Professional Documents
Culture Documents
1
Niacin Hypercholesterolemia treatment that → flushing and
pruritus.
Treat existing heart failure and replace the tricuspid IV drug use with JVD and holosystolic murmur at
valve the left sternal border. Treatment?
2
Echocardiogram (showing thickened left ventricular Diagnostic test for hypertrophic
wall and outflow obstruction) cardiomyopathy.
3
Evaluation of a pulsatile abdominal
Abdominal ultrasound and CT
mass and bruit.
> 5.5 cm, rapidly enlarging, Indications for surgical repair of abdominal aortic
symptomatic, or ruptured aneurysm.
4
Pharmacologic stress test (e.g., Appropriate diagnostic test? ■ A 65-year-old woman
with left bundle branch block and severe
dobutamine echo) osteoarthritis has unstable angina.
5
The diagnostic test for pulmonary
V/Q scan embolism.
Oral surgery—amoxicillin; GI or GU
procedures—ampicillin and gentamicin before and Endocarditis prophylaxis regimens.
amoxicillin after
6
Pain, pallor, pulselessness, paralysis, paresthesia, The 6 P’s of ischemia due to
poikilothermia peripheral vascular disease.
Stasis, hypercoagulability,
endothelial damage Virchow’s triad.
7
Red plaques with silvery-white
Psoriasis scales and sharp margins.
8
Bullous pemphigoid - Nikolsky’s sign.
Acanthosis nigricans. Check fasting blood sugar to A 55-year-old obese patient presents with dirty,
rule out diabetes velvety patches on the back of the neck.
Dermatomal
Varicella zoster
distribution.
9
A lesion characteristically occurring in a linear
Contact dermatitis pattern in areas where skin comes into contact with
clothing or jewelry.
10
Premalignant lesion from sun exposure that can →
Actinic keratosis squamous cell carcinoma.
11
Inflammation and epithelial thinning of the
Lichen sclerosus anogenital area, predominantly in postmenopausal
women.
12
Iatrogenic steroid administration. The second most The most common cause of
common cause is Cushing’s disease Cushing’s syndrome.
13
α-antagonists (phentolamine and Should α- or β-antagonists be used first in treating
phenoxybenzamine) pheochromocytoma?
14
1° adrenal insufficiency (Addison’s disease). Treat A patient presents with weakness, nausea, vomiting,
with replacement glucocorticoids, weight loss, and new skin pigmentation. Labs show
mineralocorticoids, and IV fluids hyponatremia and hyperkalemia. Treatment?
15
Bias introduced when screening detects a disease
Lead-time bias earlier and thus lengthens the time from diagnosis to
death.
Out Sensitive tests have few false negatives and are used
to rule _____ a disease.
16
Chronic diseases such as SLE—higher prevalence or
Higher prevalence incidence?
Cross-sectional survey—incidence or
Prevalence prevalence?
Case-control study—incidence or
Neither prevalence?
17
Describe a test that consistently gives identical
High reliability, low validity results, but the results are wrong.
Cohort studies can be used to calculate relative risk Difference between a cohort and a
(RR), incidence, and/or odds ratio (OR).
Case-control studies can be used to calculate an OR case-control study.
18
1 ÷ (rate in untreated group − rate in Number needed to
treated group)
treat?
Prostate cancer is the most common cancer in men, The most common cancer in men and the most
but lung cancer causes more deaths common cause of death from cancer in men.
19
Number of live births per 1000
women 15–44 years of age Fertility rate?
20
Number of deaths from 20 weeks’ gestation to birth
per 1000 total births Fetal mortality?
No. Parental consent is not necessary for the medical A 15-year-old pregnant girl requires hospitalization
treatment of pregnant minors for preeclampsia. Should her parents be informed?
21
A doctor refers a patient for an MRI at a facility
Conflict of interest he/she owns.
The patient is a danger to self, a danger to others, or Involuntary psychiatric hospitalization can be
gravely disabled (unable to provide for basic needs) undertaken for which three reasons?
False. Withdrawing and withholding life are the True or false: Withdrawing life-sustaining care is
same from an ethical standpoint ethically distinct from withholding sustaining care.
