Question Main

Id
Division

Sub Division

Notes

3886

Internal
Medicine

Biostatistics

PPVdepends on the prevalence of the disease.(Directly proportional)

4178

Internal
Medicine

Biostatistics

attrition bias is a type pf bias,when there is loss to followup..ie the study pts doent folowup

2691

Pediatrics

Cardiology

hypertrophoc cardiomyopathy: c/f carotid pulse with dual upstroke due to midsystolic obstructio
during cardiac contraction. systolic ejection murmur due to the obstruction.

2695

Internal
Medicine

Cardiology

mITRAL VALVE PROLAPSE IS THE MOST COMMON CAUSE OF mITRAL REGURGITAION .

Common in women in young age.

2698

Internal
Medicine

Cardiology

most common cuase of Aortic stenosis are: Senile calcific aortic stenosis Bicuspid arotic walve and
rheumatic heart dises Senile calcifif valve is common pts with age >70 while in pts whith age <70
years is due to bicusfid aortic valve.

2711

Internal
Medicine

Cardiology

HOCM: there is hypertrophied interventricular septum plus abnormal motion of the mitral valve which
si also caleed as Systolic anterior motion(SAM)

2713

Internal
Medicine

Cardiology

cardiac myxoma: fever wt loss fatigue diastolic rumble iT MIMICS MITRAL VALVE DISEASE.
tRANSESOPHAGEAL ECHO WILL SHOW MASS IN THE LEFT ATRIUM.

2722

Internal
Medicine

Cardiology

variant angina is associated with other vasospastic disorder like Raynaud's phenomenon and
Migraine headache.

2726

Internal
Medicine

Cardiology

RIGHT VENTRICLE IS INVOLVED IN 1/3 OF THE inf wall MI.

2731

Internal
Medicine

Cardiology

Ventricular aneurysm is the complication of STEMI.occurs within days to month. C/F persistent
ST-segment elevation after a recent MI and deep Q WAVES IN THE SAME LEADS.

2741

Internal
Medicine

Cardiology

Viral myocarditis,caused by Coxsacie B virus ,is the most common cause of CH in young
patients,with no risk factor of coronary artery disease.

3056

Internal
Medicine

Cardiology

in aortic dissection give beta blockers like Labetalol which decrases heart rate and also blood
pressure,thus minimizing stress on aortic wall.

3065

Internal
Medicine

Cardiology

Chagas disease:Caused by trpanosoma cruzi(PROTOZOA) C/F: megacolon.megaesophagus and

cARDIAC DISEASE

3069

Internal
Medicine

Cardiology

Treatment of patient with WPW nd Afib: Dont give dIgoxin,CCB,bETA BLOCKER AND ADENOSINE.
Give procainamide or Crdioversion if pt is not stable.

3093

Internal
Medicine

Cardiology

Bicuspid aortic valve is also a cause of aortic regurgitaation.There is early diastolic murmur at the left
sternal border.

3096

Internal
Medicine

Cardiology

Atrial tachcardia with AV block is the most specipic arrhythmia for digitalis toxicity.

3158

Internal
Medicine

Cardiology

uses of N acetylcystein: Dissoluton of mucus protection against contrast induced renal failure
Therapy for acetaaminphen overdose

3596

Internal
Medicine

Cardiology

DVT ALGORITHM: if probability is low then dow D dimer IF probability is high then do compression
ultrasound first.

3920

Internal
Medicine

Cardiology

Peripheral edema is the common sideffect of the dihydropyridamole calcium channel blockers like
Amlodipine.

3921

Internal
Medicine

Cardiology

sITUATIONAL SYNCOPE:It occurs mostly in old age ppl with prostate hypertrophy,who wake up at
night and go for urinate and loose consciousness..there is no hx of arrhythmia or postural hyotension.

3950

Internal
Medicine

Cardiology

Cholesterol emboli: c/f livedo retcularis,renal injury,ocular envolvemnt,elevated

CRT,Eosiinophilia,and Hypocomplementemia skin or renal biopsy will show needle shaped cleft
withon the occlded vessels.

3973

Internal
Medicine

Cardiology

High dose Niacin causes cutaneous flushing and inyensive generalzied pruritus.This is die tp niacin
induced vasodilation.

3977

Internal
Medicine

Cardiology

Malignant hypertension: associated with retinal hemorrhages and pappiloedema

3979

Internal
Medicine

Cardiology

hemodialysis is the most effective treatemnt of uremic pericarditis.

3994

Internal
Medicine

Cardiology

wITH AGE THE arterial wall becomes rigid,Thus systolic blood pressure increases,while diastolic
blood pressure is reserved because of the elastic recoil of the arterial wall. TX: systolic blood is low
dose thiazide,acei,CCBS

4042

Internal
Medicine

Cardiology

Management of cocaine induced chest pain: Benzos for blood pressure nd anxiety aspirin nitro nd
CCB

4042

Internal
Medicine

Cardiology

Emergency tx of cocain toxicity: Supplemntal oxygen and intravenous benzos

4068

Internal
Medicine

Cardiology

lIDOCAINE INCREASES THE RISK OF ASYSTOLE IF GIVEN TO PT WITH VENTRICULAR

PREMATURE BEATS. BUT IT DECREASES THE RISK OF A.FIB..

4068

Internal
Medicine

Cardiology

lidocaine decrease the risk of V fib in pts with ACS but increases the risk of asystole.

4129

Internal
Medicine

Cardiology

Risk factors for descending aortic aneurysm are Hypertension,hypercholesterolemia and smoking.

4238

Internal
Medicine

Cardiology

Tachycardia meditaed cardiomyopathy: AF,atrial flutter,V tach,AVNRT can cause cardiomyopathy. tx

: tx the cause ,not the cardiomyopathy first.COntrol rate and rhythm ..

4238

Internal
Medicine

Cardiology

tACHCARDIA ASSOCIATED CARDIOMAYOPATHY:MOST COMMON AFTER

A.FIB,FLUTTER,AVNRT ETC tx: treat the tachcardia(rate and rhythm)

4298

Internal
Medicine

Cardiology

Clopidogrel should be given to pt who have done PCI for UA/NSTEMI.

4345

Internal
Medicine

Cardiology

Cardiac temponad: Hypotension,Distended enck veins,Muffled heart sounds Due to fluid

accumulation in the pericardial cavity,there is the decrease in preload i-e th heart cannot filled up.

4398

Internal
Medicine

Cardiology

Tricuspid regurgitation is the most common complication of IE and it causes holosystolic murmur that
increase in intensity with inspiration.

4484

Internal
Medicine

Cardiology

Marfan suyndrome: cardiac abnormalities: Aortic dilation,regurgitation or dissection The patient will
have diastolic murmur.

4497

Pediatrics

Cardiology

Vascular rings: baby with inpiratidy stridor in prone position and relieved by extension of the neck.
the baby will be congenital heart defect as well.

4616

Internal
Medicine

Cardiology

HIT1: is due to direct ffect of heparin on palateles,The pt count will normalize with cotinued therapy.
HIT2: IS DUE TO ANTIBODIES against plateletes facto 4(PF4) COMPLEXED WITH HEPARIN.usally
repesent 4 to 5 days afer heparin therapy.

4673

Internal
Medicine

Cardiology

HOCM--cRECSENDO DECRESCENDO SYSTOLIC MURMUR ALONG THE LEFT STERNAL

BORDER

4676

Internal
Medicine

Cardiology

Cogenital long qt syndrome have associated hearing loss.

4679

Internal
Medicine

Cardiology

aN ABNORMAL S4 CAN BE HEARD IN KOST PTS DIRUNG ACUTE PHASE OF MYOCARDIAL

INFARCTION.

4680

Internal
Medicine

Cardiology

EXTRARENAL COMPLICATION OF PKD: cerebral aneurysm hepatic and pacreatic cysts cardiac
valvlar abnormalities colonic diverticula inguinal hernia

4709

Internal
Medicine

Cardiology

TX of narrow complex tachcardia: if pt is stable:do maneuveors,if still present then give adenosine. If
pt is unstable,then give sedation and do synchronized cardioversion

4727

Internal
Medicine

Cardiology

IE cause by viridans group shoudl be treated with either pnicillin G or IV ceftriaxone.

4727

Internal
Medicine

Cardiology

viridans group streptococci are msotly suscetipble to IV pen G OR iv ceftriaxone.

4738

Internal
Medicine

Cardiology

rISK FACTOR FOR dEVELOPMENT OF AAA: older age >60yrs cigarrette smoking family hIstory of
AAA ATHEROSCLEROSIS

4742

Internal
Medicine

Cardiology

Aspirine causes bronchoconstriction ESpecially in patients with asthma,chronic rhinitis and nasal
polyps.

4854

Pediatrics

Cardiology

VIRAL MYOCARDITIS CAUSE BY COXSACKIE B OR ADENOVIRUS D/X: CARDIOMEGALY ND

PULMONARY EDEMA ENDOMYOCARDIAL BIOPSY IS GOLD STANDAR SHOWING
INLAMMATORY INFILTRATE WITH MYOCYTE NECROSIS

8472

Internal
Medicine

Cardiology

pULMONARY VEINS ARE THE MOST FREQUENT ORIGIN FOR THE ECTOPIC FOCI THAT
CAUSES ATRIAL FIBRILLATION.

2747

Internal
Medicine

Dermatology

Tinea versicolor: cause by malassezia furfur pale,velvety pink whitish hypopigmented macule,that
scales on srapping. spaghetti nd meatball appearnace on KOH prep tx: topical slenium sulfide lotion
or ketoconazole shampoo

2748

Internal
Medicine

Dermatology

Miliaria: also know sas heat rash.Presents as superficial small vesicles,papules,pustues, which is
burning and itching..Caused by hot and moist climates.

2754

Internal
Medicine

Dermatology

ICYTHOSIS VULGARIS: also called lizard skin.the skin become dry and lizard skin like plaque
formed on extensor srfaces.

2760

Internal
Medicine

Dermatology

Clazion is nodular rubbery chronic granulomatous conition,caused by the obstruction of meibomian

gland. Hodoleum is the acute infection of the eyelid mostly commonly caused by Staph.

2770

Internal
Medicine

Dermatology

ACE inhibitors are the most comon caues of acquired angioedema.

2775

Internal
Medicine

Dermatology

Pemphigus vulgaris: IGg deposition i the epidermis Bullous pemphigoid:IGg and C3 deposits i dermal
epidermal junction deRMATITIS HERPETIFORMIS:igA deposits along dermal papillae

4296

Internal
Medicine

Dermatology

Autoimmune condition associayed with vitiligo: Graves,Type 1 DM,pernicious anemia,primary

adrenal insufficiecny,hypopituitarism and alopecia areata.

