Shared Flashcard Set

Details

XX
DIT Rapid Review / Preview
230
Medical
Post-Graduate
07/04/2010

Additional Medical Flashcards

 


 

Cards

Term
Common causes of seizures in children 2-10
Definition

trauma

febrile

infection

idiopathic

Term
Beck's triad
Definition

JVD

Distant heart sounds

hypotension

Term
Lab findings diagnostic of Hashimoto's
Definition

Increased TSH

Decreased T4

Antimicrosomal antibodies

Term
You want to know if maternal age affects infant mortality rate but most of the variation in infant mortality is predicted by socioeconomic status. Socioeconomic status would be considered______?
Definition
a confounding variable
Term
Treatment for systemic shock
Definition

Fluids

Pressors - norepinephrine

ABX

Term
Type of bias present when clinician is aware of the type of treatment the patient is receiving
Definition
observer bias
Term
Type of back pain exacerbated by standing and walking and relieved by sitting and hyperflexion of hips
Definition
spinal stenosis
Term
In what circumstances should confidentiality not be protected?
Definition

homicidal / suicidal

when permission has been granted by patient

police investigation

reportable diseases

abuse (child, elderly)

Term
First test in a woman presenting w/ secondary amenorrhea
Definition
beta-HcG
Term
Treatment for mild and severe unconjugated hyperbilirubinemia
Definition

Mild - phototherapy

 

Severe - exchange transfusion

Term
Exception for requirement of informed consent
Definition

Emergencies - implied

Patient without decision-making capacity

Patients who sign waivers

Term
Treatment for mild persistent asthma
Definition

short-acting inhaled beta agonist

Consider mast cell stabilizers, leukotriene inhibitors or theophylline

Term

25 year old male presents w/ white plaques on his tongue and back of his throat that scrape off w/ depressor.

Dx?

Screening?

Definition

Candidiasis

Screen for HIV

Term
Infectious cause of aplastic anemia in a sickle cell patient
Definition
Parvovirus B-19
Term
Drugs blocking transmission of AV node
Definition

Calcium channel blockers (diltiazem, verapamil)

Beta blockers

Digoxin

Term
Cardinal movements of labor
Definition

Engagement 

Decent

Flexion

Internal rotation 

External rotation

Expulsion

 

Term
Child has flesh-colored, umbilicated lesions on the face.  What are they and where do they appear in adults?
Definition

Molluscum contagiosum

 

Perianal area in adults

Term
What diagnostic test differentiates central from nephrogenic diabetes insipidus?
Definition

DDAVP (desmopressin)

Measure urine osmolality

Term

CSF analysis shows low glucose, elevated eosinophils and gram + diplococci

Dx?

Definition
strep pneumo
Term

22 year old male has 4 months of social withdrawal, worsening grades, decreased emotional expression and concrete thinking.

Dx?

Definition
Schizophreniform disorder
Term

75 year old male presents w/ fatigue, lymphadenopathy, splenomegaly and isolated lymphocytosis.

Dx?

Definition
CLL
Term
Next step in the management of a positive PPD
Definition
Get a CXR
Term

ER patient w/ blood in the urethral meatus and high-riding prostsate

Dx?

Definition

Bladder rupture

Urethral injury

Term
Acute renal failure in a pt w/ a FENa <1%
Definition

Prerenal azotemia

 

Decreased volume /blood

Term
Protein and LDH for an exudative effusion
Definition

Protein >0.5

 

LDH >0.6

Term
Muscle rigidity, fever and rhabdomyolysis in a schizophrenic patient
Definition
Neuroleptic malignant syndrome
Term
Bilious emesis in a newborn w/in hours after first feeding
Definition
duodenal atresia
Term

60 year old woman leaking urine when laughing/coughing.

non-surgical options?

