Practice Test Flashcards
(277 cards)
1
Q
macular degeneration hallmark
A
drusen bodies
central vision loss
affects detail and color vision
2
Q
Charcot joint
A
destructive neuropathic joint arthropathy, assoc w/ DM
3
Q
fleck fracture
A
fx at base of 2nd metatarsal
highly suspicious for lisfranc injury
4
Q
PKD patients are at risk for
A
MVP, diverticulosis, berry aneurisms (subarachnoid hemorrhage)
5
Q
stills murmur
A
mid systolic, musical, vibratory, noisy, high pitched murmur on inferior aspect of LLSB and apex
6
Q
venous hum
A
grade 1 or 2 harsh systolic ejection murmur on LUSB
7
Q
graham steell murmur
A
high pitched early diastolic murmur left sternal edge 2nd ICS w/ patient in full inspiration
assoc w/ pulmonary HTN
8
Q
phenelzine can cause hypertensive crisis by combo with
A
tyramine containing foods (aged cheese and wines)
9
Q
pill rolling tremor
shuffling gait with lack of arm movements
fixed facial expression
seborrhea of the skin
A
parkinson
10
Q
Parkinson tx
A
levidopa/ carbidopa
11
Q
first line tx idiopathic pulmonary fibrosis
A
CCB: reduces pulmonary arterial pressure
12
Q
Menkel diverticulum from what embryonic structure
A
vitelline duct
13
Q
isotrentinoin AE
A
teratogenic, psych AE, hepatitis, inc triglycerides, hypercholesterolemia
14
Q
increased estrogen
increased LH, increased FSH
A
FH/LSH secreting pituitary adenoma
15
Q
decreased estrogen, decreased LH, decreased FSH
A
hypothalamic or pituitary failure
16
Q
mixing study results in no correlation of increased PTT
A
clotting factor inhibitor (antiphospholipid syndrome)
17
Q
meds that can be used in severe hypercalcemia
A
furosemide
IV NS
calcitonin, bisphosphonates
18
Q
legg calve perthes classic presentation
A
loss of abduction and internal rotation of leg
19
Q
MC therapeutic agents that can be used intrapleurally for pleurodesis in recurrent malignant pleural effusions
A
bleomycin
20
Q
diverticulitis MC site
A
sigmoid colon
21
Q
anthrax causative agent
A
bacillus anthracis
22
Q
Q fever causative agent
A
coxiella burnetii
23
Q
chancroid causative agent
A
Haemophilus ducreyi
24
Q
conn’s syndrome tx
A
spironolactone
25
protocol for chemical exposure in eye
irrigation -> check pH -> visual acuity
26
med that can decrease psychotic episodes in patients w/ resistance to 1st line meds
clozapine
27
blurring of optic disk w/ optic disk swelling + neurologic sx diagnosis
head CT to r/o cranial tumor
28
sarcoidosis tx
oral prednisone
29
dubin johnson syndrome labs
isolated direct (conjugated) bilirubinemia
30
isolated increased indirect bilirubin
gilbert syndrome
criggler najjar syndrome
31
poison ivy presentation
erythematous pruritic rash arranged in linear or streak like configurations (where plant made contact w/ skin)
32
tx urge incontinence
oxybutinin
33
tx stress incontinence
pseudoephedrine
34
dawn phenomenon
decreased insulin sensitivity from nightly surge in glucagon and cortisol during nighttime fasting (normal glu evening then increased during late night or early morning, elevated when awake)
35
somogyi effect
nocturnal hypoglycemia then rebound early morning hyperglycemia. normal evening glucose then early morning hypoglycemia then hyperglycemia when waking
36
pronator syndrome
median nerve compression at level of proximal forearm
37
best treatment modality for patient w/ neuroleptic malignant syndrome
bromocriptine
38
tx trigemical myalgia
carbamazepine
39
atrial flutter tx
CCB (verapamil)
40
mycobacterium avium complex tx
clarithromycin + ethambutol or rifampin
41
Test for lithium induced nephrogenic DI vs central DI
