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PLE 2018 > Internal Medicine > Flashcards

Internal Medicine Flashcards

1
Q

Weil’s syndrome

A

Hemorrhage (hemoptysis)
Acute kidney injury
Jaundice

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2
Q

Infective stage of malarial parasite to humans

A

Sporozoites

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3
Q

Most effective drug for typhoid fever

A

Ciprofloxacin

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4
Q

Schedule of pre exposure prophylaxis for rabies

A

0, 7, 28 days

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5
Q

Schedule of postexposure prophylaxis for rabies

A

Day 0, 3, 7, 14

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6
Q

Adequate fluid resuscitation is PAWP of _____ or CVP of ______

A

> 12mmHg

>8mmHg

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7
Q

MAP of _____ is a sign of organ dysfunction in severe sepsis

A

less than or equal to 70mmHg

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8
Q

PEP for HIV

A

2 NRTIs x 4 weeks
or
2 NRTIs + NNRTI/PI x 4 weeks

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9
Q

Histologic finding that is an ominous sign of irreversibility and progression to renal failure

A

Interstitial fibrosis

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10
Q

Indications of surgical drainage of arthritis

A

Septic hip
Osteomyelitis
Prosthetic
Nonresponsive in 3-5 days

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11
Q

Tx of gonococcal septic arthritis

A

1-3 days IV ceftriaxone ff by oral ciprofloxacin to complete 7-10 days

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12
Q

Duration of treatment of nongonococcal septic arthritis

A

4 weeks:

2 weeks IV, 2 weeks oral

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13
Q

Duration of treatment of osteomyelitis

A

atleast 8 weeks

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14
Q

Major genetic risk factor for Rheumatoid arthritis

A

HLA DR4

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15
Q

Gold standard in treatment of RA

A

Methotrexate

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16
Q

JAK inhibitor

A

Tofacitinib

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17
Q

anti-IL6 monoclonal antibody

A

Tocilizumab

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18
Q

anti-IL1 receptor antagonist

A

Anakinra

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19
Q

monoclonal AB against CD20

A

Rituximab

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20
Q

Uric acid levels in gout
men:
premenopausal women:

A

> 7 mg/dL

>6 mg/dL

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21
Q

Hgb levels in anemia
women:
men:

A

<12 g/dL

<13 g/dL

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22
Q

Hypersegmentation of neutrophils is characteristically seen in what type of anemia

A

Megaloblastic macrocytic anemia

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23
Q

Initiate urate-lowering therapy if serum uric acid levels reach:

A

9 mg/dL

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24
Q

Treatment target serum uric acid levels

A

5 to 6 mg/dL (below 6)

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25
Q

Joint most freq affected in calcium pyrophospate deposition disease (pseudogout)

A

Knee

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26
Q

Ideal tx for psorIAtic arthritis

A

Infliximab
Adalimumab
Golimumab
(anti-TNF a)

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27
Q

Hepcidin is increased in what type of anemia

A

Anemia of chronic disease

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28
Q

Serum haptoglobin is decreased in what type of anemia

A

Hemolytic anemia

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29
Q

Diagnostic test for hereditary spherocytosis

A

Osmotic fragility test

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30
Q

Test for paroxysmal nocturnal hemoglobinuria

A 
Hams test
Flow cytometry (CD 55 and 59)
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31
Q

Stomatocytes (slit-like central pallor in RBCs) are seen in

A

Liver disease

acute alcoholism

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32
Q

Echinocytes or burr cells (evenly distributed spicules >10) are seen in:

A

Uremia
PUD
Gastric CA
Pyruvate kinase deficiency

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33
Q

Genetic abberation in chronic myeloproliferative neoplasms

A

Mutation in tyrosine kinase JAK2

valine is replaced with phenylalanine

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34
Q

Tx of CML

A

Imatinib (Gleevec)

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35
Q

Alkylating agent-assoc leukemias

4-6 years

A

Busulfan
Chlorambucil
Cyclophosphamide
Melphalan

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36
Q

Topoisomerase II inhibitor-assoc leukemias

1-3 years

A

Etoposide
Doxorubicin
Daunorubicin

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37
Q

Acute promyelocytic leukemia is a translocation in _____ treated with _____

A

t (15;17)

ATRA

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38
Q

smudge cells or basket cells are seen in this hematologic malignancy

A

CLL (B-cell)

