Incorrects 2 Flashcards
(208 cards)
1
Q
Rx for candida vaginitis?
A
Fluconazole
2
Q
Rx for trichomoniasis?
A
Metronidazole; Rx sexual partner
3
Q
Rx for BV?
A
Metronidazole or clindamycin
4
Q
Pt presenting with thyrotoxicosis and low radioactive iodine uptake may have what conditions?
A
Thyroiditis (painless, subacute, or amiodarone induced)
Exogenous thyroid
Iodide exposure
Struma ovarii
5
Q
Thyrotoxicosis with normal or elevated radioactive iodine uptake may have what conditions?
A
Graves
Toxic multinodular goiter
Toxic nodule
6
Q
How does subacute (de Quervains) thyroiditis present vs painless (silent) thyroiditis on PE?
A
Subacute presents with tenderness to palpation, painless does not, though both may have goiter and low RAIU on thyroid scan.
7
Q
BPPV Sx?
A
Nystagmus, nausea without significant ear pain, tinnitus, or hearing loss.
8
Q
Meniere disease Sx?
A
Triad: Episodic dizziness Low-frequency hearing loss Tinnitus ***Vertigo lasts for days with NV and horizontal-torsional nystagmus during episodes.
9
Q
Vertebrobasilar insufficiency Sx?
A
Vertigo with neurological Sx like dysarthria, diplopia, numbness.
10
Q
What antibiotcs can lead to ototoxicity causing vertigo?
A
Aminoglycosides (eg gentamicin)
11
Q
What criterion are met to indicate the need for excision of cervical neoplasia?
A
Must be >25yo with CIN3 or more. Clear margins and no evidence of invasion means Pap testing is required with HPV co-testing q 1-2 yrs afterwards.
12
Q
13/40
A
4516
13
Q
Antibody assoc. with celiac’s disease?
A
IgA anti-tissue transglutaminse (TTG) antibody. IgA endomysial antibody and IgA/IgG against gliadin peptide.
14
Q
Next step after positive serology for anti transglutaminase antibody?
A
Upper endoscopy and small bowel biopsy regardless of positive serology to confirm Celiac’s Dx.
15
Q
Pneumococcal vax recommended for who?
A
> 65 year olds and anyone 19-64 within a nursing home, with immunocompromise, or cochlear implants.
16
Q
Antibody associated with Wegener’s granulomatosis (granulomatosis with polyangiitis)?
A
c-ANCA (cytoplasmic antineutrophilic cytoplasmic antibodies). p-ANCA negative.
17
Q
What part of the penis is responsible for erection?
A
Corpus cavernosum is filled with vascular epithelial cells. Sildenafil inhibits PDE5 resulting in cGMP elevation and vasodilation. Corpus spongiosum forms the glans and surrounds the urethra distally.
18
Q
What diuretic will enhance the prevalence of gout?
A
HCTZ. It causes uric acid resorption.
19
Q
What is guarda resp altor?
A
A judicially appointed guardian.
20
Q
What is the primary difference between a DNR and a living will?
A
DNR: medical document outlining wishes during the current stay in the hospital
Living will: legal document outlining wishes if the patient were to get sick/incapacitated
21
Q
What is bronchiolitis?
A
Inflammatory illness of small airways affecting children <2. Low fever, rhinorrhea, cough, and periods of apnea may occur. MCC is RSV. Xray may be negative or show interstitial infiltrates/atelectasis.
22
Q
Most sensitive testing modality for H. Pylori?
A
Serology. 90-99% sensitive. Biopsy is only done if there are signs of danger (bleeding, anemia, early satiety, etc.). Conversion of positive serology to negative after Rx suggests bacterial cure, but this may take months/years after eradication.
23
Q
Can H. Pylori be cultured?
A
No. Never culture it. It is fastidious.
24
Q
Most specific testing for H. pylori?
A
Biopsy with urease testing is highest (95-100%).
25
What is the best Dx test for H. pylori and the best test after Rx for eradication?
Serology and urea breath test respectively.
26
What is triple therapy for H. Pylori?
