incorrects Flashcards

Question

What is Henoch-Schönlein purpura (HSP)?

Answer 1

An acute immune-complex mediated vasculitis of the small vessels ## Footnote HSP is characterized by its association with upper respiratory infections.

Answer 2

An upper respiratory infection ## Footnote This is a common trigger for the onset of HSP.

Answer 3

History of pharyngitis, palpable purpura, arthritis, and abdominal pain ## Footnote These symptoms help in the diagnosis of HSP.

Answer 4

Yes, it can present with bloody stools or occult bleeding ## Footnote These symptoms may occur alongside other classic signs.

Answer 5

It is accompanied by a normal platelet count ## Footnote This distinguishes HSP from other conditions that may cause similar symptoms.

Answer 6

Progesterone ## Footnote Progesterone is essential for maintaining pregnancy.

Answer 7

To maintain the pregnancy ## Footnote The corpus luteum is removed, which produces progesterone.

Answer 8

It regresses ## Footnote The placenta takes over the production of progesterone.

Answer 9

Produces sufficient progesterone to maintain the pregnancy ## Footnote This reduces the reliance on the corpus luteum.

Answer 10

Common during pregnancy ## Footnote They usually resolve by the end of the first trimester.

Answer 11

Untreated aortic coarctation ## Footnote This is due to brachiocephalic hypertension.

Answer 12

Intracranial aneurysm formation ## Footnote This is due to hypertension and/or genetic risk factors.

Answer 13

By causing brachiocephalic hypertension and aneurysm formation.

Answer 14

False ## Footnote Aortic coarctation is associated with aneurysm formation.

Answer 15

coarctation

Answer 16

Cyclothymia ## Footnote Cyclothymia is a mood disorder involving fluctuating periods of depressive and hypomanic symptoms.

Answer 17

≥ 2 years (or ≥ 1 year for children) ## Footnote This duration is essential for the diagnosis of cyclothymic disorder.

Answer 18

≤ 2 consecutive months ## Footnote A longer symptom-free period disqualifies the diagnosis.

Answer 19

Symptoms should not meet criteria for hypomanic episode (i.e., ≥ 3 hypomanic symptoms) ## Footnote This ensures the symptoms are distinct from hypomanic episodes.

Answer 20

Symptoms should not meet criteria for major depressive episode (i.e., ≥ 5 SIGECAPS symptoms) ## Footnote SIGECAPS stands for Sleep, Interest, Guilt, Energy, Concentration, Appetite, Psychomotor agitation or retardation, and Suicidal thoughts.

Answer 21

depressive ## Footnote This highlights the dual nature of cyclothymic disorder.

Answer 22

Dysthymia ## Footnote Dysthymia is a chronic form of depression.

Answer 23

Depressed mood and ≥ 2 SIGECAPS symptoms ## Footnote SIGECAPS stands for Sleep, Interest, Guilt, Energy, Concentration, Appetite, Psychomotor agitation/retardation, and Suicidal ideation.

Answer 24

≥ 2 years ## Footnote Symptoms must be present for most of the day, for the majority of the time.

Answer 25

≤ 2 consecutive months ## Footnote A longer symptom-free period would indicate that the diagnosis may not be persistent depressive disorder.

Answer 26

Substance use, bipolar disorder, psychotic disorders, or another medical condition ## Footnote These conditions can mimic or contribute to depressive symptoms.

Answer 27

Bilateral, symmetrical weakness, hyporeflexia, paresthesia in the ankles and feet, cranial nerve deficits, and back pain ## Footnote These symptoms indicate nerve root inflammation associated with GBS.

Answer 28

Recently diagnosed HIV infection ## Footnote The onset of GBS symptoms can be linked to viral infections, including HIV.

Answer 29

hyporeflexia

Answer 30

True ## Footnote Back pain is a common symptom due to inflammation affecting nerve roots.

Answer 31

Cranial nerve deficits ## Footnote These deficits can manifest in various forms, affecting facial movement, sensation, and other functions.

Answer 32

ARP = (RR - 1)/RR

Answer 33

A clinical diagnosis supported by electrodiagnostic studies and cerebrospinal fluid analysis.

Answer 34

Electrodiagnostic studies and cerebrospinal fluid analysis.

Answer 35

[electrodiagnostic]

Answer 36

Nerve conduction studies and electromyography.

Answer 37

A history of smoking ## Footnote AAA refers to Abdominal Aortic Aneurysm, a serious condition that can lead to life-threatening complications.

Answer 38

A common benign phenomenon in women of reproductive age caused by physiologic enlargement and rupture of the follicular cyst during ovulation.

Answer 39

Physiologic enlargement and rupture of the follicular cyst during ovulation, leading to the release of intraperitoneal fluid and peritoneal irritation.

Answer 40

Usually subsides within a few hours to two days.

Answer 41

Symptomatic treatment with NSAIDs as needed.

Answer 42

[enlargement and rupture]

Answer 43

Reassurance and symptomatic treatment.

Answer 44

Used in the diagnosis of choledocholithiasis ## Footnote Choledocholithiasis refers to the presence of gallstones in the common bile duct.

Answer 45

Hepatoiminodiacetic acid scintigraphy (HIDA scan) ## Footnote HIDA scans assess the function of the liver, gallbladder, and bile ducts.

Answer 46

In patients with both suspected uncomplicated acute cholecystitis and inconclusive findings on abdominal ultrasound ## Footnote Acute cholecystitis is an inflammation of the gallbladder, often due to gallstones.

Answer 47

A poor prognosis in HL and many other malignancies ## Footnote Examples of malignancies include non-Hodgkin lymphoma, testicular cancer, and AML.

Answer 48

Non-Hodgkin lymphoma, testicular cancer, AML ## Footnote AML stands for acute myeloid leukemia.

Answer 49

tumor burden

Answer 50

A good prognosis ## Footnote Lymphocytosis is characterized by an increased number of lymphocytes in the lymph nodes.

Answer 51

* Lymphocyte-rich classic HL * Nodular lymphocyte-predominant HL * Nodular sclerosing classical HL ## Footnote These subtypes are associated with better prognoses.

Answer 52

Nodular sclerosing classical HL ## Footnote This subtype is noted for its prevalence among other types of HL.

Answer 53

False ## Footnote Lymphocyte-rich classic HL has one of the best prognoses among HL subtypes.

Answer 54

Toxic acute tubular necrosis (ATN).

Answer 55

Toxic acute tubular necrosis (ATN).

Answer 56

Development of nitrate tolerance leading to decreased drug effectiveness

Answer 57

Decreased sensitivity of the vascular endothelium to nitrates

Answer 58

Intermittent therapy with nitrate-free intervals of at least 8 hours

Answer 59

effectiveness

Answer 60

Hypokalemia ## Footnote Hypokalemia refers to a lower than normal level of potassium in the bloodstream, which can affect heart function.

Answer 61

50 to 70 years of age

Answer 62

Upper motor neurons (UMN) and lower motor neurons (LMN)

Answer 63

Clinical diagnosis

Answer 64

Electromyography (EMG)

Answer 65

Random firing of denervated motor units

Answer 66

Activity of denervated muscle fibers at rest

Answer 67

Nitrate poisoning from drinking water

Answer 68

High-altitude areas (e.g., the Appalachian Mountains)

Answer 69

It reduces methemoglobin (MetHb) back to hemoglobin (Hb)

Answer 70

Infants have lower cytochrome b5 reductase activity

Answer 71

Lower cytochrome b5 reductase activity, higher fetal Hb levels, and higher water consumption per kilogram body weight

Answer 72

methemoglobin (MetHb)

Answer 73

A condition characterized by elevated levels of methemoglobin in the blood

Answer 74

A mitochondrial toxin

Answer 75

Oxidative phosphorylation

Answer 76

Trimethoprim/sulfamethoxazole ## Footnote PCP stands for Pneumocystis pneumonia, a common opportunistic infection in immunocompromised patients.

Answer 77

Rapidly once PCP is suspected ## Footnote Timely initiation of treatment is critical to improve patient outcomes.

Answer 78

Glucocorticoids ## Footnote This treatment is recommended when PaO2 is ≤ 70 mm Hg or A-a gradient is ≥ 35 mm Hg.

Answer 79

PaO2 ≤ 70 mm Hg or A-a gradient ≥ 35 mm Hg ## Footnote These criteria indicate severe respiratory distress in HIV-infected patients.

Answer 80

Improved mortality ## Footnote Combination therapy has been shown to enhance survival rates in severe cases.

Answer 81

ARF is a delayed inflammatory complication that occurs 1–5 weeks following an untreated group A beta-hemolytic streptococcal infection, particularly pharyngitis. ## Footnote ARF can lead to serious health issues if not treated properly.

Answer 82

Two major or one major plus two minor revised Jones criteria are required. ## Footnote The Jones criteria help in identifying ARF based on clinical findings.

Answer 83

* Arthritis (migratory polyarthritis primarily involving the large joints) * Subcutaneous nodules * Carditis (pancarditis, including valvulitis) * Sydenham chorea (CNS involvement) * Erythema marginatum ## Footnote These criteria reflect significant clinical manifestations of ARF.

Answer 84

* Polyarthralgia * Fever * Elevated acute phase reactants (ESR, CRP) * Prolonged PR interval on ECG ## Footnote Minor criteria help support the diagnosis of ARF when major criteria are present.

Answer 85

False ## Footnote Arthritis in ARF is typically migratory and affects large joints.

Answer 86

two major ## Footnote This emphasizes the need for a combination of criteria for accurate diagnosis.

Answer 87

CNS involvement characterized by involuntary movements. ## Footnote It is one of the major criteria used to diagnose ARF.

Answer 88

Involvement of the heart, including valvulitis. ## Footnote Pancarditis is a serious condition that can arise from ARF, affecting all layers of the heart.

Answer 89

A history of seizures, intellectual disability, and nonprogressive spastic paresis ## Footnote Cerebral palsy is characterized by various motor function disorders and can be associated with other neurological conditions.

Answer 90

It has neuroprotective effects on the fetus and is associated with a significantly reduced incidence of cerebral palsy.

Answer 91

Before 32 weeks' gestation

Answer 92

cerebral palsy

Answer 93

Neuroprotective effects

Answer 94

Stimulation of 5HT2A and dopamine D2 receptors ## Footnote LSD is a hallucinogenic drug that affects serotonin and dopamine pathways in the brain.

