NBME 500 2.0?

Study online at quizlet.com/_3kbt5h

1. ... Veriget prophoryia 7. A 35-year-old man is brought to the Decrease

Herditary emergency department because of Chloride
coprophroyia intractable nausea and vomiting of Decrease
nonbilious fluid over the past 48 hours. He potassium
2. Two of the following are needed: for Two of the
has a history of duodenal ulcer disease increase bicarb
diagnosis NF1 following are
treated with H2-receptor blocking agents. in the kidney by
needed:
His temperature is 37 C (98.6 F), blood reabsorbing
At least 5 caf-
pressure is 90/60 mm Hg, pulse is 130/min, sodium
au-lait spots >5 mm
and respirations are 10/min. Examination
prepubertal or at
shows mild epigastric tenderness. Which
least 6 caf-au-lait
of the following are the most likely serum
spots
electrolyte findings?
>15 mm
postpubertal 8. 62yo F in for resection of ovarian tumor. 25 -Renal U/S
Axillary/inguinal lb weight loss over past 2 months. Exam
freckling shows adnexal mass, and no other
>2 iris Lisch abnormalities. Preop labs: Serum - BUN
nodules (seen on 80; Cr 5.7; Urine - Glucose none; protein
slit lamp only) trace; WBC 0-2; RBC 0-2; Casts none;
>2 neurofibromas crystals none; bacteria none. Most
or one plexiform appropriate next step to determine cause
neurofibroma of renal failure?
Osseous lesions,
9. Abacavir A/E lactic acidosis
splenoid dysplasia
hepatitis and
or cortical thinning
hypersensitivity
of long-bones (LE)
RXN
Optic gliomas
10. ABG in pulmonary edema alkalosis -
3. 3 day history of rash followed by a roseola infantum -
increased
blanching erythematous macular rash HHV6
respiratory rate,
4. 4 h's Hypovolemia more CO2
Hypoxia leaves more
Hydroden ions - easily than o2
acidosis enters the
Hyper/hypokalemia bloodstream
hyperthermia
11. Abortive therapies for migraines triptans -
5. 5 treatable T PEA Pneumo throax sumatriptan
Tamponade - ECG NSAIDS -
first naproxen
Toxins -Drugs Acetaminophen
THrombosis - Ergots
Pumonary or
12. Accumulation of matrix substance causing Hypothyroidism
cartoid
carpal tunnel is seen in what disease
Trauma myocardial
contusion 13. Ace inhibitor mechanism of action inhibits the
cleavage of C-
6. 6yo boy with cramping abdominal pain Operative
terminal
& right-sided scrotal pain for 4 hours. procedure - from
peptides on
Vomited once, Exam shows distended pestana immediate
angiotensin I
abdomen. BS decreased, and diffuse surgical
( normally Ace
tenderness to palpation with intervention is
found on
involuntary guarding. Right indicated as any
pulmonary and
hemiscrotum discolored with swelling other test is
renal
& tenderness superiorly. Left paramount to
endothelium)
hemiscrotum is wnl. Most appropriate malpractise for
next step in management? time wasting
14. Achalasia mamometry decrease in esophageal peristalsis 24. After Steroid
and increased in LOWER weaning in some
esophageal sphincter tone - on with crohns
Normal 25 mmhg what is feared
achalasia - > 100 nutcracker complication
achalasia > 200
Higher intraesophageal pressure
then intragastric
15. ACLS protcol shock -cpr-drug -shock
16. ACTH - MSH is a cleavage product
Small bowel obstruction - from a
hyperpigmentation Skin, scars, the palmar crease the
rebound of the disease severity= fibrotic
occurs inner surface of the lips
strictures
17. ACTH is what type of POlypeptide hormone 39 Watchi for vomting
hormone hormones
25. AIP Neurogenic pain, anxiety depression,
18. acute panic attack aka Benzo Red urine,
MRI claustrophobia - ALA PBG Elevated blood and URINE
what is the treatment
26. Alcohol effect on alcohol can lead to thrombocytosis AS
19. Adjustment Disorder maladaptive reaction to an thrombocytes it is toxic to the megakayocytes
identifiable stressor, such as loss of
27. Aldosterone: renin 20 ! is normal
job, divorce, or failure in school.
ration normal > 20 is primary hyperaldosteronism
**They are severe enough to cause
value
impairment in functioning.
Psychotherapy is the treatment of 28. Allergic interstitial - Rash, Eosinophilia, fever
choice. Both individual and group nephritis acute Laboratory abnormalities include
therapy have been used signs eosinophilia, eosinophiluria, hematuria-
effectivel*** 95%, proteinuria, and
an increase in serum IgE levels.
20. Adrenoleukodystrophy Ages 4-8
* remember the UA Cant distinguish
X-linked genetic disorder typically
Eosinophils from WBC*
affecting males. Disrupts
metabolism of very-long-chain 29. Alpha 1 antitrypsin 75-85% - severe panacinar emphysema
fatty deficiency smoker at the age of 40 vs 53
acids -> excessive buildup in liver disease in 12-16%
nervous system, adrenal gland, and 30. Alzheimers early insidious short term memory loss
testes. Progressive disease that disease language deficits and spatial
can lead to long-term coma/death disorientations
and adrenal gland crisis. later personality changes
Symptoms//mental
31. AMS and Cirrhosis Consider SBP
deterioration//aphasia//
mild hypotension SAAG - low level protein increases your
hyperpigmentation of skin//
& tachycardia + risk of SBp
seizures/// vision loss (33%)
distended tense PMN > 250 = diagnostic
21. Afib + Weight loss think hyperthyroidism abdomen
22. AFIB- NO PULSE Just do CPR for 2 min recheck + ab tenderness
PEA EPInephrine 3-5 min 32. Anterior shoulder Most techniques are facilitated by the
23. AFIB Irregular QRS dislocations following 2 maneuvers:
txt afib if no if no tachycardia then start with
tachycardia : Aspirin or warfarin : Flexion of the elbow 90 to relax the
Txt of afib with + Tachycardia- Betablockers : biceps tendon
tachycardia metoprolol or esmolol External rotation of the humerus, which
or nondihydropyridine : ccb - act releases the superior glenohumeral
on the AV node - diliazem or ligament and presents the favorable
veramil side of the humeral head to the glenoid
fossa
33. Anti centromere CREST syndrome 45. atrophy of the hand ALS- LMN ( fascilculations and
antibodies muscles bilaterally atrophy) signs & UMN (
+ upgoing babinski hyperreflexia and babinski) signs ---
34. Anti Jo is Lung fibrosis
and hyperactive knee affects the motor
associated with
jerk Sensation is preserved
what
+ fatigue cognitive dysfunction can occur
complication
+ trouble with clinical diagnosis
35. ANti primary biliary cirrhosis coordination
mitocondrial in a 54 year old man
antibodies
46. At what weeks can between weeks 24 -32 ; if used 33-
36. Antineutrophil Positive Ulceratives you use 34 then close ductus arteriosus &
cytoplasmic cyclooxygenase as a cause oligohydramnios
antitibody tocolytic s Ae: gi symptoms, platelet
(ANCA) dysfunction
37. Anti Positive- Crohns 47. Atypical pneumonia Erythromycin
Saccharomyces treatment
cerevesiae
48. auscultation for dry velcro like crackles
antibody (ASCA)
restrictive lung
38. Anti smooth autoimmune hepatitis disease
muscle
49. Azathioprine and 6- Antimetabolites used to weans
antibodies
mercaptopurine poeple on IBD off steroids
39. ANti-synthetase Anti jo
50. Bacillus cereus Sources : Fried rice
syndrome!!! interstitial lung disease +
Source Symptoms: Vomiting within several
derma/polymyositis
symptoms hours of eating, diarrhea later
40. Ascertainment occurs when the results from an atypical TXT TXT Self-limited; hydration
biases population are extrapolated in the entire
51. Bacteria sepsis in strep pneumoniae
population
sickle sepsis h. influenzae
41. Ascities and Think necrositic pancreatitis and
52. Bad taste, cough, Gastroesophageal reflux
Amylase Borehaaves
hoarseness
42. asthma Daytime Symptoms:Intermittent 2/week Response to PPis;aluminum
intermediate Nighttime symptoms: hydroxide
Nighttime and magnesium
Symptoms hydroxide; viscous
Treatment lidocaine
Intermittent 2/week 2/month
53. Bartholin gland found at the 4 and eight o'clock
43. AStrocytoma 1 and 2 grade: increased cell proliferation, abscess positions- seen in the medial aspect
grade 1 or 2 atypia NO necrosis; mitosis or of the labia major
neovascularity txt incision and drainage
Grade 3 - aplastic astrocytomas - increase
54. Best initial test for PANENDOSCOPY !!!
mitosis
squamous cell
Grade 4-
carcinoma of the
44. Atopic occurs on the flexor surfaces + head and neck
dermatitis erythematous scaly pruitic rash --- ON
55. Best way to maintain orotrachea tubes
FLEXOR surfaces of the arms and knees
an airway in patients
with no facial trauma
56. Beta agonists - cause bladder relaxation + worsen
BLADDER urinary retention
--- can be given for urinary
overflow incontinence
57. Beta blocker affect on Increase TG ( VLDL) decrease HDL
LIPIDS
58. bhg cross reacts LH, FSH And TSH 68. Calcium Calcium increases the threshold potential,
gluconate thus restoring the normal gradient between
59. BINSWANGER Slowly progressive
threshold potential and resting membrane
subcortical luekencephatlpathy
potential, which is abnormally elevated in
Vascular dementia d/t loss of white
hyperkalemia. Onset of action is within 5
matter
minutes, and duration of action is about 30-
SMALL ARTERIES
60 minutes. Doses should be titrated with
60. Blood cultures that the infection is from the cather tip constant monitoring of ECG
that grow faster
69. Calculation of LDL= total cholesterol -HDL - TG/5
from the cather
LDL
tip vs. blood
cultures suggest 70. Cal. gluconate ECG changes
for or
61. Blood samples Type 3 hyperlipidemia - high
hyperkalemic above 6.5
appear milky triglyceridemia
pancreatitis post Treatment FENOFIBRATE 71. Campylobacter Sources : Poultry (second most common
drinking jejuni foodborne bacterial GI infection)
and yellowish Source Symptoms: Bloody diarrhea, abdominal
streaks on the symptoms pain, fever;
hands TXT rare Guillain-Barr syndrome
Txt : Hydration, erythromycin;
62. BLOUNT DISEASE defective medial tibial + tibial torsion)
generally self-limited
+ diagnosis TIBIA VARA
Xray - Bre 72. Can you give Yes but you must monitor the blood
betamethasone glucose control
63. BLOUNT DISEASE a) Bracing for 1 year if the M-D angle is
to a diabetic
Management greater than 16 or if
mother with a
the patient is 2-3 years of age
premature
(b) Surgical osteotomy if there is no
infant
improvement with bracing,
if the patient is older than 4 years of age, 73. Carboplatin myelosuppression
if there is recurrence
74. Cardiac Rarely associated with prodromal period
of angulation, or if the deformity is very
arrhythmia
severe
syncope
64. Borderline A life long patter of behaviour
75. Carotid body paragangliomas 75 % ---- Succinate
personality characterized by unstable relationships
tumor dehydrogenase related 25%
disorder labile mood and poor sense of self, --
impulsive paranoids - so intense there is 76. Catheter coagulase negative staphylococcus
micropsychotic episodes infections -
Most common
65. BPH urinary 1st catherization - + at tie give 5 a
pathogen
retention txt reductase inhiboion
long term therapy 5alpha reductase 77. Causalgia Complex regional pain syndrome of the
inhibitors extremities characterized by swelling pain
and bone demineralization often following
66. BPPV treatment the most beneficial treatment for BPPV
a minor trauma
includes using certain maneuvers to
reposition the displaced otoliths - dix 78. Cause of - twisting injuries when the foot is in flexed
hallpike medial positions
and maneuvers to reposition the meniscal tears -immediate pain but often not enough to
displaced ototliths - such as epley Symptoms stop their activityes
maneuver Knee swelling worse the day after
--- locking and catching
67. Brain abscess seizures
-- pain in squatting position
+ #rd gen cephalo + metronidazole
( ligament injury will be severe swelling day
Treat with medication first unless
of and etreme pain)
neurological signs --
Treat 2-3 cm, incision and drainage
if drainage failures
79. Cause Qt Lithium 86. Chancroid type of lesion ? -
prolongations Macrolides type of lesion ? purulent ulcer,
Amitriptyline, impramine - TCA pain? shaggy border
Navir- Number of lesions? pain? yes
Clozapine lymphadenopathy -->Pain? --> type ? Number of
CITALOPRAM, paroxetine - SSRI constitutional symptoms lesions? single in
Ciprofloaxcin, levofloxacin men multiple in
chlorpromazine women
chloroquine lymphadenopathy
cocaine -> 50-65% and
Diphenhydramine usually unilateral -
Famotidine >Pain? Yes -->
Fluconazole, itraconazole type fluctuant
hydrochlorothiazide and may fixtulize
metronidazole ?
