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1
Q

What 2 conditions increase TBG

A

Increase estrogen, acute hepatitis

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2
Q

What 4 conditions decrease TBG?

A

Androgenic hormones, high-dose glucocorticoids, hypoprotenemia, CLD

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3
Q

Levothyroxyne dose with increased TBG

A

Needs to be increased

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4
Q

When to start pharm treatment for osteoporosis?

A

T-score

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5
Q

How to correct calcium for albumin?

A

Measured calcium + 0.8 x (4-albumin)

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6
Q

What value is used to monitor treatment of thyroid

A

Total T3 and T4 since TSH changes after

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7
Q

When to give VitK for supratherapeutic INR

A

low dose if 4.5-10 with increased risk of bleeding or high dose if >10 with no serious bleeding

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8
Q

Octreotide and sulfonylurea

A

In sulfonylurea poisoning, octreotide decreases insulin secretion by acting as somatostatin analog

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9
Q

Nelson’s syndrome

A

Adenoma seen in patients with high ACTH after removal of adrenals 2/2 Cushings

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10
Q

When to treat subclinical hypothyroid?

A

TSH>10, sympotmatic, + TPO

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11
Q

Side effect of B12 supplementation if severe anemia?

A

Hypokalemia within the first 48hours

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12
Q

Difference between Type 1 and MODY

A

MODY has strong family history and generally do not develop ketoacidosis

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13
Q

Treatments associated with pseudomotor cerebri

A

Isotretinoin and minocycline

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14
Q

Metabolic disarray associated with SCC of the lung

A

hypercalcemia (PTHrp)

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15
Q

Charact of MEN disorders

A

1) Hyperpara, pancreas, pituitary 2A) Med thyroid, pheo, parathyroid 2B)marfanoid, MTC, pheo

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16
Q

Differences in orders of dyphagia

A

Both at first = neuromuscular; first solid and then liquid= mechanical

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17
Q

Toxicity of anthracyclines

A

Dose-dependent decline in EF leading to dilated CM

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18
Q

Treatment of thyroid nodules

A

Surgery is preferred but need to be euthyroid before procedure

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19
Q

How to reverse warfarin immediately?

A

Prothrombin complex concentrate (vitamin K dependent clotting factors that reverses immediately) + Vitamin K (takes 12-24hours for effect)

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20
Q

First step after diagnosis of thyroid papillary cancer

A

US of neck and cervical lymph node for staging

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21
Q

Surgeries for papillary thyroid CA

A

<1cm= lobectomy; >1cm = total thyroidectomy

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22
Q

What rises first with iron supplementation

A

Reticulocyte count—> Hgb/Hct within 1month

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23
Q

First step in patients diagnosed with H&N cancer?

A

Chemo and radiation (usually advanced by time of dx)

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24
Q

What to biopsy if concern for metastasis?

A

A site of mets (mostly lymphnodes supraclavicular because they are easy to access)

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25
Q

Metabolic disarray in adrenal insuff

A

hyponatremia, hyperkalemia and hyperchloremic metabolic acidosis

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26
Q

EPO level in polycythemia vera

A

Low

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27
Q

When to start IVIg for Itp

A

If platelets <30 or mucosal bleeding noticed

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28
Q

Charact of CLL

A

Usually >70yo, lymphocytosis, can be asymptomatic

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29
Q

Bad prognosis in CLL

A

lymphadenopathy, hepatosplenomegaly and anemia/thrombocytopenia

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30
Q

PEF in mild and severe asthma exacerbation

A

mild-mod: 40-69%; severe <40%

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31
Q

When to start HIV meds after dx of meningitis?

A

2-10 weeks

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32
Q

How long to treat cryptococcal meningitis?

A

About 2 weeks w/ amphotericin and flucytosine, then 8 weeks of high-dose fluc and then 1 year maintenance with low-dose fluc

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33
Q

Centor criteria and treshold for test

A

1) tonsillar exudate 2) absence of cough 3) fever 4) tender anterior cervical LN (test if 3 or more)

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34
Q

Charact of epididymitis

A

Scrotl pain, swelling and tenderness, better with elevation

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35
Q

Non infectious fluids for HIV

A

Urine, feves, vomitus, tears

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36
Q

Post extubation stridor is sign of…

A

Laryngeal edema and should be re-intubated

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37
Q

Diagnosis of TB in patients with advance HIV usually require what?

A

pleural biopsy

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38
Q

Hydrophobia

A

Rabies

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39
Q

Who gets lung CT screning?

A

Patients 50-80 with >20pack-year hx and current smokers or quit <15 years ago

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40
Q

Treatment of Giardia

A

Tinidazole

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41
Q

Difference between entamoeba hystolitica and hydatid cysts

A

Echinococcus cysts usually take years to cause symptoms and usually don’t cause fevers if not ruptured

42
Q

Treatment of prostatitis

A

Bactrim or FQN for 6 weeks

43
Q

Most common cause of erythema multiforme?

A

HSV

44
Q

Charact of antifreese toxicity

A

severe AG metabolic acidosis, resulting in Kussmaul (rapid and deep breathing) respirations

45
Q

Treatment of antifreeze ingestions

A

Fomepizole

46
Q

When is elective repair of AAA recommended?

A

If large (>5.5cm) or rapidly enlarging (>0.5cm in 6m onths) or associated with PAAD or aneurysm

47
Q

Immune response in ABPA

A

Vigourous IgE and IgG response

48
Q

Main difference between cardiac contusion and flail chest?

A

Flail chest has tachypnea and vitals can be seen

49
Q

Normal nutrition diet?

