Board Vitals Flashcards
(156 cards)
1
Q
How does infection with Mycoplasma pneumoniae present?
A
Atypical community-acquired pneumonia
2
Q
Does Mycoplasma pneumoniae infection cause agglutination?
A
Yes
3
Q
How long after Mycobacterium pneumoniae infection do cold agglutinin titers decline?
A
6 - 8 weeks
4
Q
What conditions cause chronic cold agglutinin titers?
A
- Certain B-cell neoplasms
- Infectious mononucleosis
5
Q
How much should the initial fluid challenge for sepsis-induced hypoperfusion be?
A
30 mL/kg
6
Q
Have SSRIs shown a benefit in treating irritable bowel syndrome?
A
No
7
Q
What is the next step in patients with irritable bowel syndrome who have already been treated with lifestyle interventions and addressed underlying motility issue?
A
As needed anti-spasmodic to be taken when stressed or for known triggers.
8
Q
What is the next step if antispasmodics do not resolve symptoms in irritable bowel syndrome?
A
Tricyclic antidepressants
9
Q
Which artery supplies the posteromedial papillary muscle in the heart?
A
Posterior descending artery
10
Q
In patient with left dominant circulation, where can a thrombus dislodged from the left circumflex artery during PCI end up?
A
Posterior descending artery
11
Q
What is the best way to evaluate for stool overflow incontinence?
A
Digital rectal exam
12
Q
What is the next step if digital rectal exam does not show palpable fecal impaction in cases of overflow incontinence?
A
Abdominal X-rays
13
Q
What is the treatment of fecal impaction?
A
- Disimpaction
- Colonic evacuation
- Maintenance regimen
14
Q
What is the usual treatment of acute colonic ischemia?
A
Supportive care
15
Q
When is surgery indicated for colonic ischemia?
A
- If it is associated with hypotension, tachycardia and abdominal pain without rectal bleeding
- Pancolonic ischemia
- Gangrene
16
Q
What percentage of acute renal failure in hospitalized patients is attributed to intrinsic acute renal failure?
A
69%
17
Q
In acute renal failure, does the glomerular filtration rate decrease faster or slower than the renal plasma flow?
A
Faster
18
Q
Which is better vascularized - the renal medulla or renal cortex?
A
Renal cortex
19
Q
What is the distribution of tubular necrosis in the kidney?
A
Patchy distribution
20
Q
Is tubular necrosis correlated to the degree of renal dysfunction?
A
No
21
Q
Is the fractional excretion of sodium lower or higher than 1% in acute tubular necrosis?
A
Higher
22
Q
Which test can differentiate between vitamin B12 deficiency and folate deficiency?
A
Methylmalonic acid
23
Q
What happens to methylmalonic acid in vitamin B12 deficiency?
A
It is elevated.
24
Q
What happens to methylmalonic acid in folate deficiency?
A
It is normal.
25
What happens to homocysteine in vitamin B12 deficiency?
It is elevated.
26
What happens to homocysteine in folate deficiency?
It is elevated.
27
What should you use first to treat benign paroxysmal positional vertigo (BPPV)?
Epley maneuver
28
Should vestibular therapy be used in acute vertigo?
No
29
Metoclopramide and prochlorperazine are anti-dopaminergic and should be avoided in which medical condition?
Parkinson's disease
30
Are most allergic reactions to penicillin IgE-mediated or not?
Most are not IgE-mediated
31
What kind of allergies is skin testing sensitive for?
IgE-mediated allergies
32
What percentage of patients report an allergy to penicillin?
5 - 10%
33
What percentage of patients with self-reported penicillin allergy will have negative skin testing?
90%
34
What type of allergic reaction do people usually have to penicillin - delayed reaction or IgE-mediated?
Delayed reaction
35
What are most allergic reactions to penicillin - delayed or IgE-mediated?
Delayed
36
Are the results of desensitization therapy long-lasting?
No
37
How long do the results of desensitization therapy for penicillin last?
As long as the patient is exposed to penicillin.
38
What deficiency causes Wernicke's encephalopathy?
Thiamine
39
Which psychiatric disorder has the highest mortality rate?
Anorexia nervosa
40
Do people with body dysmorphic disorder fixate on their weight?
No
41
What are the possible causes of a patient having positive Hepatitis C antibody test and negative HCV RNA testing?
- Old resolved infection
- False positive
42
Do patients with limited life expectancy benefit from statin therapy to prevent cardiovascular events?
No
43
Which protein is a well-established risk factor for Alzheimer's disease?
Apolipoprotein E
44
Which gene codes for apolipoprotein E?
APOE
45
Which chromosome is the APOE gene that encodes for apolipoprotein E located on?
19
46
Which allele on chromosome 19 is associated with a higher risk of Alzheimer's disease?
Epsilon 4
47
What kind of flow volume loop does paradoxical vocal cord motion disorder have?
Flattening of inspiratory loop
48
Do patients with asthma have flattening of inspiratory loop on flow volume loops?
No
49
What is the treatment of paradoxical vocal cord motion disorder?
Cognitive behavioral therapy
50
What is the gold standard for diagnosing paradoxical vocal cord motion disorder?
