COMQUEST material updated Flashcards
1
Q
Initial test for diagnosing acromegaly
A
Insulin-like growth factor level (get an MRI)
2
Q
Collection of blood beneath the periosteum of one of the calvarial bones; does not cross the suture lines
A
Cephalhematoma
3
Q
Egg-on-a-string x-ray
A
Transposition of the great vessels
4
Q
Benign tumors most commonly seen in women of reproductive age and are associated with contraceptive use, anabolic steroids, and glycogen storage disease
A
Hepatic adenomas (surgically remove if they are symptomatic, more than 5 cm, or do not regress after discontinuation of OCPs)
5
Q
Mononeuritis multiplex and hepatitis B are associated with
A
Polyarteritis nodosa
6
Q
Chest pain precipitated by hot or cold liquids without other obvious pathology is most likely the result of
A
diffuse esophageal spasm (use manometry to diagnose)
7
Q
Classic triad of patent ductus arteriosus, deafness, and cataracts
A
Rubella (German measles)
8
Q
Hypocellular marrow with loss of precursor cells, predominated by fat and stroma, is diagnostic of
A
aplastic anemia
9
Q
Which labs should be checked prior to prescribing lithium?
A
BUN/Cr, thyroid function, and pregnancy
10
Q
Most common causative agent of osteomyelitis
A
Staph aureus
11
Q
Elevated methylmalonic acid and homocysteine
A
Vitamin B12 deficiency
12
Q
Splitting of the basement membrane (tram-track appearance)
A
Membranoproliferative glomerulonephritis
13
Q
Bead-like pattern on cholangiography; presents with pruritis and jaundice
A
Primary sclerosing cholangitis (associated with ulcerative colitis)
14
Q
Boot-shaped heart
A
Tetralogy of Fallot
15
Q
Low risk moms are advised to take how much folic acid before conception?
A
.4 mg (400 mcg)
16
Q
Painful limp after a URI
A
transient synovitis
17
Q
Cafe-au-lait spots, neurofibromas, freckling of the groin or the axilla, skeletal abnormalities, ad hamartomas of iris (Lisch nodules)
A
Neurofibromatosis type 1 (more common)
18
Q
Always start lymphatic drainage techniques with
A
thoracic inlet release
19
Q
Sacrum nutation and counternutation, while standing,occur about the
A
middle transverse axis
20
Q
Defect in excretion of bilirubin and results in conjugated hyperbilirubinemia; liver has black pigmentation on biopsy
A
Dubin-Johnson syndrome
21
Q
What is the most sensitive screening test for SLE?
A
ANA
22
Q
Transient hyperthyroidism and thyroid tenderness followed by hypothyroidism
A
Subacute thyroiditis (de Quervain thyroiditis)
23
Q
Positive blood culture for S. bovis along with features of infective endocarditis, you should suspect
A
colorectal cancer (order a scope)
24
Q
Lateral and posterior margin of the IT band (Chapman’s point)
A
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
