1. initial management of a sle patient with kideny involvement?
    renal biopsy
  2. depot drugs of antipsychotics    ?
    • haloperirol
    • fluphenazine
    • risperidone
    • paliperidone
  3. soap bubble appearing tumor?
    giant cell tumor
  4. rx for threatened abortion?
    reasure and observe
  5. rx for a missed abortion?
    d and c
  6. nucleic acid amplification for gc and chamydia have what sensitivity?
    90% +
  7. most common lysosomal storage disease?
    enzyme deficiency?
    • gaucher
    • beta glucosidase
  8. a tumor with high afp and beta hcg?
    non seminamotous germ cell tumor
  9. anemia in a young child?
    • transient erythroblastenia of childhood
    • iron deficiency
  10. breast milk is low in what vitamin?
    vitamin d
  11. timeline of alcohol withdrawals?
    • seizures -1st 2 days
    • hallucisnosis 1st 2 days
    • 2 to 3 days after last drink
  12. difference between alcoholic hallucinosis and dt?
    hallucinosis has vital signs and dt doesnt
  13. patietns post splenectomy should receive what antibiotics for up to 5 years?
  14. differential for vestibulopathy and vertigo?
    • menieries
    • labirynthitis
    • benign positional vertigo
    • acoustic neuroma
    • perilymphatic fistulas
  15. who gets cyclical vomiting?
    kids of parents who have migraines
  16. when do you start ace inhibitors in diabetics?
    • microalbuminuria
    • 130/80 on two occasions
  17. best initial test for minimal blood per rectum?
  18. when is external cephalic version performed?
    after 36 weeks
  19. mutation in cf results in what?
  20. best initial test for hemorrhage in a blunt abdominal trauma patient?
    • fast
    • if unequivical then lavage
  21. if looking for a hemoorage in the peritonieum from blunt abdominal trauma and the fast is negative, next step?
  22. when are pregnant women test for gbs?
    test for gestational diabetes?
    at 36 weeks

    27 weeks for gestational diabetes and cbc
  23. difference between alzheimers vs multi infarct demenia?
    alzheiemers--agnosia, apraxia, aphasia

    multi infarct--focal neurological defects--sensory or motor losses
  24. calcium gluconate protects the heart in what conidtion?
  25. mechanism of statin induced rhabdomyolysis?
    inhibition of coq10 production
  26. caroli syndrome vs choledochal cyst?
    • caroli --intrahepatic dilatation
    • choledochal cyst--intra or extra hepatic dilation
  27. 2 causes of cholangiosarcoma?

    choledochal cyst
  28. most common type of cancer in the neck?
  29. a muffled voice and a unilateral lymphadenopathy of the neck +
    peritonisillar abscess
  30. all deiseases where a functional part is mutated as in hypertrophic cardiomyomapthy are inherited how?
    autosomal dominant
  31. what is the only shock that has normal mixed venous o2 saturation?
  32. when a patients chest moves in when taking a deep breath this means?
    ribs are fractures--flail chest
  33. necrotizing pneumonia cuaseing absecesses post viral infection?
    staph aureus
  34. what predisoposes to aortic dissection?
    aortic aneurysm?
    • hypertension
    • atherosclerosis
  35. what vasculitis causes aortic dissection?
    giant cell arteritis
  36. what causes cough in left atrial enlargement?
    in mitral stenosis
    irriation of the phrenic nerve
  37. earliest sign of diabetes in the kidney?
    earliest quanitfiabel?
    • hyperfiltration
    • basement membrane thickening the the earliserst quantifibale
  38. what electrolytes predispose to vtach?
    • hypokalemia 
    • hypomagnesemia
  39. after chronic steroid administartion, how long does it take acth and cortisol level to come back to normal?
    several months
  40. when is base used to treat severe metabolic acidosis?
    when ph is less than 7.2
  41. what neurotransmitter is involved in ocd?
    decreased serotonin
  42. risk factors for placental abruption?
    • hypertension
    • sle
    • cocaine
    • smoking
    • diabetes
  43. rx for intrauterine fetal demise?
    • expectant management
    • or 
    • induction of labor
  44. rash in a newborn with eosinophils on biopsy?
    erythema toxicumc
  45. cause of any intestinal atresia?
    intrauterine vascular accident causing necrosis of the bowel
  46. what leukemia in childhood can metastesize to the brain?
  47. symptoms of bronchiectasis?
    • linear atelectasis on x ray
    • copious purulent sputum with +/- blood
  48. rx for bronchiectasis?
    • chest physiotheray and postural drainage
    • antibiotics
    • surgical resection of affected lung
  49. what class of medications can cause hyperthermia as well as hypothermia?
    typical antipsychotics
  50. post cholecystectomy pain can be of two etiologies, what are they? and the rx for them?
    • functional--analgesics
    • sphincter of oddi dysphunction---surgery to correct it
  51. cause of fatty liver?
    insulin resistance--leads to increased lipolysis and oxidation of fats leading to inflammation
  52. hyperthryoid with decreased RAIU?
    increased RAIU?
    • facticious intake
    • graves
  53. what congenital anomalies give cyanosis and increased pulmonary blood flow? loud s2
    decreased pulmonary blood flow? soft s2
    • increased--togv
    • truncus arteriosus
    • TAPVC
  54. what electrolyte produces a sine pattern?
  55. when is hyperkalemia treated?
  56. how is mania diagnosed?
    • 3 of the following
    • distractibility
    • insomnia
    • grandiosity
    • flight of ideas
    • activity increased
    • speech increased
    • thoughtlessness
  57. 2 immunodeficienies that have decreased b and t cells?
    • wiscot aldrich
    • scid
  58. infection in the eye with inflammation and edema post surgery, most common cause?
    post operative endopthalmitis
  59. how are cancers tackled?
    • induction
    • consolidation
    • maintenenace therapies

