIDS |
|
Toxo: reactivates when CD4 <___?
|
<100
|
|
Toxo: screen for Abs in ALL HIV pts?
|
YES -- if positive --> prevent reactiv with ppx Bactrim
|
|
Toxo: how tx?
|
Bactrim
|
|
HIV: initiate MAC ppx if CD4 <___
|
<50
|
|
What drug:
MAC ppx |
Azithro
|
|
PID: screen for HCV?
|
No - screen for HBV
Only screen HCV if h/o IVDU |
|
#1 atypical PNA in ambulatory setting
|
Mycoplasma pneum
|
|
Mycoplasma pneum: assoc w/what skin finding?
|
E multiforme
|
|
Mycoplasma pneum: how appear on G stain?
|
No cell wall --> no appear on G stain
|
|
Dissem gonorrh: mono or poly arth? migrat?
|
Poly, migratory
|
|
Psoas abscess: tx w/surg?
|
NO --- increase m&m
abx, IVF, CT-guided drain |
|
What type of RTA:
Fail secrete H+ |
I
|
|
Type I RTA: alka or acidic urine?
|
Alka
(fail to secrete H+) |
|
Type I RTA: more common child or adult?
|
Child
|
|
What type of RTA:
Decrease bicarb reabs |
2
|
|
What type of RTA:
Fanconi syndrome |
2
|
|
What type of RTA:
Defect Na+/K exchange in DT |
4
|
|
What type of RTA:
HyperK, hyperCl acidosis |
4
|
|
#1 inj knee ligament
|
MCL
|
|
What knee inj:
2/2 forceful abduction & torsion |
MCL
|
|
What knee inj:
Dx valgus stress test |
McL
|
|
MCL tear: how tx?
|
Brace & early amb
|
|
What dz:
Mutate type I collagen |
Osteogen imperfect
|
|
Osteogenesis imperfecta: what protein mutated?
|
Type I collagen
|
|
A/typicals:
S/E tardive dyskinesia |
Typical
Also RISPERIDONE (atypical) |
|
Which atypical is most likely to produce tardive dyskinesia?
|
Risperidone
|
|
Which antipsychotic is least likely to produce tardive dyskinesia?
|
Clozapine
|
|
#1 source blood in hemothorax?
|
Ao
|
|
#1 bacterial pharyngitis
|
Strep pharyngitis (GAS)
|
|
Strep pharyngitis:
-LAD? -tonsil exudate? |
Painful bilat LAD
Tonsil exud |
|
Strep pharyngitis:
How tx? |
PCN (decrease risk rheum fever)
|
|
Hemochromatosis & cirrhosis: increase risk infection with what 3 pathogens?
|
Listeria
Yersinia Vibrio vulnificus |
|
Allergic rhinitis & PND: tx w/what med class?
|
H1-R blocker
(chlorpheniramine) |
|
Chlorpheniramine: what drug class?
|
H1-R blocker (tx allerg rhinitis, PND)
|
|
What dz:
URI --> (few days) --> gross hematuria |
IgA nephropathy
|
|
#1 glomerulonephritis in adult
|
IgA nephropathy
|
|
IgA nephropathy: how affect complement level?
|
normal
|
|
IgA nephropathy or Post-infectious glomerulonephritis?:
Few days s/p URI |
IgA
|
|
IgA nephropathy or Post-infectious glomerulonephritis?:
10d after pharyngitis OR 20d after impetigo |
Post-infxn
|
|
IgA nephropathy or Post-infectious glomerulonephritis?:
Low complement |
Post-infectious
|
|
What dz:
Sore throat --> (2d) --> sandpaper blanching rash (starts neck & generalizes) + gray exudate throat + strawberry tongue |
Scarlet Fever
|
|
Scarlet Fever:
-how long after sore throat? -does rash blanch? |
2d s/p sore throat
Rash blanches |
|
Scarlet Fever: how tx?
|
Pen V
|
|
CF: what abx to tx lung infection?
|
IV gent & CTX
|
|
A/typical: olanzapine
|
Atypical
|
|
Olanzapine: main S/E
|
wt gain (important)
|
|
What antipsychotic:
S/E wt gain |
olanzapine
|
|
#1 etiology of increased MS AFP
|
Mis-dated
|
|
Chronic pancreatitis: how affect amy & lipase?