Amoxicillin
Clarithromycin
PPI
27
Drugs for Parkinson's Rx?
Bromocriptine (dopaminergic)
Amantadine (antiviral/dopaminergic)
Levodopa/carbidopa
Selegiline (MAOI)
28
Drugs for Alzheimer's Rx?
Donepezil (AChase Inhibitor)
| Tacrine, rivastaigmine, galantamine are also AChAse Inhibitors.
29
Memantine use?
Dementia.
30
Memantine MOA?
NMDA receptor antagonist can be neuroprotective in dementia. Often combined with galantamine.
31
Management of croup?
Humidified O2 in mild disease. Steroids and racemic epi in severe.
32
What is the confirmatory test in a patient with a positive PPD?
QuantiFERON-TB Gold test.
33
Immigrants, prisoners, and IV drug users with a PPD test must have how much induration for a positive test?
≥10mm
34
What is a positive PPD in ALL persons?
≥15mm
35
HIV+ or immunosuppressed or those who came into contact with a TB+ person require how much induration for positive PPD test?
≥5mm
36
At what ages do immediate family have to have MI Hx to increase the chance of MI in the patient?
Father or brother w/ MI BEFORE 55 or mother or sister with MI BEFORE 65 would increase the chance of MI in a patient.
37
Expected joint changes in psoriatic arthritis?
Spine and DIPs.
38
Expected joint changes in RA?
MCP, PIP, ankles, knees, hips, spine.
39
Required creatinine for IV contrast administration?
1.5 or less.
40
Medication that must be DCed before contrast administration?
Metformin. IV contrast can cause decreased metabolism and accumulation leading to lactic acidosis.
41
HbA1c levels for normal, pre, and postDM?
6, 6-6.4, and ≥6.5% respectively.
42
Fasting plasma glucose for normal, pre, and postDM?
<100
100-125
≥126 respectively.
43
2 Hour postprandial blood sugar in normal, pre, and post DM?
<140
140-199
≥200
44
Random blood sugar that confirms Dx of DMII?
≥200
45
Name the 7 activities of daily living (ADL) in elderly?
```
Bathing
Continence
Toileting Transferring
Grooming
Dressing
Eating
***These ADLs are self-care activities needed for daily living.
```
46
What activities are needed for independent living in the elderly?
Instrumental activities of daily living (IADL)
47
Name the 8 IADL?
```
Transportation
Shopping
Cooking
Housecleaning
Laundry
Using telephone
Managing money
Taking meds
```
48
ABx for mastitis?
Anti-S. Aureus meds: amox/clav, dicloxacillin, cephalexin. Azithro or clindamycin if PCN allergy.
49
Fundoscopic exam in non-proliferative retinopathy in DM2?
Cotton wool spots (nerve fiber layer infarcts)
Intraretinal hemorrhage
Macular edema
50
Fundoscopic exam in proliferative retinopathy in DM2?
Neovascularization of retinal vessels due to VEGF from ischemia. Can lead to hemorrhage and retinal detachment.
51
Define complete abortion
Products of conception have evacuated uterus and cervical os is now closed
52
Define incomplete abortion
Vaginal bleeding and cramping are occurring alongside an open cervical os where products of conception can be seen/palpated within the CERVICAL CANAL (vs inevitable within internal cervical os)
53
Define inevitable abortion
Bleeding/cramping pain accompanied by dilated os and visible/palpable products in the INTERNAL CERVICAL OS (vs incomplete within cervical canal)
54
Define threatened abortion
Vaginal bleeding that occurs within the first 20 weeks of pregnancy
55
What is the biggest RF for future miscarriage?
Previous miscarriage. Maternal age and smoking are also RFs, but not as strong.
56
First-line OUTPATIENT Rx in normally healthy person with typical pneumonia?
Macrolides (azithro or clarithromycin)
OR
Doxycycline
***These cover typicals and atypicals for PNA.
57
First-line OUTPATIENT Rx in Pt with cormorbidities with typical pneumonia?
