does rupture of the aorta occur? etal meals. Dx c barium, tx c surgery.

136. Barett’s Esophagus – 5yrs of dysphagia, weight loss, no reflux, s/s visible on EGD so do
biopsy. If biopsy shows no dysplasia then repeat in 2-5yrs, if bx shows low dysplasia, repeat in 3-6
months, if bx shows high grade dysplasia – resection
137. Esophageal CA – progressive dysphagia for meals. Dx c barium, tx c surgery.
136. Barett’s Esophagus – 5yrs of dysphagia, weight loss, no reflux, s/s visible on EGD so do
biopsy. If biopsy shows no dysplasia then repeat in 2-5yrs, if bx shows low dysplasia, repeat in 3-6
months, if bx shows high grade dysplasia – resection

137. Esophageal CA – progressive dysphagia forv Angina

– contractions in the meals. Dx c barium, tx c surgery.

136. Barett’s Esophagus – 5yrs of dysphagia, weight loss, no reflux, s/s visible on EGD so do
biopsy. If biopsy shows no dysplasia then repeat in 2-5yrs, if bx shows low dysplasia, repeat in 3-6
months, if bx shows high grade dysplasia – resection
137. Esophageal CA – progressive dysphagia for meals. Dx c barium, tx c surgery.
136. vIf biopsy shows no dysp meals. Dx c barium, tx c surgery.
136. Barett’s Esophagus – 5yrs of dysphagia, weight loss, no reflux, s/s visible on EGD so do
biopsy. If biopsy shows no dysplasia then repeat in 2-5yrs, if bx shows low dysplasia, repeat in 3-6
months, if bx shows high grade dysplasia – resection
137. Esophageal CA – progressive dysphagia for lasia then repeat in 2-5yrs, if bx shows low dysplasia,
repeat in 3-6 months, if bx shows high grade dy meals. Dx c barium, tx c surgery.
136. Barett’s Esophagus – 5yrs of dysphagia, weight loss, no reflux, s/s visible on EGD so do
biopsy. If biopsy shows no dysplasia then repeat in 2-5yrs, if bx shows low dysplasia, repeat in 3-6
months, if bx shows high grade dysplasia – resection
137. Esophageal CA – progressive dysphagia for meals. Dx c barium, tx c surgery.
136. Barett’s Esophagus – 5yrs of dysphagia, weight loss, no reflux, s/s visible on EGD so do
biopsy. If biopsy shows no dysplasia then repeat in 2-5yrs, if bx shows low dysplasia, repeat in 3-6
months, if bx shows high grade dysplasia – resection
137. Esophageal CA – progressive dysphagia for meals. Dx c barium, tx c surgery.
136. Barett’s Esophagus – 5yrs of dysphagia, weight loss, no reflux, s/s visible on EGD so do
biopsy. If biopsy shows no dysplasia then repeat in 2-5yrs, if bx shows low dysplasia, repeat in 3-6
months, if bx shows high grade dysplasia – resection
137. Esophageal CA – progressive dysphagia for vsplasia – resection
137. Esophageal CA – progressive dysphagia for vv meals. Dx c barium, tx c surgery.
136. Barett’s Esophagus – 5yrs of dysphagia, weight loss, no reflux, s/s visible on EGD so do
biopsy. If biopsy shows no dysplasia then repeat in 2-5yrs, if bx shows low dysplasia, repeat in 3-6
months, if bx shows high grade dysplasia – resection
137. Esophageal CA – progressive dysphagia for vsm contractions in the smooth muscle esophagus,
normal peristalsis in the striaghted muscle, normal UES). Tx c same things as GERD.
134. Schatzki Ring – young pt with episodic difficulty (not pain) swallowing. Dx c barium, tx c pneumatic
dilatation of LES
135. Plummer vinson synd – hypopharyngeal web c iron deficiency. Risk of SCC. Middle-aged female c
dysphagia immediately after meals. Dx c barium, tx c surgery.
136. Barett’s Esophagus – 5yrs of dysphagia, weight loss, no reflux, s/s visible on EGD so do
biopsy. If biopsy shows no dysplasia then repeat in 2-5yrs, if bx shows low dysplasia, repeat in 3-6
months, if bx shows high grade dysplasia – resection
137. Esophageal CA – progressive dysphagia for solids and eventually liquids, wt loss, CP,
hypercalcemia (SCC), dx c barium, then comfirm c EGD and biopsy. Tx c surgery, chemotherapy
(cisplatin, 5-FU) and radiation.
138. Gastroparesis – delayed gastric emptying causing n/v, bloating and upper abdm discomfort,
common in DM, tx c metoclopramide
139. When you suspect GI perforation, use gastrograffin (not barium), when you suspect aspiration, use
barium (not gastrograffin).
140. Diarrhea – see ID notes
141. Irritable Bowel Syndrome – alternating constipation/diarrhea, pain relieved c defacation. Tx c
increased fiber in diet.
