Notes Flashcards
(194 cards)
1
Q
Glucosuria is ____ in pregnancy
A
Glucosuria is normal in pregnancy
2
Q
High levels of HbA2 + hypochromic anemia suggests _____
A
High levels of HbA2 + hypochromic anemia suggests Thalassemia
3
Q
Mathe test:
A
Mathe test: kidney not moving in inspiration in a perinephric abscess.
4
Q
Adjunctive Tx in resistant depression?
A
Lithium, 2nd gen antipsychotics, and triiodothyronine are adjunctive Tx in resistant depression.
5
Q
Screening for ASx bacteuria is done in ____
A
Screening for ASx bacteuria is done in pregnant, renal transplant, and immunocompromised patients.
6
Q
Immunization against HBV:
A
Immunization against HBV: Anti-HBs (+), all the rest are negative
7
Q
Breast milk is deficient in _____
A
Breast milk is deficient in vitamin D
8
Q
Freckling in the axila =
A
Freckling in the axila = neurofibromatosis type 1
9
Q
Hakim triad:
- Neurocognitive disorder
- Urinary incontinence
- abnormal gait
A
Normal-pressure hydrocephalus
10
Q
Management for chronic insomnia.
A
Cognitive behavioural stress management is the best management for chronic insomnia.
11
Q
MTDZ and ceftriaxone are ______ in breastfeeding women
A
MTDZ and ceftriaxone are contraindicated in breastfeeding women
12
Q
HLA-B27 –> PAIR
A
HLA-B27 –> PAIR Psoriatic arthritis, Ankylosis spondylitis, IBD, Reactive arthritis
13
Q
Eczema + malabsorption syndrome =
A
Eczema + malabsorption syndrome = Celiac disease (dx IgA transglutaminase)
14
Q
PPIs impair the absorption of ____
A
PPIs impair the absorption of Ca++
15
Q
Neonate HR < 60 =
A
Neonate HR < 60 = compressions
16
Q
Amenorrhea + hypergonadotropism + hypoestrogenism =
A
Amenorrhea + hypergonadotropism + hypoestrogenism = Premature ovarian failue
17
Q
Differecnes between Oppositional defiant disorder and Conduct disorder
A
Oppositional defiant disorder fight authority DO NOT hurt peers. Conduct disorder fight authority AND hurt peers
18
Q
If ischemic stoke while on ASA–> Tx with _____
A
If stoke while on ASA–> Add dipyridamole to ASA
19
Q
Corticoid regimes that are more likely to suppress the axis?
A
Late night doses of corticoid are more likely to suppress the axis
20
Q
Memory loss, changes in personality, changes in behaviour, aggression –>
A
Memory loss, changes in personality, changes in behaviour, aggression –> encephalitis
21
Q
Nebulized ipratropium may cause blurred vision
A
Nebulized ipratropium may cause blurred vision
22
Q
Alarm signs in irritable bowel is iron deficiency anemia
A
Alarm signs in irritable bowel is iron deficiency anemia
23
Q
Medicine wheel:
A
Medicine wheel: mental, emotional, physical, spiritual
24
Q
Most common inherited cause of intellectual disability in males. Long forehead, large ears, long face.
A
Fragile x
25
Topiramate --\> Increase risk of \_\_\_\_
Topiramate --\> Increase risk of kidney stones
26
\_\_\_\_\_\_ doses of corticoids increase the risk of suppressed adrenal secretion
Late evening doses of corticoids increase the risk of suppressed adrenal secretion
27
GERD should be managed more aggressively in males because an increased incidence of Barret's
GERD should be managed more aggressively in males because an increased incidence of Barret's
28
\_\_\_\_ levels should be normalized before hyperaldo investigations to avoid false-negative results.
K+ levels should be normalized before hyperaldo investigations to avoid false-negative results.