4314

Internal
Medicine

Dermatology

Pophyria cutanea tarda : c/f painless blisters,increased sin fragility,facial hyertrichosis,and

hyperpigmentation.Triggered by ethanol or estrogens. TX:phlbotomy or hyrdoxholorquine or
interferon alpha in pts with hep c.

2831

Pediatrics

ENT

cholesteatoma can be congenital or acquird secondary to chronic middle ear disease. c/f New onset
eharing loss or chronic ear draingage despite antibiotic therapy are typical presentation.

3972

Pediatrics

ENT

most common cause of Acute ottitis media are: Streptococcus pneumonia nontypeable hemophilus
type b Moraxella catarrhalis

4282

Internal
Medicine

ENT

Malignant otitis externa:Common in Diabetic pts cause by Pseudomonas aeruginosa present with
ear ache,difficulty to chew or open mouth.ear drianage,Granulation tissue can damage the facial
nerver Cuases osteomyelitis of skull base of TMJ TX: CIPROFLOXACIN

2817

Internal
Medicine

Electrolytes

Adrenal insufficiecny: Increse potassium low sodium low glucose low bp since there is low cortisole
and aldosterone ,thus leading to decrease sodium,increase potassium andincrease Hydrogen ions
as well...Thus it causes normal anion gap metabolic acidosis.

2821

Internal
Medicine

Electrolytes

Lactice acidosis decondary to tonic clonic seizure: No treatment is required to corretct metabolic
acidosis,wait and obserrver the pt for 2 hours>

3654

Internal
Medicine

Electrolytes

Potassium can be removed from the body by cation exchange resins,dialysis and diuretics.
Examples of cation exchange resins are: Kayexelate or sodium polystyrene sulfonate.

4423

Internal
Medicine

Electrolytes

Alcoholism causes hypokalemia,hypomagnesemia and hypophospatemia. All the three should be

corrected together.

4428

Internal
Medicine

Electrolytes

Succinly choline causes significant potassium release so it is contraindicated in pt who already have
hyperkalemia.

8331

Internal
Medicine

Electrolytes

Meds causing hyperkalemia: ACEI/ARBS BETA BLOCKERS CYCLOSPORIN DIGOXIN NSAID

HEPARIN TMP-SMX SUCCINLYCHOLINE

2176

Internal
Medicine

Endocrinology

Parathyroidectomy indications: serum calcium >1 mg/dl above the upper limit of normal young age
.50 yrs bone mineral density,-2.5 reduced renal function

2178

Internal
Medicine

Endocrinology

if a pt suffer from leukocytosis after taking antithyroid drugs,discontine the drug and do WBC
COUNT.if count is less than 1000 PER CUBIC MM permanently discontinue the drug.IF TOTAL WBC
COUNT IS GREATER THAN 1500 PER CUBIC MM,ANTITHYROID IS UNLIKELY THE CAUSE.

2189

Internal
Medicine

Endocrinology

arterial PH Nnd anion gap are the most reliable indicator of metabolic recovery in patients having
DKA.

2192

Internal
Medicine

Endocrinology

Side effects of hypoglycemics: Metformain: mactic acidosis Sulfonylureas:weight gain and

hypoglycemia Pioglitazones(tzds):weightgain,edema,CHF,bone fracture,bladder cancer dpp-iv inhib:
it can be used in renal insufficiecny GLP-1 RECEPTOR AGONIS: WEIGHT LOSS IF DESIRED

3083

Internal
Medicine

Endocrinology

vIT D toxicity: the patient will have sx of hypercalcemia like abdominal pian,polyuria,polydipsia.

3231

Internal
Medicine

Endocrinology

hYPERALDOSTEONE TX:- Unilateral adrenal tumor: spironlactome,eplerenon Bilateral adrenal

tumor:Aldosterone antagonists

3483

Internal
Medicine

Endocrinology

Hypothyroidism can cause: hyperlipidemia hyponatermia elevated ck

3487

Internal
Medicine

Endocrinology

PROPYLTHIOURACIL ND METHIMAZILE both causes AGRANULOCYTOSIS

3494

Internal
Medicine

Endocrinology

MEN 2B: Medullary throid cancer Pheochromocytoma and 1. mucosal & intestinal neuroma 2.
marfanoid habitus

3495

Internal
Medicine

Endocrinology

Subclinical Hypothyroidism: Normal t3 nd t4 ,Low TSH eUTHYROID SICK SYNDROME: DECREASE

T3 while normal t4 nd TSH

3518

Internal
Medicine

Endocrinology

pget disease: The patient should be given Bisphoponates,calcium and vitamin D.

3520

Internal
Medicine

Endocrinology

RET Proto oncogene testing shoudl be done in pts suspeting MEN 2 SYNDROMES.

3594

Internal
Medicine

Endocrinology

LEYDIG CELL TUMOR PRODUCE ESTROGEN,THUS CAUSES GYNECOMASTIA IN MALES. IN

SEMINOMA beta hcg and alpha feto proteins levels are norma. in teratome both are elevated.

3634

Internal
Medicine

Endocrinology

Most common cause of death in pts having acromegaly is cardiovascular.

3781

Internal
Medicine

Endocrinology

Monofilament testing is used to asses the peripheral neuropathy in diabetic patients.

3800

Internal
Medicine

Endocrinology

tx of diabetic neuropathy: TCA,GABAPENTIN OR NASIADS.

3899

Internal
Medicine

Endocrinology

in primary polydipsia serum sodium is kess than 137 while in diabetes insipidus the serum sodium is
higher than 150.

3952

Internal
Medicine

Endocrinology

HTN causes in Hypo nd Hyperthyroidism: in hyo there is increase vascular resistance. In hyper
thyroidism there is hyperdynamic circulation.

3976

Internal
Medicine

Endocrinology

in pheochromocytoma ,beta blocker with alphablockers will cause unopposed stimulation of vascular
alpha receptors by circulating catecholamines which reslts in rapid catastrophoc increase in BP.

4132

Internal
Medicine

Endocrinology

Hypothyroidism is the major sideeffect of radioactive iodine therapy.

4191

Internal
Medicine

Endocrinology

Siledenafil pharmacotkinetics: Contraindicated with Nitrates interfer with erythromycin and

cimetedine taken 4 hours earlier than Alpha blocker,used for BPH

4239

Pediatrics

Endocrinology

lATE ONSET CAH: HAVE SIGNS OF ANDROGEN EXCESS INSTEAD OF SALT WASTING as in in
neonatal CAH.

4307

Internal
Medicine

Endocrinology

Untreated hyperthyroidism increase the risk of rapid bone loss.

4308

Internal
Medicine

Endocrinology

iF THERE IS HYPERCALCEMIA THEN NEXT step is to measure PTH LEVEL. if PTH level is high
then cause is primary or tertiary hyperthroidism,or familial hypercalcemia hypocaciuria,or lithium
induces. IF pth is high then it might be malignancy,vit D toxicity,granul matous disease,vit a toxicity
immobilization or drug induced.

4323

Internal
Medicine

Endocrinology

Diagnosis of Acromegaly:- 1st step: Measure IGF-1 LEVEL--IF HIGH THEN DO ORAL GLUCOSE
SUPPRESSION TEST

4415

Internal
Medicine

Endocrinology

radioactive iodine therpy worsend the exophthalmos.

2217

Internal
Medicine

GIT

E-coli an d klebsiela are the most common pathogen envolved in SBP. Neutrophils counts >250/mm3
is dignaostic.

2464

Pediatrics

GIT

miLK OR SOY PROTEIN INDUCED PROCTOCOLITIS: painless bloddy stools,eczema and

regurgitation or vomiting

2467

Pediatrics

GIT

dOWN SYNDROME IS ASSOCIATED WITH HIRSCHPRUNG DISEASE WHILE CYSTIC FIBROSIS

WITH MECONIUM ILLEUS. In MI,the obstruction is at the level of the illeum while in Hirschprung the
obstruction is at rectsigmoid level.

2649

Internal
Medicine

GIT

VIPoma: watery diarrhrea decreases gastric acid secretion hypokalemia VIP>75 do abdominal ct or
MRI to lcalized tumor in pancreatic tail

2966

Internal
Medicine

GIT

cigarrette smoking,obesity,low physical activity,chronic pancretitis are the major risk factors for
pancreatic cancer.

2977

Internal
Medicine

GIT

only conjuagted bilirubin can be detected in urine,cos it is water soluble.

3835

Pediatrics

GIT

Beckwith-wiedmann syndrome: aleration in 11p15 Macrosomia\macroglossia hemihyperplasia

abdominal wall defects( Umbilical hernia,omphalocele) Hypoglycemia Do U/S to rule out wilms tumor
and hepatoblastoma

3835

Pediatrics

GIT

beckwith-widemann syndrome: 11p15 chromoso defect which encoded IGF2 ND GROWTH

PROMOTING HORMONSE SIMMILAR TO INSULIN. c/f macrosomia,macroglossia and
hemihyperplaisa and abdominal wall defects. The childs are at increased risk of Wilms tumor nd
Hepatoblastoma.

3887

Internal
Medicine

GIT

Giardia: Hx of developing country visite,Hiking or Gay MEN C/F : FOUL SMELLING STOOL,FATTY
STOOL,FLATULENCE,ABDOMINAL CRAMPS dx:STOOL ANTIGEN TEST tx: Metronidazole

3918

Internal
Medicine

GIT

Villous atrophy polys which are sessile polys,are the most premalignant polys of the colon.

4183

Pediatrics

GIT

narly all pts with CF have sinoplumonary disease.Opcaification of the sunises is seen in all CF pts at
age 8 months.

4389

Internal
Medicine

GIT

Nonalcoholic steatohepatitis causes: obesity DM hypertriglyceridemia the ot is aymptomatic with

hepatomegaly and elevted transaminseses there is fatty infiltration of the liver.

2221

Internal
Medicine

Genitourinary

Left side varicocele is rekated with Renal cell carcinoma. There is flank paon,hematuria,and palpable
abdominal renal mass.

2223

Internal
Medicine

Genitourinary

Focal segmental GS: Common is heroin users,obesity and HIV Membranous: NSAIDS,HEP B SLE
Minimal change:NSAIDS,LYMPHOMA

2224

Internal
Medicine

Genitourinary

Indication for Hemodialysis: Refractory hyperkalemia volume overload,Pul edema not respondng to
diuretics Refractory met acisosis Uremic pericarditis uremic encephalopathu or neuropathy
Coagulopathy due to renal failure

2228

Internal
Medicine

Genitourinary

Struvite stones are formed by ureas producing bacteria( proteaus) especially where the urin is
Alkaline.

2230

Internal
Medicine

Genitourinary

IGA nephropathy: normal complements,Mesangial IGA depostits seen in kidney biopsy PIGN: LOW
C3 COMPLEMENT elevated ASO TITRE subepithelial bumps consisting with c3 complements

2232

Internal
Medicine

Genitourinary

Mixed essential cryoglobulinemia: Palpabel purpura proteinuria heamturia dx:circulating cryglbulins

most pts have underlying hep c infection.

