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Cam's Cards > Family Medicine EOR part 2 > Flashcards

Family Medicine EOR part 2 Flashcards

1
Q

Treatment for vasospastic angina

A

CCBs or nitroglycerina.

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2
Q

Precipitating factors for vasospastic angina?

A

Early in the morning, cold weather, and emotional stress.

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3
Q

Describe the typical vasospastic angina patient?

A

Female smoker >50

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4
Q

Cobblestoning of the mucosa on colonoscopy in what condition?

A

Chron disease

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5
Q

T/F? Ulcerative colitis has “Skip lesions” on colonoscopy.

A

False - skip lesions are found in Chron disease

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6
Q

What is the most common segment of the GI tract affected by Chron disease?

A

Terminal ileum

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7
Q

Skin manifestation of Chron disease?

A

Pyoderma gangrenosum and erythema nodosum

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8
Q

Mainstays of treatment for Chron disease?

A

5-ASA derivatives, corticosteroids, and immunomodulators.

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9
Q

When is colorectal surgery considered for Chron disease patients?

A

Fisulizing disease, cachexia, systemic symptoms, intra-abdominal abcesses.

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10
Q

Between Chron’s and ulcerative colitis, which presents with bloody diarrhea and which does not.

A

UC- bloody

Chron’s - not bloody

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11
Q

What antibody tests are positive in Chron’s?

A

ASCA

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12
Q

What medication is notorious for causing interstitial lung disease?

A

Amiodarone

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13
Q

What is the x-ray finding of interstitial lung disease?

A

Reticular opacities, ground glass opacities, honeycombing, or reticulonodular opacities.

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14
Q

What is the best diagnostic test for interstitial lung disease?

A

CT

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15
Q

What pear-shaped protozoan has four flagella at its anterior end and can be seen on urine microscopy?

A

Trichomonas vaginalis.

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16
Q

How long after treatment for chlamydia should retesting occur?

A

3 weeks

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17
Q

Does strep throat typically cause anterior or posterior cervical chain lymphadenopathy?

A

Anterior

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18
Q

What are the Centor criteria?

A

Fever >100.4
Sore throat
Lack of cough
White pharyngotonsillar exudates

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19
Q

How many Centor criteria should be met for patients to undergo strep testing?

A

3/4

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20
Q

1st line treatment for strep throat?

A

Oral penicillin or cefuroxime

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21
Q

Treatment for strep throats in patients with penicillin allergy?

A

Macrolides

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22
Q

Which culture medium is used to isolate Neisseria gonorrhoeae from a throat swab?

A

Thayer-Martin medium.

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23
Q

What is the definitive treatment for rectocele?

A

Surgical correction with posterior colporrhaphy.

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24
Q

What is the common name of a pulmonary aneurysm found in tuberculosis that begins in the infected cavity and spreads to the bronchial arteries, causing massive hemoptysis upon rupture?

A

Rasmussen aneurysm.

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25
Q

What are two causes of a cholesteatoma?

A

Chronic Eustachian tube dysfunction or tympanic membrane perforation

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26
Q

Symptoms of a cholesteatoma?

A

Painless malodorous otorrhea and conductive hearing loss

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27
Q

Definitive treatment for cholesteatoma?

A

Surgical excision with tympanoplasty

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28
Q

Conductive hearing loss associated with cholesteatoma is most commonly due to erosion of which of the ossicles?

A

The distal portion of the incus.

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29
Q

The vast majority of testicular tumors are?

A

Germ cell tumors -95%

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30
Q

Risk factors for germ cell tumors?

A

Cryptorchidism!!, also HIV and hx of Fhx of testicular cancer

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31
Q

What are some abnormal lab findings in testicular cancer?

A

Elevated HCG, AFP, and LDH.

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32
Q

Diagnosis of testicular cancer is made by?

A

Inguinal orchiectomy.

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33
Q

Is cryptorchidism more likely to occur on the right or left side?

A

Right side.

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34
Q

What is the cutoff for HFrEF?

A

<40% EF

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35
Q

What 3 medication are used in heart failure to improve mortality?

A

Diuretics, ACEIs and beta blockers

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36
Q

What medication used in HFrEF improves morbidity but not mortality?

A

Digoxin

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37
Q

Which class does sacubitril-valsartan, a heart failure medication, belong to?

A

Angiotensin receptor-neprilysin inhibitor (ARNI).

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38
Q

How is orbital cellulitis differentiated from preseptal cellulitis?

A

Orbital cellulitis has ophthalmoplegia, pain with eye movements, and proptosis.

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39
Q

Initial treatment for orbital cellulitis?

A

IV vancomycin + ceftriaxone or cefotaxime.

+ metronidazole if rhinosinusitis is present

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40
Q

What anatomical structure is infected in preseptal cellulitis?

A

Anterior portion of the eyelid.

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41
Q

Which antibiotic is used to treat confirmed pertussis infections?

A

Macrolides, such as azithromycin.

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42
Q

Back pain accompanied by urinary incontinence or retention should give you concern for?

A

Cauda equina syndrome

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43
Q

What response with plantar stimulation is a positive Babinski sign in adults characterized by?

