STEP 2CK deck 2 Flashcards Preview

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Flashcards in STEP 2CK deck 2 Deck (163):
1

Antibodies for scleroderma

Antinuclear Ab
Anti-topoisomerase I (anti-Scl-70) ab
Anticentromere ab

2

S/S medial meniscus tear

popping at time of injury
sense of instability
effusion
reduced extension
joint catching

3

When to suspect herpetic whitlow

Young pt
multiple sexual partners
Painful vesicular hand rash

4

Most common type of shoulder dislocation

Anterior dislocation after direct blow or FOOSA

5

Signs of anterior shoulder dislocation

Holding arm slightly abducted and externally rotated

6

Common cause of posterior shoulder dislocations

seizures or electrocution

7

s/s posterior shoulder dislocation

Holding shoulder in adduction and internal rotation
Flatened anterior aspect of shoulder

8

Anticardiolipin Ab

antiphospholipid syndrome

9

Anti-cyclic citrullinated peptide Ab

RA

10

Anti-smooth muscle ab

AIH

11

Anti-neutrophil cytoplasmic Ab

GPA (wegener)

12

Cause of edema in hands and feet in kid with Turner syndrome

Congenital lymphedema

13

Diagnostic test for acute diverticulitis

Abd CT w/ contrast

14

When to do surgery for PAS

limb-threatening complication (non healing ulcer), significant limitation in ADLs, failure to respond to exercise and meds

15

Treatment for Bipolar I

Quetapine, lurasidone
Lamotrigine

NOT SSRI

16

Prenatal labs in initial visit

Rh(D) type and Ab screen
CBC
HIV, Syph, hep B
Rubella and varicella immunity
Pap
CG PCR
Urine Cx and protein

17

prenatal labs at 24-28wks

Hbg
Ab screen if Rh(D) neg
50g 1h GCT

18

When to do GBS test for pregnancy

35-37 wks

19

Most common cause of spontaneous lobar (parietal and occipital) hemorrhage

Cerebral amyloid angiopathy

20

Meningeal artery tear

epidural hemorrhage
(biconvex)

21

Rupture of bridging veins

Subdural hematoma
(crescent shaped)

22

Egg shell calcifications of liver mass

Hydatid cyst from echinococcus granulosus

23

Causes of osteoporosis

Chronic inflammation
Steroids
lack of physical activity
Vit D deficiency

24

RA
Neutropenia
Splenomegaly

Felty syndrome

25

Sjogren Ab

Anti Ro and La

26

Enthesitis

inflammation at tendon insertion sites
Associated with AS, psoriatic arthritis and reactive arthritis

27

First test to order for SLE

ANA

28

Causes of gout

Increased rate production: primary, myeloproliferative, tumor lysis syndrome, HGPT deficiency

Decreased rate clearance: CKD, thiazide/loop diuretics

29

Signs of missed abortion

Closed cervix
No bleeding
No fetal cardiac activity or empty sac

30

Signs of threatened abortion

Vaginal bleeding
Closed cervical os
Fetal cardiac activity

31

Signs of inevitable abortion

vaginal bleeding
Dilated os
might see products of conception

32

signs Incomplete abortion

Bleeding
dilated os
some products of conception expelled

33

signs of complete abortion

Vaginal bleeding or not
closed os
no products

34

How to treat if woman tests + for CT but - GC

Azithromycin only

35

Fetal complication of preeclampsia

small for gestational age from chronic uteroplacental insufficiency

36

What is considered arrest of active phase of labor

no cervical change for >4hrs with adequate contractions (>200)
OR
No cervical change for >6hr w inadequate contractions

37

Etiology of early decelerations

Fetal head compression

38

Etiology of Late decelerations

Uteroplacental insufficiency

39

Etiology of variable decelerations

Cord compression
Oligohydramnios
Cord prolapse
(recurrent=fetal hypoxemia)

40

Anti-beta2-glycoprotein Ab

antiphospholipid syndrome

41

Uterotonics

Oxytocin and misoprostol

42

What makes a fetus nonviable?

