Challenge Bowl

  1. 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
  2. catecholamine producing large tumors of adrenals
  3. Papilledema must be present
    malignant hypertension
  4. Alcohol can raise
    blood pressure
  5. First Line Therapy for HTN
    Thiazide Diuretic
  6. Beta-blockers end in
  7. Ace inhibitors end with
  8. What antihypertensive can cause Hyperkalemia
  9. What do most ARBs end with
  10. S1
    closing of mitral valve
  11. S2
    closing of aortic valve
  12. normal site of Apical impulse
    midclavicular line 5th left intercostal space
  13. Flex the knee slightly and dorsiflex the foot. Pain in the calf is a positive test
    Homan's sign
  14. Ensures patency of the ulnar artery before puncturing the radial artery for blood sampling
    Allen test
  15. The trachea is ~ __cm long
  16. decreased fremitus
    pulmonary edema, emphysema
  17. increased fremitus
  18. percussion of fluid filled or solid area
  19. Identify drawn figure (draw number or letter) Deficit may indicate lesion in sensory cortex or posterior column
  20. Rigid flexion=Corticospinal tract above brainstem
    Decorticate posturing
  21. Rigid extension=Brainstem lesion
    Decerebrate posturing
  22. Loss of ability to recognize previously familiar objects
  23. Winging of scapula-Medial border of scapula juts outward with arm extension
    Weakness of serratus anterior muscle or injury to long thoracic nerve
  24. most common cause of right heart failure is
    left heart failure
  25. Chagas disease is a common form of myocarditis which is caused by infection with
    Trypanosoma cruzi
  26. The most common primary cardiac tumor is
    atrial myxoma
  27. what are the 4 distinct types of pain
    nociceptive, inflammatory, neuropathic, functional
  28. what is the study of what the body does to a drug
  29. what are the two broad categories of pain
    adaptive, and maladaptive
  30. what is a study of what a drug does to the body
  31. this type of chemotherapy agent inhibits cell growth and proliferation by competing for binding sites on enzymes and incorporating into DNA or RNA
  32. what is the most effective drug for Parkinson's
  33. what is a molecule that has both affinity and efficacy at a receptor site
  34. what type of bacteria is Helicobacter pylori
    gram negative bacilli
  35. what is stomatitis
    inflammation of the oral mucosa
  36. what is a molecule that has affinity but no efficacy at a receptor site
  37. A patient presents with epigastric pain, vague diffuse pain, worsened by food, with N/V, what is wrong with this patient
    gastric ulcer
  38. What is considered the fifth vital sign
  39. what is the incubation period for influenza
    1-2 days
  40. what is considered first line treatment for mild to moderated osteoarthritis
  41. 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
  42. what organism is a classic postinfluenza complication
    Staphylococcus aureus
  43. what has developed when greater doses are needed to produce previously obtained effect
  44. what is the drug of choice in acute otitis media
  45. what type of diuretic is best for someone with CKD
  46. treatment of choice in beta-lactam allergic patient with sinusitis
    levofloxacin or moxifloxacin
  47. when meidcations have a combined effect that is greater thatn the sum of individual effects this is called
  48. what is the maximum daily dose for acetaminophen in a healthy individual
  49. what is currently the only COX-2 inhibitor available in the US
  50. 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
  51. what is the disease modifying anti-rheumatic drug of choice
  52. what pregnancy category has some fetal risk, benefits may outweigh risk
  53. what pregnancy category has fetal abnormalities in animal or human studies, risk outweighs any benefit
  54. what opioid antagonist is used for opioid reversal
    Naloxone (Narcan)
  55. what medication is used for benzodiazepine overdose
  56. What is the treatment of choice for hypothyroidism
    Levothyroxine (T4)
  57. a ventricular arrhythmia caused by digitalis toxicity should be treated initially with
  58. the systolic ejection murmur in hypertrophic obstructive cardiomyopathy is diminished when the patient
    performs the Valsalva maneuver
  59. in the patient with fever and productive cough what diagnosis would be suggested by egophony at the left base
    LLL pneumonia
  60. which hormone peaks at ovulation in the normal menstrual cycle
    Luteinizing hormone (LH)
  61. what knee injury is indicated in a positive anterior drawer sign
    anterior cruciate ligament tear
  62. crampy abdominal pain that waxes and wanes is also called what
  63. what is the most commonly injured area of the mandible
  64. what is the most commonly abused drug by teenagers
  65. what is the most common location for ectopic pregnancies
