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Medicine > Cumulative Final > Flashcards

Cumulative Final Flashcards

1
Q

need a fungal cultures for tinea capitis or unguium because

A

hard to treat, make sure you have the right organism

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2
Q

atopic triad

A

Eczema, asthma and hay fever (allergic rhinitis)

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3
Q

lichen simplex chronicus

A

due to constant itching of atopic dermatitis. scaly, well demarcated, rough plaques with exaggerated skin lines

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4
Q

pityriasis rosea presentation and treatment

A

herald patch, then 2 weeks–>salmon colored macules in trunk and upper extremities in “christmas tree” pattern. NO TREATMENT NEEDED. its very itchy though so maybe topical steroids, po antihistamines

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5
Q

what causes psoriasis

A

inflammatory/autoimmune (genetics). keratin hyperplasia (epidermal thickening/dermis is continually turning over) due to T cell activation

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6
Q

what are you going to see for tinea versicolor on diagnostics (which diagnostic too)

A

KOH: “spaghetti and meatballs” hyphae and spores. ALSO yellow/green on wood’s lamp

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7
Q

treat tinea versicolor

A

selenium sulfide lotion, oral fluconazole–>dont shower need to sweat it out to get to skin.

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8
Q

seborrheic dermatitis occurs where

A

high sebaceous oversecretion–>scalp, face, eyebrows, body folds. fungal?

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9
Q

treat psoriasis

A

-NEVER USE SYSTEMIC CORTICOSTEROID -phototherapy, high potency topical corticosteroid + Vitamin D analogs

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10
Q

oval, fawn/salmon-colored, scaly plaques with collarette scale

A

Pityriasis Rosea

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11
Q

seborrheic dermatitis treatment

A

-scalp: zinc pyrithione.selenium shampoo -facial and intertriginous: hydrocortisone

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12
Q

what is this

A

erythema multiforme: classic target lesion 3 concentric zones of color change, found acrally on hands and feet

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13
Q

benign, pruritic, TENSE blisters in flexural areas

A

bullous pemphigoid

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14
Q

pruritic, VIOLACEOUS, flat-topped papules with fine white streaks; mucosal lacy lesions of buccal/vaginal mucosa; on flexural surfaces and trunk. starts at the WRIST

A

lichen planus, can develop into SCC

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15
Q

burning or stinging (CNS); erythematous, dilated vessels on cheeks—telangiectasias; papules/pustules possible

A

rosacea, mc 30-50. avoid the triggers and treat with topical metronidazole or clindamycin

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16
Q

rosacea vs ance?

A

neurovascular component of rosacea and comedones are in acne and absent in rosacea

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17
Q

actinic keratosis

A
  1. prolonged sun exposure

“sandpaper pink macules/papules”

  1. Pre-malignant–>SCC
  2. treat with 5-FU/cryotherapy

–>can also get hypertrophic

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18
Q

Basal cell vs SCC

A

Basal: pearly/waxy/arborizing vessels/telangestasias. mc, local infiltrating, doesnt met

SCC: more likely to met, often preceded by actinic keratosis

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19
Q
A
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20
Q

seborrheic keratosis

A

“stuck on” benign lesion of elderly people with sun exposure–velvety/warty

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21
Q

extensor (elbows and knees) vs flexor (antecubital and knee fossa)

A

psoriasis–>extensor and nail pitting

atopic dermatitis–>flexor, atopic triad

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22
Q

impetigo causative agents and treatment

A

s aureus, GAS

mupirocen

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23
Q

erysipelas caused and DOC

A

group A streptococcus

(edematous hot raised circumscribed red area on *cheeks or leg)

Penicillin! (GAS)

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24
Q

Edematous erythematous warm spreading plaque. chills, fever, malaise, lymphadenopathy

A

cellulitis. have to have a break in the skin (ex tinea pedis). treat with antibiotics 7-10 days. s aureus GAS common offenders.

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25
Q

treat folliculitis

A

mupirocin, s aureus mc. its a hair follicle infection

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26
Q

what do folliculitis and furuncle have in common

A

folliculitis is superficial infection of the hair follicle and furuncle/boil is deeper infection—tender nodule. i&d that shit.

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27
Q

scabies!

