Anda di halaman 1dari 220

What is a seizvalproic acid

A patient camA patient in a developing country like Cambodia with lung and brain signs will present with Rheumatic
What is anothGive patients with COPD with >/2 cardinal symptoms an antibiotic since a common cause of COPD is a
Blistering le Patients with blistering lesions on the dorsum of their hands from outdoor activity are diagnosed with
What is the f Administer insulin. Furosemide takes up to 30 minutes to work.
ns will present with Rheumatic fever. Remember that in rheumatic fever, the mitral valve is occluded, leading to mitral stenosis,
a common cause of COPD is an URI infection.
oor activity are diagnosed with P.C.T.
ded, leading to mitral stenosis, elevating left atrial pressure, and causing the hempoptyis and SOB. At the same time, the clot on
. At the same time, the clot on the mitral valve can embolize to the brain, which causes left-sided hemiparesis.
Prinzmetal angina typically occurs during what time of the day? Prinzmetal angina typically occurs at night betw
When does prinzmetal angina occur - at rest or during exercise? Prinzmetal angina typically occurs at rest, and c
What is the treatment for prinzmetal angina? C.C.B., Nitrates
What medications can you use to antagonize the CCB-related perip Use antagonist of the RAAS system like an ACE
When do you administer antiretroviral therapy after anti-fungal therAntiretroviral therapy should be deferred for at
How do you know to treat hepB? If hepatitis B is highly active then you should tre
Zinc deficiency can lead to what findings? Alopecia, pustular skin rash, hypogonadism, im
Crohn's disease patients can present with what type of kidney ston Crohn's disease patients present with excessive
Pyoderma gangrenosum presents with what type of disorders? Pyoderma gangrenosum presents with inflamm
What is pes anserinus pain syndrome? Pes anserinus pain syndrome occurs when a pa
First line treatment for Torsades de Pointes is what? Magnesium Sulfate
Cyclosporine side effects Cyclosporine side effects include nephrotoxicity
GLP-1 agonists such as exenatide and liraglutide causes what side ef GLP-1 agonists induce weight loss and have low
na typically occurs at night between midnight and eight a.m.
na typically occurs at rest, and can be intermittent, lasting 15-20 minutes and resolving spontaneously.

of the RAAS system like an ACE inhibitor or an A.R.B.

erapy should be deferred for at least two weeks after antifungal therapy is started.
highly active then you should treat it. For example, if you HbE is positive, then it is highly active. Additionally, if the Hep B levels
ar skin rash, hypogonadism, impaired wound healing, imapired taste, immune dysfunction
patients present with excessive oxalate stones because oxalate cannot bind calcium in patients presenting with fat malabsorpti
renosum presents with inflammatory diseases like rheumatoid arthiritis
ain syndrome occurs when a patient experiences pain on the medial side of the tibia below the knee.

de effects include nephrotoxicity, hyperkalemia, HTN, gum hypertrophy, hirsutism, tremor.

nduce weight loss and have lower hypoglycemia risk.
dditionally, if the Hep B levels are very high (above 20,000 IU/mL), then you should treat.

resenting with fat malabsorption. Therefore oxalate levels are elevated.

Patients with adhesiv Adhesive capsulitis patients complain of stiffness
Patients with AdhesiveAdhesive capsulitis patients cannot passively or actively perform movements with shoulders.
What is the primary p Nonselective B - blocker and endoscopy
What is the preferred MRI with gadolinium
Patient was a victim o Cyanide poisoning occurs in patients who are victims of house fires.
How do you treat cya Cyanide injury should be treated with hydroxocobolamin or sodium thiosulfate or with nitrite
Cyanide poisoning leadCyanide poisoning binds cytochrome oxidase in E.T.C. and prevents oxidative phosphorylation
A patient with structuEchocardiogram. Keep in mind that an exercise stress test is used for patients who have suspe
erform movements with shoulders.

or sodium thiosulfate or with nitrites to induce methemoglobinemia.

prevents oxidative phosphorylation.
is used for patients who have suspected issues with their coronary arteries.
Hypomagnesmia Hypomagnesmia is a cause of hypocalcemia , particularly in alcoholics. Hypomagnesmia causes decre
FibromuscularCT scan of the abdomen.
What is the inThe first test to use is an exercise E.C.G for ischemic stable heart disease.
Esophageal chePain in esophageal disease lasts for >1 hr
Esophageal cheEsophageal chest pain occurs at rest. It is associated with regurgitation, nausea, and dysphagia.
In someone prupper airway obstruction
Patients with Use warm water to treat frostbite.
What is the n #1 cause is occult bleeding.
Hypomagnesmia causes decreased released of PTH and PTH resistance.

nausea, and dysphagia.

What is the grThe greatest risk factor for strokes is hypertension
Describe cherCherry hemangiomas regress spontaneously, but they are bengin
The most comm Bleeding is the most common cause of anemia in older adults.
Enesthitis is Enesthitis occurs in ankylosing spondylitis and other spondyloarthropathies.
Ankylosing spoAnkylosing spondylitis occurs in individuals less than 40 years old, and the symptoms last >3 months.
A patient comeThe diagnosis is heart failure due to coxackie b virus which results in dilated ventricles with diffuse hy
he symptoms last >3 months. The symptoms are relieved with exercise, but NOT rest.
ated ventricles with diffuse hypokinesia.
Pulmonary embolism shows up on x-ray as what shape? Pulmonary embolism sho
What is the shape a lung cancer lesion? Lung cancer lesions appea
What is the most common valvular lesion associated with infective endocarditis? Mitral regurgitation
Control of diabetes will most likely reduce which of the following microvascular complica Retinopathy
Control of diabetes has what effect on macrovascular complications? Control of D.M. has uncer
P.M.L. will show up on imaging as what? There will be multiple non
Inflammatory bowel disease shows up as intermittent lower abdominal pain. What is the dUse an abdominal x-ray to
I.B.D. patient shows what finding on physical exam? Physical exam findings sho
How often should women be screened for cervical cancer? Take pap smear every 3 ye
TDAP - vaccination schedule: When do you start your Tdap? How often thereafter do you Tdap starts at age 11, and
Ethylene glycol poisoning is associated with what findings? ethylene glycol poisoning
How do you treat ethylene glycol poisoning? Administer fomepizole or
Patients with cyanide poisoning will have elevtaed levels of what molecule? Patients with cyanide pois
Nonalcoholic fatty liver disease will be diagnosed wth what type of AST/ALT ratio? AST/ALT ratio<1 in non-alc
Hyperechoic structure is seen on ultrasound in what GI disease? Nonalcoholic fatty liver di
Non-alcoholic fatty liver disease requires a history of what? Nonalcoholic fatty liver di
Nicotinic receptor antagonists such as tubocurarine and atracurium are nondepolarizing These agents are used for
Itchy dry skins on hands along with scaly cracking skin on dorsum of hands describes wha Contact dermatitis
What is the treatment for managing bone pain in patients with prostate cancer? Radiation therapy is usef
Coronary artery disease severity is based on risk factors. How do we identify a low-risk C. Men <40, woman age <50
Chronic pulmonary aspergillosis presentation Pulmonary aspergillosis p
Patient who is using contact lenses will be infected by what organism? Pseudomonas aeruginosa
What is the earliest kdiney problem in diabetes patients? glomerular hyperfiltration
Gastric mucosal erosion will occur after what events? Ischemia of the esophagu
How can you recognize fibromyalgia? Fibromyalgia is defined by
How do you treat fibromyalgia? Any time a patient has ch
How do you diagnose glaucoma? Gonioscopy is the gold sta
When an X-ray shows osteolytic or mixed lytic-sclerotic lesions along with elevated alkali Paget's disease of the bon
ulmonary embolism shows up as a wedge-shaped infarction.
ung cancer lesions appear as ROUND, spiculated masses. They are NOT wedge-shaped which characterizes a pulmonary embolis
itral regurgitation

ontrol of D.M. has uncertain effect on macrovascular complications (myocardial infarction, stroke), and all-cause mortality.
here will be multiple nonenhancing brain lesions with no mass effect(edema).
se an abdominal x-ray to diagnose Inflammatory bowel disease.
hysical exam findings show colon distension. Toxic megacolon is the initial presentation of inflammatory bowel disease.
ke pap smear every 3 years at age 21-65.
dap starts at age 11, and then you get a new one every 10 years thereafter.
hylene glycol poisoning is associated with hypocalcemia, calcium oxalate deposition in the kidneys. This leads to flank pain, hem
dminister fomepizole or ethanol to inhibit alcohol dehydrogenase, sodium bicarbonate to alleviate the acidosis.
atients with cyanide poisoning present with elevated lactate levels because they do not undergo oxidative phosphorylation due
ST/ALT ratio<1 in non-alcoholic fatty liver disease.
onalcoholic fatty liver disease.
onalcoholic fatty liver disease can be explained by obesity.
hese agents are used for muscle paralysis during endotracheal intubation and surgery.
ontact dermatitis
adiation therapy is useful in managing bone pain in patients with prostate cancer who have undergone orchiectomy
en <40, woman age <50, atypical chest pain, and no sigifnicant cardiac risk factors (non-smoker, no family hx)
ulmonary aspergillosis presnts with >3 months of weight loss, cough, hemoptysis, and fatigue in patients with hxof underlying lu
eudomonas aeruginosa
omerular hyperfiltration
chemia of the esophagus or exposure of gastric mucosa to various injurious agents (alcohol, ASA, cocaine) will cause acute eros
bromyalgia is defined by chronic pain in many locations , including the proximal body parts.
ny time a patient has chronic pain, give them amitriptyline. Then, the alternatives after that include pregabalin, duloxetine, and
onioscopy is the gold standard for diagnosis, and ocular tonometry can be helpful if urgent consult is not available.
aget's disease of the bone
acterizes a pulmonary embolism.

, and all-cause mortality.

matory bowel disease.

ys. This leads to flank pain, hematuria, oliguria, and acute kidney injury, and anion gap metabolic acidosis.
e the acidosis.
oxidative phosphorylation due to inhibition of complex IV in the E.T.C.

rgone orchiectomy
no family hx)
atients with hxof underlying lung disease.

cocaine) will cause acute erosive gastropathy.

de pregabalin, duloxetine, and milnacipran.

t is not available.
What is the next step in management after you have clinically determined a paGive them glucocorticoids, don't proc
A patient is suffering from a renal calculus. What is the best treatment in helpiGive an alpha-1 antagonist called Tam
Patient has both proteinuria and hematuria, what is their diagnosis? Diagnosis is kidney disease because p
Papillary necrosis can be diagnosed with certain risk factors. Pneumonic is NSANSAIDS, SICKLE CELL DISEASE, ANALG
Essential tremor is characterized by what type of movements? Essential tremor is suppressed at rest
What is the second line treatment for essential tremor? Primidone and topiramate
Acute coronary syndrome may present atypically. What are the causes? Abdominal pain/vomiting are atypica
In the basence of an advanced directive, how do you treat a jehova's witness? Give life-saving blood transfusion in a
For patients experiencing pulmonary thromboembolism and kidney disease (GF Unfractionated heparin is better than
Pernicious anemia is the msot common cause of vitamin B12 deficiency in patie glossitis, autoimmune conditions like
ve them glucocorticoids, don't proceed with any physical exam findings stuff like E.S.R. (treat the patient not the monitor)
ve an alpha-1 antagonist called Tamsulosin to relax the bladder.
agnosis is kidney disease because patient presents with both hematuria and proteinuria. Urinary bladder infections typically oc
sential tremor is suppressed at rest and worsened with activity. This is in contrast to parkinson's disease, which is characterized
imidone and topiramate
bdominal pain/vomiting are atypical presentations of acute coronary syndrome. The pain is sudden and severe.
ve life-saving blood transfusion in an emergency if no advanced directive exists. Fiancees do NOT count as legal decision maker
nfractionated heparin is better than Xa inhibitors, LMWH. Fondaparinux is a L.M.W.H. Rivaroxaban is Xa inhibitor.
ossitis, autoimmune conditions like vitiligo or thyroid disease, and neurological abnormalities.
patient not the monitor)

bladder infections typically occur in older people.

disease, which is characterized by resting tremor.

n and severe.
count as legal decision makers, so you cannot count their opinion.
n is Xa inhibitor.
What is the strongest predictor for stent thrombosis within the If you prematurely discontinue the antiplatelet ther
Primary hyperthyroidism is different from secondary hyperthyr Primary hyperthyroidism occurs at the level of the t
When a patient is angry, how do you respond? Acknowledge their anger and respond using an ope
Inflammatory bowel disease can present with what other disor I.B.D. can present with arthiritis. Treatment with NS
Heart failure symptoms that occur in the absence of hyperteni Amyloidosis occurs in a patient with heart failure sy
G.B.S presents with what lab values? G.B.S presents with elevated protein and NORMAL l
A middle-aged woman pesents to your office with intense itchinP.B.C. - diagnosed with anti-mitochondrial antibodie
Diabetic foot ulcer should be diagnosed with what tool? Monofilament testing
Haloperidol will treat what disorder that involves medications, Haloperidol treats delirium.
Follicular carcinoma is defined by what histologicla presentatio Follicular carcinoma is defined by invasion of the th
Osteopphytes are the most common findingso n cervical radiogrSpondylosis affects people older than 50 years of ag
What's the next best step in management of a patient's urinary urinalysis and culture.
What is the difference between CT and MRI use? CT is best test for initial imaging study and MRI is m
When do ou use a CT scan? Use a CT scan when patient has an unprovoked first
Patients with aortic stenosis will eventually develop what prob Patients with aortic stenosis develop left ventricular
Presbyopia is a common age-related problem that leads to diffi Patients with presbyopia have problems with lens e
ely discontinue the antiplatelet therapy, you will be at risk for stent thrombosis. These antiplatelet therapy include Aspirin and P
hyroidism occurs at the level of the thyroid; secondary hyperthyroidism occurs at the level of the pituitary.
eir anger and respond using an open-ended question; "May I ask what is upsetting you to help you the best way I can?"
nt with arthiritis. Treatment with NSAIDS may exacerbate the underlying disease.
urs in a patient with heart failure symptoms who lacks a history of hypertension.
with elevated protein and NORMAL lab values elsewhere (wbc, rbc, glucose)
ed with anti-mitochondrial antibodies.

ats delirium.
oma is defined by invasion of the thyroid capsule.
ects people older than 50 years of age, the history of the chronic neck pain is typical. Limited neck rotation and lateral bending i

or initial imaging study and MRI is more sensitive in most structural causes of epilepsy , and is the neuroimaging modality of cho
hen patient has an unprovoked first seizure to exclude acute neurological problems.
rtic stenosis develop left ventricular hypetrophy and can have exertionl angina due to subendocardial ischemia with increased m
esbyopia have problems with lens elasticity.
t therapy include Aspirin and Platelet P2Y12 Receptor Blocker (Clopidogrel, Prasugrel, Ticagrelor).

ou the best way I can?"

rotation and lateral bending is due to osteoarthritiis and secondary muscle spasm.

neuroimaging modality of choice in elective situations.

rdial ischemia with increased myocardial O2 demand during exercise.

Cushing patie Cushing patients are at risk for increased rate of fungal infections.
Women with Cu Women will present with acne type features like PCOS because androgens are secreted with cortisol.
Tick-borne parTick-borne paralysis is characterized by ascending symmetrical paralysis that takes hours. G.B.S. is an a
What is treat IV immunoglobulin or plasmapharesis.
Staph aureus Stapha ureus can make a nodular infilrate with cavitation
Interstitial c Interstitial cystitis presents as chronic pain that last a period of months.
What is the uriThe urinalysis results are normal in a patient with interstitial cystitis.
Interstitial cy Interstitial cystitis is relieved by voiding. Dyspareunia, urinary frequency/urgency can also be present.
What is the vaGive the mengincoccal vaccine following splenectomy, PCV-13 first, and H. influenza type B in 2 weeks
Prolonged imm Prolonged immobilization can lead to hypercalcemia.
ens are secreted with cortisol.
that takes hours. G.B.S. is an ascending symmetrical paralysis that takes days to weeks.

y/urgency can also be present.

