Step 3 Review - What I Missed

Front 1

next step after vitals for someone with suspected pancreatitis

Back 1

LFTs with lipase levels

Front 2

characteristics of torsades

Back 2

ventricular rate
>100
frequent variations in morphology
QPRS peaks twist

Front 3

treatment for torsades in a hemodynamically unstable patient

Back 3

defibrillation

Front 4

treatment for torsades in a stable patient

Back 4

magnesium sulfate

Front 5

treatment for stable ventricular tachycardia

Back 5

synchronized cardioversion

Front 6

treatment for stable atrial fibrillation

Back 6

synchronized cardioversion

Front 7

a drug that can potentially cause torsades

Back 7

amiodarone

Front 8

common cause of torsades

Back 8

QT prolongation

Front 9

causes of QT prolongation

Back 9

hypomagnesium
hypokalemia

Front 10

first step in treating heat stroke

Back 10

augment evaporative cooling

Front 11

what to do if him clunks during birth

Back 11

1) Barlow test)
2) ultrasound of hips
3) refer to ortho
4) Pavlik harness to abduct for 1-2 mos

Front 12

victim at wheel of auto, chest bruises, peripheral cyanosis, breath sounds in lower fields b/l

Back 12

flail chest

Front 13

hypotension and neck vein distension

Back 13

cardiac tamponade

Front 14

likelihood of HIV transmission by human bite

Back 14

o%

Front 15

likely infections with human bits

Back 15

Eikinella
Stap aureus
alpha-hemolytic strep
Haemophilus
Peptostrep
Actinomyces

Front 16

likely infections with cat and dog bites

Back 16

pasteurella multicoda and especially with cats can lead to osteo

Front 17

best abx for human bites

Back 17

amp-sulbactam

Front 18

best abc for cat and dog bites

Back 18

amp sulbactam (the same!)

Front 19

in metastatic disease to brain can radiation help

Back 19

yes, it improves survival 3-6 mos

Front 20

in metastatic disease to brain can steroids help

Back 20

yes, up to 2 months

Front 21

do we prophylax with anti seizure meds for brain mets?

Back 21

no

Front 22

best first test for suspected perforated ulcer with peritonitis

Back 22

upright chest xray

Front 23

after X-ray what do we do next for perforated ulcer with peritonitis

Back 23

laparotomy

Front 24

what cause xanthomatous nodules

Back 24

hereditary hyperlipidemic syndromes
(versus cholesterol for xanthelasma)

Front 25

memory loss with 2 of cognitive fluctuations, VH, parkinsonism

Back 25

Lewy Body

Front 26

demential that presents in 50 year olds with changes in personality first

Back 26

frontotemporal

Front 27

what class of meds increases VH in parkinsons pts

Back 27

dopamine agonists

Front 28

best initial mgmt for person with diabetes and succession splash

Back 28

upper GI endoscopy

Front 29

best test for diagnosing diabetic gastroparesis

Back 29

scintigraphic gastric emptying study

Front 30

meds for diabetic neuropathy

Back 30

amitiptyline, duloxeting, pregabalin

Front 31

precocious puberty in males and females with rapid acceleration of height, bone age, thelarche, adrenarche, pubarche, menarche

Back 31

Hypothalamic hamartomas (secreting GnRH)

treated with GnRH analog

Front 32

precocious puberty in infancy

Back 32

benight premature thelarche

not treated, will reverse

Front 33

precocious puberty with virilization in females and peripheral isosexual precocious puberty in males, leading to Cushing's

Back 33

Adrenal tumors

Front 34

precocious puberty with accelerated height, bone age, menstrual bleeding, estradiol elevated

Back 34

ovarian tumor producing estrogen

tx is usually surgical

Front 35

cafe au laid spots
fibrous dysplasia of bone
precocious puberty

Back 35

McCune-Albright caused by excessive production of estrogen from ovarian cysts

Front 36

FEV1/FVC in asthma

Back 36

decreased

Front 37

what happens to asthmatics on methacholine challenge

Back 37

normal

Front 38

imaging modality for abdominal abscess

Back 38

ultrasound

Front 39

how to use abc for patients with esophageal varicose that bleed

Back 39

prophylactically given high risk of infectious complications

Front 40

what is an apical lung nodule with popcorn calcifications

Back 40

pulmonary hamartoma, and not concerning

Front 41

are eccentric , reticular/punctate calcifications in the lung concerning?

Back 41

yes

Front 42

what kinds of lung calcification are benign?

