Deck 1 Flashcards
(500 cards)
1
Q
Question
A
Explanation
2
Q
what do you do for infacnts with brachial plexus injury
A
you just observe them and can do physical therapy
3
Q
what causes irregular menses and anovulatory bleeding in adolescesnts
A
immature HPA axis
4
Q
what population of HIV patients get HIV associated dementia
A
patients with uncontrolled HIV that are not on ART
5
Q
skin findings of NF1
A
cafe-au-lait spots, axillary and inguinal freckling, lisch nodules
6
Q
tumors associated with NF1
A
optic glioma, pheo, neurofibromas
7
Q
skin findings NF2
A
skin nodules (schwannomas)
8
Q
tumors associated with NF2
A
bilateral vestibular schwannoma
9
Q
skin findings tuberous sclerosis
A
multicle facial adenomas, ash-leaf spots, shagreen patchs, ungual fibromas
10
Q
neuro findings tuberous sclerosis
A
seizures, intellectual disability
11
Q
tumors associated with tuberous sclerosis
A
hamartomas, giant cell astrocytoma, cardiac rhabdomyomas, renal angiomyolipoma, cysts and RCC
12
Q
findings of von-hippel lindau disease
A
cerebellar and retinal hemangioblastomas, pheo, RCC
13
Q
what color does blood show on non contrast CT
A
white
14
Q
what is bright in T1 weighted MRI
A
fat and contrast
15
Q
what is bright in T2 weighted MRI
A
water (CSF), and fat (but less intense than T1)
16
Q
flesh colored raised papules in anogenital area
A
condyloma accuminata (HPV)
17
Q
sudden decline in development of a young girl
A
Rett syndrome
18
Q
signs of Rett syndrome
A
gait disturbances, sudden decline in development, hand movements, loss of speech
19
Q
signs of myotonic dystrophy
A
myotonia and weakness, distal mm atrophy
20
Q
complications of myotonic dystrophy (heart)
A
cardiomyopathy, arrythmias,
21
Q
if a vertebral body goes forward what joint get dislocated
A
facet joint dislocation
22
Q
what brain issues do people with ADPCKD get
A
aneurysms (berry)
23
Q
what is associated with difficulty with an upward gaze
A
pinealoma
24
Q
functional tremor signs
A
abrupt stopping in the tremor, stops with distraction, changeable features of the tremor
25
where do neuroblastomas arise
adrenal medulla or along the sympathetic chain
26
where do medulloblastomas arise
in the cerebellum
27
clinical features of neuroblastoma
opsoclonus-myoclonus, periorbital eccymosis, abdominal mass
28
clincal features of medulloblastoma
cerebellar signs (gait changes, central uncoordination), hydrocephalus
29
what cervical nerve is injured if patient has claw hand and wrist extension
C8 and T1
30
are antipsychotics safe in pregnancy
yes, use for acute mania
31
dx of a fluid collection spanning multiple vertebra on MRI
spinal epidural abcess
32
treatment of spinal epidural abcess
ABX and urgent laminectomy
33
what is most specific to seizure activity
tongue biting
34
treatment of organophosphate poisoning
atropine and then pralidoxime
35
what is physostigmine
achetylcholineesterase inhibitor
36
complications of asymptomatic bacteruria of pregnancy
pyelo or preterm labor
37
what nerve can be compressed with uncal herniation
occulomotor (CNIII)
38
what type of brain hernation occurs after epidural hematoma
uncal
39
signs of pelvic organ prolapse
any mass that increases in size with valsalva
40
what is the main defining feature of PTSD
exposure to a life-threatening trauma
41
difference between rathkes cleft cyst and craniopharyngioma
craniopharnygioma will have calcifications seen on imaging
42
day and night time eneureis in children with red flags eval
MRI
43
treatment of NPH
high volume lumbar puncture
44
what does the head thrust test evaluate
vestibuloocular reflex
45
what happens to TSH during pregnancy
decreased because HCG stimulates thyroid hormone production so TSH decreases bc neg feedback
46
presentation of conus medullaris vs. cauda equina pain
conus medullaris is severe low back pain and cauda equina is radicular pain (down leg
47
presentation of conus medullaris vs. cauda equina upper motor or lower motor neuron signs
conus medullaris has upper motor and cauda equina has lower
48
presentation of conus medullaris vs. cauda equina bladder symptoms
both have bowel and bladder dysfunction because of pudendal nerve
49
alcohol withdrawal vs. thiamine deficiency differentiation
alcohol withdrawal has autonomic instability and thiamine is more of an encephalopathy
50
central cord syndrome signs
sensory distubances in upper extremities, upper extremity weakness because the corticospinal tract has arms closest to the center of the cord
51
1hr glucose tolerance test cutoff
200
52
do absence seizures have a postictal period
no!
