Top 100 Facts Flashcards
(192 cards)
1
Q
the number one cause of preventable morbidity and mortality (e.g., atherosclerosis, cancer, chronic obstructive pulmonary disease) in the US
A
smoking
2
Q
number two cause of preventable morbidity and mortality in the US
A
alcohol
3
Q
What is the classic ratio of AST to ALT in alcoholic hepatitis?
A
AST:ALT ≥ 1:1, although both may be elevated
4
Q
Give _____ to reproductive age women before pregnancy to prevent _____
What should you keep an eye out for and how should this be managed if it does present?
A
Folate, Neural tube defects
watch out for pernicious anemia (loss of gastric parietal cells/loss of IF production); treat with B12 to prevent permanent neurological deficits
5
Q
what medication can cause B6/pyridoxine deficiency?
A
isoniazid
6
Q
what should you treat alcoholic patients with and why?
A
Thiamine
prevent Korsakoff dementia
7
Q
most common cause of anemia
A
IDA
8
Q
which vitamin is a known teratogen?
in whom would you commonly see this vitamin used for?
A
A
reprodcutive-age women who is treating acne with vitamin A analog, isotretinoin
9
Q
What are some complications of atherosclerosis?
What are the risk factors?
A
MI, heart failure, stroke, gangrene
age/sex, family history, smoking, HTN, DM, high LDL, and low HDL
10
Q
Complications of DM? 6
A
DM leads to
- atherosclerosis and its complications
- retinopathy (a leading cause of blindness)
- nephropathy (a leading cause of end-stage renal failure)
- peripheral vascular disease (a leading cause of limb amputation)
- peripheral neuropathy (sensory and autonomic)
- increased incidence of infections
11
Q
complications of severe HTN
A
hypertensive emergency:
headaches, dizziness, blurry vision, papilledema, cerebral edema, altered mental status, seizures, intracerebral hemorrhage (classically in the basal ganglia), renal failure/azotemia, angina, MI, and/or heart failure.
12
Q
lifestyle modifications (diet, exercise, weightloss, cessation of alcohol/tobacco use) may be able to treat which disorders without the use of medications? 7
A
HTN, hyperlipidemia, DM, GERD, insomnia, obesity, and sleep apnea.
13
Q
What does an ABG tell you?
A
pH = 1˚ event (acidosis vs alkalosis)
CO/HCO3 = cause (same direction as pH) and any compenstatory effect (opposite of pH)
14
Q
exogenous causes of hyponatremia
A
narcotics
oxytocin
diuretics
IV fluids (excess)
anti-epileptic medications
NO-DIE
15
Q
ECG findings in hyperkalemia
A
peaked T waves
16
Q
ECG changes in hypokalemia
A
T-wave flattening and U waves
17
Q
ECG changes in hypocalcemia
A
Qt prolongation
18
Q
ECG changes in hypercalcemia
A
Qt shortening
19
Q
Initial management of a patient in shock
A
O2
start IV line
set up pulse ox, ECG, vitals
give fluid bolus if patient does not have CHF
20
Q
Virchow’s triad of DVTs
A
1) endothelial damange
2) venous stasis
3) hypercoagulable state
21
Q
3 mainstay therapies for CHF
A
1) diuretics
2) ACEi
3) ß blockers
22
Q
what is cor pulmonale?
A
Right-sided heart enlargement, hypertrophy, or failure caused by primary lung disease (usually COPD)
23
Q
w/u for a patient with a-fib
A
assess for underlying etiology:
TSH
Electrolytes
ECHO
24
Q
complications of a-fib
A
- ventricular rate and ischemia (if needed, slow the rate with medications)
- atrial clot formation/embolic disease (consider anticoagulation with warfarin)
25
management of v-fib or **pulseless** v-tach
immediate defibrillation followed by amiodarone, lidocaine, vasopressin, & epinephrine **(ALiVE)**
26
management of v-tach with a pulse
amiodarone and synchronized cardioversion
27
management of **pulseless** v-tach vs v-tach with a pulse
**_pulseless v-tach_** - immediate defibrillation followed by amiodarone, lidocaine, vasopressin, & epinephrine **(ALiVE)**
**_v-tach with a pulse_ -** amiodarone and synchronized cardioversion
28
most important parameter on pulmonary function testing to distinguish between obstructive vs. restrictive lung disease
