1
Q
epigastric pain + jaundice + courvoiseir sign + hi conjugate Bili in longterm smoker: DX, Test,
A
Cholangiocarcinoma
pancreatic cancer
CT scan
CA-99/CEA markers
2
Q
NBS to relief severe pain and jaundice in unresectable cholangiocarcinoma/pancreatic cancer
A
ERCP
3
Q
Rapid onset hirsutism
Hi androgen + virilization+US with ovarian cyst
A
PCOS
4
Q
Rapid onset hirsutism
Hi androgen + virilization+ hi 17 hydoxyprogesteron
A
nonclassic CAH
5
Q
Rapid onset hirsutism
Hi androgen + virilization+ galactorrhea/ amenorrhea
A
prolactinoma
6
Q
Rapid onset hirsutism
Hi androgen + virilization+ moon face, buffalo hump
A
cushing
dexa not suppress/ hi 24 hr urine cortisol
7
Q
Rapid onset hirsutism
Hi androgen + virilization+hat/ shoes does not fit
A
acromegaly
8
Q
delirium
A
acute, fluctuating attetion, distrubance in thinking and conciousness
9
Q
Delirium + fever, crackle, leukocytosis
NBS
A
UTI and Pneumonia
CRX, UA, CBC, CMP, medication review
10
Q
risk factor
pleural effusion
A
smoking–> malignacy
11
Q
NBS pleural effusion sign
low breath sound, friction rub, dull to percussion
A
X-ray
thoracetesis
12
Q
low protein
characteristics of Nephrotic syndrome
A
massive edema(periorbitl, ascites, anasarca)
frotty/foamy urine
weight gain
no RBC cast
Oval fat bodies- multase cross
normal complement except Lupus
13
Q
pt with low albumin, edema, hi lipid sudden flank pain
A
Renal vein thrombosis
dt hypercoagulability
14
Q
pt with low albumin, edema, hi lipid, fatty cast always sick, why
A
low IgG
dt loss of protein
15
Q
why is vit D and Ca low in nephrotic syndrom
A
Kidney function
loss of carrier protein
16
Q
nephrotic
HIV , heroin, obese pt with proteinuria
A
FSGS
17
Q
nephrotic
Kid +viral infection , low almumin
A
minimal change
18
Q
nephrotic
autoimmune, maligancy thick GBM, spike ad dome
A
membranous nephropathy
19
Q
nephrotic
kimmelsteal wilson
A
Diabetic (>10y)
20
Q
nephrotic
Chronic inflammation +Nephrotic
lab
A
AL or AA amyloid
congo red/ apple green
21
Q
RBC cast, HTN, Azotemia, Hematuria, oliguria
A
Nephretic
22
Q
Dark urine + HTN, protein<3.5
A
Nephritic
23
Q
sequence of neoplasm progression
A
AK53
APC
KRAS
P53
24
Q
Peutz-jeghers association
A
Pacreatic cancer
pigmented lips
25
Renal paillary necrosis and painless hematuria mc seen in pt with
sickle cell
chronic NSAID use
26
ADPKD associated with
aneurysm, MVP, anterior communicating artery
27
# what they have in common
Ehlers danlos, scoliosis, grave dz, marfan
MVP
Collagen disease
28
CREST mc distribution
ELbow/knees -->distal
29
G6PD
See in bld?
Inheritance?
hinz body
x-linked (boys)
Assay for dx
30
treatment for heart block
Mobitz 1 Atropine, IV fluid
Mobitz II : paces maker require
3rd degree: Pace, Dopami or epi if hypotesive
31
19 yo extreme fatigue, fever, swollen lymph node, ass w/? Neuro lesson ?
