Missed questions Flashcards
(177 cards)
1
Q
Drugs that cause folic acid deficiency
A
Phenytoin
Trimethoprim (dihydrofolate reductase)
Methotrexate (DHFR) leucovorin rescue
2
Q
Pruritis after shower, dizziness, headache, HTN, facial plethora, hypercellular BM
A
PCV
- Primary = LOW EPO, JAK2 mutation
- Secondary = Normal/high EPO, hypoxemia, renal tumor, hepatic tumor, testosterone replacement
- can precipitate GOUT attack
3
Q
Immune-mediated drug reaction by captopril
A
Membranous GN
4
Q
35 weeks gestation, HTN, dec urinary output, thrombocytopenia
A
Preeclampsia w/ severe features (pul edema, LFTs, SBP >160, inc Cr) –> hydralazine or labetalol then mag sulfate
5
Q
93 y/o vaginal bleeding, odor, mass, no mets
A
SCC –> resect 2cm or poor surgical candidate
Combination chemotherapy stage III, IV
6
Q
High non-response rate, use only hospital-based patients, loss of study patients type of bias
A
Selection bias
7
Q
Improves mortality in CHF
A
ACE, BBs, spironolactone
8
Q
Exudative pleural effusions
A
Protein >0.5, LDH >0.6 that of normal
Infection, auto-immune, neoplasm
INC CAPILLARY PERMEABILITY
9
Q
Low TSH, high T4, T3, no signs of Grave disease, low RAIU
A
Facticious or exogenous thyrotoxicosis = LOW serum thyroglobulin
10
Q
Low TSH, high T4, T3, no signs of Grave disease, high RAIU
A
Diffuse = Grave Nodular = toxic adenoma or mulitnodular goiter
11
Q
Tachycardia with buried P-waves, chest pain, diaphoresis, normal BP, hx anxiety, dizziness
A
SVT = Adenosine
12
Q
Bone pain, difficulty walking, cramps, pseudofractures
A
Osteomalacia = INC PTH, alk phos + LOW Ca, phos, 25D-OH
- malabs, chronic liver, kidney, intestinal bypass, celiac
- # 1 = vit d deficiency
13
Q
Fever, back pain w/ local tenderness, recent UTI, NO leukocytosis, INC ESR/CRP, normal x-rays
A
Osteomyelitis –> MRI –> CT guided aspiration
14
Q
White edematous retina following retinal arterioles, curtain falling over eye
A
Retinal emboli –> carotid doppler
15
Q
Painless loss of vision, boxcar segmentation, cherry fovea, pallor or hyperemic disc
A
CRAO
16
Q
Mallory bodies and neutrophilic infiltrate on liver bx
A
Alcoholic hepatitis = completely reversible w/ etOH cessation
Regenerative nodules = cirrhosis = irreversible
17
Q
Encapsulated yeast
A
Cryptococcus neoformans = amphotericin B + flucytosine –> fluconazole for 1 yr
Itraconazole does NOT cross BBB
18
Q
DOC for Lyme disease < 8/yo
A
Amoxicillin or cefuroxime
19
Q
HIV pt, pancytopenia, palatal ulcers, hepatosplenomegaly, intetstitial pneumonitis
A
Histoplasma
20
Q
New DOE, swelling of head, neck, arms, plethora of face, no LE edema, ascities
A
SVC syndrome –> CXR for NHL or lung CA
21
Q
DVT –> heparin therapy –> 6th day new right sided weakness, aphasia, 50,000 platelets, skin necrosis, normal CT, heart RRR, no fibrin split products
A
HIT type 2 (antibody platelet activation)
- –> binds PF4 –> IgG –> activates Fc receptor leading to platelet activation
- –> ARTERIAL or venous THROMBOSIS
22
Q
HIV esophagitis work-up
A
- Candida –> oral fluconazole
- esophagoscopy + bx, cytology, culture w/o improvement
HSV = round/ovoid ulcers + perioral ulcers CMV = linear ulcers
23
Q
Common findings in anorexic patients
A
- Osteoporosis
- Elevated cholesterol and carotene
- Prolonged QT
- Euthyroid sick syndrome
- HPA axis - amenorrhea, anovulation, dec estrogen
- HypoNa
- Small for gestational age baby, intellectual impairment, miscarriage, depression, hyperemesis, c/s
24
Q
Southern US + tick bite + thrombocytopenia + leukopenia, fever, malaise, inc LFTs, inc LDH, intracytoplasmic morulae
A
Ehrlichiosis –> doxycycline
25
32 w/ hx seizures, migraines, bipolar --> slurred speech, very drowsy, unsteady gait, normal resp, normal pupils, no nystagmus
Benzo overdose
26
65 w/ PNA sx + very high WBC, 84% lymphocytes w/ smudge cells."
