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COMLEX 2 Board Review
Terms in this set (325)
What would you suspect in an ER patient with blood in the urethral meatus or a high-riding prostate?
Bladder Rupture or Urethral Injury
What type of acute renal failure would you suspect in patient with FENa < 1%?
What are the protein and LDH criteria for an exudative effusion?
Pleural: serum > 0.5 (protein)
Pleural: serum > 0.6 (LDH)
What is the cause of muscle rigidity, fever, and rhabdomyolysis in a schizophrenic patient?
neuroleptic malignant syndrome
What is the cause of bilious emesis in a newborn within hours after the first feeding?
A 60 year old woman leaks urine when laughing or coughing. What are her nonsurgical options?
Kegel exercises, estrogen, Pessaries
What is the most common cause of HTN in young women?
oral contraceptive pills
What are the most common causes of seizures in children aged 2-10?
frebrile, infection, trauma, idiopathic
Positive p-ANCA is associated with what conditions?
What organism is known for causing infection in burn victims?
A patient presents with a painless, pruritic papule with regional lymphadenopathy that evolves over 7-10 days into a necrotic ulcer with a black eschar. What is the diagnosis and treatment?
Dx: Cutaneous Anthrax
Tx: Penicillin, Ampicillin, Doxycycline
What is the late, life-threatening complication of chronic myelogenous leukemia (CML)?
Which hernia carries the highest risk of incarceration indirect, direct, or femoral?
What cause of aplastic anemia is associated with thumb abnormalities, diffuse hypo- or hyper pigmentation, cafe-au-lait spots, and short stature?
What biostatic calculation looks at individuals with and without a disease and determines the likelihood of exposure to a risk factor?
Which anti diabetic agent is associated with lactic acidosis?
What is "cradle cap" and what is the treatment?
Tx: selenium sulfide shampoo and topical antifungals
i love you to the moon and back
What disease causes glomerulonephritis with deafness?
What is the preferred diagnostic test for a pulmonary embolism?
CT scan with PE protocol
What rash presents with herald-patch followed by a Christmas tree pattern?
What is Beck's triad for cardiac tamponade?
Distant heart sounds
What lab findings are diagnostic of Hashimoto's thyroiditis?
If you want to know if maternal age affects infant mortality rate but most of the variation in infant mortality is predicted by socioeconomic status, then socioeconomic status is a _____?
What are the three reasons for involuntary psychiatric hospitalization?
Danger to self
Danger to others
What is Charcot's triad in cases of gallbladder disease?
Dx: Ascending Cholangitis
What is the treatment for ITP in children?
IVIG and/or steroids
What infection causes aplastic crisis in sickle cell disease?
Elderly male complains of bone pain and adds that his favorite hat no longer fits likely has what condition?
What test is used in the tenth week of gestation to screen for chromosomal abnormalities?
Chorionic Villus Sampling
What causes secondary emenorrhea in a patient with normal prolactin and no response to estrogen-progesterone challenge and a history of D&C?
What causes a crescent-shaped hyper density on CT that does not cross the midline?
Most common pathogen causes croup is _____?
What causes a transudative pleural effusion?
Immunodeficiency with doughy skin in characteristic of _______?
(hyper immunoglobuline syndrome)
What is the treatment for opioid overdose?
Naloxone and Naltrexone
What is the treatment of septic shock?
IV fluids, Antibiotics +/- NE
Most serious side effect of clozapine is ______?
What are the five basic criteria for metabolic syndrome?
1. Abdominal Obesity
2. Increased TG
3. Decreased HDL
5. Insulin resistance
What type of bias is present when a clinician is aware of the type of treatment his patient received?
Sentinel loop on abdominal x-ray is seen with ______?
What are the usual imaging studies in a trauma series?
AP and lateral C-Spine
What do an elevated erythropoietin level, elevated HCT, and normal O2 saturation suggest?
Renal cell carcinoma
Other erythropoletin producing tumor
Hampton's hump on x-ray is associated with _____?
