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Step 2 CK > May 10th > Flashcards

May 10th Flashcards

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1
Q

Hypoketotic hypoglycemia during fasting

A

MCAD - inability to break down fatty acid chains

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2
Q

4 month old presenting with hypoglycemia, lactic acidosis, hyperuricemia, hyperlipidemia, doll-like face and hepatomegaly

A

Glucose 6 phosphatase def (type I glycogen storage dz, Von Gierke disease)

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3
Q

What cancer is associated with pernicious anemia?

A

Gastric cancer (due to atrophic gastritis)

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4
Q

Patient with HIV, presents with floaters and blurred vision of right eye, photophobia, with fundoscopy showing yellow-white exudates immediately adjacent to the fovea and retinal vessels. Diagnosis?

A

CMV retinitis

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5
Q

What is the proper work up for a palpable breast mass in a 36 yo F?

A

Mammogram (+/- US); mammo first in anyone >/= 30 years; if under 30 US firstline

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6
Q

How is lichen sclerosus definitively diagnosed?

A

Punch biopsy

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7
Q

How is lichen sclerosus treated?

A

Topical steroids (high potency)

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8
Q

What are the treatment options for chlamydia/gonorrhea in women?

A

Empiric: azithromycin + ceftriaxone; confirmed chlamydia: azithromycin; confirmed gonorrhea: azithromycin + ceftriaxone

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9
Q

Pseudogout is associated with what diseases?

A

Hyperparathyroidism, hypothyroidism, and hemochromatosis

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10
Q

What is the genetic abnormality in CML?

A

BCR-ABL fusion

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11
Q

What are the criteria for initiating long term home oxygen therapy in COPD?

A

Resting arterial oxygen tension (PaO2) = 55 mmHg or pulse oxy = 88% on room air; PaO2 = 59 or pulse ox = 89% in patients with cor pulmonale, RHF or Hct > 55%

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12
Q

MCHC in hereditary spherocytosis?

A

Increased

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13
Q

Methylmalonic acid level in B12 deficiency?

A

Elevated

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14
Q

Parkinson’s disease is due to loss of what?

A

Dopaminergic neurons in the basal ganglia

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15
Q

Prior to starting trastuzumab, patients need what type of work up?

A

Baseline echocardiography

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16
Q

What is the pathophysiology of bone loss in hyperthyroidism?

A

Thyroid hormones result in increased osteoclast activity, resulting in increased bone resorption

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17
Q

Elevated 24 hour urinary excretion of 5-HIAA is seen in what tumor?

A

Carcinoid

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18
Q

What is the treatment for carcinoid syndrome?

A

Octreotide for sxs/prior to surgery; surgery definitive

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19
Q

Patients with carcinoid syndrome can become depleted in what?

A

Niacin

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20
Q

PAS + material in laminia propria

A

Whipple’s disease - Tropheryma whippelii (bacillus)

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21
Q

What is first line treatment for tinea corporis?

A

Topical antifungal (eg clotrimazole, terbinafine); second line is oral antifungals (eg terbinafine and griseofulvin)

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22
Q

What medications cause granulomatous liver injury?

A

Allopurinol and phenylbutazone

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23
Q

What drugs cause cholestasis type drug-induced liver disease?

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A

Chlorpromazine, nitrofurantoin, erythromycin, anabolic steroids

24
Q

What medications cause fattyliver disease?

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A

Tetracycline, valproate, anti-retrovirals

25
Halothane, phenytoin, isoniazid, and alpha-methyldopa cause what type of liver disease?
Hepatitis
26
Carbon tetrachloride and acetaminophen result in what type of liver disease?
Fulminant liver failure
27
Variable decels on FHR monitor are due to what?
Cord compression, oligohydramnios, cord prolapse
28
What are the causes of meningitis in children <3 months?
1. GBS 2. E coli 3. L monocytogenes 4. HSV
29
What is the most common cause of meningitis in children age 3 months to 10 years?
1. S pneumo 2. N meningitidis
30
What is the MOA of pramipexole?
Dopamine agonist
31
What channel does gabapentin work on?
It is a Alpha-2-delta calcium channel ligand
32
What is the treatment for Tourette disorder?
Antipsychotics (eg risperidone), alpha-2 adrenergic agonists (clonidine, guanfacine), habit reversal therapy
33
How is a dystonic reaction treated?
Dystonic reaction resulting from a dopamine antagonist - give Benztropine or diphenhydramine
34
What cardiac index is seen in hypovolemic shock?
Low cardiac index
35
What are the risk factors for placenta previa?
Prior placenta previa, prior Cesarean delivery/uterine surgery, multiple gestation, smoking
36
How is PAO2 calculated?
150 - (PaCO2/0.8) if at sea level breathing room air
37
How does a glucagonoma present?
DM (easily controlled with diet/one oral med), necrolytic migratory erythema (erythematous plaques with central clearing and eroded boarders), weight loss, diarrhea, anemia
38
How is MS exacerbation treated?
IV steroids; plasmapharesis if refractory to steroids
39
What are the prophylaxis medications for HIV opportunistic infections?
TMP SMX at CD4 200 for PCP; TMP SMX at CD4 100 for Toxo; Azithromycin at CD4 50 for MAC; itraconazole at CD4 150 for histo
40
What diseases are associated with erythema nodosum?
Strep infection, sarcoid, TB, endemic fungal infections (eg histo), IBD, and Behcet disease
41
What are the most common causes of death in Friedreich ataxia?
Cardiomyopathy (causes concentric hypertrophic cardiomyopathy) and respiratory complications
42
What are the common manifestations of Friedreich ataxia?
Neuro (ataxia, dysarthria), skeletal (scoliosis, hammer toes), cardiomyopathy - concentric hypertrophy
43
What are Howell-Jolly bodies and when do you see them?
Nuclear remnants of RBCs; seen in asplenia (eg Sickle Cell)
44
What is basophilic stippling and when is it seen?
Ribosomal precipitates; seen in thalassemia and lead/heavy metal poisoning
45
What are Heinz bodies and when are they seen?
Denatured aggregates of Hgb; seen in G6PD def (and thalassemia)
46
Renal vein thrombosis is most common in what nephrotic syndrome?
Membranous glomerulopathy
47
What is an abnormal 50 g oral glucose tolerance test?
BS >/= 140 one hour after glucose load
48
What is the clinical presentation of milk-protein induced entercolitis?
Age 2-8 weeks, regurgitation or vomiting, painles bloody stools, eczema
49
What is the treatment for milk protein induced colitis?
Mother eliminate all soy and dairy products from diet; or switch to hydrolyzed formula
50
Parotid gland enlargement can be seen in alcohol use, why?
Thought to be due to fatty infiltration from chronic alcohol use
51
How often should patients with cirrhosis have an US?
Q6 months
52
Urinary alkalization in a UTI is concerning for what?
Urease-producing bacteria (P mirabilis most common; K pneumo)
53
What thyroid nodule US findings are suspicious?
Hypoechogeneity, microcalcifications, internal vascularity
54
How is panic disorder treated?
Acute sxs: benzo; start SSRI and CBT for longterm management
55
How is the Reitan trail test useful?
Its a timed connect the numbers test that helps detect subtle mental status changes; useful with SBP

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