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Internal Medicine Shelf Exam > Internal Medicine > Flashcards

Internal Medicine Flashcards

1
Q

ECG Leads: V1 - V6

A

Anterior

LAD

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2
Q

ECG Leads: II, III, avF

A

Inferior

RCA, LCX

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3
Q

ECG Leads: V1 - V3

A

Posterior
RCA – I, avL (depression)
LCX – I, avL (elevation)

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4
Q

ECG Leads: I, avL, V5, V6

A

Lateral

LCX, diagonal

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5
Q

ECG Leads: V4-V6R

A

Right Ventricle

RCA

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6
Q

anasarca + pulmonary/facial edema + hypertension + abnormal u/a with proteinuria and microscopic hematuria =

A

acute nephritic syndrome

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7
Q

CAP + arthralgias + erythema nodosum/multiforme =

A

Coccidiodies (Valley Fever)

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8
Q

Development of _____ _____ in a patient with infective endocarditis should raise suspicion for _____ _____ extending into the adjacent cardiac conduction tissues.

A

AV block

perivalvular abscess

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9
Q

Factors that differentiate tricuspid vs. aortic endocarditis (2)

A
  1. TV endocarditis usually presents with a holosystolic murmur (AR)
  2. Cardiac conduction abnormalities are mrore common with aortic valve involvement
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10
Q

Dobutamine (beta 1 agonist) works by…

A

improving ejection fraction AND reducing left ventricular end-systolic volume

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11
Q

Liver Failure: Portal HTN Sx

A 
Esophageal varices
Splenomegaly
Ascites
Caput medusae
Anorectal varices
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12
Q

Liver Failure: Hyperestrinism Sx

A 
Spider angiomas
Gynecomastia
Loss of sexual hair
Testicular atrophy
Palmar erythema
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13
Q

Pathohysiology of AML

A

atypical promyelocytes in the bone marrow

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14
Q

Malaria prophylaxis for India

A

Chloroquine resistance; prophylaxis with mefloquine; begins 2 weeks before travel and continued 4 weeks after returning

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15
Q

Sick Sinus Syndrome (SSS) Definition

A

inability of SA node to generate an adequate heart rate

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16
Q

SSS EKG Findings

A

3-6 seconds with no sinus nodal activity + dizziness

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17
Q

DX: low cortisol + high ACTH + hyper pigmentation + hyponatremia + hyperkalemia =

A

Primary Adrenal Insufficiency; likely due to autoimmune etiology

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18
Q

G6PD Deficiency

A

X-linked; Black men; Episodic hemolysis in response to Rx, illness, etc.; Heinz bodies and bite cells seen on peripheral smear

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19
Q

Management of severe hypercalcemia

A

Aggressive fluids
Calcitonin
+/- Pamidronate (takes 2-4 days to work)

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20
Q

Round face + bruises think…

A

Cushing’s

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21
Q

HTN + hyperglycemia + weight gain =

A

Cushing’s

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22
Q

DOE + HTN + prominent pulmonary arteries + enlarged R heart border =

A

Pulmonary HTN

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23
Q

Arsenic Poisoning

A

Polyneuropathy
Pancytopenia
Mild LFT elevation
Skin Lesions

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24
Q

Type of HTN Rx that has been proven to slow the progression of end-organ damage in patients with DM2…

A

ACE inhibitors

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25
Q

Bilateral hilar adenopathy on CXR

A

Sarcoidosis

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26
Q

Pathophysiology of sarcoidosis

A

chronic granulomatous inflammation; noncaseating granulomas

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27
Q

Hypopituitarism Features (3)

A

Glucocorticoid deficiency
Hypogonadism
Hypothyroidism

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28
Q

Splenic infarction usually occurs due to…

A

hypercoagulable states
embolic disease
hemoglobinopathy

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29
Q

Usually (this condition) is asx; however, it can be exacerbated by air travel and/or dehydration

A

sickle cell trait

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30
Q

Elderly patient + severe lymphocytosis + hepatosplenomegaly + lymphadenopathy + bicytopenia (anemia, thrombocytopenia)