A

start in finger/toe webs/wrist.

intensely itchy

pain increases at night

scrape the skin for dx–see the mites and eggs

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28
Q

cough, coryza (runny nose), and conjunctivitis is the prodromal (pre-rash) of which viral xanthem?

A

rubeola/measles

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29
Q

koplik spots?

A

measles/rubeola, its part of the prodromal phase

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30
Q

etological agent of erythema infectiosum (5th’s disease)

A

parvovirus B19 DNA virus

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31
Q

causative agent of rubella

A

rubivirus RNA virus

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32
Q

measles causative agent

A

paramyxoviridae

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33
Q

xanthem that could cause aplastic anemia

A

erythema infectiosum

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34
Q

cause of roseola

A

HHV 6

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35
Q

Chronic dacrostenosis presentation

A

yellow bacterial overgrowth from stagnant tears no other signs of infection. no swelling, redness, tenderness.

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36
Q

what may lead to a chalazion

A

internal hordeolum–>memobian gland abscess. the chalazion is a chronic internal hordeolum.

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37
Q

two types of anterior blepharitis and differeniating features

A

staphalococcal and seborrheic (zeis and moll gland inflammation and associated eyelid skin and eyelashes

Staph: ULCERATIONS, burning sensation. bacitracin treat.

Seborreic: white skin flakes.

keep lids clean, warm cloth

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38
Q

posterior blepharitis assoc with which dermatologic condition

A

mebomian gland infection or dysfunction.

assoc with ROSACEA–telangectasias

if blocking the cornea or involved in the conjunctiva–>antibiotics (tetracyclin) eye drop antis, corticosteroids topical short term

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39
Q

frothy oily tears assoc with

A

posterior blepharitis!

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40
Q

why do we worry about acute dacrocystitis

A

it could lead to preseptal or orbital cellulitis–>systemic antibiotics

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41
Q

treat gonoccal conjunctivits

A

1 g IM ceftriaxone

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42
Q

chemical to the eye what are you worried about and what do you do

A

IRRIGATION within 5 min! alkaline cpds worse, get through cornea

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43
Q

thickening of conjunctiva with active BV growth

A

pteryguim and pingecula

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44
Q

white patch on cornea? and s/s

A

corneal ulcer, from infection, exposure keratitis, etc.

s/s: pain, redness, photophobia, tearing, reduction in vision

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45
Q

mc cause of bacterial keratitis

A

pseudomonas, water lovin, opaque cornea. treat with cipro drops

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46
Q

defining feature of chronic glaucoma

A

aka open angle glaucoma

BIALTERAL slow peripheral vision loss, “tunnel vision”

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47
Q

key defining features to postseptal orbital cellulitis–>infection of the fat and ocular mm

A

decreased vision, pain with moving eyes–>behind the septum and PROPTOSIS

preseptal wont have the vision changes or pain with eye movements

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48
Q

defining feature of dry “non exudative” macular degeneration

A

drusen bodies, retinal pigment dies, bilateral central vision lost GRADUALLY

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49
Q

Hallmark of wet macular degeneration

A

neovascularization. its more sudden vision loss.

do the anti-VEGF therapy to prevent the new blood vessel formation

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50
Q

ischemic optic neuropathy assoc with

A

giant cell arteritis, systemic steriods to save other eye

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51
Q

associated with multiple schlerosis

A

optic neuritis

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52
Q

s/s of optic neuritis

A

UNILATERAL vision loss over a few days, color first

central loss—central scotoma

pain with eye movements

relative afferent pupillary defect!

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53
Q

the result of increased intracranial pressure in the eye is called

A

papilledema: bilateral increase of blindspot

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54
Q

rapid loss of vision in 1 eye with curtain

A

retinal detachment

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55
Q

central and branch retinal vein occlusions

A

both sudden vision loss in 1 eye with no pain or redness

difference is the amount of hemorrhage

“flame shaped hemorrhages and cotton wool spots”

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56
Q

hallmark of diabetic retinopathy

A

macular edema, in proliferative or non proliferative

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57
Q

arteriovenous nicking and copper wiring assoc with

A

chronic HTN retinopathy

later stage malignant HTN gets the papilledema

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58
Q

manifest vs latent and cominant vs incominant strabismus

A

manifest: there, cant induce ; latent: cover uncover shows it
cominant: same in all gazes, incominant: can induce with H test

