7 Flashcards

(33 cards)

1
Q

lichen planus diagnostic test
(intense pruritic polygonal shaped violaceous papules in flexure surfaces (mostly wrist), buccal mucosa, or external genitalia)

A

punch biopsy

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2
Q

Treatment of polycystic ovarian disease

A

weight loss

if that fails, then clomiphene citrate

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3
Q

In absence of MPOA or advance directives, who should the staff contact?

A

highest priority surrogate decision maker

ethics committee only consulted when opinions are opposing

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4
Q

Horner’s syndrome (miosis, ptosis and often anhidrosis) and unilateral headache, ddx and best diagnostic test

A

carotid artery dissection

CT angiography is first step, catheter angiography is gold standard, MRA alternative

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5
Q

Whats the best initial screening test for thyrotoxicosis for pregnant ladies?

A

TSH

total T4 and T3/free T4 T3 not as reliable as they are higher than normal, has to be adjusted

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6
Q

When is amiodarone preferred as antiarrythmic drug in paroxysmal afib patients?

A

structural heart disease (LVH, CHF)

normal heart: flecainide

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7
Q

Diagnosis and treatment for epistaxis, petechiae, worse with use of aspirin, normal platelet count.

A

VWF

  • ristocetin cofactor assay, VWF level (carries factor VIII in blood)
  • first line tx: desmopressin/DDAVP
  • next best step: factor VIII replacement (has both vwf and factor VIII)
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8
Q

Drugs that increase TBG and decrease free T4 may need higher doses of thyroxine replacement. Which drugs?

A

estrogen
tamoxifen
raloxifene
methadone, heroine

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9
Q

Drugs that decrease TBG and increase free T4 may need lesser doses of thyroxine replacement. Which drugs?

A

steroids
androgens
danazol

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10
Q

hydrothorax, a common cause of transudative pleural effusion in patients with cirrhosis and ascites and is located on the right. Treatment?

A
  • sodium restriction, diuretics

- TIPS as second line

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11
Q

E.coli and GBS are common bugs in neonates (<28 days), strep pneumo and neisseria (>28 days). Broad spectrum abx needed immediately. Which ones?

A
  • ampicillin and gentamicin or cefotaxime

- ceftriaxone or cefotaxime, +/- vanc based on meningeal involvement

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12
Q

Infant botulism from environmental dust containing spores. Treatment?

A

Human derived botulinum toxin

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13
Q

Following viral pericarditis/cardiac surgery, pt presents with right heart failure, peripheral edema, ascites, elevated JVP, hepatojugular reflex, Kussmaul’s sign, pericardial knock, pericardial calcifications on chest radiograph. Ddx?

A

Constrictive pericarditis

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14
Q

Saw palmetto’s use and SE

A

benign prostate hyperplasia

risk of bleeding

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15
Q

Most common complication of lumbar myelomeningocele

A

bladder dysfunction

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16
Q

Which smoking cessation meds should be avoided in pts with depression or SI? seizures?

A

avoid varenicline for unstable psych sx

avoid buproprion for seizures

17
Q

abrupt onset of butterfly rash, sharp demarcation, painful, red, edematous. ddx? common bug?

A

erysipelas

group a strep

18
Q

postpartum endometritis treatment?

A

clindamycin and gentamicin

* metronidazole is contraindicated in breastfeeding mothers

19
Q

maculopapular rash that spreads from face caudally, acute arthritis, thrombocytopenia, and encephalitis, fever, lymphadenopathy of posterior cervical and suboccipital nodes. Ddx?

20
Q

Cough, conjunctivitis, coryza, blue white koplik spots, starts on face and spreads caudally. Ddx?

A

Measles/ Rubeola

21
Q

Causes of post operative hypoxemia

A

immediate: airway obstruction/edema, residual meds effect
early: bronchospasm (wheezing)
1-5 days: pneumonia
2-5 days: atelectasis
3 days to over a week: PE

22
Q

Which electrolyte imbalance post op causes hyperactive deep tendon reflexes

23
Q

Management and treatment of seborrheic keratosis

A

if symptomatic and cosmetically disfiguring, then can do curettage/shave excision
otherwise, no treatment needed

24
Q

Whats the best contraceptive method for pts with sickle cell disease?

A

progestin only methods (intrauterine device), as it decreases amount of menses
estrogen containing methods promote thromboembolism
copper IUD has severe bleeding and dysmenorrhea first year

25
type of poisoning in improperly stored seafood that causes palpitations, abdominal cramps, diarrhea, oral burning, headache.
scombroid poisoning
26
ocular melanoma, most sensitive diagnostic test and treatment
US asx w/ small lesions - observe and reassess large lesions- radiation therapy
27
Most important factor in prognosis in COPD patients
FEV1 | FEV1 <40% is severe COPD
28
Brief shooting back pain, positive straight raising test in 60, worsens with bending and straining. Ddx?
nerve root irritation
29
Possible explanations of positive ELISA-anti-HCV antibodies? What test is needed for confirmation of HCV?
- persistent Hep C infx - cleared infection - false positive result - HCV RNA is a high specificity test
30
Treatment for latent TB
- first line: isoniazid for 9 months for both children and adults - second line: rifampin 6 months in children, 4 in adults
31
If patient presents with fever, jaundice, and RUQ (Charcot's triad), then what ddx do you think of? Management and treatment?
- acute cholangitis - hydration, VS monitoring, and antibiotics - need blood culture and abx- ampicillin and gentamicin or imipenem or levofloxacin - if clinically improves, then elective ERCP
32
Treatment of bile-induced diarrhea in short gut syndrome or post cholecystectomy
- bile salt binding resins such as cholestyramine
33
Screening test for primary aldosteronism (Conn's syndrome)- hypertension, hypokalemia
plasma aldosterone to plasma renin activity greater than 30