January Deck

Question 1

With complete tear of _____ pt cannot extend knee or keep leg straight during flexion

Answer 1

With complete tear of PATELLAR TENDON pt cannot extend knee or keep leg straight during flexion

Question 2

Tuberous sclerosis complex sx

Answer 2

ash-leaf spots, angiofibromas, shagreen patches
CNS lesions, epilepsy ID, autism,
Cardiac Rhabdomyoma, renal angiomyolipomas

Question 3

Treatment of tension pneumothorax

Answer 3

chest tube (needle decompression is only if emergent, would need CT later anyway)

Question 4

Scoliosis Red flag sx

Answer 4

Back pain
Neurologic sx
Rapidly progressive curvature
vertebral anomalies on X-ray

(could indicate tumor –> MRI)

Question 5

Cobb Angle of ______ degrees is considered variant of normal

Answer 5

Cobb Angle of <10 degrees is considered variant of normal
Therefore no intervention unless sx develop

Question 6

Cobb Angle of ________ degrees should be sent for surgical eval/intervention

Answer 6

> 40 degrees

Question 7

Spirometry obstructive pattern: FEV1/FVC _____

Answer 7

Spirometry obstructive pattern: FEV1/FVC <0.7

Question 8

If spirometry does not capture bronchospasm in suspected asthma administer _________

Answer 8

Methacholine (muscarinic agonist) challenge to initiate bronchospasm
(person w/ asthma will be more effected than person w/o)

Question 9

First line treatment of acute-mania is _______

Answer 9

anti-psychotics (ex: risperidone)

Lithium and valproate are first line for Bi-polar in general but NOT mania

Question 10

Primary biliary cholangitis sx:

Answer 10

Fatigue + puritis, mild AST/ALT high, VERY Alk phos HIGH

autoimmune fibrosis of intrahepatic bile ducts

Question 11

Primary biliary cholangitis tx

Answer 11

ursodexycholic acid

Question 12

Primary biliary cholangitis common nutritional complication

Answer 12

bone loss

Question 13

What meds to you start with new dx PAD?

Answer 13

statin and ASA

Question 14

1st line management PAD?

Answer 14

Supervised exercise class
(bipass surgery or stent placement only if limb ischemia)

Question 15

When is splinting with early mobilization/PT appropriate in wrist/hand injury?

Answer 15

Only when fracture has formally been ruled out

Question 16

Scaphoid fracture sx

Answer 16

Pain over “anatomic snuff box”
Dec grip strength
Initial Xray may be negative

Question 17

Most common complication of scaphoid fracture:

Answer 17

non-union and avascular necrosis

Question 18

Pre-diabetes A1c

Answer 18

5.7-6.4%

Question 19

Dx of diabetes

Answer 19

HA1c >6.5%
Fasting glucose >126
Random glucose >200
Glucose challenge test: 2 hr plasma glucose >200

Need 2 of these to officially diagnose lolol lies

Question 20

Lichen Planus sx

Answer 20

shiny, purple-ish, itchy, pruritic leisions w/ white lines, often wrists and ankles
white lines in mouth

Question 21

Lichen planus is associated with ______what disease?

Answer 21

liver disease (hep C)

Question 22

MEDICATION Management of Acute Chest Syndrome (SCD) is:

Answer 22

Pain control
CTX and azithromycin (infx most common trigger)

Question 23

What meds are CONTRAINDICATED in acute decompensated HF?

Answer 23

Beta Blockers
(reduce contractility, may worsen HF)

Question 24

Pts w/ Chronic Granulomatous Disease are at risk for infx from:

Answer 24

Catalyze positive bacteria and fungi
(S aureus, B cepacia, Serratia, Nocardia, Aspergillus)

Bactrim & Fluconazole

Question 25

New Hematochezia and HD INstability, first step of SURGICAL/GI management is ____

Answer 25

EGD - diagnostic AND therapeutic (most likely high volume upper GI bleed, esp if no reason to suspect lower GI bleed)

Question 26

Management of salmonalla:

Answer 26

supportive (if immunocompetent and >12 mo old)

Question 27

Suspect stress hyperglycemia in pts w/:

Answer 27

severe illness Temp >102.2 Sepsis, Meningitis

Question 28

Treat pseudofolliculitis barbae by

Answer 28

stopping shaving LOL

Question 29

Corneal abrasion management

Answer 29

1. wash out eye to remove debris 2. topical abx 3. opthalmology follow up

Question 30

Sx Sarcoidosis

Answer 30

Dry cough lymphadenopathy anterior/posterior uviitis erythema nodosum

Question 31

Cerebral venus thrombus sx

Answer 31

Stroke-like findings (ex: weakness) ICP (headache/blurry vision w/ valsalva) Prothrombotic risk factors (preg) treat: LMWH

Question 32

Chronic, scaly plaque, "sandpaper-like," +/- erythema, +/- growth/horn

Answer 32

Actinic Keratosis is a precursor to SSC Tx: liquid nitrogen

Question 33

placenta acreta =

Answer 33

placenta implanting into uterine wall

Question 34

Randomized clinical trials examine _________, not _________

Answer 34

Randomized clinical trials examine EFFICACY, not adverse events.

