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Flashcards in 5/6 Deck (93)
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1

Target INR for A-fib or idiopathic VTE

2.0-3.0

2

Target INR for patients with prosthetic heart valves

2.5-3.5

3

What should be checked in every patient w/ menopause like symptoms

TSH and FSH

4

CGD defect

NADPH oxidase enzyme complex --> can't form hydrogen peroxidase

5

Cause of LAD

Impaired neutrophil migration to the site of infection

6

LAD features

Delayed umbilical chord separation, recurrent NON PURULENT infections, marked neutropenia, and severe periodontal

7

Type 1 vs 2 HIT timing

type 1: within 2 days and usually fixes itself
type 2: 5-10 days

8

Initial carpal tunnel tx

Splinting and NSAIDs

9

Presentation of vasa previa

Painless vaginal bleeding that occurs w/ rupture of membranes followed by fetal deterioration

10

First line tx for symptomatic bradycardia

IV Atropine

11

What is Ludwig's angina? MCC of death with this

Infection of the submandibular and sublingual glands
MCC of death with this is asphyxiation

12

SCFE in pt's w/ endocrinopathies

Likely bilateral with early presentation

13

Edwards features

Trisomy 18 --> Rocker bottom feet, VSD, absent palmar creases, overlapping fingers, microcnathia

14

Newborns with Hep B pos mothers

HBIG (passive immunization) followed by active immunization with HBV vaccine

15

Dx conformation of ALL

Bone marrow biopsy showing >25% lymphoblasts

16

Why can severe pain prevent urination in BPH dudes

They need to valsalva in order to pee

17

Why bone loss in AS patients

Increased osteoclast activity in the setting of chronic inflammation

18

Inflammatory back pain feature of AS

Relieved with exercise but not rest

19

Hgb electrophoresis of beta-thal minor

Increased Hgb A2

20

Heme studies of Thal minor

MCV out of proportion to degree of anemia (Hgb > 10) and disproportionately high RBC count

21

When does iron def anemia become microcytic

When Hgb drops below 10

22

Tricomonas tx

Metronidazole

23

K in ACE use

Hyperkaelmia and rise in creatinine due to reduced GFR

24

CLL conforation

Flow cytomerty --> can demonstrate lymphocyte clonality

25

What bug causes endocarditis associated with nosocomial UTIs

Enterococci

26

Viridans group strep endocarditis with (2)

1. Dental procedures
2. Procedures involving incision and biopsy of respiratory tract

27

Lateral epicondylitis features

Pain w/ supination or extension of the wrist and point tenderness just distal to lateral epicondyle

28

Test for radial tunnel syndrome

Flexing patients long finger while patient actively extends the finger and wrists

29

MCC of paroxysmal tachycardia in people without structural heart disease? What causes it

PSVT
Usually caused by re-entry circuit in AV node

30

What is often associated with breath holding spells in children

Iron deficiency anemia

31

2ndary hyper-PTH from renal failure features

Hypocalcemia
Hyperphosphatemia
Increased PTH

32

What can thyroid surgery cause

Hypoparathyroidism

33

When do sickle cell kids spleens usually auto-infarct

First 18-36 months of life

34

What are Heinz bodies

Aggregates of denatured Hgb seen in G6PD def and thalassemia
*form bite cells with macrophages get them*

35

Alports defect? kidney biopsy?

X-linked defect in collagen-IV formation
Kidney biopsy usually shows thinning of GBM

36

Two organs goodpasutures affects

Lung and Kidney

37

Increased deposition of poorly mineralized osteoid is seen in

Vit D def

38

Most common part of the spine RA affects?

Cervical joints in the axial skeleton --> can lead to cervical spine subluxation

39

Serous otitis media otoscope exam

Dull TM that is hypomobile on pneumatic otoscope

40

Big acute interstitial nephritis drugs

Penicillins, TMP-SMX, cephalosporins, NSAIDs

41

Barter/Gittlemans syndrome labs

Normotensive w/ hypokalemia and alkalosis
*high urine [Cl]*

42

MCC of a-fib

Ectopic foci within the Pulmonary veins

43

Who gets plasma HIV RNA tests

Patients with negative serologic tests but high clinical suspicion of HIV

44

Project

Attributing undesirable feelings to someone else

45

What do MEN 2A and 2B have in common? different?

Both have MTC and Pheos
2A has parathyroid hyperplasia
2B have mucosal neuromas and marfanoid habitus

46

Lab of congenital toxo

Hyperbilirubinemia and thrombocytopenia

47

What can prolonged nitroprusside therapy cause? presentation?

