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Flashcards in ACP Questions Deck (697):
1

First two tests to evaluate secondary amenorrhea after excluding pregnancy

FSH and Prolactin

2

Precise time of day for testosterone measurement in evaluation of hypogonadism

At 8:00 AM

3

Specific diagnostic antibody associated with Graves disease

Thyroid stimulating hormone receptor antibody

4

All normotensive patients with adrenal incidentaloma are screened for these 2 endocrine disorders

Pheochromocytoma and Cushing syndrome

5

Autosomal dominant disorder causing benign hematuria

Thin basement membrane disease

6

HYVET study systolic blood pressure target associated with reduced mortality

≤ 150 mm Hg

7

Surgical procedure associated with oxalate nephropathy

Gastric bypass surgery (accept bowel resection)

8

Preferred statin for patients on dialysis for end-stage kidney disease

None

9

Most common disease cause of proximal RTA (Fanconi's syndrome) in adults

Monoclonal gammopathy (accept multiple myeloma, amyloidosis, light chain disease)

10

Classical presentation is painless localized cervical lymphadenopathy

Hodgkin disease (accept Hodgkin lymphoma)

11

Preferred drug class for postmenopausal women with HR-positive early stage breast cancer

Aromatase inhibitor

12

A monoclonal antibody to RANKL for the management of bone metastases from solid tumors

Denosumab

13

Most common kidney complication of endothelial growth factor inhibitors

Proteinuria (accept hypertension)

14

Positive staining for S100 protein, HMB-45 antigen, and vimentin supports this diagnosis

Amelanotic melanoma (accept melanoma)

15

Positive staining for S100 protein, HMB-45 antigen, and vimentin supports this diagnosis

Amelanotic melanoma (accept melanoma)

16

Indication for infective endocarditis prophylaxis following cardiac transplantation

Valvulopathy

17

The two most important human ehrlichial diseases

Human monocytic ehrlichiosis and human granulocytic anaplasmosis

18

Cause of an acute febrile reaction, headache and myalgia within the first 24 hours of erythema migrans treatment

Jarisch-Herxheimer reaction

19

Interval following Td vaccination appropriate for Tdap vaccination

At any time.

20

L. monocytogenes meningitis treatment in penicillin allergic patient

Trimethoprim-sulfamethoxazole

21

Most common presenting severe symptom of diabetic amyotrophy

Pain

22

Most effective drug treatment for trigeminal neuralgia

Carbamazepine

23

Name of syndrome describing delayed neurologic sequelae following carbon monoxide poisoning.

Delayed neuropsychiatric syndrome

24

Tremor that occurs exclusively with writing

Primary writing tremor

25

Ice-pack test is associated with this autoimmune neuromuscular disorder

Myasthenia gravis

26

Specific quantitative criterion represented by R in the CURB-65 score

Respiratory rate >30/min

27

High resolution CT shows diffuse, homogeneous, < 1cm diameter thin-walled cysts

Lymphangioleiomyomatosis (accept LAM)

28

Pulmonary artery wedge pressure required for a diagnosis of pulmonary arterial hypertension

≥ 15 mm Hg (accept < 15 mm Hg)

29

TB test for lymphocytic pleural fluid when initial smear and culture TB are negative

Adenosine deaminase

30

Warming strategy that combines warm blankets, heating pads, radiant heat, warm baths, or forced warm air

Active external rewarming (AER)

31

Two most common structural cardiac diseases associated with syncope

Aortic stenosis and hypertrophic cardiomyopathy

32

Statin therapy decreases risk of this post-CABG arrhythmia

Atrial fibrillation

33

Term for chronic but potentially reversible ischemic myocardial dysfunction

Hibernating myocardium

34

Condition associated with rising venous pressure, falling arterial pressure, and decreased heart sounds

Pericardial tamponade

35

Cardiac condition associated with Carney complex

Atrial Myxoma

36

Acronym for law that protects the privacy of individually identifiable health information

HIPPA

37

Name for federal regulations providing research subject protections

Common Rule

38

Medical ethics principle that obliges the physician to act in the patient's best interests

Beneficence

39

Name for decision making for a patient whose preferences are not known that is based on the best evidence of what the patient would have wanted

Substituted judgment

40

Statement of medical professionalism by ABIM Foundation, ACP Foundation and European Federation of Internal Medicine

Physician Charter

41

Most common diagnosis accounting for elbow swelling

Olecranon bursitis

42

The SLE skin diagnosis responsible for the "butterfly rash" (malar rash)

Acute cutaneous lupus erythematosus

43

A noninflammatory disease associated with calcification and ossification of spinal ligaments and of peripheral entheses

Diffuse idiopathic skeletal hyperostosis (DISH)

44

Syndrome of entrapment of the median nerve in the proximal forearm where it passes through the pronator teres muscle

Pronator teres syndrome

45

ENT complication shared by primary atrophic rhinosinusitis, relapsing polychondritis, and granulomatosis with polyangiitis

Saddle nose deformity

46

Consequence of complete lack of testosterone during first trimester on male embryo

Development of female external genitalia

47

Antibody predicts poor response to oral hypoglycemic drug therapy

Anti-GAD (glutamic acid decarboxylase) antibody (also accept islet cell antibody [ICA])

48

Next diagnostic step for thyroid nodule associated with low TSH

Thyroid scintigraphy (accept iodine or technetium scan or nuclear scan)

49

Enhanced susceptibility to statin-associated myopathy occurs in patients with this endocrine disorder

Hypothyroidism

50

Chemical form of testosterone replacement therapy associated with liver complications

Alkylated androgens (do not accept oral therapy)

51

Diagnosis suggested by aquagenic pruritus and elevated hematocrit

Polycythemia vera

52

Condition associated with "Waring blender syndrome" causing fragmentation hemolytic anemia

Malfunctioning mechanical prosthetic valve (accept prosthetic valve, paravalvular leak)

53

Hydroxyurea therapy in sickle cell disease increases this hemoglobin type

Hemoglobin F

54

Thalassemia diagnosis associated with 90% hemoglobin A and elevations of A2 and F

Beta thalassemia minor

55

Preferred treatment for RBC transfusion-dependent deletion 5q syndrome

Lenalidomide

56

Non-dietary lifestyle modification to slow the progression of chronic kidney disease

Smoking cessation

57

Which renal tubular disorder is associated with impaired ammoniagenesis

Type 4 renal tubular acidosis (accept hyporeninemic hypoaldosteronism)

58

GI procedure most commonly associated with acute phosphate nephropathy

Colonoscopy (accept sodium phosphate bowel prep for colonoscopy)

59

Most common pattern of glomerular injury associated with hepatitis C infection

Membranoproliferative (with or without cryoglobulinemia)

60

A circulating peptide secreted by osteocytes and osteoblasts that causes renal phosphate wasting

Fibroblast growth factor 23 (accept FGF23)

61

Most common indication for treating asymptomatic bacteruria in women

Pregnancy

62

Varicella vaccine can be given to patients with HIV infection and this CD4 count

>200

63

IDSA definition of the cfu threshold in a voided urine specimen defining asymptomatic bacteruria in women

≥105 cfu/mL

64

Antibiotic always included in a multiple antibiotic regimen for anthrax meningitis

Ciprofloxacin

65

IDSA recommended combination antibiotic therapy for severe Babesia microti infection

Oral quinine plus IV clindamycin (drug without routes acceptable)

66

Severe constipation type diagnosed by delayed passage of radiopaque markers through the proximal colon

Colonic inertia (also accept slow transit constipation)

67

Acute onset of lateral abdominal pain in older patient, followed by diarrhea, bleeding, and this sigmoidoscopy finding

Ischemic colitis

68

Most consistently effective biological therapy for recurrent and antibiotic refractory C. difficile infection

Fecal microbiota transplantation (accept fecal transplantation)

69

To reduce false-negative urea breath test results, the patient should be off antibiotics for this length of time

4 weeks

70

Two conditions associated with the highest serum gastrin level measurements

Atrophic gastritis (accept autoimmune gastritis) and Zollinger-Ellison syndrome (accept gastrinoma)

71

Diagnosis for this benign fluid filled cavity with mucous glands lining the epithelium [of inner lip]

Mucocele

72

Diagnosis for this condition also known as "picker's nodules"

Prurigo nodularis

73

Benign, noninfectious condition located on the sulcus or corona of the glans penis

Pearly penile papules

74

Diagnosis for these painful, chronic and recurrent sterile abscesses [picture of large abscess in Arm pit]

Hidradenitis suppurativa

75

Diagnosis for this condition that is associated with a bacterial infection causing malodorous feet

Keratolysis

76

Meaning of TIMI acronym

Thrombolysis in Myocardial Infarction

77

Valvular heart lesion associated with nail bed pulsations

Chronic aortic regurgitation (accept aortic regurgitation)

78

Postmenopausal women account for most cases of this syndrome of transient regional LV dysfunction

Stressed-induced (takotsubo) cardiomyopathy

79

USPSTF grade assigned to screening for abdominal aortic aneurysm in women

Grade D

80

Most likely congenital heart disease diagnosis for this asymptomatic adult [EKG picture]

