Uworld 6/26/13

Front 1

Pt w/ positive Rf and weak positive ANA w/ symmetric small hand joint paint and swelling w/ mild fever. Pain subsides after 2wks.
ML Dx?
Causes?

Back 1

Viral Arthritis (symmetric small joint inflammatory arthritis)
-Parvovirus, HIV, hepatitis, mumps, rubella

Front 2

How to differentiate septic arthritis from crystalline arthritis?

Back 2

Joint aspiration

Front 3

Types of seronegative spondylarthropathies?
Type of arthritis seen?
Rf?

Back 3

Ankylosing spondylitis, psoriatic arthritis, reactive arthritis
-assymetric w/ inflammatory back pain
-negative Rf

Front 4

55yo Pt w/ sore stiff muscles in neck, shoulders, ANA normal, ESR 45
ML Dx?

Back 4

Polymyalgia rheumatica (neck/shoulder stiff, ESR>40, normal ANA, >50yo)

Front 5

Type of diarrhea in IBD?
-findings suggesting this?

Back 5

Inflammatory diarrhea (is chronic >4wks)
-fecal occult stool, up ESR, reactive thrombocytosis (elevated plts), anemia, acute phase reactants

Front 6

Type of diarrhea in lactose intolerance?

Back 6

Osmotic diarrhea

Front 7

Type of diarrhea in hyperthyroidism?

Back 7

motor diarrhea

Front 8

Side effect of carbamazepine?
Uses?

Back 8

Aplastic Anemia (routine cbc before use)
-Atypical bipolar and Trigeminal Neuralgia

Front 9

Pt to ED from restaurant w/ difficulty breathing from laryngeal edema.
Flow-volume loop pattern?
Cause?
TMT Steps?

Back 9

-horizontal top and bottom lines (difficulty on inspiration and expiration)
-allergy to food
-Epinephrine, systemic corticosteroids, and antihistamines

Front 10

What stat is the probability of being free of disease if negative test result? ("doc, what's the chance I really don't have it?)

Back 10

Negative predictive value (this varies by pretest probability so if hi pretest prob, then low neg predictive value)

Front 11

A patient had an CXR for dx of pancreatitis. What stat term is low here?

Back 11

Low validity (appropriateness of test)

Front 12

3yo girl w/ red rash starting on face, now blisters over body, febrile, exam w/ flaccid bullae that detach on gentle pressure, crusting at mouth.
ML Dx?
Result of bullae cx?
TMT?
Timecourse?
Pathophys?

Back 12

Staph Scalded Skin Syndrome
-sterile bullae (since toxin mediated)
-anti-staph abx and supportive wound care
-Prodrome (fever, irritability, skin tender)->face erythema in 24hrs->flaccid blisters and perioral crusting->for 5 days, resolved in 1-2wks
-exfoliative staph aureus toxin disrupts desmogleins causing separation keratinocyte adhesion (as in pemph vulgaris)

Front 13

Kid w/ honey-colored crusting lesions on face =?
Cause?

Back 13

Impetigo
-s. aureus or group a strep

Front 14

Pt w/ fatigue, weight loss, AST/ALT 70/90, Alk phosph 400, hepatomegaly, Hgb 8.9, MCV 70, vague abd pain, fecal occult Positive, smoker, alcoholic, negative hepatojug reflex, ankle edema.
ML Dx?
Next Dx Test?

Back 14

Metastatic GI malignancy
-IV contrast CT Scan

Front 15

4mo old infant vomiting 10-12x daily nbnb emesis occuring after feeds, normal growth, no other sx, takes normal formula.
ML Dx?
Timecourse?
Initial TMT?

Back 15

Infantile GERD (in 50% infants)
-peaks at 4mos and resolves by 1yo
-Thicken formula w/ rice cereal and reposition baby upright (prone), if this fails, then PPI

Front 16

Risk of uterine cancer progression by endometrial hyperplasia reports on bx?

