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UWORLD NOTES Flashcards

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1
Q

Anterior mediastinal mass ddx

A

thymoma
teratoma
thyroid
terrible lymphoma

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2
Q

Ovarian mass:

  • solid with thick septae
  • solid
  • calicifcations
  • ground glass/internal echo
A
  • solid with septae: malignancy
  • solid: luteoma/krukenburg
  • calcifications: teratoma
  • ground glass: endometrioma
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3
Q

What rules out retained placenta

A

thin endometrial stripe

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4
Q

Damage caused by clavicular fracture

A
  • subclavian artery

- brachial plexus

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5
Q

PSC findings on ERCP

A

bile duct fibrosis with “onion skinning”

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6
Q

Primary amenorrhea first step in dx

A

pelvic us
if there is a uterus –> check FSH
no uterus –> check karyotype

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7
Q

Cause of absent uterus with 46XX vs 46CY karyotype

A

46XX mullerian agenesis

46XY AIS

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8
Q

Breast feeding decreases which cancer risks

A

breast

ovarian

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9
Q

Causes of hyperandrogrenism in pregnancy

A

luteoma/theca lutein cyst

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10
Q

Splenectomy med treatment

A

vax weeks before when possible

penicillin px for 3-5 years

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11
Q

Tumor lysis labs

A

high uric acid
high K+
high PO4
low Ca

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12
Q

Treatment and risks assc with TLS

A

IVF, allopurinol

arrhythmia/renal failure

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13
Q

Lights criteria for exudative effusion

+cause

A

pleural/serum protein ratio more than 0.5; LDH ratio more than 0.6 or LDH greater than 2/3 ULN

cause is increased permeability

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14
Q

Transudative effusion cause

A

increased hydrostatic pressure or decreased oncotic pressure

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15
Q

Labs assc with hemolytic anemia

A

high indirect billi, high LDH, low haptoglobin (binds Hgb)

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16
Q

Three causes of low albumin

A

cirrhosis
nephrosis
protein wasting enteropathy

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17
Q

Pain + fever +hematuria esp when pt has membranous glomerulonephrosis=

A

renal vein thrombosis

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18
Q

Location of pain in:
IT band syndrome
patellofemoral syndrome
pes anserinus

A

IT band syndrome: lateral femoral condyle
patellofemoral syndrome: anterior knee
pes anserinus: opposite ITB (medial condyle)

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19
Q

CMV vs HSV retinitis

A

CMV- fluffy granular painless lesions
HSV- central retinal necrosis, painful
Both assc with AIDS

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20
Q

Normal ABG in pregnancy

A

respiratory alkalosis

high TV/MV/ PaO2

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21
Q

Cause of hepatorenal syndrome

A

splanchnic arterial dilation

low GFR with no other clear cause

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22
Q

Porphyria cutanea cause

A

low uroporphyrinogen decarboxylase = high prophyrins

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23
Q

Treatment PCT

A

phlebotomy and hydroxychloroquine

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24
Q

RAI needs to be combined with?