A

CLL

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31
Q

Diagnostic tool for CLL

A

Flow cytometry of the peripheral blood

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32
Q

Claw toes in an elderly patient are most likely due to…

A

diabetic neuropathy

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33
Q

Management for acute limb ischemia s/p MI

A

immediate anticoagulation, vascular surgery consultation, transthoracic echo

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34
Q

Addison’s Disease (AKA primary adrenal insufficiency) presents with this acid-base disturbance:

A

normal anion gap acidosis

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35
Q

Elevated anion gap metabolic acidosis causes:

A

DKA
Intoxication
Tissue Hypoxia
Renal Failure

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36
Q

Metabolic alkalosis causes:

A

Vomiting
Hyperaldosteronism
Excessive Volume Contraction

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37
Q

Respiratory acidosis causes:

A

Conditions that impair proper ventilation = hypoventilation

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38
Q

Respiratory alkalosis causes:

A

Conditions that impair proper ventilation = hyperventilation

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39
Q

Leukoplakia

A

Presents as white patches or plaques over the oral mucosa that usually can NOT be scraped off; R/F include smokeless tobacco and alcohol use

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40
Q

Primary lymphoma of the thyroid is characterized by…

A

rapidly progressive thyroid enlargement with compression of surrounding structures; more common in patients with a PMH of Hashimoto thyroiditis

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41
Q

Test to rule in RA =

A

anti-CCP antibody

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42
Q

When a patient presents with carpal tunnel, you must also r/o this condition

A

RA (order inflammatory factors, RF, and xrays)

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43
Q

LFTS >3000 think…

A

Ischemic hepatic injury

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44
Q

Tx for hyperkalemia w/ EKG changes

A

calcium gluconate

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45
Q

Most common cause of asx elevated alk phos in elderly patient is:

A

Paget disease of the bone

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46
Q

XR findings for Paget’s disease of the bone:

A

osteolytic/mixed lytic-sclerotic lesions

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47
Q

All pts with RA should be on…

A

DMARDS, specifically methotrexate

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48
Q

Dyspepsia + postprandial fullness + nausea in the context of a patient that is from a low income country

A

Helicobacter pylori

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49
Q

Pathophysiology of H. pylori

A

urease-producing bacterial infection

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50
Q

Three most common causes of aortic stenosis:

A
  1. senile calcific aortic stenosis (>70)
  2. bicuspid aortic valve
  3. rheumatic heart disease
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51
Q

Patients with ankylosing spondylitis can develop ______ due to diminished chest wall and spinal mobility.

A

restrictive lung disease

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52
Q

PFTs for patient with ankylosing spondylitis show…

A

mildly restrictive pattern with reduced VC and TLC

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53
Q

Wart like “rash” in groin region that is NOT flesh colored…

A

HIV - Kaposi’s Sarcoma

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54
Q

Acid in eye =

A

WATER FLUSH

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55
Q

Prevalence is high, _____ is high.

A

PPV

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56
Q

Prevalence is low, _____ is high.

A

NPV

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57
Q

Left sided diastolic heart failure due to…

A

MI

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58
Q

4th heart sound due to…

A

MI

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59
Q

DX: substernal discomfort + left-sided neck pain + diaphoresis + dyspnea

A

acute MI

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60
Q

Loss of p waves =

A

A.Fib

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61
Q

Anion gap =

A

Na - (Cl + BiCarb)

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62
Q

Winter’s Formula =

A

1.5 * (BiCarb) + 8 (+/- 2)

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63
Q

Normal pH

A

7.35 - 7.45

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64
Q

Normal BiCarb

A

22-28

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65
Q

Normal CO2

A

33-45

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66
Q

Electrolyte imbalance that is the best predictor for severity of heart failure =

A

hyponatremia

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67
Q

IBD that is bloody =

A

UC

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68
Q

IBD that is non-bloody =

A

Crohn’s

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69
Q

Warfarin + acetiminophen =

A

BLOOD

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70
Q

Warfarin + green foods =

A

CLOT

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71
Q

Number Needed to Treat Formula =

A

Inverse of Absolute Risk Reduction

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72
Q

Tx for minor frostbite

A

Rapid rewarming with warm water

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73
Q

Acute goat path findings:

