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1
Q

sternal clicking followed by CABG

A

sternal dehiscence - requires surgical fixation

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2
Q

TB treatment causing anemia

A

isoniazid interferes with RBC production - should give B6 (pyridoxine)

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3
Q

treatment of alcoholic seizures

A

lorazepam - intermediate acting benzo

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4
Q

pseudoachalasia

A

narrowing in the esophagus that looks like achalasia but is caused by malignancy

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5
Q

monochorionic twins are at risk for….

A

twin-twin transfusion syndrome

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6
Q

chronic hypertension in pregnancy

A

before 20 weeks, two measurements taken 4 hours apart

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7
Q

risk with hypertension in pregnancy

A

placental dysfunction from thickened vessels that can cause preterm labor

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8
Q

factors favoring albuminuria in diabetic patient not cause by diabetic nephropathy

A

onset of proteinuria less than 5 years after onset, urine sediment, 30% reduction of GFR after starting ACEi

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9
Q

initial evaluation of mixed urinary incontinece

A

voiding diary - to classify dominant type and determine treatment

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10
Q

risk of infection with atopic dermatitis

A

can have superimposed infection due to underlying inflammation

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11
Q

painful vesicles with an erythematous base

A

HSV

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12
Q

dehydrated patient with high urine sodium and orthostatic hypotension

A

diuretic abuse

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13
Q

respiratory features of CF

A

chronic sinus infections, nasal polyps, bronchiectasis, digital clubbing

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14
Q

oxygen lab values in methemoglobin

A

o2 sat shows 85% because it absorbs light differently, PaO2 shows normal because it only measures unbound 02
- does not improve with supplemental oxygen

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15
Q

treatment of methomaglobin

A

methylene blue

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16
Q

most common cause of aortic dissection

A

systemic hypertension

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17
Q

EKG finding in pericardial effusion

A

electrical alterans

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18
Q

actinic keratosis can lead to…

A

squamous cell carcinoma

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19
Q

treatment of pulmonary hypertension due to LV failure

A

ACEi and diuretic

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20
Q

signs of congenital syphilis

A

copious nasal discharge, maculopapular rash on feet and buttocks that desquamates, abnormal long bone xrays

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21
Q

binge eating followed by compensatory behavior

A

bullemia

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22
Q

treatment for ITP in kids

A

usually self resolves - advance to treatment if there is mucosal bleeding

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23
Q

screening for AAA

A

65-75 ultrasound with smoking history

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24
Q

migraine prevention meds

A

beta blockers, tricyclics, divalproex, topirimate

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25
colonoscopy in IBD
10 years after diagnosis then every 1-3 years
26
seizure in COPD patient
caused by CO2 retention
27
febrile illness after syphilis treatment
JH reaction caused by release of spirochetes
28
cause of HIV dementia
macrophage induced neuronal damage
29
Lambert Eaton
autoantibodies against presynaptic calcium channels | - proximal muscle weakness, *reduced tendon reflexes* and autonomic dysfunction
30
recommendation to reduce calcium stones
decreased sodium intake (sodium increases calcium excretion causing stones
31
timing of Rh administration
in a negative mother at 28-32 weeks, after abortion or after birth if baby is positive
32
infection timing after transplant
- less than one month = bacterial from operation - 1-6 months = opportunistic pathogens (CMV) - more than 6 months = same as general pop
33
hypotension after epidural
caused by venous pooling and vasodilation
34
medications that exacerbate anaphylaxsis
NSAIDS or beta blockers (mast cell activation or alpha activation)
35
definition of second stage arrest
- 3-4 hours of pushing in primip | - 2 hours of pushing in multip
36
cause of endometrial hyperplasia
unopposed estrogen exposure
37
first step in evaluation of precocious puberty
bone age (if it correlates - it is likely benign)
38
sunburst pattern and codman triangle
osteosarcoma
39
periosteal reaction with onion skinning
ewing sarcoma
40
congenital infant hypothyroid
apathy, weakness, abdominal distension, large tongue, sluggish movement and hernia
41
treatment for urge incontinence
antimuscarinics (oxybutynin)
42
most common symptom of sickle trait
hematuria
43
treatment of alcoholic with altered mental status
glucose and thiamine
44
causes of acute erosive gastropathy
- aspirin - decreases prostaglandin - cocaine - vasoconstriction - alcohol - direct injury
45
treatment of moderate to severe rhinitis
antihistamine and inhaled steroid
46
how does a pharm stress test work
give adenosine to maximally dilated all vessels - affected vessels can dilate any further
47
features of Felty syndrome
- Rheumatoid arthritis - neutropenia - splenomegaly
48
presbycusis
age related hearing loss - can also have tinnitus
49
features of Menieres disease
fullness, vertigo, tinnitus, hearing loss | - cause = accumulation of endolymph
50
type of gout associated with hypercalcium
pseudogout
51
test for vesicovaginal fistula
bladder dye
52
tenderness to gentle percussion over back in IV drug user
osteomyelitis
53
most common heart defect in Edwards syndrome
VSD
54
cause of cutaneous flushing after giving niacin
prostaglandin related reaction
55
green drainage after chest tube placement in MVA
esophageal rupture (gastric contents)
56
seizures in GI illness in children
Shigella
57
schizotypal vs schizoid
``` typal = like schizophrenics oid = loner types ```
58
drug of choice in PBC
ursodeoxycholic acid - should be started right away | - most will eventually need a liver transplant
59
CSF in GBS
elevated protein, all else normal
60
when to PCI
within 12 hours of symptom onset, with 90 minutes of medical contact
61
DIC and seizures in patient after birth
may be amniotic embolus -
62
most common cause of pneumonia in CF
s aureus in young - followed by pseudomonas in old
63
disease causing common VDRL false positive
antiphospholipid antibody
64
medication to reduce pregnancy risk in APS
LMWH
65
medications causing hemolysis in G6PD
dapsone, primaquine, bactrim
66
jaundice, light stools and dark urine in 2-3 week old infant
biliary atresia
67
most common cause of stroke
hypertension
68
confirmatory test for preeclampsia
urine protein to creatinine ratio
69
only contraindications to giving vaccines
anaphylaxis, unstable neurological disorders, and encephalopathy (not seizures)
70
cause of vertigo after head illness
vestibular neuritis
71
electrolyte change after treating COPD
beta agonist causes potassium shift into cells leading to hypokalemia
72
bladder problems, neurological changes and no reflexes after aortic dissection
anterior spinal artery infarction
73
calciphylaxis
usually in end stage renal disease - nodules that can become necrotic - high PTH and hyperphosphatemia - calcium can be normal
74
fever after antipsychotic
NMS - dose independent reaction
75
treatment for cancer pain
short acting opioid - can use longer if ineffective
76
treatment of septic arthritis in addition to vancomycin
need to cover gram negative - ceftriaxone
77
cause of pityriasis versicolor
malassezia globosa - budding yeast - spaghetti and meatballs
78
preferred first line in treatment of fibromyalgia
tricyclic antidepressants
79
vesicular rash in auditory canal
herpes zoster
80
no urinating after giving birth
pudendal nerve damage or bladder atony after epidural

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