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First Aid USMLE Step 2 B
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301
Medical
Professional
02/22/2009

Additional Medical Flashcards

 


 

Cards

Term
Down syndrome pts are at increased risk for which hematologic cancer?
Definition
ALL
Term
Which two cancer are pts with Paget's disease of bone at increased risk for developing?
Definition
secondary osteosarcoma & fibrosarcoma
Term
Pts who develop acanthosis nigricans are at increased risk for developing which kinds of cancers?
Definition
visceral (stomach, lung, breast, uterus)
Term
What is the clinical definition of neutropenia?
Definition
less than 2000/mm^3
Term
How can a sputum gram stain be determined to be an "adequate" sample?
Definition

many neutrophilsn (greater than 25/hpf)
few epithelial cells (less than 25/hpf)

Term
What are the three most common causes of pneumonia in COPD pts?
Definition

H. influenzae

Moraxella catarrhalis

S. pneumoniae

Term
Any pt with suspected TB should have what two tests performed?
Definition
PPD and acid-fast stain of sputum
Term
Which bacteria is responsible for strep throat?
Definition
Group A (beta-hemolytic Streptococcus pyogenes)
Term
T or F: Cough is typical of strep throat (due to Group A beta hemolytic Streptococcus pyogenes)?
Definition
False
Term
What are the three most common causes bacterial sinusitis?
Definition
Strep. pneumoniae
H. influenzae
M. catarrhalis
Term
What time frames separate acute and chronic sinusitis?
Definition
Acute – less than 1 mo
Chronic – more than 3 mo.
Term
Which two "signs" are classic for meningitis?
Definition
Kernig's
Brudzinski's
Term
What IV fluid can be used to treat cerebral edema?
Definition
mannitol
Term
What are the three most common causes of meningitis in neonates?
Definition
Group B streptococcous (Strep. agalactiae)
E. oli
Listeria
Term
What re the four major causes of meningitis in children 6mo-6yr?
Definition
S. pneumoniae
Neisseria meningitidis
H. influenzae (B)
Enteroviruses
Term
What are the four major causes of meningitis in pts 6-60ys?
Definition
Neisseria meningitidis
Enteroviruses
S. pneumoniae
HSV
Term
What are the major causes of meningitis for elderly pts?
Definition
S. pneumoniae
Listeria
Neisseria meningitidis
Term
What antibacterial agents are used in neonates under 1 mo?
Definition
Ampicillin + cefotaxime or gentamicin
Term
What antibacterial agents are used in neonates 1-3 mo with meningitis?
Definition
Vancomycin + ceftriaxone or cefotaxime
Term
What antibacterial agents are used in 3mo-adulthood pts with meningitis?
Definition
Vancomycin + ceftriaxone or cefotaxime
Term
What antibacterial agents are used in elderly pts with meningitis?
Definition
Ampicillin + vancomycin + ceftriaxone or cefotaxime
Term
What are the two most common pathogens of encephalitis?
Definition
HSV
arboviruses
Term
How are encephalitis due to HSV and CMV treated differently?
Definition
HSV-IV acyclovir
CMV-ganciclovir +/- foscarnet
Term
Which two tests are utilized in the diagnoses of HIV?
Definition
ELISA (sensitivity)
Western blot (confirmatory b/c of specificity)
Term
Once HIV diagnosis is confirmed what other baseline tests should be run?
Definition
HIV RNA PCR (viral load)
CD4 cell count
CXR
PPD
Pap smear
VDRL/RPR
CMV, hepatitis, toxoplasmosis, VZV
Term
How is Cryptococcal meningitis usually diagnosed?
Definition
via LP
Term
How is histoplasmosis generally diagnosed in AIDS pts?
Definition
serum or urine antibody
or
silver stain on biopsy (yeast form)
Term
Pneumocystis carinni pneumonia is commonly seen in AIDS pts with what description of their CXR?
Definition
diffuse, bilaterrral interstitial infiltrates w/ ground-glass appearance
Term
Which organism is the most common BACTERIAL STD in the US?
Definition
Chlamydia
Term
Lymphogranuloma venereum is caused by what bacterial agent?
Definition
Chlamydia
Term
Which antibacterial agent is first-line treatment for Chlamydia?
Definition
Doxycycline 100mg BID x 7 days
Term
Condylomata lata lesions are caused by what?
Definition
syphilis (Treponema pallidum)
Term
What is the sensitivity of VDRL/RPR tests?
Definition
60-75%
Term
Which test for syphilis is both sensitive and specific?
