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. Name the organism:
Sporothrix schenckii
Phencyclidine hydrochloride (PCP) intoxication
RCC or other erythropoietin - producing tumor; evaluate with CT scan
Spontaneous pneumothorax. Spontaneous regression. Supplemental O2 may be helpful


2. Lung cancer associated with SIADH.
Small cell lung cancer (SCLC)
Substance abuse
Regresses after menopause
Inevitable abortion


3. First - line treatment for otitis media.
RSV bronchiolitis
ALS
Amoxicillin
50 cc/hour


4. Auer rods on blood smear.
Acute myelogenous leukemia (AML)
Agranulocytosis
Surfactant deficiency
Self - limited - painless vaginal bleeding


5. Identify key organisms causing diarrhea:
Pulsus paradoxus (seen in cardiac tamponade)
Hypotension and bradycardia
Fluids and antibiotics
Salmonella


6. Class of drugs that may cause syndrome of muscle rigidity - hyperthermia - autonomic instability - and extrapyramidal symptoms.
Antipsychotics (neuroleptic malignant syndrome)
Cluster headache
Fecal occult blood test and sigmoidoscopy; suspect colorectal cancer
Nephrotic syndrome


7. Bone is fractured in fall on outstretched hand.

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8. ? risk of what infection with silicosis?
Bullous pemphigoid
Reye's syndrome
Mycobacterium tuberculosis
Administration of DDAVP ? serum osmolality and free water restriction


9. Salicylate ingestion ? In What type of acid - base disorder?
46 -XX
MS
Number of deaths from 28 days to one year per 1000 live births
Anion gap acidosis and 1


10. Classic physical findings for endocarditis.

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11. The most common cause of hypothyroidism.

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12. The three most common causes of fever of unknown origin (FUO).
MAOIs
Infection - cancer - and autoimmune disease
Prinzmetal's angina
Multiple myeloma


13. A 50-year - old woman leaks urine when laughing or coughing. Nonsurgical options?
Snowstorm on ultrasound. 'Cluster - of - grapes' appearance on gross examination
IgA nephropathy (Berger's disease)
ALS
Kegel exercises - estrogen - pessaries for stress incontinence


14. Cause of amenorrhea with normal prolactin - no response to estrogen - progesterone challenge - and a history of D&C.

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15. T- wave flattening and U waves.
Endometriosis
Hypokalemia
Regresses after menopause
Glanzmann's thrombasthenia


16. Diagnostic test for hypertrophic cardiomyopathy.
Fibrin split products and D- dimer are elevated; platelets - fibrinogen - and hematocrit are ?.
Echocardiogram (showing thickened left ventricular wall and outflow obstruction)
Beta- blockers - Ca2+ channel blockers - TCAs
Septic or anaphylactic shock


17. Drugs that slow AV node transmission.
CHF - shock - and altered mental status
Lesch - Nyhan syndrome (purine salvage problem with
Prevalence
Beta- blockers - digoxin - calcium channel blockers


18. ? CO - ? PCWP - ? PVR.
46 -XX
Osmotic fragility test
Cardiogenic shock
INH - penicillamine - hydralazine - procainamide


19. A tall white male presents with acute shortness of breath. Diagnosis? Treatment?
Spontaneous pneumothorax. Spontaneous regression. Supplemental O2 may be helpful
< 7.0
Vibrio - HAV
Hashimoto's thyroiditis


20. Indications for surgical repair of abdominal aortic aneurysm.
Morphine - O2 - sublingual nitroglycerin - ASA - IV Beta- blockers - heparin
Dantrolene or bromocriptine
AP chest - AP/lateral C- spine - AP pelvis
> 5.5 cm - rapidly enlarging - symptomatic - or ruptured


21. Name the defense mechanism:
Fever - pharyngeal erythema - tonsillar exudate - lack of cough
Displacement
Patient on dopamine antagonist
Seminoma


22. Rhomboid - shaped - positively birefringent crystals on joint fluid aspirate.
Wernicke's encephalopathy due to a deficiency of thiamine
Allergic interstitial nephritis
Pseudogout
Dantrolene or bromocriptine


23. Odds ratio?
46 -XX
Likely BPH. Options include no treatment - terazosin - finasteride - or surgical intervention (TURP)
Lichen sclerosus
The likelihood of a disease among individuals exposed to a risk factor compared to those who have not been exposed


24. An 11-year - old obese - African - American boy presents with sudden onset of limp. Diagnosis? Workup?
Slipped capital femoral epiphyses. AP and frog - leg lateral view
Lung - breast - skin (melanoma) - kidney - GI tract
Consider Fitz - Hugh - Curtis syndrome
The likelihood of a disease among individuals exposed to a risk factor compared to those who have not been exposed


25. Medication to avoid in patients with a history of alcohol withdrawal seizures.
Neuroleptics
Prostate cancer is the most common cancer in men - but lung cancer causes more deaths
MAOIs
Osteogenesis imperfecta


26. Identify key organisms causing diarrhea:
Giardia
Febrile seizures (roseola infantum)
Surfactant deficiency
Factitious disorder (Munchausen syndrome)


27. Type of ARF in a patient with FeNa < 1%.
Trauma - alcohol withdrawal - brain tumor
Partial mole
Varicella zoster
Prerenal