2233

Internal
Medicine

Genitourinary

ALPORT SYNDROME: Hematuria,proteinura and Sensorineural deafness Histology shows

alternating areas of thinned and thickened capillary loops with splitting of glomerular basement
membrane

2235

Internal
Medicine

Genitourinary

tx of uncomplicated cystitis: Nitrfurantoin,TMP-SMX COMPLICATED

CYSTITIS:FLUORQUINOLONES pYELENEPHRITIS:outpt-fluoroquinoloes inpt:iv ceftraiaxone or
fluoroquinolones

2236

Internal
Medicine

Genitourinary

Common cause of urethritis/cystitis Neisseria gonnorrhea (most common) Chlamydia trachomatis

mycoplasma genitalium Tichomonas

2237

Internal
Medicine

Genitourinary

Ciprofloxacin is the only oral medications used in patients with Pyelonephritis empirically. or give IV
CEFTRAIXONE,OR GENTA

2243

Internal
Medicine

Genitourinary

RENAL VEIN THROMBOSIS is an important complication of nephrotic syndrome.Antithrombin 3 is

lost in urine and puts the ot at increased risk of thrombosis. RVT present with sudden onset of
abdominal pain,fever and hematuria in a nephrotic patient,with Membranous glomerulnephritis..

2243

Internal
Medicine

Genitourinary

renal vein thrombosis is common in Nephroti syndrome,especially most common in Membarnous

glomerulonephritis.

2513

Pediatrics

Genitourinary

dESMOPRESSIN: CAUSES HYPONATREMIA IF TOO MUCH FLUID IS CONSUMED IN EVENING

3894

Internal
Medicine

Genitourinary

the usual cause of renal arter stenosis in young adults is Fibromuscular dysplasia. In older patients
renal artery stenssi is usually caused by Atheromatous plaque.

3894

Internal
Medicine

Genitourinary

Rena artery stenosis in young pts is due to fibrmuscular dysplaisa.Tx by angioplasty with stent
placement.

3916

Internal
Medicine

Genitourinary

Common causes of Priapism: Trazodone Prazosin sickle cell disease and leukemia perineal or
genital trauma neurogenic lesion suck as spinal cord injury,cauda equina

3939

Internal
Medicine

Genitourinary

Polycystic kidney diesseas: Autosomal dominant(ADPKD) COMPLICATIONS: Intracranial aneurysm

to high BP HEPTIC CYSTS VALVULAR HEART DISEAS COLONIC DIVERTICULA ABODOMINAL
WALL AND INGUINAL HERNIA

3939

Internal
Medicine

Genitourinary

Extrarenal complication of ADPKD: hepatic cysts(most common) Vavular heart ds(mostly mvp nd AR)
colonic diverticula abdominal and inguinal hernia

3940

Pediatrics

Genitourinary

Membanous Nephropathy is the most common cause of nephrotic syndrome in opts with Hepatitis B.
FSGN is coomon in HIV.

3942

Internal
Medicine

Genitourinary

Hypertension causes Nephrosclerosis.

3942

Internal
Medicine

Genitourinary

hYPERTENSION S THE LEADING CUASE OF END STAGE RENAL DISESE IN USA.It cause
nephrosclerosis.

3946

Internal
Medicine

Genitourinary

Membranoproliferative Glomerulnephritis is due to persistent activation of the alternative

complement pathway.Biopsy shows dense deposits within glomerular basement membrane.

3949

Internal
Medicine

Genitourinary

Cystinuria: recurrent stones postve family history typical hexagonal crystals on urinalysis and postive
urinary cyanide nitroprusside test

3949

Internal
Medicine

Genitourinary

Cysteinuria: Fmilial Hexagonal crstals on urinalysis postive urinary cyanide nitroprusside test

3955

Internal
Medicine

Genitourinary

Prolonged hypotension from any cause can lead to ATN.The hallmark of finding is muddy borwn
granualr casts . Broadand waxy casts--Chronic renal failure RBC casts--glomerular disease
WBC--pYELONEPRITIS,Interstitial nephtrits Fatty casts--Nephrotic nysdrome

3965

Internal
Medicine

Genitourinary

Emergency plasmaphaersis is required in patients having Goodpasture's syndrome.

3966

Internal
Medicine

Genitourinary

NSAIDS nd Hodgkins lymphoma are the most common cause of Minimal change disease.

3967

Internal
Medicine

Genitourinary

Sickle cell patients are at increased risk of Hematuria due to renal pappillary ischemia or
necrosis,renal medullary carcinoma,and UTI.

3978

Internal
Medicine

Genitourinary

ERYTHROPOEITIN SIDE EFFECTS: hypertension or worseing of rpeexisting hypertension Flu liek

syndrome Headcahes red cell aplasia

3984

Internal
Medicine

Genitourinary

Focal segmental glomerulnephritis is the most common kidney disease in HIV positive pts regardless
of the CD4 count

3987

Internal
Medicine

Genitourinary

Intravenous acyclovir can cause crystal induced acute kidney inury.The drug have low urinf solubility
and thus precipitates in the renal tubules,causing intralobular obstruction and direct renal toxicity.

3997

Internal
Medicine

Genitourinary

Amylodosis: Apple green birefringent under polarized light afetr staining with congo

4007

Internal
Medicine

Genitourinary

Papillary necrosis and tubulointerstitial nephritis are the two common pathologies caused by NSAIDS.

4026

Internal
Medicine

Genitourinary

Cardiovascular disease is the most common cause of death in dialysis pts.

4058

Internal
Medicine

Genitourinary

tx of hypercalciuric hypocalcemia: Increase fluid intake normal or increased calcium intake dietary
sodium restriction oxalate restriction Thiazide/ameloride diuretcs dcreased dietary proteins

4266

Internal
Medicine

Genitourinary

Patients with nephrotic syndrome are at increase risk of hypercoagulability due to many causes. due
to increase rinary loss of antithrombin altered level of preotin c nd S increase platelte aggregation
impaired fibrinolysis

4288

Internal
Medicine

Genitourinary

MEDICATION cause Hyperkalemia: NSAIDS ACEI ARBS POTASSIUM SPARING DIURETICS

DIGOXIN NONSELECTIVE BETA ADRENERGIC BLOCKERS

4491

Internal
Medicine

Genitourinary

Prevention of contrast induced nephropathy: Normal saline iv Isotonic bicarbonates Acetylcysteine

4506

Internal
Medicine

Genitourinary

Risk factor for bladder cancer: age> 35 smoking ccupational hx( chemicals,dyes) drug exposure liek
cyclophosphamide

4750

Internal
Medicine

Genitourinary

Most common Histologic lesion in pts with diabetes is DIFFUSE GLOMERULOSCLEROSIS.

4751

Internal
Medicine

Genitourinary

Blood in start of urination-Urethral problem Blood in the end of urintion-Prostate or bladder Blood
through out urination-Kidney or ureter

4752

Internal
Medicine

Genitourinary

Hepatorenal syndrome: Occurs due to decreased renal blood flow,renal vasoconstriction oddur and
thus GFR is reduced. two type: TPYE 1 IS RAPIDLY PROGRESSIVE TYPE 2 IS SLOWLY WITH AN
AVERAGE SURIVIAL OF 3 TO 6 MONTH. tx: here is no specific tx for HRS,Liver transplantation is
the only tx.

4807

Internal
Medicine

Genitourinary

Interstitial cystitis:unclear etiology Cf: Urinar urgency,frequency as well as chronic pelvic pain in the
absence of another disease that could cause the symptoms.Symptoms are relieved by voiding.
cystoscopy shows submucosal petechiae or ulcerations.

2248

Internal
Medicine

Hem&Onc

Spherocytes can be seen in Hereditary spherocytosis as well as in AIHA (AUTOIMMUNE HMOLYTIC

ANEMIA)

2249

Internal
Medicine

Hem&Onc

MGUS: no anemia,Hypercalcemia,lytic lesion or renal insufficiency Serum monoclonal proteins

<3g/dl Multiple myeloma: There is anemia,hypercalcemia lytic lesions and renal insufficiecny Serum
monoclonal prteins <3 g/dl

2250

Internal
Medicine

Hem&Onc

HIT: PT count reduction >50 % Thrombsosis Necrotic skin lesion at inj sites ANaphylactic reactions
after heparin DX:Serotonin release assay Stop heparin and give Argatroban,Bilavlirudin or
Fondaparinux

2258

Internal
Medicine

Hem&Onc

Paroxysmal nocturnal hemoglubinuria: Hemolysis Cytopenias Venous thrombsosis Dx: FLOW

CYTOMETRY(CD55 DN CD59 ABSENT) tx: iron nd folate Eculizumab

2589

Internal
Medicine

Hem&Onc

In testicular cancer,First do high inguinal orchiectomy ( reomove testes and associated cord) and
then examin for the type of cancer.

2590

Internal
Medicine

Hem&Onc

Anterior Medistinal masses: 4ts Themoma teratoma thyroid neoplasm terrible lymphoma

2590

Internal
Medicine

Hem&Onc

Anterior medistinal masses: 4Ts Themoma,teratoma,thyroid neoplasma nd terrible lumphoma

2605

Internal
Medicine

Hem&Onc

Breast cancer prognosis: Prognosis depends on TNM staging ER+ ND pr+ are good prognostic
overexpression of HER-2/NEU-ONCOGENE is owrse prognostic

2606

Internal
Medicine

Hem&Onc

Tamoxifen increases to types of uterine cancers: 1;Endometrial caner,which arsises in the lining of
the uterus 2:Uterine sarcoma:which arises in the muscular wall of the uterus.

2607

Internal
Medicine

Hem&Onc

paget's disease of the breast: 85% pts ahve underlying breast cancer as well,mostly
adenocarcinoma. Biopsy will show large cells surrounded by halo like aread invading the epidermis.

2612

Internal
Medicine

Hem&Onc

Overexpression of oncogene HER2 can be detected by Immunohistochemical staining IN BREAST

CANCER. pOSITIVITY PREDICTS a positive response to trstuzumab and anthracycline
chemotherapy.

2618

Internal
Medicine

Hem&Onc

gIANT CELL Tumor:beningn Epiphysis tumor x-ray: expansible and eccentric lytic area (Soap-bubble
appearance) Increase pathologic fractures due to thinning of the bone cortex in weight bearing areas

2623

Internal
Medicine

Hem&Onc

5HT3 antagonists are considered first liek agent for Chemotherapy induced nausea.

