BLOCK 3 FINALS REVIEW Flashcards
(375 cards)
1
Q
What does PVC stand for on an ECG?
A
Premature ventricular contraction.
2
Q
What arrhythmia is characterized by sawtooth flutter waves?
A
Atrial flutter.
3
Q
What ECG syndrome can cause sudden cardiac death and shows a coved ST segment?
A
Brugada syndrome.
4
Q
What electrolyte imbalance is commonly caused by vomiting?
A
Hypokalemia.
5
Q
What lab test helps rule out congestive heart failure?
A
BNP (B-type natriuretic peptide).
6
Q
What ECG finding is associated with acute pericarditis?
A
Diffuse ST elevation and PR depression.
7
Q
What rhythm is described as irregularly irregular with a variable rate?
A
Atrial fibrillation.
8
Q
What is the term for a wide-complex tachycardia with no P waves?
A
Ventricular tachycardia (V tach).
9
Q
What is the appropriate monitor for transient cardiac symptoms in a 24-year-old?
A
30-day event monitor.
10
Q
What test is appropriate for a 62-year-old with chest pain relieved by nitroglycerin?
A
Stress test with ECG.
11
Q
What test uses plethysmography for arterial flow assessment?
A
Arterial study with plethysmography.
12
Q
What electrolyte is often associated with ventricular arrhythmias if low?
A
Magnesium.
13
Q
What condition causes orthopnea and paroxysmal nocturnal dyspnea?
A
Heart failure with reduced ejection fraction (HFrEF).
14
Q
Where is the murmur of mitral regurgitation best heard?
A
At the cardiac apex.
15
Q
What ECG change suggests right atrial enlargement?
A
Tall peaked P waves in lead II.
16
Q
What ECG finding indicates left ventricular hypertrophy?
A
Large S wave in V1 + R wave in V5 or V6 > 35 mm.
17
Q
What is the normal upper limit for a PR interval?
A
Less than 200 ms.
18
Q
What imaging test assesses coronary calcium score?
A
Cardiac CT for calcium scoring.
19
Q
What condition presents with angina but no ST elevation or enzyme elevation?
A
Unstable angina.
20
Q
What is the normal QT interval for women?
A
Less than 460 ms.
21
Q
What ECG component corresponds to ventricular repolarization?
A
T wave.
22
Q
What imaging test visualizes coronary arteries directly?
A
Coronary angiography.
23
Q
What ECG finding is pathognomonic for WPW?
A
Delta wave (slurred upstroke of QRS).
24
Q
The J point must be elevated above what for concern?
A
Above the PR segment.
25
What is the first-line imaging for suspected endocarditis?
Transthoracic echocardiogram (TTE).
26
What do you do if a TTE is negative but endocarditis is still suspected?
Transesophageal echocardiogram (TEE).
27
What radiologic sign is seen with pericardial effusion on CXR?
Water bottle heart sign.
28
What CXR finding is suggestive of aortic dissection?
Widened mediastinum.
29
What imaging confirms thoracic aortic aneurysm?
Chest CT.
30
What does 'reversible ischemia' on nuclear medicine stress test indicate?
Positive stress test.
31
Which lipid panel value is most concerning?
Elevated LDL.
32
What ABI value indicates peripheral artery disease?
ABI < 0.9.
33
How much time does one small ECG box represent?
40 milliseconds (ms).
34
Using the 300-150-100 rule, what was the heart rate?
Around 65–70 bpm.
35
What defines sinus bradycardia?
Heart rate < 60 bpm.
36
When is a sinus pause concerning?
If it lasts longer than 3 seconds.
37
Which ECG lead should be negative?
aVR.
38
What congenital defect involves a hole between atria?
Atrial septal defect.
39
What is an ectopic ventricular rhythm faster than escape but slower than V tach?
Accelerated idioventricular rhythm.
40
What is a junctional rhythm with a rate of 60–100 bpm?
Accelerated junctional rhythm.
41
What EKG finding can be seen with lateral MI?
Right axis deviation.
42
What ECG finding suggests prior MI?
Pathologic Q waves.
43
What axis deviation is concerning on EKG?
Left axis deviation.
44
What ECG finding is common with pulmonary embolism?
Sinus tachycardia.
45
Which leads are contiguous for lateral MI?
Leads I, aVL, V5, V6.
46
What is bigeminy?
Every other beat is a PVC or PAC.
