21 JAN 2017 1348 IM

Question 1

what level is diagnostic for gastrinoma?

Answer 1

fasting gastrin level over 1000 pg/mL

Question 2

what stimulates the release of gastrin from gastrinoma cells?

Answer 2

• secretin
• (normal gastric G cells are inhibited by secretin; therefore secretin administration should not case a rise in serum gastrin concentrations in patients with other causes of hypergastrinemia)

Question 3

what is the gold standard diagnostic evaluation for type 2 heparin inducted thrombocytopenia?

Answer 3

serotonin release assay

Question 4

patients with pernicious anemia need to be monitored for the development of what type of cancer?

Answer 4

gastric

Question 5

what are the most frequent location of the ectopic foci that cause atrial fibrillation?

Answer 5

pulmonary veins

Question 6

what is westermark’s sign? it can be seen in what condition?

Answer 6

• peripheral hyperlucency due to oligemia

- PE

Question 7

what is hampton’s hump? it can be seen in what condition?

Answer 7

• peripheral wedge of lung opacity due to pulmonary infarction
• PE

Question 8

what is fleischner sign? it can be seen in what condition?

Answer 8

• enlarged pulmonary artery

- PE

Question 9

what is the treatment for hemophilia A and B?

Answer 9

• factor VIII (A) or factor IX (B)

- desmopressin for mild hemophilia A

Question 10

morning stiffness for over one hour is indicative of ________

Answer 10

RA

Question 11

TTP pentad

Answer 11

• thrombocytopenia
• microangiopathic hemolytic anemia (schistocytes)
• renal insufficiency
• neurologic changes
• fever

Question 12

how can TTP and DIC be differentiated? how can TTP be differentiated from HUS?

Answer 12

• in TTP lab markers (PT) are normal; in DIC they are abnormal
• HUS is due to e. coli O157:H7 and is primarily a disorder of the renal system; neuro findings and fever are uncommon in HUS

Question 13

how is TTP treated?

Answer 13

plasma exchange

Question 14

what is Felty syndrome? what is the classic triad?

Answer 14

• severe, seropositive RA with increased risk for extra-articular manifestations (vasculitis, skin ulcers)
• inflammatory arthritis, splenomegaly, neutropenia

Question 15

how is the defect in INO described?

Answer 15

• affected eye (ipsilateral to lesion) is unable to adduct and the contralateral eye abducts with nystagmus
• convergence and pupillary light reflex are preserved

Question 16

what would be observed in damage to the edinger westphal nucleus?

Answer 16

ipsilateral fixed and dilated pupil that is nonreactive to light or accomodation

Question 17

INO is due to damage of the ________

Answer 17

MLF

Question 18

• unilateral MLF lesions can occur with what type of stroke?
• bilateral MLF lesions can occur with __________

Answer 18

• unilateral MLF lesions: lacunar stroke in the pontine artery distribution
• bilateral MLF lesions: multiple sclerosis