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

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2. Name the organism:
Pheochromocytoma
Pregnant women. Treat this group aggressively because of potential complications
ALS
Actinomyces israelii


3. The percentage of cases within one SD of the mean? Two SDs? Three SDs?
Prevalence
Pityriasis rosea
Hypoparathyroidism
68% - 95.5% - 99.7%


4. Renal tubular acidosis (RTA) associated with abnormal H+ secretion and nephrolithiasis.
Uterine massage; if that fails - give oxytocin
Alopecia areata (autoimmune process)
Type I (distal) RTA
Number of deaths per 1000 population


5. Hernia with highest risk of incarceration
Femoral hernia
Number of deaths during pregnancy to 90 days postpartum per 100 -000 live births
CML
Murphy's sign - seen in acute cholecystitis


6. Class of drugs that may cause syndrome of muscle rigidity - hyperthermia - autonomic instability - and extrapyramidal symptoms.
Small cell lung cancer (SCLC)
Antipsychotics (neuroleptic malignant syndrome)
Infection - cancer - and autoimmune disease
Vibrio - HAV


7. Reed - Sternberg cells

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

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9. Risk factors for DVT.

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10. Maternal mortality?
Endometriosis
Glomerulonephritis/nephritic syndrome
Number of deaths during pregnancy to 90 days postpartum per 100 -000 live births
Fibrin split products and D- dimer are elevated; platelets - fibrinogen - and hematocrit are ?.


11. Diagnostic modality used when ultrasound is equivocal for cholecystitis.
Treat because the disease represents an immediate threat to the child's life. Then seek a court order
Beta- blockers - Ca2+ channel blockers - TCAs
HIDA scan
? Ca2+ - ? K- - ? phosphate - ? uric acid


12. A patient fails to lactate after an emergency C- section with marked blood loss.

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13. Identify key organisms causing diarrhea:
Type I (distal) RTA
Nitroprusside
ETEC
Lobular carcinoma in situ


14. ? CO - ? pulmonary capillary wedge pressure (PCWP) - ? peripheral vascular resistance (PVR).
High TSH - low T4 - antimicrosomal antibodies
Hypovolemic shock
Cellulitis
Prolactinoma. Dopamine agonists (e.g. - bromocriptine)


15. The most common pituitary tumor. Treatment?
False. Patients may change their minds at any time. Exceptions to the requirement of informed consent include emergency situations and patients without decision - making capacity
Ulcerative colitis
TICS
Prolactinoma. Dopamine agonists (e.g. - bromocriptine)


16. A middle - aged man presents with acute - onset monoarticular joint pain and bilateral Bell's palsy. What is the likely diagnosis - and how did he get it? Treatment?
Selective IgA deficiency
Pleural/serum protein > 0.5; pleural/serum LDH > 0.6
Lyme disease - Ixodes tick - doxycycline
Real threat of harm to third parties; suicidal intentions; certain contagious diseases; elder and child abuse


17. Treatment of anaphylactic shock.
Correct metabolic abnormalities. Then correct pyloric stenosis with pyloromyotomy
Diphenhydramine or epinephrine 1:1000
Lobular carcinoma in situ
Panic disorder


18. Testicular cancer associated with Beta- hCG - AFP.
Lesion of 1
Patient on dopamine antagonist
Choriocarcinoma
Monoclonal gammopathy - Bence Jones proteinuria - 'punched - out' lesions on x- ray of the skull and long bones


19. Molar pregnancy containing fetal tissue.
Partial mole
Patent ductus arteriosus (PDA)
Guillain - Barr
Actinic keratosis


20. Bias introduced when screening detects a disease earlier and thus lengthens the time from diagnosis to death.
Lead - time bias
Postinfectious glomerulonephritis
Restrictive pulmonary disease
Guillain - Barr


21. Treatment for TTP.
Acute dystonia (oculogyric crisis). Treat with benztropine or diphenhydramine
Oral or topical metronidazole
Emergent large - volume plasmapheresis - corticosteroids - antiplatelet drugs
Patent ductus arteriosus (PDA)


22. Erythema migrans.
Bacillus cereus
Flumazenil
Lesion of 1
Acute myelogenous leukemia (AML)


23. A patient presents with weakness - nausea - vomiting - weight loss - and new skin pigmentation. Labs show hyponatremia and hyperkalemia. Treatment?
Obstetric conjugate: between the sacral promontory and the midpoint of the symphysis pubis
Sensitivity
Lichen sclerosus
1


24. Cannon 'a' waves.
Partial mole
Third - degree heart block
Calcium oxalate
Excessive EtOH


25. 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
Hereditary spherocytosis
Fever - heart murmur - Osler's nodes - splinter hemorrhages - Janeway lesions - Roth's spots
Alopecia areata (autoimmune process)


26. Rhomboid - shaped - positively birefringent crystals on joint fluid aspirate.
Neuroleptics
Pseudogout
Niacin
Chronic lymphocytic leukemia (CLL)