Answer 95

Inhibition of NMDA receptors and activation of dopaminergic neurons

Answer 96

Through smoking

Answer 97

* Increased pain tolerance * Dissociative feelings * Miosis * Vertical nystagmus * Delirium * Seizures

Answer 98

Benzodiazepines

Answer 99

Antipsychotics (e.g., haloperidol)

Answer 100

Kidney transplantation ## Footnote ESRD refers to patients who are at the final stage of chronic kidney disease.

Answer 101

False ## Footnote The statement contrasts the benefits of kidney transplantation versus dialysis.

Answer 102

Severe beta blocker intoxication ## Footnote These symptoms are critical indicators of beta blocker toxicity.

Answer 103

True ## Footnote Confusion can occur due to hypotension or hypoglycemia.

Answer 104

* Bradycardia * Hypotension ## Footnote These are among the most significant symptoms to monitor.

Answer 105

beta blocker

Answer 106

B) Wheezing ## Footnote Wheezing is not typically associated with increased heart rate.

Answer 107

Scar tissue formation that leads to thinning and weakening of the ventricular wall

Answer 108

Systolic murmur, S3 and/or S4 gallop, persistent ST elevations on ECG

Answer 109

Systolic murmur

Answer 110

ST elevations

Answer 111

Children 6 months to 5 years of age

Answer 112

Generalized tonic-clonic seizures

Answer 113

Less than 15 minutes

Answer 114

Do not recur within 24 hours

Answer 115

A quick return to a normal state without focal neurologic deficits

Answer 116

Benign familial macrocephaly is the most likely diagnosis ## Footnote No additional neuroimaging or treatment are required.

Answer 117

Benign familial macrocephaly ## Footnote Indicates that further neuroimaging or treatment is not necessary.

Answer 118

No additional neuroimaging or treatment are required ## Footnote This diagnosis is based on the Weaver curve.

Answer 119

A palpable pulsatile mass in the thigh with a bruit on auscultation ## Footnote This indicates the presence of the aneurysm in the femoral artery.

Answer 120

Antibiotic, antiinflammatory, and antioxidant properties ## Footnote These properties contribute to its effectiveness in treating skin conditions.

Answer 121

Mild rosacea ## Footnote Specifically, it helps with erythematous and papular lesions.

Answer 122

Alpha-adrenergic agonists such as topical brimonidine or oxymetazoline ## Footnote These medications help to constrict blood vessels in the skin.

Answer 123

Oral tetracyclines, oral isotretinoin, and laser therapy ## Footnote These treatments are used when topical therapies are insufficient.

Answer 124

erythematous and papular

Answer 125

False ## Footnote It also has antiinflammatory and antioxidant properties.

Answer 126

It is used for severe or refractory disease ## Footnote Oral isotretinoin is a potent medication for severe skin conditions.

Answer 127

Features of bowel perforation or ischemia, massive gastrointestinal hemorrhage, no improvement of symptoms after 24–72 hours of conservative therapy ## Footnote Features of bowel perforation include abdominal guarding, rebound tenderness, and air under the diaphragm on radiography.

Answer 128

[bowel perforation]

Answer 129

* Abdominal guarding * Rebound tenderness * Air under the diaphragm on radiography

Answer 130

Plain abdominal x-ray and/or CT scan with contrast ## Footnote These imaging techniques help visualize the condition of the colon.

Answer 131

Patients who present with bloody diarrhea, abdominal distention, and signs of systemic inflammation ## Footnote These symptoms are key indicators for potential toxic megacolon.

Answer 132

False ## Footnote A CT scan with contrast is specifically recommended for better diagnosis.

Answer 133

plain abdominal x-ray ## Footnote This imaging is crucial for evaluating the condition.

Answer 134

Selenium sulfide is an antifungal agent used to treat tinea versicolor infections. ## Footnote Tinea versicolor is a common skin condition caused by yeast that leads to discolored patches on the skin.

Answer 135

Intralesional triamcinolone ## Footnote Alopecia areata is a condition that causes nonscarring hair loss.

Answer 136

Nonscarring hair loss ## Footnote This type of hair loss does not result in permanent damage to hair follicles.

Answer 137

Finasteride. ## Footnote Finasteride is commonly prescribed for treating androgenetic alopecia.

Answer 138

Androgenetic alopecia. ## Footnote Androgenetic alopecia is a common form of hair loss in men.

Answer 139

False. ## Footnote They actually decrease this conversion.

Answer 140

first-line. ## Footnote This indicates they are the preferred initial treatment option.

Answer 141

A genetic condition often causing a marfanoid habitus and ocular complications.

Answer 142

Complications due to neuromas.

Answer 143

Combined oral contraceptive therapy (estrogen-progestin combinations) ## Footnote This therapy is commonly used for various reproductive health issues.

Answer 144

Estrogen-containing oral contraceptives ## Footnote Cardiovascular side effects include hypertension and thromboembolism.

Answer 145

* Hypertension * Thromboembolism ## Footnote These side effects can pose significant health risks.

Answer 146

Hyperlipidemia ## Footnote This condition involves elevated levels of lipids in the blood.

Answer 147

True ## Footnote Hepatic adenomas are benign tumors of the liver that may be influenced by estrogen.

Answer 148

[cardiovascular side effects] ## Footnote This includes conditions such as hypertension and thromboembolism.

Answer 149

Neurodegenerative disease ## Footnote It belongs to the Parkinson-plus syndromes.

Answer 150

* Motor abnormalities (tremor and rigidity) * Autonomic dysfunction (orthostatic hypotension and urinary incontinence) * Cerebellar symptoms (dysdiadochokinesia, gait disturbances, dysarthria) ## Footnote These symptoms highlight the diverse impact of the disease on the nervous system.

Answer 151

[autonomic]

Answer 152

True ## Footnote Symptoms such as dysdiadochokinesia, gait disturbances, and dysarthria are related to cerebellar function.

Answer 153

* Tremor * Rigidity ## Footnote These motor symptoms are similar to those seen in Parkinson's disease.

Answer 154

[orthostatic hypotension]

Answer 155

A cerebellar symptom characterized by the inability to perform rapid alternating movements ## Footnote It is one of the hallmark symptoms of cerebellar dysfunction.

Answer 156

Anti-VCA IgM antibodies alone are sufficient to diagnose acute EBV infection ## Footnote EBV stands for Epstein-Barr Virus, which is associated with infectious mononucleosis and other diseases.

Answer 157

Amenorrhea (primary or secondary), polyuria, and fatigue ## Footnote Amenorrhea refers to the absence of menstruation, which can be primary (never having a period) or secondary (the cessation of periods after they have begun).

Answer 158

A group of bacteria, including S. epidermidis, that can adhere to foreign bodies and form biofilms.

Answer 159

Coagulase-negative staphylococci, particularly within 12 months following surgery.

Answer 160

≤ 12 months following surgery.

Answer 161

Streptococcus pneumoniae is a very rare cause of IE (T)

Answer 162

Intravenous therapy with nafcillin and rifampin for at least 6 weeks in combination with gentamicin for 2 weeks ## Footnote This combination is specifically effective for infections caused by methicillin-susceptible staphylococci.

Answer 163

Quetiapine or another second-generation antipsychotic with a low risk of extrapyramidal adverse effects ## Footnote Examples include clozapine or pimavanserin.

Answer 164

Second-generation antipsychotic ## Footnote These have a lower risk of extrapyramidal adverse effects.

Answer 165

* Clozapine * Pimavanserin

Answer 166

Greater risk for extrapyramidal adverse effects ## Footnote Compared to other second-generation antipsychotics

Answer 167

Second-generation antipsychotic ## Footnote Also known as atypical antipsychotics

Answer 168

Dopamine D2 receptors ## Footnote This is linked to the risk of side effects

Answer 169

False ## Footnote It poses a greater risk of extrapyramidal symptoms

Answer 170

The passage of the fetus through the birth canal

Answer 171

Lower back pain

Answer 172

[relaxation of the pelvic girdle]

Answer 173

Expected pCO2 = (1.5 x HCO3-) + 8 (+/- 2) ## Footnote This formula is used in clinical settings to estimate the expected partial pressure of carbon dioxide based on bicarbonate levels.

Answer 174

Every 1–5 years ## Footnote This is due to the increased risk of developing colorectal cancer (CRC).

Answer 175

8–10 years following the onset of symptoms ## Footnote This timing is crucial for early detection of potential cancerous changes.

Answer 176

False ## Footnote Patients with long-standing inflammatory bowel disease have an increased risk of developing colorectal cancer.

Answer 177

A triad consisting of hypoglycemic symptoms, documented hypoglycemia during an episode, and relief of symptoms upon administration of glucose.

Answer 178

* Hypoglycemic symptoms (e.g., sweating, palpitations) that typically follow exertion or fasting * Documented hypoglycemia during an episode * Relief of symptoms upon administration of glucose

Answer 179

* Sweating * Palpitations

Answer 180

Exertion or fasting

Answer 181

To reproduce hypoglycemic symptoms and reach a definitive diagnosis in insulinoma ## Footnote Insulinoma is a type of tumor that causes excessive insulin production, leading to hypoglycemia.

Answer 182

Insulinoma ## Footnote Insulinoma is characterized by inappropriate insulin secretion and can lead to severe hypoglycemia.

Answer 183

Prompt pharmacologic cardioversion with intravenous antiarrhythmics such as procainamide, sotalol, or amiodarone.

Answer 184

* Procainamide * Sotalol * Amiodarone

Answer 185

Hemodynamically stable patients with sustained monomorphic VT.

Answer 186

[prompt pharmacologic cardioversion with intravenous antiarrhythmics]

Answer 187

Emergent management of barbiturate intoxication ## Footnote Urine alkalinization helps to enhance the excretion of certain drugs, including barbiturates.

Answer 188

Stable chest pain in women < 60 years or men < 40 years of age without additional risk factors or concerning findings on the initial ECG ## Footnote CAD stands for coronary artery disease.

Answer 189

* Pneumocystis jirovecii * Human cytomegalovirus (CMV)

Answer 190

Pneumocystis jirovecii

Answer 191

Cushing syndrome ## Footnote Cushing syndrome is characterized by excessive cortisol production, which can have various health impacts.

