NTK2 Flashcards
(537 cards)
1
Q
Small Cell Lung Ca
A
Smoking
Centrally located
ACTH
SIADH
chemo/radiation
2
Q
less than 1 year old
bilateral symmetrical limb jerking
not generalized
no fever
dx?
imaging?
tx?
associated condition?
A
infantile spasm
EEG interictal
tx: ACTH
can be associated with tuberous sclerosis
3
Q
Narcolepsy associated with low CSF levels of what?
A
orexin-a, hypocretin-1
4
Q
UNa and FeNa in pre-renal azotemia
A
UNa <20
FeNa <1%
why? - usually d/t hypotension = Aldosterone release = Na reabsorption = low UNa and FeNa
5
Q
Indications for bacterial endocarditis prophylaxis
A
prosthetic heart valve previous IE structural abnormality in TRANSPLANTED heart unrepaired cyanotic CHD repaired CHD with residual defect
6
Q
Thready pulses that disappear with inspiration
A
pulsus paradoxus
cardiac tamponade
7
Q
Characteristics of tuberculous effusions
A
very high protein levels (>4)
lymphocytic leukocytosis
low glucose
8
Q
gallbladder wall - bluish color and brittle consistency
A
procelain gallbladder
gallbladder adenocarcinoma
9
Q
Physical exam findings of aortic stenosis
A
pulsus parvus et tardus (diminished and elayed)
mid to late peaking systolic murmur
soft and single second heart sound S2
10
Q
When do you add IV K with DKA
A
serum K less than or equal to 5.2
11
Q
Right to Left shunts in peds (2)
A
Tetralogy
Transposition
cyanotic babies right away
12
Q
Wilms tumor vs Neuroblastoma
A
WT - unilateral - 2 to 5 years old
Neuro - crosses midline - usually younger
13
Q
What has been proven to prolong survival in COPD patients?
What hasn’t?
A
long term home oxygen therapy
vaccinations against influenza and pneumococcus
14
Q
best preventive therapy for migraine
A
propranolol
15
Q
Anti-social personality disorder diagnosed after what age?
A
18
with symptoms of conduct disorder beginning before age 15
16
Q
Is metronidazole teratogenic?
A
No
17
Q
Retinoblastoma is associated with what bone tumor?
A
osteosarcoma
18
Q
spike differentiation between multiple myeloma and waldenstroms
A
waldenstroms is IgM specifically
MM - produces monoclonal IgG, IgA, or light chains
19
Q
What electrolyte abnormality can occur with folate/B12 replenishment?
A
Hypokalemia
due to high cell production
20
Q
Measles long term risk?
A
subacute sclerosing panencephalitis
21
Q
most common pathogen of bartholin abscess
A
E. coli
22
Q
MCC of bacterial tracheitis
A
staph aureus
23
Q
Common murmur in infective endocarditis
A
Tricuspid regurgitation
Increases on inspiration
24
Q
MCC of euvolemic hyponatremia
A
Pseudo (hyperglycemia)
Psychogenic polydipsia
Hypothyroid
SIADH
25
Target of Myasthenia graves
Lambert eaton
Post synaptic acetyl choline receptors
Pre synaptic Calcium channels
26
3 main causes of hyperbilirubinemia
pre-hepatic
intrahepatic
posthepatic
27
Biphasic stridor in an infant =
Vascular rings
vs
Laryngomalacia = INSPIRATORY stridor
28
Watery conjunctivitis 5 to 14 days after delivery
CHLAMYDIAL
29
two types of macular degeneration
dry - slow progressive, bilateral
wet - unilateral, aggressive
30
Triad of wisckott-aldrich
eczema
decreased platelets
infections
31
Cancers with VHL
hemangioblastoma
Clear cell renal carcinoma
Pheo
32
Measles = ?
infectious agent?
Prodrome?
fever and rash - timing and spread?
Rubeola
measles virus
rash on face - spreads to body (clears opposite direction)
Fever and rash at same time
Cough, Coryza, COnjunctivitis, Kopliks
33
What joints are NEVER involved in RA?
DIP's
34
Effect of formula feeding on gastric emptying
Decreases it
Can be related to pyloric stenosis
35
what can differentiate transient synovitis from Legg-Calves-Perthes in a young boy who is of normal BMI?
length of pain
Months for LCP vs Up to 4 weeks for Transient synovitis
36
VSD murmur can be heard
Left Lower sternal border
Holosystolic
37
With increasing prevalence what happens to PPV?
increases
38
Natalizumab is associated with development of?
progressive multifocal leukoencephalopathy
39
What medications are associated with possibility of slowing progression of parkinsonism
MAO-B inhibitors
40
Ulcerative colitis associated with what gall bladder condition?
Primary sclerosing cholangitis
can have + p-ANCA
41
Primary adrenal insufficiency mcc?
significance of symptoms?
Autoimmune
more severe symptoms - hyperpigmentation, hypotension, hyperkalemia
42
Transposition of the great vessels associated with what maternal condition?
diabetes mellitus
43
Imiquimod
Locally applied immunostimulant
Leads to sloughing off of skin
Warts, BCC, actinic keratosis
44
Refractory cases of CLL tx
Cyclophosphamide
45
Cushing Syndrome
Initial work up tests (3)
24 hour urinary free cortisol
Late night salivary cortisol
Low dose dexamethasone suppression
46
High iron =
Sideroblastic anemia
alcoholic induced commonly
47
Triple or quad screen done when?
15-20 weeks
48
How logn does it take for cholestasis to develop with parenteral nutrition?
2 weeks or more
49
Anaphylactic egg allergy - which vaccine cannot be given?
Yellow fever
50
when can PUBS be done?
between 20 and 34 weeks gestation
benefit - can transfuse
51
Mild cases of CLL in the elderly tx?
Chlorambucil
52
intraplacental villous lakes
irregular placent
Placenta accreta
53
mechanism of decreased renal blood flow in hepatorenal syndrome
increased nitric oxide generation in splanchnic circulation secondary to portal HTN
NO reduces peripheral vascular resistance and blood pressure = decreased renal perfusion
54
3rd gen cephalosporins
ceftriaxone and cefotaxime
55
Complex vs simple seizures?
Complex = LOSS OF CONSCIOUSNESS
56
Where is Broca's area located?
other associated findings with stroke?
posterior inferior FRONTAL lobe gyrus
DOMINANT side
right hemiparesis (face and upper limb)
57
Increasing pain, worsens at night
Relieved by NSAID's
Osteoid osteoma
58
Ending -navir =?
Main adverse effect
Protease inhibitors
Hyperlipidemia, hyperglycemia
59
Carcinoid of the lungs
serotonin syndrome
5-HIAA in the URINE
60
Meds for Wolff Parkinson White
Procainamide or Ibutilide
61
Uncommon but specific sign of Graves Disease
digital clubbing thyroid acropathy
62
Specific therapy for hereditary angioedema
Ecallantide
63
What immunodeficiency may be associated with false negative serologic studies in celiac patients?