CLL --> flow cytometry
27
RBCs 1-6hrs later fever, chills, malaise
Nonhemolytic transfusion rxn = leukoreduction (red HLA, CMV)
Anaphylaxis w/ PRBCs = IgA deficiency = wash cells 1st
28
Eczematous, itchy rash over nipple, no other hx of skin problems
Paget disease of breast = underlying adenocarcinoma
29
Truncus arteriosus, micrognathia, no thymus, cleft lip
DiGeorge = hypoCa
30
Thickening of pre-vertebral tissues, neck pain, fever next step
IV abx, IVFs & surgical drainage
31
Uncontrolled DM, weight loss, neuropathy, 3months of N/V, dec appetite
Gastroparesis ---> gastric scintography
32
1. Hepatitis uses reverse transcriptase
| 2. Hepatitis coats itself in LDL
1. HBV
| 2. HCV --> IF-a
33
Infective endocarditis bugs
1. dentition
2. IVDU
3. UTI
1. HACEK group, strep viridan/sanguis
2. SA, staph epi/CoagN
3. Enterococcus faecalis
34
Tx of hypercalcemia
```
Asx = avoid thiazides, lithium, dehydration
Sx = nothing immediate or see severe
Severe/malignancy = NS + calcitonin short term --> zoledronic acid long term
Granulomatous = steroids to reduce VitD
```
35
Shoulder dystocia --> extended forearm, MCP, flexed PIP/DIPs, horner syndrome, ABSENT grasp reflex
C8, T1 injury = Klumpe's palsy
| ---> massage and gentle PT
36
COPD w/ inhaled salmeterol, duonebs, theophylline --> recent URI w/ cipro --> HA, N/V, insomnia, multifocal atrial tachycardia
Theophylline toxicity --> check serum level
37
1st febrile UTI <24mo work-up
7-14d abx
| renal and bladder US (also if recurrent or do not respond to abx)
38
Physiology of CHF w/ peripheral edema
Dec circulating BV --> inc angiotensin & aldosterone release --> *constrict renal arterioles* & reabsorb salt and water --> increased BV which exacerbates CHF further
39
Muscle aches and pains, HIGHLY ELEVATED CPK, mild elevation in LFTs
Stop statins - muscle injury --> rhabdomyolysis & RF
40
Hazard ratio >1
More likely to occur in tx group
1 = no difference
<1 = more likely in control
41
Teen, gradual difficulty walking, speech problems, falling down, scoliosis, hammer toes
Freidrich ataxia
| - Cardiomyopathy --> death
42
Gestational bleeding
1. HTN, contractions
2. Painless, C/S, smoking, multiple gestation
3. Painless bleeding + rapidly deteriorating fetal tones
1. Abruption
2. Previa
3. Vasa previa
43
Young obese female on OCPs, steroids, Vit A, tetracycline, has dull HA for 3 weeks, papilledema
Benign intracranial HTN --> blindness
| 1. weight reduction, *acetazolamide* then shunt and optic nerve fenestration
44
A.A. woman with pelvic heaviness + constipation + urinary frequency and posterior uterine mass and enlargement and HEAVY, prolonged periods WITHOUT spotting
Uterine leiomyoma/fibroid
45
Hypotension, bradycardia, cold, clammy, AV block - unresponsive to IVFs and atropine
Glucagon
| - BB overdose (w/ wheezing), CCBs
46
A.A. male w/ fam hx of fatal blood disorder, recurrent otitis media, HAV --> nocturia, frequency
