Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

AFP boards > Q bank > Flashcards

Q bank Flashcards

1
Q

40ish female recurrent SOB improves with steroid and albuterol. CXR with pan lobular emphysema w/o smoking history. FEV1/FVC 0.67. Dx?

A

A1 antitrypsin deficiency

RFs: 40s, non smokerCXR with COPD, FEV1/FVC <0.7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Man with low testosterone. What test do you get next?

A 
FSH/LH
Helps to determine if primary or secondary hypogonadism
(Low or normal FSH/LH suggest secondary)
IF secondary - MRI
If primary - Karyotyping
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Kiddo with constipation, give them

A

Miralax

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

If pt is on amiodarone, they need periodic testing of?

A

TSH
At risk of hyper or hypo
q6mo screening

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Toddler isn’t using left arm. Hold arm slightly pronated, flexed and close to body. TTP at lateral elbow. Now what?

A

Attempt to reduce the nurse maids with reduction of sublimed radial head
AS long as there is not e/o other injury (bruising, deformity) it is considered safe to attempt reduction w/o imaging

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

IVDU has a fever. Automatically get?

A

Blood cultures. Risk of IE is too high

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

1st line tx for dysmenorrhea?

A

NSAIDs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Pt has syx of BPH (nocturia) with normal PVR and PSA. What are your treatment options?

A

alpha-adrenergic blocker or PDE-5 inhibitor

MUST have enlarged prostate or PSA > 1.5 to start 5-a-reductase inhibitor (finasteride)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

you suspect appy in a kiddo, what study do you order?

A

US

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

If you suspect SIADH, what confirms diagnosis?

A

Increased urine osmolarity
Remember, urine is too concentrated given how watered down the blood is
Also, increased arginine vasopressin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

1st line BP meds for AA

A

Thiazide diuretics and CCBs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

GLP-1 agonist that also lower risk of cardiovascular events?

A

Liraglutide (Victoza)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Most common sulfonylurea?

A

Glipizide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

2 y/o with SCD needs what screening test?

A

Transcranial doppler - increased risk of vascular disease, especially stroke. Should be screened ages 2-16.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Signs of Fetal alcohol syndrome

A

Thin upper lip
Flat philtrum
Curvature of 5th digit of the hand (clinodactyly)
Flexion deformity of fingers (camptodactyly)
radioulnar synostosis
Spinal malformation/scoliosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

1st case of OM w/ effusion. Tx?

A

Conservative management, follow up in 3 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Tx for low back pain w/o red flag syx?

A

1st line - NSAID
2nd line - NSAID + muscle relaxant
Steroids have no evidence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

When would you image acute low back pain?

A

If red flag syx were present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Pt with parathesia in feet has A1C 5.8% and microcytic anemia. Dx?

A

B12 deficiency

Risk is higher with PPI use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

If you’re suspicious for Addison’s disease, what BL test should you get before stim test?

A

ACTH
Helps to establish if primary or secondary adrenal insufficiency
ACTH 2x NL –> primary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Easy ORT for kiddos

A

Half strength apple juice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

If you identify HCOM, what med do you start them on?

A

BBlocker - decreases DOE and chest pain and prevents sudden death.
Systolic murmur worse with Valsalva
can do NHD CCB if BBlock not tolerated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Demented lady doesn’t get better with redirecting. Next recommendation?

A

Start antipsychotic (ie Abilify)
Off label use of antipsychotics for behaviors is associated with increased mortality
D/c after 1 month if no improvement
- Vs donepezil which is prescribed to delay progression of dz

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Tx for anovulatory uterine bleeding?

A

Hormonal IUD or 21 day cycle of Progestin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Patient with knee OA declines surgery and asks what would be most effective at pain relief

A

PT with quad strengthening

Intra articular steroids give short term relief, but do not effect moderate term outcomes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Pt just had PCA for angina and LDL 90. How do you manage him?

A

High intensity statin (Crestor 20-40mg, atorvastatin 40-80,)

indicated for all pts <75 with known CAD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Moderate intensity statins

A

Simvastatin 40

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Pt has subclinical hyperthyroidism (low TSH, NL T4/T3), what complications are they at risk for?

A

Afib
CHF
Osteoporosis
Tx hyperthyroidism is patient is over 65, or TSH <0.1, Or if a comorbidity is present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is a positive finding on Dix-Hallpike?

A

Nystagmus when vertigo is elicited

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

preferred antidepressant for elderly pt?

A

Lexapro

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Pt with PTSD on Zoloft is having vivid dreams. Rx?

A

Prazosin

1st line PTSD - SSRI/SNRI, prazosin can then be added to augment therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

OTC supplement with highest risk of drug interactions?

A

St. Johns wort

CYO3A4 inducer - messes up cyclosporine, warfarin, OCPs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

1st line tx for social anxiety disorder?

A

SSRI

SNRIs are also a good choice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

12 y/o with groin pain x 3 weeks, recent illness. On exam BMI >95%, limited internal rotation of hip. Dx?

A

Slipped capital femoral epiphysis
Most common hip disorder age 8-15
early dx essential to prevent early onset DJD of hip
Rarely associated with trauma/overuse
Need frog leg lateral views
Transient synovitis is more likely in kids under 10

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Kiddo using albuterol ATC. Next step up?

A

Add an ICS

Next step add LABA or leukotriene receptor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What syx help to determine if palpitations are cardiac in nature

A

Occurs in their sleep or at work

If it happens in public places more like psych etiology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Female has scaling, redness, and irritation under her breasts x months not improving with antifungals. Dx?