Definition
FTA-ABS should be used in cases when clinical presentation of syphilis is suspected w/ neg. VDRL/RPR
Term
Which organism causes cancroids?
Definition
Hameophilus ducreyi
Term
What type of adenopathy is common in pts with a cancroid?
Definition
inguinal lymphadenopathy (caused by Haemophilus ducreyi)
Term
The gnumonic SEEKS PP is used to recall causes of UTIs. What does each letter stand for?
Definition
Serratia
E. coli
Enterobacter
Klebsiella
S. saprophyticus
Pseudomonas
Proteus mirabilis
Term
What is the most common cause of osteomyelitis?
Definition
staph aureus
Term
IV drug users are most likely to have ostemyeltitis cause from which two organisms?
Definition
Staph aureus
pseudomonas
Term
Osteomyelitis following a foot puncture wound should make a physician suspicious for what pathogen?
Definition
Pseudomonas
Term
For what duration should pts w/ osteomyelitis be treated on antibiotics?
Definition
4-6 wks
Term
Which aspect of a complete physical exam should be avoided in pts w/ neutropenic pts?
Definition
rectal exam
increased risk for bleeding
Term
Which disease of North America is the most common vector-borne disease?
Definition
Lyme disease
Term
What organism causes lyme disease?
Definition
Borrelia burgdorferi
Term
Which type of tick carries Borrelia burgdorfei?
Definition
Ixodes
Term
What cutaneous lesion is associated with Lyme disease and described as "bull's eye"?
Definition
erythema migrans (usually gets larger after initial manifestation)
Term
Which two tests are diagnostic for Lyme's disease?
Definition
ELISA followed by confirmatory Western Blot
Term
What RXs are used in early and late Lyme disease?
Definition
Early-doxycyline
late-ceftriaxone
Term
Describe the spread of the rash in Rocky Mountain Spotted Fever?
Definition
starts at ankles and wrists
then migrates to trunk/centrally
Term
What bacteria causes Rocky Mountain Spotted Fever?
Definition
Rickettsia rickettsii
transported by Dermacentor variabilis (dog tick)
Term
How is a diagnosis of Rocky Mountain Spotted Fever confirmed?
Definition
indirect immunofluorescence of rash biopsy
Term
What common and inexpensive antibiotic is frequently used in the treatment of Rocky Mountain Spotted Fever?
Definition
Doxycyline
Term
Which virus is the most common congenital infection?
Definition
CMV
Term
What is the number one cause of endocarditis (more than 80% of cases) in pts with IV drug use?
Definition
Staphylococcus aureus
Term
Which three organisms are the most common pathogens of acute endocarditis?
Definition
Staph aureus
Step. pneumoniae
Neisseria gonorrhoeae
Term
In what timeframe after the halo lesion of anthrax does the black eschar normally form within?
Definition
7-10 days
Term
What are the symptoms of cauda equina syndrome?
Definition
bowel/bladder dysfunction
impotence
saddle-area anesthesia
Term
Which lower extremity muscular action is reduced w/ compression of L5 nerve root?
Definition
great toe dorsiflexion
Term
Reiter's syndrome (AKA reactive arthritis) commonly follows infections of what organisms?
Definition
Campylobacter
Shigella
Salmonella
Chlamydia
Ureaplasma
Term
What is the inheritence pattern for Duchenne muscular dystrophy?
Definition
X-linked recessive
presents most commonly in 3-5 yr lds
Term
Which physical sign is frequently present in young children with Duchenne Muscular dystrophy?
Definition
Gower's maneuver (using hands to push off thights when rising from floor)
Term
Hypertrophy of which lower extremity muscle is commonly seen in young children with Duchenne muscular dystrophy?
Definition
gastrocnemius
Term
What is the classic description of a pt with either polymyositis or dermatomyositis?
Definition
Female
50-70
Black
Term
Shawl sign (rash of shoulder, upper chest, and back) and Gottoron's papules are classic for which disease?
Definition
dermatomyositis
Term
Both polymyositis and dermatomyositis require biopsy of what for diagnosis?
Definition
muscle tissue
(will demonstrate inflammation)
Term
What are the components of Felty's syndrome?
Definition
RA
splenomegaly
neutropenia
Term
T or F: The vast majority of juvenile RA pts have spontaneous resolution by puberty?
Definition
true
95% resolve at puberty
Term
Which type of juvenile RA has an asymmetric presentation of weight-bearing joints?
Definition
Pauciarticular
Term
T or F: In both Juvenile RA and RA most pts are RF positive.
