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1
Q

café au lait spots with smooth borders café au lait spots with irregular borders

A

neurofibromatosis I - freckling, check eyes Mccune-albright: fibrous dysplasia + precocious puberty neurofibromatosis II- no cafe au lait, check ears

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2
Q

Overlapping confidence intervals

A

there may not be statistically significant difference

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3
Q

NSTEMI treatment

A

Aspirin, Plavix, atorvastatin, heparin drip, metoprolol

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4
Q

Hereditary hemochromatosis

A

arthropathy (2nd and 3rd MCP joints, calcium pyrophosphate- positively birefringent rhomboids, not improved with phlebotomy) +hepatomegaly+diabetes

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5
Q

Toxic megacolon treatment

A

NGT decompression, antibiotics, steroids if IBD, not c. diff

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6
Q

TP FP FN TN

A

PPV = TP/ (TP+FP) NPV= TN/ (TN+FN) Sensitivity= TP / (TP+FN) Specificity= TN/ (TN+FP)

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7
Q

Ptosis and miosis with unilateral headache

A

Carotid artery dissection

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8
Q

Perforated ulcer Renal colic vs peritonitis

A

IV PPI, abx, fluids Writhe in pain vs motionless

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9
Q

C. diff treatment

A

Severe: WBC >15k, cr 1.5x baseline, albumin <3-vanc Severe+ileus: vanc+ IV flagyl Mild/moderate: PO flagyl

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10
Q

Continue antidepressants for 1-3 years in

A

chronic, severe, recurrent depression

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11
Q

Restless legs syndrome lab treatment

A

ferritin, supplement if <75 pramipexole/ropirinole/gabapentin

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12
Q

Oropharngeal dysphagia

A

difficulty initiating, drooling, aspiration, coughing do nasopharyngeal laryngoscopy

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13
Q

Tight glycemic control effect

A

decreases microvascular complications-nephropathy, retinopathy

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14
Q

Abdominal pain nonproportional to exam

A

mesenteric ischemia

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15
Q

C. diff treatment prevention of diarrhea

A

14 days of flagyl, 14 days of flagyl, then vanc minimize antibiotics, PPIs *prevention of MRSA-chlorhexidine bathing

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16
Q

Most common cause of hereditary thrombophilia

A

Factor V leiden

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17
Q

Onychomycosis diagnosis treatment

A

KOH prep terbinafine (hepatotoxicity), itraconazole

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18
Q

Varices treatment

A

Band ligation with surveillance and rebanding prn, Propanolol, nodalol (nonselective beta blockers)

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19
Q

NAAT

A

chlamydia and gonorrhea, first prenatal visit, repeat in 3rd trimester. complications: PPROM, preterm labor, postpartum endometritis

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20
Q

Spinal TB Health care workers post exposure

A

Pott disease If PPD initially negative, retest in 8-10 weeks

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21
Q

Chest pain and neuro symptoms in cocaine ingestion

A

Aortic dissection-CTA, MRA, TEE

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22
Q

Plantar warts

A

HPV, salicylic acid and tape/liquid nitrogen/topical imiquimod, scrape

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23
Q

Anti epileptics in pregnancy

A

Change 6 months before conception. High dose folic acid, AFP testing and u/s

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24
Q

SLE treatment

A

Prednisone, hydroxychloroquine Cyclophosphamide (if vasculitis, CNS, nephritis)

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25
Q

Absent cremasteric reflex

A

Testicular torsion *Epididymitis-increased blood flow on Doppler, pain relief with scrotal elevation*

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26
Q

FFP

A

When INR>2, vitamin k deficiency

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27
Q

Dengue fever Typhoid fever

A

Break bone fever, retroorbital pain, thrombocytopenia, petechiae—->shock rising fever, chills, abdominal pain, rose spots (salmon coloured macules)—->intestinal perf *leptospirosis-conjunctival suffusion—>jaundice and renal failure

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28
Q

Saw palmetto for treatment of Garlic St. John’s wort Glucosamine, chondroitin

A

BPH–(side effect: bleeding) HLD–bleeding Depression–GI distress, photosensitivity, fatigue OA *ephedra can cause MIs

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29
Q

Intention to treat analysis preserves

A

randomization despite dropout and crossover *Type II error-failure to reject a false hypothesis, dependent on power of study

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30
Q

Drug induced pancreatitis

A

thiazide, loop diuretics, immunosuppressive drugs, analgesics, AEDs, HIV

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31
Q

Internal validity External validity

A

Are you measuring what you think you are? Applicability

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32
Q

SSRI side effects usually

A

go away, continue

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33
Q

EHEC, ESCS Tests

A

E. coli, Shigella, Campylocater, Salmonella- bloody diarrhea. Do not treat e. coli with abx-HUS. fecal leukocytes, stool culture, shiga toxin

