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PANCE Practice Exam Online
Comprehensive Review
320
Medical
Graduate
07/22/2011

Additional Medical Flashcards

 


 

Cards

Term
Diastolic rumbling murmur located at the apex and best heard in the left lateral position.
Definition
Mitral Stenosis
Term
Diastolic rumbling murmur typically accompanied by a thrill heard along the left sternal border and is louder with inspiration
Definition
Tricuspid Stenosis
Term
Which murmur presents as a soft, early diastolic, high pitched murmur heard best when sitting and leaning forwards
Definition
Aortic regurgitation
Term
What vitamin deficiency causes poor night vision and frequent sore throats?
Definition
Vitamin A
Term
What vitamin deficiency causes pellagra which includes symmetrical dermatitis on sun exposed areas, scarlet glossitis, diarrhea, and memory aberrations?
Definition
Niacin deficiency
Term
Which vitamin deficiency can cause hemolytic anemia in infants?
Definition
Vitamin E deficiency
Term
Which vitamin deficiency presents with bleeding tendencies, impaired wound healing, swollen friable gums, splinter hemorrhages on the nails?
Definition
Vitamin C
Term
Which vitamin deficiency can present with peripheral neuropathy, seborrheic dermatosis, glossitis, and cheilosis?
Definition
Pyridoxine or Vitamin B12 deficiencies
Term
Which organism is responsible for enterocolitis caused by shellfish?
Definition
Vibrio parahaemolyticus
Term
What is the first-line therapy for C Difficile?
Definition
Metronidazole
Term
What heart condition is seen in Turner's pts?
Definition
Coarctation of the aorta
Term
Which heart condition causes stronger pulses in the arms than in the legs, pulses paradoxes?
Definition
Coarctation of the aorta
Term
What is cervical motion tenderness a "red flag" for?
Definition
PID
Term
What does a fat-pad sign in pediatric x-ray of an elbow mean?
Definition
fracture
Term
Which condition has characteristic signs including Kayser-Fleischer rings and low serum ceruloplasmin?
Definition
Wilson's Dz
Term
What is the tx for a cholesteatoma?
Definition
Surgery
Term
Adult pt with Pink, red papulosquamous rash with scattered discrete coppery papules on the palms of the hands. What does this rash indicate?
Definition
Secondary syphillis
Term
First step in treating an acute presentation of severe hypercalcemia associated with malignancy?
Definition
Aggressive hydration with normal saline
Term
What SE can sumatriptan used to treat a migraine have?
Definition
coronary vasospasms causing chest pain or discomfort
Term
What is the most appropriate treatment for actinic keratosis?
Definition
cryosurgery
Term
What test is confirmatory for a thoracic aorta dissection?
Definition
Chest CT
Term
How do amphetamine salts, used in dieting work? Should you recommend them to your patients?
Definition
Release of dopamine and norepinephrine; NO
Term
What is the treatment for pulmonary sarcoidosis?
Definition
Corticosteroids
Term
What is the treatment for extra-pulmonary sarcoidosis?
Definition
Anti-tumor necrosis factor (Anti-TNF)
Term
Is sarcoidosis in the lungs caseating or non-caseating?
Definition
non-caseating granuloma
Term
Which syndrome has a clinical picture of iron deficiency anemia causing fatigue and dyspnea, as well as esophageal webs causing dysphagia?
Definition
Plummer-Vinson Syndrome
Term
What condition is caused by the normal lining of the esophagus being replaced by metaplastic cells and is commonly seen in individuals with longstanding reflux disease?
Definition
Barrett's esophagus
Term
What condition is described as a post-MI condition that is an auto-immune phenomenon and presents as pericarditis with associated fever, leukocytosis, and pericardial or pleural effusions?
Definition
Dressler Syndrome
Term
What condition is described as an esophageal motility d/o that causes progressive, gradual dysphagia for solids and liquids, with regurgitation of undigested foods? What is confirmatory for this condition?
Definition
Achalasia; Barium esophagram shows "bird's beak" appearance
Term
What condition is characterized by tears in the mucosa at the gastroesophageal junction that is many times linked to alcohol abuse and excessive vomiting?
Definition
Mallory-Weiss Syndrome
Term
With a presumptive diagnosis of a thoracic aortic dissection what would a finding on CXR consistent of that diagnosis?
Definition
Widening of the mediastinum
Term
What is the MC space-occupying CNS lesion in pts with HIV/AIDS with CD4 counts under 100 while not on prophylaxis?
Definition
Toxoplasmosis
Term
Head CT reveals multiple peripheral ring-enhancing lesions. Pt is immunosuppressed and has sx including stumbling, memory problems, confusion and had 1 tonic/clonic seizure. What condition has these characteristics?
Definition
Toxoplasmosis
Term
What is the most reliable method of moving an esophageal foreign body?
Definition
Rigid esophagoscopy with a fiberoptic telescopic system and forceps extraction
Term
What condition typically presents with crampy abdominal pain, N/V and localized hyperactive bowel sounds?
Definition
Small bowel obstruction
Term
Best empiric medication for CAP, especially Mycoplasma pneumoniae?
Definition
Azithromycin
Term
On EKG T-wave inversions and Q-waves in lead II, III and aVF, what do these findings indicate?
Definition
Acute inferior myocardial Infarction
Term
What is the treatment for gestational diabetes?
Definition
Diet, exercise, and insulin therapy if blood glucose remains high despite diet control
Term
Where is the most likely site for pathology in Addison's disease?
Definition
Adrenal cortex
Term
Pt presents with lethargy, weight loss, N/V, and salt craving. Labs show hyponatremia and hyperkalemia as well as elevated ACTH. What condition do you suspect?
Definition
Addison's dz
Term
What is the most likely pathogen causing pneumonia in the hospital setting?
Definition
Klebsiella pneumoniae
Term
What is the major COD in hypothermia cases?
Definition
Cardiac arrest
Term
At what body temp is hypothermia diagnosed?
Definition
Below 35C
Term
A 59-year-old woman presents by ambulance for second- and third-degree burns to her head and neck, anterior surface of her upper extremities, anterior surface of her right leg, and her anterior trunk including her genital area. What percentage of her body is burned?
