FEB 2019 YEAR III Flashcards
- 60/F, is readmitted for radical mastectomy after a biopsy of her breast mass shows malignancy. Upon admission, which set of laboratory parameters can be used for nutritional assessment?
A. Complete blood count, prothrombin time, transthyretin
B. Hemoglobin, TPAG, blood urea nitrogen
C. Serum pre-albumin, serum electrolytes, 24-hour urinary creatinine
D. Serum albumin, serum creatinine, total iron-binding capacity
D. Serum albumin, serum creatinine, total iron-binding capacity
- A 58-year old patient develops mesenteric ischemia, and post-operatively has remaining short bowel. After being lost to follow-up, and being noncompliant to dietary advice, he comes back complaining of loss of taste and smell. Which micronutrient should be supplemented?
A. Chromium
B. Magnesium
C. Selenium
D. Zinc
D. Zinc
- What drug may trigger a cutaneous eruption resembling lichen planus?
A. Thiazide diuretics
B. Metronidazole
C. Lithium
D. Phenytoin
A. Thiazide diuretics
- A 28/F, complains of pruritic hands. PE shows multiple small papules and vesicles in the thenar and hypothenar eminences, xerosis and fissuring along the fingers. What medication would you prescribe?
A. Glucocorticoid cream
B. Lidocaine gel
C. Neomycin ointment
D. Tacrolimus lotion
A. Glucocorticoid cream
- Which laboratory finding would suggest a serious adverse drug-induced cutaneous reaction?
A. Serum potassium – 3.0 mEq/L
B. WBC count in the CBC – 4,000 cells/cmm
C. BUN – 40mg/dL; Creatinine – 1.6 mg/dL
D. Serum calcium 11mg/dL
C. BUN – 40mg/dL; Creatinine – 1.6 mg/dL
- A 19/M, presents with fever and lower extremity rash. He also complains of abdominal and joint pains in the knees and ankles. He had cough and colds 1 week ago. PE shows circular, palpable purpura on both lower extremities and buttocks. What is your diagnosis?
A. Polyarteritis nodosa
B. Acute meningococcemia
C. Ecthyma gangrenosum
D. Henoch-Schonlein purpura
D. Henoch-Schonlein purpura
- What diagnostic test is performed by pressing a microscope side against a lesion and noting the amount of blanching that occurs?
A. KOH preparation
B. Tzank smear
C. Diascopy
D. Patch test
C. Diascopy
- A 25/M presents with sharply demarcated erythematous plaques with silvery, mica-like scales on the scalp. Fingernails are thickened with punctate pitting. What are the expected histologic findings?
A. Interface dermatitis
B. Acanthosis and vascular proliferation
C. Hyphae and neutrophils
D. Teardrop-shaped subepidermal blisters
B. Acanthosis and vascular proliferation
- A 45/M, presents with fever, jaundice and oliguria for 4 days after wading in flood water. A LeptoMAT was requested and the patient was started on Ceftriaxone 1g/IV Q24. However, after 2 days, the result of LeptoMAT was negative. What is the best management plan for the patient?
A. Request for Leptospira PCR or culture to confirm the diagnosis and just continue the antibiotic
B. Commit that this is not leptospirosis since the LeptoMAT is negative and work-up the patient for other causes of infection
C. Do aerobic cultures and shift to Piperacillin-tazobactam to broaden the coverage while waiting for the result
D. Request for a repeat LeptoMAT or convalescent-phase serum sample to document a four-fold rise in titer and just continue the antibiotic
D. Request for a repeat LeptoMAT or convalescent-phase serum sample to document a four-fold rise in titer and just continue the antibiotic
- What is the gold standard for the diagnosis of leptospirosis?
A. Culture and isolation
B. IgM ELISA
C. Microagglutionation test
D. PCR
A. Culture and isolation
