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USMLE Step 2 > UWorld First Pass > Flashcards

UWorld First Pass Flashcards

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1
Q

What glomerulopathy is associated with HIV and African Americans?

A

Focal Segmental Glomerulosclerosis

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2
Q

What differentiates CML from a leukemia reaction?

A

Low Leukocyte Alkaline Phosphatase

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3
Q

What are the 5 P’s?

A 
Pain
Pallor
Pullselessness
Poikilothermia
Paresthesias
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4
Q

Which genital ulcers are associated with painful LAD?

A

HSV!
LGV is very large, very painful, and fluctuant
Chancroid has large nodes, but not as painful

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5
Q

What can you treat a pen-allergic pt with syphillis with?

A

Doxycycline (or ceftriaxone for tertiary). Desensitize in pregnancy.

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6
Q

What is a normal ABI result?

A

1.0 - 1.2

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7
Q

What is a defining feature of pseudoclaudication?

A

It is posture dependent (shopping cart sign)

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8
Q

What is the treatment for dermatitis herpeteformis?

A

Dapsone

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9
Q

How does INH differ from other drug induced liver injury?

A

It doesn’t usually have extra hepatic manifestations of drug reaction

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10
Q

What drugs cause Cholestasis?

A

Chlopromazine
Nitrofurantoin
Erythromycin
Anabolic Steroids

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11
Q

What drugs cause fatty liver?

A

Tetracycline
Valproate
Anti-Retrovirals

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12
Q

What drugs cause hepatitis?

A

Halothane
Phenytoin
INH
alpha-methyldopa

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13
Q

What drugs cause fulminant liver failure?

A

Carbon tetrachloride

Acetaminophen

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14
Q

What drugs cause granulomatous hepatitis?

A

Allopurinol

Phennylbutazone

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15
Q

What distinguishes anorexia from bulimia?

A

In anorexia, you don’t have a normal BMI while bulimics still maintain a low-normal BMI

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16
Q

What is the cortical findings in status epileptics?

A

Cortical laminar necrosis

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17
Q

What class of drugs can cause cerebellar atrophy?

A

Anti epileptic Drugs

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18
Q

What should be suspected in infants with bilateral bulbar palsies?

A

Botulism

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19
Q

What is the triad of McCune-Albright Syndrome?

A

Precocious puberty, cafe-au-alit spots and bone defects

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20
Q

What type of tumor can develop in Peutz-Jeghers syndrome?

A

Estrogen secreting tumors

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21
Q

What type of intracranial tumor can occur with McCune Albright?

A

Pituitary adenomas (e.g. Cushings, Prolactinoma, etc.)

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22
Q

True or false, low grade fever and leukocytosis are common in the first 24 hours postpartum?

A

True

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23
Q

Why does fat malabsorption increase incidence of oxalate stones?

A

Fatty acids chelate calcium and prevent it from binding with oxalateq

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24
Q

Why do alcoholics get hypokalemic?