A mother who is frustrated with her child yells at her husband. What defense mechanism is she displaying?
In which immunodeficiency are there chronic respiratory infections and a positive nitroblue tetrazolium test?
Chronic Granulomatous Disease
What is the natural history of a leiomyoma?
Regress after Menopause
Which antihypertensives are used in a patient with severe preeclampsia?
Hydralazine, Labetolol, Nifedipine, HCT2, Sodium nitroprusside
What type of headache causes unilateral, severe periorbital headache with tearing?
What type of back pain is exacerbated by standing and walking
A patient presents with acute-onset monoarticular joint pain and Bell's palsy. What is the likely diagnosis, how did he get it, and what is the treatment?
Dx: Lyme disease
A teenage girl presents with prolonged bleeding after dental surgery and with menses. Labs reveal a normal PT, normal or increased PTT, and increased BT. What is the diagnosis and treatment?
Dx: von Hillebrands disease
Tx: Desmophressin, FFP, Cryoprecipitate
What is the most common cause of "traveler's diarrhea"?
ETEC (E. Coli)
In what circumstances should confidentiality not be protected?
Real harm to third party
What ist he only indication for administering hypertonic saline to a patient with SIADH?
What causes rash with dermatornal distribution?
What is the next step in the evaluation of a pulsatile abdominal mass and bruit?
What causes flat-topped purplish, pruritic, papules?
What is the definition of maternal mortality?
Number of deaths during pregnancy to 90 days post partum per 100,000 live births
Auer rods are associated with ______?
What is the cause of joint pain and stiffness that worsens over the course of the day and is relieved by rest?
What is the treatment of cardiogenic shock?
What systemic diseases can cause nephritic syndrome?
Hypoxemia + pulmonary edema + normal pulmonary capillary wedge pressure
What disorder is present in a teenage with a history of theft, vandalism and violence toward family pets?
What causes a continuous machine-like murmur?
What would you suspect in a woman with preeclampsia in the first trimester?
What CSF findings would you see in a case of subarachnoid hemorrhage?
High CSF pressure
RBCs in all three tubes
What acid-base disturbance is commonly seen in pregnant women?
A husband asks that his wife not be told about her recently discovered lung cancer. What do you do?
Tell the patient
Does a cose control study measure incidence or prevalence?
What is the first-line treatment for a growth hormone-secreting pituitary adenoma?
Transsphenoidal Tumor Resection
What are the indications for surgical repair of an abdominal aortic aneurysm?
Rapidly increasing in size
What characteristics of a nevus suggest that it may actually be a melanoma?
Low urine specific gravity in the presence of high serum osmolality. What is the diagnosis?
What is the treatment of atrial fibrillation of unknown duration?
Rate Control and Anticoagulation
Which lung cancer is associated with SIADH?
What important side effects are common to many of the atypical antipsychotics?
Type II DM
What is the most common location for an ectopic pregnancy?
Ampulla of tube
Uterine bleeding at 18 weeks gestation and no products expelled and membranes ruptured and cervical os open. What is the diagnosis?
ICU patient is awake and alert but cannot move anything but the eyes and eyelids. What is the diagnosis?
What type of shock causes a decreased cardiac output, decreased PCWP, and decreased peripheral vascular resistance?
What is the most common form of nephritic syndrome?
What is the initial treatment for child presenting with acute asthma attack?
+/- O2 (<= 92%)
What type of psychotherapy is used in treating phobias, obsessive-compulsive disorder (OCD) and panic disorder?
Cognitive behavioral therapy (CBT)
What is the underlying cause of neonatal respiratory distress syndrome?
What is the first test in the assessment of a woman presenting with secondary amenorrhea?
What are the components of HELLP syndrome?
What medication is used to diagnose symptomatic myasthenia gravis?
An 11 year old obese, african american boy presents with sudden onset limp. What is most likely diagnosis, and what imaging studies would confirm this?
Slipped capital femoral epiphysis
(A/P and frog leg lateral)
What organism is associated with dog or cat bites?
