BUSINES CLASS 2 Flashcards

Question

Tests for Celiac Disease?

Answer 1

IgA-tTG + IgA level Small bowel biopsy = Gold standard

Answer 2

Gluten-free (no wheat/barley/rye; oats OK if pure) Treat deficiencies (Fe, B12, Folate, Vit D) Dietitian referral DEXA (OP risk) Screen 1st-degree relatives

Answer 3

Osteoporosis, Infertility, NHL, Autoimmune disease

Answer 4

5-ASA (Mesalamine, Sulfasalazine) Steroids (Prednisone, Budesonide) Immunosuppressants (Azathioprine, 6-MP, MTX) Antibiotics (Metronidazole, Cipro) Biologics (Infliximab, Adalimumab, Vedolizumab)

Answer 5

Mefloquine (unless CI).

Answer 6

Seizures, Psych hx (depression, psychosis, schizophrenia), Conduction abnormalities.

Answer 7

N/V, diarrhea, pruritus, Dizziness, insomnia, vivid dreams, psychosis.

Answer 8

Avoid dusk–dawn outdoors, Long sleeves + tuck in, Mosquito nets (insecticide-treated), DEET repellents, Avoid stagnant water.

Answer 9

Emphasize strict non-pharm prevention above.

Answer 10

N-acetylcysteine (NAC) – best within 4h.

Answer 11

INR, Bilirubin, AST, ALT, Creatinine, Glucose.

Answer 12

Anaphylactoid reaction, Flushing, tachycardia, edema, Rare: autoimmune.

Answer 13

Hypotension, PDE-5 inhibitor use <48h (tadalafil, sildenafil), Severe anemia, ↑ ICP.

Answer 14

RV infarct, Brady/tachycardia, Alcohol intoxication.

Answer 15

ECG, Troponins, CK-MB, Lipids, A1C, Cr, Echo, CXR, Stress test (if stable).

Answer 16

Bulging, immobile TM, Loss of landmarks, erythema, ± Purulent discharge.

Answer 17

Most viral → observe, f/u 48h, Give analgesia, Hand hygiene, Avoid 2° smoke, Vaccinations UTD.

Answer 18

No improvement at 48h, <6 months old, Severe symptoms.

Answer 19

Amoxicillin 90 mg/kg/day ÷2 x 5 days.

Answer 20

Growth: length, weight, head circumference, Feeding: volume & frequency, wet diapers, Vit D.

Answer 21

Red reflex bilateral.

Answer 22

Assess for hip stability (Barlow/Ortolani).

Answer 23

No co-sleeping, Avoid smoke exposure, No pillows/stuffed toys.

Answer 24

Store ammo separate from gun, Wash/change clothes before handling baby.

Answer 25

Bacterial vaginosis (most common), Candida, Trichomonas, PID, Foreign body, Malignancy.

Answer 26

Metronidazole.

Answer 27

Vaginal swab microscopy → Clue cells.

Answer 28

No alcohol, Avoid douching, No need to treat partner.

Answer 29

Pneumonia, COPD exacerbation, CHF exacerbation, Pulmonary embolism.

Answer 30

Hand hygiene, Avoid 2° smoke (and quit smoking if applicable).

Answer 31

CXR, CBC/WBC, CRP, Antibiotic Rx.

Answer 32

PEP for HIV, GC, Chlamydia, Emergency contraception, Counseling / Support, Vaccination (Hep B).

Answer 33

Option to report to police/legal, If no period → return for pregnancy test, HPV vaccination.

Answer 34

Copper IUD up to 7 days.

Answer 35

N/V, abdo pain, Fatigue, dizziness, HA, Breast tenderness.

Answer 36

Pregnancy test if no bleeding in 3 weeks.

Answer 37

Use with Gravol to ↓ nausea, Offer long-term contraception, STI screening, HPV vaccination.

Answer 38

Bulging, immobile, Erythema, opaque, Loss of light reflex.

Answer 39

Observe + antipyretics, follow up in 48h.

Answer 40

Amoxicillin 90 mg/kg/day ÷2 × 5 days.

Answer 41

Infection (UTI, pneumonia), Insulin non-compliance, MI, pregnancy, intoxication

Answer 42

ABG / VBG: pH, HCO₃, anion gap; Glucose, serum ketones; K+, Na+, Cr, Osm; ECG

Answer 43

IV fluids (NS); Correct K+ first (no insulin if <3.3); IV insulin 0.1 U/kg/hr; Monitor, treat trigger

Answer 44

Age, gender (male), Recent breakup, Chronic illness, Non-adherence to meds

Answer 45

HTN, Increased venous pressure (vomit, strain, cough, sneeze), Coagulopathy, Trauma, FB, Infection

Answer 46

Visual acuity, IOP measurement, Slit lamp exam

Answer 47

Stool softeners (docusate), Bulk agents (psyllium), Osmotic (lactulose, PEG), Stimulant (bisacodyl, senna)

Answer 48

High fibre diet, Optimal fluid intake, Regular exercise, Don’t ignore urge to defecate

Answer 49

Linaclotide, Lubiprostone, Naloxegol

Answer 50

Dix-Hallpike

Answer 51

Horizontal or torsional nystagmus

Answer 52

Epley’s manoeuvre

Answer 53

CXR, D-dimer (if PE suspected)

Answer 54

SSRI (for depression/eating disorder)

Answer 55

Dietician, Psychiatrist, Psychologist, Social worker

Answer 56

Pneumonia, Asthma exacerbation, COPD exacerbation, MI, CHF, PE, Pneumothorax

Answer 57

↓ air entry on affected side, Hyperresonance, ↓ chest wall movement, Tracheal deviation to opposite side, Use of accessory muscles

Answer 58

If <3 cm + minimal symptoms → Observe; If >3 cm or symptomatic → Aspiration; If unstable/tension PTX → Needle decompression → chest tube

Answer 59

Arrange for medical interpreter

Answer 60

Ask about intimate partner violence (IPV)

Answer 61

Safety planning, Offer reporting to authority, Document findings, Follow-up, Social work referral

Answer 62

MI, PE, Aortic dissection, Cardiac tamponade, Tension pneumothorax, Esophageal rupture

Answer 63

Pneumonia, Pericarditis, CHF exacerbation, Asthma exacerbation, Stable angina, Esophageal spasm

Answer 64

BP, BMI / Waist circumference, Lipids (TC, LDL, HDL), A1C, Pap smear (if indicated), FIT/FOBT for CRC, Mammogram (per age)

Answer 65

Regular exercise, Avoid smoking, Moderate alcohol intake, Mediterranean diet, Vaccinations (flu, shingles, pneumococcal, Tdap), Seatbelt, sunscreen, safe driving

Answer 66

Androgenetic alopecia, Alopecia areata, Tinea capitis, Traction alopecia, Trichotillomania, Post-trauma scar

Answer 67

Topical or intralesional steroid (AA), Minoxidil, Wig/hair piece, Camouflage make-up, Dermatology referral

Answer 68

Class II (symptoms with ordinary activity like walking dog)

Answer 69

HTN, CAD / MI, AFib, COPD, Anemia, Thyroid disease, Alcohol / substance abuse, Sarcoidosis / amyloidosis

Answer 70

PND, Orthopnea, Fatigue, Peripheral edema, Palpitations, Confusion in elderly

Answer 71

MRA (spironolactone), ARNI (sacubitril/valsartan), SGLT2 inhibitor (empagliflozin), β-blocker (metoprolol, bisoprolol, carvedilol), ACEi / ARB (ramipril, candesartan)

Answer 72

Benzodiazepines (Lorazepam IV, Diazepam PR, Midazolam IM/buccal if no IV).

