Challenge Bowl #2 Flashcards by Shelby W

1 month h/o of tingling pain in the index finger. What maneuver should you perform?

Tinnel test

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Sxs of dopamine excess?

Hallucinations
Confusion
GI (N/V)
Orthostasis

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How long can sutures be left on the face?

3-5 days

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Pt has chronic back pain and decreased proprioception. What part of the spinal cord is most likely affected?

Posterior columns

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Total duration of antibiotics for complicated pyelonephritis?

Outpt 7-10 days

Inpt 14 days

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Function of the lens in the eye?

Focus light on the fovea.

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Pt has right sided eye pain and blurred vision. You see a dendritic ulcer on the R cornea. Dx?

Herpes opthalmicus

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What class of migraine tx can cause chest pain in some pts?

Triptans

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4 risk factors for stroke?

HTN
Age
A fib
Smoking

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In females which hernia is most common?

Direct hernia

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What class of drugs is used to tx open angle glaucoma and can cause bradycardia?

Timolol

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MC cause of legal blindness in pt >65yrs in the US?

Macular degeneration

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What are the features of a smith fracture?

Transverse fx of the distal radius with volar displacement

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What nonopioid analgesic has an analgesic and antipyretic effect?

APAP

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What lab value allows you to tell decrease production vs. increase destruction of RBC?

Reticulocyte count

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T or F? DRE has been known to reduce mortality and morbidity in colon CA?

False

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What meds can be used to shorten an acute MS exacerbation?

Prednisone

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What are 3 common sxs of a lower UTI?

suprapubic pain, urgency, frequency

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What are two PEx tests to evaluate meningeal irritation?

Babinski and Kernig’s sign

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What diabetes medication works by decreasing hepatic production and can rarely cause lactic acidosis?

Metformin (Biguanides)

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What does TTP stand for?

Thrombotic Thrombocytopenic Purpura

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What is the most common orthopedics dx in primary care?

Knee OA

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Anemia secondary to chronic renal failure can be tx’d with what agent?
What is the MC AE of this medication?

EPO

Can cause HTN

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What is the normal FBG?

70-100

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What is the maneuver that can tx BPPV?

Epiley maneuver

What do you need to monitor using an ophthalmic corticosteroid?

intraocular pressure

How is a TIA different than a stroke?

Transient duration; resolves <24hrs

What are the features of a colles fx?

Transverse fx of the distal radius with dorsal displacement.

What AED can cause hirsutism, ataxia, and nystagmus?

phenytoin

How do the pathogens of epididymitis in men 35y.o. vs older men?

Younger men: G/C MC | Older men: E. coli

Pt had trauma to the knee and now presents with laxity of valgus stress. What injury did he likely sustain?

MCL tear

What 3 things are likely to slow the progression of diabetic nephropathy?

ACEI, BP control, BG control

T or F? Varicose veins may result as a complication of DVT.

True

What are considered first line tx for urge incontinence?

Oxybutynin | class: anticholinergics/antispasmodics

What is the MC pathogen causing a UTI?

e. coli

What is the typical onset of typical cases of food poisoning?

1-8 hrs after ingestion

What is the recommended tx for anemia with high TIBC, low ferritin, and low serum iron?

200mg elemental Fe PO in two or three divided doses MC ferrous sulfate 325mg PO tid

What are the two coagulation pathways?

intrinsic and extrinsic

After surgical repair of a hernia, how long should the pt avoid heavy lifting?

4-6wks

Pharm therapy for obesity should be considered for pts with a BMI of what?

>27 with 2 RF or >30

Single most important factor in the development of obesity?

genetics

Macular degeneration loses sight in what area of vision?

Central

What is the empiric tx of bacterial meningitis for 1mo. to 50y.o.?

Vancomycin and Ceftriaxone

What is the % of men who have an elevated PSA who are ultimately dx'd with prostate CA?

30%

What drug class is recommended for a pt with BPH whose prostate is >30g? When will it start to work?

5 alpha reductase inhibitor (Finesteride) Relief in 6 months

What is the biggest risk of testicular torsion?

Losing the testicle

Name the insulin with the longest action

Glargine

What are 4 sxs of a concussion?

N/V, HA, amnesia, difficulty concentrating, fatigue, dizziness, mood changes, irritability

What class of antidiabetic agents delays carbohydrate absorption and helps with postprandial hyperglycemia?

Alpha glucosidase inhibitors e.g. acarbose

What is the world wide MC cause of microcytic anemia in children?

