1. Name the 5 conditions of CHF.

a. CHF occurs in patients with an inherited or acquired abnormality of

cardiac structure or function.
b. Pulmonary edema, cardiac dialation, dyspnea on exertion, orthopnea,
paroxysomal nocturnal dyspnea, (rt side->) hepatosplenomegaly, rt jug.
Vein distension, rt heart failure due to left heart failure, ankle and sacral
edema and cor pumonale
2. Picture of a murmur (murmur and abnormality)
a. Holosystolic with regurgitationabnormality in mitral or tricuspid valve
3. What are the three complications of MI that can lead to death:
a. Cardiac Arrythmia- important cause of death before reaching hospital and
is common in the first few days
b. Cardiogenic Shock- Large infarct with high risk of mortality
c. Free wall rupture leading to cardiac tamponade
d. Pappilary muscle rupture
e. LV failure and pulmonary edema
f. Aneurysm formation
4. Name the three signs of endocarditis:
a. Osler nodes- tender raised lesions on fingers or toe pads
b. Janeway lesions- small erythematous lesions on palms or sole
c. Roths spots- round white spots on retina surrounded by hemorrhage
d. Splinter hemorrhage- on nail beds
e. Fever
5. What is the normal total cholesterol level?
a. less than 200
6. Normal PSA level?
a. 4
7. Give an example of Prerenal, intrarenal and postrenal?
a. Prerenal= hypovolemia or decreased renal perfusion
b. Intrarenal= acute tubular nephritis
c. Postrenal= obstruction or stone
8. Metabolic Syndrome characteristics:
a. abdom obesity (for men a waist size of 40 inches or more and for women
a waist size of 35 or more.) triglyc. Levels. Blood Pressure. Over 130/85,
HDL level less than 40 for males and less than 50 for females
9. Why is progesterone important:
a. Secreted by corpus luteum, placenta, adrenal cortex testes
b. Stimulates endometrial glandular secretion
c. Helps with maintenance of pregnancy and increases body temp
d. Inhibits gonadotropin (LH and FSH)
e. Uterine Smooth Muscles relaxation (preventing contraction)
f. Produces a thick cervical mucous which inhibits sperm entry into the
uterus
10. Whats the best treatment for enuresis (bedwetting in children):
a. Behavior Modification and then imipramine
11. Why are women more prone for infection:
 a. Shorter urethra
12. What is the day of ovulation:
a. Day 14
13. Signs and symptoms of liver cirrhosiscomplications of cirrhosis?
a. Yellowing of the skin (jaundice) due to the accumulation of bilirubin in
the blood
b. Fatigue
c. Weakness
d. Loss of appetite
e. Itching
f. Easy bruising from decreased production of blood clotting factors by the
diseased liver.
g. Gynecomastia, testicular atrophy, anemia, ankle edema
h. Complications: splenomegaly, capud medusa, esoph. Varices leading ot
hemetemesis, hemmhoroids
14. Name 2 diff. between ulcerative colitis and chrons disease.
a. Ulcerative colitis is continuous and involves mostly the rectum and
terminal ileum and Chrons can involve any part of the GI tract and has
skipping leasions and rectal sparingIn chrons you see non caseating
granulomas, strictures and fistulas and in UC you see ulcers, crypt abscess
and there is bleeding involved.
15. Name three conditions associated with H Pylori:
a. PUD, MALT, gastric carcinoma (intestinal and diffuse), Type B chronic
gastritis
16. Rovsing's sign-
a. Continuous deep palpation starting from the left iliac fossa upwards (anti
clockwise along the colon) may cause pain in the right iliac fossa, by
pushing bowel contents towards the ileocaecal valve and thus increasing
pressure around the appendix. This is the Rovsing's sign
b. It is a test for appendicitisbasically you apply pressure to the LLQ and if
the patient feels pain or tenderness in the RLQ it is an indication that the
patient may have appendicitis.
17. What is restrictive lung disease? Esp. emphysema and asthma (look at pulm
function chart) (remember in emphysema there is also a increase in tvc and not in
asthma)???
18. What is Barretts esophagus?
a. When you have glandular metaplasia. It is the replacement of non-
keratinized stratified squamous cells with simple columnar epithelium in
the distal esophagus. (Due to Gerd: Gerd presents itself as heartburn and
regurgitation upon lying down and presents with nocturnal cough and
dyspnea) Barrets Esoph. Can end up turning into Adenocarcinoma.
19. What causes Esophagitis besides Gerd?
a. Drug Induced
b. Chemical ingestion
c. Viruses- Herpes Zoster- latent in the sesory ganglia and involves skin lips
and dermatomes
 d. CMV or HSV1 or candida albicans causing oral thrush.
e. Motility Disorders: Achalasia, Scleroderma
20. Why do you do a coronary artery bypass on a patient that had an MI 4 hours ago?
a. less blood flow and less oxygen going to the heart muscles (bc of a
blocked artery most probably the left anterior descending artery).after
four hours of less blood going to the heart coagulation necrosis begins and
you have an increased risk for an arrhythmia and can end up getting a
heart attack or any other serious heart condition if the problem isnt
resolved. (in a cabg the doctor takes a vein or artery from another location
in the body (usually the saphenous vein and uses it to bypass the blocked
artery ensuring adequate blood flow and oxygenation to the heart)
21. Which are the main two signs for MI?
a. Troponin and CKMB
i. Troponin rises after 4 hours and stays for 7-10 days
ii. Ckmb rises after a day or so and then decreases over time (sign for
reinfarc)
22. Pneumonia is AIDS patients with a count of less than 200?
a. Pneumocystis Carini, Cryptococcus Pneumonia, mycobacterium avium
23. What causes cystitis:
a. E- Coli
24. What do you find in potato salad?
a. Staph. Aureus
25. Patients on antibiotics get what?
a. Clostridium Difficile
i. Can happen at any age up to 4 weeks following the anitobiotic use
and forms pseudomembranes
ii. Get fever, abdominal pain, diarrhea, toxic megacolon, (treat with
metronidazole)
26. People that eat hamburgers get?
a. Hemmorhagic Ecoli: 0157:H7
i. Occurs at any age causes hemmhorhagic colitis, hemolytic uremic
syndrome and theres no invasion.
