Important Associations

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1. Streptococcus May causes infective endocarditis 8. Fibrillin 2 gene

Gallolyticus A/w Colorectal Cancer; need
colonscopy
2. Young female with SLE
sunburns despite
use of sunscreen;
joint pain, +/- oral
ulcers, proteinuria
3. Gastric bypass Gallstone Disease; 40% risk of
followed by developing symptomatic gallstone Congenital Contractural
abdominal pain after disease after gastric bypass 2/2 Arachnodactyly; tall stature,
weight loss increased concentration of bile arachnodactyly, large joint contractures
Rx: 6 months of ursodeoxycholic acid 9. Eosin-5-maleimide Gold standard for diagnosing
if asymptomatic b4 bypass; Binding test w/ Hereditary Spherocytosis
cholecystectomy if symptomatic Acidified Glycerol
before bypass Lysis Test
4. Thin, shiny, hairless 10. CD55, CD59 Erthrocyte proteins tested for in
skin on extremities Protein Testing Paroxysmal Nocturnal Hematuria; Use in
patients with hemolytic anemia,
cytopenias, hypercoagulability
11. Absent lymph SCID
nodes, absent
tonsils, absent
thymic shadow.
lymphopenia
12. Baby with
midfacial
hypoplasia, excess
hair, cleft lip, cleft
peripheral vascular disease, (rubor will palate,
resolve with elevation of extremity, no microcephaly.
calor) digital hypoplasia,
Fetal Hydantoin Syndrome 2/2
5. Costochondral joint RIcketts, also a/w genu rib anomalies, nail
anticonvulsant use during pregnancy
enlargement varum,enlarged anterior fontanelles, hypoplasia
long bone joint enlargement (wrist) 13. positively
6. Exclusive Ricketts, infants need either fortified birefringent
breastfeeding, formula/food or 400 IU daily as rhomboid crystals
homemade baby supplement on joint aspiration
food
7. Fibrillin 1 gene Marfan Syndrome

Pseudogout
14. calcium 23. GI issue associated GI angiodysplasia causing a GI
pyrophosphate with Severe Aortic bleed
(phosphate Stenosis
dihydrate) crystals
24. Endomysial and Tissue Celiac Disease
in synovial fluid
Transglutaminase IgA
antibodies
25. Causes of paralytic abdominal surgery, retroperitoneal
(adynamic) ileus bleed 2/2 vertebral fracture
pseudogout 26. Lenticular Nucleus Wilson's Disease
Atrophy
15. negatively
birefringent, 27. Infarction of the medial severe vertigo and nystagmus
needle-shaped cerebellar vermis
crystals in 28. Lateral cerebellar dizziness, ataxia, weakness,
synovial fluid infarct tendency to sway toward infected
side
29. Centor Criteria Fever (by hx), Tender anterior
cervical lymphadenopathy, Tonsilar
exudates, no cough
Gout
30. Treatment for strep Amoxicllin or Penicillin (Oral); use
16. Monosodium
throat macrolide in PCN allergic children
Urate crystals
31. Treatment for invasive Voriconazole or caspofungin
aspergillosis
32. Testicular tumor with Leydig Cell Tumor
decreased LH and FSH
33. Testicular tumor in Leydig Cell Tumor
adult with
gynecomastia

gout 34. Testicular tumor is a Leydig Cell Tumor

child with precocious
17. Lung cancer with Hypercalcemia 2/2 PTHrP secreting
puberty
constipation, Squamous Cell Carcinoma of the lung
increased thirst, 35. Testicular tumor with Yolk Sac (Endodermal Sinus)
easy fatiguability elevated AFP Tumor or Teratoma

18. Hypercalcemia in Squamous Cell Carcinoma (sCA++mous 36. Testicular tumor with Choriocarcinoma or teratoma or
lung cancer cell) or metastasis to bone elevated beta-hCG seminoma

