5/24/2016

Arletesnotesforstep3USMLEForums

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Arletesnotesforstep3

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ARLETESNOTESFORSTEP3
1.Gastroparesis(DM)Rx=metoclopramide,erythromycinsymptoms:postprandialfullness,hypoglycemia,sweating,dizziness,constipation
2.Drugsthatleadtohypercalcemia=thiazides,lithium
3.Calciumgreaterthan12orsymptoms=NSSIV36lin24h,furosemideifnecessary
4.Hungrybonessyndrome=hypocalcemiapostopremovalofparathyroidadenoma
5.Sarcoidosis=increaseinvitDlevels
6.Familialhypocalciurichypercalcemia=low24hurinecalcium
7.Chronicthyroiditis(Hashimoto)=antimicrosomalantibodies
8.Drugsthatleadtohypothyroidism=lithium,ASA
9.Largenodule(cold)inmultinodulargoiter(hot)=FNAiffollicularelements=excision
10.Psammomabodies=papillarycarcinomaofthyroid=MCtypeofthyroidcancer,RFradiationexposure,lymphaticspread
11.Thyroidcancertypes=papillary,follicular(hematogenicspread),anaplastic,medullary(MEN)painful,lowuptake,increasedESR
12.GravesdiseaseRx=bringthepatienttoeuthyroidstate,then:radioactiveiodine,steroidsforophtalmopathy
13.Plummerdisease=longstandingmultinodulargoitersthatbecomethyrotoxiclater
14.Thyroiditis=low24hradioactiveiodineuptake
15.GravesdiseaseDx=increasedthyroid,"hot",proptosis,positiveTSHIg
16.Nitrobluetetrazoliumtest=chronicgranulomatousdiseasetestsphagocytefunction,oxidativeburst
17.Cellulardeficiencydisease=fatalinfectionsafterreceivingliveviralvaccines(MMR,varicella)
18.Abdeficiencydisease=encapsulatedorganisms,sino=pulmonarybacterialinfections,sepsis
19.Phagocyticdeficiencydisease=recurrentabscesses,lymphadenitis,periodontalinfections,Gramnegatives,catalasepositives,e.g.CGD,
ChdiakHigashi
20.Complementdeficiencydis=C2C4:autoimmunedisterminal:NeisseriaC3:encapsulated,unusualstrains
21.Severecombinedimmunodeficiency=firstyearoflife,decreaseinTandBcells
22.IgAdeficiency=MCprimaryimmunedeficiency,majoranaphylaticreactiontobloodproducts
23.XlinkedhypogammaglobulinemiaRx=IVIgdefectintyrosinekinase
24.Xlinkedlymphoproliferativedisease=catastrophicafterEBVinfection
25.Chronicgranulomatousdisease=decreasedintracellularandfungalkillingS.aureus,AspergillusRx:prophylaticantibiotics(TMP/SMX,doxycycline),interferon
gammavaccinate:Haemophilus,Pneumoccocus,Neisseria,viralvaccines
26.TcelldeficiencyRx=bonemarrowtransplant
27.Transfusionincellulardeficientpatient=irradiated,leukodepleted,virusfreeproduct
28.C3deficiency=increasednumberofpyogenicinfections
29.ProperidinandC5deficiency=increasedNeisseriainfections
30.C1inhibitordeficiency=hereditaryangioedema
31.Decayacceleratingfactordeficiency=paroxysmalnocturnalhemoglobinuria
32.Clomiphenecitrateuse=ovulationinduction(forpatientswithgoodestrogenproduction,suchasinOPCD)
33.Pregnancy=increaseinalkalinephosphatasedoesnotindicatediseasenecessarily,maybenormalfinding
34.Primaryhypothyroidism=mayleadtoincreaseinpituitary,amenorrhea,galactorrhea
35.Meconiumileussuspicion=bariumenema
36.Cysticfibrosistests=sweattest,nasalpotentialtesting
37.HepatitisBmother=breastfeedisOK!

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38.GravesinpregnancyRx=propylthiouracil
39.Cocaineuseinpregnancy=placentalabruption
40.Cluecells=bacterialvaginosisRx=metronidazolecounselnottodrinkalcoholbecauseofdisulfiramlikereaction
41.Pruriticurticarialpapulesandplaquesofpregnancy=thirdtrimester
42.RFforectopicpregnancy=age,PID,salpingitis,morethan3pregnancies
43.Testicularfeminization=dysfunctionorabsenceoftestosteronereceptorspatientisXY,normalbreastdevelopment,scantpubicandaxilarhair,
blindvagina,undescendenttesticles,maybefeltonthegroin.
44.fevergreaterthan38Cinlessthan4m.o.=admission,IVantibiotics,fullevaluation,multiplecultures
45.Pyloricstenosis=nonbiliousemesis,midepigastricolive:Dx=USGRF=erythromycinuse
46.MCCofjaundiceinpregnancy=viralhepatitis
47.Symptomaticbiliarystones=pregnancyRx=laparoscopiccholecystectomy
48.AsymptomaticbiliarystonesRx=none
49.N.gonorrhea=GramnegativediplococciRx=ceftriaxone+azithromycin(tocoverChlamydia,whichgenerallyistheretoo)notifypublchealthauthorities
50.Trichomonasvaginalis=motileflagellatedmicroorganismsinvaginalwetmount
51.Lowgradesquamousintraepitheliallesion(cervix)=CINIRx=rescreenin46months
52.Abnormalvaginalbleedinginwomanolderthan
35yonextstep=officeendometrialpipellebiopsy
53.SmallsubchorionichenorrhageRx=clinicalandUSGobservation
54.Menorrhagais,anovulatorybleeding=orderaTSH!
55.GroupBstrepprophylaxis=penicillinorampicillintomotherduringactivelabor,CBCandbloodcultureonthenewborn
56.Lowplasmabicarbonatecauses=diarthea,renaltubularacidosis
57.Erythemainfectiosum=notcontagiuosduringtherash(slappedface,lacy),onlybeforeit
58.Bleedinginpregnancy=orderboodtype,Rh,atypicalantibodies
59.Biliousvomitingininfant=thinkmalrotationwithvolvulusifnoperitonealsigns,flexiblesigmoidoscopyisdiagnosticandtreatmentatthesametime
60.Biliousvomitinginnewborn=rememberthe3Ds:duodenalatresia,doublebubbleonabdXR,greaterincidenceinDown'ssyndrome
61.SideeffectsofMgSo4usefortheNB:meconiumplugsyndromeinthiscase,contrastenemaisbothdiagnosticandcurative
62.Polythelia=accessorynipple
63.Polymastia=extraglandularbreasttissue
64.Hughgradeintraepitheliallesion(cervix)management=colposcopy+endocervicalcuretage+biopsy
65.Followingamolarpregnancy=contraceptivesfor1year,monitorbetaHCG,ifitgoesup,itcouldbechoriocarcinoma
66.Fetalalcoholsyndrome=cardiacmalformation(VSD),CNSabnormalities,facedeformities
67.TuboovarianabscessRx=IVatbtcssurgeryonlyifnecessaryit'soneofthefewcasesofabscessthatarecuredwithoutincision!
68.ProstatecancerDx=USGguidedneedlebiopsywith612specimens
69.MetastaticprostatecancerRx=GnRhagonists(flutamide),orchiectomy+chemo
70.Stagingfortesticularcancer=serumLDH,AFP,betaHCG,CTchest/abd/pelvisRx=radicalinguinalorchiectomy+spermaticcordligation
71.MCsitesofmelanoma=trunkformen,legsforwomen
72.Basophilicpalisidingcells,pearlappearance,upper1/3oftheface=basalcellca(theMCskinca)
73.Moh'smicrographicsurgery=forsquamouscellca(lower1/3oftheface),makes12mmmargins
74.MCCofencephalitisinadults=HSVmeningealsigns+focalneurologicalsigns,temporallobechangesonCTRx=IVAcyclovir1421days
75.ListeriamonocytogenesmeningitisRx=ampicillinNB,elderly
76.Chronicsinusitis=longerthan3monthsclinicalDx,butifsomethingisgoingtobeordered=CTsinusRx=amoxicillin+/clavulanate+/
clindamycinfor21days,nasalsteroidsprays,endoscopicsurgeryifnecessary
77.Otitismedia,ac.sinusitisRx=TMP/SMXoramoxicillin+/clavulanate
78.OtitisexternaRx=topicalofloxacinwithsteroidsremembertocleantheearbeforeapplyingtheRxPseudomonas,swimmers
79.ChrcarriersofgroupAstrepRx=clindamycin
80.Smokerwithpneumonia,diarrhea,increasedLDH=thinkLegionellaDx=urineAgRx=doxycycline
81.CysticfibrosispneumoniaRx=IVceftazidime+IVlevofloxacine=IVaminoglycosideMCC=Pseudomonas
82.AspirationpneumoniaRx=IVceftriaxone+IVazythromycin+IVclindamycinchronic,notpresentiated,RFpositive
83.Aspirationpneumonitis=acuteevent,presentiatedbysomebody,noneedforatbtcs
84.PCPpneumoniaDx=silverstainofsputum,bronchiallavageRx=IVTMP/SMXorinhaledpentamidine,addprednisoneif:PaO2lessthan70or
Aagradientmorethan35
85.TBRx=RIPEfor8w.,thenINH+rifampinfor16w.more
86.Addvit.B6forINH
87.KeepaneyeonuricacidforPyrazinamide
88.OrderophtalmologicavaliationforEthambutol
89.LatentTBRx=ninemonthsofINH(+B6)
90.TB+HIV=useRifabutininsteadofRifampinbecauseofpossibledruginteraction
91.Ac.prostatitisRx=TMP/SMXorfluoroquinolonefor14d
92.ChrprostatitisRx=fluoroquinolone1m.orTMP/SMX3m.
93.Primary/secondarysyphilisRx=PenicillinG2.4millionUIMifdiseasepresentformorethan1year=threedoseswith1w.intervalsnotifyhealth
department
94.NeurosyphilisRx=PenicillinGIVfor14days
95.DMDx=randomglucosetest>200+symptomsORtwicefastingglucose>126OR75GTT>200at2h.OR50gGTT>146at2h
96.Annualinfluenzavaccine=patientsolderthan
50yo,healthcareworkers
97.OCPs=decreaseriskforgonococcalPID
98.OsteoporosisRxwithdrugs,notonlycalciumisindicatedwhen=Tscore<1.5OR<2.5+RF
99.DualXrayabsorptiometry(DEXA)Tscore=comparedtoyoungadults
100.DEXAzscore=comparedtoageandracematchedpopulation
101.Elderly+fall=doahomesafetyevaluation,avoidnarcotics
102.Womansexuallyactive,youngerthan25yoorwithRF=screenforChlamydia
103.HTNDx=3separatereadingswithincreasedBP
104.PostexposureTBprophylaxis=2drugschosenaccordingtobugsusceptibility
105.SmallpoxRx=Cidofovir
106.AnthraxRxandprophylaxis=ciprofloxacin(adults),penicillin(children)
107.Householdwithchildren=waterheater<120130F
108.Pneumococcalvaccine=q5yfor>50yowithchrdisease
109.Tdvaccine=q10yoronceatage50yo
110.womanwithrelativewithbreastca=mammogram10ybeforetheaffectedpersonage+selfbreastexamination
111.Menwithrelativewithprostatecancer=annualPSA+DREafter40yo
112.BipolarI=Hxofmaniamajordepression+or

