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Remembered Step 3 1200 Questions!! - pth
#1
REAL EXAM QS STEP 3 USMLE….

1…HYPOSPADIASIS IS THE CONTRAINDICATION OF CIRCUMCISION…
2…HORIZONTAL TESTIS WITH PAIN AN D SWELLIN..UROLOGY CONSULT ASAP IF CHILD IS YOUNG AND NO FEVER …
3..ULTRASOUND IS ANS TO EVERY FLANK PAIN ,URGENCY FREQENCY FEVER MORE THAN 100.2 AND HEAMTURIA…CALL UROLOGIST IF URETREAL STONE IS MOR THAN 3 CM LESS THAN THIS WILL PASSS AWAY WITH I VF BLOUSES…
4…..NO CONTRAST STUDY OF ANY KIND IF PT IS ALLERIGIC OR IF CRETININE IS MORE THAN 2…
5…BOYS DON’T GET UTI THEY ALWAYS GET VUR….DO VOIDING URETHROGRAM..
6…THE MOST C C OF INABILITY TO VOID IN IST 24 H IS POST URETHRAL VALVE….
7……MEN DON’T GET CYSTITIS WOMEN DO BCZ OF THEIR URETHRA CLOSE TO VIGINA..MEN GET PROSTTIS….
8….PYLO ..NEED HOSPITAL ADMISSION,IV ABX,AND RENAL ULTRASOUND…9….IF K IS LOW IST CHECK MG IF ITS LOW …
10….RECTAL PROLAPSE ,MECO NIUM ILIUS,PUDOMONS AND STAPHLO INFECTION,NASAL OLYP ,MALABSORBTION,PAN INSUFFICIENCY AND RECURRENT BRONCHTIESIS IS DUE TO CYSTIC FIBROSIS, CHEST PHYSICAL THERAPY HIGH CALORIC DIET AND PANC ENZY ADMINSTRATION FAT SOULBLE VITAMAIN IS GOOOD IN MANAGEMNET ITS AR…WITH THE DEFECTIVE GENES AT CH 7…GTFR..GENES
11…IF ANIMAL WHO BITES IS RABID LIKE BAT AND DOG OR RACUUNE JUST KILL THE ANIMAL AND EXAMINE THE BRAIN AND LOOOK FOR NEGRI BODYIF POSITIVE GIVE PT VACCINE AND IGAT SEP PLACE AND SPRINKLE HALF IG AROUND THE WOUND…12…
IF P T HAS DOG BITES BY NEIGHBOURS DOG WHO HAD FULL VACCINATION JUST WASH THE WOUND WITH SOAP AND WATE R AND CLOSE PBSERVE THE WOUND...
12…MITOCHONDRIAL INHERITANCE ….ITS JUST AN APPOSITE OF SEX LINK WHRE ONLY FEMALE HAS THE DISEASE LIKE IN THE PREVIOUS ONLY MEN HAVE THE DISEASE…
13…UPSLANTING PALPEBRAL FISSURE,EPICANTHAL FOLD , FLAT NASAL BRIDGE, SIGLE PALMER CREASE,LARGE TONGUE,,,,IS DOWN SYNDROME….MSAFP WILL B DECREASE..AND THEY HAVE DUDINAL ATRESIA,LEUKIMIA AND ALZIMERZ
14…AGE IS THE MOST COMMON FACTOR IN ALZIMERZ..
15….BERRY ANURYSM IF ADULT POLYCYSTIC DISEASE…AND RF IS COMMON…GET ULTARSOUND…
16….PSUDOHYPERTHYROIDISM….LOW SERUM CA AND HIGH POSPHATE LEVEL…AND HIGH PTH
17…VIT D RESISTANT RICKETS…..X LINK DOMINENT….TRAITS…SO MALES HAVE MORE SEVER FORM OF DISEASE…
18
VONGERKIES DISEASE….. IS A G6 P DEFICIECY DISEASE…I NC LIPID,INC TG,NA AN D K R LOW USUALLLY..

19….


…20….CAH…IS DUE TO 21 HYDROXYLASE DEFICIENCY….DEC CORTISOL AND DEC MINERLOCORTICOID. PT HAS HYPONATRIMIA AND HYPERKALEMINA…DEHYDRATION,HYPOTENTION.SHOCK …
21…BE SHOWS THAT CECUM IS DOWN THERE IN LEFT LQ..AND PT HAS NV AND BILIARY VOMITUS AND BIRD BEAK APPREANCE ON UGI IS VULVULUS…RECTAL TUBE AND SIGMOIDOSCOPY IS THE ANS..
22…
BABY BECOME CYANOSES WHEN TRY TO FEED HER AND CYANOSIS DIDN’T IMPROVE BY REMOVING THE BOTTLE AFTER BABY BORN FEW H AFTER THIS HAPPENED IS DUE TO TRANSPOSITION OF GREAT V IS IF NORMAL SIZ EHERAT EGGGAND STRING PATTERN..INC PUL VACULATURE PATTERN…ECHO SHOWS RVH AND RVSTRAINTAD,
23….. CYANOSIS AFTER A WK IS DUE TO TOF…..

24…TRICUPID ATRISIA…EARLY CYANOSIS BUT DEC VASCULAR MARKING ON CXRWITH LAD AND LVH….
25…..PUL ATRESIA CYANOSIS IS EARLY BUT LUNG VASCULAR MARKING R NORMALAND THERE IS CARDIOMAGALY…
25,,,,TOXIC SYNOVITIS INVOLVE USUALLY LARGE JOINTS,,,AND THERE IS NO INC ESR OR WBC…
26….FIX SPLITTING OF SEC HEART SOUND…ASD NO NEED FOR GIVING ABX PROPHYLAXISIS IF FIX BY SURGERY OR PT IS ASYMPTOMATIC…
27….TRICUPID REGURG …. MID DIASTOLIC RUMBLE AT LOWER LEFT STERNAL BORDER

28…THE EARLY SIGN OF DIG TOXICITY IS FREQENT VOMITING AND THEIR THERAPETIC DOSE IS 4 NG AS COMPARED TO 2 NG INADUL T IN ADULT THE SIGN IS YELLOW VISUAL CHANGES..AND IN ELDERLY CONFUSION IS IST SIGN OF DIG TOXICITY…HYPOKALEMIA IS THE MAIN CAUSE…SO GIVE THE K AND FIX THE LO W MAG WHICH IS USUALLLY PRESENT AND GIVE DIGIBAND…NEVERDO CV OR NEVER GIVE EPI ..PHPHENYTOIN IS GRETA…. AND PACEMAKERS TOOO..



29…RDS…IS COMMON IN DIABETIC MOMS BABY DUE TO LACK OF SURFACTANTANYT AND PREMATURITY….RTOLEFT SHUNT,DEC LUNG COMPLIANCE,GROUND GLASS APPERANCE .MV IS HIGH AND NEED INTUBATION AND PEEP…
24…IF PT HAS HYPERLIPIDIMIA AND HTN GIVE ALPHA BLOCKER NOT BETA BLOCKERS..AND DON’T EVER GIVE DIURETICS TO THE…25 SPIRAL CT.……IS... BESTTO CONFIRN MASSIVE PE AND APPENDIX

25…IF A ASTHAMAA AND HTN IN A PT GIVE CA CHANEEL BLOCK SAME IS WITH ACHALSIA ND HYPERTENTION.
26….BB OR COLONIDINE IS BEST IN HTN AND ALCOHAL WITHDRAWL PT..27…..UNEQUAL PUPIL..IN INTRA CRANIAL P…IS SIGN OF UNCAL HERNIATION SO INTUBATE AND HYPERVENTILATE KEEP THE CO2 LESS THAN 30 AND GIVE MANITOL AND FOR VASOSPASM PROPHYLAXIS GIVE NIMODIPINE..

28…IF CAUS EOF STROKE IS HEART ALWAYS GIVE HEAPARIN AND COUMDINE…
29….. IF CH MITRAL STENOSIS DON’T GIVE TPA..

30….UA ,UC IS IS T THING TO DO WITH HEMATURIA IF PT IS YOUNG AND IF MORE THAN 50 DO THE CYSTOSCOPY IF ITS OAINLESS HEMATURIA AND IF PIANFUL DO THE SAME.

31….GOLD STANDRAD FOR UTI IS U C
32….IF CLINICAL SUSPITION IS HIGH THAT CHILD HAS MENINGITIS…. JUST GIVE CEFTRIXONE TO A KID OR OLDER IV THEN DO LP DON’T WAIT FOR THE LP BCZ IT TAKES TIM ENA DU CANT AFFORD TO PUT PT LIFE IN DANGERS U CAN ALWAYS CHANGE ABX

33……IF MOM SAID THAT I WILL NOT LET U DO THE LP THEN DO IT BCZ ITS MED EMERGENCY….
34….FEVER.EXUDATIVE PHARANGITIS AND GENERLIZED LYMAPHADENOPATHY INA 14 YR OLD DO THE MONO SPOT T O CHECK THE HETROPHILE ITS IS NOT POSITIV E IN IST 2 WKS SO IST DO THE CBC AND SMEAR TO LOOK FOR ATYPICAL LYPHOCYTES…
35…..IF AMPICILLLIN CAUS E RASH DON’T DO ANY THING IT WILL GO AWYAS ITS COMMON IN IMONONUCLEOSIS PT…
36….N O CONTACT SPORT AND SYMPTOMATIC TRETEMENT ONLY

37….IF U GIVE THE IG TO A KID AND HE HAD ANAPHYLAXIS…ITS IGA DEFICIENCY
38…MASTOIDITIS…IS A MASTOID AIRCELL SWELLLING IN IS CH BY THE POST AURICULAR SWELLING…OVER MASTOID PROCESS..DISPLACE THE EAR LATREALLLYIV ABX REQ AND ITS A SERIOUS COMPLICATIONOF TE AOM..
39…KAWASAKI IS A MEDIUM V VASCULITIS …
40…..MECONIUM ILIUS AND CLUDING AND RECUREENT RES INFECTION MEAN CHECK FOR THE SWEAT CHOLORIDE TEST..41…

INDIRECT COMBS TEST IS POSITIVE.IN ABO INCOMPTIBILITY
42…AV NODAL REENTRY I S THE MOST C C CAUSE OF SVT
43….DON GIVE VERAPAMIL IN SVT IN INFANT
44…VISIBL E GASTRIC PARISTALIC WAVE AND OLIVE SHAPE MASS IN EPIG IS PYLORIC WITH NON BILIRY PROJECTILE VOMINTTING IN A IST BPORN BOY WHO IS MORE THANA MONTH OLD,,, ULTARSOUND…. AND PYLOROMYOTOMY ONCE U FIX THE ELETROLYTES WHICH IS MEDICIAL EMERGENCY BRING CHORIDE UP TO 90 AND MOV ETHE BICARB DOWN TO 24….ITS USUALLY HYPOCHOLOREMIC HYPOKALEMIC ALKALOSIS…
45….STAPHLO IS THE CAUSE OF SEPTIC ARTHRITIS IN ALL GAES EXCEPT SEXUALLLY ACTIVE EVEN IN THE SICKLERS…

46….COOL MIST THERAPY …CROUP…IF NOT EFFECTIVE RACEMIC EPI…
47…..ENTEROVIRUS IS THE MOST OF ASEPTIC MENINGITIS…
48….HERPEZ IS MOST COMON CAUSE OF ENCEPHALITIS PCRIS DIAGNOSTIC AND IV ACYLOVIR HERPEZ 1 IS THE CAUSE…

49…3YR OLD COPY CIRCLE.UNDRESS COMPLETELY DRESS PARTIALLLY STACK 8 BLOCK
50…4 YRS OLD COPY CRISS BUTTON CLOTHING,DRESS COMPLETELY.CATHES BALL
51…4-5 COPY SQ…..52…

5 YRS…COPY TRIANGLE.TIES SHOES SPREAD WITH KNIFE
53….STREOID SALT RESTRICTION AND PNUMO VAC IS THE BEST FOR UNCOMPLICATED NEPHROTIC SYND

54…MINIMAL CHANGE IS THE MOST CC OF NEPHROTIC YOUNGER THAN 17 AND MEMBRANOUS IS MOST COMONCAUSE AFTER WORDS.
55..FOCAL IS MOST CC OG GLOMULITIS IN AID AND IN D A

56…OSTEO MYLITIS IS ANENATES MOSTL INVOLVE MORE THAN I BONE AND IN KIDS TRAUMAIS A CAUSE IN MORE HAN 2/3 OF THE CASES
57…CUSHING TRID IS POSITIV EIN INC INTRACRAIAL P….BRADY .HTN.IRREGULAR BREATHING
58….CRESENT SHAP ON CT IS SUBDURAL BLEED MOST IN OLD AGE AND ALCOHALOC…BUT LENTICULAR SHAPED IS ALWAYS EPIDURAL…EVACUATION WITH BURR HOLE OF THE HEMATOMA IS REQ…59….MACULAR DEGEN…IS M CC OF BLINDNESS IF PT IS MORE THAN 60,,

60….STYE NEED JUST WARM COMP…
61…CHALAZION NEED WARM COMP AND EXCISION
62…VITROUS HEMORRAGE IS BLEED FROM NEO VACULARIZATI ON IN DIBETIC NEURO PATHY

63…. BOLAT LOSSS O F TEMP AND PAIN BELOW THELESION IS SYRINGOMYLIA ANG DANDY WALKER AND ARNOLD CHEARI IS MOST COMON ASOOCITED SYNDROME….THORACIC AND CERVICAL SPINAL CORD MOSTLY…MRI
64…..MRI IS GOOD FOR OSTEO ANF BONE BIOPSY IS THEBESTFOR OSTEOMY
65…BRANCHING DENDRITIC ULCER……SLIT LAMP AND FLUROCEIN HERPZ KERATITIS…NEED OGPH CONSULT FOR TOPICAL MEDICATION NO TOPICAL STEROIDS.
66…. ONLY TOPICAL STEROID CAN B GIVEN BY EYE DOC..
67…NO NITRO PRUSIDEIN PREG
68…REVERSE TRENDELENBURG IN THEAIR EMBOLISMM LEFT SIDE SO THAT AIR STLLL B IN TH E RT V OR ET ATRIUM SO CAN B REMOVED BY THECATHTER

69…AMOXICILLINN 10 DAYS FOR SINUSITIS
70….LIMISIL IS FOR NAIL FUGAL…NOTGIVEN ID HEPATO RENAL DISEASE POSITIVE

71….IN NAIL AND HAIR FUNGAL INF ALWAYS GIVE ORAL GRESIOFULVIN OR FLURADIBIN ORAL BCZ TOPIA WORKS ON OTHER DERMATOPHYTES

72


IF THERE IS TINEA CAPITUS ALWAYS CHECK THIR UNDERWEAR FOR T CRURIS OR RING WORMM …ROUND LESION WITH CENTRAL CLEARING AND WELL DEFINED BORDERS
73….IV STEROIDISIST IN SPINAL SHOCK AS WELL AS IN ACUTE MS

74…CRYPTO INC 40 FOLD CHANCE OD TESTICULAR CA
ORCHIOPEXY AFTER I YR IS BEST IN PT INTEEST BU T NOT DRC THE CHANC OF CA

75…INC ALPH FETP PROT IS IN YOLK SAC TUMOR THOSE R NON SEMINOMA AND THEY NEED ORCHIECTOMY.. PLUS RADUATION AND IF LN POSITIVE ADJUVENTTHERAPY

76….HCG IS CHORIO CA

77 SENINOMA IS RADIO SENSTIVE
78….LEYDIG CELL IN MALE ANDGRANULOSA CELL IN F CAUSE PRECOCCUOUS PREG
79….IF APT WITH SCOLOSIS HAS AN ANGLEOF 40 NEED BRACEC BY ORTHOPEDICS
80..IF ANGLE IS LESS THAN 40…CLOSE F/U
81…LAST TRIMESTER AND UPTO 6 M POST PARTUM..RECURENC Y V COOMON ADVISE PT HAVE ABORTION AND NO PREG IN FUTURE PIC IS JUST LIKE DILATED CMP ITS CALLLED PEROPARTUM CMP…..TRANSPLANT IS THE ONLY TREATMENT…
82…ACUTE CHOLE….. ULTRASOUND….. IF PREG PT IS IN PAIN AN D NOT GETTING BTTER AND IF STONE POSITIVE THEN DO THE LAP CHOLE AT SEC TROMESTER AND IF WE HAVE TO TO DO OPEN CHOLE THEN IN THIRD TRIMESTER IF PT IS AYMPTPMATIC NOW NO NED FOR SURGREY IF S/S CAME BACK D O IT AFTER DELIVERY 6 WKS AFTER ..

84….PSVT NARROW QRS..GIVE ADENO.
85…AFIB WIDE QRS…GIVE BB OR CA CH ANG IF CHF GIVE DIG
86…PRECARDIAL THUMP ONLY IN WITNESS C AREST
87….PAINLESS MI IS COMMON IN DIABETIC ANDIN ELDERLY
88LIDOCAIN CAUSE CONFUSION IN ELDERLY
MOST C RHYTHM IN THE MONITOR WITH PT WHO IS UNDERGOING CPR IS V F
89…ST ELEVATION IN 23 AND AVF AND ST DEP IN AVL..INF RMI…GIV EVOLUM EAND NO DIURETICS AND NO NITRATES…KEEP THE PRELOAD HIGH OTHERWISE PT WILL B IN CARDIOGENIC SHOCK…
90…CARDIAC SARCOMA IS MOST C MELIGNAT TUMOR AND LFT ATRIAL MYXOMA IS LIKE MOST BENIGN
91…NO DORSIFLEX AND NO EVERTION IF CPN IS DAMAGED CAUSE IS PROLONG LITHOTOMY POSITION…
92..THOMPSON TEST IS BEST TO DIAG THE ACHILIS TENDON RUTUTRE…BCZ PT FEEL SUDDENPOP IN TH ECALF MUSCLE…WHEN U SQ IN THIS TEST THE GASTRONEMIUS AND SOLIUS THERE IS NO DORSIFLEXTION OF THE ANKEL
93..ACL…IS SKI INJURY IS THE MOST C C OF ACL..ANT DRAWER TEST IS MOST USEFUL
94..CN 3 PALSY…EYE IS DOWN AND OUTWARD AND CANT DO ANY THING BUT MOVE LATERALLLY..
95…CN4 PALSY…ON MEDIAL GAZE PT CANT LOOK DOWN…
96…CN6 PALSY…EFECTED EYE CANT LOOK LATERALLY…
IBUTALID EIS GOO D FOR A FIB

97…IF AFIB IS LESS THAN 3 WK NO NEED FOR ANTI COAG JUST DO CARDIO VERTION
98
IF MORE THAN 3 WK DURATION DO THE ANTICOAG FOR 3 WKS AND LOOOK IN TEE THE THROMBUS IN RT ATRIUM AND IF NON THEN GO FOR CV
99….11HYDROXYLASE DEFICIENY CAUSE HYPERNATRIMIA NOT HYPO..
100…FROG LE G XRAY OF THE SHOULDER IF SUSPECTED DILOACTION ANT IS COMMON..
101…RECURRENCY IS MOST CC AND NEED SURGERY IF YOUNG PT OTHERWISE CLOSE REDUCTION AND IMMPBILZATION AND NSAID..
102…SREING OF PERAL ON ULTRASOUND ….FIBROMUSCULAR HYPERPLASIA IT IS THE MOST CC OF NEW ONSET HTN INA WOMEN.
103…AV NICKING I GRADE 2…ARTERIOLAR NARROWING IS GRADE I AND HEMARRAGE IS GRADE 3 AND PAPLIDEMA IS GRADE 4 RETINOPATHY
104..IF NO PAPILEEDEMA NO MELIGNANT HTN
105…NO HTN AND NO HEAMTURIA IN NEPHROTIC ITS IS IN GNPHRITIS
106…PAVILIZUMAB IS A MONO CLONAL ANTIBODY AGAIST RSV IS PROTECTIVE FROM RSV INF IN WINTER LIKE BRONCHIOLITIS..
107URTICARIA…R EDEMATUS ,BLANCHING RED AND WHIT EPLAQUE THE R RAISED PRURITIC AND RESOLVED IN 24 H
108…25 MG OF UNCONGUGATED BILI CAN CAUSE KERNICTURUS TO TH EBABY
ONLY UN CONGUGATED COMES IN URIN CONGUGATED CANT
PHOTO THERAPY AT 20 AND IF NOT EFFECTIVE THEN EXCHANG ETRANSFUSION

109…ABNORAMLA PLACEMENT OF LIG OF TRETZ IN THE RT HAND IS DIGNOSIS OF MALROTAION CALL SURGERY INMIDIATELY
110,,,ASD IS NOT WITH TOF 111…SHORT PR INT V PLUS DELTA WAVE IS WPW IF IT IS WITH AFIB JUST GIV EPROCAINAMID E NOTHING ELSE..