Definition
False
more than 75% in adults
only 15% in juvenile RA
Term
What is the most common symptomatic presentation of scleroderma?
Definition
CREST syndrome
Calcinosis
Raynaud's phenomenon
Esophageal dysmotility
sclerodactyly
Telangiectasias
Term
What are the roles of CCBs and ACEI's in scleroderma?
Definition
CCBs manage Raynaud's
ACEIs maintain renal perfusion
Term
What is the most sensitive test for SLE?
Definition
positive ANA
Term
Aside from Antinuclear antibodies (ANA) what other antibodies are highly specific for SLE but less sensitive?
Definition
anti-dsDNA
anti-Smith
Antiphospholipid antibodies
Term
In what position is the upper extremity maintained in pts with an anterior dislocation of the shoulder?
Definition
external rotation
Term
Which carpal bone is the msot commonly fractured?
Definition
scaphoid
Term
Which metacarpal bone is damaged in a boxer's fracture?
Definition
5th metacarpal
Term
Which two bones are the most common sites for osteosarcomas?
Definition
distal femur
proximal tibia
Term
What is the most common primary turmor of bone?
Definition
multiple myeloma
Term
What is the classic radiologic finding on a pt with an osteosarcoma?
Definition
sunburst pattern
Term
What is the classic radiologic finding on a pt with Ewing's sarcoma?
Definition
onion skinning
Term
Which artery is affected in stroke pts with aphasia or neglect?
Definition
MCA
Term
Which artery is affected in stroke pts with homonymous hemianopsia and memory deficits?
Definition
PCA
Term
If a pt with a history of head trauma has a negative CT (w/o contrast of course) but a SAH is still clinically suspect, which test should then be performed?
Definition
lumbar puncture
Term
Which artery is the cause of an epidural hematoma?
Definition
middle meningeal artery
Term
Which type of headaches are the most common in adultes?
Definition
tension
Term
Why do pts with myasthenia gravis have CXR performed?
Definition
evaluation for thymoma
Term
What is the most common cause of dementia?
Definition
Alzheimer's disease
Term
In addition to chlinesterase inhibitors which vitamin may also slow progression of cognitive decline?
Definition
Vitamin E
Term
What are the four signs of Parkinson disease?
Definition
resting tremor
rigidity
bradykinesia
postural instability
Term
What are the two most common primary tumors in adults?
Definition
glioblastoma multiforme
meningioma
Term
What is the number one most common primary brain tumor?
Definition
glioblastoma multiforme
Term
Cafe-au-lait spots are associated with which disease?
Definition
Neurofibromatosis type I
Term
Which condition causes bilateral acoustic neuromas?
Definition
neurofibromatosis type II
Term
Which condition presents with infantile spasms and ash-leaf hypopigmented lesions of trunk and extremities?
Definition
tuberous sclerosis
Term
Which medications are most often used for the treatment of acute closed-angle glaucoma?
Definition
acetazolamide
pilocarpine
Term
What is the classic ophthamalogic finding with open-angle glaucoma?
Definition
cupping of optic disks
(bilateral involvement)
Term
At approximately which week is the uterus palpable above the pelvic symphysis?
Definition
week 12
Term
Between which weeks of pregnancy should maternal AFP be determined?
Definition
15-19
Term
During which week should RhoGAM be administered to Rh negative women?
Definition
28
Term
During which weeks of pregnancy does quickening usully start?
Definition
17-18 weeks
Term
What genetic syndrome is at significantly increased risk with a mother's tripple screen revealing decreased AFP, decreased estriol, and decreased beta-hCG
Definition
Down syndrome
Term
If a mother's tripple screen test demonstrates decreased AFP, decreased estriol, and decreased beta-hCG what genetic disorder of the fetus is likely?
Definition
Edward syndrome (trisomy 18)
Term
What does hyperglycemia in the first trimester suggest?
Definition
pre-existing diabetes
Term
Which two classes of anti-HTN medications should be avoided in pregnant pts with hypertension?
Definition
ACIEs and diuretics (both may cause uterine ischemia)
Term
What type of pregnancy moles result from a sperm firtilizing an empty ovum and are 46 XX?
Definition
complete mole
Term
What is an incomplete (or partial) mole?
Definition
normal ovum fertilized by two sperm resutling in a 69 chromosome XXY
Term
Which type of mole has fetal tissue present?
Definition
incomplete (partial) mole
Term
What type of appearance is classic for a molar pregnancy?
Definition
snowstorm
Term
Which hormone is markedly elevated in molar pregnancies?
Definition
beta-hCG
Term
What is the follow-up for a pt with hydatidiform mole?