    fallopian tube
  66. what organism induces rose spots and watery diarrhea, as well as high fever and relative bradycardia
  67. 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
  68. what type of hearing loss is experienced by the patient with cerumen impaction
  69. what organism is known to cause hand-foot-mouth disease
  70. the first cardiac enzyme to be detected in the setting of acute MI
  71. the absence of audible bowel sounds for several minutes in a patient with acute abdominal pain indicates what underlying problem
    ileus or obstruction
  72. a chest x-ray on a 69 year old smoker shows flattened diaphragms, what do you suspect
    Emphysema or COPD
  73. Alzheimer's disease is the most common type of dementia. what is the next most common type
  74. what disease is suggested by the presence of Kaiser-Fleisher rings around the corneas
    Wilson's disease
  75. what will be the appearance of pericardial effusion on an x-ray
    a water bottle silhouette
  76. livedo reticularis commonly develops on what body part
    the legs
  77. 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
  78. 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
  79. What rash presents with a Christmas tree distribution and a herald patch
    pityriasis rosea
  80. what microbial agent is associated with mesenteric adenitis and pseudoappendicitis
  81. 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)
  82. what class of antihypertensive medication would you want to avoid in a patient who has asthma
    beta blockers
  83. what organism causes diarrhea that is profuse and bloody, but does not cause vomiting
    entamoeba histolytica
  84. what is the organism most commonly identified with antibiotic associated colitis
    clostridium difficile
  85. what is the drug class of choice in reducing afterload in patients with congestive heart failure
    ace inhibitor
  86. the most appropriate initial test for the detection of prostate cancer is
    digital rectal exam
  87. peptic ulcer disease may be causally related to an infection of
    helicobacter pylori
  88. poisoning from this gas may result from exposure to improperly vented gas heaters, automobile exhaust, or smoke inhalation
    carbon monoxide
  89. which medications may be used for Crohn's disease but not for ulcerative colitis
    antidiarrheal agents
  90. you are following a patient with pernicious anemia, what vitamin deficiency are you concerned about
    vitamin B12
  91. what is the pediatric condition occurring when a portion of the intestine telescopes into an adjoining section
  92. bilateral black eyes due to a basilar skull fracture are called
    raccoon eyes
  93. what is the most common cause of visual impairment in the elderly
  94. what diagnosis is suggested byt he presence of translucent papules with central ubilication
    molluscum contagiosum
  95. what are you testing by grasping the great toe and moving it up and down
  96. what condition is best treated by following a gluten free diet
    celiac disease
  97. infection with what organism is associated with an increased risk of cervical cancer
    human papilloma virus
  98. which gastric gland secrete pepsinogen
    chief cells
  99. 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
  100. 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)
  101. what two drugs are used as first line treatment of uncomplicated gonorrhea in a non-pregnant patient
    Rocephin and doxycycline
  102. acute pyogenic pericarditis is most commonly caused by what organism
    staphylococcus and haemophilus influenza
  103. what percentage of patients with palpitations also have cardiac disease
  104. what does normal ventilation with decreased lung perfusion suggest
    pulmonary embolus
  105. what disease is the M protein associated with
    multiple myeloma
  106. community acquired pneumonias are most often caused by what organism
    Strep pneumoniae
  107. what is the most common cause of embolic stroke
    atrial fibrillation
  108. what is the infection caused by Borrelia burgdorferi
    Lyme disease
  109. Your patient has a low frequency resting tremor of the hand. What diagnosis do you suspect
    Parkinson’s disease
  110. what does a delta wave on EKG suggest
    Wolfe-Parkinson-White syndrome
  111. What is the most common cause of traveler's diarrhea
    E. coli
  112. which bacterium is associated with peptic ulcer disease
    helicobacter pylori
  113. 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
  114. What is the most common sign on physical exam of the patient with pelvic inflammatory disease (PID)
    cervical motion tenderness
  115. what is the most common joint dislocation
    anterior shoulder dislocations account for half of all joint dislocations. they occur with abductions and external rotation.
