buzz words 2 Flashcards
(507 cards)
1
Q
tx pcp pneumonia
pneumocystis jiroveci pneumonia
A
bactrim
2
Q
tx for tetanus
A
pcn
immune globulin
supportive care - resp esp.
3
Q
how do hookworm larvae enter the body
A
through the skin
usually the soles of the feet
4
Q
tx hookworm
A
azoles
5
Q
what type mosquitoes carry malaria
A
anopheles
6
Q
tx white oral plaques that can be scraped off
A
candida
topical nystatin or oral fluconazole 1mg
7
Q
ct scan shows ring enhancing lesions in an HIV pt
dx
A
toxoplasmosis
8
Q
drug of choice for toxoplasmosis
A
bactrim
9
Q
what organism causes toxoplasmosis
A
toxoplasma gondii
10
Q
what drug do you use to treat pinworm
A
everyone in the house with albendazole
tx again 2 weeks later
11
Q
scotch tape test dx?
A
pinworm
12
Q
nisseria gram + or -
A
gram -
13
Q
syphilis is caused by what organism
A
treponema pallidum
14
Q
gram positive organism in chains
dx
A
strep
15
Q
gram - diplococci
dx
A
neisseria
16
Q
most common pre-op prophylaxis
A
ancef, cephalexin
17
Q
oral abx for pseudomonas
A
cipro
18
Q
suffix for most fluoroquinolones
A
oxacin
19
Q
why aren’t fluoroquinolones used more often
A
lots of side effects
20
Q
pt with ruptured achilles tendon
recent abx, which class
A
fluoroquinolones
21
Q
why can’t you give fluoroquinolones to kids
A
cause cartilage development problems
22
Q
class of abx for community acquired pneumonia
A
macrolides
23
Q
list macrolides
A
erythromycin
azithromycin
clarithromycin
24
Q
abx class for chlamydia
A
macrolides
25
class of abx for its effects on increasing GI motility
macrolides
26
which is worse for pads
| tetracycline or aminoglycoside
tetracycline
27
pizza pie retinopathy
| dx
CMV
| cytomegalovirus
28
pt with metallic taste and dark brown urine
| what abx on?
flagyl
29
abx most likely to cause c.diff
clindamycin
30
drug of choice MRSA
vancomycin
31
pt on rifampin
| warn of what side effect
orange-red discoloration of body fluids
32
infuse vanc too fast
red man syndrome
33
2 oral meds for MRSA
linezolid (zyvox)
| bactrim
34
organism most commonly responsible for community acquired pneumonia
strep pneumoniae
35
most common organism for UTI
E. Coli
36
gummas or granulomatous nodules
| dx?
tertiary syphilis
37
bloody stool with cysts and trophozoites
| dx
amebiasis
38
community acquired carditis is most often caused by one of the HACEK organisms
List HACEK organisms
```
haemophilus
actinobacillus
cardiobacterium
eikenella
kingella
```
39
3 meds combined to tx h pylori
omeprazole (prilosec)
clarithromycin
amoxicillin
40
prophylactic abx before dental procedure
| dose?
amoxicillin
| 2gm po 1 hr before procedure
41
pregnant women and cat litter
| dx?
toxoplasmosis
42
tx for urethritis neisseria
| dx?
ceftriaxone
43
klebsiella gram + or -
gram -
44
gram + clusters
| dx
staph
45
best test for dx rocky mountain spotted fever
indirect immunofluorescent antibodies
46
gram - coccobaccili found in sputum with pneumonia
| dx
H flu
47
med used as prophylaxis for meningococcal meningitis
rifampin
48
secretory phase of the menstraul cycle
| day 14-28 is dominated by what hormone
progesterone
49
nulliparous or multiparous women more likely to develop preeclampsia
nulliparity
50
since a genetic cause is the number one reason for primary amenorrhea
one important test
karyotype
51
purulent cervical dc
| dx
neisseria gonorrhoeae
52
young girl with a web neck or wide chest
| dx
turner's syndrome
53
cervical bx comes back as CIN1 next step
repeat pap smear in 6 months and repeat colposcopy in 12 months
54
most common cause of secondary amenorrhea
pregnancy
55
3 labs if considering secondary amenorrhea
beta hcg
tsh
prolactin
56
define premature birth
delivery 20-36 weeks
57
a unilateral, single, mobile, firm, non-tender solid breast mass
dx
fibroadenoma
58
metrorrhagia
bleeding between menstrual cycles
59
postmenopausal bleeding
| dx
endometrial cancer
60
what portion of the menstrual cycle does pms occur
second half and menstruations should relieve sxs
61
BV tx
flagyl x 7 days
62
location within the pelvis is endometriosis found
on an ovary
63
gold standard lab for chlamydia
nucleic acid amplification test
64
are fibrocystic breast masses usually b/l or unilateral
bilateral
65
definitively dx endometriosis
ex lap
66
most common uterine tumor
leiomyoma, fibroids
67
ethnic background increased risk of fibroids
AA 5x more likely
68
tx vaginal candida
fluconazole po 1 dose or azole cream x 1 week
69
1st step of tx for endometrial cancer
