usmle ck step 2
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| "Sawtooth" P waves | Classic ECG finding in atrial flutter.
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| Angina is new, is worsening, or occurs at rest | Definition of unstable angina.
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| ACEI | Antihypertensive for a diabetic patient with proteinuria.
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| Hypotension, distant heart sounds, and JVD | Beck's triad for cardiac tamponade.
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| β-blockers, digoxin, calcium channel blockers | Drugs that slow AV node transmission.
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| Niacin | Hypercholesterolemia treatment that → flushing and pruritus.
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| Anticoagulation, rate control, cardioversion | Treatment for atrial fibrillation.
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| Immediate cardioversion | Treatment for ventricular fibrillation.
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| Dressler's syndrome: fever, pericarditis, ↑ ESR | Autoimmune complication occurring 2–4 weeks post-MI.
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| Treat existing heart failure and replace the tricuspid valve | IV drug use with JVD and holosystolic murmur at the left sternal border. Treatment?
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| Echocardiogram (showing thickened left ventricular wall and outflow obstruction) | Diagnostic test for hypertrophic cardiomyopathy.
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| Pulsus paradoxus (seen in cardiac tamponade) | A fall in systolic BP of > 10 mmHg with inspiration.
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| Low-voltage, diffuse ST-segment elevation | Classic ECG findings in pericarditis.
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| BP > 140/90 on three separate occasions two weeks apart | Definition of hypertension.
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| Renal artery stenosis, coarctation of the aorta, pheochromocytoma, Conn's syndrome, Cushing's syndrome, unilateral renal parenchymal disease, hyperthyroidism, hyperparathyroidism | Eight surgically correctable causes of hypertension.
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| Abdominal ultrasound and CT | Evaluation of a pulsatile abdominal mass and bruit.
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| > 5.5 cm, rapidly enlarging, symptomatic, or ruptured | Indications for surgical repair of abdominal aortic aneurysm.
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| Morphine, O2, sublingual nitroglycerin, ASA, IV β-blockers, heparin | Treatment for acute coronary syndrome.
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| Abdominal obesity, high triglycerides, low HDL, hypertension, insulin resistance, prothrombotic or proinflammatory states | What is the metabolic syndrome?
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| Exercise stress treadmill with ECG | Appropriate diagnostic test? ■ A 50-year-old male with angina can exercise to 85% of maximum predicted heart rate.
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| Pharmacologic stress test (e.g., dobutamine echo) | Appropriate diagnostic test? ■ A 65-year-old woman with left bundle branch block and severe osteoarthritis has unstable angina.
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| Angina, ST-segment changes on ECG, or ↓ BP | Signs of active ischemia during stress testing.
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| ST-segment elevation (depression means ischemia), flattened T waves, and Q waves | ECG findings suggesting MI.
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| Prinzmetal's angina | A young patient has angina at rest with ST-segment elevation. Cardiac enzymes are normal.
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| CHF, shock, and altered mental status | Common symptoms associated with silent MIs.
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| V/Q scan | The diagnostic test for pulmonary embolism.
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| Protamine | An agent that reverses the effects of heparin.
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| PT | The coagulation parameter affected by warfarin.
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| Hypertrophic cardiomyopathy | A young patient with a family history of sudden death collapses and dies while exercising.
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| Oral surgery—amoxicillin; GI or GU procedures—ampicillin and gentamicin before and amoxicillin after | Endocarditis prophylaxis regimens.
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| Pain, pallor, pulselessness, paralysis, paresthesia, poikilothermia | The 6 P's of ischemia due to peripheral vascular disease.
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| Stasis, hypercoagulability, endothelial damage | Virchow's triad.
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| OCPs | The most common cause of hypertension in young women.
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| Excessive EtOH | The most common cause of hypertension in young men.
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| Seborrheic keratosis | "Stuck-on" appearance.
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| Psoriasis | Red plaques with silvery-white scales and sharp margins.
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| Basal cell carcinoma | The most common type of skin cancer; the lesion is a pearly-colored papule with a translucent surface and telangiectasias.
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| Impetigo | Honey-crusted lesions.
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| Cellulitis | A febrile patient with a history of diabetes presents with a red, swollen, painful lower extremity.
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| Pemphigus vulgaris | + Nikolsky's sign.
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| Bullous pemphigoid | - Nikolsky's sign.
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| Acanthosis nigricans. Check fasting blood sugar to rule out diabetes | A 55-year-old obese patient presents with dirty, velvety patches on the back of the neck.
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| Varicella zoster | Dermatomal distribution.
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| Lichen planus | Flat-topped papules.
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| Erythema multiforme | Iris-like target lesions.
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| Contact dermatitis | A lesion characteristically occurring in a linear pattern in areas where skin comes into contact with clothing or jewelry.
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| Pityriasis rosea | Presents with a herald patch, Christmas-tree pattern.
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| Alopecia areata (autoimmune process) | A 16-year-old presents with an annular patch of alopecia with broken-off, stubby hairs.
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| Pityriasis versicolor | Pinkish, scaling, flat lesions on the chest and back. KOH prep has a "spaghetti-and-meatballs" appearance.
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| Asymmetry, border irregularity, color variation, large diameter | Four characteristics of a nevus suggestive of melanoma.
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| Actinic keratosis | Premalignant lesion from sun exposure that can → squamous cell carcinoma.
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| Lesions of 1° varicella | "Dewdrop on a rose petal."
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| Seborrheic dermatitis. Treat with antifungals | "Cradle cap."
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| Acne vulgaris | Associated with Propionibacterium acnes and changes in androgen levels.
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| Herpes simplex | A painful, recurrent vesicular eruption of mucocutaneous surfaces.
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| Lichen sclerosus | Inflammation and epithelial thinning of the anogenital area, predominantly in postmenopausal women.
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| Squamous cell carcinoma | Exophytic nodules on the skin with varying degrees of scaling or ulceration; the second most common type of skin cancer.
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| Hashimoto's thyroiditis | The most common cause of hypothyroidism.
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| High TSH, low T4, antimicrosomal antibodies | Lab findings in Hashimoto's thyroiditis.
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| Graves' disease | Exophthalmos, pretibial myxedema, and ↓ TSH.
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| Iatrogenic steroid administration. The second most common cause is Cushing's disease | The most common cause of Cushing's syndrome.
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| Hypoparathyroidism | A patient presents with signs of hypocalcemia, high phosphorus, and low PTH.
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| Signs and symptoms of hypercalcemia | "Stones, bones, groans, psychiatric overtones."
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| 1° hyperaldosteronism (due to Conn's syndrome or bilateral adrenal hyperplasia) | A patient complains of headache, weakness, and polyuria; exam reveals hypertension and tetany. Labs reveals hypernatremia, hypokalemia, and metabolic alkalosis.
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| Pheochromocytoma | A patient presents with tachycardia, wild swings in BP, headache, diaphoresis, altered mental status, and a sense of panic.
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| α-antagonists (phentolamine and phenoxybenzamine) | Should α- or β-antagonists be used first in treating pheochromocytoma?