A

needle shaped spindles

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74
Q

HIV patient with multiple non-enhacning brain lesions

A

PML

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75
Q

Tx for pulmonary HTN

A

ACE + diuretic

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76
Q

Cor pulmonale is usually caused by…

A

impaired function of the R ventricle secondary to pulmonary htn

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77
Q

Ejection click + crescendo-decrescendo systolic murmur over L second intercostal speace

A

Pulmonic valve stenosis

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78
Q

OSA can cause transient periods of hypoxemia which leads to…

A

polycthemia; the kidney responds by increasing erythropoietin

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79
Q

Drug for recurrent nephrolithiasis secondary to hypercalcemia

A

Thiazide diuretics

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80
Q

Febrile nonhemolytic transfusion reaction

A

occurs within 1-6 hours; fever, chills, nausea, and malaise; prevent by leukoreduction

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81
Q

Most common cardiac S/E with SLE

A

acute pericarditis

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82
Q

Bullae on erythematous background

A

bullous pemphigoid

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83
Q

Bullous pemphigoid tx

A

topical clobetasol

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84
Q

Hyperthyroidism + increased RAIU =

A

de novo thyroid hormone synthesis

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85
Q

Hyperthyroidism + decreased RAIU =

A

preformed hormone, exogenous hormone intake

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86
Q

Shoulder pain + horner =

A

pancoast tumor

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87
Q

Choice of drug for patients that are allergic to penicillin but have primary syphillis

A

Doxycycline

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88
Q

Lithium can cause…

A

nephrogenic diabetes insipidus

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89
Q

Tx for lithium DI =

A

d/c lithium, salt restriction

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90
Q

Most common type of cancer associated with asbestos

A

bronchogenic carcinoma

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91
Q

Pleural plaques

A

Asbestos

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92
Q

Test for Sjogren Syndrome

A

Antibodies to Ro/SSA and La/SSB

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93
Q

Sx of Sjogrens

A 
dry mouth
difficulty swallowing
thrush
dental caries
dry eyes
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94
Q

Sx of SLE

A

photosensitive rash

symmetric oligoarthritis

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95
Q

SLE + hx of PE/DVT + hx of miscarriages

A

antiphospholipid syndrome

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96
Q

Dx finding in patients with antiphospholipid syndrome

A

prolonged PTT

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97
Q

Unilateral uptake on RAUI scan…

A

toxic adenoma = autonomous thyroid production

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98
Q

Lynch Syndrome

A

Colon
Endometrial
Ovarian

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99
Q

What part of the spine does RA affect first?

A

Cervical

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100
Q

Obesity hypoventilation syndrome

A

high BMI
daytime hypercapnia
alveolar hypoventilation

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101
Q

Erysipelas

A

superficial skin rash that has raised, sharply demarcated borders; caused by Group A Strep

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102
Q

Cardiac index = reduced; PCWP = increased

A

Cardiogenic shock secondary to MI

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103
Q

Cold water immersion works by…

A

slowing AV node conduction

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104
Q

Massive PE would cause this heart problem…

A

RV dysfunction

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105
Q

Metabolic acidosis to alkalosis in a patient with ascites…

A

+ loop diuretic

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106
Q

Slowly growing papule with irregular borders

A

BCC

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107
Q

Familial hypocalciuric hypercalcemia

A

mutation in the calcium-sending receptor; benign d/o characterized by elevated calcium, normal/elevated parathyroid hormone, low calcium excretion

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108
Q

Most common cause of back pain

A

lumbosacral strain

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109
Q

Felty Syndrome

A

inflammatory arthritis
splenomegaly
neutropenia

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110
Q

Achalasia

A

chronic dysphagia with both solids and liquids; better when standing up; classic bird beak finding on barium swallow

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111
Q

Tx of uric acid stones

A

high fluids

potassium citrate

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112
Q

Dx test for fibromuscular dysplasia

A

CT angio of abdomen

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113
Q

Medications shown to improve long-term survival in patients with L ventricular systolic dysfunction:

A 
Beta blockers
ACE inhibitors
ARBs
mineralcorticoid receptor antagonist
AA -- hydralazine + nitrates
114
Q

