Step 2 Flashcards
(500 cards)
1
Q
4 Ts of mediastinal masses
A
Find mobile, teratoma, thyroid neoplasm, and terrible lymphoma
2
Q
ACA stroke syndrome
A
contralateral motor and sensory deficits that are more pronounced in the lower limb than the upper limb
3
Q
Acid-base status in adrenal insufficiency
A
Non-anion hyperkalemic and hyponatremic metabolic acidosis
4
Q
adenomyosis
A
presence of endometrial glands in the uterine muscle
5
Q
affects of increase of pH on ionized calcium
A
causes more to be bound to albumin
6
Q
aldosterone in central adrenal insufficiency
A
relatively preserved in these patients
7
Q
ALL cell characteristics
A
PAS positive material, TdT staining positive in 95%
8
Q
amiodarone toxicitiy
A
pulmonary fibrosis, thyroid dysfunction, hepatotoxicity, corneal deposits, and skin discoloration
9
Q
analgesia nephropathy
A
chronic analgesia use causes papillary necrosis in the kidneys
10
Q
antibody: primary billiary cirrhosis
A
anti-mitochondiral antibody
11
Q
antipsychotic that disrupts thermoregulation and body shivering
A
fluphenazine IM for poor compliance
12
Q
aortic stenosis murmur
A
crescendo-decrescendo murmur at the LLSB
13
Q
APGAR scores that require further evaluation and resuscitation
A
<7
14
Q
ARDS dx criteria
A
bilateral infiltrate, PCWP <200
15
Q
area of the intestine that the D-xylose test evaluates
A
proximal small intestine (celiac’s disease)
16
Q
associated with dermatomyositis
A
internal malignancies; MC ovarian
17
Q
atypical antipsychotic to most likely cause EPS
A
risperidone
18
Q
azathioprine toxicity
A
dose related diarrhea, leukopenia, and hepatotoxicity
19
Q
Background or simple diabetic retinopathy
A
Microaneurysms, hemorrhages, exudates, and retinal edema
20
Q
Baker cyst
A
excessive fluid production by inflamed synovium, occurs in RA, osteoarthritis, and cartilage tears
21
Q
Basic labs after diagnosis of hypertension
A
UA, chemistry panel, lipid profile, baseline EKG
22
Q
best test for detection of fetal chromosomal abnormalities in first trimester
A
CVS
23
Q
best test: primary amenorrhea with presence of uterus
A
FSH
24
Q
best way to monitor respiratory status in GBS
A
vital capacity
25
biliary consequence of TPN
causes gallbladder stasis and predisposes gallstone formation/bile sludging
26
blastomycosis cutaneous findings
verrucous or ulcerativew
27
breastfeeding contraindications
Active untreated TB; HIV; active illicit drug/EtOH abuse
28
bronchial breath sounds
have full expiratory phase
29
BUN and creatinine changes during pregnancy
Increase in renal plasma flow and glomerular filtration rate
30
calcification in fate necrosis
coarse (micro in malignancy)
31
Calcium oxalate stone predispositions
Small bowel disease, surgical resection or chronic diarrhea; leads to malabsorption of that is the bile salts
32
cardiac consequences of hemochromatosis
dilated or restrictive cardiomyopathy, conduction defects
33
cardiac manifestations of Friedrich Ataxia
necrosis and degeneration of muscle fiber; can lead to t-wave inversion/myocarditis
34
carpal tunnel pathophysiology
deposition of mucopolysaccharide protein complexes in the sheathes of the median nerve
35
cause of amaurosis fugax
retinal emboli from the ipsilateral carotid
36
Cause of ascending aortic aneurysms
cystic medical necrosis of connective tissue disorder
37
cause of calcium oxalate crystal in urine
ethylene glycol poisoning
38
cause of central primary amenorrhea (low FSH)
pituitary
39
cause of heat stroke
thermoregulation failure
40
cause of hydatid cysts
echinococcus granulosus
41
cause of hyponatremia in central adrenal insufficiency
excessive ADH production from the posterior pituitary
42
cause of hypotension after epidural
sympathetic fiber block that results in vasodilatation of the lower extremity vessels
43
cause of premature adrenarche
premature androgen secretion of the adrenal gland
44
cause of primary dysmenorrhea
increased levels of prostagladins during the breakdown of endometrium
45
cause of secondary amenorrhea
estrogen deficiency
46
cause of sickle cell aplastic crisis
infections; e.g. parvo
47
cause of synringomylia
cavitation of the central cord
48
causes of exudative effusions
infection, malignancy, PE, connective tissue disease, and iatrogenic causes
49
Causes of hypercalcemia in malignancy
osteolytic mets, increase PTH-related protein, increased 1,25 vit D and increased IL6
50
Causes of hypoparathyroidism
Postsurgical, autoimmune, defective calcium sensing
51
causes of macrocytic anemia with hypersegmented neutrophils
folic acid or cobalamin deficiencies
52
CD-19 cells
B-lymphocytes
53
CD-3 cells
T-lymphocytes
54
celiac's disease antibody
anti-endomysial
55
Cervical mucous during the ovulating phase
profuse, clear and thin; will stretch 6cm and exhibit ferning
56
change in L-thyroxine in patients receiving HRT
increases due to increased liver enzyme production, increased TBG, and increased volume of distribution of thyroid hormone
57
characteristic microscpoic findings for membranoproliferative glomerulonephritis
dense intramembranous deposits that stain for C3
58
clopidogrel indications in CAD
1 year s/p UA/NSTEMI, 30 days s/p bare metal stents, 1 year s/p drug eluting stents
59
CN that controls corneal sensation
V1 branch of trigeminal
60
coccidioides cutaneous findings
erythema multiforme and erythema nodosum
61
collagen affected in OI
type I
62
common association with carpal tunnel syndrome
hypothyroidism
63
common complication of coronary catheterization
hematoma formation in soft tissues or extension to the retroperitoneal space
64
common consequence of treated Hodgkin's lymphoma with chemotherapy and radiation
3.2% develop secondary malignancy
65
Common extrapulmonary manifestation of mycoplasma pneumonia
Erythema multiforme
66
common injury after tonic-clonic seizure
posterior dislocation of the shoulder
67
complete placenta previa management
Cesarean section
68
Complication of the first two years of menarche
Cycles are irregular, complicated by menorrhagia and are anovulatory
69
complication of untreated vesicoureteral reflex
UTIs, pyelo, and progressive renal scarring
