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Flashcards in COMQUEST material updated Deck (232):
1

Initial test for diagnosing acromegaly

Insulin-like growth factor level (get an MRI)

2

Collection of blood beneath the periosteum of one of the calvarial bones; does not cross the suture lines

Cephalhematoma

3

Egg-on-a-string x-ray

Transposition of the great vessels

4

Benign tumors most commonly seen in women of reproductive age and are associated with contraceptive use, anabolic steroids, and glycogen storage disease

Hepatic adenomas (surgically remove if they are symptomatic, more than 5 cm, or do not regress after discontinuation of OCPs)

5

Mononeuritis multiplex and hepatitis B are associated with

Polyarteritis nodosa

6

Chest pain precipitated by hot or cold liquids without other obvious pathology is most likely the result of

diffuse esophageal spasm (use manometry to diagnose)

7

Classic triad of patent ductus arteriosus, deafness, and cataracts

Rubella (German measles)

8

Hypocellular marrow with loss of precursor cells, predominated by fat and stroma, is diagnostic of

aplastic anemia

9

Which labs should be checked prior to prescribing lithium?

BUN/Cr, thyroid function, and pregnancy

10

Most common causative agent of osteomyelitis

Staph aureus

11

Elevated methylmalonic acid and homocysteine

Vitamin B12 deficiency

12

Splitting of the basement membrane (tram-track appearance)

Membranoproliferative glomerulonephritis

13

Bead-like pattern on cholangiography; presents with pruritis and jaundice

Primary sclerosing cholangitis (associated with ulcerative colitis)

14

Boot-shaped heart

Tetralogy of Fallot

15

Low risk moms are advised to take how much folic acid before conception?

.4 mg (400 mcg)

16

Painful limp after a URI

transient synovitis

17

Cafe-au-lait spots, neurofibromas, freckling of the groin or the axilla, skeletal abnormalities, ad hamartomas of iris (Lisch nodules)

Neurofibromatosis type 1 (more common)

18

Always start lymphatic drainage techniques with

thoracic inlet release

19

Sacrum nutation and counternutation, while standing, occur about the

middle transverse axis

20

Defect in excretion of bilirubin and results in conjugated hyperbilirubinemia; liver has black pigmentation on biopsy

Dubin-Johnson syndrome

21

What is the most sensitive screening test for SLE?

ANA

22

Transient hyperthyroidism and thyroid tenderness followed by hypothyroidism

Subacute thyroiditis (de Quervain thyroiditis)

23

Positive blood culture for S. bovis along with features of infective endocarditis, you should suspect

colorectal cancer (order a scope)

24

Lateral and posterior margin of the IT band (Chapman's point)

Prostate

25

Once the anterior fontanelle is closed, it is known as

bregma

26

Best test to assess iron deficiency

Ferritin

27

Once the posterior fontanelle is closed, it is known as

lambda

28

Hypogonadism plus impaired sense of smell equals

Kallmann syndrome

29

What leads to insulin resistance during pregnancy?

Human placental lactogen (chorionic somatomammotropin)

30

Hand, foot and mouth disease is most commonly caused by

Coxsackie A virus

31

Which type of stroke will result in contralateral motor and sensory deficit of the face, hand and arm? 

Middle cerebral artery stroke 

32

Gastric ulcers are more common in which blood type?

Type A
gAstric ulcers = type A

33

First-line vasopressor for sepsis

Norepinephrine

34

Decreased iron (Fe), decreased ferritin, increased TIBC

Iron deficiency anemia

35

The most common cause of SBO in adults in the US is

adhesions

36

The presence of a widened mediastinum on chest x-ray in patients who handle animal wool/hides/hair is a classic finding of

inhalational anthrax

37

Patients have a higher incidence of colon and multiple other cancers, especially endometrial cancer in women

Hereditary non-polyposis colorectal cancer (Lynch syndrome)..mutation of DNA mismatch repair genes. 3-2-1 rule: three affected family members, involving at least two generations, one or more cancer diagnosed before the age of 50

38

Hematochezia and narrow (pencil-thin) stool is usually indicative of

Left-sided colon cancer

39

Anytime a pt presents with a new onset murmur, what is the diagnostic modality of choice?

