week of 4/27

Question 1

Absolute contra indications to combined hormonal contraception

Answer 1

• Migrane w aura
• 15+ cigarettes per day and being over 35
• HTN >160/100
• ❤️ dz
• DM w end organ damage
• thrombous
• antiphosphoipid syndrome
• hx stroke
• breast cancer
• cirrhosis/liver cancer
• major surgery w prolonged imobilization
• use <3 weeks postpartum

Question 2

high calcium and high pth is most likely

Answer 2

primary hyperparathyroid

Question 3

sick patient with normal TSH and T4 low t3

Answer 3

euthyroid sick syndrome

Question 4

Serum Na Central DI

Answer 4

⬆️

Question 5

Serum Na Nephrogenic DI

Answer 5

Normal

Question 6

weight gain and increase in lipids next test

Answer 6

TSH

Question 7

where is patella in quad tendon tear

Answer 7

low ridding

Question 8

where is patella in patellar tendon tear

Answer 8

high riding

Question 9

infertility testicular mass that does not transilluminate, smaller when supine

Answer 9

varicocele- hernia doesn’t affect fertility

Question 10

what causes Ogilvie syndrome

Answer 10

surgery
electrolyte abnormalities
meds

Question 11

tx for Ogilvie syndrome

Answer 11

NPO, nasogastric decrompresison

neostigmine if no improvement within 48 hours

Question 12

breast lump over 30 next step

Answer 12

mammogram

Question 13

breast lump less than 30

Answer 13

ultrasound plus minus mammogram

Question 14

what are the mast cell stabilizers used for chronic allergic conjunctivitis

Answer 14

Olopatadine and azelastine

Question 15

what types of acne gets erythromycin after benzoyl peroxide and tretinoin fail.

Answer 15

inflammatory or nodular/cystic

Question 16

what type of acne can benefit from isotrenititoin

Answer 16

nodular/cystic

Question 17

porphyria cutanea Garda associated conditions

Answer 17

Hep C
HIV
Alcoholism
Estrogen use
smoking

Question 18

enterococci endocarditis association

Answer 18

nosocomial uti

Question 19

what class of med is diclofenac

Answer 19

NSAID

Question 20

abx for pseudamonus otitis externa

Answer 20

ciprofloxicen

Question 21

pupil in open globe injury

Answer 21

teardrop of eccentric

relative afferent pupillary defect

Question 22

causes of sialadenois - enlargement of salivary glands

Answer 22

chronic oh use.

Vit a deficiency also but they will have other sx

Question 23

initial imaging for toxic megacolon if mostly stable

Answer 23

x-ray

Question 24

phenytoin/ other anti-epileptic birth defects

Answer 24

fetal hydantoin syndrome : cleft lip and palate, wide anterior fontanelle, distal phalange hypoplasia, cardiac anomalies. sometimes microcephaly and neural tube defects

Question 25

what muscle is involved in congenital torticollis

Answer 25

sternocleidomastoid

Question 26

clinical feature Reye syndrome

Answer 26

Acute liver failure | encephalopathy

Question 27

labs in reye syndrome

Answer 27

⬆️ transaminases ⬆️ pt/inr /ptt ⬆️ NH3

Question 28

small painless papule, rough skin, motted perifolicular erythema, worse in cold dry weather, posterior upper arm

Answer 28

Keratosis pilaris

Question 29

what causes damage in membranoproliferazive glomerulonephritis

Answer 29

persistant activation of alternative complement pathway

Question 30

labs osteomalacia

Answer 30

⬆️ PTH | ⬇️ Ca and Phos

Question 31

Hx pancreatic insufficiency, weight loss and abdominal pain, jaundice next test

Answer 31

US to look at head of pancreas

Question 32

HX pancreatic insufficiency, weight loss, and abdominal pain, NO jaundice next test

Answer 32

CT

Question 33

how does 23 valent PNA vac cause immunity

Answer 33

T-cell independent B- cell response, less effective very young and old (polysaccharides)

Question 34

how does 13 valent PNA vac cause immunity

Answer 34

T-cell dependent B cell response (conjugate)

Question 35

WAGR

Answer 35

Wilms Tumor Aniridia - no iris Genito urinary abnormalities Retardation

Question 36

most common cause of blindness worldwide

Answer 36

chlamydia trachomas

Question 37

What tx for baby if mom has chickenpox

Answer 37

passive immunization with monoclonal antibodies

Question 38

tx for visualized foreign body in vagina(child)

Answer 38

Irrigate with warmed fluid after local anesthetic application- no speculum in peds

Question 39

Coxascakie B/ adenovirus myocarditis sx

Answer 39

``` viral prodrome heart failure respiratory distress murmur hepatomegaly ```

Question 40

sepsis sickle cell organisms

Answer 40

strep pneumo, H. flu- don't get confused with osteo

Question 41

common cancer after breast cancer tx

Answer 41

angiosarcoma

Question 42

what can tx for uveitis cause as se

Answer 42

glaucoma - steroids can raise intraocular pressure

Question 43

what cells in medullary thyroid cancer

Answer 43

parafolicular cells

Question 44

what do you measure to see if medullary thyroid cancer reoccurs

Answer 44

calcitonin

Question 45

chronic bacterial prostatitis sx

Answer 45

like UTI but recurrent and pain with ejaculation

Question 46

Heriditary spherocytosis inheritance

Answer 46

AD, Northern European

Question 47

Heriditary spherocytosis MCHC

Answer 47

⬆️

Question 48

Heriditary sperocytocis Coombs

Answer 48

negative

Question 49

hereditary spherocytosis osmotic fragility test

Answer 49

⬆️

Question 50

hereditary spherocytosis tx

Answer 50

folic acid blood transfusion splenectomy

Question 51

most common PNA in young children with CF

Answer 51

Stahp aureus- watch out for pseudomonus though

Question 52

why do babies get jaundice

Answer 52

At birth RBC's only last 90 days = increased turnover. bili clearance is down because UGT does not reach max speed until 2 weeks enterohepatic recycling is increased