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Question 1

features of fetal alcohol syndrome

Answer 1

small palpebral fissures, absent philtrum and thin upper lip border, growth compromise and intellectual delay

Question 2

features of down syndrome

Answer 2

flat facial profile, slanted palpebral fissures, low set ears, palmar crease, large space between toes

Question 3

estrogen and thyroid

Answer 3

increases TBG, causing increase need for levothyroxine dose (this is only with oral)

Question 4

when to treat the flu

Answer 4

risk factors - over 65, chronic medical problems, pregnancy or less than 2 days duration

Question 5

diarrhea in HIV

Answer 5

• crypto = severe and watery
• microsporidium - no fever
• MAC - watery, high fever
• CMV - small volume, bloody, pain

Question 6

antiemetic causing extrapyramidal symptoms

Answer 6

metoclopramide - dopamine antagonist

Question 7

akathisia

Answer 7

restlessness, inability to sit still

Question 8

treatment for acute dystonic reactions

Answer 8

anticholinergics or benadryl

Question 9

severe features of preeclampsia

Answer 9

• BP above 160/110

- thrombocytopenia, high creatinine, LFTs, pulmonary edema, headaches

Question 10

hypertensive drugs in pregnancy

Answer 10

hydralazine, labetalol (don’t use if brady), nifedipine

Question 11

ectopic pregnancy with unstable vitals

Answer 11

surgical exploration

Question 12

irregularly enlarged uterus, think….

Answer 12

fibroids, with AUB

Question 13

PCOS symptoms with very high testosterone

Answer 13

sertoli-Leydig cell tumors - causing virilization

Question 14

complex multiloculated adnexal mass

Answer 14

tubo-ovarian abscess

Question 15

treatment of akathisia

Answer 15

decrease antipsychotic and add propranolol, benztropine or a benzo

Question 16

kids with posttussive emesis

Answer 16

think pertussis

Question 17

burr cells

Answer 17

spiculated RBCs seen in liver and ESRD

Question 18

spur cells

Answer 18

acanthocytes in liver disease

Question 19

next step in child with UTI

Answer 19

renal ultrasound for anatomic abnormalities

Question 20

manifestations of CF

Answer 20

respiratory infections, pancreatic insufficiency, failure to thrive, nosebleeds (due to vitamin deficiencies)

Question 21

acute iron poisoning

Answer 21

damage to intestinal tract - abdominal pain, vomiting, diarrhea, bleeding - metabolic acidosis
- opacities in stomach and intestines due to iron deposits

Question 22

opacities on x-ray after ingestion

Answer 22

iron intoxification

Question 23

curtain coming down over eyes

Answer 23

retinal detachment

Question 24

expressive aphasia

Answer 24

Brocas area in frontal lobe

Question 25

parietal lobe lesions

Answer 25

- dominant = contralateral sensory loss and inferior homonymous quadrantanopia - nondominant = anosognosia and apraxia

Question 26

cushing reflex

Answer 26

hypertension, bradycardia and respiratory depression

Question 27

signs of intracranial hypertension

Answer 27

headaches worse at night, focal neuro symptoms, pain with leaning forward (sinusitis will also have nasal discharge)

Question 28

signs of theophylline toxicity

Answer 28

CNS stimulation, GI disturbances, cardiac toxicity

Question 29

nephrotic syndrome in RA

Answer 29

amyloidosis

Question 30

when to CT with pyelonephritis

Answer 30

no improvement in 72 hours

Question 31

guillain barre pathophys

Answer 31

demyelination of peripheral nerve fibers

Question 32

thrombocytopenia can be presenting symptoms in...

Answer 32

HIV or hep C

Question 33

best initial test for ankylosing spondylitis

Answer 33

SI joint xray

Question 34

retics and platelets in splenic sequestration

Answer 34

``` retic = high, trying to respond platelets = low, also stuck in spleen ```

Question 35

fibromuscular dysplasia vessel affected

Answer 35

carotids and renal arteries

Question 36

labs after starting lithium

Answer 36

BMP, calcium, thyroid and u/a

Question 37

evaluation for endometrial cancer

Answer 37

transvaginal ultrasound or endometrial biopsy

Question 38

most sensitive test for B12

Answer 38

elevated MMA

Question 39

most common risk factor for orbital cellulitis is....

Answer 39

bacterial sinusitis

Question 40

risks for SGA babies

Answer 40

hypoxia, asphyxia, hypothermia, hypoglycemia, hypocalcemia and polycythemia (for EPO 2/2 hypoxia)

Question 41

complications of primary biliary sclerosis

Answer 41

HCC, nutrient deficiencies, osteomalacia/osteoporosis

Question 42

treatment of UTI in pregnancy

Answer 42

cephalexin, amox-clav, nitrofurantoin, fosfomycin

Question 43

treatment of afib with high CADS-VASC

Answer 43

warfarin or DOACs

Question 44

best test for peripheral neuropathy

Answer 44

monofilament test

Question 45

best medication for bacterial prophylaxis after solid organ transplatation

Answer 45

bactrim

Question 46

epitrochlear lymphadenopathy

Answer 46

seen in syphillus

Question 47

diffuse rash in STD

Answer 47

syphillus (palms and soles)

Question 48

chemo drugs causing peripheral neuropathy

Answer 48

vinca alkaloid, cisplatin, taxanes

Question 49

next step in child with hydrocephalus

Answer 49

CT/MRI

Question 50

presentation of acute closure glucoma

Answer 50

severe eye pain, dilated pupil, poor light response, headache, nausea, vomting

Question 51

erysipelas

Answer 51

sharply demarcated borders, caused by group A strep

Question 52

testing for CGD

Answer 52

dihydrorhodamine 123 or nitroblue tetrazolium

Question 53

blue fingers after getting vasopressors

Answer 53

norepi-induced vasoconstriction

Question 54

elevated BUN/creatinine ratio in UG bleeds

Answer 54

increased urea production from intestinal breakdown of hemoglobin

Question 55

filamentous, gram-positive, weakly acid fast lung organism

Answer 55

nocardia