1
Q
What is the triad of Wernicke encephalopathy?
A
confusion, ataxia, and ophthalmoplegia
2
Q
What is the BP target range in a SAH? What is the BP med of choice?
A
systolic less than 160
Nimodipine
3
Q
What antibiotics are associated with an increased risk of pyloric stenosis?
A
macrolides
4
Q
What are the 3 components of Hesselbach’s triangle? What dx is it associated with?
A
rectus abdominis muscle
the inferior epigastric vessels
Poupart ligament
DIRECT inguinal hernia
5
Q
What acid base disturbance is a post-op laparoscopic sx pt most at risk for? What is the MC underlying cause?
A
metabolic alkalosis
Volume contraction combined with gastric fluid loss is the most common cause.
6
Q
Which of the following is a known common side effect of using etomidate for rapid sequence induction?
A
myoclonic jerks
7
Q
Heathcare needlestick and nothing is known about the pt, what is given to the healthcare member prophylaxis?
A
HIV and hep B after good wound wash out
8
Q
What is the prophylaxic tx regimen for a healthcare worker needlestick to HIV?
A
4-week regimen of tenofovir 300 mg PO daily, emtricitabine 200 mg PO daily, and raltegravir 400 mg PO twice a day.
9
Q
Which of the following is the most common benign cause of large bowel obstruction?
A
volvulus
10
Q
What type of basal call carcinoma is the MC?
A
nodular
11
Q
What layer of the adrenal gland is responsible for the production of catecholamines?
A
adrenal medulla
12
Q
technetium-99m pertechnetate scan. What dx?
A
Meckel diverticulum scan
13
Q
What is the presentation of a Meckel diverticulum in a kiddo aged 10 and younger?
A
hematochezia
14
Q
What is the presentation of meckel diverticulum in adults?
A
gastrointestinal obstructive symptoms, such as abdominal pain, nausea, vomiting, fever, or obstipation secondary to a small bowel obstruction or volvulus that developed as a complication
15
Q
What is Meckel diverticulum caused by?
A
caused by incomplete obliteration of the vitelline duct
and has all 3 layers of the small intestine
16
Q
“bent inner tube” on abdominal xray. What dx?
A
sigmoid volvulus
17
Q
What dx? What is the tx?
A
sigmoid volvulus
sigmoidoscopy
18
Q
What is the best location for the filter tip of the vena cava filter?
A
at the inflow of the renal veins
19
Q
Where do PEs most commonly orginate from?
A
most commonly from deep veins of the lower extremity above the knee (iliofemoral vein
can also arise from the deep veins of the pelvis
20
Q
What 3 lab values are used to test protein status in a pre-op pt?
A
serum albumin, serum transferrin, and serum prealbumin
21
Q
What lab value best assesses short-term protein nutritional status?
A
prealbumin
22
Q
What is the MC cause of upper GI bleeding?
A
peptic ulcer disease
duodenal ulcers are more common that gastric ulcers
23
Q
Gastric ulcers tend to cause pain _____ after eating, while duodenal ulcers tend to cause pain ______ after meals
A
gastric: shortly
duodenal: 2–5 hours
24
Q
What is the Boas sign?
A
pain radiating to the right scapula in cholecystitis
25
What is the classic triad for kidney malignancy?
abdominal mass
flank pain
hematuria
26
compartment pressure above _____ is a medical emergency and should have an emergent fasciotomy
30mmHg and above
27
What type of esophageal cancer is associated with GERD/Barrett's esophagus?
adenocarcinoma
28
What type of esophageal cancer is associated with smoking and alcohol use?
squamous cell carcinoma
29
What is Plummer-Vinson syndrome?
A triad of dysphagia, esophageal webs, and iron deficiency anemia.
30
What are the 4 degrees of internal hemorrhoids?
31
What type of breast cancer is MC?
invasive ductal carcinoma
32
What medications should be prescribed to the patient after incision and drainage of a perianal abscess?
Antibiotics, stool softeners, and analgesics.
33
What location of esophageal varices is most likely to bleed?
Varices that are closest to the gastroesophageal junction are the thinnest and most likely to hemorrhage
34
What are the drugs of choice for active acute esophageal varices?
Pharmacotherapy agents, such as vasopressin and nitroglycerin, can be used to stop acute bleeds as well as to decrease portal resistance
35
Crohns or UC more likely to have anal fistulas?
crohns
36
What is the tx for postoperative drug eruption?
topical triamcinolone and hydroxyzine 25 mg PO tid for 7 days.
37
When are postoperative drug eruptions most likely to occur? What timeframe?
typically occur 5–14 days after initial exposure to the offending agent.
38
After how many hours of arterial occlusion does the risk of compartment syndrome increase?
4 hours
39
Which patients would not be amenable to endoscopic biliary drainage?