Echocardiogram

40

First-line tx to slow diabetic nephropathy

ACE inhibitors

41

Antimitochondrial antibodies are associated with

primary biliary cirrhosis

42

Pruritus associated with primary biliary cirrhosis (antimitochondrial antibodies) can be treated with

cholestyramine or colestipol

43

Tumor marker that is useful in the management of pancreatic cancer

CA 19-9

44

The inherent motion of the sacrum between the ilia as part of the primary respiratory mechanism happens on the

superior transverse axis (respiratory axis)

45

Tumors that arise at the confluence of the hepatic ducts

Klatskin tumors

46

Drugs of choice for absence seizures

Valproic acid or ethosuximide

47

Most common form of leukemia in children

Acute lymphoblastic leukemia (ALL) TdT+

48

Overdose associated with nystagmus

PCP

49

What is the most common infection leading to GBS?

Campylobacter jejuni

50

When the forearm pronates, the radial head moves

posterior

51

Patient's limit for range of motion

Physiologic

52

Most specific test for myasthenia gravis

Acetylcholine receptor antibody test

53

Osteomyelitis in a patient with sickle cell disease is most likely due to

Salmonella

54

Most common cause of nephrotic syndrome in children

Minimal change disease (effacement of foot processes)

55

Seizures, mental retardation, ash-leaf spots (hypomelanotic macules), facial angiofibromas, and cutaneous nevi

Tuberous sclerosis

56

Treatment of choice for Shigella dysentery

Ciprofloxacin, azithromycin, or ceftriaxone

57

Essential tremor is best treated with

beta blockers

58

Smudge cells are a characteristic finding in

chronic lymphocytic leukemia

59

In a neutral group of segments, sidebending and rotation occur in

opposite directions

60

Leukocytosis after an infection with a lab finding of increased leukocyte alkaline phosphatase

Leukemoid reaction

61

Similar to Dubin-Johnson syndrome, resulting in conjugated hyperbilirubinemia, but the liver will not turn black

Rotor syndrome

62

Turner syndrome is treated with

human growth hormone and estrogen replacement therapy

63

Muscles involved with correction of a first rib dysfunction

Anterior and middle scalenes

64

Side effect associated with trazodone

Priapism

65

Most useful lab value to monitor heparin therapy

PTT

66

Best initial choice in workup of a breast mass in a woman < 30 years old or pregnant

Breast ultrasound

67

Most preferred test to diagnose renal cell carcinoma

CT with and without contrast

68

Patient presents with hundreds of thousands of adenomatous polyps in addition to osteomas, dental abnormalities, desmoid tumors, and cutaneous lesions

Gardner's syndrome

69

Antidepressants associated with strong anticholinergic effects (dry mouth, drowsiness, nausea, constipation)

Tricyclic antidepressants

70

Multiple pigmented spots most often found on the lips, oral mucosas, and GI mucosa

Peutz-Jeghers syndrome

71

Most infantile hemangiomas require

observation

72

In dorsiflexion, the talus is

posterior

73

Zenker's diverticulum is managed with

myotomy +/- diverticulectomy

74

First time PE should be treated with heparin followed by coumadin for

3-6 months

75

Causes ipsilateral hemiparesis, loss of proprioception and vibratory sense, as well as contralateral loss of pain and temp

Brown-Sequard syndrome

76

When endocarditis is suspected, the most important initial step is to

obtain three sets of blood cultures

77

Most common cause of meningitis from newborn to 3 months

GBS

78

Arousal by the clothing worn by the opposite sex

Transvestic fetishism

79

Most common inherited thrombophilia

Factor V Leiden

80

Injury of which nerve causes winging of the scapula?

Long thoracic nerve (serratus anterior)

81

Most common cardiac manifestation associated with Marfan's syndrome

Mitral valve prolapse

82

Viscerosomatic reflex of the thyroid gland is between

T1-T4

83

Polycythemia vera leads to _______ erythropoeiten

decreased

84

Highest diagnostic sensitivity for the diagnosis of colorectal cancer

CEA (carcinoembryonic antigen)

85

Appropriate first-line tx for uterine relaxation for retained placenta

Nitroglycerin

86

The middle meningeal artery can be found just deep to

pterion

87

Most common type of testicular germ cell tumor

Seminomas (bhCG might be elevated)

88

First line tx for sideroblastic anemia with ringed sideroblasts

Pyridoxine (Vit B6)

89

Most common cause of meningitis from 3 months to 9 years

S. pneumoniae

90

Test of choice for suspected nephrolithiasis

Noncontrast CT

91

In plantarflexion, the talus is

anterior

92

Pruritic, purple, polygonal, papules/plaques

Lichen planus (look for Wickham striae)Most common: flexor surfaces of wrists/ankles

93

Which type of adenomas carry the highest risk of transformation to a malignant lesion?