70
complications of acute pancreatitis
pleural effusion, ARDS, ileus, and renal failure
71
Condition characterized by defective mineralization of bone
osteomalacia
72
Condition characterized by defective mineralization of bone and growth plate cartilage
Rickets
73
Condition characterized by disordered skeletal remodeling
Paget's disease of the bone
74
Conditions other then taponade that have pulses paradoxus
Severe asthma or COPD
75
confirmatory testing: muscular dystrophy
muscle biopsy, CK for screening
76
confirmatory tests for SLE
anti-Smith or anti-dsDNA
77
contraindication to breastfeeding
maternal HIV infection
78
Cri-du-chat deletion
5p
79
cyclosporin toxicity
nephrotoxicity, hyperkalemia, HTN, gum hypertrophy, hisutism, and tremor
80
cystinuria screening
cyanide nitroprusside test
81
damage that occurs in ethylene glycol poisoning
kidney damage
82
damage that occurs in methanol poisoning
eye damage
83
ddx: anterior mediastinum mass
thymoma
84
ddx: elevated peak pressure with elevate plateau pressure
decreased pulmonary compliance: edema, atelectasis, PNA, or right mainstem intubation
85
ddx: elevated peak pressure with normal plateau pressure
pathological process causing increased resistance of airways: bronchospasm, mucous plug, biting ET tube
86
ddx: Howell-Jolly bodies
absence of spleen, splenic infarct, infiltrative d/o of spleen, or splenic congestion
87
ddx: middle mediastinum mass
bronchogenic cysts, tracheal tumors, pericardial cysts, lymphoma, lymph node enlargement, and aortic aneurysms
88
DDx: normotensive patients with hypokalemia and metabolic alkalosis
diuretics, vomiting, Bartter synfrom, Gitelman syndrome
89
ddx: posterior mediastinum mass
meningocele, enteric cysts, lymphomas, diaphragmatic hernias, esophageal tumors, and aortic aneurysms. ALL neurogenic tumors
90
definitive syphilis dx
dark field microscopy, patients may not have formed antibodies for serologic testing
91
device to use with pulmonary foreign body
rigid broncoscopy
92
differentiate types of COPD
chronic bronchitis: normal DLCO, emphysema: decreased DLCO
93
digoxin toxicity
nausea, vomiting, diarrhea, vision changes, and arrhythmias
94
DPL indication
hemodynamically unstable with inconclusive FAST examination
95
drug category: trihexyphenidyl
anticholinergic
96
drug contraindicated during ACS
dihydropyridine CCBs because the cause peripheral vasodilation and reflex tachycardia leading to worsening ischemia
97
drug to increase appetite and weight in cancer related anorexia/cachexia
progesterone analogs (megestrol acetate)
98
drugs that cause folic acid deficiency
phenytoin (impaired absorption), methotrexate, TMP-SMX (antagonize)
99
drugs that cause interstitial nephritis
cephalosporins, PCN, sulfonamides, NSAIDs, rifampin, phenytoin and allopurinol
100
drugs that increased the risk of bleeding in those taking warfarin
acetaminophen, NSAIDs, amiodarone, and antibiotics
101
dx: adult parvo
Anti-B19 IgM
102
dx: ALL
bone marrow bx
103
dx: CLL
flow cytometry
104
DX: developmental dysplasia of the hip
< 6 months: ULS
105
>4-6 months: X-ray
...
106
dx: endometriosis
laparoscopy
107
dx: esophageal perforation
gastrografin esophography
108
dx: esophageal rupture
water-soluble contrast esophagram
109
dx: histoplasmosis
antigen detection in urine or serum
110
dx: major depressive disorder
5/8 symptoms x 2 weeks, significant functional impairment
111
dx: melanoma
excisional biopsy
112
dx: primary hyperaldosteronism
PA:PRA level >30
113
dx: pyloric stenosis
ULS
114
dx: SBP
paracentesis with PMN >250 and positive ascites cultures
115
dx: vasovagal syncope
upright tilt table testing
116
dx: Zollinger-Ellison syndrome
serum gastrin levels > 1000
117
dysfunctional uterine bleeding
heavy vaginal bleeding that occurs in absence of structural or organic disease
118
earliest renal abnormality in diabetes
glomerular hyperfiltration
119
ECG changes in coarctation
LVH, increased GRS voltage and ST- and T-wave changes
120
eczema herpeticum
primary HSX associated with atopic dermatitis
121
electrolyte abnormality in SAH
hyponatremia, cerebral salt wasting syndrome
122
elevated in CAH 21-hydroxylase deficiency
17-hydroxyprogesterone
123
elevated in folic acid and cobalamin deficiencies
homocysteine
124
endocrine disease that causes proximal myopathy
hyperthyroidism
125
epi: FSGS
AA, obesity, heroin use, and HIV
126
epi: stress fractures
athletes/nonathletes who increase physical activity, female runners with oligomenorrhea and poor eating habits
127
factoral study design
randomization into 2 interventions with additional study of 2 or more variables
128
Familial conjugate hyperbilirubinemia with dark granular pigment in hepatocytes
Dubin-Johnson
129
features of bacterial sinusitis
sx >10 days, severe sx, fever>39, purulent discharge/face pain, >5 days worsening after improving URI sx
130
first line agents for HTN in pregnancy
labetalol and methyldopa (ACEi and ARBs teratogenic)
131
first line therapy for controlling stable angina symptoms
beta-blockers
132
first line tx HTN in pregnancy
methyldopa, central acting alpha agonist
133
first renal change in diabetes that can be quantitated
thickening of the glomerular basement membrane
134
first step in management: suspected congenital diaphragmatic hernia
Placement of orogastric tube
135
first step in primary amenorrhea evaluation
is there at uterus present
136
first step in suspected child abuse
full PE
137
first step in thrombosis of a central line
removal of catheter
138
Friedrich Ataxia inheritance pattern
AR; trinucleotide repeats
139
Gaucher's deficient enzyme
beta-glucosidase
140
GBS screening in pregnancy
35 to 37 weeks gestation
141
goal of colposcopy during pregnancy
exclusion of invasive cancer
142
Gold standard for evaluating cervical incompetence
Transvaginal ultrasound
143
greatest risk factor for future suicide attempts
past history of suicide attempts
144
hallmark of prolonged seizures
cortical laminar necrosis
145
Hallmark ventricular aneurysm EKG findings
Persistent ST elevation after recent MI and deep Q waves in the same leads
146
