Preferred test for c.diff
EIA
object penetration thoruhg shoes and socks, what organism
psuedomonas
all pts who faint have what pathophysiology
transient generalized cerebral hypoperfusion
what HTN meds cause heart block
beta blockers
verapamil
diltiazem
alpha blockers
HIT pathophys
autoimmune antibody destruction of platelets
what tx for seborrhea on face
low potency topical corticosteroid
non-caseating granuloma
sarcoid
what drug to lower urine Ca++ to prevent kidney stones
thiazides
macrocytic megaloblastic anemia is seen in
B12 anemia d/t gastrectomy
primary cause of astham
airway inflammation
who to give zoster vaccine
anyone who isn't CI >60 yo
spontaneous subconjunctival hemorrhage tx
no medical care
heterophile antibodies are seen in
epstein barr virus
slow relaxation of DTRs -- what dx
hypothyroidism
low TIBC, normal to elevated ferritin -- what dx
anemia of chornic dz
63 y/o with 2 month hx weakness and sudden onset palpitations and new afib -- what dx
Grave's disease
melena means blood came from where
esophagus
stomach
duodenum
klebsiella PNA tx
ceftriaxone
59 yo male with ecchymoses on body and prolonged PT -- what dx
cirrhosis
what drug can precipitate acute gout
niacin
MC bacterial pathogen causing illness in pts with HIV
strep PNA
MC etiologic agent for impetigo
group A strep
malignant hyperthermia tx
dantrolene
100% O2
bacterial meningitis CSF
neutrophils
low glucose
elevated protein
pt with solid + liquid dysphagia along with skin difficulties -- what dx
scleroderma
why is chlorthalidone better than HCTZ
longer duration of action
preferred initial therapy for fibrocystic breast changes
NSAIDs
paget's disease of bone labs
increased 24 hr urinary excretion of hydroxyproline
18 year old man with headaches. eval shows unruptured cerebral aneurysm - waht is most likely underlying disorder
polycystic kidney disease
hearing loss and transient yellow discharge on pillow -- what dx
cholesteatoma
which infection of eyelid is painful? which is painless?
chalazion is painless
hordeolum is painful
CSF showing mononuclear cells, normal glucose, slightly elevated protein -- what dx
viral meningitis
CSF showing neutrophils, low glucose, elevated protein -- what dx
bacterial meningitis
patient with myopia is at greatest risk for developing what eye disorder
retinal detachment
what advice should you give to patient on hydroxychloroquine therapy
get opthalmic exams
normal pressure hydrocephalus presentation
dementia
urinary incontincence
abnormal gait
lung cancer in apex of left lung most likely complication
horner's syndrome
50% of older patients who have bipolar also have
dementia
positive drop arm test -- what dx
cuff tear
treatment for painful crisis in sickle cell disease
hydroxyurea
c. diff that doesn't respond to metronidazole, what tx
oral vanco
patient with manifestations of chronic adrenal insufficiency - preferred initial diagnostic test
cosyntropin test
uncomplicated cystitis during pregnancy what tx
fosfomycin
most likely underlying disorder of raynaud's phenomenon
systemic sclerosis
donezepil adverse effects
diarrhea, nausea, vomiting
acute arterial occlusion preferred inital therapy
IV heparin
MC viral cause of pericarditis
cocksackie virus
why is LMWH better than unfractionated heparin
it has greater bioavailability
what HTN drug cannot be used in pts with nephritic syndrome
ace inhibitors
most likely ocmplication of chronic pancreatitis caused by chronic alcohol abuse
steatorrhea
most underlying cause of cranial nerve VI palsy
diabetes
how do ace-is reduce proteinuria
decreasing intraglomerular pressure
new-onset severe seborrheic dermatitis - what is underlying disorder
HIV infrection
what to monitor in patient on methotrexate therapy
serial liver studies
preferred initial diagnostic test to confirm PAD
ABI
primary objective treatment for choledocholithiasis and acute pancreatitis
IV hydration
alangesia
IV abx
patietn on HCTZ develops unsteady gait, decreased concentrating ability, HAs, mild nausea -- what is most likely cause
hyponatremia
anion gap in DKA with emtabolic acidosis
increased
patient with chronic alcohol abuse has acute attack of severe pancreatitis and hypotension -- most likely cause of hypotension is
sequestration of fluid in a 3rd space
screening for AAA
one time screening by abdominal U/S for anyone who has ever smoked between 65-75 y/o
normal exam and torsades de pointes seen in the field are consistent with