Back 16

Simple-1% penny
Complex -5% nickel
Simple atypical -10% dime
Complex atypical -25% quarter

Front 17

female w/ menorrhagia w/ complex hyperplasia w/ atypica on endometrial bx.
Risk of cancer?
TMT?
What if want to get pregnant in future

Back 17

29%
Hysterectomy
-cyclic progestins w/ rpt bx in 3-6mos

Front 18

female w/ menometrorrhagia w/ complex hyperplasia w/ no atypia on endometrial bx.
Risk of ca?
TMT?

Back 18

5%
Cyclic progestins

Front 19

Female w/ LLQ abd pain, last menses 2wks ago, no fever or accompanying sx, not taking OCPs
ML Dx?
Pathophys?

Back 19

Mittelschmerz (midcycle pain)
-pain from ovulation itself that is unilateral in pts not on birth control (so ovulating)

Front 20

70yo Pt w/ brbpr, negative blood in NG tube placement, rectal w/ blood on glove, no pain.
ML Dx?
Greatest risk factor?

Back 20

Diverticulosis (most common in elderly, more than angiodysplasia)
Constipation from low fiber diet

Front 21

Pt w/ abd pain out of proportion to findings, naus/vom, bloody diarrhea =?

Back 21

Acute mesenteric thrombosis (causing mucosal sloughing), pts have multiple atherosclerotic risk factors

Front 22

28yo sexually active female w/ no hx STDs or UTIs, yesterday w/ R wrist joint pain, L ankle joint pain, now w/ R knee joint pain and swelling, febrile, knee warm w/ effusion. Tapping knee shows WBC 75000.
ML Dx?
Criteria?
Dx Test?

Back 22

Gonoccocal Septic arthritis
-young sexually active, either asymmetic polyarthritis (w/ skin rash or tenosynovitis) that can lead to purulent monoarthritis. Criteria: fever, joint pain, synovial fluid WBC high)
-Gram stain of synovial fluid/blood cx/ Urethral cx

Front 23

What is important factor for potassium uptake from GI?

Back 23

magnesium

Front 24

Alcoholic pt admitted, found to have low K, is given IV and oral supplement w/ no change.
ML cause?

Back 24

hypomagnesemia (needed for absorption to gi tract)

Front 25

Risk factors for nasopharyngeal ca?
Prognosis of this?

Back 25

mediterranean/far east descent, EBV, smoking, nitrosamines (salted fish)
-very poor since usually dxed late and already mets

Front 26

Pt w/ hx multiple otitis media, alcohol use, syphilis, recurrent sinusitis, smoker, takes vitamins, has episodes epistaxis. Nasal exam shows mass in posterior cavitiy.
ML Dx?
Dx test?
Risk factor?
How to track therapy?

Back 26

Nasopharyngeal Carcinoma
-Bx of mass
-EBV, smoking, nitrosamines, mediterranean/far east descent
-EBV titer levels

Front 27

Pt found to have peptic ulcer dz.
What ca increased risk for?

Back 27

H. pylori increases risk of gut-associated lymphoid tissue lymphoma (GALT)

Front 28

Pt recently swallowed chicken bone, now with scratchy throat, unable to fully open mouth, pain on extending neck, febrile,
ML Dx?
Signs?
Dx Test?
TMT?

Back 28

Retropharyngeal Abscess
-Trismus (unable to open mouth), limited cervical extension, usually following blunt trauma (chicken bone)
-CT scan neck and/or lateral XR
-immediate drainage and abx

Front 29

Child w/ fever, sore throat, pain on swallowing. Exam shows vesicles on soft palate and tonsils.
ML Dx?
Cause?

Back 29

Herpangina
-Cocksackie A virus

Front 30

Child w/ low grade fever, unilateral nasal discharge, cervical lymphadenopathy, pharyngitis, no neck pain.
ML Dx?
Finding on op exam?

