Medical Terminology and Concepts, Exams of Nursing

Download Medical Terminology and Concepts and more Exams Nursing in PDF only on Docsity! PACKRAT Exam Questions | 100% Correct Answers | Verified | Latest 2024 Version A 16 year old has just moved schools. He is quiet, moody and not like himself at all. Within six months he seems to have completely changed back to his previous personality. What is the most likely diagnosis? - ✔✔Adjustment disorder What is the prophylactic antibiotic most commonly given before a dental procedure if one is necessary? - ✔✔Amoxicillin 2 grams po 1 hour before procedure Wilson's disease is associated with a build up of what mineral? - ✔✔There is a deficiency of the copper binding protein and therefore a buildup of copper. Name one oral medication that can be used for MRSA. - ✔✔Linezolid (Zyvox) and Bactrim Which cardiac medication is used to help with cardiac contractility after you have optimized most of the other cardiac medications? - ✔✔Digoxin What medication used in hepatitis B infection helps prevent the need for liver transplant? - ✔✔Lamivudine How is celiac disease most commonly diagnosed? - ✔✔Endoscopic biopsy Mononucleosis A 14 year old field hockey player presents with prominent adenopathy, white purple exudates in the throat and a palpable spleen. What is the most likely diagnosis? - ✔✔Wernicke's aphasia A patient presents with what appears to be an inability to understand speech. Which aphasia should be at the top of your differential? - ✔✔It is blood in the joint indicating a fracture even if the fracture line cannot be seen. A fat pad sign on a lateral x-ray of the elbow has what significance? - ✔✔It is blood in the joint indicating a fracture even if the fracture line cannot be seen. A corkscrew appearance on barium study should make you think of what diagnosis? - ✔✔Esophageal spasms What is the treatment for Turner's syndrome? - ✔✔Cyclical estrogen and progesterone What is the gold standard for diagnosing myocarditis? - ✔✔Myocardial biopsy By what age should a child be able to hold up her head? - ✔✔3 months On physical exam, you notice ulnar deviations and swan neck deformities. What is the most likely diagnosis? - ✔✔Rheumatoid arthritis What is the most accurate way to diagnose urethritis? - ✔✔Urine PCR You hear a loud harsh holosystolic murmur in a child. It is heard best at the LLSB. What is the most likely diagnosis? - ✔✔Ventricular septal defect The accessory pathway known as the James bundle should make you think of what syndrome? - ✔✔Lown-Ganong-Levine syndrome A Blalock procedure is used to correct what congenital heart condition? - ✔✔Tetralogy of Fallot What medication can be used to control bleeding due to uterine atony? - ✔✔Oxytocin (Pitocin) What is the most common cause of a folate deficiency? - ✔✔Alcoholism List three risk factors for placental abruption. - ✔✔HTN, smoking, AMA, cocaine use, PROM What ejection fraction is typical for a patient with CHF? - ✔✔35-40% List 4 risk factors for endometrial cancer. - ✔✔Chronic unopposed estrogen, nulliparity, early menarche, late menopause, tamoxifen, DM, obesity, HTN, breast CA, ovarian CA Tall peaked P waves should make you think of what diagnosis? - ✔✔Right atrial enlargement What is the best test to check for H. pylori? - ✔✔Urea breath test What it is the recommended treatment for hepatitis C infection? - ✔✔Pegylated interferon alpha-2 Is a nulliparous or mulitparous woman more likely to get preeclampsia? - ✔✔Nulliparity is a risk factor for preeclampsia. Name the condition in which the head of the penis curves downward or upward, at the junction of the head and shaft of the penis. (Hint: It is often associated with hypospadias.) - ✔✔Chordee Acute sinusitis is most commonly caused by which two pathogens? - ✔✔Strep pneumoniae and haemophilus influenzae A physical exam finding of egophony should make you think of what diagonsis? - ✔✔Lobar pneumonia A patient presents with erectile dysfunction and complains of some numbness in his feet. On second thought he has noticed significant polyuria and polydipsia. What diagnosis should you be thinking of? - ✔✔Diabetic neuropathy What percentage of diabetes in the US is type 2? - ✔✔80-90% What is the treatment for pneumocystis jiroveci pneumonia? - ✔✔Bactrim What will the bowel sounds be early on in a small bowel obstruction? What will they be later on? - ✔✔Early they are hyperactive. Late they are absent. A feathery border in an eye exam should make you think of what diagnosis? - ✔✔Fungal infection List six medications that can be used for migraine prophylaxis? - ✔✔Beta blockers, tricyclics, calcium channel blockers, NSAIDs and valproic acid What is the #1 cause of retinal artery occlusion? - ✔✔Carotid atherosclerotic disease. What is the formula for calculating estimated date of confinement or due date? - ✔✔First day of last menstrual period + 7 days - 3 months The pap smear results on a 23 year old patient come back as atypical squamous cell uncertain significance (ASCUS). What is your next step? - ✔✔Repeat pap smear in 12 months although HPV test is acceptable. What causes Mallory-Weiss tears? - ✔✔Forced vomiting or retching (often involving alcohol) Ghon or Ranke complexes on CXR should make you think of what diagnosis? - ✔✔TB During pregnancy which is the prefered treatment of hyperthyroidism PTU or methimazole? - ✔✔PTU What are three causes for a postpartum hemorrhage? - ✔✔Uterine atony, genital laceration, retained placenta What is the name of the test for dry eyes? - ✔✔Schirmer's test Will serum potassium be decreased or elevated in renal failure? - ✔✔Elevated Which lab should be tightly monitored in a patient taking an aldosterone antagonist? - ✔✔Potassium, they may have hyperkalemia. What is the definitive treatment for atrial flutter? - ✔✔Radiofrequency catheter ablation What medication is often used to treat postpartum depression in a woman who is breast feeding? - ✔✔Sertraline (Zoloft) A doughnut shaped burn should make you think of what issue? - ✔✔Abuse either child or elder A strawberry cervix with copious yellow/green discharge should make you think of what diagnosis? - ✔✔Trichomonas vaginitis During a physical exam of a child, you feel a tubular or sausage-shaped mass. What is the most likely diagnosis? - ✔✔Intussusception What is the first line treatment for carpal tunnel? - ✔✔Night splint What is the most common cause of a hip dislocation? Is it usually anterior or posterior? - ✔✔MVA, posterior Maltese crosses in the urine should make you think of what diagnosis? - ✔✔Nephrotic syndrome Cystoscopy and biopsy Spermatocele You place a patient on rifampin. What side effect should you warn her about? - ✔✔Orange-red discoloration of body fluids A patient believes that her 15 year old daughter is sleeping with the mailman. She has no evidence of this. She has confronted her daughter who denies it. It is not interfering with her daily activities, but she does spend time thinking about it. What is the most likely diagnosis? - ✔✔Delusional disorder What two leads do you use to determine the axis of the heart? - ✔✔Lead I and AVF What is the other term for Mobitz type I? - ✔✔Wenckebach List three possible treatments for stress incontinence in women. - ✔✔Kegels, estrogen therapy, surgical placement of a urethral sling Under routine circumstances when should patients begin getting screening colonoscopies? - ✔✔Age 50 The scotch tape test is used to diagnose what disease? - ✔✔Pinworm A child with a fever lasting longer than five days should make you think of what diagnosis? - ✔✔Kawasaki syndrome Which heart valve is most associated with rheumatic fever? - ✔✔Mitral What is the most common precipitating event for posttraumatic stress disorder in women? - ✔✔Rape Hampton's hump on CXR should make you think of what diagnosis? - ✔✔Pulmonary embolism Forchheimer spots are associated with what disease? - ✔✔Rubella A 15 year old boy presents complaining of night pain in the pelvis. Since you have no idea what to do, you order an x-ray. The report comes back with a description of a mass with an "onion skin appearance." What is the most likely diagnosis? - ✔✔Ewing sarcoma What ligament is most commonly injured in an ankle sprain? - ✔✔Anterior talofibular ligament (ATFL) What is the treatment for epiglottitis? - ✔✔2nd or 3rd generation cephalosporin (ceftriaxone), macrolides may also be used (clindamycin) In Cushing's disease is ACTH elevated or decreased? - ✔✔Elevated What is the #1 cause of small bowel obstruction? - ✔✔Postoperative adhesions What Rh combination for mom and dad might cause the mother to create antiboides against the baby's red blood cells? - ✔✔Mom Rh-negative and dad Rh- positive Which are painful and found on the fingers and toes, Osler nodes or Janeway lesions? - ✔✔Osler nodes What is the most common prophylactic antibiotic used preoperatively? - ✔✔Cefazolin = Ancef, Keflex = Cefalexin, The answer is Cefazolin (Ancef) What will an x-ray show in acute osteomyelitis? - ✔✔Nothing - it will show bone destruction in chronic osteomyelitis. You suspect mitral regurgitation. What is the most accurate way to prove your diagnosis? - ✔✔Transesophageal echo As it relates to diabetics, what is the dawn phenomenon? - ✔✔Reduced insulin response between 5 and 8 am If you hear crackles in the lung fields list three pulmonary issues that should be in your differential. - ✔✔Pneumonia, fibrosis, CHF, Bronchitis A pathology report comes back showing negatively birefringent crystals. What is the most likely diagnosis? - ✔✔Gout Cottage cheese discharge should make you think of what diagnosis? - ✔✔Vaginal candidiasis What is the most common organism causing pneumonia in COPD patients? - ✔✔Haemophilus influenzae What type of hearing loss would be caused by cerumen impaction? - ✔✔Conductive A christmas tree pattern should make you think of what diagnosis? - ✔✔Pityriasis rosea What is the age range for Duchenne's muscular dystrophy? - ✔✔3-5 years old A question about