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1
Q

Which MD presents with sx age 2-3, proximal muscle weakness, Gower sign, calf pseudohypertrophy, dilated cardiomyopathy, elevated CK, and treated with glucocorticoids?

A

Duchenne Muscular Dystrophy (absent dystrophin)

XLR inheritance

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2
Q

Which MD presents with milder weakness than Duchenne, cardiomyopathy, and presents age 5-15?

A

Becker Muscular Dystrophy

XLR inheritance

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3
Q

Which MD presents age 12-30, facial weakness, grip myotonia, dysphagia, arrhythmias, cataracts, excessive daytime sleepiness, and testicular atrophy?

A

Classic Myotonic Dystrophy

AD inheritance
Trinucleotide repeat in DMPK gene

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4
Q

What dx presents with parathyroid adenomas, pituitary adenomas, and pancreatic/GI tumors?

A

MEN1

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5
Q

What dx presents with medullary thyroid cancer and pheochromocytoma?

A

MEN2

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6
Q

How do you differentiate MEN2A from MEN2B?

A

MEN2A has parathyroid hyperplasia and MEN2B has mucosal neuromas and marfanoid habitus

Neuromas kind of look like B shape, and marfanoid habitus is a B-male

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7
Q

What dx presents with massive amounts of watery diarrhea, hypokalemia, episodic flushing, mass in the pancreatic tail, and can sometimes correspond with MEN1?

A

VIPoma

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8
Q

What dx presents with multiple ulcers in the stomach, duodenum, and small intestine, severe diarrhea, and thickened gastric folds on endoscopy?

A

Gastrinoma

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9
Q

Which dx causes bone pain and deformity, osteolytic or mixed lytic/sclerotic bone lesions, can cause hearing loss and radiculopathy, giant cell tumor or osteosarcoma, has elevated alk phos but normal calcium and phosphate, is a dysfunction of osteoclasts, and is treated with bisphosphonates?

A

Paget disease

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10
Q

Which dx causes bone pain and presents with elevated alk phos, elevated PTH, normal/decreased calcium, decreased phospate, and decreased Vit D?

A

Osteomalacia/Rickets

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11
Q

What’s the most common cause of unilateral nipple bleeding?

A

Intraductal papilloma

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12
Q

What tumor marker is elevated in hepatocellular carcinoma?

A

AFP

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13
Q

What 3 fetal conditions cause elevated maternal serum AFP?

A
  1. Open neural tube defects
  2. Ventral wall defects
  3. Multiple gestations
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14
Q

What 2 fetal conditions cause decreased maternal serum AFP?

A
  1. Trisomy 18

2. Trisomy 21

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15
Q

How do you differentiate between Trisomy 18 and Trisomy 21 on second-trimester quad screen?

A

Both:

  • Decreased AFP
  • Decreased estriol

Trisomy 18:

  • Decreased B-hCG
  • Normal Inhibin A

Trisomy 21:

  • Increased B-hCG
  • Increased Inhibin A
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16
Q

What tumor marker is elevated in non-seminomatous germ cell testicular tumors?

A

AFP

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17
Q

What 2 tumor markers are elevated in malignant biliary obstruction?

A
  1. AFP

2. Alk phos

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18
Q

What might a low level of PAPPA at 8-14 weeks gestation mean?

A

Increased risk of IUGR, premature delivery, preeclampsia, and stillbirth

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19
Q

Do seminomas have elevated AFP?

A

No

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20
Q

Do mixed germ cell tumors have elevated AFP?

A

Yes

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21
Q

Can mixed germ cell tumors metastasize to the anterior mediastinum?

A

Yes

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22
Q

Which testicular tumor has elevated hCG and LDH?

A

Seminoma

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23
Q

Which testicular tumor has elevated AFP and hCG?

A

Mixed germ cell tumor

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24
Q

Which testicular tumor can cause increased estradiol in a man?

A

Leydig

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25
Q

Which tumor can cause increased testosterone production in a female?

A

Sertoli-Leydig

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26
Q

Which ovarian tumor has elevated hCG and LDH?

A

Dysgerminoma

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27
Q

Which ovarian tumor in females grows quickly, often presenting with pelvic pain, and secretes AFP?

A

Yolk sac

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28
Q

Which ovarian tumor has elevated AFP and LDH?

A

Endodermal sinus tumor

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29
Q

Which ovarian tumor has elevated AFP only?

A

Immature teratoma

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30
Q

Which ovarian tumor has elevated AFP and hCG?

A

Embryonal carcinoma

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31
Q

Which ovarian tumor has elevated hCG only?

A

Choriocarcinoma

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32
Q

Which testicular tumor has elevated hCG and LDH?

A

Seminoma

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33
Q

Which testicular tumor has elevated AFP, hCG, and LDH?

