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Step2 CK > General > Flashcards

General Flashcards

0
Q

Common cause of bitemporal hemianopsia in adult and children?

A

Prolactinoma in adults and craniopharyngeoma in children

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1
Q

What are the four most common causes of pancreatitis?

A
  • gallbladder stones
  • alcoholism
  • hypercalcemia
  • hyper triglyceridemia
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2
Q

Causes of eosinophilia

A 
DNAAACP
drugs
Neoplasm
Allergy, asthma (Churg-strass)
Addisons adrenal insufficiency 
Acute tubular necrosis
Collagen vascular disease
Parasites (loffler's pneumonitis due to ascaris lumbricoides)
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3
Q

Common causes of secondary hypertension

A

Pheochromocytoma, hyperaldosteronism, Cushing syndrome, renal artery stenosis, oral contraceptives, coarctation of the aorta and chronic kidney disease

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4
Q

What anti-hypertensives can be used in a patient with severe pre-clampsia?

A

Hydralazine, labetalol, nifedipine or sodium nitroprusside

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5
Q

When is it appropriate to administer hypertonic saline in SIADH?

A

When there are active seizures

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6
Q

What cause of back pain is exacerbated with standing and walking but relieved with sitting a son hyperflexion of the hips?

A

Spinal stenosis

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7
Q

What causes flat top purple pruritic polygonal papules?

A

Lichen planus

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8
Q

Continuos machine like murmur

A

PDA

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9
Q

What should you suspect in a woman with pre-eclampsia in the first trimester

A

Consider hyditaform mole

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10
Q

What is the first line treatment for a GH secreting pituitary adenoma

A

Transphenoidal resection of the tumor

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11
Q

What are the indications for the repair of an AAA (4)

A

Size >5.5cm
Symptomatic
Rupture
Rapidly expanding

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12
Q

What is a side effect that many of the atypical antipsychotics have

A

Weight gain leading to the development of diabetes type II

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13
Q

What type of lung cancer is associated with SIADH and other paraneoplastic syndromes

A

Small cell lung cancer

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14
Q

Decreased urine specific gravity and increased serum osmolality

A

Diabetes insipidus

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15
Q

Treatment of afib of unknown duration

A

Anticoagulation heparin to long term warfarin

Rate control with beta blockers, verapamil, digoxin

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16
Q

What characteristics would make you suspect a Nevus to be melanoma?

A 
ABCD
Asymmetry
Irregular boarders
Color changes or variation
Diameter changes
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17
Q

Most common site for ectopic pregnancy

A

Ampulla of the Fallopian tube

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18
Q

What acid base disturbance is seen in pregnant women

A

Respiratory alkalosis

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19
Q

CSF findings of SAH

A

Increased pressure and a lot of RBC…if a few days then xanthochromia

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20
Q

Pre-teen with anger, destruction of property, theft and violence towards family and pets

A

Conduct disorder;considered as a precursor to antisocial personality disorder

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21
Q

Hypoxia, pulmonary edema with a normal pulmonary capillary wedge pressure

A

Problem is in the lungs since PCWP is indicative of the left atrial pressure and that’s normal; ARDS

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22
Q

Vaginal bleeding in a 18 week gravid patient with no products of conceptus in the vaginal vault, membrane rupture, open cervical os

A

Inevitable abortion

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23
Q

Treatment for cardiogenic shock

A

Number one is pressors, specifically dobutamine

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24
Q

ICU pt that has woken up and is alert but cannot move at all except his eyes

A

Locked-in syndrome (lesion at the level of the brain stem)