Definition
46% - In this case, 9% for her head and neck, 9% for the anterior surface of both arms, 9% for the anterior surface of her right leg, 9% for her anterior upper torso, 9% for her anterior lower torso, and 1% for the genital area for a total of 46%
Term
What is the MC arrhythmia associated with hyperthyroidism?
Definition
Sinus tachycardia
Term
A 28y/o gravid female @ 24 weeks gestation presents with c/o insomnia, fatigue, DOE, and palpitations. On PE mild periorbital edema is found with hyperreflexia. What condition do you suspect, and how would you confirm the dx?
Definition
gestational thyrotoxicosis - confirm with thyroid panel
Term
What is chronic cough in a non-smoker MC due to? How do you confirm this?
Definition
Post-nasal drip; trial of anti-histamines
Term
What are the initial steps in managing moderate to severe hypothermia?
Definition
Acid-base balance correction and cardiac support
Term
How do you confirm Multiple Myeloma in a pt?
Definition
Serum protein electrophoresis
Term
What condition has typical presentation of symptoms including fatigue, pallor, back pain and occasional infection (especially in an older pt)?
Definition
Multiple Myeloma
Term
Which condition presents in an infant with choking, cyanosis, respiratory distress, and copious secretions with symptoms generally worsening during feeding and commonly there is a hx of polyhydramnios?
Definition
Tracheoesophageal fistula
Term
White reflex in the eye = ?
Definition
Retinoblastoma
Term
What is the most appropriate f/u if on DRE you find a non-tender, non-enlarged prostate, with an isolated left posterior lobe nodule?
Definition
Refer the patient for a transrectal ultrasound of the prostate and order a PSA level
Term
What muscle lies directly lateral and adjacent to the spinous process of the spine?
Definition
Interspinales
Term
Which trace mineral has the following functions: transports vitamin A, taste perception, wound healing, making of sperm, and essential in fetal development?
Definition
Zinc
Term
What is a major risk factor found in almost every epidemiological study of SIDs
Definition
Maternal smoking during pregnancy
Term
What is the confirmatory test for scabies?
Definition
skin scraping with immersion oil
Term
What 'condition' has presenting symptoms can include hypertension, tachycardia, diaphoresis, anxiety, dilated pupils, agitation, nasal congestion, and psychosis?
Definition
Cocaine intoxication
Term
A RadioActive I131 Uptake (RAIU) and scan on a symmetrically enlarged thyroid reveals high uptake in a diffuse, uniform pattern throughout the gland. What do you suspect?
Definition
Grave's Disease
Term
What does hyperresonance to percussion on lung exam accompanied by dyspnea and one-sided chest pain indicate?
Definition
Atelectasis
Term
Can lisinopril be used in a pregnant pt for control of BP?
Definition
ACE I are category D
Term
What is the confirmatory test for CO poisoning?
Definition
Carboxyhemoglobin level
Term
What does increased TIBC, decreased serum ferritin and decreased serum iron indicate?
Definition
Iron deficiency anemia
Term
What examination technique can help to show that a mass is a ganglion cyst?
Definition
Transilluminating the mass
Term
What is the best initial tx for Meniere's disease?
Definition
Low Na diet
Term
What is recommended to prevent contrast nephropathy in higher-risk patients?
Definition
Mild volume expansion
Term
In the management of a patient with alcoholic cirrhosis, what is the most important factor for their survival?
Definition
Alcohol abstinence
Term
What are the most reliable predictors of drowning outcome?
Definition
presence or absence of coma, pupillary response and blood glucose levels
Term
What is the best diagnostic test to confirm a diagnosis of acute thyroiditis?
Definition
Needle aspiration for culture
Term
What are the MC organisms responsible for causing acute thyroiditis? (3)
Definition
Staphylococcus aureus, Streptococcus, and S. pneumoniae
Term
An 8-year-old child is brought to you with acute fever. Parents notice redness of the skin in the neck area. The thyroid gland is extremely tender to palpation. What condition do you suspect?
Definition
Acute thyroiditis
Term
Whenever, a young patient presents with fever, progressive exertional dyspnea, hypoxia, and loss of weight, what condition should always be in your ddx?
Definition
pneumocystis carinii pneumonia (PCP) and acquired immunodeficiency syndrome (AIDS)
Term
What is the mainstay of treatment for PCP in AIDS pts?
Definition
trimethoprim-sulfamethoxazole and corticosteroids
Term
Where/how is mitral valve stenosis best auscultated?
Definition
With the patient lying on the left side, at the apex of the heart
Term
On close inspection of a 6 y/o child, you note a tiny, white, wingless insect and tiny eggs attached to the hair shafts. What condition do you suspect?
Definition
Lice
Term
What is the most appropriate treatment for gestational thyrotoxicosis?
Definition
Propylthiouracil (PTU) therapy
Term
What is the most common nerve traumatized in head injuries? What does this cause?
Definition
sixth nerve palsy; Injury of this nerve results in internal deviation of the eye and failure to move the eye outwards
Term
How is traumatic sixth nerve palsy managed?
Definition
Observation for 6 months plus prism
Term
What is the treatment for paroxysmal supraventricular tachycardia (PSVT)?
Definition
Adenosine 6 mg IV
Term
What is the most appropriate treatment for severe acne?
Definition
oral isotretinoin added to other acne regimen
Term
What type of seizure is described as a pt suddenly blacking out, her body became very rigid and unmovable, accompanied by jerking motions with her arms, legs and head for a few minutes, then stopped?
Definition
Grand mal seizure
Term
A 20-year-old woman presents with intermittent nosebleed for the past 2 weeks. She also reports that her menstrual periods have increased in amount in the past 2 months. She recently underwent surgery for small bowel resection and only eats 1 meal a day. Laboratory investigations reveal prolonged prothrombin time and prolonged activated partial thromboplastin time and a normal platelet count. What is the most likely diagnosis?
Definition
Vitamin K deficiency
Term
Seal-like cough in child = ?
Definition
Croup
Term
Steeple sign on lateral head/neck x-ray = ?
Definition
Croup
Term
Where is the uterine fundus typically palpable at 20 weeks from the last menstrual period (LMP)?
Definition
Lower border of umbilicus
Term
What is the treatment for ultraviolet keratitis, or "snow blindness"?
Definition
Cyclopentolate drops
Term
Differential for a coin lesion in the lungs? (3)
Definition
a) lung carcinoma (most commonly an adenocarcinoma)
b) granuloma
c) hamartoma
Term
What is the most appropriate treatment Dressler's syndrome?