A

Corynebacterium minutissimum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Coral pink under woods lamp

A

Corynebacterium minutissimum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Pale blue under woods lamp

A

Psuedomonas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Yellow under woods lamp

A

Tinea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Totally white under woods lamp

A

vitiligo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What’s the reasoning for not doing a pap yearly?

A

Annual screening does very little to prevent cervical cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Pt has Severely high bp in office (>180/110) w/o syx. What do you do?

A

Wait 30 min and recheck

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

For generally healthy patients (ASA II, ASA II) what preoperative testing should be done before a major surgery

A

CBC and renal function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

You identify a stress fracture on a foot in a runner. How do you manage?

A

no weight bearing for a few days, followed by a walking boot, then a rigid soled shoes in 4-6 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

11 y/o if referred to you for persistent proteinuria. What do you do next?

A

A spot protein/Cr preformed first thing in am

Helps to differentiate if pathologic vs. transient exercise induced or orthostatic proteinuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

20 y/o F with very long history of vague syx with normal workup. Requesting surgical intervention. Dx?

A

somatic syx disorder

Commonly also abuse opioids or alcohol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Dupuytren conjecture over 30 degrees needs what intervention?

A

Surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Pt admitted for cellulitis, which abx?

A

Vanc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Most effective medication to prevent motion sickness?

A

Scopolamine (better than dramamine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

initial infertility work up, normal semen analysis

A

Luteal phase progesterone level (day 21 of cycle)
If NL (>5) pt should have hysterosalpingography to confirm if Fallopian tube is patent
If low (<5) check TSH, estradiol, FSH and prolactin
If unremarkable pt is candidate for clomiphene
if unsuccessful –> refer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Crohns pt s/p ideal resection has chronic diarrhea, tx?

A

cholestyramine QD

Pt has bile acid diarrhea and tx with bile acid sequestrate (cholestyramine) is helpful

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Recommendation for child bearing age females not on OCP?

A

Folic acid 0.4-0.8mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Most accurate maneuver to detect ACL tear?

A

Lachman

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Donepezil increases risk of what side effect?

A

bradycardia

acts an an anticholinergic and increases vagal tone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Risk of being on a long term PPI?

A

Fx of hip, wrist, spine, CAP, C. diff, low mag, absorption of various vitamins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Pt has concussion without LOC. How do you manage return to sport?

A

Initial complete cognitive and physical rest followed by individualized graded return

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Pre-op exam, patient has <1% risk of cardiac event and is asymptomatic. What additional testing is needed?

A

Nothing

Only get EKG if symptomatic or known CAD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Head lice observed on a kid - whence he return to class?

A

Immediately

discourage close contact w/ others

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Otherwise healthy 40ish F has blood tinged sputum in setting of acute illness. Next?

A

CXR

Looking to r/o malignancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Most common conditions associated with anterior uveitis?

A

Seronegative spondylarthropathies, sarcoidosis, syphilis, rheumatoid arthritis, reactive arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Indication for emergent opt referral in conjunctivitis?

A

Reduced visual acuity

suggestive of acute angle-closure glaucoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Significant risk factor for esophageal adenocarcinoma?

A

Obesity

In Europe also GERD and obesity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

What would b e a worrisome syx in a patient with aortic stenosis and a systolic murmur?

A

DOE or dizziness

Indicator for valve replacement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Teenager has BP 130/80s (pre HTN). What do you do?

A

Stage I HTN
Check BMP lipids UA
Lifestyle modifications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Sarcoid pts should have annual exam of what organ system?

A

Ocular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Pt has thrombocytopenia (23k) without obvious cause, initial tx??

A 
Steroids
Most likely Idiopathic thrombocytopenia purport
Autoimmune
Tx if PLT <50k
FFP only needed if signs of hemorrhage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

syncope work up should include?

A

Orthostatic and EKG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Patient has normocytic anemia, initial work up?

A

Iron studies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Pt with posterior heel pain w/ nodular appearance at insertion of Achilles. Tx?

A

PT w/ eccentric calf-strengthening exercises

Dx: Achilles tendinopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

chronic inflammation of eyelids

A

Blepharitis

Tx: warm compresses and mild shampoo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

What meds can help improve mortality after an ACS NSTEMI admission?

A

Statin
ASA
ACEI/ARB
BBlocker

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

How much formula must a kiddo be on to not need Vitamin D?

A

At least 1L

If less than 1L they need 400 IU of vitamin D

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

How do you decide if scoliosis warrants referral?

A

Cobb angle >20 degrees

Also consider Female sex and if premenarche

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

If a patient has low Calcium d/t CKD what other labs are abnormal?

A 
Elevated PTH
Elevated phos
This is CKD and mineral/bone disorder
At increased risk of fractures and CAD
phos isn't appropriately secreted
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

newborn has dimple on sacrum 1cm superior to anus with dark tuft of hair. Next?

A

Needs US
Need US when dimple is >0.5cm, wishing 2.5 cm of anal verge
US to dx spinal dysraphism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

Diabetic patient has red warm foot that did not get better with abx. VSS, no SIRS criteria. Xray w/o gas or boney involvement. Now what?

A

Needs immobilization for Charcot neuroarthropathy

inflammatory condition in obese patients with peripheral neuropathy leading to foot deformity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

What happens in a nurse maids (ie what bone has an issue?)

A

sublimation of the head of the radius

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

Tx for PAD?

A 
Walking program
Smoking cessation
healthy diet
statin - regardless of LDL
single anti platelet
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

interventions for weight loss in a nursing home pt

A

avoid dietary restrictions

shakes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

According to cardiology, what is the cut off for HTN?

