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ABIM - Redo > Deck 1 > Flashcards

Deck 1 Flashcards

1
Q

Osmotic stool gap calculation

A

290 - 2(Na +K)

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2
Q

What does stool osmolal gap >125 indicate?

A

Osmotic diarrhea (ex sorbitol)

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3
Q

What does stool osmolal gap <50 indicate?

A

Secretory diarrhea (crohns, celiac, neuroendocrine, etc)

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4
Q

How do you treat neurosyphilis?

A

Penicillin G x14 days

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5
Q

How do you treat neurosyphilis?

A

Penicillin G x14 days

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6
Q

How do you treat early syphilis? (<100 days)

A

Penicillin B x 1

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7
Q

How do you treat late syphilis? (>100 days)

A

Penicillin B x 3 (late includes tertiary syphilis)

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8
Q

How do you diagnose ALS?

A

Electrodiagnostic tests, including electomyography (EMG) and nerve conduction velocity (NCV)

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9
Q

Can lacunar strokes cause motor/sensory alone deficits?

A

YES!

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10
Q

When should you use carotid endarterectomy?

A

70-99% occlusion

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11
Q

What commonly causes lobar hemorrhagic strokes the elderly?

A

Amyloid

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12
Q

How to treat acute MS?

A

IV steroids

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13
Q

How to treat acute MS?

A

IV steroids

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14
Q

How do you treat Guillain-Barre?

A

IVIG or plasmapheresis

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15
Q

Besides iron replacement if low ferritin is present, what medication can be given for RLS?

A

Gabapentin/pregabalin

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16
Q

Who should be screened for syphilis?

A

High risk sex, MSM, pregnant women

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17
Q

When to screen for osteoporosis?

A

Women 65 and older

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18
Q

Who should be screened for Cervical cancer

A

21-65
-HPV +/- cytology Q5y
OR
-Cytology Q3y

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19
Q

Who to screen for breast cancer?

A

40-74 Q2yr

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20
Q

Screening for BRCA?

A

If family history or ethnicity associated with BRCA, use risk tool to determine risk then make decision to send for testing

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21
Q

Who should get screened for colon cancer?

A

45-85yo
If high risk, favor colonoscopy rather than other screening methods

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22
Q

Who should get lung cancer screening?

A

50-80 (20py within last 15yr)
(20% chance of false positive)

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23
Q

Who should get the pneumo vaccine?

A

65+ (OR immunosuppression, heart disease, lung disease, DM, and more!)

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24
Q

What BUN:Cr suggests an upper GI bleed?

A

BUN:Cr >30

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25
Q

Indications for endoscopy for dyspepsia

A

-anemia
-gi bleeding
-weight loss
-dysphasia
-age >50
-nausea/vomiting

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26
Q

What is the treatment for hpylori

A

Clarithromycin/amoxicillin/PPI x14 days

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27
Q

How do you test for hpylori eradication?

A

Urea breath test or fecal antigen test

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28
Q

When do you screen for colon cancer? Interval?

A

45-85
Normal q10y
Tubular q5-7y
Serrated Q3y

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29
Q

What is HIDA used for?

A

Cholecystitis
Acalculous cholecystitis

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30
Q

How to treat hot flashes WITH a uterus?

A

Estrogen AND progesterone (prevent endometrial hyperplasia to cancer)

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31
Q

Be able to identify dry and wet macular degeneration

A
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32
Q

Characteristics of aortic stenosis (location, how the murmur sounds)

A

Best heard at RUSB
Has a late-peaking murmur with radiation into the carotids
Possible delayed/diminished carotid upstroke

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33
Q

What is treatment for AS?