A

Dorsal extension and fanning of the toes.

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44
Q

What labs should be ordered for a patient in whom you suspect hemochromatosis?

A

Serum iron, TIBC, transferrin saturation (TSAT), and ferritin.

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45
Q

What is indicated in hemochromatosis patients with serum ferritin >1000ng/mL?

A

an MRI to estimate body iron stores and phlebotomy to prevent progression.

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46
Q

Patients with hemochromatosis have increased risk of infections with what organisms?

A

Siderophilic organisms

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47
Q

How much alcohol intake per day increases the risk of developing cirrhosis?

A

Over 30 grams.

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48
Q

Patients testing positive for APC mutation are at high risk of having?

A

Familial adenomatous polyposis

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49
Q

Patients with familial adenomatous polyposis have a ___% risk of developing CRC.

A

100%

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50
Q

How often should FAP patients get colonoscopys?

A

Annually beginning at 12 until a colectomy is performed

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51
Q

What orthopedic test is performed by squeezing the calf muscle and observing for plantar flexion?

A

Thompson test.

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52
Q

A lateral ankle sprain usually involves what ligament?

A

Anterior talofibular ligament

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53
Q

What is the mechanism of injury for a lateral ankle sprain?

A

Inversion injury

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54
Q

What grade sprain is a complete tear of a ligament”?

A

Grade 3

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55
Q

What rule is used to determine if a patient needs and ankle x ray?

A

Ottawa ankle rules

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56
Q

What BPH medication reduces the size of the prostate as well as improves symptoms?

A

Finasteride

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57
Q

What class of medications is finasteride?

A

5-alpha reductase inhibitor

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58
Q

What drug class is considered first-line pharmacotherapy for dyslipidemia that is recalcitrant to lifestyle modifications?

A

Statins.

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59
Q

A crescendo-decrescendo murmur hear best at the second right intercostal space describes what murmur?

A

Aortic stenosis

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60
Q

What is the definitive test to diagnose aortic stenosis?

A

echocardiogram

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61
Q

What is the definitive treatment for aortic stenosis?

A

Aortic valve replacement,

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62
Q

What value is considered hypertriglyceridemia?

A

> 150mg/dL

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63
Q

Triglyceride levels greater than _____ are associated with pancreatitis.

A

1000

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64
Q

What medication should a patient with a triglyceride level over 500 be prescribed?

A

A fibrate (fenofibrate or gemfibrozil.)

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65
Q

What is Courvoisier sign?

A

A nontender palpable enlarged gallbladder that is associated with pancreatic cancer.

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66
Q

What procedure is also known as a pancreaticoduodenectomy and is indicated for treatment of pancreatic cancer?

A

Whipple procedure.

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67
Q

What x-linked inherited red blood cell enzyme deficiency makes RBCs prone to oxidative injury?

A

G6PD deficiency

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68
Q

Peripheral blood smear of a G6PD patient reveals?

A

Heinz bodies and bite cells

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69
Q

What supplement should be initiated in patients with chronic hemolysis?

A

Folic acid.

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70
Q

What is the most commonly used imaging modality to diagnose a PE?

A

CT pulmonary angiography.

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71
Q

What is the name of the triad of risk factors for PE?

A

Virchow triad

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72
Q

What are the components of Virchow triad?

A

Venous stasis, vascular injury, and hypercoagulability.

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73
Q

What 2 x ray findings, although uncommon, are associated with PE?

A

Westermark sign and Hampton hump.

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74
Q

Although EKG changes are rare in PE, what EKG finding is highly specific for PE?

A

S1Q3T3

S wave in lead 1, q wave and t inversion in lead 3.

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75
Q

In patients with high risk for PE but have contraindications to anticoagulation, what treatment is indicated?

A

Inferior vena cave filter.

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76
Q

What is the treatment for stable patients with a PE?

A

Anticoag with heparin, direct anticoagulant, or warfarin

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77
Q

What is the treatment for an unstable patient with a PE?

A

Thrombolytic therapy or ebolectomy.

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78
Q

What is the McGinn-White sign?

A

An S1Q3T3 pattern seen on ECG in patients with acute right heart strain.

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79
Q

What is the recommended procedural treatment for patients with refractory grade II internal hemorrhoids who are on anticoagulants?

A

Sclerotherapy because the risk of bleeding is very low.

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80
Q

What anatomic landmark determines whether hemorrhoids are internal or external?

A

The dentate line.

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81
Q

Name 2 autoimmune diseases that can cause corneal ulcers.

A

RA and Sjogren syndrome

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82
Q

Tonic-clonic seizures are also known as?

A

Grand mal seizures

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83
Q

A 24 year old patient presents to the ER after having a grand mal seizure.. He has never had a seizure before. What should you order?

A 
MRI of the head
EKG
EEG
Electrolytes
Glucose
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84
Q

Treatment for focal seizures?

A

Phenytoin, valproic acid, phenobarbital, or lamotrigine

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85
Q

Treatment for absence seizures?

A

Ethosuximide or valproic acid.

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86
Q

Treatment for tonic clonic seizures?