Dextrocardia

81

Describes the illusion of either personal or environmental movement

Vertigo

82

First-line oral drug for symptomatic treatment of myasthenia gravis

Pyridostigmine

83

Age exclusion for stroke-related thrombolytic therapy between 3 and 4.5 hours post stroke

Age >80 years

84

Likely diagnosis for neck pain, partial Horner syndrome, and TIA or stroke

Carotid artery dissection

85

Effective injectable therapy for prevention of chronic migraine headache

Botulinum toxin (accept OnabotulinumtoxinA, Botox)

86

Most common joint condition associated with anserine bursitis

Osteoarthritis

87

Disease most commonly associated with "capillary dropout" on nailfold capillary microscopy

Systemic sclerosis (accept scleroderma)

88

A bacterial organism known to trigger reactive arthritis

Chlamydia , Yersinia, Salmonella, Shigella, Campylobacter, Clostridium difficile (any one)

89

Diagnosis for a painful and stiff glenohumeral joint that has lost distensibility of the capsule and range of motion

Frozen shoulder (adhesive capsulitis)

90

Most common form of lung inflammation associated with Sjögren's syndrome

Nonspecific interstitial pneumonia

91

Most common congenital malformation of the gastrointestinal tract

Meckel diverticulum

92

Condition associated with periodic acid-Schiff-positive macrophages and negative acid-fast stain

Whipple disease

93

SAAG and ascitic protein concentration thresholds associated with constrictive pericarditis

SAAG ≥ 1.1; Protein ≥ 2.5 g/dL

94

A typically transient anemia complication of TIPS

Hemolytic anemia (accept microangiopathic anemia)

95

Antibiotic most commonly responsible for drug-induced liver disease

Augmentin

96

Enterohemorrhagic E. coli (EHEC) can produce this toxin

Shiga toxin (accept vero toxin)

97

CDC prefers IGRA over tuberculin skin testing in patients with this medical history

Previous BCG vaccination (accept BCG treatment)

98

The most common organ infected by Nocardia

Lung

99

Infection associated with merozoites arranged in Maltese Cross pattern in peripheral blood smear

Babesia

100

Vancomycin minimum trough concentration recommended for S. aureus vertebral osteomyelitis

≥15 μg/mL

101

INR range for treatment of pulmonary embolism

2.0-3.0

102

Diagnosis in ventilated patient for hypotension, decreased left breath sounds and left deviated trachea

Right main bronchus intubation

103

Most common acid-base disorder associated with malignant hyperthermia

Respiratory acidosis

104

Liver condition that may result in brown pleural effusion

Amebic abscess

105

Most common antecedent of critical illness polyneuropathy

Severe sepsis (accept sepsis)

106

Most patients with leukostasis syndrome are also at risk for this oncological emergency

Tumor lysis syndrome

107

Playing this musical instrument is classically associated with intravascular hemolysis

Bongo drum

108

Two diagnoses most commonly accounting for acute fall in hemoglobin in patients with sickle cell anemia

Aplastic crisis and hyperhemolytic crisis

109

Definitive treatment for porphyria cutanea tarda

Phlebotomy

110

Giant hemangiomas can be associated with this coagulation disorder syndrome

DIC (also accept Kasabach-Merritt syndrome)

111

Eponym for hereditary nonpolyposis colorectal cancer

Lynch syndrome

112

Standard initial therapeutic approach for patients with metastatic prostate cancer

Androgen deprivation therapy (accept hormone therapy)

113

Histological stain used to diagnose AL amyloidosis

Congo red (accept thioflavin T)

114

This mutation in non-small cell lung cancers predicts favorable response to specific tyrosine kinase inhibitors

EGRF activating mutation

115

Cancer suggested by positive immunostaining for chromogranin A or synaptophysin

A neuroendocrine carcinoma (accept small cell lung cancer, carcinoid, or islet cell tumor)

116

'Popeye' arm deformity is associated with rupture of this tendon

Biceps tendon

117

Inflammatory condition characterized by quotidian fevers, arthritis, an evanescent rash and markedly elevated serum ferritin concentrations

Adult Onset Still's Disease

118

Besides the sun, common source of UVB radiation that may result in photosensitive reactions

Fluorescent light bulbs

119

Condition associated with pain at the radial side of the wrist during pinch grasping or during thumb and wrist movement

de Quervain’s tenosynovitis

120

The two most common ocular syndromes associated with giant cell arteritis

Amaurosis fugax and anterior ischemic optic neuropathy

121

Factor that carries factor VIII in the circulation

von Willebrand factor

122

Four vitamin K dependent coagulation factors

II, VII, IX, and X (name all)

123

A metalloproteinase that is deficient in patients with TTP

ADAMTS 13

124

Therapy that decreases recurrent stroke in sickle cell disease

Exchange transfusion

125

Cause of splenomegaly and hepatomegaly in myelofibrosis (myeloid metaplasia)

Extramedullary hematopoiesis

126

Vasculitis that is associated with stenosis and aneurysms of the renal artery

Polyarteritis nodosa

127

Electrolyte-associated syndrome characterized by quadriparesis, "locked in" syndrome, and coma

Osmotic demyelination syndrome (accept central pontine myelinolysis or pontine myelinolysis)

128

Diagnosis associated with this skin finding and angiomyolipomas or tubers of the skin, retina, brain, and kidneys [image of ash-leaf spot]

Tuberous sclerosis complex (accept tuberous sclerosis)

129

Syndrome caused by metabolism of ADH by circulating vasopressinase

Gestational diabetes insipidus

130

Therapeutic infusion associated with type B lactic acidosis, rhabdomyolysis, and hyperlipidemia

Propofol infusion

131

Lung cancer complication suggested by dyspnea, cough, and facial swelling

Superior vena cava syndrome

132

Components of FOLFOX chemotherapy

Folinic acid (leucovorin), 5-FU, oxaliplatin

133

Diagnosis suggested by peripheral blood smear [abnormal leukocytes with hairy protrusions]

Hairy cell leukemia

134

Cancer treatment cause of LV dysfunction that is not dose dependent

Trastuzumab

135

Treatment for this symptomatic, early-stage non-Hodgkin lymphoma [skin rash on back]

Topical corticosteroids or PUVA

136

Atrial fibrillation ablation therapy involves this cardiac structure

Pulmonary vein

137

Most likely finding on ECG prior to this arrhythmia [torsades de pointes EKG]

Long QT

138

Headache drugs implicated as a cause of valvular heart disease

Ergotamine and methysergide (either)

139

Lenient atrial fibrillation heart rate shown to be non-inferior to <80/min

<110 BPM

140

Late gadolinium enhancement on CMR is associated with this condition

Myocarditis

141

Sigmoidoscopic finding associate with anthraquinone laxative abuse

Melanosis Coli

142

Constipation diagnosis associated with failure to relax the puborectalis and external anal sphincter muscles

Dyssynergic constipation (accept pelvic floor dysfunction or pelvic floor dyssynergia)

143

Diagnosis associated with acute upper abdominal pain, vomiting, and an inability to pass a nasogastric tube

Acute gastric volvulus

144

Concurrent inflammatory bowel disease that may be found with celiac disease

Microscopic colitis (accept lymphocytic colitis)

145

Parasitic disease causing Symmer's pipestem fibrosis, splenomegaly and portal hypertension

Schistosomiasis

146

Dementia intervention associated with increased physical conditioning and delay in cognitive decline

Exercise training

147

Tremor that increases at the end of goal-directed movements

Essential tremor

148

Encephalitis associated with muscle weakness and extrapyramidal symptoms

West Nile virus encephalitis (accept Japanese encephalitis)

149

Treatment as effective as plasma exchange for Guillain-Barr syndrome

Intravenous immune globulin

150

Term describing a form of hypertonia with an involuntary variable resistance during passive movement

Paratonia or gegenhalten

151

Most sting-related reactions are caused by this order of insects

Hymenoptera

152

Condition associated with urticaria pigmentosa

Mastocytosis (systemic or cutaneous mastocytosis)

153

Syndrome characterized by reaction in mouth to eating fresh fruits, nuts, and vegetables

Oral allergy syndrome

154

Fish-related poisoning often misdiagnosed as "seafood allergy"

Scombroid poisoning

155

Eponym for accentuated lines or folds below the lower lids associated with allergic conjunctivitis

Dennie-Morgan lines

156

Most common cause of primary glomerulopathy in developed countries

IgA nephropathy

157

Non-inflammatory, nonatherosclerotic disorder that leads to arterial stenosis, occlusion, aneurysm, and dissection

Fibromuscular dysplasia

158

Antihypertensive drug class that decreases risk of acute gout

Calcium channel blockers (accept losartan but not ARBs)

159

Diagnostic urinalysis finding associated with acyclovir acute kidney injury

Needle shaped crystals (accept crystals or crystalluria)

160

Sonographic criteria for the diagnosis of type 1 ADPKD for at risk individuals ages 15 to 30 years

≥ 2 unilateral or bilateral cysts

161

Timing of initial imaging follow up for 4 mm pulmonary nodule on CT scan in high risk patient

CT scan in 12 months (accept 12 months)