How is polycythemia vera distinguishable from secondary polycythemia?
Low or normal erythropoietin
Normal O2 saturation
What is the medical treatment for hepatic encephalopathy?
A young child presents in status epileptics, but her parents refuse treatment on religious grounds. What do you do?
Treat patient and seek court order
What percentage of values falls within one standard deviation (SD) of the mean? Two SDs? Three SDs?
1 SD = 68%
2 SD = 95%
3 SD = 99.7%
In which endocrine disorder might weight loss completely eliminate the need for medication?
Type 2 DM
What rash is classically described as dew drops on rose petals?
What is the classic endocarditis prophylaxis regimen?
Dental: amoxicillin before and after
GI/GU: gentamicin/ampicillin before, amoxicillin after
Cafe-au-lait spots on skin are characteristic of ______?
Neurofibromatosis type I
What is the treatment for mild unconjugated hyperbilirubinemia? Severe unconjugated hyperbilirubinemia?
Severe: exchange transfusion
What number is needed on bacterial culture of a clean-catch specimen to diagnose a UTI?
What is the classic ECG appearance in atrial flutter?
Sawtooth pattern of the P waves
A 60 year old obese patient presents with dirty, velvety patches on the back of the neck. What is the diagnosis and what is the initial workup?
Dx: Acanthosis nigricans
Workup: Check blood glucose and look for visceral malignancy
What is the most common cause of hypothyroidism?
Which type of bias is introduced when screening detects a disease earlier and thus lengthens the time from diagnosis to death?
Lead time bias
What are the exceptions to the requirement of informed consent?
Patients without decision making capacity
Patients who signed waivers to right of informed consent
A 19 year old man presents with palpable flank mass and hematuria and U/S shows bilateral enlarged kidneys with cysts. What brain anomaly is associated with this condition?
What are the four main causes of microcytic anemia?
1. Iron deficiency anemia
3. Anemia of chronic disease
4. Lead poisoning
What are four signs and symptoms of streptococcal pharyngitis?
2. Tonsillar exudates
3. Pharyngeal erythema
4. Lack of cough/rhinorrhea
In which region of the US is Lyme disease endemic?
Which joints in the hand are affected in rheumatoid arthritis?
MCP and PIP
What causes xerostomia + parotid enlargement + xerophthalmia + anti-LA antibodies?
What are the most common causes of seizures in young adults (18-35 years)?
What is the most common cause of non-obstetric postpartum death?
Uterine bleeding at 18 weeks gestation and no products expelled and cervical os closed. What is the diagnosis?
Which immunodeficiency presents with eczema, thrombocytopenia, and a high levels of IgA?
Which defense mechanism is displayed when a woman calmly describes a gory murder in great detail?
What is the treatment for mild persistent asthma?
Inhaled low dose corticosteroids
EKG with peaked T-waves
What is the treatment for iron overdose?
What is the acceptable minimum urine output in a stable patient?
What method is used to calculate fluid repletion in burn patients?
4ml/kg x % body surface burned
Salicylate ingestion results in what type of acid-base disorder?
Respiratory alkalosis + metabolic acidosis
(high anion gap)
What medication is used most commonly to induce ovulation?
Psychiatric condition in which a person travels a long distance, takes a new name and has no memory of his prior life?
Which congenital infection might present with a "blueberry muffin" rash?
Which type of breast cancer increases the future risk of invasive carcinoma in both breasts?
Lobular carcinoma in situ
What is the classic symptom of placenta previa?
Painless vaginal bleeding
An active 14 year old boy has anterior knee pain. What is the most likely diagnosis?
Joint aspiration reveals rhomboid-shaped, positively birefringent crystals. What is the diagnosis?
What type of oral infection has branching rods when examined microscopically?
What is the next step in the evaluation of a patient with two consecutive pap smears with atypical squamous cells of undetermined significance (ASCUS)?