Definition

Stress incontinence

 

Kagal exercises

estrogen

Term
MCC of HTN in a young woman
Definition
OCP's
Term
Hernia w/ greatest risk of incarceration
Definition
Femoral
Term
Cause of aplastic anemia associated w/ thumb abnormalities, diffuse hypo or hyperpigmentation, cafe au laite spots, and short stature
Definition
Fanconi's anema
Term
biostatistical calculation that looks at individuals w/ or w/o a disease and determines likelihood to a risk factor
Definition
odds ratio
Term
anti-diabetic associated w/ lactic acidosis
Definition
metformin
Term
cradle cap - TX?
Definition

seborrheic dermatitis

 

selenium sulfide shampoo or topical antifungals

Term
glomerulonephritis w/ deafness
Definition
Alport's
Term
diagnostic test for a PE
Definition

CT - PE protocol

 

VQ scan

Term
rash presenting w/ herald patch and christmas tree pattern
Definition
pytariasis rosea
Term
charcot's triad
Definition

RUQ pain

Fever/chills

Jaundice

 

May also be indicative of ascending cholangitis

Term
Infection causing aplastic crisis in sickle cell patients
Definition
Parvovirus B19
Term
Elderly male complains of bone pain and adds that his favorite hat no longer fits
Definition

Paget's disease

 

Tx w/ bisphosphonates

Term
Used in 10th week of gestation to screen for chromosomal abnormalities
Definition
Chorionic Villous Sampling
Term
Cause of secondary amenorrhea in a patient w/ normal prolactin, no response to estrogen/progesterone challenge and history of D&C
Definition
Ahserman's syndrome
Term
Causes transudative pleural effusion
Definition

Kidney and liver disease

Protein-losing enteropathies

Term
MC pathogen causing croup
Definition
parainfluenza virus
Term
causes a crescent-shaped hyperdensity on CT that does not cross the midline
Definition
subdural hematoma
Term
TX for opioid overdose
Definition
naloxone/naltrexone
Term
Most serious side of clozapine
Definition
agranulocytosis
Term
Sentinel loop on AXR seen with?
Definition
Acute pancreatitis
Term
Visual imaging studies in a trauma patient
Definition

AP pelvis

AP chest

AP/lateral C-spine

Term
Hampton's hump on xray
Definition
PE
Term
A mother who is frustrated with her child yells at her husband.  Defense mechanism?
Definition
Displacement
Term
Natural history of leiomyoma
Definition
After menopause and estrogen decline, they shrink
Term
Immunodeficiency w/ chronic respiratory infections and positive nitro blue tetrazolium test
Definition
Chronic granulomatous disease
Term
type of headache causing unilateral severe periorbital headaches w/ tearing
Definition
Cluster headache
Term
antihypertension meds for patients w/ preeclampsia
Definition

sodium nitroprusside

nifedapine

labetalol

methyldopa

Term
MCC of travelor's diarrhea
Definition
e. coli
Term
Only indication for administering hypertonic saline to a patient w/ SIADH
Definition
active seizures
Term
Rash w/ dermatomal distribution
Definition
herpes zoster
Term
next step in evaluating a puslatile mass in abdomen and bruit
Definition
abdominal ultrasound
Term
flat topped purplish pruritic papules
Definition
lichen plannus
Term
definition of maternal mortality
Definition
# of deaths during pregnancy to 90 days post partum / 1000 live births
Term
joint pain and stiffness that worsens over the course of the day and relieved by rest
Definition
osteoarthritis
Term
treatment for cardiogenic shock
Definition
pressors - dobutamine
Term
Teen with history of theft, vandalism and violence toward family and pets
Definition
conduct disorder
Term
continuous machine-like murmur
Definition
PDA
Term
woman w/ preeclampsia in first trimester
Definition
hydadiform mole
Term
CSF finding in SAH
Definition

xanthochromia (2 days out)

Increased CSF opening pressure

RBC's in all four tubes

Term
Acid-base disorder in pregnancy
Definition
Respiratory alkalosis
Term
Husband asks that his wife not be told about her recent diagnosis of lung cancer.  What do you do
Definition
tell her, unless you feel it will be a danger to do so (ie suicide)
Term
case-control measures incidence or prevalence?
Definition
neither - it's just one study
Term
first line tx for growth-hormone secreting pituitary adenoma
Definition
transphenoidal tumor resection
Term
characteristics of a nevus that may suggest melanoma
Definition

asymmetry

boarder irregularity

color variation

diameter

Term
important side effect common to many atypical antipsychotics
Definition
weight gain ->DM type II
Term
MC location for ectopic pregnancy
Definition
ampulla of uterine tube
Term
Uterine bleeding at 18 weeks gestation and no products expelled and membranes ruptured and cervical os open
Definition
inevitable abortion
Term
ICU patient awake and alert but cannot move anything but the eyes and eyelids
Definition
locked in syndrome
Term
type of psychotherapy used to treat OCD, phobias and panic disorder
Definition
cognitive behavioral therapy
Term
underlying cause of neonatal RDS
Definition
surfactant deficiency
Term
components of HELLP syndrome
Definition

Hemolysis

Elevated liver enzymes

low platelets

Term
medication used to diagnose myesthenia gravis
Definition
tensilon test (edrophonium)
Term

11 year old obese African American boy presents w/ sudden onset limp

Dx?