Flourquinolones (levo or moxifloxacin)
OR
a ß-lactam plus a macrolide
58
Retinal examination revealing irregular, white ovoid lesions on the retina are likely?
Cotton-wool patches. These soft exudates are from infarcted nerve fibers 2nd to chronic HTN. AV nicking often accompanies.
59
What are Drusen spots?
Small yellow, round spots on the retina that may indicate macular degeneration or normal aging.
60
Microaneurysms in the macular area are commonly associated with what Dx?
DM retinopathy.
61
Roth spots are commonly associated with?
Bacterial endocarditis. They appear as hemorrhagic lesions with pale white centers.
62
Aneurysm diameter with increased risk of rupture?
>5.5cm or rapid expansion (>0.5cm) over 6 month period
63
AAA recommended screening?
Men b/t 65-75 yo who have ever smoked
64
Best method to reduce risk of rupture in AAA?
Smoking cessation is biggest. HTN and reduction of lipids doe not play a big role oddly enough, only in CV disease.
65
What is the primary hip extensor?
Glut maximus (L4-S1) mainly, but also hamstring (L4-S2 sciatic)
66
What is the primary hip abductor?
Glut medius (L4-S1)
67
Claudication in a young adult should consider what Dx?
Impingement of the artery. Atherosclerosis in a young adult is unlikely.
68
Initial study in child >2 years with at least one prior UTI?
Voiding cysturethrogram. Detection of vesicoureteral reflux is critical. It is the MC cause of febrile UTIs.
69
Initial study in child <2years (2-24 months) with first febrile UTI?
Renal/bladder US. If abnormalities are found (hydronephrosis), a voiding cysturethrogram is next.
70
What is first-line Rx for onychomycosis?
Oral terbinafine OR oral itraconazole
71
When suspecting primary ovarian failure in a young female with early menopausal signs, what should be measured first?
FSH. Elevation on 2 occasions separated b y amonth is Dx of POF. Elevation of LH may accompany FSH, but is not diagnostic of POF.
72
What is primary ovarian failure?
Women under 40 with signs of menopause (oligo/amenorrhea and hot flashes, irritability, weight gain, dryness/itching/atrophy of vagina).
73
Indwelling catheters that lead to infxn by a gram-negative rod that is motile and has a green appearance on culture and a fruity odor is likely?
Pseudomonas. Often a flouroquinolone is appropriate Rx (Levo or cipro)
74
Dx and Rx in BPPV?
Dx: Dix-Hallpike maneuver (tilt head back and rotate head to side - causes dizziness and nystagmus)
Rx: Epley maneuver (series of maneuvers that reposition otoliths in canals)
75
A female with Rx for bacterial vaginosis goes out with friends and experiences an unusual reaction, GI upset, HA, and flushing. Dx?
Disulfram-like reaction. Metronidazole is a typical Rx for BV and can cause this SE when mixed with alcohol.
76
First line Rx for HTN in African American patients?
HCTZ or another diuretic OR a calcium channel blocker (amlodipine)
77
At 12-16 weeks gestation, what rule out test should be done?
Urine culture for asymptomatic bacteriuria as to prevent pre-term labor risk.
78
Goal INR for A. fib?
INR between 2 and 3 is normal.
79
What differentiates classic from non-classic migraine headaches?
Classic present with an aura, but nonclassic do not, though both share the same symptoms otherwise.
80
FEV1 increase that is considered "reversible"?
12-15%
81
Common HTN meds that can precipitate gout?
Thiazides and loop diuretics. Both enhance urate reuptake by blocking its excretion.
82
Meds used for painful diabetic neuropathy?
Tricyclics (amitriptyline, desipramine)
| Anticonvulsants (gabapentin, pregabalin)
83
List the next of kin in order.
```
Spouse
Adult child
Parent
Next of kin (adult sibling)
Default surrogate (legally appointed)
```
84
If a patient does not improve after empiric Rx for GERD what is the next Dx step?
Upper endoscopy
85
Brown tumors of the bone are associated with what?
