UWorld Pass 2b Flashcards
(500 cards)
1
Q
Hypercalcemia in sarcoidosis, how?
A
1-alpha hydroxylase is produced in granulomatous activity -> increased 1.25-dihydroxyvitamin D
2
Q
Tacrolimus side effects?
A
neurotoxicity, glucose intolerance,diarrhea
3
Q
Treatment for pseudomonas?
A
gluoroquinolone
4
Q
Causes of ACL injury? Signs?
A
Rapid deceleration, direction changes
Signs: “popping” sensation, significant swelling (effusion/hemarthrosis), joint instability
5
Q
Primary biliary cholengitis- clinical findings?
A
fatigue, hepatomegaly, pruritis, icterus
6
Q
Drugs that can cause pill esophagitis?
A
KCL, tetracyclines, bisphosphonates, NSAIDs
7
Q
First step in anticoagulation with renal failure?
A
unfracitonalized herparin
8
Q
Liver mass with central scar?
A
gocal nodular hyperplasia
9
Q
Most common physical symptoms from pancoast tumor?
A
Shoulder pain
10
Q
Diagnostic requirements for nacrolepsy
A
recurrent lapses in sleep or naps (3x/week for 3 months
plus 1 of the following:
- cataplexy (brief loss of muscle tone precipitated by strong emotion)
- low cerebrospinal fluid levels of hypocreit-1, shortened REM sleep latency
11
Q
Thromboangitis obliterans Signs? AKA? Evaluation? Treatment:
A
AKA: buerger disease
Less than 45, smoking history, distal lumb ischemia, ulcerations due to nonatherosclerotic occlusion
Evaluation: ischemia on bascular studies (digital plethysmography), segmental occlusion of small and medium vessels on agiography
Treatment: smoking cessation
12
Q
MCL tear cause? Signs
A
Cause: pivoting/twisting, lateral impacts
Signs-minimal swelling
13
Q
Most common cause of spontaneous lobar hemorrhage over > 60?
A
amyloid angiopathy
14
Q
Progressive loss of peripheral vision? Treatment?
A
open-angle glaucoma
Treatment: Mannitol
15
Q
Abnormal thumbs, hypopigmented/hyperpigmented skin area, cafe au lait spots, middle ear abnormalities, aplastic anemia? Inheritance?
A
Ganconi anemia
Autosomal recessive or X-linked
16
Q
Cardiac temponade is
A
rapid accumulation of blood in the pericardial sack
17
Q
First step in management after exposure to infectious hep B?
A
Immunoglobulin and vaccinate
18
Q
Affects of beta HCG on homrone levels?
A
total T4 increased,
free T4, unchanged/mildly increased
TSH decreased
19
Q
Raynaud phenomenia- presentation
A
Bilateral upper hands
20
Q
Signs of thyroid lympgoma?
A
hashimoto thyroiditis, rapidly enlarging, firm guiter with compressive symptoms and systemic B symptoms
21
Q
Signs of secondary amyloidosis?
A
Extracellular deposits of polymeric protein, inflammatory arthritis, chronic infections, IBD, mmalignancy lymphona) vasculitis, aymptomatic proteinuria, nephrotic syndrome
22
Q
Abdomianl pain with hip extension, think?
A
Appendicitis, psoas sign
23
Q
Uncel herniation
A
dilation of the pupil ipsilateral, (oulomotor nerve compression) along with ipsilateral hemiparesis
24
Q
Diagnosis?
A
Allergic conjunctavitis
associated with pruritus, nasal symptoms, no skin rash, watery discharge, URI signs
25
Signs of lead poisoning?
basophilic stippling, neurological deficits (foot/wrist drop, congitive dysfunction), GI pain, constipation, joint pain, muscle aches, microcytic hypochromatic anemia
26
common variable immunodeficiency? Treatment?
Presents in adolescence/adulthood, low levels of immunoglobulins from abnormal B-cell differentiation. Increased risk for respiratory infections from encapsulated organisms, giarfia lamblia
Treatment: immuniglobulin infusion
27
Chorionic villus sampling use? Time?
Use: definitive karyotupic diagnosis
Time 10-13
28
distented bowel loop in an inverted "U" shape? Cause?
dilated colon
Cause: Sigmoid volvulus
29
Lower abdominal tenderness, right upper quadrant tenderness, intermentral spotting?
Pelvic inflammatory disease
30
Bleedng disorder in antiphospholipid syndrome?
Prolonger partial thromboplastin time, nut not prothrombin time
Prothrombin time in normal due to binding of the lupus anticoagulant in vitro
31
Primary ciliary dyskinesia vs CF?
PCD has situs inversus, due to immobile spermatozoa, normal growth
CF- pacnreatic insuffiency, infertility due to absent vas deferens, failure to thrive
32
Treatment for severe hypercalcemia?
Aggressive hydration with normal saline, calcitonin to reduce serum calcium
33
Amikacin
aminoglycoside 0\> can cause renal failure
34
Erysipelas? Diagnosis? Treatment?
Group A strep
infection of upper dermis and superfiscial lymphatic system
rapid development of symptoms due to inflammation, trauam, etc
rash is notable for raised, sharply demarcated borders
highly suggestive is involvement of outer ear
Diagnosis: blood cultures
Treatment: IB antibiotics (ceftriacone, cegazolin, amoxicillin (if not systemic)
35
Lorazapam vs chlordiazepoxide?
Chlordiazopoxide contraindivated in liver disease
Lorazapam-shorter acting, not metabolized by the liver
36
Mydruasus
Dilation of the pupil
37
chronic, watery diarrhea without eveidence of systemid symptoms and lactose deficiency? Signs? Pathology?
Microscopic colitis
Watery diarrhea, fecal urgency, incontinence, nocturnal diarrhea
Path: mononuclear infiltrate
38
What therapy can cause thickening and fibrosis of the pericardium?
Radiation therapy to the chest of rHodgkin lymphoma
39
Septic shock with elecated lvier enzymes?
Iscemic hepatic injury
40
Common causes of infective endocarditis?
Staphylococcal - healthcare-associated
stretococcal - community acquired
enterococci - nosocomial-acquired (Especially UTI)
41
Medications for colds that can cause hallucinations?
antihistamines
42
HIV patient with white matter lesions with no enhancement/edema? lumbar puncture findings? Treatment?
progressive multifocal leukoencephalopathy (JC virus)
LP: CSF PCR for JC virus
Treamtne: antiretroviral therapy
43
Cardiac manifestations of COPD?
4th heart sound
44
Contraindications to copper IUD?
anemia, heavy menstral bleeding
45
Ascertainment bias?
results from atypical population are extrapolated to the entire population
46
Treatment for heparin induced thrombocytopenia?
D/C heparin, anticoagulate with non heparin medication (argatroban, hondaparinux)
47
Signs of spontaneous bacterial peritonitis?
Temp \> 100, abdominal pain/tenderness, altered mental status, hypotension,paralytic ileus with severe infection
(no nausea/vomiting/etc)
48
Bicept tendor ruptor cause? signs?
Cause-forceful flexion of the arm
Signs: sudden pain with an audible pop and visiblee pulge, where the muscle retacts into the arm
49
shiny tongue and macrocytic anemia?
B12 deficiency
50
non-anion gap acidosis and preserved kidney function
rental tubular acidosisr
51
Signs of hip dysplasia?
