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ABFM Flashcards

0
Q

Normal QTc?

A

Less than 440

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1
Q

Long term effect of phenytoin on bones?

A

Caused osteoporosis

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2
Q

Treatment for multiple myeloma?

A

Asymptomatic - no Tx
Symptoms - autologous stem cell transplant, if cant tolerate, melphalan and prednisolone. Radiation therapy for bone pain

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3
Q

Hematocrit>55%, pruritus with hot showers, and splenomegaly. Diagnosis?

A

Polycythemia Vera

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5
Q

Pediatric patient with palpable purpuric rash and normal platelets. Diagnosis?

A

Henoch Schonlein Purpura

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6
Q

Patient with supra-renal AAA. Differential dx of etiology?

A

Atherosclersosis, Ehlers-Danlos, Marfans, Syphillis

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7
Q

USPSTF screening recommendations for AAA?

A

One time U/S screening for men 65-75 who have ever smoked

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8
Q

Normal diameter of abdominal aorta?Diameter of AAA that needs surgical intervention?

A

Normal - 1.8-2 cm

Surgical intervention - 5-5.5 cm

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9
Q

Which test has highest sensitivity for ACL tear? How is it performed?

A

Lachmann test.
Patient supine. Slightly flex knee. Stabilize femur with one hand and move tibia anterior and posterior with other arm to see how much movement.

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10
Q

What differentiates MGUS (monoclonal gammopathy of undetermined significance) from multiple myeloma?

A

End-organ damage. Check for hypercalcemia, anemia, renal failure, bone lesions.

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11
Q

Annual risk of progression from MGUS to multiple myeloma?

A

1% annual risk

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12
Q

Diabetic patient with unilateral leg weakness, decreased sensation to pinprick and light touch over anterior thigh, reduced hip flexion and knee extension strength. Diagnosis?

A

Femoral neuropathy

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13
Q

Low dose estrogen OCPs result in a 50% decrease in lifetime risk of which cancer?

A

Ovarian cancer

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14
Q

Diagnostic criteria for polymalgia rheumatica?

A 
Patients 50 years and older
Bilateral pain
Morning stiffness that lasts at least 45 minutes
Elevated CRP or ESR
Hip and/or Shoulder pain
No hand or feet joing involvement
No RA or anti-CCP
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15
Q

Main electrolyte deficiency in Refeeding syndrome?

A

Hypophosphatemia

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16
Q

Presentation of mononucleosis?

A

10-30 year old with sore throat, myalgias, fatigue, lymphadenopathy.

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17
Q

Management of hypercalcemia of malignancy?

A

NS IV first. Follow with IV Pamidronate

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18
Q

Advantage of myomectomy versus fibroid embolization for symptomatic uterine fibroids?

A

Recommended if patient desires future pregnancies

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19
Q

Advantage of fibroid embolization versus myomectomy for symptomatic uterine fibroids?

A

Shorter hospitalization, less time off from work

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20
Q

Sigmoidoscopy reveals brown to black leopard spotting of colonic mucosa. Diagnosis?

A

Melanosis coli. Benign condition from anthraquinone laxative use (cascara, senna, aloe)

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21
Q

The 2 murmurs that increase in loudness with valsalva?

A

HOCM, MVP

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22
Q

Obese male, age 8-15, limp and hip pain. Pain with internal rotation of hip. Diagnosis?

A

Slipped Capital Femoral Epiphysis

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23
Q

Drugs implicated in lupus pleuritis?

A

Hydralazine, procainamide, quinidine

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24
Q

Drug of choice for pharmacologic conversion of WPW with wide-complex tachycardia?

A

Procainamide or Amiodarone

AVOID adenosine, Ca blocker, or digoxin (these block conduction through AV node)

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25
Q

Antibiotic recommendations for HCAP?

