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medicine questions Flashcards

1
Q

G6pd

A

Bite cells, low haptoglobin

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2
Q

Nitrous oxide

A

B12 Def, Megaloblasit anemia

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3
Q

AERD

A

Asthma, nasal polyps, NSAIDs sensitivity,

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4
Q

Hypothyrodism and adrenal insufficiency

A

Hypothyroid can mask adrenal insuff start steroids with levothyroxine

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5
Q

GLP-1 eventide side effect

A

pancreatitis

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6
Q

Factor V Leiden

A

MC hypercoagulible in caucasians; AD

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7
Q

Kausmall Sign

A

increase in JVD on inspiration; Constrictive pericarditis

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8
Q

Good Pasture

A

anti GBM, type IV collagen, glomerulonephritis and pulmonary hemorrhage

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9
Q

PSA when to stop

A

70yo and > don’t order

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10
Q

Food allergy

A

Oral challange a gold standard

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11
Q

HSP (Henoch…)

A

Abdominal pain, Rash, glomerulonephritis

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12
Q

Warfarin

A

epoxide reductase inhibitor, 2 7 9 10

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13
Q

Tacrolimus and electrolytes

A

Hyper K, Hypo Mg and P04

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14
Q

Peutz Jegher Syndrome

A

abd pain, pigmentation eyes/lips, pigmented polyps, risk for colon cancer

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15
Q

ITP

A

auto antibodies to anti_GpIIb/IIIa

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16
Q

ttp

A

ADAMTS13

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17
Q

HUS

A

Microangiopathic hemolytic anemia; don’t use antibiotics, don’t give platelets

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18
Q

CRAO

A

MC from carotid artery emboli, cherry red spot

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19
Q

Pulmonary Histoplasmosis dx

A

Urine histoplasma antigen

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20
Q

Strep Viridens

A

Dental procedure endocarditis

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21
Q

ASD

A

when progressed to left to right shunt; first treat pulmonary hypertension prior to surgery

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22
Q

Aortic regurgitation and pulses

A

Bounding pulses

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23
Q

AS and pulse

A

Parvus a Tardus: low amplitude carotid pulse

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24
Q

+ PPD

A

Rifampin for 4 months preferred

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25
Q

Mild arthritis knee tx

A

topical steroids

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26
Q

Hepatic abscess after procedure what bacteria

A

Staph Aureus

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27
Q

APKD also associated with

A

diverticular disease and perforation

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28
Q

DM type 1, what else to screen for

A

Autoimmune thyroditis

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29
Q

OCP don’t use if

A

smoker>35 yo, HTN >160/100

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30
Q

Leser Trelot syndrome

A

Rapidly appearing seborrheic keratosis: look for cancer: : GI or lymphoid

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31
Q

SAH (hemorrhage) ; dx

A

CT first if still suspects LP

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32
Q

Staghor calculus bug

A

proteus mirabalis

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33
Q

IBS

A

Rome criteria for diagnosis

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34
Q

GPA is the same as

A

Wegners; c Anca

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35
Q

Omalizumab

A

For severe refractory asthma/decreases IgE

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36
Q

Drug induced lupus antibody

A

Anti histone antibody

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37
Q

Uremic pericarditis and EKG

A

ST elevations may not be there

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38
Q

Prinzmetal angina tx

A

Calcium channel blocker

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39
Q

Pityriasis Rosea presentation

A

Harold patch, then rash Christmas tree, KOH prep

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40
Q

IgA nephropathy

A

Hematuria and upper respiratory infection

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41
Q

Relapsing Hep A

A

within 6 months, acute illness 2-6 wks post

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42
Q

tumor lysis syndrome tx

A

IV fluids and allopurinol

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43
Q

Polymyalgia Reumatica a/w

A

Giant cell arteritis

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44
Q

IgA deff and blood

A

severe reaction to blood transfusion

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45
Q

babesiosis Tx

A

Clinda and quinine

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46
Q

HCTZ mechanism of action/stones

A

Na/Cl cotrasporter; convoluted distal tubule, helps with Ca+ stone

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47
Q

Protein c and s def risk for

A

warfarin induced skin necrosis

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48
Q

Cryptococcal meningitis tx

A

Amphothericin B

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49
Q

AS gradient and LV function

A

Severe LV dysfunction may underestimate AS gradient

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50
Q

Acute AR don’t use what meds

A

B blocker, Intraaortic balloon pump

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51
Q

Chancroid

A

H Ducrey; painfull !!!, tx: azithromycin, ceftriaxone

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52
Q

LGV

A

Painless ulcer, few weeks later LAN, tx: Doxy, inclusion bodies, tx partners for past 60 days