A

steroids or antithyroid meds to treat ophtalmopathy

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25
Thyrotoxicosis effect on circulation
hyperdynamic state; increased contractility and HR
26
Obstructive lung disease cut off
FEV1/FVC under 0.7
27
MOS of nitroglycerin
systemic vasodilation --> decreased LV stress --> decreased MVO2
28
Liver abscess three types/ management
- elederly/chronic med- bacterial must drain and give abx - asx/ animal contact- echinococcus must drain and give albendazle (calcified, daughter cysts) - sick/ endemic area- entamoeba = metronidazole no draining!
29
Strep viridans species
``` MMMOSS mutans milleri mitis oralis sobrinus sanguinis ```
30
PCD vs CF cause of infertility
PCD immobile sperm | CF absent vas
31
Four causes thyroiditis + which has +TPO also: which is the only thyroid disease with increased RAIU?
painless/silent ++TPO (hyperthyroid state) hashimoto ++TPO subacute graves- high RAIU
32
Soft S2 cause
severe aortic stenosis
33
Post op/partum fever not responsive to abx: | cause + treatment
septic thrombophlebitis | anticoag and broad spectrum abx
34
Two bone diseases that have normal Ca/PO4/PTH
pagets | osteoporosis
35
Management of placenta previa
``` pelvic rest (no sex or exams) CS at 36-37 weeks ```
36
MCC nephrotic syndrome in adults
FSGS
37
Clue to reactive arthritis vs gonococcal arthritis
reactive- enthesitis (gets nsaids while gonorrhea gets abx)
38
Polycythemia vera: labs treatment risk
all cell lines increased, JAK2 mutation phlebotomy, hydroxyurea clots and myelofibrosis
39
Two MCC prosthetic joint infections
early: aureus, acute pain and fever | late (3+ months): epi, indolent onset
40
Two smoke toxins
HCN and CO
41
Treatment for HCN tox (3)
hydroxycobalamin thiosulfate nitrates (FE3+ binds HCN)
42
PE finding that distinguishes hemothorax and PTX
hyperressonance seen with PTX
43
What distinguishes AIHA from SCA
look at the spleen | spleen large in AIHA, gone in SCA
44
When to give PEP after rabies
cant quarantine pet | high risk wild animal
45
Pernicious anemia risk
gastric cx
46
When is D-dimer an appropriate test?
less than 2 risks per wells criteria
47
phenytoin tox signs
ataxia | nystagmus
48
Polymyositis dx
biopsy first patchy necrosis also have + ANA/Jo treatment is steroids
49
PMR vs polymyositis
PMR is STIFFNESS and acute | Poly is weakness and indolent
50
Paradoxical chest wall motion after MVC =
flail chest
51
Sporotrix: -bug type -exposure treatment
dimorphic fungus decaying vegetation 3-6 months intraconazole
52
Menieres triad and cause
hearing loss tinnitus dizziness increased endolymph pressure (poor absorption)
53
Joint mass with chalky white appearance
tophaceous hout
54
Delirium must have
fluctuating consciousness
55
Thyroid changes in pregnancy
total T4 &TBG which = normal free T4 | low TSH
56
Contraindications to vaginal delivery
previa prior classical CS prior myomectomy
57
Reflex that is diminished with age
Achilles
58
Weight required for Hep B vaccine
2 kg/ 4.6 lbs
59
B2 agonists end in ?
erol
60
Arthrocentesis white count in: OA Septic
OA should be under 2k | Septic should be over 50k
61
Equilibrated cardiac pressures- clue for
tamponade
62
Vision changes + thickened eyelids=
atopic keratoconjunctivitis
63
Bacterial ocular discharge clue
comes back after cleaning off
64
MCC liver mets
GI lung breast
65
Treatment for Pagets
Bisphos and Ca/D
66
ESRD patient anticoagulation
just hep --> warf nothing fancy kidneys cant deal.
67
Supracondylar fracture assc injury
brachial artery/ median nerve | rarely compartment/volkman
68
Shingles trick
may have skin pain before shingles
69
Hemophilia A vs B + UA findings
both XR A is factor 8 B is 9 hematuria with normal renal function
70
Which is screened for in all preggos: G or C
C, gonorrhea only under 25 or high risk
71
Constellation for Granulomatosis with Polyangitis | Assc ab
URI + LRTI + renal disease + skin findings | ANCA +
72
Staph vs TB cavitary lesion
staph is acute TB is indolent
73
MCC duodenal ulcer
almost always HPylori
74
What type of bias: | treatment regimen based on disease severity
selection bias (susceptibility)
75
Lab changes with PRBCs
citrate --> low calcium and mag
76
Cause of zenkers
dysmotility
77
Air in chest that is not improved with tube placement is
bronchial rupture
78
For every 1 decrease in albumin Ca changes by
down 0.8
79
Advanced ovarian mass next step
straight to lap
80
- high gluc - skin pigment - LFTs high is....
hemochromatosis (risk KCC)
81
Meds for enuresis
1st line: desmopressin | 2nd line: TCA
82
Turners risk and treatment
osteoporosis | HRT
83
Clue to angiodysplasia
- missed on colonoscopy - painless bleeding and normocytic anemia - assc with CKD/AS/VWD
84
Treatment of acalculous chole
abx and perc cholecystostomy
85
First step in dx'ing cushings
dexa supression
86
Hemolysis AND thrombosis =
PNH
87
Clue to bacillary angiomatosis vs kaposcis
bacillary= systemic signs like fever
88
When to give progesterone for short cervix
if detected earlier than 24 wks GA
89
Enthesitis is seen in?
reactive arthritis | ank spon
90
What stress fracture requires treatment
5th metatarsal needs ORIF/casting
91
SIDs 3 risks
stomach sleeping smoking pacifier
92
Acute hep B is assc with what renal disease
membranous
93
Gross painless lower GI bleed
diverticulosis
94
RA treatment
start DMARDs (MTX) as soon as possible regardless of pain level
95
Ogilvies clue: | treatment:
distended colon on imaging | rectal tube
96
Presentation vs position in childbirth
presentation: butt vs head position: part in relation to the pelvis malposition = mcc second stage labor arrest
97
Signs of breast feeding *failure* jaundice
brick red crystals in diaper dehydration too many gaps between feeds
98
Treatment for BCC on face
Mohs
99
Nontender large salivary glands in alcoholic
sialadenosis | abnormal innervation
100
Cause of warfarin induced skin necrosis
protein C deficiency
101
MCC CAP in HIV pt
SP
102
Adjustment disorder time limit and treatment
3 months | therapy
103
How to dx ank spon
xray showing sacroilitis
104
NG tube in pulm cavity =
diaphragmatic rupture
105
Pseudogout + liver disease +DM =
hemochromatosis
106
Pt found unconscious and has hemiparalysis think...
Todds paralysis (post epileptic)
107
High risk pulm nodule size? intermediate? low?
2 cm+ high 0.8-2 med less than 0.8 low risk
108
Ataxia Nystagmus Hammer Toes Cardiomyopathy What is THIS?
Freidreichs ataxia
109
Rash that looks like an oil spill
erythema marginatum of RF
110
Type of rash assc with serum sickness
urticarial
111
Intravascular cath MC infection
coag - staph
112
MC COD in PAD
MI
113
Fanconis vs Diamond Blackfan labs
Fanconis is aplastic | Diamond is pure red/macro (triphalangeal thumbs)
114
MCC neonatal sepsis
GBS
115
Lithium labs to monitor
LFTs thyroid Ca level
116
Contraindications to vaginal labor are also contraindications to _____
contraction stress test
117
Cyanosis after topical anesthetic use is
methemoglobinemia
118
Tet squatting effect
