Rapid Review 2 Flashcards
(220 cards)
1
Q
The most common 1° malignant tumor of bone.
A
Multiple myeloma
2
Q
Unilateral, severe periorbital headache with tearing and conjunctival erythema.
A
Cluster headache
3
Q
Prophylactic treatment for migraine.
A
β-blockers, Ca2+ channel blockers, TCAs
4
Q
The most common pituitary tumor. Treatment?
A
Prolactinoma. Dopamine agonists (e.g., bromocriptine)
5
Q
A 55-year-old patient presents with acute “broken speech.” What type of aphasia? What lobe and vascular distribution?
A
Broca’s aphasia. Frontal lobe, left MCA distribution
6
Q
The most common cause of SAH.
A
Trauma; the second most common is berry aneurysm
7
Q
A crescent-shaped hyperdensity on CT that does not cross the midline.
A
Subdural hematoma—bridging veins torn
8
Q
A history significant for initial altered mental status with an intervening lucid interval. Diagnosis? Most likely etiology? Treatment?
A
Epidural hematoma. Middle meningeal artery. Neurosurgical evacuation
9
Q
CSF findings with SAH.
A
Elevated ICP, RBCs, xanthochromia
10
Q
Albuminocytologic dissociation.
A
Guillain-Barré (↑ protein in CSF with only a modest ↑ in cell count)
11
Q
Cold water is flushed into a patient’s ear, and the fast phase of the nystagmus is toward the opposite side. Normal or pathological?
A
Normal
12
Q
The most common 1° sources of metastases to the brain.
A
Lung, breast, skin (melanoma), kidney, GI tract
13
Q
May be seen in children who are accused of inattention in class and confused with ADHD.
A
Absence seizures
14
Q
The most frequent presentation of intracranial neoplasm.
A
Headache
15
Q
The most common cause of seizures in children (2–10 years).
A
Infection, febrile seizures, trauma, idiopathic
16
Q
The most common cause of seizures in young adults (18–35 years).
A
Trauma, alcohol withdrawal, brain tumor
17
Q
First-line medication for status epilepticus.
A
IV benzodiazepine
18
Q
Confusion, confabulation, ophthalmoplegia, ataxia.
A
Wernicke’s encephalopathy due to a deficiency of thiamine
19
Q
What % lesion is an indication for carotid endarterectomy?
A
Seventy percent if the stenosis is symptomatic
20
Q
The most common causes of dementia.
A
Alzheimer’s and multi-infarct
21
Q
Combined UMN and LMN disorder.
A
ALS
22
Q
Rigidity and stiffness with resting tremor and masked facies.
A
Parkinson’s disease
23
Q
The mainstay of Parkinson’s therapy.
A
Levodopa/carbidopa
24
Q
Treatment for Guillain-Barre syndrome.
A
IVIG or plasmapheresis
25
Rigidity and stiffness that progress to choreiform movements, accompanied by moodiness and altered behavior.
Huntington’s disease
26
A six-year-old girl presents with a port-wine stain in the V2 distribution as well as with mental retardation, seizures, and leptomeningeal angioma.
Sturge-Weber syndrome. Treat symptomatically. Possible focal cerebral resection of affected lobe
27
Café-au-lait spots on skin.
Neurofibromatosis 1
28
Hyperphagia, hypersexuality, hyperorality, and hyperdocility.
Klüver-Bucy syndrome (amygdala)
29
Administer to a symptomatic patient to diagnose myasthenia gravis.
Edrophonium
30
1° causes of third-trimester bleeding.
Placental abruption and placenta previa
31
Classic ultrasound and gross appearance of complete hydatidiform mole.
Snowstorm on ultrasound. “Cluster-of-grapes” appearance on gross examination
32
Chromosomal pattern of a complete mole.
46,XX
33
Molar pregnancy containing fetal tissue.
Partial mole
34
Symptoms of placental abruption.
Continuous, painful vaginal bleeding
35
Symptoms of placenta previa.
