deck 16

Question 1

most common cause of abnormal liver tests

Answer 1

NAFLD/metabolic syndrome

Question 2

in patients with severe CAP, urine should be tested for…

Answer 2

legionella and pneumococcus

Question 3

best intervention for low back pain without sciatic involvment

Answer 3

Resumption of physical activity as tolerated

Question 4

other association with sexual abuse

Answer 4

functional GI disorders

Question 5

screening test in routine prenatal care

Answer 5

HIV screening

Question 6

earliest and most specific sign of autism

Answer 6

delayed attainment of social skill milestones

Question 7

chronic neck pain with radicular symptoms imaging

Answer 7

c spine series

Question 8

PE initial treatment

Answer 8

LMWH, unfractionated heparin, or fondaparinux for at least 5 days

Question 9

when can PE meds be stopped

Answer 9

INR has been greater than 2.0 for at least 24 hours

Question 10

cardiovascular changes associated with aging

Answer 10

decreased cardiac output, maximum heart rate, and stroke volume, as well as increased systolic and diastolic blood pressure.

Question 11

other physio changes with ageing

Answer 11

decreases in nerve conduction, proprioception and balance, maximum O2 uptake, bone mass, muscle strength, and flexibility

Question 12

respiratory changes with aging

Answer 12

increase in residual lung volume and a decrease in vital capacity

Question 13

CENTOR criteria

Answer 13

Tonsillar exudates
Tender anterior cervical lymphadenopathy
Absence of cough
History of fever

Question 14

interpreting CENTOR criteria

Answer 14

4 = treat with abx
3 = test and treat with positive
0-1 = analgesics + supportive care

Question 15

long term prognosis in HSP depends on involvement of what?

Answer 15

renal involvement

Question 16

DM drugs that help people lose weight

Answer 16

metformin
incretin mimetics (exenatide)

Question 17

tenderness in pes anserine bursitis is located…

Answer 17

medial aspect of proximal tibia

Question 18

pes anserine bursitis treatment

Answer 18

NSAIDS + PT + corticosteroid injection

Question 19

alternative meds for IBS

Answer 19

• peppermint oil
• Restriction of fermentable, poorly absorbed carbohydrates is beneficial, including fructan (found in wheat and onions), sorbitol, and other such alcohols.

Question 20

postcholecystectomy pain w/ jaundice think…

Answer 20

retained common duct stone

Question 21

USPSTF recommendation on breast exams

Answer 21

don’t do it (evidence suggests leads to more additional imaging and biopsies with no gains in BC detection or reduction)

Question 22

other criteria for gastric bypass surgery

Answer 22

• weight loss by nonoperative means

- eval by dietitian + mental health professional before surgery

Question 23

best test for renovascular HTN

Answer 23

duplex doppler US (contrast can damage kidneys so can’t do CT angio)

Question 24

renovascular HTN

Answer 24

condition in which high blood pressure is caused by the kidneys’ hormonal response to narrowing of the arteries supplying the kidneys.

Question 25

1st line for pregnancy associated N/V

Answer 25

doxylamine + B6

Question 26

initial warfarin dose in elderly or in patients with HF, liver disease, or h/o recent surgery

Answer 26

5 mg

Question 27

2 most impt interventions for symptomatic arterial vascular disease

Answer 27

1) walking program

2) stop smoking

Question 28

best med for symptomatic arterial vascular disease

Answer 28

cilostazol

Question 29

features of polycythemia vera

Answer 29

• elevated hematocrit
• splenomegaly
• thrombocytosis
• leukocytosis
• low serum ego

Question 30

treatment of mild recurrent c diff

Answer 30

metronidazole again

Question 31

multiple c diff recurrences treatment

Answer 31

metronidazole + vancomycin

Question 32

diabetes diagnostic criteria

Answer 32

hemoglobin A1c level ≥6.5% be used to diagnose diabetes mellitus. Other criteria include a fasting plasma glucose level ≥126 mg/dL, a random glucose leve l≥200 mg/dL in a patient with symptoms of diabetes, or a 2-hour oral glucose tolerance test value ≥200 mg/dL.

Question 33

osteoporosis screening

Answer 33

1) All women older than 65
2) all men older than 70
3) men and women 50-70 with RF’s –> FH, falls, inactivity, low vitamin D or calcium,

Question 34

alcoholic ketoacidosis classic setting

Answer 34

• patient who has been binge drinking and eating nothing

-

Question 35

treatment of alcoholic ketoacidosis

Answer 35

NS + thiamine/glucose

Question 36

initial treatment of grade 2 ascites (visible with abdominal distention)

Answer 36

Spironolactone + salt restriction

Question 37

initial treatment of grade 3 ascites

Answer 37

large-volume paracentesis

Question 38

biceps tendon rupture presentation

Answer 38

present with a visible lump in the upper arm following an audible, painful “pop.” The injury typically results from application of an eccentric load to a flexed elbow. Risk factors for biceps tendon rupture include age >40, deconditioning, contralateral biceps tendon rupture, a history of rotator cuff tear, rheumatoid arthritis, and cigarette smoking. Weakness in forearm supination and elbow flexion may be present. The biceps squeeze test and the hook test are both sensitive and specific for diagnosing the condition.

Question 39

serpiginous beach rash

Answer 39

hookworm called cutaneous larva migrant

Question 40

acute bacterial sinusitis diagnosis

Answer 40

• symptom duration of at least 10 days before starting abx

Question 41

boxer’s fracture

Answer 41

fracture of 5th metacarpal head

Question 42

boxer’s fracture manage

Answer 42

ulnar gutter splint

Question 43

guttate psoriasis often triggered by…

Answer 43

group a strep infection

Question 44

most common RF for frozen shoulder

Answer 44

DM

Question 45

frozen shoulder presentation

Answer 45

middle aged patient with stiffness + restricted motion + severe pain

Question 46

differences between men and women that can affect pharmacokinetics

Answer 46

1) GI transit time is slower in women, reducing absorption (means women should also wait longer after eating before taking meds that shouldn’t be taken on an empty stomach)
2) Women secrete less gastric acid than men
3) women typically have higher fat stores than men
4) women have lower GFRs

Question 47

target glucose level in critically ill patients

Answer 47

• 140-180.

- just want to avoid hypoglycemia

Question 48

recommended duration of dual anti platelet therapy following placement of drug-eluting stent

Answer 48

1 year

Question 49

management of intrahepatic cholestasis of pregnancy

Answer 49

ursodiol

Question 50

why do we give abx for pertussis infections?

Answer 50

• reduces infectivity. no effect on disease duration or severity.

Question 51

management of blisters with frost bite

Answer 51

• leave non-tense blisters intact. Aspirate tense or bleeding blisters.

Question 52

frost bite management

Answer 52

• rewarm in whirlpool bath with mild antiseptic

- analgesics

Question 53

caveat about BC screening

Answer 53

Breast cancer screening has resulted in an increase in the diagnosis of localized disease without a commensurate decrease in the incidence of more widespread disease. Unfortunately, it cannot predict which of the discovered cancers are more aggressive, and cannot accurately detect premalignant lesions. The decrease in the mortality rate of breast cancer is due both to earlier detection and better follow-up medical care.