A

-Asymptomatic: consider valve replacement, medical management
-Symptomatic AS +/- LV dysfunction: valve replacement (surgery vs TAVR)

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34
Q

Characteristics of HOCM (location, how the murmur sounds)

A

Can mimic AS!
-Murmur is loudest with preload-reducing maneuvers (valsalva, standing)
-softer with preload-increasing maneuvers (squatting, leg raise)

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35
Q

Treatment for HOCM

A

-Maintain volume!
-Nodal blockade (bb, CCB) to maintain preload and/or disopyramide
-Surgery

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36
Q

Characteristics of aortic insufficiency (location, how the murmur sounds)

A

Best heard at LSB
Early, high-pitched diastolic murmur
Head Bob/nodding
Bounding peripheral pulse

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37
Q

Characteristics of mitral stenosis (location, how the murmur sounds)

A

-Best heard at apex
-Diastolic low pitched rumbling murmur
-Opening snap after s2 of leaflets are mobile

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38
Q

Characteristics of mitral regurgitation (location, how the murmur sounds)

A

-best heard at apex
-Holo (mostly), mid, or late systolic murmur

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39
Q

When a woman with hypothyroid gets pregnant, what should you do with her levothyroxine? Why?

A

Increase dose
Pregnancy causes an increase in thyroid binding globulin and b-hcg increases TSH, both can cause fetal issues

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40
Q

How much is the ideal levothyroxine dosing for a patient? Should you do this with elderly patients or those with cardiac disease?

A

1.6mg/kg
No, ramp up slowly

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41
Q

What is the preferred antiarrhythmic for afib in 1) no CAD or structural heart disease? 2) LVH? 3) CAD w/o HF? 4) HF? 5) recurrent sxs refractory to meds?

A

1) Class I
2) Amio
3) Sotalol
4) Amio
5) ablation

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42
Q

When should you refer someone for prostate biopsy?

A

If PSA >7 and/or abnormal DRE

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43
Q

When to treat hypertriglyceridemia

A

> 500

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44
Q

What microbe causes hot-tub lung

A

Nontuberculous mycobacterium (NTM)

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45
Q

What issues can cause compression of the CN II, III, IV, V?

A

Pituitary apoplexy
Cavernous sinus thrombosis
SAH

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46
Q

In the setting of presumed psuedoachalasia shown via barium swallow, what is the next test to perform?

A

Endoscopy

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47
Q

What should you do when you suspect a DVT but US is negative and D-dimer is high?

A

Repeat scan in a couple of days

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48
Q

Can chronic opioid use cause central hypogonadism?

A

Yes!

49
Q

Which ingested alcohol does NOT cause a AGMA OR NAGMA ?

A

Isopropyl alcohol (rubbing alcohol, hand sanitizer)

50
Q

What are the clinical features of primary ovarian insufficiency?

A

-Amenorrhea <40yo
-high FSH
-low estrogen
-hypoestrogenic symptoms

51
Q

What are suspicious findings for a thyroid nodule that indicate FNA?

A

-microcalcifications
-hypoechoic
-increased vascularity
-infiltrative margins

52
Q

What is the evaluation for a thyroid nodule?

A
53
Q

If someone fails a statin, what should you do?

A

Try a different statin

54
Q

What are the causes of hirsutism in women?

A
55
Q

What is the treatment for h pylori?

A
56
Q

If the clinical suspicion for giant cell arthritis is high but biopsy is negative, what should you do?

A

Repeat the biopsy as 40% of biopsies are negative

57
Q

What is the treatment for digoxin toxicity?

A

Digoxin-specific antibody fragments

58
Q

When should you screen someone with DEXA scan with celiac disease

A

At the time of diagnosis

59
Q

What are the 3 causes of urinary incontinence?

A

1) Stress incontinence
2) Urge incontinence
3) Overflow incontinence

60
Q

What is the etiology of stress incontinence? What are the common history findings? Treatment?

A

1) Decreased urethral sphincter toneUrethral hypermobility
2) leakage with coughing, sneezing, lifting
3) Pelvic floor training, pessaries, estrogen

61
Q

What is the etiology of urge incontinence? What are the common history findings? Treatment?

