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GK ROSH Summative Exam Review > Random Review > Flashcards

Random Review Flashcards

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1
Q

What is patellofemoral syndrome (chondromalacia)

A

idiopathic softening/fissuring of the patellar articular cartilage

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2
Q

S/S of patellofemoral Syndrome

A

anterior knee pain “behind” or around the patella, worse with knee hyperflexion

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3
Q

Dx for patellofemoral syndrome

A

+ apprehension sign

(examiner applies pressure medial-lateral patella with pain or patient refuses test in anticipation of pain)

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4
Q

Mgmt of patellofemoral syndrome

A

NSAIDS

rest & rehab

strengthen vastus medialis obliquus of the quadriceps

weight loss

elastic knee sleeve

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5
Q

What is MOI for anterior cord syndrome?

A

MC after direct injurt: blowout vertebral body burst fractures (flexion)

indirect injury to anterior spinal artery

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6
Q

What deficits are present with anterior cord injury?

A

bilateral loss of motor function and pain and temperature sensation below the level of injury

vibration sense and proprioception are preserved

POOR PROGNOSIS!

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7
Q

What is the MCC of chlamydial cervicitis?

A

chlamydia trachomatis

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8
Q

Tx for chlamydia trachomatis

A

Azithromycin 1g single dose

Doxy 100mg BID x 7 days

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9
Q

What medication is known to reduce calcium absorption?

A

PPIs: decrease gastric acidity which leads to a decrease in calcium absorption. However, it is thought that calcium citrate does not have this same consequence when taken with omeprazole.

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10
Q

How does Botulinum Toxin cause paralysis?

A

It inhibits acetylcholine release at presynaptic receptors

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11
Q

What are the 3 ways someone can get botulism?

A
  1. ingestion of honey contaminated w/spores
  2. food-borne: inadequately preserved or undercooked foods
  3. wounds contaminated by spores
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12
Q

What are the S/S of Botulism?

A
  • descending, symmetric, flaccid paralysis (upper>lower)
  • Cranial Nerve deficits
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13
Q

Tx for Botulism

A

>1 y/o: equine serum antitoxin

<1 y/o: human-derived botulism Ig

abx for wounds

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14
Q

floppy baby

A

botulism

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15
Q

What labs should be ordered if suspecting acromegaly?

A

initial: IGF-1 (elevated), postprandial serum GH, TRH stimulation test

Secondary: oral glucose tolerance test (conclusive if failure to suppress serum GH to < 2 ng/mL after an oral load of 100 g glucose)

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16
Q

What is the MCC of acromegaly?

A

pituitary adenoma

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17
Q

Tx for acromegaly

A

ocreotide (a somatostatin analog)

transsphenoidal resection

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18
Q

What physical exam finding suggests globe perforation?

A

Hyphema

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19
Q

What is the most common type of knee dislocation?

A

anterior knee dislocation

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20
Q

“dimple” sign on PE w/ posterolateral dislocation

A

knee dislocation

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21
Q

Cause of knee dislocations

A

anterior: hyperextension of the knee
posterior: a direct blow to the anterior tibia w/knee flexed

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22
Q

What is the tx for anterior knee dislocation?

A

reductiona nd knee splint w/ 15-20 degree flexion

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23
Q

What nerve may be injured during anterior knee dislocation?

A

common peroneal nerve

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24
Q

What artery may be injured in an anterior knee dislocation?