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53
Q

Syphillis

A

Painless ulcer. Chancre, Later 2nd Syphillis: fevers/myalgias, rash trunk and extremities

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54
Q

Leukemoid reaction

A

wbc>50 000, smear: left shift, bands, metamyelocytes, myelocytes

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55
Q

Perimembraneous VSD

A

The only that causes diastolic murmur; may lead to AR, aortic valve caps gets pulled to VSD

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56
Q

Losartan and uric acid level

A

Losartan reduces uric acid levels

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57
Q

Severe oral candidiitis

A

IV flucanazole

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58
Q

Fungal sinusitis

A

Dematiacus Fungi

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59
Q

Interferon Alpha (tx for bladder ca) when using what to check for

A

unmasks autoimmune disease; check TSH

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60
Q

Cushings diagnosis

A

1)DSt overnight 1mg. 2)late night salivary cortisol 3)24 hour urine cortisol

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61
Q

Corticosteroids for meningitis: benefits?

A

Reduce hearing loss, likely survival benefit

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62
Q

Apixiban/Rivaroxaban reversal agent

A

Andexanet; factor Xa

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63
Q

Dabigatran reversal agent

A

Idarucizumab

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64
Q

Dengue

A

Break bone fever, severe joint pain, –> may progress to Dengue hemorrhagic fever

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65
Q

Organophosphates poisoning/ presentation

A

cholinergic: salivation, urination, lacrimation

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66
Q

Tick paralysis/Lambert Eaton pathophys

A

inhibition of pre synaptic Ca+ channels

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67
Q

Sarcoid hypercalcemia pathophysiology

A

increased activity of 1-alpha hydroxyls activity

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68
Q

Porphyria Cutanea Tarda

A

bulla formation on sun exposed skin, milia small white papule, linked to hep B, hep C

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69
Q

Pituitary hypoplexy what to start first

A

steroids

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70
Q

Polycythemia vera tx

A

Hydroxyurea

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71
Q

Autoimmune pancreatitis

A

IGg-4, salivary glands, dry mouth

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72
Q

Altitude sickness; ABG?

A

Ph up; PC02 down, 02 down, bicarb down

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73
Q

Type I reaction

A

IgE mediated; anaphylaxis, allergies

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74
Q

Type II reaction

A

IGg, IgM, Good pastures, autoimmune hemolytic anemia

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75
Q

Type III reaction

A

immune complexes: PSGN, lupus nephritis, serum sickness

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76
Q

Type IV reaction

A

PPD, contact dermatitis, poison Ivy

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77
Q

Cowdens Syndrome

A

Trichelemmomas, hamartomas, polyps GI, fibrotic breast disease, breast and thyroid cancer

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78
Q

Polymyocytis and CPK

A

Greatly elevated CPK

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79
Q

Inclusion body myosytis

A

Assymetric and distal involvement, grip affected

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80
Q

Achalasia

A

dysphagia to both solids and liquids, regurgitation of undigested food

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81
Q

Chagas Disease tx

A

parasite: Trypanozoma Cruzi; tx: benznidasole, nifurtimox

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82
Q

ASD

A

fixed split s2

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83
Q

Early signs of hypoglycemia may be masked by

A

B blockers

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84
Q

Apthous Ulcer; seen with? tx:

