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high yield step 2

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ruhland1's version from 2016-06-20 18:34

Section

Question Answer
SE of cyclosporine vs. tacrolimusboth cause nephrotoxicity, hyperkalemia, htn, and tremor but cyclosporine causes hirsutism and gum hypertrophy
SE of azithioprinedose-related diarrhea, leukopenia and hepatotoxicity
major SE of mycophenolatebone marrow suppression
treatment for PCOSclomiphene citrate or metformin for induction of ovulation
medication used in public speaking phobiabeta blocker
features of a benign murmurasymptomatic patient, grade 2 or less, normal S2, no clicks, normal pulses, no other abnormalities
carcinoid syndrome triadflushing, diarrhea, wheezing
sunburst periosteal reaction and codman's triangleosteosarcoma
most common primary bone tumor in children and young adultsosteosarcome
second most common primary bone tumor in children and young adultsewings sarcoma
causes gallbladder stasisTPN
androgen predominately produced in the adrenals only DHEAS
treatment for 3rd degree heart blockexpeditious pacemaker placement
when the effect of the main exposure on the outcome is modified by the level of another variableeffect modification
bizarre behavior and hallucinations, often without meningeal signsHSV encephalitis
treatment for HSV encephalitisIV acyclovir immediately upon suspicion
a systemic disease causing nephrotic syndrome, hepatomegaly, cardiomyopathy, pseudohypertrophy, and peripheral neuropathysecondary amyloidosis
megaloblastic anemia, shiny tongue, vitiligo, thyroid disease, and neurologic abnormalitiespernicious anemia (vit B12 deficiency)
gross hematuria after URI in adultsIgA nephropathy
treatment of choice for sphincter of oddi dysfunction ERCP with sphincterotomy
exposure of people with disease to exposure of people without diseaseexposure odds ratio (case-control study)
loss of follow up in prospective studies creates potential for this biasselection bias
can slow progression of diabetic nephropathyACE inhibitor
metacholine challengecan diagnose asthma
murmur from rheumatic heart diseasemitral stenosis (causes atrial enlargement and predisposes to a.fib)
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cardio

Question Answer
total cholesterol with no risk factors< 200
LDL with < 2 risk factors< 160
LDL with 2 or more risk factors< 130
LDL in patients with known CAD, DM, PVD or AAA, symptomatic carotid disease< 100
treatment for LDL 130-159exercise and diet modification
treatment for LDL > 160 or > 130 + 2 risk or > 100 with multiple riskmedication
risk factors for CADsmoking, HTN (BP > 140/90 or on antihypertensive), HDL < 40, family hx of CAD in male < 55 or female < 65, age male > 45 or female > 55)
when is a post MI pt at greatest risk for ventricular wall rupture 4-8 days post-MI
when is a post MI pt at greatest risk for Dressler syndrome2-4 weeks post MI (fever, pericarditis, and elevated ESR)
CK-MB timelineincreases 2-12 hours post MI, peaks in 12-40 hours, and decreases 24-72 hours
LDH timelineincreases in 6-24 hours and peaks in 3-6 days
Troponin-I timelineincrease in 2-3 hours, peaks in 6 hours, and gradually decreases over 7 days
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high yield from question set

Question Answer
pruritic skin lesions in infant symmetrically distributed over the face, scalp, chest and extensor surfaces. spares diaper regionatopic dermatitis
physical changes in brain of schizophrenic patientincreased ventricle size (increased ventricular size)
drug of choice for diabetic neuropathyTCAs (use gabapentin as alternative with urinary symptoms and orthostatic htn)
hep c treatmentinterferon and ribavirin
hep b treatmentinterferon and lamivudine
trousseau's syndrome migratory thrombophlebitis, could mean occult tumor
possible early complications of operation on abdominal aortabowel ischemia and infarction
presentation of bowel ischemia and infarctionabdominal pain, bloody diarrhea, fever and leukocytosis, does not have peritoneal signs (as in perforation)
this post-op complication can be prevented with adequate fluid hydration and oral hygieneacute bacterial parotitis (s. aureus), dehydrated and elderly at risk
better to keep systolic BP below this to slow end-organ damage in patients with diabetes and CRF<130
major thoracic trauma with paradoxical thoracic wall movements that correct with positive pressure ventilationflail chest
when an MMR vaccine can be given to HIV patientwhen CD4 counts > 200 and no evidence of AIDs defining illness
vaccines contraindicated in HIV patientsBCG, anthrax, oral typhoid, intranasal flu, oral polio, yellow fever
yellow-ish white patches of retinal opacification and retinal hemorrhages in AIDS paitientCMV retinitis
false + VDRL, prolonged PTT and thrombocytopeniaantiphospholipid antibody syndrome
treatment for antiphospholipid antibody syndromeprophylaxis with low dose aspirin and LMWH
ARDS vs. cardiopulmonary edemaARDS has PCWP < 18 while cardiogenic pulm edema has PCWP > 18 meaning edema creates pressure, ARDS is a different process that doesent put pressure on pulm vasculature
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Question Answer
PaO2/FiO2 ratio in ARDSP/F ratio < 200
P/F ratio <200, bilateral infiltrates on CXR, and normal PCWPARDS
soft blue compressible masses up to a few cm in size, large dilated vascular spacescavernous hemangioma
benign tumors that consist of dilated lymphatic spaces lined by endothelium, commonly on neckcystic hygromas
benign vascular proliferations in adultscherry hemangiomas
anti-estrogen that increases the risk of endometrial cancer and venous thrombosistamoxifen
chronic neck pain with limited neck rotation and lateral bendingcervical spondylosos (osteoarthritis)
most common radiographic finding in cervical radiography in patients with cervical spondylosisbody spurs
preferred treatment for most patients with hyperthyroidism, including gravesradioactive iodine ablative therapy
atrophy of the caudate nucleushuntingdon's chorea
pellagraniacin deficiency = 3Ds -- diarrhea, dermatitis, dementia
glutamate inhibitor currently approved for use in patients with ALSRiluzole
progressive inflammatory back pain and stiffness improves with exerciseankylosing spondylitis (males/females - 2/1)
tears in the mucosa of the distal esophagus and proximal stomachmallory-weiss tears (10% of GI bleeds)
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high yield from question set