Definition
A corticosteroid taper
Term
A 63-year-old man presents with bleeding gums and a general feeling of illness. He indicated that he has been running a low-grade fever for the last few days, feels fatigue, and has bone and joint pain. He thought that he just had the flu, but he became concerned when his gums began to bleed. On examination, you note a pale individual, mild petechia on the extremities, gingival hyperplasia, and a palpable spleen. You order a CBC, which reveals pancytopenia and blasts with auer rods on the differential. What is your diagnosis?
Definition
Acute myelogenous leukemia (AML)
Term
A 39-year-old woman presents with a history of repeated, short episodes of intensely anxious moments with physiologic manifestations such as tachypnea, tachycardia, dizziness, headache, and a smothering sensation. After an extensive workup, she was diagnosed with panic disorder. What is the best initial drug of choice for sustained treatment of her condition?
Definition
Paroxetine
Term
What tests can be done to help in the diagnosis of MS?
Definition
Visual Evoked Potentials, CSF oligoclonal bands, CSF gamma globulin
Term
What is the treatment for renal cell carcinoma?
Definition
Referral to a urologic surgeon for radical nephrectomy
Term
On a PF test, what value is a combo of Inspiratory Reserve Volume, Expiratory Reserve Volume and Tidal Volume?
Definition
Vital Capacity
Term
On a PF test which value is described as the amount of air inhaled and exhaled during quiet, resting breathing?
Definition
Tidal Volume (TV)
Term
On a PF test, which value is described as the amount of air forcefully inhaled after normal inhalation?
Definition
Inspiratory Reserve Volume
Term
On a PF test, what value is described as the amount of air forcefully exhaled after a normal exhalation?
Definition
Expiratory Reserve Volume (ERV)
Term
What classification system helps to classify the severity of COPD? What is the basis of this system?
Definition
GOLD Classification; Spirometric Findings (FEV1, FEV1/FVC ratio)
Term
What condition is characterized by thickening of the renal artery causing decreased vessel diameter which eventually leads to renal artery stenosis? What is a common symptom of this dz?
Definition
fibromuscular disease (FMD) of her renal arteries; HTN
Term
A 4 y/o presents with a red area on his cheek that has gradually enlarged, and is slightly pruritic although it is non-tender. On PE the lesion is described as a 3-cm annular erythematous lesion on his right cheek that is slightly scaly with central clearing and a papulovesicular border. What condition do you suspect?
Definition
Tinea corporis ("ringworm")
Term
What is the common causative agent of tinea corporis in children?
Definition
Microsporum canis
Term
What is the treatment for ringworm, or tinea corporis in a child?
Definition
Clotrimazole 1% cream topically tid for 3 weeks
Term
A 21-year-old woman presents at 10 weeks gestation with vaginal bleeding and lower abdominal cramping. This is her second pregnancy, and she is concerned about losing her baby. Examination demonstrates bright red blood coming through a closed cervical os. What is the most likely diagnosis?
Definition
Threatened Abortion
Term
What does the Neer test evaluate for?
Definition
rotator cuff injury
Term
You order an ultrasound of the lower abdomen and find the intestinal sac has traversed through a weakened area of the abdominal wall and through Hesselbach's Triangle. What type of hernia is this?
Definition
Direct inguinal hernia
Term
What is the classic triad of a pheochromocytoma crisis?
Definition
Headache, palpitations, and diaphoresis
Term
What is the MC cardiac manifestation of thyrotoxicosis?
Definition
arrhythmia
Term
In the medication regimen for HIV, zidovudine, lamivudine, and efavirenz, which one is contraindicated for use in pregnant pts?
Definition
Efavirenz
Term
What part of the EKG tracing shows that the ventricles are completely depolarized?
Definition
S - T
Term
A soft, early diastolic, high pitched murmur, best heard with sitting and leaning forward.
Definition
Aortic regurgitation
Term
Is MVP a systolic or diastolic murmur?
Definition
systolic
Term
Is pulmonic stenosis a systolic or diastolic murmur?
Definition
systolic
Term
What is the most important diagnostic criteria for pneumonia?
Definition
CXR will show consolidation
Term
A CXR shows hyper-translucent lung fields with loss of peripheral vascular markings and the pt c/o a dry cough, diagnosis?
Definition
Emphysema
Term
What pathogen is associated with bloody diarrhea, fever and a recent anti-biotic use?
Definition
Clostridium difficile
Term
Which murmur type is a machinery like murmur?
Definition
PDA - Patent ductus arteriosis
Term
Harsh pan-systolic murmur?
Definition
Ventricular septal defect
Term
What is the treatment of Wilson's disease?
Definition
lifelong chelation or oral zinc and a low copper diet
Term
28y/o presents with a pink-red papulosquamous eruption with scattered discrete coppery papules on the palms of his hands, he is afebrile and has had no recent hx of illness. Skin exam reveals soft, flat, moist papules scattered on his perineum. What condition do you suspect?
Definition
Syphillis
Term
Impingement which nerve root may cause numbness and tingling primarily on the medial surface of the arm and into the lateral hand into the fourth and fifth digits. It may also cause dysfunction of the hand as it innervates the small hand muscles
Definition
C8
Term
Impingement of which nerve root may cause neck and upper shoulder numbness and pain
Definition
C4
Term
Impingement of which nerve root may cause deltoid and shoulder numbness and pain, and biceps tendon reflex may be diminished
Definition
C5
Term
Impingement of which nerve root can cause numbness and tingling down the arm into the thumb, with weakness in the bicep muscle and diminished brachioradialis tendon reflex in the affected extremity
Definition
C6
Term
Impingement of which nerve causes numbness and pain down the affected arm and into the middle finger, and the triceps reflex may be diminished on exam
Definition
C7
Term
What part of the body is affected by Addison's disease?
Definition
adrenal cortex
Term
What is death in the cases of hypothermia usually caused by?
Definition
cardiac arrest
Term
What is the diagnostic test of value for detecting multiple myeloma?
Definition
serum protein electrophoresis
Term
Most common direction of shoulder dislocation
Definition
Anterior
Term
Most common primary malignant intraocular tumor of childhood
Definition
Retinoblastoma
Term
What diagnostic test should be used in the management of children with minor closed head injury with loss of consciousness, amnesia at the time of evaluation, or headache or vomiting?
