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First Aid CK
Rapid Review
439
Medical
Post-Graduate
02/13/2011
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Term
Classic ECG finding in atrial flutter
 Definition
"Sawtooth" P waves
Term
Definition of unstable angina.
 Definition
Angina is new, is worsening, or occurs at rest.
Term
Antihypertenisce for a diabetic patient with proteinuria.
 Definition
ACEI
Term
Beck's triad for cardiac tamponade.
 Definition
Hypotension, distant heart sounds, and JVD.
Term
Drugs that slow AV node transmission.
 Definition
β-blockers, digoxin, calcium channel blockers.
Term
Hypercholesterolemia treatment that leads to flushing and pruritus.
 Definition
Niacin
Term
Murmur-hypertrophic obstructive cardiomyopathy (HOCM).
 Definition
Systolic ejection murmur heard along the lateral sternal border that ↑ with Valsalva maneuver and standing.
Term
Murmur-aortic insufficiency.
 Definition
1. Diastolic,
2. Decrescendo,
3. High-pitched,
4. Blowing murmur that is heard best sitting up;
5. ↑ with ↓ preload (handgrip maneuver).
Term
Murmur- aortic stenosis.
 Definition
1. Systolic crescendo/decrescendo murmur that radiates to the neck;
2. ↑ with ↑ preload (Valsalva maneuver).
Term
Murmur - mitral regurgitation.
 Definition
Holosytolic murmur that radiates to the axillae or carotids.
Term
Murmur - mitral stenosis.
 Definition
Diastolic, Mid - to late, low pitched murmur.
Term
Treatment for atrial fibrillation and atrial flutter.
 Definition
If unstable, cardiovert. If stable or chronic, rate control with calcium channel blockers or β-blockers.
Term
Treatment for ventricular fibrillation.
 Definition
Immediate cardioversion.
Term
Autoimmune complication occurring 2-4 weeks post MI.
 Definition
Dressler's syndrome: fever, pericarditis, ↑ ESR.
Term
IV drug use with JVD and holosytolic murmur at the left sternal border. Treatment?
 Definition
Treat existing heart failure and replace the tricuspid valve.
Term
Diagnostic test for hypertrophihc cardiomyopathy.
 Definition
Echocardiogram (showing thickened left ventricular wall and outflow obstruction).
Term
A fall in systolic BP of > 10 mmHg with inspiration.
 Definition
Pulsus paradoxus ( seen in cardiac tamponade).
Term
Classic ECG findings in pericarditis.
 Definition
Low-voltage, diffuse ST-segment elevation.
Term
Definition of hypertension.
 Definition
BP > 140/90 on three separate occasions two weeks apart.
Term
Eight surgically correctable causes of hypertension.
 Definition
1. Renal artery stenosis,
2. Coarctation of aorta,
3. Pheochromocytoma,
4. Conn's syndrome,
5. Cushing's syndrome,
6. Unilateral renal parenchymal disease,
7. Hyperthyroidism,
8. Hyperparathyroidism.
Term
Evaluation of a pulsatile abdominal mass and bruit.
 Definition
Abdominal ultrasound and CT.
Term
Indications for surgical repair of abdominal aortic aneurysm.
 Definition
> 5.5 cm, rapidly enlarging, symptomatic, or ruptured.
Term
Treatment for acute coronary syndrome.
 Definition
Morphine, O2, sublingual nitroglycerin, ASA, IV β-blockers, heparin.
Term

What is metabolic syndrome?

 

 Definition
1. Abdominal obesity,
2. High triglycerides,
3. Low HDL,
4. Hypertension,
5. Insulin resistance,
6. Prothrombic or proinflammatory states.
Term

Appropriate diagnostic test?

  • A 50 y/o man with angina can excercise to 85% of maximum predicted heart rate.
  • A 65 y/o woman with left bundle branch block and severe osteoarthritis has unstable angina.
 Definition
  • Excercise stress treadmill with ECG.

 

  • Pharmacologic stress test (e.g. dobutamine, echo).
Term
Target LDL in a patient with diabetes.
 Definition
< 70.
Term
Signs of active ischemia during stress testing.
 Definition
Angina, ST - segment changes on ECG, or ↓ BP.
Term
ECG findings suggesting MI.
 Definition
ST - segment elevation (depression means ischemia), flattened T waves, and Q waves.
Term
Coronary territories in MI.
 Definition
Anterior wall (LAD/diagonal), inferior (PDA), posterior (left circumflex/oblique, RCA/marginal), septum (LAD/diagonal).
Term
A young patient has angina at rest with ST - segment elevation. Cardiac enzymes are normal.
 Definition
Prinzmetal angina.
Term
Common symptoms associated with silent MIs.
 Definition
CHF, shock, and altered mental status.
Term
The diagnostic test for pulmonary embolism.
 Definition
V/Q scan.
Term
An agent that reverses the effects of heparin.
 Definition
Protamine.
Term
The coagulation parameter affected by warfarin.
 Definition
PT.
Term
A young patient with a family history of sudden death collapses and dies while exercising.
 Definition
Hypertrophic cardiomyopathy.
Term
Endocarditis prophylaxis regimen.
 Definition
Oral surgery - amoxicillin; GI or GU procedures - ampicillin and gentamicin before and amoxicillin after.
Term
The 6 P's of ischemia due to peripheral vascular disease.
 Definition
1. Pain,
2. Pallor,
3. Pulselessness,
4. Paralysis,
5. Paresthesia,
6. Poikilothermia.
Term
Virchow's triad.
 Definition
1. Stasis,
2. Hypercoagulability,
3. Endothelial damage.
Term
The most common cause of hypertension in young women.
 Definition
OCP's.
Term
The most common cause of hypertension in young women.
 Definition
Excessive EtOH.
Term
"Stuck on" appearance.
 Definition
Seborrheic keratosis.
Term
Red plaques with silvery-white scales and sharp margins.
 Definition
Psoriasis.
Term
The most common type of skin cancer; the lesion is a pearly-colored papule with a translucent surface and telangiectasias.
 Definition
Basal cell carcinoma.
Term
Honey-crusted lesion.
 Definition
Impetigo.
Term
A febrile patient with a history of diabetes presents with a red, swollen, painful lower extermity.
 Definition
Cellulitis.
Term
+ Nikolsky's sign.
 Definition
Pemphigus vulgaris.
Term
- Nikolsky's sign.
 Definition
Bullous pemphigoid.
Term
A 55 y/o obese patient presents with dirty, velvety patches on the back of the neck.
 Definition
Acanthosis nigricans. Check fasting blood glucose to rule out diabetes.
Term
Dermatomal distribution.
 Definition
Varicella zoster.
Term
Flat - topped papules.
 Definition
Lichen planus.
Term
Iris - like target lesions.
 Definition
Erythema multiforms.
Term
A lesion characteristically occuring in a linear pattern in areas where skin comes into contact with clothing or jewelry.
 Definition
Contact dermatitis.
Term
Presents with herald patch, christmas - tree pattern.
 Definition
Pityriasis rosea.
Term
A 16 y/o presents with an annular patch of alopecia with broken - off, stubby hairs.
 Definition
Alopecia areata (an autoimmune process).
Term
Pinkish, scaling flat lesion on the chest and back; KOH prep has a "spaghetti - and - meatballs" appearance.
 Definition
Pityriasis versicolor.
Term
Four characteristics of a nevus suggestive of melanoma.
 Definition
1. Asymmetry,
2. Border irregularity,
3. Color variation, and
4. Large diameter.
Term
A premalignant lesion from sun exposure that can lead to squamous cell carcinoma.
 Definition
Actinic keratosis.
Term
"Dewdrops on a rose petal."
 Definition
Lesions of 1° varicella.
Term
"Cradel cap."
 Definition
Seborrheic dermatitis. Treat with antifungals.
Term
Associated with Propionibacterium acnes and changes in androgen levels.
 Definition
Acne vulgaris.
Term
A painful, recurrent vesicular eruption of mucocutaneous surfaces.
 Definition
Herpes simplex.
Term
Inflammation and epithelial thinning of the anogenital area, predominantly in postmenopausal women.
 Definition
Lichen sclerosus.
Term
Exophytic nodules on the skin with varying degrees of scaling or ulceration; the second most common type of skin cancer.
 Definition
Squamous cell carcinoma.
Term
The most common cause of hypothyroidism.
 Definition
Hashimoto's thyroiditis.
Term
Lab findings in Hashimoto's thyroiditis.
 Definition
High TSH, low T4, antimicrosomal antibodies.
Term
Exophthalmos, pretibial myxedema, and
↓ TSH.
 Definition
Graves' disease.
Term
The most common cause of Cushing's syndrome.
 Definition
Iatrogenic corticosteroid administration.  The second most common cause is Cushing's disease.
Term
A patient presents with signs of hypocalcemia, high phosphorus, and low PTH.
 Definition
Hypoparathyroidism.
Term
"Stones, bones, groans, psychiatric overtones."
 Definition
Signs and symptoms of hypercalcemia.
Term
A patient complains of headache, weakness, and polyuria; exam raveals hypertension and tetany. Labs reveal hypernatremia, hypokalemia, and metabolic alkalosis.
 Definition
1° hyperaldosteronism (due to Conn's syndrome or bilateral adrenal hyperplasia).
Term
A patient presents with tachycardia, wild swings in BP, headache, diaphoresis, altered mental status, and a sense of panic.
 Definition
Pheochromocytoma.
Term
Should α- or β- anatagonists be used first in treating pheochromocytoma.
 Definition
α- antagonists (phentolamine and phenoxybenzamine).
Term
A patient with a history of lithum use presents with copious amounts of dilute urine.
 Definition
Nephrogenic diabetes insipidus (DI).
Term
Treatment of central DI.
 Definition
Administration of DDAVP ↓ serum osmolality and free water restriction.
Term
A postoperative patient with significant pain presents with hyponatremia and normal volume status.
 Definition
SIADH due to stress.
Term
An antidiabetic agent associated with lactic acidosis.
 Definition
Metformin.
Term
A patient presents with weakness, nausea, vomiting, weight loss, and new skin pigmentation.  Labs show hyponatremia and hyperkalemia. Treatment?
 Definition
1° adrenal insufficiency (Addison's disease).  Treat with replacement glucocorticoids, mineralocorticoids, and IV fluids.
Term
Goal HbA1c for a patient with DM.
 Definition
< 7.0
Term
Treatment of DKA.
 Definition
Fluids, insulin, and aggressive replacement of electrolytes (e.g., K+).
Term
Why are β- blockers contraindicated in diabetics?
 Definition
They can mask symptoms of hypoglycemia.
Term
Bias introduced into a study when a clinicain is aware of the patient's treatment type.
 Definition
Observational bias.
Term
Bias introduced when screening detects a disease earlier and thus lenghtens the time from diagnosis to death.
 Definition
Lead - time bias.
Term
If you want to know if geographical location affects infants mortality rate but most variation in infant mortality is predicted by socioeconomic status, then socioeconomic status is a ________________.
 Definition
Confounding variable.
Term
The number of true positive divided by the number of patients with the disease is _______________.
 Definition
Sensitivity.
Term
Sensitive tests have few false negatives and are used to rule _______ a disease.
 Definition
Out.
Term