Selective IgA deficiency
64
Meckels is a remnant of what?
vitelline duct
65
Aldolase B deficiency =
hereditary fructose intolerance
66
three common causes of hyponatremia with hypervolemia
CHF
Nephrotic syndrome
Cirrhosis
67
Leuprolide
MOA?
GnRH agonist
given continuously suppresses estrogen
68
What is increased with both folate and B12 deficiency?
Homocysteine
69
delayed separation of cord + infections without pus?
Leukocyte adhesion deficiency
70
What RDW is associated with iron deficiency anemia?
>20%
71
Treatment for chlamydial conjunctivits
ORAL erythromycin
72
Which source of vaginitis requires both partners to be treated?
Trichomonas
73
IgA nephropathy affects what part of the kidney?
glomerulus
74
Osteoarthritis is not associated with what type of anemia?
Anemia of chronic disease
75
Treatment of hyponatremia is based on?
Symptom severity (NOT the Na level)
76
Treatment for GBS
IVIG
OR
Plasmapharesis
NOT BOTH
77
firm hyperpigmented nodule
dimples in the center when pinched
dermatofibroma
78
Aplastic Anemia vs Aplastic crisis
Anemia = PANcytopenia
Crisis = ERYTHROpenia
79
RTA has positive or negative UAG?
Positive
80
Scabies treatment
Permethrin and Lindane
81
Treatment for Pertussis
erythromycin
82
4 of the most common complications of EPO therapy
Worsening of HTN
Headaches
Flu like syndrome
Red cell aplasia
83
Early decrescendo diastolic murmur
left sternal boarder (3rd/4th IC space)
with patient sitting up, leaning forward, and holding breath in full expiration
Aortic regurgitation
most commonly due to bicuspid aortic valve in the developed world
84
Increased Methylmalonic acid is associated with?
B12 deficiency
normal with folate
85
Complete androgen insensitivity syndrome
genetically male, phenotypically female
Cryptorchid testes
Orchiectomy after puberty
86
3 p's of Mccune Albright
Precocious puberty
Pigmented spots
Polyostotic fibrous dysplasia
87
treatment for a-fib with RVR
beta blocker
diltiazem
digoxin
88
does long term use of OCP's decrease breast cancer risk?
no , slight increase
89
Treatment options for non-ICU community acquired pneumonia
Fluoroquinolone
OR
Beta-lactam + Macrolide
90
what does mixed venous oxygen saturation tell you?
the amount of oxygen being extracted by tissues
91
flutamide mechanism of action
androgen blockade by binding to dihydrotestosterone receptors
92
Sevelamer and Lanthanum are?
phosphate binders
93
Diarrhea has positive or negative UAG?
Negative
94
Condyloma lata =
Condyloma acuminata =
Syphilis
Genital warts
95
When is post op atelectasis most comm?
Days 2-3
96
Renal changes in pregnancy
Increased risk of pyelonephritis
Increased GFR
Decreased BUN/creatinine
97
Methanol overdose is associated with what physical exam finding?
inflamed retina
98
Biliary atresia work up
U/S = no ducts
7 days of phenobarbital
HIDA scan
99
Patients with primary biliary cirrhosis are at increased risk of developing what?
Osteomalacia
100
Pulses parvus et tardus associated with what valve abnormality
Aortic stenosis
101
Accuracy
measures what it is supposed to measure
102
Periarticular osteopenia is a buzzword for?
Rheumatoid Arthritis
103
Tolcapone, Entacapone
MOI
COMT inhibitors
block metabolism of dopamine
Parkinsons
104
Most accurate imaging for adenomyosis?
MRI
105
Mild, irregular contractions with no cervical change =
braxton-hicks
reassure and send home
106
Medications that cause Acute interstitial nephritis are same drugs that cause what 4 other conditions?
Drug allergy/rash
Stevens-Johnson Syndrome
Toxic Epidermal Necrolysis
Hemolysis
107
Oligohydramnios
Single deepest pick of amniotic fluid <2cm or amniotic fluid index <5
108
MS patient with equivocal or non-diagnostic MRI
look for?
oligoclonal bands in CSF
not SPECIFIC to MS
109
what diuretic is associated with ototoxicity?
furosemide
damages hair cells of cochlea
110
Most commonly injured bronchus in chest trauma
Right main
RARE
111
SNRI's
Venlafaxine
Desvenlafaxine
Duloxetine
112
what pharmacotherapy can be given with subarachnoid hemorrhage
CCB to prevent subsequent ischemic stroke from vasospasm
Phenytoin for seizure prophylaxis
113
preemie + GI bleed + air under diaphragm or pneumatosis intestinalis
NEC
NPO, IVF, TPN, IV abx
114
Common causes of priapism
```
Sickle cell
Leukemia
Perineal or genital trauma
neurogenic lesions
meds - trazodone and prazosin
```
115
Adrenal medulla produces?
catecholamines
116
Swelling limited to surface of one cranial bone
cephalohematoma
caput crosses suture lines
117
Most common cause of labial fusion
21-B Hydroxylase deficiency
118
TInea capitis vs seborrheic dermatitis
TC doesn't involve face, nasolabial folds, or eyebrows
119
Tx to prevent renal failure from tumor lysis
allopurinol
hydration
rasburicase
120
Three most common underlying causes of addisons
Autoimmune
TB
Anterior pituitary
121
Severe features for pre eclampsia
SBP >160 or DBP >110
Thrombocytopenia
Creatinine elevation
Elevated LFT's
Pulmonary edema
Visual or cerebral symptoms
122
Which treatment for graves can cause worsening ophthalmopathy
Radioactive iodine
Due to increase in thyroid receptor antibodies
123
Male child
| Decreased or absent tonsils, adenoids, lymph nodes, spleen
Brutons agammaglobulinemia
IVIG
124
dorsal column is responsible for?
vibration and proprioception
includes fasciculus cuneatus and fasciculus gracilis
posterior spinal artery
125
Sickle cell trait commonly results in ?
inability to concentrate urine
126
Hemodynamics in Septic shock
```
RA pressure
PCWP
cardiac index
sVR
MVO2
```
Normal or decreased
Normal or decreased
Increased
Decreased
Increased
127
3 general steps of bilirubin excretion
Uptake -
Conjugation -
Excretion -
128
Parkinsonism due to loss of cells where?
Neurotransmitter that is low?
Substantia Nigra
Dopamine
129
Which skin cancer can cause neuro symptoms due to neural invasion?
Squamous cell
130
What cell is most distinct abnormality in myelodysplastic syndrome?
Pelger-Huet
Bilobed nucleus
131
barking, seal like cough
inspiratory wheeze in between
dx?
croup
parainfluenza virus
132
most frequent type of delusion in delusional disorder
persecutory type
133
Cells of Hodkgkins?
Reed Sternberg
Owl-eyed cells
134
Cancers with Lynch Syndrome HNPCC
Colorectal
Endometrial
Ovarian
135
Treatment for intrauterine fetal demise >24 weeks?
vaginal delivery with labor induction
can be delayed until mother is ready
less than 24 weeks = dilation and evacuation
136
What milk intake can lead to folate deficiency?
