2/5/13 b

Question 1

What disorder should be suspected in a diabetic pt w/ non-anion gap metabolic acidosis, persistent hyperkalemia, and renal insufficiency?

Answer 1

type 4 RTA

Question 2

What is the pathophysiological mech of type 4 RTA?

Answer 2

deficiency of or insensitivity to aldosterone

Question 3

What drugs can worsen type 4 RTA?

Answer 3

ACE-I’s and ARB’s

Question 4

Where does the murmur of aortic stenosis typically radiate to?

Answer 4

the carotids

Question 5

A mid-diastolic murmur and opening snap are characteristic of what valvulopathy?

Answer 5

Mitral stenosis

Question 6

What is the biggest risk in ots w/ porcelain gallbladder?

Answer 6

gallbladder carcinoma

Question 7

What must be formed preceding gallstone ileus?

Answer 7

fistula btwn gallbladder and small bowel

Question 8

Toxicity from what vitamin can cause constipation, abdominal pain, weight loss, polyuria, and polydipsia?

Answer 8

D

Question 9

What is the first diagnostic step in the evaluation of suspected biliary obstruction?

Answer 9

US or CT

Question 10

What drugs are used to Tx ankylosing spondylitis?

Answer 10

analgesics and anti-TNF meds

Question 11

What measures are most important for reducing the risk of contrast-induced nephropathy?

Answer 11

IV hydration w/ isotonic bicarb or saline + acetylcysteine

Question 12

A renal mass on CT with thin walls, no solid component, no septae, and no enhancement is most likely ______.

Answer 12

a simple renal cyst and requires no intervention

Question 13

How can you differentiate the pain of rotator cuff tear from rotator cuff tendonitis?

Answer 13

pain of tear does not resolve on injection of lidocaine

Question 14

What is the imaging modality of choice for rotator cuff tears?

Answer 14

MRI

Question 15

_______ ahould be suspected in any pt over 50 w/ new-onset temporal headache, jaw claudication, vision loss, or symptoms of polymyalgia rheumatica.

Answer 15

Temproal arteritis

Question 16

What is the first step when temporal arteritis is suspected?

Answer 16

hi-dose steroids immediately (to prevent damage to retinal artery and vision loss or damage to other arteries)

Question 17

About 50% of pts. with temporal arteritis also have what other rheumatological disease?

Answer 17

polymyalgia rheumatica

Question 18

What are the main Sx of polymyalgia rheumatica?

Answer 18

pain in the shoulders and pelvic girdle, esp. in the morning, fatigue, anemia

Question 19

How do you confirm the Dx of giant cell arteritis (once hi-dose steroids have been administered)?

Answer 19

temporal artery biopsy

Question 20

What is the most common cause of painless hematuria in adults?

Answer 20

bladder tumors

Question 21

What should be suspected in older children presenting w/ diffuse edema, including the face, limbs, genitalia, larynx (causing breathing difficulty), and bowels (causing colicky pain)?

Answer 21

hereditary angioedema

Question 22

What is the common mechanism underlying both forms of hereditary angioedema?

Answer 22

C1 esterase inhibitor deficiency

Question 23

A young black male presenting with painless hematuria is most typical for _______.

Answer 23

sickle cell trait

Question 24

Progressive bilateral loss of central vision in a pt over 50 is what?

Answer 24

macular degeneration