NBME 6 Flashcards Preview

Step 2 > NBME 6 > Flashcards

Flashcards in NBME 6 Deck (53)
Loading flashcards...

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


what nerve causes the eyes reactivity to light

cranial nerve 2- optic nerve


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

small bowel obstruction


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

gallstone ileus


what to do if pt has potassium level > 6.5

give calcium gluconate before they have an arrhythmia and die


patient struggles to let go of something once they grasp it

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


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


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

possible Ulcerative Colitis


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

huntingtons chorea


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)


hilar lymphadenopathy with fever plus recent travel

think TB


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

thyroid issue


any sort of abdominal bruit

renal artery stenosis likely due to atherosclerosis


what type of casts do you expect with dehydration

hyaline casts


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)


why do glucocorticoids increase wbc and pmns

glucocorticoid-induced demargination and storage pool release of segmented neutrophils


second most common cause of constrictive pericarditis

radiation therapy comes after viral/idiopathic


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


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


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

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


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



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


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


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


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

multiple myeloma


what do hiccups indicate

phrenic nerve irritation


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


patient vomiting what do you expect the problem to be

metabolic alkalosis


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

vascular ring compressing the airway


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