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COMBANK Review 5

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jmanderson's version from 2017-06-17 01:41

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Question Answer
dx: F of childbearing age, acute abd pain, vag bleeding, amenorrheaectopic pregnancy
mc RF for ectopic pregnancyPID
dx: F of childbearing age, acute abd pain, RLQ, mass, no s/sx infxnectopic pregnancy
lab for ectopic pregbhcg
metabolic synd criteriawaist>40" (M) >35" (F), TG>150, HDL<40 (M) <50 (F), htn >130/85, FBG>100
1st step as code leader walking in on cprhave RN check pulse
2nd step as code leader walking in on cprcall 911 (not more CPR, don't delay)
1st step as code leader on vfib ptdefibrillator
Abs for Sjogrenanti-Ro/SSA or anti-La
dx test for Legionellaurine Ag
primary amennorhea with high FSH, what nextkaryotype (gonadal agenesis, turner synd)
dx: ICU pt with hypoxemia, bilat infiltrates on cxr, event w/in 1 wk, pulmonary edemaARDs
mgmt: TIA with 80% occluded L carotid and 100% occluded Rsurgery on L (only for 70-99% stenosis)
test for pleural effusionsthoracentesis (transudate vs exudate)
rx in unilat renal a stenosisACEI (c/i in bilat renal a stenosis)
dx and imaging: F with neuro s/sx, sz, LP with blood and protein, NMDAR absNMDAR encephalitis (from teratoma), pelvic CT
mcc large bowel obstructionneoplasm
mcc small bowel obstructionadhesions
abx for C perfinigensclindamycin
dx: smoker with dyspnea, facial and UE edema, cough, JVD, blurred visionSVC syndrome
mcc SVC syndromebronchogenic ca
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Question Answer
bleomycin s/epulm fibrosis
cisplatin and carboplatin s/eacoustic nerve damage and nephrotoxicity
cyclophosphamide s/ehemorrhagic cystitis
doxorbucin s/ecardiotoxicity
MTX, 5 FU and 6 MP s/emyelosuppression
MTX s/efolate def, hepatotox, myelosuppression
vincristine s/eperipheral neuropathy
CVA artery: aphasia, neglect, hemiparesis, homonymous hemianopsiaMCA
CVA artery: leg paresis, hemiplegia, urinary incontinenceACA
CVA artery: homonymous hemianopsiaPCA
CVA artery: coma, CN palsies, apnea, drop attack, vertigobasilar artery
CVA artery: DB/HTN, silent, pure motor or sensory, dysarthria-clumsy hand syndrome, ataxic hemiparesislacunar stroke
vitamin def: cardiac dysfxn, ataxiaB1 (thiamine) wet beriberi
vit def: symemetrical peripheral neuropathyB1 (thiamine) dry beriberi
vit def: etoh, ataxia, horizontal nystagmusB1 (thiamine) wernicke encepholopathy
vit def: 2 C's cheilosis (fissure at lip), corneal vascularization, magenta tongueB2 (riboflavin)
vit def: 3 D's pellagra (diarrhea, dermatitis, dementia)B3 (niacin)
vit def: caused by INH, carcinoid synd, hartnup dzB3 (niacin)
vit def: sideroblastic anemia, stomatitis, glossitis, depression, peripheral neuropathyB6 (pyridoxine)
vit def: assoc with INH rx for TBB6 (pyridoxine)
dx: inability to fully extend finger, swelling at DIP, after sportsmallet finger
databank for checking out docs professionalismntl practictioner data bank
filtration fraction eq.GFR/RPF
NSAID effect on FFno change (decreases GFR and RPF equally)
ACEI effect on FFdecrease (block AngII, less efferent constriction, inc RPF)
HHS labs: ketone, b-HB, pH, plasm osmnL ketone, nL b-HB, pH>7.3, inc osm
tx: unstable hear tamponade from chest stabemergent peicardiocentesis
tx: schuermann dz in adultPT and OMM
mc DVT vein to become PEproximal deep veins (common femoral)
h1c goal for DB<7%
psoas CS location and txmedial to ASIS, hip F and ER
hep C txribavirin and weekly IFN alpha
image of choice: epidural abscess (ex- after endocarditis surg)MRI
bug causing neonatal conjunctivitischlamydia
abx for chlamydiadoxycycin
abx for gonorrheaceftriaxone
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Question Answer
latent and active stage 1 laborlatent 0-4 cm, active 5-10 cm
nL rate of dilation in nulliparous and mutliparous stage 11.2cm/hr nul, 1.5cm/hr mult
dx: child with fever and vesicles in tonsillar region, soft palate, post pharynxherpangina (coxackie A)
dx: sepsis or trauma pt with bleeding from puncture sites and purple rashesDIC
labs for DIC (PT, PTT, LDH, fibrinogen, Hb, PLTs)high PT, PTT, and LDH; low fibrinogen, Hb, PLTs
