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2014-11-25 22:10:34

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  1. acute asthma tx
    inhaled B adrenergic agent
  2. Legionella tx
  3. anemia: hypoxic from severe hemorrhage
    anemic hypoxia
  4. sarcoidosis tx
    systemic steroids
  5. pneumothorax tx
    immediate needle decompression
  6. pleural effusion, CHF results
    (effusion LDH
  7. pleuritic chest pain distribution
    distributed along intercostal nerves
  8. COPD risk factor
    smoking is a major risk factor
  9. PFT results
    differentiates between restrictive and obstructive
  10. body’s response to hypoxia
    first response is tachycardia
  11. pleurisy tx
  12. lung CA c metastasis staging
    stage 4
  13. spacer benefits
    makes MDI with albuterol more effective
  14. purpose of thoracentesis
    treats pleural effusion
  15. clinical sleep apnea tx:
    nasal CPAP (clinical)
  16. lymphadenopathy, elevated ACE:
  17. worst prognosis for ABG
    ABG pH 7.27; PCO2 46; PO2 56; (pH low, PCO2 high, PO2 very low)
  18. physical exam of pneumonia (tactile fremitus):
    increased tactile fremitus
  19. CF bacteria:
    pseudomonas aeruginosa
  20. physical exam of emphysema:
    bullae, blebs
  21. hypoventilation can cause:
    can cause retention of CO2
  22. most common cause of bacterial pneumonia
    strep pneumo
  23. population of primary spontaneous pneumo
    male 15-35
  24. cor pulmonale can be caused by
    recurrent PEs
  25. CHF is the most common cause of
    transudative PE
  26. COPD with combivent, additional tx;
    add Advair
  27. 19 y/o with asthma, SABA, additional tx
    add low dose inhaled corticosteroids
  28. (CF) elevated sweat chloride test: sputum culture
    haemophilus influenza + staph A
  29. physical exam of pneumonia:
    increased tactile fremitus, dull to percussion
  30. pneumo, order:
  31. PE, order:
    spiral CT of chest
  32. lifestyle tx sleep apnea;
    weight loss (lifestyle)
  33. 30 y/o asthma, albuterol; add
    ICS + LABA
  34. PET useful for:
  35. physical exam of pneumo:
  36. false/negative PPD in:
  37. mycoplasma pneumoniae tx:
  38. Thoracentesis results will be either:
  39. D-dimer: can r/o
  40. course of small cell lung CA:
    aggressive, spreads
  41. Asthma 3 things:
    smooth muscle airway constriction; mucus membrane swelling; increased mucus production
  42. complications of chest PT
    rib fractures; postural drainage (what?)
  43. Acid fast bacilli in:
  44. 35 y/o nonsmoker with emphysema think (genetics):
    alpha-1 antitrypsin
  45. sleep apnea common sx:
  46. physical exam of pleural effusion:
    dull percussion, decreased tactile fremitus
  47. egg-shell calcification of hilar lymph nodes:
  48. acute asthma PFT and tx
    low FEV1/FVC ratio; B agonist
  49. incentive spirometry for:
    post-op atelectasis
  50. HTN (on ACE) with cough:
    switch to ARB
  51. brawny edema, irregular wound:
    venous insufficiency
  52. S3 gallop, BP 158/92, HR 84, EF 45%, LVH on EKG, give
    K supplementation
  53. soft S1, blowing diastolic murmur at the sternal border
    aortic regurgitation
  54. atherosclerotic HD: what part of HPI is most important?
    current symptoms are most important
  55. boot shaped heart, RVH, small LV, small PA:
    tetrology of Fallot
  56. cholesterol, first tx
  57. widespread STE on EKG:
    pericardial friction rub
  58. RBBB in V1:
    primary positive deflection
  59. DM + HTN tx:
    ACE inhibitor
  60. 71 y/o M with DM, dyslipidemia, chest pain in the ED:
    repeat enzymes and EKG in 4-6 hr
  61. trauma pt: CP, dyspnea, cough, tachy, JVD, T wave changes; tx:
  62. STE tx:
    thrombolytic (fibrinolytic) to achieve reperfusion
  63. substernal CP blood workup:
    CPK abnormal
  64. bruits on physical exam in:
    renal artery stenosis (HTN)
  65. PAD, when to use invasive tx
    invasive if rest pain + ulcer
  66. cor pulmonale (R-sided heart failure), disease state not seen is:
    pulmonary congestion least likely; would see edema of the lower extremities
  67. supravalvular aortic stenosis murmur
    ejection murmur
  68. CP relieved with rest, no murmur, no EKG changes, no trops, further tx
    nuclear stress test
  69. newborn with “machine” murmur:
    patient ductus arteriosus
  70. hyperlipidemia pharmacotherapy:
    atorvastatin 80mg Qday
  71. IV drug user, fever, petechiae, II/III out of VI murmur:
    infective endocarditis
  72. irregularly irregular:
    a fib
  73. endocarditis affects which valve first
    tricuspid valve first
  74. leads II, III, AVF: (anterior/inferior/lateral)
  75. peaked T waves on EKG:
  76. streptokinase not for which heart condition
    not for N-STEMI
  77. follow up HTN, hyperlipidemia with this blood test
  78. infective endocarditis workup:
    2 blood cultures
  79. anteroseptal MI leads:
    V1, V2, V3, V4
  80. CHF lifestyle tx:
    prevent readmission with daily weights
  81. venous insufficiency physical exam:
    lower extremity edema
  82. 68y/o M with bovine prosthetic mitral valve:
    must have prophylaxis to endocarditis prior to dental procedure
  83. acute MI blood tests:
  84. HTN (on ACE), angina, CC of cough
    withdraw captopril
  85. CHF (SOB increased HR, edema, hepatomegaly, JVD), first tx:
    O2 therapy
  86. myocarditis, unlike endocarditis,
    not = to IV drug
  87. diastolic murmur accentuated where
    at left upper sternal border sitting up and leaning forward
  88. CAD, SOB, orthopnea, edema, no CP, EF 30%; listening to the heart would hear
    find S3
  89. BP regulation via:
  90. opening snap murmur:
    mitral stenosis
  91. varicose veins tx:
    compression stockings
  92. v fib tx:
  93. ST depression with a normal cardiac catheter
    Prinzmetals angina (coronary artery vasospasm)
  94. 48 y/o M c anterior CP, increased with breathing, coughing, orthopnea; EKG shows STE and PR depression;
    pharyngitis diagnosed as mono: give ibuprofen
  95. newborn with ducuts arteriosis tx
    increased O2 tension within the blood
  96. endocarditis bacteria:
    staph A
  97. 160/100: stage of HTN
    stage 2 HTN
  98. CHF and on HCTZ, new tx
    HCTZ —> loop diuretic (Lasix/furosemide)
  99. beta antagonists cause:
    sexual dysfunction
  100. 24 y/o F with mid systolic click with murmur
    mitral valve prolapse
  101. RV: aorta, coronary arteries, PA: LV and ventral septal defect
    transcription of great arteries
  102. on an island and only have one lipid lowering med,
    45 y/o M with LDL of 200 (because it’s 200)
  103. pt c HTN on HCTZ
    increase HCTZ to 25mg Qday
  104. GI consider this other system
    consider psychosocial
  105. GI prescriptions:
    prescribe meds carefully
  106. Vitamin K effects:
    the blood
  107. GI problems with diagnosis
    difficulty in specific cause
  108. GI issue, this physical exam
  109. peptic ulcer bleed: do not prescribe
  110. Abd pain high risk population:
  111. examine patient
  112. RLQ pain (__ sign):
    Rovsings sign
  113. jaundice: wt loss, boring abdominal pain R to back, palpable gallbladder:
    pancreatic tumor
  114. 28 y/o F; postpartum with BRB
    can be seen out patient
  115. dyspepsia: early satiety, dysphagia schedule
    upper endoscopy
  116. neuropathy, fatigue, confusion check this vitamin
    vitamin B12
  117. cause for oropharyngeal dysphagia
  118. 22 y/o F, PA school, constipation, diarrhea, bloating
  119. ascites
    caused by portal HTN
  120. esophageal spasm triggered by
    hot/cold foods
  121. 45 y/o M 3m hx difficulty swallowing solids progressed to liquids, discomfort after eating
  122. pre-malignant in the throat:
  123. 56 y/o DM F with postprandial pain, full quickly, not H pylori tx:
  124. drank heavily, severe pain radiates to back, green vomit, check the
  125. esophageal diverticulae work up with
  126. cholelithiasis hx: relieved by leaning forward tx
    NPO, bed rest, NG tube, analgesia
  127. esophageal spasm tx:
    short acting nitrates
  128. Mallory-Weiss tx
  129. alcoholic with UGI bleed, esophageal varicose dx
  130. epigastric pain, ask about NSAID use and evaluate with
    upper endoscopy
  131. long hx substernal burn after meals: columnar epithelial, bx gastric-cardiac type mucosa and intestinal mucosa —> acquired with chronic GERD
  132. burn ulcer
    curling’s ulcer
  133. h pylori tx
    2abx + PPI/H2 blocker
  134. Hep B testing
    at baseline, 1m, 6m later
  135. Red flag for sx:
    sx worse at night
  136. gym in evenings and eats late schedule
    upper endoscopy
  137. with progression: erosive esophagitis,
    Barrett’s esophagus, adenocarcinoma
  138. cholelithiasis: 5 Fs
    fat, female, fertile, forty, fair (and flatulent)
  139. plain abd Xray, CBC, CMP normal: more thorough work up with
  140. lower GI bleed cause
  141. C diff (diarrhea, after abx) tx:
  142. Italy 24/40 abd pian, bloating, chronic diarrhea tx:
    gluten free
  143. outbreak of illness at restaurant:
    hep A: self-resolving
  144. Hep B vaccine does not
    guarantee immunity
  145. liver damage from Hep C
    accumulated by ETOH
  146. vitamin D affects
    Ca++, parathyroid hormone
  147. cirrhosis, liver is:
    fatty liver
  148. cirrhosis is
    somewhat preventable
  149. food “gets stuck,” workup c:
    barium esophagography UGI
  150. acute pancreatitis caused by
  151. concerning symptom
    weight loss
  152. blood tests cannot predict severity and course of acute pancreatitis
  153. acute pancreatitis, first tx
    hemodynamic stabilization
  154. cirrhotic liver disease physical exam:
    Terry nails
  155. calcifications on pancreas:
    chronic pancreatitis
  156. locally advanced or metastatic CA of pancreas, prognosis:
    survival is poor
  157. abd surgery risk
    for SBO
  158. SBO proximally ____ and distally ____
    dilates; decompresses
