Miscellaneous medicine

Question 1

54 yo pt has several days of low grade fever, malaise, and severe pain in the R side of ribcage. Exam reveals an erythematous rash with clusters of tense vesicles, with clear content, on a belt distribution from the front of the chest to the back under the nipple, limited to the right side. Likely causal viral agent?

Answer 1

Varicella Zoster virus

Question 2

17 yo pt has an insidious onset of unusual behavior and argumentativeness. The mouth is held slightly open. Pt has mild dysarthria and hoarseness, generalized slowness, rigidity, and a mild resting tremor of the L arm and head. R/o drug and /or alcohol abuse. Liver function test show elevated transaminases. An increase in which laboratory test is most likely to confirm dx?

Answer 2

Urinary copper excretion

Question 3

45 yo M with recurrent episodes of LOC while wearing a shirt with a tight collar, has a feeling of faintness accompanied by pallor, followed by collapse and LOC, and several seconds later by a few bilateral jerks of the arms and legs. Entire episode lasted less than one minute. Most likely explanation?

Answer 3

Carotid sinus syndrome

Question 4

Genome study technique without looking for something in particular

Answer 4

Genome wide association studies

Question 5

Decreases in men during andropause

Answer 5

Penile rigidity

Question 6

Normal changes with motor function in aging?

Answer 6

Stooped posture and slowed walking

Question 7

55 yo with diplopia when looking right, drooping of L eyelid, and drooping L eye, sx better in the morning

Answer 7

Myasthenia Gravis

Question 8

19 yo F has bouts of motor agitation, often followed by intense seemingly meaningless writing; also mood lability, tactile and olfactory hallucinations. During interview, the patient abruptly stops paying attention and begins rapidly pacing around the room. What should be the next step?

Answer 8

Wait 15 min, then obtain prolactin level

Question 9

Immunocompromised pt with confusion and mild headache, b/l papilledema and cerebellar ataxia. CSF= pleocytosis, increased protein, low glucose? India ink stain shown below. Dx?

Answer 9

Cryptococcus

Question 10

45 y/o pt has recurrent episodes of LOC. A detailed description by fam: pt reporting a feeling of faintest accompanied by pallor, followed by collapse and LOC and several seconds later by a few bilateral jerks of arms and legs. Prior to recovery, face and chest are flushed.No precipitating factors identified. Which is the most likely explanation?

Answer 10

Cardiac syncope

Question 11

Side effect of vagal stimulation?

Answer 11

Dyspnea

Question 12

43 y/o pt with memory loss x 8 months associated with abdominal pain, weight loss, joint distention/pain, fever, lymphadenopathy, hyperpigmentation of skin, decrease Hgb, and fat in stool. Which test result is likely to be found?

Answer 12

CSF with PAS+ cells infected with tropheryma

Question 13

2 yo child with history of upper respiratory infections, most likely cause

Answer 13

Haemophilus influenza

Question 14

22 yo female is hospitalized with paranoia, hallucinations, abdominal pain worse with periods, physical exam shows resduced strength in upper and lower extremities and reduced tendon reflexes. Which of the following lab values is likely to be elevated and explain her sx?

Answer 14

Porphobilinogen

Question 15

Component of type A behavior most reliable risk factor for CAD

Answer 15

Hostility

Question 16

50 yo pt with MG and a 3 day hx of cough, low grade fever and chills, pmts with great difficulty breathing. The pt appears tired and anxious, and the pt’s skin is clammy and sweaty. Initial management

Answer 16

Mechanical ventilation

Question 17

55 yo M with changes in his voice, orthostatic hypotension and one immobile vocal cord on inspection suffers from

Answer 17

Shy-Drager syndrome

Question 18

Neoplasms of the thymus are associated with

Answer 18

MG

Question 19

A 25 yo pt develops progressive hearing loss, has acoustic neuromas and cafe au lait spots, dx?

Answer 19

Neurofibromatosis 2

Question 20

Pediatric Autoimmune Disorder associated with Strep (PANDAS) is associated with what disorder?

Answer 20

OCD

Question 21

Children with pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection (PANDAS) often manifest

Answer 21

Choreiform movements and OCD symptoms

Question 22

Age that corticospinal tract complete myelination

Answer 22

3 yrs

Question 23

Alternative stimuli that can be used to overcome withdrawal response to Babinski reflex

Answer 23

Downward scraping of the shin

Question 24

This neuropsychological sx is most commonly seen in mild neurocognitive disorder

Answer 24

Depression