All about the heart
Women's Health
MSK
Instant Recall
Bugs
100
Name 2 absolute contraindications to exercise stress testing.
1. Severe CHF
2. Significant aortic stenosis
3. Myocarditis,
4. Unstable angina and/or acute MI within 2 day
5. Recent PE
6. BP >200/120
100
What do late declerations on a FHT represent?
Placental insufficiency
100
A 5y/o boy with acute L anterior thigh and hip pain, had a viral URI 7 days ago. The boy has a low grade fever and cannot bear weight but there is no obvious joint swelling. What is the most likely diagnosis?
Transient (toxic) synovitis.
100
Skin lesion that is found by looking for "ABCDE" and what the letters stand for.
Melanoma:
A- asymmetric shape
B- borders irregular
C- color variegated
D- diameter >6 mm E- enlargement of any lesion
100
At what CD4 count do you start prophylaxis for Pneumocystis jirovecii pneumonia? What do you use? Name 2 out of 3 possibilities.
CD4<200.
1. TMP-SMX
2. Dapsone
3. Atovaquone
200
22 yo F p/w a history of palpitations. Currently she denies any dizziness or palpitations. You capture the arrhythmia on the monitor in your office: isolated PACs. She is otherwise healthy, does not take any medications, and has no FHx of arrhythmia. How would you treat this patient?
No treatment unless symptomatic. A beta blocker like metoprolol may help to reduce symptomatic PACs
200
What is the Quad Screen Results for Down Syndrome?
High or Low for each one: Maternal Serum AFP, estriol, beta-hCG, and inhibin A
Low Maternal Serum AFP
Low Estriol
High beta-hCG
High inhibin A
200
15 yo F cross country runner with knee pain that has been gradually increasing since the start of the season 3 weeks ago. Pain is anterior, mild swelling, + crepitus and pain worse with climbing stairs and running. What is the most likely diagnosis?
Patellofemoral syndrome.
200
Define SIRS Criteria.
Temp: > 100.4°F (38°C) or < 96.8°F (36°C)
Pulse: >90
Respiration Rate: >20 (or PaCO2 <32)
Leukocytes: >12000 or <4000 or >10% bands
200
Name the 3 most common causes of CAP?
1. Strep pneumoniae
2. H. influenzae
3. Atypicals - Mycoplasma pneumoniae
300
Which NYHA class of CHF is a good candidate for spironolactone?
has been shown to reduce mortality in patients with NYHA Class 3-4
300
What is the most common STD in the US?
HPV
300
A 2 yo M accompanied by a mom for not using his right arm. According to mom, the child was unwilling to leave the sandbox and a tug of war ensued with mom eventually picking the child by his forearm. What happened?
Radial head subluxation (nursemaid's elbow)
300
What are the indications for emergent HD? There are 5, must get at least 3.
1. Acidosis
2.Electrolytes
3. Ingestion (toxins)
4. Overload (volume)
5. Uremic symptoms (encephalopathy, pericarditis)
300
3 most common causes of bacterial meningitis in neonates (0-4 weeks)?
1. Group B strep
2. E.coli
3. Listeria
400
A 78-year-old male with past medical history of coronary artery disease presents to the emergency department for a 2-week history of intermittent episodes of lightheadedness and dizziness. Basic labs along with troponin and electrocardiogram were ordered as seen in the image below.
Junctional Rhythm
400
28 yo G1P0 at 8 weeks by sure LMP presents to establish care. She is healthy, takes no medications. BP 112/68, HR 76, Temp 36.7, wt 140lbs, ht 5 feet 4 inches. She wants to know how much weight she should gain. What do you recommend.
Normal Weight 18.5–24.9: 25–35 lbs (ACOG, 1/2013)
400
What is the first ligament injured with an inversion ankle sprain?
Anterior talofibular ligament (ATFL)
400
"CRASH and Burn..." is what you look for in this disease. Define CRASH acronym and Burn.
Kawasaki Disease (aka Mucocutanous Lymph Node Syndrome)
C - Conjunctivitis
R- Rash
A- Arthritis
S- Strawberry Tongue
H- Hands - Skin peeling
BURN- Uncontrolled high fever lasting >5 days.
400
Name the 2 most common organisms responsible for toxic shock syndrome.
1. Saphylococcus aureus (Staph)
2. Group A Streptococcus (Strep. )
500
According to the 2013 Heart Rhythm Society (HRS), what would support the diagnosis of Brugada syndrome:
- presence of first degree AV block and left axis deviation on EKG
- atrial fibrillation
- late potentials seen on signal-averaged EKG
- fragmented QRS complex
- ST-T wave alternans with spontaneous ventricular premature beats in a left bundle branch block pattern on prolonged EKG recording
- absence of structural heart disease, including myocardial ischemia
500
A 55y/o G0 postmenopausal woman presents for routine f/u. She states that last month she had 2 episodes of vaginal spotting that self resolved. She has no other sx. You order a TVUS. At what endometrial thickness is an endometrial biopsy indicated?
>4 mm (per ACOG) >5 mm (per radiological society)
500
25 yo M with a h/o a soccer injury. Someone fell on his R foot while trying to steal a ball. The patient is rapidly and forcefully twisted around the fixed foot. Since then, he has had significant pain and swelling of his midfoot. Xrays show a widened space b/t first and second metatarsals. What does this patient have?
LISFRANC fracture
500
What is the Thrombotic Thrombocytopenic Purpura pentad?
1. Renal failure Fever
2. Anemia (microangiopathic hemolytic)
3. Seizure (ie. neurologic signs, AMS)
4. Thrombocytopenia - HUS + fever and fluctuating neuro signs
Causes: HIV, pregnancy, lupus, cancer, organ transplant - TOC: plasmapheresis
500
Diarrhea caused by this bug is associated with Hemolytic Uremic Syndrome.
E.coli - usually the strain known as O157:H7.