53
best form of emergency contraception
IUD and then levonorgestrel
54
time course for alteplace/TNK for stroke
<4.5 hours
55
signs of PTSD in kids
emotional dysregulation, play that imitates trauma, nightmares
56
signs of reactive attachment disorder
lack of emotional responsiveness, no seeking of comfort from caregivers
57
what causes reactive attachment disorder
early childhood abuse
58
what types of hemorrhage is cause by nonaccidental trauma
subdural and retinal hemorrhage
59
what is pituitary apoplexy
hemorrhage or acute ischemia of the pituitary causing acute adrenal insufficiency
60
what is the most common childhood brain tumor
low-grade astrocytoma
61
what do you use for benzo overdose
flumenazil
62
what does elevation of the diaphragm on chest xray typically indicate
this means that there is diaphragmatic weakness likely from ALS
63
why do pts with spinal cord injurys get autonomic dysreflexia
because the parasympathetic response cannot be sent down the spinal cord
64
noxious stimulus below a spinal cord injury effects
you get autonomic dysreflexia which means you get sweating, palpitations, etc, above the lesion and
65
clinical signs of sturge webber
seizures, port wine stain, glaucoma,
66
signs of methamphetamine intoxication vs. acute manic disorder
meth often has severe dental symptoms, more tactile hallucinations, and skin excoriations vs. mania which is more grandiose delusions and no sympathetic overdrive
67
PML on imaging
multiple NON enhancing lesions
68
new onset psychosis plus tremor/parkinsonism
wilsons diseaseI
69
pH of genitourinary syndrome of menopause
elevated pH (6.5) due to decreased vaginal secretions that are acidic
70
CNS lesions in tuberous sclerosis
subependymal tumors, giant cell astrocytoma, etc
71
where are brachial cleft cysts on the neck
lateral
72
difference between nightmare disorder and sleep terror disorder
nightmare the child is fully aware and they are able to communicate but in sleep terror disorder they are not aware and have amnesia
73
long term complication of delerium
cognitive decline
74
main difference between serotonin syndrome and neuroleptic malignant syndrome
serotonin syndrome has hyperreflexia vs. NMS is just rigidity
75
4 clinical manifestations of IgA vasculitis
palpable purpura, arthralgia/arthritis, abdominal pain, renal disease
76
signs of cerebellar dysfunction
truncal or gait ataxia, wide-based gait, poor heel-toe coordination
77
what happens with blood pressure in TRALI
tanks
78
is INO ipsilateral/contralateral in terms or MLF lesion to eye not adducting
ispilateral
79
orthopedic signs of tethered cord
back pain, scoliosis, foot deformities
80
is a sputum cytology helpful for cancer dx
no!
81
difference between illness anxiety disorder and somatic symptom
illness anxiety is where you have preoccupation with having a serious illness vs. somatic symptom disorder you have unexplained symptoms and anxiety around the symptoms
82
treatment of stroke in sickle cell
exchange transfusion
83
5-alpha reductase defiency genotype
46 XY
84
5 alpha reductase signs
virulization at puberty due to increased testosterone (acne, cliteromegaly, increased muscle mass, male pattern hair)
85
treatment of phantom limb pain
multimodal, antidepressants, CBT etc.
86
return to sports after concussion timeline
rest for 2 days, gradual progression of activity with return to rest if there is headaches etc.
87
who gets cyclic vomiting syndrome
people with migraines or fam hx of, identifialble triggers like stress
88
timeline for adjustment disorder
sx onset within 3mo of an identifiable stressor
89
management of hyaditiform mole after curretage
month B-hcg levels and 6mo of contraception
90
physical exam of a patient with cervical insufficiency
shortened cervix or dilated cervix, no vaginal bleeding, pelvic pressure
91
signs of placenta previa
painless vaginal bleeding at >20 weeks gestation
92
sleep changes in MDD
decreased REM sleep latency, increased REM, decreased non-rem, multiple nighttime awakenings
93
5 P's of acute intermittent porphyria
painful abdomen, polyneuropathy, psychologic disturbances, port wine pee, precipitated by drugs
94
can scfe be bilateral
yes
95
pain with internal rotation in a child with hip pain
SCFE
96
management of frostbite
rapid warming, angiography if rewarming not successful
97
triad of wiskott aldrich
recurrent infections, eczema, purpura
98
what is transient hypogammoglobulinemia of infancy
this is when the infant has delayed rise in IgG after physiologic nadir after 6mo of age, will resolve
99
ultrasound findings of placenta accreta
US with placenta previa, numberou lacunae, myometrial thinning
100
what is considered adequate contractions
>200 montevideo units
101
dx of hirschsprungs
biopsy, contrast enema, anorectal manometry
102
who gets uterine rupture
patients with previous uterine surgeries
103
what does the uterus feel like in uterine rupture
can feel palpable fetal parts
104
clinical presentation of placental abruption
sudden onset vaginal bleeding, abdominal pain, high freq/low intensity contractions, rigid uterous
105
when do you do a ERCP for pancreatitis
if there is CBD dilation indicating stone or evidence of acute cholangitis
106
management of gallstone panc after panc resolved and no cholangitis/biliary issue
cholecystectomy once pancreatitis resolved
107
treatment of periorbital hemangioma in infant
propanolol
108
treatment of port wine stain
laser (cosmetic)
109
can you give metronidozole in pregnancy
Yace
110
treatment of binge eating disorder
SSRI
111
signs of NMDA (ecstacy) toxicity
sympathomimetic tox and serotonin sydrome and hyponatremia
112
signs of blunt thoracic aortic injury
bruising on the chest, weak femoral pulses, cool limbs, proximal hypertension
113
what is aspirin exacerbated respiratory disease (triad)
asthma, bronchospasm following aspirin use, chonic rhinosinusitis with nasal polyps
114
treatment of parkinsons tremor
anticholingergic therapy
115
signs of separation anxiety
reluctance to leave, avoidance of activities, excessive worry
116
signs of growing pains
worse at night, primarily at night
117
what does a positive arm drop test mean
rotator cuff tear
118
what newborns get ABO incompatability hemolytic disease
newborns who are AB that have mothers who are O
119
in a neonate with cyanosis does their O2 sat change when they are given oxygen if it is a heard issue
no it wont change so if it increases they have a pulmonary pathology
120
effects of gestational diabetes on fetal lungs
immaturity, poor surfactant maturation
121
what are pulses like in aortic regurg
wide pulse pressure
122
treatment of NEC
stopping enteral feeds, fluids, BCX and then ABX, if no improvement or has bowel perf, then surgery
123
treatment of migraine in pregnancy
acetominophen, antiemetics, NSAIDs, opioids
124
treatment of croup
dexamethasone and racemic epinephrine
125
when does uric acid precipitate from the urine
it precips at low pH <5.5
126
why do crohns or CF patients get Ca oxalate stones
because they absorb less Ca and Ca binds oxalate in the intestine so more oxalate gets absorbed and then excreted in the kidney which causes increased Ca oxalate stones
127
treatment of frequent uric acid stones due to gout
alkalinazation of the urine
128
what part of the brain gets atrophy in alzheimers
temporal lobe (with the hippocampus and amygdala
129
signs of croup
barking cough, hoarseness, inspiratory stridor
130
signs of babeosis
flu like sx, DIC, anemia, thrombocytopenia, increased bili, LDH etc.