A

IBD, Behcets, HIV, Celian

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85
Q

Adrenal Crisis tx

A

IV hydrocortisone

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86
Q

Hypocalcemia and reflexes

A

Hyperreflexia

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87
Q

Myotonic macular dystrophy

A

MC cause of mascular dystrophy in adults, can’t release hand shake

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88
Q

Restless leg syndrome; 2nd causes

A

DM, hypothyrodism

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89
Q

Methemoglobinemia causes

A

dapsone, topical anaesthetic, lidocaine

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90
Q

Dermatomyocytis tx

A

Gottrons papule, tx: steroids + azathioprine or methotrexate

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91
Q

Polycythemia Vera: what to order if suspected

A

EPO and JAK 2

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92
Q

Arsenic Poisoning

A

Well water; white lines on patients nails, leukonychiai

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93
Q

Folate can correct B12 def; but what about physical exam

A

Neurologic symptoms don’t go away

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94
Q

Erythema nodosum: MC causes, when to bx

A

Strep MC (check antistreptolysin), if TB prevalent bx may be diagnostic of TB

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95
Q

Anti-U1 RNP antibodies? what disease

A

Mixed connective tissue disease

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96
Q

Anti Jo-1 antibody ?

A

ILD in dermatomyocytis and polymyositis

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97
Q

Sensitivity

A

Few false negative; positive test and has disease/all patients

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98
Q

Specificity

A

Few false positives; Negative test and no disease/all patients

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99
Q

Vitiligo: treatment for mild disease

A

topical steroids

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100
Q

Sweet syndrome

A

febrile neutrophilic dermatosis; strong association with leukemia

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101
Q

Meralgia Parasthetica

A

Numbness along outer thigh, lateral femoral cutaneous nerve, tight belt/obesity

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102
Q

Prasugrel; don’t give to

A

prior CVA, TIA (plavix preferred)

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103
Q

Iga vasculitis another name

A

HSP

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104
Q

PNH

A

Thrombosis abd veins; Coombs negative, tx: eculizimab

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105
Q

Dronaderone don’t use in

A

NYHA 3, NYHA 4

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106
Q

Nitrofurantoin don’t use in

A

advanced CKD

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107
Q

Pregnancy and thyroid

A

any hypothyroid treat; usually in pregancy: TSH goes down and t3 t4 up

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108
Q

Most specific for RA

A

CCP

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109
Q

RTA type I

A

Distal; not absorbing bicarbonate, Sjogrens, Glue sniffing

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110
Q

Tamponad and pressures on swan ganz

A

High RA pressure and equalization of pressures; RA, PA and wedge pressure.

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111
Q

Anxiety least side effects tx

A

SSRI, SNRI, and buspirone

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112
Q

Hypocalcemia and reflexes

A

HYPERreflexia

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113
Q

Sotalol

A

Negative inotrope; don’t give if EF<35%; prolonged QT

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114
Q

Ehrlichisis; causes, and tx

A

E chaffeensis, Amblyomma Americanum; tx; doxycyclin

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115
Q

Acute Eosoniphilic pneumonia; tx

A

Steroids, (can be caused by cocaine)

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116
Q

Eosinophilic Esophagitis tx

A

PPI first line then topical steroids

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117
Q

Hemmorhagic shock tx:

A

1) whole blood, 2)LR 3)NS

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118
Q

Lemierris syndrome

A

Jugular vein thrombophlebitis, Fusobaterium Necrophorum, septic emboli to the lung–> abscess/cavitaiton lung

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119
Q

Poison Ivy

A

severe rash tx with oral steroids 14-21 days

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120
Q

Nitroprusside can cause what toxicity

A

Cyanide toxicity: tx: sodium nitrate, sodium thiosulfate

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121
Q

Split s2

A

RBBB

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122
Q

Paradoxical S2

A

AS, LBBB

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123
Q

SCC charasteristics

A

ulcerated, irregular, crusted over

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124
Q

Differentiate Celiac disease from Whipple

A

Both villous atrophy; lymphocytic infiltration of lamina proper in Whipple

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125
Q

Cowdens syndrome

A

hamartomas

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126
Q

Trousseau Syndrome

A

Migratory superficial thrombophlebitis

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127
Q

Macular degeneration

A

Central vision loss

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128
Q

H pylori; after tx confirm irradication, when

A

4 weeks post treatment; urea breath test or stool antigen

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129
Q

Galcanezumab

A

Prophylaxis for cluster headache

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130
Q

Recent MI dont use

A

Amytriptiline

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131
Q

Acyclovir and renal failure

A

Crystal induced AKI stones

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132
Q

Exercise

A

Decreases systemic vascular resistance

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133
Q

Fbn1 mutation

A

Marfans syndrome

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134
Q

PNH diagnosis

A

Flow cytometry

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135
Q

Steroids induced acne

A

No comedos

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136
Q

E coli 0157

A

NO antibiotics, supportive care

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137
Q

Sweet syndrome

A

Neutrophilia, fever, painful erythematous plaques

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138
Q

Dyspepsia

A

First test for H pylori and tx if positive, (not trial of ppi)