29
Mitral stenosis is a well-known cause of hemopthysis
Mitral stenosis is a well-known cause of hemopthysis
30
Management of 2nd or 3rd metatarsal fractures
2nd or 3rd metatarsal fractures are managed with ice, acetaminophen and resting.
31
Instrumental activities of daily living
Instrumental activities of daily living are not necessary for fundamental living but allow independence. E.g., taking meds, shopping groceries, driving.
32
Preeclampsia vs gestational HTN
* HTN after 20 weeks of gestation + poteinuria = preeclampsia
* HTN after 20 weeks of gestation - proteinuria = gestational HTN
33
Erythema nodosum + cough + travelling to wooded area =
Erithema nodosum + cough + traveling to wooded area = histoplasmosis
34
30% of turner syndrome patients have hypothyroidism.
30% of turner syndrome patients have hypothyroidism.
35
Thrombotic thrombocytopenic purpura treatment of choice is \_\_\_\_. Frist sign of improvement is \_\_\_\_\_\_
Thrombotic thrombocytopenic purpura treatment of choice plasma exchange. Frist sign of improvement is improvement of neuro sx.
36
Achilles tendon rupture --\> tx with \_\_\_\_\_\_
Achilles tendon rupture --\> tx with immobilization x 2 weeks, walking boot and physio
37
Multiple sclerosis --\> detrusor hyperactivity
Multiple sclerosis --\> detrusor hyperactivity
38
\_\_\_\_\_\_\_ are first line tx in asthma
Corticosteroids are first line tx in asthma
39
LSIL vs ASCUS
LSIL --\> Colpo or repeat in 6 months ASCUS --\> HPV-DNA or repeat in 6 months
40
Urethral syndrome
Urethral syndrome: dysuria + pyuria + negative culture. Tx: doxycycline, azithromycin, erythromycin, levofloxacin
41
Quaternary prevention:
Quaternary prevention: action taken to protect patients from medical interventions that can cause more harm than good. E.g., prevent overmedication and iatrogenic harm
42
Spherocytosis is treated with \_\_\_\_\_
Spherocytosis is treated with splenectomy
43
Avoid antibiotics in E.Choli diarrhea because of risk of release of shiga toxin
Avoid antibiotics in E.Choli diarrhea because of risk of release of shiga toxin
44
Eisenmerger syndrome has the highest mortality rates for pregnant women.
Eisenmerger syndrome has the highest mortality rates for pregnant women.
45
Neonate should gain ____ grams per day
Neonate should gain 20-30 grams per day
46
Estrogen-progesterone challenge not resulting in bleeding =
Estrogen-progesterone challenge not resulting in bleeding = asherman
47
Pain in the scrotum that is relieved with elevation =
Pain in the scrotum that is relieved with elevation = epididymitis
48
College teenager with pneumonia =
College teenager with pneumonia = mycoplasma
49
Allopurinol vs Probenecid
Allopurinol for overproducers. Probenecid is for undersecretors.
50
Prevention of contrast-induced nephropathy
Hydration + HCO3 prevent contrast-induced nephropathy
51
Pruritus when taking a shower with hot water =
Pruritus when taking a shower with hot water = Polycythemia vera
52
Niacin increases \_\_\_\_\_
Niacin increases glucose
53
Young + hypertension + enlarged kidneys + family hx of early-onset hypertension =
Young + hypertension + enlarged kidneys + family hx of early-onset hypertension = polycystic kidney disease
54
Velvelt hyperpigmentation =
Velvelt hyperpigmentation = acanthosis nigricans
55
Clostridioides difficile =
Clostridioides difficile = clostridium difficile
56
"Frozen shoulder" =
"Frozen shoulder" = adhesive capsulitis
57
Stoll culture confirms the Dx of botulism
Stoll culture confirms the Dx of botulism
58
Maternal Varicella IgG protects the baby
Maternal Varicella IgG protects the baby
59
Azathriopine's side effect is decrease of \_\_\_
Azathriopine's side effect is decrease of WBC
60
\_\_\_\_ is the most specific test to diagnose multiple myeloma
Bone marrow Bx is the most specific test to diagnose multiple myeloma
61
Secondary spontaneous pneumothorax occurs secondary to lung diseases like \_\_\_
Secondary spontaneous pneumothorax occurs secondary to lung diseases like COPD, asthma, sarcoidosis, TBC, cystic fibrosis
62
PID + sepsis/acute abdomen = Tx?