|
often normal
|
|
Chronic esterase: best test to dx?
|
Stool esterase (most sens & spec)
|
|
Dx what dz?:
Stool esterase |
Chronic panc
|
|
Niacin: high- or low-dose to increase HDL?
|
HIGH
|
|
Niacin:
-does flushing improve? -how prevent? |
Flushing improves after 2-4w
Prevent via pre-tx ASA 30 minutes |
|
What dz:
Abd distens + flatulence + CHF + migratory polyarth + dementia |
Whipples dz
|
|
What dz:
PAS positive lamina propria |
Whipples dz
|
|
Isoniazid w/out pyridox: what cell count abn?
|
Micro hypochromo anemia (sim IDA)
|
|
S/E what med?:
Dimorphic RBC pop: hypo- & normochromic |
Isoniazid (w/out pyridox)
|
|
Isoniazid-anemia or IDA:
Increased serum Fe, decreased TIBC |
Isoniazid
|
|
Hemochromatosis: see dilated or restrictive cardiomyopathy?
|
Either
|
|
Hemochromatosis: hyperpig 2/2 deposit what proteins?
|
Melanin + hemosiderin
|
|
Mitral stenosis:
-presents what age? -#1 etio -predisp what arryth? |
30-50
Rheum hd A-Fib |
|
What heart murmur:
30-50yo with dysnea, pulm edema (worse w/exercise, preg) |
mitral stenosis
|
|
What heart murmur:
Elevate L mainstem broncus |
Mitral stenosis
|
|
Nocardia: how tx?
|
bactrim
|
|
What pathogen:
Gram +, weakly acid fast, filamentous branching rod |
Nocardia
|
|
What type of delusion:
-special powers & mission from God -one's thoughts control events |
Grandiose
Magical thinking |
|
What dz:
Adult with long bone bowing & fxs --> hip/knee arthritis |
Pagets
|
|
If suspect EBV infect mono but heterophile negative --> next dx step?
|
repeat heterophile later
(negative early) |
|
What vulva dz:
White polygonal patches; cigarette paper |
Lichen sclerosis
|
|
Lichen sclerosis: predisp what cancer?
|
vulvar scc
|
|
Lichen sclerosis: how tx?
|
HIGH-potency topical steroid
|
|
What dz:
Neonate chokes + regurges + coughes during 1st feed |
Esoph atresia
|
|
What dz:
Smoker w/small vol hemopt & chronic prod cough |
Chronic bronchitis
|
|
Lost to f/u --> increase what bias?
|
Selection bias
|
|
Polycythemia vera: de/increase EPO?
|
Decrease EPO (compens)
|
|
P vera: increase risk what GI dz? what joint dz?
|
PUD
Gout |
|
P vera: how tx?
|
Phlebotomy hct <45%
|
|
#1 extracranial pedi tumor
|
neuroblastoma
|
|
Neuroblastoma: presents what age?
|
2yo
|
|
Pedi neuroblastoma: arises what 2 extracranial locations?
|
1. Adrenal
2. Retroperitoneal ganglia |
|
What dz:
2yo with adrenal mass with CALCIFIC & HEMORRH |
Neuroblastoma
|
|
Pedi neuroblastoma:
-common mets? -what urine tests? -p/w catechol sxs? |
70% have mets at dx (long bone, liver, LN)
Increase serum & urine MVA, HVA NOT p/w catechol sxs (contrast pheo) |
|
What dz:
2yo w/increased urine HVA, MVA |
Neuroblastoma
|
|
Wilm's tumor: arises what embryo later?
|
Metanephros
|
|
CAH: in/decrease 17-alpha hydroxyprogesterone?
|
Increase
|
|
CAH: how affect Na? K?
|
Decreased production of mineralo/glucocorticoids -->
HypoNa Hyperk |
|
What dz:
Neonate with ambig genitalia & salt-wasting |
Severe CAH (complete defs mineralo/glucocorticoids)
|
|
CAH: what dx test?