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139
Q

Scromboid

A

histamine release, minutes after eating

140
Q

Ciguatera toxin

A

reef fish, perioral parasthesias, hot cold sensation, hours after eating

141
Q

Tetrodotoxin

A

puffer fish; minutes after eating, weakness, ascending paralysis, SOB

142
Q

Amoebic colitis

A

Flask shaped ulcers

143
Q

Celiac sprue; what they need to supplament

A

Vid d

144
Q

Post bariatric surgery long term complications

A

def in: Vit D, B12, copper, iron

145
Q

Infective endocarditis; how to establish diagnosis

A

blood cultures

146
Q

Contact lens conjuctivitis

A

pseudomonas

147
Q

Treatment of metabolic syndrome

A

Use fibrates

148
Q

Disseminated gonncocal infection, tx

A

IV ceftriaxone

149
Q

Oral mucosa burns: what illicit drug?

A

Meth

150
Q

Nitrofurantoin side effect

A

Pulmonary fibrosis

151
Q

Thiamine def: besides ETOH ?

A

TPN

152
Q

B blockers

A

Increase systemic vascular resistance

153
Q

What drugs elevate glucose

A

Olanzapine, statin, steroids, bb, hctz

154
Q

PE; PFTs

A

Only decreased DLCO

155
Q

Ankylosing spondylitis

A

hla27; unilateral anterior uveitis

156
Q

Anterior Uveitis cuses

A

Ankylosing spondylitis, Reactive arthritis, Sarcoid

157
Q

Coronary Microvascular disease

A

Female, reversible defect but clean coronaries; ranalozine helps with angina

158
Q

Causes of uveitis

A

Bescets, Reiters Syndrome, ankylosing spndylitis

159
Q

Pituitary Hyperplasia

A

Primary hypothyroidism not treated for a long time (presents like pituitary adenoma)

160
Q

Statins and A1c

A

Can increase HA1c

161
Q

Hypothyroidism and lipids

A

Elevates lipid levels

162
Q

Exanatide

A

Cant be used as monotherapy

163
Q

Colestipol

A

reduces LDL, used with statin, interupts bile acid reabsorption

164
Q

Ezetimibe

A

as adjunct to statin

165
Q

Thyroglobulin level decreased causes

A

Exogenous thyroid, thyroidectomy, radioactive iodine ablation

166
Q

Sideroblastic anemia can be caused by what medications

A

INH, linezolid, chloramphenical

167
Q

Primary Biliary Cirrhosis tx;

A

Ursodeoxycolic acid

168
Q

Pyrodixine is tx for what:

A

Sideroblastic anemia from INH resulting in B6 def

169
Q

Pressure ulcer not healing

A

May convert to malignant; not healing ulcer; induration

170
Q

Tumor lysis syndrome

A

Besides: allopurinol and IV hydration; rasburicase and febuxostat can also be used

171
Q

cannon a waves

A

3rd degree av block, pulmonary htn, VT

172
Q

Inferior wall infarct

A

Acute mitral regurgitation from papillary muscle rupture

173
Q

Rapid onset of nausea/vomiting after ingestion of food; what bugs

A

B Cereus, Staph Aureus

174
Q

If using Ca channel blockers in heart failure; which ones

A

Amledopine and felodipine

175
Q

Inappropriate sinus tachycardia; tx

A

BB or CCB

176
Q

Radiation therapy fo prostate cancer, side effects profile

A

Lowest risk for ED and urinary incontinence up to 5 years

177
Q

Pleaural fluid with >80% of lymphocytes; etiologies

A

TB, Chylothorax, lymphoma, RA, Sarcoid, trapped lung

178
Q

HUS; what is the treatment

A

Supportive, no antibiotics, no platelets

179
Q

Barrets can lead to what cancer

A

adenocarcinoma (vs etho smoking risk factor for squamous cell carcinoma)

180
Q

Carcinoid is associated with ?