Examples of MRAs

A

spironolactone

eplerenone

115
Q

HFpEF AKA

A

diastolic dysfunction

116
Q

Basal insulin should cover patients for…

A

24 hours

117
Q

Dull, hypomobile TM

A

serous otitis media

118
Q

HIV patient on horse farm with diarrhea…

A

Cryptosporidium parvum

119
Q

Isolated thrombocytopenia =

A

ITP

120
Q

Once a patient is diagnosed with ITP, they should undergo screening for… (2)

A

Hep C, HIV

121
Q

Acute MI + MR =

A

papillary wall rupture

122
Q

HIV associated nephropathy =

A

focal segmental glomerulosclerosis (FSGS)

123
Q

Thyroiditis s/p URI

A

subacture/ de Quervain

124
Q

Tx for subacute thyroiditis

A

beta blockers, NSAIDs

125
Q

Early decrescendo diastolic murmur best heard at RUSB

A

aortic regurgitation

126
Q

S/E of chlorthalidone

A

hyperglycemia (insulin resistance)

127
Q

Common causes of exudative pleural effusion

A

Infection (PNA)
RA
Malignancy

128
Q

Patients with RA are at a higher risk for…

A

osteoporosis

129
Q

Drug to prevent DVT in patient with A.Fib =

A

anticoagulant

130
Q

Patient with upper lobe PNA + cavitary lesion + HIV =

A

reactivated TB, mycobacterial infection

131
Q

Aortic stenosis + early peaking systolic murmur =

A

mild - moderate

132
Q

Aortic stenosis + late peaking systolic murmur =

A

severe

133
Q

Severe aortic stenosis additional sound

A

soft S2

134
Q

Metformin can cause lactic acidosis in patients with…

A

acute renal failure
liver failure
sepsis

135
Q

Recent anticoag + new thrombocytopenia =

A

heparin induced thrombocytopenia (HIT)

136
Q

Back pain + hypercalcemia + anemia + renal insufficiency =

A

Multiple myeloma (monoclonal protein)

137
Q

Liver + kidney stuff =

A

Goodpasture’s

138
Q

calcitonin + thyroid nodule

A

medullary thyroid carcinoma

139
Q

If pt has medullary thyroid carcinoma, worry about this other cancer…

A

pheochromocytoma

140
Q

Prophylaxis for esophageal varices

A

nadolol

141
Q

Mechanism of aplastic anemia

A

acquired deficiency of pluripotent stem cells

142
Q

Recurrent bacterial infections in an adult should raise suspicion for…

A

CVID

143
Q

Dx test for CVID

A

quantitative measurement of serum immunoglobulin levels

144
Q

Glucagonoma

A

rare neuroendocrine tumor on pancreas; presents with mild DM2, eczema, weight loss, and diarrhea; dx with glucagon level (>500)

145
Q

Erythema nodosum

A

Sarcoid
TB
Behcets
IBD

146
Q

If secreting renin, you can expect the efferent arteriolar resistance to _____ and the tubular sodium reabsorption to _____.

A

increase

increase

147
Q

Hypocalcemia next step (dx)

A

PTH
high = vit d def
low = autoimmune

148
Q

Systemic sclerosis

A

Raynaud
esophageal dysmotility
skin thickening
interstitial lung disease

149
Q

COPD + digital clubbing =

A

hypertrophic osteoarthropathy

150
Q

Dx test for hypertrophic osteoarthropathy

A

CXR

151
Q

______ is the most common cause of death in patients with end-stage renal disease.

A

Cardiovascular disease

152
Q

Definition of acute liver failure

A

acute onset of severe liver injury with encephalopathy and impaired synthetic function in a patient w/o cirrhosis/underlying liver disease

153
Q

difficulty breathing/wheezing + nasal polyps + angina =

A

AERD (aspirin exacerbated respiratory disease)

154
Q

Mechanism for AERD

A

pseudoallergic drug reaction

155
Q

HA + dizziness + blurry vision + large gamma gap (difference b/w protein and albumin) + retinal changes =

A

Waldenstrom macrogloblinemia

156
Q

S/E of HIT

A

arterial and venous thrombus

157
Q

HIV + central/midwestern area + fever + cough + papules/nodules + hepatosplenomegaly + pancytopenia =

