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0 - Internal Medicine Shelf > COMQUEST > Flashcards

COMQUEST Flashcards

1
Q

What is the most likely dx in a pt taking laxatives for weight loss who develops weakness and muscle cramps; what is seen on ekg?

A
  • HYPOkalemia
  • U waves on the ekg (small waves just after the T wave)
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2
Q

How does the DLCO differ btw chronic bronchitis and emphysema?

A
  • Normal in chronic bronchitis
  • Decreased in emphysema due to alveolar destruction
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3
Q

Pt’s with HIV and a CD4 count <50/mm3 should receive prophylaxis with what antibiotic(s) against MAC?

A

Clarithromycin or Azithromycin

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4
Q

Using the mnemonic N’ TIME2 what are the the features of Wiskott-Aldrich syndrome?

A
  • Neutropenia
  • Thrombocytopenia
  • frequent Infections
  • ↓ levels IgM
  • Eczema
  • ↑ levels IgE
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5
Q

What is the gold standard for dx of Dermatomyositis?

A

Muscle biospy

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6
Q

What is the most common cause of fever in a pt returning from a developing country; what is the initial test of choice?

A
  • Malaria
  • Initial test = thick and thin blood smear
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7
Q

Which anti-malarial agent can kill parasites lying dormant in the liver?

A

Primaquine

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8
Q

Which SNRI can be used in pt’s with stress urinary incontinence + concomitant depression?

A

Duloxetine

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9
Q

What is the next best step in the management of suspected Sheehan’s syndrome?

A

IV Dexamethasone (“stress dose” steroids) —> MRI of head

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10
Q

What is the initial step in managemnt of an otherwise healthy pt presenting with sx’s suggesting community-acquired pneumonia?

A

Empiric tx with a macrolide or doxycycline

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11
Q

What are the 3 major risk factors for pancreatic cancer and how does it classically present?

A
  • Smoking (#1), chronic pancreatitis, and diabetes
  • Presents w/ painless jaundice
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12
Q

What is the definitive tx for pheochromocytoma and how should the BP and HR be managed?

A
  • Surgery
  • 10-14 days prior give an alpha blocker i.e., phenoxybenzamine
  • 3-4 days prior give a beta blocker i.e., propranolol
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13
Q

In acute MI what is the earliest marker of ischemia?

A
  • Myoglobin, rises within first hour and peaks at 6
  • CK-MB and troponins take several hours to rise
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14
Q

What are the first line agents for management of pyelonephritis?

A

- IV fluoroquinolones (ciprofloxacin, levofloxacin)

- IV ceftriaxone

- IV ampicillin/sulbactam

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15
Q

How can the aldosterone-renin ratio help distinguish primary from secondary hyperaldosteronism?

A
  • >20 in primary
  • <10 in secondary w/ high renin i.e., renin-secreting tumor, fibromuscular dysplasia, renal artery stenosis
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16
Q

An induration of 5mm or greater on PPD skin testing is considered positive for tuberculosis in which pt populations?

A
  • HIV pt’s
  • Immunocompromising conditions i.e., hx of chemo, post-organ transplant
  • Household contact of TB pt
17
Q

How is a diagnosis of sarcoidosis confirmed?

A

Biopsy of affected organ w/ evidence of non-caseating granulomas and no evidence of infection

18
Q

Drusen (subretinal deposits - yellow/white deposits) are a characteristic finding of what eye pathology; how does it present?

A
  • Age-related macular degeneration
  • Gradual onset of bilateral central vision loss w/ preservation of peripheral vision
19
Q

The diagnosis of orthostatic hypotension is confirmed with a drop of how much systolic or diastolic upon standing from a supine position?

A

>20 mmHg systolic or >10 mmHg diastolic

20
Q

What is the tx of choice for acute bacterial meningitis w/ N. gonorrhea and S. pneumonia?

A
  • N. gonorrhea = Cefotaxime or Ceftriaxone
  • S. pneumo = Vanco + ceftriaxone
21
Q

What is the test of choice for dx BPH?

A

Pelvic ultrasound w/ post-void residual

22
Q

What are the 1st line tx’s for metastatic prostate cancer?

A
  • GnRH agonists: leuprolide or goserelin
  • GnRH antagonists: degarelix
23
Q

What is the most effective first-line tx for hemochromatosis?

A

Periodic phlebotomy

24
Q

In a pt with suspected diverticulitis what type of imaging is used to confirm the diagnosis?

A

Abdominal CT scan

25
Q

What is the initial imaging study that should be ordered in a pt with diverticular disease who presents with signs of diverticular perforation?

A

Upright abdominal x-ray

26
Q

What is the most likely dx in a pt with pathologic fractures, bone pain, anemia, and recurrent infections?

A
  • Multiple myeloma
  • IgG or IgA spike on serum electro. + Plasmacytosis on BM biopsy
27
Q

Which type of lung cancer is associated with paraneoplastic secretion of PTHrP?

A

Squamous cell carcinoma

28
Q

What is the first line tx for small cell lung carcinoma?

A

Chemotherapy; surgery is NOT indicated

0 - Internal Medicine Shelf (2 decks)

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