A

Carbamazepine, phenobarbital, levetiracetam, or phenytoin

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87
Q

First line treatments for status epilepticus?

A

IV lorazepam, diazepam, or IM midazolam.

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88
Q

What condition is characterized by a brief period of unilateral paralysis following a seizure?

A

Todd paralysis.

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89
Q

What is the difference between irritant contact dermatitis and allergic contact dermatitis?

A

Irritant causes physical, chemical, or mechanical irritation to the skin. Irritant is localized to sites of direct contact.
Allergic contact dermatitis is a type IV hypersensitivity reaction. Allergic may pccur beyond sites of direct contant.

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90
Q

Name some causes of irritant contact dermatitis.

A

Soaps, detergents, organic solvents

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91
Q

Name some causes of allergic contact dermatitis.

A

Poison ivy, poison oak, nickel, adhesive tape, topical antimicrobials.

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92
Q

Treatment for allergic contact dermatitis?

A

Topical corticosteroids for localized involvement and systemic corticosteroids for widespread involvement.

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93
Q

What type of hypersensitivity reaction is a transfusion reaction due to ABO incompatibility classified as?

A

Type II hypersensitivity reaction.

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94
Q

What is the differential diagnosis for abnormal uterine bleeding?

A 
PALM (structural causes)-COEIN (nonstructural causes)
Polyps
Adenomyosis
Leiomyoma
Malignancy
Coagulopathy
Ovulatory dysfunction
Endometriosis
Iatrogenic
Not yet classified.
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95
Q

When do women with von Willebrand disease typically present with menorrhagia?

A

Near menarche or at menopause.

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96
Q

Define menorrhagia

A

Blood loss > 80mL during one cycle.

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97
Q

When should oral bisphosphonates be taken?

A

In the morning on an empty stomach, and the patient should remain upright for 30 minutes afterward.

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98
Q

What is the first line treatment for osteoporosis?

A

Bisphosphonates

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99
Q

What is the screening modality for osteoporosis?

A

DEXA scan

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100
Q

A patient with osteopenia has a T score of?

A

-1.0 - -2.5

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101
Q

A patient with osteoporosis has a T score of?

A
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102
Q

What is the second line treatment for osteoporosis for patients who cannot tolerate bisphosphonates?

A

SERMs such as raloxifene.

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103
Q

What is the gold standard diagnosis for active TB?

A

Culture of acid-fast bacilli bacteria

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104
Q

List the 4 drugs used to treat active TB.

A

Rifampin, isoniazid, pyrazinamide, and ethambutol.

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105
Q

Treatment for latent TB?

A

9 months isoniazid + pyridoxine to combat peripheral neruopathy
OR
4 months rifampin.

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106
Q

Which RIPE antibiotic (rifampin, isoniazid, pyrazinamide, and ethambutol) is associated with higher rates of hepatitis?

A

Isoniazid.

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107
Q

What is the first-line treatment for primary dysmenorrhea?

A

Nonsteroidal anti-inflammatory drugs (NSAIDs).

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108
Q

What is the triad of symptoms caused by endometriosis?

A

Dysmenorrhea, dyschezia,(pain with bowel movements) and dyspareunia (painful intercourse)

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109
Q

Describe the appearance of seborrheic keratosis.

A

Brown macules and papules with well defined borders with a stuck on appearance and are nodular and rough to the touch.

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110
Q

Are seborrheic keratoses benign of malignant?

A

Benign.

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111
Q

What is Zollinger-Ellison syndrome?

A

A gastrin producing neuroendocrine tumor that causes hypersecretion of gastric acid.

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112
Q

What disorder is Zollinger-Ellison syndrome closely associated with?

A

Multiple endocrine neoplasia type 1.

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113
Q

What is the most effective prescription therapy for smoking cessation?

A

Varenicline

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114
Q

Bupropion is effective in smoking cessation but is contraindicated in patients with?

A

Seizures.

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115
Q

When do nicotine withdrawal symptoms peak?

A

3 days.

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116
Q

What disorder is associated with blue sclerae, short stature, easy bruising, and ligamentous laxity?

A

Osteogenesis imperfecta.

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117
Q

Which class of medications used for the treatment of osteoporosis has been associated with osteonecrosis of the jaw?

A

Bisphosphonates.

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118
Q

What is Rovsing sign and what is suggestive of?

A

Pain in the RLQ when palpating the LLQ.

It is suggestive of appendicitis

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119
Q

What other special tests are suggestive of appedicitis?

A

Psoas sign

Obturator sign

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120
Q

Where is the Mcburney point?

A

2/3 of the way from the umbilicus to the anterior superior iliac spine.

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121
Q

The psoas sign if suggestive of _____ position of the appendix whereas the obturator sign is suggestive of the _____ position of the appendix.

A

Psoas - retrocecal

Obturator - pelvic

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122
Q

Treatment of acute appendicitis?

A

Surgical appendectomy with a single dose of preoperative antibiotics

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123
Q

What is the preferred imaging study for appendicitis in pregnant women?

A

MRI of the abdomen and pelvis.