162

First line treatment for reversible posterior leukoencephalopathy

Lower BP

163

The strategy of permissive hypercapnia is used to manage this mechanical ventilation complication associated with COPD

Auto-PEEP or intrinsic PEEP

164

Strongest indicator for critical illness myopathy

IV glucocorticoids

165

Acid-base disorder characteristic of propofol infusion syndrome

Metabolic acidosis (accept increased anion-gap metabolic acidosis)

166

MEN 2A and MEN 2B have these 2 conditions in common

Medullary thyroid cancer and pheochromocytoma

167

Syndrome manifesting the most common sex chromosome abnormality

Turner syndrome (gonadal dysgenesis)

168

Syndrome of vitiligo, autoimmune thyroid and adrenal disease , type 1 DM, and hypopituitarism

Polyglandular autoimmune syndrome

169

Adjuvant treatment for thyroid storm that blocks release of T4 and T3

Iodine (accept lithium)

170

Mediator of transient subclinical hyperthyroidism during first half of pregnancy

HCG (human choriogonadotropin)

171

Leukemia most commonly associated with leukostasis syndrome

AML or CML in blast crisis

172

Most common thrombophilia associated with warfarin skin necrosis

Protein C deficiency

173

Patients with hemochromatosis are at risk for this bacterial infection

L. monocytogenes, Y. enterocolitica, V. vulnificus, Klebsiella sp (any one)

174

Diagnosis accounting for Coombs-negative hemolytic anemia and Budd-Chiari syndrome

Paroxysmal nocturnal hemoglobinuria

175

Myelodysplastic syndrome-associated skin condition that may herald change to acute leukemia

Sweet syndrome (acute febrile neutrophilic dermatosis)

176

Class of drug for hormone-receptor positive early stage breast cancer in premenopausal women

Selective estrogen receptor modulator (accept SERM or tamoxifen)

177

Recommended type of endoscopic surveillance following colectomy for familial adenomatous polyposis

Upper endoscopy

178

Leukemic variant of cutaneous T cell lymphoma commonly presenting with erythroderma and generalized lymphadenopathy

Sézary syndrome

179

Most likely primary cancer accounting for metastatic squamous cell carcinoma to upper cervical lymph node

Head and neck

180

The Gynecologic Oncology Group definition of optimal cytoreduction for ovarian cancer in terms of remaining residual disease

Residual disease < 1 cm in diameter

181

Systolic blood pressure level that excludes thrombolytic therapy for acute stroke

≥ 185 mm Hg

182

Name of retinal finding associated with subarachnoid hemorrhage

Subhyaloid hemorrhage

183

Name for temporary worsening of multiple sclerosis symptoms in the setting of fever

Pseudorelapse (accept Uhthoff phenomenon)

184

Sustained cervical muscle contractions and abnormal posture of the head

Cervical dystonia (torticollis)

185

Myelitis and optic neuritis and positive NMO-IgG autoantibody

Neuromyelitis optica (Devic disease)

186

The most common somatoform disorder

Somatization

187

Personality disorder characterized by unstable interpersonal relationships, impulsiveness, and self-destructive behaviors

Borderline personality

188

Disorder characterized by excessive fears of scrutiny, embarrassment and humiliation in social situations

Social anxiety disorder (accept social phobia disorder)

189

SSRI-associated syndrome of myoclonus, muscular rigidity, and hyperthermia

Serotonin syndrome

190

First line therapy for post traumatic stress disorder

Cognitive behavioral therapy (accept CBT, exposure therapy, cognitive therapy, eye movement desensitization and reprocessing)

191

Liver disorder associated with platypnea and orthodeoxia

Hepatopulmonary syndrome

192

Vasculitic disorder characterized by chronic rhinosinusitis, asthma, and prominent peripheral blood eosinophilia

Churg-Strauss syndrome (allergic angiitis and granulomatosis)

193

Sudden jerking leg movements that may accompany restless leg syndrome

Periodic limb movement of sleep (accept periodic limb movement disorder)

194

Fleischner criteria for timing of next imaging study for incidentally discovered 3 mm pulmonary nodule in high risk patient

12 months

195

Most common cause of hypopituitarism

Pituitary tumor or treatment of tumor (either)

196

Cause of thyrotoxicosis and elevated TSH, elevated T3, and elevated free T4

TSH secreting pituitary adenoma (accept pituitary, pituitary tumor, pituitary adenoma, central hyperthyroidism)

197

In patients with diabetes, 2 criteria used to unequivocally attribute chronic kidney disease to diabetes

Microalbuminuria (or proteinuria) and diabetic retinopathy

198

Most common manifestation of MEN 1

Multigland hyperparathyroidism (accept hyperparathyroidism)

199

Name for this finding associated with obstructive substernal goiter [red face when hands are held in air]

Pemberton's sign (Pemberton's maneuver)

200

Clinical tool used to calculate 10-year probability of fracture risk

Fracture Risk Assessment Tool (FRAX)

201

Gold standard test for diagnosing "white coat hypertension"

Ambulatory blood pressure measurement (not home blood pressure measurement)

202

BMI range defining "overweight"

25-29.9

203

Chronic non-productive cough, atopy and positive sputum eosinophils without airway hyperresponsiveness

Nonasthmatic eosinophilic bronchitis (accept eosinophilic bronchitis)

204

Reasoning error characterized by accepting at face value a previous diagnosis

Anchoring heuristic

205

Major pulmonary complication of bleomycin therapy

Interstitial pulmonary fibrosis (also fibrosing alveolitis, pulmonary fibrosis)

206

Duration of VTE treatment with LMWH in patients with cancer

Indefinitely or until cancer is resolved (accept either)

207

Age when HPV vaccination should be initiated in females

Age 11-12

208

Mutated gene responsible for Gardner's syndrome

APC (adenomatous polyposis coli)

209

Eponym for cancer syndrome associated with tumor protein p53 gene mutation

Li-Fraumeni syndrome

210

A "box car"-shaped gram-positive bacillus that produces lethal toxin

Bacillus anthracis (accept anthrax)

211

Recommended antibiotic treatment for Campylobacter gastroenteritis

Azithromycin or erythromycin

212

Cause of chronic diarrhea in patient exposed to day care center

Giardia Lambia

213

Bacteria responsible for emetic syndrome related to fried rice

Bacillus cereus

214

Breakbone fever" has been used to describe a symptom of this disease

Dengue fever

215

Most common medical cause of gastroparesis

Diabetes

216

Most common chronic motility complication following Roux-en-Y bypass operation for obesity

Dumping syndrome

217

IDSA recommended drug and route for severe C. difficile colitis

Oral Vancomycin

218

Biliary disease associated with increased risk for colorectal cancer

Primary sclerosing cholangitis

219

Congenital pancreatic anomaly associated with recurrent pancreatitis

Pancreas divisum

220

Most common cause of recurrent episodes of this condition [picture of erythema multiforme]

Herpes virus infection (accept HSV infection)

221

Agent causing this lesion following fish tank exposure [yellow lesion on medial ankle]

Tuberculosis marinum

222

Diagnosis of these lesions distributed in "Christmas tree" pattern on truck and chest

Pityriasis rosea

223

Childhood skin condition that can also be spread sexually

Molluscum contagiosum

224

Diagnosis for this condition [nikolsky sign]

Toxic epidermal necrolysis

225

Autoimmune blistering disease caused by autoantibody to desmoglein

Pemphigus vulgaris (accept pemphigus)

226

Childhood vasculitis associated with red chapped lips and strawberry tongue

Kawasaki disease (accept mucocutaneous lymph node syndrome)

227

Class of allergic drug reaction responsible for contact dermatitis

Type IV

228

Most common malignancy associated with common variable immunodeficienc

Non-Hodgkin lymphoma (accept lymphoma)

229

Atrial septal defect that accounts for 70% of all atrial septal defects

Secundum atrial septal defect

230

Best test for a patient with intermediate risk of coronary artery disease and left axis deviation

Exercise stress test.