congenital long QT interval
treatment of choice for hypotension induced from administration of verapamil is
calcium chloride
what differentiates RA from OA
involvement of MCP joints
low pitched, rumbling diastolic murmur heard best at apex is
austin-flint murmur
sandpaper like rash and sore throat is
scarlet fever
what causes hypotension in patietn wtih chronic adrenal insufficiency
aldosterone
DKA tx
1-3L bolus normal saline over 1 hr
fine red rash over neck and chest, sore throat, HA, fever for 2-3 days is
scarlet fever
nitrite dipstick test is used in assessment of
gram negative bacilli in urine
initial medication therapy for fibro
amitryptiline
most sensitive test to indicate myocardial necrosis
troponin I
what medication administered within the first 1-2 weeks of life is assocaited with increased incidence of infantile hypertrophic pyloric stenosis
erythromycin
MC inflammatory disease leading to development of thoracic aortic aneurysm
GCA
MC adverse effect of niacin
flushing
preferred initial therapy of diabetic autonomic neuropathy manifested by orthostatic hypotension
fludrocortisone
pathophys of sumatriptan
serotonin agonist acusing vasoconstriction
hypercortisolism caused by ectopic ACTH production from small cell CA of lung is associated with what electrolyte abnormality
hypokalemia
what risk factor is negatively correlated with development of a thoracic aortic aneurysm
diabetes
most specific enzyme for diagnosis of acute pancreatitis
lipase
what does aortic regurgitation do to PMI
displaced downward and to the left
what causes apical lift
aortic stenosis
murmur heard in right 2nd ICS is what valve
aortic
aortic stenosis symptoms
ASH - angina, syncope, heart failure
mitral regurg/stenosis symptoms
PHD = palpitations, heart failure, dyspnea with exertion
preferred initial test to confirm diagnosis of hirschprung's disease
suction rectal biopsy
prior URI plus vertigo, n/v is
acute labrynthitis
what determines whether anterior talofibular ligament tear has occured
anterior drawer test
somatic manifestations of acute panic attack
diaphoresis
chest pain
mydriasis
common side effects of isotrenitoin therapy
dry mouth and nose
chelitis
pruritis
initial step in management of cardiogenic shock after MI
IV bolus normal saline or lactated ringers
anti-double stranded DNA and anti-Sm antibodies are seen in what
SLE
most common complication of post-strep glomerulonephritis iwth nephritic syndrome is
hyperkalemia
durg of choice for enuresis in children is
imipramine
enlargements of DIP are
heberdens nodes
enlargeents of PIP are
bouchards nodes
birds beak on barium swallow =
achalasia
ST elevation in V1, V2 is what location
septal
ST elevation in 1, aVL, V5, V6 is what location
lateral
ST elevation in V3, V4 is what location
anterior
patient with no co-morbidities what is first line tx for HTN
thiazide
what type of shock is most commonly associated with long bone fracture
hypovolemic shock
most likely underlying cause of endometrial cancer is
exogenous estrogen therapy
diastlic harsh rumbling murmur with opening snap that radiates to apex is best heard where
mitral stenosis
best heard with patient on left side at apex of heart
what vaccine is CI in patietns with AIDS
herpes zoster
women epxosed to diethylsillbesterol in utero are at increased risk of developing what
clear cell adenocarcinoma of the vagina
common extraintestinal complications of crohn's
cholelithiasis/cholecystitis
uveitis
arhtritis
erytehma nodosum
definitive therapy for acute angle closure glaucoma after initial treatment and stabilization is
laser iridotomy
how to ddx chlamydia vs gonorrhea
gonorrhea usually has purulent discharge, chlamydia d/c is clear
what drugs can worsen psoriasis
beta blockers
lithium
anti-malarials
treatmetn for insecticide poisoning
atropine
low-risk patients who have DVT with or without PE -- what is tx
warfarin for 3 months
new diagnosis of hyperthyroidism during pregnancy - what tx
thioamide
waht is most sensitive imaging for chronic pancreatitis
ERCP
recommended management of diarrhea due to viral gastroenteritis
oral rehydration with fluids containing electrolytes
primary mechanism behind GERD
loss of lower esophageal sphincter tone
1st line tx to relieve sxs and promote healing of gastritis
PPIs
gastric inflammation due to NSAIDs is due to
diminished prostaglandin production
most effective change to reduce symptoms of PUD
