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Comlex bits 2 7-24

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ruhland1's version from 2016-07-24 18:22

Section

Question Answer
Varicocelepainless bag of worms “rope like”, have srx or emboliztion
Smoking pregnantup spont abort, up intrauterine growth retardartion, low birth weight prematurity, SIDS
Acute cholecystitisget u/s, shows stones thickened GB wall, pericholecystic fluid, get HIDA if u/s is equivocal
Spina bifidanot taking folic acid 400mg during 1st trim, take 4g a day if issues before
Pb poisonanemia, abd colic, enceph, burtons lines (gingival lead lines) wrist drop
Pb antidote adultdimercaprol and EDTA
Pb antidote kidsuccimer
Hg poisonperiphreal neuropathy, tachy , sweat, loss hair teeth nails
Hg txdimercaprol
memorize

Section 2

Question Answer
Pneum 0-6 wksGBS and E Coli, give ampilcillin with AZT/Eryth or 3rd gen ceph
Pneumo 6wk-18yrRSV (lt 1yo), Parainflu (2-5yr), mycoplasma, chlymadia, strep
Pneum HIVP.Carinni but S.Pneu is MCC
Ecoli Pneumcefrtaxime and ampicillin
Caput Succedaneumalien head of neonate due to prolonged labor
Cephalohaematomaodd bump of head
Dermatofibromapink like nodule
Osteochondromaon bones very obvious on XR
Zidovudinedown HIV vertical transmission
HIV viral load hi copiesgt 1000/uL
Best drug to reduce reinfarct rate of MIB B
Delirium non med txT-A-DA method, tolerate, anticipate dont agittae, avoid restraints unless severe, use haloperidol
PNSOA to C2 and S2-S4
Anaphylaxis1 1000 IM Epi every 30 min, if profound shock give 1 10000 IV, then add bronchodil and IV cortico
Cystic fibrosisCFTR on chr 7, pancreatic exocrine insuff, sweat cholirde test is dx,, tx is physical ther apy broncho dil cortio DNA-ase, panc enzymes and FAT soluble vitamins
Steven johnson and TEN+ nikolsky, epid and dermis deattach
TEN mxadmit to burn unit, maybe IVIG, corticosteriods NO
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Section 3

Question Answer
Mesenteric Ischsudden severe, abd px out of proportion to physical exam, NVD mild GI bleed
Mesenteric Isch dxAXR then CT scan with Contrast, mesenteric angiography is gold standard
Carbon MonoxidaO2 sat is usually NORMAL, tx is O2, hyperbaric O2 in severe, order an ABG and serum carboxyhemoglobin, up anion gap metabikic acid due to build up lactic
Combined OCP moasupresses midcycle estrogen and LH surge * inhib ovulation, progesterone thickens cervical mucus, supressing LH hormone release
Pyloric stenosis dxpxex and hx then U/S
Pyloris sten mxsrx is needded
Brenner tumorof the ovary, often benign
Uterine myomataaka uterine fibroids, tx is GNRH ag, myomet if preserve fet, hysterect if completed childbearing
Adenomyosisprogressively heavier blood loss, heterogenous echos in myometrium
Gential herpes dxviral culture
Rapid plasma reaginfor syphillis
Acyclovirused to prevent recurrence
Scoliget brace at 20 degres, get srx at gt 40 o when still growin
Adams testfoward bend test to check for scoli
Campylobacter jejunipoultry, shiga like toxin, up Guillan Barre Syndo
Giardiacamping fatty foul smelling rrhea, dx is trophozites or cysts in stool, tx is Flaagyl
GET GAPat the Metro Giardia, Entamoeba, Tricho, Gard, Anerobes (Actinomyces Israell, Bacteroides, Clostrium), H Pylori
Epidural hematomadoes not cross SUTURE LINES
Cephalohematomadoes not CROSS suture lines, up in forceps use
Onion skin and sunburstewings sarcoma t 11 22
Codmans triangle and B symptomsosteosarcoma
memorize

Section 4

Question Answer
Clornochis sinesisliver parasite, up cholangitis, common bile duct pathos
Raw shellfishhepatits A
SchistomiasisHS meg, bladder cx, F diahrrea, liver fibrosis eggs in urine feces dx, tx is Praziquantel
Sarcoidpersitant dry cough and SOB
Follicular phaseday 1 to 14, endometrial proliferation d/t estrogen then FSH supp,
Luteal phaseday 14 to 28 corpus luteum sec progesterone, endometrial maturation
Rifampinppx if someonw has meningococcal meningitis in family
RA eye complicMC is dry eye tx is cycloporine. Also scleritis, glaucoma, cataracts, if you take prednisone you need to worry about glaucoma
Glaucomagradual loss of perpihreal vision
Macular degenage related complaint of central vision loss
RA txinfliximab anti TNF A and entanercept anti TNF receptor AB
RA S Meg and leukopeniafelty syndrome
Stranger anxiety6-12 mo
Night terror3 -12 yo, peaks at 3.5
Whole milkstart at 1 yo
Mittelschmerzmid cycle px that is sharp and contant and resolves spont, do to ovarian wall rupture of folliculartion
Griefsx of one year, aka bereavement
Acute stress reactionif lt a month, if gt * = PTSD, must arise from traumatic episode
Adustment disordersx after 3 month
Pathological griefaka prolonged grief, lasts gt 1 year
OCD txgive clomimpramine
Tau proteinneurofib tangles of AL Dz
Amyloid precursor proteinplaques of alzehimers
Why downsyndrome up Alz Dzamyloid precursor protein is on Chr 21
Sphinx testof become worse it is backwards torsion, better is forward torsion
L on L or R on Rforward sacral torsion (better with sphinx)
L on R or R on Lbackward sacral torsion (worse with sphinx)
CN III palsy2/2 posterior communicanting artery if vasculopath
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Section 5