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| Nephrogenic diabetes insipidus (DI) | A patient with a history of lithium use presents with copious amounts of dilute urine.
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| Administration of DDAVP ↓ serum osmolality and free water restriction | Treatment of central DI.
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| SIADH due to stress | A postoperative patient with significant pain presents with hyponatremia and normal volume status.
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| Metformin | An antidiabetic agent associated with lactic acidosis.
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| 1° adrenal insufficiency (Addison's disease). Treat with replacement glucocorticoids, mineralocorticoids, and IV fluids | A patient presents with weakness, nausea, vomiting, weight loss, and new skin pigmentation. Labs show hyponatremia and hyperkalemia. Treatment?
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| < 7.0 | Goal hemoglobin A1c for a patient with DM.
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| Fluids, insulin, and aggressive replacement of electrolytes (e.g., K+) | Treatment of DKA.
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| They can mask symptoms of hypoglycemia | Why are β-blockers contraindicated in diabetics?
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| Observational bias | Bias introduced into a study when a clinician is aware of the patient's treatment type.
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| Lead-time bias | Bias introduced when screening detects a disease earlier and thus lengthens the time from diagnosis to death.
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| Confounding variable | If you want to know if race affects infant mortality rate but most of the variation in infant mortality is predicted by socioeconomic status, then socioeconomic status is a _____.
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| Sensitivity | The number of true positives divided by the number of patients with the disease is _____.
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| Out | Sensitive tests have few false negatives and are used to rule _____ a disease.
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| Highly sensitive for TB | PPD reactivity is used as a screening test because most people with TB (except those who are anergic) will have a +PPD. Highly sensitive or specific?
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| Higher prevalence | Chronic diseases such as SLE—higher prevalence or incidence?
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| Higher incidence | Epidemics such as influenza—higher prevalence or incidence?
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| Prevalence | Cross-sectional survey—incidence or prevalence?
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| Incidence and prevalence | Cohort study—incidence or prevalence?
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| Neither | Case-control study—incidence or prevalence?
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| High reliability, low validity | Describe a test that consistently gives identical results, but the results are wrong.
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| Cohort studies can be used to calculate relative risk (RR), incidence, and/or odds ratio (OR). Case-control studies can be used to calculate an OR | Difference between a cohort and a case-control study.
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| The incidence rate (IR) of a disease in exposed − the IR of a disease in unexposed | Attributable risk?
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| The IR of a disease in a population exposed to a particular factor ÷ the IR of those not exposed | Relative risk?
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| The likelihood of a disease among individuals exposed to a risk factor compared to those who have not been exposed | Odds ratio?
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| 1 ÷ (rate in untreated group − rate in treated group) | Number needed to treat?
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| Patients with IBD; those with familial adenomatous polyposis (FAP)/hereditary nonpolyposis colorectal cancer (HNPCC); and those who have first-degree relatives with adenomatous polyps (< 60 years of age) or colorectal cancer | In which patients do you initiate colorectal cancer screening early?
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| Prostate cancer is the most common cancer in men, but lung cancer causes more deaths | The most common cancer in men and the most common cause of death from cancer in men.
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| 68%, 95.5%, 99.7% | The percentage of cases within one SD of the mean? Two SDs? Three SDs?
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| Number of live births per 1000 population | Birth rate?
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| Number of live births per 1000 women 15–44 years of age | Fertility rate?
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| Number of deaths per 1000 population | Mortality rate?
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| Number of deaths from birth to 28 days per 1000 live births | Neonatal mortality?
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| Number of deaths from 28 days to one year per 1000 live births | Postnatal mortality?
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| Number of deaths from birth to one year of age per 1000 live births (neonatal + postnatal mortality) | Infant mortality?
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| Number of deaths from 20 weeks' gestation to birth per 1000 total births | Fetal mortality?
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| Number of deaths from 20 weeks' gestation to one month of life per 1000 total births | Perinatal mortality?
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| Number of deaths during pregnancy to 90 days postpartum per 100,000 live births | Maternal mortality?
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| False. Patients may change their minds at any time. Exceptions to the requirement of informed consent include emergency situations and patients without decision-making capacity | True or false: Once patients sign a statement giving consent, they must continue treatment.
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| No. Parental consent is not necessary for the medical treatment of pregnant minors | A 15-year-old pregnant girl requires hospitalization for preeclampsia. Should her parents be informed?
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| Conflict of interest | A doctor refers a patient for an MRI at a facility he/she owns.
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| The patient is a danger to self, a danger to others, or gravely disabled (unable to provide for basic needs) | Involuntary psychiatric hospitalization can be undertaken for which three reasons?
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| False. Withdrawing and withholding life are the same from an ethical standpoint | True or false: Withdrawing life-sustaining care is ethically distinct from withholding sustaining care.
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| When there is no rationale for treatment, maximal intervention is failing, a given intervention has already failed, and treatment will not achieve the goals of care | When can a physician refuse to continue treating a patient on the grounds of futility?
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| Treat immediately. Consent is implied in emergency situations | An eight-year-old child is in a serious accident. She requires emergent transfusion, but her parents are not present.
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| Real threat of harm to third parties; suicidal intentions; certain contagious diseases; elder and child abuse | Conditions in which confidentiality must be overridden.
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| When treatment noncompliance represents a serious danger to public health (e.g., active TB) | Involuntary commitment or isolation for medical treatment may be undertaken for what reason?
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| Treat because the disease represents an immediate threat to the child's life. Then seek a court order | A 10-year-old child presents in status epilepticus, but her parents refuse treatment on religious grounds.
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| A patient's family cannot require that a doctor withhold information from the patient | A son asks that his mother not be told about her recently discovered cancer.
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| Emergent laparotomy to repair perforated viscus, likely stomach | Patient presents with sudden onset of severe, diffuse abdominal pain. Exam reveals peritoneal signs and AXR reveals free air under the diaphragm. Management?
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| Diverticulosis | The most likely cause of acute lower GI bleed in patients > 40 years old.
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| HIDA scan | Diagnostic modality used when ultrasound is equivocal for cholecystitis.
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| Acute pancreatitis | Sentinel loop on AXR.
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| Fat, female, fertile, forty, flatulent | Risk factors for cholelithiasis.
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| Murphy's sign, seen in acute cholecystitis | Inspiratory arrest during palpation of the RUQ.
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| Campylobacter | Identify key organisms causing diarrhea: ■ Most common organism
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| Clostridium difficile | Identify key organisms causing diarrhea: ■ Recent antibiotic use
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| Giardia | Identify key organisms causing diarrhea: ■ Camping
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| ETEC | Identify key organisms causing diarrhea: ■ Traveler's diarrhea
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| S. aureus | Identify key organisms causing diarrhea: ■ Church picnics/mayonnaise
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| E. coli O157:H7 | Identify key organisms causing diarrhea: ■ Uncooked hamburgers
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| Bacillus cereus | Identify key organisms causing diarrhea: ■ Fried rice
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| Salmonella | Identify key organisms causing diarrhea: ■ Poultry/eggs
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| Vibrio, HAV | Identify key organisms causing diarrhea: ■ Raw seafood
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| Isospora, Cryptosporidium, Mycobacterium avium complex (MAC) | Identify key organisms causing diarrhea: ■ AIDS
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| Yersinia | Identify key organisms causing diarrhea: ■ Pseudoappendicitis
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| Crohn's disease | A 25-year-old Jewish male presents with pain and watery diarrhea after meals. Exam shows fistulas between the bowel and skin and nodular lesions on his tibias.