A

130/80

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

Goal for fasting glucose ina gDM?

A

<95

2 hour Post prandial goal is <120, 1 hour <140

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

Tx for lyme

A

doxycycline 100 mg BID 7-21 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

Pt is going to be on long term steroids. How do you prevent osteoporosis?

A

Alendronate (Fosamax)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

Pt FOOSH and + TTP over anatomical snuff box. NL Xray Tx?

A

Place in thumb spica splint with f/u in 2 weeks

Exam c/w scaphoid fx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

Man has sTEMI, BP soft, what do you start?

A

ASA/Plavix, heparin

avoid Block d/t him going into cariogenic shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

Pt with syncope has murmur over RUSB, dx?

A

Aortic stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

What is the only tx that improves mortality in aortic stenosis?

A

Aortic valve replacement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

What anxiety medication also helps with IBS?

A

Citalopram (Celexa)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

Most sensitive/specific test for Herpes?

A

PCR or tissue culture

ELIZAs are sensitive, but not specific

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

Hallmarks of diabetes insipidus d/t lithium

A

Lithium levels can be therapeutic
Kidney’s ability to concentrate urine is resistant to vasopressin
Central DI responds to vasopressin
NL Sodium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

Initial tx for GERD

A

4-8 wk of PPI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

Medication that helps prevent altitude sickness?

A

Acetazolamide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

Post partum pt with systolic heart murmur (chronic) increases intensity with valsalva. + hx of sisters with sudden cardiac death. Concern for?

A 
HCOM
Most common CM
LVH w/o chamber dilatation
AD inheritance
Peripartum CM presents as heart failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

Patient has L main cardiac stenting with drug eluting stent for aCS and low risk of bleeding, how long should they be on dual antiplatelet?

A

At least 12 months in patients in pts with ACS with high risk of ischemic disease (DM, PAD, L main stenting, or h/o cardiovascular event

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

Abxs that increase risk of rupturing an aneurysm

A

Fluorquinolones (cipro, levo)

Avoid in patients with pre-existing aneurysms or at risk of them (ie, Ehlers-Danlos)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

Pt with hyperthyroid on methimazole now with hyper syx and radioactive iodine uptake scan shows accumulation of tracer in multiple ares. Definitive treatment?

A

Thyroidectomy

dx - toxic multi nodular goiter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

Which patient pop has highest prevalence of syphilis?

A

Men who have sex with men

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

When is tinnitus bothersome?

A

When it is unilateral, pulsatile tinnitus, or tinnitus with asymmetric hearing loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

What is the stages of change model?

A

Assess patient’s motivation for change and determine what stage they are in (pre contemplation, contemplation, preparation, action, maintenance)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

Heel pain that is worse when a pt first gets out of bed, gets better with walking

A

Plantar fasciitis

achilles tendinopathy gets worse with activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

What lab tests helps to predict the severity of pancreatitis?

A

Hematocrit
BUN
Cr
Helps measure degree of intravascular volume depletion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

When should a doc report possible child abuse?

A

If they suspect a child has experienced abuse or neglect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

Which medications can improve survival in ACS?

A

Statin
ASA
ACEI
BBlockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

Pt with Sickle cell disease presents with T2DM syx, but HA1C 5.2%. What lab do you need?

A

Sr fuctosamine

HA1C falsely low in sickle cell d/t ban glycation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

Young healthy pt presenting with SOB and LE edema. + proteinuria. Dx?

A

nephrotic syndrome

Check A:Cr to confirm if in nephrotic range

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

sewer has thumb pain over radial stylus. Dx Tx?

A

De Quervain’s

Immobilize in thumb spica and NSAIDS 1-4 wk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
108
Q

7 y/o has stinky pits and acne. Otherwise Tanner 1. Next?

A

Follow up in 3-6 months
Premature adrenarche with breast or pubic hair is usually idiopathy and can lead to normal development
If they have breast/pubic hair or height velocity before age 8 –> need w/u

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
109
Q

7 y/o has elevated BP. Next?

A

Renal US

Most common: glomerulonephritis, congenital abnormalities, reflex nephropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
110
Q

Which medication can increase presence of calcium renal stones?

A

Topiramate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
111
Q

Tx for 5th metatarsal non displaced tuberosity avulsion fx?

A

Compressive dressing with weight bearing and range of motion exercises as tolerated
if minimally displaced - short leg walking boot
If >3mm displacement –> ortho referral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
112
Q

When do kiddos only need two doses of HPV?

A

If they get the first dose of HPV before age 15

vaccinate up to 21 in males, 26 in females

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
113
Q

When is AV nodal ablation considered in fib?

A

When fib is refractory to medical therapy

Must be on AC for 1 month prior to procedure and several months afterwards

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
114
Q

Patient has low back pain + shooting pain down the back of his leg x 1 week? What imaging do you get?

A

None

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
115
Q

prophylactic abx after a cat bite?

A

Augmentin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
116
Q

Leading cause of death in the world?

A

Ischemic heart disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
117
Q

Patient with hyperthyroid labs and high radioactive iodine uptake on a thyroid scan. Dx?

A

Graves dz

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
118
Q

25 yo with b/l hilarious lymphadenopathy on CXR, otherwise asymptomatic. Now what?

A

Follow up CXR in 6 months
Possible this is asymptomatic - likely early sarcoid
this can resolve in most cases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
119
Q

Recommendation for vasomotor syx of menopause?

A

combined estrogen/progesterone

Not enough data to recommend black cohosh

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
120
Q

Best long term management for symptomatic WPW that breaks into SVT?

