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April EOR Exams > Internal Medicine > Flashcards

Internal Medicine Flashcards

1
Q

18 year old comes in with a non productive cough x 3 months. Also has the atopic triad. What will be found on physical exam?

A

wheezing

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2
Q

Pt with end stage liver disease what will be found on physical exam?

A

lower extremity muscle wasting (they will try to get you to pick hepatomegaly but remember just like ESRD you get small kidneys, with ESLD you get a small liver - so no hepatomegaly)

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3
Q

Genetic d/o with cerebellum and spinal cord demyelination?

A

Friedreich ataxia

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4
Q

What disease has increased tactile fremitus?

A

PNA

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5
Q

Female with HA, myalgia, fever, increased HR, neg kernig. Rash at wrist and ankles.

A

Rocky Mountain Spotty Fever

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6
Q

Pt with 2 months of myalgia, abdominal pain, wt loss, lower leg edema with purpura and ulcers. Dx?

A

polyarteritis nodosa

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7
Q

They give a long story about ankylosing spondylitis and even tell you its +HLA-B27 but they want you to describe the spine

A

enthesitis

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8
Q

Pt with a URI, what’s the treatment?

A

anticholinergic

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9
Q

What is the initial diagnosis of sarcoidosis?

A

chest x-ray

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10
Q

MC type of glomerulonephritis?

A

IgA nephropathy

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11
Q

Most effective way to avoid a concussion?

A

helmet

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12
Q

What is the initial treatment of spinal stenosis?

A

abdominal muscle strengthening, weight loss, bracing, and corticosteroid injections

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13
Q

MC malignant solitary pulmonary nodule?

A

adenocarcinoma

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14
Q

Pt with emphysema hyperinflated lungs with decreased lung markings, what is on physical exam?

A

hyperresonance to percussion

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15
Q

Pt was drinking a lot over the weekend and now has chest pain, SOB…think holiday heart, what would you expect on dx?

A

a-fib

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16
Q

Lytic lesions with increased alk-phos?

A

pagets disease of bone

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17
Q

What is the number one risk factor for peripheral artery disease?

A

smoking

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18
Q

Pt is 5 weeks post MI with no chest pain but is still having increased ST elevation in V2 - V4. Dx?

A

ventricular aneurysm

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19
Q

What is the treatment to decrease hepatic complications from hemochromatosis?

A

phlebotomy

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20
Q

Cause of increased conjugated bilirubin?

A

hepatic injury or biliary obstruction

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21
Q

Pt has an injured finger playing football, a ball hit tip of finger and no he can not extend. What is the dx?

A

mallet finger

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22
Q

Pt has severe upper GI bleeding, he is critical and in shock. Tx?

A

immediate endo band ligation, then octreotide

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23
Q

Pt has pneumonia and has a pleural effusion that on centesis shows frank pus, low pH, and low glucose. What is the tx?

A

thoracostomy tube

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24
Q

What is the tx when a pt with glomerulonephritis from SLE?

A

steroids

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25
Q

Pt has a mass on his testicle which gets worse with Valsalva. What is the dx?

A

varicocele

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26
Q

They give you a Hep B panel to interpret, mine was +HbsAg +HbeAg +IgM anti-Hbc

A

acute hep B

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27
Q

What is the def. dx of idiopathic pulmonary fibrosis?

A

CT scan: diffuse patchy fibrosis with pleural based honeycombing

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28
Q

Pt is obese with daytime sleepiness what will you expect to find on physical exam?

A

a history of snoring (its OSA)

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29
Q

When do you begin to admin the PPV vaccine?

A

65 years old

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30
Q

What drug do you not give for a concussion?

A

hydromorphone

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31
Q

What is the best way to decrease chances of getting diabetes if pre-diabetic?

A

weight loss

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32
Q

Elderly female has signs of SOB, sleeps upright on recliner with pillows. They increase her lasix but it doesn’t help her. What does she most likely have?

A

diastolic murmur

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33
Q

What disease is due to an increase in conjugated bilirubin?

A

hepatocellular injuries and biliary obstruction

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34
Q

What medication do you avoid in acute glaucoma?

A

atropine (anticholinergic)

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35
Q

MI and now has a murmur?

A

mitral regurgitation - due to papillary muscle rupture/defect

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36
Q

Loss of parietal cells

A

give vitamin B12

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37
Q

Has hypotension and a low sodium

A

addisons

-tx hydrocortisone

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38
Q

Has high Na

A

Primary hyperaldosteronism (Conn’s syndrome)

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39
Q

Swollen big toe

A

gout

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40
Q

EKG ST elevations I, aVL, V5 - V6

A

lateral circumflex

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41
Q

LLQ pain, slight fever

A

diverticulitis

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42
Q

Headache jaw claudication, shoulder pain

A

giant cell arteritis

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43
Q

Patient with a smoking hx with hematuria, what do you do next?

A

do a cystoscopy next

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44
Q

Painful defecation

A

anal fissure

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45
Q

Pain relieved with defecation

A

IBS

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46
Q

Medication to relieve symptoms of BPH

A
  • tamsulosin

- finasteride treats the actual disease

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47
Q

Guy has signs of hypocalcemia (trousseaus, chvostek’s etc.) how tx?

A

calcium gluconate

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48
Q

COPD with 2 different P wave morphologies

A

multifocal arterial tachycardia

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49
Q

Progressive lengthening of PR interval and a dropped beat

A

Mobitz type 1 (second degree type one)

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50
Q

What is the criteria of metabolic syndrome?

A 
130/85 BP
Triglycerides > 150 
Glucose > 100 
HDL < 50 females, < 40 males
Truncal obesity
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51
Q

HA, HTN, diaphoresis, tachycardia, palpitations, what is the dx?

A

Pheochromocytoma

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52
Q

First line tx active seziure

A

lorazepam

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53
Q

Everything is dry and has keratoconjunctivitis sicca

A

sjogren’s

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54
Q

Status epilepticus compared to tonic-clonic seizure

A

no post-ictal phase

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55
Q

College student with URI sx and has patchy infiltrates on CXR

A

mycoplasma

-treat with macrolide

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56
Q

Physical exam of patient with end stage alcoholic liver cirrhosis

A

esophageal varices

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57
Q

What is in a patient’s history of painless rectal bleeding?

A

constipation

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58
Q

Nephrotic syndrome

A

> 3.5 proteinuria
hypoalbuminemia
hypertriglyceridemia
hypercoagulable state

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59
Q

Describe SVT

A

narrow QRS with 160 BPM

-give adenosine

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60
Q

Reactive arthritis - cause and symptoms?

A

dysenteric infection can cause it (like campylobacter)

-presentation of conjunctivitis, arthritis, urethritis

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61
Q

Ileum recently resected, what do you want to replace?