27. A young child presents with proximal muscle weakness - waddling gait - and pronounced calf muscles.
Pityriasis rosea
Streptococcus pneumoniae
Duchenne muscular dystrophy
Third - degree heart block


28. Treatment for opioid overdose.
Osgood - Schlatter disease
They can mask symptoms of hypoglycemia
Age > 45-50 years; lesions new or larger in comparison to old films; absence of calcification or irregular calcification; size > 2 cm; irregular margins
Naloxone


29. RTA associated with aldosterone defect.
Membranous glomerulonephritis
Type IV (distal) RTA
Weight gain - type 2 DM - QT prolongation
Broca's aphasia. Frontal lobe - left MCA distribution


30. Classic ECG finding in atrial flutter.

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31. Microcytic anemia with ? serum iron - ? ferritin - and ? TIBC.
Varicella zoster
Iron deficiency anemia
MAOIs
Normal


32. Combined UMN and LMN disorder.
Pseudomonas
ALS
Group B strep - E. coli - Listeria. Treat with gentamicin and ampicillin
Salmonella


33. Chronic diseases such as SLE
Out
Consider Fitz - Hugh - Curtis syndrome
Higher prevalence
Actinomyces israelii


34. Nontender abdominal mass associated with elevated VMA and HVA.
46 -XX
Intraductal papilloma
Neuroblastoma
Hypotension and bradycardia


35. First - line treatment for moderate hypercalcemia.
IV hydration and loop diuretics (furosemide)
Subarachnoid hemorrhage (SAH)
Renal artery stenosis - coarctation of the aorta - pheochromocytoma - Conn's syndrome - Cushing's syndrome - unilateral renal parenchymal disease - hyperthyroidism - hyperparathyroidism
Both have ? hematocrit and RBC mass - but polycythemia vera should have normal O2 saturation and low erythropoietin levels


36. Conditions in which confidentiality must be overridden.
Real threat of harm to third parties; suicidal intentions; certain contagious diseases; elder and child abuse
Dissociative fugue
Candidal thrush. Workup should include an HIV test. Treat with nystatin oral suspension
Sulfonamides - antimalarial drugs - fava beans


37. Signs of active ischemia during stress testing.
Hemophilia A or B; consider desmopressin (for hemophilia A) or factor VIII or IX supplements
M3
Neither
Angina - ST- segment changes on ECG - or ? BP


38. Chvostek's and Trousseau's signs.
Hypocalcemia
Conflict of interest
OCPs - danazol - GnRH agonists
Iatrogenic steroid administration. The second most common cause is Cushing's disease


39. A nonsuppurative complication of streptococcal infection that is not altered by treatment of 1
Iron deficiency anemia
Choriocarcinoma
Postinfectious glomerulonephritis
Confounding variable


40. Treatment of supraventricular tachycardia (SVT).
Developmental dysplasia of the hip. If severe - consider a Pavlik harness to maintain abduction
Flumazenil
Rate control with carotid massasge or other vagal stimulation
Endometrial biopsy


41. A 55-year - old patient presents with acute 'broken speech.' What type of aphasia? What lobe and vascular distribution?

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42. Name the defense mechanism:
Pentad of TTP
Diffuse interstitial pulmonary fibrosis. Supportive care. Steroids may help
Isolation
CA-125 and transvaginal ultrasound


43. A 21-year - old male has three months of social withdrawal - worsening grades - flattened affect - and concrete thinking.
Schizophreniform disorder (diagnosis of schizophrenia requires = 6 months of symptoms)
Infection - cancer - and autoimmune disease
Emergent laparotomy to repair perforated viscus - likely stomach
Bacillus cereus


44. Fertility rate?
Kl
Number of live births per 1000 women 15-44 years of age
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
105 bacteria/mL


45. A 50-year - old male presents with early satiety - splenomegaly - and bleeding. Cytogenetics show t(9 -22). Diagnosis?
B12 deficiency
Placental abruption and placenta previa
Squamous cell carcinoma
CML


46. Sudden onset of mental status changes - emesis - and liver dysfunction after taking aspirin.

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47. The most common pathogen causing croup.
50 cc/hour
Bruton's X- linked agammaglobulinemia
Group B strep - E. coli - Listeria. Treat with gentamicin and ampicillin
Parainfluenza virus type 1


48. Beck's triad for cardiac tamponade.
BP > 140/90 on three separate occasions two weeks apart
Alopecia areata (autoimmune process)
Obstructive pulmonary disease (e.g. - asthma)
Hypotension - distant heart sounds - and JVD


49. The diagnostic test for pulmonary embolism.
Real threat of harm to third parties; suicidal intentions; certain contagious diseases; elder and child abuse
V/Q scan
Seborrheic keratosis
Neisseria meningitidis


50. Radiographic evidence of aortic disruption or dissection.
Hemophilia A or B; consider desmopressin (for hemophilia A) or factor VIII or IX supplements
Widened mediastinum (> 8 cm) - loss of aortic knob - pleural cap - tracheal deviation to the right - depression of left main stem bronchus
Selective IgA deficiency
Cluster headache