Imaging?

 

Definition

Slipped capitofemoral epiphysis

 

AP and frogleg lateral

Term
Organism associated w/ dog or cat bites
Definition
pasturella multocida
Term
how is PCV distinguishable from secondary polycythemia?
Definition

Both have increased H&H

PCV does not have elevated EPO and is not due to low O2

Term
Medical treatment for hepatic encephalophathy
Definition

lactulose - binds ammonia in colon ->excreted better

Neomycin

Term
child presents w/ status epilepticus, but parents refuse treatment on religious grounds.  What do you do?
Definition
Treat the child and then seek court order
Term
In what disorders might weight loss might completely eliminate the need for medication?
Definition

DM type II

PCOS

Term
Rash typically described as dewdrops on rose petals
Definition
primary varicella
Term
Cafe au lait spots on skin
Definition

Neurofibromatosis type I

Fanconi's anemia

McCune Albright  (fractures and deformity of the legs, arms and skull, different pigment patches on the skin, and early puberty with increased rate of growth)

Term
What number is needed on bacterial culture on clean-catch urine specimen to diagnose UTI?
Definition
100,000/mL
Term
Classic EKG in atrial flutter
Definition
saw tooth
Term

obese 60 year old pt w/ dirty velvety patches on back of neck

Dx?

Workup?

Definition

Acanthosis Nigricans

 

 

Diabetes

Visceral malignancy

Term
MCC of hypothyroidism
Definition
Hashimoto's thyroiditis
Term
What type of bias is introduced when screening detects a disease earlier and thus lengthens the time from diagnosis to death?
Definition
lead-time bias
Term

19 year old male presents w/ palpable flank mass, hematuria, and ultrasound shows bilaterally enlarged kidneys w/ cysts.

Brain anomaly?

Definition
berry aneurysm (APKD)
Term
in which region is lyme disease endemic?
Definition
Northeast
Term
xerostomia, parotid enlargement and xerophthalmia, anti-La antibodies
Definition
Sjogren's syndrome - elderly females
Term
MCC of non-obstetric post partum death
Definition
hypercoagulable state - venous thromboembolic disease
Term
EKG w/ peaked T waves and widened QRS
Definition
hyperkalemia
Term
Tx for iron overdose
Definition
defuroxamine
Term
Acceptable urine output in a stable pt?  Trauma pt?
Definition

stable - 30 cc's/hr

trauma - 50 cc's/r

Term
calculation of fluid replacement in burn pt
Definition

Parkland formula

 

4mL's/Kg  X  TBSA burned (+ maintenance fluids)

Term
salicylate ingestion results in what type of acid-base disorder?
Definition
respiratory alkalosis w/ metabolic acidosis
Term
medication most commonly used to induce ovulation
Definition
clomiphene
Term
congenital infection w/ blueberry muffin rash
Definition
rubella
Term
classic symptom of placenta previa
Definition
painless bleeding in the third trimester
Term
active 14 year old boy has anterior knee pain
Definition
Osgood slaughters
Term
Which type of breast cancer increases the risk of invasive carcinoma in both breasts?
Definition
lobular carcinoma in situ
Term
Joint aspirate reveals rhomboid-shaped positively birefringent crystals
Definition

pseudogout  - calcium pyrophosphate dihydrate crystals

 

Chondrocalcinosis refers to the radiographic evidence of calcification in hyaline and/or fibrocartilage.