mirtazapine - constitutional
nicardipine symptoms No
oxytocine
87. characterized by profound asthenia; Adrenal Criss
trazadone
severe pain in the abdomen, lower back,
80. Causes of or legs; peripheral vascular collapse;
diarrhea < 1 week and, finally, renal shutdown with
and > 2 weeks azotemia. Body temperature may be
low, although severe fever often occurs,
particularly when crisis is precipitated
by acute infection. A significant number
of patients with partial loss of adrenal
function (limited adrenocortical reserve)
appear well but experience adrenal
crisis when under physiologic stress (eg,
surgery, infection, burns, critical illness).
Shock and fever may be the only signs.

> 2 weeks Cryptospordium cystiosospora

giardia
81. Causes of Diarrhea vomiting
hypovolemic burns
hyponatremia pancreatitits
LOW urine
sodium
82. Causes of it is an acute phase reactant so from
reactive surgery infections or trauma, bleeding
thrombocytosis iron def. and neoplasms
83. Causes of Post surgery - Pseudos-asplenia from
thromboCYTOSIS shock to spleen
or post removal of the spleen as the
spleen removes the old platelets
84. Cerebral Salt txt with
wasting TXT
85. Cerebral Salt Cerebral salt wasting presents with
wasting Vs siADH HYPOVOLEMIA
whereas SiADH has EUVOLEMIA
develop under similar circumstances
88. Charcot-Marie- Also known as hereditary motor and 94. Classic Refsum's Genetic deficiency of a single
Tooth sensory neuropathy (HMSN). Group of disease peroxisomal enzyme, phytanoyl-CoA
disease progressive hereditary hydroxylase, which catalyzes
nerve disorders related to the defective metabolism of phytanic acid (a
production of proteins involved in the common dietary plant component),
structure and progressive peripheral neuropathy,
function of peripheral nerves or the myelin impaired vision caused by retinitis
sheath. Typically autosomal dominant pigmentosa, hearing deficit, anosmia,
inheritance cardiomyopathy and conduction
pattern and associated with scoliosis and defects, and ichthyosis
foot deformities (high or flat arches).
95. Classic X ray for
89. Child les sthen Retropharngeal abscess in a child less active TB : night
5 has a fever then 5 sweats, weight loss,
and toricollis, cough + blood,
pain with neck fever
extension
90. Chorioadenoma There is invasion of the myometrium by
dustruens hydropic chorionic villi, accompanied by
proliferation of both cytotrophoblast and
syncytiotrophoblast. tumor is locally
destructive and may invade parametrial
tissue and blood vessels. Hydropic villi
may embolize to distant sites, = lungs and
brain, but do not grow in these organs as UNILATERAL upper lobe infiltrate with
true metastases, and even without cavitation and hilar lymphadenopathy
chemotherapy they eventually regress.
96. Clinical Features Otitits Media
The tumor is manifested clinically by
triad of otalgia,
vaginal bleeding and irregular uterine
fever (especially in
enlargement. It is always associated with a
younger children),
persistently elevated serum HCG and
and conductive
varying degrees of luteinization of the
hearing loss
ovaries. The tumor responds well to
chemotherapy but may result in uterine 97. clinical findings in Mon facies, buffalo hump stria
rupture pt with ACTH tumor hypertension fatiru glucose
intolerance osteoepnia weakness and
91. chronic bladder Bladder neck dyssynergia
easy bruising
inflammation
98. Clinical findings of LOW urine Sodium < 20 mEq
92. Chronic Lack of NADPH oxidase = Decreased
volume depletion Decrease serum osmolaity
granulomatous reactive oxygen species
decreased urine sodium
disease (e.g., superoxide) and
Test: absent respiratory burst in 99. Clostridium Source: Honey, home-canned
neutrophils. botulinum foods
Test: DiHydrorhodamine - leukocytes are Source symptoms: Nausea, vomiting,
Loaded with lipophilic dye (DCFH-DA) - symptoms diarrhea, flaccid paralysis
Acetate cleaved by hydrolytic enzymes- TXT TXT: Botulism antitoxin
So dye cant leave the cells - PMA-induced (not given to infants); self-limited
oxidation converts cleaved dye to adults
fluorescent form (DCF) - Fluorescence is 100. Clostridium difficile Sources: Antibiotic-induced
measured by flow cytometry Source suppression of normal colonic flora
93. Cipsplatin A/E renal toxicity, electrolyte abnormalties symptoms Symptoms: *Watery or bloody
tinnitus TXT diarrhea*; gray pseudomembranes
hearing loss ( unilateral or bilateral) seen on colonic mucosa
nausea and vomting and ne Txt: Metronidazole, vancomycin
depends on recurrence and on WBC
>15,000 Creatine > 1.2
101. Colchicine exerts by reducing lactic acid production by 107. Complications Of Hypotension because vasvagal d/t
its effects leukocytes, which in turn decreases uric post voiding changes inthe bladder wall tension
acid deposition and reduces complication in
phagocytosis, with abatement of the urinary retention
inflammatory response.
108. Co-prophyrin
102. COLD diuresiss Decrease temp - = Kidney malfunciton =
lots of dilute urine
-hypovolemia ( but masked Because of
-vasoconstriction )
= sudden shock during re-warming D/t
vasdilation
103. Common causes
of pneumonia in
--COPD
--Recent viral
infections 20% Skin
--Alcoholism, 100% neurovisceral
diabetes
--Poor dentition,
aspiration urine co-prophyrin in the urine
--young healthy COPD= LAWAY HAEMOPHILUS - Gram 109. Costochondritis PE
pt negative most accurate chest wall tenderness
Hoarness _--- pneumonia with hoarseness test
Contaminated chlamydophilia
110. CPAP Constant pressure - 7mmhg For trachea
water sources,
pressure
air condition,
ventilation 111. criteria for home 88% PaO2
systems oxygen COPD
Birds patient
Animal at the 112. Cryoglobulinemia associated with: hep C ( also seen in
time of giving associated with : endocarditis or connective tissue
birth,, disease - sjorens)
veterinarians, menifestations: joint pain,
farmer glomerulonephritis
104. Common MCC present with UTERINE BLEEDING purpuric skin lesions
presentation for AND PREECLAMPSIA BEFORE 20 WKS neuopathy
complete and igM
partial moles LOW compliment
before 20 weeks 113. Cryptococcal immunocompotent people
105. Complete mole Larger b-hgc leve then normal gatti blindness d/t cerebral edema
pregnancy CXR looks like pumocystis
all dads DNA, most likely XX, (sometimes 114. Cryptosporidium Source: Food/water;
XY, ) parvum immunocompromised
2% risk for choriocarcinoma Source patients
15-20% malignant trophoblastic disease symptoms Symptoms: Watery diarrhea,
complications - uterine rupture, high TXT abdominal pain, malaise; acid-fast
blood pressure, Lots of vomiting stain of stool shows parasites
106. Complex febrile Duration >15 min Treatment: Control immune suppression;
seizure Focal onset or focal features during nitazoxanide
seizure 115. Crytococcal increased CSF protein and Low glucose
Recurrent seizures (>1 in 24-h period) meningitis mononuclear pleocystotsi
Previous neurological impairment or NARROW based buds with capsule
neurological indian ink stain
deficit after seizure - CSF culture
116. CSF findings in lymphocytic pleocytosis 130. Diabetic Autonomic neuropathy can cause
HSV increased protein neuropathy: postural hypotension, impotence,
encephalitis elevated RBC count Autonomic incontinence,
normal glucose neuropathy and diabetic gastroparesis (i.e., delayed
gastric emptying).
117. Cutaneous t cell Mycosis fungoides - Scaly pruritic
lymphoma --- patches or plaques 131. Diagnosis of Biopsy the edge of the lesion which
bullous shows subepidermal blister under the
118. Cystine stones hexagonal - Sodium nitroprusside turns
pemphigoid microscopy
purple s/p 10 min
- look for immunoglobulin deposition in
119. Dementia and mental status tends to deteriorate with a linear pattern along the basment
sundowning nightfall membrane under immunofluoresnece
120. Dermatomyositis In 25/o of cases. 132. Diagnostic stiffness > 1 horus
Is associated Ovary criteria >3 more joints
with cancer Lung rheumatoid Skin nodules
Gastrointestinal Symmetric
Lymphoma erosions seen on Xray with Periarticular
121. DES exposure Diethylstilbestrol. DES syndromeT- osteopenia
shaped uterus, vaginal adenosis (with Anti - CCP
predisposition to 133. DIc is related to Gastric, breast and lung cancer among
vaginal clear cell carcinoma), cervical what others
hood, incompetent cervix, preterm malignancies
delivery.