Definition
close monitoring of beta-hCG
prevent pregnancies for at least one year
Term
Malignant gestational trophoblastic disease (mole pregnancies) are highly sensitive to what forms of oncologic treatment?
Definition
chemo and X-ray
Term
What are the most common causes of third-trimester bleeding?
Definition
placental abruption
placental previa
Term
What is placental abruption?
Definition
premature separation of normally implanted placenta
Term
What is placenta previa?
Definition
some portion of placenta covers cervical os
Term
Which color of blood is more concerning in a third-trimester bleed, bright red or dark?
Definition
bright red
more likely to be a placenta previa
Term
How is premature rupture of membranes defined?
Definition
rupture or membranes before the onset of contractions
Term
What type of gynecologic exam should NOT be performed on pts less than 34 weeks with premature rupture of membranes?
Definition
digital vaginal exam
Term
Preterm labor occurs in what time frames of pregnancy?
Definition
between 20-37 weeks
Term
What is the number one cause of neonatal morbidity and mortality?
Definition
preterm labor
Term
What are the criteria for postpartum hemorrhage?
Definition
more than 500 mL w/ vaginal deliver
1.0 L for C-section
Term
What is the most common cause of postpartum hemorrhage?
Definition
uterine atony
Term
What is Sheehan's syndrome?
Definition
aka Postpartum Pituitary Necrosis
pituitary ischemia/necrosis secondary to hemorhage
Term
What is the most common manifestation of Sheehan's syndrome?
Definition
failure lactate postpartum (due to decreased prolactin levels)
Term
What is the most common cause of mastitis?
Definition
Staphylococcus aureus
Term
What percentage of clinically recognized pregnancies terminate in spontaneous abortions?
Definition
20%
Term
Women of what age group are at most risk for fibrocystic breast disease?
Definition
30-50
rarely present in postmenopausal women
Term
Despite fibrocystic breast disease being a benign condition, what concomitant finding increases the pt's risk for breast cancer?
Definition
ductal epithelial hyperplasia
Term
What is the most common breast lesion in women under 30 years of age?
Definition
fibroadenoma
Term
Which portion of the breast are breast cancers most commonly located?
Definition
upper outer quadrant (45%)
Term
Breast cancer localized to the breast has what chance for cure?
Definition
75-90%
Term
If metastatic breast cancer is found in axillary disection what is the five-year survival rate?
Definition
40-50%
Term
In a pt with secondary amenorrhea and elevated FSH levels what is the most likely cause?
Definition
ovarian failure
Term
What is metrorrhagia?
Definition
bleeding between periods
Term
What is menometrorrhagia?
Definition
excessive and irregular bleeding
Term
Testosterone levels above 200 ng/dL in a female with hirustism and/or virilization is most suspicious for what?
Definition
ovarian neoplasm
Term
What hormones demonstrate a greater than 2:1 ratio in PCOS?
Definition
LH:FSH
Term
What ultrasound founding of the ovaries helps with a diagnsis of PCOS?
Definition
pearl necklace sign
Term
What is the average age of menopause?
Definition
51
Term
What hormone levels are elevated in menopause?
Definition
FSH and LH
Term
40% of infertility issues are due to what?
Definition
abnormal spermatogenesis
Term
Where is the most common site of an ectopic pregnancy?
Definition
ampulla of oviduct
Term
What life-threatening condition must be ruled out in pregnant pts presenting with sharp abd pain, orthostatic hypotension, tachycardia, and perhaps rebound tenderness?
Definition
rupture ectopic pregnancy
also suspect in pts with secondary amenorrhea
Term
What is the best way to diagnose an ectopic pregnancy?
Definition
empty uterine cavity on U/S w/ beta-hCG of 6500 mIU/mL or greater
Term
66% of PID cases are due to what two pathogens?
Definition
Neisseria gonorrhoeae
Chlamydia trachomatis
Term
What is chandelier sign?
Definition
extreme cervical tenderness with palpation
Term
What is concerning when chandelier sign is evident?
Definition
PID
Term
What is the most common cause of bacterial vaginosis?
Definition
Gardnerella (clue cells)
Term
What pts population composes 90% of pts with toxich shock syndrome?
Definition
women of child-bearing age
Term
What tumor marker can be measured for recurrence of ovarian cancer?
Definition
CA-125
Term
What is the most common BENIGN neoplasm of the female genital tract?
Definition
uterine leiomyoma (fibroid)
Term
What releasing hormone can be used to suppress growth of firoids?
