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Internal medicine > NBMEs > Flashcards

NBMEs Flashcards

1
Q

Important indicator for anticoagulation

A

Prosthetic heart valves

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2
Q

Pt who has a skin rash that resolve but then has it again in two different locations

A

Probably an autoinfection

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3
Q

Patient with CD4 count of >500 and viral load of 2000 or less

A

Do not start on antiretroviral therapy

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4
Q

Tx of patient with unstable AV dissociation

A

DC cardioversion

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5
Q

Young patient with swollen cervical lymph nodes and systemic B sx.

A

Hodgkin lymphoma

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6
Q

Patient who has an obstructive pneumonia due to stage IV cancer but denies any further chemo

A

Send home with hospice care

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7
Q

Best way to prevent hypertensive strokes in the future

A

Lisinopril therapy

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8
Q

Pt with history of heartburn who progressively has trouble swallowing solids

A

Get an upper endoscopy

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9
Q

Patient >40 with a solitary thyroid nodule but no signs of hyperthyroidism

A

Still get FNA; need to rule out cancer

If negative, THEN you can just monitor

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10
Q

Female woman who has dilated intrahepatic ducts, epigastric pain, and increased direct bilirubin

A

Choledocholithiasis

Causing pancreatitis as well if there is epigastric pain

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11
Q

Crescendo-decrescendo murmur along the left sternal border w/ carotid radiation

A

HCOM

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12
Q

Serotonin syndrome presentation

A

AMS

Autonomic instability

Neuromuscular excitability (tremor, hyperreflexia, myoclonus)

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13
Q

NMS syndrome presentation

A

Fever

AMS

Muscle rigidity

Autonomic instability (arrhythmia, labile BP, tachypnea, diaphoresis)

Causes: Antipsychotics, antiemetics, dopamine agonists, infxn, surgery

Tx: Stop drug, supportive, dantrolene if it doesn’t remit

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14
Q

Gift accepting from pharmaceuticals

A

Small gifts that MUST DIRECTLY BENEFIT PATIENT

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15
Q

Otosclerosis pt

A

Can be a young female

Tx with hearing aids

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16
Q

Complication of viral myocarditis

A

Dilated cardiomyopathy

Echo shows dilated ventricles with diffuse hypokinesia =» decreased EF

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17
Q

Lateral mid-pons lesion

A

Disrupts nuclei of CN V

=» Weakness in muscles of mastication, diminished jaw jerk reflex, and impaired tactile and position sensation on the face

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18
Q

Poor prognostic factors of HF

A

Clinical: Resting tachycardia, S3, Elevated JVP, low bp, mitral regurg, low maximal O2 consumption peak

Lab: **HYPONATREMIA, elevated BNP, renal insufficiency

EKG: Prolonged QRS, LBBB

Echo: SEvere LV dysfnxn, reduced right ventricular fnxn, pulmonary HTN

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19
Q

COPD pt who doesn’t respond to normal treatments

A

Start NONINVASIVE positive-pressure ventilation

Decreases RR and PaCO2

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20
Q

VZV is contagious when…

A

Open vesicles are present

IC

Never had chickenpox

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21
Q

VZV vaccination recommendation ion

A

All patients over 60

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22
Q

Pt with mental retardation and has increasing episodes of vomiting after eating and has weight loss

A

Consider gastric bezoar

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23
Q

Pt who has history of travel, abdominal bloating, increasing flatulence, and diarrhea that is non-blood and foul smelling

A

ETEC?

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24
Q

Treatment of acute RA exacerbation

A

NSAIDs

DONT FALL FOR JOINT INJXN

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25
Q

Patient who has a cough but it is mostly when she is in bed at night but also has signs of wheezes

A

Sounds like asthma

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26
Q

Patient who is currently on antihypertensive therapy and wants to start a new experimental drug? What kind of study is this?

A

Randomized controlled trial of a drug X versus standard therapy?

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27
Q

UC association

A

PRIMARY SCLEROSING CHOLANGITIS

28
Q

Pt who initially has an insect bite on their cheek that progresses to eye swelling and abnormal ocular movements

A

Cavernous sinus thrombosis

Ophthalmic venous system is valveless =» uncontrolled infxn

Other S/s: Headache, papilledema, binocular palsies, hyperesthesia

Dx: MR venography

Tx: Broad-spectrum abx; prevent cerebral herniation

29
Q

If a patient has deviation of the eyes towards one side after a stroke

A

Probably a putamen hemorrhage

30
Q

Patient with bacterial endocarditis and recently had a dental thing done

A

Consider Eikenella corrodens

31
Q

First line treatment for pulmonary HTN DUE TO HF

A

ACEIs and Diuretics

Endothelin-antagonists used for idiopathic pulmonary HTN

32
Q

Tx for complete heart block

A

Cardiac pacing; regardless of stability

33
Q

Diabetic opthalmoplegia

A

Causes CNIII palsy with preserved pupillary response

34
Q

Patient who presents with a history of difficulty initiating swallow with food getting stck in the throat while swallowing

