Buzz words Flashcards
(710 cards)
1
Q
age for starting dexa scans
A
males 70, females 65
2
Q
dexa score for osteopenia, osteoporosis?
A
osteopenia 1-2.4, osteoporosis 2.5
3
Q
1 fracture for compartment syndrome
A
tibial shaft fracture
4
Q
+ smith antibodies & + double stranded DNA antibodies Dx?
A
Lupus
5
Q
where are bouchards nodes
A
PIP joint
6
Q
can an x-ray show an acute osteomyelitis
A
Nothing only chronic osteo
7
Q
best imaging osteo
A
bone scan or an MRI
8
Q
22 yr old male septic joint and lesions on knee and hands pathogen?
A
Neisseria gonorrhoeae
9
Q
wbc if septic joint
A
> 50,000 at minimum
10
Q
painless mass in R wrist
A
Ganglion cyst
11
Q
age range for osteosarcoma? Where most likely in body
A
15-25 yo males and knees
12
Q
think pt has osteoid osteoma, x-ray pending, in the meantime what med do you start?
A
if it is osteoid osteoma ibuprofen will resolve the pain
13
Q
clicking or locking of the knee is what diagnosis
A
meniscal tear
14
Q
65 year old woke up severe pain in his great toe. It is swollen, red and very tender. dx?
A
gout #1, consider infection
15
Q
uric acid level that confirms gout
A
> 7.5
16
Q
medical treatment for gout?
A
Allopurinol, colchicine
17
Q
+ birefringent crystals dx?
A
pseudogout
18
Q
pt with hx of hepatitis B presents complaining of bilateral knee pain, fever and weight loss. Dx?
A
polyarteritis nodosa
19
Q
suspect polyartheritis nodosa. Test for dx and what is Tx?
A
biopsy, high dose steroids
20
Q
ulnar deviations and swan neck deformities, dx?
A
rheumatoid arthritis
21
Q
+ Neer’s test dx?
A
rotator cuff impingement
22
Q
3 meds that cause lupus
A
procainamide, isoniazid and quinidine
23
Q
what test for Sjogren’s syndrome
A
Schirmer test
24
Q
A pt with RA is heading to OR, what x-ray do you need?
A
C-spine, due to concerns about instability of C1 & C2
25
What carpal bone has a high rate of non-union and occult fracture
Scaphoid
26
med used for pts with lupus
systemic steroids
27
Scleroderma limited version has 5 main characteristics for which CREST acronym is used, what are those 5 things?
```
Calcinosis
Raynaud's
Esophageal dysmotility
sclerodactyly
telangiectasia
```
28
there is a sunburst appearance on x-ray, what is the most likely Dx?
osteosarcoma
29
where are 80% of clavicle fractures anatomically
middle third
30
path shows negatively birefringent crystals. most likely dx?
gout
31
4 muscles of the rotator cuff
```
SITS
supraspinatus
infraspinatus
teres minor
subscapularis
```
32
characteristics of a lytic lesion on x-ray
speculated, elevated periosteum, bone destruction
33
most common injured ligament in ankle sprain
ATFL
| anterior talofibular ligament
34
dx?
| vasculitis with a hep B hx
polyarteritis nodosa
35
most common fracture in children
clavicle
36
fat pad sign on a lateral elbow x-ray means?
it is blood in the joint indicating a fracture even if a fracture line is not seen
37
progressive neck and proximal muscle weakness
PE- see a reddish purple maculopapular rash
lab- anti-jo-1 antibodies
dx?
polymyositis
38
what way does a collies fracture angulate dorsal or velar?
| smith fracture?
colles - dorsal
| smith - volar
39
tenderness over anatomical snuffbox, fx?
scaphoid
40
most common fracture in pt with osteoporosis?
compression fracture vertebra then hip
41
15 yo night pain in pelvis
| x-ray - mass with an "onion skin appearance" dx?
ewing sarcoma
42
name of 4th and 5th metacarpal fx from throwing a punch
boxer's fracture
43
new mom with pain over the radial wrist
+ Finkelsteins test
dx?
de Quervain's tenosynovitis
44
+ McMurry
| dx?
meniscal tear
45
McMurry test
the knee is held by one hand, which is placed along the joint line, and flexed to complete flexion while the foot is held by the sole with the other hand. The examiner then places one hand on the lateral side of the knee to stabilize the joint and provide a valgus stress in order to identify a valgus deformity. The other hand rotates the leg externally while extending the knee. If pain or a "click" is felt, this constitutes a "positive McMurray test" for a tear in the medial meniscus.
46
1st line treatment for carpal tunnel
night splint
47
most common cause of c-spine fracture
MVC
48
medical term for hunchback?
kyphosis
49
another term for podagra
gout
50
saddle anesthesia and loss of bowel and bladder function
| dx?
cauda equina
51
pt with HIV
severe groin pain
dx?
avascular necrosis of the femoral head
| antiretroviral meds increase risk for AVN
52
short, ext rotated leg dx?
hip fracture
53
instructions when taking biphosphonates?
| tx?
tx osteoporosis
| upright for 30 mins
54
```
#1 cause hip dislocation?
anterior or posterior?
```
MVC
| posterior
55
most common injured rotator cuff muscle
supraspinatus
56
tennis elbow aka?
lateral epicondylitis
57
1st line tx for RA
methotrexate
58
baseball bat to knee, unable to extend knee
| dx?
patella fracture
59
most common shoulder dislocation anterior or posterior?
anterior
60
most useful physical exam for ACL tear?
Lachman's followed by anterior drawer
61
Lachman's test?
The therapist holds the patients knee between full extension and 30 degrees of flexion.
The patient’s femur is stabilized with one of the examiner’s hands (the “outside hand) while the proximal aspect of the tibia is moved forward with the other (“inside”) hand.
62
most common knee injury
medial meniscal tear
63
where are heberden's nodes found?
DIP distal interphalangeal joint
64
knee pain after soccer
joint line tenderness medically and locking from time to time
what 2 physical exam tests?
medial meniscal tear
| McMurry and apply tests
65
Pt with conjunctivitis, urethritis, arthritis and oral lesions
dx?
other lab that is +
reactive arthritis
| HLA B-27
66
limping, feels like kicked in back of leg but wasn't
| dx?
Achilles tendon rupture
67
Anti-Jo-1 antibodies should make you think of what dx?
Polymyositis
68
+ crossover test dx?
AC joint injury
| acromioclavicular joint
69
crossover test
Adduct arm across front of chest
| Touch opposite Shoulder
70
+ Hawkins test
| dx?
Rotator cuff impingement
71
Hawkins test
Forward flexion of the shoulder to 90 degrees and internal rotation
72
+ Finkelstein's test
| dx?
de Quervain's tenosynovitis
73
Finkelstein's test
examiner pulls the thumb of the patient in ulnar deviation and longitudinal traction. If there is an increased pain in the radial styloid process and along the length of the extensor pollicis brevis and abductor pollicis longus tendons, then the test is positive for De Quervain’s syndrome.
74
+ Phalen and Tinel's sign
| dx?
carpal tunnel
75
bamboo spine
| dx?
