DIT Flashcards
1
Q
What is maintenance therapy for MS?
A
Interferon B Glatiramer Natalizumab Dimethyl Fumarate Teriflunomide
2
Q
What is the treatment for syringomyelia?
A
Surgical Decompression and shunting
3
Q
What kind of vision loss is seen in MS?
A
Central vision loss
4
Q
What pupillary defect is seen in MS?
A
Marcus Gunn pupil: no constriction of either pupil when light is shone into the affected eye. But pupils constrict when light shone in non affected eye.
5
Q
What bug causes food poisoning resulting from reheated rice?
A
Bacillus Cereus
6
Q
Why is RPR included in the dementia workup?
A
neurosyphilis can cause dementia
7
Q
What is the primary step causing the symptoms in Normal Pressure Hydrocephalus?
A
Inflammation and fibrosis of the arachnoid granulations.
8
Q
What drugs can cause delirium?
A
Antihistamines Alcohol/ drugs of abuse Anticholinergics Benzos Glucocorticoids
9
Q
What medications are used in the treatment of Alzheimer’s dementia?
A
Cholinesterase inhibitors Donepezil Galantamine Rivastigmine Memantine
10
Q
MLD: Pt in a coma with large and non reactive pupils
A
Uncal herniation - CN III involvement below the midbrain, supratentorial mass effect.
11
Q
MLD: pt in a coma with small and reactive pupils
A
Thalamic involvement, possible tentorial herniation
12
Q
MLD: pt in coma, immobile but reactive eyes
A
Metabolic cause, benzo overdose
13
Q
Cause of syncope: Positive tilt test after taking blood pressure medication
A
Orthostatic
14
Q
Cause of syncope: prolonged loss of consciousness
A
Cerebrovascular
15
Q
What measurements indicate a positive tilt test (3)
A
- Increase in HR by >/=20 BPM
- Decrease in systolic >/= 20 mmHg
- Decrease in diastolic >/= 10 mmHg
16
Q
What is the best empiric antibiotic treatment for infective endocarditis?
A
Vancomycin
17
Q
What is the treatment of narcolepsy?
A
- Regular sleep schedule
- Improve daytime sleepiness: modafinil, armodafinil, amphetamines
- Reduce REM: venlafaxine, fluoxetine, atomoxetine
- Severe symptoms: Sodium oxybate
18
Q
What is treatment for restless leg syndrome?
A
Pramipexole/Ropinirole first line
19
Q
What neoplasms commonly metastasize to CNS?
A
"Lots of Bad Stuff Kills Glia" Lungs Breast Skin (melanoma) Kidney GI tract - esp colon cancer.
20
Q
What is the next step once a brain tumor has been identified on CT/ MRI of head?
A
Full body scan
21
Q
What is the main symptom difference between encephalitis and meningitis?
A
Encephalitis presents with focal neurological defects.
22
Q
What treatment should not be given to someone with presumed Guillain Barre?
A
Glucocorticoids
23
Q
What is the treatment for Bell’s palsy?
A
Oral Glucocorticoids
Valacyclovir for severe treatment
Eye care - to prevent corneal trauma
24
Q
What is the treatment for essential tremor?
A
Alcohol, Propranolol, Benzos, Primidone, thalamotomy, deep brain stimulation
25
What is athetosis?
Snake like movements.
26
What is the treatment for dystonia?
Levodopa
Carbidopa
Botulinum toxin
Diphenhydramine can be used for acute dystonic reaction.
27
Treatment for hemiballismus
Halloperidol
28
What is an early manifestation of cataracts?
Nearsightedness
29
What accumulates in the retina of dry atrophic armd?
Drusen -- cellular debris
30
What is presentation and diagnosis of Dry ARMD?
Gradual loss of vision, diagnose with slit lamp exam
31
What is presentation and diagnosis of Wet ARMD?
Sudden loss of vision and diagnose with fluorescein angiography.
32
What is seen in funduscopic exam of Central Retinal Artery Occlusion and Central Retinal Vein Occlusion?