A

1) detrusor overactivity
2) sudden, overwhelming urge to pee
3) bladder training, estrogen, anti-muscsrinic

62
Q

What is the etiology of overflow incontinence? What are the common history findings? Treatment?

A

1) impaired detrusor activity, bladder outlet obstruction
2) incomplete emptying, involuntary dribbling
3) alpha blocker and/or 5alpha reductase inhibitor

63
Q

What should be immediately done in pituitary apoplexy?

A

Give steroids THEN neurosurgery

64
Q

How does pituitary apoplexy present?

A

Headache, CN III, IV, V deficits, visual deficits (optic chaism compression), and panhypopituitarism

65
Q

A patient has thyroid nodules that look malignant. What are risk factors for thyroid malignancy? (Give 3)

A

Radiation exposure
Family history
High TSH

66
Q

What is this?

A

Discoid lupus
Has hyperpigmented boarders

67
Q

What is this?

A

Discoid lupus
Has hyperpigmented boarders

68
Q

What is this?

A

Lichen planus
Commonly seen on flexor surfaces and are intensely pruritic

69
Q

What is the best test for acromegaly? What is the confirmatory test?

A

1) Insulin growth factor one levels
2) Glucose suppression test (give glucose then check growth hormone level which should be elevated)

70
Q

What is normal LV wall thickness?

A

<15mm

71
Q

What medication should be used in conjunction with sulfadiazine/pyrimethamine for toxo treatment?

A

Leucovorin
(Pyrimethamine blocks folic acid pathway)

72
Q

What are the light’s criteria? What is the serum-effusion protein difference? What is the serum-effusion albumin difference?

A

Pleural:serum protein >0.5
Pleural:serum LDH >0.6

serum-effusion protein difference >3.1
serum-effusion albumin difference >1.2
-suggestive of a transudative

73
Q

What are the light’s criteria? What is the serum-effusion protein difference? What is the serum-effusion albumin difference?

A

Pleural:serum protein >0.5
Pleural:serum LDH >0.6

serum-effusion protein difference >3.1
serum-effusion albumin difference >1.2
-suggestive of a transudative

74
Q

What is this?

A

Guttate psoriasis
Typically occurs following a strep infection

75
Q

What is the management for dyspepsia?

A

Might have another card with answers

76
Q

When do you treat sinusitis with antibiotics?

A

Symptoms >10 days and/or fever and/or facial pain

77
Q

What is the preferred method to diagnose SBO? What if first method is negative and concern remains high?

A

1) Plain films
2) CT imaging

78
Q

What medications are good for bony Mets? Which one can be given with renal disease?

A

1) Denosumab and Zolendronic acid (IV bisphosphonate)
2) Denosumab

79
Q

What rare cancer can be seen in celiac disease?

A

Intestinal lymphoma

80
Q

What T1DM antibody is a must know?

A

GAD

81
Q

What is the prediabetes A1c?

A

5.7-6.4

82
Q

Can you trust A1c in ESRD?

A

No, especially in those taking EPO

83
Q

If a diabetic patient has unilateral retinopathy, what test should you order?

A

Carotid duplex as they likely have narrowing causing ischemia

84
Q

What hounsfield unit and size adrenal lesion is concerning for malignancy?

A

HU >20 and >4cm

85
Q

How do you treat pericarditis?

A

Colchicine and ASA (preferred after MI) or NSIAD

86
Q

What are clinical features of idiopathic intracranial HTN? Diagnosis? Treatment?

A

1) Headache/nausea/vomiting, visual changes, CN VI palsy, tinnitus
2) papilledema, normal MRI (empty sella), LP with elevated opening pressure
3) weight loss, acetazolamide, topiramate

87
Q

What are symptoms of retinal detachment?

A

Floaters, flashing lights, loss of vision

88
Q

What are the next steps if a patient’s PT or PTT are elevated?

A
89
Q

What are the characteristics of of lofgren’s syndrome?