Answer 73

Secure airway, breathing, circulation Oxygen if hypoxemic IV glucose if hypoglycemic Suction secretions Draw blood (lytes, glucose)

Answer 74

Fosphenytoin, phenytoin, levetiracetam, or phenobarbital.

Answer 75

Early satiety Weight loss Anemia Epigastric pain Anorexia

Answer 76

Pallor Virchow’s node (L supraclavicular) Sister Mary Joseph nodule (umbilical) Ascites Hepatomegaly

Answer 77

Acanthosis nigricans Trousseau’s (migratory thrombophlebitis) Dermatomyositis

Answer 78

Multidisciplinary (psych, OT, PT, social work, education support) Parental training Vocational training Regular follow-up with FP/specialist Family counseling

Answer 79

Lithium levels (q1–2w initially → q3mo once stable) TSH (risk of hypothyroidism) Renal function LFTs

Answer 80

Every 1–2 weeks until stable, then every 3 months.

Answer 81

SABA: Salbutamol LABA: Salmeterol SAMA: Ipratropium LAMA: Tiotropium ICS: Budesonide

Answer 82

Spirometry (FEV1/FVC) COPD Assessment Tool (CAT) 6MWT Weight/nutrition Imaging if worsening

Answer 83

SABA (salbutamol).

Answer 84

Add ICS/LABA (e.g., Symbicort).

Answer 85

Exercise challenge test (e.g., stair climbing).

Answer 86

Cold/dry air Smoke Air pollution Chlorine/pool chemicals

Answer 87

Use Ventolin puffer 10–20 min before exercise, review inhaler technique, spacer if needed.

Answer 88

SOB Fatigue Orthopnea/PND Peripheral edema

Answer 89

ARNI (sacubitril/valsartan) SGLT2i (empagliflozin) MRA (spironolactone) Beta-blocker (metoprolol, carvedilol)

Answer 90

Barky cough Inspiratory stridor Hoarseness Worse at night

Answer 91

Dexamethasone (PO/IM) Nebulized epinephrine if mod–severe Oxygen if hypoxemic

Answer 92

Stridor at rest Severe distress/hypoxemia Poor PO intake/dehydration Repeated racemic epi use Unreliable home situation

Answer 93

Fever >5 days + 4/5: Conjunctivitis (bilateral, non-exudative) Rash (polymorphous) Extremity changes (erythema, edema, peeling) Adenopathy (cervical >1.5 cm) Mucosal changes (strawberry tongue, cracked lips)

Answer 94

Echocardiogram (baseline + 6 weeks).

Answer 95

IVIG 2 g/kg single dose (<10 days) High-dose aspirin → low-dose until ESR/platelets normalize

Answer 96

Coronary artery aneurysm.

Answer 97

Seizure disorder Eating disorder Alcohol or benzo withdrawal MAOI use in last 14 days Recent bupropion use

Answer 98

Insomnia Dry mouth Restlessness Hypertension Nausea

Answer 99

Insomnia Vivid dreams Suicidal ideation Psychosis Nausea, constipation

Answer 100

AMS <15 min → return same day if resolved

Answer 101

AMS >15 min → observe, return after 1 wk sx-free

Answer 102

LOC <1 min → imaging, admit; return after 1 wk sx-free

Answer 103

LOC >1 min → admit, return after 2 wks sx-free

Answer 104

↑ ICP → Cushing’s triad

Answer 105

Basal skull fracture signs (Battle’s, raccoon eyes, CSF leak), open/depressed skull fracture, ≥2 vomiting episodes, age >65, GCS <15 after 2h

Answer 106

After 3 months seizure-free, with workup/referral.

Answer 107

Must be seizure-free for 12 months (compliant).

Answer 108

No driving ×3 months after med change.

Answer 109

Drive only if seizure-free & alcohol-free for ≥12 months.

Answer 110

Can drive if unchanged x5 years.

Answer 111

Viral pharyngitis, Strep throat, EBV/Mono, CMV, HIV

Answer 112

Fever, pharyngitis, generalized LAD.

Answer 113

Monospot (heterophile Ab); if negative → CBC + EBV serology

Answer 114

Supportive: rest, fluids, analgesia; avoid contact sports ×4 weeks (risk splenic rupture); corticosteroids if airway obstruction.

Answer 115

Splenic rupture, tonsil hypertrophy → airway obstruction, hepatitis, neurologic (optic neuritis, transverse myelitis)

Answer 116

Weight loss, anemia, nocturnal diarrhea, blood in stool, FHx GI cancer/IBD

Answer 117

Serology: IgA anti-tTG (with total IgA); confirm: small bowel biopsy

Answer 118

Dermatitis herpetiformis

Answer 119

Strict gluten-free diet (avoid wheat, rye, barley; oats allowed if pure); replace deficiencies (iron, folate, B12, Vit D, Ca); dietitian referral; BMD baseline + repeat serology q6–12mo; screen 1st-degree relatives.

Answer 120

Nutritional deficiencies, osteoporosis, infertility, delayed puberty, intestinal T-cell lymphoma, other autoimmune diseases

Answer 121

5-ASA (mesalamine, sulfasalazine), steroids (prednisone, budesonide), immunosuppressants (azathioprine, 6-MP, methotrexate), antibiotics (metronidazole, ciprofloxacin), biologics (infliximab, adalimumab, vedolizumab)

Answer 122

M1 antagonist: scopolamine; H1 antihistamines: diphenhydramine, dimenhydrinate; D2 antagonists: metoclopramide, prochlorperazine; 5-HT3 antagonist: ondansetron

Answer 123

Long sleeves, tucked clothing; insect repellent (DEET); insecticide-treated bed nets; avoid outdoors dusk–dawn; remove stagnant water.

Answer 124

Epilepsy, depression, psychosis/schizophrenia, cardiac conduction defects

Answer 125

GI upset, pruritus; headaches, dizziness; vivid dreams, insomnia; psychosis/hallucinations

Answer 126

Joint space narrowing, subchondral sclerosis, subchondral cysts, osteophytes

Answer 127

Bony erosions, symmetric joint space narrowing, cartilage loss, marginal erosions; MRI/US more sensitive.

Answer 128

TCA (amitriptyline, nortriptyline), anticonvulsants (gabapentin, pregabalin), SNRIs (duloxetine, venlafaxine), topical lidocaine or capsaicin

Answer 129

Urethral swab for Gram stain & NAAT; midstream urine culture; NAAT urine for GC/Chlamydia

Answer 130

Ceftriaxone 250 mg IM once + doxycycline 100 mg BID ×10–14 days

Answer 131

4: Spontaneous 3: To speech 2: To pain 1: None

Answer 132

5: Oriented 4: Confused 3: Inappropriate words 2: Incomprehensible sounds 1: None

Answer 133

6: Obeys commands 5: Localizes pain 4: Withdraws from pain 3: Abnormal flexion 2: Extension 1: None

Answer 134

Max = 15, Min = 3

Answer 135

FP is a skilled clinician FP is community-based FP is a resource to a defined population Patient–physician relationship is central

Answer 136

Viral, bacterial, fungal Trauma Malignancy Autoimmune (SLE, RA)

Answer 137

Sharp pleuritic chest pain, ↑ leaning forward, ↓ lying down Fever, fatigue, SOB

Answer 138

Pericardial friction rub Sinus tachycardia

Answer 139

Diffuse ST elevation PR depression

Answer 140

Effusion, tamponade, constrictive pericarditis

Answer 141

Muffled heart sounds Hypotension ↑ JVP

Answer 142

NSAIDs Steroids if refractory/autoimmune Bacterial: vanco + ceftriaxone Tamponade: pericardiocentesis, surgical call

