Step 3 Flashcards
(207 cards)
1
Q
Radioactive iodine uptake of Subacute thyroiditis, iodine exposure, exogenous use
A
low
2
Q
Trich features
A
Pear shaped, ph greater than 4.5
3
Q
Number needed to treat
A
NNT= 1/control group event rate-experimental group rate
4
Q
Treat TB pregnancy
A
INH, ridampin and ethambutol for 2 months then inh and rifampin for 7 months
5
Q
Case control
A
Participants into groups based on WHO HAS DISEASE!!!. Then assessed for risk factors
6
Q
Factorial study design
A
Study type that utilizes 2+ interventions and all combos of the interventions
7
Q
Cushing syndrome sx
A
Hypertension, hyperglycemia, mood swings, osteopenia, hypokalemia and metabolic alkalosis
8
Q
Screen for Cushing
A
Overnight dexamethasone suppression test or measurement of 24 hour urinary free cortisol
9
Q
Ssri for adolescent
A
Fluoxetine
10
Q
Sx for craniopharyngioma in adult vs child
A
Adult is sex dysfx and just is growth failure
11
Q
Ppx for pertussis in household
A
Everyone even if vaxed. Azithro
12
Q
Follow up for Barrett esophagus
A
No dysplasia 3-5 years, low grade dysplasia 6-12 mo. High grade eradication therapy
13
Q
Polycythemia in newborns risk factors
A
Post term, SGA, infant of DM, monochorionic twins, and chromosome abnormalities
14
Q
Primary hyperparathyroid labs
A
High calcium and low phosphate
15
Q
PCA aneurysm findings
A
CN 3 palsy. Ptosis and anusocoria.
16
Q
Erysipelas def and tx.
A
Caused by strep pyogenes. Fever with rapid erythema well demarcated borders. Tx with a penicillin
17
Q
Treat tet spell
A
Increase SVR, Knee to chest position
18
Q
VACTERL
A
vertebrae, anal, cardiac, trachea esophageal, renal, radial bone, limb defects
19
Q
Treat tic paralysis
A
Remove tic
20
Q
Previously vaccinated person exposed to rabies
A
Only a 2 dose booster of vaccine.
21
Q
Complications of MRSA bacteremia
A
Metastatic infections: heart valves, lungs, osteoarticilar, particularly vertebral osteomyelitis
22
Q
Indications for thrombolysis in Pe
A
Hemodynamic instability, severe right ventricular dysfx, large clot burden, free right side cardiac thrombus
23
Q
Management of partial Kawasaki, fever for 5+ days and <=3 sx
A
Get CRP and ibuprofen and re examine next day
24
Q
How long no live vaccines after tax Kawasaki
A
11 months
25
Scrombroid poisening def, sx, tx
Def: ingestion improperly stored seafood. Sx: flush, abdominal cramps, HA, palpitations, diarrhea. Tx: self limit
26
Hypoglycemia s/e diabetes Med
Sulfonureas and meglitinides
27
Rheumatic fever, good pasture, ITP, myasthenia gravis, graves, pemphigud vulgaris
Type II hypersensitivity
28
Transient erytheoblastopenia of childhood
Normocytic, normochromic anemia in healthy toddler. Tx supportive unless Hgb 5>
29
Size concerning for melanoma
6 mm
30
First step in eval hypercalcemia
PTH even if suspect malignancy
31
Initial test to determine if patient has excess androgen production due to adrenal neoplasm
DHEAS
32
What use prostaglandin E1 for and s/e
Used to keep PDA open in ductus dependent heart diseases. S/e apnea, bradycardia, hypotension
33
Prsentation of Guillian Barre
Ascending weakness and arreflexia
34
SAAG Formula and causes
SAAG=Serum albumin-ascitc albumin. Greater than 1.1: portal HTN: CHF, cirrhosis, alcoholic heptitis
Less than 1.1: no PH: peritonial carcinomastosis, peritoneal TB, nephrotic syndrome, pancreatitis
35
Age to refer for orchiopexy for indescended testes
6 mo
36
Tx optic neuritis
IV steroids, oral has risk of recurrence
37
Tx muscle spacity in MS
Baclofen or tizanidine
38
Def and eval of delayed puberty in boys
Lack of testes enlargment by age 14; bone age and FSH, LH, Testosterone
39
Histrionic personality disorder
Excessive superficial emotion, attention seeking, secual behavior
40
Define second atage labor arrest
No fetal descent after nulli pushes for 3+ without or 4+ with epidural
41
Tx latent syphillis
3x weekyl pennicillin G
42
Tx of asymptomatic lead
5-44: nothing
45-69: meso-2,3-dime (DMSA)
70+: dimercaprol + EDTA
43
LH in central vs perioheral precocious puberty
High in central low in peripheral
44
Relative risk equation
Risk of outcome in exposed group/risk of outcome in nonexposed
45
SIADH assoc with which lung cancer
Small cell
46
