april 12

Question 1

Low magnesium results in excessive loss of…

Answer 1

potassium

Question 2

intracellular magnesium in the kidney inhibits the secretion of…

Answer 2

potassium

Question 3

long QT and sensorineural deafness =

Answer 3

Jervell & Lange-Nielson syndrome

Question 4

what can trigger torsades de points in someone wiht long QT syndrome?

Answer 4

increased sympathetic activity / rapid heart rate (exercise)

Question 5

what drug can be given to prevent torsades de pointes in someone with long QT sydnrome?

Answer 5

non-selective beta blockers (dampen sympathetic activity and short the QT interval)

Question 6

at what level is elevated K a hyperkalemic emergency?

Answer 6

> 6.5

Question 7

if patient has hyperkalemic emergency (>6.5) how should you treat them?

Answer 7

calcium gluconate

Question 8

if a patient has CKD and hyperkalemia (but not hyperkalemic emergency), what drug can you give them to decrease K?

Answer 8

patiromer

Question 9

MOA of patiromer

Answer 9

binds K in the colon preventing reabsorption

Question 10

A joint is inflamed and XRAY shows chondrocalcinosis… diagnosis?

Answer 10

pseudogout

Question 11

Chondrocalcinosis is characteristic of..

Answer 11

pseudogout

Question 12

most common cause of death in the setting of ACUTE MI?

Answer 12

ventricular arythmia

Question 13

what is the most commonly etiology of ventricular arythmia int he setting of ACUTE MI?

Answer 13

reentrant ventricular arythmia

Question 14

enveloped shaped calcium oxalate crystals are seen in which type of poisoning?

Answer 14

ethylene glycol

Question 15

what drugs can increase the appetite of a patient with cancer?

Answer 15

• progesterone analogues (megestrol acetate)

- steroids

Question 16

In a patient wiht cancer and loss of appetite, with a longer life expectancy, do you give progesterone analogues or steroids?

Answer 16

progesterone analogues (less SE)

Question 17

symptoms of milk-alkali syndrome?

Answer 17

• nausea, vomiting, constipation
• polyuria, polydipsia
• neuropsychiatric symptoms

Question 18

labfindings of milk alkali syndrome?

Answer 18

• hypercalcemia
• metabolic alkalosis
• acute kidney injury
• suppressed PTH

Question 19

what drugs can increase risk of milk alkali syndrome?

Answer 19

• calcium carbonate

- ACEi, thiazides, NSAIDs

Question 20

why does AKI occur in milk alkali syndrome?

Answer 20

hypercalcemia causes renal vasoconstriction and also inhibits Na-K-2Cl transporter

Question 21

which renal transporter is inhibited in milk alkali syndrome and what are the consequences?

Answer 21

Na-K-2Cl -> water and sodium losss

Question 22

MRI findings in transverse myelitis?

Answer 22

T2 hyperintensity

Question 23

treatment of transverse myelitis?

Answer 23

high dose IV glucocorticoids

plasmapheresis

Question 24

transverse myelitis often follows…

Answer 24

a recent infection

Question 25

clinical features of rocky mountain spotted fever?

Answer 25

• fever, myalgias, headache, arthralgia

- macular/petechial rash on wrists/ankles

Question 26

complications of rocky mountain spotted fever?

Answer 26

encephalitis, pulmonary edema, bleeding, shock

Question 27

laboratory findings in rocky mountain spotted fever?

Answer 27

low platelets,
low sodium,
increased AST/ALT

Question 28

treatment of rocky mountain spotted fever?

Answer 28

doxycycline

Question 29

In a patient wiht a likely PE with no contraindications for anticoagulation, shoudl you do CT angiography first or provide anticoags?

Answer 29

anticoags before CT angiography