22
Real threat of harm to third parties; suicidal Conditions in which confidentiality
intentions; certain contagious diseases; elder and
child abuse must be overridden.
When treatment noncompliance represents a serious Involuntary commitment or isolation for medical
danger to public health (e.g., active TB) treatment may be undertaken for what reason?
Treat because the disease represents an immediate A 10-year-old child presents in status epilepticus, but
threat to the child’s life. Then seek a court order her parents refuse treatment on religious grounds.
A patient’s family cannot require that a doctor A son asks that his mother not be told about her
withhold information from the patient recently discovered cancer.
23
Diverticulosis The most likely cause of acute lower GI bleed in
patients > 40 years old.
24
Campylobacter Identify key organisms causing diarrhea: ■ Most
common organism
25
Identify key organisms causing diarrhea: ■
E. coli O157:H7 Uncooked hamburgers
26
Yersinia Identify key organisms causing diarrhea: ■
Pseudoappendicitis
27
Mallory-Weiss—superficial tear in the esophageal Difference between Mallory-Weiss
mucosa Boerhaave—full-thickness esophageal
rupture and Boerhaave tears.
28
Hemolytic-uremic syndrome (HUS) A four-year-old child presents with oliguria,
petechiae, and jaundice following an illness with
due to E. coli O157:H7 bloody diarrhea. Most likely diagnosis and cause?
29
A 50-year-old man with a history of alcohol abuse
Confirm the diagnosis of acute pancreatitis with
presents with boring epigastric pain that radiates to
elevated amylase and lipase. Make patient NPO and
the back and is relieved by sitting forward.
give IV fluids, O2, analgesia, and “tincture of time”
Management?
Fecal occult blood test and sigmoidoscopy; suspect An elderly male with hypochromic, microcytic
colorectal cancer anemia is asymptomatic. Diagnostic tests?
30
Hereditary The most common inherited
hemolytic anemia.
spherocytosis
Diamond-Blackfan
Pure RBC aplasia.
anemia
31
Both have ↑ hematocrit and RBC mass, but How to distinguish polycythemia
polycythemia vera should have normal O2 saturation
and low erythropoietin levels vera from 2° polycythemia.
Usually resolves spontaneously; may require IVIG Treatment for idiopathic thrombocytopenic purpura
and/or corticosteroids (ITP) in children.
32
Which of the following are ↑ in DIC: fibrin split
Fibrin split products and D-dimer are elevated;
products, D-dimer, fibrinogen, platelets, and
platelets, fibrinogen, and hematocrit are ↓.
hematocrit.
Monoclonal gammopathy, Bence Jones proteinuria, A 60-year-old African-American male presents with
“punched-out” lesions on x-ray of the skull and long bone pain. Workup for multiple myeloma might
bones reveal?
33
Non-Hodgkin’s A 10-year-old boy presents with fever, weight loss,
and night sweats. Examination shows anterior
lymphoma mediastinal mass. Suspected diagnosis?
34
Acute myelogenous leukemia (AML) Auer rods on blood smear.
35
Intracellular inclusions seen in thalassemia, G6PD
deficiency, and postsplenectomy Heinz bodies?
O2, analgesia, hydration, and, if A 25-year-old African-American male with sickle cell
anemia has sudden onset of bone pain. Management
severe, transfusion of pain crisis?
36
Infection, cancer, and autoimmune The three most common causes of fever of unknown
disease origin (FUO).
Fever, pharyngeal erythema, tonsillar exudate, lack Four signs and symptoms of
of cough streptococcal pharyngitis.
37
Pregnant women. Treat this group aggressively Which healthy population is
because of potential complications susceptible to UTIs?
38
Pneumococcus, meningococcus, H. influenzae. Treat Meningitis in infants. Causes?
with cefotaxime and vancomycin Treatment?
Check for ↑ ICP; look for What should always be done prior to
papilledema LP?
39
MS CSF findings: ■ ↑ gamma globulins
Cutaneous anthrax. Treat with Initially presents with a pruritic papule with regional
lymphadenopathy and evolves into a black eschar
penicillin G or ciprofloxacin after 7–10 days. Treatment?
40
A 24-year-old male presents with soft white plaques
Candidal thrush. Workup should include an HIV
on his tongue and the back of his throat. Diagnosis?
test. Treat with nystatin oral suspension
Workup? Treatment?
