Medicine In-Review Flashcards
(238 cards)
0
Q
Which area of the body is most frequently injured by runners?
A
Knee
1
Q
Which neoplasm is Imiquod cream approved for?
A
Superficial basal cell carcinoma.
2
Q
If a patient sustains an injury and has had a tetanus shot one year ago - does he need tetanus toxoid or immunoglobulin?
A
He does not need either of those.
3
Q
What class if drugs does chlorpropamide belong to?
A
Sulfonylureas.
4
Q
What effect does chlorpropamide have on warfarin?
A
Displaced warfarin from albumin leading to high levels and possibly bleeding.
5
Q
How can aminoglycoside nephrotoxicity be attenuated?
A
By once daily dosing.
6
Q
Is malignant ascites a portal hypertension mediated process or a non-portal hypertension mediated process?
A
Non-portal hypertension mediated.
7
Q
What blood type is the universal donor?
A
O negative.
8
Q
What medication is commonly used to treat precancerous actinic keratosis?
A
5-fluorouracil
9
Q
What are less invasive treatment options for an old patient with comorbidities who has achalasia?
A
Bougienage or botulinum toxoid injections.
10
Q
Which cancer is associated with malignant acanthosis nigricans?
A
Gastric cancer.
11
Q
Is a PAP smear recommended in women who have has a hysterectomy because of benign causes?
A
No.
12
Q
What is the next step if a patient has symptomatic bradycardia?
A
Permanent pacemaker implantation.
13
Q
Management of mitral stenosis in a patient with hockey stick deformity of the anterior leaflet with restricted motion predominantly at the leaflet tips and minimal mitral regurgitation.
A
Balloon mitral valvoplasty.
14
Q
Can hypokalemia cause hepatic encephalopathy?
A
Yes.
15
Q
Bilateral ground glass opacities with low DLCO on pulmonary function tests.
Diagnosis?
A
Idiopathic pulmonary fibrosis.
16
Q
Sudden cardiac death after being struck on the chest.
Diagnosis?
A
Commotio Cordis
17
Q
Which marker of hepatitis B indicates prior infection with complete recovery?
A
Hepatitis B core antibody IgG.
18
Q
Autosomal dominant condition with multiple keratocanthomas in sun exposed areas.
A
Ferguson-Smith syndrome
19
Q
What effect do bile acid binding resins have on the lipid panel?
A
- Increase VLDL triglyceride production.
- Decease LDL cholesterol via increased hepatic LDL receptor activity.
- Increase HDL.
20
Q
What is the best time to schedule elective surgery in a pregnant woman if the surgery cannot be postponed?
A
Second trimester.
21
Q
What three common manifestations are common in patients with cryoglobulinemic vasculitis?
A
- Purpura
- Glomerulonephritis.
- Peripheral neuropathy.
22
Q
How high does the Hepatitis B surface Antibody need to be to indicate immunity?
A
More than 12 mIU/mL
23
Q
Pemphigus erythematosus (uncommon variant of pemphigus foliaceus with additional features of lupus erythematosus). Also known as...
A
Senear-Usher syndrome.
24
Elevated free T4 with normal TSH.
| Next step?
MRI of pituitary gland.
25
Heyde's syndrome...
| Development of arteriovenous malformations in patients with...
Severe aortic stenosis.
26
Brachyonychia, eruptive keloids, and multiple pilomatricomas.
Diagnosis?
Rubinstein-Taybe syndrome.
27
What systemic disease is associated with generalized granuloma annulare?
Diabetes mellitus.
28
What is the most common cardiac disease diagnosed in pregnant women?
Congenital heart disease.
29
What metabolic disturbance occurs if ileum is used as a urinary conduit?
Non-anion gap metabolic acidosis.
30
Irregular heart rate, tachycardia, different morphologies for P waves...
Diagnosis?
Multifocal atrial tachycardia.
31
What eye problem do you suspect in a patient complaining if increased glare?
Cataracts.