smoking cessation
what is tx to prevent NSAID induced ulcers
PPI (omeprazole)
10-days of large-volume liquid stols iwthout blood or mucus is likely due to
pancreatic insufficiency
air fluid levels on KUB =
SBO
tx for PMR
low dose prednisone (high dose if above the neck sxs)
what causes osteoporosis
increased bone resorption
patient with ankylosing spondylitis with NSAID resistance what is tx
entaracept
first line tx for osteoporosis and osteopenia
alendronate
definitive tx for SCFE
surgical pinning
fiery red painful rash with well-demarcated margins n both cheeks -- what dx
erysipelas
diffuse round-to-oval calicfied lesions on CXR is
silicosis
pleural effusions and granulomatous lesions on CXR is
TB
TOC for inhalation anthrax
cipro
initial menifestation of tetanus
pain and tingling at site of contaminated wound
malaise, headache, abdominal pain, distention, thick green stool -- what dx
salmonellosis
atypical lymphocytosis is characteristic of
epstein-barr virus
perioral cyanosis, resonance, wheezing, coarse ronchi -- what dx
chronic bronchtiis
most lung abscess are due to
mixed anaerobes
lung abscess tx
clinda or augmentin
for which of hte microbes implicated in CAP is a urinary antigen test available
leigonella
oval salmon-colored plaques with crinkle appearing centers -- what dx
pityriasis rosea
first line tx of hidradenitis suppurativa
intralesional triamcinolone
itching, burning, stinging of feet with erythematous annular patches with distinct borders, central clearing, fine scales =
dermatophytosis
MC dermatophye causing athlete's foot
trichophyton rubrum
patchy tanning where areas of skin don't tan is
tinea veriscolor
MC side effects of finasteride
ED and loss of libido
patietnw ith recurrent OM presents iwth ear pain and purulent d/c -- what dx
chronic OM most likely caused by pseudomonas
1st line tx for cerumen impaction
hydrogen peroxide drops
how does metformin lower glucose
decreasing hepatic glucose production and increasing glucose utilization
initial treatment of choice for prolactinoma
cabergoline
in adults with no significant risk factors, how often to do fasting lipid profile
every 5 years
nephrogenic DI labs
low urine osmolality
high plasma oslmolality
how does PTH regulate extracellular calcium concentration
increasing the dissolution of bone mineral by osteoclasts
what artery occlusion is homonymous hemianopsia seen in
MCA
what artery occlusion is alexia seen in
PCA
what causes huntington disease
trinucleotide repeat
restless leg syndrome tx
dopamine agonist
underlying mechanism of migraine headache
activation of the trigeminal nerve
what vitamin is needed to aid iron absorption
vitamin C
reed-sternberg cells are diagnostic for
hodgkin lyphoma
hypersegmented neutrophils are seen in
b12 deficiency anemia
what is seen on CT of patient with schizophrenia
ventricular enlargement
for which antipsychotic med is periodic eye exam recommended
quetiapine
which antipsychotic is most strongly associated iwth weight gain
clozapine
what is best tx after stressful event to reduce risk of PTSD
brief psychotherapy
MC cause of fugue state
emotional crisis
what med may slow the absorption of lorazepam/BZDs
antacids
initial treatment of choice for molar pregnancy
suction curettage
septated irregular mass on U/S is indicative of
ovarian CA
large multinodular whorled mass on U/S =
leiomyoma
well-defined hypoechoic mass on U/S =
ovarian cyst
clustered polymorphic microcalcificatinos in branch shapes seen on mammogram is
ductal carcinoma in situ
patient on ACE wishes to become pregnant - what do you do for HTN
switch to methyldopa
hypokalemia that is refractory to K+ administration - waht other electrolyte disturbance shoul dbe looked for
hypomagnesemia
what slows progression of pulmonary HTN
supplemental oxygen
MC cause of restrictive cardiomyopathy
amyloidosis
TOC for fever and pain in rheumatic fever
ASA
what ECG finding would confirm suspected dx of angina
downsloping ST segment depression
what abx class can oyu not give to patietn with long QT syndrome
macrolides
roth spots
retinal lesions
osler nodes
painful violaceous lesions of fingers, toes, or feet
janeway lesions
painless erythematous lesions of palms and soles
best method to differentiate betweeen exacerbation of angina and acute MI is
cardiac biomarkers
Patient with unstable angina in addition to ASA, metoprolol, and heparin, what else do you give?