Answer 192

It causes inhibition of calcitriol synthesis ## Footnote Calcitriol is the active form of vitamin D, crucial for calcium absorption and bone health.

Answer 193

Decreased bone mineral density and osteoporosis ## Footnote Osteoporosis increases the risk of fractures and other skeletal problems.

Answer 194

50% ## Footnote This statistic highlights the significant impact of Cushing syndrome on bone health.

Answer 195

A benign, vascular tumor characterized by rapid growth and a tendency to bleed profusely after minor trauma ## Footnote Pyogenic granulomas are often mistaken for other types of growths due to their appearance and behavior.

Answer 196

Rapid growth and tendency to bleed profusely after minor trauma ## Footnote These characteristics make pyogenic granulomas notable in clinical diagnosis.

Answer 197

False ## Footnote Pyogenic granulomas are classified as benign tumors.

Answer 198

vascular ## Footnote This vascular nature contributes to its tendency to bleed.

Answer 199

A dose of MMR vaccine ## Footnote This applies to those with unknown vaccination status, no laboratory evidence of immunity, or born after 1957.

Answer 200

> 200 cells/mm3 ## Footnote This threshold indicates an adequate immune status for vaccination.

Answer 201

True ## Footnote Adults born before 1957 are generally considered immune due to prior exposure.

Answer 202

Reflex triage testing should be performed for risk stratification (HPV testing)

Answer 203

A high-frequency mid-systolic click ## Footnote This click is caused by sudden tensing of the chordae tendineae as the valve leaflets prolapse.

Answer 204

Sudden tensing of the chordae tendineae ## Footnote This tensing occurs as the valve leaflets prolapse.

Answer 205

Mitral valve prolapse ## Footnote EDV stands for End-Diastolic Volume, which influences the timing of leaflet prolapse.

Answer 206

It results in an earlier onset and increased intensity of auscultatory findings ## Footnote Auscultatory findings refer to sounds heard during auscultation, often indicating valve function.

Answer 207

Ataxia telangiectasia ## Footnote Ataxia telangiectasia is a rare genetic disorder that affects the nervous system and immune system.

Answer 208

IgG and IgA deficiency ## Footnote These deficiencies contribute to the increased susceptibility to infections.

Answer 209

Elevated alpha-fetoprotein (AFP) is a biomarker associated with ataxia telangiectasia ## Footnote AFP levels can be elevated in various conditions, but in this context, it supports the diagnosis of ataxia telangiectasia.

Answer 210

True ## Footnote Cerebellar ataxia refers to a lack of voluntary coordination of muscle movements.

Answer 211

cerebellar ataxia

Answer 212

Episodes of apnea that last > 20 seconds or are accompanied by bradycardia and/or oxygen desaturation ## Footnote Apnea of prematurity is a common condition in preterm infants due to their immature respiratory control.

Answer 213

Treatment includes ncpap and caffeine therapy ## Footnote NCPAP (nasal continuous positive airway pressure) helps maintain airway patency.

Answer 214

> 20 seconds

Answer 215

* ncpap * caffeine therapy

Answer 216

Adenocarcinoma of the lung

Answer 217

Arthritis, digital clubbing, and periostitis of the distal diaphysis of long bones

Answer 218

arthritis, digital clubbing, and periostitis of the distal diaphysis of long bones

Answer 219

AML has a higher proportion of blasts which are not the same as myelocytes and metamyelocytes ## Footnote Blasts are immature cells typically found in acute leukemia, while myelocytes and metamyelocytes are more mature forms of myeloid cells.

Answer 220

t(9:22) translocation ## Footnote This translocation is also known as the Philadelphia chromosome.

Answer 221

BCR-ABL fusion gene

Answer 222

An overactive tyrosine kinase enzyme

Answer 223

Excessive proliferation of myeloid progenitor cells

Answer 224

Targeted tyrosine kinase inhibitors, such as imatinib

Answer 225

Both the exposure and the outcome

Answer 226

Angiography ## Footnote Angiography is used to identify and potentially treat bleeding sources.

Answer 227

Patients with active hematochezia, hemodynamic instability despite resuscitation efforts, and a normal EGD ## Footnote Hemodynamic instability indicates a critical condition that requires immediate intervention.

Answer 228

hemodynamic ## Footnote Hemodynamic instability refers to inadequate blood flow, which can be life-threatening.

Answer 229

Torus fracture ## Footnote A torus fracture is also known as a buckle fracture and typically occurs in children due to their softer bones.

Answer 230

An axial force that causes impaction of the distal radius and/or ulna ## Footnote Common incidents include falls on an outstretched hand or falls from a height.

Answer 231

At the junction of the metaphysis and diaphysis ## Footnote This area is more porous, making it more susceptible to fractures.

Answer 232

Pain and swelling of the distal forearm ## Footnote These symptoms arise after an axial force is applied to the area.

Answer 233

False ## Footnote Torus fractures are primarily seen in children due to the flexibility of their bones.

Answer 234

Steatorrhea, recurrent epigastric pain, and weight loss ## Footnote These symptoms often indicate pancreatic dysfunction.

Answer 235

History of chronic alcohol use ## Footnote Chronic alcohol use is a significant risk factor for developing pancreatitis.

Answer 236

True ## Footnote Steatorrhea indicates malabsorption due to pancreatic insufficiency.

Answer 237

chronic pancreatitis ## Footnote These symptoms arise from pancreatic damage and dysfunction.

Answer 238

History of chronic alcohol use ## Footnote Alcohol consumption can lead to inflammation and damage to the pancreas.

Answer 239

An abdominal contrast-enhanced CT scan ## Footnote This imaging technique is preferred due to its ability to provide detailed images of the pancreas and surrounding structures.

Answer 240

A protease inhibitor used in HIV therapy

Answer 241

HIV-associated lipodystrophy

Answer 242

HIV-associated lipodystrophy

Answer 243

The negative predictive value (NPV) is inversely related to pretest probability. ## Footnote This means that as pretest probability increases, NPV decreases.

Answer 244

directly ## Footnote PPV indicates the probability that subjects with a positive screening test truly have the disease.

Answer 245

Analgesia and empiric intravenous broad-spectrum antibiotic therapy ## Footnote Examples of antibiotics include ceftriaxone and ampicillin/sulbactam.

Answer 246

It reduces the mucociliary clearance ## Footnote Mucociliary clearance is a defense mechanism that helps clear mucus and pathogens from the respiratory tract.

Answer 247

Increases susceptibility to infection

Answer 248

Acute limb ischemia ## Footnote Mural thromboembolism refers to a blood clot that forms on the wall of the heart and can dislodge, leading to ischemia in the limbs.

Answer 249

3–14 days ## Footnote A myocardial infarction is commonly known as a heart attack, and the pseudoaneurysm is a complication that can arise during the healing process.

Answer 250

3–5 days post-infarction ## Footnote This timing is critical for diagnosis and management.

Answer 251

Acute right heart failure ## Footnote This can significantly impact hemodynamics.

Answer 252

Ultrasound-guided thrombin injection ## Footnote This procedure stops blood flow to the hematoma.

Answer 253

Ultrasound-guided thrombin injection ## Footnote This method is specifically recommended for pseudoaneurysms of this size.

Answer 254

> 90% ## Footnote This indicates a high effectiveness of the procedure.

Answer 255

≥ 3 cm ## Footnote Pseudoaneurysms smaller than this may not be treated with this method.

Answer 256

False ## Footnote It is specifically indicated for those measuring ≥ 3 cm.

Answer 257

Middle ear barotrauma ## Footnote This condition is often associated with changes in air pressure.

Answer 258

Otalgia ## Footnote Otalgia refers to ear pain, which can occur due to pressure changes.

Answer 259

Presence of blood in the tympanic cavity ## Footnote Hematotympanum can indicate trauma or other ear conditions.

Answer 260

Conservative management with analgesics ## Footnote Common analgesics include oral ibuprofen.

Answer 261

Analgesics ## Footnote Analgesics help alleviate discomfort associated with barotrauma.

Answer 262

analgesics

Answer 263

A group of bacteria that are commonly found in the mouth and throat. ## Footnote They are known to play a role in dental health and can be involved in infective endocarditis.

Answer 264

S. sanguinis. ## Footnote S. sanguinis is often associated with dental procedures and poor oral hygiene.

Answer 265

In damaged native heart valves. ## Footnote Damaged valves can include conditions like bicuspid aortic valve.

Answer 266

False. ## Footnote They are the most common cause in specific conditions.

Answer 267

viridans streptococci. ## Footnote This group includes bacteria such as S. sanguinis.

Answer 268

Bicuspid aortic valve. ## Footnote This type of valve can be congenitally malformed and is prone to complications.

Answer 269

Vaginal progesterone supplementation ## Footnote Short cervix is defined as less than 25 mm at less than 24 weeks' gestation.

Answer 270

Less than 25 mm ## Footnote This measurement is considered at less than 24 weeks' gestation.

Answer 271

For patients with a short cervix without a history of spontaneous preterm birth ## Footnote The context is crucial for determining the treatment approach.

Answer 272

False ## Footnote It is specifically for those without a history of spontaneous preterm birth.

Answer 273

A surgical procedure to support the cervix during pregnancy.

Answer 274

Pregnant patients with a short cervix ≤ 25 mm.

Answer 275

History of preterm delivery, previous second-trimester pregnancy loss, or cervical insufficiency.

Answer 276

16–23 weeks' gestation.

Answer 277

[preterm delivery, previous second-trimester pregnancy loss, or cervical insufficiency].

Answer 278

Assessment of the nodule's risk for malignancy ## Footnote This evaluation is crucial for determining the appropriate follow-up and management strategy.

Answer 279

Large nodule size (≥ 8 mm) ## Footnote Nodule size is a critical factor in risk assessment.

Answer 280

Location in the upper lung fields ## Footnote The anatomical location influences the likelihood of malignancy.

Answer 281

Irregular, spiculated, or scalloped borders ## Footnote The morphology of the nodule is an important diagnostic feature.

Answer 282

Hypotension, tachycardia ## Footnote These features indicate a significant decrease in blood volume.

Answer 283

1000 mL ## Footnote A blood loss of 1000 mL or more is considered a significant indicator of PPH.