Calcium-albumin correction
Calcium decrease 0.8 for every 1 decrease in albumin
47
Complications of hyperthyroid
Arrhythmia, cardiomyopathy, osteoporosis
48
Treat BV
Clinda or metro
49
What is raloxifene
Selective estrogen modulator for breast cancer chemo and osteoporosis
50
Treat mastitis
Dickoxacillin or cephalexin
51
Tx first line fir breast abscess
Fine needle aspiration
52
Positive predictive value equation
PPV= TP/(TP+FP)
53
Length time bias
When survival benefits of screening test are overstated cause of detection of lots of slowly progressive benign cases
54
Suspect PJP and Sputum negative
BAL
55
Abx for PPROM
Amp + azithro
56
Migrating polyarthalgia, tenosynovitis, dermatitis (pustular lesions)
Disseminated gonnococcal infection
57
Dyspepsia without other sx
H pylori testing
58
Proximal muscle weakness, high CK and inflammatory markers
Polymyositis
59
Pulm complications of polymyositis
Interstitial lung disease, infection, drug induced pneumonitis, resp muscle weakness
60
Abdominal pain, fat malabsorption, alcohol intake
Chronic pancreatitis, confirm with MRCP
61
Dx urethral diverticulum
MRI or tranvag Us
62
FOOSH fxs
Colles (distal radial)(deformity)
| Scaphoid (pain in snuffbox)
63
When tx asymptomatic subclinical hypothyroid besides AB?
Abnormal lipids, sx, or menstrual dysfx
64
Relative risk reduction
(Risk in unexposed- risk in exposed)/ (risk in unexposed)
65
Eval gynecomastia
Look at photo
66
Mechanism of organophosphate poisening
Cholinergic tox by acetylcholinesterase inhib
67
Dialectal Behavioral therapy for…
Borderline
68
When get carotid endarterectomy
70+%, >5 yr life, symptomatic
69
Relative risk
Incidence in exposed/incidence in nonexposed
70
Cover for in CF
Pseudomonas
71
Complications of multiple myeloma
Hypercalcemia, renal insuff, infections, lytic lesions, thrombosis, hyoervoscity (rare)
72
Hypothyroid in pregnancy and tx
See pic
73
Midline neck mass moves with swallowing
Thyroglossal duct cyst
74
Parhophys and tx renal osteodystrophy from secondary hyperparathyroid
CKD cause less phos filtration and elevated phos snd low calcium, then elevated PTh. Tx wtih phos restrict
75
Analgesic nephropathy sx
Hematuria, pyuria, proteinuria, renal colic
76
Normal caloric response
Deviation of eye to side of stimulus, saccadic correction to midline
77
Risk for reactive arthritis
Greater in HLA B27 And also salmonella and chlamydia
78
Management if NSTEMI/Unstable angina
See photo
79
bilateral polyspike and slow wave activity
juvenile myclonic epilepsy
80
sx of endometriosis
pelvic pain, DEEP dyspareunia, dysmennorrhea, dyschezia
81
when do c/s for HIV
viral load >1000
82
define allergic bronchopulm aspergillosis
hypersensitivity disorder in asthma and CF; reccurent fleeting infiltrates and central bronchiectasis
83
acute, monocular vision loss, cherry red macula on fundoscopy
central artery occlusion
84
size of nodule that needs mangament or surveilence
>0.8 cm
85
screening for diabetic kidney disease
urine albumin/creatinine ratio
86
Rule of 10s for reconstruction of cleft lip
10 lbs, 10 weeks, 10g hemoglobin
87
Sx of HIT
Thrombocytopenia and arterial and venous thrombus
88
Switch to for HIT
Direct thrombin inbunitor (argatroban, bivalirudin) or fondaparinux
89
Right ventricular strain on EKG
RBBB, atrial arrythmias, Qwaves or St change in infeior leads
90
tx catatonia
benzos
91
AKI in TLS
Ca-Phos stone formation
92
when get cold agglutinin hemolytic anemia
after a viral infection
93
boy with hemolytic anemia
G6PD
94
early systolic murmur at appex
mitral regurg
95
MOA of loop diuretics
block Na-K-2Cl transporter in loop of Henle
96
calcium and thiazide
reabsorb more so more in serum less in urine
97
sx of aspirin OD
n/v, tachypnea, lactic acid, hyperthermia, AMS
98
death in tuberous sclerosis
seizure, aspiration pneumonia, obstructive hydrocephalus
99
what is pyelophlebitis
infection of portal vein thrombosis, complication of appendicitis
100
tx pagets
bisphosphates
101
presbycusis
hearing loss elderly
102
3+ months of dysuria, pain with ejac, perianal pain and tx
chronic prostatitis (tx with tamsulosin)
103
what screen for in patients with primary biliary sclerosis
osteoporosis
104
what is scleroderma renal crisis and tx?
