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DU PA challenge bowl

Duke PA Challenge Bowl

Question	Answer
congenital abnormality which results in narrowing of the aorta, usually in the ascending region, which increase pulmonary vascular resistance PVR due to the stenosis.	coarctation of the aorta
catecholamine producing large tumors of adrenals	Pheochromocytoma
Papilledema must be present	malignant hypertension
Alcohol can raise	blood pressure
First Line Therapy for HTN	Thiazide Diuretic
Beta-blockers end in	olol
Ace inhibitors end with	pril
What antihypertensive can cause Hyperkalemia	ACEI's
What do most ARBs end with	sartan
S1	closing of mitral valve
S2	closing of aortic valve
normal site of Apical impulse	midclavicular line 5th left intercostal space
Flex the knee slightly and dorsiflex the foot. Pain in the calf is a positive test	Homan's sign
Ensures patency of the ulnar artery before puncturing the radial artery for blood sampling	Allen test
The trachea is ~ __cm long	10
decreased fremitus	pulmonary edema, emphysema
increased fremitus	consolidation
percussion of fluid filled or solid area	dullness
Identify drawn figure (draw number or letter) Deficit may indicate lesion in sensory cortex or posterior column	Graphesthesia
Rigid flexion=Corticospinal tract above brainstem	Decorticate posturing
Rigid extension=Brainstem lesion	Decerebrate posturing
Loss of ability to recognize previously familiar objects	agnosia
Winging of scapula-Medial border of scapula juts outward with arm extension	Weakness of serratus anterior muscle or injury to long thoracic nerve
most common cause of right heart failure is	left heart failure
Chagas disease is a common form of myocarditis which is caused by infection with	Trypanosoma cruzi
The most common primary cardiac tumor is	atrial myxoma
what are the 4 distinct types of pain	nociceptive, inflammatory, neuropathic, functional
what is the study of what the body does to a drug	pharmacokinetics
what are the two broad categories of pain	adaptive, and maladaptive
what is a study of what a drug does to the body	pharmacodynamics
this type of chemotherapy agent inhibits cell growth and proliferation by competing for binding sites on enzymes and incorporating into DNA or RNA	anti-metabolites
what is the most effective drug for Parkinson's	levodopa
what is a molecule that has both affinity and efficacy at a receptor site	agonist
what type of bacteria is Helicobacter pylori	gram negative bacilli
what is stomatitis	inflammation of the oral mucosa
what is a molecule that has affinity but no efficacy at a receptor site	antagonist
A patient presents with epigastric pain, vague diffuse pain, worsened by food, with N/V, what is wrong with this patient	gastric ulcer
What is considered the fifth vital sign	pain
what is the incubation period for influenza	1-2 days
what is considered first line treatment for mild to moderated osteoarthritis	acetaminophen
A patient presents with epigastric pain that is relieved by food and antacids, present at night, with heart burn, what is wrong with this patient	duodenal ulcer
what organism is a classic postinfluenza complication	Staphylococcus aureus
what has developed when greater doses are needed to produce previously obtained effect	tolerance
what is the drug of choice in acute otitis media	amoxicillin
what type of diuretic is best for someone with CKD	loop
treatment of choice in beta-lactam allergic patient with sinusitis	levofloxacin or moxifloxacin
when meidcations have a combined effect that is greater thatn the sum of individual effects this is called	synergism
what is the maximum daily dose for acetaminophen in a healthy individual	4000mg
what is currrently the only COX-2 inhibitor available in the US	Celecoxib
this injection for osteoarthritis can give patients up to 6 months of relief. Forms viscoelastic solution in water and functions as a joint lubricant	hyaluronic acid
what is the disease modifying anti-rheumatic drug of choice	methotrexate
what pregnancy category has some fetal risk, benefits may outweigh risk	D
what pregnancy category has fetal abnormalities in animal or human studies, risk outweighs any benefit	X
what opioid antagonist is used for opioid reversal	Naloxone (Narcan)
what medicationis used for benzodiazepine overdose	Romazicom
What is the treatment of choice for hypothyroidism	Levothyrosine (T4)
a ventricular arrhythmia caused by digitalis toxicity should be treated initially with	lidocaine
the systolic ejection murmur in hypertrophic obstructive cardiomyopathy is diminished when the patient	performs the Valsalva maneuver
in the patient with fever and productive cough what diagnosis would be suggested by egophony at the left base	LLL pneumonia
which hormone peaks at ovulation in the normal menstrual cycle	Leteinizing horomone (LH)
what knee injury is indicated in a positive anterior drawer sign	anterior cruciate ligament tear
crampy abdominal pain that waxes and wanes is also called what	colic
what is the most commonly injured area of the mandible	angle
what is the most commonly abused drug by teenageres	alcohol
what is the most common location for ectopic pregnancies	fallopian tube
what organism iduces rose spots and watery diarrhea, as well as high fever and relative bradycardia	salmonella