Self-limited, painless vaginal bleeding
36
When should a vaginal exam be performed with suspected placenta previa?
Never
37
Antibiotics with teratogenic effects.
Tetracycline, fluoroquinolones, aminoglycosides, sulfonamides
38
Shortest AP diameter of the pelvis.
Obstetric conjugate: between the sacral promontory and the midpoint of the symphysis pubis
39
Medication given to accelerate fetal lung maturity.
Betamethasone or dexamethasone × 48 hours
40
The most common cause of postpartum hemorrhage.
Uterine atony
41
Treatment for postpartum hemorrhage.
Uterine massage; if that fails, give oxytocin
42
Typical antibiotics for group B streptococcus (GBS) prophylaxis.
IV penicillin or ampicillin
43
A patient fails to lactate after an emergency C-section with marked blood loss.
Sheehan’s syndrome (postpartum pituitary necrosis)
44
Uterine bleeding at 18 weeks’ gestation; no products expelled; membranes ruptured; cervical os open.
Inevitable abortion
45
Uterine bleeding at 18 weeks’ gestation; no products expelled; cervical os closed.
Threatened abortion
46
The first test to perform when a woman presents with amenorrhea.
β-hCG; the most common cause of amenorrhea is pregnancy
47
Term for heavy bleeding during and between menstrual periods.
Menometrorrhagia
48
Cause of amenorrhea with normal prolactin, no response to estrogen-progesterone challenge, and a history of D&C.
Asherman’s syndrome
49
Therapy for polycystic ovarian syndrome.
Weight loss and OCPs
50
Medication used to induce ovulation.
Clomiphene citrate
51
Diagnostic step required in a postmenopausal woman who presents with vaginal bleeding.
Endometrial biopsy
52
Indications for medical treatment of ectopic pregnancy.
Stable, unruptured ectopic pregnancy of < 3.5 cm at < 6 weeks’ gestation
53
Medical options for endometriosis.
OCPs, danazol, GnRH agonists
54
Laparoscopic findings in endometriosis.
“Chocolate cysts,” powder burns
55
The most common location for an ectopic pregnancy.
Ampulla of the oviduct
56
How to diagnose and follow a leiomyoma.
Ultrasound
57
Natural history of a leiomyoma.
Regresses after menopause
58
A patient has ↑ vaginal discharge and petechial patches in the upper vagina and cervix.
Trichomonas vaginitis
59
Treatment for bacterial vaginosis.
Oral or topical metronidazole
60
The most common cause of bloody nipple discharge.
Intraductal papilloma
61
Contraceptive methods that protect against PID.
OCP and barrier contraception
62
Unopposed estrogen is contraindicated in which cancers?
Endometrial or estrogen receptor– _x0001_ breast cancer
63
A patient presents with recent PID with RUQ pain.
Consider Fitz-Hugh–Curtis syndrome
64
Breast malignancy presenting as itching, burning, and erosion of the nipple.
Paget’s disease
65
Annual screening for women with a strong family history of ovarian cancer.
CA-125 and transvaginal ultrasound
66
A 50-year-old woman leaks urine when laughing or coughing. Nonsurgical options?
Kegel exercises, estrogen, pessaries for stress incontinence
67
A 30-year-old woman has unpredictable urine loss. Examination is normal. Medical options?
Anticholinergics (oxybutynin) or Beta-adrenergics (metaproterenol) for urge incontinence.
68
Lab values suggestive of menopause.
↑ serum FSH
69
The most common cause of female infertility.
Endometriosis
70
Two consecutive findings of atypical squamous cells of undetermined significance (ASCUS) on Pap smear. Follow-up evaluation?
Colposcopy and endocervical curettage
71
Breast cancer type that ↑ the future risk of invasive carcinoma in both breasts.
Lobular carcinoma in situ
72
Nontender abdominal mass associated with elevated VMA and HVA.
Neuroblastoma
73
The most common type of tracheoesophageal fistula (TEF). Diagnosis?
