Kaplan 2

Question 1

girl gets intermittent nonproductive cough and wheezing around menses every month that resolve in 3-4 days. she takes no meds except OTC painkillers for prementral cramps. mechanism of bronchospams?

Answer 1

increased LT production! = pt is taking NSAIDs for menstral pains that are causing bronchospasms via inhibition of COX

Question 2

32 yo male with 2 wk hx of urgency, sensation of incomplete rectal evacuation and bloody diarrhea up to 12x a day. 8 months ago pt had PCP pneumo. smokes, heroin daily for 8 yrs, clean for 5. organism ?

Answer 2

CMV colitis!

**key is immuno comp + tenesmus(rectal spasms & feeling of incomplete defication after defication). Tenesmus is key to CMV colitis

Question 3

Chronic Diarrhea vs Chronic Vomiting

electrolyte disturbances?

Answer 3

Diarrhea = hypokalemia, hypotensive, metabolic ACIDOSIS (bicarb lost in GI)

Vomiting = hypokalemic, hypotensive, metabolic ALKALOSIS (HCl lost in vomit)

Question 4

MC location for endometriosis? #2?

Answer 4

1: ovary
2: cul-de-sac/uterosacral ligament

Question 5

Things that will give an elevated CA125

Answer 5

things that irritate teh peritoneum!

- ovarian cancer, cirrhosis, endometriosis, peritonitis, pancreatitis

Question 6

22 yo healthy male. 1d hx of vomiting and abdominal pain. pulse 115, rr24, PaCO2 26(low), K 5.6(high), HCO3 18 (low), pH 7.28; BP, Temp, Cl, Na, PaO2 all normal. there is decreased skin turgor. whats teh dx? what lab woudl be abnormal?

Answer 6

135 -(95+18) =22

Question 7

status epilepticus hierarchy

Answer 7

Status Epilepticus-

1. Lorazepam
2. Phenytoin or Phosphenytoin
3. Phenytoin or Fosphenytoin = more!
4. Phenobarbital
5. Phenobarbital =more!
6. Anethesia
   * kaplan

Question 8

when do you remove a cervical cerclage?

Answer 8

36-38wks

Question 9

why do granuloamatous diseases cause hypercalcemia?

Answer 9

granulomatous diseases product calcitriol/1,25-dihydroxycholecalciferol(active vitD) = increased ca!!!

Question 10

Normal Pressure Hydrocephalus(NPH) classic triad? dx?

Answer 10

urinary incontinence, gait ataxia and dementia

dx: CT & LP

Question 11

What vitamin def should u be worried about with long term metformin use?

Answer 11

B12 - competes for the same spot in the gut

Question 12

Person with hx of uncontrolled DM with average glucose in the 180-200s. comes in pale, weak/fatigue(anemic) and A1C is 6.5. how?

Answer 12

A1C measures glycosated Hg. if Hg is low then it wont be accute = will be lower than it actually is.