47
How is an anterior vs. posterior MI localized?
Anterior = V1–V4, posterior = reciprocal changes in V1–V2.
48
What does the QRS complex represent?
Ventricular depolarization.
49
What coronary artery is involved in inferior STEMI?
Right coronary artery (RCA).
50
What coronary artery is involved in anterior STEMI?
Left anterior descending artery (LAD).
51
What radiologic sign of CHF is visible on CXR?
Cephalization of pulmonary vessels.
52
What two CXR findings suggest CHF?
Kerley B lines and cardiomegaly.
53
When should a patient NOT undergo a stress test?
If asymptomatic and low pretest probability.
54
What is Wenckebach?
Mobitz type I second-degree AV block.
55
What EKG finding defines third-degree heart block?
P waves and QRS complexes are independent.
56
What imaging should be done for a new murmur?
Transthoracic echocardiogram (TTE).
57
What can cause dilutional anemia in hospitalized patients?
Hemodilution from IV fluids.
58
Which coagulation test results are prolonged in Factor V deficiency?
Both PT/INR and PTT are prolonged.
59
What lab test is used after surgery to investigate abnormal coagulation in a woman?
Plasma mixing study.
60
What test helps differentiate CML from leukemoid reaction?
Leukocyte alkaline phosphatase (LAP); low in CML.
61
A woman with heavy periods has anemia. What is the most likely cause?
Iron deficiency anemia.
62
How many blasts on a peripheral smear indicate acute leukemia?
20% or more blasts.
63
A 1-year-old with elevated ALA should have what confirmatory test?
Blood lead level.
64
Peripheral smear shows spherocytes. What is the diagnosis?
Hereditary spherocytosis.
65
What does hemoglobin electrophoresis measure?
Types of hemoglobin: Hgb A, Hgb F, Hgb A2.
66
What findings are seen in alpha thalassemia on a smear?
Target cells and Heinz bodies.
67
What lymphocyte finding is classic for chronic lymphocytic leukemia (CLL)?
Smudge cells.
68
What finding on smear is diagnostic of acute myeloid leukemia (AML)?
Auer rods.
69
What cell type is characteristic of Hodgkin lymphoma?
Reed-Sternberg cells.
70
What clotting factor is part of the intrinsic pathway?
Factor XI.
71
What is a normal adult hemoglobin value?
Hgb ~16.2 g/dL.
72
What findings are associated with sideroblastic anemia?
Ringed sideroblasts and Pappenheimer bodies with high iron and ferritin.
73
What red cell findings are seen in a G6PD crisis after infection or drug exposure?
Bite cells and Heinz bodies.
74
What score helps assess risk of HIT (heparin-induced thrombocytopenia)?
4T score.
75
Which labs are used to evaluate macrocytic anemia?
Folate, methylmalonic acid, and homocysteine.
76
What factor is involved in von Willebrand disease with gingival bleeding?
Von Willebrand factor.
77
What is the significance of a low platelet count?
Increased risk of bleeding.
78
What causes decreased haptoglobin in hemolysis?
It binds free hemoglobin, so levels fall in hemolytic anemia.
79
What red cell inclusion is seen in sickle cell disease?
Howell-Jolly bodies.
80
What does hemoglobin electrophoresis show in sickle cell trait?
Hgb A and Hgb S.
81
If 30% of WBCs are lymphocytes with no infection, what is suspected?
Lymphocytosis, possibly viral or chronic lymphocytic leukemia.
82
What is the diagnosis for a child with bloody diarrhea, jaundice, and renal failure?
Hemolytic uremic syndrome (HUS).
83
What type of anemia results from a low folate diet?
Macrocytic anemia.
84
What are the early findings in iron deficiency anemia?
Normocytic anemia before it becomes microcytic.
85
What iron panel findings are seen in anemia of chronic inflammation?
Low serum iron, low TIBC, high ferritin.
86
What are the globin chains in Hgb A2?
2 alpha and 2 delta chains.
87
What are the globin chains in adult hemoglobin A?
2 alpha and 2 beta chains.
88
What is a classic finding in idiopathic thrombocytopenic purpura (ITP)?
Petechiae or shin bleeding from low platelets.
89
What is a common thrombophilia in a young adult with clots?
Factor V Leiden.
90
What lab is used to monitor warfarin?
PT/INR.
91
What is included in a type and crossmatch?
Patient’s blood type and antibody screen for transfusion.