Child was limp "trendelenburg gait" when learning to walk
52
soft, rounded, well-demarcated dwelling at the point of the elbow? ROM?
chronic olecranon bursitis, range of motion is normal
53
After starting amiodarone therapy, how long before pneumonitis can present?
Months
54
midline defects, polydactyly, curis aplasia?
Patau (trisomy 13)
55
Aflatoxin B1 association?
Hepatocellular carcinoma
56
X-rays in chronic gout?
punched-out erosions with an overhanging rim of cortical bone known as a "rat bite"
57
familial adenomatous polyposis
colorectal cancer, desmoids, osteomas, brain tumors
58
Congenital effect of carbomazepine? Treatment?
folic acid deficiency, supplement with 4mg of folic acid
59
Fever, chest pain, hemoptysis
pulmonary nodules with halo sign
in immunocompromised patient?
Invasive aspergillosis
60
Decrease active and passive ROM?
adhesive capsulitis
61
Signs of hemochromatosis?
diabetes, hyperpigmented skin (sun exposed), elevated liver enzymes
62
How to reduce risk of HIV infection?
Circumcision of the infection partner, postexposure prophylacis
63
Organism responsible for infections in deep puncture wounds? Time?
P. aeruginosa
64
Tinea cruris- sign? Diagnosis?
Sign: annular lesions with partial central clearing, scay raised border
Diagnosis: KOH prep with septated (segmented) hyphae
65
baby with irregular breathing at birth?
considere positive pressure ventilation
66
Babesiosis? Risks?
intraerythrocytic rings (maltese cross), glu-like symptoms, anemia, thrombocytopenia, NE US
Protozoal illness, Ixodes scapularis
Rosl? splenectomy
67
what is clobeasol?
high potency steroid
68
Papillary muscle rupture post MI?
2-7 days post
Acute, severe, MR (hypotension, pulmonary edema, cardiogenic shock), no persist ST changes
69
CNS findings in fetal alcohol syndrome?
ADHD, learning disabilities, mental retardation
70
Disultram candidate?
Abstinent and highly motivated
71
Ovarian torsion vs rupture, doppler?
Ovarian torsion-decreased
rupture-normal
72
Diagnosis?
Arthritis mutilans
73
Preferred deliver method in preeclampsia?
Vaginal delivery, c-sections reserved for failed induction, or nonreassuring fetal heart tones
74
What are the B vitamins?
B1- thiamine
B2 - riboflavin
B3 - niacin
B6 - pyridoxine
B9 - folate, folinic acid
B12 - cobalamin
C - ascorbic acid
75
Cause of ARDS?
lung injury -\> fluid/cytokine leakage into alveoli -\> impaired gas exchange -\> decreased lung compliance, PHTN
76
RBC casts?
glomerular nephritis
77
Theophylline? toxicity?
Theophylline-bronchodilator, used in asthma
Toxicity- CNS stomulation \*headahce, insomnia, seizures, HI) cardiac toxicity (arrhythmia)
78
Most common symptoms on bronchietasis?
mucopurulent sputum streaked with blood, fatigue, weight loss
79
Post-menopausal woman with new breast mass, first step? Signs of malignancy?
Mammorgram
Signs: calcification
80
Granulomatous inflammation in growth, think?
syphilis
81
CMV pneumonia
duspnea, nonproductive cough, low-grade feve, patchy or diffuse ground-glass opacities
82
Signs of lateral epicondylitis?
pain with resisted wrist extension, pain with passive wrist flexion
83
How often should infants be fed?
Every 2-3 hours
84
Cholangitis vs acalculous cholecystitis?
Cholangitis has juandice, caused by gallstone or malignancy, elevated alk phos
85
Wiskott-Aldrich syndrome
Eczema, micriThrombocytopenia, recurrent infections
X-linked recessive defect in WAS protein
86
What bilirubin is elevated in hemolytic diseases?
Unconjugated (indirect)
87
Sertonin syndrome vs TCA
Serotonin has increased bowel sounds, hperreflexia, clonus
88
Risk factors for necrotizing enterocolitis?
Prematurity, very low birth weigh, reduced mesenteric perfusion (congenital heart disease), enteral feeding (formula \> breast milk)
89
Location of damage in alcoholic cerebellar degeneration?
Cerebellar vermis
90
UMN signs and sisolated symmetric lower-extremity sumptoms
spinal cord compression
91
Risk associated with infectious mononucleosis?
Acute airway obstruction
92
Peutz-Jeghers syndrome
GI tract polyposis and mucocutaneous pigmentation, prococious puberty
93
bradycardia, AV block, hypotension, diffuse wheezing, overdose? Antidote?
Bet bloackers
Treatment: IV atropine, fluids -\> glucagon (increased intracellular cAMP
94
What disease is associated with myasthenia gravis?
thymoma
95
c-section with severe abdominal pain, peritoneal signs, hemodynamic instability, vagnal bleeding?
Uterine dehiscence
96
igns of compartment syndrome
Pain out of proportion to injury, increased pain on passive stretch
Parasthesia in the first sign
97
Type of lesion in lung squamous cell carcinoma?
Cavitary
98
Cardiac manifestations of TCA toxicity?
QRS widening
99
Benztropine treatts?
dystonias and parkinsonism
100
INR target for heart valve replacement?
2.5-3.5 mitral, 2.0-3.0 aortic
101
saying for primary hyperaldosterism?
Aldosterone saves socium and pushes potassium out
102
What does an odds ratio less than 1 suggest?
negative association (decreased risk)
103
Why is serotonin syndrome increased when taking tramadol?
Tramadol is an analgeic medication with sertonergic activity
104
Diagnosis of walkenstrom macroglubulinemia?
serum protein electrophorisis (igM spike) and bone marrow biopsy
105
106
Affect of PE on the heart?
Decreased cardiac outpout to right ventricular dysfunction
107
In suspected pancreatic cancer, what is the first step in diagnosis?
US/CT, followed by ERCP
108
Mycophenolate side effects?
bone marrow suppression
109
Disease most commonly causing nephrotic syndrome in adults?
membranous glomerulopathy
110
Signs of CMV in AIDS patients?
CD4 \< 50, frequency small volume diarrhea, hematochezia, abdominal pain
111
Amniocentesis Use?
Time?
Use Definitive karytupic diagnosis
Time: 15-20 weeks
112
Risks of herarin-induced thromocytopenia
Thrombocytopenia,
thrombus-HIT antobodies -\> arterial and venous thrombus
113
Late diastolic murmur at cardiac apex?
Mitral stenosis
114
progressive confusion and lethargy over several hours and hyperdensity on head CT?
cerebral amyoid angiopathy
115
Signs of hypothalamic amenorrhea? Cause?
Cause: excessive weight loss, strenuous activity, chronic illness, eating disorder
Decreased FSH, LH, estrogen -\> amenorrhea, bone loss
116
most commonca use of chronic renal insufficiency in children?
Posterior urethral valves
117
Cause of hyper IgM?
c-linked genetic defect in CD40 ligand
118
Management of esophageal perforation?
Antibiotics and supportive caure
surgical repair for significant leakage with systemic inflammatory response
119
sudden-onset neurological deficits with irregular heart beat?
Cardioembolic stroke
120
How to diagnose Borrelia burgdorferi?