Definition
CT Scan
Term
Which trace mineral has the following functions: transports vitamin A, taste perception, wound healing, making of sperm, and essential in fetal development?
Definition
Zinc
Term
What factor has emerged as a major risk factor in almost every epidemiologic study of SIDS?
Definition
Maternal smoking during pregnancy
Term
Confirmatory test for scabies?
Definition
Skin scraping with immersion oil
Term
Pt with one month of hoarseness, not recent illnesses. Hx of 20 pk/yr smoking. Has non-tender anterior lymphadenopathy, what is the dx?
Definition
laryngeal CA
Term
Patient c/o fever, flank pain, urinary changes (dysuria, gross hematuria), and nausea/vomiting. On physical exam, findings include an elevated temperature, no hypertension, no edema, and a moderately ill-appearing patient with tenderness at the costoverterbral angle (CVA). Dx?
Definition
acute pyelonephritis
Term
Pt presents with purpuric rash, arthralgias, abdominal pain and mild hematuria on the urinalysis. Proteinuria is noted at <3.5. What is the Dx?
Definition
Henoch-Schönlein Purpura, a systemic small vessel vasculitis, classified as a nephritic disease
Term
Presenting symptoms of which intoxication can include hypertension, tachycardia, diaphoresis, anxiety, dilated pupils, agitation, nasal congestion, and psychosis.
Definition
Cocaine intoxication
Term
Pt presents with sharp pain on one side of the mouth that radiates to the ipsilateral ear, eye, or nostril. What is the Dx?
Definition
Trigeminal neuralgia
Term
Pt c/o a multitude of symptoms that have included diplopia or blurred vision early on, then an insidious onset of progressive weakness, numbness, and/or tingling in the extremities. What are you considering as a dx?
Definition
Multiple Sclerosis
Term
Pt presents with ptosis and diplopia, as well as difficulty swallowing, fatigue, and muscle weakness. What condition are you considering as the dx?
Definition
Myasthenia gravis
Term
What is an upper motor neuron disease that causes limb weakness, stiffness, and fasciculations?
Definition
Primary lateral sclerosis
Term
After an acute respiratory illness, the pt presents with an acute onset of pain in the thyroid gland, and a fever, elevated WBCs, and high sedimentation rate. Thyroid hormone is elevated and TSH is low. What is the dx?
Definition
Thyroiditis
Term
What is the most consistent finding on PE for a pneumothorax?
Definition
hyperresonance to percussion over the affected area
Term
Treatment of choice for peptic ulcer disease?
Definition
Proton Pump Inhibitors
Term
What condition has hallmark symptoms of epigastric pain (dyspepsia) described as aching, dull, or gnawing?
Definition
PUD (Peptic Ulcer Disease)
Term
What is the confirmatory test for carbon monoxide poisoning?
Definition
Carboxyhemoglobin level
Term
What examination technique would help to show that a mass is a ganglion cyst?
Definition
Transilluminating the cyst
Term
How can an acute thyroiditis diagnosis be confirmed?
Definition
Needle aspiration of the thyroid
Term
What test is performed first in the diagnosis of atherosclerotic vascular disease?
Definition
Doppler ultrasound can detect narrowing of arteries and is not invasive
Term
A 60-year-old man presents with severe, cramping pain in his lower extremities. He states that for the last 6 months, he noted that he has had pain in his lower legs when he walks and when walking with his wife for several blocks, the pain would extend to his hips and buttocks. The pain would go away with a period of rest. On physical examination, you note that his legs are pale, cool to the touch, and atrophy of the muscles is noted bilaterally. The femoral pulses are diminished upon palpation and a bruit can be heard over the iliac and femoral arteries. What is the dx?
Definition
occlusive disease of the lower extremities
Term
What test can be used to diagnose occlusive disease of the lower extremities?
Definition
Doppler Ultrasound
Term
Retinal examination of the right eye reveals a cherry-red spot, what do you suspect?
Definition
Central retinal artery occlusion
Term
What is a key indicator of acute massive hemorrhage due to perforation?
Definition
key to this assessment is the large drop in hemoglobin and hematocrit indicating significant blood loss
Term
What is the MC presentation of upper GI bleeding?
Definition
hematemesis (bright red blood of coffee grounds) or melena
Term
Pt presents with R shoulder pain that has become progressively worse overtime, he has not tried to alleviate the pain and it is worse at night while he is trying to sleep or when he is in the shower washing his hair. There was no hx of trauma or injury. PE shows no swelling, atrophy, redness or bruising. Point tenderness is located over the right lateral deltoid muscle. ROM at 80 degrees ABduction elicits pain. Pos Neer's impingement. Neg drop arm test. Neg apprehension test. What is the dx?
Definition
Rotator cuff tendonitis (tendinopathy)
Term
What PE test is positive if there is an Acromioclavicular sprain?
Definition
Cross body ADduction test would be positive
Term
Which pts are at a higher risk of adhesive capsulitis?
Definition
diabetics, pts with thyroid disorders, and pts who were immobilzed after a recent illness
Term
Pt has a wide-complex, rapid, regular tachyarrhythmia at 160 beats per minute, crushing chest pain and the monitor shows evidence of "P" waves at 75 beats per minute. What is his rhythm?
Definition
Ventricular tachycardia
Term
Which arrhythmia is described as a very chaotic tachyarrhythmia with no readily discernible P waves and no readily discernible QRS complexes?
Definition
Ventricular fibrillation
Term
What medication can you use in a patient with acute renal failure as a diuretic?
Definition
Loop diuretics
Term
What diuretic should be used to reduce intracranial pressure in cerebral edema?
Definition
Osmotic diuretics
Term
What disorder includes symptoms of both schizophrenia and a mood disorder?
Definition
Schizoaffective d/o
Term
What disorder requires the presence of symptoms, namely delusions, hallucinations, speech disturbances, and negative symptoms for a period of more than 1 month but less than 6 months?
Definition
Schizophreniform d/o
Term
What disorder requires the presence of symptoms, namely delusions, hallucinations, speech disturbances, and negative symptoms for a period of more than 6 months?
Definition
schizophrenia
Term
Which drug is recommended as a prophylaxis for influenza when the flu vaccine cannot be taken?
