All Questions 601-

Question 1

rapidly progressive dementia, myoclonus, sharp triphasic syncronous discharges on EEG

Answer 1

Crutzfeldt-Jakob disease

Question 2

this is not a shockable rhythm during cardiac arrest with no palpable pulses

Answer 2

A-fib

Question 3

Temporal arteritis Tx’ed w/ steroids followed by LE muscle weakness

Answer 3

Drug-induced myopathy

Question 4

Conjugated hyperbilirubinemia (urine dipstick pos for bili w/ dark urine)

Answer 4

Rotor syndrome

Question 5

Travel followed by RUQ pain and a single right lobe liver cyst

Answer 5

Entamoeba histolytica (an ameba)

Question 6

Intimate contact w/ dogs followed by development of a cyst

Answer 6

Echinococcus granulosus (a hyatid)

Question 7

Sx of CREST w/ exertional SOB

Answer 7

Pulmonary fibrosis 2/2 systemic sclerosis

Question 8

Lower back pain less severe walking uphill than walking downhill and worse w/ prolonged standing but relieved by sitting

Answer 8

Lumbar spinal stenosis

Question 9

Lower back pain w/ limited spinal mobility w/ Sx’s that improve w/ exercise early in disease

Answer 9

Ankylosing spondylitis

Question 10

Flesh colored / erythemetaous vesicles on the elbows, knees, etc. in the context of celiac sprue Dx, best treated w/ dapsone

Answer 10

Dermatitis herpetiformis

Question 11

Syncope w/ hypotension and/or acute R heart strain

Answer 11

Massive pulmonary embolism

Question 12

Tense bullae on normal appearing skin w/ pruritis and IgG and C3 on immunofluorescence

Answer 12

Bullous pemphigoid

Question 13

Flaccid bullae on normal appearing skin w/ IgG on immunofluorescence

Answer 13

Pemphigus vulgaris

Question 14

Numbness and occasional pain in the palm and thenar eminence atrophy

Answer 14

Carpal tunnel syndrome

Question 15

Cirrhosis, Kayser-Fleischer rings, neuropsychiatric changes

Answer 15

Hepatolenticular degeneration (Wilson’s disease)

Question 16

Decrease in bone density treated by bisphosphonates (-dronates) and calcitonin (keeps Ca2+ in the bone)

Answer 16

Osteoporosis

Question 17

Increased glucose secretion, protein catabolism, and lipid catabolism caused by excess glucocorticoid as a result of any cause leading to DM, osteoporosis, and central adiposity. Test for with AM cortisol or 24 hour urine cortisol

Answer 17

Cushing’s syndrome

Question 18

Hypertension, hypokalemia, metabolic alkalosis. Test for with plasma aldosterone-renin activity ratio

Answer 18

Hyperaldosteronism (Conn’s Syndrome)

Question 19

Increased PT, PTT, bleeding time, and D-dimer titer with reduced fibrinogen level and platelet count with MAHA

Answer 19

Disseminated intravascular coagulation (DIC)

Question 20

Thrombocytopenia, MAHA, fever (also renal impairment, neurologic deficits) (PT, PTT not affected)

Answer 20

Thrombotic thrombocytopenic purpura (TTP)

Question 21

Child (most often), kidneys affectd by platelet-fibrin thrombi (PT, PTT not affected)

Answer 21

Hemolytic uremic syndrome

Question 22

Thrombocytopenia, other symptomatic diseases or medications (often follows a viral illness) (PT, PTT not affected). Tx w/ high dose corticosteroids

Answer 22

Immune thrombocytopenic purpura

Question 23

Sx’s of hyperviscosity (hypertension, headache, dizziness, blurred vision) due to increased hematocrit with normal erythropoietin levels and high-oxygen-affinity hemoglobin

Answer 23

Polycythemia vera

Question 24

Palpitations, sweathing, headaches and hypertension with increased catecholamine levels (Dx w/ abdominal CT)

Answer 24

Pheochromocytoma

Question 25

Throat or neck discomfort, wheezing, stridor, and anxiety in a patient who does not respond to asthma treatment

Answer 25

Vocal cord dysfunction (VCD)

Question 26

Severe polyuria, polydipsia, with mildly increased hypernatremia ( due to water loss) and decreased urine osmolality (< 300)

Answer 26

Diabetes insipidus (DI, may be central (e.g. pituitary tumor) or nephrogenic (e.g. due to lithium))

