motorola
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step2ck and step3 takers, please contribute
Edited by motorola on 11/18/07 - 04:50 PM
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| motorola
Forum Extremist
Topics: 66
Posts: 413
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Pearl 1 : marijuana can cause gynecomastia
Edited by motorola on 11/18/07 - 04:48 PM
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| motorola
Forum Extremist
Topics: 66
Posts: 413
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Pearl 2 : MVP and HOCM are the only two murmurs that 'W'orsen 'W'ith 'W'alsalva maneuver
Edited by motorola on 11/18/07 - 04:48 PM
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| mukho
Forum Elite
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Posts: 517
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good job motorola...i'll try to keep up...most of my knowledge is from UW but reading useful stuff repeatedly doesnt harm, so here goes
3)Following treatment with B12 in a pernicious anemia case monitor serum pottasium levels (it falls due to uptake by newly forming RBC)
4)Asymptomatic bacteriuria in elderly need not be treated if <20WBC/HPF
Edited by mukho on 11/10/07 - 01:52 PM
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| motorola
Forum Extremist
Topics: 66
Posts: 413
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hey mukho y dont u number the points in series with mine so that we can keep track. u can edit ur own post by clicking the pensil sign in ur post
Post from UW if thats what u r reading now a days.  shhhhhhh...
i am not gonna join uworld and u r probably not going to read the books i have... we can all benefit in that way !
If all those who visit this forum daily decide to write one line per visit...i am sure we can have a very good resource for studying. even those studying for the step 2 ck or even step 1 can post the clinically relevant stuff here. so please contribute.
Edited by motorola on 11/09/07 - 12:20 AM
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| motorola
Forum Extremist
Topics: 66
Posts: 413
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Pearl 5 : selegeline is a MAO B inhibitor
Pearl 6 : MAC pneumonia in HIV occurs with cd4 <50 while MTB can occur at higher counts. (good way to know that the smear showing ABF is MTB and not MAC as cultures take time)
Edited by motorola on 11/18/07 - 04:48 PM
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| mukho
Forum Elite
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Posts: 517
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u should read UW...why wont u? i cant seem to score more that 60 and its just breaking my heart
7. http://www.nationaltbcenter.edu/courses/index.cfm
try this site for TB doubts...doesnt always open easily though
8. gardisil is the anti HPV vaccine against 6/11/16/18 and is recommended for age group 11-26
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| motorola
Forum Extremist
Topics: 66
Posts: 413
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9. Clostridium difficile diarrhea is contagious and when suspected in ICU, the patient must be isolated awaiting the result of toxin assay.
and i'm sad no one else is contributing. cummon guys...if there is something u find difficult to remember ...write it down here and u r sure to remember it forever !
91 views of this post and only 2 contributors !!! thanks mukho. we keep going okay...
Edited by motorola on 11/18/07 - 04:49 PM. Reason: spelling error
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| motorola
Forum Extremist
Topics: 66
Posts: 413
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10. Hypertension is the most important modifiable risk factor for stroke. (not smokin, dm, lipids or obesity)
11. PMS 1st line rx is SSRIs
12. MC cause of AOE is pseudomonas
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| motorola
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13. Rhomboid positively birefringent crystals = CPPD i.e. pseudogout ..... keep hemochromatosis as a possibility
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| mukho
Forum Elite
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sorry motorola for not updating but exam tommorrow and am freaking out !! but here are a few
14) gout in patient with renal failure/disease --treatment is intraarticular steroids (none of the gout medications can be given in renal failure)
15) lyme's: if erythema migrans present--no need for serology, just treat
for all symptoms and isolated facial nerve palsy--DOC is Doxy;
if pregnant--amoxicillin
for all cns symptoms (including isolated facial palsy) however csf is mandatory---and if positive the treatment is IV ceftriaxone.
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| motorola
Forum Extremist
Topics: 66
Posts: 413
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good luck mukho. let me know ur experience  m sure u will do well
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| egomez2001
Forum Guru
Topics: 51
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Good job Motorola
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| motorola
Forum Extremist
Topics: 66
Posts: 413
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o thank u egomez2001 but u see people dont seem interested in contributing !
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| motorola
Forum Extremist
Topics: 66
Posts: 413
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16. Not exactly step 3 stuff but...Xanthine oxidase is a molybdenum containing enzyme, Carbonic anhydrase is Zn containing and Glutathione peroxidase is Se containing
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| motorola
Forum Extremist
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Posts: 413
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17. Which anti parasitic drug will u use in pregenency ?
no not albendazole, mebendazole or pyrantel palmoate...Use Niclosamide or piperazine
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| medocuk
IM-RES
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This is great stuff going on here. Thank you.
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| mukho
Forum Elite
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ok this is from topic i got today in the exam (not the exact ques, thats illegal right )
18. glucosamine is a non prescription drug used for osteoarthritis---it also causes glucose intolerance (herbal medication do come, especially side effects)
19. tsh, t4 and t3 all high--its either central (meaning tsh/trh overproduction) or thyroid resistance--d/d based on alpha subunit level (raised in central causes)
20. most sensitive marker of vit d deficiency--25, hydroxy vit d levels
will finish step 3 tmrw...then will update more thoroughly
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| motorola
Forum Extremist
Topics: 66
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good going mukho. good luck for the ccs. its 11 am and i m sure u r doing well.
21. erythropoetin levels increased in secondary polycythemia and not so in polycythemia vera
22. remember the often forgotten causes of macrocytic anemia: alcohol, drugs (example azathiprin, AZT), liver diseases and myelodysplasia
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| mukho
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thnks man...CCS was actually quite fun...at least no one deteriorated...i did make mistakes like giving antibiotics and then ordering blood culture; forgetting to add KCL in hyperosm DM coma...but overall felt it wasnt that bad....mcqs on the other hand were 'jaan leva' as they would say in india meaning very tough! whole lot of very similar ques sounding like ALS...confused me totally, just am keeping my fingers crossed---some more facts:
23. restless leg syndrome may have iron deficient anemia as a cause; treat first with iron then pramipexzole
24. ransons criteria on admission-- (WALGA) WBC; Age; LDH; Glucose; AST---no calcium (thats at the 48 hr evaluation)
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| motorola
Forum Extremist
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25. In hyperkalemia if TTKG (TransTubular K+ Gradient) <4 think of hypoaldosteronism as the cause.
for explanation of TTKG read the post below:
http://www.prep4usmle.com/forum/thread/64952
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| motorola
Forum Extremist
Topics: 66
Posts: 413
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26. eculizumab, a complement antagonist is the new drug used in PNH.