142. Diverticulosis – d/t low fiber/high fat diet. LLQ pain, fever, tenderness. Dx c colonoscopy. Tx c
increased fiber.
contractions in the smooth muscle esophagus, normal peristalsis in the striaghted muscle, normal UES).
Tx c same things as GERD.
134. Schatzki Ring – young pt with episodic difficulty (not pain) swallowing. Dx c barium, tx c pneumatic
dilatation of LES
135. Plummer vinson synd – hypopharyngeal web c iron deficiency. Risk of SCC. Middle-aged female c
dysphagia immediately after meals. Dx c barium, tx c surgery.
136. Barett’s Esophagus – 5yrs of dysphagia, weight loss, no reflux, s/s visible on EGD so do
biopsy. If biopsy shows no dysplasia then repeat in 2-5yrs, if bx shows low dysplasia, repeat in 3-6
months, if bx shows high grade dysplasia – resection
137. Esophageal CA – progressive dysphagia for solids and eventually liquids, wt loss, CP,
hypercalcemia (SCC), dx c barium, then comfirm c EGD and biopsy. Tx c surgery, chemotherapy
(cisplatin, 5-FU) and radiation.
138. Gastroparesis – delayed gastric emptying causing n/v, bloating and upper abdm discomfort,
common in DM, tx c metoclopramide
139. When you suspect GI perforation, use gastrograffin (not barium), when you suspect aspiration, use
barium (not gastrograffin).
140. Diarrhea – see ID notes
141. Irritable Bowel Syndrome – alternating constipation/diarrhea, pain relieved c defacation. Tx c
increased fiber in diet.
142. Diverticulosis – d/t low fiber/high fat diet. LLQ pain, fever, tenderness. Dx c colonoscopy. Tx c
increased fiber.
contractions in the smooth muscle esophagus, normal peristalsis in the striaghted muscle, normal UES).
Tx c same things as GERD.
134. Schatzki Ring – young pt with episodic difficulty (not pain) swallowing. Dx c barium, tx c pneumatic
dilatation of LES
135. Plummer vinson synd – hypopharyngeal web c iron deficiency. Risk of SCC. Middle-aged female c
dysphagia immediately after meals. Dx c barium, tx c surgery.
136. Barett’s Esophagus – 5yrs of dysphagia, weight loss, no reflux, s/s visible on EGD so do
biopsy. If biopsy shows no dysplasia then repeat in 2-5yrs, if bx shows low dysplasia, repeat in 3-6
months, if bx shows high grade dysplasia – resection
137. Esophageal CA – progressive dysphagia for solids and eventually liquids, wt loss, CP,
hypercalcemia (SCC), dx c barium, then comfirm c EGD and biopsy. Tx c surgery, chemotherapy
(cisplatin, 5-FU) and radiation.
138. Gastroparesis – delayed gastric emptying causing n/v, bloating and upper abdm discomfort,
common in DM, tx c metoclopramide
139. When you suspect GI perforation, use gastrograffin (not barium), when you suspect aspiration, use
barium (not gastrograffin).
140. Diarrhea – see ID notes
141. Irritable Bowel Syndrome – alternating constipation/diarrhea, pain relieved c defacation. Tx c
increased fiber in diet.
142. Diverticulosis – d/t low fiber/high fat diet. LLQ pain, fever, tenderness. Dx c colonoscopy. Tx c
increased fiber.
contractions in the smooth muscle esophagus, normal peristalsis in the striaghted muscle, normal UES).
Tx c same things as GERD.
134. Schatzki Ring – young pt with episodic difficulty (not pain) swallowing. Dx c barium, tx c pneumatic
dilatation of LES
135. Plummer vinson synd – hypopharyngeal web c iron deficiency. Risk of SCC. Middle-aged female c
dysphagia immediately after meals. Dx c barium, tx c surgery.
136. Barett’s Esophagus – 5yrs of dysphagia, weight loss, no reflux, s/s visible on EGD so do
biopsy. If biopsy shows no dysplasia then repeat in 2-5yrs, if bx shows low dysplasia, repeat in 3-6
months, if bx shows high grade dysplasia – resection
137. Esophageal CA – progressive dysphagia for solids and eventually liquids, wt loss, CP,
hypercalcemia (SCC), dx c barium, then comfirm c EGD and biopsy. Tx c surgery, chemotherapy
(cisplatin, 5-FU) and radiation.
138. Gastroparesis – delayed gastric emptying causing n/v, bloating and upper abdm discomfort,
common in DM, tx c metoclopramide
139. When you suspect GI perforation, use gastrograffin (not barium), when you suspect aspiration, use
barium (not gastrograffin).
140. Diarrhea – see ID notes
141. Irritable Bowel Syndrome – alternating constipation/diarrhea, pain relieved c defacation. Tx c
increased fiber in diet.
142. Diverticulosis – d/t low fiber/high fat diet. LLQ pain, fever, tenderness. Dx c colonoscopy. Tx c