92
What antibodies are present in type A blood?
Anti-B antibodies.
93
What lab finding is elevated in disseminated intravascular coagulation (DIC)?
D-dimer.
94
What antibodies are present in type B blood?
Anti-A antibodies.
95
What term describes variation in red blood cell shape?
Poikilocytosis.
96
What smear finding confirms hemolytic transfusion reaction?
Schistocytes.
97
What test is done for painless axillary or inguinal lymphadenopathy?
Lymph node biopsy.
98
What genetic finding is diagnostic of chronic myeloid leukemia?
Philadelphia chromosome (t(9;22)).
99
What tests should be ordered for microcytic anemia?
Iron panel and peripheral blood smear.
100
What does a positive direct Coombs test indicate?
Autoimmune hemolytic anemia.
101
What factor is part of the extrinsic clotting pathway?
Factor VII.
102
What condition is suspected in an older adult with recurrent DVTs and family history?
Factor V Leiden.
103
What test shows an M spike for plasma cell myeloma?
Serum protein electrophoresis (SPEP).
104
What mnemonic helps recall symptoms of TTP?
FAT RN: Fever, Anemia, Thrombocytopenia, Renal failure, Neurologic symptoms.
105
What imaging is preferred to diagnose small bowel obstruction?
CT scan of the abdomen and pelvis.
106
What does diverticulosis typically look like on colonoscopy?
Multiple diverticula (outpouchings) seen in the colon, especially sigmoid.
107
What imaging finding suggests pancreatic cancer?
Hypodense mass in the pancreatic head on CT.
108
What does GERD-induced esophagitis look like on EGD?
Erythema, erosions, and friability of the distal esophagus.
109
What finding on barium swallow is diagnostic of achalasia?
Bird beak appearance due to narrowed LES.
110
What manometry findings support achalasia?
Incomplete LES relaxation and absent peristalsis.
111
What is a common cause of gastric ulcers on EGD?
Helicobacter pylori infection.
112
What test is used to evaluate suspected gastroparesis?
Gastric emptying study.
113
Which noninvasive test is preferred for active H. pylori infection?
Urea breath test.
114
Which lab pattern indicates immunity to hepatitis B due to vaccination?
Positive anti-HBs, negative anti-HBc.
115
What two labs help assess for hemolysis?
LDH (elevated) and haptoglobin (decreased).
116
What test should be ordered in a patient with iron deficiency anemia?
Guaiac stool test to evaluate for occult GI bleeding.
117
What diagnosis presents with painless jaundice and cholestasis but no signs of acute illness?
Cholangiocarcinoma (bile duct cancer).
118
What lab can support the diagnosis of Crohn’s disease?
Fecal calprotectin or elevated WBCs.
119
What lab is often low in alcohol-related liver disease?
Albumin.
120
What is the next diagnostic step for GI bleeding not found on endoscopy or colonoscopy?
Video capsule endoscopy.
121
What antibody is tested for suspected celiac disease?
Anti-tissue transglutaminase IgA.
122
What nuclear medicine scan detects active GI bleeding?
Tagged red blood cell scan.
123
What should be checked after acute mesenteric ischemia to assess organ function?
Serum creatinine (for chronic kidney disease).
124
Which hepatitis virus depends on co-infection with hepatitis B?
Hepatitis D.
125
What is a key imaging finding of acute mesenteric ischemia?
Bowel wall thickening and lack of enhancement on CT.
126
What non-invasive test screens for colon cancer annually?
Cologuard or fecal immunochemical test.
127
What is the next step if a fecal occult blood test is positive?
Colonoscopy.
128
What is a common pathogen in bloody diarrhea outbreaks?
Shigella.
129
What bacterial infection causes HUS in children with bloody diarrhea?
E. coli O157:H7.
130
What is the test of choice for parasitic causes of diarrhea in travelers?
Stool antigen and ova and parasites.
131
What test should be ordered for altered mental status and suspected hepatic encephalopathy?
Hepatic function panel.
132
What condition presents with confusion and asterixis in liver disease?
Hepatic encephalopathy.
133
What labs should be drawn for a septic patient requiring IV fluids and antibiotics?
CMP, blood cultures, lactate.
134
What coagulation finding may be seen in fatty liver or cirrhosis?
Elevated PT/INR.
135
What abdominal CT finding is associated with cirrhosis?
Ascites.