A

B12

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62
Q

What drug do you not give if a person has gout?

A

Thiazide diuretics

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63
Q

Major side effect of inhaler

A

thrush

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64
Q

MCC of lung cancer

A

adenocarcinoma

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65
Q

Progressive dysphagia from solid to liquid, weight loss, what is the dx?

A

esophageal carcinoma

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66
Q

What is seen with aortic regurgitation?

A

bisferiens pulse

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67
Q

(+) ANA, confirm (lupus)?

A

Anti-double stranded DnS

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68
Q

Pt has mild persistent asthma, what to do?

A

add low dose ICS

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69
Q

Nodules on DIPs, dx?

A

OA - hebertons

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70
Q

IVDA, which valve?

A

tricuspid

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71
Q

Mas on tricep, bilateral arthralgia on PIPs, MCPs, dx?

A

RA

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72
Q

Pt was fatigued and weak, rash on face, lesions all over of different appearances (vesicles, papules), what is the cause?

A

varicella

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73
Q

Hyperinflation of lungs on CXR, what additional finding?

A

hyperresonance to percussion

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74
Q

What do you want to give patient with COPD?

A

Ipratropium (bronchodilators)

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75
Q

What is associated with sjogren’s?

A

EBV

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76
Q

MC seen with hypercalcemia

A

nephrolithiasis

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77
Q

Ptosis, diplopia, facial nerve sxs, what is the dx?

A

myasthenia gravis

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78
Q

How do you tx Raynaud’s?

A

nifedipine

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79
Q

How do you tx prinzmetal angina?

A

CCB

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80
Q

How do you tx hepatic encephalopathy?

A

lactulose

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81
Q

Lab test to monitor with someone who is treated for thyroid problem

A

TSH

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82
Q

Bilateral hilar infiltrates and cough for 2 months. What other manifestation will you see on PE? Sarcoid?

A

treat with prednisone

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83
Q

High trigs can lead to what?

A

pancreatitis

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84
Q

What is the MC physical exam findings in a patient with polyarteritis nodes?

A

livedo reticularis

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85
Q

Pt with kidney stones. Has hypercalcemia to 13.4. What are some symptoms?

A

constipation

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86
Q

What do chief cells secrete?

A

pepsinogen

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87
Q

Pt has CKD, what med to stop?

A

NSAIDs

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88
Q

18 year old with tenderness in the scrotum and mucopurulent discharge

A

epididymitis

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89
Q

Pt with MS. How do you control muscle spasms?

A

baclofen

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90
Q

Pt with obesity, hypertension, cholesterolemia, excessive drinker, current smoker. What are they most at risk for?

A

coronary vascular disease

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91
Q

Pt with obesity hypoventilation syndrome. You suggest they lose weight. What is another initial tx?

A

positive airway pressure

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92
Q

Pt has a CABG 2 days ago and now has chest pain, what is the most likely finding on PE?

A

mitral regurgitation - holosystolic murmur high pitched and blowing

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93
Q

Pt has an MI and now has pleuritic CP and fever

A

dressler’s syndrome

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94
Q

Pt that worked in the coal mines for a really long time, and they have stuff in the upper lobs of their lungs, what do they have?

A

pneumoconiosis

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95
Q

Suprucondylar fracture tx

A

long arm splint

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96
Q

Rotator cuff tear

A

abnormal empty can test

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97
Q

Humerus fracture - what nerve are you concerned for injury?

A

axillary

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98
Q

Pt has mild persistent asthma - what is initial step?

A

inhaled SABA + ICS

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99
Q

Echo shows enlarged superior pulmonary vessel

A

PE

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100
Q

Man with large neck circumference

A

tx with CPAP

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101
Q

Pathophysiology of MG

A

AB against ACH receptors

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102
Q

Pathophysiology of DM I

A

autoimmune pancreatic beta cell destruction

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103
Q

Initial test to monitor thyroid problems

A

TSH

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104
Q

High triglycerides lead to

A

pancreatitis

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105
Q

patient with multiple sclerosis

A

control SPASTICITY - tx with baclofen

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106
Q

Patient has lockjaw, trismus, and tetany, what is the causative agent?

A

C. tetani

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107
Q

Pleuritic CP after MI

A

Dressler’s syndrome

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108
Q

History of COPD comes to the clinic with increasing dyspnea + productive cough on systemic steroid what do you give them

A

ipratropium bromide (bronchodilator)

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109
Q

Nerve that innervates sticking out the tongue

A

hypoglossal (12 cranial nerve)

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110
Q

What age does a patient get pneumococcal?

A

65

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111
Q

Patient with G6PD what medication should you not give them?

A

sulfonamides

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112
Q

What on EKG shows LVH?

A

S wave in V1 plus the R wave in V5 or V6 sum > 35

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113
Q

What drug should you not be given to a patient with gout?

A

thiazide diuretics

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114
Q

Patient has LLQ, fever, most likely diverticulitis, how do you dx?

A

CT scan

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115
Q

Patient presents with tunnel obesity, HTN, low HDL, what do they have?

A

metabolic syndrome

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116
Q

MC nephropathy?

A

IgA

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117
Q

Patient was sick a couple weeks ago with sore throat, now has kidney problems, what is the dx?

A

Post-strep glomeruloneprhtis

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118
Q

Bilateral ptosis, diplopia, muscle weakness, facial nerve, dx?

A

MG

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119
Q

Lab test to monitor for someone on Valproate?

A

LFTs

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120
Q

What is seen with cardiac tamponade?

A

pulsus paradoxus

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121
Q

Patient in MVA and now has HoTN, JVD, decreased heart sounds (beck’s triad), tx?

A

pericardiocentesis

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122
Q

Initial treatment of PUD?

A

pantoprazole

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123
Q

What do you give patients in the ICU to prevent gastric stress?

A

pantoprazole

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124
Q

MC area for polymyalgia rheumatica pain?

A

shoulders

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125
Q

What is the mainstay treatment for someone with polymyalgia rheumatica?

A

steroids

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126
Q

Pt has mild persistent asthma and uses albuterol 4 times a week, what do you want to add?

A

low dose inhaled corticosteroids

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127
Q

How do you treat someone with asterixis (hepatic encephalopathy)?

A

lactulose

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128
Q

IVDA has murmur of what valve?

A

tricuspid

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129
Q

Nodules on DIPs, what is diagnosis?

A

OA

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130
Q

Patient has bilateral pain in shoulder, hips, knees, and swelling of MCP joints, what is the dx?

A

RA

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131
Q

HTN, diaphoresis, HA, dx?

A

pheochromocytoma

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132
Q

Patient has a red papule on face that she scratched and now has papules, vesicles on erythematous bases, what is dx?

