Mix13

Question 1

Prophylaxis for opportunistic infections following solid organ transplant. What do you use?

Answer 1

TMP-SMX for PCP and CMV. Many patients also receive ganciclovir/valganciclovir for CMV

Question 2

Inflammatory arthritis, splenomegaly, and neutropenia:

Answer 2

Felty syndrome. High assoc with RA

Question 3

Best test for early primary syphilis?

Answer 3

FTA-ABS. Fluorescent treponemal antibody absorption.. Greater sensitivity than RPR and VDRL

Question 4

Initial treatment for trigeminal neuralgia?

Answer 4

Carbamazepine. Due to risk of developing leukopenia and aplastic anemia, the pt should receive frequent CBC monitoring.

Question 5

Rx for cat scratch dz:

Answer 5

azithromycin, though it is generally self limiting

Question 6

Pathogenesis behind staph scalded skin syndrome:

Answer 6

S aureus exfoliative toxin. Disrupts keratinocyte adhesion in superficial dermis

Question 7

Management for catatonia:

Answer 7

BENZOS

Question 8

Short webbed neck, dysplastic nails, bilateral, nonpitting edema of the hands and feet in a neonate;

Answer 8

congenital lymphedema (can occur in turner syndrome) resulting from lymphatic network dysgenesis.

Question 9

Genetic problem in CML:

Answer 9

9:22 translocation&raquo_space; constitutively active Tyrosine Kinase

Question 10

Neonate w/ webbed neck, mild hypertelorism, flat nasal bridge, pale mucous membranes, macrocytic anemia, and messed up hands:

Answer 10

Diamond Blackfan anemia (congenital erythroid aplasia). Triphalangeal thumbs.

Rx = corticosteroids and transfusions

Question 11

Lynch syndrome is assoc with what types of cancer?

Answer 11

Associated neoplasms include colorectal cancer, endometrial ca, and ovarian ca. Defect in DNA mismatch repair

Question 12

How do you differentiate primary adrenal insufficiency from central adrenal insufficiency from glucocorticoid use?

Answer 12

Exogenous glucocorticoids can suppress pituitary secretion of ACTH and hypothalamic production of CRH. However, in PAI, secretion of melanocyte stimulating hormone is not increased, so these Pt don’t have hyperpigmentation. Mineralocorticoid production is controlled by RAAS so aldosterone levels are normal and hyper K isn’t seen with excess glucocorticoid use.

Question 13

What’s the MCC of primary adrenal insufficiency in US?

Answer 13

Autoimmune adrenalitis