Colposcopy with endocervical curettage
A 45 year old obese female with pruritus, clay colored stools, and a dark urine has an elevated alkaline phosphate and elevated bilirubin. What is the most likely cause?
Biliary tract obstruction
What infection can cause diarrhea and pseudo appendicitis?
Which is more ethically unfavorable in a DNR patient: withdrawing life sustaining care of withholding care?
What is the most likely cause of acute lower GI bleed in patients older than 40?
What is the most common underlying cause of pathologic fractures in elderly, thin women?
What is the causative agent in pityriasis versicolor?
What is the cause of chest pain in a young patient that has angina at rest with ST - segment elevation but normal cardiac enzymes?
What hypercholesterolemia treatment causes flushing and pruritus?
What causes target lesions with a red center, pale zone, and a dark outer ring appearing on the palms and soles with a prodrome of malaise and myalgias?
What autoimmune complication occurs 2-4 weeks after an MI?
What name is given to stress-related hair loss? What is the treatment?
What is the most common cause of Cushing's syndrome?
What it the most likely cause of galactorrhea, impotence (or menstrual dysfunction), and decreased libido in a patient with a history of schizophrenia?
What ethical problem exists when a doctor refers a patient for an MRI at a facility he owns?
Conflict of interest
Patient presents with a sudden onset of severe, diffuse abdominal pain (AXR reveals free air under the diaphragm). What is the next step in management?
What are the two most common food borne bacterial GI tract infections in the US?
What is the diagnostic test for hereditary spherocytosis?
Osmotic fragility test
What bullous skin diseases has a negative Nikolsky's sign?
A 25 year old male presents with white plaques on his tongue and back of his throat that scrape off with a tongue depressor. What is the diagnosis? What should he be screened for?
(screen for HIV)
Young male with hip and back pain along with stiffness that improves with activity and worsens at rest. What is the most likely diagnosis?
Cold water is flushed into a patient's ear, and the fast phase of the nystagmus is toward the opposite side. Where is the lesion?
No lesion (normal)
What findings would you expect to see in a post-term pregnancy beyond 42 weeks gestation?
Oligohydramnios, meconium, neonate with dry, peeling skin, very mature placenta with calcifications
What annual screening is recommended for women with strong family history of ovarian cancer?
A 1 year old is able to cruise, use two finger pincer grasp, babble and imitate actions. What part of his development is delayed?
What defense mechanism is a person who subconsciously pushes memories of past abuse out of his conscious mind using?
What are some of the causes of an exudative pleural effusion?
Infections, cancer, TB, PE, pancreatitis
What would you suspect with eosinophilic casts found in the urine?
Acute interstitial nephritis (AIN)
What are the side effects of corticosteroids?
Acne, immunosupression, osteoporosis, thin skin, mania/insomnia, cushingoid features, cataracts
What is an acceptable urine output in a trauma patient?
What is the treatment for ventricular fibrillation (VF)?
Cardioversion at 360J
Epi every 3-5 minutes
What skin blistering disease has a positive Nikolsky's sign?
What is the most common inherited cause of hypercoaguability?
Factor V leiden mutation
Which genetic disorder is associated with multiple fractures and is commonly mistaken for child abuse?
What is the most common cause of bloody nipple discharge?
Which antibiotics should be avoided during pregnancy due to potential teratogenic effects?
Antihistone antibodies are seen with what condition?
What is the infectious cause of aplastic crisis in sickle cell disease?
Tachycardia + wild fluctuations in BP + headache + diaphoresis + panic attacks indicate what condition?
What should always be done prior to LP?
Check for increased ICP
What is the next step in the diagnosis of cholecystitis when U/S is equivocal?
What is the clinical definition of HTN?
BP>140/90 on 3 separate occasions 2 weeks apart
What are the most common causes of fever of unknown origin (FUO)?
What is the most feared complication of a scaphoid fracture?
Albuminocytologic dissociation (increased protein in CSF with only modest increase in cell count) indicates what condition?
What two disorders should come to mind when a neonate has meconium ileus?
