Mock Exam Part 2, #31-60 Reviewer

Question 1

prominent lower jaw, elevated mandible and localized tenderness to the tragus. Mandibular dislocation is most likely

Answer 1

anterior dislocation

Question 2

first-line therapy for Group A B-hemolytic Streptococcus pharyngitis in patients with no known drug allergies

Answer 2

Penicillin

Question 3

Most common cause of sudden hearing loss

Answer 3

Idiopathic

Question 4

In hypothyrodism, the dose of thyroxine T4 should be increased by approximately ___% as as soon as pregnancy is confirmed

Answer 4

30%
The thyroid function should be checked every 8 weeks

Question 5

In thyroid replacement therapy of myxedema crisis, this is started first

Answer 5

IV THYROXINE (LEVOTHYROXINE
at 4 mcg/kg (typically 200-4000 mcg as initial dose), followe in 24 h by 100 mcg IV then 50 mcg IV until oral medicaiotns is tolerated
Starting dose in the elderly is 100 mcg IV

IV triiotothyronine (liothyronine) can be added if treatment with IV levothyroxine alone is not effective or in patients with persistent hemodynamic instability or poor respiratory effort

Question 6

Altered mental status in myxedema crisis can result from

Answer 6

CO2 narcosis or hypoglylcemia

Question 7

typical stress dose for patients receiving chronic steroids

Answer 7

3x the daily maintenance dose of glucocorticoid

Question 8

Most common agent used to correct bleeding in patients with uremic plately dysfunction

Answer 8

desmopressin

Question 9

most prevalent inherited hypercoagulable disorder

Answer 9

Activated Protein C resistance
caused by Factor V Leiden mutations

Question 10

TRUE or FALSE
Patients with mild hemophilia A with mild bleeding still always require factor replacement

Answer 10

FALSE
these patients may be treated with **desmopressin*, which stimulates release of VWF, promoting increase of Factor VIII in plasma

Question 11

Most common inherited bleeding disorder

Answer 11

Von Willebrand’s disease

Question 12

Which is the leading cause of death in patients with sickle cell anemia in the US

Answer 12

acute chest syndrome

Question 13

8 medications causing acute hemolysis in patients with G6PD deficiency

Answer 13

1. Dapsone
2. Phenazopyridine
3. Nitrofurantoin
4. Primaquine
5. Rasburicase
6. Pegloticase
7. Methylene blue (methylthioninium chloride)
8. Toluidine blue (tolonium chloride)

Question 14

triad of hemolytic-uremic syndrome (HUS)

Answer 14

ART
Anemia (MAHA)
Renal failure
Thrombocytopenia

Question 15

classic pentad for thrombotic thrombocytopenic purpura (TTP)

Answer 15

FAART
Fever
Altered sensorium
Anemia (MAHA)
Renal failure
Thromcotytopenia

Question 16

Initial dose of platelet concentrate (pooled donor platelet)

Answer 16

6 units or 5 mL/kg
(50-60 mL/unit)
each unit contains platelets 8-9x 10^10/unit

Question 17

an initial dose of platelets raises platelet count by

Answer 17

up to 50,000/mm3

Question 18

initial dose of pRBC

Answer 18

2 units (adult)

Question 19

an initial dose of PRBC hgb and hct by

Answer 19

hgb by 2g/dL
hct by 6%

Question 20

Initial dose of FFP

Answer 20

4 units or 15mL/kg
200-350 mL/unit
each unit contains 200-250 units of each individual coagulation factor and 400-500 units of fibrinogen

Question 21

an initial dose of FFP increases most coagulation factor by

Answer 21

approx 20%

Question 22

Treatment of DVT/PE

Answer 22

Unfractionated heparin 80 units/kg IV bolus, followed by 18 units/kg/h infusion
Enoxaparin 1 mg/kg SC every 12 hours or 1.5mg/kg SC OD
Alteplace 100 mg IV infused over 2 hours
Fondaparinux 5 mg SC OD (pt weight <50kg), 7.5 mg SC OD (50-100 kg), 10 mg SC OD (>100 KG)

Question 23

Prophylaxis of DVT/PE

Answer 23

Enoxaparin 40mg SC OD
Fondaparinux 2.5 mg SC OD

Question 24

Anticoagulation and thrombolytics in STEMI

Answer 24

Unfractionated heparin 60 units/kg IV bolus, followed by 16 units/kg/h IV infusion
Enoxaparin 30 mg IV bolus, followed by 1 mg/kg SC every 12 hours
Alteplace 15 mg bolus, followed by 0.75 mg/kg over 30 minutes, followed by 0.5 mg/kg over 60 minutes

Question 25

Metabolic abnormalities in tumor lysis syndrome

Answer 25

hyperuricemia
hyperkalemia
hyperphosphatemia
hypocalcemia

Question 26

A lesion at the left occipital lobe causes

Answer 26

right homonymous hemianopia