usmle Dr Danil Hammoudi 1 Sinoe Medical Association

usmle Dr. Danil Hammoudi 1 Sinoe Medical Association

OSTEOARTHRITIS IS LEAST LIKELY TO BE ASSOCIATED WITH: n 2 ULCERATIVE COLITIS Sinoe Medical Association

OSTEOARTHRITIS ASSOCIATED WITH n n 3 GOUT HEMOPHILIA WILSON’S DISEASE EHLERS DALOS SYNDROME Sinoe Medical Association

AMBIGOUS GENITALIA n 4 ADRENAL HYPERPLASIA Sinoe Medical Association

EYES MUSCLES ABDUCTING EYEBALL n 5 INTERNAL RECTUS Sinoe Medical Association

EXTRINSIC EYE MUSCLES AND ROLE 6 MUSCLE INNERVATION MOVEMENT LATERAL RECTUS ABDUCENS [VI] LATERAL MEDIAL RECTUS OCULOMOTOR [III] MEDIAL SUPERIOR RECTUS OCULOMOTOR SUPERIOR AND MEDIAL INFERIOR RECTUS OCULOMOTOR INFERIOR AND MEDIAL INFERIOR OBLIQUE OCULOMOTOR SUPERIOR AND LATERAL SUPERIOR OBLIQUE TROCHLEAR [IV] INFERIOR AND LATERAL Sinoe Medical Association

EXTERNAL MUSCULATURE OF THE EYE n n 7 LEVATOR PALPEBRAE SUPERIORIS MUSCLES OPEN THE UPPER EYELID ORBICULARIS OCULI, A SPHINCTER LIKE MUSCLE, CLOSE EYELIDS Sinoe Medical Association

STAPHYLOCOCCAL FOOD POISONING: n 8 2 TO 4 HOURS Sinoe Medical Association

KRABBE’S DISEASE n n n 9 GLOBOID CELL LEUKODYSTROPHY ONSET IN INFANT WITH RIGIDITY TERMINAL BLINDNESS DEFICIENCY OF BETA GALACTOSIDASE ACCUMULATION OF GALACTOCEREBROSIDE. Sinoe Medical Association

COBALT IS AN ESSENTIAL COMPONENT OF: n 10 CYANOCOBOLAMIN [B 12] Sinoe Medical Association

HIRSUTISM ARE ASSOCIATED WITH n n 11 ADRENAL TUMOR HYPOTHYROIDISM DANAZAL THERAPY CYCLOSPORINE THERAPY Sinoe Medical Association

INCREASED IN VMA IS USUALLY SEEN IN : n n 12 NEUROBLASTOMA PHEOCHROMOCYTOMA Sinoe Medical Association

LANGHERAN’S CELL HISTIOCYTOSIS CLINICAL FORMS n n 13 LETTER SIWE DISEASE HAND SCHBLIER CHRISTIAN DISEASE EOSINOPHILIC GRANULOMA HASHIMOTO PRITZKER DISEASE Sinoe Medical Association

HISTIOCYTOSIS, LETTERER SIWE DISEASE n n n n 14 ONSET IN THE FIRST YEAR HAVE SEBORRHEIC RASH OTITIS MEDIA LYMPHADENOPATHY, PURPURA ANEMIA, HEPATOSPLENOMEGALY EXTENSIVE LYTIC SKULL LESION =RAINDROP SKULL UNKNOWN ETIOLOGY WORST PROGNOSIS Sinoe Medical Association

HISTIOCYTOSIS X n INTENSE PROLIFERATION OF RETICULOHISTIOCYTIC CELLS n n n 15 EOSINOPHILIC GRANULOMA HAND SCHULLER CHRISTIAN DISEASE LETTER SIWE DISEASE Sinoe Medical Association

EOSINOPHILIC GRANULOMA: EG -60 -80% OF HISTIOCYTOSIS X -AGE 5 -10 YRS MOST COMMON -BEST PROGNOSIS HAND SHULLER-CHRISTIAN DISEASE -AGE 1 -3 YRS LETTERER SIWE DISEASE -AGE 0 -1 YRS -WORST PROGNOSIS : MORTALITY 70%] -=MALIGNANT FORM OF HISTIOCYTOSIS 16 Sinoe Medical Association

