Internal Medicine Flashcards
1
Q
Weil’s syndrome
A
Hemorrhage (hemoptysis)
Acute kidney injury
Jaundice
2
Q
Infective stage of malarial parasite to humans
A
Sporozoites
3
Q
Most effective drug for typhoid fever
A
Ciprofloxacin
4
Q
Schedule of pre exposure prophylaxis for rabies
A
0, 7, 28 days
5
Q
Schedule of postexposure prophylaxis for rabies
A
Day 0, 3, 7, 14
6
Q
Adequate fluid resuscitation is PAWP of _____ or CVP of ______
A
> 12mmHg
>8mmHg
7
Q
MAP of _____ is a sign of organ dysfunction in severe sepsis
A
less than or equal to 70mmHg
8
Q
PEP for HIV
A
2 NRTIs x 4 weeks
or
2 NRTIs + NNRTI/PI x 4 weeks
9
Q
Histologic finding that is an ominous sign of irreversibility and progression to renal failure
A
Interstitial fibrosis
10
Q
Indications of surgical drainage of arthritis
A
Septic hip
Osteomyelitis
Prosthetic
Nonresponsive in 3-5 days
11
Q
Tx of gonococcal septic arthritis
A
1-3 days IV ceftriaxone ff by oral ciprofloxacin to complete 7-10 days
12
Q
Duration of treatment of nongonococcal septic arthritis
A
4 weeks:
2 weeks IV, 2 weeks oral
13
Q
Duration of treatment of osteomyelitis
A
atleast 8 weeks
14
Q
Major genetic risk factor for Rheumatoid arthritis
A
HLA DR4
15
Q
Gold standard in treatment of RA
A
Methotrexate
16
Q
JAK inhibitor
A
Tofacitinib
17
Q
anti-IL6 monoclonal antibody
A
Tocilizumab
18
Q
anti-IL1 receptor antagonist
A
Anakinra
19
Q
monoclonal AB against CD20
A
Rituximab
20
Q
Uric acid levels in gout
men:
premenopausal women:
A
> 7 mg/dL
>6 mg/dL
21
Q
Hgb levels in anemia
women:
men:
A
<12 g/dL
<13 g/dL
22
Q
Hypersegmentation of neutrophils is characteristically seen in what type of anemia
A
Megaloblastic macrocytic anemia
23
Q
Initiate urate-lowering therapy if serum uric acid levels reach:
A
9 mg/dL
24
Q
Treatment target serum uric acid levels
A
5 to 6 mg/dL (below 6)
25
Joint most freq affected in calcium pyrophospate deposition disease (pseudogout)
Knee
26
Ideal tx for psorIAtic arthritis
Infliximab
Adalimumab
Golimumab
(anti-TNF a)
27
Hepcidin is increased in what type of anemia
Anemia of chronic disease
28
Serum haptoglobin is decreased in what type of anemia
Hemolytic anemia
29
Diagnostic test for hereditary spherocytosis
Osmotic fragility test
30
Test for paroxysmal nocturnal hemoglobinuria
```
Hams test
Flow cytometry (CD 55 and 59)
```
31
Stomatocytes (slit-like central pallor in RBCs) are seen in
Liver disease
| acute alcoholism
32
Echinocytes or burr cells (evenly distributed spicules >10) are seen in:
Uremia
PUD
Gastric CA
Pyruvate kinase deficiency
33
Genetic abberation in chronic myeloproliferative neoplasms
Mutation in tyrosine kinase JAK2
| valine is replaced with phenylalanine
34
Tx of CML
Imatinib (Gleevec)
35
Alkylating agent-assoc leukemias
| 4-6 years
Busulfan
Chlorambucil
Cyclophosphamide
Melphalan
36
Topoisomerase II inhibitor-assoc leukemias
| 1-3 years
Etoposide
Doxorubicin
Daunorubicin
37
Acute promyelocytic leukemia is a translocation in _____ treated with _____
t (15;17)
| ATRA
38
smudge cells or basket cells are seen in this hematologic malignancy
CLL (B-cell)
39
Tx of CLL
Chlorambucil
| Fludarabine (purine analog)
40
Common organisms implicated in reactive arthritis
```
Shigella
Salmonella
Yersinia
Campylobacter
Chlamydia
HIV
```
41
Type of NHL characterized by:
translocation on chrom 8
starry sky pattern
Burkitt’s lymphoma
42
Most common type of Hodgkin’s lymphoma
Nodular sclerosis
43
Most common primary malignancy of the bone
Multiple myeloma
44