|
ACTH stim test
|
|
Esoph perf: 1st dx test to order
|
H2O-con esophagram
(NOT EGD) |
|
Allergic conjunctivits vs. Atopic keratoconjunctivitis:
Thick mucus |
Atopic keratoconjunct
|
|
Allergic conjunctivits vs. Atopic keratoconjunctivitis:
Photophobia, blurry vision |
Atpoic keratoconjunc
|
|
What dz:
Obstruct nasolacrimal duct --> infect lacrimal sac --> pain, red, swell |
Dacrocystitis
|
|
Dacrocystitis: obstruct what structure?
|
Nasolacrimal duct (infect lacrimal sac)
|
|
What antipsychotic:
S/E agranulo, decrease sz threshold |
Clozapine
|
|
What antipsychotic:
S/E pigmentary retinopathy |
Thioridazine
|
|
What antipsychotic:
S/E cataracts |
Quetiapine
|
|
Premature ovarian failure: see in/decrease:
-LH -FSH -what is FSH:LH ratio? |
compens increase both LH & FSH
FSH:LH >1 |
|
Meckle's: fail obliterate what structure?
|
Vitelline
|
|
How dx:
Gastric mucosa in Meckel's |
technetium-99 pertechnate
|
|
Technetium-99 pertechnate: dx what dz?
|
Meckel's w/gastric tissue
|
|
Most sensitive lab measure to assess dehydration?
|
ratio BUN:Cr
|
|
Increase risk pancreas cancer?:
-DM -EtOH -Gallstones -Smoke |
Increase risk: DM, Smoke
NOT: ETOH, GALLSTONES |
|
Goats milk: what vitamin def?
|
Folic acid def
|
|
NF-2: oncogene or TSG? what chromo?
|
TSG on chromo 22
|
|
What genetic dz:
TSG on chromo 22 |
NF-2
|
|
NF-2 variants: which more severe:
-Nonsense mutation (Wishert) or Gardner (missense/splice) |
nonsense (Wishert)
|
|
Order WHICH cardiac enz:
Pt s/p MI re-presents with CP |
CK-MB (decreases the fastest)
|
|
Which cardiac enz:
Most sens & specific to MI |
Trop T
|
|
Which cardiac enz:
Takes 10d to normalize |
Trop T
|
|
IV heroin: S/E vasospasm?
|
No
|
|
How tx:
Septic emboli |
Abx
(not fibrinolytic) |
|
How tx:
Nodulocystic acne |
po isoretinoin
|
|
If suspect Ao dissection --> order what dx test?
|
TEE
(not arteriogram) CONTROL BP FIRST |
|
What dz:
Increase urine hydroxyproline, telopeptide |
Pagets dz
|
|
Open or Closed angle glaucoma:
More common AfAm |
Open
|
|
Open or Closed angle glaucoma:
Optic cupping + decreased periph vision |
open
|
|
Open angle glauc: lose periph or central vision?
|
Periph --> tunnel vision
|
|
Open angle glaucoma: tx what med? surg?
|
Beta-blocker --> laser trabeculo
|
|
#1 acq blindness US
|
DM retinopathy
|
|
DM retinopathy: how present:
-early -late |
Early: asympto
Late: decrease night vision, curtain, floaters |
|
What dz:
Decrease central vision first |
Macular degen
|
|
What dz:
CXR thumbprint sign; obliterate vallecula |
Epiglottitis
|
|
AVN hip: what dx imaging?
|
MRI
(normal XR) |
|
What part of bladder:
Covered by peritoneum --> refers pain to shoulder |
DOME
|
|
What part of bladder: most likely to rupture?
|
Dome
|
|
Dermatis herpetaformis: flexors or extensors?
|
Extensors
|
|
Dermatis herpetaformis: tx what med?
|
DAPSONE
|
|
Dapsone: txs what skin dz?
|
dermatis herpetaformis (celiac sprue)
|
|
Scabies: how tx?
|
1% lindane
|
|
Another name for:
Helmet cells |
Schistocytes (fragmented RBCs)
|
|
Shistocytes: assoc w/increased or decreased haptoglobin?
|
2/2 valve dz or DIC/ttp/HUS
Shistos (fragmented RBCs) --> increase free hgb --> DECREASE HAPTOGLOBIN |
|
Name for:
CPPD crystals |
Pseudogout
|
|
#1 site pseudogout
|
Knee
|
|
Pseudogout:
-what shape crystals? -neg or pos? |
Rhomboid, pos
|
|
Pseudogout: what joint comp?