A

Vitiligo

181
Q

Prolong use of metranidazole side effect

A

peripheral neuropathy

182
Q

Sulfasalazine: not effective in?

A

Small bowel disease, (broken in the colon into active metabolites)

183
Q

String sign

A

Narrowing of the distal ileum from Crohns (everywhere else called apple core -> Ca)

184
Q

UC

A

P anca, arthtitis, ankylosing spondylitis, uveitis, Erythema nodosum, Primary sclerosing cholangitis

185
Q

Sarcoid and vit d

A

elevation of 1,25 (OH) D3

186
Q

IV fomepizole for treatment of what?

A

Ethylene glycol and methyl alcohol

187
Q

AERD

A

pseudo allergic reaction, polyps

188
Q

Graves Orbitopathy ; what can make it worse

A

Radioiodine therapy makes it worse; if chosen for treatment use steroids; Radioiodine should not be used in severe orbitopathy.

189
Q

When using methotrexate; what else to prescribe

A

Folic acid

190
Q

Hydrochychloroquine: what needs to be monitored

A

Retinal exam; at baseline and every 5 years

191
Q

Diverticulosis is painless

A

True

192
Q

Dronedarone; should be avoided in patient with ?

A

EF<35 % avoid it

193
Q

Cocaine induced chest pain: tx

A

1)Benzo 2)Nitrate 3) ASA, and to prevent chest pain in the future CCB

194
Q

Only gastric varices

A

Splenic vein thrombosis. (ex: chronic pancreatitis)

195
Q

HD can rarely lead to what?

A

Hemolysis and hyperkalemia

196
Q

Methimazole

A

Don’t use during pregnancy

197
Q

PTU

A

Aplastic anemia, agranulocytosis, hepatotoxic

198
Q

Ziel-Nielsen stain

A

same as acid fast stain

199
Q

Arteriol Clots

A

antiphospholipid antibodies: lupus anticoagulant, anticardiolipin, also in HIT

200
Q

Inhalation Anthrax

A

Hemorrhagic mediastanitis. CXR with wide mediastinum, tx: Cipro IV + clindamycin

201
Q

IBD screen

A

best fecal Calprotectin

202
Q

UC

A

smoking makes it better, crypt abscesses

203
Q

Crohns

A

ASCA, granulomas on bx, Ca oxalate stones, perianal fistula

204
Q

Listeriasis

A

Soft Cheese

205
Q

Whipple disease

A

Arthritis, weight loss, neurologic symptoms, hyperpigmentation

206
Q

Celiac sprue

A

Bullous skin disease, dermatitis herpetiformis, Howell jolly bodies

207
Q

Howell jolly bodies

A

asplenia or spleen dysfunction, (blue dot inside RBC), Celiac, MDS, Megaloblastic anemia, radiation, hemolytic anemia, spherocytosis

208
Q

Tropical sprue

A

Megaloblastic anemia

209
Q

1 cancer risk in Lupus

A

NHL

210
Q

After diagnosis of DM or PM what to do next

A

ILD screening (chest xray, pfts, CT), cancer screening

211
Q

Daptomycin

A

Don’t use for pneumonia

212
Q

Post herpetic neuralgia

A

desipramine or gabapentin

213
Q

Isolated reduction in DLCO

A

PE, Anemia, PAH

214
Q

Dexa who gets it

A

Women over 65 yo

215
Q

Quinidine: side effect

A

class 1 antiarrythmic, can cause drug induced hemolytic anemia

216
Q

Leptospirosis

A

Markedly elevated T bili when compared to AST, ALT

217
Q

Tularemia

A

Ulcers and glands; hunting, tx: streptomycin 7-10 days

218
Q

Ring enhancing lesion in the brain causes:

A

abscess, toxoplasmosis, lymphoma

219
Q

Brucella associated with

A

cryoglobulin +, endocarditis with negative cultures

220
Q

Macroadenoma and pregnancy

A

formal visual field testing every trimester

221
Q

HIV patient what statin not to use

A

simvastatin (increase level of HIV meds)

222
Q

Venous ulcer tx

A

compression stocking and leg elevation

223
Q

LAM

A

spontaneous PTX, interstitial marking, chylothorax (chylothorax also in lymphoma)