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124
Q

What are the two main cardiac emergencies associated with severe hypertension?

A

Acute heart failure and acute coronary syndrome.

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125
Q

What two medications should be given to a patient in acute heart failure?

A

A loop diuretic and a vasodilator such ad sodium nitroprusside or nitroglycerine.

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126
Q

Hypertensive emergency is defined as a blood pressure greater than _____ with evidence of end organ damage.?

A

180 systolic or 120 diastolic

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127
Q

True or false: hypertensive urgency is defined as a markedly elevated blood pressure without evidence of end-organ damage.

A

True.

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128
Q

What is the treatment for PTSD?

A

SSRI and CBT

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129
Q

What is the appropriate treatment for a patient with acute stress disorder?

A

Psychotherapy.

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130
Q

What is the preferred imaging modality for lumbar radiculopathy?

A

MRI

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131
Q

What are the most common nerve root radicilopathies?

A

L5 and S1

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132
Q

S1 radiculopathy pain radiates where?

A

Posterior thigh, leg, and lateral plantar aspect of foot.

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133
Q

L5 radiculopathy radiates where?

A

Buttocks wrapping around lateral aspect of thigh and calf to the medial aspect of the dorsum of the foot.

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134
Q

L4 radiculopathy radiates where?

A

Wraps around from buttocks to anterior thigh stopping mid shin.

135
Q

L3 radiculopathy radiates where?

A

Wraps around from buttocks to anterior thigh stopped at the knee.

136
Q

What condition is a kyphoplasty used to treat?

A

Vertebral compression fracture.

137
Q

Which HPV types account for the majority of cervical cancer cases?

A

16 and 18

138
Q

How often do women aged 21-30 need pap smears?

A

Every 3 years if testing is negative.

139
Q

When is the HPV vaccine recommended for males and females?

A

11 or 12 years of age.

140
Q

What is the recommended approach for women aged 25 and older with low-grade squamous intraepithelial lesions and a positive human papillomavirus test?

A

Colposcopy.

141
Q

Are most cases of age related macular degeneration dry or wet?

A

Dry

142
Q

What is the classic finding associated with dry age related macular degeneration?

A

Drusen bodies (proteins that appear as bright yellow spots on the retina.)

143
Q

What are the classic findings associated with wet age related macular degeneration?

A

Retinal hemorrhages and neovascularization.

Manifests as grey-green fluid in the macular area

144
Q

Treatment for dry age related macular degeneration?

A

No treatment available.

145
Q

Treatment for wet age related macular degeneration?

A

Combination vitamins eith C, E, lutein, zeaxanthin, zinc, copper.
Antivascular endothelial growth factors such as bevacizumab or ranibizumab.
Photodynamic therapy.

146
Q

What is metamorphopsia?

A

Distortion of straight lines, such as perceiving doors or blinds as curved. Metamorphopsia can be seen in wet macular degeneration.

147
Q

What is the main organ responsible for the conversion of T4 to T3?

A

The liver.

148
Q

What is the most common cause of primary hypothyroidism?

A

Autoimmune Hashimoto disease.

149
Q

A positive thyroid peroxidase antibody test is diagnostic of?

A

Hashimoto disease

150
Q

First line treatment for Hashimoto disease?

A

Levothyroxine

151
Q

First line treatment for acute uncomplicated cystitis?

A

SMX-TMP BID x 3 days
OR
Nitrofurantoin 100mg BIG x 5 days

152
Q

UTIs are most commonly caused by?

A

E coli

153
Q

First line therapy for acute bacterial rhinosinusitis?

A

Amoxicillin-claculanate 875/125 BID or 500/125 TID x 5-7 days

154
Q

Second line therapy for acute bacterial rhinisinusitis?

A

Doxycycline 100mg BID or 200mg QD x 5-7 days

155
Q

Most common bacterial causes of acute bacterial sinusitis?

A

H flu and Strep pneumo

156
Q

What is the initial recommended treatment for acute invasive fungal sinusitis?

A

IV amphotericin B and surgical debridement.

157
Q

Industrial work in the 1930s and 1940s is a risk factor for?

A

Asbestos exposure

158
Q

The hallmark of asbestos related diseases seen on chest XR is?

A

Pleural involvement.

159
Q

What are the six Ps of an acute arterial embolism?

A

Paresthesia, pain, pallor, pulselessness, paralysis, and poikilothermia.

160
Q

What would an ECG for a patient with a coarctation of aorta show?

A

Left ventricular hypertrophy.

161
Q

Coarctation of the aorta is commonly associated with _____ syndrome.

A

Turner

162
Q

What murmur can be heard in severe coarctation of the aorta?

A

A continuous murmur heard in mid to late systole heard best on the patients midline upper back.

163
Q

What is the gold standard diagnostic for coarctation of the aorta?

A

CT angiogram.

164
Q

What is shown on a chest x ray in coarctation of the aorta and is known as a “3 sign”

A

Rib notching

165
Q

Treatment for coarctation of the aorta?

A

Widening the narrowed area of the aorta via anastamoses, ablation, or stenting.

166
Q

How long does morning stiffness typically last in osteoarthritis?

