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jmanderson's version from 2017-06-17 00:34

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Ddx for elevated transaminases(4)Viral hep, apap, autoimmune, budd-chiari
Initial tx for upper GI bleedIVF, NG tube, PPI - order endoscopy
Rai staging for CLLLymphocytosis (0)  Nodes (1) → organs (2) → anemia (3) → low plt (4)
Rx for DB gastroparesisErythromycin or metoclopramide (motility agent)
Ewing sarcoma histology cell typeNeural origin
Dx, tx (1st and 2nd line) for dry white vulva with excoriationLichen sclerosis chronicus- Topical steroids; Calcineurin inhibitors
Rx for UTI in pregnancyfosfomycin
Pt with DEXA scan on Ca that had a fxOsteoporosis (T score <2.5 or h/o fxr)
Image of choice to confirm thoracic aneurysmCT w/ contrast
New onset myoclonus and AMS with histo of convalescent clear vesiclescreutzfeldt-Jakob
Shoulder pain exacerbated by arm flexed (resisted extension) with scapula stabilization- test and dxNeer’s test, subacromial bursitis
Rx for hemodynamically stable pt with sustained V tach or SVTamiodarone
1st and 2nd line for SVTVagal maneuvers, cardioversion
what CS spot is 1" below iliac crest and posterior to TFLglut minimus
tx for CS glut minimusF hip 90 deg, IR leg
anemia type: high ferritin, nL Fe, low transferrinanemia of chronic dz
anemia type: high ferritin, nL TIBC, nL RDWalpha thal
dx: triad of RA, splenomegaly, and granulocytopeniafelty's syndrome
mcc bug of erysipelasGABHS (GPC in chains)
etiology: cushing's in pt with copd and asthmaiatrogenic (2/2 steroid use)
dx: dyspnea, hemoptysis, hematuria, red cell and granular castgoodpasture (anti-GBM abs)
dx: sinusitis, lung cavitary lesions, glomerulonephritis wegener's granulomatosis (c-anca, tx with steroids/cyclophosphomide)
w/u for normal P hydrocephalusCT w/o contrast
term: cycles of apnea followed by hyperpneacheyne stokes respirations (ex- CHF)
dx: transient acantholytica dyskeratosis as itchy papular rash over trunk in elderlyGrover dz
doc for ppx of traveler's diarrheafluorquinolones
drugs CI in prinzmetal'snon specific BBs (propranolol, vasoconstriction)
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Herbal that may cause yellow skinCamelia sinensis (black/green tea)
Dx test for GBSAlbuminocytologic dissociation
Organism- F with dysuria, recurrent UTI, positive Lloyd’s, u/a with RBCs and WBCs and alkali pHProteus (staghorn calculi)
How much proteinuria for mild and severe preeclampsiaMild- >300 mg/d; Severe- >5g/d
Acute abd distension, dilation of colon, electrolyte abn, no acute s/sxColonic pseudo-obstruction (ogilvie’s syndrome)
Pt with severe hypoK mgmtAdminister KCl, admit with cardiac monitor
Young F with b/l conductive hearing loss (BC > AC with Rinne) and +fam hx (AD)Otosclerosis (loss of stapedial reflex)
Pain out of proportion to exam (3 d/o)Mesenteric ischemia, necrotizing fasciitis, compartment syndrome
Rx for premenopausal women w/ bleeding (2/2 hyperplasia of endometrium)Cyclic progestins
Multiple myeloma pt w/ s/sx of chf- dx/echoRestrictive CMP (dec. SV on echo)
most likely dx: New onset severe ha with fever, LP pendingViral meningitis
Rx for stable angina sx control that reduces CV eventsBBs (metoprolol)
CST axis for sphenoid/occiput in lateral strain2 vertical axes
Dx, eval- pt with knee pain, wam fluid lesion in popliteal lesionBaker’s cyst, U/S
Alpha 1 antitrypsin def. complication and txcirrhosis/encephalopathy, lactulose
Test to confirm acute cholangitis dxERCP
CHF s/sx in alcoholic ptDilated CMP (weak systole) 2/2 thiamine def.
