Instructions:

• Answer 50 questions in 15 minutes.
• If you are not ready to take this test, you can study here.
• Match each statement with the correct term.
• Don't refresh. All questions and answers are randomly picked and ordered every time you load a test.

This is a study tool. The 3 wrong answers for each question are randomly chosen from answers to other questions. So, you might find at times the answers obvious, but you will see it re-enforces your understanding as you take the test each time.

1. Molar pregnancy containing fetal tissue.
Number of deaths during pregnancy to 90 days postpartum per 100 -000 live births
Charcot's triad plus shock and mental status changes - with suppurative ascending cholangitis
Partial mole
Consider Fitz - Hugh - Curtis syndrome


2. Natural history of a leiomyoma.
TB medications (INH - rifampin - pyrazinamide) - acetaminophen - and tetracycline
Regresses after menopause
Dantrolene or bromocriptine
MAOIs


3. Radiographic evidence of aortic disruption or dissection.
Widened mediastinum (> 8 cm) - loss of aortic knob - pleural cap - tracheal deviation to the right - depression of left main stem bronchus
Charcot's triad plus shock and mental status changes - with suppurative ascending cholangitis
Pasteurella multocida
Osteoarthritis


4. Causes of transudative effusion.
Think of intact capillaries. CHF - liver or kidney disease - and protein - losing enteropathy
Cellulitis
Septic or anaphylactic shock
Fever - heart murmur - Osler's nodes - splinter hemorrhages - Janeway lesions - Roth's spots


5. Odds ratio?
The likelihood of a disease among individuals exposed to a risk factor compared to those who have not been exposed
Weight gain - type 2 DM - QT prolongation
Hypoparathyroidism
Conduct disorder


6. Treatment of anaphylactic shock.
Clomiphene citrate
Pregnant women. Treat this group aggressively because of potential complications
Cohort studies can be used to calculate relative risk (RR) - incidence - and/or odds ratio (OR). Case - control studies can be used to calculate an OR
Diphenhydramine or epinephrine 1:1000


7. How to diagnose and follow a leiomyoma.
Ultrasound
Actinic keratosis
The patient is a danger to self - a danger to others - or gravely disabled (unable to provide for basic needs)
Bruton's X- linked agammaglobulinemia


8. The mainstay of Parkinson's therapy.
Both have ? hematocrit and RBC mass - but polycythemia vera should have normal O2 saturation and low erythropoietin levels
Levodopa/carbidopa
Squamous cell carcinoma
Emergent large - volume plasmapheresis - corticosteroids - antiplatelet drugs


9. Waxy casts in urine sediment and Maltese crosses (seen with lipiduria).
105 bacteria/mL
Morphine - O2 - sublingual nitroglycerin - ASA - IV Beta- blockers - heparin
Haemophilus ducreyi
Nephrotic syndrome


10. Rigidity and stiffness with resting tremor and masked facies.

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11. Acceptable urine output in a stable patient.
Lichen planus
Type IV (distal) RTA
Kl
30 cc/hour


12. Non - small cell lung cancer (NSCLC) associated with hypercalcemia.
ST- segment elevation (depression means ischemia) - flattened T waves - and Q waves
Spinal stenosis
Squamous cell carcinoma
Hypertension - bradycardia - and abnormal respirations


13. Pinkish - scaling - flat lesions on the chest and back. KOH prep has a 'spaghetti - and - meatballs' appearance.
Lesion of 1
Pityriasis versicolor
The likelihood of a disease among individuals exposed to a risk factor compared to those who have not been exposed
Parvovirus B19


14. Rhomboid - shaped - positively birefringent crystals on joint fluid aspirate.
? serum FSH
Signs and symptoms of hypercalcemia
Administration of DDAVP ? serum osmolality and free water restriction
Pseudogout


15. Flat - topped papules.
Hypernatremia
Chloramphenicol - sulfonamides - radiation - HIV - chemotherapeutic agents - hepatitis - parvovirus B19 - EBV
Immediate needle thoracostomy
Lichen planus


16. When can a physician refuse to continue treating a patient on the grounds of futility?
Wrist drop - loss of thumb abduction
Frotteurism (a paraphilia)
When there is no rationale for treatment - maximal intervention is failing - a given intervention has already failed - and treatment will not achieve the goals of care
Low - voltage - diffuse ST- segment elevation


17. Perinatal mortality?

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18. Typical antibiotics for group B streptococcus (GBS) prophylaxis.
IV penicillin or ampicillin
Bladder rupture or urethral injury
Glomerulonephritis/nephritic syndrome
Parainfluenza virus type 1


19. Acute - phase treatment for Kawasaki disease.
High - dose aspirin for inflammation and fever; IVIG to prevent coronary artery aneurysms
Herpes simplex
Actinomyces israelii
von Willebrand's disease; treat with desmopressin - FFP - or cryoprecipitate


20. Neonatal mortality?
Number of deaths from birth to 28 days per 1000 live births
Iron deficiency anemia
Endometriosis
Flumazenil


21. Treatment for Guillain - Barr
Out
Mallory- Weiss
IVIG or plasmapheresis
Acne vulgaris


22. A 17-year - old female has left arm paralysis after her boyfriend dies in a car crash. No medical cause is found.
Isolation
Reactive (Reiter's) arthritis. Associated with Campylobacter - Shigella - Salmonella - Chlamydia - and Ureaplasma
Conversion disorder
Fanconi's anemia


23. Arthritis - conjunctivitis - and urethritis in young men. Associated organisms?

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24. Inflammatory disease of the colon with ? risk of colon cancer.
Ulcerative colitis
Regresses after menopause
Immediate needle thoracostomy
Ampulla of the oviduct