Laryngoscopy
51
What is the most effective treatment for preventing long term complications in patients with atrial flutter?
Ablation
52
What is an Allay lamp used for?
Treatment of photophobia (emits only green light)
53
What is a Cafaly device used for?
Aborting or preventing a migraine
54
What is a single pulse transcranial magnetic stimulation (TMS) device used for?
Preventing a migraine
55
What is a Nerivio arm stimulator used for?
Aborting of migraine
56
What is a GammaCore vagus nerve stimulator used for?
Aborting of migraine (acute treatment during an attack)
57
Which patient populations get Listeria meningoencephalitis?
- Immunocompromised
- Elderly
- Pregnant
58
Which organism has gram-positive or gram-variable rods?
Listeria monocytogenes
59
How does Neisseria meningitidis show up on a gram stain?
Gram negative diplococcus
60
What is the most common complication of a Zenker's diverticulum?
Aspiration
61
Is carbamazepine a P450 inducer or inhibitor?
P450 inducer
62
Is grapefruit juice a P450 inducer or inhibitor?
P450 inhibitor
63
What are the indications for surgery in scoliosis patients?
- Cobb angle more than 25 degrees in any patient
- Progression of 5 degrees or more in Cobb angle of any patient
- Cobb angle of 20 - 24 degrees in premenarchal females
- Cobb angle of 20 - 24 degrees in males aged 12 - 14 years
64
Is bracing recommended for skeletally immature patients with scoliosis?
Yes
65
Is bracing recommended for skeletally mature patients with scoliosis?
No
66
Are physiotherapeutic scoliosis-specific exercises generally recommended in scoliosis?
No
67
How often should methadone be dosed?
Every 6 - 8 hours
68
What type of drugs are butorphanol and buprenorphine?
Partial opioid agonists
69
What type of drug is nalbuphine?
Opioid agonist/antagonists
70
Should you give opioid partial agonists or agonist/antagonist drugs with methadone?
No
71
Why should you not give opioid partial agonists or agonist/antagonist drugs with methadone?
They can cause opioid withdrawal symptoms.
72
Is diarrhea a side effect of hyoscyamine?
No
73
Is bradycardia a side effect of hyoscyamine?
No
74
Is xerostomia a side effect of hyoscyamine?
Yes
75
Is urinary frequency a side effect of hyoscyamine?
No
76
Is hyperhydrosis a side effect of hyoscyamine?
No
77
What is a tender testicular mass that develops within 24 hours?
Testicular torsion
78
If newborn screening shows an abnormally elevated level of immunoreactive trypsinogen - what is the diagnosis?
Cystic fibrosis
79
What electrolyte abnormality are patients with cystic fibrosis prone to?
Hyponatremia
80
Why are patients with cystic fibrosis prone to hyponatremia?
Because of excessive salt wasting
81
What can be considered prior to prescribing opioids in a patient who reports inadequate pain relief?
Querying the State's prescription drug monitoring program
82
What are the most common side effects of prostaglandin therapy for erectile dysfunction?
- Penile pain
- Urethral trauma
83
What is a first line therapy for erectile dysfunction?
Oral phosphodiesterase inhibitors (e.g. sildenafil)
84
Is penile pain and urethral burning more common when prostaglandin E1 (alprostadil) is given via the intraurethral route by suppository or by the intracavernosal route by injection?
Intraurethral via suppository
85
Is prostaglandin E1 (alprostadil) more effective when given via the intraurethral route by suppository or by the intracavernosal route by injection?
Intracavernosal route
86
Is prostaglandin E1 (alprostadil) associated with higher rates of discontinuation when given via the intraurethral route by suppository or by the intracavernosal route by injection?
Intracavernosal route
87
Is prostaglandin E1 (alprostadil) associated with higher rates of fibrosis when given via the intraurethral route by suppository or by the intracavernosal route by injection?
Intracavernosal route
88
Should an erection last longer than 4 hours?
No - seek medical attention
89
How high can the ALT and AST be in severe acetominophen poisoning?
> 10,000
90
Can PT be prolonged in severe acetaminophen poisoning?
Yes
91
Can bilirubin be elevated in severe acetaminophen poisoning?
Yes
92
Which drugs have the greatest tendency to induce drug-induced lupus?
- Hydralazine
- Procainamide
- Isoniazid
93
Toxicity such as anemia and thrombocytopenia is worsened for which immunotherapy drug when it is used with allopurinol?
Azathioprine
94
Can fibrates cause hepatotoxicity?
Yes
95
Can fibrates cause myopathy?
Yes
96
Can sensitivity, specificity and prevalence be used to calculate positive predictive value and negative predictive value?
Yes
(UpToDate Calculator)
97
Which ion is responsible for membrane depolarization (phase 0)?
Sodium
98
What is the hypercalcemia in sarcoidosis due to?
Increased 1 alpha-hydroxylase activity
99
Which antibodies do patients with drug induced lupus have?
Anti-histone antibodies
100
Is imaging typically required in patients who present with low back pain?
No - not unless there are red flags.
101
When correcting for severe hypernatremia, in addition to sodium level, what also needs to be monitored closely?
