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Internal Medicine > General Internal Medicine > Flashcards

General Internal Medicine Flashcards

1
Q

Tumor marker CA 19-9 is associated with which cancer?

A

Pancreatic cancer.

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2
Q

What cancer is associated with tumor marker CA 125?

A

Ovarian cancer.

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3
Q

What cancer is associated with HPV 16 and HPV 18?

A

Cervical cancer.

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4
Q

What trimester in pregnancy is ideal for air travel?

A

Second trimester.

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5
Q

What level is increased on bloodwork in a patient with folate deficiency?

A

Mean corpuscular volume (MCV).

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6
Q

What is the minimum timeframe that a patient must live in a tropical country before developing tropical sprue?

A

1 month.

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7
Q

What are 5 major medications that can cause folate deficiency?

A

Phenytoin, Trimethoprim, Metformin, Methotrexate and Sulfasalazine

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8
Q

Which vitamin is most likely to be deficient in a patient with celiac disease: B1, B2, C, or D?

A

Vitamin D.

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9
Q

In addition to fat-soluable vitamins, what else is not absorbed in patients with celiac disease?

A

Folic acid, Iron, Vitamin B12.

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10
Q

Positive antibodies to tissue transglutaminase suggests what diagnosis?

A

Celiac disease.

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11
Q

What type of antidepressant is imipramine?

A

Tricyclic antidepressant.

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12
Q

What is the first-line agent for major depression?

A

The first-line agent for major depression is a selective serotonin reuptake inhibitor (SSRI).

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13
Q

True or False: One of the most common side effects of selective serontonin reuptake inhibitors is sexual dysfunction including decreased libido

A

True.

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14
Q

What type of antidepressant is duloxetine?

A

Serotonin-norepinephrine reuptake inhibitor (SNRI)

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15
Q

After a patient falls, what is the strongest predictor of a fracture?

A

Presence or absence of osteoporosis.

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16
Q

At what age is osteoporosis screening initiated in women?

A

65 years.

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17
Q

In addition to age greater than 65 years, what are the risk factors for osteoporosis?

A

Chronic glucocorticoid use, previous fracture, low body weight (less than 127 lbs), cigarette smoking, excessive alcohol consumption, family history of hip fracture.

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18
Q

What are the 3 main effects of serotonin syndrome?

A

Neuromuscular excitation, Autonomic hyperactivity, and Altered mental status.

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19
Q

What is the most common diagnostic feature of serotonin toxicity?

A

Clonus (usually at the ankle)

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20
Q

Of the following 3 pain medications, which is most commonly implicated in the development of serotonin syndrome? Oxycodone, Tramadol, Hydrocodone/acetaminophen

A

Tramadol.

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21
Q

What is the likely diagnosis in individuals who restrict their caloric intake to a minimum because of the fear of gaining weight and losing their ideal body image?

A

Anorexia nervosa.

22
Q

What are the main signs and symptoms of anorexia nervosa?

A

Symptoms include dry skin, cold intolerance, and soft downy hair (also known as lanugo). Signs include hypothermia, hypotension and bradycardia.

23
Q

What is the preferred treatment for eating disorders?

A

Cognitive behavioral therapy. If necessary after trying psychotherapy, selective serotonin reuptake inhibitors (SSRIs) may be prescribed.

24
Q

At what age should cholesterol screening be initiated in males?

A

35 years of age.

25
Q

At what age is colorectal cancer screening initiated in patients without family history of colorecal cancer?

A

50 years.

26
Q

According to the latest guidelines by the USPSTF, when should Pap smears be initiated?

A

Age 21, regardless of sexual history

27
Q

What are the major reversible causes of dementia?

A

Hypothyroidism, Vitamin B12 deficiency, Depression, Polypharmacy, Normal pressure hydrocephalus, or infections like Syphilis, Lyme disease, Meningitis and Whipple’s disease

28
Q

What are the major degenerative causes of dementia?

A

Multi-infarct dementia, Dementia with Lewy bodies, Parkinson’s, Frontotemporal dementia (Pick’s disease) and Alzheimer’s dementia.

29
Q

How are reflexes affected in Subacute combined degeneration and Multi-infarct dementia?

A

Increased reflexes.

30
Q

Which type of anti-psychotic (atypical or typical) is preferred due to the reduced risk of tardive dyskinesia?

A

Atypical anti-psychotic

31
Q

What type of anti-psychotic (atypical or typical) are Haloperidol and Fluphenazine?

A

Typical anti-psychotic

32
Q

What are some examples of symptoms related to tardive dyskinesia?

A

Involuntary movements of the trunk and lower face including tongue rolling, lip smacking, facial grimacing, and repetitive chewing.

33
Q

Both postural and kinetic components are seen in which tremor?

A

Essential tremor.

34
Q

What is the typical frequency range of essential tremors?

A

7-10 Hertz

35
Q

What are the main treatments for essential tremors?

A

Propranolol, Primidone, Gabapentin, Alprazolam, or Topiramate

36
Q

What are the 3 main indications for prescribing prophylactic medication to patients experiencing migraine headaches?

A

Beta blockers, Calcium channel blockers, Riboflavin (Vitamin B2), Topiramate, Amitriptyline

37
Q

Which tricyclic antidepressant is typically used for prophylaxis against migraines?

A

Amitriptyline.

38
Q

What type of urinary incontinence occurs because of increased detrusor bladder activity?

A

Urge incontinence.

39
Q

What agents can be used in the treatment of urge incontinence?

A

Anti-cholinergic agents (e.g. oxybutynin, tolteridine, and imipramine)

40
Q

What do the 5 R’s represent in the motivational interviewing technique for smoking cessation counseling?

A

Relevance, Risk, Reward, Roadblock, Repetition

41
Q

HLA-2 allele presents to which CD marker?

A

HLA-2 allele presents to CD4 marker.

42
Q

HLA-1 allele presents to what CD marker?

A

HLA-1 allele presents to CD8 cell marker.

43
Q

(CD4 or CD8) is involved in cell mediated immunity.

A

CD4 is involved in cell mediated immunity

44
Q

What signs and symptoms are seen in patients using phencyclidine in low doses?

A

Loss of coordination, slurred speech and loss of balance.

45
Q

What signs and symptoms are seen in patients using phencyclidine in high doses?

A

Depersonalization–a sensation of “living a dream,” hallucinations and hostile or aggressive behavior.

46
Q

To what category of drugs does phencyclidine belong?

A

NMDA receptor antagonists.

47
Q

In overflow incontinence, is the detrusor activity increased, decreased, or the same as unaffected patients?

A

Detrusor activity is decreased.

48
Q

Which type of urinary incontinence is defined by increased detrusor (bladder muscle) activity?

A

Urge incontinence

49
Q

If behavioral therapy (e.g. frequent voiding, biofeedback) fails to control urge incontinence, what is the mainstay of pharmacological treatment?

A

Anti-cholinergics (e.g. oxybutinin or tolterodine)

50
Q

What type of urinary incontinence is due to increased intra-abdominal pressure overwhelming the urinary sphincter tone?

A

Stress incontinence.

Internal Medicine (7 decks)

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