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113.BipolarII=Hxofhypomania+majordepressionNOmania
114.Autismsuspicion=orderahearingtestbeforesayingitis!
115.Gingkobiloba+warfarin=increasedriskofbleeding
116.1yovaccines=Hib,MMR,varicella,PCV
117.Adoptedforeignchild=serologyhepB,C,HIV,syphilis,PPD,stooltests
118.HIV+CD4,200=TMP/SMXprophylaticforPCPpneumonia
119.Pediculosis,scabiesRx=permethrinlotioninscabies:treatallhouseholdmembers
120.Necrotizinginfection+DMRx=Xray,ORfordebridement,amputationifneeded
121.InfectioninCRF+indwellingcatheterRx=vancomycin+gentamycin
122.TineaversicolorRx=topicalketoconazole
123.WaterhouseFriderichsensyndrome=adrenalinfarctionafter/duringmeningococcalmeningits,decreasedcortisollevel
124.PostherpeticneuralgiaRx=amitriptiline
125.Mononucleosis=leukopeniawithatypicallymphocytes,heterophileAbs
126.BacteremiainababyRx=ampicillin+cefotaximecoveringgroupBstrep,Listeria,E.coli
127.Hep.Bwindowperiod=surfaceAgandAbnegative(theycanceleachother),DxmaybemadethroughcoreAgIgMAb+
128.RatbitefeverRx=penicillinGortetracycline
129.HUS=ac.renalfailure+anemia+thrombocytopeniaE.coli0157:H7,rawmeat
130.TineapedisRx=topicalantifungalfor23w,ifnotgone=oralgriseofulvin68w
131.Invasiveaspergillosis=multiplebilaterallungnoduleswithsurroundinghemorrhages
132.PostchemofeverRx=hospitalize,broadspectrumatbtcs,antifungalifnoresponse
133.HPVinfectionDxwhenlesionsnotapparent=applyvinegartotheregion
134.CatscratchdiseaseDx=lymphnodebiopsytreatonlyif=bactsuperinfection(S.aureus),encephalitis
135.Ac.postinfectiouscerebellarataxia=postvaricellainfectionorvaccinedifferential=poisoning
136.Fever+neutropeniaRx=antipseudomonalthirdgenerationcephalosporinORantipseudomonalpenicillin+aminoglycoside
137.Firstgenerationcephalosporin=cefadroxil,cefalexin,cefalotin,cefazolin
138.Secondgeneration=cefaclor,cefuroximeantianaerobe:cefotetan,cefoxitin
139.Thridgeneration=cefixime,cefotaximeantipseudomonal:cefoperazone,ceftazidime
140.HerpeszosterRx=acyclovir141.CrushinjuriesRx=copiousalkalinizedIVcrystaloid(forrenalprotection)
142.Exertionalheatstroke=mayleadtoDICandrhabdomyolysisRx=icewater,coldwetsheets+fan
143.Ecstasyintoxication=mayleadtorhabdomyolisis
144.Ac.ethanolwithdrawalRx=chlordiazepoxide
145.Edrophonium=acetylcholinesteraseinhibitor
146.OrganophosphatepoisoningRx=atropine,pralidomide
147.Ac.tubularnecrosisduetocontrastprophylaxis=hidration,acetylcysteine
148.Avoid/suspendmetforminusebeforetestswithIVcontrast(forrenalprotection)
149.Opioidintoxication=miosis,resp.depression,coma,hypotension,bradycardiaRx=naloxone
150.Severedehydrationinelderly=mayleadtoac.suppurativeparotitisbyS.aureusRx=IVhidration,sialogogues,atbtcssurgicaldrainageifnotbetterin12h
151.Intoxicatedpatient=impossibletoclearcervicalspinebecauseyouneedtohavepatientcommunicatingsymptomstodoit
152.Priapismcauses=TPN,sicklecelldisease,crack/cocaine,trauma,spinalorgeneralanesthesia,trazodone,leukemia
153.Alcoholwithdrawal=happensinhoursto10days
154.Urinaryretentioncauses=BPH,prostateca,prostatitis,urethralstricture,meds,bloodclots
155.Cyanidetoxicity(nitroprusside)Rx=sodiumthiosulfate
156.Gallbladderrupturesuspicion=exploratorylaparotomy
157.Compartmentsyndromesigns=mostsensitiveislossofDTRs,mostominousislossofpulse6Ps=pallor,pain,paralysis,paresthesia,pulselessness,
poikilothermia
158.Hyperkalemia+EKGchangesRx=calciumgluconate
159.Motorvehicleaccidentwithseatbeltinplace=maycausepancreaticfracture=orderaCTscanwithIVcontrast
160.Carboxyhemoglobinlevel>40%(>15%inpregnancy)Rx=hyperbaricO2therapy
161.Methylenechloride(paintremover)intox.=carbonmonoxidepoisoningusecooxymeter
162.MethemoglobinemiaRx=Methyleneblue
163.IVepinephrine=RxofpulselessVTorVF(posteletriccardioversiontry),notforhypovolemia
164.PCPintoxication=aggression,ac.psychosis,ataxia,violence,nystagmus,suicide,fever,hypersalivation,hyperacusis
165.QRSamplitudealternance=cardiactamponade
166.ERCPcomplications=ac.pancreatitis,infectedpancreaticpseudocystformation,cholangitis,perforation
167.Disrupted/transectedurethrasuspicionnextstep=retrogradeurethrogrambloodatmeatus+highridingprostate
168.LeakingCSF(ears)=cribiformfracture=blindnasogastricornasalintubationsarecontraindicated!
169.Femoralcanal=NAVELfromlat.tomedial
170.Radialheadfracture(outstretchedhand,Cole'sfracture)Rx=sling23days,earlyexercises
171.Wounddehiscence=newonsetserousdischarge
172.CXRinpneumothorax=atmaximalexpiration
173.Compartmentsyndromesuspicion=measurecompartmentpressures,emergentfasciotomyifconfirmed
174.Inburnpatients,succinylcholineuseiscontraindicatedduetotheriskofhyperkalemia
175.ThioridazineS.E.=prolongedQT
176.Diureticforsulfaalergicpatients=etacrinicacid
177.AnabolicsteroidsS.E.testicularatrophy,liverdisease,gynecomastia,impotence
178.Concussion=headtrauma+transientLOC+shortamnesia,mayhavenotseriouslatesymptomsupto6m.later
179.IncreasedICPfirststepsinmanagement=intubation+hyperventilation
180.Lumbarpunctureheadache=positional,within24h.
181.Anteriorspinalarterialocclusion=decreasedmotorfunction,decreasedsensation,decreasedpinprick,preservedproprioception
182.AST=lessspecificforliverthanALTincreasedinalcoholicliverinjury
183.Ketorolac=NSAID,IV,usedintesticulartorsionS.E.=gastriculceration,GIbleeding
184.HumanbiteRx=ampicillinsulbactamORTMP/SMX+clindamycinifHIVinvolved=don'tworry,itdoesn'tgettransmittedbybite(yet!)
185.Methanoltoxicity=visionchangesorder:ABG,electrolytes,osmolalityRx=IVethanol,dyalisis
186.AmytriptilineS.E.=constipation,ac.glaucoma,urinaryretention,drymouth,paralyticileusbuttheworsteventinintoxication=cardiacarrhythmias
187.Electromyography=checksnerveandmuscleintegrity
188.Evokedpotentialstudies=monitortransmissionofmotorimpulsesintheanteriorcolumnsofspinalcord
189.JCvirus+HIVRx=HAART
190.JCviruscauses=progressivemultifocalleukoencephalopathy
191.EpididimoorchitisRx=Doxycycline100mgPObidfor10d+ceftriaxone250mgIM
192.HTN+BPHRx=terazosin,doxazosin
193.IncreaseinAFP=embryonal,yolksacelements(nonseminomas)