A

< 30 minutes

167
Q

First line pharmacologic treatment for osteoarthritis?

A

NSAIDs

168
Q

What pharmacologic therapy may be used for osteoarthritis in those who have contraindications to NSAIDs?

A

Duloxetine and topical capsaicin

169
Q

Which orthopedic condition is associated with ulnar deviations, swan-neck deformity, and boutonnière deformity of the hand?

A

Rheumatoid arthritis.

170
Q

Is OA more likely to be bilateral or unilateral?

A

Unilateral

171
Q

First line therapy for obstructive sleep apnea?

A

CPAP

172
Q

What is Pickwickian syndrome?

A

Hypoventilation due to obesity.

173
Q

Acute community-acquired diarrhea that is productive of visible blood is called _____.

A

dysentery

174
Q

What are the most common pathogens causative of dysentery?

A

Shigella, campylobacter, and salmonella

175
Q

What is the empiric antibiotic used for dysentery?

A

Azithromycin or a fluoroquinolone

176
Q

Which antibiotic is used for the treatment of diarrhea due to Clostridioides difficile?

A

Oral vancomycin.

177
Q

Berylliosis is an occupational lung disease associated with?

A

Nuclear power/reactors, aerospace, dental, and metal machine shops.

178
Q

What unique findings sets berylliosis apart from other pneumoconiosis diseases?

A

Cutaneous nodules

179
Q

What is the most appropriate initial test for a patient suspected of berylliosis?

A

Blood beryllium lymphocyte proliferation test

180
Q

Treatment for berylliosis?

A

Lifelong low-dose glucocorticoid therapy.

181
Q

Silicosis is often seen in what ocupations?

A

Mining, glass manufacturing, sandblasting, quarry industries.

182
Q

Byssinosis is commonly seen in what occupations?

A

Textile industries that process cotton, help, or flax.

183
Q

Asbestosis is seen in what ocupations?

A

Insulation demolition, shipbuilding, textile industries

184
Q

Does pneumoconiosis typically present with an obstructive or restrictive pattern on pulmonary function testing?

A

Restrictive pattern.

185
Q

What is the most common cause of roseola?

A

Human herpesvirus 6.

186
Q

Unopposed estrogen in a woman with an intact uterus can cause ______ and increase the risk of ________

A

endometrial hyperplasia

Endometrial cancer

187
Q

Treatment of perimonopausal symptoms that interfere with daily activities can be treated with?

A

Estrogen or estrogen-progestin combination therapy.

188
Q

Where in the body is follicle-stimulating hormone (FSH) synthesized?

A

The gonadotropic cells of the anterior pituitary gland.

189
Q

HLA-B51 is associated with?

A

Behçet disease

190
Q

Behçet disease causes what symptoms?

A

Patients present with recurrent painful oral and genital ulcers

191
Q

HLA-B8 is associated with?

A

Graves disease and myasthenia gravis

192
Q

HLA-DR4 is associated with

A

RA

193
Q

What endocrine disorder is strongly associated with HLA-DR3 and HLA-DR4?

A

Type 1 diabetes mellitus.

194
Q

Patients who recently had a stent placed should be prescribed

A

dual antiplatelet therapy with aspirin and a P2Y12 inhibitor (e.g., ticagrelor or clopidogrel).

195
Q

What are macrophages called after ingesting LDL at the site of a fatty streak?

A

Foam cells.

196
Q

What type of hernias ALWAYS need surgery?

A

Strangulated hernias

197
Q

Which type of inguinal hernia is most common?

A

Indirect.

198
Q

Urticaria is a ____ mediated reaction?

A

IgE

199
Q

Individual lesions from urticaria should last how long?

A

< 24 hours

200
Q

Lateral pressure on the initial lesion caused separation of the epidermis describes what sign?

A

Nikolsy sign

201
Q

Nikolsky sign is indicative of?

A

Staphylococcal scalded skin syndrome or pemphigus vulgaris

202
Q

What sign refers to localized urticaria caused by stroking skin lesions seen in cutaneous mastocytosis?

A

Darier sign.

203
Q

What are the three types of innocent murmurs?

A

Still murmurs, pulmonic murmurs, and venous hums

204
Q

Describe a Still murmur.

A

A soft, high-pitched, crescendo-decrescendo murmur during midsystole along the left sternal borderq

205
Q

How can you differentiate a innocent murmur of childhood from a pathologic murmur?

A

Have the patient stand up. It should decrease the murmur.

206
Q

What are the three other causes of midsystolic murmurs excluding innocent murmurs of childhood?

A

Hypertrophic cardiomyopathy, aortic stenosis, and pulmonic stenosis.

207
Q

Treatment for an acute paronychia?

A

I and D

208
Q

What would be a good antibiotic choice(after I and D) for an acute paronychia in an immunocompromised patient?

A

Dicloxacillin or cephalexin

209
Q

What are some complications of acute paronychia in immunocompromised patients?

A

Eponychia, tenosynovitis, osteomyelitis, and felon formation.

210
Q

What is the mainstay of therapy for salicylate poisoning?