Esophageal atresia with distal TEF (85%). Unable to pass NG tube
74
Not contraindications to vaccination.
Mild illness and/or low-grade fever, current antibiotic therapy, and prematurity
75
Tests to rule out shaken baby syndrome.
Ophthalmologic exam, CT, and MRI
76
A neonate has meconium ileus.
CF or Hirschsprung’s disease
77
Bilious emesis within hours after the first feeding.
Duodenal atresia
78
A two-month-old presents with nonbilious projectile emesis. What are the appropriate steps in management?
Correct metabolic abnormalities. Then correct pyloric stenosis with pyloromyotomy
79
The most common 1° immunodeficiency.
Selective IgA deficiency
80
An infant has a high fever and onset of rash as fever breaks. What is he at risk for?
Febrile seizures (roseola infantum)
81
Acute-phase treatment for Kawasaki disease.
High-dose aspirin for inflammation and fever; IVIG to prevent coronary artery aneurysms
82
Treatment for mild and severe unconjugated hyperbilirubinemia.
Phototherapy (mild) or exchange transfusion (severe)
83
Sudden onset of mental status changes, emesis, and liver dysfunction after taking aspirin.
Reye’s syndrome
84
A child has loss of red light reflex. Diagnosis?
Suspect retinoblastoma
85
Vaccinations at a six-month well-child visit.
HBV, DTaP, Hib, IPV, PCV
86
Tanner stage 3 in a six-year-old female.
Precocious puberty
87
Infection of small airways with epidemics in winter and spring.
RSV bronchiolitis
88
Cause of neonatal RDS.
Surfactant deficiency
89
What is the immunodeficiency? ■ A boy has chronic respiratory infections. Nitroblue tetrazolium test is +.
Chronic granulomatous disease
90
What is the immunodeficiency? ■ A child has eczema, thrombocytopenia, and high levels of IgA.
Wiskott-Aldrich syndrome
91
What is the immunodeficiency? ■ A four-month-old boy has life-threatening Pseudomonas infection.
Bruton’s X-linked agammaglobulinemia
92
A condition associated with red “currant-jelly” stools.
Intussusception
93
A congenital heart disease that cause 2° hypertension.
Coarctation of the aorta
94
First-line treatment for otitis media.
Amoxicillin × 10 days
95
The most common pathogen causing croup.
Parainfluenza virus type 1
96
A homeless child is small for his age and has peeling skin and a swollen belly.
Kwashiorkor (protein malnutrition)
97
Defect in an X-linked syndrome with mental retardation,
Lesch-Nyhan syndrome (purine salvage problem with
98
Defect in an X-linked syndrome with mental retardation, gout, self-mutilation, and choreoathetosis.
Lesch-Nyhan syndrome (purine salvage problem with HGPRTase deficiency)
99
A newborn female has continuous “machinery murmur.”
Patent ductus arteriosus (PDA)
100
First-line pharmacotherapy for depression.
SSRIs
101
Antidepressants associated with hypertensive crisis.
MAOIs
102
Galactorrhea, impotence, menstrual dysfunction, and ↓ libido.
Patient on dopamine antagonist
103
A 17-year-old female has left arm paralysis after her boyfriend dies in a car crash. No medical cause is found.
Conversion disorder
104
Name the defense mechanism: ■ A mother who is angry at her husband yells at her child.
Displacement
105
Name the defense mechanism: ■ A pedophile enters a monastery.
Reaction formation
106
Name the defense mechanism: ■ A woman calmly describes a grisly murder.
Isolation
107
Name the defense mechanism: ■ A hospitalized 10-year-old begins to wet his bed.
Regression
108
Life-threatening muscle rigidity, fever, and rhabdomyolysis.
Neuroleptic malignant syndrome
109
Amenorrhea, bradycardia, and abnormal body image in a young female.
Anorexia
110
A 35-year-old male has recurrent episodes of palpitations, diaphoresis, and fear of going crazy.