Hyperparathyroidism due to osteitis fibrosa cystica. These lesions are cysts filled with blood, fibrous tissue, and osteclasts.
86
First-line agent in human bite?
Amox/clav. Gram stain with aerobic and anaerobic cultures are needed. Copious irrigation, debridement needed.
87
Intermittent asthma FEV1?
>80%
88
Mild persistent asthma FEV1?
>80%
89
Moderate persistent asthma FEV1?
60-80%
90
Severe persistent asthma FEV1?
<60%
91
Asthma daytime frequency by class?
Intermittent: <2x/wk
Mild: >2x/wk (not daily)
Moderate: daily
Severe: many times a day
92
Asthma night time frequency by class?
I: <2x/mo
Mi: 3-4x/mo
Mo:>1x/wk, not nightly
Severe: 7nights a week
93
Escalating management of asthma by class?
I: SABA
Mi: SABA + low dose inhaled glucocorticoid
Mo: SABA + low dose inhaled glucocorticoid + LABA
Severe: SABA + high dose inhaled steroid + LABA
94
First-line Rx in ACUTE gout attack?
Indomethacin (an NSAID). Colchicine largely not used anymore.
95
What cause of ED must be ruled out first?
Meds (~25% of cases are meds)
96
What feature of allergic conjunctivitis differentiates it from other causes?
Pruritis (sometimes a grainy or foreign body sensation). Adenovirus does not have itchiness.
97
Rx for allergic conjunctivitis?
Topical NSAID (Ketorolac) and antihistamines
98
Prophylaxis required for needle stick by healthcare professional in HIV+ patient?
Inhibition of viral replication. This is usually done by blocking reverse transcriptase via NRTIs and NNRTIs.
99
Proper management of smoking cessation?
Behavioral and pharmacologic (Varenicline preferred over bupropion). Initial should include counseling and the patch, then meds and counseling if that fails. No bupropion if SZ Hx. Verenicline contra'd in depression for suicide risk.
100
Can schedule II drugs (eg morphine, etc) have refills?
No. A new script must be written. Schedule 3-5 however have different rules.
101
Impairment of pain, temperature, and sensation in neuropathy is due to loss of?
Small nerve fibers.
102
Impairment of vibratory and proprioceptive sensations in neuropathy is due to loss of?
Large nerve fibers.
103
Most sensitive antibody for Celiac's disease?
Anti-transglutaminase Ab.
104
Most specific antibody for Celiac's disease?
Anti-gliadin Ab.
105
Most important step in celiac's disease management?
Gluten free diet. Can retest 3 months post diet change and see if serology is still present.
106
Initial pharmacological management after MI?
MONA-GBS. Morphine, O2, nitro, ASA, GP2a3b inhibitors, ß-blocker, high dose statin. Only ASA and ß-blockers reduce mortality.
107
Appropriate total diet Ca++ intake and Vit D intake in osteoporotic females?
Daily intake should be at 1200mg Ca++ and 800IU Vitamin D. Do not supplement if adequate levels are part of diet.
108
Optimal intake of Ca++ and Vit D in PREmenopausal women and men with osteoporosis?
1000mg C++ and 600IU Vitamin D.
109
Chapman's for upper and lower lung?
Ant: 3rd IS upper lung, 4th IS lower lung
Post: B/t spinous/transverse processes of vertebrae
110
FEV1/FVC expected in COPD?
<0.7 or (<70%)
111
FEV1 expected in COPD?
<80% with little change post-dilator.
112
What reduces pain in duodenal ulcer?
Eating. Pain usually resumes ~2-3 hours after a meal.
113
What physical manifestation accompanies duodenal ulcer?
Weight gain due to eating, whereas in gastric ulcers weight loss is common due to decreased eating.
114
NSAID use is more common in what type of ulcer?
Gastric ulcers.
115
H. Pylori infxn is more commonly responsible for what type of ulcer?
Duodenal ulcers.
116
What is in triple therapy?
PPI and two antibiotics. Typically amoxicillin and clarithromycin. If PCN allergy, use metronidazole.
117
What is in quadruple therapy?