| monospot pos, downing cells
Mono
Burkets T 8-14
Primary CNS lymphoma
32
19 yo extreme fatigue, fever, swollen lymphnode
| mono neg
CMV
33
# seen in liver, inheritance
a1-antitrypson
| treatment
PAS globule in liver biopsy
Autosomal co-dominent
| a1-antitrypson
34
# pathophys
MVP
mixomatous degenegration
35
# pathophys
aortic dissection
cystic media necrosis
36
# pathophys
Aortic stenosis
calcification
37
# likely to die
AS + heart failure
pt dies in 1 year
38
PCOS + acne treatment
OCP
39
Acne treatment sequence
1. Topical Vit A
2. Topical antibiotic/ Benzoid
3. oral Antibiotic
4. Isotretinoid (prego test + 2 form of birth control)
40
what is cosyntropin
ACTH analog
does not work in 21,11,17
41
testing for lyme
| treatment
Elisa
confirm with westernblott
| Doxy, Amoxicillin, cefuroxime/IV ceftriaxone
42
# treatment
lyme carditic/minigitis
IV Ceftriaxzone
43
# DX
Chronic Bronchietesis + renal failure =
Amyloid
44
mc cause of Bronchietesis in U.S.
CF
primary ciliary dsyfunction
45
# association
Erythema nodosum
| painful erythema pretibial nodules
Fungus: cocidiomycosis
Sarcoidosis
46
confirming cushing
hi 24hr urine cortisol
night salavary cortisol
low dose dexa suppresses
47
high ACTH in chushing
ACTH dependent
Not suppressed by high dose dexa: cancer
| check inferior petrosal/MRI
48
high ACTH in chushing
| high dose dexa supresses
Petuitary adenoma
49
valves involved with rheumatoid fever
MAT
50
DX criteria for rheumatic fever
J
O
N
T
S
51
2 mc bugs associated with membrancous nephropathy
Hep B/C
52
is membranous nephropathy associated with solid cancer
yes
53
sudden flank pain + Membranous nephropathy
renal vein thrombosis
dt low antithronbin 3
54
# venous thrombosis and causes
Polycythemia
Pancreatitis
membranous Nephropathy
Hepatic Vein
Splenic vein
Renal V. thrombosis
55
Dermatomyocitis
| proximal muscle weakess
CD4
Kids
Perimysium
| associated with lung cancer
56
# lab
Dermatologist/polymyocitis
| treatment
CK--if high
MRI/muscle biopsy +EMG
| high dose steriod
57
antirior uvietis+ pretibia lesion
Sarcoid
False Neg TB
| High ACE , Ca
58
Treatment CHF
L
M
N
O
P
59
Drug that improve mortality in CHF
ACE1
BB: carvidilol, metoprolol, bisoprolol
spironolactone
isosorbid 1-nitrite
60
Pressure overload HF is a ____________ problem
diastolic
61
Volume overload HF is a _____________problem
Sistolic
62
# MOA
Milrinone
PDE 3 inhibitor
improves tissue perfusion
| used when you want to avoid tachycardia. reduces systemic and pulmonnary
63
# treatment
acalculus cholecystitis
| risk factor
percutaeous cholecystetomy
| long hospital stay, takinng PPI
64
# induration
TB test
5
10
15
Immunosuppressed pt
med student, jail
everyone
65
INH effect
Nepho/ hepatotoxic
Lupus
66
Ethambutol effect
optic neuritis, blurre vision, red-green blindness
67
# location
Batter syndrome
loop diuretic---> hypo Ca
68
# location
Gittleman syndrome
DCT--like Thiazide--Hyper Ca
69
thiazide cause
Hyper GLUC
70
gittlemen, thiazide and hemochromatosis associated with
Pyrophosphate deposition dz
71
All diastolic, 3+ systolic and symptomatic murmur must get
Echo
72
painful red lesion under the skin
intertrigo
Candida
73
Primary sclerosing cholangitis treatment
| anca
liver transplant
| P-ACA
74
beed on a strain with ERCP/ Hx of bloody diarrhea
| damages?