A

varicella

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133
Q

Hyperinflation of lungs on CXR, what is physical exam finding?

A

hyperresonance to percussion

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134
Q

Tx of legionella pneumonia?

A

azithromycin

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135
Q

Blood mucous diarrhea, relief with defecation, positive family history for psoriatic arthritis, what is dx?

A

UC

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136
Q

70 year old patient with 40 year smoking history and microscopic hematuria, what study do you want to do?

A

cystoscopy

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137
Q

Patient has Tissue Transglutaminase (tTG) antibody, IgA in the setting of foul smelling diarrhea, dx?

A

celiac

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138
Q

Patient has BRBPR on toilet paper, toilet and perianal itching, what is dx?

A

thrombosed hemorrhoid

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139
Q

How do you treat PID in nonpregnant patient?

A

ceftriaxone + doxy + metronidazole

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140
Q

How do you treat UTI in a female patient?

A

nitrofurantoin

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141
Q

Patient presenting with symptoms of ITP, how do you treat?

A

steroids

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142
Q

Patient has micrographia, cogwheel rigidity, what else would you see on physical exam?

A

resting tremor

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143
Q

What murmur do you see post MI?

A

mitral regurgitation

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144
Q

Patient presents with HoTN and high K, what is dx?

A

addisons

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145
Q

Patient has bent arms, with legs internally rotates and plantar flexed, what kind of posturing?

A

decorticate

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146
Q

How long after dx RA do you refer to a rehumatologist?

A

immediately

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147
Q

Man goes to Nicaragua and gets nausea, vomiting, and now he has jaundice and scleral icterus, what bug?

A

hepatitis A

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148
Q

Patient has hep B, what is concomitant infection?

A

Hep D

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149
Q

Patient has fever, RUQ pain and positive murphy’s, what could have caused her condition?

A

high triglycerides

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150
Q

Patient has spinal stenosis, what is the initial treatment?

A

NSAIDs, PT, Steroid injections

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151
Q

Patient’s family history significant for brother at 41 has ESRD and father died young of a cerebral aneurysms, what would you see on physical exam?

A

palpable kidneys

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152
Q

Patient has pain in 14 out of 18 pressure points, what is mainstay of treatment?

A

amitriptyline

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153
Q

Patient in the ICU has sudden onset respiratory distress, looks like ARDS, dx?

A

ARDS - non invasive or mechanical ventilation with positive end-expiratory pressure

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154
Q

Patient has symptoms of PAD, how do you dx?

A

Ankle-brachial index or arterial doppler

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155
Q

Patient presenting with trismus, jaw stiffness, what is the causative agent?

A

clostridium tetani

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156
Q

Patient has rice water stools, what did they most likely ingest?

A

shellfish - vibrio cholera

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157
Q

Patient has restrictive cardiomyopathy due to amyloidosis, what would you see?

A

rigid ventricles due to scar tissue

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158
Q

Patient has delta waves, what is the MOA?

A

accessory pathway that bypasses the AV node

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159
Q

Pericardial knock, radiation, what is the dx?

A

constrictive pericarditis

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160
Q

Patient has auer rods, what is dx?

A

AML

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161
Q

Treatment for sick sinus syndrome?

A

implantable pacemaker

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162
Q

Treatment for patient with life threatening ventricular arrhythmias?

A

implantable defibrillator

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163
Q

Treatment for patient who is pulseless with no discernable P or QRS but has weird waves, tx?

A

defibrilaate

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164
Q

How to dx GERD with normal endoscopy?

A

pH monitoring

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165
Q

Patient has PNA that is gram positive cocci in pairs, what is the dx?

A

Staph aureus

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166
Q

Patient has ST segment depression in leads I and aVL, what is dx?

A

acute coronary syndrome

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167
Q

Patient with HIV and pneumonia, what is tx?

A

bactrim

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168
Q

Patient had lytic lesions with elevated alk phos, dx?

A

pagets

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169
Q

Patient had weakness, sudden onset renal insufficiency (looks like multiple myeloma), how to dx?

A

serum protein electrophoresis

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170
Q

Patient who is an alcoholic with PNA, what is the MCC?

A

klebsiella

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171
Q

Patient from Ukraine lived in Chernobly, what cancer is he most at risk for?

A

thyroid cancer

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172
Q

Patient has no risk factors and is getting a purified protein derivative, what would indicate positive?

A

> 15 mm

173
Q

Healthcare worked getting purified protein derivative, what would indicate positive?

A

> 10 mm

174
Q

HIV patient gets purified protein derivative, what would indicate positive?

A

> 5 mm

175
Q

Mechanism of Graves disease?

A

antibodies bind to receptors to produce more TSH

176
Q

Patient presents with gastroenteritis and now has ascending weakness, dx?

A

guillain-barre

177
Q

Patient has been cough for 3 months, dx?

A

chronic bronchitis

178
Q

Patient has bouts of bradycardia and tachycardia, dx?

A

sick sinus syndrome

179
Q

Patient has high riding testicle with loss of cremasteric reflex, dx?

A

testicular torsion

180
Q

Patient has sudden onset SOB and is on oral contraceptive, what is the dx?

A

pulmonary embolism

181
Q

Patient has ulcer at medial malleolus, what is the dx?

A

venous stasis

182
Q

What do you see on physical exam for person with venous stasis?

A

hyperpigmentation

183
Q

Patient with PNA sating at 90%, what do you want to do next?

A

admit to hospital

184
Q

Patient has petechiae and ulcer on leg, what is the dx?

A

polyarteritis nodosa

185
Q

Patient is a past smoker, with no issues, what screening do you want to do for him?

A

CXR or low dose CT scan

186
Q

Kid has sore throat and now has some sequelae, what is the cause?

A

strep pyogenes

187
Q

What do you tell patient taking iron?

A

supplement with vitamin C

188
Q

College student with positive brudzinski, what is most common cause?

A

strep pneumo (without petechial rash = pneumo, with rash = n. meningitis)

189
Q

Patient comes in with uncontrolled DM with family hx of DM and HTN, what is she most at risk for?

A

CAD

190
Q

Was given an UA to interpret that had 2+ protein, 2 WBC and 20 RBC, what is the dx?

A

glomerulonephritis

191
Q

Patient with AMS and wrist drop when asked to pronate, what is the dx?

A

hepatic encephalopathy

192
Q

Treatment of T score of -2.8?

A

prolia

193
Q

Patient presents with SVT, what is the tx?

A

adenosine

194
Q

What do you hear on physical exam for CHF?

A

S3

195
Q

Patient had hypertension and low K, what is the dx?

A

primary hyperaldosteronism

196
Q

Patient had thyroidectomy and now has perioral paresthesia and positive Chvostek’s, what is the tx?