231

Blood test distinguishing constrictive pericarditis from restrictive cardiomyopathy

B-type natriuretic peptide (accept BNP)

232

Target resting heart rate for atrial fibrillation therapy suggested by the RACE II Trial

Less than 110/min

233

Denominator in the number needed to treat calculation

Absolute risk reduction (accept control rate event-experimental rate event)

234

Formula to calculate "power"

1-(type 2 error rate) or 1-β

235

Ratio estimating risk of an event occurring at an instantaneous point in time

Hazard ratio

236

A receiver operator characteristics (ROC) curve is a plot of these 2 variables

Sensitivity (true positive rate) and 1- specificity (false-positive rate)

237

Benign skin tumor on the face often mistaken for basal cell carcinoma

Sebaceous hyperplasia

238

ACIP recommended initial age for vaccine to prevent this condition [zoster]

Age 60 years

239

Name for linear depressions in nail that result from chemotherapy

Beau lines

240

Genus of yeast associated with this condition [hyperpigmented lesions]

Malassezia (accept older name Pityrosporum)

241

Diagnosis for these hyperpigmented papules [underneath eyes]

Dermatosis papulosa nigra

242

Polycythemia vera symptom characterized by burning of palms and soles

Erythromelalgia

243

Liver produced peptide that down regulates enterocyte absorption of iron

Hepcidin

244

Name of this cell responsible for secondary pure red cell aplasia

Large granular lymphocyte

245

Scoring system used to estimate pretest probability of heparin induced thrombocytopenia

4t score

246

FDA approved DNA hypomethylating agent that improves survival in myelodysplastic syndrome

Azacitidine (accept decitabine)

247

ACP guideline recommends pulmonary rehabilitation for symptomatic patients with stable COPD and this FEV1

FEV1 < 50% predicted

248

New name of idiopathic form of bronchiolitis obliterans organizing pneumonia

Cryptogenic organizing pneumonia (accept COP)

249

New name for bronchoalveolar cell carcinoma

Adenocarcinoma in situ (accept minimally invasive adenocarcinoma)

250

Poisoning associated with diagnostic mnemonic "SLUDGE"

Organophosphate (accept insecticide, sarin)

251

Exposure associated with radiographic finding of progressive massive fibrosis

Silica (accept silicosis

252

Character of tinnitus that suggests an underlying vascular cause

Pulsatile

253

Most common bacterial etiology of otitis externa in immunocompetent patients

Pseudomonas aeruginosa (accept Pseudomonas)

254

Name of anterior septal vascular area responsible for 90% of epistaxis

Kiesselbach plexus

255

Subtype of nonallergic rhinitis associated with eating

Gustatory rhinitis

256

Name for mucocele at floor of mouth resulting from obstruction of sublingual glands

Ranula

257

Diagnosis for acute episode of muscular weakness following high carbohydrate meal

Hypokalemic periodic paralysis

258

24 mEq/L-(δ anion gap) calculates this entity

Corrected bicarbonate level

259

Mediator of retinal toxicity associated with methanol poisoning

Formic acid

260

Type of acidosis associated with short bowel syndrome and normal serum lactic acid level

D-Lactic acidosis

261

Cause of anion gap metabolic acidosis and increased osmolar gap associated with intravenous lorazepam

Propylene glycol

262

Word for inflammation at sites of ligamentous or tendon attachment to bone

Enthesitis (accept enthesopathy)

263

Condition significantly associated with high titers of anti-U1-ribonucleoprotein antibodies

Mixed connective tissue disease

264

Indicated pulmonary test for patient with this disorder [psoriasis]

Flow volume loop

265

Diagnosis for spine changes [look up x-ray]

Diffuse idiopathic skeletal hyperostosis (accept DISH)

266

Form of scleroderma presenting as localized indurated plaques

Morphea

267

Term denoting transient improvement in insulin production following treatment of newly diagnosed type 1 diabetes mellitus

"Honeymoon period"

268

Cause of retinal changes in this patient with diabetes

Photocoagulation therapy

269

In the evaluation of male hypogonadism, next test if total testosterone level is indeterminate (200-350 ng/mL)

Free or bioavailable testosterone

270

Cause of hypercalcemia associated with mutations of the calcium-sensing receptor gene

Familial hypocalciuric hypercalcemia

271

Prednisone threshold dose of any duration that does not require perioperative testing or replacement to prevent adrenal crisis

Less than or equal to 5 mg/day

272

AHRQ number 1 strategy to improve patient safety in hospitals

VTE prophylaxis

273

In adults who have never received Tdap, timing of Tdap following last Td vaccination

Anytime, regardless of interval

274

Most effective prophylactic drug for tension headache

Tricyclic antidepressant

275

Antibiotic with highest risk of hyperkalemia

Trimethoprim-sulfamethoxazole (accept trimethoprim)

276

HLA-B5701 allele is associated with this dermatologic condition

DRESS syndrome (accept hypersensitivity reaction)

277

Two USPSTF recommendations to prevent falls in elderly

Exercise (or PT) and Vitamin D

278

Antidepressant for elderly with weight loss and insomnia

Mirtazapine (accept Remeron)

279

Drug implicated in 33% of medication-related emergency hospitalizations

Warfarin

280

Important clinical outcome predicted by gait speed for 6 meter walk

Survival

281

The two basic components of the Mini-Cog test

3-Word recall and clock drawing test (both required)

282

Most common genetic neurodegenerative choreic disorder

Huntington disease

283

Seizure characterized by localized discharges without impairment of consciousness

Simple partial seizure

284

Longest therapeutic window for rt-PA administration resulting in benefit for selected stroke patients in ECASS 3 trial

4.5 Hours

285

Specific treatment for chronic paroxysmal hemicrania

Indomethacin

286

Name of tic characterized by repetitive utterances of obscenities

Coprolalia

287

Most significant risk factor for ovarian cancer

BRACA1/BRAC2 gene

288

Evidence-based 3-component treatment for epidural cord compression

Corticosteroids, decompressive surgery and radiation (name all 3)

289

Most common side effect of VEGF pathway inhibitors

Hypertension

290

Only cancer where removing just the primary tumor in setting of metastatic disease improves overall outcome

Kidney cancer

291

Prophylactic cancer treatment for small cell lung cancer following combination radiation and chemotherapy

Cranial radiation

292

Cause of dendritic appearing corneal ulcers

Herpes simplex

293

Eponym for this finding associated with infective endocarditis [retinal hemorrhage]

Roth spot

294

Most common associated rheumatological disorder [hemorrhage in cornea]

RA

295

Charles Bonnet syndrome is associated with this diagnosis [bloody fundoscopic exam].

Age-related wet macular degeneration (accept macular degeneration)

296

Eye condition that predisposes to spontaneous occurrence of this condition [retinal detachment]

Myopia

297

Best cardiovascular risk prediction tool for a 45-year-old woman

Reynolds Risk Score

298

Duration of clopidogrel therapy following insertion of drug-eluting stent

1 year

299

Specific name for this rhythm diagnosis

Torsades de pointes

300

QT interval/square root of the RR interval calculates this entity

Corrected QT interval (accept QTc)

301

Drug toxicity most likely responsible for this rhythm

Digitalis

302

Time to initiate colorectal cancer surveillance in patients with inflammatory bowel pancolitis

8 years of disease duration

303

Syndrome name for episodic abdominal pain, nausea and vomiting in habitual marijuana user

Cannabinoid hyperemesis syndrome

304

Pancreatic neuroendocrine tumor least likely to metastasize

Insulinoma

305

Most common myeloproliferative disorder associated with Budd-Chiari syndrome

Polycythemia vera

306

Cost of 30-day supply of rifaximin to treat hepatic encephalopathy

$1300 (accept $1100 to $1500)

307

First drug to inhibit the action of the BCR-ABL fusion gene

Imatinib

308

First-line drug combination for high risk essential thrombocythemia

Hydroxyurea and aspirin

309

Protein structure represented by the dark inclusions in this crystal violet stained cell

Denatured hemoglobin (accept Heinz body)

310

Condition most likely associated with this peripheral blood smear [spurr cells]

CKD

311

Minimum anticoagulant duration beyond parturition for VTE in pregnant patient

6 weeks

312

"Signature injury" of soldiers deployed to Iraq and Afghanistan

Traumatic brain injury

313

Descriptive name of severe headache that reaches maximum intensity in 60 seconds

Thunderclap

314

Name of self-limited chorea that occurs during pregnancy

Chorea gravidarum

315

Parkinson-plus syndrome associated with distinctive eye findings

Progressive supranuclear palsy

316

Most common manifestation of temporal lobe epilepsy associated with this coronal FLAIR MRI

Complex partial seizure

317

Number of symptoms required to fulfill DSM IV criteria for major depression

Five

318

Symptom duration criteria to diagnose dysthymia

2 or more years

319

Traumatic brain injury increases the risk of this psychiatric disorder by 6 fold

Posttraumatic stress disorder

320

Condition characterized by repeated episodes of aggressive violent behavior grossly out of proportion to situation

Intermittent explosive disorder

321

The SCOFF questionnaire screens for this psychiatric disorder

Eating disorder (accept anorexia nervosa, bulimia nervosa)

322

Systemic disease diagnosis responsible for findings [red eyelids and face]

Dermatomyositis

323

Eponym for test to detect abnormal lacrimal gland function with tear test strips

Schirmer test

324

Spondyloarthropathy associated with this finding [foot rash]

Reactive spondyloarthropathy (accept Reiter syndrome)

325

Diagnosis for woody induration of extremities, sparing hands and face, and absent Raynaud phenomenon

Eosinophilic fasciiti

326

Crystals associated with highly destructive osteoarthritis including "Milwaukee shoulder"

Basic calcium phosphate (accept hydroxyapatite)

327

Hemoglobin A1c level that corresponds to average glucose level of 154 mg/dL

7%

328

Age criterion for parathyroidectomy for asymptomatic patients with primary hyperparathyroidism

Age <50

329

The single best blood test for making the diagnosis of acromegaly

Insulin-like growth factor 1 (accept IGF-1)

330

Cause of thyrotoxicosis and low thyroglobulin level

Ingestion of excess thyroid hormone (accept factitious hyperthyroidism)