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59
Q

unequal red relfex in a kid could mean

A

retinoblastoma

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60
Q

strabismus can be tested with

A

corneal light relfex and cover/uncover

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61
Q

treatment line up for AOM in kid 1.2.3

A
  1. amoxicillin (higher dose with single red flag like daycare)
  2. augmentin (diarrhea)
  3. 2nd, 3rd gen cephalosporin
62
Q

3 mc organisms to cause OM

A

s pneumo, h flu, and m cat

ALSO THE SAME ONEs in Sinusitis

63
Q

ototoxic meds

A

aminoglycosides, loop diuretic (furosemide), NSAIDs, acetominphen

64
Q

when to treat OM after watchful waiting

A
  1. kid under 2
  2. symptoms >48 hours
  3. fever
  4. severe pain even after analgesics
65
Q

pseudomonas loves

A

otitis externa and contact lens!

66
Q

what precipitates eustachian tube dysfunction or serous otitis media

A

URI or allergies—swelling/edema

“Symptoms include aural fullness, difficulty popping ears, intermittent sharp ear pain, hearing loss, tinnitus, and dysequilibrium”

67
Q

what is this

A

tympanoschlerosis: recurrent inflammation from AOM or tubes.

conductive hearing loss

68
Q

presbycusis is _____ Sensineural Hearing loss

A

high frequency, and speech discrimination in a crowded room

69
Q

triad for menieres disease

A

episodic vertigo

tinnitus with aural fullness

fluctuating hearing loss

70
Q

treat menieres

A

symptomatic

vertigo: vestibular suppressant like meclizine for the motion sickness

antiemetic for nausea

diuretics/salt restriction bc its a fluid problem, aural fullness

71
Q

sudden and severe vertigo lasting days with associated hearing loss following URI

A

labrynthitis

treat with fluids, antiemetic, meclizine, and antibiotic if bacterial.

72
Q

Best treatment for allergic rhinitis

A

intranasal corticosteroid (+antihistamines for immediate relief)

73
Q

most commonly see nasal polyps in ______ rhinitis

A

allergic

74
Q

lichen planus is what and can present where?

A

Lichen planus occurs when the immune system mistakenly attacks cells of the skin or mucous membranes.

skin or mucous membranes–>lacy pattern on mucous membrane

75
Q

glossitis vs glossodynia

A

glossitis is painless red shiny tongue assoc with nutritional deficiencies

glossodynia is “burning mouth syndrome” mc in post menopausal women. assoc with diabetes, tobacco and candida infections

76
Q

cause of aphthous ulcer

A

HHV 6 and stress!

77
Q

erythroplakia is indicative of

A

SCC / pre-malignancy

78
Q

4 main things to dx pharyngitis (GAS throat)

A
  1. fever
  2. anterior cervical lymphadenopathy
  3. sore throat
  4. enlarged tonsils with exudate
79
Q

treat strep throat to prevent

A

rheumatic fever and glomerularnephritis

80
Q

neck masses are classified as ____, _____, ____

A

congenitial

inflammatory

neoplastic

81
Q

midline neck masses

dermoid cyst vs thyroglossal duct cyst

A

dermoid cyst: teratoma, DOES NOT move with swallowing or tongue protrusion

thyroglossal duct cyst: moves with tongue elevation and protrusion

82
Q

what is this

A

ranula. cystic lesion: block of the salivary gland, right next to frenulum

83
Q

sialadenitis: what is it and how do you treat

A

bacterial inflammation of gland: parotid or submandibular

treat: massage gland, oral antibiotics, warm compress

dehydration, sjogrens contributes to the blockage and swelling

84
Q

sialolithiasis most commonly in where

A

wharton duct (submandibular duct)

85
Q

where does lugwig’s angina come from

A

infected tooth

this is an emergency! airway obstruction!