136
What imaging may show an esophageal mass?
Chest X-ray or barium swallow.
137
What study evaluates for oropharyngeal dysphagia after pneumonia?
Modified barium swallow.
138
What antibody is positive in primary biliary cholangitis?
Anti-mitochondrial antibody.
139
Which labs assess synthetic liver function?
Albumin, PT/INR, and platelets.
140
Elevated IgM but not IgG suggests what type of hepatitis?
Acute hepatitis (IgM for recent infection).
141
What SAAG value suggests portal hypertension as the cause of ascites?
SAAG >1.1.
142
What lab value in ascitic fluid supports spontaneous bacterial peritonitis?
PMN count >250.
143
What are the screening tests for hepatitis C?
Hepatitis C antibody or HCV RNA (viral load).
144
What is the best test to confirm NASH or fatty liver disease?
Liver biopsy.
145
Which hepatitis viruses can become chronic?
Hepatitis B, C, and D.
146
What test detects pancreatic insufficiency in chronic pancreatitis?
Fecal fat test.
147
What imaging suggests gastric outlet obstruction?
Air-fluid levels and distended stomach on X-ray.
148
What procedure should be done for vomiting blood or coffee-ground emesis?
Esophagogastroduodenoscopy (EGD).
149
What does a suspicious lesion on colonoscopy likely indicate?
Colon cancer or colonic mass.
150
What test is done for gallstones with elevated bilirubin or cholangitis?
Endoscopic retrograde cholangiopancreatography (ERCP).
151
What bowel diameter suggests cecal dilation or obstruction?
Cecum >12 cm is concerning.
152
What imaging finding suggests perforation of a peptic ulcer?
Extraluminal (free) air under the diaphragm on X-ray.
153
Which lab finding indicates acute kidney injury (AKI)?
Elevated serum creatinine.
154
What lab finding suggests CKD from diabetic nephropathy?
Elevated BUN and creatinine.
155
What imaging shows a horseshoe kidney?
CT abdomen with renal protocol.
156
What imaging finding suggests vesicoureteral reflux?
Retrograde flow of contrast from bladder into ureters on VCUG.
157
What imaging shows enlarged kidneys with multiple cysts?
Polycystic kidneys on CT or ultrasound.
158
What test should be done for unilateral testicular pain?
Scrotal ultrasound with Doppler.
159
What is the next step for overactive bladder symptoms refractory to medications?
Refer to urology for urodynamic testing.
160
What diagnosis is likely with weight loss, hematuria, RBC casts, and no WBCs?
Renal cell carcinoma.
161
Is prostate cancer screening recommended for a healthy 34-year-old?
No, not recommended under age 55.
162
What imaging is safest for suspected renal mass in stage 4 CKD?
Renal ultrasound (avoids contrast).
163
What hormone test should be ordered in male infertility with small firm testes?
Testosterone.
164
What test follows persistent proteinuria on two UA samples?
24-hour urine protein collection.
165
What gram-negative lactose-fermenting organism causes UTI?
Klebsiella.
166
What gram-positive cocci cause UTI seen on UA?
Enterococcus.
167
What is the most common cause of UTI with positive nitrites and leukocyte esterase?
E. coli.
168
What lab finding is expected in a dehydrated patient?
High urine osmolality.
169
What lab finding is seen in hemolytic anemia but not in liver disease?
Urobilinogen in urine, no bilirubin.
170
What does hemoglobinuria without RBCs suggest?
Rhabdomyolysis.
171
What urine finding is seen in nephrotic syndrome with swelling?
Fatty casts or cholesterol crystals.
172
What crystal is seen with ethylene glycol poisoning?
Calcium oxalate crystals.
173
How is a UTI diagnosed in pregnancy?
Urine culture with >100,000 CFU.
174
Does a woman with dysuria and culture <10,000 CFU need antibiotics?
No, not a confirmed UTI.
175
What do BUN:Cr > 20:1 and FENa < 1% suggest?
Pre-renal AKI from hypoperfusion (e.g., sepsis).
176
What do normal BUN:Cr and high FENa suggest?
Acute tubular necrosis (ATN).
177
What is the next step after unexplained kidney injury with normal labs?
Kidney biopsy.
178
What is indicated by a rising PSA?
Biopsy and imaging for prostate cancer.
179
What diagnosis presents with bone pain, proteinuria, and M spike?
Multiple myeloma.
