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PANRE review > Exam Master Questions > Flashcards

Exam Master Questions Flashcards

1
Q

What is the treatment for chlamydial conjunctivitis?

A

Tetracycline (250 PO QID x 3 weeks)

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2
Q

What anemia has increased ferratin/serum iron without supplementation?

A

sideroblastic anemia

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3
Q

Large MCV anemia with neurologic changes

A

Megaloblastic anemia

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4
Q

What is the first step in breast lump identification?

A

Imaging then biopsy only if necessary

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5
Q

young patient with inflammation of tibial tuberosity, diagnosis? treatment?

A

Osgood-Schlatter disease - Rest, Ice, supportive, symptomatic

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6
Q

What is a common complication of chronic blood transfusion for an otherwise relatively healthy patient?

A

Iron overload

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7
Q

What is the most valuable diagnostic study for MS?

A

60-70% of patients will have findings during a Visual Evoked Potentials study

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8
Q

When should a UTI be tested for in women in general?

A

symptomatically or in pregnant women between 12-16 weeks gestation

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9
Q

When should a UTI be treated in women?

A

When it’s symptomatic or in pregnant women between weeks 12-16 gestation

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10
Q

Pt p/w coin-like lesions with a distribution on the extensor surface of the extremities as well as posterior portion of the trunk, buttock, and legs some with purulent drainage. Diagnosis? Treatment?

A

Nummular eczema: Treatment includes topical steroids, systemic antibiotics, and antihistamines

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11
Q

What is the primary treatment of absence seizures?

A

Ethosuximide

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12
Q

What is the antidote to isoniazid toxicity?

A

Pyridoxine (vitamin B6)

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13
Q

What neurologic disorder is associated with thymus dysfunction?

A

Myesthenia gravis

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14
Q

What are treatment options for myesthenia gravis?

A

Medical treatment includes neostigmine therapy, plasmapheresis, or intravenous immunoglobulin therapy. Thymectomy may be considered in cases of thymoma.

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15
Q

What is a genetic disorder associated with deficiency of the structural protein dystrophin in muscles?

A

Duchenne muscular dystrophy

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16
Q

Patient has Negri bodies on brain biopsy, diagnosis?

A

Rabies

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17
Q

Target like lesions in HSV positive patient, diagnosis? treatment? prevention of future eruption?

A

Erythema multiforme, benadry, acyclovir - most common cause of EM

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18
Q

What is the easiest difference between a hordeolum and a chalazion?

A

Hordeolum is red and hot and painful and a chalazion isn’t

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19
Q

What is the definitive diagnostic test for carcinoid?

A

5HIAA 24 hour urine test

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20
Q

What is Churg-Strauss syndrome?

A
  1. Asthma
  2. Eosinophilia of more than 10% in the peripheral blood
  3. Pulmonary involvement such as infiltrates
  4. Paranasal sinusitis
  5. Mononeuritis multiplex or polyneuropathy
  6. Histological proof of vasculitis with extravascular eosinophils
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21
Q

What is the normal fetal heart rate?

A

110-160 bpm

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22
Q

Young patient without risk factors with community acquired pneumonia, first line abx?

A

doxycycline

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23
Q

Young female patient presents with weakness/fatigue ?vague vision complaints, ?swallowing difficulty. Work up?

A

Myesthenia gravis work up: edrophonium challenge (short-acting anticholinesterase) results in returned strength short term, The acetylcholine receptor antibody test, CT scan of the thorax to detect a thymoma if present, Electromyogram (EMG)

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24
Q

What is the treatment algorithm for Myesthenia gravis?

A
  1. Neostigmine and other anticholinesterase drugs, improving symptoms.
  2. Avoidance of drugs such aminoglycosides.
  3. Thymectomy(removal of the thymus), which produces an improvement in over 85% of the patients between puberty and 55 years of age. It is usually performed in cases of moderate-to-marked generalized myasthenia gravis, and in some, it can produce complete remission of the disease. A thymoma is an indication for surgery.
  4. Steroids provide for symptom management as well; improvement is the most dramatic with high-dose corticosteroids.
  5. Plasmapheresis and IV immunoglobulins.
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25
Q

A middle age p/w weakness of the proximal muscles of the lower and then upper limbs. A muscle biopsy made what diagnosis?

A

Inclusion body myositis

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26
Q

Which lung CA do non-smokers get?

A

Adenocarcinoma

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27
Q

FOOSH fracture with with a dinner fork deformity, what’s the name of the fracture?

A

Colles’ fracture

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28
Q

Fall on a bent wrist fracture with appropriate displacement in the other direction from the FOOSH fracture, name that fracture!