A

1st Anti-pseudomonal - Cephalosporin (Cefepime, Ceftazidime) or Carbapenem (Imipenem or Meropenem) or extended-spectrum B-lactam/B-lactamase inhibitor (Zosyn)
2nd anti-pseudomonal - Fluroquinolone (levaquin, cipro), or Aminoglycoside (Gentamicin, Tobramycin, Amikacin)
Anti-MRSA - Vanc or Linezolid

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26
Q

Benzodiazepine use during pregnancy, what risk to fetus?

A

Cleft lip/palate

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27
Q

Which SSRI is contraindicated in pregnancy?

A

Paroxetine. Other SSRI’s appear to be fine, Fluoxetine has best evidence for safety

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28
Q

Age and classic presentation of Intussusception?

A

Less than 2 years

Paroxysmal abdominal pain, lasts a few minutes, and then resolves, palpable RUQ mass

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29
Q

Patient with osteoporosis refractory to bisphosphonates. Next step in therapy?

A

Teriparatide (Forteo)

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30
Q

Most common cause of erythema multiforme?

A

HSV

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31
Q

pyogenic tenosynovitis, treatment?

A

If less than 48 hours, splint finger and po abx

If after 48 hours, surgical drainage and abx

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32
Q

Diagnosis of POTS (Postural Orthostatic Tachycardic Syndrome)?

A

Heart rate increase >30 beats/min or HR >120 within 10 minutes of standing, along with symptoms.

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33
Q

Which type of Tinea infection requires systemic antifungal treatment?

A

Tinea capitis

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34
Q

Estimated fetal weight where c-section is an option for fetal macrosomia?

A

4500 g if infant of diabetic mother

5000 g for any infant

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35
Q

What is erythrasma? How is it treated?

A

Intertrigo complicated by Corynebacterium minnutissum infection. Will see reddish-brown macules that coalesce to form larger patches with sharp borders. Treat with erythromycin.

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36
Q

Patient with E. coli 0:157 infection. Need to monitor for what renal complication?

A

Hemolytic Uremic Syndrome

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37
Q

Clinical presentation of erythema multiforme?

A

Sharply demarcated red or pink macules, progress to papules and plaques, start on extremity, symmetric, may involve palms and soles, spread proximally, resolve spontanesouly in 3-5 weeks, may recur several times a year

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38
Q

Age group affected by erythema multiforme?

A

Typically 20-40 but can affect any age group

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39
Q

Most common cause and other etiologies of erythema multiforme?

A

MCC - HSV 1&2

Others - Mycoplasma pneumonia (more in children), drugs (barbiturates, NSAIDS, hydantoins, penicillins), vaccines

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40
Q

Treatment for erythema multiforme?

A

Acyclovir

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41
Q

Treatment for recurrent erythema multiforme?

A

Continuous acyclovir

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42
Q

Typical age seen for Henoch Schonlein Purpura?

A

90% are children less than 10. Can affect adults too. Peak incidence is age 6.

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43
Q

Pathophysiology of Henoch Schonlein Purpura?

A

Acute systemic vasculitis. IgA complexes deposit in small vessels. May deposit in small vessels of intestinal walls or also renal mesangium.

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44
Q

Henoch Schonlein Purpura triggered by?

A

Most common Group A Streptococcus. Immune response may be triggered by antigen from environment, medications, other infectious etiology.

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45
Q

Clinical presentation of Henoch Schonlein Purpura?

A

Usually follows URI
Purpura - Everyone gets this. Erythematous papules becomes petechiae and purpura. Lasts for couple weeks
Arthritis - Transient. Knees and ankes most common
GI - Severe pain like an acute abdomen, or may be colicky, may have vomiting with GI bleeding
Renal - late sequelae, starts within 1 month, usually resolves by 6 months, microscopic hematuria, red cell casts, proteinuria

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46
Q

Diagnostic criteria for Henoch Schonlein Purpura?

A

Palpable purpura with one or more of the following:

  1. Diffuse abdominal pain
  2. Any biopsy showing predominant immunoglobulin A deposition
  3. Arthritis (acute, any joint) or arthralgia
  4. Renal involvement (any hematuria or proteinuria)
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47
Q

Labs and what to look for in Henoch Schonlein Purpura?

