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2020 ABIM studying > GIM > Flashcards

GIM Flashcards

1
Q

Unilateral then bilateral Purulent discharge without pain or visual disturbance. Dx?

A

Bacterial conjunctivitis

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2
Q

Conjunctivitis associated with rash involving ophtho division of fifth cranial n, Dx?

A

Herpes zoster conjunctivitis

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3
Q

Acute hyperpurulent ocular discharge in a sexually active adult. Dx?

A

Neisseria gonorrhea conjunctivitis

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4
Q

Unilateral then bilateral conjunctivitis with Daytime watery or mucoid discharge. Dx?

A

Viral conjunctivitis

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5
Q

Itching and tearing of the eyes, nasal congestion. Dx?

A

Allergic conjunctivitis

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6
Q

Anaphylaxis reaction is an example of which type of hypersensitivity reaction?

A

Type 1 hypersensitivity reaction

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7
Q

Back pain that improves with leaning forward is the classic presentation of what musculoskeletal condition?

A

Spinal stenosis

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8
Q

Before starting a patient on TNF-alpha inhibitors, what test should be performed?

A

Purified protein derivative(PPD) tuberculin skin test

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9
Q

Best next step after pt has tried NSAIDs /OCPs for primary dysmenorrhea but symptoms persist >3 months?

A

Ultrasound to rule out uterine abnormalities like fibroids

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10
Q

Name the supplement: Sleep aid also used for stress/anxiety relief. If combined withEtOH, can oversedate.

A

Kava

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11
Q

Finasteride, used to assist patients with benign prostatic hyperplasia, acts on which enzyme to inhibit conversion of testosterone to dihydrotestosterone?

A

5 alpha reductase

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12
Q

Excessive ingestion of licorice can lead to which electrolyte abnormality?

A

Hypokalemia

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13
Q

Name the supplement: Used against dementia. Can increase the risk of bleeding.

A

Ginkgo Biloba

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14
Q

Name the supplement: Used for benign prostatic hyperplasia. Can cause headaches and/or abdominal pain/nausea.

A

Saw Palmetto

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15
Q

Name the supplement: Used as an anti-depressant. Can potentially induce cytochrome P450 drug metabolism.

A

St. John’s Wort

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16
Q

Name the supplement: Used against the common cold. Can cause nausea, rash and itchiness.

A

Echinacea

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17
Q

Name three conditions that are very often associated with hypogammaglobulinemia

A

CLL, nephrotic syndrome, bronchiectasis

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18
Q

On fundoscopic examination, which condition is associated with cherry red spots on the macula?

A

Retinal artery occlusion

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19
Q

1-3% with 1 long bone fracture 33% with bilateral femur fractures - acute neurological abnormalities, hypoxemia and petechial rash. Dx?

A

Fat Embolism Syndrome

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20
Q

On a DEXA scan, what T score will indicate osteoporosis?

A

T score of less than -2.5

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21
Q

Digestion of which toxin from reef fish can cause for peri-oral paresthesias to occur?

A

Ciguatera toxin (found in barracuda, grouper, red snapper, moray eel, sea bass)

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22
Q

Loss of passive flexion of the foot when the calf is squeezed with achilles tendon tears is known as what test?

A

Positive Thompson test

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23
Q

During exercise, what is the formula used to determine the maximum heart rate an individual should achieve?

A

(220 - age in years) X 85%

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24
Q

Rapid fire txt: Bipolar disorder

A

Mood stabilizers (eg, lithium, valproic acid, carbamazepine), atypical antipsychotics

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25
Q

Rapid fire txt: Anorexia

A

Nutrition, psychotherapy, antidepressants not helpful (?olanzapine)

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26
Q

Rapid fire txt: Alcohol withdrawal

A

Long-acting benzodiazepines

chlordiazepoxide, clonazepam, Diazepam

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27
Q

Rapid fire txt: Alcoholism

A

Disulfiram, acamprosate, naltrexone, supportive care

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28
Q

Rapid fire txt: Bulimia nervosa

A

CBT, SSRIs

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29
Q

Rapid fire txt: ADHD

A

Methylphenidate, CBT, atomoxetine, guanfacine, clonidine

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30
Q

Rapid fire txt: Depression

A

SSRIs or CBT

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31
Q

What are the possible agents for treating hypertension in pregnant women?

A

Hydralazine, Labetalol, Alpha Methyldopa

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32
Q

Rapid fire txt: Benign prostatic hyperplasia

A

α1-antagonists, 5α-reductase inhibitors, PDE-5 inhibitors

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33
Q

HLA-DR4assoc w/?