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| motorola
Forum Extremist
Topics: 66
Posts: 413
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27 )
Various secondary Glomerulonephritis
HBV - Membranous
HCV - MPGN
Hodgkins - MCD
HIV - FSGS
typical of SLE - Diffuse Proliferative
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| drbcshah
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These are not my notes but I found them to be useful short form of kaplan OB gyn
Gynecology jillus notes
1. Progression to malignancy in complete mole is 20 %
2. Progrssion to malignancy in incomplete mole is 10 %
3. Taiwan and Philippines history, and H.T < 20wks, AND passage of grape like vesicles < 16wks , suspect molar pregnancy
4. Theca luetin cysts in molar pregnancy
5. MOST COMMON SITE OF MET OF MOLAR PREGNANCY IS THE LUNG
6. Squamous hyperplasia of the vulva =whitish, focal, firm areas
Lichen sclerosis =bluish white papules coalesce to form white plaques
Squamous dysplasia =white red or pigmented and multifocal in location
melanoma of vulva = dark black lesion in vulva
Paget’s disease = red lesion in a postmenopausal female
7. All vulvar lesions should be biopsied
8. Paget’s disease of vulva related to other cancers of git , g.u.,Trt and breast
9. Treatment of vulvar cancer -study
10.The most common cause of death in ovarian ca is BOWEL OBSTRUCTION
11.TUMOUR MARKER FOR OVARIAN CA IS CA 125
12. Ovulation and ocp’s decrease the risk for ovarian carcinoma
13.ovarian cancer is the most common form of gynecological ca leading to death
14. T he current screening test for the ovarian ca is bimanual pelvic examination
15.dysgerminoma is a tumor sensitive toxicity- RAY
16.chemotheraphy to ovarian cancer only if there is metastasis
17.carcinoid syndrome has been described originating from the dermoid cyst
18. The most common cause of post menopausal bleeding is NOT END .CA BUT ITS VAGINAL OR ENDOMETRIAL ATROPHY
19.ADENOMYOSIS is differentiated from endometriosis by the cf of secondary dysmenorrhea and menorarhagia , And tenderness most common immediately before and after the menses and the utx is globular and diffusely enlarged 2- 3 times
20.treat adenomyosis with LVG [levonorgestrol] ius surgery definitive treatment
21.ENDO CERVICAL CURETTAGE IS CONTRAINDICATED IN THE PREGNANCY , AND after the suspicious pap positive do only ecto cervical biopsy ..
22. Before 24wks , treat invasive cervical cancer with radical hysterectomy and radiation therapy
23. After 24 wks , treat cervical cancer invasive with conservative management and then c.s after the lung maturity has completed
24. The pt with distant met from the invasive cerrvical cancer, shud be consisdered chemo and the most effective chemo drug is cisplatin .
25. The initial test for the cervical cancer , [sq ,cell .ca ] is cervical boiopsy
26. Ascus ==hpv 6 r 11 = repeat PAP in one yr
27. Ascus =HPV ?DNA =16 R 18 = EVALUATE WITH colposcopy and biopsy .
28. HPV 6 and 11 asso. with condylomata accuminata
29. Indications for the cone biopsy.
a. abnormal pap
b. abnormal ECC histology
c. lesion seen entering the endocervical canal
d. biopsy showing microinvasive carcinoma of the cx
30 .Most common complication of cone biopsy -incompetent cervix and cervical stenosis.
31. Sexual excitement is by hte parasympathetic connections
32. Sexual orgasm is by the sympathetic connections
33.desire of sexual activty is by the Dopamine stimulationa and seratonin inhibition
34.difficulty in vaginal lubrication becoz of estrogen deficiency
35. After an sexual assualt , the female shud be treated with cphalosporin , doxy and metronidazole and hep b and for pregnancy prevention , 2 large dose tablets of progesterone in 12hrs or LNG tablets are prescribed
36.vaginismus is the only sexual dysfunction tat can be diagniosed on physical examination and treatment is with the vaginal dilators ...
37.in pregnancy post sterlization , suspect == Ectopic
38.copper t =contraception nearly for about 10 yrs
39.. The risk factors for IUD are ,recent chlamydia inf ,vaginal inf , HIV , immunosuppression , and pts with crohns with the treatment of steroids
40. The subserosal fundal fibroid shud not interfere with the IUD placement
41 . If too large sized vaginal diaphragm are used, it results in urinary incontinence
42.T he frequent side effect of POP, i.e. minipill, depot provera , LNG TABLETS ARE ALL BREAK THRO bleeding
43,. Low doses of ocp’s apart from regularising the menses does not cause serious side effects
44.Yeast vaginitis transmitted by candida albicans , is not transmitted sexually ....so partner is not to be treated
45.Mtz IS SAFE TO USE DURING THE PREGNANCY including the first trimester
46. 3RD MOST COMMON Cause of STD in USA is T.V
47.ACUTE SALPHINGO OPHORITIS IS A CLINICAL DIAGNOSIS
48.out patient treatment for PID =oflox + metro =14days
49. Inpatient treatment in toxic pts with PID , is i.v cefoxitin, cefotetan plus doxy or i.v clinda + gentamycin
50.condyloma accuminata - HPV -16 and 18 =cauliflower like mass - clinical diagnosis - treat it with podophyllin , TCA acid , imiquinod
51. Number one STD in females is == Chlamydia
52.transmission of Chlamydia infection from mother to baby may present as Chlamydia conj or otitis media
53. THE CLASSIC CLINICAL FINDING OF CHLAMYDIA IS =mucopurulent cervical discharge
54. DISSEMINATED gonorrhea Presents as DERMATITIS, POLYARTHRALGIAS AND TENOSYNOVITIS
55. SINCE COINFECTION is present between Chlamydia and gono , treat with both ceftriaxone and azithro or doxy
56. Bartholin’s abscess present in gono.. Infection needs Marsupilation
57. PCR AND DNA PROBE FOR CHLAMYDIA
58. SWABS AND THAYER MARTIN MEDIA FOR GONORRHEA
59. The most common site of ectopic is in OVIDUCT AND IN IS IS THE DISTAL AMPULLA
60.SUCTION AND CYRETTAGE IS DONE IN hydatidiform mole and not dilatation and curettage because of the risk of perforation of Uterus.