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34
Q

Oliguria ff hypotension Drug-induced AIN Pre-renal

A

ATN-FeNa>2%, does not respond to fluids 3-5 days after abx, eosinophils BUN/creatinine ratio >20

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35
Q

New onset afib Calculating HR on ECG

A

BB/CCB (verapamil, dilt) QRSs x6

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36
Q

Relative risk

A

Exposed/ Unexposed

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37
Q

refractory diverticulitis

A

abscess-get CT *f/u colonoscopy, elective partial colectomy*

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38
Q

Cocaine related chest pain

A

Benzos, nitroglycerin. Phentolamine. No beta blockers

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39
Q

Newborn weight

A

Lose 10% in first few days, surpass birth weight at 2 weeks

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40
Q

Temporal headaches + weight loss

A

Temporal arteritis

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41
Q

Primary biliary cholangitis Treatment Wilson’s

A

Elevated alk phos, fatigue, pruritus, xanthelasma, AMA antibodies, osteoporosis ursodeoxycholic acid neuropsychiatric, low serum ceruloplasmin

42
Q

Diabetic neuropathy management

A

TCAs, duloxetine, pregabalin

43
Q

Recurrent pneumonia in the same spot, responsive to abx

A

Endobronchial obstruction

44
Q

SLE antibodies Sjogren’s CREST (scleroderma)

A

Anti-dsDNA, Anti-Smith most specific Anti-Ro/SSA Anti-centromere

45
Q

Congenital rubella

A

Hearing loss, cataracts, PDA, maculopapular rash (head to feet) supportive care

46
Q

GBS prophylaxis (penicillin) if status unknown

A

ROM >18 hours/ febrile/ preterm

47
Q

Folate deficiency drugs

A

Methotrexate, phenytoin, trimethoprim -block conversion of folic acid to folinic acid Give folinic acid (leucovorin)

48
Q

Compression fracture management

A

surgery

49
Q

Steroid ulcer ppx

A

Misoprostol can be used

50
Q

Hypercalcemia 2/2 granulomatous disorder (sarcoid, TB) Drug induced hypercalcemia

A

Production of extrarenal Vitamin D Thiazides, lithium tx: bisphosphonates

51
Q

MODY

A

hyperglycemia without ketones, family history

52
Q

Testing multiple endpoints

A

increases type 1 error

53
Q

Vibrio treatment

A

marine environments in liver, diabetic, chronic medical conditions, rapidly progresses to hemorrhagic bullae cellulitis IV ceftriaxone and doxy

54
Q

Psychogenic vs metabolic(true) coma

A

Presence of caloric response (cold water in ear)

55
Q

Cirrhosis+varices abc prophylaxis

A

Fluoroquinolone for 7-10 days

56
Q

Cardiovascular disease risk equivalents

A

DM, CKD, atherosclerosis

57
Q

Hyperthyroidism in pregnancy Treatment

A

Measure total T4, not free T4 Subclinical hyperthyroidism is normal if symptomatic (clinical)-PTU in first trimester, then methimazole

58
Q

Splenic vein thrombosis 2/2 results in treatment

A

Pancreatitis/ pancreatic cancer gastric varices, left sided portal htn, splenomegaly splenectomy

59
Q

Sjogren syndrome

A

Sicca (dry eyes), dry mouth (white patches-oral candida)

60
Q

TPN refeeding syndrome

A

Monitor phosphorus

61
Q

Posterior urethral valve

A

Bilateral hydronephrosis + dilated, thickened, palpable bladder+ oligohydramnios——> Potter sequence (pulmonary hypoplasia, flattened facies) Dx: voiding cystourethrogram Tx: foley then ablation

62
Q

Gout diagnosis Treatment

A

arthrocentesis- negatively birefringent, needle-shaped, monosodium urate NSAIDs (not if CHF, PUD, anticoagulation, AKI/CKD), colchicine *no allopurinol in acute gout*

63
Q

DMARDs for RA

A

erosions mtx, hydroxychloroquine, sulfasalazine, leflunomide, azathioprine

64
Q

Net clinical benefit

A

Benefit -harm *CI which includes 1 is not statistically significant*

65
Q

Acute hep B treatment % progression to chronic hep B

A

Close outpatient follow up if not in functional liver failure, clearance w/in 6 months children-90%, adults-<5%

66
Q

CBT-exposure response therapy for CBT-dialectic behavior therapy for

A

OCD borderline

67
Q

AVN treatment Diagnosis

A

Stage 1-2 (no femoral collapse)-core decompression Stage 4-THA MRI

68
Q

Rheumatoid arthritis

A

clinical diagnosis, RF/anti-CCP (more specific) help NSAIDs, not steroids *lupus-more migratory, shorter morning stiffness*

