03 APR 2017 1256 MIX

Question 1

Painless hematuria in sickle cell disease is due to what type of renal pathology?

Answer 1

Renal papillary ischemia or necrosis

Question 2

What are the renal complications of sickle cell disease?

Answer 2

• Renal papillary ischemia or necrosis
• Inability to concentrate the urine (vasa recta damage with inability to maintain concentrated medullary gradient)
• Distal renal tubular acidosis (tubular damage with impaired proton secretion)

Question 3

What is the treatment for invasive pulmonary aspergillosis?

Answer 3

• 1-2 weeks IV voriconazole plus an echinocandin (caspofungin)
• Followed by prolonged therapy with voriconazole alone

Question 4

What is the gold standard test for diagnosing DM2 in patients with PCOS? Why?

Answer 4

• Oral glucose tolerance test

- More sensitive in detecting glucose intolerance than standard screening tests (fasting glucose, HbA1C)

Question 5

Why is creatinine clearance not used as a screening tool for diabetic nephropathy?

Answer 5

Creatinine clearance is high early in kidney disease due to glomerular hyperfiltration, and low later on

Question 6

Why is dipstick testing not indicated as screening for protein in diabetic nephropathy?

Answer 6

Can only detect macroproteinuria (over 300 mg/24hr)

Question 7

What is the medication profile for severe asthma exacerbation?

Answer 7

• SABAs
• Ipratropium nebulizer
• Systemic corticosteroids

Question 8

Adding ________________ to SABAs may cause greater bronchodilation than either agent alone and is recommended during emergency care of severe asthma exacerbations

Answer 8

Ipratropium

Question 9

After an hour of severe asthma exacerbation following SABAs, ipratropium, and systemic corticosteroid therapy, what medication can be used?

Answer 9

Magnesium sulfate, one time infusion

Question 10

Urinary retention caused by anticholinergic agents results from impairment of:

Answer 10

Detrusor muscle contraction, and to a lesser extent internal sphincter contraction

Question 11

In adjustment disorder, symptoms must present within ____ months of an identifiable stressor and last no more than ____ months after the stressor ends

Answer 11

3, 6

Question 12

What is the treatment for acute dystonia?

Answer 12

Benztropine or diphenhydramine

Question 13

What is the treatment for akathisia?

Answer 13

BB (propanolol) or benzodiazepine (lorazepam)

Question 14

What is the treatment for parkinsonism (drug-induced)?

Answer 14

Benztropine or amantadine

Question 15

The most common site of metastatic spread of a choriocarcinoma is the:

Answer 15

Lungs

Question 16

Head sparing growth lag suggests fetal growth restriction that occurred during what trimester(s)?

Answer 16

2nd or 3rd

Question 17

The most common cause of vaginal bleeding and discharge in the neonatal period is:

Answer 17

Maternal withdrawal of estrogen

Question 18

What is the first line imaging study in a woman over 30 with a palpable breast mass? What about women under 30?

Answer 18

• Over 30: mammography

- Under 30: US

Question 19

Definition: lochia

Answer 19

Vaginal discharge containing blood and mucous – normal up to 6-8 weeks postpartum

Question 20

Most patients who fall ill with vibrio vulnificus infection have underlying ______________ and show manifestations of:

Answer 20

• Liver disease (hemachromatosis most common)

- Necrotizing fasciitis with hemorrhagic bullous lesions, septic shock

Question 21

What are the unfavorable metabolic side effects of thiazide diuretics? What are the electrolyte abnormalities?

Answer 21

Metabolic:

• Hyperglycemia
• Increased LDL and plasma trigs
• Hyperuricemia

Electrolyte:

• Hyponatremia
• Hypokalemia
• Hypomagnesemia
• Hypercalcemia

Question 22

Osteomalacia can be a consequence of what type of renal tubular acidosis?

Answer 22

Type 2 (proximal)

Question 23

Maternal serum AFP is used primarily to screen for:

Answer 23

• Open neural tube defects
• Fetal abdominal wall defects
• Multiple gestations

Question 24

How can tay sachs and nieman pick disease be distinguished?

Answer 24

• Tay sachs: hyperreflexia

- Nieman pick: areflexia