Answer 143

Athletes Older age Obesity Leg length discrepancy

Answer 144

Heel pain, worst in AM/1st steps Pain ↑ with running, prolonged standing

Answer 145

Pain at medial calcaneus Pain on passive dorsiflexion

Answer 146

Stress fracture Achilles tendinitis Gout

Answer 147

X-ray usually normal US: fascia >4 mm

Answer 148

Acute: NSAIDs, ice, orthotics, stretching Night splints Local corticosteroid injection Ortho referral if refractory

Answer 149

Neural tube defects FTT Developmental delay

Answer 150

Pancytopenia Peripheral neuropathy Papillary atrophy (glossitis) Posterior column neuropathy (↓ vibration, proprioception) Pyramidal signs (incontinence, paraplegia)

Answer 151

PO: 2000 mcg/day ×2 wk → 1000 mcg/day maintenance IM (pernicious anemia): 1000 mcg daily ×1–2 wk → monthly

Answer 152

OA/degenerative Osteomyelitis (incl. TB/Pott’s) Spinal epidural abscess Malignancy/mets/myeloma Compression fracture (HIV/steroids/osteoporosis)

Answer 153

Spinal immobilization + urgent neuro & ortho consult (don’t move until cleared).

Answer 154

Explain/consent (if able) Pre-oxygenate (bag-mask O₂) Prepare equipment: correct tube size, suction, meds Confirm placement: auscultate, EtCO₂, chest rise Monitor SpO₂, ECG, BP

Answer 155

Fever >5 d + ≥4/5: Conjunctivitis (non-exudative, bilateral) Rash (polymorphous) Extremity changes (erythema, edema, peeling) Adenopathy (cervical >1.5 cm, unilateral) Mucosal changes (strawberry tongue, cracked lips)

Answer 156

Echocardiogram (initial + 6 wk).

Answer 157

IVIG 2 g/kg once (within 10 d) ASA: high dose → low dose until ESR/plt normalize

Answer 158

Coronary artery aneurysm (fatal) Myocarditis/pericarditis (most common)

Answer 159

Seizures Eating disorders MAOI within 14 d Recent bupropion use Allergy

Answer 160

Insomnia ↑ BP Dry mouth Restlessness Nausea

Answer 161

Insomnia Vivid dreams Suicidal ideation Psychosis, depression Nausea, constipation

Answer 162

If BP ↑ + HR ↓ → ↑ ICP

Answer 163

No driving × 3 months (need EEG/CT + neuro referral).

Answer 164

Must be seizure-free ≥12 months + compliant.

Answer 165

Can drive if stable ≥5 years with no change.

Answer 166

No driving × 3 months after med change.

Answer 167

No driving × 6 months.

Answer 168

Eligible for all vehicles.

Answer 169

Drive only if EtOH-free + seizure-free ≥1 year.

Answer 170

No restriction if fully recovered.

Answer 171

Viral pharyngitis, Group A strep, EBV mono, CMV, HIV, Influenza.

Answer 172

Fever, Pharyngitis, Generalized LAD.

Answer 173

Heterophile Ab test (Monospot). If −: CBC diff + EBV serology (Anti-EBV IgM).

Answer 174

Supportive (fluids, analgesics, rest). Avoid amoxicillin (→ rash in EBV). Avoid contact sports × 4 weeks (splenic rupture risk). Steroids if airway obstruction.

Answer 175

Splenic rupture, Tonsillar hyperplasia → airway obstruction, Fatigue (8–12 wk recovery).

Answer 176

Fatigue, diarrhea, foul-smelling stools, Weight loss, FTT in kids, Extraintestinal: dermatitis herpetiformis, peripheral neuropathy, anemia, infertility, ↓ bone density.

Answer 177

Best serology: IgA anti-tTG (with total IgA). Confirm: small bowel biopsy (villous atrophy).

Answer 178

Strict gluten-free (avoid wheat, barley, rye; oats OK if pure). Replace deficiencies: Fe, folate, B12, Vit D, Ca. Dietitian referral. BMD baseline. Repeat serology after 6 months.

Answer 179

Malnutrition, OP/osteoporosis, Intestinal T-cell lymphoma, Autoimmune diseases, Delayed puberty/fertility issues.

Answer 180

5-ASA (mesalamine, sulfasalazine), Steroids (pred, budesonide), Immunosuppressants (azathioprine, 6-MP, methotrexate), Antibiotics (metronidazole, ciprofloxacin), Biologics (infliximab, adalimumab, vedolizumab).

Answer 181

M1 antagonist: Scopolamine, H1 antihistamine: Dimenhydrinate, diphenhydramine, D2 antagonist: Metoclopramide, prochlorperazine, haloperidol, 5-HT3 antagonist: Ondansetron.

Answer 182

Long sleeves, tucked-in clothing, Insect repellents (DEET, picaridin), Insecticide-treated bed nets, Avoid dusk–dawn outdoors, Remove stagnant water.

Answer 183

Mefloquine contraindicated if: seizures, psychosis, depression, schizophrenia, conduction defects.

Answer 184

Nausea, vomiting, diarrhea, Pruritus, dizziness, vivid dreams, insomnia, Rare: psychosis, hallucinations.

Answer 185

Joint space narrowing (asymmetric), Subchondral sclerosis, Subchondral cysts, Osteophytes.

Answer 186

Symmetric joint space narrowing, Bony erosions, Cartilage loss, MRI/US more sensitive early.

Answer 187

TCA (amitriptyline, nortriptyline), Anticonvulsants (gabapentin, pregabalin), SNRI (duloxetine, venlafaxine).

Answer 188

Topical lidocaine, Capsaicin cream, Opioids only if refractory.

Answer 189

Urethral swab for GC/Chlam NAAT, Midstream urine culture, Urine NAAT for GC/CT.

Answer 190

Ceftriaxone 250 mg IM once + doxycycline 100 mg BID × 10–14 d. Rest, scrotal support, NSAIDs.

Answer 191

Eye 4, Verbal 5, Motor 6. ## Footnote Max 15, min 3.

Answer 192

1️⃣ Skilled clinician 2️⃣ Community-based discipline 3️⃣ Resource to a defined population 4️⃣ Patient–physician relationship is central

Answer 193

Viral (most common), bacterial, TB, fungal, trauma, malignancy, autoimmune (SLE, RA)

Answer 194

Sharp pleuritic chest pain → better leaning forward, worse supine; fatigue; exercise intolerance; fever

Answer 195

Pericardial friction rub; sinus tachycardia

Answer 196

Diffuse ST elevation; PR depression

Answer 197

Pericardial effusion; constrictive pericarditis; tamponade (Beck triad: ↑JVP, hypotension, muffled heart sounds)

Answer 198

NSAIDs ± colchicine; steroids if autoimmune/refractory; bacterial: IV Vanco + ceftriaxone; tamponade: pericardiocentesis + urgent surgical referral

Answer 199

Athletes; older age; obesity; leg length discrepancy

Answer 200

Heel pain (medial calcaneus); worse with 1st steps in AM or after rest; worse with running, prolonged standing

Answer 201

Pain with passive dorsiflexion; pain standing on tiptoes

Answer 202

Calcaneal stress fracture; Achilles tendinitis; gout

Answer 203

X-ray usually normal; US: fascia thickness >4 mm

Answer 204

NSAIDs, ICE; orthotics, stretching, strengthening; night splints; steroid injection if refractory; ortho referral

Answer 205

Neural tube defects; FTT; developmental delay

Answer 206

Pancytopenia; peripheral neuropathy; papillary atrophy (glossitis); posterior cord involvement (sensory ataxia); pyramidal tract signs (paraplegia, incontinence)