Anencephaly
Bilateral renal genesis
Holoprosencephaly
Acardia
Thanatophoric dwarfism
Intrauterine fetal demise

43

Treatment of hypertensive emergency in pregnancy

IV Labetalol
IV Hydralazine (if HR low)
Nifedipine PO

44

Firm fixed breast mass with fat globules and foamy histiocytes on path

Fat necrosis

(post procedure)

45

Treatment for asymptomatic bartholin cyst

observation

46

SE SERM

VTE

47

HELLP effects on liver

centrilobular necrosis, hematoma formation, thrombi in portal cap system

Leads to liver swelling and distention of capsule

48

Characteristics of acute fatty liver of pregnancy

Nausea, vomiting
abd pain
elevated LFT
Third trimester

(leukocytosis, hypoglycemia and AKI possible)

49

Lab findings in hypogonadotropic hypogonadism

Low LH and FSH
Low estrogen

50

Cause of thrombocytopenia in HELLP

systemic inflammation and activation of coag system

51

What is second stage arrest of labor

>3hr if nulliparous
>2hr if multiparous

2nd is 10cm to birth

52

Etiology of second stage arrest of labor

Cephalopelvic disproportion
Malposition
Inadequate contrations
Maternal exhaustion

53

Characterstics of placenta prevue

painless bleeding in third trimester

54

Effects of O mom with AB dad

Baby usually asymptomatic or mild anemia at birth
Can develop jaundice in first 24hrs (responds to phototherapy)

55

Signs of granulosa cell tumor of ovary

Child: precocious puberty
Postmenopausal: bleeding/endometrial hyperplasia

Large adnexal mass

56

Diagnostic findings in pts w granulosa cell tumor

Elevated estrogen
U/S: ovarian mass, thickened endometrium

57

Treatment for ovarian torsion

laparoscopy

58

S/S placental abruption

third trimester bleeding
PAIN
abnl FHRT

59

SE oxytocin

Hyponatremia (seizures)
Hypotension
Tachysystole

60

Treatment for postpartum endometritis

Clinda and gentamicin

61

Clinical features of postpartum endometritis

Fever >24h postpartum
Uterine fundal tenderness
Purulent lochia

62

S/S hydatidiform mole

Abnl vaginal bleeding
Uterine enlargement
Abnormality elevated beta-hCG
Hyperemesis
Preeclampsia with severe features
hyperthyroid

63

Management of PPROM 34-37wks

Antibiotics
+/- corticosteroids
delivery

64

Risk factors for postpartum urinary retention

Nulliparity
Prolonged labor
Epidural anesthesia

65

Presentation of CAH

acne, irregular menses, hirsutism

Boys with precocious puberty

elevated 17 HO progesterone

66

Foodborne dz with mainly vomiting

S. aureus
Bacillus cereus
Norovirus

67

Foodborne illness with mainly watery diarrhea

C. perfringens
E. coli
Enteric virus
Cryptosporidium
tapeworms

68

Foodborne illness with mainly inflammatory diarrhea

Salmonella
Campy
Shiga E. coli
Shigella
Enterobacter
Vibrio
Yersinia

69

Causes of AOM

S. pneumo
H. flu
Moraxella catarrhalis

70

Treatment for AOM

PO amoxicillin

71

Cause of precocious puberty with high LH and high FSH

Gonadotropin dependent (central) percocious puberty

72

Treatment for central precocious puberty

GnRH agonist

73

Risk factors for tinea corporis

Athletes with skin to skin contact
Humid environment
Contact with rodents

74

Causes of metabolic alkalosis

Emesis
Diuresis
dehydration

75

CF vs primary ciliary dyskinesia

Both: Chronic infections
nasal polyps
Bronchiectasis
Digital clubbing

CF: Pancreatic insufficiency
Infertility
FTT

PCD: Situs inversus
Infertility
Normal growth

76

PPx for sickle cell pt

Vaccination
penicillin for S. pneuma until age 5
Folic acid supplement

77

Sickle cell pts are at high risk of getting sepsis from...

