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1
Q

Alopecia areata

Tinea capitis

A

well-demarcated, non-scarred, round patches of hair loss, exclamation point hairs, history of autoimmune conditions, nail pitting

erythema, scaling, black dot alopecia, LAD

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2
Q

Early pubic hair growth + acne with no testicular enlargement

only pubic hair with normal bone age

A

congenital adrenal hyperplasia, dx: ACTH stimulation test, elevated 17-hydroxyprogesterone, tx: hydrocortisone
idiopathic premature pubarche

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3
Q

painful oral ulcers+ rash on palms/soles/buttocks, nonitchy

HSV6

A

hand-foot-mouth disease, coxsackie virus, supportive care

roseola, rash after high fever

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4
Q

Chronic adrenal insufficiency electrolytes

A

hyponatremia, hyperkalemia, hyperchloremic metabolic acidosis
decreased hair, myalgia

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5
Q

chronic pancreatitis pain meds

A

TCAs, NSAIDs, pregabalin, conservative measures first

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6
Q

Pyelo in child

A

antibiotics before imaging

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7
Q

Pyelo in child

A

antibiotics before imaging

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8
Q

Antidepressant trial

A

6 weeks before adjusting

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9
Q

Loss of antidepressant response

A

substance use

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10
Q

post exposure HIV prophylaxis

A

triple therapy within 72 hours for 4 weeks

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11
Q

webbed neck, congenital lymphedema, high arched palate

A

Turner (random error (nondisjunction) resulting in one X, no increased risk of recurrence)
evaluate for coarctation, horseshoe kidney, celiac, hypothyroidism

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12
Q

premalignant complication of GERD

A

Barrett’s esophagus

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13
Q

PMS, increased risk for

A

mood and anxiety disorders

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14
Q

Acute heart failure that doesn’t respond to diuretics

A

vasodilator (nitroglycerin)

  • give before diuretics in flash pulm edema due to hypertension*
  • no digoxin in acute heart failure*
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15
Q

