May 6th

Question 1

What is appropriate ppx treatment for a cat bite?

Answer 1

Amoxicillin clavulanate, copious irrigation, tetanus booster as indicated (incompletely vaccinated children, last vax >5 years ago), avoid wound closure

Question 2

What is the amsel criteria?

Answer 2

Used in dx of BV - vaginal pH > 4.5, amine odor with KOH (whiff test), and clue cells

Question 3

How is bacterial vaginosis treated?

Answer 3

Metronidazole or clindamycin

Question 4

What are the coagulation studies in HUS?

Answer 4

Usually normal; though have microangiopathic hemolytic anemia and thrombocytopenia

Question 5

What is sialadenosis? What is it commonly associated with?

Answer 5

Enlargement of submandibular glands; found in advanced liver disease; can also be seen in patients with malnutrition

Question 6

Patients with HIV and subacute-onset of low-grade fever, HA, and signs of increased ICP should be evaluated for what?

Answer 6

Cryptococcal meningitis

Question 7

Enlarged lateral ventricles is commonly associated with what psychiatric illness?

Answer 7

Schizophrenia

Question 8

Increased sensitivity to lactate infusion has been associated with what psychiatric illness?

Answer 8

Panic attacks

Question 9

What are the indications for renal and bladder US in children?

Answer 9

Infants/children <24 months with first febrile UTI; recurrent UTIs, UTI in child with FH of renal or urologic disease, HTN or poor growth; not responsive to treatment

Question 10

What are the clinical manifestations of serum sickness-like reaction?

Answer 10

Fever, urticaria, and polyarthralgia in a patient with a recent exposure ( antibiotic therapy)

Question 11

Upper lung nodule with caviatry lesion, BAL reveals filamentous gram + rods that are weakly acid fast

Answer 11

Think nocardia - seen in immunocompromised

Question 12

How is nocardiosis treated?

Answer 12

TMP-SMX; surgical drainage of abscess

Question 13

The presence of what is associated with increased mortality in a PE?

Answer 13

RV dysfunction, along with elevated BNP and troponin levels

Question 14

What are the renal complications of sickle cell trait?

Answer 14

Hematuria, renal medullary carcinoma, inability to concentrate the urine, distal RTA, and UTIs

Question 15

What are the physiologic renal changes seen in pregnancy?

Answer 15

Increased renal blood flow, increased GFR, and increased renal basement membrane permeability

Question 16

2 week old FTT, bilateral cataracts, jaundice, HSM and hypoglycemia

Answer 16

Think about galactosemia - caused by galactose-1-phosphate uridyl transferase def

Question 17

How do patients with galactokinase def present?

Answer 17

Cataracts only

Question 18

How does uridyl diphosphate galactose-4-epimerase def present?

Answer 18

Hypotonia, FTT, nerve deafness, cataracts, jaundice

Question 19

How is impetigo treated?

Answer 19

Limited: topical antibiotics (eg mupirocin); extensive: oral antibiotics (eg cephalexin, dicloxacillin, clinda)

Question 20

What is the pathogenesis of Henoch-Schonlein purpura?

Answer 20

IgA-mediated leukocytoclastic vasculitis

Question 21

What are the clinical manifestations of Henoch-Schonlein purpura?

Answer 21

Purpura, arthritis/arthralgia, abdominal pain/intussusception, renal disease

Question 22

What is the most common cause of spontaneous lobar hemorrhage?

Answer 22

Amyloid angiopathy; seen > 60 yo

Question 23

What conditions is mixed cryoglobulinema syndrome associated with?

Answer 23

HCV, and SLE

Question 24

How is hepatorenal syndrome diagnosed?

Answer 24

Renal hypoperfusion, FeNa <1% (or urine Na < 10), absence of tubular injury, no RBC, protein or granular casts in urine, no improvement in renal function with fluids

Question 25

How is NNT calculated?

Answer 25

1/ARR (absolute risk reduction)