69
Q

Chronic Hep B diagnosis post exposure treatment

A

Hep B surface antigen IG + vaccine

70
Q

Extrapyramidal symptoms causes treatment

A

Dystonia (muscle stiffness), akathisia, parkinsonism metoclopramide Benadryl/benztropine

71
Q

Diabetic ulcer osteo

A

bone biopsy and culture if bone probe is negative, get MRI

72
Q

Acute otitis media orgs AOM+Purulent conjunctivitis AOM+nonpurulent conjunctivitis Treatment

A

Strep pneumo/Nontypeable H. influenzae/ M. catarrh H. influenzae Adenovirus amoxicillin, amoxicillin-clavulanate if recurs

73
Q

Acute painless vision loss

A

central retinal artery occlusion: pale with cherry red spot, cnt make distinctions like fingers, tx: ocular massage, acetazolamide, call ophtho central retinal vein occlusion: retinal hemorrhage and edema vitreous hemorrhage: dark streaks, elevated head *angle closure glaucoma-painful*

74
Q

Discrete, circular, smooth hair loss Progressive frontal, temporal hair loss Moth-eaten, scarring hair loss

A

Alopecia areata-regrows but can also relapse, thought to be autoimmune-give intralesional/topical steroids Androgenetic alopecia Syphilis

75
Q

upper esophageal lesion lower esophageal lesion

A

alcohol, smoking-squamous cell GERD/Barrett’s-adenocarcinoma

76
Q

Ethylene glycol toxicity

A

Fomepizole-inhibits ADH *do not give with ethanol

77
Q

foley candida

A

do not treat

78
Q

FFP

A

When INR>2, vitamin k deficiency

79
Q

ADHD diagnosis treatment

A

impairment in 2 settings behavioral therapy, if >6-can consider meds (obtain cardiac history and exam, weight and vital signs before) *can immediately switch to another without tapering*

80
Q

Reactive arthritis

A

Post GI/GU infection, circinate balanitis, salmonella, chlamydia, synovial fluid-WBCs, culture negative Retest for chlamydia *Syphilis/LNV-lymphadenopathy*

81
Q

Anti-D immune globulin administration

A

at 28 weeks in Rh D negative with negative anti-D antibody screen, repeat after delivery if baby is +

82
Q

Seborrheic keratosis herald patch café au lait macules

A

stuck on pityriasis rosea neurofibromatosis

83
Q

ADLs Homebound

A

nonskilled care, PT/OT/meds-skilled care use of assist devices/cnt leave without someone/medical condition

84
Q

NSAIDs

A

ibuprofen, naproxen, indomethacin

85
Q

Adverse events in medical patients

A

drugs, infections

86
Q

Multiple linear regression Correlation 1 way analysis of variance, 2 sample t test multiple logistic regression

A

1 quantitative, 1 qualitative, other variables 2 quantitatives only >2 group means, 2 group means

87
Q

Abdominal pain nonproportional to exam

A

mesenteric ischemia

88
Q

Cauda equine/cord compression 2/2 trauma/malignancy Spinal epidural abscess treatment

A

steroids surgical decompression and drainage

89
Q

Aspiration pneumonia Aspiration pneumonitis

A

clinda resp distress hours after aspiration event-no abx-supportive care

90
Q

Ankylosing spondylitis diagnosis Monitoring Extraarticular manifestations

A

Back pain/stiffness >3 mos+ limited ROM of spine+ limited chest expansion, x ray x rays, ESR uveitis (acute pain, photophobia, blurry vision), AR, apical pulm fibrosis, IgA nephropathy, restrictive lung disease Exercise is good, most do well, same life expectancy, no disability

91
Q

Graves treatment eyes meds side effects

A

methimazole preferred (PTU causes hepatotoxicity)-total t3 and free t4 4-6 weeks, then 2-3 months-normalize thyroid state before definitive tx give prednisone agranulocytosis

92
Q

Lung cancer screening

A

55 years old, annual low dose CT *AAA-65 yo*

93
Q

vertebrobasilar insufficiency cataplexy

A

labyrinth and brainstem-vertigo, dizziness, dysarthria, diplopia, numbness sudden, temporary loss of muscle

94
Q

Reactive arthritis

A

post GI/GU infection

95
Q

Traveler’s diarrhea

A

most commonly E.coli *rotavirus/norovirus-vomiting *giardia-fatty stools/ salmonella-fevers/campylobacter-pseudoappendicitis, bloody *sporidia-chronic in immunosuppressed/ cyclospora-prolonged, relapsing

96
Q

Cough variant asthma

A

Coughing upon exercise, at night, forced expiration

97
Q

Only give lasix

A

if volume overloaded

98
Q

Inability to extend knee or raise leg

A

patellar tendon rupture-surgery

99
Q

Glutamic acid decarboxylase antibody

A

pancreatic autoantibody

100
Q

Febrile seizures increase risk of

A

recurrence and epilepsy

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