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| Ulcerative colitis | Inflammatory disease of the colon with ↑ risk of colon cancer.
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| Uveitis, ankylosing spondylitis, pyoderma gangrenosum, erythema nodosum, 1° sclerosing cholangitis | Extraintestinal manifestations of IBD.
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| 5-aminosalicylic acid +/− sulfasalazine and steroids during acute exacerbations | Medical treatment for IBD.
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| Mallory-Weiss—superficial tear in the esophageal mucosa Boerhaave—full-thickness esophageal rupture | Difference between Mallory-Weiss and Boerhaave tears.
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| RUQ pain, jaundice, and fever/chills in the setting of ascending cholangitis | Charcot's triad.
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| Charcot's triad plus shock and mental status changes, with suppurative ascending cholangitis | Reynolds' pentad.
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| ↓ protein intake, lactulose, neomycin | Medical treatment for hepatic encephalopathy.
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| Establish the ABCs | First step in the management of a patient with acute GI bleed.
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| Hemolytic-uremic syndrome (HUS) due to E. coli O157:H7 | A four-year-old child presents with oliguria, petechiae, and jaundice following an illness with bloody diarrhea. Most likely diagnosis and cause?
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| HBV immunoglobulin | Post-HBV exposure treatment.
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| TB medications (INH, rifampin, pyrazinamide), acetaminophen, and tetracycline | Classic causes of drug-induced hepatitis.
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| Biliary tract obstruction | A 40-year-old obese female with elevated alkaline phosphatase, elevated bilirubin, pruritus, dark urine, and clay-colored stools.
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| Femoral hernia | Hernia with highest risk of incarceration—indirect, direct, or femoral?
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| Confirm the diagnosis of acute pancreatitis with elevated amylase and lipase. Make patient NPO and give IV fluids, O2, analgesia, and "tincture of time" | A 50-year-old man with a history of alcohol abuse presents with boring epigastric pain that radiates to the back and is relieved by sitting forward. Management?
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| TICS—Thalassemia, Iron deficiency, anemia of Chronic disease, and Sideroblastic anemia | Four causes of microcytic anemia.
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| Fecal occult blood test and sigmoidoscopy; suspect colorectal cancer | An elderly male with hypochromic, microcytic anemia is asymptomatic. Diagnostic tests?
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| Sulfonamides, antimalarial drugs, fava beans | Precipitants of hemolytic crisis in patients with G6PD deficiency.
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| Factor V Leiden mutation | The most common inherited cause of hypercoagulability.
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| Hereditary spherocytosis | The most common inherited hemolytic anemia.
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| Osmotic fragility test | Diagnostic test for hereditary spherocytosis.
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| Diamond-Blackfan anemia | Pure RBC aplasia.
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| Fanconi's anemia | Anemia associated with absent radii and thumbs, diffuse hyperpigmentation, café-au-lait spots, microcephaly, and pancytopenia.
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| Chloramphenicol, sulfonamides, radiation, HIV, chemotherapeutic agents, hepatitis, parvovirus B19, EBV | Medications and viruses that → aplastic anemia.
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| Both have ↑ hematocrit and RBC mass, but polycythemia vera should have normal O2 saturation and low erythropoietin levels | How to distinguish polycythemia vera from 2° polycythemia.
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| Pentad of TTP—"FAT RN": Fever, Anemia, Thrombocytopenia, Renal dysfunction, Neurologic abnormalities | Thrombotic thrombocytopenic purpura (TTP) pentad?
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| Anemia, thrombocytopenia, and acute renal failure | HUS triad?
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| Emergent large-volume plasmapheresis, corticosteroids, antiplatelet drugs | Treatment for TTP.
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| Usually resolves spontaneously; may require IVIG and/or corticosteroids | Treatment for idiopathic thrombocytopenic purpura (ITP) in children.
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| Fibrin split products and D-dimer are elevated; platelets, fibrinogen, and hematocrit are ↓. | Which of the following are ↑ in DIC: fibrin split products, D-dimer, fibrinogen, platelets, and hematocrit.
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| Hemophilia A or B; consider desmopressin (for hemophilia A) or factor VIII or IX supplements | An eight-year-old boy presents with hemarthrosis and ↑ PTT with normal PT and bleeding time. Diagnosis? Treatment?
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| von Willebrand's disease; treat with desmopressin, FFP, or cryoprecipitate | A 14-year-old girl presents with prolonged bleeding after dental surgery and with menses, normal PT, normal or ↑ PTT, and ↑ bleeding time. Diagnosis? Treatment?
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| Monoclonal gammopathy, Bence Jones proteinuria, "punched-out" lesions on x-ray of the skull and long bones | A 60-year-old African-American male presents with bone pain. Workup for multiple myeloma might reveal?
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| Hodgkin's lymphoma | Reed-Sternberg cells
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| Non-Hodgkin's lymphoma | A 10-year-old boy presents with fever, weight loss, and night sweats. Examination shows anterior mediastinal mass. Suspected diagnosis?
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| Anemia of chronic disease | Microcytic anemia with ↓ serum iron, ↓ total iron-binding capacity (TIBC), and normal or ↑ ferritin.
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| Iron deficiency anemia | Microcytic anemia with ↓ serum iron, ↓ ferritin, and ↑ TIBC.
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| Chronic lymphocytic leukemia (CLL) | An 80-year-old man presents with fatigue, lymphadenopathy, splenomegaly, and isolated lymphocytosis. Suspected diagnosis?
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| Blast crisis (fever, bone pain, splenomegaly, pancytopenia) | A late, life-threatening complication of chronic myelogenous leukemia (CML).
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| Acute myelogenous leukemia (AML) | Auer rods on blood smear.
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| M3 | AML subtype associated with DIC.
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| ↓ Ca2+ , ↑ K− , ↑ phosphate, ↑ uric acid | Electrolyte changes in tumor lysis syndrome.
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| Retinoic acid | Treatment for AML M3.
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| CML | A 50-year-old male presents with early satiety, splenomegaly, and bleeding. Cytogenetics show t(9,22). Diagnosis?
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| Intracellular inclusions seen in thalassemia, G6PD deficiency, and postsplenectomy | Heinz bodies?
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| Glanzmann's thrombasthenia | An autosomal-recessive disorder with a defect in the GPIIbIIIa platelet receptor and ↓ platelet aggregation.
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| Parvovirus B19 | Virus associated with aplastic anemia in patients with sickle cell anemia.