61 Hormone replacement treatment mainly for the vasomotor symptoms in the female [hot flashes, genitourinary atrophy and dyspareunia ]
62. Hormone replacement therapy for postmenopausal osteoporosis, -anti estrogen med.
63.Tamoxifen is a SERM with Bone and endometrium agonist and breast antagonist
64.Hormone replacement should not be given primarily for prevention of cardiovascular risk
65.Raloxifene has bone agonist and endometrial antagonistic effect
66. Estrogen replacement therapy should be given for a max of 4 yrs ....because of the risk of breast cancer after prolonged period of treatment
67.the most bone type for osteoporosis is trabercular bone and the most common involved site are the vertebral bodies
68.In the postmenopausal female, here is increased gonadotropins [FSH , LH ]AND DECREASED ESTROGEN and the main reason fro all the post menopausal vasomotor effects is because of decreased estrogen
69. The most common cause of mortality in he postmenopausal female is cardiovascular disease
70.clomid acts by fitting into the estrogen receptors and fools the pit by creating a low estrogen state and thus secretes gonadotropins for the For the ovulation induction
71. With clomid the patient is stimulated with the persons own gonadotropins but with HMG , the patient is being stimulated with exogenous gonadotropins
72.LH , FSH ratio increased in PCOD , 3;1 , normal 1.5:1 and sex hormone binding globulin [SHBG] IS DECREASED IN PCOS . OCP’S act by suppressing the testosterone in 2 ways in the treatment of the PCOS BY
1. SUPP THE LH stimulation
2. By increasing SHBG with decreases the free testosterone level
73. IDIOPATHIC OLIGOZOOSPERMIA IS THE MOST COMMON MALE INFERTILITY FACTOR
74 .Ovarian failure occurs before age of 30 yrs and may be associated with autoimmune disease of Y CHROMOSOME mosaicism and so karyotyping is done
75. The most common method of assessing the bone density is with DEXA scan .
76.SSRI;s are the treatment of choice fro the emotional symotoms Of PREMENSTURAL SYNDROME
77. High doses of vit b6 thatis pyridoxine in PREMENSTURAL SYNDROME causes permanent sensory neuropathy and so the consumption of vit b6 shud be discouraged
78.kallman’s syndrome is the inability of hypothalamus to produce GNRH and also anosmia
79. The important cause of premenarcheal vaginal bleeding is the FOREIGN BODY, and the other causes r estrogen medications, sarcoma botryoids , pit . Adrenal and ovarian tumor ,sexual abuse and idiopathic precocious puberty ... and the patient pelvic examination should be done under SEDATION
80.The normal pubertal dev stages can be remembered as T>A>G>M [TAGM] that is thelarchae , adnarchea , growth spurt , menarche
81. Classification of precocious puberty -study
82. FSH stimulates INHIBIN but it is SUPPRESED by INHIBIN
83. DURING the cyclical changes of menstruation the functionalis zone is sloughed off and basalis zone does not undergo any changes and basalis has the basilar arteries.
89. The drug of choice for idiopathic hirsuitism is spironolactone
90. Axillary lymph node status is the important factor in prognosis of patients with breast cancer
91. Hormone receptor status determination is a critical importance as a predictive factor
92.Over expression of HER-2, shows a bad prognosis in the breast cancer
93.The criteria for the excision biopsy in the breast are
#bloody fluid on aspiration of the cyst
#mass does not disappear on fluid aspiration
#bloody nipple discharge with or without the mass
#skin edema and erythema suggestive of inflammatory ca , so needle biopsy could not be performed
#pt who has undergone FNAC before
94.PhyLLODES TUMOUR of the breast behaves like a sarcoma .
95. Mammography should not be performed until 2 wks after the aspiration of cyst or mass in the breast . USG distinguishes the cyst from a solid mass
96. Hyperthyroidism in pregnancy suspect hydatidiform mole
97 .choriocarcinoma is always treated by chemo
98.stress incontinence is treated by surgery
99. Neurogenic bladder treated by medications
100.definitive diagnosis of endometriosis is only by laparoscopy
101 .Flagyl is CONTRAINDICATED IN APREGNANT FEMALE IN THE first trimester but can be given in 2nd and third trimester
102.The best time for the physician to examine the breast is 10-14 days after the menses
103. Fibrocystic disease of the breast is not usually seen in the postmenopausal females
104 . The contraception which is safe for nursing mothers is depot provera
105 . Do regular endometrial samplings on the pt with tamoxifen- because INCREASED RISK FOR ENDOMETRIAL CANCER
106.MICROADENOMA OF THE BREAST < 1cm is treated with bromocriptine , where as macroadenoma is treated with >1cm is treated with surgery
107.The most common side effects of HMG [PERGANOL ] is increased twin pregnancy, ovarian hyperstimulation syndrome, hypovolemia, tachycardia and electrolyte imbalance.
108. Do not remove the testis in less than 20 yrs in testicular feminization syndrome, since testis is the source of estrogen for the breast development and > 20yrs it can be removed since the risk for the testicular cancer
109. External iliac artery ligation in the treatment of PPH , results in the ischemia of the lower limbs
110.ALL ENDOMETRIAL HYPERPLASIAS R TREATED BY PROVERA EXCEPT ATYPICAL HYPERPLASIA WHICH IS TREATED BY HYTERECTOMY SINCE U NEVER CAN sample the entire uterus so 10- 15% is always a carcinoma
111 . Most common epithelial CA of the ovary is SEROUS
112. Dysgerminoma responds well to the radiation
113. Clear serous discharge in the post menopausal female suspect FALLOPIAN TUBE CARCINOMA
114.Hormone replacement therapy does not have a negative effect on the postmenopausal female smokers since the dose of the estrogen is decreased.
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| drbcshah
Forum Elite
Topics: 48
Posts: 227
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Some more notes made by Dr. Jiggy and his step 3 experience
GI questions:
- pt c hematemesis, not actively bleeding -> sclerotherapy
- pt had hematochezia and bluish dicoloration of the cecum -> I don’t know I put angiodysplasia
- toxic megacolon, NPO/IVF/NGT wasn’t enough, then more pain and more fever c free air in abdomen ->laparotomy
- kid swallowed some acid, what to do in ER -> esophagoduodenoscopy
- no questions on h.pylori
- easy question to diagnose achalasia
- question on sjogrens what is next step -> SSA/SSB Ab or parotid biopsy
- guy had halitosis -> zenkers
- several questions on gout -> trial of PPIs
- question on esophageal scleroderma -> trial of PPIs
- guy has heartburn well controlled with antacids, used to have trouble swallowing only steaks, now cannot swallow many solids but liquids is ok -> PPIs or EGD
- diagnose esophageal cancer
- diverticulitis -> ct scan
- woman with jaundice, only + result was HAV IgG, what is she at risk for in the future? HAV, HBV, Hemachromatosis, Hepatocellular Ca, etc.
- pt with hepatic encephalopathy and high Cr -> dialysis
- question was very long, said pt had epigastric pain radiating to upper quadrants, fever, no jaundice, labs weren’t that bad (mildy elevated alk phos) what does she have -> cholecystitis, choledochilithiasis, pancreatitis, bla bla bla…
- Cholecystitis -> abdm U/S
- Older woman with h/o CABG and history of A.fib gets diffuse abdm pain after eating, and has abdm bruit, what does she have? Embolis in SMA, abdm aortic aneurysm, polycystic kidney disease?
- Acute pancreatitis question
- Question on malabsorption, pt had steatorrhea… lol I don’t remember the rest
- Guy had bloody stools and passed out on the floor, recent history of aortofemoral bypass -> I put fistula
- Dx pyloric stenosis
- What is the cause of intussuseption of small bowel in a 65yo? Idiopathic, tumor, cancer of small bowel, lymphadenitis?