PPD reactivity is used as a screening test because most people with TB (except those who are anergic) will have a

 + PPD. Highly sensitive or specific?

 Definition
Highly sensitive for TB.
Term
Chronic diseases such as SLE - higher prevalence or incidence?
 Definition
Higher prevalence.
Term
Epidemics such as influenza - higher prevalence or incidence.
 Definition
Higher incidence.
Term
Cross - sectional survey - incidence or prevalence.
 Definition
Prevalence.
Term
Cohort study - incidence or prevalence?
 Definition
Incidence and prevalence.
Term
Case-control study - incidence or prevalence?
 Definition
Neither.
Term
Describe a test that consistently gives identical results, but the results are wrong.
 Definition
High reliability, low validity.
Term
Difference between a cohort and a case-control study.
 Definition
Cohort studies can be used to calculate relative risk (RR), incidence, and/or odds ratio (OR). Case-control studies can be used to calculate an OR.
Term
Attributable risk?
 Definition
The incidence rate (IR) of a disease in exposed - the IR of a disease in unexposed.
Term
Relative risk?
 Definition
The IR of a disease in a population exposed to a particular factor ÷ the IR of those not exposed.
Term
Odds ratio?
 Definition
The likelihood of a disease among individuals exposed to a risk factor compared to those who have not been exposed.
Term
Number needed to treat?
 Definition
1 ÷ (rate in untreated group - rate in treated group).
Term
In which patients do you initiate coloreactal cancer screening early?
 Definition
Patient with IBD; those with familial adenomatous polyposis (FAP) / hereditary nonpolyposis colorectal cancer (HNPCC); and those who have first-degree relatives with adenomatous polyps (<60 years of age) or colorectal cancer.
Term
The most common cancer in men and the most common cause of death from cancer in men.
 Definition
Prostate cancer is the most common cancer in men, but lung cancer causse more deaths.
Term

The percentage of cases within ine SD of the mean?

 Two SDs? Three SDs?

 Definition
68%, 95.4%, 99.7%.
Term
Birth rate?
 Definition
Number of live births per 1000 population in one year.
Term
Fertility rate?
 Definition
Number of live births per 1000 females (15 -44 years of age) in one year.
Term
Mortality rate?
 Definition
Number of deaths per 1000 population in one year.
Term
Neonatal mortality rate?
 Definition
Number of deaths from birth to 28 days per 1000 live births in one year.
Term
Postnatal mortality rate?
 Definition
Number of deaths from 28 days to one year of age per 1000 live births in one year.
Term
Infant mortality rate?
 Definition
Number of deaths from birth to one year of age per 1000 live births (neonatal + postnatal mortality) in one year.
Term
Fetal mortality rate?
 Definition
Number of deaths from 20 weeks' gestation to birth per 1000 total births in one year.
Term
Perinatal mortality rate?
 Definition
Number of deaths from 20 weeks' gestation to one month of life per 1000 total births in one year.
Term
Maternal mortality rate?
 Definition
Number of deaths during pregnancy to 90 days postpartum per 100,000 live births in one year.
Term
True or false: Once patients sifn a statement giving consent, they must continue treatment.
 Definition
False.  Patients may change their minds at any time.  Exceptions to the requirement of informed consent include emergency situations and patients without decision-making capacity.
Term
A 15 y/o pregnant girl requires hospitlization for preeclampsia.  Is parental consent required?
 Definition
No. Parental consent is not necessary for the medical treatment of pregnant minor.
Term
A doctor refers a patient for an MRI at a facility he / she owns?
 Definition
Conflict of interest.
Term
Involuntary psychiatric hospitalization can be undertaken for which three reasons?
 Definition
The patient is a danger to self, a danger to others, orgravely disabled (unable to provide for basic needs).
Term
True or false: Withdrawing a nonbeneficial treatment is ethically similar to withholding a nonindicated one.
 Definition
True.
Term
When can a physician refuse to continue treating a patient on the grounds of futility?
 Definition
When there is no rationale for treatment, maximal intervention is failing, a given intervention has already failed, and treatment will not achieve the goals of care.
Term
An eight-year-old child is in a serious car accident.  She requires emergent transfusion, but her parents are not present.
 Definition
Treat immediately.  Consent is implied in emergency situations.
Term
Conditions in which confidentially must be overridden.
 Definition
Real threat of harm to third parties; suicidal intentions; certain contagious diseases; elder and child abuse.
Term
Involuntary commitment or isolation for medical treatment may be undertaken for what reason?
 Definition
When treatment noncompliance represents a serious danger to public health (e.g., active TB).
Term
A 10 y/o child presents in status epilepticus, but her parents refuse treatment on religious grounds.
 Definition
Treat because the disease represents an immediate threat to the child's life.  Then seek a court order.
Term
A son asks that his mother not be told about her recently discovered cancer.
 Definition
A physician can withhold information from the patient only in the rare case of therapeutic privilege or if the patient requests not to be told.  A patient's family cannot require the physician to withhold information from the patient.
Term
A patient presents with sudden onset of severe, diffuse abdominal pain. Exam reveals peritoneal signs, and AXR reveals free air under the diaphragm.  Management?
 Definition
Emergent laparotomy to repair perforated viscus.
Term
The most likely cause of acute lower GI bleed in patients > 40 years of age.
 Definition
Diverticulosis.
Term
Diagnostic modality used when ultrasound is equivocal for cholecystitis.
 Definition
HIDA scan.
Term
Risk factors for cholelithiasis.
 Definition
Fat, female, fertile, forty, flatulent.
Term
Inspiratory arrest during palaption of the RUQ.
 Definition
Murphy's sign, seen in acute cholecystitis.
Term
Inspiratory arrest during palpation of the RUQ.
 Definition
Murphy's sign, seen in acute cholecystitis.
Term
The most common cause of SBO in patients with no history of abdominal surgery.
 Definition
Hernia.
Term
The most common cause of SBO in patients with a history of abdominal surgery.
 Definition
Adhesions.
Term

