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Question How do you treat Neisseria Gonorrhea? How do you treat chlamydia trachomatis? Which STI leads to swollen lymph nodes? CSF of bacterial meningitis CSF of viral meningitis txt for pos HSV2 what rx covers for pseudomonas txt for bacterial meningitis older pts are mostly going to be infected with and txted how? question not clear mc cause of diarrhea in US? What are sxs of toxo? When do you start HAART? Name three protease inhibitors (HIV meds). Name five Nucleoside Reverse Transcriptase Inhibitors (HIV meds). Name a Nucleotide Reverse Transcriptase Inhibitor. Name two Non-Nucleoside Reverse Transcriptase Inhibitors indinavir ritonavir atazanavir Combivir Lamivudine Abacavir Stavudine Zidovudine tenofavir Efavirenz Nevirapine Answer ceftriaxone 125mg IM Azithromycin 1 g orally in a single dose OR Doxycycline 100 mg orally twice a day for 7 days Lymphogranuloma venereum, chancroid Glucose:low Protein:high Cells:PMNs >300 Glucose:nl Protein:nl Cells:Mononuclear <300 Acyclovire 200mg and reassess in 1 yr piperciliin ceftriaxone, ampicillin and vanc legionella txted with ampicillin Sanford: legionella is txt with a macrolide (azith) or FQ pg62 campylobacter flu like pt symptomatic, any Hx of Opportunistic Infx, cd4 count below 200; IF between 201-350 offer it to patient, above 350 only offer if viral load above 100K IRA: Indinavir, Ritonavir, Atazanavir CLASZ (Combivir (Lamivudine/AZT), Lamivudine, Abacavir, Stavudine, Zidovudine) Tenofavir Efavirenz and Nevirapine PI PI PI NRTI NRTI NRTI NRTI NRTI Nulceotide RTI NNRTI NNRTI Which TB med can result in visual disturbances? Ethanbutol

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MC cause of CAP? What do use for prophylaxis in a pt with endocarditis allergic to PCN? Best way to dx osteo? MCC of osteo? cryptococcal causes: PCP prophylaxis

Strep pneumo clinda bone scan Staph chronic diarrhea Bactrim, dapsone, aerosol pentamidine (AP) JCV-> PML, Toxo, tuberculoma, cryptococcoma, CNS lymphoma, brain abscess, bacterial meningitis, crypto meningitis, hsv encephalitis, neurosyphilis, TB meningitis, bacteremia, AIDS dementia, cva, seizure, depression, uremic/hepatic encephalopathy <200, ground glass opacities on cxr <100, same as PCP: bactrim <100, prophylaxis is clarithromycin <200 some source says <75, other says <50, Clarithromycin * Male: 13.8 to 17.2 gm/dL * Female: 12.1 to 15.1 gm/dL * Male: 40.7 - 50.3% * Female: 36.1 - 44.3% erythromycin asymmetric jt space narrowing diplococci Fixed S2 spilt, dxed by cardiac cath mesalamine b/c it causes spasms of the sphincter of oddi, increasing the pn androgen therapy erythromycin acetazolemide diabetic nephropathy, amylodosis, membranous glomeruloneohritis, minimal change dz, glomerulosclerosis cefoxitin, intraoperative

Causes of AMS in HIV pt:

At what CD4 does PCP affect pts? At what CD4 does toxo affect pts? What is prophylactic txt? At what CD4 does cryptosporidium affect pts? At what CD4 does microsporidia affect pts? At what CD4 does MAC affect pts? txt? What is nl range for Hgb? Nl range for hct? What is the txt for chlamydia in the prego? On Xray, how will jts affected with OA appear? On micro, what do you see if it's gonorrhea? What PE finding is present with ASD? How is it dxed? What rx is given for UC? why is morphine avoided as an alagesic with acute cholecystitis? What med is rec for endometreosis? Med for pertussis? what is the first medical txt for acute angle glaucoma? what is a cause of nephrotic syndrome? What and when is an abx given to an appenidcitis? pt had a cold 2 weeks ago and now UA: hematuria 4+, proteinuria 2+, 15WBC/HPF, and red cell casts What condition includes >3.5g/24hr proteinuria, periorbital edema progressing to anasarca, oliguria, hyperlipidema, hypercoag, microcytic

acute glomerulonephritis (chararcterized by gross hemauria)

Nephrotic syndrome

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hypochromic anemia? Post MI pts should be put on what med? beta blocker Diabetic, with normotensive BP should be put on ACE-I (has renal protective effects) what med? Albumin less than 3 causes what? edema If a pt is put on an ACE and cr increases, what is bilateral renal artery stenosis this indicative of? A pt with hemalytic anemia with elevated BUN and cr with decreased urine output (renal failure) loop diuretic to encourage diuresis should be given what med and why? which abx are given for diverticulitis? what meds should a pt with BPH avoid? Pt with PMH for Rheumatic fever should be put on what for prophylaxis? Ped pt with URI txt with? Pt with painful, bright red, raised, edematous, indurated plaque onhis nose and left cheek sharply marginated with no skin trauma is caused by what? what murmurs are accentuated by standing? a fx at the base of the thumb is called what? name a vasopressor used in cardiogenic shock how is tinea capitis txted? Why is gonoccal conjunctivitis an ophthalmic emergency? what is the txt for thrombotic thrombcytopenia purpura? which valve is most likely to be effected by endocarditis? prophylaxis for endocarditis MCC of secondary HTN what class of BP meds can cause ED? what med is given for traumatic iritis? MCC of EO in immunocompromised pts? ranitidine and cimentidine are what class of meds? omeprazole and lansoprazole are what class of meds? MCC of primary HTN cipro or bactrim decongestants benzathine pen g erythromycin

group A beta hemolytic streptococcus causes cellulitis

mitral valve prolapse and hypertrophic cardiomuopathy bennets's fx dopamine with oral griseolfulvin or any systemic azole/imidazole b/c corneal involvement can lead to perforation daily plasmaphoresis until in remission tricuspid amp and gent AND amp or moxi (vanc can sob fo r amp in pen allergic pts) renal disease beta blockers topical cycloplegics pseudomonas H2 blocker PPI cirrohsis 2/2 EtOH or Hep

what test is done to find metastatic prostate CA? radionuclide bone scan

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MCC of PUD MCC of non-hemorrhagic GI bleed MC gastrin secreting tumor (gastrinoma) MC finding with gastrinf adenocarcinoma MCC of adolescent death MC extranodal site for non-hodgkins lymphoma MC metastatic site of gastric adenocarcinoma MCC cause of infectious diarrhea MC site of colonic obstruction MC site of crohns dz MCC of thiamin (B1) def MC site of intussusception MCC of chronic/recurrent abd pn Gold standard for dx of hepatitis MC finding on EKG with stable angina MC genetic abnl of the GI tract MC emergency abd surgery MCC of pancreatitis MCC of gallbladder CA MCC if acute hep MC primary tumor of the liver MCC of chronic hep MC benign hepatic tumor MC hernia MC site of bowel atresia MCC of abx associated diarrhea MCC of Howell Jolly bodies on labs MCC of target cells MCC of hypersegmented PMNs MCC of B12 def MCC of Heinz bodies MC lab finding with AML MC leukemia in peds MC leukemia of all MC lab finding with Hodgkins MCC of abnl bleeding MCC of aquired platelet dysfxn

H pylori PUD ZES IDA accidental stomach liver campylobacter, shigella, e. coli Left side terminal illeum and R colon alcoholism terminal illeum IBS liver bx ST depression Meckels diverticulum appendicitis EtOH abuse adenocarcinoma viral HCC hep B, C, D hemangioma indirect hernia (pass thru inguinal ring) illeum c diff folic acid def IDA/thalassemia folic acid def (folate def) pernicious anemia (can be caused by terminal illectomy) G6PD def auer bodies ALL CLL Reed sternberg cell thromocytopenia NSAIDs, ASA

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MC congenital coagulopathy MC aquired coagulopathy MC coagulopathy in Ashkenazi Jews MCC of hemoptysis MCC of uticaria MCC of bell's pallsy MCC of HTN MCC of R heart failure MCC of cardiac related death/disability Most sensitive cardiac enzyme in MI MC RF associated with atherosclerotic dz MMC of CHF MCC of CAD MCC of aortic/mitral valve defects MC valve dz presenting with mid systolic click adn late systolic murmur MCC of wide pulse pressures MCC of cardiomyopathy MCC of differnet UE and LE BP Tool for definative dx of valvular def MCC of mitral stenosis MC finding of aortic stenosis MC valvular dz MC valvular deformity seen on males with skeletal abnl MC chronic arrythemia MC arrythmeia in COPD pt MCC of cardiac arrest MCC of PVCs MCC of LVH MC type of cardiomyopathy MC murmur associated hypertrophic cardiomyopathy Only dz process to cause PR depression MC valve affected by IVDU MC s/sx with pericarditis MC sx seen with cardiac tamponade MC EKG finding with cardiac effusion

van villebrand dz Vit K dependent def Factor XI def bronchitis idiopathic idiopathic essential HTN L heart failure atherosclerotic heart dz Troponin (elevated longer) smoking CAD Atherosclerosis congenital mitral valve prolapse aortic insuffiency/regurg CAD coartation of the aorta echo rheumatic fever ascending/descending murmur at 2nf R ICS aortic stenosis mitral valve prolapse afib a flutter vfib hypoxia HTN dilated cardiomyopathy systolic murmur pericarditis tricuspid pleural chest pn relieved by leaning forward/sitting upright pulsus peradoxus, narrow pulse pressure electrical alternans