  159. SBO vomiting worsens when obstruction is
  160. camping trip, 5 weeks, mild diarrhea, bulky, greasy, frothy, malodorous, no blood or pus, afebrile
  161. auscultation of SBO:
    high pitched or hypo-active bowel sounds
  162. SBO workup:
    small bowel series with barium
  163. partial SBO tx
    observe; complete: surgery
  164. Crohn’s location:
    any part of the GI tract
  165. IBD tx:
    sulfasalazine (Azulfidine)
  166. IBS presentation:
    diarrhea, constipation, alternating
  167. acute mesenteric ischemia severity:
  168. lower GI bleed workup:
  169. diverticulitis: LLQ: uncomplicated tx
    treat conservatively
  170. anemia, tTG, IGA abnormal: small bowel biopsy, tx
    educate and send to nutritionist
  171. colonoscopy screening age
    screen at 50
  172. virtual colonoscopy con:
    bx cannot be done
  173. child with diarrhea cause
  174. when to give abx with diarrhea:
    not unless documented stool infection
  175. documented pathogens
    reporting is imperative
  176. travel, consumption of unsafe foods, predisposing medical conditions, risks for what:
    risks for diarrhea
  177. infants, children with diarrhea, tx:
    oral rehydration
  178. incisional hernia, locations of incisions:
    vertical or midline incisions
  179. mess repairs of hernia, pro:
    less recurrence of hernia than open suturing
  180. groin hernia is:
    indirect inguinal
  181. diastasis recti: is not
    a hernia
  182. small pockets in esophagus:
    esophageal diverticula
  183. achelasia on Xray:
    narrowing with beak-like appearance at lower esophageal sphincter
  184. tearing pain, throbbing in anal area with defecation, BRB, cracked epithelium
    straining is the cause
  185. 32 y/o F, diarrhea constipation: no blood, wt loss
  186. abd cramping, pain, fever, diarrhea, RLQ abd pain, bowel sounds, occult blood, colonoscopy shows ulceration and mucosal edema in ascending colon not transverse or descending colon
    Crohn’s dz
  187. prostate CA, workup blood levels of:
  188. bacterial cause of UTI:
    E coli
  189. infection of kidneys and renal pelvis:
  190. sudden, at rest incontinence:
  191. spaghetti feel at inguinal canal:
  192. burning on shaft of penis, tender inguinal adenopathy:
    herpes simplex
  193. phimosis:
    inability to retract foreskin
  194. weak stream, physical exam work up:
    abdominal exam with DRE
  195. epididymitis <35 cause:
    N gonorrhea
  196. acute, colicky pain:
  197. PSA 2.2 to 6.6, otherwise WNL:
  198. Gleason:
    likelihood CA will grow and spread
  199. viagra is contraindicated with
  200. blood in urine, wt loss, infections, kidney stones, smoking, ETOH, palpable abdominal mass:
    smoking is a risk factor
  201. renal cell CA presents with
  202. painless hematuria, palpable mass:
    renal cell CA
  203. fever, chills, N/V, back pain, L flank tenderness, CVAT:
    acute pyleonephritis
  204. bladder CA tx:
  205. painless “spot” on penis” is
    syphilitic chancre
  206. painless mass in scrotum, PE WNL, can get gloved finger through both inguinal rings, mass is cystic-like:
  207. scrotum red and tense, L testicle mildly sore and swollen:
    acute orchitis
  208. warm, boggy, tender prostate at risk for STD:
  209. overdose of K on EKG:
    tall K waves
  210. tender testicular swelling caused by
  211. BPH more than CA if [age] [race] [other symptom]
    72 y/o white with poor urinary stream
  212. underdeveloped testis, not palpable:
  213. most stones lodged at
    ureterovesicular junction
  214. most common stone
    Ca oxalate
  215. paraphimosis tx:
    surgical emergency
  216. retain CO2 in COPD causes
  217. prostate CA risk factors:
    family hx is a contributing factor
  218. acute cystitis sx:
    dysuria, painful urination, foul smelling cloudy urine
  219. stress incontinence tx:
    Kegel exercises
  220. nursing home resident can’t get to bathroom, incontinence:
    functional incontinence
  221. 1m boy with UTI, workup:
    do VCUG
  222. growths on penile shaft, moist papules:
    condylomatoa acuminata
  223. pain in testicle and penis, severe tenderness at superior pole of normal-sized L testicle, tenderness with structures superior to testicle through scrotal wall, WBC
    acute epididymitis
  224. difficulties with sex, divorce, other issue to consider include
    psych issues
  225. acute testicular P, no cremasteric reflex, retracted upward, decreased blood flow via duplex
    torsion of testicle
  226. hydrocele
    non-tender fluid-filled lesion that transilluminates
  227. gonorrhea tx:
    ceftriaxone 250mg IM once and azithromycin 1g now
  228. newborn with 1 testicle
    attempt to bring testicle down from inguinal canal
  229. L shoulder P, multiple osteoblastic lesions along L ribs and L humerus workup includes:
    DRE and PSA
  230. BPH tx
    alpha-1 adrenergic antagonists
  231. prostatitis contraindications:
    prostatic massage is contraindicated
  232. RBBB in V1 is seen as a:
    positive deflection
  233. increased pain, migrates to RLQ, WBC left shift, urine clear, physical exam finding
    positive Rovsings
  234. mass in testicle, “heaviness,” lymph node noted
    testicular cancer
  235. severe testicular pain, no cremasteric response tx
    surgical consult and emergent surgical intervention (for testicular torsion)
  236. higher risk for ED
    29 y/o triathlete
  237. peaked T, lengthening PR, wide QRS
    give Ca gluconate
  238. AG metabolic acidosis blood values:
    ketones, hyperglycemia, DKA
  239. fraternity pledge drank antifreeze (ethylene glycol); blood work would show
    increased AG with metabolic acidosis
  240. dehydrated, hyponatremia, increased creatinine, increased urea
    metabolic alkalosis due to vomiting
  241. Ca oxylate crystals look like
  242. lung cancer, secondary disorder
  243. most common type of nephrolithiasis
    Ca oxylate
  244. nursing home, dementia, confused, HA, decreased Na:
    inappropriate ADH
  245. acute onset abdominal pain, RLQ to groin, colicky, N/V:
  246. proteinuria: thickening of glomerular basement membrane, irregular mass between basement membrane and overlying epithelial cells. granular deposition of immunoglobulin and complement:
    membraneous glomerulonephritis
  247. protein, liver cirrhosis, malaise, melena (GI bleed), acute tubular necrosis
    Wilson’s disease
  248. most stones at the
    ureterovesicle junction
  249. prevent stones with
  250. mass in scrotum, spermatic cord not palpable above mass, not transilluminated, can be reduced
    inguinal hernia
  251. glomerular damage; autoantibodies produced against glomerular basement membrane
  252. acute renal failure see ___ on blood smear:
    epithelial cells casts
  253. drug induced nephrotic syndrome
  254. MVA, prevent acute kidney injury by giving
    IV normal saline
  255. muscle aches, dark urine, hypercholesterolemia, hypertriglyceridemia:
    acute renal injury caused by rhabdomyolysis
  256. proteinuria blood levels:
    150mg/L over 24h
  257. cause of reversible and persistant proteinuria
  258. increased urine osmolality, decreased Na, increased BUN: creatinine: few RBC + WBC, no casts
    post-renal cause
  259. 7 y/o F, bloody urine, past fever with sore throat, acetaminophen, amoxicillin, RBC dysmorphic and indicate RBC casts:
    post infectious glomerulonephritis
  260. nephrotic syndrome common cause:
    diabetic neuropathy
  261. nephrotic or nephritic, look at:
  262. decreased blood flow, type of azotemia (pre/post/inter):
    pre renal azotemia
  263. burning urine, urethral d/c, multiple sex partners:
    Ceftriaxone 125mg IM + azithromycin 1gm PO
  264. bad smelling d/c, mild itching, thin gray-white d/c; pH 4.5, fishy with KOH, clue cells
  265. IUD not contraindicated with
  266. severe one-sided lower abdominal pain, foul discharge, fever 101 or 102, pulse 110, purulent yellow d/c, cervical motion tenderness, left adnexa swollen and tender
  267. fibroadenoma feels like a
    rubbery mass
  268. HPV tx
    resolves spontaneously in 1-2 years
  269. pelvic pain radiates to R side, no cervical motion tenderness, right adnexal area swollen and tender:
    ovarian cyst
  270. thin, foul-smelling frothy, greenish d/c, tx:
    give metronidazole
  271. gestational HTN:
    HTN after 20 weeks
  272. mass in left adnexal region, 14cm, cystic, cheesy material with hair tufts and solid area protruding into cavity, stratified squamous epithelium with underlying sebaceous-cartilage:
    dermoid cyst
  273. snowstorm appearance, grape vesicles, no fetal parts, lower abdominal pain, uterus is bigger than expected:
    complete hydatidiform mole
  274. HA, visual disturbances in pregnancy
  275. 21 y/o pregnant, vaginal bleeding work up with:
    pelvic US
  276. ovarian CA blood levels
    CA-125 levels
  277. hormone secreted by placenta in early pregnancy:
  278. most common cause of infertility in women is
    ovulatory dysfunction
  279. increased risk of breast CA:
    first live birth after 35
  280. vasomotor symptoms of menopause, give:
  281. 16 y/o amenorrhea tx:
    oral medroxyprogesterone (Provera)
  282. most common cause postpartum bleed:
    uterine atony
  283. pregnant 33 weeks, sudden severe pelvic pain and dark clotted blood, abdomen is board-like; no fetal heart tones:
    abrupt placentae
  284. 62 y/o on premarin, occasional vaginal spotting work up:
    schedule endometrial bx and/or transvaginal US
  285. 2 days abdominal pain without vaginal bleeding, closed cervix, R adnexal pain; bhCG 9000; no intrauterine gestational sac:
    ectopic pregnancy
  286. maternal HFP increased, next:
    perform amniocentesis and check AFP levels to know values for fetus
  287. Indications for C-section based on fetal HR:
    100 bpm with late decelerations
  288. endometriosis: dyspareunia, chronic pelvic pain, infertility, dysmenorrhea:
    not OCP?