32
What is the most prevalent gynecological disorder associated with chronic pelvic pain?
Endometriosis.
33
Patients with an inferior wall myocardial infarction should get a...
... Right sided ECG.
34
Girl with rounded face, obesity, short 4th and 5th fingers, area of subcutaneous calcification and evidence of hypocalcemia.
Diagnosis?
Pseudohypoparathyroidism type 1a.
35
Which body part has the highest per cutaneous absorption of topical steroids?
Scrotum.
36
Which antibody is the most specific for SLE?
Anti Smith Antibody.
37
What is the most common site if involvement of cicatricial pemphigoid?
Oral mucosa.
38
In dermatomyositis, which auto antibody is indicative of increased risk of pulmonary disease?
Anti-Jo-1 antibody.
39
When do you do aggressive suctioning in the setting of aspiration pneumonia?
When the patient is vomiting or it is an acute event.
40
What exposure would you expect in a car painter who develops lung disease?
Isocyanate
41
What does estrogen do to the HDL?
Increases it.
42
Are toll-like receptors (TLR) part of the innate or acquired immune system?
Innate immune system.
43
What organism causes (erosio interdigitalis blastomycetica) white stuff between fingers?
Candida albicans.
44
What kind of tumor do patients with Zollinger Ellison syndrome have?
Gastrinoma.
45
What is ectropion?
Eyelid margins turned away from the eye.
46
Is sickle cell disease an absolute contraindication to oral contraceptives?
Yes.
47
What should you expect in patients with hemoptysis who are homeless?
Tuberculosis.
48
What is the most common endocrine abnormality found in adrenal incidentalomas?
Autonomous cortisol hypersecretion.
49
Patient with recurrent infections, eczema, and thrombocytopenia.
Diagnosis?
Wiskott-Aldrich syndrome.
50
What are the risk factors for developing ARDS in trauma patients?
1. Female sex.
2. Chronic Alcohol Abuse.
3. Cigarette smoking.
4. Advanced age
51
If the calcium containing phosphate binding drugs used in chronic kidney disease cause hyperkalemia; then what phosphate binders can be used?
Lanthanum carbonate.
| Sevelamer.
52
What is the most common cause of nephrotic syndrome in adults?
Membranous glomerulonephritis.
53
Is hyperlipidemia a possible metabolic abnormality with long term systemic glucocorticosteroid therapy?
Yes
54
Which site of squamous cell carcinoma has the greatest risk of metastasis?
Lip.
55
What kind of therapy do you need to give for transitional cell carcinoma of the bladder?
Intravesical therapy.
56
Young patient with persistent isolated asymptomatic microhematuria.
Diagnosis?
Thin basement membrane nephropathy.
57
If someone has a high grade dysplasia on biopsies obtained with EGD for Barrett's esophagus then what is the longest time they can wait before getting an EGD if they don't want to get surgery or endoscopic resection at this time?
3 months
58
Does propranolol disrupt sleep structure?
Yes.
59
What medication can be used to medically treat recurrent obscure GI bleeding likely secondary to angioectasias?
Thalidomide.
60
Compared to non smokers, how much greater is the risk of stroke in active smokers?
Four fold.
61
Compared to nonsmokers, what is the risk of stroke in former smokers?
Two fold.
62
Compared to non-smokers, what is the risk of stroke of smokers with hypertension?
Twenty fold.
63
What disease is pseudofolliculitis barbae associated with?
End stage renal disease.
64
What is the first step if a patient ingests a caustic substance causing burns to the throat and upper airway?
Emergent laryngoscopy.
65
Which subtype of HPV has been implicated in giant conduloma of Buschke and Lowenstein and anogenital condyloma?
HPV type 6.
66
What antibody immune complexes are expected to be found on direct immunoflorescence in Henoch-Schonlein purpura?
IgA.
67
Do pleural effusions from nephrotic syndrome usually cause dyspnea at rest?
No.
68
If a serrated adenoma is found during colonoscopy; when does the patient need to have the next colonoscopy?
