MKSAP IM I

Question 1

Pts aged 20 years or older with an LDL cholesterol level of ______ or higher should receive high-intensity statin

Answer 1

190 mg/dL (4.92 mmol/L)

Statins should be DC’ed 1-2 months prior to pregnancy

Question 2

For patients undergoing orthopedic surgery without increased bleeding risk, postoperative dual venous thromboembolism prophylaxis with low-molecular-weight heparin should be continued for ____.

Answer 2

35 days

Question 3

What is a good treatment for end-of-life depression?

Answer 3

Methylphenidate (as SSRIs take weeks to work) should work 24 - 48 hours

Question 4

First line treatment for bacterial conjunctivitis in a patient without contacts? With contacts?

Answer 4

1. Bactrim-polymyxin B or erythromycin drops

2. Need pseudomonal coverage (topical fluoroquinolones)

Question 5

What does NNT equal?

Answer 5

1/absolute risk reduction

Question 6

The most common infectious cause of acute bacterial prostatitis is Escherichia coli or other gram-negative bacilli (especially in older people); the treatment of choice is a prolonged course of ___ or ___.

Answer 6

trimethoprim-sulfamethoxazole or ciprofloxacin

Keflex would be appropriate if UCx showed gram-positive cocci in clusters suggesting infection with Staphylococcus aureus or coagulase-negative staphylococci (Staphylococcus epidermidis or Staphylococcus saprophyticus).

Question 7

When can you give 2nd dose of MMR in adults?

Answer 7

28 days after first

Question 8

Hypobaric hypoxia apply to commercial airplanes, in which cabins are pressurized to the equivalent of 1500 to 2500 meters (approximately _______ feet) in altitude

Answer 8

approximately 5000 to 8200 feet

Question 9

Just FYI, although not a Federal Aviation Administration requirement, most airlines have contracts with 24-hour call centers with a ground-based physician to aid in the event of an in-flight emergency. So if it’s outside your scope of practice ____.

Answer 9

connect with the ground-based physician

Question 10

If a patient is resistant to advice to retire from driving, a ______ may be helpful.

Answer 10

formal occupational therapy driving evaluation

But if he is isn’t, don’t bother getting one???? MKSAP is so weird.

Question 11

Pt with fatigue for at least 6 months, accompanied by substantial reduction in preillness activities, postexertional malaise, unrefreshing sleep and either cognitive impairment or orthostatic intolerance.

Comorbidities: fibromyalgia, mood disturbances, irritable bowel syndrome and interstitial cystitis

Answer 11

Systemic Exertion Intolerance Disease:

Don’t get a crazy work-up.

Pathophysiology: “central sensitization”

Management: regular visit (lol, so she can whine at us that we don’t do anything), PT/OT, CBT

Question 12

Age cut off for getting a breast US rather than mammo for low-risk breast mass.

Answer 12

younger than 30 years

Question 13

Bariatric surgery should be considered in patients who do not lose weight with lifestyle modifications and have a BMI of ____ or greater, or a BMI of ___ or greater with obesity-related comorbid conditions, such as type 2 diabetes mellitus, coronary artery disease, obstructive sleep apnea, or osteoarthritis.

Answer 13

40; 35

Question 14

Up to 20% of patients taking an ACE inhibitor develop a dry cough, usually ___ weeks of therapy initiation. Onset of cough, however, may be delayed by months in a small percentage of patients.

Answer 14

within 1 to 2

Question 15

The U.S. Preventive Services Task Force recommends that clinicians discuss potential benefits and harms of PSA-based screening for prostate cancer in men aged ___.

Answer 15

55 to 69 years

Question 16

Tinnitus associated with unilateral sensorineural hearing loss suggests ___ and requires advanced imaging with ____.

Answer 16

acoustic neuroma; MRI

Question 17

Pulsatile tinnitus, when synchronous with the heartbeat, may suggest a _____.

Answer 17

vascular anomaly, including atherosclerotic disease, arteriovenous fistulas, or paragangliomas, most commonly in the jugular bulb or tympanic arteries of the middle ear.

Question 18

Pulmonary rehabilitation is recommended for all symptomatic patients with an FEV1 less than ___ of predicted and specifically for those hospitalized with an acute exacerbation of COPD.

Answer 18

50%

Question 19

Patients with decompensated liver disease should avoid elective surgery and be referred for liver transplant evaluation (especially if MELD > ____)

Answer 19

15; decompensated liver cirrhosis is a huge risk factor for even intermediate risk surgeries (orthopedic). However, people with compensated cirrhosis can proceed to surgery.