LOUDER murmur but improved CYANOSIS
119
Components of BPP
``` NST (2+ accels) AFI (2x1 cm) Movement (3+) Tone (1 flexion/extension) Breathing (1+ breathing episode) ```
120
Long QT treatment
BBer | Pacer
121
MC bug in acute parotitis following surgery
staph | prevent with hydration/hygiene
122
Peak Pressure = ____ + _____
plateau + airway resistance
123
Plateau pressure = ____ + ___
PEEP + elastic pressure
124
Elastic pressure = _____/ ____
TV/ compliance
125
Increase in peak pressure without a change in plateau pressure means
airway obstruction (mucus plug, biting tube, bronchospasm)
126
Cause of increasd plateau pressure
PTX/pulm edema/PNA/atelectasis/right sided intubation
127
Bilious emesis + small colon? big colon?
small colon- meconium ileus | big colon- toxic megacolon
128
Characterize hypercalemia assc with HCTZ
MILD, like 12 or less
129
How does viral illness lead to intussusception?
peyers patch hypertrophy
130
What determines severity of CHF
degree of hyponatremia
131
All pregnant patients should be screened for which STDs?
Chlamyida Hep B HIV Syphillis
132
MC kidney stone type
calcium oxalate
133
Stone type assc with RTA & hyperparathyroidism
CaPO4
134
MC risk assc with prolonged pregnancy
oligo
135
Migratory superficial thrombophlebitis next step
CT to look for visceral malignancy
136
Central precocious puberty --> next step
bone age normal: reassure increased: MRI to r/o mass --> GNrH agonist
137
Two LSD with cherry red macula
Neiman Pick and Tay Sachs
138
How to distinguish neiman pick and tay sachs
neiman: HSM and arreflexia | tay sachs: normal spleen and reflexes
139
Krabbes disease typical finding + enzyme
vague... regression of milestones but no HSM, no cherry red macula a galactosidase
140
Gauchers disease enzyme + findings
glucocerebrosidase | anemia/low platelets and HSM
141
Ovarian torsion must have
ovarian mass
142
Treatment for homocysteine elevation
B6/folate
143
MCC nonreactive NST
sleeping
144
Gilberts enzyme def
UDP glucuronosyltransferase
145
Palpable purpura in adult + renal disease =
cryoglobulinemia --> HCV
146
Fatigue + proximal muscle WEAKNESS + ^^CK =
thyroid myopathy (can be hypo or hyper)
147
What three yeasts present with skin and lung findings and how to tell these apart?
blasto- central US histo- MS/Oh River valleys coccidio- southwest us
148
What type of bug is aspergillus
mold
149
Costochondral joint enlargement=
rickets
150
myositis periorbital edema eosinophilia =
trichinellosis
151
Vision loss in mac degen (describe)
central vision gone | straight lines look wavy
152
Bilious emesis first step in evaluation after stabilizing
AXR double bubble dilated loops do contrast enema (MI, hirschsprungs)NG tube in duodenum = malrotation
153
Clubbing + sudden onset arthropathy
hypertrophic osteoarthropathy
154
Three clues to sickle trait
renal pap necrosis splenic infarct exertional rhabdo
155
Scrotal mass that is worse with standing
varicocele
156
What type of hernia is felt in the scrotum?
inguinal
157
Trauma --> delayed heart failure cause?
AVF
158
At what hgb are patients with GIBs transfused?
7 or less
159
SCA sudden drop in hgb and retics =
aplastic crisis | *Splenic sequestration will not have low retics*
160
Swelling at floor of mouth and submandibular area =
Ludwig angina | dental infection
161
MTX mc ADR
oral ulcers
162
Chorio must get what meds in addition to abx
Pitocin to speed up labor even if already in labor.
163
Appendicits longer than 5 ays is likely
abscess
164
Treatment of neonatal gonococcal conjunctivitis? chlamydial?
IM ceftriaxone- G | oral macrolide- C
165
Penile fracture is rupture of what structure? | Whats the first step?
corpus cavernosum | do retrograde urethrogram --> surgery
166
Histoplasma treatment
mild- itraconazole | widespread- amphotericin
167
Central cord syndrome is what deficit types
classic: pain and temp | but can also apparently be weakness
168
fluctuance is basically another word for
abscess
169
AVF (cranial) sx in the elderly is
amyloid
170
Carcinoid tumors cause what deficiency
niacin
171
whistling following rhinoplasty is
septal perforation
172
Postpartum bleeding + pulmonary infiltrates is?
chorio
173
Cholecystitis with stone at duct needs ____ cholecystitis without obstruction needs ____ biliary colic needs _____
with stone- ERCP without- chole within 72 hours colic- elective chole
174
Child with unilateral lymphadenitis has
staph aureus
175
Elderly man with irritative voiding --PSA -- infxn: | ddx
chronic prostatitis- back pain | BPH- no back pain
176
Unstable aortic dissection gets
TEE
177
Acute agitation in dementia treatment
antipsychotics
178
Normal T4/TSH but change in T3 is
euthyroid sick syndrome
179
Lymphatic obstruction should have
thick/rigid skin
180
Amio ADRs
``` -ocular blue skin neuropathy pulm fibrosis thyroid hyper or hypo brady or QT long liver disease ``` (all organ systems)
181
1st line treatment for HE
lactulose
182
MCC orbital cellulitis
bacterial sinusitis
183
Recurrent hemarthrosis leads to
hemosiderin deposition/fibrosis/chronic pain
184
Microcytic anemia + GI sx + neuropsych sx + uric acid =
lead tox
185
Recurrent diffuse molluscum test for
HIV
186
Clotting in lupus is caused by
APL sx
187
Strongest stroke risk is
HTN
188
CDH first steps
intubate + gastric tube
189
Papullary thyroid cancer spread? Follicular?
Papillary is lymph | Follicular is blood
190
Amenorrhea in athletes stems from
hypothalamus | GnRH low
191
MC ADR assc with SERMS
hot flashes
192
How to treat uric acid stones
alkalinize urine with Pot citrate
193
Liver cyst + calcification + dogs =? treatment?
echinococcus | surg + albendazole
194
Capillary lead test is positive next step
confirm with venous & treat at 50+
195
Compensation in met acidosis?
Co2= 1.5(bicarb) + 8 +/-2
196
Compensation in met alk
1 bicarb = 0.7 Co2
197
Resp acid compensation
10 CO2 = 1 bicarb
198
Resp alkalosis compensation
10 CO2 = 2 bicarb | alkalosis compensation stronger
199
Which anti diabetic causes weight loss? weight gain?
weight loss- GLP1 (glutide) | gain- sulfonylurea, TZDs
200
Treatment of malignant otitis
IV Cipro
201
Treament of asx endometriosis
don't
202
Attributable risk formula
RR-1/RR
203
Painless bloody stool, eczema, regurg=
milk protein enterocolitis
204
Neonatal dx: respiratory distress low glucose high Hct
polycythemia vera | assc with delayed clamping and hypoxia
205
Inspiratory stridor that is worse when supine:
laryngomalacia (collapse of supraglottic structure) *self resolves
206
Solitary painful bone lesion with high Ca assume
malignancy
207
Always treat AOM under what age?
2
208
Cause of sudden death right after intubation
drop in rvp
209
succinylcholine MC ADR
K+ high --> arrhythmia
210
Halothane MC ADR
hepatotoxicity
211
Etomidate MC ADR
inhibits 11B hydroxylase (adrenal insufficiency)
212
NO MC ADR
inhibits B12 and methionine synthase --> neurotoxic
213
Growth at 12 months should be?
weight x3 and height up 50%
214
No fetal heart tones next step
must confirm with transabdominal US
215