Cyanide toxicity --> presents with AMS, lactic acidosis, seizures, and coma

48

Gold standard to dx cervical incompetence

Transvaginal US --> look for funneling of cervix or short cervical length

49

Two best tx for stress incompetence

1. Pelvic muscle exercises
2. Urethropexy

50

MCC of isolate proteinuria in children

Transient proteinuria --> repeat urine dipstick for protein 2x to rule out anything else

51

Whistling noise after rhinoplast

Nasal septal perforation likely 2/2 septal hematoma

52

After MI, rupture of ventricular free wall presentation

5 days to 2 weeks after --> Acute chest pain and profound shock, w/ rapid progression to PEA and death

53

Best diagnostic test for diverticulitis

Abdominal CT (w/ oral contrast)

54

Earliest signs of serious infection in neonate

Poor feeding and decreased levels of alertness

55

Why is a head CT not needed in neonates before an LP

They do not herniate, as their open fontanelles serve to relieve intracranial pressure

56

Pertussis ppx for house w/ sick contact

Macrolide for all close contacts

57

Viral myocarditis MCC by what virus

Coxsackievirus B

58

herpes simplex keratitis characterized by

Corneal vesicles and dendritic ulcers

59

Most common nerve injury in association with mid-shaft fracture of the humerus

Radial nerve injury

60

Most reliable sign for spinal osteomyelitis

Tenderness to gentle percussion over the spinous process
*Inc ESR and Inc platelets*

61

R Ventricular MI features

Hypotension
JVD
Clear lung fields

62

Right MI mgmt

Avoid nitrates and diuretics, as these patients are preload dependent
Bolus them

63

Most common vaccine-preventable disease among travelers

Hepatitis A

64

What should DM patients age 40-75 get regardless of baseline lipid levels

Statin

65

BCC features

Slow growing papule with pearly rolled borders

66

Two Ab for cellulite w/ systemic signs

IV nafcillin or cefazolin

67

Aspergillosis CT

Pulmonary nodules with a halo sign or lesions with an air crescent

68

Histo CXR

Hilar adenopathy and areas of pneumonitis

69

Acute angle closure glaucoma presentation

Unilateral orbitoforntal headache ass w/ n/v, unilateral hey pain w/ conjunctival injection, and dilated pupil w/ poor light response

70

Drugs that causes idiosyncratic liver injury w/ histological features similar to viral hepatitis

Isoniazid
Halothane
Phenytoin
Alpha-methyldopa

71

pronator drift a sign of

upper motor neuron damage in UE

72

Dx for esophageal perf

Water soluble contrast esophagram

73

What is constitutional growth delay characterized by

Delayed growth spurt
Delayed puberty
Delayed bone age

74

Anterior shoulder dislocation can cause damage tow hat

Axillary nerve or artery

75

What is Kehr's sign

Pain radiating to the shoulder due to diaphragmatic irritation

76

Neonatal thyrotoxicosis results from? tx?

Transplacental passage of anti-TSH receptor antibodies
Tx: Methimazole + B blocker

77

All RA patients should get what

MTX early in the course to prevent joint damage

78

An adolescent with a solitary breast mass is likely

Fibroadenoma
*re-examine after menses for decrease in mass size or tenderness*

79

Why hypocalcemia from blood transfusion

Citrate in transfused blood binds ionized calcium

80

Two worst kinds of mutation

Non-sense and frameshift

81

Dx of CO poisoning

Carboxyhemoglobin level

82

One of the earliest manifestations of macular degeneration

Distortion of straight lines so they appear wavy

83

When should COPD patients get home O2

PaO2

84

Prolactin stimulated by and inhibited by what

Stimulated by serotonin and TRH and inhibited by dopamine

85

Nocardia micro

Gram+ weakly acid fast filament branching rod

86

Descending aortic dissection tx

Labetalol--> lower BP and HR, minimizing stress on the aortic wall

87

Risk factors for polyp progressing into malignancy

Villous adenoma
Sessile adenoma
Size > 2.5cm

88

Most common non-neoplastic polyps of the colon

Hyperplastic polyps

89

Non-vaccinated healthcare workers exposed to Hep B blood

Hep B vaccine and Hep B Ig

90

Early symptoms of CO poisoning

Typically neurologic (agitation, confusion, and somnolence)

91

Surgery for Androgen insensitivity folks

Bilateral gonadectomy after completion of puberty (e.g. after attainment of adult height)

92

Acute transplant rejection tx

IV steroids

93

AS is characterized by

Chronic inflammatory bain pain and stiffness, lumbosacral tenderness, and reduced spinal range of motion