hearing tests suggestive of conductive hearing loss
bone conduction>air conduction on Rinne test
147
height goal by first birthday
50% increase
148
hemi-neglect lesion
non-dominant parietal lobe
149
hemophilic arthropathy
iron deposition and synovial thickening with fibrosis
150
Henoch-Schonelein purpura predisposition
children susceptible to intussusception
151
Hep E in pregnant women
progression to fulminant hepatitis, especially in 3rd trimester
152
hereditary spherocytosis pathophys
AD inheritance of abnormal ankryin gene leading to abnormal scaffolding
153
histoplasma endemic areas
Mississippi and Ohio River Valleys and Central America
154
how acyclovir causes nephropathy
precipitates in renal tubules causing obstruction and acute renal failure
155
how dipyridamole works for perfusion scanning
redistribution of blood flow to 'non-diseased' segments by inducing coronary steal
156
how immunizations should be given with pre-term children
given at chronological age, must weigh at least 2 kg before given hep B vaccine
157
how long to continue antidepressant when treating episode
6 months following the patient's response
158
how to differentiate Bartter/Gitleman from diuretics/vomiting
>20-40 urine Cl
159
how to differentiate COPD from asthma
bronchodilator response test
160
how to differentiate emoblic vs. thrombotic limb ischemia
acute onset vs. insidious onset
161
How to differentiate leukemoid reactions from chronic myeloid leukemia
leukocyte alkaline phosphatse high in leukemoid, low in CML
162
How to prevent chlamydial conjunctivitis during birth
Maternal prenatal testing, or erythromycin ointment is not effective
163
how to start opioid pain management
begin with short acting doses, then titrate up to longer acting doses
164
How trichomonas changes the vaginal milieu
Disrupts normal vaginal pH, increases it between 5-6
165
Howell - Jolly bodies
Nuclear remnants of red blood cells usually removed by the spleen
166
Howell-Jolly bodies
nuclear remnants within RBCs, typically removed by the spleen
167
hypertrophic osteoarthropathy
clubbing and sudden onset of arthropathy in a chronic smoker
168
hyposthenuria
In sickle cell disease and sickle cell trait, kidneys impaired ability to concentrate urine
169
imaging: hydatid cysts
eggshell calcification of hepatic cysts on CT
170
Immunofluorescent findings in bullous phemphigoid
pruritis, tense bullae, urticarial class, IgG and C-3 distributed linearly along the basement membrane zone
171
important in achalasia workup
endoscopy to r/o esophageal cancer
172
important management step in androgen insensitivity
gonadectomy after completion of puberty to avoid risk of testicular carcinoma
173
important screening for cirrhosis dx
endoscopy for varices, ascites prevention, and liver ULS q 6 months for HCC
174
important tx in CML with Philadelphia chromosome
tyrosine kinase inhibitor
175
increased risk of seborrheic dermatitis
Parkinson's and HIV
176
increased risk with RA
osteopenia and osteoporosis
177
indicated before trastuzumab initiation
echocardiogram because risk of cardiotoxicity, especially in those with low EF
178
indicates poor prognosis in CLL
thromnocytopenia
179
Indication for steroids in PCP
PaO2 < 70, A-a gradient > 35
180
indication: metformin in PCOS
impaired glucose tolerance
181
Indication: pica especially for ice
Iron deficiency anemia
182
Indications for aortic valve replacement
Symptomatic; severe AS undergoing CABG or other valvular surgery; poor LV systolic function or hypertrophy
183
indications for bladder/renal ULS in children
<24 months with febrile UTI, recurrent UTI, fmhx of urological disease, HTN, poor growth, lack of response to appropriate tx
184
indications for carotid endarterectomy
symptomatic 70-99% occlusions, asymptomatic 60-99%
185
indications for endometrial biopsy in endometrial bleeding
>35, HTN, diabetes or obesity present
186
indications for endoscopy for dyspepsia
>55 with alarm symptoms: weight loss, dysphagia, or persistent vomiting
187
indications for external cephalic version
>37 weeks, no contraindications to vaginal delivery and fetal well being established
188
indications for GBS ppx in unknown status
18 hours, GBS bacteruria during pregnancy, hx prior GBS sepsis baby
189
indications for hospitalization for anorexia nervosa
dehydration, electrolyte disturbance, bradycardia, severe weight loss
190
indications for parathyroidectomy in asymptomatic hyperparathyroid patients
Ca>1mg upper limit of normal,
191
initial manifestation of hypocalcemia
hyperactive DTRs
192
Innervation: common peroneal nerve
Muscles of the interior and lateral leg; sensation to anterolateral leg and dorsum foot
193
Innervation: for moral nerve
Anterior compartment of the thigh, responsible for knee extension and hip flexion
194
Innervation: obturator nerve
New York compartment of the thigh; controlled abduction of the thigh; sensation over the medial side
195
Innervation: tibial nerve
Posterior compartment of the thigh and leg; flexion of the knee and digits, and plantar flexion of the foot
196
instructions for laryngomalacia
hold child upright for 1/2 hour after feeding, never feed lying down
197
instructions for sildenafil when patient on alpha blocker
given with at least 4 hour interval to reduce risk of hypotension
198
iron overload infection predispostion
listeria and yersinia enterolitica
199
JAK2 mutation association
PCV
200
Jones criteria for rheumatic fever
major- carditis, migratory polyarthritis, Sydenham chorea, subcutaneous nodules and erythema marginatum
201
Klumpke palsy
traction of C8, T1; hand paralysis; ipsilateral horners
202
lab indications for thyroid testing
hyperlipidemia, unexplained hyponatremia, elevated serum muscle enzymes
203
labs of osteomalacia
vit D deficiency, low-normal calcium, low phosphate, increased PTH, elevated all phos
204
labs: central precocious puberty
basal LH increased with GnRH stimulation
205
labs: hereditary spherocytosis
Low to normal MCV, increased MCHC (because of dehydration), negative coombs test
206
labs: PIGN
UA: hematuria, RBC casts, proteinuria
207
Serum: C3 complement levels low
...