180
What infection precedes post-streptococcal glomerulonephritis?
Streptococcal pharyngitis or skin infection.
181
What phosphate level is seen in CKD?
Hyperphosphatemia.
182
What antibody is positive in Goodpasture syndrome?
Anti-glomerular basement membrane antibodies.
183
What finding on CT identifies the left kidney?
Labeled as structure A.
184
What ABG value indicates hypoxia?
O2 saturation < 90%, e.g., 66%.
185
What ABG finding indicates diabetic ketoacidosis?
High anion gap metabolic acidosis with high glucose.
186
What acid-base imbalance is caused by vomiting?
Metabolic alkalosis.
187
What does an ABG with respiratory acidosis and AG of 21 indicate?
High anion gap metabolic acidosis (HAGMA).
188
What UA finding suggests acute interstitial nephritis (AIN)?
WBC casts.
189
What labs are monitored in CKD?
CBC, BMP, urine protein.
190
What finding suggests kidney damage from long-standing hypertension?
Elevated creatinine or proteinuria.
191
What screening should be done for diabetes-related kidney disease?
Urine protein or albumin-to-creatinine ratio.
192
What are the types of metabolic acidosis?
High anion gap (HAGMA) and normal anion gap (NAGMA).
193
What CKD stage corresponds with GFR of 22?
Stage 4 CKD.
194
What UA findings suggest glomerulonephritis?
+ blood, RBC casts, dysmorphic RBCs.
195
What cast type is classic for ATN?
Muddy brown casts.
196
What test is both diagnostic and therapeutic in urology?
Cystoscopy.
197
How is a renal cyst diagnosed?
Ultrasound.
198
What causes ketonuria with no other abnormal UA findings?
Low-carb/high-protein diet (e.g., keto diet).
199
A lateral ankle X-ray showed severe bone erosion. What is the likely diagnosis?
Osteomyelitis.
200
Which carpal bone is found at the base of the 4th and 5th metacarpals?
Hamate.
201
What joint connects the clavicle to the acromion of the scapula?
AC joint (acromioclavicular joint).
202
Which bone is medial in the midfoot near the first metatarsal?
Medial cuneiform.
203
What structure is found on the inner part of the lower femur?
Medial condyle of the femur.
204
Which part of the humerus is fractured in medial epicondyle injury?
Medial epicondyle.
205
What pelvic fracture causes anterior and posterior pelvic widening?
Open-book pelvic fracture.
206
Which hip dislocation shows femoral head displaced anteriorly?
Anterior femoral dislocation.
207
Which pediatric hip condition shows femoral head slippage at the growth plate?
Slipped capital femoral epiphysis (SCFE).
208
What structure is the socket of the hip joint?
Acetabulum.
209
What fracture occurs at the 5th metacarpal neck?
Boxer’s fracture.
210
What fracture occurs at the base of the 5th metatarsal?
Jones fracture.
211
What is volar displacement on wrist X-ray?
Anterior displacement of a fracture fragment.
212
What type of fracture spirals along the femur?
Spiral fracture.
213
What does fat pad separation in the knee suggest?
Joint effusion.
214
What is the anterior fat pad sign?
Dark shadow anterior to the humerus indicating joint effusion.
215
What type of clavicle fracture involves ends no longer aligned?
Translation (displacement).
216
What is an odontoid type II fracture?
Fracture at the base of the dens (C2).
217
What indicates a C1 burst fracture on imaging?
Lateral masses displaced outward.
218
What is a Salter-Harris type III fracture?
Fracture through growth plate and epiphysis.
219
What type of shoulder dislocation shows humeral head anterior to glenoid?
Anterior shoulder dislocation.
220
What spinal fracture results from flexion-distraction injury?
Chance fracture.
221
What compression fracture affects the vertebral body?
T12 compression fracture.
222
What line helps evaluate vertebral alignment on lateral spine X-ray?
Spinolaminar line.
223
What bone tumor shows 'popcorn calcification' on X-ray?
Chondrosarcoma.
224
What bone tumor affects diaphysis and is common in children?
Ewing sarcoma.
225
What tumor shows sunburst periosteal reaction on X-ray?
Osteosarcoma.
226
What spinal condition involves anterior slippage of vertebrae?
Spondylolisthesis.
227
What is the next test after positive ANA and butterfly rash?
Anti-dsDNA and anti-Sm antibodies.