Hyposthenuria - sickling in vasa recta impairs water re-absorption
47
HSM, anemia, thrombocytopenia, night sweats, HA, dizziness, visual problems, pain and numbness in extremities, IgM spike
Waldenstrom's macroglobulinemia
- MM have IgG or IgA
- MGUS = Asx
48
Winter's formula for acid-base compensation
PCO2 = 1.5 (HCO3-) + 8
49
Post- transplant fever, chills, sputum production + RLL consolidation + branching, beaded gram + rods
Nocardiosis (partially acid-fast) ---> TMP-SMX
50
Anterior MI + muffled heart sounds, S3, bibasilar crackles and dyspnea next step
Flash pulmonary edema --> lasix --> dec preload, pulm capillary pressure
Avoid BBs in this setting
51
When can exposure odds ratio from a case-control study = relative risk?
Prevalence of disease is low
52
S/P CABG with ventricular rhythm narrow QRS irregular tachycardia, hypotensive
AFIB --> DC cardioversion
53
Failure to pass meconium, 1st step XR --> marked bowel dilation & r/o pneumoperitoneum next step
Contrast enema --> microcolon for CF --> Gastrografin enema
54
Central/above pons Facial nerve palsy vs. peripheral/below pons
Central = CL weakness + preserved forehead, eyebrow, eyelid function
55
Co-morbidities in Turner syndrome
Osteoporosis
Coarctation of aorta
Congenital lymphedema (non pitting), short 4th digit, nail dysplasia, horseshoe kidney
56
Young male anterior mediastinal mass + bHCG + AFP
NON-seminimatous germ cell tumor (AFP+)
57
Acyclovir + acute renal failure cause
Insoluble --> crystalluria --> renal tubular OBSTRUCTION
58
Mood disorder and paranoia, hallucinations --> mood improves but paranoia remains
Schizoaffective disorder
59
Tx OCD
SSRIs
60
When to hospitalize anorexic pt
Dehydration, hypoK, hypoPhos, bradycardia, severe weight loss ---> refeeding syndrome w/ electrolyte abn, arrhythmia and heart failure
61
Tx in anorexia and bulimia
1st is nutritional and CBT
Buproprion is CI d/t SEIZURE
```
anorexia = olanzapine
bulimia = SSRI
```
62
Dysparenunia, dysmenorrhea, DYSCHEZIA, cyclical pelvic pain, infertility, CMT
Endometriosis --> OCPs + NSAIDs
Unrelieved --> laparoscopy
63
Precursor to GB adenocarcinoma
Porcelain gallbladder
64
Cyanotic infant w/ LEFT axis deviation, no R waves in precordial leads, dec pulmonary markings, tall peaked P waves, LLSB holosystolic murmur
Tricuspid valve atresia
65
Conservative vs. laparoscopy in SBO
Laparoscopy
| - tachycardia, leukocytosis, fever, acidosis, peritoneal signs
66
Inc QRS from 0.8 --> 0.13 with inc HR during stress test result of what drug?
Flecainide
- ventricular arrhythmia and SVTs like AFIB
- use-dependence block of Na channels
67
Post-partum patient, fever, chills, WBC 11,000, uterus firm, non-tender, bloody discharge with clots --> pale --> yellow/white next step
Reassurance
- lochia foul smelling = endometritis
- fever normal in first 24hrs or so
68
HL treated 20 years ago w/ chemo and radiation --> now circular mass on xray dx?