A

poor intake and from vomiting

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25
What ar the indications for carotid endarterectomy?
Men: 60%+ Stenosis if Asymptomatic. Symptomatic: 50-69% (Grade IIA) 70%+ (Grade IA) Women: 70%+ for both symptomatic and not
26
What is the cause of ED following pelvic fracture?
Parasympathetic nervous injury
27
What are the pleural effusion findings in Esophageal Rupture?
Exudative, low pH, very high amylase (>2,500 IU)
28
What intestinal finding can be caused by the vagal section to ureteral colic?
Illeus
29
What cells do non-functioning pituitary adenomas usually arrive from?
Gonadotrophs
30
What values is usually mildly elevated in gonadotroph adenomas?
Prolactin from disruption of the dopaminergic neural pathways
31
Which blistering disease has flaccid blisters?
Pemphigus Vulgaris
32
What are the interpretations for ABI?
1.3 Calcified vessels
33
In what populations are screening U/S for AAA recommended?
Men age 65-75 with a history of smoking
34
What is the difference between Hordeolum and Chalzion?
Hodreolum - Infection of a gland (abx and hot compress) | Chalazion - Granulomatous condition from obstruction of gland
35
What is the presentation of CO poisoning after a fire?
Confusion, wheezes, seizure | Carboxyhemoglobin (>15% in smokers, >3% in non smokers)
36
What vaccines are recommended for HIV patients?
``` HAV HBV HPV Influenza Meningococcus Pneumococcus Tdap (once, then Td every 10 years) ```
37
What pulmonary fungal infection is associated with the "Halo Sign"?
Aspergillosis
38
What are the indications for statin therapy?
Atheroslerotic disease LDL > 190 Age 40-75 with diabetes 10-year ASCVD risk > 7.5%
39
What are the indications for surgical revascularization in claudication?
Limb-threatening complications Limitations of ADL Non-response to exercise and pharmacologic program
40
What is the indication for home O2 therapy?
COPD with PaO2 55% | Awake PaO2 > 60/ SaO2 > 90 if hypoxic during sleep
41
What are the criteria for APGAR scoring?
Score 0-2 Appearance (Blue central, central pink, all pink) Pulse (0, 100) Grimace (0, grimace, grimace and cough) Activity (limp, some, active) Respiratory Effort (0, irregular, regular)
42
What is the interpretation of APGAR scoring?
4-7: observe, stimulate, vent support 0-3: resuscitate - HR
43
At what PaCO2 do you usually see CO2 narcosis?
> 60
44
What is the preferred treatment for hyperthyroidism?
Radioiodine ablation therapy
45
What is the deficiency/accumulation/symptom of Fabry's Dz?
Deficiency: alpha-galactosidase A Accumulates: Ceramide trihexoside S/Sx: Limb pain, angiokeratomas, renal failure, thrombosis
46
What is the deficiency/accumulation/symptom of Krabbe's Disease?
Deficiency: galactosylcermidase Accumulates: galactrocerebroside S/Sx: CNS degeneration, optic atrophy, death by 3
47
What physical findings are common in homocystinuria?
Fair hair, eyes, and marfanoid habitus | They get thromboembolic events
48
What is the triad of disseminated gonococci infection?
Tenosynovitis Dermatitis Migratory Polyarthritis
49
What are the synovial fluid findings in gonococci arthritis?
~ 50,000 WBC/mm^3
50
What injury should come to mind in the knee with significant hemarthrosis?
ACL injury
51
What is the formula for LR+?
sensitivity/1-specificity
52
What is the formula for LR-?
1-sensitivity/specificity
53
What type of study provides an exposure OR?
Case Control Studies
54
What type of study provides a prevalence OR?
Cross Sectional Studies
55
What are the live-attenuated vaccines?
``` Measles MumpsRubella Polio (Sabin) Yellow Fever Nasal Influenza ```
56
What are the 5 stages of behavioral change?
``` Precontemplation Contemplation Preparation Action Maintenance/Relapse ```
57
What differentiates MM and MGUS?
MM: Band > 3 mg/dL, anemia, renal disease, lytic lesions MGUS: Band
58
What disease would you obtain and abdominal fat pad biopsy for?
Amyloidosis
59
What is the treatment for PID?
Inpatient: Cefotetan/Doxycycline Outpatient: Ceftriaxone and Doxycycline
60
What interventions are useful for diabetic foot ulcers?
1. Off-loading 2. Debridement 3. Wound Dressings 4. Antibiotics 5. Revascularization 6. Amputation