Glucose
102
Does tacrolimus more commonly cause hyperkalemia or hypokalemia?
Hyperkalemia
103
Does tacrolimus cause hypomagnesemia or hypermagnesemia?
Hypomagnesemia
104
Does tacrolimus cause hypocalciuria or hypercalciuria?
Hypercalciuria
105
Is creatinine an anion or a cation?
Cation
106
How is creatinine transported in the renal tubule?
Organic cation transporter (OCT)
107
Does cimetidine competitively inhibit creatinine secretion, leading to reversible rise in creatinine?
Yes
108
In what age groups do women have a similar of higher risk of stroke compared to men?
Age 25 - 34 years, and over 85 years
109
It is harder to induce diuresis in patients with low albumin or high albumin?
Low albumin
110
What is the primary cause of mortality in burn patients?
Hypovolemia
111
What does the McMurray test help identify?
Meniscal tear
112
What does the Lachman test help identify?
Anterior cruciate ligament (ACL) injury
113
What does the pivot-shift test help identify?
Anterior cruciate ligament (ACL) injury
114
What does the Thompson test help identify?
Achilles tendon rupture
115
What does the anterior drawer test help identify?
Anterior cruciate ligament (ACL) injury
116
Is hypothyroidism a common adverse effect of paclitaxel?
No
117
Is cardiomyopathy a common adverse effect of paclitaxel?
No
118
Is pulmonary fibrosis a common adverse effect of paclitaxel?
No
119
Is paresthesia a common adverse effect of paclitaxel?
Yes
120
Is hemorrhagic cystitis a common adverse effect of paclitaxel?
No
121
Is cardiomyopathy a common adverse effect of doxorubicin?
Yes
122
Is hypothyroidism a common adverse effect of pembrolizumab?
Yes
123
Is pulmonary fibrosis a common adverse effect of bleomycin?
Yes
124
Is hemorrhagic cystitis a common adverse effect of cyclophosphamide?
Yes
125
What acid base imbalance does high altitude cause?
Respiratory alkalosis (compensated)
126
Samples may allow estimations of error in resulting statistics.
True or false?
True
127
What is the treatment of patellofemoral pain syndrome (PFPS)?
Physical therapy
128
What is the lactate level in patients with D-lactic acidosis?
Normal
129
What patients are more likely to get D-lactic acidosis?
Short-bowel syndromes
130
What should be monitored in patients on nitroprusside?
Thiocyanate level
131
What kind of dietary restrictions do patients have when they are on monoamine oxidase inhibitors (MOAI)?
Cannot take foods containing tyramine
132
Can dronedarone be used in severe heart failure or decompensated heart failure?
No
133
What is the mechanism of action of varenicline?
Nicotine partial agonist
134
What is the mechanism of action of clonidine?
Alpha-2 agonist
135
What is the mechanism of action of gabapentin?
GABA (gamma-aminobutyric acid) analog
136
What is the mechanism of action of bupropion?
Neuronal norepinephrine and dopamine reuptake inhibitor
137
Which type of anemia is associated with restless leg syndrome?
Iron deficiency anemia
138
What can help the treatment of restless leg syndrome if ferritin is less than 75 mcg/L?
Iron replacement
139
Is silver nitrate used to treat hyperhydrosis?
No
140
Is botulinum toxin therapy used to treat hyperhydrosis?
Yes
141
What is the first line treatment for hyperhydrosis?
- Topical aluminum chloride 12%
- Topical glycopyrronium tosylate solution
142
Can oral oxybutynin effectively treat hyperhidrosis?
Yes (but not first line)
143
What is the treatment of male pattern alopecia?
- Topical minoxidil
- Oral finasteride
144
Can phenytoin cause gingival hyperplasia?
Yes
145
Can vigabatrin cause visual field defects?
Yes
146
What is availability bias?
Believing a diagnosis that occurred recently is more likely to occur again.
147
Does propofol cause a dissociative state?
No
148
Does ketamine cause a dissociative state?
Yes
149
Does routine pre-procedural fasting reduce risk of aspiration during procedural sedation and analgesia?
No
150
Where is a direct inguinal hernia in relation to the inferior epigastric artery?
Medial to the inferior epigastric artery
151
What is another name for drug reaction with eosinophilia and systemic symptoms (DRESS)?
Drug-induced hypersensitivity syndrome (DIHS)
152
Which of the following develop 1- 2 weeks after starting a new medication?
Drug-induced hypersensitivity syndrome
Stevens-Johnson syndrome
Toxic Epidermal Necrolysis
Stevens-Johnson syndrome
Toxic Epidermal Necrolysis
153
Which of the following develop 2- 6 weeks after starting a new medication?
Drug-induced hypersensitivity syndrome
Stevens-Johnson syndrome
Toxic Epidermal Necrolysis
Drug-induced hypersensitivity syndrome
154
How many half-lives does a drug take to reach steady state?
5
155
What is the mechanism of action of phenelzine?
Monoamine oxidase inhibitor
156
What happens if you take tyrosine containing foods (e.g. cheese) when taking an MOA inhibitor (e.g. phenelzine)?
Hypertensive crisis