Answer 207

Oral: 2000 mcg daily × 2 wk → 1000 mcg daily maintenance; IM: 1000 mcg daily × 1–2 wk → monthly for life (if pernicious anemia)

Answer 208

Osteoarthritis / degenerative; osteomyelitis (incl. TB, Potts); spinal epidural abscess; malignancy (mets, myeloma); compression fracture (osteoporosis, steroids, HIV)

Answer 209

Spinal immobilization + urgent ortho/neurosurg consult

Answer 210

Consent if able; pre-oxygenate (bag–mask O₂); prepare equipment: tube size, suction, meds; confirm placement: auscultation, EtCO₂, chest rise; monitor SpO₂, ECG, BP

Answer 211

Warm CREAM: Fever > 5 days + ≥4/5: Conjunctivitis (non-exudative, bilateral); rash (polymorphous); extremity changes (erythema, edema, peeling); adenopathy (cervical, >1.5 cm); mucosal changes (strawberry tongue, cracked lips)

Answer 212

Echo (baseline + repeat 6 wk)

Answer 213

IVIG 2 g/kg once (<10 days); ASA high dose → then low-dose until ESR/platelets normalize

Answer 214

Coronary aneurysm

Answer 215

Myocarditis/pericarditis

Answer 216

Seizure disorder; eating disorder; MAOI use in past 2 weeks; Bupropion allergy/previous use

Answer 217

Insomnia; ↑BP; dry mouth; restlessness; nausea

Answer 218

Insomnia, vivid dreams; suicidal ideation, psychosis; depression; nausea, constipation

Answer 219

Grade 1: AMS <15 min → may return same day if sx resolved; Grade 2: AMS >15 min → out ≥1 wk, return if asymptomatic; Grade 3: LOC <1 min → out ≥1 wk, imaging, admit if needed; Grade 3: LOC >1 min → out ≥2 wk, admit, imaging

Answer 220

↑BP + bradycardia = ↑ICP (Cushing’s triad)

Answer 221

Basal skull fracture (Battle’s, raccoon eyes, CSF leak); suspected open/depressed skull fracture; vomiting ≥2; age ≥65; GCS <15 at 2h post-injury

Answer 222

3 mo after single seizure, 12 mo seizure-free after dx, 5y stable for sleep-only seizure

Answer 223

Viral (adenovirus, EBV, CMV, HIV, influenza, coxsackie, HSV) Bacterial (GAS, Mycoplasma, Chlamydia, GC, diphtheria)

Answer 224

Fever Pharyngitis Generalized LAD

Answer 225

Monospot (heterophile Ab) If negative: CBC + EBV serology (anti-EBV IgM/IgG)

Answer 226

Supportive: hydration, analgesia, rest Steroids if airway obstruction

Answer 227

Splenic rupture → avoid contact sports x4wk Tonsil hypertrophy/airway obstruction Hepatitis

Answer 228

↑ C. diff risk ↓ Mg, ↓ Ca absorption → osteoporosis, fractures ↓ Vit B12 absorption ↑ Pneumonia

Answer 229

Weight loss Anemia Dysphagia/odynophagia Melena/hematemesis Persistent sx despite max therapy Age >50 new sx

Answer 230

Bones, stones, groans, psychiatric overtones N/V, constipation, arrhythmia, weakness, polyuria/polydipsia, confusion

Answer 231

IV fluids Calcitonin (fast) IV bisphosphonate (zoledronic acid) Steroids (if lymphoma/MM) Dialysis if severe/refractory

Answer 232

Radiation ADT (GnRH analogues, orchiectomy) Bisphosphonates/denosumab Analgesia

Answer 233

RUQ pain, fever, leukocytosis

Answer 234

Murphy’s sign (inspiratory arrest) Guarding, rebound

Answer 235

↑ WBC Mild ↑ ALP, AST/ALT, bilirubin

Answer 236

US (first line) HIDA if uncertain

Answer 237

Empyema, gangrene Perforation Gallstone ileus Cholangitis, pancreatitis

Answer 238

NPO, IV fluids, analgesia IV abx (ceftriaxone + metronidazole) Surgical referral

Answer 239

Female sex FHx anxiety/depression Trauma/abuse Stressful life events Substance use Childhood shyness/overprotection

Answer 240

CBT, counselling, relaxation, mindfulness Group therapy, stress reduction

Answer 241

SSRI, SNRI (first-line) Benzos (short-term only)

Answer 242

STUDENTS FEAR 3Cs Sweating, Trembling, Unsteady, Derealization, Excess HR, Nausea, Tingling, SOB, Fear, Chest pain, Chills

Answer 243

Hypoxia, hypoglycemia, stroke, infection, withdrawal, meds (steroids, stimulants)

Answer 244

Recognize early, de-escalate (calm tone, boundaries, stand near exit) Involve family/security if needed Address underlying cause

Answer 245

Lorazepam, diazepam Haloperidol ± benztropine

Answer 246

NPH (“wet, wobbly, wacky”) Multi-infarct dementia (CVD) Subdural hematoma Brain tumor/metastases CJD Severe depression (“pseudo-dementia”)

Answer 247

Hearing/vision impairment Endocrine/metabolic: hypothyroid, anemia, DM, malnutrition Psych: ADHD, depression, PTSD Social: language barrier, bullying

Answer 248

Screen vision/hearing CBC, TSH Mental health assessment School support

Answer 249

Psychogenic → depression, anxiety, OSA, fibromyalgia, CFS Sedentary lifestyle Vascular → stroke, TIA Infectious → TB, mono, HIV, hepatitis Neoplastic → malignancy Nutrition → iron, B12, folate deficiency Drugs → BB, benzos, antihistamines Idiopathic Chronic disease → CHF, COPD, CKD, CLD Autoimmune → SLE, RA, PMR Toxins → EtOH, heavy metals Endocrine → hypothyroid, DM, Addison’s, Cushing’s

Answer 250

Multiple MVCs last 5 yrs, caregiver/family concern, aggression/impulsivity, MMSE ≤24, self-restricted driving.

Answer 251

Clinical Dementia Rating ≥1, on-road OT driving assessment.

Answer 252

Opioid overdose.

Answer 253

Airway, O₂, IV access, monitor ECG, glucose, pupils.

Answer 254

Tremor (resting, pill-rolling, unilateral), rigidity (cogwheel, lead-pipe), akinesia/bradykinesia (slow, ↓ initiation), postural instability (late).

Answer 255

Masked facies, hypophonia, micrographia, sleep disturbance, seborrhea.

Answer 256

HTN, CAD, MI, HF, valvular disease, thyrotoxicosis, PE, pneumonia, hypoxia, hypoK/Mg, EtOH ('holiday heart'), ASD, sick sinus.

Answer 257

12-lead ECG, echocardiogram, CBC, INR/PTT, renal/liver panel, TSH, fasting glucose, lipids.

Answer 258

Option 1: Continue DOAC, delay dose 4–6h after procedure, use tranexamic mouthwash. Option 2: Hold morning dose, resume next day.

Answer 259

Narcotic bowel syndrome, constipation, IBS, IBD, celiac, peptic ulcer, GERD, gallstones, renal stones, ovarian issues, malignancy.

Answer 260

Carbs 45–60%, protein 15–20%, fat 20–35%, <9% total energy from saturated fat, high fibre 30–50 g/d, low GI, avoid refined carbs, limit EtOH.

Answer 261

150 min/wk aerobic, 2+ sessions resistance/wk.

Answer 262

Weight loss 5–10%, smoking cessation.

Answer 263

Children: intermittent grief, limited understanding of death, may need help remembering deceased, longer grief period, depend on caregiver. Adults: continuous grief awareness, mature understanding, fully developed memories, shorter grief period, independent.