MC cardiomyopathy and MCCDilated CMP (systolic dysfxn), myocarditis mcc
Wilson’s labs (ceruloplasmin, urinary Cu, plasma Cu)Low ceruloplasmin, increased urinary Cu, decreased plasma Cu
Acute and chronic tx of MSSteroids acute, IFN-beta chronic
Impaired pt drives home, doc lets him, he gets hurtBreach of duty (negligence causing direct harm)
Tx of choice for non ruptured ectopic pregLaparoscopic surgery
Med $ org for pts aged, blind, disabled, low incomemedicaid
Empiric abx for bacterial meningitis neonatesampicillin, cefotaxime
Empiric abx for bacterial meningitis -adultsceftriaxone, vancomycin
Rx in acute NSTEMI to reduce morbidity/mortalityASA
Mgmt of De Quervain's if conservative NSAIDs and splint failCorticosteroid injection
Oral retinoid s/e’sSuicidal ideations, teratogen, high TG/chol/AST/ALT
Dx- elderly pt, fatigue, night sweats, diffuse painless LAD, splenomegaly, high WBCCLL
Dx- recent travel, flu sx, rose spots on abd, splenomegaly, bloody diarrheaSalmonella typhi (typhoid fever)
Cast type, position, and time for achilles tendon ruptureLong leg cast, plantarflexion, 6 wks
Mgmt of suspected SBO 2/2 adhesionsSupine and upright abd radiographs, NG suction, IVF
Tricuspid atresia assoc with what teratogenlithium
Rifampin moaBacterial dependent DNA-dep RNA polymerase inhibitor
Curative tx for PNHAllogeneic bone marrow transplant
QoL tx for PNHPrednisone, eculizumab
Tx for aortic regurgHydralazine, catopril (decrease afterload)
Thoracic CS anterior txflex, STRA
Widespread fluid blisters in kid with feverStaph scalded skin syndrome
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renal lab of waterhouse friderichsenElevated renin
Viscerosomatics for adrenalsT10-12
Ppx for MAC in HIVazithromycin
Child with abd pain, hematochezia, HSP, s/p URIIntussusception
Sudden dyspnea and mill wheel murmur s/p central lineVenous air embolism (O2, lateral decubitus)
SBO 2/2 gallstones dx/txGallstone ileus, surgical consult
NYHA CHF class- unable to carry on activity w/o discomfortIV
Tx for Wilson’sChelators (penicillamine), low Cu diet (shellfish, chocolate, nuts, mushrooms, liver), vit B6 and Zn suppl
MDD s/sx in elderly (unique)Somatic complaints and dec activity
Mgmt- 17 y/o F w/ amenorrhea, nL mullerian structures, elevated FSHKaryotype (to r/o Turner syndr, etc.)