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194.IncreaseinHCG=seminomasandnonseminomas
195.Hydrocele=DxwithUSG,noRxrequired
196.MetastaticprostatecaRx=leuprolide,goserelinORbilateralorchiectomy
197.Priapismetiology=idiopathic(60%),leukemia,sicklecelldis,pelvictuandinfections
198.PSA>4nextstep=prostatebiopsy
199.Chancroid=Haemophilusducreyi,painful,unilaterallymphadenopathy,lesionwithpurulentbaseRx=ceftriaxone,azithromycin
200.Granulomainguinale=C.granulomatis,painless,beefyredlesionRx=TMP/SMX
201.Lymphogranulomavenereum=Chlamydiatrachomatis,herpetiformvesiclewitherosion,bilateralsuppurativelymphadenopathyRx=doxycycline
202.Syphillis=Treponemapallidum,painlesspapulawithclear,cleanbase,nontender,nonsuppurativelymphademopathyDx=RPR,VDRL,darkfieldmycroscopy
Rx=penicillin,doxycycline,erythromycinnotifyhealthauthorities
203.HematospermiawithnormalPEandlabs=observationandreassurance
204.Tertiarysyphilis=notcontagious
205.HAARTindications=symptomaticHIV,CD4<200,pregnancy
206.CD4<200=PCPprophylaxis=TMP/SMX,dapsoneoratovaquone
207.CD4<50=MAIprophylaxis=azithromycinweekly
208.ToxoIgG+andCD4<100=TMP/SMXORdapsone+pyrimethamine+leucovorin
209.TBcontactORPPD>5mm+HIV=INH+vitB6for9m.
210.HIVDx=vaccinestobegiven=pneumococcalq5y.,influenzaq1y.,hepatitisB
211.MefloquineS.E.=bradycardia,neuropsychiatricsymptoms,prolongedQT
212.NBofwomanwithSLEmayhave=congenitalCHB
213.Chronicfatiguesyndrome=fatigue+cognitivechangesfor1y.ormoreinfectiousbasis:virus,Chlamydiapneumoniae
214.Fibromyalgia=pain,tenderpoints(11of18),sleepchanges,psychologicaldistress,allodynia,morethan3m.,realatedtoSLE,RA
215.Allodynia=evengentletouchisunpleasant
216.Avascularnecrosisoffemoralheadcauses=pancreatitis,alcoholism,fatembolus,sicklecellanemia,airemboli,steroidsDx=MRI,SPECT
217.IdiopathicAVN=LeggCalvePerthesdisease
218.AVNRx=avoidanceofactivity,tapersteroid
219.PyogenicgranulomaRx=shave,electrodesiccatebase,sendittopathologyevaluation
220.Amelanoticmelanoma=Itcanresemblepyogenicgranulomaclinically
221.Temporomandibularjointdisease=orofacialpain,noisyjoint,restrictedjawfunctionDx=MRI
222.Complicationofhand/wristtrauma=AVNofscaphoid(navicular)bone
223.OslerWeberWendu=hereditaryhemorrhagictelangiectasia=epistaxis,GIbleeding,polycystickydneys
224.VonHippelLindaudis.=cavernoushemangiomas,hemangioblastomasinCNS,retina,renalcellca
225.SturgeWebersyndrome=facialportwinestain,seizure,ocularchanges
226.Caplansyndrome=rheumatoidnodulesinthelungs
227.Feltysyndrome=splenomegaly+neutropeniainsevereR.A.
228.Tuberoussclerosis=ashleafmacules(hypopigmented),calcifiedintracranialnodules,epilepsy,lowinteligence,adenomasebaceum
229.LeserTrelatsign=multiplepruriticseborrheickeratosisassociatedwithinternalmalignancy
230.Polymyalgiarheumatica=veryhighESRRx=lowdosecorticoidskeepaneyeopenforpossibletemporalarteritis
231.VitiligoRx=topicalsterois,phototherapy232.Porphyriacutaneatarda=blisteringinasunexposedarea+miliaDx=urineprophirinlevel+
hepatitispanel
233.Dermatitisherpetiformis=chr.pruriticpapulovesicularlesionsonextensorsurfaces,post.hairlineRx=dapsone
234.PemphigusvulgarisRx=immediatehighdosecorticosteroids
235.Hypertensiveurgency=thegoalistodecreasethediastolicBPtoabout100105mmHgwithinaperiodof26hours
236.Avoidnitroprussideinfusionformorethan48h(itmayleadtocyanidetoxicity)
237.Hypert.urg.inpregnancyRx=hydralazine,labetalol
238.Inpheochromocytoma,serotoninsyndrome,cocaineuse=IVphentolamine
239.Inaorticdissection=nitroprusside+labetalol/metoprolol
240.Jointreplacementinosteoarthritisindications=refractorypain,functionallimit,inabilityforADLs
241.Alendronate(Fosamax)S.E.=esophagealirritation,ulcerationandithastobetakenwithanemptystomach,soalwayscounselthepatienttotake
itinthemorningandsitorstanduprightfor30minutes
242.Achantosisnigricans=DM,hypothyroidism,Cushing's,Addison's,malignancy
243.Kaposi'ssarcoma=vasculartu,purplishlesions,extravasationoferythrocytes
244.MCCofalergiccontactdermatitis=nickel
245.Methotrexate,azathioprine,chloroquine,etanercept,infliximab=diseasemodifyingantirheumaticdrugs
246.Lumbarstenosis=pseudoclaudication,worsewithhyperextendingmovements,betterwithleaningforward,normalanklebrachialindexDx=MRIofthelumbar
spine
247.KneeligamentinjuryDx=MRI
248.PNH=GPIanchorprotdefic.=hemolyticanemia+pancytopenia+venousthrombosis(e.g.hepatic)
249.PNHDx=flowcytometry,HAMtest
250.PNHlabs=increasedLDH,reticulocyte,decreasedornegativehaptoglobin,hemosiderinuria,hemoglobinuria
251.PNHRx=iron,folicacid,transfusion,corticoids,eculizumab
252.ErythemanodosumRx=NSAIDs
253.BackpainMRIindications=spinalstenosis,osteomyelitis,epiduralabscess,posttrauma
254.Downsyndrome=shouldNOtparticipateincontactsports
255.Fractureonlandingonfeet=calcaneum,spine,acetabulum,post.hipdislocation
256.Melanomasuspicion=excisionalbiopsy
257.OsgoodSchlatterdis.=apophysitisoftibialtuberosityRx=decreasephysicalactivity
258.Rotatorcufftear=weakness,instabilityDx=MRIRx=arthroscopicrepair
259.Slippedcapitalfemoralepiphysis=Dx=XrayRx=fixationofepiphysiswithlongscrews
260.Iliotibialbandsyndr.=paininlat.aspectofknee
261.Axillaryadenopathyinwoman=mammography
262.Supraclavicularlymphnode=lymphnodebiopsy
263.Miliaria=heatrash
264.Erythemamultiformeminor=bull'seyeonpalms,herpessimplexRx=longtermuseacyclovir
265.Pustularpsoriasis=sterile,poststeroids,fever,malaise,arthralgia,diarrheaRx=cyclosporine
266.Seborrheickeratitis="stuck=on",waxygreasescale
267.Dermatomyositis=oftenisparaneoplasic
268.Hypercalciuria(renalstones)Rx=hctzorally
269.DyeS.E.=ac.tubularnecrosis=muddygranularcasts
270.ATN=BUN/Cr<20:1cisplatinisoneofthecauses
271.Ac.interstitialnephritis(drugs)=rash,fever,hematuria,whitecellcasts,eosinophiluria