Definition
Rimantadine
Term
Which drug is used to help treat influenza?
Definition
Zanamivir
Term
In which pts should the use of Zanamivir be avoided?
Definition
Pt with Asthma or COPD
Term
A 48-year-old female patient complains of a sore tongue. Upon examine, her tongue is pinkish-red, completely smooth, and appears to be without any papillae. It protrudes symmetrically. No lesions, white patches/areas, or ulcerations are appreciated. What is the most likely diagnosis?
Definition
Atrophic glossitis
Term
What does atrophic glossitis indicate?
Definition
Deficiency in riboflavin, niacin, folic acid, vitamin B12, pyridoxine or iron
Term
Pt presents with a sore tongue that is white on examination. The white curdlike d/c can be scraped off and leaves a red denuded area underneath. What is your diagnosis?
Definition
Oral Candidiasis
Term
A 40 y/o pt with a hx of HIV presents with a lesion on her tongue. It is whitish-tan in color and has a feathery appearance. On PE the lesion cannot be scraped off. What is your diagnosis?
Definition
Hairy leukoplakia
Term
A pt with a suspected inguinal hernia has a U/S study done with findings including the intestinal sac has traversed the deep inguinal ring. What type of inguinal hernia is this?
Definition
INDIRECT Inguinal hernia
Term
What are the borders of Hesselbach's triangle?
Definition
the rectus abdominus, the inferior epigastric artery, and the inguinal ligament
Term
A pt with a suspected inguinal hernia has a U/S study done with findings including the intestinal sac entering through the weakened abdominal fascia and into the anatomic region known as Hesselbach's Triangle. What type of inguinal hernia is this?
Definition
Direct
Term
A 40 y/o female pt presents with anorexia, nausea, vomiting, constipation, fatigue, HA, and confusion. CBC and CMP reveal hypercalcenia of 14mg/dl. What is the first-step in the initial management of this pt?
Definition
aggressive rehydration with IV normal saline then give the bisphosphonate pamidronate
Term
A pt came in to the ER for a severe migraine and received treatment 20 minutes ago. Upon re-examination she is c/o significant chest pain that wasn't there previously. Which med used in the treatment of migraines can cause this adverse effect?
Definition
Sumatriptan can cause coronary vasospasms
Term
What is the treatment for actinic keratosis?
Definition
cryosurgery
Term
A 57-year-old man comes in for a routine checkup, but he also is concerned about a lesion on his head. On PE the lesion is rather crusted, rough, yellow-brown solitary lesion on the middle forehead at the hairline. You question him about his use of sunblock. He replies that he does not use any type of SPF protection. Additionally, he informs you that he has had major sunburns throughout life and spends the weekends on his sailboat when possible. What is your dx?
Definition
Actinic Keratosis
Term
What confirmatory imaging technique is most useful in detecting thoracic aortic dissection?
Definition
Chest CT
Term
A 42-year-old woman presents for an evaluation of back pain. She states that she has a history of recurrent UTIs and that on occasion, she has noted that her urine appears red. Upon physical examination, she demonstrates CVA tenderness and a palpable abdominal mass. Her vital signs include blood pressure of 145/90 mmHg, respiratory rate of 16 breaths/min, and heart rate of 72 bpm. You order a urinalysis which has the following abnormal results: leukocyte esterase 1+, protein trace, and blood 3+. The microscopic examination reveals 5-10 WBCs/hpf and 20-30 RBCs/hpf. You perform an abdominal ultrasound that demonstrates multiple, bilateral fluid collection within the kidneys. What is the most likely diagnosis?
Definition
Polycystic Kidney Dz
Term
Which HTN medication should be used in pregnant pts to control their HTN?
Definition
Methyldopa
Term
What is the MOA of amphetamines?
Definition
Release of dopamine and norepinephrine
Term
A 36-year-old African-American woman presents to your facility for an evaluation of a nonproductive cough, malaise, mild fever, and mild dyspnea. A chest X-ray demonstrates a right hilar mass. A pulmonologist is consulted and performs a biopsy during bronchoscopy. The report reveals that the mass is a noncaseating granuloma. What is the dx? Which therapeutics should you prescribe?
Definition
Sarcoidosis; Corticosteroids
Term
A 68-year-old woman presents with symptoms of dyspnea on exertion, easy fatigability, and lassitude for past 2 to 3 months. She also stated that recently she is having difficulty swallowing. She denied hemoptysis, GI, or vaginal bleeding. Occult blood was negative. A Hemoglobin & Hematocrit was ordered, and the results were 7.2 g/dl and 22%, respectively. She was diagnosed with iron deficiency anemia. The results of a barium esophagram reveal esophageal webbing. What is this condition known as?
Definition
Plummer-Vinson syndrome
Term
What is an esophageal motility disorder with gradual, progressive dysphagia for solids and liquids with regurgitation of undigested food and appears on barium swallow as a "bird's beak" appearance?
Definition
Achalasia
Term
What condition occurs post-MI, and presents as pericarditis with associated fever, leukocytosis, and pericardial or pleural effusions?
Definition
Dressler syndrome
Term
What condition is described as a mucosal tear at the gastroesophageal junction and has a history of vomiting?
Definition
Mallory-Weiss syndrome
Term
What condition is described as a condition where the normal lining of the esophagus is replaced with metaplastic cells and occurs in individuals with long standing reflux disease?
Definition
Barrett's esophagus
Term
You decide that a patient most likely has a thoracic aortic dissection. You obtain a STAT chest x-ray. Which finding would be most consistent with your presumptive diagnosis on CXR?
Definition
Widening of the mediastinum
Term
What is the MC space-occupying CNS lesion seen in pts with HIV and CD4 cell counts under 100?
Definition
Toxoplasmosis
Term
A 42-year-old man presents to the local emergency department with a history of HIV infection/AIDS. He has been non-compliant with his HIV medication and has taken no medication at all for at least 4 months. His last CD4 count was 123 cells/mcL 6 months ago, and his HIV viral load was 9,26,000 copies/mcL. His girlfriend states that he has been stumbling and having memory problems and confusion for the past month. He also had what his girlfriend described as a tonic-clonic seizure 1 week prior but refused to come for treatment at that time. A CT of his head revealed multiple peripheral ring-enhancing lesions. What is the most likely diagnosis?
