Last Day Review Flashcards
1
Q
Child with flu symptoms + pneumonia symptoms + gastroenteritis + conjunctivitis, fever , diagnosis
A
Adenovirus infection
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
3
Q
treatment of Community-acquired pneumonia? Fluoroquinolones
A
Fluroquinon
4
Q
Pneumonia with cold agglutination test =
A
Atypical pneumonia
5
Q
what time taken for patches on x ray of Lobar pneumonia to disappear?
A
6 weeks
6
Q
Influenza pneumonia case , what to consider when you want to isolate?
A
Droplets
7
Q
Pneumonia vaccine in elderly?
A
PCV13 first, followed by a dose of PPSV23
8
Q
pseudomembrane over tonsillitis with mild fever ( diphtheria) What complication you suspect
A
Pneumonia
9
Q
Interstitial pneumonitis” is a pathologic hallmark for:
A
Viral pneumonia
10
Q
sarcoma how to assess metastasize
The most common site of distant spread of sarcomas is the …….
A
Chest CT, Lung
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
12
Q
Scenario about croup, pt having barking cough, diagnosis?
A
laryngotracheobronchitis
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
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
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
16
Q
Patient was found to have cavity on x ray ( TB ) what is the type of precaution?
A
Airborne
17
Q
Patient with ascites + fever +low SAAG =
A
TB ( because high SAAG is ass with cirrhosis & CHD
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 )
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 )
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)
21
Q
TB medications has an increase in uric acid =
A
Pyrazinamide ( is the most hepatotoxic drug in TB ttt )
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
23
Q
Facial plethora and JVP distended, which of the following is associated
with this condition? SLCC
A
Don’t know
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
25
Case that seemed like obstructive sleep apnea. Obese patient with uncomfortable sleep + snoring. Has cyanosis and dyspnea best investigation= polysomnography
MRI + IV steroids
26
A case about a pt with pleural effusion and asks about the most
AFB culture ( acid fast bacili )
27
Th is ass, with what pneumoconiosis disease
Silicosis
28
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
TB
29
Anti TB drug cause neuropathy
Isoniazid
30
pleural TB most sensitive test:
ADA- Adenosine deaminase ( while AFB is most specific )
31
TB treatment?
= RIPE( the four drugs) .
| = rifamycin isoniazid, pyrazinamide, and ethambutol.
32
Indian with history of Tb presented with elevated JVP and hepatosplenomegaly:
Constrictive pericarditis
33
anti tb medications, might increase creatinine?
Rifampin
34
TB pt what is the medication increase liver enzymes ?!
INH
35
Pt with bilateral hydronephrosis with dilated bladder and proximal urethra?
Posterior urethral valve
36
Pt with aspirin toxicity, what is the most important next step in management:
Blood-urine alkalization by giving Iv sodium bicarbonate
37
Nephrotic syndrome first line Tx?
Steroids, and furosemide for symptoms
38
patient with edema Urine analysis: Oval fat body, some hyaline cast.
Occasional RBC case.
Nephrotic syndrome
39
how to prevent calcium stone?
Give thiazide
40
pregnant with blood pressure 160/110 with protein in urine what first thing to give ? Preeclampsia case
Magnesium sulfate
41
pediatric patient with hematuria and hemoptysis? Treatment? Test for diagnosis?
Goodpasture's syndrome / steroids +- cyclophosphamide / antiglomerular basement membrane antibodies
42
Cressnt moon in kidney disease means
Rapidly progressive glomerulonephritis
43
Case with hematuria and RBC cast on urine analysis , recent hx of URTI . which inv support dx of PSGN ?
Low C3 / serum creatinine
44
child with multiple joint pain and subcutaneous nodules , diagnosis by
ASO ( antistreptolycin antibody titer )
45
arthritis and splenomegaly , diagnosis
Felty’s syndrome
46
Female pt asymptomatic, previous Hx of URTI 2 weeks ago. O/E: mid diastolic murmur, how to confirm dx?
A. Echo B. ASO titre✅
47
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?
Sulfasalazine
48
Patient with acute migraine What is the treatment?