Answer 284

True ## Footnote These symptoms are indicative of hypovolemia, which can occur in PPH.

Answer 285

1000 ## Footnote This volume is significant in assessing the risk of PPH.

Answer 286

Genital tract injury

Answer 287

Well-contracted uterus and active vaginal bleeding without visible injuries of the vulva or perineum

Answer 288

Uterine atony

Answer 289

Extranodal/distant metastases at the time of presentation and increased alpha-fetoprotein (AFP) levels ## Footnote Alpha-fetoprotein (AFP) is a protein that is typically produced by the liver and yolk sac of a developing fetus, and elevated levels can indicate certain types of tumors.

Answer 290

Cisplatin, etoposide, and bleomycin

Answer 291

Stage I in select patients

Answer 292

In stages II and III

Answer 293

A JAK2 inhibitor

Answer 294

Patients with PMF not eligible for transplant

Answer 295

Severe constitutional symptoms and/or symptomatic splenomegaly

Answer 296

Patients who are eligible for allogeneic stem cell transplantation

Answer 297

They typically close spontaneously without complication

Answer 298

At 6 months of age for spontaneous closure

Answer 299

Urine alkalinization with intravenous sodium bicarbonate (NaHCO3), which increases elimination of weak acids such as barbiturates,

Answer 300

Prophylaxis refers to preventive treatment against infections caused by opportunistic pathogens.

Answer 301

Pneumocystis jirovecii and human cytomegalovirus (CMV)

Answer 302

Prophylaxis should be administered in posttransplant patients on immunosuppressive therapy.

Answer 303

posttransplant

Answer 304

Neuroimaging ## Footnote This is to rule out stroke.

Answer 305

Diffusion-weighted MRI ## Footnote It shows even small ischemic changes within 30 minutes after onset.

Answer 306

Within 30 minutes after onset ## Footnote Compared to CT scans, which show changes only after 6–24 hours.

Answer 307

Acute from chronic lesions ## Footnote This is crucial for diagnosing TIA.

Answer 308

MRI ## Footnote This is part of the diagnostic protocol.

Answer 309

Diffuse pulmonary hypoperfusion ## Footnote This is seen in conditions like CTEPH.

Answer 310

Decreased vascular markings on chest x-ray ## Footnote This sign is indicative of conditions such as CTEPH.

Answer 311

Flow murmurs over obstructed lung vessels ## Footnote These can be indicative of vascular issues in the lungs.

Answer 312

CTEPH ## Footnote CTEPH stands for Chronic Thromboembolic Pulmonary Hypertension.

Answer 313

False ## Footnote Decreased vascular markings are indeed associated with diffuse pulmonary hypoperfusion.

Answer 314

Umbilical cord entanglement occurs in almost all monoamniotic twin pregnancies due to the close insertion of the umbilical cords on the chorionic surface. ## Footnote Monoamniotic pregnancies involve twins sharing the same amniotic sac.

Answer 315

CT scan of the abdomen with contrast and abdominal ultrasound ## Footnote These imaging techniques are commonly used due to their effectiveness in diagnosing appendicitis.

Answer 316

Edwards syndrome ## Footnote Trisomy 18 is a genetic disorder caused by the presence of an extra 18th chromosome.

Answer 317

* Characteristic craniofacial morphology * Micrognathia * Prominent occiput * Pointy, low-set ears * Clenched fists with flexion contractures of the fingers * Rocker-bottom feet ## Footnote These features are commonly associated with the physical presentation of infants with Edwards syndrome.

Answer 318

A condition of having a small jaw ## Footnote Micrognathia is often seen in various congenital conditions, including trisomy 18.

Answer 319

A notably protruding back of the head ## Footnote This feature is part of the craniofacial morphology seen in trisomy 18.

Answer 320

Convex foot deformity with prominent heel ## Footnote Rocker-bottom feet are often associated with several congenital syndromes, including Edwards syndrome.

Answer 321

True ## Footnote This physical characteristic is commonly observed in infants with Edwards syndrome.

Answer 322

Patau syndrome

Answer 323

* Low-set ears * Flexed fingers * Signs of congenital cardiac defect

Answer 324

Ventricular septal defect

Answer 325

* Cleft lip and palate * Microphthalmia * Polydactyly

Answer 326

low-set ears

Answer 327

↓ free estriol, ↓ AFP, ↔ inhibin A, and ↓ β-HCG ## Footnote AFP stands for alpha-fetoprotein, a protein produced by the fetus. β-HCG is beta-human chorionic gonadotropin, a hormone produced during pregnancy.

Answer 328

β-HCG ## Footnote Indicates no abnormality for Patau syndrome

Answer 329

Cesarean delivery ## Footnote This is due to the position of the fetus making vaginal delivery risky.

Answer 330

A management option in pregnancies with a breech presentation or oblique/transverse lie near or at term.

Answer 331

Before the onset of active labor.

Answer 332

37 weeks' gestation.

Answer 333

To manage hypertension and control proteinuria ## Footnote Examples include captopril.

Answer 334

Decrease renal damage and subsequent progression to end-stage renal disease (ESRD) ## Footnote These medications are indicated for all patients with ADPKD.

Answer 335

End-stage renal disease (ESRD)

Answer 336

Mefloquine ## Footnote Mefloquine is specifically recommended due to its safety profile compared to other options.

Answer 337

Resistance to chloroquine is likely ## Footnote This is particularly relevant in endemic areas.

Answer 338

It is consistent with cytomegalovirus (CMV) pneumonia ## Footnote CMV pneumonia is most commonly seen in immunocompromised patients.

Answer 339

Immunocompromised patients ## Footnote This includes individuals with weakened immune systems due to conditions like HIV/AIDS, organ transplantation, or chemotherapy.

Answer 340

It serves as a biomarker for the presence of CMV infection ## Footnote Detection of pp65 antigen can help in the early diagnosis of CMV pneumonia.

Answer 341

Intravenous ganciclovir, possibly combined with intravenous immunoglobulin therapy ## Footnote Ganciclovir dosage should be adjusted to renal function

Answer 342

CMV pneumonia ## Footnote CMV pneumonia is a serious manifestation of CMV infection

Answer 343

IV foscarnet ## Footnote Foscarnet is used when ganciclovir is ineffective

Answer 344

To assess the likelihood of osteomyelitis in patients with diabetic foot ulcers ## Footnote Osteomyelitis is an infection in the bone that can occur as a complication of diabetic foot ulcers.

Answer 345

Antiviral therapy with oseltamivir or zanamivir (T)

Answer 346

Anemia, jaundice, splenomegaly, spherocytes, reticulocytosis, increased RBC distribution width, increased MCHC ## Footnote These symptoms indicate a specific blood disorder known as hereditary spherocytosis.

Answer 347

spherocytes

Answer 348

A rapid test that is highly sensitive and specific for hereditary spherocytosis ## Footnote This test is used to diagnose hereditary spherocytosis by evaluating the binding of EMA to red blood cells.

Answer 349

Hereditary spherocytosis ## Footnote Hereditary spherocytosis is a genetic condition that affects red blood cells, causing them to be spherical in shape.

Answer 350

False ## Footnote The EMA binding test is characterized as a rapid test.

Answer 351

Oral amoxicillin therapy ## Footnote This therapy is specifically aimed at treating the infection caused by group A Beta-hemolytic streptococci.

Answer 352

Group A Beta-hemolytic streptococci (GAS) ## Footnote GAS is responsible for a range of infections, including this specific dermatitis.

Answer 353

Well-demarcated, erythematous perianal rash with possible pseudoexudate, crusting, and superficial anal fissures or cracks ## Footnote These features are indicative of the infection and its effects on the skin.

Answer 354

* Pruritus * Rectal pain during defecation * Blood-streaked stools ## Footnote These symptoms can significantly affect the quality of life of individuals suffering from this condition.

Answer 355

True ## Footnote The condition may cause cracks in the skin, leading to fissures.

Answer 356

A tumor that can manifest as an enlarged scrotal mass that does not transilluminate.

Answer 357

No, Leydig cell tumors do not produce β-hCG.

Answer 358

An enlarged scrotal mass that does not transilluminate.

Answer 359

Acute-onset chest pain that is reproducible with palpation along the costochondral junction

Answer 360

A young patient who recently began a workout program

Answer 361

[reproducible]

Answer 362

A workout program

Answer 363

A condition characterized by abnormal thyroid hormone levels in critically ill patients with intact thyroid function.

Answer 364

Low T3 with low-normal levels of T4 and TSH.

Answer 365

[abnormal]

Answer 366

T4 and TSH

Answer 367

Chronic mesenteric ischemia

Answer 368

Acute mesenteric ischemia (AMI)

Answer 369

High-resolution CT angiography (CTA) of the abdomen and pelvis

Answer 370

Peritonitis

Answer 371

Lyme carditis ## Footnote Symptoms include palpitations and dyspnea.

Answer 372

* Palpitations * Dyspnea * AV block * Other cardiac arrhythmias

Answer 373

Intravenous ceftriaxone ## Footnote This applies to both adults and children.

Answer 374

* Symptomatic patients * First-degree AV block with PR interval ≥ 300 ms * Second-degree AV block * Third-degree AV block

Answer 375

Neurogenic tumors (e.g., neurofibromas and schwannomas) ## Footnote Neurogenic tumors account for approximately 60% of posterior mediastinal masses.

Answer 376

Young adults (20–30 years) ## Footnote This age group is commonly affected by intrathoracic neurofibromas.

Answer 377

Chest pain ## Footnote The chest pain is typically caused by mass effect upon the chest wall.

Answer 378

False ## Footnote Neurogenic tumors account for approximately 60% of posterior mediastinal masses.

Answer 379

neurofibromas ## Footnote Neurofibromas are a type of neurogenic tumor.

Answer 380

In the anterior mediastinum.

Answer 381

Cough due to mass effect.

Answer 382

An underlying H. pylori infection ## Footnote Particularly in individuals who are not taking NSAIDs.

Answer 383

Heals > 90% of duodenal ulcers ## Footnote Also prevents further complications.

Answer 384

* Rebleeding * Perforation * Fistulation * Gastric outlet obstruction

Answer 385

omeprazole

Answer 386

No, they do not require treatment.

