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Clin Med 1 > Final - Student/Jeopardy Questions > Flashcards

Final - Student/Jeopardy Questions Flashcards

1
Q

which dizziness condition usually presents after a URI

A

labyrinthitis

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2
Q

A 75 yo is depressed and not gaining wt. What would your first choice med be?

A

Remeron (Mirtazapene)

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3
Q

difference btw HFrEF and HFpEF

A

less than or equal to 50% ejection fraction

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4
Q

what two medications improve morbidity and mortality in HFrEF

A

ACEI
beta blockers

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5
Q

med for pt w. LVEF less than or equal to 40% who can’t tolerate ACEI and ARBS

A

hydralazine and nitrate

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6
Q

Eliquis reversal agent

A

Andexanet alfa (Andexxa)

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7
Q

symptoms associated w. UMN lesion

A
  1. spasticity
  2. slow RAM
  3. hyperreflexia
  4. stiffness
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8
Q

which med prolongs ALS life expectancy

A

Rilutek (Riluzole)

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9
Q

Pseudobulbar affect in ALS

A
  1. inappropriate emotional response
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10
Q

CHADS

A
  1. CHF
  2. HTN
  3. age >75
  4. DM
  5. previous stroke/TIA (2 pt)

2 or higher = anticoagulate

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11
Q

what drug is best for rhythm control in afib

A

Amiodarone

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12
Q

which tremor is improved w. moderate etoh

A

benign essential

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13
Q

most effective drug in symptomatic Parkinson’s

A

Sinemet (Carbidopa/Levodopa)

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14
Q

tx for benign essential tremor

A

Propranolol

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15
Q

posterior pituitary hormones (2)

A
  1. oxytocin
  2. vasopressin
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16
Q

ABI diagnostic of PAD

A

<0.9

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17
Q

most common pituitary screening hormone

A

prolactin

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18
Q

tx for Alzheimer’s

A

Aricept

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19
Q

first line maintenance therapy for vasospastic angina

A

CCB

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20
Q

EKG for vasospastic angina during episode

A

ST elevations

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21
Q

statin benefit groups

A
  1. ASCVD
  2. LDL>190
  3. 40-75 yo w. DM
  4. 10 year risk for ASCVD 7.5% or higher
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22
Q

first line alternative med for pt who do not tolerate statins (or used as adjunctive to statins)

A

Ezitimibe

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23
Q

which type of nystagmus is the most concerning why?

A

vertigal; CNS

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24
Q

which anticoagulant do you prescribe to a pt w. a mechanical valve

A

Warfarin (Coumadin)

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25
Q

which lab is continuously monitored for pt on Warfarin

A

INR

26
Q

nl INR

A

2.0-3.0

27
Q

nl INR for mechanical heart valve

A

2.5-3.5

28
Q

tx for Afib pt with scheduled cardioversion

A

anticoags 30 days before AND after cardioversion

29
Q

test for myasthenia gravis that improves symptoms

A

ice pack

30
Q

single most sensitive test for MG

A

single fiber electromyography

31
Q

differentiating factor between MG and botulism

A
  1. descending paralysis in botulism
  2. fatigabillity in MG
32
Q

1st test to order if GH excess is suspected

A

IFG-1

33
Q

most common cause of acromegaly

A

benign pituitary adenoma

34
Q

manifestations of acromegaly

A

enlargement of hands, feet, jaw, internal organs
HTN; DM2; CHF
cardiomegaly, macroglossia
deep voice
OSA; spinal stenosis; arthralgias; wt gain; hypogonadism
decreased libido; ED; irregular menses; temporal hemianopsia
HA; thick skin; hyperhidrosis; acne; skin tags; colon polyps

35
Q

gold standard lab test for confirming acromegaly

A

1 hour glucose tolerance test → should stop GH from being released

36
Q

fxns of GH

A

increase calcium retention

increase muscle mass

stimulate growth of all internal organs except brain

decrease liver uptake of glucose

promote lipolysis

promote gluconeogenesis

maintain homeostasis

maintain fxn of pancreatic islets

increase protein synthesis

37
Q

layers of the adrenal gland

A

zona glomerulosa → mineralocorticoids

zona fasiculata → glucocorticoids

zona reticularis → sex hormones

38
Q

mineralocorticoid examples

A

steroid hormones that regulate salt and water → aldosterone

39
Q

glucocorticoid examples

A

fight inflammation → cortisol; cortisone; dexamethasone; hydrocortisone; prednisone; methylprednisone

40
Q

examples of sex hormones released by adrenal gland

A

androgens

estrogens

41
Q

MEN 1 tumors affect

A

parathyroid

anterior pituitary

pancreas

PAP

42
Q

pheochromocytoma triad

A

HA

sweating

tachycardia

43
Q

2 tests if you suspect pheochromocytoma

A

24 hr urine fractionated metanephrines and catecholamines

plasma fractionated metanephrines

44
Q

first line tx for a pt w. bilateral adrenal hyperplasia causing hyperaldosteronism if surgery is not an option

A

spironolactone (Aldactone)

45
Q

main lab abnormality in hypoaldosteronism

A

hyperkalemia

46
Q

3 fxns of aldosterone

A

water resorption

Na+ resorption

increased bp

K+ secretion

H+ secretion

47
Q

adrenal adenoma that causes hyperaldosteronism

A

Conn’s syndrome

48
Q

3 clinical findings i pt w. hyperaldosteronism

A

hypokalemia

hypernatremia

metabolic alkalosis

difficult to control HTN

49
Q

elevated PAC and elevated PRA = what type of hyperaldosteronism

A

secondary → kidney’s secretion of renin is stimulating aldosterone → negative feedback is not working on kidney to stop PRA secretion

50
Q

factors that can trigger renin secretion

A

CHF

cirrhosis

volume depletion

51
Q

main hormone underproduced in adrenal insufficiency

A

cortisol

52
Q

pathology of tertiary adrenal insufficiency

A

lack of CRH from hypothalamus

53
Q

tx for sick pt who has adrenal insufficiency

A

high dose steroids

54
Q

2 features seen in primary but not secondary or tertiary adrenal insufficiency

A

hyperpigmentation

hyperkalemia

dehydration

GI symptoms

55
Q

what meds should you give to pt w. primary adrenal insufficiency on a daily basis

A

corticosteroids:

florinef

hydrocortisone or prednisone

+/- DHEA

56
Q

where is Cushing’s dz localized

A

pituitary → tumor oversecreting ACTH

57
Q

clinical manifestations of Cushing’s

A

hyperglycemia

hyperpigmentation

moon facies

buffalo hump

fungal infxns

acanthosis nigricans

58
Q

tx for cushing’s dz

A

transphenoidal resection

59
Q

most common cause of ACTH-producing tumor

A

small cell lung cancer

60
Q

3 first line tests to show increased cortisol

A

dexamethasone suppression

late night salivary cortisol

24 hr urinary free cortisol excretion

Clin Med 1 (6 decks)

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