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| O2, analgesia, hydration, and, if severe, transfusion | A 25-year-old African-American male with sickle cell anemia has sudden onset of bone pain. Management of pain crisis?
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| Iron overload; use deferoxamine | A significant cause of morbidity in thalassemia patients. Treatment?
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| Infection, cancer, and autoimmune disease | The three most common causes of fever of unknown origin (FUO).
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| Fever, pharyngeal erythema, tonsillar exudate, lack of cough | Four signs and symptoms of streptococcal pharyngitis.
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| Postinfectious glomerulonephritis | A nonsuppurative complication of streptococcal infection that is not altered by treatment of 1° infection.
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| Encapsulated organisms––pneumococcus, meningococcus, Haemophilus influenzae, Klebsiella | Asplenic patients are particularly susceptible to these organisms.
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| 105 bacteria/mL | The number of bacterial culture on a clean-catch specimen to diagnose a UTI.
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| Pregnant women. Treat this group aggressively because of potential complications | Which healthy population is susceptible to UTIs?
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| Coccidioidomycosis. Amphotericin B | A patient from California or Arizona presents with fever, malaise, cough, and night sweats. Diagnosis? Treatment?
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| 1° syphilis | Nonpainful chancre.
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| Rubella | A "blueberry muffin" rash is characteristic of what congenital infection?
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| Group B strep, E. coli, Listeria. Treat with gentamicin and ampicillin | Meningitis in neonates. Causes? Treatment?
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| Pneumococcus, meningococcus, H. influenzae. Treat with cefotaxime and vancomycin | Meningitis in infants. Causes? Treatment?
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| Check for ↑ ICP; look for papilledema | What should always be done prior to LP?
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| Bacterial meningitis | CSF findings: ■ Low glucose, PMN predominance
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| Aseptic (viral) meningitis | CSF findings: ■ Normal glucose, lymphocytic predominance
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| Subarachnoid hemorrhage (SAH) | CSF findings: ■ Numerous RBCs in serial CSF samples
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| MS | CSF findings: ■ ↑ gamma globulins
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| Cutaneous anthrax. Treat with penicillin G or ciprofloxacin | Initially presents with a pruritic papule with regional lymphadenopathy and evolves into a black eschar after 7–10 days. Treatment?
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| Tabes dorsalis, general paresis, gummas, Argyll Robertson pupil, aortitis, aortic root aneurysms | Findings in 3° syphilis.
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| Arthralgias, migratory polyarthropathies, Bell's palsy, myocarditis | Characteristics of 2° Lyme disease.
🗑
|
||||
| Mycoplasma | Cold agglutinins.
🗑
|
||||
| Candidal thrush. Workup should include an HIV test. Treat with nystatin oral suspension | A 24-year-old male presents with soft white plaques on his tongue and the back of his throat. Diagnosis? Workup? Treatment?
🗑
|
||||
| ≤ 200 for PCP (with TMP); ≤ 50–100 for MAI (with clarithromycin/azithromycin) | Begin Pneumocystis carinii pneumonia (PCP) prophylaxis in an HIV-positive patient at what CD4 count? Mycobacterium avium-intracellulare (MAI) prophylaxis?
🗑
|
||||
| Pregnancy, vesicoureteral reflux, anatomic anomalies, indwelling catheters, kidney stones | Risk factors for pyelonephritis.
🗑
|
||||
| 7–10 days | Neutropenic nadir postchemotherapy.
🗑
|
||||
| Lesion of 1° Lyme disease | Erythema migrans.
🗑
|
||||
| Fever, heart murmur, Osler's nodes, splinter hemorrhages, Janeway lesions, Roth's spots | Classic physical findings for endocarditis.
🗑
|
||||
| Parvovirus B19 | Aplastic crisis in sickle cell disease.
🗑
|
||||
| Taenia solium (cysticercosis) | Ring-enhancing brain lesion on CT with seizures
🗑
|
||||
| Actinomyces israelii | Name the organism: ■ Branching rods in oral infection.
🗑
|
||||
| Haemophilus ducreyi | Name the organism: ■ Painful chancroid.
🗑
|
||||
| Pasteurella multocida | Name the organism: ■ Dog or cat bite.
🗑
|
||||
| Sporothrix schenckii | Name the organism: ■ Gardener.
🗑
|
||||
| Toxoplasma gondii | Name the organism: ■ Pregnant women with pets.
🗑
|
||||
| Neisseria meningitidis | Name the organism: ■ Meningitis in adults.
🗑
|
||||
| Streptococcus pneumoniae | Name the organism: ■ Meningitis in elderly.
🗑
|
||||
| Klebsiella | Name the organism: ■ Alcoholic with pneumonia.
🗑
|
||||
| Klebsiella | Name the organism: ■ "Currant jelly" sputum.
🗑
|
||||
| Pseudomonas | Name the organism: ■ Infection in burn victims.
🗑
|
||||
| Pseudomonas | Name the organism: ■ Osteomyelitis from foot wound puncture.
🗑
|
||||
| Salmonella | Name the organism: ■ Osteomyelitis in a sickle cell patient.
🗑
|
||||
| Legionella pneumonia | A 55-year-old man who is a smoker and a heavy drinker presents with a new cough and flulike symptoms. Gram stain shows no organisms; silver stain of sputum shows gram-negative rods. What is the diagnosis?
🗑
|
||||
| Lyme disease, Ixodes tick, doxycycline | A middle-aged man presents with acute-onset monoarticular joint pain and bilateral Bell's palsy. What is the likely diagnosis, and how did he get it? Treatment?
🗑
|
||||
| S. aureus or S. epidermidis. | A patient develops endocarditis three weeks after receiving a prosthetic heart valve. What organism is suspected?
🗑
|
||||
| All-compartment fasciotomy for suspected compartment syndrome | A patient presents with pain on passive movement, pallor, poikilothermia, paresthesias, paralysis, and pulselessness. Treatment?
🗑
|
||||
| Spinal stenosis | Back pain that is exacerbated by standing and walking and relieved with sitting and hyperflexion of the hips.
🗑
|
||||
| MCP and PIP joints; DIP joints are spared | Joints in the hand affected in rheumatoid arthritis.
🗑
|
||||
| Osteoarthritis | Joint pain and stiffness that worsen over the course of the day and are relieved by rest.
🗑
|
||||
| Osteogenesis imperfecta | Genetic disorder associated with multiple fractures and commonly mistaken for child abuse.
🗑
|
||||
| Suspect ankylosing spondylitis. Check HLA-B27 | Hip and back pain along with stiffness that improves with activity over the course of the day and worsens at rest. Diagnostic test?
🗑
|
||||
| Reactive (Reiter's) arthritis. Associated with Campylobacter, Shigella, Salmonella, Chlamydia, and Ureaplasma | Arthritis, conjunctivitis, and urethritis in young men. Associated organisms?
🗑
|
||||
| Gout. Needle-shaped, negatively birefringent crystals are seen on joint fluid aspirate. Chronic treatment with allopurinol or probenecid | A 55-year-old man has sudden, excruciating first MTP joint pain after a night of drinking red wine. Diagnosis, workup, and chronic treatment?