Ankylosing spondylitis
76
+ straight leg test
| dx?
herniated disc
77
straight leg raise
If the patient experiences sciatic pain when the straight leg is at an angle of between 30 and 70 degrees, then the test is positive and a herniated disc is likely to be the cause of the pain
78
African American female
malar rash + double stranded DNA antibody
dx?
lupus
79
carpal tunnel which nerve?
| parts of hand?
median nerve
| thumb, pointer and ring finger
80
thenar wasting
advanced carpal tunnel
| The thenar region of the palm refers to the group of muscles in the thick pad just underneath the thumb.
81
silver fork deformity on x-ray
| dx
colles fracture
82
+ Apley dx?
meniscal tear
83
Apley test
the patient lays prone (face-down) on an examination table and flexes their knee to a ninety degree angle. The examiner then places his or her own knee across the posterior aspect of the patient's thigh. The tibia is then compressed onto the knee joint while being externally rotated. If this maneuver produces pain, this constitutes a "positive Apley test"
84
5 meds migraine prophylaxis
```
beta blockers
tricyclics
calcium channel blockers
NSAIDS
Valproic acid
```
85
unable to understand speech
| which aphasia?
wernicke's aphasia
86
facial paresis, arm drift and abnormal speech
| first 3 tests
brain CT or MRI
glucose
o2 sat
87
seizure without LOC
| dx
simple partial seizure
88
stroke no evidence hemorrhage
within 48 hours thrombolytics
89
painful ipsilateral third nerve palsy
| dx?
posterior communicating artery aneurysm
90
seizure med that causes overgrowth of gums
phenytoin
91
sudden thunderclsp ha
| dx
subarachnoid hemorrhage
92
Kernig's sign
pt lies supine, flex hip while keeping knee straight
| back pain is +
93
definitive test subarachnoid
LP
94
lateralized throbbing ha
N/V photophobia
type ha?
migraine
95
middle age male
unilateral periorbital ha daily for weeks
ha type
cluster ha
96
3 drugs that tx cluster ha
O2, immitrex, stadol (butorphanol)
97
34 yo relapsing and remitting x weeks,
vision issues, weakness R arm
dx
MS
98
tremor with motion in hands
| meds?
beta blocker like propranolol
99
shuffling gait
| dx
parkinson's
100
2 classes of drugs for parkinsons
dopaminergic (levodopa)
| anticholinergics
101
decreased GABA and substance P
| dx?
huntington's
102
Huntington's autosomal dominant or recessive
dominant
103
weakness in lower legs and now in knees and hips b/l
progressive
dx
Gullain-barre
104
% stroke ischemic
| hemorrhagic
I- 80%
| H - 20%
105
believe stroke
aphasia, loss hearing in 1 ear, loss vision L eye
blockage posterior or anterior circulation
posterior
106
when would asa or clopidogrel (plavix) as TIA prophylaxis
antiplatelet meds
used unless known cardiac etiology for embolism
if cardiac use heparin or coumadin
107
asymptomatic what % blockage of carotid for sx?
| symptomatic?
>70% asymptomatic
| >60% symptomatic
108
worst ha of life
| bp?
subarachnoid
| bp elevated
109
abortive meds for migraines
triptans (immitrex, zolitriptain)
| ergotamine
110
EEG shows focal rhythmic discharges at the onset of the seizure
dx?
simple partial seizure
111
most important concern status epilepticus
airway then management hyperthermia
112
brudzinski's sign
lift its head the pt bends his hips, knees
113
3 meds break a seizure
diazepam - valium
lorazepan - ativan
phenytoin - dilantin or fosphenytoin - cerebrex
114
MRI result of multiple foci of demyelination in the white matter
dx?
MS
115
3 meds to tx MS
steroids
interferon beta
copolymer 1
116
most common cause dementia
alzeimers 80%
117
4 chromosomes linked dementia
1, 14, 19, 21
118
ankle jerk reflex of lumbar or sacral origin
sacral
119
intracellular neurofibrillary tangles and extracellular neuritic plaques
dx?
alzheimer's
120
aching ha which feels like band around head
| dx?
tension ha
121
tremor R hand
gone after a beer
dx
benign essential tremor
| familial tremor
122
2 meds tx essential tremor
beta blocker - propranolol
| primidone
123
age huntington's appear
30 years old
124
35 yo increasingly irritable and moody, restless
CT shows cerebral atrophy, atrophy of the caudate nucleus
dx?
huntington's disease
125
med for tourette's
haloperidol
126
slit lamp shows Kayser-fleischer rings
| dx
wilson's disease
127
wilson's build up of what mineral
copper
128
genetic characteristics of wilson's
autosomal recessive
| chromosome 13
129
bells palsy which nerve
7
130
LP for bacterial menigitis
| wbcs, glucose, protein
wbc elevated
glucose decreased
protein elevated
131
classic migraine
aura
132
elevated circulating acetylcholine receptor antibodies
| dx
myasthenia gravis
133
Duchenne's and Becker's muscular dystrophy
| genetics
x-linked recessive
134
age range for duchenne's muscular dystrophy
3-5 years old
135
EEG shows spikes and associated slow waves
| dx
generalized or absence seizure
136
most common primary intracranial neoplasm
glioma
137
most common cause subarachnoid other then trauma
ruptured cerebral aneurysm
138
most common primary cancer sites that met to brain
lung, breast and kidney
139
resting or pill-rolling tremor
| dx
parkinson's
140
weakness and numbness in L hand blockage of which carotid
right
141
intracranial neoplasm causing auditory illusions, olfactory hallucinations and emotional changes
which lobe
temporal
142
looking for lesions with MS
| with or without gadolinium
with contrast
143
defining sx of Alzheimer's
progressive memory impairment
144
which nerve root for knee jerk reflex
L3, L4
145
EEG shows interictal spikes
| dx
complex partial seizure
146
most commonly herniated disc
L4-L5 followed by L5-S1
147
3 sxs are classic for normal pressure hydrocephalus
gait disturbance
dementia
urinary incontinence
148
unable to speak
R sided weakness
understands and follows commands
aphasia type
broca's aphasia
149
alcohol major factor encephalopathy
wericke's
150
muscle weakness, fatigability improves with rest
| dx
myasthenia gravis
151
lead pipe or cogwheel rigidity
| dx
parkinson's
152
how long panic attack last
10-20 mins
153
most common hallucination with schizophrenia
auditory
154
cause anorexic its to have osteopenia
a decrease in estrogen
155
benzos for acute or chronic tx
acute
156
most common cause PTSD in women
rape
157
pt male that is hyper vigilant and hyper startle response
| dx
PTSD
158
are its with phobias aware they are strange
yes
159
sudden development stage freight
| tx
beta blocker
| propranolol
160
doughnut shaped burn
| issue?
child or elder abuse
161
generic prozac
fluxetine
162
how long sxs for ADD
6 months
163
no friends, seldom leaves house, terrified meeting people
avoidant personality disorder
164
ADD sxs at school not at home
| add?