208
lactation suppression
tight-fitting bra, avoid nipple manipulation and ice packs/analgesics to relieve pain
209
Lactose intolerance labs
Positive hydrogen breath test, positive stool test for reducing substances, low stool pH and increased stool osmotic gap
210
legionella tx
azithromycin or levofloxacin
211
lesch-nyhan inheritance pattern
X-linked recessive
212
Light's criteria
protein fluid/protein serum >0.5, LHD ratio >0.6, or LDH is 2/3 upper limit of normal serum
213
live vaccines not contraindicated in HIV
MMR and varicella if CD4>200
214
location of Broca's area
dominant posterior frontal lobe
215
location that most medulloblastomas develop
cerebellar vermis
216
long term risk in turner's syndrome
osteoporosis from lower estrogen levels
217
lung cancer with least smoking association
adenocarcinoma, peripheral
218
lung disease in cystic fibrosis abx
penicillin/cephalosporin + aminoglycoside
219
MAC ppx in HIV CD4<50
azithromycin
220
major cause of anemia in patients with ESRD
EPO deficiency
221
malignancy risk with Hashimoto's
thyroid lymphoma
222
malignant hypertension
in patients with long term HTN, associated with retinal hemorrhages, exudates, and papilledema
223
manifestations of systemic sclerosis
GERD, right heart failure, and HTN from involvement of esophagus, pulmonary arteries and kidneys
224
Maternal quadruple screen in down syndrome
Increased levels of beta hCG and inhibin a, decreased levels of MSAFP and estriol
225
MC cause of unilateral, acute lymphadenitis
S aureus
226
MC complication of sickle cell trait
painless hematuria
227
MC complication supracondylar fracture in the pediatric population
Radio artery compression, must assess radial artery pulse when fracture is reduced
228
MC epiglottitis in adults
H flu and S. pyogenes
229
MC form of glomerulopathy associated with HIV
focal segmental glomerulosclerosis
230
MC injured nerve in association with fracture of midshaft humerous
radial nerve, runs on posterior surface of humerous
231
MC kidney stone
Calcium oxalate
232
MC locations of hypertensive ICH
basal ganglia, thalamus, pons and cerebellum
233
MC malignant tumor of the eyelid
BCC
234
MC manifestations of polycythemia in newborns
respiratory distress, poor feeding, and neurologic manifestations
235
MC organ injury in blunt trauma
splenic laceration
236
MC predisposing factor to aortic dissection
HTN
237
MC side effects of EPO for anemia tx
worsening HTN, HA, and flu like sx
238
MC side effects of levodopa/carbidopa
hallucinations, confusion, agitation, dizziness, somnolence and nausea
239
MC site for ulnar nerve entrapment
elbow, medial epiconylar grove
240
MC site of actual skeleton involvement of us
cervical spine
241
MC site of hypertensive hemorrhages
putamen, internal capsule lies adjacently
242
MC thyroid nodule
benign colloid nodules
243
MC valular abnormality in non IVDU
mitral valve prolapse
244
MC valvular abnormality in IVDU
mitral regurgitation
245
MCC abnormal MSAFP
gestational age error
246
MCC complication of PUD
hemorrhage
247
MCC congenital hypothyroidism in USA
thyroid dysgenesis
248
MCC constrictive pericarditis
radiation, viral, cardiac surgery
249
MCC constrictive pericarditis in developing countries
TB
250
MCC constrictive pericarditis in US
viral, radiation, then cardiac surgery
251
MCC death in dialysis patients
CV disease
252
MCC death in renal transplant patients
CV disease
253
MCC death s/p MI
reentrant ventricular arrhythmia (ventricular fibrillation)
254
MCC foot drop
neuropathy, L5 radiculopathy, and traumatic damage to the common peroneal nerve
255
MCC hip pain in children
Transient synovitis
256
MCC megaloblastic anemia in alcoholics
folate deficiency
257
MCC mitral regurgitation
mitral valve prolapse from myxomatous degeneration of the mitral valve leaflets
258
MCC mucopurulent cervicitis
Chlamydia trachomatis
259
MCC nephrotic syndrome in adults that is not from systemic disease
membranous nephropathy and FSGS
260
MCC nephrotic syndrome in children
minimal change disease
261
MCC nephrotic syndrome renal thrombosis
membranous glomerulonephritis
262
MCC nephrotic syndrome with Hodgkin's lymphoma
Minimal change disease
263
MCC of communicating hydrocephalus in children
SAH
264
MCC of glomerulonephritis in adults
IgA nephropathy; several days after URI
265
MCC of orbital cellulitis
bacterial sinusitis
266
MCC painless hematuria in adults
bladder tumors
267
MCC pulmonary complications in systemic sclerosis
interstitial fibrosis
268
MCC purpura in children
thrombocytopenia, clotting factor deficiencies and vasculitis; if nor thrombocytopenia, then think vasculitis
269
McMurray's sign
indicative of middle mediscus tear, palpable or audible snap occuring while slowly extending the leg at the knee from full flexion
270
measles types of virus
paramyxovirus
271
mechanism behind urinary retention in anti-cholinergics
failure of detrusor contraction, controlled by PNS input from pelvic splanchnic
272
Mechanism impaired in the post-splenectomy patients
Anti-body mediated opsonization in phagocytosis
273
mechanism of hypercalcemia in malignancy
production of PTH related peptide
274
medical treatment for ALS
Riluzole: glutamate inhibitor
275
metal that causes allergic contact dermatitis
nickelm type IV hypersensitivity
276
method to decreased contrast induced nephropathy
non-ionic contrast
277
microprolactinoma
<10mm
278
mild pre-eclampsia
BP>140/90, protein excretion >.3g/24hrs
279
missed abortion
dead fetus still retained in the uterus; disappearance of nausea and vomiting in early pregnancy
280
Most common cause of travelers diarrhea
E. Coli
281
most common deficiency of CAH
21-hydroxylase
282
most common type of pediatric supratentorial and intratentorial tumors
benign astrocytomas
283
most consistent reversible risk factor for pancreatic cancer
cigarette smoking
284
most effective fetal weight estimation parameter in suspect FGR
abdominal circumference
285
Most important risk factor in SCC
sunlight exposure
286
most likely mass of the rostral midbrain
pinealoma or germinoma
287
most reliable sign for spinal osteomyelitis
