6.12.2019

Question 1

Acute mesenteric arterial thrombosis tx:

Answer 1

IVF, Nasogastric decompression, heparin anticoag, broad spectrum abx therapy.

Question 2

Difference between Mobitz type 1 and 2

Answer 2

Type 2: PR is constant and then a suddenly dropped QRS (can occur every 2, 3, or 4 beats)

Type 1 is Wenkebach is where PR progressively increases to where it drops a QRS

Question 3

Histo findings for celiac dz:

Answer 3

intraepithelial lymphs & villous blunting in duodenum

Question 4

Extraintestinal manifestations of celiacs:

Answer 4

depression, anemia, osteopenia, dermatitis herpetiformis, IgA nephropathy

Question 5

Boerhaave’s tx

Answer 5

if contained can be treated medically!

Question 6

What is the most likely nerve to be compressed in an intracranial mass?

Answer 6

CN VI as it has a long course. Manifested by weak abduction

Question 7

SIBO or blind loop syndrome:

Answer 7

occurs when there is normal colon flora that makes it’s way to the small intestine. The way to test for this is with a breath carbohydrate test. In people with altered motility or something that puts that at risk for intestinal stasis will be at risk for SIBO.

Question 8

Preseptal vs Orbital cellulitis

Answer 8

Preseptal (periorbital cellulitis) is everything anterior to orbital septum: unilateral eyelid swelling, redness, and pain. Dermis infection mostly!

Orbital is more the orbital fat that is infected and can track intracranially: proptosis, diplopia, and painful extraocular movements

Question 9

Relative risk:

Answer 9

(exposed with dz/total exposed)/(unexposed with dz/total not exposed)

Question 10

Constitutional growth delay:

Answer 10

where the child is born at normal size then drops low at age 3ish, then has delayed pubertal growth spurt- will reach normal adult stature. Rule out hypopituitarism via looking at no other pituitary hormone problems.

Question 11

Seborrheic dermatitis

Answer 11

is anywhere sebaceous glands are present. On the head it is known to cause cradle cap in babies and dandruff in adults. Non-pruritic, red patches, causes white flakes, no blood.

Question 12

Sheehans syndrome… lab levels?

Answer 12

is where all of the pituitary hormones will be at low levels!

Question 13

Auspitz sign.

Answer 13

Psoriasis has white silvery scaley rash. Will have pinpoint bleeding if the lesion is peeled

Question 14

Dumping syndrome is

Answer 14

related to a number of different surgeries (all related to GI and usually stomach). It is where usually a high carb load eaten will make you have symptoms (weakness, diaphoresis, palpitations) and then explosive diarrhea.

Question 15

Dx Dumping syndrome

Answer 15

Diagnosed by a glucose challenge test.

Question 16

Central herniations:

Answer 16

downward. Tear of basilar A (Duret hemorrhage). Hyperventilation & Cheyn-Stokes breathing.

Question 17

what is a tonsillar herniation

Answer 17

downward of cerebellum through foramen magnum causing compression of medulla causing cardiac dysfunction.

Question 18

Lichen Planus: 5P’s

Answer 18

Pruritic 
    Purple 
    Polygonal 
    Papules 
    Plaques

Question 19

Pheo rules of 10

Answer 19

recurrence post surgery, familial, bilateral, extra-adrenal, malignant, in kids

Question 20

acute decompensated HF tx

Answer 20

WET&COOL- diuretics/inotropes…
WET&WARM- diuretics/vasodilators…
DRY&COOL- IVF/Inotropes…
DRY&WARM- stable CHF so bb’s and Acei’s

Question 21

PCOS: need 2/3 of what sx’s to dx?

Answer 21

acne, hirsutism, hyperandrogenism

Question 22

Tx for PCOS hyperandrogenism?

Answer 22

spironolactone

Question 23

Meckels diverticulum…

Answer 23

rules of 2:

Question 24

rules of 2: (for meckels)

Answer 24

2% of population, presents before 2YO, 2:1 male, 2 ft of IC valve, 2 inches in length, 2 types of mucosal tissue (gastric or pancreatic)

Question 25

Histo of thalassemias

Answer 25

Target cells

Question 26

Histo of primary myelofibrosis

Answer 26

Dacryocytes

Question 27

mnemonic for causes of delirium

Answer 27

MI WATCH DEATH: Metabolic derangements, infections, withdrawal, abuse of substance, trauma, CNS path, Hypoxia, deficiencies, endocrine, acute MI, heavy metals

Question 28

most common causes of small bowel obstructions?

Answer 28

Adults: Adhesions
Kids: Hernias

Question 29

Erthematous patchy raised scaly lesions over back. Bx reveals T-cell infiltrates.

Answer 29

Mycosis fungoides #1 common cutaneous T-cell lymphoma, a non-hodgkin lymphoma.

Question 30

Where does Calcitonin come from?!?!?

Answer 30

The medullar C-cells of the thyroid

Question 31

What job to look for silicosis?

Answer 31

rock quarry, sand blasting

Question 32

What job to look for asbestosis?

Answer 32

shipyard, construction

Question 33

What job to look for beryllliosis?

Answer 33

electrical manufacturing, and aeronautics

Question 34

DPLD

Answer 34

Diffuse parenchymal lung disease

Question 35

pft’s in DPLD?

Answer 35

FEV1 down, FVC down, however the FEV1/FVC ratio will be normal or up!`

Question 36

paramyxoviridae?

Answer 36

Measles, mumps, RSV, parainfluenza

Question 37

Measles AKA?

Answer 37

Rubeola

Question 38

Mumps complication?

Answer 38

SSPE (subacute sclerosing pan encephalitis)

Question 39

Parainfluenza virus AKA?

Answer 39

Croup, laryngotracheobronchitis