- Dx meckels
CARDIO
- Question said positional chest pain, showed EKG of diffuse ST elevation -> pericarditis
- Had two heart murmur audio questions
- IVDA and vegetations on the heart -> tricuspid regurge
- Guy with angina and a.fib -> I put ECG stress test
- Which is the greatest risk factor for CAD? LDL-chol ration, HDL chol ratio, triglycerides, lipids
- Murmur got worse with standing and valsalva -> HOCM
- Kid with cyanosis in the 1st 24hrs of life -> transposition
- Diagnose tamponade
- Kid with holosytolic murmur -> left to right shunt (it’s a vsd)
- Diagnose MVP (said mid-systolic click)
- Diagnose ASD (said wide, fixed S2)
- Endocarditis prophylaxis for dental procedure in a kid with h/o reaction to ampicillin -> clinda
- Teenager with cramps in the legs, muscles on top are bulky, weak on the bottom, bad LE pulses -> coarctation
- Hyperaldosteronism -> PRA ratio
- 3 questions on temporal arteritis (2 dx 1tx)
- woman with renal artery stenosis what is elevated? Rennin
- diagnose dissecting aortic aneurysm -> TEE
- pt had low Na, low K, high Cl on thiazides and ACEI what is the reason for the labs? I put thiazide and ACEI reaction, other choices were hyperaldosteronism, hypoaldosteronism, other stuff
SKIN
- picture of some bad bad acne -> proprionobacterium
- HSV
- How do you treat ringworm > clotrimazole, permethrin, hydrocortisone?
- Pt had dermatitis herpetiformis -> gluten free diet
- Pt had optic glioma what will you find on skin -> café au lait
- Guys nose had a pearly looking thing on it -> basal cell
- Mentally retarted kid with seizures and a skin disorder -> tuberous sclerosis
- Acathosis nigrans -> check glucose
- Kid with DIC
- Picture of a hand with DIP inflammation and said his ankle was very tender -> gout
- Kid went into the woods now has itchyness and rash in a linear pattern -> contact dermatitis
- Mom wants to prevent daughter from getting sunburns ->advise not to go out before 2pm
- Contact dermatitis question -> cell-mediated hypersensitivity
ENDOCRINE
- Guy is depressed after his wife died and labs show high tsh, low t4 -> depression due to medical conidition, other choices were MDD, Adjustment disorder
- Graves disease what Abs are after -> TSH receptor
- Guy with A.fib what must you rule out -> hyperthyroid
- SOOO many questions on diabetes I and II soooooo many. Guy with DKA (give fluids and what type of insulin), guy with DM and foot ulcer (angiography or foot amputation), soooo many know your DM inside out
- Health care worker comes in after fainting has sugar of 40, normal c-peptide -> took insulin
- Guy with low insulin and high c-peptide -> insulinoma
- Guy with rash and high sugar -> glucagonoma
- Dx hyperparathyroidism
- Guy on lithium -> nephrogenic DI
- Dx SIADH
- Guy with loss of facial hair, small testes and is infertile -> check pituitary
- Pt cannot lactate after birth, had postpartum hemorrhage, what is deficient? GnRH, inhibin, progesterone?
- Dx PCOS
Hematology
- 3-4 questions on B12 deficiency
- 3-4 questions on folate deficiency
- what is low in goats milk? folate
- What is low in breast milk? Vit D
- Guy from Saudi Arabia has rash on the face that resolves, MCV is low? Thalassemia
- Sickle cell crisis, after analgesia what do you give? Fluids or transfuse?
- 4-5 questions on iron deficiency
- kid eats anything now has low MCV -> lead poisoning
- I had like 4 questions that starts with a pt who had recurrent nosebleeds.
- One said pt c recurrent nosebleeds on lithium, bupropion and valproic acid, lithium levels are too high what to do next? D/c lithium, d/c valproic acid, d/c buproprion, check platelet level, check AST levels?
- Dx Hemophilia A (question said effusion of blood in the knee)
- Dx von Willebrands
- Question said besides the stockings how else can you prevent DVT? LMW heparin, warfarin, aspirin, tPA.
- Question on HUS (said history of recent infection)
- Dx Henosh-schonlein (said palpable purpura)
ID
- Dx otitis media
- Hard question on sinusitis, know how to differentiate chronic s/s from acute.
- Kid with barking cough -> laryngotrachietis
- A lot of wheezing questions in children
- CSF has RBCs -> HSV
- Pt exposed to so many things, one of them was unpasteurized milk, CSF was normal -> listeria
- Ring-enhanced lesion in the brain in an aids pt prophylaxis -> TMP-SMX
- Kid with h/o meningitis what is the diagnosis to the most common sequela -> confused between tympanometry or air-conduction hearing studies (I know the answer was hearing loss)
- Encephalitis question -> HSV
- Kid c wheezing and has tonsillar inflammation and had trouble opening his mouth but uvula was not displaced and it showed a picture of the lateral neck and asked what it was-> peritonsillar abscess or retropharyngeal abscess im not to sure, know the pix
- Dx pharyngitis
- Nurse with pernichila (the finger infection) that gets it drained, warm compress and Abx, what is next? Keep her away from pts, prophylax all pts, treat all the pateints she was exposed to, etc.
- 2 questions on mycoplasma dx (college students)
- 2 questions on aspiration pneumona
- PPD positive next step -> cxr
- Guy with white fluffy things that don’t scrap off, what is next test? HIV
- 3 questions on Lyme disease
- MANY MANY STD questions, all of them like syphilis, chancroid, gonorrhea, chlamydia, trichomonas (like 4), candida (2)…at least 2 on each one
- Guy with everything that seemed like gout, what is next step? Aspirate fluid from joint (treatment wasn’t an option)
- Had maybe 9-10 questions on the immunodefiencies, know them real well.
- Guy with indurated 5cm mass on thigh and fever, what do you do next? Surgical debridement or I&D?
- Pt has on several meds gets hearing loss, what is the cause? Gentamycin
- CO was low, resistance was high, PCWP was low, what kind of shock?
Rhematology
- How do you treat pseudogout? Indomethacin, hyaluronidase injections, aspirin?