A

Alkalinization with sodium bicarbonate.

211
Q

What lab can be used for serial monitoring of CRC?

A

Carcinoembryonic antigen (CEA)

212
Q

Basophilic stippling is associated with?

A

Lead poisoning, thalassemias alcohol use, and heavy metal poisoning

213
Q

What is the most common cause of a large bowel obstruction in an older patient?

A

Neoplasm.

214
Q

True or false: nitroglycerin is contraindicated in right ventricular infarction.

A

True.

215
Q

What is the most appropriate treatment for secondary prevention of an ischemic stroke in a patient who just had a TIA?

A

Aspirin 325 and clopidogrel 75

216
Q

A slog-growing, waxy nodule with pearly, rolled borders and telangiectasias describes what lesion?

A

Basal cell carcinoma

217
Q

True or false: non-Hodgkin lymphoma is more common than Hodgkin lymphoma.

A

True.

218
Q

How is the diagnosis of a BCC made?

A

Shave biopsy

219
Q

What is Tietze syndrome?

A

an inflammatory disorder presenting with costochondral tenderness and is likely preceded by infectious, rheumatologic, or neoplastic processes.

220
Q

How is Tietze syndrome differentiated from costochondritis?

A

Costochondritis involves more than one area of reproducible tenderness, and does not present with localized swelling.

221
Q

Which ribs attach directly to the sternum via their costal cartilage?

A

The first seven ribs.

222
Q

What condition presents with an expiratory monophonic wheeze best heard over larger airways?

A

Tracheomalacia.

223
Q

What medication should patients with cirrhosis be on to prevent rebleeding of esophageal varices?

A

non selective beta blockers (nadolol, propanolol)

224
Q

What medication is used for cirrhosis patients to reduce ascites?

A

furosemide.

225
Q

What medications are used as prophylactic therapy for spontaneous bacterial peritonitis?

A

TMP-SMX or ciprofloxacin

226
Q

What medication is used to treat hepatic encephalopathy?

A

Lactulose or lacitol +/- rifaximin

227
Q

What side effect of lactulose makes patients non-compliant?

A

They shit a lot to get the ammonia out

228
Q

What lab marker can be used to monitor for hepatocellular carcinoma?

A

AFP

229
Q

Which grade of hepatic encephalopathy is characterized by asterixis?

A

Grade 2.

230
Q

Reactive arthritis can occur after what type of infections?

A

GI or GU (chlamydia) infections

231
Q

List some associated signs/symptoms of reactive arthritis?

A

bilateral injected conjunctiva, mucocutaneous lesions, nausea and vomiting.

232
Q

Treatment for reactive arthritis?

A

Supportive care for nausea and vomiting, NSAIDs for arthritis.

233
Q

What four diseases are most commonly associated with HLA-B27 positivity?

A

Psoriatic arthritis, ankylosing spondylitis, irritable bowel syndrome, and reactive arthritis (noted by the mnemonic PAIR).

234
Q

Which electrolyte abnormality has the United States Food and Drug Administration associated proton pump inhibitor therapy with?

A

Hypomagnesemia.

235
Q

What intravenously administered nutritional supplement has been shown to improve functional outcomes in patients with heart failure?

A

Iron.

236
Q

What heart sound might you hear in a patient with acute decompensated heart failure?

A

S3 heart sound

237
Q

What is the most useful study in evaluation of acute decompensated heart failure?

A

echo

238
Q

What is the treatment for comedonal acne?

A

Topical retinoid

239
Q

What is the treatment for mild papulopustular and mixed acne?

A

Topical antimicrobial and topical retinoid
or
benzoyl peroxide and topical antibiotic

240
Q

What is the treatment for moderate papulopustular acne?

A

Topical retinoid and oral antibiotic and topical benzoyl peroxide.

241
Q

What is the treatment for severe acne?

A

Topical retinoid and oral antibiotic and topical benzoyl peroxide or oral isotretinoin monotherapy.

242
Q

What antibiotics are used for treatment of acne?

A

Oral doxycycline or tmp-smx

topical erythromycin or clindamycin

243
Q

What acne medications are contraindicated in pregnancy?

A

Retinoids and doxycylcine.

244
Q

Which type of lesion is the hallmark of acne vulgaris?

A

Comedo.

245
Q

What is the most common subtype of melanoma?

A

Superficial spreading melanoma

246
Q

What type of melanoma predominantly affects dark-skinned individuals?

A

Acral lentiginous melanoma

247
Q

For how long should proton pump inhibitors be discontinued prior to performing urea breath tests and fecal antigen assays for Helicobacter pylori?

A

7–14 days.

248
Q

First line outpatient treatment for pyelonephritis?

A

Cipro or levofloxacin x 14 days

249
Q

What type of bacteria is the most common cause of acute prostatitis?

A

Gram-negative rods, specifically Escherichia coli.

250
Q

Kidney stones are most commonly composed of?

A

Calcium oxalate

251
Q

What is the preferred diagnostic test for nephrolithiasis?

A

non contrast CT of abd and pelvis

252
Q

Pharmacologic therapy for nephrolithiasis?

