COMBANK Review 3

jmanderson's version from 2017-06-17 00:30


Question Answer
Ddx for elevated transaminases(4)Viral hep, apap, autoimmune, budd-chiari
Rx- pregnant F with syphilis but h/o rash with PCNBenzathine PCN G (only tx good for baby, desensitize if you have to)
F on clomiphene at higher risk forMult gest preg
Initial tx for upper GI bleedIVF, NG tube, PPI - order endoscopy
Car seat <2y/oBackseat, rear facing
Rai staging for CLLLymphocytosis (0)  Nodes (1) → organs (2) → anemia (3) → low plt (4)
Elderly pt, wk, fatigue, fever, LAD, organomegaly, anemia, low pltCLL
Tx for cerebellar hematoma surgery
Kid with mild bleeding laceration in ED, do sutures, or wait for parentsPut pressure, wait for parents to consent
Dx test for DB gastroparesis Gastric scintigraphy (measure emptying time)
Rx for DB gastroparesisErythromycin or metoclopramide (motility agent)
Baby with poor feeding, abn facial features, jaundiceCong. hypothyroidism (cretinism)
Baby jaundice with neuro s/sxKernicterus
Protein in Down’s that → alzheimer’sAmyloid beta (extra copy)


Question Answer
Kidney stone <4mm % likely to pass80
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
Imaging of choice for aortic dissectionCTA
Tx aortic dissection (ascending, descending)Ascending → surg; descending → ctrl HTN
All women of child bearing age should takefolate
Tx for FB removal inhaled by childRigid bronchoscopy
Goal BP >60 y/o via JNC8150/90
Pt with DEXA scan on Ca that had a fxOsteoporosis (T score <2.5 or h/o fxr)
Knee tenderness, jt effusion, and popping with passive F/EMeniscal injury
Initial mgmt for meniscal injuryRICE + NSAIDs
Image of choice to confirm thoracic aneurysmCT w/ contrast
New onset myoclonus and AMS with histo of convalescent clear vesiclescreutzfeldt-Jakob
Progressive memory loss and change in behavior, bx with intraneuronal aggregates of abn modified proteinalzheimer’s
Shoulder pain exacerbated by arm flexed (resisted extension) with scapula stabilization- test and dxNeer’s test, subacromial bursitis
After DKA, when to start insulin aspart2 hr before insulin drip has stopped (prevent rebound DKA)
ME type of contractionIsometric (no approx of origin/insertion)
Fatigue 8 mo after monoChronic fatigue syndrome
MC site of vaginal injury in sexual assaultPosterior fourchette
Kid with itchy rash on extensors, excoriations, fam h/o autoimmune dzDermatitis herpetiformis (celiac)
Testicular pain, n/v, intense, + prehn's sign [pain relief w/ testicle lift] and intact cremaster- dx and txEpididymitis- ceftriaxone + doxy
dx: testicular pain, n/v, (-) phren’s [lifting does not relieve pain] and absent cremasterTesticular torsion
Cobb angle for bracing20-40 degrees
Cobb angle for surgical eval>45 degrees
Fort fxr of the face typesType 1 (through maxilla); type II (through maxilla/orbits/nasal); type III (through orbits, nasal))
Rx for Graves in pregnancyPTU (methimazole is teratogenic)
Rx for hemodynamically stable pt with sustained V tach or SVTamiodarone
Complex VT with narrow QRS and absent p wavesSVT
1st and 2nd line for SVTVagal maneuvers, cardioversion


Question Answer
dx: circumferetnial restricted areas on limbs of newborn amniotic band syndrome (streeter dysplasia)
ca assoc with radon exposurelung ca
eye finding in child abusevitreous hemorrhage
1st line surg ppx for endocarditis adult (and dose/timing)amoxicillin 2g 30min before surg
ribs 6-10 mm attachmentserratus anterior
golfer elbow is lateral or medial epicondylitismedial
dx: symettric proximal mm wkness in 50-70 y/o Fpolymyositis (anti-Jo1)
polymyositis labs (CK and Abs)inc CK, inc aldolase, + anti Jo 1 AB
tx for proliferative DB retinopathylaser photocoagulation
mcc bacterial pna in nursing home ptsstrep pneumo
mcc bacterial pna in neuro impaired elderlyanaerobic
doc for bacterial pna in neuro impaired elderlyzosyn or cefapime (cover anaerobes and pseudomonas)
1st w/u for 2nd visit high bpecg (check LVH for heart end organ damage), bmp, ua, lipids, cbc
LP in fungal meningitis (cell count/type, P, glucose, protein)10s-100s, lymphocyte, high P, dec gluc, high protein
dx and w/u: young obese F taking OCP and isotretinoin w/ papilledema and recurring haidiopathic elevated ICP; get head CT (before LP)
mc location of ureter injury during TAHcardinal ligament (ureter over uterine a. [water under bridge])
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
mcc death 3d after acute MIarrhythmia
mcc epididymitischlamydia and N gonorrhoeae
dx: triad of RA, splenomegaly, and granulocytopeniafelty's syndrome
dx: RA and pneumoconiosis with intrapulmonary nodulescaplan syndrome


Question Answer
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: young adult male with nephropathy s/sx (gross hematuria) with URI or GI infxnIgA nephropathy
dx: 3-14 y/o kid with oliguria, brown urine s/p GABHS infxpost-strep glomerulonphritis
dx: nephropathy inheritied with hearing loss alport syndrome
dx: sinusitis, lung cavitary lesions, glomerulonephritis wegener's granulomatosis (c-anca, tx with steroids/cyclophosphomide)
organ assoc with alpha-1 antitrypsin (copd in nonsmoker)liver (cirrhosis)
wet wacky wobblynormal P hydrocephalus
w/u for normal P hydrocephalusCT w/o contrast
step therapy asthmaSABA > low dose ICS > med dose ICS > LABA/montelukast > high dose ICS > PO steroids
term: cycles of apnea followed by hyperpneacheyne stokes respirations (ex- CHF)
dx: transient acantholytica dyskeratosis as itchy papular rash over trunk in elderlyGrover dz
dx: peritoneal fluid with serum-ascites albumin >1.1 g/dLportal HTN (mc 2/2 CHF)
proper ETT placement4cm above carina
if intubation hoes past carina, what happensu/l lung collapse (r lung, shift of mediastinum)
doc for ppx of traveler's diarrheafluorquinolones
TIA is mc assoc with what causeA fib
transient angina with diffuse non specific STEsprinzmetal's
drugs CI in prinzmetal'snon specific BBs (propranolol, vasoconstriction)
DOC for prinzmetal'sCCBs, nitrates
complication of alpha-1 antitrypsin (not liver)chf (emphysema --> r hf, cor pulmonale)
image of choice for osteomyelitisMRI
blocked artery in anterior wall MILAD