hammer

Question 1

4 Risk factors for placental abruption

Answer 1

Maternal HTN, Abdominal trauma, Prior placental abruption, Cocaine use

Question 2

Clinical presentation for placental abruption

Answer 2

sudden onset vaginal bleeding, abdominal or back pain, high frequency, low intensity contractions, hypertonic and tender uterus

Question 3

2 Maternal complications of placental abruption

Answer 3

Hypovolemic shock and DIC

Question 4

Signs and symptoms of meningogcoccal meningitis (Neisseria meningitis)

Answer 4

Fever, headache, AMS, petechial or purpuric rash

Question 5

What does a Turner patient look like 4 characteristics?

Answer 5

webbed neck, horseshoe kidney, carpal and pedal edema, nail dysplasia

Question 6

What causes congenital lymphedema in Turner patients?

Answer 6

Abnormal development of lymphatic system

Question 7

What is the presentation and diagnosis of Meckel’s diverticulum?

Answer 7

2yo with asymptomatic painless hematochezia, intusussception, intestinal obstruction, volvulus and diagnosed with Technetium 99m pertechtnetate scan

Question 8

What is the pathophysiology of Meckel’s diverticulum?

Answer 8

Ectopic gastric mucosa

Question 9

What type of EEG pattern is seen on Absence seizures?

Answer 9

3 Hertz spike and wave

Question 10

Where does a focal seizure originate from and is there LOC?

Answer 10

1 cerebral hemisphere with +/- loss of conciousness

Question 11

What are the 4 types of focal seizures?

Answer 11

Motor - Jacksonian march, turning of eyes/head/trunk
Sensory - paresthesias, vertigo, visual phenomena
Autonomic - sweating,
Psychic - Deja vu

Question 12

Which disorder is Srep gallolyticus associated with?

Answer 12

Colonic neoplasms

Question 13

Which patients between 19 - 64 get PPSV23 alone?

Answer 13

Chronic heart, lung, liver disease, diabetics, curent smokers, alcoholics?

Question 14

Which patients between 19 - 64 get the sequential PCV13 + PPSV23?

Answer 14

CSF leaks, cochlear implants, sickle cell disease, asplenics, Immunocompromised, CKD

Question 15

Which age group gets the sequential PCV13 + PPSV23? and in what intervals?

Answer 15

Age > 65, 6-12 months apart

Question 16

When is Td and Tdap vaccine given?

Answer 16

Tdap once as a substitute for Td booster, then Td every 10 years

Question 17

Which is the most common epithelial thyroid cancer and how does it spread?

Answer 17

papillary > 70% via lymphatics

Question 18

Which is the second most common epithelial thyroid cancer and how does it spread?

Answer 18

follicular, hematogenously

Question 19

What is the presentation of Cushing syndrome 5 symptoms?

Answer 19

central obesity, facial plethora, proximal muscle weakness ,abdominal striae, ecchymosis, amenorrhea, HTN

Question 20

What are the 4 sideeffects of Erythropoietin therapy?

Answer 20

1. Worsening of HTN 2. Headaches 3. Flu like syndrome 4. Red cell aplasia

Question 21

What are the clinical features of Obsessive Compulsive disorder?

Answer 21

Obsessions which are recurrent and intrusive, anxiety prokoking and Compulsions - which are repeated behaviors or mental acts and are time consuming

Question 22

How is OCD treated

Answer 22

1. Cognitive behavioral therapy with exposure and response prevention 2. SSRI

Question 23

What two medications can be used for narcolepsy?

Answer 23

Modafinil and amphetamine stimulants

Question 24

Which narcolpesy medication reduces cataplexy?

Answer 24

sodium oxybate

Question 25

What are pregnancy related risks of hypertension in the mother?

Answer 25

postpartum hemorrhage ,gestational diabetes

Question 26

What are pregnancy related risks of hypertension in the fetus?

Answer 26

fetal growth restriction, oligohydrammnios, perinatal mortality, preterm delivery

Question 27

What are signs of HIV infection in an infant ?

Answer 27

Failure to thrive, lymphadenopathy, thrush

Question 28

When should pregnant patients with possible HIV get tested?

Answer 28

in 1st and 3rd trimesters since it can take upto 3 months to develop a detectable antibody

Question 29

What is the diagnostic criteria for Kawasaki?

Answer 29

Fever more than 5 days plus >4 of the following 1. B/l nonexudative conjuctivitis, 2. mucositis (strawberry tongue, injected pharynx or lips) 3. cervical lymphadenopathy, 4. erythematous polymorphous rash, 5. extremity changes

Question 30

What is the comlications for Kawasaki?

Answer 30

Coronary artery aneurysm, MI

Question 31

What is the treatment for Kawasaki?

Answer 31

Aspirin plus IVIG

Question 32

What are the three subtypes of cerebral palsy and what is the greatest risk factor? Comorbidities

Answer 32

spastic, dyskinetic, ataxic - premature birth, intellectual disability

Question 33

What is the treatment for catbites?

Answer 33

clean and treat with amoxicillin/clavulanate and Tetanus booster as indicated

Question 34

What are the symptoms of herniated disk?

Answer 34

acute back pain that radiates to the thighs and typically below the knee with positive leg raise test

Question 35

What are the symptoms of lumbosacral strain?

Answer 35

local tenderness and contraction of paraspinal muscles with negative straight leg test

Question 36

What is the treatment for subconjuctival hemorrhage?

Answer 36

Nothin

Question 37

What are the levels of Ca, PTH and P in GI diseases with fat malabsorption? Why are Ca and P that way?

Answer 37

High PTH and low Ca and low P, because Vit D mediates their absorption from the intestine and ADEK is fat soluble

Question 38

What should you give patients with ischemic stroke to improve their outcomes?

Answer 38

Fibrinolytic therapy

Question 39

What is the treatment for antiphospholipid antibody syndrome?

Answer 39

LMWH plus low does aspirin

Question 40

What are the features of CMV esophagitis?

Answer 40

Deep linear ulcers at the distal esophagus

Question 41

What are the electrolyte imbalances in tumor lysis syndrome?

Answer 41

Decreased Cacium only, increased Phosphate, K, Uric acid

Question 42

What are the characteristics of Iron deficiency anemia and what can cause it in children?

Answer 42

Increased RDW and increased TIBC, excess cow milk intake

Question 43

What is the management of blunt abdominal trauma patients who are hemodynamically unstable?

Answer 43

FAST exam - if positive do laparotomy, if inconclusive do DPL, if negative and no signs of extra abdominal hemorrhage - stabilize then CT, if there are signs , stabilize

Question 44

What type of lesion is pronator drift and which tract is it located on?

Answer 44

UMN lesion located on the pyramidal/corticospinal tract

Question 45

What does raising the cutoff of a test do to sensitivity and specificity?

Answer 45

specificity up, sensitivity down

Question 46

What is the causative organism of erysipelas and what does it look like?

Answer 46

group A beta hemolytic strep/ sharply demarcated, erythematous ,edematous, tender skin lesion

Question 47

What is seen in tissue biopsy of sarcoidosis?

Answer 47

non caseating granulomas

Question 48

What 3 things cause symmetric fetal growth restriction?

Answer 48

Genetic disorders congenital heart disease, intrauterine infections

Question 49

Which nerve is damaged when anterior shoulder is dislocated?

Answer 49

Axillary nerve

Question 50

Which nerve is damaged when humerus is fractured midshaft or crutches are used?

Answer 50

Radial nerve

Question 51

Which nerve is damaged when medial epicondyle of humerus is fractured ?

Answer 51

ulnar nerve