A

calcium gluconate

197
Q

Fever, RUQ pain, jaundice, what is the dx?

A

ascending cholangitis

198
Q

Patient drank a lot and now has chest pain and SOB, what is the dx?

A

a. fib

199
Q

What is the treatment to decrease hepatic complications from hemochromatosis?

A

phlebotomy

200
Q

Patient injured his finger and now has a mallet finger, what is the tx?

A

hyperextension splint

201
Q

What does a patient with IBS present with?

A

relief with defecation

202
Q

What is the tx for a supracondylar fracture?

A

posterior splint

203
Q

What is RA associated with?

A

older aged Caucasian

204
Q

What is a complication of trigeminal neuralgia?

A

double vision, jaw weakness, loss of corneal reflex, dysesthesia

205
Q

How do you treat SIADH?

A

hyponatremia replenished - H2O restriction

206
Q

How do you treat hypoglycemia when the pt has collapsed and is having seziures?

A

dextrose 50% IV

207
Q

Amyloidosis symptom?

A

diastolic dysfunction

208
Q

What is the initial step in atherogenesis of CAD?

A

endothelial damage

209
Q

What is a risk factor of Alzheimer’s?

A

dementia

210
Q

Increased PT, AST, ALT, bilirubin and decreased albumin, what is the dx?

A

cirrhosis

211
Q

How do you dx sarcoidosis?

A

biopsy

212
Q

Diastolic rumble that radiates to carotids, how do you definitively dx?

A

angio

213
Q

What is the tx of sarcoidosis?

A

steroids

214
Q

What is the microorganism of pericarditis?

A

coxsackie

215
Q

18 year old with 1 week/3 month symptoms, 2x per month night time awakening, what is the tx?

A

albuterol

216
Q

18 year old dx with asthma, what do you do next?

A

asthma action plan

217
Q

What is the tx for gouty arthritis?

A

indomethacin

218
Q

What is seen with acute bronchitis?

A

white clear sputum, nocturnal dyspnea, fever

219
Q

Behavioral changes, dancing like movements, what is the dx?

A

huntington’s

220
Q

Med that should be removed in CKD?

A

NSAIDs

221
Q

What is the landmark that differentiates upper GI bleed form lower GI bleed?

A

ligament of treitz

222
Q

SOB, no edema, jvd or other symptoms, what is the dx?

A

PE

-very vague vignette

223
Q

What is the tx for Myasthenia gravis?

A

pyridostigmine

224
Q

JVP and murmur that is on the right side?

A

tricuspid

225
Q

Radio ablation cause?

A

pericarditis

226
Q

Sick sinus syndrome initial tx?

A

radioablation

227
Q

Gonococcal arthritis, what is the initial dx?

A

arthrocentesis or urethral swab

228
Q

What is the definitive tx for a fissure?

A

sphincterotomy

229
Q

Eosinophilia in urine, what is the dx?

A

allergic interstitial nephritis

230
Q

Pt extreme SOB walking two blocks, hx of alcohol consumption, what is the initial management?

A

regular exercise or alcohol cessation

231
Q

Kidney stone 6 mm already on Tamsulosin, what is the next tx?

A

lithotripsy

232
Q

Pt has COPD, what med will change the course of their disease?

A

home oxygen

233
Q

What cranial nerve is involved in sticking out your tongue?

A

XII

234
Q

How do you dx sarcoid?

A

CXR

235
Q

What is the tx of chronic bronchitis?

A

LABA

236
Q

What is Charcot triad?

A

RUQ pain, jaundice, fever

237
Q

Finding on PE with cerebellar tumor?

A

abnormal gait

238
Q

What is the causative agent of glomerulonephritis?

A

strep pyrogens

239
Q

What are the sxs of sick sinus syndorme?

A

dizzy, syncope, bradycardia, tachycardia

240
Q

What is the pathophysiology of Wolff-Parkinson-White?

A

accessory pathway that bypasses the AV node

-delta wave

241
Q

What is the first line tx for symptomatic bradyarrhythmia due to sick sinus syndrome?

A

pacemaker

242
Q

What is the dx characterized by RVH due to chronic hypoxia?

A

pulmonary hypertension

243
Q

32 year old male with cough, malaise, fever, chills, night sweats, anorexia, weakness, arthralgias, native of AZ and worked for 10 years in construction, no smoking hx, CXR show solitary pulmonary nodule. What tx options most likely result in clinical improvement?

A

radiation and chemo

244
Q

Well circumscribed mass in right lung periphery, how do you definitively diagnosis?

A

FNA and biopsy

245
Q

34 year old worsening dyspnea, dyspnea brought on by activity relieved with rest, S4, echo shows LVH and thickening of septum, what additional symptom?

A

exertional syncope

246
Q

History of a. fib significant dyspnea on exertion, chronic cough, hemoptysis occasional, physical exam reveals crackles, loud first heart sound, diastolic rumble, which murmur?

A

mitral stenosis

247
Q

DM II, dyslipidemia, not getting adequate glucose control with metformin, diet and exercise. Which medicine should be added to help with his hyperlipidemia?

A

colesevelam

248
Q

Patient has a blood pressure of 212/144. what is the tx?

A

labetalol

249
Q

Most likely risk factor for intrinsic sinoatrial node?

A

increased age

250
Q

CSF panel findings for bacterial meningitis?

A

elevated opening pressure and protein, decreased glucose

251
Q

A question on a classic picture of meningitis, pt has a rash, what is the causative organism?

A

Neisseria meningitidis

252
Q

What is the long term treatment for Wolff-Parkinson-White?

A

radiofrequency ablation

253
Q

What increases NA reabsoprtion?

A

aldosterone

254
Q

What is the tx of sexual caused epididymitis?

A

doxy + ceftriaxone

255
Q

What is a symptom of venous ulcer?

A

hyperpigmentation

256
Q

What is the function of urine specific gravity?

A

measures concentration of urine

257
Q

What is the tx of ventricular aneurysm?

A

defibrillation

258
Q

What is the finding of EKG for ventricular aneurysm?

A

persistent ST elevation, VI, V2 6 weeks post MI

259
Q

What is a side effect of rifampin?

A

discoloration of body fluids

260
Q

What should all patients with SLE be placed on?

A

hydroxychloroquine

261
Q

Woman is 9 months post/op/injury to her arm. She starts to develop erythema, paresthesia, swelling and pain. What is the dx?

A

complex regional pain syndrome

262
Q

Patient has thickened skin on distal fingers, what is the dx?

A

systemic sclerosis (scleroderma)

263
Q

Patient went to a foreign country (Caribbean) and returned with bloody diarrhea. What is the causative agent?

