MCCQE

Question 1

Triptan

Answer 1

wiki
Triptans are a family of tryptamine-based drugs used as abortive medication in the treatment of migraines and cluster headaches.
While effective at treating individual headaches, they do not provide preventive treatment and are not considered a cure.
The drugs of this class act as agonists for serotonin 5-HT1B and 5-HT1D receptors at blood vessels and nerve endings in the brain.
The first clinically available triptan was sumatriptan

Question 2

first line against migrant

Answer 2

nsaids,, asa, ibuprofen and naproxen

Question 3

treatment for moderate to severe migraines

Answer 3

triptans

Question 4

prophylactic treatment of migraines

Answer 4

first line: Amitriptyline, propranol, nadolol

many second lines

Question 5

OCP is contraindicated with complicated migraines, why?

Answer 5

because of risk of stroke

Question 6

schizotypal

Answer 6

uncomfortable in interpersonal situations, emotionally distant, difficult to engage, and isolate and exhibit strange or quasi-delusional beliefs

Question 7

4 types of urinary incontinence

Answer 7

overflow incontinence
stress
urge
mixed

Question 8

Gold standard test to differentiate between different types of incontinence

Answer 8

urodynamic testing

Question 9

Air leak syndrome

Answer 9

escape of air fromt he traceobronchial tree into other body spaces where it is not normally present. It is named according to the location of the air, for example, it is called pneumothorax (pleural space), pneumomediastinum (mediastinum), and subcutaneous emphysema (subcutaneous tissues)

Question 10

treatment for tension pneumothorax

Answer 10

emergent needle thoracostoy, life-saving and should be done as soon as possible, no need for imaging confirmation. vein needle is inserted into the third intercostal space at the mid clavicular line to evacuate the air and relieve the tension

Question 11

why is a tension pneumothorax life-threatending?

Answer 11

decreases venous return to heart

Question 12

major adverse effect of acetaminophen overdose

Answer 12

hepatotoxicity

Question 13

large doses of acetaminophen deplete which molecule, what is essential for

Answer 13

Glutathione is essential for metabolism in the liver to nontoxic compounds

Question 14

what doses are dangerous for acetaminophen overdose

Answer 14

hepatic necrosis is rare with ingestion less than 10 g and death is rare with less than 15 g

Question 15

effects of acetaminophen ingestion are delayed, taking how long?

Answer 15

24-36 hours

Question 16

name of acetaminophen nongram

Answer 16

Rumack Matthew nomogram can be used for a single ingestion

Question 17

Most common ingested toxic medication?

Answer 17

acetaminophen

Question 18

Ddx for right upper quadrant abdmoinal pain

Answer 18

Biliary: cholecystitis, choletlithiasis, cholangiits
colonic: colitis, divericulitis
hepatic: abscess, hepatitits, mass
pulmonary: pneumonia, embolus
Renal: nephrolithiasis, peylonephritis

Question 19

Cullens sign and grey turner sign are suggestive of

Answer 19

pancreatitis

Question 20

moon face, buffalo hump and thin limbs

Answer 20

cushing syndrome

Question 21

what causes cushing syndrome

Answer 21

chronic glucocorticoids

Either excesive adrenocorticotropic hormone (ACTH) secretion by a tumor of the pituitary gland or elsewhere int he body (ectopic secretion)
OR
primary excessive secretion of glucocorticoids by a tumor in or simply hyperplasia of the adrenal gland

Question 22

what blood results seen in cushings syndrome

Answer 22

hypokalemia and metabolic alkalosis, increased neutrophils

Question 23

Screening of cushing syndrome

Answer 23

first 24 hour urinary cortisol, if it is 4 times as normal then it can make the diagnosis

Question 24

test to distinguish between adrenal hyperplasia and adrenal adenoma

Answer 24

high dose dexamethason supression test

Question 25

how to distinguish between primary and secondary cushings

Answer 25

measurement of plasma ACTH