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Question 1

Meralgia paresthetica

Answer 1

lateral femoral cutaneous nerve comp inguinal lig, car rides, tight pants/belts

Question 2

Drug-induced type 1 hypersensitivity rxn

Answer 2

Anti-histamine unless s/s resp distress/systemic stuff give IM epi/steroids

Question 3

Oculomotor nerve palsy

Answer 3

PUPIL DILATED aneurysm get CTA

Question 4

Fat embolism

Answer 4

Pulm edema can mimic ARDs

Question 5

Pronator drift

Answer 5

pyramidal

Question 6

Bartonella disseminated

Answer 6

HIV purple papules (vascularized) –> pedunculated nodules, +constitutional sx wt loss/night sweats, +hypodense liver lesions/other organ involvement, dx culture, tx doxy

Question 7

Macular degeneration

Answer 7

Grid test wavy lines

Question 8

Acute necrotizing mediastinitis

Answer 8

Retropharyngeal abscess, danger zone posterior mediastinum

Question 9

Tracheobronchial injury

Answer 9

Chest trauma, PTX air leak, bronchoscopy

Question 10

Thiazide SE

Answer 10

Hyperglycemia (insulin resistance) but still first line ALLHAT

Question 11

Heat stroke

Answer 11

Inadequate thermoregulation

Question 12

Paroxysmal nocturnal hemoglobinuria

Answer 12

40yo, CD55 CD59 –> hemolytic anemia (+/- other cytopenia), venous thrombus abd + cerebral, dx flow cyto tx hematopoetic stem cell tplant

Question 13

Frostbite

Answer 13

Warm in WATER

Question 14

Cervical spinal injury

Answer 14

C3-5 innervate diaphragm, trauma pt w/ resp distress–> intubate (orotracheal w/ manual stabilization)

Question 15

Trigeminal neuralgia

Answer 15

NOT A VIRUS (on the test)

Question 16

Pt in a fire

Answer 16

CO + cyanide (hydroxocobalamin, sodium thiosulfate)

Question 17

Positive predictive value

Answer 17

Chance if TEST IS POSITIVE, really have the dz –> true positives/total positives

Question 18

Paraphymosis

Answer 18

REDUCTION OF FORESKIN manual or surgical

Question 19

Hypothyroidism in pregnancy

Answer 19

NL PT: inc total T4, nl-slightly high free T4, low TSH (2.5, 3.0), euthyroid (hyperemesis gravidarum transient hyperthyroid)
PT W/ HYPOTHYROIDISM: inc levothyroxine dose 30% monitor q4w

Question 20

Panic disorder

Answer 20

SSRI 1st line, don’t put BZD on the test

Question 21

Uric acid

Answer 21

Crohn’s dz bicarb losses from diarrhea make urine more acidic = urate kidney stones (also oxalate by different mech)

Question 22

Hernias

Answer 22

Indirect: infants, LATERAL to inf epigastric a, deep ring, processus vaginalis
Direct: old guys, direct, MEDIAL, superficial ring, transversalis fascial defect
Femoral women always needs to be fixed high risk of incarceration, SBO

Question 23

Legionella pneumonia

Answer 23

Levofloxacin (CAP + diarrhea)

Question 24

Fibroids

Answer 24

Dx saline-infused sonogram

Question 25

Adjustment disorder

Answer 25

CAN'T DX IF PT MEETS CRITERIA FOR MDD

Question 26

Miller Fisher Syndrome

Answer 26

GBS variant ophthalmoplegia, ataxia, weakness usually no paralysis

Question 27

DM drugs for pts w/ co-occurring cardiovascular dz

Answer 27

GLP-1 agonists (glutide) + SGLT2-inhibitors (gliflozin)

Question 28

DM ophthalmoplegia

Answer 28

CNIII ischemia PUPILARY DILATION preserved

Question 29

Thyroid and birth control

Answer 29

Increased binding proteins=inc total T4 but nl free T4/euthyroid state

Question 30

Myelodysplastic syndrome

Answer 30

PMNs HYPOsegmented, hypogranulation, pancytopenia (anemia, hematoma, infxns), h/o chemo/radiation, dx BM bx, tx hem stem cell tplant

Question 31

Polymyalgia rheumatica vs glucocorticoid-induced myopathy

Answer 31

PR is PAINFUL, GIM weakness

Question 32

Prosthetic valve

Answer 32

THROMBUS DOESN'T HAVE TO BE SEPTIC

Question 33

ESRD MC cause of death

Answer 33

cardiovascular dz (infx 2nd MC)

Question 34

Secondary Raynaud’s

Answer 34

Ulcers

Question 35

Hodgkin lymphoma

Answer 35

<30y chemo/rad 18x lung ca risk, acute leukemia, non-HL

Question 36

Axillary nerve injury

Answer 36

Anterior shoulder dislocation, deltoid

Question 37

Case-control vs cohort

Answer 37

CC groups are dz no dz, cohort groups are exposure/no exposure

Question 38

Migraine

Answer 38

ACUTE nonresp NSAID, SQ triptan EXCEPT IF PT HAS HEART DZ give prochlorperazine/other antiemetic

Question 39

NPH

Answer 39

Urinary urgency early, poor CSF absorption

Question 40

Syphillis vs B12

Answer 40

Syph hyporeflexia ARGYLL ROB PUPIL non reactive to light +react to accom, B12 hyperreflexia/UMN

Question 41

Smoking pre-op

Answer 41

4-8w

Question 42

TIA vs MS

Answer 42

CV RFs + 24/48h | MS sx 1-3w

Question 43

TMP

Answer 43

Hyper K enac?? Who knew

Question 44

Ascertainment bias

Answer 44

TYPE OF SELECTION BIAS not reporting bias

Question 45

Lupus can have fever?

Answer 45

YES GET ANA basically any time there’s a photosensitive rash + systemic sx, leukopenia w/ fever is odd for infx (diss gon PUSTULAR rash, EBV also can have rash)

Question 46

Brain abscess

Answer 46

Preceding URI/tooth infx, staph a strep viridans anaerobes, broad abx (metro, Ctx vanc)

Question 47

When is acute otitis externa a big deal?

Answer 47

Necrotizing, pt DM, jaw pain, granulation tissue, IV cipro

Question 48

Lung resection post op mortality

Answer 48

FEV1, DLCO <40% ng

Question 49

Turner syndrome preggo

Answer 49

Aortic dissection

Question 50

Progressive multifocal leukoencephalopathy vs HIV-dementia

Answer 50

JC virus, focal lesions, HAND=rep of HIV in the brain, diffuse white matter hyperintensities on MRI

Question 51

Myopathies

Answer 51

``` Painful = PR, polymyositis Eyes/face = MG Absent DTRs = LE (or endo) Esophageal sx = polymyositis Dry mouth = LE ```