Artery: pale retina with cherry red spot
Vein: retinal edema, retinal hemorrhages, venous dilation, cotton wool spots.
33
What is the treatment for dry age-related macular degeneration?
Supportive Care
Smoking Cessation
Antioxidant Supplements.
34
What is the best initial test to assess stable angina?
Exercise stress test
35
What is the gold standard test to assess the degree of coronary artery occlusion?
Coronary angiogram
36
What are deposits in the periphery of the corneas due to hypercholesterolemia called?
Acrus senilis
37
At what LDL level should we start high intensity statin therapy?
LDL > 190
38
Who should be started and moderate intensity statins?
Diabetes Type 1/2 and between 40-75 yo
39
What 10 year ASCVD risk score warrants high intensity statins?
>7.5% in someone between 40-75 yo
40
According to 2013 AHA/ ACC guidelines, which patients should be on statin therapy? (4)
1. Clinical ASCVD: ACS, MI, Stable/ Unstable Angina, Stroke/ TIA, PAD
2. LDL > 190
3. DM 1/2 between 40-75 yo
4. 10 year ASCVD > 7.5% between 40-75%
41
Which agents are used in pharmacological stress test for ischemic heart disease?
Dobutamine (classic)
Adenosine
Dypyridamole
42
What non MI causes can cause an increase in cardiac enzymes?
1. CHF
2. myocarditis
3. Rapid AFIB
4. Sepsis.
43
What leads signify the anterior wall?
V2, V3, V4, V5.
44
What are the three treatment for Stable Angina?
B-blockers
Calcium Channel Blockers
Nitrates
45
For patients with ACS, what anticoagulation should be given to those undergoing PCI? What about those not undergoing PCI?
PCI: unfractionated heparin
not undergoing PCI: Enoxaparin (LMWH)
46
What should be avoided in non-ST elevation myocardial infarction?
Fibrinolysis
47
What should be avoided in Prinzmetal angina?
Non selective B-blockers and triptans
48
What is the most common cause of death in patients with an acute MI?
Arrhythmias - Ventricular fibrilation
49
What cardiac auscultation findings are considered benign when there is no evidence of disease?
1. Split S1
2. Split S2 on inspiration
3. S3 heart sound in patient
50
How long after the onset of an MI does troponin I begin to rise, and for how long does the level remain elevated?
Begins to rise: after 4 hours
| Stays elevated: 1 week - 2 weeks
51
What is Fick's principle?
CO = (rate of O2 consumption)/ (arterial O2 content - venous O2 content)
52
What is normal range for LV ejection fraction?
55-75%
53
A patient with AIDS and signs and symptoms concerning for meningitis. What specific CSF prep should be ordered in addition to usual CSF studies?
Cryptococcal meningitis
| Order india ink
54
What are the four most common sequelae of meningitis in children?
1. Hearing loss
2. intellectual disability
3. Seizure D/O
4. Spastic Paralysis
55
What is the first line treatment for open angle glaucoma?
Prostaglandins - increase outflow of aqueous humor
56
What is the most common cause of bacterial conjunctivitis?
Staph Aureus
57
What should never be prescribed to someone with corneal abrasion?
Topical anesthetic or topical steroids
58
What is the major exam finding in open-angle glaucoma?
Cup to disk ratio > 50%.
59
What is the empiric treatment for a brain abscess?
IV ABX - dependent on source
Steroids if mass effect
Drain by needle aspiration
60
What type of diuretic is Bumetinide?
Loop diuretic
61
What type of diuretic is Metolazone?
Thiazide
62
What type of diuretic is Torsemide?
Loop Diuretic
63
What type of diuretic should be used in conjunction with loop or thiazide diuretics to retain K+?
K+ sparing diuretics -- amiloride/ triamterene
64
What type of diuretic should be used to treat edema associated with nephrotic syndrome?
Loop diuretic
65
What is the most likely cause of secondary hypertension in a pt with hyperkalemia?