19. Lung cancer with Small Cell Lung Cancer

salt retention,
hypokalemia,
elevated ACTH
20. Lung cancer with Small Cell Lung Canccer
SIADH
21. Ulcerated, pearly Basal Cell Carcinoma; most common
skin nodule with a skin cancer in the US
rolled border
found in a skin-
exposed area
22. Rapidly growing, Squamous Cell Carcinoma of the Skin;
hyperkeratotic precursor commonly actinic keratosis
skin lesion, arising
from a precursor
37. Signs of 43. Ataxic Hemiparesis Lacunar syndrome caused
Rheumatic infarction of the anterior limb
Fever of the internal capsule
resulting in weakness that is
more pronounced in the
lower extremity and
ipsilateral incoordination of
arm and leg
44. Dysarthria Clumsy Hand lacunar syndrome due to
Follows group A strep pharyngitis Syndrome stroke at the basis pontis;
characterized by hand
JONES: weakness and minor motor
Joints (migratory arthritis) aphasia with NO sensory
<3 (carditis) abnormalities
Nodules (subcutaneous)
Erythema Marginatum - pink rings on the trunk 45. Pregnant woman with HELLP Syndrome
and inner limbs preeclampsia (HTN + Hemolysis (microangiopathic
Syndenham Chorea proteinuria) who develops hemolytic anemia)
RUQ abd pain, low hgb, Elevated
also: fever, arthralgias, elevated ESR/CRP, elevated t. bili, schistocytes Liver enzymes
prolonged PR interval on smear, elevated AST and Low
ALT, and thrombocytopenia Platelets
Late Sequelae: Mitral regurg or stenosis, 50% develop DIC
aschoff bodies in heart 46. Woman in third trimester of Acute Fatty Liver of
pregnancy with Pregnancy
Prevention: Treat GAS pharyngitis with PCN encephalopathy,
38. Anorexia CBT, Nutritonal rehabilitation, OLANZAPINE if hypoglycemia, elevated PT
Nervosa other measures fail and PTT, elevated WBC, low
Treatement platelets, elevated
creatinine
39. Bulimia CBT, nutritional rehabilitation, SSRIs
Nervosa 47. Pregnant woman with Intrahepatic Cholestasis of
Treatment generalized pruritis, pregnancy
hyperbilirubinemia,
40. Psoas Abdominal pain, fever, leukocytosis, NO transaminitis, elevated
Abscess rebound tendernses, deep palpation is serum bile
required to elicit tenderness; may spread
hematogenously or from bone 48. HELLP Syndrome Treatment prompt delivery at 34 weeks,
Mg Sulfate, control HTN
CT is required to confirm the diagnosis; usually 49. Treatment of intrahepatic Ursodeoxycholic acid,
S. Aureus cholestasis of pregnancy delivery at 37-38 weeks or
41. Pure Motor Lacunar syndrome caused by infarct to the early in severe cases esp with
Hemiparesis posterior limb of the internal capsule; results history of fetal demise
in unilateral motor deficit in face, upper limb, 50. Treatment of acute fatty Prompt delivery
maybe leg with mild dysarthria and no liver of pregnancy
cognitive impairment; lacunar infarcts are
51. Tamoxifen effect on cancer increased risk for
caused by chronic HTN resulting in
risk endometrial cancer and
lipohylanitic thickening of small vessels
uterine cancer; also increases
42. Pure Lacunar syndrome due to stroke in VPL risk of venous thrombosis
Sensory nucleus of the thalamus causing unilateral
52. Treatment for HBV infection Interferon (short term)
Hemiparesis numbness, parasthesias, and hemisensory
in compensated younger
deficit in the face, arm, trunk, and leg
patient
53. Treatment for HBV infection Tenofovir or Entecavir
in a decompensated patient
54. Treatment for HCV
55. When to treat HBV infection?
56. Correction of Severe
Hyponatremia
57. Lymphocytosis and smudge
cells on peripheral smear
58. Thiazide Diuretic Side Effects
59. Liver biopsy in CHF
60. Lever biopsy in NASH or
alcoholic hepatitis
61. alpha 1 antitrypsin liver biopsy
62. biliary atresia liver biopsy
63. Reye syndrome liver biopsy
64. Tachycardia, hypertension,