134. DIC labbs Decreased fibrinogen, increase LDH,
122. Detrusor URGE !!! - increase INR, and thrombocytopenia
hyperactivity is bilirubin and increase Reticulocyts
what type of
135. didanosine pancreatitis
incontinence
136. Difficulty rising POLYMYOSITIS
123. Detrusor - Bladder outlet obstruction = overflow
from a chair and - anti jo ( increased incidence of lung
sphincter incontinence
climbing the fibrosis) and anti RNP
dyssynergia is - ms is causes
stairs suggest
what
that he has increase AST & ALT
124. Detrusor neurogenic causes of overflow symmetric Increase CPK
underactivity incontinence weakness of his increase LDH
125. Development -- Breech presentation proximal muscles
dysplasia of the -- Other deformities like torticollis and increase LDH
hip foto deformities and CPK are
- asymetrical skin creases elevated
- exam and then imaging 137. Disseminated
126. Development PALVIK harnes Gonococcal
dysplasia of the Abbduction infection
hip treatment
127. Diabetes Cause by tumors to the brain, stroke
Insipidus hypoxia sarcoidisos,
Kidneys: chronic pyleonephritis
Hypercalcemia, hypokalemia
128. Diabetic Blood 140/90
Pressure
requirements
first two blood cultures are negative
129. Diabetic foot secondary to unnoticed trauma,
screen HIV and syphilis screen
ulcers diminished sensation of pain and
-- FEVER , polyarthralgia, and a pustular
temperature ---DEbride the ulcer until
rash
bleeding tissue is discovered
138. D-Miner level > 500 > 500 - do CT angiogram 147. Dyskitits INfection of the intervertebral disc -
< 500 staph aureus mcc
URI or minor trauma and then pinpoin
139. DM type 1 Islet cell Ab present in up to 60-85%
pain on the disc
Most common islet cell Ab is against
( focal tenderness)
glutamic
Physical
acid decarboxylase (GAD)
Localized tenderness over the involve
Up to 60% have Ab against insulin
area with concomitant paraspinal
140. Drugs to improve Ace inhibitors, angiotensin 2 receptor muscle spasm is the most common
survival in CHF blockers Arbs beta blockers physical sign. If the cervical or lumbar
aldosterone antagonist segments are involved, restricted
141. DSM 5 - and Illness anxiety - preoccupied with a mobility secondary to pain occurs
somatic symptom specific disease ( can have more then - ESR labs, and MRI to confirm
disorder one symptom) Treatment BED REST
illness anxiety Somatic symptoms disorder - 1 or 148. E. coli type O157:H7 Source: Ground beef, indirect
more symptoms (enterohemorrhagic) fecal contamination
142. Duchenne muscular X linked recessive ( becker too) Source Symptoms: Bloody diarrhea,
dystrophy First sign may be poor head control symptoms vomiting, fever, abdominal pain (risk o
in infancy. TXT HUS)
By year 2, may have subtle findings Treatment: Hydration; self-limited;
of hip-girdle weakness antibiotics may actually
Gower sign as early as age 3 years worsen symptoms
but fully developed by age 5-6 years; because of toxin release
with 149. ecthyma gangrenosum starts as small erthematous macule to
hip-waddle gait and lordotic development larger nontender nodules with necros
posturing - goes throught the adventitia a& med
143. Duchenne muscular CPK15,000-35,000 U/L (normal is of blood vessels
dystrophy- LAB <160 U/L) (initial screen for myopathy) 150. Ectopic ACTH production and Dexamethasone cannot suppress ACT
Best initial testmolecular genetic dexamethasone production if it is ECOPTIC
diagnosis: deficiency or defective
151. EEG signs of herpes high amplitude slow waves
dystrophin
encephalitis
cytoskeletal protein from gene at
Xp21.2 (one-third will not be 152. Efacirenz A/E Causes vivid dreams - often with the
diagnostic) first few doses
Muscle biopsy ( to confirm ) to show
153. Effusions in the lungs with high esophageal rupture and pancreatitis
the abnormal or absent dystrophin;
amylase
most accurate test
(do in the one-third who do not give a 154. EKG demonstrates a wide
molecular diagnosis) complex tachycardia
bp 90/60 mmHg
144. Duchenne muscular Cardiomyopathy is a constant
he is conscious and has a
dystrophy - second feature.
pulse
decade Intellectual impairment in all; IQ <70
in about 30%; most with learning Stable is determined - conscious an
disabilities has a pulse
Respiratory insufficiency therefore start with amiodarone
Repeated pulmonary infections
155. EMG in Most characteristic - Fibrillation
Pharyngeal weakness (aspiration)
Polymyositis/Dermatomyositis, potentials in multiple extremtities
145. dysgerminoma LDH or hcg : Sheets of uniform cells. Inclusion Body Myositis
Associated with Turner syndrome
156. EMphysematous Clostridium welchai,
146. Dyshidrotic eczema dermatitis that involves the palms and cholestocystitis - US air in the Klebseillia Ecoli
soles wall, or Xray
157. Empiric antibiotics 3rd gen cephalosporin - ceftriaxone 168. factitious intentional falsification or inducement of
for a febrile sickle + vancomycin for meningitis or disorder symptoms with goal to assume sick role
cell disease osteoarticular
169. Factor H a cause of atypical HUS
If concern for
meningitis or 170. Failure to NPH - d/t stretching of the cortical fibers
osteoarticular inhibit
voiding
158. Empyema effusion Frank collection of pus - purulent
reflex is what
exudative -
low glucose 171. Familial FAP is defined as the presence of
PMNs adenomatous thousands of polyps with an abnormal
thick pus polyposis genetic test known as the adenomatous
LIGHT CRITERIA : Protein > 0.5 (FAP): polyposis coli (APC) test. Start screening
effusion/serumfluid with sigmoidoscopy at age 12 every
year.
159. Enrollment Nonrandom assignment of subjects
(selection) to 172. Felty RA
study groups syndrome: Splenomegaly
Neutropenia
160. Entamoeba histolytic Source: Water, areas of poor
Source sanitation 173. Felty Felty syndrome, a triad of rheumatoid
symptoms Symptoms: Mild to severe bloody syndrome arthritis,
TXT diarrhea, abdominal splenomegaly, and neutropenia, have this
pain; cysts and trophozoites disorder as an
seen in stool sample underlying cause. The basis for these varied
Treatment: Metronidazole, clinical abnormalities
paromomycin is unknown, but autoimmunity, provoked in
some
161. Epidural abscess Percussion tenderness, fever and
way by the tumor, seems likely.
worsened by recumbency
174. Fibroma Benign tumor of fibroblasts
162. Epigastric Duodenal ulcer disease Endoscopy
2. Associated with pleural effusions and
discomfort,
ascites (Meigs syndrome); syndrome
pain better when
resolves with removal of tumor
eating
175. findings in pulses paradoxus - decrease of systolic
163. Escherichia coli Source: Food/water (travelers'
cardiac bloodpressure on inspiration
(enterotoxigenic) diarrhea)
tamponade
Source Symptoms: Watery diarrhea,
symptoms vomiting, fever 176. Fistulae - severe disease unresponsive to other agents
TXT Treatment: Hydration; self-limited medications is treated with antitumor necrosis factor
(often treated with FQ) (TNF) agents such as infliximab. Surgery is
done for fistulae only if there is no response
164. Excessive doses of -- reducing acetylcholine release at
to anti-TNF agents.
magnesium sulfate the myoneural junction ---
can cause what depressed respiratory effort/ apnea, 177. Fluticasone is Treats allergies an for asthma step up
ONLY GIVE UNDER muscle paralysis for what
32 weeks visual disturbances 178. For non Risperidone
and decrease DTR compliant pt and then go Haloperidol deconate or
Pulmonary Edema who need Pluphenazine deconate
165. Exercise - in a Hypoglycemic symptoms: antipsycotics
diabetic tachycardia, diaphoresis, dizziness, Start with
palpitations, trembling 179. FREE AIR Somatic pain - from peritonitits - it is sharp
LOW BLOOD SUGAR UNDER the and localized pain ( lots of nerve fibers)
166. Extra adrenal typically seen adjacent to the aorta - diaphragm
pheochromocytomas organ of zuckerlandl what kind of
pain is it
167. Facial acne come Pilosebaceous follicles
from what unit 180. Free wall ...
reupture
181. Freshwater, in which is hypotonic, alters pulmonary 190. Granuloma inguinale type? nodules coalesing
lungs surfactant, resulting in unstable alveoli, type of lesion ? grenulomatous ulcers
which then collapse. The hypotonic pain? pain?- no
freshwater is absorbed into the body, Number of lesions? Number of lesions? - single or
resulting lymphadenopathy -- multiple
in acute hypervolemia, hemodilution, and >Pain? --> type ? lymphadenopathy -Suppurating
intravascular hemolysis. At autopsy, constitutional symptoms pseudobubo->Pain? no --> type
the lungs may contain little water. ?
constitutional symptoms 1-5%
182. Frontotemporal early personality changes
dementia apathy disinhibition and compulsive 191. Granulosa cell tumor Most common sex cord stromal
behaviour tumor. Predominantly women in
Frontotemporal atrophy on neuroimaging their 50s. Often produce
estrogen
183. Gallstones s/p 40% of developing symptomatic
and/or progesterone and
gastric bypass gallstones --- d/t rapid weight loss
present with abnormal uterine
surgery following the surgery
bleeding, sexual precocity (in
+ if at the time of surgery there is
preadolescents),
gallstones - then prophalectic
breast tenderness. Histology
cholestectomy
shows Call-Exner bodies
if not then prophylatic ursodeoxycholic
(resemble primordial follicles).
acid is used for six months
192. Hawthorne effects refers to a change in behaviour
184. Genu varum Bow legs - physiologic until 18 months = IF
that occurs if the participants
it persists then it is BOUNT DISEASE (
know they are being studied
defective medial tibial + tibial torsion)
TIBIA VARA 193. HAzard ration HELP
185. Giardia lamblia Source: Surface water (usually 194. headaches worse SVC syndrome - TREATMENT IS
Source limited to wilderness or other countries) leaning forward - that RADIATION
symptoms Symptoms: Greasy, foul-smelling are diffuse and get
TXT diarrhea; abdominal pain, malaise; weight worse when leaning
loss, cysts and trophozoites seen forward + hx of smoking
in stool sample + neck vein distension
Treatment: Metronidazole; hydration
195. Hepatic encephalopy abnormal albumin and elevated
186. A girl presents This is because impaired cell mediated INR -
with chronic immunity high ammonia
candida waxing and waning
infections
196. herpes gingivostomatitis Herpes gingivostomatitis -
+ DM
vs. Coxsackie infection vesicular eruptions on anterior
+ thyroiditis
oral mucosa & perioral region
187. Glucose to INcrease 100 mg of glucose -> decrease Coxsackie A - vesicles are
sodium sodium by 3 located at the back of the
oropharynx and the tonsil palate
188. Goal paO2 on a 60 mmhg to 80 mmHg
vent 197. Herpes simplex form of viral encephalitits - Pt
encephalitis have fever headache adn seizure
189. Good better overall prognosis: Being female,
+ confusion adn stupor-
prognosis for rapid (vs. insidious) onset of symptoms,
abnormalities in the
schizophrenia older age of first episode, predominantly
frontotemporal regionso f the
positive (rather than negative) symptoms,
brain
presence of mood symptoms, and good
- can have temporal based
pre-illness functionin
seizures anosmia gustatory
hallucinations
198. HEr sclera is seen above lid lag
her irsis on downward
gaze
199. High-risk 208. Hypercalcemia -lithium
features for with elevated primary adn teritary
malignancy: PTH hyperparathyroidism
SOlitary Familial hypercacemic hypocaliuria
2.3 cm diameter, spiculated, >60 yo, >1
pulmonary teriparatide.