28. A young weight lifter receives IV haloperidol and complains that his eyes are deviated sideways. Diagnosis? Treatment?
Fever - pharyngeal erythema - tonsillar exudate - lack of cough
Acute dystonia (oculogyric crisis). Treat with benztropine or diphenhydramine
68% - 95.5% - 99.7%
Isospora - Cryptosporidium - Mycobacterium avium complex (MAC)


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

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30. CSF findings with SAH.
Epidural hematoma. Middle meningeal artery. Neurosurgical evacuation
Elevated ICP - RBCs - xanthochromia
No. Parental consent is not necessary for the medical treatment of pregnant minors
Transitional cell carcinoma


31. The most common type of skin cancer; the lesion is a pearly- colored papule with a translucent surface and telangiectasias.
Basal cell carcinoma
Absence seizures
Mycoplasma
Ultrasound


32. Should a - or Beta- antagonists be used first in treating pheochromocytoma?
Free air under the diaphragm - extravasation of contrast - severe bowl distention - space - occupying lesion (CT) - mesenteric occlusion (angiography)
Parvovirus B19
Hypertrophic cardiomyopathy
a - antagonists (phentolamine and phenoxybenzamine)


33. A 16-year - old presents with an annular patch of alopecia with broken - off - stubby hairs.
Flumazenil
Confirm the diagnosis of acute pancreatitis with elevated amylase and lipase. Make patient NPO and give IV fluids - O2 - analgesia - and 'tincture of time'
Cellulitis
Alopecia areata (autoimmune process)


34. The most common inherited hemolytic anemia.
Observational bias
Acute mania. Start a mood stabilizer (e.g. - lithium)
Spinal stenosis
Hereditary spherocytosis


35. Macrocytic - megaloblastic anemia with neurologic symptoms.
B12 deficiency
IVIG or plasmapheresis
Salmonella
Neuroblastoma


36. An eight -year - old child is in a serious accident. She requires emergent transfusion - but her parents are not present.
Treat immediately. Consent is implied in emergency situations
Pseudomonas
Chloramphenicol - sulfonamides - radiation - HIV - chemotherapeutic agents - hepatitis - parvovirus B19 - EBV
No. Parental consent is not necessary for the medical treatment of pregnant minors


37. The diagnostic test for pulmonary embolism.
Emergent laparotomy to repair perforated viscus - likely stomach
S. aureus
Distal radius (Colles' fracture)
V/Q scan


38. Neonatal mortality?
Fluids - insulin - and aggressive replacement of electrolytes (e.g. - K+)
Anorexia
Number of deaths from birth to 28 days per 1000 live births
IV benzodiazepine


39. Presence of red cell casts in urine sediment.
Phototherapy (mild) or exchange transfusion (severe)
Aseptic (viral) meningitis
SSRIs
Glomerulonephritis/nephritic syndrome


40. A 13-year - old male has a history of theft - vandalism - and violence toward family pets.
Polymyalgia rheumatica
Epidural hematoma. Middle meningeal artery. Neurosurgical evacuation
Conduct disorder
Wait - surgical resection - radiation and/or androgen suppression


41. Genetic disorder associated with multiple fractures and commonly mistaken for child abuse.
Osteogenesis imperfecta
TB medications (INH - rifampin - pyrazinamide) - acetaminophen - and tetracycline
Right - to - left shunt - hypoventilation - low inspired O2 tension - diffusion defect - V/Q mismatch
Highly sensitive for TB


42. Non - small cell lung cancer (NSCLC) associated with hypercalcemia.
Endometrial biopsy
Squamous cell carcinoma
No. Parental consent is not necessary for the medical treatment of pregnant minors
Pasteurella multocida


43. Difference between a cohort and a case - control study.
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
Tabes dorsalis - general paresis - gummas - Argyll Robertson pupil - aortitis - aortic root aneurysms
Incidence and prevalence
Regression


44. Side effects of corticosteroids.
Acute mania - immunosuppression - thin skin - osteoporosis - easy bruising - myopathies
Nephritic syndrome
Endometrial or estrogen receptor - breast cancer
Angina - ST- segment changes on ECG - or ? BP


45. A postoperative patient with significant pain presents with hyponatremia and normal volume status.
Immediate needle thoracostomy
SIADH due to stress
Continuous - painful vaginal bleeding
Fibrin split products and D- dimer are elevated; platelets - fibrinogen - and hematocrit are ?.


46. Blood in the urethral meatus or high - riding prostate.
Establish the ABCs
Herpes simplex
Bladder rupture or urethral injury
Osteogenesis imperfecta


47. Name the defense mechanism:
Epidural hematoma. Middle meningeal artery. Neurosurgical evacuation
Isolation
Stasis - hypercoagulability - endothelial damage
A patient's family cannot require that a doctor withhold information from the patient


48. A child has loss of red light reflex. Diagnosis?
Suspect retinoblastoma
Actinic keratosis
Cluster headache
'Sawtooth' P waves


49. A neonate has meconium ileus.

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50. + Nikolsky's sign.
Conflict of interest
Lung - breast - skin (melanoma) - kidney - GI tract
Think of intact capillaries. CHF - liver or kidney disease - and protein - losing enteropathy
Pemphigus vulgaris