Back 30

Diphtheria
-pseudomembranous pharyngitis (grey covering)

Front 31

posterior cervical lymphadenopathy in kid = ?
What's the triad?

Back 31

MONO (EBV)
-fever, pharyngitis, posterior cervical lymphadenopathy
-will have atypical lymphocytosis on blood smear

Front 32

Differential for HIV pt CD4 <50?

Back 32

MAC, TB, disseminated CMV, non-Hodgkins lymphoma

Front 33

HIV pt w/ CD4 40. What to do?

Back 33

start azithromycin ppx against MAC
should already be on Bactrim for PCP ppx

Front 34

TMT for pt w myocbacterium avium complex infxn?

Back 34

Clarithromycin + Ethambutol

Front 35

When give CMV ppx and what to give in HIV pt?

Back 35

CD4 <50 and serum CMV IgG + or biopsy for CMV +
Ganciclovir

Front 36

Pt being treated for TB has red urine.
ML Dx?

Back 36

Rifampin induced drug rxn (causes body fluids to turn orange, including coontacts from tears)
-since pt is on RIPE

Front 37

Cancer pt w/ weight loss, decreased appetite and cachexia.
Best TMT?
-side effect tmt

Back 37

Progestins (megestrol acetat and medroxyprogesterone acetate) or corticosteroids
-slight increased risk DVT

Front 38

15yo F w/ breast development, hair tanner stage 3, blind vaginal pouch, no menses, bilateral inguinal masses.
ML Dx?
Alternative name?
Pathophys?
What organs has/missing?
Dx Test?
TMT?
Increased risk for what?

Back 38

Androgen insensitity Syndrome
-Male pseudohermaphrodite
-46 XY, mutation in androgen receptor causes them to not be sensitive to testosterone, breasts develop since testosterone converted to estrogen
-No mullerian structures (uterus, fallopian tubes), has testes
-Karyotype and abd U/S to document testes
-gonadectomy after puberty
-increased risk testicular ca

Front 39

Pt w/ painless blistering on back of hands, increased fragility of skin, noticed when outside gardening, has hyperpigmentation of face, started OCPs last month, hx of chronic hep C, mom w/ similar stuff.
ML Dx?
Cause?
Pathophys?
Dx Test?
TMT?

Back 39

Porphyria Cutanea Tarda
-from drugs (ethanol, estrogens) and related to Hep C
-from deficiency of uroporphyrin decarboxylase needed for heme synthesis, causes painless blisters, skin fragile, and facial hypertrichosis and hyperpigment
-Urinary porphyrin level elevated
-Phlebotomy or Hydroxychloroquine or interferon-alpha (if also has Hep C)

Front 40

What test confirms herpes zoster?

Back 40

Tzanck smear positive from vesicle

Front 41

Pt w/ GI irritability, pruritic papules and vesicles on elbows, knees, buttocks
ML Dx?
Association?

Back 41

Dermatitis Herpetiformis
-Celiac Dz (gluten-sensitive enteropathy)

Front 42

HIV pt w/ deteriorating vision bilaterally w eye pain, conjunctivitis, marked keratitis, fundoscopy w/ retinal lesions and retinal central necrosis.
ML Dx?
Cause

Back 42

Acute Retinal Necrosis Syndrome
Herpes Simplex (also can be herpes zoster): cause bilateral necrotizing retinitis, most common cause corneal blindness in USA)

Front 43

differentiate CMV retinitis from HSV retitinits in HIV pt

Back 43

CMV is painless w/ fundoscopy w/ fluffy granular retinal lesions around retinal vessels
HSV is painful w/ fund w/ keratitis, pale, peripheral lesions and central retinal necrosis

Front 44

Pt in MVC s/p splenectomy for bleeding, no stable postop.
Next step?

