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. Lung cancer highly related to cigarette exposure.
They can mask symptoms of hypoglycemia
Prostate cancer is the most common cancer in men - but lung cancer causes more deaths
A patient's family cannot require that a doctor withhold information from the patient
SCLC


2. Associated with Propionibacterium acnes and changes in androgen levels.
Subdural hematoma
High TSH - low T4 - antimicrosomal antibodies
Acne vulgaris
Morphine - O2 - sublingual nitroglycerin - ASA - IV Beta- blockers - heparin


3. What % lesion is an indication for carotid endarterectomy?
Sporothrix schenckii
Seventy percent if the stenosis is symptomatic
Treat existing heart failure and replace the tricuspid valve
Snowstorm on ultrasound. 'Cluster - of - grapes' appearance on gross examination


4. Meningitis in neonates. Causes? Treatment?
Group B strep - E. coli - Listeria. Treat with gentamicin and ampicillin
1
Placental abruption and placenta previa
Febrile seizures (roseola infantum)


5. A 10-year - old child presents in status epilepticus - but her parents refuse treatment on religious grounds.

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6. Type of ARF in a patient with FeNa < 1%.
Prerenal
Weight gain - type 2 DM - QT prolongation
The patient is a danger to self - a danger to others - or gravely disabled (unable to provide for basic needs)
Intraductal papilloma


7. Hypercholesterolemia treatment that ? flushing and pruritus.
Niacin
Streptococcus pneumoniae
Hemophilia A or B; consider desmopressin (for hemophilia A) or factor VIII or IX supplements
Benzodiazepines


8. Prophylactic treatment for migraine.
Beta- blockers - Ca2+ channel blockers - TCAs
Renal artery stenosis - coarctation of the aorta - pheochromocytoma - Conn's syndrome - Cushing's syndrome - unilateral renal parenchymal disease - hyperthyroidism - hyperparathyroidism
'Sawtooth' P waves
Encapsulated organisms -- pneumococcus - meningococcus - Haemophilus influenzae - Klebsiella


9. A 50-year - old man with a history of alcohol abuse presents with boring epigastric pain that radiates to the back and is relieved by sitting forward. Management?

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10. The most common 1
Multiple myeloma
HIDA scan
Nephrotic syndrome
Naloxone


11. Signs of active ischemia during stress testing.
Sarcoidosis
Angina - ST- segment changes on ECG - or ? BP
Elevated ICP - RBCs - xanthochromia
Streptococcus pneumoniae


12. Mortality rate?
Surfactant deficiency
Glanzmann's thrombasthenia
Pregnancy - vesicoureteral reflux - anatomic anomalies - indwelling catheters - kidney stones
Number of deaths per 1000 population


13. The most common 1
Lung - breast - skin (melanoma) - kidney - GI tract
'Sawtooth' P waves
Trauma; the second most common is berry aneurysm
Protamine


14. Waxy casts in urine sediment and Maltese crosses (seen with lipiduria).
Exercise stress treadmill with ECG
Pulsus paradoxus (seen in cardiac tamponade)
Nephrotic syndrome
Alopecia areata (autoimmune process)


15. Causes of transudative effusion.
Administration of DDAVP ? serum osmolality and free water restriction
Think of intact capillaries. CHF - liver or kidney disease - and protein - losing enteropathy
'Chocolate cysts -' powder burns
Abdominal ultrasound and CT


16. Exophytic nodules on the skin with varying degrees of scaling or ulceration; the second most common type of skin cancer.
Squamous cell carcinoma
HBV - DTaP - Hib - IPV - PCV
Beta- blockers - digoxin - calcium channel blockers
Hypotension and bradycardia


17. Findings in 3
Angina is new - is worsening - or occurs at rest
Treat existing heart failure and replace the tricuspid valve
Lesion of 1
Tabes dorsalis - general paresis - gummas - Argyll Robertson pupil - aortitis - aortic root aneurysms


18. Presents with a herald patch - Christmas - tree pattern.
Pityriasis rosea
Depersonalization disorder
Emergent laparotomy to repair perforated viscus - likely stomach
Amoxicillin


19. Identify key organisms causing diarrhea:
Glomerulonephritis/nephritic syndrome
Menometrorrhagia
Vibrio - HAV
Treat existing heart failure and replace the tricuspid valve


20. A first - born female who was born in breech position is found to have asymmetric skin folds on her newborn exam. Diagnosis? Treatment?
Right - to - left shunt - hypoventilation - low inspired O2 tension - diffusion defect - V/Q mismatch
Prerenal
Absence seizures
Developmental dysplasia of the hip. If severe - consider a Pavlik harness to maintain abduction


21. Inspiratory arrest during palpation of the RUQ.

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22. The most common cause of seizures in young adults (18-35 years).
Psoriasis
Cerebral berry aneurysms (AD PCKD)
Murphy's sign - seen in acute cholecystitis
Trauma - alcohol withdrawal - brain tumor


23. Identify key organisms causing diarrhea:
DI
Giardia
IV benzodiazepine
Calcium oxalate


24. A 25-year - old Jewish male presents with pain and watery diarrhea after meals. Exam shows fistulas between the bowel and skin and nodular lesions on his tibias.