A

catheter ablation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
121
Q

Patient with hip/back pain. FABER produces pain in the back. Dx?

A

Sacroiliac joint dysfunction

IF FABER produced pain in the groin –> femoroacetabular impingement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
122
Q

Tx length for provoked PE?

A

3 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
123
Q

Initial tx for focal hyperhidrosis

A

TOP 20% aluminum chloride

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
124
Q

scrotal pain. US: hyperemia, swelling, increased blood flow to testis and epidiymis. Tx?

A

Doxy + CTX

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
125
Q

How should you counsel a patient regarding LASIK?

A

Satisfactory improvement of vision in almost all patients
May still need corrective lenses for 20/20 vision
40% experience dry eyes
20% have glares, also, starbursts

126
Q

What can a patient do to reduce admission for COPD?

A

Written self-management plans that include smoking cessation plans

127
Q

Tx for somatic symptom disorders?

A

SSRI (sertraline/zoloft) + CBT

SNRIs, TCAs, etc not effective

128
Q

How do you interpret TSH in pregnancy

A

The TSH range in pregnancy is lower than the non pregnant state
hCG looks like TSH –> slightly higher T4 –> lower actual TSH

129
Q

Pt with HTN and back pain has normocytic anemia and cr 1.6. NL iron levels. Now what?

A

Serum protein electrophoresis
C/f MM
normocytic anemia + renal insufficiency suggest MM

130
Q

Pt in remission for breast cancer and has recent mamogram (<6 mo). What follow up does she need?

A

H&P and physical q3-6months for the first 3 years, 6-12 months for the next 2 years, then annually

131
Q

kid can’t ambulate more than 2 steps after fall, now what?

A

X-rays

if can’t ambulate more than 4 steps needs imaging

132
Q

Percentage of patients with a disease who have a positive test result

A

Sensitivity

133
Q

Percentage of patients without the disease who have a negative test result

A

Specificity

134
Q

What space are you targeting for rotator cuff tendinitis

A

Subacromial space

135
Q

For stone 5-10mm what helps for expulsion from distal ureter?

A

Flomax

136
Q

Pts with severe CAP benefit from IVF broad spectrum abx and?

A

Steroids

Criteria for severe increased RR, confusion, hypotension

137
Q

What test is helpful in confirming post partum thyroiditis

A

Radioactive iodine uptake
During hyperthyroid phase radioactive iodine uptake is low which confirms dx
Can’t do this during pregnancy or BF

138
Q

Elevated TPO Ab

A

Chronic autoimmune thyroiditis (Hashimoto’s)

Typically presents as hypothyroidism

139
Q

Elevated thyrotropin receptor Ab

A

Graves dz

140
Q

Teenager had sore throat and now is having dark urine and lower extremity swelling

A

acute post strep glomerulonephritis

Gross hematuria + HTN + systemic edema

141
Q

Classic Microscopic UA finding in flomberuloneprhitis?

A

RBC cases

142
Q

When do you see WBC casts on micro UA?

A

Pyelonephritis

143
Q

When do you see EOS on micro UA?

A

Acute interstitial nephritis

144
Q

Calcium oxalate on micro UA suggest

A

Stones

145
Q

What can be a helpful office treatment for a patient with bad migraine refractory to po triptans

A

IM antiemetics - help with more than just nausea

146
Q

Pancreatitis patient would like to try food on HD 2 but still has pain on exam. What do you do?

A

po as tolerated
recommend initiating oral food early in the course to protect gut-mucosal barrier and limit infectious complications
Does not increase LOS

147
Q

Fancy word for liver spot

A

Solar Lentigines

bx if growing rapidly, change, painful, itch, bleeding, or atypical appearance

148
Q

At 12 wks gestation women at high risk of Pre-e should start

A

81 ASA

149
Q

Runner with heal pain, improved with rest. On exam heel I swollen and very tender when squeezed on the sides. Anterior heel and achilles ten insertion are not tender. C/f?

A

Calcaneal stress fx. Get MRI

Delay in dx increases risk of delayed union

150
Q

Pt with morbid obesity, failed fad diets x years. Now what?

A

Bariratrics

151
Q

Criteria for PCOS

A

Hyperandrogenism
Oligomenorrhea
PCOS on imaging

152
Q

Pt has 50% occlusion on carotid a. Asymptomatic. Management?

A

Start statin and repeat in 1 year

Consider vascular referral if occlusion >70%

153
Q

Tx for eosinophilic esophagitis?

A

Budesonide po suspension 1mg BID
or INH corticosteroid sprayed into mouth and swallowed
No systemic steroids

154
Q

PTSD patient is in therapy but wants a med. Which rx?

A

SSRI or venlafaxine

155
Q

Pt had rash after PCN in childhood. Had amoxicillin with rxn. What do you tell her?

A

She doesn’t have a PCN allergy

156
Q

1st line tx for OA?

A

Exercise

157
Q

what do most women with accidental pregnancy do?

A

Carry to term and keep baby - 58%

158
Q

phenytoin increases risk of?

A

Osteoporosis

159
Q

1 RF for AAA

A

long hx of smoking

160
Q

In a head lice outbreak, in addition to permethrin tx, what do you recommend?

A

Wash closing, bedding in hot water and dry with hot air

161
Q

Suspicious findings in lung nodules

A 
non solid "ground glass" appearance
size >6mm
non calcified
irregular borders
doubling in size that takes more than 1 month but less than 1 year
162
Q

Pt having a hard time falling and staying asleep after sleep hygiene and trial of doxepin, ER melatonin. What would you try next?