1. Cystic fibrosis
2. Hirschsprungs disease
Immunodeficiency with a positive nitroblue tetrazolium test
Chronic granulomatous disease
Pediatric patient with red "currant-jelly" stools
A young female with amenorrhea, bradycardia and abnormal body image
What is the treatment for superior vena cava syndrome?
Radiation to lower size of tumor
What statistical calculation looks at true positives and divides them by the number of patients with the disease?
A 15 year old pregnant girl requires hospitalization for preeclampsia. Should her parents be informed?
A patient is unable to inspire completely due to pain during palpation of the RUQ. What is this sign? What is the diagnosis?
What is the reversal agent for herapin?
What substances are known to cause hemolysis in patients with G6PD deficiency?
High close aspirin
What medications can be given to a pregnant woman with cystitis?
1st/2nd gen cephalosporins
A patient presents with limb pain on passive movement, pallor, poikilothermia, paresthesias, paralysis, and pulselessness. What is the treatment?
Dx: Compartment syndrome
Tx: All compartment fasciotomy
What complication may arise from overly rapid correction of hyponatremia?
Central pontine myelinosis
A 60 year old patient presents with an acute onset of broken speech. What type of aphasia is this? What lobe and vascular distribution has been affected? What is the first step in the workup?
Type: Brocas aphasia
Affects the frontal lobe
Vascular distribution: Left MCA
First step: CT head
What are the most common primary sources of metastases to the brain?
What is treatment for mastitis in a patient that is breast feeding?
What characteristics favor carcinoma in an isolated pulmonary nodule?
>45 year old
Lesion larger compared to past films
Absence of calcification
Size > 2cm
In which disease would you find atrophy of the mammillary bodies?
What term describes heavy bleeding during and between menstrual periods?
What is the most common type of tracheoesophageal fistula?
Esophageal atresia (blind pouch)
Distal esophagus connected to the trachea
What is the treatment for Kawasaki disease in the acute phase?
High dose aspirin and IVIG
What is considered first-line pharmacotherapy for depression?
Which antidepressants are associated with hypertensive crisis? What substance can exacerbate this effect?
A 40 year old black female is found to have noncaseating granulomas of the lung and hypercalcemia. What is the diagnosis?
In what disease might you find Curschmann's spirals (whorled mucus plugs)?
Which type of renal tubular acidosis (RTA) is associated with abnormal H secretion and nephrolithiasis?
Type 1 RTA
What are the causes of hypervolemic hyponatremia?
A burn patient presents with cherry red flushed skin and coma. O2 saturation is normal, but carboxyhemoglobin is elevated. What is the treatment?
100% O2 or hyperbaric O2
What is the treatment for delirium tremens?
What is the most common cause of postpartum hemorrhage?
Which drugs block transmission through the AV node?
Ca2+ channel blockers
What skin lesion causes a pearly colored papule with a translucent surface and telangiectasias?
Basal cell carcinoma
What type of infection causes honey crusted lesions usually around the nose or mouth?
What causes hypocalcemia, high phosphorus and low PTH?
What causes stones, bones, groans and psychotic overtones?
(usually due to hyperparathyroidism)
What is the first line treatment for acute otitis media?
Does a cohort study identify incidence or prevalence?
When can a physician refuse to continue treating a patient on the grounds of futility?
No rationale for treatment
Max intervention has failed
Treatment doesn't achieve goals of care
A violent patient with vertical and/or horizontal nystagmus has been exposed to what substance?
What diarrheal illness is associated with church picnics/mayonnaise?
What is a cause of congenital pure RBC aplasia?
What is the pentad of thrombotic thrombocytopenic purport (TTP)?
2. Hemolytic anemia
3. Renal failure
5. Neurologic changes (altered mental status)
A patient who visited the southwest US presents with fever, malaise, couch and night sweats. What is the diagnosis and treatment?
Ring-enhancing brain lesion on CT with seizures shows what?
What are the classic physical findings in the cases of endocarditis?
