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Internal Medicine > General Internal Medicine > Flashcards

General Internal Medicine Flashcards

1
Q

Diagnostic physical exam finding for sacroiliac joint dysfunction

A

Pain with hip flexion, abduction, external rotation (FABER)

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2
Q

Most appropriate treatment for smoking cessation in hospitalized patients with ACS

A

Varenicline or combination nicotine replacement therapy

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3
Q

Vertigo that is suggested with abnormal result on any one of the three HINTS (Head Impulse, Nystagmus, and Test of Skew)

A

Central vertigo

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4
Q

Most common adverse effects of second generation antipsychotic agents

A

Weight gain and Hyperlipidemia

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5
Q

Pain with flexion and extension of knee while examiner’s thumb lies over the lateral femoral condyle

A

Iliotibial band syndrome

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6
Q

First line therapy for premenstrual dysphoric disorder

A

Second generation anti-depressant (i.e. SSRI)

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7
Q

Positive Likelihood ratio
2
5
10

A

Sensitivity/(1-specificity)

Increases probability of disease
15%
30%
45%

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8
Q

Negative Likelihood ratio

  1. 5
  2. 2
  3. 1
A

(1-sensitivity)/Specificity

Decrease the probability of disease
15%
30%
45%

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9
Q

Absolute risk

A

Patients with event in group / total patients in group

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10
Q

Relative risk

A

The ratio of the probability of developing a disease with a risk factor present to the probability of developing the disease without the risk factor present

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11
Q

Contraindication for nicotine

A

Recent MI, arrhythmia, unstable angina

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12
Q

Contraindication for bupropion

A

Seizure disorder and eating disorder

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13
Q

Contraindication to naltrexone

A

Patients receiving Or withdrawing from any opioid and in those with liver failure or hepatitis

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14
Q

Contraindication to acamprosate

A

Kidney disease

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15
Q

Adverse effect of disulfiram

A

Flushing, headache, emesis

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16
Q

Major risk factors for opioid overdose

A

1) receiving more than 50 morphine mg Eq/day

2)  Receiving opioids and benzodiazepines concurrently

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17
Q

Most effective long-term treatment for patellofemoral pain syndrome

A

Physical therapy

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18
Q

Unexplained fatigue lasting > 6 consecutive months that impairs the ability to perform desired activities, post exertional malaise, unrefreshing sleep, and either cognitive impairment or orthostatic intolerance (symptoms wors in upright position)

A

Systemic exertion intolerance disease

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19
Q

Appropriate management for chronic insomnia refractory to cognitive behavioral therapy for insomnia or who declined to participate in CPT – I.

A

Low-dose doxepin or non-benzodiazepine benzodiazepine receptor agonist (i.e. zolpidem, zaleplon, eszopiclone)

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20
Q

Primary treatment for chronic venous insufficiency

A

Compression therapy

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21
Q

Order of management In patients with chronic cough and negative findings on chest radiography after discontinuation of ACE therapy and tobacco

A

1) empiric treatment for upper airway cough syndrome
2) spirometry or empiric treatment for asthma
3) Sputum analysis for eosinophils or empiric treatment with inhaled glucocorticoids
4) Empiric treatment for GERD

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22
Q

deep anterolateral shoulder pain That worsens with abduction and external rotation. Pain is also often caused by repetitive overhead stress

A

Superior labrum anterior and posterior lesion

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23
Q

Vertigo with Vertical, horizontal, or torsional nystagmus

A

Central disease

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24
Q

Primary treatment for benign paroxysmal positional vertigo

A

Epley maneuver

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25
Q

First line therapy for insomnia

A

CBT

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26
Q

Positive Spurling test

A

Cervical radiculopathy

27
Q

Pain occurs between 60 and 120° during passive abduction of the arm

A

Rotator cuff tendinopathy

28
Q

First line therapy for urge incontinence

A

Bladder training with timed voiding

29
Q

Red flags of cauda equina syndrome

A

1) Urinary retention or incontinence
2) Diminished perineal sensation
3) Bilateral motor deficits

30
Q

Radiating back pain and lower of extremity numbness that is exacerbated by walking and spinal extension but improved by sitting and leading forward. A wide base gait and/or abnormal Romberg tests are highly specific

A

Spinal stenosis

31
Q

Most common cause of knee pain and patience <45 years, especially women

A

Patellofemoral pain syndrome

32
Q

Knee pain that is worse with activity and at night

A

Anserine bursitis

33
Q

Indications for ankle x-ray following ankle trauma

A

1) inability to bear weight

2) Bone pain localized to the lateral or medial malleolus, base of a 5th metatarsal, navicular bone