tenderness to gentle percussion over the spinous process
288
most serious potential sequelae of kawasaki's disease
coronary artery aneurysms
289
most serious side effect of hydroxychloroquine therapy for SLE
retinopathy, eye exams q 6 months
290
most specific arrhythmia for digitalis toxicity
atrial tachycardia with AV block (increased ectopy and increased vagal tone)
291
Most specific marker for diagnosis of acute hepatitis B
IgM anti-HBc
292
most specific test for androgen-producing adrenal tumors
DHEA-S
293
most useful indicator for dehydration
BUN/Cr ratio
294
murmur from acute aortic dissection
aortic root dilatation-->aortic regurgitation
295
must do in all patients with clavicular fracture
careful neuro-vascular examination to r/o injury to underlying brachial plexus and subclavian artery
296
must do in young patients with systemic hypertension
evaluation for the presence of coarctation
297
MVP murmur
mid systolic click over the apex, short systolic murmur at the apex if regurg present, squatting decreases the murmur
298
mycophenolate toxicity
marrow suppression
299
negative TB test in those with no risk factors and who are healthy
<15mm
300
nephrotic disease associated with hep B
membranous glomerulonephritis
301
nephrotic syndrome associated with african americans and HIV
focal segmental glomerulosclerosis
302
new clubbing in patients with COPD
indicative of development of lung cancer
303
next best step: solitary pulmonary nodule on CXR
CT scan
304
next best test after abnormal MSAFP levels
ultrasound to confirm GA, defect fetal anomalies, detect multiple gestation and confirm viable pregnancy
305
next step: CIN I in low risk lesion on Pap smear
repeat Pap at 6 and 12 months, or repeat HPV in 12 months, if positive again, repeat colposcopy
306
next step: high clinical suscpicion of PE
early empiric anticoagulation prior to confirmatory testing
307
Next step: LISL in young/high risk women
colposcopy
308
Next step: proteinuria, isolated in children
repeat dipstick on 2 different occasions
309
next step: pt with PAD symptom but normal ABI
exercise testing with post-excercise ABI
310
next step: pyelonephritis that does not respond to 2-3 days of tx
ULS or other imaging techiques
311
next step: recurrent chalazion
histopathologic investigation, increased risk of underlying sebaceous carcinoma; BCC also common malignancy of the eyelid
312
next step: simple renal cyst
benign, no further evaluation
313
Next step: threatened abortion
f/u ULS in one week after it has been determined that fetus is still alive
314
NF-1 characteristics
cafe-au-lait spots, macrocephaly, feeding problems, short stature, learning disability
315
NF-2 characteristics
acoustic neuromas and cataracts
316
normal BPP score
8-10; only repeat 1-2x/week in those with high risk pregnancies
317
nutritional deficiency that is heat sensitive
folic acid
318
One of the few conditions that presents with bilateral trigeminal neuralgia
Multiple sclerosis
319
only region of bladder covered by peritoneum
dome of the bladder, most susceptible to injury
320
Optic complication of neurofibromatosis type one
Optic glioma in 15%
321
order of frequency of brain mets by primary cancer
Lung>Breast>unknown>melanoma>colon
322
ototoxic drugs
aminoglycosides, chemotherapy, ASA and loop diuretics (high doses)
323
outflow obstructions in HOCM
septal hypertrophy and systolic anterior motion of the mitral valve
324
Paget disease of bone labs
normal calcium and phosphate, increased alk phos and urinary hydroxyproline
325
Parinaud's syndrome
paralysis of vertical gaze associated with pupillary disturbances and eyelid retraction
326
Parinaud's syndrome lesion
rostral midbrain at level of the superior colliculus and CN III (Collier's sign)
327
part of DTaP vaccination that causes reactions
pertussis component
328
pathophys: immobilization hypercalcemia
increased osteoclastic bone resorption
329
Pathophysiology between hypothyroidism and hyperprolactinemia
Prolactin production inhibited by dopamine, simulated by serotonin and TRH
330
Pathophysiology of aspirin sensitivity syndrome
Pseudo - allergic reaction, from prostaglandin and leukotriene misbalance insusceptible individuals
331
pathophysiology of membranoproliferative glomerulonephritis type II
antibody against C3 convertase, leading to persistent complement activation
332
PCT associations
hep C infection, substance ingestion (etoh, estrogens)
333
peak airway pressure formula
resistive pressure + plateau pressure
334
persistent complex bereavement disorder
12 months of depressive symptoms and loss of function after the death of a loved one
335
pH consistent with transudative effusion
>7.2, <7.2 indicates pleural inflammation
336
physiologic leukorrhea
copious vaginal discharge that is white/yellow, non malodorous, and occurs in the absence of other symptoms or findings on the vaginal exam
337
plateau pressure formula
elastic pressure + PEEP
338
pleural fluid characteristics in esophageal rupture
low pH, high amylase
339
post-exposure ppx for varicella
immunocompetent: vaccine, immunocompromised: VZIG w/in 10 days of exposure
340
post-tictal acid/base disturbance
normal to have anion gap acidosis that resolves 60-90 min after the seizure
341
postoperative cholestasis
prolonged surgery, hypotension, extensive blood loss into tissues, massive blood replacement
342
ppx in chloroquine resistant malaria locations
mefloquine (sub-saharan africa and india)
343
ppx in rheumatic fever
continuous abx ppx to prevent recurrent strep pharyngitis and limit the progression of rheumatic disease
344
CNS stimulation, GI disturbance, cardiac
PR theophylline toxicity
345
sudden onset of eye pain, photophobia, and mid-dilated pupil
PR: acute glaucoma
346
fever, CP, leukocytosis and widened mediastinum on CXR s/p cardiac surgery
PR: acute mediastinitis
347
females, episodic, abdominal pain, nausea, vomiting, diarrhea and sweating, no photosensitivity
PR: AIP
348
RA, enlarged kidneys and hepatomegaly, amyloid deposits on polarized light
PR: amyloidosis nephrotic syndrome
349
premature, low birth weight; diminished RBC production, shortened RBC lifespan, blood loss; iron deficiency not the cause