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39
Q

Tx of CLL

A

Chlorambucil

Fludarabine (purine analog)

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40
Q

Common organisms implicated in reactive arthritis

A 
Shigella
Salmonella
Yersinia
Campylobacter
Chlamydia
HIV
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41
Q

Type of NHL characterized by:
translocation on chrom 8
starry sky pattern

A

Burkitt’s lymphoma

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42
Q

Most common type of Hodgkin’s lymphoma

A

Nodular sclerosis

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43
Q

Most common primary malignancy of the bone

A

Multiple myeloma

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44
Q

Triad of hemolytic anemia

A

Pallor
Jaundice
Splenomegaly

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45
Q

Screening test for Paroxysmal Nocturnal Hemoglobinuria

A

Sucrose Test

activates complement

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46
Q

Drug of choice for enteric fever

A

Ciprofloxacin (fully-susceptible)

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47
Q

Most common mode of transmission of HIV in developing countries

A

Heterosexual transmission

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48
Q

Most common mode of transmission of HIV in western countries

A

Male to male sexual transmission

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49
Q

Most common glomerulonephritis in HIV

A

FSGS

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50
Q

Most common nephrotic syndrome in adults

A

Membranous nephropathy

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51
Q

Type of drugs contraindicated in CHF

A

CCBs

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52
Q

Swan-neck deformity in RA involves which joint

A

DIP joint flexion

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53
Q

Most common renal malignancy assoc with von Hippel Lindau syndrome

A

Renal Cell Carcinoma

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54
Q

Most common preceding infection assoc with the dev’t of aplastic anemia

A

Hepatitis (non-A, non-B, non-C)

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55
Q

Cells that store vitamin A in the liver

A

Ito cells

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56
Q

Only markers of mortality for acute pancreatitis

A

BUN and Hct

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57
Q

Most common cause of early death in acute pancreatitis

A

Hypovolemic shock

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58
Q

Most important treatment intervention for acute pancreatitis

A

Fluid resuscitation

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59
Q

Leading infectious cause of meningitis in patients with AIDS

A

Cryptococcus

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60
Q

Night distress is the most discriminating symptom of which type of ulcer

A

Duodenal ulcer

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61
Q

Most common cause of seizures in patients with HIV

A

HIV encephalopathy

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62
Q

Most common peripheral neuropathy in HIV

A

distal sensory / painful sensory polyneuropathy

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63
Q

Most common hematologic abnormality in HIV

A

Anemia

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64
Q

Most prevalent dermatologic disorder in HIV

A

Seborrheic dermatitis

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65
Q

Treatment of severe C. difficile diarrhea

A

Oral vancomycin

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66
Q

Cercarial dermatitis occurs after how many days of skin penetration in schistosomiasis

A

2-3 days

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67
Q

Katayama fever (acute schistosomiasis) occurs how many weeks after skin invasion

A

4-8 weeks

68
Q

Periportal “pipestem” fibrosis of the liver occurs after a granulomatous reaction with which species

A

S. mansoni and japonicum

69
Q

prognostic indicator of multiple myeloma

A

serum beta 2 microglobulin

70
Q

treatment of multiple myeloma

A

high dose pulse dexamethasone therapy

71
Q

target cells / codocytes are seen in

A

sickle cell anemia

thalassemia

72
Q

most important prognostic factor in breast CA

A

tumor stage

73
Q

premalignant lesion that suggests elevated risk of breast CA

A

lobular neoplasia

74
Q

Screening tests with level A recommendation

A

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
Q

most common sign of hepatocellular CA

A

hepatomegaly

76
Q

subluxation of 1st MCP joint with hyperextension of 1st IP joint

A

Z-line deformity

in rheumatoid arthritis

77
Q

most common early clinical manifestation of gout

A

acute arthritis

78
Q

earliest radiologic finding in RA

A

juxta-articular osteopenia

79
Q

antibodies in drug-induced lupus

A

anti-histone

80
Q

Conditions when insulin should be considered as initial therapy in type 2 DM

A

severe weight loss
hospitalized/acutely ill
underlying renal or hepatic disease

81
Q

risk of fractures is a possible side effect of which class of antidiabetic agents

A

SGLT-2 inhibitors

canagliflozin

82
Q

empiric therapy for meningitis

A

3rd gen ceph + vancomycin + ampicillin

83
Q

drug of choice for prophylaxis of meningococcal disease

A

ceftriaxone

84
Q

happens when hollenhorst plaques get lodged in the retinal artery

A

amaurosis fugax

85
Q

squatting and handgrip which increases venous return will result to an increase or decrease in intensity of murmur in HOCM & MVP?