pelvic organ prolapse

A

bleeding due to erosions, treat erosions with estrogen

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16
Q

pruritic excoriated lichenified plaques

A

allergic contact dermatitis

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17
Q

exercise induced amenorrhea complications

A

osteoporosis, breast and vaginal atrophy, mild hypercholesteremia, infertility

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18
Q

febrile illness+ rash+ mucocutaneous ulcer+ leukopenia + thrombocytopenia

A

acute HIV

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19
Q

eisenmenger (unrepaired VSD->pulm htn->R to L shunt) pregnancy

A

abort

*also LVEF<40%, Class III-IV heart failure, aortic dilation>40 mm

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20
Q

if distribution tail is on the right side

if symmetric

A

median < mean and vice versa

median=mean=mode

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21
Q

stuck on lesions

A

seborrheic keratosis-do not treat unless symptomatic

itchy ones associated with GI/lung malignancies

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22
Q

iron deficiency in babies

A

cow’s milk, limit milk, rec count will rise before H/H

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23
Q

iron deficiency in babies

A

cow’s milk, limit milk, rec count will rise before H/H

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24
Q

Antiepileptics can reduce efficacy of OCPs

A

not gabapentin/ valproate

IUD/ implant preferred

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25
vertigo, hearing loss, tinnitus
Meniere's disease
26
Parinaud's syndrome (no pupillary reaction, vertical gaze paralysis, no optokinetic nystagmus, ataxia)
pineal tumor (some secrete hcg)
27
valproic acid pregnancy
neural tube defects
28
Mini-mental state exam will not distinguish | late life depression linked to increased risk of
pseudodementia from dementia | Alzheimer, vascular dementia
29
when informing about involuntary hospitalization
acknowledge feelings, treatment in a safe environment
30
constructional (can't draw) and dressing apraxia aphasia acalculia, finger agnosia, agraphia
nondominant parietal lobe dominant temporal lobe dominant parietal lobe (gerstmann syndrome)
31
Kawasaki scarlet fever (strep)
febrile >5 days + 4/5: rash, LAD, mucosal changes, conjunctivitis, extremity erythema/edema if not all criteria met-obtain CRP/ESR, reexamine tx: IVIG (no live vaccines for a year), aspirin, echo at presentation and 2 and 6 wks circumoral pallor, sandpaper rash, strawberry tongue
32
better test in study->higher power
better at establishing difference
33
honey colored crust
impetigo | tx: topical mupirocin, cephalexin
34
polymyalgia rheumatica
pain and stiffness in shouders, pelvic girdle | dx: ESR, tx: low dose prednisone
35
isolated elevated anti-Hbc
repeat serologies, measure IgM anti-Hbc and LFTs to determine acuity
36
Transfusion related acute lung injury long term
neurocognitive deficits, impaired muscle strength and lung function, psychiatric illness
37
Pericarditis EKG pericarditis vs dressler syndrome persistent ST elevation and q waves in same leads weeks post MI post MI pericarditis treatment
Diffuse PR depression, ST elevation days post Mi vs weeks ventricular aneurysm high dose aspirin, colchicine, narcotics
38
TSH secreting pituitary adenoma thyroid resistance syndrome
elevated TSH and thyroid hormone levels, elevated alpha subunit, increased sex hormone binding globulin tx: somatostatin analog, transsphenoidal surgery normal alpha subunit and sex horm binding globulin
39
subclinical thyrotoxicosis
decreased TSH, normal thyroid hormone
40
meralgia paresthetica
entrapment of lateral femoral nerve, lose weight, avoid tight fitting garments
41
meralgia paresthetica
entrapment of lateral femoral nerve, lose weight, avoid tight fitting garments
42
Pheo treatment hypertensive crisis cardiac tachyarrhythmias
alpha blockers after testing->imaging-> if negative, MIBG scan optimize alpha blockade (10-14 days) and volume status before surgery nitroprusside, phentolamine esmolol, lidocaine
43
perioral numbness, muscle cramps, twitching post massive transfusion
serum calcium will be normal | obtain ionized calcium
44
gradual onset of fever, cough, extreme dyspnea/hypoxia, tachypneic with diffuse rales in immunocompromised
PCP, prevent with Bactrim
45
Babies should walk by
16 months
46
Insomnia therapy
CBT
47
parathyroidectomy in hyperparathyroidism if MEN 1
symptomatic/ urinary calcium >400/ end-organ complications/ <50 yo *calcitonin is for medullary thyroid cancer* pituitary, parathyroid, GI tumor
48
splenic rupture treatment
supportive care | if do not improve-e lap
49
Kleuihuaer-Betke test
detect abruptio placentae after trauma in order to give Rho-D
50
Enterococcus
vanc, ampicillin
51
primordial prevention | quarternary prevention
prevention of risk factors | prevent unnecessary interventions
52
complex regional pain syndrome
allodynia, burning, edema, skin changes, decreased ROM after joint injury tx: nerve block/ IV anesthesia
