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0
Q

Confusion, ataxia, nystagmus with drinking hx

Dx? Treatment?

A

Wernicke’s

Give thiamine BEFORE glucose

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1
Q

What is parinaud’s syndrome

A

Pineal gland tumour
Loss of pupillary vision & vertical gaze
Also headaches & poss. HCG secretion

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2
Q

Craziness following wernickes - name, symptoms andparts of brain involved?

A

Korsakoff. Confabulations, halluc. Mamm.bodies & thalamus

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3
Q

Carbamazepine SE

A

Bonemarrow suppression, SIADH, anticholenergic effects

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4
Q

First line for bradycardia

A

Atropine

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5
Q

Treatment for alzheimers

A

Anticholinesterase inhibitors

Tacrine & donepezil

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6
Q

Teratogenic haart drugs

A

Efavirenz & delavirdine (effa deadly)

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7
Q

Anti-citrullinated peptide antibodies - wtf?

A

Test for RA

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8
Q

Treatment for lyme arthritis?

A

Doxy or amoxacillin for 28 days

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9
Q

What does congenital toxo cause in babies?

A

Microcephaly, MRetard, deaf, seizures, hydrocephalus

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10
Q

Scaly, eczema lesions over knuckles - most likely dx?

A

Gottrons’s sign - dermatomyositis

Likely 2/2 malignancy

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11
Q

Proximal muscle weakness?

A

Dermatomyositis (think malignancy, gottrons sign, heliotrope rash)

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12
Q

Treatment for als?

A

Riluzole (glutamate inhibitor)

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13
Q

Leriche syndrome?

A

Impotence, muscular atrophy and claudication

Aortoilliac occlusive disease

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14
Q

Sig. of nocturnal erctions?

A

If you don’t have them, likely neuro or vascular cause

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15
Q

Hematuria and recent immigration from 3rd world

A

Schistosomiasis (parasite). Collect urine between 10a&2p.

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16
Q

How does ATN commonly present?

A

Following a hypoperfusion > oliguric state with AGMA

Check muddy brown casts

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17
Q

First line for detecting kidney stones

A

CT helical non-contrast

Then (or if preg pt) - IVP

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18
Q

Drug of choice with sclerodermal renal crisis?

A

ACEI (even with elevate Cr) with whatever fo BP

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19
Q

ACEI of choice for sclerodermal renal crisis?

A

Captopril (shortest onset, most data)

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20
Q

Differentiate between IgA and PSGN ?

A

PSGN follows 10+ days after illness. IgA is quicker (<10)

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21
Q

Treatment for IgA nephritis?

A

Nothing. Symptomatic.

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22
Q

Most common cause of cryoglobulimemia?

A

Hep c

Conversely - check all cryoglobulin patients for hep c

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23
Q

In PSGN - complement levels?

A

C3, C4 and CH50 reduced (C4 could be normal)

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24
Q

Complement levels with wegeners?

A

All normal. (Check C-ANCA)

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25
Q

Treatment for priapism?

1st? Then? Is it doesnt work? Sickle cell?

A

Ice pack. Alpha agonist. Terbutaline. IV fluids

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26
Q

Stages of renal CA and treatment

A

1) confined to capsule - partial nehprec.
2) through cap but not beyond gerota - radical neph
3) invas of major veins, LN or adren.gl - rad or debulking
4) mets - chemo etc

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27
Q

What IV fluids can be used to guard against contrast nephropathy

A

Sodium bicarb or NS with acetylcysteine

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28
Q

What electrolyte problem is common with TURP?

A

Hyponatremia 2/2 tons of isoosmotic flush used

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29
Q

Drugs that cause a descrease in Cr secretion (with serum elevation)

A

Cemetidine, trimethoprim, probenecid

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30
Q

Most common complication of ADPKD?

A

Hypertension & hepatic cysts

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31
Q

Name of rapid in-hosp urine test?

A

Urine immunoassay

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32
Q

Premedication before blood - helpful?

A

No! Acetaminophen & benadryl does NOT help

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33
Q

Ear pain, ipsilateral facial paralysis & vesicles in audio canal?

A 
Ramsey hunt (herpes zoster oticus)
Reactivation
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34
Q

Malignant otitis externa - pathogen?

A

P.aeruginosa most common

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35
Q

Scalp ringworm - what else could it be? Why?

A

Microsporum canis (lights up green under woods lamp)

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36
Q

When is surgical correction needed for kyphosis?

A

Spine change more than 70-80°

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37
Q

Triad of reactive arthritis

A

Conjunctivitis, urethritis, spondyloartropathy

38
Q

Common cause of diarrhea post GB removal?

Treatment?

A

Bile-salt induced diarrhea (also seen w short bowel syn)

Treat w cholestyramine

39
Q

First line for emergency contraception?

A

Levonorgestrel (if <120h)

Copper IUD if longer

40
Q

Neurologic abnormalities - B12 or folic acid?

41
Q

HIV brain lesion that does NOT show mass effect?

A

PML (JC virus)

42
Q

3 components of MELD (and liver mortality)

A

Bilirubin, INR, creatinine

43
Q

First line treatment of acute gout

A

Nsaids (indomethacin). Then colchicine & roids

44
Q

First line for chronic prostate infxn

A

Levoflox or cipro, then bactrim

45
Q

What is saw palmetto for?

46
Q

Treatment for genital warts?