112
PL EDEMA IS ABSENT IN RDS.. GROUND GLASS ON XRAY AND NEED INTUBATION AND PEEP AN D WEGD IS ALWAYS NORMAL..
113…BYPASS TRACT THROUGH KENT BUNDLE IS POSITIVE IN WPW
114..TGA EKG IS NORMAL AND VACULARITY IS INC AND TVH AND TAD IS POSITIVE WITH CYANOSIS AT BITH OR IN 24 H

115….ANDROGENS R HIGH IN TH E CAH SEC TO 21 HYDROXYLASE DEF
116…ETHOSUXIMIDE IS TE IST DRUG OF CHOICE IN THE ABSENCE SEIZURE

117…HYPOTONIC DEHYD IS COMMON IN CHILDREN THROUGH DIRREA GIVE ORS AND PEDIALYTES
118..XRAY CHANGES IN JRA IS MINIMAL AND 80% OF THE KIDS WILL OUTGROW OF THIS CONMDITION
119…LEAD 20 IS POSIONING REMOV ETHE CHILD…AND LEVEL LESS THAN 49 NEED JUST EDTA AND BAL AND MOR ETANH 50 NEED THE BAL PLUS EDTA AND THIS IS FOR 7 DAYS AND PCN CELLIMIN E FOR 6 MONTH
HOSPITAILIZE CHILD IF IT IS MORETHAN 70 LEVEL OF LEAD …
INC FEP IS POSITIVE AND LEAD LINE BASOPHILIC STIPLING ANDWRIST DROP AND ENCEPHALOPATHY SEIZURE ….

120…MILK ALLERG Y IS A COMON CAUSE OF LOWER GI BLEED.

121…FALGYL IS BEST AN D COST EFFECT FOR CDIF AND VANCO ONLY IF IT IS NOT EFFECTIVE TOXIN IN STOOL IS DIAGONSTIC AND STOP ABX ..
122…CROHN IS TRANSMURAL AND FISTULA AND CA OXALTE STONE COMON AND ARTHRITIS AND OTHET STUFFF
123…IF PT IS T ORTHO STATIC IT MEANS MORE THAN 20 % FLLUID LOSS OR BLOOD LOSS..
124…FECAL LEUCO IS POSITIVE IN SHEGALLA ,SALMONELLA , YERSENIA,ECOLI
125…ROTA VIRUS IS M CC OF GASTROENTREITIS AND GIARDISIS IS MOST COMON CAUSE OF WATERY PARACITIC D CAUSE
126…BACTRIM IS GOOOD FOR TRAVELLER DIRREHEA
127…NO ABX IN THE TRETAMENT OF TOXIC SYNOVITI SSINCE THERE IS NO INC IN C REACTIVE PROT NO IN IN ESR AND NO INC IN WBC
128….LEAD SCREENING IS AT 12 M AND 24 M IN ALL CHILDREN
129…SAUSAGE SHAP MASS IN R U Q IS COMMON WITH INTUSSEPTION
130…SUBLAXED RADIAL HEAD IS COMON IN NURSE MIAD
131… MOST C C OF SURGERY IN TERM IN FANT IS IGUNO RAPHY
132…HELD ARM IN PRONATION BY THE KID BUT NO PAIN IS THE NURSE MAID
133…WALK ALONE IS 12 M….PUT FEET IN MOUTH SIX M
134…DADAMAMA 10 MHOLD BOTTLE 8 MONTH
135…SOCIAL SMILE 3 M
META PHYSIS,TRAUMA,BOYS AND HEAMOTOGENIOUS SPREAD NO XRA UNTIL 3 WK B SCAN POSITIVE EARLYB BIOPST GOLD MRI IS GOOD
136…COCKSACK B VIRUS IS TH EMOST C C OF MYOCARDITIS..FOR PE ECHO IS THE BEST
137…GARM STAINING OF SPUTUMIS THE BEST FOR PNUMONIA
138… TH ENON TREPONAMAL TEST I SUSED TO CHECK THE RESPONSE OF THE TREATMENT
139…ASLOW RIS 15 HIGH RISK 10 AND HIV IS 5 MM PPD WHICH I SPOSITIV E FOR TB
140….IN H AND RIF FOR 9 MONTH IS THE STANDRAD IF PT IS NOT RESISTANT FOR TB

141… 2 MONTH OF INH AND RIFAMP PAZ AN D ETHAMBUTOL AND 2 MONTH OF RIF AND INH
142…C JUJINI…INVOLVE SMAL AND LARG E BOWEL…. MOST CC OF LONGEST INC BATION PF CAUSE OF DIRREA…ERETHRO I
143… THE OSMOTIC DIRREA IS MOM AND LACTOSE INTOLENACE…STOPED WITH FASTING AND GAP IS MORE THAN 40 AND SECTERTORY IS NOT STOPED BY FASTING AND GAP IS LESS THAN 40

144…CAPMING TRIP IN SUMMER DIRREA IS DUE TO GIARDISIS..
145…DAY CARE IS ALSO GIARDISIS..SMALL BOWEL BIOPSY AND STRING TEST ..FLAYGYL AND LPERAMIDE IS GOOOD
146…. INF LUENZA VACCINE IS MUST FOR PT WITH COPD AS WELL AS SMOKING CESSATION
147…I/2 OF FREE WATER DEFICET IS REPLACED IN IST 24 H AND REST IN 48 HDESIRED TBW-CURRENT TBW…IS THE FWD…

CURREN T TOTAL BODY WATRE IS….O.6 MULTIPLIED BY WT INKILG
148 ….DESIREDTBW= NA DIVIDED BY 140MULTIPLIED BY CURRENT TOTAL BODY WATRE

149….K SOULUTION SHOUL D NOT B GIVEN MORE THAN 20 MEQ /H
150…. NUCLEAR MEDICINE RENAL SCAN IS GOOOD FOR UNILAT RAS BUT NOT FOR BILATERAL …IN WHICH W E DON’T GIVE ACE,,UNIL WE CAN GIVE..
151…IF RENAL ULTARSOUND IS POSITIVE FOR POLYCYSTIC KIDNEY UROOLOGY CONSULT IS NEXT
152…FENA IS LESS THAN 1 AND RATION OF BUN CRETININE IS MORE THAN 20 IN PRERENAL GIVE FLUID CHALLLENEG AND THEN GIVE LASIX…BUT IST PUT FOLEY
153…K MOR ETHAN 6.5 WITH CARDIO CHANGES NEED HD
154…ANCA IS WEGENERS NEED CYCLO AND BACTRIM FOR AN YR
155…IF OBST RUCTION IS AT THE URETER AND PELVISOR VESICOURETRERAL JUNCTION N EED NEPHROSTOMY TUB E BY UROLOGIST…OR URTERAL STENT PLACEMNTPERCUTANOUS NEPHROSTOMY IS REQ..

156…REMOV ETHE GFOLY IF URIN EIS CLOUDY IN FOLY AND GIV EPT ABX
157..TEE DETECT ABCESSES AND VEGETATION IN ENDOCARDITTIS SO IF PT IS NOT GETTING BETTER WITH ABX PCN /GENT OF NAF AND VANCO IN STAPHLO CASE THEN CALL CARDIOLOGY FOR TEE

158…CUSTARD CREAM MET STAPHLO FOOD POISONING SHORTEST INCUBATION PF SYMPTOMATIC TRETAMENT
BACTRIM IN PREG IS NOT SAFE GIVE AMPICILIN OR AMOXICILINE OR VENTIN ALSO CAN GIVE ZITHRO IT IS SAFE,,
NO ORAL HYPO GLYCEMIC IN PREGNCNY…JUST INSULIN KEEP THE FASTING BELOW 9 0 AND POST PONDRIAL LESS THAN 120
159…90 % OG GASTRIC ULCER IS DUE TO H PYLORI..MOC IS GOOD TRETAMENT FOR 14 DAYS AND ANTOBODIES IN SERUM OR UREA BREATH TEST IS GOOOD …
160…COBBLE STONE TRANSMURAL LESION WT LOSS MUCUS IN DURREA ABD PAIN…IS CROHN..
161…BLOOODY DIRREA AND PUSDO POLYP..IS UL COLITIS
162…MOLUSCUM CONTIGIOSUM IS COMON IN YOUNG BOYS WITH UMBLICATE D DEP AND ITS IS BEST TERATED BY CRYO AND ITS CAUSED BY POX VIRUS

163…ALWAYS IST THING IN HTN IS TO LIFE STYLE MODIFICATION SAME IN GERD..
164…D4T CAUSE NEUROPATHY
ABACAVIR SEVER HYPERSENSTIVITY REACTION,INDIANAIR IS NEPHRO LITHISIS…

165…SQUNINAVIR G I UPSET INC LIPID
166…DELAVIRIDINE..RASH AND INC LIVER ENZ
167…AZT LEUKOPENIA AND ANEMIA AND MYOSITIS.
168….HIV IS NOT REPORTABLE AIDS IS..
169…DDC,PANC ,NEUROPATHY
170..DDI…MORE SEVER NEUROPATHY AND PANC
171..HETROSEXUAL TRANS MITION IS MOST COOMON MODE OF TRANSMITION THESE DAYS.
172…INPREG START AZT IN THE IST DAY OF 2ND TRIMESTER AND IF SHE IS ALREADY ON KEEP ON CONTINUING THE AZT
173…HAART IS 2 NUCLEOSIDE AND ONE PI… DEC MORTALITY ..
174….NO MATTRE WHAT THE CD IS IF PT IS SYMPTOMATIC GIV EHAART
175…IF PT IS STUCK WITH NEEDLE OF A PT BLOOOD THEN GIV E BOTH AZT AND LUMIVIDINE AND INDIANAVIR..FOR 2 M
176…..IF PT STUCK WITH THE NEEDLE CHANCE OF GETTING HIV IS .3 % FROM VERTICAL TRANSMITION ITS 30% AND WITH AZY DURING LABOR AND PREG AFTER IST TROMESTER IT DEC TO 7%
177…GIVE BABY AZT FOR 6 WKS…AND CHECK HIVE TEST AT 6 AND 12 MONTHS,,
ALL BABIES BORN TO MOTHERS WHO HAV E HIV WILL HAV ETHE HIV POSITIV E TEST BCZ OF MATRENAL ANTIBODIES GOEST O BABY…
178….NON NUCLEOSIDE INHIBITERS R ENDING IN INE AND NEVREAPINE AND DELAVIRIDINE IS SOE AND OTHER IS EFAVERINZ..
179… C ANCA IS SP FOR WEGENERS DIEASES..
180..TAKAYASU IS TREATE DWITH STEROID AND METHOTREXATE…181..SP CORD COMPRESSION NEED MRI ASAP…182….MO BON E SCAN IN MULTIPLE MYELOMA
183…ST LEG RAISING TEST IS POSITVE IN DISC HERNIATION AND ITS MORE COMON IN L5-S1..184 SICKLE CELL TARIT PPL DON’T HAV EMALARIA BCZ NO DUFY ANTIGEN
184..…for nocturnal agitataion givehaloperidol never diazapine…
185….ZOLDIPEM IS A HABIT FORMING MEDICATION
186… BUPROPION IS GOOOD WHEN SEXUAL DYSFUNCTION IS POSITIVE BUT IT CAUSE SEIZURE..
187…..THE FACIAL DISCOLORATION IN PREG IS DUE TOINC ESTROGEN AND MSH ITS CALLLED MELASMA…
188..IST GIV E FLUIDS AND THEN STRAT CATHTRE IN CASE OF POST OP ANURIA..

189….. ALL GYNE SURGERIES ONE DAY SURGERY OR SAM EDAY SURGERY PT CAN B D/CED WHEN SHE WILL PEE..
190…DIRECT COMMMS TEST IS NEGATIV EIN TTP AND HUS BUT POSITIV EIN ABO INCOMPATIBILITY..
191…TERBUTALINE CAUSE TACHYCARDIA HYPOKALEMIA AND PUL EDEMAA
192…SVR DEC IN PREG SO BP IS DEC UNTIL IST26 WKS
193…PROTRUSON THROUGH INT RING IS INDIRECT INGUINAL H IT’S THE MOST MOST C C OG HERNIA IN BOTH SEXES..
194….HYPOXIMIA AND PLURAL FRICTION RUB WITH SOB AND SUDDEN CP…THINK OF PE…
195…BARRIER IS BEST TO PROTECT FROM PID….PID CAUSE ECTOPIC AND OCP PROTECT FROM PID B ALTERATION OF CEVICAL MUCUS… STOP OCP I MONTH SURGERY…ITS PROTECTIVE FROM OVARIAN AND UTREINE CA..
196….AP24PCR IS BEST TO DETREMINE EARLY SERO CONVERTION….OF HIV WITH IN A MONTH OR B4THAT…
197…POSITIVE REINFORCEMENT AND ALARM IS MOST EFFECTIVE TREATMENT AND FOR QUICK FIX IS DDAVP IN ENURSIS,,,
198…. APPOSITIONAL DEFIENT DISORDER ..THYE R KIDS THAT THEY JUST BARK…NOT OBEYING RULE BICKERING YELLING AT PARENTS AND FDS ….
199…CONDUCT DISORDER IS SAME AS ANTOSOCIAL BUT LESS THAN 18…
200….RASH IN TH E PALM AND SOLE AND IN AXILLLA ,,,STRAWBEERY TONGUE..SCARLET FEVER IT CAUSE RHU FEVER AND GLOMURO NEPHRITIS…
201…RECURRENT ABORTION DO KARYOTYPING BOT PARENTS…
202….DUB MOST CC IS ANOVULATION ..MOST AT ETREME AGE AND IT IS TREATED WITHOUT ENDOMETRAIL BIOSY IF PT IS LESS THAN THIRTY AND WITH IF MORE ..IN SEVER BLEEDING USE ESTROGEN 25 MG IV Q4H UNTIL BLEEDING IS NOT CONTROLLED..AND FOR MILD BLEEDING THE DOSE IS JUST 1.2 MG…PLUS MPA AN OCP IS ALSO GOOD…
203…NEVER TRANSFUSE A YOUNG PT UNLESS NOT IN HYPOVOLEMIC SHOCK DUE TO SEVER HEMARRGE AND FLUIDS R NOT BRINGING BP BACK OR LOW O2 SAT….
204….RISK OF HIV FROM NEEDLE STICK IS .3% AND RISK IF HEP C IS 1.7% AND RISK OF HEP B IS 9%..
205…INCOMPLETE ABORTION…BLEEDING PLUS PRODUCTS R COMING OUT OS OPEN..NEED DNC…
206….OS IS CLOSE BLEEDING …THRETENED ABORTION..
207…A MISSED ABORTION IS ETENTION OF FAILED IUP FOR MORE THAN 2 CYCLESIF S RETENTION LAST FOR MOR ETHAN 8 WK DIC…IMIDIATE D AN D E REQ..
208…DELIVERY OF TH EBABY IF MATURE IN PREECLEMSIA AND ABRUPTIO OR PLACENTA PREVIA IF NOT THEN GIVE STREOID…
209…IST TRIMESTER RECURRENT ABORTION IS DUE TO CHROMOSOMAL BUT SEC TRIMESTER R SEC TO MATERNAL SYSTEMIC DIEASES…
210…NO METHERGINE IF HISTORY OF HYPERTENTION IF SYTO DIDN’T STOP BLEED ING GO FOR HEMATE OR PG E2ALPHA BUT MAKE SURE PT IS NOTASTHAMATIC…
211…LDH MORE THAN 350 AND GLUCOSE MORE THAN 30 CA LESS THAN 8AGE MORE THAN 55 WBC MORE THAN 16KAST MORE THAN 250 AND NO ALT IS IN TH E TRANSON CRITARIA…ALL THIS IS A SIGN OF POOOOR PROG…
212,,IF HEMOLYSIS THEN NO INFECTION IF BOTH IS ABSENT IN A NEONATE THE CAUSEOF INC ID BILI IS PHYSIOLGICAL OR BREAST MILK JAUNDANCE….BUT IST CHECK CBC AND MAKE SURE U CHECK RETICULOCYTE COUNT AND SMEAR…IF HEMOLYSISI IS POSITIVE AND IN DIRECT COMB STOOO IT IS THEN ABO INCOMP..WHICH IS THE MOST CC OF 24 H HEOLYSISI OR JAUNDDANCE..IF INDIRECT BILI IS MORE THAN 15 ON 3RD DAY GIVE PHOTO THERAPY IF NOT DECLING THEN EXCHANG TRANSFUSION TO PRESENT BASAL GANGLIA KERICTERUS…
213…..ONLY UNCONGUGATED COMES IN URINE..AND ONLY STERCOBILN COMES IN FECES..
214…PUL EDEMA….GIVE 100 %O2…HAV EPT SIT UP…AND GIVE LASIXIV AND CHECK XRAY PERIODICALLLY AND CHECK GAS…CONTINOUS PULSE OX GIVE NITRO TOO IF STILL NOT IMPROV EINTUBATE AND MOVE HIM TO ICU…
215…INFORMED CONSENT IS IMP B4 REPORTING RAPE AND HER PH Y EXAM..IN RAPE U WILL PROBABLY NEVER OVER IT..WHEN PT ASK U ABOUT RAPE WHEN I WILL B OVER IT DOC…DON’T LIE..DON’T GIVE FALSE HOPE…DON’T OVER INFORM OR UNDER INFORM THE PT TELL HER HOW MUCH HE OR SHE WANA KNOW…
216…U R OBLIGATED TO TH EPT NOT THE FAMILY…
217…SPEND THE PT MORE TIME WITH FAMILY
218,,DON’T CHANGE THE SCHADULE TO VISIT IF HE IS MOVE TO HOSPICE REMMBER HE IS STILL UR PT…
allupurinol is not for acute gout indocin is and allupurinol only after checking 24 h uric acid in th e urine if less than 800 then probenecid and if more than this then allopurinol but only after 2 wks of acute state..
219….IN PHYSIOLOGICAL JAUNDANCE THE BILI SHOULD B DEC BY 2 MG BYTH E END OF WK…DUROING PHOTO THERAPY CHECK THE BILI 6 H…
220…SIGMPOD VULVULUS…ABD PAIN ,DISTENTION,OBSTIPATION,,,XRAY SHOW BIRD BEAK APPERANCE …SIGMOIDO I STHE BEST FOR DISG AND THERAPETICALLY AND TO PASS RECTAL TUBE…
221….THERE IS PROMINENT U SHAPED SIGMID COLON IN THE LOWER ABD…
222…LIKELIHOOOD RATIO=SENS DIVIDED BY 1-SP…
223…AMPHO B WITH FC IS BEST FOR CRYPTO..INDIA INK ANTIGEN IS SESTIVE HEACHE AND FEVER…
224…SAAG MORE THAN 1.1 IS DUE TOPORTAL HTN…PEROTONEAL CARCINOMATOSIS I S ALWAYS SAAG OF LESS THAN 1.1
BUDD CHERI AND PVT AL CAUSE PORTAL SO INC SAAG…
225..HEMOCHROMOTOSISI IN A THALASEMIA IS DUE TO IRPON OVERLOAD FROM FREQ BLOOOD TRANF…GIVE DEF…
226…CA PAN 19-9 AND BRXA 1AND 2 IS BREAST CA..
227…CT ABDOMINAL AND PELVIS AND SURGICAL AND PATHOLOGICAL STAGING FOR OVARINA NAD ENDO METRIAL CA…
228…AMENORREA ,PERIPHRAL VISION DEFECT AND GAALCTOREA…ITS MOST LIKE PROLACTONOMA GIVE BROMO IF THE PPROLACTIN IS MORE THAN 25 AND MORE THAN 200 IN PREG ..DO MRI…
229…CRYPTOC IS MOST C COF DIRHEAA..I N HIV230….MAC WILL B PREVENTED WITHWKLY CLARITHROMYCIN…ETHAMBUTAL..CAUSE UVEITIS..PROPHYLAXIX… IF CD LESS THAN 50-100……
230..INC AMOUNT OF LIGHT CHAIN IN THE URINE OR SERUM…MM…BENCEJONES PROEIN…LYTIC BONE LESION…
231….INDIRECT ING HERNIA ORIGINATE AT DEEP INGUNAL RING AN DLIES LAT TO IN F EPIG V..232..RAPID TAPERING OF STREOID IN ASTHAMA CAN CAUSE ADDDISON CRISES…
233…DHEAS IS INCREASE MORE THAN 700 IN ADRENAL TUMOR…IN POLYCYSTIC OVARIAN SYNDROM E…..234….FANESTRIDE…IS 5 ALPHA REDUCTASE INHIBITER THATINHIBIT TH ECONVERSION OF TESTO TO DHT…235…HIRSUTISM…TESTO GREATRE THAN 2.0 IS DUE TO ADROGEN SECRETING TUMOR…
236…NEUROLETICS ANTAGONIZE D2 RECEPTERS SO NO REGLANAND NO HALDOL IN PARKINSON DIEASE WILL FURTHER DEC THE DOPAMINE…237…LEVELOF ABI ROARIO.5 OR LESS NEED BYPASS IN PVD AS WELLL AS IF PT HAS CALUDICATION AT REST AND IF THERE IS SOME MUSCLE ATROPHY… NEED SURGERY OTHER WISE JUST CESAATION OF SMOKING AND REGULAR EXERCISE…
238.. A PAP SMEAR I S TAKEN FROM VIGINAL CUFFF…239…MYOPATHY IS SIDE EFFECT OF STATIN…
239..CHOLESTYRAMINE CAUSE INC TG…240…2 READING OF MOR ETHAN 140/90 6 H APART IS HTN…