S. pneumo
H. flu
N. meningitidis

78

Diagnostic features of acute bacterial rhino sinusitis

Persistant sx >10d
OR
Severe sx (fever 39, purulent discharge, face pain >3d)
OR
Worsening sc >5d after initial improvement

79

Characteristics of constitutional growth delay

delayed growth spurt
delayed puberty
delayed bone age

80

Clinical findings in congenital CMV

periventricular calcifications

plus IGR, HSmegaly, Jaundice, blueberry muffin spots

81

Clinical findings in congenital Toxo

Diffuse intracerebral calcifications
Hydrocephalus
Deafness
severe chorioretinitis

82

Clinical findings in congenital syphilis

Rhinorrhea
Abnormal long-bone XR
Desquamating or bullous rash
Saddle nose
funny teeth

83

Clinical findings in congenital rubella

Cataracts
PDA
deafness
jaundice
blueberry muffin spots

84

Single S2 and cyanosis in <24h

Transposition of great vessels

85

Treatment for transposition of great vessels

prostaglandins

86

Genetics of myotonic dystrophy

AD expansion CTG

87

Myotonic dystrophy S/S

onset 12-30
Facial weakness
hand grip myotonia
Dysphagia

88

Comorbidities of myotonic dystrophy

arrhythmias
cataracts
balding
testicular atrophy

89

Rocker-bottom feet, overlapping fingers, micrognathia, microcephaly

Trisomy 18
Edwards syndrome

90

Heart defect associated with trisomy 18

VSD

91

S/S neurofibromatosis 1

Cafe-au-lait spots, macrocephaly, feeding problems, short, LD
Fibromas, neurofibromas, optic gliomas

92

S/S Vitamin B2 deficiency

Angular cheilosis, stomatitis, glossitis
Normocytic anemia
Seborrheic dermatitis

93

S/S vitamin B6 deficiency

Cheilosis, stomatitis, glossitis
Irritability, confusion, depression

94

pt with short stature, primary amenorrhea and absent thelarche

Turner syndrome

elevated FSH

95

s/s choanal atresia

cyanosis worse with feeds and relieved by crying

(can breath though nose)

96

post op Mediastinitis signs

14 days post sternotomy

Fever, tachycardia, CP, leukocytosis, sternal wound drainage

97

treatment for mediastinitis

surgical debridement and Abx

98

Dilated common bile duct in the absent of stones, elevated LFT, episodic RUQ pain

sphincter of Oddi dysfunction

99

Tx of penile fracture

Retrograde urethrogram

100

Most common solid organ injuries after blunt abdominal trauma

Hepatic laceration and splenic laceration

101

Markers of mixed germ cell tumor

beta HCG
AFP

102

Ddx for anterior mediastinal mass

Thymoma
Teratoma
Thyroid neoplasm
Terrible lymphoma

103

Types of teratomas

seminomatous germ cell tumors from nonseminomatous germ cell tumor

104

Compartment syndrome s/s

POOP
paresthesia
Pain worse with stretch
Swelling
Paralysis (late)
Loss of sensation

105

Treatment for anal fissures

High-fiber diet
Stool softeners
Sitz baths
Topical anesthetics and vasodilators

106

s/s ruptured ovarian cysts

Sudden-onset, severe, unilateral lower abd pain after strenuous or sexual activity

107

u/s finding of ruptured ovarian cysts

pelvic free fluid

108

treatment for small pneumothorax

supplemental O2

109

s/s dumping syndrome

Abd pain, diarrhea, nausea
Hypotension/tachycardia
Dizziness, fatigue, diaphoresis
15-30min after meals

110

Tx of dumping syndrome

small/frequent meals
Eat complex carbs and drop simple sugars
Incorporate high-fiber and protein-rich foods

111

Pulsatile groin mass below inguinal ligament with anterior thigh pain

Femoral artery aneurysm

Associated with AAA

112

Most common peripheral artery aneurysm

popliteal aneurysm

113

Midline sacrococcygeal with mucoid and bloody drainage

Pilonidal disease

most commonly young males, obese, sedentary lifestyles

114

s/s hidradenitis suppurativa

multiple, recurrent, painful nodules in axillae, inguinal folds and perineal areas

115

patient with blunt abdominal trauma who is stable with negative FAST but high risk features

subsequent CT scan

116

Possible retropharyangeal abscess comorbidity

Acute necrotizing mediastinitis

117

Management of massive hemoptysis after securing the airway

Bronchoscopy
for finding bleed and therapeutic intervention

118

s/s varicocele

soft scrotal mass that decreases in size in supine position
increase in size with standing/valsalva
Subfertility
Testicular atrophy

119

Risk factors for stress fracture

Repetitive activities
Abrupt increase in physical activity
Inadequate Ca and vit D
Decreased caloric intake
Female athlete triad