Back 44

Give meningococcal vaccine, and vaccines for SHIN encapsulated organisms (strep pneumo, HiB, neiserria meningtitis)
pneumococcal booster q5yrs

Front 45

Incidental xray shows solitary round lesion right upper lobe lung.
Next Step?
Features suggestive of Ca?

Back 45

Compare to prior Xrays, if no change->regular follow up w/ CT scans, if changed->do bronch for central located lesion or CT guided bx for peripheral located lesion
-large size, low density, spiculated border, no calcifications = cancer

Front 46

Pt w/ hyperthyroidism w/ single 2cm hot nodule is at risk for what if not treated?

Back 46

Rapid bone loss from increased osteoclastic resorption (not proptosis if pt only has toxic adenoma not graves)

Front 47

Area of brain damaged in pt w/ unilateral violent arm flinging.
What is this

Back 47

contralateral subthalamic nucleus
-hemiballismus

Front 48

1yo boy w/ bloody stool, multiple episodes otitis media, pna, easy bruising, afebrile, dry scaly patches on cheeks and lower extremites, bruising and purpura on lower extrem, plts 20,000, Hgb 11.5, WBC 6500. On blood smear, few plts and all small
ML Dx?
Pathophys?

Back 48

Wiskott-Aldrich Syndrome
-x linked recessive, plts less than 50000, decreased plt production, can cause life-threatening bleeds
-triade thrombocytopenia, eczema, recurrent bacterial infxn w/ SHIN

Front 49

How to differentiate orbital and preseptal cellulitis?
Dx test to differentiate if unclear?
TMT of each
Complications orbital?

Back 49

both have eyelid edema, erythema, tenderness, fever, leukocytosis. Only orbital has opthalmoplegia (double vision), pain w/ extraocular movement, proptosis, vision impairment (low visual acuity)
-CT scan of orbits
-outpt abx if preseptal, admit for IV abx for orbital
-blindness, abscess, cavernous sinus thrombosis, intracranial infxn

Front 50

36wk gestation preg mom w/ dull low back pain less in morning worse later.
ML Dx?

Back 50

Increased lumbar lordosis (common in 3rd trimester)

Front 51

Differentiate Allergic vs. nonallergic rhinitis (NAR) presentation and tmt?

Back 51

features allergic: EYE sx, early age onset, identifiable triggers, pallor nasal mucosa, rhinorrhea, sneezing (ME)
-TMT w/ allergen avoidance and topical intranasal glucocorticoids
features NAR: nasal stuffed, dry cough (postnasal drip), late onset >20, no trigger, red nasal mucosa
-TMT w/ topical intranasal glucorticoids or intranasal antihistamine

Front 52

Most common kidney stones?
Causes of them?

Back 52

Calcium Oxalate
-small bowel disease, surgical resection bowel causing malabsorption (in IBD)), any fat malabsorption, ethylene glycol

Front 53

Cause of calcium phosphate kidney stones?

Back 53

primary hyperparathyroidism, RTA

Front 54

Cause of uric acid stones?

Back 54

hyperuricemia from increased cell turnover, dehydration, in acidic urine

Front 55

Cause of cysteine stones?

Back 55

up excretion cystein from inborn metabolism error, look for family hx, seen at young age

Front 56

Cause of struvite stones?

Back 56

urine alkaline from invsn (urease producing bacteria Proteus), hx of UTI

Front 57

Pt s/p mastectomy for breast ca, now w/ solitary long nodule.
Steps?
TMT?
what if bone mets too?

Back 57

1.CT scan body to determin other mets
2.Bx of lesion
TMT: if solitary: surgery (since primary tumor removed, no other mets, low op risk w/out comorbid conditions)
-if mets, do systemic chemo or homone therapy

Front 58

Pregnant mom w/ HIV. Steps?

Back 58

Zidovudine tmt to mom throughout pregnancy and labor. Zidovudine tmt to neonate for 1st 6wks of life (risk down 70%)

Add on C-section (reduce risk 50%) after zdv tmt if mom agrees

Do NOT breastfeed

Front 59

What vaccine can reduce risk of developing ca?