Definition
GnRH
Term
Infection with which strains of HPV increase risk for cervical cancer?
Definition
16, 18, 31, 33
Term
Pts with one relative w/ a history of ovarian tumors are at what percentage increased risk for developing an ovarian tumor?
Definition
5%
Term
BRCA1 and BRCA2 carry what lifetime risk for developing ovarian cancer?
Definition
BRCA1 – 45%
BRCA2 – 25%
Term
How does OCP use affect risk for ovarian cancer?
Definition
decreases
Term
How should pts with known BRCA1 mutation be managed for ovarian cancer?
Definition
annual US & CA-125 screening
prophylactic oophorectomy is recommended by age 35
Term
If a child appears to have been either neglected or abused what findings on ophthalmologic exam might be evident?
Definition
retinal hemorrhages
also order CT (subdural hemorrhages) & MRI (white matter changes)
Term
How can neonates with congenital heart disease be distinguished from having a right-to-left shunt vs a left-to-right shunt based solely on physical exam?
Definition
left-to-right are noncyanotic
right-to-left produce cyanosis
Term
What are the three causes of left-to-right shunts?
Definition
VSD
ASD
PDA
Term
What is the most common conenital heart defect?
Definition
VSD
Term
What heart sounds are evident in a child with a left-to-right shunt?
Definition
pansystolic murmurloud pulmonic S2
Term
What test is diagnostic for a VSD?
Definition
echocardiogram
Term
What is the firstline treatment for a VSD of a neonate?
Definition
Nothing, most spontaneously close
Term
What is the classic heart sound of an ASD?
Definition
fix, split S2
Term
Why is a right-axis deviation seen on an EKG in a pt with an ASD?
Definition
B/c the R heart has lower filling pressure than the L causes a L-to-R shunt and R-sided atrial dilation
Term
What infection of the mother's first-trimester increases the risk for a neonate to have a PDA?
Definition
rubella
Term
Any any neonate with recurrent respiratory infections, in addition to perhaps a primary lung disorder what other condition should be suspected?
Definition
congenital heart disease
Term
Children with HTN should have what aortic anomaly investigated?
Definition
coarctation
Term
What are the four characteristics of Tetralogy of Fallot?
Definition
pulmonary stenosis
RVH
overriding aorta
VSD
Term
What is the most common CYANOTIC heart disease of INFANCY?
Definition
transposition of the great arteries
Term
What is the most common CYANOTIC heart disease of CHILDHOOD?
Definition
tetralogy of fallot
Term
What radiographic finding is seen in pts with tetralogy of fallot?
Definition
boot-shaped heart
Term
What prostaglanind is used to maintain a PDA?
Definition
PGE-1
Term
What vaccination should be given to neonates at birth?
Definition
Hepatitis B vaccine
Term
There are four vaccines which should ideally be givein at 2, 4, and 6 months. What are they?
Definition
DTaP
Hib
IPV (inactivated polio vaccine)
PPV
Term
What is the diagnostic criteria for failure to thrive?
Definition
below the third to fifth percentile on growth curve
Term
What genetic disorder presents with mental retardation, rocker-bottom feet, low-set ears, and micorgnathia?
Definition
Edward syndrome (trisomy 18)
Term
What is Patau's syndrome?
Definition
Trisomy 13
mental retardation, microophthalmia, microcephaly, cleft deformities, poludactyly
Term
What genetic condition is the most common cause of primary amenorrhea?
Definition
Turner's Syndrome
Term
What is Fabry's disease?
Definition
alpha-galactosidase A deficiency
leads to renal failure
x-linked recessive
Term
What is Krabbe's disease?
Definition
galactosylceramide beta-galactoside is not produced
optic atrophy, spasticity, death
autosomal recessive
Term
What is Niemann-Pick disease?
Definition
sphingomyelinase deficiency
death by age 3
Term
Which enzyme is deficient in Tay-Sachs disease?
Definition
hexosaminidase A
Term
What ocular manifestation is characteristic of tay-Sachs disease?
Definition
Cherr-red spot on macula
Term
What condition is the most common cause of bowel obstruction within the first two years of life?
Definition
intussusception
Term
What procedure is diagnostic and often curative of intussusception?
Definition
air-contrast barium enema
Term
The gnumonic CATCH-22 is used to remember the characteristics of DiGeorge Syndrome. What does each letter/number stand for?
Definition
Congenital heart disease
Abnormal facies
Thymic aplasia
Cleft palate
Hypocalcemia
22q deletion
Term
What is Bruton's agammaglobulinemia?