331

Psychiatric drug that increases set point at which calcium suppresses PTH

Lithium

332

Most common cause of health-care related diarrhea

C. diff

333

Empiric 2-drug antibiotic therapy for patient with this CSF gram-stain

Vancomycin and 3rd generation cephalosporin (e.g., cefotaxime, ceftriaxone)

334

Definition of multidrug-resistant tuberculosis

Resistant to at least isoniazid and rifampin

335

Infection associated with properdin deficiency

Neisseria infection (accept either Neisseria meningitis or gonorrhea)

336

Condition associated with this rash is transmitted by the Lone Star tick

Southern tick-associated rash illness (STARI)

337

Condition associated with ECG J waves (Osborne waves)

Hypothermia

338

PO2/FiO2 Berlin criteria for severe ARDS

PO2/FiO2 ≤ 100

339

Diagnosis suggested by these findings and interstitial lung disease with hilar adenopathy [findings on face and nose]

Sarcoidosis

340

ACP guideline recommends bronchodilators for symptomatic patients with stable COPD and this FEV1

FEV1 < 60% predicted

341

Chronic illicit drug abuse associated with bruxism, decreased saliva, and dental decay

Amphetamine abuse (accept "meth mouth")

342

Type of immune reaction mediate by T cells

Type IV

343

Name of nonallergic watery rhinitis in response to eating

Gustatory rhinitis

344

Preferred pharmacologic treatment for severe eyelid atopic dermatitis

Topical tacrolimus or pimecrolimus (accept topical calcineurin inhibitors)

345

Asthma treatment consisting of a monoclonal antibody that binds IgE

Omalizumab

346

Most frequent extrapancreatic manifestation of type-1 autoimmune pancreatitis

IgG-4 sclerosing cholangitis (accept sclerosing cholangitis)

347

Antihypertensive drug class associated with greatest risk of gout

Diuretics (accept thiazides)

348

Cause of acute episodic muscle weakness triggered by high carbohydrate meal

Hypokalemic periodic paralysis

349

Name of this urine crystal [hexagonal crystal]

Cystine

350

Decoy cells are associated with this infection in kidney transplant patients

BK virus (accept polyomavirus)

351

Autosomal dominant disorder caused by mutation of genes coding for the alpha-3 or alpha-4 chains of type IV collagen

Thin basement membrane disease

352

Antidote for methanol poisoning if fomepizole is unavailable

Ethanol

353

Most common form of amiodarone pulmonary toxicity

Interstitial pneumonitis

354

Pulmonary fungal infection that may result in a black pleural effusion

Aspergillus (also accept Rhizopus)

355

Hyperthermia and myoclonus syndrome caused by the drug 'Ecstasy'

Serotonin syndrome

356

Eponym for thymoma and acquired hypogammaglobulinemia

Good syndrome

357

Diagnosis for this longitudinal melanonychia

Subungual melanoma (accept melanoma)

358

Most common autoimmune endocrine disorder associated with this finding [vitiligo]

Autoimmune thyroiditis (accept Hashimoto thyroiditis)

359

Condition caused by blockage and rupture of eccrine sweat ducts

Miliaria (accept heat rash)

360

Name for this rapidly growing, friable, benign vascular papule

Pyogenic granuloma

361

Eponym for this non-invasive skin cancer

Bowen disease

362

USPSTF recommends this cervical cancer screening interval when performed with both cytology and HPV testing

5 years

363

The CDC recommends one-time screening for hepatitis C for persons born during this interval

1945-1965

364

High-dose influenza vaccine is restricted to this group

Age ≥ 65 years

365

Cause of lateral knee pain when climbing stairs, tenderness over lateral femoral condyle, and positive Noble test

Iliotibial band syndrome

366

ACP guideline specifically identified this VTE prophylaxis for hospitalized medical patients as causing more harm than benefit

Graduated compression stockings

367

Most common female sexual disorder

Hypoactive sexual desire disorder

368

FDA approved androgen drug for severe mastalgia

Danazol

369

Contraceptive class associated with prolonged infertility after discontinuation

Long acting progesterone (accept specific examples; long-acting progesterone injection, implants, or IUD)

370

Period of time after intercourse levonorgestrel is effective in preventing pregnancy

5 days (120 hours)

371

When indicated, timing of Tdap during pregnancy

Between 20 weeks and delivery (accept after 20 weeks; do not accept after delivery)

372

A sudden, temporary edema of a localized area of skin or mucosa

Angioedema

373

Drug associated with Samter's triad

Aspirin

374

Physical examination finding that excludes hereditary angioedema as cause of recurrent angioedema

Hives (accept urticaria)

375

Fever, rash and hypotension following penicillin therapy for primary syphilis

Jarisch-Herxheimer reaction

376

Acute drug reaction characterized by generalized pustules, fever, leukocytosis and eosinophilia

AGEP (acute generalized exanthematous pustulosis)

377

Vitamin that reduces risk of falls in the elderly

Vitamin D

378

Vitamin deficiency associated with petechiae and perifollicular hemorrhage

Vit C

379

Diagnosis for syncope following meal in elderly person

Postprandial syncope

380

Normal time threshold for "Get up and go" test

<10 seconds (accept <10-15 seconds)

381

Ipsilateral absence of this reflex is 99% sensitive for testicular torsion

Cremasteric reflex

382

First study used to differentiate factor deficiency from factor inhibitor

Mixing study

383

Least frequent of the myeloproliferative disorders

Primary myelofibrosis (accept idiopathic myelofibrosis and agnogenic myeloid metaplasia)

384

Gold standard diagnostic test for heparin-induced thrombocytopenia

Serotonin release assay

385

Characterized by lack of expression of CD55 and CD59 on erythrocytes

Paroxysmal nocturnal hemoglobinuria

386

FDA approved thrombopoietin mimetic

Romiplostim, eltrombopag (either)

387

Recommended duration of antibiotic treatment for inhalational anthrax

60 days

388

Treatment of first recurrence of mild C. difficile colitis

Metronidazole [new evidence recommends vancomycin for all though]

389

Shock syndrome caused by bacterial exotoxins that act as superantigen

Toxic shock syndrome

390

Tropical zoonosis associated with hemorrhage, abdominal pain, hepatosplenomegaly and this finding [severe injected sclera]

Leptospirosis

391

Infection associated with this erythrocyte inclusion [maltese cross]

Babesioses

392

Alcohol poisoning associated with normal acid-base homeostasis

Isopropyl alcohol

393

Diagnosis for normal blood pressure, hypokalemia, metabolic alkalosis, and elevated renin and aldosterone levels

Bartter syndrome

394

Treatment of scleroderma renal crisis and serum creatinine >3 mg/dL

ACE inhibitor (accept specific ACE inhibitor)

395

Characterized by glycosuria, phosphaturia, aminoaciduria, and tubular proteinuria

Proximal (type 2) renal tubular acidosis (accept Fanconi syndrome)

396

Renal vascular disease associated with this finding on angiography [google an image]

Fibromuscular disease (accept Fibromuscular dysplasia)

397

Hand finding virtually diagnostic for dermatomyositis

Gottron papules

398

Cause of red, hot, painful ears and saddle nose deformity

Relapsing polychondritis

399

Treatment for familial Mediterranean fever

Colchicine

400

In patients with chronic limb pain, measurement of skin temperature helpful to establish this diagnosis

Complex regional pain syndrome (accept reflex sympathetic dystrophy and causalgia)

401

Characterized by pain, numbness, and tingling in the forefoot, aggravated by high heel shoes

Morton neuroma

402

Maximum TIMI score

Seven

403

Cause of STEMI in woman with migraines and Raynaud syndrome

Coronary vasospasm (accept Prinzmetal angina, variant angina)

404

Characterized by pathologic fibrofatty infiltration of the right ventricle

Arrhythmogenic RV dysplasia

405

Diagnosis for restrictive cardiomyopathy, neuropathy, proteinuria, hepatomegaly and purpura

Amyloidosis

406

Diagnosis associated with septal shudder and bounce on echocardiography

Constrictive pericarditis

407

Diagnosis for atopy, recurrent food impaction and esophageal rings, furrows, plaques, or strictures

Eosinophilic esophagitis

408

Immunological cause of false-negative IgA anti-tTG antibody test for celiac disease

IgA Def

409

Cause of nausea, early satiety, and bloating in patient with systemic sclerosis

Gastroparesis (accept delayed gastric emptying)

410

Eponym for perihepatitis and pelvic inflammatory disease

Fitz-Hugh Curtis syndrome

411

Syndrome of abdominal pain, bloating, and difficulty belching following fundoplication

Gas-bloat syndrome

412

Women with peritoneal carcinomatosis of unknown primary are treated for this cancer

Ovarian

413

The Gail model 5-year risk cut point dividing "high" and "low" risk

1.67% (accept range >1.66% to 1.7%)

414

Histological scoring system for patients with biopsy proven prostate cancer

Gleason score

415

Eponym for gastrointestinal metastases to ovary

Krukenberg tumor

416

The BRAF mutation is specific for this endocrine cancer

Papillary thyroid cancer (accept thyroid cancer)

