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1
Q

acute painless monocular vision loss

A

central retinal artery occlusion, cherry red macula (preserved circulation via posterior ciliary arteries), retinal pallor

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2
Q

Renal failure that does not respond to fluids in cirrhotic

A

hepatorenal syndrome
midodrine, octreotide, albumin
BUN/Cr ratio >20-pre renal

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3
Q

serotonin syndrome

A

autonomic dysfunction, fever, GI, clonus, hyperreflexia, tremor, rigidity

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4
Q

disseminated gono

A

systemic symptoms, tenosynovitis, dermatitis, polyarthralgia
ceftriaxone and azithromycin

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5
Q

herpangina

A

coxsackie group A, painful vesicles on posterior oropharynx, tx: supportive care
group A pharyngitis would have cervical LAD and tonsillar exudates

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6
Q

Refractory carpal tunnel

A

Nerve conduction studies in prep for surgery

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7
Q

Chagas

A

LV apical aneurysm in absence of CAD
protozoa, trypanosome cruzi, complete heart block, ventricular tachy
lyme-AV conduction block

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8
Q

WPW arrhythmia

treatment

A

short PR, delta wave, wide QRS
tachy->syncope
catheter ablate

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9
Q

trastuzumab (chemotherapy for breast cancer, HER 2) cardiotox

A

reversible after discontinuation

anthracycline isn’t reversible

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10
Q

Lead poisoning

A

at risk with level <5: repeat level in a year
5-44: remove sources, repeat level within a month
>45: chelation with EDTA, succimer

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11
Q

Unstable angina, NSTEMI management

A

no trops vs trops

TIMI score: low risk-stress test, cath otherwise

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12
Q

cirrhosis thrombocytopenia due to

A

portal hypertension and splenic sequestration

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13
Q

Prostaglandin for baby hypoxia

A

PDA dependent conditions (transposition, hypoplastic left heart)

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14
Q

st johns wort depression

A

effective for mild to moderate, multiple drug interactions, do not use with SSRIs-serotonin syndrome

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15
Q

External cephalic version timing

A

37 weeks if still breech

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16
Q

Ischemic stroke in the setting of DVT

Diagnosis

A

Paradoxical emboli, from venous system to arterial system through intracardiac shunt
TEE or bubble study

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17
Q

multi-nutrient malabsorption in young adult
screening

skin findings

A

celiac disease, can present without GI symptoms
anti-endomysial, anti-tissue transglutaminase antibodies
vitiligo, dermatitis herpetiformis

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18
Q

patellofemoral pain syndrome

treatment
prepatellar bursitis
patellar tendonitis

A

reproduced on extension of knee with anterior pressure on patella, squatting, stairs
stretching and strengthening exercises
being on knees
inferior patella, jumping sports

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19
Q

Transfusion/volume expansion electrolyte abnormality

A

hypocalcemia- hyperactive DTRs

hypermagnesemia-hypoactive DTRs

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20
Q

tachypnea(respiratory alkalosis), tachycardia, fever, dizziness, GI symptoms, lactic acidosis

A

salicylate toxicity

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21
Q

deep dyspareunia, dysmenorrhea, chronic pelvic pain, dyschezia, rectovaginal nodularity, ovarian mass

