Missed On 2nd Eoc

Question 1

Main risk factor for aortic dissection

Answer 1

HYPERTENSION
Advances age
Cocaine use

Question 2

Tx of graves hyperthyroidism presenting to the ER

Answer 2

FIRST BB (metoprolol/propranolol) for sx reduction
THEN methimazole

Question 3

Oppositional defiant disorder vs conduct disorder

Answer 3

Oppositional is the bark
Conduct is the bite

Antisocial personality is conduct disorder in adults

Question 4

Incomplete abortion

Answer 4

Os is opened and some fetal parts are coming out but not done

Question 5

Inevitable abortion

Answer 5

Os is opened but not passage of fetus

Question 6

Reye’s syndrome is
Tx

Answer 6

Encephalopathy + fatty degeneration of the liver

Aspirin exposure in a viral illness

Supportive care

Question 7

Adrenal crisis tx

Answer 7

Hydrocortisone
Needs corticosteroid supplementation with BOTH GCC and MCC

Dexamethasone is GCC
Fludrocortisone is MCC

Question 8

Tx of purulent cellulitis vs nonpurulent

Answer 8

Purulent Needs MRSA coverage
• Doxy bactrim clinda

Nonpurulent ok to treat with Keflex, if a bite can treat with Augmentin

Question 9

Mc presenting sx in Hodgkin lymphoma

Answer 9

PAINLESS lymphadenopathy in the cervical or supraclavicular region

Splenomegaly is a late stage presentation

Question 10

BZD overdose sx and tx

Answer 10

CNS depression, respiratory depression, VS normal, pupils are normal

Supportive, flumazenil if severe sx

Question 11

Diverticulitis tx

Answer 11

Supportive
Diet modification
Cipro + metronidazole

Question 12

Proximal humeral fracture

Answer 12

Immobilize and sling

Question 13

Acute dystonia vs tardive dyskinesia

Answer 13

Acute dystonia: reaction is a medication due to excessive ACh, within hours to days of new med

Tardive dyskinesia: dopamine receptor blocking drugs, develops after months

Question 14

Malignant hyperthermia pathology

Answer 14

Altered Ca channel gated leading to an excess of Ca — hypermetabolism

Question 15

CSF results for (differentiating findings)
1. Bacterial
2. Viral
3. Fungal
4. TB

Answer 15

1. HIGH WBC >1k with neutrophils predominance
2. NORMAL GLUCOSE & PROTEIN
3. Lymphocyte predominance & + fungal on culture
4. VERY high protein, positive AFB

Question 16

Bacterial meningitis tx

Answer 16

Rocephin + vanco (add ampicillin if >50 or a baby)

Question 17

Tx of acute decompensated HF

Answer 17

1. NIPPV: increases O2, decreases pre and afterload
2. Nitro drip: decreases preload and afterload (Dec SVR)
3. Diuretics IV: sx relief
4. Shock: norepi (levophed)

Question 18

Stress vs overflow vs urge vs functional incontinence

Answer 18

Stress: pee with stress on bladder
Overflow: poor stream and incomplete emptying (BPH)
Urge: urgency and frequency
Functional: unable to get to bathroom

Question 19

Diabetes inspidus serum & urine NA and osmolality

Answer 19

SERUM Na & osmolality HIGH
URINE low

Question 20

SIADH serum & urine NA and osmolality

Answer 20

SERUM Na & osmolality LOW
Urine HIGH

Na is being peed out

Question 21

Pheochromocytoma sx dx tx

Answer 21

Headache sweating tachy
Plasma metanephrines
Alpha blockers before beta blockers

Question 22

Chronic Treatment for afib

Answer 22

Direct oral anticoagulants
Apixaban, rivaroxaban, dabigatran

Question 23

MVP and HCOM increase with ___

Answer 23

Standing and valsalva

Question 24

MCP click changes

Answer 24

Standing & valsalva — early click
Squatting — click disappears

Question 25

Viral prodrome with signs of heart failure in a kid

Answer 25

Myocarditis

Question 26

WPW

Answer 26

Delta wave (slurred upstroke of QRS)
Asx but may have Tachyarrhythmias

Question 27

First degree block
Second degree block
• mobitz 1
• mobitz 2
Third degree block

Answer 27

1st: PR long, no dropped beats
2nd type 1: progressive lengthening of PR then dropped beat
2nd type 2: consistent PR length with random dropped beats
3rd: a free for all

Question 28

Sick sinus syndrome

Answer 28

Old patients
Brady
Brady then tachy
Needs pacemaker

Question 29

Silica on xray

Answer 29

Apex + hilar LA

Question 30

Abestosis on cxr

Answer 30

Lower pleural plaques

Question 31

Tx of stable vtach

Answer 31

Procainamide
Amiodarone

Question 32

1. Narrow complex irregular
2. Narrow complex regular
3. Wide complex irregular
4. Wide complex regular

Answer 32

1. Afib: rate control (metoprolol)
2. AVNRT (svt) vagal or adenosine
3. Afib with abberancy
4. Vtach: amiodarone/procainamide