  289. 30 y/o F with hypothalamic amenorrhea; decreased running intensity, fatigue, nausea, dizziness, feeling unwell. no contraception, breast tenderness, decrease appetite, wt loss work up with:
    hCG test
  290. white, thin, atrophic-appearing plaques
    lichen sclerosis
  291. hirsutism, obese, oligomenorrheic, deep voice
  292. HELLP:
    hemolysis, elevated liver enzymes, low platelets
  293. increased pelvic pain:
  294. painful, itchy blisters, increased temperature, enlarged lymph nodes, vesicles ruptured, crusted over the node tx:
    give acyclovir
  295. 1st trimester miscarriage cause:
    chromosomal abberations
  296. most common ovarian tumor
    serous cystadenocarcinoma
  297. hx cervical conization and second trimester miscarriage due to cervical dilation:
    cerclage: define
  298. chronic pelvic pain, infertility, endometriosis, confirmed with
  299. complete placenta previa at 37 weeks:
  300. endometrial ablation treats
  301. baby affected by syphilis, mom has no symptoms, which stage:
    latent stage
  302. depression with menstrual cycle tx:
  303. missed 2 periods, pain @ pelvic, work up:
    pregnancy test
  304. easiest way to diagnose pregnancy:
    hCG level
  305. infertility, FSH and estradiol levels if >35 y/o, prolactin test, semen analysis, TSH level, NOT:
    not post-coital test
  306. lower abdomen pressure, bloating, heavy vaginal bleed, dysmenorrhea, uterus enlarged with multiple nontender discrete, firm irregular masses:
    uterine leiomyomas
  307. over cervix, ______ is the concern
    placental location
  308. foul-smelling d/c, green, hx STDs (chlamydia)
  309. HPV: most serious pap is
    atypical glandular cells of undetermined significance
  310. incision with C-section, concern
    rupture of uterine scar in future pregnancy or labor
  311. undiagnosed vulvar CA sx
  312. drop in BP, boggy, high uterus, tx
    mitigate uterine contractions with massage (fundus)
  313. DM screen, standard 50g glucose challenge with fasting glucose level of 150 is abnormal
    requires further testing for dx
  314. total hysterectomy includes:
    uterus (fundus and cervix)
  315. pap testing at 33 y/o:
    pap smear with HPV or testing every 5 years
  316. What is NOT a risk factor for uterine hyperplasia
    not breastfeeding
  317. 1wk heavy d/c, severe itching, just finished abx, thick, white, curdy d/c pH 4.1; negative KOH test; tx:
  318. fixed, nodular breast mass with dimpling of overlying skin
    breast cancer?
  319. best predictor of preterm labor
    hx preterm labor:
  320. organs that regulate female reproductive cycle
    hypothalmus, pituitary, ovary
  321. puerpera:
    woman has just given birth
  322. most accurate to date gestation
  323. amenorrhea, galactorrhea, infertility
  324. increased frequency periods:
  325. When to give RhoGam
    after delivery if infant is RH-
  326. post-partum depression:
    suicide attempt, family stress, baby daddy not interested
  327. cigarette smokers undergo menopause
    earlier than non-smokers
  328. PID tx:
    ceftriaxone 250mg x1; doxy 100mg BID 10-14 days
  329. 35 weeks gestation, bleeding, last baby was C-section, workup:
    do an US
  330. 20 y/o, pain with menstruation tx:
    give NSAIDs
  331. 9 y/o premature sexual development with uterine bleed, hypertrophy of uterus due to ovarian tumor, estrogen producing
    granulosa cell CA
  332. 3m hx postcoital bleed, foul d/c:
    cigarette smoking is the risk factor for cervical CA
  333. pain in left vulvar, no sex because of severe pain, afraid to sit:
    bartholin gland abscess
  334. vaginal fullness, pressure worsens with strain, cough, incontinence:
  335. lower abdominal pain 14 days after period is
  336. vaginismus, consider this system
  337. abortion before xx weeks
    20 weeks
  338. causes of male infertility:
    spermatogenesis, varicocele, infections, drugs, heat
  339. RLQ pain with intercourse, Nausea without vomiting, LMP 33 days ago; breast tenderness, closed cervix, slight cervical motion tenderness; right adnexa tender; bhCG 1800; 3cm multi cystic mass in R ovary; apparent intrauterine sac without identifiable embryonic pole:
    intrauterine pregnancy with corpus luteum cyst
  340. C-section if the baby is in what position:
    transverse lie
  341. most common symptom of perimenopausal:
    hot flushes
  342. abnormally slow labor progress:
  343. gush of flood, workup:
    nitrazfine test and fern test to confirm ROM
  344. 2 ova fertilized by 2 sperm;
  345. diaphragm is hormonal or non hormonal contraception
  346. lichen simplex chronicus secondary to
    irritant dermatitis
  347. education for postpartum includes: lochia (vaginal bleed) up to 8 weeks; breastfeeding: colostrum for 5 days; nothing vaginally until next office visit; uterus will return to size over 6 weeks. Not:
    feelings of sadness, despair that will worsen
  348. 6m vaginal itching, discomfort with intercouse; dry vulvar skin, vaginal walls red, dry, bleed easily
    Atrophic vaginitis
  349. position of baby in complete breech:
    hips and knees flexed
  350. 5h hx substernal CP:
  351. LLQ pain with nausea, fever:
  352. weight lifter, discomfort: dyspnea; tachypneic, decreased breath sounds, hyperresonant CXR,
    no peripheral lung marking with presence by pleural line—pneumo
  353. TOF: make sure adequate O2
  354. 46 y/o F, overweight abdominal pain, nausea, would see a
    RUQ lithiasis of gallbladder on US
  355. healthy weight loss from
    decreased calories and exercise
  356. 28 y/o healthy, order blood work for
    lipid profile
  357. narrow maxilla, long thin face + limbs and fingers; arm span > height, pectus carinatum; perform this physical exam:
    cardiac auscultation
  358. chest tightness, SOB, especially with exertion; retrosternal pain 6/10, 10 min radiates to neck, jaw, shoulders, systolic crescendo-decrescendo murmur in R second intercostal space and radiates to carotids bilaterally
    aortic stenosis
  359. polyps on colonoscopy:
    repeat colonoscopy in 5 years
  360. normal saline (flattened T, U waves) K 2.5
  361. most common inherited disorder
    polycystic kidney disease:
  362. swelling, protein in urine, decreased albumin, hyperlipidema:
    nephrotic syndrome
  363. sudden decreased vision, pain in R eye, lacrimation, dilated pupil with circumcorneal injection; clouding of cornea:
    acute glaucoma
  364. red, swollen eyelids:
  365. itchy eyes, nose bilaterally; rhinorrhea, sneezing with exposures—determined to be vasomotor rhinitis:
    exposures are cold weather
  366. persistent dizziness 3-4h, N/V; resolved spontaneously; tinnitus. Weber lateralizes to R side; AC=BC. nystagmus seen:
    Meniere’s dz
  367. avid swimmer. pain, drainage in left ear. pain with manipulation. canal is narrowed and erythematous with white debris:
    otitis externa
  368. acute blurred vision and severe pain in left eye. halos, n/v, shallow anterior chamber, hazy cornea. fixed, moderately dilated pupil, ciliary injection:
    check tonometry
  369. fever, ST, enlarged glands in neck for 3 days. no cough, rhinorrhea. malaise, body aches, HA. Temp of 101.5, pulse is 102, swollen tonsils with exudates, enlarged cervical nodes bilaterally and tender:
    group A strep
  370. nasal stuffiness, HA, fatigue, facial pain, chronic PND 2-3 times for the past year. acute sinusitis. symptoms for 3m, given abx. nasal mucosa is inflamed, mucopurulent secretion in nasal cavity. right maxillary sinus is tender:
    get CT of sinuses
  371. decreased vision in right eye, mild opacification, cataract, the patient would see:
    visual halos around objects
  372. swollen, inflamed left tonsil displaces uvula. temp of 102, pain with swallowing and opening mouth. cervical lymph node enlargement:
    peritonsillar abscess
  373. normal veins are smaller/larger than normal arteries
  374. 1hr hx severe right eye pain with blurred vision, halos. pupil is 7mm right and 3mm left. right is nonreactive to light. cornea is steamy:
    acute angle closure glaucoma
  375. 3wk old baby: persistent tearing on the right eye. eyelashes crusted. increased tear meniscus, macerated eyelid skin, slight conjunctival hyperemia. material expressed from puncta with palpation:
    lacrimal sac massage, reevaluate at 12m.
  376. painful, pruritic left ear after returning from beach. erythematous canal without clear visualization of the TM, debris, discharge, pain with manipulation:
    otitis externa
  377. not able to hear in right ear. whisper test decreased on right, weber materializes to right. BC>AC:
    conductive hearing loss, possible cerumen impaction
  378. mouth, jaw pain. swelling on right side with eating and subsides within 2 hrs. palpable mass near TMJ:
    calculus formation in stenson’s duct
  379. ST, think it’s strep. dry cough, 102F, feels miserable. PE: 101.2F, TM dull bilaterally. pharynx is red with whitish exudates. cervical lymph nodes palpable bilaterally in cervical chains. tonsils large and inflamed. rapid strep is positive, tx:
    10days of penicillin
  380. clear nasal drainage and nighttime cough. clear rhinorrhea, dark circles under eyes, transverse nasal crease:
    allergic rhinitis.