A
  1. Antistreptolysin-O titers
  2. BMP - renal function
  3. CBC - leukocytosis, platelets MUST be normal (thrombocytopenia may suggest thrombocytopenic purupura)
  4. IgA levels - suggestive but nonspecific
  5. UA - Microscopic hematuria, RBC casts, proteinuria
  6. Skin or renal biopsy
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48
Q

Complications of Henoch Schonlein Purpura?

A

Renal failure, intussusception. Less commonly pulmonary hemorrhage, MI, scrotal swelling

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49
Q

Stepwise treatment approach for Henoch Schonlein Purpura?

A
  1. Tylenol or NSAIDs
  2. Prednisone 1-2 mg/kg
  3. Cyclophosphamide or Azathioprine
  4. Plasmapharesis, IVIG
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50
Q

Renal surveillance needed for Henoch Schonlein Purpura?

A

Monthly UA to detect signs of renal involvement for 6 months time.

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51
Q

Penicillin prophylaxis recommendation for sickle cell patients?

A

Twice daily penicllin PO from 0-5 years age.

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52
Q

Immunization recommendations for sickle cell patients?

A
  • 6-18 y/o with functional asplenia -> PCV 13

- >18 y/o w/ functional asplenia -> PCV 13 -> wait 8 wks and then PPSV 23 -> wait 5 years then PPSV 23 again

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53
Q

Retinopathy screening recommendations for sickle cell patients?

A

Dilated eye exams yearly beginning at age 10

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54
Q

Screening for stroke risk recommendation for sickle cell patients?

A

Yearly for children age 2-16 with transcranial doppler

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55
Q

Presentation of Acute Chest Syndrome in sickle cell disease?

A

Acute combination of cough, SOB, rales with new pulmonary infiltrate on CXR.

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56
Q

Incentive Spirometry is useful during vasoocclusive crisis to prevent what?

A

Acute Chest Syndrome

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57
Q

Treatment for Acute Chest Syndrome in Sickle Cell Disease?

A
  • IV cephalosporin, PO macrolide, supplemental oxygen, incentive spirometry
  • Transfusion if Hgb less than 1 g/dl from baseline (if baseline <10 g/dl)
  • Plasma apharesis if worsening Acute Chest Syndrome
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58
Q

Treatment of Sickle Cell Disease associated priapism?

A

IV fluids, urology consult. Do not tranfuse.

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59
Q

Treatment of acute splenic sequestration in Sickle Cell Disease?

A

IV fluids, transfuse to maintain Hgb at a stable level. Consult for splenectomy.

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60
Q

Hip pain in a patient with Sickle Cell Disease, evaluate for?

A

Avascular Necrosis

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61
Q

Who should receive hydroxyurea therapy in sickle cell disease?

A

Children older than 9 months and all adults except pregnant or lactating women.

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62
Q

How do you start and monitor hydroxyurea therapy? What adverse side-effects need to be monitored?

A
  • Before starting check CBC, Retic count, Hemoglobin electrophoresis, Renal and Liver function tests, Pregnancy test for women
  • Start at 15 mg/kg daily. CBC q4 weeks to monitor for neutropenia and thrombocytopenia. Maintain ANC 2000-4000/microliter and platelets >80,000.
  • May increase by 5 mg/kg q 3 months. Once stable check cbc q3 months.
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63
Q 
Which of the following Sickle Cell Disease complications is transfusion indicated and what type?
Acute Chest Syndrome
Splenic Sequestration
Acute Stroke
Anemia
Priapism
AKI and multi-organ system failure
Children with transcranial doppler over 200cm/s
Pre-operatively
A

Acute chest syndrome - If severe use exchange transfusion
Splenic Sequestration - If severe anemia use simple
Acute stroke - Simple or exchange
Anemia - Only if symptomatic
Priapism - No transfusions
AKI and multi-organ system failure - No transfusions
Children with transcranial doppler over 200cm/s - Simple or exchange for stroke prevention
Pre-operatively - To Hgb level of 10 if general anesthesia required

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64
Q

Increased nuchal translucency on OB ultrasound suggests?