high fever, tremor, lid lag,
altered mental status +/- N/V,
diarrhea, anxiety, arrhythmia
(a. fib) following an acute
illness, surgery, trauma,
childbirth, or use of iodine
contrast
65. Thyroid Storm Treatment
Pegylated Interferon +
Ribavirin, telapravir in
genotype 1
Acute Liver Failure, Clinical
complications of cirrhosis,
+HbeAg, HBV > 20000, ALT
>2x ULN, to prevent
reactivation during chemo
or immunocompromise
With 3% NaCl solution at
0.5mEq/L/hr
Likely Chronic Lymphocytic
Leukemia; Dx with flow
cytometry to show
clonality; usually seen in
older people (70 median
age); typically detected
incidentally; at risk for
recurrent infecitons
Hyperglycemia/reduced
glucose tolerance, elevated
LDL, elevated TGs,
hypercalcemia,
hyponatremia,
hypokalemia, elevated uric
acid and increased risk of
gout
sinusoidal congestion,
hepatic necrosis
macrovesicular fatty
changes
cirrhosis, periportal
eosinophilic inclusion
bodies
bile plugs in bile and
canalicular ducts, portal
tract edema, fibrosis; will
be accompanied by
hyperbilirubinemia
microvesicular steatosis
Thyroid Storm
Beta blocker, PTU,
Glucocorticoids, Find and
treat trigger, supportive
care
66. Adrenal Crisis/Acute Adrenal Dexamethasone or
Insufficiency treatment Hydrocortisone, high-
flow IVF, monitor
electrolytes
67. Hypotension, shock, N/V, abd pain, Acute Adrenal
weakness, fever, AKI in the setting Insufficiency/ Adrenal
of adrenal hemorrhage/infarction or Crisis
acute illness/injury/surgery in a
patient with chronic adenral
insuffiency, CAH, or CHRONIC
GLUCOCORTICOID use
68. Classic Triad in Pheochromocytoma episodic HTN plus
episodic headache,
diaphoresis,
tachycardia
69. hypercarbia, sinus tachycardia, Malignant
muscle rigidity, elevated creatine Hyperthermia; Rx:
kinase, hyperkalemia, and Dantrolene
hyperthermia is a post-op patient
70. Older patient +/- bilateral hearing Paget's Disease of
loss, skull enlargement, dizziness, Bone
bone pain, spinal stenosis, nerve
compression, bowing deformities,
giant cell tumors, osteosarcomes;
ALL LABS NORMAL EXCEPT ALK
PHOS; Rads shows osteolytic or
mixed lytic/sclerotic lesions, dense,
expanded bones
71. Causes of Acute Otitis Media Streptococcus
Pneumoniae,
Hameophilus
influenzae, moraxella
catarrhalis
72. acute otitis media treatment amoxicillin; 2nd line
or if AOM returns
within 1 month:
amoxicillin-
clauvulanate
73. Risk factors for acute otitis media age 6-36 months
(short eustachian
tubes), formula intake,
cigarette smoke
exposure, allergic
rhinitis, viral URI,
craniofacial
abnormalities, chronic
middle ear effusion,
day care attendance
74. When to perform myringotomy with 3 or more episodes
tympanostomy tube placement? of AOM in 6 months
or 4 or more in 1 year
despite appropriate
antibiotic treatment
75. Malignancy Squamous Cell Carcinoma 86. MEN2B Medullary thyroid carcinoma,
arising from pheochromocytoma, mucosal & intestinal
scarred, neuromas, Marfanoid habitus
chronically
87. Most frequent Pulmonary veins
wounded, or
location of
inflamed skin
ectopic foci that
76. Early Normal; symmetric with uterine contraction, cause A fib
Decelerations gradual with nadir more than 30 seconds
88. Colonic polyps sessile villous adenoma >2.5 cm
from onset of decel, peak of contraction
most likely to
and nadir or decel line up. Sign of fetal
become
head compression
malignant
77. Late Gradual decels with nadir more than 30
89. Renal Frequently seen in Tuberous Sclerosis
Decelerations seconds from onset of decel, nadir is
Angiomyolipoma
delayed in reference to peak of
contraction; Caused by uteroplacental 90. Anti-TSH Graves Disease
insufficiency receptor
antibodies
78. Intermittent Rapid decels of 15 bpm or more that last
Variable more than 15 seconds but less than 2 min 91. Anti-thyroid Hashimoto's Thyroiditis