A

Smith fracture

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29
Q

What is the treatment for a bleeding hemaphiliac?

A

PCC

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30
Q

What is the diagnosis in a sick patient with perihilar infiltrates?

A

PCP, likely an HIV patient

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31
Q

Or with GERD. Linear streaks on biopsy of esophagus. Diagnosis? Treatment?

A

Candidiasis - systemic treatment

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32
Q

Pt with GERD with punctate lesions or ulcers on biopsy

A

CMV or herpes

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33
Q

Baby with beefy red diaper rash and areas of redness outside the diaper, may have pustules. Diagnosis? Tx?

A

Candidiasis, topical or oral fluconazole

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34
Q

Pt within 2 months of valve replacement p/w new murmur petechiae, splenomegaly - likely causes?

A

Infectious from implantation. Staph, strep or yeast

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35
Q

What kind of cancer is typically of colon origin?

A

Adenocarcinoma

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36
Q

What type of hemorrhoid can be manually reduced?

A

Type 3

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37
Q

Baby with short coarse severe diarrhea. The pathogen?

A

Rotavirus

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38
Q

First line agent for GERD according to the books?

A

PPI

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39
Q

What is the first line treatment recommendation for osteomalacia besides bisphosphenates?

A

Sun exposure for vitamin D

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40
Q

Known alcoholic presents with memory loss, muscle cramps, tachycardia, peripheral edema, constipation and dysphagia. Diagnosis? Tx?

A

Beriberi (thiamine deficiency) treat with thiamine injection over several days

41
Q

What is typical of the physical exam findings on a patient with bowel ischemia?

A

Normal abdominal exam

42
Q

Alcoholic presents with bleeding joints and petechiae. Diagnosis?

A

Scurvy, vitamin C deficiency

43
Q

Edematous patient with hypertension, proteinuria and red cell casts.

A

Glomerulonephritis

44
Q

Patient with hypertension, hematuria and palpable flank masses, diagnosis?

A

Polycystic kidney disease

45
Q

In patient with high K, initial treatment?

A

Kayexelate

46
Q

What is the modality of choice to evaluate for kidney stones?

A

Helical abdominal CT

47
Q

What factor puts a patient at risk for renal cell carcinoma?

A

Smoking

48
Q

What finding on smear is associated with bacterial vaginosis?

A

Clue cells

49
Q

What condition is associates with multi uncleared giant cells on smear of vaginal secretions?

A

Herpes virus

50
Q

What is the treatment regimen for postpartum endometritis? In what order do you add additional abx coverage?

A

Clinda then add gent then add amp

51
Q

At what serum level of magnesium are the first side effects appreciated? What are they?

A

Serum level 10-12, loss of deep tendon reflexes

52
Q

What is the treatment of choice for an ectopic b-hcg < 5000 and <3.5 cm?

A

Methotrexate

53
Q

What are the indications for laparoscopy in ectopic pregnancy?

A

Instability in vital signs, history of peptic ulcer disease, renal disease, blood dyscrasias or b-hcg > 5000, size > 3.5cm

54
Q

What is vasa previa?

A

Rare condition caused by the rupture of fetal vessels that cross the membranes covering the cervix. The diagnosis isn’t usually made until rupture of membranes

55
Q

What is the treatment of choice for PID?

A

3rd gen cef or flagyl + doxy

56
Q

What is the treatment of choice for uncomplicated conjunctivitis?

A

topical sulfonamides

57
Q

What are three objective findings of glaucoma?

A

increased intraoccular pressure, peripheral visual loss, cupping of the optic disc

58
Q

What is the initial screening test for infectious mononucleosis?

A

heterophile antibodies aka monospot test

59
Q

What agent reverses angle closure glaucoma once the pressure begins to decline?

A

pilocarpine

60
Q

Where do patients with mastoiditis have pain?

A

post auricular and usually ear pain d/t otitis media

61
Q

Why should fqs be avoided in children?

A

risk of tendon rupture

62
Q

A patient has a history of chronic eustachian tube dysfunction and p/w otorrhea. Otoscopic examination reveals an epitympanic retraction pocket with associated keratin debris. Diagnosis?What is the most appropriate therapeutic intervention?

A

cholesteatoma, surgical removal or marsupealization

63
Q

Eggshell findings on cxr of a blue collar patient with progressive onset dyspnea, diagnosis?

A

silicosis

64
Q

What pulmonary med is category B in pregnancy?

A

azithromycin

65
Q

What antibiotic can cause a prolonged QT interval?