A

shigellosis

264
Q

Patient received radiation therapy for cancer, now has cardiac complaints and pericardial friction rub (constrictive pericarditis), what are you most likely to see on echo?

A

diastolic dysfunction from pericarditis

265
Q

Patient with transmural inflammation of intestines and patches of separate ulcerations (skip lesions), what is the dx?

A

Crohn’s disease

266
Q

Patient has anal fissure (or hemorrhoids) what is the best tx?

A

increased fiber in diet or sphincterotomy

267
Q

Patient has right handed worsening tremor, what is the best tx?

A

beta blockers

268
Q

Patient has mildly erythematous right eye upon waking, also complains of pain, no history of infection or trauma, unilateral symptoms only. What else do you expect to find on exam?

A

fixed, mild dilated pupil on right

269
Q

Patient is post CABG, develops chest pain, EKG shows low voltage and electrical alternans, what else do you expect to find on exam?

A

pericardial effusion - JVD

270
Q

Patient has heart failure, what do you see on CXR?

A

cephalization of flow

-due to pulmonary vasculature dilation

271
Q

What is the presentation of Hodgkin’s lymphoma?

A

bimodal, EBV association, painless mediastinal lymphadenopathy, pain with alcohol, b- symptoms, reed Stenberg cells

272
Q

What is the tx for angina pectoris?

A

MONA, beta blocker, statin if high LDL and low HDL

273
Q

How do you dx sick sinus syndrome?

A

tachy then brady on EKG

-risk factor is age due to SA node pulmonary fibrosis

274
Q

How do you dx tricuspid regurgitation?

A
  • blowing holosystolic murmur
  • LLSB
  • carvallo’s sign: increased with inspiration
  • decreases with Valsalva
275
Q

What are the dx study findings for restrictive cardiomyopaty?

A
  • Echo = diastolic dysfunction with preserved contractility, S4 heart sound
  • CXR = dilated atria, normal ventricles
  • ventricular rigidity impedes ventricular filling
  • R sided heart failure
276
Q

What are the clinical therapeutics for hyperlipidemia?

A
  • niacin, nicotinic acid, vitamin B3 - best drug to increase HDL
  • Side effects: hyperglycemia, hyperuricemia, gout
  • niacin causes hyperglycemia so use in caution in patients with diabetes
277
Q

How do you dx Dressler syndrome?

A

pericarditis 2-5 days status post MI associated with fever and pulmonary infiltrates

278
Q

What is the tx for Dressler syndrome?

A

colchicine, indomethacin, NSAIDs

279
Q

How do you dx secondary hypertension?

A

MC: CKD

  • hypertension due to renal artery stenosis
  • severe refractory hypertension
  • abdominal: renal bruit
280
Q

What are the dx studies for LVH?

A

Sokolow - Lyon Index

-measure lowest S in V1 or V2 + tallest R in V5 or V6 if > 35 mm = LVH

281
Q

What is heard on auscultation with aortic stenosis?

A
  • crescendo decrescendo at RUSB
  • paradoxically split S2
  • pulsus parvus et tardus = weak delayed pulse = narrow pulse pressure
  • radiated to carotids: delayed carotid pulse
282
Q

What are the sxs of CHF?

A

syncope, angina, dyspnea on exertion

283
Q

What is central diabetes insipidus?

A

deficiency of ADH from posterior pituitary/hypothalamus
-no ADH production most common type: idiopathic, autoimmune destruction of posterior pituitary from head trauma, brain tumor, infection, or sarcoidosis

284
Q

What is nephrogenic diabetes insipidus?

A

lack of reaction to ADH
-partial or complete insensitivity to ADH: caused by drugs (Lithium, amphoterrible), hypercalcemia and hypokalemia after the kidney’s ability to concentrate urine, acute tubular necrosis

285
Q

What is the tx for central diabetes insipidus?

A

desmopressin

286
Q

What is the tx for nephrogenic diabetes insipidus?

A

sodium and protein restriction, HCTZ, indomethacin

287
Q

What medication is contraindicated in pregnancy?

A

cipro

288
Q

What is the presentation of testicular torsion?

A
  • asymmetric high riding testicle
  • sudden, severe pain and swelling in the testicle
  • associated with nausea and vomiting
  • cremaster reflex is absent
289
Q

What is the tx of epididymitis?

A

supportive care: bed rest, scrotal elevation, analgesics

  • > 35 years = levofloxacin
  • < 35 years = ceftriaxone+ doxy
290
Q

What is status epilepticus?

A

a single epileptic seizure lasting more than five minutes or two or more seizures within a five-minute period without the person returning to normal between them

291
Q

How do you dx diverticulitis?

A

abdominal/pelvic CT scan revealing fat stranding and bowel wall thickening

292
Q

What is the treatment of celiac?

A

lifelong gluten free diet

293
Q

What is the risk of resected brain tumor?

A

cerebral aneurysm. dementia, seizures

294
Q

What is the most common cause of aseptic meningitis?

A

viral - enteroviruses, HSV, HIB, mumps, West Nile

295
Q

What drug is use to treat a bleeding PUD?

A

pantoprazole (protonix)

296
Q

What is the tx for pyelonephritis?

A

ciprofloxacin

297
Q

Patient has a hx of GERD, takes ASA, clopidogral, atorvastatin, lisinopril, metoprolol succinate. What drug should be avoided?

A

omeprazole

298
Q

What are the symptoms of BPH?

A

decreased force of urinary stream, hesitancy (stop and start) and straining, postvoid dribbling, incomplete emptying, frequency, nocturia, urgency, recurrent UTIs

299
Q

What are the funduscopic findings of hypertension retinopathy?

A

arteriolar constriction, arteriovenous nicking, vascular wall changes, flame-shaped hemorrhages, cotton-wool spots, yellow hard exudates, and optic disk edema.

300
Q

3 months burning pain in 2nd and 3rd toes, numb, what is the dx?

A

morton’s neuroma

301
Q

What is the presentation of systemic sclerosis (scleroderma)?

A
  • Tight, shiny, thickened skin due to fibrous collagen buildup
  • Limited cutaneous systemic sclerosis “CREST SYNDROME” - Calcinosis cutis, Raynaud’s phenomenon, esophageal motility disorder, sclerodactyly (claw hand), telangiectasia
302
Q

Signs, symptoms and treatment for pericarditis?

A
  • Pleuritic Persistent chest pain
  • Pericardial friction rub
  • Better leaning forward
  • Persistent ST elevations in precordial leads and PR depression in same leads
  • Tx: NSAIDS
303
Q

Signs and symptoms of renovascular HTN?

A
  • Bruit over Epigastrium
  • AKI w/ initiation of ACE
  • Severe refractory HTN and HA
304
Q

Signs and symptoms of constrictive pericarditis?