-if tap joint --> what CBC findigns? |
Chondrocalcinosis
See LEFT SHIFT (tricky; resembles infxn) |
|
Heparin: binds what protein? in/decreases activity?
|
Binds AT-III --> INCREASES activity --> prevent thrombus formation
|
|
What dz:
Reid-Sternberg cells |
Hodgkins
|
|
#1 intervention to decrease SBP
|
Wt loss
#2: phys activity (not smoking) |
|
WPW: predisp what arryth?
|
a-fib
|
|
WPW: admin what med to convert to NSR?
|
Procainamide
|
|
WPW: admin beta-blocker? CEB? dig? adeno?
|
NO - all block AV node --> predisp WPW to V-fib
|
|
GSW: below what level --> assume intra-abd?
|
Below ICS 4
|
|
Preg: how dx renal stone?
|
U/S
NOT VP, CT, litho |
|
What dz: Child with micro anemia and:
-normal RDW -RDW >20% |
normal RDW: thal
RDW >20%: IDA |
|
GERD w/u:
1st step --> 2nd step |
EGD --> 24hr pH (if EGD neg)
|
|
Hypothyroid: if start ERT --> in/decrease dose Synthroid?
|
ERT stims P450 metab --> req INCREASED DOSE Synthroid
|
|
Preg: increase or decrease req dose of Synthroid?
|
increase
(meas TSH q4-6w) |
|
#1 PNA in HIV
|
Strep pneumo
|
|
What HIV PNA:
dry cough, dysp, bilateral diffuse infiltrates w/out effusoin |
Pcp
|
|
#1 risk native valve endocarditis
|
mvp (not Rheum HD)
|
|
Which valve:
Endocard --> SPLINTER HEMMS |
MV
|
|
IUGR: most sensitive U/S measure? (which part of body)
|
Abdom circum
(NOT head) |
|
Warfarin: risk hypercoag if what underlying dz?
|
protein C def
|
|
Mongolian spot: melanocytes in what layer?
|
Dermis
|
|
What dz:
Parkinsonism + ED + ortho hypoT |
Multisystem Atrophy (Shy-Drager)
|
|
Multisystem Atrophy (Shy-Drager):
-how present? -how tx? |
PD + ANS dysfxn (ED, ortho hypoT) + widespread neuro sx
NO tx pd drugs Give fludrocortisone |
|
Familial dysautonomia: how inh? what population?
|
AR; Ashkenazi; ANS dysfxn
|
|
What dz:
B-glucosidase |
Gaucher
|
|
What dz:
Erlenmeyer flask femur; BM shows wrinkled paper cells |
Gaucher
|
|
Gaucher: present child or adol?
|
adol
|
|
MI: which better outcome:
PCTA or fibrinolytic |
PCTA
|
|
What murmur:
Narrow pulse pressure |
Ao sten
|
|
What dz:
Chronic granuloma of Meibomian gland |
Chalazion
|
|
Episcleritis: eye pain?
|
Pain, photophobia, watry eye
|
|
SLE: req renal bx?
|
RENAL BX ALL PATIENTS (determine tx)
*BX even before start tx! |
|
SBP: req PMN > ___
|
>250
|
|
#1 H/N cancer
|
SCC (hard unilat non-tender ln)
|
|
What dz:
IgG & C3 linear at hemidesmo BM |
Bullous pemphigoid
|
|
What dz:
Abs against demogleins |
Pemphigus vulgaris
|
|
CD: in/decrease abs oxalate?
|
increase --> oxalate kidney stones
|
|
What dz:
Delete 5p |
Cri-du-chat
|
|
Suspect what dz:
back pain & hypoT s/p cardiac cath |
Retroperitoneal bleed --> order abd CT w/out contrast
|
|
What dz:
FAP/HPNCC + brain tumor (GBM, medulloblastoma) |
Turcot syndrome
|
|
Turcot syndrome: what 2 tumor types
|
HPNCC/FAP + brain GBM/medulloblastoma
|
|
What dz:
Colon polyps + desmoid tumors + epidermal cysts + MANDIBLE OSTEOMA + supernumerary teeth |
Gardner's
|
|
What dz:
Bite cells, Heinz bodies |
G6PD
hgb denatures --> Heinz --> disrupts RBC membrane |
|
What dz:
hgb denatures --> Heinz --> disrupts RBC membrane |
G6PD
|
|
RA:
-avg age onset -increase risk what bone dz? |
30-50yo
Increase OP |
|
What dz:
Sticking in throat + absent peristal lower 2/3 esoph |
Scleroderma
|
|
DJD: pain limits ACTIVE or PASSIVE ROM?