a healthy asymptomatic 68 yo woman is found to have bacteriuria on a clean catch urine specimen. what would be the most appropriate next step in her management	no treatment or further testing necessary
what type of hearing loss is experienced by the patient with cerumen impaction	conductive
what organism is known to cause hand-foot-mouth disease	coxsachievirus
the first cardiac enzyme to be detected in the setting of acute MI	troponin
the absene of audible bowel sounds for several minutes in a patient with acute abdominal pain indicates what underlying problem	ileus or obstruction
a chest x-ray on a 69 year old smoker shows flattened diaphragms, what do you suspect	Emphysema or COPD
Alzheimer's disease is the most common type of dementia. what is the next most common type	multi-infarct
what disease is suggested by the presence of Kaiser-Fleisher rings around the corneas	Wilson's disease
what will be the appearance of pericardial effusion on an x-ray	a water bottle silhouette
livedo reticularis commonly develops on what body part	the legs
a 60 year old man presents with seborrheic dermatitis affecting mostly the face. He has also noticed the onset of a shuffling gait and slowness of movement. From his history what diagnosis might account for all of these features	Parkinsonism
your pateint complains of calf pain. Forceful dorsiflexion of the foot cuases an increase in the pain. What is this finding called	Homan's sign
What rast presents with a christmas tree distribution and a harald patch	pityriasis rosea
what microbial agent is associated with mesenteric adenitis and pseudoappendicitis	Yersinia
two weeks after a myocardial infarction a patient takes warfarin and ahs sudden onset of hypotension, right flank pain, right CVA pain, epigastric pain, fever, nausea, and vomiting. what is the diagnosis	adrenal gland hemorrhage (adrenal apoplexy)
what class of antihypertensive medication would you want to avoid in a patient who has asthma	beta blockers
what organism cuases diarrhea that is profuse and bloody, but does not cause vomiting	entamoeba histolytica
what is the organism most commonly identified with antibiotic associated colitis	clostridium deficile
what is the drug class of choice in reducing afterload in patients with congestive heart failure	ace inhibitor
the most appropriate initial test for the detection of prostate cancer is	digital rectal exam
peptic ulcer disease may be causally related to an infection of	helicobacter pylori
poisoning from this gas may result from exposure to improperly vented gas heaters, automobile exhaust, or smoke inhalation	carbon monoxide
which medications may be used for Crohn's disease but not for ulcerative colitis	antidiarrheal agents
you are following a patient with pernicious anemia, what vitamin deficiency are you concerned about	vitamin B12
what is the pediatric condition occuring when a portion of the intestine telescopes into an adjoining section	intussuception
bilateral black eyes due to a basilar skull fracture are called	raccoon eyes
what is the most common cause of visual impairment in the elderly	cataracts
what diagnosis is suggested byt he presence of translucent papules with central ubilication	molluscum contagiosum
what are you testing by grasping the great toe and moving it up and down	proprioception
what condition is best treated by following a gluten free diet	celiac disease
infection with what organism is associated with an increased risk of cervical cancer	human papilloma virus
which gastric gland secrete pepsinogen	chief cells
upon fertilization and implantation of the ovum during pregnancy, the developing placenta secretes __ which in turn stimulates the corpus luteum to continue to secrete estrogen and progesterone, preventing endometrial sloughing	HCG or hyman chorionic gonadotropin
what are the three elements of the triad of Reiter's syndrome	iritis, urethritis, and arthritis (can't see, can't pee, can't climb a tree)
what two drugs are used as first line treatment of uncomplicated gonorrhea in a non-pregnant patient	rocephin and doxycycline
acute pyogenic pericarditis is most commonly caused by what organism	staphylococcus and heamophilus influenza
what percentage of patients with palpitations also have cardiac disease	50%
what does normal ventilation with decreased lung perfusion suggest	pulmonary embolus
what disease is the M protein associated with	multiple myeloma
community aquired pneumonias are most often caused by what organism	Strep pneumoniae
what is the most common cause of embolic stroke	atrial fibrillation
what is the infection caused by Borrelia burgdorferi	Lyme disease
Your patient has a low frequency resting tremor of the hand. What diagnosis do you suspect	parkinson's disease
what does a delta wave on EKG suggest	Wolfe-Parkinson-White syndrome
What is the most common cause of traveler's diarrhea	E. coli
which bacterium is associated with peptic ulcer disease	helicobacter pylori
your patient has weight loss, weakness, nausea and vomiting and diffuse muscle pain. On exam you find increased skin pigmentation. What condition is consistent with these findings	Addison's disease
What is the most common sign on physical exam of the patient with pelvic inflammatory disease (PID)	cervical motion tenderness
what is the most common joint dislocation	anterior shoulder dislocations account for half of all joint dislocations. they occur with abductions and external rotation.
