8 Flashcards

1
Q

low back pain w/ alarm symptoms (worsening at night, >50 yo, fever, trauma, radiculopathy)
cord compression

A

back x rays, inflammatory markers

MRI

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2
Q

obese diabetic med

A

metformin

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3
Q

enuresis alarm vs desmopressin therapy

A

when behavioral interventions fail

alarm has better long term success, desmopressin is short term solution has high rate of relapse

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4
Q

type I
type II

treatment of type II

A

progressive elongation of PR, then drop->benign
regular PR, intermittent nonconducted Ps->progression to complete AV block->pacemaker
IV atropine if unstable (hypotension, confusion, chest pain)
long term->pacemaker

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5
Q

Nursemaid’s elbow imaging

treatment

A

unnecessary

hyperpronation/ supination

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6
Q

persistent and localized LAD

A

biopsy (lymphoma)

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7
Q

disagreement about futile care

A

ethics committee

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8
Q

optimal kidney donor

A

living, related, identical blood type

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9
Q

Rotator cuff tendonitis

A

lateral shoulder/deltoid pain, aggravated by abduction and external rotation

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10
Q

Amiodarone chronic interstitial pneumonitis

treatment

A

nonproductive cough, chest pain, weight loss, DOE, interstitial opacities on CXR

stop amiodarone, steroids if severe

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11
Q

amaurosis fugax

A

sudden, transient monocular blindness

marker of advanced CAD, carotid bruit

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12
Q

Polymyalgia rheumatica associated with

muscle weakness without pain

A

giant cell arteritis

polymyositis

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13
Q

Hemophilia A genetics

A

X linked recessive

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14
Q

Rash post ampicillin/amoxicillin in mono

A

discontinue and observe

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15
Q

preggo tdap

A

26-36 weeks of gestation

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16
Q

Unilat, spontaneous nipple d/c

A

imaging (mammogram + u/s in >30 yo)

papilloma

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17
Q

splenic vein thrombosis causes — bleeding

A

variceal

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18
Q

in dyspepsia, only test for h. pylori if

h. pylori diagnosis
NSAID induced

A

no history of nsaid/cox 2 or persistent symptoms after PPI

breath/stool antigen (not serum)
give PPI

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19
Q

HIV associated thrombocytopenia
active bleeding
if refractory

A

give ART
steroids or IVIG
splenectomy

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20
Q

In treatment naïve HIV, ART should decrease VL to

A

<50 in 6 months
<500 in 8-16 weeks
<5000 in 4 weeks

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21
Q

TB meningitis

diagnosis

A
choroidal tubercles (yellow-white nodules near optic disc)
basilar meningeal enchancement
CSF: prot >250, gluc <10, lymphocytic pleocytosis, adenosine deaminase 

serial LPs->acid fast bacilli smear and culture

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22
Q

TB meningitis treatment

A

RIPE + fluoroquinolone/aminoglycoside for 2 months, then 9-12 months of rifampin and isoniazid
adjuvant steroids

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23
Q

Vulvodynia treatment

A

pelvic physiotherapy, CBT->botox

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24
Q

preterm labor at 34-36 weeks

A

penicillin (if positive or unknown GBS) and steroids

  • tocolytics before 34 weeks*
  • Rh doesn’t have to happen during labor*
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25
Q

Infant botulism

diagnosis
treatment

A

neurotoxin that inhibits presynaptic ach release
constipation, oculobulbar weakness, desc flaccid paralysis, hyporeflexia
stool studies
IV botulism immune globulin

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26
Q

pain out of proportion to fracture/muscular injury
physical exam
fasciotomy

A

compartment syndrome
tightness, weakness, pain on passive movement
pressure > 20-30

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27
Q

investigate outbreak of infectious disease

prevalence

A

case-control study

cross sectional study

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28
Q

Occupational back pain, likelihood of returning to work

A

recovery expectation

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29
Q

lung cancer screening with low dose CT false positive rate

A

96%

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30
Q

Menopausal transition bleeding

diagnosis

A

> 45 yo->endometrial biopsy

clinical, no labs needed

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31
Q

EEG in AMS

A

nystagmus, hippus, automatism

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32
Q

Hep B serum sickness

treatment

A

immune complexes activate complement
fever, polyarthritis, dermatitis, fatigue, malaise
polyarteritis nodosa, glomerulonephritis
supportive care, steroids/plasmapheresis if severe