Arginine vasopressin challenge test
42
high dose dexamethasone suppression test
Cushing's syndrome
43
fluid challenge test
suspected prerenal azotemia
44
PCA occlusion
visual hallucinations, ipsilateral cranial nerve deficits, comas, drop attacks
contralateral muscle weakness
45
acute anterolateral infarction PE
4th heart sound
46
empiric management bacterial meningitis
IV ceftiaxone + IV vancomycin
47
Bowen's disease
SCC in situ: epidermal and dermal cells w/ large pleomorphic hyper chromatic nuclei
48
refractory ITP tx
splenectomy
49
patho of positive sx in schizophrenia
excess dopamine receptors in mesolimbic pathway
50
patho of negative sx of schizophrenia
dopamine dysfunction in mesocortical pathway
51
parkinson pathology
idiopathic dopamine depletion in substantial nigra
52
bilateral hilar lymphadenopathy, noncaseating granuloma
sarcoidosis
53
swollen painful LN in groin, axilla, and cervical w/ multiple flea bites. safety pin appearance
yersinia pestis
54
which cell isn't affected by polycythemia vera
lymphocyte line
55
med that can cause hypokalemia
furosemide (loop diuretic)
56
most important RF for cervical carcinoma
HPV infx
57
1st line sickle cell crisis
IVF and oxygen
58
adrenocortical insufficiency ABG
metabolic acidosis
59
MMR vaccine CI
hx of HIV and CD4 of 100
60
PCP pneumonia presentation
immunocomp (CD4<200), F, dyspnea, O2 desat, extremely high LDH, bilateral diffuse interstitial infiltrates
61
PCP pneumonia tx
bactrim
62
hypermagnesemia presentation
decreased DTR
63
Panama, F, cough, anorexia, light red spotted maculopapular rash w/ photosensitivity and joint pain
rubella
64
COPD which pneumonia etiology
H. flu
65
abnormal gait, weakness leg > arm, abulia, urinary incontinence, which artery occluded
anterior cerebral artery occlusion
66
neuroleptic malignant syndrome sx
1-2wks after initiating or increasing dose of DA antagonist (1st gen antipsychotics)
autonomic instability, incontinence, hyper salivation, hyperthermia, lead pipe rigidity, hyporeflexia, possible rhabdo
67
serotonin syndrome sx
autonomic instability, tremors, hyperthermia
mydriasis, diarrhea, abdominal cramps
68
erythema marginatum
rheumatic fever: macular, erythematous nonpruritic enlarging annular rash w/ rounded sharp demarcated edges, no central clearing, blanches w/ pressure
69
erythema migrans
lyme, target appearance
70
erythema nodosum
painful erythematous inflammatory nodules on anterior shins. increased estrogen exposure (pregnancy), sarcoidosis, TB, fungal infx
71
erythema multiforme
type IV hypersensitivity reaction. dusty violet red purpuric macules w/ vesicles or bull in center (target appearance)
72
erythema infectiosum
5th disease, slapped cheek appearance
73
cryptococcus meningitis test
india ink
74
MC cancer for smokers
adenocarcinoma
75
huntington disease sx
behavioral changes, chorea, dementia
76
parkinsons sx
resting tremor. bradykinesia, rigidity
77
thoracid outlet syndrome test
adson test: loss of radial pulse when head is turned to the affected side
78
pheochromocytoma test
24h urine vanillylmandelic acid levels
79
aseptic (viral) meningitis CSF
increased WBC count, normal glu, lymphocytosis
etiology: enterovirus
80
causative agent hairy leukoplakia
EBV
81
Medication used for Parkinson pill rolling tremor in young patients
benztropine
82
auspitz sign
psoriasis: punctate bleeding spots when the plaques of psoriasis are unroofed
83
guttate psoriasis classic description
small erythematous discrete papules w/ fine scales
84