131
consequenses of preeclampsia
ischemic stroke, seizures, AKI, hepatic subcapsular hematoma, ARDS, placental abruption
132
signs of central brain herniation
decorticate to decerebrate posturing
133
why do you get thrombocytopenia in SLE
peripheral destruction due to immune thrombocytic purpura
134
can you hear a bruit on exam for aortic aneurysm
no
135
what do nitrates do to the heart
they decrease preload which decreased left ventricular end diastolic volume because of venous dilation
136
which is external vs. internal in CNIII for parasympathetic vs. motor
external is parasympathetic and internal is motor
137
is parasympathetic or motor (somatic) fibers more susceptible to ischemia
motor because the center of the nerve is more susceptible to ischemia because the blood vessel is on the outside
138
granulomatosis with polyangiitis pulmonary findings
ulceration, lung nodules with cavitation
139
signs of retinal detachment in the history
flashes of lights, dark spots or webs, floaters, peripheral vision defects
140
describe odds ratio
the odds that an event with occur in one group vs. the odds of an event occuring in another group
141
describe risk ratio
the likelihood of an outcome in one group exposed to a potential risk factor compared to the risk in another unexposed group
142
what is considered macrocephaly
>97th percentile
143
what is the uterus like in adeomyosis
symetrically enlarged and painful
144
what is the mutation in CML and what is the chromosome
this is chrom 22 which is the BCR ABL gene creating always active tyrosine kinase
145
differences in TM in acute otitis media vs. otitis media with effusion
AOM has bulging and erythema of the TM whereas otitis media with effusion is not bulging just immobility
146
management of prepnant people with HSV prior to pregnancy
if they have lesions you do a c section if they are asymtomactic you do antiviral therapy starting at 36 weeks
147
how do you treat SCFE
screw fixation
148
size of ovary in torsion
enlarged due to trapped blood flow
149
CHARGE syndrome
Coloboma, heard defects, choanal atresia, retardation of growth, genitourinary anomalies, ear abnormalities
150
VACTERL features
vertebral anomalies, anal atresia, cardiac issues, TEF, renal and limb issues
151
signs of choanal atresia
hypoxia during breast feeding or sleeping that gets better with crying
152
two main causes of pleural fluid with glucose less than 30mg/dl
rheeumatoid pleuracy or empyema
153
causes of infectious adrenalitis
TB, CMV, histo
154
risks for somatic sx disorder
sexual trauma, lower education level, chroic chiIdhood illness, female
155
signs of mesenteric ischemia
rapid onset periumbilical pain, hematochezia, extreme pain
156
lab abnormalities in acute mesenteric ischemia
leukocytosis, elevated hemoglobin, elevated amylase, metabolic acidosis
157
signs of psychosis
delusions, hallucinations, disorganized speech
158
159
what is the mutation in fanconi anemia
DNA repair defect
160
clinical findings of fanconi anemia
short stature, hypo or hyper pigmented macules, abnormal thumbs, genitourinary findings
161
thyroid changes in pregnancy
TSH goes down (BHCG), free T4 and total T4 goes up
162
signs of open globe injury
fixed tear drop pupil, relative afferent pupillary defect, decreased intraocular pressure
163
urticarial transfusion reaction
hives and itching NO RESP DISTRESS
164
treatment of urticarial transfusion reactions
cessation of transfusion, antihistamines, then resume if theyre well
165
what is a dupuytren contracture
thickening of palmar fascia at the 3/4/5th digits
166
neuro sx of B12 deficiency
sensory ataxia, upgoing plantar reflexes, lower extremity paresthesias, neuropsychiatric changes
167
emypema vs. abscess imaging
empyema is just puss filled NO AIR FLUID LEVEL // abcess has an air fluid level
168
what is transverse myelitis
this is immune mediated destruction of the spinal cord
169
clincial features of transverse myelitis
bilateral motor weakness, LMN to UMN symptoms, bilateral sensory dysfunction, autonomic dysfunction
170
likely dx of a person with fluctuating bulbar weakness
myasthenia gravis
171
WAGR syndrome
wilms tumor, aniridia, genitourinary abnormalities, range of developmental delays
172
clinical features of fat necrosis of the breat
firm irregular mass, skin/nipple retraction
173
signs of urethral injury
blood at urethral meatus, high riding prostate
174
what does an MECP2 mutation do
rett syndrome (girls X dom, hands)
175
tay sachs enzyme and common findings
hexosaminidase A and this is severe neurodegeneration and death by 2-5
176
clinical features of osteogenesis imperfecta
frequent fractures, blue sclera, dentinogenesis imperfecta
177
symptoms of pelvic organ prolapse
pelvic pressure, voiding dysfunction (incontinence, urinary retention, etct)
178
what lab abnormality is seen in von willebrand disease
long bleeding time, normal PT and PTT
179
methotrexate adverse effects
myelosuppression, pulmonary fibrosis, hepatotoxicity, nephrotoxicity,
180
causes of duodenal vs. jejenal atresia
duodenal is typically failure to recanalize vs. jejenal is due to vascular accident
181
most common cause of potter sequence in males
posterior urethral valves
182
where are venous vs. arterial ulcers on the maleoli of legs
venous are on the medial side and arterial are on the lateral maleolus
183
first step in evaluation of hypospadias
karyotype analysis
184
features of disseminated neisseria gonorrhea infection
skin manifestations, tenosynovitis, polyarthralgias, purulent arthritis
185
what mutation causes osteosarc and retinoblastoma
Rb
186
frequent bronchitis, pneumonia and bronchiectasis
common variable immunodeficiency
187
treatment of wide complex tachycardia
synchronized cardioversion
188
epidural hematoma shape
lemon aka DOES NOT cross suture lines
189
which type of hematoma has a lucid interval
epidural hematoma
190
signs of eosinophilic esophagitis on EGD
circumfrential lesions, strictures, linear longtitudinal furrows
191
what is the best way to improve burnout
organization directed interventions like scribes, and reducing workload
192
clinical features of x linked agammaglobulinemia
recurrent pyogenic infections, hypoplastic tonsils, absent B cells on flow
193
treatment of x linked agammaglobulinemia
IV immunoglobulin therapy
194
which is associated with IBD PSC or PBC?