PPI
Bismuth
Metronidazole
Tetracycline
118
Treatment of pheochromocytomas?
Alpha blockade (Phenoxybenzamine) followed by ß-blockers
119
Histopathology in Alzheimer's disease?
Plaques containing amyloid beta deposition and neurofibrillary tangles made of hyperphosphorylated tau filaments.
120
Rx in hepC?
IFN-alpha and ribavirin
121
Form of hepatitis virus that leads to fetal mortality?
HepE. Spread through fecal-oral route this virus leads to infxn of pregnant women.
122
When is the methacholine challenge used?
If PFTs are normal OR bronchodilator challenge is nondiagnostic, but asthma is still suspected.
123
When is an ABG used?
In an acute setting with a dyspneic, obtunded, or non-responsive Pt in order to determine the etiology of their respiratory condition.
124
What criteria indicate bisphosphonates in an elderly female?
Anyone with osteopenia (T-score: -1 to -2.5) and a 10 year probability of hip Fx >3%.
125
Additional drug used in the treatment of a patient with asthma taking ASA, but experiencing side effects?
Leukotriene receptor antagonist (-lukast). Elevated leukotrienes result from the blockade of COX1 and 2 which exacerbate asthma.
126
What does Spurling's maneuver test for?
Turning and extending the cervical spine while compressing it leads to raducular Sx in affected.
127
Chapman's point for adrenal gland?
A: 1" lateral and 2" superior from umbilicus
P: TP of T11
128
How many views in suspected spondylolisthesis Xray?
5. AP, lateral, 2 oblique, and a zoomed-in of L5-S1.
129
Lateral epicondylitis results from damage to what muscle?
Extensor carpi radialis brevis.
130
Initial HTN management in African-Americans and elderly?
HCTZ. Unless they have DMII of kidney disease, then its an ACEI/ARB.
131
What is the goal of the initial evaluation after HTN Dx?
Target organ damage. Do an ECG, CBC, BMP, UA, and check lipids.
132
Fxn of the ACL?
Prevent forward motion of tibia on femur (especially in 15-30° flexion) and prevent lateral and medial movement .
133
When is the ACL most commonly injured?
Tibia is externally rotated and planted and receives a valgus strain on knee.
134
Most sensitive PE test for ACL tear?
Lachman's test. Stabilize femur with one hand and bend knee to 30° flexion and pull tibia forward.
135
CAG repeats are assoc with?
Huntington's
136
GAA repeats assoc with?
Friedreich's ataxia
137
CTG repeats assoc with?
Myotonic dystrophy
138
CGG repeats assoc with?
Fragile X
139
What are Lewy bodies made of?
Abnormal alpha-synuclein conformational protein folding.
140
Initial scan required in malignant otitis externa?
Brain CT or MRI. Malignant otitis externa means that it will spread to the local bone tissue. This is usually pseudomonas.
141
What is the current theory on the cause of migraine HA?
Trigeminovascular system input. Cerebral vasodilation is no longer the assumed cause.
142
Abortive for migraine HA?
Sumatriptan and other triptans. The SSRI effects result in relief. NSAIDs, ergotamin, and dihydroergotamine are used also.
143
Rx for cluster HA?
100% O2.
144
Prophylaxis for migraine HAs?
```
ß-blockers
Ca++ blockers (verapamil)
TCAs
Valproic acid
SNRIs (venlafaxine, topiramate)
```
145
Most commonly fractured carpal bone?
Scaphoid, followed by the triquetrum.
146
Missed Fx of the scaphoid can lead to what?
Nonunion (delayed/arrested fracture repair within 6 months of injury) or AVN (can lead to nonunion also).
147
What is a nondisplaced fracture?
One in which the fracture is stable. Thumb spica is appropriate in scaphoid Fx, for example.
148
What is the treatment of a nondisplaced scaphoid Fx?
Thumb spica and serial radiographs with CT after completion to check for union.
149
To ensure bone union after Fx, what study is required?
CT is the most sensitive and specific.
150
Special tests for subacromial impingement of the supraspinatous tendon?