HAND SCHUELLER CHRISTIAN DISEASE n n n n n 17 1 -3 YRS, MOST COMMON HISTIOCYTOSIS FORM SKULL – MANDIBULE LESION SEMILAR EOSINOPHIL GRANULOMAS BUT MORE NUMEROUS GEOGRAPHIC SKULL “FLOATING TEETH” ADENOPATHY HEPATOSPLENOMEGALY SKIN LESION DIABETES INSIPIDUS EXOPHTALMOS LUNG DISEASE Sinoe Medical Association

LETTERER SIWE DISEASE SYNONYMS n n n 18 ACUTE DIFFUSIBLE HISTIOCYTOSIS ACUTE INFANTILE RETICULOENDOTHELIOSIS ACUTE RETICULOSIS OF INFANCY GENERALIZED HISTIOCYTOSIS NON LIPID RETICULOENDOTHELIOSIS Sinoe Medical Association

CURLING ULCER OF THE STOMACH /MARJOLIN OF THE SKIN ARE CAUSES BY: n 19 BURNS Sinoe Medical Association

CEREBROSPINAL FLUID IN VIRAL ENCEPHALITIS SHOWS: n n n 20 VARIABLE PLEOCYTOSIS DECREASED SUGAR LEVEL INCREASED PROTEIN LEVEL Sinoe Medical Association

n n 21 MORE COMMON IN WOMEN THAN IN MEN ASSOCIATED WITH PRURITUS, JAUNDICE, XANTHOMATOUS LESIONS INCREASED ALKALINE PHOSPHATASE AND CHOLESTEROL MITOCHONDRIAL ANTIBODIES AND INCREASED SERUM Ig. M. Sinoe Medical Association

SABER SHIN OCCURS MAINLY IN CHILDREN WITH: n 22 CONGENITAL SYPHILIS Sinoe Medical Association

THE MOST COMMON INTRACRANIAL GERM TUMOR n 23 GERMINOMA Sinoe Medical Association

GERMINOMAS n 24 HIGHLY RADIOSENSITIVE Sinoe Medical Association

TYPES OF GLIOMAS n n n 25 ASTROCYTOMAS EPENDYNOMAS GANGLIOMAS OLIGODENDROGLIOMAS MIXED GLIOMAS Sinoe Medical Association

CHILDHOOD GLIOMAS n n n 26 ASTROCYTOMAS EPENDYMOMAS GANGLIOMAS Sinoe Medical Association

GERM CELL TUMORS [CGTs] n n n 27 GERMINOMAS TERATOMAS CHORIOCARCINOMAS ENDODERMAL SINUS TUMORS EMBRYONAL CARCINOMAS MIXED GCTs Sinoe Medical Association

PINEAL PARENCHYMAL TUMORS n n 28 PINEOBLASTOMAS PINEOCYTOMAS Sinoe Medical Association

PINEAL GLIOMAS n n 29 ASTROCYTOMAS EPENDYMOMAS Sinoe Medical Association

PINEAL NEOPLSMS n 30 5% OF ALL PEDIATRICS BRAIN TUMORS Sinoe Medical Association

OSGOOD SCHLATTER DISEASE USUALLY OCCURS IN CHILDREN AGED n 31 11 TO 13 YEARS Sinoe Medical Association

OSGOOD SCHLATTER n n n n 32 OSTEOCHONDROSIS PARTIAL AVULSION OF THE TIBIA TUBEROSITY, WITH NO INVOLVEMENT OF THE TIBIA PHYSIS COMMON CAUSES OF KNEE PAIN IN ADOLESCENT SWELLING AND TENDERNESS JUST BELOW THE KNEE OVER THE SHIN BONE [TIBIA] MORE COMMON IN BOYS 8 -13 YEARS GIRLS, 10 -15 BOYS GROWTH SPURT AND MAY AFFECT BOTH KNEES , ENLARGEMENT OF THE TIBIAL TUBERCLE. GOES AWAY WITH TIME Sinoe Medical Association

RED SCALY WITH A SHARP RAISED BORDER ON THE PERINEUM , THIGHS AND BUTTOCKS ARE SEEN IN TINEA n 33 CRURIS [JOCK ITCH] Sinoe Medical Association