A

Increased fluid collection, could be due to Down syndrome, Turner syndrome or cardiac abnormalities

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65
Q

First trimester genetic screening consists of what and when does it take place?

A

Weeks 11-14. Consists of nuchal thickness, hCG, and PAPP-A. Detects Down syndrome.

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66
Q

Second trimester quad screening consists of what and when is it done?

A

Weeks 15-19wk6day. Consists of hCG, uE3 (unconjugated estriol), inhibin A, AFP. This evaluates genetic defects as well as neural tube defects

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67
Q

GBS cultures reliable for how many weeks?

A

5 weeks

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68
Q

Define “reactive strip”

A

Nonstress test with at least 2 accels of at least 15 beats for at least 15 seconds in a 20 minute interval in gestations over 32 weeks. Gestations less than 32 weeks are 10 beats above baseline for 10 seconds.

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69
Q

What do you monitor for OB patients on magnesium?

A

Urine output, DTRs, consciousness

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70
Q

Post-exposure prophylaxis for Anthrax inhalation?

A

Ciprolfloxacin

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71
Q

Best agent for treatment of TCA induced arrhythmia?

A

Sodium bicarbonate

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72
Q

Indiscriminate zone for BNP?

A

Between 100-400 you can’t tell if there is CHF or not and need to do further work-up. Over 400 correlates with 95% sensitive.

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73
Q

ACE-i can cause AKI by what mechanism?

A

Impairing autoregulation of glomerular blood flow

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74
Q

Criteria to clear cervical spine after an injury?

A
  1. No central neck pain on questioning or palpation
  2. No distracting painful injury
  3. Absence of paralysis or other signs attributable to the neck
  4. Normal mental status
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75
Q

What is SCIWORA syndrome?

A

Spinal Cord Injury Without Radiologic Abnormality, paralysis or other neuro deficits secondary to stretching of the spinal cord during flexion-extension type movements in an accident

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76
Q

Treatment for SCIWORA syndrome?

A

IV methylprednisolone 30 mg/kg bolus. Limited evidence on its efficacy

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77
Q

Formula for calculated osmolality?

A

Calculated osmolality = 2(Na) + BUN/2.8 + Glucose/18

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78
Q

Signs and symptoms of methanol poisoning?

A

Abdominal pain, N/V, Meningeal signs (nuchal rigidity), Tachypnea, Basal ganglia hemorrhage, Optic disk abnormalities

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79
Q

Treatment options for methanol or ethylene glycol posioning?

A

Fomepizole, ethanol, or hemodialysis

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80
Q

Treatment for beta-blocker overdose in order of first to last line therapy?

A
  1. Fluids
  2. Pressors
  3. Glucagon 3-5 mg IV bolus
  4. Milrinone or Caclium chloride
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81
Q

Treatment for isoniazid-induced seizures?

A

Vitamin B6. (INH is a B6 antagonist)

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82
Q

Suspect carbon monoxide poisoning, what lab do you check?

A

Venous carboxyhemoglobin

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83
Q

First step in treating patient with carbon monoxide poisoning?

A

Administer 100% oxygen

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84
Q

Criteria for hyperbaric oxygen in carbon monoxide poisoning?

A
  • Mental status changes
  • Carboxyhemoglobin levels >25%
  • Acidosis
  • CV disease
  • Age over 60
  • Pregnancy
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85
Q

Concussion definition?

A

Neurological symptoms after head trauma

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86
Q

Indications for parathyroidectomy in patient with primary hyperparathyroidism?

A
  1. Age less than 50
  2. Decreased bone density
  3. Nephrolithiasis
  4. Ca level greater than 1 mg/dl over upper-limit of normal
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87
Q

Radiographic double bubble sign in infant signifies?

A

Midgut volvulus

88
Q

CEA is a marker for which types of cancer?