34
Q

Indications for carpal tunnel release surgery

A

1) severe carpal tunnel syndrome (Muscle weakness or EMG evidence of nerve injury)

35
Q

ACC/AHA indications for Recommending Statin therapy to reduce risk of ASCVD

A

1) clinical ASCVD
2) LDL > 190
3) DM aged 40-75 years w/ LDL 70-189 + no clinical ASCVD
4) without clinical ASCVD or DM and LDL 70-189 + 10-year ASCVD > 7.5%

36
Q

Initial management for gout in patients of Asian dissent

A

Genetic testing for the HLA-B *58:01 haplotype

37
Q

Sudden onset, severe, persistent vertigo and hearing loss following viral inflammation

Management

A

Labyrinthitis

Prednisone

38
Q

First line treatment for genitourinary syndrome of menopause

A

Daily vaginal moisturizer and vaginal lubricants

39
Q

First line therapy for lower urinary tract symptoms secondary to BPH

A

Tamsulosin

40
Q

Topical broad-spectrum antibiotic for bacterial conjunctivitis in patients who wear contact lenses

A

Ofloxacin

41
Q

Tender prostate + positive urine culture

Empiric antibiotic coverage

A

Acute prostatitis

Bactrim or fluoroquinolone for 4 to 6 weeks

42
Q

USPSTF recommended breast cancer screening

A

Biennial screening mammography Beginning at age 50 years for average risk women

43
Q

USPSTF recommended cervical cancer screening

A

Every 3 years with cytology (pap test) for women aged 21 to 65 years

Can increase to every 5 years in women aged 30 to 65 years by either performing high-risk HPV testing or combining cytology and high-risk HPV testing

44
Q

USPSTF recommended lung cancer screening

A

Annual low-dose CT chest for persons aged 50 to 80 years with at least a 20 pack year smoking history who are still smoking or who quit within the past 15 years

45
Q

Dystrophic nails with yellow- red (oil stain) discoloration, pitting, and distal onycholysis. Commonly affecting the fingernails more than toenails

A

Nail psoriasis

46
Q

Management for primary dysmenorrhea

A

Supportive care

47
Q

 First line therapy for endometriosis

A

NSAIDs

48
Q

Thin white discharge with fishy odor but without irritation or pain

A

Bacterial vaginosis

49
Q

External and internal erythema with itching and irritation. Non-odorous white caurd-like to charge

A

Candidiasis

50
Q

Frothy, yellow discharge. Erythema of the vagina and cervix “strawberry cervix”

A

Trichomoniasis

51
Q

T cell mediated disease classically presenting with pruritic purple papules that are often flat topped and characteristically erupt on the low back, volar wrists, elbows, knees, ankles

A

Lichen planus

52
Q

Urticarial lesions that last >24 hours that burn and sting rather than itch; wheals that resolve with hyperpigmentation; and associated symptoms, such as fever and joint pain

A

Urticaria vasculitis

53
Q

Painless vision loss, unilateral flashing lights, floaters, visual field defect

A

Retinal detachment

54
Q

Afferent pupillary defect and cherry red fovea that is accentuated by a pale retinal background

A

Central retinal artery occlusion

55
Q

Facial nerve paralysis, sensorineural hearing loss, and vesicular lesion on and in the ear canal; often caused by a varicella zoster virus infection

A

Ramsay hunt syndrome

56
Q

Appropriate preoperative warfarin management

A

Withhold 5 days prior to surgery. Restart 12 hours after surgery

57
Q

Management nonbullous impetigo

A

Topical mupirocin or retapamulin

58
Q

Hyperpigmentation disorder that occurs mostly on the sun exposed areas on the face. Most commonly affects women of childbearing age

A

Melasma

59
Q

First therapy for stress incontinence

A

Pelvic floor muscle training for women (kegel exercises)

60
Q

First line therapy for overflow incontinence

A

Time urination

61
Q

Appropriate time of delay for elective surgery after a prior stroke

A

6 to 9 months

62
Q

Appropriate empiric antibiotic treatment for acute bacterial prostatitis

A

Oral Bactrim or an oral fluoroquinolone

63
Q

Appropriate diagnostic evaluation for a androgen deficiency

A

2 separate early morning (8 am) serum total testosterone levels < 300 combined with suggestive symptoms and/or signs

Internal Medicine (12 decks)

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