228
What imaging detects bone metastases in breast cancer?
Nuclear medicine bone scan.
229
What does a DEXA score of -3.0 indicate?
Severe osteoporosis.
230
What test follows positive ANA, anti-dsDNA, and anti-Sm?
Anticardiolipin and lupus anticoagulant tests.
231
What X-ray finding is classic for psoriatic arthritis?
Pencil-in-cup deformity.
232
What joints are commonly affected in rheumatoid arthritis?
MCP and PIP joints.
233
What HLA type is associated with ankylosing spondylitis?
HLA-B27.
234
What test is needed for joint bleeding in a child?
PT/INR and PTT.
235
What inflammatory myopathy causes difficulty painting or lifting?
Polymyositis.
236
What lab is elevated in polymyositis?
Creatine phosphokinase (CPK).
237
What imaging evaluates spinal stenosis if MRI is contraindicated?
CT myelography.
238
What is the initial imaging for chronic neck pain and radiculopathy?
Cervical spine X-ray series.
239
What condition presents with diffuse pain, fatigue, and 'fibro fog'?
Fibromyalgia.
240
What diagnosis follows joint pain after a URI?
Reactive arthritis.
241
What antibody is ordered for dermatomyositis with rash?
Anti-Jo-1 antibody.
242
What antibody is seen in systemic sclerosis (scleroderma)?
Anti-Scl-70, ANA, anti-topoisomerase.
243
What antibodies are seen in Sjögren’s syndrome?
Anti-Ro (SSA) and Anti-La (SSB).
244
What test follows a high ANA titer?
Lupus workup (anti-dsDNA, anti-Sm).
245
What crystals appear blue on arthrocentesis?
Calcium pyrophosphate (CPPD).
246
What antibody is highly positive in mixed connective tissue disease?
Anti-RNP.
247
What diagnosis causes difficulty rising from chairs with normal CPK?
Polymyalgia rheumatica.
248
What findings support septic arthritis on arthrocentesis?
Cloudy fluid, very high WBC count (>50,000), low glucose.
249
What is the water bottle sign on CXR indicative of?
Cardiac abnormality → pericardial effusion → tamponade
250
Best imaging study to see pericardial effusion?
Echo
251
What does a UA result positive for blood but negative for RBC on microscopy indicate?
Rhabdomyolysis (detects myoglobin)
252
What protein complex regulates contraction of striated muscle to rule out MI?
Troponin
253
When does troponin detect myocardial injury?
3-12 hours after injury
254
Initial follow-up test for a patient with abnormal PTT and/or PT/INR not on meds?
Mixing study
255
What determines if the mixing study works on the deficiency?
Coagulation corrects
256
What appears in AML?
Auer rods
257
In which type of cells are Auer rods found?
Blast cells
258
What diagnostic test is indicated for suspected gastroparesis?
Gastric emptying study
259
What type of study is a gastric emptying study?
Nuclear medicine study
260
What is the diagnostic procedure to measure esophageal pressure?
Manometry
261
What is a contraindication for manometry?
History of nasal trauma
262
What does Salter Harris type IV fracture involve?
Through all 3 parts
263
What is the most common Salter Harris fracture?
Type II, FOOSH, through the growth plate and above the metastasis
264
What test is performed if a transthoracic echo is nondiagnostic?
Transesophageal echo
265
What are absolute contraindications for transesophageal echo?
Esophageal varices, stricture, recent surgery, upper GI bleed
266
What does RBBB with ST elevation in V1-V3 resemble?
Shark fin
267
In which populations is RBBB with ST elevation most common?
Asian populations
268
What four findings on X-ray are indicative of heart failure?
Kerley B lines, cephalization, cardiomegaly, pleural effusion
269
What echo findings might indicate heart failure?
Reduced ejection fraction, diastolic dysfunction, wall thickness, wall motion abnormalities, enlargement of chambers, IVC does not collapse on inspiration
270
What is the first-line non-invasive test for evaluation of Helicobacter pylori?
Urease breath test
271
What tests for H. pylori on biopsy?
PCR, culture, CLO test, stain
272
What disease is associated with low ADAMTS13 activity?
TTP
273
What are three findings for hemolytic anemia?
Increased bilirubin, low haptoglobin, increased LDH
274
What stage is chronic kidney disease with stable EGFR between 15-29?
Stage IV
275
What indicates acute kidney injury in serum creatinine?
