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Step 2 DIT > 3, 4, 5 Star topics 4 > Flashcards

3, 4, 5 Star topics 4 Flashcards

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1
Q

CYP450 inducers (3)

A 
Ken(ytoin) Rides Shotgun in Barbie's Girl Car
Phenytoin
Rifampin
St. John's wort
Barbiturates
Griseofulvin
Carbamazepine
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2
Q

Medications that reduce OCP effectiveness (3)

A

Rifampin (griseofulvin lesser)
Antiepileptics including phenobarbital
St. John’s wort

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3
Q

Suspicious findings on mammogram (5)

A

Hyperdense regions

Microcalcifications

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4
Q

PE findings in breast cancer (5)

A

Solid, immobile* breast lump
Peau d’orange (lymphedema and skin thickening)
Nipple retraction (new)
Skin dimpling
Axillary lymphadenopathy (poor prognosis)

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5
Q

MC breast cancer, MC site (5)

A

Ductal (80%) > Lobar (20%)
Infiltrating ductal is MC
Upper outer quadrant is MC site

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6
Q

Breast cancer in unilateral ducts w/o stromal invasion (5)

A

Ductal carcinoma in situ (DCIS) (pre-malignant)

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7
Q

Breast cancer in lobules w/o stromal invasion, can be multifocal and/or bilateral (5)

A

Lobular carcinoma in situ (LCIS)

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8
Q

Breast cancer in ducts w/ invasion and fibrotic response (5)

A

Infiltrating ductal carcinoma

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9
Q

Breast cancer in lobules w/ infiltration and some fibrotic response, frequently b/l or multifocal (5)

A

Infiltrating lobular carcinoma

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10
Q

Ductal breast carcinoma w/ rapid progression and angioinvasion, poor prognosis (5)

A

Inflammatory carcinoma (can mimic multiple mastitis)

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11
Q

Eczema-like patches on nipple and areola (5)

A

Paget’s disease of breast (suggests underlying DCIS)

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12
Q

DCIS treatment (5)

A

Lobectomy +/- radiation

Masectomy if high risk

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13
Q

LCIS treatment (5)

A

Observation + tamoxifen or raloxifene (all LCIS is ER+ and PR+)
Can do prophylactic bilateral masectomy (higher risk of invasive cancer overall than DCIS)

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14
Q

Invasive breast cancer treatment (5)

A

Lumpectomy (early focal cancers)
Masectomy (multifocal or prior breast radiation)
+Radiation (>5 cm)
Sentinal LN biopsy (axillary node dissection if +)
Systemic therapy (chemo/hormones) for LN+, size >1 cm, aggressive histology

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15
Q

Hormonal testing and treatment for breast cancer (5)

A

Test all breast cancers for estrogen and progesterone receptors (tamoxifen, raloxifene)
And for HER-2-neu receptors (trastuzumab)

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16
Q

Common breast cancer mets (5)

A

Bone, thoracic cavity, brain, liver

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17
Q

Developmental milestones at 2 months (4)

A

Social smile
Lifts head 45 degrees
Eyes follow object to midline
Coos

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18
Q

Developmental milestones at 4 months (4)

A

Laughs, aware of caregiver, localizes sound
Lifts head 90 degrees
Eyes follow object across midline

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19
Q

Developmental milestones at 6 months (4)

A

Differentiates parents, stranger anxiety
Rolls over, holds self up with hands, sits w/o support
Grasps/rakes, attempts to feed self
Babbles

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20
Q

Developmental milestones at 9 months (4)

A

Interactive games, separation anxiety starts
Crawls, pulls to stand
Grasps with thumb
First words

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21
Q

Developmental milestones at 12 months (4)

A

Separation anxiety continues
First steps, walks w/ help
Pincer grasp, tower of 2 blocks
~2-10 word vocabulary

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22
Q

Developmental milestones at 18 months (4)