A

Alpha blockers such as tamsulosin at 0.4mg/day to help promote stone passage.

253
Q

What type of stone is associated with the development of staghorn calculi?

A

Struvite stones.

254
Q

What sign is characterized by referred left shoulder pain and associated with splenic rupture?

A

Kehr sign.

255
Q

What blood pressure defines stage 1 hypertension?

A

systolic of 130-139 or a diastolic blood pressure of 80-89

256
Q

What blood pressure defines stage 2 hypertension?

A

SBC >140 or DBP>90

257
Q

hich medication is the only calcium channel blocker with established safety in patients with severe heart failure?

A

Amlodipine.

258
Q

Which patients with primary hypertension should not increase dietary potassium intake to lower blood pressure?

A

Patients on medications that reduce potassium excretion and patients with chronic kidney disease.

259
Q

What is the first-line treatment for major depressive disorder?

A

A selective serotonin reuptake inhibitor (SSRI).

260
Q

What is the first line drug choice for generalized epileptic seizures?

A

Valproate, lamotrigine, or levetriacetam

261
Q

What medication is recommended for absence seizures?

A

Ethosuximide

262
Q

What medications are recommended for focal seizure disorders?

A

Lamotrigine, oxcarbazepine, or phenytoin.

263
Q

What is the term used to describe periodic paralysis following a seizure?

A

Todd paralysis.

264
Q

What are the parameters consistent with a healthy lipid panel?

A

Total cholesterol <200, HDL > 60, LDL <100, triglycerides <150.

265
Q

What disorder is a severely elevated triglyceride level (> 1,000 mg/dL) a risk factor for?

A

Pancreatitis.

266
Q

What is the most common cause of acute gastroenteritis?

A

Norovirus

267
Q

What is the physiologic cause of diarrhea in infectious diarrhea?

A

Reduced absorption of electrolytes across the intestinal epithelium.

268
Q

What is the treatment for viral gastroenterieis?

A

Supportive with oral rehydration and antiemetics

269
Q

What type of diarrhea does ingestion of polyethylene glycol 3350 induce?

A

Osmotic.

270
Q

Iron absorption is enhanced by what vitamin?

A

Vitamin C

271
Q

Name 3 physical exam findings consistent with iron deficiency anemia?

A

Koilonychia, atrophic glossitis, and angular cheilosis

272
Q

Iron absorption is decreased by food and drink containing?

A

Calcium, phosphates, phytates, and tannates

273
Q

What is the average age of menopause in U.S. women?

A

Around age 50.

274
Q

What is the most common symptoms associated with menopause?

A

Hot flashes

275
Q

What will estrogen and FSH levels look like in menopause?

A

Decreased estrogen and high FSH.

276
Q

What is the treatment for perimenopausal symptoms?

A

Estrogen or estrogen-progestin combination therapy.

277
Q

How does alopecia areata differ from androgenetic alopecia?

A

Alopecia areata occurs in patche(s), whereas androgenetic alopecia causes gradual recession of the front hairline or temporal areas.

278
Q

What is telogen effluvium?

A

A type of alopecia characterized by diffuse hair shedding most commonly in the scalp.

279
Q

What is alopecia universalis?

A

Complete hair loss on all hair-bearing areas throughout the body.

280
Q

What is the treatment for alopecia areata?

A

Intralesional corticosteroid therapy (triamcinolone) every 4-6 weeks or topical corticosteroid therapy,

281
Q

What condition is often associated with placenta previa, particularly with the increasing number of cesarean deliveries, and should be excluded?

A

Placenta accreta spectrum.

282
Q

Painless vaginal bleeding during pregnancy is typical of?

A

Placenta previa

283
Q

In what trimester does placenta previa typically occur?

A

Third

284
Q

Painful vaginal bleeding during the third trimester is typical of?

A

Placental abruption

285
Q

Diagnosis of placenta previa is diagnosed by?

A

Ultrasound

286
Q

Nephritic syndrome is characterized by what urinalysis findings?

A

Hematuria, proteinuria, red blood cell casts

287
Q

Treatment for PSGN?

A

Loop diuretics and nifedipine for blood pressure and edema, antibiotics if infection is still present, and dialysis if high BUN or hyperkalemia

288
Q

Persistent microscopic hematuria, bilateral sensorineural hearing loss, and ocular defects describes what syndrome?

A

Alport syndrome

289
Q

What nephropathy is the most common cause of acute glomerulonephritis and most often affects young men within 2 days following a URI or GI infection?

A

IgA nephropathy

290
Q

Which cytoplasmic antibodies are associated with microscopic polyangiitis?

A

Perinuclear antineutrophil cytoplasmic antibodies (pANCA).

291
Q

What is the initial study in the emergency setting for patients presenting with symptoms concerning for a stroke?

A

Noncontrast CT of the head

292
Q

What is the most sensitive test for evaluation of a stroke?

A

MRA

293
Q

A patient must present within how many hours of symptom onset to be treated with tPA?