Villous adenomas

94

RhoGAM is administered to all Rh-negative women at

28 weeks gestation

95

First line treatment for whooping cough

Macrolides (Azithromycin, erythromycin, clarithromycin)

96

Glucagonomas arise from pancreatic

alpha cells

97

MEN IIA

Medullary thyroid carcinoma, pheochromocytoma, parathyroid tumors/hyperplasia

98

Low calcium, low phosphate, elevated PTH

Secondary hyperparathyroidism due to Vitamin D deficiency

99

Occurs when the supratentorial brain herniates downward and compresses cranial nerve 3, resulting in an ipsilateral dilated pupil that cannot constrict to light

Uncal herniation

100

Preferred method of biopsy for a suspected melanoma

Excisional biopsy

101

Diagnostic test of choice for lactose intolerance

hydrogen breath test

102

Treatment of choice for acromegaly

Transsphenoidal surgical resection

103

Painless blistering of the dorsal surface of the hands with increased facial hair and hyperpigmentation

Porphyria cutanea tarda (does not present with abdominal pain)

104

Primary treatment for hydatidiform mole

D&C

105

Test of choice for patients with uncomplicated diverticulosis

Colonoscopy

106

ANA and anti-smooth muscle antibodies are positive; associated with SLE

Autoimmune hepatitis

107

Albinism is associated with loss of pigmentation secondary to

tyrosinase deficiency

108

CD4 count below 100, which prophylaxis should be started

Toxoplasma gondii (TMP-SMX)

109

Bilateral tremor (6-10 Hz) that improves with alcohol use

Essential tremor

110

What has been shown to reduce the morbidity and mortality of measles (rubeola)?

Vitamin A

111

What should be given with isoniazid to prevent deficiency?

Vitamin B6 (pyridoxine)

112

Muscle involved in a rib 2 dysfunction

Posterior scalene

113

Anticoagulation of choice in pregnancy

Subcutaneous heparin

114

Irregularly prolonged or heavy menstrual period that maintains a normal menstrual cycle

Menorrhagia

115

Most common cause of renal stenosis in young adults, especially women

Fibromuscular dysplasia

116

BLT with Mayo and a Kosher Pickle

Breast, Lung, Thyroid, Multiple myeloma, Kidney and Prostate (cancers with bone mets)

117

Treatment of choice for dermatitis herpetiformis

Dapsone

118

Most common organism associated with spontaneous bacterial peritonitis

E. coli

119

An inflammatory vasculitis characterized by claudication from vaso-occlusion; known as thromboangiitis obliterans; smoking is strongest risk factor

Buerger disease

120

Characterized by menorrhagia and dysmenorrhea; physical exam will reveal and enlarged and soft uterus

Adenomyosis (ectopic endometrial glands)

121

Patients at risk for tumor lysis syndrome should receive prophylaxis with

allopurinol or rasburicase

122

Defect in the pars interarticularis; radiography may reveal a scotty dog "collar"

Spondylolysis

123

Word substitutions, meaningless words, meaningless phrases (poor comprehension, "word salad").

Wernicke's aphasia (receptive)

124

First trimester hyperthyroidism is treat with

propylthiouracil

125

CD4 count below 50, which prophylaxis should be started?

Mycobacterium avium complex (azithromycin)

126

What is often the first manifestation of asbestosis?

Decreased DLCO (carbon monoxide diffusing capacity)

127

Doxorubicin is associated with

dilated cariomyopathy

128

Muscle involved in rib 12 dysfunction

Quadratus lumborum

129

NNT formula

1/absolute risk reduction

130

Most sensitive test for pancreatic cancer

CT scan

131

Numbness and tingling at the fifth finger and ulnar half of the fourth finger is associated with

Cubital tunnel syndrome

132

Trigeminal neuralgia can be treated with

carbamazepine or oxcarbazepine

133

The most specific test for CREST syndrome is

anti-centromere antibody

134

The most common cardiac abnormality associated with Turner syndrome is

bicuspid aortic valve

135

Granular casts (muddy brown casts) and renal tubular casts

Acute tubular necrosis

136

Most common location for compartment syndrome

Anterior compartment

137

Patients with family history of familial adenomatous polyposis should undergo annual flexible sigmoidoscopy or colonoscopy starting at

puberty

138

Treatment of choice for endometriosis

NSAIDs and OCPs

139

Major risk factor for placenta accreta

Previous c-section

140

Isoniazid can deplete vitamin ____ so supplementation is necessary

B6

141

Nephritic syndrome, low C3 levels; biopsy reveals IgG and C3 in a granular pattern

Postinfectious glomerulonephritis 

142

Most common cause of nephrotic syndrome in patients with HIV, IV drug abuse and sickle cell

Focal segmental glomerulosclerosis

143

Trinucleotide repeat (CGG) on FMR1 gene

Fragile X syndrome

144

Treatment of choice for von Willebrand disease

Desmopressin (DDAVP)

145

What class of anti-hypertensives can be used for osteoporosis or kidney stones?

