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Comquest 5

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jmanderson's version from 2017-09-09 23:09

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Question Answer
mgmt- FAP on colonoscopyppx colectomy
mgmt- asx umbilical hernia in <4 y/oobserve until 4 (then elective surg)
CLL periph smearsmudge cells
polycistic kidney complicationsintracerbral aneurysm, hepatic cyst, thoracic aneruysm
mc site of ZES (diarrhea, refractory pud)duodenum
mcc adrenal insuff worldwide (not us)tb
1st line mgmt- gestational dbdiet, exercise, bg checks
mgmt- gestational db not resolved w/ lifestyleinsulin
infiltrative dz (sarcoid, amyloid, hemochromatosis) leads to _________ cmprestrictive cmp
mgmt- hemochromotosisdeforoxamine (acute), phlebotomy (chronic)
mgmt- nephrogenic DINa restrictioin, fluid, hctz +/- amiloride
mgmt- nephrogenic DI from Lithiumd/c lithium, amiloride
vit b def- neuropathy (confusion, ataxia, nystagmus) and cv failureb1 (thiamine)
vit b def- cheilosisb2 (riboflavin)
vit b def- neuropathyb6 (pyridoxine)
vit b def- diarrhea, dermatitis, dementiab3 (niacin)
grade- muscle twitch only1
grade- contract w/o gravity2
grade- contract w/ gravity but w/o resistance3
grade- contract w/ gravity and some resistance4
grade- contract w/ gravity and full resistance5
dx test- diff ARDs from cardiogenic pulm edema in hosp ptecho
PaO2 to FiO2 ratio in ARDS<200
dx- rhinitis, c-ancaGAP
dx- low C3 and ASO nephriticpsgs
dx- hemoptysis, igG and c3 against GBMgoodpasture (p and c anca)
churg strauss _-ancap-anca
GAP _-ancac-anca
goodpasture _-ancac and p anca
dx- nephritic mcc after infxn but no dec C3IgA (berger)
NNH eq1/attributable risk
NNT eq1/ARR
mgmt- hemodynamically unstable cardiac tampanodepericardial window
forgiving pcp co-payments and deductibles is called _________fraud
memorize

section

Question Answer
etoh, cocaine, and doxorubicin cause _________ cmpdilated
gestational db is due to HPL (chorionic somatommamotropin) leading to _________ resistanceinsulin
mc bug SBP e coli > klebsiella
1st and 2nd step- suspect aortic dissectioncxr -> ct w/ contrast
mgmt- testicle ca based on pe, u/s and bhcgradical orchiectomy (no bx needed)
warfarin increases _________ due to VII sup (vit K def)PT inc
mgmt- full thickness burnimmediate excision and grafting
mgmt- partial thickness burnsilver sulfadizine totpical
1st line rx to improve survivial in chfacei
dx- abd pain, neuropathy, psych sx, urine aminovulinic acidacute intermittent prophyria
dx- adnexal mass with precocious puberty (young) or vag bleed (old) granulosa-thecal tumor (E secretion)
rf- gastic ulcerndaids
rf- duodenal ulcerh pylori
memorize

section

Question Answer
see gest sac w/ bhcg >_________ on tvus and >_________ on abd us>1500, >6500
lateral epicondylitis pain with wrist _________ and _________ against resistancewrist extension, supination against resistance
mgmt- angiodysplasia bleeding w/ vwdcoloncopic coagulation
mgmt- asx angiodysplasianothing
most specific test- pancreatic caercp
most sensitive test- pancreatic cact scan
1st step- painless jaundiceabd u/s
dx- dyspnea with arthritis, erythema nodosum, ACE and high Casarcoidosis
mgmt- lung abscessclindamycin
dx- hypert4 -> hypot4, tender neck, after illnesssubacute thyroiditis
dx- hypert4 -> hypot4, non-tender neckhashimoto
mgmt- LSIL on pap >25 y/ocolposcopy
mgmt- HSIL on papLEEP
mgmt- ASCUS on pap >25 y/oreflex HPV -> colpo if +
mgmt- ASCUS on pap <25 y/orepeat pap in 1 yr
CV4 techinique akabulb decompression
dx- vaginitis with strawberry cervixtrich
trich puts pts at risk for _________HIV
mgmt- trich vaginitisMTZ for pt and partner
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section