  116. You are treating a patient for syphilis who develops high fever and worsening clinical picture, you suspect what?
    Jarisch-Herxheimer Reaction
  117. The medical record indicates your patient has “Cullen’s sign”, what does this indicate?
    Periumbilical ecchymosis which is classically associated with hemorrhagic pancreatitis
  118. In general children should triple their birth weight by what age?
    In the first year
  119. This extrapelvic manifestation of PID presents with RUQ pain and is associated with inflammation of the liver capsule.
    Fitz-Hugh-Curtis Syndrome
  120. 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
  121. Koplik’s spots are pathognomonic for what disease?
  122. Rapidly progressive mental deterioration and myoclonus are the two cardinal manifestations of this prion disease?
    Creutzfeldt-Jakob disease
  123. This periumbilical nodule represents metastasis from an intraperitoneal source?
    Sister Mary Joseph’s Node or Nodule
  124. Where would you find Virchow’s node?
    Left supraclavicular area
  125. Who is the father of the PA profession?
    Eugene Stead, MD (if you get that wrong. . . )
  126. what hormones are produced by the medulla of the adrenal gland
    epinephrine and norepinephrine
  127. what is the treatment of choice for an HIV positive patient with Pneumocystis carinii pneumonia
    Trimethoprim-sulfamethoxazole (TMP-SMZ)
  128. The most common initial symptom of subarachnoid hemorrhage is?
    severe headache
  129. Which is the most common type of hernia in children?
    Indirect. Direct inguinal hernias are more common in the elderly.
  130. What is the most common complication of Nitroprusside?
    Hypotension, Thiocyanate toxicity accompanied by blurred vision, tinnitus
  131. The most common cause of Left Ventricular Hypertrophy is?
  132. What level of prevention is treatment for a person with AIDS using AZT?
    Secondary Prevention
  133. 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
  134. The most common physical finding in symptomatic patients with Pulmonary Embolism is?
    Tachypnea or tachycardia
  135. What is the drug of choice for the initial treatment of an anaphylactic reaction?
  136. The most common pathogen associated with bronchiolitis in infants under the age of 2 y.o. is?
    Respiratory Syncytial Virus (RSV)
  137. Which do nitrates affect, preload or afterload?
    Predominantly preload
  138. The most common type of benign primary tumors of the heart are
  139. A diastolic murmur is associated with
    Aortic regurgitation
  140. A patient with atrial fibrillation is at high risk of developing
    Arterial emboli
  141. The most common congenital heart malformation is
    ventricular septal defect
  142. The physical exam finding most consistent with coarctation of the aorta after one year of age is
    diminished or absent femoral pulses
  143. For a patient with a prosthetic heart valve, endocarditis prophylaxis is NOT recommended in which of the following procedures
    Cardiac catheterization
  144. The earliest and most frequent symptom in congestive heart failure in an adult is
    Shortness of breath
  145. What is Virchow's triad
    1) Injury to the endothelium of the vessels 2) Hypercoagulable state3) Stasis
  146. With which liver disease would you expect to find Kaiser-Fleisher rings around the corneas?
    Wilson's Disease
  147. What is the most common sign of CA of the urogenital tract?
  148. What is the most important lab test in the diagnosis of endocarditis?
    Blood cultures
  149. 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)
  150. What skin disorder is characterized by greasy yellow and red macules involving the scalp, eyebrows, and nasolabial folds?
    Seborrheic dermatitis
  151. 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?