After one year.
69
What is the target range of hemoglobin in dialysis patients?
10 - 11 g/dl
70
What system is involved in most women with chronic pelvic pain?
Gastrointestinal system.
71
What's an MDCT of the chest?
CT PE protocol.
72
What is the potency of Halobetasol propionate cream 0.05%?
Super potent Class 1 topical steroid.
73
What should you try to do in a patient with subclinical hyperthyroidism and osteoporosis?
Investigate the cause by a radioactive iodine uptake scan.
74
What disease is associated with pterygium like formations on the nails?
(Hint: patient has arthritis)
Systemic sclerosis.
75
How do you treat jelly bean stings?
5% acetic acid.
76
What state is angiosarcoma related to?
Chronic lymphadematous states.
77
What cardiovascular defect is associated with Turner's syndrome?
Coarctation of aorta and aortic dissection.
78
Which disease is herpes gestationis associated with?
Grave's disease.
79
Generally when is an MRI breast done?
Evaluating breast implants.
| Metastasis where the breast may have the occult primary.
80
Does jaundice cause confusion?
No.
81
What is adrenal hemorrhage most frequently associated with?
Heparin induced thrombocytopenia.
82
Can nephrogenic systemic fibrosis be fatal?
Yes
83
What is the optimal initial therapy for severe symptomatic hypercalcemia?
Intravenous hydration and calcitonin.
84
Which malignancy commonly cause ectopic vitamin 1,25 OH D production?
Hodgkin's lymphoma
85
Which joint disease is para-articular osteopenia seen in?
Rheumatoid Arthritis
86
Does papillary muscle rupture and acute mitral regurgitation cause palpable thrill?
No.
87
If a heart failure patient with a low ejection fraction has symptoms on maximal medical therapy, what can be done to improve symptoms, functional capacity and survival rate?
Biventricular pacemaker.
88
What differentiates NSAID induced interstitial nephritis from other kinds of interstitial nephritis?
Absence of urine eosinophils in NSAID induced interstitial nephritis.
89
What happens to the heart sounds in first degree block?
S1 decreases in intensity
90
Where can a DVT best be investigated by compression ultrasound?
The superficial femoral vein.
91
How do you manage necrotizing pancreatitis with no evidence of infection?
IV hydration continued. If not better in 2 - 3 weeks the surgical debridement considered.
92
Are prophylactic antibiotics recommended for procedures such as bronchoscopies?
No.
93
Which anti-scabies medication interferes with GABA function?
Lindane.
94
What happens if you don't treat tuberculous pleural effusions?
Most resolve spontaneously within 4 - 16 weeks.
95
Greasy, yellow, scaly plaques - central face and chest.
| Diagnosis?
Seborrheic dermatitis
96
Does aspirin cause drug induced TTP/HUS?
No.
97
Erythema multiforme and herpes simplex virus infection have been linked to which HLA type?
HLA B15
98
Is tolectin associated with dependency?
No.
99
Is the pneumococcal vaccine indicated for smokers?
Yes.
100
What do you do if GERD does not respond to PPI?
EGD
101
What kind of exercise can people over 40 years old who are not already active begin for weight loss?
Non-strenuous like walking.
102
Is constipation a side effect of niacin?
No.
103
What is the best predictor of post-op survival in breast cancer?
Tumor grade/stage
104
How do you treat Bartonella Henselae?
Erythromycin
105
What is the most common etiology of longitudinal erythonychia?
Onychopapilloma
106
What's the most commonly identified cause of bronchiectasis?
Childhood infection.
107
What's the most common valvular pathology?
Mitral valve prolapse.
108
What type of hypersensitivity reaction does sarcoidosis represent?
Type 4 hypersensitivity reaction.
109
What's the leading infectious cause of deafness and mental retardation in the US?
Congenital CMV.
110
Leading cause of maternal mortality in the United States is...