Question 35

ANY concern for child abuse notify _______

Answer 35

child protective services

Question 36

Acute mesenteric ischemia sx

Answer 36

Sudden onset (embolus) Periumbillical pain out of proportion to exam N/V

Question 37

Colonic ischemia

Answer 37

gradual onset 2/2 dec blood flow to watershed areas minimal-mod pain bloody diarrhea

Question 38

Diagnosis of urinary schistosomiosis

Answer 38

identify eggs on urine sediment microscopy (no imaging)

Question 39

HELLP sx:

Answer 39

hemolysis Elevated Liver enzymes Low Platelet count THIRD trimester

Question 40

Thrombotic thrombocytopenic purpura (TTP) sx

Answer 40

1 AMS 2 Thrombocytopenia 3 Renal insufficiency 4 MAHA (hemolysis) 5 Fever ADAMTS13

Question 41

Thrombotic thrombocytopenic purpura (TTP) treatment:

Answer 41

Plasma exchange

Question 42

chronic, watery diarrhea, flatulance, bloating AFTER meals is...

Answer 42

Lactose intolerance

Question 43

Prior to starting stimulant therapy, patient needs....

Answer 43

throughout PE and cardiac history (no ECG/imaging)

Question 44

Hypocalcemia sx

Answer 44

1. Depression, fatigue, muscle cramps 2. Tetany, carpal spasm (trousseau sign) and facial twitch (Chvostek sign)

Question 45

UTI management

Answer 45

1. nitrofurantoin, bactrim, fosfomycin (nitrofurantoin & fosfomycin ok in pregnancy)

Question 46

Medication risks of pyloric stenosis:

Answer 46

macrolide abx exposure

Question 47

Ischemic stroke pts, thrombolysis contraindicated if....

Answer 47

BP >185/110 - risk transition hemorrhagic stroke So dec BP first, then give tPA

Question 48

Best treatment premenstrual syndrome or premenstrual dysphoric disorder is...

Answer 48

SSRI

Question 49

cryoglobinemia syndrome is associated with...

Answer 49

hep C virus

Question 50

Sx overflow incontinance

Answer 50

constant dribbling, incomplete bladder emptying vs. stress or urge

Question 51

Treat PE with thrombolysis if...

Answer 51

PE + Hypotension + low risk of bleeding

Question 52

Treat PE with embolectomy if...

Answer 52

Shock w/ expected death in hours OR: failed management with thrombolysis (continues hypotensive)

Question 53

Management iodine-induced hyperthyroidism...

Answer 53

Mild: BB Severe/lasting: anti-thyroid med ex: methimaxol triggers: radiocontrast dye, amiodarone, topical-antiseptics, kelp-based dietary suppliments

Question 54

Dementia w/ Lewis Body patient's should avoid... (med type)

Answer 54

antipsychotics worsen confusion, parkinsonism, autonomic dysfunction

Question 55

Suspect pneumoperitoneum, study of choice:

Answer 55

1. Abd X-ray - sitting up 2. CT

Question 56

Treatment pneumoperitoneum (ulcer erosion)

Answer 56

SURGERY, and abx EGD just not gonna cut it

Question 57

Indications PPV in newborn:

Answer 57

1. Ineffective respirations 2. Pulse <100

Question 58

highest risk indicator for PID

Answer 58

multiple sexual partners (not previous STI/PID)

Question 59

Nephrotic syndrom in obesity. Most likely:

Answer 59

Focal Segmental Glomerulosclerosis (FSGS) 2/2 hyperfiltration given increased blood supply usually ASYMPTOMATIC

Question 60

Shoulder injury with WEAKNESS? then you...

Answer 60

Suspect rotator cuff TEAR MRI

Question 61

1st degree relative with colon cancer? Start colonoscopy at....

Answer 61

40 or 10 years prior to relative diagnosis otherwise start 45

Question 62

esophageal variceal prophylaxis medication?

Answer 62

Non-selective BB (reduce portal pressure)

Question 63

SBP management?

Answer 63

Abx +/- albumin NOT major thoracentesis (causes fluid shifts, kidney failure is what kills you, thora makes kidney failure worse)

Question 64

MELD score takes into account:

Answer 64

Sodium, Creatinine, bilirubin, INR

Question 65

Meds for aspiration pneumonia?

Answer 65

Same as CAP (CTX + azythro) (don't cover anaerobs unless abscess or empyema)

Question 66

atrophic scaring velvety skin joint hypermobility risk rupture cordae tendineae (acute MR)

Answer 66

Ehlers-Danlos (marfan doesn't have skin findings)