Goats milk
137
Schizoaffective vs Major depression with psychotic features
Mood symptoms and psychotic symptoms occur together with MDD with psychotic features
Psychotic symptoms persist for >2 weeks by themslves in schizoaffective
138
Brown Sequard loss of?
pain and temp OPPOSITE SIDE
position and vibratory SAME SIDE
139
what medication should every stroke patient be given if they aren't already on it?
Statin
140
2nd line treatment for Lyme
Treatment for neurologic infxn?
Amoxicillin
IV ceftriaxone
141
Pinworm =
itchy butt
scotch tape test
albendazole
142
Severe infections in CLL tx
IVIG
143
Tertiary prevention =
treatment of a given disease
144
What condition can present with bilateral trigeminal neuralgia
MS
145
agent of choice for prophylaxis of pasteurella?
amoxicillin/clavulanate
146
Rotavirus contraindicated in?
individuals with previous intussusception
147
corkscrew shaped and rightward displaced duodenum +
midgut volvulus
148
atypical glandular cells on pap smear
next step =
endometrial biopsy
149
Uric acid and BUN in SIADH are?
low
150
4 options for emergency contraception?
most effective?
Copper IUD
Ulipristal - antiprogestin
Levonorgestrel - progestin
OCP's - progestin
Copper IUD most effective
OCP's least effective for EMERGENCY contraception
151
Initial pharmacotherapy for pseudotumor cerebri
Acetazolamide
152
When do children need a renal and bladder ultrasound
with a first UTI between 2 and 24 months
153
Subacute combined degeneration = ?
loss of?
B12 deficiency or Neurosyphilis
position and vibratory sense
154
Autoimmune blistering disease
no mucosal involvement
linear IgG deposits on basement membrane
Bullous pemphigoid
155
when can you do a trans cranial doppler?
over 20 weeks
fetal anemia
increased velocity is a positive test
156
Exogenous glucocorticoid induced adrenal insufficiency doesn't have what physical finding?
hyperpigmentation
central deficiency - steroids inhibit ACTH release
157
What kidney disease is associated with Hodgkin Lymphoma?
Minimal Change Disease
158
Normal nadir of maternal anemia in pregnancy
Hgb 10/ Hct 30
Reflex iron studies if less
159
gross hematuria 1 TO 2 DAYS AFTER URI
IgA nephropathy
most accurate test is kidney biopsy
160
common cause of complex partial seizures
temporal lobe epilepsy
161
Autoimmune thrombocytopenia or hemolysis in association with CLL tx?
Prednisone
162
Can you intubate patients with cervical spine trauma?
Yes
Only contraindication is significant facial trauma
163
what vitamin deficiency may present with hyperemesis gravidarum?
triad?
thiamine deficiency
AMS, ataxia, nystagmus
164
Cyanosis in an infant relived by crying = ?
Choanal atresia
165
Pregnant patient and possible DVT
1st step V/Q
Only a NORMAL v/q rules out PE
low probability v/q requires further testing - CT angio
166
Transudates tend to be high or low protein?
low protein
167
What infection is associated with membranous nephropathy in children?
Hep B
168
Graves vs painless thyroiditis
Graves has diffuse iodine uptake
Painless has low uptake
169
What curious thing occurs with Lymph nodes in Hodkgins?
EtOH causes tenderness
170
Best initial therapy for warm hemolytic anemia
Prednisone
IVIG if prednisone fails
171
SN-N-OUT
Sensative test - negative - rules out disease
172
Don't use copper IUD as post birth contraception in what class of patients
Hypermenorrhea
Or
Anemic
173
When to switch to subQ insulin in DKA
able to eat
glucose <200
anion gap <12
serum HCO3 >15
174
what region of the brain does toxoplasmosis have a preference for?
basal ganglia
175
When to do C section for labor arrest
>6 cm dilated
arrested for 4 to 6 hours
176
high arches, LE wasting, decreased DTR's
Charcot-Marie-Tooth Disease
EMG
no tx
177
Normal iron studies =
Thalassemia
178
CSF findings in Guillain-Barre
Increased protein, normal cell counts
179
Unconjugated hyperbilirubinemia = patho or physio?
Steps of diagnosis
1, 2, 3, 4
physiologic
1. Coombs test
2. Hgb level
- low = hemorrhagic
- high = transfusion (twin-twin, delayed clamping)
3. Retic
4. Reabsorption
180
Contralateral somatosensory and motor deficit FACE, ARM, LEG
Eye deviation toward side of infarct
Aphasia (if dominant hemisphere)
Hemineglect (if non-dominant)
Middle Cerebral artery
181
Definitive diagnosis of CJD
Brain biopsy
Or
PRNP gene mutations
182
Type II RTA also known as?
Mechanism of impairment?
common side effect?
Proximal RTA
failure to reabsorb Bicarb in the PCT
osteomalacia (after chronic metabolic acidosis)
give bicarb then test urine
183
SAAG
subtract peritoneal albumin from serum albumin
ascites source determination
>1.1 = portal
<1.1 = non-portal
184
First line treatment for OCD
exposure and response prevention
+/- SSRI
185
TYPE I RTA is also known as?
Mechanism of impairment?
common side effect?
initial step in work up?
Distal RTA
failure to generate new Bicarb in distal tubule - alkaline urine
nephrocalcinosis
UA for pH >5.5
186
Topical erythromycin is to prevent?
gonorrheal conjunctivits
2 to 7 days
187
persistent platelet elevations post infectious with a phx of abdominal trauma
splenectomy due to BAT
reactive thrombocytosis
188
Nontender lymphadenopathy - first step?
excisional biopsy
189
eosinophils on UA
what stain?
allergic or acute interstitial nephritis
Wright and Hansel
190
Polycythemia vera is caused by?
increased RBC production
NOT INCREASED EPO OR INCREASED EPO RESPONSIVENESS
191
PPV =
TP/(TP+FP)
patients want to know what a positive test means
192
Amniotic fluid
Ferning
Turns nitrazine paper blue
193
mechanism of action of hyperprolactinemia in hypothyroidism
TRH has some stimulation of lactotrophs = prolactin secretion
nipple discharge in hypothyroid patient
194
Sudden onset pain and redness in the MEDIAL CANTHAL region
Children or adults over 40
Dacrocystitis
Staph aureus, beta hemolytic strep
195
SP-P-IN
Specific test - positive - rules in disease
196
Bilateral pale gray nipple discharge
Guiac negative
Labs?
TSH and Prolactin level
197
What cbc findings can be found with EBV?
autoimmune hemolytic anemia
thrombocytopenia
elevated reticulocyte count
positive Coombs
due to IgM cold agglutinins
198
Work up of Addisons steps
early morning cortisol
cosyntropin stim test (no change = adrenal gland problem)
if adrenal gland - tx with cortisol + fludrocortisone
199
NPV =
TN/(TN+FN)
patients wants to know if the negative test is really negative
200
What immunosuppressant causes gingival hyperplasia and hirsutism
Cyclosporine
201
what is the other cause of floppy baby syndrome
Werdnig hoffman
AR degeneration of anterior horn cells and cranial nerve motor nuclei
202
What are the primary immune responses to PPSV23 vaccine and PCV 13 vaccine?