A

Hilar adenopathy, erythema nodosum, arthritis (commonly ankles)

90
Q

What is the treatment for microscopic colitis?

A

Stop possible offending medications (PPI, NSAID, SSRI), smoking cessation, oral budesonide, antidiarreal medications

91
Q

What is the regimen for post-exposure prophylaxis (PEP) for HIV?

A

3 drug regimen
1)Tenofovir
2) Emtricitabine
3) Raltegravir OR Dolutegravir

92
Q

What is the pre-exposure prophylaxis regimen for HIV?

A

2 drug regimen
1)Tenofovir
2) Emtricitabine

Check HBV status

93
Q

What is the antibody for drug-induced lupus?

A

DNA-histone complex

94
Q

What is the antibody for SLE?

A

Double-stranded DNA
Can see smith-ab
All SLE has positive ANA

95
Q

What are the antibodies for systemic sclerosis?

A

RNA polymerase II and III
Scl-70/anti-topoisomerase type I

96
Q

What is the antibody for MCTD?

A

Ribonucleoprotein (RNP)

97
Q

What are the antibodies for Sjogren syndrome?

A

SS-A/Ro and SS-B/La

98
Q

What is the antibody for limited scleroderma?

A

Anti-Centromere

99
Q

What are the antibodies for polymyositis, dermatomyositis?

A

Aminoacyl-transfer RNA synthetases (ex Jo-1)

100
Q

What is the antibody for microscopic polyangiitis?

A

MPO

101
Q

What is the antibody for GPA?

A

Proteinase 3 (PR3)

102
Q

What viruses belong to the polyoma virus family?

A

JC and BK viruses

103
Q

What is the treatment for Paget’s disease?

A

Bisphosphonate

104
Q

How to diagnose Cushing? (3 steps)

A
  1. Confirm Cushing (2/3: low dose dex suppression, 24hr urine free cortisol, late night salivary cortisol)
  2. Obtain ACTH
  3. If elevated ACTH, high dose dex suppression test
105
Q

Features of tricuspid regurgitation?

A

Holosystolic murmur at left sternal border that increases with inspiration

106
Q

What vitamins are at risk for deficiency in a Roux-en-Y bypass?

A

Calcium
Iron
B12
Thiamine
Folate
Vit A, D, E, K

107
Q

What is the preferred anti hypertensive agent for aortic dissection?

A

Beta blocker (ex esmolol, labetolol)

108
Q

If osteoporosis is diagnosed, what lab should be obtained?

A

25 OH vit D

109
Q

What medication is used to treat anorexia nervosa?

A

Olanzapine

110
Q

How does BMI affect BNP levels?

A

High BMI can cause lower levels of BNP is heart failure

111
Q

What are some findings of Behcet

A

Recurrent painful ulcers
Ocular manifestations (ex uveitis)
Skin lesions
Positive pathergy

112
Q

What is the first line medication treatment for fibromyalgia?

A

TCA

113
Q

What is the treatment for thyroid storm?

A

Beta blocker
PTU followed by iodine
Steroids

114
Q

Can thyroid dysfunction cause myopathy?

A

Yes! Be sure to add it to the differential of elevated CK

115
Q

What inhalers can/should be used in asthma in pregnancy?

A

Albuterol
ICS-LABA

Steroids okay for exacerbation

116
Q

What two diseases is seborreic dermatitis seen? Obviously can be seen outside of this

A

HIV
Parkinson’s

117
Q

What arthopathy disease causes chondrocalcinosis?

A

Calcium pyrophosphate dihydrate crystals (CPPD aka pseudogout)

118
Q

What arthopathy disease causes chondrocalcinosis?

A

Calcium pyrophosphate dihydrate crystals (CPPD aka pseudogout)

119
Q

What type of cardiac ischemic exam should be performed in those with a LBBB or ventricular over rhythm (ex pacer)?

A

Pharmacological radionuclide perfusion imaging

ABIM - Redo (1 decks)

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