A

popliteal artery

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25
What are the 3 main types of polyps?
1. **_hyperplastic_** (nonmalignant) 2. **_adenomatous_** **MC\*** 3. **_malignant_**
26
AAFP **_routine_** colorectal cancer screening guidelines
**Fecal occult** blood testing, **sigmoidoscopy**, or **colonoscopy** in adults, beginning at **_50 until 75_**
27
AAFP colorectal cancer screening guidelines if **_1 relative w/colon cancer_**
colonscopy at **40** OR **10 yrs before the age** at which relative was **diagnosed**
28
AAFP colorectal cancer screening guidelines if **_familial adenomatous polyposis_**
**sigmoidoscopy** at age **12**, then **every 1-2 years**
29
What is volume of distribution?
describes **how far** a drug will partition from the **bloodstream** to the **surrounding tissues**.
30
Drugs with low volumes of distributions tend to stay in the \_\_\_\_\_\_\_\_\_\_\_.
bloodstream
31
drugs with high volumes of distribution preferentially accumulate in ________ and \_\_\_\_\_\_.
drugs with high volumes of distribution preferentially accumulate in **_extravascular tissues_** and **_fluids_**.
32
What is a knee effusion?
A knee effusion is defined as **fluid within the knee joint**.
33
What abnormality can ethanol toxicity cause?
hypoglycemia
34
What is the mechanism of injurty for scaphoid fracture?
fall on an outstretched hand (FOOSH)
35
S/S of **scaphoid fracture**
dorsal radial wrist pain w/**decreased ROM** of **wrist and thumb** tenderness to palpation of anatomic **snuffbox**
36
scaphoid fx tx
thumb spica splint
37
What are the live attenuated vaccines?
* Herpes Zoster * Influenza * MMR * Rotavirus * Typhoid (bacterial) * Vaccinia (smallpox) * Yellow fever
38
What is the triad for Grave's disease?
1. Diffuse goiter 2. exophthalmos 3. pretibial myxedema
39
S/S of hyperthyroidism
Patient will be complaining of **heat intolerance, palpitations, weight loss, tachycardia, and anxiety**
40
What will PE of hyperthyroidism (graves dz) show?
**hyperreflexia, goiter, exophthalmos, pretibial edema**
41
Tx for hyperthyroidism
Methimazole or PTU **PTU** if **P**regnant
42
What is the 1st line tx for latent TB infection?
Isoniazid
43
What will CXR for Primary TB show?
Ghon FOcus
44
Tx for subarachnoid hemorrhage?
nimodipine
45
S/S of retinal detachment
**_painless_ loss of vision, floaters, flashing lights, curtain lowering sensation** **reduced brightness in involved eye**
46
Hydroxychloroquine is an anti-malarial drug used for which two diseases?
RA and Lupus
47
S/S of systemic Lupus Erythematosus
fever, lymphadenopathy, weight loss, general malaise, or arthritis
48
What will PE of Systemic Lupus Erythematosus show?
butterfly rash/malar rash
49
What will labs of SLE show?
**(ANA), anti-dsDNA** antibodies, **anti-smith** antibodies, **anti-histone** antibodies
50
Dx for osteoporosis
DEXA scan - T-score **≤ -2.5**
51
Tx for osteoporosis
bisphosphonates
52
MC fractures associated w/osteoporosis
vertebral body compression fractures
53
What electrolyte imbalance is a child with pyloric stenosis at most risk for?
hypokalemia
54
hot potato voice
peritonsillar abscess
55
Which medication is recommended for patients with atrophic vaginitis and dyspareunia who do not want to use a vaginal route of medication delivery?
The selective estrogen receptor modulator **ospemifene**
56
What is stasis dermatitis and in what disease can you see it?
Stasis dermatitis occurs with **venous insufficiency** and **valvular incompetency**. The proximal skin appears thin and brown, and may occur with distal macules, papules, red irritation, skin thickening and edema.
57
Dx for varicose veins
duplex ultrasound
58
Tx for varicose veins
compression stocks + leg elevation
59
What is the initial tx for hypercalcemia?
normal saline
60
What does EKG for hypercalcemia show?
shortened QT interval
61
What are most kidney stones composed of?
calcium oxalate or calcium phosphate
62
Is peptic ulcer disease a risk factor for developing nephrolithiasis?
Yes, b/c pts with PUD usually ingest a lot of calcium to ease their symptoms.
63
What are the clinical signs of Kawasaki Disease?