PID + sepsis/acute abdomen = surgery
63
Risk factors of transient tachypnea of the newborn.
Maternal diabetes, maternal asthma, smoking, prematurity are risk factors of transient tachypnea of the newborn.
64
Treatment of epiglotitis
Ceftriaxone is the treatment of epiglotitis
65
Tx of choise on back pain if NSAIDs don't work
Cyclobenzaprina: Tx of choise on back pain if NSAIDs don't work
66
Phase with highest drug failure rate?
Phase 2: Highest drug failure rate
67
Most common cause of lateral knee pain in athletes?
Most common cause of lateral knee pain in athletes is iliotibial band syndrome. Noble test (+)
68
Verapamil may cause hyperprolactinemia
Verapamil may cause hyperprolactinemia
69
Megacolon in a patient with ulcerative colitis = tx?
Megacolon in a patient with ulcerative colitis = urgent surgery!
70
Baby HR \< 60 --\> next step?
Baby HR \< 60 --\> compressions
71
\_\_\_\_\_ better than SSRIs in severe personality disorders
Lithium better than SSRIs in severe personality disorders
72
Take bilateral x-ray of clavicles when suspecting fracture
Take bilateral x-ray of clavicles when suspecting fracture
73
\_\_\_\_\_\_\_ are tx of choice in fistulizing Chron's
Anti-TNF (e.g., infliximab) are tx of choice in fistulizing Chron's
74
History of heart-lung transplantation + SOB, wheezing, crackles =
History of heart-lung transplantation + SOB, wheezing, crackles = Bronchiolitis obliterans
75
\_\_\_\_ meniscus tears are more common than \_\_\_\_
Medial meniscus tears are more common than lateral
76
3-16 week-old baby with conjunctivitis and respiratory symptoms =
3-16 week-old baby with conjunctivitis and respiratory symptoms = Chlamydia
77
empiric tx for bacterial infection in neonates?
Ampi+Genta are empiric tx for bacterial infection in neonates.
78
SNRIs (e.g., Venlafaxine) are a good 2nd choice for depression
SNRIs (e.g., Venlafaxine) are a good 2nd choice for depression
79
Fixed splitting of S2 is Dx of \_\_\_\_\_
Fixed splitting of S2 is Dx of atrial septal defect
80
AAA \< 5.5 are only treated conservatively.
AAA \< 5.5 are only treated conservatively.
81
Levodopa/carvidopa dose is \_\_\_\_\_
Levodopa/carvidopa dose is 1 tab (25/100mg) TID
82
The immediate cause of death on a certificate:
The immediate cause of death on a certificate: Injury or complication directly producing death.
83
Anion gap =
Anion gap = Na - (Cl + HCO3)
84
Omeprazole side effects:
Omeprazole side effects: decreased vit B12 absorption, increased risk of C dif colitis, increased risk of pneumonia, atrophic gastritis, exacerbation of lupus
85
Brain tumor most common found in ventricular system =
Brain tumor most common found in ventricular system = ependymoma
86
\_\_\_\_\_\_ has emerged as the tx of choice for social anxiety disorder
Paroxetina has emerged as the tx of choice for social anxiety disorder
87
Fothergill sign =
Fothergill sign = when an abdominal mass does not pass midline nor changes its shape with valsalva = rectus sheath hematoma
88
Antifreeze = ethylene glycol poisoning
Antifreeze = ethylene glycol poisoning
89
Antifreeze/Ethylene glycol poisoning. Acid-base abnormality
Anion gap metabolic acidosis
90
Normal anion gap =
Normal anion gap = 8-15
91
Most common cause of jaundice in pregnancy?