A

Diabetes mellitus type 1, rheumatoid arthritis, Addison disease

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34
Q

Rapid fire txt: Ethylene glycol/methanol intoxication

A

Fomepizole (alcohol dehydrogenase inhibitor)

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35
Q

Rapid fire txt: Drug of choice for anticoagulation during pregnancy

A

1st trimester: warfarin if <5mg, LMWH, UFH 2nd trimester: warfarin

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36
Q

Rapid fire assoc: Mammary gland (“blue domed”) cyst

A

Fibrocystic change of the breast

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37
Q

Rapid fire txt: Buerger disease

A

Smoking cessation

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38
Q

HLA-B27 assoc w/? 4 things

A

Psoriatic arthritis, ankylosing spondylitis, IBD-associated arthritis, reactive arthritis (formerly Reiter syndrome)

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39
Q

HLA-DR3assoc w/?

A

Diabetes mellitus type 1, SLE, Graves disease, Hashimoto thyroiditis, Addison disease

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40
Q

Rapid fire assoc:”Thumb sign” on lateral neck x-ray

A

Epiglottitis (Haemophilus influenzae) Medical emergency

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41
Q

What are the two most common nerve root impingements in lower back pain?

A

L5 and S1

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42
Q

What blood test is the initial screening test for suspected systemic mastocytosis?

A

Serum tryptase level

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43
Q

What environmental exposure can lead to acute vitamin B12 deficiency?

A

Nitrous oxide (Nitrous oxide inactivates vitamin B12.)

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44
Q

What is the enzyme that converts testosterone to estradiol?

A

Aromatase

45
Q

What class of anti-depressants can be used for patients who are suffering from urge incontinence?

A

TCAs (Tricyclic anti-depressants)

46
Q

What is the anti-depressant category of choice in patients with bulimia?

A

SSRIs

47
Q

What is the fundoscopic exam finding often seen with idiopathic intracranial hypertension (Pseudotumor cerebri)?

A

Papilledema

48
Q

Which vitamin toxicity may lead to idiopathic intracranial hypertension(Pseudotumor cerebri)?

A

Vitamin A

49
Q

Which vitamin is used to enhance iron absorption?

A

Vitamin C (Ascorbic acid)

50
Q

Which pain medication should be avoided in patients who are taking SSRIs for depression?

A

Tramadol (concurrent use of SSRI with tramadol can cause serotonin syndrome)

51
Q

Situs inversus, chronic sinusitis, bronchiectasis, infertility

A

Kartagener syndrome (dynein arm defect affecting cilia)

52
Q

Telangiectasias, recurrent epistaxis, skin discoloration, arteriovenous malformations, GI bleeding, hematuria

A

Osler-Weber-Rendu syndrome

53
Q

Which knee test can indicate that patient has a lateral collateral ligament tear?

A

Positive varus test

54
Q

Swollen gums, mucosal bleeding, poor wound healing, petechiae

A

Scurvy (vitamin C deficiency: can’t hydroxylate proline/lysine for collagen synthesis)

55
Q

Which statin is the drug of choice in HIV patients?

A

Pravastatin

56
Q

Rapid fire assoc: “Chocolate cyst” of ovary

A

Endometriosis (frequently involves both ovaries)

57
Q

What is the most common presenting symptom of an individual with acute altitude sickness?

A

Headaches

58
Q

What is the laboratory screening test for chronic alcohol abuse?

A

Carbohydrate free transferrin level elevated

59
Q

What is the most common symptom of Hereditary Hemorrhagic Telangiectasia(HHT)?

A

Epistaxis (nose bleeding)

60
Q

What is the most commonly used agent in the treatment of Familial Mediterranean Fever?

A

Colchicine

61
Q

What is the main anti-depressant to be avoided in patients with seizure disorder?

A

Bupropion

62
Q

Slow, progressive muscle weakness in boys

A

Becker muscular dystrophy (X-linked missense mutation in dystrophin; less severe than Duchenne)

63
Q

Streak ovaries, congenital heart disease, horseshoe kidney, cystic hygroma at birth, short stature, webbed neck, lymphedema

A

Turner syndrome (45,XO)

64
Q

Dermatitis, dementia, diarrhea

A

Pellagra (niacin [vitamin B3] deficiency)

65
Q

Dilated cardiomyopathy, edema, alcoholism, or malnutrition

A

Wet beriberi (thiamine B1] deficiency)

66
Q

Enlarged, hard left supraclavicular node

A

Virchow node (abdominal metastasis)

67
Q

Episodic vertigo, tinnitus, hearing loss

A

Meniere disease

68
Q

Unilateral deep regular pain, nausea, vomiting, fixed non-reactive pupil, Shallow anterior chamber

A

Acute angle closure glaucoma

69
Q

Severe ocular pain that worsens with eye Movement and light exposure; A raised hyperemic lesion that may be localized or diffuse and obscures the underlying vasculature

A

Scleritis

70
Q

Red eye with scales and crusts around the eyelashes or dandruff like skin changes and greasy scales around the eyelashes

A

Blepharitis

71
Q

Non-painful red, flat, superficial lesion that allows visualization of the underlying vasculature

A

Episcleritis

72
Q

Facial muscle spasm upon tapping

A

Chvostek sign (hypocalcemia)

73
Q

Bluish line on gingiva

A

Burton line (lead poisoning)

74
Q

Bone pain, bone enlargement, arthritis

A

Paget disease of bone (increased osteoblastic and osteoclastic activity)

75
Q

What vitamin deficiency can occur with use of Isoniazid (INH)?