2632

Internal
Medicine

Hem&Onc

Squamous cell carcinoma : Is associated with symptoms of hypercalcemia,because the SSC secret
PTH RELATED PROTEIN,WHICH IS SIMILar to PTH in the receptor niding area. Squ........aCA

2641

Internal
Medicine

Hem&Onc

Tumor Lysis Syndrome: Hyerphospatemia hyperuricemia hyperkalemia nd Hypocalcemia( b/c

released phosphate binds the calcium)

2645

Internal
Medicine

Hem&Onc

GLUCAGONOMA: there is Necrolytic migratory erythema Diabetes mellitus Diarrhea weight loss dx:
hyperglycemia with elevated glucagon Normocytic,normochromic anemia Abdominal imaging

2645

Internal
Medicine

Hem&Onc

Glucagonoma: Migratory necrolytic erythema+ DM+diarrhea(watery)+weight loss

2646

Internal
Medicine

Hem&Onc

progesterone analogs and steroids are helpful in end stage cancer pts with decrease apetite,weight
loss .

2865

Internal
Medicine

Hem&Onc

CLL: smudge cells are highly characteristic Most cells have over matured look b/c of the
hypersegmented nuclea chromatin material.

2867

Pediatrics

Hem&Onc

ALL: PAS +VE (periodic acid schiff) blasts cells

2868

Internal
Medicine

Hem&Onc

Hairy cell leukemia: B lypmphcytic derived chronic leukemia There are ahiry projection seen on the
lymphocytes.tHE BONE MARROW BEOCME FIBROTIC( A DRY TAP) Tratrate-resistant acid
phosphatase stain and CD11 c marker are relatively specific. TX: treated with Cladribine

2869

Internal
Medicine

Hem&Onc

Infectious mononucleosis: hISTOLOGICALLY MANY VARIENTS OF LYMPHCYTES ARE

SEEN,including cells with convolted neclei and highly vacoulated cytoplasm.

2886

Internal
Medicine

Hem&Onc

LEUKEMOID REACTION: is a marked incease in leukocytes due to sever infection of

inflammation.An increase Leukocyte alkaline phosphatase (LAP) score is typical for this condition.

3062

Internal
Medicine

Hem&Onc

Hereditary Spherocytosis: There is defects in Ankyrin gene abnormal rbc plasma membrane
scaffolding proteins. Elevated MCHC,RDW hIGHr risk of gallstones and aplastic crisis by PARVO
VIRUS B19 DX:osmotic fragility test (Eosine-5-maleimide binding test) tx:supportive,folic acid and
splenectomy

3062

Internal
Medicine

Hem&Onc

hERDITARY SPHERCYTOSIS: hAVE ELEVATED MCHC nad RDW .dx by Frragility test or eosin 5
maleimide binding test. Tx:SUPPORTIVE,FOLIC ACID OR TRANSFUSION IF SEVER ANEMIA

3284

Pediatrics

Hem&Onc

presence of greater than 25 % lymphoblasts on bone marrow biopsy are significant for the diagnosis
of ALL.

3552

Pediatrics

Hem&Onc

wilms tumor: Associated with WAGR(WILMS,ANIRIDIA,GU anomalies,medntal retardation)

3665

Pediatrics

Hem&Onc

Pinealoma: causes Parinaud syndrome in which: paralysis oif vertical gaze+pupillary problem+eyelid
retraction the patient also have endocrine problems.

3680

Internal
Medicine

Hem&Onc

Spinal cord compression: due to spinal cord injury Malignancy Infection TX: Emergency MRI IV
steroids Radiotherapy nd Neurosurgeon consultation

4037

Internal
Medicine

Hem&Onc

Acquired sideroblastic anemia:Most commonly cause by pridoxine deficiency. ASA manifest as

microcytic,hypochromic anemia. two type od RBCs can be demonstrated on
microscopy:Hypochromic and normochromic

4147

Internal
Medicine

Hem&Onc

Folate deficiency is acused by: Phenytoin TMP-SMX Methotrexate

4147

Internal
Medicine

Hem&Onc

tRIMETHPRIM,methotrexate and Phenytoin chronic use can cause Folic acid deficiency.

4316

Internal
Medicine

Hem&Onc

Type 1 HIT: 1 to 4 days after heparin,PT cnt >100,000 continue heparin nd observe Type 2 HIT:
OCCURS AFTER 5-10 DAYS pt count usually >20,000 Increase risk of thrmbosis stop heparin nd
start argatroban etc

4350

Internal
Medicine

Hem&Onc

vIT B12 acts as a cofactor for the demethylation of methyl-tetrahydrofolate.Tetrahydro folate is used
in foration of purine molecules for DNA synthesis.

4351

Internal
Medicine

Hem&Onc

Nodes whicha re firm,immobile and diameter >2 cm are likely to be malignant.

4352

Internal
Medicine

Hem&Onc

most of the head and neck cancer are SCC.represent as hard,non tender submandbular nodes.Mpst
common in smokers.

4374

Internal
Medicine

Hem&Onc

Androgen use in men (athletes) causes sideeffects like: depressed testiclar function,testicular
atropy,gynecomastia,mood disturbances In women: Acne,hirsutism,deepning of voice,and menstrual
irregularities LAB:ERYTHROCYTOSIS,HEPATOTOXIXCITY AND DYSLEPIDEMIA

4412

Internal
Medicine

Hem&Onc

In lupus coagulant: PTT will eb normal or slightly prolingedVWF ,bt nd PT COUNT WILL EB
NORMAL d DIMER WILL BE Hight or normal.

4416

Internal
Medicine

Hem&Onc

Most common cause of thrombocytopenia and lukopenia in SLE is immune mediated pereihperal
destruction.

4440

Internal
Medicine

Hem&Onc

Alpha thamssemia trait and Beta thalassemia minor is differentiated from iron defficiency anemia by
the presence of TART=GET CELLS ON SMEAR. there is also normal to increase iron nd ferritin in
BOTH THALASEEMIAS (MINOR ND TRIT)

4440

Internal
Medicine

Hem&Onc

bETA THAlassemia trait have high rbc count,HGb > 10 WHILE iron def anemia have low RBC count
and HGB is <10.

4447

Internal
Medicine

Hem&Onc

herditary telangiectasia( Psler-weber-rendu syndrome) Diffuse telagectasia,recurrent epistaxis and

widespread AV malformation.AVM in the lungs can cause shunting ,thus causing chronic hypoxemia
nd reactive polycythemia.pulmonary AVMs can cause hemoptysis.

4466

Internal
Medicine

Hem&Onc

Multiple myeloma: MM pts are at increased risk of infections due to total decrease in functional
antibodies and leukopenia secondary to over crowding of bone marrow with malignant plasma cells.

2896

Pediatrics

Hepatology

Reye syndrome: There is micrvesicular fatty infiltration and hepatic mitochondrial dysfunction

2910

Internal
Medicine

Hepatology

Non-alcoholic fatty liver diease: common in obese,Hypertriglyceridemia aND DM. Biopsy show
macrovesicular steatosis,polymorphnuclear cellellaer infiltrates and necrosis

2915

Internal
Medicine

Hepatology

Hepatits has no chronic carrier state,However it can progress to fullminant hepatitis in pregnant
femaile.Mother can also tranist to teh baby.

2917

Internal
Medicine

Hepatology

Iosniazid induced hepatiits: Histology will hsow panlobular monuclear infiltration and hepatic cell
necrosis.

2919

Internal
Medicine

Hepatology

aLPHA 1 ANTITRYPSIN DEF: Chromosone 14 defect Tx/:Purfied human A1AT HORMONE OR

LIVER TRANSPLANT

2923

Internal
Medicine

Hepatology

bening Unconjugated hyperbilirubinemia: Gilbert: decrease UDP glucuronyl tranferase no treatment

required Criggler Najjar syndrome type 1:autosomal recessive,in which there is neurologic
impairment sue to kernicterus.No improvemnt with phenbarbital.do plasmapharesis or
phototheraphy. Crigler n typ 2: milder autosomal recessive disorder,no kernicterus,give phenobarbital

2924

Internal
Medicine

Hepatology

Dubin Jhonson Syndrome:there is predominanatly conjuagted hyperbilirubinemia without

hemolysis,This is bening condition common in jews. Liver biopsy shows dark granular pigment in the
hepatocytes.

2932

Internal
Medicine

Hepatology

Hepatic adenoma: benign epithelial tumor,associated with OCP intake,anabolic androgen

use,glycogen sotrage disease ad DM. BIOPSY SHOWS MULDLY ATYPICAL ENLARGED
HEPATOCYTES CONTAINING GLYCOGENA ND LIPID DEPOSITIS.

2932

Internal
Medicine

Hepatology

hEPATIC ADENOMA: histology:atypical enlarged hepatocytes containing glycogen and lipid deposits

2938

Internal
Medicine

Hepatology

Alcoholic liver disease and wilson's dieseae have same findings on the biopsy of the liver cells. but In
ALD there is history of alcoholic intake with in wilson disease there is history of gait and
neuropschiatric symptoms.

2940

Internal
Medicine

Hepatology

Emphysematous gallbladder: cause by infection of gall bladder by gas forming

bacteria(ESCHIRCHIA,CLOSTRIDIUM,STAPH,STREP,PSEUDOMONAS,AND KEBLSIELA)
C/F.RUQP,nausea,vomiting and low grade fever DX: Abd radiograph demonstraing air fluid levels in
gallbladder, U/S SHOW CUVELINIER gas shadowing in gallbladder

2942

Internal
Medicine

Hepatology

Risk factors for galbladder cancer: Age gallstones porecelain gb salmonella typhi carriage anatomic
variations carcinogen exposure

2960

Internal
Medicine

Hepatology

hEPATITIS C treatment: tx should be started after detectable HCV RNA in serum AND Liver
biopsy,to find if there is portala nd bridging fibrosis. Contraindication to tx are: Alcohol or drug
abuse(currently) Major uncontrolled depression

2965

Internal
Medicine

Hepatology

possible causes of pancreatitis: Gallstone.alcohole hypertriglyceridemnia,ERCP,thyzide

2978

Internal
Medicine

Hepatology

Acute cholangitis: charcot triad: fever,jaundice and RUQP REYNOLD PENTAD: above sx with
confusion and hypotension. ERCP WITH SPHINCTEROTOMY is therapeutic and diagnostic as well.

2983

Internal
Medicine

Hepatology

Postoperative cholestasis: IS A BENIGN CONDITION ,after a amjor surgery in which there is

hyptonesion ,massiev blood loss. thre is acute jaundice with Increase alk phosphatase.

2986

Internal
Medicine

Hepatology

Fulminant hepatic failure: Most common in hep B or Hep D pts with history of acetaaminphen,alcohol
and methamphetamines. There is sudden elevation of transaminases,and prithrombin time and
elevtaed Prothrombin tine.