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272.Increaseineosinophils=tumors,parasiticinfectious,autoimmunediseases
273.Renalcalculi=AbdXR,if=CTscanofabdomen(showsalltypesofstones)
actuallythisinformationisconflictingbetweensomesources,sooneshoulddosomeresearchaboutit
274.Indinavir(HIVdrug)S.E.=renalstone
275.Struvitestones=Mgammoniumphosphate,pH>7.2,presenceofureasplittingbugs(Proteus,Pseudommonas,KlebsiellaRx=removal
276.Uricacidstones=radiotranslucent
277.Asymptomaticbacteriuriainnonpregnant,healthypatient=noRxisindicated
278.Doxorubicin(Adriamycin)S.E.=cardiactoxicity,myelosuppression
279.VincristineS.E.=motor,sensoryandautonomicneuropathy
280.BleomycinS.E.=pulmonaryfibrosis
281.Myelosuppressantdrugs=methotrexate,vinblastine,doxorubicin
282.Polycystickidneydis=colonicdiverticulardis(withincreasedriskforperfuration),itmayevolutetoendstagerenaldis,1015%ofthepatientshaveintracranial
aneurysm
283.ChrugStraussdis=nephriticsyndr+eosinophilia+asthma,panca+Rx=steroids,cyclophosphamide,azathioprine
284.Goodpasturesyndr=nephriticsyndr+pulmonaryhemorrhageAbstoglomerularbasementmembrane
285.Wegenergranulomatosis=nephritis+nasal/sinusproblems,canca+Rx=sameasChrugStrauss
286.Berger'ssyndr=IgAnephropathy,nolatentperiodpostinfection,nephroticsyndr
287.DMSArenalscan=radionucleotidestudyforrenalfunction
288.IVpyelogram=C.I.inrenalinsufficiency
289.Kegelexercises=benefitswithin6weeks
290.Dribbling+dyspareunia+dysuriainwoman=urethraldiverticulumDx=urethroscopyorvoidingcystourethrography
291.Nephroticsyndr=increasedsusceptibilitytobact.infections,hyperlipidemia,mildlyhypercoagulablestate,hypovolemia
292.Renalcellcasuspicion=radicalnephrectomyBxonlyformetastaticcases(whenSxisnotindicated)
292.RapidlyprogressiveGNRx=highdoseIVmethylprednisolone
293.Alportsyndr=hematuria+/blindness+/deafnesstypeIVcollagenofGMBinabnormal
294.Membranousglomerulonephropathy=MCCofnephroticsyndrinadultsRx=ACEi
295.MembranoprolipherativeGN=nephroticsundrrenaldis+decreasedcomplement,realtedtohepatitisCvirus
296.Painlesshematuria=CTurogramorIVP(checkureteres)
297.Pyelonephritissuspicion=blood+urinecultures,urinalysis
298.Immunotherapy=forasthmaticspatientswithasingleallergen
299.Interstitialfibrosis=decerasedFVC,FEV1,
RV,TLC,diffusionincreasedFEV1/FVCnoresponsetobronchodilator
300.Immunisuppressedpat+pulm.aspergilosisRx=IVamphotericinB
301.Primarypulm.HTNRx=inhalednitrousoxide,Calciumchannelblockers
302.ARDSRx=limittidalvolumeto6cc/kgorless
303.LungnoduleonXray=thoraxCTscanwithcontrast
304.Appropriatetubeplacement=colorimetricdetectionofendtidalcarbondioxide
305.SarcoidosisDx=skin,transbronchiallungbiopsy
306.Todecreaseaspirationriskduringentubation=cricoidpressure
307.AfterpulmHTNDx=vasodilatorresponsetesting
308.Albuterolusage>twiceaweek=addtriamcinoloneMDI
309.Ipratropiumbromide=takesabout45minutestomakeeffect
310.Nonmassivehemoptysis=CXR,thenbronchoscopy,thenhighresolutionCTscantoDxnotalltestsnecessaryeverytime,though
311.Croup(laryngotracheobronchitis)=subgloticswelling,steeplesignonXR,parainfluenza,barkingcoughRx=misttent,racemicepinephrine,IV
corticosteroid,diphenhydramine312.TBconfirmatoryDxtest=sputumacidfaststain
313.Ciprofloxacin=doesNOTcoverstreptococcus
314.CommunityacquiredpneumoniaRx=azithromycin,levofloxacin
315.Sup.venacavasyndrduetocaRx=radiationtherapy
316.Penicillinalergy=cephalosporinuseisOKifpenicillinskintestis
317.Heparin=givenwithwarfarinuntill2daysafterINRreachesdesiredlevel
318.Foreignbodyaspirationinchildren=rigidbronchoscopy,methylprednisolone,cefazolin
319.GoutRx=foroverproducers=allopurinolforunderexcreters=probenecid
320.Caudaequinasyndr.suspicion=MRIit'sanemergency!
321.GiancellarteritisRx=Prednisone4060mddailyfor12m.,thentaperdownifthereissuspicion,treatimmediately,evenbeforebiopsy,to
avoidblindnessasacomplication!
322.Fightbitebug:Eikenella
323.Thompsontest=pressureongastrocnemiusdoesnotcausefootflexion,+inAchillestendonrupture
324.Fibromyalgiasymptomswithlessthan11triggerpoints=myofascialpainsyndr.
325.Gottron'spaules=happenindermatomyositis
326.PolymyosistisDx=increasedcreatinine,aldolase,CPKEMGmuscleBxRx=highdosecorticosteroids
327.Urobilinogen=increasedinhemolysis,hepatocelulardis.decreasedinbiliaryobstruction
328.LithiumS.E.=nephrogenicdiabetesinsipidus,hypothyroidism
329.SymptomatichyponatremiaRx=3%hypertonicsalinetoincreasePNaby35mEqin6h,butnomorethan12mEqperday,becauseoftheriskofcentralpontine
myelinolisis
330.Centralpontinemyelinolisis=flacidparalysis,dysarthria,dysphagia
331.Osmoticdiuresis=Uosm/Posm>0.7
332.Diabetesinsipidus=Uosm/Posm<0.7
333.HypernatremiaRx=correct<12mEq/dtopreventcerebralswelling
334.Symptomatichypercalcemiaor>13.5Rx=hydration+furosemide,thenbiphosphonateorcalcitoninhemodyalisisifnecessary
335.Hypercalcemiahasnospecificsignsandsymptoms,onlyhypocalcemiahasthem(Chvostek,carpalpedalspasm)!
336.Intraductalpapilloma=bloodynippledischarge
337.Ductectasia=fever,greenishcheesydischarge,pain,tenderness
338.Breastca=single,hard,immobile,irregularborders,>2cm
339.TripleDx=PE+mammogram+FNAcitology/Bx
340.Around15%ofbreastcancershaveafalsenegativemammogram
341.Breastlumpinwomanyoungerthan35yo=ifcystic=FNA=ifnonbloodyliquid=reassurance,ifbloody=citologyifnot=USandcoreBxor
excisionalbiopsy
342.MCsequelaeofmeningitis=hearinglossrememebertoorderaudiometryinccsoncethemeningitisiscured
343.Meningococcalmeningitisprophylaxis=rifanpimorciproforclosecontacts
344.Measles=highfeverfor3days,thenKoplik,then1dayafterheadtotoerashpneumoniaO.M.encephalitis(ac.),subac.sclerosingpanencephalitis(evenafter
years)

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345.Roseolainfantum(exanthemasubitum)=highfeverfor4days,stop,thenrashontrunkhumanherpesvirus6
346.Erythemainfectiosum(fifthdisease)=slappedcheekrashparvovirusB19whentherashisthere,it'snotcontagiousanymore
347.VaricellaIg=forimmunodebilitated,NB,within4daysofexposure
348.Scarletfever=sandpaperrash,circumoralpallor,strawberrytongueRx=penicillintopreventRF
349.KawasakisyndrRx=aspirin+IVIgf/uwithecho
350.RockymountainspottedfeverRx=tetracycline+chloranfenicolORdoxycyclineitmaycauseDIC,delirium
351.EpiglottitisRx=entubateottracheostomy,thirdgenerationcephalosporin"thumbsign"onXR,child25yo,H.influenzae,S.aureus
352.RSV/bronchiolitisRx=O2,misttent,bronchodilators,IVfluids,ribavirinifsevere,child<18mo
353.Diphteria=grayishpseudomembranous+myocarditisRx=atbtc+antitoxin
354.Pertussis=paroxysmalcoughing+whoopinginspiratorynoiseRx=atbtc
355.PoststreptococcalGN=NOTpreventedbyatbtc
356.Congenitaltoxoplasmosis=ICcalcifications,chorioretinitis
357.Congenitalvaricellazoster=limbhypoplasia,scarringoftheskin
358.CongenitalCMV=deafness,cerebralcalcifications,microphtalmia
359.Conjunctivitisinthefirstdayoflife=chemicalreaction
360.GonorrheaconjunctivitisRx=erythromycinointmentfor25days
361.ChlamydialconjunctivitisRx=topical+oralerythromycinfor514daystheintentionistoavoidthatitbecomesaChlamydialpneumonia
362.NBcataracts=TORCH,inheritedmetabolicdis(e.g.galactosemia)
363.Orbitalcellulitis=ophtalmoplegia,ptosis,severepain,decreasedacuity,it'sanemergency!Rx=bloodculture,inpatientIVatbtc
364.UveitisinjuvenileRA=Dx=slitlampexamRx=steroiddrops
365.Orchiopexy=correctionofcryptorchidismafter1yodoesNOTaffectriskoftesticularca,wichisincreasedinthesecases
366.PDA=congenitalrubella,highaltitudes
367.T4F=VSD+RVhypertrophy+pulm.stenosis+overridingAo
368."Tet"spells=squattingafterexertionincreasesvenousreturnandperiphericresistance,keepingmorebloodinlungsandimprovingoxygenation
verycommoninT4F,althoughnotpatognomonic
369.CoarctationofAo=Turnersyndrmidupperbacksystolicmurmur,BPdifferencebetweenarmsandlegs
370.VSD=MCcongenitalcardiacdefectmusculartypeistheonethathasthegreatercahnceofclosingbyitselfbefore2yo,butrarelyafter4yofetal
alcoholsyndr,TORCH,Downsyndr
371.Necrotizingenterocolitis=premature,fever,rectalbleeding,airinbowelwallRx=NPO,gastrictube,IVfluids,atbtcs
372.Cysticfibrosis=meconiumileus,rectalprolapse
373.Kernicterus=increasedunconjugatedbilirubin,depoistsintothebasalganglia,poorfeeding,seizures,flaccidity,opisthotonus,apnea
374.Breastmilkjaundice=peakat23wRx=temporarybottlefeeding
375.Increasedunconjugatedbilirubin=CrigglerNajardis.,Gilbertdis.
376.Increasedconjugatedbilirubin=Rotor,DubinJohnsondis.
377.Sulfainneonates=displacebilirubinfromalbumin,leadstokernicterus
378.Exchangetransfusion=unconjugatedbilirubin>20mg/dl+failedphototherapy
379.MCprimaryimmunodeficiency=IgAdeficiency:respiratoryandGIinfectionsavoidgivingIg(antiIgAantibodies)
380.Brutonagammaglobulinemia=6mo,lung+sinusinfectionsStreptococcus,Haemophilus
381.WiskottAldrichdefic.+boy,eczema+thrombocytopenia+resp.infections
382.ChediakHigashisyndr.=giantgranulesinneutrophils+oculocutaneousalbinism
383.Complementdefic.(C59)=recurrentNeisserialinfections
384.Chr.mucocutaneouscandidiasis=oftenassociatedwithhypothyroidism
385.Osteosarcoma=1020yo,abouttheknee,"sunburst"onXray
386.JobBuckleysyndr=intenseincreaseinIgE,recurrentStaphinfectionsfairskin,redhair,eczema
387.Unicameralbonecyst=expansile,lytic,prox.portionofhumerus
388.Bitotspots(debrisinconjunctiva)=vitAdeficiency
389.VitAtoxicity=pseudotucerebri,bonethickening,teratogenicity
390.Vit.Edefic.=anemia,peripheralneuropathy,ataxia
391.Givevit.Afor=patientswithmeasles
392.Givevit.Efor=Alzheimer'spatients
393.GivevitCfor=irondeficiencyanemia(increasesabsorptionofFecalciumdecreasesit)
394.VitEtoxicity=necrotizingenterocolitisininfants
395.VitKtoxicity=hemolysis(kernicterus)
396.Vit.B6defic.andtoxicitybothmanifestas=peripheralneuropathy
397.Vit.B12(cobalamin)defic.=megaloblasticanemia+neurologicsymptoms
398.Folicaciddefic.=megaloblasticanemia
399.BonepaininvitCdefic=periostealhemorrhages
400.Wernicke/Korsakoffsyndr=vitB1deficiency(thiamine)nevergiveglucosebeforethiamineforanalcoholicintheER
401.Manganesetoxicity="manganesemadness"inminersofore
402.Chromiumdeficiency=impairedglucosetolerance
403.Removaloftheileum,tapewormDiphylobothriumlatum=B12defic.
404.MCCofvit.B12defic.=perniciousanemia
405.Pernitiousanemiaassociation=vitiligo,hypothyroidism,hypoadrenalism
406.Liverfailure+increaseinPTRx=freshfrozenplasma
407.Rubellavaccine=NOTforimmunocompromisedpatients(exceptforHIV),ifgiventoawomanandshegetspregnantinthefirstthreemonthsafter,abortionis
NOTindicated,chancesarenothingbadwillhappentothefetus
408.Mean=averagevalue
409.Median=middlevalue
410.Mode=MCvalue
411.Braindeathwithconfoundingmedicaldis.=needsadditionalconfirmatorytest
412.TardivedyskinesiaRx=switchanitipsychotictoclozapine
413.Ac.dystonia,parkinsonismasS.E.Rx=diphenhydramine,trihexyphenidyl,benztropine
414.AkathisiaRx=betablockers
415.Neurolepticmalignantsyndrome,malignanthyperthermiaRx=dantrolene
416.ThioridazineS.E.=retinalpigmentdeposits
417.ChlorpromazineS.E.=jaundice,photosensitivity
418.P.aeruginosabacteremiaRx=tobramycinoramikacin+piperacillinORceftazidimeORcefepime
419.EcthymagangrenosumRx=IVatbtc(notdebridement)
420.CryptococcalmeningitisDx=+indiainkpreparationRx=amphotericinB+flucytosine1014d,thenfluconasoleprophylaxisforever(forHIV)
mayrequirerepeatedlumbarpuncturestodecreasethepressure
421.Phenytointoxicity=nystagmusonfarlateralgaze,neurotoxicityrememberthatitdecreasestheOCPlevelsintheblood