 

Pyrophosphate arthropathy is a term that may refer to either of the above

Term
Oral infection w/ branching rods
Definition
actinomyces israeli
Term
Most likely cause of a lower GI bleed in pts older than 40?
Definition
Diverticulosis
Term
What is more ethically unfavorable in a DNR patient - withdrawing life-sustaining care or witholding care?
Definition
Both are the same from an ethical standpoint
Term
MCC of pathologic fractures in elderly thin women?
Definition
osteoporosis
Term
Causative agent in pytariasis versicolor (AKA tinea versicolor)?
Definition
malasessia furfur
Term
Cause of chest pain in a young patient that has angina at rest w/ ST segment elevation and normal cardiac enzymes
Definition
Pritzmetals' angina
Term
Hypercholesterolemia treatment causing flushing and pruritis
Definition
niacin
Term
Ethical problem that occurs when a doctor refers a patient to an MRI center that he owns?
Definition
conflict of interest
Term
Most likely cause of galactorrhea, impotence or menstrual dysfunction and decreased labido in a pt w/ h/o schizophrenia
Definition
antipsychotic medication side effect - DA antagonist
Term
Pt presents w/ sudden onset w/ severe diffuse abdominal pain.  AXR reveal free air under diaphragm
Definition
emergency laparotomy
Term
two most common food-borne GI tract infections in the us
Definition

salmonella

campylobacter

Term
diagnostic test for hereditary spherocytosis
Definition
osmotic fragility test
Term
bullous skin disease w/ negative nikolski sign
Definition
bullous pemphigoid
Term
Young male w/ back and hip pain with stiffness that improves w/ activity and worsens w/ rest
Definition
akylosing spondylitis (HLA-B27)
Term
Cold water is flushed into a pt's ear and fast phase of nystagmus is toward opposite side.  Where is the lesion?
Definition
There is no lesion - this is normal!
Term
A one year old is able to cruise, use two finger grasp, babble and imitate actions.  What part of his development is delayed?
Definition
language
Term
Eosinophilic casts in urine
Definition
acute allergic interstitial nephritis
Term
Treatment for V-fib?
Definition

Shock 360J

Epinephrine

Term
skin blistering disease w/ positive nikolski sign
Definition
pemphigus vulgaris
Term
MC inherited cause of hypercoagulability
Definition
Factor V liden mutation
Term
genetic disorder a/w multiple fractures and is commonly mistaken for child abuse
Definition
osteogenesis imperfecta (type I collagen)
Term
MCC of bloody nipple discharge
Definition
intraductal papilloma
Term
antihistone antibodies
Definition
drug-induced lupus
Term
tachycardia and wild fluctuations in BP + headache +diaphoresis + panic attacks
Definition
pheochromocytoma
Term
clinical definition of hypertension
Definition
BP >140/90 on three separate occasions at least two weeks apart
Term
most feared complication of scaphoid fracture
Definition
avascular necrosis
Term
albuminocytologic dissociation
Definition
Guillan Barre Syndrome (increased protein in CSF w/ only modest increased in cell count)
Term
Neonatal meconium ileus
Definition

CF

Hirshsprungs

Term
Statistical calculation that looks at true positives and divides them by number of cases w/ disease
Definition
sensitivity
Term
A 15 year old requires hospitalization for preeclampsia.  Should the parents be notified?
Definition
No
Term

A pt is unable to inspire completely due to pain during palpation of the RUQ

Sign?

Dx?

Definition

Murphy's sign

Acute cholecystitis

Term
Reversal of heparin
Definition
protamine sulfate
Term
Pt present w/ limb pain on passive movement, pallor, poiklothermia, paresthesias, paralysis and pulselessness
Definition

compartment syndrome

 

fasciotomy

Term
Complication arising from overly rapid correction of hyponatremia
Definition
central pontine myelinosis
Term

60 year old pt presents w/ acute onset of broken speach.

Type of aphasia?

Lobe/vascular distribution?

first step in workup?

Definition

Broca's aphasia

Left MCA, frontal lobe

CT scan

Term
atrophy of mammilary bodies
Definition
Wernicke's encephalopathy - alchohol abuse
Term
Term describing heavy bleeding during and between menstrual periods
Definition
menometrorrhagia
Term
MC type of tracheoesophageal fistula
Definition

distal esophagus leads to trachea

proximal esophagus is a blind pouch

Term
First line pharmacotherapy for depression
Definition
SSRI's
Term

40 yo black female found to have noncaseating granulomas of the lung and hypercalcemia

dx?

Definition
sarcoidosis
Term
what disease would you find curschmann's spirals?
Definition
bronchial asthma - these are whorled mucus plugs
Term

burn pt w/ cherry red flushed skin and coma; O2 saturation normal; carboxyhemoglobin elevated

tx?