FEV1/FEV ratio
obstructive = FEV1/FEV ratio is less than normal
restrictive = FEV1/FEV ratio is often normal
29
most common type and cause of esophageal cancer
**adenocarcinoma** occurring as a result of **long- standing reflux disease** and the development of Barrett esophagus.
30
second most common type and cause of squamous cell carcinoma
smoking and alcohol abuse
31
patient presents with a gastric ulcer. what is the next best step in management?
get a biopsy OR follow it to resolution to exclude malignancy
32
best way to differentiate between upper vs lower GI bleed
test a nasogastric tube aspirate for blood
(although bright red blood via mouth or anus is a fairly reliable sign of a nearby bleeding source)
33
most common cause of GI complaints
IBS
| (usually diagnosis of exclusion)
34
how does IBS classically present?
young woman with a history of chronic alternating constipation and diarrhea
35
type of pathology found on Crohns vs UC
Crohns = transmural inflammation
UC = mucosal/submucosal inflammation
36
bowel habit changes in Crohns vs UC
Crohns = obstruction, abdominal pain
37
classic lesions of Crohns vs UC
Crohns = fistulas, abscesses, cobblestoning, string sign on barium xray
UC = pseudopolyps, lead pipe colon on barium xray, toxic megacolon
38
which forms of hepatitis are transmitted parenterally and can lead to chronic infection, cirrhosis, and hepatocellular carcinoma?
BCD
39
most common known genetic disease in white people
how do they normally present?
how do you screen these patients?
how should these patients be managed?
Hereditary hemochromatosis
fatigue, impotence, hepatomeagly
transferrin saturation (serum iron/TIBC) and ferritin level
phlebotomy
40
sequelae of liver failure (many)
Coagulopathy that cannot be fixed with vitamin K
jaundice/ hyperbilirubinemia
hypoalbuminemia
ascites
portal hypertension
hyperammonemia/ encephalopathy
hypoglycemia
DIC
41
what is pancreatitis usually caused by?
management?
complications?
**gallstones or alcohol**
**supportive treatment and pain control**
**pseudocyst formation, infection/abscess, ARDS** (results from a systemic net pro-inflammatory response that causes endothelial and epithelial injury)
42
how do you determine if jaundice/hyperbilirubinemia is physiologic vs pathologic?
jaundice in neonates = physiologic
jaundice present at brith = pathologic
43
∆ between 1˚ and 2˚ endocrine disturbances
1˚ = gland malfunctions but the pituitary and another gland and the CNS responds appropriately
2˚ = gland is doing what it is told to do by other controlling forces (e.g., pituitary gland, hypothalamus, tumor, disease)
44
side effects of excess steroids
Weight gain, easy bruising, acne, hirsutism, emotional lability, depression, **psychosis**, menstrual changes, sexual dysfunction, insomnia, memory loss, buffalo hump, truncal/central obesity with wasting of extremities, moon facies, purplish striae, weakness (especially of the proximal muscles), HTN, peripheral edema, poor wound healing, **glucose intolerance or diabetes, osteoporosis**, and **hypokalemic metabolic alkalosis** (resulting from mineralocorticoid effects of certain corticosteroids). Growth can also be stunted in children.