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25. Glomerulonephritis with deafness.

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26. Erythema migrans.
Impetigo
Hypotension and bradycardia
OCPs - danazol - GnRH agonists
Lesion of 1


27. Confusion - confabulation - ophthalmoplegia - ataxia.

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28. A congenital heart disease that cause 2
Coarctation of the aorta
Distal radius (Colles' fracture)
Blast crisis (fever - bone pain - splenomegaly - pancytopenia)
= 200 for PCP (with TMP); = 50-100 for MAI (with clarithromycin/azithromycin)


29. A 25-year - old African - American male with sickle cell anemia has sudden onset of bone pain. Management of pain crisis?
Pheochromocytoma
Lichen sclerosus
O2 - analgesia - hydration - and - if severe - transfusion
DI


30. A fall in systolic BP of > 10 mmHg with inspiration.
Conversion disorder
Legionella pneumonia
Pulsus paradoxus (seen in cardiac tamponade)
Confounding variable


31. Identify key organisms causing diarrhea:
Yersinia
Nephritic syndrome
Right - to - left shunt - hypoventilation - low inspired O2 tension - diffusion defect - V/Q mismatch
Bruton's X- linked agammaglobulinemia


32. The most common cause of hypertension in young women.
SIADH due to stress
Uterine massage; if that fails - give oxytocin
OCPs
Obstetric conjugate: between the sacral promontory and the midpoint of the symphysis pubis


33. Caf
Femoral hernia
SCLC
Neurofibromatosis 1
Abdominal ultrasound and CT


34. Medical treatment for hepatic encephalopathy.
? protein intake - lactulose - neomycin
Ultrasound
Endometrial biopsy
Taenia solium (cysticercosis)


35. A patient presents with tachycardia - wild swings in BP - headache - diaphoresis - altered mental status - and a sense of panic.
Menometrorrhagia
Pheochromocytoma
Coarctation of the aorta
Neither


36. Treatment of supraventricular tachycardia (SVT).
Kegel exercises - estrogen - pessaries for stress incontinence
Lobular carcinoma in situ
Rate control with carotid massasge or other vagal stimulation
ACEI


37. Not contraindications to vaccination.
Pleural/serum protein > 0.5; pleural/serum LDH > 0.6
Choriocarcinoma
Mild illness and/or low - grade fever - current antibiotic therapy - and prematurity
Chronic lymphocytic leukemia (CLL)


38. Nontender abdominal mass associated with elevated VMA and HVA.
Salmonella
High reliability - low validity
Levodopa/carbidopa
Neuroblastoma


39. Classic physical findings for endocarditis.

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40. CSF findings with SAH.
Elevated ICP - RBCs - xanthochromia
Graves' disease
Neuroleptics
Incidence and prevalence


41. Treatment for idiopathic thrombocytopenic purpura (ITP) in children.
Actinomyces israelii
Usually resolves spontaneously; may require IVIG and/or corticosteroids
Treat immediately. Consent is implied in emergency situations
Inhaled Beta- agonists and inhaled corticosteroids


42. A lesion characteristically occurring in a linear pattern in areas where skin comes into contact with clothing or jewelry.
Threatened abortion
Contact dermatitis
Type IV (distal) RTA
Hypovolemic shock


43. Signs suggesting radial nerve damage with humeral fracture.
Kegel exercises - estrogen - pessaries for stress incontinence
Clostridium difficile
Bacillus cereus
Wrist drop - loss of thumb abduction


44. IV drug use with JVD and holosystolic murmur at the left sternal border. Treatment?
Fluids - insulin - and aggressive replacement of electrolytes (e.g. - K+)
M3
Treat existing heart failure and replace the tricuspid valve
Fecal occult blood test and sigmoidoscopy; suspect colorectal cancer


45. Flat - topped papules.
Sheehan's syndrome (postpartum pituitary necrosis)
Lichen planus
Angina - ST- segment changes on ECG - or ? BP
Fluids - insulin - and aggressive replacement of electrolytes (e.g. - K+)


46. Symptoms of placenta previa.
Non - Hodgkin's lymphoma
Self - limited - painless vaginal bleeding
= 200 for PCP (with TMP); = 50-100 for MAI (with clarithromycin/azithromycin)
Uremic syndrome seen in patients with renal failure


47. Inflammatory disease of the colon with ? risk of colon cancer.
Haemophilus ducreyi
RSV bronchiolitis
Mild illness and/or low - grade fever - current antibiotic therapy - and prematurity
Ulcerative colitis


48. A 50-year - old male presents with early satiety - splenomegaly - and bleeding. Cytogenetics show t(9 -22). Diagnosis?
Pulsus paradoxus (seen in cardiac tamponade)
M3
Never
CML


49. Tanner stage 3 in a six-year - old female.
Non - Hodgkin's lymphoma
OCP and barrier contraception
Precocious puberty
Correct metabolic abnormalities. Then correct pyloric stenosis with pyloromyotomy


50. Meningitis in infants. Causes? Treatment?
Parvovirus B19
Niacin
Regression
Pneumococcus - meningococcus - H. influenzae. Treat with cefotaxime and vancomycin