Thiazide diuretics (reduced calcium excretion in the urine)

146

Low risk patients with a solitary lung nodule should be followed with

serial chest CTs for two years

147

Pancreatic cancer is most often located in the

pancreatic head

148

Deletion of paternal 15q11-12

Prader-Willi syndrome

(diminished fetal activity, obesity, hypotonia, mental retardation, short stature, hypogonadotropic hypogonadism, strabismus, and small hands and feet)

149

Akathisia is treated with

beta blockers, benzodiazepines, and benztropine

150

A 6-year-old child is diagnosed with pheochromocytoma and clear cell renal cell carcinoma. Testing reveals a heritable disorder

von Hippel-Lindau syndrome

151

Antibodies directed against presynaptic calcium channels; better with activity

Lambert-Eaton syndrome

152

Initial treatment for ulcerative colitis

5-ASA/mesalamine or sulfasalazine

153

Cornerstone of preventing contrast induced nephropathy

Vigorous hydration

154

What is the most common cause of gastric and duodenal ulcers?

H. pylori

155

For an acute cluster headache, what is the first line tx?

100% oxygen

156

Muscle involved in ribs 6-9 dysfunction

Serratus anterior

157

Occurs when patients are overtreated with NPH and 3am glucose measurement reveals hypoglycemia; patients will be hyperglycemic in the morning

Somogyi effect

158

Increased level of insulin and decreased C-peptide and proinsulin levels

Factitious hypoglycemia

159

Smudge cells and the CD5 protein

Chronic lymphocytic leukemia

160

Neurologic deficits and upper arm claudication with exercise of the upper extremity

Subclavian steal syndrome

161

Erythema multiforme minor is most commonly associated with

herpes simplex virus (target-like lesions)

162

Sarcoidosis causes what type of pattern on spirometry?

Restrictive (FEV1/FVC normal or elevated). Look for hypercalcemia and an elevated ACE level

163

Microcytic anemia, pica, koilonuchia (spoon shaped nails) and esophageal webs

Plummer-Vinson syndrome

164

Respiratory and craniosacral motion

Superior transverse axis

165

Contralateral motor and sensory deficit in the leg is associated with which artery?

Anterior cerebral artery

166

Roseola infantum (sixth disease) is caused by

HHV-6 (fever for 2-5 days followed by a maculopapular rash)

167

Response to treatment of osteomyelitis is monitored with

ESR and CRP

168

Presents with hematuria following a viral illness and biopsy will show IgA and C3 deposits

IgA nephropathy (Berger's disease)

169

Low dose CT of the chest is recommended for lung cancer screening for

55 to 80 years old; 30 pack year hx who are still smoking or whom have quit in the past 15 years

170

Bilat weakness; loss of pain and temp in a cape-like distribution

Syringomyelia

171

CD4 count below 200, which prophylaxis should be started?

Pneumocystis jiroveci (TMP-SMX)

172

Maculopapular rash that starts on the face and spreads caudally; arthralgias; suboccipital and postauricular lymphadenopathy

Rubella (Togavirus)

173

Postural motion

Middle transverse axis

174

Epidural hematomas are caused by rupture of the

middle meningeal artery 

175

Possible findings on a chest x-ray in a patient with PE

Westermark sign or a Hampton hump

176

Treatment for toxoplasmosis

Pyrimethamine and sulfadiazine

177

Lupus immunoglobulins

anti-dsDNA, anti-Smith

178

Reflux in a baby is very commonly due to vagal irritation secondary to congestion from

occipital condylar compression

179

Most common infection causing aplastic crisis in patients with sickle cell disease

Parvovirus B19 (tx aplastic crisis with blood transfusion)

180

During craniofacialsacral flexion, the sacrum

counternutates (extends)

181

Duodenal ulcers are more common in which blood type?