H. influenza type B in 2 weeks.
Laxative abuse can be physically identified on exam by what find
Laxative abuse is associated with dark brown discolor
Laxative abuse can show up during what part of the day? Laxative abuse shows up as a NOCTURNAL diarrhea.
What is the difference in the serum ion gap between osmotic In secretory diarrhea, the serum osmotic gap is lowe
Cardiovascular disease is the most common cause of death in a) Dialysis Patients and b) Renal Transplant patients a
Empyemas are exudative effusions that contain what glucose Empyemas contain low glucose concentration becaus
Low D-xylose in urine implies what kind of disease? A low d-xylose in the urine is associated with small in
Lateral epicondylitis can be elicited by what movements? Passive flexion or resisted extension at the wrist can
What is the treatment for pseudomonal infection? IV Ciprofloxacin
What type of patients are susceptible to pseudomonal infecti Pseudomonal infections are more prevalent in diabeti
Constrictive pericarditis will show up with what signs and sy Presence of hepatojugular reflex, Kussmaul's sign, pe
Left ventricular aneurysm occurs how many days after the myoc 5 days through 3 months
What disease should be considered in patients who presents a1-anti trypsin deficiency
with dark brown discoloration in the colon also called melanosis coli. However, VIPomas are associated with tea-colored stools d
NOCTURNAL diarrhea.
um osmotic gap is lower than in osmotic diarrhea because ions are secreted into the stool. SOG = plasma osmolarity - stool osm
al Transplant patients are most prone to death from cardiovascular disease
e concentration because of the high metabolic activity of leukocytes and bacteria within the pleural fluid.
associated with small intestinal mucosal disease, whereas normal d-xylose in the urine characterizes enzymatic disease
ension at the wrist can reproduce lateral epicondylitis.

more prevalent in diabetics or immunosuppressed patients.

flex, Kussmaul's sign, pericardial knock (mid-diastolic sound).
iated with tea-colored stools despite also being associated with hypokalemia.

plasma osmolarity - stool osmolarity, implying that stool osmolarity increases in secretory diarrhea.

zes enzymatic disease

Paget's diseasSerum calcium levels will be normal.
In what disea Paget's disease of the bone.
Multiple myelMultiple myeloma is characterized by osteolytic lesion on exam.
Multiple myelNeoplastic cells invade the bone marrow which causes hypogammaglobulinemia.
Spontaneous poorly controlled hypertension presents with occipital headache, neck stiffness, nausea/vomiting, nys
Patients with Immediate defibrillation
Patients with Synchronized cardioversion
Spinal epidur Staph aureus.
What is the t se mefloquine chemoprophaylaxis until 4 weeks after return.
stiffness, nausea/vomiting, nystagmus, and ipsilateral hemiataxia.
Patients with hypoalbuminemia present with what lab value for calcium?
What is a nightmare disorder?
In nightmare disorder, what happens when child awakes?
Nightmares that occur during REM sleep are more frequent when?
Sleep terror disorder is characterized by what type of awakenings?
Sleep terror disorder is what type of arousal disorder?
Complications of oxytocin use include what signs and symtoms?
Treatment for anal fissures include what?
How does cat-scratch disease, caused by Bartonella henselae, present?
What is the treatment for cat-scratch disease?
vaginal atrophy can be caused by what finding?
Oral contraceptives can lead to what physical exam finding?
Acute strress disorder is what type of response?
Patients with hypoalbuminemia present with decreased total serum calcium.
A diagnosis requires recurrent episodes of awakening from sleep with recall of highly disturbing and frightening dre
Chhild is fully alert, remembers the dream, and can usually be consoled.
In the second part of the night
Sleep terror disorder involves incomplete awakenings, unresponsiveness to comfort, and no recall of dream conten
Sleep terror disorder is a non-REM arousal disorder.
tachysystole, hyponatremia, and hypotension
increased fiber and fluid intake, stool softeners, sitz baths,and topical anesthetics and vasodilators (nifedipine, nitro
C.S.D. commonly presents with a mild papular or nodular skin lesion and ipsilateral lymphadenitis of gradual onset.
estrogen deficiency
oral contraceptives can lead to hypertension and discontinuing its use can correct the problem in most patients.
A.S.D. is an anxiety response characterized by experiencing trauma, dissociation, negative mood, avoidance, and hy
turbing and frightening dream content.

no recall of dream content.

sodilators (nifedipine, nitrogylcerin).

hadenitis of gradual onset.

oblem in most patients.

e mood, avoidance, and hyperarousal lasting >3 days and <1 month after exposure to a traumatic event.
Treatment for patients with IV diuresis and possible vasodilator therapy (nitroglycerine, nitroprusside)
Cardiac amyloidosis should beCardiac amyloidosis should be suspeced in patients with diastolic dysfunction, EKG fin
First line treatment for osteoaNSAID called diclofenac
Patients with I.B.S. will pre I.B.S. patients present with symptom improvement after bowel movement.
What is the prefered treatmenThe preferred treatment for Paget's disease of the bone are bisphosphonates which p
Chronic low back pain in a yo Ankylosing spondylitis
Spinal cord compression is chIf patient has UMN signs/symptoms bilaterally in lower extremities, it is a sign of spina
How do you diagnose spinal Use MRI
What disease is associated w H.C.V.
How is patellofemoral syndr Extension of the knee while compressing
Asthma-like symptoms can beAspirin
e, nitroprusside)
diastolic dysfunction, EKG findings of increased ventricular wall thickness, normal left ventricular caity dimensions, and low volta

bowel movement.
re bisphosphonates which prevent bone turnover

tremities, it is a sign of spinal cord compression.

caity dimensions, and low voltage on EKG.
Elderly patients are at an increased risk of what type of h Subdural hematoma
Delayed sleep phase syndrome patients are normal in some sDelayed sleep phase patients sleep normal when they
If digital clubbing is identified on PE, what is the diagnostic occult malignancy
AIHA and hereditary spherocytosis are bth classified as wha extravascular hemolytic anemia
Patients with peptic ulcer disease from upper GI bleed may Elevated BUN/CR finding because of the breakdown of
The mcc of hyperkalemia include what problems? acute or chronic kidney disease, medications, disorders
Persistent depressive disorder lasts how long? Persistent depressive disorder lasts >/2 years.
Consider multiple system atrophy when a patient with Parki orthostatic hypotension, impotence, incontinence, or o
In a patient with diabetes controlled with diet, what is the mo multiple system atrophy
A young woman with chronic pelvic pain will be diagnosed wEndometriosis
A young woman with chronic pelvic pain will require what diLaparoscopy
Infertility is commonly the sole presenting symptom of whatendometriosis
Reye syndrome should be diagnosed in what kind of patient Young patient taking ASA
What type of immunodeficiency would predispose a patient Xt -linked agammaglobulinemia
Small for gestational age infants may have complications wh hypoxia, polycythemia, hypoglycemia, hypothermia, an
Squamous cell carcinoma can arise in what type of skin? chronically wounded, scarred skin.
Patients with hypertension and hypokalemia should be evaluHyperaldosteronism which causes hypokalemia.
In lynch syndrome, what are female carriers at risk for? Female carriers in lynch syndrome are at risk for endom
Lower urinary tract symptoms include urinary urgency, hesitancy, nocturia, and weak urinary
sleep normal when they have their on schedule on the weekends.

ause of the breakdown of hemoglobin in the intestine and increased urea absorption
se, medications, disorders of the RAAS axis.
r lasts >/2 years.
otence, incontinence, or other autonomic symptoms.

lycemia, hypothermia, and hypocalcemia.

causes hypokalemia.
ome are at risk for endometrial carcinoma.
cturia, and weak urinary stream
How do you treat acyclovir nephrGive fluids to prevent dehydration
To treat hypokalemic metabolic aGive N.S.
Inferior wall MI will show on EC ST Elevation in leads II, III, avF
Posterior wall MI shows as what ST depression in leads I and aVL (R.C.A.)
GI blood loss in an old man may iron deficiency anemia
What scoring system tells us if t chads-2-vasc score
What drug should be used in pat Warfarin
ACUTE onset urinary retention inThe medication (diphenydramine) is an anti-muscarinic which will cause an acute o
Glucocorticoids support the margneutrophils
Most important prognostic featurTNM staging
Bartonella henselae and bartonelimmunocompromised individuals will be infected with bartonella henselae and ba
E. histoloytica is described by w E. histoloytica is described by a solitary cystic lesion on the liver.
Subdural hematomas result fromSubdural hematomas result from chronic bleeds
Anti-epileptic drugs such as phe Phenytoin may impair absorption of Folate causing folic acid deficiency.
Lactose intolerance is defined by Positive hydrogen breath test would define lactose intolerance.
hich will cause an acute onset of urinary retention. This causes detrusor hypocontracility.

rtonella henselae and bartonella quintana

cid deficiency.
levi/carbidopa lead to what side effects? hallucinations
use abd CT with contast to diagnose what diverticulitis
Community acquired pneumonia can be diChest X-ray
patients with cocaine will be at risk for w rhabdomyolysis
patients with HCV is at risk for what iseaseHBV
In patient with acute exacerbation of COP Start with non-invasive positive pressure ventilation, then transition to in
Wasting of muscles can be due to what typUMN or lMN
Vitamin b12 deficiency can result from wh Gastrectomy can lead to vitamin b12 deficiency. On PE: patient shows sh
CABG vs. medical therapy - what is the shoIn the short term, CABG leads to higher risk of death in first 30 days (HR i
Renal tubular compensation occurs within Compensation for respiratory acidosis occurs within a few days
Why does a patient present to the office wFamily history
Insulinoma and sulfonyurea patients both Elevation in c-peptide is apparent in insulinoma and sulfonylurea patient
Glucagonoma presents with what skin findGlucagonoma produces a skin rash(necrotic migratory erthema)
How is scabies diagnose? Scabies is an intensely pruritic rash in the flexor surfaces of wrist, lateral
What is the treatment for scabies? Topical permethrin or oral ivermectin
In A.T.N. what is the serum BUN/Cr ratio? Less than 20:1 because BUN is not reabsorbed.
trauma patient comes in with bleeding andAcute tubular necrosis
H.C.M. will present with what type of mu crescendo-decrescendo murmur in lower left sternal border.
A leukemoid reaction can be identified by leukemoid reaction is defined by elevated alkaline phosphatase and decr
What are the difference causes of anion g Anion gap metabolic acidosis is defined by an increase in non-chlorinated
Thalamic lesion will cause what problems?contralateral sensory loss
HOCM is treated with what medications? B-blocker: Metoprolol
Bath salt intoxicatino makes you feel what Bath salt intoxicatino is like taking amphetamines
If you screw up how do you respond to patBe tactful in how you say it, don't just say the doctor forgot; tell patient w
ntilation, then transition to intubation if NPPV for 2 hr fails.

ency. On PE: patient shows shiny tongue and pale palmar creases
of death in first 30 days (HR is greater than 1)
rs within a few days

oma and sulfonylurea patients.

migratory erthema)
exor surfaces of wrist, lateral surfaces of fingers, and finger webs. Patients have ecoriations with small, crusted, red papule arou

ft sternal border.
lkaline phosphatase and decreased basophils
an increase in non-chlorinated ions in the serum. These include lactate, acetic acid, formic acid, glycol ingestion, salicylic poison

he doctor forgot; tell patient we will talk toPCP

mall, crusted, red papule around affected areas.

ycol ingestion, salicylic poisoning, h+

Toxic adenomaunilateral adenoma indicates autonomous production of thyroid hormone from toxic adenoma.
Patients with increased fluid intake, decreased sodium intake, normal dietary calcium intake
Clopidogrel b ADP Receptors
Direct thrombiArgatroban, Bivalirudin, Dabigatran(oral)
Indirect FactoFondaparinux
How do you trGive Adenosine
Patients with restore coronary blood flow and primary percutaneous intervention
How do you knYou see itchy, red-brown rash due to helminth infection
What medicatIn African american - hydralazine and nitrates, and mineralcorticoid receptor antagonists
If cd4+<50 wha MAC - therefore give azithromycin
if cd4+<200 wPCP - give TMP-SMX
Diverticulosis Divertuclosis is strongly associated with chronic constipation which can be avoided with fiber. Compl
A 21 y.o patie infectious mononucleosis.
How do you trGive warm compresses to treat a stye (red tender bump on lower eyelid)
Patient's wit Decreased bone density, elevated alkaline phosphatase, and low serum calcium and phosphate
First line ther Sildenafil (PDE-5 inhibitor)
What is the t Urinary catheterization
ne from toxic adenoma.

eptor antagonists

n be avoided with fiber. Complications are reduced with high intake of fruit and vegetable fiber, meat consumption, NSAIDS, obe

calcium and phosphate

eat consumption, NSAIDS, obesity, smoking.
Polycystic kidney disease wills how with what signs a Patient will have high blood pressure, palpable flank mass, a
A young woman complains of numbness and pain in herTakayasu
up arteritis
Stable patient with wide-complex tachycardia should b amiodarone, procainamide, sotalol, lidocaine
Synchronized electrical cardioverion should be indicat persistent tachyarrhthymia or severely symptomatic (AMS, h
Idiopathic intracranial hypertension (pseudotumor cer Treat IIH with acetazolamide+/furosemide. Patient presents
What types of patients are at risk for IIH? Obese patients
What ocular condition is associated with neurofibromatOptic glioma
Retinal hamartoma is typical for what disease? Tuberous sclerosis
What risk factor is associated with highest risk of ane Active smoking.
N.M.S is caused by use of what class of drugs? Dopamine antagonists cause N.M.S.
Hemodynamically unstable patients who may be candida pericardiocentesis
Aoric dissection patient who is hemodynamically stabl Ct angiogram
Patients with HIV are at increased risk of pulmonary is Community-acquired pneumonia caused by strep pneumon
Pregnant patients diagnosed with lyme disease are tre Amoxicillin
Routine HIV screening is recommended for what patienHIV screening is recommended for all patients aged 15-65 y.
HPV infection can occur on what body parts? HPV infection can occur on the plantar surface and cause wa
Complicated parapneumonic effusions and empyemas pChest x-ray shows loculation, thoracocentesis reveals exudati
Most complicated parapneumonic effusiona dn empyem Chest tube drainage and antibiotics
Nephrotic syndrome patients are at risk of developing Hypercoagulability
ressure, palpable flank mass, and enlarged liver due to cystic involvement.

otalol, lidocaine
severely symptomatic (AMS, heart fialure, pulmonary edema, ischemic chest pain) or hemodyanmically unstable (hypotension,
/furosemide. Patient presents with headaches for last 6 weeks. And the headaches are pulsatile and associated with nausea. F

onia caused by strep pneumonia

d for all patients aged 15-65 y.o. regardless of risk factors

e plantar surface and cause warts.
thoracocentesis reveals exudative fluid with low glucose(<60 mg/dL) and low pH(<7.2)
mically unstable (hypotension, sign of shock).
and associated with nausea. Fundoscopy will show papilledema.
Ankle pain from gout can occur in what areas of Ankle and big toe
A patient is at risk for gout when he is in what s A patient who was recently admitted to the hospital can be at risk
How do you decrease your risk for gout? Dairy product intake, Vitamin c, coffee intake
Vitiligo is what type of disorder? Vitiligo is an autoimmune disorder.
How do you treat vitiligo? Treat vitiligo with Corticosteroids
How do you increase sensitivity of a test by look Move the curve upward
How do you know a test is accurate on the ROC c Look at the total area under the ROC curve.
Thyrotoxicosis can cause other problems with theAtrial fibrillation/flutter or increased myocardial contracility.
In sickle cell disesase what other deficiency can Folate deficiency can occur in sickle cell disease.
A patient presents with dyspnea, chest pain, heopt pulmonary embolism
Symptoms VIPOMA include what? muscle weakness/cramps (due to hypokalemia), hypochlorhydria (
What is the treatment of choice for Dressler's synNSAIDS
What is the diagnostic finding of pericarditis? Any time symptoms iMPROVE when the patient leans forward, po
PE that shows systolic-diastolic bruit may indica Renal artery stenosis
Disease that is resistant to >/3 anti-hypertensive Renal artery stenosis
Carcinoid syndrome presents with what findings episodic flushing, secretory diarrhea, wheezing, and murmur of tr
Patients with thromboembolic disease and recu progressive dyspnea and deceased exercise tolerance.
Right-sided infective endocarditis is associated IV drug use
Bilateral PE findings of decreased breath sounds aCongestive heart failure
Pneumothorax presents with what PE findings? hyperresonance to percussion, diminished tacile and vocal fremitu
Dullness and decreased breath sounds are present When transudate effusions are present from hepatic hydrothorax
Heart failure signs and symptoms include increased JVP, S3, bilateral crackles
Alcoholic cardiomyopathy may be a synonym for Heart failure
Hepatopulmonar syndrome results from what finintrapulmonary vascular dilations in setting of chronic liver disease
Patients presenting with rapid worsening of res Secondary spontaneous pneumothorax which occurs due to ruptu
Patient can hear their heart beating on left later Aortic regurgitation
What chronic airway disease can cause hemoptysiChronic bronhcitis
This disease presents with progress hip pain tha Diagnosis of Avascular Necrosis.
dmitted to the hospital can be at risk for gout
c, coffee intake

he ROC curve.
reased myocardial contracility.
sickle cell disease.

e to hypokalemia), hypochlorhydria (due to decrased gastric acid secretion).

when the patient leans forward, post-infarction pericarditis is a choice to be considered.

arrhea, wheezing, and murmur of tricuspid regurgitation

eased exercise tolerance.

n, diminished tacile and vocal fremitus, decreased or absent breath sounds in affected area.
e present from hepatic hydrothorax you will get diagnosis of hepatic hydrothorax

ons in setting of chronic liver disease.

mothorax which occurs due to rupture of alveolar bleb.
Initial treatm glucocorticoids
How do you diPolymyositis is an autoimmune disorder that involves inflammation of muscles which will elevate the
Polymyositis Polymyositis is associated with malignancy.
What is the clSymmetric proximal muscle weakness (cannot comb hair, lift shoulder, walk up stairs)
What is the grHistory of travel (remember what the nurse in San Diego asked you?) - Mexico, Philippines, China, Vie
Glioblastoma G.B.M. presents with classic butterfly appearance.
What disease Coarctation of the aorta
The most comm oropharyngeal candidiasis.
What is a uni Hepatic failure, ANCA-associated vasculitis
What types ofPatients at increased risk of contracting hepatitis A viruses including MSM, travelers to countries whe
Polycythemia polycythemia vera is a polcythemia purely based on the upregulation of JAK-2 tyrosine kinase, not on
How do you trGive IVC filter.
An HIV infect Primary CNS lymphoma
Several randoACE inhibitors should be used to slow the progession of diabetic nephropathy
An abnormal fS4 heart sounds can be heard during the acute phases of myocardial infarctions due to left ventricular
Acute coronarFourth heart sound
RedistributionCoronary steal syndrome
Persistent pa Trazodone
Squamous cellTobacco and alcohol use
What are the Worsening of HTN, headaches, and flu-like symptoms
What is the fi Methotrexate; if inadeqaute response switch to alternative TNF-a inhibitor and continue MTX.
Tension pneum Hyperresonance to percussion, diminished breath sounds, decreased tactile vocal fremitus, hypotens
MCC of lower Diverticulosis (which is typically painless, but may be associated with lightheadedness and hemodyna
What is the mDiverticular hemorrhage resolves spontaneously but occasionally requires endoscopic or surgical inte
A patient expeMPO causes excess urate production which would cause gout.
What drug doAtropine is an anticholinergic that serves as a mydriatic (dilates the pupil)
muscles which will elevate the ESR and CK values. Patient will be a young woman who presents with progressive weaknes for th

walk up stairs)
Mexico, Philippines, China, Vietnam, India, Dominican Republic, Haiti)

SM, travelers to countries where hepatitis A is prevalent. Also for adults with chronic liver dz.
f JAK-2 tyrosine kinase, not on hypoxia.

arctions due to left ventricular stiffening and dysfunction induced by myocardial ischemia.

tor and continue MTX.

actile vocal fremitus, hypotension: decreased V.R.
ghtheadedness and hemodynamic instability)
res endoscopic or surgical intervention.
ith progressive weaknes for the past several months.
How do you trStop all heparin products and start a direct thrombin inhibitor like argatroban or findaparinux
How do you trTopical clobetasol (high potency glucocorticoid)
What is the bePanendoscopy is used for patients with suspected squamous cell carcinoma.
Graves diseas Anti-thyroid drugs such as methimazole and PTU. RAI is used in significant hyperthyroidism at significa
Infectious ep sore throat, fever, muffled voice, drooling, stridor, hoarseness
Management Sotretch and strengthen the back muscles and aerobic conditionoing.
Niacin flush i Prostaglandin related reaction
When physiciaGastric outlet obstruction
Lewy Body disDementia shows up as lewy body disease and motor symptoms show up in Parkinson's disease.
roban or findaparinux

ant hyperthyroidism at significant risk of complications.