Answer 264

Anxiety, depression, headaches, GI upset, HTN, poor sleep, relationship problems.

Answer 265

Exercise, mindfulness/meditation, breathing exercises, progressive muscle relaxation, counselling/CBT, social support, problem-solving, stressor management.

Answer 266

Low SES, pregnancy, disability, age 18–24, substance use, history of abuse.

Answer 267

Recognize: screen for IPV, relate: assess readiness for change, refer: resources, shelters, crisis line, social work, ask about weapons, create safe exit plan, document carefully, support autonomy.

Answer 268

Create urgency, build guiding coalition, develop vision & strategy, communicate vision, empower broad-based action, generate quick wins, consolidate gains, anchor new approaches in culture.

Answer 269

Maternal: multiparity, cervical incompetence, infection, low SES, poor nutrition; Fetal: congenital anomalies, multiple gestation; Past obstetric: short interpregnancy interval, prior PTD; Other: tobacco, alcohol, cocaine, polyhydramnios; Comorbid: DM, thyroid disease, HTN, periodontal disease.

Answer 270

Maternal alcohol use, low birth weight, developmental delay, facial features: flat midface, microcephaly, short palpebral fissures, long smooth philtrum, thin upper lip, CNS dysfunction.

Answer 271

PROM >18h, maternal fever, chorioamnionitis, maternal GBS status, prematurity.

Answer 272

CBC, CRP, blood culture, urine C&S, lumbar puncture, CXR if respiratory symptoms, glucose, lytes.

Answer 273

Ampicillin + Gentamicin.

Answer 274

Psychogenic, sedentary lifestyle, vascular, infectious, neoplastic, nutrition, drugs, idiopathic, chronic illness, autoimmune, toxins, endocrine.

Answer 275

Ethnicity (thalassemia), low-iron diet, pallor.

Answer 276

Microcytic → check ferritin + Hb electrophoresis.

Answer 277

Macrocytic → check reticulocyte count, B12.

Answer 278

Shared genetics (thal trait), diet, financial limitation.

Answer 279

Depression, hypothyroidism, anemia, pregnancy.

Answer 280

Melatonin, antihistamines.

Answer 281

Hashimoto’s thyroiditis (autoimmune).

Answer 282

Fatigue >4 mo, not relieved by rest, causes dysfunction + ≥4 of: new HA, sore throat, tender LN, myalgia/arthralgia, unrefreshing sleep, post-exertional malaise, memory/concentration deficit.

Answer 283

Fibromyalgia, anemia, TB, HIV, MG, hypothyroid, DM, OSA, malignancy.

Answer 284

CBC, TSH, LFT, lytes, FBG, iron, sleep study.

Answer 285

Reassurance, sleep hygiene, CBT, pacing/exercise, support groups.

Answer 286

Treat depression/anxiety, NSAIDs for pain.

Answer 287

Use only in Acute Vestibular Syndrome (continuous vertigo + nystagmus).

Answer 288

Abnormal corrective saccade → peripheral; normal → central (stroke).

Answer 289

Horizontal, unidirectional → peripheral; vertical, bidirectional → central.

Answer 290

Skew deviation → central.

Answer 291

Unsafe if: Multiple MVAs, self-restricted driving/family concern, aggression/impulsivity, MMSE ≤24.

Answer 292

Clinical Dementia Rating ≥1 → unsafe. On-road OT driving test.

Answer 293

Likely cause: opioid overdose. Immediate drug: Naloxone (0.4–2 mg IV/IM q2–3 min, up to 10 mg).

Answer 294

Tremor (resting, pill-rolling), rigidity (cogwheel, lead-pipe), akinesia/bradykinesia, postural instability. ## Footnote Other features: shuffling gait, mask-like facies, micrographia, hypophonia, sleep disturbance.

Answer 295

HTN, cardiomyopathy, valvular disease, MI, pericarditis, ASD.

Answer 296

Hyperthyroidism, PE, pneumonia, OSA, EtOH ('holiday heart'), hypokalemia/magnesemia.

Answer 297

Rheumatic heart disease, sick sinus.

Answer 298

ECG, Echo (size, EF, valves), CBC, INR, renal/liver, TSH, glucose, lipids.

Answer 299

Bleeding risk: low. Options: Hold DOAC on day of procedure, resume next day; Continue DOAC, but delay dose 4–6h post-procedure + use tranexamic acid mouthwash.

Answer 300

Narcotic bowel syndrome, ectopic pregnancy, ovarian torsion, nephrolithiasis, constipation, bowel obstruction, malignancy, biliary colic, hepatitis.

Answer 301

Carbs 45–60%, protein 15–20%, fat 20–35% (<9% sat fats), low GI carbs, ↑ fibre (30–50 g/day), limit EtOH.

Answer 302

Exercise: 150 min/week aerobic + resistance ≥2x/week. Weight loss: 5–10% if overweight. Lifestyle: smoking cessation, stress mgmt, consistent carb intake.

Answer 303

Intermittent grief, limited understanding of death, limited memory pre-puberty, grieve longer, depend on caregiver.

Answer 304

Continuous grief awareness, mature understanding of death, complete memory of deceased, independent in basic needs.

Answer 305

Risk of prolonged grief, PTSD, depression, anger, loss of security.

Answer 306

Violence, alcohol, tobacco, drugs, risky sex, eating disorders, crime/law-breaking.

Answer 307

Stage of change (not ready), ambivalence, no internalized risk perception.

Answer 308

Stop at age 74 (if previous normal screens).

Answer 309

Opioid toxicity, Opioid withdrawal, Hypoxia, Brain metastases, Infection (PNA, UTI), Stroke/TIA, Hypercalcemia (paraneoplastic)

Answer 310

After 12 months trying

Answer 311

After 6 months

Answer 312

Immediately

Answer 313

Sooner if hx: PID, pelvic surgery, chemo/radiation, recurrent miscarriage, severe endometriosis

Answer 314

Both partners

Answer 315

Multiparity, cervical incompetence, STI/UTI, vaginitis, low SES, poor nutrition

Answer 316

Congenital anomaly, multiple gestation

Answer 317

PROM, polyhydramnios, short interpregnancy interval, prior preterm delivery, age <17 or >35, smoking/EtOH, physical abuse, OSA, DM/HTN, uterine anomalies

Answer 318

Maternal EtOH use, LBW, cognitive/attention deficits

Answer 319

Flat midface (maxillary hypoplasia), Microcephaly, Short palpebral fissures, Long smooth philtrum, Thin upper lip

Answer 320

ADHD, learning disability, intellectual impairment

Answer 321

Ask about: PROM >18h, Maternal GBS status, Maternal fever / chorioamnionitis, Prematurity

Answer 322

Psychogenic → depression, anxiety, OSA, fibromyalgia, CFS; Sedentary lifestyle; Vascular → stroke, TIA; Infectious → mono, TB, HIV, hepatitis; Neoplastic → malignancy; Nutrition → IDA, B12, folate deficiency; Drugs → BB, benzos, antihistamines, anticholinergics; Idiopathic; Chronic illness → CHF, COPD, CKD, CLD; Autoimmune → SLE, RA, PMR; Toxins → EtOH, heavy metals; Endocrine → hypothyroid, DM, pregnancy, Addison’s, Cushing’s

Answer 323

Unexplained persistent fatigue >4 mo + dysfunction + ≥4: Impaired memory/concentration, Sore throat, tender LNs, Myalgia/arthralgia, Non-restorative sleep, New HA, Post-exertional malaise >24h

Answer 324

Fibromyalgia, anemia, depression, mono, HIV, TB, hypothyroid, DM, malignancy, OSA

Answer 325

CBC, TSH, LFTs, lytes, glucose, iron, sleep study

Answer 326

Reassurance, sleep hygiene, CBT, support groups, graded exercise, antidepressants, NSAIDs

Answer 327

Use if: acute vestibular syndrome (continuous vertigo + nystagmus)

Answer 328

Abnormal (corrective saccade) → peripheral; Normal → central

Answer 329

Unidirectional horizontal → peripheral; Vertical/torsional/bidirectional → central

Answer 330

Vertical misalignment = central cause (stroke)

Answer 331

Multiple MVCs, Family concern, Aggressive behaviour, Self-restricted driving, MMSE ≤24

Answer 332

Clinical Dementia Rating ≥1, On-road OT driving assessment

Answer 333

Naloxone (suspected opioid overdose)

Answer 334

Post-stroke depression. Start SSRI (sertraline). Monitor suicidality.

