6-26

Question 1

bony destruction, osteophyte formation, foot deformity in pt w/ diabetic neuropathy

Answer 1

neurogenic arthropathy

Question 2

treatment for acute hyponatremia

Answer 2

hypertonic saline

Question 3

rapidly progressive cellulitis of the submandibular space

Answer 3

ludwig angina - usually due to dental infections

Question 4

cancer arising from chronic wound

Answer 4

SCC

Question 5

treatment for greater trochanteric pain syndrome

Answer 5

NSAIDs, activity mod, heat -> PT, corticosteroid injection

Question 6

management of possible scaphoid fracture

Answer 6

CT/MRI if XR is neg

or splint + re-XR in 7-10 days

Question 7

test for thoracic aortic injury

Answer 7

CT angio of the chest

Question 8

most common malignancy of the lip

Answer 8

SCC

Question 9

drugs assoc w/ methemoglobinemia

Answer 9

topical anesthetics + dapsone

Question 10

imaging to confirm appropriate central venous catheter tip placement

Answer 10

CXR

Question 11

test for possible AAA

Answer 11

focused bedside US

Question 12

acid/base status in TB w/ primary adrenal insufficiency

Answer 12

non-AG metabolic acidosis (w/ hyperkalemia + hyponatremia)

Question 13

fever, maculopapular rash, + renal failure following administration of SMX-TMP

Answer 13

acute interstitial nephritis

Question 14

calcium changes during panic attacks

Answer 14

dec in serum ionized calcium (hypervent -> inc blood pH -> dec H+ bound to albumin -> inc Ca bound to albumin)

Question 15

AKI assoc w/ acyclovir

Answer 15

crystal-induced AKI (pcpt drug causes intratubular obstruction)

Question 16

glomerulonephritis following URI w/ low complement vs nml complement

Answer 16

low = PIGN

• subepithelial humps
• kids
• 10-21 days post URI

nml = IgA nephropathy

• mesangial
• adults
• 5 days post URI

Question 17

macrocytic anemia w/ nml MMA

Answer 17

folate deficiency

Question 18

dense intramembranous glomerular deposits

Answer 18

membranoproliferative GN - caused by persistent activation of alternative complement pathway

Question 19

renal vein thrombosis is assoc w/ what nephrotic syndrome?

Answer 19

membranous glomerulopathy

Question 20

treatment for hypovolemic hypernatremia

Answer 20

.9% saline until euvolemic -> then 5% dextrose

5% dextrose if asymptomatic

Question 21

urine casts following hypovolemic shock

Answer 21

muddy brown casts from acute tubular necrosis

Question 22

PBC treatment early in dz course

Answer 22

ursodeoxycholic acid

Question 23

1st line therapy for renal artery stenosis

Answer 23

ACE-Is and ARBs

Question 24

dz + treatment of stomal stenosis following roux-en-Y GB

Answer 24

esophagogastroduodenoscopy

Question 25

how does sarcoid cause hypercalcemia?

Answer 25

inc calcitriol production

Question 26

pts w/ nephrotic syndrome have an inc risk for what CV complications?

Answer 26

atherosclerosis + hypercoagulability (from hyperlipidemia + loss of ATIII)

Question 27

pain exacerbated by bladder filling, relieved by voiding - assoc w/ dyspareunia

Answer 27

interstitial cystitis (painful bladder syndrome)

Question 28

avoid what DMII drug in acutely ill pts w/ ARF, liver failure or sepsis?

Answer 28

metformin - leads to inc risk of lactic acidosis