417

An ulcerative form of impetigo

Ecthyma

418

This parasitic cutaneus infection is transmitted by the sandfly

Leishmaniasis

419

Painful condition of the axillary, inguinal, and perianal areas

Hidradenitis suppurativa

420

Develops after infection with β-hemolytic Streptococcus [multiple red spots on back]

Guttate psoriasis

421

Eponym describing the ability to laterally extend bullae by application of pressure

Asboe-Hansen sign (accept indirect Nikolsky sign or Nikolsky II sign)

422

Split urine collection (daytime and nighttime) used to diagnose this condition

Orthostatic (accept positional) proteinuria

423

Predominant protein comprising the matrix of urinary casts

Tamm-Horsfall mucoprotein

424

Diagnosis suggested by serum potassium of 7.0 meq/L and this ECG [normal]

Pseudohyperkalemia

425

Multiple myeloma type typically associated with low anion gap

IgG myeloma

426

Eponym for renal carcinoma, CNS hemangioblastomas and retinal angiomas

von Hippel-Lindau disease

427

Eponym for criteria used to diagnose acute rheumatic fever

Jones criteria

428

Syndrome of nonarthritic lateral hip pain that worsens with direct pressure

Trochanteric bursitis

429

Most likely diagnosis of a lateral knee large cyst lesion]

Baker's cyst [google image]

430

Eponym for test that measures forward spine flexion

Schober test

431

Name for cutaneous sarcoidosis characterized by red indurated papules, plaques, or nodules on the central face

Lupus pernio

432

Agent responsible for painful vesicular blepharitis

Herpes zoster

433

Name for a focal area of vision loss

Scotoma

434

Eponym given to tonic pupil without reaction to light or accommodation

Adie's pupil

435

Most common noninfectious cause of granulomatous uveitis and hypercalcemia

Sarcoidosis

436

Name for asymptomatic raised yellow plaque on the lateral side of the limbus

Pingueculae

437

Most common presentation of thoracic endometriosis

Catamenial pneumothorax (accept pneumothorax)

438

Device that uses 4 rather than 2 wavelengths of light to detect oxyhemoglobin, deoxyhemoglobin, carboxyhemoglobin, and methemoglobin

Co-oximeter

439

Most common exposure associated with rounded atelectasis

Asbestos

440

Cardinal distinguishing radiological feature of lymphangioleiomyomatosis

Homogenous thin-walled cysts

441

Syndrome associated with elevated ratio of LH to FSH, elevated testosterone and dehydroepiandrosterone

Polycystic ovary syndrome

442

Eponym for benign thrombophlebitis of the superficial veins of the breast

Mondor disease

443

Disorder associated with primary amenorrhea and 45 XO karyotype

Turner syndrome (accept gonadal dysgenesis)

444

Agent causing sexually transmitted vaginitis

Trichomonas vaginalis

445

Vaginitis associated with normal vaginal pH

Candidal vaginitis

446

Initial test to diagnose immune-mediated hemolysis

Coombs test (direct antiglobulin test)

447

Anemia associated with this nail finding [picture of spoon nails]

Iron deficiency anemia

448

Irradiated blood prevents this fatal transfusion-related complication

Graft vs Host disease (GVHD)

449

Condition associated with elevated homocysteine and normal methylmalonic acid levels

Folate def

450

Hemolytic anemia associated with IgM antibodies directed against RBC I/i antigens

Cold agglutinin disease

451

Name of intracytoplasmic inclusion associated with ehrlichiosis

Morulae

452

Animal associated with non-bite rabies transmission

Bats

453

Etiological agent responsible for cat scratch disease

Bartonella henselae

454

Diagnosis for this painless lesion in animal-hide worker

Cutaneous anthrax (accept anthrax)

455

Most likely malarial agent causing an 8% RBC parasitemia rate

P. falciparum

456

Forearm rolling test is used to elicit this motor finding

Hemiparesis

457

Scoring system to predict risk of stroke at 2, 7, and 90 days after TIA

The ABCD2

458

Dementia presenting with early personality changes, fixation, disinhibition and emotional lability

Frontotemporal dementia

459

Cause of noninflammatory, nonatherosclerotic carotid artery stenosis in a young woman

Fibromuscular dysplasia

460

Minimum duration of clopidogrel treatment for drug-eluting stents

12 months

461

Acronym for regular SVT with no visible P wave

AVNRT (atrioventricular nodal reentrant tachycardia)

462

Tachycardia associated with an abrupt halving of the pulse rate with Valsalva

Atrial flutter

463

A cannon wave involves this part of the venous wave form

A wave

464

Diagnosis for slow regular rhythm associated with changing intensity of S1

Atrioventricular dissociation (accept complete heart block, complete AV block, 3rd degree block)

465

Protozoan cause of this condition [picture of achalasia]

Trypanosoma cruzi (accept Chagas disease)

466

Most common benign hepatic tumor

Cavernous hemangioma (accept hemangioma)

467

In addition to gallstones, classic ultrasound imaging finding of acute cholecystitis

Pericholecystic fluid and thickened wall (accept either)

468

Percussion of Traube's semilunar space is used to detect this condition

Splenomegaly

469

Specific gene mutation most often associated with hemochromatosis

C282Y gene mutation

470

Immunoglobulin involved in most cases of anaphylaxis

IgE

471

Gell and Coombs immunologic classification type for serum sickness

Type III

472

The most common congenital immunological defect

Selective IgA deficiency

473

Group of urticarial disorders induced by environmental stimuli

Physical urticaria

474

Darier sign is associated with mediator release from this cell type

Mast Cell

475

Elevated level rules out surreptitious insulin administration as cause of hypoglycemia

C-peptide

476

24-Hour albumin excretion defining microalbuminuria in men

30-300 mg/day

477

Diagnosis for hyperosmolar hypernatremia and elevated arginine vasopressin (AVP)

Nephrogenic diabetes insipidus (diabetes insipidus not acceptable)

478

Look up picture for this..

Semmes-Weinstein monofilament (accept Semmes-Weinstein or monofilament)

479

Hematologic disorder associated with the autoimmune polyglandular syndromes

Pernicious anemia

480

The most common cause of conductive hearing loss

Cerumen impaction (accept cerumen, occluded external ear canal)

481

Office test that examines the relative adequacy of air and bone conduction of sound

Weber or Rinne (either)

482

Condition associated with bony overgrowth of the footplate of the stapes

Otosclerosis

483

Condition associated with ozena

Atrophic rhinitis (accept atrophy of the nasal conchae, atrophic rhinosinusitis)

484

Most commonly identified bacterial cause of Lemierre's syndrome

Fusobacterium necrophorum (accept Fusobacterium)

485

Word for a normally nonpainful stimulus that evokes pain

Allodynia

486

Initial drug and route of administration for acute optic neuritis

Intravenous methylprednisolone

487

Most likely diagnosis for neck pain, Horner syndrome, pulsatile tinnitus and cranial nerve palsy

Carotid artery dissection

488

Disease associated with diminished visual acuity while taking a hot shower

Multiple sclerosis

489

Diagnosis for myoclonic and generalized tonic-clonic seizures on awakening with onset in adolescence

Juvenile myoclonic epilepsy

490

Name to describe a fever that returns every day

Quotidian fever

491

Name of reflex associated with blinking when forehead is tapped

Glabellar

492

Diagnosis associated with pain upon resisted thumb extension

de Quervain's tenosynovitis

493

Name for respiratory pattern characterized by groups of quick, shallow inspirations followed by periods of apnea

Biot's respiration

494

Enlargement of the Delphian node suggests this cancer diagnosis

Thyroid

495

Diagnosis associated with bilateral auricular chondritis

Relapsing polychondritis (accept polychondritis)

496

Diagnosis for chronic, burning pain after an injury that does not correspond to a dermatome

Reflex sympathetic dystrophy or complex regional pain syndrome (either answer)

497

SLE complication characterized by acute leg paralysis, bladder and bowel dysfunction

Transverse myelitis

498

Name of test associated with these findings 48 hours following 5 insertions of a sterile needle [red papules]

Pathergy test

499

Classical bacterial cause of folliculitis following hot tub exposure

Pseudomonas aeruginosa

500

Diagnosis of a bronchoscopy with a parasite.

Strongyloides stercoralis (accept Strongyloides)

501

Look up picture of..

Subconjunctival hemorrhage (accept conjunctival hemorrhage)

502

Look up picture of..

Hyphema

503

Look up picture of..

Iritis (accept anterior uveitis iridocyclitis)

504

Retinal findings associated with osteitis deformans

Angioid streaks

505

Look up picture of..

