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163-220 Flashcards

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1
Q

What is the next step in managing someone with intermediate probability for strep (2/4) and a negative rapid?

A

Culture, do not treat empirically

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2
Q

What is a PDA associated with other than a continuous to-and-fro murmur?

A

Bounding pulses and a widened pulse pressure

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3
Q

What is the next step in management after gastric adenocarcinoma is concerned by biopsy?

A

CT Scan, EUS (H pylori screening only indicated if it’s gastric lymphoma)

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4
Q

How is DI treated?

A

Intranasal desmopressin

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5
Q

How is Legg-Calvé-Perthes treated?

A

Ibuprofen, rest, and close followup

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6
Q

What are the symptoms of cerebellar hemorrhage?

A

Ataxia, vomiting, occasional headache, and gaze palsy

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7
Q

What is the first step if child abuse is suspected?

A

Detailed physical exam

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8
Q

What common analgesic potentiates the effects of warfarin?

A

Acetaminophen

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9
Q

What post-MI complication presents with persistent ST elevations months after the MI?

A

Ventricular aneurysm

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10
Q

How long does lithium therapy last for bipolar disorder?

A

1 year

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11
Q

Kid with scrotal mass that transilluminates… next step?

A

It’s a hydrocele, you can reassure.

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12
Q

Patient is diagnosed with essential HTN… What are the next steps in management?

A

FLP and urinalysis

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13
Q

Fetus is exhibiting sinusoidal fetal heart tracing after rupture of membranes… diagnosis?

A

Vasa previa

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14
Q

Treatment for hemodynamically stable SVT?

A

DC cardioversion

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15
Q

Fundoscopic findings associated with central retinal vein occlusion?

A

Hemorrhage, dilated veins, cottonwool spots (“blood and thunder”

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16
Q

What should be tested prior to initiating lithium therapy?

A

TFTs and serum creatinine

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17
Q

How can polymyositis and steroid-induced myopathy in the context of temporal arteritis be distinguished?

A

Polymyositis almost always has an elevated ESR, whereas steroid myopathy does not.

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18
Q

What is the most common cause of constrictive pericarditis in the developing world?

A

TB

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19
Q

Describe laryngomalacia

A

Congenital flaccid larynx. Produces an inspiratory noise. The child should never be fed while laying down and should be held upright after feeding

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20
Q

Presentation and fundoscopic findings in open-angle glaucoma?

A

Loss of peripheral vision, cupping of optic disk

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21
Q

How can you distinguish a ruptured berry aneurysm from a basal ganglia deficit if motor exam cannot be performed?

A

Gaze palsy

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22
Q

Next step in diagnosing ankylosing spondylitis after clinical suspicion arises?

A

X-ray of the spine; HLA-B27 not the next step. Likely to be positive, but not diagnostic

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23
Q

Rash associated with tinea versicolor?

A

Velvety pink or whitish hypopigmented macule that do not appear scaly

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24
Q

How do you distinguish premature ovarian failure from diminished ovarian reserve?

Study These Flashcards
A

Amenorrhea is present in premature ovarian failure, whereas diminished ovarian reserve jut describes why it’s more difficult for older women to conceive

25
When do you give the varicella vaccine post-exposure?
To every asymptomatic and immunocompetent patient; although it works best within 3-5 days of exposure, it can still help prevent transmission
26
How do you manage a tylenol overdose?
Get a serum acetaminophen level at 4 hours post-exposure
27
Describe laryngomalacia
Congenital flaccid larynx. Produces an inspiratory noise. The child should never be fed while laying down and should be held upright after feeding
28
Presentation and fundoscopic findings in open-angle glaucoma?
Loss of peripheral vision, cupping of optic disk
29
How can you distinguish a ruptured berry aneurysm from a basal ganglia deficit if motor exam cannot be performed?
Gaze palsy
30
Next step in diagnosing ankylosing spondylitis after clinical suspicion arises?
X-ray of the spine; HLA-B27 not the next step. Likely to be positive, but not diagnostic
31
Rash associated with tinea versicolor?
Velvety pink or whitish hypopigmented macule that do not appear scaly
32
How do you distinguish premature ovarian failure from diminished ovarian reserve?
Amenorrhea is present in premature ovarian failure, whereas diminished ovarian reserve jut describes why it's more difficult for older women to conceive
33
When do you give the varicella vaccine post-exposure?
To every asymptomatic and immunocompetent patient; although it works best within 3-5 days of exposure, it can still help prevent transmission
34
How do you manage a tylenol overdose?
Get a serum acetaminophen level at 4 hours post-exposure
35
How many days after birth does chlamydial conjunctivitis present?
5-15
36
How do you distinguish Todd's paralysis from an acute stroke?
Focal neurologic deficits resolve within 24 hours
37
Parkinson's medication associated with anticholinergic toxicity?
Trihexyphenidyl
38
CBC abnormalities associated with HS?
elevated MCHC, elevated RDW
39
What is the most common cause of aortic regurgitation in young adults?
Bicuspid aortic valve
40
How do you distinguish breast milk jaundice from breastfeeding jaundice?
Breastfeeding failure jaundice: First week of life | Breast milk jaundice: Unconjugated hyperbilirubinemia in the first 3-4 weeks of life
41
A patient with urosepsis that was treated develops ATN... what drug is the likely offender?
Amikacin (as the urosepsis was likely caused by gram negative rods
42
How do you distinguish polymyalgia rheumatica from polymyositis?
PMR usually prevents with pain in neckshoulders/pelvic girdle, whereas polymyositis presents with weakness
43
What is the diagnostic test for pseudotumor cerebri?
LP with opening pressure
44
Child with increasing head circumference and elevated ICP... what is the next step in diagnosis?
CT scan
45
What kind of acne patients get oral isotretinoin?
Patients with moderate to severe acne, specifically in nodulocystic form and those that have scarring
46
What is the NBME-preferred definitive modality for treating Graves disease?
Radioactive iodine ablation
47
How do you distinguish Kaposi's sarcoma from Bacillary angiomatosis?
KS: Papules-plaques are the skin lesions BA: Bright red, firm, friable masses
48
What is the treatment for cellulitis with systemic signs?
IV Nafcillin
49
Patient has an endoscopy, develops problems breathing, chest pain, tachycardia and tachypnea. Diagnosis?
Boerhaave syndrome
50
How do you treat sphincter of Oddi dysfunction?
ERCP sphincterotomy
51
What distinguishes the presentation of Bartter's syndrome from a reninoma?
The absence of hypertension
52
What distinguishes CMV from HSV retinintis?
CMV: painless, fluffy/granular lesions near retinal vessels HSV: retinal necrosis with follicles
53
At what age is bedwetting abnormal?
>5 years old
54
What is the most important pathophysiologic factor in the development of cardiogenic edema?
Renal hypoperfusion secondary to overactivation of the RAAS
55
How do you treat variable decelerations?
Change maternal position
56
How do you distinguish inflammatory from noninflammatory nonbacterial prostatitis?
The inflammatory form has >10 WBC/HPF
57
What's a synonym for Paget's disease?
Osteitis deformans
58
When do you do a VCUG in peds patients with UTI?
Only if the renal ultrasound is abnormal

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