p in Parkinson's disease.
Drug-induced 1. i Pencillin class (penicillin, cephalosporin), 2. TMP, 3. Rifampin, 4. NSAIDS, 5. Diuretics
In drug-induceeosinophils
Patient with Total body K+ Deficit.
A patient deveRuptured popliteal cyst
Recurrent misLow molecular weight heparin.
What is the p Low dose ASA and LMWH are recommended to avoid pregnancy loss.
What is the prTicks shuold be removed with tweezers as soon as they are noticed to reduce the risk of a tickborne il
How does MLFIn MLF the affected eye cannot adduct, whereas the non-affected eye will abduct. Therefore, if left ey
Central DI ca Serum Na is high in cetral DI
NephROGEIC DI Nephrogenic DI presents with normal serum na+
Acute angle c Acute angle closure glaucoma occurs in response to anti-cholinergics or another stimulus(dim light).
Untreated patAcute vision loss within 2-5 hours of symptom onset.
Temporal arterESR>50 in temporal arteritis
optic neuriti acute vision loss, pain, afferent pupillary defect in women <50 afte presentatin of M.S.
Patients with Upper GI endoscopy if they have alarm symptoms - dysphagia, odynophagia, weight loss, anemia, GI b
In aortic diss In aortic dissection, the treatment goal is to decrease blood pressure by using a Beta Blocker. Avoid va
a 23-year old cavernous sinus thrombosis
Atrial fibrill hyperthyroidism
HyperthyroidiHypertthyroidism is characterized by proximal muscle weakness and muscle atropy.
Opiod intoxicaDecreased respiratory rate
What two opioMethadone and Buprenorphine
Ulcerative col 15-40 and 50-80.
Ulcerative col Recto-sigmoid involvement.
What procedur Use ERCP to diagnose biliary or pancreatic cause of abdominal pain post-cholecystectomy.
DS, 5. Diuretics

educe the risk of a tickborne illness. Antimicrobial prophylaxis for Lyme disease is not required if the tick is attached for <36 hou
will abduct. Therefore, if left eye cannot adduct towards right then there is dx of internuclear opthalmoplegia.

r another stimulus(dim light). Patients develop orbitofrontal headache associated with vomiting.

entatin of M.S.
hagia, weight loss, anemia, GI bleeding, recurrent vomiting) or are men age >50 with chronic (>5 years) symptoms and cancer ri
y using a Beta Blocker. Avoid vasodilator like hydralazine and nitroprosside because these drugs produce reflex tachycardia.

uscle atropy.

the tick is attached for <36 hours.

years) symptoms and cancer risk factors (tobacco use).

oduce reflex tachycardia.
Weakly acid cast orgaNocardiosis
How do you treat NoTMP-SMX
What diagnostic testUltrasound
What diagnostic test CT with contrast because this condition involves dye that messes up the kidneys.
Giant cell arteritis headache, ESR elevation, fatigue, and weight loss. Shoulder muscles will feel stiff in the mornin
Giant cell arteritis Aortic aneurysm is associated with giant cell arteritis.
Treatment for active Octreotide
If octreotide is not Endoscopy for esophageal varices
If after endoscopy paB-blocker, balloon tamponade, TIPS or shunt surgery
Patient with first ti Colonscopy
Catheter associated Clean intermittent catheterization
What types of patienHIV patients, or patients with cellular immunodeficiency.
Autoimmune adrenalEosinophilia,
i and hyperpigmentation
Patient with elevatedcholestasis
The causes of cholestinside the liver and outside the liver
If patient has diarrh C. difficile colitis
Trastuzumab side effeUse echocardiography with trastuzumab
Patient with subauricFibromuscular dysplasia.
Diagnosis of F.M.D. duplex US, C.T.A, M.R.A, catheter based arteriography.
F.M.D. presents withF.M.D will cause headaches due to internal carotid artery stenosis and secondary hypertension
Greasy rash on an er seborrheic dermatitis.
This rash is associat Seborrheic dermatitis.
What is the treatmenTopic antifungal treatments (ketoconazole, selenium sulfide)
What is the treatmenWrist splinting
What treatments areNSAIDS like indomethacine
Can glucocorticoids Yes, glucorticoids can treat carpel tunnel syndrome but they only treat secondary to wrist splin
Anterior spinal cor flaccid paralysis and loss of p/T below level of spinal cord
Flu virus can infect Flu virus infects people above age of 65.
How is gilbert treate Reassurance and supportive care.
When jaundice is prov Gilbert's syndrome
l feel stiff in the morning.

econdary hypertension due to R.A.S.

secondary to wrist splinting measures.

Simple renal cysts require what treatment? Reassurance only - they are not multilocular like complex renalc ysts
Prolonged QRS interval and dry mucosa with TCA d toxicity
Scleroderma is a multi -system disorder thatRestrictive lung disease
In alcoholic liver disease, the AST and ALT v AST and ALT are less than 500
Porcelain gallbladder is a sign of what disea Gallbladder adenocarcinoma
Patienets with C.A.P. hospitalized on the me Fluoroquinolone or a beta lactam plus macrolide
Patient with drug abuse and white patches i Kaposi's sarcoma.
ACE inhibitors side effects include? Angioedema caused by ACE inhibitors lead to facial edema.
Osteoarthiritis will present with nodes at th Alphabetically, bouchard is more proximal and heberden is distal.
nucleic acid amplificatino shows urethral dis Chlamydia does not show up on urine culture, but gonnorhea does.
Case control - study comparing an outcome (fExposure odds ratio is used
Patients with diabetic nephropathy require Patients with diabetic nephropathy require strict blood pressure contro
Proteinuria in diabetic nephropathy may cauGFR will decline with increases in proteinuria. This is also why ACE/ARB
What is the site of a. fib origination? Pulmonary veins
Spinal cord compression can occur from trauBilateral lower extremity weakness = spinal cord compression
Central cord syndrome is identified by what upper extremity motor weakness is more pronounced than the lower.
Marine infection causing cellulitis vibrio vulnificus
What is the treatment for vibrio vulnificus? Ceftriaxone and doxycycline for the cellulitis.
Patients with liver disease such as cirrhosis, V. vulnificus
What happens when you correct hyponatremi Water will move from the ICF of the cell to the ECF causing cell damage
What is the treatment for osmotic demyelin Give 3% or hypertonic saline at a rate of no more than .5 mEq/L/hr to a
Sialadenitis is caused by what risk factors? Sialadenitis is caused by benign liver disease which can be caused by a
Arterial ulcers occur in what part of the bod Distal extremities, for example the toes
Venous ulcers occur in what parts of the bo They are common over pre-tibial areas over medial malleolus
Pressure ulcers risk factors impaired mobility, malnutrition, AMS, decreased skin perfusion, reduc
Rotator cuff tears usually occur when/ Rotator cuff tears usually occur inpatients age >40 with fall on outstret
What test cnfirms diagnosis of rotatorciff teaMRI of shoulder
Patients with U.C. Should be diagnosed with colorectal cancer
When patient has a negative straight leg rais lumbosacral strain
Patient has high post void residual volume a Neurogenic bladder dysfunction due to DM
What diagnostic test do you use to diagnose M.R.I.
When do you use a carotid doppler ultrasou Patient has suspected stroke.
patient has a prolonged QRS duration and i Na channel blocker like flecainide, which will prolong QRS duratino.
High frequency hearing loss that affects adultPresbyacusis
r like complex renalc ysts

to facial edema.
nd heberden is distal.
re, but gonnorhea does.

strict blood pressure control.

ia. This is also why ACE/ARB must be initiated carefully because they also initiate a decline in GFR.

cord compression
ronounced than the lower. There isa lso localized deficit in pain and temperature sensation.

he ECF causing cell damage.

more than .5 mEq/L/hr to avoid CNS osmotic demyelination syndrome
e which can be caused by alcoholism.

medial malleolus
eased skin perfusion, reduced sensation.
ge >40 with fall on outstretched arm.

ll prolong QRS duratino.

ACL injury occACL injuries occur in athletes involved with pivoting their foot. They experience rapid onset pain with
Treatment forRICE(rest, ice, compression, elevation) +/- surgery
Transudative f7.40 - 7.55
What is the b Avoid exposure to birds.
perience rapid onset pain with popping sensation.
In hypertensive intracranial hemorr Global neurological symptoms which include stupor, A.M.S, etc. - anything whe
In patients with lacunar strokes, wh Focal neurological symptoms, for example muscle weakness are present in lacu
Lung consolidation presents with w Lung consolidation presents with dullness to percussion, increased intensity of
Pneumothorax is characterized by whDecreased breath sounds and decreased tactile fremitus.
What is the criteria for high risk s Age >60, smoking status is curent, smoking cessation <5 years, nodule margins
Patient in 30s with diplopia becaus myasthenia gravis
Idiopathic intracranial hypertension overweight women of childbearing age, possible link to certain medications (te
IIH symptoms shows what symptoms/ headache, transient vision loss, pulsatile tinnitus, diplopia
IIH shows what PE findings? papilledema, peripheral visual field defect, CN VI palsy
Diagnosis of IIH includes what techn MRI +/- M.R.V., LP (CSF>250 MMH2O with normal analysis)
Treatment of IIH Stop the offending medications, weight loss and acetzolamide for idiopathic ca
What is the diagnostic procedure forLumbar puncture, assuming no communicating or non-communicating hydroce
Arterial embolism presents with whaacute presentation of neurological problems
What are the six Ps of arterial embo pain, pallor, parasthesias, pulselessness, poikilothermia, paralysis
How do you manage acute limb isch Anticoagulation (heparin), thrombolysis versus surgery
Sporotriochiosis is decsribed as a d landscapers
Treatment for CO poisoning from so 100% hyperbaric oxygen
The most important test to perform C.B.C.
In a Non-African patient with thalas C.B.C.
In a patient of African descent, whatHB Electrophoresis
A patient diagnosed with post-ictal l Stop the offending medications, weight loss and acetzolamide for idiopathic ca
What is the treatment for patients Albuterol continuation
Horner's syndrome presents with whright shoulder pain radiates to the hand, constricted pupil, droopy eyelid
What diagnostic study do you use toObtain an abdominal ultrasound
The USPSTF recommends screening fo Former or active smokers aged 65-75 years old
What diagnostic test do you use to abdominal ultrasound, it's better than CT (not as dangerous and less expensive
Scleroderma with renal crisis may prSchistocytes
CML presents with what findings? Basophilia and a low LAP score.
Elevated ESR and proximal muscle wePolymyalgia rheumatica
What is the highest ESR value for m Males = 15; Females = 20
Cardiac index is a measure of what? Cardiac index is surrogate marker for myocardial contracility
Elevated PCWP occurs as a result o Myocardial infarction leads to elevated P.C.W.P.
Pulmonary embolism leads to decreas CI is typically low.
Volume depletion leads to what occuVolume depletion leads to decreased venous return to right atrium.
What is the treatment for R.A.S.? Give ACE/ARB
What is the secondary treatment forSurgical revascularization or Renal artery stenting (patients with recurrent flash
Which intervention decreases adverse pharmacist directed interventions
Decreaesd uptake of technetium-99 C.A.D. - treat with antiplatelet agent.
CML can present with what findings splenomegaly, fatigue, basophilia, leukocytosis, ETC.
Erysipelas is a well-demarcated rash Strep pyogenes
A young man in his thirties has high Coarctation of the aorta.s
e stupor, A.M.S, etc. - anything where the patient is unresponsive.
muscle weakness are present in lacunar strokes.
o percussion, increased intensity of breath sounds, and increased tactile fremitus
ctile fremitus.
cessation <5 years, nodule margins are irregular (corona radiata or spiculated)

sible link to certain medications (tetracyclines, hypervitamonisis A)

nitus, diplopia

normal analysis)
and acetzolamide for idiopathic cases
ting or non-communicating hydrocephalus

kilothermia, paralysis
sus surgery

and acetzolamide for idiopathic cases. NaHCO3 can be used by may cause myocardial depression.

nstricted pupil, droopy eyelid

ot as dangerous and less expensive)

rdial contracility

us return to right atrium.

enting (patients with recurrent flash pulmonary edema or refractory heart failure)
How do you diagnose S.C.C.? Give biopsy of lesion.
Vertebral compression fracture is a sign of whaAdvanced osteoporosis - low back pain after stressful movements.
What is the alternative treatment for syphillis Doxycycline
prolactinomas present with normal values of prolacatinoma present with normal TSH values and low LH values be
small intestinal disease and malabsorption can Calcium oxalate stones because of malabsorption of fatty acids and b
diastolic dysfunction High blood pressure with normal ejection fraction
Renal vein thrombosis is a common complicati Nephrotic syndrome is associated with renal vein thrombosis - neph
Renal vein thrombosis is associated with what Membranous nephropathy
Achilles tendinopathy can be caused by what dFluoroquinolones
r stressful movements.

ues and low LH values because low GnRH

rption of fatty acids and bile salts.

l vein thrombosis - nephrotic syndrome is characterized by wide-spread protein loss which leads to edema.
How do you screen for diabetic nephropathy? Random urine for microalbumin/creatinine ratio
65 year old man presents with decreased in vision i diabetic retinopathy
Ehlriciohiosis is like lyme disease in terms of locati Ehrlicihiosis presents without a rash
Ehlrichiosis presents with what PE findings/ leukopenia and thrombocytopenia
Treatment for ehrlichiosis Doxycycline
What criteria do we utilize to diagnose an exudative e Pleural protein/serum protein > .5, Fluid LDH/serum LDH >.6,
What type of pathologies represent exudative effusio increased capillary or pleural membrane permeability or disr
What pathologies represent transudative effusions? decreased intrapleural or plasma oncotic pressures or elevate
A patient is gaining weight despite increased thirst - t Diabetes
A female athlete is experiencing anterior knee pain - wpatellofemoral pain syndrome
What is the treatment for patellofemoral pain syndro Just imagine a female athlete overusing their muscles; best tr
Surreptitious vomiting leads to what levels of urinary urinary chloride is lower in surreptitious vomiting because pa
Bartter/gittelman/diuretics have one common feature.They all affect a transporter that affects na/cl reabsorption ba
Cirrhosis can lead to what findings on the physical ex hypogonadism despite having gynecomastia since the androg
Cirrhosis is associated with elevated level of what h Estrogen - due to increased conversion from androgens, whic
Who is at risk for developing PTSD? Returning combat veterans.
What are common symptoms of PTSD? amnesia, nightmares, sleep disturbance, irritability, emotiona
What skin disorder is characterized by diffuse dermal Ichthyosis vulgaris.
What are the treatment options for diffuse scaling disoEmollients, keratolytics, topical retinoids.
Atopic dermatitis distribution patchy symptoms of erythema, lichenification, and severe pru
Irritant contact dermatitis cause irritant contact dermatitis is caused by chemicals such as soa
Icthysosis vulgaris is symptoms diffuse dermal scaling
Treatment options for wide spread itching emollients, keratolytics, topical retinoids.
What are some important risk factors for diabetes? high blood pressure, obesity, family history, dyslipidemia.
Patients with asplenia are at risk of fulminant infecti Strep pneumoniae, h. influenza
What defense system is compromised in patients withAntibody response to encapsulated organisms.
A patient is experiencing recurrent pergnancy loss andHashimoto's - with subclinical hypothyroidism which implies
What is subclinical hypothyroidism? When the T4 values seem euthyroid but the patient is actuall
Lumbar spinal stenosis can occur when middle aged orAny activity that causes compression of that nerve (standing,
Ankle branchial index is used to evaluate what diseas Use ankle brachial index to evaluate peripheral vascular disea
When do you use dopper ultrasonography? D.v.t.
What diagnostic technique do you utilize to diagnose MRI
pleural effusions can be associated with empyemas, wh Empyemas show up when bacteria eat up surrounding glucos
Histoplasmosis is associated with what Laboratory fin Histoplasmosis can cause pancytopenia, and elevated aminot
Disseminated histoplasmosis is treated with what dru Amphotericin b
Diuretic therapy can lead to what downstream probl Diuretic therapy can lead to acute kidney injury, as evidence b
Lactose intolerance would show up in a patient with Could be a chronic problem lasting a few months
Lactose intolerance is identified on exam by what feat Bloating, flatulence after ingesting food.
What are the three most common cause of esophagitis1. candida, 2. CMV, 3. Herpes
Candida esophagitis is treated with what drug? fluconazole
What is the inclusion criteria for a patient to be plac Use of drug within 3-4.5 hours of symptom onset.
What is the first drug you use after the 4.5 hr throm ASA
What happens if ASA is not entirely effective for trea Add clopidogrel or dipyrimadole
What happens if ASA is not entirely effective for patienadd clopidogrel
Warfarin is indicated in what type of patient? Patient with atrial fibrillatinon or elevated CHAD-2 score
What's the role of CT scans in stroke patients? CT scans rule out hemmorhagic bleeds.
Obesity hypoventilation sndrome is defined by what f Obesity, daytime hypercapnia and alveolar hypoventilation.
Any disease with high levels of post-void residual vo There must be an obstructive lesion as in BPH or something e
Poison ivy will lead to linear streaks on hands - the di Contact dermatitis
What does the straight leg raise test test for? lumbosacral radiculopathy - inflammation of the appropriate
min/creatinine ratio

> .5, Fluid LDH/serum LDH >.6, Fluid LDH >2/3 (max serum LDH)
membrane permeability or disruption to lymphoatic flow
ma oncotic pressures or elevated H.S. pressures

overusing their muscles; best treatment is to reduce activity in those muscles and stretch.
rreptitious vomiting because patient is in hypovolemic state, which means he vomits out chloride, and less is available in his uri
hat affects na/cl reabsorption back into the blood stream. When this transporter is blocked, the chloride ends up in the urine.
gynecomastia since the androgens can still convert to estrogens.
onversion from androgens, which will display as gynecomastia.

sturbance, irritability, emotional numbing and detachment, intrusive flashbacks, hypervigilance, increased startle response

al retinoids.
a, lichenification, and severe pruritus involving hands, feet, and flexural areas
aused by chemicals such as soaps, detergents, or solvents.

al retinoids.
family history, dyslipidemia.

ulated organisms.
hypothyroidism which implies that the lab values for T4 may not yet be in hypothyroid range (it could seem cliincal euthyroid).
hyroid but the patient is actually a hypothyroid patient.
ression of that nerve (standing, walking downhill)
aluate peripheral vascular disease, which causes worsened pain with movmeent.

cteria eat up surrounding glucose in pleural fluid and increase production of metabolic break down products like lactate, produc
cytopenia, and elevated aminotransferase levels.

cute kidney injury, as evidence by elevation in creatinine.

sting a few months
s of symptom onset.

or elevated CHAD-2 score

and alveolar hypoventilation.

lesion as in BPH or something else.

nflammation of the appropriate nerve roots in ipsilateral leg in the lumbosacral region.
, and less is available in his urine.
hloride ends up in the urine.

ncreased startle response

ould seem cliincal euthyroid).