A

Colon, Esophageal, Hepatic

89
Q

Indications for head CT after trauma?

A
  • Intoxication
  • Age over 60
  • Vomiting
  • Seizures
  • Headache
  • Memory deficit
90
Q

Most common inherited disorder of bilirubin metabolism?

A

Gilbert’s syndrome

91
Q

Lifetime transmission risk of Hepatitis C in a monogamous relationship?

A

Less than 1%

92
Q

Spot urine test for homovanillic acid (HMA) and vanillylmandelic acid (VMA) is useful for identifying what 2 disorders?

A

Pheochromocytoma or Neuroblastoma

93
Q

Hand, foot, mouth disease caused by what organism?

A

Coxsackie virus, sometimes enterovirus

94
Q

Acne neonatorum typically resolves how quickly?

A

In about 4 months

95
Q

Cutaneous larva migrans contracted how?

A

Walking barefoot on soil or dirt contaminated by cat or dog hookworm in feces (Ancyclostoma species)

96
Q

Cutaneous leishmaniasis presentation?

A

Patient coming from Iraq with boils resistant to treatment, lasting several months, tender, central ulceration, and no systemic symptoms

97
Q

Malar rash in pregnancy. Most likely diagnosis?

A

Melasma of pregnancy

98
Q

How large does glass have to be to be seen on x-ray?

A

2 mm or greater

99
Q

Most common infection transmitted person-to-person in wrestlers?

A

Herpes gladiatorum

100
Q

Treatment for recurrent calcium oxalate kidney stones?

A

Potassium citrate at mealtime

101
Q

Second line imaging after plain radiographs for stress fracture diagnosis?

102
Q

Treatment of choice for essential tremors?

A

Primidone, second-line is beta-blockers

103
Q

First line treatments for urge incontinence?

A

Pelvic floor exercises and anticholinergics

104
Q

Back pain worse with sitting and relieved by standing, diagnosis?

A

Spinal stenosis

105
Q

Organism responsible for farmer’s lung?

A

Thermoactinomyces candidus

106
Q

CT findings in farmer’s lung?

A

Centrilobular micronodules and ground-glass opacification

107
Q

Treatment for farmer’s lung?

A

Oral steroids

108
Q

Add-on therapy for patients with aspirin-sensitive asthma?

A

Leukotriene inhibitors (Montelukast, Zafirlukast)

109
Q

Criteria for referral for lung transplant in COPD patients?

A

BODE index >5

110
Q

Microscopic findings of synovial fluid in pseudogout?

A

blunt rod, rhomboid and cuboid crystals

111
Q

Most common species isolated from cat and dog wounds?

A

Pasteurella multocida

112
Q

Female aged 1-11 with beefy red, itching rash in perineum resistant to antifungals, diagnosis?

A

Perineal Group A Strep disease

113
Q

Pneumothoraces up to what % can be safely monitored if the patient has minimal symptoms and is stable?

114
Q

Bisphosphonates that reduce risk of hip fractures?

A

Zoledronic acid, risedronate, alendronate

115
Q

Most effective single-dose prophylaxis for Lyme disease?

A

Doxycycline 200 mg PO x1 within 72 hours of tick bite

116
Q

What is secondary prevention?

A

Screening someone who may have an asymptomatic disease to identify the disease (BP screening, Pap smear, Lipid screening, etc)

117
Q

When starting coumadin for a patient, how long do you need to bridge with Lovenox?

A

Can stop Lovenox after 5 days if INR >2 for at least 24 hours

118
Q

Which NSAID is on the Beer’s list and should be avoided in geriatric patients?

A

Indomethacin

119
Q

Which anti-hypertensive drug should be stopped prior to patients starting allergy shots?

A

Beta-blockers, can blunt response to epinephrine just in case it might be required

120
Q

Which 2 diabetic medications can help weight loss?

A

Metformin and exenatide (incretin mimetics)

121
Q

Pes anserine bursitis causes tenderness where?

