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End Of Rotation Exam Reviews > Internal Medicine EORE > Flashcards

Internal Medicine EORE Flashcards

1
Q

What is the most appropriate first-line therapy for a Black Patient with HTN?

A

thiazide type diuretic or calcium channel blocker (amlodipine) as initial monotherapy

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2
Q

What two electrolyte side effects are seen with thiazide diuretics?

A

hyponatremia and hypokalemia

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3
Q

What is the most common side effect of finasteride and why?

A

decreased libido, sexual dysfunction due its reduction in the conversion of testosterone to dihydrotestosterone preventing prostatic gland growth which is suspected to decrease nitric oxide in the corpus cavernosum

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4
Q

Most common side effects of tamsulosin?

A

orthostatic hypotension and floppy disc syndrome

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5
Q

What is the recommended screening age for prostate cancer?

A

55-65 and should be determined with shared decision making

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6
Q

Treatments for SIADH (5)

A
  1. treat underlying cause
  2. water restriction to approximately 500-1500mL per day
  3. correct sodium deficit
  4. vasopressin receptor antagonists
  5. Loop diuretic
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7
Q

Dilated cardiomyopathy may have coexisting

A

dysrhythmias such as atrial fibrillation due to dilated ventricles

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8
Q

adenocarcinoma is typically found in the _____ of the lung and is more common in patients who _______.

A

periphery of the lung and is more common in patients who do not smoke

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9
Q

Large cell lung cancer is typically located in

A

the outer regions of the lungs causing SOB and fatigue

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10
Q

Pancoast tumors are found in the ____ of the lung

A

apex of the lung and commonly cause symptoms of pain in the shoulder, neck, and shoulder blade

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11
Q

Small cell lung cancer is most closely associated with ______ and demonstrates ______ growth

A

smoking exposure
rapid

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12
Q

Types of non-small lung cancer

A

adenocarcinoma
squamous cell
large cell

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13
Q

location of small cell carcinoma

A

arise in central airways (hilar mass/ bulky mediastinal lymphadenopathy)

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14
Q

Treatment for prolactinomas

A

dopamine agonists:
cabergoline
bromocriptine

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15
Q

Transsphenoidal surgery indications for pituitary ademonas

A

with pituitary adenomas that do not respond to initial management with medications, large, or causing significant visual field deficits may be candidates for surgery

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16
Q

symptoms of a prolactinoma

A

galactorrhea
amenorrhea
loss of libido
vaginal dryness
dyspareunia
osteoporosis

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17
Q

What is contraindicated in a patient that is experiencing acute-closure glaucoma

A

atropine

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18
Q

what is it called when you have an incomplete relaxation of the lower esophageal sphincter and aperistalsis in the distal two-thirds of the esophagus

A

achalasia

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19
Q

best treatment for this condition (achalasia)

A

pneumatic balloon dilation
if refractory to this procedure then surgical intervention can be performed

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20
Q

What can cause pseudoachalasia

A

primary or metastatic tumors

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21
Q

What is the appearance on a barium swallow that indicates achalasia

A

bird-beak appearance

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22
Q

diagnostic test that confirms achalasia

A

esophageal manometry - shows increased LES pressure

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23
Q

what is the most common central nervous system infection in pts with AIDS who are not receiving appropriate ppx?

A

Cerebral toxoplasmosis

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24
Q

What is the imaging modality of choice for suspected cerebral toxoplasmosis? and what does it show?

A

MRI
often shows multiple ring-enhancing brain lesions which are assosicated with edema

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25
Q

treatment for cerebral toxoplasmosis

A

sulfadiazine and pyrimethamine as well as antiretroviral therapy for immune recovery

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26
Q

what is used for treatment of hepatic encephalopathy?

A

lactulose

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27
Q

what is the treatment for wernicke enceohalopathy

A

thiamine

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28
Q

What are two idiopathic inflammatory myopathies and are characterized by bilateral proximal muscle weakness?

A

polymyositis and dermatomyositis

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29
Q

Polymyositis is

A

disease with symmetrical, progressive proximal muscle weakness that occurs over a period of weeks to moths that affects the neck and muscle groups of the upper and lower extremities
face and eyes are spared

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30
Q

dermatomyositis is

A

polymyositis symptoms along with a dusky red heliotrope rash commonly seen around the eyes and facial erythema that mimics a butterfly shaped rash seen in patients with systemic lupus erythematosus however this rash includes the nasolabial folds unlike the malar rash in lupus

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31
Q

Polymyositis and dermatomyositis are associated with an increase incidence of

A

malignancy

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32
Q

how to test for polymyositis and dermatomyositis

A

EMG abnormalities
muscle bx shows chronic inflammation
elevated muscle enzymes

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33
Q

management of dermatomyositis

A

glucocorticoids
azathioprine, methotrexate

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34
Q

what drug is known to cause myopathy

A

statins

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35
Q

What medication therapies are avaiable to aid in smoking cessation?

A

bupropion
varenicline
nicotine replacement therapy

36
Q

Risk factors for stroke

A

older age
HTN
Hyperlipidemia
DM
History of cigarette smoking

37
Q

Most common cause of acute bronchitis

A

viruses

38
Q

What diagnosis should be suspected if the patient has a hx of cough with a fever and rales on PE?

A

pneumonia

39
Q

What is the recommended anticoagulation for a patient that has a. fib and a score greater than or equal to 2

A

apixaban or rivaroxaban (DOACs)

40
Q

What disease has the classic hallmark of morning stiffness that improves with movement when compared to other causes of joint pain.