TINEA CRURIS= JOCK ITCH n n n n 34 ANY ITCHING IN THE GROIN RASH IN MEN WHEN CAUSED BY A FUNGUS = RASH=TINEA CRURIS CAUSE OF TINEA CRURIS= FUNGUS DERMATOPHYTES=RINGWORM FUNGI NOT CONTAGIOUS BILATERAL DO NOT INCLUDE PENIS AND SCROTUM MIGRATE TO THE BUTTOCK AND GLUTEAL CLEFT AREA Sinoe Medical Association

DERMATOPHYTES INFECTION IN TINEA CRURI n n n 35 MICROSPORUM TRICHOPHYTON EPIDERMOPHYTON Sinoe Medical Association

THE MOST COMMON CAUSE OF A VIGINITIS IN A 10 YEARS OLD GIRL IS n 36 FOREIGN BODY Sinoe Medical Association

RETINOBLASTOMA n n n 37 MOST COMMON IN LESS THAN 3 YEARS OF AGE SHOW WHITE CAT’S EYES REFLEX ON FUNDOSCOPY ARE AUTOSOMAL DOMINANT BILATERAL 30% OF CASES ARE THE MOST INTRAOCULAR TUMOR IN CHILDREN Sinoe Medical Association

RETINOBLASTOMA n n n 38 LEUKOCORIA [WHITE PUPIL REFLEX] STRABISMUS EXOTROPIA ESOTROPIA RED PAINFUL EYE POOR VISION , INFLAMMATION TISSUE AROUND THE EYE ENLARGED OR DILATATED PUPIL HETEROCHROMIA FAILURE TO THRIVE EXTRA FINGERS OR TOES MALFORMED EARS RETARDATION Sinoe Medical Association

NOT A CLINICAL FEATURE OF ANOREXIA NERVOSA n 39 HISTORY OF CHILDHOOD HYPERACTIVITY Sinoe Medical Association

ANOREXIA NERVOSA n n n 40 AMENORRHEA BRADYCARDIA ONSET BEFORE 25 YEARS OF AGE Sinoe Medical Association

CHROMOSOMAL ANALYSIS IS USEFUL IN n n 41 TESTICULAR FEMINIZATION GONADAL DYSGENESIS Sinoe Medical Association

42 Sinoe Medical Association

DIFFERENTIAL DIAG OF TINEA CRURIS n n n 43 INTERTRIGO ERYTHRASMA SEBORRHEIC DERMATITIS OF THE GROIN PSORIASIS OF THE GROIN CANDIDIASIS OF THE GROIN Sinoe Medical Association

SINDING LARSEN JOHANSSON SYNDROME n RESEMBLES OSGOOD SCHLOTTER DISEASE, EXCEPT SYMPTOMS LOCALIZED IN THE INFERIOR POLE OF PATELLA n CHRONIC OVERTENSION OF EXTENSOR MECHANISM n PAIN OSSIFICATION DISTURBANCE SWELLING WEAK QUAD REPETITIVE LOADED KNEE FLEXION ACTIVITIES: n LIGAMENT AVULSION n SOFT TISSUE CALCIFICATION n STRESS FRACTURE n n 44 Sinoe Medical Association

OSTEOCHONDROSIS n n n n 45 LEGG CALVE PERTHES DISEASES =CAPITAL FEMORAL EPIPHYSIS KOHLER DISEASE =TARSAL NAVICULAR OSGOOD SHLATTER DISEASE=TIBIAL TUBEROSITY SCHEUERMANN DISEASE=VERTEBRAL RING EPIPHYSES FREIBER INFRACTION =METATARSAL HEAD SEVER DISEASE = APOPHYSIS OF OS CALCIS OSTEOCHONDRITIS DISSECANS Sinoe Medical Association

OSTEOCHONDROSIS DISSECANS n n n n 46 SUBCHONDRAL FATIGUE FRACTURE COMMONLY SEEN IN ADOLESCENT CAPITELLUM OF THE ELBOW KNEE [MEDIAL FEMORAL CONDYLE CLOSE TO FOSSA INTERCONDYLARIS] TALUS MOUSE= OSTEOCHONDROTIC FRAGMENT MOUSE BED= SCLEROSED PIT IN ARTICULAR SURFACE Sinoe Medical Association

SEVER DISEASE n n 47 OSTEOCHONDROSIS APOPHYSIS OF THE OS CALCIS [UNDERGOES FRAGMENTATION] Sinoe Medical Association