n products like lactate, producing very low levels of glucose and an acidic pH.
What is the prUrticaria presents as wide-spread papules or plaques.
What diagnostUse a CT scan for histological staging.
What is the mCalcium to stabilize the cardiac myocyte
Nitrates poss Nitrates decrease left ventricular wall stress
Nephrotic synNephrotic syndrome patients overproduce lipids, leadin to accelerated atherosclerosis
What disease Alpha-1- antitrypsin deficiency. It should be considered in patients who have COPD but lack typical ris
What are the These patients present with fatigue and delayed reflexes. Initial diagnostic testing includes TSH and fr
Elevated sedi polymyositis
Any patient wHypothyroid myopathy
Carpale tunnethumb opposition
Carpel tunnel Anatomic compression of the nerve.
Multiple myelhypercalcemia, anemia, renal insufficiency, and elevated protein(>4g/dL)
Silicosis is s miners and stone workers
Contrast proviIntravenous hydration.
IN a small dat The mean would increase
In pulmonary Prominent pulmonary arteries and an enlarged right heart border. EKG shows right axis deviation.
Tumors in theweight loss, jaundice, nontender distended gallbladder on examination.
Tumors in theTumors in the head of the pancreas cause intra-and extra-hepatic biliary tract dilation.
A patient wit Lower urinary tract symptoms (urinary frequency, nocturia, hesitancy)
Prostate-SpeciPotential for prostate cancer
The cystoscopCystoscopy is used for patients with bph who present with chronic bladder obstruction.
Prostate cancePatients age >40, African American, usually peripheral zone of prostate, enlarged nodules.
Hypothyroidishyperlipidemia, hyponatremia and asymptomatic elevations of creatinine kinase and serum transamin
Secondary hypprolactinoma
First treatmenNSAID
In developing Constrictive pericarditis
Calcifications constrictive pericarditis
What drugs poAcetaminophen, NSAIDS, amiodarone, antiobitics
Caustic poiso Caustin poisoning can cause perforation of the stomach or esophagus, causing peritonitis or mediasti
Inhalational Bitter almond odor
Electrical al QRS complexes vary from beat to beat.
Electrical alt pericardial effusion
Enlargement opericardial effusion
Prion disease Rapidly progressive changes, behavioral changes, myoclonus/seizures
Vascular demestepwise decline in executive function with mild memory loss early in disease.
Any rash that Chikungunya fever which shows with polyarthalgias and thrombocytopenia need supportive care fo
Treatment forDopamine agonists (pramipexole) or alpha-2-delta calcium channel ligands (gabapentin)
have COPD but lack typical risk factors or who have a family history of emphysema or liver disease.
tic testing includes TSH and free T4 lvels.

shows right axis deviation.

y tract dilation.

der obstruction.
enlarged nodules.
ne kinase and serum transaminase.

causing peritonitis or mediastinitis

enia need supportive care for 7-10 day

nds (gabapentin)
What disease is PAS+ and presents with sk Whipple's disease
What is the protocol for patient with infect Continue current therapy of IV antibiotics to reduce risk of cardiac embo
Squatting from standing position has what eSquatting increases preload
What effect does handgriip have on cardiacHand-grip increases afterload. Increased afterload decreases the intensi
What are the atypical murmurs? HCM, MVP - these get softer with increased intensity of bloodflow from
Acute rejection of renal graft should be tr Steroids
Renal biopsy of the transplant shows heavy Acute rejection of renal graft.
Chest pain that occurs after rest or meals G.E.R.D.
Treatment for GERD PPI (Omeprazole)
After a negative chest x-ray, what is the ne Give patient a C.T. scan to detect for risk of malignancy
If professional colleague inquires about theMake sure you give the patient's information confidential.
What is a dermatofibroma? firm, hyperpigmented nodule that is usually <1cm in diameter. They are
How do you diagnose a patient with coug This patient could have PCP and you want to give bronchoalveolar lavag
pcp infection dx - B.A.L.
A patient who is braind dead will still have Spinal cord
The benefit of PEEP is that it can reduce w PEEP reduces the FiO2 - in general FIo2 should not exceed 60%
A patient wakes up with a red eye but is a The treatment for such a patient is to observe, because it is likely benign
Bronchiechstasis typically occurs in what l Bronchiecstasis occurs in upper lobe.
Emphysema occurs in what lobes? Emphysema occurs in lower lobes
Chronic cough with a rule out of lung cancepost-nasal cough condition
When a mother holds her baby with outstrede quervain's tenosynovitis
Nasal polyps occur in what type of patient?Nasal patients occur in pregnant women with nose bleeds.
What disease is characterized by losing bal Parkinson's disease - Need a P.E.
Bacillus cereus forms what type of toxin? B. cereus forms a pre-formed toxin
What is the treatment for patient with M Treat for H. pylori with omeprazole, clarithromycin, and amoxicillin.
What is the initial therapy for patients pres Give a beta blocker.
Fio2 levels should be below what level to r <60%
Packed red blood cell transfusion occurs Acute gastrointestinal bleed.
What is the most common cause of mitral vMyxomatous degeneration of mitral valve
What is the most common cause of suddenRe-entrant
ca ventricular arrthymias (ventricular fibrillation) are the most c
Pancreatic cancer in the body/tail should CT scan
Pancreatic cancer in the head should be ru ultrasound
PPSV23 is recommended for what patients Adults <65 who are current smokers or have chronic medical condition,
What is the sequence of Td/Tdap usage Give Tdap once as a substitute for Td booster, then Td every ten 10 years
o reduce risk of cardiac embolization.

erload decreases the intensity of HCM and AS murmurs.

intensity of bloodflow from squatting or handgrip.

n confidential.
<1cm in diameter. They are usually due to fibroblast proliferation and occur on lower extremities. The lesions have a fibrous co
o give bronchoalveolar lavage.

uld not exceed 60%

ve, because it is likely benign spontaneous subconjunctival hemorrhage.

th nose bleeds.

omycin, and amoxicillin.

ar fibrillation) are the most common cause of sudden cardiac arrest

e chronic medical condition, including heart or lung disease, diabetes, and chronic liver disease
er, then Td every ten 10 years
s. The lesions have a fibrous component that cause the central area to dimple.
Recurrent bacterial infections in an adult should raise suspicion for what dis Common variable immunodeficiency -
What is the treatment for multiple sclerosis? Riluzole
What is the drug of choice for PCP? TMP-Smx
What is the CD4+ count for PCP diagnosis? CD4+ < 200
What other drugs should be administered with TMP-SMX for use in pcp? corticosteroids for patients with pao2<
A smoker with hypercalcemia presents with a normal amount of 1,25 dihydrox Hypercalcemia of malignancy as in sm
Pyelonephritis is diagnosed 48-72 hours later with what diagnostic test? CT scan
Wernicke encephalopathy clinical features include what? Encephalopathy, ocular dysfunction, ga
A patient with a myocardial infarction also presents with leg pain. What is t Perform echocardiogram for acute lim
Chest x-ray can be used to diagnose what disease? CHF and Aortic Dissection (widened m
V/Q scan is used for the diagnosis of what diseases? V/Q scan is used to diagnose pulmona
What is the common outcome of digitalis toxicity? Atrial tachycardia (due to activation of
Patient with a disease that can affect others like meningococcal meningitis d You need to hospitalize against his will
P.S.C is associated with what other disease? ulcerative colitis
Ulcerative colitis show with what liver function tests? Elevated liver function tests in a choles
Treat symptomatic sinus bradycardia with what drug? Atropine
When is a CT angiogram of chest necessary? pulmonary embolism
What are the aminotransferase levels for acetaminophen intoxication and vira>1000 U/L
Asbestosis shows up in what type of worker? Industrial worker like a ship-yard work
When does pulmonary contusion occur? Following trauma, patient has trouble
SJS involves burns with how much body surface area <10%
Burns >30% of body TEN
Acute acalculous cholecystitis is found in what type of patients? Patients who are in hospital or after su
Patients with myasthenia gravis need to be managed next with what test? CT scan of the chest
What disease is a common complication of sickle cell disease? Osteonecrosis(aseptic necrosis) of the
ommon variable immunodeficiency - with recurrent respiratory (pna, sinnusitis, otitis) and gi infections (salmonella, campylobac

orticosteroids for patients with pao2</70mmHg or A-a gradient>/35mmHg on R.A.

ypercalcemia of malignancy as in small cell lung cancer. (elevated PTHrP)

ncephalopathy, ocular dysfunction, gait ataxia.

erform echocardiogram for acute limb ischemia to screen for LV thrombus
HF and Aortic Dissection (widened mediastinum)
Q scan is used to diagnose pulmonary embolism which presents with S.O.B., tchypnea, pleuritic chest pain, D.V.T signs/symptom
rial tachycardia (due to activation of ectopic foci) and AV block due to vagal activation.
ou need to hospitalize against his will because he is a threat to community members.
cerative colitis
evated liver function tests in a cholestatic pattern.

ulmonary embolism

dustrial worker like a ship-yard worker

ollowing trauma, patient has trouble breathing; PCWP is normal which suggests it is a non-cardiac cause

atients who are in hospital or after surgery will be diagnosed with acute acalculous cholecystitis
T scan of the chest
steonecrosis(aseptic necrosis) of the femoral head
tions (salmonella, campylobacter), autoimmune disease like RA and thyroid disease

hest pain, D.V.T signs/symptoms.

Patients newly diagnosed with T.B. and a history >5 mm
A negative chest x-ray for T.B. would indicate Treat as if the patient has latent T.B. for 9 months
What are some "radiolucent stones" - which impl1. uric acid stones, xanthine stones, 2. calcium stones <1-3 mm in d
Uric acid stones are radiolucent, but they are u CT scans and renal ultrasound
How do you treat uric acid stones (with acidic p Hydration and alkalinization with potassium citrate
Diabetics have large volume diuresis which lowersThere is no intracellular uptake of K+
What is the most important therapy following suMake sure you defibrillate
What is the most common presentation of hemop Recurrent hemarthrosis
Patient with HCV infection should be treated wi Hep A and Hep B vaccination - check which one is actually an activ
Patient with suspected bladder cancer (hematur Give cystoscopy, not treatment. Need to confirm that it is not bladd
Febrile non-hemolytic transfusion reactions occu1-6 hours post transfusion
whole blood is only transferred in what situationMassive hemmorhage because whole blood contains numerous le
Neoplastic epidural spinal cord compression pre worsening focal back pain, bilateral LE weakness, sensory loss, gait
Patient with upper GI bleed from esophagela va Endotracheal intubation before you do a upper gi endoscope
Uremic pericarditis occurs with a BUN level grea Uremic pericarditis occurs with BUN >60 mg/dl
How do you treat perciarditis? Hemodialysis
What is trihexylphenidyl? Trihexylphenidyl is an anticholinergic drug
Cardiac catherization may predispose a patient t Cholesterol embolism
Iodine contrast can predispose a patient to what A thyroid storm which is when a patient develops fevers, hemodyn
Treat patient with COPD with what? Long term oxygen therapy
nt T.B. for 9 months
tones, 2. calcium stones <1-3 mm in diameter, 3. non-stone ureteral obstruction (blood clot, tumor)

with potassium citrate

- check which one is actually an active infection.

nt. Need to confirm that it is not bladder cancer first if you see bloody urine.

e whole blood contains numerous leukocytes, and increases the risk of febrile reaction
ateral LE weakness, sensory loss, gait ataxia
re you do a upper gi endoscope
h BUN >60 mg/dl

linergic drug

n a patient develops fevers, hemodynamic instability, cardiac arrthymia, and CHF

What disease is defined by inactivation of pancreatic enz ZE Syndrome
A patient developed chronic renal insufficiency - what is t Renal transplantation from a living related donor.
What are the two treatment options for Legionella pneumFluoroquinolone and Macrolides
What is the most common cancer associated with asbestoBronchogenic Cancer
What is the preferred treatment for patients who have as Inhaled albuterol a few times a week.
What is the preferrred treatment for people who have as Steroid/anti-LT agents
Hereditary hemochromatosis is associated with what othePseudogout
Hepatomegaly and diabetes history is associated with whaHereditary hemochromatosis
Adenocarcinoma is common in what patient population? non-smokers
Which pulmonary disease is not characterized by solitar Tuberculosis
Minimal change disease is associated with what disease?Hodgkin lymphoma
Chronic cough in a patient with an ACE inhbitor patietn ACE inhibitor
Diabetic foot infetions show with what type of infections?polymicrobial infections with contiguous spread from the
The elderly are susceptive to what problems? intravascular volume depletion which leads to prerenala c
To diagnose acute pancreatitis what do we need to measuFasting lipid profile
When is it appropriate to use ERCP? Biliary pancreatitis
What tool do we use to diagnose pancreatic cancer? CT Scan
What is the treatment for someone receiving surgery and Bladder catheterization to treat acute urinary retention
Digoxin toxicty presents with what gastrointestinal symp anorexia, nausea, vomiting, abdominal pain
Chronic digoxin toxicity presents with what other types neurologic and visual symptoms (changes in color vision,
Amiodarone has what effect on digoxin toxity? Amiodarone increases digoxin toxicity
S. bovis needs a follow up diagnostic test with what? Colonscopy
Paget's disease of the bone will lead to what problems? Headaches and hearing loss
Paget's disease of bone will cause what presentation? Bowing of the leg
Between Histo and Blasto, which one is systemic. Blastomycosis is a systemic infectino and cause cause a w
A patient experiences trauma and cold fingers, why? NE induced vasospasm
A patient with community acquired pneumonia and a low CAP leads to sepsis, which is also characterized by low vo
A patient presents with diabetes and bph but expresses prIn this case, it is diabetes damaging kidneys because bph
Steppage gait is caused by what damage? L5 Radiculopathy to the common peroneal nerve
How do you treat esophageal varices? B- blocker
How do you treat vasovagal syncope? Education about increasing the venous return - handgrip,
Amiodarone can cause toxicity chronic interstitial pneumonitis and arrthymia
What are some co-infections associated with n. gonorrhe chlamydia, HIV, t. pallidum, hep B
Cardiac sarcoidosis is a disease of what? non-caseating granuloma of myocardium, results in arrhy
What drugs will worsen Grave's disease? Radioactive iodine
Hydroxychloroquine has what side effect for treatment of Hydoxychloroquine presents with retinal neuropathy
When do you administer a varicella vaccine in an HIV pati When CD4+ > 200, administer varicella vaccine
OSA can lead to hypoxia, which will acuse release of wh EPO
iving related donor.

contiguous spread from the wound.

n which leads to prerenala cute kidney injury -- their BUN/Cr will be > 20:1

at acute urinary retention

bdominal pain
ms (changes in color vision, scotomas, blindness)

fectino and cause cause a well-circumscribed verrucouos nodule and plaques on skin.

also characterized by low volume state (low blood pressure). Remove metformin to prevent kidney damage
aging kidneys because bph doesn't cause proteinuria
mon peroneal nerve

e venous return - handgrip, etc

tis and arrthymia

myocardium, results in arrhythmia, cardiomyopathy, heart failure, s.c.d.

with retinal neuropathy

varicella vaccine
Polymyositis Proximal muscle weakness
PMR is characproximal muscle pain
AminoglycosidAminoglycoside toxicity presents as hearing loss and balance loss (vestibulopathy, characterized by ho
How often doOnce every two years
Papilledema i Increased ICP causes papilledema which presents with transient vision loss lasting a few seconds with
Optic neuritis multiple sclerosis
Amaurosis fugTransient monocular blindness that lasts a few seconds.
If heparin is HIT, consider argatroban or fondaparinux
What disease CJD
Isoniazid the Pellagra
bulopathy, characterized by horizontal saccades)

oss lasting a few seconds with changes in head position.

Patients with rheumatoid arthiritis are at increased risk for wh Osteoporosis
What disease leads to muscle atrophy, weakness of proximal muCushing syndrome
Warfarin leads to what future problems? Warfarin leads to protein C deficiency
Nontraumatic S.A.H presents with what presentaiton thunderclap headache and symptoms of meningeal
Postoperative endopthalmitis is due to what problem? Usually due to cataract surgery.
Pituitary adenoma will affect what lab values? Pituitary adenoma will affect both the TSH and LH v
What is an example of a fixed upper airway obstruction which cLaryngeal edema after eating food
Patient presents with clubbing, smoking, and bilateral hand pa IT doesn't matter what the diagnosis is. The only thi
An elderly woman (<65) in a senior residential facility with ty This person most likely has a community acquired p
A common cause of NOSOCOMIAL pneumoniae is what bug? P. aaeruginosa
What diagnostic test reveals diagnosis of pneumonia? Chest x -ray
>65 year old patient with immunosupression with C.A.P. may Meningitis, pneumonia, endocarditis)
Wilson's disease presents with neuropsychiatric symptoms resting tremor,muscular rigidity, clumsy gait
Palms are sweaty and contain a doughy feel. What is the diagnoIGF-1 stuff
What disease in endocrinology is associated with carpel tunne Acromegaly
Dual antiplatelet therapy is needed in patients with what diag STEMI
What is the dual antiplatelet therapy combination? ASA + Clopidogrel, Prasugrel, Ticagrelor
Hyperpigmentation in palmar creases which suggest what pro Primary adrenal insufficiency which would suggest a
What infection will follow influenza infection? Staph Aureus
P.S.V.T should be treated with what maneuver? Vagal maneuver treats P.S.V.T. which slows down the
What test possesses the greatest sensitivity for dx heart failure Elevate BNP
A patient with night-time cough is a candidate for what diagnosC.H.F.
Hypochloremic, hypokalemic, metabolic alkosis is due to what Gastrointestinal loss
Sympathetic ophthalmia is due to what? Damage of one eye after penetrating injury to other
What is the pathophysiologic mechanism of Sympathetic ophthRecognition of hidden antigens.
Respiratory alkalosis will facilitate what process? Increased calcium bound to albumin.
Marijuana side effects include what? Marijuana slows reaction time, impairs attention, co
Preferred treatment for actinomyces? Penicillin
Lacunar strokes present as what? Lacunar strokes affect the SENSORIMOTOR system o
What is the most appropriate system to diagnose hepatitis B in HBSAG AND IgM anti-HBc
Hypercalcemia of malignancy requires what treatment? Bisphosphonate therapy
PCP pneumonia presents in what type of patients with what RF pcp pneumoniae can present in HIV (immunocompr
What is the LDH value for a patient presenting with PCP PNE PCP pneumoniae patients present with elevated LDH
What is the treatment for pcp? TMP-SMX 21 days
Microcytic anemia in a patient from Greece would imply what B- thalassemia
Warm patient with nose bleed presents with what problem? Heat stroke
Myasthenia gravis presents with what UNIQUE problems that areye problems like diplopia
o protein C deficiency
adache and symptoms of meningeal irritation
ataract surgery.
ma will affect both the TSH and LH values, which is different than a medication effect, which would only affect one of them (LH)
a after eating food
er what the diagnosis is. The only thing that matters is that I know this is a lung problem and that the CHIEF complaint is most im
st likely has a community acquired pneumonia caused by the most stereotypical organism (Strep pneumoniae); if patient was al

umonia, endocarditis)
muscular rigidity, clumsy gait

el, Prasugrel, Ticagrelor

insufficiency which would suggest an autoimmune problem with adrenal gland, leading to aldosterone deficiency and hyperka

treats P.S.V.T. which slows down the A.V. node

eye after penetrating injury to other eye.