Identify key organisms causing diarrhea:

  1. Most common organism          
  2. Recent antibiotic use            
  3. Camping                             
  4. Traveler's diarrhea               
  5. Church picnics/mayonnaise   
  6. Uncooked hamburgers         
  7. Fried rice                         
  8. Poultry / eggs                  
  9. Raw seafood                   
  10. AIDS                             
  11. Pseudoappendicitis          
Definition
  1. Campylobacter
  2. Clostridium difficle
  3. Giardia
  4. ETEC
  5. S. aureus
  6. E. coli O157:H7
  7. Bacillus cereus
  8. Salmonella
  9. Vibrio, HAV
  10. Isospora, Cryptosporidium, Mycobacterium avium complex (MAC)
  11. Yersinia
Term
A  25 y/o Jewish man presents with pain and watery diarrhea after meals. Exam shows fistulas between the bowel and skin and nodular lesions on his tibias.
 Definition
Crohn's disease.
Term
Inflammatory disease of the colon with ↑ risk of colon cancer.
 Definition
Ulcerative colitis (greater risk than Crohn's).
Term
Extraintestinal manifestations of IBD.
 Definition
Uveitis, ankylosing spondylitis, pyoderma gangrenosum, erythema nodosum, 1° sclerosing cholangitis.
Term
Medical treatment for IBD.
 Definition
5 -ASA agents and steroids during acute exacerbations.
Term
Difference between Mallory-Weiss and Boerhaave tears.
 Definition

Mallory-Weiss - superficial tear in the esophagus mucosa;

Boerhaave - full thickness esophageal rupture.
Term
Charcot's triad.
 Definition
RUQ pain, jaundice, and fever/chills in the setting of ascending cholangitis.
Term
Reynold's pentad.
 Definition
Charcot's triad plus shock and mental status changes, with suppurative asendig cholangitis.
Term
Medical treatment for hepatic encephalopathy.
 Definition
↓ protein intake, lactulose, rifaximin.
Term
First step in the management of a patient with an acute GI bleed.
 Definition
Establish the ABCs.
Term
A four year old child presents with oliguria, petechiae, and jaundice following an illness with bloody diarrhea.  Most likely diagnosis and cause?
 Definition
Hemolytic-uremic syndrome (HUS) due to E.coli O157:H7.
Term
Post-HBV exposure treatment.
 Definition
HBV immunoglobulin.
Term
Classic causes of drug-induced hepatitis.
 Definition
TB medications (INH, rifampin, pyrazinamide), acetaminophen, and tetracycline.
Term
A 40 y/o obese woman with elevated alkaline phosphatase, elevated bilirubin, pruritus, dark urine, and clay-colored stools.
 Definition
Biliary tract obstruction.
Term
Hernia with highest risk of incarceration - indirect, direct, or femoral?
 Definition
Femoral hernia.
Term
A 50 y/o man with a history of alcohol abuse presents with boring epigastric pain that radiates to the back and is relieved by sitting forward.  Management?
 Definition
Confirm the diagnosis of acute pancreatitis with elevated amylase and lipase.  Make the patient NPO and give IV fluids, O2, analgesia, and "tincture of time."
Term
Four causes of microcytic anemia.
 Definition
TICS - Thalassemia, Iron deficiency, anemia of Chronic disease, and Sideroblastic anemia.
Term
An elderly man with hypochromic, microcytic anemia is asymptomatic. Diagnostic tests?
 Definition
Fecal occult blood test and sigmoidoscopy; suspect colorectal cancer.
Term
Precipitants of hemolytic crisis in patients with G6PD deficiency.
 Definition
1. Sulfonamides,
2. Antimalarial drugs,
3. Fava beans.
Term
The most common inherited cause of hypercoagulability.
 Definition
Factor V Leiden mutation.
Term
The most common inherited bleeding disorder.
 Definition
von Willebrand's disease.
Term
The most common inherited bleeding disorder.
 Definition
Hereditary spherocytosis.
Term
Diagnostic test for hereditary spherocytosis.
 Definition
Osmotic fragility test.
Term
Pure RBC aplasia.
 Definition
Diamond-Blackfan anemia.
Term
Anemia associated with absent radii and thumbs, diffuse hyperpigmentation, cafe au lait spots, microcephaly, and pancytopenia.
 Definition
Fanconi's anemia
Term
Medications and viruses that lead to aplastic anemia.
 Definition
1. Chloramphenicol,
2. Sulfonamides,
3. Radiations,
4. HIV,
5. Chemotherapeutic agents,
6. Hepatitis,
7. Parvovirus B19,
8. EBV.
Term
How to distinguish polycythemia vera from 2° polycythemia.
 Definition
Both have ↑ hematocrit and RBC mass, but polycythemia vera should have normal O2 saturation and low erythropoietin levels.
Term
Thrombotic thrombocytopenic purpura (TTP) pentad?
 Definition
"FAT RN": Fever, Anemia, Thrombocytopenia, Renal dysfunction, Neurologic abnormalities.
Term
HUS triad?
 Definition
1. Anemia,
2. Thrombocytopenis, and
3. Acute renal failure.
Term
Treatment of TTP.
 Definition
Emergent large - volume plasmapheresis, corticosteroids, antiplatelet drugs.
Term
Treatment for idiopathic thrombocytopenic purpura (ITP) in children.
 Definition
Usually resolves spontaneously; may require IVIG and/or corticosteroids.
Term
Which of the following are ↑ in DIC: fibrin split products, D-dimer, fibrinogen, platelets. and hematocrit.
 Definition
Fibrin split products and D-dimer are elevated; platelets, fibrinogen, and hematocrit are ↓.
Term

An 8 y/o boy presents with hemarthrosis and ↑ PTT with normal PT and bleeding time. Diagnosis? Treatment?