PR: anemia of prematurity
350
false positive VRDL, prolonged PTT, and thrombocytopenia
PR: antiphospholipid antibody syndrome (APS)
351
Normal internal genitalia with ambiguous external genitalia, deficiency in and then it converts androgens to estrogens
PR: aromatase deficiency
352
late exposure to maternal factor, normal head size, decreased abdominal circumference
PR: asymmetric IUGR
353
Down syndrome; increased mobility between the atlas and access; behavioral changes, torticollis, urinary incontinence, and vertebrobasilar symptoms; upper motor neuron symptoms
PR: Atlantoaxial instability
354
recurrent infections after passing 6 months, impaired ability destroying encapsulated organisms, lack of IgA predisposes giardia infection
PR: B cell deficiencies
355
tetany, night blindness, neuropathy, dermatitis, arthritis, and hepatic injury
PR: bacterial overgrowth
356
multi-systemic inflammatory condition, recurrent ulcers, skin lesions; seen in Turkish, Asian, and Middle Eastern population
PR: Behcet's syndrome
357
slurred speech, unsteady gait, and drowsiness, no nystagmus, no pinpoint pupils, no respiratory depression
PR: benzo overdose
358
AV block, bradycardia, hypotension, wheezing, and potential cardiogenic shock
PR: beta blocker overdose
359
isolated, round, smooth, ring-enhancing intracranial lesion on CT in immuncompetent patient with known extra cranial infection
PR: brain abscess
360
parasthesias of first 3.5 digits, occasionally thenar eminence atrophy
PR: carpal tunnel syndrome
361
hyperextension injury, elderly, spondylosis; weakness >upper extrmities, than lower, localized deficit of pain and temperature sensation
PR: central cord syndrome
362
mucopurulent urethral discharge, absent bacteriruia, and hx of multiple sex partners
PR: Chlamydial urethritis
363
waxing and waning transaminase levels, but few symptoms
PR: chronic hep C
364
The equinus and varus of the calcaneum and talus, varus of the mid foot, and adduction of the forefoot
PR: clubfoot
365
seborrheic dermatitis; pupular, scaly; eyebrows, nasolabial folds, and scalp
PR: cradle cap
366
palpable purpura, glomerulonephritis, non-specific systemic symptoms, arthralgias, hepatosplenomegaly, peripheral neuropathy, and hypocomplementemia, most have hep C
PR: cryoglobulinemia
367
Travelers in tropical regions, pruritic elevated serpiginous skin lesions; contact through sand
PR: cutaneous larva migrans
368
inflammatory changes in the medical canthal region of the eye; usually staph or beta-hemolytic strep
PR: dacryocystitis
369
new mothers who hold infants with outstretched thumbs; abductor pollicis longus and extensor pollicis brevis tendons affected, passive stretch elicits pain
PR: De Quervain tenosynovitis
370
Macrocytic pure red aplasia associated with congenital anomalies such as short stature, webbed neck, cleft lip, shielded chest and triphalangeal phones
PR: diamond Blackfan syndrome
371
palatal ulcers, hepatosplenomegaly and pancytopenia, Mississippi and ohio river basins
PR: disseminated histoplasmosis
372
bloody diarrhea, abdominal pain, lack of fever, no travel history
PR: E coli diarrhea
373
micrognathia, microcephaly, rocker bottom feet, overlapping fingers, absent palmar creases, VSD
PR: Edward's syndrome
374
dysparenunia, dysmenorrhea, and dyschezia
PR: endometriosis
375
hypocalcemia, calcium oxalate deposition in kidneys; flank pain, hematuria, ARF, anion gap acidosis
PR: Ethylene glycol poisoning
376
autosomal recessive inheritance, bone marrow failure, poor growth, morphological abnormalities, macrocyclic anemia
PR: fanconi's anemia
377
small body size, microcephaly, digital hypoplasia, nail hypoplasia, hirsutism, cleft palate and rib anomalies
PR: fetal hydantoin syndrome
378
chronic, widespread pain d/o with fatigue, poor sleep and depression; multiple trigger points of tenderness
PR: fibromyalgia
379
combination of neurologic (ataxia, dysarthria), skeletal (scoliosis, feet deformities) and cardiac (hypertrophic cardiomyopathy)
PR: Friedreich ataxia
380
Ashkenazi Jews, adolescents, anemia, easy bruising, thrombocytopenia, bone pain, erlenmeyer flask deformity on distal femur
PR: Gaucher's disease
381
adult-onset asthma symptoms after meals, exercise, or lying down
PR: GERD induced asthma
382
pain, swelling, and decreased ROM at the involved site; radiograph with osteolytic lesions (soap bubble) in epiphyseal regions of long bones
PR: giant cell tumor of bone
383
mild DM or hyperglycemia, necrotic migratory erythema, diarrhea, anemia, and weight loss, glucagon >500pg/mL
PR: glucagonoma
384
hypoglycemia, lactic acidosis, hyperuricemia, and hyperlipidemia; doll-like facies, thin extremities, short stature, protuberant abdomen
PR: glucose-6-phosphatase deficiency
385
Triad of systemic vasculitis, upper and lower airway granulomatous inflammation, and glomerulonephritis; nasal cartilage destruction and vasculitic cutaneous lesions are common
PR: Granulomatosis with polyangitis (Wegener's)
386
excessive amounts of estrogen; precocious puberty in young/post-menopausal bleeding in elderly; must differentiate from excessive androgens
PR: granulosa cell tumor
387
Marfan's features, mental retardation, thromboembolic events, downward this location of the lens
PR: homocystinuria
388
IgA-mediated vasculitis of small vessels, results in rashes, arthralgias, abdominal pain and renal disase
PR: HSP
389
Low calcium and elevated phosphorus in the presence of normal renal function
PR: hypoparathyroidism
390
dry and rough skin with horny plates over the extensor surfaces of limbs
PR: ichthyosis vulgaris
391
prolonged premature rupture, maternal fever, leukocytosis, uterine tenderness or tachycardia
PR: intraamnotic infection
392
Intermittent bloody discharge from one nipple, benign, masses not appreciated
PR: intraductal papilloma
393
IC paitnet, fever, cough, dyspnea, or hemoptysis, CXR cavitary lesion, CT pulmonary nodules with halo sign with air crescent
PR: invasive aspergillosis
394
children, isolated thrombocytopenia after viral infection
PR: ITP
395
