deck 35

Question 1

most beneficial therapy to reduce progression of diabetic nephropathy

Answer 1

strict blood pressure control

Question 2

meds that can cause pancreatitis

Answer 2

valproic acid, diuretics, metronidazole

Question 3

demographic for UC

Answer 3

bimodal distribution with second peak in 50-80

Question 4

UC endoscopy

Answer 4

continuous involvement with erythematous and friable mucosa and ulcers

Question 5

threshold for platelet transfusions

Answer 5

10,000

Question 6

management of wide-complex tachycardia

Answer 6

anti arrhythmic drugs (amiodarone, procainamide, sotalol, lidocaine)

Question 7

acalculous cholecystitis

Answer 7

acute inflammation of the gallbladder in the absence of gallstones

Question 8

acalculous cholecystitis setting

Answer 8

usually seen in hospitalized and severely ill patients

Question 9

features suggesting arterial ulcer

Answer 9

location at tips of digits, diminished pulses, skin pallor, loss of hair, claudication

Question 10

cause of anemia in CKD

Answer 10

epo deficiency

Question 11

caveat about epo replacement with CKD

Answer 11

need to give iron too because eps-induced surge in RBC production can precipitate an iron-deficient state

Question 12

zinc deficiency presentation

Answer 12

hypogonadism + impaired taste + impaired wound healing + alopecia + skin rash w/ perioral involvement

Question 13

panendoscopy

Answer 13

triple endoscopy (esophagoscopy, bronchoscopy, laryngoscopy)

Question 14

concern with untreated hyperthyroid patients

Answer 14

rapid bone loss from increased osteoclastic activity in bone cells + tachyarrhythmias including afib

Question 15

secondary pneumonia in a young patient?

Answer 15

• happens with MRSA following influenza.

- causes severe, necrotizing pneumonia that is rapidly progressive and often fatal

Question 16

MRSA pneumonia in young patient presentation

Answer 16

high fever + productive cough w/ hemoptysis + multi lobar cavitary infiltrates

Question 17

urinary infection with alkaline urine think..

Answer 17

proteus mirabilis

Question 18

best markers indicating resolution of DKA

Answer 18

serum anion gap + beta-hydroxybutyrate levels

Question 19

hypopituitarism features

Answer 19

glucocorticoid deficiency + hypogonadism + hypothyroidism

Question 20

why are patients with MM at increased risk of infection?

Answer 20

bone marrow infiltration by neoplastic ells alters normal leukocyte population and causes hypogammaglobulinemia

Question 21

caveat about adrenal insufficiency

Answer 21

patients can have cushingoid appearance with suppressed HPA axis

Question 22

how to confirm adrenal insufficiency

Answer 22

8 AM serum cortisol + plasma ACTH + ACTH stimulation test (plasma ACTH is slow, and cosyntropin fast is test, so cosyntropin usually ordered too)

Question 23

presentation of candida esophagitis

Answer 23

oral thrush + dysphagia/odynophagia

Question 24

malaria chemoprophylaxis

Answer 24

atovaquone-proguanil, doxycycline, or mefloquine

Question 25

presentation of myopathy w/ cushing's

Answer 25

- progressive painless muscle weakness predominantly involving proximal muscles (caused by direct effect of cortisol on skeletal muscle, leading to muscle atrophy)

Question 26

other findings in parvovirus infection in adults

Answer 26

fever, fatigue, diarrhea, rash

Question 27

management of ventilator-associated pneumonia

Answer 27

need lower respiratory tract sampling (gram stain and culture)

Question 28

caveat about b12 anemia

Answer 28

can look hemolytic with hyperbilirubinemia (increased intramedullary hemolysis of immature megaloblasts)

Question 29

other name for soap-bubble appearance of giant cell tumor

Answer 29

expansile and eccentric lytic area

Question 30

diabetic age group that needs statin regardless of lipid levels

Answer 30

40-75

Question 31

x-ray findings with osteomalacia

Answer 31

decreased bone density with thinning of cortex and pseudo fractures

Question 32

management of hypercalcemia of malignancy (cancer patients with bone mets)

Answer 32

- bisphophonates (inhibit osteoclastic activity of bone, stabilizing destructive bony tumors and reducing risk of skeletal-related events such as pathologic fracture and malignant hypercalcemia)

Question 33

TTP treatment

Answer 33

life threatening, requires emergent plasma exchange

Question 34

cause of altered sensorium in hyperosmolar hyperglycemic state

Answer 34

high serum osmolality

Question 35

induced sputum for pneumocystis

Answer 35

often negative so need bronchoalveolar lavage

Question 36

management of PAC's in asymptomatic patient

Answer 36

stop drinking alcohol and using tobacco

Question 37

management of PAC's in symptomatic patient

Answer 37

beta-blockers

Question 38

salvage therapy definition

Answer 38

treatment for a disease when standard therapy fails

Question 39

how to prevent febrile non hemolytic transfusion reaction

Answer 39

leukoreduction

Question 40

labs with lactose intolerance

Answer 40

positive hydrogen breath test positive stool test for reducing substances low stool pH increased stool osmotic gap

Question 41

ethnic group in which lactose intolerance is most common

Answer 41

Asian-Americans

Question 42

standard test for lactose intolerance

Answer 42

hydrogen breath test

Question 43

metabolic abnormalities caused by hypothyroidism

Answer 43

hyperlipidemia (most hypothyroid its have hypercholesterolemia alone or combined hypertriglyceridemia and hypercholesterolemia) hyponatremia

Question 44

workup of isolated thrombocytopenia

Answer 44

Need to rule out Hep C and HIV before diagnosing ITP (can be initial presentation of HIV)

Question 45

other common causes of thrombocytopenia

Answer 45

alcohol use EBV B12/folate deficiency

Question 46

cardiomyopathy associated with acromegaly

Answer 46

concentric myocardial hypertrophy

Question 47

consequences of hyperestrinism in cirrhosis

Answer 47

gynecomastia, testicular atrophy, decreased body hair, spider angiomas, palmar erythema

Question 48

waldenstrom macroglobulinemia presentation

Answer 48

hyper viscosity syndrome + neuropathy + bleeding + HSM + lymphadenopathy

Question 49

waldenstrom on labs

Answer 49

hyper IgM

Question 50

positive urine bilirubin assay suggest

Answer 50

buildup of conjugated bilirubin (plasma buildup of conjugated bilirubin leaks into urine)