- 3-4 questions on RA
- 2-3 questions on Gout
- 1-2 questions on OA
- pt c psoriasis what else should you find? Clubbing of the finger
- 3 questions on Kawakaki’s disease (2 to dx, 1 to tx)
- dx polymalgia rheumatic
- tx SLE (prednisone)
- how do you treat fibromyalgia
- dx polymyositis
- dx DMD
- kid with recurrent fractures and blue sclera -> collagen 1 deficiency
- Showed picture of carpal tunnels -> median nerve at wrist
- Dx slipped capitus femoral (fat kid with a limp)
- Dx Osgood shlatter (showed picture of tibial tuberosity)
- Dx developmental hip displasia (said mom heard popping when changing diapers)
- Picture of chondrocalcinosis -> pseudogout
OBGYN
- Almost every other question started with G-P- (my test was A LOT of obgyn)
- Dx and tx ectopic
- 4 questions on mole (2 dx like HTN in 1st TM and enlarged uterus 2 tx)
- pt is 31weeks and gets in a car accident now has vaginal bleeding and uterine tenderness -> abruptio placenta
- pt is 11 weeks and has passage of fetal contents but no fetal parts noted, very high hCG -> 46XX
- Pt with TOA keeps getting worse and fever getting higher -> surgery
- Pt c cyst on labia majora, nowhere else, only on the majora -> labial abcess, bartholins abscess, bartholin cyst
- HSV at 39 weeks c 4min contractions c no breakouts while pregnant but she feels weird and said that usually when she feels weird she breaks out, what do you do? C-section, augmentation of labor, tocolysis
- 10cm dilation and after 10 minutes all you get is a “palpable minimal caput” what do you do next? Vacuum, continue contractions, c-section
- 37yo c breast mass and gets lumpectomy and after it showed noninvasive intraductal cancer without margins, what is next step? Tamoxifen, radiation, chemo, observe, or sentinel node bx
- Woman at 28wks had an amnio before and got RhoGAm what do you do now? Administer rhogam again
- Woman has baby that’s too small for gestation age, stress test shows late decelerations what is the cause of the IUGR? Uteroplacental insufficiency
- Mom is smoker while pregnant? IUGR
- What is high in a pt with gestational DM? HPL
- Mom is 34wks and gets severe preeclampsia what will the child suffer from? Sepsis, pulmonary insufficiency (that’s what I put).
- High AFP on triple screen? Anencephaly (other choices were trisomy 21, 13, 18)
- Tx gbs
- Pt with vaginal discharge, turns out fern+ what is the d/c? PROM
- Pt with postpartum hemorrhage, what do you do? Give oxytocin, give prostaglandin, surgery, artery ligation (massage was not an answer)
- Macrosomic kid whose mom had gestation DM gets seizures -> hypoglycemia, hyperglycemia, hypo or hypercalcemia, kalemia, natremia, etc.
- 3 questions on cervical dysplasia
- woman with PCOS is at risk for -> endometrial cancer
- woman who has BMI 33 is at risk for ->endometrial cancer
- woman with menopause and fracture -> dexa
- 2-3 questions on endometriosis
- 2 questions on fibroids
- 57yo with vaginal pruritis -> vulvar cancer
- 14yo girl has not had menses, all her friends make fun of her, physical exam is completely normal, what is the dx? Normal, hypothalamic problem, adrogen insensitivity, turners, etc.
- post menopausal bleeding -> endometrial cancer
- obese F with menstrual cycle problems that when you take pap smear what else should you do? Endometrial biopsy
- woman feels bulging from her vagina, she had a total hysterectomy in the past, she has absolutely no other s/s besides the bulging which gets worse when she stands up -> cystole, rectocele, uterine prolapse?
- Guy who gets urge to pee but pisses on himself before he makes it to the bathroom -> detrusor hyperactivity.
- Know how to treat your STDs!!
- Bloody discharge -> intraductal papilloma
- 37yo woman with breast mass -> mammo, FNA, biopsy, sonogram?
- Menopause lady wants to prevent bone fractures that she seen in her sister, takes no HRT, what should she do? Calcium supplements, estrogen replacement, etc.
SURGERY
- Bleeding from urethral meatus ->retrograde urethrogram
- Dx tension ptx
- Stab wound to stomach -> ex lap
- Guy was on motorcycle crashed into truck and now feels abdm pain, VS are stable, what do you do next? DPL, CT, ex-lap
- Picture of a severely displaced radial bone and pt had no pulses, loss of sensation, and pallor. They said the feeling of the forearm was still very soft, what do you do next? ORIF, fasciotomy, angiography, cast.
- Not too much surgery
Growth development/preventative medicine
- 3yo rides a tricycle, still pees in his bed, can say two worded sentences, is he normal delayed (in each field like social, developmental, motor)
- dx separation anxiety
- kid wants to get circumcised, want should you tell him? Need parents consent
- no formula questions (sensitivity, specificity, odds ratio, bla bla bla)
- dx t-test
- what is the best test to measure incidence? Cohort study
- no bias questions
- if an HIV ELISA test is 99% sensitive and 95% specific, what happens to the sensitivity and specifity if you do “another test” (I don’t know if that meant another ELISA test or a western-blot, so I assumed another elisa and put stays the same)
NEURO
- carotid stenosis of 90% in an asymptomatic pt -> CEA
- how to treat cluster headache? Oxygen
- 3 questions on temporal arteritis
- a question about tremor at rest, not with motion or walking, the answer was related to parkinsons
- Showed a picture of the brain and said the pt had no memory problems but had personality changes, frontal area and temporal area looked atrophied -> Picks
- Guy is taking care of his wife (both really old) and she is getting worse, he promised he wont send her to a nursing facility. He cant afford a nursing aid anymore. Now his wife is making sexual advances and hes disgusted by it. What do you do? Put his wife in assisted living, give him sexual therapy, give him SSRI, give her diazepam.
- Woman with alzheimers is getting more crazy (screaming at her son for stupid reasons), what do you do? Tell her son its normal
- A LOT of dementia questions (not that hard)
- Wet wacky wobbly -> normal pressure hydrocephalus
- Woman who is one week ok and one week very bad (demented c loss of motor function), has history of CABG and her BP is still high -> multi-infarct dementia
- Dx MS
- 2 questions on Guillian barre (both diagnosis, one was hard)
- One question was on ALS, where is the problem -> motor neuron
- Dx subarachnoid
- One question asked what is the fastest way to treat high intracranial pressure? Intubation and hyperventilation, manitol, trendelenburg, head elevation
- Dx Narcolepsy
- Construction worker in the sun all day gets an episode of confusion (just confusion), he is otherwise healthy and on no medications, what is the dx? Heat stroke, malignant hyperthermia, some other dumb answers.
- Old pt with long history of DM and HTN gets progressive loss of vision, on physical exam the eye has no hemorrhages, no cotton wool spots, no neovascularization, what is the dx? Glaucoma, DM retinopathy, HTN retinopathy, cataracts
PULM
- Acute asthma attack tx
- Pt with situs inverses, recurrent pneumonia and bronchiectasis (so your thinking CF) but it says sweat-chloride was negative -> nasal scrapings
- Many questions on pneumonia
- No questions on pulmonary effusions
- 2 questions on sarcoidosis
- Dx asbestosis
- Dx chronic bronchitis (really easy)
- One question said what is the pathyphysiology of chronic bronchitis (what happens to the vessel walls, something about elasticity)
- 13month old kid with sudden inspiratory wheezing, CXR shows hyperinflation of just the right lung but no foreign object what is next step? Scope
- Dx Aspiration pneumonia. One question said what is the pneumonia consisting of? Gram + only, gram – only, both, gram + and anaerobes, gram – and anaerobes, etc.
