1. Osteonecrosis in SCD:
- Up to 50% of Hb-SS will develop this by adulthood
- Most commonly humeral and femoral heads
- Tx: pain management, no weight bearing, joint reconstruction if that fails
2. Kidneys compensate for chronic hypercapnea by increasing bicarb retention
3. Paralytic ileus vs SBO: 
- On the board exams, paralytic ileus will present with absent or hypoactive bowel sounds, while SBO will present with hyperactive or "tinkling" bowel sounds
- In the real world, hard to differentiate as the utility of bowel sounds in diagnosis of acute bowel obstruction is questionable (increased OR decreased bowel sounds have a sensitivity 25-40%, PPV ~10% - prospective cohort study, N=1200, 1998). For what its worth, most of the attending general surgeons I trained under did not listen for bowel sounds, and some of them were really old-school too....
4. Strange thoughts. 
- Delusions: fixed, false belief not consistent with cultural norms - grandiose delusions "I have special powers and a relationship with god"
- Magical thinking: belief in supernatural forces, that ones thoughts can control events
- Ideas of reference: "the TV is talking to me" - common in schizophrenia
- Illusion: misinterpretation of external stimulus
- Hallucination: illusion without external stimulus
5. Types of polyps: 
- Hyperplastic: most common non-neoplastic polyps
- Hamartomatous: juvenile (not cancerous, removed 2/2 bleed risk) & Peutz Jeghers (non malignant)
- Adenoma: most common polyp in colon. Present in 30-50% of old people. Potentially premalignant, <1% will go on to malignancy. <5% +FOBT.
6. Odd of adenomatous polyp transforming into invasive cancer: 
<2% if <1.5 cm
2-10% if 1.5-.2.5 cm
>10% if >2.5 cm
Risk factors: villous pathology, sessile.
7. Endocarditis: 
- AV block development in patient with infective endocarditis: perivalvular abscess. Apparently seen in 30-40% of patients with endocarditis at surgery or autopsy...!
- Tricuspid endocarditis: holosystolic murmur
8. Pseudogout 
- often occurs in setting of recent surgery or illness.
- Rhomboid crystals
- chondrocalcinosis (calcified articular cartilage) on xray
9. Failure to pass meconium in infant
- First: KUB to r/o perforation or surgical emergency
- Second: Water soluble contrast enema -- microcolon -> meconium ileus, dilated descending colon with narrow sigmoid -> Hirschprungs's
- If meconium ileus - hyperosmolar (ie gastrografin) enema may break up the meconium; if that fails, then surgery. Should also w/u CF b/c meconium ileus is almost pathognomonic
- If Hirschprungs suspected - rectal bx (absence of ganglion cells); if that's not diagnostic, may need anorectal manometry.
10. Everyone's favorite endocrinology chart: 
21-OH deficiency is most common, and presents with ambiguous genitalia in girls, salt wasting, hypotension -- too much T and not enough aldo or cortisol.
11-B hydroxylase presents similarly to 21-OH but not as bad because if I remember correctly 11-deoxycortisol (or maybe deoxycorticosterone).. have some mineralcorticoid/corticosteroid effects, so it's a milder disease.
17-a deficiency: no T, no cortisol, only aldosterone.