A
  • Pericardial Knock - high pitched 3rd heart sound
  • Right sided heart failure, Dyspnea
  • S4
  • Kussmaul’s sign - increased JVD during inspiration
305
Q

Signs and symptoms of acute arterial occlusive disease?

A
  • Pallor, pain, pulselessness, paresthesia, paralysis, poikilothermia
  • Lateral malleolus ulcer
306
Q

Clinical Interventions for Wolff parkinson white syndrome?

A
  • Pharm Tx: Procainamide or Amiodarone

- Definitive: radiofrequency ablation of the accessory pathway

307
Q

Signs and symptoms of Mitral Stenosis?

A
  • Enlarged/Dilated LA on CXR
  • CHF sx’s of right sided heart failure
  • Opening snap
  • Diastolic rumble
  • Associated with Afib
308
Q

Signs and symptoms of Peripheral Arterial Disease?

A

Intermittent Claudication, mc pain brought on by exercise relieved with rest

309
Q

What are characteristics of systolic CHF?

A
  • MC CHF
  • Low EF
  • S3 -filling of dilated ventricle
310
Q

What are characteristics of Diastolic CHF?

A
  • Normal EF

- S4 - atrial contraction into stiff ventricle

311
Q

Signs and symptoms of L sided HF?

A
  • Fluid backs up to lungs, increased pulmonary venous pressure
  • Dyspnea MC sx
  • Pulmonary congestion- pink frothy sputum Orthopnea, PND
312
Q

Signs and symptoms of R sided HF?

A
  • Systemic fluid retention- increased systemic venous pressure
  • Peripheral pitting edema
  • JVD
  • GI/Hepatic congestion: Ascites
313
Q

What is becks triad for cardiac tamponade?

A

Distant muffled heart sounds, increased JVP, Hypotension

314
Q

Cardiac Tamponade echo finding and tx?

A
  • Diastolic collapse of cardiac chambers

Tx: Pericardiocentesis

315
Q

Signs and symptoms of Acute glaucoma?

A
  • Increased intraocular pressure
  • Sudden severe unilateral eye pain, watery, tunnel vision, foggy, injected
  • “Steamy Cornea” (cloudiness)
  • Mid dilated non-reactive pupil
  • Hard to palpation
316
Q

Clinical Therapeutics for Acute angle closure glaucoma?

A
  • Acetazolamide IV - 1st line
  • Topical BB: Timolol
  • Miotics/cholinergics: Pilocarpine, Carbachol
317
Q

Clinical Therapeutics for Acute Adrenal Insufficiency?

A
  • IV fluids: NS (D5NS if hypoglycemic)
  • Glucocorticoids: Hydrocortisone- if dx, if undx: Dexamethasone
  • Reverse electrolyte abnormalities
    0 Give Fludrocortisone
318
Q

Signs and symptoms of Adrenal Insufficiency?

A

Shock, hypotension, hypovolemia = Severe DEHYDRATION

319
Q

Lab studies for Adrenal Insufficiency?

A
  • Hypoglycemia
  • Hyponatremia
  • Hyperkalemia
  • Hypercalcemia
320
Q

Signs and symptoms of Addisons disease?

A
  • Hyperpigmentation: due to increased ACTH production
  • Low Aldosterone - Can’t hold onto Sodium
  • Decreased sex hormones: low lobido, Amenorrhea, loss of axillary and pubic hair
321
Q

Graves disease laboratory concepts?

A
  • Igg Antibody –> binds to TSH receptors and triggers synthesis of excess thyroid hormone
  • Circulating TSH receptor ab –> causes increase thyroid hormone synthesis
322
Q

Most common thyroid cancer?

A

Papillary 80%: MC after radiation exposure, young females, local cervical LN mets

323
Q

Signs and symptoms of Hypercalcemia?

A
  • Stones : kidney stones
  • Bones: fractures
  • Abdominal Groans: Constipation, Ileus
  • Psychiatric overtones: HA, weakness, fatigue, decreased DTR
  • Shortened QT interval
324
Q

Causes of hypocalcemia?

A
  • Hypoparathyroidism , post surgical
  • Chronic Renal Dz
  • Vitamin D deficiency : Rickets, Osteomalacia
325
Q

+ Chvostek and Trousseau is a sign of what?

A

Hypocalcemia

326
Q

Signs and symptoms of Acromegaly?

A
  • Enlargement of Hands, feet, and skull
  • Coarsened facial features
  • Micrognathia - enlarged jaw
  • Organomegaly
  • DM, Kidney stones
  • HA, visual defects
327
Q

How do you diagnoses metabolic syndrome?

A
  • HDL <40 men and <50 women
  • BP 135/85
  • TG >180
  • Fasting blood sugar 100-135
  • Waist circumference > 35 women, > 40 men
328
Q

Signs and symptoms of Paget disease of bone?

A
  • Abnormal bone remodeling
  • MC > 40y
  • MC in Western European descent
  • High Alk phos with normal calcium & phosphate
329
Q

What are the imaging finding and tx for Paget disease of bone?

A
  • XRay: blade of grass/flame shape lucency
  • Skull have cotton wool appearance
  • Tx: Bisphosphonates & calcitonin
330
Q

Signs and symptoms of DiverticulOsis?

A
  • LLQ pain
  • Bright red blood per rectum
    (low fiber diet, constipation, obesity)
  • MC cause of acute lower GI bleed
331
Q

Diagnostic studies of diverticulitis?

A
  • CT scan is test of choice
  • Elevated WBC
  • +Guaiac
332
Q

Signs and symptoms of diverticulitis?

A
  • Fever, LLQ Pain, N/V/D/C, flatulence, bloating
333
Q

Tx for diverticulitis?

A
  • IV fluids + ABX

- Broad spectrum Abx: Cipro or Bactrim + Metronidazole

334
Q

What are the diagnostic studies for crohns disease?

A
  • Colonoscopy: “Skip lesions” w/ Cobblestone appearance
  • Barium study: “String sign” Ba flow through narrowed ileum
  • Acute dz: Upper GI series with Small bowel follow through: test of choice Labs: +ASCA (Anti-Saccharomyces Cerevisiae Antibody)
335
Q

Signs and symptoms of Cirrhosis?

A
  • Ascites and gynecomastia
  • Fatigue, weakness, weight loss, muscle cramps, anorexia
  • Skin: Spider angioma, caput medusae, muscle wasting, palmar erythema,
    hepatosplenomegaly, jaundice
  • Dupuytren’s contractures
336
Q

Diagnostic studies for colon cancer?

A
  • Colonoscopy with Biopsy
  • Barium Enema: Apple Core Lesions
  • Elevated CEA tumor marker
337
Q

Diagnostic studies for ulcerative colitis?