class 2 anti arrhythmic that blocks alpha 1, beta 1, and beta 2
carvedilol
labetalol
85
cardioselective BB that affect beta 1 receptor only
atenolol
metoprolol
86
nonselective BB that block beta 1 and beta 2
propranolol
nadolol
87
first line tx osteomyelitis w/ beta lactamase positivity
IV nafcillin
88
first line tx TTP
plasmapheresis
89
TOC tumor lysis syndrome from chemotherapy
allopurinol + IVF
90
ALS sx
difficulty swallowing, abn speech w/ hoarseness, progressive weakness. atrophic tongue w/ fasciculations, increased DTR, babinski sign w/ muscle atrophy on head neck and torso (mixed UMN/LMN sx)
91
mittelschmertz
ovulation pain: low abd or pelvic pain during ovulation
92
IT band syndrome sx
lateral knee pain and tenderness
runners MC
93
chondromalacia sx
anterior knee pain behind or around patella
94
hematuria test <40yo
UA and culture
95
hematuria test >40yo
cystoscopy
IV pyelogram
urine cytology
96
RF bladder cancer
white male, cyclophosphamide, pioglitazone, dye exposure, rubber and leather, schistosomiasis infx, chronic bladder infx
97
close PDA
indomethacin
98
keep PDA open
prostaglandins
99
aortic stenosis sx
pulses parvus et tarsus (weak and delayed pulse)
fixed cardiac output
100
aortic regurgitation sx
bounding pulses
wide pulse pressure
101
pyloric stenosis test
US
102
PTSD first line
paroxetine (SSRI)
103
first line tx for long term schizophrenia
olanzapine (2nd gen antipsychotic)
104
Parkinson patho
idiopathic depletion of dopamine in basal ganglia
105
EKG severe chronic bronchitis
negative QRS in lead 1, positive QRS lead AVF (RAD from hypoxemia)
106
longstanding systemic HTN or aortic stenosis EKG
depth in S wave V1 + height of R wave V6 >35mm
107
lansoprazole AE
macrocytic anemia
108
tx hepatitis C
pegylated alpha interferon + ribavirin
109
toxoplasmosis presentation
hx HIV, F, body aches, HA. ring enhancing lesion on CT
110
toxoplasmosis RF
cat exposure
111
patho psoriasis
keratin hyperplasia in stratum basale and spinous due to T cell activation
112
type 2 hypersensitivity in basement membrane
bulbous pemphigoid
113
autoimmune disruption of desmosome later
bulbous pemphigoid
114
MC benign ovarian neoplasm
dermoid cystic teratomas
115
endometrial hyperplasia tx
progesterone only if want to preserve possibility of fertility
hysterectomy if do not want to preserve fertility
116
chancroid etiology
H. ducreyi
117
thrombocytopenia classic presentation
petechiae
118
MC clinical presentation in sickle cell
episodic hematuria
119
dequervain (subacute) thyroiditis lab
positive ESR
120
smooth muscle antibodies
autoimmune hepatitis
cirrhosis
121
PANCA
UC, microscopic polyangiitis, primary sclerosing cholangitis, churg-strauss
122
anti mitochondrial antibodies
primary biliary cirrhosis
123
endomysial antibodies
celiac disease
124
streptomycin AE
ototoxic
nephrotoxic
125
myersons sign
parkinsons
tap bridge of nose causes sustained blink
126
lhermittes sign
MS, inc DTR
127
positive ice pack test
myasthenia gravis
128
myasthenia gravis sx
diplopia, ptosis, generalized weakness (including respiratory), bulbar weakness (slurred speech, dysphasia)
129
best med for lowering isolated triglycerides
fibrates
130
MC presentation sickle cell
dactylitis
131
rash associated w/ celiac
dermatitis herpetiformis
132
kawasaki tx
aspirin + IVIG
133
MC echo and blood culture findings in endocarditis (no IVDU)
streptococcus viridian's
mitral valve
134
MC echo and blood culture findings in endocarditis w/ IVDU
S. aureus
tricuspid valve
135
med that can cause hypothyroidism
amiodarone
136
chlamydia pneumophilia sx