PSC!!!
195
pathology of PSC
inflammation and fibrosis of intra and EXTRA hepatic ducts, strictures and dilatations
196
pathology of PBC
autoimmune destruction of intrahepatic dugs, lymphocytic infiltration of portal areas and granulomas
197
how are becker/duchenne dx
genetic analysis, only do mm bx if genetics inconclusive!
198
respiratory changes in pregnancy
respiratory alkalosis due to increased minute ventilation to facilitate gas exchange at the placenta
199
what is the depot shot made of
progesterone, hypercoag ppl can take it
200
definition of mood disorder with psychotic features
this is like MDD or bipolar with psychosis DURING the manic/depressive episode, you dont see the psychosis anytime else
201
what is schizoaffective disorder
features of both schizophrenia AND mood disorder and the pscyhosis has to be >2 weeks from the mood disorder, essentially you have psychosis episodes AND depressive/manic episodes
202
brief psychotic disorder vs. schizophreniform vs. schizophrenia
brief psychotic : 1 day -1 month // schiziphreniform: 1-6months // schizophrenia: >6mo
203
management of laryngomalacia
reassurance and follow up
204
treatment of lead poisoning
oral succimer
205
where do you see herpetic whitlow
fingers and sometimes orally
206
do healthly term neonates need VZV PEP
no! only if they are premature or their mother was infected at birth
207
treatment of chronic suppurative otitis media
fluoroquinolone topical
208
best way to prevent cathether associated UTI
do intermittent catheterization instead of leaving an indwelling cathether in
209
treatment of condyloma accuminata (anal warts)
curretage, cryotherapy, laser, etc.
210
fibromyalgia vs. myofascial pain syndrome
fibromyalgia is widespread pressure points whereas myofascial pain syndrome is more focal in one anotomic position
211
what is the treatment for Myasthenia gravis
pyridostigmine which increases the availability of Ach by inhibiting Achesterase
212
what is edrophonium
this is also an achetylcholinesterase inhibitor
213
when does babinski sign dissipate
max two years
214
steps in treatment of malignant hyperthermia
discontinue anesthetics, then dantroline and then cooling measurres
215
signs of sjogrens
dry mouth, dry eyes, arthritis, etc.
216
what ab is positive in sjogrens
anti Ro/SSa and SSb
217
what ab is positive in systemic sclerosis
anti topoisomerase/ scl-70 or centromere
218
hepatic and pulmonary granulomas in an infant infection
listeria
219
if a child missed a vaccination do they need to restart
NO!!
220
if there is gas in the stomach where is the TEF
the TEF is connected to the esophagus somehow likely the distal part
221
in trauma, what is the main difference in imaging modalities in a stable vs. unstable patient
stable: can do CT unstable: do FAST scan with ultrasound
222
treatmenbt of ITP plts <10k and <30k
<10k you transfuse plts <30k you do steroids IVIG
223
signs of horner syndrome
ptosis, miosis, anhydrosis (too much parasympathetic bc no sympathetic input
224
premenstrual dysphoric disorder vs. premenstrual syndrome
PMDD is more severe mood disturbances prior to the onset of menses whereas PMS is more just bloating cramping and off mood
225
when do you give the tetanus vaccine for wounds
if it is a tetanus prone wound and they either have an unknown vax hx or <3 doses OR it has been 5yrs since they got a booster
226
what is the typical genotype of pts with 5 alpha reductase deficiency
46XY
227
differentiate between acute fatty liver of pregnancy vs. intrahepatic cholestasis of preg
AFLP: sudden onset jaundice, nausea, vom, RUQ pain, coagulopathy // cholestasis: pruritis, jaundice
228
treatment of acute fatty liver of pregnancy vs. intrahepatic cholestasis of preg
AFLP: immediate delivery // cholestasis: ursodeoxycholic acid
229
what is a luteoma and how do you manage it
this is a rare benign tumor of the ovary caused by hormonal effects of pregnancy, causes virulization, just observe bc it will likely regress on it sown
230
how often do braxton hicks contractions occur
couple an hour
231
what is considered true labor
coordinated regular contractions about every 10 minutes AND cervical change
232
management of duodenal hematoma
NG tube to decompress the stomach and TPN for
233
what is the most common side effect of ECT
reversable amnesia headaches, nausea
234
what is the confirmatory test for multiple myeloma
bone marrow biopsy
235
what is the purpose of intention to treat analysis
helps avoid selection bias by keeping the balance of characteristics that was created during randomization
236
when do you use unpaired t tests
comparing two groups independent data
237
when do you use paried t tests
comparing one groups dependent variables across two points in time
238
when do you use ANOVA
comparing the means of dependent variables between 2 or more categories
239
what are the greatest two things that impact COPD patients survival
1- smoking cessation 2- long term oxygen
240
what is a potential AE of local anesthetic
methemoglobinemia, perioral numbness, dysgeusia, tinnitus, etc.