 Definition
Hemophilia A or B; consider desmopressin (for hemophilia A) or factor VIII or IX supplements.
Term
A 14 y/o girl presents with prolonged bleeding after dental surgery and with menses, normal PT, normal or ↑ PTT, and ↑ bleeding time.
Diagnosis?
Treatment?
 Definition
von Willebrand's disease; treat with desmopressin, FFP, or cryoprecipitate.
Term
A 60 y/o African American man presents with bone pain. Workup for multiple myeloma might reveal?
 Definition
Monoclonal gammopathy, Bence Jones proteinuria, "punched-out" lesions on x-ray of the skull and long bones.
Term
Reed-Sternberg cells.
 Definition
Hodgkin's lymphoma.
Term
A 10 y/o boy presents with fever, weight loss, and night sweats. Exam shows an anterior mediastinal mass.  Suspected diagnosis?
 Definition
Non-Hodgkin's lymphoma.
Term
Microcytic anemia with ↓ serum iron, ↓ total iron-binding capacity (TIBC), and normal or ↑ ferritin.
 Definition
Anemia of chronic disease.
Term

Microcytic anemia with ↓ serum iron, ↓ ferritin, and

 ↑ TIBC.

 Definition
Iron deficiency anemia.
Term

An 80 y/o man presents with fatigue, lymphadenopathy, splenomegaly, and isolated lymphocytosis. 

 Suspected diagnosis?

 Definition
Chronic lymphocytic leukemia (CLL).
Term
The lymphoma equivalent of CLL.
 Definition
Small lymphocytic lymphoma.
Term
A late, life-threatening complication of chronic myelogenous leukemia (CML).
 Definition
Blast crisis (fever, bone pain, splenomegaly, pancytopenia).
Term
Auer rods on blood smear.
 Definition
Acute myelogenous leukemia (AML).
Term
AML subtype associated with DIC.
 Definition
M3.
Term
Electrolyte changes in tumor lysis syndrome/
 Definition
↓ Ca2+, ↑ K+, ↑ phospahte, ↑ uric acid.
Term
Treatment for AML M3.
 Definition
Retinoic acid.
Term
A 50 y/o man presents with early satiety, splenomegaly, and bleeding. Cytogenetics show t(9:22).
Diagnosis?
 Definition
CML.
Term
Heinz bodies?
 Definition
1. Intracellular inclusions seen in thalassemia,
2. G6PD deficiency, and
3. Postsplenectomy.
Term
An autosomal-recessive disorder with a defect in the GPIIbIIIA platelet receptor and ↓ platelet aggregation.
 Definition
Glanzmann's thrombasthenia.
Term
Virus associated with aplastic anemia in patient with sickle cell anemia.
 Definition
Parvovirus B19.
Term
A 25 y/o African American man with sickle cell anemia has sudden onset of bone pain. Management of pain crisis?
 Definition
O2, analgesia, hydration, and, if severe, transfusion.
Term
A significant cause of morbidity in thalassemia patients. Treatment?
 Definition
Iron overload; use deferoxamine.
Term
The three most common causes of fever of unknown origin (FUO).
 Definition
Infection, cancer, and autoimmune disease.
Term
Four signs and symptoms of streptococcal pharyngitis.
 Definition
1. Fever,
2. Pharyngeal erythema,
3. Tonsillar exudate,
4. Lack of cough.
Term
A nonsuppurative complication of streptococcal infection that is not altered by treatment of 1° infection.
 Definition
Postinfectious glomerulonephritis.
Term
Asplenic patients are particularly susceptible to these organisms.
 Definition
Encapsulated organisms - pneumococcus, meningococcus, Haemophilus influenza, Klebsiella.
Term
The number of bacteria on a clean-catch specimen to diagnose a UTI.
 Definition
105 bacteria/mL.
Term
Which healthy population is susceptible to UTIs?
 Definition
Pregnant women.  Treat this group aggressively because of potential complications.
Term

A patient from California or Arizona presents with fever, malaise, cough, and night sweats.

Diagnosis?  Treatment?

 Definition
Coccidioidomycosis. Amophotericin B.
Term
Nonpainful chancre.
 Definition
1° syphilis.
Term
A "blueberry muffin" rash is characteristic of what congenital infection?
 Definition
Rubella.
Term

Meningitis in neonates.

Causes? Treatment?

 Definition

Group B strep, E. coli, Listeria. 

Treat with gentamicin and ampicillin.
Term

Meningitis in infants.

Causes?  Treatment?

 Definition

Pneumococcus, Meningococcus, H. influenza. 

Treat with cefotaxime and vancomycin.
Term
What should always be done prior to LP?
 Definition
Check for ↑ ICP; look for papilledema.
Term

CSF findings:

  1. Low glucose, PMN predominance
  2. Normal glucOse, lymphocytic predominance
  3. Numerous RBCs in serial CSF samples
  4. ↑ gamma globulins
 Definition
  1. Bacterial meningitis
  2. Aseptic (viral) meningitis
  3. Subarachnoid hemorrhage (SAH)
  4. MS 
Term

Initially presents with a pruritic papule with regional lymphadenopathy; evolves into a black eschar after

 7-10 days.

Treatment?

 Definition

Cutaneous anthrax.

Treat with penicillin G or ciprofloxacin.
Term
Finding in 3° syphilis.
 Definition
  1. Tabes dorsalis,
  2. general paresis,
  3. gummas,
  4. Argyll Robertson pupil,
  5. aortitis,
  6. aortic root aneurysms.
Term
Characteristics of 2° Lyme disease.
 Definition
  1. Arthralgias,
  2. migratory polyarthropathies,
  3. Bell's palsy,
  4. myocarditis.
Term
Cold agglutinins.
 Definition
Mycoplasma.
Term

A 24 y/o man presents with soft white plaques on his tongue and the back of his throat.

Diagnosis? Workup? Treatment?

 Definition

Candidial thrush.

Workup should include HIV test.

Treat with nystatin oral suspension.
Term

Begin Pneumocystis jiroveci pneumonia prophylaxiz in an HIV-positive patient at what CD4 count?

Mycobacterium avium-intracellulare (MAI) prophylaxis?

 Definition

≤ 200 for P. jiroveci (with TMP-SMX);

≤ 50 - 100 for MAI (with clarithromycin/ azithromycin).
Term
Risk factors for pyelonephritis.
 Definition
  1. Pregnancy,
  2. vesicoureteral reflux,
  3. anatomic anomalies,
  4.  indwelling catheters,
  5.  kidney stones.
Term
Neutropenic nadir postchemotheraphy.
 Definition
7-10 days.
Term
Erythema migrans.
 Definition
Lesions of 1° Lyme disease.
Term
Classic physical findings for endocarditis.
 Definition
  1. Fever,
  2. Heart murmur
  3. Osler's nodes
  4. Splinter hemorrhages
  5. Janeway lesions
  6. Roth's spots.
Term
Aplastic crisis in sickle cell disease.
 Definition
Parvovirus B19.
Term
Ring-enhancing brain lesion on CT with seizures.
 Definition
Taenia solium (cysticercosis).
Term

Name the organism:

  1. Branching rods in oral infection
  2. Painful chancroid
  3. Dog or Cat bite
  4. Gardener
  5. Pregnant women with pets
  6. Meningitis in adults
  7. Meningitis in elderly
  8. Alcoholic with pneumonia
  9. "Currant jelly" sputum
  10. Infection in burn victims
  11. Osteomyelitis from foot wound puncture
  12. Osteomyelitis in a sickle cell patient

 

 Definition

1. Actinomyces israeli

2. Haemophilus ducreyi

3. Pasturella mulocida

4. Sporothrix schenckii

5. Toxoplasma gondii

6. Neisseria meningitidis

7. Streptococcus pnemoniae

8. Klebsiella

9. Klebsiella

10. Pseudomonas

11. Pseudomonas

12. Salmonella 
Term

A 55 y/o man who is a smoker and a heavy drinker presents with a new cough and flulike symptoms.  Gram stain shows no organisms; silver stain of sputum shows gram - negative rods.

 

What is the diagnosis?

 

 Definition
Legionella pneumonia.
Term

A middle aged man presents with acute-onset monoarticular joint pain and bilateral Bell's palsy.

 

What is the likely diagnosis, and how did he get it?

Treatment?

 Definition

Lyme disease.

Ixodes tick.

Doxycycline.
Term

A patient develops endocarditis three weeks after receiving a prosthetic heart valve.