CP at rest w/ nL troponinUnstable angina
CP w/ feeling of impending doomMI
Type of RTA in multiple myelomaType II (proximal, hypoK)
Dx- asian pt, sudden collapse/death, STE V1-3 w/ RBBB and terminal S wave on lateral leadBrugada syndrome
Dural attachmentsForamen magnum, C2, C3, S2
Succinylcholine moaDepolarizing nmsk blocker w/ cellular K efflux
Succinylcholine electrolyte s/ehyperK
Kidney injury 2/2 trauma- dx and urine microATN, granular “muddy brown” casts
GFR to d/c metformin d/t renal clearance<30 mL/min
1st line mgmt + sleep study for osacpap
1st line tx for infant GERDFormula thickening, rice cereal
2nd and 3rd line tx for infant gerdAntacids, then H2RAs or PPIs
Why the electrolyte d/o in addison’sLow mineralocorticoids, low aldosterone, Na wasting, K reabsorption
Dx- fever, RUQ pain, jaundice, high AST/ALTAscending cholangitis
Imaging finding of ascending cholangitisDilated common bile duct (2/2 stone block)
Progressive LE dysfxn and low DTRLambert eoton
Dx- child with painless limp, dec internal rotation and adduction of hip, adhd, xr w/ misshapen growth plate and flat femoral headLegg calve perthes dz
Disease modifying Rx for dementiaMemantine (NMDA antagonist)
Rx for neutropenic fever in chemo ptsPseudomonal abx (ceftazadime, zosyn, meropenem, imipenem, cefepime)
Rx for persistent neutropenic fever Anti-fungal (amphotericin B)
Rx for candida esophagitisPO fluconazole
Body surface area rule for burns (rule of 9’s)Adults (9% head and each arm, 18% front, back, and legs); kids (9% each arm, 14% each leg, 18% head, front, and back)
Testicular ca assoc. with peutz Jeghers (intestinal polyposis) and Carney’s synd (mucosal melanin spots)Sertoli cell tumors (stimulated by FSH for spermatogenesis)
Ppx for migrainesBBs (also TCAs, divalproex, topiramate)
Ag present in Hep B with high viral loadHBsAg
Serology in window period of Hep Banti-HBc (IgM) only
Triple therapy for h pyloriPpi + 2 abx (pcn + macrolide), metronidazole if pcn allergy
Unstable WPW pt with irregularly irregular rhythm, dx/txA fib, cardioversion
Tx afib in stable WPW ptIV procainamide
Bleeding d/o with factor XI def.Hemophilia C
Rx and route to tx C diffPO metronidazole
DOC essential tremor (at rest and intention)Propranolol (BB)
DOC for RLS nightly tremorPramipexole (DA agonist)
DOC for dyskinesia of huntington’s Tetrabenazine (VMAT inhb, dec DA, 5HT, NE)
Sudden dyspnea in tall, thin, smoker malesSpontaneous ptx
Next step with solitary lung nodule on cxrCompare to previous cxr
Epi dose for anaphylaxis, IM v. IVIM 1-1,000, IV 1-10,000
Term- homeless man deserves same care as those who payStandard of care
Complex regional pain synd type 1 stage- limb swollen/red/burn, diaph., sx near site (wks)1 (acute)
Tx for leg-calve paresthesis d/oBrace w/ partial wt bearing (surgery if fails)
Confirm dx of lead poisoningSerum free erythrocyte protoporphyrin
Avoid what rx in WPWDigoxin, BBs, CCBs (d/t AV node blockage → SVT)
Test of raising leg in uninvolved extremityWell SLR
GBS w/u includes what for mcc mortalityPFTs (to r/o resp muscle weakness)
Imaging of choice for Budd ChiariDoppler u/s
Mcc budd chiariHypercoagulability
Rx for budd chiariwarfarin
HCM dx on echoLarge interventricular septum (LVH, large atri)
Abx empiric for neutropenic fever (2/2 chemo)Ceftazidime and vancomycin
Image for pt with active CP and no ischemic changes on ecgMyocardial perfusion imaging
MC type and mgmt for dx Hodgkin'sNodular sclerosing, excisional LN bx
Meconium asp is mc assoc. withPersistent pulmonary HTN
Infant days old with cardiogenic shock, s/sx of CHF, weak LE pulses- dx and txCoarctation of the aorta (s/p DA closure), tx with PGE1 (keep PDA open)
Septic arthritis in IVDU initial abx Ceftriaxone (gonococcal) and vanc (MRSA)