A

Moxifloxacin

66
Q

Cancer patient presents with hyporeflexia, shortened QT interval on EKG and nausea and vomiting. What is the likely cause?

A

hypercalcemia

67
Q

What type of CXR is most useful in detecting a pneumothorax?

A

Expiratory PA

68
Q

Who is eligible for pneumococcal vaccine?

A

children < 5 and adults > 65, booster every 5 years

69
Q

What term refers to a loss of vision (without ocular or CNS pathology) caused by inadequate stimulation during the “critical age” for ocular development (birth to 8-9 years old)?

A

amblyopia

70
Q

A 69-year-old male presents with complaints of right groin pain that has progressively worsened over the past year. On exam he has a decrease in internal and external rotation of the right hip in comparison to the left hip. He complains that it hurts with movement. What imaging study would be most appropriate? Suspected diagnosis?

A

Xray - Osteoarthritis

71
Q

A 45-year-old female presents with pain, stiffness and swelling in both hands for the past 2 months; the pain is isolated to her metacarpophalangeal joints. The pain is present upon waking and lasts for 3-4 hours often requiring over-the-counter pain medications. Further history reveals low grade fever, malaise and an 8 lb. unintentional weight loss since her last appointment 4 months ago. What is the most likely diagnosis?

A

Rheumatoid arthritis

72
Q

A 38-year-old female on chronic steroid therapy for systemic lupus erythematosus (SLE) presents with pain in her hip when she walks. On exam the patient has pain with internal and external rotation and extreme flexion. What diagnostic study would be most sensitive for diagnosing the suspected condition?

A

MRI - most sensitive for early stages of avascular necrosis

73
Q

A 39-year-old male presents with pain in the right shoulder after a fall 4 weeks ago. The shoulder is most painful with overhead activities and at night when he sleeps on his right side. On exam the patient has a positive drop arm sign; what is the diagnosis?

A

The drop arm sign tests the strength of the supraspinatus and when a patient has a tear of this muscle he/she is unable to sustain the arm at 90 degrees of abduction.

74
Q

A 52-year-old black female presents with insidious onset of progressive weakness of the large muscle groups X 2 weeks. She has had particular difficulty rising from a chair without assistance. She denies pain or fever. Physical exam is normal. Creatine kinase is elevated; ESR is normal. What is the diagnosis and best treatment option?

A

polymyositis, prednisone

75
Q

A 15-year-old male presents with pain in the right knee that wakes him up at night. Two weeks ago he noticed a bump on his right lateral thigh. He denies history of trauma. Exam reveals a firm, immobile bump over the right lateral femur. The knee exam is unremarkable. X-ray reveals cortical destruction and a sunburst appearance of the distal lateral femur. What is the most likely diagnosis?

A

This is the typical presentation of osteosarcoma; it is most often seen in young males and in the long bones, often around the knee. It is the most common primary malignancy of bone.

76
Q

A patient complains of elbow pain. Exam reveals point tenderness over the medial epicondyle. What is the diagnosis? What type of motion against resistance will cause pain?

A

Repetitive wrist flexion causes microtrauma leading to medial epicondylosis or golfer’s elbow due to the fact that the tendons that attach the muscles that flex the wrist are attached to the medial epicondyle of the humerus. The old terminology, epicondylitis, is a misnomer; there is no inflammation but rather degeneration.

77
Q

What is the treatment for de Quervain’s tenosynovitis?

A

Steroid injection and immobilization

78
Q

At what point should Guillain-Barre patients be intubated?

A

If forced vital capacity reaches 15 mL/kg or the oxygen saturation declines

79
Q

A 30-year-old female complains of fluctuating but progressive episodes of muscle weakness, diplopia, ptosis and difficulty chewing and swallowing. The symptoms are made worse by activity. On physical exam, muscle weakness is readily apparent and exacerbated by repetitive movement. Sensory and reflex examination is completely normal. What diagnostic test can generally best confirm the diagnosis?

A

edrophonium or tensilon test will confirm Myesthenia Gravis

80
Q

CSF analysis of a patient with meningitis shows variable pleocytosis, reduced glucose, and elevated protein, what is the inciting organism class?

A

Fungal

81
Q

A 37-year-old female presents with severe burning pain and swelling of her left hand. She states she fractured her wrist 5 weeks ago and has been out of the cast and in a splint for 1 week. She reports severe burning pain even when the skin is lightly touched. Exam reveals diffuse swelling of the hand, with dusky color and warmer temperature. Ultrasound is normal. Diagnosis? Treatment?