Definition

100% O2

hyperbaric O2

Term
MCC of post-partum hemorrhage
Definition
uterine atony
Term
skin lesion causing a pearly colored papule with a translucent surface and telangeictasias
Definition
basal cell carcinoma
Term
infection causing honey crusted lesions usually around the nose and mouth
Definition
impetigo
Term
first line treatment for otitis media
Definition
amoxicillin for 10 days
Term
violent patient w/ vertical and/or horizontal nistagmus has been exposed to what?
Definition
PCP
Term
diarrheal illness a/w church picnics or mayonaisse
Definition
staph aureus
Term
Ring-enhancing brain lesion on CT w/ seizures
Definition
brain abscess
Term

pt presents w/ history of lithium use and has copious amounts of dilute urine

dx?

Definition
nephrogenic diabetes insipidus
Term
male w/ testicular mass found to have elevated beta HCG - dx?
Definition
choreocarcinoma
Term

50 year old female w/ hematuria

dx?

Definition
bladder cancer
Term
30 year old female immigrant w/ hematuria - dx?
Definition
shistosomiasis
Term
type of bone fracture most likely to result from falling on outstretched hand
Definition
Colle's fracture
Term
16 year old female has left arm paralysis after her boyfriend dies in a car accident
Definition
conversion reaction
Term
a normalizing PCO2 in a patient having asthma exacerbation may indicate what problem?
Definition
fatigue ->impending respiratory failure
Term
Pt has dyspnea, hilar lymphadenopathy on CXR and hypercalcemia
Definition
sarcoidosis
Term
young pt whose father died at age 30 in an MVA suddenly collapses and dies while exercising - cause of death?
Definition
hypertrophic cardiomyopathy
Term

Gyn exam of a post-menopausal woman reveals inflammation and epithelial thinning in the anogenital area

dx?

Definition
lichen sclerosis
Term
classic EKG findings in pericarditis
Definition
diffuse ST elevation in most leads
Term
treatment for NMS?
Definition

dantrolene

bromocriptine

Term
medication used more than any other for tx of Parkinsons
Definition
levadopa-carbidopa
Term
child presents with oliguria, petichiae and juandice following an illness w/ bloody diarrhea
Definition

HUS

 

E. coli O157H7

Term
11 year old boy presents w/ fever, weightloss and night sweats.  Radiology reveals anterior mediastinal mass.  What do you suspect?  What if pt was 30 years old?
Definition

Non hodgekins lymphoma in child

 

30 years old - hodgekins

Term
MC testicular cancer
Definition
seminoma
Term

Child presents w/ palpable purpura on legs, abdominal pain and arthritic pain in numerous joints.  

Dx?

Tx?

Definition

HSP

 

self-limited illness

Term
hyperphagia, hyperorality, hypersexuality
Definition
cluver busey sydrome - bilateral amigdala lesions
Term
After a minor car accident, a woman wears a neck brace and requests permanent disability - dx?
Definition
malingering
Term
Patient's w/ silicosis are at higher risk for what infection?
Definition
TB
Term

PFT's show decreased FEV1/FVC.

Dx?

Definition
COPD
Term

Post-menopausal female presents w/ vaginal bleeding for the past 5 days.

Next step?

Definition
Endometrial biopsy
Term
type of lung cancer a/w hypercalcemia
Definition
squamous cell carcinoma
Term
what does a fall in systolic bp >10mmHg indicate?
Definition

cardiac tamponade

hyperinflation disorder

Term
Laproscopic findings in endometriosis
Definition

chocolate cysts

powder burns

Term
hypertension +hypernatrema +hypokalemia +metabolic alkalosis
Definition
Conn's syndrome - hyperaldosterone and bilateral adrenal hyperplasia
Term
LDL goal in pts w/ diabetes
Definition
<100
Term
8 year old child in MVA requires emergency transfusion - parents are not present.  Child states she is a Jehovah's Witness.  What do you do?
Definition
Give the transfusion
Term
25 year old male presents w/ pain and watery diarrhea after meals.  Exam shows fistulas between bowel and skin and nodular lesions on tibias
Definition
Crohn's disease
Term
40 year old female presents w/ a discrete area of complete hairloss on scalp that has worsened over weeks.  Tx?
Definition
intradermal steroid injections
Term
A young child presents w/ thigh muscle weakness, woddling gait and pronounced calf muscles.  Dx?
Definition
Duchenne muscular dystrophy
Term
Medication for seizure prophylaxis in severe eclampsia
Definition
MgSO4
Term
cause of erythroblastosis fetalis
Definition
Rh incompatibility - maternal antibodies against infant's RBC's
Term
Maternal 
Definition
Term
Treatment of HTN in cases of pheochromocytoma
Definition
Alpha blockade, THEN beta blockade, then surgery
Term

7 yo boy presents w/ hemarthrosis.  Labs show elevated PTT and normal PT and bleeding time

Dx?