Viral hepatitis
92
Glasgow coma scale
Eye 4 Verbal 5 Movement 6
93
Lung tumor + PTH + keratine pearls =
SCC
94
Medication that increases risk for Achilles tendon rupture
Fluoroquinolones
95
"Snowman in storm" on CxR =
Total anomalous venous return
96
HTN in pregnancy. Tx?
Labetalol, methyldopa, nifedipine
97
Henosh-Scholein purpura aka \_\_\_
Henosh-Scholein purpura aka IgA vasculitis
98
Doxycycline is contraindicated in 2nd and 3rd trimester
Doxycycline is contraindicated in 2nd and 3rd trimester
99
Coag test in Von Willebrand
PT normal, PTT ↑/normal, BT ↑
100
Hematuria + hemoptisis =
Good-Pasteur syndrome (Dx. anti glomerular Antibodies)
101
HyperCa++, Renal failure, Anemia, Bone pain, multiple infections.
Dx and test?
Multiple myeloma; Test: Bone marrow Bx
102
Pneumonia + hypoNa + BCYE culture =
Legionella
103
Asbolute contraindication of OCPs
Migraine with aura
104
Liver anzimes in ETOH abuse
↑ALT, ↑↑AST (2 x ALT)
105
Primary amenorrhea + anosmia + normal anatomy =
Kallman syndrom (hypothalamic deficiency) Tx: GnRH
106
Kawasaki AKA \_\_\_\_\_\_\_\_
Kawasaki AKA necrotizing angiitis
107
Hypocalcemia on ECG
prolonged QT
108
Hypercalcemia on ECG
shortened QT
109
Irregularly enhancing mass on CT of brain =
glioblastoma multiforme
110
Ring-enhancing session on CT of brain =
brain abscess
111
Primary syphilis is dx with \_\_\_\_\_
Primary syphilis is dx with dark field microscopy
112
Right-lower abdominal pail + hyperCa =
ureterolithiasis
113
\_\_\_\_\_\_\_\_\_\_ are associated with higher than expected BNP levels
Female sex, old age, CKD, cirrhosis, hyperthyroidism, sepsis, HTN are associated with higher than expected BNP levels
114
_Most concerning_ Clonazepine side effect
Agranulocytosis
115
Renal U/S is recommended in children with UTI when
116
African woman + cough + rales
Sarcoidosis
117
Skin manifestations of sarcoidosis
Skin papules
Erythema nodosum
Lupus pernio
118
Initial treatment of osteoarthritis
Initial treatment of osteoarthritis are oral NSAIDs (if renal function allows) and topical NSAIDs
119
The most common infection transmitted from person to person in wrestlers is \_\_\_\_\_
The most common infection transmitted from person to person in wrestlers is herpes gladiatorum
120
Dx of Meckel's diverticulum
Technetium 99 radionucleotide scan
121
\_\_\_\_ and ____ deficiency should be investigated in celic disease
Iron and vit D deficiency should be investigated in celic disease
122
Fever headache, sore throat, tonsillar swelling, adenopathies, splenomegaly
Dx? Diagnostic test?
Mononucleosis
Test: heterophile antibody
123
Body surface area calculation for burns
124
Parkland formula
[Kg x BSA burned (2nd or 3rd degree) x 4] cc of LR
50-50 8-16
* Give 50 % in 8 hrs
* Give 50% in the next 16 hrs
125
Osborn J wave
Associated with hypothermia
126
Centor criteria
**Centor criteria:**
* no Cough +1
* Exudates +1
* Nodes +1
* Temperature +1
* Age \<14 -1; \>14 +1
Interpretation:
* \< 1: nothing it’s viral
* 2-3: rapid strep test
* \> 4: treat with Ab
127
Screening of vit D deficiency.
The _inactive_ form (**25-hydroxy vit D**) rather than the active form (1,25-hydroxy vit D) is used for screening of Vit D deficiency.