1. Clinical (if erythema migrans)
2. serology (ELISA, then Western Blot)
121
Most common cause of renal disease in cirrhosis?
hypoprofusioin disease ue to hepatorenal sydrome
cause increased renin -\> hyponatremia
122
Management of pimary biliary cholangitis?
Ursodeoxycholic acid, transplave if severe
123
\> 40, chronic cough, significant tobacco use, progressive dyspnea?
COPD, evaluate with spirometry
124
IBD with crypt abscess?
Ulcerative colitis
125
indications for lung cancer screening?
Low-dose CT yearly in patients 55-80 with more than 30 pack-year histories and active smoking within the last 15 years
126
acalculous cholecustitis? population? Predispositions? Presentation
acute inflammation of the gallbladder without stones
Population-critically ill
Predisposures: surgery, severe trauma;
Presentation: unexplained fever, RUQ pain, leukyctosis
127
How to treat viral pleuritis?
Supportive and NSAIDs for pain
128
X-ray findings of gallstone ileus?
Pneumobilia and gallstones
129
Signs of mineralocorticoid deficiency?
orthostatic hypotension
130
Diagnosis of acute pancreatitis? Complications?
Acuteepigastric abdominal pain
increased amylase/lipase (3 times normal)
ComplicationsL Pleural effusion, Ileus, pancreatic pseudocyst/abscess/necrosis, ARDS
131
recurrent seizures and muscle spams in a newborn with cleft palate?
Hypocalcemia in DiGeorges syndrome
132
fever, night sweats, rapid enlarging medistinal mass?
Diffuse B cell lymphoma (an AIDS defining illness
133
Uncal herniation? Sign?
mass effect pushes part of the temporal lone laterally and downward agains the tentorium cerebeli
Compression of the third cranial nerce -\> dilated, non-reactive ipsolateral pupil, contralateral extensor posturing, come, respiratory compromise
134
Greatest risk factor for TB?
Recent arrival from an edemic area
135
First line treatment of alcohol use disorder?
Naltrexone
136
Diagnosis of Sjogran syndrome
Schirmer test (fluid absorption onto a paper in 5 min)
Anti-Ro, Anti-La testing
137
What causes symptomatic hypocalcemia in patients with liver problems and blood transfusions
chelation of calcium by citrate
138
Alternative name for hear failure with preserved efection fraction? (HFpEF)? Cause?
Diastolic dysfunction
Cause: HTN, left ventricular hypertrophhy
139
Treatment for herpes?
Acyclovir, hamciclocir, valacyclovir
140
Rheumatic heart disease?
Mitral stenosis
141
Severe left atrial enlargement, concentric left ventricular hypertrophy, ejection fraction 65%?
diastolic heart failure
142
chronic fluctuating mood disturtabces? How long?
Cyclothymic disorder
More than 2 years (1 year in children)
143
macrocutic red blood cells, hypersegmented neutrophils, normal methylmalonic acid? Signs, if severe?
Folate deficiency
Severe can be pancytopenia
144
jaundice, tender hepatomegaly, mild elevation and AST:ALT 2:1, macrocytic anemia
heavy alcohol abuse
145
child, acute onset of ataxia with disturbances in gain and coordination, symmetric and staggaring fain? Diagnosis? Treatment?
Acute cerebellar ataxia (post-infectious)
Diagnosis-none
Treatment-supportive
146
oral succimer use?
moderate lead poisoning
147
What does a cross-sectional trial measure?
prevalence
148
Fatigue, anorexia, nausea, blurred visoin, disturbed color perception, caridac arrhythmias? Overdose?
Digoxin
149
Manifestations of sheehan syndrome?
hypotension, inability to breastfeed, amenorrhea
150
How is niacin synthesized?
From tryptophan
151
sudden onset of hypotension, tachycardia, flat neck veins after catheterization on heparin?
retroperitoneal hematoma
152
Action of dobutamine?
inotrophic agen that cause cause significant vasodilation, hypotension
153
diagnosis fo hiolain barre syndrome?
Lumbar puncture
154
How to confirm ovarian torsion?
pelvic ultrasound showing an adndexal mass with absent doppler flow
155
Significant hypoxia with chest pain?
Pulmonary embolism
156
Name? Cause?
Livedo reticularis
Cause: vasculic (polyarteritis nodosa, SLE) or vascocclusive (cholesterol emobolization, antiphospholipid syndrome, cyroglobulinemia)
157
Treatment for aactinomyces?
Penicillin or surgery in extreme cases
158
Signs of serum sickness? Treatment?
fever, urticaria, polyarthralgia without mucosal involvement, 1 week after exposure to beta lactams, acute hep. B
Treatment: stop offending agent
159
Cause of hypoxia in OSA? pCO2 level?
hypoventilation -\> increased pCO2
160
HTN and cocaine use puts you at risk for what?
hypertensive vasculopathy -\> spontaneous intracranial hemorrhage
161
advanced bone age in a child with high lutenizing hormone?
Brain MRI with contrast
162
Diagnosis?
Tophaceous gout
163
What is oxytocin structurally similar to?
ADH
164
Common trigger for bronchoconstriction in asthma patients?
Aspirin (most comone) beta blockers
165
Signs of retrosternal expansion of thyroid lymphoma?
facial plethora, raising arms above head causes head swelling
166
holosystolic murmur at cardiac apex after mitral valve replacement
paravalvular regurgitation due to valvular dysfunction
167
Waldenstrom macroglobulinemia?
high IgM, hepatosplenomegaly, hyperviscosity syndrome, bleeding
168
Pulmonary hypertension
mean pulmonary aterial pressure more than25 at rest
169
Diabeted with protinuria, RBC casts, and hematuria, management?
kidney biopsy
170
Treatment for hoarding?
CBT, targeting hoarding behavior
171
Ludwig Angina?
cellulitis of the sublingual or submandibular space, caused from bacterial spread from adjacent spread of infection (dental abscess or tongue infection
172
What drugs significantly reduce the risk of acute arterial occlusion in thromboembolism in the setting of atrial fibrillation?
Apixaban, dabigatran, rivaroxaban, edoxaban, warfarin
173
osteolytic lesions, fractures, anemia are characteristic of what cancer?
Multiple myeloma
174
CMV esophagitis? CD4 count?
CD 4 \<50
sever odynophagia, without trouble swallowing
long. linear lesions
175
Diastolic heart failure leads to pulomary arterial HTN, how?
pulmonary venous hypertension
176
How to calculate specificity from false positive rate?
1-specificity
177
Bupropion - MoA
norepinerphrine doapmine reuptake inhibitor
178
SLE vs post-streptococcal glomerulonephritis?
SLE has thrombocytopenia photosensitive skin (rash), PSGN does not
179
Emergent reversal of warfarin?
Fresh drozen plasma
180
Which SSRI is associated with what congenital malformation?
Paroxitine, cardiac malformation
181
\*rubicine affects on the heart?
Oxidative damage to cellular membranes of cardiomyocyte -\> fibrotic replacement
182
Treatment for adrenal crisis?
hydrocortisone, dexamethoasone
183
Pharmacotherapy for anal fissures?
topical anesthetics and vasodilators
184
Treatment for ingantile hemangiomas?
Monitor
Timolol if on face
185
What causes the warfarin skin nexrosis?
Protein C deficiency
186
Causes of lumbar stenosis?
defenerative arthritis, degernative disk disease, thickeing of the ligamentus glavum
187
Pellagra?