A

Medial proximal tibia, where sartorius, gracilis, and semitendinosus muscles insert.

122
Q

Peppermint oil can help what condition?

123
Q

Severe complication of pseudotumor cerebri?

A

Vision loss

124
Q

Postcholecystectomy pain and jaundice, most likely diagnosis?

A

Retained common duct stone

125
Q

Best initial test to for Duchenne’s muscular dystrophy?

A

Creatine Kinase

126
Q

What tests can you order to differentiate Folate from B12 deficiency?

A
  • RBC folate
  • Serum homocysteine and methylmalonate levels. Both will be elevated in B12 deficiency, while only homocysteine will be elevated in Folate deficiency.
127
Q

Treatment for Wilson’s disease?

A

Lifelong Penicillamine or trientine (chelating agents)

128
Q

Patient with suspected meningitis, within what time-frame do you need to get antibiotics started?

A

30 minutes

129
Q

Patient’s taking red yeast rice, what benefits does it have and what needs to be monitored?

A

Reduces cholesterol (similar to statin), monitor liver enzymes

130
Q

Compression stockings beneficial for what after DVT?

A

Preventing post-thrombotic syndrome

131
Q

What anti-hypertensive can help with PMS symptoms?

A

spironolactone

132
Q

What do test for to check for Vitamin D deficiency and less than what number is considered “deficient?”

A

Check 25-hydroxyvitamin D. Less than 20 is considered deficient.

133
Q

OTC supplement that may be beneficial for osteoarthritis?

A

Glucosamine sulfate

134
Q

Which second generation antipsychotic agent is associated with the least amount of weight gain?

A

Aripiprazole (Abilify)

135
Q

Definition of osteopenia?

A

T-score between -1 and -2.5 or hip or spine on Bone Mineral Density

136
Q

First line agents for BPH symptoms?

A

alpha blocker (Terazosin, Doxazosin)

137
Q

Antibiotic of choice for acute prostatitis?

A

Fluoroquinolones (Cipro) for 28 days

138
Q

Scoring system to evaluate BPH severity?

A

AUA symptom score

139
Q

Indications for TURP in BPH?

A

Failure of medical therapy, recurrent infections, bladder calculi, renal insufficiency, patient preference

140
Q

Presentation of chancroid?

A

TENDER, erythematous, 1 cm papule with deep central ulceration. Mild lymphadenopathy in inguinal area.

141
Q

First diagnostic study to evaluate a scrotal mass?

A

Ultrasound

142
Q

Torsion of the appendix testis presentation?

A

Teenager or boy, Well localized testicular pain, present for a few days, gradually getting worse. Possible swelling, bluish discoloration under skin

143
Q

Testicular painful swelling that develops weeks to months after vasectomy, most likely diagnosis?

A

Congestive epididymitis

144
Q

Treatment for priapism?

A

Insert needle into corpus cavernosa, withdraw blood and inject phenylephrine

145
Q

Which urologic drug class falsely lower PSA tests?

A

5-alpha-reductase inhibitors (Finasteride, Dutasteride)

146
Q

Classic triad for Klinefelter syndrome?

A

Small firm testicles, gynecomastia, azoospermia

147
Q

What anti-hypertensive drug classes are contraindicated in patient’s taking Phophodiesterase type 5 inhibitors?

A

nitrates and alpha-blocers

148
Q

Diagnostic Criteria for polymyalgia rheumatica?

A
  • Age>50
  • Pain/aching in 2 of the following: neck, shoulders, proximal arms, pelvis
  • ESR > 40
  • Morning stiffness
149
Q

Typical demographic of patient with polymyalgia rheumatica?

A

Average age is 70, rarely occurs in non-white people, women twice as common as men

150
Q

Typical demographic of patient with polymyalgia rheumatica?

A

Average age is 70, rarely occurs in non-white people, women twice as common as men

151
Q

Microscopy findings of synovial fluid in gout?

A

needle-shaped negatively birefringent crystals (remember, being stuck with a needle hurts - so does gout)

152
Q

Which gout medication is used for prophylaxis not for acute treatment?