A

decrease intensity of murmur

86
Q

“CREST” of acute pericarditis

A

Chest pain
Rub
Effusion
ST elevation (widespread)

87
Q

anti- TNFa used for psoriasis

A

Adalimumab
Etanercept
Infliximab

88
Q

Graft rejection is classified under what type of hypersensitivity reaction

A

Type IV

89
Q

anti-asthma drugs safe for pregnancy

A

SABA
ICS
Theophylline

90
Q

initiate supplemental oxygen for COPD patients when pO2 _____ or O2sat _____

A

pO2 <55

O2sat <88%

91
Q

most common extrapulmonary TB in HIV

A

TB lymphadenitis

92
Q

sign of PE showing hypokinesia of V3 wall in 2d echo

A

mcconnell’s sign

93
Q

sign of PE showing peripheral wedge shaped density on CXR

A

Hampton’s hump

94
Q

sign of PE showing abrupt tapering of a vessel

A

westermark’s sign

95
Q

sign of PE showing the R pulmonary artery

A

Palla’s sign

96
Q

initial diagnostic test in adults with presumed HIV-assoc TB

A

Gene Xpert

97
Q

Optimal time to start antiretroviral therapy in patients with HIV and TB

A

after 2 weeks of TB treatment

98
Q

Optimal time to start antiretroviral therapy in patients with HIV and TB meningitis

A

after the intensive phase of TB treatment

99
Q

preferred NNRTI for HIV patients on TB treatment

A

Efavirenz

100
Q

a patient clinically diagnosed to have TB is considered non-infectious after

A

5 days of treatment

14 days if bacteriologically diagnosed

101
Q

most common superficial skin infection

A

tinea versicolor

102
Q

Snarling facies

A

Myasthenia Gravis

103
Q

Torpid facies

A

Hypothyroidism

104
Q

Mask-like facies

A

Parkinsonism

105
Q

Osler nodes
Janeway lesions
Roth spots

A

Bacterial endocarditis

106
Q

4 syndromes associated with familial pheochromocytoma

A

VHL syndrome
MEN 2A and 2B
NF type 1
Paraganglioma

107
Q

most frequent location of spider angiomata

A

face and neck

108
Q

most common protozoal cause of septic shock

A

toxoplasma

109
Q

commin etiologies of acute pancreatitis

A 
GATED
Gallstone
Alcohol
TAG >1000
ERCP
Drugs
110
Q

electrolyte imbalances in refeeding syndrome

A

hypophosphatemia (hallmark)
hypokalemia
hypomagnesemia

111
Q

most feared complication of temporal arteritis

A

blindness

112
Q

Recombinant IL-2 (Aldesleukin) is used for

A

Renal cell carcinoma, metastatic

Melanoma, metastatic

113
Q

part of the conplement system that is an anaphylotoxin and a potent mediator of inflammation

A

C3a

114
Q

screening test for acromegaly or dwarfism

A

IGF-1 level

115
Q

frequent hallmark of rheumatoid arthritis

A

flexor tendon tenosynovitis

116
Q

valvular problem presenting with widened pulse pressure

A

aortic regurgitation

117
Q

most common cause of pleural effusion

A

LV failure

118
Q

indications of CTT in parapneumonic effusion

A
  • loculated
  • pH <7.2
  • glucose <60mg/dL
  • (+) gram stain / culture
  • gross pus
119
Q

most frequent symptom of DVT

A

cramp in the lower calf

120
Q

best noninvasive diagnostic test for DVT

A

venous duplex scan

121
Q

diseases presenting with Charcot’s triad

A

Acute cholangitis
(pain, jaundice, fever)
Multiple sclerosis
(nystagmus, intention tremor, scanning speech)

122
Q

types of hepatitis causing fulminant hepatitis

A

B-E-D-ridden

123
Q

Treatment of primary spontaneous bacterial peritonitis

A

Cefotaxime 2g IV q8 for 5 days

2nd gen cephamycin

124
Q

the only bacterium to invade peripheral nerves

basal lamina of Schwann cells

A

Mycobacterium leprae

125
Q

most freq. involved nerve trunk in type 1 Lepra reaction

A

ulnar nerve (elbow)

