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2011-03-24 13:13:04
CK review

Step 2 CK review
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  1. What is the most common inherited form of mental retardation?
    Fragile X syndrome
  2. 10 y/o M brought to ER with colicky abdominal pain and dizziness for past two hours. Seven episodes with vomiting with bright red blood in vomitus, and has also had diarrhea with dark green stools. Mother takes acetominophen, aspirin, iron supplements, and paroxetine.
    Iron toxicity - Iron is toxic to GI tract - associated with hemorrhagic vomiting/diarrhea
  3. 42 y/o F twisted leg while hiking. Initially felt pain in right knee but was able to continue to walk. Next morning, noticed right knee swelling and was painful to bear weight on it. Severe pain in medial aspect of knee while squatting.
    Meniscal tear
  4. 67 y/o M discovers several lumps in axilla while showering. PE: bilateral cervical and axillary lymphadenopathy. Tip of the spleen is palpable. Labs: Hb: 8.5, MCV: 89, Leukocyte count (56,000 (80% mature lymphocytes). Platelets: 90K.
    Chronic lymphocytic leukemia
  5. What cells are seen on blood smears of patients with CLL?
    "Smudge cells" - fragile lymphocytes
  6. Soft holosystolic murmur over xiphoid process in known IV drug user
    Tricuspid regurgitation due to right sided endocarditis
  7. How to differentiate loops of small bowel vs large bowel on abdominal plain film?
    • Small bowel - center of abdomen
    • Valvulae Conniventes extending across bowel lumen
  8. Treatments for PCOS - first and second line
    • 1. Weight loss
    • 2. Clomiphene or Metformin
  9. What is the treatment for BPPV?
    Epley manuever - resposition displaced otoliths
  10. Fracture involving middle portion of humerus - what nerve to worry about? How to tell?
    Radial nerve - travels along dorsal aspect of humerus

    Sensation on dorsal surface of hand
  11. Classic EKG findings in atrial fibrillation?
    • absent P waves
    • irregularly irregular QRS complexes (irregular R -R intervals)
  12. 71 yo M evaluated for impaired cognition and memory loss. Family members report that suddenly 1 year ago he started to become more forgetful. About 5 months ago, he started having trouble balancing checkbook and began getting lost around neighborhood. PMH: DM, HTN, high cholesterol.
    Vascular/multi infarct dementia
  13. What test can be used to help diagnose carcinoid syndrome?
    Urinary 5-HIAA excretion
  14. What lab test to order for suspected celiac disease?
    Anti-endomysial antibodies
  15. What if you see RBCs stacked together like coins?
    • Rouleaux formation
    • Suspect multiple myeloma - elevated proteins cover RBCs removing normal electrostatic repulsion that prevents RBCs from sticking to each other
  16. 73 y/o F hospitalized following anterior wall MI. On day 3, develops SOB and chest discomfort. BP: 80/40, HR: 120. On exam: holosystolic murmur at left sternal border.
    Ventricular septal defect - secondary to rupture of interventricular septum
  17. What is the most common coagulopathy seen in cancer patients?
    Disseminated intravascular coagulation
  18. 23 y/o African American male passes out while unloading heavy packages. Has had brief episodes of light headednesss over last few years. PE: systolic murmur heard best at left sternal border that decreases in intensity when he goes from standing to supine position.
    Hypertrophic cardiomyopathy
  19. Murmur noted with mitral valve prolapse?
    Midsystolic click with late systolic murmur
  20. 16 y/o M pw severe sharp right sided testicular pain. Not sexually active. PE: right sided testicular swelling and extreme tenderness. Touching inner thigh does not lead to elevation of the testes. Elevating testes does not lead to relief of pain.
    Testicular torsion
  21. Most common presentation of IgA nephropathy?
    Gross hematuria following upper respiratory infection
  22. What is the most common cause of nephrotic syndrome in adults (particularly African Americans)?
    Focal segmental glomerulosclerosis