4278

Internal
Medicine

Hepatology

Alcoholic fatty liver: Biopsy will shpw mALLORY BODIES,INFILTRATION BY NEUTRPHILS,LIVER

NECROSIS

4321

Internal
Medicine

Hepatology

Non alcoholic fatty liver disease is due to peripheral insulin reisistance that elaad s to increased
peripheral lipolysis,trigylceride synthesis,and hepatic uptake of fatty acids.

4624

Internal
Medicine

Hepatology

Vanishig bile duct syndrome: characterized by progressive destruction of the intrahepatic bile
ducts.histological hallmark is ductompenia. Other causes of ductpenia are: PBC hodgkin's diease
failing liver transplant GVHD hiv CMV INFECTION

4648

Internal
Medicine

Hepatology

Ischemic hepatic injury: (shock liver) the pt is having septic shock and develope suddenly elevtaed
AST ND ALT one day later,with odest leve of bilirubin and ALP elevation.

4654

Internal
Medicine

Hepatology

HCV:pts can have PORPHYRIA CUTANEA TARDA,INwhich there si fragile

skin,photosenstivity,vesicles and erosions on the dorsum of the hands. HCV also has strong
corelation with Essential mixed cryoglobulinemia.

2270

Internal
Medicine

ID

CMV mononucelosis: atypical lymphocytosis,with no pharyngitis,and cervical lymph have vacoulated

basophils.

2272

Internal
Medicine

ID

ELISA IS THE SCREENING TESY AND WESTERN BLOT IS THE CONFIRMATORY TEST FOR HIV.

2273

Internal
Medicine

ID

PCP 1st line tx: Trimethprim smx iv for acute ill... Add steroids if if pao2 <70 or A-a gradient >35.

2994

Internal
Medicine

ID

Mucomycosis: TX SURGICAL DEBRIDEMENT PLUS IV AMPHOTERICIN

2995

Internal
Medicine

ID

Histoplasmosis: The fungus targets histiocytes and the reticulendotheial systme,thus causing
lymphadenopathy.pancytopenia and hepatosplenomegaly. thre are platal ulcers as well. xray show
hilar adenopathy with or wthout areas of pneumonitis.

2998

Internal
Medicine

ID

Coccidiomycosis: Fever,fatige,dry cough and weight loss and pleauritic chest pain Cutaneau findings
include Erythema multiformse,erythema nodisum as well as arthralgias.

3000

Internal
Medicine

ID

sporotrichosis is caused by Sporothrix schenckii..it is common in gardners

3014

Internal
Medicine

ID

Streptococcus Sanguinis: belongs to the viridans group which also include S.mitis,S oralis,S
mutans,S sobrinus. All of these becteria causes IE in patients having native valves after dental
procedures.

3104

Internal
Medicine

ID

Babesiosis:caused by babesia,which si psread by ixodes tick. c/f hemolytic anemia jaundice

hemoglobinuria renal failure

3131

Internal
Medicine

ID

Complication of Infectious mononeucleosis: Autoimmune hemolytic anemia Thrombocytopenia

3247

Internal
Medicine

ID

Ehrlichiosis: transmitted by tick Flue liek sx confusion no rash leukopenia and thrombocytopenia
elevated liver enzyme. TX: Doxcycline

3260

Internal
Medicine

ID

PSEUDOMONAS EXTERNA IS THE MOST COMMON CAUSE OF malignant otitis externa.

3262

Internal
Medicine

ID

Clue for UTI caused by proteaus mirabilis: The urine ph will akaline ,and this due to alkaline urine
there are high chances of Struvite stones.

3266

Internal
Medicine

ID

rubella in elders: SYMPTOMS ARE SAME LIEK MEASLE BUT MILDER +ARTHRALGIA

3286

Pediatrics

ID

streptococcus pneumonia and haemophilus influenza are the msot common cause of acute bacterial
rhinosinusitis.

3444

Pediatrics

ID

patients with infectious monnucelosis,can get post antibiotic polymorphous and maculopapular
rash.Its not a true drug alergic rash and the antoibiotics can be given in the future. Infectious
monnucleosis ,there is diffure cerical lymphadenopathy while in GAS INFECTION,there is anterior
cervical lymphadenopathy

3613

Internal
Medicine

ID

cmv in immunspressed:suspect cmv in immunosuppressed with lung nd GI symptoms.

3636

Pediatrics

ID

Doxycycline is contraindicated in children age <8 yrs and in pregnant women.

3663

Pediatrics

ID

Congenital rubella infection: Catarcts + murmur of PDA+ HEARNIGN LOSS

3808

Internal
Medicine

ID

neurocysticercosis: cause by the ingenstion of larva of Teania solium.They reach the cns
hematgenously. characterized by multiple,smal fluid filled cysts in the brain parenchyma.

3830

Pediatrics

ID

gram positive cocci in cluster: staph aureus gram positive cocci in chians: streptococcus pneumonia
gram negative rod: pseudomonas aeruginosa these bacteria are the common pathogens causing
pneumonia in pts with CYSTIC FIBROSIS.

3917

Internal
Medicine

ID

CMV can cuase chronic bloody diarrhea in HIV pts with cd4 <50

3917

Internal
Medicine

ID

CMV: bloody diarrhe with normal stool exaination do colonoscopy for biopsy which will show multiple
musocal erosions and coloinc ulcerations.alSO THERE are large number of eosinophilic intranuclear
and basiphilic cytoplasmic inclusions. TX IS WITH GANCICLOVIR.

4030

Pediatrics

ID

Staph aureaus is the most common cause of pneumonia in CF CHILDS while Pseudmonas is the
most common cause in CF adult pts.

4092

Internal
Medicine

ID

C diff: dx detection of toxin in the stool via PCR IF NEGATIEV THEN do sigmoidoscopy or
colonoscopy for biopsy to detect pseudomembranous colitis.

4163

Internal
Medicine

ID

iNFECTIVE ENDOCARDITIS IS MOST COMMONLY ASSOCIATED WITH mITRAL VALVE

REGURGITATION.

4186

Pediatrics

ID

postexposure tx of varicella: if pt is immunocpmetent with ni hx of vaccination,then give only varicella

vaccine. if pt is immunsupressed,then give immunoglubulin with 10 days of exposure. in pts whol are
already vaccined,then just obsereve.

4353

Pediatrics

ID

Lymphadenitis: most common cause is staph aureaus or strep pyogenes tx: clindamycin for both

4373

Internal
Medicine

ID

Bacilary angiomatosis: A condition caused by bartonella henselae, common in immunosupressed

pts. c/f include fever,wt loss,abdominal pain in addtition to skin lesion and viscera. Extreme caution
must be taken in biopsy,because these lesions are extremely prone to bleeding.

4417

Internal
Medicine

ID

Nocardia, Partially acid fat,gram positive,bracnhing rod.affects immunosppressed hosts and

confused with TB. r=tx; TMP-SMX

4475

Internal
Medicine

ID

Tdap should be given every 10 years after age 18. Pneumococcal polysaccharide vaccine shold be
giver in adults at age >65 but can also be gievn in ots at age <65 with Chronic lung dieses diabetes
chronic liver diese cigarrete smking alcoholism immunocomprmising chronic cardiovascular disease

4611

Internal
Medicine

ID

HIV pts should be screened for antibodies against Toxoplasmosis gondii..

4852

Pediatrics

ID

Congenital Syphilis: C/F: ulcerative lesion on palms and soles hepatosplenmegaly jaundice anemia
and rhinorhea X-ray: Metaphseal dystrophy and periostitis

4852

Pediatrics

ID

Congenital syphilis: Causes early manifestation like ulcerative lesions on palms and
soles,Hepatosplenmegaly,jaundice,anemia and rhinorrhea. late manifestations are frontal
bossing,high arched palate,hutchinson teeth,saddl nose,and perioral fissure.

9111

Surgery

ID

Protsthetic joint infection: Within 3 months of surgert: staph aureus After three months:Coagulase
negative taph epidermidis

9111

Surgery

ID

Infection after Knee Joint Replacement: EARLY ONSET(within 3 months) cause by staph aureus,tx is
remove the prosthetics Delayed onset(>3 months)caused by staph epidermidis,tx is remove
prosthetics

9885

Internal
Medicine

ID

Cryptococcal meningoencephalitis: pTS HAVE FEVER,HEACHES AND PAPILLOEDEMA. common in

ots with HIV. DX: cryptococcal antigen trsting of CSF

10301

Internal
Medicine

ID

Hiv screening test is 4TH GENERATION ASSAY WHICH DETECTS BOTH hiv p24 antigen and HIV
antbdies.Plasma HIV RNA testing is recmmended in those pts with negative serologic tests and high
clinical suspicion of acute HIV.

2276

Internal
Medicine

Neurology

Presence of EBV DNA in the csf of HIV positive patient ,with a ring enahancing lesion ,is suggestive
of CNS lymphoma.

2277

Internal
Medicine

Neurology

PML: in hiv patients caused by a jc ,a human polyoma virus. MRI shows multiple demyelinating.non
enhancing lesions with no mass effects, no seefective tx available.

2279

Pediatrics

Neurology

abscence seizure: day dreaming episodes,brief staring spells,declining school performance dx: on
EEG show 3-hz spike and wave activity tx: ethosuximide or valproic acid

2284

Internal
Medicine

Neurology

cerebral salt wasting syndrome may occur in patients wth Subarachnoid hemorrhage. Hyponatremia
is common after SAH.

2469

Pediatrics

Neurology

Infant botulism: can be either from ingestion of soil botulism spores or from ingestion of pre formed
botulism toxin in food:c/f bilateral bulbar palsies followe by descending flaccid paralysis.

2680

Pediatrics

Neurology

Partial with secondary generalization seizure: They have loss of cosciousness with tonic clonic
activity.

2990

Internal
Medicine

Neurology

C-J disease: rapidly progressive dementia myoclonus sharp wave complexes on EEG Elevated
14-3-3 proteins in csf

3044

Internal
Medicine

Neurology

Pseudotumor cerebri: Pathology envolves the impaired absorption of CSF by the arachnoid villi.

3226

Surgery

Neurology

icp: HEAD ELEVATION--increse venous outflow Sedation--decrease metabolic ddemand iv

Mannitol--osmotic diuresis Hyperventilation--co2 washout jut causing cerebral vasoconstriction..

3461

Internal
Medicine

Neurology

carbamazepine can cause aplastic anemia.,so routine CBC is advised

3461

Internal
Medicine

Neurology

Trigeminal neuralgia: tx:carbamazepine or surgically gangliolysis or suboccipital craniectomy

3514

Pediatrics

Neurology

Absence seizure: rarely last longer than 30 sec abruptly return to consciousness no postictal
somnolence or confusion

3664

Pediatrics

Neurology

GBS is a ascending polyneuropathy affecting peripheral nerves. There is demyelination of the

peripheral motor nerves.