FREIBERG INFRACTION n OSTEOCHONDROSIS n METATARSAL HEAD n 2 ND COMMON 3 RD AND 1 ST LESS COMMON INFARCTION OR STRESS FRACTURE LATE ADOLESCENCE A END ARTICULAR BECOMES FLATTENED SMALL OSSICLES MAY FORM AFTER HEALING DJD IS COMMONLY LATE COMPLICATION n n n 48 Sinoe Medical Association

SCHMORL NODE n 49 CHONDRIFICATION DEFECTS WHERE PERIOSTEAL VESSELS PENETRATE CARTILAGE PLATE OF DISC Sinoe Medical Association

KOHLER DISEASE n 50 OSTEOCHONDROSIS OF TARSAL NAVICULAR Sinoe Medical Association

LEGG CALVE PERTHES DISEASE n n n n n 51 OSTEOCHONDROTIS DEFORMANS COXA PLANA IDIOPATHIC AVASCULAR NECROSIS OF PROXIMAL FEMORAL EPIPHYSIS MALE UNILATERAL 4 -8 YRS OLD UNCOMMON BEFORE 3 Y/O SELF LIMITED CAN PROGRESS TO COXA PLANA Sinoe Medical Association

MEDIASTINAL ADENOPATHY IS NOT SEEN IN n 52 IDIOPATHIC PULMONARY FIBROSIS Sinoe Medical Association

MEDIASTINAL ADENOPATHY IS SEEN IN n n n 53 SARCOIDOSIS MILARY TUBERCULOSIS PNEUMOCYSTIS CARNII PNEUMONIA Sinoe Medical Association

ANTERIOR MEDIASTINAL MASSES n n 54 THYMOMA TERATOMA THYROID [ECTOPIC] LYMPHOMA Sinoe Medical Association

MIDDLE MEDIASTINAL MASSES n ADENOPATHY: INFECTION [BACTERIAL, GRANULOMATOUS] n NEOPLASM : LEUKEMIA, LYMPHOMA METASTASES n BRONCHOPULMONARY FOREGUT MALFORMATIONS: n n n 55 ESOPHAGAL DUPLICATION CYST BRONCHOGENIC CYST SEQUESTRATION Sinoe Medical Association

POSTERIOR MEDIASTINAL MASSES n SYMPATHETIC GANGLION TUMORS n n n MASSES] NEUROBLASTOMA GANGLIONEUROMA [95% OF POSTERIOR MEDIASTINAL MASSES NEUROFIBROMAS n NEURENTERIC CYST n EXTRAMEDULLARY HEMATOPOESIS n PARAVERTEBRAL SOFT TISSUE MASS FROM INFECTION n 56 Sinoe Medical Association

BEHAVIOR PSYCHOTHERAPY IS DISTINGUISHED FROM COGNITIVE PSYCHOTHERAPY BY: n 57 THE VIEW OF BEHAVIOR AS A RESPONSE TO THE ENVIRONMENT Sinoe Medical Association

OF ALOPECIA THAT ARE WOOD’S LAMP POSITIVE n n n 58 TINEA CAPITIS DUE TO : MICROSPORUM CANIS TRICHOPHYTON SPECIES [TOSURANS] MICROSPORUM SPECIES FLIORESCE A BRIGHT BLUE GREEN COLOR EPIDERMOPHYTON FLOCCOSUM IS A CAUSE OF TINEA CRURIS Sinoe Medical Association

CANDIDA ALBICANS IS RESPONSIBLE FOR n n 59 ORAL RUSH DIAPER DERMATITIS IN INFANTS Sinoe Medical Association

MUMPS IS A COMMON CAUSE OF: n 60 VIRAL PAROTITIS Sinoe Medical Association

ASSOCIATED WITH EYE PAIN n n n 61 ACUTE ANTERIOR UVEITIS OPTIC NEURITIS ACUTE GLAUCOMA Sinoe Medical Association

CENTRAL RETINAL VEIN OCCLUSION n n 62 SUDDEN, PAINLESS, UNILATERAL LOSS OF VISION IN PATIENTS WITH : 1/HYPERCOAGULABILITY STATE [POLYCUTHEMIA RUBRA VERA] 2/DIABETES MELLITUS 3/ GLAUCOMA Sinoe Medical Association

