6 Flashcards
(101 cards)
1
Q
strongest risk factor for PID
A
multiple sexual partners
2
Q
wide insignificant confidence interval due to
A
small sample size
3
Q
case fatality rate
A
no. of people who die from specific condition
4
Q
single rubbery mobile breast mass in young woman
tender solitary mass
A
fibroadenoma
breast cyst
5
Q
Normal breasts +no hair+ no menses
diagnosis
A
androgen insensitivity syndrome
testes, no uterus, 46 XY, adult male levels of testosterone
6
Q
RR
OR
A
risk of developing disease->observational
exposure and outcome
7
Q
asymmetry in funnel plot
A
publication bias
8
Q
Preggo exercise
A
no scuba diving or contact sports
9
Q
Clozapine side effect
A
neutropenia, monitor ANC
used for refractory schizophrenia
10
Q
Infantile pyloric stenosis imaging
Associated with abx
A
ultrasound
erythromycin, azithromycin (post exposure prophylaxis for pertussis)
11
Q
Preggo TB treatment
A
no pyrazinamide
12
Q
cat scratch disease treatment
A
azithromycin
13
Q
chronic bacterial prostatitis
treatment
A
recurrent UTI symptoms, pain during ejaculation, GU pain for >3 months
6 weeks of Bactrim/Cipro
14
Q
Diabetes diagnosis
A
symptomatic: HgbA1c> 6.5%, fasting glucose >126, glucose >200 after tolerance test ONCE
asymptomatic: must repeat
15
Q
Hashimoto’s thyroiditis with rapid enlargement of thyroid
A
thyroid lymphoma
16
Q
in skewed distributions what is the most valid measure of central tendency
A
median
17
Q
quality adjusted life years vs disability adjusted life years
A
every yr of this life to blank year of full health vs
years of life lost and years lived with disability
18
Q
Reticular rash with arthritis
A
parvovirus, ff URI
slapped cheek malar rash
19
Q
Tourette is associated with ADHD and OCD.
treatment
A
antipsychotics, therapy
20
Q
persistent hematuria with peripheral eosinophilia
diagnosis
treatment
A
schistosomiasis
urine sediment microscopy
praziquantel
21
Q
surgical correction of spine
A
convexity>60
22
Q
Apnea of prematurity vs periodic breathing
A
> 20s, resolves by 37 weeks vs 5-10s pauses and rapid breathing, resolves by 6 mos
23
Q
IVC filter complications
A
recurrent DVT, IVC thrombosis
24
Q
pressure ulcer
A
moist wound environment
debride devitalized tissue
25
paget disease of the bone
incidental, elevated alk phos, normal calcium
| bone scan and bisphosphonate
26
Acute intermittent porphyria
elevated urinary porphobilinogen
| acute psychosis, abdominal pain, family history
27
Congenital adrenal hyperplasia
treatment
21 hydroxylase deficiency: no cortisol/aldosterone, elevated 17 hydroxyprogesterone
ambiguous genitalia, hyponatremia, hyperkalemia, hypoglycemia, hypotensive shock
glucocorticoid, mineralocorticoid (hydrocortisone+fludrocortisone)
28
Meds that cause SIADH
SSRIs, carbamazepine, valproic acid
29
knee dashboard injury
posterior cruciate ligament
30
kappa statistic
inter-rater reliability
31
First degree relative with colon cancer or adenomatous polyps <60 yo or 2 at any age
screen at 40 yo
32
chronic cough in children
spirometry to test for asthma, CXR
33
abnormal puberty evaluation
measure hormones first-FSH, testosterone, LH
| *increased prolactin and TSH decrease GnRH*
34
Parkinson diagnosis
| treatment
bradykinesia (resistance to flexion) + ridigity/ tremor
| pramipexole, levodopa+ entacapone later
35
speech development at 2 yo
>50 words with 2 word phrases
36
Infected obstructing kidney stone
perc nephrostomy or ureteral stent placement
37
down's syndrome heart
| higher risk of
endocardial cushion defect