A

Allopurinol (Use Allo After)

153
Q

What lab do you need to check periodically for patients on testosterone?

A

Hematocrit, can cause polycythemia, check q 6months for 18 months and then annually
Also PSA

154
Q

Antiphospholipid syndrome in pregnancy, what medications should you place patient on?

A

Aspirin and Heparin

155
Q

Empiric prophylactic treatment for someone exposed to a person with meningococcal mengingitis?

A

Rifampin 600 mg PO q12 hrs for 48 hours

156
Q

Contraindications and adverse reactions of gabapentin?

A

Fatigue, drowsiness, vertigo, dizziness, ataxia, peripheral edema, renal failure

157
Q

Most common infectious cause of peripheral neuropathy worldwide?

158
Q

Most likely etiology of an isolated wrist drop?

A

Radial nerve palsy, often known as “saturday night palsy”. Someone or something lays on your arm for an extended period of time and compresses the nerve, patient is usually sedated with drugs or alcohol to not feel this.

159
Q

Treatment for nausea and vomiting associated with migraines?

A

Reglan, this can help reduce migraine severity as well

160
Q

Contraindication to triptan use?

161
Q

Mechanism of action of edrophonium or pyridostigmine in treating Myasthenia Gravis?

A

Acetycholinesterase Inhibitors

162
Q

Diagnose Myasthenia Gravis in a patient, what next should you look for when considering etiology?

A

Thymoma, thymus hyperplasia. Get CT scan of the chest.

163
Q

Risk of what with IM hydroxyzine?

A

Muscle necrosis. Try to avoid it.

164
Q

Patient took 2 doses of a triptan, what drugs should be avoided for the next 24 hours?

A

Any additional doses of triptans and dihydroergotamine (DHE)

165
Q

Treatment for herpes encephalitis?

A

IV acyclovir

166
Q

DRESS syndrome characterized by?

A

Drug Reaction with Eosinophilia and Systemic Symptoms. Patient will have erythema with fever, lymphadenopathy, elevated liver enzymes, and eosinophilia.

167
Q

Medications associated with DRESS syndrome?

A

Anti-seizure medications (phenytoin, carbamazepine, lamotrigine, phenobarbital), also allopurinol

168
Q

Treatment for alcoholic ketoacidosis?

A

NS, Thiamine, Glucose

169
Q

Serum test to confirm low B12 level?

A

Serum methylmalonic acid will be elevated

170
Q

Side-effects of Varenecline?

A

Weight gain, Cardiovascular events

171
Q

Psychiatric drug class with worse sexual dysfunction profile?

172
Q

Herb Valerian is useful for?

A

Anxiety and Insomnia, acts similar to Benzos (think Valium)

173
Q

Which type of kidney stone should you acidify the urine?

A

Calcium Phosphate

174
Q

Child age 5 to 11 with bilateral heel pain, most likely diagnosis?

A

Calcaneal apophysitis

175
Q

Which Vitamin, when taken in large quantities can cause increase in INR?

176
Q

Recommended dosages of vitamin D for different ages?

A

Infants - 400 IU/day
1-70 - 600 IU/day
Age 70 and above - 800 IU/day

177
Q

Ginko biloba is used for? Bad thing about it?

A

Dementia and peripheral vascular disease. No evidence that it helps. Can prolong bleeding time.

178
Q

Licorice, what’s bad about it?

A

Has aldosterone like effects (fluid retention, htn, hypokalemia). Also can cause preterm labor

179
Q

SAM-e can be used to treat?

A

Depression
Osteoarthritis
Fibromyalgia
Maybe cirrhosis

180
Q

Feverfew can be used to treat?

A

Migraine headaches

181
Q

Chondroitin sulfate can be used to treat?

A

Possibly useful for osteoarthritis

182
Q

Patients with PCOS are at elevated risk for which cancer?

A

Endometrial Cancer

183
Q

Treatment for a mallet fracture (fracture of dorsal surface of proximal portion of distal phalanx)?