25. A man has repeated - intense urges to rub his body against unsuspecting passengers on a bus.
Group B strep - E. coli - Listeria. Treat with gentamicin and ampicillin
Ulcerative colitis
Frotteurism (a paraphilia)
Benzodiazepines


26. An infant has a high fever and onset of rash as fever breaks. What is he at risk for?
Treat because the disease represents an immediate threat to the child's life. Then seek a court order
Febrile seizures (roseola infantum)
Restrictive pulmonary disease
Administration of DDAVP ? serum osmolality and free water restriction


27. Identify key organisms causing diarrhea:
Iatrogenic steroid administration. The second most common cause is Cushing's disease
Hyperkalemia
E. coli O157:H7
ST- segment elevation (depression means ischemia) - flattened T waves - and Q waves


28. Endocarditis prophylaxis regimens.
Agranulocytosis
Salmonella
68% - 95.5% - 99.7%
Oral surgery


29. 'Doughy skin.'
Hypernatremia
Prostate cancer is the most common cancer in men - but lung cancer causes more deaths
Levodopa/carbidopa
Giardia


30. A child has loss of red light reflex. Diagnosis?
Factor V Leiden mutation
Suspect retinoblastoma
Beta- blockers - Ca2+ channel blockers - TCAs
Number of live births per 1000 women 15-44 years of age


31. Post - HBV exposure treatment.
Lung - breast - skin (melanoma) - kidney - GI tract
HBV immunoglobulin
Hyperkalemia
Pregnancy - vesicoureteral reflux - anatomic anomalies - indwelling catheters - kidney stones


32. A five - month - old girl has ? head growth - truncal dyscoordination - and ? social interaction.

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33. Should a - or Beta- antagonists be used first in treating pheochromocytoma?
Seborrheic keratosis
High TSH - low T4 - antimicrosomal antibodies
No. Parental consent is not necessary for the medical treatment of pregnant minors
a - antagonists (phentolamine and phenoxybenzamine)


34. A 24-year - old male presents with soft white plaques on his tongue and the back of his throat. Diagnosis? Workup? Treatment?
Candidal thrush. Workup should include an HIV test. Treat with nystatin oral suspension
Edrophonium
1
IV penicillin or ampicillin


35. Identify key organisms causing diarrhea:
> 5.5 cm - rapidly enlarging - symptomatic - or ruptured
Low - voltage - diffuse ST- segment elevation
IVIG or plasmapheresis
ETEC


36. Presents with a herald patch - Christmas - tree pattern.
Absence seizures
Pityriasis rosea
Uveitis - ankylosing spondylitis - pyoderma gangrenosum - erythema nodosum - 1
Herpes simplex


37. Treatment for mild and severe unconjugated hyperbilirubinemia.
Phototherapy (mild) or exchange transfusion (severe)
Anticholinergics (oxybutynin) or Beta- adrenergics (metaproterenol) for urge incontinence.
Nephrogenic diabetes insipidus (DI)
Higher incidence


38. 'Cradle cap.'
Pseudomonas
Seborrheic dermatitis. Treat with antifungals
Nephrogenic diabetes insipidus (DI)
Frotteurism (a paraphilia)


39. Dermatomal distribution.
Varicella zoster
Number of deaths per 1000 population
Neisseria meningitidis
'Sawtooth' P waves


40. Medication to avoid in patients with a history of alcohol withdrawal seizures.
Anorexia
Iron overload; use deferoxamine
Neuroleptics
Spinal stenosis


41. Bias introduced when screening detects a disease earlier and thus lengthens the time from diagnosis to death.
Confounding variable
Chronic granulomatous disease
Lead - time bias
Phencyclidine hydrochloride (PCP) intoxication


42. An 11-year - old obese - African - American boy presents with sudden onset of limp. Diagnosis? Workup?
Observational bias
B12 deficiency
Snowstorm on ultrasound. 'Cluster - of - grapes' appearance on gross examination
Slipped capital femoral epiphyses. AP and frog - leg lateral view


43. An 80-year - old man presents with fatigue - lymphadenopathy - splenomegaly - and isolated lymphocytosis. Suspected diagnosis?
Chronic lymphocytic leukemia (CLL)
Subdural hematoma
30 cc/hour
Beta- blockers - Ca2+ channel blockers - TCAs


44. Side effects of corticosteroids.
E. coli O157:H7
Depersonalization disorder
IV penicillin or ampicillin
Acute mania - immunosuppression - thin skin - osteoporosis - easy bruising - myopathies


45. Cold water is flushed into a patient's ear - and the fast phase of the nystagmus is toward the opposite side. Normal or pathological?
Squamous cell carcinoma
Normal
ARDS
Pneumococcus - meningococcus - H. influenzae. Treat with cefotaxime and vancomycin


46. Caf
Cirrhosis - CHF - nephritic syndrome
DM - SLE - and amyloidosis
> 5.5 cm - rapidly enlarging - symptomatic - or ruptured
Neurofibromatosis 1


47. Treatment of septic shock.
Fluids and antibiotics
IVIG or plasmapheresis
> 5.5 cm - rapidly enlarging - symptomatic - or ruptured
Hypotension and bradycardia


48. Autoimmune complication occurring 2-4 weeks post - MI.

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49. Joints in the hand affected in rheumatoid arthritis.
O2 - analgesia - hydration - and - if severe - transfusion
Cellulitis
MCP and PIP joints; DIP joints are spared
Threatened abortion


50. RTA associated with aldosterone defect.
? Ca2+ - ? K- - ? phosphate - ? uric acid
Type IV (distal) RTA
Cirrhosis - CHF - nephritic syndrome
CHF - shock - and altered mental status