Rough skin, dermatitis, diarrhea, dementia
Caused by niacin deficiency,
188
Organisms that can cause bloody diarrhea?
E. Coli, shigella, campylobacter
189
Cause of spinder angiomas?
hyerestrinism due to impaired hepatic metabolism of circulating estrogens
190
Mean corpuscular hemoglobin concentration
hemoglobin/hematocrit =hemoglobin conventration of each erythrocyte
191
Reversal for warfarin?
Vitamin K and prothrombin complex concentrate
192
Teenager that experiments with marijuana, alcohol, sexual curiosity, increasing need for privacy and transient oppositional behavior?
Normal
193
Turner syndrome karyotyoe?
45 XO
194
Polymyalgia rheumatica? Treatment?
Mornign stiffness (proximal joints), age \>50, ESP \>40,
Treatment: low-dose steroids
195
What does fish oil reduce?
Triglycerides
196
Tinea versicolor? Organism? KOH findings? Treatment
Malassezia
Salmon-colored, hypo/hyperpigmented macules (hypo after sun exposure)
KOH- blunt hphae and thick walled budding yeast
Treat with selenium sulfide or ketconazole
197
Hodgkin lymphoma
painless lympadenopathy and B symptoms (night sweats, fevers) with normal peripheral smear and CBC
198
When do galactoceles occur? Pathogenesis?
Weeks to months after cessation of breastfeeling
due to stagnaget milk
Caused by deposit proteins in the lactiferous duct forming a blockage
199
Chondrosarcoma?
50-60, signs of acial involvement (back pain)
200
Coinfections common with gonorrhea?
Chlamydia, HIV, syphilis, hepatitis B
201
What factor affects a teenager used aof safe sexual practices
Use by peers
202
Inferior wall MI ECG?
ST elevation in II, III, aVF
203
Direct inguinal ligament? Cause
older men, weakness of transverse fascia
medial to inferior epigastric vessels
204
How to calculate the anion gap?
sodium-(Chloride and bicarb)
205
cause of chronic bursitis?
pressure, driction, overuse, AI disease
206
Breast feeding jaundice vs breast mild jaundice
Breastfeeding - first week of life, lactation failure (decreased bilirubin eliination), signs of dehydration, suboptimal feeding
Breast mild- starts peaks 2 weeks, high levels of beta-gluronidase in breast milk, adequate breastfeeding/examination
207
Signs of adenoid hypertrophy? concurrent findings? Diagnosis?
nasal congestion, refractory to medical management, recurrent sinal and ear infections, snoring, mouth breathing
Concurrent findings: tonsilar hypertrophy
Diagnosis is clinical
208
HUS signs?
shiga toxin cause from E. Coli O157:H7 or shigella
anemia, thrombocytopenia, acute renal failure
209
Rett syndrom: Signs? Cause?
Cause: MECP2 gene
Signs: deceleration in head growth, loss of communicative skills, stereotypical hand movements
210
Reversal of hepain?
Protamine sulfate
211
Signs of cerebral palsy?
spastic diplegia - hypertonia, hyperreflexia
intellectual disability
212
What parts of the hypothalamic-pituitary axis does respiradone affect?
Causes hyperprolactinoma alone
213
Murmur in pregnancy woman?
systolic ejection murmur
214
Rotator cuff impingement
pain with abdumction, external rotation, subacromial tenderness, normal ROM, positive impingement tests
215
Vesicouretheral reflex?
urinary reflux from bladder into the kidneys -\> scarring
216
Shin splints vs stress fracture
Stress fracture demonstrated point tenderness, where as shin splints is more diffuse
Shin splints are also more common in overweight individuals
217
Inferior MI symptoms?
Hypotension, bradycardia, artioventricular block
218
Cholchocine -MoA, side effects? Contraindication?
inhibits polymerization of beta-tubulin into microtubules -\> prevents migration and activation of neutrophils
Side effects: nausea, abdominal pain, diarrhea
Contraindications - elderly,severe renal dysfunction
219
fatigue and pruritis scleral itcherus and and elevated alk phos? Association? Cancer risk?
primary sclerosis cholangitis
Association with IBS, mainly UC
Cancer: cholangiocarcinoma
220
Treatment for NMS?
damtrolene or bromocriptine
221
peripheral neuropathy is associated with what type of urinary dysfunction?
Overflow incontinence
222
AIN Signs? Drugs?
Signs: 7-10 days after medication exposure, skin rash, eosinophilia, pyuria,
Drugs: beta lactams, propon pump inhibitors
223
Renal findings in Alport syndrome? Urinalysis?
Hist: thinned and thickened capillary loops with splitting of the glomerular basement membrane
Urinalysis: hematura and protein
224
Risk factors for retained placenta?
gestations age 24-27 weeks, stillbirth
225
olecranon bursitis
226
high fever, lead pipe rigidity, mental status changes, autonomic instability? Causes? Treatment:
neuroleptic malignancy syndrome?
Causes: drugs, anti-psychotics,
Treatment: stop drug, supportive, dantolene or dopaminergic agents
227
constipation, back pain, anemia, renal insufficiency, hypercalcemia
Mulitple myeloma
228
Reasons to report a physician? Who to?
medical psychiatric, substance use
physician health program -\> state iicensing board
229
BRCA cancer risks?
Breast, ovarian
230
Heart valve replacement with symptoms of heart failure?
prosthetic valve thrombosis (mitral \> aortic)
231
Signs of low serum testosterone?
Decreased libido, gynecomastia, testicular atrophy with gradual onset
232
How to diagnose anal cancer?
biopsy of the lesion
233
Diagnosis? Treatment?
Complete heart block
Cardiac pacing
234
When does vitamin K reverse warfarin?
Over time, when warfarin is stopped. Not approved for ermegency situations
235
Tremor that worsens at rest, improves with movement? Treatment?
Parkinson's disease
Treatment: anticholinergics (trihexylphenidyl)
236
Inheritance pattern in hredrich atarix?
autosomal recessive
237
plasma renin activity use?
Primary aldosterism diagnosis
238
Diagnosising a supraspinatus tear?
Drop arm test,
unable to lower arm smoothly and will drop mid-adduction
239
recent URI, persistent cough productive of yellow, blood-tinged sputum?
acute bronchitis
240
Complications from heat stroke
Rhabdomyolysis, renal failure, ARDS\< coagulopathic bleeding
241
Substances that can ellicit porphria cutanea tarda?
estrogens, ethanol, hepatitis C
242
Left ventricular end-diastolic volume and CI in heart failure?
Cardiac index, decreased
LVEDV-increased
243
What is the risk factor for developmental dysplasia of the hip?
Breach presentation
244
General signs of Fetal alcohol syndrome?
fetal growth restirction, microcephaly, facial dysmorpholgy
245
Drugs to decrease ammonia concentration in hepatic encephalopathy?
Laculose to reduce serum levels, and rifaxmin (nonabsorbable antibiotic) , decreasing ammonia producng bacteria
246
Signs of acute adrenal insufficiency
hypotension/shock nausea, vomiting, abdominal pain, weakness, fever
247
micrognathia
undersized jaw
248
Patient over 50 that is immunocompromised, presenting with meningitis symptoms, iwth waters diarrhea, nausea, vomiting
Listeria
249
Diagnosis?
