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AFP boards > ITE 2020 > Flashcards

ITE 2020 Flashcards

1
Q

NH resident tests positive for flu. How do you manage all the other residents?

A

All aysx residents should get chemoprophylaxis

Only do it if there are two lab confirmed cases on the unit

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2
Q

How do you decide if you should tx for PID?

A

If there is enough of a clinical suspicion
Don’t wait for testing
Exam: CMT, uterine tenderness
Often WBCs on wet mount
only need TVUS if you are concerned for tubo-ovarian abscess

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3
Q

Gender affirming tx for F to M

A

testosterone

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4
Q

FTT pt, while checking BP you see capo pedal spasms. What electrolyte disturbance?

A

HypoCalcemia

Trousseau sign - spasmodic contraction of muscles caused by pressure on the nerves that control them

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5
Q

Hypercalcemia would present with

A

Hyperrreflexia

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6
Q

Pt with non Hodgkins lymphoma presents with SOB and CXR shows large mass around SVC. Now what?

A

This is SVC syndrome
Seen in lung CA and lymphoma
Admit pt to hospital and start steroids, chemo, radiation
NOT Bronchoscopy

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7
Q

Most likely complication of HIT

A

Thrombosis (NOT BLEEDING OR DIC!)
This is different than other causes of thrombocytopenia
DVT and PE are most common
Tx - stop heparin, start argatroban/danaparoid/fondaparinux/bivalirudin (non heparin AC)

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8
Q

Class I HF

A

heart dz with no syx or limitations in activity

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9
Q

Class II HF

A

Mild syx with normal physical activity

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10
Q

Clas III HF

A

Significant limitation of activity incl symptoms with less than normal activities

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11
Q

Class IV HF

A

Syx at rest, unable to carry on activity w/o discomfort

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12
Q

pt presents for her 2nd bartholian abscess. Tx?

A

marsupialization - doesn’t matter how long ago the last one was

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13
Q

IBD syx with perianal fistual

A

Crohn’s

UC doesn’t NOT have perianal lesions

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14
Q

abortive migraine tx in pregnancy

A

Tyl
Reglan
NOT Triptan (not safe after 1st trimester) or Dihydroergotomine (too similar to oxytocin)

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15
Q

Longest acting insulin

A

Tresiba

42 h

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16
Q

what is an instrumental ADL

A

Activities necessary to live independently (telephone, doing housework, preparing meals, taking meds, finances)
others are self are ADLs and don’t require independent living

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17
Q

significant risk of anorexia that is regulated by HPA axis?

A

Bone loss

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18
Q

ways to remove impacted cerumen

A

irrigate with warm water

or carbide peroxide ear drops

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19
Q

young patient has pain of finger x days. No injury. erythema on tip of affected finger w/ several vesicles that have an opaque fluid. Distal digest pup is soft but tender. Dx and Tx

A

Herpetic whitlow - HSV
self-limited
tx - pain control and dressings to prevent spread

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20
Q

fluid filled bump on distal surface of distal finger

A

Digital mucos cyst (aka cutaneous myxoid cyst)

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21
Q

when should pts be on ASA?

A

If + h/o CVA or MI

Otherwise, it should be stopped. Even if ACSVD >10%

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22
Q

what med can give false + for amphetamines?

A

bupropion
labetalol
ranitidine
trazodone

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23
Q

false positive for opioids

A

levofloxacin

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24
Q

false positive for cannabinoids

A

PPIs

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25
Q

False positive for benzos

A

Sertraline

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26
Q

When do you give O2 to a pt with CP?

A

If pulse ox <90%

Low utility with normal pulse ox

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27
Q

Pt wants to focus on exercise for weight loss, how do you counsel?

A

exercise alone does improve insulin, glycemic control. Better or BP and CV risks and maintaining weight
- Only moderately beneficial for weight loss - need diet changes too

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28
Q

In which pts are DOACs contraindicated?

A

Mechanical heart valves

Need Warfarin

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29
Q

most common syx of EtOH w/d in elderly?

A

Confusion

NOT tremor or tachycardia

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30
Q

Most common cause of SBO

A 
Intestinal adhesions (60-75%0
Neoplasm (13-20%)
Hernia (2-15%)
Volvulous (<5%)
Constipation is rare
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31
Q

Auscultation finding in aortic regurgitation

A

“blowing” decrescendo diastolic murmur at rUSB, loudest at LLSB

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32
Q

which iron supplement is preferred in CKD pts?

A

Ferric citrate

similar to IV Iron

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33
Q

medicare part A

A

Covers hospital and hospice

34
Q

Medicare part B

A

covers outpatient services and labs

35
Q

Medicare part D

A

Prescriptions

36
Q

Polymyalgia reumatica is associated with what other chronic inflammatory condition?

A

Giant cell arteritis

37
Q

What surveillance labs do CRC survivors need?

A

CEA

NOT CBC or LFTs

38
Q

Effects of smoking on pregnancy

A

Fetal growth restriction and lower birth weight
Quitting smoking - increases birth weight and reduces risk of preterm delivery
NO effect o if woman develops pree

39
Q

At what age should girls have primary amenorrhea w/u?

A

15

40
Q

What combo therapy should you consider for pt with T2DM and HTN for BP control?

A

CCB + ACEI

Better outcomes than HCTZ + ACEI

41
Q

Pt has frostbite and undergoing rewarming, what do you give in addition?

A

NSAIDs

rewarming causes and inflammatory response

42
Q

Non atopic asthma (ie negative skin testing, low IgE)
ASA sensitivity
Associated with?