Renal failure
66
What type of renal pathology has Linear pattern of IgG deposition and Anti-GBM antibodies, hematuria, hemoptysis?
Goodpasture syndrome
67
What two classes of drugs dilate both veins and arteries?
Calcium channel blockers
| Nitroprusside
68
What cardiac abnormalities are associated with ADPKD?
Mitral valve prolapse
| Aortic regurgitation
69
Which antihypertensive classes should first be considered in a patient with Heart Failure?
Ace Inhibitors
Beta Blockers
Spironolactone
70
What test is used for screening diabetic patients for kidney damage?
Microalbumin
71
What volume status would you expect to find in a patient with hyponatremia due to hypothyroidism?
Euvolemic
72
What are the common causes of SIADH?
```
NSAIDS
malignancy SCLC
HIV/AIDS
Head Trauma
Pneumonia (lung disease)
```
73
What is the treatment for nephrogenic diabetes insipidus? (4)
1. amilioride
2. increase fluid take
3. Thiazides
4. indomethacin
74
What medications can rapidly correct hyperkalemia? (3)
1. Insulin + glucose
2. Beta agonists
3. Calcium bicarbonate
75
What are the causes of normal anion gap metabolic acidosis?
Diarrhea
Renal Tubular Acidosis
TPN
Hypoaldosteronism.
76
What is the treatment of uric acid stones?
Can be dissolved with medical therapy:
1. Potassium Citrate
2. Sodium Bicarbonate
3. Sodium Citrate
77
Which antihypertensive class should be considered first in patients with left ventricular hypertrophy?
Beta blocker
Ace I
ARB
CCB
78
What is the underlying cause of urge urinary incontinence?
Uninhibited bladder contractions.
79
What is the most common treatment for acute bacterial prostatitis? (3)
1. Alpha blockers
2. 5 alpha reductase inhibitors
3. Antibioitics - ciprofloxacin.
80
What are the GNRH analogues used for metastatic prostate cancer called?
Leuprolide
| Goserelin
81
What is required for diagnosis of menopause?
Amenorrhea > 1 year in woman over 40 yo
82
As periods become less frequent during perimenopause, what hormonal changes are occurring?
Increase in FSH
| Estrogen fluctuates month to month.
83
OCP use decreases the incidence of which types of cancer?
Ovarian
Colon
Endometrial
84
What are the four different options for emergency contraception?
1. Levonorgestril
2. Copper IUD
3. Ethinyl/ Levonorgestrel Combo
4. Antiprogestins - Ulipristal/ Mifepristone
85
What medications are effective in the treatment of PMS and PMDD?
NSAIDS
exercise/ relaxation
SSRIs
GNRH agonists
86
What is the most common cause of irregular heavy uterine bleeding in a non pregnant, premenopausal woman?
Annovulation
87
When is an endometrial biopsy a necessary part of the work up for abnormal uterine bleeding?
>45 yo
88
In which patient populations are triptan drugs contraindicated?
1. Prinzmetal angina
2. Coronary artery disease
3. Pregnancy
4. Sulfa Drug allergy
89
A lesion to which area of the brain is responsible for each of the following clinical scenarios?
1. Resting Tremor
2. Intention Tremor
Resting: Substantia nigra, Basal Ganglia
Intention: Cerebellar Hemisphere
90
What is the treatment for a prolactin-secreting pituitary adenoma?
Dopamine agonist:
Cabergoline
Bromocriptine
91
A child presents with acute-onset ear pain. Otoscopy reveals large, reddish vesicles on the tympanic membrane. What are the diagnosis, most likely causal organism and treatment?
Bullous Myringitis is diagnosis
Org: Mycoplasma pneumoniae
Tx: Macrolide: erythromycin, azithromycin, clarithromycin.
92
What are the diagnostic criteria for polycystic ovarian syndrome?
2 out of 3 of the following:
1. Oligoovulation
2. Hyperandrogenism
3. Polycystic ovaries on US (Beads on a string)
93
What is the most common cause of sensorineural hearing loss? What is the most common cause of conductive hearing loss?