  381. 10 y/o asmatic, sore throat. tongue: creamy white curd-like patches that cover other oral mucosal surfaces. epiglottis, tonsils not inflamed, red. takes inhaled steroids:
    candida albicans
  382. 5 y/o in acute respirator distress. ST, fever, dyspnea. neck extended, chin protrudes as if something is blocking throat. drooling. 38.7C, RR 130/m?? bright red epiglottis, extremely swollen and obstructing pharynx:
    Hflu (epiglottitis)
  383. bacteria of dental caries:
    strep mutans
  384. 6 y/o grinds teeth, tell the parent:
    common and will stop by age 12 without intervention
  385. decreased appetite, fever, ST, not feeling well. rash on hands, 3y/o, febrile, ill, flushed face. vesicular lesions on palms, soles of feet, ulcers on mucosa:
    hand foot mouth
  386. early childhood caries causes damage to permanent teeth. failure to thrive, oral infections, difficulty in school. not:
    ear infections
  387. low grade fever, HA, nasal congestion, green nasal discharge, tenderness to palpation over right maxillary sinus: URI, tx:
    give nasal saline lavage and acetaminophen prn
  388. ha, stuffy nose, green nasal discharge, low grade fever, body aches, facial pain, dry cough. temperature 99.9, nasal mucosa boggy, tenderness over maxillary:
    acute sinusitis
  389. cerumen impaction:
    conductive hearing loss
  390. cause of sensorinerual hearing loss:
  391. inflamed eyelids, normal vessels, normal pupil, unaffected vision
    red eye blepharitis:
  392. homogenous bright red patch between conjunctiva and sclera; normal pupil, unaffected vision
    • subconjunctival hemorrhage
    • 2.5h painless, progressive vision loss in right eye. htn controlled with beta blockers. cardiac dysrhythmia treated with amiodarone. blood pressure 180/110. right eye: can see light but can’t see anything else. pale retina with red spot
    • central retinal artery occlusion
  393. stuffy, runny nose with watery discharge. itchy, tearing eyes in spring. frontal head ache, decreased appetite. nasal membranes swollen, reddish-blue conjunctival injection visible bilaterally one eyes. IgE 1520 IU/mL, eosinophiles:
    allergic rhinitis
  394. ST, fever, red throat, red, beefy tongue, tonsillar exudates, swollen anterior cervical lymph nodes. rapid strep positive. allergic to penicillin—anaphylactic response:
  395. red lump on left eyelid. red pustule, hyperemia, swelling, oozing:
  396. left ear pain, hx of travel to the beach. pain with retraction of the pinna. left ear canal is inflamed, white discharge. TM not visualized:
    cortisporin otic suspension topically to the ear
  397. 2 week old: pain & white reflux in right eye: 
  398. poked in eye. pain, tearing, blurred vision. pupils equal and reactive, EOMI; sclera mildly injected, visual acuity 20/30 OS, OD; no foreign body seen:
    stain cornea with fluorescein
  399. poked in right eye; pain, photophobia, increased tearing, redness, no foreign object seen. dark red fluid level in lower half of iris.
    immediate referral to ophthalmologist
  400. 23m old: irritable, cough, congestion, rhinorrhea, 101.8F, pulls left ear. 1 week ago had URI: cough, rhinorrhea, congestion. rhonchi in both lung fields. bilateral TMs are red, bulging, middle ear infusion:
    amox 10 days
  401. child (ear infections) is back for 4th time this year:
    give abx and recommend placement for tympanostomy tubes
  402. ST, fever of 39C, dull, midepigastric pain. 1 episode of non-bilous emesis. frontal HA, allergic to penicillin. tonsils enlarged, beefy red with purulent exudate. petechiae on soft palate. white coat on tongue. cervical adenopathy. sandpaper rash. group A strep +:
    azithromycin 12mg/kg/day for 5 days
  403. acute red eyes, watery discharge, aversion to bright lights. gritty foreign body. conjunctiva injected and mildly swollen. palpable conjunctiva with cobblestoning. bilateral conjunctival redness with watery discharge:
    allergic conjunctivitis
  404. 21m old cranky, refused food. pulling right ear, fever. coughing, runny nose, diarrhea, flushed, temp 103.1F. red pharynx with mucous. right TM erythematous and bulges, light reflex is displaced:
    otitis media.
  405. tinnitus, loud noises often, music. uncomfortable in crowds, deteriorating grades. Weber to the middle of the forehead. AC>BC. 30db hearing threshold at 4000Hz:
    noise induced hearing loss
  406. ST, fever, drooling, change in voice, difficulty swallowing. temp 102.4, hot potato voice, fluctuant left tonsil displaced medially, erythema and edema of soft palate. uvula deviated to the right; cervical adenopathy:
    IV abx and ENT surgical consultation
  407. 4y/o with 6 episodes of tonsillitis; fever, difficulty swallowing, throat pain, tender enlarged cervical nodes. tonsils moderately swollen and inflamed with exudate on 3 occasions. 4/6 episodes were strep. intermittent snoring, apnea. more aggressive in preschool:
  408. dizzy, spinning, sudden onset, worse with position changes, nausea, vomiting once. no tinnitus:
  409. location of most nosebleeds:
    kiesselbach’s plexus
  410. chronic rhinitis, congestion, decreased sense of smell. yellow, boggy nasal mucosal masses bilaterally in nares. tissue is pale without erythema. clear discharge. posterior oropharynx inflamed without exudate. dry, nonproductive cough:
    nasal polyps
  411. MVA, trauma to chest:
    pneumo—needle decompression
  412. carotid pulses +3 bilaterally without bruits. soft S1. blowing diastolic murmur at sternal border. murmur increased with handshake. fingernails blanche with pressure:
    aortic regurg
  413. hungerlike epigastric pain, NSAID use, baby aspirin:
    upper endoscopy
  414. risk factor for cervical CA
    cigarette smoking
  415. bad smelling vaginal discharge. mild itching. thin, gray white discharge. pH 4.5, fishy odor with KOH. epithelial cells with stippled borders (clue cells):
    bacterial vaginosis
  416. psoriasis of nails, would see:
  417. scabies in children usually on the
    hands and feet
  418. teenage boy with lesions on trunk. small, oval, slightly raised along the folds. had a single larger lesion about a week ago:
    pityriasis rose
  419. larger vesicle:
  420. bulls eye rash, fever, fatigue, joint pain, tick. Rash is
    erythema migrans (Lyme disease)
  421. irregular borders, asymmetry, multiple colors, change in colors, diameter >6mm (pencil eraser), elevated/evolving
  422. 3 year old, erythematous vesicle with thick yellowish/gold crust around lips:
  423. acute spreading inflammation of dermis and subcutaneous tissue often caused by bacteria:
  424. 11 year old itching skin rash on back. appeared 1 week ago, growing. ½ dollar size, annular with sharp margins and lightly scaly. center is starting to clear. KOH shows hyphae.
    Tinea corporis
  425. severe plant contact dermatitis, tx:
    systemic steroids
  426. 40 year old with 3 day history of right sided CP. increasing intensity, burning, like a band across mid chest and mid back on the right side. light rash in the area. fatigue and malaise. on R chest, small vesicles with surrounding erythema in mid region. skin is tender in dermatomal fashion along affected area.
    Herpes zoster infection
  427. molluscum contagiouscum common in children (very contagious) in adults, considered:
    sexually transmitted
  428. 30 year old with itchy pimples on wrist for 2 weeks. violaceous papules with network of grey lines on surface of medial aspect of R wrist:
    lichen planus
  429. hypopigmented macules with enhanced appearance after sun exposure in lighter skinned patients:
    tinea versicolor
  430. 8 year old with papular rash. lesions are vesicular and crusted. 3 stages are visible:
  431. urticaria treated with antihistamines, H2 blockers, systemic steroids. Not
  432. HSV 2 is transmitted
  433. tinea capitus tx:
    oral antifungals
  434. 48 year old long term inflamed papules about face and thickened appearance of nose (rhinophyma), flares with alcohol:
  435. do not drain subungual hematoma if suspected
    fracture of digit
  436. impetigo tx:
    antibiotics (not for rubella, varicella, 5th dz)
  437. urticaria:
  438. topical steroids, topical vitamin D, oral steroids (Not ABX) for
  439. delivery vehicles for hairy areas:
    gels and lotions
  440. symptom in eczema:
  441. tinea unguium (onychomycosis) tx
    oral antifungals
  442. I&D alleviates
    hidradenitis suppurativa
  443. actinic keratosis, rosacea, melanoma (not keloids) common factor is
    sun exposure
  444. oral antifungals: assess what (on physical exam)
  445. melanoma staging:
    Breslow depth and Clark level
  446. a common area that harbors bacteria that causes impetigo
  447. 15 year old with constant itching, burning on arms and thighs for 2 weeks. acetaminophen without relief. multiple 2cm wheals with a few small papules on thighs and forearms. red and slightly raised.
  448. pityriasis rosea starts with lesion called
    herald patch
  449. 65 year old with skin lesions in dermatomal distribution on trunk. preceded by pain (shingles): tx
    oral steroids, antivirals, pain meds
  450. 45 year old professional surfer with a lesion on his face with a waxy appearance with pearly, rolled borders:
    basal cell carcinoma
  451. 52 year old coming in for a mole check; lesion on R forearm. present several months, getting bigger. poor sunscreen use, at least 3 blistering sunburns: Diameter of what is bad
    >6mm is bad
  452. location of leukoplakia:
  453. majority of skin CA deaths from:
  454. biopsies used for
    suspicious lesions
  455. atopy:
    eczema and asthma and allergic rhinitis
  456. 24 year old with flu like sx including malaise, anorexia, chills, fever, petechial lesions on wrists and ankles, spread inward to trunk. went camping:
    Rocky Mountain spotted fever
  457. Lyme dz, Rocky Mt Spotted Fever: give
  458. 5 year old with macular, erythematous rash on cheeks that resembles sunburn:
    5th dz (slap cheek)
  459. 32 year old with a rash for 4 days. recently on abx. target lesions on arms, soles of feet:
    erythema multiforme
  460. 44 year old with 3 week history of generalized rash. minimal pruritus. no fever. single lesion grew in size; rash progressed elsewhere. scaly, reddish pink plaques concentrated on the trunk in a Christmas tree pattern with a single lesion (PR): least likely to affect
    palms and soles
  461. 45 year old identical twins. 1 looks younger. loss in tone, elasticity, keratoses, telangiectasias, pigmented and depigmented lesions on face, neck, hands, occupation:
  462. 2 year old scratches head. patch of hair loss on top. patchy hair loss in right parietal area and another area of “black dot” alopecia about 4 cm lateral to it. area of hair loss—grayish ring-shaped lesion. KOH prep—branching hypae and spores: tinea capitus, give
    oral griseofulvin
  463. 23 year old with severe itching and burning pain in earlobes. hx of new studs. allergic contact dermatitis:
  464. 33 year old with redness, itching, burning on back of hands. clearing weeds—3 leaves. several tiny blisters with linear distribution:
    poison ivy dermatitis
  465. 3 year old with a 6 day history of sx including itchy red “wound” on R knee. worsened. a few intact vesicles and ruptured vesicles covered with honey colored crust on R knee. Staph Areus:
    ABX ointment
  466. 45 year old with overgrowth on forehead over 2 weeks. has grown in size. bleeds. hx of tanning beds. SCC risk:
    tanning beds
  467. 2 year old with atopic dermatitis. long term care:
    frequent lubrication with emollient cream and BID hydrocortisone 1’1 cream
  468. 16 year old F with severe cystic facial acne. Isotretinoin (Accutane): ALWAYS
    rule out pregnancy
  469. 47 year old with “CA” on back: single lesion 3mm, brown/black, “stuck on” appearance:
    seborrheic keratosis
  470. 28 year old with itchy, scaly rash on elbows for 1 week. knees are also affected. lesions are whitish on erythematous base, irregular but well demarcated (psoriasis), tx:
    topical fluorinated glucocorticoids
  471. 20 year old who needs increased acne therapy. progressed to severe:
    add oral isotretinoin
  472. 55 year old with lesions on top of head. 6 months ago more are appearing. multiple lesions <1cm. yellow-brown, dry, scaly, rough, coarse-like texture and tender.
    actinic keratosis.