secure airway, IV antibiotics

86
Q

treat gonococcal in general

A

IM cephtriaxone

87
Q

common causes of bacterial conjunctivitis

A

staph aureus, s pneumo, h flu, m cat

88
Q

diagnostics for a corneal ulcer

A

fluorescein stain

89
Q

what is this

A

acanthamoeba keratitis

90
Q

what do behcets, chronhns, reactive arthritis, and psoriasis all have in common

A

uveitis!

mutton fat deposit/fibrin stuff and hypopyon

91
Q

diagnostic tool for peptic ulcers

A

endoscopy, do biopsy too

92
Q

PE and diagonsis of pyloric stenosis

A

PE: olive right after emesis

Diagnosis assisted with US

clinical picture of projectile vomit after eating as well

93
Q

diagnostics for choledocholithiasis: common bile duct blockage (not infection)

A

Ultra sound and ERCP

treat: sphinterectomy and usually followed by cholecystectomy

94
Q

treat acute cholecystitis

A

NPO

IV fluids

emetics

2nd gen cephalosporin

Cholecystectomy

95
Q

charcot’s triad of cholangitis?

what makes this Reynold’s Triad?

A

jaundice, fever, RUQ pain

reynolds means its more septic: hypotension and altered mental status

96
Q

calculating BMI (peds lecture)

A

weight in kg/height in meters squared

(other is pounds/inches x 703)

97
Q

at birth to 7 days babies lose ______% birth weight

at 2 weeks will be ________

A

5-10%

back to normal weight

98
Q

0-6 mo needs _____ calories per day

A

110-120 cals/day

99
Q

from 2-12 years calculate calories how

A

1000 + 100 cals/year

12 year old= 1000 + 100x12 = 2200

100
Q

rule of 3’s with which common pediatric problem

A

Colic

3/day

3 days/wk

>3 weeks

peaks at 3 months!

101
Q

triad for chronic pancreatitis

A

calcifications, steatorrhea and Diabetes Mellitus

102
Q

erythemia infectiousum worst complication

A

aplastic anemia

103
Q

if its waking you up at night it cant be IBS

A

has to be IBD

104
Q

whole milk until age

A

2!

105
Q

gestational age:

term for an infant

A

38-42 weeks

106
Q

low birth weight is

very low birth weight is

A

<2500

<1500

107
Q

polyhydramnios and oligohydramnios

(normal is 1000-1500)

A

poly is >2000cc and Oligo is <500cc

108
Q

2 newborn screenings

A

metabolic: PKU, galactosemia

hemoglobinopathies like sickle cell and thalasemia

109
Q

treating chrohns UC

A

anti-inflamm like sulfasalazine (good for the arthritis too)

steroid

azathioprine/methotrexate

biologics

110
Q

dx celiacs and treat

A

IGA blood test and bowel biopy–see flattening

gluten free, watch for TTG levels to go down

111
Q

coffee ground hematemesis ddx

A

peptic ulcer, varices, gastritis, mallory weis tear (prob more normal blood), cancer

112
Q

hemolytic uremic triad

A

hemolytic anemia

low platelets

acute kidney failure

113
Q

what pediatric gut condition is suseptible to volulus

A

midgut malrotation.

s/s: bilous vomit, tender over area, foul stools.

MUST do an upper GI series with barium

114
Q

sausage shaped mass

current jelly stool

sqautting

< 2 years

A

intusseption

barium enema treats it!

115
Q

<10% is ok for weight loss early in breast fed baby.

how much does baby need to transfer per feeding?

A

40-60 ml

116
Q

how much should a baby gain per day in ml

A

30 ml / 1 oz

117
Q

elbow fx. what is most common for peds and adults?

A
  1. peds supracondylar fx
  2. adults is radial head fx
118
Q

what fx is this

A

galeazzi.

radius fracture with distal ulnar dislocation

119
Q

what fx is this

A

monteggia

proximal ulnar fracture and radius displaced at elbow

120
Q

different injuries overhead throwing athletes get

A
  1. SLAP labral tear
  2. anterior shoulder dislocation
  3. ulnar collateral ligament injury (valgus stress test)
121
Q
A

colles

distal tip pointing in toward palm

122
Q

this is demonstrating which ligament injury? treatment?

A

gamekeepers thumb: injury to ulnar collateral ligament

thumb can be abducted way farther

thumb spica cast 4 weeks

123
Q

ulnar gutter splinting indicated for which common hand fracture?