A

Finger splint in full extension for 8 weeks

184
Q

Positive Thessaly test indicates?

A

Medial meniscal tear

185
Q

Metal foreign body in eye and after extraction reddish-brown discoloration in cornea around site is noted. Next step?

A

This is a rust ring, urgent ophthalmologic referral.

186
Q

3 year old at a daycare where another kid was diagnosed with Hep A. What do you recommend for the un-infected child?

A

Hep A vaccine

187
Q

Treatment for tinea capitis?

A

Oral Griseofulvan

188
Q

Basal Cell carcinoma, high risk site of recurrence?

189
Q

Organism most commonly identified in intertrigo?

190
Q

Treatment for Kawasaki’s Disease?

A

Aspirin and IVIG

191
Q

Best treatment for acute rectal fissure

A

Botox injection in anal sphincter

192
Q

Most specific vital sign abnormality for Delirium Tremens compared to less severe forms of alcohol withdrawal?

193
Q

Heroin overdose affects lungs how?

A

Causes respiratory depression and pulmonary edema

194
Q

Suspect acromegaly, what typically causes this and what lab should you check?

A

98% of time caused by growth hormone secreting pituitary adenoma. Check GH and IGF-1 levels.

195
Q

3rd time getting C. diff colitis, what’s the treatment?

A

PO Vancomycin taper over 15 weeks

196
Q

What is Jersey finger, what do you do if diagnosed?

A

Injury to flexor digitorum profundus tendon or even avulsion of volar distal phalynx. Mechanism of injury is typically when a player tries to grab another jersey and opposing player slips away causing an extending force on finger. Urgent Orthopedic referral.

197
Q

B12 deficiency associated with which medications?

A

Metformin, PPI’s, and H2 blockers

198
Q

Primary Biliary Cirrhosis, which auto-immune antibody should you check?

A

antimitochondrial antibodies

199
Q

Uric acid levels should be maintained below what number for patients with gout to prevent long-term joing damage?

200
Q

Repeated syncope during exercise in elderly patient, concerning for?

A

Some form of cardiac disease, especially aortic stenosis

201
Q

Lyme disease exposure prophylaxis

A

Doxycycline 200 mg PO, one dose

202
Q

First line prophylactic agent for cluster headaches?

203
Q

Child age 2-12
sx: unilateral hip pain, limp
pe: limited abduction and internal rotation, shortening of one leg
imaging: x-ray-sclerosis of proximal femur and widening of joint space, mri-osteonecrosis
Diagnosis?

A

Legg-Calve-Perthes disease

204
Q

Growing pains typically affect children at what age?

A

Between 4-6 years old

205
Q

Methylergonovine contraindicated when?

A

If hypertensive

206
Q

First-line drug therapy for ulcerative colitis?

A

Sulfasalazine

207
Q

Thyroid nodules greater than what size will need some form of work-up irregardless of TSH levels?

208
Q

Drugs most commonly implicated in Stevens-Johnson syndrome?

A

Allopurinol, antibiotics, anti-epileptics, NSAIDs

209
Q

Patient with history of WPW presenting in stable condition with wide-complex tachycardia,, drug of choice?

A

Procainamide or amiodarone

210
Q

Which herbal medicine is good for varicose veins?

A

Horse chestnut seed extract

211
Q

Treatment for cervical radiculopathy?

A

NSAIDs, most improve with conservative management

212
Q

Amsel’s criteria for bacterial vaginosis?

A

3 of 4 must be present:

  1. pH > 4.5
  2. Homogenous thin white discharge
  3. Clue cells > 20%
  4. Positive whiff test
213
Q

Treatment of choice for intravaginal warts during pregnancy?

A

Liquid nitrogen or trichloroacetic acid

214
Q

STD which also causes strawberry cervix appearance?

A

Trichomonas

215
Q

Treatment for Trichomonas?

A

Flagyl 2 gm PO x1

Medicine (10 decks)

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