  473. 20 year old pruritic rashes on arms. recurrent for forever. asthmatic. erythematous maculopapular lesions with hyper pigmentation and lichenification in antecubital fossae bilaterally:
    atopic dermatitis
  474. 21 year old with recurrent painful nodules in axillae. red inflammatory nodules tender to palpation. areas break down and drain a foul-smelling purulent material:
    hidradenitis suppurativa
  475. 18 month old infant with a 1 day history of fever of 101F rectally. back 2 days later with small red spots that became bumps and are now blisters. itchy. on thorax. vesicles reside on erythematous base:
  476. 22 year old with painful blisters at a R angle to the mouth. tingling and burning 3-4 days before. temperature of 99.5F. multiple vesicles seen at mouth but have not spread: give
  477. 35 year old with a changing mole on the neck. irregular, nodular, superficial with variegated appearance. malignant. for an accurate long term prognosis: assess the
  478. 83 year old bedridden patient with lesion below the surface of tissue. lesion is a crater. loss of epidermis and dermis. inflammation accompanies the lesion:
  479. 66 year old with a rash over 3 weeks. getting worse. blisters in the mouth itch. red with blisters about a week ago. also on abdomen. uricarial, inflammatory papules and plaques with blister formation. abdomen—inflammatory plaques surmounted by tense blisters:
    bullous pemphigoid
  480. poorly differentiated, diffuse redness with warmth
  481. 38 year old with a skin rash. history of psoriasis. salmon-pink papular lesions on flexor surfaces of wrists. linear pattern. around 3 days old. scratched and lesions appeared:
    Koebner’s phenomenon
  482. 55 year old with lower back 2mm well-circumscribed non-raised black lesion:
  483. 6 year old who is scratching his scalp. tiny, white, wingless insect and tiny eggs attached to hair shafts. also on eyelashes:
  484. 65 year old with a lesion on his upper back. flat, slightly raised, blue-gray pigmented lesion. 1x2 cm with irregular borders:
    malignant melanoma
  485. 50 year old with facial rash. 10 year history of reddening of the face that comes and goes. erythema, telangiectasia, red papules, tiny pustules on bilateral cheeks:
  486. 17 year old son with a rash on his face, getting worse over 3 years. multiple comedones and papulo-pustules covering his cheeks, forehead, chin. mild acne, tx:
    topical retinoids
  487. 60 year old with itchy lesions on left ankle for 6 months. left leg is erythematous with scaly patches and ulcer over medial malleolus. bilateral varicose veins:
    stasis dermatitis
  488. 40 year old with itchy lesions on the face for 2 days. new after shave. erythematous, sharply demarcated, weeping lesions on cheeks and chin:
    contact dermatitis
  489. 25 year old with itchy lesion on the back of neck for 1 year. increased itching when studying. scaly, well-circumscribed lichenified plaque on posterior nuchal region
    Lichen simplex chronicus
  490. 20 year old with 2 month history of itchiness of scalp. greasy yellowish scales on scalp and eyebrows.
    seborrheic dermatitis
  491. 10 year old with rash on scalp present for 1 week. scratching scalp, hair has fallen out. no improvement with OTC. erythematous, circular, scaly patches. areas without hair are brittle and broken off. KOH showed hypae:
    tinea capitus
  492. 12 year old with itchy, redness between toes. anti fungal before. interdigital spaces are macerated and erythematous, tx:
    continue anti fungal and give health education
  493. 19 year old with a new rash for 2 days. sore throat treated with penicillin. target like lesions on palms bilaterally and symmetric.
    erythema multiform
  494. 24 year old with a new rash. mild itching. scattered, multiple lesions. sharply marginated with central clearing that an annular configuration that appears on arms, neck, trunk. etiologic cause:
  495. 27 year old with painful itching blisters on genitalia. 2 days ago, sick, OTC aspirin, increased temperature to 37.5C. enlarged lymph nodes in inguinal area. vesicles on labia and perineum. some ruptured and some crusted over. no vaginal discharge: give
    acyclovir (herpes)
  496. 73 year old with toenails that are thick, hard to cut, discolored, dystrophic. KOH showed a fungal infection:
  497. eczematous dermatitis are:
    micro vesicles
  498. 23 year old with skin lesions, history of allergic rhinitis and asthma:
  499. 41 year old with itchy rash on R foot for 1 day. allergy to nickel from boot. irregular papular reaction over medial malleolus of right ankle distally to level of mid foot. some excoriation. prescribe topical corticosteroid flucinonide 0.05% strength: do not apply to
    genitalia or face
  500. 63 year old farmer. 4mm papule on forehead, pearly white with rolled borders. small tenangiectasias in the lesion. small scale in the center:
    basal cell carcinoma
  501. 66 year old ulcerative lesion on plantar surface of the right foot in pressure point area:
    diabetic ulcer
  502. hairless, pale, shiny skin:
    arterial ulcer
  503. venous insufficiency caused by:
    venus reflux dz
  504. conservative therapies for venous insufficiency (exercise, elevation, compression hose, unna boot):treats the sx but
    not root cause
  505. regular part of wound care
    wound debridement
  506. COPD with pedal and sacral edema, JVD, EKG showed narrow P waves:
    cor pumonale
  507. fever, malaise, ST, erythematous pharynx with tonsillar exudate. posterior cervical nodes 2+ and tender, strep negative:
  508. 23 year old with URI, CP, worse lying down, better sitting up and leaning forward, EKG showed ST elevation:
    pericardial friction rub
  509. Varicella transported through
    respiratory droplets
  510. Most common STD is
    Chlamydia Trachomatis
  511. A sporeforming anaerobic bacilli is
  512. Number of MMR vaccines are given
  513. Aplastic anemia presents with
    hypocellularity of bone marrow
  514. Smudge cells are pathognomonic for
  515. An elderly patient lost 30lbs over 6 months. She attributes it to a loss of appetite and cooking for one since her husband’s death. Her blood smear shows hypochromic, normocytic anemia, low serum iron, low total iron binding capacity (TIBC), and high ferritin. She has
    anemia secondary to chronic disease.
  516. HIV + mom gives birth. At 2 months old, her baby is found to be HIV+. Is this true? Any more testing to be done?
    Newborn is HIV+
  517. 5 year old boy presents with increased lethargy for the past 2 months. On PE, he has a Temp of 37.3C and ecchymoses. Hgb and Hct are decreased. MCV is normal. PLT is normal. WBC is increased. A bone marrow biopsy is done and shows 100% cellularity with replacement by primitive cells with large nuclei and indistinct nucleoli with scanty cytoplasm. Cells mark + CALLA CD 10 antigen. He has
  518. 62 year old male with increasing Dyspnea On Exertion and abdominal discomfort for 4 months. On exam, nontender cervical adenopathy. liver span is 10cm with a smooth and palpable liver edge. Spleen is palpable. WBC increased; segs decreased; bands decreased; and lymph increased. Direct Coombs test +. He has
  519. Parts of Clostridium tetani:
    neurotoxin + exogenous infection.
  520. 12 year old boy with bulls eye rash. The tick carried
    borrelia burgdorfer bacteria.
  521. 17 year old female complaining of vaginal discharge. Mucopurulent discharge is present. No cervical motion tenderness or adnexal tenderness. Chlamydia is positive. Give
    Azithromycin 1g x1.
  522. A 20 year old white male presents with 2 week history of fever. A friend had strep throat but he doesn’t have ST, HA, or stiff neck. Went hot-tubbing recently.
    Fever of Unknown Origin.
  523. 21 year old female nursing student with low grade fever, ST, malaise, and fatigue. Swollen lymph nodes and LUQ discomfort is present. 50% atypical lymphocytes. Heterophile antibody test +. Has
    Epstein-Barr virus. (mono)
  524. 22 year old female immigrant has entamoeba histolytic present in her stool. Give
  525. 23 year old female presents with a partner who is HIV+ but her ELISA was negative. Work up?
    Repeat the ELISA in 6 months.
  526. 23 year old presents with painful sores on penis. Fever, tender, enlarged inguinal lymph nodes. Numerous vesicular sores on red tissue. Has
    herpes genitalis.
  527. 24 year old IV drug user presents with a 4 week history of fever, dry cough, dyspnea, and rapid breathing. Diffuse, interstitial pattern on Xray. Has
    pneumocystis jiroveci.
  528. 28 year old male presents with a rash on his nose. It is painful, red, and itchy with blisters. It is linear with small vesicles and a crust. Examine for
    involvement of cornea.
  529. 3 month old female is lethargic and weak. She won’t eat. Hypotonia of extremities and flaccid neck. Poor gag and suck reflex. Decreased respirations. Had eaten honey.
    Clostridium botulinum.
  530. 32 year old female reports being tired and run down. She has difficulty swallowing and reports changes in her tongue and mouth. She is pale with angular stomatitis and atrophic glossitis.