128
Antidote for beta-clocker toxicity
Glucagon
129
Result of a brain Bx in Alzheimer:
* Neurofibrillary tangles
* Amyloid plaques
* Tau proteins
130
When to intubate a patient with asthma exacerbation?
Peak expiratory flow (PEF) \< 25%
PaCO2 \> 42 mmHg
Altered mental status
131
Tetanus immunization and wound management
132
Tx of chlamydia urethritis
Single dose of azitromycin treats chlamydia urethritis
133
Most common long-term complication of bacterial meningitis is
Hearing loss
134
Displacement of tricuspid leaflets towards the apex resulting in enlarged right ventricle =
Ebstein's abnormality
135
Courvoisier sign =
palpable gallbladder in a jaundiced patient (shows obstruction of the biliary tree generally due to reasons other than gallstones
136
Kariotype in turner =
45 X0
137
Large and coarse popcorn calcifications of mammography =
Fibroadenoma (benign)
138
Most varicoceles are \_\_\_\_-sided
Most varicoceles are left-sided
139
Tension headache may be associated with insomnia
Tension headache may be associated with insomnia
140
Overweight + fatigue + abnormal uterine bleeding --\> Consider hypothiroidism as part of diferential
Overweight + fatigue + abnormal uterine bleeding --\> Consider hypothiroidism as part of diferential
141
Cushing's workup
142
Colon and breast screening guidelines
Colon
* Start: 50 yrs or 10 yrs before the Dx of a primary relative
* Stop: 75 yrs
* How: Flex sigmoidoscopy / 10 yrs; Or Fecal occult blood test / 2 yrs
Breast
* Start: 50 yrs
* Stop: 75 yrs
* How: Mamography / 2 yrs
143
Difference between schizophrenia, schizophreniform, brief psychotic episode, schizoid personality disorder, and schizoaffective
144
Late complication of epidural hematoma
Dural arteriovenous fistula
145
Lymphoma staging
146
Hydralazine is contraindicated in aortic dissection
Hydralazine is contraindicated in aortic dissection
147
Air Conduction \> Bone Conduction
Webber lateralizes to the right
Dx?
Sensorial hearing loss of left ear
148
Bone Conduction \> Air Conduction
Webber lateralizes to the right
Dx?
Conductive hearing loss of right ear
149
Investigation for Meckel diverticulum
Scintigraphy with Technetium 99 radionucleotide scan
150
Animal bite treatment
Amoxa/clavulanato
Doxycycline (if PNC allergy)
151
HTN treatmen in postpartum
Nifedipine or labetalol
152
Dark urine after trauma, infraction or muscle disease.
Dx?
Myoglobinuria
153
Relationship between HbA1C and average blood glucose
Average blood glucose (mmol/L) = (1.6 x HbA1C) - 2.6
154
Organisms that causes hand, foot, mouth disease.
Coxsackie A
155
Loss of voice but whisper is maintained
Conversion aphonia
156
Sclerodermal renal crisis is associated with
Glucocorticoid use
157
HiB vaccine is recommented for
All children at age of 2 months
158
Most common cause of infective diarrhea
Campylobacter jejuni
159
Suspicion of epiglottitis in a patient without the typical symptoms. Next step?
xR of neck
160
First-line Tx in female pattern baldness
Topical minoxidil.