Prinzmetal's angina will often contain what key thing in the patient's history? - ✔✔Cocaine use Will unconjugated bilirubin be high or low in a patient with sickle cell disease? - ✔✔High The heart rate is irregular, so you can't count boxes between QRS waves to determine heart rate. What is another method you can use to determine rate on an EKG? - ✔✔Count QRS waves in a six second strip and multiply by 10 to get beats per minute. If you have a patient with positive blood cultures for candida what is the first line drug? - ✔✔Amphotericin B Would a B12 deficiency anemia most likely be microcytic, normocytic or macrocytic? - ✔✔Macrocytic What is the most serious complication of Kawasaki syndrome? - ✔✔Aortic Aneurysm Are one half of all adult hernias direct or indirect inguinal hernias? - ✔✔Indirect inguinal hernias makeup 50% of all adult hernias. Which way does a Colles fracture angulate: dorsal or volar? What about a Smith fracture? - ✔✔Colles = Dorsal, Smith = Volar A patient complains of seeing halos and rainbows around lights. She also complains of moderate photophobia? What is the most likely diagnosis? - ✔✔Glaucoma What is the appropriate treatment for a patent ductus arteriosus. - ✔✔Indomethacin What is the term for difficulty swallowing? - ✔✔Dysphagia An RSR prime in leads V1 or V2 should make you think of what diagnosis? - ✔✔Right bundle branch block Tenderness over the anatomical snuffbox is indicative of what fracture? - ✔✔Scaphoid If you have heartburn that does not improve with medication what is the most likely diagnosis? - ✔✔Gastrinoma Steatorrhea should make you think of what diagnosis? - ✔✔Pancreatitis Describe Barlow's test. - ✔✔Adduct and internal rotation of the hips What two viral hepatitis infections are self limiting? - ✔✔Hepatitis A and hepatitis E What is the most common organism that causes a bladder infection? - ✔✔E. coli Where are Heberden's nodes found? - ✔✔Distal interphalangeal joint (DIP) What is the leading cause of iron deficiency anemia? - ✔✔E. coli A 65 year old male presents with frequency. On digital rectal exam you feel an elastic moderately enlarged prostate. What is the most likely diagnosis? - ✔✔BPH What is the most common fracture in a patient with osteoporosis? - ✔✔A compression fracture of a vertebral body followed by hip fractures. At approximately how many weeks pregnant is the uterus at the level of the umbilicus? - ✔✔20 weeks Following a myocardial infarction, what medication should you be using to treat hypertension? - ✔✔Beta blocker A COPD patient has apical cavities and calcified nodes on his CXR. You also discover he has a pet bat and a few birds. What is the most likely diagnosis? - ✔✔Histoplasmosis Since a genetic cause is the number one reason for primary amenorrhea what is one very important test? - ✔✔Karyotype "What is the name for the triangular or wedge shaped growth on the conjunctiva that may interfere with vision?" - ✔✔Pterygium Scleroderma limited version has five main characteristics for which the CREST acronym is often used. What are those five things? - ✔✔Calcinosis, Raynaud's, esophageal dysmotility, Sclerodactyly, Telangiectasia What CXR finding might make you think of mesothelioma? - ✔✔Pleural thickening, remember 80% are found in the pleura lining You recommend bisphosphonates for a patient with osteoporosis. What instruction do you give her for immediately after taking the medication? - ✔✔Remain upright for 30 minutes With a gastric ulcer are the patient's symptoms exacerbated or relieved with food? - ✔✔Exacerbated Which EKG leads are used to diagnose an anterior wall MI? - ✔✔V1, V2 and V3 A patient presents to the ER with chest pain. An EKG shows diffuse ST elevations in almost all of the leads. What is the most likely diagnosis? - ✔✔Pericarditis A 45 year old female complains of feeling the ground rolling under her feet at times. What is the most likely diagnosis? - ✔✔Vertigo At what BMI should a patient be hospitalized for anorexia? - ✔✔BMI of <17.5 or 20% below appropriate body weight How do fibrates work to affect the lipid profile? Describe Courvoisier's sign. - ✔✔They inhibit synthesis of VLDL and elevate lipoprotein lipase. Describe Courvoisier's sign. - ✔✔Nontender, palpable gallbladder which may indicate pancreatic neoplasm. When is the typical onset of Tourette's syndrome? - ✔✔3-8 years old You are treating a patient for TB. He has noticed that his body fluids now have an orange tint. What drug is most likely causing this? - ✔✔Rifampin Will evidence of TB be seen more frequently in the upper or lower lung lobes on CXR? - ✔✔Upper List three causes of decreased tactile fremitus. - ✔✔COPD, Asthma, pleural effusion, pneumothorax At approximately how many weeks pregnant is the uterus at the level of the symphysis pubis? - ✔✔12 weeks What are the ABC's of melanoma? - ✔✔Asymmetry, border, color, diameter, elevation/irregularity, evolving What life threatening side effect do statins have? - ✔✔Rhabdomyolysis What two hormones are secreted by the posterior pituitary? - ✔✔Oxytocin and antidiuretic hormone (ADH, vasopressin) Define paraphimosis. - ✔✔Foreskin is retracted and cannot be reduced. Borderline personality disorder is on the border of what two psychological disorders? - ✔✔Neurosis and psychosis Does FEV1 go up or down with asthma? - ✔✔It goes down A biphasic P wave should make you think of what diagnosis? - ✔✔Left atrial enlargement What characteristic of pelvic inflammatory disease will help to differentiate it in a question stem from ectopic pregnancy, appendicitis, ovarian torsion and ovarian cyst? - ✔✔It will be bilateral pain. Most other common abdominal complaints have unilateral pain. A blockage of which artery causes a lateral wall MI? - ✔✔Left circumflex artery What are two tocolytic medications you should be aware of? - ✔✔Magnesium sulfate and calcium channel blockers Vision loss described as curtain coming down should make you think of what diagnosis? - ✔✔Retinal detachment Carpal tunnel affects what nerve and what parts of the hand? - ✔✔Median nerve. Thumb, pointer and ring fingers. Thenar wasting is sign of advanced disease. Define phimosis. - ✔✔Foreskin can not be retracted. An HIV patient presents with a nonproductive cough and a CXR showing diffuse interstitial infiltrates. What is the most likely diagnosis? - ✔✔Pneumocystis jiroveci pneumonia (PCJ) formerly known as Pneumocystis pneumonia (PCP) Do loop diuretics cause hyperkalemia or hypokalemia? - ✔✔Hypokalemia White blood cell casts should make you think of what diagnosis? - ✔✔Pyelonephritis A young boy comes into your office. He has elevated blood pressure when taken in his arm, but no femoral pulses can be palpated. What is the most likely diagnosis? - ✔✔Coarctation of the aorta Oral herpes is best treated with systemic or topical antivirals? - ✔✔Topical is the first line. Systemic antivirals will help but are only indicated for severe cases. What medication class is used to lower triglycerides? - ✔✔Fibric acid derivatives List the four cluster B personality disorders. - ✔✔Bad antisocial, borderline, histrionic and narcissistic An 82 year old patient complains of headaches and jaw claudication. What is the most likely diagnosis? - ✔✔Giant cell (temporal) arteritis What specific breathing pattern is associated with diabetic ketoacidosis? - ✔✔Kussmaul respirations What is Reynold's pentad and why does it matter? - ✔✔Charcot's triad + hypotension + altered mental status. It indicates high risk of sepsis. What class of antibiotics is sometimes prescribed specifically for its effects on increasing GI motility? - ✔✔Macrolides A Gram-negative coccobaccili found in the sputum of patient with pneumonia should make you think of what diagonsis? - ✔✔Kussmaul respirations A patient presents to the ER in acute CHF. What drug class will likely be the first choice? - ✔✔Loop diuretics Define priapism - ✔✔Painful persistent erection Are ulcers from arterial insufficiency painful or painless? - ✔✔Painful An African American female presents with malar rash and a positive double-stranded DNA antibody. What is the most likely diagnosis? - ✔✔Lupus A patient presents with a ruptured Achilles tendon. He states he that he was recently in the hospital for a "blood infection and on a ton of antibiotics." What antibiotic class may he have been on? - ✔✔Fluoroquinolones Clue cells should make you think of what diagnosis? - ✔✔Bacterial vaginosis Which medication is worse to give to a pediatric patient, tetracycline or an aminoglycoside? - ✔✔Tetracycline How long after a radiant energy burn do symptoms typically show? - ✔✔6-12 hours What dermatologic finding is associated with insulin insensitivity? - ✔✔Acanthosis nigricans White curd like vaginal discharge should make you think of what diagnosis? - ✔✔Vaginal candida infection Is sickle cell microcytic, macrocytic or normocytic? - ✔✔Microcytic Tapioca blisters should make you think of what diagnosis? - ✔✔Dyshidrosis - these are usually on the hands and feet A college student presents with a little purulent drainage from one eye and nontender preauricular lymphadenopathy. What diagnosis and pathogen should you be thinking of? - ✔✔Chlamydia conjunctivitis When is it recommended to begin pap smears? - ✔✔Guidelines suggest beginning at age 21 regardless of sexual history. At what age is primary amenorrhea diagnosed? - ✔✔Age 14 if no secondary sex characteristics. Age 16 if some secondary development. What is the name for the 4th and 5th metacarpal fractures that often result from throwing a punch? - ✔✔Boxer's fracture What is the medical term for lazy eye? - ✔✔Amblyopia What tests are done to screen for HIV? - ✔✔ELISA and then if the positive diagnosis is confirmed with a Western blot test What is the most likely diagnosis for a young man who experiences sudden death while playing sports? - ✔✔Hypertrophic cardiomyopathy What is the treatment for a bad brown recluse spider bite? - ✔✔Debridement, the venom causes tissue necrosis. What antibiotic