total hysterectomy and b/l salpingo-oophorectomy
70
chocolate cyst
| dx
endometrioma
71
surge in what hormone leads to ovulation
luteinizing hormone
72
irregular menses, hirsutism and infertility
| dx
PCOS
73
what endocrine issues is associated with PCOS
insulin insensitivity
74
pt with PCOS wants to get pregnant
| 2 meds to start on
metformin
| clomid
75
medical tx for early ectopic
methotrexate
76
ovarian cyst with hair and teeth
| dx
teratoma
77
mean age for ovarian cancer
63
think of in an older pt with vague and sxs
78
second stage of labor
fully dilated to delivery
79
66yo female pt with bouts of N, wt loss, vague and pain
| dx
ovarian cancer
80
when to begin pap smears
when you are sexually active or 21 yo
81
cervical bx CIN2 or CIN3
| next step
excision
LEEP
cold knife (incompetent cervix)
cryotherapy
82
2 risk factors for cervical ca
multiple sexual partners
| smoking
83
how much time needs to pass before dx secondary amenorrhea
if cycles have been nl 3 months
if cycles have been irregular 6 months
84
what is a cystocele
a herniation of the bladder into the vagina
85
tx for turners syndrome
cyclical estrogen
| progesterone
86
3 txs for uterine prolapse
pessary
kegel maneuvers
surgery
87
most common organism for mastitis
staph aureus
88
about how pregnant is the uterus at the umnilicus
20 weeks
89
most common cause of postpartum hemorrhage
uterine atony
90
defined missed ab
no vaginal bleeding, cervix is closed, POC inside
91
what age is primary amenorrhea dx
14 if no secondary sex characteristics
16 is some secondary development
92
tx for mastitis
1st line dicloxacillin
2nd line cephalexin or erythromycin
93
should breast feeding stop for mastitis
mastitis no
abscess yes
94
PE- retroverted uterus or uterosacral ligament nodularity
| dx?
endometriosis
95
at how many weeks can you do an amniocentesis
15-20 weeks
96
5 risk factors for breast cancer
```
BRCA1 or 2 positive
unopposed estrogen
nulliparity
early menarche
late menopause
```
97
avg age of menopause
51
98
cottage cheese dc
| dx
vaginal candidiasis
99
follicular phase of menstruation dominated by what hormone
estrogen
100
how wt should you gain during pregnancy
20-35 lbs
101
thin, sticky, malodorous vag d/c
| dx?
BV
102
vaginal infection with motile flagellated protozoa
| dx
trichomonas
103
2 meds used for htn in pregnancy
methyldopa
| labetalol
104
triad of pre-eclampsia
htn
edema
proteinuria
105
why is ovarian cancer so hard to dx
there are no good markers and sxs are very vague
106
2 important things to tell its on flagyl
stay out of the sun
| no alcohol
107
define inevitable ab
vaginal bleeding
cervix is open
POC inside
108
how is the first day of the menstrual cycle defined?
1st day of menstrual bleeding is 1st day of the cycle
109
what is the karotype for patient with turner's syndrome
(45,X)
| they are missing one sex chromosome
110
give the time frame for preterm labor
20-37 weeks
111
pt presents with mucopurulent dc and CMT
| dx
chlamydia - cervicitis
112
4 human papillomaviruses are linked to cervical ca
16, 18, 31, 33
113
clue cells
| dx?
BV
114
hallmark of PE for placenta previa
trick ?
| never do a pelvic on someone with presumed placenta previa
115
medium to grow out gonorhea
thayer-martin
116
age range for HPV vaccination
9-26 yo
117
pt with primary amenorrhea and low FSH
| dx
hypothalamic pituitary insufficiency
118
characteristic that sets apart PID from other and issues
bilateral pain
119
6 risk factors for ovarian ca
```
BRCA1
family hx
nulliparity
late menopause
caucasian
asian
```
120
define ab
delivery of urerine contents before 20 weeks
121
mastitis tend to be unilateral or bilateral
unilateral and only one quadrant
122
full term?
37-42 weeks
123
when does quickening occur
nulliparous 18-20 weeks
| multiparous 14-16 weeks
124
quickening
the first motion of a fetus in the uterus felt by the mother
125
5 risk factors for placental abruption
```
htn
smoking
ama (advance maternal age)
cocaine use
PROM
```
126
tx for ovarian ca
total hysterectomy
bilateral salpingo-oophorectomy
chemo + radiation
127
pt is pregnant and slight blue on cervix
| name of that sign?
Chadwick's sign
128
how many weeks when uterus is at the level of the symphysis pubis
12 weeks
129
snowstorm appearance on US
| dx?
hydatidiform mole
130
med used to control bleeding due to uterine atony
oxytocin (pitocin)
131
term when placenta is implanted directly over the cervical os
placenta previa
132
at how many weeks of pregnancy can chorionic villus sampling be done?
