Topnotch Flashcards
(143 cards)
1
Q
Screening if lipid in adult
A
Start 20 years old then every 5 years
2
Q
Holosystolic murmur at the left parasternal border
👆in intensity during inspiration
Valve involved?
A
Tricuspid valve
3
Q
Carvallo sign
A
Tricuspid regurgitation
4
Q
Standard treatment: suspected multidrug resistant HAP
A
2 anti-pseudomonal + 1 MRSA-active antibioticsii
5
Q
2D-echo: hypokinetic right ventricular free wall with a normal apex
A
Pulmonary embolism
6
Q
McConnell’s sign
A
Pulmonary embolism
7
Q
Standard test for examining CSF
A
VDRL
8
Q
Conditions with falsely low vit B12
A
Folate deficiency
Pregnancy
OCP use
9
Q
Conditions with falsely normal vit B12
A
Bacterial overgrowth
Liver disease
Myeloproliferative disorder
10
Q
Absolute contraindication for fibrinolysis in STEMI
A
Any prior ICH
Known structural cerebrovascular lesion
Known malignant intracranial neoplasm
Ischemic stroke within 3 months
Suspected aortic dissection
Active bleeding or bleeding diatheses (excluding menses)
Significant closed head or facial trauma within 3 months
11
Q
Poor prognostic markers for alcoholic hepatitis
A
Discrimination function of >32 Encephalopathy Ascites Renal failure Prolonged PT Bilirubin >20mg/dl
12
Q
Acute hypoxemic respiratory failure due to alveolar flooding and subsequent intrapulmonary shunt physiology
A
Type I
13
Q
Respiratory failure results in alveolar hypoventilation secondary to impaired respiratory drive
A
Type II
14
Q
Respiratory failure due to lung atelectasis
A
Type III
15
Q
Hypoperfusion of respiratory muscles in patient in shock
A
Type IV
16
Q
Best treatment of choice for multinodular goiter
A
Subtotal thyroidectomy
17
Q
Test of choice to document H. pylori eradication following treatment
A
Urea breath test
18
Q
Drug of choice in acute adrenal crisis
A
Hydrocortisone
19
Q
Brocas area
A
Inferior frontal gyrus
20
Q
Only pharmacologic therapy demonstrated to unequivocally decrease mortality rates in patients with COPD
A
Supplemental oxygen
21
Q
SAAG
A
Infection
Malignancy
Nephrotic syndrome
22
Q
SAAG >1.1
A
Portal hypertension
23
Q
Most common manifestation of diffuse CNS lupus
A
Cognitive dysfunction (difficulties with memory and reasoning)
24
Q
Presence of x+y descent in jugular venous waveform is correlated in
A
Constrictive pericarditis
25
Earliest radiographic finding in RA
Periarticular osteopenia
26
ADA treatment goals for DM
Hba1c 40mg/dl (men), >50mg/dl (women)
| TAG
27
Bedside Index of Severity in Acute Pancreatitis
```
BUN >22mg%
Impaired mental status
SIRS 2/4
Age >60
Pleural effusion
```
28
Most common genetic cause of ESRD in children and adolescence
Medullary cystic kidney disease
29
Minimum definition of clinically important involuntary weight loss
>5% loss of body weight in 6-12 months
30
Most common hematologic abnormality in RA
Normocytic, normochromic anemia
31
Earliest manifestation of ophthalmopathy in Grave's disease
Excessive tearing
32
Most common cause of cerebral embolism overall
Nonrheumatic atrial fibrillation
33
Initial treatment of cirrhotic ascites
Restriction of salt intake
34
Clinical hallmark of acne vulgaris
Comedomes
35
Mid to late crescendo murmur at the apex
Mitral valve prolapse
36
Cardinal symptom of heart failure
Fatigue
37
Most useful index of LV function
Ejection fraction
38
Libman-Sacks endocarditis
| Sterile?non-sterile?
Sterile
39
Extrapulmonary sites (in order of frequency)
1. Lymph nodes
2. Pleura
3. GUT
4. Bones and joints
5. Meninges
6. Peritoneum
7. Pericardium
40
PNH
| Deficient surface proteins?