A

Eszopiclone (Lunesta)

163
Q

Best fluid to cleanse a pressure wound with a shallow reddish-pink base?

A

Water or saline

Stage 2 pressure ulcer

164
Q

4 y/o had first time seizure in setting of fever. Management?

A

Reassurance. Happens in 2-5% of kiddos under age 5

165
Q

Pt about to undergo organ transplant wants contraception. What do you recommend?

A

IUD
Should avoid pregnancy in first 12 months after transplant d/t risk of preterm delivery and graft rejection
Female fertility tends to increase after transplant
IUD avoids medication interactions

166
Q

Unilateral HA x months with conjunctival hyperemia and rhinorrhea. Dx and Tx?

A

Variant of cluster headache

Tx with indomethacin

167
Q

Specific things to avoid when improving sleep hygiene

A

Pets in the bedroom
Caffeine after 4pm
Exercising within 2 hours of bed time
Nicotine

168
Q

Tx for predominantly diarrheal IBS?

A

SSRIs
TCAs
Decrease abdominal pain

169
Q

Pt with DOE, normal spirometry on PFTs but DLCO is low. Dx?

A 
Chronic Pulmonary emboli
CHF
Connective tissue dz
primary pHTN
NOTE: asthma, bronchiectasis, COPD, fibrosis would have abnormalities on spirometry
170
Q

Pt with artificial heart valve is allergic to PCN. What would you give?

A

Clinda or Azithromycin

171
Q

Type of prevention who identifies at risk population and intervenes to prevent condition onset

A

Primary prevention

- ie childhood vaccine programs, fluoride in water, antismoking, safe sex

172
Q

Type of prevention targeting people who have asymptomatic disease and applies a treatment to prevent progression

A

Secondary prevention

- ie BP screening, Pap tests, HA1C/cholesterol panel

173
Q

Type of prevention that targets patients with known disease with goal to prevent progression

A

Tertiary

- Prevent MI with Block and ASA

174
Q

How do you counsel patient receiving IUD about back up contraception?

A

If inserted within 7 days following menses, no back up needed
If more than 7 days, use back up x 7 days

175
Q

Pt on HCTZ is started on carbamazepine for trigeminal neuralgia. What lab abnormality are that at risk of?

A

HypoNa

Carbamazepine causes SIADH

176
Q

Pt with plaque psoriasis with high potency TOP steroids now has resistant plaques on trunk and arms. Now what?

A

Add TOP calcipotriene or TOP tazarotene

177
Q

What is a modifiable risk factor for macular degeneration?

A

Smoking

Need urgent referral to ophthalmology

178
Q

What has been shows to reduce mortality and length of stay in pancreatitis?

A

continuous NG enteral nutrition

179
Q

kiddo has bug bites on arms/legs. Has excoriated erythematous papule on both forearms/legs that are itchy. Dx?

A

bed bugs

180
Q

FEV1/FVC < 0.7

A

COPD

Start SABA

181
Q

Pt has peripheral neuropathy in toes x months. NL CBC, A1C, B12. Elevated ESR and total protein. Next labs?

A

Sr protein electrophoresis

Elevated protein, ESR suggestive of MGUS or MM

182
Q

Annual failure rate of OCP?

A

9%

183
Q

Annual failure rate of hormonal IUD?

A

0.2%

184
Q

Failure rate of depo?

A

6%

185
Q

Failure rate of male condom

A

18%

186
Q

Failure rate for pull out?

A

22%

187
Q

All adolescents and adults should be screened for?

A

depression

188
Q

kiddo bit by his cat and given CTX + augmentin x 10 days. Returning for persistent erythema and decreased ROm of thumb. Next?

A

Refer to surgery

C/f tendon sheath or joint infection

189
Q

Post op patient has some confusion. What tool can you use to assess?

A

Confusion Assessment Method (CAM)
Useful when patient has acute change from cognitifve BL c/f delirium
- NOTE other tests like mini mental, MOCA, Mini Cog look from chronic BL function, not testing for acute change

190
Q

what is true of direct observational therapy for TB?

A

decreases drug resistance

191
Q

IN which ortho problem is a steroid INJ fix the underlying problem?

A

Trigger finger

- OA, epicondylitis, impingement, bursistis are all for pain control

192
Q

What test should be done at a 9-11 y/o WCC?

A

Cholesterol panel

11-21 should also have depression screening

193
Q

Fibromyalgia patient asks about adding SSRI. What do you say?

A

Does provide some pain reduction (up to 30%)

TCAs might be better

194
Q

Patient has delirium, what’s the first thing you should do?

A

Determine and treat underlying cause of behavior change

Not physical or chemical restraints

195
Q

Skin finding: pearly papular with telangiectasia

A

Basal cell carcinoma, most common skin cancer
more common on face/ears
Rarely mets

196
Q

Diagnostic criteria of ADD

A

Syx interfere in more than one setting of: social, academic, occupational functions
Syx start before age 12

197
Q

Person just used epi pen, now what?

A

go to ER

198
Q

Tx for bacterial sinusitis

A

Augmentin

Must have: relapse of illness, >7 days of syx

199
Q

infant has FTT and recurrent PNA. Sibling had SIDS. NL sweat test. Dx?

A

GERD

Syx: reccurent PNA, low growth curve, FHx of SIDS, normocytic anemia

200
Q

SCD patient presents with cough, CP, hypoxia and CXR shows consolidation in RLL. Dx?

A

Acute chest syndrome

tx - 3rd gen cephalosporin/Azithro (need to cover mycoplasma and chlamydophila)

201
Q

Screening test for vitamin D

A

25-dihydroxyvitamin D

1,25-dihydroxy D is better at monitoring the disease

202
Q

PCOS patient wants a contraceptive to help regulate periods and decrease hirsutism. REcommend?