10-13 weeks
133
why is folic acid given in pre-natals
low folic acid can lead to neural tube defects
134
most common endometrial ca
75% are adenocarcinomas
135
strawberry cervix with copious yellow/green dc
| dx?
trichomonas
136
what organism causes us to warn pregnant pt to not eat deli meats and soft cheeses
listeria
137
baby was delivered several mins ago
sudden increase in blood flow from vagina and cord lengthens
cause?
placental separation
138
2 meds to induce labor
cervidil (prostaglandin gel applied to the cervix) - which encourages cervical ripening
oxytocin - encourages uterine contractions
139
antepartum testing a + stress test
| what does that mean?
they have had 2 heart rate accelerations in a 20 min period of 15 beats above baseline for at least 15 secs, this is a good thing
140
is FSH high or low in turner's syndrome
high
there are no ovaries to respond to FSH and so there is no negative feedback
141
most common ovarian cyst
functional cyst - no tx
142
define threatened ab
vaginal bleeding, closed cervix, POC inside
143
10 risk factors for endometrial cancer
```
chronic unopposed estrogen
nulliparity
early menarche
late menopause
tamoxifen
dm
obesity
htn
breast ca
ovarian ca
```
144
what do you see on a KOH prep if pt has vaginal candidiasis
pseudohyphae
145
#1 cause of septic arthritis is sexually active young adults
gonorrhea
146
how many days after conception is a serum beta positive
8
147
if the pap smear results come back anything other than negative or ASCUS
next step?
colposcopy and bx
148
3 risk factors for an ectopic
previos ectopic
scarred tubes (hx PID or salpingitis)
IUD
149
grape-like vesicles or a sack of grapes on US
| dx?
hydatidiform mole
150
what med is used to increase surfactant levels and help with lung maturity if you are worried about pre-term labor
betamethasone
151
2 tocolytic meds
mag sulfate
| calcium channel blockers
152
tocolytic meds
anti-contraction medications or labor repressants
medications used to suppress premature labor
153
pt thinks in pre-term labor, 1st tx
give IV fluids
most often just dehydration
154
pap smear comes back ASCUS next step
repeat pap in 4-6 months
155
3 ways you can check for ruptured membranes
ferrying pattern on a slide
visualize leakage from the cervix
pooling in the vagina
156
nl fetal heart rate
120-160
157
menorrhagia?
heavy prolonged menstraul flow
158
Rh combo for mom and dad might cause the mother to create antibodies against the baby's red blood cells
mom rh -
| dad rh +
159
at what point is PhoGAM given
28 weeks
160
complete ab?
vaginal bleeding
cervix open
POC have passed
161
gestational DM - mom and baby at risk for 3 things
preeclampsia
macrosomia (traumatic birth)
slowing in fetal lung development
162
painful 3rd trimester bleeding
placental abruption
163
3 causes fro a postpartum hemorrhage
uterine atony
genital laceration
retained placenta
164
3rd stage of labor
delivery of baby to delivery of placenta
165
what meds tx a postpartum metritis
clindamycin and gentamicin together
166
most common STD
chlamydia
167
interference with work or school is part of which PMS syndrome
premenstrual dysphoric disorder
168
which reproductive cancer carries the higher rates of death in women
ovarian cancer
169
most common infection after c-section
metritis
170
tx trich
flagyl
171
define incomplete ab
vaginal bleeding
cervix is open
POC partially passed
172
what is the most common site of an ectopic
within a fallopian tube
173
early in pregnancy how often beta double
48-72 hours
174
define procidentia
uterine prolapse beyond the introitus
175
what is the more popular term for stein-leventhal syndrome
PCOS
176
formula for calculating EDD
first day of last period +7 days - 3 months
177
5 parts of the biophysical profile
```
non-stress test
fetal breathing
2 gross body movements
fetal tone
amniotic fluid index
```
178
define 1st stage of labor
onset of contractions to full dilation of the cervix
179
rope like breast mass
| dx
fibrocystic breast mass
180
what should a pcp do for a presumed retinal detachment
refer & position patient with head down
181
what age range do you expect to find amaurosis fugax
older then 50
182
#1 cause of retinal artery occlusion
carotid atherosclerotic disease
183
tx for herpes keratitis
| topical antiviral, topical steroid or both
don't use steroids
topical antiviral
refer
184
pt describes his vision loss as a curtain coming down and going back up
dx?
amaurosis fugax
185
Amaurosis fugax
sx CAD - occurs when a piece of plaque in one of these arteries breaks off and travels to an artery in the eye.