Patients with a history of any of the following: Roux-en-Y anastomosis, Whipple resection, or duodenal narrowing.
40
How long after completing treatment should a patient be tested to confirm eradication of Helicobacter pylori?
4 weeks after completing abx
41
What is the quadruple therapy for H pylori?
Tetracycline
Omeprazole
Metronidazole
Bismuth
TOMB
42
What is triple therapy for H. pylori?
Clarithryomycin
Amoxicillin
PPI (omeprazole)
43
What is the underlying cause of central DI? Nephrogenic DI?
decreased secretion of ADH
decreased sensitivity to ADH in the kidneys
44
What drug in high doses is known to cause nephrogenic DI?
lithium
45
What test should you order to differentiate between central and nephrogenic DI?
Water deprivation followed by administration of vasopressin (ADH)
46
What is the drug of choice for central DI tx?
desmopressin
47
What is the drug of choice for nephrogenic DI tx?
NSAIDs (indomethacin)
Thiazide diuretics
48
What kind of hypertension is common in pts with hypothyroidism? Hyper or hypo active reflexes?
diastolic HTN
hypoactive reflexes
49
Markedly elevated fasting serum gastrin. What dx? What level is common to see?
levels are associated with gastrinoma or Zollinger-Ellison syndrome
oversecretion of gastric acid. Fasting serum gastrin levels > 10 times the upper limit of normal
50
What are the 3 common symptoms of Zollinger-Ellison syndrome?
diarrhea
weight loss
peptic ulcer disease
51
name this sign. What dx is it associated with?
apple core sign
colorectal carcinoma
52
What is the most commonly used system for staging of colorectal carcinoma?
Dukes staging system
53
What is the gold standard diagnostic test for cholangitis?
ERCP
54
When should vitamin K be administered to patients with acute cholangitis?
If the patient has hypoprothrombinemia as a result of liver damage secondary to cholangitis
55
By what mechanism does a Roux-en-Y procedure promote weight loss?
by bypassing most of the stomach, duodenum and proximal jejunum
56
What is the tx for a perforated PUD?
Initial treatment should include intravenous fluids, nasogastric suctioning, intravenous proton pump inhibitor (PPI), and broad-spectrum antibiotics. Urgent surgical consultation should be obtained after initial hemodynamic stabilization to repair the perforated bowel and limit ongoing abdominal contamination.
57
What are transudative effusions caused by?
secondary to increased hydrostatic or decreased oncotic pressures in normal capillaries
58
What is the MC cause of transudative effusion?
CHF
59
Transudative effusions will have a ratio of ______ to _____ will be _____, and the ratio of pleural fluid _____ to serum ____ will be _____
pleural fluid PROTEIN to serum PROTEIN less than or equal to 0.5
LDH LDH less than or equal to 0.6
60
What are exudative effusions caused by?
are secondary to increased production of fluid in the pleural space secondary to abnormal capillary permeability, decreased lymphatic clearance, or pleural space infection
61
What is the MC cause of acute lower GI bleeding?
diverticular bleeds
62
What are the risk factors for diverticulosis?
low-fiber diet
Ehler-Danlos syndrome
Marfan syndrome
scleroderma
63
Which sign is characterized by a palpable gallbladder on physical examination from a dilated gallbladder?
Courvoisier sign
64
Polymorphonuclear leukocyte cells and abscesses in the bowel wall crypts and inflammation that is limited to the serosal and subserosal layers. Pathology finding of what dx?
UC
65
Should cilostazol be prescribed to a patient with heart failure?
No, can cause decreased survival rates in pts with heart failure
66
_____ from a nipple indicates bleeding within a mammary duct.
Bloody discharge
67
What is the precancerous breast condition that having multiple papillomas is associated with?
atypical hyperplasia
68
What anatomical location does Boerhaave syndrome most commonly involve?
left posterolateral aspect of the distal intrathroacic esophagus
69
what dx? Pt has at the left parasternal and anterior cervical region she has reproducible pain and subcutaneous emphysema that progressively worsens each time she coughs.
boerhaave syndrome
70
In what location of the prostate does benign prostatic hyperplasia occur?
the transitional zone
71
What is the most common dermatologic extraintestinal manifestation of Crohn disease?
Erythema nodosum.
72
What is ogilvie syndrome?
which is also known as an acute colonic pseudo-obstruction, typically presents in patients who are critically ill and hospitalized. It results in significant distention due to marked colonic dilation. This is evident on X-ray, which will show a significantly dilated cecum without mechanical obstruction
73
How does toxic megacolon differ in clinical presentation from Ogilvie syndrome?
Patients with toxic megacolon have fever, tachycardia, altered mental status, and more severe abdominal pain, which are typically absent in Ogilvie syndrome. They may also have a preceding history of inflammatory bowel disease or Clostridioides difficile.