is the first line treatment for mycoplasma pneumonia? - ✔✔A macrolide (azithromycin or erythromycin) Decreased GABA and substance P should make you think of what diagnosis? - ✔✔Huntington's What is the most common thyroid cancer? - ✔✔Papillary makes up about 80% of thyroid cancers. Currant jelly stool should make you think of what diagnosis? - ✔✔Intussusception Melasma is most often found in what patient population? - ✔✔Women of childbearing age Paradoxical pulses may be found in what pulmonary disorder? - ✔✔Asthma Currant jelly stool should make you think of what diagnosis? - ✔✔Intussusception A barrel chest should make you think of what diagnosis? - ✔✔Emphysema A physical exam revealing a retroverted uterus or uterosacral ligament nodularity should make you think of what diagnosis? - ✔✔Endometriosis Dullness to percussion should make you think of what diagonsis? - ✔✔Lobar pneumonia A positive Auspitz sign should make you think of what diagnosis? - ✔✔Psoriasis What is the best test for diagnosing Rocky Mountain spotted fever? - ✔✔Indirect immunofluorescent antibodies A dendritic lesion is seen with fluorescein stain. What is the most likely diagnosis? - ✔✔Herpes keratitis A fluid filled painless mass found in the scrotum which transilluminates should make you think of what diagnosis? - ✔✔Hydrocele Tea-colored urine with red cell casts should make you think of what diagnosis? - ✔✔Glomerulonephritis When is watchful waiting with a diagnosis of acoustic neuroma an appropriate plan? - ✔✔This tumor is very slow growing. Watching a small tumor in an elderly patient is appropriate treatment. Strict vegans are at risk for what type of anemia? - ✔✔B12 deficiency anemia What are the most common colors lost in color blindness? - ✔✔Red and green A patient presents with unilateral blurriness developing over a few days. Fundal exam shows a "blood and thunder" pattern. What is the most likely diagnosis? - ✔✔Central vein occlusion What might happen if you infuse vancomycin too fast? - ✔✔Red Man syndrom A 60 year old male presents to the ER with severe dizziness and back pain. His blood pressure is dropping, and you can feel an abdominal pulsatile mass on physical exam. What is the most likely diagnosis? - ✔✔Ruptured aortic aneurysm Give the DEXA score for osteopenia and osteoporosis. - ✔✔Osteopenia = 1 to 2.4 standard deviations, osteoporosis = 2.5 standard deviations or greater Will ACTH be elevated or decreased in Addison's disease? - ✔✔Elevated if the problem is at the adrenal glands. What is the definitive treatment for a patient with recurrent ventricular tachycardia? - ✔✔Implanted defibrillator A patient is brought in following a seizure in which she did not lose consciousness. What is the most likely diagnosis? - ✔✔Ruptured aortic aneurysm Both lead I and AVF have positive QRS complexes. Does this represent normal axis, left axis deviation or right axis deviation? - ✔✔Normal axis What is the most common cause of dementia? - ✔✔Alzheimer's disease, it may be as high as 80%. HLA-DR gene is a marker for what endocrine disorder? - ✔✔DM type 1 At what age do symptoms of Huntington's disease appear? - ✔✔Around 30 years old You hear a loud, harsh pulmonary murmur along the left sternal border. What is the most likely diagnosis? - ✔✔Ventricular septal defect White oral lesions which can be scraped off leaving punctate bleeding should make you think of what diagnosis? - ✔✔Oral candida A unilateral, single, mobile, firm, nontender solid breast mass should make you think of what diagnosis? - ✔✔Fibroadenoma What is the most common cause of DM type 1? - ✔✔Autoimmune destruction of the islet cells in the pancreas What is a cystocele? - ✔✔A herniation of the bladder into the vagina. What is the term for eyelids that turn in? - ✔✔Entropion What siezure medication may cause overgrowth of the gums? - ✔✔Phenytoin Tympany to percussion should make you think of what diagonsis? - ✔✔Large pneuomthorax A patient presents with pain in one eye. The cornea is hazy and the pupils are fixed. What is the most likely diagnosis? - ✔✔Glaucoma What is the treatment for a patient with a Mobitz II AV block? - ✔✔Pacemaker You see regular P waves and regular QRS complexes, but they do not seem to have any correlation to each other. What is the diagnosis? - ✔✔Third degree AV block Where do most aortic dissections occur? - ✔✔The ascending or descending thoracic aorta What medical treatment is given for a gastrinoma? - ✔✔Proton pump inhibitors What is the clinical name for whooping cough? - ✔✔Pertussis What two labs do you want to monitor in a patient on an ACEI? - ✔✔Serum creatinine and serum potassium In what age range do you expect to most commonly find amaurosis fugax? - ✔✔Patients older than 50 An involuntary loss of urine during coughing or laughing is what type of incontinence? - ✔✔Stress incontinence Which thyroid cancer is the most aggressive? - ✔✔Anaplastic Define threatened abortion. - ✔✔Vaginal bleeding, closed cervix, products of conception are still inside How much more potent is T3 than T4? - ✔✔3-4x List four disease states in which you may find basophilic stippling. - ✔✔Lead poisoning, beta or alpha thalassemia, sideroblastic anemia, arsenic poisoning What is the most common cause of hyperparathyroidism? - ✔✔Single parathyroid adenoma in 80% of cases. Is staph gram (+) or gram (-)? - ✔✔Gram (+) What are the two main causes of aortic stenosis? - ✔✔Congenital bicuspid valve and calcification of the valve secondary to coronary artery disease You notice drusen deposits on fundal exam. What is the most likely diagnosis? - ✔✔Macular degeneration List the 5 insulins in order of peak efficacy? - ✔✔Lispro 1-2 hrs, Regular 2-4 hrs, NPH 5-7 hrs, Lente 4-8 hrs, Ultralente 8-14 hrs What would you expect to see on a KOH prep if the patient had vaginal candidiasis? - ✔✔Pseudohyphae Will a hemolytic anemia generally have an elevated or decreased retic count? - ✔✔Elevated Define the third stage of labor. - ✔✔Delivery of baby to delivery of placenta How do you treat alcohol withdrawal - ✔✔Benzodiazepines What is the treatment for myxedema? - ✔✔Levothyroxine and slow warming What is the therapeutic range for INR following an organic valve replacement? - ✔✔2 to 3 What would you expect the WBC count to be in the joint fluid of an infected knee? - ✔✔>50,000 at a minimum and probably much higher. A 34 year old presents with symptoms which are relapsing and remitting over the past few weeks. These include visual problems and weakness in her right arm. What is the most likely diagnosis? - ✔✔Multiple sclerosis List the four things that suggest group A beta- hemolytic strep in a patient with pharyngitis. - ✔✔Fever, tender anterior cervical adenopathy, no cough and an exudate in the throat A patient exhibits splitting, seeing others as all good or all bad. What is the most likely diagnosis? - ✔✔Borderline personality disorder What is the medical treatment for gout? - ✔✔Allopurinol, colchicine In order to contract hepatitis D what must you already have? - ✔✔Hepatitis B A CXR finding of notched ribs in a child should make you think of what diagnosis? - ✔✔Coarctation of the aorta A leukemia patient has a CT of the liver which shows punched out lesions. What diagnosis should you be thinking of? - ✔✔Hepatosplenic candida What two main causes should you be thinking of in a macrocytic anemia? - ✔✔Malnutrition and severe blood loss Where are Bouchard's nodes found? - ✔✔Proximal interphalangeal joint (PIP) What is the first line treatment for tinea corporis? - ✔✔Topical azoles Which of the four rotator cuff muscles is most commonly injured? - ✔✔Supraspinatus What three symptoms are classic for a normal pressure hydrocephalus? - ✔✔Gait disturbance, dementia and urinary incontinence A new mother presents with pain over the radial wrist. She has a positive Finkelstein's test. What is the most likely diagnosis? - ✔✔Cystic fibrosis What is erythema nodosum? - ✔✔de Quervain's tenosynovitis What is the most common anorectal problem affecting patients over 50? - ✔✔Tender red nodules usually found on the shins. You should be thinking alpha thalassemia if the question stem includes which four geographic areas? - ✔✔Hemorrhoids What is the most common cause of an upper respiratory tract infection? - ✔✔Southeast Asia, China, Middle East, Africa What is the drug of choice to treat a urethritis caused by neisseria? - ✔✔Rhinovirus What is the medical treatment for an early ectopic pregnancy? - ✔✔Ceftriaxone (Rocephin) A Salter-Harris type III fracture affects what area of the bone? - ✔✔Methotrexate What is the treatment for Addison's disease? - ✔✔The physis (growth plate) as well as the epiphysis What is the term for a chronic mild depression which has lasted greater than two years? - ✔✔Hydrocortisone or prednisone Dysthymia Which NSAID has the highest rate of peptic ulceration? - ✔✔Naproxen What is the only curative therapy for gastric adenocarcinoma? - ✔✔Surgical resection What should a primary care provider do for presumed central retinal artery occlusion? - ✔✔Ophthalmic emergency! Refer and intermittent pressure and release of the eye. What is a good beta blocker to reduce portal HTN? - ✔✔Propranolol A waxy stuck on appearance should make you think of what diagnosis? - ✔✔Seborrheic keratosis A sawtooth pattern on EKG should make you think of what diagnosis? - ✔✔Atrial flutter Ethambutol has what two major side effects? - ✔✔Optic neuritis, red green vision loss How does levothyroxine work? - ✔✔It is a synthetic T4 How do you treat pityriasis rosea? - ✔✔Reassurance How long does menstration need to be absent before secondary amenorrhea can be diagnosed? - ✔✔If cycles have been previously normal: 3 months. If cycles have been previously irregular: 6 months. A patient is arrogant with an inflated self image. He feels he is special and should be treated that way. What is the most likely diagnosis? - ✔✔Narcissistic personality disorder Will the serum ferritin be high or low in a patient