 

What organism is suspected?

 Definition
S. aureus or S. epidermidis.
Term
Back pain that is exacerbated by standing and walking and relieved with sitting and hyperflexion of the hips.
 Definition
Spinal stenosis.
Term
Joints in the hand affected in rheumatoid arthritis.
 Definition
MCP and PIP joints; DIP joints are spared.
Term
Joint pain and stiffness that worsen over the course of the day and are relieved by rest.
 Definition
Osteoarthritis.
Term
Genetic disorder associated with multiple fractures and commonly mistaken for child abuse.
 Definition
Osteogenesis imperfecta.
Term

Hip and back pain along with stiffness that improves with activity over the course of the day and worsens at rest.

 

Diagnostic test?

 Definition

Suspect ankylosing spondylitis.

 

Check HLA-B27.
Term

Arthritis, conjunctivitis, and urethritis in young men.

 

Associated organisms?

 Definition

Reactive (Reiter's) arthritis.

 

Associated with

  1. Campylobacter
  2. Shigella
  3. Salmonella
  4. Chlamydia
  5. Ureaplasma
Term

A 55 y/o man has sudden, excruciating first MTP joint pain after a night drinking red wine. 

 

Diagnosis, workup, and chronic treatment?

 

 Definition

Gout.

 

Needle-shaped, negatively birefringent crystals are seen on joint fluid aspirate.

 

Chronic treatment with allopurinol or probenecid.
Term
Rhomboid-shaped, positively birefringent crystals on joint fluid aspirate.
 Definition
Pseudogout.
Term

An elderly woman presents with pain and stiffness of the shoulders and hips; she cannot lift her arms above her head.

 

Labs show anemia and ↑ ESR.

 Definition
Polymyalgia rheumatica.
Term

An active 13 y/o boy has anterior knee pain.

 

Diagnosis?

 Definition
Osgood - Schlatter disease.
Term
Bone is fractured in a fall on an outstretched hand.
 Definition
Distal radius (Colles' fracture).
Term
Complication of scaphoid fracture.
 Definition
Avascular necrosis.
Term
Sign suggesting radial nerve damage with humeral fracture.
 Definition
Wrist drop, loss of thumb abduction.
Term
A young child presents with proximal muscle weakness, waddling gait, and pronounced calf muscle.
 Definition
Duchenne muscular dystrophy.
Term

A first-born female who has born breech position is found to have asymmetric skin folds on her newborn exam.

 

Diagnosis?

Treatment?

 Definition

Developmental dysplasia of the hip. 

 

If severe, consider a Pavlik harness to maintain abduction.
Term

An 11 y/o obese African-American boy presents with sudden onset of limp.

 

Diagnosis?

 

Workup?

 Definition

Slipped capital femoral epiphysis.

 

AP and frod-leg lateral view.
Term
The most common 1° malignant tumor of bone.
 Definition
Multiple myeloma.
Term
Unilateral, severe periorbital headache with tearing and conjunctival erythema.
 Definition
Cluster headache.
Term
Prophylactic treatment for migraine.
 Definition
Antihypertensives, antidepressants, anticonvulsants.
Term

The most common pituitary tumor.

 

Treatment?

 Definition

Prolactinoma.

 

Dopamine agonists (e.g., bromocriptine).
Term

A 55 y/o patient presents with acute "broken speech."

 

What type of aphasia? 

 

What lobe and vascular distribution?

 Definition

Broca's aphasia.

 

Frontal lobe.

 

Left MCA distribution.
Term
The most common cause of SAH.
 Definition
Trauma; the second most common is berry aneurysm.
Term
A crescent-shaped hyperdensity on CT that does not cross the midline.
 Definition
Subdural hematoma - bridging veins torn.
Term

A history significant for initial altered mental status with an intervening lucid interval.

 

Diagnosis?

 

Most likely source?

 

Treatment?

 Definition

Epidural hematoma.

 

Middle meningeal artery.

 

Neurosurgical evacuation.
Term
CSF findings with SAH.
 Definition
Elevated ICP, RBCs, xanthochromia.
Term
Albuminocytologic dissociation.
 Definition
Guillain-Barre syndrome (↑ protein in CSF without a significant ↑ in cell count).
Term

Cold water is flushed into a patient's ear, and the fast phase of the nystagmis is toward the opposite side.

 

Normal or pathologic?

 Definition
Normal.
Term
The most common 1° sources of metastases to the brain.
 Definition
  1. Lung
  2. Breast
  3. Skin (melanoma)
  4. Kidney
  5. GI tract
Term
May be seen in children who are accused of inattention in class and confused with ADHD.
 Definition
Absence seizures.
Term
The most frequent presentation of intracranial neoplasm.
 Definition
Headache.
Term
The most common cause of seizures in young adults (18-35 years).
 Definition
Trauma, alcohol withdrawal, brain tumor.
Term
First-line medication for status epilepticus.
 Definition
IV benzodiazepine.
Term
Confusion, confabulation, ophthalmoplegia, ataxia.
 Definition
Wenicke's encephalopathy due to a deficiency of thiamine.
Term
What % lesion is an indication for carotid endarteredtomy?
 Definition
Seventy percent if the stenosis is symptomatic.
Term
The most common causes of dementia.
 Definition
Alzheimer's and multi-infarct.
Term
Combined UMN and LMN disorder.
 Definition
ALS.
Term
Rigidity and stiffness with resting tremor and masked facies.
 Definition
Parkinson's disease.
Term
The mainstay of Parkinson's therapy.
 Definition
Levodopa / carbidopa.
Term
Treatment for Guillain-Barre syndrome.
 Definition
IVIG or plasmapheresis.
Term
Rigidity and stiffness that progress to choreiform movements, accompanied by moodiness and altered behavior.
 Definition
Huntington's disease.
Term
A 6 y/o girl presents with a port-wine stain in the V2 distribution as well as with mental retardation, seizures, and ipsilateral leptomeningeal angioma.
 Definition

Sturge-Weber syndrome.

 

Treat symptomatically.

 

Possible focal cerebral resection of the affected lobe.
Term
Cafe au lait spots on skin.
 Definition
Neurofibromatosis type 1.
Term
Hyperphagia, hypersexuality, hyperorality, and hyperdocility.
 Definition
Kluver-Bucy syndrome (amygdala).
Term
May be administered to a symptomatic patient to diagnose myasthenia gravis.
 Definition
Edrophonium.
Term
1° causes of third-trimester bleeding.
 Definition
Placental abruption and placenta previa.
Term
Classic ultrasound and gross appearance of complete hydatidiform mole.
 Definition
Snowstorm on ultrasound.  "Cluster-of-grapes" appearance on gross examination.
Term
Chromosomal pattern of a complete hydatidiform mole.
 Definition
46, XX.
Term
Molar pregnancy containing fetal tissue.
 Definition
Partial mole.
Term
Symptoms of placental abruption.
 Definition
Continous, painful vaginal bleeding.
Term
Symptoms of placenta previa.
 Definition
Self-limited, painless vaginal bleeding.
Term
When should a vaginal exam be performed with suspected placenta previa?
 Definition
Never.
Term
Antibiotics with teratogenic effects.
 Definition
  1. Tetracycline,
  2. Fluoroquinolones,
  3. Aminoglycosides,
  4. Sulfonamides.
Term
Shortest AP diameter of the pelvis.
 Definition
Obstetric conjugate: between the sacral promontory and the midpoint of the symphysis pubis.
Term
Medication given to accelerate fetal lung maturity.
 Definition
Betamethasone or dexamethasone x 48 hours.
Term
The most common cause of postpartum hemorrhage.
 Definition
Uterine atony.
Term
Treatment for postpartum hemorrhage.
 Definition
Uterine massage; if that fails, give oxytocin.
Term
Typical antibiotics for group B streptococcus (GBS) prophylaxis.
 Definition
IV penicillin or ampicillin.
Term
A patient fails to lactate after an emergency C-section with marked blood loss.
 Definition
Sheehan's syndrome (postpartum pituitary necrosis).
Term
Uterine bleeding at 18 weeks' gestation; no products expelled; membranes ruptured; cervical os open.
 Definition
Inevitable abortion.
Term
Uterine bleeding at 18 weeks' gestation; no products expelled; cervical os closed.
 Definition
Threatened abortion.
Term
The first test to perform when a woman presents with amenorrhea.
 Definition
β-hCG; the most common cause of amenorrhea is pregnancy.
Term
Term for heavy bleeding during and between menstrual periods.
 Definition
Menometrorrhagia.
Term
Cause of amenorrhea with normal prolactin, no response to estrogen-progesterone challenge, and a history of D&C.
 Definition
Asherman's syndrome.
Term
Therapy for polycystic ovarian syndrome.
 Definition
Weight loss and OCP's.
Term
Medication used to induceovulation.
 Definition
Clomiphene citrate.
Term
Diagnostic step required in a postmenopausal woman who presents with vaginal bleeding.
 Definition
Endometrial biopsy.
Term
Indications for medical treatment of ectopic pregnancy.
 Definition