126
Q

most dramatic manifestation of type 1 Lepra reaction

A

foot drop

127
Q

most characteristic microscopic feature of type 1 Lepra reaction

A

edema

128
Q

pathognomonic feature of leprosy

A

actual granuloma formation within dermal nerves

129
Q

conditions presenting with high output heart failure (increased peripheral demand)

A 
wet beri beri
hyperthyroidism
large AV fistula
paget’s disease of the bone
chronic severe anemia
severe liver / kidney disease
130
Q

rash on palms and soles

A

CARS
Coxsackie A
Rocky mountain spotted fever
Syphilis

131
Q

cause of chronic tubular interstitial nephritis presenting with flank pain that occurs only with micturition

A

VUR / reflux nephropathy

132
Q

what produces EPO?

A

interstitial fibroblasts in the kidney in close assoc with peritubular capillary and PCT

133
Q

Causes of secondary hypertension

A 
CHAPTERS
Cushing
Hyperaldosteronism
Aortic coarctation
Pheochromocytoma
Thyroid/Parathyroid dso
Effects of drugs
Renal dso
Sleep apnea
134
Q

Goal of therapy in HTN with DM

A

BP < 130/80

135
Q

Goal in hypertensive crisis (emergency / urgency)

A

Lower BP no more than 25% in 2 min to 2 hours

then towards 160/100 in 2 to 6 hours

136
Q

Other conditions that elevate troponin levels

A

CHF
Myocarditis
Pulmo Embolism

137
Q

Hemodynamic hallmark of mitral stenosis

A

abnormal elevation of L atrioventricular pressure gradient

138
Q

most specific manifestation of rheumatic fever

A

carditis

139
Q

most characteristic component of rheumatic carditis

A

valvulitis

hallmark: mitral insufficiency

140
Q

duration of RF prophylaxis

A

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
Q

treatment of chorea (in RF)

A

carbamazepine or sodium valproate

142
Q

gold standard for allergic contact dermatitis

A

Patch test

preferred site: upper back

143
Q

treatment of seborrheic dermatitis

A

topical low potency glucocorticoid + antifungal

144
Q

why are high potency steroids not used on the face

A

steroidi duces rosacea or atrophy

145
Q

causative agent in seborrheic dermatitis

A

pityrosporum ovale

146
Q

AIDS-defining malignancies (3)

A

Kaposi’s sarcoma
NHL
Invasive cervical carcinoma

147
Q

Start tx in HIV even if asymptomatic if CD4 count is less than

A

500/L

148
Q

diagnostic test of choice for chronic pancreatitis

A

secretin stimulation test

149
Q

best imaging study for the initial evaluation of acute panc

A

abdominal CT

150
Q

risk factors for severe disease and mortality in acute panc

A

Hct >44%

BUN >22

151
Q

Activated charcoal lavage is not useful for (2)

A

cyanide poisoning

iron poisoning

152
Q

most common substance of abuse

A

ethanol

153
Q

most common designer drug

A

ecstasy (MDMA/Molly)

154
Q

ecstasy may cause death if taken with

A

alcohol

155
Q

antidote for cyanide poisoning

A

sodium thiosulfate

hydroxycobalamin

156
Q

Asboe Hansen sign and Nikolsky sign are seen in

A

Pemphigus vulgaris

157
Q

+ Nikolsky sign

3 conditions

A

Pemphigus vulgaris
SSSS
SJS/TENS

158
Q

Herald patch
Collarette scaling
HHV 6 and 7

A

Pityriasis rosea

159
Q

Jarisch - Herxheimer Reaction

3 conditions

A

Leptospirosis
Syphillis
Lyme disease

160
Q

Moth-eaten alopecia is a sign of

A

secondary syphillis

161
Q

DOC for norweigan scabies / severe scabies

A

Ivermectin

162
Q 
Koebner phenomenon
Auspitz sign
Distal onycholysis
Nail pitting
Oil spots*
Salmon patches*
A

Psoriasis

163
Q

Histopath: accumulation of neutrophils in stratum corneum

A

Munro microabscesses

164
Q

most common cause of erythema multiforme

A

infection: HSV

165
Q

most notorious drug causing SJS/TENS

A

Cotrimoxazole (TMP-SMX)

166
Q

Most common type of melanoma for Filipinos

A

Acral lentiginous

PLE 2018 (12 decks)

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