hidden antigens.
m bound to albumin.
s reaction time, impairs attention, concentration, coordination, increases appetite

affect the SENSORIMOTOR system of both the UPPER and LOWER extremities

e can present in HIV (immunocompromised) patients but they do not have to have HIV history. Anyone taking glucocorticoids is
e patients present with elevated LDH values.
d only affect one of them (LH)

the CHIEF complaint is most important. This is an obstructive lung disease.

pneumoniae); if patient was also immunosuppressed, symptoms may be worse, could have meningitis symptoms too. But iin th

terone deficiency and hyperkalemia

nyone taking glucocorticoids is at increased risk for PCP pneumoniae

ngitis symptoms too. But iin this case, pure pneumonia is pretty convincing.
What is mobitz type 1? Going, going, gone
How do you treat lumbosacral radiculopathy? Give NSAIDS
History of tuberculosis would be suggestive of Pericarditis
What does a positive hepatojugular reflex imp Positive hepatojugular reflex implies a cardiac cause of edema.
Patients with hypertension should be worked Lipid abnormalities - basically assess for risk factors for HTN
What hormone causes a rise in T.B.G levels? Estrogen - as in pregnancy, oral contraceptives, menopausal estrogen
Optic neuritis is associated with what other di Multiple sclerosis
Analgesic nephropathy can lead to what futurePapillary necrosis and chronic tubulointerstitial nephritis
What drug use can lead to papillary necrosis/ cNaproxen (NSAID)
ac cause of edema.
k factors for HTN
ves, menopausal estrogen replacement

tial nephritis
Pleural effusion leads to what fin Nonpalpable point of maximal impulse
Pericardial effusion that leads No J.V.D
Intracranial HTN can lead to wha Headaches, blurred vision
Most important intervention for cWeight loss
Vasovagal syncope episodes are pnausea, diaphoresis, bradycardia, and pallor
Pain, stress, situations that inc Vasovagal syncope
What's a good cut-off value for P PSA >4 ng/ml is a cut-off for prostate cancer
What is consolidation therapy? This is a therapy given after induction therapy with multi drug regimens to furthe
Any patient who is suffering from Prothrombin complex concentration
Patients who develop acute bleedMedication - related bleed like Warfarin overdose
Patient has symptoms of acute artpain, pallor, poikilothermia, parasthesia, pulselessness, and paralysis
Patient with acute lim bischemia Anticoagulation wit heparin
Treatment for myasthenic crisis therapeutic plasma exchange
Crohn's disease presents with whaoral ulcers in mouth
Parkinson's patients appears withA shuffling gait (or a hypokinetic gait)
Single brain abscess is causedd Viridans streptococcus and staphyloccosu aureus.
Ring-enhancing lesion could indic Viridans streptococcus and staphylococcus aureus.
When patient is interested in alte Physician asks why
Epidydymitis in patients above 35Eserichia coli
Livedo reticularis is caused by w cholesterol embolism
drug regimens to further reduce tumor burden. An example is multi-drug therapy after induction therapy for acute leukemia.

nd paralysis
therapy for acute leukemia.
The first step of evaluation of solitary pulmonary nodules is what? Obtain previous radiographic lung images; ab
If there are no previous radiographic films to detect a malignancy, wh Perform CT
What technique is best for centrally located lesions? Bronchoscopy
What is best technique for peripheral lesions? CT-guided percutaneous biopsy
What is the profile for idiopathic pulmonary fibrosis? Decreased TLC, Normal FEV1/FVC ratio, decre
IgA nephropathy occurs how many days after URI? 5 days
What is the complement values for patient with IgA nephropathy? Normal complement values unlike Lupus and
Someone with chronic cough > 8 weeks needs to gather what test? P.F.T test to rule out asthma.
Causes of chronic cough include four types: upper airway cough syndrome, G.E.R.D., and
Diffuse scleroderma occurs with what signs/symptoms esophageal dysmotility, fibrotic lung disease,
Systemic sclerosis leads to what issues downstream? Decreased peristalsis and decreased tone in t
Patient presents to ED with severe dyspnea and right sided chest pain Anti-platelet therapy (intravenous heparin inf
Which of the following is the most likely diagnosis in a patient with Chronic lymphocytic leukemia
A 42-year old woman comes to the office due to 4 weeks of episodic up Peptic ulcer disease (probably due to h. pylor
What is the preferred treatment for asterixis due to ammonia intoxica Nonabsorbable dissacharides (lactulose, lacti
Any person with difficulty swallowing from throat may present with w Barium swallow study
Cerebellar ataxia presents with what finding? ipsilateral ataxia
Low back pain in a patient with cancer would suggest what cause for Low back pain from metastatic disease
Reperfusion treatment Percutaneous transluminal coronary angiopla
Reperfusion treatment 2 Thrombolysis (if PTCA not available within 12
radiographic lung images; absence of growth over 2-3 years rule out malignancy.

utaneous biopsy
Normal FEV1/FVC ratio, decreased diffusion capacity C.O.

ment values unlike Lupus and PSGN.

out asthma.
ugh syndrome, G.E.R.D., and ACE inhibitors
motility, fibrotic lung disease, arthralgias
talsis and decreased tone in the LES.
erapy (intravenous heparin infusion)
cytic leukemia
ease (probably due to h. pylori)
dissacharides (lactulose, lactitol)

rom metastatic disease

ansluminal coronary angioplasty (PTCA) within 90 minutes
PTCA not available within 120 minutes)
Rheumatoid arthiritis predisposes to what disease? AA Amyloidosis
Multiple myeloma predisposes to what type of amyloidosis AL Amyloidosis
Amyloidosis can be discerned by what findings? Organ enlargement of the kidneys and liver
How do you treat acute exacerbations of multiple sclerosis Treat with glucocorticoids.
How do you know someone is experiencing relapsing symptIf patient stopped medication and experienced symptom
Alveolar hypoventilationc can be the cause of what sympt Lethargy
Infectious esophagitis is a common complication in patien CMV esophagitis
When do you first get mengincoccal vaciations? 11-12 years old
When do you get booster for mengincoccal vaccination? 16 years old
High - risk patients for meningoccal vaccination include complement deficinecy patients, asplenia, college stude
Pseudotumor cerebri is suspected in what type of patients?Young obese females with headaches.
What is the treatment for pseudotumor cerebri? Weight loss and acetazolamide
What is one of the sequlae of pseudotumor cerebri? Blindness
TPN causes what sequlae? Gallbladder stasis and predisposes to gallstone formatio
What is the role of progesterone with respect to gall stone Progesterone slows gall bladder emptying, and facilitate
Lymphoproliferative disorders can cause anemia. What doe A lymphoproliferative disorder is one that involves bone
Infective endocarditis can be identified by what findings? Arthralgias, pain in hands, elevated ESR.
Foley catheter can cause what reaction? Allergic reaction
Allergic reaction presents in what way? Wheals over abdomen.
Fat embolism symptoms include SOB, confusion, and petechiael rash.
What is the next best step in management of a patient with Compression ultrasonography
Long-term analgesic use from drugs such as NSAIDS can ca Tubulointerstitial nephritis and hematuria due to papilla
P.E. presents with what finding? May look like right heart failure with clear lungs, and inc
How often do you get a sigmoidoscopy and FOBT? Sigmoidoscopies occur every 5 years and FOBT occur ev
If your first degree relative has colon cancer, when should 10 years earlier
NSAIDS like narpoxen and ASA cause GI blood less which wilIron deficiency anemia.
If pyelonephritis does improves within two hours after IV Switch to oral antibiotics
The treatment for nodular BCC is what? Moh's microsurgery
A patient with diabetes complains of right sided foot pain. Nerve damage
Acanthosis nigricans is associated with what conditions? insulin resistant states 9DM, PCOS) in younger patinets
When trigemineral neurlagia presents bilaterally what condMultiple sclerosis
neys and liver

and experienced symptoms such as incontinence and hemisensory loss

nts, asplenia, college students in resident housing, travel to endemic areas

poses to gallstone formation and bile sludging.

er emptying, and facilitates formation of cholesterol gallstones during pregnancy.
r is one that involves bone marrow infiltration.

d hematuria due to papillary necrosis.

re with clear lungs, and increased J.V.D.
5 years and FOBT occur every 3 years.

PCOS) in younger patinets and GI malignancy in older individuals

Delirium tremautonomic hyperactivity from alcohol withdrawal - hallucinate.
The dominantLeft side
Broca's aphasLeft side - language side
rawal - hallucinate.
ARDS presents with what physical exam finding? Lower lobe consolidation, high - grade fe
For immunocompromised patient what is the treatment option? Use TMP-SMX
Retroperitoneal hematoma may be indicated by what findings? Back pain
Chondorcalcinoisis in a joint with typical acute inflammatory arthiritis wou Pseudogout
Rhomboid shaped, weakly positive birefringent CPPD crystals would indica Pseudogout
What is the first line treatment for central DI? Desmopressin
What is the role of sodium bicarbonate when treating TCA overdose? E.C. sodium reduces the effect of the dru
Methanol poisoning causes what PE findings? Methanol damages the eyes.
Ethylene glycol causes what problems? Ethylene glycol damages the kidneys.
Recurrent lacunar infarccts can lead to what types of sequlae? Motor deficits, causes gait disturbance, u
BPPV can cause dizziness due to CV causes like what? arrthymia, aortic stenosis, hypokalemia
Crohn's disease can lead to steattorhea and diarrhea. What is the net effe Decreased calcium absorption in the gut
If melanoma I suspected what is the management? excisional biopsy
How do you treat actinic keratoses? Treat with cryotherapy or 5-FU
What test do you NOT use to diagnose melanoma? Shave biopsy because it does not allow f
What test do you use to compare the means between two groups? Two - sample t-test
What test do you use to compare the means between two groups and measTwo - sample z-test
Ventricular remodeling in weeks to months following an MI can lead to dilaACE Inhibitors
What is the most significant reversible risk factor for pancreatic cancer? Cigarette smoking.
isoniazid can cause what issues? Isoniazid can cause idiosyncratic liver inj
When considering the causes of hepatitis what is the order to look at? (1) viral, (2) Alcoholic, (3) autoimmune, (
What is ITP? ITP is a diagnosis of exclusion when we k
Alcoholic patients need to be monitored for what vital sign? Blood pressure. Reducing alcohol intake
AVM occurs in what patient populations? Children
Amyloid angiopathy occurs in what patient types? Elderly who also have alzheimer disease
Colovesical fistula is most commonly due to what disease? Diverticular Disease
Colovesicular fistula can present with what findings? Pneumaturia, fecaluria, consistent with U
What is the treatment guideline for rabies patients who are low - risk? Squirrels, chipmunks, mouse/rats, rabbit
Actinic keratosis can be identified on exam by what lesion? White, scaling lesions
Nearly 20% of cocaine overdoses are complicated by what finding? Rhabdomyolysis - as indicated by market
solidation, high - grade fever, shaking chills

uces the effect of the drug (TCA) on the sodium channel.

ges the eyes.
damages the kidneys.
causes gait disturbance, unsteadiness, and mild memory impairment.
c stenosis, hypokalemia
um absorption in the gut.

herapy or 5-FU
cause it does not allow for accurate depth measurement.

use idiosyncratic liver injury

oholic, (3) autoimmune, (4) Medications
s of exclusion when we know that lab values are fairly in safe range for example prothrombin time and fibrinogen times are nor
Reducing alcohol intake will regulate blood pressure

o have alzheimer disease.

caluria, consistent with URINARY TRACT INFECTION.

munks, mouse/rats, rabbits are low-risk animals - do not give them immediate prophylaxis

s - as indicated by market elevated in serum CPK. The main danger associated with cPK leves greater than 20,000U/l is acute ren
e and fibrinogen times are normal.

ter than 20,000U/l is acute renal tubular necrosis.

If you are goi Only accept gifts on behalf of patients and the gift must have some non-monetary value (educational
What are some Cannot ingest food by mouth, antibiotic use
Migraine peopPhotophobia.
People with t Pain all around their head.
People with hPeople with this condition have headaches.
Patients with Atrial dilation
Mitral stenos Atrial fibrillation
Bright red, fr Bacillary angiomatosis
PCP causes prAround the ears, but can be treated with TMP-SMX
Small fibers c Small fibers are the positive fibers (pain and parsthesias)
Large fibrers Large fibers cause negative symptoms - numbness, loss of prioception/vibration, diminished ankle refl
Patients with SaO2<89% or PaO2<59 mmHg
Patients with Home oxygen therapy
Infective endosplenic abscess
Infective endopleural effusion
Risk factors f Hematogenous spread, immunosuppression, IV drug use, trauma, hemoglobinopathies
Infective end Splenomegaly
SpondyloarthrPeople are who are <40 years old who experience improvement in symptoms with exercise may have
Pregabalin M Pregabalin inhibits the release of excitatory neurotransmitters
What drug willSodium nitroprosside
Macular degene OLD people
Pt. with COPDFewer patients will die if they quit smoking.
How do you trCefepime, vacnomycin, ampicillin
Presbyacusis High frequency hearing loss ( guy cannot hear when other people are in the room)
C.I. and samplC.I. and sample size are inversely related.
C.L.L. is diag Flow cytometry
C.L.L. is foun Old people with enlarged lymph nodes and bicytopenia (anemia and thrombocytopenia)- they have h
CLL patients Enhanced lymphocytosis
C.R.A.O. TR Ocular massage and high flow O2 therapy
Hairy cell leu chronic B cell neoplasm that infiltrates the bone marrow, spleen, peripheral blood. Resultsin cytopeni
OsteoarthritisAge > 40.
Osteoarthriti Osteoarthritis is worsened by activity and relieved by rest.
Flat and broa Electrolyte disturbance from hypokalemia (which also leads to difficulty walking due to waekness)
Patient with dDiabetics are prone to spinal cord injury (epidural abscess)
Hypertensive Hypertensive vasculopathy causes ACUTE neurological changes and appears as a hyperdense lesion in
Cardiac tamp Sudden onset of severe tearing chest pain to the back.
Patients with Type 2 DM.
Mild drug alleAntihistamine - look at the vital signs.
-monetary value (educational in nature, etc.)

vibration, diminished ankle reflex.


ptoms with exercise may have a spondyloarthropathy

n the room)

rombocytopenia)- they have hypogammaglobulinemia

heral blood. Resultsin cytopenias, splenomegaly, and atypical lymphocytes

walking due to waekness)

pears as a hyperdense lesion in one focal area of the brain. (usually near the middle)
TB presents asupper lobe cavitary lesion
Aspiration PNLower Lobe cavitary lesion
Cryptococcal CD4<100/mm3
PCP presents CD4<200/mm3
Central cord Decreased sensation/motor Fx in arms with relative sparing of legs after forced hypeextension
Hypovolemic Low PCWP and CVP values
What is a coh Cohort can be performed when studying incidence of disease in 2 populations with/without a given R
Odds ratios arCase control studies
Rupture of th 5 days to two weeks after an acute MI occurs.
Pericardial f 1-3 Days after an MI.
Aortic dissec Acute pericardial tamponade if dissection involves aortic root
Ventricular a late (weeks to months) after acute ST elevation - scarred or fibrotic myocardial wall
Viral arthirit Viral arthiritis ism ore benign - symptoms improve over 10-15 minutes of normal activity.
BenzodiazepinBenzo does not cause respiratory depression or pupillary constriction. Alcohol and phenytoin intoxica
CT scan of muDiffuse axonal injur occurs from traumatic brain injury.
What is the t First line is 100% O2, followed by ergotamine ( because 100% o2 is most rapid form of treatment)
IV Drug users Bacterial endocarditis involving right sided heart valves.
What are two Tobacco
r and alcohol
What is the t Beta blockers
Holter monitoroutpatient settings to identify intermittent arrythmias in patients with symptoms (syncope, pallpitatio
What is the d Lorazepam
Most commonP.U.D. (symptoms occur in absence of a food buffer)
Opthalmoscope Cataract
blurred visionCataract
Primary hyperPrimary hyperaldosteronism does not present with hypernatremia because of the atrial natridiuretic e
Duodenal ulceDuodenal ulcer improves with eating.
What is a coinSeborrheic keratosis
What type of Acute pericarditis
What is the r <6 months of life left over.
Resting tremoParkinson's disease
r forced hypeextension

lations with/without a given R.F. - allows for RR calculation

cardial wall
of normal activity.
Alcohol and phenytoin intoxication look like benzo OD but they have nystagmus too.

t rapid form of treatment)

ymptoms (syncope, pallpitations).

ause of the atrial natridiuretic effect.

What is the general guideli Order P.S.A.
Familial hypocalciuric hype <.01
UCCR in primary hyperparath>.02
Theophylline can manifest asCNS stimulation (headache, insomnia, seizures), GI disturbance, cardiac toxicity (arrythm
Idiopathic intracranial hyp Vitamin A (isotretinoin)
Patient with metabolic acidoASA toxicity.
HIT causes what laboratory HIT causes prolonged PTT and low platelet count
Aortic dissection can cause Acute aortic regurgitation
Neurologic presentation alo TTP
Behchet syndrome is charactRecurrent oral ulcers along with skin involvement in young adults who are of Turkish, M
PMI is displaced to left and AV Fistula will increase cardiac preload
Post-ictal sate what happen Acidosis from hypoventilation
Inhaled corticosteroids play Inhaled corticosteroids are used in long - term management of persistent asthma.
What is the treatment for a inhaled bronchodilators (b2 agonists and anti-cholinergics)
Management for patient witAvoid contact sports for three weeks
Hepatorenal syndrome is anEnd-stage liver disease causes hepatorenal syndrome.
Higher consumption of coffee Coffee consumption reduces uric acid levels
Smoking is associated with wSmoking is associated with lower risk of gout.
Blood transfusion can lead tHypocalcemia
Prophylaxis for tumor lysis Allopurinol and rasburicase
Tumor lysis syndrome wouldHyperuricemia, hyperkalemia, hyperphosphatemia, hypocalcemia
What test do you use to dia Echocardiography
How do you treat cocaine toGive benzodiazepine
What is the cutoff for T.B. i >15 mm
bance, cardiac toxicity (arrythmias)

g adults who are of Turkish, Middle Eastern, and Asian descents.

ent of persistent asthma.

