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ITE questions Flashcards

1
Q

Difference between hoarders and normal collectors (characteristic of hoarding disorder)

A

disposing of the items causes extreme anxiety and emotional distress

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2
Q

Testing for early syphilis

A

A non-treponema like test such as RPR or VDRL test, is the initial step for evaluating a patient with suspected syphilis. These tests become positive within 3 weeks of the appearance of the primary chancre, so they may be negative in patients with an early infection. If there is a strong suspicion of syphilis, a repeat nontreponemal test in 2 weeks is indicated. Patients with positive nontreponemal test should be tested with a specific treponemal test for confirmation. These tests may lack reactivity in early primary syphilis, however, and are not indicated for use in the initial evaluation.

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3
Q

Smoking cessation

A
  • Nicotine patches
  • Varenicline (Chantix)
  • Bupropion
  • Nortriptyline
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4
Q

Level of severity of anorexia nervosa

A

Mild –> BMI > 17
Moderate –> BMI 16 - 16.99
Severe –> BMI 15 - 15.9
Extreme BMI

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5
Q

Difference between acute stress disorder and PTSD

A

Time interval 1 month

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6
Q

Ottawa Ankle rules

A

Patients who were able to bear weight immediately following their injury and how can take 4 steps independently in a clinical setting require radiographic study only when the following criteria are met :
pain is present in the malleolar zone and bony tenderness of the posterior edge or tip of either malleolus is elicited, or
pain is present in the midfoot zone and bony tenderness of either the base of the fifth metatarsal or the navicular region is present

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7
Q

Endocarditis prophylaxis associated with dental, GI or GU procedures (2007 AHA guidelines)

A

High risk patients with prosthetic valves
A previous history of endocarditis
Unprepared cyanotic congenital heart disease (CHD) or CHD repaired with prosthetic material
Cardiac transplant recipients who develop valvular disease
Exclude mitral valve prolapse and acquired valvular disease even if they are associated with mitral regurgitation.

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8
Q

Asymptomatic aortic stenosis follow up

A

every 6-12 months in patients with severe aortic stenosis
every 1-2 years in those with moderate disease
¶ Every 3-5 years in those with mild disease.

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9
Q

A vector (especially in homeless people) for Bartonella Quintana, which causes trench fever, an influenza-like syndrome with relapsing fever

A

Lice

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10
Q

Asymptomatic aortic stenosis follow up

A

every 6-12 months in patients with severe aortic stenosis
every 1-2 years in those with moderate disease
¶ Every 3-5 years in those with mild disease.

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11
Q

A vector (especially in homeless people) for Bartonella Quintana, which causes trench fever, an influenza-like syndrome with relapsing fever

A

Lice

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12
Q

Asymptomatic aortic stenosis follow up

A

every 6-12 months in patients with severe aortic stenosis
every 1-2 years in those with moderate disease
¶ Every 3-5 years in those with mild disease.

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13
Q

Statin and ASA recommendations

A

ASCVD > 10% –> aspirin

ASCVD > 7.5% –> statin

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14
Q

Vaccine that increase the risk up seizures up to 2 weeks after administration

A

MMR

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15
Q

Treatment of Tinea Capitis

A

Tinea capitis is an infection of the scalp caused by a variety of superficial dermatophytes. The treatment of choice for this infection is oral griseofulvin. It has the fewest drug interactions, a good safety record, and anti-inflammatory properties. Terbinafine has equal effectiveness and requires a significantly shorter duration of therapy, but it is only available in tablet form. Since tinea capitis most commonly occurs in children, tablets would have to be cut and/or crushed prior to administration. Oral itraconazole, fluconazole, and ketoconazole have significant side effects. Topical antifungals such as ketoconazole and miconazole are ineffective against tinea capitis.

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16
Q

Longest symptom relief for carpal tunnel symdrome

A

Studies suggest that local corticosteroid injections offer symptom relief for 1 month longer than oral corticosteroid therapy and some individuals experience relief for up to 1 year. Severe or chronic symptoms usually require surgical intervention for nerve compression. Physical therapy is not recommended and full rest is unlikely in a person in a high-risk occupation for overuse syndromes

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17
Q

Intoeing (pediatrics)

A

Intoeing is usually cuased by internal tibial torsion. The problem is believed to be caused by sleeping in the prone position and sitting on the feet. In 90% of cases, internal tibial torsion gradully resolves without intervention by the age of 8. Avoid sleeping in a prone position enhances resolution of the problem.

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18
Q

Rubella non-immune in pregnancy

A

Vaccination immediately after childbirth or abortion is recommended

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19
Q

Initial screening for hereditary hemochromatosis

A

Ferritin and transferrin saturation. If serum ferritin or the transferrin saturation is elevated, HFE gene should be checked

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20
Q

Medical conditions that decrease responsiveness to warfarin and reduce INR

A

Hypothyroidism, visceral carcinoma, increased Vitamin K intake, diabetes mellitus and hyperlipdemia

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21
Q

Conditions that increase responsiveness to warfarin, the INR and risk of bleeding

A

Vitamin K deficiency caused by decreased dietary intake, malabsorption, scury, cachexia, small body size, hepatic dysfunction, moderate to severe renal impairment, hypermetabolic states, fever, hypothyroidism, infectious disease, and biliary obstruction

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22
Q

The preferred site for emergency airway

A

The cricothyroid membrane

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23
Q

Test before testosterone replacement

A

Hemoglobin/hematocrit because testosterone replacement can induce polycythemia

24
Q

Risk factor for prolonged recovery from a sports-associated concussion

A

Headache lasting 60 hours or more, self-reported fatigue or fogginess, and four or more symptoms at the onset of injury

25
Q

Classic symptoms of hypoparathyroidism

A 
Refractory heart failure
Tetany
Seizures
Altered mental status
Stridor
26
Q

Treatment of uveitis

A

Treatment includes topical corticosteroids, but oral or parenteral corticosteroids and NSAIDs are also effective.