A 55 year old man has a sudden onset on pain in his first metatarsophalangeal joint after a night of drinking red wine. What is the diagnosis, workup and how can it be treated chronically?
Workup shows needle shaped, negatively birefringent crystals
Tx: allopurinol, colchicine or probenecid
Patient presents with a history of lithium use presents with copous amounts of dilute urine. What condition is this?
Nephrogenic diabetes insipidus
What is the most common pituitary tumor, and what is the treatment?
Tx: bromocriptine (dopamine agonist)
A male with a testicular mass is found to have an elevated beta-hCG. What its the diagnosis?
What are the cardinal movements of labor?
A 50 year old female smoker presents with hematuria. What do you suspect?
A 30 year old female African immigrant presents with hematura. What do you suspect?
What therapies are used in treating polycystic ovarian syndrome?
What type of bone fracture is most likely to result from a fall on an outstretched hand?
Distal radius fracture
A 2 month old presents with projectile, non-bilious, projectile emesis. What is the first step in the management?
Dx: Pyloric stenosis
First Step: Check for and correct metabolic abnormalities
A 16 year old female has left arm paralysis after her boyfriend dies in a car crash. No medical cause is found. What is the diagnosis?
A patient presents to the ER after a MVA with hypertension, bradycardia, and abnormal respirations. After ABC's, what is the next step in management?
Dx: Cushing's triad for ICP
Tx: Raise the head of bed, hyperventilate, give mannitol and consult neurosurgery
A normalizing pCO2 in a patient having an asthma exacerbation may indicate what problem?
Fatigue and impending respiratory failure
A patient has dyspnea, hilar lymphadenopathy on CXR and hypercalcemia. What its he diagnosis?
Which type of renal tubule acidosis is associated with abnormal HCO3 and rickets?
Type 2 RTA
Chvostek and Trousseau signs are associated with what metabolic abnormality?
A young patient whose father died at age 30 in an MVA suddenly collapses and dies while exercising. What is the cause of death?
Gyn exam of a postmenopausal woman reveals inflammation and epithelial thinning of the anogenital area. What is the diagnosis?
An IV drug user has JVD and a holosystolic murmur at left sternal border. What is the treatment?
Dx: Tricuspid regurgitation
What is the classic ECG finding in pericarditis?
Low voltage diffuse ST segment elevation
What is the treatment for neuroleptic malignant syndrome?
Dantrolene or Bromocriptine
A child has flesh colored, umbilicated lesions on the face. What are these lesions, and where do they appear in adults?
Dx: Molluscum contagiosum
Appear perichal or perigenital in adults
Which medication is sued more than any other in the treatment of Parkinson's
Levodapa + Carbidopa
What diagnostic test differentiates central from nephrogenic diabetes insipidus?
DDAVP and measure urine osmolality
A postop patient with significant pain presents with hyponatremia and normal volume status. What is the diagnosis?
(due to stress)
An elderly female presents with pain and stiffness of the shoulders and hips. She cannot lift her arms above her head. Lab shows an elevated ESR. What is the diagnosis?
A child presents with oliguria, petechiae, and jaundice following an illness with bloody diarrhea. What is the most likely diagnosis and infectious cause?
HUS due to E. Coli 0157:H7
An 11 year old boy presents with fever, weight loss and night sweats. Radiology reveals an anterior mediastinal mass. What do you suspect? What if the patient was 30 years old?
Non hodgkins lymphoma
If 30 y/o: Hodgkins lymphoma
What prophylactic medication is indicated in an HIV patient with a CD4 less than 100?
TMP-SMX, daspsane, or pentamidine for PCP
Clarithromyccin for MAC
What is the most common testicular cancer?
A child presents with palpable purport on the legs, abdominal pain and arthritic pain in numerous joints. What is the diagnosis and treatment?
Dx: Henoch-schonlein purpura
Anti-centromere antibodies are associated with what condition?
Hyperphagia, hyperorality, hyperdocility and hypersexuality. What is the diagnosis?