The most common cause of community acquired bacteriaStrep pneumoniae
Strep pneumoniae infection causes what symptoms? Both meningismal and pneumococcal symptoms - as in ne
What autoimmune disorder causes dental caries and eyeSjogren syndrome
MEN2B would show up with what other findings? Marfanoid habitus
Smoker >35 with RBCs in urine and NO casts indicates w Bladder cancer
What is the best treatment for tachy-cardia mediated c Rate or rhythm control to control atrial fibrillation.
Painful eye movements and proptosis with fast pulse wouGrave's disease
Increased icp WILL LEAD TO WHAT FINDING? Papilledema as in pseudotumor cerebri.
G6PD deficiency causes hemolytic anemia due to oxidative Sulfa drugs, anti malarials, and nitruofurantoin.
Stress fractures occur after what occurs Repetitive activities can elicit stress fracture; for example,
What is the female athlete triad? Low caloric intake, hypomenorrhea/amenorrhea, low bone
Management of stress fracture Reduce weight-bearing for 4-6 weeks..
Anion gap must be calculated after what is already foundIf patient has metabolic alkalosis, calculate the anion gap t
A patient with a suspected viral infection causing pneumoInfluenza
What is the secondary bacterial infection following an in Staphylococcus Aureus.
What's the first course of action when you splash somethGo to the eyewash station.
Describe MTX Antimetabolite that causes oral ulcers.
When do you administer thrombolytics? Within 4.5 hrs of onset of stroke symptoms
When do you give ASA in a stroke patient? ASA is given 24 hours after use of thrombolytis.
How do you treat toxoplasmosis? CD4+<100 - treat with sulfadiazine and pyrimethamine
Polycythemia vera is characterized by what physical examSplenomegaly
What is the treatment for polycythemia vera? Phlebotomy.
Ischemic hepatic injury follows what problem? Ischemic hepatic injury follows patients with shock liver, m
Morton neuroma causes pain in what areas of the toe? Burning pain in the distal forefoot from the metatarsal hea
What is the treatment for SIADH? Give HYPERTONIC saline; serum osmolarity is <275 mOsm/
Patient with secondary Raynaud phenomenon should be Autoantibodies and inflammatory markers.
Most common medications that cause hyperkalemia? non-selective B-blockers, ACE inhibitors, ARBS, NSAIDS.
Dextrose is the treatment for what condition? Hypovolemic hypernatremia or euvolemic hypernatremia.
When does the false negative values rise? When the cut off is raised.
mococcal symptoms - as in neurologic deficits and productice ough. Aemophiluz is less common.

trol atrial fibrillation.

d nitruofurantoin.
stress fracture; for example, running or gymnastics.
rrhea/amenorrhea, low bone density

osis, calculate the anion gap to detect the cause of the metabolic alkalosis.

ke symptoms
e of thrombolytis.
azine and pyrimethamine

s patients with shock liver, massive increases in AST/ALT, and milder increase in total bilirubin and alkaline phosphatase
foot from the metatarsal heads to the third and fourth toes.
m osmolarity is <275 mOsm/kg
tory markers.
inhibitors, ARBS, NSAIDS.
or euvolemic hypernatremia.
alkaline phosphatase
TB can cause what condition that leads to eT.B. can cause autoimmune adrenal insufficiency which is a normal anio
When a patient experiences syncope upon st orthostatic hypotension
When a woman experiences syncope after str Vasovagal syncope
When someone wakes up 3-4 times a monthTreatment indication is to add an inhaled corticosteroid.
When should an x-ray be used when diagnoSuspected malignancy should be diagnosed with X-ray.
In patient with suspectd stroke what is th CT first to rule out bleeds followed by MRI
Further pap tests are not necessary for wo Any woman >65 who had their cervix removed for reasons other than c
IV n.s. is used to treat what condition? Hypovolemic hypernatremia from lithium use.
Hypovolemic hypernatremia that is not sym5% dextrose.
Renal disease presents with certain lab findproteinuria or fluid retention (acute nephritic syndrome)
M.S. leads to what symptoms? optic neuritis and transverse myelitis (motor and sensory loss below les
What cardiac drug does NOT show improvemen Digoxin
Mixed cryoglobulinemia presents with whathepatitis C
if the CHA2DS2-VASc score = 0 what does t no additional therapy needed for patient with a.fib, because no risk fo s
Heinz bodies are seen in what type of anemG6PD deficiency (thalassemia)
Endotracheal intubation preferentially fills Right side of lungs is filled with E.T. tube due to shorter trachea on right
What does acromegaly cause? Concentric myocardial hypertrophy
Pseudomonas aeuriginosa is the cause of whGranulomatous infection of ear, which is malignant otitis externa. This c
P.C.D.K. is diagnosed with what test? ultrasound
Bilateral palpable abdominal mass indicate A.D.P.C.K.D
Ureteral stone obstruction that radiates to Abdominal ultrasonogram
ency which is a normal anion gap metabolic acidosis.

with X-ray.

ved for reasons other than cancer does not need another pap smear.

tic syndrome)
r and sensory loss below lesion, incontinence)

th a.fib, because no risk fo systemic tromboembolization

e to shorter trachea on right side.

alignant otitis externa. This causes ear pain.

Urge incontin Pelvic floor exercises and bladder training followed by anticholinergic
Pseudogout wiPseudogout leads to hypercalcemia.
Acyclovir can Renal tubular obstruction
Perforated peFree air under the diaphraghm
U.D.C.A is useP.B.C.
What disease Pi arkinson's disease
What is the t Trihexyphenidyl
Central retinaacute painless monocular vision loss.
Central retin Retinal hemorrhages, dilated veins, and cotton wool spots.
Optic neuriti Multiple sclerosis
Acute pancreaAcute pancreatitis can lead to intravascular volume loss due to endothelial injury, which causes plasm
lial injury, which causes plasma leak into retroperitoneum.
Exertional heat stroke is characteri Temperature >40C(104F) and CNS dysfunction.
What is the management of E.H.S.?Rapid cooling with rapid ice water immersion
PNH is associated with what condit PNH is associated with hypercoaguable state (intra-abdominal or cerebral vein t
C.H.F characteristics Decreased Cardiac Index, increased S.V.R., increased L.V.E.D.V.
TMJ joint dysfunction what sympt TMJ joint issues presents with nocturnal teeth grinding.
Facial nerve lesion would prevent Facial nerve lesion would prevent eye from closing.
Valve replacement can cause what Tricuspid regurgitation - which leads to J.V.D., and liver enlargement.
What are the symptomf of Arsenic tPainful sensorimotor neuropathy, skin lesions (hypo or hyperpigmented skin les
Viral hepatitis is a common cause o Chronic liver disease (cirrhosis)
Hypovolemic hyponatremia presents High renin, high aldosterone, ADH
INH side effects? Peripheral neuropathy and hepatotoxicity
Mixed cryoglobulinemia syndrome pH.C.V.
Mixed cryoglobulinemia presents Fatigue, palpable purpura, arthralgias, renal disease, peripheral neuropathies.
Consider natural history disease whCannot draw conclusions from a cold infection study if these colds self-resolve in
What is treatment option for unila Surgery
What is the treatment option for b Medication
How do you diagnose adrenal prob Abdominal imaging (CT scan)
What are some signs/symptoms of ce 1. progressive gait dysfx, 2. truncal ataxia, 3. nystagmus, 4. intention tremor or d
Lesions of the upper thoracic spina Paraplegia, bladder/rectal incontinence, absent sensation from nipple downwar
45 y.o. woman with 3 mo excessive Cancer
Acute mitral regurgitation due to Elevated LV EDP - due to excessive diastolic volume overload?
e (intra-abdominal or cerebral vein thrombosis)
ncreased L.V.E.D.V.
eth grinding.

D., and liver enlargement.

ns (hypo or hyperpigmented skin lesions), pancytopenia, mild transaminase elevation.

disease, peripheral neuropathies.

on study if these colds self-resolve in one week.

. nystagmus, 4. intention tremor or dysmetria, 5. impaired R.A.M. 6. pendular knee reflex; clonus = pyramidal tract disease (not
sent sensation from nipple downwards.

volume overload?
= pyramidal tract disease (not brisk.)
An obese person that cannot sleep at night is d Obstructive sleep apnea.
Mucocutaneous lesions with flaccid bullae and Pemphigus vulgaris
What is the treatment for pemphigus vulgaris? Systemic glucocorticoids
Autism age of presentation Autism presents early during early preschool and school-aged pop
What are the signs/symptoms of autism? School-aged with fixed interest, plays with toys, and social exclusio
Septic shock presents in what type of patient? Post-op patient a few days after surgery, give .9% saline to restore
Post-op day 4 after abdominal surgery shows fev Could have septic shock. Give .9% n.s.
RBC transfusion goal is to keep HB above what v >7g/dl unless they have not responded to crystalloid and vasopres
Patient experienced a clavicular fracture. What Performa an angiogram for neurovascular structures (subclavian a
Panic disorder patients complain of what complaSudden CV, GI, neurological complaints that go away after short tim
Patient with CERVICAL cord injury experiences w Syringomyelia - causes loss of pain/temperature and muscle atrop
Pre-renal injury is indicated by a BUN/cr ratio of BUN/Cr>20
What is the indication for prerenal acute kidney Volume loss
Anastamosis after a sigmoid resection would in Cirrhosis
Acute cholecystitis shows with what presentatio RUQ pain, fever, leukocytosis within past 12 hours.
Chronic prosthetic joint infection is commonly Coagulase negative Staph Aureus
Prosthetic joint infections due to Staph aureus a Acute infections <3 months
gram - sepsis can cause what lab values? Thrombocytopenia and elecated glucose levels
Patients with M.D.D. present with what sympto Insomnia, early morning awakenings, low energy
A.B.I is used to diagnose what condition? Peripheral arterial disease
Abdominal ultrasound is used to diagnose what AAA
When do you use arterial ultrasound? P.A.D. patient who obtained abnormal A.B.I.
What is the treatment for acute pancreatitis tha Endoscopic drainage procedure.
Schizophreniform disorder is defined by what t 1-6 mo of symptom onset, same symptoms as schizo -doesn't requ
A patient with S.B.O. with distended loops of bowSurgery
Bulimia patient presents with what type of com Bulimic patients can compensate for over-eating by fasting or exer
How much do bulimic patients weight? normal weight to overweight
Patients with somatic symptom disorder require Regularly schedule appointments with physician to establish a stro
Patient with G.A.D. must have multiple issues fo >6 months
Adjustment disorder would require emotional/beWithin 3 months of stressor.
What are some stabilizing treatments for bipolar Lithium and valproate, but remember lithium messes up your kidn
What is the treatment for a stress fracture found Rest and analgesics.
Stress fractures typically occur on what bone? Second metatarsal
Psoas abscess presentation? Fever with lower abdominal or flank pain radiating to the groin.
How do you diagnose psoas abscess? CT scan.
Patient with M.D.D. who is bereaving needs wha Psychotherapy and antidepressant like mirtazapine
Following rhinoplasty, whistling noise is heard duNasal septum perforation
early preschool and school-aged population.
st, plays with toys, and social exclusion
er surgery, give .9% saline to restore blood pressure to >90mmHg.

esponded to crystalloid and vasopressors.

eurovascular structures (subclavian artery).
omplaints that go away after short time period.
pain/temperature and muscle atrophy

within past 12 hours.

ed glucose levels
kenings, low energy

bnormal A.B.I.

me symptoms as schizo -doesn't require decline in function. Remember, that for schizoaffective there needs to be delusions in a

ate for over-eating by fasting or exercising too much. Remember, compensatory behavior not only implies fasting, but also exer

ents with physician to establish a strong physician-paient relationship.

member lithium messes up your kidneys. Other options are quetapine and lamotrigine.

r flank pain radiating to the groin.

ssant like mirtazapine

here needs to be delusions in absence of mood symptoms for </2 weeks.

y implies fasting, but also exercise.

malrotation wUpper abdominal series with upper gi tract
What is trochaTrochanteric burisitis causes exercise-induced hip pain
When is exploA patient with abdominal trauma that is unstable which indicates signs of internal organ damage(rigid
What is treat Minimize conflict with family in schizo patient.
What is physi Lactation in men or non-pregnant women.
What type of Anti-depressants
What type of Second-gen antipsychotics quetiapine, lurasidone
Elevated 17O CAH, not PCOS
Cannabis is a conjunctival injection, dry mouth, tachycardia, increased appetite.
Cocaine falls Stimulants 2.22
Cocaine intox anxiety, paranoia, tachycardia, pupillary dilation.
How do we kno The patient will have pain the distal extremities
Arterial occl Think about intermittent claudication (leg pain), also nervous system issues like pulselessness and coo
Schizo patien Don't tell them they are crazy. Just acknowledge that they have concerns. Don't tell them I think your
Pilonidal dise Males 15-30 years old that are obese who have pain and blood above the anus in intergluteal region
HIV+ patient Tell local health department + person infected.
Inevitable aboIf patient is bleeding in first trimester <20 weeks with dilated cervix and gestational sac in lower segm
HELLP syndro Pregnant person with distended liver capsule and elevate alkaline phosphatase with low platelet coun
A patient wit Pulmonary edema
of internal organ damage(rigidity, guarding) and hemodynamic instability.

sues like pulselessness and cooolness to touch.

ns. Don't tell them I think your symptoms are due to schizophrenia.
he anus in intergluteal region

d gestational sac in lower segment of uterus.

phatase with low platelet coun.
Dopamine antN.M.S
G6pd deficienhypoglycemia = seizures, hyperuricemia, lactic acidosis
HCM HCM increase preload or afterload effect
OrganophosphRemove all clothes and wash the body
SSSS causes wgeneralized erythema and superficial flaccid blisters
SSSS usually Children below age 10
A. fib patient Mitral stenosis
Knee pain in Traction apophysitis
No rash + multjuvenile idiopathic arthiritis
Patient needsCopper iUD
Triple bubbllejejunal atresia
Graft versus host disease can occur in wha G-V-H-D occurs in <100 days post transplant [pg. 193] step 2 ck
G-V-H-D involves what immunological mec GVHD involves T-cell cell mediated immune dysfunction.
G-S-W below 4th nipple in hemodynamicallyExploratory laporatomy
What is dumping syndrome? Post-gastrectomy complication with GI (nausea,diarrhea, abdominal cra
What is treatment plan for patient with An Bilateral gonadectomy after puberty.
Someone relapses on anti-psycotic what is Give longer-acting drug like iv injectable anti-psychotic
Lyme disease is caused by what organism? A spirochete
Patients who desire lactation suppression Wear a supportive bra, avoid nipple stimulation, and use ice packs and a
R.D.W is normal in what disease conditions A.C.D. and Thalassemia [Variability between R.B.C.s does not exist in Tha
R.D.W is increased in what disease? Iron-deficiency Anemia.
What is the role of hCG? hCG mantains the corpus luteum.
Rapid deceleration injury and chest tube p Tracheobronchial rupture (lung rupture)
A patient is depressed and loses interest in Initiatite anti-depressant therapy because they likely have major depres
t [pg. 193] step 2 ck

sea,diarrhea, abdominal cramps) and vasomotor (palpitations, diaphoresis) symptoms.

tion, and use ice packs and analgesics to relieve associated pain.
n R.B.C.s does not exist in Thalassemia]

hey likely have major depression.

HTN increases the risk of what condition? Superimposed preeclampsia, abruptio placenta, fetal gro
Phenytoin use can lead to what findings? Small body size, microcephaly, digital hypoplasia, nail hy
Hoarding disorder is treated with what therapy? C.B.T.
Hyperemesis gravidarum signs/symptoms Metabolic alkalosis is present due to loss of gastric acid.
4 year old boy presents with fver and neck pain, lateral n Retropharyngeal abscess
Amoxicillin with clavulanate has activity against what bugs Pasteurella multocida and oral anaerobes.
D.B.S characteristics macrocytic pure red cell aplasia, associated with THUMB
What is antisocial disorder? People >/18 years old violate societal rules.
Oppositional defiant disorder is characterized by what? A position of deviant behavior toward authority figures.
What is the plan for Lithium use? Use lithium indefinitely if it's been working to prevent re
Testicles fail to descend from abdomen - name of disease? Crytpoorchidism
What is the complication of cryptoorchidism? Infertility
Placenta previa presents with what risk factor? Prior c-section, grand multiparity, advanced maternal ag
Placenta previa clinical presentation? Hemmorhage at the time of clinical delivery.
Necrotizing fasciitis can present with what signs/symptom Systemic signs/symptoms such as hypotension should ra
Acute GI perforation requires emergent laparotomy. If on wa Replace deficient vitamin K with F.F.P.
When is the tissue considered to be hypoxic? HB drops below 7/dL.
An adolescent kid is experiencing gender dysphoria (feelin Encourage them to get a support system and consider m
If a boy has gout, what is a common condition that they p Lesch - Nyhan Syndrome
A boy presents with self-mutilating behavior, mental status Lesch-nyhan - deficiecny HGPRT
If a reproductive age person has secondary amennorhea wha Ectopic pregnancy
An adnexal mass would suggest what? Structures closely related structurally and functionally to
What is the protocol for use of clozapine? Clozapine has a risk of agranulocytosis - only use in treat
When do you use a long-acting injectable ariprazole antips If patients are non-compliant with medications use long
When do you use C.B.T. for schizo therapy C.B.T. is used for stable schizo
Fetal heart rate decelerations would suggest what cause? umbilical cord compression, which pushes on the fetal h
Intermittent variable decelerations are relieved by what ac Maternal reositioning will alleviate intermittent variable
Maternal repositioning is indicated for what issue? Fetal heart rate decleration.
SCID is defined by what findings? Absence of lymphocytes T/B cells; treat with stem cell
Nystagmus characterized use of what drug? PCP
Functional asplenia in sickle cell patients will lead to what Howell Jowell bodies
Basophilic stippling shows up in what conditions? G6PD deficiency and lead poisoning
heinz bodies show up in what conditions? G6PD deficnecy and thalassemia
Boeerhave syndrome would lead to what finding? Crepitus
abruptio placenta, fetal growth restriction, preterm labor, stillbirth
, digital hypoplasia, nail hypoplasia, midfacial hypoplasia, hirsutism, clef palate and rib anomalies

due to loss of gastric acid. Volume depletion also causes a contraction metabolic alkalosis with activation of the R.A.A.S

l anaerobes.
ia, associated with THUMB abnormalities (unlike fanconi's). Also presents with short stature, webbed neck, cleft lip, shielded ch
societal rules.
r toward authority figures.
been working to prevent relapse.

rity, advanced maternal age, multiple gestation, prior placenta previa.

linical delivery.
h as hypotension should raise suspiscion for necrotizing asciitis.

ort system and consider medications to delay hormones.

cturally and functionally to uterus such as ovaries, fallopian tube, or any structure surrounding connective tissue
locytosis - only use in treatment resistant schizophrenia (resistant to >/2 antipsychotic drugs)
with medications use long-acting injectable.

which pushes on the fetal heart, slowing it down to a nadir, where the heart will contract.
viate intermittent variable decelerations.