You are treating a patient for syphilis who develops high fever and worsening clinical picture, you suspect what?	Jarisch-Herxheimer Reaction
The medical record indicates your patient has “Cullen’s sign”, what does this indicate?	Periumbilical ecchymosis which is classically associated with hemorrhagic pancreatits
In general children should triple their birth weight by what age?	In the first year
This extrapelvic manifestation of PID presents with RUQ pain and is associated with inflammation of the liver capsule.	Fitz-Hugh-Curtis Syndrome
These 1-3 mm white/gray elevations with an erythematous base are seen on the buccal mucosa typically opposite the molar teeth.	Koplik’s Spots
Koplik’s spots are pathognomonic for what disease?	Measles
Rapidly progressive mental deterioration and myoclonus are the two cardinal manifestations of this prion disease?	Creutzfeldt-Jakob disease
This periumbilical nodule represents metastasis from an intraperitoneal source?	Sister Mary Joseph’s Node or Nodule
Where would you find Virchow’s node?	Left supraclavicular area
Who is the father of the the PA profession?	Eugene Stead, MD (if you get that wrong. . . )
what hormones are produced by the medulla of the adrenal gland	epinephrine and norepinephrin
what is the treatment of choice for an HIV positive patient with pneumocystis carinis pneumonia	Trimethoprim-sulfamethoxazole (TMP-SMZ)
The most common initial symptom of subarachnoid hemorrhage is?	severe headache
Which is the most common type of hernia in children?	Indirect. Direct inguinal hernias are more common in the elderly.
What is the most common complication of Nitroprusside?	Hypotension, Thiocyanate toxicity accompanied by blurred vision, tinnitus
The most common cause of Left Ventricular Hypertrophy is?	Hypertension
What level of prevention is treatment for a person with AIDS using AZT?	Secondary Prevention
Your Diabetic patient presents with white plaques on his tongue and palate that, when scraped, reveal a red base, What is your diagnosis?	Thrush or Oral Candidiasis
The most common physical finding in symptomatic patients with Pulmonary Embolism is?	Tachypnea or tachycardia
What is the drug of choice for the initial treatment of an anaphylactic reaction?	Epinephrine
The most common pathogen associated with bronchiolitis in infants under the age of 2 y.o. is?	Respiratory Syncytial Virus (RSV)
Which do nitrates affect, preload or afterload?	Predominantly preload
The most common type of benign primary tumors of the heart are	myxomas
A diastolic murmur is associated with	Aortic regurgitation
A patient with atrial fibrillation is at high risk of developing	Arterial emboli
The most common congenital heart malformation is	ventricular septal defect
The physical exam finding most consistent with coarctation of the aorta after one year of age is	diminished or absent femoral pulses
For a patient with a prosthetic heart valve, endocarditis prophylaxis is NOT recommended in which of the following procedures	Cardiac catheterization
The earliest and most frequent symptom in congestive heart failure in an adult is	Shortness of breath
What is Virchow's triad	1) Injury to the endothelium of the vessels 2) Hypercoagulable state3) Stasis
With which liver disease would you expect to find Kaiser-Fleisher rings around the corneas?	Wilson's Disease
What is the most common sign of CA of the urogenital tract?	Hematuria
What is the most important lab test in the diagnosis of endocarditis?	Blood cultures
A 45 y.o. woman has had several episodes of sudden stabbing pain in her R face lasting about 5 minutes. There are no other symptoms and no focal neurological findings on exam. What is the most likely diagnosis?	Trigeminal neuralgia (tic douloureux)
What skin disorder is characterized by greasy yellow and red macules involving the scalp, eyebrows, and nasolabial folds?	Seborrheic dermatitis
An adult patient presents with a circumferential burn of the right arm. Using "the rule of nines" what is the percentage of body surface area involved?	9%
What disease is caused by rickettsia rickettsii?	Rocky Mountain Spotted Fever
What is the most common cause of death during the first few hours of a MI?	Cardiac dysrhythmias, generally ventricular fibrillation
What finding on physical examination of the abdomen would be consistent with congestive heart failure?	Hepatojugular reflux
Chronic synovitis with pannus formation is pathologic for what disease?	rheumatoid arthritis
What sign best indicates the severity of airway obstruction during an asthma attack	Use of accessory muscles for respiration
The reticulocyte count provides an indirect assessment of _____________	Bone marrow activity
Which type of hepatitis is transmitted via the fecal/oral route	Hepatitis A
Your patient is being treated with IV cephalosporin for pneumonia and develops diarrhea and abdominal pain. The most likely cause of these symptoms is	C. difficile (pseudomembranous colitis)
On x-ray, what is the finding considered diagnostic of intestinal obstruction	Air-fluid levels
What is the anatomic location of conduction delay in first degree AV block	AV node
What is the drug of choice in treating methicillin-resistant staph aureus infections	Vancomycin
A 2 year old child presents with a 4 day history of URI and onset in the past 12 hours of barking cough. The most likely diagnosis is _________	croup (viral)
What is the most common cyanotic heart lesion in pediatric patients	Tetralogy of Fallot
Your healthy 12 year old patient has a continuous murmur associated with a palpable thrill in the right lower neck only when in an upright position. What is this	venous hum