increased fiber.
contractions in the smooth muscle esophagus, normal peristalsis in the striaghted muscle, normal UES).
Tx c same things as GERD.
134. Schatzki Ring – young pt with episodic difficulty (not pain) swallowing. Dx c barium, tx c pneumatic
dilatation of LES
135. Plummer vinson synd – hypopharyngeal web c iron deficiency. Risk of SCC. Middle-aged female c
dysphagia immediately after meals. Dx c barium, tx c surgery.
136. Barett’s Esophagus – 5yrs of dysphagia, weight loss, no reflux, s/s visible on EGD so do
biopsy. If biopsy shows no dysplasia then repeat in 2-5yrs, if bx shows low dysplasia, repeat in 3-6
months, if bx shows high grade dysplasia – resection
137. Esophageal CA – progressive dysphagia for solids and eventually liquids, wt loss, CP,
hypercalcemia (SCC), dx c barium, then comfirm c EGD and biopsy. Tx c surgery, chemotherapy
(cisplatin, 5-FU) and radiation.
138. Gastroparesis – delayed gastric emptying causing n/v, bloating and upper abdm discomfort,
common in DM, tx c metoclopramide
139. When you suspect GI perforation, use gastrograffin (not barium), when you suspect aspiration, use
barium (not gastrograffin).
140. Diarrhea – see ID notes
141. Irritable Bowel Syndrome – alternating constipation/diarrhea, pain relieved c defacation. Tx c
increased fiber in diet.
142. Diverticulosis – d/t low fiber/high fat diet. LLQ pain, fever, tenderness. Dx c colonoscopy. Tx c
increased fiber.
ooth muscle esophagus, normal peristalsis in the striaghted muscle, normal UES). Tx c same things as
GERD.
134. Schatzki Ring – young pt with episodic difficulty (not pain) swallowing. Dx c barium, tx c pneumatic
dilatation of LES
135. Plummer vinson synd – hypopharyngeal web c iron deficiency. Risk of SCC. Middle-aged female c
dysphagia immediately after meals. Dx c barium, tx c surgery.
136. Barett’s Esophagus – 5yrs of dysphagia, weight loss, no reflux, s/s visible on EGD so do
biopsy. If biopsy shows no dysplasia then repeat in 2-5yrs, if bx shows low dysplasia, repeat in 3-6
months, if bx shows high grade dysplasia – resection
137. Esophageal CA – progressive dysphagia for solids and eventually liquids, wt loss, CP,
hypercalcemia (SCC), dx c barium, then comfirm c EGD and biopsy. Tx c surgery, chemotherapy
(cisplatin, 5-FU) and radiation.
138. Gastroparesis – delayed gastric emptying causing n/v, bloating and upper abdm discomfort,
common in DM, tx c metoclopramide
139. When you suspect GI perforation, use gastrograffin (not barium), when you suspect aspiration, use
barium (not gastrograffin).
140. Diarrhea – see ID notes
141. Irritable Bowel Syndrome – alternating constipation/diarrhea, pain relieved c defacation. Tx c
increased fiber in diet.
142. Diverticulosis – d/t low fiber/high fat diet. LLQ pain, fever, tenderness. Dx c colonoscopy. Tx c
increased fiber.
contractions in the smooth muscle esophagus, normal peristalsis in the striaghted muscle, normal UES).
Tx c same things as GERD.
134. Schatzki Ring – young pt with episodic difficulty (not pain) swallowing. Dx c barium, tx c pneumatic
dilatation of LES
135. Plummer vinson synd – hypopharyngeal web c iron deficiency. Risk of SCC. Middle-aged female c
dysphagia immediately after meals. Dx c barium, tx c surgery.
136. Barett’s Esophagus – 5yrs of dysphagia, weight loss, no reflux, s/s visible on EGD so do
biopsy. If biopsy shows no dysplasia then repeat in 2-5yrs, if bx shows low dysplasia, repeat in 3-6
months, if bx shows high grade dysplasia – resection
137. Esophageal CA – progressive dysphagia for solids and eventually liquids, wt loss, CP,
hypercalcemia (SCC), dx c barium, then comfirm c EGD and biopsy. Tx c surgery, chemotherapy
(cisplatin, 5-FU) and radiation.
138. Gastroparesis – delayed gastric emptying causing n/v, bloating and upper abdm discomfort,
common in DM, tx c metoclopramide
139. When you suspect GI perforation, use gastrograffin (not barium), when you suspect aspiration, use
barium (not gastrograffin).
140. Diarrhea – see ID notes
141. Irritable Bowel Syndrome – alternating constipation/diarrhea, pain relieved c defacation. Tx c
increased fiber in diet.
142. Diverticulosis – d/t low fiber/high fat diet. LLQ pain, fever, tenderness. Dx c colonoscopy. Tx c
increased fiber.