🗑
|
||||
| Pseudogout | Rhomboid-shaped, positively birefringent crystals on joint fluid aspirate.
🗑
|
||||
| Polymyalgia rheumatica | An elderly female presents with pain and stiffness of the shoulders and hips; she cannot lift her arms above her head. Labs show anemia and ↑ ESR.
🗑
|
||||
| Osgood-Schlatter disease | An active 13-year-old boy has anterior knee pain. Diagnosis?
🗑
|
||||
| Distal radius (Colles' fracture) | Bone is fractured in fall on outstretched hand.
🗑
|
||||
| Avascular necrosis | Complication of scaphoid fracture.
🗑
|
||||
| Wrist drop, loss of thumb abduction | Signs suggesting radial nerve damage with humeral fracture.
🗑
|
||||
| Duchenne muscular dystrophy | A young child presents with proximal muscle weakness, waddling gait, and pronounced calf muscles.
🗑
|
||||
| Developmental dysplasia of the hip. If severe, consider a Pavlik harness to maintain abduction | A first-born female who was born in breech position is found to have asymmetric skin folds on her newborn exam. Diagnosis? Treatment?
🗑
|
||||
| Slipped capital femoral epiphyses. AP and frog-leg lateral view | An 11-year-old obese, African-American boy presents with sudden onset of limp. Diagnosis? Workup?
🗑
|
||||
| Multiple myeloma | The most common 1° malignant tumor of bone.
🗑
|
||||
| Cluster headache | Unilateral, severe periorbital headache with tearing and conjunctival erythema.
🗑
|
||||
| β-blockers, Ca2+ channel blockers, TCAs | Prophylactic treatment for migraine.
🗑
|
||||
| Prolactinoma. Dopamine agonists (e.g., bromocriptine) | The most common pituitary tumor. Treatment?
🗑
|
||||
| Broca's aphasia. Frontal lobe, left MCA distribution | A 55-year-old patient presents with acute "broken speech." What type of aphasia? What lobe and vascular distribution?
🗑
|
||||
| Trauma; the second most common is berry aneurysm | The most common cause of SAH.
🗑
|
||||
| Subdural hematoma—bridging veins torn | A crescent-shaped hyperdensity on CT that does not cross the midline.
🗑
|
||||
| Epidural hematoma. Middle meningeal artery. Neurosurgical evacuation | A history significant for initial altered mental status with an intervening lucid interval. Diagnosis? Most likely etiology? Treatment?
🗑
|
||||
| Elevated ICP, RBCs, xanthochromia | CSF findings with SAH.
🗑
|
||||
| Guillain-Barré (↑ protein in CSF with only a modest ↑ in cell count) | Albuminocytologic dissociation.
🗑
|
||||
| Normal | Cold water is flushed into a patient's ear, and the fast phase of the nystagmus is toward the opposite side. Normal or pathological?
🗑
|
||||
| Lung, breast, skin (melanoma), kidney, GI tract | The most common 1° sources of metastases to the brain.
🗑
|
||||
| Absence seizures | May be seen in children who are accused of inattention in class and confused with ADHD.
🗑
|
||||
| Headache | The most frequent presentation of intracranial neoplasm.
🗑
|
||||
| Infection, febrile seizures, trauma, idiopathic | The most common cause of seizures in children (2–10 years).
🗑
|
||||
| Trauma, alcohol withdrawal, brain tumor | The most common cause of seizures in young adults (18–35 years).
🗑
|
||||
| IV benzodiazepine | First-line medication for status epilepticus.
🗑
|
||||
| Wernicke's encephalopathy due to a deficiency of thiamine | Confusion, confabulation, ophthalmoplegia, ataxia.
🗑
|
||||
| Seventy percent if the stenosis is symptomatic | What % lesion is an indication for carotid endarterectomy?
🗑
|
||||
| Alzheimer's and multi-infarct | The most common causes of dementia.
🗑
|
||||
| ALS | Combined UMN and LMN disorder.
🗑
|
||||
| Parkinson's disease | Rigidity and stiffness with resting tremor and masked facies.
🗑
|
||||
| Levodopa/carbidopa | The mainstay of Parkinson's therapy.
🗑
|
||||
| IVIG or plasmapheresis | Treatment for Guillain-Barré syndrome.
🗑
|
||||
| Huntington's disease | Rigidity and stiffness that progress to choreiform movements, accompanied by moodiness and altered behavior.
🗑
|
||||
| Sturge-Weber syndrome. Treat symptomatically. Possible focal cerebral resection of affected lobe | A six-year-old girl presents with a port-wine stain in the V2 distribution as well as with mental retardation, seizures, and leptomeningeal angioma.
🗑
|
||||
| Neurofibromatosis 1 | Café-au-lait spots on skin.
🗑
|
||||
| Klüver-Bucy syndrome (amygdala) | Hyperphagia, hypersexuality, hyperorality, and hyperdocility.
🗑
|
||||
| Edrophonium | Administer to a symptomatic patient to diagnose myasthenia gravis.
🗑
|
||||
| Placental abruption and placenta previa | 1° causes of third-trimester bleeding.
🗑
|
||||
| Snowstorm on ultrasound. "Cluster-of-grapes" appearance on gross examination | Classic ultrasound and gross appearance of complete hydatidiform mole.
🗑
|
||||
| 46,XX | Chromosomal pattern of a complete mole.
🗑
|
||||
| Partial mole | Molar pregnancy containing fetal tissue.
🗑
|
||||
| Continuous, painful vaginal bleeding | Symptoms of placental abruption.
🗑
|
||||
| Self-limited, painless vaginal bleeding | Symptoms of placenta previa.
🗑
|
||||
| Never | When should a vaginal exam be performed with suspected placenta previa?
🗑
|
||||
| Tetracycline, fluoroquinolones, aminoglycosides, sulfonamides | Antibiotics with teratogenic effects.
🗑
|
||||
| Obstetric conjugate: between the sacral promontory and the midpoint of the symphysis pubis | Shortest AP diameter of the pelvis.
🗑
|
||||
| Betamethasone or dexamethasone × 48 hours | Medication given to accelerate fetal lung maturity.
🗑
|
||||
| Uterine atony | The most common cause of postpartum hemorrhage.
🗑
|
||||
| Uterine massage; if that fails, give oxytocin | Treatment for postpartum hemorrhage.
🗑
|
||||
| IV penicillin or ampicillin | Typical antibiotics for group B streptococcus (GBS) prophylaxis.
🗑
|
||||
| Sheehan's syndrome (postpartum pituitary necrosis) | A patient fails to lactate after an emergency C-section with marked blood loss.
🗑
|
||||
| Inevitable abortion | Uterine bleeding at 18 weeks' gestation; no products expelled; membranes ruptured; cervical os open.
🗑
|
||||
| Threatened abortion | Uterine bleeding at 18 weeks' gestation; no products expelled; cervical os closed.