Answer 387

They often remain stable or regress on their own.

Answer 388

Approximately every 6–12 months.

Answer 389

* Symptom monitoring * Pelvic ultrasonography

Answer 390

leiomyoma growth

Answer 391

Uterine leiomyoma ## Footnote Uterine leiomyoma, also known as fibroids, are benign tumors of the uterus.

Answer 392

* History of early menarche * Obesity ## Footnote Early menarche refers to the onset of menstruation at an unusually young age.

Answer 393

Upper gastrointestinal tract hemorrhage ## Footnote This complication can lead to significant morbidity and may require urgent medical intervention.

Answer 394

A common cause of spontaneous cortical intracerebral hemorrhage (ICH) in elderly patients.

Answer 395

Spontaneous cortical intracerebral hemorrhage (ICH).

Answer 396

Elderly patients.

Answer 397

Protruding rectal polyp and multiple hamartomatous polyps ## Footnote Peutz-Jeghers syndrome is associated with mucocutaneous hyperpigmentation.

Answer 398

Peutz-Jeghers syndrome (PJS) ## Footnote PJS is a genetic condition that increases the risk of certain cancers.

Answer 399

True ## Footnote It is one of the key diagnostic criteria for PJS.

Answer 400

Peutz-Jeghers syndrome ## Footnote PJS is important to recognize due to its cancer predisposition.

Answer 401

1-1.3 ## Footnote The ankle-brachial index (ABI) is a simple test used to check for peripheral artery disease.

Answer 402

PAD stands for Peripheral Artery Disease

Answer 403

Patients with PAD are at significantly increased risk for myocardial infarction and stroke

Answer 404

Anticonvulsants and tricyclic antidepressants ## Footnote Anticonvulsants include topiramate and sodium valproate; tricyclic antidepressants include amitriptyline.

Answer 405

Beta blockers

Answer 406

Topiramate and sodium valproate

Answer 407

Tricyclic antidepressants ## Footnote An example is amitriptyline.

Answer 408

Beta blockers

Answer 409

Acute management of severe migraine ## Footnote Ergotamine is a medication that helps alleviate the symptoms of severe migraine attacks.

Answer 410

Human-derived botulism immune globulin ## Footnote This treatment is preferred because the risk of a hypersensitivity reaction is lower than with equine-derived antitoxins.

Answer 411

Lower risk of a hypersensitivity reaction ## Footnote This is particularly important for children under 1 year of age.

Answer 412

Hypotension, muffled heart sounds, and distended neck veins ## Footnote Beck triad is a clinical finding associated with cardiac tamponade.

Answer 413

Electric alternans ## Footnote Electric alternans can be indicative of cardiac tamponade.

Answer 414

Beta blockers such as propranolol are the mainstay of therapy for congenital LQTS ## Footnote Beta blockers help manage the condition and prevent serious complications.

Answer 415

Patients with symptomatic LQTS (history of syncope or cardiac arrest) should be treated with beta blockers ## Footnote Treatment aims to reduce the risk of polymorphic ventricular tachycardia and sudden cardiac death.

Answer 416

To reduce the risk of polymorphic ventricular tachycardia and sudden cardiac death ## Footnote This is crucial for patients with a history of syncope or cardiac arrest.

Answer 417

Congenital deafness ## Footnote LQTS stands for Long QT Syndrome, which can present in different forms with varying symptoms.

Answer 418

Romano-Ward syndrome ## Footnote Romano-Ward syndrome is a type of LQTS without associated deafness, unlike Jervell and Lange-Nielsen syndrome.

Answer 419

It is associated with sensorineural hearing loss ## Footnote Jervell and Lange-Nielsen syndrome is characterized by both LQTS and congenital deafness.

Answer 420

False ## Footnote Jervell and Lange-Nielsen syndrome includes sensorineural hearing loss as a key feature.

Answer 421

An invasive form of intrapartum fetal heart rate (FHR) monitoring

Answer 422

In patients whose external FHR monitoring poses technical difficulties

Answer 423

* Polyhydramnios * Uterine leiomyomas * Multiple gestation * Obesity

Answer 424

Internal monitoring

Answer 425

[technical difficulties in external FHR monitoring]

Answer 426

FSE monitoring is only performed in patients whose membranes have already ruptured, either spontaneously or via amniotomy. ## Footnote FSE stands for fetal scalp electrode monitoring, which is used to assess fetal heart rate during labor.

Answer 427

Inhibition of mycolic acid synthesis ## Footnote Mycolic acids are essential components of the cell wall in Mycobacterium species, including the bacteria that cause tuberculosis.

Answer 428

Liver injury, evidenced by mildly elevated transaminases. ## Footnote A small number of patients may develop fulminant hepatitis, especially older patients.

Answer 429

Older age. ## Footnote Age is a significant risk factor for more severe liver injury.

Answer 430

Vitamin B6 deficiency. ## Footnote This deficiency can manifest as sideroblastic anemia and peripheral neuropathy.

Answer 431

* Sideroblastic anemia * Peripheral neuropathy ## Footnote Vitamin B6 is crucial for various metabolic processes.

Answer 432

Cytochrome P450 inhibition. ## Footnote This can affect the metabolism of other drugs processed by the liver.

Answer 433

Drug-induced lupus erythematosus. ## Footnote This condition can present with various symptoms including joint pain and skin rashes.

Answer 434

Optic neuropathy and impaired color vision. ## Footnote These effects highlight the importance of monitoring visual function in patients.

Answer 435

Concurrent administration of pyridoxine (vitamin B6). ## Footnote This helps prevent the adverse effects associated with the deficiency.

Answer 436

A biopsy ## Footnote A biopsy is a medical procedure that involves taking a small sample of tissue for examination.

Answer 437

Heterogeneous collections of polygonal, eosinophilic cells that contain Birbeck granules ## Footnote Birbeck granules are unique structures found within Langerhans cells and are indicative of Langerhans cell histiocytosis.

Answer 438

A rare disorder that most commonly affects children 5–10 years of age.

Answer 439

Single or multiple osteolytic lesions that cause bone pain and swelling.

Answer 440

The skull.

Answer 441

* Long bones * Vertebrae * Ribs

Answer 442

* Rash * Lymphadenopathy * Hepatosplenomegaly * Central diabetes insipidus

Answer 443

A type of bone cancer that typically manifests during childhood or adolescence.

Answer 444

Localized pain and swelling, and anemia in some patients.

Answer 445

Diaphyses of long bones, such as the femur or tibia.

Answer 446

osteolytic

Answer 447

Bacillary angiomatosis ## Footnote Bacillary angiomatosis is associated with the presence of bacteria detected on Warthin-Starry stain.

Answer 448

Warthin-Starry stain ## Footnote This stain is specifically used for identifying certain bacteria in tissue samples.

Answer 449

* Abdominal pain * Nausea * Anorexia ## Footnote These symptoms indicate that bacillary angiomatosis can affect the gastrointestinal tract.

Answer 450

False ## Footnote Bacillary angiomatosis can also manifest with gastrointestinal lesions.

Answer 451

Bacillary angiomatosis ## Footnote The diagnosis is supported by the presence of specific symptoms and staining results.

Answer 452

Erythromycin

Answer 453

Oral doxycycline

Answer 454

For a similar duration of time as erythromycin

Answer 455

Frequent vaginal douching and the use of soaps with perfumes and irritating chemicals ## Footnote These practices disturb the normal vaginal microflora.

Answer 456

It decreases the amount of lactic acid-producing lactobacilli ## Footnote This leads to an increase in the vaginal pH balance.

Answer 457

A pH higher than 4.5 ## Footnote This level is no longer acidic enough to prevent proliferation.

Answer 458

Gardnerella vaginalis ## Footnote Its proliferation is associated with bacterial vaginosis.

Answer 459

lactic acid-producing lactobacilli

Answer 460

True ## Footnote A pH below 4.5 is considered acidic enough.

Answer 461

It contributes to the proliferation of certain organisms ## Footnote Specifically, it can lead to bacterial vaginosis.

Answer 462

No treatment is required and reassurance should be provided.

Answer 463

Atrial premature beats

Answer 464

Chronic lead poisoning ## Footnote It is commonly seen in patients exposed to lead, especially in occupational settings.

Answer 465

Battery factory workers ## Footnote They are frequently exposed to lead in their work environment.

Answer 466

* Peripheral neuropathy * Abdominal colic * Anemia ## Footnote These symptoms can vary in severity among individuals.

Answer 467

Chronic lead poisoning ## Footnote The Burton line is a blue line on the gums indicative of lead exposure.

Answer 468

Chelation therapy ## Footnote Chelation therapy helps remove lead from the body.

Answer 469

A congenital anomaly of laryngeal cartilage that causes the collapse of supraglottic structures during inspiration.

Answer 470

Inspiratory stridor that improves in the prone position and worsens in the supine position and during feeding and crying.

Answer 471

Frequent regurgitation.

Answer 472

6–8 months of age.

Answer 473

Flexible laryngoscopy.

Answer 474

Reassurance and close follow-up.

Answer 475

supraglottic.

Answer 476

They strengthen.

Answer 477

A vascular ring is a congenital anomaly that encircles the trachea and esophagus.

Answer 478

Inspiratory stridor and regurgitation of food ## Footnote These symptoms usually manifest within the first weeks of life.

Answer 479

Within the first weeks of life.

Answer 480

Dyspnea, dysphagia, and choking.

Answer 481

It classically improves.

Answer 482

Tracheal compression is often associated with vascular rings, contributing to symptoms.

Answer 483

A single dose of high-dose intravenous immunoglobulin (IVIG) ## Footnote IVIG is most effective within the first 10 days of disease onset.

Answer 484

Within the first 10 days of disease onset

Answer 485

High-dose oral aspirin ## Footnote Aspirin is used to treat other inflammatory symptoms such as arthritis until the fever subsides.

Answer 486

Other inflammatory symptoms, e.g., arthritis

Answer 487

At diagnosis, at 2 weeks, and 6–8 weeks after onset ## Footnote Echocardiography is used to evaluate for coronary artery aneurysms.

Answer 488

To evaluate for coronary artery aneurysms

Answer 489

Prophylaxis of neonatal GBS infection ## Footnote GBS stands for Group B Streptococcus.