(bilateral amygelala lesion)
After a minor car accident, a woman wears a neck brace and requests permanent disability. What is the most likely diagnosis?
What medication is given to accelerate fetal lung maturity? For how long is it given? At what gestational age is it no longer necessary?
Dexamethasone or Betamethasone
Give for 48 hrs
No longer necessary > 34 weeks
Patients with silicosis are at higher risk for what type of infection?
A patient has exophthalmos, pretrial myxedema and a decreased TSH. What is the diagnosis?
PFTs show decreased FEV1/FVC. What is the diagnosis?
Obstructive lung disease
A postmenopausal female presents with vaginal bleeding for the last 5 days. What is the next step?
Which type of lung cancer is associated with hypercalcemia?
Squamous cell cancer of lung
What does a fall in systolic BP of >10 mmHg with inspiration indicate?
(Seen with cardiac tamponade and hyperinflation)
What laproscopic findings can be seen in endometriosis?
Powder burn lesions
Hypertension + hypernatermia + Hypokalemia and Metabolic alkalosis. What is the diagnosis?
What is the LDL goal in a patient with diabetes?
LDL < 100
LDL < 70 if any vessel disease
An 8 year old child was in a motor vehicle accident and now requires emergency blood transfusion. Her parents are not present, but the child states she is a Jehovah's witness. What do you do?
Treat child, consent is implied
A 25 year old male presents with pain and watery diarrhea after meals. Exam shows fistulas between the bowel and skin and nodular lesions on his tibias. What is the diagnosis?
A 40 year old female presents with a discrete area of complete hair loss on the scalp that has worsened over weeks. What its he treatment?
Dx: Alopecia areata
Tx: Intralesional steroids
CSF analysis shows low glucose, elevated neutrophilis, and Gram-positive diplococci. What is the diagnosis?
Strep pneumoniae meningitis
A female who was born in breech position is found to have asymmetric inguinal and gluteal skin folds on her newborn exam. What is the diagnosis and treatment?
Dx: Development dysplasia of the hip
Tx: Pavlik harness
Head injury -> initial altered mental status -> resolution of mental status for a few hours -> now with reemerging altered mental status. What is the diagnosis, underlying injury and treatment?
Dx: Epidural hematoma
Underlying Injury: Middle meningeal a.
Tx: Evacuation of hematoma
What medication is given for seizure prophylaxis is severe preeclampsia?
What is the cause of erythroblastosis fetalis?
Maternal antibodies against the infants Rh+ RBCs
Describe the treatment of hypertension in cases of pheochromocytoma?
Alpha antagonist first, then beta blocker
A 7 year old boy presents with hemarthrosis. Lab work shows increased PTT and normal PT and bleeding time. What is the diagnosis and treatment?
Dx: Hemophilla A or B
Tx: Desmopression or supplement
A young child has loss of the red light reflex. What is the diagnosis?
A 22 year old male has 4 months of social withdrawal, worsening grades, decreased emotional expression and concrete thinking. What is the diagnosis?
Honeycomb pattern on CT scan of the chest. What is the diagnosis and treatment?
Dx: Diffuse interstitial pulmonary fibrosis
A tall white male presents with acute shortness of breath. What diagnosis do you suspect? What is the treatment?
Dx: Spontaneous pneumothorax
Tx: Will spontaneously regress; give 02 as needed
( >15% = chest tube)
What is the first line treatment for moderate hypercalcemia?
(2nd line = Loop Diuretics)
A 45 year old male presents with acute onset flank pain and hematuria. What is the most likely etiology?
What test is used to rule out urethral injury?
A 75 year old man presents with fatigue, lymphadenopathy splenomegaly and isolated lymphocytosis. What diagnosis do you suspect?
Meningitis is diasnosed in a neonate. What are the most likely organisms and what is the empiric treatment?
Organisms: GBS, E. coli, Listeria
Tx: ampicillin and gentamicin
What pathology causes an ohio skin appearance of the bone on X-ray?
Which skin cancer classically presents with varying degrees of scaling or ulcerations?
