Internal Medicine Knowledge

Mycoplasma Pneumonia ------------> cannot be seen on GramStain
high IgM cold agglutinins
low Ht
high RetiCount ------------> hemolytic anemia
Mycoplasma infections ------------> Hemolytic Anemia
Trt of Mycoplasma infection ------------> Erythromycin
Epiglottitis ------------> indirect laryngoscopy , soft tissue X - ray of the neck
Epiglottitis ------------> hoarsness , stridor
palms and soles diffuse rash ------------> secondary Syphilis
anal warthlike lesions ------------> Condylomata lata ------------> specific for Secondary Syphilis
Secondary Syphilis ------------> VDRL +
weil felix test ------------> rickettsial infection
Secondary Syphilis ------------> Penicillin is the drug of choice , then Ceftriaxone , TetraCycline
Trt of condylama acuminata ------------> Interferon @

Medicine

Paget ' disease ----------> nipple and vulva , ascociated with ADK or squamous C.C. ,
Trt ----------> Surgery
in the dying pt ----------> give analgesics , oral regular narcotics
non-painful buccal mucosal ulcerations ----------> Syphilis
person presenting for yearly physical exam ----------> no indication for doing stress test
ELISA and western blot ----------> HIV (+) ----------> syphilis , PPD , CXR , T4 lymphocyte count
Dg of taenia saginata ----------> isolating spores (or scolex)
Trt of torsade de points ----------> direct current cardioversion
cardiac index ----------> cardiac output to work of the heart
% of lung cancer directly attritutable to cigarette smoking ----------> 83 %
the greatest fear of the dying pt is ----------> suffering alone
more perpetrator of elder abuse ----------> the spouse
higher tolerance of pain occurs with ----------> Companionship
m.potential adverse effect of hospitalization of elderly ----------> adverse response to medication
major cause of constipation in elderly ----------> lack of mobility
moderate HTN ----------> Diastolic : 105 - 114 mmHg
sudden aggravation of mitral regyrgitation ----------> mitral valve chordea rupture
does not require dose modification in renal failure (crea clearence : 10 ml/min) ----------> Clindamycin
emphysema ----------> vetilation-perfusion mismatch ----------> hypoxia
CRF onset in NOT associated with ----------> Oliguria
lead poisoning screening ----------> blood lead level
liver cirrhosis ----------> isovolumic hypotonic hypoNa+
not recommended for elderly ----------> Hep B immunization
obesity is ----------> NOT a risk factor for osteoporosis
age related physiologic changes ----------> increased Fat , decreased liver mass and serum albumin level
recurrent urinary infections ----------> aggravate CRF
penicillin ----------> canNOT aggravate it
in Nephrogenic diabetes insipidus ----------> NO hypoNa+
bilateral proximal leg muscle wekness
hyperactive knee and ankle reflexes
extensor planter responses ----------> transverse myelopathy
loss of pinprick sensation below the umbilicus
main complication of Viral pneumonia ----------> Bacterial super infection
Addison disease ----------> asthenia ----------> NO predominance in the morning
m.c. circumstance for finding diabetes mellitis type 1 ----------> keto acidosis
inflamatory synovial fluid ----------> more than 2000 cells / mm3
in Alzheimer ----------> depressive reaction and NO moria
Urease positiv reaction ----------> Phospho - ammonioco - magnesium
epidermoid bronchial cancer ----------> Dysphonia ( worst prognostic sign)
pulmonary fobrosis ----------> crepitation rales
psitaccosis
in coeliac disease ----------> constipation may replace diarrhea
----------> bone age is NOT expected to be normal
basal cell carcinoma ----------> grows slowly , over most area of the body
cushing Sd ----------> short stature in bone age
baroreceptors ----------> may be denervated by changes in their wall
massive intra cellular dehydration
HyperNa+ ----------> give: dextrose 2.5 % in water
m.c. immune deficiency disease ----------> Transiant hypoGammaGlobulinemia in infancy
helpful in status asthmaticus ----------> hydration , steroids , Isoproterenol
severe rickets ----------> short stature
clostridium perfringens ----------> food poisoning
beta hemolytic streptococcus group D (Enterococcus) ----------> NO food poisoning
m.f.cause of PNO ----------> bleb rupture
m.c.c. of atypical Pneumonia ----------> Mycoplasma
Nephrotic Sd ----------> increased proximal tubular reabsorption , catabolism , of protein
----------> increased Hepatic synthesis
renal vein thrombosis ----------> Nephrotic Sd
lease likely to cause Nephrotic Sd ----------> Polycystic kidney disease
blind loop Sd ----------> NO vomiting
Lactose intolerance ----------> stool is NOT alkaline
M.S. manifested by ----------> Diplopia
cerebral angioma , tumor ----------> can cause Epilepsy
Polio vaccine is ----------> effective in aborting Epidemy
a single dose give a rapid immunogenic effects
major criteria for acute rheumatic fever ----------> A.S.O
craniotabes ----------> congenital syphilis , normal before 4 months
cyanotic congenital heart disease ----------> brain abscess
Gravest pg in HTN ----------> papilledema and retinal Hg
sweat gland ----------> cholinergic stimulation
PseudoHypoParaThyroidism ----------> high serum phosphate
low K+ ----------> low T-waves
severe hypoalbuminimea ----------> Protein - losing enteropathy
asymptomatic M.S. ----------> regular medical examinations
minority of pt with orthostatic proteinuria ----------> persistant proteinuria
presence of lupic inhibitor ----------> APTT
Tuberculous meningo-encephalitis ----------> not a cause of progressive multofocal leuco-encephalitis
Unstable angina ----------> NO Lidocaine - NO Xylocaine
cholestasis ----------> Gamma G.T.