239….IF LDL IS MORE THAN MOR ETHAN 160 AND 2 FACTOR POSITIVE GIVE STATIN…AND DIET MODIFICATION…

240….A LOUD SYSTOLIC EJECTION MURMER HEARD OVER TH E AORTIC POSITION IS CHARACTERSTIC…AND THRILLL WITH THIS IS IN SUPRASTRENAL NOTCH…
241…OLIGOSPERMIA WITHLOW FSH AND LH I S SUGGESTED OF PROLACTONOMA..
242…TEMP ARTERY BIOPSY IS MUST IN 24 AND 72 H AFTERSTARTINGOF STREOID.
243…STREPKINASE OR TPA ONLY IF ST ELEVATION IN TWO CONSECTIVE LEAD IS POSITIVE …AND R/O PERICARDITIS…
245..PUL STEOSIS ,PRIOR CPR.SURGERY LESS THAN 3 WK STROKE WITHIN I YR AND GIBLEED AND UNCONTROLLED HTN,MARFAN SYNDROME,,, I S CONTRAINDICATION OFOF TPA…
246…IF PE IS MASSIVE WITH LOW BP LIKE 70/40 GIVE FLUIDS AND GIVE TPA …OR STREPTO..
247…LDAL OF 140 WITH 2 FACTOR NEED DIET MODIFICATIONONLY…
248….mgso4 therapetic level is 4-7 and loss of dtr is at level of 10 and 12 bretahing prob and more than 15 heart prob..249…INILAT LEG SWELLLING AND WITH WARMTH AND REDNESS IN ABSENCE OF INFECTION I SMOST LIKELY DVT…PALPABLE CORD IS POSITIVE…GIVE HEAPRIN..
250..FACTOR V LADEN DEFICIENCY IN CAUCASION CAUSE DVT
251..BECKWEITH IS ASSOCIATED WITH WILMS AND NEUROBLASTOMA…
252…P53 SUPPESSER GENE IS ASSOCIATED WITH MANY MELIGNANICES.
253…NMYCO PROTOONCOGENE IS ASSOCIATED WITHNEUROBLASTOMA..PRESENT IN POS T MEDICASTINUM
POSTPARTUM BLUES RESOLVE AFTER 2 WK SITS NORMA…START WITH A PD OF WEEPING ON 3RD DAY…AND PEAK BET 5TH AND 7TH DAY… SUPPORTIV ETHERAPY IS BEST…REASUURANCE PT EDUCATION I S GOOOD..
254..RESPERIDONE AND HALOPERIDOL IS GOOOD FOR ACUTE AGIATATION…
255… POST PARTUM PYCHOSIS.. BIZZAR PERSECUTURY DELUTIONS,GARDIOSE SOME TIME,THOUGHT DISORGINATION,MAIC S/S MAY B PRESENT THEY R INC RISK OF SUCIDE AND INFANTICIDE SO SEP THE CHILD AND TRETA TH E PT..HALDOL IS GREAT FAMILY THERAPY AND BEHAVIOR THERAPY AND REGULAR VISIT BY MENTAL HEALTH PPPL FOR F/U
256….SUPPORTIV E GROUP OR INDIUAL THERAPY IS GOOD FOR POST PARTUM PSYCHOSIS…237…JH REACTION IS COMMON AFTER TRETMENT OF SYPHLIS BY PCN IT CAN AS LATE AS 15 DAYS HEADCHE, FEVER
257…MYALGIA.HYPOTENTION IS COMON TRETEMNT IS SALICYALTE OR PREDNISONE FOR JH REACTION
258…URETHRAL PHARANGEAL AND CERVICAL SWOB FOR CULTURE INTRA CELULAR DIPLOCOCI IS POSITIVE.
259… THE MOST COMON CAUSE OF EPIDYMITIS IS CHALMYDIA TRACHOMATIS AND TREAT MENT WITHDOXYCYCLINE NSAIDS,ICE PACK,SCROTAL LELEVATION,RED AND TENDER SCROTUM AND PAIN MORE WITH ELEVATION OF TESTIS FEVER AND INC WBC…POSITIVE

260…DARK FIELD FO RPRIMARY SYPHILIS AND TREATMENT WITH 2.4 M BENZA THIN E PCN G
361…CRYO IS BEST FOR MOLUUSUCM AND GENITAL WARTS
362…ACYCLOVIR DEC VIRAL SHEDDING BUT RECURRANE IS STILL COMMON.
363..DEC LABIDO AND INHIBITED ORGASM WITH SSRIS..
364..COGNITIV EPSYCHO THERAPY IS BEST FOR MAJOR DEP..
365….ADJUSTMENT DISDORDER AND DEP MOOOD…TREATMENT IS COUSELLING ABOUT STRESS MANAGEMENT AND BREIF PSYCHOTHERAPY..
366…ATYPICAL DEP IS ASSOCIATED WITHHYPERPHAGIA AND HYPERSOMIA AND TREATMNT IS MAO BUT DON’T GIVE WITH SSRI DUE TO SEROTININE SYND..
367… IF LITHIM IS NOT INDICATE DOR NOT EFFECTIVE CARBAMAZEPINE AND VALPORETE IS NEXT BEST CHOICE,
368…10 YR WAS TALKING TO THE TEACHER AND SUDDENLY STOP TALKING AND STARTED STAING AT HIM FOR FE SEC ..GIVE ETHOSUXIMDE..ABSENCE SEIZURE
369…WITHDRAWL AND FLAT EFFECTAPATHY AND LACK OF MOTIVATION IS POOOR PROG …IN SHIZO
370… DELUSION AND HALUCINATION FOR MORE THAN I MONTH IS SHIZO
371..CATATONIC..RIGIDITY AND POSTURING…LORAZEPAM IS GOOOD
372..DEKUTIONAL DISORDER IS DELUSION WICH IS NON BIZZAR AND FOR I MONTH…NO DELUSION AND HALUCINATION OF GRANDIOSE TYPE…
373…BREIF PSYCHOSIS …IS LESS THAN I MONTH AND EVERY THING DELUSION HALUCINATION AND DISORIENTAION IS POSITIVE
374.. BIPOLAR 1 IS PT IS PYCHOTIC WHEN PT IS DEP OR MANIC N ORAMAL IN BET AND FUCTION G IS GRETA IN BET
375… HEROIN WITHDRAWL ..METHADON IS THE BEST
376….DON’T GIV E FLUMAZEMIL WHEN MIXED DRUG OVER DOSE OR TRICYCLIC BCZ INC CHANCE OF SEIZURE WITH THIS…
377.. DUAL DIAG IS A TERM WHEN THERE IS SUBSTANCE ABUSE AND ANOTHER PHYCHATRIC CONDITION POSITIVE
378…ADMIT TH E DRUG PROB AND FAMILY SUPPORT IS IST THING
379…LONG TERM INDIVUAL AND GROUP THERAPY
DETOX. AND PREVENTION OF WITHDRWAL IN DRUG TRETAMENT….DRUG ADDICTION.
380….OCD IS POSITIV E 25% IN ANOREXIA..BRADY CARDIA HYPOKALEMIA AND BODY WT IS LESS THN A 15 % OF TH EIDEAL WT OF THE AGE
381…PROZAC IS GRETA IN BING EEATING AND COGNITIV EBEHAV THERAPY
382….BUSPRION IS BEST FOR THE GENARLIZED ANXIETY DISORDER
383..SYSTEMI C DESENSTIZATION AND COGNITIV ETHERAPY FOR GAD..DURATION SHOULD B AT LEAST 6 MONTH..
384… FACTIOU S DISORDER …TO BEHAVE AS A SICK ROLE.. TO CAUSE PHYSICAL AND PYCHOLOGICAL S/S OF TH E DIESEE
385…SSRIS IS THE BEST FOR OCD CLOMI IS SALSO GOOODIN OCD
386..VIGINISMUS…DIF DILATERS IS THE TRETMENT
387…ERECTILE DYSFUNCTION IS MOSR COMMON IN ELDERLY AND CAUSE IS USALLLY ANTI HYPERTENSIV EAN DOTHERS MED..SO D/C MEDSAND CHANG EIT WITH OTHERS..
388…NO VIAGRA WITH ANY NITRATED LIFE THRETENING HYPOTENTION.
389..BRONZ BABIES IS ALSO DUE TO PHOTO THERAPY
390..FEVER MORE THAN 105 IN TH ELAST DPT DON’T GIVE THIS PERTUSIS JUST GIV E DT
391….MATICULUS HANDWASHING AND AVOIDANC EOF CONTACT WITH FACE OR NOSE IS THE BEST TO DEC THE SPREAD OF INFLUENZA
393..RSV PNUMONIA IS MOST COMMON UNER 5 YRS

394…NO ANTIPYRETIC IN THE HEAT STROKE
JUST COOLING MEASURE..ICE ON THE BODY..
394….FROST BITE….RAPID REWARMING WITH HOT WATER…
395…OSGOOOD IS INFLAMATION OF TIBIAL TUBERIROSITY INA RUNNNER BEST TRETAMENT IS REST AND STOP VIGROUS ACTIVITY
396…PATELOFEMORAL SYNDROM EI S MOST COMON CAUSE OFANT KNEE PAIN IN TH ETEENAGERS… TRETEMENT IS AGGRESSIVE ISO METRIC RESISTANCE EXERCISES
397..BRACES AND CASTING FOR 1-2 YR S FOR LEGGG PERTHESE DISEASE.
PINNING IS REQ IN SLIPED FEMORAL DISEASE COMON IN OBESE KIDS IN 10-14 YRS OLD AGE,
398…TOXIC SYNOVITIS…NON WT BEARING…REST IN BED..NSAIDS .NO ABX ..BCZ NO GRAM STAIN POSITIV EAND NO WBC INC..
399…AVASCULAR NEC OF TH EFEMOARL NECK ..LEG PERTHESE
400… THE MOST C C OF INTOWING IN KIDS IS ANTEVERTON OF FEMUR
WATCH FUL WAITING IS ENOUGH IN THIS…
401…UA IS THE IST THING IN ENURESIS PT …USUALLY EMOTIONAL…OR SEXUAL ABUSE
402…BEHAVIOR MODIFICATION IS BEST TRETEMENT FOR THIS ENRESIS..
403…REGWEED POLLLEN IS M CC OF ALLERGIC RHINITI SIN US
404..VASOMOTOR RHINITIS IS TRIGGGER BY SMELL ODOR RTEMPSPIY FOOOD..NASAL OBSTRUCTION IS TH EPRIMARY SYMPTOM…NO SNEEXING ITCHING AND RHINORREA…IN VASO MOTOR RHINITIS…
405…BEST TREATMENT FOR ALLERGIC CONJTIVITI SIS CROMYLN SODIUMTHE MOST COMON CAUSE OF RAGWEED I S POLLEN..
406…EXTENSER LESION WHICH R PRURITIC ECZEMATIC IS COMON IN KID WITH ATOPIC DERMATITIS…. FLEXER LESION IN ADULT
407..ENVIRONMENTAL PREVENTION ALL TH ETRIGGGERING FACTOR SHOULD B PREVENTED….. IN ATOPIC..FOOOD MILK EGGGD FABRIC .

408… WET COMPRESSES IS TH EIST TRETAMENT OF THE SEBORRIC DERMATITIS…
409…KETOCONAZOLE CREAM FOR DIAPER RASH
410…MUPURIINE IS BEST FOR INFECTED ATOPIC DERMITITIS
411.HYDROXYZINE ,BENADRYL FOR ITCHING IS BEST AND NO HOT WATRE BATH,,
412…SMOOTH TEXTURE COTON GRAMENTS AND REGULAR FARMULA IF ALLLERGIC TO COW MILK…
RICE ALLLERGY IS THE LEAST ALLERGIC IN FOOOD SO USE
413..POSITIV EAND NEGATIV E PREDICTIV E VALUE DEPEND ON PREVALENC E OF TH E DIASESE
SAMPL ESIZE IS MOST IMP FACTOR IN THE SUCCESS OF ANY STUDY..
414..BICONCAVE AND FISH MOUTH VERTEBRA IS CLUE TO SICKLE CELL DISEASE
415

IN SICK TRET AGGRESSIVE FLUID //O2 AND PAIN CONTROL WITH NORCOTIC…AND GIVE INF AND PNUMOVAC AND PCN FOR INF…
416….SESSIL E LESION R MORE LIKE LY TO BECOME MELIG THAN PEDUNCULATE DONE..
417..ECOLI AND B FARI GALIS IS MOST C ORG IN THE DIVERTICULITIS
418….LEFT COLON CA,,CHANG EIN VBOWEL HABIT/WITH PENCIL LIK E STOOOLGROSS BLOOO DIN STOOOL.OBSTRUCTIVE S/SIN COLON CA
419…IN RT COLON CA….DIRREA MUCUC AND BLOOOD IN THE STOOL BUT OCCULT..ANEMIA.PALPABLE ABD MASSDYSPEPSIA…
420..CA OF RT COLON IS COMON IN WOMEN AND COLORECTAL CA IS MORE IN MEN..
421….ADENOMATUS POLYP SHOULD B REMOVED IF NOT BY COLONOSCOPE THEN BY LASERS ORLAPROTOMY..BC ZTHEY R MELIGNANT
422…INFILTRATING DUCTAL CA IS MOST CA..IN BREAST
423…MAMO IS T THEN BIOPSY
424… PREMENOPASAL AND POST MENOPAUSAL IF ER POSITIVE GIV ETIMOXIFEN
425…FIBROADENOMA IST FNA

426.. PAIN IN TH EBERAST I WK B4 MENSES IS FIBROCYSTIC DIEASE AND RECHECK PT AFTER 6 WKS I STH EBEST
427…LUMPECTOMY AND IRRAIDIATIONIS BEST AND MRM ONLY WHEN NIPPLE AND SKIN INVOLVED
427… KI RAS GENE …CA PAN…19-9 IS ALSO FOND IN TH ECA PAN CT IS TH EBEST..
428…PT LIE FLAT AND PUT OBJECT UNDER NECK OR UNDER BACK WILL RELIEVE PRESSURE…
429… PAIN FUL LEFT EYE WITH BLURRED VISION AND AND SHE WEARS CONTACT LENSES… HEPETIC CORNEAL ULCER…
430…UNILAT MUCUPURENT DISCHARGE IS BECT CONTUTIVITIS……NORMAL VISION IS POSITIVENO STAINING OF CORNEA ON FLUROCEIN WHIL E GREEN STAINING ON STAINING WITH FLUROCEIN IN HERPETIC ULCER
431..NO ABX IN VIRAL AND BEC WITH SULFACETAMIDE EYE DROPS…OR GARAMYCIN…
432…STAPHLO STREPTP MOST LY AND ADENO IS TH ECAUSE OF VIRAL..
433.ITCHY RED EYE IS ALLLERGIC CONJUCTIVITIS….TREATMNT AVOID ALLERGENS.IMUNOTHERPY.CHEMOSI S IS WITH ALLLERGIC CONJECTIVITIS…
434…EPISCLERITIS PT HAS A RED ,SORE AND TENDER EYE THERE MAY B REFLEX LACRIMATION,UT NO DISCHARGEITS COMON IN AUTOIMUN E DISEASES LIKE RA SLE
435…SCLERITIS IS MOR EPAINFUL EYE THAN EPISCLRTIS…
436….DAMOX OR TIMOLOL IST IF EYE IS PAINFUL AND HARD TO TOUCH AND SUDDENLOSS OF VISION WITH HAZY STEAMY CORNEA…ACUT ECLOSE ANGLE GLAUCOMA…LASER IREDECTOMY LATER..
437…MRIS IS BEST FOR DISC HERNIATION…
438…WHILASH IS MOS C INJURY….
439…UPPER 2/3 OF TH EURTER STONE ESWL….
440…IF STONE R LESS THAN 2CM AND LOCATED IN UPPER POLE OF TH E KIDENY ESWL IS TH EBEST… IF STON EIS MORE THAN 1 CM AN DLOCATE DIN LOWER POLE OF KIDNEY THEN COMBINED ESWL AND PERCUTANIOUS NEPHROLITHOMY…
441…MOS C TUMOR INMEN IS PROSTRATE AND MOST COMMON CAUS EOF DEATH IS LUNG
MOST COOMN CA IN FEMALE IS BREAST AND MCC OF DEATH IS BREAST CA
442..MOST CC O F DEATH FROM GENITAL CA IS OVARIAN CA
443…BEC PROSTITIS MOST CC IS ECOLI AND AND KLEBSELLA BACTRIM IS BEST
44.4….SWOLLEN TENDER BOGGY PRSTATE DON’T MASSAGED
445..BACTRIM AND CIPRO IS BEST FOR PROSTIOTIS..
446…MENNERES DIEASE..A MIDDLE AGE WOMNE WITH TINITIS HEARING LOSS AND VERTIGO….FLUCTUATING SENSONURAL LOSS.AURAL FULLNESS IS A CLUE…HCTZ,CHOLORPROMAZINE…
447…BREIF VERTIGO OFTEN POSITIONAL FINISHED BY FIXATION TO A POINT IS BPPV
448…. RATATORY HORIZONTAL NYSTAGMUS IS CH OF BPPV
449…AMOXICLIIN FOR 100 DAYS IS BEST FOR ACUT E SINUSITIS
450…FRONTAL SINUSITIS IS SERIOUS..
451… REASSURANCE AND SIMPLE EXERCISES IS GOOD FOR BPPV AND ACUTE ATTACK NEED BEZO DIAPINE AND LOW SALT DIET
452..VSTIBULAR NEURITIS IS MOSTLY AFTER URI…DOESN’T INVOLV E CHOCHLEAATAXIA N/V POSITIVENO AURAL PAIN,NO HERAING LOSSS RECOVERY USUALLY TAKES I .2 WKS..
453…. THICK AN D GREENISH DISCHARGE IS BEC T SINUSITIS..GIVE AMOXICILIN FOR 10 DAYS
454..BEC SISUSITIS MOST CC IS STAPHLO AURIUS
455..MASTOIDITIS IS CAUSED BY TH E STREPTO PNUME..
456…ACTE LABYRINTHTIS…NEED REST,ANTIEMITIC AND ANTIBOITICS,,AFTER URI MOST COMONHAVE MIDDLE EAR EFFUSION CHEMICAL IRRITATION OF INNNER EAR..
457..NORTRIPTALIN EIS BEST TRICYCLIC IN ELDERLY
458…ACH DEFICENCY IS COOMON IN ALZIMERS..APO E4 POSITIVE AGE IS TH EMOST COMON RISK FATOR
459..DONEZEPIL IS BEST IST FOR ALZIMERZ
460…DELIRIUM IS MOST COMON MENTAL DISORDER IN HOPSITAL
PROG MMEORY LOSS IST IN ALZIMERZ
461…DELUSION HALUCINATION AND LOST INTERST IN DAILY ACTIVITY VISEOSPATIAL DISTURBANCES LANGUAGE IMPAIRMENT ALL IN ALZIMERZ…
462…DISORG SLEEP WAKEFUL CYCLE OIS PATHOGONOMIC OF DELIRIUM..
463..PMR NO ALDOLASE HIGH NO CPK HIGH N MUCLA BIOPSY NORMAL ONLY INC ESR AND PAIN IN SHOULDER AND HIP…ASSOCIATE DWITH TEMP ARTERITIS…
464..ORAL PREDNISON E 10-20 I S BEST FOR PMR AND 60 MG OF IV IS FOR TEMPORAL FOR ATLEAT I YR
465,,SYSTOLIC ELVATION IS DANGROUS AND SHOUL DB TRETAED
466..SYNCOPE IN ELDERLY IS SEC O THEIR MEDICATIONS…
467..COUGH AND LOSS OF TASTE AND I NC K WITH ACE..
468…FGIVE LOSARTAN IN COPD IF EJECTION FARCTION IS LOW..BCZ OF COUGH OF ACE…
469…DEPRENYLE EARLY WILL DEC THE DISABLITY IN PARKINSON
470…DEP IS COMMON PROB IN PARKINSONS
471…BENIGN ESSENTIAL TREMORS NEED BETA BLOCKERS
472..DRE TO CHECK IMPACTED STOOL IN CONSTIPTAION PT
473..CAP REQUIRES..ERETROMYCINE,ZITHROMAXAND CLARITHRO MYCIN…
474…RELAPSIN UTI IN TH EMALE IS DUE TO CH PROSTITIS…