ppd
nodule
current smoker, no prior smoking 209. Hyperkalemia
cessation
200. Hit 1 Non immune causes the activation of
plate
201. HIT 1 vs HIT 2

210. Hyperosmolar Extremely high glucose with profound

hyperglycemic dehydration
nonketotic b. Occurs in patients with DM type II
syndrome (HHNS with lengthy infections, stress, or illness;
You can continue heparin in HIT 1 insulin production is sufficient to prevent
DIC in HIT 2 DKA
HIT 2: Nonheparin anticoag (argatroban, c. H/P polyuria, polydipsia, dehydration,
bivalirudin)--> start warfarin when plt mental status changes; seizures and
>150k stroke can occur in severe cases
202. HIT 2 The antibodies bind to the PF4-heparin 211. Hypertension -- Think secondary causing
complexes on the platelet surface and that is refractory with history of Smoking and PAD
induce platelet activation by cross- to maximal think Renal artery stenosis
linking FcIIA receptors medical therapy
203. HOCOM murmur Louder When standing less blood in the 212. Hypokalemia, 1. surreptitious vomiting - decreased Cl
ventricle and the septum deviates more alkalosis and 2. Diuretic abuse
into the left ventricle = MORE normotension 3. Bartter syndrom
OBSTRUCTION 4. Gietelman syndrom
204. How can you - surgical removal and alkalinzing the 213. Hyponatremia - Fluid Restriction - all patients to re-
help a cysteine urine hypotonic 120- equilibrate
stones 130 mmol/L
205. How fast to 1 C per hour is acceptable 214. hypothyroidism hypothyroidism -will have slowing of the
elevation in the + fluid recessatation vs. cushing's reflexes
temp for syndrom Cushings will have have more bruising,
hypothemeria normal reflexes and acne
206. How to reduce Venodilation decrease decrease the : both have myositis, weight gain aadn
cheat pain in MI preload -- reducing the ventricular menstrual irregularities
volume as well as the ventricular weall 215. Hypovolemic Diuretics
stress Hyponatremia > Una and FEna > 1%
as a result = decrease myocardial
216. IBD, inflammatory Heme positive diarrhea, crampy
oxygen demand is decreased
bowel disease abdominal pain, and weight loss are
NITRATES cause veno dilation
classic findings
207. Hyedes Angiodysplasia + aortic stenosis
217. If a patient has steroids
syndrome Can induce vWF2A - because high
acute gout and
sheer stress activation of ADAMS T 13
cant use NSAIDS
which deactivates vWF = Bleeding
or Colchicine
disorder.
then what is the
next therapy
218. if a patient with a Ergot should be avoided -- as the 226. Indications for As a substitute for nursing care of the
migraine has combination with tritans can cause NOT patient or resident with incontinence
already take severe prolonged vasconstriction- catheterizing a As a means of obtaining urine for culture
sumatriptan what elevated BP MI or stroke patient or other diagnostic tests when the patient
drug should be can voluntarily void
avoided For prolonged postoperative duration
without appropriate indications (e.g.,
219. If previous hx of Heparin use if h/o HIT: if PF4 Ab
structural repair of urethra or contiguous
HIT can you use (typically >100 d after dx) re-
structures, prolonged effect of epidural
heparin exposure to UFH reasonable (eg, for
anaesthesia, etc.)
surgery); HIT recurrence low
220. IF RENAL FAILURE LMWH, Agrobatin and WARFARIN Note: These indications are based
( CT 25%) what primarily on expert consensus.
anticoagulation do
227. Indications for Draining over 1500ml when first inserted
you use in CT
surgery after or
221. ileus characteris Obstruction of both small and large placeing a chest 600ml in the first 6 hours
bowel tube for a
222. Inclusion Body AFter age 50 in men - slowly hemothroax
myositis prgressive wekness 228. Infants of high maternal blood glucose results in
Dysphagia is common, occurring in 40- diabetic elevated fetal insulin (= will hypertrophy
66% of patient mothers and at the expense of maturation) ===>
Myalgias and cramping are relatively surfactant therefor the pneumocytes aren't mature
uncommon. enough to produce surfactant
The distribution of weakness in s-IBM is The risk for RDS does no because equal
variable, but both proximal and distal to non diabetic children until 38-39
muscles are usually affected and, weeks
unlike polymyositis and
229. INfectious fibrosing mediastinitis from
dermatomyositis, asymmetry is
etiology of SVC granulomatous infections such as TB or
common
syndrome histoplasmosis
Muscle wasting is prominant
compared to poly and derma 230. Inferior MI Heart block because RCA is infarcted
223. Increased RDW + iron def anemia 231. Inhaled Example of ICS are:
microcytic coritcosteroids Beclomethasone, budesonide,
flunisolide, fluticasone, mometasone,
224. Increase risk of endometriosis
triamcinolone
ovarian neoplasma brac
Alternate long
PCOS
Advanced age 232. In NPH what is Failure to inhibit the voiding reflex
HPNCC the cause of the
infertility / nuliparious urinary
decrease risk : breast feeding, OCP, incontinence
PRegnancy
233. In pulmonary EKG as it changes managment, A
225. Indications for These include edema what is fibrillation, atrial flutter, ventricular
indwelling catheter a) urinary retention the most tachycardia -- rapid synchronized
, b) obstruction to the urinary tract, important test cardioversion
c) close monitoring of the urine output to do
of critically ill patients, immediately -
d) urinary incontinence that poses a
234. Insulin downregulation of GLUT 4
risk to the patient because of Stage 3
resistance
or greater ulcer to the sacral area, and
e) comfort care for terminally ill
patients.
235. Interpretation 2 criteria = SIRS 245. Klippel-Feil relative fusion of the involved
of SIRS *2 criteria + source of syndrome vertebrae
Criteria infection*= sepsis Associated abnormalities may include
*2 criteria + source congenital torticollis, genitourinary
of infection + organ anomalies, congenital heart disease,
dysfunction* = severe hearing loss, and Sprengel's
sepsis deformity (congenital abnormality of
*2 criteria + source the scapula in which the
of infection+ organ scapula is rotated laterally leading to
dysfunction + hypotension* shoulder asymmetry and diminished
= septic shock shoulder motion
236. Intestional Jejunum mcc and from Warfarin, can cause 246. Kohler Bone Osteochondrosis of the tarsal nalicular
hematoma pseudo-obstruction - vomiting a drop a disease Swollen painful foot
HCT and 3-5 in boys
Tenderness over the medial longitudial
237. Investigator Subjective interpretation of data
arch
by investigator deviates toward
Weight bearing and walking Increase
" desired" conclusions
discomfort
238. IRON Toxicity As few as ten tablets are needed --- Nausea XRAY - FLATTENED AND SCLERORIC
vomiting, diarrhea and since it is caustic - AND THEN FRAGMENTED
blood is present
247. Krabbe disease Autosomal recessive lysosomal storage
fluid losses = hypovolemic shock => sever
disease due to deficiency of
lactic acidosis
galactocerebrosidase. Buildup
hepatotoxicity and organ failure
of galactocerebroside and psychosine
** survival can result in bowel scarring and
destroys myelin sheath. Findings:
Obstruction ***
peripheral neuropathy,
239. Isoniazid Neurotoxicity, hepatotoxicity. Pyridoxine developmental delay, optic atrophy,
(vitamin B6) can prevent neurotoxicity, lupus globoid cells
240. IS Staph toxin NO 248. Kussmaul sign pericarditis
affect by Tricuspid stenosis
heat? RVA infarct
241. Juvenile Features of JRA rash: 249. Lab abnormalities ___Increased Na in serum
arthritis Often only with fever spikes in diabetes __Low urine osmolality with large urine
"Salmon" colored insipidus volume
On chest and abdomen
250. LAb findings for -- Serum glucose > 200 mg/dL
Other features of JRA:
ketoacidosis Serum bicarbonates < 15 mEq/L
Splenomegaly
Venous ph < 7.3
Pericardial effusion
Anion gap > 14
Mild joint symptoms
LAB: ANA is normal. Ferritin level is 251. LABS for SiADH - Plasma hypoosmolality
markedly HIGH urine osmolarity > 200
elevated. high urine sodium > 30 mEq/L
242. Juvenile Half of cases improve with aspirin or 252. lactate ringer hyponatermia -fluids
arthritis NSAIDs. If there is no response, then use
253. Lamivudine A/E Hepatotoxicity
Treatment steroids. Steroid resistant cases are treated
with TNF drugs. 254. LANDMARKS on 12 weeks Pubic Symphysis
the body 20 weeks Umbilicus
243. Juvenile age 10 = absence seizures
12 weeks 36 weeks Xiphoid Process of Sternum
myoclonic myoclonic seizures age 15 ---> generalized
20 weeks 37-40 weeks Regression of fundal
epilepsy tonic clonic around age 16
36 weeks height between 36-32 cm
244. Kaplan Rheumatoid arthritis with a pneumoconiosis 37-40 weeks
syndrom
255. Late presentation You want to manage the HTN but the
of coarctation of most important measure is surgeical
the aorta correction !!
256. LDL for < 100 266. LGSIL in a women > Unknown - colposcopy and biopsy
diabetics 30 with unknown + colposcopy and biopsy
HPV status - --> repeat co-testing in 1 year or
257. Lead-time Screening test provides earlier diagnosis
+ HPV status colposcopy biopsy
in studied group compared with
- HPV status
controls but has no effect on time of
survival 267. Lithium - Dose-related: Tremor,
gastrointestinal (GI) distress,
258. Legg-Calv- Self limited AVN, 20% bilateral
headache
Perthes disease associations
Dermatologic problems: acne;
family history
interferes with patient compliance
low birth weight
Weight gain: may interfere with
abnormal pregnancy/delivery
patient compliance
history of trauma to affected hip
Cardiac conduction:
259. Legg-Calv- brace in flexion and abduction x 2-3 yr electrocardiogram (ECG) changes
Perthes disease femoral or pelvic osteotomy usually benign
treatment prognosis better in males, <5 yr old, <50% Hypothyroidism: 5% of patients
of femoral head involved, abduction >30 develop thyroid problems
50% of involved hips do well with non- Leukocytosis: usually occurs and
operative treatment seems to be benign
complicated by early onset Polyuria: diabetes insipidus is
osteoarthritis and decreased ROM common - treat with amollride
260. Leiomyomata Classified based location - Intramurual Teratogenicity: associated with
uteri RF > 40, AA, No pregnancy, cardiac abnormalities;
Very transform contraindicated in first trimester,
Estrogen and progestion sensitive Ebstein's anomaly (tricuspid valve) in
the left ventricle
261. Lemierre strep pharyngitis - moves to the clots
Nephrotoxic
syndrome down to the IJ and sends out septic clots
268. Lower colonoscopy
262. Length Screening test detects several slowly
gastrointestional
progressive cases of a disease and
bleed first test of
misses rapidly progressive cases
choice
263. Lennox -gastaut Under 7
269. LOw risk factors Non fasting total cholestrol
syndrome wide array of seizures types
what lipid level HDL
+ mental retardation
---- If total cholesterol is under 200,
264. Leukocytoclastic henoch-schonlein purpura ( HSP) - 1/2 of then check them again in 5 years
vasculitis time it is triggered by an URI
270. Lymphangiosarcoma Stewart-Treves syndrome is a rare,
Palpable nonblanching symmetric
deadly cutaneous angiosarcoma that
purpuric lesions are characteritic skin
develops in long-standing chronic
findings
lymphedema; post mastectomy]
+ joint pain ( oligoarticular -knees and
----multiple reddish blue macules or
ankles)
nodules that may become polypoid.
