Things I Want to Remember Flashcards
(200 cards)
1
Q
Define chronic bronchitis
A
productive cough for at least 3 months a year for 2 consecutive years
2
Q
panacinar involvement is seen in which type of emphysema?
A
alpha-1 antitrypsin deficiency
3
Q
What abx is known to cause QT prolongation?
A
macrolides
4
Q
What what O2 levels would you initiate oxygen therapy in a pt with COPD?
A
O2 stat less than 88%
Pa02 less than 55mm of mercury
5
Q
What is the MOA of heparin?
A
enhances the activity of antithrombin III
6
Q
What is cryoprecipitate? What 3 conditions is it used to treat?
A
a frozen blood product derived from plasma that is used to replenish clotting factors, especially fibrinogen, in patients with low levels of these factors
von Willebrand dz
hemophilia A
DIC
because all 3 conditions have decreased levels of fibrinogen
7
Q
Which of the following is a known risk factor for developing endometrial cancer?
early menarche
multiple pregnancies
long term use of tamoxifen
long term use of raloxifene
late menopause
A
long term use of tamoxifen
8
Q
What 2 hem conditions have fragemented RBC on peripheral smear?
A
DIC and TTP
9
Q
Describe Reed-Sternberg cells. What dz?
A
large binucleate cells. CD15 and CD30
Hodgkin’s lymphoma
10
Q
mono and Mycoplasma infections can cause ___________ anemia and are ____ immunoglobins
A
cold autoimmune hemolytic anemia
IgM immunoglobulins
11
Q
hematocrit increases by _____ points when 1 unit of packed RBC are given
hemoglobin increases by ____ points when 1 unit of packed RBC are given
A
hematocrit = 3
hemoglobin = 1
12
Q
When cells are destroyed in the process of hemolysis the _____ and _____ levels will be increased
A
indirect bilirubin and LDH levels will be increased
think hemolytic anemia
13
Q
What is the triad of Meneire disease?
A
tinnitus
vertigo
progressive hearing loss
14
Q
What are the first line meds for generalized epileptic seizures?
A
Valproate, lamotrigene, levetiracetam
15
Q
What are the 3 components of the Samter triad?
A
Asthma, asa sensitivity and nasal polyps
16
Q
What are the 2 FDA approved drugs that can be used as monotherapy in bipolar 1 and 2?
A
Quetiapine and lurasidone
17
Q
Pts with familial adenomatous polyposis (FAP) with test positive for what mutation?
A
APC mutation
18
Q
What antigen marker is associated with ankylosing spondylitis?
A
HLA-B27
19
Q
What is the shape of neisseria meningitis? What is the empiric treatment?
A
Gram- negative diplococci
Vanc plus ceftriaxone or cefotaxime
Ampicillin added for IC and older adults
20
Q
The risk for what type of cancers are reduced by using oral contraceptives?
A
Ovarian and endometrial cancer
21
Q
What is the first line med for absence seizures? What is the second line?
A
ethosuximide
valproate
22
Q
Carbmazepine is a first line med for _______. What is the MOA?
A
trigeminal neuralgia
blocks sodium channels
23
Q
Describe the nystagmus associated with labyrinthitis. What is the treatment?
A
horizontal and the fast phase moves away from the affected side
prednisone
meclizine or diphenhydramine
+/- benzo and antiemetics
24
Q
What type of lung cancer is LEAST associated with smoking?
A
adenocarcinoma
25
PNA with rust-colored sputum, what pathogen?
Strep Pneu
26
PNA with red currant-jelly sputum, what pathogen?
Klebsiella pneu
27
PNA with green sputum, what pathogen?
