Step 2, Set 2

Front 1

TFTs in pregnancy

Back 1

Elevated TOTAL T3 and T4, otherwise normal

Front 2

Study of choice in suspected stroke

Back 2

Non-contrast CT

Front 3

Pain after a fatty meal resolving between episodes: dx?

Back 3

Biliary colic (GB contraction causing pain from stones)

Front 4

Severe symptomatic hyponatremia (incl 2/2 SIADH): tx?

Back 4

3% saline

Front 5

Complication of overrapid correction of hyponatremia

Back 5

* (complication of?)
Central pontine myelinolysis

Front 6

Primary amenorrhea without breast development: workup

Back 6

FSH
-If low: GnRH stimulation test (central problem)
-If normal: Dx ovarian a/dysgenesis
-If increased: Karyotype (gonadal problem)

Front 7

Cyanosis aggravated by feeding and relieved by crying: dx?

Back 7

* (presentation)
Choanal atresia

Front 8

Lyme dz treatment
-Early-localized, <9 years
-Early-localized, >9 years
-Disseminated

Back 8

-Amoxicillin
-Doxycycline
-Ceftriaxone or Penicillin G

Front 9

Biliary condition a/w IBD

Back 9

Primary sclerosing cholangitis

Front 10

Structures affected by PSC

Back 10

* (damaged in what?)
Medium and large ducts of intra- and extra-hepatic biliary tree

Front 11

Histological finding in PSC

Back 11

*
"Onion-skinning" pattern

Front 12

Cholangiographic finding of PSC

Back 12

*
"Beading" (stricture and dilation of bile ducts)

Front 13

Medical tx of PSC

Back 13

Ursodeoxycholic acid

Front 14

Gender in which PBC is more common

Back 14

Women

Front 15

Gender in which PSC is more common

Back 15

Men

Front 16

Biliary condition with anti-mitochondrial antibodies

Back 16

* (antibody)
PBC

Front 17

Biliary condition with postive p-ANCA

Back 17

PSC

Front 18

MCC of polycythemia in term newborn

Back 18

Delayed clamping of umbilical cord

Front 19

MC presenting signs of polycythemia in newborn (3)

Back 19

Respiratory distress
Poor feeding
Neuro manifestations

Front 20

Hemodynamically unstable trauma pt with inconclusive FAST: next step?

Back 20

DPL

Front 21

Lichenoid papules over joints: dx?

Back 21

Dermatomyositis

Front 22

Constipation: a metabolic cause

Back 22

Hypercalcemia (consider MM etc in appropriate context)

Front 23

Med for tx of SIADH

Back 23

* (use)
Demeclocycline

Front 24

Tx of nephrogenic DI (3)

Back 24

Indomethacin (NSAID) and HCTZ
Amiloride if lithium-induced

Front 25

Diastolic heart failure
-Classic cause
-Arrythmia

Back 25

-Hypertension
-AFib

Front 26

Symmetric erythematous vesicles over extensor surfaces of elbows and knees: dx?

Back 26

Dermatitis herpetiformis, a/w celiac dz

Front 27

Cluster headaches
-Ppx (3)
-Tx (2)

Back 27

-Verapamil, lithium, ergotamine
-100% O2, subQ sumatriptan

Front 28

Tricuspid atresia
-Cyanotic?
-EKG
-CXR
-Tx

Back 28

*
-Cyanotic
-LAD
-Decreased pulm vascular markings, normal sized heart
-PGE1 and balloon atrial septostomy

Front 29

TOF
-CXR
-EKG

Back 29

*
-Decreased pulm vasc markings with normal sized heart
-Right atrial dilation, RVH

Front 30

Truncus arteriosus
-CXR
-EKG

Back 30

*
-Cardiomegaly, increased vasc markings, right aortic arch
-Biventricular hypertrophy