no must be in both
165
18 months, no speaking, does not point, no eye contact
| dx
autism
166
3 + sxs schizophrenia
Hallucinations, delusions, movement disorders
167
typical onset tourettes
3-8 yo
168
anorexia egosyntonic or ego-dystonic
| bulimia?
anorexia - egosyntonic
| bulimia ego-dystonic
169
Egosyntonic
referring to behaviors, values, feelings that are in harmony with or acceptable to the needs and goals of the ego, or consistent with one's ideal self-image.
deny issue
170
Egodystonic
ewers to thoughts and behaviors (e.g., dreams, impulses, compulsions, desires, etc.) that are in conflict, or dissonant, with the needs and goals of the ego, or, further, in conflict with a person's ideal self-image.
aware issue
171
3 cluster A personality disorders
"mad" schizoid
schizotypal
paranoid
172
amenorrhea time
3 months if use to be regular, 6 if irregular
173
16yo changed schools
quiet, mossy and not himself
6 months back to nl
adjustment disorder
174
pt with major depressive disorder
| once sxs resolved how long to still treat
a 6 month minimum
175
meds for PPD while breast feeding
sertraline - zoloft
176
strange magical thinking
| dx
schizotypal personalty disorder
177
4 sxs serotonin syndrome
hyperthermia
seizure
MSC
tremor
178
chronic mild depression greater 2 years
dysthymia
179
whats needed for bipolar 1 dx
1 manic episode
| no depressive episode needed
180
major concern with using lithium
very narrow therapeutic window
| monitor blood level q 4 weeks
181
pt thinks 15 yo sleeping with mailman, no evidence, not interfering with DAL but thinking about a lot
dx
delusional disorder
182
BMI hospitalized for anorexia
BMI < 17.5 or 20% below IBW
183
term for being afraid of being out in a terrible situation with no help available
agoraphobia
184
borderline personality disorder is on the border of what 2 psychological disorders
neurosis and pychosis
185
waxy flexibility, dx
catatonic schizophrenia
186
how long before normal grief resolves
about a year
187
pt always craves attentions, often using sex
acts like a child when doesn't get their way
dx?
histrionic personality disorder
188
ADD sxs before what age
7
189
russell's sign
abraded knuckles from forcing oneself to vomit
190
how long sxs before schizophrenia
6 months
191
posturing
| dx
catatonic depression
192
pt with acute paralysis left arm, doesn't bother him
neuro work up neg
dx
conversion disorder
193
psych pt with confusion, fever, lead pipe rigidity
| dx
neuroleptic malignant syndrome
| occurs with high dose antipsychotics
194
pt concerned that she has breast ca, full negative work up, still unsatisfied and convinced
dx
hypocondriasis
195
time frame for 1st sxs withdrawal alcohol
tremor in 8-18 hours
196
tx alcohol withdrawl
benzos
197
list the 4 cluster B personality disorders
"bad" antisocial
borderline
histrionic
narcissistic
198
2 cluster C personality disorders
"sad" avoidant
| obsessive compulsive
199
med clearly contraindicated in anorexia and bulimia
bupropion (wellbutrin) in can increase risk of seizures
200
2 psychiatric issues more common in males then females
autism and ADD
201
pt works at home, seldom leaves, no interest in meeting others and happy to be home alone
dx
schizoid personality disorder
202
SSRIs
```
Fluoxetine - prozac
paroxetine - paxil
sertraline - zoloft
citalopram - celexa
escitalopram - lexapro
dapoxetine
zimelidine
mesembrine
seproxetine
```
203
pt concern can't trust anyone, everyone out to get him, everyone else's fault
dx
paranoid personality disorder
204
pt charming, no concern for hurting or using others, no remorse
dx
antisocial personalty disorder
205
antisocial personality disorder can't be dx till what age
18 yo
206
antisocial personality disorder but only 14 yo
| dx
conduct disorder
207
pt splitting, all others as all good or all bad
| dx
borderline personality disorder
208
type behavioral therapy works best for borderline pts
dialectical behavior therapy
209
pt is arrogant with an inflated self image, feels he is special and should be treated that way
dx
narcissistic personality disorder
210
Is obsessive compulsive disorder egosyntonic or ego-dystonic?
obsessive compulsive personality disorder?
OCD is ego-dystonic. OCPD is egosyntonic.
211
2 things needed dx bipolar 2
one major depressive and 1 hypomanic episode
212
good 1st med bipolar 1 and 2
lithium
213
how is acute stress different then PTSD
acute within 1 month of event and resolved in 1 month
| PTSD about 1 month after event last indefinitely
214
spinal fx
| dx
elder or child abuse
215
"i have been anxious for as long as I can remember"
| dx
generalized anxiety disorder
216
are hallucinations normal during a normal grieving period
yes as long as they are not persistent or intrusive
217
side effect stop ACEI
cough
218
orthostatic hypotension
drop in systolic >20 when standing
219
vibrating pulse
thrill
220
3 differentials for paradoxical pulse
cardiac tamponade
pericarditis
obstructive lung disease
221
paradoxical pulse
abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration.
the drop is more than 10mm Hg
222
on palpation nl size aorta
<3cm
223
a fixed consistent split S2
| dx
atrial septal defect
224
pathologic S3
| dx
CHF
225
mid systolic click
| click
MVP
226
opening snap
| dx
mitral stenosis
227
continuous murmur, area heart
septal defect
228
continuous machine like murmur
| dx
PDA
| patent ductus arteriosus
229
3 meds used for pharmacological stress test
adenosine
dobutamine
dipyrudamole
persantine
230
gold standard CAD
cardiac cath
231
stage 1 htn
systolic 140-159
| diastolic 90-99
232
tx goal dm with htn
130/80
233
most common cause secondary htn
chronic kidney disease
234
can't control htn no matter meds
hyper pigmented skin and truncal obesity
dx
cushing's disease
235
3 sxs of pheochromocytoma
```
thin
diaphorectic
tachy
agitated
hypertensive
```
236
pt with pheochromocytoma
| while waiting for sx, alpha or beta blocker
alpha
| never use beta blocker
237
young boy
elevated bp, no palpable femoral pulse
dx
coarctation of the aorta
238
nl BMI
18.5-24.9
239
1st line tx stage 1 htn
thiazide diuretic
240
after thiazide diuretic start in pt with dm
and ACEI or ARB
241
after MI med for htn
beta blocker
242
paroxysmal nocturnal dyspnea
| dx
CHF
243
most common cause CHF
CAD
244
EF for pt with CHF
35-40%
245
most likely dx young man who experiences sudden death while playing sports
hypertrophic cardiomyopathy
246
bat wing vessels or kerley B lines on CXR dx?
CHF
247
BNP level rules out CHF
<100
248
INR goal after valve replacement
2.5-3.5
249
1st line inotropic agent with cardiogenic shock
dopamine
250
dx IVDA with heart murmur and fever
endocarditis
251
dx abc prophylaxis for "dirty procedure"
Prosthetic valve
valve repair with any prosthetic material
prior endocarditis diagnosis
congential cyanotic heart defect.
