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Exam Questions Flashcards

1
Q

What medications commonly available as second line agents in the emergency department could you use next to terminate seizure activity

A

Keppra
Valproic acid
Phenobarbital
Phenytoin

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2
Q

First investigation in pt arriving with seizure in ER

A

Capillary glucose

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3
Q

In pt in treatment for Tuberculosis, what Medication should we add?

A

Pyridoxine - B6.

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4
Q

Manifestation of B6 deficiency

A

Stomatitis, glissitis, irritability, confusion, weight loss, depression. Can also in children give encephalopathy w seizures

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5
Q

A pt continues to seize despite 2nd line medication. For intubation - what medication do you choose

A

Propofol
Ketamine

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6
Q

An 8 yo with 4 day bc of abdominal pain now in the RLQ - name 5 differentials

A

Appendicitis
Testicular torsion
Inguinal hernia
Meckels diverticulum
Mesenteric adenitis
Urinary tract infection

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7
Q

For a child with suspected appendicitis or other intra abdominal infection which medics to give and how other then ATB

A

Acetaminophen PR
Ondansetron or gravol IV
Ketorolac IV
Fentanyl / morphine IV

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8
Q

For a child with suspected appendicitis or other intra abdominal infection which medics to give and how other then ATB

A

Acetaminophen PR
Ondansetron or gravol IV
Ketorolac IV
Fentanyl / morphine IV

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9
Q

In a 36 yo pregnant woman G1, 11 weeks pregnant - with dyspnea, no fever, cough or PV bleeding. Other than PE name 3 other differentials

A

Pneumonia
Asthma
Covid

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10
Q

What familial thrombophilia conditions would increase the risk of thromboembolism. List 3

A

Factor V Leiden
Protein C deficiency
Protein S deficiency
Antithrombin

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11
Q

How to treat venous thromboembolism in 1st trimester?
Include drug and dose

A

Enoxaparin 1mg/kg/BID

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12
Q

What gout medication drug har been associated with reduction in cardiovascular events in pt with CAD?

A

Colchicine

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13
Q

Primary side effect of Colchicine

A

GI upset
Diarrhea

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14
Q

Common symptoms of pulmonary embolism

A

Dyspnea
Pleuritic chest pain
Hemoptysis
Tachycardia
Fatigue
Diaphoresis

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15
Q

What wells score should make you send pt directly to imaging?

A

4,5

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16
Q

What is the recommendation regarding threshold for D-diner levels when assessing patients for PE?

A

Age adjusted threshold (pt age multiplied by 10 in ug/L).
Pt younger than 50yo use the conventional threshold of 500 ug/l

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17
Q

For a pt age 56, what D-dimer is deemed a negative test

A

<560 ug/l

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18
Q

Pharmacology and non-pharmacology treatment for cessation of cigarette smoking:

A

Bupropion
Varenicline
Naltrexone
Nicotine replacement
Hypnosis

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19
Q

Most efficient drug for cigarettes cessation:

A

Varenicline

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20
Q

Best double treatment for cigarette cessation

A

Varenicline and nicotine patches

21
Q

Treatment for cigarette cessation should at least last?

A

6-12 weeks

22
Q

Treatment of hypoglycemia

A

15g of carbs
If severe/unconscious: 1mg glucagon IM

23
Q

A1C Can be affected by?

A

Will be increased if: iron deficiency. B12 deficiency, alcoholism, chronic opioid use /chronic renal failure

Decreased if: use of iron/B12/asa/vit C/ vit E/ hemoglobinopathy/ chronic liver disease/antiretroviral /chronic renal failure / rheumatoid arthritis

24
Q

A pt comes in with concerns of memory loss. What specific things should you assess for on your physical?

A

Gait speed
Neuropsychiatric symptoms
Hearing
Vision
Frailty

25
A pt comes in with concerns of memory loss. What specific things should you assess for on your physical?
Gait speed Neuropsychiatric symptoms Hearing Vision Frailty
26
List reasons to do neuroimaging in pt who scores bellow average on cognitive function:
Onset in past 2 years Unexpected decline in or known w dementia Recent head trauma History of cancer Unexplained neurological symptoms
27
Which type of vaccines is not safe in pt undergoing chemotherapy
Live vaccines
28
List types of elder abuse
Physical abuse Neglect/phycological abuse Financial abuse Sexual abuse
29
Finding on physical exam that may suggest that a patient is being mistreated
Signes of injuries Poor hygiene Poor eye contact Fear
30
Lab work up to consider if suspecting elder abuse
Creatinine/eGFR (dehydration) Creatinine kinase (rhabdomyolyse) Albumin and B12 (malnutrition)
31
When to screen for chlamydia?
All patients that are sexually active <30 y.o q1year
32
Complication of chlamydia in women
PID Ectopic Pregnancy Infertility Pelvic pain Reiter syndrome
33
Name 4 classes of antidepressants
1) SSRI 2) SNRI 3) bupropion 4) trintellix
34
Questions to ask before choosing/starting and antidepressants
Sleep Weight gain Weight loss Eating habits Anxiety GI issues Headaches
35
Contraindications for bupropion
Anorexia Seizures CVA
36
Name 3 medications that helps with neuropathic pain
Pregabalin Gabapentin Amitryptyline
37
Measures to prevent worsening of delirium in patients
- Optimize pain control - Preference oral nutrition and hydration - Avoid use of restraints - Preference non-pharmacologic agents for sleep - address communication deficits - preference intermittent straight Cath for urinary retention
38
In male 65-80 y/o and women 65-80 y/o if hx smokink or CVD - which screening to add
U/S abdomen for AAA x 1
39
Ok j
40
Signes of PCOS
- Hirsutism - acne/oily skin - virilization - hair thinning - Acanthosis nigricans
41
Blood work to confirm Dx of PCOS
⬆️ total testosterone ⬆️ DHEAS ⬆️ androstenedione
42
Imaging PCOS
Transvaginal u/s —> polycystic ovaries
43
Longterm complication of PCOS
Hyperlipidemia Adult-onset DM Obstructive sleep apnea Infertility Endometrial hyperplasia
44
STI risk factors
- previous STI - sexual contact with person(s) known STI - sexually active <25 - new sexual partner - > 2 sexual partners in the last year or serial one-partner relationships - no barrier contraption use -IVDU - homelessness - substance use, especially if associated w sex - sex workers - sexual assault
45
In sexual assault STI testing:
Repeat testing at 6w,12w and 6mo 1w gonorrhea 2-3w chlamydia 12 w syphilis, HIV, HBsAg/HCVab
46
Gonorrhea and chlamydia treatment
Gonorrhea: Cefriaxone 500mg IM X 1 Chlamydia: doxycycline 100 mg PO BID x 7 days If pregnant: 1g azithromycin po x 1
47
Don’t forget to explore barriers to partner notification in STIs Such as fear of abuse, losing partner, legal procedures, anonymity.
48
Side effects of antipsychotics
Extra pyramidal symptoms Weight gain Sedation Orthostatic hypotension Sexual dysfunction Hyperprolactemia

FM Exam (7 decks)

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