Paget disease
250
When do aneurysms occure after heart attack? Signs?
5 days - 3months
ECG: persistent ST\_segment elevation and recent MI, deep Q waves
Diagnosis is ECHO
251
Immediate management of panic disorder? Long-term?
Short- benzo
Long- SSRI
252
What does winter's formula calculate for expected PCO2 level?
1.5 \* bicarb + 8+/-2
253
What causes diastolic dysfunction?
impaired myocardial relaxation and LV stiffness -\> increased LV end diastolic pressure
254
Treatment for urge incontinence?
Bladder training, antimuscarinics (oxybutynin, tolterodine)
255
What lymphnode changed can be observed?
soft, mobile, less than 2 cm, no systemic symptoms
256
What are nasal polyps associated with? How to examine?
Associated with: cystic fibrosis
Examine by looking into nostrils
257
Probenecid - MoA
Promte renal excretion of uric acid crystals in the urine
Second-line if allopurinol of febuxostat is ineffective
258
Signs of hypocalcemia
Muscle cramps, chvotek and trousseau sign, paresthesias, hyperreflecia/tetany seizures
259
Gouty arthitis findings on aspiration? Treatment
neddle-shaped, negative birefringement cyrstals
Treatment: NSAIDS (when no contraindications), colchicine. glucorticoids
260
Ertapenem?
carbapenem that treats many multidrug-resistant organisms,
261
Where is histoplasmosis found?
Ohio and mississippi valley
262
Neurological risk of chronic hypothyroidism?
calcium deposition in the basal ganglia -\> extrapryamidal manifestations (movement disorders)
Also develop nephrocalcinosis and cataracts
263
First step in management peripheral artery disease?
smoking cessation, statin, aspirin
264
reactive arthritis triad?
nongonococcal urethritis, asymmetric iligoarthritis, conjunctivitis
265
Dressler syndrome?
pericarditis weeks after an MI
Treatment: NSAIDS
266
Manifestations of prophyria cutanea tarda? Treatment?
blisters that heal with scarring, hyperpigementation
Treatment: phlebotomy, hydroxychloroquine
267
Antibiotics for septic hip?
vancomycin
268
Signs of hypoglycemia
low vlood sugar, systolic hypertension, widened pulse pressure
269
Signs of moderate to severe group? When to intubate?
Corticosteroids and nebulized epinephrine
Intubate if epi fails
270
Decreased T3 levels, normal T4 and TSH?
euthyroid sick syndrome
271
What is required for bipolar II disorder?
MDD plus functional mania
272
Describe a Bartholin duct cyst?
soft, mobile, nontender mass, at the based of the labium major
273
Polymyalgia rheumatica? Treatment?
\> 50
malaise, fever, proximal muscle pain, weakness, elevated ESR/CRP
prednisone
274
Hypotension, teachycardia, distended jugular veins, respiratory variantion in systolic blood pressus is?
cardiac temponate
275
Cause of testicular torsion?
Twisting of the spermatic cord, due to inadequate fixation
276
Adjustment disorder? Treatment?
identifiable stressor, onset within 3 months, significant impairment, does not meet MDD
Treatment: psychotherapy
277
Cause of trenelenburg sign?
Gluteus medius and minimus muscle, innervated by the superior gluteal nerve
278
Defects associated with cigarette smoking in pregnancy?
IUGR, fetal demise, cleft lip/palate
279
porphyria cutanea tarda - cause?
deficiency of uroporphyrinogen decarboxylase
280
X-ray findings in pagent disease?
osteolytic or mixed lytic/schlerotic lesions
281
Bilirubin problems in asian children?
Decreased uridine diphosphogluconurate glucuronosylthransferase
282
Crest syndrome
**C**alcium deposits
**R**aynaud
**E**sophageal dysfunction
**S**clerodactyly
**T**elangiectasias
283
First step in altered mental status?
Thiamine, followed by glucose
284
Electrolyte causes of Torsades?
hypomagnesiium, hypokalemia
285
Diagnosis? Treatment? Risk?
Actinic keratosis
Risk: squamous cell carcinoma
Treatment cryotherapy, fluorouracil
286
Common risk factor for hypermagnesium in preeclampsia?
Renal insufficiency
287
Most common congenital CMV findings?
periventricular calcifications and microcephaly
288
Management of retained placenta?
Uterine massage -\> oxytocin -\> D and C
289
Sing sof central adrenal insufficiency?
Decreased cortisol, ACTH
normal aldosterone
290
First-line treatment for condylomata acuminata during pregnancy?
Topical trichlorroacetic acid
291
Suspected urethritis, but negative gram stain? gram-negative cocci?
Chlamydia trachomatis
Gram negative cocci- gonorrhea
292
Signs of sarcoidosis?
Cough, dyspnea, bilateral hilar adenopathy, noncaseating granulomas, hypercalcemia, percalciuria
293
invasive cords of squamous cells with keratin pearls?
Squamous cell carcinoma
294
Side effects of niacin use in diabetes?
Worsening glucose control
295
What is seborrheic dermatitis assoicated with? Treatment?
Parkinson disease and HIV
Treatment: topical antifungals
296
HSV esophagitis? CD4 count?
\<50
round ovoid lesions, concurrent perioral/oral involvement
297
Why do vondylomata acuminata increase during pregnancy? Subtypes?
HPV becomes more active due to natural immunosuppressive state and hormonal alterations
Tyles 6, 11
298
High output heart failure? Cause?
Severe anemia, hyperthyroidism, beriberi, paget disease, AV fistulas
299
joint pain, facial rash, glomerulonephritis in an AA female
SLE
300
PaO2 level for COPD oxygen supplementation?
less than 59mmg Hg with cor pulonale or 55 without
301
Myxonamtous valve disease, what valve?
Mitral valve prolapse
302
Nerve involvement in shingles?
Sensory
303
Cardiac findings in down syndrome
1. Loud S2 due to pulmonary HTN
2. Systolic ejection murmur from increased flow across the pulmonary valve from left to right across ASD
3. holosystolic mumur from VSD
304
Bruit in an av fistula?
Continious, palpable thrill
305
What type of spondyloarthropathy is reactive arthritis?
seronegative
306
Risks for developing penile cancer?
Cigarette smoking, HPV, phimosis (tight foreskin stuck over penis)
307
Allergic bronchopulmonary aspergillosis-history, chest imaging, diagnosis? Treatment?
History of asthma, CF
Imaging-recurent, fleeting ingiltrates, bronchiectasis (on CT)
Diagnosis: Eosinophilia, positive skin test for Aspergillus, Aspergillus-specific IgGm elevated aspergillus specific and total IgE
Treatment: corticosteroids for several months and itrazonazole
308
Palpable thril and a loud, harsh holosystolic murmur in the fourth intercostal space?
VSD
309
CDrugs that can cause cyrstal-induced acute kidney injury? Signs?
Acyclovir, sulfonamides, methotrexate, ethylene glycol, protease inhibitors
Signs: elevated creatinine within 1-7 days after starting drugs
310
TreaTreatment for invasive aspergillosis?
Voriconazole plus caspofungin
311
What is chlorperazine? Name others.
Antiemetic with dopamine activity (can cause EPS)
promethazine, metclopramide
312
Subclinical hypothyroidism
elevates TSH with normal T4, T3
313
patient is immobilized with hypercalcemia, cause? Treatment?