252
abx for dental work with MVP
no now mod risk not high risk
253
3 major criteria for endocarditis
2 + blood cultures
+TEE
new murmur
254
painful and found on fingers and toes
osler nodes
255
4 minor criteria for endocarditis
fever
embolic event (janeway lesios, perechiae, splinter hemorrhages)
immunological event (osler nodes, glomerulonephritis
1 + blood culture
256
5 components of tetralogy of fallot
```
ventricular septal defect
R ventricular hypertrophy
R ventricular outflow obstruction (pulm valve stenosis)
overriding aorta
R sided aortic arch
```
257
gold standard dx myocarditis
myocardial biopsy
258
where do most aortic dissections occur
the ascending or descending thoracic aorta
259
severe pleuritis chest pain worse with leaning forward
| dx?
pericarditis
260
1st line tx for pericarditis
ASA and NSAIDS
261
syndrome that involves pericarditis several days after MI
Dressler syndrome
262
ER with CP
EKG shows diffuse ST elevations in all of the leads
dx
pericarditis
263
paradoxical pulse
large difference in pulse pressure between inhalation and exhalation
264
pulsus alternans
EKG waveform changes from beat to beat
265
definitive tx for cardiac tamponade
pericardiocentesis
266
harsh systolic murmur along the R sternal border
| dx?
aortic stenosis
267
wide pulse pressure with a blowing diastolic decrescendo murmur at the right 2nd intercostal space
dx?
aortic regurgitation
268
location to hear aortic valve issues?
2nd R intercostal space
269
location to hear pulmonary valve best
2nd L intercostal space
270
2 abx for endocarditis
vanc and ceftriaxone together
271
2 valvular issues with Marfan's syndrome
Aortic regurg and MVP
272
2 main causes of aortic stenosis
congenital bicuspid valve
| calcification of the valve due to CAD
273
elderly pt with dyspnea, angina and syncope on exertion
EKG nl
dx?
aortic stenosis
274
harsh blowing pan systolic murmur at the apex
| dx?
mitral regurgitation
275
suspect mitral regurgitation, how to dx
TEE
276
pt with MVP what physical characteristics
thin female
277
best patient position to hear aortic regurg and aortic stenosis
sitting up and leaning forward
278
Tietze syndrome
costochondritis
279
are most pulmonary valve problems congenital or acquired
95% congenital
280
INR after organic valve replacement
2 to 3
281
60yo male in ER severe dizziness and back pain
BP dropping +abd pulsatile mass
dx
ruptured aortic aneurysm
282
pt with aortic stenosis, will the PMI be medially displaced, normal or laterally displaced
laterally displaced due to LVH
283
severe crushing CP
EKG shows ST segment elevations
all labs negative
dx?
prinzmetal's angina
284
key hx of prinzmetals angina
cocaine use
285
+ stress test
drop in BP
new arrhythmia
increase in angina sxs
st depressions
286
ulcers from venous insufficiency painful or painless
painless
287
how long after cardiac stent on asa and plavix
1 year
288
issues with mitral valve best heard
apex
289
initial tx MI
MONA
| morphine, oxygen, nitro, asa
290
clot busting drugs within 3 hours of which 2 cardiac events
STEMI, new LBBB
291
3 catastrophic complications of a MI
papillary muscle rupture
myocardial wall rupture
L ventricular aneurysm
292
EKG shows a regular heart rate of 200 bpms
QRS narrow
dx?
supraventricular tachyacrdia
293
most common cause of sudden death
ventricular fibrillation
294
acute endocarditis is most commonly caused by what organism
staph aureus
295
3 congenital heart diseases
```
ASD - atrial septal defect
VSD - ventricular septal defect
coarctation of the aorta
PDA - patent ductus arteriosus
tetralogy of fallot
```
296
most common cause of an atrial septal defect
patent foramen ovale
297
atrial septal defect best heard murmur
at the left second or 3rd interspace
298
a CXR shows a "3" sign with notching of the ribs
| dx
coarctation of the aorta
299
tx for a patent ductus arteriosus
indomethacin
300
blalock procedure corrects what congenital heart condition
tetralogy of fallot
301
loud, harsh pulmonary murmur along the left sternal border
| dx?
ventricular septal defect
302
subacute endocarditis caused by what organism
strep viridans
303
most common place for an aortic aneurysm
in and and below the renal arteries
304
males or females more likely to have an aortic aneurysm
males are 8 times as likely
305
accessory pathway known as the james bundle, what syndrome
Lown - Ganong - Levine syndrome
306
what imaging before OR with aortic aneurysm
CT
307
risk factors for an aortic dissection
htn
marfans syndrome
bicuspid aortic valve
pregnancy
308
tearing CP rad to back
| dx
aortic dissection
309
CXR for pt with aortic dissection shows
widened mediastinum
310
best test to dx an aortic dissection
CT
311
6 P's of an ischemic limb
```
pain
paresthesias
pallor
pulselessness
poikilothermia
paralysis
```
312
pt with pulses paradoxes
| dx's?
pericarditis
pericardial effusion
obstructive lung disease
313
pt ℅ of pain in legs with walking
goes away after sitting
term for sxs?
dx?
intermittent claudication
| peripheral arterial disease
314
giant cell arteritis
| what disease?
polymyalgia rheumatica
315
sawtooth pattern on EKG
| dx
atrial flutter
316
what accessory pathway is associated with wolff-parkinson-white syndrome
the bundle of kent
317
a biphasic P wave should make you think of what dx
left atrial enlargement
318
gold standard for dx giant cell arteritis
biopsy of the temporal artery
319
tx for giant cell arteritis
high dose prednisone
320
virchow's triad (3)
stasis
vascular injury
hypercoagulability
321
calf pain
| dx?
DVT
322
best hear issues of the tricuspid valve
along the left sternal border
323
most common congenital heart disease
VSD - ventral septal defect
324
ulcers from arterial insufficiency painful or painless
painful
325
3 contraindications of ACEI
bilateral renal artery stenosis
hx of angioedema
pregnancy
326
both lead I and AVF have + QRS complexes
| axis?
normal
327
what med might you switch pt to for cough on ACEI
ARBs
| angiotensin receptor blocker
328
class of cardiac meds not used in asthma
Beta blockers
| blocks receptors for brochodilators
329
boot shaped heart on CXR
| congenital dx
tetralogy of fallot
330
RSR prime in leads V1 or V2
| dx?
RBBB
331
labs monitored in pt taking aldosterone antagonist
K
| may have hyperkalemia
332
dest test dx CHF
echo
333
what cardiac med is used to help with contractility after optimizing most others?
