NBME Flashcards


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created 11 years ago by ellie321
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updated 11 years ago by ellie321
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1

Kawasaki

IVIG

2

TET

- boot-shaped
- blue when feeding

3

Hypothyroidism

can cause HLD

4

19 yo breast mass

fibroadenoma (not fibrocystic change)

5

Strep Viridens

gram positive cocci in chains

6

Hep B mom

IVIG + vaccine
- can continue breast feeding

7

Gout

needle vs rhomboid
WBC 100 vs 20,000

8

Psoriasis vs atopic dermatitis

Atopic dermatitis
- presents at age < 5
- flexor surfaces
- assocaited with asthma, allergic rhinitis
- "scratch that itches"
- risk for impetigo

Psoriasis
- extensor surfaces
-

9

encephalitis

HSV = bitemporal hyperintensities (MRI)
CMV = intracranial calcifications (CT)

Not unusual for CSF to have RBCs, leukocytosis with either lymphs or neutrophils, slightly elevated protein, normal glucose

*monocytes (aka macrophages) on CSF

10

Lung Ca

?

11

Toxic Shock Syndrome = Staph Aureus

risk factors = barrier contraceptives, tampons

= Fever + Rash + hypotention + 3:
- GI (n/v)
- muscular (myalgia)
- mucous membrane (cervical ulceration)
- renal
- hepatic
- CNS

Treatment:
1. iv nafcillin + gent (aminoglycoside)
2. iv methicillin + gent
3. iv vancomycin (if possibly MRSA)
--generally requires pressor support

12

Testicular torsion vs Epididymitis

Torsion
- age < 30
- testis elevated into inguinal canal
- pain not relieved by elevation
- *immediate surgery*

Epididymitis
- age > 30
- swollen, urethral discharge/urethritis/prostatitis
- pain decreases with elevation
- Abx:
---chlamydia: azithromycin or doxycyclin
---gonorrhea: IM ceftriaxone or cipro/levo
---UTI/E.Coli: TMP-SMZ or cipro

13

AIDS CD4 < 500

- pneumonias
- TB
- vaginal candidiasis
- herpes zoster

14

AIDS CD4 < 200

(start PCP prophylaxis)
(start toxo proph at CD < 100 by increasing TMP-SMZ)

- PCP (pneumocystis jirovecu) = fungus
---giemsa or silver stain
---dry cough
---elevated LDH
---if PO2 < 70 or A-a > 35: Give Steroids!
---Treat: TMP-SMZ

- toxoplasmosis (know how to differentiate from CNS lymphoma) = protozoa
---multiple ring enhancing lesions near basal ganglia
---treat: sulfadiazine + pyrimethamine
(if not improve, it's CNS lymphoma..can check EBV)

- cryptococcosis (meningitis) = fungus
---CSF pressure high...need multiple therapeutic taps
---stain CSF with india ink to visualize yeast
---vague, chronic, indolent infection

- histoplasmosis

15

AIDS CD4 < 50

- MAC
---chronic watery diarrhea
---diagnose via blood culture
---Treat: clarithromycin, ethambutol, rifabutin for weeks

- CMV (retinitis, esophagitis, colitis)

- CNS lymphoma

16

axillary subclavian venous thrombosis
?????????

jackhammer operator with pain/swelling right arm
cap refill < 3s

17

cholesteoma

- epithelia tissue proliferation behind eardrum
- seen in kids with recurrent ear infections
- can result in hearing loss
- "The metabolically active squamous epithelium has the ability to erode bone: first the delicate ossicles (picture 2) and then the solid cortices of the temporal bone. The keratin debris may become infected following water exposure or a middle ear infection, resulting in chronic purulent drainage"

"Cholesteatomas that are not surgically excised continue to enlarge. Complications may include hearing loss, cranial nerve palsies, vertigo, and potentially life-threatening infection (eg, meningitis, brain abscess)"

18

Acute Asthma

- inhaled glucocorticoids DO NOT HELP !!!!

**Inhaled B-2 ag + oral glucocorticoid**
can also give ipratropium (inhaled anticholinergic)

19

Needle stick with HIV+

start reverse transcriptase inhibitor!!
(don't wait for tests)

20
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Pampiniform plexus

Varicocele
- left spermatic vein enters renal vein at right angle
- can be bilateral
- if unilateral on the right, look for something compressing IVC

21
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Hydrocele

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Fluid between tunica viceral and perietal tunica vaginalis and