T-cell INDEPENDENT B cell response for PPSV23
T-cell DEPENDENT B cell response for PCV 13
203
Contrast induced renal failure lab values
LOW UNa
LOW FeNa
VERY HIGH spec grav
d/t spasm of afferent arteriole - renal tubular dysfunction and tremendous reabsorption of Na and Water
usual labs from toxin induced ATN would be the exact opposite
204
Untreated hyperthyroidism has increased risk for?
Bone loss
Osteoclast activity increased
205
Triple screen?
Quad?
Alpha fetoprotein
Estriol
Beta-hcg
Add inhibin A
206
Most common method of hep B transmission world wide
Perinatal
207
DTaP =
TdaP +
Kids
Adults
208
Proximal muscle weakness + hirsutism + weight gain
Cushing's related MUSCULAR ATROPHY
209
EKG findings in tricuspid atresia
chest x ray findings
peaked P waves, Left axis deviation, small R waves
decreased pulmonary markings
210
headaches secondary to ICP are often worse when?
in the morning
211
Is BUN/Cr elevated or decreased in Upper GI Bleed?
elevated
212
Breast milk jaundice vs Breast feeding
Breast feeding = quanitity - not enough - bilirubin sits around due to lack of bowel movements - BEFORE DAY 7
Breast milk = quality - moms milk inhibits conjugation - AFTER DAY 7 - hydrolyzed formula
213
High radioactive iodine uptake scan = 3?
graves - diffuse pattern
toxic adenoma/multinodular goiter - nodular pattern
214
Hierarchy of growth in peds
Head
Height
Weight
(most to least important)
FTT leads to losses in the order of least to most important
215
Where is H and K excreted in the kidney?
cortical collecting tubule
216
seizure stoppage in pregnancy
phenobarbital - relatively safe
217
Nephrotic syndrome associated with what 3 physiologic responses?
edema
hyperlipidemia
thrombosis (hypercoagulable state)
218
cogwheel rigidity
slowing of movement on passive flexion or extension of extremities
219
VSD murmur
Holosystolic along left lower eternal border
With diastolic rumble at apex
220
Chemical conjunctivits is associated with?
silver nitrate
within 24 hours
bilateral, nonpurulent
221
Change in sensitivity and specificity with cutoff being decreased for a positive test
sensitivity increases
specificity decreases
222
Nocardia pulmonary findings
nodular or cavitary lesions in the upper lobes
223
cytologic findings of CSF with GBS
high protein, normal WBC's
224
Benztropin and Trihexylphenidyl
anti-cholinergic
Parkinsons
225
When do you increase levothyroxine dose with pregnancy?
When the pregnancy is detected
226
Asymmetric IUGR
Brain weigh is NOT decreased
After 20 weeks gestation
227
First steps in SIADH
Fluid restriction
Salt tablets
228
Erythema infectiosum = ?
infectious agent?
presentation?
fifths disease
parvovirus b19
fever and rash (SAME TIME)
229
at what gestational age can you use a chorionic villous sampling?
over 10 weeks
230
What test is more specific for Rheumatoid arthritis?
CCP
231
painful, flaccid bullae, MUCOSAL EROSIONS
positive nikolsky sign
antibodies?
pemphigus vulgaris
antidesmoglein 1 and 3
chickenwire pattern on immunofluorescence - "intercellular deposits of IgG"
232
```
1 year
2year
3 year
4 year
5 year
```
walk
steps
tricycle
hop
skip
233
Asymmetric growth in infants due to?
Uteroplacental abnormalities
Maternal malnutrition
234
First line intervention for variable decels
maternal repositioning
235
Effect of knee to chest positioning on cardiovascular system
Increases systemic vascular resistance
Decreases amount of R to L shunting in Tetralogy
236
Hypertension, bilateral flank masses, micro he matures =
ADPKD
Berry aneurysms
237
Only time you give tetanus immune globulin
Dirty wound
Uncertain vaccination history
OR
Less than 3 doses in history
238
painless bleeding in 3rd trimester
placenta previa
transabdominal ultrasound to determine placental position
usually a patient with no prenatal care
239
most common nutritional deficiency in infants?
iron
240
Central lytic lesion
Onion skinning
Moth eaten appearance
Ewings Sarcoma
241
Specificity =
TN/ (TN+FP)
242
2month
4month
6month
gross motor
lift head
roll over
sit up
243
Enzyme to supplement with elevated homocysteine levels and DVT
Pyridoxine (B6)
244
Meds for treatment of glaucoma
mannitol
acetazolamide
pilocarpine
timolol
245
best treatment for absence seizures
ethosuximide
246
X ray findings of rheumatoid arthritis
periarticular osteopenia and erosions of the joint margin
247
Imaging needed for initial diagnosis of bronchiectasis
High resolution CT scan
248
Prevention of passing measles accomplished by
Airborne precautions
249
When does mittleschmerz occur?
At the time of ovulation
About halfway between periods
250
CSF findings with Creutzfeld-Jacob
14-3-3 protein
Triphasic spikes on EEG
251
Live attenuated vaccines
MMRV
Intranasal flu
252
Increased level of what is diagnostic of Menopause?
FSH
253
adequate contractions
>200 montevideo units in 10 mins
IUPC measures
at least every 5 mins
254
Sensitivity =
TP/ (TP+FN)
255
Aortic dissection + elevated creatinine
Preferred imaging?
TEE
256
Adenocarcinoma
non-smokers
asbestosis
peripherally located
no paraneoplastic syndrome
257
In Brown Sequard hemisection loss of pain and temp occurs where approximately?
1 to 2 levels below the level of the transection
starting at umbilicus (T10) means injury occurred at T8
258
Magnesium decreases the risk of what complication in preterm infants?
cerebral palsy
259
Lab results of vomiting/nasogastric suctioning
hypochloremia, hypokalemia, metabolic alkalosis
elevated bicarb - for each H lost a bicarb is produced
260
Pathophysiology behind toxic adenoma and multinodular goiter
autonomous production of thyroid hormone
261
Two treatments for neuroleptic malignant syndrome
Dantrolene
Bromocriptine
262
Pre-renal azotemia =
hypoperfusion
increased BUN and creatinine
BUN more
263
gold standard for diagnosing vesicoureteral reflux?
voiding cystourethrogram
264
predisposing condition of dementia patients to aspiration pneumonia
lack of cough reflex
265
Best test to confirm Duchennes
Genetic testing
266
Screening tests tend to be what?
high sensitivity
pap smear
267
What anti-arrhythmic can cause dig toxicity when combined with dig?
Amiodarone
268
What value is most useful in differentiating anemias?
RDW
269
Epilepsy and absence seizures carry increased risk of development of what?
ADHD
Anxiety
270
Rasagiline, Selegiline
MOI
MAO inhibitors (MAO-B)
271
Kidney biopsy in Goodpasture shows?
linear deposits
272
Morning stiffness + C1 and C2
what to do next?