A 
Nasal polyps
("intrinsic asthma")
43
Q

T2DM pt is on insulins while pregnant. Now s/p sVD, what do you do?

A

restart metformin/oral agents

44
Q

Tx for HFrEF and LBB and h/o angiodema to ACEI

A

SA node ablation

Entresto would be contraindicated

45
Q

if you suspect septic arthritis in kiddo w/ nl xray get?

A

CBC ESR CRP

If positive get US to look for effusion to tap

46
Q

medications that cause hypercalcemia

A

Lithium

Thiazide diuretics

47
Q

Increase in Cr after starting ACEI suggests?

A

renovascular HTN

Get MRA of renal arteries

48
Q

how to decide COPD tx based on Gold group

A

A - SABA or LABA monotherapy
B - LAMA or LABA mono therapy
C - LAMA (itratropium)
D LAMA, OR ICS/LABA

49
Q

Anal fissure not improving with sits baths or TOP nifedipine

A

Botox

50
Q

COPD pt should be on oxygen if SPO2 is

A

<88%

51
Q

Pt has anaphylaxis to eggs. How do you counsel about flu vax?

A

Can receive any version of the flu vax in the office.

52
Q

While working pt up for cirrhosis, what medicine should they avoid?

A

NSAIDs NOT Tylenol
D/t risk of renal insufficiency
Tyl and Statins are safe in cirrhosis

53
Q

type of hallucinations associated with Parkinson’s?

A

Visual

NOT auditory

54
Q

Tx of scaphoid fx with displacement?

A

Surgery
high risk of AVN
if non displaced - thumb spica

55
Q

Pt has hirtruism with regular menses. Next?

A

OCPs x 6 months

c/f idiopathic hirsutism

56
Q

pt ran out of BP meds, no SBP >180 and had a HA. What to do?

A

po labetalol (or clonidine, captopril, prazosin) until SBP <180 then restart home meds

57
Q

USPTF screening recs for mammogram?

A

biennial mammo for women 50-75

58
Q

benefit of low salt diet in CKD?

A

Lowers BP

NOT - change in mortality of time to HD

59
Q

When do you offer daily hydroxyurea to SCD pt?

A

When pts have 3 or more vast-occlusive pain crisis/year or if they have daily pain
Can be offered to as young as 9 m/o
Goal is to reduce incidence of acute chest (NNT 6)
PCN ppx to prevent pneumococcal sepsis is recommended in kiddos until age 5

60
Q

Only type of contraception that does not require back up method immediately after placement regardless of where she is in her menses?

A

Paraguard

61
Q

How do you confirm clearance of H pylori?

A

breath or stool Ag test 1 month s/p tx

d/c PPI prior to test

62
Q

Pt has SLE syx, ANA +, what other tests confirm dx?

A

Low complement

63
Q

Anti CCP ab

A

Rhematoid Arthritis

64
Q

Anti smooth muscle Ab

A

autoimmune hepatitis

65
Q

anti-centromere ab

A

systemic sclerosis

66
Q

HLA-B27

A

seronegative spondyloarthropathy (psoriatic arthritis)

67
Q

Tx for Etoh and opioid abuse?

A

Naltrexone

68
Q

how long do you keep teen out of sport for heat cramps?

A

Until syx resolve

69
Q 
Pt with fatigue weight loss
patches of non pigmented skin on hands
Na 132
K 5.3
Next step?
A

ACTH stim test
w/u for Addison’s (adrenal insufficiency)
suspect autoimmune etiology d/t vitiligo

70
Q

pt uses heating pad on back. Now has reticular brown hyper pigmented skin changes. Dx?

A

Erythema ab igne

d/t heating pad eppsoure

71
Q

4 priniciples of medical ethics

A

autonomy
beneficence
nonmaleficence
justice

72
Q

middle aged man has meniscal tear w/o OA. Tx that will have the best long term outcomes?

A

PT

arthorscopy hasn’t shown significant benefit for long term pain or function

73
Q

which abx can increase INR for pts on warfarin?

A

Bactrim, flatly, fluconazole (increase warfarin by 25%)

Rifampin DECREASES INR

74
Q

dude has grown rash with red/brown macula’s. Pink under woods lamp. Dx?

A

Erythrasma (Corynebacterium minutissima)

Tx erythromycin TOP BID until rash resolves

75
Q

Pathophys of achalasia?

A

Aperstalsis in distal 2/3s of esophagus w/ incomplete lower esophageal sphincter relaxation
Associated with loss of ganglion cells in esophageal wall –> loss of peristalsis and failure of relaxation of lower esophageal sphincter. Incomplete LES relaxation is highly specific for achalasia

76
Q

what medicines can increase risk of dementia?

A

anticholinergic’s and other sedatives

77
Q

what do you do for preggo exposed to flu?

A

vax and Tamiflu

78
Q

Tx for recurrent c. diff after course of vanc?

A

Fidaxomicin 299mg BID x 10 days

Can offer flatly if diaxomicin not available

79
Q

when do you start statins in T2DM?

A

> 40 y/o

80
Q

IVDU
progressive DOE
CXR b/l perihilar shadowing
bronch bx would reveal?

A

Foreign body granulomas

caused by injection of crushed pills, talc etc

81
Q

non infectious cause of injected clear?

A

Episcleritis
Self limited idiopathic w/ mild discomfort and focal hyperemia
NO discharge

AFP boards (5 decks)

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