241
what antibodies/antigen are present in chronic Hep B infection
Hbc IgG, HBsAg, antiHbe
242
what infections are common in kids with selective IgA deficiencyI
mucosal infections (sinusitis, giardia)
243
treatment of dermatitis herpetiformis in celicacs
oral dapsone
244
first step in evaluation of precocious puberty
GnRH stim test, increase in LH means this is central
245
treatment of body dysmorphic disorder
CBT
246
what does meconium aspiration put a term neonate at risk of
persistent pulmonary hypertension of the newborn
247
for wounds is it best to do tension free or with tension
tension free
248
dx of a patient with low total Ca but normal ionized Ca
pseudohypocalcemia mostly due to low albumin
249
how do you dx appendicitis in pregnant ppl
graded compression ultrasonography
250
abdominal compartment syndrome effect on the heart
decreased preload because fo compression of the vena cava which restricts blood flow causing decreased preload. There is increased CVP though due to the compression it just cant get to the heart
251
what is the equation for Number needed to treat
1/ARR
252
which tay sachs or nieman pick has hepatomegaly
nieman pick
253
what disorder does a neonate with e coli sepsis likely have
galactosemia
254
signs of benzo overdose
normal vitals, ataxia, lethargy, coma, slurred speech
255
meniscal tear vs. mcl tear
both have joint line tenderness and delayed effusion but only meniscal tear has clicking
256
what is the child version of a pheo
neuroblastoma
257
what shape are calcium oxalate crystals
dumbell or envelope rhomboid
258
signs of glucose 6 phosphatase deficiency
hepatomegaly, hypertriglyceridemia, hyperuricemia, elevated lactate,
259
which cells make testosterone
leydigs
260
what is waldenstrom
this is abnormal production of IgM
261
signs of IgM
progressive nephropathy, impaired platelet function, hyperviscosity, anemia
262
management of ectopic pregnancy with surgery vs. methotrexate
do surgery if the patient is unstable or bhcg is >5000
263
what leads show elevation in LAD infarct
I, aVL, V1-V6
264
treatment of lichen sclerosis in the vagina
topical steroids
265
if a patient has hepatojugular reflux, is it a heart or a liver issue
heart! because there wouldnt be reflux if the right heart could keep pumping
266
signs of alport syndrome
cant pee cant see cant hear a bee (kidneys, eyes, ears)
267
treatment of symptomatic pagets
IV bisphosphonates
268
do you need to give rhogam in ectopic pregnancies
yace
269
when can you administer stimulants for ADHD
>6yo
270
what is transient proteinuria and who gets it
this is minimal proteinuria transiently which is seen in kids just do urinalysis 1x ayear
271
what type of intubation do you do if you cannot do endotracheal in an emergency setting
cricothyroidotomy
272
what does a positive direct coombs mean
Ab against the RBC surface
273
jauncide with a positive coombs test
autoimmune hemolytic anemia
274
hwo do you treat genitourinary schistosomiasis
praziquantel
275
treatment of fulminant hepatic failure
liver transplantation
276
signs of congenital toxo
chorioretinitis, diffuse calcifications, ventriculomegaly
277
what is systemic vascular resistance like in hypovolemic shock
high! because the sympathetic sys is telling the body to try to increase blood pressure
278
treatment of vtach
amiodarone
279
what is considered prolonged labor in the first stage
slow progression with <6cm in dilation
280
whta is considered prolonged second stage of labor
>3 hours in nulliparous or >2 hours in multiparous
281
what causes prolonged labor
3 Ps, passenger (too big of head), pelvis (pelvic inadequacy), <200 montevedo units in 10 minutes
282
skin effects of warfarin
warfarin induced skin necrosis
283
who gets warfarin skin induced necrosis
strongest factor is defiency or protein C
284
signs of amaurosis fugax on fundoscopy
bright yellow plaques at bifucation of retinal arterioles, microaneurysms, increased tortuosity of retinal arteries
285
signs of retinal vein occlusion
dilated tortuous retinal veins, macular edema, papilledema, retinal hemorrhages
286
what is the cause of abdominal pain in HELLP syndrome
stretching of the glisson capsule
287
complication of IgA vasculitis
intussusception
288
when do transplanted kidneys get RAS
within the first two years
289
timeline for when isoniazid can cause liver injury
can cause it months later as it has a variable latent period
290
seminoma elevations
bhcg
291
leydigs hormone elevations
estrogen or testosterone
292
sertoli hormone elevations
estrogen
293
non seminoma germ cell (yolk, embryonal carcinoma, teratoma, chorio)
bhcg and AFP
294
complications of pprom
placental abruption, preterm labor, intraamniotic infection, cord prolapse
295
what do patients with beta thal need who also get frequent transfusions
chelation therapy
296
when do you initiate nutritional support for critically ill patients
asap
297
which two foodborne illnesses do you ingest the toxin
bacillus cereus and staph aureus
298
does craniopharyngioma or pit ademomas have calcifications
cranios
299
von hippel lindau
hemangioblastomas, RCC, pheos
300
evaluation of a post menopausal adnexal mass
ultrasound and then if no malignant features, do CA-125, if malignant do surgery
301
what does the tinel sign dx
tarsal tunnel syndrome
302
when does acute chest syndrome happen like timing wise
it happens later down the line like after somethign that triggers it liek infection or vasoocclusive pain crisis
303
common cause of intraventricular hemorrhage in the newborn
prematurity, low birth weight
304
treatment of vesicouretal reflex
prophylacitic abx in mild-severe cases and surgery in severe reflux
305
drugs to avoid in parkinsons patients
first gen antipsychotics, because of their potent dopamine antagonism
306
management of rectus diastasis
observation and reassurance
307
what disorder has multiple personality states
dissociative identity disorder
308
what is the main feature of depersonalization disorder
feelings of detachment from or observing yourself
309
causes of jitteriness in neonates
hypoglycemia and hypocalcemia
310
difference in dementia with lewy bodies vs. parkinsons demenita
in lewy body disease the dementia occurs at the same time as the parkinsonism and in parkinsons it occurs late in the disease
311
what tumor gives opsoclonus myolconus syndrome
neuroblastoma
312
what does each value increased from 1 mean for odds ratio
1 = 100% chance increased odds, 2 = 200% chance increase etc.