Second line: finasteride
161
Prevention of Sudden infant death syndrome (SIDS)
* Back to sleep (lay infant on their back on a firm mattress)
* Turn head to each side each night to prevent flatten occiput
* Front play (supervised play)
* Don’t share bed
* Smoking cessation
* Avoid overheating and overdressing
162
Best tests to diagnose a breast mass
Core needle Bx or FNA
163
Uncorrected coagulopathy is an absolute contraindication for laparoscopy
Uncorrected coagulopathy is an absolute contraindication for laparoscopy
164
Dx tests in Zollinger-Ellinson (gastrinoma)
* Gastrin level \> 1600 (normal \< 250)
* Between 250 and 1600 Secretin stimulation test
* **_To localize the tumor:_** Somatostatin receptor Scintigraphy (SRS)
165
NNT calculation
1/ absolute risk reduction (ARR)
166
Oral treatment for acne in a pregnant patient
Erythromycin or clindamycin
167
Severly ill patient with RUQ pain, high LFTs, normal U/S
Acalculous cholecystitis
168
Differentials of PCOS
* Cushing
* Adrenal hyperplasia
* Ovarian cancer
* Adrenal neoplasm
169
History of trauma/sinusitis/surgery
+
Bulging eye, visual disturbance, pain on eye movement
Orbital cellulits
170
Murmur characteristics that should tip you off for evaluation of structural heart condition
* Increased intensity when standing
* Holocystolic murmur
* Grade 3 or +
* Harsh quality
* Abnormal S2
* Maximal intensity in upper left sternal border
* Diastolic murmur
* Systolic click
171
Treatment of choice for fistulizing Chron's
Anti-TNF (e.g., Infliximab)
172
Carbon monoxide toxicity tx
100% O2, Hyperbaric oxygen, obtain COHb
173
Tx of ADHD
Methylphenidate, anphethamine crystals
174
Constipation, weight loss, low pback pain, anemia, elevated ESR
Multiple myeloma
175
Hypoglycemia + Low Peptide C
Factitious
176
Pancreatic cancer classified as resectable on CT. Contraindicated test
Percutaneous aspiration Bx (risk of spreading cancer)
177
Pancreatic cancer classified as unresectable on CT. Next step
Percutaneous aspiration Bx (to directly confirm it is unresectable)
178
PID tx
Ceftraixone + azithromicin for patient and partner
179
Macular lesions, pale but not white, well defined but the edge is a little indistinct, rounded-oval,
Pityriasis alba (sub-acute form of dermatitis)
180
Evaluation of hearing loss in children according to age
* \< 6 months: auditory brainstem response, tympanometry, evoked potentials
* 6 months–2.5 yrs: behaviour audiometry
* 2.5–5 yrs: play audiometry
* \> 3 yrs: pure tone aidiometry
181
Rapid initial growth, then stabilization, then resolution. Presents in sun-exposed area, solitary lesion, dome-shaped, 1-2 cm, with central keratinous plug
Keratocanthoma
182
Abnormal uterine bleeding
+
U/S: globally enlarged uterus, with areas of decreased echogenicity, cystic spaces in myometrium
Adenomyosis
183
Delusion seen in schizophrenic patients when they believe a person has been replaced by a double
Capgras symdrome
184
Lofgren syndrome
Bilateral hilar lymphadenopathy
Erythema nodosum
Arthralgia
185
Cough
Plentiful, copious, foul-smelling sputum
cRx with peribronchial thickening
Bronchiectasis
Dx with High-res CT
186
Old patient, constipation, weight loss, bone pain, anemia, high ESR
Multiple myeloma
187
HIV+ patient with diarrhea. Next step?
Acid-fast stain of the stool to Dx cryptosporidium
188
HIV opportunistic infection prophylaxis
189
Patient with nephrotic syndrom who presents vomiting, flank pain, hematuria, worsening of hematuria, high LDH.
DX?
Renal vein trombosis
190
Most common microorganism causing otitis
Streptococcus penumoniae
191
Windlass test positive
Plantar fascitis
192
Tx of clostridoisdes difficile:
Stop antibioticas + oral vanco or oral fidaxomicin
193
Estimated date of term delivery by Naegele's formula:
LMP + 7 days - 3 months
194
Natalizumab (tx for MS and Chron's) may have leukoencephalopathy (cognitive impairment, behavioural changes, motor/visual disorders)
Natalizumab (tx for MS and Chron's) may have leukoencephalopathy (cognitive impairment, behavioural changes, motor/visual disorders)