The most common cause of fever 1-2 days post-operatively is ____________	atelectasis
A laryngeal fracture is suggested by noting the hyoid bone elevated above what cervical level on an x-ray	C3
What is the most common cause of upper GI tract hemorrhages	duodenal ulcers
What is the most effective treatment for pernicious anemia	Monthly IM injection of B12
The treatment of choice for bacteria vaginosis	Metronidazole/Flagyl
Which antibiotic is associated with a disulfiram-like reaction when alcohol is taken concurrently	Metronidazole/Flagyl
An adult presents to the ER with burns of the entire right leg and arm. Using the "rule of 9's", what percent burn injury does he have	27%
Which skin neoplasm has the greater potential for metastasis: basal cell or squamous cell carcinoma	Squamous cell
What is the most likely cause of increasingly secondary dysmenorrhea associated with a tender premenstrual uterus	uterine adenomyosis
Describe the location of a Spigelian hernia	3-5 cm above the inguinal ligament
A postmenopausal woman presents with vaginal bleeding. What diagnostic test is indicated	Endometrial biopsy
A holosystolic murmur heard best in the apical area is most suggestive of what valvular condition	Mitral regurge
What strain of influenza is more common in adults	influenza A
What strain of influenza is more common in children	influenza B
Name a part of the body where you would want to avoid using lidocaine with epinephrine for local anesthesia	Digits, ear lobe, or tip of nose
What is the triad of symptoms present in Reiter's syndrome	Arthritis, urethritis, and conjunctivitis
What is the most common parasite in the US	Giardia. Infected individuals present with foul-smelling, floating stools; abdominal pain; and perfuse diarrhea. The parasite may be identified with a positive string test or duodenal aspiration for trophozoites
What is the most common cause of intestinal obstruction	Adynamic ileus
What organism most commonly causes subacute infectious endocarditis	S. viridans
What are the major sequelae of untreated streptococcal infections	Acute glomerulonephritis unrelated to treatment and rheumatic heart disease
Strangulation is most common with which type of hernia: direct, indirect, or femoral	Femoral
A 60 yo male presents with sore mouth. On exam, he has glossitis and stomatitis. Lab studies show anemia, leukopenia, and low platelets. What is the likely diagnosis	B12 deficiency/Pernicious anemia
What is the causative organism in Lyme disease	Borrelia burgdorferi
Rubella is commonly known to patients by what other name	German measles
Bitemporal hemianopsia is caused by a lesion of what part of the optic pathway	Optic Chiasma
This EKG abnormality is distinguished by Delta waves. What is it called	WPW
Heberden's nodes are associated with what disease	Osteoarthritis
What does an anti-HB indicate	Prior infections and immunity
Condylomata acuminata are caused by ______	human papillomavirus
A firm, movable yellowish nodule on the helix of the ear of a patient with arthritis is most likely what	tophus
Red cell casts in the urine would be indicative of what renal disease	Glomerulonephritis
What is the drug of choice for a patient with primary herpes genitalis	Oral acyclovir
The most common organism in otitis media in children is what	strep pneumonia (30% of cases)
The absence of bowel sounds for several minutes in a patient with acute abdominal pain indicates what underlying problem	ileus or obstruction
Name an ocular finding in cases of endocarditis	Roth spots or conjunctival hemorrhage
Subluxation of the radial head in young children is called what	Nursemaid's elbow
Is TSH increased or decreased in hyperthyroidism	Decreased
Which side effect most commonly leads to a request for removal of levonorgestreal implant (Norplant)	Menstrual irregularities
What is hematochezia	Bright red blood in stool
2 weeks following what seemed like a common cold you patient develops numbness and weakness of her toes and fingers. Over the next 48 hours her symptoms extend proximally. DTRs are decreased, and there is symmetric weakness. What diagnosis is suggested	Guillain-Barre Syndrome
In cases of hyperkalemia, the initial EKG finding is often what	tall, peaked T waves
What is the drug of choice for treating an uncomplicated chlamydial infection of the urethra, cervix or rectum	Doxycycline
Name the congenital or acquired disorder affecting the lungs, and causing permanent abnormal dilation and destruction of bronchi	Bronchiectasis
In a woman with no known risk factors, by what age should the first mammography be done	40
What is the virus most often associated with colds in adults	Rhinovirus
What is the most common presenting illness in AIDS patients	Pneumocystis carinii pneumonia
The most common cause of bowel obstruction is	Adhesions
On chest exam, your patient has increased tactile fremitus and dullness to percussion. What is more likely: Asthma or pneumonia	Pneumonia
Which organism is most often the cause of urinary tract infections in women	E. coli
What organism is associated with botulism food poisoning	Clostridium botulinum
What is the most common cause of water-borne infectious diarrhea in the US	Giardia lamblia
What constitutes a normal Weber test	Sound perception is midline
A 35 yo woman, with many hospitalizations for unexplained sepsis is found to e injecting herself with infected material. What disease does this support	Munchausen's
What syndrome presents with obesity and sleep apnea	Pickwickian syndrome
What is the antibiotc of choice for trichomonas vaginits	Metronidazole, (Flagyl)
