11/9/21 bonus

Question 1

Cyanocobalamin is?

Answer 1

vitamin B12

deficiency: megaloblastic anemia –> inadequate dietary intake, gastrectomy, pernicious anemia (intrinsic factor deficiency)
sx: weakness, paresthesias, or subacute combined degeneration, which is involvement of the posterior column elements of the spinal cord leading to ataxia and loss of vibratory sensation

Question 2

What genetic syndrome is associated with Hirschsprung disease?

Answer 2

Down syndrome.

Question 3

Anticholinergic Toxidrome rx

Answer 3

Treatment is supportive care alone or in combination with antidotal therapy with physostigmine

Question 4

Vitamin Deficiencies

anemia, peripheral neuropathy, ataxia

Answer 4

E

Question 5

Vitamin Deficiencies

sideroblastic anemia, convulsions, peripheral neuropathy, INH use

Answer 5

B6 (pyridoxine)

Question 6

Vitamin Deficiencies

megaloblastic anemia + neurological symptoms, hypersegmented neutrophils

Answer 6

B12 (cobalamin)

Question 7

Vitamin Deficiencies

dermatitis, dementia, diarrhea, corn-based diet (pellagra)

Answer 7

B3 (niacin)

Question 8

Vitamin Deficiencies

alcohol use, malnutrition, Wernicke-Korsakoff syndrome

Answer 8

B1 (thiamine)

Question 9

What syndrome is characterized by the triad of glomerulonephritis, pulmonary hemorrhage, and circulating anti-glomerular basement membrane antibodies?

Answer 9

Goodpasture syndrome

Question 9

What syndrome is characterized by the triad of glomerulonephritis, pulmonary hemorrhage, and circulating anti-glomerular basement membrane antibodies?

Answer 9

Goodpasture syndrome

Treat with plasmapheresis, steroids, cyclophosphamide

(Granulomatosis with polyangiitis (aka Wegener granulomatosis presents with upper / lower respiratory tract and renal symptoms, but is not associated with anti-glomerular basement membrane antibodies)

Question 10

What is the mechanism of action of tPA?

Answer 10

It binds fibrin-bound plasminogen, thereby activating it to plasmin which then causes breakdown of fibrin

Question 11

Guillain-Barré Syndrome rx

Answer 11

Treatment is supportive, plasmapheresis, or IVIG

Question 12

How long can an elevated troponin level be detected after acute myocardial infarction?

Answer 12

Up to seven days.

Question 13

Alcoholic hallucinosis is classically characterized by what type of transient hallucinations?

Answer 13

Visual

Question 14

What are the classic visual hallucinations experienced by patients with alcoholic hallucinosis?

Answer 14

Pink elephants or Lilliputians (very small people).

Question 15

Open fractures are at high risk for infection, and studies have shown that the risk increases greatly when antibiotics are delayed __________ from the time of injury.

Answer 15

more than 3 hours

Question 16

__________ fractures are associated with Colles fractures

Answer 16

Ulnar styloid

Question 17

Median Motor and Sensory Hand Function Testing

Answer 17

Motor: OK sign
Sensory: two-point discrimination of tip of index finger

Question 18

Ulnar Motor and Sensory Hand Function Testing

Answer 18

Motor: abduct index finger (scissors motion)
Sensory: two-point discrimination over tip of fifth finger

Question 19

Radial Motor and Sensory Hand Function Testing

Answer 19

Motor: wrist and finger extension
Sensory: dorsal thumb-index finger web space