Triad of hemolytic anemia
Pallor
Jaundice
Splenomegaly
45
Screening test for Paroxysmal Nocturnal Hemoglobinuria
Sucrose Test
| activates complement
46
Drug of choice for enteric fever
Ciprofloxacin (fully-susceptible)
47
Most common mode of transmission of HIV in developing countries
Heterosexual transmission
48
Most common mode of transmission of HIV in western countries
Male to male sexual transmission
49
Most common glomerulonephritis in HIV
FSGS
50
Most common nephrotic syndrome in adults
Membranous nephropathy
51
Type of drugs contraindicated in CHF
CCBs
52
Swan-neck deformity in RA involves which joint
DIP joint flexion
53
Most common renal malignancy assoc with von Hippel Lindau syndrome
Renal Cell Carcinoma
54
Most common preceding infection assoc with the dev’t of aplastic anemia
Hepatitis (non-A, non-B, non-C)
55
Cells that store vitamin A in the liver
Ito cells
56
Only markers of mortality for acute pancreatitis
BUN and Hct
57
Most common cause of early death in acute pancreatitis
Hypovolemic shock
58
Most important treatment intervention for acute pancreatitis
Fluid resuscitation
59
Leading infectious cause of meningitis in patients with AIDS
Cryptococcus
60
Night distress is the most discriminating symptom of which type of ulcer
Duodenal ulcer
61
Most common cause of seizures in patients with HIV
HIV encephalopathy
62
Most common peripheral neuropathy in HIV
distal sensory / painful sensory polyneuropathy
63
Most common hematologic abnormality in HIV
Anemia
64
Most prevalent dermatologic disorder in HIV
Seborrheic dermatitis
65
Treatment of severe C. difficile diarrhea
Oral vancomycin
66
Cercarial dermatitis occurs after how many days of skin penetration in schistosomiasis
2-3 days
67
Katayama fever (acute schistosomiasis) occurs how many weeks after skin invasion
4-8 weeks
68
Periportal “pipestem” fibrosis of the liver occurs after a granulomatous reaction with which species
S. mansoni and japonicum
69
prognostic indicator of multiple myeloma
serum beta 2 microglobulin
70
treatment of multiple myeloma
high dose pulse dexamethasone therapy
71
target cells / codocytes are seen in
sickle cell anemia
| thalassemia
72
most important prognostic factor in breast CA
tumor stage
73
premalignant lesion that suggests elevated risk of breast CA
lobular neoplasia
74
Screening tests with level A recommendation
papsmear q 3 years for cervical CA (21-65 y/o)
sigmoidoscopy q 5 years for colorectal CA (50-75 y/o)
FOBT yearly
colonoscopy q 10 years
75
most common sign of hepatocellular CA
hepatomegaly
76
subluxation of 1st MCP joint with hyperextension of 1st IP joint
Z-line deformity
| in rheumatoid arthritis
77
most common early clinical manifestation of gout
acute arthritis
78
earliest radiologic finding in RA
juxta-articular osteopenia
79
antibodies in drug-induced lupus
anti-histone
80
Conditions when insulin should be considered as initial therapy in type 2 DM
severe weight loss
hospitalized/acutely ill
underlying renal or hepatic disease
81
risk of fractures is a possible side effect of which class of antidiabetic agents
SGLT-2 inhibitors
| canagliflozin
82
empiric therapy for meningitis
3rd gen ceph + vancomycin + ampicillin
83
drug of choice for prophylaxis of meningococcal disease
ceftriaxone
84
happens when hollenhorst plaques get lodged in the retinal artery
amaurosis fugax
85
squatting and handgrip which increases venous return will result to an increase or decrease in intensity of murmur in HOCM & MVP?
