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COMBANK Review 6

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jmanderson's version from 2017-06-17 16:03

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Question Answer
mc OCD compulsionwashing
dx: jaundice, wt loss, abd pain, enlarged nontender GB (courvoisier's)pancreatic head ca
ppx for uric acid kindey stones in gout ptcitrate (alkalnize urine)
ppx for ca phosphate stonestzd diuretics (lower Ca)
most significant RF for psoriasisfam hx
salter harris type: no xr fxr with swelling over physistype 1
ekg leads to eval axis deviationI and aVF
direction of ekg I and aVF for LADI up , aVF down
leads to eval LVHV1 and V5
if S wave V1 + R wave of V5 is > ? = LVH35 mm
QRS in V1 + or - in LVHnegative
rx for acute fluid overload from LVHfurosemide
biphasic p wave representsatrial hyperterophy
R vs L atrial hypertrophyR 1st p wave is big, L 2nd p wave is big
parkland's formula4 x wt x BSA burned = mL (1/2 over 8 hr, 1/2 over 16-24 hr)
moniter what with fluid admin in burn pturine output
OD: anti-htn rx causing brady, HoBG, s/sx pulm edemaBB
tx for BB ODatropine
1st step mgmt 3rd degree burngsairway (intubate)
ovarian ca assoc with virilizationsertoli-leydig cell tumor
ovarian ca with high E (thick endo, vag bleed, early puberty)granulosa cell tumor (inhibin)
1st line rx for allergic rhinitisintranasal steroids
pt with MI now in shock, what CO, PVR, and PCWP?low CO, high PVR, high PCWP (cardiogenic shock)
can docs attend big pharma dinnersyes
can docs accept big pharma gifts (medical or not)no
best long term tx for uterine prolapsekegel exercises
dx: eye swelling, redness, pain with EOMorbital cellulitis
dx: eyelid swelling, redness, pian not assoc with EOMperiorbital cellulitis
least radiosensitive tissue in bodybone
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Question Answer
dx: few days s/p MI, recurrent CP, chf, cardiogenic shock, harsh systolic murmur to axilla, L->R shungventricular septal rupture (rare)
alk phosph, pth, and Po4 in ricketshigh alk phosph, high PTH, low PO4
best time to check cortisol in adrenal w/u6-8 am
nephrotic synd pts inc risk for what infxn, e.g. what ppxencapsulate (strep pneumo) get PPV23
pap with atypical granular cells in >35 y/o mgmtget colpo and endometrial bx
mgmt of CIN 2 and 3 cervical caexcision or ablation (LEEP)
medial epicondylitis CS txelbow F, wrist pronated, arm adducted
nephritis bx with subendothelial deposits and marked capillary wall thickeninglupus nephritis
nephritis bx with linear basement membrane staingoodpasture (anti-GBM abs)
nephritis bx with mesangial deposition EM and asx hematuriaIgA nephropathy
nephritis bx EM with bumpy deposits of IgG and C3post-infectious
nephrotic bx EM with spike and dome basement membrane thickening membranous glomerulonephritis
nephrotic bx with basement membrane thickening with double layer train track on EMmembranoproliferative
dx: pt with h/o SIADH in hosp with AMS and horizontal gaze palsy with nL Nacentral pontine myelinolysis
how to prevent central pontine myelinolysisslowly correct hypoNa with NS at <0.5 mEq/L/hr
best initial tx for HTN emergencyIV nitroprusside
bishop score for vag delivery, against vag delivery>8 is favorable, <6 is not
bishop score 0-3 dilation0, 1-2cm, 3-4 cm, 5-6 cm
bishop score 0-3 effacement0-30, 40-50, 60-70, >70
bishop score 0-3 station-3, -2, -1 or 0, +1 or +2
bishop score 0-2 cx consistencyfirm, medium, soft
bishop score 0-2 cx positionposterior, middle, anterior
mmHg of nL circulation after CPR35-40 mmHg
noninvasive test for lactose intoleranceH+ breath test
abx for staph infective endocardititsIV vanc
abx for elderly bacterial meningitisampicillin, ceftriaxone, vancomycin (H flue, Listeria, Strep)
high PP BGs in pt on glargine and lispro, change what?increase lispro for meals
mc environmental RF for pancreatic casmoking
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Question Answer