61
Which immunosuppressant causes gum hypertrophy and hirsutism?
cyclosporine
62
What is the triad of wiskot-aldrich syndrome?
Eczema, Thrombocytopenia, recurrent infections with encapsulated organisms (X-linked Recessive) High IgA/IgE levels, low IgM
63
When do you start surveillance in UC patients?
After disease has been present for 8 years
64
What does flattening of top and bottom of a flow-volume loop indicate?
Fixed-upper airway obstruction
65
Where does atrial flutter typically originate from?
The tricuspid annulus
66
What is the treatment for legionella?
Respiratory quinolone or new macrolide
67
What is the order of effectiveness of BP interventions?
1. Weight loss (in overweight people) 2. DASH diet 3. Exercise 4. Dietary sodium decreased 5. Decrease EtOH intake
68
What is the formula for calculated osmolality?
2Na + Glu/18 + BUN/2.8
69
What are the findings in Beckwith-Wiedman syndrome?
Macrosomia, Macroglosia, Hemihyperplasia, Abdominal Wall Defects. Monitor for hypoglycemia
70
What screening should kids with beckwith-wiedman syndrome get?
Abdominal U/S and AFP for Wilm's Tumor and Hepatoblastoma
71
In what patients might you use stimulants to treat depression?
Those with short life expectancy as SSRIs can take 4 weeks for effect
72
What is the treatment for Lyme in a pregnant patient?
Amoxacillin If allergic to amoxacillin, can use macrolide If severe/disseminated, can do ceftriaxone
73
At which GA should pre-term labor be delayed?
23 weeks to 34 weeks | Highly increased risk of CP at
74
What age is mammography screening recommended?
50-75
75
What are the signs of Anorexia?
1. Osteoporosis 2. Elevated cholesterol/carotene 3. Arhythmias (long QT) 4. Euthyroid sick sinus syndrome 5. HPA dysfunction 6. Hyponatremia 7. SGA babies (even if in remission from disease)
76
At what GA is conversion of breech presentation indicated?
37 Weeks
77
What condition has upward lens dislocation?
Marfans
78
What is the timeline for charcoal administration in acetomenophen poisoning?
Within 4 hours of ingestion
79
When are abx indicated in COPD exacerbation?
When there is > 1 cardinal symptom (SOB, increased cough, increased sputum purulence)
80
What age does gonococci and chlamydial conjunctivitis present at?
Gonoccocal: 2-5 days (ppx with erythromycin ointment) Chlamydial: 5-14 days
81
What disease is associated with breath-holding spells?
Fe deficiency anemia
82
What is the treatment for trypanosomes disease?
Benznidazole
83
What is the treatment for pinworms?
Albendazole
84
What disease does the D-xylose absorption test for?
celiac disease (test for small bowel mucosa functionality)
85
What are the back pain red flags to get XR and ESR?
Age > 50 Nighttime symptoms > 1 month Constitutional or Neuro Symptoms
86
What are the 5 Hs?
``` Hyperkalemia Hypothermia Hypoxia Hypovolemia Hydrogen Ions ```
87
What are the 5 T's?
``` Tension Pneumo Tamponade Toxins Thrombosis Trauma ```
88
What type of solitary pulmonary nodule requires surveillance even if it's appearance is stable?
GGO
89
What are the size-risk categories for solitary pulmonary nodules?
2.0 cm - High Risk
90
What is Charcot's triad of cholangitis?
Fever RUQ Pain Jaundice +Confusion/Hypotension = Reynaud's Pentad
91
What should you suspect in back pain on anticoagulation?
Retroperitoneal Hematoma
92
What is the management of Alkali ingestion?
Decontamination, Irrigation, Endoscopy within 24 hours
93
Should you provoke vomiting in Alkali ingestion?
NO
94
What is the first test you should get for suspected adrenal insufficiency?
Morning cortisol/ACTH and Cosyntropin test
95
What is a sign of ventricular aneurysm post-MI?
Persistent ST elevation, signs of HF/mitral regurge (5days - 3 months)
96
What age is HPV vaccination indicated for?
9-26
97
At what age is bed-wetting normal until?
Until age 5
98
What is susceptibility bias?
Form of selection bias, treatment dictated by disease severity.
99
How might UC present in the acute setting?
Toxic Megacolon
100
What are the 5 causes of hypoxemia?
``` V/Q Mismatch Shunt Diffusion Barrier Decreased O2 Tension Hypoventilation ```
101
Which nephrotic syndrome is associated with HBV?