severe HTN and renal failure, ACE and nitropruside
105
psych med complications
see pic
106
Exam findings for severe AS
Soft single heart sound, delayed and dimished carotid pulse, loud and late peak systolic murmur.
107
Rate ratio
Incidence in intervention/incidence in control
108
Number needed to harm
1/(rate in treatment-rate in placebo)
109
Tx post op a fib after cardiac surgery
Most spont convert. However can reccur
110
asymmetry in a funnel plot suggests...
publication bias
111
positive and negative likelihood ratio
+LR= sensitivity/(1-specificity)
| -LR=(1-sensitivity)/specificity
112
korsacoff MRI finding
mammilary body atrophy
113
when switch to subQ insulin in DKA
able to eat, glc <200, anion gap <12, and bicarb >15
114
who gets ppx for n. mening
household, roomates, child care, directly exposed to secretions, seated next to for >8 hr
115
calcifications in nodule that raise susp for malignancy
eccentric, reticular, punctate
116
Proximal muscle weakness, CK, skin
Dermatomysostis
117
Extrarenal manifestations of ADPKD
Cerebral aneurysms, helatic and pancreatic cysts, mitral valve prolapse, aortic tegurg, colonic diverticula, ventral and inguinal hernias
118
Screen for ADPKD
US for patients above 18
119
Soinal cord level of cremasteric reflex
L1-2
120
supra INR
<4.5 nothing
4.5-10: low dose oral vit K
10+: high dose oral vit K
Bleeding: iv vit K and PCC
121
1st step for pancreatic cyst
US with aspiration
122
what fluids non infectious for HIV
stool, urine, vomit,vtears as long as not bloody
123
When treat with fibrates for hypertrigly.
>880
124
Type 1 error=
False positivie
125
Late in life depression at risk for
Alzheimers
126
Herbal meds and their side effects
See pic
127
Labor cannot progress without
Adequate contractions every 2-3 mins
128
Antipsychotics with worst parkinson risk
Haloperidol-risoeridone-olanzipine
129
Schistosomiasis sx and tx
Dysuria, urinary freq, hematuria, perioheral eosinophillia, praxiquantel
130
how does octreotide help variceal bleed
lower elevated portal venous pressure that causes varcieals
131
primary and secondary prevention of variceal hemmorrhage
propanolol
132
physical activity and insulin
reduce prior to activity
133
LCIS if found on FNA next step and why
excisional bx because could be DCIS or other cancer
134
meds cause pseudo tumor and findings on fundoscope
isotretinoin and minocycline; flame hemmorrhages, venous engorge, hard exudates
135
gram stain for G vs C
G: leukocytes with intracellular gram neg diplococci
C: leukocytes with no organisms
136
CHD risk equivalent
Noncoronary athersclerosis, DM, CKD
137
Relative risk
Risk exposed/risk unexposed
138
Attributable risk percent
ARP=(RR-1)/RR
139
Population attributable risk percent
PARP=(risk in total pop-risk in unexposed)/risk in total
140
Most common parhogen of nec fasc
Group A strep
141
Tx CAP
Ctx and azitrho, no anaerobic coverage even if aspiration
142
____ challenge for asthma
methacholine
143
what NOT to use orally for tinea versicolor
terbinafine and grisefulvin
144
When total thyroidextomy for papilary thryroid cancer
>1 cm, tukor extension, distant met, or radiation exposure
145
Clinical benefit of medication equation
Possible benefit-possible harm
146
Intention to trrat primciple
Participants analyzed in groups they were randomized even if dropped out or fucked up
147
CKD cardio findings
LVH and anemia
148
Pempjigoid gestationis def
Automimmune urticarial papules and plaques vesicles and bullar. Periumbilical
149
Hematuria, abdominal mass, erythrocytsosis
RCC
150
Tx tines pedis
Topical terbinafine, azole or oral terbinafine or azole
151
Erythetamous mass from rectum with concentruc rings
Rectal prolapse
152
What hematoma not good in head injury <2 yeats
Nonfrontal scalp hematoma
153
Good prognostic factors for schizophrenia
Late onset, female, acute onset with precipitant, positive sx, no fam hx
154
def of neg and pos likelihood ratios
-: probability neg result in cancerous tissue compared to normal