  152. What disease is caused by rickettsia rickettsii?
    Rocky Mountain Spotted Fever
  153. What is the most common cause of death during the first few hours of a MI?
    Cardiac dysrhythmias, generally ventricular fibrillation
  154. What finding on physical examination of the abdomen would be consistent with congestive heart failure?
    Hepatojugular reflux
  155. Chronic synovitis with pannus formation is pathologic for what disease?
    rheumatoid arthritis
  156. What sign best indicates the severity of airway obstruction during an asthma attack
    Use of accessory muscles for respiration
  157. The reticulocyte count provides an indirect assessment of _____________
    Bone marrow activity
  158. Which type of hepatitis is transmitted via the fecal/oral route
    Hepatitis A
  159. 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)
  160. On x-ray, what is the finding considered diagnostic of intestinal obstruction
    Air-fluid levels
  161. What is the anatomic location of conduction delay in first degree AV block
    AV node
  162. What is the drug of choice in treating methicillin-resistant staph aureus infections
  163. 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)
  164. What is the most common cyanotic heart lesion in pediatric patients
    Tetralogy of Fallot
  165. 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
  166. The most common cause of fever 1-2 days post-operatively is ____________
  167. A laryngeal fracture is suggested by noting the hyoid bone elevated above what cervical level on an x-ray
  168. What is the most common cause of upper GI tract hemorrhages
    duodenal ulcers
  169. What is the most effective treatment for pernicious anemia
    Monthly IM injection of B12
  170. The treatment of choice for bacteria vaginosis
  171. Which antibiotic is associated with a disulfiram-like reaction when alcohol is taken concurrently
  172. 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
  173. Which skin neoplasm has the greater potential for metastasis: basal cell or squamous cell carcinoma
    Squamous cell
  174. What is the most likely cause of increasingly secondary dysmenorrhea associated with a tender premenstrual uterus
    uterine adenomyosis
  175. Describe the location of a Spigelian hernia
    3-5 cm above the inguinal ligament
  176. A postmenopausal woman presents with vaginal bleeding. What diagnostic test is indicated
    Endometrial biopsy
  177. A holosystolic murmur heard best in the apical area is most suggestive of what valvular condition
    Mitral regurge
  178. What strain of influenza is more common in adults
    influenza A
  179. What strain of influenza is more common in children
    influenza B
  180. 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
  181. What is the triad of symptoms present in Reiter's syndrome
    Arthritis, urethritis, and conjunctivitis
  182. 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
  183. What is the most common cause of intestinal obstruction
    Adynamic ileus
  184. What organism most commonly causes subacute infectious endocarditis
    S. viridans
  185. What are the major sequelae of untreated streptococcal infections
    Acute glomerulonephritis unrelated to treatment and rheumatic heart disease
  186. Strangulation is most common with which type of hernia: direct, indirect, or femoral
  187. 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
  188. What is the causative organism in Lyme disease
    Borrelia burgdorferi
  189. Rubella is commonly known to patients by what other name
    German measles
  190. Bitemporal hemianopsia is caused by a lesion of what part of the optic pathway
    Optic Chiasma
  191. This EKG abnormality is distinguished by Delta waves. What is it called
  192. Heberden's nodes are associated with what disease
  193. What does an anti-HB indicate
    Prior infections and immunity
  194. Condylomata acuminata are caused by ______
    human papillomavirus
  195. A firm, movable yellowish nodule on the helix of the ear of a patient with arthritis is most likely what
  196. Red cell casts in the urine would be indicative of what renal disease
  197. What is the drug of choice for a patient with primary herpes genitalis
    Oral acyclovir
  198. The most common organism in otitis media in children is what
    strep pneumonia (30% of cases)
  199. The absence of bowel sounds for several minutes in a patient with acute abdominal pain indicates what underlying problem
    ileus or obstruction
  200. Name an ocular finding in cases of endocarditis
    Roth spots or conjunctival hemorrhage
  201. Subluxation of the radial head in young children is called what
    Nursemaid's elbow
  202. Is TSH increased or decreased in hyperthyroidism
  203. Which side effect most commonly leads to a request for removal of levonorgestreal implant (Norplant)
    Menstrual irregularities
  204. What is hematochezia
    Bright red blood in stool
  205. 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
  206. In cases of hyperkalemia, the initial EKG finding is often what
    tall, peaked T waves
  207. What is the drug of choice for treating an uncomplicated chlamydial infection of the urethra, cervix or rectum
  208. Name the congenital or acquired disorder affecting the lungs, and causing permanent abnormal dilation and destruction of bronchi
  209. In a woman with no known risk factors, by what age should the first mammography be done
  210. What is the virus most often associated with colds in adults
  211. What is the most common presenting illness in AIDS patients
    Pneumocystis carinii pneumonia
  212. The most common cause of bowel obstruction is
  213. On chest exam, your patient has increased tactile fremitus and dullness to percussion. What is more likely: Asthma or pneumonia
