03 APR 2017 1149 MIX

Question 1

what is the treatment for congenital toxoplasmosis?

Answer 1

• pyrimethamine
• sulfadiazine
• folate

for one year

Question 2

infants with congenital toxoplasmosis who are asymptomatic at birth can go on to manifest what condition later in life?

Answer 2

chorioretinitis

Question 3

what are the 3 Ds of endometriosis?

Answer 3

• dysmenorrhea
• dyspareunia
• dyschezia

Question 4

in contrast to leukemoid reaction, CML is characterized by a _______ (low / high) leukocyte alkaline phosphatase level

Answer 4

low (due to cytochemically abnormal neutrophils)

Question 5

how does CML differ from leukemoid reaction in the context of peripheral smear?

Answer 5

in CML there is absolute basophilia and eary neutrophil precursor cells (as opposed to late precursors - metamyelocytes, bands - in leukemoid reaction)

Question 6

why may IgA anti-endomysial and anti-TTG antibodies be negative in celiac disease?

Answer 6

if there is concurrent selective IgA deficiency

Question 7

persistent depressive disorder is chronic depressed mood for over ____ years with no symptom-free period for more than ____ months

Answer 7

• 2

- 2

Question 8

what is the first line medical treatment for idiopathic intracranial hypertension? what is the MOA?

Answer 8

• acetazolamide

- inhibits choroid plexus carbonic anhydrase, thereby decreasing CSF production

Question 9

_____________________ testing is a noninvasive and highly sensitive and specific screening test for fetal aneuploidy

when can it be used?

Answer 9

• cell free fetal DNA

- after 10 weeks

Question 10

why do patients with preeclampsia get pulmonary edema?

Answer 10

generalized arterial vasospasm leads to increased SVR and high afterload

Question 11

magnesium sulfate toxicity can cause:

Answer 11

neuromuscular depression - decreased respiratory effort / apnea, muscle paralysis, somnolence, visual disturbances, and decreased or absent deep tendon reflexes

Question 12

what are the clinical features of aromatase deficiency?

Answer 12

• normal internal genitalia
• external virilization
• undetectable estrogen levels

Question 13

what is the triad of mccune-albright syndrome?

Answer 13

• cafe au lait spots
• polyostotic fibrous dysplasia
• autonomous endocrine hyperfunction

gonadotropin-independent precocious puberty

Question 14

what is the treatment for toxoplasma encephalitis? what is the PROPHYLAXIS treatment for CD4 under 100?

Answer 14

• sulfadiazine and pyrimethamine (plus leucovorin)

- PROPHYLAXIS: TMP-SMX for CD4 under 100

Question 15

what is the role of leucovorin in toxoplasma enchephalitis treatment (in addition to the sulfadiazine and pyrimethamine)?

Answer 15

prevention of hematological side effects

Question 16

what is chloracne? what is the presentation?

Answer 16

• severe skin disorder caused by exposure to halogenated hydrocarbons
• inflammatory nodules and large comedones affecting the head, neck and axillae

Question 17

how is delayed sleep phase syndrome characterized?

Answer 17

• sleep onset insomnia and excessive morning sleepiness
• “night owls” who have chronic problems going to sleep at a societally accepted time - they sleep normally when allowed to set their own schedule

Question 18

how is advanced sleep phase syndrome characterized?

Answer 18

• inability to stay awake in the evening

- early morning insomnia

Question 19

what is the presentation of hypertrophic osteoarthropathy?

Answer 19

digital clubbing accompanied by sudden onset arthropathy commonly affecting the wrist and hands