Back 59

Hep B vaccine: prevents Hepatocellular Ca

Front 60

What is cause of lacunar stroke?
What are 4 types of lacunar stroke?

Back 60

HYPERTENSION
1. pure motor hemiparesis: posterior limb internal capsule, unilat motor deficit
2.pure sensory: VPL thalamus, unilateral numbness
3.ataxic-hemiparesis: Anterior limb internal capsule, lower extrem weakness w/ ipsilateral arm/leg incoordination
4.Dysarthria-clumsy hand; basis pontis, hand weak, motor aphasia (slutted speech)

Front 61

Pt w/ bony hard mass in mouth hard palate for years, no sx.
ML Dx?
Causes?

Back 61

Torus palatinus
-Congenital benign bony growth (exostosis) seen in younger women, asians (may slightly increase in lifetime, usually <2cm)-->surgery if interferes w/ eating/speech

Front 62

Pt w/ 6mos non-healing ulcer on R forearm w/ scaling plaque and central ulceration 1.5cm diameter. Bx w/ polygonal cells and atypical nuclei at all epidermal levels w/ zones keratinzation.
ML Dx?
Greatest risk factor?

Back 62

Squamous Cell Carcinoma (2nd most common non-melanoma skin ca)
-Sunlight (UV damages DNA and is mutagenic)

Front 63

Pt w/ 3days SOB, cough, breath sounds less in LLL, full inspiratory/expiratory phases, dullness to percuss, increased fremitus.
ML Dx?
ML Cause lung findings?

Back 63

Lobar community acquired pna
-Consolidation (bronchial breath sounds = full expiratory phase, dull percuss, increased fremitus, egophany, bronchophnoy)

Front 64

Differentiate pleural effusion from consolidation?

Back 64

consolidatioon has increased fremitus, effusion has decreased

Front 65

Findings on lung exam in emphysema?

Back 65

hyperinflation, hyperresonance to percuss, decreased breath sounds, decreased fremitus, wheezing present

Front 66

Pt w/ air fluid level in gallbladder and curvilinear gas shadowing.
ML Dx?
TMT?

Back 66

Emphysematous Cholecystitis (clostridium)
-Cholecystectomy, fluid rescuscitate, and IV abx against gram + anaerobic clostridium (amp-sulbactam, pip/taz, aminoglycoside or quinolone w/ clinda or metronidazole)

Front 67

Charcot's triad =
pathomenonic for?
labs elevated?

Back 67

fever, RUQ pain, jaundice
Acute Cholangitis
Alk phosph and WBC

Front 68

Pt w/ suspected kidney stone.
Step of management?

Back 68

1. NonCon CT scan abd
2. narcotics and NSAIDS (nsaids prefered if normal renal function since don't affect nausea/vom)
3.If stone<5mm, will pass spont->fluid hydrate >2L/day
if stone >5mm, ESWL or stone retrieval
4. Uro referall if pt anuria, urosepsis, acute renal failure

Front 69

Pt w/ 3rd episode kidney stone
What do?

Back 69

After tmt kidney stone, do metabolic eval w/ 24hr urine collection measuring Ca, citrate, cr, uric acid, oxalate, pH, Na

Front 70

Pt w/ hx Hep C, IV drug user, no evidence HepB infxn or immunization.
Next Step?

Back 70

Hep B Vaccination

Front 71

Pt w/ likely Fe deficiency anemia, low serum fe and ferritin.
1st step?
Most likely cause in adults?

Back 71

Test occult blood in stool
Chronic GI blood loss

Front 72

Pt w/ UTI or pyelo has dipstick done.
ML findings?
ML organism?