27. What is the most common secondary cause of ammenorhea?
a. Menopause and pregnancy
28. What are the complications of Endometriosis?
a. Endometriosis is non neoplastic endometrial glands/ stroma in abnormal
locatons outside the uterus.
b. Cyclic Bleeding
c. Infertility
d. Adenomyosis- endometrial within myometrium
29. Signs and symptoms of BPH and treatment?
a. Increased frequency of urination, nocturia, dysuria, difficulty starting and
stopping peeing and may lead distention and hypertrophy of the bladder,
hydronephrosis and UTIs.
b. Alpha blocker or Finesteride
30. Signs and symptoms of PE (know at least 5)
a. Rales, fever, edema, cyanosis, heart gallop, chest pain, tachypnea,
tachycardia
31. Urine sediment in glomerulonephritis?
a. Red blood cell cast
32. Know the 7 things in a renal panel:
a. Na, K, bun, creatinine, Cl, bicarb, protein,
33. MCC of PID?
a. N. Gonnorhea or Clamidiya trach.
b. PID occurs when bacteria move upward from a woman's vagina or cervix
(opening to the uterus) into her reproductive organs. Many different
organisms can cause PID, but many cases are associated with gonorrhea
and chlamydia, two very common bacterial STDs. A prior episode of PID
increases the risk of another episode because the reproductive organs may
be damaged during the initial bout of infection.
34. Besides abstinence what is the safest sex practice?
a. Condoms or oral contracept.
35. 3 causes of incontinence. Menopause, overactive bladder, and diabeties
a. Stress- surgical, hormones
i. (intraabd. Pressure adds pressure to the sphincter and causes
people to go pee) also in women going through menopause
ii. Urine loss with straining or exertion (coughing laughing exercizing
associated with pelvic relaxation and displacement of
urethrovesical junction)
b. Total- seen after surgery
i. Continuous leakage due to urinary fistula resulting from pelvic
sugery or pelvic radiation
ii. (give imipramine to relax the bladder)
c. Urge-
i. due to infection or irritation
ii. (feel like you have to void all the time- urine leakage due to
involuntary bladder contractions known as detrusor instability
d. Overflow incontinence
36. What is egophony and when do you see it?
a. Increased resonance of voice sounds heard when auscultating the lungs
indicating lung consolidation and fibrosis indicates pneumonia
b. Ask the patient to say the letter E and if you hear the letter A through the
stethoscope it means there is some type of consolidation present and fluid
present in that specific area. You will see it in a patient with pneumonia.
37. Where do u see a WBC cast?
a. Acute Pyelonephritis.
38. 2 main causes of chronic renal failure:
a. Diabetes and Hypertension
39. What is the treatment best for eclampsia and HEELP?
 a. Deliver the baby asapbed rest, salt restrictionif needed give
magnesium sulfate and diazepam (for seizures)
b. HELLP syndrome is a serious complication of severe pregnancy-induced
hypertension (high blood pressure problems of pregnancy). It occurs in
about 2 percent to 12 percent of women with high blood pressure of
pregnancy. It usually develops before delivery, but may occur postpartum
(after delivery) as well. HELLP syndrome consists of the following
problems:
c. hemolysis - red blood cells break down.
d. elevated liver enzymes - damage to liver cells cause changes in liver
function lab tests.
e. low platelets - cells found in the blood that are needed to help the blood to
clot in order to control bleeding.
40. 3 causes of secondary hypertension
a. Coarctation of the aorta, oral contraceptives, renovascular disease, primary
aldosteronism, sleep apnea, hyperparathyroidism
41. (Metabolic acidosis look at the values given.)
42. Which is an example of gram positive dipplococci?
a. Strep Pneum.
43. Fried Rice?
a. B. Cereus
i. Could happen at any age and causes both vomiting and diarrhea
44. Hepatitis: there are two hepatitis that go together one was the host and one was
the need. (maybe B and D)
45. Hep. A- E know fecal oral?
a. A and E
46. 8 year old has parents in the Himalayas and he has a sub arachnoid hematoma and
needs to be treated? What do you do?
a. You treat the patient because it is a life or death situation.
47. Which is the childhood disease for males that causes sterility and infertility?
a. (maybe cryptochordism?) mumps orchitis.varicocele. (endocrine
problems)
48. What is the most common type of stone? Calcium oxalate. (theres also others like
cysteine, uric acid, staghorns)
49. How do you distinguish something from tb as opposed to any there pneumonia
a. Caseating granulomas and positive PPD. (if secondary then the reinfection
will be in the apex) fever night sweats.
50. why cant u give a patient 100% oxygenation right away- co2 is the drive for
respiration so you need to give o2 gradually.
51. what is the cause for penile stricture- accidental (tearing of external urethra) or
infection
52. What is the test for pancreas? Lipase. And then amylase
53. Risk factors for CVD:
a. Sleep Apnea, Obesity, Diabetes, hypertension, Dyslipidemia, Chronic
Kidney Disease, Primary Aldosteronism, Coarctation of the Aorta,
Thyroid, Parathyroid Disease,Cushings, Pheochromocytoma