Appropraite workup for IUFD
autopsy karyotype placental eval maternal clotting eval
216
Treatment of LOCALZIED lyme in pregnancy
amoxicillin
217
Two year old appropriate speech
50+ words | two word phrases
218
Valgus stress tests
MCL
219
How does ZES lead to diarrhea?
acid inactivates lipase
220
Lynch cancers
colon endometrial ovary
221
FAP cancers
colon brain soft tissue
222
VHL cancers
clear cell renal hemangioblastoma pheos
223
MEN2A cancers
pheo para medullary
224
MEN2B masses
medullary pheo marfan habitus neurofibromas
225
Lynch px screening
annual endometrial bx or hysterectomy
226
Papillary cancer cells + treatment
orphan annie, surg --> RAI
227
Reyes histo
microvesicular fatty infiltration
228
Toxo methods of acquiring
cat shit | undercooked meat
229
Only measure that is increased in hypovolemic shock
SVR
230
Prader willi is loss of ______ 15q11-q13
paternal
231
Mongolian spots what to do
not shit. they'll go away. leave that shit alone. let the little babies eat their rice.
232
Acute rejection treatment
steroids.
233
Lacunar stroke: presentation cause histo
pure motor lipohyalinosis HTN
234
When to give rhogam
28 wks | exposure to fetal blood
235
Treatment of postpartum psychosis
hospital | antipsychotics
236
Hydrocele in neonate management
surg at 1 year but usually resolves
237
Clue to AD complications
clear lungs: tamponade | crackles: AR
238
How to distinguish tinea from vitiligo
tinea: chest, back, some color vitiligo: face/distal, complete loss of color
239
Inferior MI means patient may also have ____
RVI
240
``` 95% = within ____SDs 99.7= within ______SDs 68% = within _____ SDs ```
95-2 99-3 68-1
241
Dig arrhythmia
atrial tach with AV block
242
Baldness + skin findings = _____ Deficiency
zinc
243
Skin depigmentation sideroblastic anemia = _____ Deficiency
Cu
244
If you need to workup any pulm nodule you need to start with ___
CT
245
Loss to follow up is what bias type?
attrition --> selection
246
Reporting bias description
patient doesn't report exposure due to fear of stigma
247
Normal liver span?
less than 12
248
McCune Albright constellation + cause
puberty early pigmentation polyostotic fibrous dysplasia cAMP kinase g protein defect
249
PCOS infertility cause
failed follicular maturation
250
SCID infection types
viral + fungal + bacterial
251
RUL lesion? RLL lesion?
UL- TB | LL-Aspiration
252
LDL needs to be increased to start statin: T or F?
F | just need risk factors
253
MC complication Ank Spon
anterior uveitis
254
RA eye complication
episcleritis
255
Urine pH higher than 8 = what infections
klebsiella | proteus
256
Which trisomy is associated with midline defects? give some examples?
13 holoprosencephaly omphalocele cutis aplasia
257
GFR, BUN, Cr, urine protein in pregnancy
low BUN/Cr high GFR high urine protein
258
Hgb, plts, fibrinogen, protein C in pregnancy
low hgb, plts, protein C | high fibrinogen
259
Contrast intellectualization and rationalization
intellectualization: turning something hard into just an intellectual puzzle rationalization: making excuses for bad behavior
260
Cause of RUQ pain in HELLP
distention of glissons capsule
261
MCC SCD post infarction
re-reentrant vtach arrhythmia
262
MCC hypercoag with NORMAL labs
factor V leidein (protein C resistance)
263
Lab abnormality in APL
^PTT
264
Antithrombin deficiency causes
DIC, cirrhosis, nephrosis
265
MCC nepgrosis in hodgkins
minimal change
266
Mechanism of vagal maneuvers to stop PSVT/ANRT
increased parasympathetic tone, stops AV node
267
When and how to work up first UTI in peds
if under age of two, or recurrent | do first RUS --> VCUG
268
Post MI acute limb ischemia: check for?
LV thrombus (do echo)
269
How to treat post ictal lactic acidosis
don't, itll go away on its own soon
270
Fall with object in mouth -
traumatic carotid injury
271
SCA hip issue
avascular necrosis
272
Mom holding baby gets what hand/wrist issue?
de quervains tendonitis | pain at side of wrist
273
Turners karyotype
45 XO
274
Klinefelters karyotype
47 XXY
275
Myelodysplastic syndrome labs
pancytopenia
276
How to distinguish adenomyosis from endometriosis
adeno should = tender UTERUS and HMB
277
Botulism clinical presentation + tx
descending paralysis (opposite GBS) bilateral cranial neuropathies equine antitoxin
278
NNT equation
1/ARR
279
When to workup delayed menarche
14 with no characteristics | 16 if has secondary sex characteristics
280
How to deal with acute pulm hemorrhage
bleeding lung down and bronch
281
Meningitis management
focal deficits need CT otherwise: | LP --> abx
282
Targets for gestational DM
keep postprandial under 140 | keep fasting under 95
283
Causes of ascending aortic aneurysm? descending? | dissection?
ascending- CMN/CT disorder descending- atherosclerosis dissection- HTN
284
Eye thing in rubella? toxo?
rubella- cataracts | toxo- chorioretinitis
285
FOOSH risk for?
rotator cuff tear
286
Pulsus bisiferens causes
AR PDA HOCM
287
Expressive aphasia lesion
Brocas, frontal
288
How to treat pulm HTN
idiopathic- endothelin, PDEi, prostanoids | 2/2 LV dysfxn- loop or ace
289
Assymetric corneal light reflex =
strabismus patch the normal eye
290
Uterine inversion first step
manual replacement
291
Systemic sclerosis abs
scl/ topoisomerase
292
RA ab
anti citrullinated peptide
293
Retropharyngeal abscess is a risk for
acute necrotizing mediastinitis
294
Valproate must monitor
LFTs and platelets
295
Poor kidney function prevents use of what mood stabilizer
Depakote
296
Prevent worsening diabetic nephropathy by decreasing _____
BP
297
Sensitivity and Specificity equations
Sensitivity: TP/ TP+ FN Specificity: TN/ TN+ FP
298
Crepitus between 3rd and 4th toes is
mortons neuroma (conservative treatment)
299
Treatment of Dresslers
NSAIDs
300
Buproprion helps with? Buspirone?
Buproprion- smoking | Buspirone- anxiety
301
HTN increases risk of?
Preterm labor but not PPROM
302
Menopausul GU constellation + treatment
stress and urge incontinence recurrent UTIs vaginal estrogen
303
Bacterial meningitis + immunocompromised =
vac, amp, cefepime
304
Treatment of penetrating trauma to the skull
vanc and meropenem
305
Swllowed battery when to intervene
in esophagus gotta get out
306
HTN & bilateral palpable kidneys =
ADPKD
307
Rapidly fatal neuro disease with brain scarring and atrophy
SSPE
308
Multiple nonenhancing lesions on brain =
PML
309
Posterior arm dislocation position
internal rotation
310
Origin of afib location
pulmonary veins
311
Origin of aflutter
tricuspid annulus
312
Goal of O2 in advanced COPD
90-93%
313
Intracerebral hemorrhage + patient on Coumadin what to do?
Prothrombin complex & K
314
Persistent productive cough linear atelectasis blood tinged sputum dx
bronchiectasis
315
Herpangina (coxsackie) vs Herpetic Gingivostomatitis
Herp (cox)= posterior, gray | HSV- anterior, clusters, on gingiva
316
Dx & tx of lichen sclerosis
bx of vulva | treat with steroids
317
NF1 is chromosome ___ and called _____.
17; von Recklinghausen
318
NF2 is chromosome ____ and has bilateral ______ and ______ on skin.