Membranous nephropathy (can have low C3)
102
What drugs can cause digoxin toxicity?
Amiodarone, Verapamil, Quinidine, Propafenone
103
Does trichomonas cause cervicitis?
No it is a vulvo-vaginitis
104
Is chlaymydia or gonorrhea a more common cause of mucopurulent cervicitis?
Chlamydia
105
What disease causes mild conjugated hyperbili with no enzyme elevation?
Rotor Syndrome
106
What is clomiphene citrate?
An estrogen analogue used in anovulatory disorders
107
What cancer is minimal change disease associated with?
Hodgkin's Lymphoma
108
What is the role of ppx in rheumatic fever?
Penicillin, with cardiac involvement and valvular do it for 10 years or until age 40
109
Where does terminal hematuria localize?
Bladder
110
When is RhoGam intitially administered?
28-32 weeks
111
What lab must you check prior to starting lithium?
Renal function
112
What is winters formula?
15(bicarb) + 8 +/- 2
113
At what age is AAA screening indicated?
age 65-75 with smoking Hx. >5.5 cm repair
114
What nerve supplies the medial leg?
Saphenous, branch of femoral
115
What electrolyte abnormality occurs in Cushing's syndrome?
Hypokalemia
116
What markers are elevated in non-seminomatous germ cell tumors?
bHCG and AFP
117
What electrolyte must be monitored with high-dose TMP?
Potassium, can cause hyperkalemia
118
Where is the anserine bursa located?
Antero-medially over the tibial plateau
119
What is a case of pleural fluid pH
Empyema
120
What is the INR threshold for FFP admin?
1.6
121
What nephrotic syndrome is associated with Renal vein thrombosis?
Membranous Glomerulopathy
122
What two diseases is HepC strongly correlated with?
Porphyria Cutanea Tarda | Mixed cryoglobulinemia
123
What are the symptoms of mixed cyroglobulinemia?
Immune complex deposits in small vessels. Palpable purport and possible membranoproliferazive glomerulonephritis
124
What is polyarteritis nodosa associated with?
HepB
125
What is erythema nodosum?
Painful nodules on anterior legs, associated with infections (e.g. strep and TB) and sarcoid
126
Should premature infants be vaccinated based on gestational or chronologic age?
Chronologic age (except hepB shouldn't be given if less than 2 kg)
127
What are the three questions to ask in hypocalcemia?
1. Low Mg? 2. Due to a drug? 3. Recent blood transfusion?
128
When did blood screening for hepC start?
1992
129
What drug should always be stopped in sepsis/kidney injury?
Metformin
130
What is first line treatment for Alzheimers disease?
Cholinesterase inhibitors
131
What is the treatment for Tourett's?
Antipsychotics | Alpha 2 Agonists: clonidine/guanfacine
132
What cancer is associated with Hashimotos?
Thyroid Lymphoma
133
In a child older than 2, what is most common cause of intussiception?
Meckel's Diverticulum
134
Must INH always be stopped with transaminitis?
No, not if mild and asymptomatic
135
What is the formula for PAO2t?
FiO2(Patm-47)-PaCO2/R
136
At what LN diameter should you consider a biopsy?
2.0 cm
137
What is the treatment for restless leg syndrome?
Dopamine agonists (pramipexole, ropinirole)
138
What is the DLCO in chronic bronchitis?
Normal
139
When is cytology of fibrocystic aspirate indicated?
Bloody or foul smelling fluid
140
At what time point should abortive seizure therapy be provided?
5 Minutes
141
Which glomerular disease presents with deposits of C3 only?
MPGN Type II (dense deposit disease) due to C3 nephritic factor causing persistent alternative complement activation
142
Is botulism ascending or descending?
Descending
143
How does OA of the hip present?
Anterior hip pain worse with movement without TTP
144
What is first line treatment for asymptomatic bacteuria in pregnancy?
Amoxicillin
145
How does one differentiate AOM from OM with effusion?
OM with effusion lacks any acute infective symptoms
146
What is characteristic of a cerebellar tremor?
Amplitude increases as the hand reaches its target
147
What lab highly indicates empyema and mandates chest tube?
pH less than 7.2 (also glucose less than 60)
148
What should you suspect in an AA patient with nocturne?
Hyposthenuria from sickle cell trait
149
What characterizes HSV keratitis?
Corneal vesicles and dendritic ulcers
