Vinartmodel

Fetal hydantoin syndrome - D/t use of phenytoin or other anti-epileptic (*valproic acid, carbamazepine*), which can cross the placenta, generating *low folate* and high oxidative metabolites. Results in *cleft lip and palate, wide anterior fontanelle, distal phalange hypoplasia, cardiac anomalies, neural tube defects, microcephaly*, causing developmental delay and poor cognitive outcomes. Of these risks, *neural tube defects* is the *greatest*. Fetal alcohol syndrome - Can present w/ mi...

65 yo F has a 3 month hx of *increasing low back pain*. Had low back pain for past 3 yrs that's been treated w/NSAIDs and codeine. Now rated as 7/10 in severity. Pain radiates to both legs, worsens when walking or standing & Relieved when sitting. 1 YEAR AGO: X ray lumbosacral spine: mild osteoarthritis. Exam: 4/5 mm strength LE, hyporeflexia of knees&ankles b/, unsteady gait b/c of pain. No other abnormalities. Most appropriate diagnostic study of lumbosacral spine to order at this time? - *MR...

Abdominal pain, ascites, hepatomegaly, (also high D dimer, CHF without JVD) - Budd-Chiari syndrome Achilles tendon xanthoma - Familial hypercholesterolemia Adrenal hemorrhage, hypotension, DIC - Waterhouse-Friderichsen syndrome (meningococcemia) Arachnodactyly, lens dislocation, aortic dissection, hyperflexible joints - Marfan's (fibrillin defect) Athlete with polycythemia - Erythropoietin injection Back pain, fever, night sweats, weight loss - Pott's (TB to the vertebrae) Bi...

A 25-year-old man comes to the physician because of persistent, high-pitched ringing noises in his ears. He has also been losing his balance lately. A CT scan of the head shows bilateral tumors involving the vestibulocochlear nerve. Which of the following chromosomes contains the tumor suppressor gene most likely to be involved in this case? 3p 5q 13q 17q 22q - E)22q The patient has bilateral acoustic neuromas, probably due to neurofibromatosis type 2, an autosomal dominant inheri...

Night incontinence without urge = - overflow incontinence (T2DM) Alcoholic cirrhosis AST/ALT, ALkPhos, GGT, bili, PT, albumin - AST/ALT 2:1 (not >500) AlkPhos mildly elevated GGT very elevated bilirubin elevated (conjugated > unconjugated) +/- bandemia, thrombocytopenia increased PT decreased albumin Who gets pneumococcal vaccine? - >65 immune compromised (cirrhosis) HTN emergency medication - nitroprusside hyphema - blood in anterior eye hypopyon - inflammatory ce...

3 yo M has a 8 day hx of 3-4 daily episodes of soft, *foul-smelling diarrhea*. Increased belching & Flatus, decreased appetite but drinks liquids without difficulty. 6 yr old sister has same sx. Fam went on cruise to Mexico last month so he tried new foods and went swimming at beach&in cruise ship pool. Went on wkd camping trip 3 wks ago and ate the fresh fish. After vacation, he went back to reg diet fruits, veggies 7 meats. P 108, hyperactive bowel sounds. negative stool occult blood. CAUSE of...

Skin rash and itching worse at night, mostly between fingers. Treatment? - topical permethrin for scabies 41yo M with fever, dysuria, pyuria and bacteruria. Next step in management? - perform DRE - must distinguish between UTI and prostatitis - prostatic warmth, tenderness, edema, boggyness suggests prostatitis 3yo girl, mother is not sure when she ingested coin. Next step? - flexible endoscopy - if ingestion time <24hrs and asx, observation and repeat xrays in 12-24hrs to ensure coi...

Wide pulse pressure and bounding peripheral pulses - PDA Echo findings in dilated cardiomyopathy - Diffuse hypokalemia and dilation of the ventricles Causes of dilated cardiomyopathy - Viral illness, alcohol, ischemia Tx for life threatening hyperkalemia - Calcium chloride or calcium gluconate X-ray finding doe ankylosing spondylitis - Narrowing or sclerosis of the SI joints Cause of amenorrhea is bleeding occurs after progesterone challenge - Anovulation Treatment for SIADH - ...

A 12-month-old girl has been spitting up her meals since 1 month of age. asymptomatic and without findings on physical examination. - Diagnosis: GERD is a common pediatric complaint, often seen in the first 1 to 2 months of life and resolving by 1 to 2 years of age. For children w/ NO respiratory symptoms attributed to reflux, small feeds, avoid high-fat meals are enough. -medication or surgery only seen in rare cases. jaundice - skin and the the sclera of the eye turn yellow due to excess b...

A 25-year-old woman has a 3-day history of vomiting and diarrhea. She has postural hypotension and poor tissue turgor. Her serum sodium concentration is 130 mEq/L. Which of the following findings is most likely? - Increased serum ADH (vasopressin) concentration A 52-year-old woman 2-day history of fever and left flank pain. She has been treated for multiple episodes of pyelonephritis. Physical examination shows left flank tenderness. Urinalysis shows WBCwith features of macropha...