17 JAN 2017 2102 IM

Question 1

What prophylaxis is given to HIV patients with CD4 counts under 50?

Answer 1

Azithromycin for MAC

Question 2

Short systolic murmur at the cardiac apex that disappears with squatting?

Answer 2

Mitral valve prolapse

Question 3

What is the empiric treatment of choice for meningococcal meningitis?

Answer 3

Third generation cephalosporin (ceftriaxone) and vancomycin

Question 4

What is the most feared side effect of antithyroid drugs (PTU, MMI)? What symptoms should you look for?

Answer 4

Agranulocytosis – fever and sore throat

Question 5

in what ways can metabolic alkalosis be classified?

Answer 5

• saline-responsive (lower urinary chloride)

- saline unresponsive (higher urinary chloride)

Question 6

does saline responsive metabolic alkalosis have low or high urinary chloride?

Answer 6

lower

Question 7

does saline unresponsive metabolic alkalosis have low or high urinary chloride?

Answer 7

higher

Question 8

what are the usual causes of saline-responsive metabolic alkalosis?

Answer 8

• loss of gastric secretions
• self-induced vomiting
• NG suctioning

results in ECF loss

Question 9

what are the ramifications of ECF loss as a result of saline-responsive metabolic alkalosis?

Answer 9

• increased renal mineralocorticoid levels
• increased renal sodium and chloride reabsorption
• increased urinary H and K excretion

END RESULT: decreased urinary chloride, hypokalemia, metabolic alkalosis

Question 10

Does persistent diarrhea lead to a metabolic acidosis that is anion gap or non-anion gap?

Answer 10

Non-anion gap

Question 11

All forms of renal tubular acidosis lead to an acidosis that is ________________ (anion gap / non-anion gap)

Answer 11

Non-anion gap

Question 12

Primary hyperaldosteronism leads to what type of acid base disorder?

Answer 12

Metabolic alkalosis

Question 13

What can be done to differentiate Bell’s palsy from an intracranial process?

Answer 13

Raising of eyebrows – forehead muscle sparing is suggestive of an intracranial lesion

Question 14

what should be suspected in a patient presenting with BILATERAL trigeminal neuralgia?

Answer 14

MS

Question 15

crescent shaped hyperdensity on non-contrast CT?

Answer 15

subdural hematoma

Question 16

a posterior cerebral artery thrombosis results in what type of vision abnormality?

Answer 16

contralateral homonomous hemianopia with macular sparing

Question 17

what are the most common symptoms of MR? why?

Answer 17

• exertional dyspnea
• fatigue

decreased CO and increased left atrial pressure

Question 18

headaches that are worse in the morning are usually due to:

Answer 18

ICP

Question 19

acid base disturbances can be diagnosed by assessing the pH changes and either the _______________ or ________________

Answer 19

• serum bicarb

- serum pCO2

Question 20

in mechanical ventilation, the PaO2 is influenced mainly by what two factors?

Answer 20

• FiO2

- PEEP

Question 21

in mechanical ventilation the PaCO2 is a measure of _________________ and is affected by what two factors?

Answer 21

• pulmonary minute ventilation
• RR
• TV

Question 22

what mechanical ventilation setting should be reduced in order to prevent over-oxygenation leading to free radical damage and atelectasis?

Answer 22

FiO2

Question 23

what are some causes of NAFLD?

Answer 23

• increased transport of FFA from adipose tissue to liver
• decreased oxidation of FFA in the liver
• decreased clearance of FFA from the liver (due to decreased VLDL production)
• peripheral insulin resistance - increased peripheral lipolysis, TG synthesis, and hepatic uptake of FA

Question 24

what is the most common mechanism responsible for ventricular arrhythmias in the immediate post-infarction period?

Answer 24

re-entry