Definition
Toxoplasmosis
Term
A Head CT reveals RING-ENHANCING lesion in a pt with HIV, who is non-compliant on meds. Neurological sx including balance difficulties, confusion, memory issues and seizures are present. What is your dx?
Definition
Toxoplasmosis
Term
What is the most reliable method of removing an esophageal foreign body?
Definition
Rigid esophagoscopy
Term
A pt presents with localized high pitched bowel sounds with crampy abdominal pain, nausea, and vomiting. What condition do you suspect?
Definition
Small Bowel Obstruction
Term
What is an infectious disorder characterized by fever, lymphadenopathy, arthralgias, weight loss, and chronic diarrhea?
Definition
Whipple's Dz
Term
What is the appropriate treatment for a patient with a suspected scaphoid fracture has radiographs that are read as "normal," but clinically there is a fracture?
Definition
Thumb spica splint, limit use, follow up in 2 to 3 weeks for repeat radiographs
Term
First-Line therapy for community acquired pneumonia?
Definition
Azithromycin
Term
KNOW SALI
Definition
Septal - V1, V2
Anterior - V3, V4
Lateral - V5, V6
Inferior - II, III AVF
Term
A 61-year-old male presents to the local ED with chest pain for the last hour. An ECG is obtained and found to have T wave inversion and wide Q waves in leads II, III, and AVF. The EKG findings are most consistent with what type of MI?
Definition
Acute Anterior Myocardial Infarction
Term
What is the treatment for diabetes insipidus?
Definition
desmopressin
Term
A 28-year-old man presents with increasing polyuria and nocturia without significant changes in his weight. He has noted increased thirst subsequent to increased urination. Urine osmolality is low, and the urine is poorly concentrated on the water restriction test. Glucose & Na is WNL. What is the probable diagnosis?
Definition
Diabetes Insipidus
Term
Impingement of this nerve can cause numbness and tingling down the arm into the thumb, with weakness in the bicep muscle and diminished brachioradialis tendon reflex in the affected extremity.
Definition
C6
Term
Impingement of which nerve root may cause neck and upper shoulder numbness and pain.
Definition
C4
Term
Impingement of which nerve root may cause deltoid and shoulder numbness and pain, and biceps tendon reflex may be diminished.
Definition
C5
Term
Impingement of which nerve root causes numbness and pain down the affected arm but into the middle finger and the triceps, reflex may be diminished on exam.
Definition
C7
Term
A mother brings her 5-year-old son to your facility presenting with several blisters on his cheek and around his nose. On examination, you note several large flaccid, thin-roofed bullae on both cheeks, minimal involvement around the nose and several outcrops of bullae on his wrists. What is the diagnosis?
Definition
Impetigo
Term
How should Impetigo be treated?
Definition
Dicloxacillin
Term
What electrolyte abnormality would cause a shortened QT interval, and sx including loss of appetite, lethargy and constipation?
Definition
Hypercalcemia
Term
What electrolyte imbalance is associated with sarcoidosis?
Definition
hypercalcemia
Term
What is the MCC of a lung abscess?
Definition
Aspiration is the MCC
Term
What is the MCC of cholangitis?
Definition
CBD stones with obstruction of the CBD
Term
A 26-year-old man is brought to the emergency department by ambulance for second-degree burns to his right arm, anterior surface of his right legs, and his anterior trunk, sparing his genital area. Which of the following represents a reasonable estimation of the extent of his burns?
Definition
36%
Term
What is the most common cause of bacterial pneumonia among non-institutionalized individuals with no significant co-morbid conditions?
Definition
Streptococcus pneumoniae
Term
What pathogen is responsible for Roseola?
Definition
HHV 6 or 7
Term
What childhood illness is described as a maculopapular beginning on the face, spreading to the entire body, and disappearing by the 4th day after prodrome of low-grade fever, ocular pain, sore throat, and myalgias?
Definition
Rubella
Term
Which childhood illness consists of the prodrome of fever, cough, conjunctivitis, and coryza & the rash appears as maculopapular, spreading down from the face and hairline to the trunk over 3 days and becoming confluent?
Definition
Rubeola
Term
What childhood illness is described as a rash appears as raised, fiery-red maculopapular lesions on the cheeks that give a "slapped-cheek" appearance?
Definition
Erythema infectiosum
Term
What is the underlying cause of amaurosis fugax?
Definition
Retinal Artery Emboli
Term
Pt presents with an obvious bulge in the right lower quadrant extending into the right scrotal sac. The abdomen itself is soft, flat, and non-tender. Bowel sounds are slightly hyperactive; there are no rushes or tingling sounds. The bulge cannot be reduced and is tender. Bowel sounds are present within the mass. An x-ray, flat and upright, of the abdomen shows some dilated small bowel extending into the right scrotal sac, but signs of obstruction are absent. What do you suspect?
Definition
Incarcerated Indirect Hernia
Term
What is the best treatment for a ruptured proximal biceps tendon?
Definition
physical therapy
Term
What drug is the most effective drug for rapid termination of a reentrant PSVT?
Definition
Adenosine 6 mg IV
Term
What medication is recommended in pts with severe acne, cystic acne, or acne refractory to treatment? In which pts should their use be avoided?
Definition
Retinoids (isotretinoin); Should be avoided in prego women or those trying to conceive as they are teratogenic
Term
Which seizure is described as beginning with jerking motions in the pts arms and legs, then the pts body becomes rigid and unmovable with the pt being unresponsive and afterwards confused with no recollection of the event?
Definition
Grand mal seizure
Term
In which type of seizure does a pt not lose consciousness?
Definition
simple partial seizures
Term
A 20-year-old woman presents with intermittent nosebleed for the past 2 weeks. She also reports that her menstrual periods have increased in amount in the past 2 months. She recently underwent surgery for small bowel resection and only eats 1 meal a day. Laboratory investigations reveal prolonged prothrombin time and prolonged activated partial thromboplastin time and a normal platelet count. What is the most likely diagnosis?
Definition
Vitamin K deficiency
Term
What pathogen MCC croup?
Definition
parainfluenza virus
Term
4 y/o pt presents with a progressive fever, sore throat, and cough for a couple of days to a sudden midnight onset. The cough is accompanied by stridor at rest and a hoarse cough. What is your diagnosis?
Definition
Croup
Term
MCC of bronchiolitis?