Immobilization 0\> osterclastic bone reabsorption increase
TreatmentL bisphosphonates
314
Manifestations of rosacea?
1. Erythematotelangiectatic-erythema and facial flushing, roughness or scaling, burning discomfort
2. papulopustular rosacea- small papules and pustules resembling acne
3. chronic, irregular thickening or the skin, urually involving the nose
4. ocular - cornea, conjunctive, lids with burning (foreign body) sensation, blepharitis, keratitis, conjunctivits, corneal ulcers, recurrent chalazia
315
inflammation, fibrosis and stricturing of the intrahepatic and extrahepatic ducts should a "bear and string" batern
primary sclerosing cholangitis
316
Signs of acute mesenteric ischemia
severe periumbilical pain out of proportion to examination findings, elevated amylase, metabolic acidosis
317
feeding intolerance, increaseing abdominal girth, bloody stools, vomiting in an infant?
Necrotizing enterocolitis
318
Laboratory findings for neuroblastoma
elevated catecholamines and metabolistes (VHA, VMA)
flank mass with calcifications
319
Most comon fort os paroxysmal supraventircular tachycard?
atruiventricular nodal reentrant tachycardia
320
Listeria, gram stain?
gram-positive bacillus
321
After describing a procedure to a patient, what should be the next step if he denies the procedure?
Ask why
322
What is strongly associated with nasopharynheal carcinoma? Endemic location?
Ebstein-Barr virus, endemic to southern China
323
Diagnosis?
Osteoclastoma, giant cell tumor "soap bubble"
324
Causes of uric acid crystals?
Tumor lysis syndrome, gout, acidic urine
325
Neurogenic arthropathy? Cause? Management
Charcot joint
decreased prorioception, pain, temperature caused by diabetes, tabes dorsalis, etc
Management: treating underlying disease, mechanical devices to assist in weight bearing, decrease further trauma
326
Respiratory papillomatosis?
Perinatal transmission of HOV leading to benign warty tumors on the larynx and/or vocal cords
recommend c-section if large
327
Urinary frequency and painful, erythematous mass in scrutum over 35? Under 35?
Over 35-Acute epididymitis, E coli
Under 35- acute epididymitis due to Chalymidia/gonorrhea
328
GI symtoms, high fever, with relative bradycardia, pulmonary infiltrate, suspect? Diagnosis?
Legionelia pneumonophila pneumonia
Diagnosis: urine lesionella antigen
329
Dysthymia (persistent depressive disorder)
chronic depressed moood for more than 2 years, no symptom free period \>2 months, MDD criteria not met
330
When can candida cause osteomyelitis?
Injection drug users
331
Liver failure with very low alkaline phosphtase levels, suspect?
Wilson's disease
332
Walkenstrom macroglobunemia treatment?
plasma exchange -\> reduces blood viscosity
333
TCA overdose signs?
dilated pupils, hyperthermia, flushed skin, decreased bowel sounds, seizure, QRS widening
334
Anterior should pain with lifting, carrying, or overhead reaching?
noceps tendinopathy/rupture
335
Treatment for endometritis?
Flindamycin and gentamicin
336
When to perform TIPS? What can is worsen?
Patient has ascites and does not respond to diuretics or ongoing active or recurrent bleeding after appropriate treatment
Can worsen hepatic encephalopathy
337
azathioprine side effects?
dise-related diarrrhea, leukopenia, and hepatotoxicity
338
Job syndrome?
Hyper IgEm recurrent skin and lung infections
339
How to calculate the positive predictive value?
True positive/(true positive + false positive)
340
HOw to confirm the diagnosis of esophageal performation?
Gastrogragin-contrast esophagram or CT esophagram
341
Side effects of magnesium toxicity?
Hyporeflexia, lethargy, headache, respiratory failure, cardiac arrest
342
Spondylolisthesis? Signs?
forward slip of the vertebrae (L5 over S1),
Signs: chronic back pain, neurological symptoms
343
Risks associated with multiple myeloma?
hpogammaglobulinemia, increased risk of infection due to bone marrow infiltratoin
344
koplik spots?
Measles
345
Fever and otalgia, deviation of the ear, inflammation of the mastoid bone? diagnostic requirments
Acute mastitis, diagnosis is clincal
Treat with intravenous antibiotics and drainage
346
Asbestosis signs? FEV pattern seen?
Progressive dyspnea over months, no cough, etc.
Digital clubbing and bibasilar end-inspiratory crackles
Pattern: restrictive
347
Posterior wall MI
ST-segment depression in V1 and C2
348
Signs of amniotic embolism?
postpartum respiratory collapse (hypotension, tachycarida, loss of consciousness) DIC,
349
AFP in hepatocellular carcinoma?
Increased
350
Invasive aspergillosis diagnosis?
galactomannan assay, beta-D-glucan
351
Signs of ascorbic acid deficiency? Name?
Vitamin C
Scury (punctate hemorrhage, gingitivis, corkscrew hair
352
What drugs cause leukocytosis?
Ststemic glucocorticosteroids
353
click with late systolic murmur?
Mitral regurgitation, best heart at the apex
354
Signs of malignanct hypertension?
Papilledema
355
Who should receive the high dose of folic acid supplementation?
Prior NTD in pregnancy, or anticonvulsant medications
356
Types of granulomas in UC and crohn's?
UC- non
Crohn- noncaseating
357
What type of urine will cause uric acid crystals to form?
concentrated, acidic urine
358
Indirect inguinal hernia?
patent processus vafinalis
protrudes through deep inguinal ring
travels lateral to inferior epigastric vessels
359
What diseases have IgE infiltration in the lungs?
asthma, eosinophilic granulomatosis with polyangiitis (CHurg-Strauss), drug induced pneumatitis, parasitic lung infections, allergic bronchopulmonary aspergillosis
360
Kallman karytyope?
46 XX, XY
361
Hemodynamically unstable womanw ith inevitable abortion??
suction curettage
362
X-ray findings in invasive aspergillosis?
nodules with surrounding ground-glass opacities
363
High temperature, elevated creatinin, muscle regidity, leukocytosis? Management?
neuroleptic malignanc syndrome
Mangement: stop neuroleptics, restart dopamine agent, supportive, dantrolene/bromocriptine
364
piloerection is associated with?
heroin withdrawal, hairs standing on end
365
developmental delay, jerky gait, happy demeanor, hand flapping, seizures
angelman syndrome, Chromosome 15
366
Alternative to doxycycline for lyme disease?
oral amoxicillin or cefuroxime
367
Substance use disorder?
continued use despite significant substance-related cognitive, behabioral and physiological symptoms
368
Presentation of B12 deficiency?
peripheral neuropathy, cognitive dysfunction, subacute combined degeneration, megaloblastic anemia with hypersegmented neutrophils
369
Treatment for symptomatic sarcoidosis?
Glucocorticosteroids
370
Candida- diagnosis? Treatment:
KOH prep
pseudohyphae wth budding yeast forms (blastoconidia)
Treatment: nystatin, miconazole
371
Alternative to carpel tunnel therapy if splinting failure?
Glucocorticoids
372
What screening should all patients with cirrhosis undergo?
Endooscopy to exclude varicies
373
Isoniazide hypersensitivity?
maculopapular rash, pruritis, fever, hepatitis
374
Acute pericarditis post infarction timframe? ECG findings? Treatment?