186
pt with a painful red nodule on the eye lid
| dx? tx?
hordeolum (sty)
| warm compress and progress to topical abx if needed
187
fundal exam shows a cherry-red spot
| dx
central retinal artery occlusion
188
college student with a little purulent drainage from one eye and contender pre auricular lymphadenopathy
dx and pathogen?
chlamydia conjunctivitis
189
what should pcp due with presumed central retinal artery occlusion
ophthalmic emergency
| refer and intermittent pressure and release of the eye
190
pt with unilateral blurriness over a few days
fundal exam shows a "blood and thunder" pattern
dx
central vein occlusion
191
tx for central vein occlusion
self limited
| tx underlying dx
192
glaucoma more prevalent in males or femaales
females 3:1
193
2 risk factors for glaucoma
african american
| DM
194
yellow brown fleshy mass on the conjunctiva, usually doesn't interfere with vision
pinguecula
195
fundal exam shows a cup to disc ratio of >0.5
vessels bending over the disc
dx
glaucoma
196
pt presents saying he doesn't need glasses anymore after 30 yrs
dx
cataract
197
pt has metamorphopsia and central blind spot
| dx
macular degeneration
198
metamorphopsia
type of distorted vision in which a grid of straight lines appears wavy and parts of the grid may appear blank
199
most likely quadrant for a retinal detachment
superior temporal
200
pt presents with pain in one eye
cornea is hazy and pupils are fixed
dx?
glaucoma
201
most common way of testing for metamorphopsia
amsler grid
202
notice drusen deposits on fundal exam
| dx?
macular degerneration
203
drusen deposits
yellow deposits under the retina, the light-sensitive tissue at the back of the eye.
Drusen are made up of lipids, a fatty protein.
204
pt presents with irritated, burning and tearing eyes
some scurf and scales
where do you begin tx?
dx - blepharitis
| tx - good hygiene and abx as needed
205
pt has a hx of multiple stys
now with painless nodule on his eyelid and minor conjunctivitis
dx?
chalazion
206
most common colors lost in color blindness
red and green
207
term for eyelids that turn in
entropion
208
term for bilateral yellow plaques near the eyes
xanthelasma
209
fundal exam shows an opalescent retina and boxcarring of arterioles
dx
central rentinal artery occlusion
210
most common preceding event for orbital cellulitis
URI
211
vision loss described as curtain coming down
| dx
retinal detachment
212
bowing of the iris on exam
| dx
glaucoma
213
CT scan of the head shows broad infiltration or orbital fat
| dx?
orbital cellulitis
214
pt presents with watery bilateral d/c from eyes and nontender per auricular adenopathy
dx?
most common pathogen?
viral conjunctivitis
adenovirus
215
how do you test for color blindness?
ishihara plates
216
pt with hx of asthma presents complaining of stringy d/c from both eyes and severe swelling around the eyes
dx?
allergic conjunctivitis
217
name of the triangular or wedge shaped growth on the conjunctiva that may interfere with vision
pterygium
218
name of the test for dry eyes
schirmer's test
219
pt having undergone cataract sx presents complaining of vision loss in the operative eye
dx?
retinal detachment
220
pt presents with sudden painless complete unilateral vision loss
dx?
central retinal artery occlusion
221
dendritic lesion is seen with fluorescein stain
| dx
herpes keratitis
222
which nerve is involved in herpes zoster ophthalmicus
trigeminal nerve, CN 5
223
hutchinson's sign
| dx?
herpes zoster ophthalmicus
224
pt with a dense corneal infiltrate and an epithelial defect seen with fluroescein stain
dx
corneal ulcer
225
feathery border on eye exam
| dx?
fungal infection
226
pt in recovery room after foot sx is complaining of severe photophobia, feels like there is something in her eye
dx?
corneal abrasion
its scratch their eyes before they are awake from anesthesia
227
tx for subconjunctival hemorrhage
reassurance
228
19yo male took an elbow to the face while playing basketball
whole face is swollen and can't look up
dx?
orbital fracture
229
pt ℅ of seeing halos and rainbows around lights
also ℅ of moderate photophobia
dx
glaucoma
230
1st thing you should be thinking of if a peds pt comes in with blood in the anterior chamber of the eye (hyphema)
child abuse until proven otherwise
231
how long after radiant energy burn do symptoms typically show
6-12 hours
232
term for eyelids that turn out
ectropion
233
initial tx for a chemical burn to the eyes
irrigate, irrigate, irrigate
234
color blindness genetics
dominant x-linked
235
term for nearsighted?
type of lens to correct it?
myopia
concave lens
236
college student with copious purulent drainage from one eye
| dx
neisseria conjunctivitis
237
1st line tx for orbital cellulitis
IV abx, then 2 weeks po abx
238
term for being farsighted
type of lens to correct it
hyperopia
convex
239
what is tonometry used for
determining intraocular pressure
240
most common pt complaint with emphysema
SOB
241
at what age should vaccinations for pneumonia begin
65 yo
242
```
prolonged expiration (low FEV1)
dx?
```
asthma or COPD
243
hampton's hump on CXR
| dx?
PE
244
hampton's hump?
shallow wedge-shaped opacity in the periphery of the lung with its base against the pleural surface.