Sensorineural: Presbycusis
Conductive: Otosclerosis
94
A patient is brought into the ER with headache, vomiting, neck pain, and fever. There is progressive muscle weakness. But sensation is intact. CSF analysis shows normal glucose and protein, but CSF lymphocyte count is high. What is diagnosis?
Poliomyelitis
95
What type of tumor can be a risk factor for endometrial hyperplasia and endometrial cancer?
Estrogen secreting tumor -- granulosa cell tumor.
96
What is the most appropriate next step in the evaluation of each of the following patients?
46 year old obese woman with PCOS and infrequent but heavy periods.
Endometrial Biopsy
97
What is the BP goal for the following:
Ischemic Stroke
Intracerebral hemorrhage
Subarachnoid hemorrhage
Which can be treated with nitroprusside?
Ischemic:
98
What is the empiric antibiotic treatment for neonatal meningitis?
Ampicillin
| Gentamicin
99
What test can be used to distinguish autoimmune hemolytic anemia from other causes of anemia?
Direct Coombs test.
100
A patient is found to have an adnexal mass on physical examination. A pregnancy test is negative. What is the most appropriate next step in the evaluation of this patient?
1. Transvaginal U/S
| 2. Test for tumor markers.
101
What is the classic presentation of ovarian cancer?
Usually asymptomatic
- abdominal pain, ascites, early satiety
- virilization
- precocious puberty, AUB
102
What are the drugs notable for causing gynecomastia?
```
Spironolactone
THC
Alcohol (chronic)
Cimetidine
Ketoconazole
Estrogen
Digoxin
```
103
What sign is described by RLQ pain on passive extension of the hip?
Psoas sign
104
What condition is suggested by following findings: elevated erythropoietin, elevated hematocrit, normal oxygen saturation?
Erythropoietin producing tumor (RCC)
| Evaluate with CT scan
105
What is Chadwick sign?
Dark bluish red discoloration of the vaginal mucosa in early pregnancy.
106
What are the causes of hypovolemic hyponatremia?
1. Diuretics
2. Addison's Disease
3. Fluid Loss = third spacing, GI causes, skin fluid losses
107
What teratogen is associated with nasal hypoplasia and epiphyseal stippling?
Warfarin
108
A 40 year old G3P2 woman at 11 weeks gestation comes to the physician for a prenatal visit. Given her age, she is very concerned about the risk of Down syndrome and would like a definitive test immediately. What test should you recommend to this patient?
Chorionic venous Sampling.
109
What condition is suggested by 2nd trimester increase in AFP? (3)
1. Multiple gestation
2. Incorrect dating
3. Neural tube defect
110
A post-op patient who has been experiencing significant pain develops hyponatremia with a normal volume status. What is the most likely diagnosis?
SIADH due to stress
111
If viral load of a pregnant HIV patient is > 1000 copies ml at time of delivery what shoudl be done?
Intrapartum IV zidovudine and C section.
112
What are the management options for an intrauterine fetal demise?
Expectant
Dilation and evacuation
Medical induction: Misoprostol/ Oxytocin.
113
What type of acute kidney injury should be suspected in a patient with FENa
Prerenal
- Dehydration
- Blood loss
114
What are the components of a biophysical profile? (5)
1. Nonstress test
2. Amniotic Fluid
3. Fetal breathing
4. Fetal Movement
5. Fetal Tone
115
What is the most likely associated heart sound in acute pericarditis?
Friction rub
116
The recipient twin in twin-twin transfusion syndrome is at risk for what complications?
Polyhydramnios
Polycythemia
Volume Overload
HF
117
What is the most common cause of morbidity and mortality in patients with systemic lupus erythematosus (SLE)?
Kidney Disease
| Lupus Nephritis
118
What laparoscopic findings may be seen in endometriosis?
Chocolate cysts/ powder burn lesions
119
What is the next step in the evaluation of a patient with a Pap test that shows atypical squamous cells of undetermined significance? (ASCUS?)
colposcopy
| 25 +,
120
What are the cardinal movements of labor?