Haemophilus influenzae and Pseudomonas aeruginosa
28
What is the classic triad of meniere's dz?
episodic vertigo
unilateral hearing impairment
tinnitus
29
Which BPH medication works by reducing the size of the prostate to improve symptoms? What drug class?
finasteride
5-alpha-reductase inhibitors
works to block the conversion of testosterone to dihydrotestosterone
30
What are the PE findings in a pt with PNA in terms of tactile fremitus, percussion, crackles and egophony
increased tactile fremitus
dullness to percussion
inspiratory crackles
bronchial breath sounds
positive egophony over the affected areas
31
What is first line therapy for hypertriglyceridemia when the pt is already taking a statin? What is second line and why?
first: fenofibrate because it can be used WITH statins
second: gemfibrozil because it has a higher risk of muscle toxicity when taken together with a statin
32
_____ is the occupational lung disease that is associated with nuclear power, nuclear reactor, dental and metal machine shops, aerospace industries
berylliosis
33
upright chest X-ray shows a retrocardiac air-fluid level, what should you think?
hiatal hernia
34
What are the 2 types of hiatal hernia? What are the risk factors for each?
sliding and paraesophageal
sliding: trauma, congenital malformations
paraesophageal: surgical procedures that require dissection of the hiatus
35
low-pitched murmur that is best hear at the lower left sternal area. What am I? What maneuver should you do next?
innocent murmurs of childhood
will have a vibratory, musical quality that does NOT radiate
asking the pt to STAND while auscultating will decrease the murmur
36
What is the MOA of metformin?
decreases hepatic glucose production and intestinal glucose absorption and increases insulin sensitivity
37
What is the definition of binge drinking?
BAC level reachs 0.08g/dL within 2 hours
38
What is the difference between a Galeazzi and Monteggia fx?
39
What pathogen causes parotitis? What pt population?
Staph aureus
older postop patients
40
What should you do if you find a pulm nodule (single, well circumscribed) in a smoker?
review of previous chest xray to see if has changed
41
______ are nonmotile, gram-negative rods that contains enterotoxins and are common source of diarrheal illness caused by kiddos that attend daycare. What is the tx?
Shigella dysenteriae
azithro
42
What are the 5 criteria for metabolic syndrome? Inclusion of 3/5 increase risk for ____ and _____
CAD and T2DM
43
What strains of HPV are likely to cause warts? Cancer?
6 and 11 warts
16 and 18 cancer
44
In perimenopause, why is the FSH level elevated?
because the ovaries are starting to fail and FSH rising to try and stimulate them
45
What are 2 complications of balantitis?
phimosis and paraphimosis
46
What is the abx of choice for oribital cellulitis?
vanc and ceftriaxone
47
Gilbert syndrome has consistently elevated levels of _______. What is the pathophys behind it?
elevated indirect bilirubin levels
reduced production of Uridine diphosphate glucuronosyltransferase 1A1 (UGT1A1)
48
What are the differences between normal, elevated, stage 1 and stage 2 HTN?
49
Which CCB is safe to use in patients with severe heart failure?
amlodipine
50
Eggshell calcification of enlarged hilar lymph nodes, What dx should you be thinking of?
chronic silicosis
51
What is the abx of choice for a pregnant person with Lyme?
Amoxicillin
52
Describe the murmur associated with HCMO. What is the tx?
Increase with valsalva
Decrease with squatting
Loud S4 gallop
BB or CCB
53
54
What is a pathological S3 gallop associated with?
Congestive HF
Can be normal in pts less than 30 years old
55
Latent TB with a positive skin test, what is the next step?
IGRA blood test
56
Pregnant hyperthyroid medication of choice?
PTU
57
Describe all the possible thyroid panel options
Insert chart here
58
What are some extra-articular findings associated with reactive arthritis?
Conjunctivitis
Anterior uveititis
Urethritis
Oral lesions
Skin changes
59
Glomerulonephritis s/s post infection with low serum complement levels?
