16 APR 2017 1641 MIX

Question 1

what is the most common cause of meningitis in neonates? children 3mo-10y?

Answer 1

• neonates: group B strep

- children: strep pneumo (then neisseria)

Question 2

what is the treatment for babesiosis?

Answer 2

• 7-10d atovaquone plus azithromycin

- quinine plus clindamycin

Question 3

how is the diagnosis of dengue fever made?

Answer 3

tourniquet test

Question 4

what illness is diagnosed via the tourniquet test?

Answer 4

dengue fever

Question 5

dull, ill-defined pelvic pain that worsens with standing, along with dyspareunia?

Answer 5

pelvic congestion

Question 6

what is the long term treatment for severe hypercalcemia (over 14.0 mg/dL or symptomatic)? what is the MOA?

Answer 6

• bisphosphonate (zoledronic acid)

- inhibits bone resorption

Question 7

what are the presenting features of brown sequard syndrome?

Answer 7

• ipsilateral weakness, spasticity, loss of vibration and proprioception
• contralateral: loss of pain and temperature sensation

Question 8

what is the pathophysiology of anovulation secondary to obesity?

Answer 8

• FSH and LH levels are normal
• ovaries still produce estrogen, but progesterone is not being produced at the normal post ovulation levels
• progesterone withdrawal menses at the end of the cycle do not occur

Question 9

what is selective survival? it is a bias for what type of study?

Answer 9

• when cases are selected from the entire disease population instead of just those that are newly diagnosed
• case control

Question 10

what are the three main pathogens that can cause bloody diarrhea? what is the main organism that can cause bloody diarrhea in the absence of fever?

Answer 10

• e. coli (most common in absence of fever)
• shigella
• campylobacter

Question 11

using abx for e. coli diarrhea is not indicated because it can cause:

Answer 11

hemolytic uremic syndrome

Question 12

what is the pathogenesis of aspirin-exacerbated respiratory disease?

Answer 12

• pseudoallergic reaction resulting from increased production of pro-inflammatory leukotrienes and decreased production of anti-inflammatory prostaglandins
• arachadonic acid is diverted to the production of leukotrienes via the 5-lipooxygenase pathway since aspirin inhibits the COX pathway

Question 13

what is the treatment for uremic pericarditis?

Answer 13

hemodialysis

Question 14

dressler syndrome occurs within _________ weeks after MI

Answer 14

1-6

Question 15

what are exclusion criteria for cor pulmonale etiology?

Answer 15

• left heart failure
• congenital heart disease

by convention these are not considered reasons for cor pulmonale

Question 16

in cor pulmonale right heart catheterization will show pulmonary systolic pressure over ______

Answer 16

25 mm Hg

Question 17

• normal pleural fluid pH is __________
• transudative fluid has a pH range of ___________
• exudative fluid has a pH range of ___________

Answer 17

• normal pleural fluid pH: 7.60
• transudative fluid pH range: 7.4-7.55
• exudative fluid pH range: 7.30-7.45

Question 18

what are Lights criteria for an exudative pleural effusion?

Answer 18

• pleural protein / serum ration over 5.0
• pleural LDH / serum LDH over 6.0
• pleural LDH over 2/3 of upper limit of normal serum LDH

Question 19

where is DHEA prodcued in females? where is DHEAS (sulfate) predominantly produced in females? androgen producing tumors usually produce which one?

Answer 19

• DHEA: ovaries and adrenals
• DHEAS: adrenals
• androgen producing tumors produce DHEAS

Question 20

what is the mechanism behind class 1C antiarrhythmics’ efficacy against SVT?

Answer 20

“use dependence” - drug has less time to dissociate from sodium channels, leading to a higher number of blocked channels, which in turn leads to a progressive decrease in impulse conduction and widening of the QRS complex

(enhanced pharmacological effects of a drug during faster HRs and is seen with class I and class IV (CCBs) antiarrhythmics