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10 Flashcards

1
Q

Initial evaluation of chronic diarrhea

A

microscopic stool exam for leucocytes, parasites, ova, and occult blood

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2
Q

If patient develops rapid myelopathy (paresthesias, flaccid paralysis), what is best next step in management if they have bladder/bowel dysfunction? if they do not have bladder dysfx?

A
  • w/ bladder/bowel dysfx or sensory deficit, then MRI. Otherwise, it is GBS– nerve conduction study
  • If MRI is normal and gadolinum enhancement is absent, then lumbar puncture.
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3
Q

Treatment for nonfunctioning pituitary adenoma (increased alpha subunits, low gonadotropin levels)? For prolactinomas (prolactin >200)?

A
  • trans-sphenoidal surgery

- prolactinomas: cabergoline (dopaminergic meds)

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4
Q

Treatment of dumping syndrome (complication of gastrectomy, causes n/v, abdominal pain, diarrhea, neurovegetative sx like dizziness, sweating etc)

A

high protein diet, smaller more frequent meals

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5
Q

multiple brain metastasis treatment

A

whole brain radiation

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6
Q

Salmonella treatment

A
  • supportive- fluids and electrolytes
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7
Q

Plantar warts, usually due to HPV, treatment options

A
  • topical salicylic acid for at least 2-3 weeks
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8
Q

Surgical management options for renal cell carcinoma

A
  • if stage 1 (confined within renal capsule), then partial nephrectomy
  • if stage 2 (beyond renal capsule but not beyond Gerota’s fascia), then radial nephrectomy
  • if metastatic, then chemo/immunotherapy
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9
Q

Complications of multiple myeloma

A
  • hypercalcemia
  • renal insufficiency
  • infections (PNA, UTI)
  • hyperviscosity syndrome
  • lytic bone lesions- need skeletal survey, bisphosphonates for prevention
  • thrombosis
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10
Q

How does esophageal dysmotility present in scleroderma

A
  • absent peristalsis in lower two thirds of esophagus

- decreased LES tone (as opposed to achalasia, which has increased LES tone)

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11
Q

Indications for ICU admission in diabetic ketoacidosis

A
  • pH <7.1
  • bicarb < 5
  • AMS
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12
Q

Management of nonsuicidal self injury (scratching, superficial cuts)

A
  • screen for suicidal ideation

- comprehensive psych eval but no need to be admitted

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13
Q

Post partum thyroiditis vs Graves disease lab values for TSH, thyroglobulin, anti-TPO, RAIU, T4

A
  • both low TSH
  • post partum: high thyroglobulin–> occurs when thyroid gland destroyed
  • low RAIU vs high RAIU in graves
  • may have increased anti TPO in post partum
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14
Q

Clinical features of MCL tear

A
  • pain with valgus stress test
  • instability with lateral movement
  • effusion uncommon
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15
Q

When does type II error (beta) occur?

A

when study is too small
power= 1-beta
- when a study fails to reject a null hypothesis that is false

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16
Q

acute asthma exacerbation management

A
  • o2
  • short acting beta agonist (albuterol)
  • systemic steroids, NOT inhaled steroids (this is more for long term ppx)
17
Q

Treatment of metoclopramide induced acute dystonia

A
  • diphenhydramine IV- anticholinergic
18
Q

Initial evaluation of tuberous sclerosis (hypopigmented lesions/ashleaf spots, CNS lesions, seizures, autism, behavior problems, rhabdomyoma)

A
  • skin examination
  • MRI of brain for hamartomas
  • EEG if seizures are present (seizures most predominant cause of death)
19
Q

Risk factors and screening for iron deficiency anemia in children <2

A
  • exclusive breastfeeding after 6 months
  • lead exposure
  • prematurity
  • low iron diet, exposure to milk before age 1
  • screening test: CBC when 9-12months old
20
Q

What test should women with elevated AFP receive? (AFP measurements occur 16-20 weeks)

A

Ultrasound

21
Q

Clinical features of Chagas disease (leading cause of dilated cardiomyopathy in Central and South America)

A
  • Left ventricular apical aneurysm
  • embolic complications
  • arrhythmias
22
Q

Kava kava side effect (used for anxiety)

A

hepatic injury

23
Q

Side effect of licorice (used for stomach ulcers, bronchiolitis/viral infection)

A

hypertension, hypokalemia

24
Q

Prevention for acute rheumatic fever (usually after untreated streptococcal meningitis; joints, cardiac issue, nodules, erythema marginatum, syndemham chorea)

A

IM penicillin for group A strep until adulthood

25
Q

Med choice during pregnancy in hyperthyroidism patients

A
  • in first trimester: propylthiouracil

- in second and third, can use methimazole due to liver toxcity of ptu

26
Q

In blunt cardiac injury in MVA, what are initial tests that should be ordered?

A
  • chest x-ray; if abnormal, then CT chest or FAST

- ECG

27
Q

Treatment of adhesive capsulitis (frozen shoulder; decrease in both passive and active movements)

A
  • ROM exercises

- glucocorticoid injection

28
Q

What is Nelson’s syndrome?

A
  • pituitary enlargement, hyperpigmentation, visual field defect following bilateral adrenalectomy
29
Q

First line treatment for prolactinomas?

A

dopaminergic receptor agonist, including large prolactinomas

step3 (16 decks)

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