A

Combo OCP

203
Q

What other condition can affect absorption of levothyroxine?

A

H. pylori
Atrophic gastritis
PPI use
May need a 30% reduction in dosing after treatment

204
Q

Tx for uncomplicated cystitis?

A

Bactrim x 3 days

Nitrofuratonin x 5 days

205
Q

13 y/o w/ no menses and no other secondary characteristics with short stature, NL TSH and prolactin. elevated FSH/LH. Next step in work up?

A

Karyotyping

Short stature, no secondary characteristics, and high FSH/LH suggest primary ovarian failure and Turner syndrome

206
Q

IF you treat latent tb with with isoniazid, what other supplement do they need to prevent neuropathy?

A

Vitamin B6

207
Q

How do you navigate an indecent elderly patient on warfarin having falls 1x/mo

A

Counsel benefit of AC outweighs risk

including those patients iwht cognitive impairment, faulty, or falls

208
Q

Pt with chronic stable angina has HR 50s and started on ASA, statin, SL nitro. What else to start?

A

Isosorbide mononitrate or nifed/amlodipine
Pts with stable angina can be tx with BBlock, CCB, and/or long acting nitrates.
Avoid Block in this pt d/t bradycardia

209
Q

hair dressers with numbness in unilateral 5th finger, progressive over months. worse with prolonged elbow flexion. + clumsiness with fine coordination. Intrinsic muscle weakness on exam. Dx?

A

Cubital tunnel syndrome
2nd most common peripheral neuropathy
ulnar n. compression in UE

210
Q

For afib, what diameter of what structure on ECHO predicts likelyhood to maintain NSR after cardio version?

A

L Atrium

Significant enlargement makes maintaining NSR unlikely

211
Q

Tx for clavicle fx?

A

sling for 2-6 weeks

212
Q

Pt with lung cancer has new DVT. What AC do they need?

A

Lovenox

Considered a cancer associated thrombosis

213
Q

Key DSM5 for Autism

A

Deficit in social communication in multiple contexts

Restricted, repetitive patter of behavior, interest or activities

214
Q

Kiddo has GERD but is growing well and is comfortable. How do you counsel?

A

Reassurance
Generally improves with growth
Low volume feeds, elevate HOB, Thickeners
Avoid Rx in regurgitation that is effortless, painless, and not affecting growth

215
Q

When can you breach patient confidentiality?

A

Abuse of vulnerable person (child, elderly)
Public health risk
Substantial danger to others

216
Q

Blood glucose goal in septic patient?

A

<180

217
Q 
kiddo has 4 of:
Irritable mood
Argumentative/defiant behavior
vindictiveness
Must be directed toward a person other than a sibling
Dx?
A

Oppositional defiant disorder (ODD)

218
Q

Patient has post prandial fullness and early satiety with normal labs and EGD. Dx and Tx?

A

Functional dyspepsia

Reglan

219
Q

10 y/o with CAP. Tx?

A

Azithromycin (preferred first line for kids 5-16)

Most likely bugs - mycoplasma, chlamydia, S. pneumonia

220
Q

30s patient on 3 anti hypertensives and BP still elevated. K+ 3.0. Next test?

A

Plasma Aldo/renin

c/f hyperaldosteronism

221
Q

Pt has Graves. What tx helps with exaphthalmos?

A

Methemazole

222
Q

Bipolar I in remission wants to discuss d/c’ing sertraline and Seroquel. What do you do?

A

Continue all current meds

223
Q

Pt has non painful swelling of elbow. Next?

A

Conservative management with ice, compression warp, activity modification
aspiration only indicated if pain or infection present

224
Q

Incidental findings of non displaced wedge compression fx of T12. Management?

A

Early mobilization

225
Q

what biostatistics value is helpful in selecting a screening test to r/o disease

A

Likelihood ratio

226
Q

best tx for alcohol withdrawal with delirium?

A

Ativan

227
Q

What strategy can help with challenging patients?

A

Motivational interviewing

228
Q

Growing up around trauma increases risk of?

A 
Alcohol/drug abuse
Depression
suicide
obesity
hyper sexuality and STDs
229
Q

What BP med decreases stone formation?

A

HCTZ

230
Q

What is the ultimate benefit of bariatric surgery?

A

Decrease risk of dying from obesity related illness

231
Q

Constipated Pt has rectal pain and bleeding but only with BM. Dx?

A

More likely anal fissure

Hemorrhoids tend to have pain all the time

232
Q

Contraindication to using GLP-1s for T2DM?

A

Thyroid cancer or MEN syndrome

In rare cases can cause pancreatitis but this is not a strict contraindication

233
Q

Which region practices coin rubbing to promote healing and draw illness out of the body?

A

Southeast Asia (Cambodia, Korea, china, Vietnam)

234
Q

When is tPA indicated in PE?

A

Hypotension (SBP <90)

235
Q

Pt has fasting glucose of 107. Now what?

A

Repeat in 1-2 weeks

He has impaired fasting glucose (100-125) but needs to be confirmed on repeat testing

236
Q

Infant born before 37 wk GA and exclusively BF. When should start iron supplement?

A

1 month of age and continue until 12 months of age

Only exception is if they receive blood transfusion in hospital

237
Q

NH resident is MRSA positive. How do they control this when she returns to NH?