with iron deficient anemia? - ✔✔It will almost always be low A patient presents with several episodes of vertigo over the past few weeks. He has had intermittent unilateral hearing loss and a "blowing" in his ears. What is the most likely diagnosis? - ✔✔Meniere's disease What organism is the most common cause of an uncomplicated urinary tract infection? - ✔✔E. Coli Is the ankle jerk reflex of lumbar or sacral origin? What is the best test to diagnose bronchiectasis? - ✔✔Sacral Koplik spots are white clustered lesions on the buccal mucosa. What virus are they pathognomonic for? - ✔✔CT Measles/Rubeola Air fluid levels on abdominal x-ray should make you think of what diagnosis? - ✔✔Bowel obstruction Typically what is the first medication started in type 2 DM? - ✔✔Metformin What is the first step in treating atopic dermatitis? - ✔✔Behavioral modifications - reduce bathing, only use soap on face and genitals, use natural breathable fabrics A patient being treated with penicillin for a syphilis infection develops fever, chills, muscle pain and headaches. Do you stop treatment? - ✔✔No this is Jarisch-Herxheimer reaction. The patient must be closely monitored, but it is a response to released endotoxin from the death of the spirochetes and not an allergic reaction. Subacute endocarditis is most commonly caused by what organism? - ✔✔Strep Viridans What is the treatment for Shigella? - ✔✔Bactrim or fluoroquinolones and hydration. On auscultation, you hear a harsh blowing pansystolic murmur at the apex. What is the most likely diagnosis? - ✔✔Mitral regurgitation What lab result will increase the risk of digoxin toxicity? - ✔✔Hypokalemia or hypercalcemia Which nerve is involved in herpes zoster ophthalmicus? - ✔✔Trigeminal nerve, CN 5 Describe the pattern of weight gain in an infant over the following time periods: week one, 6 months, 12 months, 3 years old and 4 years old. - ✔✔Newborns lose 10% of their birth weight initially but are back to birth weight at 10 days, 6m = 2x birth weight, 12m = 3x birthweight,3 y/o= 30 lbs & 30 inches, 4 y/o = 40 lbs & 40 inches Why is ovarian cancer so hard to diagnose? - ✔✔There are no good markers and the symptoms are very vague. What role does C-peptide play in the diagnosis of diabetes? - ✔✔It is a marker of insulin production. Elevated C-peptide points to DM 2. Decreased C-peptide points towards DM 1. What is the first line treatment for genital warts? - ✔✔Imiquimod (Aldara) What side effect might make a patient stop taking an ACEI? - ✔✔Cough At how many weeks of pregnancy can an amniocentesis be done? - ✔✔15-20 weeks What is the term for being nearsighted? What type of lens do you use to correct it? - ✔✔Myopia, concave lenses You are counting boxes from the peak of a QRS wave on an EKG in order to determine the heart rate. What would the heart rate be if the next QRS wave peak were three boxes away? What numbers are associated with the first five boxes? - ✔✔The answer is 100. The heart rates by counting boxes are 300, 150, 100, 75, 60. A young child presents to ER and you see him waiting in tripod position. What is the most likely diagnosis? - ✔✔Epiglottitis A patient with HIV presents with severe groin pain. What is the most likely diagnosis? - ✔✔Avascular necrosis of the femoral head. Antiretroviral medications put patients at an increased risk of AVN. List 4 physical exam findings for Cushing's syndrome. - ✔✔Moon face, buffalo hump, purple striae, central obesity, supraclavicular fat pads, easy bruising What medicaton classes are prescribed in order to help prevent chronic renal failure in diabetic patients? - ✔✔ACEIs or ARBs What is the best imaging for a thyroid nodule? - ✔✔Ultrasound Salmon-colored scales should make you think of what diagnosis? - ✔✔Psoriasis A colonoscopy that shows cobblestone or skip lesions should make you think of what diagnosis? - ✔✔Crohn's disease The baby was delivered several minutes ago. Suddenly there is a increase in blood flow from the vagina and the cord noticeably lengthens. What is the most likely cause of these signs? - ✔✔Placental separation List three signs or symptoms which will likely be included in a description of a patient with a pheochromocytoma? - ✔✔Thin, diaphoretic, tachycardic, agitated and hypertensive Often caused by chlamydia what is the syndrome characterized by urethritis (or cervicitis), arthritis and conjuctivitis? - ✔✔Reiter's syndrome An EKG shows a regular heart rate of 200 bpms. QRS is narrow. What is the most likely diagnosis? - ✔✔Supraventricular tachycardia What is the treatment for a volvulus in a child? - ✔✔Barium enema A 65 year old presents complaining of severe pain in his great toe that began when he woke up this morning. It is swollen, red and very tender. What is the most likely diagnosis? - ✔✔Gout would be number one because of the location, but you might also think about an infection. You suspect a patient has polyarteritis nodosa. What is the test for a definitive diagnosis and what is the treatment? - ✔✔Biopsy, high dose steroids A resting or pill-rolling tremor should make you think of what diagnosis? - ✔✔Parkinson's disease What are three medications often combined as a first line treatment for H. pylori? - ✔✔Omeprazole, clarithromycin and amoxicillin (PPI + 2 Antibioitcs) What is the treatment goal for a diabetic with hypertension? - ✔✔130/80 What medication might you use prior to thyroidectomy in a patient with hyperthyroidism? - ✔✔Methimazole or propylthiouracil (PTU Is diphtheria a Gram-positive or negative organism? - ✔✔Gram-positive How do you treat achalasia? - ✔✔Loosen up the muscle - botox, dilation or surgery What is the most specific test for acute cholecystitis? - ✔✔HIDA Prolonged expiration (low FEV1) should make you think of what diagnosis? - ✔✔Asthma or COPD What imaging needs to be done before taking a patient to the OR with an aortic aneurysm? - ✔✔CT (echo may be used as initial study, but CT is need for surgery) A fundal exam shows a cup to disc ratio of >0.5. There are also vessels bending over the disc. What is the most likely diagnosis? - ✔✔Glaucoma Define inevitable abortion. - ✔✔Vaginal bleeding, cervix is open, products of conception are still inside List three medication that may cause lupus. - ✔✔Procainamide, isoniazid and Quinidine Hyperpigmentation of the skin along creases should make you think of what diagnosis? - ✔✔Gram- positive Are most shoulder dislocations anterior or posterior? - ✔✔Anterior What are three things in your differential if you have a paradoxical pulse? - ✔✔Cardiac tamponade, pericarditis and obstructive lung disease How long should pressure be applied to treat epistaxis? - ✔✔15 minutes A cervical biopsy comes back as CIN2 or CIN3. What is your next step? - ✔✔Excision - LEEP, Cold knife (worry about incompetent cervix), Cryotherapy Bird-beak esophagus on barium swallow should make you think of what diagnosis? - ✔✔Achalasia What are two common predisposing factors for esophageal varices? - ✔✔Portal HTN and cirrhosis often caused by alcoholism. What is the best treatment for molluscum contagiosum? - ✔✔It is self limiting, but can be removed if patient really wants it. Who is more likely to have an aortic aneurysm males or females? - ✔✔Males are eight times as likely to have an aortic aneurysm. A positive Neer's test indicates what diagnosis? - ✔✔Rotator cuff impingement Reactive arthritis, HLA B- 27 A patient presents with conjunctivitis, urethritis, arthritis and oral lesions. What is the most likely diagnosis? What other lab might you expect to be positive? - ✔✔Spermatocele What is the most likely diagnosis for a free floating, painless, cystic mass found posterior and superior to the testis? - ✔✔Total hysterectomy and bilateral salpingo-oophorectomy What is the first step of treatment for endometrial cancer? - ✔✔Cholecystitis A patient presents complaining of right upper quadrant pain 20 minutes after meals. What is the most likely diagnosis? - ✔✔Carbohydrates Salivary amylase breaks down what macronutrient? Name the four thyroid cancers. - ✔✔Papillary, Follicular, Medullary, Anaplastic A 22 year old male patient presents with what is clearly a septic knee. You also notice lesions on his hands and feet. What is the most likely pathogen? - ✔✔Neisseria gonorrhoeae What is the name of the condition that involves fibrous scar tissue in the penis causing a curvature of the erect penis? - ✔✔Peyronie's disease What is the most common organism that causes mastitis? - ✔✔Staph aureus Blue bloater refers to the characteristic physical exam findings of what disease? - ✔✔Chronic bronchitis What is the most common cause of postrenal renal failure? - ✔✔BPH, postrenal renal failure is secondary to an outflow obstruction Describe the characteristics of a lytic lesion on x-ray. - ✔✔Spiculated, elevated periosteum, bone destruction (think bad, very bad things) What is it called when a patient says "ee" but on auscultion you here "ay"? - ✔✔Egophony List two medications commonly used for hypertension in pregnancy. - ✔✔Methyldopa and labetalol What is the test to begin with if you suspect a pheochromocytoma? - ✔✔24 hour urine for catecholamines At what point during pregnancy is RhoGAM given if it is needed? - ✔✔28 weeks What virus causes mumps? - ✔✔Paramyxovirus What are two important things you need to tell you patients before putting them on metronidazole? - ✔✔Stay out of the sun and avoid alcohol. What medication is most commonly used for long term treatment of GERD? - ✔✔Proton pump inhibitors - omeprazole, lansoprazole, pantoprazole Which is associated with painful third trimester bleeding placental abruption or placenta previa? - ✔✔Placental abruption Paroxysmal nocturnal dyspnea should make you think of what diagnosis? - ✔✔CHF How does ezetimibe work? - ✔✔Decreases intestinal absorption of cholesterol. Does mastitis tend to be unilateral or bilateral? - ✔✔Unilateral and only one quadrant What is the suffix associated with sulfonylureas? - ✔✔Ide is the