Front 31

Ebstein's anomaly
-CXR
-EKG

Back 31

*
-Extreme cardiomegaly
-RAH

Front 32

Mechanism of nitrates in cardiac chest pain

Back 32

Venodilation --> decreased preload

Front 33

Amiodarone: use

Back 33

Atrial and ventricular arrhythmias

Front 34

SEs of amiodarone (5)

Back 34

* (drug causing)
1) Pulmonary fibrosis
2) Hypo- or hyperthyroidism
3) Hepatotoxicity
4) Corneal deposits
5) Blue-gray skin discoloration

Front 35

Normal values
-Right atrial pressure
-Pulmonary artery pressure
-PCWP

Back 35

-4-6 mmHg
<25/15 mmHg
-6-12 mmHg

Front 36

Bronchiectasis
-CXR findings (3)
-Definitive imaging modality

Back 36

*
-Prominent bronchioles, peripheral opacities, linear atelectasis
-High resolution CT

Front 37

Ehrlichiosis: tx

Back 37

Doxycycline

Front 38

Infection causing elevated LFTs, thrombocytopenia and leukopenia

Back 38

* (3 signs)
Ehrlichiosis

Front 39

Cause of hypotension with epidural

Back 39

Sympathetic block --> LE vasodilation and venous blood pooling

Front 40

Histological findings in liver in alpha-1 antitrypsin deficiency

Back 40

*
PAS+ hepatocyte inclusions that resist digestion by diastase

Front 41

Trihexyphenidyl
-Class
-Indications (2)

Back 41

-Anticholinergic
-Parkinson's, extrapyramidal SEs

Front 42

Selegiline
-Class
-Indication

Back 42

*
-MAOB inhibitor
-Parkinson's

Front 43

Bromocriptine
-Class
-Indication

Back 43

-Dopamine agonist
-Parkinson's

Front 44

Azithromycin: class

Back 44

Macrolide

Front 45

Tx for active TB

Back 45

INH + pyrazinamide + rifampin + ethambutol x 2 months
then
INH + rifampin x 4 months

Front 46

SE of rifampin

Back 46

Turns body fluids orange

Front 47

SE of ethambutol

Back 47

Optic neuritis

Front 48

SEs of INH (2)

Back 48

Peripheral neuritis (prevent with B6)
Hepatitis

Front 49

Ppx for contacts of pts with meningococcal meningitis

Back 49

Rifampin

Front 50

Turner syndrome with 45X/46XY karyotype: concern

Back 50

Gonadoblastoma --> prophylactic bilateral gonadectomy

Front 51

Benign essential tremor
-Affected areas
-Type of tremor
-Tx

Back 51

-Head and hands (not usually legs)
-Action tremor
-Propranalol

Front 52

How to monitor respiratory function in Guillain-Barre

Back 52

Serial vital capacity measurements

Front 53

PDA: type of murmur

Back 53

Continuous

Front 54

Endocardial cushion defects can cause ___

Back 54

Pulmonary hypertension

Front 55

P2 heart sound indicates?

Back 55

Pulmonary hypertension

Front 56

SE of EPO

Back 56

Worsening of HTN

Front 57

Simple asx renal cyst: management

Back 57

None

Front 58

Rx for HOCM

Back 58

Beta-blockers

Front 59

Classic triad of RCC

Back 59

Hematuria
Flank pain
Palpable abdominal mass

Front 60

Scrotal varicocele that fails to empty when pt is recumbent: concern for?

Back 60

RCC

Front 61

Tx for hairy cell leukemia

Back 61

* (tx for)
Cladribine

Front 62

Tx for NHL

Back 62

CHOP

Front 63

Tx of pt who presents >5 days after onset of appendicitis with localized RLQ findings: management

Back 63

IV hydration, 2nd/3rd gen ceph, bowel rest

Front 64

SE of methotrexate (3)
-How to prevent

Back 64

* (SEs of?)
Stomatitis (oral ulcers)
Hepatotoxicity
Anemia
-Folic acid

Front 65

Felty syndrome

Back 65

* (syndrome)
RA with splenomegaly and granulocytopenia

Front 66

When is it OK to use TMP-SMX during pregnancy?