Secondary malignancy
| - also breast, thyroid, bone, GI
69
Russian immigrant, fatigue, cough, fever, weight loss, upper lung lesion + hyperNa, hypoK, hypoglycemia, eosinophilia acid-base abnormality?
Normal anion gap metabolic acidosis d/t primary adrenal insufficiency
70
Mechanism of hypoxia in pt with AIDS, interstitial crackles
PCP --> Dec A-a oxygen gradient
71
HIV pt with hearing loss + dull hypomobile TM
Serous/non-infectious otitis media
| - HIV LAD or obstructing lymphoma
72
Manic episode on Lithium + high-risk behaviors, no drug use
Anti-psychotic + hospitalization --> check lithium level
73
Tx duodenal hematoma
NG tube + TPN ---> resolves in 1-2wks
74
2x2cm midline, hard, non-mobile mass on hard palate, no drug use
Torus palatinus = congenital
75
Lack of fetal movement felt for 2 days next steps + no doppler tones
Ultrasound for fetal heart movement --> autopsy to identify cause
76
SLE on prednisone, normal menstruation, monomorphous pink papules w/o comedones
Steroid acne
77
U/L cervical adenitis in kid, no pet or TB exposure = tx?
I&D + Clindamycin
| - staph and strep #1
78
Kid w/ fever, nasal discharge, fatigue + 2+ urine protein, no other abn
Repeat dip w/ >2 specimens
| Normal proteinuria in kids - fever, exercise, stress, dehydration
79
Prevent hemorrhagic cystitis w/ chemo
Mesna = d/t cyclophosphamide
80
HSM, cervical LAD, hypotonia, regression of milestones, cherry red macula
Niemann-pick = sphingomyelinase
Tay-sachs = Hyperacusis and seizures
81
Wide matching QRS complex @ 100bpm following MI, stable patient next step
Sustained monomorphic V-tach
- stable = amiodarone
- unstable = cardioversion
If narrow PSVT = carotid massage, cold water immersion = affects AV node conductivity
82
Precocious puberty, large cafe-au-lait spots w/ irregular borders, multiple bone defects, moon-like face
McCune-Albright
- Precocious puberty
- Pigmentation
- Polyostotic fibrous dysplasia
83
DMARD SEs
1. MTX
2. Hydroxychloroquine
3. TNF-a
1. Liver, oral ulcers/stomatitis, cytopenia, alopecia
2. Retinopathy
3. Infection/TB, malignancy, CHF
84
HIV + acid-fast oocysts in stool + diarrhea
Cryptosporidium parvum >>> Isospera belli
85
How to unmask confounding variables
stratified analysis - etOH vs. non-etOH vs. smoking and non-smoking --> cirrhosis
86
Watery diarrhea, flushing, valvular heart disease
Carcinoid syndrome
| - tryptophan --> serotonin production in carcinoid INSTEAD of ---> NIACIN
87
Pyogenic liver abscess bug
Bacteroides
88
Test sensitive for rotator cuff pathology besides arm drop
Neer test - affected limb's hand to opposite should and raise elbow --> pain --> inject lidocaine for relief
89
Kid DM-1 + weight loss, low MCV anemia, erythematous vesicles on extensor surfaces, stool occult (-)
Celiac - anti-tissue transglutaminase ab
90
#1 complication of sickle cell TRAIT
Hematuria
| - also isothenuria --> polyuria, nocturia
91
Tx endometritis
Polymicrobial = Clinda + Gent
92
Re-warm frostbite
Warm water
93
#1 injury in supracondylar fx
Brachial artery
94
Chronic HA + painless hematuria cause?
