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DHA Exam > Last Day Review > Flashcards

Last Day Review Flashcards

1
Q

Child with flu symptoms + pneumonia symptoms + gastroenteritis + conjunctivitis, fever , diagnosis

A

Adenovirus infection

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2
Q

smoker patient presented with ???. O/E he had skin lesions in the back with some of them being crusted. A CXR was done and showed bilateral infiltrates. How will you manage

A

Antibiotics✅, steroids or acyclovir or antiseptic

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3
Q

treatment of Community-acquired pneumonia? Fluoroquinolones

A

Fluroquinon

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4
Q

Pneumonia with cold agglutination test =

A

Atypical pneumonia

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5
Q

what time taken for patches on x ray of Lobar pneumonia to disappear?

A

6 weeks

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6
Q

Influenza pneumonia case , what to consider when you want to isolate?

A

Droplets

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7
Q

Pneumonia vaccine in elderly?

A

PCV13 first, followed by a dose of PPSV23

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8
Q

pseudomembrane over tonsillitis with mild fever ( diphtheria) What complication you suspect

A

Pneumonia

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9
Q

Interstitial pneumonitis” is a pathologic hallmark for:

A

Viral pneumonia

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10
Q

sarcoma how to assess metastasize

The most common site of distant spread of sarcomas is the …….

A

Chest CT, Lung

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11
Q

features of lung cancer with SVO( superior vena cava obstruction ) and ask about what type of lung cancer:

A

Non small cell cancer

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12
Q

Scenario about croup, pt having barking cough, diagnosis?

A

laryngotracheobronchitis

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13
Q

Tuberous sclerosis= multiple genetic screening

( its autosomal dominant pattern of inheritance and can be caused by mutations in the TSC1 or TSC2 gene .)

A

Not sure but probably

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14
Q

Patient with cough and hemoptysis. On auscultation: consolidation on the right upper lung zone. What will help in confirmation of diagnosis

A

Sputum culture

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15
Q

child of parents have TB his PDD test is 10mm ? A-positive ✅✅ B-neg’tive

A

It’s positive when its > 15mm but in some ppl with high risk even 10 is considered positive

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16
Q

Patient was found to have cavity on x ray ( TB ) what is the type of precaution?

A

Airborne

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17
Q

Patient with ascites + fever +low SAAG =

A

TB ( because high SAAG is ass with cirrhosis & CHD

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18
Q

Back pain + fever and xray showed calcified right sacroiliac joint, what’s the most appropriate test to order?

A

Tube agglutination test ( typhoid )

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19
Q

patient with TB on drugs development paresthesia, treatment?

TB patient he start to have some priks in the finger tips which been incresing what to do?

A

Pyridoxine ( vit B6 )

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20
Q

Patient with congestive heart disease and HTN on ACEI and Warfarin was diagnosed with TB and started on 4 regimen what is true:

A

Increase warfarin ( because Rifampicin decrease the effct of warfarin)

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21
Q

TB medications has an increase in uric acid =

A

Pyrazinamide ( is the most hepatotoxic drug in TB ttt )

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22
Q

Patient post TB bronchiectasis presents with cough, hemoptysis. CXR shows right upper lobe cavitary lesions. What is the best initial next step?

A

Chest physiotherapy

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23
Q

Facial plethora and JVP distended, which of the following is associated
with this condition? SLCC

A

Don’t know

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24
Q

Case that seemed like obstructive sleep apnea. Obese patient with uncomfortable sleep + snoring. Has cyanosis and dyspnea best investigation? Treatment?

A

Polysomnography / CPAP

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25
Q

Case that seemed like obstructive sleep apnea. Obese patient with uncomfortable sleep + snoring. Has cyanosis and dyspnea best investigation= polysomnography

A

MRI + IV steroids

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26
Q

A case about a pt with pleural effusion and asks about the most

A

AFB culture ( acid fast bacili )

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27
Q

Th is ass, with what pneumoconiosis disease

A

Silicosis

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28
Q

Plural effusion case and has high interferon gamma dx
Pleural effusion with high LDH

Plural pLDH/ serum LDH is MORE than 0.6

Elevated pleural fluid ADA levels >40IU

A

TB

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29
Q

Anti TB drug cause neuropathy

A

Isoniazid

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30
Q

pleural TB most sensitive test:

A

ADA- Adenosine deaminase ( while AFB is most specific )

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31
Q

TB treatment?

A

= RIPE( the four drugs) .

= rifamycin isoniazid, pyrazinamide, and ethambutol.

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32
Q

Indian with history of Tb presented with elevated JVP and hepatosplenomegaly:

A

Constrictive pericarditis

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33
Q

anti tb medications, might increase creatinine?

A

Rifampin

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34
Q

TB pt what is the medication increase liver enzymes ?!