    • if it fails
    • salvage therapy
  60. contraindication to bupropion?
  61. rx for diseases caused by bacteria from pets?
    zoonotic infections?
  62. when is back pain concerning?
    • when it occurs in someone older >60
    • lasts for more than 6 weeks
  63. when is delivery indicated with the BPP?
    • if the BPP is
    • 8 and oligohydramnios
    • 6, no oligohydramnios and over 37 weeks
    • 6 with hydramnios if over 32 weeks
    • <4 and at least 26 weeks
  64. complications of cath?
    • mi
    • stroke
    • death

    • retroperitoneal hematoma
    • aneurysm
    • arterial thrombosis
  65. cah vs aromatase deficiency?
    • cah has salt wasting + virilization of genitals
    • aromatase deficiency-- sexual infatilism
  66. hypotensive hypernatremia rx?
    normotensive hypernatremia rx?
    • normal saline
    • half normal saline
  67. wernickes encephalopathy?
    • nystagmus
    • ataxia
    • opthalmoplegia
    • confusion
  68. High grade intraepithelial or low grad neoplaisa next step?
  69. genital warts are pruritic?
  70. trichloroacetic acid treats what?
    genital warts
  71. best initial test for vertebral osetomyelitis?
  72. how does a vertebral osteomyelitis present?
    • vertebral tenderness 
    • paraspinal muscle spasm
  73. what gives exudative effusions?
    • infection
    • tb
    • malignancy
    • pe
  74. most important risk factor to control for ascending aortic dissection?
    abdominal aortic aneurysm?
    • hypertension
    • abdominal--control factors taht cause atherosclerosis like smoking
  75. when do you operate with carotid artery stenosis?
    stenosed 80% and up
  76. cmv retinitis?
    white patches of retinal opacification and hemorrhage
  77. painless 3rd trimester bleeding?
    painfull 3rd trimester bleeding?
    • placenta previa
    • rupture of membranes--ferning test
  78. how does a vasa previa present?
    • vaginal bleeding of fetus' origin which results in 
    • fetus distress
  79. risk factors for placenta previa?
    • multiparrity
    • ceserean section
  80. work up of secondary amenorrhea?
    • bcg
    • fsh-ovarian failure
    • tsh-- hypo and hyperthyroidism
    • prolactin--tumor or medications
    • testosterone-- pcos
    • hysteroscope with normal prl, fsh, tsh
  81. what drug combinations predisoposes to seizures?
    cocaine and opiods
  82. asymptomatic proteinuria, next best step?
    recheck it 2 more times
  83. what 2 lesions predispose to squamous cell carcinoma?
    • acitinic keratosis
    • leukoplakia
  84. description of the renal artery stenosis murmur?
    continuous in systole and diastole
  85. cause of assymetric blood pressures in the arms?
    • aortic dissection or
    • artherosclerosis of the subclavian artery
  86. what viruses is implicated in causing primary lymphoma in the brain of hiv patients?
    ebv in the csf
  87. most specific finding on biopsy of follicular carcinoma of the thyroid?
    invasion of the thyroid capsule and blood vessels
  88. what 2 thyroid cancers have hurthle cells?
    • papillary
    • follicular
  89. how is follicular cancer different from follicular adenoma?
    follicular cancer invades the thyroid capsule and the blood vessels
  90. how does follicular thyroid cancer spread?
    blood vessels
  91. chest pain brought on by rest with st segment elevation?
    prinzmetal angina
  92. what organism can cause gallbladder cancer?
    • s. typhi
    • clonorchis
  93. best indicator of tca overdose?
    qrs complex length
  94. bilateral breast enlargement, erythema 2 days post birth?
    breast enlargement with milk
  95. most common cause of bloody discharge of the nipple?
    intraductal papilloma
  96. breast mass in <30 yo? next step?
    • ultrasound
    • ultrasound and mammogram
  97. tests for lactose intolerance?
    • increased Hydrogen in breath and stool
    • increased stool osmolar gap
    • increased amount of reducing sugars in stool
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