Stable, unruptured ectopic pregnancy of < 3.5cm

at <6 weeks' gestation.
Term
Medical options for endometriosis.
 Definition
  1. OCP's
  2. Danazol
  3. GnRH agonists
Term
Laparoscopic findings in endometriosis.
 Definition
"Chocolate cysts," powder burns.
Term
The most common location for an ectopic pregnancy.
 Definition
Ampulla of the oviduct.
Term
How to diagnose and follow a leiomyoma.
 Definition
Ultrasound.
Term
Natural history of a leiomyoma.
 Definition
Regresses after menopause.
Term
A patient has ↑ vaginal discharge and petechial patches in the upper vagina and cervix.
 Definition
Trichomonas vaginitis.
Term
Treatment for bacterial vaginosis.
 Definition
Oral or topical metronidazole.
Term
The most common cause of bloody nipple discharge.
 Definition
Intraductal papilloma.
Term
Contraceptive methods that protect against PID.
 Definition
OCPs and barrier contraception.
Term
Unopposed estrogen is contraindicated in which cancers?
 Definition
Endometrial or estrogen receptor - + breast cancer.
Term
A patient presents with recent PID with RUQ pain.
 Definition
Consider Fitz-Hugh-Curtis syndrome.
Term
Breast malignancy presenting as itching, burning, and erosion of the nipple.
 Definition
Paget's disease.
Term
Annual screening for women with a strong family history of ovarian cancer.
 Definition
CA-125 and transvaginal ultrasound.
Term

A 50 y/o woman leaks urine when laughing or coughing.

 

Nonsurgical options?

 Definition

Kegel excercises, estrogen, pessaries for stress incontinence.

 
Term

A 30 y/o woman has unpredictable urine loss.  Examination is normal.

 

Medical options?

 Definition

  1. Anticholinergics (oxybutynin)
  2. β-adrenergics (metaprotenol) for urge incontinence.
Term
Lab values suggestive of menopause.
 Definition
↑ serum FSH.
Term
The most common cuase of female infertility.
 Definition
Endometriosis.
Term

Two consecutive findings of atypical squamous cells of undetermined significance (ASCUS) on Pap smear.

 

Follow-up evaluation?

 Definition
Colposcopy amd endocervical curettage.
Term
 Breast cancer type that ↑ the future risk of invasive carcinoma in both breasts.
 Definition
Lobular carcinoma in situ.
Term
Nontender abdominal mass associated with elevated VMA.
 Definition
Neuroblastoma.
Term

The most common type of tracheoesophageal fistula (TEF).

 

Diagnosis?

 Definition

Esophageal atresia with distal TEF (85%).  

Unable to pass NG tube.
Term
Not contraindications to vaccination.
 Definition
Mild illness and/or low-grade fever, current antibiotic therapy, and prematurity.
Term
Tests to rule out shaken baby syndrome.
 Definition

  1. Ophthalmologic exam
  2. CT
  3. MRI
Term
A neonate has meconium ileus.
 Definition

  1. Cystic Fibrosis or 
  2. Hirschsprung's disease.
Term
Bilious emesis within hours after the first feeding.
 Definition
Duodenal atresia.
Term

A 2 month baby presents with nonbilious projectile emesis.

 

What are the appropriate steps in management?

 Definition

Correct metabolic abnormalities.

 

Then correct pyloric stenosis with pyloromyotomy.
Term
The most common 1° immunodeficiency.
 Definition
Selective IgA deficiency.
Term

An infant has a high fever and onset of rash as fever breaks.

 

What is he at risk for?

 Definition
Febrile seizures (roseola infantum).
Term

What is the immunodeficiency?

 

  1. A boy has chronic respiratory infections.  Nitroblue tetrazolium test is +.
  2. A child has eczema, thrombocytopenia, and high levels of IgA.
  3. A 4 month old boy has life-threatening Pseudomonas infection.
 Definition
  1. Chronic granulomatous disease
  2. Wiskott-Aldrich syndrome
  3. Bruton's X-linked agammaglobulinemia
Term
Acute-phase treatment for Kawasaki disease.
 Definition
High-dose aspirin for inflammation and fever; IVIG to prevent coronary artery aneurysms.
Term
Treatment for mild and severe unconjugated hyperbilirubinemia.
 Definition
Phototherapy (mild) or exchange transfusion (severe).
Term
Sudden onset of mental status changes, emesis, and liver dysfunction after taking aspirin.
 Definition
Reye's syndrome.
Term

A child has loss of red light reflex. 

 

Diagnosis?

 Definition
Suspect retinoblastoma.
Term
Vaccinations at a 6 month well-child visit.
 Definition
  1. HBV,
  2. DTaP,
  3. Hib,
  4. IPV,
  5. PCV.
Term
Tanner stage 3 in a 6 y/o girl.
 Definition
Precocious puberty.
Term
Infection of small airways with epidemics in winter and spring.
 Definition
RSV bronchiolitis.
Term
Cause of neonatal RDS.
 Definition
Surfactant deficiency.
Term
A condition associated with red "currant-jelly" stools.
 Definition
Intussusception.
Term
A congenital heart disease that causes 2° hypertension.
 Definition
Coarctation of the aorta.
Term
First-line treatment for otitis media.
 Definition
Amoxicillin x 10 days.
Term
The most common pathogen causing croup.
 Definition
Parainfluenza virus type 1.
Term
A homeless child is small for his age and has peeling skin and a swollen belly.
 Definition
Kwashiorkor (protein malnutrition).
Term
Defect in a X-linked syndrome with mental retardation, gout, self-mutilation, and choreoathetosis.
 Definition
Lesch - Nyhan syndrome (purine salvage problem with HGPRTase deficiency).
Term
A newborn girl has a continous "machinery murmur."
 Definition
Patent ductus arteriosus (PDA).
Term
First-line pharmacotherapy for depression.
 Definition
SSRIs.
Term
Antidepressant associated with hypertensive crisis.
 Definition
MAOIs.
Term
  1. Galactorrhea
  2. Impotence
  3. Menstrual dysfunction
  4. ↓ libido
 Definition
Patient on dopamine antagonist.
Term
A 17 y/o girl has left arm paralysis after her boyfriend dies in a car crash.  No medical cause is found.
 Definition
Conversion disorder.
Term

Name the defense mechanism:

  1. A mother who is angry at her husband yells at her child.
  2. A pedophile enters a monastery.
  3. A woman calmly describes a grisly murder.
  4. A hospitalized 10 y/o begins to wet his bed.
 Definition
  1. Displacement
  2. Reaction formation
  3. Isolation
  4. Regression
Term
Life-threatening muscle rigidity, fever, and rhabdomyolysis.
 Definition
Neuroleptic malignant syndrome.
Term
Amenorrhe, bradycardia, and abnormal body image in a young female.
 Definition
Anorexia.
Term
A 35 y/o man has recurrent episodes of palpitations, diaohoresis, and fear of going crazy.
 Definition
Panic disorder.
Term
The most seriious side effect of dozapine.
 Definition
Agranulocytosis.
Term
A 21 y/o man has three months of social withdrawal, worsening grades, flattened affect, and concrete thinking.
 Definition
Schizophreniform disorder (diagnosis of schizophrenia requires ≥ 6 months of symptoms.
Term
Key side effects of atypical antipsychotics.
 Definition
  1. Weight gain
  2. Type 2 DM
  3. QT prolongation.
Term

A young weight lifter receives IV haloperidol and complains that his eyes are deviated sideways.