Question 27

Fever, cough w/ sputum, and cavitary lung lesions in an immunocompromised patient that should be treated with bactrim

Answer 27

Nocardia asteroides

Question 28

A point mutation in a gene causes a coagulation factor to become resistant to inactivation by protein C leading to hypercoagulability

Answer 28

Factor 5 Leiden

Question 29

Middle aged woman who presents with pruritis, fatigue, hepatosplenomegally, and xanthelasma progressing to jaundice with anti-mitochondrial antibodies in the serum

Answer 29

Primary biliary cirrhosis

Question 30

Middle aged man presenting with pruritis, jaundice and onion skinning fibrosis around bile ducts, related to UC

Answer 30

Primary sclerosing cholangitis

Question 31

1) didanosine-induced pancreatitis, 2) abacavir-related hypersensitivity syndrome, 3) indinavir-related crystal-induced nephropathy, 4) nevirapine-associated liver failure, 5) NRTI related lactic acidosis, 6) NNRTI related Steven-Johnson syndrome

Answer 31

Name the 6 common acute life threatening reactions associated w/ HIV therapy

Question 32

Patient > 60 complains of difficulty hearing in crowded, noisy environments (high frequency, sensory-neural hearing loss that occurs with aging

Answer 32

Presbycusis

Question 33

Middle aged patient complains of low frequency, conductive hearing loss

Answer 33

Otosclerosis

Question 34

Patient presents with tinnitus, vertigo, and sensorineural hearing loss

Answer 34

Menier’s Disease

Question 35

Patient complains of unilateral hearing loss

Answer 35

Acoustic neuroma

Question 36

A young adult patient complains of progressive back pain and spinal stiffness that is worse in the morning and improves with exercise. Bilateral sacroiliitis is seen on X-ray and the patient is at increased risk for developing anterior uveitis

Answer 36

Ankylosing Spondylitis

Question 37

Patient presents with hyperthermia, mydriasis, delirium, urinary retention, decreased bowel sounds, and dry mouth

Answer 37

Anticholinergic poisoning

Question 38

Awake, alert patient with white tongue, heavy drooling, mouth burns, and severe pain with normal vitals and benign abdomen

Answer 38

Caustic poisoning

Question 39

Patient presents with CNS depression, arrhythmias, hypotension, and anticholinergic signs such as hyperthermia, flushing, dilated pupils, decreased bowel sounds and urinary retension

Answer 39

TCA poisoning

Question 40

Patient presents with headache, vomiting, abdominal pain and flushed skin as well as bitter almond flavor

Answer 40

Cyanide poisoning

Question 41

When a the treatment regimen selected for a patient depends (or is susceptible to) on the severity of the patient’s illness, negating the effect of randomization

Answer 41

Susceptibility bias

Question 42

When an intervention appears to prolong survival versus another treatment when it really just diagnosed a disease sooner

Answer 42

Lead time bias

Question 43

When poor data collection leads to inaccurate results

Answer 43

Measurement bias

Question 44

When the observer knows prior details of the study that can affect the results, like treatment participants are getting

Answer 44

Observer bias

Question 45

When a study participant is influenced by prior knowledge to answer a study question

Answer 45

Recall bias

Question 46

HIV infected patient presents with chronic, severe diarrhea and oocytes seen on acid fast stain of stool

Answer 46

Cryptosporidium parvum

Question 47

HIV infected patient presents with chronic, severe diarrhea and spores seen in stool

Answer 47

Microsporidia

Question 48

Female patient presents with facial rash, periorbital edema, difficulty rising from a seated position and climbing stairs, lichenoid papules overlying the joints, and symmetric proximal weakness of autoimmune origin associated with malignancy

Answer 48

Dermatomyositis

Question 49

Elderly patient presents with hearing loss, elevated alk phos with normal gamma-glutamyl transferase, calcium, phos, and other liver enzymes

Answer 49

Paget’s disease of the bone

Question 50

Patient presents with cough, coryza, and conjunctivitis as well as koplik’s spots and an erythematous maculopapular rash that progresses from the head to the trunk and extremities

Answer 50

Measles

Question 51

Patient presents with fever, lymphadenopathy, and malaise as well as arthritis and an erythematous maculopapular rash that progresses from the head to the trunk and extremities

Answer 51

Rubella

Question 52

Patient presents with sore throat, pharyngitis, and leukocytosis as well as cervical lymphadenopathy and a maculopapular rash that appears after administration of ampicillin

Answer 52

Infectious mononucleosis