A

Parallel play
Walks well, walks backward
Tower of 4 blocks, uses cup/spoon
10-50 word vocabulary, 2 word sentences

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23
Q

Developmental milestones at 2 years (4)

A

Dresses self w/ help
Runs, climbs stairs
Tower of 6 blocks
50-75 word vocabulary, 2-3 word sentences

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24
Q

Developmental milestones at 3 years (4)

A

Magical thinking
Climbs and descends stairs, jumps w/ 2 feet
Tower of 9 blocks, can draw circle
Dresses self

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25
Developmental milestones at 4 years (4)
Plays with others Hops on 1 foot Able to draw line image, closed line drawing 250+ word vocab, 4 word sentences
26
Developmental milestones at 6 years (4)
Can distinguish fantasy from reality Skips Draws a person Fluent speech
27
Neonate spider webbing/marbling of skin (3)
Cutis marmorata (not concerning)
28
Neonate 2-3 mm yellow pustule w/ red base (looks like whiteheads) in first 24-72 hrs, numerous eosinophils (3)
Erythema toxicum neonatorum (self-limiting by 3 weeks)
29
Neonate reddening of gravity-dependent side and blanching of nondependent side w/ line of demarcation, most common in first few days of life (3)
Harlequin color change (self-limiting in days to 3 weeks)
30
Neonate vascular malformations MC on nape of neck, upper eyelids and middle of forehead (reddish areas) (3)
Macular stains (stork bites) (benign but permanent)
31
Neonate pustules due to accumulation of sweat beneath ducts obstructed by keratin, usu in 1st week, associated w/ excess warmth (3)
Milia (no treatment, maybe loose clothing and cool baths)
32
Neonate bluish discoloration over buttocks and base of spine, probably also present in 1 of parents (3)
Mongolian spot (benign, usu fades in 1-2 years, needs documentation to avoid confusion w/ bruises later)
33
Neonatal acne age of onset (3)
Usu 3 weeks (will resolve in 4 months, can use benzoyl preoxide or topical retinoids on severe cases)
34
Infantile acne age of onset and presentation (3)
Usu 3-4 months, yellow papules around nose and cheeks (usu resolves by age 1, may last til 3, can use benzoyl preoxide or topical retinoids on severe cases)
35
Neonate superficial pustules overlying hyperpigmented macules (3)
Transient neonatal pustular melanosis (self-limiting)
36
Cough + coryza + conjunctivitis + Koplik spots + red, maculopapular rash (lasts 4-5 days, darkens) starting at head and spreading to feet 3-5 days later (4)
Measles
37
Malaise, fever, anorexia + red, tender maculopapular rash (lasts 5 days, doesn't darken) starting at face then spreading 1-5 days later + suboccipital and posterior cervical lymphadenopathy (4)
Rubella (German measles)
38
"Sandpaper-like" "sunburn-like" coarse, red, blanching rash, starts on trunk and spreads, sparing hands and feet + strawberry tongue, beefy-red pharynx and cervical LAD (4)
Scarlet fever, strep pyogenes
39
Causes of desquamation of hands and feet in kids (4)
Scarlet fever Kawasaki disease TSS Mercury poisoning
40
Oral vesicles + small, tender maculopapular/vesicular rash on hands and feet that lasts 3-5 days (4)
Coxsackie hand, foot and mouth disease
41
Sudden high fever (>102) x3-4 days then rash starting on trunk and spreading over body x24 hrs w/ erythematous papules on soft palate and uvula, edematous eyelids (4)
Roseola infantum (HHV-6)
42
Acute, bilateral cervical LAD in children (4)
Usu viral URI: rhinovirus, adenovirus, influenza, GAS Mono: EBV, CMV, mycoplasma HIV, HSV
43