245
how long after given ppd do u read it
48-72 hours
246
pt w/o a functioning spleen is more susceptible to what organism
encapsulated organisms
most commonly strep pneumonia or H flu
247
most common cause of pneumonia in children less than 1 year old
RSV
248
tx for PCP pneumonia
bactrim
249
what occupations are associated with berylliosis
aerospace
nuclear plant workers
250
CXR finding for berylliosis
diffuse infiltrates with hilar adenopathy
251
gold standard for dx of pleural effusion
thoracocentesis
252
when performing a decompression for a tension pneumo where do u put the needle
2nd interconstal space at the midclavicular line
253
tamiflu can be given to childer over what age
1
254
Zanamivir (relenza) maybe given to kids over what age
7
255
HIV pt with ground glass appearance on CXR
| dx?
PCP
256
noncaseating granuloma
| dx
sarcoidosis
257
pearl formation on CXR
| dx
squamous cell lung cancer
258
Ghon or Ranke complexes on CXR
| dx
TB
259
westermark sign on CXR
| dx
PE
260
mesothelioma most common lung location
80% in the pleural lining
261
CXR that will make you think of mesothelioma
pleural thickening
262
hyperinflation on CXR as well as eosinophilia on CBC
| dx
asthma
263
organism is most common cause pneumonia in a pt with CF
pseudomonas
264
college student with pneumonia
| 2 organisms?
chlamydia
mycoplasma
265
at what size in HIV pt is ppd +
5mm
266
suspect pneumo
| instructions for CXR
should be an end expiratory view in order to look for visceral pleural air
267
3 most commonly used med txs for COPD
O2
ipratropium
albuterol
268
4 meds that might cause asthma
beta blockers
NSAIDS
ACEI
ASA
269
nodular opacities in the upper lung fields
| dx?
silicosis
270
initial tx for active TB
INH + RIF + PZA + EMB x several months
followed by INH + RIF after sensitivities come back
271
caseating granulomas
| dx?
TB
272
blue bloater
| dx?
chronic bronchitis
273
contralateral mediastinal shift
| dx?
tension pneumo
274
best test dx bronchiectasis
CT
275
main side effects of isoniazid 2
hepatitis
| peripheral neuropathy
276
treating a pt for TB
noticed orange tint
cause?
rifampin
277
ethambutol has what 2 major side effects
optic neuritis
red green vision loss
278
rats and pt with pneumonia
| organism?
yersinia pestis
279
most common organism causing pneumonia in COPD pts
Haemophilus influenzae
280
where is a pancoast tumor found on CXR
at the apex of either the right or left lung
281
tb in upper or lower lobes on CXR
upper
282
pt has pneumonia with rust colored sputum
| dx?
strep pneumonia
283
coal miners lung often shows nodular opacities in what lung fields
upper lung fields
284
when you step up dx from intermittent asthma to mild persistent asthma what med should you add
an inhaled steroid like fluticasone
285
rabbits and pneumonia
| dx
tularemia
286
dullness to percussion
| dx
lobar pneumonia
287
young child in er, tripod position
| dx
epiglottitis
288
+ppd in healthcare worker
10mm
289
6 extra pulmonary complications of lung cancer
```
SPHERE
SVC syndrome
pancoast tumor
Horner's syndrome
endocrine problems
recurrent laryngeal sxs
effusions (exudative)
```
290
currant jelly sputum
| dx
klebsiella pneumoniae
291
what happens to total lung capacity in sarcoidosis
it goes down
292
what will the likely findings be on a CXR of a pt with asbestosis
linear opacities at the bases with pleural plaques
293
tympany to percussion
| dx
large pneumo
294
3 most common cancers to mets to the lungs
breast
liver
colon
295
thumbprint sign on X-ray
| 2 dxs?
lateral C-spine = epiglottitis
abd= intestinal ischemia
296
barrel chest
| dx
emphysema
297
are the lungs noisy or quiet in COPD
quiet
298
4 indications for the flu vaccine
kids 6-59 months (5yo)
pregnant female
healthcare worker
older then 50
299
posttussive rales
| dx
TB
300
parenchymal mets and blebs on CXR
| dx
emphysema
301
rhonci or wheezes that clear after coughing
| dx
bronchitis or atelectasis
302
does FEV1 go up or down with asthma
down
303
very sick pt with diffuse infiltrates that spare costophrenic angles
dx
ARDS
304
most common cause of bronchiectasis
CF
305
gold standard to dx CF
sweat chloride test
306
exudative pleural effusion
| dx
TB
| lung cancer
307
tx for epiglottitis
2nd or 3rd generation cephalosporin (ceftriaxone)
macroclides may also be used (clindamycin)
308
transudative pleural effusions
| dx
CHF
309
2 lung cancers typically found centrally on CXR
small cell lung cancer and squamous cell
310
2 lung cancers typically found peripherally on CXR
adenocarcinoma
| large cell
311
pertussis most commonly treated with what abx
erythromycin
312
4 most common places lung ca will met to
bone
brain
adrenals
liver
313
pt with erythema nodosum and an enlarged parotid gland
| dx
sarcoidosis
314
erythema nodosum
tender red nodules
| usually on the shins
315
thin looking heart
flattened diaphragm on cxr
dx?