Panic disorder
111
The most serious side effect of clozapine.
Agranulocytosis
112
A 21-year-old male has three months of social withdrawal, worsening grades, flattened affect, and concrete thinking.
Schizophreniform disorder (diagnosis of schizophrenia requires ≥ 6 months of symptoms)
113
Key side effects of atypical antipsychotics.
Weight gain, type 2 DM, QT prolongation
114
A young weight lifter receives IV haloperidol and complains that his eyes are deviated sideways. Diagnosis? Treatment?
Acute dystonia (oculogyric crisis). Treat with benztropine or diphenhydramine
115
Medication to avoid in patients with a history of alcohol withdrawal seizures.
Neuroleptics
116
A 13-year-old male has a history of theft, vandalism, and violence toward family pets.
Conduct disorder
117
A five-month-old girl has ↓ head growth, truncal dyscoordination, and ↓ social interaction.
Rett’s disorder
118
A patient hasn’t slept for days, lost $20,000 gambling, is agitated, and has pressured speech. Diagnosis? Treatment?
Acute mania. Start a mood stabilizer (e.g., lithium)
119
After a minor fender bender, a man wears a neck brace and requests permanent disability.
Malingering
120
A nurse presents with severe hypoglycemia; blood analysis reveals no elevation in C peptide.
Factitious disorder (Munchausen syndrome)
121
A patient continues to use cocaine after being in jail, losing his job, and not paying child support.
Substance abuse
122
A violent patient has vertical and horizontal nystagmus.
Phencyclidine hydrochloride (PCP) intoxication
123
A woman who was abused as a child frequently feels outside of or detached from her body.
Depersonalization disorder
124
A man has repeated, intense urges to rub his body against unsuspecting passengers on a bus.
Frotteurism (a paraphilia)
125
A schizophrenic patient takes haloperidol for one year and develops uncontrollable tongue movements. Diagnosis? Treatment?
Tardive dyskinesia. ↓ or discontinue haloperidol and consider another antipsychotic (e.g., risperidone, clozapine)
126
A man unexpectedly flies across the country, takes a new name, and has no memory of his prior life.
Dissociative fugue
127
Risk factors for DVT.
Stasis, endothelial injury and hypercoagulability (Virchow’s triad)
128
Criteria for exudative effusion.
Pleural/serum protein > 0.5; pleural/serum LDH > 0.6
129
Causes of exudative effusion.
Think of leaky capillaries. Malignancy, TB, bacterial or viral infection, pulmonary embolism with infarct, and pancreatitis
130
Causes of transudative effusion.
Think of intact capillaries. CHF, liver or kidney disease, and protein-losing enteropathy
131
Normalizing PCO2 in a patient having an asthma exacerbation may indicate?
Fatigue and impending respiratory failure
132
Dyspnea, lateral hilar lymphodenopathy on CXR, noncaseating granulomas, increased ACE, and hypercalcemia.
Sarcoidosis
133
PFT showing ↓ FEV1/FVC.
Obstructive pulmonary disease (e.g., asthma)
134
PFT showing ↑ FEV1/FVC.
Restrictive pulmonary disease
135
Honeycomb pattern on CXR. Diagnosis? Treatment?
Diffuse interstitial pulmonary fibrosis. Supportive care. Steroids may help
136
Treatment for SVC syndrome.
Radiation
137
Treatment for mild, persistent asthma.
Inhaled β-agonists and inhaled corticosteroids
138
Acid-base disorder in pulmonary embolism.
Hypoxia and hypocarbia
139
Non–small cell lung cancer (NSCLC) associated with hypercalcemia.
Squamous cell carcinoma
140
Lung cancer associated with SIADH.
Small cell lung cancer (SCLC)
141
Lung cancer highly related to cigarette exposure.
Small cell lung cancer
142
A tall white male presents with acute shortness of breath. Diagnosis? Treatment?