45
most common cause of arthritis (≥75% of cases)
osteoarthritis
46
Sequelae of lung cancer 7
**Hemoptysis**
**Horner syndrome**
**SVC syndrome**
**Phrenic nerve involvement/diaphragmatic paralysis**
**Recurrent laryngeal nerve involvement (hoarseness)**
**Hypercalcemia (PTHrP)**
**Paraneoplastic syndromes** (Cushing syndrome, SIADH, hypercalcemia, Eaton-Lambert syndrome)
47
cause(s) of bitemporal hemianopsia
best diagnostic study?
pituitary tumor
get CT or MRI of brain
48
characteristics of a mole that should make you suspicious of a malignant transformation
management of such moles or if a mole starts to itch or bleed
* Asymmetry
* Borders (irregular)
* Color (change in color or multiple colors)
* Diameter (the bigger the lesion, the more likely it is malignant)
* Evolving over time
Do an excisional biopsy
49
Potential risks/ADR of estrogen therapy
hepatic adenoma
glucose intolerance/diabetes
DVT/strokes
gallstones
fibroids/fibroadenomas
migraines/epilepsy
50
This type of birth control increases risk of CAD and breast cancer
combined estrogen + progesterone therapy
51
Children in these age groups are at risk of this particular illness
0-18 mo
1-2 yr
2-5 yr
common causes?
**0-18 mo = bronchiolitis =** RSV, parainfluenza, influenza (RIP)
**1-2 yr = croup =** parainfluenza, influenza
**2-5 yr = epiglottitis =** h. influenza, staph aureus, strep pneumo
52
X-ray findings of
bronchiolitis
croup (laryngotracheitis)
Epiglottitis
bronchiolitis = hyperinflation of lungs
croup (laryngotracheitis) = steeple sign (subglottic tracheal narrowing on frontal xray)
Epiglottitis = thumb sign (swollen epiglottis on lateral neck xray)
53
Treatment of
bronchiolitis
croup (laryngotracheitis)
Epiglottitis
bronchiolitis = humidified O2, bronchodilators, **ribavirin** (for RSV)
croup (laryngotracheitis) = dexamethasone, nebulized epinephrine, humidified O2
Epiglottitis = third gen cephalosporin + vanc or clindamycin (for MRSA), establish airway
54
Sequelae of streptococcal infection 3
which of thse can be prevented by antibiotics
Scarlet fever
Rheumatic fever (complication of scarlet fever)
Poststreptococcal glomerulonephritis.
Only the first two can be prevented by treatment with antibiotics
55
3 best diagnostic tests for multiple sclerosis
of these, which are the most sensitive?
1. **M**RI = **M**ost sensitive
2. Lumbar Puncture (elevated IgG bands + MBP, mildly elevated lymphocytes and protein)
3. Evoked potentials (slowed conduction in areas with myelin damage)
56
Top 3 ddx of an unconscious or delirious patient presenting to the ED with no history or evidence of trauma. How should these be managed?
hypoglycemia -\> give glucose
opioid OD -\> give naloxone
thiamine deficiency -\> give thiamine, then glucose
57
∆ between delirium and dementia in terms of
onset
attention span
arousal level
delirium = acute onset, poor attention, fluctuating arousal
dementia = slow onset, unaffected attention, normal arousal
58
What should you consider in women between the ages of 15-50 before prescribing therapies or tests?
pregnancy
59
Initial management of patients with anaphylaxis
secure airway (intubation or cricothyroidotomy)
subcu or IV heparin
60
Colorectal screening recommendations
starting at age 50, but the frequency is determined by the type of procedure used
colonoscopy = q 10y if negative
flexible sigmoidoscopy = q 5y
FOBT = q 1y
61
prostate cancer screening recommendations
DRE = starting at age 40, annually
PSA = starting at age 50, annually \*controversial\*
62
Cervical cancer screening recommendations
**Pap smear** = start at age 21
* if Pap only, then annual screening; after 3 _consecutive_ negative, then test every 3 years
* if Pap + HPV, then test every 3 years if both are negative
63
Pelvic exam screening recommendations
**Pelvic exam** = start at age 21, and perform annually; after 3 consecutive negative, then perform every 2-3 years. If after 65, perform annually
64
Breast cancer screening recommendations
* **physical exam by MD -** begin at 20, perform every 3 years until the age of 40, then perform annually
* **mammogram** - begin at 40, then perform annually
65
lung cancer screening recommendations
sputum/CXR testing is NOT recommended for asymptomatic individuals, even if they are at high risk
Annual CT is controversial, but may be indicated for smokers/former smokers aged 55-74 who have at least a 30PY
66
what type of error does the p-value reflect?
the likelihood of making a type **I** error (claiming there is an effect or difference when none existed)
67
What are 6 ADRs of anti-psychotics and how are some of them managed?