 

Diagnosis?

Treatment?

 Definition

Acute dystonia (oculogyric crisis)

 

Treat with benztropine or diphenhydramine.
Term
Medications to avoid in patients with a history of alcohol withdrawal seizure.
 Definition
Neuroleptics.
Term
A 13 y/o boy has a history of alcohol withdrawal seizures.
 Definition
Conduct disorder.
Term
A 5 month old girl has ↓ head growth, truncal dyscoordination, and ↓ social interaction.
 Definition
Rett's disorder.
Term

A patient hasn't slept for days, lost $20,000 gambling, is agitated, and has pressured speech.

 

Diagnosis?

 

Treatment?

 Definition

Acute mania.

 

Start a mood stabilizer (e.g., Lithium).  
Term
After a minor fender bender, a man wears a neck brace and requests permanent disability.
 Definition
Malingering.
Term
A nurse presents with severe hypoglycemia; blood analysis reveals no elevation in C-peptide.
 Definition
Factitious disorder (Manchausen syndrome).
Term
A patient continues to use cocaine after being in jail, losing his job, and not paying child support.
 Definition
Substance abuse.
Term
A violent patient has vertical and horisontal nystagmus.
 Definition
Phencyclidine hydrochloride (PCP) intoxication.
Term
A woman who was abused as a child frequently feels outside of or detached from her body.
 Definition
Depersonalization disorder.
Term
A man has repeated, intense urges to rub his body against unsuspecting passengers on a bus.
 Definition
Frotteurism ( a paraphilia).
Term

A schizophrenic patient takes haloperidol for one year and develops uncontrollable tongue movements.

 

Diagnosis?

 

Treatment?

 Definition

Tardive dyskinesia.

 

↓ or discontinue haloperidol and consider another antipsychotic (e.g., risperidone, dozapine).

 

 
Term
A man unexpected flies across the ccountry, takes a new name, and has no memory of his prior life.
 Definition
Dissociative fugue.
Term
Risk factor for DVT.
 Definition
  1. Stasis
  2. Endothelial injury
  3. Hypercoagulability
Term
Criteria for exudative effusion.
 Definition

Pleural/serum protein > 0.5;

Pleural/serum LDH > 0.6.
Term
Causes of exudative effusion.
 Definition
  1. Think of leaky capillaries.
  2. Malignancy
  3. TB
  4. Bacterial or viral infection
  5. Pulmonary embolism with infarct
  6. Pancreatitis
Term
Causes of transudative effusion.
 Definition
  1. Think of intact capillaries
  2. CHF
  3. Liver of Kidney diseases
  4. Protein-losing enteropathy.
Term
Normalizing Pco2 in a patient having an asthma exacerbation may indicate?
 Definition
Fatigue and impending respiratory failure.
Term
  1. Dysnea
  2. Lateral hilar lymphadenopathy on CXR
  3. Noncaseating granulomas
  4. ↑ ACE
  5. Hypercalcemia
 Definition
Sarcoidosis.
Term
PFTs showing ↓ FEV1/FVC
 Definition
Obstructive pulmonary disease (asthma).
Term
PFTs showing ↑ FEV1/FVC
 Definition
Restrictive pulmonary disease.
Term

Honeycomb pattern on CXR.

 

Diagnosis?

 

Treatment?

 

 Definition

Diffuse interstitial pulmonary fibrosis.

 

Supportive care.

 

Steroids may help.
Term
Treatment for SVC syndrome.
 Definition
Radiation.
Term
Treatment for mild, persistent asthma.
 Definition

Inhaled β-agonist

and

Inhaled corticosteroids.
Term
Treatment for COPD exacerbation.
 Definition
  1. O2,
  2. Bronchodilators,
  3. Antibiotics,
  4. Corticosteroids with taper,
  5. Smoking cessation.
Term
Treatment for chronic COPD.
 Definition
  1. Smoking cessation
  2. Home O2
  3. β-agonists
  4. Anticholinergics
  5. Systemic or inhaled corticosteroids
  6. Flu and pneumococcal vaccines.
Term
Acid-base disorder in pulmonary embolism.
 Definition
Hypoxia and hypocarbia (respiratory alkalosis).
Term
Non-small cell lung cancer (NSCLC) associated with hypercalcemia.
 Definition
Squamous cell lung cancer (SCLC).
Term
Lung cancer highly related to cigarette exposure.
 Definition
SCLC.
Term

A tall white male presents with acute shortness of breath.

 

Diagnosis?

 

Treatment?

 Definition

Spontaneous pneumothorax.

 

Spontaneous regression.

 

Supplemental O2 may be helpful.
Term
Treatment of tension pneumothorax.
 Definition
Immediate needle thoracostomy.
Term

Characteristics favoring carcinoma in an isolated

pulmonary nodule.

 Definition
  1. Age > 45 -50 years
  2. Lesions new or larger in comparison to old films
  3. Absence of calcification
  4. Size > 2cm
  5. Irregular margins
Term

Hypoxemia and pulmonary edema with normal pulmonary

 

capillary wedge pressure.

 Definition
ARDS.
Term
Sequelae of asbestos exposure.
 Definition
  1.  
    1.  
      1. Pulmonary fibrosis
      2. Pleural plaques
      3. Bronchogenic carcinoma (mass in lung field)
      4. Mesothelioma (pleural mass).
Term
↑ risk of what infection with silicosis?
 Definition
Mycobacterium tuberculosis.
Term
Causes of hypoxemia.
 Definition
  1.  
    1.  
      1.  
        1.  
          1. Right-to-left shunt
          2. Hypoventilation
          3. Low inspired O2 tension
          4. Diffusin defect
          5. V/Q mismatch
Term
Classic CXR findings for pulmonary edema.
 Definition
  1.  
    1.  
      1. Cardiomegaly
      2. Prominent pulmonary vessels
      3. Kerley B lines
      4. "bat's - wing" appearance of hilar shadows
      5. perivascular and peribronchial cuffing
Term

Renal tubular acidosis (RTA) associated with abnormal H+

 

secretion and mephrolithiasis.

 Definition
Type I (distal) RTA.
Term
RTA associated with abnormal HCO3- and rickets.
 Definition
Type II (proximal) RTA
Term
RTA associated with aldosterone defect.
 Definition
Type IV (distal) RTA.
Term
"Doughy" skin
 Definition
Hypernatremia.
Term
Differential of hypervolemic hyponatremia.
 Definition
  1.  
    1.  
      1.  
        1.  
          1. Cirrhosis
          2. CHF
          3. Nephritic syndrome
Term
Chvostek's and Trousseau's signs.
 Definition
Hypocalcemia.
Term
The most common cause of hypercalcemia.
 Definition

Malignancy

 

Hyperparathyroidism
Term
T-wave flattening and U waves.
 Definition
Hypokalemia.
Term
Peaked T waves and widened QRS.
 Definition
Hyperkalemia.
Term
First-line treatment for moderate hypercalcemia.
 Definition
IV hydration and loop diuretics (Furosemide).
Term
Type of ARF in a patient with FeNa<1%.
 Definition
Prerenal.
Term
A 49 y/o man presents with acute-onset flank pain and hematuria.
 Definition
Nephrolithiasis.
Term
The most common type of nephrolithiasis.
 Definition
Calcium oxalate.
Term

A 20 y/o man presents with a palpable flank mass and hematuria.  Ultrasound shows bilateral enlarged kidneys with cysts.