TacchyArythmia with atrial fibrillation ----------> digitalis
in GastroEnteritis ----------> poor perfusion of tissues ----------> Acidosis
M.I. always ----------> heart muscle damage
----------> not always ECG changes
factor VII deficiency ----------> abnormal Prothrombine time
serum Hepatitis B ----------> Australia antigen
in early stages of Aspirin poisoning ----------> Respiratory alkalosis
Plasma Hypo Osmolarity and urine Hyper Osmolarity ----------> SIADH
most adverse pg factor in Infective Endocarditis ----------> Heart Failure
Trt of severe combined immunodeficiency ----------> Bone marrow transplantation
Peritonitis ----------> NO hyperK+
----------> metabolic acidosis
Postero-Inferior M.I. ----------> atrio-ventricular bloc
Myocarditis , Rheumatic fever ----------> 1 or 2 degree AV block
HTN ----------> NO AVBlock
R/O pneumonia ----------> right superior lobe consolidation ----------> Klebsiella Pneumonia
associated with asbestosis ----------> Mesothelioma
pt on coumadine ----------> prolonged PT time ----------> transfusion of fresh frozen plasma
metastasis at time of diagnosis ----------> small cell carcinoma
Brucella ----------> granulomatous lesions
scarlet fever ----------> glomerular Nephritis
Thallasemia minor ----------> HypoChromic MicroCytic
Vitamin K ----------> production of ProThrombine
poisoning pt ----------> lying face with head lower than hips
TIA ----------> regression in 24 hours
Prophylaxis againt recurrence of Rheumatic ----------> Penicillin
NOT a liver function test ----------> acid phosphatase
increased peripheral resistance ----------> elevation of mean blood presure
Herpes Zoster ----------> sensory nerve
Pulmonary calcifications ----------> HistoPlasmosis
Trt of microcytic anemia of chronic blood loss ----------> FeSO4
Dg of PheoChromoCytoma ----------> Urinary catecholamines
Streptococcus hemolyticus ----------> Erysipelas
m.c.c. of HTN ----------> Essential HTN
complications of asthma ----------> COPD , hypoxemia , hypercapnia
Dg of anginal Sd is best by ----------> History
urgent equilibration of rehydration ----------> HyperOsmolar coma
essential complication of Thiazide diuretic Trt ----------> HypoK+
Dg of Streptococcal Pharyngitis ----------> History , clinical , Throat culture
Bacteroids ----------> Septic Shock
syphilis may be communicable ----------> up to 4 years after acquiring the disease
MOST laboratory findings that confirm primary HyperParaThyroidism ----------> increased urinary Phosphorus
over 6 months period : bloody cough , dyspnea , wheezing , fever , ----------> Primary cancer of the lung
positiv tuberculin test ----------> Hypersensitivity to TB bacillus and its products
moderate leucopenia is MOST characteristic of ----------> Brucellosis
20 - 30 y active males ----------> Rheumatoid ankylosing spondylitis (Marie - Strumpell disease)
HypoParaThyroidism ----------> Cataracts
hepatocellular insuffisiency ----------> PT , Fibrinogene , amonemia ,
typical acute post tonsillitis glomerulonephritis ----------> recovery is usual
Nephrotic Sd is most usually caused by ----------> renal amyloidosis
characteristic of rheumatic heart fever ----------> Fever , rash , migratory joint pain
uremia ----------> elevated of serum amylase
serum amylase is not elevated in ----------> Chronic pancreatic insufficiency
organic heart disease ----------> atrial flutter
interstitial pulmonary fibrosis ----------> clubbing fingers , weight loss , crepitant rales
Sudden onset of optic or retrobulbar neuritis ----------> Multiple Sclerosis
PT <> Fulminant Hepatitis
Normal ECG does not exclude the diagnosis of ----------> Ischemic heart disease
most sensetive test in confirming HypoThyroidism ----------> TSH