1. Acute dystonia --\> anti-histamines or anticholinergics
2. akathisia --\> ß blocker
3. tardive dyskinesia --\> switch to a new agent
4. parkinsonism --\> anti-histamine or anticholinergics
5. hyperprolactinemia
6. autonomic nervous system-related effects
68
T/F asking about depression and/or suicidal ideation will cause patients to commit suicide
FALSE!
69
3 recreational drugs that can have fatal withdrawal effects
alcohol
barbituates
benzodiazepines
**all incr. action of GABA/inhitory action**
**note that alcohol can inhibit NMDA receptor and result in release of other inhibitors (ie dopamine and serotonin), which can activate the reward centers**
70
most common preventable cause of infertility in the US
Pelvic inflammatory disease (PID)
71
women who are heavy, amenorrheic and have hair on face, chest, abdomen, and lower back
how are these patients treated?
think **PCOS** - most common cause of dysfunctional uterine bleeding. Remember these folks have a **dysfunctional HPO circuit**, where desuppression occurs with too many GnRH pulses frequency and amplitude, resulting in an **absent feedback mechanism** to endogenous hormones; results in **elevated LH** (--\> theca cells produce androgens) and **slightly decreased FSH** (recruit follicles + estrogen production)
lack of feedback system
* long periods of unopposed estrogen
* persistent endometrial proliferation
* thick and unstable endometrium (not stabilized by progesterone) begins to outgrow vascular supply and breaks down into bits and pieces
* dysfunctional uterine bleeding
treatment:
* **progesterone** for endometrial protection
* **OCPs** for hirsutism and acne
* **clomiphene** for infertility
* **metformin** to increase insulin insensitivity
72
women with PCOS are at risk of this malignancy
what should you give these patients to prevent this?
endometrial cancer due to unopposed estrogen
treat with cyclical progesterone
73
Fetal/neonatal macrosomia is caused by
how to prevent this?
maternal diabetes until proven otherwise
prevent wiht diet and insulin
74
when should maternal serum alpha-fetoprotein be measured?
Causes of low maternal serum alpha-fetoprotein?
Causes of high maternal serum alpha-fetoprotein?
between **16 - 20 weeks** gestation.
## Footnote
LOW: Down syndrome, inaccurate dates (most common), and fetal demise.
HIGH: Neural tube defects, ventral wall defects (e.g., omphalocele, gastroschisis), inaccurate dates (most common), and multiple gestation.
75
pregnant woman presents with HTN and proteinuria
pre-eclampsia until proven otherwise
76
management of a woman who presents with a positive pregnancy test + vaginal bleeding + abdominal pain
ectopic pregnancy until proven otherwise
get a pelvic US
77
∆ between early, variable, and late decelerations
how should they be managed?
* **early** - normal, caused by head compression
* **variable** - caused by cord compression
* turn mother on side, give O2 and fluids, stop oxytocin
* **late -** caused by uteroplacental insufficiency
* turn mother on side, give O2 and fluids, stop oxytocin, measure fetal O2 saturation or scalp pH, prepare for prompt delivery
78
how should a third trimester bleeding be managed
pelvic US **_BEFORE_** pelvic exam (in case placenta previa is present)
79
most common cause of postpartum bleeding
common etiologies?
uterine atony
etiologies: uterine overdistention (twins, polyhydramnios), prolonged labor, and/or oxytocin usage.