Digoxin
334
blockage of which artery causes an anterior wall MI
left anterior descending artery
335
what lab result will increase the risk of digoxin toxicity
hypokalemia
| hypercalcemia
336
```
a pt presents in acute CHF
what class of drug is 1st choice
```
loop diuretics
337
pt has a GFR of 25 and HTN
class of htn med
Loop or thiazide
loop will work no matter how low the GFR is
| Thiazides will only work with a GFR over 30
338
anterior wall MI
V1, V2 and V3
339
do loop diuretics cause hyperkalemia or hypokalemia
hypokalemia
340
statins drug of choice for which dyslipidemia
elevated LDL
341
pt recently started lipitor
now with aches and pains
test to order?
serum creatinine kinase
| at risk for rhabdomyolysis
342
how does ezetimibe (zetia) work
decreases intestinal absorption of cholesterol
343
which hyperlipdemia med may cause flushing
niacin
344
4 med "classes" for reduction in LDL
statins
ezetimibe
niacin
nicotinic acid
345
2 fibrin acid derivatives
fenofibrate (tricor)
| gemfibrozil (lopid)
346
3 class 1a antiarrhythmics
disopyramide (norpace)
quinidine
procainamide
347
counting boxes to determine rate
300, 150, 100, 75, 60
348
U wave on EKG
| dx?
hypokalemia
349
what will heart rate be if the AV node is pacing the heart
40-60 bpm
350
cardiac med may cause gynecomastia
spironlactone
351
lead I up
AVF down
axis?
LAD
352
Osborne or J wave on EKG
| dx?
hypothermia
353
1st line med for symptomatic bradycardia
atropine
354
HR tachy or bradycardia
Tachy >100
| brady <60
355
on EKG there is an early but o/w nl PQRS complex
then a slight pause then nl rhythm continues
term for 1 beat
PAC
356
tx for polymyalgia rheumatica
low dose prednisone
357
management of pt with SVT
vagal maneuvers
carotid massage
adenosine
358
1st line med for atrial flutter
adenosine
359
82yo with ha and jaw claudication
| dx?
giant cell (temporal) arteritis
360
EKS shows irregularly irregular narrow QRS waves
| dx?
atrial fibrillation
361
EKG shows a regular rate of 50 bpm
QRS is narrow no p wave
dx
junctional rhythm
362
common cause junctions rhythm
dig toxicity
363
EKG shows 2 PVC look very different
| term?
multifocal PVCs
364
most common cause sudden cardiac death
V fib
365
pt with no pulse
| keg wide irregular complexes, irregular rate
in V Fib
| tx defibrillation
366
Tall peaked T waves
| dx
hyperkalemia
367
define 1st degree AV block
PR interval is longer then 0.2 seconds or one block on EKG
368
another term for mobitz type I
wenckebach
369
complication of giant cell arteritis
blindness
370
2 labs to monitor in a pt on an ACEI
serum creatinine
| serum K
371
HR irregular can't count boxes
| another way to determine rate
count QRS waves in a six second strip and multiply by 10
372
tx for mobitz II AV block
pacemaker
373
see regular P waves and reg QRS complexes, not correlated
| dx?
3rd degree AV block
374
aldosterone antagonists (2)
spironolactone (aldactone)
| eplerenone (inspra)
375
short PR interval and a delta have on keg
| dx?
wolff parkinson white syndrome
376
what 2 leads determines axis
lead I and AVF
377
axis I and AVF nl
+/+
378
axis I and AVF LAD
+/-
379
axis I and AVF RAD
-/+
380
RSR prime in leads V5 or V6
| dx?
LBBB
381
worse LBBB or RBBB
new LBBB is a STEMI
| RBBB normally not a problem
382
med class to lower triglycerides
fibrin acid derivatives
383
tall peaked P waves
| dx?
R atrial enlargement
384
list 3 causes of RAE
pulmonary htn
severe lung disease
pulmonary valve stenosis
385
which leads to dx an anterolateral MI
V5 and V6
386
3 inferior leads
II, III and AVF
387
lateral wall MI which artery
left circumflex artery
388
depressions greater then 1mm on EKG -
ischemia
389
rheumatic fever most commonly affects which valve
mitral valve
390
cyanotic congenital heart disease
tetralogy of fallot
391
EKG shows early wide QRS complex with no P wave
then pause and NSR
term 1 beat?
PVC
392
definitive tx recurrent VT
implanted defibrillator
393
EKG gradually lengthening PR interval and then a missed QRS complex, repeats
what AV block?
mobitz I or wenckebach
394
side effects of digoxin
```
N/V
anorexia
confusion
arrhythmias (sinus brady, av block)
fatigue
vision disturbances
```
395
1st line tx for torsades de pointes
magnesium sulfate
396
why tx actinic keratosis
it may progress to squamous cell carcinoma
397
1st line tx for rosacea
metronidazole
| tetracycline 2nd
398
where are 90% of basal cell lesions found on the body
on the head and neck
399
purple pruritic polygonal papule on PE
| dx?
lichen planus
400
ABCDE of melanoma
```
asymmetry
border
color
diameter
elevation/irregular
evolving
```
401
+ auspitz sign
| dx
psoriasis
402
auspitz sign
Auspitz's sign is the appearance of punctate bleeding spots when psoriasis scales are scraped off
This happens because there is thinning of the epidermal layer overlying the tips of the dermal papillae and blood vessels within the papillae are dilated and tortuous, which bleed readily when the scale is removed
403
key indicator for the prognosis of melanoma
thickness of the lesion
404
tx melaonma
wide local excision
405
waxy stuck on appearance
| dx?
seborrheic keratosis
406
5yo in jan with a red itchy rash behind knees and on flexor surfaces of elbows
dx?
atopic dermatitis
407
term satellite lesion
| dx
candida diaper rash
408
coin shaped plaques
| dx
nummular eczema
409
30 yo female with pustules on face that spare vermillion border
hx using topical steroids
dx
perioral dermatitis
410
pt presents with flaky skin in the nasolabial folds and in hair
dx
seborrheic dermatitis
411
tx stasis dermatitis
compression stockings
412
tapioca blisters
| dx?
dyshidrosis
| usually on the hands and feet
413
tx dyshidrosis
topical steroids
414
giant cells on tzanck smear
| dx
herpes simplex virus
415
tx lichen simplex chronicus
get the pt to stop scratching it
416
herald patch
| dx
pityriasis rosea
417
tx pityriasis rosea
reassurance
418
pt with hx herpes now with target lesion
| dx
erythema multiforme
419
rhinophyma
| dx
acne rosacea
420
silvery scales
| dx
psoriasis
421
teardrop lesion after a course of strep throat
| dx
guttate psoriasis
422
are lesions from psoriasis found on flexor or extensor surfaces
extensor
423
1st line tx for tine corporis
topical azoles
424
2 most common organisms for cellulitis
strep and staph
425
pitting nails
| dx
psoriasis
426
nummular eczema is most like what?