Answer 335

Hypothyroidism. Start levothyroxine. Check anti-TPO for Hashimoto’s.

Answer 336

Lung cancer. Next → chest CT, biopsy, refer oncology.

Answer 337

Pyloric stenosis. Do abdominal US.

Answer 338

Chlamydia/Gonorrhea. Rx ceftriaxone IM + doxycycline/azithromycin.

Answer 339

Esophageal carcinoma. Do endoscopy + biopsy.

Answer 340

Severe pre-eclampsia. Admit, IV labetalol/hydralazine, MgSO₄, plan delivery.

Answer 341

Prolactinoma. Order MRI pituitary.

Answer 342

Multiple myeloma. Ix: SPEP/UPEP, bone marrow biopsy.

Answer 343

Testicular torsion. Emergency urology consult.

Answer 344

Opioid-induced delirium. Prevention: bowel regimen, review meds.

Answer 345

Cardiac tamponade. Do emergent pericardiocentesis.

Answer 346

Chickenpox (VZV). Supportive. Isolate until crusted.

Answer 347

Osteomyelitis. Treat with ceftriaxone/fluoroquinolone.

Answer 348

CRAO. Ocular massage, urgent ophthalmology.

Answer 349

Bacterial meningitis. Start IV cefotaxime + vancomycin ± ampicillin.

Answer 350

Postpartum cardiomyopathy. Echo → LV dysfunction.

Answer 351

PCP pneumonia. Rx TMP-SMX ± steroids if PaO₂ <70.

Answer 352

Pituitary adenoma. Confirm with MRI.

Answer 353

Bladder cancer. Order cystoscopy + biopsy.

Answer 354

Acute uncomplicated cystitis. Treat with nitrofurantoin x5d or TMP-SMX x3d.

Answer 355

COPD. Confirm with spirometry (FEV1/FVC <0.7).

Answer 356

Hypothyroidism. Start levothyroxine, monitor TSH.

Answer 357

Genital herpes (HSV-2). Treat with acyclovir.

Answer 358

Osteoporosis. Confirm with DEXA.

Answer 359

Scarlet fever. Treat with penicillin V or amoxicillin.

Answer 360

SLE. ANA (sensitive), anti-dsDNA (specific).

Answer 361

Parkinson’s disease. Start levodopa/carbidopa.

Answer 362

Gastric cancer. Confirm with endoscopy + biopsy.

Answer 363

Acute appendicitis. Order surgical consult.

Answer 364

Type 1 diabetes with DKA. Admit, IV fluids, insulin, correct electrolytes.

Answer 365

Menopause/perimenopause. Counsel lifestyle ± HRT if no contraindication.

Answer 366

Infectious mononucleosis (EBV). Supportive, avoid sports x4w (risk splenic rupture).

Answer 367

Subacute (de Quervain’s) thyroiditis. Rx NSAIDs ± steroids.

Answer 368

Pancreatic cancer (Courvoisier’s sign).

Answer 369

Post-strep GN. Do urinalysis, ASO titer.

Answer 370

Molar pregnancy. Evacuate uterus, monitor β-hCG.

Answer 371

Stable angina. Confirm with stress test.

Answer 372

Reye’s syndrome (post-ASA use in viral illness).

Answer 373

Microcytic anemia → iron deficiency (menorrhagia most likely).

Answer 374

Carcinoid syndrome. Check urinary 5-HIAA.

Answer 375

Esophageal varices. Start octreotide + ceftriaxone, urgent endoscopy.

Answer 376

Endometrial biopsy (rule out endometrial cancer).

Answer 377

TB until proven otherwise. Order sputum AFB.

Answer 378

Hand-foot-mouth disease (Coxsackie virus). Supportive care.

Answer 379

Antiphospholipid antibody syndrome. Test: lupus anticoagulant, anticardiolipin Ab.

Answer 380

Central retinal artery occlusion. Immediate ocular massage + call ophtho.

Answer 381

Bladder cancer. Confirm with cystoscopy + biopsy.

Answer 382

Peritonsillar abscess. ENT consult, IV Abx, drainage.

Answer 383

Diabetes insipidus. Do water deprivation test.

Answer 384

Bacterial meningitis. Start IV ceftriaxone + vancomycin immediately.

Answer 385

Chlamydia urethritis. Test NAAT, Rx doxycycline or azithromycin.

Answer 386

Cystinuria (inherited). Confirm with cyanide-nitroprusside test.

Answer 387

Dermatomyositis. Check CK, anti-Jo-1 Ab. Screen for malignancy.

Answer 388

Intussusception. Confirm with US. Air/contrast enema is diagnostic + therapeutic.

Answer 389

Delirium tremens. Treat with IV benzodiazepines, thiamine before glucose.

Answer 390

Acute lymphoblastic leukemia (ALL).

Answer 391

Infective endocarditis. Order 3 sets blood cultures + echo.

Answer 392

Candida vulvovaginitis. Treat with fluconazole or topical azole.

Answer 393

Lung cancer. Confirm with bronchoscopy + biopsy.

Answer 394

Chronic liver cirrhosis. Monitor for HCC with AFP + US.

Answer 395

Primary hyperaldosteronism (Conn syndrome). Confirm with aldosterone/renin ratio.

Answer 396

Strangulated inguinal hernia. Emergency surgical consult.

Answer 397

Graves’ disease. Confirm with TSH (low), free T4 (high), TSH-receptor Ab.

Answer 398

Vitamin B12 deficiency (pernicious anemia common cause).

Answer 399

Aortic dissection. Confirm with CT angiography.

Answer 400

PID. Start empiric ceftriaxone IM + doxycycline PO.

Answer 401

Cholangiocarcinoma (biliary tract cancer).

Answer 402

Substance-induced psychosis (rule out primary psych).

Answer 403

Acute pyelonephritis. Treat with oral ciprofloxacin or IV ceftriaxone if severe.

Answer 404

Addison’s disease (primary adrenal insufficiency). ## Footnote Test: AM cortisol, ACTH stimulation test.

Answer 405

Gonorrhea. ## Footnote Rx: Ceftriaxone IM + doxycycline PO.

Answer 406

Small-cell lung cancer (paraneoplastic SIADH).

Answer 407

Parkinson’s disease. ## Footnote Rx: Levodopa/carbidopa.

Answer 408

Pheochromocytoma. ## Footnote Test: Plasma free metanephrines.

Answer 409

Prolactinoma. ## Footnote Test: Serum prolactin + MRI pituitary.

Answer 410

Scarlet fever (GAS). ## Footnote Rx: Penicillin V.

Answer 411

Start anticoagulation (DOAC/warfarin).

Answer 412

Appendicitis. ## Footnote Ix: US (young F), CT (adults). Rx: Appendectomy.

