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Comquest 2

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jmanderson's version from 2017-09-06 20:06

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Question Answer
dx- secondary htn with ha and abd bruit in young femaleRAS fibromuscular dysplasia
rx- 1 hr s/p apap o/dcharcoal
mgmt- apap o/dcharcoal w/i 1 hr, blood levels at 4/6/8 hr, NAC prn
herb- depression, affects inr, p450st john wort
t cruzi heart problemdilated cmp
dilated cmp- edv, esv, ef, and thicknessinc edv/esv, dec ef/thickness
shoulder dystocia rfmacrosomia, db, post term, prolonged 2nd stage labor, mutiparity, hx
_________ r/o dzsensitivity (snout)
_________ r/i dzspecificity (spin)
dx- necrotizing migratory erythema, dm, wt loss, stomatitis, high amino acidsglucogonoma
dx- runner with mid foot pain worse w/ wt bearingstress fxr
dx test- lactose intoleranceH+ breath test
dx- 10d baby w/ jaundice, HSM, vomiting, cateractsgalactosemia (use soy milk)
dx- baby with MR, musty odor, low pigmentPKU (avoid Phe)
dx- baby tall, lens subluxation, MR, osteoporosishomocystinuria (vit b6 for life)
dx test- suspect prolactinomaMRI
dx- hip pain in chr steroid use ptAVN
omm- rib tx ordert spine, structural rib, resp rib dsyfxn
tx- anterior rib cs ptsf st rt
w/u- suspected ascitesparacentesis and u/s
tx- ascitesaldactone/lasix -> TIPS/tap if fail
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section

Question Answer
w/u order- pheourinary metanephrines -> ct/mri -> mibg
dx- tremor at rest and intentionessential tremor
mgmt- essential tremorBBs
dx- painless rectal bleed, old man, a/w AS, vWF, esrdangiodysplasia (AVM)
omm- cp for prostatelateral posterior ITB
omm- cp for rectumlesser trochanter
dx- dm, diarrhea/steatorrhea, gb stones, wt losssomatostatinoma
mgmt- malignant hyperthermiastop agent -> give dantrolene
omm- bone to tx otitis mediatemporal (occipitomastoid spead)
CI with 1 in it means _________may be diff than null, but not statistically sign
pvd pain vs stenosis painpvd not relieved w/ rest
dx- s/p stent, eosinophilia, rf, livvedo reticularischolesterol embolus
term- flat fee for pt from HMO doc groupcapitation
term- lessening in severitymitigation
abx for SBP3rd gen ceph (cefotaxime)
dx- 3d old baby, no mec passed, bilious vomithirshprung
dx test of choice for hirshprungrectal bx
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section

Question Answer
omm- cp for heart2nd ics
dx- heart complication of strep throatrhematic fever (MS, MR)
triple therapyamox, clarithromycin, ppi
triple therapy if all to pcnmetro, clarithromycin, ppi
triple therapy if all to macrolidesamox, metro, ppi
quad therapytriple + bismuth
when can doc be held liable from ptonce relationship pt/doc with hpi, dx, tx
indication for prostate bxabnl dre (not psa)
nerve stim with LESincremental response (gets better)
nerve stim with MGdecremental response (gets worse)
mgmt- septic shock nonresponsive to ivfnorepi (1st line pressor)
when is phenylephrine 1st line pressorseptic shock + arrhythmia or mi
indications for take home O2saO2<88%, paO2<55 mmhg, paO2 55-59 if r hf
dx- non-compliant pt, ams, hypothermia, hoTN, low ventilationmyxedema coma
mgmt- myxedema comaIV T3/4, steroids, ivf, blanket, resp therapy
pregn physio- tbg, total and bound t3, t4. tshtbg inc, total and bound t4/3 inc, nl tsh
dx- kid bloody diarreha, abd pain, aphthous oral ulcers, perirectal tagcrohn
dx- severe bleeding in crohn's ptvit k def
sz vs syncopept loses continence in sz
lichen planus has purple, polygonal, pruritic, papules, AND _________wickham striae (white oral lesions)
cxr- silica lungnodular opacity upper lobe
cxr- berrylium lungbilateral hilar adneopathy
cxr- asbestos lungbilateral opacities with pleural plaques
cva artery- homonymous hemianopsia, spares macula, can't recognize facePCA
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section

