Step studying 6 Flashcards

1
Q

Order of pubertal events

A
(Think: Tits, pits, mits, and lips) 
♣	Thelarche (Breasts) (8)
♣	Pubarche (Axillary and pubic hair) (9)
♣	Growth (10) 
♣	Menarche (11)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the older version of conduct disorder

A

Antisocial personality disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Is conjugated bilirubin considered direct or indirect

A

Direct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What disease presents with sharp triphasic waves on EEG

A

Creutzfeldt Jakob (spongiform encephalopathy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Diagnosis of aortic dissection

A

♣ Transesophageal echo (TEE) – preferred method in patients with renal insufficiency of hemodynamic instability
♣ CT angiography with contrast – preferred in hemodynamically stable patients; requires contrast so avoid in renal insufficiency
♣ MR angiography – time consuming; avoid in patients with kidney disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Most common cause of liver mets

A

Colorectal cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Indications for statin therapy

A

♣ Clinically significant ASCVD (ACS, stable angina, arterial revascularization (e.g. CABG), stroke, TIA, PAD)
♣ LDL >/= 190
♣ Age 40-75 with DM and LDL of 70-189
♣ Age 40-75 w/o DM with estimated 10-year ASCVD risk >/= 7.5%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the pathogenesis of tardive dykinesia in patients on antipsychotics

A

Dopamine D2 receptor upregulation and supersensitivity resulting from chronic blockade of dopamine receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Tx of chest pain in acute cocaine toxicity

A
  • Benzos for BP and anxiety – reduction of sympathetic outflow, thus improving BP and HR
  • Aspirin – reduces thrombus formation
  • Nitroglycerin and CCB for pain – vasodilation
  • Beta blockers contraindicated
  • Immediate cardiac catheterization with reperfusion when indicated
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Time frame of major depressive disorder

A

> 2 weeks (5/9 of SIGECAPS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Definition of bipolar II

A

♣ Hypomanic episode + major depressive episode

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Definition of dysthymia

A

♣ May have major or minor depressive symptoms
• Lasting > 2 years
• Can’t go more than 2 months without symptoms within the 2 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Time frame of grief to distinguish it from MDD

A

12 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Time frame of postpartum blues

A

<2 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the duration of sx on the schizophrenia spectrum

A

♣ Brief psychotic disorder > 1 day and < 1 month
♣ Schizophreniform disorder > 1 month and < 6 months
♣ Schizophrenia > 6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is schizoaffective disorder

A

♣ Mood episodes and active symptoms of schizophrenia occurring at the same time + at least 2 week lifetime history of delusions or hallucinations in the absence of prominent mood symptoms
♣ Aka normal schizo sometimes and schizo + mood at other times

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Tx of tardive dyskinesia

A

Antimuscarinics (Benztropine or Trihexaphenydyl)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Tx of neuroleptic malignant syndrome

A

Dantrolene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

First line medication for anorexia nervosa

A

Antipsychotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

First line medication for bulimia

A

SSRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the time cut-off between acute stress disorder and PTSD

A

o ASD lasts > 3 days and < 1 month

o PTSD lasts > 1 month

22
Q

Greatest risk involved in parenteral nutrition

A

Bloodstream infection

The risk of cholecystitis (secondary to cholestasis) increases if pt has been on TPN >2 weeks

23
Q

Definition of FHR acceleration

A

An increase in 15 BPM above baseline for 15 second duration

24
Q

Definition of FHR moderate variability

A

6-25 bpm

25
Q

What will you see in CSF in bacterial meningitis

  • Cells
  • Protein
  • Glucose
  • Other
A
Cells = neutrophils
Protein = high
Glucose = low
Other = + culture/gram stain
26
Q

What will you see in CSF in viral meningitis

  • Cells
  • Protein
  • Glucose
  • Other
A
Cells = lymphocytes
Protein = high
Glucose = normal
Other = + viral PCR
27
Q

What will you see in CSF in TB meningitis

  • Cells
  • Protein
  • Glucose
  • Other
A
Cells = lymphocytes
Protein = high
Glucose = very low
Other = acid fast bacilli
28
Q

What will you see in CSF in Guillain Barre

  • Cells
  • Protein
  • Glucose
  • Other
A
Cells = none (normal leukocyte count)
Protein = high
Glucose = normal
29
Q

What FEV1/FVC ratio indicates obstructive lung disease and restrictive lung disease

A
Obstruction = <80%
Restriction = >80% (FEV1 and FVC will both be decreased but FVC is more decreased)
30
Q

What are considered adequate uterine contractions

A

Q2-3 min

31
Q

When is amniotomy indicated

A

For labor induction only if fetus is well applied to the cervix to prevent umbilical cord prolapse (e.g. not indicated if fetus is at -4 station)

32
Q

What is Light criteria for pleural effusion

A

Exudative = 1/3 criteria

  • Pleural fluid protein/serum protein ration >0.5
  • Plerual fluid LDH/serum LDH ration >0.6
  • Pleural fluid LDH >2/3 upper limit of normal serum LDH
33
Q

What can you use to determine cause of ascites

A

Serum ascites albumin gradient (SAAG)

> 1.1 = occurs when there is not a lot of stuff in ascites e.g. caused by hydrostatic pressure pushing fluid out

<1.1 = lots of stuff in ascites e.g. caused by oncotic pressure pulling fluid in to belly

34
Q

What SAAG will you see in cirrhosis

A

SAAG >1.1

35
Q

Treatment of hemodynamically stabe V-tach

A

Anti-arrythmics

  • Lidocaine
  • Procainamide
  • Amiodarone
36
Q

What is Adenosine used for

A

Supraventricular arrhythmias

37
Q

Describe how chronic kidney disease affects calcium, phosphate, and PTH

A

Kidney is not able to form active form of Vitamin D = decreased absorption of calcium (hypocalcemia) and decreased secretion of phosphate (hyperphosphatemia) = PTH increases to try to get more calcium (parathyroid hyperplasia) = PTH stimulates bone resorption (renal osteodystrophy)

38
Q

Tx of overflow incontinence

A

Cholinergic agonists (opposite of oxybutynin) = Want to increase bladder contractility

39
Q

What is used for spontaneous bacterial peritonitis prophylaxis

A

Fluoroquinolones

40
Q

Most common cause of pneumonia in sickle cell patients

A

Step pneumo (pt’s are at higher risk to encapsulated organisms secondary to asplenia)

41
Q

What are the 4 major side effects of antipsychotic

A
  • Dystonia
  • Akithisia
  • Parkinsonism
  • Tardive dyskinesia
42
Q

Tx of extrapyramidal side effects

A

Antimuscarinics (Benztropine or Diphenyhydramine)

43
Q

First step in tx of infertility in PCOS

A

Weight loss

44
Q

What structure might be damaged in fracture to radial shaft

A

Radial nerve

45
Q

What structure might be damaged in anterior shoulder dislocation

A

Axillary nerve

46
Q

What does elevated lactate dehydrogenase indicate

A

Hemolysis

47
Q

What drugs are used for rate control in A-fib

A
Beta blockers (Metoprolol)
Non-dihydropyridine CCB (Verapamil, Diltiazem)
48
Q

Diagnose: anemia, renal insufficiency, hypercalcemia, fatigue, and weight loss

A

Multiple myeloma

49
Q

Tx of agitation in the elderly

A

Haloperidol

50
Q

What will you see in a pt with Lennox-Gestaut syndrome

A

Multiple types of seizures (beginning at age <7) + mental retardation