Triptan
49
headache at 3 am with eye symptoms ( cluster headache) what is best prophylaxis ?
Verapamil ( CCB )
50
16 years old female. Fever and Chronic diarrhea , wt loss for 10 months Post meal Paraumbilical
Crohn’s disease
51
Pt had IBD flare , had been managed with IV fluid, what to do
Oral budesonide
52
Crohn's disease and have stricture it was single 1 cm , 1cm from the ileocecal valve =
strictureplasty
53
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 :
Infliximab
54
crohn's diseases patient with perianal abscess on infliximab and azithromycin. Mx?
IV antibiotics as ciprofloxacin, metro
55
extraintestinal symptom of crohn Disease :
Erythema nodosum
56
weight loss over 2 months. Ilieal biopsy showed noncaseating granuloma
Crohn’s
57
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
Chest X-ray
58
Case of bloody diarrhea biopsy shows transmural inflammation where is the most common site ?
Ileum
59
Male with non bloody dirrhea, pale, oral ulcer?
Crohn’s
60
Pt known case of crohn's did terminal ileum resection complain of diarrhea what to give?
B12
61
lead pip point on X.ray =
UC
62
Ulcerative colitis ercp done shows intra and extra hepatic bile duct strictures. What is the dx?
Primary sclerosing cholangitis
63
Ulceritive colitis , investigations :
CT abdomen
64
Young male patient came with chronic bloody diarrhea, joint pain and skin rash what’s the most likely diagnosis?
UC
65
female patient with *positive Anticardiolipin antibody* and other symptoms, what is the diagnosis
Anti-phospholipid syndrome
66
Recurrent sinusitis + hematuria+ saddle nose =
Wegener syndrome
67
IgA Nephropathy (Berger Disease)= symptoms? Treatment?
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
Scenario of patient with hematuria, pulmonary hemorrhage ,recurrent sinusitis and numbness in Rt Upper limb and Lt lower limb
Granulomatosos with polyangitis
69
Case SLE , Coomb test diagnosis what?
Autoimmune Hemolytic anemia
70
Pt have SLE with neurological manifestation, pt already on corticosteroids what to add now =
Cyclophosphamide
71
The most common medicine known to cause drug-induced SLE
Hydralazine
72
SLE with UTI , drug Contraindicated or to avoid?
Sulfamethoxazole
73
Hx of. SLE ask about diagnostic test:
Anti dsDNA
74
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?
Methotrexate and cyclophosphamide /
Steroids + hydroxychloroquine
75
Case of post viral petechiae and other symptoms, What to expect in bone marrow?
Increase megacryocytes
76
Ptn with DM and RA, has bone pain and hypercalcemia, high renal function test . What’s the diagnosis
Amyloidosis
77
Left eye unable to abduct, when looking forward there’s squint towards the
nose which nerve affected
Left 6th nerve
78
eczema, bruising ( thrombocytopenia) and repeated infections=…….
wiskott aldrich syndrome
79
Schistosomiasis complication
Pulmonary HTN
80
Patient with rhumatic arthritis on methroxat and Hydrochloroquine but still not managed. What to add?
Adalimumab
81
RA + lung symptoms ( pneumoconiosis) =…….syndrome
Caplan
82
RA marker
Anti CCP
83
What of these is the minor criteria of jones criteria of rheumatic fever
Fever , arthralgia , Prolonged PR interval , High CRP and ESR , leukocytosis.
84
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)
True
85
Case of rheumatic fever with painful nodule.and fever and joint pain ///what investigation to order
Throat culture or ASO
86
one of these is a minor criteria for rheumatic fever :
Polyarthralgia , fever
87
Celiac disease = Ass by
Celiac disease = Ass by = tissue transglutaminase IgA
88
Pt 28 yrs e symptoms of celiac disease symptoms. Which part of intestin is affected
Jejunum
89
Celiac px , lost follow up what expect to see?