Type O
duOdenal ulcers = type O

182

Polyarteritis nodose related to hep B should be treated with

interferon alpha-2b

183

Most common hereditary cause of colon cancer

Lynch syndrome

184

Most specific test for pancreatic cancer

ERCP

185

Defects in type III collagen are associated with

Ehlers-Danlos syndrome (joint hypermobility and cutaneous fragility and hyperelasticity)

186

Used to slow the progression of disease in ALS

Riluzole

187

Number needed to harm equation

1/attributable risk

188

Lyme disease is caused by

Borrelia burgdorferi (Ixodes tick)

189

Necrolytic migratory erythema is associated with

glucagonoma

190

Autoantibodies directed against the postsynaptic acetylcholine receptors; worsens with activity

Myasthenia gravis

191

First-line tx of diabetic gastroparesis

metoclopramide or erythromycin

192

Most common cause of acute pancreatitis

Gallstones

193

Most common risk factor for dementia

Age

194

Patients develop significant anxiety about development of a serious physical illness in response to minor or no symptoms

Illness anxiety disorder

195

Measles (rubeola) is caused by

Paramyxovirus (conjunctivitis, cough and coryza; Koplik spots)

196

Anti-glomerular basement membrane (anti-GBM) antibodies and ANCA are indicative of

Goodpasture syndrome

197

Caused by tertiary syphilis; decreased reflexes, unsteady gait, formication, and impaired proprioception

Tabes dorsalis

198

Skin condition associated with celiac disease

Dermatitis herpetiformis (IgA and gliadin protein combine)

199

Treatment of choice for diffuse esophageal spasm

Calcium channel blockers (e.g., diltiazem)

200

Reveal blasts from myeloid lineage and be positive for reactions with myeloperoxidase and sudan black

Acute myelogenous leukemia

201

Target organ resistance to PTH

Pseudohypoparathyroidism (low Ca, elevated phosphate, elevated PTH)

202

Primary adrenal insufficiency requires replacement of

both mineralocorticoid and glucocorticoid (hydrocortisone)

203

Innominate rotation

Inferior transverse axis

204

Caused by growth hormone secretion in the morning; 2 am glucose measurement will reveal hyperglycemia

Dawn phenomenon

205

Decreased iron (Fe), increased ferritin, decreased TIBC

Anemia of chronic (inflammatory) disease

206

Primary hyperparathyroidism is most commonly caused by

adenoma (look for serum PTH and calcium levels to be elevated; phosphorous will be decreased)

207

Best diagnostic test for C. difficile colitis

Detecting toxin A or B in the stool

208

MEN I

Pituitary tumor, Pancreatic tumor, Parathyroid tumors

209

Familial adenomatous polyposis and CNS malignancy

Turcot's syndrome

210

Muscle involved in ribs 10&11 dysfunction

Latissimus dorsi

211

Haptoglobin is ________ in hemolysis

decreased

212

Used to monitor the response of ovarian cancer to treatment

CA-125

213

Most common type of breech presentation

Frank breech

214

Vertigo, tinnitus and hearing loss

Meniere's disease

215

High risk moms are advised to take how much folic acid before conception?

4 mg

216

Associated with newborns whom are delivered via C-section

Transient tachypnea of the newborn

217

Decreased FEV1, decreased FEV1/FVC, decreased vital capacity, decreased peak expiratory flow rate, increased residual volume, and increased total lung capacity

Obstructive pulmonary disease

218

Personality disorders are classified into three clustersL

Cluster A (weird), Cluster B (wild), Cluster C (worried)

219

Most common sequelae of meningitis is

hearing loss

220

Most common type of cutaneous T-cell lymphoma

Mycosis fungoides

221

Which type of colon cancer typically presents with melena and occult blood in the stool leading to iron deficiency anemia?

Right-sided tumors

222

Adenomatous polyps plus osteomas, lipomas, fibromas, cysts and dental abnormalities

Gardner's syndrome

223

Gold standard for the diagnosis of endometriosis

Laparoscopy

224

Few words, difficulty producing words (non-fluent); good comprehension; loss of oral coordination

Broca (expressive)

225

Allergic rhinitis, asthma, blood eosinophilia and positive p-ANCA

Churg-Strauss Syndrome

226

Confirm intussusception with

ultrasound (bulls-eye sign)

227

Most of the edema is located over the occipital bones and crosses over the suture lines to involve portions of the parietal bones bilaterally

Caput succedaneum

228

If the dipstick shows blood but no RBC's, than _______is most likely

hemolysis

229

Findings in infective endocarditis can be remembered by FROM JANE

-Fever
-Roth spots
-Osler nodes
-Murmur
-Janeway lesions
-Anemia
-Nail hemorrhages
-Emboli

230

Most common causes of acute interstitial nephritis (AIN)

Penicillins and NSAIDs

231

While rheumatic heart disease can involve any heart valve, what is the most common outcome?

Mitral stenosis

232

Caused by decreased activity of hepatic UGT; unconjugated hyperbilirubinemia is typically the only finding

Gilbert's syndrome