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25
Q

Systemic diseases that can result in nephritic syndrome

A

Diabetes , SLE, Amyloidosis

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26
Q

Diagnosis: hypertension, depression and kidney stones

A

Hyperparathyroidism

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27
Q

Diagnosis: elevated BP in arms and low BP in legs

A

Coarctation of aorta

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28
Q

Diagnosis: Hypertension with proteinuria

A

Renal disease

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29
Q

Hypertension with hypokalemia

A

Hyperaldosteronism

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30
Q

Hypertension and hyperkalemia

A

Renal artery stenosis and renal failure

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31
Q

Hypertension, tachycardia , diarrhea and heat intolerance

A

Hyperthyroidism

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32
Q

Anti-hypertensive medication with 1st dose hypotension

A

Alpha blockers

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33
Q

Anti-hypertensive medication with hypertrichosis

A

Minoxidil

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34
Q

Anti-hypertensive medication with dry mouth, sedation and rebound hypertension

A

Clonidine

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35
Q

Anti-hypertensive medication with cough

A

ACEI

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36
Q

Anti-hypertensive medication with bradycardia, impotence and asthma exacerbation

A

Beta blockers

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37
Q

Anti-hypertensive medication with reflexive tachycardia

A

Vasodilators

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38
Q

Anti-hypertensive medication to avoid in sulfa allergies

A

Loop and thiazides diuretics

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39
Q

Anti-hypertensive medication with SE of angioedema

A

ACEI

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40
Q

Anti-hypertensive medication known to cause drug induced lupus (antibodies seen)

A

Hydralazine (anti-histone)

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41
Q

Anti-hypertensive medication that can cause cyanide toxicity

A

Nitroprusside

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42
Q

What anti-hypertensive medication is contraindicated in COPD?

A

No selective beta blockers

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43
Q

What anti-hypertensive medication is contraindicated in pregnancy?

A

ACEI/ARBS

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44
Q

What anti-hypertensive medication is contraindicated in advance renal disease with hyperkalemia ?

A

ACEI/ARBS and k sparing

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45
Q

What anti-hypertensive medication is contraindicated in gout?

A

Diuretics

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46
Q

What heart sounds are considered benign in asymptomatic pts with no history of disease?

A

Low grade early systolic murmurs, sometimes s3, splitting of s1, splitting of s2 on inspiration

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47
Q

What heart defect is associated with chromosome 22q11 deletion?

A

Tetralogy of fallout and turncus arteriosus is associate with DiGeorge syndrome

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48
Q

What heart defect is associated with Down syndrome?

A

Endocardial cushion defects (VSD, ASD)

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49
Q

What heart defect is associated with congenital rubella?

A

PDA and pulmonary artery stenosis

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50
Q

What heart defect is associated with Turners?

A

Coarctation of the aorta

51
Q

What heart defect is associated with Marfans?

A

Aortic insufficiency (AR)

52
Q

What is the next best step in management after a brain tumor has been diagnosed by head CT/MRI?

A

Full body scan and Bone scan to find source of tumor or presence of mets

53
Q

What are the Ws of post operative fever?

A 
Wind-atelectasis
Water- UTI
Wound- infection after 5 days
Wonder drugs- medications including antibiotics
Walk-dvt
Wain- thrombophlebitis
54
Q

What medications are used to treat TB meningitis?

A

Same medication protocol used for pulmonary TB: rifampin, isoniazid,pyrazinamide and ethambutol

55
Q

Characteristic features of pericarditis?

A 
Pleuritic chest pain better when leaning forward worse when supine
Dyspnea
Cough
Friction rub
Pulsus paradoxus
JVD
Fever
ST segment elevation in all leads
56
Q

Antidote to toxicity with acetaminophen

A

n acetyl cysteine

57
Q

Antidote to toxicity with Lead

A

EDTA, dimercaperol and succimer

58
Q

Antidote to toxicity with cyanide

A

Na thiosulfate, hydroxycobalamin,Na nitrate

59
Q

Antidote to toxicity with methyl hemoglobin

A

Methylene blue and vitamin c

60
Q

Antidote to toxicity with opioids

A

Naloxone and naltrexone

61
Q

Indication for surgical excision of parathyroid adenoma? And how is this different from the indication in parathyroid hyperplasia?