Trauma
111
How often do you do surveillance endoscopies after diagnosis of Barrett's esophagus?
Every 3 - 5 years.
112
What's the most common medical complication of pregnancy?
Diabetes mellitus.
113
Which has the longer half life; torsemide or furosemide?
Torsemide.
114
Next colonoscopy after a small serrated polyp with no dysplasia is discovered?
5 years.
115
What kind if pulse does someone with very advanced heart failure have?
Pulsus alternans.
116
What vaccination is recommended when you are 60 years old?
Zoster vaccination.
117
Is tachycardia is frequent in a healthy pregnancy?
Yes.
118
Which vitamin deficiency occurs in carcinoid syndrome?
Pellagra.
119
Hypertension in Cushing's syndrome is primarily related to...
Retention of water and salt.
120
What is the initial step after you find a palpable ovarian mass?
Pregnancy test.
121
What is the greatest independent risk factor for stroke?
Hypertension.
122
What happens to the calcium in scrotal calcinosis?
Nothing.
123
What does glucosamine do in osteoarthritis patients?
Produces mild to moderate analgesia effects.
124
What is the treatment if sick sinus syndrome?
Permanent pacemaker.
125
What is used to dilate the cervix during labor?
Prostaglandin E2.
126
Which cancers are common in patients with ataxia-telangiectasia?
Breast cancer
Leukemia
Lymphoma
127
What is a common cause of eyelid dermatitis in women?
Tosylamide formaldehyde (nail polish remover)
128
Hemophilia C has deficiency of which of the following?
Factor IX.
129
When is post-pyloric feeding done?
When patient is intolerant of gastric feeding, has history of aspiration or gastroparesis.
130
How soon after a meal does early dumping syndrome occur?
Half an hour.
131
How soon after a meal does late dumping syndrome occur?
2 - 3 hours.
132
Which malignancy is associated with dermatomyositis?
Ovarian cancer.
133
Is chronic hepatitis C or HIV/AIDS a contraindication to a liver transplant?
No
134
Is MRSA increasing or decreasing in the hospital setting?
Decreasing.
135
If ovarian cancer is found unexpectedly on pathology then what is the next step?
Oophorectomy and full staging.
136
Name a prodrug of acyclovir.
Valacyclovir.
137
What condition causes a variable intensity S1?
Atrial fibrillation.
138
What should you check if you suspect hypercalcemia secondary to sarcoidosis.
1,25(OH)2D.
| It will be increased.
139
Name drugs that can cause cardio version in atrial fibrillation patients that lasts less than 90 days.
Amiodarone.
Dofetilide.
Propafenome.
Quinidine.
140
Common symptoms of hypercalcemia of malignancy.
Weakness.
| Constipation.
141
What infection does guttate psoriasis follow?
Streptococcal infection.
142
Is aura associated with absence seizures?
No.
143
What disease is Norwegian or crusted scabies associated with?
HIV.
144
What happens to the complement levels in membranoproliferative glomerulonephritis?
Low complement levels.
145
What happens to the potassium in Cushing's syndrome?
Potassium decreases and patient is hypokalemic.
146
Screening for colon cancer in patients with ulcerative colitis.
Colonoscopy 8 years after diagnosis.
| Every other year after that.
147
Cn chlorpromazine cause photosensitivity?
Yes.
148
Twenty nail dystrophy, nail plate splitting, and pterygium formation on nails.
Diagnosis?
Lichen planus.
149
Protease inhibitors can cause lipodystrophy.
| True or false?
True.
150
Which virus causes viral rhinitis?
Rhinovirus.
151
Does allergic rhinitis depend on the season?
Yes.
152
Is increased total cholesterol a risk factor for coronary artery disease?
No. LDL is a risk factor.
153
What kind of WBCs are elevated in patients in chronic urticaria?
Eosinophils.
154
What side effect can ifosfamide cause?
Hemorrhagic cystitis.
155
Is lichen sclerosis is associated with other auto-immune diseases?
Yes.