tetany , 170/100 , polyuria ----------> adrenal cortex
most damaged during nephrotoxicity ----------> proximan tubule
NO steatorrhea in ----------> Pellagra
no healing prepyloric stomach ulcer after 8 weeks of Trt ----------> Laparotomy with gastric resection
recto colic high risk pt ----------> Total Colonoscopy ----------> early prevention
m.c. metaboloc complication od Diabetes type 1 ----------> HypoGlycemia
Typhoid fever ----------> positive blood culture ----------> first week
CO2 90 in O2 tent ----------> immeduate removal from the tent
trt of M.G. ----------> Neostigmine
decrease in XRay size of Gastric ulcer under Trt ----------> Gastroscope pt for cytology
Trt of osteomyelitis ----------> 3 months
Gas gangrene ----------> clostridium perfringens
-prostatic adenoma
-prostatin cancer
-bladder cancer ----------> Pollakiuria
-ureter lithiasis
No Pollakiuria in ----------> PyeloLithiasis
Atypical Pneumonia ----------> Mycoplasma Pneumonia
Trt of Primary Hypogonadism ----------> Testosterone
hypophysis adenoma ----------> Papillary edema , diabetes insipidus
indication of severity of G.I.Bleeding ----------> Hb
NO dyspagia in ----------> oesophagal varices
cervical diverticulosis ----------> Dysphagia
m.c. complication of colic diverticulosis ----------> Abscess
Heparin ----------> Osteoporosis , Alopecia , Allergic rash ,
circulatory arrest + AV Block ----------> Isuprenaline
digitalis intoxication ----------> AV Block 2d degree , ventricular tachycardia , vomiting , bigeminal venttricular ES
No depression (?)
Hyper Amylasemia
Hyper Amylasuria
increased BUN ----------> acute pancreatitis
Hypo Ca+

Adrenal gland calcification ----------> TB ----------> adrenal insufficiency
ITP ----------> Steroids ----------> increase the dose if no response
Trt of Torsade-de-pointe ----------> temporary PaceMaker , IsoProterenol , IV Mg,discontinue quinidine
FEATURE OF MI ----------> MITRAL REGURGITATION
No LADP in ----------> M.M.
- Nausea
- Vomiting ----------> acute intermitent porphyria , familial hyperlipidemia , diabetic ketoacidosis
- abd pain
asthmatic with PaO2 : 68 mm Hg ----------> admission
chemoprophylaxis for meningococcemia ----------> Rifampin
Trt of HyperKalemia ----------> Calcium Gluconate
HIV ----------> cerebral toxoplasmosis , dementia
Trt of carbon Monoxyde poisoning ----------> 100 % Oxygen

Internal Medicine Examination

canNOT aggravate syptoms of urination in Prostatic Adenoma ----------> alpha-blokers
not found in Nephrotic Sd ----------> Hyper Amylasemia
ClindaMycin ----------> PseudoMembranous colitis ----------> bloody diarrhea + fever 40' C
Trt of Chlamidya Trachomatis ----------> Erythromycin
duration of action of ordinary insulin ----------> 6 hours
in Septic Shock ----------> no important peripheral vasoplegia
Proteinuria ----------> can NOT be determined by Urine Analysis
Spironolactone (diuretic) ----------> Gynecomastia
age > 70 y
addiction
pregnancy ----------> False (+) VDRL
disseminated Lupus
connectivitis
Colchicine ----------> No Pericarditis
streptococcal angina ----------> sudden onset
Bullous impetigo ----------> Staphylococcic lesion
adrenal failure ----------> HyperCalcemia
acromegaly ----------> No HyperCalcemia
Vertical heart
hilar overcharge ----------> Radiologic signs of emphysema
low diaphragm
increase of retrocardiac clear space
PheoChromocytoma ----------> Paroxysmal event , orthostatic HypoTN
complement deficiency ----------> recurrent neisserial infections
protein calory malnutrition ----------> disseminated herpes simplex
physical exercise ----------> can NOT decrease cholesterol level
most sensitive for bony metastasis Dg ----------> technetium bone scan
large volume of alchohol is needed for ----------> achieving desired effect