Post streptococcal glomerulonephritis
60
What are the histopathologic findings associated with Alzheimer disease?
amyloid plaques and the accumulation of hyperphosphorylated tau proteins in neurofibrillary tangles within the brain
61
What is coractation of the aorta? What is it associated with?
when the aortic arch has an area of narrowing just distal to the origin of the left subclavian artery
Turner syndrome
62
What are the key PE findings in coarctation of the aorta?
diminished femoral pulse
difference in brachial and popliteal blood pressures
contineous murmur heard in mid-to late systole and is best heard on the pt's midline upper back between the scapulae or over the left anterior chest
63
CXR shows rib notching and the 3 sign. What dx?
coarctation of the aorta
64
What is the tx of choice for a corneal abrasion in a pt who wears contacts?
topical gentamicin drops
need to cover for pseudomonas
65
What is Dressler's syndrome? What is the tx?
acute pericarditis after MI
ASA and colchicine
66
What is the first line tx for acute pericarditis?
NSAIDs plus colchicine to prevent recurrence
67
What are the 3 keys findings in a retinal detachment?
vision changes as moving spots and flashing lights
curtain moving across the visual field
68
What is the tx for sarcoidosis?
steroid therapy for up to 6 months before tapering
methotrexate is the alternative
69
What are the 3 components of triple therapy for H pylori?
amoxicillin, clarithromycin and PPI
70
What are the 2 recommended medication classes for a pt in acute heart failure? How will it present?
loop diuretic and vasodilator
acute left ventricular dysfunction and pulmonary edema
71
What is the tx for acute uncomplicated UTI?
bactrim or nitrofurantoin
72
What is the tx for acute uncomplicated UTI in a pregnant pt?
amoxicillin, augmentin, cephelexin or fosfomycin
73
What is the ideal lipid profile of a healthy person?
total cholesterol below 200
LDL below 100
triglycerides below 150
HDL above 60 in women and above 50 in men
74
What 2 vaccines are very important for HIV pts to have and keep updated?
Meningococcal and pneumococcal (15 (goes with 23) or ***20*** valent)
75
community acquired PNA, no cormorbities. Have NOT been treated with abx in the past 3 months. What is the abx?
amoxicillin, doxy or macrolide
macrolide resistance is growing
76
community acquire PNA with comorbities. What is the abx?
augementin OR cephalosporin
AND
doxy or macrolide
OR
fluoroquinolone monotherapy
77
confirmed placenta previa with active bleeding, what should you do next?
send to the hospital! OB emergency
78
What is the difference between an inevitable and incomplete spontaneous abortion?
inevitable: cervical os is OPEN but no passage of fetal tissue
incomplete: cervical os is OPEN and some passage of fetal tissue
79
What T score is consistent with osteopenia?
between -1.0 and -2.5
80
What T score is consistent with osteoporosis?
being more negative than -2.5
OR pt has fragility fx
81
T score between -2 and -2.49, how often should their DEXA scan be repeated?
every 2 years
82
T score between -1.5 and -1.99, how often should their DEXA scan be repeated?
every 3-5 years
83
T score great than -1.49, how often should they have a DEXA scan repeated?
q 10-15 years
84
What are the 3 findings in Meniere's dz?
episodic vertigo
tinnitus
LOW-frequency sensorineural hearing loss
85
What is the tx for Meniere dz?
limit sodium, caffeine, alchohol, nicotine and MSG
diuretic can be prescribed to prevent
86
What is the criteria for low dose CT for lung cancer screening?
50-80 years old with 20 pack year history and currently smoke OR have quit in the last 15 years
87
What is the test of choice for chlamydia?
urethral swab OR nucleic acid amplification test
88
What are the 2 tests of choice to dx addison's dz?
morning serum cortisol level and rapid adrenocorticotropic hormone stimulation test
89
What is the most characteristic PE finding in addison's dz?
hyperpigmentation of the skin
will also have weakness, fatigue, weight loss, loss of appetite
90
serum thyroxine is ______
T4
91
What is the preferred imaging of choice for kidney stone?