suffix. Examples: glipizide, tolbutamide, tolazamide. What is the first symptom of a rabies infection? - ✔✔Pain and anesthesia at the site of the bite What two blood test can be used to diagnose celiac? - ✔✔IgA endomysial antibody and IgA tTG antibody Which problem is an emergency phimosis or paraphimosis? - ✔✔Paraphimosis A Westermark sign on CXR should make you think of what diagnosis? - ✔✔Pulmonary embolism A description of a young girl with a web neck or wide shield chest should make you think of what diagnosis? - ✔✔Turner's syndrome What area of the prostate is the primary site for prostate cancer? - ✔✔The peripheral zone Syphilis is caused by what organism? - ✔✔Treponema pallidum A thumbprint sign on an abdominal film should make you think of what diagnosis? - ✔✔Intestinal ischemia In order to diagnose rheumatic fever what one thing must you have? - ✔✔Evidence of a strep infection either positive titer or positive culture. In addition to that you need 2 major criteria or 1 major and 2 minor criteria. What is the treatment for seborrheic keratosis? - ✔✔It is bengin so there is no need to treat it. Lesions may be removed if unsightly. Thin, sticky, malodorous vaginal discharge should make you think of what diagnosis? - ✔✔Bacterial vaginosis What diagnosis is most likely in an IV drug user with a new heart murmur and fever? - ✔✔Endocarditis A pathology report comes back with positive birefringent crystals. What is the most likely diagnosis? - ✔✔Pseudogout What is the most common fracture in children? - ✔✔Clavicle Which nerve root is responsible for the knee jerk reflex? - ✔✔L3-L4 A thumbprint sign on x-ray should make you think of what two diagnoses? - ✔✔Lateral C-spine = epiglottitis, abdominal = intestinal ischemia What organism causes us to warn pregnant patients to stay away from deli meats and soft cheeses? - ✔✔Listeria What is the most common cause of hypoparathyroid? - ✔✔Post thyroidectomy with the complication of parathyroidectomy. What is the name of the syndrome that involves pericarditis several days after a myocardial infarction? - ✔✔Dressler syndrome Hyperpigmented velvety plaques should make you think of what diagnosis? - ✔✔Acanthosis nigricans What oral antibiotic can be used for pseudomonas? - ✔✔Ciprofloxacin Imaging is negative for blood, but you strongly believe that there is a subarachnoid hemorrhage. What test can you order that will be definitive? - ✔✔Lumbar puncture What is the treatment for ovarian cancer? - ✔✔Total hysterectomy and bilateral salpingo-oophorectomy. Chemo + radiation. A Salter-Harris type I fracture affects what area of the bone? - ✔✔Only the physis (growth plate). List four risk factors for breast cancer? - ✔✔BRCA1 or BRCA2 positive, unopposed estrogen, nulliparity, early menarche, late menopause A lumbar puncture for a patient with bacterial meningitis will show elevated or decreased WBCs? Glucose? Protein? - ✔✔Elevated WBCs, decreased glucose and elevated protein At what size induration would a PPD be positive for a healthcare worker? - ✔✔10mm Clicking or locking of the knee indicates what diagnosis? - ✔✔Meniscal tear If you believe there may be a foreign body obstructing a child's breathing what type of CXR should you order? - ✔✔Expiratory view looking for hyperinflation due to air trapping. Purulent cervical discharge should make you think of what diagnosis? - ✔✔Neisseria gonorrhoeae A teardrop lesion after a course of strep throat should make you think of what diagnosis? - ✔✔Guttate psoriasis A patient presents with a painful, red nodule on the eyelid. What diagnosis should you be thinking of? What treatment should you begin with? - ✔✔Hordeolum (sty). Warm compress and progress to topical antibiotics if necessary. Hyperresonance to percussion should make you think of what diagnosis? - ✔✔Emphysema, pneumothorax, asthma What is the term for eyelids that turn out? - ✔✔Ectropion What is the accessory pathway associated with Wolff-Parkinson-White syndrome? - ✔✔The bundle of Kent List two ectopic tumors that may produce ACTH and give a patient Cushing's syndrome? - ✔✔Small cell lung cancer, pancreatic islet cells, thymomas A CXR shows vascular redistribution and blurred vascular outlines. What is the most likely diagnosis? - ✔✔CHF A 16 year old girl presents with an exudative sore throat and general malaise. On physical exam you observe some posterior chain lymphadenopathy and mild splenomegaly. What is the most likely diagnosis? - ✔✔Epstein-Barr virus You believe a patient has had a stroke. He presents with aphasia, loss of hearing in one ear and loss of vision in his left eye. Is the blockage likely in the anterior or posterior circulation? - ✔✔Anterior A patient with a history of smoking presents with a new onset hoarsness. This has been persistant for the past two weeks. What is the most likely diagnosis? - ✔✔Laryngeal squamous cell carcinoma Which is more likely to pass into the scrotum, a direct or indirect hernia? - ✔✔Indirect A patient recently started taking Lipitor. He is now complaining of aches and pains. What test should you order? - ✔✔Serum creatinine kinase, you're looking for rhabdomyolysis. Rope-like breast mass should make you think of what diagnosis? - ✔✔Fibrocystic breast mass List four diagnostic criteria for diabetes? - ✔✔Random glucose >200, fasting glucose >126, two hour postprandial glucose >200, HgA1c >6.5% What is the mean age for ovarian cancer? - ✔✔63, you will need to think of this in an older patient with vague abdominal symptoms. Name one aldosterone antagonist. - ✔✔Spironolactone, eplerenone A patient presents with flaky skin in the nasolabial folds and in her hair. What is the most likely diagnosis? - ✔✔Seborrheic dermatitis What is the most common way of testing for metamorphopsia? - ✔✔Amsler grid During what portion of the menstrual cycle does PMS occur? - ✔✔By definition it is in the second half and menstruation should relieve the symptoms. What medication class does metformin (Glucophage) fall into? - ✔✔Biguanide What medication(s) are used to treat a postpartum metritis? - ✔✔Clindamycin and gentamicin together What disease does Rickettsia rickettsii cause? - ✔✔Rocky Mountain spotted fever What are the 5 points of Ranson's criteria on admission? - ✔✔older than 55, WBC>16, glucose>200, LDH>350, AST>250 Name three serious reactions a patient may have with the use of vancomycin? - ✔✔Nephrotoxicity, ototoxicity and Stevens-Johnson syndrome A positive Hawkins test indicates what diagnosis? - ✔✔Rotator cuff impingement What are the three most common cancers to metastasize to the lungs? - ✔✔Breast, liver and colon What is the most common pituitary adenoma? - ✔✔Prolactinoma What does an Anti-HBc (hep B core antibody) indicate? - ✔✔Previous or ongoing hepatitis B infection Describe Grey-Turner's sign. - ✔✔Flank ecchymosis often related to pancreatitis What is the best test for diagnosing CHF? - ✔✔Echo List three drugs that treat cluster headaches. - ✔✔Oxygen, sumatriptan, Stadol (butorphanol) What are the five components of the biophysical profile as part of antepartum testing? - ✔✔A non-stress test, fetal breathing, two gross body movements, fetal tone, amniotic fluid index A very sick patient with diffuse infiltrates that spare the costophrenic angles should make you think of what diagnosis? - ✔✔Acute respiratory distress syndrome (ARDS) List three medications which may be used for pharmacological stress test. - ✔✔Adenosine, dobutamine, dipyridamole and Persantine What is the first thing you should be thinking of if a pediatric patient comes in with blood in the anterior chamber of the eye (hyphema). - ✔✔Child abuse until proven otherwise How many days after conception is a serum beta- HCG positive? - ✔✔8 What is appropriate treatment for central vein occlusion? - ✔✔Typically self limited. Treat underlying disease. What is the medical term for tennis elbow? - ✔✔Lateral epicondylitis On physical exam, you hear a harsh systolic murmur along the right sternal border. What is the most likely diagnosis? - ✔✔Aortic stenosis Should a breast feeding mother stop breast feeding if she develops mastitis? - ✔✔Mastitis is not a reason to stop breast feeding, but an abscess is. What is the definitive treatment for cardiac tamponade? - ✔✔Pericardiocentesis Define full term. - ✔✔Delivery at 37-42 weeks List the time of year when each of the following allergens is most prominent: pollen, grass, mold and ragweed. - ✔✔Pollen from trees and flowers = spring, grasses are the summer, mold and ragweed are fall What is the most common cause of hypopituitarism? - ✔✔Tumor You have a patient with pulsus paradoxus. What two diagnosis should you be thinking of? - ✔✔Pericarditis, pericardial effusion and an obstructive lung issue A patient complains of muscle weakness and fatigability that improves with rest. What is the most likely diagnosis? - ✔✔Myasthenia gravis What is the generic name for Prozac? - ✔✔Fluoxetine What is the drug of choice for toxoplasmosis? - ✔✔Bactrim A patient complains of periumbilical pain which has now moved over McBurney's point. What is the most likely diagnosis? - ✔✔Appendicitis What is Tietze syndrome? - ✔✔Costochondritis What is the heart rate for tachycardia? How about bradycardia? - ✔✔Tachycardia >100, bradycardia <60 A patient complains of pain in his legs when he walks. It goes away after sitting. What term comes to mind for this symptom? What diagnosis is it associated with? - ✔✔Intermittent claudication. Peripheral arterial disease. What class of medications is the first line for lowering LDL? - ✔✔Statins What is the best test to diagnose an aortic dissection? - ✔✔CT What is represented by ST segment depressions greater than 1mm on EKG? - ✔✔Ischemia A patient is having a stroke and there is no evidence of hemorrhage. What is the first line medical treatment? - ✔✔Within the first 48 hours and with no contraindications thrombolytics should be given. A Gram-positive organism in chains should make you think of what diagnosis? - ✔✔Strep