chest *ain at !
est" S) ele,ation
note the +
ca'ses o S)
ele,ationa!e 9I
ine!io! LDA4
is II" III A6; late!
al ci!
c'mle( a4is I"
A6L" 6<" 6=;
ante!io! is 61>6?
4"7e!ica!ditis
di'se"
meaning e,e!0
lead has it4" and
6a!iant Angina4
&ith negati,e ma!
#e!s. )!eat&ith
Ca>channel
bloc#e!s Cabs4
o! nit!ates.?.
Ac'te 9I – chest
discomo!t"
c!'shing *ain
&itho't &a!ning
emales and
diabetics get
at0*icalchest
*ain" &hich is
abdm *ain"
atig'e" nec#
*ain o!
&ea#ness4" *!
olonged d'!ation
ho'!s4"
5CGma0 be
abno!mal st
ele,ation o! de*!
ession4" inc!
eased ma!#e!s"
t( c 9O@A"
AC5I" he*a!in"
bb"t7Aâ€s i
B1 h!s ate!
onset o *ain"
com*lications
incl'de 9R" 6SD"
ca!diac !'*t'!e
and,ent!ic'la!
ane'!0sm.<. CAD
!is# acto!s:
smo#ing" )@"
amil0 h$o *!
emat'!e CAD
B<< in male"
B=< in emale4"
male2?<"
emale 2<<"
DL B?3" LD
etal Angina –
chest *ain at !est"
S) ele,ation
note the +
ca'ses o S)
ele,ationa!e 9I
ine!io! LDA4
is II" III A6; late!
al ci!
c'mle( a4is I"
A6L" 6<" 6=;
ante!io! is 61>6?
4"7e!ica!ditis
di'se"
meaning e,e!0
lead has it4" and
6a!iant Angina4
&ith negati,e ma!
#e!s. )!eat&ith
Ca>channel
bloc#e!s Cabs4
o! nit!ates.?.
Ac'te 9I – chest
discomo!t"
c!'shing *ain
&itho't &a!ning
emales and
diabetics get
at0*icalchest
*ain" &hich is
abdm *ain"
atig'e" nec#
*ain o!
&ea#ness4" *!
olonged d'!ation
ho'!s4"
5CGma0 be
abno!mal st
ele,ation o! de*!
ession4" inc!
eased ma!#e!s"
t( c 9O@A"
AC5I" he*a!in"
bb"t7Aâ€s i
B1 h!s ate!
onset o *ain"
com*lications
incl'de 9R" 6SD"
ca!diac !'*t'!e
and,ent!ic'la!
ane'!0sm.<. CAD
!is# acto!s:
smo#ing" )@"
amil0 h$o *!
emat'!e CAD
B<< in male"
B=< in emale4"
male2?<"
emale 2<<"
DL B?3" LD
etal Angina –
chest *ain at !est"
S) ele,ation
note the +
ca'ses o S)
ele,ationa!e 9I
ine!io! LDA4
is II" III A6; late!
al ci!
c'mle( a4is I"
A6L" 6<" 6=;
ante!io! is 61>6?
4"7e!ica!ditis
di'se"
meaning e,e!0
lead has it4" and
6a!iant Angina4
&ith negati,e ma!
#e!s. )!eat&ith
Ca>channel
bloc#e!s Cabs4
o! nit!ates.?.
Ac'te 9I – chest
discomo!t"
c!'shing *ain
&itho't &a!ning
emales and
diabetics get
at0*icalchest
*ain" &hich is
abdm *ain"
atig'e" nec#
*ain o!
&ea#ness4" *!
olonged d'!ation
ho'!s4"
5CGma0 be
abno!mal st
ele,ation o! de*!
ession4" inc!
eased ma!#e!s"
t( c 9O@A"
AC5I" he*a!in"
bb"t7Aâ€s i
B1 h!s ate!
onset o *ain"
com*lications
incl'de 9R" 6SD"
ca!diac !'*t'!e
and,ent!ic'la!
ane'!0sm.<. CAD
!is# acto!s:
smo#ing" )@"
amil0 h$o *!
emat'!e CAD
B<< in male"
B=< in emale4"
male2?<"
emale 2<<"
DL B?3" LD
etal Angina –
chest *ain at !est"
S) ele,ation
note the +
ca'ses o S)
ele,ationa!e 9I
ine!io! LDA4
is II" III A6; late!
al ci!
c'mle( a4is I"
A6L" 6<" 6=;
ante!io! is 61>6?
4"7e!ica!ditis
di'se"
meaning e,e!0
lead has it4" and
6a!iant Angina4
&ith negati,e ma!
#e!s. )!eat&ith
Ca>channel
bloc#e!s Cabs4
o! nit!ates.?.
Ac'te 9I – chest
discomo!t"
c!'shing *ain
&itho't &a!ning
emales and
diabetics get
at0*icalchest
*ain" &hich is
abdm *ain"
atig'e" nec#
*ain o!
&ea#ness4" *!
olonged d'!ation
ho'!s4"
5CGma0 be
abno!mal st
ele,ation o! de*!
ession4" inc!
eased ma!#e!s"
t( c 9O@A"
AC5I" he*a!in"
bb"t7Aâ€s i
B1 h!s ate!
onset o *ain"
com*lications
incl'de 9R" 6SD"
ca!diac !'*t'!e
and,ent!ic'la!
ane'!0sm.<. CAD
!is# acto!s:
smo#ing" )@"
amil0 h$o *!
emat'!e CAD
B<< in male"
B=< in emale4"
male2?<"
emale 2<<"
DL B?3" LD
They might say Hx of gastric bypass + now there’s a meal + patient gets diarrhea +/-