atypical sx
sinusitis
137
mycoplasma pneumoniae sx
bulbous myringitis
pharyngitis
138
klebsiella pneumoniae sx
alcoholics and debilitated patients
cavitary lesions
currant jelly sputum
139
lacunar infart sx
Hx HTN and DM. dysarthria, clumsy hand syndrome. punched out hypotenuse lesions near basal ganglia
140
MC intrinsic kidney injury in hospitalized patients
ATN: oliguria, inc BUN/Cr
141
epithelial cell or muddy brown casts
ATN
142
ATN MCC
prolonged prerenal azotemia
contrast dye
ahminoglycosides (gentamicin)
143
sunburst
hair on end appearance
osteosarcoma
144
glyburide MOA
sulfonylureas: stimulates pancreatic beta cell insulin release in non-glucose dependent fashion
145
MOA metformin
decreases hepatic glucose production with no effect on pancreatic beta cells (biguanides)
146
acarbose and miglitol MOA
delays intestinal absorption of glucose (alpha glucosidase inhibitors)
147
pioglitazone and rosiglitazone MOA
increases insulin sensitivity at peripheral receptor sites of adipose and muscle tissues (thiazolidinedione)
148
liraglutide and eventide MOA
lowers glucose by mimicking incretin (glucagon like peptide 1 agonst
149
CI use of MTX in ectopic pregnancy
serum hCG >5000
ruptured ectopic pregnancy
hx TB
presence of fetal heart activity
150
DOC narrow complex SVT
adenosine
151
MC etiology from deli meats and unpasteurized cheeses that is gram positive bacilli
listeria monocytogenes
152
listeria tx
IV ampicillin
153
anthrax sx
painless black eschar
widened mediastinum
154
Ludwig angina sx
swelling and erythema to upper neck and chin. pus on floor of mouth
155
Vincents angina
trench mouth: profuse gingival bleeding, severe gingival pain, interdental papilla w/ ulcerative necrosis
156
zofran MOA
serotonin antagonist
157
serotonin syndrome sx
tachycardia, BP fluctuations, hyperthermia, hyperreflexia, myoclonus, dilated pupils, agitation, hyperactive GI tract
158
serotonin syndrome tx
cyproheptadine
benzo (for hyperthermia)
159
MS CSF
increased oligoclonal bands
160
GBS CSF
high protein w/ increased WBC (polymorphonuclear neutrophils) w/ dec glucose
161
vibrio cholera sx
diarrhea, grey w/ no odor, pus, or blood. ingesting shellfish
162
salmonella sx
invasive diarrhea, bloody, pea soup colored
163
Zollinger Ellison syndrome test
gastrin secretin in gastronomes not inhibited by secretin
164
management of choice localized renal cell carcinoma
radial nephrectomy
165
L4 disc herniation sx
pain and paresthesia along anterior leg, weakness w/ ankle dorsiflexion, loss knee jerk reflex
166
S1 disc herniation sx
pain and paresthesia posterior calf and plantar surface of foot w/ weakness when plantar flexion, loss ankle jerk reflex, walking on toes harder than on heels
167
TOC mycoplasma pneumoniae
fluid filled blisters on TM
macrolide or doxy
if child <8yo, azithromycin
168
patients w/ coarctation of aorta usually has
bicuspid aortic valve
169
cyclophosphamide AE
hemorrhagic cystitis
increase risk of bladder cancer
170
cimetidine AE
CP450 inhibition, gynecomastia, impotence
171
septic arthritis tx for gram negative diplococcus
gonorrhea: IV ceftriaxone
172
PE classic presentation tests
westermarks sign
hamptons hump
173
mainstay tx long term for chronic asthma
inhaled fluticasone
174
screening test for SLE
ANA (not specific)
175
anti histone ab
drug induced lupus
176
medications that increase incidence of myasthenia gravis
gentamicin
BB, FQ, aminoglycosides
177
tx nosocomial pneumonia (HAP)
piperacillin/ tazobactam + gentamicin
178
+ ASO titers
post streptococcus glomerulonephritis