A

Parathyroid adenoma: symptomatic, high elevated serum calcium, 24 hour urine calcium greater than 400mg, bone scan score T -2.5, creatinine clearance reduced by 30% and age

62
Q

Classic EKG finding in atrial flutter

A

Saw tooth pattern appearance of p waves

63
Q

60 year old obese patient with dirty-looking velvety patch at the back of the neck: diagnosis and work up required

A

Acanthosis nigricans
Work up for diabetes and in pts over 45 years with new development of this dermatological finding should concern for visceral malignancy

64
Q

MCC hypothyroidism

A

Hashimoto’s

65
Q

Bias when a screening test can detect a disease earlier in the course increasing survival time

A

Lead time bias

66
Q

Exceptions to informed consent

A

Emergency situations, pt lacking decision making capacity and pt that has waived his right to informed consent

67
Q

90 year old with palpable flank mass and he atria found to have bilaterally enlarged kidneys with cysts: diagnosis and brain finding associated with this condition

A

Adult PCKD and look for berry aneurysm

68
Q

4 main cause of microcytic anemia

A

MC is iron deficiency, thalessemia, anemia of chronic disease and lead poisoning

69
Q

Treatment in iron OD

A

Deferoximine

70
Q

What is the minimum acceptable urine output in a stable patient

A

30 cc/hr

71
Q

What are the classic symptoms (and lacking symptoms) for strep pharyngitis

A

Fever, sore throat, erythematous pharynx, tonislar exudate

Lack of cough and rhinorrhea

72
Q

What defense mechanism is a person displaying when they can calmly describe a gory murder scene they witnessed

A

Isolation

73
Q

EKG finding of peaked T waves and flattened QRS

A

Hyperkalemia

74
Q

What area is Lyme disease endemic to

A

North east US

75
Q

What joints are affected in rheumatoid arthritis

A

MCP and PIP joints (not DIP)

76
Q

Dx: xerostomia, enlarged parotid gland, xerophthalmia and anti-LA antibodies

A

Srögren’s syndrome

77
Q

MCC seizures in young adults

A

Head trauma, ETOH withdrawl and brain tumors

78
Q

MCC of non-obstetric post-partum cause of death

A

Thromboembolic event (DVT->PE)

79
Q

Uterine bleeding in a 18 week gestation with no products of concepts expelled and closed cervical os

A

Threatened abortion

80
Q

Dx: immunodeficiency with eczema, thrombocytopenia and high IgA

A

Wisckott-Aldrich syndrome

81
Q

Dx: pt with diarrhea, tachycardia and heat intolerance

A

Hyperthyroid

82
Q

Complications of pressors like norepinephrine in shock?

A

Ischemia/ necrosis Of fingers and toes
Mesenteric ischemia
Renal failure

83
Q

What intervention is most effective in reducing blood pressure

A

Weight loss

84
Q

What is the preferred initial anti-hypertensive in other with no comorbidities

A

Thiazides: hydrochlorothiazide and chlorthalidone

85
Q

What is the anti-hypertensive indicated in diabetes pt?

A

ACEI/ARBS

86
Q

What is the anti-hypertensive indicated in CHF pts?

A

ACEI/ARBS
Beta blockers
Spironolactone
Loops (do not decrease mortality but improve congestive symptoms)

87
Q

What is the anti-hypertensive indicated in pt wig BPH?

A

Alpha blockers

88
Q

What is the anti-hypertensive indicated in LVH?

A

ACEI/ARBS (remember that angiotensin increases remodeling of heart)
Beta blockers

89
Q

What is the anti-hypertensive indicated in pts with hyperthyroidism?

A

Beta blocker

90
Q

What is the anti-hypertensive indicated in pts with osteoporosis?

A

Thiazides

91
Q

What is the anti-hypertensive indicated in patients with benign essential tremor?

A

Beta blockers

92
Q

What is the anti-hypertensive indicated in post menopausal females?

A

Thiazides

93
Q

What is the anti-hypertensive indicated in patients with migraines?

A

Beta blockers

94
Q

What bacteria causes diarrhea and pseudo appendicitis?

A

Yersenia entercolitica

95
Q

Most common cause of lower GI bleed in pt >40 years old?

A

Diverticulosis

96
Q

Dx: 45 year old obese female with puritis, clay colored stool and increased bilirubin and alkp?

A

Biliary obstruction (many causes, gallstone common)

97
Q

Next step in pt with two Pap smears showing atypical squamous cells?