156
Does C. trachomatis predispose to reactive arthritis?
Yes.
157
Is anal cell carcinoma an AIDS defining malignancy?
No.
158
Treatment of cryptosporidium in HIV patients?
Nitazoxanide.
159
Is ocular and bulbar involvement common in Lambert-Eaton syndrome?
No
160
Is tachycardia a sign of nicotine withdrawal?
No.
161
What happens if you combine isotretinoin with tetracycline?
Increased risk of pseudo tumor cerebri.
162
What is the target blood pressure in diabetics?
130/80 mmHg or lower.
163
Black discoloration of nail plate. What infection can cause this?
Proteus infection of nail.
164
What is the first line treatment for axillary hyperhidrosis?
Aluminium chloride solution.
165
What's a normal pulmonary capillary wedge pressure?
10 mmHg.
166
Which HIV medication is the most potent inhibitor of 3A4 isoenzyme?
Ritonavir.
167
What dermatological condition can develop after upper respiratory infection secondary to group A beta-hemolytic streptococci?
Guttate psoriasis.
168
Peripheral blood eosinophilia can be detected in vast majority of allergic disorders.
True or false?
False.
169
Eosinophils are primary tissue-dwelling cells.
| True or false?
True.
170
What happens to the renin level in primary aldosteronism?
Plasma renin levels are decreased.
171
What happens to the renin levels in renovascular hypertension?
Renin level increases.
172
What is the most common cause of ARDS?
Sepsis.
173
Name an arrhythmia you can use dabigatran for?
Non valvular atrial fibrillation with CHADS score of more than 2.
174
In which hematological malignancy are retinoic acid derivatives useful?
Acute pro-myelocytic leukemia.
175
How long is the incubation period of hepatitis A?
Approximately one month.
176
When do you do vaginal and rectal cultures for group B streptococcal infection in pregnant women?
At 36 weeks of gestation.
177
Does inflammatory back pain improve with rest?
No.
178
What percentage of the population suffers from restless legs syndrome?
5%
179
Is digitalis contraindicated in pregnancy?
No.
180
What is the most common site of urethral cancer in males?
Bulbomembranous urethra.
181
Recurrent endometrial cancer grade 1 treatment?
Megestrol acetate.
182
What is the treatment of cystocele in women?
Pelvic muscle strengthening exercises and the use of a pessary.
183
Does cortical blindness affect the pupillary light reflex?
No.
184
What consultation needs to be obtained in patients with candidemia?
Ophalmologic consultation.
185
What kind of diseases is alopecia areata associated with?
Auto-immune diseases.
186
Which virus is associated with Kaposi sarcoma in HIV patient?
HPV 8.
187
What test do you do to check for psuedotumor cerebri?
Lumbar puncture.
188
What's the mortality of TTP/HUS if untreated?
90%
189
Can patients with psoriasis have rheumatoid factor positive?
Yes.
190
What does IgG bind to in HIT?
Platelet factor-4 bound to heparin.
191
Calabar swellings are characteristic of which disease?
Loiasis.
192
Are oncocytomas likely to metastasize?
No.
193
How is the diagnosis of eosinophilic esophagitis made?
Biopsy of the proximal and distal esophagus with greater than 15 eosinophils per high power field.
194
What is used to treat hypercalcemia of malignancy in the hospital?
Zoledronic Acid.
| Palmidronate.
195
What are the second line treatments for smoking sensation?
Clonidine.
| Nortriptyline.
196
Next step in someone diagnosed with primary sclerosing cholangitis?
Colonoscopy to screen for ulcerative colitis.
197
What medications are avoided in severe alcohol induced hepatitis?
NSAIDS.
198
When someone is on a diet; how many calories should they be taking?
1000 kcal/day.
| This is restricted. Less than this is not advised.
199
A calcium score of zero has a negative predictive value of > 95% for obstructive coronary disease in women.
True or false?
True.
200
Do you need prophylaxis before ERCP for primary sclerosing cholangitis?