80
acute abdomen pathology localized by physical exam
RUQ
LUQ
RLQ
LLQ
Epigastric area
* **RUQ -** Gallbladder/biliary (cholecystitis, cholangitis) or liver (abscess)
* **LUQ -** Spleen (rupture with blunt trauma)
* **RLQ -** Appendix (appendicitis), PID
* **LLQ -** Sigmoid colon (diverticulitis), PID
* **Epigastric area -** Stomach (peptic ulcer) or pancreas (pancreatitis)
81
Causes of post-op fever
* water = UTI
* wind = atelectasis, pneumonia
* walk = DVT
* wound = surgical wound infection
* "wawa” = breast (post-partum)
* weird drugs
82
what should you consider in a patient with daily fever spikes that do not respond to antibiotics? what test should you order to confirm?
postsurgical abscess
Order a **CT scan** to locate, then **drain the abscess** if one is present.
83
What are the ABCDEs of trauma?
airway, breathing, circulation, disability (either coma or convulsion), and exposure.
84
6 thoracic injuries that must be recognized and treated immediately
1. Airway obstruction (establish airway).
2. Open pneumothorax (intubate and close defect on three sides).
3. Tension pneumothorax (perform needle thoracentesis followed by chest tube).
4. Cardiac tamponade (perform pericardiocentesis).
5. Massive hemothorax (place chest tube to drain; thoracotomy if bleeding does not stop).
6. Flail chest (occurs when rib is broken in two palces; consider intubation and positive pressure ventilation if oxygenation is inadequate).
85
3 causes of neonatal conjunctivitis
when do they normall present?
chemical reaaction - first 12-24 hours of giving drops for prophylaxis
gonorrhea - 2-5 days after birth
chlamydial infection - 5-14 days after birth
86
∆ between open angle and closed angle glaucoma?
* **_open angle_** = painless, irreversible
* usually due to optic disc atrophy with cupping, usually with increased IOP and progressive peripheral visual field loss
* **_closed angle_** = painful, sudden vision loss with halos around eyes, frontal HA with rock-hard eye
* if chronic, then it is often asymptomatic with damage to optic nerve and peripheral vision
* usually due to enlargement or movement of lens against central iris
87
how does uveitis present?
in what diseases do you commonly find them in?
*remember, it is inflammation of the middle layer of tissue in the eye wall (uvea)*
presents with photophobia, blurry vision, and eye pain
usually a marker for systemic conditions: juvenile rheumatoid arthritis, sarcoidosis, IBD, ankylosing spondylitis, reactive arthritis, MS, psoriasis, lupus
88
3 causes of bilateral (although often asymmetric) painless gradual loss of vision
cataracts, macular degeneration, or glaucoma
89
6 features of compartment syndrome
1. Pain with passive movements, usually out of proportion to the injury
2. Paresthesias (numbness, tingling, decreased sensation)
3. Pallor (or cyanosis)
4. Pressure (firm feeling muscle compartment, elevated pressure reading)
5. Paralysis (late, ominous sign)
6. Pulselessness (very late, ominous sign; treat with fasciotomy to relieve compartment pressure to prevent permanent neurologic damage)
90
Name this nerve:
wrist extension
provides sensory to back of forearm, back of hand (first 3 digits)
clinical scenario usually is a humeral facture
radial n.
91
Name this nerve:
finger abduction
provides sensory to front and back of last 2 digits
clinical scenario usually is an elbow dislocation
ulnar n.
92
Name this nerve:
pronation, thumb opposition
provides sensory to palmar surface of hand (first 3 digits)
clinical scenario usually is carpal tunnel syndrome or humeral fracture
median n.
93
Name this nerve:
abduction, lateral rotation
provides sensory lateral shoulder
clinical scenario upper humeral dislocation or fracture
axillary n.
94
Name this nerve:
dorsiflexion, eversion
provides sensory to dorsal foot and lateral leg
clinical scenario usually is knee dislocation
peroneal (common fibular nerve)
95
Which pediatric hip disorder is associated with female, firstborn, or breech delivery?
When does it first present?
What are some signs/symptoms associated with it?
What is the main treatment?
Congenital hip dysplasia
at birth
barlow and ortolani signs
harness
96
Which pediatric hip disorder is associated with short male wiht delayed bone age?
When does it first present?
What are some signs/symptoms associated with it?
What is the main treatment?
Legg-Calvé-Perthes disease
4-10 years
knee, thigh, groin pain, limp
orthoses
97
Which pediatric hip disorder is associated with overweight male adolescent?