A

endometriosis

NSAIDs and combined OCPs

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22
Q

Diabetic baby heart

A

transient HCOM - spontaneous resolution within a few weeks

hypoplastic left ventricle in second trimester ultrasound

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23
Q

pancreatitis severity assessment

A

obesity, age, hematocrit, BUN, CRP

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24
Q

hypocalcemia post parathyroidectomy

A

hungry bone syndrome, bilateral neuro symptoms

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25
cremasteric reflex
L1-L2, can be affected by diabetic neuropathy
26
acute multiple sclerosis treatment maintenance therapy pregnancy spasticity treatment
IV steroids, plasmapheresis if refractory beta-interferon/ glatiramer gets better, but increased c/s and assisted delivery baclofen/ tinazidine
27
hemophilia A genetics
x linked recessive
28
nursemaid's elbow
normal xray, manual reduction by flexion and supination
29
salicylate toxicity treatment
sodium bicarb, glucose, activated charcoal
30
aspirin at 12 weeks gestation
renal disease, DM, HTN, prior preeclampsia
31
postpartum eclampsia | Sheehan syndrome
htn, end-organ damage, edema, tx: magnesium, antihtn | post partum pituitary infarct
32
peripartum cardiomyopathy surveillance
serial echos | If LV dysfunction is persistent, advise against pregnancy
33
MEN 2A MEN 2B MEN 1
medullary thyroid cancer (get calcitonin, CEA, neck ultrasound, RET) hyperparathyroid, pheo (rule out before thyroidectomy) no hyperparathyroid hyperparathyroid, enteropancreatic tumors, pituitary
34
HCOM medical management Refractory ICD if
beta blocker, verapamil, disopyramide alcohol ablation history of cardiac arrest or v tach
35
nuchal rigidity + AMS treatment diagnosis
viral meningoencephalitis coxsackie, echo, herpes, arbo (west nile) supportive care CSF aseptic pleocytosis, viral serologies
36
nonallergic rhinitis
chronic nasal blockage, postnasal drip, rhinorrhea tx: topical intranasal steroids, intranasal antihistamines * eye symptoms-allergic rhinitis, same tx
37
urethral diverticulum diagnosis
postvoid dribbling, dysuria, dyspareunia, anterior vaginal mass, recurrent UTIs MRI or TVUS
38
Fat pad displacement on xray after fall on outstretched hand
supracondylar fracture | immobilize
39
Baby BMs
After the first month, okay to be 1-2 a week
40
keloid treatment (can have pain and itching)
intralesional steroids
41
Paresthesias in hands with dorsal sparing, worse at night, relieved by shaking hands pain reproduced by
carpal tunnel syndrome elevating hands above head, hyperflexion of wrist, tapping over median nerve *dequervian tenosynovitis-sharp pain at base of thumb
42
benzo withdrawal
autonomic instability, tremors, delirium, psychosis
43
CCB edema
decreased when combined with ACEIs | precapillary dilation vs post capillary dilation
44
scleroderma renal crisis
activaton of RAAS->hypertension | treat with captopril, + nitroprusside if papilledema
45
Localized abdominal itching in pregnancy treatment intrahepatic cholestasis of pregnancy management
normal oatmeal baths, UV light exposure, antihistamines delivery at 37 weeks, urso, antihistamines
46
randomization removes
confounding
47
pancreatic mass biopsy
endoscopic aspiration
48
Type I DM medication regimen
basal-bolus regimen
49
scrombroid poisoning pufferfish poisoning
improperly stored seafood histamine->flushing, headache, palpitations, cramps, diarrhea, oral burning, tachy, hypotension self-limited neuro symptoms
50
Benzo falls
discontinue
51
Donor nephrectomy complications
pregnancy complications, complete childbearing before if necessary
52
hormone replacement increases risk of
stroke ,CAD, breast cancer, VTE , higher > 60 | no increased mortality if <60
53
fibromyalgia, rule out
anemia (CBC), rheum (ESR, CRP), hypothyroid (TSH)
54
igg3 deficiency
recurrent sinopulmonary and GI infections
55
If GERD does not resolve with PPI
24 hour ph monitoring
56
neck stiffness not only in meningitis but also
subarachnoid hemorrhage
57
SBP prophylaxis | Advanced liver disease mortality
fluroquinolone | INR, creatinine, bilirubin, sodium