Yes.
| One dose of ciprofloxacin.
201
Utility of fecal testing in ameobiasis.
Fecal testing is of limited value.
202
Imiquimod is approved for the treatment of...
Actinic keratosis.
203
What organism causes tinea capitis?
T. Tonsurans
| M. Canis
204
Heart failure symptoms and echocardiographic evidence of left ventricular wall thickening, atrial enlargement, and increased echogenicity in conjunction with decreased QRS voltages.
Diagnosis?
Cardiac amyloidosis.
205
Chicken pox is contagious during which period?
Two days before, until 5 - 7 days after onset of rash.
206
What causes pitted keratolysis?
Micrococcus sedentarius
| Corynebacterium species
207
What do gonadotropin-releasing hormone agonists do to gonadotropins?
Down regulate release - hypogonadotrophic, hypogonadal state.
208
What is the treatment of high altitude pulmonary edema once you've brought the patient down from the mountain?
IV dexamethasone.
209
Precautions for disseminated herpes zoster?
Contact and airborne precautions.
210
Treatment of analgesic induced headaches?
Taper off the NSAIDS/pain medications.
211
What kind of tumor has spindle cell appearance and positive staining for C-KIT?
Gastrointestinal stromal tumor.
| They are most commonly found in the stomach.
212
Birbeck granules are pathognomonic for which cell type?
Langerhans cells.
213
What anti-migraine medicines are contraindicated during pregnancy?
Sumatriptan
| Ergot alkaloids
214
Where is most prostate cancer found?
Peripheral zone.
215
What is the most common type of melanoma in African American patients?
Acral lentiginous melanoma
216
Young patient with joint pain and swelling: intracapsular lesions with no calcifications; cysts of various sizes with sharp and sclerotic margins.
Diagnosis?
Pigmented villonodular synovitis.
217
What can be added to aspirin for secondary stroke prevention?
Dipyridamole.
218
What's a fancy name for my messed up sleep schedule?
Delayed sleep phase syndrome.
219
Ultrasound description:
Well-defined, hyperechoic masses in submucosa.
Diagnosis?
Lipoma.
220
Cutaneous infection with what virus increases risk of squamous cell carcinoma?
HPV
221
What disease can cause debilitating arthritis?
Multicentric reticulohistiocytosis.
222
Patient with untreated secondary syphilis with numerous smooth, flat topped, flesh-colored papules on his scrotum and perineum.
Diagnosis?
Condyloma lata.
223
What needs to be excluded before starting infliximab therapy for Crohn's disease?
Tuberculosis.
| Hepatitis B.
224
When would you give 3% saline for SIADH.
Sodium below 120 meq/l or symptoms e.g. Seizures
225
What additional test should you do in a patient with primary sclerosing cholangitis?
Colonoscopy to rule out ulcerative colitis.
226
What happens to the click and murmur of mitral valve prolapse with standing and squatting?
Standing: click and murmur closer to S1.
Squatting: click and murmur further from S1.
227
Do patients with HIV lipodystrophy have normal cortisol responses?
Yes.
228
What do you do for a patient after they have recovered from a ventricular fibrillation arrest?
ICD implantation.
229
What antibody correlates with cuticular changes in dermatomyositis?
Anti Mi 2 antibodies.
230
Should clopidogrel be held before CABG surgery?
Yes; 5 days before.
231
Can sickle cell trait predispose to rhabdomyolysis?
Yes.
232
What is the target INR for a mechanical aortic valve?
2 - 3.
233
What medications are first line for aortic dissections?
Beta blockers e.g. Labetalol.
234
Most likely cutaneous malignancy in immunosuppressed patients?
Squamous cell carcinoma.
235
What kind of malignancies do patients with Sjögren's syndrome develop?
Non-Hodgekin's lymphoma.
236
Repeat screening in Barrett's esophagus if there is no dysplasia.
3 - 5 years.
237
What happens to the HDL in CETP deficiency?
HDL is high.