* **_high fever for 5 days (necessary)_** * C/o of 4/5 of the following: 1. bilateral bulbar **conjunctival injection** 2. oral mucous membrane changes **"strawberry tongue"** 3. peripher extremity changes **(erythema/edema of hands or feet**) 4. **Polymorphous rash** 5. **Cervical lymphadenopathy**
64
**_CRASH and burn_**
**_C_**onjunctivitis **_R_**ash **_A_**denopathy **_S_**trawberry tongue **_H_**and/feet edema **_BURN_** (uncontrolled high fever) **_KAWASAKI DISEASE_**
65
What is tx for Kawasaki Disease?
**IVIG + ASA**
66
Hx of hyphema
hx of **trauma** to eye w/ **foreign object**
67
s/s of **hyphema**
dec. vision, photophobia, pain, red reflex is absent
68
PE of hyphema
blood in ant. chamber
69
what PE sign shows globe perforation?
hyphema in anterior chamber
70
what is a complication of **tibial-femoral** dislocations?
**popliteal artery rupture**
71
which nerve is at most risk of direct damage with a tibial-femoral dislocation?
common peroneal nerve
72
dx for tibial-femoral dislocation
arteriography (popliteal artery injury)
73
tx tibial femoral dislocation
immediate orthopedic consult: **_severe limb threatening emergency_**
74
pathophysiology of pulmonary hypertension
**increased pulm vascular resistance --\> RVH --\> R-sided heart failure**
75
primary vs secondary pulm HTN
primary: BMPR2 gene idiopathic secondary: COPD
76
s/s of pulm htn
dyspnea on exertion
77
PE findings pulm HTnqaccentuated S2 due to prominent P2
**Increased JVD, peripheral edema, ascites**
78
dx of pulm HTN
* CXR: **enlarged pulm arteries** * ECG: **cor pulmonale: RVH, right axis deviation** * GOLD STANDARD: **right sided heart cath = _def dx_** * CBC: **polycythemia w/ increased hematocrit**
79
tx for pulm htn
primary: CCB 1st line 2nd line: sildenafil (PDE 5 blocker)
80
s/s of acute pyelonephritis
**fever, dysuria, frequency, urgency, flank pain, CVA tenderness, N/V**
81
tx acute pyelonephritis
**FQ or bactrim** if inpatient/pregnant: **ampicillin/gentamicin**
82
Where is leviteracetam eliminated through?
kidneys caution in patients wCrCl of 30-50 mL/min
83
Tx for bacterial conjunctivitis
ofloxacin topical eye drops
84
Why should you avoid neomycin solutions in the eye?
hypersensitivity reactions
85
What score is osteoporosis defined as on a bone density scan?
-2.5 or more standard deviations
86
Tx for osteoporosis
bisphosphonates
87
MC fx in pt with osteoporosis
vertebral body compression fractures
88
s/s of idiopathic pulmonary fibrosis
chronic dry cough and dyspnea smoking hx
89
PFT for idiopathic pulm fibrosis
**decreased FVC and FEV1** **normal FEV1/FVC ratio**
90
PE of idiopathic pulm fibrosis
honeycombing
91
Tx for pulseless electrical activity
**CPR** for 2 min **Epi** q 3-5 min **check for shockable rhythm** q 2 mins
92
Dx (major/minor) for **Duke's Criteria**
To confirm a diagnosis, 1 of the 3 must be: 1. 2 major criteria 2. 1 major, 3 minor 3. 5 minor
93
What are the major criterias for infective endocarditis?
1. 2 positive **blood cultures**/hx of valve 2. **+ echo** showing vegetation (TTE) 3. **New murmur** valvular regurgitation
94
What are the minor criteria for infecive endocarditis? (Duke's Criteria)
1. **Fever** 2. **_Vascular_** issues (petechiae, **Roth spots** in fundus, **Jane Lesions**) 3. **_Immunologic_** issues (RA, Osler's Nodes, nephrotic syndrome) 4. **_Predisposition_**(**IV drug user,** prosthetic heart valve) 5. **_Microbiology culture_** unlike major criteria
95
If IV drug users get infectious endocarditis, which valvewill it most likely effect?
S aureus, Tricuspid
96
What valve will you see **infectious endocarditis** in if pt has hx of **native valve**?
mitral valve
97
What is the MC valve involved in infective endocarditis?
mitral EXCEPT if IVDA = tricuspid
98
Tx for acute IE w/native valve
**nafcillin OR vanco** (MRSA) + **gentamicin**
99
Tx for IE w/prosthetic valve
**vanco + genta + rifampin**
100
Tx for fungal IE
amphotericin B amphoterrible B
101
Which abx are effective against gram +
Penicillin + vanco
102
Which abx are effective against gram -
gentamicin
103

GK ROSH Summative Exam Review (1 decks)

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