A

Yolk sac

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34
Q

Which testicular tumor has VERY elevated hCG and elevated LDH?

A

Choriocarcinoma

Follows a pregnancy

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35
Q

Which testicular tumor has elevated AFP, hCG, and LDH?

A

Embryonal carcinoma

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36
Q

Which testicular tumor has just elevated AFP but doesn’t have to?

A

Teratoma

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37
Q

Which 2 ovarian tumors can cause increased estrogen in a female?

A

Granulosa (malignant) & thecoma (benign)

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38
Q

Polymyositis vs. Polymyalgia Rheumatica?

A

Polymyositis: proximal muscle weakness, elevated ANA & CK

Polymyalgia Rheumatica: Pain in shoulders, hip girdle, elevated ESR & CRP

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39
Q

What are the conditions that require an x-ray of the ankle?

A

Pain at the malleolar zone and 1 of the following:

  • Tender at posterior margin/tip of medial malleolus
  • Tender at posterior margin/tip of lateral malleolus
  • Unable to take 2 steps on each foot
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40
Q

What are the conditions that require an x-ray of the foot?

A

Pain at the midfoot zone and 1 of the following:

  • Tender at the navicular
  • Tender at the base of the 5th metatarsal
  • Unable to take 2 steps on each foot
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41
Q

What category of dx presents with oliguria, hematuria, HTN, RBC casts, and edema?

A

Nephritic syndrome

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42
Q

What dx presents with cola colored urine, edema, HTN, and occurs after GAS infex?

A

Post-infectious glomerulonephritis

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43
Q

What dx presents with episodic gross hematuria after URI or GI infex, often seen in young males?

A

IgA nephropathy (Berger’s disease)

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44
Q

What dx presents with fever, WL, hematuria, respiratory, and sinus sx, and hemoptysis?

A

Wegener’s granulomatosis

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45
Q

What dx presents with hematuria, hemoptysis, dyspnea, respiratory failure in males in their mid-20s?

A

Goodpasture’s syndrome

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46
Q

What dx presents with hematuria, deafness, and eye disorders?

A

Alport’s syndrome

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47
Q

What are the 5 nephritic syndromes?

A

“Nephritic WIG AP”

Wegener’s
IgA
Goodpasture’s

Alport
Post-infectious

48
Q

What category of dx presents with edema, HLD, proteinuria, and hypoalbuminemia?

A

Nephrotic syndrome

49
Q

What dx presents with sudden onset of edema in kids?

A

Minimal change disease

50
Q

What dx presents with edema, HLD, proteinuria, in a young African American male with uncontrolled HTN?

51
Q

What dx presents with edema, HLD, proteinuria, and is associated with HBV, syphilis, malaria, and gold?

A

Membranous nephropathy

52
Q

What dx presents in a diabetic patient with edema, HLD, and proteinuria?

A

Diabetic nephropathy

53
Q

What dx presents with proteinuria, edema, in a patient with lupus?

A

Lupus nephritis

54
Q

What dx presents with proteinuria, edema, in a patient with multiple myeloma or RA?

A

Renal amyloidosis

55
Q

What dx presents with proteinuria, edema, and may be associated with HCV, cryoglobulinemia, and subacute bacterial endocarditis?

A

Membranoproliferative nephropathy

56
Q

What are the 7 types of nephrotic syndrome?

A

“MMM FRLD”

Membranoprolif
Membranous
Minimal change

FSGS
Renal Amyloid
Lupus Nephritis (weird yes)
Diabetic

57
Q

Which type of kidney stone is associated with calciuria and alkaline urine?

58
Q

Which type of kidney stone is associated with staghorn calculi and urease-producing organisms?

59
Q

Which type of kidney stone is associated with gout and acidic urine?

60
Q

Which type of kidney stone is associated with a genetic disorder of transport of COLA aa’s?

61
Q

What’s the first step in suspected Cushing syndrome?

A

Low dose dexamethasone suppression test

62
Q

After the low dose dex, what are the 2 options?

A

If ACTH is suppressed, this means it’s an ectopic source

If ACTH is elevated, then do either a high-dose dex test OR a CRH test

63
Q

What does the following result mean?:
Low dose dex: ACTH elevated
High dose dex: ACTH suppressed

A

Cushing disease (pituitary)

64
Q

What does the following result mean?:
Low dose dex: ACTH elevated
High dose dex: ACTH not suppressed

A

Ectopic ACTH secretion

65
Q

What does the following result mean?:
Low dose dex: ACTH elevated
CRH stimulation test: ACTH and cortisol elevated

A

Cushing disease (pituitary)

66
Q

What does the following result mean?:
Low dose dex: ACTH elevated
CRH stimulation test: ACTH and cortisol not elevated

67
Q

What does the following result mean?:

Low dose dex: ACTH suppressed

A

Exogenous glucocorticoids or adrenal tumor

68
Q

What are the 3 options for initial steps to diagnose Cushing syndrome?