Ambiguous genitalia, no uterus/ovaries, masses in inguinal canal, nL electrolytes5 alpha reductase def. (XY, elevated T, low DHT)
Image of choice for SAHNon contrast CT
s/d mc assoc with migrainesSBS strain pattern cervical or upper T s/d
BPP measurement (out of 10)2 pts each- Fetal mvmt, tone, breathing mvmt, AFI (2x2 cm), NST
Severe abd pain with benign PEMesenteric ischemia (a fib is RF)
What murmur- RHD, loud S1, opening snap, diastolic rumble at apexMitral stenosis
Dx- osteochondrosis at Achilles insertion in kidsSever’s dz
Tx for post menopausal hot flashes if h/o breast caSSRIs (E is contraindicated)
Recent diuretic rx, now unstable v/s, what ABG values?Metabolic alkalosis (increase HCO3)
Dx, complication, tx- pt with AMS, n/v taking Ca carbonate with PR prolonged and short QTMilk alkali syndrome (2/2 too much Ca carbonate), ARF is a complication, tx with IVF and furosemide (to excrete Ca)
IJ relative to common carotid artery and CNXIJV is lateral to common carotid and anterior to vagus
Central lines should end up in the...SVC
Addison’s labs (renin and aldosterone)High renin, low aldosterone
Addison’s electrolytes (Na, K, Ca, cortisol)hypoNa, hyperK, hyperCa, low cortisol
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Question Answer
DOC for impetigoDicloxacillin (beta-lactamase resistant abx)
Dx- dec pain/temp sense in arms/hands, intact vibration/proprioception, dec DTR/strength UE, inc UMN in LESyringomyelia (spinothalamic cross at ventral white commissure)
Delta P definition and level for fasciotomyDBP - compartment P; <30 → fasciotomy
Infarction of 2nd metatarsal headFreiberg dz
Rx cyanide poisoningAmyl nitrite and thiosulfate
Electrolyte d/o - confusion, lethargy, ha, sz, diffuse STEhypoNa
Metabolic d/o - mental obtundation, low DTR, coma, blurred vision, dehydrationhyperglycemia
Electrolyte d/o - tetany, hyper DTR, dysrhythmias, STD, u waves, QRS wideninghypoMg
IVDU with CP, nausea, bitter taste in mouth, CP 2nd ICS leftesophagitis
Pt with SLE has anemia, what lab values?Low Hb, how MCV, high ferritin, low TIBC and Fe (AKA anemia of chronic dz)
Labs in Fe def. vs. anemia of chr dzFe def. (TIBC high, ferritin/Fe low), anemia of chr dz (ferritin high, TIBC/Fe low)
Artery involved w/ occulomotor n paralysis?Posterior communicating
Artery involved w/ wallenberg syndrome (dec pain/temp of same side face, opposite side body)?PICA
Old pt, fever, sore throat, hoarsness, tripodding, worse with layingEpiglottitis (H flu MC)
Glucosuria in pregnancynL
MC eye injury s/p surgeryCorneal laceration
Rx for sjogren syndromePilocarpine (muscarinic agonist)
Dandy walker vs arnold chiariDandy walker (enlargement of 4th ventricle, large posterior fossa); Arnold chiari (tonsiller herniation)
Hand Foot mouth mc virusCoxcackie A
Change in TSH with glucocorticoids Decrease
Protein that acts in thyroid + I- to make T3/4Thyroglobulin
DOC for cutaneous larval migransThiabendazole (2nd line - albendazole, ivermectin)
Tx for H ducreyi penile lesionSingle dose azithromycin, 3x dose ceftriaxone 7d, or cipro bid 3d
DOC post-herpetic neuralgiaTCA (nortriptyline)
Tx crytpococcol meningitisAmphotericin B and flucytosine
RF for PPROM (<37 wk), including MCOligohydramnios (MC), infxn, bleeding, smoking
Infraspinatous actionExternal rotation
Teres minor actionExternal rotation
Empty can test for whatSupraspinatous RC tear
Pt with wk/fatigue, sore tongue, paresthesias, wt loss, constipation, anorexia, abd fullness, loss of proprioception (+ rhomberg), dx?Pernicious anemia (IF d/o of parietal cells, dec B12 absorption)
Pt w/ diarrhea, urinary frequency, muscle cramps, low BP, lethargy, tremor, poor turgorhypoMg
Tumor marker for seminomabhcg
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