3666

Pediatrics

Neurology

Intraventricular hemmorhage: premature and under weight childs are an increase risk of IVH. c/f
letheragy,hypotonia,rapidly increasing head circumference. U/S shows bilateral ivh and dilated
ventricles.

3687

Pediatrics

Neurology

Difference between homocysteinuria and marfan syndrome: there is normal intellectual,increase lens
dislocation and aortic root dilation in marfan sndrom while in homocsteinuria there is intellectual
disability,decrease lens dislocation,thrombosis,fair complexion.

3687

Pediatrics

Neurology

Marfanoid habitus D/D: Marfon syndrome: autosomal dominant,normal intelect,increase lense

dislocation and aortic root dilatation Homocystinuria: autosomal recessive,dcrease lense
dis,intelectual disability,fair complexion,thrombosis,megaloblastic anemia

3715

Internal
Medicine

Neurology

levodopa/carbidonpa and bromocriptine,prampixiole causes hallucination in older patients.

3715

Internal
Medicine

Neurology

Levodopa/carbidopa causes hallucination in older patients after initatioan.

3771

Internal
Medicine

Neurology

riluzole is a glutamate inhibitort that is currently approved for the treatment of ALS.

3879

Internal
Medicine

Neurology

hypertension is the highest risk factor for stroke.

3919

Internal
Medicine

Neurology

Dexamethasone suppression test may be used clincial to detect endogenoue depresion in pts ahving
pseudodementia.In upto 50% pts with depression,DST will be abnormal.

4170

Internal
Medicine

Neurology

Ulnar nerve syndrome: Cuased by the ulnar nerve entrapement in medical epicondylar groob]ve at
elbow joint.This condition is common in ppl who working on desk or table and thus causing
entrapement of ulnar nerve.

4170

Internal
Medicine

Neurology

Ulnar nerve entrapemnt is most common at elbow) at medial epicondylar groove)

4218

Internal
Medicine

Neurology

nEUROFIBROMATOSIS: Non sense mutation.

4268

Internal
Medicine

Neurology

Lacunar stroke dont have apahasia,agnosia,neglect,apraxia,and hemianopsia or significant Mental

status chnage.

4322

Internal
Medicine

Neurology

Parkinson diseae: hypokinetic gait (shuffling gait) MUSCULAR DYSTROPHY: WADDLING GAIT wi,de
based gait:Multiple system atrohpy,multi infaarct dementia, and osenosry ataxia.

4513

Internal
Medicine

Neurology

bRAIN ABSCESS: CAUSES: Anaerobes like viridans streptococii Staph aureus gram negative

4618

Internal
Medicine

Neurology

Cerebellar dysfunction is common among chronic alcoholic abusers.Sx includes gait

instability,ataxia,difficulty with rapid alternating movements,hpotonia and intention tremor.

4899

Psychiatry

Neurology

Anti-psychotic medication effects in dopamine pathways: Mesolimbic: antipsychotic eeficacy

Nigrostriatal: EPS i.e acute dystonia,akathisia,parkinsonism Tuberoinfundibular: Hyperprolactinemia

2391

Obstetrics
&
OBGYN
Gynecology

Endometrial biopsy indication: postmenupausal qomen age >45 premen with age <45 with persistent
sx or risk fsactors for endometrial cancer. unoppposed estrogen exposure(obesity,pcos) prolonged
amenorrhrea

2393

Obstetrics
&
OBGYN
Gynecology

Emergency contraceptives: IUDS and Ulipristal can prevent pregnancy for 120 hours after intercouse
while levonorgestrel can prevent upto 72 hrs.

2405

Obstetrics
&
OBGYN
Gynecology

AMNIOTIC FLUID EMBOLISM: cardiogenic shock+respiratory failure+dic+coma or seizure soon after

the delivery

2415

Obstetrics
&
OBGYN
Gynecology

Luteoma of pregnancy: Appears as solid,bilateral cystic masses on both ovaries.its a benign

condition.Abt 1/3 pt develope hirsutism nd virilization.

2415

Obstetrics
&
OBGYN
Gynecology

luteoma of preganacy: These are bilateral solid masses of ovary.which regress spontaneously after
delivery. Most patients have new onset hirsutism and acne due to excess of
testosterone,dihydrotestosterone and androstendione. The fetus is at high risk of virlization.

2552

Obstetrics
&
OBGYN
Gynecology

Pseudocyesis: a sensation of pregnancy with dymptoms nf sighns of pregnancy as well but

ultrasound and clinical preganancy test rule out the pregnancy. It is a conversion disorder,nd
common in those pts who have strong desire for pregnancy. TX: is pyschological evluation nd tx.

2575

Obstetrics
&
OBGYN
Gynecology

DES exposure increses the cervial and vaginal adenocarcinoma rsk by 490 times.

3118

Obstetrics
&
OBGYN
Gynecology

external cephalic version can be done at 37 weeks if no contrindication.It can convert a breech
position into vertex.

3269

Obstetrics
&
OBGYN
Gynecology

Preterm labor: Give Tocolysis,sterods and MGSO4 for neuroprotection from cerebral palsy.

3278

Obstetrics
&
OBGYN
Gynecology

Abdominal circumference on u/s is the single best parameter for predicting fetal wieght.

3339

Obstetrics
&
OBGYN
Gynecology

progestin only contraceptives are safe in lactation as they cant decrease milk production.

3339

Obstetrics
&
OBGYN
Gynecology

Progestrone only pills are the bestoral contrceptive method in alctating mother,as it doesnt effect the
volume or composition of milk produced by mother. Combined estro-proges pills may decrease milk
volume nd pass into the milk.

3359

Obstetrics
&
OBGYN
Gynecology

Pap smear screening begins at age of 21 yrs. except in HIV,SLE AND IMMUNOSUPRESSED PTS.

3370

Obstetrics
&
OBGYN
Gynecology

At ovulatory phase of menstruation,The cervical mucus becomes thin,profuse and clear.and also
exhibit ferning on a microscopic slide. While in pre ovulatory phase,the secretion are thick,opaque
and has less strechting ability.

3707

Obstetrics
&
OBGYN
Gynecology

METRONIDAZOLE ACYCLOVIR FLUCONAZOLE AZITHROMYCIN are considered safe in

pregnancy.

3814

Obstetrics
&
OBGYN
Gynecology

iN POF ,FSH AND LH wll bothincrease but fsh is generally greaer than LH. due to slow clearance
from circulation.

3868

Obstetrics
&
OBGYN
Gynecology

Central precocious puberty: elevated fsh nd lh Peripheral precocios puberty: low FSH nd LH

3913

Obstetrics
&
OBGYN
Gynecology

Mullerian inhibing factor( MIF) produced by testes inhibit the formation of uterus,fallopiantubes and
upper portion of vagina.

4122

Obstetrics
&
OBGYN
Gynecology

alcohol,smoking,immobility,steroids,anticonvulsants,decreased vit d,malnutrition,decreased ca, r

modifie=able risk factors of osteoporosis.

4230

Obstetrics
&
OBGYN
Gynecology

Granulosa cell tumor of the ovary causes PRECOCOIUS PUBERTY. sERTOLI LYEDIG CELL tumor
causes defeminization followed by muscullinaztion.is altered body content,flattening of
breast,irregular menstraution,leading to hirsutism and enlargment of clitoris.

4496

Obstetrics
&
OBGYN
Gynecology

Aromatase deficiency: the patient have normal internal genitalia but ambigous external
genitalia.clitoromegaly is common due to high endrogen in utero.Latr on the pt develope delayed
puberty,osteoporosis,undetectable estrogen,hight conc of gonadotropins and polycystic ovaries.

4777

Obstetrics
&
OBGYN
Gynecology

Gestational hypertension: High blood pressure after 20 wk gestation in previous normal ptient

4785

Obstetrics
&
OBGYN
Gynecology

Cell fREE fetal DNA testing: Performed at first trimester when maternal age is >35,or abnormal
maternal serum screening,previous pregnancy with aneuploidy.Also used for fetal sex determination.

4786

Obstetrics
&
OBGYN
Gynecology

The greatest risk of CVS (chorionic villus sampling) is fetomaternal hemorrhage. Fetal limb reduction
defect is decreased if cvs is eprformed at increased gestational age.

4788

Obstetrics
&
OBGYN
Gynecology

Amsel criteria for BACTERIAL VAGINOSIS: thin,grey white vaginal discharge vaginal ph >4.5 positive
whiff test clue cells

4789

Obstetrics
&
OBGYN
Gynecology

Hydatidiform Mole: Hyperemesis enlarged uterus markedly elevated beta HCG

2375

Internal
Medicine

Ophthalmology maCular degeneration= Central vision loss ( c for central)

2853

Internal
Medicine

Ophthalmology maCular degeneration

3329

Pediatrics

Ophthalmology

Prophylactic erythromycin ointment can prevent gonnococcal conjuctivitis but it cant prevent
chlamydial conjunctivitis

2196

Pediatrics

Pediatrics

epiglottitis:caused by heamophilus influenza type b fever,drooling,neck hyperextended,

2439

Pediatrics

Pediatrics

T wave inversion differentials: MI Myocarditis Old pericarditis Myocardial contusion digoxin toxicity

2463

Pediatrics

Pediatrics

Risk factors of intussuception: Meckel diverticulum HSP celiac disease intestinal tumor polyps

2472

Pediatrics

Pediatrics

Cephalohematome: doesnt corss the sture line Cput succudaneum: is diffuse and crosses the suture
lines.

3077

Pediatrics

Pediatrics

vit A has been shown to reduce the morbidity and mortality in measle patients.

3079

Pediatrics

Pediatrics

Kawasaki disease complicatio: coronary artery aneurysms tx: with aspirin and iVIG

3123

Pediatrics

Pediatrics

quantitaive amin acid analysis is required for the diagnosis of phenylketonuria. c/f fair
complexion,musty odor urine,blue eyes,eczematous rash tx low phenylalanine

3194

Pediatrics

Pediatrics

rEYES SYNDROME: bIopsy of liver ,kidney and brain reveals microvesicular steatosis.

3198

Pediatrics

Pediatrics

Catalas positive organism: s.aureus,serratia,klebsiela and aspergillus Catalase negative organism:

Strptococcus pyogenes,streptococcus pneumonia and h,influenza

3404

Pediatrics

Pediatrics

DIFFERENCE BETWEEN TRANSIENT TENSYNOVITIS AND LEGG CALF PERTHES DISEASE: TT

follow viral infection and shoudl resolve with 1 to 4 weeks.

3554

Pediatrics

Pediatrics

HSP: Iga deposition in affected organs c/f: palpable purpura with nrmal pt nd coagulation studies
arthritis.abdominal pain and gIT BLEEDING/iNTUSSECEPTION

3658

Pediatrics

Pediatrics

Astrocytomas are the most common peadiatrics tumors.