X-ray c spine
RA
273
rituximab MOA
monoclonal antibody against cD20
CLL treatment
274
Isolated onset of adrenarche (hair growth) in an obese young female
source of hormone?
Adrenals!!!!!!!
275
Differentiation of PCOS from Cushing Syndrome
No skin atrophy, muscle weakness, or bruisability in PCOS
276
Skin infection + recent ENT symptoms, + renal (glomerulonephritis)
GPA or Wegeners
277
Cellular findings with Dementia with Lewy Body disease
round eosinophilic intracytoplasmic inclusions within neurons of substantia nigra
278
Contralateral somatosensory and motor deficit predominantly in LOWER EXTREMITY
Abulia (lack of will)
URINARY INCONTINENCE
what area of stroke?
Anterior Cerebral Artery Occlusion
279
Ranolazine mechanism of decreasing angina
Decreased myocardial calcium influx
280
Epiglottitis cause
usual age?
Hib
3 to 7, with no vaccines
sick as shit - rapid onset, high spiking fever
tripod with drool
airway + IV abx
281
How to determine if pancreatic pseudocyst needs drainage?
severity of symptoms
nausea/vomiting/abd pain - drainage
282
pulsus bisferiens =
associated with what?
2 strong systolic peaks of aortic pulse
associated with significant aortic regurgitation
283
Difference between euthyroid sick syndrome and subclinical hypothyroid
Euthyroid sick is LOW T3 Syndrome with normal TSH and T4
Subclinical has an elevated TSH, Normal T4
284
D xylose test is used to diagnose what?
celiac
or malabsorption syndromes
low urinary excretion of d-xylose is a + test
285
Bilious vomiting in neonate
X ray findings normal
Next test?
Likely diagnosis
Upper GI series
Volvulus
286
Myotonic dystrophy typical age of onset?
Inheritance?
Vs DMD BMD
12-30
Autosomal dominant
287
BP treatment in pre eclampsia
Labetalol
Hydralazine (if BRADYCARDIC)
288
Timing of alcohol withdrawal symptoms
12 to 48 hours = seizures
2 to 4 days = Delirium tremens
289
Rheumatoid arthritis patient with splenomegaly and neutropenia?
Felty syndrome
autoimmune
290
powder burn lesions in the pelvis =
endometriosis
291
Treatment for post partum endometritis
Clindamycin plus gentamycin
292
```
Associated nephrotic syndrome with:
Cancer?
Children?
IVDA and HIV
NSAID's
SLE
```
membranous
MCD
FSGS
MCD and Membranous
all of them
293
Live attenuated vaccines (6)
```
Polio (oral)
MMR
Rotavirus
Influenza (intranasal)
Yellow fever
Varicella/Zoster
```
294
Recurrent sinopulmonary infections + AIDS related infections
Severe combined immunodeficiency
B and T cells
295
Treatment for legionnaires
macrolide or fluoroquinolone
296
Triamterene and Amiloride are?
K sparing diuretics
297
Side effect of mirtazapine
Weight gain
May or may not be beneficial depending in patient
298
UTI/asymptomatic bacteruria Treatment in pregnancy
1. amoxicillin
| 2. nitrofurantoin
299
Precision
ability to reproduce results
doesn't necessarily measure what it intends to measure - just repeatable
300
diverticulosis vs angiodysplasia
bright red blood due to arterial source with diverticulosis
maroon colored blood from right colon with angiodysplasia
301
Blood gas findings in CHF
Vs COPD
Hypoxia
Hypocapnia
Respiratory Alkalosis
Respiratory acidosis and hypoxia in COPD
302
Empiric treatment for bacterial meningitis in IMMUNOCOMPROMISED
Cefepime + Vanco + ampicillin
303
Medication used for conceiving in PCOS patients?
Clomiphene
304
Thrombosis of mesenteric or hepatic veins, think?
PNH
305
Sensitivity =
TP/(TP+FN)
306
Conditions associated with pulsus paradoxus
cardiac tamponade
asthma
COPD
307
Estrogen effect on thyroid hormones
Increases thyroid hormone binding globulin levels
Requires and increase in thyroid hormone
308
what does gabapentin bind to?
alpha-2-delta calcium channels
309
Significant side effect of efavirenz
psychiatric symptoms
310
Chorionic villus sampling timing
10-13 weeks
311
Most common medications causing acute interstitial nephritis
```
penicillins/cephalosporins
Sulfa drugs (including diuretics)
```
312
Shy drager Syndrome
parkinson symptoms with Orthostasis
313
at what gestational age can you use amniocentesis?
over 16 weeks
314
Lice treatment
Permethrin
315
Recurrent sinopulmonary infections in adult
Low IgG, IgM, IgA
B cells?
Common variable immunodeficiency
Normal, but ineffective at making Immunoglobulins
316
exaggerated drop in systolic BP during inspiratin (>10 mmHg)
Pulsus paradoxus
317
Preferred benzodiazepine for alcohol withdrawal
Lorazepam
no active metabolites
318
```
hyporeflexia
lethargy
headache
respiratory failure
cardiac arrest
```
female early post-partum w/pre-eclampsia or eclampsia
Magnesium toxicity
319
Secondary prevention =
screening + intervention
320
Oxytocin toxicity
Hyponatremia
Hypotension
Tachyarrhythmia
Seizures
321
Important CYP 450 inducers
```
Carbemazepine
Phenytoin
Ginseng
St John Wart
Oral Contraceptives
Phenobarbital
Rifampin
```
322
Herpes simplex encephalitis imaging findings
FRONTOTEMPORAL region abnormalities
on CT, MRI, AND EEG!!!!
323
Foamy macrophages and fat globules on breast biopsy
Fat necrosis
Benign
324
What heart murmur is associated with ankylosing spondylitis?
aortic regurgitation
325
What is the greatest risk of parenteral nutrition?
central line associated bloodstream infection
326
Unilateral MOTOR involvement
no sensory, cortical deficits
no visual abnormalities
LACUNAR INFARCT
327
What physical exam finding is associated with aortic regurgitation
Bounding pulses (water hammer pulse)
328
At what gestation age is magnesium typically neuroprotective
Less than 32
329
21 hydroxylase deficiency results in elevated levels of what?
17-hydroxyPROGESTERONE
not pregnenolone
330
When can HIV patients receive live attenuated vaccines?
CD4 > 200
331
Central vs Peripheral Bells Palsy
Central - PRESERVATION of forehead and eyebrow movements
Peripheral - loss of forehead and brow movement, inability to close eyes and drooping lids, drooping of lower lip
332
Takayasu, GPA, Eosinophilic granulomatosis with polyangiities create what type of vasculitis
granulomatous
333
Test for sideroblastic anemia
Prussian Blue
334
Meds for fibromyalgia
TCA's
335
Cause of retinopathy of prematurity
high FiO2 in preemie with poor lung maturity
336
Meds for trigeminal neuralgia
oxcarbazepine, carbamazepine
337
Specificity =
TN/(TN+FP)
338
Test for Cystinuria
urinalysis findings?
urinary cyanide nitroprusside test
hexagonal crystals
339
German Measles =?
prodrome?
fever and rash - timing and spread?