Question Answer
mgmt- acute chfna restriction, acei, lasix, (avoid bb)
lawsuit term- negligence that speaks for itself (scalpel left in abd)res ipsa loquitur "the thing speaks for itself'
all states screen babies for _________ and _________pku and hypot4
mgmt- osteoporosis-dronate, ca, vit d
ppx- serm for osteoporosisraloxifine
med records should be made available w/i _________ days after written request5
pulsus parvus et tardus (radial pulse felt later than heart contraction) a/w _________ murmurAS
murmur that inc w/ valsalvaMVP, HOCM
murmur inc w/ inspiratioR heart (TR, TS)
left parasternal lift means _________ hypertrophyRVH
dx- sausage shaped cyst on adnexal u/s, h/o pidhydrosalpinx (secondary infertility)
dx- swelling of baby head after delivery, doesn't cross suture linescephalohematoma
dx- swelling of baby head after delivery, does cross suture linescaput succedaneum
dist- mode>median>mean with curve leftpositively skewed
dist- mean>median>mode with curve rightnegatively skewed
omm- psoas syndrome (flexed posture)me lumbar first, then psoas
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section

Question Answer
dx test- confirm cardiac tamponadeTEE
rx- antidepressant a/w priapism (long erections)trazodone
dx- RA, pancytopenia, splenomegalyfelty's synd
mcc lower GIB in descending orderdiverticulosis > angiodysplasia > ibd > crc
intracranial mass on fundoscopic exampapilledema (blurring of optic disc margins)
mc breech baby typefrank (but first)
mc torch infxncmv (microcephaly, jaundice, hsm, deafness, periventricular calc)
mc sequelae of meningitishearing loss
confirming dx test- ped urinasopharyngeal swab (rsv, parainfluenza)
1st and confirmatory dx test- choanal atresia1st (nose cath), confirm (ct)
mgmt- nutcracker esophageal spasmccbs (diltiazem), imipramine, ntg
ppx- mac in aidscd4<50, zithromax
mgmt- sliding hiatal hernia (type 1)tx sx like gerd
mgmt- paraesophageal hiatal hernia (type 2)surgery (prevent strangulation)
mgmt- ZESppi
mgmt- baby with 3/6 murmurecho (even if asx)
1st step mgmt- pyloric stenosis with tachy, hypoCl, hypoK, met acidivf -->u/s --> then surg
dx and mgmt- constipation in neonate w/o screening, +fam hxcystic fibrosis (mec ileus) -> gastrografin enema
dx kids and adults- holosystolic murmur at apexVSD (kids), MR (adults)
knee chest in kid w/ TOF increases _________ which decreases _________ to improve sxSVR, R->L shunt
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section

Question Answer
dx- ruq u/s pericholecystic fluid, thick gb wall, gb stonescholecystitis
dx- ruq u/s thin walled distended gbmalignancy
best next test- cholecystitis s/sx but (-) u/sHIDA (obstruction vs inflammation)
dx- copd + cirrhosisa-1 antitrypsin def
dx- male, obstructive jaundice, beads on string mrcp, +/- ibd sxpsc (p-anca)
dx- middle age female, painless jaundice, (-) imaging/obstructionpbc (anti-mitochondrial)
ig- autoimmune hepatitisanti smooth muscle
ig- pbcanti mitochondrial
colonoscopy schedule- UC pt w/o ppx colectomy8 hrs after dx and annually after
mgmt- ascending cholangitis with obstruction and severe sepsis/shockercp
mcc pre-menarchal bleeding of vagforeignn body (do exam under anesthesia)
check fetal dna 1st ticvs
check fetal dna 2nd triamnio
dx- u/s dilated biliary tree, no obstructing stone, gallstones in gbpainful jaundice (stones)
mgmt- tubo-ovarian abscess (after pid)iv cef and po/iv doxy (inpt mgmt)
mgmt- lethargic baby with retinal hemorrhagesct head 1st (subdural bleed), then call CPS
mgmt- per-surg pt, post mi yrs ago, s/sx chfrx for chf (lasix, bb, acei, asa, statin) until euvolemic
mgmt- pre-surg pt, recent post midelay surg 6 mo, heart cath
worry abt obstruction if no Uo for >_________ hrs6
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ob ca

Question Answer
dysgerminoma markerldh
epithelial ov ca markerca-125
gestational troph dz and choriocarcinoma markerbhcg
yolk sac tumor, hcc markerafp
pancreatic ca markerca19-9
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