|
both
|
|
Meralgia paresthetica: compress what nerve?
|
Lat fem cutaneous
|
|
What dz:
2/2 friction b/w gluteus medius & tensor fascia lata |
Trochanteric bursitis
|
|
Trochanteric bursitis: friction b/w what 2 structures?
|
Glut med + TFL
|
|
Pain worse w/palpation?:
-Hip OA -Meralgia parasthetica -Trochanteric bursitis |
Hip OA, meralg: not affected by palp
Trochanteric: pain worse w/palp (worse w/sleep) |
|
What dz:
Decrease color vision |
Optic neuritis
|
|
What dz:
Eye pain/red/blurry + prelimbal injection + keratic precipitates |
Ant uveitis
|
|
What dz:
Gradual decrease periph vision (tunnel vision) |
Open angle glaucoma
|
|
Open or closed glaucoma:
Optic cupping |
Open
|
|
Neutropenic fever:
-what pathogen -what abx |
Pseudomonas
IV ceftax/cefep or mero or imipenem |
|
Beta-thals: responsive to iron?
|
NO
(contrast ida) |
|
CHF: what lyte abn indicates severe dz?
|
HypoNa
|
|
CHF: in/decrease NE?
|
Increase renin --> increase NE
|
|
What age:
Stranger understands 1/2 speech |
2yo
|
|
If suspect HCC:
-what is 1st test? -2nd test? |
SERUM AFP --> then CT!
(never ascites fluid - low yield) |
|
Preg: what acid-base abn?
|
Resp alka
Progest stims resp center |
|
Chronic bronch or ephysema:
Increase pulm marks |
Chronic bronch
(emph: decrease vasc marks) |
|
Chronic bronch or ephysema:
Normal DLCO |
Chronic bronch
|
|
Chronic bronch or ephysema:
Decrease DLco |
Emphys (destroy alv)
|
|
Emphysema: centriacinar or pan?:
COPD |
Centri
|
|
Emphysema: centriacinar or pan?:
alpha-antitryp |
Pan
|
|
What drug class:
Indinavir |
protease inh
s/e needle crystals |
|
What etiology?:
HIV pt develops needle crystals in urine |
Indinavir (protease inhibitor)
|
|
What HIV med: S/E:
Pancreatitis |
Didanosine
|
|
What HIV med: S/E:
Urine needle crystals |
Idinavir
|
|
What HIV med: S/E:
Hypersens rxn |
Abacavir
|
|
NRTI or NNRTI:
S/E lactic acidosis |
NRT
|
|
NRTI or NNRTI:
S/E SJS |
NNRTI
|
|
What HIV med: S/E:
Liver failure |
nevirapine
|
|
S/p MI: discharge with what meds? what if s/p PCI?
|
ASA
ACEI Beta-blocker Statin If PCI: also add clopidogrel |
|
Clopidogrel: admin how long if:
-bare metal stent -drug-eluting stent |
Bare metal: 30d
Drug: 1yr |
|
ASA sensitivity synd: how tx?
|
D/C ASA --> initiate leukotriene inhibitor
|
|
MCL inj: valgus or varus test?
|
Valgus
|
|
#1 px indicator in breast cancer
|
TNM stage
(not hormone/her R status) |
|
What type of nephrotic synd:
Assoc obesity, HIV, heroin |
Focal segmental glomerulosclerosis
|
|
What type of nephrotic synd:
>50% nephrotic synd in AfAms |
Focal segmental glomerulosclerosis
|
|
What dz:
URI --> hematuria |
IgA nephropathy
|
|
#1 risk abruption
|
HTN
|
|
Reye's syndrome: how affect:
-PT -LFTs |
Increase all
|
|
Reye's: how tx?
|
Supportive
|
|
What dz:
URI --> scrotal swelling + purpura on butt + periph edema + hematuria |
HSP
|
|
HSP: increases risk what GI dz?
|
Intuss
|
|
HSP: how tx?
