Group 3



181. Anterior spinal arterial occlusion = decreased motor function, decreased sensation, decreased pinprick, preserved proprioception

182. AST = less specific for liver than ALT; increased in alcoholic liver injury

183. Ketorolac = NSAID, IV, used in testicular torsion; S.E. = gastric ulceration, GI bleeding

184. Human bite Rx = ampicillin-sulbactam OR TMP/SMX + clindamycin; if HIV involved = don't worry, it doesn't get transmitted by bite (yet!)

185. Methanol toxicity = vision changes; order: ABG, electrolytes, osmolality; Rx = IV ethanol, dyalisis

186. Amytriptiline S.E. = constipation, ac. glaucoma, urinary retention, dry mouth, paralytic ileus; but the worst event in intoxication = cardiac arrhythmias

187. Electromyography = checks nerve and muscle integrity

188. Evoked potential studies = monitor transmission of motor impulses in the anterior columns of spinal cord

189. JC virus + HIV Rx = HAART

190. JC virus causes = progressive multifocal leukoencephalopathy

191. Epididimoorchitis Rx = Doxycycline 100 mg PO bid for 10 d + ceftriaxone 250 mg IM

192. HTN + BPH Rx = terazosin, doxazosin

193. Increase in AFP = embryonal, yolk sac elements (nonseminomas)

194. Increase in HCG = seminomas and nonseminomas

195. Hydrocele = Dx with USG, no Rx required

196. Metastatic prostate ca Rx = leuprolide, goserelin OR bilateral orchiectomy

197. Priapism etiology = idiopathic (60%), leukemia, sickle cell dis, pelvic tu and infections

198. PSA > 4 next step = prostate biopsy

199. Chancroid = Haemophilus ducreyi, painful, unilateral lymphadenopathy, lesion with purulent base; Rx = ceftriaxone, azithromycin

200. Granuloma inguinale = C. granulomatis, painless, beefy-red lesion; Rx = TMP/SMX

201. Lymphogranuloma venereum = Chlamydia trachomatis, herpetiform vesicle with erosion, bilateral suppurative lymphadenopathy; Rx = doxycycline

202. Syphillis = Treponema pallidum, painless papula with clear, clean base, nontender, nonsuppurative lymphademopathy; Dx = RPR, VDRL, dark field mycroscopy; Rx = penicillin, doxycycline, erythromycin; notify health authorities

203. Hematospermia with normal PE and labs = observation and reassurance

204. Tertiary syphilis = not contagious

205. HAART indications = symptomatic HIV, CD4 < 200, pregnancy

206. CD4 < 200 = PCP prophylaxis = TMP/SMX, dapsone or atovaquone

207. CD4 < 50 = MAI prophylaxis = azithromycin weekly

208. Toxo Ig G + and CD4 < 100 = TMP/SMX OR dapsone + pyrimethamine + leucovorin

209. TB contact OR PPD > 5 mm + HIV = INH + vit B6 for 9 m.

210. HIV Dx = vaccines to be given = pneumococcal q 5 y., influenza q 1 y., hepatitis B

211. Mefloquine S.E. = bradycardia, neuropsychiatric symptoms, prolonged QT

212. NB of woman with SLE may have = congenital CHB

213. Chronic fatigue syndrome = fatigue + cognitive changes for 1 y. or more; infectious basis: virus, Chlamydia pneumoniae

214. Fibromyalgia = pain, tender points (11 of 18), sleep changes, psychological distress, allodynia, more than 3 m., realated to SLE, RA

215. Allodynia = even gentle touch is unpleasant

216. Avascular necrosis of femoral head causes = pancreatitis, alcoholism, fat embolus, sickle cell anemia, air emboli, steroids; Dx = MRI, SPECT

217. Idiopathic AVN = Legg-Calve-Perthes disease

218. AVN Rx = avoidance of activity, taper steroid

219. Pyogenic granuloma Rx = shave, electrodesiccate base, send it to pathology evaluation

220. Amelanotic melanoma = It can resemble pyogenic granuloma clinically

221. Temporomandibular joint disease = orofacial pain, noisy joint, restricted jaw function; Dx = MRI

222. Complication of hand/wrist trauma = AVN of scaphoid (navicular) bone

223. Osler-Weber-Wendu = hereditary hemorrhagic telangiectasia = epistaxis, GI bleeding, polycystic kydneys

224. Von-Hippel-Lindau dis.= cavernous hemangiomas, hemangioblastomas in CNS, retina, renal cell ca

225. Sturge Weber syndrome = facial port wine stain, seizure, ocular changes

226. Caplan syndrome = rheumatoid nodules in the lungs

227. Felty syndrome = splenomegaly + neutropenia in severe R.A.

228. Tuberous sclerosis = ash leaf macules (hypopigmented), calcified intracranial nodules, epilepsy, low inteligence, adenoma sebaceum