Rubella
fever and rash at same time
rash starts on face and spreads down body
generalized and tender lymphadenopthy
340
How to determine what to do after oxytocin fails in stage 2 of labor
fetal station
if negative - c-section
if positive - forceps/vacuum
341
Microcytic anemia non-responsive to iron supplementation
think?
Hemoglobinopathy
342
Right Heart cath findings in septic shock (distributive shock)
decreased SVR
decreased/lownormal PCWP
elevated MvO2
Increased cardiac index
343
Work up of Cushing's
Steps
1 - low dose Dex test (failure to suppress) + 24 hour urine or late night salivary
2 - ACTH (normal = adrenal tumor) (elevated = ACTH dependent)
3 - High dose dex suppression test (suppression = cushings disease), (failure to suppress = ectopic tumor)
Low then high
344
Apt test is for?
testing whether baby swallowed moms blood during delivery
345
Meds to help 5-7mm renal stones pass
Nifedipine or Tamsulosin
346
2nd Tri screen
Triple and Quad Screen
hCG, AFP, Estriol
quad + Inhibin A
Downs is up
Edwards is down down down
347
Normal amniotic fluid index
8 to 25
348
what two sensations are intact with anterior spinal artery infarct
position and vibratory
349
What other electrolyte may need to be replaced if hypokalemia is resistant to correction?
Magnesium
can lead to INCREASED urinary loss of K
350
omphalocele is usually located where?
MIDLINE
351
Should all Hep C patients be immunized against Hep A and B?
Yes
352
Trichinellosis vs infective endocarditis
Eosinophilia and periorbital edema in trichinellosis
353
Important CYP 450 inhibitors
```
Acetaminophen
NSAIDs
Amiodarone
Antibiotics
Cimetidine
Cranberry juice, Gingo biloba
Omeprazole
Thyroid hormone
SSRIs
```
354
Pathophysiology of uterine fibroids
Smooth muscle cell proliferation in myometrium
Irregularly enlarged uterus
355
most common skin cancer of the lower lip?
squamous cell
356
Anti smooth muscle antibodies is associated with what hepatic condition?
Autoimmune hepatitis
357
HACEK organisms
Tx?
```
Haemophilus
Actinobacillus
Cardiobacterium
Eikenella
Kingella
```
Ceftriaxone
358
most common cause of nephrotic syndrome in adults?
FSGS
359
Brain region involved with Huntingtons
Caudate nucleus
360
Most common cause of sepsis in sickle cell disease
S. pneumoniae
prophylactic penicillin until age 5
361
Most common sequelae of bacterial meningitis
Hearing loss
362
Most common causes of acquired methemoglobinemia
Topical anesthetic
Dapsone
Nitrates in infants
363
Symmetric growth restriction due to
Chromosomal anomalies
Congenital infections
364
Lymph nodes with purple to drainage
Staph, burkholderia, nocardia, aspergillosis infections
Chronic granulomatous disease
365
Rare but possible serious complication of Infectious Mono
Acute airway obstruction
366
Eggshell calcification on liver cyst =
Hydatid cyst
Echinococcus granularis
367
common side effect of roux-en-y bypass other than dumping syndrome
gall stones and cholecystitis
due to rapid weight loss
368
Maneuvers that reduce blood return to the heart typically do what to innocent murmurs?
Reduce the intensity
369
Macrosomia. Macroglossia, HEMIHYPERPLASIA
=
Beckwith Wiedmann
Abdominal ultrasound
370
What occurs with uric acid levels in SiADH?
characteristically low
371
Characteristics of RA to know
Small joints - hands and feet
Symmetric
Morning stiffness - greater than 60 mins to relieve
Cholesterol nodules
372
Antipsychotic least likely to cause extrapyramidal symptoms
CLOZAPINE
373
Aldosterone mnemonic
ASSPP
Aldo saves sodium and pushes potassium out
374
ACE-I causes what change in kidney blood flow?
efferent arteriole dilation
375
1st Trimester Screen
U/S Nuchal translucency
PAPP-A
hCG
376
vaccination, weight loss, decreased EtOH intake, decreased smoking are all forms of?
primary prevention
377
Treatment for crabs
Permethrin
378
Hemodynamics in Hypovolemic shock
```
RA pressure
PCWP
cardiac index
sVR
MVO2
```
Decreased
Decreased
Decreased
Increased
Decreased
379
Antibody for primary biliary cholangitis
Anti-mitochondrial
380
CHemo Man
Arms and Legs - Vincristine/Vinblastine = peripheral neurop
Heart - Doxi/Daunorubicin - dose dependent cardiomyopathy
Lungs - b shape - bleomycin - pulmonary fibrosis
kidneys and ears - platins - oto and renotoxic
Cystitis - hemorrhagic cystitis
381
fragile X is commonly associated with what?
autistic behavior
382
Pathophysiology behind breath sounds and tactile fremitus in pneumonia vs pleural effusion
Pneumonia = consolidation INSIDE lung = breath sounds fremitus traveling FASTER through liquid = INCREASED FREMITUS AND BREATH SOUNDS
Pleural effusion = fluid OUTSIDE lung = INSULATION of sounds = DECREASED FREMITUS AND BREATH SOUNDS
383
Painful violaceous nodules on fingers tips and toes
Osler nodes
384
Idiopathic precocious puberty is due to what?
Early activation of the HPA axis
385
lung lobes affected with aspiration in supine patients
posterior segments of upper lobes
superior segments of lower lobes
386
Envelope shaped crystals
Calcium oxalate
Ethylene glycol ingestion
387
colonscopy for ulcerative colitis diagnosed early
start 8 years from diagnosis
q1year
388
When is a Head CT needed prior to LP?
Papilledema
Seizures
Focal neurologic abnormalities
Confusion
389
CD4 count for toxo
less than 100
390
What tendon reflex decreases with age?
Achilles
391
Renal vein thrombosis most commonly associated with what kidney condition?
Membranous glomerulopathy
392
ferning or positive nitro test with pregnant women =
rupture of membranes
393
primary ovarian insufficiency is a form of?