Moans, groans, stones and bones describe symptoms of what endocrine problem? - ✔✔Hyperparathyroid What is the first line antibiotic treatment for cystitis? - ✔✔Bactrim Honey-colored crusts should make you think of what diagnosis? - ✔✔Impetigo Will a spermatocele transillumnate? - ✔✔Yes A CT scan of the head shows broad infiltration of orbital fat. What is the most likely diagnosis? - ✔✔Orbital cellulitis A patient expresses concern that he can't trust anyone. That everyone is out to get him, and his problems are all the faults of others. He has held very long grudges due to perceived past wrongs. What is the most likely diagnosis? - ✔✔Paranoid personality disorder Will a patient with achalasia have dysphagia to liquids, solids or both? - ✔✔Both What is the imaging study of choice if you suspect bladder cancer? - ✔✔Cystoscopy and biopsy Is Klebsiella gram (+) or gram (-)? - ✔✔Gram (-) What is the most common cause of lower GI bleed? - ✔✔Diverticulosis Tall peaked T waves should make you think of what diagnosis? - ✔✔Hyperkalemia A boot-shaped heart on CXR should make you think of what diagnosis? - ✔✔Tetralogy of Fallot How do you treat dyshidrosis? - ✔✔Topical steroids Haloperidol What is the medication of choice for a patient with Tourette's syndrome? - ✔✔New left bundle branch block is a STEMI equivalent. Right bundle branch block is usually not a problem. Which finding requires immediate attention: left bundle branch block or right bundle branch block? - ✔✔Abuse, either child or elder A spiral fracture should make you think of what issue? - ✔✔ What is the treatment for subconjunctival hemorrhage? - ✔✔Reassurance A beta natriuretic peptide below what level rules out CHF? - ✔✔< 100 If you are looking for lesions associated with multiple sclerosis and you order an MRI do you order with gadolinium or without? - ✔✔With gadolinium Which four human papillomaviruses are linked to cervical cancer? - ✔✔HPV 16, 18, 31 and 33 A 15 year old overweight boy presents to your office limping with knee pain. What is the most likely diagnosis? - ✔✔Slipped capital femoral epiphysis No matter what medications you use you are having trouble keeping a patient's blood pressure under control. You also notice hyperpigmented skin and truncal obesity. What is the most likely diagnosis? - ✔✔Cushing's disease Large doughy hands should make you think of what diagnosis? - ✔✔Gigantism How do you treat vaginal candida? - ✔✔Fluconazole po 1 dose or azole cream x 1 week A pearl formation on CXR should make you think of what diagnosis? - ✔✔Squamous cell lung cancer A patient has very strange magical thinking. What is the most likely diagnosis? - ✔✔Schizotypal personality disorder What is the most common cause of C-spine fractures? - ✔✔Motor vehicle accidents What are the two most common causes of pancreatitis? - ✔✔Cholelithiasis and ETOH Why should actinic keratosis be treated? - ✔✔It may progress to squamous cell carcinoma. An older patient presents with pneumonia and diarrhea. What is the most likely diagnosis? - ✔✔Legionella pneumonia German measles is also known as what disease? - ✔✔Rubella Which cardiac medication has gynecomastia in its side effect profile? - ✔✔Spironolactone Which is the most commonly herniated vertebral disc? - ✔✔L4-L5 followed by L5-S1 What antibiotic is most likely to cause C. diff? - ✔✔Clindamycin List three risk factors for an ectopic pregnancy. - ✔✔Previous ectopic, scarred tubes (hx of PID or salpingitis), IUD A gastrinoma is also known as what syndrome? - ✔✔Zollinger-Ellison syndrome A college student presents with pneumonia. What two organisms should you be thinking of? - ✔✔Chlamydia and mycoplasma Any reference to dark field microscopy should make you think of what organism? - ✔✔Treponema pallidum What is the imaging modality of choice for pancreatitis? - ✔✔CT A child presenting with an erythematous sandpaper rash should make you think of what diagnosis? - ✔✔Scarlet fever In a patient with hyperthyroidism will TSH most likely be elevated or decreased? - ✔✔Decreased Stocking glove should make you think of what diagnosis? - ✔✔Diabetic neuropathy and B12 deficiency neuropathy Posttussive rales should make you think of what diagnosis? - ✔✔TB What does Kiesselbach's plexus refer to? - ✔✔A group of vein's in the anterior nose which bleed a lot What is the medical term for feeling like there is a lump in your throat? - ✔✔Globus A patient presents with irregular menses, hirsutism and infertility. What is the most likely diagnosis? - ✔✔Polycystic ovarian syndrome A Gram-negative diplococci should make you think of what diagnosis? - ✔✔Neisseria Caseating granulomas should make you think of what diagnosis? - ✔✔TB What are the 5 criteria for metabolic syndrome? - ✔✔HDL <40 men <50 females, BP >135/85, Triglycerides >150, Fasting glucose >100, Waist >40 inches in men >35 inches in women How do you definitively diagnose endometriosis? - ✔✔Exploratory laparoscopy A college student presents with copious purulent drainage from one eye. What is the most likely diagnosis? - ✔✔Neisseria What is the best imaging to rule out testicular torsion? - ✔✔Doppler U/S for decreased blood flow to the testes How long does a panic attack typically last? - ✔✔10-20 minutes Lead pipe or cogwheel rigidity should make you think of what diagnosis? - ✔✔Parkinson's disease Is metformin indicated or contraindicated in renal failure? - ✔✔Contraindicated A pathologic S3 is most commonly associated with what diagnosis? - ✔✔CHF Pitting nails are associated with what dermatologic disorder? - ✔✔Psoriasis Gestational diabetes puts mom and baby at increased risk of for what three things? - ✔✔Preeclampsia, macrosomia (traumatic birth), slowing in fetal lung development You think a patient may have an osteoid osteoma due to his complaints of severe night pain. You set him up for an x-ray; but in the meantime what medication do you start him on? - ✔✔If it is truly an osteoid osteoma ibuprofen will resolve his pain. What is the first line medical treatment for a pheochromocytoma? - ✔✔Alpha blocker. You should never use a pure beta blocker. A wide pulse pressure with a blowing diastolic decrescendo murmur at the right 2nd intercostal space should make you think of what diagnosis? - ✔✔Aortic regurgitation What ethnic background is at an increased risk of fibroids? - ✔✔African Americans are 5x more likely to have fibroids compared to Caucasian women. Are fibrocystic breast masses usually bilateral or unilateral? - ✔✔Bilateral How do you treat a patient with respiratory syncytial virus? - ✔✔Albuterol, steroids and fluids List six extrapulmonary complications of lung cancer. - ✔✔SPHERE - SVC syndrome, Pancoast tumor, Horner's syndrome, Endocrine problems, Recurrent laryngeal symptoms, Effusions (exudative) What tumor marker can be used to follow pancreatic cancer? - ✔✔CA-19-9 What is the most common type of ovarian cyst? - ✔✔Functional cyst - no treatment necessary. What is the gold standard for diagnosis of giant cell arteritis? - ✔✔Biopsy of the temporal artery How do you treat white oral plaques that can be scraped off? - ✔✔This is most likely candida. Topical nystatin or oral fluconazole 1 mg are first line choices. What is the main function of parathyroid hormone? - ✔✔Increase serum Ca What class of medication is first line to treat inflammatory bowel disease in the maintenance phase? - ✔✔5-ASA products - sulfasalazine, mesalamine A patient who is asymptomatic should consider having an endarterectomy at what percent blockage of the carotid artery? How about in a symptomatic patient? - ✔✔70% in an asymptomatic patient and greater than 60% in a symptomatic patient. Define abortion. - ✔✔Delivery of uterine contents before 20 weeks. What type of incontinence is often associated with BPH? - ✔✔Overflow incontinence, the bladder cannot empty sufficiently Statins are the drug of choice to treat what type of dyslipidemia? - ✔✔Elevated LDL A psychiatric patient presents with confusion, fever and lead pipe rigidity. What is the most likely diagnosis? - ✔✔Neuroleptic malignant syndrome, this can occur with high dose antipsychotics. You notice a bowing of the iris on exam. What is the most likely diagnosis? - ✔✔Glaucoma What is the best imaging study for acute appendicitis? - ✔✔CT What is Graves' disease? - ✔✔The most common cause of hyperthyroidism. It is an autoimmune disease. Acute endocarditis is most commonly caused by what organism? - ✔✔Staph aureus What disease is defined as an immunologic response to gluten? - ✔✔Celiac Name a common cause of a junctional rhythm. - ✔✔Digitoxin toxicity A CXR shows a "3" sign with notching of the ribs. What is the most likely diagnosis? - ✔✔Coarctation of the aorta Pertussis is most commonly treated with what antibiotic? - ✔✔Erythromycin A urine protein of >3.5 grams/day should make you think of what diagnosis? - ✔✔Nephrotic syndrome What is the only cyanotic congenital heart disease on the NCCPA blueprint? - ✔✔Tetralogy of Fallot If you see the term chocolate cyst it should make you think of what diagnosis? - ✔✔Endometrioma A patient has just received a cardiac stent. How long will he be on aspirin and clopidogrel? - ✔✔One year A patient in the recovery room following foot surgery is complaining of severe photophobia. She feels as though there is something in her eye. What is the most likely diagnosis? - ✔✔Corneal abrasion (pt's scratch their eyes before they are completely awake from anesthesia) What medium do you need to grow out Neisseria gonorrhoeae? - ✔✔Thayer-Martin What is the treatment for giant cell arteritis? - ✔✔High dose prednisone In a folic acid deficiency anemia the folic acid level is typically below what level? - ✔✔<150 Will the retic count be elevated, decreased or normal in a B12 deficient anemia? - ✔✔Retic count will be low. Low building blocks means low production. Is surgery curative for Crohn's or ulcerative colitis? - ✔✔Ulcerative colitis What organism has been linked to reactive arthritis? - ✔✔Shigella, also