Definition
RSV
Term
What pathogen causes epiglottitis?
Definition
H. influenza
Term
3 y/o pt presents with Drooling, hoarseness, high fever, sore throat, and is sitting with hands on knees leaning forward and looks lift a sniffing dog. What is your dx?
Definition
Epiglottitis
Term
Treatment for croup?
Definition
humidified air, inhaled or oral corticosteroids, and nebulized racemic epinephrine.
Term
What is the tx for epiglottitis?
Definition
Intubation, IV ceftriaxone or cefuroxime
Term
Treatment for Kawasaki's disease?
Definition
Intravenous immunoglobin
Term
A 3-year-old girl presents with fever and rash for 5 days. She has no significant past medical history and no recent travel history. She is current up to date with her vaccinations. On exam, her temperature is 102.6 F, heart rate is 96, and blood pressure is 84/54. She is in no acute distress. She has a generalized maculopapular rash with erythematous palms. She has bilateral conjunctival injection without exudate, a strawberry tongue, cracked red lips, and grey tympanic membranes. There is an enlarged anterior cervical lymph node on the left side measuring 1.9 cm. Her lungs are clear. She has a soft systolic murmur best heard over the left sternal border. Her abdomen is soft without organomegaly. What is your Dx?
Definition
Kawasaki's dz
Term
Where is the fundus typically palpable at 20 weeks gestation?
Definition
lower border of the umbilicus
Term
At the end of the first trimester, where can the fundus be palpated?
Definition
Just above the pubic symphysis
Term
When the fundus is located just below the xiphoid, what week of gestation is the prego female at?
Definition
34 weeks to full term
Term
What nerve is affected by carpal tunnel?
Definition
Median Nerve
Term
What nerve is affected if there is thenar atrophy?
Definition
median nerve
Term
What nerve is affected if there is hypothenar atrophy?
Definition
ulnar nerve
Term
If a pt presents with snow blindness or ultraviolet keratitis, what is the treatment?
Definition
Cyclopentolate drops
Term
Differential for "coin lesions"? (3)
Definition
lung carcinoma (MC adenocarcinoma)
granuloma
hamartoma
Term
What lung condition tends to spread very quickly and commonly occur with a hx of smoking?
Definition
Small cell carcinoma
Term
What lung condition results from inflammation, destruction and dilatation of the bronchi and gives a typical honeycomb appearance on CXR?
Definition
Bronchiectasis
Term
What lung condition results from an inhalation of dust containing silica for many years and scattered nodules in the lungs?
Definition
Silicosis
Term
What is the treatment for Dressler syndrome?
Definition
ASA, NSAIDs, or corticosteroid taper
Term
A post-MI pt returns for f/u visit c/o sharp inspiratory chest pain. If Dressler syndrome is the dx, what would show on the EKG?
Definition
diffuse ST elevations
Term
A post-MI pt returns for f/u visit c/o sharp inspiratory chest pain. If Dressler syndrome is the dx, what would show on the EKG?
Definition
diffuse ST elevations
Term
A post-MI pt returns for f/u visit c/o sharp inspiratory chest pain. If Dressler syndrome is the dx, what would show on the EKG?
Definition
diffuse ST elevations
Term
A post-MI pt returns for f/u visit c/o sharp inspiratory chest pain. If Dressler syndrome is the dx, what would show on the EKG?
Definition
diffuse ST elevations
Term
CBC findings of pancytopenia, blasts with auer rods as well as gingival hyperplasia and mild petechiae on the extremities is indicative of what condition?
Definition
AML - acute myelogenous leukemia
Term
Best drug for the sustained treatment of panic disorder?
Definition
paroxetine (SSRI)
Term
Which of the evoked potential tests is the most useful in the diagnosis of MS?
Definition
visual evoked potential is pos in 85% of MS pts
Term
Tx for RCC (renal cell carcinoma)?
Definition
referral to urology for radical nephrectomy
Term
Tx for tinea corporis 'ringworm'?
Definition
clotrimazole
Term
What is the appropriate treatment for nummular eczema?
Definition
topical corticosteroids
Term
Tx for tinea capitus?
Definition
griseofulvin
Term
Tx for uncomplicated cellulitis
Definition
amoxicillin and cephalexin
Term
Bright red blood coming through a closed cervical os describes which type of clinical abortion?
Definition
threatened abortion
Term
Bright red blood coming through a dilated cervix indicates what type of abortion?
Definition
inevitable abortion
Term
When do the majority of spontaneous abortions occur?
Definition
b4 the 16th week
Term
Neer tests for what?
Definition
rotator cuff injury
Term
Hernia through hesselbach's triangle = ?
Definition
direct inguinal hernia
Term
On inguinal hernia examination the mass pushes against the side of the examiners finger, what is the dx?
Definition
direct inguinal hernia
Term
On inguinal hernia examination the mass pushes against the tip of the examiners finger, what is the dx?
Definition
indirect inguinal hernia
Term
What is a complication of giant cell arteritis of the temporal arteries if the pt does not receive tx?
Definition
risk of blindness
Term
What is the classic triad of pheochromocytomas?
Definition
HA, palpitations and diaphoresis
Term
In which pt population are pheochromocytomas MC found?
Definition
young to mid-adult women
Term
32 y/o female pt presents with paroxysmal episodes of HA, palpitations and diaphoresis which last for 20 minutes. During one episode her BP was recorded at 194/110. She denies any precipitating events and notes they have occured both with activity and at rest. PE is unremarkable. What do you suspect?
Definition
pheochromocytoma
Term
Which of the following HIV meds is prego cat D and should be d/c during pregnancy... Lamivudine, Zidovudine, Efavirenz
Definition
efavirenz
Term
What are the TOC for an active infection of meningococcemia?
Definition
PCN G (If PCN allergic give chloramphenicol and cephalosporins)
Term
What point on the EKG tracing shows where the ventricles are completely depolarized?
Definition
S-T
Term
During pregnancy what is the best treatment for chlamydia?
Definition
Erythromycin estolate
Term
Which type of fat helps decrease low-density lipoproteins?
A Butter
B Beef tallow
C Coconut oil
D Olive oil
E Palm kernel oil
Definition
D - Olive Oil
Term
The diagnostic corneal pigmentation seen in Wilson's disease is known as what?