Neer's
Hawkin's
Jobe's/Empty can
151
Special test for thoracic outlet syndrome?
Adson's
152
Test for glenohumoral instability?
Apprehension test (flex elbow and take shoulder into 90° abduction and slowly externally rotate)
153
AC joint special test?
Cross arm test
154
Cervical nerve root impingement test?
Spurling maneuver
155
What sign on MRI imaging of shoulder indicates a SItS muscle tear?
Edema within the tendons (eg supraspinatous tendon edema). MRI is used to differentiate tears from impingement.
156
Nerve root associated with all DTRs?
```
C5 - biceps
C6 - brachradialis
C7 - triceps
L4 - knee
S1 - ankle
```
157
Comedonal acne Rx?
Topical retinoid
158
Inflammatory acne Rx?
Oral antibiotics (tetracycline, doxycycline, minocycline, erythromycin)
159
Nodular acne Rx?
Oral isotretinoin
160
Definitive testing for lactose intolerance?
Hydrogen breath test (>20ppm). Lactose delivered to colonic bacteria produce short chain FAs and hydrogen gas.
161
Management of COPD exacerbation ventilation?
Noninvasive preferred over invasive. CPAP or BiPAP can help and are preferred over intubation as nosocomial infxns are so prevalent in intubated patients. Only if the Pt is not breathing on their own or are unable to protect their airway are they being intubated.
162
Best initial test in suspected sprain or separation of AC joint?
Xray of the shoulder. MRI would come later.
163
Biceps tendinitis special tests?
Yergasons (resist supination and flexion of elbow at same time)
Speeds (palpate bicep tendon in anterior shldr while supinating flexing the arm).
164
Pain with external rotation of the arm at 90° flexion of the elbow indicates possible injury to what muscles?
Teres minor
Infraspinatous
These muscles are external rotators.
165
Appropriate medications for aspiration pneumonia?
Must cover anaerobes and pseudomonas. Piperacillin/tazobactam or cefepime would be appropriate.
166
Which sleep medications are best for sleep-onset insomnia?
Zolpidem, zaleplon, triazolam
167
Which sleep meds are best for sleep-maintenance insomnia?
Estazolam, flurazepam
168
How can cubital tunnel syndrome and Guyon's canal be differentiated on exam?
Aside from the numbness pattern in the digits and possibly hypothenar atrophy, Guyon's only presents with abduction/adduction problems with the 4th/5th digits. Cubital tunnel syndrome will present with this as well as impaired flexion of these digits.
169
Chemoprophylaxis for malaria in chloroquine resistant countries?
Mefloquine
Atovaquone-proguanil
Doxycycline
170
Areas where chloroqine chemoprophylaxis is used for malaria?
Central America or Caribbean
171
Primaquine use?
Destroys P. vivax malaria hepatic hypnozoites
172
S/S of Henoch-Schönlein purpura?
```
Palpable, nonpruritic purpura
Abdominal pain
Arthralgias
Arthritis
Hematuria
Intussusception (intestinal edema/bleeding)
```
173
Viral myocarditis commonly leads to what kind of HF?
Dilated (eccentric). Usually in younger adults <45.
174
Best next step with newly discovered solitary lung nodule on Xray?
1. Compare to old CXR
| 2. Do CT (usually)
175
How far from the cervical os can a placenta be to perform vaginal delivery?
>2cm.
176
SS of eosinophilic esophagitis?
```
Dysphagia
CP/epigastric pain
Reflux/vomiting
Food impaction
Atopic Sx (rash, asthma, etc).
***Endoscopy w/ eosinophils on esophageal biopsy is diagnostic.
```
177
CN within cavernous sinus?
CN 3, 4, 5, and 6.
178
Physical features of fetal hydantoin syndrome?
Hypoplastic fingers/nails
| Cleft lip/palate
179
Cavernous sinus thrombosis Sx?
Restricted ophthalmic movements
180
What is Dawn phenomenon?