Papillary necrosis d/t analgesic nephropathy - vasoconstriction in vasa recta
95
Address anxiety by substituting behavior that is the exact opposite of own unacceptable feelings
Reaction formation
96
Double vision after reading, cramps in jaw after chewing a steak, voice/throat funny after talking on the phone for a while, normal CPK, normal reflexes
Myasthenia gravis --> CT chest to r/o thymoma
97
Signs of cholinergic toxicity/organophosphate poisoning
Bradycardia, miosis, fasciulations, salivation, lacrimation, diarrhea, urination ---> atropine & remove clothing
98
Older man w/ back pain w/ normal exam + anemia, Inc Cr, Inc Ca, Inc ESR, Inc total protein w/ normal albumin
Multiple myeloma --> serum immunoelectrophoresis
99
Nagging epigastric pain + weight loss, jaundice, food intolerance, enlarged non-tender GB
Pancreatic CA = dilation of intra and extrahepatic ducts
100
Cafe au lait, macrocephaly, feeding problems, optic glima, short stature and learning disabilities
NF-1
101
Number needed to treat
1/ARR
102
S3
Elevated LV filling pressure = CHF
103
Homeless man hematuria, flank pain, ARF, hypoCa, metabolic acidosis
Ethylene glycol intoxication --> fomepizole
104
Inc leukocyte alkaline phosphatase
Leukemoid rxn d/t infection or inflammation
105
1st step in torticollis?
XR to r/o AA subluxation, retropharyngeal abscess
106
Prurititis at night in middle aged woman, destruction of intrahepatic bile ducts, IgM, xanthelasmas
PBC = anti-mitochondrial abs ---> UDCA
107
20+ yr Ankylosing spondylitis + fall --> severe back pain dx?
Vertebral fx
108
Hypertonia, hyperreflexia in legs b/l, feet pointing down and in in newborn infant
Cerebral palsy = PREMATURITY infection, hemorrhage, drug esp in pt with no dystrophic features
109
HA, retro-orbital eye pain, blurred vision, constipation, urinary retention in Parkinson pt d/t what med?
Trihexyphenidyl - anti-cholinergic excess with acute glaucoma
110
Complication following infectious mononucleosis
Auto-immune hemolytic anemia & thrombocytopenia d/t IgM cold agglutinin + anti-I antibodies (Coombs +)
111
Test for lactose intolerance
Hydrogen breath test
112
Hexagonal urine crystals + positive urine nitroprusside
Cystinuria - amino acid transport
113
IE w/ strep mutans highly susceptible to PCN drugs of choice
IV PCN G or IV ceftriaxone, NOT oral
114
Tx hypovolemic hyperNa
NS
115
External effect + or - affects outcome (family hx)
Effect modification (Vs.confounding)
116
Cough, hemoptysis, chronic purulent rhinosinusitis, ulcer with rolled, undermined borders on leg , RBC casts, protienuria
Wegeners - cyclophosphamide
117
Flank pain w/ crohn disease or other fat malabsorption syndrome
Hyperoxaluria - Ca binds excess fat in gut and not oxalate
118
Effect of BB therapy in Pheochromocytoma
Rapid increase in BP d/t unopposed alpha vasoconstriction
119
Chest pain, NSTEMI, dilated pupils, atrophic nasal mucosa
Cocaine use --> benzo then aspirin, nitrates and CCBs
BBs are CI
120
PPx for uric acid stones
Hydration
| Potassium citrate to alkalinize urine
121
Sequelae of seizures >5 min, status epileptics, recurrent seizures etc
Cortical atrophy/laminar necrosis - hyper intensity on MRI
122
Spherocytosis
+ Coombs
- Coombs
Auto-immune hemolytic - warm (IgG)
| Hereditary - osmotic fragility
123
Leukocytosis, inc segmented neutrophils, bands, older woman w/ weight loss & night sweats
CML = LOW leukocyte alkaline phosphatase + Philadelphia Chr
124
Hearing loss, tinnitus, hold cell phone in other ear, EAR FULLNESS, spinning for 1-2hrs
Meniere disease - endolymph, inner ear disease
125
Kidney finding w/ HBV
Membranous
126
Cause of distended bowels s/p vertebral fx or retro peritoneal hemorrhage, absent bowel sounds
Paralytic ileus
Pseudo-obstruction = only large bowel dilated, tympanic hyper bowel sounds
127
Inc ventricular wall thickness w/ normal dimensions, easy bruising, normotensive, protienuria, waxy thickening of skin + diastolic CHF
Amyloidosis - tissue bx abd fat pad
128
Precocious puberty or regression of menopausal sx + bleeding + estrogen producing (breast, hair development) U/L solid pelvic mass
Granulosa cell tumor
Sertoli-leydig produce masculinization
129
Pre-menopausal woman done having children w/ complex hyperplasia w/o atypia next step?