53
standardized incidence ratio
for cancer | observed cases in population/ expected cases in gen pop
54
Most effective contraception
implant (can cause headaches, weight gain and unscheduled bleeding)
55
Tympany post lap surgery | post op urinary retention due to
due to insufflation of air, self-resolves | anesthesia and fluid resus, foley, voiding trial in a week
56
*Do not biopsy ovarian mass* | pregnancy ovarian mass
remove in 2nd trimester, chemo can be given
57
premature coronary athero in young women
lupus | leading cause of lupus death: heart
58
ferritin < 30 | target cells
iron deficient | thalassemia
59
grapy vagina | blind vaginal pouch
sarcoma botyroides in childhood or infancy | mullerian agenesis
60
HIV vaccines
pneumo, hepatitis, no live vaccines
61
opioid withdrawal treatment
methadone/buprenorphine in controlled settings | otherwise clonidine
62
lichen planus
skin, nails, mucous membranes, external genitalia shiny, discrete, pruritic, violaceous plaques and papules on flexural surfaces, wrists white lacy striae punch biopsy associated with hepatitis C liver
63
24-28 weeks preg testing
cbc, 50g glucose tolerance test (if +-100 g 3 hour test) | if rh-d negative, antibody screening
64
epidural contraindication
platelets <70k
65
chronic hypopth treatment
vitamin d, calcium, thiazide if high urinary calcium
66
TB pleural effusion
lymphocytic, exudative, elevated adenosine deaminase | biopsy-granulomas
67
Neonatal polycythemia
hematocrit >65% in peripheral draw glucose, fluids if refractory-partial exchange transfusion
68
NPH treatment
lumbar tap test | if improvement-VP shunting
69
Acute uterine bleeding
stable-OCPs with high dose estrogen | D&C if unstable/ VTE/ refractory
70
Any sharp object in esophagus
urgent flexible endoscopy
71
Contraception with clots
CI for estrogen, not progestin progestin also decreases bleeding *copper IUD associated with more bleeding*
72
Antiphospholipid antibody syndrome testing
lupus anticoagulant, anticardiolipin antibody, anti beta2 glycoprotein 1 antibody
73
torsades de pointes
hypocalcemia, hypomagnesemia, hypokalemia long QT syndrome -> v fib -> death give IV mag, if refractory-transvenous pacing
74
odds ratio
odds of exposure in case group/ odds of exposure in control group
75
OSA can cause mild cognitive impairment in elderly
don't need daytime sleepiness
76
henoch-schnonlein purpura
preceding URI pediatric vasculitis from IgA deposition abd pain and nausea due to intussusception, arthralgia, renal insufficiency, self-resolves *HUS follows bloody diarrhea*
77
fever in a traveller
<10 days: typhoid, dengue, chikungunya, influenza, legionellosis 1-3 weeks: malaria, typhoid, leptospirosis, schitosomaniasis, rickettsial >3 weeks: TB, leishmania, enteric parasites
78
young woman, 2 UTIs in 6 months or 3 in a year
antibiotic ppx with Bactrim, fluoros, nitrofurantoin
79
Treat subclinical hypothyroidism if
anti-TPO antibodies, abnormal lipid profile, symptomatic, ovulatory and menstrual dysfunction
80
drugs that cause hypercalcemia
thiazides, lithium
81
feeding goal
30 kcal/kg/day and 1g/kg/day of protein | lower if fear of refeeding syndrome
82
tamponade echo
early diastolic collapse of RV and right atrium
83
severe aortic stenosis
low intensity, single second heart sound during inspiration (no split S2), delayed and diminished carotid pulse, loud and late peaking systolic murmur *AR- wide pulse pressure (volume)
84
cardiotoxic chemo monitoring (-rubicin)
radionuclide ventriculography/MUGA (measures EF) EF <50%-reduce dose <30% or more than 10 point decrease-discontinue
85
hepatic adenoma in young woman
OCP well-demarcated lesion with peripheral enhancement when contrast is injected asymptomatic-discontinue OCP, serial imaging, AFP >5 cm-resect *uniform enhancement-focal nodular hyperplasia*
86
Dementia workup
CBC, CMP, TSH, vitamin b12, folate, syphilis, vitamin D
87
Immune thrombocytopenia treatment
isolated thrombocytopenia, antiplatelet antibodies IVIG/steroids if platelet count <30K with mucosal bleeding BTW, negative direct antiglobulin test
88
Long term maintenance of sinus rhythm when rate control fails
Rhythm control: amiodarone, dofetilide
89
psoriatic arthritis treatment
methotrexate | skin-high potency topical steroids, ultraviolet light therapy
90
post MI sex
high risk/ intermediate risk patients (refractory angina, significant valve disease, arrythmia, class IV heart failure) should undergo testing/assessment
91
Tachycardia in asthma exacerbation
not CI for SABA use | *Mg in severe exacerbation-PEF <40% of baseline/ refractory*
92
Carbamazepine side effects
SIADH, neutropenia, bone marrow suppression, anticholinergic effects
93
Akathisia treatment
propranolol
94
Rabies | treatment
hydrophobia immunized: booster (2 doses) nonimmunized: immunoglobulin + vaccine (4 doses)
95
Exercise CI in pregnancy when
cerclage, active vaginal bleeding, placenta previa, increased risk for preterm birth, preeclampsia, heart/lung issues
96
Prevent AAA expansion
smoking cessation

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