- Dx TB (question even said positive PPD)
- Dx atelectasis (fever a few hours after surgery)
- 2-3 questions on ARDS
- One on neonatal ARDS, what to tx with? Surfactant
- Women suspected of having PE, the V/Q scan was negative what do you do next? Spiral CT, d-dimer, CXR, ekg (angiography wasn’t there)
- Pt with PE what do you give? Heparin
RENAL
- I had about 10-15 renal questions, some really hard. 6 of them were in that category where you have a million answers and they give you 2 or 3 questions on the same answers. What else can I say but know your renal!!
- Guy had testicular mass, ultrasound confirms that it is a solid mass, what is the next step? Excisional biopsy or orchiectomy?
- 2 questions on BPH (dx)
- Pathophysiology of post-strep GN? I put destruction of foot processes (they didn’t have fusion)
- Muddy casts -> ATN
- Pt in car accident, CK level is off the roof, what is he at risk of? ATN
PSYCH
- Pt with depression and starts hearing voices for ONE week -> MDD, schizoaffective, schizophrenia, bipolar.
- Guy with narcolepsy, how to treat? I put methylphenidate
- Dx ADHD
- Dx anorexia
- Dx delerium
- Kid wondering the street at 2am, high BP, dilated pupils, combative and paranoid, what drug did he abuse
- Girl is found unconscious, high BP, dilated pupils, what drug?
- Woman is found wondering the streets, not oriented, dilated pupils, question said what should you give her, I put thiamine (other choices were naloxone, flumazenil, etc)
- Guy feels spiders on hit feet when hes trying to fall asleep, and he cant fall asleep because of it, what is the dx? Restless leg syndrome
- Another question on restless leg syndrome, the drug is aimed at what? Dopamine, serotinin, NE, Ach, etc.
- Girl is in love with the TV anchorman, keeps writing him letters, waits at his job, believes they will marry, what is the dx? Delusional
- 2 questions on the adverse effects of phenytoin, one was rash
- dx adjustment disorder
- dx normal bereavement
- Professor gets sweating and nervous when he gets on stage in any other place but his own university – panic disorder
- Dx social phobia
- Person feels like theyre in another place (sounds like depersonalization), but it happened after they were put at gunpoint and robbed. Now she has nightmares and can never go to the same place again, but denies having flashbacks -> PTSD, depersonalization, and other stupid answers
- Dx primary insomnia
- Woman has twins that are 2yo and now she feels loss of interest, cant sleep, hates doing anything, what is the next step? Assess suicide.
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* Re:Roh, elbaa, positive08..
#1002408
pyschotic - 10/20/07 14:11
hi dear bdj were you looking for these question from dr jiggy i have just got it.
GI questions:
- pt c hematemesis, not actively bleeding -> sclerotherapy
- pt had hematochezia and bluish dicoloration of the cecum -> I don’t know I put angiodysplasia
- toxic megacolon, NPO/IVF/NGT wasn’t enough, then more pain and more fever c free air in abdomen ->laparotomy
- kid swallowed some acid, what to do in ER -> esophagoduodenoscopy
- no questions on h.pylori
- easy question to diagnose achalasia
- question on sjogrens what is next step -> SSA/SSB Ab or parotid biopsy
- guy had halitosis -> zenkers
- several questions on gout -> trial of PPIs
- question on esophageal scleroderma -> trial of PPIs
- guy has heartburn well controlled with antacids, used to have trouble swallowing only steaks, now cannot swallow many solids but liquids is ok -> PPIs or EGD
- diagnose esophageal cancer
- diverticulitis -> ct scan
- woman with jaundice, only + result was HAV IgG, what is she at risk for in the future? HAV, HBV, Hemachromatosis, Hepatocellular Ca, etc.
- pt with hepatic encephalopathy and high Cr -> dialysis
- question was very long, said pt had epigastric pain radiating to upper quadrants, fever, no jaundice, labs weren’t that bad (mildy elevated alk phos) what does she have -> cholecystitis, choledochilithiasis, pancreatitis, bla bla bla…
- Cholecystitis -> abdm U/S
- Older woman with h/o CABG and history of A.fib gets diffuse abdm pain after eating, and has abdm bruit, what does she have? Embolis in SMA, abdm aortic aneurysm, polycystic kidney disease?
- Acute pancreatitis question
- Question on malabsorption, pt had steatorrhea… lol I don’t remember the rest
- Guy had bloody stools and passed out on the floor, recent history of aortofemoral bypass -> I put fistula
- Dx pyloric stenosis
- What is the cause of intussuseption of small bowel in a 65yo? Idiopathic, tumor, cancer of small bowel, lymphadenitis?
- Dx meckels
CARDIO
- Question said positional chest pain, showed EKG of diffuse ST elevation -> pericarditis
- Had two heart murmur audio questions
- IVDA and vegetations on the heart -> tricuspid regurge
- Guy with angina and a.fib -> I put ECG stress test
- Which is the greatest risk factor for CAD? LDL-chol ration, HDL chol ratio, triglycerides, lipids
- Murmur got worse with standing and valsalva -> HOCM
- Kid with cyanosis in the 1st 24hrs of life -> transposition
- Diagnose tamponade
- Kid with holosytolic murmur -> left to right shunt (it’s a vsd)
- Diagnose MVP (said mid-systolic click)
- Diagnose ASD (said wide, fixed S2)
- Endocarditis prophylaxis for dental procedure in a kid with h/o reaction to ampicillin -> clinda
- Teenager with cramps in the legs, muscles on top are bulky, weak on the bottom, bad LE pulses -> coarctation
- Hyperaldosteronism -> PRA ratio
- 3 questions on temporal arteritis (2 dx 1tx)
- woman with renal artery stenosis what is elevated? Rennin
- diagnose dissecting aortic aneurysm -> TEE
- pt had low Na, low K, high Cl on thiazides and ACEI what is the reason for the labs? I put thiazide and ACEI reaction, other choices were hyperaldosteronism, hypoaldosteronism, other stuff
SKIN
- picture of some bad bad acne -> proprionobacterium
- HSV
- How do you treat ringworm > clotrimazole, permethrin, hydrocortisone?
- Pt had dermatitis herpetiformis -> gluten free diet
- Pt had optic glioma what will you find on skin -> café au lait
- Guys nose had a pearly looking thing on it -> basal cell
- Mentally retarted kid with seizures and a skin disorder -> tuberous sclerosis
- Acathosis nigrans -> check glucose
- Kid with DIC
- Picture of a hand with DIP inflammation and said his ankle was very tender -> gout
- Kid went into the woods now has itchyness and rash in a linear pattern -> contact dermatitis
- Mom wants to prevent daughter from getting sunburns ->advise not to go out before 2pm
- Contact dermatitis question -> cell-mediated hypersensitivity
ENDOCRINE
- Guy is depressed after his wife died and labs show high tsh, low t4 -> depression due to medical conidition, other choices were MDD, Adjustment disorder
- Graves disease what Abs are after -> TSH receptor
- Guy with A.fib what must you rule out -> hyperthyroid
- SOOO many questions on diabetes I and II soooooo many. Guy with DKA (give fluids and what type of insulin), guy with DM and foot ulcer (angiography or foot amputation), soooo many know your DM inside out
- Health care worker comes in after fainting has sugar of 40, normal c-peptide -> took insulin
- Guy with low insulin and high c-peptide -> insulinoma
- Guy with rash and high sugar -> glucagonoma
- Dx hyperparathyroidism
- Guy on lithium -> nephrogenic DI
- Dx SIADH
- Guy with loss of facial hair, small testes and is infertile -> check pituitary
- Pt cannot lactate after birth, had postpartum hemorrhage, what is deficient? GnRH, inhibin, progesterone?
