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