mc ruptured berry aneurysm sitejxn of ACA and anterior communicating
dx: hip and back pain with stiffness and fusion of SI jtankylosing spondylitis
bony growths in ligaments of ankylosing spondylitissyndesmophytes
rib s/d names for side the move worse or better inbetter
1st line for hyper T4 in pregPTU (methimazole c/i until 2nd semester)
1st line agent for cardiogenic shockdobutamine or dopamine
mcc secondary htnrenal a stenosis
dx: liver d/o s/sx with + anti-smooth muscle antibodiesautoimmune hepatitis
dx and tx: asthmatic pt with worsening SOB after starting ASA recentlyASA-related resp dz, rx leukotriene agonist (montelukast, zileuton, azfirlukast)
rx: pregnant F with migrainesapap (-triptans cat C)
dx: kid w/o vacc, diffuse rash from head to trunk, 3 C's (cough, coryza, conjunctivitis)rubeola (measles)
dx: kid w/o vacc, blueberry rash, low grade fever, swollen glands, jt pain, ha, posterior cervical LADrubella (german measles)
dx: acute abd pain, n/v, painful eye, fixed mid dilated pupil, non reactive to lightacute angle closure glaucoma
animals unlikely to have rabiessmall rodents (squirrels, hamsters, guinea pigs, mice)
rabies post-exposure ppxvacc and IVIG after cleaning
good choice of abx for pseudomonasfluroquinolones (ciprofloxacin)
other anti-pseudomonalsaminoglycosides, gorillacillins (carbenicillin, ticarcillin, piperacillin)
male with infertility, gynecomastia, small testes, female hair distribution, tall, long UE and LEklinefelter synd
labs of klinefelter (E, T, FSH, LH)hypergonadotropic hypogonadism (high E:T ratio, high FSH/LH)
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Question Answer
posterior fibular head means what for foot in s/dsupination (plantarflexed, invert, adducted)
posterior fibular head ME txpronate foot (dorsiflex, evert, abduct)
3 mc sprained ligaments in ankleATFL, calcaneofibular, posterior talofibular
FADIR test is forhip impingment
asthma type: 3-4x awake per mo, SABA >2x/wk, nl spirometery btw exacerbationsmild persistent
asthma type: >1x awake per wk, SABA daily, FEV1 60-80%moderate persistent asthma
asthma step therapySABA -> low dose ICS -> LABA -> mod dose ICS -> high dose ICS -> PO steroids
ekg with narrow complex regular tachy w/o p wavesSVT
angiodysplasia of colon a/w what cardiac abnaortic stenosis (Heyd'es synd)
1st step mgmt in DKA with K<4IV NS (isotonic) + KCL
image if high suspicion for PEpulmonary angiography
persistent post-dural puncture ha after epidural txepidural blood patch
OGT level for DM dx>200
suspect fibroadenoma of breast, what nextcore needle bx
mastoid process echymosis is called ? and a/w what fxr?battle's sign, basilar skull fxr
term for wanting to rub genitals on strangersfrotteurism
term for wanting to flash pplexhibitionism
term for spying on naked pplvoyeurism
nerve exits above what vertebratecorresponding vertebrate
L4 dysfxn btw what 2 vertebraebtw L3-4
dx: pain btw 2nd-3rd metatarsal from wearing narrow shoesmorton neuroma
lab test for mycoplasma pneumocold agglutinins (anti-RBC abs)
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Question Answer
tx thrombosed hemorrhoidsexcision
pt w/ asx reducible inguinal hernia, 1st stepcounsel wt loss, diet, exercise, and f/u
2 tests for HIV in right orderELISA (screen) -> western blot (spec.)
current tx of choice for HCVledipasvir and sofosbuvir
tx scoliosis cobb 20-40 degbrace
dx: infant with fever +/- sz for 5d followed by 1 day rash that starts on trunk and spreadsroseola (HHV-6)
dx and tx: recurrent oral and genital ulcers, relapsing uveitis, neuro s/sxBehcet dz, prednisone
bp goal in gen pop, dbm and ckd<140/90
bp goal in elderly<150/90
rx for burkitt lymphomarituximab (CD20 ab, rids B cells)
pre-renal AKI (perfusion d/o) labsBUN/Cr >20, hyaline casts on u/a
doc for dental ppx in endocarditis ptsamoxicillin
dx: weight<85% IBW, amenorrhea, fear of wt gain, induced vomitinganorexia nervosa purging type
tx of PE in aneurysmal pt (Heparin is c/i)embolectomy
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