- Dx PCOS
Hematology
- 3-4 questions on B12 deficiency
- 3-4 questions on folate deficiency
- what is low in goats milk? folate
- What is low in breast milk? Vit D
- Guy from Saudi Arabia has rash on the face that resolves, MCV is low? Thalassemia
- Sickle cell crisis, after analgesia what do you give? Fluids or transfuse?
- 4-5 questions on iron deficiency
- kid eats anything now has low MCV -> lead poisoning
- I had like 4 questions that starts with a pt who had recurrent nosebleeds.
- One said pt c recurrent nosebleeds on lithium, bupropion and valproic acid, lithium levels are too high what to do next? D/c lithium, d/c valproic acid, d/c buproprion, check platelet level, check AST levels?
- Dx Hemophilia A (question said effusion of blood in the knee)
- Dx von Willebrands
- Question said besides the stockings how else can you prevent DVT? LMW heparin, warfarin, aspirin, tPA.
- Question on HUS (said history of recent infection)
- Dx Henosh-schonlein (said palpable purpura)
ID
- Dx otitis media
- Hard question on sinusitis, know how to differentiate chronic s/s from acute.
- Kid with barking cough -> laryngotrachietis
- A lot of wheezing questions in children
- CSF has RBCs -> HSV
- Pt exposed to so many things, one of them was unpasteurized milk, CSF was normal -> listeria
- Ring-enhanced lesion in the brain in an aids pt prophylaxis -> TMP-SMX
- Kid with h/o meningitis what is the diagnosis to the most common sequela -> confused between tympanometry or air-conduction hearing studies (I know the answer was hearing loss)
- Encephalitis question -> HSV
- Kid c wheezing and has tonsillar inflammation and had trouble opening his mouth but uvula was not displaced and it showed a picture of the lateral neck and asked what it was-> peritonsillar abscess or retropharyngeal abscess im not to sure, know the pix
- Dx pharyngitis
- Nurse with pernichila (the finger infection) that gets it drained, warm compress and Abx, what is next? Keep her away from pts, prophylax all pts, treat all the pateints she was exposed to, etc.
- 2 questions on mycoplasma dx (college students)
- 2 questions on aspiration pneumona
- PPD positive next step -> cxr
- Guy with white fluffy things that don’t scrap off, what is next test? HIV
- 3 questions on Lyme disease
- MANY MANY STD questions, all of them like syphilis, chancroid, gonorrhea, chlamydia, trichomonas (like 4), candida (2)…at least 2 on each one
- Guy with everything that seemed like gout, what is next step? Aspirate fluid from joint (treatment wasn’t an option)
- Had maybe 9-10 questions on the immunodefiencies, know them real well.
- Guy with indurated 5cm mass on thigh and fever, what do you do next? Surgical debridement or I&D?
- Pt has on several meds gets hearing loss, what is the cause? Gentamycin
- CO was low, resistance was high, PCWP was low, what kind of shock?
Rhematology
- How do you treat pseudogout? Indomethacin, hyaluronidase injections, aspirin?
- 3-4 questions on RA
- 2-3 questions on Gout
- 1-2 questions on OA
- pt c psoriasis what else should you find? Clubbing of the finger
- 3 questions on Kawakaki’s disease (2 to dx, 1 to tx)
- dx polymalgia rheumatic
- tx SLE (prednisone)
- how do you treat fibromyalgia
- dx polymyositis
- dx DMD
- kid with recurrent fractures and blue sclera -> collagen 1 deficiency
- Showed picture of carpal tunnels -> median nerve at wrist
- Dx slipped capitus femoral (fat kid with a limp)
- Dx Osgood shlatter (showed picture of tibial tuberosity)
- Dx developmental hip displasia (said mom heard popping when changing diapers)
- Picture of chondrocalcinosis -> pseudogout
OBGYN
- Almost every other question started with G-P- (my test was A LOT of obgyn)
- Dx and tx ectopic
- 4 questions on mole (2 dx like HTN in 1st TM and enlarged uterus 2 tx)
- pt is 31weeks and gets in a car accident now has vaginal bleeding and uterine tenderness -> abruptio placenta
- pt is 11 weeks and has passage of fetal contents but no fetal parts noted, very high hCG -> 46XX
- Pt with TOA keeps getting worse and fever getting higher -> surgery
- Pt c cyst on labia majora, nowhere else, only on the majora -> labial abcess, bartholins abscess, bartholin cyst
- HSV at 39 weeks c 4min contractions c no breakouts while pregnant but she feels weird and said that usually when she feels weird she breaks out, what do you do? C-section, augmentation of labor, tocolysis
- 10cm dilation and after 10 minutes all you get is a “palpable minimal caput” what do you do next? Vacuum, continue contractions, c-section
- 37yo c breast mass and gets lumpectomy and after it showed noninvasive intraductal cancer without margins, what is next step? Tamoxifen, radiation, chemo, observe, or sentinel node bx
- Woman at 28wks had an amnio before and got RhoGAm what do you do now? Administer rhogam again
- Woman has baby that’s too small for gestation age, stress test shows late decelerations what is the cause of the IUGR? Uteroplacental insufficiency
- Mom is smoker while pregnant? IUGR
- What is high in a pt with gestational DM? HPL
- Mom is 34wks and gets severe preeclampsia what will the child suffer from? Sepsis, pulmonary insufficiency (that’s what I put).
- High AFP on triple screen? Anencephaly (other choices were trisomy 21, 13, 18)
- Tx gbs
- Pt with vaginal discharge, turns out fern+ what is the d/c? PROM
- Pt with postpartum hemorrhage, what do you do? Give oxytocin, give prostaglandin, surgery, artery ligation (massage was not an answer)
- Macrosomic kid whose mom had gestation DM gets seizures -> hypoglycemia, hyperglycemia, hypo or hypercalcemia, kalemia, natremia, etc.
- 3 questions on cervical dysplasia
- woman with PCOS is at risk for -> endometrial cancer
- woman who has BMI 33 is at risk for ->endometrial cancer
- woman with menopause and fracture -> dexa
- 2-3 questions on endometriosis
- 2 questions on fibroids
- 57yo with vaginal pruritis -> vulvar cancer
- 14yo girl has not had menses, all her friends make fun of her, physical exam is completely normal, what is the dx? Normal, hypothalamic problem, adrogen insensitivity, turners, etc.