Spontaneous pneumothorax. Spontaneous regression. Supplemental O2 may be helpful
143
Treatment of tension pneumothorax.
Immediate needle thoracostomy
144
Characteristics favoring carcinoma in an isolated pulmonary nodule.
Age > 45–50 years; lesions new or larger in comparison to old films; absence of calcification or irregular calcification; size > 2 cm; irregular margins
145
Hypoxemia and pulmonary edema with normal pulmonary capillary wedge pressure.
ARDS
146
Increased risk of what infection with silicosis?
Mycobacterium tuberculosis
147
Causes of hypoxemia.
Right-to-left shunt, hypoventilation, low inspired O2 tension, diffusion defect, V/Q mismatch
148
Classic CXR findings for pulmonary edema.
Cardiomegaly, prominent pulmonary vessels, Kerley B lines, “bat’s-wing” appearance of hilar shadows, and perivascular and peribronchial cuffing
149
Renal tubular acidosis (RTA) associated with abnormal H+ secretion and nephrolithiasis.
Type I (distal) RTA
150
RTA associated with abnormal HCO3 − and rickets.
Type II (proximal) RTA
151
RTA associated with aldosterone defect.
Type IV (distal) RTA
152
“Doughy skin.”
Hypernatremia
153
Differential of hypervolemic hyponatremia.
Cirrhosis, CHF, nephritic syndrome
154
Chvostek’s and Trousseau’s signs.
Hypocalcemia
155
The most common causes of hypercalcemia.
Malignancy and hyperparathyroidism
156
T-wave flattening and U waves.
Hypokalemia
157
Peaked T waves and widened QRS.
Hyperkalemia
158
First-line treatment for moderate hypercalcemia.
IV hydration and loop diuretics (furosemide)
159
Type of ARF in a patient with FeNa < 1%.
Prerenal
160
A 49-year-old male presents with acute-onset flank pain and hematuria.
Nephrolithiasis
161
The most common type of nephrolithiasis.
Calcium oxalate
162
A 20-year-old man presents with a palpable flank mass and hematuria. Ultrasound shows bilateral enlarged kidneys with cysts. Associated brain anomaly?
Cerebral berry aneurysms (AD PCKD)
163
Hematuria, hypertension, and oliguria.
Nephritic syndrome
164
Proteinuria, hypoalbuminemia, hyperlipidemia, hyperlipiduria, edema.
Nephrotic syndrome
165
The most common form of nephritic syndrome.
Membranous glomerulonephritis
166
The most common form of glomerulonephritis.
IgA nephropathy (Berger’s disease)
167
Glomerulonephritis with deafness.
Alport’s syndrome
168
Glomerulonephritis with hemoptysis.
Wegener’s granulomatosis and Goodpasture’s syndrome
169
Presence of red cell casts in urine sediment.
Glomerulonephritis/nephritic syndrome
170
Eosinophils in urine sediment.
Allergic interstitial nephritis
171
Waxy casts in urine sediment and Maltese crosses (seen with lipiduria).
Nephrotic syndrome
172
Drowsiness, asterixis, nausea, and a pericardial friction rub.
Uremic syndrome seen in patients with renal failure
173
A 55-year-old man is diagnosed with prostate cancer. Treatment options?
Wait, surgical resection, radiation and/or androgen suppression
174
Low urine specific gravity in the presence of high serum osmolality.
DI
175
Treatment of SIADH?
Fluid restriction, demeclocycline
176
Hematuria, flank pain, and palpable flank mass.
Renal cell carcinoma (RCC)
177
Testicular cancer associated with β-hCG, AFP.
Choriocarcinoma
178
The most common type of testicular cancer.
Seminoma—a type of germ cell tumor
179
The most common histology of bladder cancer.
Transitional cell carcinoma
180
Complication of overly rapid correction of hyponatremia.
Central pontine myelinolysis
181
Salicylate ingestion → in what type of acid-base disorder?
Anion gap acidosis and 1° respiratory alkalosis due to central respiratory stimulation
182
Acid-base disturbance commonly seen in pregnant women.