emphysema
316
alcoholic who has pneumonia
| most likely organism
klebsiella pneumonia
317
honeycombing and tram tracks on CXR
| dx
bronchiectasis
| idopathic pulmonary fibrosis
318
paradoxical pulses in what pulmonary disorder
asthma
319
older pt with pneumonia and diarrhea
| dx
legionella pneumonia
320
eggshell opacities on the CXR
| dx
silicosis
321
4 causes of decreased tactile fremitus
copd
asthma
pleural effusion
pneumothorax
322
hyperresonance to percussion
| dx - 3
emphysema
pneumo
asthma
323
crackles in the lung files
| 4 pulmonary issues in differential
pneumonia
fibrosis
CHF
bronchitis
324
does total lung capacity go up or down in COPD
goes up
325
3 things on diff with wheezes
asthma
copd
bronchitis
326
pt says "ee" but on auscultation you here "ay"
egophony
327
PE - egophony
| dx
lobar pneumonia
328
cxr shows vascular redistribution and blurred vascular outlines
dx
CHF
329
difficulty swallowing
dysphagia
330
birds-beak esophagus on barium swallow
| dx
achalasia
331
most common location for an anal fissure
posterior midline
332
crown's is found where in the GI tract
esophagus to anus
333
HBsAg (hep B surface antigen) indicate
active hep B infection
334
tx for achalasia
loosen up the muscle
botox
dilation or
sx
335
a corkscrew appearance on barium study
| dx
esophageal spasms
336
epigastric abdominal pain rad to back
| dx
pancreatitis
337
in order to contract hep D what must you already have
hepatitis B
338
LLQ pain
| dx
diverticullitis
339
tx for most mallory-weiss tears
watchful waiting
| typically resolve within 48 hours
340
thumbprint on an and film
| dx
intestinal ischemia
341
bowel sounds be early on in a SBO
| later?
early hyperactive
| late they are absent
342
pt has gerd for yrs
past year increase in difficulty swallowing his food
dx
esophageal strictures
343
2 txs for esophageal strictures
dilation of the esophagus
| long term PPIs
344
2 predisposing factors for esophageal varices
portal htn
| cirrhosis from alcoholism
345
common sx with CP from gerd pts
dry cough
346
med most commonly used for long term tx of GERD
PPI
omeprazole
lansoprazole
pantoprazole
347
imaging for pancreatitis
CT
348
best test to check for h pylori
urea breath test
349
PUD more common in the duodenum or stomach
duodenum
350
most common location for a pancreatic tumor
75% occur in the head of the pancreas
351
gastric ulcer
| sxs exacerbated or relieved with food
exacerbated
352
fasting gastrin will be above what level with gastrinoma
>150 pg/ml
353
projectile vomiting
| sx
pyloric stenosis
354
most gall stones made of what
cholesterol
355
pt shows inhibited inspiration with pressure over RUQ
| dx
murphy's sign
| cholecystitis
356
most specific test for acute chole
HIDA
357
gold standard for dx, tx of bile duct stones
ERCP
358
charcot's triad
RUQ pain
fever
jaundice
ascending cholangitis
359
reynold's pentad
| why does it matter
charcot's triad
+ htn+AMS
indicates a high risk of sepsis
360
dx as an immunologic response to gluten
celiac
361
rick factor for esophagitis
immunocompromised pt
362
an endoscopy for presumed esophagitis shows multiple shallow ulcers
dx
herpes simplex virus
363
list 4 common offending agents for pill induced esophagitis
NSAIDS
KCl
iron
abx
364
30yo AA women with dyspagia
thickened skin
barium swallow demonstrates the absence of peristalsis
dx
scleroderma
365
pt ℅ of regurgitating undigested food several hours after a meal
dx
zenkers diverticulum
366
most common cause PUD
h pylori
367
most specific dx test for PUD
endoscopy
368
only curative tx for gastric adenocarcinoma
surgical resection
369
pt ℅ RUQ pain 20 mins after meals
| dx
cholecystitis
370
ERCP stand for
endoscopic retrograde cholangiopancreatography
371
most common cause of acture bacterial cholangitis
choledocholithiasis
372
onion ring fibrosis from a bile duct bx
| dx
primary sclerosing cholangitis
373
2 viral hepatitis infection are self limiting
hep A and E
374
pica often related to what anemia
iron deficiency anemia
375
what does an Anti-HBc (hep B core antibody)
previous or ongoing hep B infection
376
what does Anti-HBs (hep B surface antibody)
recovery from infection or immunization to hep B
377
recommended tx for hep C infection
pegylated interferon aplha-2
378
what med is used in hep B infection helps prevent the need for liver transplant
lamivudine
379
vaccines for which 2 heps
hep A and hep B
380
pt with achalasia have dysphagia to liquids, solids or both
both
381
heartburn that does not improve with meds
| dx
gastrinoma
382
2 main complications of cirrhosis
portal HTN
| liver insufficiency
383
2 main causes of pancreatitis
cholelithiasis
| ETOH
384
cullen's sign
umbilical ecchymosis often related to pancreatitis
385
5 points of ranson's criteria on admission
```
older then 55
wbc > 16
glucose >200
LDH >350
AST >250
```
386
1st step in treating GERD
lifestyle modifications
387
steatorrhea
| dx
pancreatitis
388
courvoisier's sign
contender palpable gallbladder which may indicate pancreatic neoplasm
389
tumor marker can be used to follow pancreatic ca
ca-19-9
390
pt ℅ of periumbilical pain which has moved over mcBurney's point
dx
appendicitis
391
how to do psoas sign
pt is supine and attempts to raise R leg against resistance
392
term for painful swallowing
odynophagia
393
how to perform the obturator sign
pt is supine and attempts to flex and internally rotate right hup
