Practice Test 2

Question 1

Initial treatment for plaque psoriasis:

Answer 1

Topical high potency glucocorticoids or Vit D derivatives (calcipotriene)

Question 2

Atopic dermatitis typically shows up on (extensor/flexural) surfaces while plaque psoriasis shows up on (extensor/flexural) surfaces:

Answer 2

atopic dermatitis = flexural

plaque psoriasis = extensor

Question 3

Best predictor of prognosis for astrocytoma in adult:

Answer 3

Most important factors are patient age, functional status, and tumor grade (degree of anaplasia/differentiation)

Question 4

First line treatment for CLL?

Answer 4

Rituximab - monoclonal Ab to CD20

** Don’t treat if patient is symptomatic (only 10 yr survival rate). Indication for treatment is BM failure, massive splenomegaly/hepatomegaly, or presence of B symptoms (fever, weight loss).

Question 5

MCC of bacteremia/sepsis in a SCD patient:

Answer 5

S pneumo.

** Salmonella and Staph are MCC of osteo in SCD.

Question 6

How do you treat acute dystonic reaction in response to 1st gen antipsych:

Answer 6

Treat with diphenhydramine and other anticholinergic meds (benztropine/trihexyphenidyl).

** Dantrolene = muscle relaxant used for NMS

Question 7

Marker for epithelial ovarian cancer:

Answer 7

CA-125

Question 8

Guy breaks humerus while biking. Dorsum of hand is numb and there is loss of wrist and finger extension:

Answer 8

Due to damage of radial nerve (travels in spiral groove along dorsal area of humerus)

Question 9

Rx for Afib:

Answer 9

BB (metoprolol or esmolol) or CCB (non-DHPR like verapamil/diltiazem)

Absent p wave, irregularly irregular QRS

Question 10

Soft midsystolic murmur at LUSB with wide splitting of S2 that does not change with inspiration:

Answer 10

ASD (L-R shunt)

Wide fixed splitting of S2 = delayed closure of pulmonic valve from enlarged R ventricle prolonged emptying

Question 11

Pt with renal failure, hypercalcemia, and anemia should be evaluated for:

Answer 11

Multiple Myeloma. Best first test is Spep/Upep.

Renal insufficiency is a common complication of MM. Light chain cast nephropathy with renal tubular injury is common in most cases.

Question 12

Best Rx for Multiple Myeloma:

Answer 12

Melphagan (oral alkylating agent) + steroids.

Question 13

Timeline for IV septal rupture post-MI

Answer 13

3-5 days. Would present as acute hemodynamic compromise and holosystolic murmur at LSB.