```
Engagement
Descent
Flexion
Internal rotation
Extension
External rotation
Expulsion
```
121
What medications are commonly used in the management of uterine tony?
Oxytocin
Methylergonovine
Misoprostol
Carboprost
122
What is the treatment for the organism which is most commonly implicated in postpartum mastitis?
Dicloxicillin for Staph Aureus
123
What would you expect to see on EGD and biopsy of the lower esophagus in a patient with Barrett's esophagus?
Columnar cells lining distal esophagus
| intestinal metaplasia
124
Child development, weight expectancy changes for:
4 months
12 months
24 months
4 months - double
12 months - triple
24 months - quadruple
125
What is the most appropriate treatment for macular degeneration?
antioxidants
126
What are the differences in the clinical features of a branchial cleft cyst and a thyroglossal duct cyst?
Branchial: Lateral, doesn't move w/ swallowing
Thyroglossal: Midline neck, moves w/ swallowing.
127
If a female child is in the 80th percentile for height and the 25th percentile for head circumference, what chromosomal abnormality should you most likely suspect?
Triple X
| 47 XXX
128
What genetic disorder: elfin facial features, cardiac defects?
Williams
129
What genetic disorder: Happy mood, inappropriate laughter, ataxic gait?
Angelman
130
What is the most likely primary bone tumor associated with Bony Spur arising from the metaphysis of a long bone?
Osteochondroma
131
What are the causes of physiologic jaundice? (3)
1. Increased RBCs at birth and fragile fetal RBCs lead to increased heme breakdown and increased bilirubin
2. Natural deficiency of UDP glucuronyslyltransferase, leads to decreased conjugation of bilirubin
3. Increased enterohepatic circulation of bilirubin.
132
What is the most appropriate treatment in a patient with cauda equina syndrome?
Surgical decompression
133
What is the possible complication of not treating scaphoid fracture?
Nonunion and avascular necrosis
134
How do you confirm the diagnosis of pertussis?
Clinical diagnosis, confirm w/ nasopharyngeal swab w/ PCR assay.
135
What treatment is available for Lyme disease, particularly for pregnant women and children?
Amoxicillin
| Cefuroxime
136
What are some causes of desquamation of the hands and the feet?
```
Scarlet fever
Kawasaki Disease
Toxic Shock Syndrome
Stevens Johnson
Mercury Toxicity
```
137
What is the cause of erythroblastosis fetalis?
Maternal Antibodies against Fetus RH positive RBCs
138
What is the most appropriate treatment for mild unconjugated hyperbilirubinemia in a neonate? Severe cases?
Mild: Phototherapy
Severe: Exchange transfusion
139
What medications are often used to treat spasticity in cerebral palsy?
Dantrolene, Botulinum toxin, Baclophen, Benzos, PT, bracing, surgery, speech therapy
140
What is the next step in management of a patient who has aspirated an object that cannot be dislodged and is now having difficulty moving air and is becoming hypoxic?
Heimlich maneuever
| Emergency trach
141
What is the Parkland burn formula?
4 mL x kg of patient X % BSA burned
142
What is the treatment for acetaminophen toxicity after four hours?
N- acetyl cysteine
| will have best results if treated within 8 hours
143
What are the primary symptoms associated with MILD theophylline toxicity?
Hyperglycemia
Hypokalemia
Vomiting
144
What is the antidote for aspirin?
Charcoal
Dialysis
Sodium Bicarbonate
145
What should a patient be examined for who presents with increased troubled night vision?
Cataracts
146
What classic toxic ingestion management options should not be chose in patients presenting with alkaline fluid ingestion?
```
These should not be done:
Charcoal
Neutralization
NG Tube
Inducing vomiting
```
147
What is the antidote for Arsenic?
Dimercaprol, Succimer, Pencillamine
148
What is Cushing's Triad?
Hypertension
Bradycardia
Bradypnea
149
In patients with cerebral palsy, what therapies are used to alleviate contractures and improve function?