What is the most common extrahepatic source of an elevated alkaline phosphatase	Prostate
A 20 yo male presents with dysuria and purulent penile discharge. Gram stain shows gram negative intracellular diplococci. What is the diagnosis	Gonorrhea
Roth's spots, Osler's nodes, and Janeway lesions are findings associated with what	Endocarditis
What are the four degrees of frostbite	First degree-erythema and edema; second degree-blister formation; third degree-necrosis; fourth degree-gangrene
What organisms are usually implicated in the development of diverticulitis	E coli and B fragilis
Kaiser-Fleischer rings of the corneas are associated with which hereditary disease	Wilson's disease
What finding is most suggestive of early oral carcinoma	Erythroplasia
What is the most common cause of painless lower GI bleeding in an infant or child	Meckel's diverticulum
Your patient has an elevated carcinoembryonic antigen (CEA). Which type of cancer would this most likely be associated with	Colon Ca
What physical finding would be expected on lung auscultations in a patient with a pneumothorax	Decreased or absent breath sounds
What physical exam finding is most consistent with an orbital fracture	Loss of upward gaze
What physical finding is most likely in a patient with lateral epicondylitis	Pain when wrist extension is resisted
What is the most common form of kidney stone	Calcium oxalate
What is the most frequent side effect for patients taking ACE inhibitors	Dry cough
What does a "delta wave" on EKG tracing suggest	Wolff-Parkinson-White syndrome
An active 13 year old boy presents with bilateral pain and edema of the tibial tuberosities. What is your diagnosis	Osgood-Schlatter Disease
Vasodilator drugs are most likely to cause what of the heart	Reflex tachycardia
The most frequent cause of Vitamin B12 deficiency in patients with pernicious anemia is	Lack of intrinsic factor
Your patient has a positive psoas sign. What does this indicate	Peritoneal irritation
A 46yo white woman is found to have a 2-cm breast nodule on physical exam. What is the next appropriate course of action	Fine needle aspiration
The rash appears as grouped vesicles on an erythematous base in a dermatomal distribution is called	Herpes zoster or shingles
The reflex associated with sustained blink response to tapping between the eyes is what	Glabellar reflex
What adverse effect is associated with aspirin useage in children	Reye's syndrome
What condition is indicated by a positive Tinel's sign	Carpal tunnel syndrome
What is the most common presenting symptom of mitral valve prolapse	Palpitations
What screening procedure has the highest sensitivity for the detection of colon cancer	Colonoscopy
What is the first line class of drugs used in the treatment of status epilepticus	Benzodiazepines
What are the seven areas included in the neuro exam	MS, CNs, Motor, Sensory, Cerebellar, DTR's
What is the most common childhood leukemia	ALL-acute lymphoblasic leukemia
Name the virus which causes recurrent small grouped vesicles on an erythematous base, especially in the oral and genital areas	Herpes simplex
What is the most common causes of small bowel obstruction	Adhesions, followed by hernias
Which type of infarct commonly leads to papillary muscle dysfunction	Inferior wall MI. Signs and symptoms include a mild transient systolic murmur and pulmonary edema
What is the drug of choice in treating methicillin resistant Staph aureus	Vancomycin
What is the most common cause of death in patients with diabetes mellitus	MI, coronary artery disease
Deficiency of which vitamin is associated with peripheral neuropathy	B12
What organisms are typically responsible for causing bacterial conjunctivits	Staphylococcal, the second most common is Streptococcal
What is the most common type of skin cancer	Basal cell carcinoma
Which material used in making jewelry is a common cause of contact dermatitis	Nickel
What is the most prevalent form of contraception in the world	Surgical sterilization
What is the drug of choice for Pneumocystis carinii pneumonia	Trimethoprim-sulfamethoxazole
What neurologic disorder is characterized by complaints of diplopia, difficulty swallowing, limb weakness and fatigue	Myasthenia gravis
What dx is suggested by the following findings: hyperpigmentation and low fasting plasma cortisol	Addison’s disease
What is the most common side effect associated with digitalis toxicity	Nausea and vomiting
Hard nodules found on the distal interphalangeal joints of patients with osteoarthritis are called	Heberden’s nodes
What is the first sign of puberty in girls	Breast enlargement
Painful sexual intercourse is called what	Dyspareunia
The two bacteria responsible for most cases of impetigo are	Strep pyogenes and Staph aureus
What dx is made by finding an elevated sweat chloride test	Cystic fibrosis
What three sensations must be tested in the sensory exam	Light touch, pain, and vibration
What are the most common causes of large bowel obstruction	Carcinoma, followed by volvulus and sigmoid diverticulitis.
What side effect can occur with a rapid infusion of procainamide	Hypotension. Other side effects include QRS/QT prolongation, ventricular fibrillation, pointe.
What organism is commonly found in infected wounds caused by animal bites	Pasteruella multocida. The second most common organism is Staphylococcus aureus.
What are the most common causes of nongonococcal urethritis	Chlamydia trachomatis. Ureaplasma urealyticum is another common cause.
What is the incubation period for hepatitis A	30 days. The disease is caused by a retro-virus.
