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Comprehensive Exam > Comprehensive Pearls > Flashcards

Comprehensive Pearls Flashcards

(107 cards)

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0
Q

Cullen sign

A

In acute pancreatitis:

Periumbilical bruising

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1
Q

Charcot Triad

A

Cholangitis

Jaundice, fever >38c, RUQ pain

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2
Q

Turner sign

A

In acute pancreatitis:

Flank bruising

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3
Q

Anion gap calculation

A

Anion gap=Na+ - (HCO3- + Cl-)

Normal 12 +- 4

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4
Q

Pulsus paradox

A

> 10mm drop in systolic BP during inspiration

Seen in cardiac tamponade, COPD, hypovolemic shock, patients using unusually strong inspiratory effort (asthma)

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5
Q

MUDPILERS

A

Anion gap metabolic acidosis

Methanol
Uremia
DKA/Alcoholic KA
Paraldehyde
Isoniazid
Lactic Acidosis
Etoh/Ethylene Glycol
Rhabdo/Renal Failure
Salicylates
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6
Q

4Fs

A

Risk factors for cholelithiasis:

Fat
Female
Fourties
Fertile

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7
Q

Mallory-Weiss tear

A

Esophageal tear from retching, vomiting, straining

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8
Q

Trousseau and Chvostek signs

A

In hypocalcemia

Trousseau: hand curling with BP cuff inflation

Chvostek: facial twitching with tap

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9
Q

Murphy’s Sign

A

In acute cholecystitis:

Patient halts inspiration with subcostal palpation

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10
Q

Collin’s Sign

A

In cholelithiasis:

Pain radiating to right scapular tip

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11
Q

Alport’s Syndrome

A

Nephritis with high frequency hearing loss and visual changes

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12
Q

Goodpasture’s Syndrome

A

Glomerulonephritis with hemoptysis

Dx: anti-GBM abs

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13
Q

Wilm’s Tumor

A

Renal tumor

Non-tender abdominal mass in a 2-5 year old

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14
Q

Reynold’s Pentad

A

In acute cholangitis:

Charcot’s triad (RUQ tenderness, jaundice, fever) plus altered mental status and hypotension; indicates sepsis

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15
Q

Courvoisier’s Sign

A

In pancreatic cancer:

Jaundice and a palpable gallbladder

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16
Q

ALT/AST in alcoholism

A

AST will be >2x ALT

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17
Q

Alkaline phosphatase

A

Elevated in biliary obstruction

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18
Q

ALT/AST

A

Released into bloodstream upon liver damage, not useful for advanced cirrhosis/fibrosis

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19
Q

Wilson’s Disease

A

Genetic abnormality in copper metabolism

Diagnostic tetrad: evidence of liver disease, neuro symptoms, low ceruloplasmin levels, Kayseri Fleischer rings on iris

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20
Q

Rovsing’s sign

A

In acute appendicitis:

Increased pain in RLQ with palpation of LLQ

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21
Q

Dressler’s Syndrome

A

1-2 weeks post-MI

Low grade fever, pleuritic chest pain, pericardial effusion

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22
Q

Metabolic syndrome

A 
3 or more of:
Abdominal obesity
Triglycerides >150
HDL 110
Hypertension
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23
Q