Jumps higher than 0.3 in 48 hours
276
What indicates acute kidney injury in creatinine levels?
Increased creatinine greater than 1.5 times the baseline in 7 days
277
What disorder is associated with schistocytes, acute kidney injury, and thrombocytopenia?
HUS
278
What toxin is associated with HUS?
Shiga toxin
279
What disease has anti-RNP as a hallmark?
Mixed connective tissue disorder
280
What is the biggest concern for a Jones fracture?
Nonunion/poor healing due to blood flow/repair issues
281
What is the gold standard for CAD evaluation?
Coronary angiography
282
What else does a heart cath evaluate besides CAD?
Heart function
283
What study is indicated in symptomatic patients with no EKG changes and intermediate risk of CAD?
Stress test
284
What pharmacologic agents are used in stress testing?
Dobutamine, Adenosine, Lexiscan, Dipyridamole
285
What is the most common bleeding disorder?
vWF
286
What disease is caused by impairment of vWF?
TTP
287
What test measures the extrinsic and common pathway of coagulation cascade?
PT/INR
288
What medication affects the extrinsic pathway and is measured through PT/INR?
Warfarin
289
What type of studies evaluate strictures, masses, and dilatation of the upper GI tract?
Barium swallow study and upper GI
290
What are indications for a modified barium swallow?
Dysphagia to solids and liquids
291
What bacteria is associated with alkaline urine?
Proteus
292
What other findings on UA are associated with a proteus UTI?
Leukocyte esterase and nitrates, +/- RBC, WBC on microscopy
293
What protein creatinine ratio is consistent with nephrotic syndrome?
> 3 g
294
What test is more specific for rheumatoid factor in diagnosis of RA?
Anti-CCP
295
What X-ray findings are associated with RA?
Ulnar deviation, swan neck deformity
296
What diagnostic procedure provides direct visualization of the upper GI tract?
EGD
297
What are one diagnostic and one therapeutic indication for EGD?
Foreign body = therapeutic, diagnostic = hematemesis/ulcer/varices
298
What type of fracture is a flexion distraction fracture of the spine?
Chance fracture
299
What injuries are associated with chance fractures?
Visceral abdominal injuries
300
What is the initial lab test if you suspect SLE?
ANA
301
What are the other two labs associated with SLE?
Anti-Smith, anti-dsDNA
302
What are indications for a hypercoagulable workup?
Unprovoked DVT/PE, recurrent provoked DVT/PE or multiple miscarriages
303
What are three hypercoagulable states?
Protein C/S deficiency, stasis, cancer, liver disease, factor V Leiden, APS
304
What type of cast is seen in interstitial nephritis?
RBC
305
What type of cast is seen in glomerulonephritis?
RBC
306
What type of cast is seen in chronic kidney disease?
Waxy
307
What type of cast is seen in acute tubular necrosis (ATN)?
Granular
308
What vitamin deficiencies are associated with macrocytic anemia?
B12 and folate
309
What is the characteristic of a Wenckebach phenomenon?
Progressively lengthening PR interval until QRS complex
310
What antibody is associated with polymyositis?
Anti-Jo
311
What enteric pathogen is associated with hemorrhagic colitis and HUS?
E. coli O157:H7
312
What is a positive test for microscopic polyangiitis?
P-ANCA
313
What is found in nearly 100% of drug-induced cases?
Anti-chromatin
314
What is the hallmark of hemolytic anemia on a peripheral blood smear?
Schistocyte
315
What do anemia of chronic disease, CKD, blood loss, and hemolytic anemia have in common?
Normocytic and normochromic cells
316
What is the study of choice for general evaluation of the GU tract?
Ultrasound
317
What antibody is associated with celiac disease?
Anti-tissue transglutaminase
318
What is the best CT for urolithiasis?
Non-contrast
319
What disease is indicated by X-ray findings of sacroiliitis and bamboo spine?
Ankylosing spondylitis
320
What is the screening test for evaluation of blood in stool?
Fecal occult blood
321
What type of RBC is associated with microcytic hypochromic anemia?
Iron deficiency anemia
322
What disease is named after three cardiologists who first described the EKG findings of short PR interval and delta wave?
WPW
323
What study is used to evaluate overt GI bleeds without an obvious cause for endoscopy?
Tagged RBC with nuclear medicine
324
What EKG finding is associated with atrial flutter?
Sawtooth flutter
325
What series of tests evaluate bladder function?