When does it first present?
What are some signs/symptoms associated with it?
What is the main treatment?
slipped capital femoral epiphysis
9-13 years
knee, thigh, groin pain, limp
surgical pinning
98
Why should you avoid lumbar puncture in a patient with head trauma or signs of increased intracranial pressure? What is an alternative option?
risk of herniation
Perform CT scan without contrast instead.
99
how do neck masses differ in children than do adults?
In children, 75% of neck masses are benign (lymphadenitis, thyroglossal duct cyst)
in adults, 75% of neck masses malignant (e.g., squamous cell carcinoma and/or metastases, lymphoma).
100
Management of symptomatic carotid artery stenosis
depends on % occlusion
* if occluded 70-99% --\> carotid endarterectomy
* if occluded 50-69% --\> assess patient specific factors to determine appropriateness
* if occluded \<50% --\> medical management with anti-hypertensive agents, statins, and antiplatelet therapy and addressing atherosclerotic risk factors
101
Pulsatile abdominal mass + hypotension =
management?
ruptured AAA
ex-lap
102
what are some conditions that are similar to angina? 3
TIA
claudication
chronic mesenteric ischemia (commonly due to atherosclerosis or a presence of a stenosis/occlusion of the mesenteric vessels; characterized by postprandial abdominal pain)
103
main identifiable risk factor for testicular cancer
management?
Cryptorchidism
surgical retrieval and orchiopexy vs orchiectomy
104
T/F BPH can present as acute renal failure
T
Patients have a distended bladder and bilateral hydronephrosis on ultrasound (neither is present with “medical” renal disease). Drain the bladder first (catheterize), then perform TURP
105
Causes of Impotence?
physical (e.g., vascular, nervous system, drugs)
psychogenic (patients have normal nocturnal erections and a history of dysfunction only in certain settings).
106
Which is more important in terms of assessing the development of a child: overall growth pattern or any one measurement?
overall growth pattern - a stable pattern is less worrisome and less likely to be correctable than a sudden change in previously stable growth
107
what are some examples of suspicious findings for child abuse? 7
* failure to thrive
* multiple injuries in different stages of healing
* retinal hemorrhages plus subdural hematomas (shaken baby syndrome)
* sexually transmitted diseases
* a caretaker story that does not fit the child’s injury or complaint
* childhood behavioral or emotional problems
* multiple personality disorder as an adult
108
What is the APGAR score? When is it usually performed?
Appearance
Pulse
Grimace
Activity
Respiration
performed at 1 and 5 minutes after birth
109
common cause of metabolic derangements
some examples of each?
diuretics
## Footnote
**thiazide** - hyperCa, hyperglycemia, hyperuricemia, hyperlipidemia, hyponatremia, hypokalemic metabolic alkalosis, hypovolemia
**loop diuretics** - hypokalemic metabolic alkalosis, hypovolemia (more potent than thiazides), ototoxicity, and calcium excretion
**carbonic anhydrase inhibitors -** metabolic acidosis, and potassium-sparing diuretics (e.g., spironolactone) may cause hyperkalemia.
110
Antidote for Benzodiazepine OD
flumazenil
111
Antidote for ß blocker OD
glucagon
112
Antidote for carbon monoxide OD
oxygen
113
Antidote for cholinesterase inhibitors OD
atropine or pralidoxime
114
Antidote for copper or gold OD
penicillamine
115
Antidote for digoxin OD
normalize K and other electrolytes
digoxin antibodies
116
Antidote for Iron OD
deferoxamine
117
Antidote for lead OD
EDTA (adults)
succimer (children)
118
Antidote for methanol/ethylene glycol OD
fomepizole, ethanol
119
Antidote for muscarinic blockers OD
physostigmine
120
Antidote for opioids OD
naloxone
121
Antidote for Quinidine or TCAs OD
Sodium bicarbonate (cardioprotective)
122
Is the platelet dysfunction reversible or irreversible with NSAID? Aspirin?
