deck 24

Question 1

most common cause of death following bariatric surgery

Answer 1

PE

Question 2

complementary med good for PMS

Answer 2

B6

Question 3

lean body mass vs fat in old people

Answer 3

Drug distribution is one important factor. In older persons, there is a relative increase in body fat and a relative decrease in lean body mass, which causes increased distribution of fat-soluble drugs such as diazepam

Question 4

1st step in management of unintentional weight loss in the elderly

Answer 4

CBC, chemistry panel, stool for occult blood, and TSH level.

Question 5

meds that can cause weight loss

Answer 5

SSRIs, NSAIDs, bupropion, digoxin, and metformin

Question 6

med for weight gain in its with cachexia with AIDS or cancer

Answer 6

megestrol

Question 7

macular degeneration RFs

Answer 7

smoking + HTN

Question 8

pap test with highest risk of cancerous lesion

Answer 8

atypical glandular cells not otherwise specified (AGC-NOS)

Question 9

drugs from canada?

Answer 9

The FDA has approved more than 90% of the drugs available from Canada. Most of these drugs come from the same manufacturers as drugs in the U.S. Health Canada takes longer, on average, to approve a drug for release than does the FDA, and most drugs discontinued for safety reasons by the FDA between 1992 and 2001 had not been approved for use in Canada.

Question 10

Bence-JOnes protein

Answer 10

seen in Waldenstrom’s, absent in MGUS

Question 11

Waldenstrom’s vs. MM

Answer 11

• lytic lesions not seen in Waldenstroms

- marrow biopsy reveals mostly lymphocytes

Question 12

management of human bites

Answer 12

prophylactic abx if any break in the skin

Question 13

persistent groin pain in military recruit or runner?

Answer 13

usually stress fracture of right femoral neck (accompanied by limited hip flexion and internal rotation)

Question 14

osteitis pubis

Answer 14

• occurs in distance runners

- pain in anterior pelvic area + tenderness over symphysis pubis

Question 15

what you should generally see in PID

Answer 15

abdominal pain + fever

Question 16

drug with evidence for reducing both vertebral fractures and hip fractures?

Answer 16

• zoledronic acid (teriparatide has evidence for vertebral fracture but not hip)
• bisphosphonates too

Question 17

when to consider secondary causes of N/V with pregnancy-associated vomiting

Answer 17

after 9 weeks gestation

Question 18

most common cause of seizures in the geriatric population

Answer 18

CVD

Question 19

management of patient with persistent SVT w/ no underlying heart disease

Answer 19

adenosine

Question 20

med contraindicated with statins

Answer 20

clarithromycin or erythromycin (most statins metabolized by CYP3A4, so increases the risk of statin toxicity)

Question 21

caveat about intranasal decongestants (eg phenylephrine)

Answer 21

• shouldn’t be used for more than 3 days since they cause rebound congestion on drug withdrawal
• when used for several months or more, can cause a form of rhinitis (rhinitis medicamentosa that is really hard to treat)

Question 22

bony torus

Answer 22

bony outgrowth on palate

Question 23

geographic tongue treatment

Answer 23

Most cases cause no symptoms so reassurance.

Question 24

diameter cutoff for melanoma risk

Answer 24

6 mm

Question 25

DKA severity determined by…

Answer 25

arterial pH, bicarbonate level, anion gap, and mental status

Question 26

most specific clinical finding for melanoma

Answer 26

evolution - change in size, shape, or color

Question 27

preferred method of biopsy for any lesion suspicious for melanoma

Answer 27

complete elliptical excision

Question 28

rash on sacrum or buttocks with blister like lesions

Answer 28

genital herpes (extragenital sites involved in 1/4 of infected women with sacrum and buttocks being frequent locations. Sacral nerve innervation from vaginal area provides a pathway for virus)

Question 29

Quinolone you can’t use for UTIs

Answer 29

moxifloxacin

Question 30

most common AE to complicate hospital course in patients 65 and over

Answer 30

drug-related events

Question 31

best study for confirming diagnosis of urinary tract stone

Answer 31

helical CT scan of the abdomen and pelvis

Question 32

only downsides of epidurals

Answer 32

an increased duration of the second stage of labor, an increased rate of instrument-assisted vaginal deliveries, and an increased likelihood of maternal fever.