+ deposition of igA in the postcapillary
Around these nodules, small satellite
venules
areas can develop and become
265. LEwy body visual hallucinations confluent, forming an enlarging
dementia + spontaneous parkinsons lesion.
fluctuating cognition - flucuating
271. Management for In low-risk patients, <35 years of age
cognitive fuction - daytime naps lasting >
pulmonary nodules and nonsmokers with calcified
2 hours, prolonged staring spells
in low risk patients nodules, you may follow
the patient with chest x-rays or chest
CT every 3 months for 2 years. Stop
the follow-up if after
2 years there is no growth.
272. Management of - surgical if persists beyond 10 years 283. MOA of angiotensin
KNock knees complication is osteoarthritis is not II
treated
273. Mastoiditis Hx of Otitits Media
Displacement of the pinna
IV CEPHTRIOXNE
Classic Triad
Otorrhea arteriolar vasoconstriction and increase
Tenderness to pressure over in blood pressure
themastoid Increases ADH secretion
Retroauricular swelling with
protruding ear 284. moderate Give with loop diuretics + Hypertonic
hyponatemia 110-120 saline until 120 after that 0.9% saline
274. MCC cause of osteoarthritis - mmol/L
spinal stenosis
285. Mohs surgery: microscopically controlled, minimally
275. McRoberts Flexing the woman's knees toward her invasive, stepwise excision for lesions on
maneuver shoulders the face or in areas that are difficult to
276. Mechanisms of - overproduction of 1,25 (OH) vitamin D, reconstruct
hypercalcemia of Bone metasis, or IL-6 286. most common brain astrocytoma ( subcategory of gilomas)
malignancy most common is PTH rp tumor in adults AGE, Functional status - and tumor
277. memantine NDMA receptor agonist important grade
receptor prognostic factors

278. Metabolic Conns 287. Most common cause Viruses (parvoB19 & HHV6 > coxsackie,
alkalosis with high cushings, of viral adeno, echo, CMV, HCV):
urine cholride licorice posiioning 288. Most common initial Look for multiple neurological deficits
Renal artery stenosis presentation of of the CNS affecting any aspect of CNS
279. Metachromatic Autosomal recessive lysosomal storage multiple sclerosis functioning. The most common
leukodystrophy disease, most commonly due to presentation is focal sensory
arylsulfatase A deficiency. symptoms, with gait and balance
Buildup of sulfatides -> impaired problems
production of myelin sheath. Findings: ----. Blurry vision or visual disturbance
central and peripheral from optic neuritis
demyelination with ataxia, dementia. is no longer as common as the first
presentation----
280. methotrexate use -hemodynamic stability
for ectopic -nonruptured 289. Most common metastases
pregnancy -size of mass <4cm intracranial tumor in lung. breast, melanoma, and renal cell
-no fetal heart rate or <3.5 cm in adults carcinoma
presence of a FHR 290. MS treat Flare - hig dose corticoosteroid
-normal liver and renal fxn recurretn Ifn B1/ keep them on it
- bhcg < 5000 Glatiramer acetate 0
281. Milller fisher Opthamalplegia, ataxia, areflexia OR
-- a type of GBS-- natalizumab- can causes PML
reactivation
282. Minute ventilation RR X TV
FATIGUE TrEATMENT AMANTIDINE or
FLUOXETINE
291. Mucinous Pseudomyxoma peritonei-
cystadenocarcinoma intraperitoneal accumulation of
mucinous material from ovarian or
appendiceal tumor.
292. Mucinous Multiloculated, large. Lined by mucus-
cystadenoma secreting epithelium
293. MUDPILES Methanol 302. Neuropathic pain pain is secondary to
Uremia destruction of the nerve
Diabetic ketoacidosis tissue itself -- as in
Propylene gylcol / paraldehyde peripheral neuropathy -
Isoniazide/ IRON burning and tingling are
Lactic acidosis common
Ethylene glycol -antifreeze
303. Neuropathy d/t sorbitol and age
Salicylates
productions
294. Myasthenia Gravis Actylel choline receptor antibody
304. Next best step in an aplastic Bone marrow aspiration
antibodies Muscle specific kinase antibody ( no
crisis
thymectomy)
305. NF1 and hypertension Essential htn can be seen
295. Myasthenia gravis Anticholinesterase - symptomatic
any age and is not
long term therapy treatment
related to renal artery
SHort term crisis Azathioprine and cyclosporine
stenosis
short term crisis - steroids (prendisone)
look for Not episodic and
plasmaphersis and IVIG
no signs of
296. Myasthenia Gravis Upward gaze 30sec = ptosis phenochromocytoma -
test ICe pack resolves it palpitations and sweating
297. Myoclonic frequent limb jerking 306. NF1 inheritance Autosomal dominant -
aeizures new mutations
298. Neonatal purpura occurs usually in patients with a 307. Normal pressure Ataxia early
fulminans deficiency of protein C. hydrocephalus urinary incontinence
2 hours after birth, a neonate with dilated ventricles on
neonatal purpura fulminans exhibits neuroimagin g
purpuric lesions over many different
308. Normal RDW + microcytic Thalasemia
skin sites, including the perineal region,
the flexor surface of the thighs, and 309. the normal reference range for DECREASE sensitivity
abdominal skin. serum calcium level in a local and increase specificity
laboratory is 8-10 if it is
299. Neo-vascularity Seen in glioblastoma
increase to 11 how does this
seen in what brain
affect sensitivity and specificity
tumor
310. NSAIDS Can cause urinary
300. Neurofibromatous CNS:
retention by decreasing
1 associated Low-grade gliomas (optic),
Detrusor muscle
symptoms hamartomas
contractility
Malignant neoplasms (astrocytoma,
neurofibrosarcoma, and others) 311. NSAIDS induced allergic Lacks fever rash, and
Transient ischemic attack, hemiparesis, nephritis eosinophila
hemorrhage 312. Nuroleptic maligant syndrom DOPAMINE
Complex partial or generalized HTN, > 40 C, Tachypneia,
seizures HR> 90
Cognitive defects, learning disabilities, DIFERENT - lead pipe
attention deficit, speech abnormalities, ridgity , hyporeflexia,
psychiatric disturbances normal pupiles
Renovascular hypertension - renal
313. Nursemaid elbow treatment Supination of the forearm
artery stenosis or pheochromocytoma
past 90degrees
- Increased incidence of leukemia,
ALTERNATIVE _
rhabdomyosarcoma, Wilms tumor
Hyperpronation of the
301. Neurogenic Cholinergic agonist - causes the forearm while in the
BLadder detrusor muscle to contract. flexed position
medication
314. Observational Subjects may *respond to subjective 322. Otitits Extrnea pain and drainage, foul
questions in a different way* than smelling discharge
normal because awareness of the pain and hearing loss
study changes their perception of the Exquiste tenderness on
examined issue --hwathtrone pulling the pinna or traction
of the tragus
315. Observer a type of measurement bias in which the
OTOSCOPE is Painful to
biases investigator unconsciously influences the
conduct
outcome of the study by knowing the
- ear cannal is moist
exposure status of each participant
swollen + purlent disease
316. Obstructive FEV1 - DEcreased --D/t water in the ear upset
levels for FEV1 FEV1 /FVC - Decreased the acid balence in the ear
and FVC MCC bacterial
317. OCP decrease Decrease risk of ovarian and endometrial pseudomonas >Proteus
the risk of cancer vulgars > staph aureus
what type of increase the risk of breast and cervical MCC aspergillus nigrans
cancer and ( increase risk of hypertension and venous black dots with cotton
increase the thrombosis) material surrounding it and
risk of what more purulent then painful
other type TXT: remove debris with
DRY suction or with wipes
318. OCP when risk returns to normal in 10 years
no water irrgation
does the risk
mild externa - 2% acetic
for breast
acid + corticostreids
cancer
moderate - 2% acetic acid +
become
corticostreids + ABX
normal again
neomycin or polymyxin
319. Only vaginitis Candida vaginitis - thick cottage cheese
323. Ovalo-macrocytes red blood bone marrow biopsy
in a ph below 4 discharge
cells and neutrophils with because this is
- vaginal inflammation and erythema
decrease segments myelodysplastic syndorme
txt fluconazole
+ thrombocytopenia and
DM, recent abx use immunosuppression
leukopenia
and increase estrogen levels ( pregnancy)
324. Pain under his left nipple that PE --- can have cough &
320. Organ of Pheochromocytoma - sue MBIG scan
decreases when he holds his hemoptysis
zuckerkandl is
breath--- he is hypoxic and
the most
tachypneic
common
extramedullary 325. Pain worse when walking osteoarthritis of the spine
sight for downhill as opposed to up leading to spinal stenosis
hill --- + bilateral thigh pain
321. Osler-Weber- Osler-Weber-Rendu disease (OWRD) is a
with walking and standing
Rendu disease rare autosomal dominant disorder that
affects blood vessels throughout the body 326. Pain worse with lying flat Electrocard iogram
(causing vascular dysplasia) and results in a better when sitting up, young with ST elevation
tendency for bleeding. (The condition is (<40) everywhe re, PR depression
also known as hereditary hemorrhagic 327. pancreatic abscess: circumscribed collection of
telangiectasia pus (usually w/o pancreatic
--- mucocutaneous telangiectases and tissue)
arteriovenous malformations (AVMs), treat with abx + drainage
(CT-guided if possible),
usually seen 4 wk into
course
328. pao2 under 70 and Add prednisone - + TMP-
Pneumocystis SMX
329. Papillary muscle rupture more common after inf 338. pheochromocytoma Adrenal medullary -chromaffin
MI (PM pap. muscle comes from cells -
supplied by episodic hypertension
PDA alone) than ant MI tachycardia, palpitations
50% w/ new diaphoresis and headaches
murmur, rarely a thrill, v
339. PIck disease dementia aphasia
wave in PCWP tracing (
spares parietal lobe
other causes is tricuspid
or mitral reguritation) ; 340. Pneumocystis what lab LDH
asymmetric pulmonary is elevated
edema. 341. POD 1-2 Atelectasis #1
Rx: diuretics, Pneumonia
vasodilators, IABP, Do a CXR if suspected followed
surgery. by sputum culture
330. Partial mole 69,XXX; 69,XXY; 69,XYY Treatment -Incentive spirometry
-Antibiotics
331. pathophysiology of carpal Accumulation of fluid in
Vanc. + Pip/Tazo
tunnel in pregnancy carpal tunnel
342. POD 3-5 UTI
332. Pericarditis radiation Left arm or shoulder
Urinalysis
333. perifollicular hemorrhages from vitamin C deficiency Nitrite "+"
Leukocyte Esterase "+"
334. A person taking steroids for Corticosteroid therapy
TREATMENT: Antibiotics
LUPUS --stops for the 3 days
and is found unconsious with 343. POD 5-6 DVT Thrombophlebitis
low blood pressure after fluid (IV site infection)
resuscitation what is the next Doppler US
best step Anti-coagulation
Heparin-> Warfarin
335. Person with early onset Alpha 1 antitrypsin
emphysema has inclusions in deficiency 344. POD 7 Incision-site
the liver that stain with PAS and Infection Cellulitis
resist digestion by distase Physical Exam
Erythema
336. Phentermin weight loss less then 3
Pus
months
Swelling
inhibits NE and
Abscess TXT Incision/Drainage
SERITOININ uptake
Antibiotics
Se Tachycardia and
increased BLOOD 345. POD 8-15 Drug Reaction OR Deep Abscess
pressure DIAGNOSIS : D/C likely
medication CT Scan
337. Pheochromocytoma associated Most common site
Drainage and abcess
disease adrenal medulla, but can
occur anywhere along 346. POlyglandular type 2 addisons and thyroiditis and DM1
abdominal
347. Polymyositis and The best initial test is CPK and
sympathetic chain
Dermatomyositis aldolase. The most accurate test is
Children age 6-14 years;
Best inital test a muscle
20% are bilateral, and
Most accurate test biopsy.