A

Histoplasma capsulatum

158
Q

Tx for Histoplasma capsulatum

A

amphotericin b

159
Q

Thyroid scintigraphy shows decreased radioiodine uptake =

A

Painless/silent thyroiditis

160
Q

Thyroid scintigraphy shows increased radioiodine uptake…

A

Graves

161
Q

Pathoyphysiology of statin induced myalgia

A

inhibition of intracellular synthesis pathway

162
Q

Medications that can trigger bronchoconstriction in a patient with asthma

A

aspirin

beta blockers

163
Q

This lab is elevated in hereditary spherocytosis

A

mean corpuscular hemoglobin concentration (MCHC)

164
Q

Young patient with refractory hypertension, suspect _____ and dx with _____.

A

primary hyperaldosteronism

PRA, PAC

165
Q

Transudative effusions are commonly caused by…

A

decreased intrapleural or plasma oncotic pressures; elevated hydrostatic pressure

166
Q

Exudative effusions are often the result of…

A

increased capillary or pleural membrane permeability or disruptions to lymphatic outflow

167
Q

Calciphylaxis (AKA calcific uremic arteriolopathy)

A

systemic arteriolar calcification and soft-tissue calcium deposition with local ischemia and necrosis

168
Q

Humoral hypercalcemia of malignancy is characterized by…

A

severe, symptomatic hypercalcemia that has a rapid onset

169
Q

Pathophysiology of humoral hypercalcemia of malignancy

A

elevated parathyroid hormone-related protein

170
Q

Pathophysiology of analgesic nephropathy

A

papillary necrosis; chronic tubulointerstitial nephritis

171
Q

Lab that is high for patients with iron deficiency anemia

A

TIBC

172
Q

oral and genital ulcers + erythema nodosum =

A

Behcet’s disease

173
Q

Erectile dysfunction with normal TSH but decreased T3/T4 =

A

chronic liver failure

174
Q

Pleural effusions with low glucose concentrations (<30) are often due to…

A

empyemas, rhuematoid pleurisy; high metabolic activity in fluid

175
Q

Suspect BPH? Order…

A

U/A, PSA

176
Q

Common cause of endocarditis associated with nosocomial UTIs

A

Enterococci

177
Q

Heartburn + dysphagia + hypomotility and LES problems =

A

systemic sclerosis = smooth muscle atophy and fibrosis

178
Q

Epitrochlear lymphadenopathy =

A

syphillis

179
Q

RA + enlarged kidneys + hepatomegaly + nephrotic syndrome =

A

amyloidosis

180
Q

The kidney compensates for respiratory alkalosis by preferentially excreting _____ in the urine.

A

bicarb (increases pH)

181
Q

Overuse of steroids can cause _____ Cushing’s. Lab studies typically show:

A

central

decreased ACTH and cortisol levels

182
Q

Patients with primary adrenal insufficiency have the following lab findings:

A

low ACTH
low cortisol levels
normal aldosterone

183
Q

Legionnaires disease

A

bilateral lung infiltrates
confusion
diarrhea

184
Q

Tx for Legionnaires disease

A

Levofloxacin

185
Q

Patient with HIV and multiple ring enhancing lesions on MRI

A

Toxo

186
Q

Tx for toxo encephalitis

A

sulfadiazine and pyrimethamine

187
Q

Really high calcium with low PTH =

A

hypercalcemia of malignancy

188
Q

Anticholinergic drug =

A

benadryl!

189
Q

Dx test for chronic arterial insufficiency

A

ankle brachial index

190
Q

Chronic venous stasis can be diagnosed with…

A

venous doppler

191
Q

_____ cardiomyopathy should be suspected in patients with unexplained CHF, proteinuria, and left ventricular hypertrophy in the absence of HTN.

