2015 ITE

Question 1

According to JNC8, what med should not be used as first line for htn?

Answer 1

BB!! Use ACEI, ARB, CCB, Thiazides first

Question 2

Risks associated with inhaled corticosteroids in COPD?

Answer 2

increase the risk of bruising, candidal infection of the oropharynx, and pneumonia. They also have the potential for increasing bone loss and fractures. They decrease the risk of COPDexacerbations but have no benefit on mortality and do not improve FEV1 on a consistent basis.

Question 3

AUA Guidelines for microscopic hematuria?

Answer 3

Equal or >3 rbcs/hpf

Question 4

First line for primary dysmenorrhea?

Answer 4

NSAID’s, not coc’s

Question 5

Classification for kids 2-18 for weight

Answer 5

5%-85% nml, 85-94% overweight, 95%-99% obese.

Question 6

Most common cause of unintentional death in children?

Answer 6

MVA > Drowning > poison > fires >falls

Question 7

Short stature, low hairline, webbed neck?

Answer 7

Turner’s syndrome, need karyotype

Question 8

RSV- time of yr, dx and tx.

Answer 8

November to April, rarely associated with bacterial co-infection, self-limited, supportive care, don’t use steroids or abx. Don’t need lab or radiology studies, can try bronchodilators.

Question 9

Non displaced midshaft clavicular fracture, manage?

Answer 9

use arm sling, works as well as figure of eight and more comfortable.

Question 10

Children 2-8, nml weight, with OSA, TX?

Answer 10

Adenotonsillectomy

Question 11

SCFE vs Legg-Calve Perthes

Answer 11

SCFE 11-13 yrs for girls, 13-15 for boys, overweight, african-americans. LCP- avascular or aseptic necrosis of femoral head, boys 4-8, limping and knee pain.

Question 12

Patient with symptomatic PAD, how can you prevent CV events? (acute MI or stroke)

Answer 12

Aspirin or clopidogrel

Question 13

Vaccine that may put patients at risk of seizure

Answer 13

MMR, risk is for up to 2 wks after injection, a/w fam hx of epilepsy. (measles component)

Question 14

PPV- positive predictive value

Answer 14

% of patients who tested + and actually have the disease

Question 15

Infertility eval- regular periods

Answer 15

likely ovulating, confirm with progesterone >5 on d21 of cycle, then check tubal patency with HSG

Question 16

Infertility eval- irregular periods

Answer 16

anovulation, check tsh, estradiol, fsh, and prolactin

Question 17

AAA screening

Answer 17

Males who have ever smoked (100 or >) 65-75 yrs of age

Question 18

Leading cause of death of pts with RA

Answer 18

CAD

Question 19

Best treatment for OCD

Answer 19

repeated exposure therapy, can also try TCA and SSRI’s

Question 20

Tx of posterpetic neuralgia

Answer 20

oral gabapentin, pregabalin, amitriptyline or topical lido patch or capsaicin cream

Question 21

Pneumococcal vaccines >65

Answer 21

Ideally give PCV13 at 65 then PPSV23 6-12 mo later

Question 22

Pneumococcal vaccine

Answer 22

Immunecompromised give PSV12 then PSSV23 8 wks later, only PSVV23 if immunecompetent.

Question 23

Harmful meds in those with HF and EF

Answer 23

Nondihydropyridine CCB with negative inotropic effects like dilt and verapimil

Question 24

Systemic conditions a/w uveitis

Answer 24

spondyloarthropathy, sarcoid, syphilis, ra, reactive arthritis.

Question 25

Risk factors for Esophageal Adeno

Answer 25

Obesity and GERD, not h. pylori, nsaids, or crohns.

Question 26

Vitamin Supplement to prevent falls in Elderly

Answer 26

Vit D

Question 27

Midwestern US with bb sized calcifications

Answer 27

Histoplasmosis

Question 28

Daycare workers are susceptible to ? causing diarrhea

Answer 28

Giardia! foul-smelling stools, bloating, flatulence, treat with flagyl

Question 29

Big event + bloody diarrhea =

Answer 29

Campylobacter, treat with Cipro

Question 30

Tamoxifen side effects

Answer 30

VTE, endometrial cancer, leg cramps, bladder control issues, vag dryness, itching, discharge., vasomotor sx

Question 31

Lights criteria

Answer 31

pleural to serum protein >0.5, LDH >0.6 and/or pleural fluid >0.67 above nml mean exudative effusions like PE.

Question 32

Causes of transudative effusion

Answer 32

chf, cirrhosis, nephrotic syndrome, svc obstruction.

Question 33

Leading cause of death worldwide!

Answer 33

Cardiovascular disease, in particular ischemic heart disease.

Question 34

Causes of hyperthyroidism and how most differ from Graves

Answer 34

Postpartum thyroiditis, silent thyroiditis, subacute thyroiditis, exogenous thyroid ingestion, grave’s will also but with increased uptake.

Question 35

All pts with Croup should get…

Answer 35

single dose of dexamethason (0.15-0.6 mg/kg usually orally) even if mild disease, humidifier doesn’t work.

Question 36

Reptile (snake, turtles, lizards) can cause this infection..

Answer 36

Salmonella

Question 37

Keloid vs hypetrophic scar

Answer 37

keloids not confined to margins of initial injury

Question 38

Causes of resistant HTN?

Answer 38

OSA (30-40%), 1ary hyperaldosteronism >RAS > Parenchymal > thyroid.

Question 39

Best intervention for obesity according to USPSTF

Answer 39

Behavioral counseling w/high intensity sessions.

Question 40

USPSTF says we should screen who for HIV?

Answer 40

Everyone 15-64 with opt-out if pt chooses.

Question 41

Disease modifying drug for RA

Answer 41

Methotrexate, Prednisone is not disease modifying

Question 42

2 medications that can cause ILD

Answer 42

nitrofurantoin and amiodarone

Question 43

Flu vaccine ok with egg allergy

Answer 43

recombinant is made without eggs,

Question 44

chemoprophylaxis of Lyme’s

Answer 44

doxy

Question 45

anti-psychotic associated with risk of cardiac death and stroke

Answer 45

Seroquel (quetiapine)

Question 46

Example of Type IV reaction

Answer 46

contact dermatitis from nickel, poison ivy

Question 47

Marker used to monitor pancreatic adeno recurrence

Answer 47

ca19-9

Question 48

Marker for monitoring ovarian cancer recurrence

Answer 48

CA-125