224
Q

Acute AR: what meds to avoid

A

b blocker or intraaortic balloon pump

225
Q

MS and atrial fibrillation

A

start anticoagulation CHADs don’t matter

226
Q

Cataract

A

Loss of red feflex

227
Q

Atrial Myxoma asucultation

A

May mimics mitral stenosis

228
Q

Cilostazol; for PAD, don’t use…

A

with heart failure with low EF

229
Q

Metastatic tumors to the heart

A

Melanoma, malignant thymoma, germ cell tumors

230
Q

Psoriasis

A

Don’t treat with systemic steroids

231
Q

Extensive seborrheic dermatitis aw

A

HIV

232
Q

Pregnancy and resistence

A

Decreased peripheral and systemic resistance

233
Q

Ramsey Hunt syndrome

A

VZV, vesicles in the ear, diminished taste anterior 2/3 of the tongue, ipsilateral facial paralysis

234
Q

Keratoacanthoma

A

Form of SCC, looks like a volcano

235
Q

Acral lentigenous Melanoma

A

dark skin patients, feet/hands

236
Q

Utricaria: wheals around the mouth

A

Monitor for airway compromise

237
Q

Jarish Herxheimer

A

Atibiotics for syphillis/lyme can precipitate it; dying spirochete releasing toxin, Tx: supportive, continue antibiotics

238
Q

Celiac dz associated with

A

Dermatitis herpitiformis(Iga deposits)

239
Q

Porphyria cutnae tarda

A

aw, hep c, vesicles and bullae on sun exposed areas

240
Q

Dermatitis Herpetiformis tx:

A

Always with gluten free diet, may add dapsone(though check for G6PD def)

241
Q

Dengue

A

south east Asia, rtetroorbital pain, maylgia, arthralgia, and rash, low platelets, leukopenia, elevated liver enzymes

242
Q

Alpha 1 antitrypsin what is the location of emphysema

A

Lower lobes

243
Q

If pheochromocytoma suspected/diagnosed what else to do

A

further imaging: MIGA scan or Valium-68 DATATATe to locate other possible regions

244
Q

Coarctation of the aorta; what else to screen for?

A

10% have berry aneurysms; cranial imaging would be indicated

245
Q

CO poisoning aw ?

A

Acute myocardial injury

246
Q

Alzheiemers disease

A

APOE 4 on chromosome 19

247
Q

Tyramine hypertensive crisis

A

tyramine rich foods(meats, cheese) + MAO inhibitor: ex: Phenelzine

248
Q

Phenylephrine for seasonal allergies can lead to

A

urinary retention (alpha agonist; opposite of alpha blocker)

249
Q

OA why falls happen?

A

Impaired postural stability from partial weight bearing

250
Q

Migraine with Aura what med not to use

A

OCPs

251
Q

PCOS with acne what med could be could here for acne

A

Aldactone:

252
Q

Sjogrens and thyroid

A

HYPOthyrodism

253
Q

Osteoporosis and thyroid

A

HYPERthyrodism is a risk factor not Hypo

254
Q

WPW aw what heart defect

A

Ebstein anonomoly(tricuspid regurgitation, nakedly enlarged right atrium)

255
Q

PDA and prophylaxis for dental procedures

A

Yes

256
Q

Triptans avoid in

A

CAD, vasculitis

257
Q

Labetolol side effect

A

throat burning, scalp tingling

258
Q

PDA

A

left to right flow—> pulmonary hypertension, infection can occur and lead to septic emboli in the lungs!!!!

259
Q

Melanosis Coli

A

Factitious diarrhea due to laxative abuse

260
Q

Gold standard to r/o asthma

A

Methacoline challange

261
Q

Gardners syndrome?

A

FAP with extra colonic manifestations, cutaneous cyst/epidermoid cysts, dental issues, Desmoid tumors, malignancies: thyroid, liver, CNS

262
Q

Melanoma

A

s-100 cells, BRAF gene mutation

263
Q

Basal cell carcinoma

A

basophilic palisading cells

264
Q

1 cause of occupational asthma

A

Latex

265
Q

Icosapent ethyl (purified fish oil)

A

add for high TB in heart failure…… (not vibrate)

266
Q

celiac disease bx

A

increased intraepithelial lymphocytes, crypt hyperplasia

267
Q

Nummular eczema

A

coin lesions, extremities, very itchy,

268
Q

Hgba1c falsely low in …?