Answer 413

Cardiac tamponade. ## Footnote Triad: Beck’s triad. Rx: Pericardiocentesis.

Answer 414

Transient synovitis. ## Footnote Key: Differentiate from septic arthritis (fever, toxic, high CRP).

Answer 415

Endometrial cancer until proven otherwise. ## Footnote Test: Endometrial biopsy.

Answer 416

Laryngeal cancer. ## Footnote Test: Laryngoscopy + biopsy.

Answer 417

Oral candidiasis. ## Footnote Rx: Fluconazole.

Answer 418

Behçet’s syndrome.

Answer 419

Pyloric stenosis. ## Footnote Test: Abdo US. Lab: Hypochloremic metabolic alkalosis.

Answer 420

Meningococcal meningitis. ## Footnote Rx: IV ceftriaxone ASAP.

Answer 421

HSV genital infection. ## Footnote Rx: Acyclovir.

Answer 422

Hepatic encephalopathy. ## Footnote Rx: Lactulose.

Answer 423

Long QT syndrome. ## Footnote Risk: Sudden death. Rx: Beta-blockers, avoid QT drugs.

Answer 424

Neuroblastoma (adrenal origin). ## Footnote Test: Urinary VMA/HVA.

Answer 425

Infective endocarditis (tricuspid valve). ## Footnote Rx: IV vancomycin ± gentamicin.

Answer 426

Polymyositis. ## Footnote Test: Muscle biopsy.

Answer 427

Paget’s disease of bone. ## Footnote Rx: Bisphosphonates.

Answer 428

Pancreatic cancer. ## Footnote Test: CT pancreas.

Answer 429

SAH. ## Footnote Test: Non-contrast CT; if negative → LP (xanthochromia).

Answer 430

CAP (pneumonia). ## Footnote Rx: Ceftriaxone + azithromycin.

Answer 431

Enterobius vermicularis (pinworm). ## Footnote Test: Tape test. Rx: Albendazole.

Answer 432

Sarcoidosis. ## Footnote Test: CXR, ACE level.

Answer 433

Goodpasture syndrome.

Answer 434

Testicular cancer (seminoma until proven otherwise). ## Footnote Test: US, AFP/β-hCG. Rx: Radical orchiectomy.

Answer 435

Ewing sarcoma.

Answer 436

SCFE. ## Footnote Test: Hip X-ray (frog leg). Rx: Surgical pinning.

Answer 437

Von Gierke’s disease (GSD type I).

Answer 438

Giant cell arteritis. ## Footnote Rx: High-dose prednisone immediately.

Answer 439

Myasthenia gravis. ## Footnote Test: ACh receptor Ab, EMG. Rx: Pyridostigmine.

Answer 440

Idiopathic intracranial HTN. ## Footnote Rx: Acetazolamide.

Answer 441

Ulcerative colitis.

Answer 442

Bronchiectasis. ## Footnote Cause: CF, infection. Rx: Airway clearance, Abx.

Answer 443

DiGeorge syndrome (22q11). ## Footnote Features: Hypocalcemia, cardiac defects, cleft palate.

Answer 444

Infectious mononucleosis (EBV). ## Footnote Test: Monospot, avoid amoxicillin.

Answer 445

Pituitary apoplexy. ## Footnote Rx: High-dose steroids + neurosurg consult.

Answer 446

Cryoglobulinemia.

Answer 447

Celiac disease. ## Footnote Test: IgA-tTG, duodenal biopsy.

Answer 448

Pericarditis. ## Footnote ECG: Diffuse ST elevation, PR depression. Rx: NSAIDs + colchicine.

Answer 449

Testicular torsion. ## Footnote Rx: Immediate surgical detorsion.

Answer 450

Croup. ## Footnote Rx: Dexamethasone ± nebulized epinephrine.

Answer 451

Esophageal cancer. ## Footnote Test: Endoscopy + biopsy.

Answer 452

Wiskott–Aldrich syndrome (X-linked). ## Footnote Triad: Eczema, low platelets, infections.

Answer 453

Zollinger-Ellison syndrome (gastrinoma). ## Footnote Test: Fasting gastrin, secretin stimulation test.

Answer 454

Levothyroxine (increase dose by ~30% once pregnancy confirmed).

Answer 455

First trimester: <2.5 mIU/L; Second/Third: <3.0 mIU/L.

Answer 456

ACS/MI, PE, Aortic dissection, Tension pneumothorax, Pericarditis, Esophageal rupture.

Answer 457

MONA: Morphine (if pain), Oxygen (if hypoxemic), Nitrates (unless RV infarct or PDE5), ASA.

Answer 458

Severe dyspnea, O₂ sat <90% on RA, confusion, hemodynamic instability, inadequate response to outpatient therapy.

Answer 459

Amoxicillin or Doxycycline (depending on local resistance).

Answer 460

Asthma, Viral bronchiolitis, Foreign body, GERD, CF, Congenital airway anomaly.

Answer 461

Spirometry: FEV1/FVC <0.8 with reversibility >12%.

Answer 462

Gallstones, Alcohol.

Answer 463

Lipase (3× upper limit normal), CT (if severe/uncertain).

Answer 464

IV fluids (aggressive), pain control, NPO.

Answer 465

Epinephrine 0.3–0.5 mg IM (1:1000), repeat q5–15 min PRN.

Answer 466

H1 blocker, H2 blocker, corticosteroid, SABA neb, fluids.

Answer 467

Mammogram q2y from age 50–74.

Answer 468

Age, BRCA1/2, family history, nulliparity, early menarche, late menopause, obesity, alcohol.

Answer 469

Sunken eyes, delayed cap refill, tachycardia, weak pulse, lethargy, no tears, oliguria.

Answer 470

NS 20 mL/kg.

Answer 471

Elevated mood, decreased need for sleep, pressured speech, grandiosity, distractibility, risky behaviors.

Answer 472

Lithium, Valproate, or Atypical antipsychotic.

Answer 473

≥140/90 mmHg.

Answer 474

Thiazide, ACEi/ARB, CCB.

Answer 475

SABA (salbutamol) via MDI + spacer.

Answer 476

O₂ sat <92%, unable to speak/feed, exhaustion, poor response after 3 nebs.

Answer 477

Joint space narrowing, osteophytes, subchondral sclerosis, cysts.

Answer 478

Weight loss, exercise, acetaminophen/NSAIDs PRN, PT.

Answer 479

Hyperglycemia, Ketosis, Metabolic acidosis.

Answer 480

IV fluids.

Answer 481

Once K⁺ >3.3 mmol/L.

Answer 482

LDL ≥5 mmol/L, Framingham >20%, diabetes >40y or >30y with >15y duration, CKD.

Answer 483

<2 mmol/L or ≥50% reduction.

Answer 484

Urine culture (catheter or suprapubic in <3y).

Answer 485

Renal/bladder US ± VCUG.

Answer 486

PCI within 90 min or fibrinolysis if <12h from onset and PCI not available <120 min.

Answer 487

Prior ICH, ischemic stroke <3mo, active bleed, suspected aortic dissection.

Answer 488

Polypharmacy, vision impairment, neuropathy, environmental hazards, orthostatic hypotension, balance/gait disorder.

Answer 489

Multifactorial: exercise, review meds, home safety, vision/hearing correction.

Answer 490

Ampicillin + Cefotaxime.

Answer 491

Ceftriaxone + Vancomycin.

Answer 492

↓Hb, microcytosis, hypochromia, ↓ferritin, ↑TIBC.

Answer 493

Oral iron 3–6 mg/kg/day; reassess in 4–6 weeks.

Answer 494

Tremor (6h), hallucinations (12–24h), seizures (24–48h), DTs (48–72h).