58
Mastoiditis | treatment
post auricular symptoms, complication of otitis media | IV antibiotics, drainage
59
multiple myeloma imaging | hyperviscosity syndrome
skeletal survey | CNS symptoms, mucosal bleeding, tx: plasmapheresis
60
Inoperable head and neck cancers
chemoradiotherapy
61
Dyspepsia (epigastric fullness, burning or early satiety)
GERD->PPI >55->endoscopy weight loss/vomiting/anemia->endoscopy otherwise->h. pylori testing
62
Subarachnoid hemorrhage rule out
CT Head, then LP
63
Asthma testing
normal till methacholine challenge (reduced FEV1 and FEV1/FVC ratio
64
Acute stress disorder vs PTSD
Less than a month vs more than a month
65
thyroglossal duct cyst branchial cleft cyst
midline, moves upward with tongue protrusion remove because of high risk of infection lateral neck, associated with sinus tract/fistula
66
pemphigoid gestationis treatment
autoimmune, abdominal itching, then rash around umbilicus and trunk, urticarial papules and plaques->bullae, no mucous involvement topical steroids
67
Depression with insomnia
no trazodone, it's not a first line antidepressant and is only effective at sedating doses
68
tocolysis <32 weeks | 32-34 weeks
indomethacin | nifedipine
69
PCP intoxication
nystagmus, lasts 8 hours | immediate benzos
70
tunneled dialysis catheter related bacteremia, remove if:
severe sepsis, hemodynamic instability, pus, symptomatic after 72 hours, endocarditis (evidence of met infection)
71
Marfans + intellectual disability+ VTE
homocystinuria
72
Mitigating lack of power due to small sample size
meta analysis
73
Stress testing assesses
risk of cardiovascular events, can't catch nonobstructive CAD
74
male breast cancer risk factors
BRCA mutation, klinefelter | hepatic dysfunction, marijuana, obesity
75
shaken baby imaging
CT Head
76
Wernicke | korsakoff
ataxia, oculomotor dysfunction, encephalopathy | mammillary body atrophy-confabulation and amnesia
77
Cyanide toxicity due to nitroprusside treatment
in setting of renal insufficiency, metabolic acidosis, AMS , seizures, flushing, cyanosis sodium thiosulfate
78
small rough erythematous keratotic lesions in sun exposed areas
actinic keratosis | *if numerous-5 FU cream*
79
primary nocturnal enuresis
>5, nighttime bedwetting | urinalysis, behavioral changes, desmopressin
80
pain and numbness in wrist and palmar surfaces of first three digits
carpal tunnel syndrome
81
scabies | treatment
itchy, contagious | topical permethrin, oval ivermectin
82
diaper dermatitis with beefy red plaques, satellite papules, involvement of genitucrural folds
candida topical nystatin/ clotrimazole *pustules/ honey crusted drainage-bacterial superinfection-mupirocin*
83
Stroke BPs
ischemic, received TPA-185/105 | no TPA-<220/120
84
Hirschsprung diagnosis malrotation with volvulus diagnosis
don't pass meconium, abdominal distension rectal suction biopsy-no innervation upper GI series
85
ectopia lentis
marfan's annual echo, beta blocker *berry aneurysm-ehlers danlos*
86
B12 deficiency | treatment adverse effect
peripheral neuropathy AND spinal cord degeneration | hypokalemia
87
Normocytic anemia lab
Rec count
88
diverticular bleeding
painless hematochezia due to erosion of artery
89
blepharospasm | treatment
focal dystonia, involuntary eye closure | botox
90
vasovagal syncope
predrome and postdrome of nausea, pallor, warmth, diaphoresis
91
active preterm labor
IM betamethasone to prevent respiratory distress, necrotizing enterocolitis, intraventricular hemorrhage
92
low T3, normal T4, normal TSH
euthyroid sick syndrome, recheck when patient is healthy
93
sarcoid biopsy
most accessible spot-noncaseating granulomas
94
Meningitis prophylaxis for contacts
Close contact, direct contact with secretions | rifampin/Cipro/IM ceftriaxone
95
diaphragmatic paralysis in ALS (tongue fasciculations, muscle atrophy) diagnosis
orthopnea, retraction of abdomen on inspiration, sniff test
96
spinal stenosis treatment | diagnosis
conservative, epidural block, laminectomy | MRI
97
history of transfusion, difficulty finding cross-matched blood
alloantibodies

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