22; bilateral acoustic neuromas; café au lait
319
Tuberous Sclerosis tumors + skin findings
cardiac/renal tumors; seizures; ash leaf spots
320
face and arm swelling = _______ caused by ____ or ____.
SVC syndrome caused by NHL or small cell cancers most commonly
321
GVHD cells implicated
donor T cells
322
Bullous impetigo =
staph aureus
323
Nocardia! That _____ ____ _____ needs to get ____!
acid fast aerobe needs to get BACK(trim)
324
Finger movement and rhomberg test ______. | Pronator drift is a sign of ______.
Finger/rhombeg- proprioception | pronator drift- pyramidal tract disease
325
Middle mediastinum masses
lymphoma | bronchogenic cyst
326
Neutropenia Arthritis Spenomegaly Ulcerating skin lesions ===
Felty
327
How to protect lung when on vent
lower TV to prevent alveolar distention | SpO2 above 88
328
A1AT biopsy findings
PAS+ globules
329
Mallory Bodies assc
Wilsons or Alcoholic
330
Granulosa Cell Tumor = need
endometrial bx
331
Lithium + NSAID =
decreased renal clearance and high risk for lithium toxicity
332
Vaccine refusal management
discuss and document
333
How does ABO disease come about
Mom type O | Baby type A or B
334
Dysgerminoma= elevated
HCG or LDH
335
Chronic MR echo finding? | Acute?
Chronic LAE | Acute high LA/LV filling pressures = acute pulm Edema
336
Gum hypertrophy and hirsutism are seen with what immunosupressant
cyclosporine
337
When giving EPO you must also give
iron
338
ACE mechanism is ____cellular and Statins are ___cellular
ACE- extra | Statins- intra
339
Thalassemias smear finding
microcytic | targets
340
Dietary recommendations for stones
increased fluids | low salt
341
Achalasia in pt greater than 60 precaution
do scope, rule out cancer
342
Management of atypical glandular cells
colposcopy endometrial bx endocervical curettage
343
normal pupil size
2-5mm
344
Treatment of acute mania
antipsychotics
345
Hemolytic anemia, jaundice, pigmented gallstones, European =
Hereditary spherocytosis
346
How to dx acute appendicitis in pregnancy
US not CT
347
NAFLD pathogenesis
insulin resistance --> increased lipolysis --> FFA build up in liver. Gluconeogenesis is increased
348
Rules for sunscreen
50 is max benefit | apply 15-30 mins before exposure
349
EPO most common ADRs
worsening HTN, HA
350
Spared eye (noninjured eye) disease
sympathetic ophtalmia = recognition of hidden antigens
351
MCC death in dialysis patients
CV disease
352
New preferred agents over warfarin for DVT
Xa inhibitors
353
When Makenzie filled out jennas food log there was _____
hawthorne effect
354
Treatment of diverticulitis with abscess
CT guided perc drainage
355
Nasal discharge + anosmia =
polyp
356
First trimester noninvasive testing is
cell free fetal DNA
357
Three meds to hold during stress test
BB, CCB, Nitrates
358
Negative RPR but clinical picture suggests syph what to do?
empirically treat
359
Alternatives to heparin in HIT
agatroban, fonduparinux
360
FTT, jaundice, cataracts in babe is suggestive of
galactosemia
361
Mumps two most common complications
meningitis orchitis MOP (men, orch, parotitis)
362
Enterotoxin is ingested to cause food poisoning with what two bugs?
staph | b cereus
363
Toxin is made in gut for what three organisms
clostridium vibrio ETEC
364
Which four bugs cause invasive diarrhea
listeria salmonella Yersinia campy
365
Periventricular enhancement =
CMV
366
Subacute meningitis, papilledema, AIDS =
crypto
367
HSV should have ____ on MRI
temporal lobe involvement
368
Where is chloroquine an okay malaria px
central America and the caribbean
369
When to add primaquine to treatment
vivax
370
MCC symmetric IUFGR
chromosomal abnl
371
Thyroid storm can be triggered by ____ In ____
stressful situations | undiagnosed patients
372
Hypomania patient should be able to keep ____
working
373
Globular mass below umbilicus =
fibroid uterus
374
Isothenuria/nocturia is common in ____
SCA
375
Hydroxyurea dose limiting ADR
myelosupression
376
Oxytocin ADRs
tachysystole hypoTN hypoNa
377
Folate and B12 def both increase
homocysteine
378
Maternal weight loss = _____ ---> __& __
IUGR ---> Preterm, polycythemia
379
Absent philtrum is clue to ____
FAS
380
Causes of clubbing
R --> L shunts CF malignancy
381
Carpal tunnel best test
nerve conduction
382
Contact lens keratitis MC bug
pseudomonas
383
COPD flat diaphragm leads to
increased WOB
384
How does obesity increase endometrial cancer risk
increased peripheral conversion to estrogen
385
How to treat hypothermeria
Mild 90-95 passive external cooling (blankets) Mod 82-90 active external cooling severe under 82 active internal cooling
386
Endocarditis murmur should be at _____
apex or in IVDU RLSB
387
How does PNA cause hypoxia?
R --> L shunting --> VQ mismatch --> low O2
388
HTN young woman first step in treatment
stop OCP if taking any
389
MG crisis treatment
IVIG, steroids
390
Describe factorial design
2+ interventions with 2+ outcomes
391
Cross over study design
similar to clinical trial but swap intervention mid way through
392
Basic tests needed when diagnosing HTN
UA chem panel lipids EKG
393
Trachea/esophagus relationship
Trachea is anterior
394
Complications of nephrotic syndrome
clotting infection loss of D anemia
395
Thyroid adenoma two MC complications
tachyarrythmias bone loss! (no eye issues with adenoma)
396
How often to do colonoscopies in UC
q1-2
397
FAP colonoscopy guidelines
start at 10; do q1
398
Lynch/HNPCC colonoscopy guidelines
start at 20-25 do q1-2
399
How does breast feeding lead to amenorrhea?
PRL ----I GnRH
400
Schizophrenia MRI findings
enlargement of lateral ventricles | decreased hippocampal volume
401
Baby with accelerated head growth is clue to
autism
402
Abnormal orbitofrontal cortex/ basal ganglia is found in what psych disorder?
OCD
403
MCC folate def
alcohol
404
Thiazide lab changes
all electrolytes lost except ^ Ca | Increased gluc, LDL/TG, uric acid
405
Meningitis type with ^^^^ opening pressure
cryptococcal
406
TTP treatment
plasma exchange
407
Weak, cataracts, tiny testicles, bald = what is the dx/inheritance pattern?
Myotonic Dystrophy; AD
408
Duchenne & Becker inheritance pattern
XR
409
Fragile X inheritance pattern
XD
410
Acute liver failure with acetaminophen tox = need for ____
transplant! stat!
411
Arm drop test looks for
rotator cuff tear
412
Giardia treatment
metro
413
Travelers diarrhea treatment
Cipro
414
Renal failure + abdominal pain next step
place bladder catheter
415
Abdominal pain/ NV should clue you to rule out
atypical cardiac
416
Penetrating trauma + signs of peritonitis next step regardless of FAST
lap | do not do CT, do not do DPL, go straight to surgery
417
Contrast somatic symptom and panic
panic disorder comes and goes, somatic constant symptoms
418
Only indication for HRT
women under 60 with menopause within 10 years; vasomotor symptoms not improved with weight loss
419
Radio-opaque tablets in kid's stomach --> next step
deferoxamine
420
Toxic megacolon treatment
start with fluids, abx, steroids --> surgery if no improvement