Definition
Kayser-Fleischer rings
Term
What lab value is most suspicious for recurrence of thyroid malignancy?
Definition
Increasing serum thyroglobulin levels
Term
What is Horner's syndrome due to?
Definition
bronchogenic carcinoma tumor mass extending to the sympathetic chain
Term
A 50-year-old African-American man presents to the emergency room complaining of inability to see well for the past 2 weeks. He is a married newspaper editor and is not on any medications. He has been smoking 2 packs of cigarettes a day for the past 30 years. On examination of his right eye, there is ptosis and miosis. A chest radiograph reveals a rounded opacity in the right lung field. What is the most likely diagnosis?
Definition
Horner's Syndrome
Term
Ptosis, Miosis, hemianhydrosis and enophthalmos are indicators of which condition?
Definition
Horner's Syndrome
Term
What is the resting membrane potential of a sinus nodal fiber under normal conditions?
Definition
-55 mV
Term
Tx for tumor lysis syndrome?
Definition
IV hydration
Term
Pt presents after recent chemo tx for lymphoma with restlessness, tachycardia, muscle weakness, increased WBC count, azotemia, hypocalcemia, and hyperkalemia. What condition do you suspect?
Definition
Tumor lysis condition
Term
What spinal abnormalities are seen in Marfan's syndrome?
Definition
Scoliosis and Kyphoscoliosis
Term
The primary site for blood pressure regulation in the vascular system is ____________________?
Definition
the arterioles
Term
What are the progestin components of an OC responsible for?
Definition
primarily suppresses luteinizing hormone (LH) secretion (and thus prevents ovulation)
Term
What are the estrogen components of OC responsible for?
Definition
suppress follicle-stimulating hormone (FSH), as well as provide stability to the endometrium and potentiation of the progestin's actions
Term
Which joints and how many does gout typically affect at initial onset?
Definition
Usually affects smaller, LE joints and usually is monoarticular
Term
Which is the leading cause of fatal accidental poisoning among children 6-years-old and under in the United States?
Definition
Iron pills
Term
Acute attack of pain, vision blurred, halos, steamy cornea, conjunctival injection and nausea are symptoms characteristic of what condition?
Definition
Acute-angle glaucoma
Term
A 34-year-old woman has been newly diagnosed diabetes. When evaluating this patient to determine if she is a type 1 versus type 2 diabetic, which laboratory results would specifically indicate type 2 Diabetes?
Definition
Elevated Serum C-peptide - markers of endogenous insulin production (which is absent in Type 1 diabetics)
Term
Which pts typically present with the following clinical findings: are impulsive, have unstable interpersonal relationships, are suffused with anger and fear, lack self-control, are suicidal, and demonstrate aggressive behavior?
Definition
Borderline personality d/o
Term
Which pts present with personalities are exhibitionists, grandiose, preoccupied with power, and have poor social interactions?
Definition
Narcissistic
Term
Which type of pts have personalities fear rejection, have low self-esteem, and hyperreact to rejection and failure?
Definition
Avoidant Personalities
Term
Which pts have personalities that are dependent, immature, seductive, vain, and egocentric?
Definition
Histrionic
Term
Which pts have personalities that are selfish, callous, impulsive, have legal problems, and are promiscuous?
Definition
Antisocial
Term
A 62-year-old man is in the hospital. He is able to hear things and repeat what is said to him. However, he does not understand what he has just heard. What is this phenomenon called?
Definition
Echolalia (Echophrasia means they don't understand what they heard)
Term
The substitution of a similar sounding word for another word is called what?
Definition
paraphrasia
Term
An aphasia where there is a problem with reading is called what?
Definition
Alexia
Term
A condition where a patient has difficulty performing motor acts, despite having the muscular capacity and coordination to do so is known as?
Definition
Apraxia
Term
A writing disturbance is called what?
Definition
Agraphia
Term
A 55-year-old male comes in with complaints of nonproductive cough which has worsened over the last two months. He recently noted the appearance of blood-streaked sputum. Sputum cytology revealed the small cluster of hyperchromatic pleomorphic cells with very scanty cytoplasm. What condition do you suspect?
Definition
Lung CA
Term
What is the prophylactic DOC for malaria with no drug-resistance?
Definition
weekly chloroquine
Term
DOC for gout?
Definition
Indomethacin
Term
What med can be used in the prevention of gout?
Definition
Allopurinol
Term
Treatment for strep pharyngitis if pt is PCN allergic?
Definition
Macrolides - Azith, Eryth,
Term
What part of the virus is used in the preparation of the Hep B vaccine in the U.S?
Definition
Hepatitis B surface antigen (HBsAg)
Term
DOC for giardia infection?
Definition
Metronidazole
Term
Pt presents after a camping trip with hx acute watery diarrhea and now c/o flatulence, foul-smelling stools, abdominal pain and distention, and anorexia. What condition do you suspect?
Definition
giardia lamblia
Term
Pt present post-seizure and caregiver describes hx of fever, abdominal pain, tenesmus, and bloody mucoid stools. What condition do you suspect?
Definition
Shigella
Term
MCC of diarrhea in children <2y/o?
Definition
Rotavirus
Term
What physical finding may indicate an advanced Carpal Tunnel Syndrome?
Definition
Thenar Atrophy
Term
Which asthma medication prevents the release of mast cell autocoids to treat exercise-induced asthmatic attacks?
Definition
Cromolyn (Intal)
Term
lightheadedness on getting up is a typically sign of what?
Definition
Orthostatic hypotension
Term
What is the most important facet of obesity treatment?
Definition
Behavioral intervention
Term
Treatment for pleuritis?
Definition
NSAIDs
Term
friction rub + recent flu infection = ?
Definition
pleuritis
Term
Which test is most sensitive to monitor the affects of heparin?
Definition
PTT
Term
What lesions is described as strictly macular, 1 to 3 cm in diameter, but can be as large as 5 cm, appear as light yellow, light brown, or dark brown, and are uniformly mixed in color?
Definition
Solar lentigo
Term
What skin lesion is described as flat-topped, yellow, firm nodules that are primarily located on the elbows and knees?
Definition
Tuberous xanthomas
Term
Positive Finklesteins test indicates?
Definition
DeQuervain's tenosynovitis
Term
What is a common hx finding of people with deQuervain's?
Definition
Repetitive use of their thumb
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