475..CUTUR THE PROSTARTE SECRETON IS DIG IN PROSTITIS.. ECOLI IS MOST COMON CAUSE IN CH AND CHALMYDIA IS MOST COMON IN ACUTE PROSTITIS…
476..INF VAC IS EFEFCTIV E AGAISNT BOTH A AND B TYPE..
477…H INF VAC IS LEAST EFEFCTED IF CD 4 IS LESS THAN 100…
VAC AND AMNTADINE IS GOOOD TO CONTRAL INF ..
478..HEADACH FEVER CHILLS MYALGIA..COUGH AN DCONGESTION IS INFLUEZA..
479…AMENTADINE IS 70 TO 80 % EFFECTIVE AGAIST INF A
480… ASYSTOL DIRETLY LEADING TO DEAT…
481…ATROPINE UP TO 4 MGAND THEN TC PACER AND THEN TV IF NOT EFFECTIVE ATROPINE..IN SYMPTOMATIC BRADY PT
482…V FIB SIST 200.300.360
SAM EIN PULSE LESS VTACH
483… THE BEST SUCCESS WITH CPR IS WHEN IT STARTED WITH IN 3 MINUTES OF C ARDIAC ARREST..
484..ONE ASYTOLE PROBABLITY OF SUCCESS IS ZERO
485…DOOOR TO NEEDLE TIM EFOR CLOT DISSOLVING IS WITH IN 30 MINUTES
486..16 G IS THE BEST FOR RESUSITATION.487..TH EMOST COMON ERROR IN ER IS AIRWAY MANAGEMENT
487…BEST THING TO CHECK IF PT IS ADEQUATELY PERFUSING IS CHECK UOP
488..INFECTION IS TH ETRIGGERING FACTOR IN DKA
489…THERE IS NO KETONES IN NKCOMA…
490…SERUM K IS ELAVTED DESPITE TOTAL K IS LOW IN IST PHASE OF DKA…
491..SPOT BLOOOD SUGAR WILL B ABNORAL TO GREATEST DEGREE IN DKA
NS IS TH EBEST FLUID IST BUT WHEN GLUCOSE REACH 250 ADD D5W…
492…GIVE MAG AND PO4 AND CHECK K EVERY 2 H…
493…KAUSSMAL AND SWETING AND ACETON E BREATH AND UTI OR ANY OTHER INFECTION WITH SUGAR OF 400 IS SKA
494…GIVE 10 UNIT OF REGULAR INSULIN S/Q B4 U D/C PUMP …
495..TURN OFFF PUMP WHEN ABG SHOW S CLOSURE OF GAP..
496..ABDOMINAL PAIN CT IS BEST
497…80% OF AAA R ASYMPTOMATIC AND MOST CC IS ATHEROSCLESIS..
498..DON’T GIVE N ACETYLECYSTEIN AND ACT CHORCOAL TOGTEHER DEC ABSORBTION 2 H AFTER OR 2 H B4
499…70%SORBITOL IS GOOOD TO GIVE WITH THEATIVATE D CHORCOAL…
500..NO CHORCOAL ..IN LITHIUM ,IRON,ETHANOL METHANOL AND HYDROCRBON
501…THROUGH WASHING OF WASHING WITH TAP WATER IF ALKALI SPILLL THEN ER …
502….ETHANOL IS GOOO D FOR ANTIFREEZ AND MATHANAL
503…HIT MOST COMON COMPLICATION IS THROMBOSIS JUST LIKE ANTI PHOPHO LIPID ANTIBODY AND IN LUPUS ANTI ANTI COAGULANT…
504…AST IS RANSON CRITARIA NOT ALT AND AYLASE IS NOT A CRITARIA…
505..EXOPHTHALAMOS.ABSENT RED REFLEX AND LEUKOCORIA IS DEFINARELY RETINO BLASTOMAA.
506..NSAID AND STEROID IS TRETAMENT FOR J H REACTION WHICH CAUSE HEACHE FEVER N V MAYLGIA…IN SYPHILIS TRETMNET
507..BEC VIGINOSIS I S MOST COOMON VIGINAL DISCHARGE AMINE OR WHIP TEST POSITIVE .CLUE CELL IS A CLUE PH IS MORE THAN 7.4
508…CAT SCRACH BITE NEED THE AUGUMENTEN..LIKE ALL OTHER BITES DOG AND HUMAN
509…PALPABLE THROMBOTIC CORD IN A UNILAT SWOLLEN RED AND WARM LEG IS DVT START HEPARIN…ESP IF IT IS PROXIMAL DOPLLER US AND D .DIMER IS DIAG
510..LGSIL HGSIL BOTH NEED COLPOSCOPY
511..CONIZATION SHOULD B INDICATED IN ANY OF THESE….TRANSFORAMTION ZON E IS NON VISULIZED…PAPSMERA IS WORSE THAN BIOPSY
..PAPSMEAR SHOWING ADENO CA…BIOPSY SHOWING MICRO INVASION….POSITIVE ENDO CERVICAL DISCHARGE..
512,,,,PAP SMEAR IS UN SATISFACTORY IF ENDOCERVICAL CELLL S R OT SEEN
513…ARTERIAL CLOTS R POSITIV EIN ANTIPHOSPHLIPID ANTIBODY.HIT,LUPUS ANTICOAG ANDANTICARDIOLIPINS NATOBODIES,HOMOCYSTONURIA.FACTOR 2 ABNORMALITY

514….U DON’T HAV ETO MONITOR DIG LEVEL WHEN PT IS TRETAED FOR A FIB…AMIDIARON VERAPAMIL AND QUINIDINE INC THE LEVEL…
516…..IN KIDS THERAPETIC DOSE OF DIG IS 4 NGM NOT 2 LIKE ADULT AND VOMITTING IS A CLUE TO TOXICITY AND IN ADULT CONFUSION AND PALE DISCOLURATION IS EARLY SIGN
517…HRT IS GOOOD TO PROTECT FROM HEART DISEASE WHICH IS NUMB I KILLER IN US IN BOTH SEXES..
518… HRT IS GOOOD AGAIST HEART DIEASES AND OSTEO AND MENOPUASAL SIGN SYMPTOM ..NO PROVEN STUDY IS YET TO PROVE THAT IT CAUSE BREAST CA
519..U MUST TELL THE PT THE RISK AND BENEFIT OF CPR WHEN U R TALKING ABOUT DNR..
520..PT CAN ALWAYS CHANGE HER LIVING WILL EVEN VERBALLY IN A SEC…
521…IF SON IS 27 AND DONATED ORGAN 10 YRS AGO AND PARENTS DDONT KNOW U MUST TALK TO PARENT AS A PHYSICIAN…THAT THIS IS WHAT UR SON WANTED…
522…IF U INTUBATE THE PT AND DNR IS PROVED EXTUBATE THE PT IMIDIATELY
523….IF U INTUBATE D PT AND SON CALLLED FROM NY THAT MY FATHER IS DNR AND I HAV E HIS LIVING WILL WHY U INTUBATED HIM…ASK SOCIAL WORKER TO CHECK THE VALIDITY OF THE LIVING WILLL AND IF OTS LEGAL THEN EXTUABTE THE PT….
524…IF UT IS NOT REMOVED AND INTACT THEN ALWAYS GIVE ESTROGEN AND PROG EVERY DAY TO DEC THE CHANCE OF ENDOMETRIAL CA…IF PT HAS NO UTERUS THEN ONLY ESTROGEN
525…IF PT IS IN REPRODUCTIVE AGE AND HAS ENDOMETRAIL CA THINK OF POLYCYSTIC OVARIAN SYNDROME BCZ ANOVUALTION CAUSE LACK OF PROGESTRON AND THIS UNAPPOSE D EFFECTOF ESTROGEN LEADS TO ENDOMETRIAL HYPERPLASIA…
526…SIADH..NEVER GIVE 3% SALINE UNLESS PT IS NOT SYMPTOMATIC FROM LOW SODIUM OTHER WISE JUST WATER RESTRICTIONIS BEST FOR CHRONIC CONDITION GIVE DEMECLOCYCLINE…
527…BRAIN DEATH ….MUST MAKE SURE PT IS NOT HUPOTHERMIC TEMPP SHOUL DB ABOVE 32 ATLEAST
528..AT 30TEMP PT CAN HAVE V FIB…
529…ANAPHYLACTIC RESPONSE IS DUE TO IGA DEFICIENCY AS IN CASE OF IVIG IF U GIVE AND PT HAS ANAPHYLAXIS THIS IS THE IGA DEF..
530…PHYCHOTIC DEP AND WHEN SSRIS OR TRICYCLIC IS NOT INDICATED THEN ECT IS BEST…TRANSIT MEMORY LOSS IS MAJOR SIDE EFFECT
531…WET MOUNT FOR TRICHOMOSIS AND BV…FLAGYL IS GOOD IF PREG CLINDA CREAM AND ZITHROMAX IS GOOOD..
532…C DIFFF IS BEST TREATED WITH FLAGYL AND VANC O ONLY IF ITS NOT EFFECTIVE
533..STOP… SALICYLATE 10 DYAS B4 SURGERY AND OCP I MONTH BEFORE..STOP COUMADIN 48 H B4 AND HEPARIN 4 H B4…
534…IF PT IS GOING FOR SURGERY AND INR IS MORE THAN 4 THEN GIVE FFP….IN NON EMERGENT SITUATION GIVE VITA K..
535…IN TORSEDESPOINTS…. GIVE MG SO2 IST IF NOT EFFECTIVE THEN GIV EISOPROTERENOL DRIP…OR PACING…BIT NOT QUINDINE OR PROCAINAMIDE THEY PROLONG QT FURTHER
536…C PERTIDE IS INC IN INSULOMA BUT DEC IN FALSE HYPERGLYCEMIA SEC TO SELF ADMISTRATION OF INSULIN…TO CREAT HYPOGLYCEMIA..
537…CUSHING….IST DO FREE CORTISOL IN SERUM IF IT IS MOR ETHAN 100 CUSHING IS POSITIVE
538…CLOZAPINE CAUSE AGRANULOCYTOSIS SO CHECK CBC OFTEN
539…TICLODIPINE CAUSE THE THROMBOCYTOPINIA…SOGIVE PLAVIX IFPLATELETS R LOW..
540…GIVE INF V AND AMANTADINE ,,,FOR MAXIMUM EFFICACY
AMNTADINE IS ONLY EFFECTIVE AGAIST HEMO INF A NOT B AS VAC…
541…HEINZ BODIES IN G6PDEFICIENCY …DON’T GIVE BACTRIM,DAPSON,PRIMAQUIN,THIAZIDES,SULFA
542…IF PT HAS PCP AND SULF AALLERGY THEN GIVE ATOVOQUIN,,
543..IF PTT IS PROLONG ANDFFP IS NOT WORKING THEN DO MIXING STUIES
544..FACTOR 13 DEFICIENCY BLEEDING IS SEVER BUT STILL NORMAL COAGS..
545..FACTOR 12 DEFICICEY NO BLEEDING SO PT CAN GO FOR SURGERY SAFELY
546..DIRETIC CAUSE CONTRACTIONALKALOSIS..547..CAP…STREP PNUMO…GIVE ERYTHRO ,ZITHRO,CLARITHRO ANY MACROLIDE WILL DO IT..RESISITANT CASES GIVE LEVAQUINOR CEFTRIOXNE
547..RAPI DSTREP POSITIVETY GIVE PCNV…IFNOT WORKING GIVE BRAOD SPECTRUM.
548…HETROPHILE IS NOT POSITIVE UNTIL 2-3 WK AFTER IM STARTS
549…HEPZES V 8 CAUSE KAPOSI…FOR FLAT WARTS GIVE 5 FU AND INDUATRED WARTS DO CRYO WITH LIQ HYDROGEN
550…HEP A IS THE MOST COMMON VAC THEY NEED WHEN GOING ABROAD..
551..CMV RETINITIS…NEED GANCICOLOVIR…CHECK CBC IF RESISTANT THEN FOSCARNET
552..PSA AND DRE IS SCREENING A T 50 YRS OLD MAN FOR PROSTATE CA
553…IF PSA IS MORE THAN 4 THEN TRANSRECTAL BIOPSY..
554..IF CA OF PROSTATE IS IN BONE ACID PO4 WILL RISE..GIVE LUPROLIDE AND FLUTAMIDE..
555..INC ALPHA FETO PROTEIN IS IN C IN EMBROYNAL AS WELL AS HCG ALSO INC..
556..DITAL RADILA FX IN KIDS WHO FALL ON OUTSTRECHED HAND IS A MED EMERGENCY AND NEED ORIF ASAP…557..SILVER FORK DEFORMITY COLLLES FX…NEED CLOSE REDUCTION AND LONG ARM CAST…MEDICAN N IS EFFECTED..DITAL RADIAL FX IT IS…
558.AI IS WITH MARFAN AND AORTIC DISECTION…CT WITH IV CONTRAST IS BEST…
559…STEEPLE SIGN IS IN CROUP..PIV..COOL MIST O2 AN D SEVER CASES NEED RACEMIC EPI AND STEROID…
560…HYDROXYUREA INC HB F SO ITS USEFUL IN THE SICKLING..
561…IF LITHIUM CAUSE HYPOTHYROIDISM DON’T DC MED JUST ADD SYNTHYROID WHEN U HAV ETO GIVE STERIOID AND SUNTHYROID ALWAYS GIVE IST CORTISOL THEN SYNTHYROID..JUST LIKE U GIV ETHIAMINE IST THEN GLUCOSE…
562..HB .H 3 ALPH A GENE R DELETED AND IN HB BART AL 4 R MISISNG…
563…MELIG HYPERTHERMIA GIVE DENTROLINE SIDE EFFECT IS MUSCLE WKNESS. IT IS AUTOSOMAL CONDITION AND NEED AVOIDANC EOF ALLL INHALATIONAL GASES AND SUCCINYCHOLINE..
564..NO SUCCINYCHOLINE IN THE SPINAL SHOCK PT AND IN BURN PT BCZ IT INC LIF ETHRETENING K ..
565…IF LOER GI IS NOT STOPED AND OT IS UNSTABLE PARTAIL COLECTOMY IS GOOOD..
566..IF P IS BLEEDING NUCLEAR SCAN WITH TAG RBC
567..INTUABTE THE PT IF PCO2 IS MOR ETHAN 50 AND PO2 IS LESS THAN 50..
568…IF PROLATIN INC ON FINDING THE CAUSE OF SEC AMNEREA DOTHEMRI TO C THE TUMOR…THENGIVE BROMO IST TO DEC THE SIZE JUST LIKE WE GIVE LEPRON TO HSRINK THE FIBROID ..
569…URGE INCOONTINCE I SMOST COOMON IN OL DAGE AND IT DUE TO DETRUSOR HYPERREFLEXIA..ANTICHOLINERGIC IS BEST
570..SEXUAL ABUSE AND AFTER MULTIPLE CSECTION AND VIGINAL SURGERIES STERSS INCONTINCE ,,HRT IS GOOD IN THAT,,,
571…CAMPING DIRREHEA IS GIARDISIS WATERY DIRREA AND GIVE FLAGYL LOPERAMIDE…572…CT WITHOUT CONTRAS T IF HEAD TRUMA TO R/O IN BLEED
572….ANY STROKE DO HEAD CT TO R/O INB SO U U CAN START TPA IF PT CAME LESS THAN 3 H AGO WINDOW PD FOR AMI IS WITHIN 3 H…BEST IS WHEN ITS LESS THAN 60 MINUTES..
573…KAWASAKI GIV EIVIG AND ASP AND CALL CARDIO TO DO AN ECHO TO C CA ANURISM
574…RASH IN IM IS DUE TO AMPICILLLIN IT WILL GO AWAY DON’T HAV ETO DO ANY THING…
575..MRM WHEN SKIN AND NIPPLE INVOLVED OTHER WISE ANY MELIG MASS NEED MASTECTOMY ANDIRRADIAATION
578..IF PT HAS MELIG OR BED RIDDEN ANTICOAG FOR LIFE OTHER WISE AFTER DVT JUST FOR 6 M..
579…HYDRATION AGGRESSIVE ONE AND FRUSAMIDE AND MANITOL IS BEST TREATMENT IN RHABDO…
580…BENIGN CYSTIC TERATOMAA IS MOS COMMON BENIGN TUMOR IN OVARY
581…24 H METANEPHRINE AND CATHACHOLAMINES AND CT ..IN CASES OF REFRACTORY NEW HTN AND HYPERGLYCEMIA SWEETING HEADACHE…
582…CORPUS LUTAL CYST IS MOST COMON WITH NEGATIVE PREG AND ABDOMINAL PAIN AND MASS IN ADNEXA…
583..IF BHCG IS LESS THAN 1500 TVUS FOR ECTOPIC AN DIF IT IS MORE THAN 6100 TRANS ABDOMINAL US IS GOOD
584..IF ECTOPIC IS LESS TAN 4CM AND PT IS STABLE WITH LESS PAINAND VITRALS R OKAY THEN GIVE METHOTREXATE…
585..CHECK BASAL MAMO AT 35-40 YRS OF AGE AND BET 40 –50 EVERY 2 YR MAMO AND AFTER 50 EVERY YR
586…IF PT HAD CA IN BREATS THEN CLINICAL EXAM IS 4-6 MONTH AND BREAST SELF EXAM EVERY ONTH AND MAMO EVERY YR
587…IF PT IS HYPOGYLEMIC D 50 IS INDICATE DAND IF CANT DRINK GLUCAGON IS EFEFCTIVE..
588…NO FLORINATED TOPICAL STREOID IN ROSEEA..IT PPT IT METRO GEL IS BEST…TETRA IF REFRACTORY
589…VILLOU SADENMOA REQ RESETION WITH COLONOCSCOPY OR LASER OR OPEN SAME IS FOR OTHER PREMELIGNAT SESSILE LESION
590…LEVEL OF DEPTH OF INVATION IS THE PROGNOSTIC IN MM…
591..IF BLEEDS OR CHANGE COLOUR SOR ITCH PUNCH BIOPSY…BIOPSY FROM CORNER IS A LOT BETTER THAN CENTER
ACTINIC KERATOSIS …NEED CRYO ITS PREMELIG TOOO CASE SQ CELL CA
592…IND ING H ORIGINATE AT DEEP ING RING AND IT IS LAT TO IEPIGASTRIC A
593….BHCG IST THEN PROGESTRON CHALLENGE IF SEC AMONRRHEA…IFIT IS AFTER DAND C THEN ASHERMAN SYNBNDROM EIS THE CAUSE..IF PROGESTRON CAUSE BLEEDING IT MEAN ENOUGH ESTROGEN IS POSITIVE IF NO BLEEDING THEN GIV E HUMAN G HCG….
594….REPEATED NEEDLE ASP AND ABX FOR 6 WKS IS GRETA IN SEPTIC ARTHRITIS NO INTRA ARTICULAR STEROID …
595…JUST IN CASE OF DONOCOCAL FEPTIC ARTHRITIS DON’T DO THE ASP BCZ WBC IS NOT LESS TAN 50 USUALLLY AND ANTIB IS ALL THAT PT NEED CEFTRIOSONE IV ..
596…PHYSIOLOGICAL JAUDNACE DIRECT BILI IS LESS THAN 2
597…IF URINARY INF OR OBSTRUCTION DO THE UA AND RENAL ULTARSOUND..
598..FLUID DEFICIT SHOULD B REPLACED HALF IN IST 24H AND REST IN NEXT 24 AND 48 H..
599…DON’T TOUCH THE HEMARAGIC BLISTER BUT PEEL THE WATERY ONE…PCN AND TETANUS REQ IN FROST BITE ..RAPID REWARMING WITH WATER IS BEST
600..TGV..IS MOST CC OF EARLY CYANOSIS AND INC VASCULAR ITY ON CXR AND RVH AND RT VENT HEAV E POSITIVE…601..THE MOST CC OF CYANOSIS IN LATER PF IS TOF…
602…C JUJINI …INC PD IS MORETHAN 16 H AND TRET WITH ERYTHRO…
603…SQUATING IN C IN PVR AND HELP IN THE HYPOXIC SPELLS IN PT WITH TOF…
604…. NO DIG OR DIURETIC IN HCM.,, BB AND CA CHENAL BLOCKERS R GOOOD NO NITRATE EITHER..
605…2 H POST PONRAIL TEST IN THE POST PRTUM VISIT TO MAKE SUR E PT IS NOT DIABETIC AFTER PREG AND GLUCOLA 50 G IS AT 28 WKS AND IF IT GIVES MORETAHN 140 GLUCOSE TEHN 3 H GGT..
606…TL IS DEC IN PREG M AND TV IS INC..
607..GULLAN BEERY ASCENDING PARALYSIS AFTER H INF VACCINATION OR ECOLI INF … GIVE IVIG OR PLASMAPHRESIS AND VENTILATION IS TO WATCH IN ACUTE CONDITION… AND RECOVERY IS DECENDING ORDER …
608..NC S AND DTR…NO DTR AND SLOW STUDIES IN GBSYNDROME
609… PT WITH CARPEL NEED SPLINT AND NSAID AND SURGERY ONLY REFRACTORY..NCS IST…
610..OLIGOCONAL BAND OF Igg IS DIAG OF MS IN CSF..IV METHYLPREDNISOLONE IN ACUTE CASES MRI IS TO F/U
611..CHEMIAL CONJUCTIVITIS IS USUALLY DUE TO SILVER NITARTES DROPS..GIVE ERYTHRO ORALLY..
SAME FOR CHALMIDIAL CONUNTCIVITIS..
613.. JUST MASSAGE IS ENOUGH IF DACTROCSTSTIS IS MILD…
614..NO DIURETIC AND ACE IN PREG..
615..PHOTOTHERAPY FOR SEASONAL DEP..
SSRI IS BEST FOR BULIMIA WITH COG THERAPY
GROUP THERAPY IS BEST FPOR ALCOHOLICS AND GRUG ADDICTS AND SEXUAL ABUSE
616.T4 LEVEL IS GOOD FOR C SECTION AFTER SPINA ANESTHSIA..
617…COCAIN OD ….BEHAVIOR MODIFICATION THERAPY…
618…PTU IS SAFE IN PREG AND DO THE SUBTOTAL THYROIDECTOMY IF HAV ETO BUT NO RAI…IN PREG..
619..IST BLOOOD CULTURE AND THEN DO ABX THERAPY LP CAN WAIT BUT ABX CANT V IMP CHAINOF ACTIONALWAYS IN EXAM
620…DO LPIF MOM IS SAYING NOIF UHAVE TO SAFE THE LIFE
621..SPINAL REFLEXES IS STILL POSITIVE AFTER BREAIN DEATH..
622…GASTRODUDINAL A WILL CAUSE BLEEDING IN PERF PEOTIC ULCER
623..FIBEROADENOMA FNA..FIBROCYSTIC CALL PT AFTER MENSES
624…INC PROTEIN BUT NOT IN LYPHOCYTES TUPICAL OF GBS..
625..CROSS TABLE LAT XRAY IS IST FOR AAA…
IF PT HAS CAD AND AAA FIX HEART IST BCZ AMIIS MOST COMMON CAUSE OF DEATH IN ALL VASCULAR DIEASE
627….MASTITIS,,,CONTINUE BREASTFEEDING AND GIVE NAFCILLIN…
628,,,DUURESIS AND ALKALIN ETHE URINE IN SALICYLATE POISIONING…
629..BLOODY DISCHARGE FROM NIPPLE IS INTRADUCTAL PAPILLOMAA.
630..H/OFBREAST TRAUMAA FAT NECROSIS ITS PAINFUL AND WILL DISSOLVE SO WATCHFUL WAITINGIS ALLTHAT IS REQ
631..PHYNTIN SHOUL DB GIVEN SLOWLY BCZ OF SEVER HYPOTENTION….
632… OXYTOSIN CAUSE HYPOTENTION WHILE METHERGIN EIS CAUSING HTN
633..ALWAYS IST LIFE STYLE MODFICATION IN GERD AND OA,AND HTN..
634 IF BPIS HIGH LIKE 180/110 IST READING IS MAKING THE PT HYPERTENSIV ESO TERAT IT GIVE COLINIDINE IF PT IS ELDERLY OR ALCOHOLIC.
635…NO VIGINAL EXAM INPLACENTA PREVIA ULTRASOUND IS GOOOD TO DIAG AND NO THRAOT EXAM IN EPIGOTITIS IN WHICH HIGH FEVER DROOLING AND INSPIRATOR STRIDER INTUBATION IS REQ… LAT NECK XRAY..
636…AFTER AAA MOST COMON CAUSE OF GI BLEEDS IS MESENTRIC ISCHEMIA…IF LDL IS MORE THAN 180 AND 2 RISK FACTOR START ON MEDS AND DIET
638 GIVE ROLAXIFEN FOR OSTEPOROSIS..IF RISK OF ENDMET CA OR BREAST CA…
639…IF BREAST CA AND SUPRACLAVICULAR NONEDS R POSITIVE ITS CLASS 4 ALREADY..IF LOBULAR CA 50% ITS BILATERAL…IF NODES POSITIVE EVERY ONE WILL GET ADJUVANT THERAPY


640….ITP FIRST TREATMENT IS STEROID IF FAIL SPENECTOMY IF BOTH FAIL CHEMO IN CASE OF BLEEDING IVIG. THIS WILL BLOCK THE FC RECEPTORS OF PHAGOCYTOS CELLS AND USED FOR EMERGENCY BLEEDING ONLY.