remember that reactive arthritis has a positive HLA-B27. A blockage of which artery causes an anterior wall MI? - ✔✔Left anterior descending artery What two antibiotics are used for empiric treatment of endocarditis? - ✔✔Vancomycin and ceftriaxone together are first line empiric treatment A patient presents with inability to speak and right sided weakness. He seems to understand speech and follows commands well. What type of aphasia should you be thinking of? - ✔✔Broca's aphasia Give two major risk factors for erectile dysfunction - ✔✔Diabetes, hypertension, depression, coronary artery disease A fundal exam shows a cherry-red spot. What diagnosis should you be thinking of? - ✔✔Central retinal artery occlusion 90% of patients are older than 50. Colorectal cancer patients are almost all older than what age? - ✔✔A decrease in estrogen What causes anorexic patients to have osteopenia? By what age should a child be able to sit up? Define metrorrhagia. - ✔✔6 months A patient is very charming during his interview. You note during your interview that he has no concern for hurting or using other people. He seems to show no remorse for any of his actions. What is the most likely diagnosis? - ✔✔Bleeding between menstrual cycles List two medications you might use to treat an essential tremor. - ✔✔Antisocial personality disorder What uric acid level helps to confirm a diagnosis of gout? - ✔✔Beta blocker (propranolol), primidone >7.5 What is the normal level of serum bicarbonate (HCO3)? - ✔✔24 mEq/Liter What is the therapeutic range for INR following a mechanical valve replacement? - ✔✔2.5-3.5 Inability to absorb vitamin B12 due to lack of intrinsic factor is what disease? - ✔✔Pernicious anemia List three side effects of digoxin. - ✔✔Nausea/vomiting, anorexia, confusion, arrhythmias (sinus brady, AV block), fatigue, vision disturbances etc. Which EKG leads are used to diagnose an anterolateral MI? - ✔✔V5 and V6 Name the sign which is defined as decreased pain with scrotal elevation? - ✔✔Prehn's sign Name two fibric acid derivatives. - ✔✔Fenofibrate and gemfibrozil What is the most common organism responsible for prostatitis? - ✔✔E. coli What is the most common type of testicular cancer? - ✔✔Nonseminoma What are three ways you can check for ruptured membranes? - ✔✔Ferning pattern on a slide, visualize leakage from the cervix, pooling in the vagina An exudative pleural effusion should make you think of what diagnosis? - ✔✔TB, Lung cancer Define procidentia. - ✔✔Uterine prolapse beyond the introitus An EKG shows two premature ventricular contractions. These two QRS waves look very different. What is the term for this? - ✔✔Multifocal premature ventricular contractions What is the term for an abscess in the sacrococcygeal cleft? - ✔✔Pilonidal disease List two causes of right atrial enlargement. - ✔✔Pulmonary HTN, severe lung disease, pulmonary valve stenosis How much time needs to pass before diagnosing secondary amenorrhea? - ✔✔If cycles have been normal 3 months. If cycles have been irregular 6 months. An ovarian cyst that contains hair and teeth should make you think of what diagnosis? - ✔✔Teratoma What is the gold standard for diagnosis and treatment of bile duct stones? - ✔✔ A patient presents with lateralized throbbing headache. He is also complaining of nausea, vomiting and photophobia. What type of headache is most likely? - ✔✔Migraine What is the suffix used for most fluoroquinolones? - ✔✔Oxacin There are vaccines for which two versions of hepatitis? - ✔✔Hepatitis A and hepatitis B A prostate biopsy consists of how many samples? - ✔✔6 to 12 What is the first line of treatment for an anal fissure? - ✔✔Fluid and fiber List the five major Jones criteria for diagnosing rheumatic fever. - ✔✔Polyarthritis, carditis, subcuticular nodes, erythema marginatum, chorea How do you definitively diagnose rabies? - ✔✔Pathology of the brain of the animal that performed the bite using fluorescent antibody stain. An endoscopy for presumed esophagitis shows several solitary deep ulcers. What is the most likely diagnosis? - ✔✔Cytomegalovirus Lead I has a QRS that is up and the AVF lead has a QRS complex that is down. Does this represent normal axis, left axis deviation or right axis deviation? - ✔✔Left axis deviation A kidney stone of less than what size will likely pass on its own? - ✔✔Less than 5 mm Why can't you give fluoroquinolones to kids? - ✔✔They can cause cartilage development problems. What is the term for bilateral yellow plaques near the eyes? - ✔✔Xanthelasma What is the best test to diagnose malaria? - ✔✔Peripheral blood smear List the 4 minor criteria for diagnosing endocarditis. - ✔✔Fever, embolic event (Janeway lesions or petechiae, splinter hemorrhages), immunological event (osler nodes, glomerulonephritis), 1 positive blood culture In a patient with aortic stenosis, will the PMI be medially displaced, normal or laterally displaced? - ✔✔It will be laterally displaced due to left ventricular hypertrophy. Diabetes insipidus is caused by a deficiency of which hormone? - ✔✔Vasopressin Why aren't fluoroquinolones used more frequently? - ✔✔They have lots of side effects. Where on your patient should you listen for the murmur associated with an atrial septal defect? - ✔✔At the left second or third interspace What is a common symptom that goes along with chest pain for GERD patients? - ✔✔Dry cough Is glaucoma more prevalent in males or females? - ✔✔Females 3:1 What is the most common knee injury? - ✔✔Medial meniscal tear What is the management of a patient in supraventricular tachycardia? - ✔✔Vagal maneuvers, carotid massage, adenosine Interference with work or school is part of which diagnosis, premenstrual syndrome or premenstrual dysphoric disorder? - ✔✔Premenstrual dysphoric disorder What is the normal range of fetal heart rate? - ✔✔120-160 What are the four muscles of the rotator cuff? - ✔✔Commonly referred to as the SITS muscles they are Supraspinatus, Infraspinatus, Teres minor, Subscapularis. What medication is a good place to start treating bipolar 1 or 2? - ✔✔Lithium What is the drug of choice for treating Rocky Mountain spotted fever? - ✔✔Doxycycline What is the first step in treating GERD? - ✔✔Lifestyle modification A patient has a history of multiple stys. He now has a painless nodule on his eyelid and minor conjunctivitis. What is the most likely diagnosis? - ✔✔Chalazion Is neisseria gram (+) or gram (-)? - ✔✔Gram (-) How do you treat lichen simplex chronicus? - ✔✔Get the patient to stop scratching it. Where is a Pancoast tumor found on CXR? - ✔✔At the apex of either the right or left lung What is the gold standard for diagnosis of a pleural effusion? - ✔✔Thoracocentesis How do you treat an H. pylori infection? - ✔✔PPI + 2 antibiotics, commonly omeprazole + clarithromycin and amoxicillin or PPI +metronidazole + tetracycline Describe the result of a Weber hearing test in a patient with conductive hearing loss. - ✔✔Patient will report the sound louder in the affected ear. Exophthalmos should make you think of what diagnosis? - ✔✔Hyperthyroidism - ✔✔Macrocytes Which herpesvirus causes Epstein-Barr? - ✔✔Herpes 4 A sponge-like prostate on digital rectal exam should make you think of what diagnosis? - ✔✔Prostatitis, but be careful. You can cause sepsis with a digital rectal exam. If you come across a question where the patient has erythema nodosum and an enlarged parotid gland what is the most likely diagnosis? - ✔✔Sarcoidosis An 18 month old is not yet speaking. He does not point to objects. He does not make eye contact with others. What is the most likely diagnosis? - ✔✔Autism Are most pulmonary valve problems congenital or acquired? - ✔✔95% are congenital List three possible causes of prerenal renal failure. - ✔✔CHF, severe dehydration, hemorrhage How do you test for color blindness? - ✔✔Polyarteritis nodosa A patient with a history of hepatitis B presents complaning of bilateral knee pain, fever and weight loss. What is the most likely diagnosis? - ✔✔Ishihara plates A patient presents complaining of a metallic taste in her mouth and dark brown urine. What antibiotic might she be on? - ✔✔Metronidazole (Fagyl) What drug is used for the treatment or prophylaxis of malaria? - ✔✔Chloroquine What is the first line medical treatment for a patient who presents with palpitations and nervousness secondary to hyperthyroidism? - ✔✔Beta Blockers Are ulcers from venous insufficiency painful or painless? - ✔✔Painless What occupations are associated with berylliosis? - ✔✔Aerospace and nuclear plant workers Postmenopausal bleeding is immediately believed to be what diagnosis? - ✔✔Endometrial cancer until proven otherwise. What are the most common primary cancer sites that metastasize to the brain? - ✔✔Lung, breast and kidney List the three most commonly used medical treatments for COPD? - ✔✔Oxygen, ipratropium and albuterol What area of the prostate is affected by BPH? - ✔✔The transitional zone What is the #1 cause of septic arthritis in sexully active young adults? - ✔✔Neisseria gonorrhoeae An EEG showing interictal spikes should make you think of what diagnosis? - ✔✔Complex partial seizure Name two tests you might use to rule out Cushing's syndrome. - ✔✔24 hour free cortisol urine test and dexamethasone suppression test Elevated circulating acetylcholine receptor antibodies should make you think of what diagnosis? - ✔✔Myasthenia gravis Are the lungs noisy or quiet in COPD? - ✔✔Quiet How do you define 1st degree AV block? - ✔✔The PR interval is longer than 0.2 seconds or one block on EKG. On EKG, there is an early wide QRS complex with no associated P wave. After that beat, there is a slight pause, and then a normal rhythm continues. What is the term for this one beat? - ✔✔Premature ventricular contraction A patient presents with a staccato cough but no fever. What is the most likely diagnosis? - ✔✔Chlamydia pneumoniae What is the gold standard for the diagnosis of cystic fibrosis? - ✔✔Sweat chloride test A bamboo spine