150
What is the major contraindication to orotracheal intubation?
Significant facial trauma
151
What may help differentiate abruption from previa?
Abruption is painful
152
What is characteristic of vasa previa?
Significant fetal distress as it is fetal blood hemhorraging
153
What food borne disease is associated with flushing and urticaria?
Scombroid
154
How long must you wait after alpha-blocker for using sildenafil?
4 hours
155
Which heart murmurs increase on expiration?
Only Left sided ones!
156
What does a UTI with alkaline urine pH indicate?
Urease positive organism (proteus, klebsiela, morganella, psuedomonas, staph)
157
How does polymyositis present?
Proximal muscle weakness, usually without pain
158
What is the differential for T wave inversion?
``` MI Myocarditis Old pericarditis Myocardial contusion Digoxin Toxicity ```
159
What is the most predictive sign of opioid intoxication?
Depressed respiratory rate
160
What are some P450 inhibitors?
Cimetidine, Ciprofloxacin, erythromycin, clarithromycin, verapamil
161
How do you distinguish peripheral thrombosis from embolism?
Embolism is acute onset with diminished pulses unilaterally
162
Which RTA is associated with fanconi syndrome?
Type 2 (impaired bicarbonate resorption)
163
What lung parameter decreases in severe COPD?
VC
164
Who needs a meningococcal booster?
vaccinated prior to age 16 needs one at age 16-21
165
What is a hordeolum?
Staph abscess of the eyelid, treat with warm compresses.
166
What is a chalazion?
Granulomatous inflame of the mebomium glands. treat with Incision and curettage
167
What is the most important risk factor for stroke?
Hypertension
168
What is first line therapy for symptomatic PVCs?
Beta Blockers | Amiodarone is second line
169
What is the treatment for actinomyces?
Penicillin (12 weeks) or Clindamycin
170
When does PNH usually manifest?
In the 30s with hemolysis, cytopenias, thrombosis
171
At what age should non high-risk patients get PCV13?
Age 65, otherwise its just the PPSV 23
172
What is eczema herpeticum?
Herpes infection that develops onto of eczema
173
What is the cause of emphysematous cholecystitis?
Gas producing bacteria (cover GNRs and GPCs) (AFLs in the gallbladder or gas on U/S)
174
Whistling noise after rhinoplasty?
Think septal perforation
175
Does the living will take legal prescedence?
Yes!
176
Which HIV drug causes crystal nephropathy?
Indinavir (a protease inhibitor)
177
What are the common life threatening HAART complications?
``` Didanosine - Pancreatitis abacavir - hypersensitivity syndrome NRTIs - Lactic Acidosis NNRTIs - SJS Neverapine - Liver Failure ```
178
What lab abnormalities are seen with cholesterol embolization?
Eosinophilia | Hypocomplementemia
179
What two syndromes result in unconjugated hyperbole?
Crigeler-Najar | Gilbert
180
What screening tests should you do in infertility first?
TSH, FSH, Prolactin first | Unless prior uterine instrumentation, then image
181
Who less than
Immunocompromised, CSF leak, Asplenia, cochlear implant
182
Which patients should succinylcholine not be used in?
Those at risk for hyperkalemia: Crush or burns > 8 hours old Tumor lysis syndrome Demyelinating syndromes
183
What is the major division for cases of fetal growth restriction?
Is it asymmetrical (maternal factors) or symmetrical (fetal factors)
184
What is lidocaine used for with ACS patients?
Can be used to ctrl vTach; however, should not be used prophylactically due to increased risk of systole
185
What are the PE findings in fetal alcohol syndrome?
1 Small Palpebral Fissure 2 Smooth philthrum 3 Thin vermillion border
186
What is the definition of arrested labor in the first stage?
> 6 cm dilated with: No change in 4 hours with good contractions or No change in 6 hours w/o good contractions
187
What are rhonchi that clear with a cough suggestive of?
Bronchitis
188
What is the treatment for Vaginismus?
Keigel exercises and gradual dilatation
189
What differentiates galactokinase deficiency form galactose-1-phosphate uridyl transferase deficiency?
In the former, they only get cataracts, other also gets systemic manifestations
190