🗑
|
||||
| β-hCG; the most common cause of amenorrhea is pregnancy | The first test to perform when a woman presents with amenorrhea.
🗑
|
||||
| Menometrorrhagia | Term for heavy bleeding during and between menstrual periods.
🗑
|
||||
| Asherman's syndrome | Cause of amenorrhea with normal prolactin, no response to estrogen-progesterone challenge, and a history of D
🗑
|
||||
| Weight loss and OCPs | Therapy for polycystic ovarian syndrome.
🗑
|
||||
| Clomiphene citrate | Medication used to induce ovulation.
🗑
|
||||
| Endometrial biopsy | Diagnostic step required in a postmenopausal woman who presents with vaginal bleeding.
🗑
|
||||
| Stable, unruptured ectopic pregnancy of < 3.5 cm at < 6 weeks' gestation | Indications for medical treatment of ectopic pregnancy.
🗑
|
||||
| OCPs, danazol, GnRH agonists | Medical options for endometriosis.
🗑
|
||||
| "Chocolate cysts," powder burns | Laparoscopic findings in endometriosis.
🗑
|
||||
| Ampulla of the oviduct | The most common location for an ectopic pregnancy.
🗑
|
||||
| Ultrasound | How to diagnose and follow a leiomyoma.
🗑
|
||||
| Regresses after menopause | Natural history of a leiomyoma.
🗑
|
||||
| Trichomonas vaginitis | A patient has ↑ vaginal discharge and petechial patches in the upper vagina and cervix.
🗑
|
||||
| Oral or topical metronidazole | Treatment for bacterial vaginosis.
🗑
|
||||
| Intraductal papilloma | The most common cause of bloody nipple discharge.
🗑
|
||||
| OCP and barrier contraception | Contraceptive methods that protect against PID.
🗑
|
||||
| Endometrial or estrogen receptor– breast cancer | Unopposed estrogen is contraindicated in which cancers?
🗑
|
||||
| Consider Fitz-Hugh–Curtis syndrome | A patient presents with recent PID with RUQ pain.
🗑
|
||||
| Paget's disease | Breast malignancy presenting as itching, burning, and erosion of the nipple.
🗑
|
||||
| CA-125 and transvaginal ultrasound | Annual screening for women with a strong family history of ovarian cancer.
🗑
|
||||
| Kegel exercises, estrogen, pessaries for stress incontinence | A 50-year-old woman leaks urine when laughing or coughing. Nonsurgical options?
🗑
|
||||
| Anticholinergics (oxybutynin) or β-adrenergics (metaproterenol) for urge incontinence. | A 30-year-old woman has unpredictable urine loss. Examination is normal. Medical options?
🗑
|
||||
| ↑ serum FSH | Lab values suggestive of menopause.
🗑
|
||||
| Endometriosis | The most common cause of female infertility.
🗑
|
||||
| Colposcopy and endocervical curettage | Two consecutive findings of atypical squamous cells of undetermined significance (ASCUS) on Pap smear. Follow-up evaluation?
🗑
|
||||
| Lobular carcinoma in situ | Breast cancer type that ↑ the future risk of invasive carcinoma in both breasts.
🗑
|
||||
| Neuroblastoma | Nontender abdominal mass associated with elevated VMA and HVA.
🗑
|
||||
| Esophageal atresia with distal TEF (85%). Unable to pass NG tube | The most common type of tracheoesophageal fistula (TEF). Diagnosis?
🗑
|
||||
| Mild illness and/or low-grade fever, current antibiotic therapy, and prematurity | Not contraindications to vaccination.
🗑
|
||||
| Ophthalmologic exam, CT, and MRI | Tests to rule out shaken baby syndrome.
🗑
|
||||
| CF or Hirschsprung's disease | A neonate has meconium ileus.
🗑
|
||||
| Duodenal atresia | Bilious emesis within hours after the first feeding.
🗑
|
||||
| Correct metabolic abnormalities. Then correct pyloric stenosis with pyloromyotomy | A two-month-old presents with nonbilious projectile emesis. What are the appropriate steps in management?
🗑
|
||||
| Selective IgA deficiency | The most common 1° immunodeficiency.
🗑
|
||||
| Febrile seizures (roseola infantum) | An infant has a high fever and onset of rash as fever breaks. What is he at risk for?
🗑
|
||||
| High-dose aspirin for inflammation and fever; IVIG to prevent coronary artery aneurysms | Acute-phase treatment for Kawasaki disease.
🗑
|
||||
| Phototherapy (mild) or exchange transfusion (severe) | Treatment for mild and severe unconjugated hyperbilirubinemia.
🗑
|
||||
| Reye's syndrome | Sudden onset of mental status changes, emesis, and liver dysfunction after taking aspirin.
🗑
|
||||
| Suspect retinoblastoma | A child has loss of red light reflex. Diagnosis?
🗑
|
||||
| HBV, DTaP, Hib, IPV, PCV | Vaccinations at a six-month well-child visit.
🗑
|
||||
| Precocious puberty | Tanner stage 3 in a six-year-old female.
🗑
|
||||
| RSV bronchiolitis | Infection of small airways with epidemics in winter and spring.
🗑
|
||||
| Surfactant deficiency | Cause of neonatal RDS.
🗑
|
||||
| Chronic granulomatous disease | What is the immunodeficiency? ■ A boy has chronic respiratory infections. Nitroblue tetrazolium test is +.
🗑
|
||||
| Wiskott-Aldrich syndrome | What is the immunodeficiency? ■ A child has eczema, thrombocytopenia, and high levels of IgA.
🗑
|
||||
| Bruton's X-linked agammaglobulinemia | What is the immunodeficiency? ■ A four-month-old boy has life-threatening Pseudomonas infection.
🗑
|
||||
| Intussusception | A condition associated with red "currant-jelly" stools.
🗑
|
||||
| Coarctation of the aorta | A congenital heart disease that cause 2° hypertension.
🗑
|
||||
| Amoxicillin × 10 days | First-line treatment for otitis media.
🗑
|
||||
| Parainfluenza virus type 1 | The most common pathogen causing croup.
🗑
|
||||
| Kwashiorkor (protein malnutrition) | A homeless child is small for his age and has peeling skin and a swollen belly.
🗑
|
||||
| Lesch-Nyhan syndrome (purine salvage problem with | Defect in an X-linked syndrome with mental retardation,
🗑
|
||||
| HGPRTase deficiency) | gout, self-mutilation, and choreoathetosis.
🗑
|
||||
| Patent ductus arteriosus (PDA) | A newborn female has continuous "machinery murmur."
🗑
|
||||
| SSRIs | First-line pharmacotherapy for depression.
🗑
|
||||
| MAOIs | Antidepressants associated with hypertensive crisis.
🗑
|
||||
| Patient on dopamine antagonist | Galactorrhea, impotence, menstrual dysfunction, and ↓ libido.
🗑
|
||||
| Conversion disorder | A 17-year-old female has left arm paralysis after her boyfriend dies in a car crash. No medical cause is found.