313
management of sleep terrors
reassurance
314
management of drowning
if they have problems obviously admit them but if theyre chilling still admit them to observe for ARDS
315
signs of preeclampsia
RUQ pain, hyperreflexia, ankle clonus, headache,
316
what does an immature hypothal-pit-ovary axis do to periods
it causes irregular and anovulatory bleeding NOT heavy bleeding
317
cause of primary dysmenorrhea
increased prostaglandin production
318
what causes hand foot mouth disease
coxsackie A
319
description of molluscum contagiosum
flesh colored papule with umbilicated center
320
classic findings of sphincter of oddi dysfunction
increased pain after opioids due to increased contraction, dilated bile duct without stones
321
where do you see toxo in the brain
basal ganglia! multiple lesions
322
who gets erythema nodosum
strep, histo, sarcoid, crohns
323
what is polyarteritis nodosa
fibrinoid necrosis of the arterial wall with tissue ishcmia
324
clinical features of polyarteritis nodosa
fever, weight loss, malaise, livdeo reticularits, ulcers, purpura, headahces, GI ischemia, myalgias, arthritis, neuropathy
325
signs of wernicke encephalopathy
encephalopathy, oculomotor dysfunction, postural and gait ataxia
326
signs of essential tremor
bilateral, worsens with stress, improves with alcohol, worsens with
327
treatment of essential tremor
propanolol, primidone
328
what is the hawthorne effect
this is when people change their actions based on the knowledge that they are being observed
329
what are uterine fibroids made of
proliferation of smooth muscle within the myometrium
330
signs of inhalent use
loss of consciousness, elevated LFTs, perioral rash
331
cause of hypoxemia in ARDS
increased R to L shunting, the blood is not getting oxygenated
332
tinea capitis skin appearance
tiny black dots from broken hair shafts and scaly patches, can have boggy scaly pus
333
manifestations of granulomatosis with polyangiits
sinusitis, interstitial lung disease, alveolar hemorrhage, glomerulonephritis, ulcers
334
management of placenta previa
c section at 36-37 weeks
335
clinical signs of placenta previa
sudden painless bright red bleeding
336
clinical signs of placental abruption
sudden onset PAINFUL bleeding, tender uterus, fetal distress, hypertonic rigid uterus
337
when do you give tdap in pregnancy
27-36 weeks
338
treatment of adjustment disorder
pscyotherapy, short term sleep aids, anti anxiety meds etc
339
difference between malingering and factitious disorder
in malingering you are doing this for another gain, and in factitious disorder you fake your sx with no gain and to assume sick role
340
somatic sx disorder vs. illness anxiety
somatic sx you have multiple physical sx that cause distress and have lots of dx testing, illness anxiety you are anxious about having a specific disease despite absent or mild sx
341
what uterine surgeries cause contraindications for trial of labors
prior classical vertical c section, myomectomy with entry to the uterine cavity
342
avoidant personality disorder
this is when people avoid situations due to fear of criticism and rejection
343
benzo withdrawal signs
seizures, tremors, anxiety, psychosis, diaphoreisis, nausea, vom, HTN
344
normal vaginal pH
4-4.5
345
what stage of labor do epidurals effect
stage 2 pushing
346
what SSR is used in people with cardiac disease
sertraline
347
complications of bicornate uterus
preterm labor, infertility, recurrent miscarriage
348
contraception to avoid in the postpartum period
estrogen because you are hypercoaguable from the estrogen increase during pregnancy
349
naltrexone vs. buprenophrine
naltrexone is a full antagonist vs buprenorphine which is partial agonist
350
treatment of magnesium toxicity
calcium gluconate
351
what causes tardive dyskinesia
dopamine receptor supersensitivity
352
what happens with constant stimulation vs. blockade of a receptor
it downregulates in stimulation and upregulates with blockade
353
most common cause of lobar intracranial hemorrhage
cerebral amyloid angiopathy
354
causes of SIADH
small cell lung cancer, pulmonary infections, head trauma, etc.
355
what drug is contraindicated in post partum hemorrhage for pts with asthma
carboprost tromethamine
356
what drug is contraindicated in post partum hemorrhage for pts with HTN
methylergonovine (methergine)
357
complications of rapid deceleration from falls or motor vehicle collisions
blunt thoracic aortic injury, hypotension, cool extremities, tachy, hemothorax, widened mediastinum
358
signs of measles
4Cs cough, coryza, conjunctivitis, koplik spots, high fever
359
signs of rubella
cephalocaudal spread of maculopapular rash fever
360
indications for removal of endometrial polyps
postmenopausal, premenopausal with: abnormal bleeding, infertility, lynch syndrome, obesity
361
do you give anticoagulation in the setting of stroke
NO you give antiplatelet therapy instead
362
what is the argyll robertson pupil
when pupils are miotic and irregular and do not accomodate to light but have normal
363
what is histrionic personality disorder
excessive emotionality, attention seeking behavior, inappropriate sexual remarks, highly involved in relationships and thinking they are more intimate than they really are
364
narcissistic PD signs
lack of empathy, interpersonal exploitation, NO EMOTIONAL DISPLAYS (thats histrionic)
365
stevens johnson syndrome vs. staphylococcal scalded skin
SJS is blistering of the skin due to medications and is in adults +Mucus membranes involved vs SSSS which is due to staph aureus and has NO MUCUS membranes and is IN CHILDREN
366
difference between 5 alpha and androgen insensitivity syndrome presentation
5alpha has no breast development because there is no estrogen vs. androgen insensitivity HAS breasts because the excess androgens get converted to estrogen via adipose tissue
367
clincial signs of wiscott aldrich syndrome
eczema, thrombocytopenia, infections with encapsulated bugs
368
pathophys of TACO
this is when you get transfusion overload due to accumulation of fluid within a couple hours, not immunologically related
369
what does HSV encephalitis look like on MRI
uni or bilateral hyperintensity in the temporal lobe
370
dx of vertebral osteomyelitis
MRI
371
do you give fluids to someone who is hemodynamically stable and has hx of heart failure and is admitted for some sort of infectino
no!