Hyperglycemic surge in the early morning due to GH and cortisol release. This results in high sugar when fasting before eating breakfast. Inadequate basal insulin would cause this problem.
181
A patient with normal fasting blood sugar (early morning), but an A1C that is high despite these recordings may have what problem?
Postprandial hyperglycemia. This is due to inadequate rapid-acting mealtime insulin and the need for a long-acting also.
182
Cavernous hemangiomas of the brain and viscera are associated with what disease?
von Hippel-Lindau disease.
183
First-line Rx for esophogeal spasms?
Ca++ Channel blockers. Nitrates and TCAs are 2nd line.
184
All sexually active women <25 require what testing?
C. trachomatis and N. gonorrhoeae screening annually via nucleic acid amplification test (NAAT) IN ADDITION TO the regular Pap smear.
185
What is pseudodementia?
Dementia-like Sx due to depression (memory changes, etc) in elderly.
186
Proper management of flail segment resulting in respiratory distress?
Positive pressure mechanical ventilation. This improves oxygenation and causes the flail segment to move normally.
187
Lithium toxicity sx (acute and chronic)?
Acute: GI (NVD) and some neuro Sx (fasciculations, Sz)
Chronic: Confusion, ataxia, tremors/fasciculations
188
Common medicines that cause lithium toxicity?
Thiazides
NSAIDs (not ASA)
ACEIs
Tetracycline Metronidazole
189
Common SE of vincristine?
Peripheral neuropathy. Remember the chemo side effect man in FA.
190
Metabolic syndrome criteria?
3/5 of the following:
1. Abdominal obesity (waist >40" in men of 35" in women)
2. Fasting glucose 100-110
3. BP >130/80
4. TGs >150
5. HDL <40 (men); <50 (women)
191
Key pathologic feature of metabolic syndrome?
Insulin resistance.
192
A female under 50 with severe or resistant HTN may have?
Fibromuscular dysplasia.
193
A female under 35 who develops HTN may have?
Fibromuscular dysplasia.
194
A female whose creatinine increases by at least 0.5 after starting an ACEI or ARB may have?
Fibromuscular dysplasia.
195
Pathology within fibromuscular dysplasia?
Noninflammatory and nonatherosclerotic cell development in the arterial wall leading to stenosis, aneurysm, or dissxn of vessels. Renal, carotid, and vertebral most likely effected, but any can be.
196
How can anovulation and premature ovarian failure be differentiated on testing?
Anovulation has normal FSH and LH levels. POF has high levels of both. Anovulation is the result of no progesterone withdrawal at the end of menses (often due to orbid obesity) and no ovulation occurs.
197
Lab findings in seminoma?
Elevated ß-hCG
198
Lab findings in nonseminomatous germ cell tumors?
Elevated AFP and usually ß-hCG
199
Pathology in chronic granulomatous disease?
Often Xlinked mutation leads to impaired phagocytic oxidative burst (no H2O2) and resultant impaired intracellular killing by phagocytes.
200
Sx of chronic granulomatous disease?
Recurrent infxns early on especially to catalase-positive organisms (S. aureus and aspergillus). Lung and skin infxns most common.
201
Testing for chronic granulomatous disease?
Dihydrorhodamine 123 or nitroblue tetrazolium test
202
Common catalase-positive organisms
```
BASS:
S. aureus
Serratia
Burkholderia
Aspergillus
```
203
X-linked (Bruton) agammaglobinemia labs?
Low B cell concentrations and Ig levels
204
X-linked (Bruton) agammaglobinemia Sx?
Recurrent sinopulmonary and GI infxns
205
CH50 assays are for what?
Determining total complement concentration. Complement deficiencies present with recurrent infxns from encapsulated bacteria (esp Neisseria)
206
DiGeorge syndrome definitie Dx?
Fluorescence in situ hybridization (22q11.2 deletion). Also dysmorphic facies, developmental delays, hypocalcemia, heart issues.
207
Two conditions where T cell levels are markedly decreased?
SCID
| DiGeorge Synd.
208
BRCA positivity enhances risk of what cancers?
Ovarian and breast, not endometrial.