atopic dermatitis
427
honey colored crusts
| dx
impetigo
428
2 herpes viruses for condyloma aceminata
6 and 11
429
double comedone
| dx
hiradenitis suppurativa
430
tx molluscum contagiosum
self limiting but can removed
431
tx for seborrheic keratosis
benign no need to treat it
| can be removed if unsightly
432
hyper pigmented velvety plaques
| dx
acanthosis nigricans
433
melanoma most common which pts
women of childbearing age
434
extremely pruritic lesions with burrows in runs
scabies
435
1st step in tx atopic dermatitis
behavioral modifications
reduce bathing
only use soap on face and genitals
natural breathable fabrics
436
tx for bad brown recluse spider bite
debridement
| venom causes tissue necrosis
437
salmon - colored scales
| dx
psoriasis
438
depigmented patches of skin
| dx
vitiligo
439
spaghetti and meatball on KOH
| dx
tinea versicolor
440
What dermatologic finding is associated with insulin insensitivity
acanthosis nigricans
441
slowly growing nodule with a central depression and a pearly border
dx
basal cell carcinoma
442
dermatologic findings associated with asthma
atopic dermatitis
443
christmas tree pattern
| dx
pityriasis rosea
444
oval patches of hair loss
| dx
alopecia areata
445
1st line tx genital warts
imiquimod (aldara)
446
pearly dome shaped lesions with a central umbilication
| dx
molluscum contagiousum
447
best test scabies
microscopic exam under oil immersion
448
2 hormones are secreted by posterior pituitary
```
oxytocin
antidiuretic hormone (adh, vasopressin)
```
449
sheehans syndrome
ischemia of the pituitary due to volume depletion during or after childbirth
450
how do giltazones work
they improve insulin sensitivity
451
most common pituitary adenoma
prolactinoma
452
large doughy hands
| dx
gigantism
453
DM insipid us is caused by a deficiency of which hormone
vasopressin
454
how much more potent is T3 than T4
3-4x
455
1st line tx for pheochromocytoma
alpha blocker
| never use a pure beta blocker
456
best imaging for a thyroid nodule
US
457
pt with ED and complains of some numbness in feet
also with significant polyuria and polydipsia
dx
diabetic neuropathy
458
pretibial myxedema
| dx
graves disease
459
35 yo F heat intolerance, wt loss and palpitations
hyperthyroidism
460
1st line tx for pt with palpitations and nervous with hyperthyroidism
beta blockers
461
hashimoto's disease
an autoimmune cause of hypothyroid
462
how does levothyroxine work
it is a synthetic T4
463
most common thyroid cancer
papillary makes 80% of thyroid cancers
464
pt with hyperthyroidism, tsh elevated or decreased
decreased
465
how do fib rates work to affect the lipid profile
inhibit synthesis of VLDL and elevate lipoprotein lipase
466
med prior to thyroidectomy in a pt with hyperthyroidism
methimazole or
| PTU propylthiouracil
467
while's triad of hypoglycemia
hx of previous hypoglycemia
serum glucose of <40
immediate recovery upon admin of glucose
468
+ antithyroid peroxidase and antithyroglobulin antibodies
| dx
hashimoto's
469
tx for myxedema
levothyroxine and slow warming
470
most common cause hypoparathyroid
post thyoidectomy with the complication of parathyroidectomy
471
chvostek's sign
tap on facial nerve and get a twitch with low Ca
472
cortical adrenal insufficiency aka
addison's disease
473
trousseau's sign
inflate BP cuff and hold for 3 minutes
| pt with low Ca will get carpel tunnel sxs
474
most common cause of hyperparathyroidism
single parathyroid ademona in 80% of cases
475
cushing's disease is ACTH elevated or decreased
elevated
476
graves disease
most common cause of hyperthyroidism
| an autoimmune disease
477
what specific breathing pattern is associated with diabetic ketoacidosis
kussmaul respirations
478
least aggressive thyroid cancer
papillary
479
2 tests you might use to rule out cushing's
24hr free cortisol urine test and dexamethasone suppression test
480
3 ectopic tumors that may produce ACTH and give a patient cushing's sndrome
small cell lung cancer
pancreatic islet cells
thymomas
481
tx for addison's disease
hydrocortidone or prednisone
482
test to begin with if you suspect pheochromocytoma
24 hour urine for catecholamines
483
exophthalmos
| dx
hyperthyroidism
484
%dm in US type 2
80-90%
485
HLA-DR gene is a marker for what endocrine disorder
DM type 1
486
main function of parathyroid hormone
increase serum ca
487
4 diagnostic criteria for dm
random glucose >200
fasting glucose >126
2hr postprandial >200
HgA1c > 6.5%
488
moans, groans, stones and bones
| what dx
hyperparathyroid
489
stocking glove should make you think of what dx
diabetic neuropathy and B12 deficiency neuropathy
490
fruity breath
| dx
DKA
491
dm
| dawn phenomenon
reduced insulin response between 5 and 8am
492
most common cause of hypopituitarism
tumor
493
how does metformin work
decreases the hepatic glucose production and increases peripheral glucose uptake
494
how do sulfonylureas meds work
stimulate the production of insulin
495
what class of meds does pioglitazone (actos) fall into
thiazolidinediones also known as glitazones
496
suffix associated with sulfonylureas
ide
| ex: glipizide, tolbutamide, tolazamide
497
1st med in DM 2
metformin
498
how ofter do u check HgbA1c goal?
every 3 months
(rbi life 90-120 days)
below 6.5%
499
5 criteria for metabolic syndrome
HDL 135/85
Triglycerides >150
Fasting glucose >100
waist >40 men, >35 women
500
1st class of meds for lowering LDL
statins
501
lipid med may cause flushing
niacin
502
life threatening side effect of statins
rhabdomyolysis
503
does niacin increase or decrease HDL
increase
504
class of med is metformin (glucophage)
biguanide
505
5 insulins in order of peak efficacy
```
lispro 1-2 hrs
regular 2-4 hrs
NPH 5-7 hours
lente 4-8 hrs
ultralente 8-14hrs
```
506
metformin contra or indicated in renal failure
contraindicated
507
most common cause of DM type 1
autoimmune destruction of the islet cells in the pancreas
508
PE in cushings (6)
```
moon face
buffalo hump
purple striae
central obesity
suprclavicular fat pads
easy bruising
```
509
propranolol what class meds
beta blockers
510
while pregnant tx for hyperthyroidism
PTU
511
4 thyroid cancers
papillary
follicular
medullary
anaplastic
512
what heparin complication is relevant to endo
adrenal infarct leading to a Cushing's syndrome
513
how does nicotinic acid work to affect the lipid profile
it inhibits secretion of VLDL
514
hyper pigmentation of the skin along creases
| dx?
addison's disease
515
most agressive thyroid cancer
anaplastic
516
how do statins work to affect the lipid profile?
they slow the rate limiting step of cholesterol synthesis
517
will ACTH be elevated for decreased in Addison's
elevated if the problem is at the adrenal glands
518
what role does C-peptide play in the diagnosis of DM
it is a marker of insulin production
Elevated C-peptide points to DM2
Decreased C-peptide points to DM 1
519
2 most common pathogens acute sinusitis
strep pneumoniae
| haemophilus infuenzae
520
oral herpes is best treated with systemic or topical antivirals
topical is 1st line
| systemic antivirals will help but are only indicated for severe cases
521
pt with several episodes of vertigo over the past several weeks
intermittent unilateral hearing loss and a "blowing" in his ears
dx?
meniere's disease
522
white oral lesion which cannot be scraped off
| dx?
oral leukoplakia
523
what type of hearing loss is associated with aging
sensory
524
which is the most commonly affected sinus in acute sinusitis
maxillary
525
pt with a hot potato or muffled voice
| dx?