```
PT
Bracing
Surgery
Dantrolene
Baclofen
Benzos
Botulinum Toxin
```
150
What childhood psych d/o: 7 yo avoids going to school to stay home with parent?
Separation Anxiety
151
What is the antidote for antimuscarinic/anticholinergic agents?
Physostigmine
152
At what point do patients with chronic COPD qualify for home O2?
When SaO2
153
What is the treatment for idiopathic pulmonary fibrosis?
Pirfenidone, nintedanib, sildenafil, corticosteroids, antibiotics, lung transplant.
154
What is the treatment of an MI due to cocaine overdose?
1. Benzodiazapine - Lorazepam
| 2. CCB
155
How is A-a gradient calculated?
ATM(713) x FIO2 (0.21) - (PaCO2/0.8 - PaO2)
156
What are the findings of pulmonary edema on chest x-ray?
Kurly B lines
Cepahlization of blood vessels
Diffuse interstitial fluid
157
Which vasodilators are used in the treatment of primary pulmonary hypertension?
CCB
Endothelin Receptor antagonists
Cyclic GMP phosphodiesterase inhibitors
Prostanoids
158
Who should be given PPSV23 alone?
```
Patients 19-64 with:
Cigarette smoking
Alcoholism
Cronic heart disease
chronic lung disease
chronic liver disease
DM
```
159
Who should be given PCV 13 and PPSV 23?
```
Age >65
CSF leak
Asplenia
Cochlear implant
Immunocompromise: cx, HIV, renal failure, nephrotic syndrome, immunosuppressive medication, immunodeficiency or transplant
```
160
What are the two most common causes of atypical pneumonia in young adults?
Mycoplasma pneumonia
| Chlamydia Trachomatis
161
What type of pneumonia is associated with currant jelly sputum?
Klebsiella
162
What is the antidote for tPA?
aminocaproic acid
163
What induction agents are commonly used in intubation?
Sedatives: Etomidate, Propofol, midazolam, ketamine
Paralytics: Succinylcholine, Rocuronium
164
When does the onset of gestational diabetes occur?
During third trimester
165
What two tests can confirm diagnosis of DKA?
1. Check ABG
| 2. Check urine/serum for ketones
166
What serum electrolytes are commonly low in patients with DKA?
```
Potassium
Phosphorus
Mg
Ca2+
Pseudohyponatremia
```
167
At what percentage stenosis should symptomatic patients get surgery (endarderectomy)?
Symptomatic patients w/ 70-99 percent stenosis
| symptomatic men w/ 50-69 percent stenosis
168
Which organism is known for causing infections in burn victims?
Pseudomonas aeruginosa
169
What is the treatment for proliferative diabetic retinopathy?
```
VEGF inhibitors
PRP
Corticosteroid injections
Vitrectomy
Photocoagulation
```
170
At what point do patients with chronic COPD qualify for home oxygen? (4)
1. PaO2 less than 88 percent
2. Pulmonary HTN
3. Peripheral Edema
4. Polycythemia
171
Which chemotherapeutic agent is a mainstay of the treatment for choriocarcinoma?
Methotrexate
172
What are four clinical features of streptococcal pharyngitis?
Fever
Lymphadenopathy
Tonsillar Exudates
Absence of rhinorrhea/cough
173
During the second stage of labor, a woman develops a fever, tachycardia and uterine tenderness. The fetus is also noted to have tachycardia. What is the most likely diagnosis? What is the most appropriate management?
Chorioamnionitis
IV abx: amp + gent
174
What should be suspected in a trauma patient with blood at the urethral meatus or a high riding prostate?
Urethral injury/ bladder rupture
175
What thyroid abnormalities might you expect to find during early pregnancy?
Increased TBG
Decreased TSH
Increased total T4, normal T4
176
Which three iaotrogenic sources of iodine might cause thyrotoxicosis?
1. Iodine dye
2. Wrong levothyroxine dose
3. Amiodarone
177
What is the treatment for nephrogenic diabetes insipidus caused by lithium toxicity
Stop lithium
Thiazide diuretics
Add Amiloride
178
What is the next step in management of a newly identified thyroid nodule in a patient with hyperthyroidism?