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33
Q

syncope without prodrome, structural heart disease

A

cardiogenic, work up, tele and echo

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34
Q

Pulm sarcoid treatment

A

1-2 years of steroids if symptomatic, usually resolves

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35
Q

schizotypal vs schizoid

A

odd vs robot

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36
Q

scrapable white lesion in mouth
ok in antibiotics, chemo, inhaled steroids
otherwise,

A

candida

test for HIV

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37
Q

scrapable white lesion in mouth
ok in antibiotics, chemo, inhaled steroids
otherwise,

A

candida

test for HIV

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38
Q

metoclopramide side effects

A

akathisia, dystonia, Parkinson-like

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39
Q

breastmilk jaundice management

A

spontaneous resolution by 3 months
f/u and check bilirubin
phototherapy only if bilirubin rises
conjugated hyperbilirubinemia is always pathologic

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40
Q

Monotherapy hypoglycemic that causes significant hypoglycemia

A

sulfonylurea, meglitinide

41
Q

bilirubin>20 or ineffective phototherapy

A

plasma exchange

42
Q

onychomycosis/ severe tinea pedis

A

oral terbinafine

43
Q

Hyperkalemia EKG

treatment

A

peaked Ps, prolonged PR, QRS, no P waves

calcium

44
Q

cervical change during active labor
if less
no cervical change for >4 hrs with adequate contractions/ >6 hours without
variable decelerations

A

1 cm/ 2 hr
oxytocin, amniotomy
c/section

umbilical cord compression->amnioinfusion

45
Q

silicone breast implants morbidity

A

contracture, deflation, rupture

46
Q

investigate ischemic cardiomyopathy with

A

stress test or cath

47
Q

good prognosis in schizophrenia

A

sudden onset, later age, positive psych symptoms

48
Q

nonmetastatic squamous cell carcinoma of one vocal cord

A

radiation, laser or partial vocal cordectomy

49
Q

Cough 5 days-3 weeks

> 3 months in 2 consecutive years

A

acute bronchitis
viral->symptomatic treatment

chronic bronchitis->PFTs

50
Q

porcelain gallbladder

A

increased risk of cancer, prophylactic chole if punctuate calcifications (not curvilinear) or biliary colic

51
Q

white spots, discoloration on teeth

A

decay

prevent with fluoride

52
Q

white spots, discoloration on teeth

A

decay

prevent with fluoride

53
Q

No fruit juice when kids have viral gastro

A

hypotonic fluids (not water)

54
Q

Pulmonary cachexia syndrome

A

loss of lean muscle mass due to energy imbalance and inflammation

55
Q

PCOS patient seeking pregnancy first line treatment

A

weight loss ->ovulation induction->IVF

IVF first line if there’s tubal obstruction

56
Q

Acute paronychia
treatment

Chronic paronychia with loss of cuticle

A

localized infection of nail fold
warm soaks, antiseptics, topical antibiotics
if abscess->drain

steroids

57
Q

penicillamine

lead toxicity

A

copper chelator

<45: nothing, 45-69: succimer, DMSA >70: EDTA, dimercaprol

58
Q

chronic psychotic symptoms w/o mania/ depression (stable mood)

A

not bipolar, schizoaffective

in bipolar/depression, psychosis always comes with mood changes.

59
Q

Ischemic stroke prevention

A

blood pressure control, smoking cessation, control of blood sugar and lipids

60
Q

Nonsuicidal self-injury (cutting)

A

assessment of suicidality and comprehensive psych eval

61
Q

Nonsuicidal self-injury (cutting)

Bulimia nervosa treatment

A

assessment of suicidality and comprehensive psych eval

fluoxetine

62
Q

polycythemia initial test

A

EPO

low: polycythemia vera
high: secondary cause such as hypoxia (rule out carbon monoxide poisoning with carboxyhemoglobin) or RCC

63
Q

polyhydramnios

causes

A

AFI > 24cm

maternal DM, multiple gestation, congenital abnormalities

64
Q

Drug induced lupus drugs

diagnosis
presentation

A

hydralazine, procainamide, minocycline, etanercept, infliximab
ANA, anti-histone antibodies
fatigue, night sweats, serositis, arthralgia, fever, organomegaly

65
Q

phencyclidine

A

PCP

66
Q

Snoring management

A

smoking and alcohol cessation, weight loss

67
Q

Organophosphate poisoning treatment

A

atropine and pralidoxime

68
Q

sac overlying lumbar spine
associated with
diagnosis

A

myelomeningocele
neurogenic bladder, bowel
elevated AFP, u/s

69
Q

Chronic urticarial
diagnosis
treatment
prognosis

A

itchy wheals/rash comes and goes spontaneously
clinical
daily cetirizine->oral steroids
spontaneous resolution in 2-5 years