A
  • Flex Sigmoidoscopy : Uniform inflammation - Sandpaper appearance
  • Pseudopolyps
  • BLOODY DIARRHEA
  • Diffuse ulceration- bleeding
  • Sheets of WBC- inflamed mucosa
338
Q

What causes Zollinger Ellison syndrome?

A

Gastrin secreting neuroendocrine tumor

339
Q

what is the Zollinger Ellison syndrome triad?

A
  • Peptic ulcers
  • Gastric acid hypersectretion
  • Tumor of pancreas
340
Q

What are the urine and serum protein electrophoresis findings for multiple myeloma?

A
  • Urine: Bence-Jones Proteins: Kappa or Lambda light chains

- Serum: monoclonal protein spike (IgG: 60%, IgA: 20%)

341
Q

Peripheral smear finding for CLL?

A

Well differentiated lymphocytes w/ scattered SMUDGE CELLS

342
Q

What are the lab and bone marrow findings for AML?

A
  • Pancytopenia

- Bone marrow: auer rods

343
Q

Lab findings for CML?

A
  • Increased WBC : 100,000
  • Blastic crisis
  • Philadelphia Chromosome
344
Q

Health maintenance protocol for Hemolytic Anemia in a pt with sickle cell?

A

IV hydration, Oxygen, Morphine or Hydrocodone, Hydroxyurea, Folic acid,
Blood transfusion, Allogeneic stem cell transplant

345
Q

Health maintenance protocol for Hemolytic Anemia in a pt with G6PD?

A

Avoid offending foods and sulfa drugs Fe/Folic acid supplement, blood
transfusion if severe

346
Q

Health maintenance protocol for Hemolytic Anemia in a pt with Hereditary Spherocytosis?

A

Folic acid, Splenectomy is tx of choice if severe.

347
Q

Health maintenance protocol for Hemolytic Anemia in a pt with Alpha Thalassemia?

A
  • Mild: no tx mod:Folate, avoid oxidative stress
  • Severe: Blood transfusions, Iron Chelating agents (Deferoxamine), Splenectomy, Bone marrow transplant, Vitamin C, Folate.
348
Q

Health maintenance protocol for Hemolytic Anemia in a pt with Beta Thalassemia?

A
  • Minor: no tx

- Major: Weekly blood transfusions, Deferoxamine, Bone marrow transplant, Vitamin C, Folate, Splenectomy.

349
Q

Health maintenance protocol for autoimmune Hemolytic Anemia?

A
  • Warm: Steroids, Immunosuppressants,
    Splenectomy
  • Cold: Avoid cold exposure, drink warm fluids, Rituximab.
350
Q

Health maintenance protocol for Hemolytic Anemia in a pt with TTP?

A

Plasmapheresis is tx of choice, steroids, Cyclophosphamides, Splenectomy if refractory

351
Q

Health maintenance protocol for Hemolytic Anemia in a pt with DIC?

A
  • Platelet transfusion if <20K, FFP if severe bleeding, Cryoprecipitate to replace
    fibrinogen, +/- Heparin for thrombosis
352
Q

Health maintenance protocol for Hemolytic Anemia in a pt with HUS?

A

Observation (in children), Plasmapheresis +/- FFP if severe.

353
Q

Treatment for Pneumocystitis?

A
  • Bactrim is tx of choice.
  • Add Prednisone if O2 Sat is <80%
  • Other regimens: Clinda + Primaquine, Trimetrexate, Dapsone
  • Use Itraconazole for Histoplasmosis
354
Q

Treatment for Pertussis?

A
  • Erythromycin is drug of choice
  • Bactrim is 2nd line
  • Tdap for booster tetanus shots
355
Q

Tuberculosis is spread via what mechanism and leads to what in the lungs?

A
  • Via airborne droplets

- Granuloma formation in the lungs

356
Q

Which phase is Tuberculosis most contagious?

A

Primary phase

357
Q

Signs and symptoms of Syphilis?

A
  • PAINLESS chancre (genital ulcer)

- Maculopapular rash on palms and soles

358
Q

Signs and symptoms of Guillain Barre Syndrome?

A

Ascending symmetrical muscle weakness, without fever or sensory deficits

359
Q

What are CSF findings in a pt with Guillain Barre Syndrome?

A
  • High protein ( >400)
  • Normal WBC
  • Normal Glucose
360
Q

Signs and symptoms of Myasthenia Gravis?

A
  • Generalized weakness
  • Reduced exercise tolerance- improves with rest.
  • Bilateral eyelid ptosis, proximal muscle weakness
  • Normal reflexes.
361
Q

Diagnostic studies for Myasthenia Gravis?

A
  • Edrophonium ( Tensilon test) rapid response to short acting IV edrophonium
    • Ach-receptor Ab
  • Ice pack test - ocular MG improves with cold
362
Q

Signs and symptoms of benign essential tremor?

A
  • Intentional tremor
  • Bilateral action tremor of hands, forearms, head, neck or voice
  • Tremor is worse with emotional stress & intentional movement
  • Tremor can be relieved by alcohol ingestion
363
Q

What medication is used to manage severe essential tremors?

A

Propranolol

364
Q

CSF finding for subarachnoid hemorrhage?

A

Xanthochromia - yellow color

365
Q

Signs and symptoms of Parkinsons?

A
  • Tremor at rest - pill rolling tremor
  • Bradykinesia - slowness of voluntary movement
  • Shuffling gait, lack of swinging of arms while walking
  • Masked Facies: Face involvement: immobile face, wide palpebral fissures
  • Myerson sign: tapping the bridge of the nose repetitively causes a sustained blinking
366
Q

What antibody lab are most specific for observing RA?

A

+ Anti-citrullinated peptide antibodies

367
Q

What are imaging findings for RA?

A

subluxation, deformities, ulnar deviations of hands, narrow joint space

368
Q

Signs and symptoms of polymyositis?

A
  • Muscle weakness affecting both sides of your body. - Difficult to climb stairs
  • Rise from a seated position
  • Lift objects
  • Reach overhead
369
Q

Lab test used to diagnose polymyositis?

A
  • Increase Aldolase and creatine kinase
    • anti-Jo 1 Ab
    • anti SRP Ab - specific
370
Q

How do you treat polymyalgia rheumatica?

A
  • Low dose corticosteroids ( 10-20mg/d)

- Methotrexate

371
Q

What medications are used for chronic management of gout?

A

Allopurinol or Colchicine

372
Q

What medications are used for acute management of gout?

A

Indomethacin

373
Q

Tx for Sjogrens syndrome?

A

PILOCARPINE - increased lacrimation & salivation

374
Q

Signs and symptoms of reactive arthritis?