27
Q

Screening in Type 1 diabetes mellitus

A

ADA recommends screening for
Hypothyroidism
Hypertension
Celiac disease and retinopathy

28
Q

Cow’s milk is not recommended for children until the age of. . .

A

12 months

29
Q

Treatment of unilateral undescended testis

A

Treatment should be started at 6-12 months of age to avoid testicular damage. It was once thought that delaying descent lowered the incidence of testicular cancer, but is it now believed that orchipexy allows for early cancer detection.

30
Q

In the hospital setting, the use of atypical antipsychotics is most appropriate for which condition

A

ICU-associated delirium

31
Q

The usual reservoir for hantavirus

A

Deer mice

32
Q

Initial approach to constipation in children

A

Oral osmotics such as polyethylene glycol-based solutions. Rectal therapies are similar in terms of effectiveness but are more invasive and less commonly used as first-line treatment. Oral stimulants and bisacodyl suppositories are not recommended for children under 2 years of age

33
Q

Cardiovascular changes recognized as age-related effect

A
  • Increased myocardial collagen and myocardial mass
  • Decreased maximal heart rate with exercise
  • Decreased left ventricular compliance
  • Decreased heart rate at rest
34
Q

Treatment of narcolepsy (and cataplexy)

A
  • Improving both the quantity and quality of sleep during the night, which can be accomplished with sodium oxyubate. This improves daytime alertness and cataplexy.
  • Scheduling naps is the second important aspect of managing narcolepsy.
  • The third important step is the use of stimulants such as methylphenidate to improve function during the day.
35
Q

A copper T IUD (ParaGard) would be preferred over a levonorgestrel-releasing IUD (Mirena) in :

A
  • Severe cirrhosis or liver cancer. Hormonal contraceptives in general should be avoided in women with severe liver disease, as there is a known association between oral contraceptive use and the growth of hepatocellular adenoma, and the risk is thought to extend to other types of hormonal contraceptives.
  • Breast cancer is another contraindication to use of levonorgestrel-releasing IUD, and the copper T IUD is preferred.
36
Q

RSV season in North America

A

November to April

37
Q

Contraindication to the use of carboprost (Hemabate) in uterine atony and postpartum hemorrhage

A

Asthma

38
Q

Contraindication to the use of Methylergonovine in uterine atony and postpartum hemorrhage

A

Hypertensive patients

39
Q

Contraindications to older adults patients taking statin (atorvastatin, simvastatin, lovastatin)

A

Coprescription of clarithromycin or erythromycin with a statin that is metabolized by CYP 3A4 (atorvastatin, simvastatin, lovastatin) increases the risk of statin toxicity

40
Q

Diabetes medicine most likely to cause weight loss

A
  • GLP-1 receptor agonists (increases insulin secretion, decreases glucagon secretion, slows gastric emptying, and increases satiety
  • Metformin
  • Amylin mimetics
  • SGLT-2 inhibitors
41
Q

strategy that will identify the highest percentage of previously unrecognized cases of chronic hepatitis C

A

Everyone born between 1945 and 1965

42
Q

The most effective treatment for patellofemoral syndrome

A
  • physical therapy and activity modification
43
Q

Opioid to avoid in severe hepatic impairment

A

Methadone

44
Q

Medications to reduce the risk of developing diabetes mellitus

A
  • Metformin
  • alpha-glucosidase inhibitor (acarbose)
  • orlistat
  • thiazolidinediones
45
Q

Universally present complaint with peritonsillar abscess

A

Trismus (difficulty opening mouth)

46
Q

Newer oral anticoagulants with reversal agent

A
  • Dabigatran (Pradaxa)

- Apixaban, edoxaban and rivaroxaban (all factor Xia inhibitors) currently do not have a reversal agent.

47
Q

Reversal agent for dabigatran (pradaxa)

A

Idarucizumab (the dose is two consecutive 2.5-g infusions)

48
Q

AAFP and ACOG recommendations for non-medically indicated (elective) inductions of labor or cesarean delivers after what gestational age

A

39 weeks, 0 days

49
Q

AAP recommends screening all children with an autism-specific screening instrument at which well child visits?

A

18-24 months

50
Q

First-line treatment for primary dysmenorrhea

A

NSAIDs

51
Q

Surveillance endoscopy for Barrett’s esophagus

A

Every 3 years

52
Q

Stiffness of ankylosing spondylitis

A

Improves with exercise and activity but worsen at night.

53
Q

Radiation exposure from a typical abdominal CT exam is approximately the same as how many PA chest X ray?

A

400

54
Q

GOLD recommendation for steroid for COPD exacerbation

A

Prednisone 40mg daily for 5 days

55
Q

Low vitamin B12 caused by drugs

A
  • Metformin
  • H2-blockers
  • Proton pump inhibitors

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