Back 66

Second trimester

Front 67

Tx of asx bacteriuria in pregnancy (3)

Back 67

Amoxicillin
Nitrofurantoin
Cephalosporins

Front 68

Abnl values in von Willebrand dz

Back 68

Increased bleeding time and PTT
(Normal platelet count)

Front 69

CNS complications of mumps (2)

Back 69

Aseptic meningitis
Encephalitis

Front 70

Tx of postherpetic neuralgia

Back 70

TCAs (amitriptyline, nortriptyline)

Front 71

Tx of enterobiasis (pinworm)
-First line
-Second line

Back 71

*
-Albendazole or mebendazole
-Pyrantel pamoate

Front 72

Turcot's syndrome
-Definition
-Inheritance

Back 72

*
-Brain tumors (medulloblastoma or glioma) a/w FAP or HNPCC
-AR

Front 73

Gardner's syndrome
-Definition
-Inheritance

Back 73

*
-Colonic polyps with various extraintestinal lesions
-AD

Front 74

Peutz-Jeghers syndrome
-Definition
-Inheritance

Back 74

*
-Intestinal hamartomatous polyps with mucocutaneous melanocytic macules
-AD

Front 75

Multiple hamartoma syndrome
-Other name
-Inheritance
-Presentation (4)

Back 75

*
-Cowden syndrome
-AD
1) GI hamartomas
2) Breast ca
3) Thyroid ca
4) Nodular gingival hyperplasia

Front 76

Cronkhite-Canada syndrome
-Presentation
-Inheritance

Back 76

*
-Juvenile-type polyps and ectodermal abnormalities (alopecia, hyperpigmentation, nail loss)
-Sporadic

Front 77

Development of sinuses

Back 77

Birth: Maxillary & ethmoid
First few years: Sphenoid
Age 9-10: Frontal

Front 78

Echinococcus
-Causes what?
-MC sites
-Who is at risk

Back 78

*
-Hydatid cysts
-Liver, then lung
-Sheep workers

Front 79

RBCs in lead poisoning

Back 79

*
Basophilic stippling

Front 80

Peripheral smear finding in HUS

Back 80

Schistocytes

Front 81

Tx of early localized Lyme in pregnant women

Back 81

Amoxicillin

Front 82

Empiric tx for bacterial meningitis

Back 82

IV ceftriaxone + vanc

Front 83

MAC ppx in HIV with CD4 <50

Back 83

Azithromycin

Front 84

PCP ppx in txplant pts

Back 84

TMP-SMX

Front 85

PID:
-Chlamydia rx
-Gonorrhea rx

Back 85

-Azithromycin
-Ceftriaxone

Front 86

Cutaneous manifestations of blastomycosis

Back 86

Verrucous or ulcerative

Front 87

Abscess near head/neck draining sulfur granules: dx?

Back 87

Actinomyces

Front 88

MCC SBE in pts with preexisting valvular disease

Back 88

Viridans group Strep

Front 89

MCC SBE in pts with prosthetic valve

Back 89

Staph epidermidis

Front 90

Peripheral neuropathy, renal failure & anemia: dx?

Back 90

* (presentation - 3)
Lead poisoning

Front 91

Adolescent with epistaxis, nasal mass and bony erosion in back of nose: dx?

Back 91

* (presentation)
Juvenile angiofibroma

Front 92

Condition a/w anaphylactic rxn to blood transfusion

Back 92

IgA deficiency

Front 93

Cytokines in stored blood product may cause ___

Back 93

* (caused by)
TRALI

Front 94

MCC painless hematuria in adults

Back 94

Bladder tumor

Front 95

"Snowstorm" on US: dx?

Back 95

Molar pregnancy

Front 96

HTN before 20 weeks in pregnancy: dx?