Neutropenic nadir
7–10 days postchemotherapy.
41
Fever, heart murmur, Osler’s nodes, splinter Classic physical findings for
hemorrhages, Janeway lesions, Roth’s spots endocarditis.
42
Name the organism: ■ Dog or cat
Pasteurella multocida bite.
43
Name the organism: ■ Alcoholic
Klebsiella with pneumonia.
44
A 55-year-old man who is a smoker and a heavy
drinker presents with a new cough and flulike
Legionella pneumonia symptoms. Gram stain shows no organisms; silver
stain of sputum shows gram-negative rods. What is
the diagnosis?
45
MCP and PIP joints; DIP joints are Joints in the hand affected in
spared rheumatoid arthritis.
Osteoarthritis Joint pain and stiffness that worsen over the course
of the day and are relieved by rest.
Suspect ankylosing spondylitis. Hip and back pain along with stiffness that improves
with activity over the course of the day and worsens
Check HLA-B27 at rest. Diagnostic test?
46
Gout. Needle-shaped, negatively birefringent crystals A 55-year-old man has sudden, excruciating first
are seen on joint fluid aspirate. Chronic treatment MTP joint pain after a night of drinking red wine.
with allopurinol or probenecid Diagnosis, workup, and chronic treatment?
47
Avascular necrosis Complication of scaphoid fracture.
Slipped capital femoral epiphyses. AP and frog-leg An 11-year-old obese, African-American boy presents
lateral view with sudden onset of limp. Diagnosis? Workup?
48
The most common 1° malignant
Multiple myeloma tumor of bone.
Broca’s aphasia. Frontal lobe, left A 55-year-old patient presents with acute “broken
speech.” What type of aphasia? What lobe and
MCA distribution vascular distribution?
49
Trauma; the second most common
The most common cause of SAH.
is berry aneurysm
50
Cold water is flushed into a patient’s ear, and the fast
Normal phase of the nystagmus is toward the opposite side.
Normal or pathological?
Infection, febrile seizures, trauma, The most common cause of seizures in children
idiopathic (2–10 years).
51
Trauma, alcohol withdrawal, brain The most common cause of seizures in young adults
tumor (18–35 years).
52
ALS Combined UMN and LMN disorder.
53
A six-year-old girl presents with a port-wine stain in
Sturge-Weber syndrome. Treat symptomatically.
the V2 distribution as well as with mental
Possible focal cerebral resection of affected lobe
retardation, seizures, and leptomeningeal angioma.
54
Snowstorm on ultrasound. “Cluster-of-grapes” Classic ultrasound and gross appearance of complete
appearance on gross examination hydatidiform mole.
55
Never When should a vaginal exam be performed with
suspected placenta previa?
56
Uterine massage; if that fails, give Treatment for postpartum
oxytocin hemorrhage.
57
β-hCG; the most common cause of The first test to perform when a woman presents
amenorrhea is pregnancy with amenorrhea.
58
Diagnostic step required in a postmenopausal
Endometrial biopsy woman who presents with vaginal bleeding.
Stable, unruptured ectopic pregnancy of < 3.5 cm at Indications for medical treatment of
< 6 weeks’ gestation ectopic pregnancy.
Laparoscopic findings in
“Chocolate cysts,” powder burns
endometriosis.
59
How to diagnose and follow a
Ultrasound leiomyoma.
60
Contraceptive methods that protect
OCP and barrier contraception
against PID.
61
Kegel exercises, estrogen, pessaries for stress A 50-year-old woman leaks urine when laughing or
incontinence coughing. Nonsurgical options?
62
Breast cancer type that ↑ the future risk of invasive
Lobular carcinoma in situ carcinoma in both breasts.
Esophageal atresia with distal TEF (85%). Unable to The most common type of tracheoesophageal fistula
pass NG tube (TEF). Diagnosis?
63
CF or Hirschsprung’s disease A neonate has meconium ileus.
64
High-dose aspirin for inflammation and fever; IVIG Acute-phase treatment for Kawasaki
to prevent coronary artery aneurysms disease.
65
Tanner stage 3 in a six-year-old
Precocious puberty female.