A

amyloid (restrictive)

192
Q

ABI =

A

PAD

193
Q

First step in diagnosing Cushing’s

A

Low-dose dexamethasone suppression test OR late nate salivary cortisol assay OR 24 hour urine cortisol excretion

194
Q

Recommendation for patients with calcium oxalate stones

A

Eat less salt

195
Q

Ramsay Hunt Syndrome

A

vesicles in ear

facial droop

196
Q

Polymyositis + anxiety + tachycardia + weight loss =

A

hyperthyroidism

197
Q

Pathophys for bleeding in hereditary hemorrhagic telangiectasia

A

AV malformations

198
Q

Patients with restrictive lung disease have an _____ A-A ratio

A

increased

199
Q

Tx for PMR

A

lose dose steroids

200
Q

Pleural effusion lung sounds

A

decreased breath sounds
decreased tactile fremitus
dullness to percussion

201
Q

Young patient with + smoking history, episodes of nighttime chest pain, ST elevations, and no blockages…

A

vasospastoc angina

202
Q

Tx for vasospastic angina =

A

CCB (dilt) and smoking cessation

203
Q

R/F for C. Diff

A

PPI use

204
Q

Early decrescendo diastolic murmur (LSB)

A

Aortic regurgitation (young person = bicuspid valve)

205
Q

Harsh crescendo-decrescendo systolic murmur (LSB)

A

HOCM

206
Q

Muscle weakness + recurrent nephrolithiasis + neuropsych sx + hypercalcemia =

A

primary hyperparathyroidism

207
Q

Fun saying for primary hyperparathyroidism

A

bones, stones, abdominal moans, and psychic groans

208
Q

Majority of primary hyperparathyroidism due to…

A

parathyroid adenoma

209
Q

Most common cause of hemoptysis

A

chronic bronchitis
cancer
bronchiectasis

210
Q

Most common cause of acute urinary retention in men

A

bladder outflow obstruction (BOO)

211
Q

Restrictive lung disease PFT findings

A

decreased lung volume
decreased diffusion lung capacity
normal FEV1/FVC

212
Q

Immediate treatment for aortic dissection

A

beta blocker

213
Q

Leukocyte count > 50,000

A

leukemoid reaction

214
Q

Yellow-red papules on extensor surfaces

A

xanthomas

215
Q

Xanthomas can be seen when…

A

hypertriglyceridemia (which can lead to acute pancreatitis)

216
Q

Nephrogenic DI tx

A

HCTZ

217
Q

SIADH tx

A

Demeclocycline

218
Q

SLE can initially present as…

A

generalized tonic clonic seizures

219
Q

Lab findings for patient’s with pagets disease of the bone

A

elevated alk phos and urine hydroxyproline; normal calcium and phosphorus

220
Q

Acromegaly can demonstrate the following finding on echo

A

Concentric myocardial hypertrophy

221
Q

Coarsening of facial features + pharyngeal crowding + enlargement of hands and feet =

A

Acromegaly

222
Q

Chondrocalcinosis =

A

pseudogout

223
Q

Pseudogout + diabetes =

A

hereditary hemochromatosis

224
Q

Drugs for cancer patients that can’t gain weight

A

progesterone analogues

225
Q

Hep B serology for patient recovering from acute infection

A

HBsAg -
HBsAb +
HBcAb +

226
Q

Weight loss + tachycardia + tremor + lid retration

A

thyrotoxicosis

227
Q

Systolic hypertension in thyrotoxicosis is caused by…

A

increased myocardial contractility and heart rate

228
Q

Early onset hypertesnion and bilateral upper abdominal masses =

A

autosomal dominant polycystic kidney disease

229
Q

Antibiotic that can cause hyperkalemia

A

Bactrim

230
Q

Early septic shock is associated with a hyperdynamic CV state that results in…

A

bounding peripheral pulses

231
Q

In patients with severe liver cirrhosis, the cause of an AKI is…

A

renal hypoperfusion

232
Q

Unprovoked DVT/PE in young white population

A

Factor V Leiden

233
Q

Factor V Leiden pathophys

A

activated protein c resistance

234
Q

Tx for alcoholic cardiomyopathy

A

Stop drinking alcohol

235
Q

GVHD is caused by…

A

activation of donor T lymphocytes

236
Q

1st line for A.Fib with RVR

A

Beta blockers (unless CHF exacerbation then give furosemide)

237
Q

epistaxis + tremor + tachy + new-onset htn =

A

cocaine use

238
Q

Coarse facial features + uncontrolled htn + carpal tunnel =

A

acromegaly

239
Q

Dx test for acromegaly

A

IGF1

240
Q

Cardiac monitoring for vasovagal syncope =

A

sinus bradycardia and sinus arrest

241
Q

Chronic COPD leads to hyperinflation of the lungs, which causes a ….