Decelerations and occur independently of uterine peroxidase
contractions; sign of cord compression, antibodies
oligohydramnios, cord prolapse; monitor 92. Thyroid in beta-hCG stimulates TSH receptors,
closely Pregnancy leading to elevated thyroid hormone
79. Recurrent Variable decels that occur in association levels and elevated thyroid globulin. TSH
Variable with greater than 50% of contractions and is suppressed if hyperthyroidism
Decelerations become progressively longer and deeper; 93. Sign's of
treat with O2 and maternal repositioning; Infective
consider amnioinfusion if ineffective Endocarditis
80. Increased Fragile X syndrome: large head, long face,
CGG repeats prominent forehead, prominent chin,
in the FMR1 protruding ears, joint laxity, large testes,
gene behavioral abnormalities
81. Diagnostic test Gastrograffin (water-soluble) contrast
for esophagram, CT esophagram
esophageal
perforation Osler's Nodes, Janeway lesions, splinter
hemorrhages, petechiae, Roth's spots,
82. Rhematic fever mitral stenosis; treat with prophylatic IM
subungual hemorrhage, splenomegaly,
heart murmur Benzathine PCN monthly for a minimum of
neuro symptoms related to CVA,
5 years to prevent recurrence of GAS infxn
meningitis or brain abscess,
and progression of heart disease
glomerulonephritis
83. Loud SI with Mitral Stenosis; usually associated with (hematuria/proteinuria)
mid-diastolic rheumatic fever; may result in a fib due to
94. Meningitis with Streptococcus Pneumoniae
rumble dilated left atrium which may lead to
gram positive
pulmonary HTN and right heart failure; if
diplococci
symptomatic treat with nitrates or diuretics
95. Meningitis with Neisseria Meningitidis
84. MEN1 Primary HyperParathyroidism
gram negative
Enteropancreatic tumors (may cause
diplococci
zollinger ellison syndrome)
Pituitary tumors 96. Meningitis with Haemophilus Influenza
small
85. MEN2A Medullary thyroid carcinoma,
pleomorphic
pheochromotcytoma, parathyroid
gram negative
hyperplasia
coccobacilli
97. Meningitis gram Listeria Monocytogenes 110. Most common otosclerosis
positive rods cause of
and coccobacilli conductive
hearing loss?
98. Treatment for Sulfadiazine, pyrimethamine
Toxoplasma 111. Components of Waist CIrcumference >40in M/>35in F; TGs
Gondii Metabolic > 150; HDL <40M/<50F; BP >130/85; Fasting
Syndrome serum glucose > 100 or tolerance test > 140
99. Toxoplama TMP-SMX when count less than 100
Prophylaxis in
AIDS
100. When to do a patient symptomatic with narrowing of 70-
carotid 99%; male patient symptomatic with
endarterectomy narrowing of 50-99%; asymptomatic
patient with narrowing of 60-99% if life
expectancy is greater than 5 years and
surgeon's complication rate is less than 3%
101. Target BP when SBP > 150
treating
subarachnoid
hemorrhage
102. Treatment for timolol, apraclonidine, pilocarpine (1 drop
Acute Closed each 1 minute apart); acetazolamide; laser
Angle peripheral iridotomy
Glaucoma
103. Treatment for timolol; pilocarpine; topical
Open Angle acetazolamide; latanoprost;
Glaucoma apraclonidine/bromonidine
104. Child with HTN, 11-beta hydroxylase deficiency/
low K+, Congenital Adrenal Hyperplasia
ambiguous
genitalia (F) or
precocious
puberty (M)
105. Child with HTN, 17-alpha-hydroxylase deficiency/ CAH
ambiguous
genitalia (M),
low K+
106. Child with 21-alpha-hydroxylase deficiency CAH
hypotension,
low Na+, high
K+, ambiguous
genitalia (F),
precocious
puberty (M)
107. Patient with ...
108. What is Sudden shift from fat metabolism to carb
Refeeding metabolism: hypophosphatemia,
Syndrome? hypokalemia, hypomagnesemia, CHF and
arrhytmias, rhabdo, delirium, seizures
109. Most common presbycusis (age-related)
cause of
sensorineural
hearing loss?