A

Strict hand washing by staff/visitors/residents

Barrier precautions to wounds

238
Q

Runner with heel pain and palpable nodule over achilles. Dx tx

A

Achilles Tendinopathy

Eccentric calf strengthening exercises

239
Q

Pt has single hyper plastic polyp on c-scope, when do they need a repeat?

A

10 years. This is considered a normal c-scope

240
Q

A kiddos hemangioma has telangiectasia, fibrofatty tissue, dyspigmentation, and scarring. It has also involutedWhat to do?

A

Refer for surgical excision
Once involuted it needs excision for better outcomes
Prior to involuting tx of choice is po propranolol

241
Q

Penile enlargement warrants endo eval when under what age?

A

9

242
Q

1st line tx for SLE?

A

hydroxychloroquine

+ ds DNA

243
Q

What can make a BNP falsely elevated?

A

Elevated Cr
Female >65
Low albumin

244
Q

PP pt is considered about depression. What now?

A

Use validated screening tool for post party depression (Edinburg depression scale)

245
Q

Pt gets PNA after staying in a hotel/cruise ship. Worry for?

A

Legionella

246
Q

What is the minimum amount of time allowed between HPV vaccines?

A

6 months

247
Q

Pt has hair thinning along pareital area and frontal hairline is preserved. Dx and tx?

A

female pattern hair loss

Minoxidil 2% BID

248
Q

kiddo is being bullied. Approach?

A

See if high school counselors can address

249
Q

spiritual assessments can be completed by?

A

Physician

250
Q

COPD pt using albuterol ATC. Next step up?

A

Lon acting anticholinergic INH

251
Q

Kiddo has round lesion with crusting. Dx Tx

A

Impetigo (S aureus)

Mucopirocin

252
Q

9 y/o with knee pain. On exam lateral patellar tracking with knee extension. Dx?

A

Patellofemoral syndrome

253
Q

Fib on AC has a STEMI no s/p drug eluting stent. how do you manage AC going forward?

A

AC + dual anti platelet

Can stop ASA at 1 month

254
Q

benefits of probiotics in kids

A

Decrease abx associated diarrhea
reduce pain associated with IBS
Reduces crying up to an hour in breastfed infants
prevention of eczema and URI

255
Q

Type of lung disease in systemic sclerosis?

A

ILD
Restrictive dz
pHTN is also common

256
Q

Testicular pain better with elevation

A

Epididimytis
tx with Doxy/CTX
US: Hyperemia, swelling, increased blood flow

257
Q

which polyp type has the highest likelihood of becoming malignant?

A

villous adenomas

258
Q

What fingerstick glucose numbers qualify for T2DM

A

Fasting glucose >126
2hr ogtt >200
symptomatic pt with glucose >200

259
Q

Dietary changes in cirrhosis

A

Low sodium

High protein

260
Q

Pt has orthostasis and hyperpigmentation. Next work up?

A

ACTH stimulation test

Work up for primary adrenal insufficiency

261
Q

What A1C range in a T2DM over 65 has the lowest mortality?

A

7.0-7.9%

262
Q

healthy patient has elevated all phos. Now what?

A

Get a GGT. Helps determine if liver or bone

263
Q

Medications that improve mortality in HFrEF

A

ACEI/ARB
Block
aldosterone antagonists

264
Q

preferred vasopressor for septic shock?

A

Norepinephrine (levophed)

fewer side effects than dopamine

265
Q

When in menses cycle can IUD be put in?

A

Anytime

266
Q

Vaccinated kid has meningitis + roomie. now?

A

treat all kids in dorm with cipro x 1 (or azithro, CTX, rifampin.
PEEP indicated regardless of vax status w/in 14 days of exposure

267
Q

40s F with proximal muscle weakness, dysphagia, pain in large joints x weeks. Difficulty getting out of chair. Violaceous rash over periorbital skin and macular erythema over thighs. Dx and other findings?

A

Dermatomyositis

Macules over extensor surfaces of joints (Gottron’s papule)

268
Q

Toddler has 3days of viral URI syx and on day 4 has fever of 104. Now afebrile, fine maculopapular rash on trunk/extremities. Dx?

A

Roseola infant
Herpesvirus 6
Self limited dz

269
Q

What is Erythema infectiousum

A

Fifth disease
“slapped check” appearance
parvo

270
Q

What is molluscum contagiosum

A

poxvirus with scattered flesh colored papule with umbilicate centers

271
Q

47 y/o is having longer, heavier periods. Next?

A

TVUS
premenopausal women account for 20% of endometrial cancers
Screen women with AUB if >45 or if they have a hx of unopposed estrogen exposure

272
Q

Tx for manic episode

A

Lithium
Anticonvulsant (divalproex)
Antipsychotic (olanzapine)

273
Q

Dancer can’t weight bear after standing on his toes and putting weight on lateral part of foot
Xray - Proximal 5th metatarsal metadiphyseal fx.
Dx and Tx

A

Jones fx
Tx depends on how active the patient is
Active patients - can return to sport sooner if they undergo surgery
Less active - posterior splint and f/u in 3-5 days, then non weight bearing cast x 6 weeks. If Xray shows healing can slowly start weight bearing. If no healing, non weight bearing status gets extended

274
Q

45 y/o F has incidental adnexal fullness on exam, simple cyst on tVUS. Now what?

A

Repeat TVUS in 8-12 weeks

Most resolve after 2-3 menses

275
Q

kiddo has ear ventilation tubes now with ear discharge. Management?

A

Cipro ear drops +/- steroid

276
Q

Cut offs in transudative vs. exudative fluid?

A

fluid protein:Sr protein >0.5 = exudative

fluid LDH: Sr LDH = exudative

277
Q

how do you manage an splenic patient?