HYPERGONADOTROPIC hypogonadism
elevated GnRH, FSH
decreased estrogen
394
Mechanism of action of riluzole
tx for?
glutamate inhibitor
ALS
395
Ring enhancing lesions in an HIV patient
Toxoplasmosis
TMP-SMX prophylaxis
396
Lennox Gastaut Syndrome
children less than 7
array of seizure type s+ mental retardation
397
Squamous cell
smoking
centrally located
PTH-RP
398
grossly lipemic serum, palmar xanthomas, pancreatitis
first line tx
fenofibrate
familial dysbetalipoproteinemia
399
Milk protein allergy presentation
due to?
soy protein allergy
failure to thrive despite adequate feeding
may present with bloody bowel movement
switch to cows milk or breast feeding
400
Biomarker for epithelial ovarian carcinoma
CA-125
check level in postmenopausal woman with ovarian mass on pelvic ultrasound
401
When do you add dextrose fluids in DKA?
glucose less than 250
402
Jarisch-Herxheimer Reaction
Fever and worsening symptoms after treatment of syphilis
Give aspirin and antipyretic
403
Symptoms of adrenal insufficiency
Initial work up
weakness, fatigue, hyponatremia, hyperkalemia
low-normal early cortisol
8am serum cortisol + Plasma ACTH
ACTH stim test in the meantime (plasma ACTH will take a few days)
404
Dyskinesia in Huntingtons treated with?
tetrabenazine
405
Can ACEi ARB be used with unilateral RAS?
yes
406
which type of colon polyp has the greatest malignant potential?
villous
VILLain
407
Relief of pneumothorax allows restoration of what?
venous return
408
CATCH
In catch 22 for digeorge
```
Conotruncal defects
Abnormal facies
Thymic aplasia,hypoplasia
Cleft palate
Hypocalcemia
```
409
Sudden loss of vision + floaters + difficulty visualizing fundus
Vitreous hemorrhage
410
What 3 conditions is FSGS associated with?
HIV
Obesity
Heroin use
And African Americans
411
inheritance of wiskott-aldrich
x-linked
412
what imaging should be done for individuals with myasthenia gravis
Chest
either X-ray, CT, or MRI
looking for THYMOMA
CT w/contrast is best
413
Peds meningitis causes
<3 months = GBS, E. coli, listeria, HSV
3 months to 10 years = Strep pneumonia, Neisseria
> 11 years = Neisseria
414
Only way to definitively diagnose adenomyosis?
Hysterectomy
415
sodium correction in DKA
+ 2 Na for each 100 mg Glucose over 100
416
Fine motor
3 year
4 year
5 year
circle
plus sign
triangle
417
Common additional findings with Legionella
bradycardia
hyponatremia
mild hepatitis
CNS/GI involvement
418
Giant granules in neutrophils, albinism
Chediak Higashi
419
Differentiation of painless vaginal bleeding in pregnancy
Placenta Previa - no abnormalities other than bleeding
Vasa previa - Fetal heart tracing changes show deterioration
420
What is the preferred treatment for adjustment disorder?
Psychotherapy
As opposed to meds for MDD
421
Bupropion MOA
NDRI
422
What drugs for epilepsy are relatively safe for pregnancy?
leviteracitam
lamotrigine
423
4th gen cephalosporin
Cefepime
424
Why is the right kidney easier to palpate in ADPKD?
it lies lower than the left
due to the liver on the right
425
Treatment for risperidone induced parkinsonism
add benztropine - anticholinergic
426
Two types of periinfarct arrythmias
type Ia - within ten minutes - due to heterogenous conduction = reentrant
type Ib - 10 to 60 minutes post infarct - due to abnormal automaticity
427
first line tocolytic at 32 to 34 weeks gestation
nifedipine
428
Type IV RTA also known as?
mechanism of impairment
common underlying disease
Diagnostic test>
Tx?
Hypoaldosteronemia, Hyporeninemia
impaired aldosterone signaling
diabetes
Urine Na loss even with salt restricted diet
Fludrocortisone
429
Genetic inheritance of Kallman
X linked recessive
congenital absence of GnRH
430
Trinucleotide repeat for Huntingtons?
CAG
431
differentiating nocardia from Actinomyces and Mycobaterium tuberculosis
weakly acid fast
not acid fast
strongly acid fast
432
Most common organism associated with contact lens keratitis
Pseudomonas
433
Glomerular disease + hearing loss + visual disturbance?
Alport
type IV collagen
434
When can you observe and follow up dog/human bites
minor in nature
not located on hands, feet, or genitalia
immunocompetent
435
hyperechoic nodules with calcifications - ovarian mass
dermoid ovarian cyst (CYSTIC TERATOMA)
benign
pre-menopausal women
436
Most common side effect of excess oxytocin
Uterine tachysystole
437
Immunodeficiency + thrombocytopenia + eczema
Wiskott-Aldrich
438
why is strep pharyngitis less common udner age 3?
don't have enough epithelial cell attachment sites
439
Most common type of vulvar cancer?
Squamous cell
440
Pathophysiology of Meckels diverticula
Incomplete obliteration of the vitelline (Omphalomesenteric) duct
441
Symmetric IUGR
Brain in proportion with rest of body
Before 20 weeks
442
What medication do you add to acute lymphocytic leukemia?
intrathecal methotrexate
443
Infectious screens at initial prenatal visit
```
HIV
VDRL/RPR
Hep B
Rubella
Varicella
Chlamydia (NOT GONORRHEA)
```
444
Young, otherwise healthy female
Myalgias, proximal muscle weakness
Dx?
Labs?
Hypothyroid myopathy
TSH and free T4
445
Bacterial tracheitis vignette
croup that doesn't improve
more toxicity - fever/leukocytosis
racemic epi doesn't work
tracheal culture
446
Differentiating thalassemia minor from iron deficiency
Mentzer index
MCW/RBC
>13 - Iron
<13 - thalassemia
447
Zones of Adrenal
Glomerulosa - aldosterone
Fasciculata - cortisol
Reticularis - testosterone
448
1 year
2 year
3 year
4 year
5 year
language
1 word
2 word
3 word
4 word
5 word sentences
449
Pramipexole and Ropinirole
Dopamine agonists
Parkinsons
450
macrocytic anemia
low retic
congenital anomalies
diamond blackfan anemia
| triphalangeal thumbs
451
what type of bili causes kernicterus?
unconjugated -> able to cross BBB
452
currant jelly stool + sausage shaped mass + intermittent colicky abdominal pain with knees to chest (normal in between)
intussusception
KUB
U/S
Air enema
453
Medication for ALS?
Riluzole
reduces glutamate buildup
454
Meds for Tourettes
Fluphenazine, Clonazepam, Pimozide
455
CD4 count for CMV disseminated
less than 50
456
What type of cell on peripheral smear is most common with thalassemia
Target cells
457
Inevitable abortion
Intrauterine bleeding + dilation of cervix
458
Rheumatic fever is more often linked to ?
As opposed to glomerulonephritis being linked to?
group A strep throat
vs
impetigo
459
Lewy Body dementia = Dementia +?
Parkinsonism
460
Underlying pathophysiology of intussusception
Hypertrophy of Peyers Patches
461
Seconary group of patients that Craniopharyngioma occurs in
55 to 65 years old
462
mycosis fungoides =
cutaneous T cell lymphoma
463
gastroschisis is usually located where?
to the right of the umbilicus
464
fatigue + weight loss + normocytic anemia + renal insufficiency + hypercalcemia
multiple myeloma
465
Hypnagogic hallucinations occur when?
Just prior to falling asleep
466
mydriasis =
can worsen what condition?
dilation of the pupil
acute glaucoma
467
Hyperventilation effect on CO2
Effect on cerebral blood flow
Decreases
Vasoconstriction
468
Teenager with possible meckels - diagnostic test?