A

hemolytic anemia, renal failure, eco administration

269
Q

Metformin aw? besides GI, lactic acidosis

A

Vit B12 def

270
Q

Acne Rosacea tx;

A

topical metronidazole vs topical sulfacetamide

271
Q

pubic lice tx:

A

topical permethrin

272
Q

Statins teratogenic?

A

yes

273
Q

Ezetimibe se

A

hepatotoxicity

274
Q

Niacin se

A

acanthuses nigricans

275
Q

Fibrates se

A

cholelithiasis and myopathy

276
Q

Celiac if suspecting what to order

A

TTG antibodies and IGa level (IgA def will make TTG negative)

277
Q

Lofflers Endocarditis

A

Eosinophilia—> restrictive cardiomyopathy

long term untreated eosinophilia from intestinal worms/parasites as ex

278
Q

Hypoparathyrodism

A

MC from surgical injury; low Ca, Low PTH, increased Ca extortion(lack of PTH activity on distal renal tubules)

279
Q

Cardiac Contusion may lead to

A

Ventricular pseudoaneurysm

280
Q

AERD and desensitization

A

To maintain desentisisation must use minimum 325 mg asa

281
Q

Kartegener Syndrome

A

AR, impaired ciliary clearance, sinusitis, bronchiectasis, sinus inverses totalis, inversion of thoracic and abdominal organs

282
Q

IE prophylaxis for GU/GI procudures?????

A

Not recommended

283
Q

Diverticular bleed

A

band ligation high rate of hemostasis

284
Q

Amiodarone and the eye

A

Corneal micro deposits

285
Q

Bladder cancer risk

A

smoking, stones, schistosome, Not NSAIDs(may be protective)

286
Q

Methemoglobenemia: and Pa02

A

normal Pa02 (after use of anesthetic: benzocaine)

287
Q

Carbon Monoxide poisoning:

A

normal Pa02

288
Q

Aortic Stenosis

A

delayed carotid upstroke

289
Q

Lichen Planus

A

Associated with hep C, 6 ps,

290
Q

Strep Bovis same as

A

Strep Gallolyticus

291
Q

After balloon angioplasty; delay elective sx for ??

A

14 days at least

292
Q

Sheehans syndrome

A

Post partum pituitary necrosis

293
Q

Melfloquine and EKG:

A

sinus Brady and prolonged QT interval

294
Q

Clostridium septicum and cancer

A

Colon cancer, relapse of leukemia

295
Q

Sjogren’s, Diagnosis:

A

Lip bx

296
Q

Glaucoma

A

Enlarged cup to disk ratio

297
Q

Pt on methimazole of PTU; presents with fevers/sore throat: diagnosis:

A

Agranulocytosis

298
Q

Decreased levothyroxine absorption with these drugs:

A

ppi, iron, calcium, celiac disease

299
Q

pt treated for non seminoma; later can present with

A

teratoma

300
Q

COPD vs asthma DLCO

A

DLCO decreased in COPD; normal or increased in ASTHMA

301
Q

Alveolar hemorrhage and PFTS

A

Increased DLCO >140%

302
Q

LOW TLC and normal DLCO?

A

Extra pulmonic source of restriction: ex: pleural effusion, NM problem, kyphosis, pleural thickening

303
Q

Normal DLCO examples

A

Asthma, CO poisoning

304
Q

Hepersensitivity pneumonitis–> eos and IgE

A

Eosinophils and IgE are NORMAL

305
Q

Dexamethasone and cortisol level

A

Dexa does not interfere with cortisol level

306
Q

Pheochromocytoma aw?

A

MEN 2, Hippel Lindau dz, Neurofibromatosis type 1

307
Q

CKD which medications slows progression

A

Sodium bicarbonate, ace/arb, SGLT -2

308
Q

Thiazide diuretics also good for

A

kidney stones; Ca oxalate stones

309
Q

Berryliosis looks like

A

Sarcoidosis

310
Q

Pleural fluid for TB

A

Increased ADA

311
Q

High osmolar GAP, but normal Anion gap

A

Isopropyl ETOH

312
Q

High osmolar GAP and high Anion gap

A

Ethyolene glycol, Methanol

313
Q

Cyonide poisoning antidote?

