5/26/13 a

Question 1

What is a good cutoff of plt count to start treating for ITP?

Answer 1

<30,000

Question 2

What is the first-line drug for ITP?

Answer 2

corticosteroids

Question 3

What is the first-line Tx for C. dif?

Answer 3

metronidazole

Question 4

What 2 drugs should be given for the empiric treatment of enephalitis in a non-immunocompromised adult?

Answer 4

Ceftriaxone (or cefotaxime) + Vancomycin

Question 5

What bug are people over 50 at risk of getting as a cause of meningitis?

Answer 5

Listeria monocytogenes

Question 6

What shoulld be added to the menignitis treatment regimen in people over 50 for Listeria?

Answer 6

ampicillin

Question 7

What should be given along w/ the Abx for menignitis in the normal adult?

Answer 7

dexamethasone

Question 8

What a re 3 indications for CT before LP in pts w/ meningitis?

Answer 8

papilledema, new-onset seizures, altered mental status, focal nauro compromise, immunocompromise

Question 9

What should be suspected in a severely immunocompromised AIDS pt w/ neurological changes and patchy, hypodense lesions in the white matter on CT?

Answer 9

Progressive Mulitfocal Leukoencephalopathy (PML)

Question 10

What is the best (most practical) confirmatory test for progressive multifocal leukoencephalopathy?

Answer 10

LP for JC virus DNA

Question 11

If an AIDS pt has a CT showing cystic lesions w/ calcifications and surrounding hydrocephalus, what is it?>

Answer 11

neurocysticercosis

Question 12

What is the tx for neurocysticercosis in the AIDS pt?

Answer 12

albendazole and methylprednisolone

Question 13

What is the treatment for progressive multifocal leukoencephalopathy in the AIDS pt?

Answer 13

no specific therapy; optimize HAART

Question 14

If AIDS pt w/ ring-enhancing brain lesions is unresponsive to pyrimethamine and sulfadiazine, what is the next step?

Answer 14

brain biopsy for CNS lymphoma (?)

Question 15

What layers of the esophageal wall are part of the outpouching of a Zenker’s diverticulum?

Answer 15

mucosa only (not a tre diverticulum!)

Question 16

Is a Zenker’s diverticulum located above or below the upper esophageal sphincter?

Answer 16

above

Question 17

What is the first step in hyperkalemia? Why do you do it?

Answer 17

calcium gluconate to stabilize the myocardium

Question 18

What causes the weakness, confusion, convulsions, and coma of hyperosmolar nonketotic coma (HONK)?

Answer 18

profound dehydration d/t hyperglycemic diuresis

Question 19

What are 2 ECG findings in hyperkalemia, other than peaked T waves?

Answer 19

short QT interval and ST depression

Question 20

A COPD pt has palpitations, feels like his heart skips a beat sometimes, and has extra stress lately. What is the most likely explanation?

Answer 20

Premature Atrial Contractions (PACs)