Back 96

Chronic HTN or hydatidiform mole

Front 97

When to retest Rh(D) Abs in pregnancy?

Back 97

24-28 weeks

Front 98

Mechanism in Meniere's dz

Back 98

Accumulation of endolymph in inner ear

Front 99

Dx/tx of intussusception

Back 99

Air contrast enema

Front 100

Vascular damage with supracondylar fracture

Back 100

* (type of injury damaging this)
Brachial artery --> loss of radial pulse

Front 101

Secondary damage with proximal humerus fracture

Back 101

* (type of injury damaging this)
Axillary nerve

Front 102

Friedreich ataxia
-Class
-Inheritance
-Manifestations (4)
-MCCs of death (2)

Back 102

*
-Spinocerebellar ataxia
-AR
1) Ataxia & dysarthria
2) Scoliosis and foot deformities (hammer toes)
3) Concentric hypertrophic cardiomyopathy
4) Diabetes
-Cardiomyopathy and respiratory complications

Front 103

Presentation of cavernous sinus thrombosis (4)

Back 103

*
1) HA
2) Low grade fever
3) Periorbital edema
4) CN palsies

Front 104

Mechanism of malabsorption in ZE syndrome

Back 104

Inactivation of pancreatic enzymes by stomach acid

Front 105

Typical antipsychotic causing hypothermia

Back 105

Fluphenazine

Front 106

Fluphenazine
-Class
-SE

Back 106

-Typical antipsychotic
-Hypothermia

Front 107

One live vaccine OK in HIV

Back 107

MMR (w/ CD4 >200 and no AIDS-defining illness)

Front 108

Tx for mild-moderate hypercalcemia in malignancy

Back 108

Bisphosphonates (incl. zolendronic acid)

Front 109

Zolendronic acid: class?

Back 109

Bisphosphonate

Front 110

Ethylene glycol poisoning: presentation (3)

Back 110

*
1) Renal failure
2) Hypocalcemia
3) Anion-gap metabolic acidosis

Front 111

Ethylene glycol poisoning: antidote

Back 111

* (antidote for?)
Fomepizole

Front 112

Multiple ring-enhancing lesions in head CT of AIDS pt: dx?

Back 112

Toxoplasmosis

Front 113

Cerebral toxo:
-Ppx
-Tx

Back 113

-TMP-SMX
-Sulfadiazine & pyrimethamine

Front 114

Tx for neurocysticercosis

Back 114

Albendazole

Front 115

Abx for inflamed, fluctuant cervical lymph node

Back 115

Dicloxacillin

Front 116

Thiazolidinediones (2)

Back 116

Pioglitazone
Rosiglitazone

Front 117

Pioglitazone & rosiglitazone: class?

Back 117

Thiazolidinediones

Front 118

Tx of cervicofacial actinomycosis

Back 118

High-dose PCN x6-12 weeks

Front 119

Appearance of Actinomyces

Back 119

*
Gram-positive branching bacteria

Front 120

PMNs filled with bacteria on gram stain: dx?

Back 120

CGD

Front 121

Adenosine deaminase deficiency causes?

Back 121

* (defect)
SCID

Front 122

Type of immune deficiency in DiGeorge syndrome

Back 122

T-cell dysfunction

Front 123

Phenytoin toxicity: prsentation (3)

Back 123

*
1) Horizontal nystagmus
2) Cerebellar ataxia
3) Confusion

Front 124

Lithium toxicity: presentation (4)

Back 124

* (SEs of what?)
1) Tremor
2) Hyperreflexia
3) Ataxia
4) Seizures

Front 125

Most common valvular manifestation of RF

Back 125

Mitral stenosis

Front 126

% within
-1 SD
-2 SDs
-3 SDs

Back 126

-68%
-95%
-99.7%

Front 127

Precocious pubarche with signs of severe androgen excess: dx?