NON-contrast CT
92
What is the difference between allergic and irritant contact derm?
allergic: type IV hypersensitivity reaction
poison ivy, poison oak, bacitracin ointment, neomycin, anesthetics, NICKLE, adhesive tape (can occur BEYOND the sites of direct contact)
irritant: excessive exposure to soap, detergents or organic solvents (LIMITED to the site of exposure)
93
What is important to note about acral lentiginous melanoma?
rare subtype of melanoma that develops in non-sun-exposed areas like the palms, soles of the feet, or under fingernails and toenails. It's not caused by sun exposure and is most common in people with darker skin. ALM typically appears as a black or brown discoloration that may be uneven and have irregular borders
94
How will superficial spreading melanoma present?
flat or slightly raised discolored plaque with irregular borders most frequently found on the trunk or legs
95
When are the 2 times a universal lipid screening is done?
between 9-11 years and between 17-21 years
96
low CV risk, when is follow up lipid screening done?
35 for men and 45 for women
97
high CV risk, when is follow up lipid screening done?
25-30 for men
30-35 for women
98
What is the mammogram recommendation for a pt with a normal risk of breast cancer (no family hx)?
bilateral screening mammogram starting at 40-74 every 2 years
99
What medication is known to cause interstitial lung dz and must be monitored for?
amiodarone
100
What is the initial CHF medication regimen for reduced output 40% and below?
Entresto (sacubitril/valsartan)
OR ace/arb
BB
diuretic
101
What are the screening guidelines for AAA?
MEN 65-75 who have ever smoked with a 1 time US
102
What is the slam dunk finding for bacterial vaginosis? What is the tx?
thin, gray white, malodorous discharge
epithelial cells covered by bacteria
metro 500mg bid for 7 days
103
What 2 medications should all pts post CAD stent placement be one?
ASA and antiplatelet
104
What is the pathophys behind acute gastroenteritis?
reduced absorption of electrolytes across the intestinal epithelium
AND
increased secretion of electrolytes
105
rod shaped, aerobic, acid-fast bacerium with hilar adenopathy
TB
106
suspicious breast mass in a pt less than 30, what imaging should you order next?
US
107
suspicious breast mass in a pt older than 30, what imaging should you order next?
mammogram +/- US
108
Bursitis abx of choice if pt has risk factors for MRSA
bactrim
109
Bursitis abx of choice if pt does NOT have risk factors for MRSA
cephalexin or dicloxacillin
110
pyelonephritis presentation with numerous struvite stones in the past after UTI, what bacteria?
Proteus mirabilis
111
What makes essential tremor symptoms worse and what improves the symptoms?
exacerbated by anxiety and relief by alcohol
112
hyperdynamic apical pulse, wide pulse pressure, high pitched, holodiastolic murmur at the left upper sternal border
what will it do with valsalva?
chronic aortic regurg
decreases with valsalva
acute: low pitched, early diastolic murmur
113
What is the first line meds for IBS?
dicyclomine or hyoscyamine
114
What is the Auspitz sign?
appearance of punctate bleeding spots that are seen with psoriasis scales are scraped off
115
What are the X-ray finding associated with RA?
Juxta particular osteoporosis, joint space narrowing, joint erosions
May be normal in the beginning
116
What is the treatment for elevated serum ammonia? Hepatic encephalopathy
Lactulose acutely
Rifaximin to prevent recurrence of hepatic encephalopathy
117
Splitting, seeing others as all good or all bad is seen in what personality disorder?
Borderline personality disorder
118
What is the general criteria for cyclothymia?
Episodes of hypomania and depression for greater than 2 years
119
Describe the characteristic lesion of pityriasis rosea.
Herald patch with scaling at the margin
Fir-tree pattern that follows cleavage lines of skin
120
When is an alpha blocker used in the treatment of kidney stones?
Symptomatic, stone is greater than 5mm but less than 10mm
121
What are some key features of roseola?
High fever that starts before rash
Starts on trunk -> extremities
6 months to 3 years
Blanching macular or maculopapular rash
122
Which antineoplastic medications is most likely to cause cardiac toxicity it and precipitate heart failure?
Doxorubicin
123
What is another term for podagra?
Gout
124
What is it called when the blood vessels are distended and the ventricles contract?
Systole
125
What type of arthritis will you see proximal interphalangeal joint hyperextension and flexion of the distal interphalangeal joint commonly seen?
RA
126
S/s onset 8-24 hours after ingestion of previously cooked or reheated meats and poultry. What pathogen?