A
  • Conjunctivitis - cant see
  • Urethritis - cant pee
  • Arthritis - cant climb a tree
375
Q

Most common cause of asymmetric inflammatory arthritis?

A

Chlamydia

- MC in males 20-40y

376
Q

Clinical intervention for carpal tunnel syndrome?

A

Volar splint & NSAIDs

377
Q

Diagnostic findings for acute gout?

A
  • Arthrocentesis - negatively birefringent needle shaped urate crystals
  • Xray - shows mouse/rat bite “ punched out erosions”
378
Q

What clinical interventions for SLE?

A
  • Hydroxychloroquine for skin lesions (s/e: Impaired night vision/retinal toxicity)
  • NSAIDs or Acetaminophen for arthritis
379
Q

What is that pathophysiology for cor pulmonale?

A
  • RVH with eventual RV failure resulting from Pulm HTN secondary to Pulm disease
  • MC from COPD: May have Polycythemia with increased HCT
380
Q

Signs and symptoms of cor pulmonale?

A
  • Accentuated increased S2
  • Increased JVP
  • Peripheral edema
  • Ascites
381
Q

Signs and symptoms of emphysema?

A
  • Dyspnea on exertion : hallmark sx
  • Accessory muscle use, prolonged expiration, mild cough
  • Hyperinflation: Barrel chest→ increased AP diameter
  • Hyperresonance to percussion
  • Decreased/ Absent breath sounds: quiet chest
  • Appearance: Cachectic with pursed lip breathing: PINK PUFFERS
382
Q

ABG finding for emphysema?

A

Respiratory Alkalosis, normal CO2

383
Q

Diagnostic studies and PE finding in pt with renal artery stenosis?

A
  • Renal Angiography - gold standard

PE finding: Abdominal bruit

384
Q

Signs and symptoms of bladder cancer?

A

Painless Hematuria, Hx of smoking

385
Q

Diagnostic study for bladder cancer?

A

Cystoscopy with biopsy

386
Q

Signs and symptoms of epididymitis?

A
  • Scrotal pain, Erythema, Swelling
    • Prehn’s sign: Relief of pain with scrotal elevation
    • Cremasteric Reflex
387
Q

Treatment for epididymitis?

A
  • Bed rest, scrotal elevation, cool compresses, NSAIDS
  • Gonorrhea/Chlamydia: Azithromycin+Ceftriaxone
  • E COli/Klebsiella: FQ
388
Q

Signs and symptoms of prostatitis?

A
  • Tender, normal or hot boggy Prostate
  • Fevers, frequency, urgency, dysuria
  • Perineal pain
389
Q

Treatment for prostatitis?

A

Bactrim or FQ + doxy

390
Q

Diagnostic findings for acute interstitial nephritis?

A
  • UA: WBC casts, urine eosinophils

- Increased serum IgE

391
Q

Signs and symptoms of acute interstitial nephritis?

A

Fever, eosinophilia, maculopapular rash, arthralgias

392
Q

Treatment for second degree AV block?

A

Pacemaker

393
Q

Signs and symptoms of second degree AV block?

A

Fainting, chest pain and feeling dizzy, tired or SOB

394
Q

Patient with gout should avoid what foods?

A

Purine rich food ( alcohol, liver, yeast, oily fish)

395
Q

Pt with Hepatic encephalopathy presents with asterixis on PE what does this mean?

A

Inability to keep hands dorsiflexed

396
Q

Murmur heard is opening snap is a sign of what?

A

Mitral stenosis

397
Q

Patient hand trembling when reaching for object is what type of tremor?

A

Benign essential tremor

398
Q

Patient presented with pericarditis after MI is diagnosed with what?

A

Dressler syndrome

399
Q

Flattened t wave what’s the tx?

A

Potassium?

400
Q

Side effect of ace inhibitors?

A

Tachycardia, Cough, Angioedema

401
Q

What medication is used to treat rickettsia rickettsii bite?

A

Doxy

402
Q

Man with metastatic colon cancer what do u recommend?

A

Hospice

403
Q

Severe cough what’s the likely causitive bacteria?

A

Bordetella pertussis

404
Q

HIV pt with Pneumocystis pneumonia, what do you treat with?

A

Trimethoprim / Sulfamethoxazole - Bactrim

405
Q

Who is at risk for RA?

A
  • +HLA
  • Smoking
  • Obesity
406
Q

What is the number one thing that decrease mortality in COPD?

A

O2

407
Q

PPD sizes in a healthy patient?

A

> 15mm

408
Q

Male pt with unilateral groin pain. Negative prehn sign. Tx?

A
  • Orchiopexy

- Orchiectomy if >6 hrs

409
Q

Mechanism of graves dz?

A

Antibodies attacking tsh receptors

410
Q

1.5 solid nodule in thyroid. Diagnostic exam?

A

Needle aspiration

411
Q

Patient has big hands and arms what’s wrong with the patient?

A

Pituitary adenoma

412
Q

Tremor healed with alcohol?

A

Essential Tremor

413
Q

A patient elbows extended, wrist pronate and arms in adduct position what is this
called?

A

Decerebrate posturing

414
Q

Multiple sclerosis dx?

A

MRI w/ gadolinium shows white matter plaques

415
Q

Prophylaxis for seizure?

A

Phenytoin

416
Q

Tx for Von Willebrand?

A

Cryoprecipitate

417
Q

Diagnostic finding for Von Willebrand?

A

Decreased Ristocetin activity

418
Q

Pt has T-wave flattening, viral gastro and V/D what do you give them?

A

Vitamin K

419
Q

Tx for Giant Cell arteritis?

A

High dose corticosteroids like Prednisone

420
Q

Pt with dislipidemia, what med worsens hyperglycemia?

A

Niacin

421
Q

Coal miner - eggshell calcification indicates what?

A

Silicosis

422
Q

What is Chylothorax?

A

Lymphatic flow disorder where lymphatic fluid leaks into the space between the lung and chest wall. When this fluid builds up in the lungs, it can cause a severe cough, chest pain and difficulty breathing

423
Q

Polyarteritis nodosa - skin manifestation is called?

A

Livedo Reticularis- netlike pattern of reddish-blue skin discoloration

424
Q

Anterior wall MI is seen in what leads?

A

V1-V4

425
Q

Deep voice, moist hands, large hands and feet what’s the dx?

A

Acromegaly

426
Q

What medications are C/I in gout?

A

Loop diuretics, thiazide diuretics and thiazide-like diuretics

427
Q

What is increased in lab values for folate deficiency?

A

MCV is increased since it is a macrocytic anemia

428
Q

Pt has decreased pulses what diagnostic study is done?

A

DOPPLER do not do ABI

April EOR Exams (3 decks)

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