04 JAN 2017 0802 IM

Question 1

what is the first line treatment for aborting a cluster headache?

Answer 1

100% oxygen by face mask

Question 2

anterior cord syndrome or central cord syndrome?

total loss of motor function below level of lesion with loss of pain and temperature on both sides below lesion - proprioception is INTACT

Answer 2

anterior

Question 3

anterior cord syndrome or central cord syndrome?

burning pain and paralysis in upper extremities with relative sparing of lower extremities

Answer 3

central

Question 4

what are the classic ECG findings for a PE?

Answer 4

• prominent S in lead I
• prominent Q in lead III
• inverted T in lead III

S1Q3T3

Question 5

how does follicular thyroid cancer spread?

Answer 5

hematogenously

Question 6

stool osmotic gap can be used to differentiate between what two types of diarrhea?

Answer 6

secretory and osmotic

Question 7

secretory and osmotic diarrhea can be differentiated by looking at what value?

Answer 7

stool osmotic gap

Question 8

what are the stool osmotic gap cutoff values for osmotic vs secretory diarrhea?

Answer 8

osmotic: over 250 mOsm/kg
secretory: under 50 mOsm/kg

Question 9

why does heparin need to be bridged for a few days while warfarin kicks in?

Answer 9

warfarin inhibits vitamin K dependent clotting factors II, VII, IX, and X. It ALSO inhibits proteins C and S. Protein C anticoagulant activity decreases 50% in the first few days, while it takes longer for procoagulant factors to decrease

Question 10

what is the treatment for warfarin induced skin necrosis?

Answer 10

protein C concentrate

Question 11

how are case control and retrospective cohort studies different?

Answer 11

distinction is in the order in which outcomes and risk factors are assessed:

• case control studies determine outcome and then look for associated risk factors
• retrospective cohort studies ascertain risk factor exposure and then determine the outcome

Question 12

treatment options for uncomplicated cystitis

Answer 12

1. nitrofurantoin (5 days)
2. TMP-SMX (3 days)
3. fosfomycin single dose

Question 13

what types of casts are seen in chronic renal failure?

Answer 13

broad and waxy

Question 14

• muddy brown casts = ?
• RBC casts = ?
• WBC casts = ?
• fatty casts = ?
• broad and waxy casts = ?

Answer 14

• muddy brown casts = ATN
• RBC casts = glomerulonephritis
• WBC casts = interstitial nephritis and pyelonephritis
• fatty casts = nephrotic syndrome
• broad and waxy casts = chronic renal failure

Question 15

what is the most common form of nephrotic syndrome associated with malignancies? what is the exception?

Answer 15

membranous glomerulopathy

*exception - minimal change disease is often seen with Hodgkin lymphoma

Question 16

what kind of analysis can be performed to deal with selection bias?

Answer 16

intention to treat analysis