70
Q

studying difference in mean values among several groups

2 paired proportions, patients as controls

A

analysis of variance

mcnemar test

71
Q

hidradenitis suppurativa

treatment

A

intertriginous areas (axilla, groin, medial thigh, perineum)

weight loss, smoking cessation, cleaning
topical abx->oral abx (sinus tracts, scarring)->TNF alpha inhibitors and surgery

72
Q

cherry angioma vs strawberry hemangioma

A

adult, increase with age, no treatment vs infant, regress with age, no treatment

73
Q

rectocele

treatment

A

protrusion of posterior vaginal wall
constipation, pelvic pressure, lower back pain, fecal incontinence

pessary, surgery

74
Q

refractory hypoglycemia

treatment

A

sulfonylurea poisoning
dextrose, octreotide
dextrose can cause transient hyperglycemia->insulin release->rebound hypoglycemia

75
Q

IgA nephropathy vs post strep glomerulonephritis

A

gross hematuria (benign) vs >10 days post infection, no hematuria, decreased complement levels

76
Q

epiglottitis
intubate if
lateral neck x ray

A

Hib,
stridor, drooling, dysphonia
thumbprint sign
racemic epi for croup (barking cough)

77
Q

inability to find significance

A

Type II error

78
Q

sudden cardiac death in young athlete with normal ECG and echo

diagnosis
brugada and long QT

A

anomalous aortic origin of coronary artery
angina/lightheadedness/syncope

coronary CTA/ MRA
not exertional

79
Q

rapid, shallow breathing with normal VS post MVA

treatment

A

flail chest

oxygen, pain control, positive pressure ventilation, surgery

80
Q

heat stroke

treatment

A

flushed, hot dry skin

evapourative cooling

81
Q

catatonia
treatment
treatment of anti-psychotic induced dystonia, parkinsonism

A

stuck
benzo
benztropine

82
Q

Likelihood ratio

negative likelihood ratio

A

probability of patient with disease to have finding/ probability of patient without disease to have finding

sensitivity/ 1- specificity
1-sensitivity/ specificity

83
Q

Preop eval METS

A

Even if symptomatic during performance, ability to complete is what matters?

84
Q

Features of benign pulm nodules

malignancy

A

popcorn calcification, concentric/central/diffuse/laminated homogenous calcification

eccentric, reticular, punctuate

85
Q

tibial stress fracture
x ray
management

A

pain, localized tenderness, swelling
normal
pneumatic splinting, reduced weightbearing, graduated exercise

86
Q

Negative symptoms in schizo

A

usually don’t respond to antipsychotics

refer for social skills training

87
Q

stool cysts, flagellated trophozoites with 2 nuclei, persistent diarrhea after camping
prevention of outbreak

treatment

A

giardia

treat symptomatic people (don’t just treat stool), stay away from recreational water
flagyl

88
Q

Pseudotumor cerebri not just obesity, but also

A

endocrine disorders, minocycline, isotretinoin

89
Q

Salmonella in anyone more than a year old

A

supportive care

90
Q

complex adnexal mass, positive B HCG, no evidence of intrauterine pregnancy

A

ectopic pregnancy

91
Q

early pregnancy of undetermined location

A

bcg <1500, not visualized

92
Q

chronic steroid therapy, add vitamins

A

D and calcium

annual DEXA

93
Q

lactational mastitis treatment

breast abscess

A

oral dicloxacillin/ cephalexin

fine needle aspiration

94
Q

tertiary hyperparathyroidism

parathyroidectomy when

A

CKD->elevated phosphorus->binds calcium->low free calcium->elevated pth->gets out of control->remains elevated

persistent hypercal/phos, very high PTH, soft tissue calcification/calciphylaxis, intractable bone pain

95
Q

Parkinson psychosis

A

can be caused by medications
carbidopa/levodopa should be last to be reduced
if refractory, start quetiapine, clozapine, pimavanserin

96
Q

NPH vs long-acting basal

A

hypoglycemia

97
Q

pear shaped motile organisms

A

trichomonasiasis

98
Q

postpartum endometritis treatment
most important risk factor
PID

A

clindamycin+ gentamicin
c/s, chorioamnionitis, preterm, protracted labor, PROM
ceftriaxone + azithromycin

99
Q

Analgesic nephropathy

A

papillary necrosis->hematuria, pyuria, renal colic, proteinuria, sterile urine