Low vit D3 / Wrist x- ray shows Cupping and fraying of metaphasis
90
Case of cystic fibrosis but without mentioning the dx, what u will find else in examination
Nasal polyps
91
🌹 Long scenario child with LL edema, periorbital, has fever and lethargy with dark urine and protein in urine what else u would ask for
Impetigo 1 month ago
92
🌹Diagnosis of meigs syndrome =
CT
93
case with situs inversus and infertility:
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
Pt will do CT with contrast after give contrast develop wheezing what you want to do ?
Epinephrine
95
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
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
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?
Chlamydia
97
Impetigo causati’e organism?
Staphylococcus aureus
98
PDA associated with which infection?
Rubella
99
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?
Honeymoon
100
Late complication of meningitis?
Deafness
101
CXR finding horizontal fissure :
transient tachypnea of newborn
102
pulmonary sarcoidosis symptoms + skin manifestation. How to confirm
Skin biopsy
103
HCV how to screen = ………. 🍒How confirm ……
Screening  = antibody / confirm  =PCR
104
Female has HTN / DM / end stage kideny disease on dialysis admeted due to
pneumonia / what is the best way for DVT prophylaxis ?
UFH ( unfractionated heparin)
105
Thumbprint sign found in x ray,
| Hx of cardiomyopathy 65Y old male , Sudden Abd pain for 8h , tenderness, abnormal bowel sound , high Amylase ?
Mesentric ischemia
106
patient with signs of acute limb ischemia. Peripheral pulses absent in right leg (dorsalis, popliteal) and dorsalis pulse absent in left leg.
Catheter thrombolosis
107
Atrial fibrillation prophylactic:
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
Female pt presented to er with pyelonephritis then suddenly developed
PE features and unstable vitals what to give ?
A. Heparin. B. Warfarin C. Alteplase >>✅
109
In case of vitiligo what to check
Intrinsic factor level
110
Pt with signs of hyperprolactinemia , MRI shows 0.7 mm pituitary adenoma ,
what’s the TTT
Cabergoline
111
Long scenario with low BP and hyperkalemia + hyponatrima dx = addisons diaeas ( 🌷
🌹Long scenario with High BP and hypokalemia + hypernatrimia dx = primary hyperaldosteronism🌷
Note
112
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?
Synchthen test /
== Morning serum cortisol levels: < 3 μg/dL. _ == ACTH stimulation test
The most specific test of adrenal function is the cosyntropin test.
113
Na Low, BP low, K high, surgery hx?
Adrenal insufficiency
114
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:
(Congenital adrenal hyperplasia) ( hydrocortisone)
115
🍒HTN don't respond to medication adrenal mass , treatment
Alpha blocker
116
Refractory hypokalemia?
A. Asses aldosterone and renin ratio
117
Cushing with 24h cortisol high. ACTH was low. Next
If ACTH high > go for high dose dexa to differentiate between ectopic Cushing or pituitary If low > CT adrenal
118
Cushing's sx with new onset DM. Best next step?
Pituitary MRI B- cortisol level✅
| ✅
119
Cushing case what is the confirmatory test:
24 urine cortisol or dexamethasone suppression or late night salivary cortisol
120
BsAG negative, Anti-HBc & Anti-HBs positive:
Immune because of natural infection
121
HBsAg *positive* , Anti-HBc positive IgG:
Chronic infection
122
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
Entecavir
123
hepatitis c type 4 management =
Sofosbuvir / Ledipasivr
124
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:
Peglyted interferone
125
Hep B, surface Ag negative, CORE AB and surface AB positive
Immunized due to resolved Infection
126
Pt chronic hepatitis B, came with jaundice and RUQ pain, lab show high liver
enzymes (ast>alt), most appropriate next step, next to check
Hepatitis D antigen/antibody
127
Nurse get infected with hepatits b , she is HBs ag And HBV rNA negative , what is your next step ?
aminotransferase test
128
Patient with significant hx of painless ulcer. Now presented with rash. =
Trypanium phallydium
129
case about hyperuricemia and negative birefringent urate crystal, how to manage?
Probenecide
130
Patient presented with feature of gout attack first line ?
Indomethacin
131
Treatment on brucellosis?
doxycycline and rifampin or Doxy and streptomycin(first line)
( 6-8w. If joints only / if neurobrucelosis then 6 months)