641… DANEZOL WORK BY DECREASE THE NUMBER OF PHAGOCYTOUS CELL FC RECEPTORS.

642…. LOVENOX CAN BE SELF MINISTERED BY PATIENT AT HOME. START WARFRIN ON DAY ONE OR TWO OF LOVENOX. . CI OF LOVENOX PUD SYMPTOMATIC PE CURRENT ACTIVE BLEEDING FEMILIAL BLEEDING DISORDERS, KNOWN DEFICIENCY OF AT3, PROTEIN C,PROTIEN S, NONCOMPLIANCE PREGNANCY, MORE THAN TWO EPISODES OF DVT OR PE

643.. RECURRENT DVT OR PROSTHETIC HEART VALVE- INR SHOULD BE 3.0-2.5. NO WARFARIN IN PREGNANCY DUE TO NASAL HYPOPLASIA AND CNS ABNORMALITIES- FLAGYL AND SULFONOMIDE INCREASE WARFERANE LEVEL BARBITURATES, CARBOMESAPYNE, RIFAMPIN DECREASE WARFERANE LEVEL. OCP SUCRALPHATE FRISEOFULVIN AND VIT. K, SETEROIDS AND SPIRONOLACTONE

645…LOVENOX IS GOOD BECAUSE NO PTT CHECK MORE PREDICTABLE RESPONSE BETTER SAFTY PROFILE EASY ADMINISTRATION LESS TIME IN HOSPITAL. PROTEIN S DEFFICIENCY IS MORE COMMON THAN AT 3 AND PROTEIN C . AT3 DEFFICIENCY OCCUR IN NEPHROTIC SYNDROME AND ARE RENAL VEIN THROMBOSIS AND OTHER DVT.

646..MIXING STUDIES WILL NOT HELP TO DECREASE THE PTT IN CASE OF LUPUS ANTICOAGULANT, RECURRENT ABORTION AND THROMBOSIS RISK NEED HEPRIN.

647.. CRYOPRECIPITATE CONTAIN FACTOR 5,8, 13 VWF AND FRIBRINOGEN

648.. FFP CONTAIN ALL FACTORS EXCEPT 5 AND 8.

649.. THE MOST C.C OF DELAY POST OP BLEEDING IS FATCTOR XIII DEFICIENCY ALL CLOTTING TESTS ARE NORMAL IN THIS CASE AND UREASE CLOT SOLUBILITY TEST IS POSITIVE. FFP IS THE BEST TREATMENT.

650.. VON WILLEBRAND DISEASE PROLONGED BLEEDING TIME NORMAL PTPTT. BECAUSE VWF IS IMPORTANT IN PLATELET AGGREGATION AND FUNCTION AS CARRIER PROTEIN FOR FACTRO VIII . IF MINOR BLEEDING GIVE DDAVP AND FOR FACTOR 8 CONCENTRATE OR CRYO FOR SEVERE BLEEDING.

651..GVHD- SINE SYMPTOMS RASH DIERREA LIVER PATHOLOGY CMV INFECTION NEED IRRADIATED RBC.

652.. CML- LOW LAP, VITAMIN B12 INCREAE WBC MORE THAN 100000 GRANULOCYTED FOUND IN ALL STAGES OF MATURATION PLATELET MORE THAN 400000 IF SMALL SPLENE GOOD PROGNOSIS IF PATIENT MORE THAN 45 AND PLATELETS LESS THAN 70 THAN POOR PROGNOSIS. ALLOBMT IS BEST IF GIVBEN EARLY WITHIN 12 MONTHS IN PATIENT LESS THAN 55 WHO HAVE HLA MATCH SURVIVAL IS 63 % FOR 3 YEARS. HYDROXYUREA DRUG OF CHOICE FOR HIGH BLASCOM AND LEUKOSTASIS SAFE IN THROMBOCYTOPENIA CONTINUED MAINTANENCE TREATMENT IS IMPORTANT. BUSULFIN IS IMPORTANT AS WELL AS ALPHA INTERFERON WHICH SUPPRESS THE PHILADELPHIA CHROMOSOME.

653..MM = MORE THAN 10% PLASMA CELL FOUND IN THE BONE MARROW IF LESS THAN 10 THAN IT IS MGUS M PROTEIN IN MM IS LESS THAN 3 GRAM IN MGUS AND MORE THAN 3 IN MM . NARMOCROMIC CORMOCYTIC ANEMIA LYTIC LESION FRACTURES OSTEOPOROSIS

654… HAIRY CELL LEUKEMIA= ESSENTIALLY A B CELL TYPE, FRIED EGG APPERANCE WITH CYTOPLASMIC PROJECTIONS SEEN ON THE BLOOD SMEARS TRAP + DRY TAP ON BONE MARROW ASPIRAION NEUTROPENIA – CAUSE INFECTION LIKE TB OTHER UNUSUAL INFECTION LIKE TUXO LEGIONELLA AND NOCARDIA. 2 CDA IS THE TREATMENT OF CHOICE COMPLETE REMISIION IN 85 –88% OF THE PATIENT AFTER A SINGLE CONTINUOUS 7 DAY IV INFUSION.

655.. HUS – SIMILAR TO TTP EXCEPT WO FEVER OR CNS INVOLVEMENT. MANAGEMENT IN ADULT IS SAME AS FOR TTP. DIERRIA SECONDARY TO ECOLI 0157H7.

656..SICKLERS (TRAIT) ARE MORE PRON TO HAVE PAINLESS HEMATURIA AND PYELO IN PREGNANCY NO ANEMIA NO INFECTION NO INCREASE MORTALITY THOSE WITH TRAIT ALSO HAVE PROBLEM WITH CONCENTRAIONO OF URINE NO PAIN CRISIS. IF SICKLER HAVE CV COMPLICATIONS GIVE EXCHANGE TRANSFUSION ON REGULAR BASIS. INFECTION IS NUMBER ONE CAUSE OF DEATH IN SICKLER’S DISEASE.

657.. ACUTE CHEST SYNDROME FEVER , CHEST PAIN TACHY INREASE WBS AND PULMORY INTARACTS AND INFECTION IF YOUNG.
658..CLL NUMBER MALIGNANCY IN US MORE THAN 60 YEAR OLD B LYMPHOCYTES FEVER IS INDICATION OF INFECTION AND NOT THE LEUKEMIA DECREASE GAMMA GLOBULINS INFECTION THRUMBOCYTOPEINA INCREASE INCIDENCE OF SOLID TUMOR OF LUNG AND SKIN, AML A POOR PROGNOSIS IS LYMP[HOCYTE DOUBLING TIME LESS THAN ONE YEAR. RAI CLASSIFICATION STAGE 0 = INCRESE LYMPHOCYTES ONLY STAGE 1= INCREASE LYMPHO + LYMPHO DENOPATY STAGE 2= INCREASELYMPHO SPLENOMEGALY STAGE 3 = LYMOCYTOSIS ANEMIA 4 LYMPHOCYTOSIS AND THRUMBO CYTOPENIA TREATMENT IS FOR STAGE 3 AND 4 ONLY. CHLORAMBUCIL + PREDNISONE FOR PATIENT WHO RELAPSE FLUDUABINE IS GOOD. MEDIAN SURVIVAL 5 YEAR AS LONG AS HIS IGG IS LESS THAN 0.3 G / DL GIVE GAMMA GLOBULIN THERAPY EVEN HE IS NOT HAVING INFECTION

659… SHCHILLING TEST TO FIND THE CAUSE OF B12 DEFICIENCY PERNICIOUS ANEMIA IS NUMBER ONE CAUSE OF VIT B12 DEFECIANCY HYPO THYROYDISM INCREASE RISK OF GASTRIC CANCE ATAXIC GAT SECONDARY TO DEGENERATAION OF POSTERIOR COLUMN IMPAIRED VIBRATION AND SENSE DECREASED REFLEXES DEMENSIA SEIZURES. INCREAE SERUM MMA INCREASE SERUM GRASTRIN LEVEL SERUM HOMOCYSTINE INCREASE

660… FE DEFICINCY ANEMIA MCV DECREAED RBC DECREAED RDW MORE THAN 16 TIBC INCREASE IRON DECREASE FERRITIN DECREASE. THALASSEMIA MINOR RDW IS NORMAL

661.. B. THAL.MAJOR= FETAL HGB INCREASE MORE THAN 50 % IT IS 2 –3 % IN THALASSEMIA MINOR MAJOR NEED BMT TO SURVIVE. ELECTROPHERIS IS NORMAL IN ALPHA TALASSEMIA. B. THALASSEMIA MIRON IS MORE COMMON IN ADULTS. PRESENT WITH MICROCYTIC-HYTPCHRONICANEMIA

662.. IF PTT DOES NOT CORRECT WITH MIXING STUDY SO PATIENT CAN HAVE FACTRO 8 INHIBITOR S , LUPUS ANTICOAG ANTICARDIOLIPIN ANTIBODY. HEMOPHILIA A NEED CRYO

663…DRUG INDUCE SLE HAS NO RENAL OR CNS PROBLEM IT IS MOST COMMON WITH HYDRYLAZINE AND PROCAINAMID AND TREATED BY DISCONTINUING THE MEDICATION ANTIHISTONES, ANTIBODIES ARE DIAGNOSTIC IF NEED TREATMENT STEROID IS GOOD.

664…FOR ACUTE LUPUS NEPHRITIS GIVE CYCLOPHOSPHAMIDE

665… HYDROXIUREA NA D ALPHA INTERFERON IS GOOD IN BLAST CRISIS LEUKOCYTOSIS ESSINTIAL THROMOCYTOSIS

666… PHILADELPHIA CHROMOSOME CARRIERS ARE HAVING GOOD PROGNOSIS IN CML AND BAD IN AML

667…AMANTADINE IS GIVEN IN FIRST 48 HRS AFTER H INFLUENZA OUTBREAK WITH VACCINE IT PROTECTS 95 % FLU VACCINE MAY BE GIVEN ALONG WITH PNEUMOVAX RELENZA AND TAMIFLU ARE NEURA MINIDASE INHIBITORS IT IS GOOD TO GIVE IF PATIENT IS HAVING SIGN SYMPTOMS LESS THAN 2 DAYS THEY ARE EFFECTIVE AGAINST A AND B TIFE THEY REDUCE THE SPREAD OF VIRUS RELENZA IN INHALOR AND TAMIFLU IS CAPSULE.

668…RABIES SERUM AND CSF MUST BE TESTED FOR RABIES AD AND NAGRI BODIES SEEN ON HIPPOCAMPAL BIOPSY SPECIMAN ARE DEFINITIVE HRIG+VACCINE ARE USEFUL IN GIVING TWO SEPARATE SIDES BUT ONLY IF GIVEN BEFORE BEGINNIG OF SYMPTOMS AFTER DOG AND CAT BITE IF STATUS IS UNKNOWN AND ANIMAL IS ON THE LOOS CONSULT PUBLIC HEALTH OFFICIALS IF ANIMAL IS RABID OR SUSPCECTED RABID GIVE VACCINE IMMEDIATELY IF ANIMAL IS HEALTHY AND AVAILABLE FOR 10 DAYS OBSERVATION DON’T START TREATMENT UNLESS ANIMAL DEVELOPS SIGN SYMPTOMS IF + THAN START HRIG +VACCINE ONLY RABID ANIMALS ARE NEED TO BE VACCINATED AGAINST LIKE FOXES ,BATS SKUNK OR RACOONS NOT FOR RODENT RABBIT SQUERELL CHIPMUNKS RATS MICE GUINIPIGS HAMSTERS. HRIG DOSE HALF OF IT SHOULD BE INJECTED DIRECTLY INTO THE WOUND AND THE REST IN THE GLUTIAL AREA. IN ADULT VACCINE SHOULD BE GIVEN ONLY ON DELTOID AREA ON DAYS 0,3,7,14,28

669… WHEN SHOULD BE MEDICATION STARTED IN HIV CD4 LESS THAN 500 VIRAL LOAD MORE THAN 5K TRIPLE THERAPY FOR 4 WEEKS AFTER NEEDLE STICK FROM HIV INDIVIDUAL DOUBLE COMBINATION LIKE AZT + 3TC IN PATIENT WITH LESS SEVERE DISESE
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#2
Some More Questions!!

REMEMBERED QUESTIONS OF STEP 3

FINISH BY 4 DAYS. 24 October 2009


* Remembered questions
#359793
pjk - 11/12/08 13:23

Remembered QUESTIONS I collected from this forum........if u have time, just go thru them..........u will do fine even without them if u r confident with concepts

good luck everyone......


Random:
baby is under 5 percentile for growth ,the mother stetes that the baby is well fed, the baby is on formula and breast milk,,,the next step is
1- reaasurance
2-continue breast feed and add more formula
other options were stop breast feeding and add more formula and some oter unrelated stuffs
Decreased growth in child Tx?

an adult pt with obstuctive sleep apnea ,,the q describes tonsillar adenopathy ,,the tx is
1-central acting stimulant
2-CPAP
3-tonsillectomy
Tonsillectomy indication!!
Obstructive sleep apnea.

a pt with emphysema if stops smoking witnin 5 yrs what is more likely?
1-fvc remains constant
2-fev1 dec
3-fev1 incre
and some more stuff,,,,,,,,,,,,,,,so what is the changes in parameters
Emphysema Tx. If stop smoking how what will be effect on the PFT.


1) 60yr male, ant MI, BP 205/125, LVF sign+,first action-
iv NTG/IV STK/IV TNK/ IV Atenolol

MDD pat. On imipramine develop Hypotension doc stop it and prescribed him SSRI. pat came back with sexual deficiency. What do you give him now???
citalopram
fluoxetine
paroxetine
Carbamazepine
Desipramine
Which SSRI has no sexual side effect?

Friedrich ataxia cause deficiency of which of the following vitamins?
1-A 2-D 3-K 4-E 5-B6 6-B12 (ans- vitamin E)
7-B1 8-B3

old pat. takes prednisone everyday. he has vertabrae fractur in L2. Next step
1-Vit D +Ca
2-stop prednisone
3-do nothing
Vertebral fracture Tx in patient taking Prednisone?
Glucocorticoid causes hypocalcaemia by three mechanisms.
1-decrease intestinal absorption of Ca.
2- Increase Ca excretion in the urine.
3- Accelerate bone resorption.
Tx. Calcium 3 times a day and Calcitriol Vitamin D Plus add alendronate if the risk of osteoporosis is very high. What if Alendronate is contraindicated? Then give Calcitonin.
Remember alendronate doesn’t work without Ca and vitamin D.

man was lost in the dessert after 3 days was found with malaise and confusion.. he wife said he used to take prednisone every day. wht is ns
1-Fluid
2-ns
3-measure Aldosteron/renin
4-iv prednisone
We will give fluid bc pt has hypernatremia because of dehydration. Giving steroid will affect his ACTH axis with Cortisol but it will have no effect on the mineralocorticoid axis.

whta is the treatment for a Pt with Asthma & PSVT?
1-Adenosine
2-beta blocker
3-Verapamil
4-alpha blocker
PSVTachycardia Mx. Rate and rhythim control with either beta blocker or Calcium channel blocker. Here patient is also having Asthma so beta blocker are contraindicated so use CCB.

Pt with depression and starts hearing voices for ONE week ->
1-MDD,
2-schizoaffective,
3-schizophrenia,
4-bipolar
Read the definition of all these entities..
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1) Pagets disease
2) Fragile syndrome – CAG repeat, MR, macroorchidism, big ears
3) Abnormal pap smear
4) Mild acne treatment – aboid oil based ointments
5) Child abuse
6) Vitamin A toxicity – pseudo turmor cerebri
7) Hemophilia a – BT reaction (hypothermia, rapid transfusion without warmer)
8) Galactose 1 phosphatase uridyl transferase dif.
9) Mcardles disease (cramps after strenous exercise
10) DVT.
11) CT/renal contrast complications and allergies
12) Xray of fragmented rbsd
13) Scfe xray
14) q's on stress fracture of 1st metatarsal Rx, Mx of first metatarsal bone?
15) A pt hd a puncture wound to his lt little finger 3 days ago, came with swollen finger upto 1st metacarpophalangeal joint and flexion causing pain-cause-osteomylitis,septicarthritis,tenosnovitis,midpalmarinfection,
Puncture wound of little finger can cause?
16) 2 q's on tension pneumothorax,
17) confusion in elderly-Alzheimer’s, pseudo dementia, Pseudodementia? Symptom consistant with dementia but the cause in a pre existing psychiatric illness rather than a degenerative one
18) stress,urge,incontinance etiology,
19) midpelvic contraction mx,
20) herpis encephalitis, MCC of sporadic encephalitis suspect when patient present with acute fever with neurological abnormalities with personality changes or seizure and withOUT meningeal sign. Dx HSV-1 in the CSF by PCR. On MRI temporal lobe enhancement is typically seen. Tx. Acyclovir 10mg/kg IV q8 hour.
21) 23 yr old female with resistant htn with impaired renal function and briut-pathology in renal arteries, Fibrous dysplasia of renal artery
22) man had a RTA-blood at urethral meatus,high riding prostate,stable obs-next step in mx,
23) lady with elevated periosteum,stable obs- etiology,
24) asymptomatic oldman with elveted IgG 2000..whts the dx- i put as MGUS,
25) man with loss of vision + loss afferent optic reflex -site of lesion,
Optic lesion and their location and identification
26) man with loss of taste, hearing loss and loss of stepedial reflex,-etio
Facial nerve lesion and their function.
27) q's on benign postural vertigo, and meneiers disease,
28) 2 ecg's-one is a man with high K+ who is in VF,stbilised, next step- rx with ca gluconate,
29) next one is 27 yr old loss of consciousness, bradycardic ecg in 2 hb- mx- pacing,
30) Q's on HOCM,
31) man with extensive mets in liver and 1 in pancreas came with itching , bili is >15, whts the
32) next step in mx- i put as stent??
33) Aymptomatic lady came to request to get investigate , as she has a strog family hx of thyroid ca in family, which Ix u do- ?? Thyroid cancer screening Asymptomatic woman with positive family history.