Cyclic progestin
130
Psoas abscess 1st step?
CT abd
(-) CT --> laparoscopy
Percutaneous drainage
Hematogenous spread from skin = SA
131
HOCM murmur and tx
INC w/ standing or valsalva = dec VR/preload
| Tx = BBs or diltiazem to slow HR and prolong diastole for better filling
132
Broad flat t-waves, U-waves, ST-depression, weakness, fatigue, muscle cramps cause
HypoK
133
Isolated systolic HTN cause
Rigid arterial walls/decreased elasticity
134
anti-CCP abs
RA
135
HIV, A.A, nephropathy
FSGS
136
HBV nephropathy
Membranous
137
HCV, jaundice, confused, lowNa and K, Normal UA, Cr 3.5 --> NS bolus has no chg in Cr
Hepatorenal syndrome --> infection, hemorrhage & death
LIVER TRANSPLANT
138
Tx HyperNa
```
Euvolemic = water
Hypovolemic = NS then D5W
```
139
Mech of CO hypoxia, acidosis
Dec DELIVERY of O2 to tissues - unable to unload O2
140
Young school teacher w/ acute symmetric b/l arthritis of MCP, PIP, wrists, knees, morning stiffness 10-15min
B19 infection
141
Tx acute HBV
Normal = IF-a
W/ HIV not on therapy = IF-a + emtracitabine + tenofovir
W/ HIV on therpay = lamivudine + adenofovir
142
Next step w/ LSIL
```
25-29 = colpo
>30 = HPV --> colpo of +
```
143
Human & animal bite drug tx
Augmentin
| Clinda + cipro if allergic
144
RAIU findings w/ hyperthyroidism
1. Heterogenous
2. Homogenous
3. Focal
4. NO uptake
1. Toxic multinodular/Plummer's disease
2. Grave
3. Functioning Adenoma
4. Facticia or exogenous like struma ovarii or subacute thyroiditis
145
Cause of type 1 RTA
Non-anion gap metabolic alkalosis
Seen in Sjogren syndrome --> kidney stones
Distal tubule can't excrete H+ --> high urine pH >5.5
146
Cause of type 2 RTA
Non-anion gap metabolic alkalosis
Proximal tubule can't re-abs PHOSPHATE, normal urine pH
147
Cause of type 4 RTA
Can't secret K+ = lost effect of aldosterone --> HYPOTENSION
148
Nail finding w/ psoriasis
Onycholysis
149
Thin concave nails w/ raised ridges cause
Koilonchyia - iron deficiency
150
Work-up for Neutropenic fever
Blood, urine, sputum cultures & CXR --> Pip/tazo
Fever after abx = fungal --> amphotericin B
151
Poisonings
1. HA, convulsions, GARLIC breath
2. Bitter almond breath
3. Hyperhidrosis, narrow vision, tachy, HTN, neuropathy
4. Salivation, lacrimation, urination, blurred vision, brady
1. Arsenic
2. Cyanide --> amyl nitrite or thiosulfate
3. Mercury --> succimer, dimercaprol, penacillamine
4. Organophosphate --> atropine
152
Anemia in CKD/RF/ESRD
EPO deficiency - normocytic, normochromic
<30
SE - HTN, HA, flu
153
Infusion reactions
1. F/C w/in 6hrs
2. Fever, flank pain, DIC, RF w/in 1hr
3. Fever, anemia 2-10 after infusion
4. Angioedema, RDS w/in seconds
5. Urticaria, flushing w/in hours
6. RDS, pulmonary edema w/in 6hrs
1. Febrile non-hemolytic (#1) = cytokines in stored blood
2. Acute hemolytic = ABO mismatch, + Coombs
3. Delayed hemolytic = anamnestic ab response
4. Anaphylaxis = IgA deficiency
5. Allergic = Recipient IgE
6. TRALI = donor anti-leukocyte abs
154
Erythema multiforme vs.