Clostridium perfringens
127
What dx imaging is required to dx achalasia?
Esophageal manometry
Incomplete LES relaxation and absent peristalsis
128
What is the EKG finding associated with HCMO?
Prominent abnormal narrow Q waves in the inferior leads, left axis deviation, tall R waves seen in V1 and V2
129
What will the pt complain about with polycythemia Vera? What gene?
HA, dizziness, pruritus after showering
JAK2
130
What are the s/s of legionella PNA? What are the xray findings?
Hyponatermia with GI symptoms
Focal patchy infiltrates
131
Which TB medication can cause peripheral neuropathy and should be taken with pyridoxine (vit B6)
Isoniazid
132
What is the classic triad of symptoms for renal cell carcinoma?
Flank pain, hematuria, palpable renal mass
133
What is the tx of choice for impetigo around the knee?
Topical mupirocin
134
Which cancer marker is associated with colon cancer?
CEA
135
What dx test best visualizes an esophageal web or ring?
Barium esophagram
136
What are a few very common medications that are know to cause acute pancreatitis?
Metro, tetracyclines, furosemide, thiazides, salicylates, calcium, estrogen
137
What 2 medication classes should you use first in stable atrial flutter?
CCB or BB
138
What is amaurosis fugax?
Transient monocular or binocular vision loss
139
What immunoglobulin is able to cross the placenta?
IgG
140
What tumor marker can be used to follow pancreatic cancer?
CA 19-9
141
Where would you find a spigelian hernia?
Below the level of the umbilicus at the lateral edge of the rectus abdominis
142
What is the classic CXR finding associated with bronchieactasis?
Tram tracks
143
What is the abx prophylaxis regimen for bacterial endocarditis?
Amoxicillin 2grams orally 1 hour before procedure
144
No eye pain, dulling of the red reflex, acute floaters, flashes of light., trouble seeing peripherally. What dx?
Retinal detachment
145
What is the Lhermitte sign? Often see with what dx?
Spinal electric shock sensation with neck flexion
MS
146
How is the gene for Duchenne and Becker’s muscular dystrophy inherited?
X-linked recessive
147
What is the rule of nines for burn patients
148
What is Peyronie Disease?
acquired, localized fibrotic disorder of the tunica albugniea
149
A supervised vasopressin challenge test is part of the work up for what dz?
Diabetes insipidus
150
What is the tx for Legionella PNA?
levo
macrolide
doxy
151
What is the mean life span of platelets?
7-10 days
152
What is the abx of choice for pertussis?
azithromycin or batrim
153
Which ankle ligament is most commonly injured?
anterior talofibular
154
What antibodies are positive in a pt with lupus?
anti-dsDNA, anti-Smith
ANA may or may not
155
What is the MOA of amoxicillin?
inhibits bacterial cell wall synthesis by binding to one or more of the penicllin-binding proteins
156
What is neologism?
type of verbal utterance that uses made-up words and phrases during speech
157
A pt who keeps repeating words that rhyme with words that either you or he say, but make no sense and are unrelated to your questions is called?
clanging
158
What is pellagra? What are the 3 presenting symptoms?
niacin (vit B3) deficiency
Dermatitis (photosensitivity)
Diarrhea
Dementia
159
What Cobb angle is considered the cut off for intervention in a patient who is at the age of skeletal maturity?
< 40 degrees
160
Ulcers from arterial insufficiency are usually _____
painful
161
retinal edema, diffuse intraretinal hemorrhages, swollen optid disc, cotton-wool spots, dilated and tortuous _____. What am I?
central retinal vein occlusion
162
What does the term "pulled elbow" mean?
subluxation of the radial head
aka nursemaid's elbow
163
An MRI showing multiple isodense of hypodense ring- enhancing mass lesions should make you think of what dx? What is the tx?
toxoplasmosis
sulfadiazine and pyrimethamine
164
multiple painful genital papules that ulcerate and inguinal buboes, what dx? What pathogen? What is the tx?
chancroid
Haemophilus ducreyi
azithro or ceftriaxone
165
166
What is the tx of minimal change disease in children?
gluoccorticoids
167
168
The follicular phase has the largest increase in what hormone?
