Mixed final study

Question 1

What drug can you use if INR is subtherapeutic on Warfarin?

Answer 1

Rivaroxaban (works in 2-4 hrs)

Question 2

What are the features of Zinc deficiency and what puts patients at risk?

Answer 2

Alopecia, abnormal taste, bullous, pustulous lesions, surrounding orifices/extremities, impaired wound healing

patients on TPN or Jejunal resection

Question 3

What endocrine abnormality is associated with Amiodarone?

Answer 3

Hypo/hyperthyroid

Question 4

How do you treat HF associated with HTN?

Answer 4

Suppl O2, IV furosemide, consider nitro

Question 5

What arrhythmia is most specific to digitalis toxicity?

Answer 5

Atrial tachy with AV block

Question 6

Most common side effects of Epo therapy?

Answer 6

Worsening HTN, HAs, flu like sx

Question 7

How can hypokalemia worsen hepatic encephalopathy?

Answer 7

Low K increases renal ammonia production

Question 8

What are the signs of alcohol withdrawal?

Answer 8

Agitation, delirium, seizures, tachycardia, HTN, fever

Question 9

What may be the cause of hypopituitarism with mild/mod increase in prolactin?

Answer 9

Nonfunctioning gonadotroph adenoma

Question 10

Treatment for acute cystitis uncomplicated?

Answer 10

Nitrofurantoin, Bactrim, fosfomycin

Question 11

What treatment for Grave’s can worsen opthalmopathy? How can you avoid?

Answer 11

Radioactive iodine therapy, because transient rise in thyroid hormones, pretreat with glucocorticoids

Question 12

Which fungal infections are ubiquitous in all regions of the country and can show pulmonary nodule with halo sign?

Answer 12

aspergillosis

Question 13

What markers can be found in patients with viral arthritis?

Answer 13

Positive RF, weakly positive ANA

Question 14

What is the chronicity of arthritis from RA or SLE?

Answer 14

chronic conditions, resolve in >4weeks

Question 15

What is the most likely cause of contact lens associated keratitis?

Answer 15

Gram negatives like Pseudomonas and Serratia

Question 16

How do you differentiate SJS from TEN?

Answer 16

SJS 30%

Question 17

What are the recommended vaccines for traveling to north africa?

Answer 17

Hep A/B, typhoid, polio booster

Question 18

How can you differentiate fibromyalgia from polymyositis and polymyalgia rheumatica?

Answer 18

FM - Young middle aged, no lab abnormalities
PM - elevated muscle enzymes
PR - very high ESR, >50yo

Question 19

What is indication for chest tube placement with parapneumonic effusion, and what can confirm the need for this?

Answer 19

Empyema - low pH of effusion fluid is indicative

Question 20

What medication shouldnt be given in patients who have MI HF w/ flash pulmonary edema? What should they get?

Answer 20

beta-blockers, give furosemide

Question 21

What test should all patients with cirrhosis get every 6 months? What test should they get at least once in the beginning of their care?

Answer 21

RUQ ultrasound to look for HCCa

EGD at least once to look for varices

Question 22

What are the signs of opioid withdrawal?

Answer 22

dilated pupils, piloerection, dysphoria, myalgias, abdominal pain

Question 23

What are the features of delirium tremens? How can you prevent?

Answer 23

Chlordiazepoxide (Librium)

DT = HTN, tachycardia, agitation, hallucinations (bugs crawling), fever

Question 24

What should be initiated while waiting for imaging studies when suspecting epidural spinal cord compression?

Answer 24

IV Steroids

Question 25

What is osteitis deformans?

Answer 25

Paget disease

Question 26

What are the effects of hydrochlorathiazide to LDL, blood glucose, triglycerides, calcium?

Answer 26

Increased LDL, trigs, hyperglycemia

Decreased Ca

Question 27

What skin finding is found with mycoplasma infection?

Answer 27

Erythema multi forme

Question 28

What are the skin findings of porphyria cutanea tarda?

Answer 28

Painless blisters, increased skin fragility, facial hypertrichosis and hyper pigmentation

Question 29

Which bacterial infections are most associated with cystoscopy?

Answer 29

Enterococcus

Question 30

What is the criteria for doing a rapid strep antibody?

Answer 30

Two or more of tonsillar exudates, tender anterior adenopathy, fever, and absence of cough

Question 31

What does increased residual lung volume indicate?

Answer 31

Obstructive process

Question 32

How do you manage risk for strep bacteremia in patients with splenectomy?

Answer 32

Vaccines for pneumo and meningococcal before, penicillin ppx 3-5 years out

Question 33

What is needle thoracostomy used for?

Answer 33

Emergently for life threatening pneumothorax

Question 34

Which patients are at an increased risk for septic arthritis?

Answer 34

Elderly, previous joint disease (gout, OA, implant, but especially RA), IV drug use, diabetes

Question 35

What is the preferred drug used to treat Hep B?

Answer 35

Tenofovir