1st line rx for CAHglucocorticoids
what part of sacrum does dura attach to?posterior superior S2
dx: child with aggressive behavior and deliberate disregard for othersconduct d/o
ov cyst on u/s, mgmtf/u u/s in 4-8 wk (often regress)
image and mgmt: old pt s/p hip replacement felt pop, hip pain, short IR LEXray, surg consult
posterior hip dislocation, can't extend toe: what nerve?sciatic n
dx: u/l white eye gunk with pain for 1 dbacterial conjuctivitis
SVT mgmt in stable ptvagal maneuvers, adenosine
SNS of L or R heart assoc with SVTL heart
does doc have to take new pt or referral for new ptno
type of vent: preset TV when pt starts breath, preset TV + backup rate if no spont breathassist-ctrl vent
type of vent: allow pt to breath spont and tries to coordinate with mech breathssynch intermittent mandatory vent
type of vent: pt makes no resp effort, all mechcontrolled mech vent
type of vent: pt can initiate breaths, but no preset TVintermittent mandatory vent
unstable SVT mgmtcardioversion w/o sedation
most appropriate image for PECT angio or V/Q
gold standard image for PECT pulm angio
asthma step 2 therapy, alt for low dose ICSluekotriene antagonist (montelukast)
order of labs for ZESgastrin -> secretin stimulation -> somatostatin receptor scintigraphy
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Question Answer
fungal lung infxn: oval yeast cells, cave exploring, ohio river valley, bird/bat poophistoplasma
fungal lung infxn: mild pna, southwest us, spherules with endosporescoccidioides
fungal lung infxn: mississippi river valley, soil, round broad-based budding yeastblastomycosis
fungal lung infxn: latin america, captain's wheel, budding yeastparacoccidioidomycosis
what transporter absorbs irondivalent metal transport 1 (DMT-1)
rx for symptomatic paget's of the breastbisphosphonate
SLE severity and acute exac assoc with what labsdrop in compliment
dx: tunnel vision, pale optic discs, pain with eye mvmtoptic neuritis
mgmt: optic neuritisadmit and start IV steroids (also MRI to w/u MS)
myasthenia gravis w/uAChR-ab, MuSK ab, RNS, single fiber EMG, CT neck (thymoma)
most sensitive/specific test for myasthenia gravissingle fiber EMG
+ neer's and hawkins shoulderimpingment (subacromial bursitis)
tx subacromial bursitis after RICE + NSAIDssubacromial steroid injection
dx: inherted dz, AR, painless hepatosplenomegaly, pancytopenia, diffuse pulm dzGaucher
enzyme def in Gaucher dzglucocerbrosidase
tx for obesity hypoventilation synd with hypoxemianoninvasive positive pressure vent
test for exercise induced bronchoconstrictionbronchial provocation test
breast d/o and tx: smooth firm mass with shiny veiny skin and u/s hypoechoic, mobilephyllodes tumor, local excisioin
male with XXYklinifelter
complication affecting romance with klinifelterazospermia (infertile)
mc cardiac d/o with Turner syndbicuspid aortic valve (aortic stenosis)
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Question Answer
restriction in R sidebending meansSB left
how old?: rides tricycle, copies circle, 9 cubes, 3/4 speech intelligible3 y/o
how old?: walks, throws objects, drinks from cup, 2 words, separation anxiety1 y/o
how old?: climbs stairs w/ help, stacks cubes, 2 word phrase, 1/2 speech intelligible, 2 step commands, parallel play2 y/o
how old?: hops, copies square or cross, almost all speech intelligible, cooperative play4 y/o
how old?: rides bicycle, copies triangle, reads6 y/o
vaccine(s) at 3 y//oflu
dx and PTT level: fatigue, palpitations, menorrhea, bleeding gums, abn ristocetinvWD, prolonged PTT
tendons involved in DeQuervain'sabductor pollicus longus and extensor pollicus brevis
dx: baby crying, bilious vomiting, knees to chest, sausage like massintussusception
dx and gene: F pt 1-4 y/o formerly nL cognition, declining oral and motor skills, hand wringingRett Synd (MeCP2 gene)
Rett synd geneMeCP2
gentamicin (aminoglycoside) s/eototoxicity and nephrotoxicity (check Bun/Cr)
L renal vein sizelonger than R (easier to transplant)
tx of hematuria in sickle cell traitobservation
most specific test for multiple myelomabone marrow bx
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