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Flashcards in NBME 6 Deck (53)
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1

if someone is getting peritoneal dialysis then has a fever... what do you think of

peritonitis so get a gram stain to figure out what is causing the infection

2

what nerve causes the eyes reactivity to light

cranial nerve 2- optic nerve

3

what to think of when you have cramping abdominal pain with distention and n/v

small bowel obstruction

4

what to think of when you have hyperactive bowel sounds and pneumobilia (gas in the biliary system)

gallstone ileus

5

what to do if pt has potassium level > 6.5

give calcium gluconate before they have an arrhythmia and die

6

patient struggles to let go of something once they grasp it

myotonic muscular dystrophy
CTG repeat- cataracts, toupee, gonads small

7

pt presents with horners syndrome, ipsi face and temp loss, vestibular sings, vertigo, diplopia, diminished gag reflex and cerebellar probs, what do you think of

PICA infarct which comes off of the vertebral artery

8

pregnant pt presents with diarrhea/blood in stool and weird rash, what do you think of

IBD
possible Ulcerative Colitis

9

patient has hallucinations and weird movements (vermicular movements of the tongue and bilateral writhing motions)

huntingtons chorea

10

young pt gets sick a lot with infections and has lots of pus and PMNs found with infections

chronic granulomatous disease
-deficiency of NAPDH Oxidase
-trap bacteria but cant kill it (impaired phagocytic oxidative metabolism)

11

hilar lymphadenopathy with fever plus recent travel

think TB

12

post-partum pt presets with high cholesterol, lethargy, boredom, sleep and memory issues, hypernatremia, and weight gain

thyroid issue

13

any sort of abdominal bruit

renal artery stenosis likely due to atherosclerosis

14

what type of casts do you expect with dehydration

hyaline casts

15

what do you think of when you hear widened pulse pressure in adults vs babies

adult --> aortic regurg
baby --> PDA
-close the PDA with indomethacin
-keep it open with PGE1 (alprostadil)

16

why do glucocorticoids increase wbc and pmns

glucocorticoid-induced demargination and storage pool release of segmented neutrophils

17

second most common cause of constrictive pericarditis

radiation therapy comes after viral/idiopathic

18

how to tell the difference b/w bacterial and cryptococcal meningitis

CSF glucose will be low in both but wayyyy lower in bacterial meningitis
-bacterial will also present with higher fever (103+) and more toxic appearing pt

19

lady with increased calcium and hx of cancer... what do you do

increased risk of cervical spine compression so be sure to decompress the spinal cord and use a cervical stabilizer

20

compare and contrast polymyalgia rheumatica and fibromyalgia

polymyalgia rheumatica
-proximal stiffness > pain (normal strength), fever malaise, weight loss
-associated with giant cell arteritis (increased inflammatory markers)
-rapid response to steroids

fibromyalgia
-chronic, widespread musculoskeletal pain with tender points and a little stiffness, poor sleep, cognitive dysfunction
-treat with regular exercise, antidepresants, neuropathic pain agents

21

proximal muscle weakness with endomysial inflammation and CT8-T cells
-usually on the shoulders

polymyositis

22

little baby has a problem with heart, liver, and muscles (no splenomegaly) what do you think of?

pompe disease
-lysosomal acid alpha-1,4-glucosidase deficiency

*if they have splenomegaly then think of GM1 gangliosidosis

23

severe fasting hypoglycemia with increased glycogen in the liver, gout, and hepatomegaly

increased lactate: Von Gierke disease (glucose-6-phophatase deficient)

normal lactate: Cori disease

24

muscle cramps and myoglobinuria and pt has a second-wind phenomenon when exercising due to increased muscular blood flow

McArdle disease (myophosphorylase deficiency)
-muscle cant break down glycogen

25

lytic bone lesions, hypercalcemia, anemia, and rouleaux formation on peripheral blood smear

multiple myeloma

26

what do hiccups indicate

phrenic nerve irritation

27

how to manage hyponatremia

if there are no signs of altered mental status treat conservatively with water restriction
-3% saline is only indicated for SYMPTOMATIC severe hypoNa

28

patient vomiting what do you expect the problem to be

metabolic alkalosis

29

infant presents with biphasic stridor and wheezing that gets better with neck extension

vascular ring compressing the airway

30

calcifications in...
-anterior lumbar spine
-lower thoracic spine

-anterior lumbar spine --> atherosclerosis in abdominal aorta (risk factor for AAA)
-anterior lower thoracic spine --> chronic pancreatitis