| acute leukemia, Alzheimer, autism, ADHD, depression, seizures
38
FOOSH with decreased grip strength, ROM, tender anatomic snuffbox
complications
scaphoid fracture
if initial imaging negative, splint wrist and reimage in a week
if nondisplaced->cast, otherwise ortho
avascular necrosis and nonunion
39
abnormal sperm analysis
intrauterine insemination/ IVF
40
v fib/VT
| PEA/ asystole
shock
| do not shock (CPR and vasopressors)
41
metastatic cancer biopsy
metastatic site first (lymph nodes)
42
Human bites org
eikenella corrodens
| *consider tetanus
43
central venous sinus thrombosis
gradually worsening headache, max in morning, increases with Valsalva
neuro symptoms 2/2 venous congestion
in spite of hemorrhage, treat with heparin
44
pericardial calcifications in CXR
constrictive pericarditis
| common complication of CABG
45
CHF or COPD exacerbation pre op
treat and delay surgery
| *stop smoking 4 weeks before
46
Refractory celiac
dietary review, endoscopy
47
shared headache, nausea, malaise, dizziness (flu-like)
diagnosis
treatment
CO poisoning
ABG with carboxyhemoglobin
high flow oxygen through nonrebreather
48
RSV bronchiolitis complication
recurrent wheezing, avoid triggers of airway reactivity
49
carotid artery stenosis <70% or 100%
| medical management
no CEA
| aspirin, statin
50
sun protection
SPF 15 for everyday use
SPF 30 for outdoor work/recreation
15-30 mins before, reapply q2hours
51
varenicline, buproprion CI
psych, seizures
52
invasive squamous cell skin cancer management
surgery, cryotherapy, electrosurgery, radiation (in older patients who refuse surgery)
53
Sydenham chorea
treatment
manifestation of acute rheumatic fever
emotional lability, irregular rapid jerking movements, facial grimacing, decreased strength, pronator drift
penicillin till adulthood, resolves
54
Grief vs MDD
Thoughts of suicide revolve around dead person not hopelessness/worthlessness
55
seborrheic dermatitis (dandruff) retreatment
weekly to prevent recurrence
56
Clozapine side effect
neutropenia, monitor ANC
57
pulm fibrosis on CXR and PPD
latent
| fibrosis not active TB
58
fetal growth restriction with reversed/absent end-diastolic flow
deliver
59
DKA glucose on insulin drip
when to stop insulin drip
how to
Glucose <200 + anion gap= halve insulin rate, add dextrose to fluids
gap<12, glucose <200, bicarb>15, patient able to eat
start subq insulin, continue drip for 1-2 hours
60
Febrile hemolytic reaction after transfusion
fever, flank pain, hematuria, DIC
stop and aggressively hydrate
ABO mismatch
61
ocular melanoma management
diagnosis
treatment
asymptomatic, <10mm by 3mm->close f/u
ultrasound
radiotherapy
62
SAAG < 1.1
cancer, TB, renal, pancreatitis, serositis
63
Pancreatitis diagnosis
2 of the ff: characteristic pain/ amylase or lipase/imaging
| labs, no imaging needed
64
necrotizing fasc organism
treatment
GAS
blisters, severely tender, fever, hypotension, shock
urgent surgical debridement and abx (vanc+ clinda (for toxins)+zosyn/meropenem)
65
positive stress test with high risk features
ST depression at low workload, ST elevation, ventricular arrhythmia-> CATH
positive stress test->aspirin, statin, beta blocker
66
Primary CNS lymphoma in HIV prognostic factor (EBV)
| treatment
CD4 count
| radiation, steroids
67
Adenomyosis treatment
progestins->hysterectomy
68
Nonfunctioning pituitary adenomas usually from
treatment
prolactin-secreting adenomas
GnRH cells, alpha subunit increased, FSH and LH decreased
transphenoidal surgery
cabergoline
nonfunctioning pit adenomas may block pit stalk and hypothalamic inhibition of prolactin secretion