Estrogen
169
What is erythema multiforme commonly caused by?
HSV
170
Enterobius vermicularis is the Latin name for______
Pinworms
171
What are the 2 PE findings associated with plural effusions?
Dullness to percussion
Decreased tactile fremitus
172
What is a Colles fx? What is the buzz word?
Distal radius fracture with dorsal displacement
Dinner fork
173
Temporal arteritis is associated with what other dx?
Polymyalgia rheumatica
174
A fixed or consistent split S2 should make you think of what diagnosis ?
Atrial septal defect
175
What part of the spinal cord is responsible for pain and temperature and sensation?
Lateral spinothalamic tract
176
What is the treatment of choice for asymptomatic bacteria in a second trimester pregnant patient? 
Nitrofurantoin
177
What is the cause of catamenial pneumothorax?
Endometriosis
178
White blood cell cast in the urine, what diagnosis?
Acute pyelo
179
Purple, probiotic, polygonal, papules on physical exam should make you think of what diagnosis?
Lichen planus
180
Progressive neck and proximal muscle weakness with a reddish purple maculopapular rash. Lab work shows anti-Jo-1 antibodies. What dx?
Dermatomyositis
181
What is the best prophylactic agent for migraine headaches?
BB
182
What is the MOA of ace inhibitors?
 Block the conversion of angiotensin, one to angiotensin two which result in the dilation of the E Ferrant arterial reducing glomerular pressure 
183
What is Korsakoff syndrome? What are some s/s?
chronic thiamine (Vit b1 deficiency) that leads to progression of Wernicke Encephalopathy
think chronic alcohol use
Confabulation
Anterograde amnesia
Retrograde amnesia
184
At what CD4 count should prophylaxis for Pneumoncystis pneumonia be started?
CD4 less than 200 cells
185
small, less than 1 cm, diffuse, innumerable, round opacities with eggshell calcifications of the periphery of the hilar lymph nodes. What dx?
silicosis
186
S/s of hypothyroidism and TSH is high, what should you do next?
test serum free T4 and repeat TSH level
187
fever, rash, pharyngitis, lymphadenopathy with leukopenia and lymphocytopenia. What is the dx?
acute HIV infection
188
What is the first line intervention in a pregnant pt who is trying to quit smoking?
behavioral counseling
2nd line: bupropion
189
what nerve transmits sensation from the medial lower leg, medial ankle and arch of the foot?
saphenous nerve
190
In addison's dz, what is the next best test to order when starting the work up?
morning serum cortisol level
191
intensely pruritic, vesicular eruptions on the palms or somes, usually in young adults, "tapioca pudding", bilateral, usually in clusters, usually worse in the summer. What dx?
acute palmoplantar eczema (dyshidrotic eczema)
192
What is the tx of choice for influenza if the pt is pregnant?
oseltamivir
aka it is safe in pregnancy
193
_______ and ____ can be used to kill insect in a pt's ear
mineral oil instillation or lidocaine
194
Bacterial conjunctivitis in a pt who wears contact lens, is most at risk for developing ______
bacterial keratitis
195
A strange hand flapping tremor is called what? Commonly seen with what diagnosis? 
Asterixis
Hepatic encephalopathy
196
A question that mentions a farmer from the southwest United States has been working in a very contaminated barn with rodent species, and now presents was signed and symptoms of pneumonia. Should make you think of what diagnosis? What is the tx?
Hantavirus PNA
Supportive care
197
gemfibrozil is CI in patient's with ______. Should NOT be used in conjunction with _____
hepatic dysfunction
severe renal dysfunction
biliary dz
simvastatin
198
HS is a disorder of what type of gland?
Apocrine
199
Muddy brown sediment in the urine should make you think of what diagnosis?
Acute tubular necrosis
200
What is the MOA of tPA?
Converts plasminogen to the natural fibrolytic agent plasmin