A

flattened diaphragm and increased WOB

242
Q

Milk-alkali syndrome

A

abdominal pain, constipation, polydipsia

243
Q

Peripheral edema, ascites, elevated JVP, pericardial knock, pericardial calcifications =

A

Constrictive pericarditis

244
Q

Prophylaxis for MAC in patients with HIV

A

Azithromycin

245
Q

Fever, cough, abdominal pain, diarrhea, night sweats, weight loss in an HIV patient…

A

MAC

246
Q

Earliest renal abnormality seen in diabetic nephropathy…

A

glomerular hyperfiltration

247
Q

Liver dysfunction + psych symptoms (chorea) =

A

Wilson Disease

248
Q

Sjrogen syndrome in old people =

A

Age related sicca syndrome

249
Q

Patellofemoral pain syndrome

A

knee pain; problems with climbing stairs/squatting; dx with isometric pain upon contraction; tx = strengthening the quadriceps and hip abductors

250
Q

Two causes of hypoglycemia in patients without DM

A
  1. insulinoma (high CCP)

2. Insulin/sulfonylureas (low CCP)

251
Q

Persistant EKG findings s/p MI

A

Ventricular aneurysm

252
Q

This drug can cause renal tubular obstruction, which looks like prerenal azotemia…

A

acyclovir

253
Q

Increased pigmentation in the palmar creases

A

Addison’s Disease

254
Q

Lab findings in Addison’s Disease

A

Hyponatremia

Hyperkalemia

255
Q

Sever aortic stenosis will present with this cardiac finding:

A

slow-rising, weak carotid pulse = pulsus parvus et tardus

256
Q

Calcium oxalate crystals are this shape

A

Envelope

257
Q

HIV + patients with severe throat pain =

A

Viral esophagitis

258
Q

HIV + patients with moderate throat pain and difficulty swallowing =

A

Candida

259
Q

Old guy with hx of pancreatitis and new onset diarrhea think…

A

chronic pancreatitis

260
Q

Analgesic nephropathy

A

Tubulointerstitial nephritis; U/A shows blood, wbc casts, trace protein)

261
Q

U/A blood, WBC casts, trace protein =

A

analgesic nephropathy

262
Q

HIV patient with bloody diarrhea

A

CMV

263
Q

Method to reducing mortality in patients with ARDS:

A

low tidal volume ventilation, which prevents overdistending alveoli

264
Q

Population at risk for SLE

A

Young, African American women

265
Q

Young patient with murmur that is best heard at URSB

A

Supravalvular aortic stenosis

266
Q

Most common cause of gross lower GI bleeding in adults

A

Diverticulosis

267
Q

Aquagenic pruritus, facial plethora, increased hematocrit =

A

polycthemia vera

268
Q

Budd-Chiari Syndrome

A

obstruction of hepatic venous outflow + polycthemia vera

269
Q

tinnitus + fever + tachypnea + OD

A

salicylates

270
Q

Cyclophosphamide S/E

A

bladder carcinoma

271
Q

Wartlike lesions, violaceous nodules, skin ulcers, mid-western farmer =

A

Blasto!

272
Q

+ antimitochondrial antibody and pruitis =

A

primary biliary cholangitis

273
Q

Best medication for a patient with COPD (inhaled)

A

SAMA (ipatropium)

274
Q

Tx for esophageal varices in patient with PMH of alcoholism and hematemesis

A

Fluids
Ceftriaxone
Ocreotide

275
Q

Carcinoid Syndrome

A

flushing
diarrhea
bronchospasm
cardiac valve abn

276
Q

Carcinoid syndrome leads to a deficiency in…

A

niacin

277
Q

Trichinellosis

A

GI complaints
periorbital edema
myositis
eosinophilia

278
Q

Chronic Mesenteric Ischemia

A

chronic abdominal pain
weight loss
food aversion

279
Q

Chronic Mesenteric Ischemia - Pathophysiology

A

atherosclerotic changes of celiac or SMA

280
Q

1 S/E of ADPKD

A

ruptured berry aneurysm

Internal Medicine Shelf Exam (1 decks)

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