|
Steroids
|
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What congen defect: LITHIUM in:
-TM1 -TM3 |
TM1: Ebsteins
TM3: goiter, transient neonatal motor dysfxn |
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What congen defect:
Atrialized RV (small) |
Ebsteins (lithium)
2/2 inf & small TV |
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What dz:
Pt w/abd pain & bloody diarrhea --> (1-2d) --> hemolytic anemia + swollen face + increased Cr |
HUS (E coli)
|
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Adol w/dysfxnl uterine bleed: how tx:
-moderate loss but no active bleed -mod + active |
No active: progestin only
Active: high-dose E |
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Dysfxnl uterine bleed: req bx if what age?
|
>35yo
|
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What dz:
White reflex in infant (assume what dz) |
Retinoblastoma
|
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Retinoblastoma: lwo or high malig?
|
Highly malig --> mets liver, brain
|
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Retinoblastoma: proto-onco or TSG?
|
Rb TSG
|
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What dz:
Spheros + Negative Coombs |
hered sphero
|
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Hered sphero: pos or neg Coombs?
|
Neg
|
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What dz:
DX osmotic fragility test |
hered sphero
|
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What dz:
Dx via SUGAR WATER TEST |
Paroxys noct hemoglobinuria
|
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What type of lung cancer:
Least assoc w/smoking |
Adenoca
|
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What type of lung cancer:
#1 type |
Adenoca
|
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What type of lung cancer:
Peripheral |
Adenoca
|
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Central or periph:
Lung adenoca |
Periph
|
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What type of lung cancer:
Columnar cells growing along septa |
Adenoca
|
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What type of lung cancer:
2/2 pulmonary scars (e.g. pulm fibrosis) |
ADENOca
mets early to bone, adrenal, CNS |
|
#1 malig of eyelid
|
BCC
|
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What murmur:
Mid-diast rumble at apex |
MS
|
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Rheum fever: give all pts <18yo ppx?
|
PCN
|
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What dz:
New mother + pain on radial wrist |
DeQuervain tenosynovitis
|
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What dz:
2/2 holding baby w/thumb outstretched |
DeQuervain tenosynovitis
|
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DeQuervain tenosynovitis: tender if palp wrist?
|
Yes
|
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What dz:
inflamm APL & EPB as pass through fibrous sheath at radial styloid |
DeQuervain tenosynovitis
|
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What dz:
Pain palmar aspect of 1st MCP |
Trigger thumb
|
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Trigger thumb: pain at what joint?
|
1st MCP
|
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Chronic hepatitis: best measure of dz severity
|
BX (not LFTs)
|
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What pathogen:
Bullous impetigo |
staph
|
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MM: affect ESR?
|
Increase
|
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Ca2+ kidney stones: recommended fluid intake
|
>3L/d
|
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Ca2+ kidney stones:
Tx w/what diuretic? |
Thiazide (decrease Ca2+ excretion into urine)
|
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In/decrease Ca2+ excretion into urine:
-thiazide -furesomide |
Thiazide: decrease Ca2+ excret (S/E mild hyperCa)
Furosemide: increase Ca2+ excret |
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Hairy: B or T?
|
B
|
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What leukemia:
Fibrotic BM --> dry tap |
Hairy (B)
|
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What leukemia:
TRAP |
hairy (B)
|
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What infection:
Bloody diarrhea & afebrile |
EHEC
|
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What infection:
Shiga toxin |
EHEC
|
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Down's: #1 heart defect
|
Endocardial cushion defect of AV canal
|
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Down's cushion defect: how tx?
|
Early surg --> prevent pulm HTN
|
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What abx:
S/E sunburn |
Tetracycline (esp DOXYCYCLIN)
|
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Fight-bite: what abx?
|
Amox-clav
|
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Hyperparathyroid: how affect BP?
|
Hypertension
|
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Renal vein thrombosis:
Assoc what type of nephrotic synd? |
Membranous glomerulonephritis
|
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Renal vein thrombosis:
2/2 loss of what protein? |
Memb glomerulonephrosis --> lose AT-III --> renal v thrombus
|
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PTU: if pt develops sore throat --> next step?
|
S/E agranulo
D/C PTU --> check CBC |
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PTU: are S/E dose dependent?