    Iron deficiency anemia.
  531. 36 year old female traveled to Indonesia. She complains of profuse, watery diarrhea, cramps, nausea, and overwhelming thirst. She is dehydrated, diaphoretic, and has orthostatic hypotension and hypokalemia. Oxidase positive curved gram negative rod on TCBS agar.
    Vibrio cholerae.
  532. 40 year old male reports being easily fatigued and feels weak with recent weight loss. Philadelphia chromosome is present.
  533. 44 year old female presents for an exam. She has pale mucous membranes, increased uterine size, and menorrhagia for the past 2 years. Her RBCs are microcytic and hypochromic. Decreased serum iron, increased TIBC, and decreased ferritin.
    Anemia secondary to iron deficiency.
  534. 5 year old hispanic male with ALL complains of fever and rash. He has been exposed to varicella. Blood tests are negative but he has small vesicles and red macules on his face and chest. Give
    Acyclovir Q8h.
  535. 52 year old alcoholic male complains of being easily distraught, tired, and constantly weak. He has GI complaints and diarrhea. He eats a poor diet and is malnourished. Decreased Hct, Hg, and increased MCV. Hypersegmented granulocytes. Bone marrow biopsy reveals hypercellularity with numerous megaloblasts.
    Anemia secondary to folic acid deficiency.
  536. 62 year old male with AML: tell him survival is based on the
    duration of his first remission.
  537. 62 year old male with increased left rib pain, tingling, numbness of lips and extremities. Hypercalcemia. X rays show a rib fracture and diffuse osteoporosis. Serum protein electrophoresis revealed monoclonal protein spike in gamma region.
    Multiple myeloma.
  538. 70 year old male here for a follow up with his cardiologist. He has pale mucous membranes. Hypochromic microcytic RBCs. Low serum iron, low TIBC, high ferritin.
    Anemia of chronic disease.
  539. 70 year old male complains of weakness in his arms and legs and disorientation You suspect pernicious anemia. He takes B12 capsules. You give him B12 shots and it relieves his symptoms. What does he have? Reduced synthesis of
    intrinsic factor.
  540. 78 year old male with ESRD on hemodialysis. Blood smear shows moderate normocytic normochromic anemia. Give
  541. IgM antibody response is [what number] with the flu infection.
  542. Patient reports tongue having a thick white coating, otherwise red and irritated. She can scrape it off.
  543. 8 year old boy with fever and URI and blue-gray spots in his mouth and a rash on his face. The rash has reddened papules and macules that is moving downwards.
  544. Fever, lymphadenopathy, HA. Toxoplasmosis found in
  545. 1 year old boy is physically underdeveloped, weak, and unresponsive. He is a recent immigrant from southern Italy. His parents also mildly anemic. RBCs decreased, Hg decreased, Hct decreased. Peripheral smear positive for basophilic stippling, hypochromia and presence of codocytes.
  546. Bence Jones proteins:
    Multiple myeloma
  547. Burkitt’s lymphoma:
    Epstein Barr Virus
  548. Clostridium botulinum produces
  549. Reed Sternberg:
    Hodgkin’s lymphoma
  550. Rubella:
  551. The most life threatening part of clostridium is the production of
  552. Malaria:
    plasmodium sp
  553. Helminthic infection: use what test for eggs
    cellophane tape test
  554. 15 year old female with ST, low grade fever for 4 days, and gray-white patch on pharynx. Gram + beaded bacilli. Long, slender bacilli with green body and deep blue prominent granules.
    Corynebacterium diphtheria
  555. 55 year old comes to the ER with complaints of fatigue, night sweats, and a low grade fever for 1 week. Spleen is palpable. CBC shows a WBC 105,000 with left shift. Increased platelets. BCR/ABL gene is present.
  556. Going to the DR. Take
    chloroquine weekly starting 1 week before travel.
  557. 22 year old Italian male orders meat with fava beans. He experiences fatigue, HA, abdominal pain, nausea, fluttering chest, and SOB. Bite cells are present.
    G6PD deficiency.
  558. 5 year old with fever, hemorrhages and repeat bacterial infections. WBC 50,000.
  559. 45 year old male complaining of a change in appearance of skin. It is thickened and reddened. A biopsy shows neoplastic T lymphocytes.
    Mucosis fungoides.
  560. 63 year old male with bleeding gums, illness, low grade fever, fatigue, and bone and joint pain. He is pale with mild petechia, gingival hyperplasia, and a palpable spleen. CBC reveals pancytopenia and blasts with auer rods.
  561. Rickettsia rickettsi: give
    doxy, even in kids
  562. Malaria tx:
  563. Multiple myleoma, CMP results show:
  564. Interstitial plasma cell pneumonia in AIDS patient:
    pneumocystis jiroveci
  565. Anopheles mosquito:
    vector for malaria
  566. Kaposi sarcoma associated with:
  567. Hematologic CA workup:
    bone marrow biopsy/aspirate
  568. 65 year old male with lymphoma. PMH includes chronic renal insufficiency. He reports vomiting, restlessness, muscle weakness, tingling, dry mucous membranes. BP 90/40; HR 110; increased WBC, BUN, creatinine, and decreased Ca. Crucial to give
    IV hydration.
  569. negri bodies (intracytoplasmic) in brain tissue
    Rabies virus
  570. Anal pruritus:
    enterobius vermicularis
  571. 19 year old male cut himself with a nail. Give
    Tdap vaccine and antibiotics
  572. Oncologic emergency associated with childhood leukemia:
    Tumor lysis syndrome
  573. Remission rate of children with ALL
  574. SCLC: very responsive to chemo. (In the center.) FALSE:
    in periphery, amenable to resection, good long term survival, not spread hematogenously
  575. Nulliparous woman with increased risk of breast cancer: more
    high risk breast lobule cell types
  576. Hypercalcemic, an adult oncologic emergency. Presents with abdominal cramping, bone pain, kidney stones, and confusion. (Bones, stones, abdominal groans) Not
  577. 70 year old black male with high grade fever, nausea, infection, and severe back pain. He fell 2 years ago and has had the back pain since. Decreased RBC. Paraprotein. Bone marrow biopsy shows 50% infiltrate by plasma cells.
    Multiple myeloma
  578. CA patient with hypercalcemia: give
    IV normal saline
  579. Hemophilia C is NOT
  580. most common bleeding disorder.
    Von Willebrand’s dz
  581. 55 year old female with a prior DVT is now on Coumadin. Target INR is
  582. 48 year old male smoker with a DVT and PE. He will be on coumadin for
  583. lab test to monitor the intrinsic pathway of the coagulation cascade.
  584. Clotting factor X is ____ dependent.
    Vitamin K
  585. used to treat Von Willebrand’s dz.
    DDAVP (Vasopressin)
  586. AML:
    auer rods
  587. Graft v. host disease is a complication of
    bone marrow transplant.
  588. Acid fast bacilli
  589. 62 year old male smoker with lung CA in the bronchus with hilar and mediastinal lymph node abnormalities. It has early hematogenous spread, is rarely amenable to surgery, and aggressive.
    Small cell lung CA
  590. Patient presents with burning lesions on his penis and tender inguinal adenopathy. Give
    Valcyclovir 1000mg PO BID x7-10 days.
  591. Least likely cause of FUO:
    Kawasaki dz
  592. FUO: temperature >101F on several occasions; diagnosis is not established after 1 week of inpatient investigation; lasts 21 days or longer. Not:
    fever presenting without any localizing symptoms over time.
  593. important in FUO: detailed history; complete PE; and frequent reassessments; least important is
    pattern of fevers.
  594. FUO: transaminases elevated
    Hepatitis serologies
  595. Sepsis: caused by
    strep pneumo
  596. Poor prognostic indicator in sepsis: (Not: urinary source, female, or 35 years old)
    WBC 3K.
  597. 63 year old black male with DM and HTN complaining of feeling woozy and unwell. Temperature 40C, HR 22, RR 26, BP 84/56, and SpO2 91%. Recently hospitalized. Suspect sepsis secondary to hospital acquired pneumonia. First tx:
    Maintain his airway.
  598. 53 year old female reports a fever and poor condition of teeth leading to a tooth infection, which has spread to her face and neck. She is febrile. An erythematous, edematous, hot, and tender area is on her lower right cheek and upper right lateral neck is present. She can swallow. No stridor. Poor dentition. Posterior pharynx isn’t affected. Give
  599. 32 year old female patient presents with a warm, painful, red, and swollen area of her forearm with multiple bullae. Culture it and expect it to come back positive for
    staph aureus.
  600. 32 year old febrile female patient presents with a warm, painful, red, swollen 12cm area on her forearm with multiple bullae. Give
    sulfa trimethoprim (SMX-TMP) double strength.
  601. 7 year old boy with a bat bite. He has local pain but no other symptoms. There is tenderness at the bite mark with 2 punctae of right thenar eminence with minimal erythema and no exudates. Give a
    rabies immunization immediately.
  602. 17 yo F heart beating ‘funny’ and intense seems down and emotional and significant wt loss, exophthalmous, fine tremor, pulse 100
  603. 42 yo F with fatigue, coldness, constipation and elevated TSH
    -skin dry and rough
  604. papillary thyroid cancer-best treatment
    -surgical removal
  605. 22 yo F with weight loss with good appetite, diarrhea, heat intolerance, menstrual irregularity, R lobe os thyroid is enlarges. She has hyperthyroid
    -palpitations and tremors
  606. most common type of thyroid cancer
  607. 32 yo white F with hyperthyroid order which test?
    -TSH and free T4
  608. Chart: TSH elevated, total T4 decreased, free T4 decreased, free T3 elevated
    -primary hypothyroidism
  609. which is most accurate test to dx thyroid cancer
    -FNA (fine needle aspiration)
  610. 55yo F with depression, fatigue, apathy, weight gain, amenorrhea, dull facial expression, periorbital swelling and coarse dry skin. No thyromegaly. She is anemic. Decreased Hct. Decreased hemoglobin. Increased MCV.
  611. 31 y/o M c constipation, fatigue, and weight gain of 20lbs over last 6months. Weigh 220 and 6ft. Low T4, High TSH (193). Prescribe
    oral levothyroxine.