Back 127

Precocious pseudo-puberty, 2/2 sex steroid excess - gonadotropin-independent process (e.g. late-onset CAH)

Front 128

Cervical spondylosis
-Presentation (3)
-Radiography

Back 128

-Chronic neck pain, limited neck rotation, arm numbness
-Osteophytes (bony spurs)

Front 129

Measles
-Type of virus
-Initial sx
-Spread of rash

Back 129

*
-Paramyxovirus
-Cough, Coryza, Conjunctivitis
-Face --> body

Front 130

Rubella: type of virus

Back 130

Togavirus

Front 131

Raloxifene
-Indication
-SE

Back 131

-Osteoporosis
-DVT

Front 132

Drugs causing pancreatitis:
-Diuretics
-IBD
-Immunosuppressive
-Sz/BPD
-AIDS
-Abx

Back 132

-Furosemide, thiazides
-Sulphasalazine, 5-ASA
-Azathioprine, L-asparaginase
-VPA
-Didanosine, pentamidine
-Metronidazole, tetracycline

Front 133

Dysphagia for solids and liquids: dx?

Back 133

* (type of dysphagia)
Motility d/o

Front 134

Dysphagia for solids progressing to liquids: dx?

Back 134

* (type of dysphagia)
Obstructing lesion

Front 135

Serous otitis media
-Definition
-Pneumatic otoscopy findings
-Found in

Back 135

*
-Middle ear effusion w/o infection
-Dull, hypomobile TM
-HIV/AIDS

Front 136

Cauda equina syndrome
-What is affected
-Presentation (4)

Back 136

*
-Spinal nerve roots
1) Saddle anesthesia
2) Bowel/bladder dysfxn
3) Low back pain
4) LE motor/sensory dysfxn

Front 137

Simple partial sz: presentation

Back 137

No loss of consciousness

Front 138

Partial sz with secondary generalization: presentation

Back 138

Includes tonic-clonic activity

Front 139

Trichenellosis: presentation

Back 139

*
GI sx followed by periorbital edema, myositis and eosinophilia

Front 140

Malignancy arising in chronic wounds or scars

Back 140

SCC

Front 141

IV-drug related endocarditis
-MC organism
-Tx

Back 141

-Staph
-Vanc

Front 142

Murmurs that increase with inspiration

Back 142

Right-sided

Front 143

Skin finding in sarcoid

Back 143

Erythema nodosum

Front 144

Polymyalgia rheumatica: association?

Back 144

Giant cell arteritis

Front 145

Odynophagia for hot and cold food: dx?

Back 145

Diffuse esophageal spasm

Front 146

Tx of NMS (3)

Back 146

*
Dantrolene
Bromocriptine
Amantadine

Front 147

Oxalate absorption increased in?

Back 147

Crohn's dz and other causes of fat malabsorption

Front 148

Babesiosis
-Region
-Common manifestation
-Increased risk among?
-Tx

Back 148

-NE US
-Hemolytic anemia
-Splenectomized
-Quinine-clindamycin or atovaquone-azithromycin

Front 149

Q fever
-Organism
-Most common victims

Back 149

*
-Coxiella burnetii
-Meat processors and veterinarians

Front 150

Cysticercosis: organism

Back 150

* (syndrome)
Taenia solium

Front 151

Presentation of duodenal atresia

Back 151

*
Bilious vomiting in first 1-2 days of life

Front 152

Duodenal atresia: XR finding

Back 152

"Double bubble" (air trapped in stomach and duodenum

Front 153

Pyloric stenosis: presentation

Back 153

Non-bilious vomiting at 3-6 weeks of age

Front 154

Classic presentation of rubella

Back 154

Low-grade fever
Sub-occipital and posterior auricular LAD
Rash, face --> body

Front 155

Dopamine pathway affecting prolactin

Back 155

*
Tuberoinfundibular pathway

Front 156

Tx of SCFE

Back 156

Internal fixation of hip with pins

Front 157

Tx of Legionella (2)