179
diphtheria tx
diphtheria antitoxin + penicillin
180
Tx pleural effusion
thoracentesis
181
meds that increase prolactin levels
1st gen antipsychotics (haloperidol)
182
organophosphate poisoning tx
atropine + pralidoxime
183
organophosphate poisoning sx
HA, muscle spasm, tremors, convulsions, visual changes, chest tightness. diffuse wheezing, sweating, lacrimation
184
echo from restrictive cardiomyopathy
diastolic dysfunction w/ dilation of both atria
185
HIV med associated w/ vivid dreams and neurologic disturbances
efaviranz
186
tx infectious mastitis
warm compress, dicloxacillin
continue to breastfeed
187
MCC myocarditis
viral (enteroviruses)
188
neurogenic shock hallmark
hypotension w/ bradycardia, decreased pulmonary capillary wedge pressure
189
brown recluse spider bite presentation
local burning at site then blanching with red halo around ischemic center -> hemorrhagic bullae -> eschar formation
190
AE beta blockers
fatigue, depression, impotence, masks sx hypoglycemia, hypotension, bradycardia, 2nd/ 3rd heart block, bronchospasm
191
first line tx acute active bleeding from esophageal varices
endoscopic ligation of bleeding vessel
192
treatment acute dystonia
diphenhydramine
193
acute dystonia sx
trismus, protruding of tongue, facial grimace, torticollis, difficulty speaking
194
paroxysmal nocturnal hemoglobinuria sx
hemolytic anemia, venous thrombosis of large vessels, pancytopenia
195
methimazole AE
myelosupression (agranulocytosis), hepatotoxicity
196
doxorubicin AE
dilated cardiomyopathy, alopecia, bone marrow suppression
197
biots breathing
irregular respirations, quick shallow breaths of equal depth w/ irregular periods of apnea (opioid induced respiratory depression)
198
PID tx
IV doxycycline + ceftriaxone
199
C diff colitis tx
metronidazole
PO vancomycin if severe
200
when to do percutaneous nephrolithotomy
stones >10mm, struvite stones, and stag horn calculi
201
first line myesthenia crisis
plasmapheresis
202
initial tx HIT
argatroban
203
thiazolidinedione AE
rosiglitazone and pioglitazone. cardiotoxicity, CHF, hepatotoxicity, fx
204
Tx hypotonic isovolemic hyponatremia
fluid restriction and tx underlying cause
205
test for syphilis in presence of chancre or condyloma
darkfield microscopy
206
test for nephrogenic DI from central DI
desmopressin stimulation test
207
low AFP, high bHCG, low estradiol
trisomy 21
208
high alpha fetoprotein in triple screen
neural tube defect
multiple gestation
underestimate gestational age
209
low alpha fetoprotein, low estradiol, low bHcG
trisomy 18
210
H shaped vertebrae
sickle cell anemia
211
tx warm antibody autoimmune hemolytic anemia
CS
212
tx lyme meningitis
ceftriaxone
213
glioblastoma multiforme hallmarks
non homogenous mass w/ hypotenuse variable ring of enhancement w/ surrounding edema w/ butterfly appearance if it crosses corpus callosum
214
medullary thyroid carcinoma secretes
calcitonin
215
herpes simplex virus associated encephalitis CSF
increased protein w/ normal glucose and increased lymphocyte count
216
class 1 anti arrhythmic that prolongs ventricular depolarization and refractory period
procainamide
217
other electrolyte imbalance associated w/ hypocalcemia
hypomagnesemia
218
meningiomas location
MC in convex of hemispheres and parasagittal regions. often attached to dura
219
light wisp of cotton to test corneal reflex evaluates which CN
CN 5: trigeminal
220
Test abdominal aortic aneurysm
abdominal US
221
TOC acute exacerbations of MS
IV high dose CS
222
TOC neisseria meningitis
IV penicillin G