  612. patient is hypothyroidism. Serem TSH decreased. After TRH stimulation decreased. T4 elevated
  613. hyperthyroidism alleviate symptoms with
  614. Recheck TSH
    4-6 weeks after Rx
  615. Iodine 131 treatment: do ____ first
    HCG test
  616. 55 yo M with weight loss, good appetite, polydipsia, polyuria. FH DM. increasingly tired and lethargic, overweight and random blood sugar 312.
    -check Chem 7
  617. 72 yo with altered level of consciousness, decreased mental status, no trauma. Glucose 678. Serum osmolality 305. K decreased.
    -treat with normal saline first
  618. superous patient progressive lethary confusion, polyuria, polydipsia, dehydrated, no Kussmal respirations. Glucose 1200, pH 7.5, osmolality 320, no ketones in UA.
  619. 21 yo F with DM
    -give metformin
  620. which of following hypoglycemic agents cause more hypoglycemia
  621. 20) 50 y/o man c 2 year hx of DM. On Glipizide 5mg/day. Weight has gone up albs and HgA1C increased. Change
    glipizide to metformin.
  622. early DM nephropathy
    -check microalbuminuria
  623. symptom of hypoglycemia in elderly patient
    -mental confusion
  624. cardiovascular complication in type II DM (CEO bank man)
    -prevented with tight control of BP
  625. 43 yo F with fasting serum glucose 130 (high) and A1C 6% (normal)
    -she is in good glycemic control
  626. Which is more prevalent in Type II vs Type I DM
    -skin infections
  627. Hispanic 45 yo with DM, sleep apnea
    -feeling of malaise due to DM
  628. 72 yo with Type II DM recent URI excessive diuresis, decreased oral intake, increasingly stuperous and lethargic
  629. high cholesterol
    -give simvastatin
  630. microaneurysms, cotton wool spots, and neovascularizations on fundascopic
    -diabetic retinopathy
  631. 62 yo M with 25 yr hx DM, worsening edema, currently on glipizide 20 mg BID, glucose 287, A1C 8.6%
    -start on metformin
  632. 18 yo DM F with altered level of consciousness, deep breathing, and fruity odor-use
    regular insulin
  633. HgA1C should be between
  634. 10 yo Hispanic boy, mom wants to prevent DM
    -favorite sport and pediatric dietician
  635. 52 yo DM F, lantis 50 units at night but post parandeal sugars are elevated and A1C is 7.8%
    -add rapid meal time insulin
  636. (Chart) 56 yo M DM and hypertensive wants to make sure no kidney problems
    -check microalbuminuria
  637. Target LDL in DM
    = 100
  638. A1C =
    glycosilated hemoglobin for 2-3 months
  639. 38 yo M has pheo (golfer): CP, HA, palpitations, flushed, diaphoretic, BP 195/110. @ ED felt better BP 150/90. Has had episodes for 2 months and HA that come like waves.
    • -treatment:
    • discharge with 24 hour urine catecholamine and f/u with PCP
  640. 53 yo F with near syncope episode, fatigues, weak, nausea, weight loss, vomiting, abdominal pain, orthostatic hypotension, suntan
  641. 44 yo F with near syncope, fatigue, n/v, weight loss, weakness, BP 95/55, orthostatic + tilt, dry mucous membrames, and increased pigmentation, distant heart sounds, tachy, diffuse abdominal tenderness s guarding, tan
  642. 44 yo F with HA, increased fatigue, weight gain, stretch marks, increased BP, neck is thick and full (buffalo hump), purple striae, and bruising
  643. 32 yo F (associate editor) fat, with pimples, hair on face (hiritism), purple stripes on tummy-which test?
    -urinary free cortisol
  644. SIADH treatment
    -restriction of free H2O
  645. DM symptoms but has acromegaly bc he needs larger wedding ring
  646. thyroidectomy, + chvostek sign
    -decreased serum calcium (hypocalcemia)
  647. most common pituitary adenoma (prolactinoma)
    -get serum prolactin level
  648. 14 yo F short stature, growth failure, Tanner stage I, wrinkles on face, apathetic
    -tumor on anterior pituitary
  649. vasopressin challenge for
  650. DI, deficient hormone:
    ADH deficient
  651. pituitary gland imaging:
  652. T score 0.8
    -bone density is normal
  653. T score -2.0 and -0.5
    -osteopenia and needs treatment
  654. 76 yo F with Fx – broke hip, demineralization
  655. primary prevention in rickets
    -inform public benefits of breast feeding and vit D supplements
  656. hyperparathyroid symptoms: kidney stones, abdominal pain, polyuria, depression
  657. 25 yo M with cramping, abdominal pain, fever, diarrhea, R abdominal pain, RLQ tenderness, bowel sounds present, + hemoccult, transverse and descending not present with ulcerations
  658. 35 yo F African American, red irritated eyes, SOB, CXR perihilar adenopathy, increased ACE (Sarcoidosis)
    -systemic steroids
  659. acute exacerbation of asthma
    -beta agonists
  660. infection of kidney in pelvis
  661. ADH location
    posterior pituitary
  662. giantism is coarse facial features, heavier browridge, large hands and feet
    giantism is NOT small jawline
  663. acromegaly dx with
    serum IgF1
  664. pituitary adenomas management goals include relief of visual impairment, multiple recurrences raise suspician for ca, transsphenoidal surgery is 1st line therapy for macro adenomas NOT
    macroadenomas are more common (false)
  665. 32 yo impaired vision, vertigo, and asks for Rx of Viagra
  666. 33 yo F HA, diplopia, macroadenoma underwent surgery, HA again, another tumor, also ptosis, difficulty hearing
    -consider work up with imaging for possible pituitary cancer
  667. increased hyperpigmentation in Cushings
  668. Addison’s hormones:
    increased ACTH and decreased cortisol
  669. pheo:
    HA, diaphroesis, palpitations, severe HTN
  670. pheo tx
    surgical resection
  671. 6 year old girl staring off into space; the teacher can’t get her attention. She seems to talk to herself but no sound is coming from her mouth. After these “episodes” the girl is fine.
    Petit Mal (absence seizure)
  672. Symptom of lesion of the trigeminal nerve
    trouble clenching teeth
  673. Absence seizures—give
  674. deteriorates first in Alzheimer’s dz
    Recent memory
  675. Motion sickness, mitral valve prolapse, hyperlipidemia, and adrenal dysfunction are associated with migranes. _____ is NOT
  676. 60 y/o F with right-sided facial pain. Severe, electrical stabbing for 15-30 seconds. Touching her face brings on the pain.
    Trigeminal neuralgia.
  677. 44 y/o M whose jaw is weak, has ptosis, and difficulty swallowing. Positive Tensilon test. (Myasthenia gravis). Look for a
  678. Dizziness, nausea, vomiting, no PMH, no injury. When patient moves his head, lies down, or rolls in his bed.
  679. Spinal epidural abscess—workup
  680. Temporal lobe damage causes
    memory loss/auditory deficits
  681. Male with difficulty tolerating medicine, ADLs. Surgery can be done for
    Parkinson’s disease.
  682. Pediatrics: most ______ for concussion
    conservative therapy
  683. Tremors are absent at rest and worsen with activity, especially as the target is neared.
    Intention tremor
  684. Injection for migraines, then chest pain. was given:
  685. Afib—risk for
    embolic stroke
  686. Daily HA, also has watery eyes, stuffy nostrils.
    Cluster HA
  687. Weakness of grip bilaterally. Hyperactive DTRs. Sensation is intact. No urinary symptoms—
  688. Give tPA within
    3 hours
  689. 3 year old girl who is irritable and weak in her legs for 1 day. Ascending symmetrical paralysis. LP has normal glucose but increased protein. Recent recovery from mild diarrhea. (Guillian-Barre); bacterial cause is
    Camplobacter jejune
  690. Ascending paralysis—
    Guillian Barre
  691. Left eye does not move outward. Lesion is located:
    Left 6th nerve lesion
  692. Stroke is
    a sudden interruption of blood flow to the brain.
  693. 18 year old F with a history of HA above the right eye. Throbbing with N/V. Alleviated with a nap. Last a few hours. Happens 2x a month.
  694. 32 year old F with difficulty brushing hair. Ptosis relieved with rest in the AM.
    Myasthenia gravis.
  695. Unilateral facial weakness. Abruptly worse overnight. Cannot close 1 eye. Difficulty eating.
    Myasthenia gravis
  696. 28 year old M with hyperplasia of the gumlines. Medication ______ is responsible
  697. Contraindication to LP—
  698. Nipple dermatome is
  699. Most common cause of dementia is
  700. Sumatriptan for migraines involves the ____ transmitter
    serotonin 5HT1 transmitter
  701. Myasthenia gravis: most sensitive test is
    Tensilon test (edrophonium)
  702. Bell’s palsy—give
  703. Hemorrhagic stroke: risk factor is
  704. done first for suspected stroke
    CT of the brain
  705. Tx of dementia with Lewy Bodies: benzodiazapines, cholinesterase inhibitors, SSRIs, and
    • TCAs. NOT
    • antipsychotics.
  706. 45 y/o M with mild tremor of the arms and hands. Father has a similar tremor. Resting tremor in hands and arms. Barely noticeable at times. (essential tremor.) —Usually resolves
    during sleep.
  707. 66 yoM c urinary incontinence, hard-time walking, barely get feet off floor.  Trouble paying attn, losing memory.  Bathroom more frequently, recent accidents.