Test TSH
179
Patients with silicosis are at higher risk for which type of infection?
Tuberculosis
180
What is the most common presentation of hyperprolactinemia?
Hypogonadism
181
What is the next step in the management of a patient with hyperprolactinemia due to an obvious drug cause?
Pituitary MRI
182
What are the symptoms of a basilar artery stroke?
Cranial nerve defects
Altered mental status
Contralateral full body weakness
183
What is the rate of transmission of HIV through a needle stick incident? What drugs should be given in case there is appreciable risk of transmission of HIV in this setting?
O.3%
| Tenofovir + amtricitabine + raltegravir
184
What is the treatment for septic abortion?
D&C
| Antibiotics - IV broad spectrum - gentamicin and clindamycin
185
Which type of infection may cause peripheral eosinophilia?
Parasite infection
186
What is the most likely diagnosis in a patient with symptoms of hyperthyroidism and:
1. Palpation of multiple thyroid nodules
2. History of thyroidectomy or radioablation of thyroid
1. Multinodular goiter
| 2. Excess thyroid hormone replacement.
187
Which mineralocorticoid medication is used in the treatment of aldosterone deficiencies such as adrenal insufficiency and 21 hydroxylase deficiency?
Fludrocortisone
188
What neurotransmitter derangements are seen in patients with depression?
Decreased: Serotonin, Dopamine, Norepinephrine
189
What is the pharmacological treatment for acromegaly?
Somatostatin - octreotide
Cabergoline
Pegvisomant
190
What is the first line treatment for moderate hypercalcemia? (2)
Normal Saline Infusion
| Loop Diuretics
191
Which antidepressant works well with SSRIs and increases REM sleep
Trazadone
192
What are the levels of Ca2+, Serum Phosphate, Alk Phos, and PTH in :
1. Hypoparathyroidism
2. Pseudohypoparathyroidism
```
Hypoparathyroid:
Ca = decreased
P = increased
Alk Phos = normal
PTH = decreased
```
```
Pseudohypoparathyroidism:
Ca = decreased
P= increased
Alk Phos = normal
PTH = increased
```
193
Which antidepressant should be considered first for a patient with depression and comorbid neuropathic pain?
Duloxetine (SNRI)
194
What drugs can be used in the case of HTN in a patient with cocaine or amphetamine intoxication?
Benzos
Antipsychotics
Phentolamine (if really increased BP)
195
What are the most appropriate treatments of OCD?
CBT
Exposure, non-response therapy
SSRI
196
A 15 year old girl is brought to the dermatologist for treatment of her acne. What is the causative organism in acne?
Propionibacterium acnes
197
What is the treatment for rosacea?
Topical: metronidazole, azelaic acid
Systemic: Tetracycline, doxy, minocycline, isotretinoin, laser therapy
198
AN obese 42 year old diabetic woman complains of pruritic rash underneath her breasts. Exam reveals an erythematous, patchy rash underneath large, pendulous breasts. What diagnostic study would be helpful, and what would be seen?
KOH prep - pseudohyphae
199
What is the treatment for delirium tremens?
Long acting Benzodiazepines - Chlordiazepoxide
200
A patient presents with erythema multiforme. Which medications are most common offenders? (5)
```
Penicillins
Sulfonamides
OCPs
NSAIDs
anticonvulsants
```
201
What type of vascular anomaly:
1. Blue compressible mass that does not regress
2. Red-pink nodule on a child that is often confused with melanoma
1. Cavernous hemangioma
| 2. Spitz Nevis
202
Under what circumstances are you allowed to break confidentiality with a patient? (4)
Penetrating injury from an assault, discuss with police
Pt danger to self/others
Suspected child/elder abuse
Reportable diseases
203
What is the treatment for seborrheic dermatitis?
Selenium Sulfide Shampoo
| Topical antifungals
204
What is the most common cause of septic arthritis?
Staph Aureus