Urodynamic study
326
What RBC indices indicate microcytic hypochromic anemia?
Low MCV and low MCHC
327
What diagnostic procedure evaluates portions of the GI tract not amenable to EGD or colonoscopy?
VCE
328
What is an atlas fracture also known as?
Jefferson fracture
329
What are arthrocentesis findings of blue positive birefringent crystals indicative of?
Pseudogout
330
What are the screening recommendations for prostate cancer (PSA use) for ages 55-69?
Screen those who wish to be screened; age over 70 do not screen
331
What type of cells are seen in beta thalassemia major?
Microcytic, severely hypochromic cells
332
What does the iron panel look like for iron deficiency anemia (IDA)?
Low iron, ferritin, increased TIBC, and low transferrin saturation
333
What are non-megaloblastic causes of macrocytosis?
Alcohol, liver disease, myelodysplastic syndrome, chemo, aplastic anemia
334
What is the reason for cardioembolic stroke?
Patent foramen ovale
335
What does generalized slowing on EEG indicate?
Some form of encephalopathy and needs LP
336
What symptoms did the college age patient present with?
Fever, confusion, vomiting, headache → needed lumbar puncture
337
What does blood appear as after 4 weeks for chronic subdural hemorrhage?
Dark gray
338
What would you expect to find on LP for a 21 year old college student?
Increased opening pressure
339
What is the most common cause of bacterial meningitis in a 76 year old?
Strep pneumoniae
340
What does a T2 image help identify?
Edema
341
What condition did the girl with lupus develop after visiting the dentist?
Brain abscess
342
What was the diagnosis for the 8 year old girl?
Brain tumor
343
What was the unexpected finding in the brain abscess thought to be glioblastoma?
It wasn’t an option
344
What MRI finding is associated with multiple sclerosis?
Dawson’s finger
345
What was found in the CSF for the case of multiple sclerosis?
Oligoclonal bands
346
What would increase serum osmolality gap indicate?
Ingestion of methanol
347
What would you suspect in Alzheimer's disease?
Decreased beta amyloid protein on CSF
348
Who should get NCS and EMG?
32 year old with muscle weakness and paresthesia
349
What were the CSF findings for the man with weakness and vision symptoms?
0-3 WBCs and clear fluid → multiple sclerosis
350
What is an abnormal finding on CSF?
Elevated WBC 100-200
351
What CSF finding indicates bacterial meningitis?
Extremely high neutrophils
352
What would you find on CT for a patient with increased confusion?
Atrophy
353
What is needed for a possible candidate for thrombectomy?
CTA of head and neck STAT
354
What tests are needed for a woman with MG who is Achr negative?
EMG and NCS
355
What abnormal waves might you see on EEG?
Delta waves while watching TV
356
What should be done for a person in status epilepticus?
Need to do EEG
357
What were the CSF findings for the little girl with meningitis?
Normal glucose, elevated protein, elevated lymphocytes → coxsackie virus
358
What does a CSF opening pressure lower than 50 indicate?
Dehydration
359
What CSF finding suggests a CNS mass?
Elevated opening pressure
360
What does it indicate if CSF tubes started bloody then became clear?
Traumatic tap
361
What does a lateral bright CT indicate?
Cerebral infarct
362
What does cloudy grey fluid with 75 lymphocytes and normal glucose indicate?
Viral meningitis
363
What would you see on DWI, T2 for stroke with left sided paralysis?
Bright on right side of brain
364
What is important about STIR MRI?
Shows inflammation and edema better
365
What does a football shaped white thing on CT indicate?
Epidural hematoma
366
What would you expect on CT for a woman with uncontrolled HTN who stopped taking meds?
Hyperdensity within parenchyma
367
What did the woman with the worst headache of her life show on CT?
Subarachnoid hemorrhage
368
What did the man with dizziness and nystagmus need?
Non-contrast CT
369
At what BAC do you begin to experience impairment?
0.05
370
What would you expect with a subacute subdural hematoma?
Dark crescent shape
371
What test is needed for a man with just right arm weakness and normal CT?
NCS and EMG
372
What test helps determine secondary stroke risk factors?
Lipid panel
373
What causes xanthochromia in CSF?
Subarachnoid hemorrhage
374
Most common finding on non-contrasted head CT
Normal
375
What did the PET scan show indicative of Alzheimer's?
Neurofibrillary tangles