229. Leser-Trelat sign = multiple pruritic seborrheic keratosis associated with internal malignancy

230. Polymyalgia rheumatica = very high ESR; Rx = low dose corticoids; keep an eye open for possible temporal arteritis

231. Vitiligo Rx = topical sterois, phototherapy

232. Porphyria cutanea tarda = blistering in a sun exposed area + milia; Dx = urine prophirin level + hepatitis panel

233. Dermatitis herpetiformis = chr. pruritic papulovesicular lesions on extensor surfaces, post. hairline; Rx = dapsone

234. Pemphigus vulgaris Rx = immediate high dose corticosteroids

235. Hypertensive urgency = the goal is to decrease the diastolic BP to about 100-105 mmHg within a period of 2-6 hours

236. Avoid nitroprusside infusion for more than 48 h (it may lead to cyanide toxicity)

237. Hypert. urg. in pregnancy Rx = hydralazine, labetalol

238. In pheochromocytoma, serotonin syndrome, cocaine use = IV phentolamine

239. In aortic dissection = nitroprusside + labetalol/metoprolol

240. Joint replacement in osteoarthritis indications = refractory pain, functional limit, inability for ADLs

241. Alendronate (Fosamax) S.E. = esophageal irritation, ulceration and it has to be taken with an empty stomach, so always counsel the patient to take it in the morning and sit or stand upright for 30 minutes

242. Achantosis nigricans = DM, hypothyroidism, Cushing's, Addison's, malignancy

243. Kaposi's sarcoma = vascular tu, purplish lesions, extravasation of erythrocytes

244. MCC of alergic contact dermatitis = nickel

245. Methotrexate, azathioprine, chloroquine, etanercept, infliximab = disease modifying antirheumatic drugs

246. Lumbar stenosis = pseudoclaudication, worse with hyperextending movements, better with leaning forward, normal ankle-brachial index; Dx = MRI of the lumbar spine

247. Knee ligament injury Dx = MRI

248. PNH = GPI anchor prot defic. = hemolytic anemia + pancytopenia + venous thrombosis (e.g. hepatic)

249. PNH Dx = flow cytometry, HAM test

250. PNH labs = increased LDH, reticulocyte, decreased or negative haptoglobin, hemosiderinuria, hemoglobinuria

251. PNH Rx = iron, folic acid, transfusion, corticoids, eculizumab

252. Erythema nodosum Rx = NSAIDs

253. Back pain MRI indications = spinal stenosis, osteomyelitis, epidural abscess, post trauma

254. Down syndrome = should NOt participate in contact sports

255. Fracture on landing on feet = calcaneum, spine, acetabulum, post. hip dislocation

256. Melanoma suspicion = excisional biopsy

257. Osgood-Schlatter dis. = apophysitis of tibial tuberosity; Rx = decrease physical activity

258. Rotator cuff tear = weakness, instability; Dx = MRI; Rx = arthroscopic repair

259. Slipped capital femoral epiphysis = Dx = X-ray; Rx = fixation of epiphysis with long screws

260. Iliotibial band syndr. = pain in lat. aspect of knee


261. Axillary adenopathy in woman = mammography

262. Supraclavicular lymph node = lymph node biopsy

263. Miliaria = heat rash

264. Erythema multiforme minor = bull's-eye on palms, herpes simplex; Rx = long-term use acyclovir

265. Pustular psoriasis = sterile, post steroids, fever, malaise, arthralgia, diarrhea; Rx = cyclosporine

266. Seborrheic keratitis = "stuck=on", waxy grease scale

267. Dermatomyositis = often is paraneoplasic

268. Hypercalciuria (renal stones) Rx = hctz orally

269. Dye S.E. = ac. tubular necrosis = muddy granular casts

270. ATN = BUN/Cr < 20:1; cisplatin is one of the causes