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Opthalmology
Ear, Nose & Throat
Dermatology
Neurology
Environmental Medicine
100
Do visual changes in patients with chronic open-angle glaucoma begin centrally or peripherally?
Peripherally. Patients with chronic glaucoma experience a gradual and painless loss of vision. Those with acute or subacute angle glaucoma have dull or severe pain, blurry vision, lacrimation, and even nausea and vomiting. The pain may be more severe in the dark.
100
What is the most common oral cancer in the United States?
Squamous cell carcinoma, which accounts for approximately 90% of oral cancers in the United States. Incidence increases with age. Tobacco use and heavy ethanol use are principal risk factors and are associated in 75% of cases. Sixty percent of oral cases are advanced at time of diagnosis, and another cancer in such sites as the larynx, esophagus, or lung are found in approximately 15% of patients.
100
In what area are Candida albicans infections of the skin most commonly located?
The intertriginous areas (i.e., in the folds of the skin, axilla, groin, or under the breasts). C albicans appears as a beefy, red rash with satellite lesions.
100
Does early treatment with IV immunoglobulin or plasmapheresis accelerate recovery from GBS?
Yes. It also diminishes the incidence of long-term neurologic disability.
100
How is frostnip treated ?
It is treated by warming the affected areas by using the hands, breathing on the skin, or by placing the exposed extremities in the armpits. The affected part should not be rubbed because this treatment does not thaw the tissue completely. Frostnip is the only form of frostbite that can be treated at the scene.
200
At funduscopic examination, what are micro aneurysms and soft exudates typical of?
Hypertension
200
What systemic sexually transmitted disease is associated with sensorineutral hearing loss?
Syphilis. Seven percent of patients with idiopathic hearing loss test positive for treponemal antibodies.
200
What are the 2 main organisms responsible for tinea capitis?
1. Microsporum canis, 2. T tonsurans, which is the more contagious
200
What is the most common malignant brain tumor in adults?
Glioblastoma
200
If a child is bitten in the scalp by a dog, what study must be performed before discharge of the patient from the emergency department?
The jaws of a large dog can exert a force of more than 450 psi, which is sufficient to penetrate light sheet metal and can inflict serious injury, especially in young children. With a bite to the scalp, the dog's teeth may penetrate the skull, which can cause a depressed skull fracture; local infection; and eventually, brain abscess. Thus, skull radiography or computed tomography (CT) should be performed in all patients with a dog bite to the scalp, even if the only visible injury is a puncture.
300
A patient presents with eye pain. She has a constricted pupil, ciliary flush, and red injected sclera at the limbus. What is the diagnosis?
Acute iritis
300
Where do salivary gland stones most frequently develop?
Eighty percent are submandibular. The least likely location is the sublingual gland.
300
A patient presents with a raised, red, small and painful plaque on the face. At examination a distinct, sharp, advancing edge is noted. What is the most likely cause?
Erysipelas, which is caused by group A streptococci. When the face is involved, the patient should be admitted to the hospital and treated with intravenous antibiotics.
300
Where are congenital berry aneurysms located?
In the circle of Willis.
300
What animals are the most prevalent vectors of rabies in the world? In the United States?
Worldwide, the dog is the most common carrier of rabies. In the United States, the skunk has become the primary carrier; in descending order, bats, raccoons, cows, dogs, foxes, and cats are also carriers.
400
What is the most common organism in contact lens-associated corneal ulcers?
Pseudomonas
400
What is the most common type of malignant parotid gland tumor?
Mucoepidermoid carcinoma. Other types of malignant tumors are acinic cell carcinoma, adenocarcinoma, malignant mixed tumor, adenoid cystic carcinoma, and epidermoid carcinoma.
400
Patients with what conditions are more likely to develop vitiligo? (Name 3)
Diabetes mellitus, Addison disease, thyroid disorders, and pernicious anemia. Vitiligo results from an immune-medicated destruction of melanocytes and is found in 1% of the general population.
400
Which cranial nerve is the most affected in pseudotumor cerebri?
Cranial nerve IV can be involved, with clinical signs of diplopia. Other findings include decreased visual acuity and restricted peripheral fields with enlargement of the blind spot.
400
What is the most common arrhythmia in patients with hypothermia?
Atrial fibrillation. Other electrocardiographic (ECG) findings include paroxysmal atrial tachycardia; prolongation of the PR, QRS, or QT waves; decreased P-wave amplitude; T-wave changes; premature ventricular contractions; or humped ST-wave segment adjacent to the QRS complex (Osborn wave).
500
What are the most common infective causes of ophthalmia neonatorium? (Name 3)
staphylococcus aureus; streptococcus pyogenes; Neisseria gonorrhoeae; herpes simplex virus; chlamydia
500
A patient presents with a swollen, tender, red left auricle. What is the diagnosis and what is the most likely cause (be specific)?
Perichondritis. This is most often caused by Pseudomonas.
500
Describe the Koebner phenomenon.
The development of plaques in areas where trauma has occurred. Just a scratch can trigger the development of a plaque. This condition is most common in patients with psoriasis and lichen planus.
500
Describe the Cushing reflex.
The elevation in blood pressure and reduction in pulse that follow an increase in intracranial pressure. It is a brain-stem-mediated reflex.
500
What does blood or hematuria on a urine dipstick from a snakebite survivor suggest?
Urine dipstick tests for the presence of blood detect myoglobin and hemoglobin (as well as hematuria), and positive results are suggestive of significant rhabdomyolysis.