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ABIM IM Recert > Board Vitals > Flashcards

Board Vitals Flashcards

1
Q

How does infection with Mycoplasma pneumoniae present?

A

Atypical community-acquired pneumonia

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2
Q

Does Mycoplasma pneumoniae infection cause agglutination?

A

Yes

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3
Q

How long after Mycobacterium pneumoniae infection do cold agglutinin titers decline?

A

6 - 8 weeks

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4
Q

What conditions cause chronic cold agglutinin titers?

A
  • Certain B-cell neoplasms
  • Infectious mononucleosis
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5
Q

How much should the initial fluid challenge for sepsis-induced hypoperfusion be?

A

30 mL/kg

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6
Q

Have SSRIs shown a benefit in treating irritable bowel syndrome?

A

No

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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.

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8
Q

What is the next step if antispasmodics do not resolve symptoms in irritable bowel syndrome?

A

Tricyclic antidepressants

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9
Q

Which artery supplies the posteromedial papillary muscle in the heart?

A

Posterior descending artery

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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

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11
Q

What is the best way to evaluate for stool overflow incontinence?

A

Digital rectal exam

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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

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13
Q

What is the treatment of fecal impaction?

A
  • Disimpaction
  • Colonic evacuation
  • Maintenance regimen
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14
Q

What is the usual treatment of acute colonic ischemia?

A

Supportive care

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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
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16
Q

What percentage of acute renal failure in hospitalized patients is attributed to intrinsic acute renal failure?

A

69%

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17
Q

In acute renal failure, does the glomerular filtration rate decrease faster or slower than the renal plasma flow?

A

Faster

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18
Q

Which is better vascularized - the renal medulla or renal cortex?

A

Renal cortex

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19
Q

What is the distribution of tubular necrosis in the kidney?

A

Patchy distribution

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20
Q

Is tubular necrosis correlated to the degree of renal dysfunction?

A

No

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21
Q

Is the fractional excretion of sodium lower or higher than 1% in acute tubular necrosis?

A

Higher

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22
Q

Which test can differentiate between vitamin B12 deficiency and folate deficiency?

A

Methylmalonic acid

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23
Q

What happens to methylmalonic acid in vitamin B12 deficiency?

A

It is elevated.

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24
Q

What happens to methylmalonic acid in folate deficiency?

A

It is normal.

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25
Q

What happens to homocysteine in vitamin B12 deficiency?

A

It is elevated.

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26
Q

What happens to homocysteine in folate deficiency?

A

It is elevated.

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27
Q

What should you use first to treat benign paroxysmal positional vertigo (BPPV)?

A

Epley maneuver

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28
Q

Should vestibular therapy be used in acute vertigo?

A

No

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29
Q

Metoclopramide and prochlorperazine are anti-dopaminergic and should be avoided in which medical condition?

A

Parkinson’s disease

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30
Q

Are most allergic reactions to penicillin IgE-mediated or not?

A

Most are not IgE-mediated

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31
Q

What kind of allergies is skin testing sensitive for?

A

IgE-mediated allergies

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32
Q

What percentage of patients report an allergy to penicillin?

A

5 - 10%

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33
Q

What percentage of patients with self-reported penicillin allergy will have negative skin testing?

A

90%

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34
Q

What type of allergic reaction do people usually have to penicillin - delayed reaction or IgE-mediated?

A

Delayed reaction

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35
Q

What are most allergic reactions to penicillin - delayed or IgE-mediated?

A

Delayed

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36
Q

Are the results of desensitization therapy long-lasting?

A

No

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37
Q

How long do the results of desensitization therapy for penicillin last?

A

As long as the patient is exposed to penicillin.

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38
Q

What deficiency causes Wernicke’s encephalopathy?

A

Thiamine

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39
Q

Which psychiatric disorder has the highest mortality rate?

A

Anorexia nervosa

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40
Q

Do people with body dysmorphic disorder fixate on their weight?

A

No

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41
Q

What are the possible causes of a patient having positive Hepatitis C antibody test and negative HCV RNA testing?