PSC
| intra and extra hepatic duct
75
Retinavir SE
fat redistribution
76
Indinavir SE
Nephrolithiasis
77
Stavudine SE
pancreatitis
78
AZT SE
nightmare
79
Abacavir SE
life threatening hypersensitivity
80
Hat don't fit + hearing loss + high output hrt failure
| treatment
Pagets
| Bisphosphonate
81
Female with shoulder pain + jaw pain
| NBS
Temporal arteritis
| high dose steriod
82
Primary biliary cholangitis damages
| treatment
intrahepatic bile duct
antimitochondria
| liver transplant
83
moonshiner
| treatment
lead poisoing
| EDTA, Dimercaperal > 70. <69 use succimer
84
shegella/EHEC treatment
Levofl
TMP-SMX
Amoxicillin
85
TTP trigger
| ADAMTS13/ acquire TTP
pregnancy, infections, medication
86
# symptom
TTP
| treatment
FAT RN
| plasma exchange/ rituximab
87
Renal cell cancer risk
smooking
| polycythemia
88
PE EKG
Sinus tachycardia
89
PE risk
| PH
virchow's triad
stasis
endothelia damage
hypercoag
| Resp Alkolosis
90
PE/DVT protocol
low risk----D-Dimer
High risk---CT-A
Pregant----VQ scan
91
Stable PE treatment
heparin
92
# treatmet
unstable PE
TPA
93
# NBS
pt with HIT
| confirmatory test
stop Heparin
start Agatraban
| serotonin releasing assay
94
# NBS
unstable PE with potential bleeding
Embolectomy
95
Atrial flutter pattern on EKG
saw tooth
96
# NBS
Stable Atrial flutter
corotid massage
CCB
BB
97
unstable Atrial flutter NBS
Synchronized cardioversion
98
V-tach stable
amiodorone
99
unstable v-tach
cardiovert
100
polymorphic V-tach+prolonged QT Torsades
Treatment
Magnisium IV
stop drug
101
hyperkalemia V-tach
calcium gluconate first
102
drug-induced V-tach (TCA, QT drug)
sodium bicarb
103
Lithium induced DI NBS
Triamterin/amioloride
Demeclocycline
104
Salmolella treatment
Floroquinolone, macrolade
105
3+ p wave morphology
| Electrolyte
multifocal atrial tach
| hypokalemia and hypo Mg
106
first lie for multifocal atrial tach
CCB, VIRAPAMIL/VIT D
107
Renal mass in a pt w/ Hx cardiac rhabdomyolysis ad periventricular tubers
| renal mass is a
tuberous sclerosis
| Renal agiomyolypoma
108
cholera affects
| treatment
Na-glut transport
| supportive care: ORS/ IV
109
HFE gene mutation
| associated with
C282y
| pseudogout-->CPPD: Rhomboid shaped crystal, pos biorefreingen
110
CD4 < 250
Cocidiomycosis
| itracoozole
111
CD4 <200
PCP
| Bactrim, TMP-SMS, Dapson, Pentamidine
112
CD4<150
Histoplasmosis
| Itraconozole
113
CD4<100
Toxoplamosis
114
CD4<50
MAC
| Ezythromycin
115
V-Fab treatment
EPi ad amniodorone
shock w/ Asynchronized
116
50yo w/ erectile dysfunction, vision loss and gynecomastia -->
pituitary Adeoma -- prolactine
| -->bromacriptin/carbargaline
117
# acite
SAAG gradiat>1.1
| SAAG <1.1 is
portal hypertension/Nephrotic syndrome
| Cancer
118
# acite
what to do when removing large volume of fluid
Give albumin
| ceftraxon/floroquinolone
119
acute tentenus treatment
antitoxin + vaccine
120
gardicil HPV 6/11/16/17 age
9-26
121
Bugs in sponaneous Bacterior peritonitis
| treatment
E-coli, Klebsiella, Strep pneumo
| ceftriaxon, floroquinolone give albumin
122
treatment for TTP (FATRN)
Plasma exchange
123
C. dif treatment
Metro, oral vanc, fedoxomycin, fical transplant
124
# gene
Alport
0485
Type 4 collagen
125
Stable angina
chest px w/ exertion
exercise stress
Nitro - veno dialater - low preload
126
# test
HIT
Antibody
sero assay
127
confirmatory test for osteomylitis
Bone culture
128
sinusitis, hemoptosis and hematuria=
| treatment
wagner
C-ANCA
| steriod and cyclophosphomide
129
# NBS (test)
CAD gold standard
| no stress test with EKG when baseline EKG is abnormal
CT angiogram
| Dobutamine/Dipyridamol=chemical stressor
130
Anti Hep B surface antigen
Immunized
131
core/ surface antibody
prior hep infection
132
surface antigen, core antibody, surface antibody and E antigen
| window period
Acute infection
| core antibody(IgM)
133
# Treatment
TTP
HD steroid + IVIg
Spleenectomy
134
# MOA
Central sleep apea=
| test, treatment
low resp drive
| Polysomnography, use CPAP, BPAP acetlezolemide
135
chronic OSA risk
HTN
Hypovent
CO2,
CPAP
136
HCM gene
| treatment
B myocine and heavy chain myocine binding protein C
heard at left sternal boarder
| BB/ vemprimil
137
HCM is associated with
Freigdrick Ataxia
138
Headache, Myalgias, hi fever, rash on palm/sole post hiking
RMSF
139
# RMSF
RMSF
| RMSF treatment for pregnant
Doxy even in below 8yo
| chloramphenecol
140
acute onset exmity px at the first MTP?