Solitary painful, but it long bone lesion with overlying swelling and hypercalcemia in children
PR: Langerhans cell histiocytosis
396
Asian patient, insensate hypopigmented patch of skin; skin biopsy shows acid-fast bacilli
PR: leprosy
397
all age groups, testosterone and possible estrogen production, inhibition of FSH and LH levels
PR: leydig cell tumors
398
AA pregnant, bilateral solid ovarian massess, hirsutisim and virilization; benign and self limited
PR: lutemoa of pregnancy
399
3 Ps: precocious puberty, pigmentation (cafe au lait spots) and polyostic fibrous dysplasia
PR: McCune Albright syndrome
400
forceful torsion of the knee with foot planted; popping sound and severe pain; McMurray's sign
PR: medical meniscus tear
401
congential foot deformity, feet that overcorrect both passively and actively into abduction; mild cases spontaneously correct
PR: metatarsus adductus
402
hypotension, non-responsive to fluids with normal/elevated CVP/PCWP, evidence of injury on the anterior chest
PR: myocradial contusion
403
AD inheritance, delayed muscle relaxation, temporal wasting, emaciated extremities
PR: myotonic muscular dystrophy
404
afebrile, irritative voiding symptoms
PR: non-inflammatory chronic prostatitis
405
African-American; gradual loss of peripheral vision, eventual tunnel vision; optic disc cupping
PR: open angle glaucoma
406
Autosomal dominant, diffuse telangiectasias, recurring expenses, and widespread AV malformations
PR: Osler-Weber-Rendu syndrome
407
blue sclerae, hearing loss, recurrent fractures and opalescent teeth
PR: osteogensis imperfecta
408
Osteoclast dysfunction, mosaic pattern of lamellar bone, increased alkaline phosphatase, femoral bowing
PR: Paget's disease
409
hemolytic anemia, venous thrombosis and diminished hematopoiesis
PR: paroxysmal nocturnal hemoglobinuria (PNH)
410
accessory conduction pathways through AV node, vagal maneuvers and medications that reduce conduction through AV node resolve PSVT
PR: paroxysmal supraventricular tachycardia (PSVT)
411
splenomegaly, pruritis with hot baths, gout attacks
PR: PCV
412
mucocutaneous blistering that is flaccid, intercellular IgG deposits, anti-bodies against desmoglein
PR: pemphigus vulgaris
413
hyperviscosity (dizziness/HA), pruritus (especially after shower), and splenomegaly; dx confirmed with JAK2 mutation
PR: polycythemia vera
414
Decreased estrogen, increased FSH and LH; FSH elevation in the setting of >3 months of amenorrhea woman under each 40
PR: primary ovarian failure
415
inflammation, fibrosis, and stricturing of bile ducts, associated with UC, unexplained fever and cholestatic LFTs
PR: primary sclerosing cholangitis
416
urethritis, conjunctivitis, mucocutaneous lesions, enthesitis, and asymmetric oligoarthritis
PR: reactive arthritis
417
nonspecific, sore throat, hyperemic/edematous OP membranes, chelitis, stomatitis, glossitis, normocytic-normochromic anemia, seborrheic dermatitis, and photophobia
PR: riboflavin deficiency
418
Secondary pneumonia complicating a viral upper respiratory infection, necrotizing bronchopneumonia resulting in pnematocoeles
PR: S aureus PNA
419
lack close friends, odd behavior, and magical thinking
PR: schizotypal personality disorder
420
dry eyes, mouth, dental carries, difficulty swallowing, anti-SSA/SSB
PR: Sjogren syndrome
421
forward slip of vertebrae (L5/S1); back pain, neurologic dysfunction, palpable step off
PR: Spondylolithesis
422
post-influenza PNA, nursing homes, IVDU, CF
PR: Staph PNA
423
repetitive overhead motions; pain with active ROM, passive internal rotation, and forward flexion at the shouder
PR: subacromial bursitis
424
rapid, progressive ascending paralysis, absence of fever, absence of sensory abnormalities and normal CSF
PR: tick paralysis
425
microcephaly, hepatosplenomegaly, deafness, chorioretinitis, and thrombocytopenia
PR: TORCH infections
426
IBD with worsening sx, signs of sepsis, xray with dilated colon
PR: toxic megacolon
427
follicular conjucntivitis, pannus (neovascularization) in the cornea, major cause of worldwide blindness
PR: Trachoma
428
GI complaints followed by triad of periorbital edema, myosotis, and eosinophilia subungal splinter hemorrhages and conjunctival/retinal hemorrhages
PR: trichinellosis
429
cyanotic congenital heart disease, LAD, 90% VSD, 30% TGA, associated defects necessary for survival
PR: Tricuspid atrestia
430
Middle-aged adults, superficial unilaterally hit pain exacerbated by external pressures upper-level bye
PR: trochanteric bursitis
431
malabsorption, living in endemic area > 1 month, blunting of villi with infiltration of chronic inflammatory cells
PR: tropical sprue
432
hyperphosphatemia, hypocalcemia, hyperkalemia, and hyperuricemia
PR: tumor lysis syndrome
433
Antepartum hemorrhage with fetal heart changes progressing from tachycardia to bradycardia, become sinusoidal pattern; occurs suddenly after ruptured membranes
PR: vasa previa
434
sudden loss of vision, onset of floaters, fundus is hard to visualize
PR: vitreous hemorrhage
435
Multisystemic, arthralgias, weight loss, fever, diarrhea and abdominal pain; PAS - positive material in the lamina propria of small intestine
PR: Whipple's disease
436
choric steroids, EtOH, hemoglobinopathies; progressive hip/groin pain without restriction of ROM, MRI gold standard
PR:avascular necrosis of the hip
437
PR:pelvic abscess
lower abdominal pain, malaise, low-grade fever and tender pelvic mass on rectal exam
438
Pre-proliferative diabetic retinopathy
Cotton wool spots
439
predisposes to anaphylactic reaction to transfusion
IgA deficiency
440
preferred diagnostic tool in aortic dissection
TEE
441
preferred hormonal contraception for lactating mothers
progestin only because does not affect milk production/volume and not associated with thrombosis
442
pregnancy complications in patients with anoerxia nervosa or previous dx
miscarriage, IUGR, hyperemesis gravidarum, premature birth, and postpartum depression
443
ophthalmoplegia, pain with EOM, proptosis, and vision impairment
presentation specific to orbitial cellulitis
444
arthritis of the MCP, PIP, wrist and ankle joints