peritonsillar abscess
526
time frame for chronic sinusitis
> 3 months
527
list the time of year when each of the following allergens is most prominent:
pollen, grass, mold and ragweed
spring: pollen from trees and flowers
Summer: grasses
Fall: mold and ragweed
528
how long pressure for nose bleed
15 mins
529
4 things that suggest group A beta-hemolytic strep
fever
tender anterior cervical adenopathy
no cough
exudate in the throat
530
child with erythematous sandpaper rash
scarlet fever
531
pt with sensorineural hearing loss what will be the results of the weber test
pt will hear the sound louder in the unaffected ear
532
4 complications of untreated strep throat
scarlet fever
glomerulonephritis
rheumatic fever
local abscess
533
pt with round ulcer in her mouth that is yellow-grey with a red halo
on buccal mucosa
painful
dx?
aphthous ulcers
534
pt with drooling, stidor and in tripod position
| dx? treatment?
epiglottitis
| 2nd or 3rd gen cephalosporin like cefuroxime or ceftriaxone
535
oral lesions that can be scraped off leaving punctate bleeding
dx?
oral candida
536
3 treatments for peritonsillar abscess
needle aspiration
I&D
tonsillectomy
537
virus that causes mumps
paramyxovirus
538
tx for allergic rhinitis
intranasal corticosteroid
| antihistamines
539
tx for strep throat
penicillin
amoxicillin
erythromycin
540
unilateral hearing loss and decrease in speech discrimination
difficulty with balance over a week
dx?
acoustic neuroma
541
acute swelling and pain in the cheek that increases at meals
| dx?
sialadenitis
salivary gland infection
staph aureus
542
when is watchful waiting with a dx of acoustic neuroma an appropriate plan
if tumor is very slow growing
watching a small tumor in an elderly pt is appropriate tx
543
what type of hearing loss would be caused by cerumen impaction
conductive
544
how do you administer the weber hearing test
tuning fork placed in the middle of the forehead
545
14 yo with adenopathy, white purple exudates in throat and palpable spleen
dx
mononucleosis
546
how do you administer the weber hearing test
tuning fork on the mastoid and then move it next to the ear
547
results of a weber hearing test in pt with conductive hearing loss
pt will report sound louder in the affected ear
548
x-ray of the skull reveals coalescence of mastoid air cells
| dx?
mastoiditis
549
abc 1st line sinusitis
amoxicillin or bactrim
550
45 yo female complains of feeling the ground rolling under her feet at times
dx?
vertigo
551
pt with hx of smoking presents with new onset hoarseness, persistent for 2 weeks
dx?
laryngeal squamous cell carcinoma
552
pt presents with acute onset of continuous severe vertigo for the past 5 days
hx URI 2 weeks ago
dx
labrynthitis
553
what does kiesselbach's plexus refer to
group of veins in the anterior nose which bleed a lot
554
small grouped vesicles on the vermillion border
| dx
herpes
555
most common type kidney stones
calcium 85% of stones
556
most specific imaging for kidney stones
CT
557
will a spermatocele transillumnate
yes
558
a stone of what size will likely pass
less than 5mm
559
3 possible treatments for stress incontinence in women
kegels
estrogen therapy
surgical placement of a urethral sling
560
65 yo male presents with frequency
on rectal exam elastic moderateley enlarged prostate
dx
BPH
561
a PSA above what is concerning
>4
562
risk factors for ED
DM, htn, depression, CAD
563
1 major risk factor for bladder cancer
smoking
564
paraphimosis
foreskin is retracted and cannot be reduced
565
which is an emergency phimosis or paraphimosis
paraphimosis
566
phimosis
the inability to retract the skin (foreskin or prepuce) covering the head (glans) of the penis.
567
what is the name of the condition that involves fibrous scar tissue in the penis causing a curvature of the erect penis
peyronie's disease
568
both testicles should be descended by what age
3 months
569
feeling a bag of worms in the scrotum
| dx?
varicocele
570
fluid filled painless mass found in the scrotum which transilluminates
dx?
hydrocele
571
1st line treatment for a variocele
watchful waiting unless there is a question of fertility
572
prehn's sign
decreased pain with scrotal elevation
573
meaning prehn's sign
the physical lifting of the testicles relieves the pain of epididymitis but not pain caused by testicular torsion
574
maltese crosses in the urine
| dx?
nephrotic syndrome
575
imaging for bladder cancer
cystoscopy and bx
576
free floating, painless, cystic mass found posterior and superior to the testis
dx?
spermatocele
577
age range is typically associated with testicular torsion
10-20 yo
578
where is the epididymis found
posterior upper pole
579
best imaging to rule out testicular torsion
doppler US for decreased blood flow to the testes
580
2 most common causes epididymitis
gonorrhea
| chlamydia
581
med classes to prevent chronic renal failure in DM pts
ACEIs or ARBs
582
will epididymitis feel better with scrotal elevation
yes
583
nl level serum bicarb
24
584
tx epididymitis
ceftriaxone and doxy
585
1st line abc for cystitis
bactrim
586
most common organism for bladder infection
E.Coli
587
1st line abx for postatitis
bactrim 4-6 weeks
588
risk factors for prostate cancer
advancing age
african american
+ family hx
high fat diet
589
what do you feel on a digital rectal exam on a pt with prostate ca
enlarged prostate
| hard nodules
590
priapism
painful persistent erection
591
how many samples from a prostate bx
6 to 12
592
painless hematuria
| dx
bladder cancer
593
most common bladder cancer
transitional cell cancer
594
phimosis
foreskin can not be retracted
595
head of the penis curves downward for upward at the junction of the head and shaft of the penis
chordee
often associated with hypospadias
596
tx urethritis
ceftriaxone and doxy
597
3 yo boy with hematuria and a painless and mass
| dx
wilms tumor
598
3 possible causes of pre renal renal failure
CHF
severe dehydration
hemorrhage
599
most common cause post renal failure
BPH
post renal renal failure is secondary to an outflow obstruction
600
muddy brown sediment in the urine
| dx
acute tubular necrosis
601
tea colored urine with red cell casts
| dx
glomerulonephritis
602
2 common predisposing factors in chronic renal failure
HTN
| DM
603
sponge like prostate on rectal
| dx
prostatitis
| you can cause sepsis with a rectal exam
604
is serum potassium decreased or elevated in renal failure
elevated
605
urine protein of >3.5 gm/day
| dx
nephrotic syndrome
606
hereditary of polycyctic kidney disease
autosomal dominant
607
nl ph of blood
7.35-7.45
608
how to dx urethritis
urine PCR
609
nl PCO2
40
610
```
abg shows
ph 7.2
bicarb 25
pco2 50
respiratory or metabolic acidosis
```
respiratory co2 is elevated
611
WBC casts
| dx
pyelo
612
what area of the prostate is affected by BPH
transitional zone
613
what area of the prostate is the primary side for prostate cancer
peripheral zone
614
involuntary loss of urine during coughing or laughing
stress incontinence
615
nl bladder function but can not get to the bathroom
functional incontinence
616
what type of incontinence is seen with BPH
overflow incontinence
the bladder can not empty sufficiently
617
at what age do you start screening for prostate cancer, how?
