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My Step 2 CK > Master the Boards (Kaplan) > Flashcards

Master the Boards (Kaplan) Flashcards

1
Q

What is the sequence of steps involved in the evaluation of asymptomatic elevated transaminases (ALT, AST)?

A
  1. through history (alcohol, travel, blood transfusions, sex, medications)
  2. repeat liver function test 6 months later (chronic elevation)
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2
Q

What is the chronology of abdominal pain in acute appendicitis?

A

visceral followed by somatic

shifting from periumbilical area to RLQ

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3
Q

What type of restrictive cardiomyopathy due to infiltrative disease is reversible?

A

Hemochromatosis (phlebotomy removes iron from blood)

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4
Q

What is the best initial test for suspected PCP in an HIV patient?

A

sputum induction with hypertonic saline

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5
Q

What is the most accurate test for suspected PCP in an HIV patient?

A

bronchoscopy with bronchoalveolar lavage (BAL)

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6
Q

What is the preferred method of respiratory support in patients with acute exacerbation of COPD?

A

non-invasive positive-pressure ventilation

used mechanical ventilation if fails

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7
Q

What are causes of non-anion gap metabolic acidosis?

A
  1. diarrhea

2. Renal tubular acidosis

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8
Q

A patient presenting with non-anion gap metabolic acidosis, hyperkalemia, and renal insufficiency most likely suffers from …

A

type 4 renal tubular acidosis

common in poorly controlled diabetics; due to aldosterone deficiency/ resistance

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9
Q

A patient presenting with GI complaints one week followed by periorbital edema, myositis, and eosinophilia most likely suffers from ….

A

Trichinellosis (roundwarm parasite)

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10
Q

What is the triad associated with Trichinellosis infection?

A
  1. periorbital edenam
  2. myositis
  3. eosinophilia
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11
Q

What is the initial best test for a patient with conjugated hyperbilirubinemia with elevated alkaline phosphatase and normal AST/ALT?

A

abdominal ultrasound (assess for obstruction)

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12
Q

What are the 4 causes of anterior mediastinal mass in a patient with sarcoidosis? (4 T’s)

A
  1. thymoma
  2. teratoma (including mixed germ cell tumor)
  3. thyroid cancer
  4. terrible lymphoma
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13
Q

A patient presenting with a rash, fever, and arthalgias in the setting of acute kidney injury most likely suffers from …

A

drug induced interstitial nephritis

penicillins, cephalosporins, sulfas, NSAIDs, rifampin, phenytoin, allopurinol

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14
Q

What tests are used to confirm Wilson’s disease?

A
  1. ceruloplasmin levels (low)
  2. slit lamp exam of eyes (Kayser-Fleischer rings)
  3. urinary copper (increased)
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15
Q

A patient presenting with elevated LFTs, neuro deficits (movement disorder), and eye problems most likely suffers from…

A

Wilson’s disease (abnormal copper deposition in liver, basal ganglia, cornea)

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16
Q

What clinical features are strongly suggestive of melanoma?

A
  1. Asymmetry
  2. Border irregularities
  3. Color variation
  4. Diameter (>6 mm)
  5. Evolving lesion
    (ABCDEs)
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17
Q

…. are cutaneous tumors that present with dome-shaped nodule and central keratinous plug

A

Keratoacnthoma

18
Q

What is the best initial treatment for symptomatic LV failure?

A

IV diuretics (decrease excess fluid)

19
Q

A low frequency diastolic sound heard just after S2 is most likely …..

A

S3 heart sound (LA blood flow hitting blood already in LV)

20
Q

A patient with anemia in the setting of lymphadenopathy, hepatosplenomegaly and decreased appetite most likely has anemia due to…

A

lymphoproliferative disorder (lymphoma)

21
Q

An HIV pt presenting with pulmonary symptoms and bilateral interstitial infiltrates when a CD4 count less than 200 most likely suffers from …

A

PCP (pneumocystis pnemonia)

22
Q

What is the best initial treatment for PCP in HIV patients?

A

Bactrim (trimethoprim-sulfamethoxazole)

23
Q

When do you add steroids to PCP treatment in an HIV patient?

A
  1. PaO2 35 mmHg
24
Q

A patient present with hyperthyroid signs, low TSH, high fT4/fT3, no proptosis, decreased radio-active iodine uptake most likely suffers from …

A

exogenous thyroid hormone (need to distinguish from thyroiditis/ iodine exposure/ extraglandular production via thyroglobulin level)
(low thyroglobulin level)

25
Q

What is the initial step of evaluation of a solitary pulmonary nodule?

A

assess whether low, intermediate or high probability of malignancy

26
Q

What is the best intial treatment for a patient with peripheral artery disease (PAD)?

A
  1. factor modification (smoking, statin, bp med, diabetes)
  2. low dose aspirin
  3. statin for cholesterol
  4. exercise program (to improve max distance)
27
Q

What are pulmonary function test findings in restrictive lung disease?

A
  1. FEV1 70%

3. FVC <80%

28
Q

What are the pulmonary function test findings in obstructive lung disease?

A
  1. FEV1 < 80%
  2. FEV1/FVC < 70%
  3. FVC normal or increased
29
Q

A patient on anti-coagulant therapy develops pain followed bullae formation and skin necrosis most likely suffers from …

A

warfarin-induced necrosis

30
Q

A patient who develops digital clubbing and sudden onset joint in a chronic smoker suggests …

A

hypertrophic (pulmonary) osteoarthropathy

associated with lung cancer –> obtain CXR

31
Q

The true positive rate on a receiver operating characteristic curve correlates with …

A

sensitivity (directly)

32
Q

The false positive rate on a receiver operating characteristic curve correlates with …

A

specificity (indirectly; 1-specificity)

33
Q

A patient presenting with recent onset confusion, fever, muscle rigidity, autonomic instability, elevated creatine kinase after treatment with Dopamine antagonist most likely suffers from …

A

Neuroleptic Malignant syndrome

34
Q

What is the treatment for Neuroleptic Malignant Syndrome?

A
  1. stop offending agent
35
Q

What is the pathophysiologic cause of metabolic syndrome?

A

insulin resistance

36
Q

A older pt develops burning localized pain followed by development of rash after severe physical stress (cancer tx, immunosuppression) most likely suffers from …

A

Shingles (reactivation of varicella zoster from dorsal root ganglion)

37
Q

A fat women presents with bloating, dyspepsia after eating fatty meals, RUQ pain most likely suffers from ..

A

Gallstone disease (cholelithiasis)

38
Q

What is the best initial test for gallbladder disease?

A

abdominal ultrasound

39
Q

A pt presenting with pneumonia, GI distress, high fever (>39), and a sputum gram stain with neutrophils but no organisms most likely suffers from ….

A

Legionella pneumophilia

40
Q

What antibiotics are best for Legionella?

A
  1. azithromycin (other macrolides)

2. levofloxacin (fluroquinolones)

My Step 2 CK (21 decks)

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