A
  1. Low dose dex
  2. Late night salivary cortisol
  3. 24-hour urinary cortisol
69
Q

What is a normal anion gap?

70
Q

What is an elevated anion gap?

71
Q

CO2 is an ____?

72
Q

Bicarb is a ____?

73
Q

What does the mnemonic “MUDPILES” stand for in elevated anion gap metabolic acidosis?

A

Methanol
Uremia
DKA

Propylene glycol
Iron tablets
Lactic acidosis
Ethylene glycol
Salicylates
74
Q

What does the mnemonic “HARDASS” stand for in normal anion gap metabolic acidosis?

A

Hyperalimentation
Addison disease
RTA
Diarrhea

Acetazolamide
Spironolactone
Saline infusion

75
Q

What is the equation for anion gap?

A

Na - (Cl+HCO3)

76
Q

What are the 4 causes of metabolic alkalosis?

A
  1. Loop diuretics
  2. Vomiting
  3. Antacid use
  4. Hyperaldosteronism
77
Q

What’s the BUN:Creatinine ratio in prerenal azotemia?

78
Q

What’s the BUN:Creatinine ratio in ATN?

79
Q

What’s the FENa in prerenal azotemia?

80
Q

What’s the FENa in ATN?

81
Q

What’s the urine sodium in prerenal azotemia?

82
Q

What’s the urine sodium in ATN?

83
Q

What’s the urine osmolality in prerenal azotemia?

84
Q

What’s the urine osmolality in ATN?

85
Q

What knee injury results from a noncontact twisting mechanism, forced hyperextension, or impact to an extended knee?

86
Q

What knee injury has a positive valgus stress test?

87
Q

What knee injury has a positive varus stress test?

88
Q

What knee injury results from directed force to the front of the flexed knee?

89
Q

What knee injury has a positive McMurray test and may have clicking or locking?

90
Q

The OS is ___?

91
Q

Which condition is fixed splitting heard in?

92
Q

What causes pulsus alternans?

A

Cardiac tamponade

93
Q

What causes pulsus parvus et tardus?

A

Aortic stenosis

94
Q

What’s the FEV1/FVC ratio in asthma?

95
Q

What’s the FEV1/FVC ratio in COPD?

96
Q

What are the 5 causes of low MCV anemia?

A
  1. Iron deficiency
  2. Thalassemia
  3. Sideroblastic
  4. Anemia of chronic dz
  5. Spherocytosis
97
Q

What are the 4 causes of normocytic anemia?

A
  1. Blood loss
  2. Hemolysis
  3. Anemia of chronic dz
  4. Aplasia
98
Q

What are the 6 causes of macrocytic anemia?

A
  1. Vit B12 & folate deficiency
  2. Alcoholism
  3. Liver disease
  4. Drugs
  5. Mydelodysplastic syndrome
  6. Sideroblastic
99
Q

If reticulocytes are high, what type of anemia is it (only 2 options)?

A

Hemolytic or chronic blood loss (both normocytic)

100
Q

How do you calculate NNT?

A

NNT = 1/ARR

101
Q

How do you calculate ARR?

A

Percent 1 - percent 2

in decimal forms

102
Q

How do you calculate ARP?

A

ARP = (RR-1)/RR

103
Q

What is this question asking:?

“What percent of colorectal carcinoma in women with high fat consumption could be attributable to diet?”

104
Q

What is the following asking:?

“How many patients with diabetes undergoing PCI need to be treated with efrenzia to prevent 1 additional event, as compared with clopidogrel?”

105
Q

What is the definition of Hazard Ratio?

A

If it’s <1, the treatment group had a lower event rate

If it’s >1, the treatment group had a higher event rate

106
Q

Sensitivity =

A

Sensitivity = A/(A+C)

107
Q

Specificity =

A

Specificity = D(B+D)

108
Q

What does a cross-sectional study measure?

A

Disease prevalence

109
Q

What does a case-control study measure?

A

Odds ratio

110
Q

What does a cohort study measure?

A

Relative risk

111
Q

What does a cohort study measure?

A

Relative risk

112
Q

What are the percents for the bell curve for the first, second, and third SD’s?

A

68%
95%
99.7%

113
Q

Which test checks for differences between means of 2 groups?

114
Q

Which test checks for differences between means of 3+ groups?

115
Q

Which test checks for differences between 2 or more percentages of categorical outcomes? Eg: comparing the percentage of members of 3 diff ethnic groups who have HTN?

A

Chi-square

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