A

Hydroxycobalamin first line, then: Sodium nitrate, sodium thiosulfate

314
Q

Pt with stemi; no Cath lab; gets asa, b blocker, thrombolysis; what other med you add

A

Plavix

315
Q

Milrinone vs dobutamine

A

can’t use Milrinone with AKI

316
Q

Eosonophilic esophagitis:

A

mc presentation food impaction; rings, >15 eosinophils, tx: first pip 8 weeks then inhaled steroids swallowed

317
Q

Sausage shaped pancrease:

A

Igg4/outoimmune pancreatitis

318
Q

HBV treatment when to start

A

treat only active inflammation, life long tx, no cure

319
Q

Wilsons: on labs

A

low ALk phos!!!!, low cerulplasmin

320
Q

Cirrhotic pts; what meds not to use

A

don’t use ace inhibitors or arbs; —> may predispose to renal failure (hepatorenal

321
Q

Imatinib: for CML, se

A

prolonged QT

322
Q

Suspect acute leukemia: Aml or ALL; first diagnostic test

A

first test to order flow cytometry (bone marrow to slow…can still get it) ALL vs AML: ALL usually presents with massive LAN

323
Q

LADA

A

latent autoimmune diabetes in adults: check GADA

324
Q

Serum 1,5-anhydroglucitol level;

A

good for assessment of glycemic control over the past 2 wks (even in hemoglomapathies)

325
Q

Labyrinthitis vs vestibular neuritis

A

labyrinthitis has hearing loss (tx with steroids both?)

326
Q

Chronic cough:

A

first chest X-ray; stop meds/smoking; then tx: post nasal drip: inhaled steroids, then r/o asthma; last resort is ppi

327
Q

Breast lump palpable:

A

always US; may add mammogram if> 30 yo. (But always do US for palpable lump)

328
Q

Sumatriptan:

A

dont give to pregnant, also if migraine with weakness (can cause vasoconstriction) also in CVA….and so on

329
Q

Headache prophylaxis:

A

migraine: topiramate; tension ha: amitryptiline; cluster: verapamil…. for prophylaxis

330
Q

Bupropion:

A

lowers seizure threshold… commonly used for depression, smoking cessation

331
Q

Topiramate SE

A

kidney stones

332
Q

Meningitis bacterial when to give steroids

A

if steroids given, must before antibiotics; ampicillin >50 yo

333
Q

West Nile: physical exam

A

flaccid paralysis

334
Q

Gram negative bacteremia:

A

can only maybe tx for 7 days…. don’t have always extend

335
Q

Mac:

A

greatly elevated alk phos

336
Q

Rifampin:

A

add it if hardware present to penetrate bio films (ex: osteomyelitis in vicinity of prior hardware on the foot)

337
Q

Rocky mountain spotted fever:

A

starts distal/palms/ and then moves central

338
Q

glaucoma:

A

loss of peripheral vision; cup to disk ratio increased

339
Q

High altitutude: ABG:

A

respiratory alkalosis; ph up; everything else down

340
Q

Duloxetine:

A

can use with PUD; or if can’t tolerate NSAIDs

341
Q

Lupus nephritis:

A

Mycophenolate Mtotefil

342
Q

MCTD:

A

associated with pulmonary hypertension (Not ILD)

343
Q

Polymyositis:

A

anti-Jo antibody (ILD association strong with that antibody)

344
Q

Inclusion body myositis (vs polymyositis: )

A

both DISTAL and proximal weakness and may be asymmetric

345
Q

SIBO:

A

small intestinal bacterial overgrowth: dsimotily; blind loops; ppi, gastroentritis….crest

346
Q

Lofgren syndrome:

A

arthritis, hilar LAN, erythema nodosum; no diagnostic test; self resolving, may give NSAIDs.

347
Q

Heerfordt Syndrome:

A

anterior uveitis; parotiditis, fevers, +/_ facial nerve palsy: no diagnostics tests

internal medicine questions (1 decks)

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