The two bacteria responsible for most cases of impetigo are:	Streptococcus pyogenes and staphylococcus aureus.
In most chemical burns to the skin or eyes, what is the cornerstone of initial treatment	Flushing or hydrotherapy.
What is the leading cause of death in patients with systemic lupus erythematosus	Renal disease.
What rash presents with a "Christmas tree" distribution and a herald patch	Pityriasis rosea.
Name the classic dissecting scissors which are used for cutting soft tissue and should not be used to cut suture material or thick fascia	Metzenbaum
The prodrome of fever, coryza, cough, conjuncitivitis, and Koplik's spots is typical of what disease	Measles
What hematologic disorder is a serum ferritin most useful in diagnosing	iron deficiency anemia
The most common AIDS defining illness is	Pneumocyctis carinii pneumonia
On physical exam, what neurological finding would suggest hypothyroidism	Decreased relaxation phase of deep tendon reflexes
Which type of hepatitis is transmitted orally	Hepatitis A
Name the pulmonary autosomal recessive disorder characterized by sweat chloride > 80 meq/L	Cystic fibrosis
The most common non-alcohol related cause of pancreatitis is	Gallstones
The first cardiac enzyme to be detected in the setting of acute myocardial infarction is	troponin
What type of glaucoma is the most common	Open-angle (chronic) Glaucoma
Which class of drugs can be responsible for the formation of cataracts	Corticosteroids
Fundal height in your pregnant patient is at the level of the umbilicus. This indicates how many weeks gestation	20 weeks
What laboratory testing would be most useful in diagnosing Cushing's syndrome	Dexamethasone suppression test
A mid-systolic click with a late systolic crescendo murmur is indicative of what cardiac disease	MVP (mitral valve prolapse)
Where can you find the Islets of Langherhans	Pancreas
Your pt's Weber test lateralizes to the R and on Rinne BC > AC on the R	R conductive loss
The phase of the cardiac cycle which occurs at the beginning of systole when the ventricles begin to contract and both the aortic and mitral valves are closed, is termed	Isovolumetric contraction
What is the classic triad of clinical manifestations in infectious mononucleosis	Fever, lymphadenopathy, pharyngitis
What is the major glucocorticoid	Cortisol
What is the most effective procedure for confirming the diagnosis of a pericardial effusion	echocardiography
What is the best way to diagnose sickle cell syndromes	Hemoglobin electrophoresis
What are the "ABCD"s of melanoma	Asymmetry, Border Irregularity, Color variation, Diameter > 6mm
What is Spanierman’s sign	Blood under the nails. This indicates nose bleeds due to nose picking. Bleeding in such cases is generally from the Keisselbach's plexus
What is the best X-ray view for diagnosing lunate and perilunate dislocations	Lateral X-ray view of the wrist
Presence of the Philadelphia chromosome is consistent with what blood disorder	Chronic Myelogenous leukemia
A 5 y.o. girl is seen with a 1 day history of a maculopapular rash on both cheeks, creating a "slapped cheek" appearance. What is the most likely diagnosis	Fifth's disease (erythema infectiosum)
Name the most sensitive diagnostic test for acute pancreatitis	Urinary amylase
What treatment is most appropriate for the alert patient who has ingested on overdose of aspirin	Syrup of ipecac (induce vomiting)
What are the classic ECG results associated with posterior MI	A large R wave and ST depression in V1 and V2
What is a major concern for a patient with unilateral Parkinsonian features	Intracranial tumor
What physical finding indicates acute pericarditis	Pericardial friction rub. The rub is best heard at the left sternal border or apex with the patient in a forward sitting position. Other findings include fever and tachycardia.
What is the most common cause of mitral stenosis	Rheumatic heart disease. The most common initial symptom is dyspnea.
Define a diastolic hypertensive emergency	Elevated diastolic blood pressure > 115 mm Hg with associated end organ dysfunction or damage.
What is the physical exam finding that is most predictive of otitis media in children	Decreased motility of the TM
What effect may be caused by the use of potent topical corticosteroids on the face	Depigmentation
In elderly patients in hospitals and nursing homes, what is the most common cause of fecal incontinence	Fecal impaction
A patient with psoriasis complains that her usual topical steroid preparation is becoming less and less effective. This phenomenon is called	Tachyphylaxis
Eighty to ninety percent of patients who experience sudden non-traumatic cardiac arrest are in what rhythm	Ventricular fibrillation. Early defibrillation is key. In an acute MI, the infarction zone becomes electrically unstable. Ventricular fibrillation is most common during original coronary occlusion or when the coronaries begin to re-perfuse.
You ask a patient to stick out her tongue. Which cranial nerve are you testing	12th CN or hypoglossal
The erythematous skin lesion considered pathognomonic for lyme disease	ECM; erythema chronicum migrans
Which type of hepatitis is caused by a DNA virus	Hepatitis B. The incubation period is 90 days.