Acute, unilateral cervical LAD in children (4)
Usu bacterial | S. aureus, GAS > anaerobes, GBS
44
Chronic, unilateral cervical LAD in children (4)
Bartonella henselae Toxoplasmosis TB Actinomyces israeli (sinuses drain pus)
45
Noninfectious (rare) causes cervical LAD (4)
Kawasaki disease | Hodgkin's lymphoma
46
Fever + aphthous ulcers + pharyngitis + adenitis every 28 days with NO neutropenia, cough, coryza, diarrhea, abdominal pain, rash, arthritis, neuro deficits (4)
PFAPA syndrome (benign, self-limiting, avg duration 4.5 years)
47
7-10 day incubation + 7-10 day mild URI + 1-6 week paroxysmal cough often worse at night (4)
Pertussis
48
Pertussis treatment (4)
Azithromycin, other abx
49
Boy w/ recurrent bacterial infections, no B cells on peripheral smear, low levels all Igs (4)
Bruton agammaglobulinemia (X-linked B cell deficiency w/ defective tyrosine kinase)
50
Recurrent viral, fungal, protozoal infections w/ congenital heart/great vessel defect and hypocalcemia (4)
Thymic aplasia (DiGeorge syndrome) (3rd and 4th pouches fail to develop -> no thymus or PTH)
51
Severe recurrent infections (including candidiasis, PCP, viral) + chronic diarrhea + failure to thrive + no thymic shadow (4)
SCID (multiple causes inc. adenosine deaminase deficiency) - NO LIVE VACCINES
52
Recurrent candida albicans infections (4)
Chronic mucocutaneous candidiasis (T-cell dysfunction)
53
Treatment chronic mucocutaneous candidiasis (4)
Antifungals (-azoles)
54
Recurrent pyogenic infections + thrombocytopenia and purpura + central eczema (4)
Wiskott-Aldrich Syndrome
55
Wiskott-Aldrich syndrome s/sx (4)
``` WAITER Wiskott Aldrich Immunodeficiency Thrombocytopenia and purpura Eczema (more trunk than extremities) Recurrent pyogenic infections ```
56
Cerebellar ataxia + poor smooth pursuit of moving target with eyes + facial telangiectasias > 5yo + increased AFP >8 months (4)
Ataxia-Telangiectasia (IgA deficiency; increased risk lymphoma and leukemias, radiation sensitivity; avg age of death = 25 years)
57
Recurrent sinus and lung infections + atopy or asthma + possibly European descent + transfusion anaphylaxis (4)
IgA deficiency
58
Recurrent S. aureus, E. coli, Klebsiella, Aspergillus, Candida infections w/ negative nitroblue tetrazolium test (4)
Chronic granulomatous disease (lack of NADPH oxidase activity -> impotent phagocytes)
59
Treatment chronic granulomatous disease (4)
Prophylactic TMP-SMX | IFN-gamma
60
Catalase + organisms (4)
``` CGD patients susceptible to these S. aureus E. coli Klebsiella Aspergillus Candida ```
61
Partial albinism + recurrent respiratory and skin infections + neurologic disorders (peripheral neuropathy, seizures, etc) (4)
Chediak-Higashi disease (defective LYST gene -> defective lysosomal transport)
62
Diagnostic for Chediak-Higashi disease (4)
Giant cytoplasmic granules in PMNs (defective phagocyte lysosomes)
63
Eczema + recurrent cold S. aureus abscesses + coarse facial features (broad nose, frontal bossing, deep set eyes, "doughy" skin) + retained primary teeth (4)
Hyper IgE syndrome (Job syndrome) (deficient IFN-gamma -> impaired neutrophil chemotaxis -> high IgE and eosinophils)
64
Delayed separation of umbilical cord (4)
Leukocyte adhesion deficiency syndrome (abnormal integrins -> phagocytes can't exit circulation)
65
Female w/ short stature, infertility, neck webbing (4)
Turner syndrome (45 XO)
66
MCC primary amenorrhea (4)
Turner syndrome (45 XO)
67
Cardiac abnormality associated w/ Turner syndrome (4)
Coarctation of aorta

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