Definition
x-link B-cell deficiency seen only in boys
Term
What are the two key characteristics to ataxia-telangiectasia?
Definition
oculocutaneous telangiectasis & cerebellar ataxia
Term
What type types of cancers are pts w/ ataxia-telangiectasia at increased risk for developing?
Definition
non-Hodgkin lymphoma
gastric carcinoma
Term
What is the cause of ataxia-telangiectasias?
Definition
DNA repair defect
Term
What congenital conditions leaves a pt w/ severe lack of both B and T cells?
Definition
Severe Combined Immunodeficiency (SCID)
Term
What is Wiskott-Aldrich syndrome?
Definition
X-linked immune system impairment of both B and T cells.
Term
What are the classic physical findings of Wiskott-Aldrich syndrome (x-linked immune impairment of B & T cells)?
Definition
eczema, bleeding, recurrent otitis media and other infections
Term
What disease is X-linked or autosomal recessive and is characterized by impairment of superoxide production?
Definition
Chronic granulomatous disease
Term
What test is diagnostic for chronic granulomatous disease?
Definition
nitroblue tetrazolium
Term
What antibacterial agent should pts w/ chronic granulomatous disease receive daily for prophylaxis?
Definition
TMP-SMX
Term
What is Chediak-Higashi syndrome?
Definition
An autosomal recessive disorder with defunct neutrophil chemotaxis
Term
What are the classic physical manifestations for Chediak-Higashi syndrome (autosomal recessive disorder of neutrophil chemotaxis)?
Definition
oculocutaneous albinism, neuropathy, neutropenia
Term
What is the treatment for pts wth Chediak-Higashi syndrome (autosomal recessive impairment of neutrophil chemotaxis)?
Definition
bone marrow transplant
Term
What congenital, autosomal dominant disorder is characterized by episodes of angioedema lasting 2-72 hours?
Definition
C1 esterase deficiency
Term
What is the treatment for C1 esterase deficiency?
Definition
daily danazol
purified C1 esterase & FFP before surgery
Term
Kawasaki disease primarily affects what age group?
Definition
children
80% are less than 5 years old
Term
The CRASH AND BURN symptoms of Kawasaki disease are what?
Definition
Conjuctivitis, Rash, Adenopathy, Strawberry tongue, Hands and feed, and BURN-fever over 40 C for at least 5 days
Term
How is Kawasaki disease treated?
Definition
high-dose ASA
IV IgG
Term
What are the major complications of untreated Kawasaki disease?
Definition
coronary artery aneurysm (40%)
MI
Term
What age group is primarily affected by bronchiolitis?
Definition
infants and children under 2
Term
What is the most common cause of bronchiolitis?
Definition
RSV
Term
How is bronchiolitis diagnosed?
Definition
CXR w/ hyperinflation, interstitial infiltrates, atelectasis
Term
What radiographic finding on an AP film is classic for croup?
Definition
subglottic narrowing (steeple sign)
Term
What pediatric infection of the upper airway is most common in 3-7 year orlds, presents with a muffled voice, drooling, high grade fever, and a "thumbprint sign" on lateral film?
Definition
epiglottitis
Term
How should a pt with epiglottis me managed?
Definition
emergently
Term
Drooling in a 5 year old pt with a muffled voice and high fever is most concerning for what emergent condition?
Definition
epiglottitis
Term
I say "thumbprint sign" on a lateral film of a pediatric pt. You say...?
Definition
epiglottitis
Term
What are the three primary causes of otitis media?
Definition
Strep. pneumoniae, H. influenzae, Moraxella catarrhalis
Term
What three findings sould be manifest for a diagnosis of otitis media?
Definition
TM erythema, bulging, and decreased mobility
Term
What Apgar scale defines a normal, healthy infant?
Definition
8-10
Term
What type of neonatal juandice is ALWAYS pathologic?
Definition
conjugated (direct)
Term
What is kernicterus?
Definition
irreversible deposition of unconjugated bilirubinin the basal ganglia, pons, and cerebellum which can be fatal
Term
What is gastroschisis?
Definition
herniation of uncovered intestines through the abdominal wall next to the umbilicus
Term
What is an omphalocele?
Definition
herniation of intestinal contents through the umbilicus covered with peritoneum and an amniotic membrane
Term
What radiographic sign is seen with congenital duodenal atresia?
Definition
double-bubble sign
Term
What is the most common congenital GI tract anomaly?
Definition
Meckel's diverticulum
Term
I say congenital megacolon. You say...?
Definition
Hirschsprung's disease
Term
What is the most common cause of respiratory failure in PRETERM infants?