inadequately treated A beta-hemolytic streptococcal infections ----------> Rheumatic fever , Rheumatic heart disease
low socioechonomic status ----------> increase the incidence of RF , RHdisease
low back pain + urinary retention ----------> acid phosphatase
early finding in Primary Biliary Cirrhosis ----------> Pruritis
TB ----------> Pulmonary ----------> Hematological spread ----------> GenitoUrinary TB
HypoThyroidism ----------> impotance
Trichinosis ----------> Parasitologic stool test ----------> eggs parasite
Heterogenous pic on XRay in superior segment of the inferior lobe ----------> TB
Nephritis ----------> leg edema
Motor Paralysis within 24 h ----------> Clostridium botulium toxin
incubation period of measles ----------> 10 days
M.G. ----------> no genetic predisposition
Trt of etiology ----------> Thymectomy on a yourng patient
best screening test for Hemophilia ----------> Partial Thromboplastin Time P T T
Plasmodium vivax ----------> Paludism ----------> may cause relapses
Migratory ThromboPlebitis -------> Neoplasm
HypoThyroidism -------> impaired memory , loss of hair
NO Systemic HypoTN
Mitral stenosis -------> RVF but not LVF
Trt of Goitre with Eltroxine -------> decrease the size of the gland
Trt of HyperThyroidism -------> Propanolol
acute epglotitis -------> Hemophilus influenza
initial management ot Tetanus -------> ventilation , Ig , ATB , Sedation (Benzodiazepines).
ethanol withdrawal Sd -------> delirium tremens -------> 3 - 5 days
MI -------> frequent ventricular ectopy -------> Lidocaine
Toxoplasmosis -------> muscle pain , irregular low fever
schizophrenia -------> symptoms at least for 6 months.
B Thalassemia -------> High transfusion -------> desferroxamine
Trt of Infectious Mononucleosus -------> Bed Rest
2 h after MI BP:85/52 P:40 -------> IV Atropine sulfate 0.6 mg
PO2 148 mm Hg and PCO2 106 mm Hg -------> intubation and ventilation
6 biopsies and brush cytology -------> no malignancy -------> Benign Gastric Ulcer
most useful -------> FEV1
Bronchiectasis -------> Amyloidosis
Typhoid Fever -------> self limited in 4 - 6 weeks
Trt of Brucellosis -------> Tetracycline and Streptomycin
serum TG = 1500 -------> Na + = 115 mEq/l
Sub-Acute infective EndoCarditis -------> @ hemolytic Streptococcus
O2 Therapy is NOT useful in -------> Cyanide poisoning
renal cancer -------> fever of long duration
first sigh of diabetic retinal blindness appears after -------> 5 years of the evolution
treatment is NOT by early Laser
I V slowly adrenaline -------> anaphylactic shock
coeliac disease -------> glutene intolerance
early complication of MI -------> arrythmias -------> death
digestive cancer metastasis -------> Liver
necrotic pulmonary tuberculosis lesion -------> Caseous
PheoChromocytoma -------> cold sweating
metastasis is responsible for -------> death
Pulmonary manifestations of Rheumatoid arthritis -------> effusion ,nodular lung, fibrosis
it can not give -------> Pulmonary Hg
Giant cell arteritis -------> PolyMyalgia Rheumatics
No convulsions
Leukocytosis is not a constant finding in -------> acute Lymphoid Leukemia
No bone marow failure in -------> HyperSplenism
proteine restriction -------> slow the progression of renal failure
type 2 HyperLipidemia -------> autosomal dominant
dog bite with cellulitis -------> Penicillin
Staphytlococcal food poisoning -------> heat stable enterotoxin
3d day :maculopapular rash -------> Infetious Mononucleosis
adult polycyctic kidney disease -------> HTN -------> Echo
Upper GI bleeding , decrese fluid intake -------> increase BUN
highest way of droplet spreading -------> sneezing
BCG is contraindicated in -------> immunosuppressed people
most common anemic parasitose -------> Ankylostorma
after URI -------> abdominal symptoms + low blood presure -------> addison