34) Pregnant lady with hyperthyroidism mx? PTH if not controlled with 2nd trimester surgery
35) q's on epidural hematoma,
36) 2 q's on temporal arteritis, >50 year age, give high dose prednisone then bx.
37) q's on histoplasmosis,
38) ulnar neuropathy, compartment synd,
39) adenocarcinnoma ( MCC of cancer in nonsmoker, woman , < 45 yr ) of lung- predisposing factor, what are risk factor for adenocarcinoma?
40) esophageal ca, risk factor for esophageal ca , Mx of this?
41) diverticuosis-abscess- mx, antibiotic plus drainage?
42) man wt severe abdo pain,septic,-ct scan of abdo- pancreas distended with grey matter,etio- i put pancreas necrosis,
43) femoral hernia, surgical treatment.
44) man sht in thigh, a femoral aneurysm developed, loss of puses distally and pale limb next step in mx,
45) man stabbed with butcher knife in left flank, 3cm deep, slight bleeding next step in mx,
46) q's on PNH, Vonwillibrands, Heamophila a,
47) herpetic whitlow,
48) child with a wart on finger-etiology,
49) Chlamydia infection rx,
50) atpical pneumonia rx,
51) heamochromatosis type of cardiomyopathy,
52) pilonidal sinus rx,
53) Loads of inheritance and On female incontinance,
54) MS-MRI pics and description-dx,
55) PNH,9;22 translocation ? CML,
56) post ercp rise of temps? cause- cholangitis,
57) tension pneumothorax,
58) post splenctomy wht mx??sickle cl aneamia kid..which vaccine-an same for both,
59) M.avium intracelluare.prophylactic drug,
60) boy came with a bee sting and treated with adrenaline..wht wud u do to prevent future such episodes..i didnt ahd a cue for this as the options were-dont let him play outside,carry adrenaline, prophylactic antihistamines,and use of insect repellants, confine to indoors..i choose insect repellants....i dono..,
61) pt on frusemide and digoxin-wht are the serum K+ and Hco3- levels in body,
62) which anti hptn ive causes peripheral oedema,
63) erythema toxicum,
64) praderwilli synd,
65) whts the defect in klinefelters,
66) patau synd,
67) women with 1 amenorrhea and weak femoral pulses wht do u do next,
68) PDA u use indomethacin-mode of action,
69) abdo perforation,
70) 2 q's on normal pressure hydrocephalus,
71) CRAO,
72) 2 q's on temporal arteritis,
73) 3 q's on SIADH,
74) dermato myositis,polymyalgia,compartment synd,conduct disorder,cocaine abuse,amphetamine abuse,DT,addisons disease,
75) lady with hypercalcemia and lytic lesions in humerus dx?, how do u prevent transmission from m other to baby( mother already on anti- HIVDRUGS),
76) intususseption, pyloric atenosis,
77) rectal prolapse in an nicaraguan child?? cause,
78) pap smear- high grade sq dysplasia wht u do next??,
79) cerebral palsy 2 q's,
80) stain for pnemocystis,
81) 50 yr old man with severe back ache-stable obs- pic of xray-which i thought showed a calcified abdo aorta..so put it as AAA.
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q on hemothorax and pneumothorax (clues are percussion)
- question on an old lady in a nursing with so many findings and PE... only to know at the end that it is a q about delirium (UA with so many WBC and positiv efor leucocyte esterase).
- a 12 yo who cannot focus ... ADHD is the closest answer?
- child with mild mental retardation
- A baby with cephalhematoma, breastfed and jaundiced... total bil 20... next step.... phototherapy or exhange Transfusion? baby is doing well and born at fullterm.
- an 85 year with a little bit of confusion, cannot sleep, normal mini-mental... looks like normal aging to me.
-pregnant woman at 12 weeks gestation schiz previously well on haldoperidol... started having positive symptoms... choices... to start re start haldol?
- CT of Budd Chiari
- question on Multiple Myeloma... dx... presents with back pain, significan hypercalcemia in the lab...
- College girl with fever, cough.... looks like pneumonia... negative gram stain.... only possible answer is Mycoplasma...
- atrial fibrillation... treatment
- Tracing of WPW syndrome q is dx
- girl with primary amenorrhea without uterus, next thng to do..
- psoriasis
- of course the ever famous pulmonary embolism (cue VQ mismatch in lab)
- fat embolism (easy..after post fx)
- pt with neuropathy on iNH.... ans.. b6
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1) broca ahasia wit asst hemiparesis
2) INH with pyridozine def
3) alcohol wihdrawal and delirium
4) opyic neuriis wit d colour lookedwashd out..usmle world
5) tricuris trichuria ass with rectal prolapse
6) diagram of deceleration and interpretation
7) image of tuerous sclerosis and ass wit seizure
8) pic of malinant melanoma and Rx
9) Diag and Rx malinant melanoma
10) mastitis..diag
11) CAH in 20yrs old
12) PCOS in 36yr
13) Endmetriosis and dyspaurenia
14) Anovulation and infertility
15) OCP use as a cause of HT
16) OCP braest changes
17) PID def Diag
18) Ectopic def Diag
19) ovarian Ca secreting oestrogen
20) Benign Ovarian mass ass wtt pregnancy
21) HSV with enhephalitis bldy CSF
22) transviginal infection of HSV
23) Candidiasis as primarily vagintis
24) T.vaginalis Diag frouty discharge
25) Rx seborrheic dermatitis
26) squamous cell Ca Rx
27) Central retinal A thrombosis Diagram
28) Polymyositis features
29) DM type1 as with auto immune phenomenon
30) aldosteronism and hypertension
31) A fib and warfarin
32) sress incontinence pathophysiology
33) sigmiod colon and Rx
34) mild preeclampsia features
35) CO poisoning features
36) cluster headache acute Rx
37) shock pathophysiology 3 quests
38) sclerderma and raynaud Rx
39) scleroderma and HT Rx
40) Osteoathriti Rx
41) TOF and systolic mumur
42) aotic stenosis and systolic mumur crescendo-descrendo
43) COPD and influenza vaccine
44) COPD pathopysiolgy of PFT
45) CGD nitroblue tetrazolium
46) common variable immunodef in a 32yr old
47) intubation tube found in bronchiole wit poor lung perfusion wat do u do?
48) otitis external in a swimer prevention
49) Di George synd patholgy
50) rhematoid A Rx
51) Bronchiectasis X-rays findings
52) Hypocalcaemia in relaton to hypoalbuminaemia
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1. Make charts.
2. Know what can make diferent one disease from the other one that is very similar
3. Do not neglect the second drug of choice in treatment of disease...they do not ask the first choice....everybody know them...think what if the pt is allergic and special circumstances like children an preganacy.
4. Do not neglecte the lab test.
5....know the exudado vs. trasudate very well in ascitis and pleural effusion.
6. Rashes.....make a list of all the rashes in every single disease...how to differentiate them
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1. Elderly woman about 67 y/o old experience difficulty driving lately and seen “HALOS “-----your answer is?????
2. Elderly woman experience “curtains are falling down honey “—your answer is???
3. Young girl with a classical clinical picture of appendicitis-what is the mechanism =intestinal fecalith
4. Young woman with Raynolds (clinical picture ) treatment =Nifedipine
5. Young man clinical picture with calcinosis, Raynods =Scleroderma
6. Young man with low back pain-x-ray shows no abnormalities????
7. Elderly pt with cardiac problem, abdominal pain=ischemic colitis
8. Pathogenesis of Type I/II DM
9. Pathogenesis of GB
10. Pathogenesis of CHF/RHF/LHF
11. Viral Myocarditis
12. Pericarditis EKG Picture
13. Inferior Wall MI
14. Rx of SLE
15. Acantosis Nigrans (velvety hyperpigmented lesion around the neck and axilla ) with increased Lipid Panel -what test to order – Serum Glucose
16. Dg of CDI
17. Treatment of SIADH –water restriction, saline, demecoclyne or what???
18. Antifreeze poisoning which is glycol poisoning which cause increased anion gap –choose the correct labs….
19. Lead poisoning in a child
20. CSpherocytosis Rx
21. Dactylitis Rx
22. Hypothyroidism Dg
23. Atrovastatin Induce Myopathy
24. EPS Rx =Benztropine
25. To recognize Neuroleptic Malignant Syndrome and Rx =Dantrolene
26. DKA Rx
27. DKA Mechanism
28. Pagets Mechanism
29. Multiple MYeloma Mechanism
30. CO Poisoning
31. Benzodiazepines Overdose Rx =Flumazenil
32. To recognize Delirium
33. To recognize Delirium Tremens
34. Treatment of DT
35. ER forgot to give Thiamine for an alcoholic pt
36. Asking to give B6 in a pt taking INH
37. Bullas Formation Pemfigus –Mechanism
38. Abruption Placente due to Cocaine use
39. The Syllabus of Jovana is continuing =To recognize Placenta Previa
40. Rx of fetal distress –Lt Lateral position of the mother
41. Preventive medicine questions –Tetanus,DT,MMR, time frame-when you order colonoscopy, FOBT,Sigmoidoscopy
42. Vitamin D Deficiency
43. A-Fib due to Hyperthyroidism
44. Addison’s
45. Patient –Doctor Relationship
46. Toxoplasmosis
47. SCID
48. Lysch Nyhan
49. ODD
50. ADHD
51. OCD
52. Major Depressive Disorder
53. Schizoaffective Disorder
54. Schizophrenic Disorder
55. Conversion Disorder
56. Substance induced Mood Disorder
57. Bereavement
58. Acute Stress Disorder
59. Rx of Panic Disorder
60. Social Phobia
61. Bulimia Nervosa Metabolic Disturbances
62. Rx Colles Fracture
63. Carpal Tunnel Nerve Involvement
64. Deltoid Muscle Nerve Problem
65. Forceps Delivery –Facial Palsy
67. Croup Dg and Croup –name the causative agent
68. HEP A if you want to visit Mexico
69. Blood Smear for Plasmodium Vivax
70. Cranypharingeoma Dg
71. Bitemporal Hemianopia –Optic Chiasm Involvement
72. Your pt is on Glypizade, Metformin and is NOT compliant –Do you give him Acarbose, Insulin or Roglatizon or what??
73. Sheenan Syndrome-Hypothalamic Amenorrhea
74. Tarner Amenorrhea-Karyotype Analysis
75. Progesterone Challenge Test for Infertility
76. Cause of Syphilis,HSV ulcers, GC –more step 1 Questions
77. Axonal Injury
78. Rest Tremor Mechanism
79. Intention Tremor Mechanism
80. Benign Essential Tremor
81. Anovulation
82. Some Genetic Pedigree –AR
83. Myotonic Dystrophy Mod of Inheritance
84. Polymyositis
85. PMR
86. Giant Cell Arteritis Rx and most deadly complication (s )
87. Papillary Renal Necrosis due to Analgesic Abuse
88. ATN
89. Side effect of Amynoglycosides –Ototoxicity
90. B12 Deficiency
91. Syrongomyelia
92. Side Effect –Hypercalcemia
93. Ca Channel Blocker Induced Constipation
94. HIT
95. ITP
96. HUS –eating Hamburgers –O :157
97. Rash on the Forearm
98. Pyoderma Gangrenosum
99. Nephrotic Syndrome
100. Preclampsia /Eclampsia
101. MgSO4 Toxicity and Indication
102. KLarke –Betke Test Positive-Vasa Previa
103. ABO Incopatibility
104. Case of Cardiogenic Shock –Increased PCWP
105. Case of Hypovolemic Shock-Low CVP
106. Duodenal Atresia –Down Syndrome
107. Pyloric Stenosis Pathogenesis –Hypertrophy of smooth concentric muscle
108. Sclerosing Cholangitis in Pt with UC
109. Fistula in Chrohn Disease
110. Pannus Formation in RA
111. Knee Pain Pt Management
112. Low Back Pain Management
113. HTN Management
114. Woman Bleeding Management
115. Painless Jaundice ,Older Pt=Pancreatic Ca
116. Post Cholecystectomy Pancreatitis –Next do ERCP
117. Opthalmic Artery Occlusion
118. Aortic Stenosis Murmur –Audio
119. MVP with Mitral Regurgitation –dental procedure =Clindamycin +Gentamycin
120. VSD in a Child
121. PDA Mechanism
122. Down Syndrome Clinical Picture
123. Opoide Withdrawal Rx=Naloxone
124. PCP =Teen Agitated
125. Mycoplamsma Pneumonia Ear Complication –Bullous Myringitis
126. Abdominal Viscus Rupture Dg
127. SBO –Dilated Sentinel Loops
128. Cluster Headache Rx-100 % Oxygen
129. Wiskitt-Aldrich –MR TEXT Pnemeonic
130. Chedaki-Higashi
131. Chronic Granulomatous Disease
132. EBV Rash –Post Ampicillin Use
133. SMA Thrombosis _Portal Vein Thrombosis Rx =Tpa
134. Rx of DVT
135. Gold Standard of PE
136. Screening Test for PE
137. Clinical Picture of PE ,Fever, unilateral chest pain +Tachypnea ,New appearance of RBBB
138. Pleural Effusion –Cloudy Appearance, Exudates, Thoracocentesis Done –Next Step is???
139. Acute Attack of Gout Second Step in Management
140. Chronic Gout Rx
141. Felty Syndrome
142. Primary Hyperthyroidism
143. PTH and Ca Mechanism
144. Chronic Renal Failure –Increase Phosphorus, Increase PTH, Decrease Ca
145. Zolpidem Rx for Insomnia due to Sertraline (just a starter )
146. Court Order to proceed with a neurosurgery procedure in a kid
147. Osteoporosis Picture –DEXA Indication
148. Aseptic Necrosis of the Femur due to Steroid Use
149. Surperstious /superimpose use of Thyroxin
150. a canon wave seen in AF
151. CHF Pathophysiology –Afterload, Preload, Contractility –increased or decreased or what???
152. Heat Stroke
153. Tetracycline side effect –photosensitivity
154. Serosanguinous discharge from breast of 45 y/o old woman
155. Torsion of testis –woke the boy at night with excruciating pain
156. Woman as soon as she cough or sneeze she is embarrassed –stress incontinence
157. Overflow incontinence Pt
158. Uterine Proplapse in elderly pt
159. Asthma Pt in ER –Intubation needed
160. COPD –Oxygen to prolong her life
161. Flucortisone added Management in Astma beside the Albuterol
162. Albuterol – ( acting on B2 receptor )
163. Terbutaline use as tocolytic
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1. DX of achalasia (lady with narrowing of oesophagus)
2. Hypovolemic shock (CO LOW, PCWP LOW)
3.Normal pressure hydrocephalus (triad given but they asked the mechanism - imparied csf/ overproduction of csf)
4. dx of alzeimer demetia
5. what is reduced in restrictive ds (FEV/FVC, TLC, ERV, IRV)
6. Q desribed by drjiggy same came in my exam on dementia pt whose husband is not willing to keep her in the nursing home and wife doing sexual advances Mx????
7. treatment of human papilloma virus
8. girl of 5 yrs talking at home but is silent in class.
9. treatment of toroutte syn
10. association of taurotte syndrome(adhd same q on uw surprised how well UW has mastered the exam prep )
11.wiskott aldrich (triad was given)
12. IgA deficiency mx (plz see the book remember it is not immunoglogin admistration)
13.Sheehans scenario - what is reduced= prolactin
14. tumour picture of spine and histolgy photo also given and asked which type of tumor -no idea )
15. dx of fetal alcohol syndrome
16 ethics: a 7 YEARS boy dx with ALL and chances of his survival with tt is 80% parents not ready to get him treated. what wii you do.
17incomplete abortion dx
18. complete abortion dx
19.pt with stab wound VITAL NORMALwhat next== laparotomy
20. DX OF pericardial tamponade
21. open hemothorax
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1) PID. Increase risk of ----I chose infertility.
2) 20w pregnant woman had a vaginal bleeding with some effacement and dilation. (preterm labor w/o problems) What's next?
3) 37y.o. pregnant woman. decreased level of ALP (fetal size matches with the dates) What to explain to her?
4) Annual pap smear, first episode of atypical cell finding. Choose from among corn biopsy, point biopsy, surgery, recheck one year later, and recheck 6 months later.
5) Young lady needs advice for contraceptive. What's best? Choose from among condom only, condom+OCP, and combination OCP (what's this?)
6) 67y.o. woman w/o problems on regular checkup. What to recommend? Pap, mammo, or nothing this time.
7) 4y.o. boy who is already trained urination recently wet bed. No option about new-stress, UTI, and Diseases.(I simply chose reassurance.)
8) Bee allergy (Mira's note #6)
9) Cyclothymia (Mira's note #15)
10) Bipolaror (obvious)
11) Schizo or Major dep w/ psych,,, confusing, looks like symple schizo
12) Schizo (obvious)
13) Picture of EKG (which has delta-wave), mechanism?---chose re-entry (Mira's note #34?, it was not confusing in my case)
14) Picture of EKG with 3-degree block, answered 3rd block (Mira's note #33)
15) Type1DM boy before entering basket ball club. What to advice? Choose from among limit activity in 30 mins, reduce insulin and other options.
16) Shipyard worker, looks like having mesothelioma. Choose asbesto.
17) Pt after MVA, who is found to have ruptured spleen. Vital stable. What's next?
18) obviouly malignant melanoma.
19) 17y.o. boy with nausea/vomitting (bloody), living with mother who is taking Iron suppliment and Acetoaminophen. I chose he took her Acetoaminophen a lot.
20) Picture of badly displaced clavicle fx. Treatment? (Pinning, Open surgery, conservative, external fixation)
21) Feeling funny of hands. Pushing wrist excerbate. I chose carpal tunnel syndrome
22) Mid humeral bone fx. What nerve impaired?--radial nerve
23) scoliosis (Mira's note #3, I wrongly chose DEXA....)
24) PPV from chart, 5-second question (Mira's note #7)
25) Splenectomy(Mira's note #11)
26) Tyramine crisis (Mira's note #20)
27) HIV, CD150, prophylaxis (Mira's note #28)
28) Picture of painful hip-femoral of Sickle cell kid (Mira's note #28)
29) Splenectomy make patient
30) Picture of foot ulcer in DM patient. Debridement, amputation, or topical steroid? (Mira's note #27?)
31) Amniofluid thrombosis case
32) New boyfriend, any prophylaxis? (I chose HAV vaccine. ????)
33) 30y.o. woman with injection of eyes and multiple arthralgias.
34) Boy of mildly mental-retardated with large ears----fragile X?
35) Pt under chemotherapy for cancer. Arthralgia-----I chose uric acid
36) Substernal pain after meal, who was found to have hiatal hernia. Need your advice. I chose sleep with head up. other options are surgery, reassurance. (No PPI included.)
37) Substernal pain after meal and exercise. confusing..
38) Becoming forgetful 74y.o. Dx among alzheimer, aging, depression, stroke. (Looked like symple aging)
39) Pt with only hypertension. I chose thiazide (This topic was argued in this forum before)
40) Patient has cancer with metastasized. You told him and his family before that the expectancy will be 6 month. His is now found to have encephally metastasized and become strange. What to explain? (correct the expectancy period, he will be fine, or something..)
41) How to treat with TB patients? Should they be packed in single-room, or mix with non-TB patients? ( No option to wash hands or wearing gown )
42) 6-months baby's well-being evaluation and choose the best set, which seems normal-normal-normal.
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1)screen: lady 62y/o, normal pap&cholesterol, heart and lungs for years, what to scren for? (mamography)
2)lady menopause, no HRT, back pain, screen for osteoporosis with DEXA/CT/MRI
3)lady menopause, nio HRT, kyphoscoliosis...do: DEXA/ pet scan/ bone scan
4) man, 32, fam history of CAD, what to screen for?-cholesterol
5) female, 32, fam hist of colon cancer, when to start screening: colonoscopy now/at 40/at 50or sygmoidoscopy at 50
6) history of allergy to bees stings: where long sleeved clothes, avoid bushes, carry epinephrine ( someone else posted this before, i had the same q)
7) positive pred value-calculate from 2x2 chart
8) cluster headache- prophylaxis
9) trigeminal neuralgia-tx with carbamazepine
10) elective splenectomy for TTP, what vaccine to give before surgery? (except pneumo)
11) splenectomy at 9y/o, now 23 y/o, had pneumo, what other vaccine is needed? (i only had hep A< hep B , meningoccocal (does it exist?) and influenza to chose from)
12) splenectomy 10 y ago, now pulm inf with gram pozitive, what is the pathophys
13) REM sleep disorder ( same as the q in UW)
14) reactive attachement dz,4y/o girl who had probl only with dad, teacher and doctor where ok
15)cyclothymia- man, depressed/maniac for 3 y
16) major depressive dz vs grief...2y after wife died
17) oppositional defiant dz- kid who argued with everybody, but had good grades
18) chronic schizo, get halloperidol and NMS after..what to treat with
19) media clip: murmur in kid of diabetic mom
20) thyramine crisis, lady at restaurant, takes MAO inhib
21) risk for fetus if mom gets in contact with epople with parvovirus B19
22) only urethral pain on urination, no frequency/urgency/fever etc...what is it? (non gonoccocal urethritis?)
23) SOB, cyanosis 30 min postpartum, BP 60/30, dies despite resuscitation, why?
24) placenta previa-bleeding, no pain, fetus transverse lie
25) female depressive adolescent, 2 suicide attempts, but says she won't do it again, admit to psych unit or treat with fluoxetine?
26) HIV, 37y/o married with attorney, doesn't want mechanical ventilation for pneumonia, husband ask you to do it anyway..
27) diabetic with foot ulcer, what causes it (derma picture)
28) HIV, CD count 150, what to give prophilaxis for
29) sickle cell female, pain on hip, normal XRay, what does she have? (Xray shown)
30) female, pain on hip, very ugly xray (shown) with necrosis, on femoral neck and intertrohanterian, but not on fem head
31) sigle liver mass- measure alphaFP levels
32) study surgery vs stent for carotid stenosis, gave 3 results from 3 studies, asks to interpret (confusing)
33) ekg: third degree block, pulse rate of 38/min
34) ekg: looked like WPW, but the history was like HOCM...confusing (athlete on bascketball
35) kawasaki-tx
36) osgood-schlatter in teenager athelete
37) slipped cap fem epyphisis- chubby 14 y/o
38) female, very high thyroxine level, very low TSH, all the signs for hyper thyroidism, lived with sister who took levo thyroxine for hypothyroidism- exogen adm??
39) pigmented lesion, grew over 2 mo, and after other appeared around it, also pigmented (derma picture)-melanoma
40) 9y/o girl, developed breasts and pubic hair, dresses like her mom, pretends to be older, mom takes OCP- what is the cause: mom's OCP/estrogen lotions/Puberty/pituitary adenoma
41) male, around 50y/o, has developed gynecomastia and and small firm testes
low TSH, LOW T3 T4, what is the cause
42) varicella after splenectomy, what is the cause (derma picture)
43) female, marrathon runner, pain on knee, normal XRAY (shown) no tenderness over tibial tubercule, full range of motion, what is it?

