01-04

Question 1

Reduced efficacy to ECT seen in?

Answer 1

Prolonged episode
Lack of response to meds
Co-existing psych disorder

Question 2

Absolute ECT contraindications

Answer 2

None

Question 3

Hard to control hypertension and hypokalemia workup

Answer 3

Plasma renin/aldosterone ratio to look for primary hyperaldosteronism

Question 4

What should be suspected in any child with fever, cyanosis, and respiratory findings

Answer 4

Pneumonia

Question 5

Reasons to admit a child with pneumonia

Answer 5

1. toxic appearance
2. hypoxemia
3. signs of respiratory distress
4. dehydration

Question 6

When do you introduce solid foods to children

Answer 6

4-6 months

extrusion reflex present until 4 months

Question 7

Ultrasonic pulse therapy doesn’t help what kind of fractures

Answer 7

Stress fractures

Question 8

Best test for late onset hypogonadism

Answer 8

Total T (free T is too expensive)
*FSH and LH levels will help determine primary vs secondary*

Question 9

Low TSH in a patient receiving levothyroxin indicates

Answer 9

Overreplacement

Question 10

Typical plantar fasciitis features

Answer 10

point tenderness to palpation on the plantar surface of the heel at the medial calcaneal tuberosity where the calcaneal aponeurosis inserts

Question 11

When is an X-ray necessary for suspected plantar fasciitis

Answer 11

When there is a hx of trauma or the diagnosis is unclear

Question 12

Best physical exam test for ACL tear

Answer 12

Lachman test

Question 13

What is McMurrey’s test used for

Answer 13

to detect meniscal tears

Question 14

MGUS to myeloma detected when

Answer 14

When there is an increase in organ damage

Question 15

Numbness and weakness over the anterior thigh

Answer 15

Femoral neuropathy

Question 16

What is Meralgia paresthetica

Answer 16

numbness and paresthesia over the anterolateral thigh with no motor dysfunction

Question 17

Iliofemoral atherosclerosis produces

Answer 17

Intermittent claudication involving one or both calf muscles but would not produce the motor weakness noted in this patient

Question 18

Low dose estrogen contraceptives reduce risk of what cancers

Answer 18

Ovary, endometrial, and colorectal

Question 19

Two main painful places with PMR

Answer 19

pain and stiffness in the shoulder and pelvic girdle

dramatic response to corticosteroids

Question 20

What is refeeding syndrome

Answer 20

Shifts in fluids and electrolytes that follow, hallmark is hypophosphatemia

Question 21

Signs of hypophosphatemia

Answer 21

nausea, vomiting, hypotension and delirium

Question 22

Two things that decrease risk of oral candidiasis when using inhaled steroids

Answer 22

Using a valved holding chamber and rinsing mouth after use

Question 23

What do you do in an older person or teacher with hoarseness that does not improve for 3 months

Answer 23

Laryngoscopy –> Then voice therapy if all other issues ruled out

Question 24

Metabolite of oxazepam

Answer 24

Diazepam

Question 25

Is morphine a product of methadone?

Answer 25

No

Question 26

Big 4 of mono

Answer 26

sore throat, fatigue, myalgias, and lymphadenopathy

Question 27

When should steroids be used in mono

Answer 27

Only when there is airway compromise

Question 28

Initial therapy of hypercalcemia of malignancy

Answer 28

Fluid replacement with normal saline (enhances renal excretion of calcium)
Pamidronate only when patient is back to euvolemia

Question 29

In symptomatic uterine fibroid patients, when is myomectomy recommended over fibroid embolization

Answer 29

When the patient wishes to become pregnant in the future

Fibroid embolization shorter time off work and less recovery

Question 30

What causes melanosis coli

Answer 30

abuse of anthraquinone laxatives such as cascara, senna, or aloe

Question 31

Valsava increases the intensity of what murmer

Answer 31

HOCM

Question 32

Most common hip disorder in the young

Answer 32

Slipped capital femoral epiphysis (more common in boys and overweight children)
limping, leg pain, and limited internal rotation

Question 33

PEG tubes in elderly don’t do anything but

Answer 33

Increase use of restraints

no increase in quality of nutrition

Question 34

Best test for COPD diagnosis

Answer 34

spirometry

Question 35

Pain with eye movement suggests? Next step

Answer 35

An orbital problem

Imaging studies if you suspect an orbital problem

Question 36

When should a high risk patient get a colonoscopy

Answer 36

At 40 or 10 years before the earliest age a family member was affected, then every 5 years if normal

Question 37

Drugs that cause drug induced lupus pleurisy

Answer 37

hydralazine, procainamide, and quinidine

Question 38

When is doxy contraindicated in pregnancy

Answer 38

2nd and 3rd trimesters due to risk of tooth staining

Question 39

Effect of an extra 100 calories a day

Answer 39

weight gain of approximately 5 kg, which will then be maintained (fat must be fed, so newly created tissue will need increased calories to be fed)

Question 40

What controls asthma the best as a single agent

Answer 40

Inhaled corticosteroids

Question 41

What is infliximab

Answer 41

TNF-a inhibitor

Question 42

What should be stopped before getting a CT contrast

Answer 42

Metformin