Question Answer
Occult bactermia 3 to 36 mo, High Fever with no sxS Pneu gt HiB and gt HiB
Occult bacteremia Children lt 3 mo, Hi F w/o other sxGBS and E Coli
Diflunisalanalog of aspirin
Propoxyphenethis narcotic in combo with acetaminophen make up Darvocet
Fibromyalgia txAerobic exercise then Amyltriptiline
Ottiis mediaup frequency with somoking, down mobility of tympanic membrane
Best way to ddx acute otitis media with ottitis media with effusionmobility of TMem, bulging is AOM
Tredelenburg gaitweak gluteus medius, Positive right leg means with standing on right leg left hip drops
Parkinsonsup orthostatic hypotn
Vertebrobasilar insuffup vertigo, diplop, perioral numb
Ginko bilobaup orthostatic hypo
Bloody lactationthink breat cx
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Section 6

Question Answer
35 yo F and smoke and OCPup thrombophelbitis
Ranulabluish cystic mass beneath tongue seen in newborns, a mucocele in the sublingual duct, ddx eruption cyst due to eruption of 1o teeth, at spot of erupting tooth
Salivary tumorpleomorphic adeomna, mc in parotid
Lower resp tractstarts below vocal cords
0 to 2 yr oldplace in rear facing car seat
Arrhenoblastomaof ovary, up testost release, up hair, deep voice, up acne
Adrenal adenomaup conns syndrome primary hyperaldosteroneism
Volarpalm of hand or sole of foot
A stensystolic cresendo decresndo, rads to both carotids, up in bicuspid turner, rheumatic F, up SOB angina HF, paradoxical split S2 in exhalation, echo is gold dx, do balloon valvuloplasty before valce replacement, up risk of arrhyth , endocard, L HF, LVH
Venous insuffup stasis dermatitis
23 yo F with gastroenteritis and able to keep down liquidsdisch on clear liquid and outpt followup
Cow milk intolerancenormal bowel sounds, no px, Fecal occult blood is positive, up melena
Hematocheziabloody stools
Meckel divertoccurs at 2 years old, up abd dist, up signs of obsruction, gold is Meckel scintigraphy, srx indicated when active bleed
Doxycyclinecontra in preg,
Ciprocategory C in preg
STDAZT and cefrtriaxone if preggers
B1 defup wernike (dn mamillary body, ataxia confusion) Korsakoff ( up confabulation and psychosis) up dry berberi (up periph neuropathy, m wasting) wet beriberi (hi output cardiac failure 2/2 dilated cardiomyopathy and edema)
Bronchiolitis obliterans2/2 pediatric adenovirus, up SOB and dry cougn, dn FEV1
Neoplastic fevercytokines(IL-6) secretion induce PGE2 which acts on hypothal (cytokine release syndrome)
Panic d/o vs phobiaphobias are specific, panic disorder is suddenly and unexpectedly
TSHnormal is lt 5
HypothryroidMCC to hashimotos
Subclinical hypothyroidpresence of anti TPO AB
Cardiac syncoperecovery is rapid no prodrome, vasovagal feel nauseated or unwell, neurogenic takes 5 min to recover
Eryspielason face butterfly like SLE, up sharp raised border, red, swollen, a superficial form of cellulitis
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Section 7

Question Answer
Trisomy 21upslanting palprebral fissure, small ears, short neck, protuberant tonngue, up duodenal atresia, up Amyloid precursor pro so up alz dz, simian creases, atlantoaxial instability, hirschsprung, atrioventricaular canal, endocardial cushion defect, up ALL
Wilms tmxup in WAGR syndrome (wilms(unilateral kidney neop) Aniridia, GU problem, retard)
Develop hip dysplasiafemale firstborn breech and fam hx, clunk on hip reduction (ortolonia), assym hip skin folds, Barlows is test of dislocation
Wilm tumorup in becwith widdeman synd
Postmenop bleedingone third have endometrial cx, need to get bx, pap smears are NOT reliable
Mycop pneuatypical pneumonia in college kids, tx is Tetracycline or eryhtoro,
Myco bugsno cell wall * cannot use penicillin or cephalosporins
Hepatitis kidthink hepatis A
Prothrombin timedegree of prolengation correlates with severeity of disease
Ovarian torsioncaused by ovarian cysts up crampy pain, extreme pain on palpation with guarding and rebound
Strep boviscolorectal cx and endocarditis
Ulcerative colitisget barium enemas, up risk toxic megacolon, up risk primary scler cholang
UC and dx pancolitis (very severe UC)annual colonoscopy after 10 years of dz
UC and colonoscopyget screenings after 8 years of disease activity at 1 to 2 year interval
memorize