Question Answer
calcium pyrophosphate dehydrate crystalspsuedogout
positively birefringentpsuedogout
collections of urate crystals which form firm, yellowish nodules at the sites of involved joints in patients with chronic gouttiphi
needle-shaped negatively birefringent crystalsgout
rhomboid shaped crystalspsuedogout
radiographic evidence of chondrocalcinosispsuedogout
final sequel of compartment syndrome in which dead muscle has been replaced with fibrous tissuevolkmann's ischemic contracture
new onset diabetes, arthropathy and hepatomegalyhemochromatosis
when a patient with infectious mono can play sports againwhen their physical exam is normal
reverses the prolongation of QRS interval by increasing the extracellular sodium concentration in TCA overdosesodium bicarb
post-term pregnancies should be closely monitored for thisoligohydramnios (AFI of 5 cm or less)
red blood cells with single, round inclusions on Wright stainhowell-jolly bodies (nuclear remnants typically removed by the spleen)
diagnostic procedure of choice for renal stonesCT because can detect calcium ans well as uric acid stones)
dietary recommendation for patients with renal calculidecrease protein and oxalate, decrease sodium, increase fluid and calcium
corneal vesicles and dendritic ulcersherpes simplex keratitis
schilling testused to determine dietary vitamin B12 deficiency vs. malabsorption vs. pernicious anemia
asymptomatic thrombocytopeniascreen for HIV
new clubbing in patients with COPD indicates thisoccult malignancy (development of lung cancer)
68% CI1 standard deviation of the mean
95% CI2 standard deviations of the mean
99.7% CI3 standard deviations of the mean
can see pulsus paradoxuscardiac tamponade, pericardial effusion, asthma, and COPD
treatment for mastitisanalgesics, antibiotics, and continuation of breast-feeding
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high yield

Question Answer
hemorrhages and fluffy or granular lesions around retinal vesselsCMV
peripheral pale lesions and central retinal necrosisHSV or VZV
conservative managment of GERD in infantsthicken milk with rice cereal and positioning
modified acid fast stain showing oocysts in stool in HIV + patientcryptosporidium or isospora (crypto more common!)
down syndrome patient who presents with upper motor neuron findingsatlantoaxial instability
treatment of choice for hairy cell leukemiacladribine
tartrate-resistant acid phosphatase staininghairy cell leukemia (leukemic reticuloendotheliosis)
mild acne treatment of choice (minimal inflammation)topical retinoids
treatment of choice for mild to moderate inflammatory acnetopical erythromycin
treatment of choice for moderate to severe inflammatory acneoral antibiotics
IgG and C2 deposits at the dermal epidermal junctionsbullous pemphigoid
keratinocyte surface-bound IgG throughout epidermispemphigus vulgaris
autoantibodies targeting desmogleinspemphigus vulgaris
multi-nucleated giant cells at base of lesionsHSV or VZV
organism causing hydatid cystechinococcus granulosis
organism causing cysticersosistaenia solium- causes cysts in brain or muscle
used for migraine prophylaxis but not useful in an acute settingamitriptyline
IV anti-emeticschlorpromazine, prochlorperazine, metoclopramide
peptic stricture (vs adenocarcinoma)causes symmetric and circumferential narrowing of involved esophagus and dysphagia to solids but no weight loss (adenocarcinoma causes asymmetric narrowing and no weight loss)
most commonly involved segment of colon in ischemic colitissplenic flexure
pansystolic murmur heard loudest at apex with radiation to axillaacute mitral regurgitation
the cause of systemic malformations of hypothyroidismdeposition of mucopolysaccharids (matrix substances, mucin)
radiolucent renal stonesuric acid (must be assessed by CT scan)
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eye pathologies