Question Answer
nephritis a/w syphilis, hbv, hcv, ca, sle, malaria, pcnamine, gold saltsmembranous (spike/dome)
dx- livestock farmer, myalgia, fever, hemoptysis, cp, cxr w/ widened mediastinumanthrax
mgmt- baccilus anthraxiscipro (FQ)
dx- gi ca mets to ovarieskrukenberg
dx- ca of bile ductscholangioca
dx- painless jaundice, cholangioca in hepatic ducts, rf pscklatskin tumor
dx test for exercise induced asthmamethacholine challenge (bronchoprovocation)
cause of mesenteric ischemia in elderly hosp popCV shock +/- vasopressors
dx- patchy hair loss on scalp or generalized loss of body hair in young pt w/ AI dzalopecia areata
dx- diffuse hair loss in women after illness d/t anagen -> telogen phasetelogen effluivium
dx- patchy hair loss with itchy scaly plaquestinea capitis
mgmt- warfarin o/d w/o bleedingd/c warfarin, vit k
mgmt- warfarin o/d w/ bleedingd/c warfarin, ffp, vit k
omm- me for inhaled bucket handle ribtx lowest, sb pt, pt reach knee, hold exhal
schizopherinia vs schizophreniform>6 mo vs <6 mo
dx test- diverticulitisct w/ contrast
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Question Answer
dx- teen w/ proximal tibia pain, swelling, hard, non mobile massosteosarcoma
mc compartment for compartment synd of leganterior (tibialis ant, ext hallucis long, ant tibial a, deep fibular n)
dx- overuse injury of posterior leg compartmentmedial tibial stress synd (shin splint)
dx test- stres fxr and shin splintnuclear medicine bone scan
dx- watery diarrhea (HoK), HoCl, hyperglycemiaVIPoma (tx w/ octreotide)
mc cardiac abn in marfanMVP
mcc cardiac morbidity in marfanaortic rupture (get serial echo)
dx- kid with fever, conjunctivitis, skin desquamation, LAD, strawberry tongue, MIkawasaki
cardiac complication in kawasakicoronary artery dilation
o/d- psych rx, ataxia, mm wk, inc dtrlithium
dx- <1mo baby, bilious vomiting, bpr, abd pain, int obstruction, upper gi corkskremidgut volvulus
mcc high MSAFPdating error
causes of MSAFPdating error, NTD, abd wall def
NTDs have high AFP and ___AChE
dx- leukemia, >30 y/o, aure rods, MPOAML
suspect hemothorax, get _________cxr
o/d- blurred vision, hallucination, low bp, tachy, long qrsTCAs
dx- uveitis, urethritis, arthritis (can't see, pee, climb a tree)reactive arthritis (reiter's, chlamydia)
dx- migratory arthritis and tenosynovitisgonococcol
ppx- cluster haccb, steroid, valproate, topiramate, ergotamine
acute mgmt- cluster haO2, subq triptan
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section

Question Answer
mgmt- open angle guacomaBB (timilol), AA, CAI, PGs
dx- painless gradual visiion loss with optic disk cuppingopen angle gluacoma
dx- blurring of central vision, spared periph vision, fat deposit on eye exammacular degen
dx- severe ocular pain, halos, hard eye, frontal ha, inc IOPclose angle gluacoma
dx- recurrent oral and genital ulcers +/- arthritis and cns d/obehcet's synd
dx- sleep paralysis, vivid hallucinations before sleep/awake, muscle weaknessnarcoleps
rx- daytime sleepiness 2/2 narcolepsymodafinil, fluoxetine
rx- cataplexy (mm wkness) 2/2 narcolepsyatomoxetine
dx- old pt with ckd gets linear bone fxrrenal osteodystrophy (high pth, low ca, high p)
mgmt- epiglottitismaintain airway, iv abx
dx- kid with n/v w/ eating and epigastric pain after a fightpancreatitis
mcc pancreatitis in kidsblunt truama
dx- edema, jvd, pericardial knock, ascited, calc around heartconstrictive pericarditis
mgmt- constrictive pericarditissurg removal of pericardium
mc cardiac abn turnerbicuspid ao valve
2nd mc cardiac abn turnercoarctation ao
dx- high fe, high ferritin, var tibc, periph smear little dotssideroblastic anemia
mgmt- sideroblastic anemiaremove agent, pyridoxine (vit b6)
dx- high wbc with high leuk alk phosphleukemoid rxn
dx- pars defect spinespondylolysis
dx- pars defect with slippagespondylolisthesis
mgmt- acute dystonia in pt on antipsychoticsbenztropine, diphenhydramine (anti-ACh)
mgmt- akathisia (restlessness) in pt on antipsychoticsBB, bzd
1st step- dx meningococcemiaiv abx (vanc, ceftriaxone)
mgmt- meningitisabx -> ct -> lp
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