|
NO - dose-independent
(contrast methimazole -- dose-dependent) |
|
Next step:
Pt on Coumadin develops back pain |
Abd CT (r/o retroperitoneal hemm)
|
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Sjogren: what histo?
|
Lymphos invade salivary glands --> enlarged, firm
|
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What dz:
-anti-SSA -anti-SSB |
Sjogren's
(both) |
|
What dz:
-anti-Ro -anti-La |
Sjogrens
(both) |
|
Supravent tachy: how does Valsalva/carotid massage break the arryth?
|
INCREASE vagal tone
|
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Txs what arryth:
Valsalva, carotid, cold immers |
Parox Supravent Tachy
-increases vagal tone --> decreases AV condxn |
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Txs what dz;
Riluzole |
ALS
|
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Clubfoot (talipes equinovarus):
-how tx |
Tx immed: stretch --> serial cast --. surg & 3-6mos
|
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#1 etio congen hypothyroid:
-US -World |
US: thyroid dysgen
world: endemic goiter |
|
What dz:
Admin X-lyose before & after abx --> no excrete xylose in urine |
Celiac dz
(contrast bact overgrowth: excrete s/p abx) |
|
What dz:
Anti-TPO |
Hashimoto (90%)
|
|
Safe to co-admin Sildenafil & prazosin?
|
Space 4h apart
|
|
#1 tx for DM-induced ED
|
Sildenafil
|
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HIT-I or -II:
occurs 0-2d s/p initiate |
hit-I
|
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HIT-I or -II:
non-immune; hep directly activates platelets |
I
|
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HIT-I or -II:
Imm; Abs against hep platelet factor 4 |
II
|
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HIT-I or -II:
occurs 4-10d s/p initiate hep |
HIT-II
|
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What dz:
Anti-desmoglein IgGs in epidermis |
Pemphigus vulgaris
|
|
Pemphigus vulgaris: how tx?
|
pred + MTX + azathio
|
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Impetigo: how tx?
|
Topical mupirocin
|
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EPO admin: leads to what mineral def?
|
Fe def 2/2 over-rapid RBC prolif
(pre-tx w/suppl Fe2+) |
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DM neuropathy: how tx?
|
TCA
Gabapentin NSAID |
|
Lead poison: what #?:
-remove child from house -chelate |
>10 --> remove house
>45 --> chelate |
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Celiac dz: affect coag?
|
Fat malabs --> decreaes vit K --> increase PT
|
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What dz:
IgA anti-gliadin |
Celiac
|
|
What dz:
Anti-endomysial |
Celiac
|
|
What dz:
Anti-transglutaminase |
Celaic
|
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What dz:
Anti-centromere |
CREST
|
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What dz:
Anti-mitochondria |
PBC
|
|
DKA: admin what type of insulin? what route?
|
IV regular insulin
|
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Factor V leidin: pro- or anti-coag? Factor V resists what protein?
|
CLOTS --- DVTs
Resists protein C |
|
Hyperparathyroid: increase what joint dz?
|
Increase Ca --> increase CPPD --> increase pseudogout
|
|
what stone:
Coffin lids |
Struvite kidney stone (urease)
|
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LE synd:
-what cancer? -how tx? -affect DTRs? |
Small cell (oat)
tx: plasmaphar & immunosupp DECREASE DTRs (contrast MG) |
|
LE or MG:
Normal DTRs |
MG
(LE --> decrease DTRs) |
|
What dz:
Osmo fragility test |
Hered sphero
|
|
What dz:
Jaundiced infant of N European descent |
Hered sphero
|
|
What dz:
Envelope crystals |
Calcium oxalate in ETHYLENE GLYCOL --> RF
|
|
What dz:
Snowfield vision & acute pancreatitis |
Methanol
|
|
Methanol or Ethylene glycol:
Acute pancreatitis |
Methanol
|
|
RV infarct:
-give nitrates prn pain? -if see JVD --> admin fluid? |
No nitrates (decrease preload)
Always give IVF to increase preload |
|
Septic joint:
-what 2 pathogens? -heme or contig spread? -how tx? |
Strep & staph aureus
HEME SPREAD IV abx & immed surg |
|
Thiazide: how affect
-K -Na -Ca -LDL -TG -HDL |
Decrease K, Na
Increase Ca Increase LDL, TG n/a HDL |