ESR increased in -------> Brucellosis , staphylococcus septicemia
ESR decreased in -------> Thypoid fever
Pneumonia ----####---> no Plasmodia
no significance in polyuric patient -------> serum creatinine
best criteria for deciding Insulin -------> decrease of Cpeptide blood level
PRBCs -------> with NSS
Cor Pulmonale in Chronic bronchitis and Emphysema -------> Home low flow O2
HyperK+ -------> decrease in Pwave, peaking Twave, prolonged PR , widened QRS
worst pg sign in acute asthmatic attack -------> Cyanosis
Trichinosis -------> Diaphragm
in Cryptococcus neoformans meningitis ---###----> LP doesn't give purulent liquid
Ascitic fluid in Cirrhosis -------> specific gravity less than 1.016
Prolonged hyperventilation doesn't give ---###----> : HyperKalemia
-------> Paresthesia , Tetany , Low HCO3-,Palpitations
ankylosing spondilitis -------> Aortic incompetence,Amyloidosis,
family history with medullary carcinoma -------> VMA , calcitonine, Ca+, pentagastrin,
No need to -------> serum Gastin
to have melena -------> 50 cc
varicella predominats at -------> the trunck
2 doses of measles vaccinations -------> 12 - 15 months ; 4 - 6 years
in Heart Failure increased Estrogen -------> fluid retention
petechial Hg in the upper thorax (after 48 h) -------> Fat Embolism Sd
late complication of 131i trt -------> HypoThyroidism
No Myocarditis in -------> Toxoplasmosis
interstitial pneumonia with foamy intra-alveolar exudate -------> Pneumocystis carinii
adult fluid maintenance requirement -------> 30 ml/kg/day
absense of Thymus is not a characteristic of -------> Myastenia Gravis
no serologic markers of HBV infections -------> Hepatitis B vaccine
recurrent OroPharyngeal lesions -------> Herpes 1
recurrent abdominal pain -------> Hyper Para Thyroidism
Untakable B.P with rapid pulse -------> IsoGroup Fresh Blood
contracted blood volume in -------> PheoChromoCytoma
Hypovolemic Shock Improvement -------> > 30 cc/h
most frequent virus that cause meningitis -------> Enteroviruses
treatment of Hyperkalemia -------> resin cation exchange
the biological characteristic of the pleural effusion in Pancreatic pleurisy -------> elevation of Amylase
best way to diagnose a pulmonary solitary nodule -------> CT Scan
HypoCalcemia -------> Alkalosis and Myocardial Depression
quarantine is impractical in measles
Vibrio cholera -------> inhibits Na+ transport
Abdominal Aortic Aneurysm -------> Abdominal Ultrasound
Neoplastic pleural effusion -------> Hemorrhagic
Parasitologic stool test -------> Trichinosis
Gastro-Enteritis after eating a pork -------> CBC and muscle biopsy
Percutaneous Cyto-Puncture -------> the least diagnostic way for Dg of Pancreatic cancer
Gouts rarely affects -------> the shoulder
In A.I.D.S. Mycoplasma Pneumonia doesn't give a pulmonary infiltrates.
Colon cancer -------> no bone metastasis
Necrotising Enterocolitis -------> PneumoPeritoneum
most specific -------> CPK - MB
eggs eliminated by a sheep -------> Hydatic Cyst
Headache is the only sign of -------> Cryptococcus Meningitis
the first sign of Scleroderma -------> Raynaud's Sd.
Scleroderma -------> Oesophagal Dyskinesia.
early treatment of Raynaud's Sd cannot stop the evolution of the disease .
Diagnosis of Scleroderma -------> Skin Biopsy
Subtotal or total atrophy of intestinal villosity --------> Diabetes, immunoglobulin defficiencies, coeliac disease, Psoriasis, neomycin intake.
Herpetic lesion more than one month --------> A.I.D.S.
most common treatment type of lung abcess is --------> Medical trt (Penicillin or Clindamycine for 4 weeks).
Bleeding duodenal ulcer --------> Gastro-duodenal artery
long bone fractures ---------> fat embolism
post-op ------> Benign post op cholestasis.
