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Residency > Internal Medicine > Flashcards

Internal Medicine Flashcards

1
Q

Test to evaluate for hypoxia with air travel in COPD patients

A

Hypoxia altitude simulation test

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2
Q

Preoperative test for patients with RA undergoing GETA

A

Flex-ex films of the c-spine to eval for atlantoaxial subluxation or instability. Missing this can cause spinal cord injury during intubation

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3
Q

What is the ideal anti-epileptic drug in an Asian male?

A

Keppra. The other seizure meds (carbamazepine, lamotrigine, oxcarbazepine, and phenytoin) put a patient with potential HLA-B1502 mutation (which asian males are at risk for) at risk for Stevens-Johnson

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4
Q

Breakpoint for observation vs chemotherapy in ovarian cancer

A

Stage IC through IV should get chemotherapy. IA for instance, can get observation only

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5
Q

Test of choice for H pylori in a patient with recent GI bleeding

A

H pylori serology. Other tests (rapid urease, histology and culture) are inaccurate if recent bleeding.

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6
Q

Test of choice for a patient with intermediate risk of ACS with a normal EKG

A

Exercise stress

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7
Q

Treatment of choice for hot flashes in women over 60 who experienced menopause at the median age

A

SNRI such as venlafaxine. Second line would be hormonal therapy if no contraindications.

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8
Q

Indications for bariatric surgery referral

A

BMI over 40 or BMI 35-40 with obesity-related complications when diet, exercise, and or medications are not effective

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9
Q

Test of choice for PNH

A

Flow cytometric analysis for CD55 and CD59

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10
Q

Presentation of PNH

A

Hemolytic anemia, pancytopenia, or unprovoked atypical thrombosis

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11
Q

Colonoscopy screening interval for UC extending beyond the rectum

A

Every 1 to 2 years starting 8 to 10 years after diagnosis

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12
Q

Treatment of locally advanced esophageal cancer

A

Surgical resection with perioperative chemotherapy

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13
Q

What is the strategy for AC after a-fib ablation?

A

All pts continue to get AC for 2-3 months. Then AC guided by CHADS2-VASC score. Continue AC in high risk pts even if asymptomatic and EKG in NSR.

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14
Q

Classic elements of MEN2 syndrome

A

Hyperparathyroidism, pheochromocytoma, medullary thyroid cancer

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15
Q

CURB-65 Components

A

Confusion, Uremia (over 19.6), Respiratory rate (30 or higher), Blood pressure (less than 90 over 60) and age (over 65)

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16
Q

CURB-65 Interpretation

A

0 to 1 consider outpatient management, 2 or higher hospitalization, 3 or higher consider ICU.

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17
Q

First line therapy for bullous pemphigoid

A

Systemic corticosteroids (prednisone)

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18
Q

Components of Churg-Strauss syndrome

A

Eosinophilia, migratory pulmonary infiltrates, purpuric skin rash, and monneuritis multiplex in the setting of asthma, AR, or sinusitis. May be p-ANCA and antimyeloperoxidase positive.

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19
Q

Blood pressure target for ischemic stroke patients outside tPA window

A

Less than 220 over 120. From ED arrival to discharge this target can be maintained, then resume previous anti-hypertensive treatment.

20
Q

Test of choice for patient with lumbar plexopathy after back trauma

A

CT abdomen, look for iliopsoas hematoma

21
Q

Which GFR formula performs best at higher (normal) GFR values?

A

CKD-Epi. The MDRD and Cockroft-Gault equations tend to underestimate GFR in healthy patients with significant muscle mass

22
Q

Anteromedial knee pain worse with step climbing and at night

A

Pes anserine bursitis

23
Q

Anteromedial knee pain worse with step climbing and at night

A

Pes anserine bursitis

24
Q

Test of choice in a woman with primary ovarian insufficiency (no periods with a high FSH)

A

Karyotyping to exclude Turner syndrome

25
Q

First test of choice in working up a patient with refractory hypertension for secondary hypertension

A

Plasma aldosterone-plasma renin activity ratio (ARR).

26
Q

Anti-Jo-1 antibodies

A

Inflammatory myopathies. Also confer increased risk for interstitial lung disease if positive.

27
Q

Test of choice for dural venous sinus thrombosis

A

MRV

28
Q

Second line therapy for H pylori infection

A

Bismuth, flagyl, tetracycline, and omeprazole (use when amoxicillin, clarithromycin, and omeprazole have failed)

29
Q

Typical murmur of MVP

A

Early systolic click, followed by soft systolic crescendo-decrescendo murmur heard best at the apex

30
Q

RA-like joint pain, obstructive pattern on PFTs and thickened nose and ear cartilage

A

Polychondritis

31
Q

Hgb A1C cutpoint values

A

Less than 5.7 normal, 5.7 to 6.4 prediabetes, above 6.4 diabetes

32
Q

White reticulated network on the buccal mucosa, desquamative gingivitis, chronic painful erosions on the oral or vulvar mucosa

A

Lichen Planus

33
Q

Most common disease related cause of death in pts with mixed connective tissue disease

A

Pulmonary arterial hypertension

34
Q

Complication of discontinuing steroids in a patient treated for psoriasis

A

Acute pustular erythrodermic flare (characterized by pustules and lakes of pus)

35
Q

Red papules on chest, back, and flank that may become pruritic with heat or sweating

A

Grover Disease (acantholytic dermatosis)

36
Q

Recommended therapy for all patients with CHF

A

ACE-I and BB (all classes). Spironolactone (NYHA 3-4) and Imdur (african american NYHA 3-4)

37
Q

First line therapy for hepatorenal syndrome

A

Albumin. Followed by octreotide, midodrine, and (if available) terlipressin

38
Q

Treatment for corticosteroid refractory transverse myelitis

A

Plasmapheresis

39
Q

Main contraindication to tamoxifen therapy after breast cancer in premenopausal women and what is the alternative therapy?

A

Increased risk of VTE (such as personal history of DVT). Alternative is ovarian ablation (if pt was postmenospausal, an aromatase inhibitor could be used).

40
Q

Woody induration of the extremities sparing the hands and face in the absence of Raynaud phenomenon

A

Eosinophilic fasciitis. (Peripheral eosinophilia is not necessarily present)

41
Q

Empiric therapy for pneumococcal meningitis

A

Vancomycin and Ceftriaxone (or cefotaxime)

42
Q

Test of choice to evaluate for CTEPH

A

V/Q scan

43
Q

Test of choice for acromegaly

A

IGF-1 level (serum insulin-like growth factor 1)

44
Q

Medication that reduces fall risk in the elderly

A

Vitamin D

45
Q

Headache, fatigue, sleep disturbances, difficulties with concentration and memory, and emotional lability with an increased tendency for depression, anxiety, and irritability.

A

Post-concussive syndrome

46
Q

Treatment of choice for keloids

A

Intralesional triamcinolone

47
Q
A

Residency (3 decks)

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