CD55 and CD59
41
Most discriminating symptom of duodenal ulcers
Epigastric pain awakening patient from sleep
42
Most common form of diabetic neuropathy
Distal symmetric polyneuropathy
43
Effects of Amiodarone of thyroid function
1. Acute, transient suppression of thyroid function
2. Hypothyroidism in patients susceptible to the inhibitory effects of a high iodine load
3. Thyrotoxicosis that may be caused by either a Jod-Basedow effect from the iodine load the the setting of MNG or incipient Graves's disease or a thyroiditis-like condition
44
Signature tachycardia of patients with significant pulmonary disease
Multifocal atrial tachycardia
Atrial rhythm is characterized by at least 3 distinct P-wave morphological and often at least 3 different PR interval and the associated atrial and ventricular rates are typical between 100 and 150 bpm
45
Metabolic syndrome by NCEP:ATPIII
Central obesity: waist circumference >102 cm (M), >88 cm (F)
HyperTAG: >/=150 mg/dl OR specific medication
👇HDL: /=130 OR diastolic >/= 85 OR specific medication
FBS: >/=100 mg/dl OR specific medication OR previously diagnosed Type 2 DM
46
Patients with angina-like chest pain and ischemic-appearing ST-segment depression during stress despite normal coronary arteriogram
Cardiac syndrome X
47
Treatment duration for extrapulmonary TB
6-9 months
48
Treatment duration for CNS TB
9-12 months
49
ECG finding is consistent with hyperkalemia
Widened QRS complex
50
Acid base abnormalities in aspirin toxicity
High anion gap acidosis
| Respiratory alkalosis
51
Organism which is the most common cause of IE in patients with prosthetic valves
Staphylococcus epidermidis
52
Most common organ involved in sarcoidosis
Lung
53
Imaging finding consistent with sarcoidosis
Bilateral symmetric hilar and mediastinal lymphadenopathy with discrete node enlargement
54
Graham-Steel murmur
Pulmonic regurgitation
55
Laboratory findings consistent with tumor lysis syndrome
HyperK
Hyperphosphatemia
Hyperuricemia
Hypocalcemia
56
Most common etiologic agent is spontaneous bacterial peritonitis
Escheria coli
57
Empiric DOC for SBP
Cefotaxime
58
Bifid pulse
Hypertrophic obstructive cardiomyopathy
59
Pulsus paradoxus and pulsus alterans
Cardiac tamponade
60
Pulsus parvus et tardus
Aortic stenosis
61
Wide pulse pressure
Aortic regurgitation
62
Prophylactic treatment with benzathin penicillin 1.2 units IM every 2-4 weeks in patient recently recovered from an episode of rheumatic fever without any sequelae
For 5 years after attack of until 21 years
63
How long will the infiltrates to clear after having CAP
4-12 weeks
64
Diffuse ST elevation
Pericarditis
65
CXR finding: peripheral wedge shaped density above the diaphragm
Hampton's hump seen in PE
66
Most accurate in diagnosing hyperthyroidism
Free T4 ("true" thyroid level)
67
Prevention of nitroglycerin tolerance
Stop nitroglycerin for 6-8 hours a day
68
Condition characterized by burning and tightness in the upper body accompanied by diaphoresis, nausea, flushing and cramps
Chinese restaurant syndrome
69
Loud S1, accentuated P2, apical diastolic rumble and murmur and opening snap
Mitral stenosis
70
Main substance causing vasodilation in urticaria
Histamine
71
Blood alcohol level: 50-100
Sedation
| High, slower reaction times
72
Blood alcohol level: 100-200
Impaired motor function
Slurred speech
Ataxia
73
Blood alcohol level: 200-300
Emesis
| Stupor
74
Blood alcohol level: 300-400
Coma
75
Blood alcohol level: >500
Respiratory depression
| Death
76
Indicator of the immunologic competence in patient with HIV
CD4 T lymphocyte count
77
Venous distention over the neck and difficulty breathing esp when the arms are raised in large retrosternal border
Pemberton sign
78
Most common cause of systolic dysfunction
Coronary artery disease
79
Most common cause of diastolic dysfunction
Concentric LVH
80
What phase will most patients recover or wen from mechanical support
Proliferative phase
81
RIFLE criteria
Risk: UO 4 weeks
ESRD: complete loss of kidney function for >3 months
82
Standard diagnostic procedure for nephrolithiasis
Helical CT scan without contrast
83
Best screening test for SLE
ANA
84
Highly specific and correlates with the disease activity
Anti-DsDNA
85
Specific for SLE
Anti-Sm
86
Most common site of TB in pregnancy
Pulmonary
87
It is the fall in systolic blood pressure by >10 mmHg with inspiration
Pulsus paradoxus
88
Jarring of the body and bobbing of the head with each systole in sever AR
De Musset sign
89
In AS, low pitched midsystolic ejection murmur at 2nd R ICS that may be transmitted to the apex resembling murmur of MR
Gallavardin effect
90
Water hammer pulse
Corrigan's pulse
91
