COMQUEST Flashcards
(28 cards)
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?
- HYPOkalemia
- U waves on the ekg (small waves just after the T wave)
How does the DLCO differ btw chronic bronchitis and emphysema?
- Normal in chronic bronchitis
- Decreased in emphysema due to alveolar destruction
Pt’s with HIV and a CD4 count <50/mm3 should receive prophylaxis with what antibiotic(s) against MAC?
Clarithromycin or Azithromycin
Using the mnemonic N’ TIME2 what are the the features of Wiskott-Aldrich syndrome?
- Neutropenia
- Thrombocytopenia
- frequent Infections
- ↓ levels IgM
- Eczema
- ↑ levels IgE
What is the gold standard for dx of Dermatomyositis?
Muscle biospy
What is the most common cause of fever in a pt returning from a developing country; what is the initial test of choice?
- Malaria
- Initial test = thick and thin blood smear
Which anti-malarial agent can kill parasites lying dormant in the liver?
Primaquine
Which SNRI can be used in pt’s with stress urinary incontinence + concomitant depression?
Duloxetine
What is the next best step in the management of suspected Sheehan’s syndrome?
IV Dexamethasone (“stress dose” steroids) —> MRI of head
What is the initial step in managemnt of an otherwise healthy pt presenting with sx’s suggesting community-acquired pneumonia?
Empiric tx with a macrolide or doxycycline
What are the 3 major risk factors for pancreatic cancer and how does it classically present?
- Smoking (#1), chronic pancreatitis, and diabetes
- Presents w/ painless jaundice
What is the definitive tx for pheochromocytoma and how should the BP and HR be managed?
- Surgery
- 10-14 days prior give an alpha blocker i.e., phenoxybenzamine
- 3-4 days prior give a beta blocker i.e., propranolol
In acute MI what is the earliest marker of ischemia?
- Myoglobin, rises within first hour and peaks at 6
- CK-MB and troponins take several hours to rise
What are the first line agents for management of pyelonephritis?
- IV fluoroquinolones (ciprofloxacin, levofloxacin)
- IV ceftriaxone
- IV ampicillin/sulbactam
How can the aldosterone-renin ratio help distinguish primary from secondary hyperaldosteronism?
- >20 in primary
- <10 in secondary w/ high renin i.e., renin-secreting tumor, fibromuscular dysplasia, renal artery stenosis
An induration of 5mm or greater on PPD skin testing is considered positive for tuberculosis in which pt populations?
- HIV pt’s
- Immunocompromising conditions i.e., hx of chemo, post-organ transplant
- Household contact of TB pt
How is a diagnosis of sarcoidosis confirmed?
Biopsy of affected organ w/ evidence of non-caseating granulomas and no evidence of infection
Drusen (subretinal deposits - yellow/white deposits) are a characteristic finding of what eye pathology; how does it present?
- Age-related macular degeneration
- Gradual onset of bilateral central vision loss w/ preservation of peripheral vision
The diagnosis of orthostatic hypotension is confirmed with a drop of how much systolic or diastolic upon standing from a supine position?
>20 mmHg systolic or >10 mmHg diastolic
What is the tx of choice for acute bacterial meningitis w/ N. gonorrhea and S. pneumonia?
- N. gonorrhea = Cefotaxime or Ceftriaxone
- S. pneumo = Vanco + ceftriaxone
What is the test of choice for dx BPH?
Pelvic ultrasound w/ post-void residual
What are the 1st line tx’s for metastatic prostate cancer?
- GnRH agonists: leuprolide or goserelin
- GnRH antagonists: degarelix
What is the most effective first-line tx for hemochromatosis?
Periodic phlebotomy
In a pt with suspected diverticulitis what type of imaging is used to confirm the diagnosis?
Abdominal CT scan