A

boxer break (5th metacarpal)

124
Q

this is for _______ when the DIP is hyperflexed—-extensor tendon is ruptured

A

mallet finger, stack splint 6-8 wks

125
Q

treat boutonniere deformity

A

splint finger in extension for 4-6 wks

126
Q

Treat De Quervain’s Tenosynovitis

A

thumb/ wrist splint

NSAIDs

steriod injections into the sheath

127
Q

lateral epicondylitis is aggrevated by which two motions

A

extension and supination at the wrist

128
Q

treat anklosing spondylitis

A

Options start with

  1. NSAIDs
  2. TNF inhibitors
  3. Sulfasalazine
129
Q

treat psoriatic arthritis

A
  1. NSAIDs
  2. MTX 10 mg 1 time per week
130
Q

Back pain. Fill in the blanks.

  1. In _______ pain is worse with extension

and

  1. In ______ pain is worse with flexion
A
  1. spinal stenosis: worse with prolonged standing/walking
  2. herniated disk: sitting, lifting, coughing makes it worse
131
Q

Risk _______ if you do not reduce a hip dislocation within 8 hours.

A

avascular necrosis. blood supply to femoral head.

132
Q

potential for ______ nerve to be compromised in a posterior hip dislocation

A

sciatic. check for foot drop!

133
Q

legg calve perthes

A

temporary AV necrosis to femoral head

egg shaped head

mc in 4-6 yo

painless limping at end of day

treat: leg braces for ABduction, eventual Total hip

134
Q

what is the mortise view on x ray?

A

true AP of the ankle to see joint space, fractures

foot internally rotated

135
Q

ottawa ankle rules on when to do an x ray

A
  1. pain at the lateral or medial malleolus
  2. ability to bear weight
  3. pain at the base of the 5th metatarsal
136
Q

three types of inflammatory arthritis

A

autoimmune

seronegative spondylarthropathies

erosive OA: gull wing central erosions

137
Q

treat fibromyalgia

(characterized by trigger points, mm pain, sleep disturbances)

A

exercise, NSAIDs, relaxation, amitryptylline, gabapentin

138
Q

treat acute gouty flares with

A

NSAIDS

Colchicine

Prednisone

139
Q
  1. characterized by pain in proximal muscles: hip and shoulder 2. common with what other condition

“can’t brush hair, can’t get out of chair”

A
  1. polymyalgia rheumatica
  2. *common with giant cell arteritis*

treat with daily prednisone

does not cause weakness like polymyositis

140
Q

treat reiter’s syndrome

A
  1. NSAIDs
  2. Sulfasalazine 1000 mg BID
141
Q

soft tissue calcifications, gottrens papules, heliotrope rash, PAINLESS WEAKNESS

A

Dermatomyositis, polymyositis

high dose steriods then MTX / Azothioprine

142
Q

common drugs to induce lupus

A

hydralazine, minocycline, procainamide, quinidine

143
Q

antimalarial hydroxychloroquine to treat

A

lupus

144
Q

treat raynauds

A

Ca channel blockers

145
Q

treat clubfoot

plantarflexion, medial hindfoot, metatarsus adductus

A

passive manipulation and serial taping for 12 weeks

146
Q

what is this and how do we treat

A

calcaneovalgus = intrauterine molding

stretching/passive manipulation

147
Q

what is this and how do we treat

A

vertical talus

its associated with neuro symptoms: spina bifida

SURGERY ONLY

148
Q

Torticollis highly associated with

A

congenital hip dysplasia

149
Q

Intoeing

_______ common BEFORE 2

________ common AFTER 2

A

internal tibial torsion common BEFORE 2 (intrauterine)

femoral anteversion common AFTER 2 (from W sitting*)

150
Q

Scoliosis degrees from cobb’s measurements and what to do based on them

A

<25 observe

25-45 brace

>50 refer, surgery

151
Q

mc breast cancer

and dx procedure of choice

A

infiltrating DUCTAL carcinoma, in situ is direct precursor

core needle biopsy guided by US

152
Q

mc site for breast cancer (quadrant)

A

upper outer quadrant

Medicine (5 decks)

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