traumatic hypovolemic shock ------------> increased blood viscosity
Unconsious man ----------> ABG's
Bacterial endocarditis --------> hematuria ,Normocytic anemia

Medical Knowledge

downware adjustment of Digoxin with ------------> verapamil , quinidine , amiodarone , erytromycin
but not with metoclopramide
normal mean pulmonry artery wedge pressure at reat ------------> 1 - 10 mm Hg
Parkinson disease ------------> L - Dopa ------------> amelioration of HypoKinesia
IV amphetamine abuse ------------> necrotizing vasculitis
peptic ulcer ------------> Trt : sucralfate ------------> binding to granulation tissue
Trt of hyperLipidemia with fibric acid derivative ( Clofibrate ) ------------> for very high LDL cholesterol level
decrease the anti coagulation effect of Warfarin / coumadin ----------> Rifampicin
PRINCIPAL sensory relay station ----------> thalamus
after fat digestion and absorption the bile is ----------> excreted in the urine
excessive doses of acetylsalicylic acid can NOT produce ------------> HypoThermia
infected nails ------------> Strepto
lymphocytes are NOT existent in ------------> Suppuration
BCG vaccine ------------> avirulent bacteria
Acute Amebic Dysentery ------------> direct smear of stool
indicated for a pt sensitive to Procaine ------------> mepivacaine
Amphotericin B ------------> Trt of Fungi
PhenylButazone ------------> Bone marrow depression
combined oral contraceptives ------------> produce endometrial changes resembling pregnancy
------------> contains estrogen and progestin
cortisone ------------> no antipyretic activity
does not respond to penicillin therapy ------------> candida albicans
Respond to penicillin Trt ------------> Gonococcus neisseria
ACE inhibitors ------------> HyperK+
SupraInfection
PhotoSensitivity ------------> Side effects of TetraCycline
GastroIntestinal Symptoms
TetraCycline Side effects ------------> No Vestibular Disturbances
teratogenic ------------> anti cancer drugs
Aspirin ------------> increase Uric acid urinary excretion
Sulfonamides
amphotericin B ------------> High rate of allergenicity
Penicillin
cross allergenic with Penicillin ------------> Cephalexin
Somatoform pain disorder ------------> disproportionate to the physical lesions

Internal Medicine Notes

prophylaxis in dental procedure ------------> Penicilline
pericarditis ------------> elevated ST segments in all 3 satndard leads
in the Trt of cardiac arrhythmias ------------> Phenytoin , Procainamide
migratory polyarthritis
spasmodic muscle twisting ------------> rheumatic fever
chorea
long standing peptic ulcer ------------> iron deficiency anemia
Addison's disease (autoimmune) ------------> adrenal cortex
B12 dficiency ------------> glossitis , bone marrow hyperplasia, achlorhydria , spinal columns degeneration
breast cancer ------------> jaw metastasis
Ludwig's angina ------------> oro-pharyngeal lesions
poorly controlled D.M. ------------> mucormycosis ------------> necrotising palate lesions
Glycosides ------------> decrease : edema , HR , Heart size , residual volume
Systolic bruit in the midepigastric area ------------> abdominal aorta
spontaneous fracture of the femur ------------> Sprue Sd
Brucellosis ------------> through ingestion OR the skin ,
cow , goat , pig
agglutinin titer 1:500 ------------> compatible with Atypical Viral Pneumonia
scarlet fever ------------> A Streptococcus toxin
metastasis of femoral osteosarcoma ------------> Lungs
sequella of A Streptococcus ------------> Rheumatic fever
post-infectious complications by A Strepto ------------> ARF , AGN
Acute Bacterial Endocarditis ------------> heart valve vegetations ------------> platlets + fibrin + bacteries
Mycoplasma , candida albicans ----------> Urethritis
injection of Iodine product ----------> could aggravate Renal Failure
recurrent urinary infections
Extra Cellular Dahydration ----------> Skin Fold Sign
Trt of labil HTN in a young pt ----------> Acebutolol (Sectral)
Leukemia ------------> Chemotherapy ------------> oral infection ------------> Candida albicans
disturbance in the metabolism of Purine ------------> Gout
in CRF ----------> Normocytic anemia
diuretics Trt ----------> CRF decompensation
in Nephrogenic Diabetes Insipidus ----------> HyperNa+ (decrease volemia)
Negative Arginin - Vasopressine test ----------> Nephrogenic Diabetes Insipidus
tonsillitis ----------> IgA glomerulonephritis ----------> Macroscopic Hematuria
incubation period of gonorrheal urethritis ----------> 5 days
No inguinal ADP in Gonorrheal urethritis
HypoNa+ ----------> too much water , rather than decrease Na +
HypoNa+ ----------> Nausea
Heparine -------> Thrombocytopenia
contrast venography -------> most effective way to demonstrate the blood clot area
NON-tender superficial varicosities -------> Deep venous insufficiency
Painful tender cord -------> Superficial thrombophlebitis
Trt of superficial thrombophlebitis -------> NSAIDS
LMWH -------> No laboratory monitoring
primary degenerative brain disease -------> Dementia
Vit B12 and B1 -------> treatable dementia
most common cause of Dementia -------> Alzhimer
Delirium = acute dementia
depression = pseudo-dementia
Trt of Hirsutism -------> Spironolactone
CRF -------> bone pain , metalic taste
No edema in -------> CRF
urine analysis -------> hyaline casts -------> pre / post renal failure
Nephrotic Sd -------> HypoAlbuminimia -------> platlet aggregation -------> Thrombosis
Nephrotic Sd -------> urinary wasting of AntiThrombine 3 , hyperUricemia , HyperLipidemia , Functional RF,salt and water retention ,
Vomiting -------> increase aldosterone -------> hypoK+
Diarrhea and Diuretics -------> HypoK+
HypoK+ -------> glucose intolerance , weakness and paralysis , polyuria ,
insulin -------> Glucose and K+ into cells
Thiazidic diuretics -------> HypoK+
dermatomyositis ------------> muscle pain and butterfly rash !