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422.Catheterrelatedsyst.infection=removal+vancomycin+gentamycin
423.VertebralosteomyelitisDx=MRIisthemostaccurate,boneBxisthegoldstandard
424.Meningococcalmeningitisprophylaxis=oralrifampinORS.D.oralciprofloxacinORS.D.IMceftriaxone
425.IVpentamidineS.E.=metabolicdisturbances,suchashypoglycemia(alwayscheckincaseofseizure)
426.HerpeszosterRx=acyclovirwithin48hofonsetofrash
427.CandidaophtalmitiswithvitrealinvolvementRx=vitrectomy+systemicantifungal
428.Hypothermiaorshockpostbloodtransfusion=thinkhypocalcemia!
429.HIVprophylaxispostexposure=zidovudine+lamivudinefor4w430.Lungs+sinusesinfectionspostbonemarrowtransplant=invasiveaspergillosis
431.RhinocerebralmucormicosisRx=surgicaldebridement+IVamphotericinB
432.MCCofFUO=infection(3040%)
433.Progressivemultifocalleucoencephalopathy(JC)=multiplefocalneurosymptomsinHIVpatient
434.ShoulderdystociaRx=stoppushing,suprapubicpressure,McRobert'smaneuver
435.McRobert'smaneuver=twoassistantsflexingthighsbackagainstabd.
436.Zavanellimaneuver=replacefetalheadbackintothepelvis,butthenyouhaveonly7minutestoperformthecsection
437.ARDS=clearlungs+diffusebilat.infiltratesonCXRRx=PEEParound9,highO2concentration,lowtidalvolume(<6ml/kg)
438.NeonatalpolycythemiaRx=hydration+partialexchangetransfusion
439.Mendelson'ssyndrome=aspirationpneumonitis
440.Ac.tubularnecrosis=afterprerenalazotemiamuddybrowncastsinurinalysisincreasedBUNandcreatinine,aniongapacidosis
441.Hemosiderinladenmacrophages=Wegener's,Goodpasture's
442.HeparininducedthrombocytopeniaRx=suspendit,lepirudinorargatrobanprevention=uselowmolecularheparininstead,orlimittheusetoa
maximumof5days
443.Ascitiesfluidanalysis=serumasciticfluidalbumingradient(SAAG)if<1.1g/dl=cirrhosis,CHFif>1.1=ca,pancreatitis
444.Ac.compartmentsyndr.complication=rhabdomyolisisthatmayleadtoARFDx=pressure>30mmHgRx=emergentfasciotomy
445.Mentalstatuschangeintheelderly=meds,infection,metabolic,thyroiddis.
446.MetastasisprostatecaRx=leuprolide(LHRHagonist)+flutamide(antiandrogen)
447.Octreotide=somatostinanalog,forbleedingesophagealvarices
448.ActivelowerGIbledding=STATcolonoscopyorradionuclidescan
449.Ac.hemolytictransfusionreactionRx=stopitandhydrate!
450.Metronidazole=contraindicatedforbreastfeedingwomen
451.PostpartumendometritisRx=clindamycin+gentamicin
452.InfantbotulismRx=supportivecare,humanderivedbotulinantitoxinexpect13mofhospitalizationandfullrecovery
453.Febriletransfusionreactionavoidance=washedcells
454.Preangiography=discontinuemetformintoavoidrenalcomplicationsandacidosis
455.Hypocalcemia=hyperactiveDTRs
456.Hypermagnesemia=lossofDTRs
457.Condylomaacuminata=vaginaldeliveryisOK!
458.TransurethralresectionoftheprostateS.E.=hyponatremia=twitching,seizures
459.Stressulcerprevention=oralPPIsuspension
460.Erb'spalsyassociation=diaphragmaticparalysis
461.Torsadesdepointswithinstability=unsynchronizedcardioversion,then,IVmagnesiumsulfate,thentemporarytransvenousoverdrive
pacemaker(inthisorden,accordingtonecessity)
462.MCCofCAH=21hydrolaseenzymedefic.(increased17alphahydroxyprogesterone)
463.11hydroxilasedefic.=HTN,hypernatremia,hypokalemia,duetotheincreasein11deoxycorticosterone,whichisamineralocorticoid
464.Classicdashboardinjury(caraccident)=post.cruciateligamentlesion
465.MechanicalvalvesINRgoal=2.53.5
466.Cimetidine,trimethoprimS.E.=decreaseclearanceofcreatinine
467.ITPinadultsRx=corticosteroids,thenIVIg,thensplenectomy(rarelyneeded)
468.HyperhomocysteinemiaRx=folicacid
469.Borderlinepersonalitydis.Rx=dialecticalbehaviourtherapy
470.RSVDx=detectionofRSVAginnasal/pulmsecretionsbyELISA
471.Suddenhyperglycemia+totalparenteralnutrition=sepsis
472.Hashimoto'sthyroiditisassociation=thyroidlymphoma
473.Chr.recurrentpancreatitiscomplication=isolatedgastricvarices
474.Doxorubicinuse=serialradionuclideventriculographyorMUGAisusedtoevaluatecardiotoxicity
475.Hospicecare=lifeexpectancy<6m
476.DMscreening=45yo,q3yifnoriskfactor
477.Chlordiazepoxide=Rxofalcoholwithdrawal
478.CeftriaxoneS.E.=increaseinbothtypesofbilirubin
479.CIN1=repeatpapsmearin6m
480.Wernicke'sencephalopathy=confusion+ataxia+nystagmus(ophtalmoplegia)
481.Korsakoff'spsychosis=mayhappenasaconsequenceofgivingglucosebeforethiamineconfabulation(creatingastorytofillthegapinmemory)mamilory
bodieschanges
482.Multiplesclerosissuspicion=MRIbrainandspineRx(acutely)=steroidstopreventrelapsing=interferonORglatiramer(remembertheyareboth
teratogenic)repeatMRIin3months
483.IncreasedbleedingtimeRx=IVdesmopressin(e.g.renalfailure)
484.Isotretinoin,minocyclineS.E.=pseudotumorcerebri
485.MCscaphoidfracturecomplication=nonunion
486.Orthostatichypotension=decreaseby20mmHginsystBPOR10mmHgindyastBP
487.Thiazides,amiodarone,sulfaS.E.=photosensitivity
488.Increaseinfibrinogenhappenswithuseof=lovastatin,atorvastatin,pravastatin,simvastatin
489.Ac.AodissectionHTNRx=IVbetablockers+nitroprussiate
490.Dipyridamole,adenosyne=C.I.inasthmaorCOPD
491.Antenatalcorticosteroidtherapy=2434w=IMbethametasone,dexamethasone
492.50mgoralglucosechallenge>140=doa100mgOGTTwith3hmeasurement
493.Glucoseinpregnancygoals=fasting6090,postprandial<120
494.TMPSMX=NOTinfirstandthirdtrimester
495.Pyelonephritis+pregnancyRx=IVceftriaxoneORampicillin+gentamycin
496.CondylomaacuminatainmucosaorpregnancyRx=trichloroaceticacid
497.SeverePIDRx=IVcefoxitin/ceftriaxone+IVdoxycycline
498.Nextdaypill=levonorgestrel(upto120hafter)
499.Cysticfibrosisinfertility=95%formen,20%forwomen