To and fro murmur when femoral artery is compressed
Duroziez sign
92
Soft low pitched rumbling mild to late diastolic murmur
Austin Flint murmur
93
Chronic macrovascular complication of DM
CAD
PAD
Cerebrovascular disease
94
Chronic microvascular complications of DM
Retinopathy
Neuropathy
Nephropathy
95
Reflects glycemic status over the prior 2 weeks
Fructosamine assay
96
Hallmark sign of liver disease and is the most reliable marker of severity
Jaundice
97
Contraindications to exercise stress testing
```
Rest angina within 48 hr
Unstable rhythm
Severe aortic stenosis
Acute myocarditis
Uncontrolled heart failure
Severe pulmonary hypertension
Active IE
```
98
Most common indication for PCI
Symptom-limiting angina pectoris despite medical therapy accompanied by evidence of ischemia during a stress test
99
Acute nephrotic syndrome associated with hepa B and C
Membranoproliferative GN
100
Most common cause of nephrotic syndrome in the elderly
Focal segmental glomerulosclerosis
101
Finkelstein's test
De Quervain tenosynovitis
102
Prayer test and Tinel test
Carpal tunnel syndrome
103
Anti-ribosomal
Neuropsychiatric lupus
104
Anti-Sm
Specific for SLE
105
Ro and La
Neonatal lupus
106
nRNP
Mixed connective tissue disease
107
Anti-centromere
Scleroderma
108
Most common cause of polyuria in both adults and children
Uncontrolled DM
109
Uncontrolled hypertension not amenable to lifestyle modification is treated with
Thiazide diuretic
110
Enlarged and pulsatile liver
Tricuspid insufficiency
111
Goal of BP reduction in a diabetic patient
112
Tissue in the body is least affected by radiation
CNS
113
Intervention increase survival in COPD patients
Smoking cessation
114
Initial imaging modality of choice for stable patients with suspected PE
Computed tomography angiography
115
Gold standard imaging modality for PE
Pulmonary angiography
116
Risk factors for breast CA
Nulliparity
Early menarche
Late menopause
History of 1st degree relative with breast cancer
117
Most common trigger in an asthmatic attack
Upper respiratory infection
118
Lack of early childhood exposure to infectious agents, symbiotic microorganisms and parasites increases susceptibility to allergic diseases by suppressing natural development of the immune system
Hygiene hypothesis
119
According to recent studies, microorganisms associated with coronary heart disease
Chlamydia pneumoniae
| Helicobacter pylori
120
Lewy bodies is associated with
```
Visual hallucinations
REM sleep disorder
Delirium
Capgra's syndrome
Parkinsonism
```
121
Framingham major criteria
```
Paroxysmal nocturnal dyspnea
Rales
👆CVP
Neck vein distention
Cardiomegaly
Acute pulmonary edema
S3 gallop
Hepatojugular reflux
Weight loss
```
Dyspnea on exertion: minor criteria
122
Redistribution of fluid from the splanchnic circulation and lower extremities into the central circulation during recumbency
Orthopnea
123
👆pressure on bronchial arteries leading to airway compression along with interstitial edema
PND
124
Diminished sensitivity of respiratory center to arterial PCO2
Cheyne-Stokes respiration
125
Transudation of fluid from the intravascular space into the alveoli
Crackles/rales
126
Cornerstone of the treatment for non-alcoholic fatty liver disease
Weight loss
127
Beck's triad
Hypotension
Muffled heart sounds
Jugular venous distention
128
Stroke with presentation such as gaze palsy, deafness, tinnitus, and ipsilateral facial weakness
Anterior inferior cerebellar artery
129
Best treatment for anemia in patients with CKD
Thrice weekly erythropoietin
130
Only intervention/s proven to improve survival in severe COPD patients
Smoking cessation
| Oxygen therapy
131
Lowest grade of murmur that you can observe thrill
Grade IV
132
Most common presenting symptom of PE
Dyspnea
133
With psoriasis, scraping off her lesions and punctuate hemorrhages appeared
Auspitz sign
134
Pathognomonic lesion for rheumatic fever
Aschoff bodies
135
Sawtooth pattern on ECG
Atrial flutter
136
Progressive lengthening of PR interval and dropped beats
Mobitz I (Wenckebach)
137
Dropped beats not preceded by change in length of PR interval
Mobitz II
138
Most common cause of bacterial meningitis in adults >20 yo
Steptococcus pneumoniae
139
Most common cause of glomerular origin hematuria
Berger's disease
140
Most common location of berry aneurysms in the circle of willis
Junction between anterior cerebral artery and anterior communicating artery
141
Drug of choice for the treatment of anaerobic infections above the diaphragm
Clindamycin
142
Earliest change on ECG with an acute transmural infarction
Peaking of T waves
143
Metabolic syndrome
```
TAG
Waist circumference
BP
HDL
FBS
```
