Form 1 Block 2 - Created July 19

Question 1

when to consider recurrent tinea pedis in patient with possible cellulitis

Answer 1

cellulitis part: red, edema, pain, (-) Doppler

tinea: scaling, fissuring btwn toes; yellow/thick nail

Question 2

type of infection common with saphenous venectomy

Answer 2

dermatophyte infection causing recurrent cellulits

Question 3

treatment of tinea pedis

Answer 3

terbinafine cream

Question 4

when to give oral isotretinoin for acne

Answer 4

severe nodulocystic acne or milder acne that is making scars or pt has failed less aggressive treatments

Question 5

what labs to monitor with isotretinoin

Answer 5

pregnancy, LFTs, lipids

Question 6

when to consider Crohn’s in pt that looks a bit like somatization disorder

Answer 6

pt had multiple UTIs and with GI bugs; fistula likely has formed

Question 7

anti-hypertensives to give if patient has angina pectoris or migraines

Answer 7

BB, CCB

Question 8

anti-hypertensives to give if patient has A. fib or A. flutter

Answer 8

BB, nonDHP CCB

Question 9

anti-hypertensives to give if patient has gout

Answer 9

losartan, another ARB, CCB; avoid diuretics!!!

Question 10

anti-hypertensives to give if patient has osteoporosis

Answer 10

thiazide (raises calcium)

Question 11

presentation of retroperitoneal hemorrhage

Answer 11

severe lower quadrant abd. pain or back pain; PE shows (+) psoas sign; get abdominal CT

Question 12

what to do if pt develops serious bleed and is on warfarin

Answer 12

stop warfarin, give 10 mg of vitamin K, give prothrombin complex concentrate (FFP)

Question 13

criteria for decision-making capacity

Answer 13

1. comprehension (medical condition and types of tx)
2. consequences (related to tx)
3. choice (clear/consistent)

Question 14

presentation of humoral hypercalcemia of malignancy

Answer 14

neuropsych sxs, nephrogenic DI, shortened QT

Question 15

how to detect C.diff

Answer 15

do PCR for toxin in stool

Question 16

common EKG finding with cardiac tamponade

Answer 16

electrical alternans

Question 17

why hypotension and syncope occurs with tamponade patient

Answer 17

pericardial fluid accumulates -> compressed right heart chambers -> decr. cardiac preload

Question 18

common presentation for multiple myeloma

Answer 18

normo/normo anemia, hyperCa, mild renal insuff, bone pain

Question 19

risks associated with varicocele

Answer 19

infertility and testicular atrophy

Question 20

newborn with cyanosis during feeds that improves with crying

Answer 20

try nasal catheter to assess choanal atresia

Question 21

what to do in pt with recurrent pleural effusions from cancer

Answer 21

chemical (talc) pleurodesis

Question 22

tx of lead intoxication

Answer 22

<44: observe; repeat in 1 mo.
45-69: DMSA
>70: dimercaprol and EDTA

Question 23

possible complication of long QT syndrome

Answer 23

torsades de pointes (form of polymorphic V. tach)

Question 24

possible causes of acquired long QT syndrome

Answer 24

hypoMg, hypoK, FQNs, antipsychotics

Question 25

what is used to screen for recurrence of previous treated prostate cancer

Answer 25

serial PSA

Question 26

what to do in patient with suspected or confirmed PCP who also have respiratory distress, tachypnea, and/or hypoxia

Answer 26

ABG analysis to determine need for steroids

Question 27

when to give steroids in PCP pt

Answer 27

partial pressure of Oxygen <70 mmHg or alveolar-arterial gradient >35 mmHg

Question 28

MC secondary solid tumor malignancies in patient with h/o Hodgkin

Answer 28

lung, breast, thyroid, bone, and GI

Question 29

when to prophylax against infective endocarditis with procedures

Answer 29

prior IE, replaced valves, bad valves, repaired CHD*, unrepaired cyanotic CHD

Question 30

single greatest RF for pancreatic cancer

Answer 30

cig smoking