Answer 490

Maternal GBS colonization

Answer 491

Between 36 0/7–37 6/7 weeks' gestation

Answer 492

Culture of vaginal and rectal swabs

Answer 493

Routine prophylactic antibiotics

Answer 494

Productive cough, hemoptysis ## Footnote Hemoptysis refers to coughing up blood.

Answer 495

History of tuberculosis ## Footnote Tuberculosis can cause lung damage that predisposes to aspergillosis.

Answer 496

Intracavitary mass on chest x-ray ## Footnote An intracavitary mass may indicate fungal colonization in a pre-existing lung cavity.

Answer 497

True ## Footnote A productive cough indicates that mucus or phlegm is being expelled.

Answer 498

intracavitary mass

Answer 499

A severe infection that manifests with pneumonia, septicemia, and extrapulmonary involvement.

Answer 500

Immunocompromised patients.

Answer 501

* Severe pneumonia * Septicemia * Extrapulmonary involvement

Answer 502

Opportunistic colonization of a heavily scarred lung cavity by Aspergillus species ## Footnote Typically occurs after a bout of pulmonary tuberculosis.

Answer 503

To decrease the size of the leiomyomatous uterus and to correct anemia by decreasing blood loss ## Footnote Preoperative therapy aims to improve surgical outcomes and manage symptoms.

Answer 504

A GnRH agonist is a medication that stimulates the release of gonadotropins from the pituitary gland.

Answer 505

Leuprolide.

Answer 506

2–3 months prior to surgery.

Answer 507

They reduce the size by inducing hypoestrogenism and hypoprogesteronism.

Answer 508

Decreases surgical time, speeds up postoperative recovery, and may enable a vaginal hysterectomy.

Answer 509

hypoestrogenism, hypoprogesteronism.

Answer 510

Within 6 hours

Answer 511

To restore blood flow and increase the probability of limb salvage

Answer 512

* Balloon thrombectomy * Bypass surgery

Answer 513

[Revascularization]

Answer 514

Angioplasty may be used for the treatment of underlying atherosclerotic lesions.

Answer 515

After the occluding thrombus has been lysed or removed.

Answer 516

Not high enough to prevent complications in infants.

Answer 517

Vitamin D supplementation is recommended.

Answer 518

Until the recommended daily vitamin D intake through diet is met.

Answer 519

Infant formula, solid foods, vitamin D-fortified whole milk after 12 months ## Footnote Infants should consume ≥ 34 oz/day of infant formula to meet vitamin D needs.

Answer 520

12 months old ## Footnote This is a key transition point for dietary sources of vitamin D.

Answer 521

vitamin D-fortified whole milk

Answer 522

False ## Footnote Solid foods are a source, but additional sources like infant formula are necessary.

Answer 523

≥ 34 oz/day

Answer 524

All bite wounds should be kept clean with a sterile dressing and allowed to heal without suturing.

Answer 525

Broad-spectrum antibiotics (e.g., amoxicillin-clavulanate, 2nd or 3rd generation cephalosporin).

Answer 526

Tetanus prophylaxis should be given to patients who are not up-to-date on their vaccinations.

Answer 527

amoxicillin-clavulanate

Answer 528

Aseptic meningitis ## Footnote Aseptic meningitis is characterized by inflammation of the meninges without bacterial infection.

Answer 529

It is indicative of an inflammatory process ## Footnote Elevated protein levels can suggest various conditions including infections and inflammatory diseases.

Answer 530

It suggests that the meningitis is likely not caused by bacteria ## Footnote In bacterial meningitis, glucose levels are typically low.

Answer 531

aseptic meningitis

Answer 532

False ## Footnote Aseptic meningitis typically shows normal glucose levels unlike bacterial meningitis.

Answer 533

Viral meningitis ## Footnote Enteroviruses, including coxsackieviruses, are the most common cause of viral meningitis.

Answer 534

Late summer and early fall ## Footnote This timing is crucial for understanding outbreaks and public health responses.

Answer 535

Nonenveloped picornavirus ## Footnote Coxsackievirus belongs to the family of picornaviruses.

Answer 536

* Carditis * Herpangina * Hand, foot, and mouth disease ## Footnote These conditions highlight the diverse clinical manifestations of coxsackievirus infections.

Answer 537

IV clindamycin and oral primaquine ## Footnote PCP stands for Pneumocystis pneumonia, a common opportunistic infection in immunocompromised patients.

Answer 538

Trimethoprim/sulfamethoxazole ## Footnote This medication is typically the standard treatment for PCP but is contraindicated in patients with sulfa allergies.

Answer 539

Viral infections ## Footnote Examples include Coxsackie B virus infection, parvovirus B19 infection, HHV-6 infection.

Answer 540

Coxsackie B virus ## Footnote It is specifically noted as the leading cause of viral myocarditis in this demographic.

Answer 541

Individuals traveling to endemic areas ## Footnote Endemic areas include tropical Africa and parts of Central and South America.

Answer 542

To protect individuals from yellow fever infection ## Footnote Yellow fever is a viral disease transmitted by mosquitoes.

Answer 543

endemic areas

Answer 544

False ## Footnote It is also recommended for parts of Central and South America.

Answer 545

* Tropical Africa * Parts of Central and South America

Answer 546

Decreased end-diastolic volume ## Footnote This is a measure of the volume of blood in the ventricles at the end of diastole.

Answer 547

Causes the leaflets to prolapse sooner ## Footnote Preload is the initial stretching of the cardiac muscle fibers prior to contraction.

Answer 548

Results in an earlier onset and increased intensity of auscultatory findings ## Footnote Auscultatory findings refer to sounds heard during auscultation of the heart.

Answer 549

Preload ## Footnote Preload is critical for determining the force of heart contractions.

Answer 550

False ## Footnote Decreased EDV can exacerbate the symptoms of mitral valve prolapse.

Answer 551

Symptoms onset occurs closer to S1 ## Footnote S1 is the first heart sound, marking the beginning of systole.

Answer 552

Ataxia telangiectasia ## Footnote Ataxia telangiectasia is a rare genetic disorder that affects the nervous system and immune system.

Answer 553

IgG and IgA deficiency ## Footnote These deficiencies can lead to increased susceptibility to infections.

Answer 554

alpha-fetoprotein (AFP) ## Footnote Elevated AFP is a notable biomarker in certain conditions.

Answer 555

False ## Footnote Ataxia telangiectasia is a genetic disorder affecting the nervous and immune systems.

Answer 556

Cerebellar ataxia, recurrent sinopulmonary infections, IgG and IgA deficiency, elevated AFP ## Footnote These features highlight the neurological and immunological aspects of the disorder.

Answer 557

Dilation of the pulmonary arteries proximal to the embolus and collapse of the distal vasculature.

Answer 558

The appearance of a sharp cut-off.

Answer 559

About 2% of patients.

Answer 560

Low sensitivity but high specificity.

Answer 561

A radiologic finding characterized by a prominent central pulmonary artery.

Answer 562

Etiologies include: * Pulmonary hypertension * Distention due to a massive pulmonary embolism

Answer 563

A radiographic finding caused by pulmonary infarction.

Answer 564

A shallow wedge-shaped opacity in the periphery of the lung, with its base against the pleural surface.

Answer 565

t(9:22) translocation ## Footnote This translocation is also known as the Philadelphia chromosome.

Answer 566

BCR-ABL fusion gene ## Footnote This gene is crucial for the pathology of CML.

Answer 567

An overactive tyrosine kinase enzyme ## Footnote This enzyme is responsible for the excessive proliferation of myeloid progenitor cells.

Answer 568

Excessive proliferation of myeloid progenitor cells ## Footnote This leads to the characteristic features of CML.

Answer 569

Targeted tyrosine kinase inhibitors, such as imatinib ## Footnote Imatinib specifically targets the BCR-ABL fusion protein.

Answer 570

Complete fractures through the physis

Answer 571

During growth spurts in puberty

Answer 572

Physeal widening

Answer 573

Falls on the outstretched hand

Answer 574

Complete fractures

Answer 575

Dorsal and radial displacement

Answer 576

Greenstick fractures are the result of an axial force that causes bending of the distal radius or ulna.

Answer 577

An X-ray typically shows some angulation and disruption of the cortex and periosteum on the side of tension (convex side).

Answer 578

The periosteum and cortex are intact on the side of compression.

Answer 579

The side of tension (convex side) shows disruption.

Answer 580

A Smith fracture is a complete fracture that commonly occurs after a fall on the outstretched hand.

Answer 581

A Smith fracture typically occurs after a fall on the outstretched hand.

Answer 582

A Smith fracture typically manifests with volar and radial displacement of the distal fragment.

Answer 583

Forced flexion results in the characteristic displacement of the distal fragment.

Answer 584

An abdominal contrast-enhanced CT scan ## Footnote CP refers to chronic pancreatitis.

Answer 585

Conjunctival injection and watery discharge ## Footnote Patients generally do not experience significant itching or eyelid edema.

Answer 586

Watery discharge

Answer 587

Redness of the conjunctiva due to inflammation or irritation

Answer 588

Any adult who did not receive the vaccine and is at high risk for HepA infection or severe disease

Answer 589

Killed vaccine

Answer 590

Immunosuppressive therapy (e.g., rituximab and high-dose prednisone) ## Footnote This therapy aims to reduce inflammation and prevent organ damage.

Answer 591

* Renal failure requiring hemodialysis * Intestinal ischemia * CNS involvement * Respiratory failure ## Footnote These features indicate a more severe condition that requires immediate attention.

Answer 592

Plasmapheresis in addition to immunosuppression ## Footnote This combination is crucial for managing severe symptoms.

Answer 593

Erythromycin

Answer 594

Oral doxycycline

Answer 595

For a similar duration of time as erythromycin

Answer 596

A condition that can occur within 6 months after transplantation.

Answer 597

Symptoms may include: * Vomiting * Jaundice * Rising bilirubin * Pain in the graft region

Answer 598

vomiting, jaundice, rising bilirubin, and pain in the graft region.

Answer 599

To rule out possible vascular complications, biliary complications, and liver infection ## Footnote Vascular complications include portal vein thrombosis and bleeding; biliary complications include leak and stricture; liver infection may involve perihepatic abscess.