Tx?

Definition

Hemophilia A or B

A- give factor 8

B - give factor 9

Term
Young child has loss of red light reflex.  Dx?
Definition
Retinoblastoma
Term

Tall white male with acute SOB

Dx?

Tx?

Definition

Spntaneous pneumothorax

Self resolving if less than 15% of lung field

if >15% - chest tube

Term
First line treatment for moderate hypercalcemia
Definition

IV fluids

Loop diuretics (2nd line)

Term
45 yo male with acute onset flank pain and hematuria
Definition
nephrolithiasis
Term
Test used to rule out urethra injury
Definition
retrograde cystourethorgram
Term
pathology causing onion-skinning of bone on xray
Definition
ewing sarcoma
Term
skin cancer classically presenting with varying degrees of scaling ulcerations
Definition
squamous cell carcinoma
Term
treatment for premalignant lesion from sun exposure that can lead to squamous cell skin cancer
Definition

5FU

cryoablation

 

actinic keratosis

Term
general tx of DKA
Definition

Fluids

Potassium

insulin/glucose

beta agonist

phosphates

Magnesium

Term
Dx to consider in a pt w/ sacroiliitis
Definition

ankylosing spondylitis

(bamboo spine on xray)

Term
Child presenting w/ midline neck mass
Definition
thyroglossal duct cyst
Term
child presents w/ lateral neck mass
Definition
branchial cleft cyst
Term
malory weiss vs borhaave's
Definition

MW - superficial tearing of the distal esophagus

 

Borhaave's - rupture of esophagus into mediastinum

Term
EKG finding in hypothermia
Definition
J wave - small positive deflection after QRS
Term
Classicallly associated w/ cold agglutinins
Definition
mycoplasma
Term
sign suggestive of radial nerve damage w/ humoral fracture
Definition

Cannot extend wrist (ie wrist drop)

Loss of thumb abduction

Term
first line tx of pediculosis pubis and capitus
Definition

permethrin cream

 

do not use lindane - causes seizures!

Term

18 yo female with no hx of abnormal pap now has first time ASCUS pap. 

Management?

Definition
re-pap in a year
Term
tx for clavicle fracture
Definition

figure of 8 sling

conservative management

Term

a 40 year old female presents w/ persistent erythema on her nose and cheeks and recurrent facial flushing, especially w/ alcohol and spicy foods.

Dx?

Definition
acne rosacia
Term

a pt w/ cirrhosis presents again in the ER to have his ascites drained.  Analysis of fluid shows absolute neutrophil cound >250 cells/mm cubed

dx?

Definition
spontaneous bacterial peritonitis
Term
tx of pilonidal cyst
Definition
I&D
Term
Tx of rectal fistula
Definition
fistulotomy
Term

pt on isotretinoin for acne begins to develop daily persistent pulsatile headaches - exam reveals papilledema

dx?

Definition

psuedotumor cerebri

NO retinoids w/ tetracyclines!

Term

18 yo male is found to have a systolic heart murmur at the apex and left lower sternal border that increases in intensity while standing after squatting

Dx?

Definition
Hypertrophic cardiomyopathy
Term
Cognitive impairment, urinary incontinence, abnormal gait
Definition
normal pressure hydrocephalus
Term
underlying cause of late fetal decelerations
Definition
uteroplacental insufficiency
Term

25 yo male diagnosed w/ solid testicular mass by ultrasound

Next step?

Definition
orchiectomy
Term
teenager on ABX presents w/ severe sunburn
Definition
tetracyclines
Term
next step in management of a female w/ poor uterine tone after delivery of placenta
Definition

uterine massage

 

oxytosin

Term
new bluetooth keyboard
Definition
works well with the ipad
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