421
Aside from PDA, what murmur may be continuous?
Aortic coarctation with collaterals through thorax | *May also have S4
422
Muscular Dystrophy gold standard in diagnosis
muscle biopsy
423
Chi squared measures what?
Proportions of categorized outcomes
424
T tests measure what?
Two means
425
ANOVA measures what?
Compares 3+ means
426
When to image UTI of any sort?
After 3 days no improvement on abx
427
HIT cause
antibodies to platelet components
428
Trisomy 18 cardiac defect
VSD
429
MCC zero puberty in female at 16+
Turners (low estrogen, increased FSH/LH)
430
Hx of rheumatic fever requires _____
continuous abx px | if valve disease they need at least to age 40 and at least 10 years
431
p value that is statistically significant
less than 0.05
432
Osteoblastic lesion =
prostate cancer
433
Cells that are PAS + and without granules
lymphoblasts
434
Stop mammos at what age?
75
435
SMH/WH symptoms
proximal muscle weakness lower more than upper
436
Essential tremor = ____ tremor
intention
437
MOA 13 valent vs 23 valent PNA Vax
13- T cell + B cell | 23- B cell only
438
1st step after pushing atropine in organophosphate poisoning
remove clothes
439
Normal post void volume
under 12
440
Dyschezia rules out _____
vaginismus
441
ASA exacerbated respiratory disease reaction type
non IgE
442
Dialted ventricles with diffuse hypokinesia is
dilated cardiomyopathy
443
Concentric vs Eccentric cardiac hypertrophy causes
concentric- pressure overload | eccentric- volume overload
444
Salvage therapy is given when?
when standard therapy fails
445
When is neoadjuvant/adjuvant therapy given?
neo before standard | adjuvant with standard
446
Treatment of AV Block/ meningitis in lyme disease- peds
IV rocephin
447
Acute angle closure glaucoma is an ADR of what drug class?
anticholinergics
448
Inpatient treatment of CAP
FQ or B lac + mac
449
Outpatient treatment of CAP
mac/doxy or FQ if sick/ recent abx
450
Treatment of decompensated heart failure
B agonist decreases LVESV (and also) LVEDV
451
How to distinguish cardiac and liver edema?
hepatojugular reflux + only in cardiac
452
Pain over tibial tubercle dx + xray findings
Osgood schlatter/ tibial apophysitis | xray shows lifting
453
Pain at inferior pole of knee =
patellar tendonitis
454
Horners and decreased gag reflex are seen in what brainstem stroke syndrome
laterally medullary (PICA/Vertebral)
455
Tongue parlysis is seen in what brainstem stroke syndrome?
Medial Medullary (Vertebral/ ASA)
456
Ipsilateral ataxia + nystagmus is caused by a stroke where?
cerebellum
457
JVP should be less than ___
8
458
Best way to reduce mortality in COPD
O2
459
Polymyositis abs
ANA JO
460
Why is HIT dangerous actually?
thrombogenic | arterial and venous clots
461
Gluconeogenic amino acids are transformed into
pyruvate --> G3P --> glucose
462
How long after pharyngitis until RF
2-4 weeks
463
How to distinguish between absence and focal seizures
absence lasts seconds and is provoked by hyperventilation
464
How to dx ectopic
have to do TVUS not transabdominal
465
Recurrent nosebleeds hemoptysis and oral lesions dx
hereditary telangiectasia, osler weber rendu (pulmonary AVMs)
466
Bicuspid aortic valve causes what type of aortic disease
AR or AS
467
Seborrheic dermatitis can be on scalp or ____
face
468
Nontender solitary node in neck is _____ until proven otherwise
squamous cell, biopsy and do panendoscopy
469
How long of poor nutrition until person becomes vitamin K deficienct
1 week
470
Melanosis coli is seen in what condition
laxative abuse
471
WPW arrhythmia DOC
procainamide | avoid: CCB, dig, adenosine
472
Reptile scale skin is called? | How to treat?
ichthyosis vulgaris | use emollients, keratlytics, retinoin
473
How to treat overflow (constant dribbling) incontinence
cholinergics (bethanechol) & Cath
474
Acute PCP treatment
steroids + Bactrim or pentamidine
475
PCP and CMV PNA appearance
patchy/diffuse
476
Bilateral trigeminal neuralgia is ____
MS
477
Measles mechanism of spread
airborne
478
Airway support for COPDE
first try NPPV
479
PACs lifestyle modification
no cigarettes or beer
480
Cross sectional study measures ____ and cohort study measures _____
cross sectional - prevalence | cohort - incidence; relative risk
481
Common injury in peds BAT
duodenal hematoma
482
Lab changes with Bactrim
increased Cr and K
483
Insulin effect on K+
Drives into cells
484
B agonist effect
Drives K+ into cells
485
BBer effect on cells
Drive K+ out of cells
486
Prednisone effect on K+
= mineralocorticoid --> increased excretion
487
Neurocysticercosis bug
taenia solium
488
Hemihypertrophy, macroglossia, umbilical hernia = ? | Pt needs what screening?
Beckwidth Wiedmin | US/AFP q3 months
489
Bilateral periorbital cellulitis is ?
cavernous sinus thrombosis
490
MC location hypertensive hemorrhagic stroke
putamen
491
Treatment for bone pain in prostate cancer
radiation
492
Labs in splenic sequestration
low RBC and platelets but high retics
493
Miscarriage and patient is positive for VDRL --> think of
APL sx
494
Management of peds vaginal foreign body
remove and irrigate
495
DM type 1 and vesicular rash =
celiacs
496
How to dx hyperemesis gravidarum
confirm with ketones
497
How to distinguish between rotator cuff tear and adhesive capsulitis
adhesive- decreased passive and active ROM | tear- decreased active ROM only
498
4 markers of lactose intolerance
+hydrogen breath acidic stool high stool osmol gap + stool reducing substances
499
Vasovagal syncope management
teach counterpressure maneuvers
500
How to treat antipsychotic parkinsonism
decrease dose or add amantadine/ benztropine
501
Hydrozychloroquine requires what monitoring
regular eye exams
502
Homocystinuria: cause stone shape test
poor renal COLA transport hexagonal +cyanide nitroprusside test
503
How to distinguish IDA from thal
thal has normal RDW/RBC count
504
B thal has increased hb___
A2
505
Penetrating wound with absent distal pulses next step
go to OR
506
Gallstone ileus exam finding
absent bowel sounds
507
Widened prevertebral space is clue to
retropharyngeal abscess
508
Treatment of social anxiety disorder
SSRI
509
RAI and IBD both predispose to
amyloidosis
510
Hyalinosis is seen in what renal disease
diabetic nephropathy
511
Randomization controls for
confounders
512
Trisomy 18 finding on triple screen
normal inhibin rest low
513
How are TP/FP on ROC curve related to sensitivity and specificity
1-FP= specificity | TP ~sensitivity
514
Child with PCP And lymphadenopathy has
AIDS not CF or SCID
515
Drugs that increase warfarin activitiy
``` NSAIDs/ Tylenol abx amio cimetidine and omeprazole SSRIs ```
516
Drugs that decrease warfarin activity
phenobarb/phenytoin/carbamazepine ginseng and st johns wart rifampin
517
BPPV cause
canaliths in semicircular canal
518
How to distinguish lipoma and epidermal inclusion cyst
lipomas do not regress and reoccur
519
Treatment for hypercalcemia of malignancy
bisphosphonates
520
Obesity is the cause of amenorrhea when ____
LH/FSH
521
When to give Tamiflu