etal
hypoglycemia à Dx simply = Dumping syndrome.

Angina – chest

*ain at !est" S)
ele,ation note
the + ca'ses o
S) ele,ationa!e 9I
ine!io! LDA4
is II" III A6; late!
al ci!
c'mle( a4is I"
A6L" 6<" 6=;
ante!io! is 61>6?
4"7e!ica!ditis
di'se"
meaning e,e!0
lead has it4" and
6a!iant Angina4
&ith negati,e ma!
#e!s. )!eat&ith
Ca>channel
bloc#e!s Cabs4
o! nit!ates.?.
Ac'te 9I – chest
discomo!t"
c!'shing *ain
&itho't &a!ning
emales and
diabetics get
at0*icalchest
*ain" &hich is
abdm *ain"
atig'e" nec#
*ain o!
&ea#ness4" *!
olonged d'!ation
ho'!s4"
5CGma0 be
abno!mal st
ele,ation o! de*!
ession4" inc!
eased ma!#e!s"
t( c 9O@A"
AC5I" he*a!in"
bb"t7Aâ€s i
B1 h!s ate!
onset o *ain"
com*lications
incl'de 9R" 6SD"
ca!diac !'*t'!e
and,ent!ic'la!
ane'!0sm.<. CAD
!is# acto!s:
smo#ing" )@"
amil0 h$o *!
emat'!e CAD
B<< in male"
B=< in emale4"
male2?<"
emale 2<<"
DL B?3" LD
-------

-
does rupture of the aorta occur? à where the ligamentum arteriosum wraps around the top of
the descending ar does rupture of the aorta occur? à where the ligamentum arteriosum wraps
around the top of the descending arch à ligament is taut but arch is more mobile à leads to
shearing.

- What will the NBME/USMLE Q say for traumatic rupture à MVA or fall followed by “widening
of the mediastinum on CXR.”
ch à ligament is taut but arch is more mobile à leads to shearing.

- What will the NBME/USMLE Q say for traumatic rupture à MVA or fall followed by “widening
of the mediast do does rupture of the aorta occur? à where the ligamentum arteriosum wraps
around the top of the descending arch à ligament is taut but arch is more mobile à leads to
shearing.

- What will the NBME/USMLE Q say for traumatic rupture à MVA or fall followed by “widening
of the mediastinum on CXR.”
es rupture of the aorta occur? à where the ligamentum arteriosum wraps around the top of the
descending arch à ligament is taut but arch is more mobile à leads to shearing.

- What will the NBME/USMLE Q say for traumatic rupture à MVA or fall followed by “widening
of the mediastinu does rupture of the aorta occur? à where the ligamentum arteriosum wraps
around the top of the descending arch à ligament is taut but arch is more mobile à leads to
shearing.

- What will the NBME/USMLE Q say for traumatic rupture à MVA or fall followed by “widening
of the mediastinum on CXR.”
m on CXR.”
inum on CXR.”

What is Blind loop syndrome? à disturbance of normal floral balance in the small bowel due to
disruption of peristalsis (i.e., surgery / post-surgical ileus), but may also be caused by conditions
like IBD and scleroderma à leads to steatorrhea + B12 def + fat-soluble vitamin deficiencies à
USMLE merely wants you to b ntify this in a vignette as Dumping syndrome. They might say Hx
of gastric bypass + now there’s a meal + patient gets diarrhea +/- hypoglycemia à Dx simply =
Dumping syndrome.

-------
-
does rupture of the aorta occur? à where the ligamentum arteriosum wraps around the top of
the descending ar does rupture of the aorta occur? à where the ligamentum arteriosum wraps
around the top of the descending arch à ligament is taut but arch is more mobile à leads to
shearing.

- What will the NBME/USMLE Q say for traumatic rupture à MVA or fall followed by “widening
of the mediastinum on CXR.”
ch à ligament is taut but arch is more mobile à leads to shearing.

- What will the NBME/USMLE Q say for traumatic rupture à MVA or fall followed by “widening
of the mediast do does rupture of the aorta occur? à where the ligamentum arteriosum wraps
around the top of the descending arch à ligament is taut but arch is more mobile à leads to
shearing.

- What will the NBME/USMLE Q say for traumatic rupture à MVA or fall followed by “widening
of the mediastinum on CXR.”
es rupture of the aorta occur? à where the ligamentum arteriosum wraps around the top of the
descending arch à ligament is taut but arch is more mobile à leads to shearing.

- What will the NBME/USMLE Q say for traumatic rupture à MVA or fall followed by “widening
of the mediastinu does rupture of the aorta occur? à where the ligamentum arteriosum wraps
around the top of the descending arch à ligament is taut but arch is more mobile à leads to
shearing.

- What will the NBME/USMLE Q say for traumatic rupture à MVA or fall followed by “widening
of the mediastinum on CXR.”
m on CXR.”
inum on CXR.”

What is Blind loop syndrome? à disturbance of normal floral balance in the small bowel due to
disruption of peristalsis (i.e., surgery / post-surgical ileus), but may also be caused by conditions
like IBD and scleroderma à leads to steatorrhea + B12 def + fat-soluble vitamin deficiencies à
USMLE merely wants you to be able to make the diagnosis from a vignette à Tx is with
antibiotics (doxycycline or fidaxomicin).

e able to make the diagnosis from a vignette à Tx is with antibiotics (doxycycline or

fidaxomicin).

this in a vignette as Dumping syndrome. They might say Hx of gastric bypass + now there’s a
meal + patient gets diarrhea +/- hypoglycemia à Dx simply = Dumping syndrome.

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does rupture of the aorta occur? à where the ligamentum arteriosum wraps around the top of
the descending ar does rupture of the aorta occur? à where the ligamentum arteriosum wraps
around the top of the descending arch à ligament is taut but arch is more mobile à leads to
shearing.

- What will the NBME/USMLE Q say for traumatic rupture à MVA or fall followed by “widening
of the mediastinum on CXR.”
ch à ligament is taut but arch is more mobile à leads to shearing.