50 with rectal and PSA
618
often caused by chlamydia what syndrome is characterized by urethritis, arthritis and conjunctivitis
reiter's syndrome
619
most common type of testicular cancer
nonseminoma
620
nl range for MCV
80-100
621
most common microcytic anemia
iron deficiency anemia
622
anemia of chronic disease is
normocytic
623
2 main causes of a macrocytic anemia
malnutrition
| severe blood loss
624
does an increase in reticulocytes indicate a decrease or an increase in RBC production
an increase
reticulocytes are newly released baby RBCs
625
auer rods
| dx?
acute myeloid leukemia
626
what molecule binds iron in the blood stream
transferrin
627
koilonychia
spoon shaped nails
| microcytic anemia
628
will the serum ferritin be high or low in a patient with iron deficient anemia
almost always be low
629
a low retic count and a normal serum ferritin
| dx?
anemia of chronic disease
630
what level consider transfusion
8
631
asplenism secondary to sickle cell disease increases a patient's risk for what type of infections
capsulated organisms like strep pneumo and H flu
632
AA teen presents with avascular necrosis of the R femoral head
dx?
sickle cell disease
633
tx for sickle cell
fluids
oxygen
pain meds
transfusion
634
in sickle cell unconjugated bill high or low
high
635
which anemia has Howell-Jolly bodies
sickle cell
due to the functional asplenia
also in folic acid deficiency
636
G6PD inheritance
X-linked
637
3dx for Heinz bodies
G6PD deficiency anemia
chronic liver disease
alpha thalassemia
638
pica?
eating non-food items
639
target cells in mild or severe iron deficiency anemia
severe
also in
alpha thalassemia
chronic liver disease
asplenia
640
level of iron in iron deficiency anemia
30
641
B12 deficiency anemia
| micro, normo or macrocytic
macrocytic
642
4 regions for alpha thalassemia
southeast asia
china
middle east
africa
643
mediterranean descent which anemia
beta thalassemia
644
level of folic acid in folic acid deficiency
< 150
645
pica which anemia?
iron deficiency anemia
646
inability to absorb vitamin B12 due to lack of intrinsic factor
dx?
pernicious anemia
647
stocking glove paresthesias
| 2dx?
B12 deficiency neuropathy
| diabetic neuropathy
648
RBCs size in B12 deficient anemia
macrocytes
649
retic count in B12 deficient anemia
retic count will be low
650
schilling's test used for
test for the cause of B12 deficiency
651
Strict vegans are at risk for which anemia
B12 deficiency anemia
652
sickle cell
| micro, macro or normocytic
microcytic
653
will hemolytic anemia have elevated or decreased retic count
elevated
654
4 dx with basophilic stippling
lead poisoning
beta or alpha thalassemia
sideroblastic anemia
arsenic poisoning
655
anemia of pregnancy
iron deficiency
656
dx?
| philadelphia chromosome
chronic myeloid leukemia
657
white curd like vaginal dc
| dx?
yeast
658
owl eye inclusion bodies
| dx?
CMV
| cytomegalovirus
659
+ blood cultures for canidida
| 1st line drug?
amphotericin B
660
tx for pertussis
erythromycin x 7 days
661
a leukemia pt has a CT of the liver which shows punched out lesions
dx?
hepatosplenic candida
662
what disease does rickettsia rickettsii cause
Rocky mountain spotted fever
663
india ink stain showing cysts
| dx?
cryptococcosis
664
COPD pt has apical cavities and calcified nodes on CXR, he has a pet bat and a few birds
dx?
histoplasmosis
665
HIV pt with a nonproductive cough and CXR with diffuse interstitial infiltrates
dx?
PCJ / PCP
| pneumocystis jiroveci pneumonia
666
honey and babies
| dx
botulism
667
what type organism causes botulism
gram + rod
| clostridium botulinum
668
tx for botulism
antitoxin
669
ER pt with acute progressive weakness, diplopia and very dry mouth
dx?
clostridium botulinum
670
rice water stool
| dx?
cholera
671
is diphtheria a gram + or negative organism
gram-positive
672
a stuck on grey membrane in the pharynx
| dx?
diphtheria
673
4 steps in treating diphtheria
antitoxin
pcn
remove membrane
report case to CDC
674
clinical name for whooping cough
pertussis
675
what type organism for tetanus
gram + rod
| clostridium tetani
676
pt ate out last pm today with cramping and bloody diarrhea
| organism?
salmonella
677
diarrhea with blood and mucus
| dx?
shigella
678
best test to dx malaria
peripheral blood smear
679
organism for reactive arthritis
shigella
| reactive arthritis has a + HLA-B27
680
tx for shigella
bacterium or fluroquinolones and hydration
681
organism for lyme disease
borrelia burgdorferi
682
minimum Amt of time needed for a tick to transfer lyme disease to a human
24 hours
683
drug of choice to treat lyme disease in kids or pregnant women
amoxicillin
684
drug to treat C. difficile
flagyl
685
pt in woods yesterday and today with erythema migrains
| dx
lyme disease
686
drug to treat or prophylaxis of malaria
chloroquine
687
pt was camping a few days ago
now has rash that began on his wrists and ankles
dx
rocky mountain spotted fever
688
drug of choice for rocky mountain spotted fever
doxycycline
689
drug of choice for syphilis
pcn
690
any reference to dark field microscopy should make you think what organism
treponema pallidum
691
staph gram + or -
gram +
692
pt being treated with pen for syphilis
develops fever, chills, muscle pain and ha
do u stop tx?
no
this is a jarisch-herxheimer rxn
pt must be closely monitored
it is a response to released endotoxin from the death of the spirochetes and not an allergic reaction
693
what organism is believed to cause PUD
h. pylori
694
painless, clean base chancre
| dx
primary syphilis
695
pseudomonas
| gram + or -
gram -
696
rash on palms and soles
fever, chills
painless chancre a few weeks ago
dx?
secondary syphilis
most contagious
697
tx for cholera
fluids
698
drug of choice for cytomegalovirus
ganciclovir
699
herpes virus that causes epistein-barr
herpes 4
700
pt education for mono
no contact sports - splenic rupture
no kissing - contagious
701
exudative sore throat, malaise
PE- posterior chain lymphadenopathy, mild splenomegaly
dx?
epstein-barr virus
702
1st sxs rabies infection
pain and anesthesia at the site of the bite
703
definitively dx rabies
pathology of the brain of the animal using fluorescent antibody stain
704
pt bit by rabies animal
what days do you give human diploid cells
0, 3, 7, 14, 28
705
diaper rash with satellite lesions
| dx
canidida
706
3 serious reactions to vancomycin
nephrotoxicity
ototoxicity
stevens-johnson
707
tests done to screen for HIV
ELISA and then if +
| confirm with western blot test
708
drug of choice for lyme disease
doxycycline
709
trismus?
lock jaw
| often secondary to tetanus
710
tx amebiasis
flagyl