A

rheumatoid arthritis

41
Q

mainstay treatment of RA

A

medication management which includes NSAIDs, corticosteroids and disease-modifying antirheumatic agents (DMARDs)

42
Q

recommendations of preventing the recurrence of diverticulitis

A

high fiber diet
smoking cessation
wt loss
reduced meat intake
regular physical activity

43
Q

True or false: Diverticulosis is associated with an increased risk of colorectal cancer

A

false

44
Q

a decrease in parathyroid hormone causes a decrease in what vitamin

A

calcium

45
Q

What mineral, if deficient, can cause a functional hypoparathyroid state?

A

magnesium, since severe hypomagnesemia inhibits PTH secretion

46
Q

What is Chvostek sign

A

contraction of the facial muscles after tapping the facial nerve

47
Q

What does Chvostek sign occur in

A

hypocalcemia

48
Q

The classic presentation of chronic bacterial prostatitis is symptoms of recurrent ________?

A

urinary tract infection, such as dysuria, frequency, urgency, perineal discomfort, and low-grade fever

49
Q

Chronic bacterial prostatitis treatment

A

fluoroquinolone
bactrim (trimethoprim-sulfamethoxazole)

50
Q

What medication prevents the progression of BPH? and what is the most common side effect?

A

Finasteride
Decreased libido

51
Q

What medication decreases the symptoms of BPH but NOT the progression of BPH? and what are the most common side effects?

A

tamsulosin
floppy iris syndrome and orthostatic hypotension

52
Q

dilated cardiomyopathy should be treated with which two medication classes?

A

beta blockers and ACEi

53
Q

What labs are usually seen in thyroid storm

A

high free t4/t3
low TSH

54
Q

treatment for thyroid storm

A

beta blockers
PTU*** or methimazole
glucocorticoids
bile acid sequestrants

55
Q

reactive arthritis is an arthritis that develops soon after ________

A

an infection

56
Q

positive testing for human leukocyte antigen B27 usually indicates what dx

A

reactive arthritis

57
Q

what does this presentation indicate:
- galactorrhea, amenorrhea, loss of libido, vaginal dryness, dyspareunia, osteoporosis

A

prolactinoma

58
Q

what is indicated for patients who have been dx with achalasia who are not good candidates for pneumatic balloon dilation?

A

botulinum toxin (but this is considered a short-term solution of the symptoms)

59
Q

How does vit D help facilitate calcium levels in the body

A

facilitates gastrointestinal calcium absorption

60
Q

following induction of chemotherapy what can occur that would cause, cough, fatigue, and diarrhea?

A

Neutropenic fever

61
Q

in the setting of neutropenic fever, what are important in initial steps when they come into the ER?

A

Obtain blood cultures and start IV antibiotics

62
Q

What is the treatment for keratosis?

A

First line treatment is 5-Fu cream, 5%

63
Q

Reed-Sternberg cells seen in

A

Hodgkin’s lymphoma

64
Q

What are the two most common causes of Cushing’s syndrome?

A

Pituitary, adenoma, or ingestion of oral steroid medication’s

65
Q

what is the main state treatment for thrombotic thrombocytopenic purpura

A

Plasma exchange

66
Q

what is the definitive treatment of choice for elderly patients diagnosed with grave disease??

A

Radioactive iodine

67
Q

what is the topical treatment of choice for rosacea?

A

metronidazole

68
Q

what is the topical treatment for acne

A

tretinoin

69
Q

what is the treatment for scabies

A

permethrin

70
Q

What are common aboard of agents for migraines?

A

celecoxib and sumatriptan

71
Q

what is a prophylactic agent for migraines that also treats insomnia?

A

Amitriptyline

72
Q

what office or laboratory test could be done initially and periodically on diabetic patients who are at risk for diabetic neuropathy?

A

Dipstick or laboratory test for diabetic microalbumin

73
Q

Forman is associated with what vitamin deficiency and may rarely cause what anemia?

A

Vitamin B 12 deficiency
Microcytic anemia

74
Q

what is the treatment for Wolff-Parkinson-White syndrome?

A

Flecanide, procainamide, sotalol and amiodarone

75
Q

Patients with a platelet count above 50,000 require what kind of treatment?

A

Observation, no treatment required

76
Q

at what number of platelets do patients require therapy

A

If they develop bleeding problems or platelet count drops to below 20,000

77
Q

What medication used for hyperlipidemia should be avoided in pregnancy?

A

Statins

78
Q

what medication for hyperlipidemia is preferred during pregnancy?

A

Colesevelam

79
Q

what are three things that support a diagnosis of cor pulmonal?

A

The presence of chronic lung disease, a holosystolic murmur, and right heart changes on ECG

80
Q

what laboratory test can be supportive of a diagnosis of pernicious anemia?

A

Presence of Anti-intrinsic factor antibodies

81
Q

What type of fluids should be given to a patient in diabetic ketoacidosis before treating with insulin?

A

2 L 0.9% normal saline

82
Q

What is the most appropriate procedure for a patient with recurrent symptomatic episodes related to a. fib?

A

Ablation therapy

83
Q

what is the best? Initial treatment for a patient with acquired nephrogenic diabetes insipidus as a result of chronic lithium use

A

Low protein and low sodium diet, thiazide, and potentially a potassium sparing diuretic like amiloride

84
Q

What is the most common benign esophageal neoplasm?

A

Leiomyoma

85
Q

If a patient is being placed on TNF therapy what testing should you obtain?

A

PPD since they are at higher risk of getting opportunistic infections, like TB

86
Q

what food barn illness can you get through eating raw oysters?

A

Cholera

End Of Rotation Exam Reviews (1 decks)

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