What murmur is heard at the LSB with the patient leaning forward and holding exhalation?
Aortic Regurgitation (early diastolic murmur)
191
What is an imaging finding with constrictive pericarditis?
Calcification along the heart border
192
What should you think of with a mid-diastolic knock?
Constrictive pericarditis
193
What are the top three causes of chronic cough?
GERD Post-nasal Drip Asthma - PFTs!!!
194
What empiric therapy for cervical lymphadenitis in children?
Clindamycin as it covers MRSA (+InD)
195
What is the treatment for amebic liver abscess?
Oral Metronidazole with Paromomycin (luminal agent)
196
What confirmatory test can be used if gastrin level is between 100 and 1000?
Secretin stim test, if gastrin elevated then it is a gastrinoma
197
What should be avoided in Meinere's disease?
High salt, EtOH, Caffeine, Nicotine
198
After the dose at age 11-18 with Tdap, should patients get Td or Tdap?
Td unless pregnant
199
Till what age should sickle cell patients take penicillin pox?
5
200
For uncomplicated cystitis is a urine culture necessary?
No
201
What factors make cystitis complicated?
Pregnancy, Diabets, CKD, UT obstruction, immunocompromised, hospital/procedure associated
202
What do ST depressions in V1/V2 indicate?
Posterior wall MI
203
How often is RV involved in an inferior infarct?
1/3 of the time, ST depression in I and AVL and indicate this
204
What is cyclical vomiting syndrome associated with?
Migraine Headaches
205
Which personality disorder has "magical thinking"?
Schizotypal Personality Disorder
206
What is Ludwig Angina?
Progressive bilateral cellulitis of the submandibular and sublingual space
207
What is the most common acute side effect of levodopa therapy?
Hallucinations
208
In what group of elderly patients should typical neuroleptics not be used?
Those with lewy body dementia
209
What is the treatment for chlamydial conjunctivitis or pneumonia in a newborn?
Oral Erythromycin
210
What is the only segment of the bladder in contact with the peritoneum?
The dome of the bladder
211
How is hypothermia classified?
Mild: 32-35 Moderate: 28-32 Severe: less than 28
212
What type of arrhythmias usually resolve with warming in hypothermia?
Atrial arrhythmia
213
What is acute stress disorder?
Like PTSD but symptoms are from 3 days to 1 month. A significant life threatening stressor is required for dx
214
For who is the PPD cutoff value 10 mm?
Recent immigrants (within 5 years) from TB area IVDU Residents and employees of high risk settings Comorbid (diabetes, ESRD, etc.) Children less than 4
215
What syndromes are associated with Wilm's tumor?
WAGR Beckwith-Wiedman Denys-Drash
216
What are indications for Hep C treatment?
Liver biopsy with at least bridging fibrosis Compensated liver disease (INR not over 1.5, no ascites) No MDD, EtOH, or IVDU
217
What are the main side effects of sulfonylureas?
Weight gain and hypoglycemia
218
What oral hypoglycemics cause weight loss?
GLP-1 receptor antagonists (exenatide)
219
What oral hypoglycemics can be used in renal insuficiency?
Glitazones and DPP-IV inhibitors
220
What is Beck's triad of cardiac tamponade?
Hypotension Distended Neck Veins Muffled heart sounds
221
What metabolic abnormality may result from thiazide treatment?
Hyperglycemia, Increased LDL, Hypertriglyceridemia, Hyperuricemia
222
What should you think of with a mono like syndrome with LAD and Gi symptoms?
Acute HIV Infection
223
What is required for the diagnosis of any psychiatric condition?
Interference with activities at work or home
224
What should proximal muscle weakness, decreased reflexes, normal ESR, and elevated CK make you think of?
Hypothyroid Myopathy
225
What is the inheritance pattern of myotonic dystrophy?
AD, trinucleotide repeat of CTG on Cr 19
226
Which disease of the breast presents like eczema?
Pagets
227
Is formula or breast milk associated with less colic?
Breast Milk
228
What are the lesions of herpangina?
Gray vesicles on the posterior oropharynx and tonsilar pillars that progress to fibrin coated ulcerations
229
In non-classical CAH, are there electrolyte disturbances?
No
230
What are the screening recs for osteoporosis?
Dexa scan in all women > 65
231