Answer 495

Benzodiazepines (symptom-triggered).

Answer 496

Joint aspiration → negatively birefringent, needle-shaped urate crystals.

Answer 497

NSAIDs, Colchicine, or Steroids.

Answer 498

“Over the last 2 weeks, have you felt down, depressed, or hopeless?” “Over the last 2 weeks, have you had little interest or pleasure in doing things?”

Answer 499

Lorazepam 0.1 mg/kg IV (max 4 mg).

Answer 500

Midazolam IM/IN or Diazepam PR.

Answer 501

One-time abdominal US in men 65–80 who have ever smoked.

Answer 502

≥5.5 cm or rapid growth >0.5 cm/6 mo or symptomatic.

Answer 503

Tonsillar exudate, tender anterior LAD, fever, absence of cough.

Answer 504

Penicillin V or Amoxicillin.

Answer 505

Symptoms with minimal activity but comfortable at rest.

Answer 506

ACEi/ARB/ARNI, Beta-blocker, MRA, SGLT2i.

Answer 507

GCS <15 at 2h, suspected open/depressed skull fracture, basal skull signs, vomiting ≥2, age ≥65.

Answer 508

Immobilize and CT C-spine.

Answer 509

Chvostek, Trousseau, paresthesia, seizures, tetany, QT prolongation.

Answer 510

Hypoparathyroidism, Vit D deficiency, CKD, hypomagnesemia.

Answer 511

Full sepsis work-up: CBC, blood culture, urine culture, LP, CXR if resp.

Answer 512

Ampicillin + Gentamicin/Cefotaxime.

Answer 513

25 (Canada).

Answer 514

q3y if normal.

Answer 515

Drooling, Dysphagia, Distress (tripod, stridor).

Answer 516

Secure airway (intubation in OR).

Answer 517

Appendicitis, Intussusception, Malrotation/volvulus.

Answer 518

Abdominal US.

Answer 519

Confusion, Urea >7, RR ≥30, BP <90/60, Age ≥65.

Answer 520

Amoxicillin or Doxycycline.

Answer 521

Alpha-blocker (tamsulosin), 5-ARI (finasteride).

Answer 522

Hematuria, recurrent UTIs, renal impairment, retention.

Answer 523

Graves, Toxic multinodular goiter, Toxic adenoma, Thyroiditis.

Answer 524

Beta-blocker (propranolol).

Answer 525

Bulging TM, erythema, loss of landmarks, decreased mobility.

Answer 526

Amoxicillin 80–90 mg/kg/day.

Answer 527

<4.5h from onset if eligible.

Answer 528

Recent ICH, surgery, bleeding disorder, BP >185/110 uncontrolled, stroke <3 mo.

Answer 529

Pre-renal (hypoperfusion), Intrinsic (ATN, GN), Post-renal (obstruction).

Answer 530

Urine electrolytes, US for obstruction.

Answer 531

Dysphagia, odynophagia, GI bleed, anemia, weight loss, persistent vomiting.

Answer 532

Lifestyle + PPI trial.

Answer 533

Smoking cessation, exercise, statin, ASA.

Answer 534

Delayed meconium, FTT, neuro deficits, ribbon stools, bloody stools.

Answer 535

HIV ELISA (antigen/antibody).

Answer 536

Western blot or nucleic acid test.

Answer 537

Syncope on exertion, during supine, family history of SCD, palpitations, abnormal ECG.

Answer 538

Symmetric polyarthritis, morning stiffness >1h, MCP/PIP joints.

Answer 539

Methotrexate.

Answer 540

Iron deficiency, thalassemia, lead poisoning, chronic disease.

Answer 541

Periumbilical pain → RLQ, anorexia, fever, nausea.

Answer 542

Abdominal US.

Answer 543

Postmenopausal bleeding.

Answer 544

Endometrial biopsy.

Answer 545

NSAID ± Triptan.

Answer 546

≥4 migraines/month, significant disability.

Answer 547

Nitrofurantoin x5d, TMP-SMX x3d, or Fosfomycin x1.

Answer 548

Atypical symptoms, recurrent, pregnant, male, complicated.

Answer 549

12–15 mo.

Answer 550

No head control by 6 mo, No sitting by 9 mo, No walking by 18 mo, No words by 18 mo, No 2-word phrases by 2 yrs

Answer 551

Hearing test, vision screen, thyroid, CBC, ferritin, lead level.

Answer 552

Loud snoring, witnessed apnea, daytime somnolence, morning headaches, poor concentration.

Answer 553

CPAP + weight loss.

Answer 554

>500 mL after vaginal delivery, >1000 mL after C-section.

Answer 555

Tone (atony), Tissue (retained), Trauma (laceration), Thrombin (coagulopathy).

Answer 556

Uterine massage, oxytocin, IV fluids, tranexamic acid.

Answer 557

Diabetes mellitus.

Answer 558

CBC, glucose/A1C, B12, TSH, SPEP/UPEP.

Answer 559

Supportive (O₂, hydration, suction). ❌ No antibiotics/steroids.

Answer 560

<6 mo, O₂ sat <90%, apnea, poor feeding, dehydration.

Answer 561

Age ≥65, Dangerous mechanism, Paresthesias in extremities, Inability to rotate neck 45°, Midline tenderness.

Answer 562

CT C-spine.

Answer 563

Croup, Epiglottitis, Foreign body, Bacterial tracheitis, Anaphylaxis.

Answer 564

Dexamethasone PO/IM; nebulized epinephrine if severe.

Answer 565

Hypothyroidism, B12 deficiency, depression, NPH, syphilis, alcohol.

Answer 566

Cholinesterase inhibitors (donepezil, rivastigmine).

Answer 567

Headache, nausea, seizures, coma.

Answer 568

Correct slowly unless seizures (then hypertonic saline 3%).

Answer 569

Night waking, early morning vomiting, neuro deficit, seizures, personality change, rapid progression.

Answer 570

MRI brain.

Answer 571

Microcalcifications, hypoechogenicity, irregular margins, taller-than-wide.

Answer 572

Soft, systolic, musical, changes with position, no symptoms.

Answer 573

Diastolic, harsh, loud, cyanosis, abnormal pulses, poor growth.

Answer 574

BP >180/120 + end-organ damage (encephalopathy, MI, AKI, pulmonary edema).

Answer 575

IV antihypertensive (labetalol, nitroprusside). Lower MAP by ≤25% in first hour.

Answer 576

Oligo/anovulation, hyperandrogenism, polycystic ovaries on US.

Answer 577

Weight loss, OCPs for menstrual regulation, metformin if insulin resistant.

Answer 578

Pinch nostrils leaning forward for 10–15 min.

Answer 579

Silver nitrate cautery, saline spray, treat allergies.

Answer 580

ASA (or clopidogrel), statin, ACEi/ARB, manage DM/HTN.

Answer 581

Usually within 4–14 days (depending on size/severity).

Answer 582

Toddler (1–3y): Septic arthritis, transient synovitis; Child (4–10y): Legg-Calvé-Perthes; Adolescent: SCFE.

Answer 583

Joint aspiration (cell count, culture).

Answer 584

Carditis, polyarthritis, chorea, erythema marginatum, subcutaneous nodules.

Answer 585

Penicillin + NSAID.

Answer 586

CBT ± SSRI (fluoxetine).

Answer 587

Suicide risk assessment.

Answer 588

Morphine (dyspnea/pain), Haloperidol (delirium/nausea), Lorazepam (anxiety), Glycopyrrolate/Scopolamine (secretions).

Answer 589

Explore patient’s values/goals and align treatment.

BUSINES CLASS 2 Flashcards

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