CT scan is better than Tech-99 scan
469
Purulent conjunctivitis 2 to 5 days after delivery
GONOCOCCAL
470
Roseola =?
what infectious agent?
fever and rash - timing and spread
HHV 6
HIGH spiking fever
fever, then rash, not together
rash starts on trunk and spreads outward
471
Pathophysiology of Hepatorenal syndrome
Splanchnic arterial dilation
Decreased GFR in absence of other clear cause
472
Amniocentesis timing
15-20 weeks
473
Inheritance of hemophilia A and B
X linked recessive
474
Urine anion gap = ?
helps determine between?
Na - Cl-
between RTA and diarrhea
475
Threatened abortion
Intrauterine bleeding + NO CERVICAL DILATION
476
Gold standard tx for pertussis
Macrolides
477
Bacterial meningitis empiric treatment
2 to 50 years
over 50
2 to 50 = vanco + 3rd gen cephalosporin
over 50 = vanco + 3rd fgen ceph + ampicillin
478
Which cancer has the highest ability to transform into acute leukemia?
CML
479
Drug used for HIV transmission prevention in baby
Zidovudine
480
What defines a positive water deprivation test
Urine osmolality stays low
Urine volume stays high
481
Left to Right shunts in peds (3)
ASD
VSD
PDA
482
clotting changes with pregnancy
increased vWF, increased 7,8,10
decreased protein C and S
increased fibrinogen
483
Child
High fever
Knee pain/Swelling (Unilateral)
refusal to bear weight
leukocytosis + elevated CRP and ESR
Recent URI or skin infection
Septic arthritis
next step: Arthrocentesis
484
Glucose levels low in pleural effusion usually due to
White blood cells in the effusion
485
Patients with gonococcal infection should be screened for?
HIV, Syphilis, Hep B
486
Polyarteritis nodosa creates what type of vasculitis
necrotizing
487
Indications for retrograde urethrogram
blood at meatus
dysuria
urinary retention
488
foot tapping, lip smacking, tongue protrusions in a patient on antipsychotics
tardive dyskinesia
when dose reduction isn't possible switch to CLOZAPINE
489
maternal diabetes associated with what congenital heart defect
transposition
490
Draw the diagram for determining NPV, PPV, SNS, SPC
TP FP PPV
FN TN NPV
SNS SPC
491
Diptheria steps of treatment
intubate
anti-toxin
IV abx
pseudomembrane - do not try to remove it
492
Melanosis coli
Dark brown discoloration of the colon with pale patches of lymphoid follicles
Associated with laxative abuse
493
Preferred pharmacotherapy for a prolonged QT
Beta blockers
Blunts increases in HR and shortens QT
494
Mupirocin
Topical antibiotic
Localized impetigo
495
What three things are commonly affected by allergenic substances?
skin
kidney
red cells
496
Rusty or dark brown lesions on laparoscopy
Chocolate cyst on ovary
Endometriosis
497
diffus breast erythema, edema, p'eau d'orange
inflammatory breast carcinoma
498
Lung destruction from smoking vs AAT deficiency
upper lobes for smoking
lower lobes for AAT deficiency
Centriacinar vs Panacinar respectively
499
At what age can you stop mammo screening?
75
500
Recurrent skin infections with staph
Hyper-IgE syndrome
501
Hemodynamics in Cardiogenic shock
```
RA pressure
PCWP
cardiac index
sVR
MVO2
```
Increased
Increased
DECREASED
Increased
Decreased
502
Dysmorphic red cells on UA =
glomerulonephritis
503
Where is Wernicke's area located?
other associated findings with stroke?
Superior posterior TEMPORAL lobe
right superior visual field defect
504
Pertussis post exposure prophylaxis
Azithromycin for 5 days
Or the other macrolides
505
Patient with stroke already on aspirin, next pharmacologic step
add Dipyridamole
OR
switch to Clopidogrel
506
Confirmatory tests tend to be ?
high specificity
colposcopy
507
Tolvaptan and Conivaptan are?
ADH Antagonists
for acute severe SIADH
Demeclocycline for chronic SIADH
508
Stroke or MI in a young person = look for?
viral infection associated?
best initial test?
Polyarteritis Nodosa
Hep B
Angiography
509
2 months
6 months
1 year
social development
social smile
stranger anxiety
separation anxiety
510
Mild vs Severe Concussion
4 factors
FND
LOC
HA
Amnesia
511
Important equation for determining pH
H+ = {pCO2}/{HCO3-}
512
Treatment for toxoplasmosis
Sulfadiazine + Pyrimethamine
| TMP-SMX for prophylaxis
513
what is the type of rash with fat embolism?
petechial
12 to 24 hours after injury
514
condyloma acuminata =
condyloma lata =
HPV
syphilis
515
Low ferritin + High TIBC =
RDW?
Iron deficiency anemia
Increased RDW
516
What imaging can induce thyrotoxic crisis
CT with contrast
Contrast is iodinated
517
Change in sensitivity and specificity if cutoff point is increased for a positive test
sensitivity decreases
specificity increases
518
Mono like illness in mom
brain calcifications
ventriculomegaly
seizures
toxoplasmosis
519
abx for gallbladder diseases (cystitis, docholithiasis, cholangitis)
cipro/metro
amp/gent/metro
520
Three A diseases associated with eosinophilic esophagitis
asthma
allergies
atopy
521
esophageal cancer vs esophageal stricture
barium swallow
stricture = symmetric
cancer = asymmetric
522
nocturnal asthma =
GERD
523
Stool osmolar gap
Measured - calculated
290 - (2x(Na + K))
524
Stool osmolar gap
Measured - calculated
290 - (2x(Na + K))
525
attributable risk percent =
ARP = (RR-1)/RR
so if a given risk factor causes 4 times the risk of getting a disease the RR = 4 and the ARP = 75%
526
do sensitivity and specificity depend on disease prevalence at all?
No
527
What is factorial study design
2 or more interventions each with 2 or more variables studied independently
528
what value of hazard ratio indicates no significant difference in adverse event outcomes between two itnerventions?
the closer to 1, the more equal they are
529
wider confidence interval including the null value of RR=1
most likely cause?
small sample size
decreases power
530
Subtypes of Selection bias
ascertainment
nonresponse
Berkson
Prevalence (Neyman)
Attrition
531
Subtypes of Observational Bias
Recall
Observer
Reporting
Surveillance (detection)
532
Case Control study
analytical observational study
retrospective
selecting cases with an outcome then controls without that outcome
then look back for risk factors
533
when can odds ratio be assumed to be representative of the relative risk?
rare diseases
tampon use and toxic shock syndrome
TSS has very low prevalence
534
research study to do to investigate incidence
cohort study
535
Mode, median, mean
in a positive skew
in a negative skew
positive
Mode> Median > mean
negative Mode < median < mean
536
a tight confidence interval =
a precise study
537
moving upward on an ROC cruve =
moving to the right on an ROC curve =
increased sensitivity
decreased specificity