Squamous cell carcinoma
What is the treatment for the premalignant lesions from sun exposure that can lead to squamous cell skin cancer?
Dx: Actinic keratosis
Tx: Cryoablation or 5-FU
What is the general treatment of DKA?
Aggressively replace electrolytes: K+, Mg2+, Phosphate
A patient presents with weakness, nausea, vomiting, weight loss and new skin pigmentation. Labs show hyponatremia and hyperkalemia. What is the treatment?
Dx: Addison's disease
What diagnosis would you consider in a patient with sacroililtis?
A child presents with a midline neck mass. What do you suspect?
Thyroglossal duct cyst
A child presents with a lateral neck mass. What do you suspect?
Brachial cleft cyst
What is the medical treatment for inflammatory bowel disease?
What is the difference between Mallory-Weiss and Boerhaave tears?
MW = superficial tear
BT = full thickness rupture
What is the treatment for TTP?
Large volume plasmapheresis steroids
Are fibrin split products high or low in DIC?
Is D-dimer high or low in DIC?
Is fibrinogen high or low in DIC?
Are platelets high or low in DIC?
Is Hct high or low in DIC?
What EKG finding is a/w hypothermia?
What infection is classically a/w cold agglutinins?
What are the signs suggesting radial nerve damage with a humeral fracture?
Loss of thumb abduction
What is the first line treatment for pediculosis pubis and pediculosis capitis?
Which immunodeficiency would you suspect in a patient with recurrent infections, thrombocytopenia and eczema?
What causes a child to have mental retardation, microcephaly, microphthalmia, short palpebral fissures, mid facial hypoplasia and cardiac defects?
Fetal alcohol syndrome
An 18 year old female with no history of abnormal pap smears now has a first time ASCUS pap. How should this be managed?
Repeat pap in one year
What are the management options of a first time ASCUS pap in a non-adolescent?
1. Reflex HPV
2. Repeat pap in 6-12 months
What is the treatment for a clavicle fracture?
Figure of 8 or sling
A 40 year old female has persistent erythema on her nose and cheeks and recurrent facial flushing especially with alcohol and spicy foods. What is the diagnosis?
A patient with cirrhosis presents again to the ER to have his ascites drained. Analysis of the ascites fluid reveals an absolute neutrophil count greater than 250 cells/mm^3. What is the diagnosis?
Spontaneous bacterial peritonitis
Otoscopy in a child presenting with acute onset of ear pain reveals large, reddish vesicles on the TM. What is the diagnosis, typical organism, and treatment?
Dx: Bulous myringitis
Tx: Erythromycin or clarithromycin
What is the treatment for pilonidal cyst?
Incision and drainage
What is the treatment for a rectal fistula?
A patient on isotretinoin for acne begins to develop daily, persistent, pulsatile headaches. Exam reveals papilledema. What is the diagnosis?
An 18 year old male is found to have systolic heart murmur heard at the apex and left lower sternal border that increases in intensity while standing after squatting. What diagnosis do you suspect?
What disorder classically presents with the triad of cognitive impairment, urinary incontinence and abnormal gait?
Normal pressure hydrocephalus
What is the underlying cause of late fetal decelerations on contraction stress test?
A middle aged man presents for knee pain and x-ray reveals bilateral calcifications of the articular cartilage. What is the treatment?
Tx: NSAIDS or colchicine
What is the next step in the management of a positive PPD?
A 25 year old male is diagnosed with a solid testicular mass by ultrasound. What is the next step in the management?
A teenager on antibiotics for acne presents with a severe sunburn. What antibiotic is he most likely taking?
What is the next step in the management of a female with poor uterine tone after delivery of the placenta?
Uterine massage then oxytocin
What are the characteristic findings in tertiary syphilis?
+ Romberg's Sign
Aortits or Aortic Root Aneurysm
A young child presents with thigh muscle weakness, a waddling gait, and pronounced calf muscles. What is the diagnosis?
Duchenne Muscular Dystrophy
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