What is the management of endometrial hyperplasia without atypia?
Progestin therapy
232
When can menopause be diagnosed clinically?
In women > 45 with 12 months of amenorrhea
233
What is the treatment for nocardia?
TMP-SMX for pulmonary | Add carbapenem for CNS disease
234
What is the typical pH in salicylate overdose?
It is usually near normal
235
What is the clinical presentation of osteoid osteoma?
Increasing pain worse at night better with NSAIDs | Hypodense lesion on x-ray
236
What should be given to decrease homocysteine levels?
B6 and Folate
237
What are the sfx of EPO administration?
Worsening HTN Headaches Flu-like syndrome Red cell aplasia
238
What are the indications for steroid use in PCP treatment?
PaO2 less than 70 | A-a gradient greater than 35 on RA
239
What is the triad of Wernicke's?
Encephalopathy Oculomotor dysfunction Gain disturbances
240
What cancers do OCPs reduce the risk of?
Endometrial and Ovarian | Decreased benign breast dz risk
241
What is a common side effect of OCPs?
HTN
242
What is the definition of primary amenorrhea?
Absence of menstruation in someone age 15 with normal growth
243
How does glucagonoma present?
With DM, necrolytic migratory erythema, weight loss, diarrhea, anemia
244
When does common variable immunodefficiency present?
Usually not till after age 15 and the B cells are present
245
What is Kehr's sign?
LUQ pain radiating to the L shoulder from diaphragmatic irritation
246
Which cell lines are up in polycythemia vera?
All three, but red cells most
247
What condition causing hand pain affects new mothers?
De Querveins Tenosynovitis
248
What Ca abnormality prolongs the QT interval?
hypocalcemia
249
What should recurrent epistaxis and AVMs make you think of?
Hereditary Hemhorragic Telengectasia
250
What is the most common complication of a supracondylar fracture?
Brachial Artery Injury (also median nerve and cubitus varus deformity)
251
What parasite might give you subungual hemorrhages, periorbital edema, chemosis?
Trichinella Spiralis
252
What infectious disease causes fever, headache, retro-orbital pain, myalgia?
Dengue
253
Which disease has chery-red macula and areflexia?
Nieman-Pick, also has HSM
254
Which disease had chery-red macula and hyperreflexia?
Tay-Sachs
255
What ist he deficiency in Nieman-Pick?
Sphingomyelinase
256
What is the deficiency in Tay-Sachs?
Beta Hexosaminidase A
257
What disease has anemia, thrombocytopenia, and HSM?
Gauchers (glucocerebrosidase deficiency)
258
What is the threshold for lead treatment in a child?
45-69 mcg - DMSA | over 70 - Dimercapol and EDTA
259
What are flat and broad T waves a sign of?
Hypokalemia
260
What signs indicate a Morton Neuroma?
Numbness and Pain between 3rd and 4th toes, clicking sensation when placating while squeezing metatarsal joints
261
What are signs of ischemia in an SBO?
fever, tachycardia, leukocytosis, metabolic acidosis
262
What are the findings in trichomonas vaginits?
Motile pear-shaped organisms
263
What are the indications for bladder and renal US in peds?
First febrile UTI before 24 months
264
What is the initial workup for an ovarian mass in post-menopausal women?
US and CA 125
265
Do OCPs cause weight gain?
NO
266
Which deficits are most severe early on in multi-infarct dementia?
Executive Function deficits
267
Why does IUGR decrease RDS incidence?
Stress in uterus causes lungs to mature early
268
What cardiac defects is most common in Trisomy 18?
VSD
269
What two things can be added to the classic triad of reactive arthritis?
Mucosal ulcers and enthesitis of the achiles
270
What is the appropriate test in primary syphilis?
Dark Field Microscopy
271
What should you think with non-anion gap metabolic acidosis and hyperkalemia?
RTA Type 4 (often older patient with poorly ctrld DM)
272
What should patients with precocious puberty with high LH undergo?
Brain MRI with contrast
273
What should be used for AF in WPW syndrome?
Procainamide
274
What organ might hydroxychloroquine damage?
Eyes
275
Where is the lesion in dysarthria-clumsy hand syndrome?
Lacunar infarct at the basis points
276
What is the workup for a simple renal cyst?
None - reassurance only
277