Which vessels are larger in the fundus, arterioles, or venules	Venules
What is the most worrisome side effect of rifampin	Hepatotoxicity
Which class of antibiotics is associated with renal failure	Aminoglycosides
What is the most appropriate drug in the management of genital HSV-2	Acyclovir
When diagnosing pericardial effusion, how much fluid must be present in the pericardial sac for visualization on a cardiac echocardiography and by x-ray	At least 15 mL for an echocardiography and 250mL for an x-ray
The most common etiologic agent in non-gonococcal septic arthritis is	Staph aureus
What neurological disorder may be associated with seborrheic dermatitis	Parkinson's Disease
What is the most common malignancy in young men	Testicular cancer
What is the drug of choice for pneumocystis pneumonia	Trimethoprim-sulfamethoxasole (Septra or bactrim)
What is the organism most commonly identified with antibiotic-associated colitis	Clostridia difficile
What abnormal finding would be expected on nasal swab in the patient with allergic rhinitis	Eosinophilia
Which class of antihypertensive medications is most effective for African-Americans	Calcium channel blockers
What is the initial treatment of choice for ganglion cyst of the wrist	Nothing
Eileen is afraid to leave the house but she isn't sure why. She has her groceries delivered and never visits her friends any more. What may she be suffering from	Agoraphobia
Which type of myocardial infarction is more often associated with thrombosis: transmural or subendocardial	Transmural. Thrombolytic therapy increases left ventricle ejection fraction post MI, reduces the development of post infarction CHF, and can reduce early MI mortality by 25%
Name a common cause of intermittent isolated proteinuria	Exercise
What anatomic landmark on the anterior thorax marks the bifurcation of the trachea	Angle of Louis or sternal angle
What are two relatively specific CXR findings in PE	Hampton's hump: area of lung consolidation with rounded border facing the hilus; Westermarks's sign: dilated pulmonary outflow tract proximal to the emboli with decreased perfusion distal to the lesion.
How much aspirin should a post MI patient ingest daily to reduce the incidence of reinfarction	160 to 325 mg/day
A 55-year-old man presents in the ED with q severe headache, vomiting, and blurred vision. HX of hypertension untreated. you note a blood pressure of 240/186,papilledema evident on fundoscopy. drug of choice in the initial treatment of this patient is	E. nitroprusside
A 60-year-old man, hospitalized for an acute myocardial infarction, has had an uneventful course and responded well to therapy. When you examine him on the third day, you note an apical systolic murmur. The most probable cause would be	papillary muscle dysfunction
Name one of the two sports with which medial epicondylitis is most commonly associated	Golf and baseball
What is the most common central nervous system manifestation of AIDS	Dementia
What is the sign produced by retroperitoneal bleeding that results in a hematoma of the flank	Turner's sign
What is the condition related to pulmonary hypertension and resulting in right ventricular dilatation and hypertrophy	Cor pulmonale
What do the letters CREST stand for in scleroderma	Calcinosis cutis, Raynaud's phenomenon, esophageal dismotility, sclerodactyly, and telangiectasia
When you tap on the facial nerve just in front of the ear, your patient's face contracts on that side. What is this sign called	Chvostek's sign
What diagnostic study is most appropriate for a patient with suspected allergic rhinitis	Nasal smear for eosinophils
Tan to dark brown discoloration of the buccal mucous membranes and the folds of exposed areas of the skin are most characteristic of ____________	Addison's disease
In cases of hypothyroidism, would you expect the TSH level to be increased, decreased or normal	Increased
Use of the artificial sweetener aspartame is contraindicated in patients with what disease	Phenylketonuria
What condition is present in a patient who has paradoxical movement of a portion of the chest wall after severe chest trauma	Flail chest
A diagnosis of AIDS is consistent with a CD4 count less than	200
The most common etiologic agent in non-gonococcal septic arthritis is	Staph aureus
What hematologic disorder can be precipitated by exposure to antimalarials or mothballs (naphthalene)	G6PD anemia
blue sclera	osteogenisis imperfecta
Your patient has frequent episodes of alternating diarrhea and constipation, abdominal pain and mucous in her stool. Exam is normal as are stool studies. What diagnosis is likely	Irritable bowel syndrome
The bicarbonate buffer system is the most important buffer in the extracellular fluid. The normal ratio of base (bicarbonate) to acid (carbonic acid) is	20:1
The optic disk is more medial or later in the fundus	medial
Which bone of the middle ear is normally visualized on otoscopic exam	Malleus
What is the most common bacterial pathogen in pediatric otitis media	Strep pneumoniae
What is the most common cause of anemia in adults	Occult blood loss
Herpes zoster infection involving the facial nerve, external ear, and occiput is known by what name	Ramsay Hunt Syndrome
How many mm’s. of induration determine a positive PPD test in an otherwise healthy individual	15mm or greater
A 40 year old woman complains of pain in the knee on kneeling. There is a slight infusion present and pain is reproduced by pushing the patella against the condyles. What is the likely diagnosis	Chondromalacia patellae
An upper motor neuron lesion would have what effect on deep tendon reflexes	Increased
Your patient has an elevated carcinoembryonic antigen. Which type of cancer would this most likely be associated with	Colon
You are following a patient with pernicious anemia. What vitamin deficiency are you concerned about	B12
What is the most common adverse reaction of intranasal corticosteroids	Nasal irritation
What disease classically presents with severe hypertension, sweating, and palpitations	Pheochromocytoma
The neurotransmitter released from preganglionic nerve fibers in the parasympathetic nervous system is___________	Acetylcholine
The two major hormones involved in the regulation of fluid balance in the kidney are ________ and ________	Aldosterone and Antidiuretic Hormone (ADH)
Nephrotic syndrome is a collection of symptoms caused by glomerular disease. It is characterized primarily by ____________	An increase in permeability to serum proteins; increased loss of plasma proteins, etc.....
