MKSAP Question Review Flashcards
Orthostatic Proteinuria
Common in kids and teens. Increase in proteinuria when standing. Asymptomatic.
Most common cause of acute interstitial nephritis?
Beta lactam antibiotics.
Presenting triad of acute interstitial nephritis?
AKI, sterile pyuria, wbc casts.
May also have
Fever, rash, eosinophilia.
How to evaluate a patient with persistent hematuria?
Cytoscopy
Rhabdomyolysis symptoms and sign on urine.
Pain, dark urine, weakness. Blood on urine dipstick but no erythrocytes.
What drugs cause acute tubular necrosis?
Aminoglycosides and cisplatin.
How much of a bump in creatinine is tolerated when placing a person on ARB/ACEi?
30%. Better to manage htn than worry about small bump in cr.
When to start dialysis?
If increase in K, increase in volume, ams, uremia+platelet issue.
Don’t do it if asymptomatic.
Which diuretic can cause severe hyponatremia?
Hydrochlorothiazide
How do NSAIDs affect kidney?
Reduce GFR, can increase K
How to treat hypercalcemia of sarcoid?
With steroids?
Major electolyte derangement in alcoholics?
Decrease in phosphate due to severe malnutrition.
Drug fever
Persistent fever while using an antibiotic even though initial infection has resolved. Tx: stop drug and reevaluate need based on sxs.
How to manage levothyroxine for hypothyroidism in pregnancy?
Need to increase dose by 30% due to increased demand.
How to manage subacute hypothyroidism?
Repeat tests in 6 months, don’t treat until TSH>10.
How to f/u adrenal incidentaloma?
Investigate with dex suppression, 24 hour metanephrines, etc, even if asx.
Management of a patient with adrenal insufficiency and upper respiratory infection
Increase dose of glucocorticoids at least 3x.
Alendronate vs Zoledronic Acid
Zoledronic acid is IV, decreases the risk for esophagitis. Prescribe IV bisphosphonates in patients with esophageal pathology (like gerd).
How to diagnose nephrolithiasis?
Helical CT scan
How to work up acute abdominal pain?
Supine and upright XR to assess for perf or obstruction.
How to confirm chronic pancreatitis?
Calcification on xray
How to diagnose HUS?
Do a peripheral smear which should show schistocytes
How to screen for HCC in Hep B
Liver US.
Common complication of hit?
Venous thrombosis due to increased mediators from platelet consumption.
Asymptomatic patient with low platelet count but above 40,000?
Check labs again in a week
Initial tx for PV?
Phlebotomy and aspirin
How to screen for bleeding disorders in a patient with no family history of bleeding?
Clinical history alone is sufficient.
How to transfuse a patient with transfusion associated anaphylaxis?
Washed erythrocytes and platelets
What to suspect in an older patient with thrombosis?
Cancer.
How to treat pyelonephritis?
Ceftriaxone or fluoroquinolone
When to give prophylactic antibiotics to a woman for UTI?
When UTIs after sex
How to treat severe cap?
Cefotaxime, vancomycin, levofloxacin
How to treat lung abscess after aspiration?
Ampicillin-Sulbactam
How to treat grave’s disease?
Atenolol and methimazole
What is post partum thyroditis
5% women become thyrotoxic after birth, followed by hypothyroid
Euthyroid sick syndrome
When very stressed, patient can be hypothyroid without symptoms. Don’t treat, just monitor.
How to treat chronic gout?
Allopurinol, but make sure to start low dose colchicine at the same time to prevent any exacerbations while uric acid levels adjust.
How to treat RA in alcoholic?
Can’t use methotrexate because of hepatic clearance, so use hydroxychloroquine
Can HIV cause psoriatic arthritis?
Yeah, at CD4 counts
How to treat lupus nephritis?
High dose steroids.
How to manage symptomatic PVCs?
Metoprolol
In which patients are BNP levels falsely elevated?
Obese patients