NSAID = reversible
Aspirin = irreversible
123
What type of renal damage would aspirin/NSAIDs cause?
interstitial nephritis, papillary necrosis
124
Why should you never give aspirin to a child with a cold?
risk of Reyes Syndrome - encephalopathy and/or liver failure
125
metabolic derangements with aspirin OD
metabolic acidosis _and_ respiratory alkalosis
126
Central pontine myelinolysis can be caused by:
overly rapid correction of **hypO**natremia
127
Low levels of this can make hypocalcemia and hypokalemia unresponsive to replacement therapy
Hypo**Mg**
128
What are examples of scenarios that can cause abnormal lab results? (4 major ones)
Hemolysis (hyperkalemia)
Pregnancy (elevated ESR and alkaline phosphatase)
hypoalbuminemia (hypocalcemia)
hyperglycemia (hyponatremia)
129
What are some ECG findings of MI?
flipped/flattened T waves
ST-elevation
Q waves in a patterned distribution (ie leads II, III, aVF for inferior infarct)
130
When would you institute interventions for cholesterol?
131
What are the differences between Type I and Type II DM in terms of:
age of onset
body habitus
development of ketoacidosis
levels of endogenous insulin
response to oral hypoglycemics
antibodies to insulin
132
How is HTN classified?
133
Rapid Associations: friction rub
pericarditis
134
Rapid Associations: Kussmaul breathing (deep rapid breathing)
DKA
135
Rapid Associations: Kayser-Fleischer ring in the eye
Wilson disease
136
Rapid Associations: Bitot spots
Vitamin A deficiency
137
Rapid Associations: Dendritic corneal ulcers on fluorescein stain of the eye
herpes keratitis
138
Rapid Associations:
Cherry-red spot on the macula without hepatosplenomegaly
Cherry-red spot on the macula with hepatosplenomegaly
W/O HSM: Tay-Sachs
W/ HSM: Niemann-Pick (niemann picks which organs)
139
Rapid Associations: Bronze skin plus diabetes
Hemochromatosis
140
Rapid Associations: Malar rash on the face
Systemic lupus erythematosus
141
Rapid Associations: Heliotrope rash (purplish rash on the eyelids)
Dermatomyositis
142
Rapid Associations: Clue cells
Gardnerella vaginalis infection
143
Rapid Associations: Meconium ileus
Cystic fibrosis
144
Rapid Associations: Rectal prolapse
Cystic fibrosis
145
Rapid Associations: Salty-tasting infant
Cystic fibrosis
146
Rapid Associations:
Café-au-lait spots with normal IQ
Café-au-lait spots with mental retardation
normal IQ: Neurofibromatosis
mental retardation: McCune-Albright syndrome or tuberous sclerosis
147
Rapid Associations: Worst headache of the patient’s life
Subarachnoid hemorrhage
148
Rapid Associations: Abdominal striae
Cushing syndrome or pregnancy
149
Rapid Associations: Honey ingestion
botulism
150
Rapid Associations: LLQ tenderness w/ rebound
Diverticulitis
151
Rapid Associations: Children who torture animals
conduct d/o
152
Rapid Associations: Currant jelly stools in children
Intussusception
153
Rapid Associations: Ambiguous genitalia and hypotension
21-Hydroxylase deficiency in girls
154
Rapid Associations: Catlike cry in an infant
Cri-du-chat syndrome
155
Rapid Associations: Infant weighing more than 10 lb
maternal diabetes
156
Rapid Associations: Anaphylaxis from immunoglobulin therapy
IgA deficiency
157
Rapid Associations: Postpartum fever unresponsive to broad-spectrum antibiotics
Septic pelvic thrombophlebitis
158
Rapid Associations: Increased hemoglobin A2 and anemia
thalassemia
159
Rapid Associations: Heavy young woman with papilledema and negative CT/ MR scan of head
how are these patients usually managed?
