More Random Q-bank questions Flashcards
Most appropriate initial management for ANCA vasculitis in a patient with organ-threatening or life-threatening disease? (like granulomatosis w/ polyangiitis w/ organ involvement)
IV glucocorticoids \+ Rituximab or cyclophosphamide \+ consider plasmapheresis
Why is it NOT recommended to use more than one biologic agent concurrently for a patient with Rheuamtoid arthritis?
Like etanercept, abatacept, anakinra, or rituximab
Concurrent use of two or more agents is NOT recommended due to significant increase in infection rates and very minimal increase in efficacy
Patient with suspected empyema gets a thoracentesis. What are the automatic indications for a tube thoracostomy w/ consideration of surgery?
Class 1a indications:
- Presence of pus
- positive gram stain
- positive culture
- pleural pH less than 7.2
Class 2a indications:
- Pleural fluid LDH >1000
- loculated pleural effusion
What is the timeline for an ATN AKI caused by aminoglycoside?
5-10 days after start of aminoglycoside
Patient with stage IIIA SCC of the lung. Treated with 6 cycles of chemo-radiation (Carboplatin/Paclitaxol). Now shows signs of progression despite tx. What is next tx step?
Nivolumab
In a recent phase 3 study comparing nivolumab, a PD-1 inhibitor, to docetaxel, a single cytotoxic agent, nivolumab resulted in increased overall survival in patients with both squamous and nonsquamous non–small cell lung cancers that had progressed despite platinum-based chemotherapy.
MELD score threshold to evaluate for transplant?
21
Screening criteria for DEXA scan in women? Two scenarios!
Women aged 65 years and older and younger women who have a fracture risk of 9.3% or higher should be screened for osteoporosis.
FDA approved treatment for irritbale bowel syndrome with diarrhea?
rifaximin (2 week course)
Can try two additional courses if first one doesn’t completely work
Criteria for diabetes screening in adults?
The U.S. Preventive Services Task Force recommends screening all adults aged 40 to 70 years who are overweight or obese (BMI >25) for abnormal blood glucose and type 2 diabetes mellitus.
Name the RTA:
- Hyperkalemia
- Urine pH < 5.5
- Root cause hypoaldosteronism
Type 4 (hyperkalemic distal) RTA is associated with a urine pH <5.5 and hyperkalemia as a result of hypoaldosteronism, neither of which is seen in this patient.
Name the RTA:
- Normal AG metabolic acidosis
- hypokalemia
- Glycosuria
- Low molecular weight proteinuria
- renal phosphate wasting
Type 2 (proximal) RTA involves a defect in regenerating bicarbonate in the proximal tubule and is characterized by a normal anion gap metabolic acidosis, hypokalemia, glycosuria (without hyperglycemia), low-molecular-weight proteinuria, and renal phosphate wasting. However, distal urine acidification mechanisms are intact, and the urine pH is usually less than 5.5 without alkali therapy. This patient’s high urine pH, absence of glycosuria, and normal urinalysis are inconsistent with type 2 (proximal) RTA.
Testing for Zika?
PCR should be performed on serum and urine samples for any patient with a clinical presentation typical of symptomatic Zika virus infection who has returned from an endemic area and who has had symptoms within 2 weeks of travel.
Name two side efects of GLP-1 analogues:
The use of glucagon-like peptide (GLP-1) analogues (exenetide and liraglutide) in the treatment of diabetes mellitus is associated with an increased risk of cholestasis, cholelithiasis, and cholecystectomy.
Also can cause weight loss
What is the most common type of skin cancer in persons following solid organ transplant?
Squamous cell carcinoma is the most common type of skin cancer in persons following solid organ transplant.
When should topical 5-FU be used on AK’s rather than cryoablation?
When there are more than 10-15 lesions to address