presentation: adult parvo
445
primary amenorrhea, bilateral inguinal masses, and breast development without pubic/axillary hair
presentation: androgen insensitivity
446
burst fracture of vertebra, total motor loss below the lesion, loss of pain/temperature, intact proprioception
presentation: anterior cord syndrome
447
slow growing papule with pearly, rolled borders and overlying telangiectasia
presentation: BCC
448
onset of HA, focal neuro deficits after and episode of acute otitis media
presentation: brain abscess
449
male infant, recurrent PNA and otitis media, serum Igs and circulating B-cells decreased
presentation: Bruton's agammaglobulinemia
450
dysphagia, severe pain, heavy salivation and mouth burns, no alteration in consciousness
presentation: caustic ingestion
451
ipsilateral ataxia, nystagmus, intention tremors, and loss of coordination
presentation: cerebellar tumors
452
infant presents with cyanosis that is aggregated by feeding and relieved by crying
presentation: choanal atresia
453
s/p bone marrow transplant with lung and intestinal involvement
presentation: CMV pneumonitis
454
HIV, AMS, EBV DNA in CSF, solitary weakly ring enhancing lesion
presentation: CNS lymphoma
455
HTN, mild hypernatremia, hypokalemia, and metabolic alkalosis
presentation: Conn's syndrome
456
hepatomegaly, ascites, and increased JVP due to decreased diastolic filling
presentation: constrictive pericarditis
457
cyanotic heart disease, anomalies of the craniofacial skeleton, absent thymus, absent parathyroid glands, recurrent infections
presentation: DiGeorge syndrome
458
fever, pharyngitis, and lymphadenopathy that is symmetric and posterior
presentation: EBV
459
chronic pelvic pain worse premenstrual, dysmenorrhea, and pain with intercourse/defecation
presentation: endometriosis
460
dysmenorrhea, heavy menses, and enlarged uterus
presentation: fibroid uterus
461
child, nocturnal pain, no obvious PE or lab findings
presentation: growing bone pain
462
hypogonadism, arthropathy, diabetes, and hepatomegaly
presentation: hereditary hemochromatosis
463
preterm infants with respiratory distress and hypoxia not responding to oxygen therapy
presentation: hyaline membrane disease
464
chronic, associated with pelvic pain worsened by bladder filling or intercourse accompanied by urgency, frequency and nocturia
presentation: interstitial cystitis
465
male adolescent with epistaxis, localized mass, and bony erosions to the back of the nose
presentation: juvenile angiofibroma
466
cooling towers, cough, severe, GI sx, confusion, intracellular poor gram stain
presentation: legionella
467
< 1 month, bilious vomiting, abdominal distention and passage of bloodstained stools
presentation: midgut volvulus
468
fatigable muscle weakness that involves the extraocular and bulbar muscles
presentation: myasthenia gravis
469
central scotoma, afferent pupillary defect, changes in color perception and decreased visual acuity
presentation: optic neuritis
470
constant visceral epigastric pain radiating to back, jaundice, and anorexia with weight loss
presentation: pancreatic cancer
471
>50, neck pain, shoulder pain, pelvic girdle pain >1 month, morning stiffness and ESR >40
presentation: polymyalgia rheumatica
472
6 weeks within surgery, eye pain, decreased visual acuity, swollen eyelids/conjunctiva, hypopyon, corneal edema and infection
presentation: postoperative endophthalmitis
473
painless blisters, increased skin fragility on dorsal hands, facial hypertrichosis and hyperpgimentation
presentation: prophyria cutanea tarda
474
tachypnea, tachycardia, and hypoxia 24 hrs w/in injury, patchy alveolar infiltrate
presentation: pulmonary contusion
475
renal insufficiency with hyperkalemia and non-anion gap metabolic acidosis
presentation: RTA type 4
476
euvolemic hyponatremia, decreased serum osmolarity, elevated urine osmolalirity, increased urine sodium concentraion, failure to correct with normal saline infusion
presentation: SIADH
477
hyperviscosity of blood owing to excess IgM production
presentation: Waldenstrom's macroglobulinemia
478
thrombocytopenia with eczema skin lesions and history of multiple bacterial infections
presentation: Wiskott-Aldrich syndrome
479
Runners, pain between 3rd and 4th toe, reproducible by palpation, clicking sensation while palpating
presentation:morton neuroma
480
adequate hydration and oral hygiene
prevention: parotitis
481
Proliferative or malignant diabetic retinopathy
Consists of newly formed vessels
482
pseudocyesis
rare, women present with all signs of pregnancy, normal endometrial stripe, negative pregnancy test
483
qualities of a benign murmur
asymptomatic, normal S2, <2 grade, no clicks, normal pulses, no other abnormalities
484
rare neurological side effect of isoretinoin A
pseudotumor cerebri
485
Reaction when taking amoxicillin with EBV infection
Polymorphism maculopapular rash
486
reason for low glc in exudative effusions
high metabolic activity of leukocytes within the pleural fluid
487
reason for pain in PE
pulmonary infarction
488
relation between NPV and sensitivity
as sensitivity increased, NPV increases
489
relation between PPV and specificity
as specificity increases, PPV increases
490
renal disease that hep C leads to
membranoproliferative glomerulonephritis
491
required in all patients with new onset lupus nephritis
renal biopsy
492
response phase
50% reduction in baseline severity of psychiatric illness
493
reversible risk factors for PACs
tobacco and EtOH
494
Reye's syndrome histo-pathology
extensive fatty vacuolization of the liver without inflammation
495
Risk factor for RDS maternally
Diabetes
496
risk factor that leads to highest risk of stroke
HTN
497
Risk factors for brain abscess
Congenital heart disease, head trauma, infections of job - mouth, meningitis, and cranial instrumentation
498
risk for untreated hyperthyroid disease
rapid bone loss from increased osteoclastic activity; cardiac tachyarrhythmias
499
Risk of DES in pregnancy
Female offspring increased risk of clear-cell adenocarcinoma of the vagina and cervix
500
risk of lidocaine in ACS treatment
increased risk of asystole