  214. Which organism is most often the cause of urinary tract infections in women
    E. coli
  215. What organism is associated with botulism food poisoning
    Clostridium botulinum
  216. What is the most common cause of water-borne infectious diarrhea in the US
    Giardia lamblia
  217. What constitutes a normal Weber test
    Sound perception is midline
  218. A 35 yo woman, with many hospitalizations for unexplained sepsis is found to e injecting herself with infected material. What disease does this support
  219. What syndrome presents with obesity and sleep apnea
    Pickwickian syndrome
  220. What is the antibiotic of choice for trichomonas vaginitis
    Metronidazole, (Flagyl)
  221. What is the most common extrahepatic source of an elevated alkaline phosphatase
  222. A 20 yo male presents with dysuria and purulent penile discharge. Gram stain shows gram negative intracellular diplococci. What is the diagnosis
  223. Roth's spots, Osler's nodes, and Janeway lesions are findings associated with what
  224. What are the four degrees of frostbite
    First degree-erythema and edema; second degree-blister formation; third degree-necrosis; fourth degree-gangrene
  225. What organisms are usually implicated in the development of diverticulitis
    E coli and B fragilis
  226. Kaiser-Fleischer rings of the corneas are associated with which hereditary disease
    Wilson's disease
  227. What finding is most suggestive of early oral carcinoma
  228. What is the most common cause of painless lower GI bleeding in an infant or child
    Meckel's diverticulum
  229. Your patient has an elevated carcinoembryonic antigen (CEA). Which type of cancer would this most likely be associated with
    Colon Ca
  230. What physical finding would be expected on lung auscultations in a patient with a pneumothorax
    Decreased or absent breath sounds
  231. What physical exam finding is most consistent with an orbital fracture
    Loss of upward gaze
  232. What physical finding is most likely in a patient with lateral epicondylitis
    Pain when wrist extension is resisted
  233. What is the most common form of kidney stone
    Calcium oxalate
  234. What is the most frequent side effect for patients taking ACE inhibitors
    Dry cough
  235. What does a "delta wave" on EKG tracing suggest
    Wolff-Parkinson-White syndrome
  236. An active 13 year old boy presents with bilateral pain and edema of the tibial tuberosities. What is your diagnosis
    Osgood-Schlatter Disease
  237. Vasodilator drugs are most likely to cause what of the heart
    Reflex tachycardia
  238. The most frequent cause of Vitamin B12 deficiency in patients with pernicious anemia is
    Lack of intrinsic factor
  239. Your patient has a positive psoas sign. What does this indicate
    Peritoneal irritation
  240. 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
  241. The rash appears as grouped vesicles on an erythematous base in a dermatomal distribution is called
    Herpes zoster or shingles
  242. The reflex associated with sustained blink response to tapping between the eyes is what
    Glabellar reflex
  243. What adverse effect is associated with aspirin usage in children
    Reye's syndrome
  244. What condition is indicated by a positive Tinel's sign
    Carpal tunnel syndrome
  245. What is the most common presenting symptom of mitral valve prolapse
  246. What screening procedure has the highest sensitivity for the detection of colon cancer
  247. What is the first line class of drugs used in the treatment of status epilepticus
  248. What are the seven areas included in the neuro exam
    MS, CNs, Motor, Sensory, Cerebellar, DTR's
  249. What is the most common childhood leukemia
    ALL-acute lymphoblasic leukemia
  250. Name the virus which causes recurrent small grouped vesicles on an erythematous base, especially in the oral and genital areas
    Herpes simplex
  251. What is the most common causes of small bowel obstruction
    Adhesions, followed by hernias
  252. 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
  253. What is the drug of choice in treating methicillin resistant Staph aureus
  254. What is the most common cause of death in patients with diabetes mellitus
    MI, coronary artery disease
  255. Deficiency of which vitamin is associated with peripheral neuropathy
  256. What organisms are typically responsible for causing bacterial conjunctivits
    Staphylococcal, the second most common is Streptococcal
  257. What is the most common type of skin cancer
    Basal cell carcinoma
  258. Which material used in making jewelry is a common cause of contact dermatitis
  259. What is the most prevalent form of contraception in the world
    Surgical sterilization
  260. What is the drug of choice for Pneumocystis carinii pneumonia
  261. What neurologic disorder is characterized by complaints of diplopia, difficulty swallowing, limb weakness and fatigue
    Myasthenia gravis
  262. What dx is suggested by the following findings: hyperpigmentation and low fasting plasma cortisol
    Addison’s disease
  263. What is the most common side effect associated with digitalis toxicity
    Nausea and vomiting
  264. Hard nodules found on the distal interphalangeal joints of patients with osteoarthritis are called
    Heberden’s nodes
  265. What is the first sign of puberty in girls
    Breast enlargement
  266. Painful sexual intercourse is called what
  267. The two bacteria responsible for most cases of impetigo are
    Strep pyogenes and Staph aureus
  268. What dx is made by finding an elevated sweat chloride test
    Cystic fibrosis
  269. What three sensations must be tested in the sensory exam
    Light touch, pain, and vibration
  270. What are the most common causes of large bowel obstruction
    Carcinoma, followed by volvulus and sigmoid diverticulitis.
