Internal Medicine

Question 1

What is an ABG indicator used to decide whether or not Corticosteroids are used in a HIV pt with severe PCP

Answer 1

alveolar-arterial oxygen gradient >/= 35 mm Hg

Question 2

What is dx:
45 yo AA F says “my L eye hurts, its too bright”
significant redness at jxn between cornea and sclera of L eye. L pupil is irregular + constricted and she flinches when light is shined into eye.

Slit lamp exam shows presence of leukocytes in anterior segment of eye

Answer 2

Iritis (Anterior uveitis) - antimicrobial therapy or topical steroids for noninfectious causes

Question 3

What is the most common cause of burn center deaths?

Answer 3

inhalation injuries ie supraglottic damage

–maintain low threshold for intubation

Question 4

What should be monitored when corrected pernicious anemia with vitamin b12?

Answer 4

Potassium levels (potassium uptake in newly forming RBCs)
--some providers transfuse 1 prbc before correcting Vit B12

Question 5

What is the most common side effect of Isoniazid?

Answer 5

Hepatotoxicity

–d/c drug if Aminotransferases >/=5 times the upper limit of normal

Question 6

How is T2DM managed in an inpatient setting?

Answer 6

1. Basal (intermed/long-acting insulin) - necessary for all T1DM
2. Nutritional boluses - short acting insulin - for postprandial
3. Correctional boluses - sliding scale

Question 7

Whats dx:
8 yr old w inappropriate crying/laughing for 2 weeks. restless, with strange movements of hands that improves w sleep. Rapid jerking movements of face and feet. hx of minor, self resolving URI.

PE: facial grimacing/tongue fasciculations, II/VI holosystolic murmur is heard at apex
Decreased muscular tone globally, pronator sign positive. patellar reflex is delayed

What should be first tx?

Answer 7

Sydenham chorea - associated with acute rheumatic fever (from untreated streptococcal pharyngitis)
–typically 1-8 months after initial strep infection

Tx: Penicillin

Question 8

What is the age of screening for lung cancer?

Answer 8

55-80

Question 9

What is the eligibility for lung cancer screening based on smoking history

Answer 9

> /+ pack-year smoking hx

and

Current smoker, quit smoking within last 15 yrs

Question 10

When should you terminate lung cancer screening?

Answer 10

age >80
or
Stops smoking >/=15 yrs
or 
other med probs that limit surg as option

Question 11

What is the criteria for the probability of PE?

Answer 11

Modified Wells Criteria
+3: Clinical signs of dvt, alternate Dx less likely than PE

+1.5: previous DVT/PE, HR > 100, Recent surgery/immobilization

+1: hemoptysis, Cancer

=4 PE unlikely
>4 = PE likely