A

This is ASCUS (atypical squamous cells of undetermined significance), a colposcopy with endocervical curretage should be done for diagnosis

98
Q

What type of breast cancer increase the risk of future invasive cancer of both breasts?

A

Lobular carcinoma in situ

99
Q

Wheat oral infection will have branching rods under the microscope?

A

Actinomyces israelii

100
Q

What is the cause of rhomboid shaped crystals that are positively bifringent on knee aspiration?

A

Pseudogout , calcium pyro phosphate

101
Q

Dx: active 14 year old boy with anterior knee pain?

A

Osgood schlatter disease

102
Q

Symptoms of placenta previa

A

Painless vaginal bleeding in the 3rd trimester

103
Q

Dx: target lesions on hands and feet with mild prodrome of fever, malaise and myalgias?

A

Erythema multiforme (type IV hypersensitivity)

104
Q

Dx: congenital condition with blue berry muffin rash

A

Rubella

105
Q

Dx: psychiatric condition where person travels to a different place and retains a new identity without memory of their past?

A

Dissociative fugue

106
Q

Medicine often used to induce ovulation

A

Clomiphene

107
Q

Hypercholesterolemia treatment that causes flushing and pruritis?

A

Niacin

108
Q

Acid base disorder seen in salicylate ingestion

A

Metabolic acidosis with anion gap and respiratory alkalosis

109
Q

Parkland formula used for fluid replacement in burn victims

A

4ml (body weight kg x BSA %burned)

110
Q

Cause of chest pain in a young patient with angina at rest, ST elevation on EKG but negative cardiac enzymes

A

Prinzmetal angina

111
Q

Organism that causes pytariasis versicolor

A

Malysia furfur

112
Q

MCC of pathological fracture in elderly thin females

A

Osteoporosis

113
Q

What are the HACEK bacteria and what are they associated with?

A

H. Influenza, actinobacillus, cardiobacter, eikenella and kingella

These organisms are associated with culture negative endocarditis

114
Q

What are the indication for home oxygen in pts with COPD

A

pO2

115
Q

Why does COPD cause cor pulmonale in the long term?

A

Hypoxia mediated shunting causes pulmonary hypertension

116
Q

What is the treatment for localized non-small cell carcinoma of the lung

A

Surgical resection followed by chemo/radiation

117
Q

What is the difference between somogyi effect and the dawn phenomenon and how to differentiate clinically

A

Both causes hyperglycemia but due to different causes

  • somogyi effect- hyperglycemia due to low early morning (3am) hypoglycemia causing release of stress hormones,’usually due to improper insulin dosing
  • dawn phenomenon- due to normal physiological rise in stress hormones in the early morning that prepare for waking; diabetics do not produce enough insulin to regulate this surge and thus it results in hyperglycemia

To differentiate do a 2-3am glucose: if low then somogyi effect , if normal glucose then dawn phenomenon

118
Q

What type of immunodeficiency increases the risk of anaphylactic transfusion reaction?

A

IgA deficiency

119
Q

What is the next best step in 50year old patient with 25 pack year history whose chest X-ray shows a lobar pneumonia in the same location as a recent pneumonia?

A

Other than give antibiotics a CT scan should be done as this is concerning for lung cancer

120
Q

Imaging that should be done if DVT suspected

A

Compression ultrasound of the lower extremities

121
Q

Imaging study used to diagnose injury to urethra

A

Retrograde cystourethrogram

122
Q

Symptoms of basilar skull fracture

A

Raccoon eyes
Hemotympanum
Mastoid bruising (battle sign)
CSF Fluid leaking from anywhere!

123
Q

Drug of choice for trigeminal neuralgia pain

A

Carbamazepine

124
Q

Treatment for normal pressure hydrocephalus

A

Shunting

125
Q

First line treatment for psuedotumor cerebri

A

Weight loss….then acetezolimide, serial LP, and if all else fails shunting

126
Q

Treatment for Guillan-Barre

A

IVIG OR plasmapheresis

And supportive care with a low clinical threshold for need to intubate

Step2 CK (12 decks)

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