A
  • Old resolved infection
  • False positive
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42
Q

Do patients with limited life expectancy benefit from statin therapy to prevent cardiovascular events?

A

No

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43
Q

Which protein is a well-established risk factor for Alzheimer’s disease?

A

Apolipoprotein E

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44
Q

Which gene codes for apolipoprotein E?

A

APOE

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45
Q

Which chromosome is the APOE gene that encodes for apolipoprotein E located on?

A

19

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46
Q

Which allele on chromosome 19 is associated with a higher risk of Alzheimer’s disease?

A

Epsilon 4

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47
Q

What kind of flow volume loop does paradoxical vocal cord motion disorder have?

A

Flattening of inspiratory loop

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48
Q

Do patients with asthma have flattening of inspiratory loop on flow volume loops?

A

No

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49
Q

What is the treatment of paradoxical vocal cord motion disorder?

A

Cognitive behavioral therapy

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50
Q

What is the gold standard for diagnosing paradoxical vocal cord motion disorder?

A

Laryngoscopy

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51
Q

What is the most effective treatment for preventing long term complications in patients with atrial flutter?

A

Ablation

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52
Q

What is an Allay lamp used for?

A

Treatment of photophobia (emits only green light)

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53
Q

What is a Cafaly device used for?

A

Aborting or preventing a migraine

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54
Q

What is a single pulse transcranial magnetic stimulation (TMS) device used for?

A

Preventing a migraine

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55
Q

What is a Nerivio arm stimulator used for?

A

Aborting of migraine

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56
Q

What is a GammaCore vagus nerve stimulator used for?

A

Aborting of migraine (acute treatment during an attack)

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57
Q

Which patient populations get Listeria meningoencephalitis?

A
  • Immunocompromised
  • Elderly
  • Pregnant
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58
Q

Which organism has gram-positive or gram-variable rods?

A

Listeria monocytogenes

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59
Q

How does Neisseria meningitidis show up on a gram stain?

A

Gram negative diplococcus

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60
Q

What is the most common complication of a Zenker’s diverticulum?

A

Aspiration

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61
Q

Is carbamazepine a P450 inducer or inhibitor?

A

P450 inducer

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62
Q

Is grapefruit juice a P450 inducer or inhibitor?

A

P450 inhibitor

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63
Q

What are the indications for surgery in scoliosis patients?

A
  • 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
Q

Is bracing recommended for skeletally immature patients with scoliosis?

A

Yes

65
Q

Is bracing recommended for skeletally mature patients with scoliosis?

A

No

66
Q

Are physiotherapeutic scoliosis-specific exercises generally recommended in scoliosis?

A

No

67
Q

How often should methadone be dosed?

A

Every 6 - 8 hours

68
Q

What type of drugs are butorphanol and buprenorphine?

A

Partial opioid agonists

69
Q

What type of drug is nalbuphine?

A

Opioid agonist/antagonists

70
Q

Should you give opioid partial agonists or agonist/antagonist drugs with methadone?

A

No

71
Q

Why should you not give opioid partial agonists or agonist/antagonist drugs with methadone?

A

They can cause opioid withdrawal symptoms.

72
Q

Is diarrhea a side effect of hyoscyamine?

A

No

73
Q

Is bradycardia a side effect of hyoscyamine?

A

No

74
Q

Is xerostomia a side effect of hyoscyamine?

A

Yes

75
Q

Is urinary frequency a side effect of hyoscyamine?

A

No

76
Q

Is hyperhydrosis a side effect of hyoscyamine?

A

No

77
Q

What is a tender testicular mass that develops within 24 hours?

A

Testicular torsion

78
Q

If newborn screening shows an abnormally elevated level of immunoreactive trypsinogen - what is the diagnosis?

A

Cystic fibrosis

79
Q

What electrolyte abnormality are patients with cystic fibrosis prone to?

A

Hyponatremia

80
Q

Why are patients with cystic fibrosis prone to hyponatremia?

A

Because of excessive salt wasting

81
Q

What can be considered prior to prescribing opioids in a patient who reports inadequate pain relief?