A

Trichloroqcetic acid. For external warts - podophyllin (not used for mucosa)

47
Q

Aldosterone - renin ratio to diagnose hyperaldo?

A

Greater than 30

48
Q

How does HCTZ cause lithium tox?

A

Reabsorbing Na also somehow rabsorbs lithium in kidneys

49
Q

When to switch to oral vanc from metro for cdiff?

A

When wbc >15K and Cr >1.5x baseline

50
Q

Treatment for latent TB?

A

INH for 9 months. If not, rifampin for 4 months (6 in kids)

51
Q

Imaging of choice for MS?

52
Q

On chronic roids - what should be added? Bone scan?

A

Calcium & vit.D. Scan yearly

53
Q

Gangrenous areas ppearing on body - 2 possible ddx and how to diff?

A

Pyoderma (face, limbs) or ecthyma (trunk) gangrenosum.

Think p. Aeruginosa

54
Q

Hip thigh or knee pain in boy 3-10 years?

Imaging?

A

Transient (toxic) synovitis. Ultrasound

55
Q

Deficiency with female atheletes and no menstr?

56
Q

Injectable antipsychotics?

A

Haldol decanoate, risperidone & fluphenazine

57
Q

Atypical antipsychotic that causes

1 weight gain 2 weight loss

A

1 gain olanzapine 2 loss aripriprazole

58
Q

Garlic odor on body

A

Organophosphate poisoning

59
Q

DOC for cocaine-induced HTN?

A

Phentolamine. Can also use nitro

60
Q

Risk for baby of getting type 1 DM?

A

Mom + 3%

Dad + 6%

61
Q

Firsline tx for diabetic neuropathy

A

SNRIs, TCA, pregabalin

Also gabapentin, lamotrigine, carbamazepine

62
Q

Lacrimation and yawning - think of?

A

Opioid withdrawal

63
Q

MCC of postpartum hemorrhage?

A

Uterine atony. Treat with fundal massage and oxytocin with aggr fluid resusc.

64
Q

Treatment for hypotension during pheo op?

A

Rapid NS infusion

65
Q

Difference between ptsd and acute stress disorder

A

Time. Ptsd is more than 1 month. Shorter is asd

66
Q

Standard gastro tube feeding regimen?

A

30kcal/kg/day with 1g protein

Can go lower kcal with malnutrition (prevent refeed)

67
Q

Treament for tourettes

A

Dopamine receptor blockers

Fluphenazine, primozide, tetrabenazine

68
Q

Treatment for rls?

A

Dopmine agonists

Pramipexole, ropirinole

69
Q

First test for ankylosing spondylitis?

A

Xray of sacrilliac joint

Then followup in 3 months

70
Q

50 and 100g glucose testing for gestational diabetes?

A

50 - 1 hour later >130 then go to

100 - 0,1,2,3 hr values <95, 180, 155, 140

71
Q

Fasting BG in pregnant patients? 2hr postprandial?

72
Q

Schober test?

A

Test for spine probels (spondyloarth., reactive arth)

15cm+ is positive

73
Q

Treatment for lead toxicity

A

0-44 nothing, 45-69 meso2,3dimer acid(DMSA,Succimer)

70+ dimercaprol, edta

74
Q

Chemoprophylaxis against neiss. Meningitis?

75
Q

Technicium99 scan - think what?

76
Q

Most common rhythm with WPW.

A

Parx. SVT (tachyarrhy)

77
Q

Treatment for symptomatic WPW?

A

Catheter ablation

78
Q

When to give tetanus toxoid also?

A

No immunization, 3x in last 10 years with CLEAN wound, 3x in last 5 years with DIRTY wound

79
Q

Decreased sensation over anterolateral thigh?

A

Meralgia paresthetica. Compression of lat. femoral cut. Nerve

80
Q

Treatmwnt for scabies?

A

Lindane or permethrin cream

81
Q

Drugs changing TBG?

A

Thyroid binding glob increases with OCP, leading to decreased FT4. Increase levothyrox.
Decreases with steroids & androgens

82
Q

Metornidazole - safe in breast feeding?

83
Q

Baby with CON jugated bilirubin - think of ..?

A

BiliRy atresia - surgery

84
Q

Schmidt syndrome?

A

Polyglandular autoimmune failure type 2

Addisons, type 1 DM, thyroid dysfunction, vitiligo

85
Q

Fevers after starting HAART?

A

IRIS - Immune Reconstitution Inflamm. Response.

Worsening of pre-exisiting infections

86
Q

What bug is achalasia assoc with?

A

Tryp. Cruzi (S. American parasite)

87
Q

Corkscrew esophagus

A

Diffuse esophageal spasm

88
Q

Drugs causing digoxin toxicity?

Symptoms?

A

VASQ - verapamil, amiodarone, spironol, quinidine

N/V, confusion, cardiac abnorm, anorexia, confusion, visual changes

89
Q

Guillain Barré but with loss of bowel and bladder fxn?

A

Transverse myelitis. Do MRI.

90
Q

Type of diet for dumping syndrome?

A

High protein low carb

91
Q

How to differentiate between a traumatic tap and SAH?

A

Sah has xanthochromia. TTap does not

92
Q

Hypocalcemia after blood transfusions?

A

Citrate overload resulting in it binding to Ca reaulting hypocalcemia
Look for seizures following transfusion

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