Kaplan Qbank Step 2

Question 0

L4 injuries decrease which reflex?

S1?

Answer 0

L4 - patellar reflex, weak quads, numb medial leg

S1 - ankle-jerk reflex, numbness of lateral foot and weak plantar flexion (gastrocnemius)

Question 1

Severe pulmonary htn can lead to what murmur?

Answer 1

Diastolic Pulmonic Regurgitation - graham-steell murmur

Question 2

Patient is a asymptomatic and has a positive fecal occult blood result. Next step?

Answer 2

Check HCT.

Question 3

Most common inherited disorder of bilirubin glucuronidation?

Answer 3

Gilbert’s syndrome (unconj bili)

Question 4

Work up of adrenal nodule

Answer 4

1. Benign or malignant - Radiology
2. Functional (secretes hormones) or non-functional (nf usually benign and don’t require surgical removal)

Next step is 24hr urine catecholamine and metanephrines (pheo) and Aldo:renin ratio (aldosteronoma).
Low dose dexamethasone suppression test to r/o cushings.

Question 5

HIV+ male with CD4 count < 50

What drugs should he be on?

Answer 5

HIV meds
PjP and Toxo prophylaxis with bactrim
M. avium Px with Azithromycin or clarithromycin

Question 6

Treatment of Costochondritis

Answer 6

NSAIDs and rest.

Cardiac causes must be ruled out

Question 7

Patient is suspected to have Lyme dz and possible CNS Involvement. What diagnostic test should you do? What med?

Answer 7

Lumbar puncture

Rx is Ceftriaxone (crosses bbb)

Question 8

Lyme disease in pediatric pts is treated with?

Answer 8

Amoxicillin (<8 yrs)

Question 9

What is the most likely cause of DKA?

Answer 9

Sepsis

Question 10

Glucose, serum/urine, pH, HCO3 levels in DKA

Answer 10

Serum glc > 250
Positive ketones in serum and urine
pH< 15

Question 11

S/e of ethambutol

Answer 11

Optic neuritis

Question 12

S/e of INH

Answer 12

Peripheral neuropathy (that’s why we give B6)

Question 13

S/e of Rifampin

Answer 13

Red discoloration of secretions

Question 14

S/e of pyrazinamide

Answer 14

GI discomfort