B cells; treat with stem cell transplant Give iVIG for HUMORAL immunodeficiencies like x-linked a gammaglobulinemia, CVID
tivation of the R.A.A.S

bbed neck, cleft lip, shielded chest.

onnective tissue

a gammaglobulinemia, CVID
PDE-5 inhibitor
bluish vision
a1 antagonist Doxazosin
Laryngoscopy Laryngomalacia which presents in infants as inspiratory stridor.
Sudden onset Systemic lupus erythematosis
Patient with Then perform CT scan
Mcc of prima Uterine atony - failure of uterus to contract and compress the placental site blood vessels.
Treatment forOxytocin
Wernicke enceneurological symptoms, oculomotor dysfunction, gait ataxia
Amennorhea >/ Elevated FSH/LH>1.0
If N.A.A.T di Treatment the chlamydia not the gonorrhea
Necrotizing e Feeding intolerance, abdominal distension, and bloody stools.
Risk factors f Prematurity, hypotension, and congenital heart disease.
Hall-mark X-raPneumatosis intestinalis
First line tre antipsychotics, lithium, valproate.
Patients with antipsychotic alone, or combo with initiation of mood stabilizer to manage symptoms effectively.
site blood vessels.

age symptoms effectively.

What is the role of progesterone during pregnancy? Progesterone activates the resp
Post-ictal seizure would be indicated by what event Tongue laceration - because bas
What is the most common cerebellar tumor in children? Pilocytic astrocytoma
What is the second most common cerebellar tumor in children? Medulloblastoma
HIV infection in infancy presents with what symptoms? Failure to thrive, lymphadenopa
The recommended sun-screen amount is what level? SPF 50, anything above SPF 50 i
Slipped capital femoral epiphysis is a common hip disorder seen in what patient po Overweight adolescents .
What is required to prevent avascular necrosis of the hip? Urgent surgical fixation.
Klumpke palsy results from what injury to infant? Shoulder dystocia to the infant.
Klumpke palsy results from injury to what nerve roots? 8th cervical and 1st thoracic ne
What is the most common cause of nephrotic syndrome in children? M.C.D.
NSAIDS increase activity of what hormone? NSAIDS increase the activity of
ogesterone activates the respiratory center and causes respiratory alkalosis.
ngue laceration - because basically he needs time to recover his neurological status.
locytic astrocytoma
ilure to thrive, lymphadenopathy, opportunistic infections such as pcp pneumonia, severe thrush
PF 50, anything above SPF 50 is not recommended
verweight adolescents .
rgent surgical fixation.
houlder dystocia to the infant.
h cervical and 1st thoracic nerves which results in hand paralysis and ipsilateral Horner Syndrome.

SAIDS increase the activity of ADH which leads to hyponatremia.

Radio opaqueIron poisoning is represented by radioopaque substance on abdominal x-ray\
Pre-natal subsIron can be ingested by infant
H.S.P. Clinic palpable purpura of lower extremities, arthralgias, abdominal pain, renal disease.
HSP lab findi Normal platelet count, coagulation studies, normal to increased creatinine, hematuria +/RBC casts +/-
Treatment HS Supportive (hydration & NSAIDS) for most patients
Treatment forHospitilization and systemic glucorticoids in patients with severe symptoms.
Atelectasis f Abdominal and thoracoabdominal procedures.
What is the trBreathing exercises
How should yoAsk the husband to leave the room so that you can speak with patient alone.
Patients with Continue antidepressant treatment for additional 4--9 months.
Infectious moHepatosplenomegaly and rash after amoxicillin.
Management A ovoid sports for >/3 weeks (contact sports >/4 weeks) due to risk of splenic rupture.
A patient in t Fetus is transverse to the uterus. The fetus will likely convert to cephalic presentation spontaneously.
Autism spectrImpaired social communications, repetitive interests or behaviors.
Management Pt hysicians should be sensitive, consider both parent views; encourage further evaluation.
Septic abortioClinical presentation of septic abortion includes fever, chills, abdominal pain. Sanguinopurulent vagina
Septic aborti Retained POC, thick endometrial stripe
Septic abort intravenous fluids, broad spectrum antibiotics, suction curettage
Vesicuovaginalpainless loss of urine into vagina. PE: pooling of clear watery fluid in vagina.
Management Continue
of breastfeeding and administer antibiotic therapy; patient does not have any fluctuance.
Children at a Grasp objects, pull to stand, babble to say some words, and respond to their name. Some speration a
Patient who dAudiology evaluation
ine, hematuria +/RBC casts +/- proteinuria.

enic rupture.
c presentation spontaneously.

urther evaluation.
pain. Sanguinopurulent vaginal discharge, boggy tender uterus, dilated cervix.

not have any fluctuance.

their name. Some speration anxiety is developmanlly normal at age 9-18 months. Delayed verbal milestones should be assesse
milestones should be assessed with an audiological evaluation.
A child with Perform repeat dipstick on two subsequent occasions to ensure that the proteinuria is not intermitem
When is brea Breast engorgement is common 3-5 days after delivery when colustrum is replaced by milk.
Symptoms of Breast fullness, tenderness, warmth, without fever. Improvement is expected as breastfeeding is estab
Femoral herniFemale patients
e proteinuria is not intermitemnt.
is replaced by milk.
ected as breastfeeding is established.
When does breast engorgement o3-5 days after delivery.
What are symptoms of engorgem Bilateral, symmetric breast fullness, tenderness, and warmth.
Varicocele clinical presentation Varicocele increase in size with standing and Valsava.
Varicocele is more common on whVaricocele is more common on the left side. Because left spermatic vein drains to
Treatment for varicocele? Gonadel vein ligation and scrotal support and NSAIDS.
Vitamin A Deficiency occurs in wh2 or 2 year old child with impaired adaptation to darkness, photophobia, dry scaly
What is the most common cause of Transient synovitis
How do you treat hip pain in childIbuprofen, rest, and F/U in 1 week
Precocious puberty is defined as Secondary sex characteristics before 8 or 9= precocious puberty.
A patient with peripheral cause o Low FSH, LH values.
Can a patient with schizophrenia Yes, patient with psych diagnosis possess decision making capcaity as long as thei
What is the treatment algorithm Use combination of Lithium/Valproate and a second-gen antipsychotic such as qu
What is primary dysmennorhea pelvic cramping during frist few days of menses in context of normal pe
Primary dysmennorhea MOA increased prostaglandin release
Dobutamine MOA causes what to Decrease in L.V. E.S.V.; keep in mind that a low cardiac output could lead to kidney
In a spontaneous abortions, thereThe difference in abortions is the amount of P.O.C (products of conception) that a
What is the treatment for CIN 3? Cervical conization
Late-term and post-term pregnanci Uteroplacental insufficiency
Antenatal fetal surveillance typic 41 weeks gestation, when biophysical profile is used to screen for fetal hypoxia.
What's the order of treatment in First diet, then pharmacotherapy
What is shoulder dystocia? Inability to deliver shoulders to gentle traction
Initial management of shoulder d Mcroberts maneuver (flexion of the hips back towards the abdomen) and applica
Significant weakness in abductionRotator cuff tear.
Massive lowering of arm from horRotator cuff tear.
First trimester maternal-fetal tra Cataracts, pda, sensorineural hearing loss.
How do you prevent rubella? Vaccination prior to conception.
Breath holding spells is associate Normal development.
spermatic vein drains to the left reinal vein.

s, photophobia, dry scaly skin, xerosis conjunctiva, xerosis cornea, keratomalacia, bitot spots, follicular hyperkeratosis of shoulde

capcaity as long as their judgement and decision making capacity is intact.

antipsychotic such as quetapine.
t of normal pe

put could lead to kidney damage, which is indicated by an increase in Creatinine.

cts of conception) that are released through the cervix.

reen for fetal hypoxia.

e abdomen) and application of suprapubic pressure.

cular hyperkeratosis of shoulders, buttocks, and extensor surfaces.
Exertional he Core body temperature must be >40C (104F) immediately after collapse
Management Rapid
of cooling - ice water immersion preferred, fluid resuscitation, electrolyte correction
Decreased barorthostatic hypotension
Dofetilide is prolong QT interval.
Metolazone clThiazide diuretic
Valsartan clasAII - receptor blocker
Arrtyhmic cauNo prodrome in arrtyhmic causes of syncope
In vasovagal Prodrome exists with vasovagal and neurocardiogenic causes of syncope.
Mitral stenosiIncreased left atrial pressure, congestion, hemoptysis.
F.M.D. is a n Women age 15-50.
F.M.D. affects Renal arteries, C.V.A
Acute pericardChest pain that is sharp and pleuritic, improves by sitting up and leaning forward, pericardial frction ru
Pericardial ca Constrictive pericaditis
Constrictive pElevated jugular venous pressure, pericardial knock, pulsus paradoxus, kussmaul's sign.
Causes of consiodiopathic or viral, cardiac surgery or radiation, tuberculous pericarditis (in endemic areas)
Ascending aorSudden-onset, tearing chest and back pain in the setting of uncontrolled hypertension.
Chest radiogr Widened mediastinum or irregular aortic ontour with inward displacement of atherosclerotic calcifica
Peptic ulcer Free air under the diaphragm.
Pneumothoraxperipheral or apical radiolucency, along with absence of lung marking beyond lung edge
HyperparathyrMuscle weakness, recurrent nephrolithiasis, neurpsychiatric symptoms, hypercalcemia
Hyperparathyrbone, stone, abdominal moan, psychic groans.
Majority of p Parathyroid adenoma.
Brachial femoCoarctation of the aorta
Sudden passincardiogenic syncope
rolyte correction

g forward, pericardial frction rub, diffuse concave upward elevations across precordial and limb leads.

kussmaul's sign.
s (in endemic areas)
d hypertension.
ment of atherosclerotic calcification

eyond lung edge

Appropriate t H2 receptor antagonist or PPI (omeprazole)
Risk factors f Obesity, smoking
Sarcoidosis r Serious arrhthmia, cardiomyopathy, heart failure, sudden cardiac death
Cardiac tamp Cardiac tamponade pushes on the heart which causes hypotension, syncope which is defined as some
Cardiac tampoCardiac tamponade presents with clear lungs on auscultation.
Cardiac tamp Widened mediastinum.
Pulsus bisferi Aortic regurgitation (with or without aortic stenosis)
What is the diCardiac tamponade
Cardiac tampoAortic dissection.
Patients with Hypotension, tachycardia, distended neck veins, pulsus paradoxus
Cyanide toxic Nitroprusside
WPW ECG findshort PR interval <120 mseconds
Factors that i Bystander CPR, prompt rhythm analysis, defibrillation
The CHA2DS2-V Thromboembolism.
AV conductionThis would suggest that endocarditis caused the AV conduction abnormalities. Then, the Q - bank say
Restrictive l Nonproductive cough. For example, pulmonary fibrosis will produce a non-productive cough.
Patient with Anti-arrhtyhmic toxicity?
Abdominal aorUltrasound
Ascending aorAortic regurgitation- diastolicmurmur
CostochondritiChest pain associated with movement = costochondritis.
Management Roeassurance
cope which is defined as someone who suddenly collapses. Patient's jugular veins are distended.

M, V-VASCULAR DZ(PRIOR MI, P.A.D., aortic plaque), a-age 65-75, sC-SEX CATEGORY (FEMALE)
malities. Then, the Q - bank says something fancy like "perivalvular" abscess which simply means "INFECTION AROUND THE VALV
on-productive cough.
Syncope from valvular obPreceding history of extertional dyspnea, chest pain, and orf atigue.
Vasovagal syncope . In response to stress, pain, certain actions(urination).
Vasovagal syncope commFemales.
Hyperventilation is can Vasoconstriction.
Abnormal fourth heart soAcute phase of MI - left sided neck pain, substernal discomfort.
How do you treat an induAnti-platelet therapy
Atrial fibrillation is mos Pulmonary veins
AV reentrant tachycardia Reentrant circuit involving an accessory AV bypass tract.
Aortic regurgitation has Enlarged left ventricle closer to the chest wall, causes a pounding sensation, increased aw
Tricuspid stenosis presenright sided h.f. (elevated JVP, hepatomegaly, ascites, peripheral edema).
Torsades de pointes has Immediate defibrillation
Torsades de pointes treatIV Magnesium.
Ventriculr aneurysm is a 5 days - 3 months
Explain the significance Ventricular aneurysm is a late complication of acute ST segment elevation
Stable patient with wid Anti-arrhythmic drugs (amiodarone, procainamide, sotalol, lidocaine)
Patients with persisent Synchronized electrocardioversion
Patients with P.A.D. and Nonfatal myocardial infarction and stroke.
Patients with P.A.D have Cardiovascular causes.
Patients with P.A.D. ; 1-2 Ischemia with risk of limb amputation.
Coronary atherosclerosis Acute coronary syndrome
Psychomotor agitation and cocaine intoxication
Stress-induced (takotsuboSeen predominantly in older adults in response to intense physical or emotional stress or a
Management of chest pain Benzodiazepines for blood pressure, ASA, Nitro, CCB, Beta blockers contraindicated, fibrino
Management of cocaine ch Immediate Cardiac Catherization with reperfusion when indicated.
Patients with diagnosis urinalysis for occult hematuria, urine protein/creatinine ratio, chemistry panel, lipid profile
Thyroid stimulating hormoccult hypothyroidism.
Twenty-four hour urine mpheochromocytoma.
Primary renal disease di Renal ultrasound duplex dopper U.S. is useful in screening for renal artery stenosis in pati
Imaging studies for renal Creatinine or abnormal urinalysis.
Acute mitral regurgitati Papillary muscle displacements in patients with acute MI.
Acute mitral regurgitati Elevated left atrial and ventricular filling pressures/ acute pulmonary edema.
Chronic mitral regurgita Significant changes in left atrial or ventricular size and/or compliance.
Acute MR - consequenceNo significant changes in size.
Hypertensive emergency Severe
- hypertension (usually >/180/120) associated with retinal hemorrhages, exudates, a
HTN encephelopathy is a Cerebral Edema.
What is hypertensive urg Severe hypertension(usually >180/120) with no symptoms or acute end-organ damage.
Hypertensive emergency Malignant
- htn - severe htn with retinal hemmorhages, exudates, papilledema.
Htn encephelopathy. Severe HTN with cerebral edema & non-localizing neurologic symptoms and signs.
Systolic anterior motion oHOCEM.
Patient with aortic steno Increased myocardial oxygen demand.
Aortic stenosis presents Right first I.C. space increases myocardial oxygen demand.
What is the initial therap Beta blockers
When patient is euthyroi Thionamides, radioidine, surgery.
Adenosine clinical use S.V.T patients.
Anti-arrhthmic drugs(amiMaintenace of sinus rhythm in patients with paroxysmal A.F.
Electrical or chemical ca Restore sinus rhythm in patients with A.F.
What is the strongest prePremature discontinuation of antiplatelet therapy
Strongest predictors of large aneurysm diameter, rapid rate of expansion, current cigarette smoking
Current indications for o aneurysm size>5.5 cm, rapid rate of aneurysm expansion (>.5 cm in 6 months or >1 cm pe
Presence of symptoms regAbdominal, back, or flank pain, limb ischemia.
Systemc HTN is the most Aortic dissection
Marfan syndrome is respoPatients<40
Marfan syndrome is uncoPatients>60
What are three risk factorHypertension, marfan, cocaine use
Clinical features of marf Severe, sharp, tearing chest or back pain with >20 mm Hg variation in systolic bp between
PCI is recommended withPCI is recommended within 90 minutes of a stemi.
What are additional stabiOxygen, full dose ASA, platelet P2Y12 receptor blockers, nitro for pain control, beta blocke
When do you give fibrinoFibrinolysis is administered within 12 hours of symptom onset of STEMI patient who cann
Atheroembolism is a comCardiac catheterization and other vascular procedures.
Atheroembolism is characBlue toe syndrome, livedo reticularis, cerebral or intesitnal ischemia, acute kidney injury, H
Treatment for atheroembStatin therapy.
Atrial fibrillation patie TSH and free T4 levels measured to screen for occult hyperthyroiism as underlying cause.
Patient with dilated card alcohol
What are the laboratory AST:ALT is 2:1
ounding sensation, increased awareness of heartbeat.
heral edema).

gment elevation
l, lidocaine)

e physical or emotional stress or acute medical illness (unexpected death of a relative, grave medical diagnosis, arguments, signi
a blockers contraindicated, fibrinolytics not preferred due to increased risk of intracranial hemmorhage.

atio, chemistry panel, lipid profile, baseline electrocardiogram.

ng for renal artery stenosis in patients with severe or resistnat hypertension.

pulmonary edema.

retinal hemorrhages, exudates, and/or papilledema. Hypertensive encelopathy is associated with cerebral edema.

s or acute end-organ damage.

udates, papilledema.
ogic symptoms and signs.
cigarette smoking
(>.5 cm in 6 months or >1 cm per year)

variation in systolic bp between arms.

nitro for pain control, beta blockers, and anticoagulation.

nset of STEMI patient who cannot undergo PCI but is associated with higher rates of recurrent myocardial infarction, intracran

al ischemia, acute kidney injury, Hollenhorsrt plaques.

erthyroiism as underlying cause.

cal diagnosis, arguments, significant loss)

cerebral edema.
myocardial infarction, intracranial hemmorhage, mortality compared to PCI.
Adenosine dx/management Adenosine can diagnose and manage narrow QRS complex tachycard
Adenosine MOA Adenosine slows sinus rate, increases AV node conduction delay, tran
Adenosine MOA2 Adenosine terminates P.S.V.T. by interrupting AV nodal reentry circuit
Amiodarone Clinical use Amiodarone is used to treat atrial fibrillation.
Patient with acute arterial occlusion should Anticoagulation while further diagnostic procedures are performed.
P.A.D. treatment Heparin prevents further thrombus propagation and thrombosis in th
Patient with suspected acute arterial occlusio Anti-coagulation with heparin.
Folley catheters contain what substance that Latex allergy
Dilated left ventricle can result after a Myoar ACE inhibitors.
An abnormal fourth heart sound (atrial gallop Acute phase of myocardial infarction due to LV stiffening and dysfunc
What is the MCC of aortic stenosis in patients Bicuspid aortic valve.
Three MCC causes of aortic stenosis in genera Senile calcific aortic stenosis, bicuspid aortic valve, rheumatic heart d
HOCEM murmur is best heard where? Lower left sternal border, it does not radiate to the carotids.
Myxomatous valve degeneration causes what Mitral valve proplapse.
Rheumatic heart disease can be the cause of wAortic stenosis.
Senile calcific aortic stenosis is MCC aortic st Age >70 years old.
What is the major cause of morbidity and morta Cardiovascular disease.
Patients with P.A.D. and intermittent claudica Nonfatal myocardial infarction and stroke
P.A.D. patients have 15%-30% risk of death du Cardiovascular cause
1-2% of patients with P.A.D. progress to devel Critical limb ischemia with risk of limb amputation.
Congenital bicuspid aortic valve is MCC cause oYoung adults in developed countries
AR leads to an early decrescendo diastolic mu Diaphraghm of stehtoscope along left sternal border at third/fourth I
w QRS complex tachycardia.
ode conduction delay, transient bock in AV node conduction.
g AV nodal reentry circuit.

ocedures are performed.

ation and thrombosis in the distal arterial and venous circulation.