RETINAL EXAM OF CENTRAL RETINAL VEIN OCCLUSION n n n 63 SWELLING OF THE OPTIC DISC VENOUS DILATATION TORTUOSITY WIDESPEAD RETINAL HEMORRHAGE COTTON WOOD EXUDATE Sinoe Medical Association

HEPARIN n 64 INCREASES EFFECTIVENESS OF ANTITHROMBIN III Sinoe Medical Association

COUMARIN [WARFARIN] n n 65 CAUSE THE PLASMA LEVELS OF PROTHROMBINE, FACTORS VIII, IX, X TO FALL WARFARIN COMPETE WITH VIT K Sinoe Medical Association

AUER ROD n 66 ACUTE MYELOCYTIC LEUKEMIA Sinoe Medical Association

REED STENDBERG CELLS n 67 HODGKIN’S DISEASE MIXED CELLULARITY Sinoe Medical Association

ERB DUCHENNE PALSY n 68 INJURY TO C-5 AND C-6 Sinoe Medical Association

NEUROBLASTOMA n THE MOST COMMON LOCATION n 69 ABDOMEN Sinoe Medical Association

NEUROBLASTOMA n n n 70 IT ACCOUNT FOR 15% OF ALL CHILDHOOD CANCER DEATH 35% OF CASES APPEAR DURING THE FIRST YEAR OF LIFE IT IS ONE OF THE MOST COMMON CHILDHOOD EXTRACRANIAL SOLID CANCER Sinoe Medical Association

CHILDREN WITH NEUROBLASTOMA [THE MOST COMMON CONGENITAL TUMOR OCCURING DURING THE FIRST YEAR OF LIFE] USUALLY PRESENT: n 71 PALPABLE ABDOMINAL MASS Sinoe Medical Association

THE MOST COMMON SOLID MALIGNANT TUMOR IN CHILDREN UNDER THE AGE OF 4 YEARS IS n 72 NEUROBLASTOMA Sinoe Medical Association

PHEOCHROMOCYTOMA AND NEUROBLASTOMA ARE ASSOCIATED WITH INCREASED URINARY n 73 VANILLYLMANDELIC ACID [VMA] Sinoe Medical Association

IN PATIENT WITH NEUROBLASTOMA , THE INCIDENCE OF METASTASES AT TIME OF INITIAL DIAGNOSIS IS n 74 70 Sinoe Medical Association

SCREENING FOR NEUROBLASTOMA IS MADE BY VMA AND HVA [HOMOVANILLIC ACID] 75 Sinoe Medical Association

THE MOST PRIMARY SITE OF NEUROBLASTOMA IS: n 76 ADRENAL GLAND Sinoe Medical Association

IN NEUROBLASTOMA, CALCIFICATION IS PRESENT IN: n 77 45% Sinoe Medical Association

CHARACTERISTIC FEATURE OF n 78 NEUROBLASTOMA Sinoe Medical Association

SPLENOMEGALY CHARACTERISTICS OF n n 79 GALACTOSEMIA CYSTINOSIS PORPHYRIA GAUCHER’S DISEASE Sinoe Medical Association

NEUROBLASTOMA IS ASSOCIATED WITH n 80 SPONTANEOUS REGRESSION Sinoe Medical Association

THE INFANT OF A DIABETIC MOTHER COMMONLY DEVELOPS : n n n 81 HYPOGLYCEMIA HYPERBILIRUBINEMIA HYPOCALCEMIA POLYCYTHEMIA INCREASED INCIDENCE OF CONGENITAL MALFORMATION [HEART AND SQUELETTAL DEFECT] Sinoe Medical Association

ASSOCIATION OF HORNER’S SYNDROME WITH A NECK MASS IN CHILREN IS MOST LIKELYDUE TO: n 82 NEUROBLASTOMA Sinoe Medical Association

83 Sinoe Medical Association

A CHILD WITH A POSTERIOR MEDIASTINAL MASS THE MOST LIKELY DIAGNOSIS IS n 84 NEUROBLASTOMA Sinoe Medical Association

