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Medicine stuff 4 Flashcards

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1
Q

Meniere pathophys?

A

increased volume and pressure of endolymph

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2
Q

Active and former male smoker 65-75 get a US to screen for AAA, or just active?

A

Active and former

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3
Q

Young pt, mediastinal mass with elevated AFP and b-hCG?

A

germ cell tumor (nonseminomatous)

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4
Q

CPAP complications (3)?

A

alveolar damage, pneumothorax, hypotension

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5
Q

Valve problem that is complication of ascending aortic aneurysm - can present with SOB?

A

aortic regurg

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6
Q

Osteolytic lesions and recurrent infections - think?

A

MM

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7
Q

Dermatitis herpetiformis - treatment (med and lifestyle)?

A

Dapsone and gluten free

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8
Q

Anemia in ESRD due to?
Replacing it causes?
And when indicated?

A

Low EPO
Worse HTN, HA, flu-like sx
when Hgb <10

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9
Q

Leukocyte alk phos score in CML - high or low?

A

low

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10
Q

Hematuria with proteinuria and RBC casts (or dysmorphic RBCs)- problem likely to be in what part of kidney?

A

glomerulus

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11
Q

Pulm infx withverruocus nodules and plaques preogressing to micro abscesses - what fungus?

A

Blastomycosis

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12
Q

HIT increases or decreased clot risk?

A

way increases

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13
Q

First lien intervention for V-fib or pulseless VTach?

A

defibrillation

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14
Q

Cancer related anorexia - pharm tx?

A

progesterone analogues

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15
Q

Intra- and extrahepatic biliary tract dilation seen on imaging is suggestive of what?

A

pancreatic cancer causing obstruction

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16
Q

Zenker’s diverticulum is caused by what?

A

upper esophageal sphincter dysfunction and espophageal dysmotility

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17
Q

Tight glucose control in DM (goal of <6.5 A1C) decreases the risk of what?

A

microvascular complications (retinopathy, nephropathy etc.)

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18
Q

Toxin in reheated rice?

A

Bacillus cereus

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19
Q

How do nitrates relive chest pain?

A

systemic vasodilation lowers preload and thus LV end-dilatolic volume thus lowering wall stress and myocardial O2 demand

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20
Q

Postoperative patient with hypotension, JVD, new-onset right bundle branch blick (right heart strain) - think?

A

Massive PE

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21
Q

Best diagnostic imaging for suspected AAA?

A

Abd US (nearly 100% spec and sens)

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22
Q

Toxicity risk with prolonged infusion of nitroprusside (esp with CKD patients), presenting with HA, confusion, arrythmia, flushing and resp depression, AMS, seizures and coma?

A

Cyanide tox

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23
Q

BILATERAL progressive loss of CENTRAL vision - think?

A

Macular degen

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24
Q

Watery diarrhea in HIV - likley bug?
Bloody diarrhea, and CD4 <50?
So test for what?

