Day 12 Review - Derm1, Derm2, Derm3

Question 1

Indications for carotid endarterectomy

Answer 1

(1) If more 70% stenosis (i.e., 70-99%) and sx (2) Asx & 80-99% stenosis w/ life expectancy of at least another 5 years; If 100% stenosis, unnecessary

Question 2

Leukemia: Most common neoplasm in children

Answer 2

ALL

Question 3

Leukemia: Most common neoplasm in adults, avg age of onset around 50 yo

Answer 3

CLL

Question 4

Leukemia: Philadelphia chromosome almost always seen

Answer 4

CML

Question 5

Leukemia: Smudge cells on peripheral smear

Answer 5

CLL

Question 6

Leukemia: Peripheral blasts PAS+, TdT+

Answer 6

ALL

Question 7

Leukemia: Peripheral blasts PAS-, myeloperoxidase+, Auer rods

Answer 7

AML

Question 8

Leukemia: pancytopenia in down syndrome pt

Answer 8

ALL

Question 9

Next step in mgt of testicular torsion confirmed with US

Answer 9

Manual detorsion; Still need surgical detorsion & b/l orchiopexy

Question 10

Causes of hypovolemic hyponatremia

Answer 10

Diuretics (especially thiazides), Addison’s disease, Fluid loss (sweating, burns, vomiting, diarrhea) replaced with water

Question 11

Fever, rash, elevated cr, eosinophilia

Answer 11

Acute interstitial nephritis

Question 12

Primary biliary sclerosis v. Primary sclerosing cholangitis

Answer 12

(1) PBS - Positive anti-mitochondrial antibodies; May or may not have positive ANA; More common in females; Assoc w/ other autoimmune disorders (2) PSC - Positive p-ANCA; More common in males; Assoc w/ ulcerative colitis; On ERCP, see beads on a string (alternating dilations & strictures)

Question 13

Tx Whipple’s disease

Answer 13

TMP-SMX for 1 yr

Question 14

Hep B exposure: Acute infection

Answer 14

Window period; Anti-HBc IgM; Note: HBeAg for acute (high infectivity) v. Anti-HBe for window (low infectivity); Also FYI: (If recovered, surface antibodies would be positive; If chronically, surface antigen would be positive)

Question 15

Hep B exposure: Chronic infection

Answer 15

HBsAg; Note: HBeAg for high infectivity v. Anti-HBe for low infectivity

Question 16

Hep B exposure: Vaccination

Answer 16

Anti-HBs

Question 17

Hep B exposure: Recovery

Answer 17

Anti-HBs; Anti-HBe

Question 18

DDx ground glass infiltrates on CXR

Answer 18

Interstital pna, PCP, pulmonary edema (CHF, ARDs), pulmonary hemorrhage, hypersensitivity pneumonitis

Question 19

Med used to close PDA

Answer 19

Indomethacin

Question 20

Complications from electrical burns

Answer 20

Eg, electrocution, lightning strikes; External & Internal (cardiac dysrhythmias, compartment syndrome, bony injuries, myoglobinuria causing renal failure, neuro disturbances)

Question 21

Abnormality seen w/ lesion in oculomotor nerve

Answer 21

Eye fixed & dilated (interruption of parasympathetics), looks down and out (EOM)

Question 22

Alzheimer’s, Pick’s, Lewy Body distinctively pw

Answer 22

ALZHEIMER’S: classic dementia; PICK’S: personality/behavioral changes; LEWY: Alzheimer’s + Parkinsonisms, visual hallucinations & unexpected falls or syncopal episodes