Central retinal artery occlusion

506

Diagnosis for ankle pain and periosteal new bone formation

Hypertrophic osteoarthropathy

507

Most common diagnosis for anterior knee pain in young athletic woman

Patellofemoral syndrome

508

look up location of anserine bursa

k

509

Aquired bone disease associated with hearing loss

Paget disease

510

Most common extra-articular manifestation of ankylosing spondylitis

Acute anterior uveitis

511

Infectious agent causing of aplastic crisis in sickle cell anemia

Parvovirus B19

512

The leading cause of mortality associated with blood product administration

TRAILI

513

Urticaria pigmentosa is the most common finding associated with this disorder

Mastocytosis (cutaneus or systemic)

514

Cause of paresthesias following plasmapheresis

Hypocalcemia (accept metabolic alkalosis)

515

The enzymatic step disrupted by warfarin

Gamma carboxylation

516

Genus of tick transmitting Lyme disease

Ixodes

517

Diagnosis for lateral neck film showing "thumb sign"

Epiglottitis

518

Classical bacterial cause of cellulitis associated with fish tank exposure

Mycobacterium marinum

519

Cholesterol-lowering drug used as adjuvant therapy for relapsing C. difficile diarrhea

Cholestyramine

520

Viral agent of meningitis associated with rodent or rodent feces exposure

Lymphocytic choriomeningitis virus

521

Mediator of most cases of malignancy related hypercalcemia

Parathyroid hormone-related protein (or peptide) (accept PTHrP)

522

Industry most strongly associated with bladder cancer

Dye, rubber, or leather industries (any one answer)

523

Diagnosis suggested by a positive sulfosalicylic acid test but negative urine protein dip stick

Immunoglobulin light chains or nonalbumin proteinuria (either)

524

Glomerular disease classically associated with solid tumors

Membranous nephropathy

525

Metabolic condition associated with malabsorption causing nephrolithiasis

Hyperoxaluria or hypocitraturia (either)

526

Arrhythmia characterized by 3 or more morphological patterns of P waves and variable PR intervals

Multifocal atrial tachycardia

527

Therapeutic Intervention of choice for symptomatic non-calcified mitral stenosis

Balloon valvuloplasty

528

Syndrome associated with pseudo-RBBB pattern and ST elevation in V1-V3

Brugada syndrome

529

Treatment of choice for recurrent pericarditis

Colchicine

530

Drug combination to treat Kawasaki disease

Aspirin and gamma globulin

531

Non-drug intervention that increases exercise tolerance in patients with COPD

Pulmonary rehabilitation

532

Recommended sleep position for patients with obstructive sleep apnea

Lateral (naming one side is acceptable)

533

Hemoglobin abnormality associated with falsely elevated oxygen saturation on pulse oximetry

Carboxyhemoglobin or methemoglobinemia (either)

534

Diagnosis for a nonimmunologic bronchial hyperresponsive reaction to an inhaled irritant

Reactive airways dysfunction syndrome (accept RADS)

535

A potentially fatal obstructive pulmonary disorder associated rheumatoid arthritis

Bronchiolitis obliterans

536

Skin lesion that is devoid of melanocytes and intraepidermal melanin pigment

Vitiligo

537

Main topical treatment for comedonal-only acne

Topical retinoid

538

Characteristically associated with "spaghetti and meatball" pattern on KOH preparation of scale

Tinea versicolor

539

Name of rash associated with acute rheumatic fever

Erythema marginatum

540

Eponym for a pustular neutrophilic dermatitis, fever, arthritis, and leukocytosis

Sweet syndrome

541

Initial drug therapy for pituitary apoplexy

Corticosteroid therapy

542

Physical examination finding in adolescent female that confirms estrogen production

Breast development

543

Diabetic complication caused by progressive loss of epinephrine and glucagon response to hypoglycemia

Hypoglycemic unawareness

544

Antibody most commonly associated with Hashimoto thyroiditis

Thyroid peroxidase antibody

545

Diagnosis associated with microcalcifications within a thyroid nodule

Papillary carcinoma

546

Bone disease associated with aromatase inhibitors

Osteopenia and osteoporosis (either

547

Condition characterized by persistent rhinitis in the setting of chronic use of nasal decongestant

Rhinitis medicamentosa

548

Neuraminidase inhibitor that is contraindicated in asthma

Zanamivir

549

Class of drug associated with the development of compulsive behaviors

Dopamine agonist (accept bromocriptine, pramipexole, ropinirole)

550

Skin disease that is an FDA-approved indication for thalidomide

Erythema nodosum leprosum (accept leprosy)

551

Common inotropic drug that causes ST-segment depression

Digoxin

552

Congenital valve disorder associated with aortic coarctation

Bicuspid aortic valve

553

Class of antihypertensive drug associated with increased risk of CHF

Alpha-blockers

554

Vasculitis associated with IgA immune-complex deposition

Henoch-Schönlein purpura

555

The most common residua after repair of tetralogy of Fallot

Pulmonary valve regurgitation

556

Auditory complication of acute salicylate poisoning

Tinnitus or deafness (either one)

557

Urine crystals (mineral) associated with ethylene glycol poisoning

Calcium oxalate crystals

558

Cause of histotoxic hypoxia due to mitochondria poisoning

Hydrogen cyanide

559

Fish most commonly responsible for scombrotoxic fish poisoning

Tuna, mackerel, bonito, and skipjack (any 1)

560

Probable poisoning responsible for "mad as a hatter" syndrome in Alice in Wonderland

Mercury poisoning

561

Rheumatologic syndrome associated with Yersinia enterocolitica

Reactive arthritis (accept Reiter syndrome)

562

Diagnosis for lateral hip pain that worsens with resisted abduction of the hip

Trochanteric bursitis

563

Disease associated with subcutaneous calcium deposits under pressure surfaces

Scleroderma

564

Name of deforming but nonerosive arthropathy associated with SLE

Jaccoud arthropathy

565

A psoriasis-like skin lesion on palms and soles associated with reactive arthritis

Keratoderma blennorrhagicum

566

Recommended colon cancer screening interval with flexible sigmoidoscopy for average risk individuals

Every 5 years

567

Liver disease associated with type 1 diabetes mellitus, thyroiditis, and celiac sprue

Autoimmune hepatitis

568

The most common nonmalignant hepatic tumor

Follicular nodular hyperplasia

569

Malabsorption syndrome associated with increased risk for intestinal lymphoma

Celiac disease (accept Crohn disease)

570

Mechanism of acute varicocele associated with renal carcinoma

Obstruction of the testicular vein

571

Monoclonal antibody that reduces mortality in early-stage, HER2-positive breast cancer

Trastuzumab

572

The infectious agent causing nasopharyngeal carcinoma

EBV

573

Tumor associated with severe, watery diarrhea, flushing, hypokalemia, hypercalcemia, and hyperglycemia

Vasoactive intestinal peptide tumor

574

Vitamin deficiency syndrome associated with carcinoid syndrome

Pellagra (accept niacin, vitamin B3 or nicotinic acid deficiency)

575

Eponym for retracting the knees to the chest when neck is flexed

Brudzinski sign

576

Neurodegenerative disease associated with micrographia

Parkinson

577

Physical finding on back of the hand that is associated with bulimia

Calluses, scarring or ulceration over dorsum of hand (accept any one)

578

Anterior midline mass that moves upward with the tongue is protruded

Thyroglossal cyst

579

Physical examination sign defined as spinal or limb paresthesias elicited by neck flexion

Lhermitte sign

580

Name of exercise recommended for urge, stress, and mixed incontinence

Pelvic muscle exercises or Kegel exercise (either)

581

Cancer associated with lichen sclerosis

Vulvar cancer (accept squamous cell carcinoma)

582

Chronic anovulation results in this endometrial change

Endometrial hyperplasia or malignancy (accept either)

583

Amsel criteria are used to diagnose this disorde

BV

584

Diagnosis suggested by dyspareunia and punctate ulcers around the Bartholin glands

Vulvar vestibulitis

585

Diagnosis for febrile illness characterized by a vesicular eruption involving the mouth, hands, and feet

Hand, foot, and mouth disease (accept Enterovirus infection)

586

Non-gastrointestinal complication of E. coli O157:H7 infection

Hemolytic-uremic syndrome (accept TTP) or reactive arthritis (accept Reiter syndrome)

587

Source of rabies in US patients without obvious inoculation

Bats

588

Name of syphilitic lesions in intertriginous areas characterized by moist, white plaques

Condylomata lata

589

Infection classically associated with hemorrhagic mediastinitis

Anthrax

590

Genitourinary source of this cellular structure found in the urine Glomerulus (dysmorphic erythrocytes)

Glomerulus

591

Most common condition responsible for pseudohyponatremia

Hyperlipidemia and multiple myeloma (either answer)

592

Cause of proteinuria in young healthy male with normal BP, creatinine, BUN and microscopic urinalysis

Orthostatic proteinuria

593

Most common cardiac valve abnormality associated with autosomal dominant polycystic kidney disease

Mitral valve prolapse

594

Diagnosis for these urine crystals [coffin lid]

Struvite (accept triple phosphate)

595

Name for zone of ischemic, viable brain tissue following an ischemic stroke

Ischemic penumbra or watershed

596

Common name for syndrome characterized by quadriplegia and paralysis of horizontal eye movements

Locked in syndrome

597

Anatomical location of the lesion responsible for internuclear ophthalmoplegia

Medial longitudinal fasciculus

598

Diagnosis for dementing syndrome characterized primarily by impairment of interpersonal and executive function

