Endocrine/Hematology

Question 1

Small bowel obstruction on abdominal X-ray

Answer 1

Ladder-like or staircase pattern of dilated bowel with air-fluid level and no colonic distention

Question 2

Large bowel obstruction on abdominal x-ray

Answer 2

Frame pattern dilated bowel loop with air-fluid levels

Question 3

Ulcerative colitis on abdominal x-ray

Answer 3

mural thickening and thumbprinting

Question 4

Perforated bowel on abdominal x-ray

Answer 4

free air

Question 5

Lab that indicates upper GI bleed

Answer 5

elevated serum sodium and BUN
Hypernatremia through due to loss of fluid through emesis
Elevated BUN due to large protein load from the breakdown of blood

Question 6

Infectious organism from ingesting contaminated water

Answer 6

Giardia lamblia
Incubation period of 7-21 days

Question 7

Adrenal insufficiency diagnostic test

Answer 7

ATCH stimulation test
Serum Cortisol level fail to rise greater than or equal to 5-10% from baseline cortisol

Question 8

Chronic liver disease and Hepatic encephalopathy physical examination findings

Answer 8

Asterixis
-pt extends their arms out and dorsiflex the hands at the wrist.
+ arms will move in a tremor-like movements

Question 9

Priority treatment for DKA

Answer 9

1-3 L of fluid needed in the first hour
Example: 0.9% sodium chloride rate 15-20ml/kg/hr

second line therapy : Insulin bolus 0.15 then Insulin infusion 0.1units/kg/hr

Potassium check or potassium replacement is required before starting insulin gtt

Question 10

Adverse effect of Tacrolimus

Answer 10

Neurotoxicity
s/s:
-Tremors
- weakness
-altered mental status
- simple neuropathies

These symptoms progress to:
-encephalopathy
-paresis
-seizure
-coma

Question 11

Hypothyroidism s/s

Answer 11

-Bradycardia
-cold intolerance
- periorbital edema
-dry skin
-difficulty concentrating
-cold extremities
-constipation
-hoarse voice
-decreased deep tendon reflexes

Question 12

Which oral hypoglycemic agent causes hypoglycemia if not taken with adequate amount of food

Answer 12

Glyburide

Question 13

RA signs/symptoms

Answer 13

• Pain worse in the morning and gets better as the day progresses
• ulnar deviation at the metacarpophalangeal (MCP) joints
  -proximal interphalangeal joint
  -swelling, redness and warmth to bilateral wrist

Question 14

Osteoarthritis s/s

Answer 14

symptoms better in the morning at gets worse throughout the day
-Joint involvement asymmetrical
-Heberden’s nodes (DIPs)
-Burchard’s nodes (PIPs)

Question 15

Gout s/s

Answer 15

monoarticular and occur in the lower extremities

Question 16

Reynaud’s phenomenon s/s

Answer 16

sudden onset of vasoconstriction that causes restricted blood flow to the digits resulting in changes to skin color (pallor, cyanosis and erythema)
-attacks generally last 15-20 mins

Question 17

Diagnostic test for Cushing syndrome

Answer 17

Dexamethasone suppression test

Question 18

SIADH labs

Answer 18

-low serum sodium
-low serum osmolality
- increase urine osmolality >100
-increase urine sodium concentration >40

Question 19

When should insulin infusion be stopped after giving basal insulin?

Answer 19

1-2 hours after basal insulin is administered.

Question 20

Indication for discontinuation of insulin drip

Answer 20

Closure of anion gap

Question 21

What lab values would warrant the treatment of subclinical Hypothyroidism

Answer 21

-TSH concentration greater than 10 mU/L
-Presence of TPO antibodies
-Risk factors in younger adults with TSH concentration 4-10mU/L

Question 22

Recommended drug of choice for first time cellulitis with no risk for MRSA

Answer 22

Cefazolin

Question 23

Drug of choice for MRSA skin and soft tissue infections

Answer 23

Vancomycin

Question 24

HIV acute retroviral syndrome assessment findings

Answer 24

-cervical lymphadenopathy
-rash
-arthralgia
-fever
-pharyngitis

Question 25

Treatment goal for a patient prescribed a HMG-CoA reductase inhibitor

Answer 25

Get the patient to the maximum dose of statin

Question 26

TACO vs TRALI related to blood transfusion

Answer 26

TACO- Hypertension, increased crackles over lung fields, increased oxygen requirements

TRALI- Hypotension and leukocytosis

Question 27

Acceptable HbgA1c range for the elderly?

Answer 27

8-8.5
Recognize that hypoglycemia is a risk for the elderly

Question 28

Hodgkins lymphoma presentation

Answer 28

painless lymphadenopathy in the cervical and supraclavicular areas

Question 29

Appropriate decrease of glucose on insulin drip

Answer 29

10% within the first hour
If that is not achieved an additional bolus of insulin with an increase of the drip is recommended

Question 30

Appropriate decrease of glucose on insulin drip

Answer 30

10% within the first hour
If that is not achieved an additional bolus of insulin with an increase of the drip is recommended