A

INH

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35
Q

Pt with bilateral hydronephrosis with dilated bladder and proximal urethra?

A

Posterior urethral valve

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36
Q

Pt with aspirin toxicity, what is the most important next step in management:

A

Blood-urine alkalization by giving Iv sodium bicarbonate

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37
Q

Nephrotic syndrome first line Tx?

A

Steroids, and furosemide for symptoms

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38
Q

patient with edema Urine analysis: Oval fat body, some hyaline cast.
Occasional RBC case.

A

Nephrotic syndrome

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39
Q

how to prevent calcium stone?

A

Give thiazide

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40
Q

pregnant with blood pressure 160/110 with protein in urine what first thing to give ? Preeclampsia case

A

Magnesium sulfate

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41
Q

pediatric patient with hematuria and hemoptysis? Treatment? Test for diagnosis?

A

Goodpasture’s syndrome / steroids +- cyclophosphamide / antiglomerular basement membrane antibodies

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42
Q

Cressnt moon in kidney disease means

A

Rapidly progressive glomerulonephritis

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43
Q

Case with hematuria and RBC cast on urine analysis , recent hx of URTI . which inv support dx of PSGN ?

A

Low C3 / serum creatinine

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44
Q

child with multiple joint pain and subcutaneous nodules , diagnosis by

A

ASO ( antistreptolycin antibody titer )

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45
Q

arthritis and splenomegaly , diagnosis

A

Felty’s syndrome

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46
Q

Female pt asymptomatic, previous Hx of URTI 2 weeks ago. O/E: mid diastolic murmur, how to confirm dx?

A

A. Echo B. ASO titre✅

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47
Q

Male pt with hx of right knee pain and swelling, left ankle pain and swelling, for 6 month. Previous hx of UTI 2weeks prior to symptoms, what to give?

A

Sulfasalazine

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48
Q

Patient with acute migraine What is the treatment?

A

Triptan

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49
Q

headache at 3 am with eye symptoms ( cluster headache) what is best prophylaxis ?

A

Verapamil ( CCB )

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50
Q

16 years old female. Fever and Chronic diarrhea , wt loss for 10 months Post meal Paraumbilical

A

Crohn’s disease

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51
Q

Pt had IBD flare , had been managed with IV fluid, what to do

A

Oral budesonide

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52
Q

Crohn’s disease and have stricture it was single 1 cm , 1cm from the ileocecal valve =

A

strictureplasty

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53
Q

Pt has chron illeocecal since 3 months he started on steroid and pentasa from 3 weeks, he is complaining of anal discharge and fistula what is the tx u wanna give him

Fistula in crohn not taking any medications :

A

Infliximab

54
Q

crohn’s diseases patient with perianal abscess on infliximab and azithromycin. Mx?

A

IV antibiotics as ciprofloxacin, metro

55
Q

extraintestinal symptom of crohn Disease :

A

Erythema nodosum

56
Q

weight loss over 2 months. Ilieal biopsy showed noncaseating granuloma

A

Crohn’s

57
Q

Woman n who has progressive Dyspnea and fatigue, on auscultation she has fine crackles, while examining her legs she has tender red induration on her shin . What is the best next step

A

Chest X-ray

58
Q

Case of bloody diarrhea biopsy shows transmural inflammation where is the most common site ?

A

Ileum

59
Q

Male with non bloody dirrhea, pale, oral ulcer?

A

Crohn’s

60
Q

Pt known case of crohn’s did terminal ileum resection complain of diarrhea what to give?

A

B12

61
Q

lead pip point on X.ray =

A

UC

62
Q

Ulcerative colitis ercp done shows intra and extra hepatic bile duct strictures. What is the dx?

A

Primary sclerosing cholangitis

63
Q

Ulceritive colitis , investigations :

A

CT abdomen

64
Q

Young male patient came with chronic bloody diarrhea, joint pain and skin rash what’s the most likely diagnosis?

A

UC

65
Q

female patient with positive Anticardiolipin antibody and other symptoms, what is the diagnosis

A

Anti-phospholipid syndrome

66
Q

Recurrent sinusitis + hematuria+ saddle nose =

A

Wegener syndrome

67
Q

IgA Nephropathy (Berger Disease)= symptoms? Treatment?

A

Look for an Asian patient with recurrent episodes
of gross hematuria 1 to 2 days after an upper respiratory tract infection / Ptn usually resolve wirh supportive ttt if not give ACEI

68
Q

Scenario of patient with hematuria, pulmonary hemorrhage ,recurrent sinusitis and numbness in Rt Upper limb and Lt lower limb

A

Granulomatosos with polyangitis

69
Q

Case SLE , Coomb test diagnosis what?