| treatment
Gout
| NSAID, Steriod, Colchicine
141
do you give Aspirin in Gout and why
No, Aspirin affect uric acid build up
142
chronic gout treatment and tumor lysis syndrome
Allopurinol Febustostat, 'buracase
143
Chronic Hep B treatment
| Nurse stuck with needle from infected pt
NRIT
entracitabin
Tenovovir
| Vaccine /IVIG
144
Auer rod T?
T15-17
| AML(APML) -DIC
145
Maltese cross --Hiking, tict..Northeast
| treat with
Babesiosis
| Atovoqueen
146
Muscle Strain
Paraspinal tenderness
NSAID, Excersis
147
pt feels better when shopping(flexion)
Lumbar Spinal Stenosis
148
Possitive Straight Leg raise
DJD
149
Caulda equinal syndrome
incontinence and progressive neuro deffect
150
Hx of smoking, dyspnea on exersion and fine crackle
| NBS
DLCO low
Idiopathic pulmonary fibrosis
| high resolution on CT showing Honey combing pattern
151
Dilated cardiomyopathy..dysfunction of ...
| causes
systolic
| chagas, doxyrubinson, trastuzumab, chronic Alcohol
152
Hrt sound o Dilated Cardiomyopathy
| Diagnose and treatment
S3
| Echo, BB, ACEi Diuretic
153
Palpable purpura, hi IgM, hxo Hep C, Hi complemennt
Mix cryoglobulenemia
154
MCC hepator Carcinoma inUS
Chroic Hep C
155
Dermatological Hep C manifestation
| treatment
Porphyria cutaneous Tarda
| Sofusvovir, interferon (screen for depression)
156
lytic mets
Multiple myeloma
Breast
thyroid
lung
Renal cell carcinoma
157
Blastic met
Prostate
Breast
158
chronic treatment for V-tach risk:
| Pulmonary fibrosis risk factor
pulmonary fibrosis
| Ammiodorone, metotrexic, nitroferotoin, Busofen annd bliomycin
159
Thermophillic actinomysis associated with
farmer--Barn
hypersensitivity
Fever
respiratory difficulties
160
Bronchiolitis oblitaran organizing pneumonitis present with
| treat with
RA + bilateral micronodular consolidation on CRX, respiratory symptom
| steriod
161
vatimin associated with hyperhomocysteiemia
B12, B9, B6
162
Men 1
Pituitary adenoma
parathyroid hyperplasia
pancreatic ZE syndron (gastrioma)
163
MEN 2
Parathroid hyperplasia
Pheo
Medulary thyroid cancer (MTC)
| RET gene AD, screen family
164
ME2B
Pheo, marfenoid habitus, MTC,
Mucosal neuroma
| gene RET AD. screen family
165
prophalysis for esophageal varices
BB
spironolactone
166
Hep encephalopathy treatment
lactulose
orifaxomine
TIP (IR procedure)
167
Polycythemia Vera present with?
Puritic post hot bath
Jak2
Epo-->low
HCT-->high
02 Sat--normal
shelf
flashcards
Decks in class (13)
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