🗑
|
||||
| Displacement | Name the defense mechanism: ■ A mother who is angry at her husband yells at her child.
🗑
|
||||
| Reaction formation | Name the defense mechanism: ■ A pedophile enters a monastery.
🗑
|
||||
| Isolation | Name the defense mechanism: ■ A woman calmly describes a grisly murder.
🗑
|
||||
| Regression | Name the defense mechanism: ■ A hospitalized 10-year-old begins to wet his bed.
🗑
|
||||
| Neuroleptic malignant syndrome | Life-threatening muscle rigidity, fever, and rhabdomyolysis.
🗑
|
||||
| Anorexia | Amenorrhea, bradycardia, and abnormal body image in a young female.
🗑
|
||||
| Panic disorder | A 35-year-old male has recurrent episodes of palpitations, diaphoresis, and fear of going crazy.
🗑
|
||||
| Agranulocytosis | The most serious side effect of clozapine.
🗑
|
||||
| Schizophreniform disorder (diagnosis of schizophrenia requires ≥ 6 months of symptoms) | A 21-year-old male has three months of social withdrawal, worsening grades, flattened affect, and concrete thinking.
🗑
|
||||
| Weight gain, type 2 DM, QT prolongation | Key side effects of atypical antipsychotics.
🗑
|
||||
| Acute dystonia (oculogyric crisis). Treat with benztropine or diphenhydramine | A young weight lifter receives IV haloperidol and complains that his eyes are deviated sideways. Diagnosis? Treatment?
🗑
|
||||
| Neuroleptics | Medication to avoid in patients with a history of alcohol withdrawal seizures.
🗑
|
||||
| Conduct disorder | A 13-year-old male has a history of theft, vandalism, and violence toward family pets.
🗑
|
||||
| Rett's disorder | A five-month-old girl has ↓ head growth, truncal dyscoordination, and ↓ social interaction.
🗑
|
||||
| Acute mania. Start a mood stabilizer (e.g., lithium) | A patient hasn't slept for days, lost $20,000 gambling, is agitated, and has pressured speech. Diagnosis? Treatment?
🗑
|
||||
| Malingering | After a minor fender bender, a man wears a neck brace and requests permanent disability.
🗑
|
||||
| Factitious disorder (Munchausen syndrome) | A nurse presents with severe hypoglycemia; blood analysis reveals no elevation in C peptide.
🗑
|
||||
| Substance abuse | A patient continues to use cocaine after being in jail, losing his job, and not paying child support.
🗑
|
||||
| Phencyclidine hydrochloride (PCP) intoxication | A violent patient has vertical and horizontal nystagmus.
🗑
|
||||
| Depersonalization disorder | A woman who was abused as a child frequently feels outside of or detached from her body.
🗑
|
||||
| Frotteurism (a paraphilia) | A man has repeated, intense urges to rub his body against unsuspecting passengers on a bus.
🗑
|
||||
| Tardive dyskinesia. ↓ or discontinue haloperidol and consider another antipsychotic (e.g., risperidone, clozapine) | A schizophrenic patient takes haloperidol for one year and develops uncontrollable tongue movements. Diagnosis? Treatment?
🗑
|
||||
| Dissociative fugue | A man unexpectedly flies across the country, takes a new name, and has no memory of his prior life.
🗑
|
||||
| Stasis, endothelial injury and hypercoagulability (Virchow's triad) | Risk factors for DVT.
🗑
|
||||
| Pleural/serum protein > 0.5; pleural/serum LDH > 0.6 | Criteria for exudative effusion.
🗑
|
||||
| Think of leaky capillaries. Malignancy, TB, bacterial or viral infection, pulmonary embolism with infarct, and pancreatitis | Causes of exudative effusion.
🗑
|
||||
| Think of intact capillaries. CHF, liver or kidney disease, and protein-losing enteropathy | Causes of transudative effusion.
🗑
|
||||
| Fatigue and impending respiratory failure | Normalizing PCO2 in a patient having an asthma exacerbation may indicate?
🗑
|
||||
| Sarcoidosis | Dyspnea, lateral hilar lymphodenopathy on CXR, noncaseating granulomas, increased ACE, and hypercalcemia.
🗑
|
||||
| Obstructive pulmonary disease (e.g., asthma) | PFT showing ↓ FEV1/FVC.
🗑
|
||||
| Restrictive pulmonary disease | PFT showing ↑ FEV1/FVC.
🗑
|
||||
| Diffuse interstitial pulmonary fibrosis. Supportive care. Steroids may help | Honeycomb pattern on CXR. Diagnosis? Treatment?
🗑
|
||||
| Radiation | Treatment for SVC syndrome.
🗑
|
||||
| Inhaled β-agonists and inhaled corticosteroids | Treatment for mild, persistent asthma.
🗑
|
||||
| Hypoxia and hypocarbia | Acid-base disorder in pulmonary embolism.
🗑
|
||||
| Squamous cell carcinoma | Non–small cell lung cancer (NSCLC) associated with hypercalcemia.
🗑
|
||||
| Small cell lung cancer (SCLC) | Lung cancer associated with SIADH.
🗑
|
||||
| SCLC | Lung cancer highly related to cigarette exposure.
🗑
|
||||
| Spontaneous pneumothorax. Spontaneous regression. Supplemental O2 may be helpful | A tall white male presents with acute shortness of breath. Diagnosis? Treatment?
🗑
|
||||
| Immediate needle thoracostomy | Treatment of tension pneumothorax.
🗑
|
||||
| Age > 45–50 years; lesions new or larger in comparison to old films; absence of calcification or irregular calcification; size > 2 cm; irregular margins | Characteristics favoring carcinoma in an isolated pulmonary nodule.
🗑
|
||||
| ARDS | Hypoxemia and pulmonary edema with normal pulmonary capillary wedge pressure.
🗑
|
||||
| Mycobacterium tuberculosis | ↑ risk of what infection with silicosis?
🗑
|
||||
| Right-to-left shunt, hypoventilation, low inspired O2 tension, diffusion defect, V/Q mismatch | Causes of hypoxemia.
🗑
|
||||
| Cardiomegaly, prominent pulmonary vessels, Kerley B lines, "bat's-wing" appearance of hilar shadows, and perivascular and peribronchial cuffing | Classic CXR findings for pulmonary edema.
🗑
|
||||
| Type I (distal) RTA | Renal tubular acidosis (RTA) associated with abnormal H+ secretion and nephrolithiasis.
🗑
|
||||
| Type II (proximal) RTA | RTA associated with abnormal HCO3 − and rickets.
🗑
|
||||
| Type IV (distal) RTA | RTA associated with aldosterone defect.
🗑
|
||||
| Hypernatremia | "Doughy skin."
🗑
|
||||
| Cirrhosis, CHF, nephritic syndrome | Differential of hypervolemic hyponatremia.
🗑
|
||||
| Hypocalcemia | Chvostek's and Trousseau's signs.