indicates what diagnosis? - ✔✔Ankylosing spondylitis You have a patient with major depressive disorder. Once his symptoms have completely resolved how long should you continue with treatment? - ✔✔A six month minimum is recomended due to very high relapse rates. Epigastric abdominal pain which radiates to the back should make you think of what diagnosis? - ✔✔Pancreatitis What is the most likely quadrant for a retinal detachment? - ✔✔Superior temporal By what age should a child be able to roll over? - ✔✔4 months What is the first line medical treatment for stage 1 hypertension? - ✔✔Superior temporal On an EKG, you notice a patient has a gradually lengthening PR interval and then a missed QRS complex. The pattern repeats again. What type of AV block is this? - ✔✔Mobitz I or Wenckebach Painless bright red blood per rectum should make you think of what diagnosis? - ✔✔Hemorrhoids Bruises may be purple, green, yellow and brown. How many days old is a yellow bruise? - ✔✔Purple day 1-5, Green day 5-7, Yellow 7-10, Brown 10-14 How is acute stress disorder different than posttraumatic stress disorder? - ✔✔Acute stress disorder occurs within 1 month of event and resolves within about a month. PTSD begins at about 1 month after event and can last indefinitely. Which viral exanthem often has conjunctivitis as one of it's symptoms? - ✔✔Measles/Rubeola List three catastrophic complications of a myocardial infarction. - ✔✔Papillary muscle rupture, myocardial wall rupture and left ventricular aneurysm What is the most common cause of pneumonia in children less than 1 year old? - ✔✔Respiratory syncytial virus (RSV) A patient on sulfasalazine for an inflammatory bowel disease should be supplemented with what vitamin? - ✔✔Folate A patient of yours always craves attention, often using sex as a tool to gain it. She often acts like a child when she does not get her way? What is the most likely diagnosis? - ✔✔Histrionic personality disorder When treating psychiatric patients are benzodiazepines used more commonly for acute or chronic treatment? - ✔✔Acute On EKG there is an early but otherwise normal PQRS complex. After that beat there is a slight pause and then a normal rhythm continues. What is the term for this one beat? - ✔✔Premature atrial contraction List two risk factors for cervical cancer. - ✔✔Multiple sexual partners, smoking Small grouped vesicles on the vermillion border should make you think of what diagnosis? - ✔✔Herpes What is the most important complication of giant cell arteritis? - ✔✔Blindness Under what conditions would aspirin or clopidogrel be used following a TIA as prophylaxis? - ✔✔These are antiplatelet medications. They would be used unless there is a known cardiac etiology for the embolism. Patients with a cardiac cause should use heparin or Coumadin. What heparin complication is relevant to endocrinology? - ✔✔Adrenal infarct leading to a Cushing's syndrome What is the term for being farsighted? What type of lens do you use to correct it? - ✔✔Hyperopia, convex At what age should a child begin to say momma and dadda? - ✔✔12 months A white oral lesion which cannot be scraped off should make you think of what diagnosis? - ✔✔Oral leukoplakia How do you treat pneumocystis jiroveci pneumonia (PCJ) formerly known as pneumocystis pneumonia (PCP)? - ✔✔Bactrim A 30 year old African American woman presents with dysphagia. You notice she also has thickened skin. A barium swallow demonstrates the absence of peristalsis. What is the most likely diagnosis? - ✔✔Scleroderma Projectile vomiting should make you think of what diagnosis? - ✔✔Pyloric stenosis Pretibial myxedema should make you think of what diagnosis? - ✔✔Graves Disease How often should patients with pernicious anemia have a screening endoscopy performed? - ✔✔Every 5 years looking for signs of gastric carcinoma. What is first line treatment for rosacea? - ✔✔Metronidazole, tetracycline is probably a close second. A patient complains of having suddenly developed stage fright. It is very important to his career that he be able to speak in front of groups. What medication might you treat him with? - ✔✔Beta blocker - propranolol What is the gold standard for the diagnosis of cystic fibrosis? - ✔✔Sweat chloride test What is the most common cause of subarachnoid hemorrhage aside from trauma? - ✔✔Ruptured cerebral aneurysm Left lower quadrant pain and tenderness should make you think of what diagnosis? - ✔✔Diverticulitis A child presents with paroxysmal abdominal pain, nausea, vomiting and diarrhea. What is the most likely diagnosis? - ✔✔Intussusception What symptom is associated with a classic migraine? - ✔✔Having an aura What are the three inferior leads? - ✔✔II, III and aVF List the components of Virchow's triad. - ✔✔Stasis, vascular injury, hypercoagulability What fracture is the #1 cause of compartment syndrome? - ✔✔Tibial shaft fracture A patient has had GERD for years. Over the past year, he has noticed an increase in difficulty swallowing his food. This should make you think of what diagnosis? - ✔✔Esophageal strictures What two lung cancers are typically found peripherally on CXR? - ✔✔Adenocarcinoma and Large cell You feel a pulse that seems to be vibrating. What term do you use to describe it? - ✔✔Thrill What is the single most important thing to be concerned about with a patient in status epilepticus? - ✔✔Airway, followed by management of hyperthermia At what age should vaccinations for pneumococcal pneumonia begin? - ✔✔65 years old Owl eye inclusion bodies should make you think of what diagnosis? - ✔✔Cytomegalovirus (CMV) What is the key indicator for the prognosis of melanoma? - ✔✔Thickness of the lesion Rheumatic fever most commonly affects which valve? - ✔✔The mitral valve Rhonci or wheezes that clear after coughing suggest what diagnosis? - ✔✔Bronchitis or atelectasis Define incomplete abortion. - ✔✔Vaginal bleeding, cervix is open, products of conception partially passed Gummas or granulomatous nodules should make you think of what diagnosis? - ✔✔Tertiary syphilis Coin-shaped plaques should make you think of what diagnosis? - ✔✔Nummular Eczema When performing a decompression for a tension pneumothorax where do you put the needle? - ✔✔2nd intercostal space at the midclavicular line What is the treatment for melanoma? - ✔✔Wide local excision A patient with primary amenorrhea and a low FSH should make you think of what diagnosis? - ✔✔Hypothalamic pituitary insufficiency At what age should a child be able to use a spoon and stack 3-4 blocks? - ✔✔18 months Rice water stool should make you think of what diagnosis? - ✔✔Cholera Give two risk factors for glaucoma. - ✔✔African American descent and diabetes A patient having recently undergone cataract surgery presents complaining of vision loss in the operative eye. What is the most likely diagnosis? - ✔✔Retinal detachment What is the drug of choice to treat C. difficile? - ✔✔Metronidazole (Flagyl) Calf pain should always make you think of what diagnosis? - ✔✔DVT What is the first line antibiotic for otitis media? - ✔✔Amoxicillin A fundal exam shows an opalescent retina and boxcarring of arterioles. What is the most likely diagnosis? - ✔✔Central retinal artery occlusion Both testicles should be descended by what age? - ✔✔3 months Name three SSRI's - ✔✔Fluoxetine, paroxetine, sertraline, citalopram, escitalopram, dapoxetine, zimelidine, mesembrine, seproxetine What four chromosomes have been linked to dementia? - ✔✔1,14,19,21 What is the drug of choice for the treatment of syphilis? - ✔✔Pencillin A 66 year old female patient presents with bouts of nausea, weight loss and vague abdominal pain. What is the most likely diagnosis? - ✔✔Ovarian cancer A patient complains of regurgitating undigested food several hours after a meal. What is the most likely diagnosis? - ✔✔Zenker's diverticulum A patient presents to the ER with tearing chest pain radiating to his back. What is the most likely diagnosis? - ✔✔Aortic dissection What class of medications does pioglitazone (Actos) fall into? - ✔✔Thiazolidinediones also known as glitazones "What should a primary care provider do for a presumed retinal detachment?" - ✔✔Refer & position patient with head down What medication might you switch to if a patient develops an intolerable cough on an ACEI? - ✔✔Angiotensin receptor blocker (ARBs) How often should a diabetic's HgbA1c be checked and what should it be? - ✔✔Every three months (remember the life of an RBC is 90-120 days) and it should be below 6.5% What is a first line treatment for rheumatoid arthritis? - ✔✔Methotrexate List three class 1a antiarrhythmics. - ✔✔Disopyramide, quinidine, procainamide Does adenocarcinoma arise from the proximal or distal esophagus? - ✔✔Distal List four indications for the flu vaccine. - ✔✔Child 6-59 months, pregnant female, healthcare worker, age greater than 50 When you step up the diagnosis from intermittent asthma to mild persistent asthma what medication should you add? - ✔✔An inhaled steroid like fluticasone What medication is used as prophylaxis for meningococcal meningits? - ✔✔Rifampin What test do you do for Sjogren's syndrome? - ✔✔Schirmer test Varicocele Feeling a bag of worms in the scrotum should make you think of what diagnosis? - ✔✔Varicocele What drug do you use to treat pinworm? - ✔✔You treat everyone in the house with albendazole. Two weeks later you treat them again. What is the most specific imaging modality for diagnosing kidney stones? - ✔✔CT Diarrhea with blood and mucus should make you think of what diagnosis? - ✔✔Shigella What is the only cyanotic congenital heart disease on the NCCPA blueprint? - ✔✔Tetralogy of Fallot Will the RBC's be large, small or normal size in a B12 deficient anemia? - ✔✔Macrocytes A patient describes his vision loss as curtain coming down and then going back up. What might the diagnosis be? - ✔✔Amaurosis fugax What is the treatment for epiglottitis? - ✔✔2nd or 3rd generation cephalosporins (ceftriaxone), macrolides may also be used (clindamycin)