Rosh Rapid Review | Questions & Answers (100 %Score) Latest Updated 2024/2025
Comprehensive Questions A+ Graded Answers | With Expert Solutions
Juvenile Idiopathic Arthritis (JIA) - -Onset must be less than 16 years of age and
symptoms persist > 6 weeks.
-3 main subtypes: systemic (Still's disease), pauciarticular, polyarticular (most common)
-Unknown etiology
-Dx: clinical
-Rx: NSAIDs, methotrexate, steroids, specialist referrals
Hypertension: Eighth Joint National Committee (JNC 8) Recommendations - -PreHTN:
systolic blood pressure (SBP) 120-139 mmHg or diastolic blood pressure (DBP) 80-89
mmHg
-Stage I HTN: SBP 140-159 mmHg or DBP 90-99 mmHg
-Stage II HTN: SBP >160 mmHg or DBP >100 mmHg
-Treatment goals:
-->60 years: SBP<150, DBP<90
--All others: SBP<140, DBP<90
-1st line rx for general population: thiazide, CCB, ACEI, or ARB
-1st line rx for African Americans: CCB or thiazide
Chronic kidney disease: Rx should include ACEI or ARB
Nursemaid's Elbow - -Hyperextension and pulling → subluxation of radial head under
annular ligament
-Presentation: elbow flexed + arm pronated
-Normal x-ray
-Management: flex and supinate elbow or hyperpronate and extend forearm
Corneal Abrasion - -Pain, photophobia, tearing
-Fluorescein stain: epithelial injury
-Foreign body sensation
-Topical abx
-Antipseudomonal for contact lens wearers
-Most abrasions are self-limiting
Reflex Sympathetic Dystrophy (Complex Regional Pain Syndrome) - -Patient with
previous extremity injury
-Light touch → extreme pain
-Rx: NSAIDs, gabapentin, sympathectomy
Celiac Disease - -Northern European descent
-Fe deficiency anemia
-Anti-endomysial, anti-tissue transglutaminase, anti-gliadin antibodies
-Dx gold standard: small intestine biopsy
-Dermatitis herpetiformis
,-↑ Malignancy risk
Influenza - -Season: November - April
-Antivirals only given within 48 hours of sx
-Zanamivir contraindicated in patients with COPD/asthma
Celiac Disease - -Patient will be complaining of diarrhea, steatorrhea, flatulence, weight
loss, weakness and abdominal distension
-Labs will show IgA anti-endomysial (AGA) and anti-tissue transglutaminase (anti-tTG)
antibodies
-Diagnosis is made by small bowel biopsy
-Treatment is gluten free diet
-Comments: associated with dermatitis herpetiformis (chronic, very itchy skin rash
made up of bumps and blisters)
Varicella - -Viral prodrome → maculopapular rash → clear vesicles on an erythematous
base ("dew drop rash on a rose petal")
-Lesions occur in crops
-Contagious 5 days before and after vesicles
-Multiple stages of lesions present
-Treatment:
-<12: supportive care
->12: acyclovir
-Immunocompromised: IV acyclovir
Abdominal Aortic Aneurysm (AAA) - -Advanced age, male, smoking hx, HTN
-Acute abdominal pain + hypotension + pulsatile abdominal mass
-US: 100% sensitive
-CT: 100% sensitive, detects rupture/leak
-AAA > 5 cm: ↑ risk of rupture
-Renal colic in elderly: r/o AAA
Idiopathic Pulmonary Fibrosis - -Smoking males
-Unknown agent → repeated alveolitis → fibrosis
-Chronic cough, dyspnea
-Honeycombing
-Rx: O2, pulmonary rehabilitation
Botulism - -Patient will be an infant
-With a history of eating honey
-Complaining of feeble cry, constipation
-PE will show symmetric descending paralysis ("floppy baby")
-Most commonly caused by Clostridium botulinum
-Treatment is IV botulism Ig