Back 72

positive nitrites (indicates enterobacteriaceae/family of e. coli present converting nitrates to nitrites) and leuk esterase (indicated pyuria)
-E. Coli

Front 73

Pt s/p surgery managed postop on broad spec abx POD 6 now febrile w/ naus/vom/abd pain and profuse watery diarrhea.
ML Dx?
Dx Step?
TMT?

Back 73

C. Diff colitis
-Cytoxin assay of stool (since c. dif secretes toxin that affects instesinal epithliocytes, and can be detected w/ hi sensitivity wheras stool cx takes long time)
-po or IV metronidazole

Front 74

"stocking glove" sensory loss =
-TMT if painful?
-side effects and alternate?

Back 74

diabetic neuropathy
-TCAs (amitryptiline, nortiptyline)
-worsen urinary sx and ortho hypotension
-2nd line gabapentin

Front 75

Mexican farmer w/ RUQ discomfort/nausea, hepatomegaly, U/S w/ smooth round big cysts and daughter cysts.
ML Dx?
Pathophys?
what does he farm?

Back 75

Echinococcosis: parasitic tapeworm/hydatid cyst
-found in sheep, transmitted to dog who are fed sheep intestines, infectious eggs in dog feces past to humans. Alternative form causes lung dz (alveolar echinococcus)
-sheep

Front 76

18yo female w/ nosebleed yesterday treated w/ nasal packing now w/ vomiting/fever/dizzy/rash w/ diffuse confluent erythematous macules on trunk and extrem, orthostatic hypotension to 70/40, RR 23, HR 120
ML Dx?
Risk factors?
Cause?

Back 76

Toxic Shock Syndrome
-Nasal packing, tampon use, foreign bodies
-s. aureus exotoxin (TSST-1) is superantigen cause massive cytokine release and rash eruption, includes palms/soles, strawberry tongue, conjunctiva red, desquamation (may occur 1-2wks later)

Front 77

Differentiate Scarlet fever vs. Toxic shock?

Back 77

toxic shock acute rash w/ systemic shock
scarlet fever has prodrome fever/ha/vom/sore throat, hx of strep infxn preceding it, sandpaper like texture

Front 78

What common drugs cause TEN and SJS?
What is difference of 2?

Back 78

Sulfa abx, antiepileptics, NSAIDS, allopurinol, NNRTI HAART meds
-SJS<10% body area involved, TEN >30%

Front 79

How to evaluate palpable breast mass?

Back 79

If <30: U/S->if simple cyst->needle aspiration;
->if complex cyst/solid mass->image guided bx

If >30: Diagnostic mammo & U/S->suspicion for malignancy->core bx

Front 80

Breast findings concerning for malignancy vs benign

Back 80

benign: rubbery, firm, mobile
malignant: hard, irregular, fixed

Front 81

New mother w/ pain lateral side wrist, esp when lifting baby from crib. Exam w/ tender radial side wrist and first dorsal comparment. Passive stretch of thumb over radial styloid aggravates pain.
ML Dx?
Pathophsy?
Name of test?

Back 81

De Quervain tenosynovitis
-affects new mom, inflammation abductor pollicis longus/extensor pollicis brevus passing under fibrous sheet at radial stylloid process
-Finkelstein test: passive stretch affect tendon by grabbing flexed thumb into palm w/ fingers=pain

Front 82

Pt w/ pain over palmar aspect 1st MCP joint and locking of thumb in flexion
ML Dx?

Back 82

Trigger thumb

Front 83

What is motion that causes scaphoid fracture?

Back 83

forceful hyperextension of wrist on falling on outstretched hand

Front 84

Pain w/ radial flexion wrist and point tenderness over trapezium?

Back 84

Flexor Carpi Radialis Tenosynovitis

Front 85

Gardener w/ painless ulcer on finger R hand that began as painless papule, has multiple nontender nodules on R foream.
ML Dx?

Back 85

Sporotrichosis (from dimorphic fungus hyphae in bark tree/shrubs/garden plant), after inoculation at initial site, fungus spreads thru lymphatics causing nodules upward

Front 86

What 2 resp dz do not correct w/ supplemental O2?