Pulsus parodoxus

A

> 10mm fall in BP with inspiration

Occurs in cardiac tamponade

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24
Ankle brachial index
<0.9 is peripheral arterial disease
25
Thumbprint sign
In acute epiglottitis
26
Steeple sign
In croup, also seal-like barky cough
27
S1Q3T3
Classic ECG finding in PE (seen in <20%)
28
Hypertension Dx (JNC 7)
Systolic >140 or diastolic >90 on 3 separate occasions
29
Desirable lipid levels (ATP III)
Total cholesterol 60
30
Janeway Lesions
Painless erythematous lesions of palms and soles Seen in infective endocarditis
31
Osler's Nodes
Painful violaceous lesions of lesions of fingers, toes, or feet In infective endocarditis
32
Pyramidal system damage sx
Weakness Hyperactive tendon reflexes Spasticity Babinski positive (up going)
33
Extrapyramidal system damage sx
Bradykinesia Rigidity Tremor Athetosis/chorea
34
Cerebellar damage sx
``` Errors of: Rate Range Force Direction ```
35
"Lucid interval"
Epidural hemorrhage
36
"Worst headache of my life"
Subarachnoid hemorrhage
37
Cushing's Triad
For increased ICP: Increasing BP Falling pulse + widening pulse pressure Abnormal respiratory patterns
38
Status epilepticus duration
At least 5 minutes
39
Guillain-Barre
Symmetrical extremity weakness that begins distally and ascends Associated with preceding infection of the lungs or GI tract, esp. Campylobacter jejuni
40
Myasthenia gravis
Antibodies against Ach receptors Weakness and fatigability of skeletal muscles
41
Multiple sclerosis
Autoimmune Multiple foci of demyelination of CNS white matter Initially episodes of reversible neurological deficits
42
ALS
Amyotrophic Lateral Sclerosis "Lou Gehrig's Disease" Degeneration of upper and lower motor neurons in the CNS Progressive weakness of speech, swallowing, extremities No sensory loss
43
RBC lifespan
120 days
44
Platelet lifespan
7-10 days
45
Hemophilia A
Factor VIII deficiency X-linked recessive, males only
47
Von Willebrand Disease
Deficient or defective vWF Tx desmopressin (ADH)
48
HIT
Heparin-induced thrombocytopenia 5-14 days after starting heparin Mild to moderate thrombocytopenia and thrombosis
49
ITP
Immune thrombocytopenic purpura Common in children (2-4) following infectious process, not very sick Isolated thrombocytopenia Tx: prednisone, gamma globulin
50
TTP
Thrombotic thrombocytopenic purpura Deficiency of vWF-cleaving ADAMTS13 Thrombocytopenia, progressive renal failure, CNS sx Tx: plasmapharesis
51
HUS
Hemolytic uremic syndrome In children, follows bloody diarrhea Microthrombi are confined to kidneys
52
Reed Sternberg Cells
Hodgkins Lymphoma
53
Philadelphia chromosome
CML | Treated with Gleevec
54
Auer rods
AML
55
Can't see can't pee can't climb a tree
Reactive arthritis Acute asymmetric arthritis 3-4 weeks after GI or STI infection Especially shigella and chlamydia
56
Sausage fingers
Psoriatic arthritis
57
Bamboo spine
Ankylosing spondylitis
58
Inflammatory arthritis in patients with IBD
Enteropathic arthritis
59
HLA-B27+ RF- ANA-
Seronegative spondyloarthropies
60
Scottie dog fracture
Spondylolysis
61
Bugs that cause reactive arthritis
Shigella and chlamydia
62
Gottron's papules, heliotrope rash, shawl sign
Dermatomyositis | Dx: inc. CK and aldolase, muscle bx
63
+ANA
Lupus (in 99%)
64
Legg-Calve-Perthes Disease
Aseptic necrosis of hip in 4-8 year olds
65
Osgood-Schlatter
Osteochondritis of tibial tubercle | Mostly 11-13 year olds
66
Heberden and Bouchard nodes
In osteoarthritis: Heberden DIP Bouchard PIP
67
+RF and +CCP | DIPs spared
Rheumatoid arthritis
68
Tophus
Urate crystal Seen in gout Usually attacks metatarsal phalangeal joint of great toe first
69
Herald patch and Christmas tree pattern
Pityriasis rosea Tx: self-limiting
70
Auspitz's Sign
Peeling a scale produces specks of bleeding Seen in psoriasis
71
"Stuck on look"
Seborrheic keratosis
72
Ototoxic med
Gentamicin and other aminoglycosides
73
Otitis media organisms
Strep pneumo, H. influenzae, M. catarhhalis Tx: amoxicillin, augmentin as 2nd line
74
Central vs peripheral vertigo
Central: nystagmus vertical Peripheral: nystagmus horizontal
75
Centor Criteria
Tonsillar exudates, tender cervical nodes, hx of fever, absence of cough
76
Blood and thunder retina
Central retinal vein occlusion
77
Intertrigo
Rash in body folds Seen in Type II diabetes
78
Curtain-like loss of vision
Retinal detachment
79
BP Target in Diabetics
<130/80
80
Metabolic syndrome
3 or more of: ``` BP >130/85 Fasting glucose >100 Large waist Low HDL High triglycerides >150 ```
81
"Bones, stones, moans, and psychiatric overtones"
Hypercalcemia
82
24hr Urine VMA
Used to diagnose pheochromocytoma | Excess catecholamine production
83
Goiter with a bruit
Grave's disease | Hyperthyroidism
84
Prolactin regulation
Release inhibited by dopamine Stimulated by TRH Inhibits GnRH
85
Sheehan's Syndrome
Post-partum infarction of pituitary | Posterior pituitary usually spared
86
Grayish membrane
Diphtheria Tx: horse serum antitoxin from CDC
87
Rash with azithromycin for suspected strep pharyngitis
EBV infectious mononucleosis Dx: monospot or heterophile Ab test
88
Sandpaper rash with strep throat
Scarlet fever
89
Jones Criteria
For acute rheumatic fever: ``` J-joints, arthritis O-heart, carditis N-nodules, subcutaneous E-erythema marginatum S-Syndenhan's chorea ``` Occurs 15-20 days after strep pharyngitis
90
Koplik spots
In measles Bluish-white lesions
91
Slapped cheek
Erythema infectiosum (Fifth disease) Caused by parvovirus
92
Skin infection antibiotic of choice
Cephalexin
93
RPR or VDRL
Test for syphillis Tx: pen G
94
SIRS
Systemic inflammatory response syndrome Fever, tachycardia, tachypnea, high leuks Most commonly in sepsis
95
ASO titer
Increased in rheumatic fever
96
Roth spots
Retinal hemorrhages Seen in infective endocarditis
97
Rice water diarrhea
Cholera
98
"Owl eye" inclusions
Cytomegalovirus
99
Lewy body dementia
Visual hallucinations or paranoia/delusions
100
Prehn's Sign
For evaluating testicular pain: Positive-pain relieved when lifting testicles, likely epididymitis Negative-pain not relieved, likely testicular torsion
101
Ballard score
Estimates gestational age
102
Blueberry muffin spots
Congenital rubella in 1st trimester
103
Basophilic stippling
Lead toxicity
104
Lisch nodules
Neurofibromatosis-1
105
Fixed split S2
Atrial septal defect
106
Stills Disease
In children Spiking fevers at least 2 weeks in addition to arthritis Salmon colored rash
107
Legg-Calve-Perthes Disease
Avascular necrosis of femoral head in peds

Comprehensive Exam (2 decks)

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