LV stiffening and dysfunction, induced by myocardial ischemia

c valve, rheumatic heart disease.

e to the carotids.

al border at third/fourth IC space.

In CHF, what Hyponatremia is independent predictor of heart failure and is caused by fluid overload - an example i
How do you t Loop diuretics, ACE inhibitors, fluid restriction
Ascending aortAcute aortic regurgitation
Reversible ris Tobacco and alcohol
What is the t B-blockers
What is holte A form of monitoring for patient with intermittent arrhthmias (syncope, palpitations)
TTE is useful Cardiac/valvular structural and or functional abnormality.
Patient with Low-dose beta blockers
What are the rAlcohol and Tobacco
Heart failure Heart failure activates RAAS which leads to constriction of efferent renal arterioles
Patients with Fluid build up , which generates the S3
Coarctation ofEchocardiography
How do you trBalloon angioplasty, stnet placement, surgery
Cardiogenic s No, you just collapse.
NeurocardiogeYes. Prodrome exists for these two
What is the t Glucagon
Chornic venouvaricose veins, skin discoloration, and medial skin ulceration.
What is the inconservative measures, with leg elevation, exercise, compression therapy
PE findings of Displaced apical impulse, holosystolic murmur, third heart sound
What is the mMitral Valve proplapse.
Patient has a Arteriovenous Fistula, which increases cardiac preload.
Does ASA haveYes.
What is the Lose weight
Raynaud phenCCB is preventive, followed by B blockers
45 - year old Raynaud phenomenon.
Tachycardia mRate or rhythm control.
y fluid overload - an example is renin, ADH, or NE.

, palpitations)

l arterioles
A. fib in hemodynamicallB blocker or CCB
Hemodynamically unstabl Synchronized cardioversion
Atrial fibrillation origi Atrial fibrillation originates in the pulmonary veins
What is an independent Hyponatremia.
Normal ejection fractionRestrictive cardiomyopathy
Hepatojugular reflex, KuConstrictive pericarditis
Treatment option for rigGive normal saline bolus
Right ventricular infarct Hypotension, JVP is low or normal, lungs clear
Bounding pulses is asso Aortic regurgitation
Most important factors iadequate bystander CPR, prompt rhythm analysis and defibrillation
Descending aortic aneu Atherosclerosis
What PE finding is pres Widened mediastinum.
How do you diagnose avfDoppler ultrasound
What is the treatment f Surgical therapy
Exercise stress ECG is Initial test/dx for risk stratification in patients with suspected stable ischemic heart disease.
Aortic dissection in a Ct angiography
Marfan syndrome presenEarly diastolic murmur
Amiodarone is associatePatient with a fibrillation and underlying ventricular systolic dysfunction.
Verapamil side effects constipation, impaired cardiac conduction/contracility.
How do you treat pulseleCompressions
Systolic diastolic abdom Renal artery stenosis
What is the common caus Bicuspid aortic valve
Aortic dissection risk fa htn (most common), marfan syndrome, cocaine use.
Knife like pain describe Aortic dissection
Knife like pain describe Aortic dissection
Ascending aortic dissectAortic regurgitation
What PE findings are moHepatojugular reflex, unlike cirrhosis of liver which would not show hepatojugular reflex.
Tachycardia mediated c Rate/rhtyhm control
Niacin flushing is cause Prostaglandin reaction
Pulsus paradoxus occursCardiac tamponade and pericardial effusions from disease like severe asthma or COPD
e ischemic heart disease.

w hepatojugular reflex.

ere asthma or COPD

Pulseless electrical activity or systole management
Cardiac tamponade and hemodynamic cmpromise management
Electrical alternans with sinus tachycardia is specific for what diseas
Pocainamide management
Synchronized direct current cardioversion management
Thrombolytic therapy in STEMI patients - when do you use?
Temporary tranvenous pacemaker - treatment
Can too much alcohol cause high blood pressure?
What is excessive alcohol intake?
What is binge drinking?
What is the preferred pharmagologic treatment for vasospastic angi
Ronalazine Clinical Use
Ventricular fibrillation or pulseless V.ach shuold be managed with w
Hemodynamic instability due to narrow or wide QRS complex tachyarrht
Patients with HOCEM present with what PE finding?
Common causes of cor pulmonale
Emergency pericardiocentesis is indicated in what patients?
Hemodynamically stable with acute aortic dissection requires what
Episodic syncope in a 78 year old working in garden who has a widen
Early diastolic murmur aortic regurgitation is associated with what p
Patient with mediastinal irradiation and hepatojugular reflex, Kussma
Ascending aortic aneurysms are due to what conditions?
Descending aortic aneurysms are due to what conditions?
Acute coronary syndrome does not always present with chest pain. It
Chronic venous insufficiency treatment
Patient with electrical alternans and hemodynamic instability shoul
uninterrupted cardiopulmonary resuscitation + vasopressor therapy
Emergency pericardiocentesis
Large pericardial effusion
Treat supraventricular and ventricular arrhthmias, WPW
A. flutter, a. fib, stable monomorphic v. tach
Emergency PCI is not readily available
Sick sinus syndrome or symptomatic second-degree or third-degree heart block
>2 drinks/day
>/5 drinks in a row
CCB(Diltiazem, amlodipine) cause coronary artery vaosdilation.
Inhibit sodium inflex into ischemic cardiomyocytes - treats stable angina due to atherolscerotic C.A.D.
Immediate defibrillation
manage with synchronized cardioversion.
Systolic anterior motion of the mitral valve leaflet.]
COPD (most common), interstitial lung disease, pulmonary vascular disease(thromboembolic), obstructive sleep ap
Patients with pericardial effusion and cardiac tamponade with hemodynamic instability or cardiogenic shock
CT Angiogram
Aortic dissection
Bounding pulses
Constrictive pericarditis
Cystic medial nerosis or CT disorders
Dyspnea, nausea, vomiting, epigastric pain -- it looks like acute pancreatitis. Because coronary syndrome is the mos
Leg elevation
ic), obstructive sleep apnea.
cardiogenic shock

ary syndrome is the most life threaning of them all, you need to work this one up first.
When do you Symptomatic patients with potential tachyarrythmias.
What parameters vary with pretest probability Negative predictive value.
Do sensitivity/specificity values fluctuate with No, only PPV and NPV
Injury to the lower spinal cord would result i Cauda Equina syndrome
Is Cauda Equina syndrome a LMN or UMN inju Cauda Equina syndrome is LMN - therefore you visualize hyporerefle
Spinal cord injury involves what characteristic Radiculopathy
Saddle anesthesia implies what problem? Injury to the lower spinal cord
Parkinson's vs . Bening Essential Tremor Benign Essential tremor worsens as you get closer to object(intention
What are some abortive therapy for migrane Triptans (sumatriptan), NSAIDS (naproexen), acetaminophen, antiem
What are some preventive therapy for migrai Topiramate, divalproex sodium, T.C.A., beta blockers (propranolol)
Patient with seizure comes in after a traumatic Cb.T. without contrast (because we are not looking for primary disease
Curtain over eye suggests what diagnosis? Amourasis fugax.
What is the most common risk factor for amourAtherosclerotic emboli-- give ipsilateral caridectomy
Crescendo-decrescendo systolic murmur is heard Interventricular septal hypertrophy
If the primary cause of pulmonary hypertensionDiuretic/ACE inhibitor
Widened mediastinal silhouette would be suggThoracic aortic aneurysm, increased aortic knob, tracheal deviation.
How do you confirm diagnosis of a T.A.A.? C.T. scan with contrast
A.A.A. is typically associated with what cardiac Atherlosclerosis
Cerebellar bleeding may be caused what risk f Hypertension
High blood pressure is a cause of what type of Intraparenchymal hemmorhage, causing ipsilateral hemiataxia
Ascending aortic dissection can propagate pro Aortic valve insufficiency
Infective endocarditis (think heroin abuse) ca Can metastasize to the brain (which causes cerebral septic emboli) -
IIH (young, obese woman) is diagnosed with whLumbar puncture with opening pressure
What medications are associated with IIH? Tetracyclines, hypervitaminosis a
you visualize hyporereflexia and asymmetric muscle weakness

closer to object(intention tremor)

), acetaminophen, antiemetics (metocloproamide, prochloerperazine), ergots (dihydroergotamine)
blockers (propranolol)
ooking for primary disease like metastasis, abscess, infarction).

knob, tracheal deviation.

silateral hemiataxia

cerebral septic emboli) - which leads to hemiparesis.

15-30 year oldM.S. = oligoclonal bands
How is pseud Pseduodementia are distressed by impaired memory.
Papilledema i Increased I.C.P. will cause papilledema.
Amourosis fugDuplex ultrasound of neck - atherosclerosis is most common cause of amourosis fugax.
Epidural hemaipsilateral uncal herniation
amourosis fugax.
Calcium gluconate is used to treat whaSevere forms of magnesium toxicity during pregnancy is treated with calcium
Magnesium's MOA during pregnancy m Magnesium mimics severe myasthenic crisis because it inhibits acetyl choline
An Alzheimer's patient can be definedVisuospacial abnormality = Lost in familiar places [friends saw a guy in the str
What is Albuminocytologic dissociati Albuminocytologic dissociation is an increase in protein in CSF without increa
When is Nissen fundoplication used? if treatment is refractory to PPI usage, use Nissen Fundoplication.
Young boy with muscle issues such as Werdnig hoffman syndrome which is a progressive neurodegenerative disord
Post-op days AU - VW - Abs
pregnancy is treated with calcium gluconate (life threatening respiratory compromise)
s because it inhibits acetyl choline neuromuscular transmission.
places [friends saw a guy in the street].
se in protein in CSF without increase in cell count. [Seen in Guillan Barre]
Nissen Fundoplication.
gressive neurodegenerative disorder - will show perineural denervation.
What is considered to be a low ra Less than ten kicks in 2 hours.
R.D.W is elevated in what disease? RDW is elevated in iron deficiency anemia.
What is cryopCryoprecipitate is FFP that is centrifuged.
vHL patients develop what symptoms? multiple retinal hemangioblastomas, clear renal cell C
#1 cause of infertility is due to what? due to male.
Headache behind the eye and photophobia glaucoma
Most common cause of C.A.P. Strep pneumoniae
Young patient with atypical penumoniae is caused by what bu Mycoplasma
Moraxella Catarrhalis - what the risk factors? COPD, DM, CA, STEROIDS
P. Aeuriginosa - what types of patients get p. aeuriginosa infec Hospitalized patients, ventilated patients, C.F. patient
stomas, clear renal cell CA, endolymphatic sac tumors of middle ear, pheochromcytomas

ted patients, C.F. patients get Cystic Fibrosis.

Transplacental Transmission question - Opiates can cross the placenta, sIntubation
Gabapentin clinical use Postherpetic neuralgia and seizures
Tramadol extended-release use Dr. Pierzko uses Tramadol for patients with chronic pain who may get
nts with chronic pain who may get addicted to morphine.
What is an advanced directive? An advanced directive is a legal document signed by a patient that d
signed by a patient that decides who will make decisions for the patient if patient loses consciousness
PR elevation or depression would occur in what disease? Pericarditis
Narrow QRS signal is coming from av node or above
Wide QRS Delay in ventricular depolarization
supraventricular tachycardia comes from what part? narrow QRS because above AV node
U wave relative hypokalemia
Ventricular tachycardia wide QRS
sharp peak T wave hyperkalemia
flat low T wave hypokalemia
m av node or above
e above AV node
Patient with P.E. will eventually develop what problem? Pulmonary infarction
Patients who are chloroquine resistant need to receive what mediMefloquine
Weakly gram +, acid-fast rod describes what infection? Nocardiosis
Pt. dx with Hepatitis A will most likely experience what response? Most people with HepA infections will completely
Well-circumscribed, hypopigmented patch on the left upper arm wit leprosy - biopsy it
viridans group streotococci rx IV penicillin g OR IV ceftriaxone for 4 weeks
Miliary TB presents with what type of pattern? Diffuse reticulonodular pattern
Pneumocystis pna presents with what clinical finding? Fever, dry cough, decreased oxygen
Normal chest x-ray finding in T.B. patient would imply what/ If a patient has a normal chest x-ray finding, with
th HepA infections will completely recover in 3-6 weeks.

R IV ceftriaxone for 4 weeks

nodular pattern
h, decreased oxygen
a normal chest x-ray finding, with a larger indurated nodule, they may need latent TB treatment such as isoniazid and pyridoxine
such as isoniazid and pyridoxine.
Yellow fever vaccination yellow fever vaccination in sub-saharan afrian and equatorioal sou
Takayasu arteritis presentation there are signs of claudication in upper arms - pain and etc and blo
an and equatorioal south american countries
ms - pain and etc and blood pressure discrepancies
In pneumothorax, what is the intended treatment option? Needle thoracostomy
Terminal hematBladder or prostate disease, because BP is the most proximal organs in GU system, therefore they show up last
Initial hematururethral damage for initial hematuria because damage is closest to the outside port
Total hematuriaKidneys or ureteral damage because if the blood is present all the time, it must be present in one of the big col
If symptoms perGive them surgery; in diverticulitis, it is CT-guided percutaneous drainage.
What drug clasNSAIDS are associated with P.U.D.
How do you treaGive exploratory laparotomy
colonic ischemiatherosclerotic disease is a risk factor for colon ischemia.
Colonic ischemHematochezia and diarrhea
Perforation maPerforation may be indicated by end-stage organ findings like lactic acidosis, hemodynamic instability, hypoten
If someone is The disease is getting worse like reducible hernia transitioning to a strangulated hernia
PE should be a R. ventricular dilation and hypokinesis
Following blun Tracheobronchial rupture
stem, therefore they show up last.

st be present in one of the big collecting systems

hemodynamic instability, hypotension, so forth.

What is a post-operative PE maneuver you should perform on pati
UE/LE motor exams for strength test
ams for strength test
What is gastrograffin study? Gastrograffin enema is a contrast dye us
Anorectal disease should be ruled out with what exam? proctosigmoidoscopic exam
What is morrison's pouch Morrison's pouch is a dependent area b
Seatbelt sign Seatbelt sign is a sign of B.A.T.
Grey turner's sign Grey turner's sign represents bleeding a
What is the benefit of the gastrograffin study? The gastrograffin study is a water solubl
nema is a contrast dye used to visualize the esophagus and upper stomach much like barium enema is used to visualize colon in
scopic exam
ch is a dependent area between the liver and kidney where blood accumulates after blunt abdominal trauma that leads to hem
a sign of B.A.T.
gn represents bleeding at the flanks which represents hemmorrhagic pancreatitis
n study is a water soluble contrast study which can be used to visualize the esophagus in patients with esophageal perforation.
ma is used to visualize colon in intussusception.

minal trauma that leads to hemoperitoneum.

s with esophageal perforation.

What is the ground glass appearance describing?
If a patient has multiple dilated loops of small bowel, what is the pathophysiology of the disease?
What is used to Rx meconium ileus?
Meconium ileus
Dilated loops of small bowel represents proximal dilation from either an obstruction or ileus, which is common afte
Gastrograffin study because gastrograffin can solubilize the meconium pellets
or ileus, which is common after surgery.
By PE, a patient has wheezing, decreased breath sounds, tachycardia - what is ddx?
By PE, a patient has wheezing, crackles, decreased breath sounds, fever and sputum production - what is ddx?
By PE, a patient receives c/l tracheal deviation
When you have a potential wound infection, what is one imaging study that you can get?
Fevers may be caused by wide-spread infection, or may be a sequlae of what problem?
Massively distended transverse colon on x-ray would imply what disease?
acute eye pain in an older person would be an example of what?
Aspiration PNA
Tension pneumothorax
CT scan - think of a pancreatic pseudocyst
Fevers may be a sequlae of normal inflammation or infection after surgery; you should get the tests for normal infec
ulcerative colitis
ischemic embolization to one of the carotids
ld get the tests for normal infections like cultures everywhere, and also UA, but also consider electrolyte changes (via BMP)
ectrolyte changes (via BMP)
ASA class of drugs? ASA is known aor 2)
ASA also has another name - known as Salicylic acid

What should yAt clinic, you should continue to consult people involved in patient's care. This includes nurses, case m
What is your First, ask questions in focused manner. Then, once you got pertinent information, start asking checklis
re. This includes nurses, case mangers, and consultants.
formation, start asking checklist questions.
What is reduced effective arterial blood volume? Reduced effective arterial blood volume implies that we have
od volume implies that we have decreased tissue perfusion despite increased ECV from H.F., which makes it look like a reduced
ch makes it look like a reduced effective arterial blood volume.
High post-voi > 50 ml
reactivatino t occurs at the apices of the lung in patients who are immuncompromised; may be w/ MAC
ed; may be w/ MAC
Gout go - out => find the __ in the hay stack needle shaped crystals
RAIU scan - when RAIU is increased, w it means, thyroid is producing a lot of thyroid hormone, so you will increase
What is thyroglobulin? Thyroglobulin is a storage hormone produced in the thyroid follicular cells
What is the use of thyroglobulin? If thyroglobulin is elevated in context of hyperthyroid, then you know it's end
CD4 <180, severe watery diarrhea cryptosporidium
cd4<100, fever rare microsporidium
cd4<50, high fever >39C MAC
CD4 count<50, frequent small volume C.M.V.
id hormone, so you will increase up take.
ed in the thyroid follicular cells
perthyroid, then you know it's endogenous; low thyroglobulin is produced outside of the thyroid
Tinea corporisimmunocompromising conditions (HIV, D.M.)
1st line drug PCN
2nd line for staph or gram -
1st line for s cillins
_____ is the l Linezolid
1st line for g amox/amp w/ or w/out b-lactamase inhibitor
Name of the cCefazolin, ceft, Cefepime(pseudomonas)
Anaerobic druMTZ
Moxi-floxacin gram -
ABX FOR UTI Ampicillin/Cipro