| SJS
Erythema multiforme - follows HSV infection, sudden targetoid lesions
SJS - sulfa, NSAIDs, phenytoin, sudden targetoid lesions + MUCOSAL involvement, AMS, hypotension, conjunctivitis, fever
155
Young male, morning back stiffness, bloody diarrhea, painful nodules on shins, anemia, P-ANCA
IBD - UC
156
Whipple procedure
Pancreatic CA in head
| - remove pancreas, GB, duodenum, proximal jejunum and distal stomach
157
Next step in pt with atypical glandular cells (AGC) on cervical cytology
Colposcopy + endometrial bx
| - AGC much more likely to be malignant and squamous cells
158
Goal BP for ppl >60 y/o
150/90
159
Night time teeth grinding + ear pain
TMJ dysfunction
160
Zoster + Bell Palsy
Ramsay-Hunt syndrome
161
Fasted --> large meal + RUQ pain, N/V cause
Biliary colic = viscous distention
162
Fxn of hormones during pregnancy
1. hcg
2. progesterone
3. estrogen
1. Maintain corpus luteum
2. Inhibit contractions
3. Stimulate prolactin
163
Infant w/ vomiting, poor weight gain, hypoglycemia, cataracts
Galactosemia = G1P-uridyl transferase deficiency
ONLY cataracts = galactokinase
164
CT w/ multiple hypodense, non-enhancing lesions w/ no mass effect in HIV pt
PML
165
CT w/ multiple ring-enhancing lesions in the basal ganglia
Toxo
166
CT w/ solitary, weakly-enhancing ring lesion, periventricular
Primary CNS Lymphoma = EBV DNA
167
LOW RAIU causes
```
Subacute painless thyroiditis
Subacute granulomatous thyroiditis (DeQuervain)
Iodine-induced
Levothyroxine OD
Struma ovarii
```
168
Age of spontaneous closure of umbilical hernia
1yr
| 3-4yrs, >2cm, larger = surgery
169
Enlarged rubbery goiter w/ anti-TPO abs sequelae?
Hashimoto --> LYMPHOMA
| - suspect w/ rapid enlargement of thyroid, compressive sx, pseudocystic pattern on US
170
Conditions w/ inc BUN/Cr
Pre-renal renal failure
GI bleed
Steroids
171
Restrictions in exercise when pregnant
Multiple gestation, previa, aburption, fluid leak, preeclampsia
No contact, high fall risk, scuba, hot yoga
172
Correct hypoNa too quickly -->?
Central pontine myelinolysis
173
Tx social anxiety
1. Generalized - going to a party, meeting new people
2. Performance - public speaking
1. SSRI
| 2. BB or benzo
174
HIV pt, w/ rapid necrotizing retinitis, painful visual loss cause
HSV
CMV = painLESS, fluffy, granular lesions
175
#1 cause of large bowel obstruction
Neoplasm
176
Repeated miscarriages with cervical dilation
Cervical incompetence - DES --> adenocarcinoma of vagina
| -Cerclage placement
177
Spinal shock vs. neurogenic shock
Spinal shock = ABSENT bulbocavernosus reflex
It is present in SC damage - neurogenic shock
