8-23

Question 1

avoid metformin in…

Answer 1

acute renal failure, liver failure, sepsis - due to inc risk of lactic acidosis

Question 2

tx for antipsychotic induced parkinsonism

Answer 2

add on benztropine or amantadine if it’s working well

Question 3

tx for ingestion of botulism spores

Answer 3

botulism immune globulin

Question 4

unilateral varicocele that fails to empty when patient is recumbent

Answer 4

suspicion for mass that obstructs venous flow (RCC)

Question 5

motor: 1-5 yrs

Answer 5

walk, steps, tricycle, hop, skip

Question 6

RDW and RBCs in thalassemia minor

Answer 6

normal - see target cells on smear

Question 7

first line prevention of migraines in pregnancy

Answer 7

beta blocker

Question 8

complications of PBC

Answer 8

(anti-mito Abs) malabsorption, metabolic bone dz, HCC; tx w/ urso

Question 9

phys exam for aortic regurg

Answer 9

early diastolic murmur, bounding pulses

Question 10

Abs in hashimoto thyroiditis (high TSH)

Answer 10

anti-TPO Abs

Question 11

baby w/ unconj bili, nml Hgb, neg coombs, inc retics

Answer 11

hemolysis (G6PD def, hgb SS, etc)

Question 12

proximal muscle weakness + diminished DTRs

Answer 12

lambert-eaton (Abs to presynaptic voltage-gated Ca channels)

Question 13

AV block in pt w/ endocarditis

Answer 13

perivalvular abscess

Question 14

cough, conjunctivitis, white dots in mouth, fever, rash

Answer 14

measles (starts on head and spreads caudally)

Question 15

tx for pinworm infection

Answer 15

pyrantel pamoate OR albendazole

Question 16

tx for vasospastic angina

Answer 16

CCB

Question 17

dx of acute liver failure

Answer 17

elevated AST/ALT, hepatic encephalopathy, INR>1.5

Question 18

tx for AOM perf w/ amox tx in past 30 days

Answer 18

amox-clavulanate

Question 19

common site of HTN brain hemorrhage

Answer 19

basal ganglia

Question 20

defense mechanism: attributing one’s own feelings to someone else

Answer 20

projection

Question 21

pt w/ dizziness, SOB, chest pain relieved w/ cold water immersion

Answer 21

AVNRT

Question 22

defense mechanism: transferring feelings to a less threatening object/person

Answer 22

displacement

Question 23

social: 2 + 6 mo, 1 yr

Answer 23

social smile, stranger anxiety, separation anxiety

Question 24

motor: 2, 4, 6mo

Answer 24

lift head, roll over, sit up

Question 25

tx for scabies

Answer 25

topical permethrin vs oral ivermectin

Question 26

CHF does what to kidneys?

Answer 26

RAAS activation -> vasoconstrict afferent + esp efferent arterioles

Question 27

1st step dx for cushing syndrome

Answer 27

24 hr urine cortisol vs late night salivary cortisol vs low dose dex suppression -> then measure ACTH

Question 28

hepatorenal syndrome pathophys

Answer 28

splanchnic dilation -> RAAS -> renal vasoconstriction

Question 29

kid w/ itchy fingers

Answer 29

scabies - tx w/ permethrin

Question 30

sildenafil relative contraindications

Answer 30

alpha blockers and nitrates - cause hTN

Question 31

surveillance for beckwith-wiedemann syndrome

Answer 31

serum AFP and abd/renal US (wilms tumor and hepatoblastoma)

Question 32

child w/ painful hip after viral illness, able to bear weight, nml labs

Answer 32

transient synovitis

Question 33

clinical exam findings for laryngomalacia

Answer 33

inspiratory stridor

Question 34

baby w/ unconj bili, nml Hgb, nml retics, neg coombs

Answer 34

breast milk (not enough, dec bowel fxn) vs breast feeding (problem w/ moms milk) jaundice

Question 35

shapes: 3, 4, 5yrs

Answer 35

circle, cross, triangle

Question 36

BRUE definition

Answer 36

<1yo, <1min, change in color/tone/breathing/responsiveness

Question 37

bug + tx for chronic bacterial prostatitis

Answer 37

E Coli; tx w/ FQ for 4-6 wks

Question 38

abx relatively contraindicated in aortic aneurysm

Answer 38

fluoroquinolones

Question 39

fever, rash, tender lymph nodes

Answer 39

rubella

Question 40

why are CF pts more at risk for insulin-induced hypoglycemia?

Answer 40

lose glucagon-secreting alpha cells too

Question 41

nephrotic syndrome assoc w/ HBV

Answer 41

membranous nephropathy

Question 42

common causes of adult nephrotic syndrome

Answer 42

FSGS, membranous nephropathy, membranoproliferative glomerulonephritis

Question 43

common causes of adult nephritic syndrome

Answer 43

IgA nephropathy, membranoproliferative glomerulonephritis, crescentic glomerulonephritis