- post menopausal bleeding -> endometrial cancer
- obese F with menstrual cycle problems that when you take pap smear what else should you do? Endometrial biopsy
- woman feels bulging from her vagina, she had a total hysterectomy in the past, she has absolutely no other s/s besides the bulging which gets worse when she stands up -> cystole, rectocele, uterine prolapse?
- Guy who gets urge to pee but pisses on himself before he makes it to the bathroom -> detrusor hyperactivity.
- Know how to treat your STDs!!
- Bloody discharge -> intraductal papilloma
- 37yo woman with breast mass -> mammo, FNA, biopsy, sonogram?
- Menopause lady wants to prevent bone fractures that she seen in her sister, takes no HRT, what should she do? Calcium supplements, estrogen replacement, etc.
SURGERY
- Bleeding from urethral meatus ->retrograde urethrogram
- Dx tension ptx
- Stab wound to stomach -> ex lap
- Guy was on motorcycle crashed into truck and now feels abdm pain, VS are stable, what do you do next? DPL, CT, ex-lap
- Picture of a severely displaced radial bone and pt had no pulses, loss of sensation, and pallor. They said the feeling of the forearm was still very soft, what do you do next? ORIF, fasciotomy, angiography, cast.
- Not too much surgery
Growth development/preventative medicine
- 3yo rides a tricycle, still pees in his bed, can say two worded sentences, is he normal delayed (in each field like social, developmental, motor)
- dx separation anxiety
- kid wants to get circumcised, want should you tell him? Need parents consent
- no formula questions (sensitivity, specificity, odds ratio, bla bla bla)
- dx t-test
- what is the best test to measure incidence? Cohort study
- no bias questions
- if an HIV ELISA test is 99% sensitive and 95% specific, what happens to the sensitivity and specifity if you do “another test” (I don’t know if that meant another ELISA test or a western-blot, so I assumed another elisa and put stays the same)
NEURO
- carotid stenosis of 90% in an asymptomatic pt -> CEA
- how to treat cluster headache? Oxygen
- 3 questions on temporal arteritis
- a question about tremor at rest, not with motion or walking, the answer was related to parkinsons
- Showed a picture of the brain and said the pt had no memory problems but had personality changes, frontal area and temporal area looked atrophied -> Picks
- Guy is taking care of his wife (both really old) and she is getting worse, he promised he wont send her to a nursing facility. He cant afford a nursing aid anymore. Now his wife is making sexual advances and hes disgusted by it. What do you do? Put his wife in assisted living, give him sexual therapy, give him SSRI, give her diazepam.
- Woman with alzheimers is getting more crazy (screaming at her son for stupid reasons), what do you do? Tell her son its normal
- A LOT of dementia questions (not that hard)
- Wet wacky wobbly -> normal pressure hydrocephalus
- Woman who is one week ok and one week very bad (demented c loss of motor function), has history of CABG and her BP is still high -> multi-infarct dementia
- Dx MS
- 2 questions on Guillian barre (both diagnosis, one was hard)
- One question was on ALS, where is the problem -> motor neuron
- Dx subarachnoid
- One question asked what is the fastest way to treat high intracranial pressure? Intubation and hyperventilation, manitol, trendelenburg, head elevation
- Dx Narcolepsy
- Construction worker in the sun all day gets an episode of confusion (just confusion), he is otherwise healthy and on no medications, what is the dx? Heat stroke, malignant hyperthermia, some other dumb answers.
- Old pt with long history of DM and HTN gets progressive loss of vision, on physical exam the eye has no hemorrhages, no cotton wool spots, no neovascularization, what is the dx? Glaucoma, DM retinopathy, HTN retinopathy, cataracts
PULM
- Acute asthma attack tx
- Pt with situs inverses, recurrent pneumonia and bronchiectasis (so your thinking CF) but it says sweat-chloride was negative -> nasal scrapings
- Many questions on pneumonia
- No questions on pulmonary effusions
- sarcoidosis
- Dx asbestosis
- Dx chronic bronchitis (really easy)
- One question said what is the pathyphysiology of chronic bronchitis (what happens to the vessel walls, something about elasticity)
- 13month old kid with sudden inspiratory wheezing, CXR shows hyperinflation of just the right lung but no foreign object what is next step? Scope
- Dx Aspiration pneumonia. One question said what is the pneumonia consisting of? Gram + only, gram – only, both, gram + and anaerobes, gram – and anaerobes, etc.
- Dx TB (question even said positive PPD)
- Dx atelectasis (fever a few hours after surgery)
- 2-3 questions on ARDS
- One on neonatal ARDS, what to tx with? Surfactant
- Women suspected of having PE, the V/Q scan was negative what do you do next? Spiral CT, d-dimer, CXR, ekg (angiography wasn’t there)
- Pt with PE what do you give? Heparin
RENAL
- Guy had testicular mass, ultrasound confirms that it is a solid mass, what is the next step? Excisional biopsy or orchiectomy?
- 2 questions on BPH (dx)
- Pathophysiology of post-strep GN? I put destruction of foot processes (they didn’t have fusion)
- Muddy casts -> ATN
- Pt in car accident, CK level is off the roof, what is he at risk of? ATN
PSYCH
- Pt with depression and starts hearing voices for ONE week -> MDD, schizoaffective, schizophrenia, bipolar.
- Guy with narcolepsy, how to treat? I put methylphenidate
- Dx ADHD
- Dx anorexia
- Dx delerium
- Kid wondering the street at 2am, high BP, dilated pupils, combative and paranoid, what drug did he abuse
- Girl is found unconscious, high BP, dilated pupils, what drug?
- Woman is found wondering the streets, not oriented, dilated pupils, question said what should you give her, I put thiamine (other choices were naloxone, flumazenil, etc)
- Guy feels spiders on hit feet when hes trying to fall asleep, and he cant fall asleep because of it, what is the dx? Restless leg syndrome
- Another question on restless leg syndrome, the drug is aimed at what? Dopamine, serotinin, NE, Ach, etc.
- Girl is in love with the TV anchorman, keeps writing him letters, waits at his job, believes they will marry, what is the dx? Delusional
- 2 questions on the adverse effects of phenytoin, one was rash
- dx adjustment disorder
- dx normal bereavement
- Professor gets sweating and nervous when he gets on stage in any other place but his own university – panic disorder
- Dx social phobia
- Person feels like theyre in another place (sounds like depersonalization), but it happened after they were put at gunpoint and robbed. Now she has nightmares and can never go to the same place again, but denies having flashbacks -> PTSD, depersonalization, and other stupid answers
- Dx primary insomnia
- Woman has twins that are 2yo and now she feels loss of interest, cant sleep, hates doing anything, what is the next step? Assess suicide.
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