Answer 600

* Portal vein thrombosis * Bleeding

Answer 601

* Leak * Stricture

Answer 602

Perihepatic abscess

Answer 603

Common variable immunodeficiency (CVID) ## Footnote CVID is a disorder characterized by low levels of immunoglobulins and an increased susceptibility to infections.

Answer 604

Common Variable Immunodeficiency ## Footnote CVID is a primary immunodeficiency disorder characterized by low levels of immunoglobulins.

Answer 605

Increased risk of developing autoimmune disorders ## Footnote Autoimmune disorders linked with CVID include immune thrombocytopenia, rheumatoid arthritis, autoimmune hemolytic anemia, autoimmune thyroiditis, and vitiligo.

Answer 606

* Immune thrombocytopenia * Rheumatoid arthritis * Autoimmune hemolytic anemia * Autoimmune thyroiditis * Vitiligo ## Footnote These disorders result from immune system dysregulation.

Answer 607

False ## Footnote Patients with CVID are at increased risk of developing lymphoma.

Answer 608

Immune system ## Footnote This dysregulation contributes to the increased risk of autoimmune disorders.

Answer 609

[lymphoma] ## Footnote Lymphoma is a type of cancer that affects lymphatic tissue.

Answer 610

An empty sella turcica ## Footnote Sheehan syndrome is a condition that affects women who experience severe blood loss during or after childbirth, leading to pituitary gland damage.

Answer 611

Relatively low-pressure arterial system ## Footnote This low-pressure system makes the anterior pituitary gland more susceptible to ischemia and infarction.

Answer 612

False ## Footnote The anterior pituitary gland is vulnerable to ischemia and infarction due to its low-pressure blood supply.

Answer 613

ischemia ## Footnote Ischemia refers to the insufficient blood flow to an organ, leading to tissue damage.

Answer 614

Antibiotic prophylaxis with ampicillin and azithromycin ## Footnote This is to decrease the risk of bacterial infections in both the mother and newborn.

Answer 615

To induce fetal lung maturation ## Footnote Examples include betamethasone and dexamethasone.

Answer 616

False ## Footnote Antibiotic prophylaxis is recommended to reduce infection risk.

Answer 617

betamethasone, dexamethasone ## Footnote These medications help in preparing the fetus for breathing after birth.

Answer 618

Patients with PPROM at ≥ 34 weeks' gestation ## Footnote PPROM stands for Preterm Premature Rupture of Membranes.

Answer 619

Lymphadenopathy with cells that are positive for CD15 and CD30 (Reed-Sternberg cells) ## Footnote Reed-Sternberg cells are a hallmark of Hodgkin lymphoma and are used for diagnosis.

Answer 620

Radiotherapy and alkylating chemotherapeutic agents ## Footnote Examples of alkylating agents include procarbazine and ifosfamide.

Answer 621

Radiotherapy and alkylating chemotherapeutic agents ## Footnote These treatments are important risk factors for developing MDS and AML.

Answer 622

Up to 30% ## Footnote This highlights the potential progression from MDS to AML.

Answer 623

True ## Footnote Many patients with MDS may not exhibit symptoms.

Answer 624

A history of intermittent dribbling of urine not associated with increased intraabdominal pressure or an urge to urinate.

Answer 625

Stress incontinence ## Footnote Stress incontinence is the involuntary leakage of urine during activities that increase abdominal pressure, such as coughing or exercise.

Answer 626

Patients with pelvic fractures and/or following pelvic surgery ## Footnote Pelvic fractures can compromise the anatomical integrity of the pelvic floor, while pelvic surgery may affect the surrounding structures.

Answer 627

Underactivity of the detrusor muscle ## Footnote Overflow incontinence occurs when the bladder is overfilled and unable to empty properly due to muscle dysfunction.

Answer 628

HIT typically occurs 5–14 days after initiation of heparin

Answer 629

Thrombotic events (e.g., arterial occlusion)

Answer 630

Thrombocytopenia

Answer 631

No, bleeding manifestations are rare

Answer 632

The platelet count rarely decreases below 20,000 platelets/mm3

Answer 633

By serum immunoassays to detect anti-heparin/platelet factor 4 antibodies

Answer 634

Heparin should be immediately stopped

Answer 635

Nonheparin anticoagulation

Answer 636

Acute-onset respiratory symptoms such as hypoxemia, dyspnea, and tachypnea ## Footnote These symptoms occur due to obstruction of the pulmonary circulation.

Answer 637

* Confusion * Lethargy * Seizures ## Footnote These symptoms indicate neurological involvement in fat embolism cases.

Answer 638

Petechial rash on the axilla and chest wall ## Footnote This rash results from capillary occlusion.

Answer 639

True ## Footnote Fat embolism leads to respiratory symptoms and neurological involvement.

Answer 640

acute-onset respiratory symptoms ## Footnote Symptoms include hypoxemia, dyspnea, and tachypnea.

Answer 641

Macrolides such as clarithromycin are the antibiotics of choice for ARF in patients with hypersensitivity to beta-lactam antibiotics ## Footnote ARF refers to acute rheumatic fever.

Answer 642

Clarithromycin ## Footnote Macrolides are a class of antibiotics that include clarithromycin.

Answer 643

False ## Footnote Macrolides are specifically recommended in these cases.

Answer 644

Chronic mesenteric ischemia ## Footnote Chronic mesenteric ischemia is characterized by pain that occurs after eating due to insufficient blood flow to the intestines.

Answer 645

Acute mesenteric ischemia (AMI) ## Footnote AMI is a critical condition requiring immediate medical attention, as it involves sudden loss of blood flow to the intestines.

Answer 646

Pain is out of proportion to examination findings ## Footnote This means that the intensity of pain experienced by the patient may not correlate with physical examination results.

Answer 647

High-resolution CT angiography (CTA) of the abdomen and pelvis ## Footnote AMI refers to acute mesenteric ischemia.

Answer 648

Hemodynamically stable patients without signs of peritonitis ## Footnote Hemodynamically stable indicates that the patient’s blood circulation is stable.

Answer 649

Open mesenteric bypass surgery to restore arterial perfusion ## Footnote This is indicated when there are signs of bowel perforation, advanced bowel ischemia, or hemodynamic instability.

Answer 650

Signs include: * Peritonitis * Bowel perforation (e.g., pneumoperitoneum on CTA) * Advanced bowel ischemia (e.g., thickening of the bowel wall segment on CTA) * Hemodynamic instability (e.g., tachycardia or hypotension) ## Footnote CTA refers to Computed Tomography Angiography.

Answer 651

False ## Footnote Surgery is indicated even in patients with hemodynamic instability.

Answer 652

peritonitis

Answer 653

Computed Tomography Angiography ## Footnote CTA is used to visualize blood vessels and assess conditions like bowel perforation.

Answer 654

Parathyroid gland adenomas ## Footnote Parathyroid gland adenomas are benign tumors of the parathyroid glands that lead to excessive production of parathyroid hormone (PTH), resulting in hypercalcemia.

Answer 655

Surgical resection ## Footnote Surgical resection is necessary to remove the adenoma and correct the hyperparathyroidism.

Answer 656

Age < 50 years ## Footnote Younger patients may have a more aggressive disease course and benefit from surgical intervention.

Answer 657

DEXA T-score < -2.5 or vertebral fracture on radiograph ## Footnote A low DEXA T-score indicates osteoporosis, while vertebral fractures suggest significant skeletal compromise.

Answer 658

Estimated GFR < 60 mL/min, > 400 mg/day 24-hour urine calcium excretion, or presence of nephrolithiasis ## Footnote These indicators reflect impaired kidney function or high calcium levels that can lead to kidney stones.

Answer 659

Serum calcium level > 1 mg/dL than the upper limit of normal ## Footnote Elevated serum calcium levels are symptomatic of hyperparathyroidism and warrant surgical intervention.

Answer 660

Symptoms of hypercalcemia ## Footnote Symptoms can include fatigue, nausea, vomiting, constipation, and confusion, reflecting the effects of high calcium levels.

Answer 661

Elevated serum calcium level confirmed by repeat measurement, low phosphorus, elevated serum parathyroid hormone (PTH) level, and elevated 24-hour urine calcium excretion ## Footnote The combination of these laboratory findings indicates primary hyperparathyroidism.

Answer 662

Serum parathyroid hormone (PTH) level ## Footnote Elevated PTH is a key indicator in diagnosing primary hyperparathyroidism.

Answer 663

Elevated serum calcium level ## Footnote A single measurement of serum calcium is not sufficient; it must be confirmed by a repeat measurement.

Answer 664

Low phosphorus level ## Footnote Low serum phosphorus is often seen in conjunction with elevated calcium and PTH levels in primary hyperparathyroidism.

Answer 665

It confirms increased calcium excretion due to elevated PTH activity ## Footnote High urine calcium excretion indicates that the kidneys are excreting more calcium, consistent with hyperparathyroidism.

Answer 666

Infection with Cryptococcus neoformans ## Footnote Cryptococcus neoformans is a fungal pathogen commonly associated with meningitis, particularly in immunocompromised individuals.

Answer 667

The combination of intravenous amphotericin B and oral flucytosine for at least 2 weeks ## Footnote This combination is used to effectively treat cryptococcal meningitis.

Answer 668

Low molecular weight heparin such as enoxaparin ## Footnote APS stands for Antiphospholipid Syndrome.

Answer 669

Low-dose aspirin ## Footnote Preeclampsia is a pregnancy complication characterized by high blood pressure and signs of damage to another organ system.

Answer 670

MRI. Previously, hormone testing such as high-dose dexamethasone suppression test or CRH stimulation test ## Footnote Current guidelines recommend a pituitary MRI as the most appropriate next step.

Answer 671

Diagnosis of Cushing disease ## Footnote This is a key criterion in evaluating patients for Cushing disease.

Answer 672

Inferior petrosal sinus sampling or hormone testing ## Footnote This is necessary to measure ACTH levels for further evaluation.

Answer 673

False ## Footnote Current guidelines prioritize a pituitary MRI over hormone testing.

Answer 674

Supportive therapy alone is required for HBV infection ## Footnote This is due to the high spontaneous recovery rate associated with HBV infections.

Answer 675

A negative HBsAg and a positive IgM anti-HBc antibody ## Footnote These test results are indicative of the resolution of the infection.