120

Acid base irregularity with hypoxemia

Hyperventilation
leads to respiratory alkalosis

121

Work up of a broken clavicle

Angiogram

122

Treatment of new afib in stable pt

Diltiazem

123

Extraintestinal manifestations of IBD

arthritis
Eye (uveitis)
Pyoderma gangrenosum
PSC (UC)

124

Tx for myasthenic crisis

Stop pyrostygmine
Intubation
IVIG and steroids

125

Another name for pancoast tumor

superior pulmonary sulcus

126

Reasons for valve surgery in the setting of bacterial endocarditis

Significan valve dysfunction
Persistent infection or hard to treat
Recurrent septic embolization

127

S/S HIT

>5d after heparin
Plt down >50% bl
A or V thrombosis
Necrotic skin at injection sites
Acute anaphylactoid rxn post injection

128

Dx HIT

Serotonin release assay

129

Complications of supracondylar fx of humerus

Brachial a. injury
Median nerve injury
Cubitus varus deformity
Compartment syndrome/Volkmann ischemic contracture

130

What to do before hip surgery

Check for medical stability/ underlying conditions

131

Sequela of spinal cord injury that happens months to years after

syringomyelia

post whiplash

132

S/S syringomyelia

decreased strength
diminish pain/temp in arms/hands or cape like
Preservation of dorsal column

133

S/S patellar bursitis

painful
swelling
erythema
decreased active ROM
Intact passive ROM

*think of the job

134

DVT tx in pt with GFR <30

Unfractionated heparin and warfarin

135

Next step of tx for pt with resolved gallstone pancreatitis

cholecystectomy

136

Which nerve goes though the parotid gland

facial

137

Effect of hypovolemic shock on the heart

small left ventricular cavity with increased EF

138

Effect of succinylcholine on electrolytes

elevated potassium
decrease Na

139

When not to use succ to avoid hyperK

crush injury
diffuse muscle atrophy
Burn
Denervation (stroke, GB, critical illness polyneuropathy)

140

SE TCAD

Cardiac (QRS prolongation)
Convulsions
Coma (sedation)

141

Timing of alcohol hallucinations

12-48hrs

142

Timing of delirium tremens

2-4d

143

Timing of seizures

12-48hr

144

Escitalopram is a...

SSRI

145

Tx for chronic alcohol use disorder

Naltrexone

146

When to use acamprosate

start when alcohol abstinence achieved

MAINTAIN abstinence

147

Treatment for acute dystonia

Benztropine
OR
Diphenhydramine

148

tx Akathisia

propranolol
OR
Lorazepam

149

Tx drug induced parkinsonism

Benztropine or amantadine

150

Tx for tardive dyskinesia

No specific tx
(switch to clozapine?)

151

Brain changes seen on MRI with schizophrenia

Lateral ventricle enlargement

and decreased volume hippocampus and amygdala

152

Primary use of Amiodarone

ventricular arrhythmias in the setting of CAD

153

Tests to get before starting Amiodarone

CXR and PFTs
TSH
LFT

154

S/S pemphigus vulgaris

+Nikolsky
+ oral mucosa
30-50s
IgG on all cells

155

S/S dermatitis herpatiformis

Associated with celiac
IgA deposition
Vesicular lesions
Extensor surfaces
Buttock

156

Contralateral hemiparesis and hemianesthesia
Conjugate gaze deviation toward the lesion

Internal capsule damage

157

Most common site for HTN hemorrhages

lacunar stroke affects basal ganglia (putamen)
cerebellar nuclei, Thalamus and pons

158

S/S basal ganglia hemorrhage

Contralateral hemiparesis and sensory loss
Homonymous hemianopsia
Gaze palsy

Also can affect nearby structures

159

Medial medullary syndrome

Cont paralysis arm and leg
Cont loss position sense
Lick the lesion

160

Most sensitive test for HF?

BNP

161

What is reaction formation?

responding in a manner opposite to one's actual feelings

162

What are mature defense mechanisms

sublimation (channeling impulses into socially acceptable behavior)
Suppression

163

S/S acute intermittent porphyria

Acute abd pain
Neurologic abnl (sensory and motor neuropathies, tachycardia)
Psychiatric sxs (anxiety, insomnia, restlessness, mood changes, psychosis)

onset 30-40