69
Isoniazid + pyridoxine
to prevent neurotoxicity
| *pyrazinamide-hyperuricemia*
70
OCP CI
migraines with aura, BP > 160/100, >35yo who smoke >15 cigarettes/ day
71
Rapidly spreading erythema with well-demarcated raised borders, tender, tense
treatment
erisypelas-strep pyogenes (GAS)
penicillin
*abscess is fluctuant*
72
Skin colored small papules with indented centers
molluscum contagiosum-skin to skin contact
| HIV testing
73
Legg-Calve-Perthes
AVN of hip, deformity of femoral head
74
Neonatal clavicular fracture
supportive care
x ray only
pin arm to chest
75
Graves vs postpartum thyroiditis vs silent thyroiditis
hyperthyroidism
| high uptake vs low uptake
76
Preggo TB treatment
no pyrazinamide
77
bisphosphonate FRAX
>20% osteoporotic fracture, >3% hip
78
Flu vaccine CI
no live for anyone, just IM inactivated
mild allergy to eggs-get it
severe allergy to eggs-get it in health setting
severe allergy to vaccine itself-only CI
79
Croup
| RSV
parainfluenza, barking cough, hoarseness, stridor
| nasal congestion, rhinorrhea, apnea
80
use of herbal supplements
document
81
acute chest syndrome
treatment
new pulm infiltrate on CXR, fever, hypoxemia, chest pain, tachypnea
cephalosporin, macrolide, pain control, IV fluids
82
Antidepressant trial
```
6 weeks
if effective but intolerable->switch within class
if ineffective->switch class
```
83
Atopic dermatitis of the face
topical tacrolimus
84
Colonoscopy polyps
>2 cm/carcinoma in situ: 2-6 months
Familial polyps: annual
otherwise 3 years
85
Amiodarone thyroid
impairs T4->T3: self-resolves
thyroiditis with thyrotoxicosis: steroids
hypothyroidism: levothyroxine only
86
Psychosis
rule out substances and medical causes first
87
Delirium pharm vs physical restraints
Haldol first.
88
hyperaldosterone
hypertension, hypokalemia->polyuria
89
epistaxis
nasal pinching->topical vasoconstrictor for max of 3 days
90
pseudohypoparathyroidism
| hypocalcemia symptoms
end-organ resistance to pth
seizures, muscle cramping, calcifications, hyperreflexia, cataracts
*pth decreases phosphorus by renal excretion and increases calcium
91
gout htn
ACEI/ARB (losartan)
92
brain death reflexes
central should be gone, peripheral may be present
93
Increased risk for spontaneous abortion
prior, advanced maternal age, extreme BMIs, substance abuse
94
SIADH treatment
water restrict
95
Hip OA in young adults and adolescents
Abnormal acetabular development
| shallow hip socket with inadequate support of femoral head->accelerated wearing of cartilage
96
eosinophilia in diarrhea
treatment
parasites
pulm->GI symptoms
albendazole
97
Ecthyma gangrenosum
management
immunocompromised, pseudomonas bacteremia
rapid evolution of lesion->erythematous macule->papule->bullae->painless, gangrenous ulcer
blood, wound cultures, two medications sensitive to pseudomonas
*painful, neutrophilic->pyoderma gangrenosum
98
Secondary hypertension in children, young adults
| in older adults
renal parenchymal disease (nephrotic syndrome)
| hyperaldosteronism, renal artery stenosis
99
focal, glistening, white, mound-like lesions that extend into vitreous, painful eye, decreased visual acuity in patient on TPN
treatment
invasive candida (endophthalmitis)
systemic antifungal (amphotericin B), intra eye injection, vitrectomy
100
Post chole diarrhea
excess bile salts
bind with cholestyramine
*also seen with ileal resection/short bowel syndrome*
101
levothyroxine + OCPs
increased TBG->decreased thyroid hormone->increase dose
| *steroids and androgens cause the opposite*
