deck 13

Question 1

other problem w/ sulfonylureas

Answer 1

• may increase cardiovascular risk

- may shorten time to beta cell burnout

Question 2

best oral DM drugs

Answer 2

• GLP-1

- help you lose weight,

Question 3

problem with dropping hyperglycemic patient

Answer 3

• cerebral edema

- GO SLOW

Question 4

HTN BP goal

Answer 4

140/90

Question 5

People who need tighter BP goals

Answer 5

1) people w/ albuminuria or proteinuria – 130/80

2)

Question 6

chlorthalidone vs. HCTZ

Answer 6

chlorthalidone is better - greater BP reduction, longer acting, no electrolyte imbalances.

Question 7

when to use ARB over ACEI

Answer 7

gout patient. ARBs have uricosuric activity

Question 8

major cause of resistant HTN

Answer 8

Hyperaldosteronism

Question 9

Last med you add on to person maxed out on HTN meds

Answer 9

• mineralocorticoids (spironolactone)

Question 10

Absolute contraindications to ECT?

Answer 10

None

Question 11

causes of 2ndary HTN

Answer 11

CKD, OSA, primary hyperaldosteronism

Question 12

testing for primary hyperaldosteronism

Answer 12

morning plasma aldosterone/renin ratio

Question 13

high risk setting for kids for CAP

Answer 13

day care

Question 14

Urine burning how to clarify…

Answer 14

• ask if urethral, sometimes patient say stomach is burning

Question 15

CAP treatment in kids

Answer 15

Oral high-dose amoxicillin (90 mg/kg/day) w/ close outpatient followup

Question 16

solid foods introduced

Answer 16

4-6 months

Question 17

Midshaft posteromedial tibial stress fractures management

Answer 17

Air stirrup leg brace (aircast)

Question 18

initial screening test for late-onset male hypogonadism

Answer 18

serum total testosterone (free testosterone is very expensive)

Question 19

CENTOR criteria

Answer 19

….

Question 20

someone with a strep throat and *runny nose or cough

Answer 20

NOT STREP

Question 21

Low TSH level with person on levothyroxine…

Answer 21

Indicates over replacement. Reduce dosage slightly and repeat TSH level in 2-3 months.

Question 22

Imaging to look for students in urinary tract

Answer 22

CT pyelogram or US

Question 23

what generally rules out UTI

Answer 23

no pyuria

Question 24

sharp, severe heel pain is probably

Answer 24

plantar fasciitis

Question 25

plantar fasciitis

Answer 25

• pain on plantar surface of heel, worse after prolonged sitting or getting out of bed in morning (first step phenomenon)
• self-resolving

Question 26

1st line for plantar fasciitis

Answer 26

OTC heel inserts

Question 27

Most accurate test for ACL teaer

Answer 27

Lachman test, followed by anterior drawer test

Question 28

mcmurray test tests for

Answer 28

meniscal tears

Question 29

how do you know if MGUS has progressed to multiple myeloma?

Answer 29

• Presence of end-organ impairment in the presence of M protein, monoclonal plasma cells, or both (hypercalcemia, renal failure, anemia, or skeletal lesions).
• 1% annual risk of progression.

Question 30

femoral neuropathy

Answer 30

• mononeuropathy common with DM2
• decreased sensation to pinprick and light touch over anterior thigh + reduced motor strength on hip flexion/knee extension.

Question 31

diabetic polyneuropathy presentation

Answer 31

Symmetric, distal

Question 32

meralgia parenthetic

Answer 32

• can be secondary to DM but numbness/paresesthia with no motor dysfunction.

Question 33

iliofemoral atherosclerosis

Answer 33

• relatively common complication of DM

- intermittent claudication involving one or both calf muscles.

Question 34

other impt exam component of hypothyroidism

Answer 34

achilles reflex. (delayed relaxation phase)

Question 35

hallmark biochemical feature of referring syndrome

Answer 35

hypophosphatemia

Question 36

pharyngeal and laryngeal SE’s of inhaled corticosteroids

Answer 36

• sore throat, coughing on inhalation, weak or hoarse voice, oral candidiasis

Question 37

management of hoarseness that does not resolve

Answer 37

• laryngoscopy (if doesn’t resolve within 3 months)

Question 38

common false positives in

Answer 38

Codeine often comes up as morphine because morphine is a metabolite of codeine

Question 39

dizziness differential

Answer 39

1. vertigo
2. near syncope
3. disequilibrium
4. light headedness (high correlation with anxiety)

Question 40

initial management of hypercalcemia of malignancy

Answer 40

• get pt euvolemic

- fluid replacement with NS to correct volume depletion that is always present + enhance renal calcium excretion

Question 41

brown to black leopard spotting of colonic mucosa?

Answer 41

Melanosis coli - benign condition resulting from abuse of laxatives.

Question 42

murmurs that increase with valsalva

Answer 42

HOCM + MVP

decreases venous return to heart, thereby decreasing CO

Question 43

best test for diagnosis of COPD

Answer 43

spirometry

Question 44

Patients who need CRC screening at age 40

Answer 44

1) 1 first degree relative diagnosed with CRC or adenomatous polyps before age 60
2) at least 2 second degree relatives with CRC cancer

Question 45

preferred screening for patients at high risk of CRC

Answer 45

colonoscopy

Question 46

drugs that cause pleurisy

Answer 46

Hydralazine (lupus-induced)
procainamide
quinidine
amiodarone, bleomycin, methotrexate

Question 47

Drug to convert patient to normal rhythm from WPW rhythm

Answer 47

Procainamide

Amiodarone

Question 48

relationship between calorie consumption and weight

Answer 48

not a direct relation between daily calorie consumption and weight. An adult male consuming an extra 100 calories a day above his caloric need will not continue to gain weight indefinitely; rather, his weight will increase to a certain point and then become constant. Fat must be fed, and maintaining the newly created tissue requires an increase in caloric expenditure. An extra 100 calories a day will result in a weight gain of approximately 5 kg, which will then be maintained.