A

Querying the State’s prescription drug monitoring program

82
Q

What are the most common side effects of prostaglandin therapy for erectile dysfunction?

A
  • Penile pain
  • Urethral trauma
83
Q

What is a first line therapy for erectile dysfunction?

A

Oral phosphodiesterase inhibitors (e.g. sildenafil)

84
Q

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?

A

Intraurethral via suppository

85
Q

Is prostaglandin E1 (alprostadil) more effective when given via the intraurethral route by suppository or by the intracavernosal route by injection?

A

Intracavernosal route

86
Q

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?

A

Intracavernosal route

87
Q

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?

A

Intracavernosal route

88
Q

Should an erection last longer than 4 hours?

A

No - seek medical attention

89
Q

How high can the ALT and AST be in severe acetominophen poisoning?

A

> 10,000

90
Q

Can PT be prolonged in severe acetaminophen poisoning?

A

Yes

91
Q

Can bilirubin be elevated in severe acetaminophen poisoning?

A

Yes

92
Q

Which drugs have the greatest tendency to induce drug-induced lupus?

A
  • Hydralazine
  • Procainamide
  • Isoniazid
93
Q

Toxicity such as anemia and thrombocytopenia is worsened for which immunotherapy drug when it is used with allopurinol?

A

Azathioprine

94
Q

Can fibrates cause hepatotoxicity?

A

Yes

95
Q

Can fibrates cause myopathy?

A

Yes

96
Q

Can sensitivity, specificity and prevalence be used to calculate positive predictive value and negative predictive value?

A

Yes

(UpToDate Calculator)

97
Q

Which ion is responsible for membrane depolarization (phase 0)?

A

Sodium

98
Q

What is the hypercalcemia in sarcoidosis due to?

A

Increased 1 alpha-hydroxylase activity

99
Q

Which antibodies do patients with drug induced lupus have?

A

Anti-histone antibodies

100
Q

Is imaging typically required in patients who present with low back pain?

A

No - not unless there are red flags.

101
Q

When correcting for severe hypernatremia, in addition to sodium level, what also needs to be monitored closely?

A

Glucose

102
Q

Does tacrolimus more commonly cause hyperkalemia or hypokalemia?

A

Hyperkalemia

103
Q

Does tacrolimus cause hypomagnesemia or hypermagnesemia?

A

Hypomagnesemia

104
Q

Does tacrolimus cause hypocalciuria or hypercalciuria?

A

Hypercalciuria

105
Q

Is creatinine an anion or a cation?

A

Cation

106
Q

How is creatinine transported in the renal tubule?

A

Organic cation transporter (OCT)

107
Q

Does cimetidine competitively inhibit creatinine secretion, leading to reversible rise in creatinine?

A

Yes

108
Q

In what age groups do women have a similar of higher risk of stroke compared to men?

A

Age 25 - 34 years, and over 85 years

109
Q

It is harder to induce diuresis in patients with low albumin or high albumin?

A

Low albumin

110
Q

What is the primary cause of mortality in burn patients?

A

Hypovolemia

111
Q

What does the McMurray test help identify?

A

Meniscal tear

112
Q

What does the Lachman test help identify?

A

Anterior cruciate ligament (ACL) injury

113
Q

What does the pivot-shift test help identify?

A

Anterior cruciate ligament (ACL) injury

114
Q

What does the Thompson test help identify?

A

Achilles tendon rupture

115
Q

What does the anterior drawer test help identify?

A

Anterior cruciate ligament (ACL) injury

116
Q

Is hypothyroidism a common adverse effect of paclitaxel?

A

No

117
Q

Is cardiomyopathy a common adverse effect of paclitaxel?

A

No

118
Q

Is pulmonary fibrosis a common adverse effect of paclitaxel?

A

No

119
Q

Is paresthesia a common adverse effect of paclitaxel?

A

Yes

120
Q

Is hemorrhagic cystitis a common adverse effect of paclitaxel?