A

30kcal/kg/day and 1g/kg/day

50
Q

Treatment of alopecia areata

A

Topical or intralesional corticosteroids

51
Q

Treatment of keloids

A

Intralesional glucocorticoids

52
Q

Bug that causes otitis-conjunctivitis syndrome

A

Nontypeable H. influenzae

53
Q

Calcification in pulmonary nodule that is still benign?

A

Popcorn calcification

54
Q

How long can OM effusions last in tympanic membrane?

A

3 months (NTD unless ongoing xs)

55
Q

Most common complication of transurethral resectionof prostate

A

Retrograde ejaculation

56
Q

When to take out coin if kid ingested it?

A

if >24hours or unknown timing. If <24hours can check Xrays in 12-24hours

57
Q

Modifiable risk factors for C. diff

A

Antibiotic use, PPI

58
Q

Diagnosis of Cdiff- associated diarrhea criteria

A

Watery diarrhea (>3 loose sttol in 24hrs) +/- abd pain, fever, leukocytosis AND positive stool testing

59
Q

Causes of low SAAG ascites <1.1

A

Peritoneal carcinomatosis, TB, nephrotic syndrome, pancreatitis, serositis

60
Q

Significant Cr increase after ACE is suggestive of…

A

Renal artery stenosis

61
Q

What is pylephlebitis?

A

Infective suppurative portal vein thrombosis that results as complication of intraabdominal infections

62
Q

S+S of celiac disease

A

Large volume, foul smelling stools, flatulences, weight loss, microcytic anemia

63
Q

Abdominal pain and B Syptoms in untreated celiac disease

A

Enteropathy -associated T-cell lymphome (EATL) (malignancy of proximal jejunum)

64
Q

Crystals in gout vs pseudogout

A

Pseudo positively birefringent, rhomboid crystals/ Gout: Negatively birefringent

65
Q

Treating gout in renal failure or transplant

A

Low-dose colchicine and systemic and intra-articular glucocorticoids

66
Q

Gastritis associated with pernicious anemia

A

Autoimmune metaplastic atrophic gastritis (AMAG)

67
Q

Endoscopy findings in AMAG

A

glandular atrophy (of body and fundus), intestinal metaplasia and inflammation

68
Q

Treatment of diarrhea after cholecystectomy

A

Bile salt-binding resins (ie. Cholestyramine)

69
Q

What other sign is usually associated with Boerhaave?

A

Left sided pleural effusion

70
Q

Complication of compartment syndrome

A

Rhabdo and acute kidney failure from myoglobin

71
Q

IgA nephropathy presentation

A

Hematuria within days of URI, renal insufficiency, HTN

72
Q

Indications for ureteral stone removal

A

> 10, persistent pain, acute renal failure, UTI

73
Q

GERD complication that causes dysphagia with solids

A

Peptic stricture

74
Q

When do you need larger sample sizes?

A

With increased power or when diffferences between 2 groups are small

75
Q

Appropiate estimate of effect in RCTs when many subjects are loss to f/u?

A

Intention to treat analysis

76
Q

Equation for NPV

A

True negative/ (True negatives + False negativees)

77
Q

Equation of Relative Risk

A

Risk of outcome in exposed grou/ risk in nonexposed group

78
Q

What is a ROC curve

A

Receiver-operating charaacteristic curve plots

79
Q

Best AUC in a ROC curve

A

1= 100% on both; 0.5= 50/50

80
Q

Incidence ratio equation

A

IR= (#new cases during a period)/(total of person-times contributed by at-risk population

81
Q

When to use odds ratio

A

Association in case-control and cross-sectional studies

82
Q

What helps rul eOUT a diagnosis

A

High sensitive tests (SnOUT)

83
Q

Positive likelihood ratio equation

A

Postive LR= sensitivity/ 1- specificity

84
Q

Negative LR equation

A

Negative LR= 1-sensitivity/specificity

85
Q

When are conficence intervals statistically significant?

A

When they dod not overlap

86
Q

Type I error

A

Rejecting null hypothesis when the null hypothesis is true

87
Q

Factorial study design

A

Uses > than 2 interventions and all combinations of these interventions

88
Q

Crossover study

A

Sequential exposure to different treatment arms

89
Q

Nested study

A

Retrospective observational study in which subsets of cnotrols are matches to cases

90
Q

Odd ratio equation

A

Odd of exposed/odds of non exposed or ad/bc

91
Q

Equation of NNH

A

NNH= 1/ARI (Abs risk increase); ARI= Risk of disease among exposed - risk of disease amon non-exposed

92
Q

Equation for NNT

A

NNT= 1/ ARR (ARR= risk of disease in non exposed - risk in exposed)

93
Q

What is a net clinical benefit (NCB)

A

Benefits - harm

94
Q

Why are ITT analyses done?

A

To preserve randomization and analyze groups based on orignical randomized groups

95
Q

Common cause of recurrent cases of cellulitis

A

Tinea pedis, need to treat with antifungal

96
Q

Charact of varicocele?

A

Soft scrotal mass that hides with supine position

97
Q

Treatment of varicocele

A

Supportive if no sxs, gonadal vein ligation vs scrotal suport and NSAIDs (if older and no more children)

98
Q

Single highest risk factor for pancreatic cancer

A

Smoking

99
Q

Who gets ICD placement for primary prevention?

A

Prior MI and LVEF of <30, NYHA class II or III sxs and LVEF <35%

100
Q

Shigella vs EHEC presentation

A

Shigella usually with fever and through contaminated water; EHEC: exposure to animals

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