  271. What side effect can occur with a rapid infusion of procainamide
    Hypotension. Other side effects include QRS/QT prolongation, ventricular fibrillation, pointe.
  272. What organism is commonly found in infected wounds caused by animal bites
    Pasteruella multocida. The second most common organism is Staphylococcus aureus.
  273. What are the most common causes of nongonococcal urethritis
    Chlamydia trachomatis. Ureaplasma urealyticum is another common cause.
  274. What is the incubation period for hepatitis A
    30 days. The disease is caused by a retro-virus.
  275. The two bacteria responsible for most cases of impetigo are:
    Streptococcus pyogenes and staphylococcus aureus.
  276. In most chemical burns to the skin or eyes, what is the cornerstone of initial treatment
    Flushing or hydrotherapy.
  277. What is the leading cause of death in patients with systemic lupus erythematosus
    Renal disease.
  278. What rash presents with a "Christmas tree" distribution and a herald patch
    Pityriasis rosea.
  279. Name the classic dissecting scissors which are used for cutting soft tissue and should not be used to cut suture material or thick fascia
  280. The prodrome of fever, coryza, cough, conjunctivitis, and Koplik's spots is typical of what disease
  281. What hematologic disorder is a serum ferritin most useful in diagnosing
    iron deficiency anemia
  282. The most common AIDS defining illness is
    Pneumocystis carinii pneumonia
  283. On physical exam, what neurological finding would suggest hypothyroidism
    Decreased relaxation phase of deep tendon reflexes
  284. Which type of hepatitis is transmitted orally
    Hepatitis A
  285. Name the pulmonary autosomal recessive disorder characterized by sweat chloride > 80 meq/L
    Cystic fibrosis
  286. The most common non-alcohol related cause of pancreatitis is
  287. The first cardiac enzyme to be detected in the setting of acute myocardial infarction is
  288. What type of glaucoma is the most common
    Open-angle (chronic) Glaucoma
  289. Which class of drugs can be responsible for the formation of cataracts
  290. Fundal height in your pregnant patient is at the level of the umbilicus. This indicates how many weeks gestation
    20 weeks
  291. What laboratory testing would be most useful in diagnosing Cushing's syndrome
    Dexamethasone suppression test
  292. A mid-systolic click with a late systolic crescendo murmur is indicative of what cardiac disease
    MVP (mitral valve prolapse)
  293. Where can you find the Islets of Langerhans
  294. Your pt's Weber test lateralizes to the R and on Rinne BC > AC on the R
    R conductive loss
  295. 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
  296. What is the classic triad of clinical manifestations in infectious mononucleosis
    Fever, lymphadenopathy, pharyngitis
  297. What is the major glucocorticoid
  298. What is the most effective procedure for confirming the diagnosis of a pericardial effusion
  299. What is the best way to diagnose sickle cell syndromes
    Hemoglobin electrophoresis
  300. What are the "ABCD"s of melanoma
    Asymmetry, Border Irregularity, Color variation, Diameter > 6mm
  301. 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
  302. What is the best X-ray view for diagnosing lunate and perilunate dislocations
    Lateral X-ray view of the wrist
  303. Presence of the Philadelphia chromosome is consistent with what blood disorder
    Chronic Myelogenous leukemia
  304. 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)
  305. Name the most sensitive diagnostic test for acute pancreatitis
    Urinary amylase
  306. What treatment is most appropriate for the alert patient who has ingested on overdose of aspirin
    Syrup of ipecac (induce vomiting)
  307. What are the classic ECG results associated with posterior MI
    A large R wave and ST depression in V1 and V2
  308. What is a major concern for a patient with unilateral Parkinsonian features
    Intracranial tumor
  309. 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.
  310. What is the most common cause of mitral stenosis
    Rheumatic heart disease. The most common initial symptom is dyspnea.