Definition
RDS
Term
What is the primary cause of RDS in preterm infants?
Definition
surfactant deficiency
Term
Describe respiratory distress syndrome in the neonate.
Definition
Rapid ventilatory rate (over 60 resps/min), nasal flaring, cyanosis, intercostal retractions, expiratory grunting
Term
What radiographic sign is evident in neonates of RDS?
Definition
ground-glass appearance and airbronchograms
Term
What is the most common movement disorder in children?
Definition
Cerebral palsy
Term
What stimulatory metabolites are often elevated in the urine of pediatric pts with neuroblastoma?
Definition
VMA
HVA
Term
What is the most common renal tumor of childhood?
Definition
Wilm's tumor
Term
What is the MOST COMMON finding in Wilm's tumor?
Definition
painless abdominal mass which does not cross the midline
Term
What is the average duration of major depresive episodes in major depressive disorder?
Definition
at least 4 months when untreated
Term
what are the primary concerning side effects with atypical antipsychotics?
Definition
wt gain
insulin resistance
somnolence
agranulocytosis with clozapine
Term
What are the cluster C personality disorders?
Definition
OCD
Avoidant
Dependent
Term
What are the negative symptoms of schizophrenia?
Definition
blank affect
emotional soticism
inhibited speech
Term
How should ADHD be evaluated?
Definition
at least six months w/ symptoms in to different environements
Term
Akathisia, a symptoms of extrapyramidal syptoms, is what?
Definition
a subjective (or objective) sense of restlessness
Term
What are the four progressive stages of EPS?
Definition
acute dystonia
akathisia
dyskinesia
tardive dyskinesia
Term
What is meant by dyskinesia (an EPS)?
Definition
pseudoparkinsonism (shuffling gait, cogwheel rigidity)
Term
Autism should be evident before what age?
Definition
three
Term
What is Asperger's syndrome?
Definition
form of autism without marked language or cognitive delays
Term
What are the three leading causes of death in pts 15-24 years of age?
Definition
1. homicide
2. accidents
3. suicide
Term
What are the characteristic "lesions" of systemic sarcoidosis?
Definition
non-caseating granulomas
Term
What pulmonary conditions are pneimoconioses?
Definition
Asbestosis
Coal miner's lung
Silicosis
Berylliosis
Term
What is bronchiectasis?
Definition
disease caused by cycles of infection and inflammation in the bronchi/bronchioles leading to permanent fibrosis/remodeling/dilatation of bronchi
Term
What radiographic finding on CXR should you assocaite with bronchiectasis?
Definition
tram lines
Term
What are the two major causes of emphysema?
Definition
smoking
alpha-1-antitrypsin deficiency
Term
What measurement of pulmonary blood pressure is needed for a diagnosis of pulmonary hypertension?
Definition
25mmHg or greater
Term
What EKG finding is classic for a PE?
Definition
S1Q3T3
S wave in lead 1
Q wave in lead 3
inverted T wave in lead 3
Term
which type of non-small cell lung cancer has the worst prognosis?
Definition
Large cell (neuroendocrine carcinomas)
Term
Which type of cancer is the MOST COMMON primary lung cancer?
Definition
adenocarcinoma (peripheral location)
Term
Why is the treatment of small cell lung cancer and non-Small cell lung cancers differentiated?
Definition
b/c small cell lung cancer has a tendency to metastasize early while non-Small cell lung cancers don't
Term
The acronym CHIMPANZEES can be used to recall common causes of hypercalcemia. What does each letter stand for?
Definition
Calcium, Hyperparathyroidism, Iatrogenia, Milk-alkali syndrome, Paget's disease, Addison's disease (and Acromegaly), Neoplasm, Zollinger-Ellison syndrome
Term
Is muscle weakness associated with HYPER- or HYPO-kalemia?
Definition
hypokalemia
Term
Are muscle cramps and ileus associated with HYPER- or HYPO-kalemia?
Definition
hypokalemia
Term
What is the major cardiac concern with hypokalemia?
Definition
AV node conduction block w/ progression to cardiac arrest
Term
What type of diuretics should be employed in the treatment of hypercalcemia?
Definition
loop diuretics
thiazide diuretics may precepitate hypercalcemic symptoms as they increase calcium resorption
Term
What is the value of proteinuria in niphritic syndrome?
Definition
less than 1.5g/day
Term
What diuretic agents increase hydrogen ion retention and also block sodium resorption?
Definition
carbonic anhydrase inhibitors
Term
What acid-base disturbnce must be monitored when using loop diuretics?