 

Associated brain anomaly?

 Definition
Cerebral berry aneurysm.
Term

Hematuria

 

Hypertension

 

Oliguria

 Definition
Nephritic syndrome.
Term

Proteinuria

 

Hypoalbuminemia

 

Hyperlipidemia

 

Hyperlipiduria

 

Edema

 Definition
Nephrotic syndrome.
Term
The most common form of nephritic syndrome.
 Definition
Membranous glomerulonephritis.
Term
The most common form of glomerulonephritis.
 Definition
IgA nephropathy (Berger's disease).
Term
Glomerulonephritis with deafness.
 Definition
Alport's syndrome.
Term
Glomerulonephritis with hemoptysis.
 Definition

Wegener's granulomatosis

 

Goodpasture's syndrome.
Term
Presence of red cell casts in urine sediment.
 Definition
Glomerulonephritis/nephritic syndrome.
Term
Eosinophils in urine sediment.
 Definition
Allergic interstitial nephritis.
Term
Waxy casts in urine sediment and Maltese crossed (seen with lipiduria).
 Definition
Nephrotic syndrome.
Term
  1.  
    1.  
      1.  
        1. Drowsiness,
        2. Asterixis,
        3. Nausea, and
        4. A pericardial friction rub.
 Definition
Uremic syndrome seen in patients with renal failure.
Term

A 55 y/o man is diagnosed with prostate cancre.

 

Treatment options?

 Definition
  1. Wait
  2. Surgical resection
  3. Radiation
  4. And/or androgen suppression
Term
Low urine specific gravity in the presence of high serum osmolality.
 Definition
Diabetes insipidus.
Term
Treatment of SIADH?
 Definition

Fluid restriction

 

Demeclocycline
Term

Hematuria

 

Flank pain

 

Palpable flank mass

 Definition
Renal Cell Carcinoma (RCC).
Term
Testicular cancer associated with β-hCG, AFP.
 Definition
Choriocarcinoma.
Term
The most common type of bladder cancer.
 Definition
Transitional cell carcinoma.
Term
Complication of overly rapid correction of hyponatremia.
 Definition
Central pontine myelinolysis.
Term

Salicylate ingestion occurs in what type of acid-base

 

disorder?

 Definition

Anion gap acidosis and 1° respiratory alkalosis due to

 

central repiratory stimulation.
Term
Acid-base disturbance commonly seen in pregnant women.
 Definition
Respiratory alkalosis.
Term
Three systemic diseases that lead to nephrotic syndrome.
 Definition

DM

 

SLE

 

Amyloidosis
Term

Elevated erythropoietin level,

 

Elevated hematocrit, and

 

Normal O2 saturation suggest?

 Definition

RCC or

 

Other erythropoietin-producing tumor

 

Evaluate with CT scan.
Term

A 55 y/o male presents with irritative and obstructive urinary symptoms.

 

Treatment options?

 Definition

Likely BPH.

 

Options include: 1. No treatment

2. Terazosin

3. Finasteride

4. Or surgical intervention (TURP).

 
Term
Class of drugs that may cause syndrome of muscle rigidity, hyperthermia, autonomic instability, and extrapyramidal symptoms.
 Definition
Antipsychotics (neuroleptic malignant syndrome).
Term
Side effects of corticosteroids.
 Definition
  1. Acute mania
  2. Immunosuppression
  3. Thin skin
  4. Osteoporosis
  5. Easy bruising
  6. Myopathies
Term
Treatments for DTs.
 Definition
Benzodiazepines.
Term
Treatment for acetaminophen overdose.
 Definition
N-acetylcysteine.
Term
Treatment for opioid overdose.
 Definition
Flumazenil.
Term
Treatment for neuroleptic malignant syndrome and malignant hyperthermia.
 Definition
Dantrolene.
Term
Treatment for malignant hypertension.
 Definition
Nitroprusside.
Term
Treatment of atrial fibrillation.
 Definition
  1. Rate control
  2. Rhythm conversion
  3. Anticoagulation
Term
Treatment of supraventricular tachycardia.
 Definition

If stable, rate control with carotid massage or

 

other vagal stimulation; if unsuccessful, consider adenosine. 
Term
Causes of drug-induced SLE.
 Definition
  1. INH
  2. Penicillamine
  3. Hydralazine
  4. Procainamide
  5. Chlorpromazine
  6. Methyldopa
  7. Quinidine
Term
Macrocytic, megaloblastic anemia without neurologic symptoms.
 Definition
Folate deficiency.
Term

A burn patient presents with cherry-red flushed skin and coma.  SaO2 is normal, but carboxyhemoglobin is elevated.

 

Treatment?

 Definition
  1. Treat CO poisoning with 100% O2 or

 

  1. With hyperbaric O2 if poisoning is severe or

 

  1. the patient is pregnant.
Term
Blood in the urethral meatus or high-riding prostate.
 Definition
Bladder rupture or urethral injury.
Term
Test to rule out urethral injury.
 Definition
Retrograde cystourethrogram.
Term
Radiographic evidence of aortic disruption or dissection.
 Definition

Widened mediastinum (> 8 cm)

 

Loss of aortic knob

 

Pleural cap

 

Tracheal deviation to the right

 

Depression of left main stem bronchus
Term
Radiographic indications for surgery in patients with acute abdomen.
 Definition

Free air under diaphragm

 

Extravasation of contrast

 

Severe bowel distention

 

Space-occupying lesion (CT)

 

Mesenteric occlusion (angiography)
Term
The most common organism in burn-related infections.
 Definition
Pseudomonas.
Term
Method of calculating fluid repletion in burn patients.
 Definition
Parkland formula.
Term
Acceptable urine outout in a trauma patient.
 Definition
50 cc/hr.
Term
Acceptable urine output in a stable patient.
 Definition
30 cc/hr.
Term
Cannon "a" waves.
 Definition
Third-degree heart block.
Term
Sign of neurogenic shock.
 Definition
Hypotension and bradycardia.
Term
Signs of ↑ ICP (Cushing's triad).
 Definition

Hypertension,

 

Bradycardia, and

 

Abnormal respirations.
Term

↓ CO,

 

↓ pulmonary capillary wedge pressure (PCWP),

 

↑ peripheral vascular resistance (PVR)

 Definition
Hypovolemic shock.
Term

↓ CO

 

↑ PCWP

 

↑ PVR

 Definition
Cardiogenic ( or obstructive) shock.
Term

↑ CO

 

↓ PCWP

 

↓ PVR

 Definition
Septic or anaphylatic shock.
Term
Treatment of septic shock.
 Definition
Fluids and antibiotics.
Term
Treatment of cardiogenic shock.
 Definition
Identify cause; pressors (dopamine).
Term
Treatment of hypovolemic shock.
 Definition
Identify cause; fluid and blood repletion.
Term
Treatment of anaphylactic shock.
 Definition
Diphenhydramine or epinephrine 1:1000.
Term
Supportive treatment for ARDS.
 Definition
Continous positive airway pressure.
Term
Signs of air embolism.
 Definition

A patient with chest trauma who was previously stable

 

suddenly dies.
Term
Trauma series.
 Definition

AP chest,

 

AP/lateral C-spine,

 

AP pelvis.
Term
The most common type of testicular cancer.
 Definition
Seminoma, a type of germ cell tumor.
Term
The most common cause of seizures in children ( 2-10 years).
 Definition
1. Infection
2. Febrile seizures
3. Trauma
4. Idiopathic.
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