some with multiple
tumors 348. POrtal hypertension serum to ascites > 1.1g/dL
*Autosomal dominant; SAAG
associated with 349. Post Chemotherapy immunocompromised increase
neurofibromatosis, MEN- what infections are you risk of gram negative organisms
2A and MEN2B, at an increased risk of such as pseudomonas aeruginosa
tuberous sclerosis,
350. Posterior hip sciatic nerve
Sturge-Weber syndrome,
dislocation nerve injury
and ataxia-
telangiectasia*
351. Post- is an adverse reaction to a blood transfusion 360. Primary herpes type of lesion ? - grouped papules
transfusion or platelet transfusion that occurs when the simplex virus vesicles pustules ulcers
purpura body produces alloantibodies to the type of lesion ? pain? Yes
(PTP) introduced platelets' antigens. These pain? Number of lesions? often multiple
alloantibodies destroy the patient's platelets Number of lesions? lymphadenopathy -->YES Pain? YES-->
leading to thrombocytopenia, a rapid lymphadenopathy type FRIM ?
decline in platelet count.[1] PTP usually -->Pain? --> type ? constitutional symptoms COMMON
presents 5-12 days after transfusion, and is a constitutional
potentially fatal condition. symptoms
352. Pregnancy Amoxicillin/ ampicillin and then 361. Primary Renal
UTI nitrofurantonin causes of nephrotic
treatment pyelonephritis syndrome
hospitalization and IV antibiotics
353. presents as a Cholesteatoma - from repeated ear
"small white infectons
pearl" behind
an intact
tympanic
membrane protein uria > 3.5/day
(anterior and hypoalbuminemia
medial to NX
the malleus) 362. Primary syphilis type of lesion ? clean ulcer raised
or as a type of lesion ? pain? NO
conductive pain? Number of lesions? single
hearing loss Number of lesions? lymphadenopathy -B//L ->Pain? -NO ->
354. Pressure Delivered set pressure monitor the volume lymphadenopathy type ? FIRM
controlled for possible decreased Minute ventilation - -->Pain? --> type ? constitutional symptoms NO
because of decreased volume constitutional
symptoms
355. Pressure title volume and cycle lenght by the patient
Support HIGHER pressure less effort of breathing for 363. Prion disease RAPILY progressive
the pt startle Mycoclonus or seizure
---- can be used slowing - - Tau proteins and 14-3-3
EEG triphasivic waves
356. Preventatives Topiramate
therapies for divalproex sodium 364. Prophyia treatment Give glucose and heme - downregular
migraines tricyclic antidepressenants ala synthase
Beta blockers - propanolol and remove drugs d/t increase cyp450

357. PREVENTING DECREASE ALCOHOL 1st line 365. pseudoclaudication pain with walking and prolonged
GOUT and BMI under 25 standing a
- When can You can give medications: 366. Pseudotumor Patients present with a headache, visual
you give - repeated and disabling attacks of gouty cerbri presentation disturbances such as diplopia,
medication arthritis Peripheral loss
tophi suggesting chornic disease and sixth cranial nerve (abducens) palsy.
X-ray evidence of chronic gouty jint disease pulsatile tinnitus
uric acid kidney stones ---There is an association
renal insufficiency with obesity, chronic lung disease,
358. Previous Patient should have a colonoscopy every 3 Addison disease, oral contraceptives,
adenomatous to tetracycline use, and
polyp: 5 years. vitamin A toxicity

359. Previous Patient should have colonoscopy at 1 year

history of after resection, then at 3 years, then every 5
colon cancer: years.
367. psoriasis - where involves extensor surfaces of
the elbows and knees and
produces a well demarcated
plaque + silvery scale
+ pruritus
+ exacerbation by dry weather
+ nail pitting in 50%
368. pt 65, painless CLL -
lymphadenopathy - treatment is anti CD20 on the b
fragile lymph cells = lymphocytes
smudge cell and
decrease RBC, increased
LDH
thrombocytosis
what is it
what is the treatment
369. pt 67; Glare while driving Cataracts
at night + progressive
blurring of her vision ---
370. Pt has non blanching This is early of a pressure ulcer -
erythema on their heels frist line treatment is to elevate
the legs by placing pillows
under them
371. pt with pancreatic cancer direct conjugated
and has severe pruritus hyperbilirubemia is known to
what is the management cause pruritus -- PLACE ERCP
stent in the common sten -
would relieve the obstruction
372. Publication Studies that show a difference
between
groups are more likely to be
published
than studies that do not show a
difference
373. Pulses paradoxus what COPD and ASTHMA and
do you see in cardiac tamponade
374. Recall Errors of memory within
subjects because of prior
confounding experiences
375. Recall biases measurement bias that results
from misclassification of
exposure secondary to over or
under reporting of the exposure
376. Recurrent late management C section
decelerations
377. Renal Elevated phosphorous + low Calcium
osteodystrophy aka + renal dysfunction + bone pain
tertiary -- Low GFR = phosphate retention
hyperparathyroidism and calcium dumping = Increase PTH
release and hypertrophy of the
glands even after the kidneys are
fixed this still occurs
378. Repeated leaning on compression at the epicondylar
the elbow results in groove ---
379. Rhinitis s a condition of rebound nasal
medicamentosa congestion brought on by extended
use of topical decongestants (e.g.,
oxymetazoline, phenylephrine,
380. rhodococcus equi R equi is a facultative, intracellular,
nonmotile, non-spore-forming,
gram-positive coccobacillus
Pulmonary R equi infections include
the following:
Fever and cough (>80% of patients
with pulmonary R equi infections)
Malaise
Chest pain
Dyspnea
Hemoptysis
Weight loss
Possible chronic or relapsing course
Possible community-acquired
pneumonia that fails to respond to
empirical treatment
381. Rifamycins Minor hepatotoxicity and drug
interactions
(P-450);
orange body fluids (nonhazardous
side effect).
Rifabutin favored over rifampin in
patients with HIV infection due to
less cytochrome P-450 stimulation.
382. Right Ventricular increase JVD and + kussmaul sign (
infarction increase JVD on inspiration)
Optimize preload increase venous
return - give fluids + dobumine !!
383. Risk Factors for rise in serum [Na+] with correction >8
Osmotic mmol/L/d if chronic hyponatremia
Demyelination
384. Risk factors for otitis second-hand smoke ( H influenza
media more common in this situation)
crowded living conditions (day
care/group child care facilities) or
sick contacts
male
family history
bottle feeding, pacifier use
385. Risk of get betamethasone injection --- increase 394. Self-selection Patients with a certain medical history
Premature fetal lung maturity may be more likely to participate in a
birth at weeks study related to their condition
24 -34
395. Separates R and L Cantalies line - fiberous septum
386. Salmonella Source: Eggs, poultry, milk, LIVER
species fresh produce *(most common
396. Serotonin syndrome SERITONIN
Source foodborne bacterial GI infection)*
HTN, > 40 C, Tachypneia, HR> 90
symptoms Symptoms: Nausea, abdominal
Different - hypertonic in lower
TXT pain, bloody diarrhea, fever, vomiting
extremites, hyperreflexia, dialted pupils,
Hydration; self-limited;
hyperactive bowel sounds
treat immunocompromised
patients with FQ 397. Serous Lining similar to fallopian tube
cystadenocarcinoma epithelium Often multilocular
387. Salt water in the hypertonic water draws water out of
Histologically contain Psamomma
lungs the body into the lung, causing systemic
bodies (calcified concentric
hypovolemia and hemoconcentration. The
concretions)
lungs become even more heavy
and fluid-filled because the surfactant is 398. Sertoli-Leydig cell 1. Composed of Sertoli cells that form
essentially washed ou tumor tubules and Leydig cells (between
tubules)
388. SBP diagnosis Ascitic fluid PMN > 250 cells/uL
with characteristic Reinke crystals
TXT- cultures often negative or may grown one
2. May produce androgen; associated
organism
with hirsutism and virilization
3rd cephalosporin
fluoroquinolones and 399. SEVERE < 110 or give hypertonic saline by 1 to 2
extended spectrum penicillin symptomatic ( mEq/L/hour until symptoms improve
hiccups) ---> hypertonic saline increased the
389. Scheuermann's Osteochondrosis of the vertebral bodies
tonicity of the ECF
kyphosis ( adolescent boys
Soluching Etiologies and pathologies are uncertain 400. Shigella species Source: Food/water; associated
disease) - Round shoulder posture back ache low Source with overcrowding
grade and kyphosis symptoms Symptoms: Fever, nausea, vomiting,
3 wedge vertebra TXT severe bloody diarrhea,
abdominal pain (risk of HUS)
390. Scleroderma INCREASE RENIN
Hydration; self-limited;
crisis INCREASE activation of the coagulation
*ciprofloxacin, TMP-SMX
casade
in severe cases*
INCREASE vascular permeability
--- sudden onset renal failure and 401. SiADH
malignant htn
391. Scoliosis - 10 -20 degrees curvature follow up 4-6
Before and months
during growth if 5 degree progress then ortho for
spurts surgery and brace fixation
Urine osmolality greater then BLOOD (
Surgery vs > 40 Degrees internal Brace
in primary polydipsia urine osmo is low)
bracing if after puberty > 50 degrees then surgery
BLood sodium is LOW
392. Screening for LDL between 70-189 mg/dL, Urine Sodium 40
LIPIDS pt 40- if ASCVD is > 7.5% need treatment
402. si ADH txt Free water restriction
75 TREATMENT
if ASCVD < 7.5% need to monitor every five 403. Sick Euthyroid initially low free T3 may be followed by
years Syndrome (SES) low TSH and if severe illness low free
T4. With recovery
393. Selective IgA Celiac disease
of illness TSH may overshoot and
deficiency
become transiently high
with
autoimmune
disease
404. Side effects of palpitations, chest discomfort, tremor, 412. small bowel xray
Beta tocolytics SOB, and decreased blood pressure
Possibly can cause - Pulmonary edema +
worse in combo with glucocorticoids
405. Signs of acute chest pain adn signs of cardiogenic shock
myocardidit s and caused by coxsackievirus
406. Simple febrile Duration <15 min (95% <5 min)
seizure Generalized tonic-clonic
No recurrence in 24-h period
No neurological impairment or
developmental delay before or after
seizure
407. SIMV TITLE VOLUME AND RATE SET No
there valvulae conniventes extending
pressure
across the bowel lumen
and pt can intiate there own breath
dilated if greater then 3 cm
408. Single family Begin 10 years earlier than the age at MCC cause is adhesions
member: which the family member developed their ( colon is dilated > 6 cm)