- What will the NBME/USMLE Q say for traumatic rupture à MVA or fall followed by “widening
of the mediast do does rupture of the aorta occur? à where the ligamentum arteriosum wraps
around the top of the descending arch à ligament is taut but arch is more mobile à leads to
shearing.

- What will the NBME/USMLE Q say for traumatic rupture à MVA or fall followed by “widening
of the mediastinum on CXR.”
es rupture of the aorta occur? à where the ligamentum arteriosum wraps around the top of the
descending arch à ligament is taut but arch is more mobile à leads to shearing.

- What will the NBME/USMLE Q say for traumatic rupture à MVA or fall followed by “widening
of the mediastinu does rupture of the aorta occur? à where the ligamentum arteriosum wraps
around the top of the descending arch à ligament is taut but arch is more mobile à leads to
shearing.

- What will the NBME/USMLE Q say for traumatic rupture à MVA or fall followed by “widening
of the mediastinum on CXR.”
m on CXR.”
inum on CXR.”

What is Blind loop syndrome? à disturbance of normal floral balance in the small bowel due to
disruption of peristalsis (i.e., surgery / post-surgical ileus), but may also be caused by conditions
like IBD and scleroderma à leads to steatorrhea + B12 def + fat-soluble vitamin deficiencies à
USMLE merely wants you to be able to make the diagnosis from a vignette à Tx is with
antibiotics (doxycycline or fidaxomicin).

+ lobar pattern, but they say “interstitial” in the vignette description à Mycoplasma, not S.
pneumo Empiric Tx for CPP à azithromycin Tx for CPP is pt on Abx past three months à
fluoroquinolone over azithro Pneumonia in CF patient <10 years à S. aureus exceeds
Pseudomonas Pneumonia in CF patient >10 years à Pseudomonas exceeds S. aureus.
Pneumonia after influenza infection à USMLE wants S. aureus Pneumonia + rabbits à F.
tularensis Pneumonia + cattle à Coxiella (Q fever) Pneumonia + birds à Chlamydia psittaci Leg
swelling + pain + shortness of breath à Pulmonary embolism caused by DVT Tx of PE à Heparin
before spiral CT CPP + lobar pattern (right-lower lobe consolidation + dullness to percussion) à
Strep pneumo CPP + lobar pattern, but they say “interstitial” in the vignette description à
Mycoplasma, not S. pneumo Empiric Tx for CPP à azithromycin Tx for CPP is pt on Abx past
three months à fluoroqu Pneumonia + cattle à Coxiella (Q fever) Pneumonia + birds à Chlamydia
psittaci Leg swelling + pain + shortness of breath à Pulmonary embolism caused by DVT Tx of PE
à Heparin before spiral CT CPP + lobar pattern (right-lower lobe consolidation + dullness to
percussion) à Strep pneumo CPP + lobar pattern, but they say “interstitial” in the vignette
description à Mycoplasma, not S. pneumo Empiric Tx for CPP à azithromycin Tx for CPP is pt on
Abx past three months à fluoroquinolone over azithro Pneumonia in CF patient <10 years à S.
aureus exceeds Pseudomonas Pneumonia in CF patient Pneumonia + cattle à Coxiella (Q fever)
Pneumonia + birds à Chlamydia psittaci Leg swelling + pain + shortness of breath à Pulmonary
embolism caused by DVT Tx of PE à Heparin before spiral CT CPP + lobar pattern (right-lower
lobe consolidation + dullness to percussion) à Strep pneumo CPP + lobar pattern, but they say
“interstitial” in the vignette description à Mycoplasma, not S. pneumo Empiric Tx for CPP à
azithromycin Tx for CPP is pt on Abx past three months à fluoroquinolone over azithro
Pneumonia in CF patient <10 years à S. aureus exceeds Pseudomonas Pneumonia in CF patient
Pneumonia + cattle à Coxiella (Q fever) Pneumonia + birds à Chlamydia psittaci Leg swelling +
pain + shortness of breath à Pulmonary embolism caused by DVT Tx of PE à Heparin before
spiral CT CPP + lobar pattern (right-lower lobe consolidation + dullness to percussion) à Strep
pneumo CPP + lobar pattern, but they say “interstitial” in the vignette description à
Mycoplasma, not S. pneumo Empiric Tx for CPP à azithromycin Tx for CPP is pt on Abx past
three months à fluoroquinolone over azithro Pneumonia in CF patient <10 years à S. aureus
exceeds Pseudomonas Pneumonia in CF patient vinolone over azithro Pneumonia in CF patient
<10 years à S. aureus exceeds Pseudomonas Pneumonia in CF patient >10 years à Pseudomonas
exceeds S. aureus.

Pneumonia after influenza infection à USMLE wants S. aureus Pneumonia + rabbits à F.

tularensis Pneumonia + cattle à Coxiella (Q fever) Pneumonia + birds à Chlamydia psittaci Leg
swelling + pain + shortness of breath à Pulmonary embolism caused by DVT Tx of PE à Heparin
before spiral CT CPP + lobar pattern (right-lower lobe consolidation + dullness to percussion) à
Strep pneumo CPP + lobar pattern, but they say “interstitial” in the vignette description à
Mycoplasma, not S. pneumo Empiric Tx for CPP à azithromycin Tx for CPP is pt on Abx past
three months à fluoroquinolone over azithro Pneumonia in CF patient <10 years à S. aureus
exceeds Pseudomonas Pneumonia in CF patient >10 years à Pseudomonas exceeds S. aureus.