Back 157

Macrolide (eg azithromycin)
Newer fluoroquinolone (levofloxacin)

Front 158

MCC conductive hearing loss in adults

Back 158

Otosclerosis

Front 159

Rinne Test
-Conductive hearing loss
-Normal
-Sensorineural hearing loss

Back 159

* (Rinne test - type of hearing loss)
- Bone > air
- Air > bone
- AIr > bone

Front 160

Type of hearing loss caused by abx toxicity

Back 160

Sensorineural

Front 161

Type of hearing loss in Meniere's dz

Back 161

Sensorineural

Front 162

Presbycusis: type of hearing loss

Back 162

Sensorineural

Front 163

Chronic otitis media: type of hearing loss

Back 163

Conductive

Front 164

Acoustic neuroma: type of hearing loss

Back 164

Sensorineural

Front 165

Henoch-Schonlein purpura: mechanism

Back 165

*
IgA-mediated small vessel vasculitis

Front 166

Henoch-Schonlein purpura: presentation (4)

Back 166

*
1) Purpuric rash (lower legs, buttocks, arms)
2) Arthralgias
3) Abdominal pain
4) Renal dz

Front 167

Renal histo finding in Goodpasture's

Back 167

*
Linear IgG deposits on BM

Front 168

Test for osteogenesis imperfecta

Back 168

* (test for?)
Type I collagen assay

Front 169

Live childhood vaccines

Back 169

MMR
Varicella

Front 170

EKG finding in pericardial effusion

Back 170

* (seen in?)
Electrical alternans

Front 171

NF2: classic features (2)

Back 171

*
Bilateral acoustic neuromas
Cataracts

Front 172

Indinavir: class

Back 172

Protease inhibitor

Front 173

Indinavir: SE

Back 173

* (SE of?)
Crystal-induced nephropathy

Front 174

Didanosine: SE

Back 174

Pancreatitis

Front 175

Tenderness in anatomic snuff box: dx?

Back 175

* (presentation)
Scaphoid fracture

Front 176

Management of scaphoid fracture
-Displaced
-Non-displaced

Back 176

-ORIF
-Cast immobilization x6-12 weeks

Front 177

Tx of hyperCa of immobilization

Back 177

Bisphosphonates

Front 178

Amnio findings with NTD (2)

Back 178

* (dx with amnio findings)
-Increased AFP
-Increased acetylcholinesterase

Front 179

Quadruple screen in Down syndrome

Back 179

*
Low MSAFP
Low estriol
High beta-HCG
High inhibin A

Front 180

Analgesic nephropathy: type of damage

Back 180

Papillary necrosis

Front 181

Tx for Reiter syndrome (reactive arthritis)

Back 181

NSAIDs

Front 182

Tx of
-Acute gout
-Chronic hyperuricemia

Back 182

-Colchicine
-Allopurinol

Front 183

Imipramine: class

Back 183

TCA

Front 184

Mech of sodium bicarb for TCA overdose

Back 184

Narrows QRS by alleviating cardio-depressant action on Na channels

Front 185

Methods for detecting level of HER2 expression

Back 185

FISH or IHC

Front 186

Dx test for pyloric stenosis

Back 186

Abdominal US

Front 187

Type I Gaucher
-Deficiency
-Radiologic finding
-Histologic finding

Back 187

*
-Acid beta-glucosidase
-Erlenmeyer flask deformity of distal femur
-Wrinkled paper cells

Front 188

Niemann-Pick: deficiency

Back 188

*
Sphingomyelinase deficiency

Front 189

GM1 gangliosidosis: defiency

Back 189

*
Beta-galactosidase deficiency

Front 190

GM2 gangliosidoses
-Examples (2)
-Deficiency

Back 190

* (class)
-Tay-Sachs and Sandhoff
-Hexosaminidase

Front 191

Farber disease: deficiency

Back 191

* (dz)
Ceramidase deficiency