cancer or age 40, whichever is younger
413. sodium SPS exchanges sodium for potassium
409. SIRS criteria 1. Body temperature <36C or >38C polystyrene and binds it in the gut, primarily in the
2. Heart rate >90 BPM sulfonate large intestine, decreasing the total
3. Tachypnea >20 breaths per minute, or (Kayexalate) body potassium level by
PC02 <32 mm Hg approximately 0.5-1 mEq/L. Multiple
4. WBC <4,000 cells/mm3 or >12,000 doses are usually necessary.
cells/mm3
Onset of action ranges from 2 to 24
410. Slipped Capital Movement of the femoral neck upward
hours after oral administration and is
Femoral and forward.
even longer after rectal administration.
Epiphysis RF: Male, obese thyothryoid, tall
The duration of action is 4-6 hours
(SCFE) - multifactorial
1 meq of K for 1 meq of Na
genetic: autosomal dominant, blacks >
caucasians 414. soft murmur that this is aortic reguirgations
cartilaginous physis thickens rapidly under starts after S2 and MCC in develop nations --- 2nd aortic
growth hormone effects declines in root dilations or bicuspid aortic valve
sex hormone secretion, which stabilizes intensity unitl
physis, has not yet begun disappearing
overweight: mechanical stress suddenly before s1
trauma: causes acute slip : accentuating
when the patient
411. Slipped Capital B/L xray
sits up and leans
Femoral then surgical with screw through the
forward and put
Epiphysis epiphysis
his hands behinds
(SCFE) - txt
his head
415. Solitary lesion with GLIOMBLASTOMA MULTIFOMA
irregular borders
enhancing seen in
the MRI (on an
adult) is what type
of tumor
416. Solitary LAminated calcification - granuloma 422. SSRI Fluoxetine, paroxetine,
pulmonary popcorn calcification - hamartoma sertraline, citalopram.
nodule NO calcification - Cancer A/E: Fewer than TCAs. GI
LAminated PET scan can help distinguish benign distress, sexual
calcification from malignant nodules dysfunction (anorgasmia and
popcorn libido).
calcification Serotonin syndrome with any
NO calcification drug that
5-HT (e.g., MAO inhibitors,
417. Some risky MEds Sotol
SNRIs,
can prolong QT R-risperidone
TCAs)hyperthermia,
M- macrolides
confusion, myoclonus,
C- cimetidine, chloroquine
cardiovascular collapse,
Q- Quinidine
flushing, diarrhea,
T- thiazides
seizures. Treatment:
418. Spermatocele they usually arise from the head of the cyproheptadine (5-HT2
epididymis, they are found superior to receptor antagonist).
the testicle. They are smooth and
423. Stable AFIB stable - Beta blocks and CCB
spherical and transilluminate on
Symptomatic AFIB if only for 48 hours then
examination.
cardiovert
419. Spondylolisthesis occurs when the body of the vertebra if over 48 hours - warfarin
involved in the spondylolysis slips Symptmatic Beta blockers
anteriorly ---> Compression and CCB
420. Spondylolysis 424. Stage 2 of labor ARREST ---Cervical dilation no
Cervical cervical dilation for 2 hour-
Fetal Descent Give oxytocin
---fetal decent no fetal
decent for 1 hour tx c section
for cephalic disportion
425. Staph aueres food D/t Improper refridgeration
poisoning of food
426. Staph aureus food From improper refrigeration
poisoning of food
427. Staphylococcus aureus Source: Room-temperature
Source food
stress fracture in the pars interarticularis symptoms (caused by preformed toxin)
clinical features: activity-related back TXT Symptoms: Vomiting within
pain, several hours of eating;
Pain is localized and increases with diarrhea later
hyperextension Treamtent: Self-limited;
pain with unilateral extension (Michelis' hydration
test) 428. steroid myopathy manifests as proximal muscle
investigations weakness and atrophy,
oblique x-ray: "collar" break in the affecting
"Scottie dog's" neck the leg more than the arms.
Rest and analgesics The needle EMG is typically
421. Spontaneous Major cause of mortality and morbidity normal.2
bacterial in people with cirrhosis --- 429. _____steroid specific for IBD. Budesonide
peritonitits symptoms are nonspecific Fever + abd First pass effect is good for
pain, + nausea vomiting, malaise, EBD treatment.
FRANK peritoneal signs are absent --
430. St louis Arborvirus/ Flalvivirus- Headache nausea, 440. Taenia solium Source: Undercooked pork
encephalitis URBAN central outbreaks epidemics Source Symptoms: Mild diarrhea, CNS
Wild birds, moisquitoes, humans symptoms symptoms
Support TXT (neurocysticercosis)
Treatment: Praziquantel for
431. Stones <5 mm pass spontaneously
intestinal infection;
432. Stones 5-7 fedipine and tamsulosin to help them pass *albendazole
mm plus corticosteroids for
433. supracondylar Anterior interosseous median nerve ( close neurocysticercosis*
fracture - 2nd is radial nerve ( no shit))- unable to 441. TAG required to called 1000 greater then
HIGH FLEX interphalangeal joint of the thumb Pancreatitis
and Distal interphalangeal joint of index
442. Temporal love epilepsy - MOST OFTEN TEMPORAL
finger [ cant make ok sign]
complex partial seizure LOBE
434. Symptoms of Loss of consciousness,
a PDA based hallucinations, de ja vu,
on Age automatisms or staring blankly
+ post icital confusion
443. tenosynovial inflammation rheumatoid arthritis
with capral tunnel
syndrome seen in what
disease
Increase S2
444. Teratoma 90% of ovarian germ cell
435. Symptoms A ductus arteriosus with a moderate-to-
tumors. Contain cells from 2 or
with a PDA large left-to-right shunt may be associated
3 germ layers A B.
with a hoarse cry, cough, lower respiratory
Mature teratoma ("dermoid
tract infections, atelectasis, or pneumonia.
cyst")most common ovarian
With large defects, the patient may have a
germ cell tumor; mostly
history of feeding difficulties and poor
benign.
growth during infancy, described as failure
Immature teratoma
to thrive (FTT). However, frank symptoms of
aggressively malignant. -
congestive heart failure (CHF) are rare.
neuro tisssus
436. Symptos of Pupils unreactive to light Struma ovariicontains
hypo thermia Sinus brady cardia functional thyroid tissue. Can
Slow AFIB - lack of P wave but bradycardia present as hyperthyroidism
437. Synchronized PT determines can VOLUME delivered the 445. Tetanus, diphtheria and In all HIV pt give tdap once
intermitted lung -> the Ventilators - Delivers the pertussis vaccine in a and repeat Tdap during each
VENTILATOR Supportive breath at a set rate women pregnant with HIV pregnancy
438. Syncope with Orthostatic hypotension and TD every 10 years
blurred vision 446. Thiazide A/E Hyponatremia and
and dizziness hypokalemia :
- during *Hypokalemic metabolic
transition alkalosis,
from sitting to hyponatremia*,
standings hyperGlycemia,
439. Synovial Acromegaly hyperLipidemia,
tendon hyperUricemia, and
hyperplasia hyperCalcemia. Sulfa allergy
causes CTS 447. Thiazides affect on lipids Increase LDL, total cholesterol
seen in what TG ( VLDL)
disease
448. Third trimester Transabdominal ultrasound - to 460. Treatment for 1st LOOP diuretic
bleeding in a BIMANUAL or SPECULUM exam is NOT Pulmonary edema ECG - if d/t arrthymias fix those first
hemodynamically DONE in the third trimester Oxygen
stable pt - NEXT Morphine
BEST STEP nitrates
449. This patient has 461. Treatment for Type NIacin adn gemfribozol
headaches that 3&5
occur in the hyperlipidemia
morning and
462. treatment of Restore volume
increasing visual
hemothorax Chest tube
difficulty -- +
if > 1500 then thoracostomy
weight gain but
if > 200 then just chest tube
height velocity
has slowed down This is Thyroid disfunction from a 463. treatment of NF2 Treatment
Fundoscopy + craniopharyngioma Developmental and cognitive
papilledema evaluation and diagnosis
Prevent pathological fractures if LE
450. Three family Hereditary nonpolyposis colon cancer
cortical thinning present
members, 2 syndrome (HNPCC) comprises these
generations, 1 factors. *Start 464. Treatment of stone Treatment hydration and pain control
premature screening at age 25 with colonoscopy below 5mm (possibly narcotics and/or ketorolac);
(before 50): every 1 to 2 years.* What can be used shockwave lithotripsy can break up
on stones less then stones 3 cm diameter so that they
451. The three NSAIDs naproxen, indomethacin, and sulindac
3 cm pass
that are FDA
through the ureters; surgery may be
approved for
required for larger stones
acute gout
465. Treatment of SVT carotid massage--> Adenosine -->
452. trauma + facial cricothyroidotomy.