Pneumonia after influenza infection à USMLE wants S. aureus Pneumonia + rabbits à F.

tularensis Pneumonia + cattle à Coxiella (Q fever) Pneumonia + birds à Chlamydia psittaci Leg
swelling + pain + shortness of breath à Pulmonary embolism caused by DVT Tx of PE à Heparin
before spiral CTvrupture of the aorta occur? à where the ligamentum arteriosum wraps around
the top of the descending arch à ligament is taut but arch is more mobile à leads to shearing.

- What will the NBME/USMLE Q say for traumatic rupture à MVA or fall followed by “widening
of the mediastinum on CXR.”
ch à ligament is taut but arch is more mobile à leads to shearing.

- What will the NBME/USMLE Q CPP + lobar pattern (right-lower lobe consolidation + dullness
to percussion) à Strep pneumo CPP + lobar pattern, but they say “interstitial” in the vignette
description à Mycoplasma, not S. pneumo Empiric Tx for CPP à azithromycin Tx for CPP is pt on
Abx past three months à fluoroquinolone over azithro Pneumonia in CF patient <10 years à S.
aureus exceeds Pseudomonas Pneumonia in CF patient >10 years à Pseudomonas exceeds S.
aureus.

Pneumonia after influenza infection à USMLE wants S. aureus Pneumonia + rabbits à F.

tularensis Pneumonia + cattle à Coxiella (Q fever) Pneumonia + birds à Chlamydia psittaci Leg
swelling + pain + shortness of breath à Pulmonary embolism caused by DVT Tx of PE à Heparin
before spiral CT CPP + lobar pattern (right-lower lobe consolidation + dullness to percussion) à
Strep pneumo CPP + lobar pattern, but they say “interstitial” in the vignette description à
Mycoplasma, not S. pneumo Empiric Tx for CPP à azithromycin Tx for CPP is pt on Abx past
three months à fluoroquinolone over azithro Pneumonia in CF patient <10 years à S. aureus
exceeds Pseudomonas Pneumonia in CF patient >10 years à Pseudomonas exceeds S. aureus.

Pneumonia after influenza infection à USMLE wants S. aureus Pneumonia + rabbits à F.

tularensis Pneumonia + cattle à Coxiella (Q fever) Pneumonia + birds à Chlamydia psittaci Leg
swelling + pain + shortness of breath à Pulmonary embolism caused by DVT Tx of PE à Heparin
before spiral CTv say for traumatic rupture à MVA or fall followed by “widening of the mediast
do does rupture of the aorta occur? à where the ligamentum arteriosum wraps around the top
of the descending arch à ligament is taut but arch is more mobile à leads to shearing.

- What will the NBME/USMLE Q say for traumatic rupture à MVA or fall followed by “widening
of the mediastinum on CXR.”
es rupture of the aorta occur? à where the ligamentum arteriosum wraps around the top of the
descending arch à ligament is taut but arch is more mobile à leads to shearing.

- What will the NBME/USMLE Q say for traumatic rupture à MVA or fall followed by “widening
of the mediastinu does rupture of the aorta occur? à where the ligamentum arteriosum wraps
around the top of the descending arch à ligament is taut but arch is more mobile à leads to
shearing.
- What will the NBME/USMLE Q say for traumatic rupture à MVA or fall followed by “widening
of the mediastinum on CXR.”
m on CXR.”
inum on CXR.”

What is Blind loop syndrome? à disturbance of normal floral balance in the small bowel due to
disruption of peristalsis (i.e., surgery / post-surgical ileus), but may also be caused by conditions
like IBD and scleroderma à leads to steatorrhea + B12 def + fat-soluble vitamin deficiencies à
USMLE merely wants you to be able to make the diagnosis from a vignette à Tx is with
antibiotics (doxycycline or fidaxomicin).

8M + bloody stool + perfectly healthy otherwise; Dx? à Meckel diverticulum; student says, “huh,
I thought that was age 2.” I agree with you. But there’s an NBME Q where the kid was 8, and
the answer was Meckel à bleeding due to “heterotopic gastric / pancreatic tissue.”

How to Dx Meckel diverticulum? à Meckel scan (Tc99 uptake scan that localizes to
diverticulum).

Tx for Meckel à if asymptomatic, can leave alone; if symptomatic, surgical removal.

16F + fever + high leukocytes + RLQ pain that migrated from epigastrium; Dx? à appendicitis
(easy, but so HY how can I not at least mention it classically) à USMLE wants you to know that
migration is because, initially, epigastric pain = visceral pain; RLQ pain = inflammation of
parietal peritoneum. Must do a pregnancy test if female + adnexal ultrasound to look for gyn
causes, i.e., ruptured cyst, etc. If male, go straight to laparoscopy. If rule out gyn cause in
female, do laparoscopic removal. Ultrasound + CT can be done, but false-negatives have led to
rupture + death, so they don’t change management if clinical suspicion is high, which is why pt
goes straight to laparoscopy if under high suspicion for appendicitis à if during surgery the
appendix is normal, answer = still remove it. Mallory-Weiss tear vs esophageal varices HY point
à MWT usually caused by vomiting/retching in alcoholic + presents with a little bit of blood in
the vomitus; varices present with LOTS of blood à about half of patients with ruptured varix die.

