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Medicine Clerkship > MKSAP Question Review > Flashcards

MKSAP Question Review Flashcards

1
Q

Orthostatic Proteinuria

A

Common in kids and teens. Increase in proteinuria when standing. Asymptomatic.

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2
Q

Most common cause of acute interstitial nephritis?

A

Beta lactam antibiotics.

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3
Q

Presenting triad of acute interstitial nephritis?

A

AKI, sterile pyuria, wbc casts.
May also have
Fever, rash, eosinophilia.

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4
Q

How to evaluate a patient with persistent hematuria?

A

Cytoscopy

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5
Q

Rhabdomyolysis symptoms and sign on urine.

A

Pain, dark urine, weakness. Blood on urine dipstick but no erythrocytes.

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6
Q

What drugs cause acute tubular necrosis?

A

Aminoglycosides and cisplatin.

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7
Q

How much of a bump in creatinine is tolerated when placing a person on ARB/ACEi?

A

30%. Better to manage htn than worry about small bump in cr.

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8
Q

When to start dialysis?

A

If increase in K, increase in volume, ams, uremia+platelet issue.

Don’t do it if asymptomatic.

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9
Q

Which diuretic can cause severe hyponatremia?

A

Hydrochlorothiazide

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10
Q

How do NSAIDs affect kidney?

A

Reduce GFR, can increase K

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11
Q

How to treat hypercalcemia of sarcoid?

A

With steroids?

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12
Q

Major electolyte derangement in alcoholics?

A

Decrease in phosphate due to severe malnutrition.

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13
Q

Drug fever

A

Persistent fever while using an antibiotic even though initial infection has resolved. Tx: stop drug and reevaluate need based on sxs.

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14
Q

How to manage levothyroxine for hypothyroidism in pregnancy?

A

Need to increase dose by 30% due to increased demand.

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15
Q

How to manage subacute hypothyroidism?

A

Repeat tests in 6 months, don’t treat until TSH>10.

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16
Q

How to f/u adrenal incidentaloma?

A

Investigate with dex suppression, 24 hour metanephrines, etc, even if asx.

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17
Q

Management of a patient with adrenal insufficiency and upper respiratory infection

A

Increase dose of glucocorticoids at least 3x.

18
Q

Alendronate vs Zoledronic Acid

A

Zoledronic acid is IV, decreases the risk for esophagitis. Prescribe IV bisphosphonates in patients with esophageal pathology (like gerd).

19
Q

How to diagnose nephrolithiasis?

A

Helical CT scan

20
Q

How to work up acute abdominal pain?

A

Supine and upright XR to assess for perf or obstruction.

21
Q

How to confirm chronic pancreatitis?

A

Calcification on xray

22
Q

How to diagnose HUS?

A

Do a peripheral smear which should show schistocytes

23
Q

How to screen for HCC in Hep B

A

Liver US.

24
Q

Common complication of hit?

A

Venous thrombosis due to increased mediators from platelet consumption.

25
Q

Asymptomatic patient with low platelet count but above 40,000?

A

Check labs again in a week

26
Q

Initial tx for PV?

A

Phlebotomy and aspirin

27
Q

How to screen for bleeding disorders in a patient with no family history of bleeding?

A

Clinical history alone is sufficient.

28
Q

How to transfuse a patient with transfusion associated anaphylaxis?

A

Washed erythrocytes and platelets

29
Q

What to suspect in an older patient with thrombosis?

A

Cancer.

30
Q

How to treat pyelonephritis?

A

Ceftriaxone or fluoroquinolone

31
Q

When to give prophylactic antibiotics to a woman for UTI?

A

When UTIs after sex

32
Q

How to treat severe cap?

A

Cefotaxime, vancomycin, levofloxacin

33
Q

How to treat lung abscess after aspiration?

A

Ampicillin-Sulbactam

34
Q

How to treat grave’s disease?

A

Atenolol and methimazole

35
Q

What is post partum thyroditis

A

5% women become thyrotoxic after birth, followed by hypothyroid

36
Q

Euthyroid sick syndrome

A

When very stressed, patient can be hypothyroid without symptoms. Don’t treat, just monitor.

37
Q

How to treat chronic gout?

A

Allopurinol, but make sure to start low dose colchicine at the same time to prevent any exacerbations while uric acid levels adjust.

38
Q

How to treat RA in alcoholic?

A

Can’t use methotrexate because of hepatic clearance, so use hydroxychloroquine

39
Q

Can HIV cause psoriatic arthritis?

A

Yeah, at CD4 counts

40
Q

How to treat lupus nephritis?

A

High dose steroids.

41
Q

How to manage symptomatic PVCs?

A

Metoprolol

42
Q

In which patients are BNP levels falsely elevated?

A

Obese patients

Medicine Clerkship (12 decks)

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