Clopidogrel
Menses with longer intervals between each menstruation is called
oligomenorrhea
Clear vesicles and erythematous ulcers on vagina -- what dx
herpes
left shift refers to
increase in the number of immature neutrophils
MC presentation of sickle cell anemia in infant
hand and foot syndrome
Most specific antibodies for SLE
anti-Sm and anti-double stranded DNA
hilar mass with mediastinal adenopathy on CXR -- what dx
small cell carcinoma
post-splenectomy most likely infecting organisms
step pneumo
n. meningitides
h. flu
rapid withdrawal of BZD therapy can cause
tremor
dysphoria
anxiety
patient with GERD and frequent heartburn has newly diagnosed hyperlipidemia - what medicine shoudl not be prescribed?
niacin
patient with portal hypertension - waht else to give in addition to furosemide
spirnolactone
preferred initial therapy class in alzheimer's
cholinesterase inhibitor
MC cause of secondary hyperparathyroidism
end stage renal disease
ear canal shows fluffy white debris and exfoliated scales of black material - what dx
fungal OE
elevated serum level of CRP is predictor of what
future cardiovascular events
decreased TSH with hypothyroid symptoms -- what dx
secondary hypothyroidism
what antibiotic to give 30 minutes before appendectomy
piperacillin
what antibiotic to give 30 minutes before appendectomy in PCN allergic pt
gentamycin + clindamycin or metronidazole
pseudogout treatment
intra-articular steroid
oral NSAIDs
ice
what finding in urine is suggestive of pyelo
white blood cell casts
what sound is most likely to be heard in patient with active angina and no evidence of heart failure
S4
newly diagnosed HTN in patient with no meds and no other abnormalities except hypokalemia -- what dx
primary aldosteronism
L2/L3/L4 radiculopathy has weakness in what muscles
hip adduction
hip flexion
knee extension
MC adverse effects of amiodarone
skin discoloration
photosensitivity
radiographic sign most suggestive of pseudogout
chondrocalcinosis
preferred initial drug class for tx of tourette
dopamine receptor blocker
what causes dawn phenomenon
increased growth hormone activity
Ptosis, facial muscle weakness, diplopia, and dysphagia that has been progressively worsening for the past year - what dx
myasthenia gravis
what heart problem is most likely cause of lung abscess
tricuspid valve endocarditis
1 week history of drenching night sweats, fatigue, generalized lymphadenopathy, splenomegaly -- what dx
hodgkin's
bilateral acoustic neuromas occur with what disease
neurofibromatosis type 2
middle aged man with chest pain and subcutaneous emphysema after recent vomiting -- what dx
esophageal rupture
child who ate fava beans adn then has headache, nausea, dark red-brown urine -- what dx
G6PD deficiency
MC side effect of amlodipine
peripheral edema
in addition to ejection murmur in aortic area, what else do you hear with aortic stenosis
apical S4 gallop
thiamine and vitamin E deficiency cause what similar symptoms
neuropathy and cerebellar/ataxia symptoms
transverse fracture through radial styloid process is called what
hutchinson's fracture
multiple cafe au lait spots are assocaited with what
neurofibromatosis
what HTN meds are CI in patient with gout
thiazides
loop diuretics
most undrelying disorder for pre-menopausal osteoporosis
cushing's disease
most likely causes of nasopharyngeal carcinoma
HPV
epistein barr
what happens to calcium in hypoparathyroidism
hypocalcemia
MC cause of positive stool guic test is
peptic ulcer disease