394
best imaging for acute appy
ct
395
2 blood test to dx celiac
IgA endomysial abtibody
| IgA tTG antibody
396
how much fiber do you need in a day
30 grams
397
tx should be started for asymptomatic diverticulosis
none
398
is sx curative for crohn's or ulcerative colitis
UC
399
what causes mallory-weiss tears
forced vomiting or retching
| often involving alcohol
400
colonoscopy that shows cobblestone or skip lesions
| dx
crohn's disease
401
class of medication is 1st line to treat inflammatory bowel disease in the maintenance phase
5-ASA products
| sulfasalazine, mesalamine
402
currant jelly stool
| dx
intussusception
403
severe abd pain 30 mins after a meal
| dx
intestinal ischemia
404
most common cause lower GI bleed
diverticulosis
405
most common location of colorectal cancer
cecum about 38%
406
colorectal ca its are almost all older than what age
90% older then 50
407
epigastric olive-shaped mass
| dx
pyloric stenosis
408
an elevated serum amylase and lipase dx
pancreatitis
409
age begin screening colonoscopies
50
410
#1 cause SBO
postop adhesions
411
air fluid levels on abd X-ray
| dx
bowel obstruction
412
which hernia more likely to pass into the scrotum
| direct or indirect
indirect
413
string sign on barium swallow
| dx
pyloric stenosis
414
1st line tx for an anal fissure
fluid and fiber
415
4 things that an anal fissure off midline might suggest
crohn's
syphilis
hiv
neoplasm
416
med tx for gastrinoma
PPI
417
term for an abscess in the sacroccygeal cleft
pilonidal dx
418
tx for H pylori
PPI + 2 abx
omeprazole + clarithromycin and amoxicillin
or
PPI + flagyl + tetracycline
419
painless bright red blood per rectum
| dx
hemorrhoids
420
pt on sulfasalazine for an inflammatory bowel disease should be supplemented with what vitamin
folate
421
most common anorectal problem affecting its over 50
hemorrhoids
422
a gastrinoma is aka what syndrome
zollinger-ellison syndrome
423
salivary amylase breaks down what macronutrient
carbs
424
medical term for feelings like there is a lump in your throat
globus
425
most common vessel blocked with intestinal ischemia
superior mesenteric artery
426
describe Grey-Turner's sign
flank ecchymosis
| often related to pancreatitis
427
1st 3 steps of managing pancreatitis
NPO
pain meds
fluids
428
pt presents with unproductive retching, acute localized epigastric distention and inability to pass NG tube
dx
gastric volvulus
429
most common cause folate deficiency
alcoholism
430
should diverticulitis always be admitted
no mild cases can be outpt
| rest and clear fluids
431
which NSAID has the highest rate of peptic ulceration
naproxen
432
diagnostic test of choice for Zenker's diverticulum
barium swallow
will show the diverticulum
433
leading cause of iron deficiency anemia
chronic GI bleed
434
age start fecal occult blood tests
50 and yearly
435
how often should its with pernicious anemia have a screening endoscopy
every 5 years
looking for signs of gastric carcinoma
436
are one half of all adult hernias direct or indirect inguinal hernias
indirect inguinal hernias makeup 50% of all adult hernias
437
how is celiac dx most commonly diagnosed
endoscopic biopsy
438
define pellagra
niacin (B3) deficiency
439
an endoscopy for presumed esophagitis shows several solitary deep ulcers
dx
cytomegalovirus
440
which are more painful, hemorrhoids above or below the dentate line
below
internal hemorrhoids are not painful
441
an abd exam with pain out of proportion to the exam
| dx
intestinal ischemia
442
does adenocarcinoma arises from the proximal or distal esophagus
distal
443
german measles is aka
rubella
444
bruises may be purple, green, yellow, and brown
purple 1-5 days
green 5-7 days
yellow 7-10 days
brown 10-14 days
445
pain with movement of the pinna or tragus
| dx
otitis externa
446
1st line tx for pertussis
erythromycin
447
by what age should a child be able to hold up her head
3 months
448
a salter harris type 1 fracture affects what area of the bone
only the physis (growth plate)
449
by what age should a child be able to sit up
6 months
450
an overweight 15 yo boy with a limp presents to the office with knee pain
no hx trauma
dx
slipped capital femoral epiphysis
451
premature infant with hyaline membrane disease will have what appearance on CXR
bilateral atelectasis or ground glass appearance
452
atypical or walking pneumonia
| what pathogen
mycoplasma
453
abx 1st line for mycoplasma pneumonia
a macrolide
454
a pt is having seizures along with a mouse-like odor from the urine
dx
phenylketonuria
455
description of a dew drop on a rose petal
| dx
chickenpox
456
pale and boggy nasal mucosa
| dx
allergic rhinitis
457
5 major jones criteria for dx rheumatic fever
```
polyarthritis
carditis
subcuticular nodes
erythema marginatum
chorea
```
458
describe erythema marginatum
pink rings on the trunk and inner surfaces of the limbs
459
a child with bulky greasy stool
| dx
cystic fibrosis
460
at what age should an infant begin cooing
2 months
461
what is the most common cause of an URI
rhinovirus
462
koplik spots are clusters of white clustered lesions on the buccal mucosa
what virus
measles/rubeola
463
1st line abx for otitis media
amoxicillin
464
tx a pt with respiratory syncytial virus
albuterol
steroids
fluids
465
child presents with painful ulcers in his mouth
PE- also on hands and feet
virus?
