4/17/13

Question 1

What is the most common presenting sign of Hodgkin’s Disease?

Answer 1

Painless, firm cervical/supraclavicular lymph nodes

Question 2

Why do pts with Waterhouse-Friderichsen syndrome present with lg purpuric lesions?

Answer 2

Adrenal hemorrhage–>vasomotor collapse

Question 3

Hypo_______ is typical among alcoholics and causes refractory hypokalemia.

Answer 3

-magnesemia

Question 4

Deletion of what arm of what chromosome causes Cri-du-chat syndrome?

Answer 4

5p

Question 5

Woman has a fixed mass in her breast with nipple retraction. There is evidence of calcification on mammography. Core biopsies reveal foamy macrophages and fat globules. What does she have?

Answer 5

fat necrosis

Question 6

What is the proper treatment for fat necrosis of the breast?

Answer 6

std follow-up (self-limiting)

Question 7

What kind of paraneoplastic muscle weakness would present with symmetrical, proximal muscle weakness, without sensory loss or diminished reflexes?

Answer 7

dermatomyositis

Question 8

What do you call the condition following extended periods of vomiting that results in hypokalemic, hypochloremic metabolic alkalosis?

Answer 8

Contraction alkalosis

Question 9

There are 2 phases of contraction alkalosis. What occurs in the generation phase?

Answer 9

Loss of H+ (as HCl) causes increased serum bicarbonate.

Question 10

What occurs in the maintenance phase of contraction alkalosis?

Answer 10

Loss of volume –> Aldo –> K+ and H+ wasting in favor of Na+ retention

Question 11

Wht is the first step in treatment if contraction alkalosis?

Answer 11

Normal saline and K+

Question 12

AIDS pt presents with angioma-like growths on skin and viscera. Dx?

Answer 12

Bacillary angiomatosis (Bartonella)

Question 13

How does TPN cause gallstone formation?

Answer 13

Decreased gallbladder contraction –> stones/sludge

Question 14

How does estrogen promote the formation of cholesterol gallstones?

Answer 14

Increased activity of HMG CoA reductase.

Question 15

What diabetes medication should not be given to pts w/ renal failure, hepatic failure, or sepsis? Why?

Answer 15

Metformin; lactic acidosis

Question 16

Babesiosis is seen more commonly in pts w/ _______.

Answer 16

Asplenia or splenic dysfunction

Question 17

What complication of AAA repair should be suspected when the pt. presents post-op w/ abd pain and bloody diarrhea?

Answer 17

bowel ischemia (left and sigmoid colon)

Question 18

What causes ischemia to the left and sigmoid colon following aortic surgery?

Answer 18

loss of IMA during aortic graft placement

Question 19

What are typical MRI findings in progressive multifocal leukoencephalopathy (PML)?

Answer 19

multiple demyelinating, non-enhancing lesions in cortical white matter w/ no mass effects

Question 20

What are typical MRI findings for CNS toxoplasmosis?

Answer 20

multiple ring-enhancing lesions in basal ganglia w/ mass fx

Question 21

What are the typical MRI findings of primary CNS lymphoma?

Answer 21

solitary ring-enhancing mass lesion in periventricular area

Question 22

How do you confirm primary CNS lymphoma after MRI?

Answer 22

EBV DNA in CSF

Question 23

What must precede subacute sclerosing panencephalitis?

Answer 23

measles infection many years before

Question 24

What is another term for “external validity” when referring to a study?

Answer 24

generalizability

Question 25

What sort of neuropathy usually causes foot drop?

Answer 25

peripheral

Question 26

What nerve must be affected to cause foot drop?

Answer 26

common peroneal nerve or spinal nerve roots contributing to it (L4-S2)

Question 27

What is the acute tx for a cluster headache?

Answer 27

100% O2 and sumatriptan

Question 28

Which viral hepatitis, in its chronic form, presents w/ waxing and waning transaminase lvls and may cause arthralgias/myalgias?

Answer 28

C

Question 29

What dhould you suspect in a pt w/ + pronator drift?

Answer 29

upper motor neuron lesion (e.g. stroke)

Question 30

What 3 Sx characterize adult Still’s disease?

Answer 30

spiking fevers (>38), salmon-colored rash, and arthritis

Question 31

What is the juvenile equivalent of adult Still’s disease? (And don’t be a smart ass!)

Answer 31

systemic Juvenile Idiopathic Arthritis (a.k.a. adolescent Still’s disease)