\< 4 days following MI, pleuritic chest pain,
ECG: Diffuse ST-segment elevation
Treatment: supportive, avoid NSAIDs`
375
Erysipelas cause?
Group A strep (streo pyogenes
376
Clotrimazole
Anti-fungal treatment for tinea pedis
377
Signs of dementia with Lewy body?
fluctation congition/attention, visual hallucinations, motor manifestations of parkinsonism (postural instability), , visual spacial defects (clock drawing) with memory intact
378
Diagnosis and treatment fo acalculous cholcystilis?
Diagnosis: US (preferred), HIDA, CT
Treatment: Abx, percutaneous draining, cholecystecctomy once stable
379
Cerebeller tonsilar herniation signs?
Neck tilt, flaccid paralysis, coma, blood pressure instability, respiratory arrest, extensor posturing
NO PUPILLARY DYSFUNCTION
380
Contraindications to NSAIDS in the treatment of gout?
anticoagulation, acutely worsen heart failure
381
How to confirm measles?
PCR
382
adjuvant therapy? Salvage?
adjuvant- In addition to stardard therapy (chemo and radiation
salvage-treatment for a disease when stardard therapy fails
383
Signs of lead poisoning?
Occupation exposure (pain, batteries), anemia, cognitive deficits, peripheral neyropathy, anemia
384
Entamoeba histolytica signs? Organism type? Treatment
Protozoan
Right upper quadrant pain and fever
hepatomegaly
single subcapsular cyst in right hepatic lobe
Treatment: metronidazole and intraluminal antibacterial (paromomycin)
385
What drug has been shown to reduce PTSD nightmares?
Prazosin
386
Blastomycosis-extramedullar organ affected?
Skin, bone, prostate
387
mucosal atrophy and granulation tissue in GI tract?
Chronic ischemic colitis
388
What medications are contra indications with sildenafil? MoA?
Phosphodiesterase-5 inhibitor
Contraindications: alpha-blockers, nitrates
389
Subchorionic hematoma
abnormal collection of blood between the placenta and uterus
390
Legg-calve perthes
idiopathic osteonecrosis of the femoral head, which presents in boys 4-10
presents with mild chronic hip or knee pain of insidious onset as well as antalgic gain
391
What is the calcium phosphorus produce?
Risk of soft tissue calcification (serum Ca \* serum phosphorus \> 55
392
Cause of hereditary hemochromatosis? Treatment?
HFE mutation, serial phlebotomy
393
HIV associated dementia? Imaging?
deep gray matter structures and causes subacute congitive, behavioral, and motor deficits
Imaging: cerebral atrophy with ventricular enlargement
394
treatment for ocular rosacea?
lid scrubs, topical antibiotics (metronidazole, erythromycin) and ocular lubricants
395
24-hour urine cortisol use?
Cushings
396
Clincal findings at different bone sites for pagent disease?
Skill- headache, hearing loss
spine- spinal stenosis, radiculpathy
long bones- bowing,gracture, arthritis of adjacent joints
397
Acamprosate use?
Maintain abstinence in a patient who has already stopped drinking
398
Lynch syndrome cancer risks? Cause?
Colorectal, endometrial, ovarian
Cause: DNA mismatch repair
399
Glucocorticoid deficiency signs?
fatigue, loss of apetite, weight loss
400
Diagnosis? Cause? Signs? Histo findings?
Melanosis coli, chronic laxative use
Signs: loctural bowel movements, watery, frequent, hypokalemia
Histology: pigment in the macrophages of the lamina propria
401
Findings in CLL?
Extreme fatigue, hepatosplenomegaly, smudge cells, lymphocytosis with mature lymphocytes
402
Electrolye abnormalities with furosemide?
Hypokalemia, hypomagnesia
403
Shilling test detects?
pernicious anemia
404
What labs should be checked prior to starting lithium?
Creatinine, thyriod function
405
Signs of TSH secreting pituitary adenoma?
overproduction of alpha subunit, with elevated TSH, T4
406
cerumen?
Ear wax
407
Hearing loss with bone pain in an older adult?
Pagents disease, osteoclast dysfunction
408
Major complication of pseudotumor cerebri?
Blindness
409
Muddy brown casts?
Acute tubular necrosis, renal tubular epitherlial cells
410
Over 40 and diagnosed with DM type 2, what drug should be added?
Statin
411
Next step after diagnosing myasthenia gravis?
CT imaging to evaluate thymoma
412
Side effects of Cyclosporine?
nephrotoxicity, hyperkalemia, HTN, gum hypertroophy, hirsutism, tremor
413
Diagnosis?
Ruptured berry aneurysm
414
When can a gift be accepted by a physician?
When they are small and directly benefit patient care
415
Hemoglobin levels in fragmentation from prostetic heart valves?
Low
416
Treatment for borderline personality disorder?
Dialectival behavioral therapy
417
Microphthalmia and cutis aplasia?
small eyes and absence of the epidermis over the skull, associated with trisomy 13 (Patau
418
low-grade fever and violaceous skin lesions with scrappings demonstrating yeast?
vlastomycosis
419
Features associated with narcolepsy?
hypnagogic or hypnopompic hallucinations
sleep paralysis
420
Good prognostic factors for schizophrenia?
positive psychotic symptoms (hallucinations, delusions) as opposed to negative symptoms (flat affect, loss of motivation, anhedonia)
421
Side effects of oxytocin?
hyponatremia, hypotension, tachysystole
Seizures
422
Serosanguineous draining and incision pain cause? Risk factors?
incisionla hematoma
Risk factors: obesity, hypocoagubility
423
Behcet syndrome
painful ulcers on oral and genital areas
heal spontaneously within 1-3 weeks
424
Is a hematocele painful?
Yes
425
Severe hot flashes, episodic pounding sensationchronic diarrhea, weight loss, valvular heart disease with tricuspid regurgitation
Carcinoid syndrome
426
Trastuzumab cardiotoxicity?
Myocardial stunning/hibernation without destruction -\> reversible
427
Open angle glaucome? Population Treatment:
Population: AA
Gradual loss of peripheral vision of years, eventually tunnel vision
intraocular pressure is high -\> cupping of the optic disk
Treatment: Timolol, laser trabeculoplasty
428
Name? Diagnosis
Koplik spot, measles
429
How do uric acid stones form?
chronic bicarb loss through diarrhea -\> acid urine -\> crystal deposition
430
How to get urine samples from infants and toddlers in diapers with suspected UTI?
Cath to obtain a sterile specimen
431
Lab findings in autoimmune hepatitis, most common group affected?
Lab: increase AST/ALT/ALK, total bilirubin levels
Most effected: young woman
432
Treatment of lyme disease for pregnant, lactating, and children under 8? Alernative, if allergic?
Amoxicillin, Alt. Azithromycin
433
Acute fever, confusion, headache, neck stiffness, cerebrospinal fluid eveidence of neutrophilic pleocytosis?
bacterial meningitis
434
Effects of H1-antihistamines in the elderly?
Anticholinergics -\> acute urinary retention due to hypoactive detrusor
435
Dress syndrome? Time?