less than 48 hours from onset | above 65 and chronic med patient
522
Agitation and lower abdominal pain post op next step
do bladder us to check for AUR
523
Scoliosis + joint laxity =
ehlers danlos
524
joint laxity, clots, lens dislocation=
homocystinuria
525
Corneal dystrophy, renal failure, clots, neuropathy=
Fabrys (a glucosidase)
526
Stable patient with pericardial effusion next stap
do angio to r/o AD before doing pericardiocentesis
527
Cords on histology is a buzzword for what cancer? palisading
cords- scc | palisading- bcc
528
Timing of bowel perf 2/2 BAT
several days after
529
AIS when to do gonadectomy
afer puberty
530
Atopic dermatitis spares
genitals and groin
531
Cold dying limb from AE next step
heparin before any testing
532
Comedonal acne treatment
retinoid and topical acid
533
inflammatory acne treatment
start with comedonal treatment --> add topical abx --> add oral abx
534
Nodular/cystic acne treatment
start with topical retinoid, acid, and abx add oral abx add oral retinoin
535
Acne pathogenesis
increased sebum and hyperkeratinzation inflammation p acne
536
What rules out exogenous insulin as cause of hypoglycemia
elevated C peptide
537
MC stone type
calcium oxalate
538
Pedunculated red bleeding mass is
pyogenic granuloma
539
Dermatofibroma clue
central area dimples when pinched
540
DM neuropathy small vs large fiber
small- pain + symptoms | large- numbness - symptoms
541
legionella treatment
mac or fq
542
circulating hormone level=
total
543
MC location bowel ischemia
splenic flexure
544
Focal spinal tenderness treat as _____
osteo
545
Abscesses with ^^^^^^ leukocytes=
LAD
546
Catalase + bugs and lab findings in CGD
serratia staph burkholderia labs are normal
547
Papillary rupture presentation | Ventricular aneurysm presentation
rupture- acute MR within the first week | aneurysym- persistent STE several weeks after MI
548
Lab clue to MAC infection
high alk phos
549
Wiskott Aldrich inheritance/ cause
XR, cytoskeleton abnormality
550
Alcoholic cerebellar degeneration presentation
truncal ataxia but normal limb coordination (weird heel chin but normal finger nose) *Finger-nose abnormal in B12
551
Low albumin causes ____ ____.
low calcium
552
Immobilization raises
Ca
553
When to bx in abnormal uterine bleeding
above 45 or obese
554
What lung path has increased breath sounds/ egophony?
consolidation, all others decreased
555
When is tactile fremitus increased?
consolidation | fremitus ~breath sounds
556
In lacunar stroke- which is effected more: arm or leg?
equal
557
Clues to SCC
parasthesias | immunosuppressed
558
Sheehan path
ischemic necrosis
559
AML cell type
myeloblasts, acute symptoms
560
CML LAP score and cell type
low LAP score; myelocytes
561
Leukemoid reaction cell types
metamyelocytes; high LAP score
562
Drug induced acne appearance
monomorphic papules on arms/upper back | common with steroids
563
Clue to conus medullaris
``` UMN signs, symmetric cauda equine (spinal nerve roots)= LMN ```
564
SSRI sodium disorder
SIADH
565
Clobetasol treats what skin disorder?
bullous pemphigoid
566
Infection that mimics sarcoidosis
histoplasma
567
Labs in JIA
increased ESR/CRP/ferritin increased platelets, Igs anemic
568
Aminoglycosides most common tox
hearing and vestibulopathy
569
NRDS two most common risks
prematurity | maternal DM
570
Osteonecrosis xray findings
normal often
571
When to give Td in adults
must confirm at least one TDaP can do Td after than q10
572
If bilirubin is in urine it is ____
conjugated
573
Craniophrayngioma presents with what systemic signs
pituitary deficiencies
574
Confounding means the risk has ____ effect on disease.
Confounder- truly no effect Effect mod means the risk has effect on disease only when combined with a second risk factor (compounds)
575
Obstruction, air in small bowel and liver, no air in colon: dx
gallstone ileus | clues: no surgeries, gas in biliary tree
576
"To and fro" murmur at Left ICS with bounding pulses=
PDA
577
Cause of bruit in atherosclerosis
lipid accumulation, intimal thickening
578
Peritoneal dialysis is risk for what infection
SBP
579
Cause of RLL infiltrate in alzheimers
aspiration; decreased gag reflex
580
In addition to nystagmus, what are clues to PCP intox
catatonic/coma; violent
581
Jaundiced patient with dilation of biliary ducts needs:
ERCP
582
Criteria for intubation
RR above 35 | acidic
583
Clearance for exercise includes
stress test
584
Tip of thumb innervation
median nerve
585
Sudden severe back pain=
compression fracture
586
Rectal fissure treatment
anesthetics and stool softeners --> LIS those fail
587
First step testicular torsion
dx by H&P then straight to surgery, no need for Doppler if its obvious
588
Kidney stone- pain stops: assume?
stone is passed
589
How is staph spread at picnics
poor refrigeration
590
Anorexia with amenorrhea= risk of
osteoporosis
591
Low K+ EKG findings
PVCs, flat T waves, ST depression
592
Encapsulated bacteria assc with what deficiency?
B cell
593
Post Op Aortic Coarctation BP maintenance
should be below 60 by managing pain
594
Best way to prevent aspiration
elevate head of bed
595
Eczema like rash effect only this nipple is
pagets
596
Green discharge from nipple is
ductal ectasia
597
draining abscess at nipple is
lactiferous fistula
598
Achalsia pathogenesis
increased LES done and decreased peristalsis
599
How do ACEi effect renal flow?
decreased GFR by constricting efferent arterioles
600
Enzymes take how long to rise in MI?
as many as 6 so don't assume normal enzymes= no heart attack
601
Wide complex v tach may look similar to:
diffuse ST elevation
602
Weakness in legs and bladder issues at time of birth is
spinal dysraphism
603
TOA is ruled out how
U/S
604
Lung cancer can cause what symptoms regardless of type
arthralgias | neuropathies
605
Urine sodium above ____ is high.
40
606
SIADH sodium is?
high because all fluid is retained
607
Treatment of patient with both orthostatic hypotension and BPH
finasteride not alpa agonist
608
Patient with gurgling sounds... what should you do?
get an airway. duh.
609
Painful post void dribbling is?
urethral diverticulum
610
ANA in JIA?
negative
611
Acute lupus flare lab changes
decreased complement increased abs
612
Sodium disorder common following head trauma
SIADH
613
cohort vs case control study what is measures
cohort- rr | case control- or
614
Odds ratio equation/ how to derive
use chart but instead of test result put intervention/risk for vertical column (a/c)/(b/d)
615
Relative Risk requation
use chart --> (a/a+b)/ (c/c+d) | relative risk ~PPV/NPV
616
Attributable risk equation
(a/a+b) - (c/c+d) | relative risk but subtract instead of dividing
617
RRR equation
1-RR
618
ARR equation
(c/c+d)- (a/a+b)
619
NNT equation n
1/ARR
620
NNH equation
1/AR
621
Type 1 error
false positive
622
Type 2 error
false negative | increase power and decrease the risk of this error type by increasing sample size
623
Vaccine given at birth
Hep B
624
Vaccines given at 2 months
DR HIP + Hep B | DTaP, Rota, Hib, IPV, PCV13
625