  311. Define a diastolic hypertensive emergency
    Elevated diastolic blood pressure > 115 mm Hg with associated end organ dysfunction or damage.
  312. What is the physical exam finding that is most predictive of otitis media in children
    Decreased motility of the TM
  313. What effect may be caused by the use of potent topical corticosteroids on the face
  314. In elderly patients in hospitals and nursing homes, what is the most common cause of fecal incontinence
    Fecal impaction
  315. A patient with psoriasis complains that her usual topical steroid preparation is becoming less and less effective. This phenomenon is called
  316. 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.
  317. You ask a patient to stick out her tongue. Which cranial nerve are you testing
    12th CN or hypoglossal
  318. The erythematous skin lesion considered pathognomonic for lyme disease
    ECM; erythema chronicum migrans
  319. Which type of hepatitis is caused by a DNA virus
    Hepatitis B. The incubation period is 90 days.
  320. Which vessels are larger in the fundus, arterioles, or venules
  321. What is the most worrisome side effect of rifampin
  322. Which class of antibiotics is associated with renal failure
  323. What is the most appropriate drug in the management of genital HSV-2
  324. 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
  325. The most common etiologic agent in non-gonococcal septic arthritis is
    Staph aureus
  326. What neurological disorder may be associated with seborrheic dermatitis
    Parkinson's Disease
  327. What is the most common malignancy in young men
    Testicular cancer
  328. What is the drug of choice for pneumocystis pneumonia
    Trimethoprim-sulfamethoxasole (Septra or bactrim)
  329. What is the organism most commonly identified with antibiotic-associated colitis
    Clostridia difficile
  330. What abnormal finding would be expected on nasal swab in the patient with allergic rhinitis
  331. Which class of antihypertensive medications is most effective for African-Americans
    Calcium channel blockers
  332. What is the initial treatment of choice for ganglion cyst of the wrist
  333. 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
  334. 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%
  335. Name a common cause of intermittent isolated proteinuria
  336. What anatomic landmark on the anterior thorax marks the bifurcation of the trachea
    Angle of Louis or sternal angle
  337. 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.
  338. How much aspirin should a post MI patient ingest daily to reduce the incidence of reinfarction
    160 to 325 mg/day
  339. 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
  340. 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
  341. Name one of the two sports with which medial epicondylitis is most commonly associated
    Golf and baseball
  342. What is the most common central nervous system manifestation of AIDS
  343. What is the sign produced by retroperitoneal bleeding that results in a hematoma of the flank
    Turner's sign
  344. What is the condition related to pulmonary hypertension and resulting in right ventricular dilatation and hypertrophy
    Cor pulmonale
  345. What do the letters CREST stand for in scleroderma
    Calcinosis cutis, Raynaud's phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia
  346. 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
  347. What diagnostic study is most appropriate for a patient with suspected allergic rhinitis
    Nasal smear for eosinophils
  348. 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
  349. In cases of hypothyroidism, would you expect the TSH level to be increased, decreased or normal
  350. Use of the artificial sweetener aspartame is contraindicated in patients with what disease
  351. What condition is present in a patient who has paradoxical movement of a portion of the chest wall after severe chest trauma
    Flail chest
  352. A diagnosis of AIDS is consistent with a CD4 count less than
  353. The most common etiologic agent in non-gonococcal septic arthritis is
    Staph aureus
  354. What hematologic disorder can be precipitated by exposure to antimalarials or mothballs (naphthalene)
    G6PD anemia
  355. blue sclera
    osteogenesis imperfecta
  356. 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
  357. The optic disk is more medial or later in the fundus
  358. Which bone of the middle ear is normally visualized on otoscopic exam
  359. What is the most common bacterial pathogen in pediatric otitis media
    Strep pneumoniae
  360. What is the most common cause of anemia in adults
    Occult blood loss
  361. Herpes zoster infection involving the facial nerve, external ear, and occiput is known by what name
    Ramsay Hunt Syndrome
  362. How many mm’s. of induration determine a positive PPD test in an otherwise healthy individual
    15mm or greater
  363. 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
  364. An upper motor neuron lesion would have what effect on deep tendon reflexes
  365. Your patient has an elevated carcinoembryonic antigen. Which type of cancer would this most likely be associated with
  366. You are following a patient with pernicious anemia. What vitamin deficiency are you concerned about
  367. What is the most common adverse reaction of intranasal corticosteroids
    Nasal irritation
  368. What disease classically presents with severe hypertension, sweating, and palpitations
  369. The neurotransmitter released from preganglionic nerve fibers in the parasympathetic nervous system is___________
  370. The two major hormones involved in the regulation of fluid balance in the kidney are ________ and ________
    Aldosterone and Antidiuretic Hormone (ADH)
  371. 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.....