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MCC of infective endocarditis MCC of IVDU infective endocarditis MC valve affected by IVDU Dz MC assoc with Janeaway Lesions MC findings of osler nodes, Janeaway lesions,Rothspots assoc with: MC valve affected by rheumatic fever MC heart dz that follows beta hemolytic strep pharyngitis MCC of a friction rub MC sx accoss with PVD MC test to dx PVD MCC of varicose veins MC finding w/ DVT MC lab finding with giant cell arteritis MCC of aortic anyerism MC site for aortic anyerism to occur MC test to dx AAA MC test for thorasic aortic anyerism MC hernia accos w/ premature males MCC of newborn hypoglycemia MC neurodevelopmental disorder in children MC innocent childhood murmur MC heart defect in down's syndrome pt MCC of craddle cap MC vaccines to avoid in pregnnnancy MCC of fifths dz/ slapped cheek syndrome MCC of chicken pox MC presention of fifth's dz erythema infectiousum MCC of molluscum contagiosum MCC of koplick spots in mouth MC med class to cause QRS prolongation MCC of atopic dermititis (immune response) MCC of coin shaped plaques MC dz assoc w/ herald patch MC dz assoc w/ wickham's striae on the buccal mucosa

strep viridens staph aureus tricuspid infective endocarditis infective endocarditis mitral valve rheumatic heart dz pericarditis Leg pn w/ exercise and later w/ rest doppler US superficial venous insufficiency or valvular insuff swollen calf, heat/redness over site, (+)Homan's sign inc ESR ans CRP atherosclerosis abd abd US MRI or CT inguinal born to diabetic mothers ADHD still's murmur atrioventricular septal deviation sebborrheic dermititis MMR, variclla, live attenuated flu viruses human parvo B19 human herpes virus red slapped cheecks pox viruses measles/rubeola TCA Type I IgE nummerular dermitits pityriosis rosacia (HHV7) lichen plantus

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MC type of psoriasis MC dz assoc w/ acantholysis and IgG Ab MCC of folliculitis MCC of tinea vesicolor targetoid, raised edematous papules MCC of warts MC skin CA Dz assoc w/ pearly, rolled borders w/ central indent ulcerations and talagictagias MCC of erythema migracans (lyme dz) MCC of Tzanck smear demonstrating "multinulcleated giant cells" MCC of pneumonia MCC of atypical pneumonia MC pneumonia in college dorms/army barracks MCC of pneumonia in chlidren <1yr MC OI in pt w/ CD4< 200 MCC of diffuse perihilar infiltrates pn CXR MCC of brochilitis MCC of epiglotitis MCC of COPD MCC of death in US MC type of lung CA MC lung CA to metastisize the fastest MC findig w/ small cell CA on CxR MC predisposing factor to asthma MC dz states seen w/ pulsus peridoxus MCC of bronchiectasis MC finding on CT w/ brochiectosis MC CXR findings with emphysema Test to dx CF Gold standard in dxing pleural effusion Mc group assoc with spontaneous pneumothorax MCC of S1Q3T3 EKG MCC of hemopytsis MCC of pneumonia MC nosocomial pneumonia

psoriasis vulgaris Pemphigus vulgaris staph aureus M. furfur erythema multiforma HPV Basal cell CA, rarely malignant Basal cell CA borrelia burgdorferi (vector deer tick) HSV strep pneumonia mycoplasma pneumoniae mycoplasma pneumoniae RSV PCP PCP RSV maemophilus influ type B smoking bronchogenic CA (lung CA) adenocarcinoma small cell lung CA milar mass w/ mediastinal widening atopy cardiac tamponade, asthma COPD cystic fibrosis dilated tortuous airways flattened diaphragm, hyperinflation/blebs elevated sweat chloride test (>60mEq/L) thoracentesis skinny white males (10-30 y/o) corpulmonale bronchitis strep pneumo pseudomonias

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MC SE of TB meds MCC of pulmonary granulomas MCC of egg shell calcification on CXR 1st ine therapy for Crohn's dx 1st line therapy for IBS 1st line therapy for IDA 1st line therapy for pernicious anemia 1st line therapy for polycethemia vera 1st line therapy for chronic ITP 1st line therapy for Factor XI def 1st line medical therapy for IBS 1st line therapy for glaucoma 1st line therapy for HTN 1st line therapy for diabetic pt w/ HTN 1st line therapy for aortic dissection 1st line therapy for BPH 1st line therapy for CHF 1st line therapy for acute angina 1st line therapy for chronic angina 1st line therapy for Prinzmetals/Varient angina 1st line therapy for pts w/ ischemic heart dz 1st line therapy for a-flutter 1st line therapy for torsades de pointes Meds for V-tach txt for AV conduction blocks txt for WPW (early excitation syndrome) Meds to inc lifespan in pts with cardiomyopathy 1st line therapy for pericarditis

hepatitis sarcoidosis silicosis sulfasalazine, mesalamine (aminoglycosides) fiber diet/bulking agents (psyllium) ferrous sulfate 325mg TID X mon Lifelong Vit B12 IM (macrocytic anemia) phlebotomy prednisone FFP SSRI beat blockers thiazide diuretic ACE-I beta blocker and sodium nitroprusside alpha blockers thiazide/loop diurectic and ACE-I sublingual nitro (NTG) beta blocker CA2+ blocker statin amiodarone mag sulfate +/- beat blocker Lido, amiodarone, procanimide, mag sulfate (cardioversion drugs) cardiac pacing catheter ablation ACE-I, Aldactone, beta blocker high dose of ASA then steroids

1st line prophylaxis therapy for Rheumatic heart 1.2 mil u benz. Pen dz 1st line therapy for PVD 1st line therapy for giant cell artierititis 1st line of therapy for depression in elderly pletal (cilostazole) high dose prednisone and low dose ASA SSRI and mirtazipine

1st line therapy for neonatal jaundice 2/2 ABO incompatibility, Rh isoimmunization, non-immune transfusion hemolysis (Coombs test) 1st line therapy for systolic HTN thiazide diuretic

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1st line therapy for rheumatoid arthritis 1st line therapy for ADHD 1st line therapy for tylenol OD 1st line therapy for atopic dermatitis 1st line therapy for sebborrheic dermitits 1st line therapy for non-imflammatory acne 1st line therapy for inflammatory acne 1st line therapy for rosacea 1st line therapy for nail fungal infx 1st line therapy for tenia vesicolor 1st line therapy for scabies 1st line therapy for male pattern boldness, androgenic alopecia 1st line therapy for alopecia areata 1st line therapy for erythema migracans (Lyme dz) 1st line therapy for long term asthma 1st line therapy to reverse mag sulfate tox 1st line therapy for acute cyctitis in pregnant 1st line therapy for mild GERD 1st line therapy for mod to severe GERD 1st line therapy for ZES 1st line therapy for inpt pneumonia 1st line therapy for PCP 1st line txt for TB 1st line therapy for acute brinchitis exac 1st line therapy of bronchiolitis 1st line therapy for mycoplasma pneumo 1st line txt of strep pneumo 1st line of txt for bronchioloitis 1st line txt for mild intermittent asthma 1st line txt for chronic asthma 1st line therapy for COPD only txt to alter course of COPD 1st line/ acute therapy for pulmonary embolism txt of choice for sarcoid

DMARDS Methotrexate Ritolin, adderol (CNS stimulant) actylcystine topical corticosteroid ketoconazole/selenium sulfide shampoo retiniod therapy benzoyl peroxide metronidazole oral griseofulvin, itraconazole, ketoconazole selenium sulfide shampoo permetherine cream minoxidil steroids doxy, amoxicillin or azithromycin inhaled corticosteroid calcium gluconate cephalexin (Keflex) 1st gen cephalosporin H2 blocker (ranatidine, cementidine) PPI (omeprazole, lansoprazole) PPI (txt for strep pneumo and legionella) ceftriaxone/cefotazine + azithromycin or fluroquinolone Bactrim RIPE txt: Active TB-(RIPE X 2 mon, RI X 4 additional mon) latent TB-(INH X 9 mon, RIF X 4 mon) 2nd gen ceph ribavirin erthromycin/tetracyclin PCN G (if Pen resistant then ceftriaxone/cefotaxime) ceftriaxone X 7-10 d short acting beta agonist PRN inhaled corticosteroids +/- long acting beta agonist smoking cessation O2 heparin steroids X 6wk

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1st line med txt for COPD DVT txt 1st line txt for leiomyoma (fibroids) PE txt 1st line txt for dysfxnal uterine bleeding (DUB) 1st line txt for trichamonas 1st line txt for chlamydia in pregnant 1st line txt for candidiasis 1st line txt for bacterial vaginosis 1st line txt for breast ca in estrogen receptor (+) dz 1st line txt for obstructive/central sleep apnea 1st line therapy for infertile women who want to become preggo 1st line txt for ectopic preg 1st line txt for pretem labor 1st line txt for PROM at or > 37 wk gestational age 1st line txt for fetal lung maturity in fetus <34 WGA w/ assoc preterm labor/PROM 1st line txt for pregnancy induced HTN 1st line txt for pre-eclampsia 1st line txt for prophylaxis against Rh sensitization in pregnancy preferred method of delivery with placenta previa 1st line txt to induce contractions 1st line txt for endometritis 1st line txt for RA 1st line txt for juvinile RA

inhaled cholinerics (brochodilater: ipratropion bromide) warfarin X 6 mon myomectomy warfarin X 12 mon provera X 10 d metronidazole 2g PO erthromcyin 500 mg X 7d any -azoles metronidazole 2gm once tamoxifen wt loss and EtOH avoidence clomiphene citrate methotrexate tocolytics misoprostil +/- oxytocin betamethazone inj methyldopa or labetalol IV drip of mag sulfate (give 24 hr post partum) Rhogam, given at 28 WGA (if baby Rh +, give mom 2nd shot post partum for future pregnancies) c-sect pitocin clinda and gent methotrexate NSAIDs and PT

1st line therapy for hyperglycemia hyperosmolar normal saline state 1st line therapy for myasthenia gravis 1st line txt for alzheimers dz 1st line txt for pleuritic chest pn 1st line txt for thyroid CA 1st line txt for infectious diarrhea 1st line txt for major depressive disorder 1st line txt for psoriatic arthritis neostigmine aricept (donepezil) NSAIDs/indomethacin surgical removal flouroquinolones SSRI (-tine) (SSRI>buproprion>TCA) methotrexate

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1st line txt for gout 1st line prophylatic txt for gout 1st line txt for polymyocitis key lab difference bt polymyocitis and polymyalga rheumatica 1st line txt for polymyocitis rheumatica 1st line txt for polyarteritis nodosa 1st line txt for fibromyalga 1st line txt of osteomylitis 1st line txt for soft tissue sarcoma 1st line txt for open fx 1st line txt for boxer fx 1st line txt for game keepers thumb 1st line txt for scaphoid fx

indomethacin (NSAIDs) allopurinol steroids, methotrexate, azathiopine CK raised in polymyocitis low dose corticosteroids X 2yrs high dose prednisone TCA (or lyrica?) IV abx X 6wks, PO abx X 2 wks (flouroquinolones) radiation therapy and local resection debridement/irrgation adn 1st/2nd gen ceph or aminoglycoside ulnar gutter splint/cast thumb spica long arm thumb spica cast X 4 wks, replace with 4 weeks short thumb spica cast

txt of scoliosis: 10-15% curve 15-20% >20 20-45 f/u w/ forward bending test serial radiographs q 3-4 months >50 ortho referral brace surgery 1st line txt for avascularnecrosis (AVN) of the hip hip arthroplasty (replacement) 1st line txt for prophylactic abx c/ post/perioperative total jt replacement MCC of ARDS in preterm infant MCC of ground glass on CXR MCC of 2ndary amenorrhea MCC of primary dysmenorrhea MCC of Turners syndrome amenorrhea X 12 months 2nd/3rd gen ceph hyaline membrane dz hyaline membrane dz pregnancy prostoglandin E2 secretion (excess) gonadal dysgenesis menopause

MCC of tender, symmetrical, enlargened, boggy adenomyosis uterus Dx of menopause MCC of DUB MCC of primary amenorrhea MCC of firm, asymetrical irregular uterine mass MC gynecological malignancy MC site for endometriosis to occur MCC of infertility in women MC indication for hysterectomy MC ovarian growth MCC of androgen excess w/ hirsutism MC finding with BV FSH >30 hypothalamic/pituitary/ovarian hormonal axis Turners syndrome fibroids (leiomyoma) endometrial CA pelvic/ovary endometriosis leiomyoma (fibroids) ovarian cyst PCOS clue cells

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MC findings on US w/ PCOS MC vulvuar malignancy MC dx w/ pt who is infertile, hirsute, truncal obesity, impaired glucose tolerance test MC site of cervical neoplasia MCC of cervical neoplasia MCC of condyloma accuminata MC txt/ f/u w/ a pap smear result of ASC-US MC type of CA assoc w/ DES in female MC CA assoc with DES exposure in women MCC of strawberry cervix Most reported STD in US MC STI in US MC condition of breast MCC of mastitis MC breast CA All lobular and 2/3 of ductual breast masses are... MC female malignancy MC site of breast CA MCC of CMT Gestational age fetal heart tones can be heard MC gestational age quickening occurs MC time to do triple screen (alpha-fetoprotein, human chorionic gonadotropin and unconjugated estriol) in pregnancy MC time to screen for gestational diabetes MC result of low AFP MC result of elevated AFP MC site for ectopic pregnancy MC time and cause of spontaneous abortions MC benign form of gestational trophoblastic dz MC form of gestastional trophoblastic dz MC US finding w/ molar pregnancy MC finding if hCG is >100,000 MC form of multiple gestation MCC of neonatal death not assoc with chromosomal abnl

"string of pearls" appearance in ovaries squamous cell CA PCOS transformation zone HVP strains 16, 18 31 33 45 HPV strains 6 and 11 repeat pap in 6 months vaginal CA vaginal CA trichomonas vaginalis chlamydia HPV fibrocystic changes staph aureus ductal CA estrogen receptor positive breast CA upper outer quadrant PID 10-12 weeks nullipara (18-20 wk), multipara (14-16 wks) 15-18 wks 28 weeks Down's syndrome neural tube defect, omphalocele fallopian tube 1st trimester 2/2 chromosomal abnls hydatidiform mole (molar pregnancy) complete molar pregnancy grape like appearance or snow storm complete molar pregnancy dizygotic twins preterm labor

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MC marker for preterm labor MC dx tool for PROM HTN before 20 WGA HTN after 20 WGA MC risk factor for pre-eclampsia Gold standard for dx of pulmonary embolism MC time of maternal/fetal blood mixing causing Rh incompatability MC type of primary osteoporosis MCC of 3rd trimester bleeding MC preferred method of delivery with abruptio placenta MC bug to cause endometritis MC arthropathy of adults MCC of endometritis MCC of swan necking and boutonniere deformities of the hand MC finding on Xray w/ RA MC type of juvenile arthritis MC pathogen in jt infx MC jt affected by bacterial septic arthritis MC ophthalmic findings with macular degeneration MCC of central vision loss in pts > 50 yrs old MCC of sausage digits (dactylitis) w/ STI assoc MC Xray finding with reiters syndrome MC finding with gout Dx test for polymyocitis MC lab findings in polyarthritis nodosa

fetal fibronectin (should not be present bt 24-34 weeks, if it is then mom is in premature labor) + fern and nitrozine paper (turns blue) chronic HTN pregnancy induced HTN nulliparity pulmonary angiography at delivery type 1 post menopausal abruptio placenta c-sect anaerobic streptococci OA C-sect or ROM >24hr RA periarticular erosion and osteopenia pauciarticular (RA affecting large jts 4 or fewer for 6 consecutive weeks staph aureus knee drussen bodies macular degeneration Reiters syndrome meta tarsal head erosion (-) befringement needle shaped uric crystals (serum uric acid >8mg/dl) muscle bx inc ESR and RBC casts

CM dz assoc with tawt, shinny skin, atrophy and CREST syndrome (calcinosis, Raynaud scleroderma phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia) MC dz to destroy the salivary and lacrimal glands (autoimmune dz) Dx test for syogrens syndrome MC dx assoc with non-articular muscle aches and pns syogrens syndrome Schrimmer's tear test fibromyalgia

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MC site of bony metastasis MC primary malignant bone tumor MC sarcoma in pt 10-20yr old arising in the metaphyseal area of the long bone MC site of fx with osteoporsis MC site of fx in peds

spine multiple myeloma osteosarcoma distal radius, hip and vert physis/growth plate

Dislocation assoc w/ radial subluxation in young nursemaid's elbow child xray w/ elevated posterior fat pad Mc Burney's pt Turner's sign blue discoloration around umbilicus non-tender palpable gallbladder inhibition of inspiration 2/2 pn on palpation of RUQ RUQ pn, fever chills and jaundice (cholangitis) specks of bleeding 2/2 removal of psorasis scales muffled/distant heart sounds, inc JVP (JVD), hypotension clinched fist over the chest (agina) Post MI pericarditits (post MI, tissue dying begins to irritate pericardium) JVP rises with inspiration when it should dip down instead alternating periods of shallow and deep breathing (seen with LV failure) hemastatsis, injury to vascular endothelium, hypercoagulable state LMP- 3 months + 7 days conjunctivitis, urethitits, oligoarthritis hot potato voice flushing, diarrhea, wheezing, hypotension wheeze, eczema, seasonal rhititis pink puffer blue bloater bluish coloration of the cervix 2/2 to pregnancy, venousstasis pre-eclampsia triad tingling w/ percussion over the volar aspect of the wrist finkelstein test/de Quervain's tenosynovitis RLQ seen with appendicitis blue, red, purple, brown flanks seen with acute pancreatitis cullin's sign seen with appendicitis Courvoisier's sign seen w/ cholelithiasis and pancreatic CA Murphy's sign Charcot's triad Auspitz's sign Beck's triad Levine's sign Dressler's syndrome kussmal's sign Cheyne Stokes respiration virchow's triad nageles rule reiters' syndrome epiglotitis carcinoid syndrome atopic triad pursed lips, barrel chested, emphysema chronic bronchitits chadwicks sign HTN, proteinuria, edema tinel's sign flex thumb into plam, pn w/ ulnar deviation of the wrist

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McMurry test anterior drawer/lachman test posterior drawer/ thumb's sign Thompson test trousseau's sign Chvostek's sign rapid large volume breathing indication intense stimulation of the resp center (seen with metabolic acidosis) microscopic findings with tinea viscolor multinucleated cells on Tzank smear Reye's syndrome homan's sign name 2 meds that are gastric prokinetics aminosalicylates (anti-inflammatory) DMARDs anti-TNF alpha agents bisphosphonates thioureras (hyper-thyroid) diuretics (ascending loop) diuretics (distal tubule-thiazide) diuretics (distal tubule-K-sparing) what class of diuretics best treat volume overlaoad what class of diuretics best treat HTN Ca2+ channel blockers: dihydropyridines Ca2+ channel blockers: non-dihydropyridines alpha blockers MAOIs insulin-rapid acting insulin-short acting insulin-intermediate acting insulin-long acting

flex hip and knee then rotate internally and w/ fingers over knee jt, extend leg and feel for pops, repeat with external rotation (tests for menisical tears) test for ACL tear tests for PCL tears squeezing the calf will not cause ext of foot if achilles tendon is ruptured carpal spasm 2/2 BP cuff inflation, finding seen w/ hypoparathyroidism 2/2 decreased Ca2+ levels fascial muscle spasm with tapping on facial nerve, finding seen w/ hypoparathyroidism 2/2 dec Ca2+ kussmauls breathing spagehetti adn meatballs with KOH prep HSV fatty liver w/ encephalopathy (ASA SE in peds) pn with passive dorsiflexion of ankle with DVT cisapride and metoclopramide sulfasalazine, mesalamine methotrexate, lefuromide, hydroxychloroquin, anti-TNF alpha agents infliximab (Remicade), Entanercept (Enbrel), Adalimumab (Humira) Neidronate, Olpadronate, Risdronate, Etidronate methamazole, propylthiouracil (PTU) Loop diuretics: furosemide, bumetamide, torsemide HCTZ, metolazone, chlorthalidone, indapaminde spironolactone, amiloride, triamterene loop > thiazide thiazide > loop nifedipine, nicardipine, amlodpine verapamil, diltiazem prazosin, terazosin, doxazosin, alfazosin, pheoxybenzamine phenelzine, rasagiline, selegiline, isocarboxazid, iproniazid lispro (humalog), aspart (norolog) regular (humalin) NPH glargine (lantus)

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Insulin -mixed thrombolytic therapy anti-platelet therapy non-benzo anxiolytic sulfonylureas what is the mechanism of metformin thiazolidinediones MOA and example alpha glucosidase inhibitor (diabetic med)-MOA and ex TCAs

70/30 (long/short) streptokinase, t-PA ASA, clopidogril, LMWH, lovenox, plavix, cilostazole (1st line for PVD) buspirone inc insulin secretion, glyburide, glipizide dec glucose production of the liver inc sensitivity of peripheral tissues to insulin ex:pioglitizone, rosiglitazone delays absorption of carbs in the intestine ex:acarbose amitriptyline (elavil), clomipramine, nortripyline, imipramine WARNING: causes QRS prolongation citalopram (celexa), fluoxetine (prozac), escitalopram (lexapro), paroxetine (paxil), sertraline (zoloft) WARNING: may cause serotonin syndrome alprazolam (xanax), lorazepam (ativan), clonazepa (klonapine), diazepan (valium) diphenhydramine (benadryl), hydroxizine (vistaril), fexofinadine (allegra), cetirizine (zyrtec) ranitidine (zantac), famotidine (pepcid) cromolyn sodium, nedocromil salmetrol, albuterol leuprolide (lupron), norgestimate (ortho-cyclin), medroxyprogesterone (depoprovera) ipratropium bromide alpha-feto protein alpha feto-protein CEA CEA CA-125 BRCA1:BRCA2 gene vasoconstictor: naphazoline amikacin, gent, neomycin, streptomycin, tobramycin azithromycin, erithromycin, clarithromycin cipro, moxifloxacin, ofloxacin, levofloxacin (levaquin) ampicillin, PCN, amoxicillin, augmentin (amoxicillin and clavulonic acid), zosyn (pipercillin and tazobactam), ticarcillin, nafcillin bactrim

SSRIs

benzos H1 antihistamines H2 antihistamines mast cell stabilizers beta 2 agonist (asthma) GnRH agonist (used with endometreosis, DUB) progestins anti-cholinergic (1st line txt for COPD) CA marker for liver CA marker for testicular CA CA marker for colorectal CA CA maker for lung CA CA marker for ovarian CA CA marker for Breast CA topical med for red eyes aminoglycosides macrolides flouroquinolones PCNs sulfonamides

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tetracyclins antifungal Chemoprophylaxis abx for gram pos bacteria Serotonin and dopamine antagonist anti convulsants ped w/ PCN allergy dx w/ AOM, txt? bactrim, cipro, azithromycin, cephalexin 1st line txt for AOM in peds if ped shows no improvement of AOM after 3 days of meds (amoxicillin) with no abx the previous mon, what txt next? if ped has AOM and has had abx in last month, what is the txt?

doxy, minocyclin, tetracyclin amphotericin B Chloroquin, Quinine, Quninidine (txt for malaria) vanc respiradone (txt for schizophrenia), clonazapine, olanzopine SE: orthostatic hypotension lorazepam (ativan), valproic acid (depakote), carbamazepine (tegratol), phenytoin (dilatin), clonazepam (klonopin) macrolide: azithromycin amoxicillin augmentin (amoxicillin clavulanate) augmentin extra strength (amoxicillin-clavulanate) or amoxicillin HD

Inadequately txted streptococcal pharyngitis can rheumatic fever lead to what condition? A prego pt presents with ruptured bag of water that happened 18 hrs ago, what do you do? induce labor b/c BOW broken >12hr

what are the potential SEs of leuprolide (used to loss of bone mineral density, vasomotor symptoms, vaginal txt endometrosis) dryness, and mood changes med for over active detrusor muscle tumor marker in carcinoid syndrome MC site for carcinoid tumor What causes bloody diarrhea in peds define dysentery MCC of gastroenteritis in peds often spread in daycares MC STD in US 1st EKG change with acute MI MC inherited hypercoagulable state 1st sign of compartment syndrome Chronic use of oral steroids can cause what cauda equina syndrome delayed adduction of the eyes is MC seen in what dz detrol, oxybutynin (ditropan) 5-hydroxindoleacetic acid, carcinoid tumor occurs MC in GI or lung GI or lung shigella abdominal pain and cramps, straining at stool (tenesmus), and frequent passage of watery diarrhea or stools containing blood and mucus. rotovirus HPV peaked T waves Factor V Leiden loss of 2 pt discrimination AVN of the femoral head, glaucoma surgical emergency because if left untreated it can lead to permanent loss of bowel and bladder control and paralysis of the legs MS

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what maneuvers help accentuate the murmur of standing, deep breath, anything to decrease the volume of hypertrophic cardiomyopathy blood in the ventricles what class of anti-HTN meds should be used with caution in a ot with a pre-existing heart block? the acute onset of CHF assoc w/ loud systolic murmur on left sternal border in a pt w/ an MI suggests what? What hormone peaks at the time of ovulation 1st line txt for trigeminal neuroglea mycoplasma pnueumo occurs in what ages loss of vision in one eye MCC of painless gross hematuria in a pt > 50 Nl range for potassium txt for hyperkalemia what is the incubation period for staphylcoccus aureus and SE's what is the incubation period for Clostidium perfringens and SE's what is the incubation period for e. coli and salmonella MC initial presenting sx of primary biliary cirrhosis when does nl grief set in and how long does it last therpy of choice for long term management of esophageal varices in a pt who can not tolerate beta blocker therapy What tests are utilized in the dx of malaria beta blockers

ruptured papillary muscle, it can occur 2-7d post MI w/ sudden appearance of pulmonary edema and loud systolic murmur LH anti-convulsants: carbamazipine of dilatin (phynetoin) young (20s) amblyopia transitional cell CA until proven otherwise 3.5-5 calcium gluconate IP: 1-6 hrsSEs: watery, non bloody diarrhea and vomiting IP: 8-14hrs SEs: dysentery 2/2 poorly refrigerated cooked meat IP: >16hrs pruritis onset w/i 2 monand lasts less than 2 months sclerotherapy, inj into vessels to make them shrink, also used for hemorrhoids and varicose veins thick or thin Giemsa-stained blood smear, ELISA, PCR benign growth of nerve tissue often between the third and fourth toes causing a sharp, burning pain in the ball of the foot, toes also may sting, burn or feel numb. Common txt: changing footwear or using arch supports, corticosteroid inj or surgery mitral insuff blocks AV nod completely caused by the entrapment of the tibial nerve (compressive neuropathy) (medial aspect) -> pain, dysesthesias: burning & tingling on the sole of the foot. pn usually worsens as the day progresses & relieved by rest, elevation, or massage. along plantar medial aspect of heal w/ pn & stiffness greater in AM and worse w/ dorsiflextion trauma, repeatative motion or inflammation arthropathies. occurs on lateral aspect and w/o dysesthestias

What is Morton's neuroma

MC heart murmur to radiate to the axilla what is the MOA for adenosine?

what is tarsal tunnel syndrome

describe plantar fascitis pn What causes peroneus longus tendonitis

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Most significant complication of a dislocated knee

arterial injury which needs immediate surgery chronic, progressive degenerative dz of 1/+ jts, w/ swelling, unstabile jt, hemorrhage, heat, & atrophic & hypertrophic changes, the result of a neurologic disorder, diabetic neuropathy, leprosy, congenital absence or the depression of pn sensation. disintegration of the jt with osteophytes live attenuated intranasal influenza vaccines b/c they are at risk for bronchospams deep breathing leaning forward finger to nose, heal to knee, rapid alternating movements, and gait yrs later w/ inc dyspnea and interstitial fibrosis of the lower lungs, thickened pleura and calcified pleura plaqes, w/ restrictive pattern on PFTs asymptomatic w/ unaffected PFTs, CXR shows small rounded opacities throughout the lung and calcified hilar lymph nodes common in 3rd and 4th decades, no PE pulm findings, +hepatosplenomegaly (HSM), hypercalcemia indicating need for therapy Large cell CA and adenocarcinoma peripherally, squamous and small cell centrally hordeolum

What is charcot's jt

What is seen on xray with charcot's jt what vaccine is contraindicated in asthmatics What is the best PE maneuver to have a pt perform to dx pericarditis what PE maneuvers test cerebellar fxn

How with asbestos exposure present

how will silicosis present

describe sarcoidosis

locations of the four MC pulmonary CA pt has swollen R upper eye lid and very pnful, what is most likely dx

MC medical and surgical conditions seen during cholecystitis pregnancy Next step in txt if pt with corneal abrasion presents with infection of ulceration 1st line txt for acute cystitis in pregnancy refer to ophtho cephalexin (keflex) (1st gen ceph) abnormal levels of nitrogen-containing compounds, such as urea, creatinine, various body waste compounds, and other nitrogen-rich compounds in the blood. It is largely related to insufficient filtering of blood by the kidneys. obstruction cerebellar degeneration and peripheral atrophy resulting in Wernicke-korsakoff syndrome human rabies Ig and human diploid cell vaccine inhibits primarily the absorption of sodium and chloride not only in the proximal and distal tubules but also in the loop of Henle ACE-I HIT: heparin induced throbocytopenia

what is azotemia

MCC of post renal azotemia thiamine def assoc w/ EtOH abuse results in what condition What is appropriate rabies prophylaxis after a bite from an animal Where and how does lasix work 1st line therapy for symptomatic pts w/ CHF potential SE of heparin

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what is an advantage in dosing when using LMWH version heparin 1st line txt for HIT MC injured nerve with anteroir shoulder dislocation

LMWH is once daily vs q6 Lepirudin (Refludan) is an anticoagulant which functions as a direct thrombin inhibitor. derived from the saliva of the medicinal leech Hirudo medicinalis. axillary

ped hospitalized for meningococcemia, family and close contacts should be prophylactically txt Rifampin with what? What cardiac abnl is inc in incidence in the US what med is used to stop an active migraine what is a common 2/2 problem to pedinculosis capitis (head lice)? PT presents with recurrent diarrhea and PUD refractory to adequate therapy, what is the MC cause? what labs indicate bulemia what studies indicated anorexia nervosa What PE finding is suggestive of low thiamine Greatest risk in developing pancreatic CA CHF imitrex (sumatriptan)

what med is use to txt mirgaines prophylactically beta blockers impetigo 2/2 itching and scratching ZES presents with diarrhea 50% of the time vs resistant h. pylori which does present with diarrhea metabolic alkolsis, hypokalemia, inc amylase, dec RBC, WBC, platelets, magnesium, thiamine, albumin QT prolongation, low WBC cheilosis smoking gray-green to red-gold pigmented ring at outer margin of the cornea, pathoneumonic for Wilson's dz autosomal recess genetic disorder, copper accumulates in tissues -> neurological/psychiatric sxs & liver dz What type of MI most likely requires a lg infusion inferior wall MI will most likely involve RV of saline to maintain blood pressure? Austin flint murmur MCC of myocarditis what is discitis 1st line txt for macrocytic anemia with parathesias Mechanism of VRE and MRSA pt w/ elevated triglycerides and nl LDL, therapy is aimed at reducing the risk for what complication? pt w/ new HTN and hypokalemia has what dz soft, low pitched rumbling mid-dialstolic murmur 2/2 regurgitant blood from the aortic valve into the left vent hitting the anterior leaflet of the mitral valve during diastole Coxsackie B virus and echovirus infectious dz of the mid lumbar region at approx 6 y/o presenting with low back pn radiating to abd or LE, sometimes with n/v/f Vit B12 or cobalamin, neurological complaints are not common with folate def loss of a hydrogen at the abx-protein binding site pancreatitis primary aldosteronism most likely 2/2 renal cortex adenoma

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what is typical presentation of renal artery stenosis what med is used to dx MG what med is used to tx MG what race should have prostate exams done earlier than the rec age? 1st line emperic txt of an ill appearing pt w/ infections diarrhea who recently visited mexico what are risk factors for adrenal crisis 1st line txt foe hemophilia what is a cause of pre-renal azotemia MCC of 2ndary HTN By how much does a newborn's wt inc at age 1 Most reliable sign of AOM what effect does progesterone have on breast tissue prior to menstration proliferation of the mammary ducts is under the influence of what hormone what portion of the spinal cord is affected with abnl proprioception and vibration discrimination what is considered when calcuating a framingham 10 yr CHD risk pt w/ fever x5d, red, fissuring lips, cervical LAD, edema of hands and feet, bilateral conjuctival injections, generalized rash over body has what 1st line txt of gestational DM who should get Hep A vaccine

hard to control BP in young females with NO electrolyte abnls edrophonium neostigmine AA FQ like Cipro for infx diarrhea or bactrim as alterate stopping steriods too soon, surgery, trauma, infx, dehydration cryoprecipitate or factor VIII poor renal perfusion renal parenchymal dz triple loss of tympanic membrane mobility during pneumosufflation growth of the lobules and alveoli (PAL) estrogen (ME) posterior column Age, systolic Bp, tot Cholesterol, hDl, smoking

kawasakis, danger for coronary artery aneurysms!!! reg insulin illicit drug users, living/traveling in endemic areas,sewage wkers, food handlers, male homo/bi, animal handlers, pt w/ hx chronic liver dz or clotting dz, kids & wkrs at daycare I: clinical disorders, (major mental/developmental/learning disorders) II: underlying pervasive/personality cond, mental retardation III: acute medical cond & physical disorders IV: contributing psychosocial & enviro factors V: Global Ass. of Fxn brainstem auditory-evoked potentials primary pneumothorax HSV 3 y/o

what are the fives axises of mental disorder

what is the most appropriate method of dx hearing problems in pt <2 months rupture of subpleural apical blebs due to high negative intrapleural pressures can cause what what is a common cause of dendritic ulceration noted on fluorescein staining of the eye annual BPs should begin at what age?

In adults and IVDU, which of the following bones is most commonly affected w/ acute spine osteomyolitis

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asymoptomatic female DM has Ca2+ 12.4, what serum albumin b/c 50% of ca is protein bound test should be done nl range for Ca2+ what would cause a pos kussmauls sign what type of orbital fxs is orbital emphysema seen hematoma of the orbit can cause what in infants the eyes should move parallel w/o deviation by what age? what PE finding is consistant with moderate emphysema? MCC for interventional surgery in pt w/ chronic pancreatitis 9-10.5 MC: right sided heart failure freq caused by:pericarditis or right vent infarct medial orbitsl wall or floor into the maxillary and ethmoid sinuses respectively and will NOT lead to proptosis inc ocular pressure, proptosis, visual loss, limited EOM 6 months distant heart sounds 2/2 hyperinflation of the lungs intractable pn despite the use of non-narcotic analgesics and no EtOH

sutures in the face should be removed after how 5d many days? best way to monitor prostate CA Why should pts with inc LDL not get fibric acids (gemfibrozil) Why are fibric acids (gemfibrozil) prescribed? What effects on cholesterol levels do statins have? PSA may cause inc of LDL to lower TG and inc HDL dec TC, LDL, TG and inc HDL

what effect can bile acids (cholestyramine) have may inc on TG how does omega 3 fatty acids affect cholesterol levels what cholesterol med is not indicated for diabetics a 19 y/o f presents w/ sore throat x 2w w/ fatigue, low grade fever, LAD (cervical, axillary, inguinal) and splenomegaly, what is her dx? what is seen on blood smear with mono dec TG niacin b/c it can worsen blood sugar control

Mono lymphocytosis w/ large lymphocytes

A pt has a done drugs, a seizure and fever, what CK to assess for rhabdo is an important lab to order cold hemagglutinin titer can be used to dx what inf if inc nl range for MCHC nl range for platelets what is the beat way for an asthmatic to prophylax against allergies hand foot mouth dz is caused by what virus mycoplasma pneumo 32-36 and determines hypochromic vs normochromic 150-400 use an inhaled corticosteroid regularly prior to allergy season coxsackievirus

what reflex should disappear at about 2 months? grasping

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intraarticular inj of haluronic acid have been approved as a txt for what 1st line txt for schizophrenia what class of oral diabetic agents can result in hypoglycemia? what 3 tendons make up pes anserinus kernig's sign brudzinski's sign gowers sign what causes alcohol related hypoglycemia 1st line txt of legionella pneumophila in immunocompromised txt for legionella pneumophila in immunocompromised refractory to 1st line txt 1st line txt for chronic prostatitis what diatary substance interacts with MAOIs

RA atypical antipsychotics: olanzapine, risperidone, quetiapine, (the pt hears the ROQ talking to him) sulfonylureas: glipizide (inc insulin levels) satorus, gracilius, semitendonosus pos when pn is noted on straitening the knee after flexing both the hip and knee pos if pn is noted when flexing the neck resulting in flextion of the hips 2/2 meningeal irritation pos in Musc dystrophy when kid stands up by turning prone and pushes off the floor with arms and keeping legs straight hepatic glycogen depletion and impaired gluconeogenesis Macrolide (clarithromycin), FQ (levo) rifampin with either Macrolide/FQ FQ or bactrim tyramine meats spoiled/pickled/aged/smoked/fermented /marinated,pork(not cured ham);chocol;EtOH;cheeses,sourcream/yogurt/soybean condiments/tofu/miso soup;fava beans/green beans/avocados /bananas/pineapple/eggplants/figs/plums/raspber/peanuts /coconuts/yeast/cacti 5yrs as an analgesic for osteoporotic vertebral compression fxs pen v @ 2mon and folic acid @ 1yr etanercept (often used for RA can reactivate dormant TB) osteomalacia NSAIDs, Abx, anticonvusants

what foods contain tyramine

pt getting first pneumovax after age 65 should have a repeat shot in how long calcitonin nasal spray is used for what pt / sickle cell should prophylactically take what meds and beginning when before administering what med, should you test for TB what is a SE of chronic phenytoin use What claases of meds can cause SJS/toxic necrolysis syndrome

what causes serum levels of theophyline (COPD smoking med) to decrease in pts w/ COPD if a pt w/ ITP cont to have thrombcytopenia after splenectomy steroid therapy x 6wk, what is the next txt what are SEs of bleomycin (abx used in ABVD pulm fibrosis/inflitrates hodgkins xt and various CAs, and plantar warts)

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pt w/ pap results indicating cervical dysplasia, whats the dx procedure txt for symptomatic bradyarrhythmia 2/2 sick sinus syndrome 1st line txt for insomnia in the elderly MC nerve to be intrapped by a mid humoral fx what would be seen on singmoidoscopy w/ crohns what is a known complication of polymyalgia rheumatica 1st line txt for peylonephritis in pregnant pt what meds tx mania 1st line txt of over active thyroid 2/2 graves 35y/o nonsmoking pt found to have a single pulmonary nodule on xray with no previous xrays, what study/test should be done next cavities are caused by what bacteria most definative txt for primary enuresis post-op pt has s/sxs of PE, lung CT non-diagnostic, what do you do next when is a stool cx and exam for ova and parasites indicated with diarrhea MC hereditary hyperbilirubenmias

colposcopy directed bx permentant pacemaker benzos radial nerve intermittent LONGITUDINAL mucosal ulceration and fissures giant cell arteritis IV cephalosporins lithium, valproate, olanzapine radioactive iodine (I131) CT of chest stretococcus mutans intranasal desmopressin (inc ADH) US of legs diarrhea >3wks or assoc w/ fever, abd pn &/or bloody stools (dysentary) Gilbert's syndrome

intubation should be performed w/ caution if a pt RA has what condition 1st line txt for actinic keritosis pt w/ carpal tunnel caused by median nerve injury will have what other PE findings cryotherapy + tinels, +phalen's, weak thumb abduction and thenar atrophy

MC rotator cuff tendons to sustain injury b/c of repeated impingement b/t the humeral head and supraspinatus the undersurface of the anterior 1/3 of the acromion & coracoacromial ligament what is a dx finding in urine sediment for chronic broad waxy casts renal failure MC arrhythmia w/ mitral stenosis MC drug to cause lupus-type eruption common benign plaque in the elderly that characteristically has a velvety or warty surface associated with a stuck on appearance and greasy feel another name for acute respitory disease and who it affects MC form of kidney failure in hospitalized pts afib procanamide

seborrheic keratosis

hyaline membrane disease, premature babies pre-renal azotemia

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causes of pre-renal azotemia

anything that dec flow flow to or of the kidneys: Burns, Loss of blood volume (dehydration),vomiting/diarrhea, bleeding,Heart failure,Shock,surgery:Renal artery embolism/occlusion,Trauma to the kidney 10-20 0.5-1.2 <20, <1% respectively >40, >1% respectively >40, >4% respectively amoxicillin (doxy harmful to teeth and bine dev) chronic renal failure SSRI

Nl range for BUN nl range for Cr What values of urine Na and FEna indicate pre-renal problem what lab values of Urine Na and FEna indicate and intrinsic reneal problem what lab values for urine Na and FEna indicate post-renal problem 1st line txt for Lyme in a pt <12y/o foot drop and restless leg syndrome (RLS) may be caused by what 1st line med for bulemia

which has morning stiffness that lasts longer RA than an hr but improves with activity, RA or OA? MC seriological test for Wegener's granulmatosis How is Wegeners dxed MC areas affected by wgeners What conditions is saddle nose seen in the presentation of purpura, arthritis and abd pn/renal involvement is known as ANCA bx of nasal passages, airways or lungs to confirm or rule out the presence of both vasculitis and granulomas upper respiratory, lungs, kidneys congenital syphilis, relapsing Polychondritis, and Wegener's granulomatosis triad of henoch-schoenlien purpura

a ped is infected with a VIRAL infection (URI/flu /chicken pox), and 3-5 days later presents with swelling of the BRAIN and LIVER, blood sugar Reye's Syndrome level typically drops while the levels of ammonia and acidity in blood rise MC breast lump in premenopausal women, slow growing, firm, rubbery, well-demarcated, freely fibroadenoma moveable, non-tender, does not change with cycle what hormone is responsible for producing 1,25 dihydroxyvitamin D (calcitrol) in the kidneys What causes chest pn after a viral infection? 1st line txt for traveler's diarrhea Gold standard for dxing a retropharyngeal abscess PTH carditis cipro

where does pain present with increased Q angle retropatellar/patellarfemoral syndrome CT of neck with contrast

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MC PE finding with Peyronie's dz what anti HTN med is both alpha and beta blocker MC complaint of a pt with an undxed brain abscess MCC of blindness in pts <70 y/o in the US txt for external hemorrhoids what txt for constipation should be used with extreme caution in pts with renal insufficiency 2 y/o pt had a seizure and a fever, what test do you perform heart defects common to Marfan's AIDS pt with toxo and AMS, seizures and focal neuro def, what test do you run

fibrous band on lateral side of penis, curvature during erection carvedilol HA DM sitz bath and inc dietary fiber MOM: the failing kidneys do not excrete Mg appropriatey and lead to hypermagnesium LP, febrile seizures are rare in peds <3y/o Mitral valve prolapse and aortic root dilation MRI look for ring enhancing mass lesions

what presents w/ a macular rash on the wrists, ankles, extremities and trunk and 5 days later on rocky mountain spotted fever the palms and soles after camping 1st line txt for malignant otitis media MCC of exudative pleural effusion what three tests should be run to dx SLE absolute CI to throbolytics in an MI A fx of which part of the femur is assoc with the greatest risk of AVN what is the most important concern with abrupt cessation of an SSRI greatest risk of death for post-menopausal female 47 y/o female with new dx of HTN and hypokalemia, what is the cause are hyaline casts in the urine a concern which electrolyte abnlity inc risk for digoxin toxicity kussmauls breathing is defined as MC compostion of renal stones 1st line txt for OA MC exam finding with diptheria Type of cellulitis that involves inflammation of the tissues of the floor of the mouth, under the tongue, often occurs after an infection of the roots of the teeth (such as tooth abscess) or a IV cipro bacterial pneumonia ANA, dsDNA, anti-phospholipid antibodies previous stroke, active PUD femoral neck med withdrawl ore so than relapse of depression heart dz hyperaldosteronism: causes excretion of K and retension of Na leading to HTN no, often seen after strenuous exercise, concentrated urine, fever hypokalemia rapid deep breathing calcium oxalate acetaminophen gray pharyngeal pseudomembrane

which form of lung CA has the poorest prognosis small cell

Ludwig's angina

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mouth injury. MC skin CA causing death Which vaccine is important to give to sickle cell pts MC complication of TIPS acute adrenal insufficiency is characterized by what lab findings At what % occlusion of the left main coronary artery does a pt qualify for revascularization MC finding with MS true/false cigarette smoking induces a chronic state of inflammation greasy stools/diarrhea worse with certain foods what test should should be run 1st line txt for pinworms what describes the pathophysiological changes of pulmonary sarcoidosis MCC of death in adults with Turner's syndrome Erythema infectiosum also known as what and caused by what virus what sign is pos when the pt experiences RLQ pn with palpation of the LLQ what sign is pos wht the supine pt experiences pn when the R leg is flexed at the hip and knee and the hip is externally and internally rotated which cell produce intrinsic factor Why is intrinsic factor important what presents with distended neck veins and cold clammy skin? Erythema marginatum is pathognomonic for what what vertebral condition can occur with RA what vertabral condition can occur with OA With which arrythmia can you see canon A waves 1st line txt for mono which animal in the US is the major cause of human rabies melanoma pneumococcal vaccine b/c they are fxnally asplenic inc risk of encephalopathy b/c the blood flowing thru the shunt is not getting filtered and toxins can build in the blood hyponatremia and hyperkalemia 2/2 impaired aldosterone production 50% diploplia true celiac sprue anti-endomysial antibodies mebendazole (Vermox) granulation and inflammation of alveoli, small bronchi and small blood vessels cardiovascular malformations: coarctation of the aorta and bicuspid aortic valve (fifth disease) is a common childhood exanthem caused by human parvovirus B19 Rovsing Sign

obturated sign parietal cells of the stomach it aids in the absorption of B12 in the terminal illium cardiac tamponade rheumatic fever C1-C2 subluxation cervical spondlosis third degree heart block b/c the atria are contracting against a closed tricuspid valve. pt will also be bradicardic with third degree heart block symptomatic, no abx bats

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which cranial nerve is responsible for closing the CN V (facial) eye what condition is described by pn that usually starts 1-2 wks before the onset of menses and is endometreosis relieved at the onset of menstrual flow or shortly after what is hydroxychloroquine used to tx and what is a SE which has morning stiffness that lasts less than an hour and improves with activity, RA or OA what tests are run to dx RA pauciarticular involves how many jts SLE skin eruptions, affects the vision OA anti-ccp and RF 4 or fewer

necrotizing inflammation of medium-small polyarteritis nodosa vessels, assoc with HBV and hairy cell leukemia what is the classic presentation of dermatomyocitis/polymyocitis? what rashes are assoc with dermatomuyocitis/polymyocitis MC assoc vasculitis with polymyalgia rheumatica (PMR) What meds make gout worse and why proximal weakness Gottons on the MCPs and IPs, V/shawl rash, heliotrope rash on eyes giant cell arteritis (GCA) CANT LEAP: Cyclosporin, Alcohol, nicotinic acid, thiazides, Lasix, Ethanbutol, ASA, Pyrazinamide increase uric acid poduction or dec urinc acid excretion Different: Pseudo is 2/2 to Ca2+ deposition in the jt, Pos bifring on micro, will see Ca2+ in jts Same: cholchicine,

how is pseudogout different/same from gout What back problem is characterized with improvement with activity, worsen with rest, and calcification of vertibral ligaments appearing as bamboo spine on Xray, limiting flexion ROM starting from the sacroilliac jt and ascends with time, "young man's dz" MC test to dx ankylosis spondylitis 1st line txt for ankylosis spondylitis

ankylosis spondylitis

HLA-B27 etanercept

test used in rheumatology to measure the ability schoeber test of a patient to flex his/her lower back. reactive arthritis is also known as what What causes Reiters MC type of arthritis in children under 16 1st line txt for pauciarthtrits (juvenile RA) 1st line txt for polyarthritis (juvenile RA) 1st line txt for systemic juvenile rheumatoid arthritis Reiters it is a post infectious inflammation occurring after a GI/chlamydia infx juvenile rheumatoid arthritis NSAIDs DMARDS (methotrexate, anti-TNF) anakirna

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What is a common complication of juvenile rheumatoid arthritis what does sicca syndrome refer to MC tests for sjoegrens what does CREST stand for MC shoulder problem MC problem ped shoulder problem MC missed shoulder dislocation

chronic uveitis and can lead to BLINDNESS dry eyes and mouth SSA, SSB, ANA Calcinosis of the skin, raynauds, esphogeal dismotility, sclerodactaly, telangectasias instability/dislocation (ant>pos) clavical fx posterior a cortical depression in the head of the humerus bone resulting from forceful impaction of the humeral head against the anteroinferior glenoid rim when the shoulder is dislocated anteriorly. AXILLARY, A-P, lateral SITS: Supraspinatus, infraspinatus, teres minor, subscapularis

Hill Sacks lesion

what 3 films are important to order with a potentially dislocated shoulder muscles of the rotator cuff

1st line txt/gold standard of shoulder impingment bursa inj in the the subacromial space what condition is characterized by the inability of frozen shoulder/adhesive capsulitis movement in any direction of the shoulder MC pts with adhesive capsulitis 1st line txt for adhesive capsulitis MC fx of hand MCC of gamekeepers thumb 1st line txt for boutinere deformity fat pads are what until proven otherwise MC elbow fx in peds MC fx with highest rish of non-union 2/2 to poor blood supply MC carpal bone fx What will appear on xray to dx a scaphoid fx young, female, diabetics nothing it will resolve on its own, manipulation may result in breaking the humerous, may consider NSAIDs boxers disruption of the ulnar collateral ligament splint in extenion x 6w fx supracomdyler scaphoid scaphoid widening of the scaphoidlunate space pinching of the ulnar nerve causing pn/numbness/tingling of the 4th/5th digets maybe with pn of the medial elbow L4-L5 L5-S1 young athletes oblique spondylolisthesis steriods, EtOH, Sickle cell, RA, SLE

contraction if the 4th and 5th fingers is known as dupuytrens contractions what is cubital tunnel syndrome nerve responsible for great toe ext nerve responsible for great toe flexion MC population to have spondylolisis MC film to dx spondylolisis what is anterior slippage of the vert called MC causes of AVN

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MC concerns after femoral fx What does every knee exam need MC place knee pn originates in peds MCC of hemarthosis of the knee MC finding on xray of pt with retropatellar sydrome/femoralpetellar symdrome unhappy triad

fat emboli and hypovolemia a hip exam the hip ACL tear and tibial plateau fx on sunrise view the patella will be shifted to one side injuries to the ACL, medial colateral ligament and medial meniscus after a later force on the knee pt prone flexes knee to 90 degree angle, examiner, tibia is then compressed onto the knee joint while being externally and internally rotated. If pain, this constitutes a "positive Apley test" and damage to the meniscus is likely. PTF: post talofibular ligament, ATF: Ant talofibular lig, CF: calcanofibular lig mortis view 4/11 2000-50,000 >50.000 PB KTL prostate, breast, kidney, thyroid, lung 1: partial/complete AC sep, no CC injury 2: complete AC, partial CC sep 3: complete AC and CC sep 4: muscle torn prostate ca, prevents converion of testosterone to DHT peripheral zone (area palpable during DRE) <4.0 yearly stop testosterone production, orchiectomy e. coli WBCs, pos cx nephritic syndrome minimal change diesease minimal change disease intrinsic renal problem (nephrItic syndrome)

apley's test

What 3 ligaments are injured with inversion of the foot (ankle sprain) what film is ordered with ankle fx How many criteria must a pt meet to be dxed with SLE WBC count that classifies as an inflammatory arthritis WBC count that classifies as a septic arthritis CAa that met to bone Describe degrees of shoulder separation Leuprolide is used in the management of DUB and what and how does it work MC area for prostate CA to occur Nl PSA range How often is a PSA test in a pt with prostate ca and <10yrs to live What is the best way to slow progressing of prostate CA MCC of prostatitis What will be present on a UA with prostatitis which has hematuria, nephrotic syndrome or nephritic syndrome MC of nephrotic syndrome in peds <10 glomerulus appears normal under a light microscope, but shows podocyte foot process effacement under an electron microscope MCC of RBC casts

Is polycystic kidney disease autosomal dominant Auto dom or recessive

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MC type of acute renal faliure where is a spermatocele located MC side for varicoceles MCC of infertility MCC of testicular swelling post puberty MCC of epididymitis in pts <35 what condition does a pt have if scrotal pn is lessen by elevating the tesricle MC solid organ tumor in males MC CA in pts aged 15-35 test to help dx testicular CA MC type of kidney stone What type of kidney stone will turn purple in a sodium nitroprusside test MC type of kidney stone in chronically cathed pts which type of kidney stone may form staghorn calculi what is an adverse SE of diuretics what is a potential SE of beta blocker on cholesterol 3 CI of ACE-I admin 3 most important SEs of ACE-I with what condition is c-peptide tested MC test for PAD what is another term for hypothyroidism MC s/sxs of chancroid what bug causes syphalis what bug causes chancroid MC primary heart tumor MC site for a myxoma MCC of a tumor embolisation where in the body is bicarbonic formed is transudative fluid assoc with infection or oncotic pressure

pre-renal on the epididymus Left side, if it appears on the right you need to get imaging. Left side drains into left renal vein and has more resistance vs the right side that drains directly into the inferior vena cava varicocele epididymitis STDs: chlamydia epididymitis, it's called the Pren's sign testicular CA testicular CA beta HCG, yes the pregnancy test calcium oxalate cystine stone struvite struvite ototoxicity inc triglycerides, dec HDL Bilateral renal artery stenosis, intrinsic renal dz, Prego, angioedema, cough, hyperkalemia C-peptide can be used to help determine how much insulin the patients pancreas is still producing. ABI: if the measurement is <!, pos for PAD myxedema painful kissing hard ulcers, LAD of groin that may rupture thru the skin, Treponema pallidum Haemophilus ducreyi myxoma Left atrium myxoma kidneys, therefore if pt has renal failure, they may go into metabolic acidosis oncotic pressure

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is exudative fluid assoc with infection or oncotic pressure Parkland burn formula MC pathogens of acute sinusitis

infection 4 X body wt in kg X %BSA Streptococcuspneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. Streptococcuspneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. These microorganisms, along with Staphylococcus aureus and anaerobes are involved in chronic sinusitis. BP > 140/90, waist M > 4 F >35, fasting glucose > 110, triglycerides >150, HDL M <40 F < 50 (3/5 meet criteria for dx)

MC pathogens of chronic sinusitis

List components of metabolic syndrome 74 year-old male is diagnosed with pneumonia. The physician assistant should ensure the patient is not on which of the following before starting therapy with clarithromycin (Biaxin)? A. Lisinopril B. Furosemide C. Simvastatin D. Dipyridamole (Persantin

C. Statins are known to interact with the macrolides as they may cause prolonged QT interval, myopathy and rhabdomyolysis.

treatment of infections due to penicillin-sensitive Penicillin G staphylococci and streptococci in osteomyolitis; 1st line txt for penicillin-resistant, methicillinsensitive staphylococci osteomyolitis 1st line txt for infections due to susceptible gram-negative rods in osteomyolitis 1st line txt against Pseudomonas aeruginosa in osteomyolitis 1st line txt for Reiters syndrome MC test positive in secondary syphilis MC test of choice for the diagnosis of infectious mononucleosis. presentation of salmonella consumption MC test to dx salmonella MC fatal rickettsial dz in US Mc test to dx rocky moutain spotted fever 1st line txt for rock mountain spotted fever MC test to dx histoplasomsis MC corneal finding with herpes kerititis MC vaccines needed by multiple myeloma pts 1st line txt for Hep C what presents as targetoid lesions MCC of erythema multiforme MC presentation of erythema marginatum Tobramycin indomethacin The fluorescent treponemal antibody absorption test (FTA-ABS) A heterophile test watery, non-bloddy diarrhea 6-48hr after consuption, stool cx Rocky Mountain spotted fever indirect immunofluorescence assay (IFA) tetracyclin skin test dendritic corneal lesions flu and pneumo pegylated interferon, ribavirin erythema multiforme allergic reaction to medcation or infection (SJS) pink rings on the trunk & inner surfaces of the arms and legs which come and go for as long as several months, seen with some Rheumatic fever

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!st line prophylaxis for H. influenza pneumo in a hospitalized pt What class of medication should you verify that the pt is not taking prior to administering clarithromycin 1st line txt for an animal bite, and what bug are you txting for 1st line txt of osteomyolitis 2/2 pseudomonas cephalosporins WBC casts are pathognomic for what renal tubular epithelia casts are seen with what condition 1st line txt for impetigo A college student is diagnosed with meningococcal meningitis. All close contacts should be treated with which of the following?

Macrolide (mACroliDE: azithromycin, clarithromycin, dirithromycin, erythromycin) a statin, (macrlides with statins may lead to rhabdomyolisis or QT prolongation) augmentin (amoxicillin-clavulanate), pasteurella tobramycin 1 gen: cefalexin (Keflex), 2nd gen: cefuroxine, 3rd gen: cefotaxime pyelonephritis ischemic and nephrotoxic acute renal failure mupirocin (bactroban), PCN, Macrolide, 1st gen ceph Chemoprophylaxis for meningococcal meningitis consists of rifampin 600 mg q12h for 2 days, one dose of ciprofloxacin 750 mg, one dose of azithromycin 500 mg, or one IM dose of ceftriaxone 250 mg.

An infant presents with bullous impetigo Bullous impetigo that is localized may be treated with topical involving the face, extremities, and trunk. Which mupirocin, but extensive involvement is best treated with oral of the following is the best treatment for this antibiotics that are penicillinase-resistant, such as dicloxacillin. child? 1st line txt for prostatitis gentamycin covers what kind of bacteria 1st line txt for acute toxoplasmosis What conditions require prophylaxis prior to dental visit What med is CI for RA txt in a pt with chronic hepatitis? 1st line txt for absence seizure MC valve abnl 2/2 inf MI 1st line med for estradiol feedback inhibition on the hypothalamus Routine labs to be monitored in pts on lithium an intial concern for all burn pts 1st line txt for raynauds 1st line therapy for pt with symptomatic left vent systolic dysfxn 1st line txt for HTN in a pt with pheochromocytoma 1st line txt for pt with von Wilibrand factor def with continued bleeding Bactrim/ FQ gram neg sulfadiazine or pyrimethamine Valve replacement, congenital valve malformation, episodes of endocarditis, NOT rheumatic fever methotrexate ethosuximide, valproic acid, and clonazepam Mitral regurge clomiphene citrate TSH and kidney tetanus prophylaxis Calcium channel blocker ACE alpha blocker: phenoxybenzamine desmopressin (DDAVP)

MC presenting symptom of a Pulmonary edema tachypnea

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What condition requires higher doses of anti-depressants than depression 1st line txt for AOE What cause of pneumonia may cause diarrhea What are RBCs and RBC casts in the urine associated with? what are WBCs and WBC casts in the urine associated with what are renal tubular cells in the urine assoc with what are oval fat bodies in the urine assoc with How much protein in the urine is considered abnl how muchprotein is in the urine to be classified as 1+ 1st line txt for renal calculi 2/2 hypercalciuria glucose will spill into the urine when the serum glucose reaches what level Positive nitrite and leukocyte esterase on dip stick are indicative of what? MCC of leukocyte esterase in the urine? How many WBCs in the urine indicate infection

OCD polmyxin B sulfate legionella glomerulonephritis an allergic or infectious process such as acute interstitial nephritis or pyelonephritis respectively. acute tubular necrosis (ATN) renal tubular cells that have absorbed fats or monocytes and macrophages that have ingested fats >300 mg/24hr or a microalbumin level of >30mg/ 24hr 30 mg thiazide diuretic 180-200 mg/dL UTI UTI 4-6

If a urine cx results read >100,000 colonies what infx does it indicate MC bug to cause UTI in cathed pts pseudomonas serum sodium should be inc by no more than 1-2 meq/L/h & no more than 25-30 meq/L in 48hrs. After sxs resolve, rate of inc should be 0.5-1 meq/L/h what is a potential complication of pyelonephritis perinephric abscess how do you correct hyponatremia with neurological sxs

MC meds to cause hemolytic anemia in pts with sulfonamides and antimalarials (Bactrim) G6PD def

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