Vaccines given at 4 months
DR HIP
626
Vaccines given at 6 months
DIP + flu PRN, 2 doses first season
627
12-15 month vaccines
``` MMRV DTaP Hep A (x2) PCV13 Hib ```
628
4-5 year vaccines
DIM DTaP IPV MMRV
629
11-12 year vaccines
meningococcal TDaP start HPV series
630
16 year old vaccines
meningococcal
631
Age to give zostavax
60, 1 dose
632
HR change in all forms of shock
increased
633
Which shock type has increased CO
septic
634
Cardiac shock parameters
everything but CO increased
635
Neurogenic shock parameters
everything but HR is decreased
636
SVR is increased in what forms of shock?
cardiac and hypovolemic
637
Symptomatic evidence of increased SVR
pale and cool skin
638
HAP treatment
Must cover for pseudomonas | zosyn, carbapenem, or cefepime/ceftaz
639
VAP treatment
THREE AGENTS - antipseudomonal from HAP - FQ or AG (AP) - Linezolid or Vanc (AS)
640
Scaling lips/fissures and corneal vascularization = _____ deficiency
B2/ riboflavin
641
rash, baldness, and adrenal insufficiency = ____ deficiency
B5/ pantothenic acid
642
How can you become biotin (B7) deficient?
antibiotics, excess raw eggs
643
Neuropathy + sideroblastic anemia = _____ deficiency
B6 (pyridoxine)
644
Hemolytic anemia, weakness, spinocerebellar demyelination= ____ defi
vitamin E
645
When should baby start saying "mama" "dada" etc?
9 months | it takes nine months to become a mama
646
When should baby sit/roll/crawl/walk
sit unsupported and roll ~ 6 months crawl by 9 months walk by 12-14 months
647
Stranger anxiety when? | Separation anxiety when?
Stranger- about 6 months | Separation- one year
648
Words at one year?
about ten
649
When should kid use complete sentences and understand most basic vocabulary?
age 3
650
When does intentional smiling start?
2 months
651
How many blocks should kid stack?
age in years x 3
652
When do kids start group playing instead of parallel playing?
3
653
Sideroblastic anemia: macro or microcytic? causes? stain?
can be either alcohol, lead, INH, B6 Prussian blue
654
Only form of microcytic anemia with elevated circulating iron?
sideroblastic
655
HbF is increased in what form of microcytic anemia
B thal minor
656
What form of thalassemia has high reticulocytes?
three gene deletion a thal
657
Like hemolytic anemia, B12/folate def high high ____ & ____.
LDH and indirect billi
658
In addition to dietary/ alcohol causes what can cause B12 def (2)
pancreatic def | pernicious anemia
659
Sickle Cell mutation
B6 valine --> glutamic acid
660
Abx to be used in sickle crisis with high fever/ white count
rocephin or FQ
661
Three prophylactic needs in sickle cell
hydroxyurea folate pneumovax
662
Recurrent hemolysis + splenomegaly + family history=? | dx?
HS; osmotic fragility | put in hypotonic solution
663
Causes of warm AIHA
CLL; lymphoma; SLE; drugs
664
Exchange transfusion is used when in SCA?
ACS priapism stroke retinal infarct
665
Smear in AIHA ?
NO fragmented cells because hemolysis is extravascular
666
Causes of cold AIHA
Mycoplasma EBV Waldenstroms
667
Warm Agglutinin treatment? | Cold?
warm- steroids --> splenectomy | cold- rituximab --> plasmapheresis (NOT steroids)
668
Cause of TTP/ HUS
ADAMSTS 13 Def
669
Labs assc with HUS/TTP
normal PT/PTT/Coombs | low platelets, renal insufficiency, intravascular hemolysis
670
Episodic dark urine + pancytopenia + clots in weird places = ? dx? tx?
PNH dx with flow cytometry | treatment is steroids
671
``` Splenomegaly Bleeding Thrombosis All cell lines up Pruritis after warm shower ``` dx? tx?
Poly Vera | Phlebotomy and ASA --> hydroxyurea or allopurinol
672
Pancytopenia + dry tap + tear drop cells = ? | treatment?
myelofibrosis | ruxolinitib (rux)
673
Why are Auer Rods a big deal?
DIC risk
674
ALL gets ____ _____
intrathecal MTX
675
Ringed sideroblasts pancytopenia hypercellular marrow=
Myelodysplastic syndrome | leukemic precursor
676
Abnormality assc with Myelodysplastic syndrome
5q deletion
677
Bilobed nucleus cell is called? Assc with what d/o?
Pegler Huet | Myelodysplastic
678
CLL special cell type"?
smudge cell
679
Treatment CLL
chlorambucil simple --> cyclophospgamide refractory
680
CML treatment?
TKI--> BMT
681
Treatment of Hairy Cell
cladribine or pentostatin
682
CBC in NHL? | Best initial test?
normal | do excisional bx
683
Treatment of NHL?
``` CHOP cyclophosphamide hydroxydaunorubicin oncovin (vincristine) prednisone ``` cyclo dauno vinc prednisone CHOP OUT LYMPHOMA
684
Staging of NHL
I- one group 2- two groups 3- two sides diaphragm 4- widespread
685
Treatment of HL
ABVD A for Aunt Cindy Adriamycin Bleomycin Vinblastine Dacarbazine
686
When should pt be screened for breast cancer after HL radiation?
within 8 years
687
First test in MM
xray
688
What distinguishes MGUS from MM?
normal BMBx
689
What distinguishes Waldenstroms from MM?
Waldenstroms is IgM | MM is IgA/G
690
Only cause of clotting with high PTT?
APL syndrome
691
Wright and Hansel stains detect _______ which is seen in _____
eosinophilia acute interstitial nephritis *No eos in NSAID induced disease
692
Dysmorphic red cells in urine =
glomerulonephritis
693
Hyaline casts are caused by?
dehydration | Tamm Horsfall protein
694
NSAIDs constrict the _____ while ACEi dilate the ____
NSAIDs constrict afferent arterioles | ACEi dilate efferent
695
Post renal BUN:Cr
greater than 20:1 same as pre-renal
696
FeNa/UNa in Pre/Post renal AKI
FeNa less than 1 UNa less than 20 because decreased perfusion increases ADH
697
FeNa/UNa in ATN?
Isothenuria. Kidneys done broke.
698
In pre-renal azotemia urine osm should be?
greater than 500 (this is considered concentrated)
699
How long for a drug to cause renal tox ?
5-10 days. | don't answer drug induced AKI on same day drug is started
700
Treatment of rhabdoy
fluids mannitol bicarb
701
Hepatorenal syndrome labs match? | Treatment?
match pre-renal | treatment is octreotide/ midodrine
702
Labs assc with atheroemboli
eos | low complement
703
Grossly visible necrotic material is? | Next step in dx?
renal papillary necrosis | CT scan
704
Alport cause
type IV collagen
705
PAN spares? It is assc with?
the lung; Hep B
706
DI sodium level? | SIADH sodium level?
DI high sodium (water loss) | SIADH low sodium (water retention)
707
Psychogenic polydipsia sodium levels?
high
708
Best initial test in hypernatremia?
Water deprivation test --> ADH administration
709
What are the three types of RTAs?
Type 1- distal Type 2- proximal Type 4- Hyporenin
710
Which type of RTA is assc with stones?
Type 2
711
What is the cause of type 1/distal RTA?
Tubule cant generate bicarb means acid cant be put into tubule means high urine pH above 5.5
712
What is the cause of type 2/proximal RTA?
prevents bicarb from being reabsorbed
713
Treatment types 1,2,4 RTA
Type 1-distal- bicarb Type 2- proximal- thiazide Type 4- steroids
714
Urge incontinence treatment
oxybutynin | tolterodine
715
Little boy with absent tonsil/lymph nodes and frequent sinopulmonary infections think?
Brutons

Step 2 CK (8 decks)

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