MISCELLANEOUS REVIEW 1-10

Question 1

Abdominal pain, diarrhea (non-bloody), weight loss…usually chronic…WITH PAPULOVESICULAR RASH…also presents with bloating, fatigue, and weakness

Answer 1

celiac sprue!
associated with gluten intolerance
dermatitis herpetiformis
can also present from vitamin deficiency secondary to fat malabsorption leading to osteoporosis (form vit d deficiency), easy bleeding (vit k def) and megaloblastic anemia (vit b12 and folate)

Question 2

Types of neuropathies associated with DM

Answer 2

femoral neuropathy
diabetic polyneuropathy
meralgia paresthetic

Question 3

Mononeuropathy commonly associated wth DM; unilateral decerased motor strength of leg and decreased sensation

Answer 3

femoral neuropathy

Question 4

symmetric and distal limb sensory and otor deficitis

Answer 4

diabetic polyneuropathy

Question 5

meralgia paresthetic

Answer 5

paresthesias but no motor defecit

Question 6

Women who use low dose estrogen oral contraceptives have 50% lower risk of cancer of the….

Answer 6

OVARY

Question 7

inflammatory disorder ours in elderly patients (self limiting).
Main feature if hip and shoulder/muscle pain as well as pelvis
also presents with systemic symptoms like malaise, fever, depression, weight loss, fatigue

Answer 7

polymyalgia rheumatica

Question 8

Labs for polymyalgia rheumatica

Answer 8

ESR usually elevated

Question 9

Treatment for polmyalgia rheumatica

Answer 9

Corticosteroids (until disease is over, self limiting; resolved usually in 1-2 years

Question 10

Refeeding syndrome is characterized by potentially fatal shifts in fluids and electrolytes that ay occur in malnourished patients receiing artifical feeding. What electrolyte abnormality is is assocaited with

Answer 10

hypophosphatemia

Question 11

how to reduce risk of oral candidiasis in patients with asthma inhaler

Answer 11

metered dose and spacer

Question 12

When to be proceed with layrngoscopy for hoarseness

Answer 12

if hoarseness persists for 3 months or more

Question 13

most common cause of right heart failure

Answer 13

LEFT HEART FAILURE

also myocarditis, pulmonic stenosis, and VSD

Question 14

Infectious mononucleosis management

Answer 14

-NOT ANTIVIRALS (NO BENEFIT)
- supportive therapy (hydration, NSAIDS, throat sprays)
-

Question 15

How to manage hypercalcemia of malignancy

Answer 15

• FLUID REPLACEMENT FIRST WITH NORMAL SALINE

- once patient is euvolemic, PAMIDRONATE is the mainstay of treatment

Question 16

Myomectomy vs fibroid embolization for symptomatic uterine fibroids

Answer 16

myomectomy - for those who wish to become pregnant in future, but needs general anesthesia and blood transfusion more likely

embolization - shorter hospitalization, less time off work, no general anesthesia required, blood transfusion unlikely to be needed

Question 17

Black leopard spotting on colonic mucosa

Answer 17

melanosis coli - benign condition resulting form abuse of antrhaquinon laxatives such as cascara, senna, or aloe

Question 18

Valsalva usually decreases length and intensity of most murmurs except for

Answer 18

murmur of hypertropic obstructive cardiomyopathy and mitral valve prolapse (NOT INSUFFICIENCY)

Question 19

Overweight 12 year old male presents with left hip pain that gradually starts after playing tennis (no injury recalled). He is now walking with limp (afebrile, limited internal rotation)

Answer 19

slipped capital femoral epiphysis

if fever? - think septic artrhtis

Question 20

If a patient or nursing home resident is losing weight or has suffered acute change in ability to perform ADL, what is an option for nutrition?

Answer 20

PEG tube (percutaneos endoscopic gastrostomy)

this is very uncomfortable and agitating so restraints may need to be used

Question 21

What is a high risk patient for colon cancer and when should they start being screened for colon cancer?

Answer 21

patient with a first degree relative diagnosed before age 60 or at least two relatives with colon cancer (regardless of age)

should start screening at 40 or 10 years before earliest age that relative was diagnosed…then rescreened

Question 22

What drugs can cause pleurisy?

Answer 22

HYDRALAZINE

Question 23

Pharmacologic therapy for WPW

Answer 23

Procainamide

avoid digoxin, adenosine, or CCBs like verapamil or amlodipine since they can bring about vfib

Question 24

Which antibiotic is contraindicated in 2nd and 3rd trimesters of pregnancy for tooth discoloration of fetus

Answer 24

doxycycline

Question 25

Patients should be screened for TB before starting which gout treatment?

Answer 25

anti tumor necrosis factor inhibiting agents like infliximab! which is used if methotrexate doesn’t control disease…risk of reactivating TB

Question 26

Cautious gait with visual impairment

Answer 26

wide stance, abducted arms and legs, “walking on ice”, trying to avoid falls

Question 27

Presentation of influenza and when to initiate treatment

Answer 27

sudden onset fever, malaise, myalgias, rhinitis, cough, sore throat, headache

if you suspect clinically, START TREATMENT IMMEDIATELY