18 JAN 2017 1759 IM

Question 1

what is the treatment for febrile neutropenia?

Answer 1

immediate IV BSA - monotherapy with an anti-pseudomonal beta lactam (cefepime, meropenem, pipercillin-tazobactam)

Question 2

how can toxic adenoma and multinodular goiter be differentiated, since they both display a nodular pattern?

Answer 2

• toxic adenoma - focal uptake of radioactive iodine

- multinodular goiter - patchy distribution

Question 3

how are mild cases of hypovolemic hypernatremia treated? severe cases?

Answer 3

• mild: 5% dextrose in 0.45% saline

- severe: 0.9% saline

Question 4

what are the ECG features of a mobitz I second degree AV block (wenckebach)?

Answer 4

• progressive prolongation of PR interval leading to non-conducted P wave and a dropped QRS complex
• constant P-P interval
• increasing PR interval
• decreasing R-R interval
• group beating (repeating clusters of beats followed by a dropped QRS)

Question 5

what is the pharmacotherapy for raynaud’s phenomenon?

Answer 5

dihydropyridine CCBs - nifedipine, amlodipine

Question 6

what is the most common cause of glomerulonephritis in adults? when does it manifest?

Answer 6

• IgA nephropathy

- occurs within 5 days (as opposed to 10-21 with post-strep GN)

Question 7

what is the best diagnostic test for acute diverticulitis?

Answer 7

abdominal CT with oral and IV contrast

Question 8

what are the first and second line treatment options for beta blocker toxicity?

Answer 8

• first line: IV fluids and atropine

- second line (for profound refractory hypotension): IV glucagon