**D**rug - allopurinol and antiepileptics are more common
**R**eaction (morbiliform eruption that starts of face or upper trunk and becomes diffuse
**E**osinophilia
**S**ystemic **s**ymptoms - fever, malaise, diffuse lympadenopathy
Time: 2-8 weeks after starting drug
436
Signs of myasthenic crisis? Treatment?
revere respiratory weakness -\> respiratory failure
Increased feneralized and bulbar muscle weakness
Precipitated by infection
Treatment: plasma phoresis
437
Acute rheumatic fever?
grank arthritis, erythema marginatum, fever
438
Clinical manifestations of hereditary hemochromatosis?
elevated liver enzymes, diabetes mellitus, arthropathy (calcium pyrophospate crystal deposition), skin pigmentatio, hypogonadism (dec. labido, erectile dysfunction), restrictive cardiomyopathy
439
Use of ultrafiltration?
massive volume voerload whose condition does not response adequately to diuretics
440
Defect in osteogenesis inperfecta?
type 1 collagen mutations
441
Side effects of beta-2agonists?
reduce serum potassium by driving intracellularly
442
Hemoglobinopathy?
Thalasemia
443
focal parenchymal scarring and blunted calyces, think? Diagnosis?
Vesicoureteral reflux
Diagnosis: voiding cystourethrogram
444
Treatment for sickle cell acute chest syndrome?
Transfusion exchange
445
progressive dyspnea, nonproduce cough, bilateral check crackles, pulmonary infiltrate in someone with antiarrhthymias?
Amiodarone-induced insterstitial pneumonitis
446
Diagnosis? Description?
Osteosarcoma
"sunburst pattern"
447
rubbery, mobile mass in young woman? Timing?
fibroadenoma, most commonly found premenstrual
448
Hematoma presentation
tender, ecchymotic, indurated firm, mass
449
"popping" sensation followed by serosanguieous drainage and an incision bulge
fascial dihiscence
450
Signs of testicular cancer?
Age 15-35
Signs: unilateral painless testicular nodule, firm, ovoid mall
Diagnosis: AFP, beta HCG
scrotalultrasound
Treatment: orchiectomy
451
Short stature, primary amenorrhea, absent thelarche?
Turnery syndrome
452
scaly papules or plaques on fair-skiin individuals? Risk factors?
Actinic kertosis, chronic sun exposure
453
What happens in hyperventilation?
Increased bicarb in the urine to reduce the alkylosis
454
Antibodies found in hashimoto thyroiditis?
antithyroid perocidase
455
Hyperemesis gravidarum vs normal nausea
Ketones present in the urine define HG
456
periodic sharp waves of EEG?
Creutzfeldt-Jakob disease
457
Temporal mandibular joint syndrome?
noctural teeth drinding -\> TMJ
458
Signs of carcinoid syndrome?
Flushing, secretory diarrhea, cutaneous telangiectasias, bronchospasm, tricuspid regurgitation
459
What type of dementia is associated with primitive refleces?
frontal release isngs -\> frontotemporal dementia
460
Breast cancer that presents with dimpiling?
Inglammatory breast carcinoma "peau d'orange"
461
Anticholinergic toxicity
hyperthermia, delirium ,dyriasis, dry mucous membranes, urinary retention, decreased bowel sounds
462
Diagnosis? Treatment?
Acne vulagaris
Treatment: topical retinoids plus organic acids or benzoyl peroxide
463
Sodium bicarbonate treats what overdose?
Tricyclic and aspirin
464
How to treat atrioventricular nodal reentrant tachycardia?
vagal maneuvers that increase parasympathetic tone and slow the AV node conduction and increase refractory period
465
Side effects of SSRI?
decreased labido, decreased arousa, erectile dysfunction, anorgasmia in woman, increased efaculation latency in men
466
Mst common cardiac defect in down syndrome?
complete atrioventricular septal defect
467
Diagnosis? Cause? Treatment?
Intertrigo, candida special
Causes: disruption of skin barrier, excessive moisture
Signs: "mirror imaging" pattern across skin forl, satelite lesions
468
When to use tetanus IG?
When patient has symptomatic tetanus, otherwise just give tetanus vaccine
469
Laboratory findings in primary adrenal deficiency?
Decraese aldosterone, cortisol
increased ACTH
hyperkalemia, hyponatremia
470
Signs of fiardiasis infection?
watery diarrhea, weight loss, abdominal pain
471
How to treat SIADH initially?
fluid restriction
472
Signs that suggest amyloidosis? HIstology?
rheumatoid arthritis (predisposes to amyloidosis), enlarged kidneys and hepatomegaly
Histology: amyloid deposits that stain with congo red
473
Why is protein restriction contraindicated in cirrhoses?
malnourishment
474
Risk associated with thyroid surgery?
Removal of the parathyroid
475
Developmental dysplasia of the hip
limping as a tolder, painful degerative joint disease
476
Best trial to measure incidence?
Cohort
477
Lab findings in pagent disease?
Elevated Alk Phos, PINP, urine hydrocyproline
Normal calcium, phosphorus
478
Elevated conjugated hyperbilirubinemia and elevated level sof alkaline phosphatase
cholestasis, US
479
non functioning gonadotroph adenomas primarily secrete what?
Alpha subunit
480
What type of aneurysm is a berry?
Subarachnoid, also known as a saccular aneurysm
481
Polycystic kidney disease
flank pain, hematuria, renal failure, HTN, larege palpable kidneys
No protienuria
482
Systemic action of Calcium channel blockers? Cause?
Dilation of precapillary vessels (arteriolar dilation)
Cause: increased capillary hydrostatic pressure
483
Acute Mesenteric ischemia diagnosis?
CT angiogram
484
red cell distribution use?
Early measurment of iron deficiency, elevated \>20% are suggestive
485
Side effect of carbamazepine?
SIADH via increasinf vasopressin-2 receptors
486
Diagnostic method for fibroids?
Sonohysterography
487
Complications from liver cirrhosis on males?
Testicular atrophy, gynecomastia, loss of sexual hair
488
Signs of entamoeba histolytica? Diagnosis? Treatment?
Developing nations, contaminated food/water, fecal oral rout (rare)
Findings: colitis (diarrhea, bloody stool with mucus, abdominal pain, liver abscess (RUQ pain, fever)
Diagnosis: stool ova and parasites, stool antigen testing, E. histolytica serology (liver abscess)
Treatment: metronidazole
489
What does increasing study size do to precision? Accuracy?
Increased precision
No change in accuracy
490
What factors have the greatest impact at improving blood pressure?
Weight loss, DASH diet
491
Hallmark of vertricular aneurysm?
persistent STS segment elevation
492
Stress-induced cardiomyopathy
"apical ballooning syndrome" transient systolic dusfunction of apical and/or mid segments of the left ventricle with hyperkinesis of the basal segments causing "balloon-like" appearance
493
Treatment of septic pelvic thrombophlebitis?
anticoagulation, broad spectrum antibiotics
494
Most common congenital infection worldwde?
CMV
495
In acute pneumonia, what is responsible for hypocemia?
right-to-left intrapulmonary shunting
496
Treatment for myocarditis?
supportive, dieretics, inotropes
497
Colonoscopy findings of C. Diff?
bowel wall edema, eerythema, friability
498
mosquito with dormant phase?
p vivax, hides in liver
499
penetrating abdominal trauma and perotonitis?
Ex lap
500
Hormone levels in cushings syndrome?
Increased cortisol
decreased ACTH, DHEA
no suppression by dexamethasone
