6.10.2019

Question 1

difference between narcissistic and antisocial

Answer 1

antisocial: must have pediatric dx of conduct disorder
Narc: needing admiration (not necessarily lawbreaking)

Question 2

what is a heart path with early diastolic sound followed by a soft diastolic murmur

Answer 2

atrial myxoma

Question 3

what symptoms expected in toxic ingestion of TCA’s

Answer 3

anticholinergic symptoms

Question 4

bugs expected in IE?

Answer 4

strep species 75%, staph 25% in native valve (HACEK is less likely)

Question 5

Treatment for scabies

Answer 5

sarcoptes scabiei is treated with permethrin 5% from neck down in 2 sessions separated by 1 week

Question 6

what is another 1st line option for scabies?

Answer 6

ivermectin

Question 7

what is 2nd line option for scabies treatment?

Answer 7

lindane

Question 8

what are physiologic cranial strain patterns?

Answer 8

side bending rotation, torsions

Question 9

what should be suspected in someone with IE and + Cx growing Strep gallolyticus or bovis?

Answer 9

CRC

Question 10

crush injury worries?

Answer 10

compartment syndrome, or rhabdo (manifested by hyperkalemia and poss fatal arrhythmias)

Question 11

where is the chapman point for rectum

Answer 11

over less trochanter

Question 12

where is the chapman point for prostate?

Answer 12

posterior margin of IT band

Question 13

Intense pruritus and burning over face and chest… diffuse erythema over affected areas 10 minutes after vanc infusion was begun.

Answer 13

This is red man syndrome! Hypersensitivity type 1 thus Anti-H’s and slow infusion rate.

Question 14

coagulation factors dependent on vit K

Answer 14

1972: 10, 9, 7, 2

Question 15

what coagulation factors will be effected by warfarin?

Answer 15

1972: 10, 9, 7, 2

Question 16

which coagulation factor will be dealt with first when warafarin is started, and how will it be manifest?

Answer 16

Factor VII, the PT will rise.

Question 17

treatment of Acetminophen OD

Answer 17

depends on phase:
within 1 hour: charcoal
1-8 hours: monitor ASTALT and administer NAC if persistent rise
after 8 hours: deliver NAC

Question 18

pathophys of lambert Eaton?

Answer 18

ab’s to presynaptic Ca channel channels

Question 19

pathophys of myasthenia Gravis?

Answer 19

ab to post synaptic nicotinic Ach receptors

Question 20

Central scarring on CT of liver=

Answer 20

FNH… no need to stop contraception

Question 21

klumpke presentation

Answer 21

Intrinsic hand muscle paralysis & left sided miosis & ptosis… C8-T1 (ulnar nerve distribution numbness with horners)

Question 22

Hemorrhagic stroke risk is reduced most by

Answer 22

BP control > smoking cessation

Question 23

Size of hepatic adenomas that require surgical intervention=

Answer 23

5cm if no decrease in size after discontinuation of OCP’s

Question 24

Difference between meningitis/sepsis with Neisseria versus S. pneumo?

Answer 24

Palpable purpuric rash

Question 25

Cause of rash in celiac disease?

Answer 25

Rash is dermatitis Herpeteformis which is because of immune complex deposition in the papillary dermis. Dapsone/ diamino diphenyl sulfone is the tx.

Question 26

Mnenomic for cholinergic excess

Answer 26

DUMBELS (diarrhea urinary incontinence miosis muscle weakness bronchospasm bradycardia emesis lacrimation)