Answer 676

Mammography and axillary lymph node biopsy ## Footnote This is essential even without a palpable breast mass.

Answer 677

False ## Footnote Mammography should still be performed.

Answer 678

axillary lymph node biopsy

Answer 679

Breast malignancy

Answer 680

Serologic assays for IgG and IgM to determine infection status and risk of fetal complications ## Footnote This testing helps assess potential risks to the fetus from parvovirus B19 infection.

Answer 681

Upper endoscopy ## Footnote To screen for esophageal varices, which are a risk factor for life-threatening bleeding.

Answer 682

To screen for esophageal varices ## Footnote Esophageal varices are a risk factor for life-threatening bleeding.

Answer 683

False ## Footnote It should be performed in all patients.

Answer 684

Bilateral, nonbloody nipple discharge in a nonpregnant, nonbreastfeeding patient with normal serum prolactin levels and a normal physical examination. ## Footnote This condition is characterized by nipple discharge despite normal prolactin levels.

Answer 685

A type of nonpathological nipple discharge

Answer 686

Chronic nipple stimulation ## Footnote Examples include piercing or ill-fitting clothing

Answer 687

A systolic murmur heard best at the cardiac apex ## Footnote This murmur often radiates to the axilla.

Answer 688

Pulmonary edema due to acute mitral regurgitation ## Footnote This combination of symptoms suggests fluid overload in the lungs.

Answer 689

Tear production

Answer 690

Sicca syndrome

Answer 691

Sjogren syndrome (SS)

Answer 692

Dryness of the mouth

Answer 693

Dyspareunia

Answer 694

dyspareunia

Answer 695

Xerophthalmia and xerostomia

Answer 696

Paravertebrally, to the buttocks, and the thigh ## Footnote Pain is due to root compression rather than over the spinous processes.

Answer 697

Root compression ## Footnote This results in pain localized to specific areas rather than over the spinous processes.

Answer 698

Progressively worsening back pain that is worse at night and exacerbated by movement.

Answer 699

Hematogenous seeding of a distant infectious focus.

Answer 700

Neuroimaging. such as mri

Answer 701

* Seizures * Focal neurological deficits

Answer 702

Brain abscess.

Answer 703

A type of pelvic organ prolapse characterized by protrusion of the bladder behind the anterior vaginal wall and into the vaginal introitus. ## Footnote Cystocele is a condition where the bladder bulges into the vagina.

Answer 704

Urinary hesitancy and a sensation of pelvic fullness. ## Footnote These symptoms may vary in severity depending on the degree of the prolapse.

Answer 705

A descent of the uterus into the vagina and, in severe cases, through the vaginal introitus.

Answer 706

Atlantoaxial subluxation ## Footnote Atlantoaxial subluxation is a condition where the first cervical vertebra (atlas) becomes misaligned with the second cervical vertebra (axis), which can occur in patients with rheumatoid arthritis (RA).

Answer 707

Extension and flexion x-ray of the cervical spine

Answer 708

Anticentromere antibodies ## Footnote CREST syndrome is a limited form of systemic sclerosis (scleroderma) characterized by Calcinosis, Raynaud's phenomenon, Esophageal dysmotility, Sclerodactyly, and Telangiectasia.

Answer 709

CREST syndrome ## Footnote CREST syndrome is a subset of systemic sclerosis characterized by Calcinosis, Raynaud's phenomenon, Esophageal dysmotility, Sclerodactyly, and Telangiectasia.

Answer 710

CREST syndrome ## Footnote Limited cutaneous systemic sclerosis is one of the two main types of systemic sclerosis, the other being diffuse cutaneous systemic sclerosis.

Answer 711

CREST syndrome

Answer 712

False ## Footnote Raynaud disease is one of the key symptoms associated with CREST syndrome.

Answer 713

Fever for ≥ 5 days ## Footnote Kawasaki disease can be confirmed by fever lasting five days or more.

Answer 714

≥ 4 additional symptoms ## Footnote Along with fever, at least four other symptoms are needed for confirmation.

Answer 715

* Erythema, edema, or desquamation of hands and feet * Polymorphous rash * Painless bilateral injected conjunctivitis * Oropharyngeal mucositis * Cervical lymphadenopathy ## Footnote Symptoms must include at least four from these options.

Answer 716

Polymorphous rash originating on the trunk ## Footnote The rash typically starts on the trunk.

Answer 717

Painless bilateral injected conjunctivitis without exudate ## Footnote This conjunctivitis does not produce discharge.

Answer 718

Strawberry tongue and cracked, red lips ## Footnote These features are indicative of oropharyngeal mucositis.

Answer 719

Mostly unilateral ## Footnote Lymphadenopathy is often found on one side of the neck.

Answer 720

A type of stress ulcer that occurs in patients with brain injuries ## Footnote Named after Harvey Cushing, who first described the relationship between brain injury and gastric ulcers.

Answer 721

Increased ICP (intracranial pressure) ## Footnote ICP can rise due to various factors, including trauma, tumors, or hemorrhage.

Answer 722

Acetylcholine (ACh) ## Footnote ACh plays a key role in stimulating various physiological responses, including gastric acid secretion.

Answer 723

Muscarinic-3 receptors ## Footnote These receptors are involved in the regulation of gastric acid secretion.

Answer 724

Production of excess gastric acid ## Footnote This excess acid can lead to ulceration of the gastric mucosa.

Answer 725

ICP (intracranial pressure) ## Footnote Increased ICP has significant physiological effects, including on the gastrointestinal system.

Answer 726

True ## Footnote Excess gastric acid production is a key factor in the development of Cushing ulcers.

Answer 727

Radiographic evidence of colonic dilation (transverse colon > 6 cm in diameter) ## Footnote This measurement is critical for diagnosing toxic megacolon.

Answer 728

Multiple air-fluid levels and loss of colonic haustration ## Footnote These findings further indicate colonic dilation and paralytic ileus.

Answer 729

It confirms the diagnosis of toxic megacolon ## Footnote This measurement is a key indicator in radiographic assessment.

Answer 730

True ## Footnote Loss of haustration indicates a more severe condition.

Answer 731

air-fluid ## Footnote Air-fluid levels are relevant in the radiographic evaluation.

Answer 732

Factor V Leiden

Answer 733

Activated protein C from inhibiting the coagulation cascade

Answer 734

A procoagulant state leading to thrombophilia

Answer 735

thrombophilia

Answer 736

Excessive suspicion and pervasive distrust of others ## Footnote Psychotic symptoms are absent.

Answer 737

Sodium oxybate

Answer 738

Hydrochlorothiazide treats nephrogenic DI by paradoxically reducing the volume of urine produced.

Answer 739

A low-salt and low-protein diet.

Answer 740

A noncontrast CT scan (NCCT) of the abdomen and pelvis

Answer 741

Sudden flank pain that radiates to the groin, hematuria, and costovertebral angle tenderness ## Footnote Nephrolithiasis refers to the condition of having kidney stones.

Answer 742

Erythromycin. Alternatively, oral doxycycline can be administered ## Footnote Bacillary angiomatosis is a bacterial infection often associated with immunocompromised individuals, particularly those with HIV/AIDS.

Answer 743

Hypertension, facial plethora, truncal obesity, thin bruised skin, osteoporosis ## Footnote Osteoporosis is indicated by decreased bone density and pathological vertebral fracture.

Answer 744

hypertension

Answer 745

* Hypertension * Facial plethora * Truncal obesity

Answer 746

Osteoporosis

Answer 747

It is a sign of hypokalemia ## Footnote Hypokalemia is a condition characterized by low potassium levels in the blood.

Answer 748

Cushing syndrome ## Footnote Cushing syndrome is caused by prolonged exposure to high levels of cortisol.

Answer 749

Elevated cholestatic parameters and a dilated common bile duct (> 10 mm) ## Footnote This syndrome occurs after the surgical removal of the gallbladder.

Answer 750

Residual gallstones within the biliary tree or sphincter of Oddi dysfunction (SOD) ## Footnote Both conditions can lead to biliary obstruction.

Answer 751

ERCP with sphincterotomy ## Footnote ERCP is highly sensitive for most causes of biliary dysfunction.

Answer 752

It is highly sensitive for most causes of biliary dysfunction ## Footnote This includes identifying residual gallstones or other abnormalities.

Answer 753

Biliary-type pain, abnormal liver function tests, and a dilated common bile duct ## Footnote These symptoms suggest a need for intervention to relieve obstruction.

Answer 754

The surgical destruction of the uterine lining

Answer 755

Patients with ovulatory HMB and no desire for future pregnancies

Answer 756

When medical therapy is unsuccessful or contraindicated

Answer 757

Ovulatory HMB (heavy menstrual bleeding)

Answer 758

Intravenous benzodiazepines such as lorazepam ## Footnote Benzodiazepines are effective for both retarded and excited forms of nonmalignant catatonia.

Answer 759

If nonmalignant catatonia fails to respond to benzodiazepine therapy within a week ## Footnote ECT is considered when benzodiazepines are ineffective.

Answer 760

Intravenous benzodiazepines such as lorazepam

Answer 761

False ## Footnote ECT is indicated only if benzodiazepine therapy fails.

Answer 762

Retentive encopresis

Answer 763

Fecal disimpaction with enemas or oral agents (polyethylene glycol), followed by maintenance laxative therapy for 6–24 months

Answer 764

Enemas or oral agents (polyethylene glycol)

Answer 765

6–24 months

Answer 766

Observation ## Footnote This approach is typically recommended when the cyst does not present symptoms.

Answer 767

Diarrhea, diaphoresis, bradycardia, bronchospasm, salivation, lacrimation, miosis ## Footnote These symptoms are indicative of overstimulation of muscarinic receptors.

Answer 768

Muscle weakness ## Footnote This symptom is related to the overstimulation of nicotinic receptors.

Answer 769

Atropine ## Footnote Atropine is an anticholinergic agent that counters muscarinic receptor stimulation.

Answer 770

False ## Footnote Atropine specifically reverses muscarinic effects only.

Answer 771

An oxime (e.g., pralidoxime) ## Footnote Oximes restore acetylcholinesterase activity.

Answer 772

Catalyzes the breakdown of excessive acetylcholine ## Footnote This helps reverse symptoms.

Answer 773

False ## Footnote An oxime is also required.

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