decrease intensity of murmur
86
“CREST” of acute pericarditis
Chest pain
Rub
Effusion
ST elevation (widespread)
87
anti- TNFa used for psoriasis
Adalimumab
Etanercept
Infliximab
88
Graft rejection is classified under what type of hypersensitivity reaction
Type IV
89
anti-asthma drugs safe for pregnancy
SABA
ICS
Theophylline
90
initiate supplemental oxygen for COPD patients when pO2 _____ or O2sat _____
pO2 <55
| O2sat <88%
91
most common extrapulmonary TB in HIV
TB lymphadenitis
92
sign of PE showing hypokinesia of V3 wall in 2d echo
mcconnell’s sign
93
sign of PE showing peripheral wedge shaped density on CXR
Hampton’s hump
94
sign of PE showing abrupt tapering of a vessel
westermark’s sign
95
sign of PE showing the R pulmonary artery
Palla’s sign
96
initial diagnostic test in adults with presumed HIV-assoc TB
Gene Xpert
97
Optimal time to start antiretroviral therapy in patients with HIV and TB
after 2 weeks of TB treatment
98
Optimal time to start antiretroviral therapy in patients with HIV and TB meningitis
after the intensive phase of TB treatment
99
preferred NNRTI for HIV patients on TB treatment
Efavirenz
100
a patient clinically diagnosed to have TB is considered non-infectious after
5 days of treatment
| 14 days if bacteriologically diagnosed
101
most common superficial skin infection
tinea versicolor
102
Snarling facies
Myasthenia Gravis
103
Torpid facies
Hypothyroidism
104
Mask-like facies
Parkinsonism
105
Osler nodes
Janeway lesions
Roth spots
Bacterial endocarditis
106
4 syndromes associated with familial pheochromocytoma
VHL syndrome
MEN 2A and 2B
NF type 1
Paraganglioma
107
most frequent location of spider angiomata
face and neck
108
most common protozoal cause of septic shock
toxoplasma
109
commin etiologies of acute pancreatitis
```
GATED
Gallstone
Alcohol
TAG >1000
ERCP
Drugs
```
110
electrolyte imbalances in refeeding syndrome
hypophosphatemia (hallmark)
hypokalemia
hypomagnesemia
111
most feared complication of temporal arteritis
blindness
112
Recombinant IL-2 (Aldesleukin) is used for
Renal cell carcinoma, metastatic
| Melanoma, metastatic
113
part of the conplement system that is an anaphylotoxin and a potent mediator of inflammation
C3a
114
screening test for acromegaly or dwarfism
IGF-1 level
115
frequent hallmark of rheumatoid arthritis
flexor tendon tenosynovitis
116
valvular problem presenting with widened pulse pressure
aortic regurgitation
117
most common cause of pleural effusion
LV failure
118
indications of CTT in parapneumonic effusion
- loculated
- pH <7.2
- glucose <60mg/dL
- (+) gram stain / culture
- gross pus
119
most frequent symptom of DVT
cramp in the lower calf
120
best noninvasive diagnostic test for DVT
venous duplex scan
121
diseases presenting with Charcot’s triad
Acute cholangitis
(pain, jaundice, fever)
Multiple sclerosis
(nystagmus, intention tremor, scanning speech)
122
types of hepatitis causing fulminant hepatitis
B-E-D-ridden
123
Treatment of primary spontaneous bacterial peritonitis
Cefotaxime 2g IV q8 for 5 days
| 2nd gen cephamycin
124
the only bacterium to invade peripheral nerves
| basal lamina of Schwann cells
Mycobacterium leprae
125
most freq. involved nerve trunk in type 1 Lepra reaction
ulnar nerve (elbow)
126
most dramatic manifestation of type 1 Lepra reaction
foot drop
127
most characteristic microscopic feature of type 1 Lepra reaction
edema
128
pathognomonic feature of leprosy
actual granuloma formation within dermal nerves
129
conditions presenting with high output heart failure (increased peripheral demand)
```
wet beri beri
hyperthyroidism
large AV fistula
paget’s disease of the bone
chronic severe anemia
severe liver / kidney disease
```
130
rash on palms and soles
CARS
Coxsackie A
Rocky mountain spotted fever
Syphilis
131
cause of chronic tubular interstitial nephritis presenting with flank pain that occurs only with micturition
VUR / reflux nephropathy
132
what produces EPO?