coxackie virus
466
what is the gold standard for the dx of cystic fibrosis
sweat chloride test
467
by what age able to walk
12 months
468
FB obstructing a child's breathing what type of CXR
expiratory view looking for hyperinflation due to air trapping
469
medical term for lazy eye
amblyopia
470
pt presents with a staccato cough but no fever
| dx
chlamydia pneumoniae
471
most serious complication of kawasaki syndrome
aortic aneurysm
472
a musical vibratory murmur best heard at the apex in a child
| dx
still's murmur
473
kawasaki syndrome
is an immune disease in which the medium-sized blood vessels throughout the body become inflamed. It is largely seen in children under five years of age. It affects many organ systems, mainly those including the blood vessels, skin, mucous membranes, and lymph nodes;
474
still's murmur
benign or "innocent" functional heart murmur that is not associated with any sort of cardiac disorder or any other medical condition.[1] It can occur at any age although it is most common among children two to seven years of age and it is rare in adulthood.
475
palpable olive shaped epigastric mass in a 1 month old
| dx
pyloric stenosis
476
at what age should a child be able to use a spoon and stack 3-4 blocks
18 months
477
x-ray finding that supports dx of a slipped capital femoral epiphysis
ice cream falling of the cone
478
viral exanthem often has conjunctivitis as one sx
measles/rubeola
479
most common congenital heart defect
VSD
480
boot shaped heart of cxr
| dx
tetralogy of fallot
481
PE- tubular or sausage-shaped mass
| dx
intussusception
482
tx for a volvulus in a child
barium enema
483
by what age should a child be able to roll over
4 months
484
what is pertussis aka
whooping cough
485
which heart valve is most associated with rheumatic fever
mitral
486
loud harsh holosystolic murmur in a child
best heard at the LLSB
dx
VSD
487
child with paroxysmal abd pain, nausea, vomiting and diarrhea
dx
intussusception
488
child begin to feed themselves
6 months
489
currant jelly stool
| dx
intussusception
490
is an URI include hoarseness bacterial or viral
viral
491
describe barlows test
adduct and internal rotation of the hips
492
CXR finding of notched ribs in a child
| dx
coarctation of the aorta
493
how long should you wait for a swallowed marble to pass before considering sx
24 hours
494
4 yo boy presents between october and march with wheezing, coughing, a runny nose and increased respiratory rate
pathogen?
RSV
495
```
describe wt gain in an infant over the following time periods
1 week
6 months
12 months
3 yo
4yo
```
```
newborns lose 10% of birth weight and are back to birth at 10 days
6m = 2x birth
12m = 3x birth
3yo = 30 lbs and 30 inches
4yo - 40 lbs and 40 inches
```
496
what age should a child be able to kick a ball
24 months
497
child with a fever lasting longer then 5 days
| dx
kawasaki syndrome
498
widely split fixed S2
| dx
atrial septal defect
499
nasal polyps
| dx
cystic fobrosis
500
in order to diagnose rheumatic fever what 1 thing
evidence of a strep infection
2 major criteria or 1 major and 2 minor criteria
501
forchheimer spots
rubella
502
salter-harris type III fx what area of the bone
the physics (growth plate) as well as the epiphysis
503
a lacey pink rash
| dx
```
erythema infectiosum
aka
5th disease
aka
slapped cheek
```
504
unilateral purulent rhinitis
| dx
FB
505
medical term for cross-eyed
strabismus
506
organism most common cause of otitis media
strep pneumonia
507
at what age to say mamma, dadda
12 months