Which organism is most commonly associated with acute bacterial prostatitis	E. Coli
How many doses of Varicella vaccine are needed by a child under the age of 12, who has never had chickenpox	One
Your patient has a low frequency resting tremor of the hand. What diagnosis do you suspect	Parkinson's disease
What is the most common cause of right ventricular heart failure	left ventricular heart failure
You are doing a routine exam on a healthy 19 year old college student and find that he has a prominent third heart sound. What does this most likely indicate	this is a normal finding
Progressive, ascending, symmetric weakness associated with viral infections is known as	Guillain-BarreSyndrome
What diagnostic test is most important in the evaluation of monoarticular arthritis	Joint aspiration-gram stain/culture of joint fluid
Treatment of giant cell arteritis with prednisone is aimed at prevention of what problem	Blindness
The Philadelphia chromosome is associated with what type of leukemia	CML-chronic myelocytic
Which joints in the fingers are commonly affected by reheumatoid arthritis	PIPs or MCPs
A woman with a malodorous vaginal discharge is found to have a "strawberry cervix". What is the most likely diagnosis	trichomonas vaginitis
What test is considered the gold standard for the diagnosis of DVT	venography
What test is considered the gold standard for the diagnosis of PE	pulmonary angiography
What is the most common CXR finding in PE	elevated dome of one hemidiaphragm.
What is the most common laboratory value abnormality in pts. taking oral diuretics for hypertension	Hypokalemia
Which bacterium is associated with peptic ulcer disease	Helicobacter pylori
A 33 year-old white man traveled to South America for 3 days. Within hours of his return he had onset of watery diarrhea and abdominal cramping. What organism is the most likely etiology	E. Coli
The single most reliable physical sign of congestive heart failure in patients over the age of 40 is	a third heart sound (S3)
What is the most common side effect of esmolol, labetalol and bretylium	Hypotension
A patient presents with sudden-onset chest and back pain. Further workup reveals an ischemic right leg. What is your diagnosis	Suspect an acute aortic dissection when chest or back pain is associated with ischemic or neurologic deficits.
What is the most prevalent cause of obstruction of airway in adults	Food, usually meat. Obstruction occurs because the food was
What is the most common cause of intestinal obstruction	Surgical adhesions
What fundoscopic finding is characteristic of diabetic proliferative retinopathy	Neovascularization
In women, the leading cause of death due to malignancy is cancer of the _________	Lung
Ingestion of what substance improves benign essential tremors	Alcohol
Which heart lesion is associated with a mid-systolic click	Mitral valve prolapse
What is the most common cause of acute pancreatitis	Gallstones
Calf pain on forceful dorsiflexion of the foot is called ___________	Homan's sign
The paranasal sinus most commonly affected is ________	Maxillary
The 2 first line agents in the treatment of tuberculosis are what	Isoniazid and rifampin
In a patient with cold intolerance, constipation, and weight gain, would you expect a TSH to be increased, decreased, or normal	Increased
What laboratory finding is the earliest evidence of diabetic nephropathy	Microalbuminuria
What site does acetominophen cause its most toxic effects	Liver
What is the most common cause of pancreatitis	Alcohol abuse or gallstones
Retroperitoneal bleeding causing a hematoma at the umbilicus is called what	Cullen's sign
What problem is most commonly associated with Kerley B lines	Congestive heart failure
Which of the following is NOT a risk factor for cervical cancer: Multiple sexual partners, early sexual activity, obesity, early age 1st pregnancy	Obesity
A fundal height at the level of the umbilicus corresponds to how many weeks gestation	20-22
What is the term for excessive menstrual bleeding	Menorrhagia
The first MMR shot should be given at what age	12-15 mths
A chest x-ray on a 68 yo smoker shows flattened diaphragms. What dx do you suspect	Emphysema or COPD
Cough is a common side effect of what class of anti-hypertensive drugs	ACE-inhibitors
A 78yo woman with dementia who has been treated with Haldol, presents with bizarre repetitive movements of her tongue and mouth. What is this	Tardive dyskinesia
A patient with cholecystitis abruptly stops inspiring while you palpate beneath the Right Costal Margin. What is this called	Murphy's sign
What funduscopic exam finding would be indicative of glaucoma	Increased cupping of the disc

Created by: bwyche

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