rosacea
acne
seborrheic dermamatitis
seborrheic keratitis
porphyria cutanea tarda

Corticosteroid induced mental changes
--Dementia Vs normal age related changes
--Calculate negative predictive
--Interpret Odd ratio
--Investigate primary ameno
--Investigate ambiguos genitalia
--Erosive esophagitis - Mx
--Sjogren syn
--Scleroderma - which ANA is raised
--Serum sickness
--Mx of intermittent claudication
--Mx of pressure sores
--Mx of status epilepticus
--Mx of Alzheimer
--Diagnose Parkinson

Malignant hyperthermia, Malignant neuroleptic syn, heat stroke, heat exhaustion - how each presents
--Pathophysiology of all neurological diseases eg GBS, syringomyelia, myasthenia
--How to investigate hypertension
--Diffuse eso spasm - Tx
--Lots of cardio - MI, unstable angina, stable angina - ASD, VCD, TGA, Coart - arrhy and Mx
--Schizophrenia, brief psychotic disorder, acute stress disorder, PTSD, Adjustment disorder, delusional disorder
--Substance abuse - cocaine, cannabis, opoid, marijuana
--Trauma - aortic transection
first of all exam is completely based on concepts, exam is tougher than nbme 3, usmle world gives u orientation

1) Ascities tap finding : hemooragic/atypical cells/ ----?D ------OP Malignancy , TB
2) AScities findings: wbc> 750 ------?d ---------sbp
3)32 y m h/o whip lash car accident injury 2 year age came with b/l wasting of small muscles of hands and senory changes ------?d---------op: Amotrophic lat sc/syringomylia/ MS/cervical spondylosis/disc prolapse
4)HIV pt female cd4 PTSD, depersonalization, and other stupid answers

18.- Dx primary insomnia
19.- Woman has twins that are 2yo and now she feels loss of interest, cant sleep, hates doing anything, what is the next step? Assess suicide.


Specialties
CVS:
1. Effect of isolated HTN..I picked A.fibrillation
2. Know the mechanism of daistolic dysfunction.Ejection fraction will be normal in this case?
3. HOCM..murmur decreases with sqautting,
4. Elderly COPD with irregulat heart beat..MAT
5. PSVT or VTach..hr was 240, QRS normal and doesn't have any effect on cold emersion, I picked cardioversion and BP was very low
6. Hypertensive Cardiomyopathy, ob echo everything is normal, wall motion and not valve defect?
7. Audiovisual Q: One on TR aand another I am not sure, may be VSD?
8. P. Tamponade I don't remember the q. But HS was muffled and raised JVD, X ray shows cardiac sillhoute
9/. Congestive Heart Failure
10. claudication/ arterial insufficiency
11. AVC common sites
1. choanal atresia
2. congenital heart vessls defect
3. effect of propanolol ad verpamil I Mmii varies
4. treatment of A fib
5. tracing for WPW syndrome –dx
6. torsades was asked in ecg but referred to as polymorhic ventricular syndrome
7. wpw was asked and read ‘slurred’ in stem
8. ekgs on acute pericarditis svt afib mi
9. rx of svt
10. dx res cardiomyopathy
11. dx of ar
12. rx of as
- Question said positional chest pain, showed EKG of diffuse ST elevation -> pericarditis
- Had two heart murmur audio questions
- IVDA and vegetations on the heart -> tricuspid regurge
- Guy with angina and a.fib -> I put ECG stress test
- Which is the greatest risk factor for CAD? LDL-chol ration, HDL chol ratio, triglycerides, lipids
- Murmur got worse with standing and valsalva -> HOCM
- Kid with cyanosis in the 1st 24hrs of life -> transposition
- Diagnose tamponade
- Kid with holosytolic murmur -> left to right shunt (it’s a vsd)
- Diagnose MVP (said mid-systolic click)
- Diagnose ASD (said wide, fixed S2)
- Endocarditis prophylaxis for dental procedure in a kid with h/o reaction to ampicillin -> clinda
- Teenager with cramps in the legs, muscles on top are bulky, weak on the bottom, bad LE pulses -> coarctation
- Hyperaldosteronism -> PRA ratio
- 3 questions on temporal arteritis (2 dx 1tx)
- woman with renal artery stenosis what is elevated? Rennin
- diagnose dissecting aortic aneurysm -> TEE
- pt had low Na, low K, high Cl on thiazides and ACEI what is the reason for the labs? I put thiazide and ACEI reaction, other choices were hyperaldosteronism, hypoaldosteronism, other stuff

1. video clip with a neonate that during the chek you hear a murmur...a machinery one.
2. video clip: A boy that colapse during physical education, you hear a murmur similar to mitral regurgitation, but the answer is mitral valve prolapse because there is no the choice for mitral regurgitation.
3. a EKG with ST elevation and T abnormalities randomly in a pt after a car crash. Myiocardial contusion. The pt also has pneumotorax and can get distracted for it.
4. A eKG of a lady with FA, asymptomatic. They do not give the diagnosis just go straigh foward and ask you about treatment. ASA...but there is not ASA int he choices.
5. Make a chart knowing the radiation of the murmurs and how they change with valsalva. Like 2 qs. about it.
6. A pt with ostium secundum who is going to cystoscopy. Need or not profilaxis.
7. the same pt with ostium secundum who is going to hemicolectomy for poliposis.
8. Statin induce injury...wich one is the lower incidence in producing muscle damage
9. Two questions about how is CO and PCWP in two diferents shock

Infecto and dermato
Like 3 questions asking the same in different ways.
1. pt with necrotic ulcer in foot, diabetic...they ask the next diagnosis test if suspect osteomyelitis
2. the same as before with osteomylitis confirmed ..they ask how the bone got contaminated
3. the same as before and they ask about wich factor ist the best to assure you that the pt is going to be healed: a. time with antibiotic, b. no bearing or pressure, c. mange of diaabetes
4. pt with antibiotic who get sun exposure and come back with rash...with antibiotic: quinolonas or tetracyclines
5. Some that make the diferent diagnosis among penfigo vulgaris y bullous penfigoid based just in inmunologic markers.
6. a history of a changing mole
7. A seborreic dermatitis with a picture
8. Kawasaki disease, they ask you for treatment, no ASA in the options.
1) 60yr male, ant MI, BP 205/125, LVF sign+,first action-
iv NTG/IV STK/IV TNK/IV Atenolol
2) old mi, recurrent LOC, signs of LV aneurysm-cause of LOC-VT
3) severity of AS
-character of carotid pulse/LV apex/Intensity of murmur/Duration of murmur
4) tirofiban use-
ACS with raised trop T
5) ReMI after 48 hrs , enzynw for Dignosis
Myoglobin/CK/TropI/Trop T/LDH
6) old MI,post CABG, LV dysfunction, on aspirin, ramipril, diuretic, no sign of heart failure-
next drug to add
Carvedilol/Digoxin /clopidogrel
7) sever AS, GI bleeding, upper and lower Gi endoscopy normal-cause of bleeding
Angiodysplasia/CA colon
8)ECG- dominant R and Tall T in V 1-2, most likely cause
paosterior MI/anterior MI/inferior M|I/lateral MI/pul. Embolism
9)70 female, BP 180/100, after 3 months- BP 170/95 & 170/90 ,drug for HT
Bendrofluzide/Atenolo/Ramipril/Losartan/Amlodepin
10) 75 f in AF, rate-85, bp 140/85, drug to consider-
Warfarin/Aspirin/Digoxin/DC cardioversion/Atenolol
11) Pulmonary embolism- dignosis
CT angio/VQ scan/Ddimer
12) long QT syndrome- drug to start-
Atenolol/digoxin/?
13) after air travel- TIA cause
PFO/ASD/
14) 25 f c/o palpitation once a week lasting for 20 minutes- investigation of choice-
event recorder/holter/EP study/echo
15) man with known DVT on long term warfarin with a new thrombus in ? femoral...what action –
local thrombolysis / stop heparin/ warfarin/
16) PREGANCY HYPERTENSION-most suitable RX-
METHYL DOPA/ diuretic/ enlapril/ atenolol
17) Lady with 2 DVTs and 2 miscarriages, anti cardiolepin antibody positive . Rx:
warfarin indefinitely / warfarin for 6 months/-aspirin
18. a pt with SLE, risk of cardiovascular is increased with presence of-
anticardiolepin antibody/ anti- ro/ anti la/ ANA/
19. a case of hyper tension with hypokalemia, which investigation for diagnosis??
Renin:Aldesteron Ratio/USG/ plasma cortisol level/ plama ACTH
20. patient with known congestive heart failure and renal impairment.
features of worsening heart failure, also mentioned about decreased
urine output. ask the most useful Ix for the current condition
- echo/ ur/cr and electrolyte
RESP
1. Please know the composition of pleural fluid like for different disaeses the glucose content, protein content everything. Mine was for congestive Heart failure
2. Asthma pt with high PCO2 and silent chest..what is the next step- Intubate
3. Bronchiectasis and kartageners syndrome (Immotile cila)ism,
4. Know Cystic fibrosis very well,
5. ARDS with PEEP suddenly develops hypotension and breath sound diminished what is the next step...puncture with needle as developed pneumothorax
6. Sarcodoisis
7.One pt with lung consolidation and pleural thickening with exposure to asbestos, what is the Dx..I picked carcinoma but there was also asbestosis.
8. One q on pulmonary fibrosis,
9.Cor pulmonale
10.Asthma Tx. If the pt doesnt improve with B agonist what do you add..I picked corticosteroid inhaler
11.peep regulation – mechanical ventilatio
12.pneumonia treatment
13.tension pneumothorax and hemothorax – clues will be only percussion
14.treatmet PCP pneumonia
15.treatment of atypical pneunomia
16.college student with pneumonia, negative gram stain – mycoplasma
17. copd and influenza vaccine
18. copd and pathophysiology of PFT
farmer with copd and joint pain – kaplan sydrome
resp
asthma mx
excercise induced asthma rx
volumes in asthma
ards
copd developing into corpulmonale
asbestos worker non smoker cancer bronchogenic or mesothelioma

- Acute asthma attack tx
- Pt with situs inverses, recurrent pneumonia and bronchiectasis (so your thinking CF) but it says sweat-chloride was negative -> nasal scrapings
- Many questions on pneumonia
- No questions on pulmonary effusions
- 2 questions on sarcoidosis
- Dx asbestosis
- Dx chronic bronchitis (really easy)
- One question said what is the pathyphysiology of chronic bronchitis (what happens to the vessel walls, something about elasticity)
- 13month old kid with sudden inspiratory wheezing, CXR shows hyperinflation of just the right lung but no foreign object what is next step? Scope
- Dx Aspiration pneumonia. One question said what is the pneumonia consisting of? Gram + only, gram – only, both, gram + and anaerobes, gram – and anaerobes, etc.
- Dx TB (question even said positive PPD)
- Dx atelectasis (fever a few hours after surgery)
- 2-3 questions on ARDS
- One on neonatal ARDS, what to tx with? Surfactant
- Women suspected of having PE, the V/Q scan was negative what do you do next? Spiral CT, d-dimer, CXR, ekg (angiography wasn’t there)
- Pt with PE what do you give? Heparin
1. patient with FEV1 of 1.2 and FVC of 1.4, ask u to interpret this,results firbrosing ds as restrictive pattern/ asthma/- COAD as restrictive pattern/- COAD as obstruction pattern/- fibrosing ds as obstrutctive pattern/-
2. small cell Ca lung- no metastesis, up to bronchus- treatment
chemotherapy/radiotherapy/Surgery/transbronchial laser
3. COPD 70yrs greenish sputum- antibiotic of choice-
teichoplanin/cefotaxim/erythro/amoxy
4. malignant mesothelioma- true statement-
FNAC lead to seedling/Prolonged duration so not mesotheioma/Curable/
5. 16yr recurrent cough with sputum and have DM, sibling died in child hood b/o lung infection, dignosis-
Cystic fibrosis/Alpha anti trypsin def./Dysmotility cilia syndrome
6. Suspected PE- CXR- basal haze present- diagnostic intestigation
HR CT/VQ scan/D dimmer
7. 16 f c/o dyspnoea, exam going, anxious- dignosis of asthma considered if
>20% variation in PEFR/dyspnoea improve after exam
8. a question regarding prognosis in some fibrosing alveolitis- lung fibrosis-prognosis
-9. 21 iv drug abuser- chestpain, dyspnoea- b/l cavity at apex on CXR- dignosis
tricuspid endocarditis/pulmonary embolism
10. a case of lung carcinoma with EATON LAMBORT-
VOLTAGE GATED CA CHANNEL AB /Anti-purkinje antibody
11. PNEMONIA POOR PROGNOSIS-
UREA >13, RR 20, WBC 13000
12. a patient with COPD- what to do for prevention of further damage ?
Stop smoking/ steroid/ Beta agonist/ High flow oxygen
13. indication of chest drain-
ph sclerotherapy
- pt had hematochezia and bluish dicoloration of the cecum -> I don’t know I put angiodysplasia
- toxic megacolon, NPO/IVF/NGT wasn’t enough, then more pain and more fever c free air in abdomen ->laparotomy
- kid swallowed some acid, what to do in ER -> esophagoduodenoscopy
- no questions on h.pylori
- easy question to diagnose achalasia
- question on sjogrens what is next step -> SSA/SSB Ab or parotid biopsy
- guy had halitosis -> zenkers
- several questions on gout -> trial of PPIs
- question on esophageal scleroderma -> trial of PPIs
- guy has heartburn well controlled with antacids, used to have trouble swallowing only steaks, now cannot swallow many solids but liquids is ok -> PPIs or EGD
- diagnose esophageal cancer
- diverticulitis -> ct scan
- woman with jaundice, only + result was HAV IgG, what is she at risk for in the future? HAV, HBV, Hemachromatosis, Hepatocellular Ca, etc.
- pt with hepatic encephalopathy and high Cr -> dialysis
- question was very long, said pt had epigastric pain radiating to upper quadrants, fever, no jaundice, labs weren’t that bad (mildy elevated alk phos) what does she have -> cholecystitis, choledochilithiasis, pancreatitis, bla bla bla…
- Cholecystitis -> abdm U/S
- Older woman with h/o CABG and history of A.fib gets diffuse abdm pain after eating, and has abdm bruit, what does she have? Embolis in SMA, abdm aortic aneurysm, polycystic kidney disease?
- Acute pancreatitis question
- Question on malabsorption, pt had steatorrhea… lol I don’t remember the rest
- Guy had bloody stools and passed out on the floor, recent history of aortofemoral bypass -> I put fistula
- Dx pyloric stenosis
- What is the cause of intussuseption of small bowel in a 65yo? Idiopathic, tumor, cancer of small bowel, lymphadenitis?
- Dx meckels

