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