A

Vitamin B6 (Pyridoxine)

76
Q

What vitamin or mineral deficiency is associated with rash and alopecia in patients on TPN feeding?

A

Zinc deficiency

77
Q

What is the most likely diagnosis in diabetic pt with diarrhea, weight loss, flatulence and vitamin A, D, B12 deficiencies?

A

Small intestinal bacterial overgrowth

78
Q

What will be the folate and vitamin B12 Levels in patients with Caribbean tropical sprue?

A

Normal folate, decreased vitamin b12 levels

79
Q

What are the five major medications that can cause folate deficiency?

A

Phenytoin, MTX, tmp, sulfasalazine, metformin

80
Q

Aspirin exacerbated respiratory disease (triad asthma or samter syndrome) TX?

A

Aspirin desensitization

81
Q

Chronic non-allergic rhinitis (vasomotor rhinitis) tx?

A

Intranasal glucocorticoids, intranasal antihistamines, topical ipratropium bromide

82
Q

Absolute risk (event rate) equation?

A

Patients with event in group/Total patients in Group

83
Q

Relative risk equation?

A

Experimental event rate/ Control event rate

84
Q

Absolute risk reduction equation?

A

|ERR-CER|

85
Q

Relative risk reduction equation?

A

|ERR-CER|/CER

86
Q

NNT or NNH equation?

A

1/ARR

87
Q

Pos Likelihood ratio equation?

A

Sensitivity/(1-specificity)

88
Q

Neg Likelihood ratio equation?

A

(1-sensitivity)/specificity

89
Q

Pos likelihood ratio of 2,5,10 increase probability of dz by?

A

15, 30, 45%

90
Q

Neg likelihood ratio of 0.5, 0.2, 1 decrease probability of dz by?

A

15, 30, 45%

91
Q

Nasal polyposis, asthma, eosinophilia, mononeuritis, petechial skin lesions

A

Eosinophilic granulomatosis with polyangiitis

92
Q

Systemic illness with saddle nose deformity, nasal ulceration, chronic sinusitis

A

Granulomatosis with polyangiitis

93
Q

Young person, nasal polyposis, chronic sinusitis, malnourishment, infertility, recurrent bronchitis

A

Cystic fibrosis

94
Q

Non-seasonal rhinitis with negative skin test. Dx?

A

Chronic non-allergic rhinitis (vasomotor rhinitis)

95
Q

Refractory congestion after chronic use of topical nasal decongestants

A

Rhinitis medicamentosa

96
Q

Nasal congestion in the last six or more weeks of pregnancy

A

Pregnancy rhinitis

97
Q

Rhinitis, nasal polyps, asthma, aspirin intolerance

A

Aspirin exacerbated respiratory disease (triad asthma or samter syndrome)

98
Q

Pain, photophobia, inflammation Confined to corneal limbus, corneal irregularity, pupillary irregularity

A

Keratitis or iridocyclitis (iritis, anterior uveitis)

99
Q

transient Impairment in anterograde memory. Self awareness, motor, And social skills are preserved

A

Transient global amnesia

100
Q

Urinary urgency and Increasing pelvic pain and pressure relief with voiding in women is due to what diagnosis? Usually patients have fibromyalgia

A

Interstitial cystitis

101
Q

What are three treatments for Interstitial cystitis? (Treatment is not curative and typically focuses on improving quality of life and avoidance of triggers)

A

Amitriptyline (use limited due to side effects), pentosan Polysulfate sodium, bladder instillation

102
Q

In patients with multiple sclerosis, eye pain w/central vision loss suggest what diagnosis? What is the treatment?

A

Optic neuritis, methylprednisolone (oral prednisone leads to higher rate of recurrence)

103
Q

What 4 main drugs interfere with folic acid metabolism?

A

Methotrexate, phenytoin, pyrimethamine, trimethoprim

104
Q

What are 1st line treatments for alcohol use disorder?

A

Naltrexone and acamprosate

105
Q

What are the 2 main contraindications for naltrexone?

A

Patients currently taking opioids and acute hepatitis or liver failure

106
Q

what serum lithium levels are indications for dialysis.

A

> 4 or >2.5 with significant lithium toxicity (seizures, depressed mental status)

107
Q

Symptomatic vertebral compression fractures are managed how acutely? And if this fails, what’s another option for txt?

A

NSAIDs, acetaminophen, opioids. Intranasal calcitonin if the others don’t work

108
Q

What is the triad of serotonin syndrome?

A

Mental status change, autonomic hyperactivity (hyperreflexia), neuromuscular abnormalities. (Clonus)

109
Q

What are the findings in neuroleptic malignant syndrome?

A

Very high fever typically greater than 104ﾟ, delirium, lead pipe rigidity, autonomic instability

2020 ABIM studying (12 decks)

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