372
contraindications to NO administration
right ventricle MI, recent PDE-5 use
373
whats a positive PPD in HIV patients
5 or greater
374
when to use chi squared tests
when comparing means of things or categoral values
375
signs of necrotizing faciitis on the skin
hemorrhagic bullae, crepitus
376
what occurs after a miscarriage, hyaditiform mole or chorioCA
chorioCA
377
signs of juvenile spinal muscular atrophy
degeneration of motor neurons, scoliosis, hypotonia, areflexia, autosomal recessive
378
signs of duchenne muscular dystrophy
calf pseudohypertrophy, proximal muscular weakness, gower sign
379
what is a pterygium
this is a winged like overgrowth of the conjuctival tissue tha tcan sometimes cover the iris, wear sunglasses and lubricate the eye
380
uremia manifestations
pericarditis, uremic encephalopathy
381
does myeloma cause hematuria
no, just proteinuria
382
ketorlac administration method
injection, not good for outpatient managment
383
ecg changes in cardiac tampenode
this is just electrical alternans
384
fev1:FVC ratio and peak expiratory flow rate in asthma
both decreased
385
when to test for hemophelia in newborns
immediately test the cord blood
386
protective factors of ovarian cancer
things that decrease the number of ovulatory cycles such as OCP use
387
signs of graves opthalmology
prominant appearing eyes, bilateral scleral injetion, limited upward gaze, and diplopia
388
what is the length bias
this is when you have bias in a study that occurs when the disease is going to take a long time to show up so you make the analysis that the intervention isnt doing much
389
management of empyema
chest tube
390
onset of exposure to UV rays to cancer
decades
391
signs of cutaneous leishmaniasis
slow heaing lesion with ulceration and edema
392
what arrythmia is typically provoked by caffeine, stress, alcohol etc in a structurally normal heart
av node reentry tachycardia (AVNRT)
393
valsalva effect on afterload
this decreases after load because it decreases venous return which decreases CO and decreases blood pressure
394
complications of inserting central venous catheter
collapsed lung, air embolism
395
management of suspected air embolism
place patient in lateral decubitus position, and in trendelenburg
396
treatment of whipple disease
ceftriaxone followed by TMP-SMX
397
epidemiology of zenker diverticulum
older male patients, likely achalasia in a younger person
398
is the bili direct or indirect in breastfeeding jaundice
indirect because there is not enough of the enzyme
399
predominance of conjugated (direct) bili in a newborn with jaundice
biliary atresia
400
management of the thyrotoxic phase of subacute thyroiditis
beta blockers, NO ANTI THYROID DRUGS
401
management of breast mass concerning for malignancy on physical
>35yrs, mammography and biopsy // <35yrs ultrasound
402
what drugs allow for positive inotropic support in cardiogenic shock
dopamine, dobutamine, norepi
403
odds ratio or relative risk for case/control studies
odds ratio (odds of developing X with exposure)
404
when do we use relative risk
cohort study looking at people with exposure and seeing the risk of developing X
405
what is the equation for positive predictive value
True positives/ (TP + FP)
406
is sensitivity/specificity affected by disease prevalence in the pop or is PPV/NPV
PPV and NPV are affected by prevalence
407
what type of bias is it when you do statistical analysis after the data is seen and collected ie. when you see the outcome and then tweak the analysis
post hoc analysis
408
first step in suspected placenta previa
pelvic ultrasound then c section
409
when do patients who underwent splenectomy need abx prophylaxis
ONLY for procedures involving respirtory track
410
SCID b/t cell levels
both are low
411
digeorge b and t cell levels
only T cells are low
412
signs of medication overuse headache
taking medications at minimum every other day who experiences headaches everyother day
413
what is a hyphema
this si when you get blood in the anterior chamber of the eye due to damange to the vasculature of the iri, ciliary body, etc.
414
what is felty syndrome
fevers, neutorpenia, splenomegaly, and pleuritic chest pain in a person with RA
415
when to give the tdap vax during pregnancy
27-36 weeks EVERY pregnancy
416
screening of type 1 diabetics
lipids, kidney #s, eye exam, monofilament testing, foot exam, blood pressuer
417
timeline criteria for dx panic disorder
sx >1month
418
signs of gas bloat
upper abdominal bloating after eating, discomfort, feeling of food getting stuck
419
complication of umbilical artery catheterization
renal artery thrombosis
420
first line management of prolactinoma
bromocriptine, if fails then can go to surgery
421
does VSD cause cyanosis
NO
422
cyanosis in a child that worsens with exertion/crying
tetrology of fallot
423
principles to medication prescribing in elderly patients
limiting # prescribers, BEERS criteria, time to benefit of the drug, tailor regimine to life expectancy, frequently assess needs of prescriptions
424
when is a relative risk and odds ratio considered statistically significant
if the confidence interval does not contain 1
425
what is the complement of specificity
the false positive rate which is 1-specificity
426
what is best way to reduce sign out errors
using a standard template when conducting sign out
427
what are the best things in engineering strategies to reduce human errors
forcing functions, computerized automation, environmental design
428
what is a cluster study design
grouping data points with simular categories, involves randomization at the level of groups
429
what is a factorial design
this is when there are differentent interventions and there are multiple end points
430
saline use in right vs. left MI
use saline in Right MI to avoid low preload and avoid in left MI to avoid fluid overload
431
signs of acute heart failure in the setting of MI
basilar crackles halfway up lung fields, low O2, S3
432
signs of vasovagal syncope
brief LOC, vagal prodrome (diaphoresis, warmth), enciting factor like emotional stress or prolonged standing
433
sudden onset acute limb ischemia etiology
embolism or trauma
434
what heart defect is necessary to maintain oxygenation in tricuspid atresia
VSD
435
what does amyloidosis do to the heart
restrictive cardiomyopathy
436
noninfectoius thrombotic endocarditis
hypercoaguable states, noninfectious thrombi on a healthy valve
437
what heart valve is affected in ankylosing spondylitis
aortic valve (regurg)
438
what are the 6Ps of acute limb ischemia
pain, pallor, poikilothermia, paralysis, pulselessness, paresthesia