A

Likely oropharyngeal dysphagia

GET A VIDEOFLUOROSCOPIC MODIFIED BARIUM SWALLOW

35
Q

Pt with mental retardation and has increasing episodes of vomiting after eating and has weight loss

A

Consider gastric bezoar

36
Q

Pt who has history of travel, abdominal bloating, increasing flatulence, and diarrhea that is non-blood and foul smelling

A

ETEC?

37
Q

Treatment of acute RA exacerbation

A

NSAIDs

DONT FALL FOR JOINT INJXN

38
Q

Patient who has a cough but it is mostly when she is in bed at night but also has signs of wheezes

A

Sounds like asthma

39
Q

Patient who is currently on antihypertensive therapy and wants to start a new experimental drug? What kind of study is this?

A

Randomized controlled trial of a drug X versus standard therapy?

40
Q

UC association

A

PRIMARY SCLEROSING CHOLANGITIS

41
Q

Pt who initially has an insect bite on their cheek that progresses to eye swelling and abnormal ocular movements

A

Cavernous sinus thrombosis

Ophthalmic venous system is valveless =» uncontrolled infxn

Other S/s: Headache, papilledema, binocular palsies, hyperesthesia

Dx: MR venography

Tx: Broad-spectrum abx; prevent cerebral herniation

42
Q

If a patient has deviation of the eyes towards one side after a stroke

A

Probably a putamen hemorrhage

43
Q

Patient with bacterial endocarditis and recently had a dental thing done

A

Consider Eikenella corrodens

44
Q

First line treatment for pulmonary HTN DUE TO HF

A

ACEIs and Diuretics

Endothelin-antagonists used for idiopathic pulmonary HTN

45
Q

Tx for complete heart block

A

Cardiac pacing; regardless of stability

46
Q

Diabetic opthalmoplegia

A

Causes CNIII palsy with preserved pupillary response

47
Q

Patient who presents with a history of difficulty initiating swallow with food getting stck in the throat while swallowing

A

Likely oropharyngeal dysphagia

GET A VIDEOFLUOROSCOPIC MODIFIED BARIUM SWALLOW

48
Q

Pt with upper abdominal pain, long history of drinking, nausea, vomiting, fever, tachcardia, hypotension, hypocalcemia, occult blood positive

A

Pancreatitis

Patient has had some hemorrhage as well in this case

49
Q

Biggest indicator of a possible heart attack during surgery

A

History of MI in last 6 months

50
Q

PKD inheritance risk?

A

Go with 50% yah dingus

51
Q

Pt who has a history of a swollen, erythematous joint that is getting worse but has no fever

A

Still need to aspirate to r/o septic arthritis

52
Q

Risk factor screening in HIV pts.

A

Toxoplasma IgG abs

Hepatitis B surface abs

PPD

53
Q

Felty Syndrome blood levels

A

PANCYTOPENIA; YOUVE BEEN LIED TO

54
Q

PT with hypotension who is having trouble oxygenating their blood

A

Consider problem with increased vascular permeability

55
Q

Pt with well controlled diabetes but what drug do they need to be on to decrease complications?

A

ACEI; DONT CARE IF THEIR AIC IS GREAT

56
Q

Rash that is on pts. neck and face and she spent times in a rose garden

A

Listen dawg, people aren’t that stupid

Weeds caused this rash

She didn’t poke herself in the face with a rose thorn

57
Q

Do pts. with Klinefelter’s need to be retarded?

A

Nope; this sucks because that’s usually a give away

58
Q

Hcrt rule

A

Hgbx3 = Hcrt

Consider this for RBC transfusion thresholds

59
Q

VZV late lesions

A

Have little tiny scabs on them ya dingus

Look like black dots

60
Q

Culture of a lesion that looks like contact dermatitis but grows CNS

A

Lol it’s still contact dermatitis yah dingus

61
Q

Vitreous hemorrhage

A

Sudden loss of vision with onset of floaters most commonly caused by diabetic retinopathy

*Fundus is hard to visualize; will see floating debris and dark red glow

62
Q

Go to test for suspected histoplasmosis

A

Urine antigen test

Forgo the blood cx

63
Q

Mammogram screening recommendations

A

Every 2 years from the age of 50-75

64
Q

Hyperlipidemia screening recommendations

A

Men 35+ every 5 years

65
Q

Pt who develops afib secondary to hyperthyroidism

A

Treat with a BB

Internal medicine (3 decks)

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