Iron deficiency anemia secondary to parasitic infection

What is the MC presenting sign of hodgkins dz?

painless lymphadenopathy

What is the term used to describe a HA that will wake you from sleep and is commonly associated with tearing?

Cluster HA

Name 3 AEDs that are cytochrome P450 inducers.

phenobarbitol, carbamazepine, and phenytoin

What is the tx for a subconjunctival hemorrhage?

Watch and wait

What are the MC AE of interferons used to tx MS

HA, myalgia, flu-like sxs, injection site irritation, and depression

A sickle shaped collection of blood on head CT is consistent with what type of traumatic head injury?

Subdural hematoma

What is the name of the deformity seen with progressive RA with hyperextension of the PIP joint and flexion of the DIP joint?

Swan neck deformity

Tx for status epilepticus?

Lorazepam; if still seizing give phenytoin

What is a greenstick fx?

Fx common in children in which the cortex is still intact on side

When does the admit H&P have to be completed by?

Within 24hrs of admission

What are HgA1C, LDL, and BP goals for a pt with DM?

HbA1C <140/80

A 12y.o. is accused of staring off into space a lot. Dx?

Absence sz

What does a visual acuity score of 20/40 mean?

They can see at 20ft what a normal person can see at 40ft

What are the MC opioid AE? Most severe?

MC: NVC Severe: Respiratory depression

What are two potential causes of macrocytic anemia?

Folate and B12 deficiency

What are PEx tests that you can use to evaluate ataxia?

Tandem gait, rapid alternating movements, finger/toe taps

What meds can be used for migraine ppx?

BB, TCA, AED

What condition does the pt have if they have Bence Jones protein present in their urine?

Multiple Myeloma

If an athlete has physiologic anasocoria, what should be done and why?

Document pupil disparity in case they sustain a concussion later

Tx for uncomplicated cystitis?

Resistance 20% Cipro

What are the cellular targets of HIV?

CD4 T cells

What is the name of the sensorineural hearing loss associated with aging?

Presbecusis

How long does ASA inhibit platelet ftn?

7 days (the lifespan of the plt)

Which substance causes pinpoint pupils and drowsiness? (Think toxidromes/substance abuse)

Opioids

Tor F? Hot nodules are more likely to be a thyroid malignancy than cold nodules on a nuclear medicine scan?

False. Cold = malignancy

What are two classes of meds that work well to tx chronic neuropathic pain?

AED and TCA

What is the best test to evaluate gallstones?

What are 3 sxs that suggest psychogenic ED?

Presence of morning wood, early ejaculation, intermittent occurrence, able to obtain erection with masturbation/visual stimuli

Name two conditions that petechiae may be suggestive of?

ITP and thrombocytopenia

Name 3 agents to tx hyperthyroidism.

BB, radioactive iodine, antithyroid meds (PTU, methimazole)

Veravax is CI in what pts?

Immunocompromised pts and those who are pg. | Varicella vaccine

What pts are at high risk for GI bleed with NSAIDs?

>60, Asprin use, clopidgeral use, bisophosphate, corticosteroid use, hx of ulcers, SSRI concurrent use, chronic use

What are the 4 main sxs of PD?

tremor, bradykinesia, ataxia, and pill rolling

Tx of acute bacterial prostatitis in men with a low risk of STI?

Cipro, levo and TMP/SMX x 10-14 days

The dx of Hodgkins dz is made using what dx px?

LN bx

Which specific lab tests are required in participation in sports in MN?

None unless there are abnl findings on exam.

What is the single greatest RF for hip fx?

age

Which radiographic view is most helpful in evaluating the C-spine?

Lateral (~70% of injuries detected)

Name 3 abxs that can be used to tx a UTI in a pg pt?

TMP/SMX, augmentin, nitrofurantoin

What is the term for a lump and tightness in the throat unrelated to swelling?

globus

What is the MC etiology of duodenal ulcers?

H. pylori

What toxidrome is characterized by dilated pupils, diaphoresis, elevated body temp, and HTN?

Sympathomimetic

A 19y.o. comes in after an MVA in a c-collar and back board. PEx reveals no midline tenderness, GCS 15, not intoxicated, adn complains of knee pain that is sore with any movement. Should this pt be cleared or get films?

He has a painful, distracting injury. Need films

What empiric abx tx is recommended for epiditimitis for men <35?

Ceftrizxone 250mg x1 IM and doxycycline 100 mg bid x 10-14 days.