Back 42

popcorn
concentric or laminated
central
diffuse homogenous

Front 43

what kinds of lung calcification are not benign

Back 43

eccentric
reticular
punctate

Front 44

diet after chole

Back 44

no changes needed

Front 45

tx for nurse with low Hep B titres who is exposed

Back 45

IG and initate revaccination

Front 46

what stool studies do you do for someone with foul-smelling loose stools for 10 months

Back 46

stool microscopic exam (not cultures)

this person has celiac

Front 47

igA endomysial antibodies indicated

Back 47

celiac

Front 48

morphological changes in celiac

Back 48

villus blunting and lymphocytic and plasma cell infiltration in GI tract

Front 49

mainstay of diagnosis in celiac

Back 49

small intestinal biopsy

Front 50

transmural inflammation of mucosa

Back 50

Crohns

Front 51

superficial mucosal inflammation with infiltration of plasma cells

Back 51

UC

Front 52

girl with grimacing, delayed patellar reflex relaxation, changes in pitch and volume of voice, muscular tone mildly decreased, pronator drift, 2/6 holosystolic murmur. ? and how to treat

Back 52

Sydenham Chorea Treat with penicillin

Front 53

how to handle a new patient asking for pain meds

Back 53

2 weeks supply
pain contract

Front 54

most common side effect after LEAP

Back 54

bleeding

Front 55

when does pap smear interval change, and what are former and later frequenceis

Back 55

2 years at ag 21
change to 2-3 after
- three negatives
- age thirty

Front 56

sensitivity is

Back 56

ability to catch the disease if it's there

Front 57

best treatment for bereavement related insomnia in the elderly

Back 57

behaviorl therapy and relaxation

Front 58

future risk in a woman who had preeclampsia

Back 58

elevated but not sure to happen

Front 59

first order after suspecting pancreatitis

Back 59

LFTs and lipase

Front 60

first step in managing pancreatitis

Back 60

IV fluids and narcotics

Front 61

drug for pancreatitis

Back 61

imipenem

Front 62

twisting tachy oscillating QRS

Back 62

torsades

Front 63

first step in treatment of torsades if pt stable? unstable?

Back 63

magnesium
defibrillation

Front 64

what is synchronized cardioversion used for?

Back 64

stable ventricular tachy
a fib
a flutter
SVT

Front 65

what rhythm often happens with QT prolognation

Back 65

torsades

Front 66

causes of torsades

Back 66

low mag
lok K
macrolides
antihistamines

Front 67

milk type product that gives a cgood source of calcium ok for lactose intolerance

Back 67

yogurt

Front 68

imaging for diverticulitis

Back 68

CT

Front 69

what to do if a patient from endemic area with prior BCG has a tuberculin of 16mm and RIL fibrosis with no signs of active TB

Back 69

isonizid for 9 mod because induration >10 (

Front 70

induration to treat HIV pt

Back 70

5mm

Front 71

inducartion to treat recently exposure

Back 71

5mm

Front 72

induration with fibrotic changes suggesting prior tb

Back 72

5mm

Front 73

inducation for transplant reciptient

Back 73

5mm

Front 74

induration for IV drug user

Back 74

10mm

Front 75

induration fo healthcare workers

Back 75

10mm

Front 76

induration for kids <4

Back 76

10mm

Front 77

induration for people with no risk factors

Back 77

15mm

Front 78

fibrosis in upper lobes suggest

Back 78

latent tb

Front 79

tx for latent tb

Back 79

isoniazid for 9 mos

Front 80

what is pyelophblebitis

Back 80

infectious thrombosis in portal veins

Front 81

main complication fo appendicitis in pregnancy

Back 81

perforation with peritonitis and subsequent pylephlebitis

Front 82

chromosome mutations in CML

Back 82

9, 22

Front 83

translocation in CML

Back 83

bcr/abl

Front 84

treatment for CML

Back 84

tk inhibitors

Front 85

nail wound for someone who has a clean wound but unknown immunization status

Back 85

toxoid only

Front 86

nail wound in which patient has a clean wound, prior 3 doses, more than 10 years ago

Back 86

toxoid only

Front 87

nail wound contaminated, 3 or more doses of antitoxin >5 years ago

Back 87

toxoid only

Front 88

nail wound, contaminated, unknown immunization status

Back 88

toxoid and IG

Front 89

endocarditis and conduction system abnormalities: which vallve

Back 89

aortic (because of close proximity to ventricular conduction system)

Front 90

tx for large retrosternal multinodular goiter in euthyroid pt

Back 90

surgery

Front 91

rx for hypercholesterolemia and hyper TGL

Back 91

statin

Front 92

what to add to treatment with statin if it fails to control hyper TGL

Back 92

gemfibrozil or niazin

Front 93

first step after exposure to hazardous dry chemicals

Back 93

brush away

Front 94

next step for unresponsive patient who was hit by lightening

Back 94

continue chest compressions (quite prolonged, actually)n, and give epinephrine for the asystole

Front 95

what is defibrillation used for

Back 95

vfib
pulseless ventricular tachycardia

Front 96

treatement for carpal tunnel

Back 96

1) NSAIDS long course, stroid injections, splinting
2) occupational rehab

Front 97

most common cause of thrombophilia

Back 97

Factor V leiden