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1

One anatomical difference between pilonidal disease and perianal abscess? Suppurative hidradenitis vs pilonidal?

Perianal will be at the anal verge
Pilonidal will be over the coccyx superior to the anus
Suppurative hidradenitis is usually in axilla or groin not anus/coccyx

2

A patient 2 weeks post op of a partial gastrectomy presents with postprandial abdominal cramps, weakness, diaphoresis 30 minutes after eating- diagnosis and treatment?

Dumping syndrome- rapid emptying of stomach leads to fluid shift and autonomic reflexes
Tx is dietary changes 1st, octreotide if refractory

3

Preferred way to establish airway in patient with C spine injury?

Orotracheal intubation after stabilizing C spine

4

A patient presents with edema, hypoalbuminemia, and proteinuria- what does this do to the patient's lipid profile?

Increased LDL, low HDL--> increased risk of accelerated atherosclerosis

5

Treatment for acute dystonic reaction?

Benzotropine or benadryl

6

Treatment for akathisia?

Propanolol

7

Treatment for Drug induced parkinsonism?

Amantadine or benzotropine

8

A demented patient has pneumonia 2/2 aspiration- likely pathogenesis?

Impaired epiglottic reflex

9

A 18 month old has atopic dermatitis, gets treatment, then has umbilicated vesicles erupt over each cheek with submandibular adenopathy- diagnosis? What virus? Tx?

Eczema herpeticum- occurs over healed atopic dermatitis, HSV, acyclovir

10

Isoniazid is known for causing vitamin B6 deficiency but can also cause what side effect?

Hepatitis- will see panlobular mononuclear infiltration and hepatic cell necrosis

11

What rash typically SPARES the diaper region in infants? Is symmetric everywhere else

Atopic dermatitis

12

How should you treat tachycardia with narrow QRS complexes and retrograde P waves?

Adenosine- tx for svt

13

A patient with TB presents with hyponatremia and hyperkalemia and normal anion gap metabolic acidosis- diagnosis?

Primary adrenal insufficiency- TB is a common cause in developing world

14

A patient with sickle cell presents for their 6th pain crisis hospitalization- what will be seen on peripheral smear besides sickle cells?

Howell Jolly bodies- at this point the patient has functional asplenia due to autoinfarction

15

A patient presents with sticking sensation in her throat accompanied by dysphagia and absent peristaltic waves in the lower 2/3 of the esophagus with decreased LES tone- diagnosis?

Scleroderma- no other pathology has absent peristaltic waves
Achalasia has increased LES tone
GERD has peristalsis

16

What class of medication can inhibits autonomic thermoregulation?

typical antipsychotics such as fluphenazine and haloperidol

17

How can blood gas differentiate COPD from CHF?

CHF- respiratory alkalosis
COPD- respiratory acidosis

18

What adrenergic therapy can treat hyperkalemia?

Albuterol and beta 2 agonists

19

A patient presents with pericarditis and BUN of 96, Cr of 5.1- next step?

Dialysis- this is treatment for uremic pericarditis

20

An immunocompromised patient has diffuse bilateral interstitial infiltrates on CXR- diagnosis

PJP

21

A patient presents with trendelenburg gait- what muscles or nerves could be injured?

Gluteus medius and minimus innervated by superior gluteal nerve

22

An HIV patient with esophagitis does not get better following fluconazole treatment- next step?

Get biopsy of ulcers showing CMV-large irregular ulcers or HSV- small, well circumscribed ulcers
CMV gets ganciclovir
HSV gets acyclovir

23

What lab abnormalities are seen with lupus anticoagulant and why is this interesting?

PTT will be prolonged although patient will be hypercoaguable
Russell viper venom test is specific for lupus anticoagulant and will be prolonged

24

What is a marjolin ulcer?

non-healing burn wound which becomes squamous cell carcinoma

25

Management of metastatic brain lesions? USMLE High Yield!

If solitary with stable extracranial disease- surgery
If multiple- whole brain radiation

26

What is the pathogenesis of aspirin sensitivity syndrome? USMLE High Yield!

Pseudo-allergic reaction due to accumulation of prostaglandins and leukotrienes

27

What is one method of preventing febrile nonhemolytic reaction after blood transfusion

Leukoreduction

28

A patient has hypotension and back pain after cardiac cath that mildly improves with IV fluids- next step?

CT of abdomen to look for retroperitoneal bleeding

29

How does a knee-to-chest position help during a child's tet spell with TOF?

Increased systemic vascular resistance--> increased pulmonary blood flow

30

Murmur associated with wide pulse pressure and pounding/racing heartbeat?

AR