  372. Which organism is most commonly associated with acute bacterial prostatitis
    E. Coli
  373. How many doses of Varicella vaccine are needed by a child under the age of 12, who has never had chickenpox
  374. Your patient has a low frequency resting tremor of the hand. What diagnosis do you suspect
    Parkinson's disease
  375. What is the most common cause of right ventricular heart failure
    left ventricular heart failure
  376. 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
  377. Progressive, ascending, symmetric weakness associated with viral infections is known as
    Guillain-Barré Syndrome
  378. What diagnostic test is most important in the evaluation of monoarticular arthritis
    Joint aspiration-gram stain/culture of joint fluid
  379. Treatment of giant cell arteritis with prednisone is aimed at prevention of what problem
  380. The Philadelphia chromosome is associated with what type of leukemia
    CML-chronic myelocytic
  381. Which joints in the fingers are commonly affected by reheumatoid arthritis
    PIPs or MCPs
  382. A woman with a malodorous vaginal discharge is found to have a "strawberry cervix". What is the most likely diagnosis
    trichomonas vaginitis
  383. What test is considered the gold standard for the diagnosis of DVT
  384. What test is considered the gold standard for the diagnosis of PE
    pulmonary angiography
  385. What is the most common CXR finding in PE
    elevated dome of one hemidiaphragm.
  386. What is the most common laboratory value abnormality in pts. taking oral diuretics for hypertension
  387. Which bacterium is associated with peptic ulcer disease
    Helicobacter pylori
  388. 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
  389. The single most reliable physical sign of congestive heart failure in patients over the age of 40 is
    a third heart sound (S3)
  390. What is the most common side effect of esmolol, labetalol and bretylium
  391. 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.
  392. What is the most prevalent cause of obstruction of airway in adults
    Food, usually meat. Obstruction occurs because the food was
  393. What is the most common cause of intestinal obstruction
    Surgical adhesions
  394. What funduscopic finding is characteristic of diabetic proliferative retinopathy
  395. In women, the leading cause of death due to malignancy is cancer of the _________
  396. Ingestion of what substance improves benign essential tremors
  397. Which heart lesion is associated with a mid-systolic click
    Mitral valve prolapse
  398. What is the most common cause of acute pancreatitis
  399. Calf pain on forceful dorsiflexion of the foot is called ___________
    Homan's sign
  400. The paranasal sinus most commonly affected is ________
  401. The 2 first line agents in the treatment of tuberculosis are what
    Isoniazid and rifampin
  402. In a patient with cold intolerance, constipation, and weight gain, would you expect a TSH to be increased, decreased, or normal
  403. What laboratory finding is the earliest evidence of diabetic nephropathy
  404. What site does acetaminophen cause its most toxic effects
  405. What is the most common cause of pancreatitis
    Alcohol abuse or gallstones
  406. Retroperitoneal bleeding causing a hematoma at the umbilicus is called what
    Cullen's sign
  407. What problem is most commonly associated with Kerley B lines
    Congestive heart failure
  408. Which of the following is NOT a risk factor for cervical cancer: Multiple sexual partners, early sexual activity, obesity, early age 1st pregnancy
  409. A fundal height at the level of the umbilicus corresponds to how many weeks gestation
  410. What is the term for excessive menstrual bleeding
  411. The first MMR shot should be given at what age
    12-15 mths
  412. A chest x-ray on a 68 yo smoker shows flattened diaphragms. What dx do you suspect
    Emphysema or COPD
  413. Cough is a common side effect of what class of anti-hypertensive drugs
  414. 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
  415. A patient with cholecystitis abruptly stops inspiring while you palpate beneath the Right Costal Margin. What is this called
    Murphy's sign
  416. What funduscopic exam finding would be indicative of glaucoma
    Increased cupping of the disc
Card Set
Challenge Bowl
Questions from previous years