A

Complex regional pain syndrome, mild: TCAs/gabapentin, severe: prednisone

82
Q

What are the common lab abnormalities seen in patients with anorexia?

A

Hypokalemia, leukopenia, increased cortisol, low T3, and elevated cholesterol

83
Q

A person is described as superstitious and suspicious. He lacks interpersonal interest and has become socially withdrawn and eccentric. Which personality disorder does this patient most likely have?

A

Schizotypal

84
Q

A patient is selfish, callous, impulsive and promiscuous. The individual is unable to learn from experience and usually end up with legal problems. What disorder does this patient have?

A

Antisocial

85
Q

A Patient dependent, seductive, and egocentric. What disorder does this patient have?

A

Histrionic

86
Q

What are the first line medications for mania?

A

Olanzapine or risperidone

87
Q

A patient is admitted through the emergency department with an elevated blood alcohol level. He is acutely paranoid and admits to auditory hallucinations which are telling him everyone is out to kill him. He is oriented and displays no abnormal motor signs. What is the treatment of choice?

A

Haldol for the psychosis, benzo for the withdrawal

88
Q

A 19-year-old female has a history of binge eating and hoarding food in her dorm room. She is 5’0” and weighs 118 pounds which is 2 pounds more than last month. What type of infection would this patient be prone to?

A

Dental d/t poor hygiene and stomach acid erosion

89
Q

How long must anxiety symptoms be present before a diagnosis of general anxiety disorder can be made?

A

6 months

90
Q

What is the age of onset of specific object related phobias? Social phobias?

A

object related: childhood, social: adolescence or young adulthood

91
Q

A 23-year-old female exhibits inappropriate seductive/provocative behavior. She also becomes uncomfortable in social situations where she is not the center of attention. Her relationships are typically strained as she considers them to be more intimate than they really are. Otherwise, she feels well. Diagnosis? Treatment?

A

Histrionic personality disorder - therapy

92
Q

A 46-year-old female presents for a routine checkup without complaints; this is her first office visit in over 25 years. Cardiac exam reveals a right ventricular lift, a III/VI systolic ejection murmur, and a widely split S2 that does not vary with breathing. What is the most likely cause of these findings?

A

Atrial septal defect

93
Q

A 78-year-old female with a history of untreated rheumatic fever as a child presents with complaints of dyspnea, fatigue and shortness of breath. A new murmur that is low-pitched, mid-diastolic and heard best at the apex is noted on cardiac auscultation. Which valve is most likely abnormal?

A

Mitral valve - stenosis

94
Q

A 63-year-old female with a history of atrial fibrillation presents complaining of sudden onset of pain and paresthesia in her left leg that began 30 minutes ago. Physical exam reveals an irregularly irregular rhythm, cool, pale left leg and an absent left pedal pulse. What is the initial management?

A

Heparin then later embolectomy

95
Q

A 65-year-old male with a BP of 250/150, confusion, and severe hypertensive retinopathy has a non-focal neurologic exam and leukoencephalopathy on CT scanning. Intravenous sodium nitroprusside is initiated. What is the diagnosis and management of this condition?

A

Hypertensive crisis: lower the initially elevated arterial pressure by no more than 25% in the first 1-2 hours towards a target blood pressure of about 160/100 mm Hg by 2-6 hours.

96
Q

What is the management for a second degree type II heart block found incidentally on a routine EKG?

A

pacemaker d/t risk of progression to complete block

97
Q

A 55-year-old male presents to the emergency room with substernal chest pain without dyspnea. The pain is relieved by sitting and leaning forward. He was discharged 2 weeks ago following a mild anterolateral MI. He is currently on a beta-blocker and daily aspirin. BP is 112/80; pulse is 88. What is the diagnosis? definitive confirmatory study? What is expected on ECG? Treatment?

A

postpericardiotomy syndrome (subset Dressler’s syndrome bc of the MI as an inciting event). Definitive diagnosis is made with echo and EKG will likely show pericarditis findings of global ST elevation. Treat with NSAIDs

98
Q

A 24-year-old male with a history of recent viral upper respiratory infection, now resolved, presents with sharp, pleuritic substernal chest pain x 2 days. Physical exam reveals temperature of 100.4F and a pericardial friction rub. What is the diagnosis and treatment?

A

pericarditis - NSAIDs/Aspirin

99
Q

A 23-year-old anxious female presents with new onset chest pain and palpitations occurring intermittently x 1 day. Physical exam reveals a mid-systolic click. ECG is normal. Diagnosis? initial management?

A

Mitral valve prolapse - b-blocade

PANRE review (14 decks)

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