Which immunosupressant has gum hypertrophy and hirsutism?
Cyclosporine
278
What does thrombocytopenia, hemolytic anemia, and renal failure =?
TTP!!!!
279
How do you differentiate CMV and HSV retinitis?
CMV does not cause initial keratitis and has fluffy retinal lesions
280
What is the most common cardiac abnormality in Down Syndrome?
Complete AV Septal Defect
281
What is focal proliferative glomerulonephritis a subset of?
SLE nephritis
282
Where is the anserine bursa located?
Anteromedially below the knee joint line
283
A headache in which location in a child should raise concern?
Occipital headaches
284
What do you do intrapartum if HIV > 1,000 copies / ml?
Intrapartum zidovudine and C-section
285
When are live vaccines contraindicated in HIV?
when CD4 count is less than 200
286
When does endometriosis pain peak?
Prior to menses not during menses
287
What should you suspect in an infant with left axis deviation and tall peaked T waves?
Tricuspid Atresia
288
What is the treatment for restless leg syndrome?
Fe supplementation, dopamine agonists (pramipexole)
289
What is the treatment for cocaine intoxication and ischemia?
IV Benzodiazepines
290
What is the treatment for cancer cachexia?
Progesterone analogues
291
When is the RBC count useful?
In Fe deficiency it is down, thalasemias it is normal
292
What do recurrent chalazions require?
Histopathologic examination for carcinoma
293
What are normal values for FEV1 and FEV1/FVC?
80 to 120% of predicted
294
What are the normal values of RA pressure?
0-8
295
What are the normal values of RV pressure?
15-25/3-12
296
What are the potential side effects of abacavir?
Lactic Acidosis, Hepatits, hypersensitivity reaction
297
What are the side effects of effevirenz?
Insomnia with vivd or bizarre dreams
298
What eye disease is described as having a glare worse at night?
Cataracts
299
What is the most effective treatment for slowing the progression of diabetic nephropathy?
Blood pressure ctrl
300
What might elevate glucose in a burn patient indicate?
Sepsis
301
What does pronator drift signify?
An upper motor neuron lesion
302
What is the most common PNA causing organism in young patients with CF?
S Aureus
303
What is the Tx for duodenal hematoma?
NG tube and parenteral nutrition
304
What is the preferred regimen for penicillin sensitive viridians endocarditis?
IV Penicillin G or IV Ceftriaxone
305
What is a defining feature of the attacks in panic disorder?
They are UNEXPECTED
306
What are fusion beats with wide QRS diagnostic of?
Sustained Monomorphic Ventricular Tachycardia
307
What is the Tx for uric acid stones?
K Citrate to alkalinize the urine
308
What HIV drug causes crystal nephropathy?
Indinavir (protease inhibitor)
309
What contraceptive should be used when breastfeeding?
Progestin-only pills
310
What is the gait of parkinsonism?
Hypokinetic narrow-based gait
311
How should you follow up an RAI scan with low uptake?
Measure thyroglobulin
312
Ulcer with a purulent base and ragged violacious border?
Pyoderma Gangrenosum
313
What does hepatojugular reflux indicate?
A failing RV that can't accommodate the increased fluid
314
When is an AR murmur best heard along the LSB?
When it is due to valvular disease (as opposed to aortic root disease)
315
What murmur does tricuspid endocarditis present with?
Tricuspid Regurgitation i.e. a systolic murmur accentuated with inspiration
316
What is the presentation of Type I glycogen storage disease?
3-4 month old with doll like face, hypoglycemia, lactic acidosis, hyperuricemia. Transaminase are normal
317
What is the presentation of Type III GSD?
Similar to type one but normal uric acid and lactate levels and elevated transaminases
318
What are some P450 inhibitors?
``` Acetomenophin Antibiotics Amiodarone Cimetidine Cranberry Juice, Ginko Omeprazole Thyroid Hormone SSRIs ```
319
What are some P450 inducers?
``` Carbamazepine Ginseng OCPs Phenobarbitol Rifampin St. Johns Wort ```
320
What causes isolated systolic hypertension?
Decreased arterial wall elasticity
321
What antiarythmatic class exhibits the most "use dependence?
class IC drugs (flecanide, morcizine, propafenone)

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