223
ITP tx
IVIG in kids
CS in adults
224
MC indication for hysterectomy
leiomyomas
225
which med decrease progression of relapsing remitting form of MS
glatiramr acetate
226
clozapine 2 major AE
agranulocytosis
myocarditis
227
med given before surgery of pheochromocytoma
phenoxybenzamine (nonselective alpha blockers)
228
management nephrogenic DI
indomethacin
HCTZ
229
MC pathogen post op surgical sites
S. aureus
230
coal workers pneumoconiosis xray
small opacities in upper lung fields
231
silicosis xray
small round opacities throughout lungs
calcified hilar lymph nodes
232
asbestosis xray
interstitial fibrosis
thickened pleura
233
test intussusception
barium enema diagnostic and therapeutic
234
pathogen in stream water
dyspepsia, loose stool
giardia lamblia
235
congenital abnormality associated with tracheoesophageal fistula
esophageal atresia
236
pertussis tx
azithromycin or bactrim
237
dew drop on a rose petal
varicella
238
social phobia tx
SSRI
239
celiac test to confirm diagnosis
small bowel biopsy
240
test to confirm hepatitis B vaccination
anti- HBs (surface antibody)
241
transmural inflammation
crohns
242
increase incidence of hip dysplasia
first born
left hip
female, breech
243
myotome triceps and extension of arm
C7
244
warfarin clotting factors
2, 7, 9, 10
245
RF preeclampsia
multiple gestation, nulliparity, advanced maternal age, AA, obesity
246
medication that affects INR of patient taking warfarin
bactrim
247
venous hemorrhages, disk swelling, cotton wool spots, dark dusky retinal background
CRVO
248
pain when extend elbow, arm pronated, and extend fingers and wrist against resistance
lateral epicondylitis
249
pain from resisted pronation or flexion of wrist
medial epicondylitis
250
vaccine CI in patient undergoing chemo
MMR
251
antihypertensive med to avoid in asthma patients
non beta 1 selective BB (propranolol)
252
penicillin MOA
inhibits cell wall synthesis
253
MC malignant primary tumor of bone
osteosarcoma
254
cardiac biomarker that rises in 1-4h, peaks at 6-7h, and returns to normal after 24h
myoglobin
255
endometritis tx
clindamycin
gentamicin
256
MOA delays gastric emptying, stimulating pancreatic insulin response to glucose, reducing glucagon release after meals
liraglutide (GLP1)
257
reduce breakdown of endogenous GLP1, making higher levels of GLP1
DDP4
258
lesion right optic tract posterior to chiasm
left homonymous hemianopsia
259
RBBB + ST elevation in V1-V3
brugada syndrome
260
anti arrhythmic that inhibit T3 to T4 conversion
amiodarone
261
nerve root for patellar reflex
L3/L4
262
MC pathogen bullous myringitis
mycoplasma pneumonia
263
dacryostenosis tx
digital massage
lacrimal duct probing if persistent
264
metformin MOA
decreases hepatic glucose production and increases peripheral glucose uptake
265
suppurative complication of GAS pharyngitis
peritonsillar abscess
266
ligament injured in gamekeepers thumb
ulnar collateral ligament
267
sign associated w/ idiopathic intracranial HTN
papilledema
268
furosemide monitor for
hypokalemia
269
MRSA abscess tx
I&D + clindamycin
270
impairs absorption of iron, avoid immediately before or after taking
calcium
271
CI for use of stool DNA test for colorectal cancer
hx of IBD
272
tx outpatient diverticulitis
metronidazole and cipro
273
pain along joint line with deep squatting
meniscal injury
274
anti seizure med with AE gingival hyperplasia
phenytoin
275
MCC erectile dysfunction
vascular disease
276
post strep glomerulonephritis UA
RBC casts
277
MCC heart failure in US
coronary artery disease q