what skin disorder is associated with acute rheumatic fever
erythema marginatum
treatment for bacterial sinusitis in child allergic to PCN
clarithromycin
azithromycin
erythromycin
aortic valve stenosis primary pathophysiologic abnormality
increased afterload
wide pulse pressure =
aortic regurg
sunburst pattern on XR =
osteosarcom
moth eaten pattern and onion peel appearance on XR =
ewing sarcoma
what is ocular risk of juvenile RA
uveitis
urge incontinence is due to what
over activity of detrusor muscle
prerenal failure BUN:Cr
> 20:1
prerenal failure urine sodium
decreased
intrinsic renal failure BUN:Cr
10:1
intrinsic renal failure urinary sodium
increased
addison's electrolyte abnormalities
hyponatremia
hyperkalemia
bite cells are seen in
G6PD
heinz bodies are seen in
G6Pd
howell jowel bodies are seen in
sickle cell
auer rods are seen in
AML
philadelphia chromosome is seen in
CML
bence jones protein is seen in
multiple myeloma
rouuleax formation is seen in
multiple myeloma
wickham striae are seen in
lichen planus
india ink stain =
cryptococcus
multiple ring enhancing lesions =
toxoplasmosis
cough, coryza, conjunctivitis =
measles
koplik spots =
measles
forcheimer spots =
rubella
high fever that resolves then rash appears =
roseola
right heart failure in infats clinically manifests as
hepatomegaly
MC malignancies associated with superior vena cava syndrome
non-hodgkin's
small cell lung CA
Anion gap calculation
Na - (Cl + HCO3)
slow carotid upstroke, bibasilar rales, apical lift -- what dx
aortic stenosis
MC cardiac congenital abnormality in infant of T1DM mother
transposition of great arteries
tendinous xanthomas is associated with
premature atherosclerosis (thus carotid artery disease)
XR of small bowel in crohn's patient shows
cobblestone
narrow lumen
gram negative bacteremia is MC caused by what diseases
perforated bowel
pyelonephritis
ascending cholangitis
LSIL in patient 21-24 -- what is next step
repeat pap in 12 months
most likely transient adverse effect of adenosine
AV block
definitive treatment of hyperkalemia
dialysis
gustatory rhinitis tx
nasal ipratropium
preferred med for endocarditis prophylaxis in non-PCN allergic pt
ampicillin
hip pain in patient wtih sickle cell is due to
bone infarction
common complications of chronic amiodarone therapy
hypo/hyperthyroidism
patients born wtih VSD, ASD, or PDA are at increased risk for developing
Eisenmenger
child with angina - angina is most likely due to
hypertrophic obstructive cardiomyopathy
anomalous coronary artery
hypertropic cardiomyopathy preferred initial treatmetn
verapamil
beta blocker
pregnant woman with CAP - what tx
azithromycin
what to ACE inhibitors do to heart
decrease preload and afterload
what distinguishes diastolic left heart failure from right heart failure
pulmonary crackles
hypermagnesemia presentation
weakness, n/v
wide QRS, long PR
pregnant woman with sinusitis - what tx
amoxicillin
what kind of effusion does TB cause
exudative
initial imaging for cholecystitis
RUQ U/S
d-dimer is a measure of what
degradation product of fibrin
patient with chronic bronchitis and chronic afib - what tx
verapamil
hashimotos patients have antibodies to
thyroid peroxidase
thyroglobulin
if haloperidol is ineffective in tourettes what is next choice for tx
pimozide
50% of h. pylori strains are resistant to what
metronidazole
urge incontinence is due to what
UTI
verapamil and diltiazem most likely adverse effect
AV block
what vitamin deficiency can cause high output heart failure
vitamin B1