Respiratory alkalosis
183
Three systemic diseases → nephrotic syndrome.
DM, SLE, and amyloidosis
184
Elevated erythropoietin level, elevated hematocrit, and normal O2 saturation suggest?
Renal cell carcinoma or other erythropoietin-producing tumor; evaluate with CT scan
185
A 55-year-old man presents with irritative and obstructive urinary symptoms. Treatment options?
Likely BPH. Options include no treatment, terazosin, finasteride, or surgical intervention (TURP)
186
Class of drugs that may cause syndrome of muscle rigidity, hyperthermia, autonomic instability, and extrapyramidal symptoms.
Antipsychotics (neuroleptic malignant syndrome)
187
Side effects of corticosteroids.
Acute mania, immunosuppression, thin skin, osteoporosis, easy bruising, myopathies
188
Treatment for DTs.
Benzodiazepines
189
Treatment for acetaminophen overdose.
N-acetylcysteine
190
Treatment for opioid overdose.
Naloxone
191
Treatment for benzodiazepine overdose.
Flumazenil
192
Treatment for neuroleptic malignant syndrome.
Dantrolene or bromocriptine
193
Treatment for malignant hypertension.
Nitroprusside
194
Treatment of AF.
Rate control, rhythm conversion, and anticoagulation
195
Treatment of supraventricular tachycardia (SVT).
Rate control with carotid massasge or other vagal stimulation
196
Causes of drug-induced SLE.
INH, penicillamine, hydralazine, procainamide
197
Macrocytic, megaloblastic anemia with neurologic symptoms.
B12 deficiency
198
Macrocytic, megaloblastic anemia without neurologic symptoms.
Folate deficiency
199
A burn patient presents with cherry-red flushed skin and coma. SaO2 is normal, but carboxyhemoglobin is elevated. Treatment?
Treat CO poisoning with 100% O2 or with hyperbaric O2 if severe poisoning or pregnant
200
Blood in the urethral meatus or high-riding prostate.
Bladder rupture or urethral injury
201
Test to rule out urethral injury.
Retrograde cystourethrogram
202
Radiographic evidence of aortic disruption or dissection.
Widened mediastinum (> 8 cm), loss of aortic knob, pleural cap, tracheal deviation to the right, depression of left main stem bronchus
203
Radiographic indications for surgery in patients with acute abdomen.
Free air under the diaphragm, extravasation of contrast, severe bowl distention, space-occupying lesion (CT), mesenteric occlusion (angiography)
204
The most common organism in burn-related infections.
Pseudomonas
205
Method of calculating fluid repletion in burn patients.
Parkland formula
206
Acceptable urine output in a trauma patient.
50 cc/hour
207
Acceptable urine output in a stable patient.
30 cc/hour
208
Cannon “a” waves.
Third-degree heart block
209
Signs of neurogenic shock.
Hypotension and bradycardia
210
Signs of ↑ ICP (Cushing’s triad).
Hypertension, bradycardia, and abnormal respirations
211
↓ CO, ↓ pulmonary capillary wedge pressure (PCWP), ↑ peripheral vascular resistance (PVR).
Hypovolemic shock
212
↓ CO, ↑ PCWP, ↑ PVR.
Cardiogenic shock
213
↑ CO, ↓ PCWP, ↓ PVR.
Septic or anaphylactic shock
214
Treatment of septic shock.
Fluids and antibiotics
215
Treatment of cardiogenic shock.
Identify cause; pressors (e.g., dobutamine)
216
Treatment of hypovolemic shock.
Identify cause; fluid and blood repletion
217
Treatment of anaphylactic shock.
Diphenhydramine or epinephrine 1:1000
218
Supportive treatment for ARDS.
Continuous positive airway pressure
219
Signs of air embolism.
A patient with chest trauma who was previously stable suddenly dies
220
Trauma series.
AP chest, AP/lateral C-spine, AP pelvis