66
Bruton’s X-linked What is the immunodeficiency? ■ A four-month-old
agammaglobulinemia boy has life-threatening Pseudomonas infection.
67
A homeless child is small for his age and has peeling
Kwashiorkor (protein malnutrition) skin and a swollen belly.
68
Antidepressants associated with
MAOIs hypertensive crisis.
69
Isolation Name the defense mechanism: ■ A woman calmly
describes a grisly murder.
70
The most serious side effect of
Agranulocytosis clozapine.
71
A 13-year-old male has a history of theft, vandalism,
Conduct disorder and violence toward family pets.
Acute mania. Start a mood stabilizer A patient hasn’t slept for days, lost $20,000
gambling, is agitated, and has pressured speech.
(e.g., lithium) Diagnosis? Treatment?
72
A patient continues to use cocaine after being in jail,
Substance abuse losing his job, and not paying child support.
Tardive dyskinesia. ↓ or discontinue haloperidol and A schizophrenic patient takes haloperidol for one
consider another antipsychotic (e.g., risperidone, year and develops uncontrollable tongue movements.
clozapine) Diagnosis? Treatment?
73
A man unexpectedly flies across the country, takes a
Dissociative fugue new name, and has no memory of his prior life.
74
Fatigue and impending respiratory Normalizing PCO2 in a patient having an asthma
failure exacerbation may indicate?
75
Radiation Treatment for SVC syndrome.
Small cell lung cancer (SCLC) Lung cancer associated with SIADH.
76
Lung cancer highly related to
SCLC cigarette exposure.
Spontaneous pneumothorax. Spontaneous A tall white male presents with acute shortness of
regression. Supplemental O2 may be helpful breath. Diagnosis? Treatment?
Treatment of tension
Immediate needle thoracostomy
pneumothorax.
77
↑ risk of what infection with
Mycobacterium tuberculosis
silicosis?
Cardiomegaly, prominent pulmonary vessels, Kerley Classic CXR findings for pulmonary
B lines, “bat’s-wing” appearance of hilar shadows,
and perivascular and peribronchial cuffing edema.
78
RTA associated with aldosterone
Type IV (distal) RTA defect.
Differential of hypervolemic
Cirrhosis, CHF, nephritic syndrome
hyponatremia.
79
Hypokalemia T-wave flattening and U waves.
80
The most common type of
Calcium oxalate nephrolithiasis.
81
The most common form of
IgA nephropathy (Berger’s disease)
glomerulonephritis.
82
Waxy casts in urine sediment and Maltese crosses
Nephrotic syndrome (seen with lipiduria).
Wait, surgical resection, radiation and/or androgen A 55-year-old man is diagnosed with prostate cancer.
suppression Treatment options?
83
Hematuria, flank pain, and palpable
Renal cell carcinoma (RCC)
flank mass.
84
Anion gap acidosis and 1° respiratory alkalosis due to Salicylate ingestion → in what type of acid-base
central respiratory stimulation disorder?
Likely BPH. Options include no treatment, terazosin, A 55-year-old man presents with irritative and
finasteride, or surgical intervention (TURP) obstructive urinary symptoms. Treatment options?
85
Antipsychotics (neuroleptic Class of drugs that may cause syndrome of muscle
rigidity, hyperthermia, autonomic instability, and
malignant syndrome) extrapyramidal symptoms.
86
Treatment for benzodiazepine
Flumazenil overdose.
87
INH, penicillamine, hydralazine,
Causes of drug-induced SLE.
procainamide
88
Retrograde cystourethrogram Test to rule out urethral injury.
Widened mediastinum (> 8 cm), loss of aortic knob, Radiographic evidence of aortic
pleural cap, tracheal deviation to the right,
depression of left main stem bronchus disruption or dissection.
89
Acceptable urine output in a trauma
50 cc/hour patient.
Third-degree heart
Cannon “a” waves.
block
90
↓ CO, ↓ pulmonary capillary wedge pressure (PCWP),
Hypovolemic shock ↑ peripheral vascular resistance (PVR).
91
Identify cause; fluid and blood
Treatment of hypovolemic shock.
repletion
Diphenhydramine or epinephrine
Treatment of anaphylactic shock.
1:1000
92