MEGALOBLASTIC ANEMIA 85 Sinoe Medical Association

OCCUR DURING NORMAL GROWTH IN THE FIRST 12 MONTHS OF LIFE n n n 86 AT LEAST A DOUBLING OF THE INITIAL BIRTH WEIGHT TRIPLE THEIR WEIGHT BY 12 MONTHS CLOSURE OF THE POSTERIOR FONTANELLE [2 -4 MONTHS] ANTERIOR FONTANELLE CLOSES AT 6 -18 MONTHS ERUPTION OF AN AVERAGE OF 6 -8 DECIDUOUS TEETH INCREASE IN LENGTH OF 25 – 30 CM Sinoe Medical Association

TODDLER 24 MONTHS CAN n n 87 LINK 3 -4 WORDS TOGETHER IN SIMPLE SENTENCES ASSIST IN UNDRESSING SELF HANDLE SPOON AND CUP WELL BUILD A TOWER OF A 5 -6 CUBES Sinoe Medical Association

HEMOPHILUS INFLUENZAE B n n UNDER 2 YRS OLD MENINGITIS SEPTIC ARTHRITIS BUCCAL CELLULITIS n n n 88 OLDER CHILD EPIGLOTTITIS PNEUMONIAE Sinoe Medical Association

HEMOPHILUS INFLUENZAE B n n 89 SEPTIC ARTHRITIS IN A 4 MONTH OLD INFANT MENINGITIS IN A 3 YRS OLD CHILD EPIGLOTTITIS IN A 6 YRS OLD CHILD BUCCAL CELLULITIS IN A 15 MONTH OLD INFANT. Sinoe Medical Association

PNEUMOCOCCAL SEPSIS IS A DITINCT POSSIBILITY IN PATIENTS WITH THE FOLLOWING UNDERLYING DISEASES n n 90 PATIENT WITH ASPLENIA 10 YRS OLD WITH SICKLE CELL ANEMIA 5 YR OLD SURVIVOR OF HODGKIN’S DISEASE FOLLOWING SPLENECTOMY 8 YRS OLD WITH CHRONIC GRANULOMATOUS DISEASE Sinoe Medical Association

ESOPHAGEAL ATRESIA n n n 91 Excessive secretions noted in the new born nursery Difficulty feeding with cyanotic episode Inability to pass a catheter into the stomach A history of polyhydramnios Commonly associated with tracheoesophageal fistula Sinoe Medical Association

OTITIS MEDIA COMPLICATION n n n 92 Hearing loss Brain abscess formation, meningitis, focal encephalitis. Cholesteatoma Facial nerve paralysis Perforation of tympanic membrane Sinoe Medical Association

Otitis media n n 93 S. pneumoniae , H. influtenzae are the most common causative agents Most prevalence infectious diseases in the childhood. Sinoe Medical Association

94 Sinoe Medical Association

Congenital hypothyroidism n n n 95 Newborn screening programs have been initiated in most states due to the difficulty in identifying the affected children Delay in therapeutic can lead to brain damage Premature infants frequently have transiently low levels of thyrotropin releasing factor The breast fed infants with hypothyroidism is partially protected due to the presence of maternal thyroid hormone in the milk Normal birth weight , length , head circumference Sinoe Medical Association

The most common type of seizure seen in the new born period is: n 96 Subtle seizures [eye deviations, sucking, posturing with the extremities] Sinoe Medical Association

Most common manifestation of acute valvular disease during the initial stages of rheumatic fever: n n n 97 Mitral regurgitation Tachycardia Cardiomegaly Pericardial effusion Complication later: valvular stenosis Sinoe Medical Association

Normal hematologic values in the full term infant n n n 98 Polycythemia with a normal hb of 16 -18 and hct of 45 -60 HT and HB relatively high declining by 7 weeks of age for premature and 2 - 3 months for the term infant = physiologic anemia in infancy. Predominance of fetal hemoglobin Mcv =mean corpuscular volume high during neonatal period but declines during the later infancy. Normal white blood cell count ranging from 5000 to 30000 in the first 48 h after birth with a granulocytes predominance Midly prolonged prothrombin time [PT] and PTT Sinoe Medical Association

New born anemia n n 99 Hemolytic diseases Acute blood loss Chronic blood loss Impaired blood cell production Sinoe Medical Association

New born anemia etiology I/ hemolytic disease of the new born =erythroblastosis fetalis Blood group incompatibility n 100 Sinoe Medical Association