A

Autoimmune Hemolytic anemia

70
Q

Pt have SLE with neurological manifestation, pt already on corticosteroids what to add now =

A

Cyclophosphamide

71
Q

The most common medicine known to cause drug-induced SLE

A

Hydralazine

72
Q

SLE with UTI , drug Contraindicated or to avoid?

A

Sulfamethoxazole

73
Q

Hx of. SLE ask about diagnostic test:

A

Anti dsDNA

74
Q

SLE case with lab) All lab normal except low c3 , c4 or c2 Ask about treatment:

Pt presented with malar rash, mouth ulcer, arthritis. There was proteinuria,
high Cr, low complements, drug to give?

A

Methotrexate and cyclophosphamide /

Steroids + hydroxychloroquine

75
Q

Case of post viral petechiae and other symptoms, What to expect in bone marrow?

A

Increase megacryocytes

76
Q

Ptn with DM and RA, has bone pain and hypercalcemia, high renal function test . What’s the diagnosis

A

Amyloidosis

77
Q

Left eye unable to abduct, when looking forward there’s squint towards the
nose which nerve affected

A

Left 6th nerve

78
Q

eczema, bruising ( thrombocytopenia) and repeated infections=…….

A

wiskott aldrich syndrome

79
Q

Schistosomiasis complication

A

Pulmonary HTN

80
Q

Patient with rhumatic arthritis on methroxat and Hydrochloroquine but still not managed. What to add?

A

Adalimumab

81
Q

RA + lung symptoms ( pneumoconiosis) =…….syndrome

A

Caplan

82
Q

RA marker

A

Anti CCP

83
Q

What of these is the minor criteria of jones criteria of rheumatic fever

A

Fever , arthralgia , Prolonged PR interval , High CRP and ESR , leukocytosis.

84
Q

man with hx of reactive arthritis has another attack with aspiration of 40000 neutrophils. Intial management? A. Ibuprofen ✅ B. MTX C. infliximab

🌹 reactive arthritis ttt if no response to nsaid ? A. sulfa drug✅ B. cyclosporine

Reactive arthritis Mild> NSAId. severe > steroids
Nsaids If failed > Steroids If failed >DMARDS (sulfa, MTX)

A

True

85
Q

Case of rheumatic fever with painful nodule.and fever and joint pain ///what investigation to order

A

Throat culture or ASO

86
Q

one of these is a minor criteria for rheumatic fever :

A

Polyarthralgia , fever

87
Q

Celiac disease = Ass by

A

Celiac disease = Ass by = tissue transglutaminase IgA

88
Q

Pt 28 yrs e symptoms of celiac disease symptoms. Which part of intestin is affected

A

Jejunum

89
Q

Celiac px , lost follow up what expect to see?

A

Low vit D3 / Wrist x- ray shows Cupping and fraying of metaphasis

90
Q

Case of cystic fibrosis but without mentioning the dx, what u will find else in examination

A

Nasal polyps

91
Q

🌹 Long scenario child with LL edema, periorbital, has fever and lethargy with dark urine and protein in urine what else u would ask for

A

Impetigo 1 month ago

92
Q

🌹Diagnosis of meigs syndrome =

A

CT

93
Q

case with situs inversus and infertility:

A

Kartagener’s syndrome is a rare genetic disorder. It involves abnormalities of your cilia, which can cause a variety of health problems. It also involves situs inversus= condition in which your internal organs develop on the opposite side of your body than normal

94
Q

Pt will do CT with contrast after give contrast develop wheezing what you want to do ?

A

Epinephrine

95
Q

Patient with pharyngitis then after DAYS developed proteinuria and hematuria. Diagnosis?
Answer is: IgA Nephropathy
211. Patient with pharyngitis then after WEEKS developed proteinuria and hematuria. Diagnosis?
Answer is: Post streptococcal glomerulonephritis

A

Patient with pharyngitis then after DAYS developed proteinuria and hematuria. Diagnosis?
Answer is: IgA Nephropathy
211. Patient with pharyngitis then after WEEKS developed proteinuria and hematuria. Diagnosis?
Answer is: Post streptococcal glomerulonephritis

96
Q

month years old? Present with paroxysmal cough with deep inspiration between the cough, conjunctivitis, diarrhea, he is up to datI with his vaccination. whit is the causative organism?

A

Chlamydia

97
Q

Impetigo causati’e organism?

A

Staphylococcus aureus

98
Q

PDA associated with which infection?

A

Rubella

99
Q

Patient diagnosed with Type one Diabetes recently. Has multiple episodes of hypoglycemia in different times throughout the day, what is the name of this phenomenon?

A

Honeymoon

100
Q

Late complication of meningitis?