Definition
metabolic alkalosis
Term
What K-sparing diuretic is concerning for gynecomastia?
Definition
spironolactone (as well as other anti-androgen effects)
Term
What acid-base disturbance is concerning with K-sparing diuretics?
Definition
metabolic acidosis
Term
How should niphritic syndrome be managed/treated?
Definition
balance electrolyte and acid-base disturbances; corticosteroids may be useful in some cases
Term
What are the four characteristics of nephrotic syndrome?
Definition
proteinuria (3.5g/day)
generalized edema
hypoalbuminemia
hyperlipidemia
Term
What finding might a pt present to a physician upon questioning about the pt's urine with a case of nephrotic syndrome?
Definition
foamy urine
Term
What is the most common cause of nephritic syndrome?
Definition
Berger's disease (IgA nephropathy)
Term
What cause of nephritic syndrome is hereditary and present primarily in boys 5-20 years of age?
Definition
Alport's syndrome
Term
What is the most common cause of nephrotic syndrome in children?
Definition
minimal change disease
Term
How is minimal change disease treated?
Definition
steroids
Term
What is membranous nephropathy?
Definition
a nephrotic syndrome due to immune complex disease freq. associated w/ HBV, syphilis, malaria, and gold toxicity
Term
Is diabetic nephropathy a nephritic or nephrotic syndrome?
Definition
nephrotic
Term
How is nephrotic syndrome due to diabetes managed?
Definition
tight control of blood glucose and HTN
Term
What type of nephropathy does Lupus nephritis present with?
Definition
may either be nephritic or nephrotic
Term
Renal amyloidosis causes what type of renal syndrome?
Definition
nephrotic
Term
What special stain is used in the diagnosis of amyloidosis?
Definition
congo red
Term
A "tram-track" appearance on renal biopsy of the basement membrane is seen in what renal disease?
Definition
membranoproliferative nephropathy (may be either nephrotic or nephritic)
Term
What kidney stones are the most common?
Definition
calcium oxalate/calcium phosphate
Term
What is the genetic inheritance pattern of polycystic kidney disease?
Definition
autosomal dominant or recessive
Term
What cerebral vascular anomaly is frequently associated with polycystic kidney disease?
Definition
cerebral berry aneurysms
Term
What physiologic parameters describe renal tubular acidosis?
Definition
non-anion gap metabolic acidosis
Term
What is the most common form of renal tubular acidosis?
Definition
type IV
(distal)
Term
What is renal tubular acidosis?
Definition
metabolic acidosis due to failure of the kidneys to properly manage either H+ secretion or HCO3- resorption
Term
What test is used to diagnose ureteral reflux?
Definition
voiding cystourethrogram
Term
What is the cause of central diabetes insipidus?
Definition
failure of pituitary to secrete proper amounts of ADH
Term
How can central diabetes insipidus be tested?
Definition
desmopressin acete challenge
(ADH analog)
Term
What is the most common cancer in men?
Definition
prostatic
(second leading cause of cancer death in men)
Term
What is the recommendation for annual screening for prostate cancer?
Definition
digital rectal exam
Term
What is the most common MALIGNANT tumor of the urinary tract?
Definition
bladder cancer
(most commonly a transitional cell carcinoma)
Term
What is the most common presenting symptom of bladder cancer?
Definition
gross hematuria
Term
Where is McBurney's point located?
Definition
2/3 the ditance from the ASIS to the umbilicus<
Term
What diagnostic modality is the most sensitive for appendicitis?
Definition
contrast CT
Term
What histories are associated with most cases of aortic disruptions?
Definition
rapid deceleration injuries
(as in MVAs)
Term
What is the second leading cause of death in children?
Definition
burns
Term
What two ACLS meds are used in asystole?
Definition
epinephrine
atropine
Term
How is the management of stable atrial fibrillation/flutter different w/in the first 48 hours or after the first 48 hours?
Definition
w/in 48h: cardiovert
outside 48h: anticoagulate first (or perform transesophageal echocardiogram) then cardiovert
Term
Which abdominal organ is the most commonly damanged in blunt trauma?
Definition
spleen
Term
What are the two side effects of primary importance for chloramphenicol?
Definition
gray baby syndrome
aplastic anemia
Term
What are the three primary side effects of importance with vancomycin?
Definition
red man syndrome (histamine release)
nephrotoxicity
ototoxicity
Term
What vitamin deficiency is associated with night blindness and dry skin?
Definition
Vit A
Term
What is Alpart syndrome?
Definition
genetic condition characterized by glomerulonephritis, end stage renal disease, and hearing loss.
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