Na+ HCO3- ------------> HypoKalemia (Trt of HyperK+)
frequently on mucus membranes ------------> Candida

Internal Medicine Test

flaccid paralysis
footdrop ------------> ALS
fasciculation
denervation of the lower motor neuron ------------> ALS
denervation of nerve 12 ------------> tongue fasciculation
confirmatory of ALS ------------> muscle biopsy ------------> denervation , reinnervation
atrophy of the calf muscle in children or young adulte ------------> demyelinisation ------------> Charcot-Marie-Tooth disease(peroneal muscle atrophy)
Upper RTI ------------> ascending paralysis ------------> Guillian-Barre Sd
M.G. ------------> impaired cholinergic transmission ------------> begins in ocular muscle
Spinal Muscle Atrophy SMA ------------> infantile ALS
(Werdnig Hoffman disease)
S2 is widely slipt in ------------> large ASD
bicuspid aortic valve ------------> aortic stenosis
systolic murmur at 2d left intercostal space
ejection click ------------> congenital pulmonary stenosis
machinary like murmur ------------> PDA
m.c. porphyria ------------> Porphyria Cutanea tarda
predisposing factor for PCT ------------> Hepatitis C
acute intermittent porphyria ------------> abdominal pain
after sunlight exposure:
photosensitivity
pain ------------> Erythropoetic porphyria
sweeling
auto immune disorder ------------> perncious anemia
exclamation hairs ------------> alopecia areata
trichotillomania ------------> Psychiatric consultation
most common form of allopecia ------------> androgenic bladness ------------> Trt: Minoxidil (temporary hair regrowth)
oral contraceptive
surgery or infection stress ------------> alopecia telogen effluvium (on combing or shamponing) ------------> Trt : oral iron sulfate
pregnancy
severe malnutrition
home Trt of mild diverticulitis ------------> Cephalexin 250 mg QID
seriously ill with diverticulitis ------------> IV ATB and Surgery 20 %
barium enema ------------> confirms the Diverticulae
m.c.c. of Temporal hemianopia ------------> pituitary Macroadenoma
occipital lobe Meningioma ------------> homonymous hemianopia
astrocytoma (glioma) ------------> ipsilateral eye
Myopia and cataracts are the 2 m.c.predisposing factors of ------------> Retinal detachment
m.c. clinical manifestations of HSV 1 ------------> GingivoStomatitis and Pharyngitis
HSV1 ------------> cervical ADP
commensales of GI tract ------------> actinomyces israelii
small white papules surrounded by a red halo in posterior pharynx ------------> Coxsackie virus
Nocardia asteroids ------------> most often in the lung (draining purulent materials)
HP ------------> gastric cancer , gastric lymphoma
original Trt of HP ------------> Bismuth ,Tetra , metro
alternation metro with ------------> amoxicillin ,
urea breath test ------------> until 4 weeks after the regimen
acidosis ------------> HyperKalemia (protons into cells and potassium out)
hypoCalcemia ------------> prolonged QT intervals
QT intervals depends on ------------> heart rate
PseudoNormaliztion of T wave ------------> ischemic attack
U waves ------------> HypoK+ ------------> arrythmias ------------> urgent Trt
alcohol ------------> nocturnal headache 30 ' - 2 hours for 8 weeks / 1 year ------------> cluster headche
O2 , sumatriptane , ergotamine
worsen headache in the morning ------------> Depression headache
ESR is elevated in ------------> Giant cell arteritis
Sarcoidosis ------------> NonCaseating Granuloma
X - Ray Grade 3 of Sarcoidosis ------------> Honey-combing pulmonary fibrosis
Trt of choice of Sarcoidosis ------------> GlucoCorticoids (Prednisone 30 - 40 mg / day)
ACE in Sarcoidosis is ------------> elevated
NO Trt with ACE inhibitors
most common form of GlomeruloNephritis ------------> IgA Nephropathy (Burger disease)
Hemoptisis and NEPHRITIC Sd ------------> Goodpasture Sd
Nephritic Sd
Palpable purpura
Arthralgias ------------> Henoch - Schonlein purpara
abdominal pain
Group A Streptococcal pharyngitis or impetigo ------------> Post Infectious Gromerulonephritis
Necrotising Granulomatous vascutitis of UR system and Kidney ------------> Wegener granulomatosis
m.c.c. of primary HypoThyroidism ------------> Hashimoto disease