74
What electrolyte abnormality is associated with post-op ileus?
hypokalemia
75
What is the typical presentation of vulvar cancer? What type of cancer is MC?
single pruritic lesion located on the labia majora
squamous cell carcinoma
76
What are the characteristics of a pancreatic tumor when a FNA is done on the fluid/tissue? give CEA level, fluid viscosity and amylase levels
Carcinoembryonic antigen > 400 ng/mL
elevated fluid viscosity
decreased amylase levels
77
What are characteristics of carcinoid syndrome?
diarrhea, flushing, wheezing, hemodynamic instability and metabolic acidosis
78
__________ can help differentiate between postoperative pneumonia and other causes of fever and infiltrates after surgery.
Elevated procalcitonin levels
79
What are the most common pathogens causing postoperative pneumonia?
Pseudomonas aeruginosa
Klebsiella pneumoniae
Acinetobacter species
Staphylococcus aureus.
80
columnar metaplasia of squamous epithelium. What dx?
Barrett's esophagus
think GERD
81
Toxic megacolon is diagnosed by radiographic evidence of colonic dilation (typically _______)
(typically > 6 cm)
82
What is a complication of toxic megacolon and Escherichia coli O157 infection?
Hemolytic uremic syndrome.
83
What is normal ABI? borderline? diagnostic? noncompressible arteries?
An ABI of 1.00–1.40 is normal
0.91–0.99 is borderline
< 0.90 is diagnostic of peripheral artery disease.
ABI > 1.40 is noncompressible
84
______ is the MC location for PAD? What artery?
calf is mc location
distal superficial femoral artery
85
At what size is a solitary lung nodule considered more likely to be malignant and is more reliably biopsied?
> 8 mm
86
Renal ultrasound that shows a peak systolic velocity above 200 cm/sec represents stenosis greater than _____
60%.
Luminal occlusion less than 60% typically does not produce any measurable hemodynamic effects
87
What are the components of Virchow triad?
circulatory stasis
endothelial injury
hypercoagulable state
88
What is phlegmasia alba dolens?
A rare complication of deep vein thrombosis (DVT) in pregnancy where the leg turns milky white.
89
What are the 4 different grades of hepatic encephalopathy?
90
What is a common initial manifestation of hepatic encephlopathy?
disturbances in sleep pattern
91
How should lactulose for hepatic encephalopathy be titrated?
2-3 loose BM per day
92
The _____ grading system is used to evaluate patients with prostate cancer.
Gleason
93
PSA levels _____ are associated with advanced disease. While localized cancers are associated with PSA levels _____
> 40 ng/mL
< 10 ng/mL
94
What is the Ranson criteria used for?
used to determine the prognosis for patients with gallstone pancreatitis.
95
What zone of the prostate does prostate cancer most commonly arises from?
the peripheral zone
96
What is the difference in the lining between a pancreatic pseudocyst and true cyst?
pseudocyst are lined with granulation tissue
true cysts are lined by epithelium
97
What gene mutation causes Familial Adenomatous Polyposis (FAP)? How is it inherited? When should a kiddo with a known family hx first get screened?
This disorder is caused by a genetic mutation involving the APC gene
autosomonal dominant
age 10 with annual screen thereafter
98
What labs tests confirm the dx of hyperPTH?
Diagnosis requires an elevated parathyroid hormone level in the presence of an elevated ionized serum calcium level
99
What are the 2 LATE findings in acute arterial occlusion?
loss of motor function
poikilothermia (feeling cool to the touch)
100
What is the tx for chronic pancreatitis?
he treatment of chronic pancreatitis involves lifestyle modification, treatment of pain, and treatment of steatorrhea and diabetes mellitus when present.
Recommended lifestyle modifications include cessation of alcohol and tobacco. Patients should be educated to eat a low-fat diet.
then add on H2 receptor blocker and PPI, analgesics
101
PANCE prep
flashcards
Decks in class (32)
# Cards
-
MC90
-
Things I Want to Remember200
-
Cardio105
-
Heart Murmurs Sounds26
-
Pulm42
-
Things -part 257
-
Peds193
-
ER201
-
Derm28
-
MSK79
-
Endo26
-
EENT47
-
Women's Health129
-
Psych143
-
GI51
-
Hem41
-
Pulm3
-
Urology21
-
Nephro29
-
Neuro38
-
ER- Part 2191
-
Antibody, labs test, etc key associations79
-
High yield questions23
-
Surgery EOR101
-
Infectious Disease38
-
Surgery EOR part 2106
-
Surgery EOR part 329
-
Professionalism12
-
Preventative screening guidelines6
-
Internal Med EOR100
-
Cardio- Part 228
-
Peds - part 29