interstitial fibroblasts in the kidney in close assoc with peritubular capillary and PCT
133
Causes of secondary hypertension
```
CHAPTERS
Cushing
Hyperaldosteronism
Aortic coarctation
Pheochromocytoma
Thyroid/Parathyroid dso
Effects of drugs
Renal dso
Sleep apnea
```
134
Goal of therapy in HTN with DM
BP < 130/80
135
Goal in hypertensive crisis (emergency / urgency)
Lower BP no more than 25% in 2 min to 2 hours
| then towards 160/100 in 2 to 6 hours
136
Other conditions that elevate troponin levels
CHF
Myocarditis
Pulmo Embolism
137
Hemodynamic hallmark of mitral stenosis
abnormal elevation of L atrioventricular pressure gradient
138
most specific manifestation of rheumatic fever
carditis
139
most characteristic component of rheumatic carditis
valvulitis
| hallmark: mitral insufficiency
140
duration of RF prophylaxis
10 years / until 40 years old (if with residual heart disease)
10 years / until 21 years old (if without residual heart disease)
5 years / until 21 years old (if without carditis)
141
treatment of chorea (in RF)
carbamazepine or sodium valproate
142
gold standard for allergic contact dermatitis
Patch test
| preferred site: upper back
143
treatment of seborrheic dermatitis
topical low potency glucocorticoid + antifungal
144
why are high potency steroids not used on the face
steroidi duces rosacea or atrophy
145
causative agent in seborrheic dermatitis
pityrosporum ovale
146
AIDS-defining malignancies (3)
Kaposi’s sarcoma
NHL
Invasive cervical carcinoma
147
Start tx in HIV even if asymptomatic if CD4 count is less than
500/L
148
diagnostic test of choice for chronic pancreatitis
secretin stimulation test
149
best imaging study for the initial evaluation of acute panc
abdominal CT
150
risk factors for severe disease and mortality in acute panc
Hct >44%
| BUN >22
151
Activated charcoal lavage is not useful for (2)
cyanide poisoning
| iron poisoning
152
most common substance of abuse
ethanol
153
most common designer drug
ecstasy (MDMA/Molly)
154
ecstasy may cause death if taken with
alcohol
155
antidote for cyanide poisoning
sodium thiosulfate
| hydroxycobalamin
156
Asboe Hansen sign and Nikolsky sign are seen in
Pemphigus vulgaris
157
+ Nikolsky sign
| 3 conditions
Pemphigus vulgaris
SSSS
SJS/TENS
158
Herald patch
Collarette scaling
HHV 6 and 7
Pityriasis rosea
159
Jarisch - Herxheimer Reaction
| 3 conditions
Leptospirosis
Syphillis
Lyme disease
160
Moth-eaten alopecia is a sign of
secondary syphillis
161
DOC for norweigan scabies / severe scabies
Ivermectin
162
```
Koebner phenomenon
Auspitz sign
Distal onycholysis
Nail pitting
Oil spots*
Salmon patches*
```
Psoriasis
163
Histopath: accumulation of neutrophils in stratum corneum
Munro microabscesses
164
most common cause of erythema multiforme
infection: HSV
165
most notorious drug causing SJS/TENS
Cotrimoxazole (TMP-SMX)
166
Most common type of melanoma for Filipinos
Acral lentiginous