A

No

121
Q

Is cardiomyopathy a common adverse effect of doxorubicin?

A

Yes

122
Q

Is hypothyroidism a common adverse effect of pembrolizumab?

A

Yes

123
Q

Is pulmonary fibrosis a common adverse effect of bleomycin?

A

Yes

124
Q

Is hemorrhagic cystitis a common adverse effect of cyclophosphamide?

A

Yes

125
Q

What acid base imbalance does high altitude cause?

A

Respiratory alkalosis (compensated)

126
Q

Samples may allow estimations of error in resulting statistics.

True or false?

A

True

127
Q

What is the treatment of patellofemoral pain syndrome (PFPS)?

A

Physical therapy

128
Q

What is the lactate level in patients with D-lactic acidosis?

A

Normal

129
Q

What patients are more likely to get D-lactic acidosis?

A

Short-bowel syndromes

130
Q

What should be monitored in patients on nitroprusside?

A

Thiocyanate level

131
Q

What kind of dietary restrictions do patients have when they are on monoamine oxidase inhibitors (MOAI)?

A

Cannot take foods containing tyramine

132
Q

Can dronedarone be used in severe heart failure or decompensated heart failure?

A

No

133
Q

What is the mechanism of action of varenicline?

A

Nicotine partial agonist

134
Q

What is the mechanism of action of clonidine?

A

Alpha-2 agonist

135
Q

What is the mechanism of action of gabapentin?

A

GABA (gamma-aminobutyric acid) analog

136
Q

What is the mechanism of action of bupropion?

A

Neuronal norepinephrine and dopamine reuptake inhibitor

137
Q

Which type of anemia is associated with restless leg syndrome?

A

Iron deficiency anemia

138
Q

What can help the treatment of restless leg syndrome if ferritin is less than 75 mcg/L?

A

Iron replacement

139
Q

Is silver nitrate used to treat hyperhydrosis?

A

No

140
Q

Is botulinum toxin therapy used to treat hyperhydrosis?

A

Yes

141
Q

What is the first line treatment for hyperhydrosis?

A
  • Topical aluminum chloride 12%
  • Topical glycopyrronium tosylate solution
142
Q

Can oral oxybutynin effectively treat hyperhidrosis?

A

Yes (but not first line)

143
Q

What is the treatment of male pattern alopecia?

A
  • Topical minoxidil
  • Oral finasteride
144
Q

Can phenytoin cause gingival hyperplasia?

A

Yes

145
Q

Can vigabatrin cause visual field defects?

A

Yes

146
Q

What is availability bias?

A

Believing a diagnosis that occurred recently is more likely to occur again.

147
Q

Does propofol cause a dissociative state?

A

No

148
Q

Does ketamine cause a dissociative state?

A

Yes

149
Q

Does routine pre-procedural fasting reduce risk of aspiration during procedural sedation and analgesia?

A

No

150
Q

Where is a direct inguinal hernia in relation to the inferior epigastric artery?

A

Medial to the inferior epigastric artery

151
Q

What is another name for drug reaction with eosinophilia and systemic symptoms (DRESS)?

A

Drug-induced hypersensitivity syndrome (DIHS)

152
Q

Which of the following develop 1- 2 weeks after starting a new medication?

Drug-induced hypersensitivity syndrome
Stevens-Johnson syndrome
Toxic Epidermal Necrolysis

A

Stevens-Johnson syndrome
Toxic Epidermal Necrolysis

153
Q

Which of the following develop 2- 6 weeks after starting a new medication?

Drug-induced hypersensitivity syndrome
Stevens-Johnson syndrome
Toxic Epidermal Necrolysis

A

Drug-induced hypersensitivity syndrome

154
Q

How many half-lives does a drug take to reach steady state?

A

5

155
Q

What is the mechanism of action of phenelzine?

A

Monoamine oxidase inhibitor

156
Q

What happens if you take tyrosine containing foods (e.g. cheese) when taking an MOA inhibitor (e.g. phenelzine)?

A

Hypertensive crisis

ABIM IM Recert (42 decks)

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