stable CCB & beta blockers -->
trauma requires -
- what type of 466. treatment of the ACEI: standard of care - slows
Airway cardiac heart progression of LV dysfunction and
failure improves survival
453. Treatment for haloperidol
all symptomatic patients functional
acute agitation :
class II-IV
agitation from
all asymptomatic patients with LVEF
dementia or
<40%
delirium
-blockers: slow progression and
454. Treatment for GLucocorticoids, Anti-cholinergic, improve survival
COPD Home oxygen and ANtibtics class I-III with LVEF <40%
stable class IV patient
455. Treatment for Interferon, ribavirin, and either telaprevir
note: should be used cautiously,
cryoglobulins or
titrate slowly because may initially
boceprevir
worsen CHF
456. Treatment for FENOFIBRATE Diuretics: symptom control,
high tags management of fluid overload
457. Treatment for HIT discontinue all medications - even Aldosterone antagonists: mortality
LMWH and heparin flushes benefit in severe CHF
give arobatran spironolactone for class IIIb and IV
CHF already on ACEI and loop
458. Treatment for lice permethrin 1% (Nix cream rinse)
diuretic
(ovicidal) or permethrin 1% (RC & Cor,
Kwellada-P shampoo)
459. Treatment for amorilde - inhibits the sodium
nephrotoxicity in transporter in the kidney
lithium
467. Trichinella Source: Undercooked pork Fever, 480. Type 3 familial IDL & VLDL - Def apoE ( decrease liver
spiralis myalgias, dysbetalipoprotemia uptake of VLDL)
Source Symptoms:* periorbital edema; over JIONTS- knee & elbow
symptoms eosinophilia* *Gemfibrozil
TXT Treatment: Albendazole, *mebendazole if Niacin*
CNS or cardiac
481. Type 4 Endogenous VLDL
symptoms*
hyperlipidemia increased by: CKD, DM, OCP, Alcohol
468. Tricyclic WORSEN URINARY RETENTION Possible pancreatitis
antidepressant *Niacin
- Gemfibrozil
anticholinergic Statins*
properties -
482. Type hyperlipidemia A- No lPL
469. Trigonititis present with irritative voiding symptoms 1 a,b,c, B- no apoc2
(eg, frequency, urgency, dysuria), C- lipoprotein inhibitor protein
recurrent urinary tract infections (UTIs), Heparin
hematuria, or pelvic pain.
483. Type V Familial VLDL + chylomicrons *Niacin
470. Tubal ( allergic) Remove inciting drug hypertriglyceridemia Gemfibrozil*
interstitial
484. Valproic acid THROMBOCYTOPNEA
nephritis
WEight Gain
Treatment
Alopecia
471. Tuberculosis Protein will will be effusion/serum > 0.5 = PAncreatitis
pleural effusion exudative --- Hepatitis
TUBERCULOSIS - effusions > 4g/dL GI diarrhea
low glucose teratorgenic effects
lymphocytic leukocytosis Tremor
increased ammonia levels
472. Two biggest Haemophilus influenzae and
anexity and confusion
causes of streptococcus pyogenes
epiglottitis 485. variegate porphyria
473. Tympanometry Tympanometry is an examination used to
test the condition of the middle ear[1] and
mobility of the eardrum (tympanic
membrane) and the conduction bones by
creating variations of air pressure in the
ear canal.
474. Type 1 Chylomicrons- after 2 hour fast , Acute
pancreatitis, eruptive xanthomas on trunk
and butt
TXT DIET Acute attacks usually begin in
475. Type 1 DIET adulthood and cause abdominal pain,
hyperlipdemia vomiting, diarrhoea and constipation.
During an attack, a person may also
476. Type 2a statin niacin cholestryamine
experience muscle weakness, seizures,
477. Type 2a Increased LDL, Statins, niacin and and mental changes such as anxiety and
hyperlipidemia cholestyramine hallucinations. + skin changes changes
Achilles tendones, xanthalesma and
486. Vascular dementia STEPWISE decline
tendons of the hand
early executive dysfunction
478. Type 2b and statins, Niacin and Gemfibrizol cerebral infarction & or deep WHITE
type 4 MATTER
hyperlipidemia LARGE arteries or smaller cortical
479. Type 2b - combined LDL, VLDL RF diabers smoking, hypertension and
combined Statins, niacin and gemfibrozil hyperlipedmia
lipoproteinemia prominant executive function , abrupt
onset then with step deterioation
487. Vasovagal nausea pallor and diaphoresis can 496. Visceral pain description visceral is afferent fibers
syncope preced it are scarce compared to
somatic nerve fibers =
488. Venous stasis ALWAYS and ever compression
diffuse pain
treatment stockings
497. Warfarin induced Skin necrosis Warfin inhibits production
489. Ventilator settings As the patient initiates the breath the
of vitamin K dependent
Mode Assist ventilator will deliver the set amount.
clotting factors 2,7,9,10
control mode Breath statcking and autopeeping -
and protein c and protein
increase the PEEP and cause
s
barotrauma
Advantage increase minute ventilation 498. weakness ( 4/5) and myalgias hyperaldosteronism -
can produce respiratory alkalosis in the lower extremities + CONNS
PROBLEM with DIAPHRAGM uncontrolled hypertension &
ATROPHY no focal neurological deficits -
-
490. Ventricular 5 days to 3 months
aneurysm persistent ST elevation 499. WELLS CRITERIA Symptoms of DVT (3
points)
491. Ventricular unsyncrhonized cardioversion
No alternative diagnosis
tackycardia VT -stable - amiodarone, lido -
better explains the illness
pulseless procainamide
(3 points)
VT -stable VT- unstable - syndchronized ->
Tachycardia with pulse >
VT- unstable amiodarone, lido - procainamide
100 (1.5 points)
492. very painful and Testicular torsion Immobilization (>= 3 days)
swollen testes, 1. Twisting of spermatic cord leading to or surgery in the previous
nausea, vomiting; vascular insufficiency of testes four weeks (1.5 points)
fever, testes NEXT STEP Prior history of DVT or
displaced emergent surgical reduction of pulmonary embolism (1.5
superiorly , mass torsion within several hours of onset; points)
in spermatic cord manual detorsion can be attempted Presence of hemoptysis (1
may be felt, before surgery (may be difficult to point)
absent determine correct direction to rotate); Presence of malignancy (1
cremasteric reflex surgery : testes attached to scrotal wall point)
what is the next (i.e., orchiopexy)
500. What are the beta blockers that Metoprolol succinate,
step to prevent recurrence
improve survival in CHF carvedilol, bisoprolol
5. Complications testicular ischemia or
infarction without prompt treatment 501. What are the shockable Ventricular FIB and
rhythms Ventricular Tacycardia (
493. Vibrio cholerae Source: Water, seafood
with no
Source Symptoms: Copious watery
OR Crashing with a
symptoms diarrhea, signs of dehydration
PULSE!!!
TXT Treatment: Hydration; tetracycline or
doxycycline decreases 502. What compliment is low in hep C4 ( hepc- has 4 letters)
disease length
503. What does Erythema nodosum disease activity
494. Vibrio Source: Seafood (oysters) indicate in IBD
parahaemolyticus Symptoms: Abdominal pain, watery
504. What do the omega 3 improve the
Source diarrhea within 24 hr of eating
polyunsaturate fats do hyperlipidemia
symptoms Treament : Hydration; self-limited
TXT 505. What heart conditions need prosthetic heart valves
prophylaxis hx of IE,
495. Viral infections REYES
unrepair congenital
child + aspirin =
cynaotic heart defects
hepatomegaly,
cardiac transplant wiht
hyperventilation
valuopathy
delirium and
vomiting
506. What helps with the Hydroxychloroquine helps the skin 514. what type of diet post Low sugar
skin manifestations lesions. gastric surgery can prevent --- small frequent MEALS
in Dermatomyositis: the development of
Malar involvement dumping syndrome
*Shawl sign: what is another dietary
erythema of the recommendation
face, neck,
515. What vaccinations are all immunizations should be
shoulders, upper
indicated for all pt with HIV give soon after diagnosis so
chest, and back
the immune system is strong
Heliotrope rash:
enough to form a response
edema and purplish
pneumococcus - PCV 12
discoloration of the
once and then PPSV23 8
eyelids
weeks later then every 5
Gottron papules:
years
scaly patches over
- tdap 1x and then td every 10
the back of the
years
hands, particularly
the 516. When can cardiac filling Can only occur in deep
PIP and MCP joints occur during pericarditis Inhalation when negative
intrathorasic pressure
507. What is cause of Small bowel fibrotic strictures
Small bowel 517. When does shivering stop Below 31 degress
obstructions in 518. When lying flat aspiration upper lobes
crohn's disease occurs where
508. What is the FEV1 FEV1 is decreased 519. When Placing a central Catheter tip - infection is one
and FEV1/FVC in and both FEV1/FVC is decreased so venous line for TPN what is of the most frequent
restricted the ratio is normal to slightly MC complication encountered problems
increased ( 85% and 120%) - fluid overload
509. What is the single Tight blood pressure control. - TPN can cause refeeding
BEST method to syndrom - hypokalemia ,
control diabetic hypomagnesia,
nephropathy hypophoatmenia
progression 520. When should colonic After 8 to 10 years of colonic
510. what is the magnesium sulphate cancer screening occur in involvement, with
treatment for pt with Chrons and UC colonoscopy
prolongate PR and every 1 to 2 years.
QT 521. Who no longer need Bicuspid aortic valve
511. What stones aren't Uric acid stones are not detectable antibiotic prophylaxis ( acquired aortic valve disease
seen on Xray but on x ray but are visualized on VT heart problems) acquired mitral valve disease
seen on CT 522. Women 25 with ovoid MS
512. WHAT TO DO if 1st if they haven progressed 1.5 in plaques in the
there is Failure to mulit and 1.2 in nuli for 2 hours --- periventricular regions ,
PROGRESS IN the then consider doing an amniotmy corpus callosum and deep
active stage of the and then giving oxytocin if white seen on MRI
first age of labor contractions are inadequate
513. what type of airway Flexible bronchoscopy - and then
for someone with a orotracheal
cervical spine injury
523. A women stops taking her SSRI and
experiences ; the most commonly
reported symptoms are dizziness,
vertigo, Electrical shock like
experences nausea, lethargy and
With SSRIs, tricyclic antidepressant (TCA)-associated discontinuation syndromes also
headache
include both physical and psychological symptoms but are much less likely to be
associated with sensory abnormalities and problems with equilibrium (table 2).
Hypomania, akathisia, parkinsonism, cardiac arrhythmias, panic attacks and delirium have
been reported on rare occasions in patients discontinuing TCAs
TREATMENT - Restart SSRI and symptoms resolve in 1 day
524. xray signs of Tension pneumothorax

On the right you can see the visceral pleural line, there is flattening of the ipsilateral
hemidiaphragm
the mediastinum is moved to the opposite side
525. Yersinia enterocolitica Source : Pork, fresh produce Symptoms: Abdominal pain, bloody
Source diarrhea, right lower quadrant pain-mesenteric adenitis, fever
symptoms treatment: Hydration; self-limited
TXT
526. Zwelligers FATAL In the fist year : peroxisomal formation or protein import (the PEX gene family).
Manifestations include facial dysmorphism, CNS malformations, demyelination, neonatal
seizures, hypotonia, hepatomegaly, cystic kidneys, short limbs with stippled epiphyses
(chondrodysplasia punctata), cataracts, retinopathy, hearing deficit, *psychomotor delay,
and peripheral neuropathy.