Pseudotumor cerebri (increased ICP without clear etiology)
managed with acetazolamide +/- lasix, migraines Rx, and weight loss
160
Rapid Associations: Low-grade fever in the first 24 hr after surgery
atelectasis
161
Rapid Associations: vietnam veteran
PTSD
162
Rapid Associations: Bilateral hilar adenopathy in an African American patient
Sarcoidosis
163
Rapid Associations: Sudden death in a young athlete
Hypertrophic obstructive cardiomyopathy
164
Rapid Associations: Fractures or bruises in different stages of healing in a child
child abuse
165
Rapid Associations: Absent breath sounds in a trauma patient
pneumothorax
166
Rapid Associations: Constant clearing of throat in a child or teenager
Tourette syndrome
167
Rapid Associations: Shopping sprees
mania
168
Rapid Associations: Intermittent bursts of swearing
Tourette syndrome
169
Rapid Associations: Koilocytosis
HPV or cytomegalovirus
170
Rapid Associations: Rash develops after administration of ampicillin or amoxicillin for sore throat
Epstein-Barr virus infection
171
Rapid Associations: Daytime sleepiness and occasional falling down (cataplexy)
Narcolepsy
172
Rapid Associations: Facial port wine stain and seizures
Sturge-Weber Syndrome
173
What is this sign? **Babinski sign**
What is it an indication of?
Stroking the bottom of the foot yields extension of the big toe and fanning of other toes (UMN lesion)
174
What is this sign? **Beck triad**
What is it an indication of?
Jugular venous distention, muffled heart sounds, and hypotension (cardiac tamponade)
175
What is this sign? **Brudzinski sign**
What is it an indication of?
Pain on neck flexion with meningeal irritation (meningitis)
176
What is this sign? **Charcot triad**
What is it an indication of?
Fever/chills, jaundice, and right upper quadrant pain (cholangitis)
177
What is this sign? **Chvostek sign**
What is it an indication of?
Tapping on the facial nerve elicits tetany (hypocalcemia)
178
What is this sign? **Courvoisier sign**
What is it an indication of?
Painless, palpable gallbladder plus jaundice (pancreatic cancer)
179
What is this sign? **Cullen sign**
What is it an indication of?
Bluish discoloration of periumbilical area (pancreatitis with retroperitoneal hemorrhage)
180
What is this sign? **Cushing reflex**
What is it an indication of?
Hypertension, bradycardia, and irregular respirations (high intracranial pressure)
181
What is this sign? Grey Turner sign
What is it an indication of?
Bluish discoloration of flank (pancreatitis with retroperitoneal hemorrhage)
182
What is this sign? **Homans sign**
What is it an indication of?
Calf pain on forced dorsiflexion of the foot (DVT)
183
What is this sign? **Kehr sign**
What is it an indication of?
Pain in the left shoulder (ruptured spleen)
184
What is this sign? **Leriche syndrome**
What is it an indication of?
Claudication and atrophy of the buttocks with impotence (aortoiliac occlusive disease)
185
What is this sign? **McBurney sign**
What is it an indication of?
Tenderness at McBurney point (appendicitis)
186
What is this sign? **Murphy sign**
What is it an indication of?
Arrest of inspiration during palpation under the rib cage on the right (cholecystitis)
187
What is this sign? **Ortolani sign/test**
What is it an indication of?
Abducting an infant’s flexed hips causes a palpable/audible click (congenital hip dysplasia)
188
What is this sign? **Prehn sign**
What is it an indication of?
Elevation of a painful testicle relieves pain (epididymitis vs. testicular torsion)
189
What is this sign? **Rovsing sign**
What is it an indication of?
Pushing on left lower quadrant then releasing your hand produces pain at McBurney point (appendicitis)
190
What is this sign? **Tinel sign**
What is it an indication of?
Tapping on the volar surface of the wrist elicits paresthesias (carpal tunnel syndrome)
191
What is this sign? **Trousseau sign**
What is it an indication of?
Pumping up a blood pressure cuff causes carpopedal spasm (tetany from hypocalcemia)
192
What is this sign? **Virchow triad**
What is it an indication of?
Stasis, endothelial damage, and hypercoagulability (risk factors for DVT)