silent lymphocytic thyroiditis ------------> postpartum women
Iron deficincy anemia ------------> TIBC increased , Ferritine decreased
Anemia of Chronic disease ------------> TIBC decreased , Ferritine increased
Microcytosis ------------> Iron deficincy anemia , Anemia of Chronic disease
Chloramphenicol ------------> Aplastic Anemia ------------> LOW RETI COUNT , Bone Marrow Biopsy : HypoCellularity
Pyridoxine deficincy ------------> Microytic HypoChromic Anemia
Thiamine deficincy , malnourished alcoholics -----------> megaloblastic anemia
IntraMuscular repletion is ------------> required
a mole with a diameter greather than 0.6 cm ------------> Excisional Biopsy
m.c.c. of death due to skin malignancies ------------> Melanoma
common warts
genital warts ------------> Podophyllum resin , liquid nitrogen ,
seborrheic keratosis
non pigmented lasions
Basal cell carcinoma ------------> Shave Biopsy
Giant congenital nevi ------------> incisional biopsy
Pleuritic chest pain in Pneumonia ------------> Bacterial infection
Moraxella catarrhalis ------------> Gram Negative Diplococci (Pneumonia in : elderly , Chronic Bronchitis , Obstructive lung disease)
Klebsiella ------------> G( - ) rods ------------> nosocomial pneumonias (...nursing homes)
Staph Aureus ------------> G ( + ) cocci
HDV causes hepatitis only in ------------> the presance of HBsAg
Anti-HGV antibodies ------------> IV drug abusers , hemodialysis
Traveler's diarrhea ------------> entero toxigenic Escherichia coli
Bacillus cereus (NO FEVER)
Clostridium perfringens (NO FEVER) ------------> m.c. agents of food poisoning
Staph Aureus (NO FEVER)
E.coli (NO FEVER)
Rotavirus ------------> diarrhea in enfants and young children
mitral valve prolapse ------------> Asymptomatic / sometimes : chest pain , dyspnea , palpitations
most frequent type of congenital defect of Aorta ------------> bicuspid aortic valve
infective endocarditis ------------> ruptured papillary muscle
systolic murmur increase during inspiration ------------> Tricuspid Regurgitation
m.c.c. of Tricuspid regurgitation ------------> RV overload
aleukemic leukemia ------------> AML
pathognomonic of AML ------------> Auer rods
disease of children age ------------> ALL
pathognomonic to ALL ------------> TdT (terminal deoxynucleotide transferase)
leukocytosis 500 000 ------------> CML
Philadelphia chromosome ------------> CML
Leukemoid reaction ------------> leukocytes never exceed 50 000
MyeloDysplastic Sd ------------> HyperCellular bone marrow + Cytopenias
at least 2 cells lines are affected
disc herniation ------------> conservative management , NSAIDs , 2 days
Osteomyelitis or bone metastasis ------------> Radionuclide bone scan
tumors of infections ------------> Plain radiographs
most patient with IgA deficiencies are ------------> asymptomatic
(recurrent RTI)
Selective IgA deficiencies ------------> anaphylaxis to IgA ------------> hives after 10 ' of blood transfusion
Adenosine deaminase deficienciy ADD ------------> severe combined immunodeficiencies
Ataxia Telangiectasias ------------> immunodeficincies
DiGeorge Sd ------------> HypoParaThyroidism , thymic aplasia , deficient T cell function
Wiskott Aldrich Sd ------------> Thrombocytopenia , Lymphopenia , atopic eczema
Bleomycin ------------> cough and dyspnea ------------> Pneumonitis ------------> Pulmonary fibrosis
Cisplatine ------------> Tinitus , hearing loss , NephroToxicity
Mithramycin ------------> Hemolytic Uremic Sd , Thrombocytopenia , hepatotoxicity , Nephrotoxicity
Verapamil ------------> headache , dizziness , nausea ,
Vincristine ------------> Neuropathy
Dicloxacillin ------------> X staph , X strepto ------------> Trt of Impetigo
Penicillin G ------------> X Streptococci
Penicillin V
Staph ------------> beta-lactamase ------------> break the Penicillin
Vancomycin ------------> reserved for beta-lactamase resistent
Clarithromycin ------------> RTI , skin infection , Prophylaxis for Mycobacterium avum
Benzotropine ------------> prophylaxis of ExtraPyramidal symptoms
Diazepam ------------> anxiety disorder
Fluoxetine ------------> depressive illnesses
Lithium ------------> bipolar disorder