3661

Pediatrics

Pediatrics

Myotonic dystrophia: c/f myotonia: pt is unable to release the hand after handshake. Dysphagia
cardiac conduction problem and arrhythmias

3662

Pediatrics

Pediatrics

Most common caue of congenital hypothyroidism in childs is thyroid dysgenesis.

3667

Pediatrics

Pediatrics

Medulloblastoma is the second common posterior fossa children in children(first one is cerebellar
astrocytoma). 90% medullo develope in the vermis.

3681

Pediatrics

Pediatrics

Retinoblastoma: Inactivation of the RB supressor gene

3824

Pediatrics

Pediatrics

neuroblastoma: originated from Neural crest cells Wilms tumor: originated from metanephros

3871

Pediatrics

Pediatrics

Mccune albright syndrome: 3 Ps precocious puberty pigmentation polyostotic fibrous dysplasia( bone
defect)

3970

Pediatrics

Pediatrics

Neonatal conjugated jaundice is suggestive of neonatal cholestasis(billiary atresia) and needs further
evaluation.

3974

Pediatrics

Pediatrics

kartagner's syndrome:triad of situs inversus(dextrocardia),recurrent sinusistis and bronchiectasis.

4143

Pediatrics

Pediatrics

impaired leukocyte adhesion: the leucocytes are unable to leave the vessels and migrate to the
areasof infection nd thus increa e in wbc. hx of not falling umbilical crd at birth no pus formation at
infection site recurrent skin and mucosal bacterial infections dx: lecucytes with neutrophil
predoiminance cultures positive for staph aureus and pseudomonas

4198

Pediatrics

Pediatrics

waiter tip : erb duchene palsy intact grasp reflex claw hand: klumpke palsy intact moro and biceps
reflex and also have horner syndrome

4249

Pediatrics

Pediatrics

hemiphillia: have hemarthrosis and hemophilic arthropathy due to hemosiderine deposition and
resulting fibrosis

4302

Pediatrics

Pediatrics

Riboflavin deficiency (vit b2): cheilosis,glossitis stomatitis normocytic normochromic anemia

seborrhoic dermatitis

4832

Pediatrics

Pediatrics

Osteogenesis imperfecta: Autosomal dominant mutation of COL1A1 BLUE SCLERA HEARING LOSS
RECURRENT FRACTURES PRIMARY AND PERMANENT TEETH AFFECTED

4890

Pediatrics

Pediatrics

rISK FACTOR FOR JEJUNAL/SAMLL BOW ATRESIA: maternal use of vasoconstrictive meds or
dugs such as cocaine and tobacco. Triple bubble sign on the x-ray

4893

Pediatrics

Pediatrics

cocaine withdrwal in new born can cause Jitteriness,excessive sucking and hyperactice moro reflex.

2655

Pediatrics

Poisoning

Iron poisonign cause free radical production and lipid peroxidation,which impairs cell processes
causinf abdominal pain,hematemesis,hypovolemic shock and metabolic acidosis.

2661

Internal
Medicine

Poisoning

Delirium tremens: Occurs after 48-96 hours c/f Hypertension agitation tachcardia hallucinations fever
tx:Benzos like chlordizepoxide

2663

Internal
Medicine

Poisoning

Beta blockers intoxication: Bradycardia Av block hypotension Diffuse wheezing TX: give iv fluids and
atropine if no improvement ,give Glucagon

2664

Internal
Medicine

Poisoning

Bnzos intoxication:surred speech,unsteady gait,drwosiness Phenytoin :horizontal

nystagmus,cerebellar ataxia,and confusion Opiod:respiratory depression,miosis,sedation
lithium:Tremor,hyperreflexia,ataxia and seizures

3139

Internal
Medicine

Poisoning

Fluphenzine:Is atypical antipsychotic,injected every 2 -3 weeks it causes hypothermia by inhibiting

body's shivering mechanism and/or inhibiting autonomic thermoregulation.

3161

Internal
Medicine

Poisoning

Methanole intoxication: CAUSES headache nausea vomiting and epigastric pain vision loss and coma

4511

Internal
Medicine

Poisoning

Ethylene glycol intoxication: Metabolic acidosis(high anion gap) flank pain, oliguria tetany Urine show
calcium oxalate crstals(Envelope shaped) TX: Ethanol or Fomepizole(competitive inhibitor of alcohol
dehydrogenase)

2386

Internal
Medicine

Preventive
Medicine

pcv13 induces T cell dependent B cell response while PCV23 induces T cel independent B cell
response.

3863

Internal
Medicine

Preventive
Medicine

Mammographhy screening should be every 2 years in women at age 50-75 years. Cholestrol
screeing in men start at 35 nd in women at 45.

4479

Pediatrics

Preventive
Medicine

Hep b first dose shoudn't be given to babies with weight less than 2 kg.

4530

Obstetrics
Preventive
&
Medicine
Gynecology

8951

Pediatrics

Preventive
Medicine

Contraindication of rota VIRUS VACCINE: anaphylaxis to vaccine hx of itussucceptio congenitl

malformation of git (meckel diver) SCID

2498

Psychiatry

Psychiatry

most common sideeffect of ECT is amnesia.

2508

Psychiatry

Psychiatry

in simple delusional disorder,one or more delusions in the absence of other psychotic symptoms.

2521

Psychiatry

Psychiatry

Hypochondriasis is also called Ilness anxiety disorder.

all pregnant woman should be screened for syphilis,HIV, nad hep B REGRADLESS of risk fators.

3191

Psychiatry

Psychiatry

fORMICATION:the pt is convinced that bugs are crawling all over his body.It common after cocaine
or Methamphetamine (Meth). LSD INTOXICATION: halluciantions,Subjective perceptual
internsification(like colore are riched,tatses are heightened and sensation is
enhanced),depersonalization and illusions.

3378

Psychiatry

Psychiatry

Neuoimagiing fidings in Psychiatric disorders: Autism:Increased total brain volume OCD:

Abnormalities in orbitofrontal cortex and striatum Panic disorder:Dcreased volum of amygdala
PTSD:decreased hippocampal volume Schizoprenia:Enlargement of cerebral ventricles

3378

Psychiatry

Psychiatry

Neuroimaging findings in psychiatric disorders: Autism:Inreased brain vilume OCD:abnormalities in

orbitofrontal cortex and straitum Panic disorder:dcerased volume of amygdala PTSD:dECREASED
hippocampal volume Schizophrenia:Enlargment of cerebral vetricles

3760

Psychiatry

Psychiatry

Comorbid conditions with Tourette syndrome: ADHD(60%) OCD(27%)

3953

Psychiatry

Psychiatry

Anorexia nervosa pts are at risk of: Osteoporosis elevated cholesterol and carotene levels cardiac
arhythmias(prolonged QT) EUTHYROID SICK SYNDROME HPO dysfunction leading to anovulation,
amenorrhea and Estrogen deficiency Hyponatremia seconday to excess water drinking

3953

Psychiatry

Psychiatry

Complication ofanorexia in later life: Osteoporosis,elevatd cholesterole and carotene level.prolonged

QT interval,cardiac arrhythmias,euthyroid sick syndrome,HPS dysfunction,Hyponatremia due to
excessive water drinking Pregnant women are at increased risk of giving birth to premature ,small for
gestational age or both.

4192

Psychiatry

Psychiatry

Ebstein anomaly: malformed and infeiorly attached tricuspid valve,which causes the rt ventricle to
become a part of right atrium,which is known as ATRIALIZATION of rt ventricle.

4215

Psychiatry

Psychiatry

Dugs intoxication: PCP: Amnesia,nystagmus(vertical or jorizotal),ataxia LSD: visual hallucination

,euphoria, tachycardia and hypertension Coaine: euphoria,agitation,chect pain,seizures,mydriasis
Methamphetmines: Psychosis,diaphorsis,choreiform movements,tachcardia/hypertension Marijuana:
increased appetitie,conjunctival inj,impaired tiem perception,dry mouth Heroin: Dpressed mental
state,respiratory depression, miosis,constipation

4924

Pediatrics

Psychiatry

silmulating forepla,preoccupation with masturbation,extensive sexul knowldge,touching others

genitalia,or intercourse are the concerning sexual behaviours in childs.

7723

Psychiatry

Psychiatry

Treatment of depression in cancer patients: Short life expectency: give SSRI Longer life expectancy:
give psychostimulants e.g methylphenidate,modafinil

8875

Psychiatry

Psychiatry

Hoarding disorder: difficulty discarding possession regardless of their actual value difficulty due to a
perceived need to save items TX: CBT + SSRI

2298

Internal
Medicine

Respiratory

hypertrophic osteoarthropathy where tigital clubbing is accompanied by sudden onset arthropathy

commonly affecting wrist nd hand joints.Hyer pulmonary ostoarthropathy is a subest of HOA where
HOA is due to lung cancer,TB Bronchiectasis,emphysema etc

2432

Pediatrics

Respiratory

laryngomalacia: inspiratory stridor worse in supine position diagnosed by larnygoscopy findings are:
omega shaped epiglottis nd collapse of the supraglottic structures during inspiration there is
increased risk of GERD.

3016

Internal
Medicine

Respiratory

Bird Fancier's lung: a form of hypersensitivity pneumonitis caused by repeated inhalation of inciting
antigen,which elads to alveolar inflammation x.ray shows: ground glass opacity,or hazziness of the
lower lung.

3020

Internal
Medicine

Respiratory

ARDS: there is impaired oxygen exchange decreased lung complaince pulmonary hypertension

3021

Internal
Medicine

Respiratory

Asbestosis:Common in plumber, electricians, caerpenter,pipe fitters X.ray show: hONEY COMBING

AN FBIATERLA PLEURAL THICKENING, CT SHOW: PLEURAL PLAQUES

3037

Internal
Medicine

Respiratory

blastomycosis: same x ray finids as TB or Histoplasmosis there is ulcerated skin lesion and lytic bone
lesions as well.

3054

Internal
Medicine

Respiratory

Travel associated legionaire's disease caused by legionella that has been linked to teh cruise and
hotel water supplies. The patietns have GI sx,fever and confusiob( Neurologic)along with
Pneumonia. Gram stain doesnt show any bacteria s it is Intracelullar. Definitve DX: uUrinar antigen
test TX:mACROLIDE OR fLUROQUINOLONES

3289

Pediatrics

Respiratory

Epiglotittis: DASTRESS DYSPHAGIA AND DROOLING DX;tHUMB PRINT SIGN ON X-RAY MX:
Emergency endotracheal intubation in the OR

3553

Pediatrics

Respiratory

childs suffering from broncholitis( RSV INFECTION) ARE AND INCREASED RISK OF DEVELOPING
apnea.