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500.Hyperthyroidism+pregnancyDx=freeT4,totalT4,TSH
501.Papsmearscreening=3yafterfirstintercourseor18yo
502.Hypothyroidisminpregnincy=doseofLthyroxineneedstobeincreased(increasedthyroglobulin)
503.Pessaries(+vaginalestrogen)=structurestosupportthevaginawalls
504.ASCUSDxnextstep=HPVDNAtesting,thencolposcopyifnecessary
505.RAwithpoorresponsetomethotrexate=infliximabORetanerceptdoaPPDfirst!
506.PCPintoxicationRx(ifpatientnotextremelyagitated)=lowsensoryenviromenthaloperidol,diazepamifnecessary
507.MetoclopramideS.E.=extrapyramidalsymptoms
508.InfluenzaRx=zanamivir,rimantadineoramantadinewithinfirst3048hofsymptoms
509.Sup.venacavasyndr=CTofneck+chestw/contrast
510.MCCofGuillainBarresyndr=C.jejuniiinfectionRx=IVIgorplasmapheresis,respiratorysupportifnecessary,keepaneyeonthepatient,with
bedsidepulmonaryfunctiontests!
511.Ac.stressdisorder=<4wpostevent
512.Posttraumaticstressdisorder=>4wpostevent,evenyears
513.Hyperviscositysyndr=Waldenstrom'smacroglobulinemia(increasedIgM),multiplemyeloma
514.PEsuspicion=V/Qscan,thenvenousUSG,thenCTangiogramofthechest(inthisorder,ifnecessary)
515.Chlamydiainfection+HLAB27+=Reiter'ssyndrRx=atbtc,exercise,sulfasalazine,methotrexate
516.Ethyleneglycol=severeaniongapacidosis,Kussmaul'srespiration
517.Ethyleneglycol,methanolintox.Rx=fomepizoleinfusion(ADHcompetitiveinhibitor)
518.Klinefelter'ssyndr=riskfactorformalebreastcancer
519.DoxycyclineS.E.=photosensitivity
520.IsotretinoinS.E.=hypertriglyceridemia,mayleadtopancreatitis
521.Pulm.contusionRx=admissionfor2448h,pulm.toilet,O2,paincontrol,fluidmanagement
522.Renalcellca=renalmass+polycythemia+flankpain+smoking
523.AmiodaroneS.E.=thyroiddysfunction,cornealdeposits,skindiscoloration,pulm.fibrosis,livertoxicity
524.MetforminS.E.=metabolicacidosis,weightloss
525.Glyburide=metabolizedbykydneysglitazones=metabolizedbyliver
526.indirectinguinalherniaRx=electiverepairASAP
527.TSSRx=clindamycin+/naficillin+IVfluids(upto20L!)
528.MetforminC.I.=CHF,alcoholism,renalfailure
529.GlitazonesC.I.=CHFNYHAclassesIII,IV
530.C.difficileinfectioniscausedby=clindamycin,ampicillin,amoxacillin,cephalosporins
531.After2cystitisin6months=prophylaxisfor612m
532.DecreasedTSH,butnormalT3,T4=repeatTSHafter68w
533.Anorexianervosawith<75%ofidealweight=hospitalization
534.Earlychildhoodrespiratorydiseasewithapnea=RSVbronchiolitis
535.HeatstrokeRx=augmentationofevaporativecooling
536.Isolatedincreaseinalkalinephosphatase=livertb,liverlymphoma(prolipherativeprocesses)
537.Epididimitisassociation=hydrocele
538.Rabiesprophylaxisinpat.prevoiuslyvaccinated=onlyvaccine,noIg
539.Hemochromatosis=liverdysfunction,arthropathy,centralhypogonadism,skinpigmentation,DMDx=serumironstudies
540.HormonereplacementtherapyS.E.=increaseintriglycerides
541.PrimaryHIVassociatedthrombocytopeniaRx=zidovudine
542.HAARTforHIVfor6m=decreaseviralloadto<50copies/mlisexpected
543.Perimenopause=periodbetween28yprecedingmenopauseto1yafter
544.Dysfunctionalbleedingduringperimenopause=vaginalUSGorendometriumbiopsy
545.Menieredisease=periodicvertigo+unilat.hearingloss+tinnitusassociatedwithsyphillis
546.H.piloryerradicationtestafterRx=ureabreathtestorfecalAgtestafter412w
547.Varicealhemorrhagerebleeding=endoscopy+bandligationorsclerotherapy
548.NongonococcalurethritisRx=azithromycin(SD)ORdoxycyclineifnoresponse=metronidazole+erythromycinORhighdoseerythromycin
549.Reiter'ssyndr=conjunctivitis+urethritis+spondiloarthropathy
550.Patellartendontear=inabilitytomantainextensionofkneeRx=earlysurgicalrepair
551.EpistaxisRx=topicalvasoconstrictor+anesthetic+chemicalorelectrocauterizationifitfails=bacitracincoveredantnasaltampon
552.Centralmidbrainlesion=abnormalCNIIIfunction
553.MultiplemyelomaDx=serumprot.electrophoresis,bonemarrowBx(>20%plasmacells),skeletalsuvey,wholebodyXR
554.Cleftlipsurgicalcorrection=10pounds,10weeks,10gofHb
555.Marfan'ssyndr=correctiveSxwhenAoroot=45mm
556.Asymptomaticalfa1antitrypsindefic.=spirometryq3m
557.Opioidwithdrawal+HTNRx=clonidine
558.Meningoencefalitis+pneumonia+splenomegaly=Chlamydiapsittacipneumonia(birdscontact)Rx=doxycycline100mgq12hfor21days
559.Lymedis.withBell'spalsy=orderCSFanalysis!
560.AsymptomaticincreaseinTSH=orderantiTPO!
561.AnybiteRx=ampicillinsulbactam
562.ExposuretoactiveTB=immediatePPD,ifrepeatin3m
563.EarlystressfractureDx=MRI,triplephasebonescanswithtecnitiumRx=restfor46w,paincontrol,gradualreturntoactivity
564.SpinalepiduralabscessDx=gadoliniumenhancedMRIorCTwithmyelographyRx=earlysurgicaldecompression+drainageinthefirst24h
565.Lactoseintolerance=yogurtisrecommended
566.Ureteralstones<5mm=usuallypassbythemselvesifnot=shockwavelithotripsy
567.Ureteralstones>810mm=flexibleureteroscopy+laserlithotripsy
568.Cervicalcerclage=doneat1317w,removedat36w
569.ScrotaltraumawithabnormalPE=surgicalexploration
570.Riskfactorforprostatecancer=startscreening(PSA+DRE)at45yo
571.AlopeciaareataRx=topicalorintralesionalcorticosteroids
572.Hypokalemia+paralyticileus=correcthypokalemiaimmediately!
573.Marfan'ssyndr=duralectasia(MC),ectopialentis,Aodilatation,MVP
574.Pinealtu=Parinaud'ssyndr=lossofpupillaryreaction,verticalgaze,optokineticnystagmus,ataxia,cansecreteHCG
575.MCsymptomofsicklecelldis=dactylitissecond=splenicsequestration
576.Coughduetoforcedexpiration=asthma
577.Commonmigraine=noauraclassicmigraine=aura+
578.ChlamydiainpregnancyRx=erythromycin
579.DMretinal,vitreoushemorrhagesRx=laserphotocoagulation