A

3-4.5 hours

294
Q

A lateral medullary infarction resulting in an array of manifestations, including dizziness, difficulty sitting upright, diplopia, nystagmus, hypotonia and limb ataxia of the ipsilateral arm, and loss of pain and temperature sensation in the ipsilateral face and contralateral trunk and limbs describes what syndrome?

A

Wallenberg syndrome

295
Q

Is Bell’s palsy forehead sparing or not?

A

Not forehead sparing

296
Q

Treatment for Bell’s palsy?

A

Prednisone 60-80mg/day x 1 week

297
Q

How does Bell’s palsy affect special senses?

A

Causes hyperacusis and loss of taste

298
Q

A patient presenting with Bell’s palsy symptoms and hearing loss should be evaluated for?

A

Ramsay Hunt Syndrome

299
Q

What is Melkersson-Rosental syndrome?

A

A rare condition characterized by recurrent episodes of facial swelling and facial paralysis in patients with a fissured tongue.

300
Q

Which food craving is characteristic of primary adrenal insufficiency?

A

Salt.

301
Q

What TB medication has the side effect of neuropathy?

A

Isoniazid

302
Q

What may be prescribed to patients undergoing TB treatment to prevent neuropathy?

A

Vitamin B6

303
Q

How many millimeters of induration will be present on a patient with HIV and tuberculosis who undergoes a tuberculin skin test?

A

≥ 5 mm.

304
Q

What is the first line treatment for lyme disease?

A

doxycycline BID x 10-21 days

305
Q

Second line treatment for lyme disease?

A

Amoxicillin

306
Q

What is the bacterial spirochete responsible for Rocky Mountain spotted fever?

A

Rickettsia rickettsii.

307
Q

What rash is pathognomonic for lyme disease?

A

Erythema migrans

308
Q

What is Budd-Chiari syndrome?

A

A disorder that occurs when the hepatic venous outflow is obstructed due to a thrombus within a hepatic vein.

309
Q

What gene mutation is associate with polycythemia vera?

A

JAK2

310
Q

What radiographic findings are consistent with chronic obstructive pulmonary disease?

A

Flat diaphragm, increased retrosternal lung space, rapidly tapering vasculature, and bullae.

311
Q

Warfarin induced skin necrosis is a complication of warfarin in patients with?

A

Protein C deficiency

312
Q

Which orthopedic test detects tightness of the iliotibial band, tensor fascia lata, and gluteus maximus?

A

Ober test.

313
Q

What is the first line treatment for patients with mild-to-moderate Alzheimer’s disease?

A

Cholinesterase inhibitors such as donepezil.

314
Q

When is memantine (NMDA antagonist) indicated in treatment of Alzheimer’s disease?

A

Can be used in addition to a cholinesterase inhibitor or as monotherapy in patients with severe disease.

315
Q

What is the most common cause of death in patients with severe dementia?

A

Aspiration pneumonia

316
Q

How much activity is recommended to reduce cardiovascular mortality in patients with a history of coronary artery disease?

A

Between 30–60 minutes of moderate-intensity aerobic activity, 5 to 7 days per week.

317
Q

What cancer has been associated with ectopic ACTH syndrome that may lead to Cushing syndrome?

A

Small cell lung cancer.

318
Q

What complication of untreated hypothyroidism is considered life-threatening?

A

Myxedema coma.

319
Q

What is the first test you should order for a patient in whom you suspect hypothyroidism?

A

TSH assay

320
Q

What is atopy?

A

the genetic tendency to develop allergic diseases,

321
Q

Asthma is characterized by three components: obstruction to airflow, bronchial hyper-reactivity, and what?

A

Inflammation of the airway.

322
Q

Claudication in the lower third of the calf is due to atherosclerotic occlusion of what artery?

A

Popliteal artery.

323
Q

PCOS can be confirmed by?

A

Ultrasound

324
Q

What lab findings support a diagnosis of PCOS?

A

Elevated total free testosterone.

325
Q

What medications are recommended to help induce ovulation in patients with polycystic ovary syndrome?

A

Clomiphene, letrozole, and metformin.

326
Q

What class of diabetes medications is most likely to cause recurrent yeast infections?

A

SGLT2 inhibitors such as empagliflozin

327
Q

Which class of antidiabetic drug should be avoided in patients with a family or personal history of medullary thyroid carcinoma?

A

Glucagon-like peptide-1 agonists.

328
Q

What is more common, small cell or non-small cell lung cancer?

A

non-small cell lung cancer

329
Q

What is the most common type of non-small cell lung cancer?

A

Adenocarcinoma

330
Q

What are the USPSTF recommendations for breast cancer screening in patients with normal risk for breast cancer?

A

Begin at age 50, screen every 2 years, and stop screening at 75.

331
Q

Children and adolescents who are receiving aspirin- or salicylate-containing medications are at risk of developing what syndrome if they become infected with the influenza virus?

A

Reye syndrome.

332
Q

What is the first line treatment for benign essential hypertension in black patients?

A

CCB such as amlodipine and/or thiazide diuretics

333
Q

What beta-blockers do not carry the risk of impaired glucose tolerance or diabetes?

A

Carvedilol and nebivolol.

Cam's Cards (103 decks)

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