6

Question 1

what disease are you looking for with TPO antibodies

Answer 1

Hashimoto thyroiditis

Question 2

hyperglycemia, ketoacidosis in setting of fever, sepsis, dehydration, hypotension

Answer 2

stress hyperglycemia- transient elevated glucose in setting of illness (not DM!)

Question 3

physiological lung mechanism of COPD and emphysema

Answer 3

VQ mismatch!

COPD- low vent: perfusion
emphysema: high vent: perfusion

Question 4

what type of shoulder pain affected (anterior, post, lateral) for rotator cuff tendinitis affecting abduction and ext rotation

Answer 4

lateral shoulder pain

Question 5

which bug illness? fever + severe polyarthralgias

Answer 5

chikugunya

Question 6

managing hep B

Answer 6

70% asymptomatic, few get badly sick. only hospitalize badly sick otherwise treat as close OP.

Hep B vaccine/Ig isnt helpful for known virus. And antiretrovirals only used for acute liver failure or immunocompromised

Question 7

risk of turning from acute to chronic hep B depending on the age group

Answer 7

adults: <5%

age 1-5: 20-50%

perinatal: 90%

Question 8

what AED changes can you make after conception in pregnant woman with epilepsy?

Answer 8

no changes!

Question 9

can you use AEDs in breastfeeding?

Answer 9

yes

Question 10

meds preferred for maintenance of afib with heart failure

Answer 10

amiodarone

dofetilide

Question 11

can you use rate control meds after cardio version for afib?

Answer 11

no not helpful (they failed rate control)

Question 12

rhythm control for afib with no CAD or structural heart disease

Answer 12

flecainamide,

propfenone

Question 13

ovarian torsion dx

Answer 13

US with doppler

Question 14

maintenance on SSRI for one episode vs >1

Answer 14

1: 6 months

> 1: 1-3 years or indefinitely

Question 15

which back pain improves with leaning forward and sitting and worse with extension?

Answer 15

lumbar spinal stenosis

Question 16

dx for spinal stenosis

Answer 16

MRI

Question 17

stress test- exercise or pharm indications

Answer 17

exercise preferred but do pharm when they cant tolerate exertional walking

Question 18

patient with high Ca, high Phos, high PTH

Answer 18

tertiary hyperparathyroidism

Question 19

how does CKD affect PTH

Answer 19

secondary hyperparathyroidism-

low vitamin d, phosphate retention –> low serum Ca –> PTH synthesis

——> then nl calcium levels

Question 20

treatment for tertiary hyperparathyroidism

Answer 20

parathyroidectomy if:

• persistent hypercalcemia, hyperphos
• very high PTH level
• soft tissue calcification
• intractable bone pain

Question 21

treatment of choice for sclereoderma renal crisis

Answer 21

ACEI

Question 22

fully immunized patients get a bad animal bite. get tetanus shot/ig?

Answer 22

get tetanus booster if:
clean wound and last vaccine >10 years
dirty wound and last vaccine >5 years

Question 23

non-immunized patients get a dirty animal bite. what do they get tetanus wise?

Answer 23

tetanus booster and Ig

Question 24

fever, ear pain, crankiness, purulent ear drainage

Answer 24

supporative otitis media

Question 25

when to avoid exercise in pregnant patient:

Answer 25

cervical insufficiency, cerclage
PPROM
placenta previa
persistent vaginal bleeding in 2nd and 3rd tri
Underlying conditions (HTN, lung dz, anemia)

Question 26

osteoporosis vs osteopenia t scores

Answer 26

penia:

Question 27

treatment for acute cystitis or asx bacteriruia in pregnant woman

Answer 27

cephalexin
amox-clauv
fosftomycin
nitrofurantoin- not in 1st semester

Question 28

bilateral hilar adnopathy, joint pain, cough, hypercalcemia

Answer 28

sarcoid

Question 29

prognosis of sarcoid

Answer 29

most (75%) resolve over time