Back 86

intracardiac shunt and extensive ARDS

Front 87

25yo female recently married has pain on sexual intercourse, genital pain during menses, and same pain during bowel movements.
ML Dx?
Only definitive Test?
TMT?

Back 87

Endometriosis (3D's dyspareunia, dyschezia, dysmenorrhea)
-OCPs, could also tryp GnRH analog Leuprolide, or Danazol

Front 88

Define early fetal HR decelerations?
Cause?

Back 88

drop in fetal HR by 15 bpm for more than 15sec beginning at initiation uterine contraction and ending before contraction ceases.
-fetal head compression (is not concerning)

Front 89

Define late fetal HR decelerations?
Cause?

Back 89

drop fetal HR 15bpm for 15sec that begins at or after peak of uterine contraction and continues after contraction ends.
-Fetal acidosis, uteroplacental insufficiency

Front 90

What causes variable fetal HR decelerations?

Back 90

fetal cord compression

Front 91

TMT of mumps w/ orchitis?
Other common mumps complications?

Back 91

cold compresses on parotid and testes
-aseptic meningitis & encephalitis

Front 92

Cause of constitutional growth delay?
Tests and findigns?

Back 92

btwn 6mo to 3yo, height growth velocity slows, but returns to normal at 3yo causing delay
-hand radiograph bone age less than chronologic age and growth curve height matches bone age.

Front 93

Lung findings in COPDers?

Back 93

increased total lung capacity, functional residual capacity, and residual volume, hyperinflation, diaphragm flattening (causing increased work of breathing)

Front 94

Leukemia pt w/ hi dose induction chemo now w/ sudden painful L 1st MTP joint.
ML Dx?
How to confirm?
What ppx should have been used

Back 94

Acute Gouty Arthritis (from tumor lysis syndrome)
-joint aspiration showing needle-shaped negative birefringent urate crystals w/ WBC <50000.
-Allopurinol (xanthine oxidase inhibitor that decreased uric acid production)

Front 95

What screening for pts who prior had received blood products?

Back 95

if b4 1986: screen for anti-HBcAg and Hep C
if b4 1992: screen for Hep C

Front 96

What is often used to treat COPD pt w/ cor pulmonale?
What is its major side effect?

Back 96

diuretics/furosemide
-Hypokalemia and prereanl renal failure from reduced cardiac output (OH DANG = ototoxicity, hypokalemia, dehydration, allergy/sulfa, nephritis/interstitial, gout)

Front 97

Strongest risk factor for Stroke?
other risk factors

Back 97

Hypertension
-smoking, DM

Front 98

Difference btwn allergic conjunctivitis and atopic keratoconjunctivitis?

Back 98

atopic has mucus discharge, photophobia, and blurred vision
allergic has tearing, eyelid edema, itching, family/personal hx of asthma/allergies/rhinitis

Front 99

Pt w/ crusty discharge on eyelashes.
ML Dx?

Back 99

Anterior Blepharitis (chronic inflammatory condition of eyelid margins)

Front 100

Pt w/ hyperemic lid magins and telangiectasias.
ML Dx?

Back 100

Posterior blepharitis (chronic inflammatory condition of eyelid margins)

Front 101

Pt w/ metastatic breast ca to bone w/ lytic lesions treated w/ chemo and hormone therapy w/ hypercalcemia.
Cause?
TMT?
What if in hypercalcemic crisis?

Back 101

Tumor secretes PTHrP and osteolytic cytokines
-Zoledronate
-IV fluids and furosemide

Front 102

TMT of mysasthenia gravis?
Permanent tmt?

Back 102

Pyridostigmine or neostigmine (acetylcohinesterase inhibitor) since MG causes antibodies to ACh receptors
-Thymectomy and immunosuppresive (prednisone/azathioprine/cyclosporine)