A

Give po amoxicillin or levofloxacin to empirically treat fever until they can get medical care

278
Q

initial tx for acne

A

TOP benzoyl peroxide, TOP retinoid, OCPs

279
Q

Bariatric labs

A 
CBC
CMP
Folic acid
Iron studies
PTH
Lipids
Vitamin B12
24h urinary calcium
25-hydroxyvitamin D
DEXA q2yr
280
Q

progesterone only contraception

A 
levonorgesterel IUD
Depot
POPs
Nexplanon
safe for pts where estrogen is contraindicated
281
Q

How do you handle iron deficiency in a bariatric pt?

A

They need IV iron d/t poor ability to absorb iron through gut

282
Q

Pt taking Roxy regularly has a negative UDS. Now what?

A

Get a chromatography

Oxy is often negative on UDS

283
Q

Pt has PLT of 100k, no syx. What do you do?

A

Review med list

Consider the H2 blockers as they can lower PLT

284
Q

Pt with syncope has a big tongue, cardiomegaly and b/l carpal tunnel. Ddx?

A

Amyloid
Extracellular deposition of fibrous amyloid protein
Syx: proteinuria, peripheral neuropathy, tongue enlargement, cardiomegaly, malabsorption, b/l CTS, orthostatic hypotension.
Amyloid can be idiopathic or can be seen w/ MM

285
Q

Asthmatic with a bad flare, having hard time weaning off red. Now what?

A

Increase dose of his maintenance INH, specifically ICS

286
Q

1st line tx for depression in adolescent?

A

fluoxetine (prozac)

Monitor weekly x 4 weeks

287
Q

1st line meds to rate control a fib?

A

Beta blocker or nondi CCB

288
Q

Greatest risk factor for t2DM?

A

Personal hx of gDM

289
Q

Medical care is paid on a fee for service, but his can go up or down based on quality or efficiency measures. What is this?

A

Value based reimbursement

290
Q

Pt has dysphagia and unintentional 20lb weight loss. What does she need?

A

EGD to r/o esophageal CA

NOT a barium swallow

291
Q

When do you need to r/o PNA in someone with acute bronchitis

A

dyspnea, tachypnea, tachycardia
T >100F
bloody sputum
Focal consolidation on lung exam

292
Q

Nail goes through a kids shoes and makes a puncture wound. 2 days later it is warm and draining purulent fluid. tx?

A

Cipro
apparently nail through shoe is high risk for pseudomonas and only cipro has coverage (not reflex, doxy, Bactrim, augmenting)

293
Q

back pain that awakens a kiddo from sleep nearly nightly. Dx?

A 
Discitis
osteomyelitis
diskitis
osteoid osteoma
osteoblastoma
spinal cord tumor
294
Q

Tx for salmonella

A

supportive care

only abx if septic

295
Q

when doc relies on an initial diagnostic impression despite subsequent information that suggested alternative dx could be more likely

A

Anchoring bias

296
Q

How do you decide if a pt needs BRCA testing?

A

Administer a familiar risk stratification tool

297
Q

kiddo has a barking cough, they need?

A

po dexamethasone

298
Q

Male pt with h/o cryptorchidism s/p orchiopexy has a lump on testicle and US reveals hypo echoic mass. Now what?

A

Refer to urology (not check labs or re-asses in a few months)
High risk for testicular CA
Cannot biopsy d/t high risk of seeding cells
Next step would be radical inguinal orchiectomy - diagnostic and therapeutic

299
Q

Pt has hyperthyroid syx/labs. Radioactive iodine uptake shows low uptake. Dx?

A

Subacute thyroiditis
“destructive phase” has hyperthyroid syx but uptake scan is negative
Uptake would be high in Graves and Multinodular goiter

300
Q

All overweight or obese patients should be screened for T2DM after what age?

A

40

Can be done earlier if other RF present (Fix, gDM, PCOS)

301
Q

F teen, anterior knee pain, worse with running down hill

A

patellofemoral syndrome

302
Q

What T2DM med can you use in a pt that also has CHF class III and CKED (Cr 2, GFR 40)

A 
GLP-1s (liraglutide = Victoza)
Metformin contraindicated if Cr > 1.5
SGLT 2s (Invokana) contraindicated in GFR < 50
Tiazolidinedione (rosiglitazone = Avandia) not recommended in Class III or Class IV HF
303
Q

Older adult with watery diarrhea up to 12 x day. Ddx and W/u

A

Microscopic colitis

Need bx of transverse colon

304
Q

How long are fibronolytics contraindicated after ischemic stroke?

A

3 months

305
Q

Based on Ottawa rules, when should you get foot and ankle Xrays

A

Inability to bear weight for less than 4 steps
TTP - posterior malleolus, 5th metatarsal, navicular
99% sensitive for detecting fracture

306
Q

best way to assess a pts response to po iron?

A

Reticulocyte count in 1-2 weeks

307
Q

Tx for chronic uticaria not responsive to loratadine?

A

H1 antihistamines - cimetidine

Doxepine

308
Q

GLP1s

A

Liraglutide (Victoza) - only one with CV benefit
Exenatide (Byetta)
Dulaglutide (trulicity)

309
Q

When do you consider treating subclinical hyperthyroidism?

A

ABN DEXA scan
A fib
CHF

310
Q

Asyx smoker wants to be screened for COPD. What do you do?

A

No screening

Would get spirometry if they developed DOE or chronic cough

311
Q

Pt with obesity, T2DM has thrombocytopenia with PLT 70k. LFTS mildly elevated. Dx?

A

Chronic liver dz from NASH

AFP boards (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions