142896503 dit high yield questions

8/16/2019 142896503 DIT High Yield Questions

http://slidepdf.com/reader/full/142896503-dit-high-yield-questions 1/13

y Stack - DIT HYQ's Table Review

//www.studystack.com/PrintTable.jsp?studyStackId=753232[11/7/11 6:55:33 AM]

DIT HYQ's

Question Answer

DIT HYQ's (Please note this material is copyrighted and

ot authorized for distribution)

Answers

gardener presents with SOB, salivation, miosis, andiarrhea. What is the cause/ MOA?

Organophosphate poisen, anticholinesterase

tropine is not effective in reversal of organophosphateoisoning. Why? What helps?

No effect on cholinesterase, use Pralidoxime

What muscarnic agonist / antagonist is used in asthma /COPD?

Ipratropium (an antagonist)

0 YO has urinary rentention due to neuroleptic, what doou treat with?

Cholinergic Agonist (problem is anti cholinergics/e's

n Dark both pupils dialate. In light one pupil is mioticwhile another, given drug X, is mydratic. What is X? Anticholinergic (atropine)

What drug is most apropriate in a pt with shock in order tomaintain renal blood flow

Dopamine (although clinically doesn't really wo

0 YO male. Has a hard time driving at night due toworsening vision and halos appearing around headlights.What is causing this?

Cataracts

gymnast sustains and anterior sholder dislocation.What nerve is injured

Axillary n.

kid falls while skateboarding and injures his elbow. He

an't feel the medial part of his palm. What nerve isnjured? What "sign"?

Ulnar N. Ulnar Claw (can't extend 4/5 digits)

highschool athlete falls on his arm. Radiograph showsmidshaft break of humerous. Which nerve / artery are at

sk?Radioal n. Deep Brachial Art.

What patients are suseptible to Listeria?Immunocompromised, Neonates, PregnantWomen

What Organisms are implicatd in subacute endocarditis? S. Veridians, Staph Epi, Enterococci. Staph Au

woman is breast feeding develops swelling and redness

ver her right breast. Exam reveals a warm, fluctuantmass. What is this? Acute Mastitis -> Staph Aur

Most common aerobic skin flora? Staph Epi

month old child is given honey for a cough and cold andecomes flaccid. What causes this? Moa?

C. Botulinum (Gm + Rod) inhibist Ach release

One hour after eating a potato salad at a picnic. Wholeamily vomits. 10hrs later they are better. Whats theause?

Staph Aureus. Preformed toxin ingested (noinfection)

Which Complement is responsible for neutrophilC5a (also leukotriene B4, IL8)





hemotaxis

Child presents with tetany from hypocalcemia andandidias due to immune suppression. What is defienent?

What Dz?Tcells, No Thymus

oung child has recurrent lung infection andranulomatous lesions. What defect in neutrophils causeshis?

Lack of NADPH oxidase

Mother brings 2 YO child w/ Hx of multiple viral, fungalnfections and his hypo calcemic. Which Germ layer givesse to the missing structure? (Endo, Ecto, Meso)

No Thymus, DiGeorge, Endoderm (from tongu

child with immune diorder w/ repeated Staph Abcesses.eutrophils do not respond to chemotactic stimuli. What

s diag?Hyper IgE aka Job Syndrome

patient Suffers recurrent Neisseria Infections. What partf complement is defective?

C5-C9, (LatE)

ow does mechanism of Type 2 Hyper sensitivity differ om Type3

Type 2

5 YO female, Malar rash and arthritis. Which Ab ispecific for the dz?

Anti dsDNA, Anti Smith. ANA is nonspecfic

fter bone marrow transplant a patient suffers dermatitis,nteritis, and hepatitis. What dz is this?

Graft vs Host Dz.

physican is looking for a risk factor for Pancreatitis. Henterviews 100 w/ and 100 w/o pancreatitis. What kind of tudy is this?

Case Control

ew glucose test arrives. You test it with a solution of 0mg of glucose. The test gives you thefollowingeadings: 54, 56, 55, 54, 53, 56, 55, 54. What is itsresions and accuracy?

High Precision low accuracy

group of ppl who smoke and do not smoke are followedver 10 years. Every two years they check who developsancer. What kind of study is this?

Cohort

certain screening test has a 1% false negative rate.What is the sensitivity?

99%

revalence of varicella in Pop A is 2x that of Pop B. It hashe same incidence in both populations. Why is therevalence different

Dz in Pop A has longer duration

Gm (-), oxidase (+), diplo cocci Niesseria2 YO medical student. Burning feeling after meals. EGDhows gm (-) rods in gastric mucosa, what are they?

H. Pylori

0 YO male smoker with new cough and flu likeymptoms. Gm stains shows nothing. Silver stains showsods. Daig?

Legienella (atypical pneumonia)

0 Yo female. Acute unilateral knee pain and bilateralells Palsy. What organism? How is it transmitted?

Lyme Dz via Burreli Burgdorferi via Tick

1 YO male. 5 day hx ofr fever chills and enlarged painful Gonorrhea -Ceftriaxone or Azithyromyocin if





nee. What oranisim? And what treatement? allergy

fter taking a course of Amoxicillin, and adult ptsevelops toxic megacolon and diarrhea. What causedhis?

C. Diff

5 YO with mycoplasma atypical pneumonia, exhibitsnemia due to cryoagglutinins. What type of Ig isesponsible for anemia?

IgM

omeless alcoholic pt vomited while intoxicated.Develops foul smelling sputum. What organism? Klebsiella or anerobe

5 YO ask husband to stay in hospital overnight b/c shes afraid of being alone. What defnese mechanism is this?

Regression

Which defense mechanism underlies all others? Repression

0 Yo man admitted for chest pain, jumps out of bed andoes 50 push ups to show he has not had a heart attack.

What is the defense mechanism?Denial

Yo girl complains of painful genitalia. On examischarge with smear showing N. gonorrhoeae. What

appened?

Sexual Abuse

2 YO patient is unable to recall 3 objects during minimental status exam. When asked what he would do if hemelled smoke he says "yell fire". When asked what aable can chair have in common he says both are madef wood. Family reports he needs consta

Dementia

2 YO brought to the clinic by family. Strange behaviorsn last week. Very agitated, naps frequently during theay, urinates on self, poor appetite. Unable to focusuring exam. Diag?

Delerium

ou are on call and receive a call from a nurse asking toive sleep medication (diphenhramine) to an elderly pt.

with dementia. What do you do?

No diphenhydramine, no Benzos, use Trazadoor Haliperidol

patient tries to commit suicide by cutting wrists. After eening cared for in the ER what question would you asko determine her level of commitment?

What did she do after cutting her wrists? Callsomeone? Lie in a bathtub?

8 Yo female with mild depression for 6 yrs. What diag? Dysthamia

months after losing her spouse a 42 YO female isaving trouble eating, concentrating, and sleeping/ What

o you do?

This is still with in normal. But you can tx theinsomnia and help with trazadone or somethin

elsepatient on whom you want an MRI tells you they areaustophobic. What can you do?

Give two Benzos for during tx.

young woman is anxious about her 1st pap smear ands told to realx and to imagine what the steps are. What ishe process and example of?

Systamatic Desensitization

woman has flashbacks about her boy friends death onemonnth ago in a hit and run accident. She often cries andwishes for justice. Diag?

Normal Greif





urse has hypoglycemia with no elevation of C-protein.Diag?

Malingering or Facistious depenidng on 2nd ga

0 YO female tells you she is in love with you. You refer er (which you should never do during USMLE) and shettempts suicide. What is this personality disorder?

Splitting (Borderline )

0 Yo woman tells you that you are the best doctor andhe nurses are very bad. On subsequent visit shehreatens to change doctors because you do not feel a

pecific lab test is justified. You also notice severalscartches" on her left arm. What persona

Splitting (Borderline )

5 YO female wearing all black with a black feather boand excess lipstick. What type of personality disorder?

Histrionic

pt. demands only the best most famous doctor in town.What personality disorder?

Narcissistic

patient returns from a trip to New Mexico, now hasneumonitis. What is fungal cause?

Coccidioidomycocces

30 Yo female has "cauliflower" skin lesion. Tissue

iopsy shows broad based budding yeast. What is thisrganism?

Blastomycoisis

n HIV (+) pt with CSF showing 75/mm3 lymphocytesuddenly dies. Yeast is identified in the CSF. What is theiag?

Cryptococcus

pt presents with a "rose garden scenario" (thorn prickwith ulcers along lymphatic drainage). What is infection?

Sporothrix

Pt who visted Mexico presents with Bloody Diarrhea.What infection could be found in the stool?

Cryptosporidium (usually filtered from city watesupply....) more severe in AIDS

2 YO male went camping in N. California 2 wks ago. Ptad a 2 day stint of diarrhea and how has liver damagend Jaundice. What is diag?

Entamoeba Histolytica (not Giardia b/c Jaundicpresent)

t returns after 2 wk vacation in Africa. Typical malariaresentation and recurrent fever. what is the mechanismor the cyclic?

Malaria cycle in RBS's causing lysis every 48-hrs

Which Fetal Vessel has the highest 02 concentration? Umbilical Vein (1 verin, 2 arteries)

5 YO male with BP 160/90 on right arm and 170/92 onhe left arm. No pulse in feet or ankle. What is diag?

Coarctation of the Aorta (adult type)

Describe blood flow through a PDA? Just for fun whateeps it open, what closes it?

Left to right shunt. (during pregnancy not calle

"patent" so incorrect to say R-> L then becomeL-> R). Hear a continuous machine murmer. O

Monozygotic twins are delivered. One is pale and has aematocrit of 15% the other is flushed with hct of 55%.

What caused this? who will do better?

This is twin transfusion, mostly like due tomonochorionic, mono amniotic pregnancy. Twwith lower hct will do better due to "sludging" inthe one with high hct.

child presents with Cleft lip. What process failed?

Fusion of the maxillry process with the MedialNasal Process. Cleft lip is mostly a aestheticdefect were cleft pallate has functional defiect well





3 YO male presents with one testicle. what is he at riskor?

Germ Cell tumor of teste

4 YO male develops testicular cancer. Mets spreadwhere?

via Inguinal canal to para-aortic LN's

6 Yo female with amenorhea. Pt lacks uterus andterine tubes. Has two round structures in midline justuperior to labia majora. What is diag?

Androgen Insensitive (46XY)

While on an ACE-i a pts develops a cough. Why? what isreplacement? No Ang II

%0 yo male on lipid lower meds. Develops rash, puritisnd diarrhea. What drug? Is this a allergic rxn? what

mediates this response?

Niacin, not allergic due to prostaglandins (takeasprin b4 hand to decrease) also dec with longterm therapy

What is mechanism of action of Cardiac GlycosidesDigoxin)?

Blocks the Na/K atpase pump. Na leaves cell vNa/Ca counter transporter and increasesintracellular Ca lvls

n abdominal Aortic aneurysm is most likley due to? Atheroscerois

pt with poorly controlled HTN has actue sharp

ubsternal pain raidiating to the back. Death occurs withinfew hours. Diag?

Disecting Aorta

During a high school football game a young althleteollapses and dies immediately. What Dz?

Hypertrophic cardiomyopathy

What murmers are heard best in the Left LateralDecubitous Position?

Mitral Stenosis/ Regurg. And Left sided S3 / S4

0 yo male. systolic cresendo decresendo murmur. Diag? Aortic Stenosis (probabley due to calcified aort

V drug user presents with Chest pain, dyspnea,achycardia, tachypnea. Diag?

Bacterial Endocardidits -> PE (remeber drugusers get it on the right)

t brought to ER after MVA presents with Chest pain,yspnea, tachycardia, tachypnea. Diag?

Tension Pneumothorax most likely, could beCArdiac Tamponade too

ost-op pt presents with Chest pain, dyspnea,achycardia, tachypnea. Diag?

PE

young girl with a congeital valve dz is given penicillinrophylactically. In the ER bacterial endocarditis is diag.

What is next?

IV Vancomyocin and possible echo to checkvalves (might need replacement)

n adult pt with hx of HTN presents with sudden sharp,earing pain, radiating to his back. What do you see on

CXR?Widening of the mediastinum (Disecting Aorta)

On auscultation of a patient you hear a pansystolicmurmur at the apex with radiation to the axilla. Cause?

Mitral Regurg (Aortic Stenosis is not PANsysto

25 yo pregnant woman in her 3rd trimester has normalP when standing and sitting but drops to 90/50 whenhe lies supine. Diag?

Compression of IVC, dont lie on your back.

5 YO male with squamous cell carcinoma of the penis.e had exposure to what Virus?

HPV - 16 / 18

0 yo college student presents with LAD, fever, andepatosplenmegaly. His serum agglutinates sheep

B Cells - EBV mononucleosis (+) monospot.





RBC's. What cell is infected?Cause of (-) monospot mononucleosis? CMV

ow does rabies travel through the CNS to cause fatalncephalitis and seizures?

Retrograde along neurons

What is the characteristic shape of rabies? Bullet Shaped

n adolescent presents with cough and rust coloredputum. What does gm stain show?

Strep. Pneumo -> Gm (+) diplococci

IV (+) pt with a CD4 count of 250 presents with signs of meningitis. CSF shows a heavily encapsulated organism.What is it?

Cryptococcus Neoformans

n older patient has blood in his urine and renal stones.What organism?

Proteus

50 yo pt is recovering from Abd surgery from 2 daysgo. He has had an internal catheter in place since then.e now has a fever of 100F. Most likely org?

EColi (UTI)

emidesmisomes, cadherin, integrin, ICAM-1. Whichoins only cells of teh same type and does not attach to

he basement membrane?

Cadherin

Where does new bone formation take place in growingong bones?

Epipseal Plate

football player was kick in the legs and suffered aamaged medial meniscus. What else is likely to haveeen damaged?

ACL, MCL

man presents with pain and swelling of the knees,ubcutaneous nodules around the joints and achillesendon, equisite pain in the metatarsophalangeal joint of is right big toe. Biopsy reveals needle like crystals.

DIag?

Most likely Gout

reatment of Acute Gout exacerbation? NSAID, Colchicine

patient has difficulty swallowing, distal cyanosis in coldemp, anti-centromere antibodies. What other S/S will youee?

CREST: Calcinosis, Sclerodactyly, Telangiecta

patient presents with photosensitivity, arthritis, renalisease and recurrent oral ulcers. She is takingrimaquine and NSAIDS. What should be checked 2/yr?

Renal Fxn (SLE)

0 yo woman presents with low grade fever, rash acrosser nose and gets worse in the sun and widespreaddema. What blood test would you use to screen?

ANA - SLE

CT scan of the chest shows bilateral hilar LAD. Diag? Sarcoidosis

75 yo male presents with acute knee pain and swelling.ray reveals erosion of the joint space and calcium

eposits in the menisci. What is Diag? What would beound on FNA of joint?

PsuedoGout -> Calcium pyrophosphate

50 YO female complains of double vision, amenorrheand headaches. What is likely diagnosis?

Prolactinoma

patients MRI shows replacment of tissue in the sella Most likley asymptomatic or defieciency in





ursica with CSF. What is presentation? Pituitary Hormones

What hormones come from the anterior pituitary? FSH, LH, ACTH, GH, prolactin, TSH

Which hormones share a common alpha unit? FSH, TSH, LH, bHCG

young woman is found to have short stature andhortened 4th and 5th metacarpals. What endocrineisorder is this?

Albrights osteodystrophy(Pseudohypoparathydroiism) aka body notresponsive to PTH

5 yo female presents with diffuse goiter and

yperthyroidism. What is TSH / T3/t4?Low TSH High T3,T4

8 yo female presents with progressive lethargy, andxtreme cold sensitivity. What is Diag? Lab values?

Hypothyroid / Hasimotos most likely (High TSHlow T3/4)

nd adult male with elevated serum cortisol and signs of ushing syndrome undergoes dexamethasoneuppresion. 1mg does not decrease cortisol, 8mg does.

What is diag?

ACTH secreting pituitary adenoma

very tan child with pale mother comes in and is found toe hypotensive. Diag?

Addisons

8 yo male with normal well managed IDDM comes inwith DKA hae had recently been taking OTC coldmedicine. What caused his DKA?

Infection

ow is hemoglobin glycosylated in DM to make HA1c? Non enzymatically (slowlly do to glucose build

What are the sources of Carbon for Purine formation? For yrimidine?

Co2, Glycine, tetrahydrofolate / CO2 andaspartate

ow does UV light damage DNA? Causes Thymine Dimers to form

What ammino acid frequently has more codingequences in mRNAt the represented in the peptide?

AUG - methione

What happens to hnRNA before it leaves the nucleus? Spliced (remove introns), Poly A tail, and 5' Ca

wo pts have the same mutation on chromosome 15. buthey have different phenotypic expressions. One has a

mutation from the father the other from the mother. Whats this an example of?

Genetic Imprinting

requency of CFTR mutation X in pts with cystic fibrosiss 0.1. CF is (in this scenario) caused by either mutation Xr Y. What percent of pts are homozygotes for y?

P^2+2PQ+Q^2

n obese woman presents with amenorrhea andncreased serum testosterone. Diag?

Polycystic Ovarian Syndrome (stein-leventhau

What type of cancer are patients with polycystic ovarianz are risk for?

endometrial

Why is progesterone used in combo with estrogen inormone replacement therapy?

To protect Uterus / endometrium from unregulahyperplasia / cancer

What circustance would cause an elevated LH?Polycystic Ovarian Syndrome (stein-leventhauphysiological LH surge, low estrogen lvls, turn

pregnant woman with previous C section is atncreased risk for what pregnancy complications?

Placenta Accreta, Previa

pregnant women at 16 weeks gestation presents withHydatifrom Mole, increased beta HCG





arge abd and HTN. Diag? Lab values?

What substance is elevated in hydatifrom molesbeta HCG (Really high in complete, slightlyelevated in partial)

5 yo pt who normally comes in with her parents presentslone. She states she is sexually active but knows she isot pregnant because she has never menstrated. Whathould you tell her?

Check for delayed puberty, talk about how youcan get pregant on your first time even before menstrated, STDs and maybe contraceptives

3 yo female is on rifampin for TB and OCP. She getsregnant. Why? Rifampin increase Cyp450 metabolism of OCPdecreasing their effectiveness

What is the best option of birth control of mental retartedts?

Medroxyprogesterone (injection q3 months) (awhat do you do if you find a mentally retard pt iroom with a bat?)

58 yo post menopausal women is on Tamoxifen. Whats she at risk of aquiring?

Endometrial Carcinoma

What cells are responsible for maintaing a highestosterone concentration in the seminiferous tubules?

Leydig Secrete, Sertoli - release ABG holdtestosterone in place

55 yo man undergoing tx for BPH has increased

estosterone and decreased DHT as well asynecomastia and edema. What medication is he on?

Finasteride - 5 alpha reductase inhibitor

Where does testicular cancer first metastasize? Para Aorotic Lymph Nodes

What protein is involved in transporting an endocytosedesicle from the plasma membrane to the endosome?

Clatherin

What molecule targes proteins in the endoplasmiceticulum for lysosomes?

mannose 6 phosphate

patient with a corticol lesion is unaware of hi neurologiceficiency. Where is the lesion?

Located on his non Dominate parietal Lobe(usually right)

What are the findings of Brown Sequard Syndrome?

Ipsilateral UMN lesion below the lesion | Ipsilatloss of tactile, vibration and proprioception belolesion | Contralateral pain and temp loss belowlesion | ipsilateral all sension for a few levelsabove lesion | LMN at level of lesion

man in his 40s begins to develop early dementia andncontrolable movements of his upper extremities. where

n the brain do you expect to see atrophy?Caudate -> Huntingtons

Male presents with involuntary flailing of one arm.Where is the lesion?

This is hemibalismus. Contral lateral thalamus

8 yo chemist presents with MPTP exposure. Whateurotransmitter is depleted?

Dopamine

patient cannot abduct her left yere on lateral gaze butonvergence is normal. She also has difficulty smiling.

Where in the CNS is the lesion?

CN IV (MLF tract) + CN VII. Both are at level oPontine

8 yo woman in a MVA. Initally feels fine then losesonsiousness. CT shows intracranial hemorrhage thatoes not cross suture lines. What bone and vessel whereamaged?

MMA, and temporal bone





5 yo man with alzheimers falls at home and presents 3ays later with severe headache and vomiting. What ishe diag? What is dmg?

Subdural hematomaBridging veins

woman involved in a accident cannot turn her head to theeft and has a right sholder droop. What is dmged?

CN XI - accessory

19 yo pt presents with a furuncle on his philtrum and theavernous sinous becomes infected. What might youee?

defects in CN 3, 4, 6

pt has a leftward deviation of the tongue on protusionnd has a right sided spastic paralysis. Where is the

esion?

Left Medulla + corticospinal tract (happens befthe tract decusates)

pt can not blink his right eye or seal his lips. What is theiag and which nerve?

CN7 due to bells palsy

t falls off a motorcycle and lands on his right shoulder.E shoulder has abnormal configuration. X Ray showsnterior dislocation. What artery and nerve are likleymg?

Axillary Nerve, Posterior circumflex artery

pt fractures there humerous mid shaft. What nerve andrtery are dmged?

Radial nerve and Deep Brachial artery

pt presents with decreased pain and temperatureensation over the lateral aspects of both arms. Where iseh lesino?

Syringomylenia (congential defect, enlargedcentral canal in SC)

xam shows decreased pin prick sensation over theateral aspect of foot and leg. What muscular defect islso present?

Dec Dorsal Flexion and Toe Flexion, Foot Dro

pt falls while rollerblading hurts his elbow. He cant feelhe medail part of his palm. What nerve is dmg?

Ulnar N via medial epicondyle

n elderly womand complains of pain, numbness and angling sensation over the lateral digits of her right hand.xam shows thenar wasting. What nerve is dmg?

Median, Carpal Tunnel

0 yo dancer reports decreased planter flexion andecreased sensation over the back of her thigh, calf and

ateral foot. What Spinal nerve?Tibial N.

pt fractures her fibula neck. What nerve is dmg Deep perioneal

MS + internuclear opthalmoplegia. What is thebnormality?

Can't abduct eye on lateral gaze but can conve

pt can not look laterally but can converge. What ismged?

Medial longituidinal Fasiculous

ight stimulus in the pts right eye produces bilateralonstriction. When the light is shown in the left eye there

s paradoxical bilateral pupilllary dilation. Defect?

Damage in afferent of affect eye (ishchemia ofCN3)

Woman with headache, visual disturbance, amenorrhea. Pit Adenoma

3 yo man with dizziness and tinnitus. CT showsnlarged internal acoustic meatus

Schwannoma

child exhibits proximal muscle weakness and enlargedDuschanes Muscular Dystrophy





alfs

5 yo female with sudden uniocular vision loss andurred speech. Hx of weakness and paresthesia that

esolved.MS (relapsing remitting)

0 yo child spaces out in class and then continues as if othing has happened

Abssence Sezuire

t has vertigo, tinnitus and hearing loss Schwannoma

What is primary energy soucre in pt that has not eaten for wo days?

fatty acids

what is the equation for gibbs free energy? Delta G

rrange the following in decreasing level of exergonicnergy. AMP, ATP, phosphoenol pyruvate

PEP>ATP>AMP

tressed physician comes home from work, consumes 7o 8 shots of tequila in rapid succession, then becomesypoglycemic. What is mechanism?

Increase in NADH/NAD ratio

woman commenly develops intense muscle crampsnd darkening of her urine after exercise. Diag?

McArdels Dz

What histological changes occur in a smoker? (in theachea?

Columnar epithelium -> squamous

pt in the ER is having anaphylaxis. Incision belowhyroid cartilage. What are you cutting through?

Criciothyroid

young woman has infertility, recurrent URI andextrocardia. What is defective?

Cilia, Dyien Arm

t has the following Lung volumes. FRC 5, IRV

2 yo female with fibroids is chronically tired. what is

iag? what changes to O2 content and saturation?

Chronic Dz / microcytic anemia. No change in sat (normal lungs) no change in Concent. Only

change in amount of hemoglobin being in bloo

t has hypoxia and a CXR reveals and enlarged heart.What is likley cause of hypoxia

Pulmonary HTN -> poor lung perfusion

pt suffers a stroke after incurring multiple long boneactures in a skiing accident. What caused the infract?

Fat Embolism + VSD or ASD

pt with a recent tibial fracture and no hx of COPD or sthma presents with hypoxia. CXR is normal. What isause

PE

pt with asthma attack. What is the immune rxn

ccuring?

Bronchoconstriction via Mast cell and IgE

histamine releasept has an extended expiratory phase. What type of dz? Obstructive lung dz

&E of lung biopsy from a plumber shows elongatedtructures with clubbed ends. Diag? Risk?

Asbestos -> Mesothelium + Bronchogeniccarcinoma

preterm infant has difficulty breathing. X ray revealsiffuse ground glass. Diag? What could have preventedhis?

Neonatal ARDS -> steroids giving to mother pto birth

t develops ARDS from occupational inhalation of NO.What histological change is seen?

Hylanien membrane, increase in type 2pneomocytes (repair / replace dmg type 1 )





all teenage male, abrupt onset dyspnea and left sidedhest pain. perccussion on the affected side revealsyperresonance and deminished breath sounds. Diag?

Phemothorax

CXR shows plueral effusions. What are PE findings?Dull resonance, dec. Breath sounds, dec.Fremitus

CXR shows collapsed middle lobe of right lung and massn right bronchus. pt has hx or recurrent pneumonias.iag?

Lung cancer - bronchogenic

t developds brochogenic lung cancer but has never moked. He is a coal miner. What but him at increasedsk?

Not coal, Radon (heavy element)

xam on lung autopsy reveals peropheral lesion withaseous necrosis. Diag?

TB

0 yo comatose man on ventilator support in ICUevelops and infection and dies. Autopsy shows pus filledavity in right lung. Etiology?

Psuedomonis

5 yo who is smoker and heavy drinker. Presents wtih

ew cough and flu like symptoms. Gm stain shows norganisms, Silver stain shows gm (-) rods. Diag?

Legionella

What deficiency causes familial hypercolesterolemia? Defect or lack of LDL receptor

t with PKU should have a diet low in phenylalanine.What other dietary modifications should a pt make?

Increase tyramine, replace THF and biotin

ull term neonate becomes mentally retarded andyperactice, has a musty odor. Diag?

PKU

yo girl has an increase in abd girth, failure to thrive, andkin/hair depigmentation. Diag?

Kwashiorkowr

middle aged man has dark spots on sclera and has notedrine turns black on standing. Diag? Alkaptouria

x for a pts genetic dz includes protein restriction torevent mental retardation, ketoacidosis, and death.

Diag?Maple Syrup Urine dz

8 yo female has moderate generalized abd pain, normalWBC and no fever. Paresthesias in her lower extremities.Diag?

Acute intermittent porphoria

5 yo male alcholic gets blisters lesions in sun exposedreas especially the dorsum of the hands. also has hyper

chosis of the face. Diag?

Porphia Cutania

x for homocystineuria Decrease methione, increase cystine and B6/B

t taking NSAID for management of her gout, developsnemia, pain on eating and (+) ocult blood. What drugs iest at treating the cause?

Misopristol

ew born is having trouble feeding. vomits milk when fednd has gastric air pubble. What is diag?

TE Fistula

60 yo man with chronic reflux presents with esogealancer. What type?

Adenocarcinoma





fter loss of job a 35 you man has diarrhea andematochezia. Intestinal biopsy shows transmural

nflammation. Diag?Crohns.

Weightlifter undergoes emergency surgery for a lifehreatening condintion. Exam of small bowel reveals focalemorrhages. What is responsible

Ibguinal hernia -> bowel incaruration

40 yo woman presents with having to defecate 4x per ay for several months and a low grade abd pain.

olonoscopy is normal. Diag?

IBS

0 YO man complains of diarrhea on exam his face islethoric and a heart murmur is detected. Diag?

Carcinoid tumor

oung man presents with ataxia and tremor. brownigmentation in a ring around the periphery of cornea.x?

Wilsons dz -> plasmaphoresis

0 yo woman comes to your clinic b/c her family isoncerned about her yellowing skin. Yellowing skin of alms and soles but no scleral icterus. Cause?

No Jaundice

0 yo man contracts influenza then presents with andiopathic hyperpilrubinemia. Cause?

Gilberts dz (infection caused flair)

what is fate of bilirubin after it is conjugated andecreated into GI tract?

Urobiliogen

t complains of pain in URQ that is localized to onenger. Area is tender touch and pains is worse when ptsaises arms. Diag?

Viserceral pain is usually diffuse (not locallizedthis is musculoskeletal, rectus abd tear

ow does acidosis/alkalosis affect K+ lvls Acid

t is on cyclosporin post renal transplant and developsnd fungal infection. what antifungal would causedroblmes?

ketaconazole (p450)

t presents with renal insuffiency. What changes doigoxin and digitoxin?

Decrease digoxin, no change to digitoxin

what effect does a renal stone ->hydronephros have onGFR / FF?

Decreases both

What is maximal serum glucose conc that can bebsorbed in renal?

Spill into urine at 200g/dl, max at 350

what change in metabolic panel would you see in a youngt being treated for status asthmaticus

Beta agonist

Causes of Acidosis with anion GapMUDPILES: Methanol, uremia, DKA,Paraldehyde/Phenformin, Iron tablets / INH, La

Acidosis, Ethylene glycol, Salicylates

t is taking lisinopril complains of new onset constantoughing. Medication alter?

ARB

t with CHF needs diauresis but is sulfa allergic. Whatrug>

Ethacrynic Acid

t presents with HTN, hypoK, metabolic alkosis and lowlasma renin. Diag?

Conn Syndrome




Glomerular histology shows multiple mesangial nodules.What dz?

DM - kimmel wilson lesion

eenager with nephrotic syndrome and hearing loss. Dz? Alports

yo boy with facial edema and proteinuria. Diag? Minimal Change Dz

IT caused by proteus vulgaaris. What kidney problem?Renal Stone (Phosphate, magneuisum,ammonium)

t with hx of acetaminophen use. Risk for? Papillary necrosis

What prevents a horseshoe kidney from ascending in thebd

IMA

What electrolytes changes seen in kidney failure? Inc in K, PO4, BUN, Cr, dec in Ca

CT shows massive bilateral enlarged kidneys. Diag? ADPCKD

child has been anemic since birth. Cured withplenectomy. Dz?

Hereditary spherocytosis

t diag with macrocytic megaloblastic anemia. Danger of olate?

W/o co adminsitering B12 could hide concurrinB12 defiency

t with anemia, hyper Ca and bone pain receives bone

marrow biopsy. Shows large plasma cells. Diag? foundn urinalysis?

Multiple Myeloma. Bence Jones Protines

eart failure pt is newly diag with cancer and is beingvaluated for chemo. What should be avoided?

Doxrubucin

hromosomal analysis of a leukemia pt reveals PHLhromasome (9:22) Tx?

CML tx with imatinib

fter a normal spontaneous vaginal delivery, new momleeds profusely. Lab abnormalities?

DIC -> DDimer and Inc and PT/PTT

1 yo child presents with a chronic non healing ulcer on

is foot. img shows small calcified spleen. Diag / Drug?

Sickle cell (autosplenectomy) use hydroxyurea

SAIDs inhibit what that leads to platetlet aggregation? Thromboxane A2

Does fetal hgb have more or less affinity for 23 BPG? Less affiinty for 2,3BPG

142896503 dit high yield questions

Documents