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