Question Answer
chronic, sterile, granulomatous inflammatory lesion of meibomian glandchalazion
purulent infection of one of the glands of the eye, usually caused by staphhordeolum
painless retinitis in HIV + patientCMV retinitis
painful retinitis in HIV + patientHSV keratitis
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fractures, mechanisms and treatments

Question Answer
colles fracturedistal radius +/- ulna
mechanism of colles fracturefall on outstretched hand
treatment of colles fractureclosed reduction, long arm cast, possible surgery
smith fracturedistal radius
scaphoid fracturefracture of scaphoid
h/p of scaphoid fxsnuffbox tenderness
mechanism of scaphoid fxfall on outstretched hand
treatment of scaphoid fxthumb spica cast, possible surgery
not seen on x-ray for 1-2 weeks after injuryscaphoid fracture
increased risk of AVNscaphoid fx and hip fx
most common wrist fracturecolles
wrist drop or weakened thumb abductionradial nerve injury from humerus fracture
monteggia fxdislocation of radial head with ulnar diaphyseal fracture
galeazzi fxDRUJ dislocation and radial diaphyseal fracture
increased risk of AVN and DVThip fx
increased risk of compartment syndrometibial fracture
high risk of major blood losspelvic fracture
waiter's tiperb-duchenne palsy
injury to superior trunkerb-duchenne palsy
injury to ulnar nerveclaw hand
separation of medial epicondyle of humerusclaw hand
weak finger adduction, clawed 4th and 5th digits form lumbrical weaknessclaw hand
anterior shoulder dislocation causing axillary nerve impingementdeltoid paralysis
injury to posterior or medial cords causing hyperabduction of armklumpke's palsy
claw hand, association with Horner syndromeklumpke's palsy
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back pain

Question Answer
pain worsens with straight leg raisingdisk herniation
pain improves with flexion of the hips (bending over a shopping cart)spinal stenosis
pain made worse by walking and standing (pseudoclaudication)spinal stenosis
loss of foot dorsiflexion and pain on crossed straight leg raisedisk herniation
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nerve injury

Question Answer
shaft of humerusradial
surgical neck of humerusaxillary artery and nervce
supracondyle of humerusmedian nerve
medial epicondyleulna
anterior shoulder dislocationaxillary artery and nerve (deltoid injury--can't raise arm)
injury to carpal tunnelmedian nerve
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pediatric

Question Answer
x-ray reveals femoral head sclerosisAVN
x-ray reveals femoral head falling off of femurslipped capital femoral
obese male adolescent with dull hip pain and inability to bear weightslipped cap fem
radial head subluxationnursemaid's elbow
AVN of capital femoral epiphysis in 3-8 year oldleg-calve-perthe's disease
7 year old with growth delay and inner thigh painleg-calve perthe's disease
separation through growth plate of femoral epiphysis from metaphysisslipped capital femoral
impaired calcification of bone caused by vitamin D deficiencyrickets
inflammation of bone-cartilage interface of tibial tubercleosgood schlatter (osteochondritis)
most common fracture in childrenclavicular fracture
tx of clavicular fracturefigure of 8 sling
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high yield

Question Answer
treatment of HIV + patient with + PPDisoniazid for 9 months with pyridoxime for prophylaxis
acute treatment of goutNSAIDs and colchicine
first-line treatment for OCDSSRI or clomipramine
albuminocytologic dissociation (high protein with few cells) guillan barre syndrome
the earliest renal abnormality see in diabetesglomerular hyperfiltration to process glc out
cushings triad of elevated ICPwide pulse pressure, irregular respirations, bradycardia
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epidemiology

Question Answer
hazard ratiochance of event to occur in treatment arm vs. control arm
hazard ratio < 1event is more likely to occur in control arm
hazard ratio > 1event is more likely to occur in treatment arm
attributable risk percent(risk in exposed-risk of unexposed)/ (risk in exposed)
occurs due to poor data collectionmeasurement bias
reatment is selected for patient based on the severity of their disease, without taking into account other confounding variablessusceptibility bias
test used to compare proportionschi-square test
the subjects are free of the outcome at the time the study beginscohort study
also knowns as a retrospective studycase control study
used to compare three or more meansANOVA test
used to compare two meanstwo-sample t test
loss of follow-up creates this biasselection bias
risk calculationexposed with disease/total exposed
compares incidence of disease in two populationscohort study
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