1. Man with 15 years of UC, al LFT, ALT & AST around 60, GGT 250, bilirubin 15, Allk Phos 700 – primary sclerosing cholangitis/hepatic mets/ cholecystitis
2. a35 female 6 yrs hx for intermittent loose stool and constipation.....inx normal what action next - reassure/
3-H PYLORI MALT- H pylori ERADICATION/ Surgery
4-ASYMTOMATIC GALL STONES- lap cholecystectomy/ ECSW/ OBSERVATION
5-ANTI SMOOTH MUCLE ANTIBODIES- DO LFT /
6 60 lady- folte def anemia, fe def anemia, malabsorption-- what is the diagnosis -CASE OF COELIAC Ds-
7. ASSOCIATION WITH CHRONIC HEP C- POLYARTERITIS NODOSA /PORPHYRIA CUTANA TARDA /
8. MARKER- PANCREATIc carcinoma –
CA199/ CA 125- / CEA
9. a patient of alcoholic cirrhosis with ascites, and fever, what next?
Diagnostic tap/ albumin infusion/ blood culture
10. qs about forced entry of substances due to pressure gradiant in gut filtration,active transport, facilitated diffusion.....
????????????? a clinical pictureof mal absorption suggestive of celiac ds., investigation for diagnosis- Small bowel biopsy, small bowel enema, breath test/sigmoidoscopy
???????????Analgesic induced colitis?????????
Rheumatology:
1. Know the back pain very well,
2. Raynauds phenomenn Px and Tx
3. Polymyositis (features) and dermatomyositis..know the diff
4. One q on Polymyalgia Rheumatica
5. Acute attack gout what do you give first I picked Ibuprofen..there was also naproxen
6. Septic Arthritis
7. Another Gout q with crystal finding negatively birefringent,
prednisione mode of actions
myasthenia pathophysiology
polymyalgia rhematica with gaint cell arteritis developing blindness
sjogren syndrome dx
tension headache cluter headache dx
multiple sclerosis dx
- How do you treat pseudogout? Indomethacin, hyaluronidase injections, aspirin?
- 3-4 questions on RA
- 2-3 questions on Gout
- 1-2 questions on OA
- pt c psoriasis what else should you find? Clubbing of the finger
- 3 questions on Kawakaki’s disease (2 to dx, 1 to tx)
- dx polymalgia rheumatic
- tx SLE (prednisone)
- how do you treat fibromyalgia
- dx polymyositis
- dx DMD
- kid with recurrent fractures and blue sclera -> collagen 1 deficiency
- Showed picture of carpal tunnels -> median nerve at wrist
- Dx slipped capitus femoral (fat kid with a limp)
- Dx Osgood shlatter (showed picture of tibial tuberosity)
- Dx developmental hip displasia (said mom heard popping when changing diapers)
- Picture of chondrocalcinosis -> pseudogout
Reumato
everything....
1Pt with RPC antibodies
2Pt wih a gout clinically but they show u x ray more than osteoartrosis. they ask about treatment as next step...they put lose wieght and there is no aines in answer.
3a lady with hystory of migraine but increase in ESR, when you see the choices in the answer you realize that is not migrain and it is gian cell arteritis
4.Inside out polimialgia reumatic vs polimiositis vs. fibromialgia
5. Reiter
6. Still
7. Pt with recurrent tumor in meninges in lumbar area and they tell you that the lateral aspect of thight is numbnes and they ask wich one is compromise: L2 -L3 -L4..and so on
8. Carpal tunel...mechanism of disease......inflamation, infiltration with fibrotic tissue, and so on.
9. Easy one like treatment of lumbar disc and lumbar stenosis treatment.
10. Paget....mechanism of disease...osteoclastic dysfuntion, osteoblastic, vit D/PTH imbalance. Remodelation was not in the choices.
1. Pain in wrist when abducting thumb :
De quervain tenosynovitis /radial neuroma/ # base of thumb
2. Meningiococcal susceptibility which complement ? C5/ C3 / C4
3. 72 yr old lady with pain in L knee. Xray hand:ostophyte. Limited L hip flexion. X-ray knee normal. What next ?
MRI of knee/ Arthroscopy of knee/ CT scan etc…
4. Lady with whiplash injury 5 yrs ago. Now come with pain in neck, shoulder unrelieved by 12 cocodamols a day. What next ?
amitryptilline/NSAIDs, physio, etc
5. 16 Girl with features of possibly ??psoriatic arthritis ( swollen r wrist, l knee, r ankle) with positive ANA 1:60 with –ve Rh factor. What is she at risk of ?
uveitis/Erosive join disease/
6. Girl OD of paracetamol given N –acetylcyctine. Developed tachy, flushing, etc. Why ? igE hypersensitivity reaction/ disulfiram type reaction/
7. Kid multiple staph infections, cousin died, what imune deficency – Neutrophil def/
8- . weakness plus very high ck- best investigation for diagnosis- biopsy( myositis)
9. young chap with rt hip pain,had left hip back previously, relieved with NSAIDS- spine movements normal -? sacroilitis/gluteus medius tendonitis / FRACTURE etc
10. a patient with weakness, joint aches and gritty sensation in eye,ANA++, RF++ what is the diagnosis?
Primary Sjogeran syndrome/ polymyositis/ reiter’s sundrome/ PAN
11-SCLERODERMA RENAL CRISIS with TOD- RX ORAL CAPTOPRIL /IV NITRO /
12. RESIST PAINFUL ABDUCTION- SUPRASPINATUS/ infraspinatus/ deltoid/ pectoralis major/ teres minor
13.loss of sensation over radial half of palm with paralysis of abductor pollisus and oppones pollisus- which nerve?
media/ulnar/radial/posterior interosseous
14. positively bifringent crystals- diagnosis-
calcium pyrophosphate/ urate/ calcium carbonate/
15. a man with asthma and renal dysfunction- which anti body??
ANCA/ ANA/ antiphospholipid/
16. a man with haemoptysis and renal dysfunction- antibody against-
proteinase3/ smooth cell/ dsDNA
17. a boy develop red eye and rhinitis especially during the start of the summer, what is the likely triggering agent?
Grass pollen/ house mite/ willow pollen/
18. a postmenopausal lady with a family history of osteoporosis, what is for prevention??
HRT/ Ca/ Vit .D
19. a lady with # femue, osteoporotic, what will be the treatment to prevent further #???/
Alendronate/ Alendronate+ Ca/ Alendronate+ Ca+ Vit.D/ Vit.D
20.???? sensory , mild power loss in UL plus loss of triceps and sup reflex- cervical spondylosis
Dermatology
1. Man with SKIN rash on forhead and hand- porphyria cutanea tarda
2. man with clinical pisture of erythroderma with PSORIASIS- initial treatment-
oral steroid/ cooling with air/ topical tar/ topical steroid/ topical soft white paraffin
3. 60 yrs lady, venous ulcer on leg, Doppler normal. Appropriate management-
compression dressing/ leg elevation/ antibiotics
4. man with multiple pustular lesion with crust on head and trunk- the most appropriate in management-
IV flucoxacillin/ steroid/ paracetamol
5. a 26 yrs boy presents with recurrent urticatia which last for 20 minutes and subsides it self, what is management?#
non curable/ H2 receptor antagonist/ avoid NSAID
6. a 22 yrs girl develop weezing and flushing of face, what investigation?
C1 easterase inhibitor level/ patch test with latex/ prick test with latex/
7. pat. with URTICARIA after eating chinese dish peanut allergy, idiopathic URTICARIA, monosodium glutamate allery
dx of rosacea
dx of seborrheic keratitis
acne prevention - options were avoiding fatty foods oily based creams washing with soap water
- picture of some bad bad acne -> proprionobacterium
- HSV
- How do you treat ringworm > clotrimazole, permethrin, hydrocortisone?
- Pt had dermatitis herpetiformis -> gluten free diet
- Pt had optic glioma what will you find on skin -> café au lait
- Guys nose had a pearly looking thing on it -> basal cell
- Mentally retarted kid with seizures and a skin disorder -> tuberous sclerosis
- Acathosis nigrans -> check glucose
- Kid with DIC
- Picture of a hand with DIP inflammation and said his ankle was very tender -> gout
- Kid went into the woods now has itchyness and rash in a linear pattern -> contact dermatitis
- Mom wants to prevent daughter from getting sunburns ->advise not to go out before 2pm
- Contact dermatitis question -> cell-mediated hypersensitivity
Immunology
brutons
de Goeorge
scid
aids
Endo:
1. Two matching q on Ca, one was CRF and anopther was chronic alcoholism,
2. A Lot on adrenals,
3. Kallman's syndrome: A boy with short stature and underdeveloped testes..what other abnormalities you would see..smell
4. One q with graves disease,
5. What is the cause on Cong hypothy...thyroid dysgenesis,
6. Prolactinoma,
7.Pgy and postpartum bleeding...sheehan's syndrome
8. Lots of q on DM, I don't remember the q ..one was on insulinoma, DKA and DM nephropathy what drug to give ACEI
9. thyroid!
DM type 1 with auto immune phenomenon
aldosterone and hypertension
- Guy is depressed after his wife died and labs show high tsh, low t4 -> depression due to medical conidition, other choices were MDD, Adjustment disorder
- Graves disease what Abs are after -> TSH receptor
- Guy with A.fib what must you rule out -> hyperthyroid
- SOOO many questions on diabetes I and II soooooo many. Guy with DKA (give fluids and what type of insulin), guy with DM and foot ulcer (angiography or foot amputation), soooo many know your DM inside out
- Health care worker comes in after fainting has sugar of 40, normal c-peptide -> took insulin
- Guy with low insulin and high c-peptide -> insulinoma
- Guy with rash and high sugar -> glucagonoma
- Dx hyperparathyroidism
- Guy on lithium -> nephrogenic DI
- Dx SIADH
- Guy with loss of facial hair, small testes and is infertile -> check pituitary
- Pt cannot lactate after birth, had postpartum hemorrhage, what is deficient? GnRH, inhibin, progesterone?
- Dx PCOS
1. Lady with cirrhosis with post prandial glc of 16. Give what ? pre-prandial insulin, metformin, glibenclanide, glicazide etc
2. Man with gynaecomastia secondary to cirrhotic liver disease. What caused the gynaecomatia ? reduced testoeteron production , Reduced oestrogen metabolism, increased oestrogen production, increased testesteron destruction etc
3. Pituitary tumor- which structure will be compressed first- 3 rd nerve/ optic nerve/ 6th nerve/hypothalamus
4. boy with bilateral gynaecomastia, what points to hypogonadotrophic hypogonadism? anosmia/- microphallus/- small testes/- - hypospiadius
5. man with IDDM, asymptomatic, on followup- neovascularization on optic disc- hbalc/bp suboptimal control what treatment- photocoagulation/ followup after 3 months/ control diabetes/ better bp control
6. 50 lady with signs of hyperparathyroid and gastric ulcers, h. plylori positive, ulcers not cured even after H. pylori eradication, diagnosis? MEN 1/ primary hyperparathyroid
7-BARTER ASSO WITH- HYPOKALEMIA / hyperkalemia/ acidosis
8- incrased u/o to 4-5L/day after adding one drug, plasma Na 141, K normal, plasma osm normal ~ 29X, urine osm a bit low ~ 28X. -
LITHIUM /chlorpropamide/ carbamazepine/ Lasix
9) TEST FOR ACROMEGALY-
OGTT WITH GH
10.CASE OF CUSHING-investigation of choice- low dose Dexamethasone test/ synacthen test/ cortisone level
11. a 20yrs boy, head injury, CT scan – pituitary enlarged- prolactin normal, tsh normal, 9am cortisol normal, GH low normal, FSH and LH raised , diagnosis of pituitary tumor supported by
raised FSH and LH/ high prolactin/ low GH
12. a lady with fasting blood sugar raised on investigation- 6.8 mmol/L, what is next invest?
GTT/ Random blood sugar/ insulin level
13. yound man with pain and tenderness ?also swelling over medial aspect of thigh. high spot glucose of > 20, ask the most useful investigation USG/ Bone MRI/ Xray
14. sudden thyroid painful enlargement/ euthyroid, what is the diagnosis?
- haemmorage into cyst/ thyroiditis
15. a lady with symptoms suggestive of hypercalemia, the best initial teartment - normal saline
ID:
1. Tx of Chanchroid, Gonorrhoea, Pseudomonas and PCP,
2. q was on Traveller's diarrhoea, Tx I picked cipro, person was travelling to MExico
3. Salmonella transmitted through egg,
4. Tx of cystitis
5hiv/hepc
6septic arthritis – what improves progosis – arthrocetesis x corticosteroids
7EBV – time to return to sports
8Sore ulcers – first sign
9Pyelonephritis treatment
10Chlamydia infection rx
11. INH with pyridozine deficiency
12. tricuris trichuria ass with rectal prolapse
pathophysiology of shock

- Dx otitis media
- Hard question on sinusitis, know how to differentiate chronic s/s from acute.
- Kid with barking cough -> laryngotrachietis
- A lot of wheezing questions in children
- CSF has RBCs -> HSV
- Pt exposed to so many things, one of them was unpasteurized milk, CSF was normal -> listeria
- Ring-enhanced lesion in the brain in an aids pt prophylaxis -> TMP-SMX
- Kid with h/o meningitis what is the diagnosis to the most common sequela -> confused between tympanometry or air-conduction hearing studies (I know the answer was hearing loss)
- Encephalitis question -> HSV
- Kid c wheezing and has tonsillar inflammation and had trouble opening his mouth but uvula was not displaced and it showed a picture of the lateral neck and asked what it was-> peritonsillar abscess or retropharyngeal abscess im not to sure, know the pix - Dx pharyngitis
- Nurse with pernichila (the finger infection) that gets it drained, warm compress and Abx, what is next? Keep her away from pts, prophylax all pts, treat all the pateints she was exposed to, etc.
- 2 questions on mycoplasma dx (college students)
- 2 questions on aspiration pneumona
- PPD positive next step -> cxr
- Guy with white fluffy things that don’t scrap off, what is next test? HIV
- 3 questions on Lyme disease
- MANY MANY STD questions, all of them like syphilis, chancroid, gonorrhea, chlamydia, trichomonas (like 4), candida (2)…at least 2 on each one
- Guy with everything that seemed like gout, what is next step? Aspirate fluid from joint (treatment wasn’t an option)
- Had maybe 9-10 questions on the immunodefiencies, know them real well.
- Guy with indurated 5cm mass on thigh and fever, what do you do next? Surgical debridement or I&D?
- Pt has on several meds gets hearing loss, what is the cause? Gentamycin
- CO was low, resistance was high, PCWP was low, what kind of shock?
1. Legiona infection. Dignosis-
urinary antigen/serum IFA/sputum IFA/sputum culture
2. HIV chap CSF analysis low glc3.3 (serum glc 6.6), lymphocytic:
cyptococcal mengingitis/tubercular meningitis
3. fever, headache, neck stiffness, multiple cranial nerve palsy-
tubercular meningitis/sunarach hge
4. HIV chap with multiple enhancing lesions , had seizures. Give what first ?
Steroids /cotrimoxazole
5. TURKISH LADY WITH emaciated, massive spleenomegaly/ hepatomegaly, treat with what ?
pentavalent antimony /quinine/praziqental
6. a student developed heavy bloody diarrhoea 3 days after visited the farm. ,possible pathogens? - salmoella/ entamoeba/ CASE OF SHEGILLA?
7-went on a cruise -ABDOMINAL CRAMPS AND BLOODY DIARRHOEA- SALMONELLA/ CAMPYLOBACTER JEJUNI / Na mono glutameth/
8- a 50 pt with gradually progressive dementia with myoclonic jerks- cause- CJ disease/ hiv/ parkinsons/ alzihmers ds
9. protection against Plamodium vivex- which is absent?
Duffy/ Kell/ Rhesus
10. a patient present with fever with intermittent rigors after 6 months of travel to a other country, what is diagnosis?
P. malaria/ dengu/ P. falsiparum/
11. female with lyphadenopathy, diarhoe/ oesophageal candidiasis
HIV/ infecsious mononucleosis/
?????????????????-case of herpes simplex encephalitis
?????????Cerebral malaria --------management?????
????????? HIV with oral thrush – what is management?—
Nystatin/ ketoconazol/
Pharmacology and TOXICOLOGY----------
1. man confused and agitated after cocaine abuse, ask the electrolyte disturbance finding-
hyperthermia/ hyperkalemia/ hypothermia/ hyokalemia/ hypernatremia
2. Elderly lady with acne with ?bluish pigmentations in her legs. What drug cause this?
minocyclin,Hydroxychloroquine, amiodarione, / tetracycline/
3. Lady with systemic sclerosis. BP noted to be 180/90. Fundoscopy showed ?Av nipping .urea and creat increased Give what next ? stop captopril , oral atenolol, iv nitroprusside , etc
4. lady with dipression with jaundice , dry mouth, drowsy , acure urinary retaintion.
Amitriptylin /paroxetin overdose /
5.drug effecting opiod receptor on circular and longitudnal muscles of the gut –
loperamide/ metaclopromide/ ranitidine
6. pat with OA on ?paracetamol. having knee pain what next-
diclofenac / opioid,/? local ibuprofen
7. pt with OA on codeine+/- paracet. 30 qds not having pain relief... what is the cause not enough codeine /
8. mechanism of action of adertonate-
osteoclast inhibition/ osteoblast stimulation
9. drug which potentiates hypoglycemia of glibenclamide Fluconazol/ ranitidine/ phenytoin/ steroid/ aspirin
10. - WARFARIN INR>9.1 BLEEDING- RX
PROTAMINE CONCENTERATE/ CRYO ppt/ factorVII
11. METHHAEMOGLOBINEMIA>70% UNCONCIOUS- definitive management
Methylene blue/HYPERBARIC OXYGEN /
12. a patient found unconscious with smelling alcohol with ?????ETHYLENE GLYCOL WITH RAISED CK AND RENAL IMPAIRMENT-
RHABDOMYOLYSIS / alohol intoxication/ tricyclic antidepreesent
13. H/O DIAZEPAM AND DOTHIPEN HR 140- DO what next? ECG/ Iv flunazil/
14. PARTIAL AGONIST opiodide COMBINE AITH morphin AGONIST cause- REDUCED ANALGESIA / ^ resp depression, ^ sedation
15- AZOSPERMIA caused by
SULFASALAZINE / azathioprine/ meslazine/ ASA
16. A renal transplant recipient on steroid/ azthiptine/ present with infection- WBC 3000, cause low WBC of it-
azthioprine/ steroid/ infection
17. a patient with bicarbonate def.- contraindication of oral bicarbonates is- hypercalemia/ hypokalemia/ acidosis
18. mode of action of thyroxine-
increase insulin sensitivity/
19. thyrotoxic on carbimazole treatment, what will be the first to improve?
TSH/ free T3/total t4/ Thyoglobulin
20. a patient has taken 50 tablets of sustained release theophyllin, what is true?
Activated charcoal will not be effective/ causes res. Acidosis/ ipeccahuan induced vomiting would be appropriate/causes hyperkalemia
21. mechanism of action of Haloperidol as an anti emetic???????
D2 receptor antagosit at CTZ/ D2 receptor antagosit at brain centre/ D2 receptor antagosit at periphery/ GI motility reduced
22. hx of head injury/trauma, put on some medication. became jaundiced, ask what's the possible drug - oxybutynin/ - txxnidazine
23. lady being treated for chest infection in geriatric long-staying ward on antibiotics, developed features of acute parotiditis, ask u the most appropirate rx - NSAID/- augmentin/ - flagyl/ - panadol
24. patient with hypNa, hypoK, increased Ur Ca. ask the most likely,causative agents - thiazide/ - lasix
25. ??????????????alcoholic found unconcious paracetamol poisoning.

RENAL:1. Tx of hyperkalemia
2. Know the antihypertensive drgs,
3. Kidney stones,
RTA!
- Guy had testicular mass, ultrasound confirms that it is a solid mass, what is the next step? Excisional biopsy or orchiectomy?
- 2 questions on BPH (dx)
- Pathophysiology of post-strep GN? I put destruction of foot processes (they didn’t have fusion)
- Muddy casts -> ATN
- Pt in car accident, CK level is off the roof, what is he at risk of? ATN
1. Renal transplant pt 4 weaks ago. Pst transplant Creatinine 118. Now creatinine 127. Febrile. kidney was CMV and EBV antibodies positive and HIV positive. . Whats the problem here? Acute graft vs host disease, CMV, EBV, pneumocystic carinii?
2. a pt with palpitation and HYPERKALEMIA- initial management- GIVE CALCIUM GLUCONATE / frusomide/ dialysis/ sodabicarbonate
3. CASE OF INFECTIVE ENDOCARDITIS H/O MALAISE ARTHRALGIA with glomeulonephritis- REDUCED C3
4. 20 male with IDDM for 5 yrs present with leg oedema, investigation- urinary protein 5 gm%, serum cholesterol- 8 mmol/l- dx- MINIMAL CHANGE DIESEASE / DIABETIC nephropathy/
5. pt with OA takes diclofenac for 6 yrs, penicillamin for 2yrs but stooped 1 yrs back- urine- albimin +, rbc –ve, bilateral small kidneys- diagnosis- analgesic glomerulonephritis, analgesic interstitial nephritis, ISCHAEMIC NEPHROPATHY
6. a patient with renal stone- which is true?
Cystine stones radio-opaque/ alkalization of urine in cystine stone ppt. it/ Urate stone radiolucent/hexagonal crystals
7. a patient with pH 7.2, pCO2 30, pO2 80, HCO3- 14, diagnosis?
Metabolic acidosis/ metabolic alkalosis/ resp acidosis/ resp alkalosis
8. a diabetic on tablets, BMI 17, urea 21, createnin 190, HCO3- 14, cause of this finding?
Metformin/ CRF/Gastroparesis induced vomiting/ RTA
9. a patient with renal dysfunction, and rash on renal biopsy- IgA linear deposited in basement membrabe, diagnosis?
HUS/ Good Pasture syndrome/
10. Pt with hematuria/ hypertension/ urinary protein +, what is the diagnostic investigation?
Renal biopsy/ IVU/ USG
????????? CASE OF ACUTE TRANSPLANT REJECTION
.??????????? middle aged man have proteinuria, ask the most likely cause
- minimal change GN/- IgA nephropathy
CNS:
1. Dementia, Dementia and Dementia, - all
2. I had a q on tertiary syphilis with Argyll robertson pulil ad Dementia
3. Alz
4. MS – MRI pics ad descriptio - dx
5. Transverse Myelitis
6.Meinier's Disease,
7. Stroke Tx,
8. ALS and GBS
9. Tx of Mysthenia crisis
10. BS of brain and lesion to differnt parts with loss of BS
11. Migraine Headache,
12.back pain
13.7th nerve palsy – taste sensation
14.atipsycotic induced akathasia
15.episodic headache ad high bpp (pheochromocytoma)
16.an 85 year old with little confusion, cannot sleep, nomral mmse – normal aging
17.CT of budd chiari
18.Multiple myeloma – dx. Presents with back pain, significant hypercalcemia
man was reading newspaper on the street and suddely piece of pape
Reply
#3
Hello can you send it to me to my email drsharaf2012

thank you so much.
Reply
#4
Hi pth....did you find this useful?
Reply
#5
Well to be honest I never read them all, one of my friend gave to me !! it has some good point if you have time then go through them,

Reply
#6
Quetions.
Reply
#7
question on sjogrens what is next step -> SSA/SSB Ab or parotid biopsy


guy has heartburn well controlled with antacids, used to have trouble swallowing only steaks, now cannot swallow many solids but liquids is ok -> PPIs or EGD

what is corticosteroid induced mental changes?
Reply
#8
pth can you please shoot me a mail at giangium @ g mail . com

Thanks
Reply
#9
If you are looking for a research position or a clinical rotation in the U.S. to improve your CV for the Match, we can help. Most of the positions we arrange for are at well-known universities. Please provide some details about your credentials, and your specialty and location of interest, and contact us at BetterCVinMatch2014. We can provide a list of references upon request - most likely we have some from your own country.
Please do not send duplicate emails and allow some time for us to reply you back. Due to number of emails we receive, it may take us 24 hours to reply you back.

Thank you.






If you are looking for a research position or a clinical rotation in the U.S. to improve your CV for the Match, we can help. Most of the positions we arrange for are at well-known universities. Please provide some details about your credentials, and your specialty and location of interest, and contact us at BetterCVinMatch2014. We can provide a list of references upon request - most likely we have some from your own country.
Please do not send duplicate emails and allow some time for us to reply you back. Due to number of emails we receive, it may take us 24 hours to reply you back.

Thank you.






If you are looking for a research position or a clinical rotation in the U.S. to improve your CV for the Match, we can help. Most of the positions we arrange for are at well-known universities. Please provide some details about your credentials, and your specialty and location of interest, and contact us at BetterCVinMatch2014. We can provide a list of references upon request - most likely we have some from your own country.
Please do not send duplicate emails and allow some time for us to reply you back. Due to number of emails we receive, it may take us 24 hours to reply you back.

Thank you.






If you are looking for a research position or a clinical rotation in the U.S. to improve your CV for the Match, we can help. Most of the positions we arrange for are at well-known universities. Please provide some details about your credentials, and your specialty and location of interest, and contact us at BetterCVinMatch2014. We can provide a list of references upon request - most likely we have some from your own country.
Please do not send duplicate emails and allow some time for us to reply you back. Due to number of emails we receive, it may take us 24 hours to reply you back.

Thank you.






If you are looking for a research position or a clinical rotation in the U.S. to improve your CV for the Match, we can help. Most of the positions we arrange for are at well-known universities. Please provide some details about your credentials, and your specialty and location of interest, and contact us at BetterCVinMatch2014. We can provide a list of references upon request - most likely we have some from your own country.
Please do not send duplicate emails and allow some time for us to reply you back. Due to number of emails we receive, it may take us 24 hours to reply you back.

Thank you.






If you are looking for a research position or a clinical rotation in the U.S. to improve your CV for the Match, we can help. Most of the positions we arrange for are at well-known universities. Please provide some details about your credentials, and your specialty and location of interest, and contact us at BetterCVinMatch2014. We can provide a list of references upon request - most likely we have some from your own country.
Please do not send duplicate emails and allow some time for us to reply you back. Due to number of emails we receive, it may take us 24 hours to reply you back.

Thank you.






Reply
#10
this is entirely unuseful for the test. THey've removed these "remembered" qs form step 3 long ago. Not a single one showed up on my test.
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