    NPH—ventriculoperitoneal shunt placement
  708. dementia with socially inappropriate behavior
    Frontotemporal dementia (Pick’s dz)
  709. Dementia After stroke—
    vascular dementia
  710. eyes closed, does not open to voice, pinch nail bed and eyes stay closed, flexes arms and extends legs, mumbles incomprehensible sounds
    GCS of 6
  711. CT of head c subdural hematoma image is
    crescent shaped
  712. Greatest risk for TIA—
    subsequent stroke
  713. lacunar stroke, ___ ischemia
    small vessel
  714. child abuse, story doesn’t match, physical exam (image)—blood behind ear drum
  715. Concussion = kids and teens more/less susceptible
  716. DSM 5 = delirium: disturbance in attn, change in cognition, short period of time. NOT –
    known, existing dementia
  717. Wernike’s encephalopathy: ataxic gait, lateral nystagmus, confused stated. NOT –
    hearing loss
  718. Difference between DSM IV and V dementia: NOT
    cog. deficits not better explained by another medical disorder
  719. Dementia – requires assistance c
    meds and paying bills
  720. 12 yo dyspnea, wheezing. Otherwise healthy, clear throat
  721. elevated ACE
  722. cut on arm infected
    staph. Aureus 
  723. Positive pregnancy test, LLQ tenderness, bimanual tenderness
    tubal pregnancy
  724. thin, malodorous vaginal d/c, coccobacilli and epithelial cells c indistinct cell borders
  725. paralyzed L side of face, cannot close L eye, L forehead cannot furrow, no smile L side
    (Bell’s Palsy) CN VII
  726. ‘beating’ of foot against hand
  727. R eye medially deviated, cannot move laterally
  728. Heel on knee run down shin, called
  729. treatment of ADHD:
    Methylphenidate (Ritalin)
  730. 10 y/o girl who has trouble completing assignments, careless mistakes
  731. 19 y/o female 5’6, BMI 16.6; dieting seriously and refuses to eat with family. Purging type.
  732. 70 y/o F at the nursing home. eats excessively, sleeps too much, low self-esteem, history of depression, SI
    major depressive disorder, recurrent
  733. 85 y/o F with bizarre behavior, seizure disorder, she wakes up and cannot get out of here
    anxiety disorder due to medical condition
  734. Test for recent memory
    ask patient to repeat list of items 3-5min later
  735. Chemical in Cannabis
  736. Submissive and clinging behavior
    dependent personality disorder
  737. excessive emotionality and attention seeking
    histrionic personality disorder
  738. bipolar II
    depression + hypomania
  739. RULE OUT schizotypal personality disorder by
    having symptoms occurring only at home
  740. swollen nasal mucosa, behavior is odd after school
    inhalant use disorder
  741. Generalized anxiety disorder—duration is over
    weeks to years
  742. microchip in head controlling the patient
    Bizarre delusion
  743. confabulation defined as:
    making up memory; amnestic syndrome; attempt to disguise memory loss
  744. schizophreniform vs. schizophrenia
    duration of symptoms: (1-6m) (schizophreniform) and schizophrenia (more than 6m)
  745. schizophrenic laughing or smiling while talking of electric shock
    affect is disturbed
  746. scared to be seen in public, everyone is looking at patient
    social anxiety disorder (agoraphobia = panic attack)
  747. violating the rights of others, unable to conform to norms of society
    antisocial personality disorder
  748. Genotype for mental disorders; also influenced by
    environmental factors
  749. 20s male in ED c police drowsy fading in and out of consciousness, words slurred, difference in attention and memory, pupils constricted, unresponsive to pain. Heroin user
    Opiod intoxications s perpetual disturbances
  750. 30yo F, 18 office visits in past 2 years presents c different symptoms each time
    Somatic symptom disorder
  751. 20yo college student lives at home c parents: feels exhausted, doesn’t enjoy activities she used to, cranky and irritable
    major depressive disorder
  752. 40yo F lack of sleep, loss of appetite, low self esteem, lack of interest in activities, depressed mood. Hx of MS for past 10 years
    depression due to another medical condition
  753. 80yo F sudden blindness, no medical reason
    Conversion disorder
  754. Tx for major depression involves placing electrodes on head
  755. 39yo F loss of patch of hair due to pulling it out
  756. Mid 20s F rapid shallow breathing, pounding heard, shaking hands and knees.  ‘I’m scared I’m dying’ and it feels like she is suffocating
    Panic disorder
  757. 4yo male: child never looks at mother when she talks to him, doesn’t engage in play time c siblings, becomes very violent if change routine
    autism spectrum disorder
  758. 25 yo M- feels sad all the time, lonely, and relationships always fail.  Tells GF that if she leaves him, he will kill himself.  Was in hospital for overdosing and cutting
    borderline personality disorder
  759. 4 yo M recurrent cough c wheezing. Oily, smelly poop
  760. 60yo F Dx c HTN and type II DM c dry cough.  She is taking an ACE (pril).  What medication should we switch her to?
    ARB (angiotensin 2 blocker)
  761. Esophageal spasm is often confused c
    cardiac disorders
  762. 17 yo M – 1 day Hx of painful and pruritic ear after beach. Erythematous external canal s TMs visible. Large amounts of debris and discharge
    otitis externa
  763. 45 y/o M with sudden ammunition of vision in R eye and lacrimation. Dilated pupil with circumcorneal injection, clouding of cornea.
    acute glaucoma
  764. 25 y/o M with acute otitis media with serous otitis in R ear.
    weber louder on R ear, ring BC>AC R ear
  765. 3. 18 y/o F wart on finger, elevated, diameter less than 1cm—papule
  766. college student with mono, enlarged lymph nodes behind SCM
    posterior cervical
  767. 43 y/o F aching in neck, shoulders, low back, more than 1 year. stiffness in AM, cold, stress.
  768. which medication is FDA approved for fibromyalgia?
    Savella (milnacipran)
  769. 24 y/o WM with pain in R posterior neck for 3 days. Head and neck in usual position for prolonged time. Pain and stiffness. No radicular symptoms. ROM decreased with twisting and bending.
    ice, heat, rest, stretches
  770. 57 year old WF with pain from neck down R arm. Intermittent for a few months but is now constant. 9/10 pain. weakness R arm. diminished triceps reflex. What is the least likely cause?
    Least likely cause is neoplasm.
  771. 47 y/o M with back pain for 2 weeks. no injury. pain is unrelenting and doesn’t change with positions. recent respiratory illness. which part of Hx is most significant?
    quality of pain.
  772. 34 y/o M with 7/10 pain down the right leg radiating to the foot. Straight leg raise aggravates the pain.
  773. measure scoliosis with the angle between the superior and inferior vertebrae. the most tilt from horizontal
    cob angle
  774. X ray 55 y/o with back pain. no history of trauma. displacement of L4 on L5, 25% of vertebra is displaced. Name ______; displacement _______
    spondylolisthesis; anterior
  775. 61 y/o F in ED. Bilaterally radiating leg pain and paresthesia in saddle distribution for 24h.
    immediate imaging and surgical consult
  776. scottie dog sign
    abnormality found in the collar represents fx of pars articularis. condition is spondylolysis.
  777. 87 y/o with acute back pain. started after brief coughing spell 3 days ago. hx of osteoporosis. pain increased with bending forward.
    compression fracture
  778. 23 y/o M in ED with acute neck pain following diving accident. Dove into shallow water. Xray of shifty lateral masses in proximal C-spine.
    Jefferson fx of atlas.
  779. stable odontoid type:
    type I
  780. Hangman MOA is hyperextension. Xray shows
    fracture of pedicle of C2
  781. C7 fracture tx
  782. most common dislocation
    anterior dislocation
  783. Bankhard definition
    avulsion of anterior labrum
  784. scaphoid (thumb/snuffbox tenderness). Exam to NOT do
    FALSE: CT scan of R wrist should be ordered.
  785. Guarding arm, rounded contour is lost. head of humerus is under the coracoid process. Dx
    anterior glenohumeral dislocation.
  786. inversion of ankle is painful; swollen ankle. Negative anterior drawer and Thompson test.
    ankle sprain
  787. L knee popping sound; L knee effusion. + Anterior drawer, Lachman. Negative McMurray.
    ACL tear
  788. Burning left heel pain for last few weeks. worse in the AM when he starts to walk.
    plantar fasciitis
  789. 3m hx of pain in the left shoulder of a baseball pitcher. pain during training. ibuprofen provides some relief. tender to palpation. negative drop arm and cross over.
    rotator cuff tendonitis
  790. pain at the base of the thumb with gripping. snuffbox tenderness.
    scaphoid fracture
  791. Computer keyboardist with numbness/tingling in 1st 3 fingers.
    carpal tunnel
  792. knock-kneed child
    genu valgum
  793. posterior curve of thoracic spine; prominent and bulging backwards
  794. overweight 14 y/o M with pain upon kneeling and exercise. swollen tibial tuberosity.
    osgood-schlatter dz
  795. Fusiform swelling of PIP in both hands
  796. RA with decreased lacrimation and salivation.
    Sjogens syndrome
  797. Pt with CHF and gout (taking digoxin)
    give NSAIDs
  798. negative birefringent crystals
  799. dinner fork deformity
    Colles fracture
  800. no extension of DIP joint wit sudden jamming injury
    Mallet finger
  801. 5 y/o child with ankle fracture through metaphysic plate and ends at epiphyseal plate
    Salter Harris II
  802. fx in child:
    Xray shows fat pad sign
  803. worsening eye pain, urethritis, joint pain
  804. F with severe unilateral HA:
    polymyalgia rheumatica (giant cell arteritis)
  805. pain to index, middle fingers, nerve root
    C7 nerve root
  806. cox-2 inhibiting NSAIDs
    Not a DMARD
  807. osteoarthritis
    more likely to be seen in trauma
  808. pt has Raynauds with difficulty swallowing
    Scleroderma (CREST)
  809. F with pain on anterior knees, R>L; increased with compression of patella, tender to palpation of patella; atrophy of medial thighs
    Patellofemoral syndrome
  810. Positive McMurry’s
    Medial meniscus tear
  811. Tender to palpation of lateral aspect of affected hip. full ROM without pain
    Trochanteric bursitis
  812. DeQuivains test
  813. with advancing age, loss of photoreceptors around the fovea
    macular degeneration
  814. Sensorineural hearing loss cause
    destruction of cochlear hair cells by abx
  815. erythema infectious caused by
  816. rotator cuff tendonitis (pitcher)
  817. optimal imaging for meniscal tear
  818. Fx of the metaphysis, epiphysis, and diaphysis
    Salter Harris IV
  819. isoenzyme for polymyositis
  820. Joint aches, cold sores in mouth on buccal mucosa, scrotum
    Behcet’s syndrome?
  821. RA with low WBC and with splenomegaly
    Felty’s Sydrome
  822. Fx of cortex on 1 side, bent on the other
    greenstick fx
  823. Nursemaid’s elbow—reduce by
    supination, flexion, and hyperpronation
  824. hip fx: r leg shortened, abducted and ____ rotation
  825. SLE (Lupus) workup, will find
    anti ds DNA
  826. 67 y/o F with dizziness and light-headed (EKG shown)