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580.SydehamschoreaRx=oralpenicillin10d,thenprophylaxis
581.HAARTRxforasymptomaticHIV=CD4<
350,viralload>55000,checkq3m
582.Paget'sdisoftheboneRx=biphosphonates(alendronate)
583.Firstgenerationrelativewithcolonca=startscreeningat40yo
584.Asymptomaticbacterialvaginosisinpregnancy=NORx!ifhighriskforpretermlabororsymptomatic=oralmetronidazoleorclyndamycin
585.Anaphylaxiswithpulm/cardiovascularsymptoms=epinephrineIV
586.HemochromatosisRx=therapeuticphlebotomy
587.Penicillamine=promotesexcretionofcopper
588.Postcommunicatingartaneurysm=CNIIIpalsy
589.Inoperableheadandneckca=chemo+radiotherapy
590.P.cariniipneumniaDx=fiberopticbronchoscopywithbronchoalveolarlavageRxifmod/severe=admission+IVTMP/SMX,addcorticosteroidsifAagradient
>35orpO2<70
591.CarbonmonoxidepoisoningDx=cooxymeter
592.ChrmesentericischemiaDx=mesentericduplexUSG
593.AtopicdermatitisRx=topicalsteroids,tacrolimus,pimecrolimus
594.PyloricstenosisDx=USGassociatedwitherythromycinuse
595.Pertussisprophylaxis=erythromycin
596.Airinthedistalcolon=partial(nottotal!)obstruction
597.IncreasedinsulinandincreasedCpeptide=insulinoma,sulfonylureause
598.Medullarythyroidca=screenforpheochromocytoma
599.HTNinac.ischemicstroke=treatonlyifsyst>
220,dyast>120
600.Rhabdomyolisiscauses=cocaine,acohol,trauma,exertion.hypothermia,hypothyroidism
601.Drugsthatcausepancreatitis=diuretics,valproicacid,metronidazole,tetracycline
602.PeripheralvascdisRx=cilostazol(plateletinhibitorandartvasodilator)
603.RockymountainspottedfeverRx=doxycycline
604.Newonsetofsevereseborrheicdermatitis=orderanHIVtest!
605.NecrotizingfasciitisduetogroupAstrepRx=surgicaldebridement+IVclyndamycin
606.Pillinducedthyrotoxicosis=undetectablethyroglobulin
607.Gravesdis.Rx=bringthepatienttoanormalthyroidstatewithbeta=blockers,PTU,methimazole,
thenradiodineablation+glucocorticoids(forophtalmopathy)
608.ThyroidstormRx=PTUormethimazole+glucocorticoids
609.Cushing'striad(increasedICP)=bradycardia,HTN,respiratorydepression
610.PostherpeticneuralgiaRx=desimipramine,amitriptyline,capsaicin,gabapentin,topicallongactingoxycodone
611.DiabeticneuropathyDx=nerveconductionstudies
612.Amaurosisfugax=carotiddopplerevaluation
613.TCAinducedVTRx=lidocaine
614.Watchingoutforsclerodermarenal
involvement=monthlyBPmeasurement
615.Constructional,dressingapraxia=nondominant
parietallobelesion
616.Aphasia=dominanttemporallobelesion
617.Porphyriacutaneatarda=painlessblisters+hyperthricosis+hyperpigmentation,associatedwithhepatitisC
618.LymearthritisDx=synovialfluidELISAorwesternblottRx=30dofamoxicillinorceftriaxoneordoxycyclineorerythromycin90%of
curein1y
619.PheochromocytomaRx=alphablockade1014dpreop+CT/MRI
620.NeonateopiatewithdrawalRx=paregoricortinctureofopium
621.AmyotrophiclateralsclerosisRx=riluzole
622.Neurogenicsyncope=vasovagal,commonfaint
623.Autonomicneuropathy=leadstoposturalhypotension
624.RestlesslegssyndrRx=pramipexole,ropinirole(dopamineagonists)
625.Pick'sdis=slowlyprogressivefrontaland/ortemporallobedementia=notonlycognitive,butbehavioralchanges
626.Varicocelecomplication=testicularatrophy
627.Obesitysurgeryindication=BMI>40kg/m2
628.Aostenosisassociation=angiodysplasiaincolon
629.COpoisoning=severalpeopleinthesamehouseholdwiththrobbingheadache,nausea,malaise,dizziness
630.Ovaries=23cminyoungwomen,nonpalpableaftermenopause
631.VenoussinusthrombosisRx=heparin,evenwithhemorrhagicinfarction
632.Ac.varicealbleeding=givefluoroquine710dforinfectionprophylaxis,itimprovestheoutcome
633.Infantbotulismsymptoms=decreasedgagreflex,constipation,lethargy,poorsucking
634.Ac.goutDx=arthrocentesisRx=ibuprofen,indomethacin,colchicine,glucocorticoids
635.Giardia=noeosinophilia
636.Downsyndrscreening=AFP,HCG,unconjugatedestriol,dimericinhibinA
637.SeverepneumoniaRx=hospitalization+ceftriaxone+azithromycin
638.Delayedpuberty=noincreaseintesticlesizeby14yo,diameter<2.5cmDx=boneagedetermination(XR)
639.HTN+sclerodermarenalcrisisRx=ACEi
640.Scombroid=fishbadconservation1030minutesafteringestion,patienthashistaminerealtedsymptomsselflimited
641.Ac.dystonicreaction(e.g.metoclopramide)Rx=IVdiphenhidramine
642.Urinetoxicology=urineimmunoassayscreen(resultsin1hour)
643.Achalasia=dysphagiaforbothsolidsandliquids
644.Fastingbloodglucose100126=increasedriskforCADmetforminmaybegiven,speciallyifmetabolicsyndrpresent
645.Sjogren'ssyndrDx=minorsalivaryglanBxisgoldstandard
646.Celiacdis.Dx=antiendomisial,antitissuetransglutaminaseAblevels
647.SAH=xantochromiainCSFisfoundonlyafter4hofsymptoms
648.COPDprognosis=FEV1
649.Cosyntropinstimulationtestindication=adrenalfailure
650.RA=clinicalDxifRForderantiCCPAbiferosivejointdis=treatwithmethotrexateandotherDMARDs
651.MotherwithDMtypeI=3%risk,father=6%riskthechildwillhaveittoo
652.Transversemyelitis=rapidlyprogressiveweaknesspostURI+sensoryloss+urinaryretention
653.NonbacterialprostatitisRx=sitzbaths+NSAIDs

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654.Mesentericischemia=metabolicacidosis
655.HIVteratogenicdrugs=efavirenz,delavirdine
656.Dextrose+insulin=decreasetryglycerides
657.Extrapyramidalsymptoms+dementia=subcorticaldementia
658.CarpaltunnelsyndrinitialRx=continuouswristsplint
659.Cutaneouscryptococcosissuspicion=bxofskinlesions
670.Trichomoniasisinbreastfeedingmother=nobreastfeedingfor24hafterSDofmetronidazole,discardpumpedmilk
671.Erysipela=groupAstrep
672.PapillarythyroiscaRx=neartotalthyroidectomynoneedtostagebeforeit
673.OnychomicosisRx=oralterbinafineoritraconazole
674.DisseminatedgonococcalinfectionDx=cultures=jointfluid,mucosalsurfaces
675.Leadbloodlevel>44=chelationtherapyintoxication=>10
676.VitB12replacement=checkKcloselyfor48h(itmaydecreasequickly)
677.DumpingsyndrRx=highprot,lowcarbohydratediet
678.Initialscreeningforinfertility=semenanalysis
679.ExcessiodinecontrastS.E.=thyrotoxicosis
680.CD4<200=TMP/SMX(P.carinii)
681.CD4<50=azithromycinorchlarithromycin(MAC)
682.INR>20=FFP,IVvitKbetween5and20=oralvitK<5=holdcoumadinuntildesiredlevel
683.Ac.retroviralsyndr=thrombocytopenia,leukopenia
684.LactoseintoleranceDx=lactosebreathhydrogentest
685.DrugsthathaveanemiaasS.E.=phenytoin,methotrexate,trimethoprimRx=folinicac(leucovorin)
686.RosaceaRx=topicalmetronidazolerememberthisdiseasemayhaveocularsymptoms,andcan'tbetreatedasacne
687.CarbamazepineS.E.:neutropenia,SIADH,glaucoma,constipation
688.Eryhtemachr.migrans+tickbite=treatitwithdoxycyclinerightaway(28d),don'twaitforserology
689.GonorrheaRxincephalosporinallergy=ofloxacin,ciprofloxacin(+azithromycin)
690.BPPVRx=canalithrepositioningprocedure
691.HIVlipodystrophy=HAARTS.E.,increasetryglyceridesRx=gemfibrozil
692.PerniciousanemiaDx=antiintrinsicfactorAbtesting(notSchillingtest!)
693.Psoriaticarthritis,naildisRx=methotrexate
694.Chr.liverdis=givehepatitisAvaccine
695.BacterialconjunctivitisRx=erythromycinointment,sulfadrops
696.Bilesaltinduceddiarrhea=postcholecystectomy,shortbowelsyndrRx=cholestyramine
697.Diseasetransmittedonlybymothersinafamily=mitochondrialheritance
698.AdultStill'sdis=RAvariantfever+salmoncoloredmaculopapularrashRx=NSAIDsmonitorliverfunction!
699.Amiodaroneinanticoagulatedpatients=doctorshoulddecreasethewarfarindosein25%
700.Backpainformorethan6w=orderESRif>20,orderimagingstudies
701.TineaversicolorRx=topicalterbinafine
702.BacterialovergrowthDx=quantitativejejunalcultures
703.Ultrarapidactinginsulin=lispro,aspart
704.Hydrocortisone=lowpotencysteroid
705.Betamethasone=highpotencysteroid
706.Barret'sesophaguswithoutdyspalsia=endoscopy+Bxq13y
707.PremenstrualsyndrRx=SSRIsnoimprovement=alprazolam
708.Retrosternalgoiterwithcompressivesymptoms=surgery
709.Drugsthatdecreasesexualdrive=bupropion,mirtazapine
710.ValproicacidS.E.=urinaryfrequencyandincontinence
711.Renalart.stenosisDx=MRangiography
712.Primarypulm.HTNRx=anticoagulation(INR=2)+oralvasodilator
713.CoAoDx=MRIofchest
714.Undescendedtests=waituntil6mo
715.Initialsmokingcessationaid=highdosenicotinepatch(butpatientneedstobecommited,becausesmokingusingthepatchmayleadtocoronaryspasmandeven
MI!)bupropionlater
716.Initialsleepapneainvestigation=medicalworkup(investigatehypothyroidismtoo)
717.Rareeventstudy=metaanalysis(increasesamplesize,thereforeincreasepower)limitation=heterogeneousstudiesputtogether
718.MassinthehepaticductRx=ERCP+stentplacementifitfails=percutaneoustranshepaticcholangiography+stent
719.Borderlinepersonality=splitting,e.g.primitiveidealizationRx=dialecticalbehavourtherapy
720.Fallingonanoutstretchedhand=scaphoidfractureDx=CTscanofthehand,bonescancomplication=nonunion
721.Epiduralspinalcordcompression(metastasis)=thoracicradicularpain,neurosymptomsRx=highdosecorticosteroids,MRI,radiation
722.HemochromatosisRx=phlebotomy
723.Penicillamine=promotescopperexcretion(Wilson'sdis)
724.Extremelyominoussignofpreeclampsia/eclampsia=retinalhemorrhages
725.Ac.adrenalinsuf.Rx=dexamethasone+cosyntropinstimulationtest
726.SymptomaticrectoceleRx=surgeryorpessary+estrogencream
727.HIVandRPR+=CSFexaminationifnl=benzathinepenicillinweeklyx3,warnaboutpossibleJarischHerxheimerreaction
728.PainlesslowGIbleeding=colonoscopyorradionuclidescanwithtechnitium99
729.IgMHIVAbassay=lowsensitivity,doNOTuse!
730.IndeterminateHIVELISA=orderHIVRNAPCRassayorp24Ag
731.HIVwithorwithoutRx=monitorCD4countandHIVloadq34m
732.Survivalanalysis=accountsfornumberofeventsANDtimingofevents
733.Blepharospasm=focaldystoniaRx=botulintoxininjection
724.Prerenalazotemia=decreasefractionalexcretionofsodium
725.Druginducedallergicinterstitialnephritis=happensafter35dofcausalagenteosinophilsinurine
726.Mostbenefitialsteptodecreaseosteoporosisrisk=quitsmoking
727.Ankylosingspodilitissuspition=Xraysacroiliacjoint,repeatq3m+ESR
728.Chr.Foleycatheter+candidaonurineculture=noRxifasymptomatic
729.Viralmeningitisinchidren=enterovirus,arbovirusinadults=HSV
730.DrugswiththrombocytopeniaasS.E.=clopidogrel,heparin
731.Idealbloodculture=1hbeforefever
732.Chr.nonremitingclusterheadacheRx=verapimil,lithiumac.crisis=100%oxygeninhalation
733.Condylomaacuminatainpregnancy=doNOTusepodophilin,usetrichloroaceticacidinstead