Mallory-Weiss tear vs Boerhaave à MWT is not transmural; Boerhaave is transmural à causes

subcutaneous emphysema (crepitus due to air under the skin).

Tx of varix? à banding + octreotide.

does rupture of the aorta occur? à where the ligamentum arteriosum wraps around the top of
the descending arch à ligament is taut but arch is more mobile à leads to shearing.

- What will the NBME/USMLE Q say for traumatic rupture à MVA or fall followed by “widening
of the mediastinum on CXR.”
does rupture of the aorta occur? à where the ligamentum arteriosum wraps around the top of
the descending arch à ligament is taut but arch is more mobile à leads to shearing.
does rupture of the aorta occur? à where the ligamentum arteriosum wraps around the top of
the descending arch à ligament is taut but arch is more mobile à leads to shearing.

- What will the NBME/USMLE Q say for traumatic rupture à MVA or fall followed by “widening
of the mediastinum on CXR.”

- What will the NBME/USMLE Q say for traumatic rupture à MVA or fall followed by “widening
of the mediastinum on CXR.”
does rupture of the aorta occur? à where the ligamentum arteriosum wraps around the top of
the descending arch à ligament is taut but arch is more mobile à leads to shearing.

- What will the NBME/USMLE Q say for traumatic rupture à MVA or fall followed by “widening
of the mediastinum on CXR.”
does rupture of the aorta occur? à where the ligamentum arteriosum wraps around the top of
the descending arch à ligament is taut but arch is more mobile à leads to shearing.

- What will the NBME/USMLE Q say for traumatic rupture à MVA or fall followed by “widening
of the medias CPP + lobar pattern (right-lower lobe consolidation + dullness to percussion) à
Strep pneumo CPP + lobar pattern, but they say “interstitial” in the vignette description à
Mycoplasma, not S. pneumo Empiric Tx for CPP à azithromycin Tx for CPP is pt on Abx past
three months à fluoroquinolone over azithro Pneumonia in CF patient <10 years à S. aureus
exceeds Pseudomonas Pneumonia in CF patient >10 years à Pseudomonas exceeds S. aureus.

Pneumonia after influenza infection à USMLE wants S. aureus Pneumonia + rabbits à F.

tularensis Pneumonia + cattle à Coxiella (Q fever) Pneumonia + birds à Chlamydia psittaci Leg
swelling + pain + shortness of breath à Pulmonary embolism caused by DVT Tx of PE à Heparin
before spiral CT CPP + lobar pattern (right-lower lobe consolidation + dullness to percussion) à
Strep pneumo CPP + lobar pattern, but they say “interstitial” in the vignette description à
Mycoplasma, not S. pneumo Empiric Tx for CPP à azithromycin Tx for CPP is pt on Abx past
three months à fluoroquinolone over azithro Pneumonia in CF patient <10 years à S. aureus
exceeds Pseudomonas Pneumonia in CF patient >10 years à Pseudomonas exceeds S. aureus.

Pneumonia after influenza infection à USMLE wants S. aureus Pneumonia + rabbits à F.

tularensis Pneumonia + cattle à Coxiella (Q fever) Pneumonia + birds à Chlamydia psittaci Leg
swelling + pain + shortness of breath à Pulmonary embolism caused by DVT Tx of PE à Heparin
before spiral CTv CPP + lobar pattern (right-lower lobe consolidation + dullness to percussion) à
Strep pneumo CPP + lobar pattern, but they say “interstitial” in the vignette description à
Mycoplasma, not S. pneumo Empiric Tx for CPP à azithromycin Tx for CPP is pt on Abx past
three months à fluoroquinolone over azithro Pneumonia in CF patient <10 years à S. aureus
exceeds Pseudomonas Pneumonia in CF patient >10 years à Pseudomonas exceeds S. aureus.
Pneumonia after influenza infection à USMLE wants S. aureus Pneumonia + rabbits à F.
tularensis Pneumonia + cattle à Coxiella (Q fever) Pneumonia + birds à Chlamydia psittaci Leg
swelling + pain + shortness of breath à Pulmonary embolism caused by DVT Tx of PE à Heparin
before spiral CT CPP + lobar pattern (right-lower lobe consolidation + dullness to percussion) à
Strep pneumo CPP + lobar pattern, but they say “interstitial” in the vignette description à
Mycoplasma, not S. pneumo Empiric Tx for CPP à azithromycin Tx for CPP is pt on Abx past
three months à fluoroquinolone over azithro Pneumonia in CF patient <10 years à S. aureus
exceeds Pseudomonas Pneumonia in CF patient >10 years à Pseudomonas exceeds S. aureus.

Pneumonia after influenza infection à USMLE wants S. aureus Pneumonia + rabbits à F.

tularensis Pneumonia + cattle à Coxiella (Q fever) Pneumonia + birds à Chlamydia psittaci Leg
swelling + pain + shortness of breath à Pulmonary embolism caused by DVT Tx of PE à Heparin
before spiral CTtinum on CXR.”
vv