Frontotemporal Dementia

599

CSF protein 14-3-3 is associated with this condition

Creutzfeldt-Jacob dementia

600

Part of the macula that is the point of visual fixation

The fovea

601

Mechanism by which topical beta-blockers reduce intraocular pressure

Reduction of aqueous humor secretion

602

Agent causing conjunctivitis and umbilicated papular lesions on lid margins

Molluscum contagiosum

603

Meaning of metamorphopsia

Seeing wavy or distorted lines

604

Physical examination hallmark of endophthalmitis

Hypopyon (accept pus in anterior chamber)

605

Pickwickian syndrome refers to this condition

Obesity hypoventilation syndrome

606

Stage 2 chest x-ray findings in sarcoidosis

Adenopathy plus infiltrates

607

Antibody implicated in TRALI syndrome

Antileukocytic antibody

608

Name of memory disturbance associated with GABA agonists for sleep

Anterograde amnesia

609

The most specific symptom of narcolepsy

Cataplexy

610

Diagnosis for nonseasonal rhinitis and negative allergy skin tests

Vasomotor rhinitis

611

Disease associated with Jarisch-Herxheimer reaction

Syphilis

612

Congential immune deficiency syndrome classically associated with recurrent infection with encapsulated bacteria

Common variable immunodeficiency

613

Immune disease associated with abnormal nitroblue tetrazolium dye test

Chronic granulomatous disease

614

Eponym describing urticarial lesions that worsen when stroked

Darier sign

615

Diagnosis characterized by flushing and persistent central facial erythema

Rosacea

616

Blistering disease associated with intercellular antibody and complement deposition

Pemphigus vulgaris

617

Psoriatic-like genital lesion associated with reactive arthritis

Circinate balanitis

618

Diagnosis associated with elevated LDL, tendinous xanthoma, and family history of early cardiovascular death

Familial hypercholesterolemia (or, type 2)

619

Hypoglycemic drug that decreases GI absorption of carbohydrates

Acarbose

620

Provocative test to assess estrogen status in secondary amenorrhea

Progestogen challenge

621

Syndrome of gynecomastia, small testes, and hypergonadotropic hypogonadism

Klinefelter syndrome

622

Pituitary disorder associated with colon polyps and colon cancer

Acromegaly

623

Primary therapy for common variable immunodeficiency

Immunoglobulin replacement therapy

624

Immune deficiency that poses risk of allergic reaction to transfused plasma

IgA deficiency

625

Type of physical urticaria that means "to write on the skin"

Dermographism (accept dermatographism)

626

Drug class used to prevent recurrences of angioedema in patients with hereditary angioedema

Androgens (also accept synthetic 17-alpha alkylated androgens, or danazol, stanozolol oxandrolone, oxymetholone, methyltestosterone)

627

Drug for epinephrine refractory anaphylaxis in patients taking beta-blockers

Glucagon

628

Diagnosis for asymptomatic unconjugated hyperbilirubinemia and normal hemoglobin and liver chemistry tests

Gilbert disease

629

Most common physical examination finding associated with Barrett esophagus

Obesity (accept BMI > 25)

630

Alternative medication to antibiotics in mild traveler's diarrhea

Bismuth subsalicylate

631

Restricted drug for irritable bowel syndrome associated with ischemic colitis

Alosetron

632

Drug class that decreases the risk of cholecystitis in acute biliary colic

Nonsteroidal anti-inflammatory drug

633

Drug causing von Willebrand factor to be released from storage sites

Desmopressin (accept DDAVP, arginine vasopressin)

634

A two-gene defect [(--/--), (α/α)] produces this thalassemia variant

α-thalassemia

635

Blood banking procedure to prevent primary alloimmunization to HLA antigens

Leukocyte reduction (accept Leukopore filter)

636

Drug treatment for erythromelalgia

Aspirin

637

Diagnosis for IgM antibodies directed against RBC I/i antigens

Cold agglutinin disease

638

The most common symptom of scabies

Itching

639

Common drug that exacerbates chronic idiopathic urticaria

Aspirin (accept NSAIDs)

640

Topical drug treatment for superficial basal cell carcinoma

Imiquimod or 5-fluorouracil (either acceptable

641

Most frequent side-effect of isotretinoin

Dry lips and eyes (accept dry skin)

642

Syndrome of familial hypercalcemia and low urine calcium level

Familial benign hypocalciuric hypercalcemia (accept familial hypocalciuric hypercalcemia)

643

Diagnosis in a hyperosmolar patient with an elevated level of arginine vasopressin

Nephrogenic diabetes insipidus

644

Isthmus of thyroid gland is inferior to this cartilage

Cricoid cartilage

645

Best drug class to restore fertility in women with prolactinoma

Dopamine agonist (accept bromocriptine or cabergoline)

646

Mechanism of type 1 amiodarone-induced thyrotoxicosis

Iodine-induced thyrotoxicosis

647

The ossicles conduct vibration from the ear drum to this structure

Cochlea

648

Endolymphatic hydrops is associated with this disease

Meinier Disease

649

Condition associated with otoliths in semicircular canal

Benign positional vertigo

650

Eponym for acute onset of interstitial keratitis and vestibuloauditory dysfunction

Cogan syndrome

651

Environmental cause of auricular calcification

Frostbite (accept hypothermia, cold exposure)

652

Device that reduces afterload and increases coronary perfusion

Intra-aortic balloon pump

653

MI location most commonly associated with papillary muscle rupture

Inferior wall

654

First-line drug for congenital long QT syndrome

β-blocker

655

Mechanism responsible for the pacemaker syndrome

Atrioventricular dyssynchrony (accept dyssynchrony)

656

Anatomical location of pancreatic cancer associated with obstructive jaundice

Head of pancreas

657

Second most common cause of cancer death in the U.S.

Colorectal cancer

658

Surgical intervention associated with increased risk of renal cancer

Renal transplantation

659

Stage classification for a patient with small-cell lung cancer involving both lungs

Extensive (accept stage IV)

660

A tripartite benign tumor composed of blood vessel, muscle, and fat elements

Angiomyolipoma (accept hamartoma)

661

Device that prevents 50% of unintentional carbon monoxide poisonings

Carbon monoxide detector

662

Time after acetaminophen overdose when aminotransferase levels begin to rise

36 hours (accept any answer within 24 to 72 hours range)

663

Cause of bright red venous blood due to mitochondria poisoning

Hydrogen cyanide

664

Acute metal exposure associated with abdominal colic, headache, and fatigue

Lead

665

Stimulation of this parasympathetic receptor produces salivation, bronchorrhea, and bronchospasm

Muscarinic

666

Look up picture of..

Keratoacanthoma

667

Look up picture of..

paget disease of the breast

668

Look up picture of renal failure skin finding..

uremic frost

669

Most common cause of goiter worldwide

Iodine deficiency

670

Dietary syndrome characterized by hypercalcemia, metabolic alkalosis, and renal failure

Milk-alkali syndrome

671

Ovarian disorder associated with polyglandular autoimmune syndrome

Ovarian failure

672

Most common endocrine expression of the MEN 2A syndrome

Medullary thyroid cancer

673

Eponym for the most common inherited glycosphingolipid metabolism disorder

Fabry Disease

674

Diagnosis for intestinal villous atrophy and positive antiendomysial antibody

Celiac sprue

675

Liver tumor associated with oral contraceptive

Hepatic adenomas

676

Immune deposit associated with dermatitis herpetiformis

IgA

677

Defining imaging characteristic of hepatic follicular nodular hyperplasia

Central scar

678

Syndrome of colonic polyps, benign soft tissue, skin, bone, and desmoid tumors

Gardner syndrome

679

Most common secondary cause of tricuspid regurgitation

Pulmonary hypertension

680

STD associated with thoracic aortic aneurysm formation

Syphilis

681

Cause of coronary arteritis in children

Kawasaki disease

682

Type of urinary incontinence associated with sudden need to void

Urge incontinence

683

Age criteria for routine Chlamydia screening in sexually active women

25 years or younger

684

Most likely diagnosis for this normal cervical finding [redness around the os]

Cervical ectopy (accept ectropion)

685

First-line drug class to reduce PMS symptoms

SSRIs (accept a member drug within class)

686

Vulvar lichen sclerosis predisposes to this malignant condition

Vulvar squamous cell carcinoma

687

Diagnosis of purpura of the legs [look up picture of]

asculitis (accept leukocytoclastic vasculitis)

688

Jaccoud arthropathy is primarily associated with this collagen vascular disease

SLE

689

Diagnosis for hypogammaglobulinemia and recurrent bacterial infections

Common variable immune deficiency

690

Infection characteristically associated with terminal complement deficiency

Neisseria (accept N. gonorrhea or meningitidis)

691

Immune deficiency that is contraindication to IV immunoglobulin therapy

IgA deficiency

692

Hypersensitivity reaction associated with chronic transplant rejection

Type IV hypersensitivity

693

Diagnosis suggested by galactorrhea and amenorrhea

Prolactinoma

694

Most common cause of goiter and hypothyroidism in USA

Hashimoto disease

695

Fasting glucose range for "impaired fasting glucose"

100-125 mg/dL

696

Drug that inhibits thyroid peroxidase

Methimazole and propylthiouracil (either answer)

697

Diabetes in elderly resulting from autoimmune beta-cell failure

Latent autoimmune diabetes in adults (accept LADA)