🗑
|
||||
| Malignancy and hyperparathyroidism | The most common causes of hypercalcemia.
🗑
|
||||
| Hypokalemia | T-wave flattening and U waves.
🗑
|
||||
| Hyperkalemia | Peaked T waves and widened QRS.
🗑
|
||||
| IV hydration and loop diuretics (furosemide) | First-line treatment for moderate hypercalcemia.
🗑
|
||||
| Prerenal | Type of ARF in a patient with FeNa < 1%.
🗑
|
||||
| Nephrolithiasis | A 49-year-old male presents with acute-onset flank pain and hematuria.
🗑
|
||||
| Calcium oxalate | The most common type of nephrolithiasis.
🗑
|
||||
| Cerebral berry aneurysms (AD PCKD) | A 20-year-old man presents with a palpable flank mass and hematuria. Ultrasound shows bilateral enlarged kidneys with cysts. Associated brain anomaly?
🗑
|
||||
| Nephritic syndrome | Hematuria, hypertension, and oliguria.
🗑
|
||||
| Nephrotic syndrome | Proteinuria, hypoalbuminemia, hyperlipidemia, hyperlipiduria, edema.
🗑
|
||||
| Membranous glomerulonephritis | The most common form of nephritic syndrome.
🗑
|
||||
| IgA nephropathy (Berger's disease) | The most common form of glomerulonephritis.
🗑
|
||||
| Alport's syndrome | Glomerulonephritis with deafness.
🗑
|
||||
| Wegener's granulomatosis and Goodpasture's syndrome | Glomerulonephritis with hemoptysis.
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| Glomerulonephritis/nephritic syndrome | Presence of red cell casts in urine sediment.
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| Allergic interstitial nephritis | Eosinophils in urine sediment.
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| Nephrotic syndrome | Waxy casts in urine sediment and Maltese crosses (seen with lipiduria).
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| Uremic syndrome seen in patients with renal failure | Drowsiness, asterixis, nausea, and a pericardial friction rub.
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| Wait, surgical resection, radiation and/or androgen suppression | A 55-year-old man is diagnosed with prostate cancer. Treatment options?
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| DI | Low urine specific gravity in the presence of high serum osmolality.
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| Fluid restriction, demeclocycline | Treatment of SIADH?
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| Renal cell carcinoma (RCC) | Hematuria, flank pain, and palpable flank mass.
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| Choriocarcinoma | Testicular cancer associated with β-hCG, AFP.
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| Seminoma—a type of germ cell tumor | The most common type of testicular cancer.
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| Transitional cell carcinoma | The most common histology of bladder cancer.
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| Central pontine myelinolysis | Complication of overly rapid correction of hyponatremia.
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| Anion gap acidosis and 1° respiratory alkalosis due to central respiratory stimulation | Salicylate ingestion → in what type of acid-base disorder?
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| Respiratory alkalosis | Acid-base disturbance commonly seen in pregnant women.
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| DM, SLE, and amyloidosis | Three systemic diseases → nephrotic syndrome.
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| RCC or other erythropoietin-producing tumor; evaluate with CT scan | Elevated erythropoietin level, elevated hematocrit, and normal O2 saturation suggest?
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|
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| Likely BPH. Options include no treatment, terazosin, finasteride, or surgical intervention (TURP) | A 55-year-old man presents with irritative and obstructive urinary symptoms. Treatment options?
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|
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| Antipsychotics (neuroleptic malignant syndrome) | Class of drugs that may cause syndrome of muscle rigidity, hyperthermia, autonomic instability, and extrapyramidal symptoms.
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| Acute mania, immunosuppression, thin skin, osteoporosis, easy bruising, myopathies | Side effects of corticosteroids.
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| Benzodiazepines | Treatment for DTs.
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|
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| N-acetylcysteine | Treatment for acetaminophen overdose.
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|
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| Naloxone | Treatment for opioid overdose.
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|
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| Flumazenil | Treatment for benzodiazepine overdose.
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|
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| Dantrolene or bromocriptine | Treatment for neuroleptic malignant syndrome.
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|
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| Nitroprusside | Treatment for malignant hypertension.
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|
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| Rate control, rhythm conversion, and anticoagulation | Treatment of AF.
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|
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| Rate control with carotid massasge or other vagal stimulation | Treatment of supraventricular tachycardia (SVT).
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|
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| INH, penicillamine, hydralazine, procainamide | Causes of drug-induced SLE.
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|
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| B12 deficiency | Macrocytic, megaloblastic anemia with neurologic symptoms.
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|
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| Folate deficiency | Macrocytic, megaloblastic anemia without neurologic symptoms.
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|
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| Treat CO poisoning with 100% O2 or with hyperbaric O2 if severe poisoning or pregnant | A burn patient presents with cherry-red flushed skin and coma. SaO2 is normal, but carboxyhemoglobin is elevated. Treatment?
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|
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| Bladder rupture or urethral injury | Blood in the urethral meatus or high-riding prostate.
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|
||||
| Retrograde cystourethrogram | Test to rule out urethral injury.
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|
||||
| Widened mediastinum (> 8 cm), loss of aortic knob, pleural cap, tracheal deviation to the right, depression of left main stem bronchus | Radiographic evidence of aortic disruption or dissection.
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|
||||
| Free air under the diaphragm, extravasation of contrast, severe bowl distention, space-occupying lesion (CT), mesenteric occlusion (angiography) | Radiographic indications for surgery in patients with acute abdomen.
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|
||||
| Pseudomonas | The most common organism in burn-related infections.
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|
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| Parkland formula | Method of calculating fluid repletion in burn patients.
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|
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| 50 cc/hour | Acceptable urine output in a trauma patient.
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|
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| 30 cc/hour | Acceptable urine output in a stable patient.
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|
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| Third-degree heart block | Cannon "a" waves.
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|
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| Hypotension and bradycardia | Signs of neurogenic shock.
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|
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| Hypertension, bradycardia, and abnormal respirations | Signs of ↑ ICP (Cushing's triad).
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|
||||
| Hypovolemic shock | ↓ CO, ↓ pulmonary capillary wedge pressure (PCWP), ↑ peripheral vascular resistance (PVR).
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|
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| Cardiogenic shock | ↓ CO, ↑ PCWP, ↑ PVR.
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|
||||
| Septic or anaphylactic shock | ↑ CO, ↓ PCWP, ↓ PVR.
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|
||||
| Fluids and antibiotics | Treatment of septic shock.
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|
||||
| Identify cause; pressors (e.g., dobutamine) | Treatment of cardiogenic shock.
🗑
|
||||
| Identify cause; fluid and blood repletion | Treatment of hypovolemic shock.
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|
||||
| Diphenhydramine or epinephrine 1:1000 | Treatment of anaphylactic shock.
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|
||||
| Continuous positive airway pressure | Supportive treatment for ARDS.
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|
||||
| A patient with chest trauma who was previously stable suddenly dies | Signs of air embolism.
🗑
|
||||
| AP chest, AP/lateral C-spine, AP pelvis | Trauma series.
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|
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