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734.Chr.hepatitisCRx=interferonalpha2b(+/ribavirin)
735.Hormonereplacementtherapycessation=donotdoitabruptly,taperitdowninstead!
736.Confidenceintervalincludes1.0=notsattisticallysignificant
737.LatentTBinfection=PPD+andCXRWNLRx=isoniazid+B6for612m
738.ARDScauses=sepsis,pneumonia,severetrauma,burns,drowning,pancreatitisclearlungsonPE+diffuse,bilatinfiltratesonCXRRx=PEEP
around9cmH2O,highO2concentration,lowtidalvolume(6ml/kg)
739.Emergencycontraceptionafter120h=copperIUD
740.DM+Csectionprep=normalinsulinthenightbeforeinsulindrip+D51/2NS+KClduringtheday,keepglucose<160
741.SinglemostimportantpredictorforCVrisk=DM
742.Dietfordiarrhea=normal,ageappropriatewithlowfatandlowsugar
743.Sedativeandhypnoticdrugsfortheelderly=increasedriskforfalls,soriskxbenefitshavetobecarefullyevaluated
744.BZDwithdrawal=tremolousness,seizure,psychosis,increasedHR,BP,bodytemperature,anxiety,restlessness,confusion,disorientationRx=
IVlorazepam,diazepam
745.Anemiaofchr.dis.=RA,SLE,vasculitisifsevere,withnormalerythropoietinlevels=redcelltransfusion
746.Sjogren'ssyndrDx=antiRo,antiL2insalivaryglandgoldstandard=labialminorsalivaryglandBx=focalcollectionsoflymphocytesassociatedwithnon
Hodgkin'slymphoma(Bcelllymphoma)
747.MEN1=hyperparathyroidism,pancreatictu,pituitarytu
748.MEN2A=medullarythyroidca,pheochromocytoma,hyperparathyroidism
749.MEN2B=medullarythyroidca,pheochromocytoma,mucosalneuromas,marfanoidhabitus
750.Vertebraeosteomyelitisanddiabeticfoot=mostaccuratetest=MRIgoldstandadrd=boneBxculture=deepcuretagetissue
751.Addison'sdis=decreasedNa,increasedK,hyperchloremicmetabolicacidosisDx=ACTHstimulationtest,earlymornongcortisol
752.IVpentamidineS.E.=increasedordecreasedK,decreasedCa,hyperorhypoglycemia
753.Obesitysurgeryindications=BMI>40,coexistingdiseases,decreasedqualityoflife
754.Erb'spalsyprognosis=80%chancenearfullrecoveryin1y
755.NF1=cafeaulaitspots,cutaneousneurofibromas,axillaryfreckling,unilat.acousticneuroma
756.NF2=hypopigmentedspots,familyhistoryofbilat.deafness(bilat.acousticneuromas)
757.Tuberoussclerosis=congenitalashleafspots,glialprolipheration,organhamartomas/cysts
758.SturgeWebersyndr=facialportwinestain,leptomeningealangiomatosis
759.OslerRenduWebersyndr=vascularlesionsoftheCNS,multipletelangiectasias
760.DiaperrashRx=topicalzincoxydepaste,petrolatun,keepareadryifitfails=lowpotencycorticosteroidsointment,butkeepaneyeopenfor
fungalinfections!
761.Situationswithincreasedamylase=pancreatitis,ac.parotiditis,intestinaldis.,renalfailure,cholecystitis,fallopiantubedis.
762.Mildac.pancreatitisRx=IVfluids+paincontrol+NPO+NGtubeaspirationatbtcsifseverenecrotizingpancreatitis,fever,evidenceofinfection
(imipenem,thirdgen.cephalosporin,piperacillin,fluoroquinolone,metronidazole)ifitfails=CTguidedaspirationoftissue,cultureandsensitivity
763.Infant,childrenwithTBmeningitisRx=12mofantiTBdrugs+corticosteroidsifresistant=1824m
764.LDLgoalis<100in=coronarydis.peripheralandcerebralvasculardis.,DM
765.Hypophosphatemia=respiratoryweakness,hemolysis,decreasedreleaseofO2fromHb
766.Postpartumendometritis+breastfeedingRx=clindamycin+gentamycinmainriskfactor=Csection
767.Sarcoidosis=hypercalciuria,hypercalcemia,thrombocytopenia,increasedserumACE,hypergammaglobulinemia
768.Herpesgestationis=paules,plaques,vesiclesaroundumbilicusRx=topicalsteroids,oralantihistamins(ithasnothingtodowiththevirus)
769.InflammatorymyositisRx=highdoseglucocorticoids(prednisone1mg/kg),immunosuppressants
770.Depotmedroxyprogesteroneindicatedascontraceptive=menorrhagia,PID,fibrosis,heavysmokingdecreasetheincidenceofendometrialca
771.Shufflinggait=decreasedspeedandamplitudeoflegmovementsParkinson's
772.Spasticparaparesis=patientdragslegsforward,nobendingoftheknees
773.Cerebellarataxia="drunkensailor",zigzag,jergygait
774.Senilegait="walkingonice"
775.Neonatalpolycythemia=Htc>65%,apnea,hypoglycemia,increasedbilirubin,cardiacandrespiratorycompromiseRx=adequatehydration+
partialexchangetransfusion
776.C.botulinumsoilspores=California,Pennsylvania,Utah
777.NeuropathiccapainRx=sharp=carbamazepinedull=desipramine
778.OrganophosphatepoisoningRx=atropine+pralidoxime
779.Meralgiaparesthetica=entrapmentoflat.femoralcutaneousnerve
780.Higherspecificity=higherPPVhighersensitivity=higherNPV
781.Emphysematouspyelonephritis(DM)Rx=IVatbtcs+immediatenephrectomy
782.Pregnancy+epilepsywithnoseizuresfor25y=trytotaperdownandwithdrawalthedrug
783.NoadequateresponsetoosteoporosisRx=investigatemultiplemyeloma!
784.Pseudomembranouscolitis=repeatimmunoassayifbutstrongsuspition,repeatRxwithmetronidazoleifnoresponseonfirsttry
785.Diabeticmononeuropathyprognosis=verygood,improvementinafewweeks
786.Metoclopramide=manyS.E.,tachyphylaxis
787.Singlesmallpedunculatedpolyp=colonoscopyq3y
788.SeizurespoststrokeRx=phenytoin,carbamazepine
789.Glucocorticoidsfor<3weeks=noneedtotaperitdown
790.Increasedaniongapmetabolicacidosis=renalfailure,ketoacidosis,lacticacidosis,metformin,intoxications=aspirin,ethyleneglycol,methanol
791.CCSRuptureofAAAcase=ordermonitors,oxygen,IVaccessBEFOREPE
792.CCSDKA=ordercalcium,phosphate,amylase,lipase,serumosmolality,ketones
793.CCSCOPDwithpneumonia=monitorpeakflowandFEV1
794.CCSAnaphylaxiscase=giveepinephrineBEFOREPE
795.CCSParacentesisneeded=orderanalysisofthefluid=ceelcount,diff.,prot,glucose,cytologydependingonthecase=Granstain,culture,AFB
staining,amylase,bilirubin
796.CCSDomesticabuse=urinetoxicology,skeletalsurvey,supportgroup,socialworker
797.CCSSLE=ESR,serumANA,UA,CXR,totalcomplement,antidsDNA,DEXA,prednisone,NSAIDs,rheumatoconsult,nephroconsult,
sunblockuse
798.CCSCroup=coolmisttent,decadron,racemicepinephrine,observefor4h
799.CCSTurner'ssyndr=GH,oxandrolone,estrogen+progestin,vit.D
800.CCSWhenorderingcorticosteroidsinhighdosesorprolongeduseintended=H2blockers,vit.D,calcium,DEXAscan,exercise,sometimeseven
viphosphonate
AttachedFiles
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02172010

#2

khkhbaba
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thankyou

Woow
that'sgreatman
I'vebeenlookingforArlete'sNoteslongtimeagoandIdidnotfinditinPDF
YOUAREASTAR

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02172010

#3

ApplicantGuide
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Youarewellcome,IpasteditinthethreadbutIamnottheonewhoaddedthePDF)!Maybeoneoftheadminsdidit.Goodluck.

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08122011

ednorton
USMLEForumsScout

#4

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Quote:

OriginallyPostedbyApplicantGuide
Youarewellcome,IpasteditinthethreadbutIamnottheonewhoaddedthePDF)!Maybeoneoftheadminsdidit.
Goodluck.
ThanksabunchApplicantGuide!!!

08202011

#5
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Haisook
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Thanksalotbut..

..who'sArlete?what'sthesourceofthesenotes?,andaretheyworthourtime?
__________________
I'veregainedmyhonor[99/99].

08202011

#6

Arletef
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Hi.IamArlete.IamanIMG.Iwaswritingthesenoteswhilestudyingforstep3,sothesourcesaremany,evenfromsomeCME
classesIwasattendingatthetime.Theyhelpedmetogeta99score.Ithinktheyareworthyforalastreading,afteryou'redone
studyingandansweringquestions.Goodluck!

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slime66
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WOW!

Itisgreatandveryuseful!Manythanks

01182013

ag2011n
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#8

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Thanksforthisgreateffort.

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