439
management of suspected acute limb ischemia
heparin
440
meds for acute coronary syndrome
nitrate, beta blocker, antiplatelet (aspirin and clopidegrel), anticoag, statin
441
when do you not give a beta blocker for ACS
hypotension or acute heart failure
442
treatment of hypertrophic cardiomyopathy in an infant of diabetic mother
beta blockers and fluids
443
what does inspiration do to preload
increases preload because it increases pressure to the venous system
444
cardiovascular complications of turner syndrome
coarc, bicuspid valve, aortic dilatation/dissection, metabolic syndrome
445
in the setting of possible ACS what do you give regardless of etiology of chest pain
you give aspirin
446
management of pulseless electrical activity
NO SHOCK, you just do CPR and treat the cause of the arrythmia
447
what rhythms are shockeable
ventricular fibrillation, pulseless ventricular tachycardia
448
what are the nonshockeable rhythms
pulseless electrical activity, asystole
449
characteristic murmur of tetrology of fallot
Left upper sternal border due to RVOT obstruction
450
what type of PFT pattern is seen in sarcoid
this is a restrictive pattern
451
restricive FEV1, Total lung, DLCO
FEV1 is normal or decreased, TLC is decreased, DLCO is decreased
452
treatment of toxic megacolon
IV steroids
453
congential cmv signs
calcifications mainly in the periventricules, chorio, sensorineuronal hearing loss, microcephaly
454
common sign of cryptococcal meningitis
increased ICP
455
signs of toxo
focal neurological signs, seizures, confusion, headaches
456
meningitis skin findings (by pathogen)
viral: maculopapular rash // neisseria meningitidis: petichiae // cryptococcall: umbilicated papules
457
management of unstable angina
same as STEMI, nitrates, beta blocker, antiplatelet, anticoag, statin, corinary reperfusion
458
what is bicarb like in anion gap acidosis
high gap means low bicarb
459
treatment of high altitude sickness
supplemental O2, acetazolamide, dexamethasone
460
screening age for low dose ct vs. AAA ultrasound
low dose CT is yearly at 50 and ultrasound is one time at 65
461
signs of hyperkalemia on EKG
peaked T waves, widened QRS with low amplitude which causes a sine wave pattern
462
when do you get low aldosterone in adrenal insufficiency
ONLY when its primary adrenal insufficiency so like in addisons
463
what are the main nerve roots in knee and achilles reflex
knee: L4 achilles: S1
464
what are the ulcerations like in bacterial vs. herpes vs. fungal keratitis
bacterial is a central round ulcer // herpes is branched keratitis // fungal is feather margins with satellite lesions
465
what is the formula for number needed to harm
1/ARI (absolute risk increase)
466
aldosterone in primary vs. secondary adrenal insufficiency
primary it is decreased but in secondary its normal
467
management of a myasthenic crisis
intubation --> plasmapheresis or IVIG with steroids
468
what is selection bias
this is when the sample group is not representative of the population from which the participants are drawn because the sampling or treatment allocation is not random
469
what is susceptibility bias
one disease predisposes affected individuals to another disease and the treatment for the first disease is mistakenly interpreted sa a predisposing factor for the second disease
470
what is measurement bias
poor data collection methods with inaccurate results
471
signs of physiologic tremor
tremor that worsens with stress and can be seen at rest and during action
472
what does a succession splash mean
gastric outlet obstruction
473
what is an afferent pupillary defect
this is when the eye cannot react to light but can accomodate. the direct pupillary reflex is absent in affected eye but DOES accomodate when light is shone in the non affected eye. there is NO consensual response in the non affected eye
474
risk factors for sigmoid volvulus
chronic constipation and colonic dysmotility.
475
effect of tamoxifen on the uterus
agonist affect
476
adverse effects of tamoxifen
hot flashes, endometrial hyperplasia, VTE, uterine sarcom
477
timing of worsening symptoms for different types of strokes
embolic is worst at onset, thrombotic is fluctuating, and hemorrhagic is progressively worse and worse
478
signs of stroke in the putamen
strokes in the putamen almost always involve the internal capsule so you will get contralateral hemiparesis and contralateral sensory loss
479
do you have focal neuro signs in subarachnoid hemorrhage
no!
480
who gets optic gliomas
NF1
481
genetic syndromes with pheo
VHL, MEN2
482
what is associated with wilms tumor
WAGR, beckwith wiedman syndrome
483
next step in management of person with anorectal fistula
surgery with fistulagram to evaluate tracks
484
causes of asymmetric fetal growth
maternal hyptertension, maternal malnourishment
485
causes of symmetric fetal growth restriction
chromosomal abnormalities, infections
486
management of superficial wound dehiscence vs. rectus dehiscence
superficial: regular dresssing changes // rectus: urgent surgery
487
lab abnormalities in DIC
high PT and PTT, low platelets, low fibrinogen (because it is being used up)
488
what type of cholecystitis do pts. get that are critically ill
acalculous cholecystiits, can happen with TPN
489
what is RBC mass
total # of red blood cells in circulation NOT the mass of the individual RBC
490
which thalassemia has HIGH HbA2
beta thal
491
what does it mean if the patient has no bleeding with progesterone challenge test
there is a structural issue or there is estrogen deficiency
492
what antibodies are seen in UC vs. Crohns
UC: p-ANCA // Crohns: anti-saccharomyces cerevisiae antibodies
493
whats the leading cause of death for adults over 65yrs
cardiovascular disease
494
management of distal biceps tendon rupture
surgical repair within 2-3 weeks
495
adverse effects of nitrates
hypotension, headaches, flushing, cyanide toxicity
496
what is bronchopulmonary dysplasia
this is premature arrest of pulmonary development, continued 02 requirement >28 days from birth
497
common presentation of chronic bacterial prostatitis
recurrent UTI, pain with ejaculation, transient improvement with ABX, typically no swelling or tenderness of prostate
498
signs of ecthyma gangrenosum
painless red macules that quickly progress to pustules and form gangrenous punched out ulcers
499
what is the threshold in which you can visualize a pregnancy
>3500 bhcg
500
when do you do ABX for mammalian bites
if its a puncture wound, if its on the face, hand/foot, joint or genitals, immunocompromised pts, if they need primary closure