A

Deafness

101
Q

CXR finding horizontal fissure :

A

transient tachypnea of newborn

102
Q

pulmonary sarcoidosis symptoms + skin manifestation. How to confirm

A

Skin biopsy

103
Q

HCV how to screen = ………. 🍒How confirm ……

A

Screening  = antibody / confirm  =PCR

104
Q

Female has HTN / DM / end stage kideny disease on dialysis admeted due to
pneumonia / what is the best way for DVT prophylaxis ?

A

UFH ( unfractionated heparin)

105
Q

Thumbprint sign found in x ray,

Hx of cardiomyopathy 65Y old male , Sudden Abd pain for 8h , tenderness, abnormal bowel sound , high Amylase ?

A

Mesentric ischemia

106
Q

patient with signs of acute limb ischemia. Peripheral pulses absent in right leg (dorsalis, popliteal) and dorsalis pulse absent in left leg.

A

Catheter thrombolosis

107
Q

Atrial fibrillation prophylactic:

A

Aspirin or warfarin is recommended for use in patients between 65 and 75 years of age with no other risk factors, and warfarin is recommended for use in patients without risk factors who are older than 75 years of age

108
Q

Female pt presented to er with pyelonephritis then suddenly developed
PE features and unstable vitals what to give ?

A

A. Heparin. B. Warfarin C. Alteplase&raquo_space;✅

109
Q

In case of vitiligo what to check

A

Intrinsic factor level

110
Q

Pt with signs of hyperprolactinemia , MRI shows 0.7 mm pituitary adenoma ,
what’s the TTT

A

Cabergoline

111
Q

Long scenario with low BP and hyperkalemia + hyponatrima dx = addisons diaeas ( 🌷

🌹Long scenario with High BP and hypokalemia + hypernatrimia dx = primary hyperaldosteronism🌷

A

Note

112
Q

Female patient who has dizziness when standing and noticed a scar on the back of the hand that is getting darker, how to confirm?

🍒 Female with hypotension ,hyper k+ , hyponNa , dark line in hand scar what next?

A

Synchthen test /

== Morning serum cortisol levels: < 3 μg/dL. _ == ACTH stimulation test

The most specific test of adrenal function is the cosyntropin test.

113
Q

Na Low, BP low, K high, surgery hx?

A

Adrenal insufficiency

114
Q

Child had recurrent vomiting, skin turgor muscle wasting The external genetalia is abnormal of size of the clitoris pediatrician، Labs showed na120 started on sodium chloride What is the next management:

A

(Congenital adrenal hyperplasia) ( hydrocortisone)

115
Q

🍒HTN don’t respond to medication adrenal mass , treatment

A

Alpha blocker

116
Q

Refractory hypokalemia?

A

A. Asses aldosterone and renin ratio

117
Q

Cushing with 24h cortisol high. ACTH was low. Next

A

If ACTH high > go for high dose dexa to differentiate between ectopic Cushing or pituitary If low > CT adrenal

118
Q

Cushing’s sx with new onset DM. Best next step?

A

Pituitary MRI B- cortisol level✅

✅

119
Q

Cushing case what is the confirmatory test:

A

24 urine cortisol or dexamethasone suppression or late night salivary cortisol

120
Q

BsAG negative, Anti-HBc & Anti-HBs positive:

A

Immune because of natural infection

121
Q

HBsAg positive , Anti-HBc positive IgG:

A

Chronic infection

122
Q

Ptn came for routine clinic known case of Chronic hep B pt US shows coarse texture liver ( i think means liver cirrhosis ) his LFT mild
elevation pt is stable and asymptomatic

A

Entecavir

123
Q

hepatitis c type 4 management =

A

Sofosbuvir / Ledipasivr

124
Q

Chronic Hepatitis B, symptomatic, laps show high AST ALT and US shows
micro-changes. How to manage

pt known case of chronic HBV present with elevated LFT and direct and total bilirubin What most appropriate treatment:

A

Peglyted interferone

125
Q

Hep B, surface Ag negative, CORE AB and surface AB positive

A

Immunized due to resolved Infection

126
Q

Pt chronic hepatitis B, came with jaundice and RUQ pain, lab show high liver
enzymes (ast>alt), most appropriate next step, next to check

A

Hepatitis D antigen/antibody

127
Q

Nurse get infected with hepatits b , she is HBs ag And HBV rNA negative , what is your next step ?

A

aminotransferase test

128
Q

Patient with significant hx of painless ulcer. Now presented with rash. =

A

Trypanium phallydium

129
Q

case about hyperuricemia and negative birefringent urate crystal, how to manage?

A

Probenecide

130
Q

Patient presented with feature of gout attack first line ?

A

Indomethacin

131
Q

Treatment on brucellosis?

A

doxycycline and rifampin or Doxy and streptomycin(first line)
( 6-8w. If joints only / if neurobrucelosis then 6 months)

DHA Exam (21 decks)

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