+: probability of pos result in cancerous tissue compared to normal
155
reflexes and electrolytes
hypocalcemia=hyperactive
hypermagnesemia=hypoactive
hypophos= hypoactive
156
sensitivity help
rule out disease
157
tsh in hypothyroid
high
158
pregnancy complications for subclinical hypothyroid
recurrent miscariges, PEC, preterm birth, low birth weight, and placenta abruption
159
acute cholangitis sx
fever, RUQ pain, jaundice, confusion
160
odds ratio equation
see pic
161
clinical features of cervical insufficiency
2+ prior painless 2nd trimester pregnancy losses, painless cervical dilation
162
interpret hazard ratio
<1 means less likely to occur in treatment than event group
| >1 means more liekly
163
Hirschaprung dx
Suction bx
164
Primary hyperparathyroid indications for surgery
Age <50, symptomatic, calcium >1 above normal, urine >400
165
High dose statins
Atorvastatin 40-80 or rosuvastatin 20-40
166
Palpable breast mass
Photo
167
Hyperkalemia EKG
See pic
168
Tx pertusis
Macrolides
169
Bleeding from fibroids
Regular and heavy
170
Hyoercalcemia EKG
Short QT
171
What is electrical alternans and when does it happen
Cardiac tamponade, alternating amplitude in QRS complexes
172
Pain and stiff without weakness
PMR
173
When initiate discussion about renal replacement therapy
GFR <30
174
What can Factor V ledien lead to
Protein C resistance
175
When bariatric surgery
BMI more than 40
176
myopathies and ESR and CK
see pic
177
urine chloride distinguish causes of metabolic alkalosis
```
low= gastric losses
high= diuretic use
```
178
cohort vs case control
cohort prospective, case control retrospective
179
erythropoetin and polycythemia
if low: primary/PV
| if high: secondary
180
autoimmune metaplastic atrophic gastritis caused by and lead to
caused by: autoimmune aggression against gastric mucosa
| lead to: pernicious anemia
181
warfarin effected by meds increase INR and decrease
increase INR "a"s + flagyl + quinolones
182
MOA of carbidopa
decrease peripheral conversion of levodopa to dopamine
183
tx allergic bronchopulmonary aspergillosis
prednisone and if not work itraconazole or voriconazole
184
selection bias
inappropriate selection or poor retention of subjects
185
what is sheehan syndrome
pan hypopituitarism due to ishcemic necrosis after a postpartum hemmorrhage
186
drugs affect lithium levels
thiazides, NSAIDs, ACE and ARB,tetracycline, Flagyl
187
when do dialysis for lithium
>4
188
schizoaffective
2+ weeks psychotic sx without mod sx
189
Mentzer index and significance
MCV/RBC; >13 is iron def anemia, less is thalassemia
190
target for treating graves in pregnancy
hyperthyroid state
191
markers for autoimmune hepatits
ANA and anti-smooth muscle AB
192
traumatic LP ratio
1 WBC per 750-1000 RBCs
193
toxic nodule characteristics
increased idioine uptake in nodule, decreased in rest
194
valve for IV drug user endocarditis
tricuspid
195
first line therapy for MDD with psychotic features
Electroconvulsive therapy
196
meds for heart failure during preg
BB, digoxin, hydralyzine, nitrates, loop diuretics
197
erythema infectiosum
parvo reticulated rash
198
low T4 and normal/low TSH
central hypothyroidism
199
silicosis in what lobes of lung
upper
200
hyperchloremia, hypokalemia non anion gap met acidosis, hypercalciuria
Distal RTA Type 1
201
painful vs painless genital ulcers
painful: HSV, chanchroid (H. ducry)
painless: Syphillis charcre, lymphavenereum-chlamydia (then turn painful buboes)
202
manifestations of stongyliodes
pulm: cough and wheeze, GI: n/d, skin: linear erythetamous
203
AIN drugs
PPI, NSAIDs, penicillins, diuretics
204
lights criteria
pleural/serum protein >0.5
pleural/ serum LDH >0.6
pleural LDH >2/3 upper lim normal serum
205
chronic open angle glaucoma presentation
progressive loss of peripheral vision and increased cup to disk ratio
206
fever cough rhinorrhea, then cephalocaudal rash and conjunctivia
measles
207
criteria for BiV pacer
LVEF <35%, CHF sx, and left bundle branch block >150 ms