Hyperthyroidism - -Anxiety, weakness, palpitations, heat intolerance
,-Tachycardia, hyperreflexia, thin hair, lid lag, exophthalmos
-Rx: Propylthiouracil, beta blockers, iodine, steroids
Substance Abuse - -Use → impairment or distress
-Not dependent
Rabies - -Raccoons > bats > skunks
-< 50% of cases due to bats have a documented bite
-Viral prodrome
-Hydrophobia, agitation, spasms
-PEP: wound care (scrubbing), Ig at wound site, vaccination
Sarcoidosis - -African-Americans, females
-Primary target organ: lungs
-Parotid enlargement
-Hypercalcemia
-CXR: bilateral hilar adenopathy
-Biopsy: noncaseating granulomas
-Steroids
Parkinson's Disease - -Lewy bodies, substantia nigra dopaminergic neuron loss
-TRAP: Tremor (resting, "pill rolling"), Rigidity, Akinesia, Postural instability
-Carbidopa/levodopa, anticholinergic drugs
-Avoid antipsychotics
Acute Tubular Necrosis - -MCC of intrinsic renal failure
-Types: ischemic and nephrotoxic
-Nephrotoxins: aminoglycosides > contrast agents
-Granular "muddy brown" casts
Developmental Dysplasia of the Hip (DDH) - -↓ Pressure of the femoral head against
the acetabulum → shallow socket
-Galeazzi test: flexing the infant's hips and knees to compare knee heights
-Dx: < 4 mos: ultrasound
-Rx: Pavlik harness
Balanoposthitis - -Balanitis: glans penis inflammation
-Posthitis: foreskin inflammation
-MCC: Candida
-Rx: hygiene, topical antifungals
Myocardial Infarction: ECG findings - -Earliest finding: hyperacute T waves
-ST elevation
-Reciprocal ST depression (PAILS: posterior → anterior → inferior → lateral → septal)
-T wave inversions
-New LBBB
, -Sgarbossa Criteria for STEMI with LBBB
-Concordant ST elevation > 1 mm in leads with a positive QRS (5)
-Concordant ST depression > 1 mm in V1-V3 (3)
-Discordant ST elevation ≥5 mm in leads with a negative QRS (2)
-≥3 = STEMI
Vitamin B12 (Cobalamin) Deficiency - -Patient will be a vegan
-Complaining of fatigue, weakness and peripheral neuropathy
-PE will show pallor and glossitis
-Labs will show MCV > 100, hypersegmented neutrophils, elevated homocysteine,
elevated methylmalonic acid
-Treatment is parenteral vitamin B12
-Comments: only vitamin B12 deficiency results in neurological symptoms
Epiglottitis - -Fever, dysphagia, drooling
-Patient leaning forward
-Neck film: "thumbprint" sign
-Airway management
Peptic Ulcer Disease - -Most common cause of UGIB
-RFs: smoking, H. pylori, NSAIDS, ASA, steroids
-Duodenal > gastric
-Duodenal: pain decreases food
-Gastric: pain greater with food
-Proton pump inhibitors, endoscopy
-Complications: perforation, gastric outlet syndrome
Dyshidrotic Eczema - -Patient will be complaining of intense pruritus on their palms and
sides of the fingers
-PE will show vesicles that appear to contain "grains of tapioca"
-Treatment is avoidance of long exposure of the hands to water, topical corticosteroids
for acute flares
Ankle Sprain - -Patient with a history of ankle inversion
-PE will show pain and swelling
-Imaging will show partial or complete tearing of ligaments
-Most commonly injured anterior talofibular ligament (ATFL)
-Treatment is RICE therapy
-Comments: Ottawa Rules to determine imaging
Salter-Harris Fractures - -I: S (Slipped epiphysis)
-II: A (fracture Above physis), most common
-III: L (fracture beLow physis)
-IV: T (fracture Through physis)
-V: R (wRecked physis)
-I/II rx: nonoperative