3579

Internal
Medicine

Respiratory

In Goodpastuer's disease there is linear IGg deposition along the glomerular basement membrane.

3579

Internal
Medicine

Respiratory

Goodpastuer's disease pathology: Anti to alpha-3 chain of type 4 collagen renal biopsy shows: IgG
deposition along glomerular basement membrane

3580

Internal
Medicine

Respiratory

Wegner's disease( also called Granulomatosis with polyangitis) HX of sinusitis,lung and kidney
problem C-ANCA +ive

3775

Internal
Medicine

Respiratory

Non seminomatous nd seimonatous germ cells both produce bETA HCG BUT ONLY NON
SEMINOMATOUS TUMOR also produces alpha fetoprotein.

4014

Internal
Medicine

Respiratory

Scystemic sclerosis: Causes pulmonary fibrosis.

4036

Internal
Medicine

Respiratory

Glucocorticoid causes neutrophila in asthma patients,after prolonged stroids intake.

4039

Internal
Medicine

Respiratory

Roflumilast ,Phospodiesterase inhbitor,dcrease the exacerbation of copd in pts with history ofe
xacerbations.

4040

Internal
Medicine

Respiratory

ACUTE EXACERBATION OF COPD is treated with NON INVASOE POSTIVE PRESSURE

VENTILATION.

4052

Internal
Medicine

Respiratory

Middle medistainum masses: bronchogenic cyst,tracheal tumors,pericardial cyst,lymphoma,aortic

aneurysm. Anterior mediastinum masses: Thymoma,retrosternal throid,teratoma,and lymphoma

4052

Internal
Medicine

Respiratory

aLL neurogenic tumours are located in the posterior medistinum.i.e meningocele,enteric

cysts,lymphomas,dighramatic hernias,esophageal tumors and aortic anurysm.

4053

Internal
Medicine

Respiratory

Pleural flui ph <7.30 represent Empyema.

4073

Internal
Medicine

Respiratory

ph <7.2 and glucose < 60mg/dl are indication of tube thoracstomy.

4118

Internal
Medicine

Respiratory

causes of recurrent pneumonia involving same lung region: Local anatomic obstruction like broncial
compression or intrinsic bronchial obstruction or recurrent aspiration from seizure,ethanol alcohol or
GERD,DYSPHAGIA OR achalasia.

4119

Internal
Medicine

Respiratory

CAP in dementia patient is most liekly due to impaired swallowing and Impaired epiglottic reflex.
Anaerobic bactera with aerobic oral flora( viridans) are the most common bacteria.

4210

Internal
Medicine

Respiratory

hISTOPLASMOSIS: caused by the inhalation of the yeast cacified nodes in lung,mediastinum,spleen

and liver Xray may demonstrate central or target calcification.

4519

Internal
Medicine

Respiratory

Most common causes of chronic cough are: Postanasal drip(Upper airway cough syndrome) Asthma
GERD

4536

Internal
Medicine

Respiratory

PaCO2 value depends on repiratory rate and tidal volume while Pao2 value depends on Fi02 nd
PEEP.

4629

Internal
Medicine

Respiratory

LMWH can be used in patients with kidney problem.So start with Unfractionated heparin in pt with PE
nd also kidney problem.

4699

Pediatrics

Respiratory

Epinephrine have both alpha 1 and beta 2 agonist effects. BETA 2: Bronchodilation,decrease
systemic inflammatory mediators Alpha 1:vasoconstriction

4753

Internal
Medicine

Respiratory

eXUADTIVE FLUID AHVE GLUOCSE LESS THAN 60 MG/DL,plus LDH is >2/3 of the upper limit of
normal of serum LDH (250)

4762

Pediatrics

Respiratory

CD19-POSITIVE LYMPHCYTES ( B LYMPHOCYTES) CD 3_POSITIVE( T LYMPHOCYTES)

4831

Pediatrics

Respiratory

Risks for RDS: Prematurity male sex perinatal asphyxia maternal diabetes c section without labor

3059

Internal
Medicine

Rheumatology

peak age for incidence of polymyositis and dermatositis is between 40-50 years..nd most common in
women.

3151

Internal
Medicine

hyperparathyroidism,hemochromatosis,hypophospatemia,hypmagnesemia are associated with

Rheumatology pseudogout. coffin shaped crystal are the struvite crystal seen in nephrolithiasis aasued by UTI
WITH ureaease producing organsims.

3153

Internal
Medicine

Rheumatology

3164

Internal
Medicine

Giant cell arteritis: headaches,jaw cluadication,polymyalgia rheumatica there is association of

Rheumatology Amaurosis fygax and anterior ischemic optic neuropathy as well with GCA. tx: for PMR GIVE LOW
DOSE STEROIDS FOR GCA give high dose oral steroids for GCA with vision loss: give iv steroids

3169

Internal
Medicine

Rheumatology

Side effects of immunosuppressants: Cyclophospamide: bladder cancer,sterility, cisplati: cochlear

dysfunction ethambutl nd hydroxychloroquine: optic neuritis Methotrexate: folate deficiency

3171

Internal
Medicine

Rheumatology

Viral arthritis: caused by parvo virus b19 polyarticular pain is the major sx esp, in MCP AND PIP ,wih
no swelling,redness or tenderness.

3171

Internal
Medicine

Rheumatology Viral Arthritis: Mostly caused by Parvovirus b19 Acute onset of polyarticular and symmetric arthiritis

3176

Internal
Medicine

Rheumatology Sarcoidosis: do chest xray: showing bilateral hilar adenopathy and reticular opacities.

3177

Internal
Medicine

Rheumatology In sarcoidosis angiotensin converting enzyme level will be elevated.

3202

Internal
Medicine

Rheumatology

3203

Internal
Medicine

PATHOGENESIS OF CARPAL TUNNEL SYNDROME: DEPOSITION OF MUCOPOLYSACHARIDE

PROTEIN COMPLEXES WITH IN TH PERINEURIUM AND ENDONEURIUM OF THE MEDIAN
Rheumatology
NERVE AND IN THE TENDONS AND SYNOVIAL SHEATH THAT CAUSES PRESSURE ON THE
MEDIAN NERVE.

3208

Internal
Medicine

DERMATOMYOSITIS: heliotrope sign(violaceaous periorbital edema) gOTTRON PAPULES

Rheumatology ANTI-Mi-2 (against helicse) positive The patients are at increased risk of malignancies like
ovarian,breast,lung and other female urogenital cancers.

3317

Internal
Medicine

Rheumatology

polymyalgia rheumatica: 2 of the following required for diagnosis neck or torso shoulder or proximal
arms proximal thigh or hip constitutional sx liek fever,malaise and wt loss

3321

Internal
Medicine

Rheumatology

Sjogren syndrome: dental caries and difficulty swallowing due to no saliva.lYMPHOCYTIC

INFILTRATION OF THE SALIVAR GLANDS CAUSES THE GLANDS ENLARGMENT ND FIRMNESS.

3322

Internal
Medicine

Rheumatology Scleroderma: ANA +ve Anti topoisomerase-1 antibodies in all pts

3575

Internal
Medicine

Rheumatology Lateral epicondylitis is due to the inflammation of extensor carpal radialis tendon.

3815

Internal
Medicine

Rheumatology

bEHCET'S SYNDROME: RECURRENT ORAL ULCERS UVEITIS GENITL ULCERS ERYTHEMA

NODOSUM

3898

Internal
Medicine

Rheumatology

iMMUNE COMPLEX MEDIATED INJURY TO THE RENAL CELLS IS THE MOST COMMON CAUSE
OF RENAL FAILURE IN SLE.

4123

Internal
Medicine

Rheumatology

Dermatomyositis: symmetrical proximal muscle weakness and erythematous rash on the dorsum of
the fingers and upper eyelids. DX: muscle biopsy

4205

Internal
Medicine

Rheumatology

cervical spondyloysis: there is limited neck rotations and kateral bending due to osteoarthritis and
secondary muscle spasm. radiography will show bony spurs and sclreotic facet joints.

4368

Internal
Medicine

Rheumatology

If there is suspection of disc disease,cancer or spinal infection in pt with chronic back pain,worst at
night,,first d spinal x-ray fpr lytic lesion or other findings.....IF eqviocal,then do MRI or CT.

4370

Internal
Medicine

Rheumatology Ankylosing spodylitis invloves primarily the apophyseal joints of the axial skeleton.

4576

Internal
Medicine

Rheumatology

Enthesistis: inflammation and pain occur at the site of tendon and ligament attachment to the bone.it
is common in pts with ankylosing spondylitis.It is associtaed with HLA-B27.

4578

Internal
Medicine

Rheumatology

patients with chronic ankylosing spondylitis are at increased risk of verttebral fractures due to
decreased bone mineral density.

4584

Pediatrics

Rheumatology

serum sickned liek reaction: happens after 1 to 2 weeks after administration of

penicillins,amoxi,tmp.smx. pt have fever,arthralgia,urticaria,

4743

Internal
Medicine

Rheumatology

CHARCOT JOINT (NEUROGENIC ARTHROPATHY) CAUSES:vit b12 deficia=ency Diabetes mellitus

c/f deformed joints with history of DM.

2327

Surgery

Surgery

dECELERATION INJURY TO THE ANTERIOR CHEST CAUSES AORTIC RUPTURE WHILE BKUNT
ABDOMINAL TRAUMA CAUSES SPLENIC OR LIVER RUPTURE.

2335

Surgery

Surgery

water soluble esophagram is the test of choice for esophageal rupture.Initial dx test is chest
radiograph. Common causes are recent endoscopy.

Septic arthritis in young sexually active women is always caused by n.gonnorhea unless proved
otherwise.

Mnagement of fibromyalgia rheumatica: regular aerobic exercise,strengh training nd stretching good

sleep hygiene medications include TCAs.

2362

Surgery

Surgery

Fat Necrosis of the berast: mIMICS THE BREAST CA calcification on mamography Escisional biopsy
will show fat globules and foamy histiocytes. Tx: routine followup

3302

Surgery

Surgery

Fat embolism: c/f sever respiratory distress,petechial rash,cubconjuctival hemorrhage,tachcardia

and fever.. DX.PRESENCE OF FAT DROPLETS IN URINE OR INTRA ARTERIAL FAT GLOBULES
ON FUNDOSCOPY

3500

Surgery

Surgery

Nasopharyngeal carcinomasare strongly associated with EBV.

4534

Surgery

Surgery

Trendelenburg Sign: D due to weaknesses of the Gluteaus muscles which is innervated by superior
gluteal nerve.Any patholgy to superior gluteal nerve will cause this sign.

4554

Surgery

Surgery

aNTERIOR CRUCIATE LIG TEAR WILL CAUSe rapid joint swelling and inavbility to carry weight
while Meniscal tear ,the joint swelling is progressive and gradual nd s not noticeced on the following
day.