A

cryptosporidium
CMV
retinitis

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25
Heberden's and Bouchard's nodes are present in OA but which proximal and which distal?
Bouchard prox, Heberden distal | becasue H is distal to the beginning of the alphabet
26
Sever asthma attack - when pCO2 starts to normalize or get high - good or bad sign? What do you do?
V bad | Intubate as sign of impending resp failure
27
Amiodarone can cause digoxin tox if used together - how does it present (acute and chronic)?
GI sx acutely, then neuro and visual sx chronically
28
Pancreatic cancer where is the mass if there's jaundice, and no jaundice?
Jaundice - head of pancreas | No jaundice: body/tail
29
Diarrhea and abd pain, with arthralgias, weight loss, fever, sometimes hyperpigmentation, WITH PAS POSITIVE material in LAMINA PROPRIA - think?
Whipple's dz
30
What can make Graves worse by increasing TRAB levels? | Do steroids help?
Radioactive iodine | They can
31
Essential hypertension in a young person (sloping ST depression, T wave inversion on EKG) - with EPISTAXIS or asymptomatic - think?
coarctation of aorta
32
Acute Liver Failure and dz is worsening or not improving - what do you do?
transplant
33
Hyponatremia with very concentrated urine while taking an SSRI - liekly to be?
SIADH
34
Strep mutans is what kind of strep found where?
Viridans, oral cavity
35
Post-vrial staph auresu PNA - possible characteristic lung CXR finding?
multilobar cavitary infiltrates
36
Common joint related complication of steroid use, foten presenting with progressive hip pain?
avascular necrosis
37
``` porcelain gallbladder (calcified on imaging) increases risk for? Tx? ```
gallbladder adenocarcinoma | cholecystectomy
38
3 causes of transudative effusion?
decreased intrapleural pressure decreased plasma oncotic presure increased hydrostatic pressure
39
2 causes of exudative effusion?
increased capillary/pleural membrane permeability | disruption to lymphtic outflow
40
A-fib in hemodyanmically unstable patient - next step? | In stable?
cardioversion | rate or rhythm control (metop, dilt, vera or amiodarone etc.)
41
A-fib in hemodyanmically unstable patient - next step? | In stable?
cardioversion | rate or rhythm control (metop, dilt, vera or amiodarone etc.)
42
Free air under diaphragm (pneumoperitonitis) with epigastirc pain - think?
perfed ulcer (PUD)
43
Do you ever need to screen for bladder cancer?
NEVER!
44
Heart ausculatation finding that correlates with high BNP in HF?
S3
45
Diuretics associated with hyperglycemia and and hyperlipidemia, and hyperuricemia (and hypercalcemia)? What happens to Na, K, and Mg?
thiazide | all low
46
Vasospastic angina (occuring in sleep, ST elevations but no CAD on angiograpy) - tx?
CCBs to prevent, NG to abort
47
Vasospastic angina (occuring in sleep) - tx?
CCBs to prevent, NG to abort
48
Knee pain with "soap bubble" on x-ray (eccentric lytic area) - think?
Giant cell tumor
49
Small tonsils and lymph nodes - what immune probelm?
Bruton
50
Treatment for myasthenic crisis (reps failure in myasthenia gravis)?
intubate, plasmapheresis or IVIG, then steroids
51
What heparin OK for ESRD?
unfractionated
52
Acromegaly - initial test?
IGF1
53
Top cause of SVC syndrome?
malignancy
54
Guillain Barre CSF finding?
Incr protein with normal everything esle
55
IIH/psuedotumor cerebri etc. tx?
acetazolamide
56
Cephalohematoma vs caput - whitch crosses suture lines?
Caput Crosses (hard C)
57
CNIII (down and out) palsy in diabetics due to what?
ischemic neuropathy
58
Left hemineglect - brain area?
right parietal
59
Tay Sachs vs Niemann Pick - both have red eyes spots but which one has hepatomegaly? And reflex difference? And enzymes?
NPD NPD - hyper, TS - areflexia NPD - sphingomyelinase, TS - hexosaminidase
60
Corneal abrasion on exam, but no pain or gritty sensation - which nerve?
opthalmic branch of trigeminal (V1)
61
Parkinson's gait, festinating and hypokinetic but broad or narrow bsed?
narrow
62
BILATERAL trigeminal neuralgia - suspect what?
MS
63
Traumatic (hyperextension) nerve injury to suspect in an elderly patient with spondylosis?
Central cord syndrome
64
Areflexic weakness in UE and cape of sesnory loss - think? | Path?
syringomyelia | fluid filled cavity in center of spinal cord
65
Niklosky sign in scarlet fever (strep) vs staph scalded skin?
present in scalded, not in scarlet
66
CD19 marker for what? | CD3 marker for what?
B cell, T cell
67
SCID tx?
stem cell transplant
68
Sarcoidosis tx?
steroids
69
CLL diagnostic test?
peripheral blood flow cytometry for clonality of mature B cells (not lymphnode bx)
70
No fever suggests reactive arthritis vs gonococcal - pharm tx?
NSAIDs
71
Perciardial calcifications on chest radiograph - diagnx?
CONTRICTIVE pericarditis
72
Infective endocarditis - tx? | Get the heparin on early?
ABX | NO early heparin, increases head bleed risk
73
how to tell difference between intra/extra peritoneal bladder injury?
intra would have peritoneal signs
74
Atypical glandular cells on pap - next step?
endometiral biopsy
75
Cyanotic infant with left axis deviation of EKG (and decreased pulmonary markings) - diagnx?
tricupsid atresia
76
Prader Willi deletion?
Paternal deletion
77
Malrotation/volvulus best test?
Upper GI series
78
Probable toxic ingestion of acetaminophen - next step?
gastric decontamination (charcoal ) and measurement of aceta levels
79
Pain and stiffnes in neck, shoudler, hips, patient >50, elveated ESR - think? treat?
polymylagia rheumatica | low dose steroids
80
Chest Xray in tamponade looks ....
NORMAL!
81
In Brown sequard where does the contralateral deficit start?
1-2 levels beneath
82
Abdominal ausculatation gives systolic-diastolic bruit (can be upper abd too) - think?
renal stenosis
83
Can Xrays be normal in osteonecrosis?
yup
84
Age of woman with struma ovarii thyrotoxicosis? | Tye of tumor?
>40 | teratoma
85
Boys 4-10 with limp (osteonecrosis of hip) - diagnx?
Legg Calves Perthes
86
TSH level in prolcatinoma? | PRL level?
Normal | >200

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