Brainscape's Knowledge GenomeTM

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


See full index

Internal Medicine > Qbank/MKSAP > Flashcards

Qbank/MKSAP Flashcards

1
Q

A patient has a blue toe 3 days following cardiac cath s/p MI. What is the most likely cause?

A

Dislodged atheroembolism during cath

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

Criteria of metabolic syndrome? (5)

A 
Abdominal obesity- waist circumference > 40 in men, 35 in women
Fasting glucose > 100
BP > 130/80
TGs > 150
HDL <50 in women
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How does guillan barre cause respiratory failure? What is the best test to monitor?

A

Muscle weakness

Vital capacity

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

When should tpa be used in strokes? Contraindications?

A

Within 3 hours and CT shows no brain bleed

Contraindicated when- hx of stroke in past 3 months, hx of intracrial bleed, major surgery, MI, active bleed

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

Why is it important to remove clothing soaked in vomit due to an organophosphate poisoning?

A

transcutatneous absorption

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

What is different about vitamin D deficiency in adults compared to children?

A

Adults have defective bone mineralization

Children have defective bone AND cartilage mineralization

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

How do you definitively diagnose bronchiectasis?

A

High resolution CT scan

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

Which tests should be performed at the diagnosis of HTN? (4)

A

Urinanalysis
CMP
Lipid profile
EKG

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

A patient 2 months s/p MI comes in with persistent ST elevation and deep Q waves- what complication has occurred?

A

Ventricular aneurysms

Papillary muscle rupture typically occurs between 2 days a a week

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

A patient slaps his foot as it hits the ground while he walks- what vertebrae could be damaged?

A

L5 radiculopathy

Others causes include neuropathy and trauma

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

A patient has a dull hypomobile tympanic membrane and HIV- what is the cause?

A

Serous otitis media or non infectious effusion

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

A patient has X-ray showing expansile and eccentrically lytic area in epiphysis of distal femur- likely diagnosis?

A

Giant cell tumor- this is a soap bubble lesion

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

What restrctive lung disease is associated with a normal or increased FRC?

A

Ankylosing spondylitis- due to chest wall motion restriction

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

What are EPO levels in PV?

A

Low- the increase in RBC is EPO independent

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

What is the best treatment for acute rejection of a kidney transplant?

A

IV steroids regardless of cause

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

What is amaurosis fugax? What is it a warning since of?

A

Painless loss of vision due to emboli

Warning sign of a stroke

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

An anterior cerebral artery stroke has what deficits?

A

Contralateral motor deficits more pronounced in lower limb than upper limb

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

A middle cerebral artery stroke has what deficits?

A

Contralateral motor deficits more pronounced in upper limbs than lower limbs +/- aphasia

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

A middle aged woman presents with pruritis, jaundice, xanthelasmas and is positive for anti-mitochondrial antibodies- what is the best treatment? Diagnosis?

A

Ursodeoxycholic acid

Primary biliary cirrhosis

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

What are some manifestations of systemic sclerosis?

A

GERD, R heart failure, HTN, anti-topoisomerase antibodies, pulmonary fibrosis

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

What is the treatment for cat scratch disease?

A

Azithromycin for 5 days

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

How does sodium bicarbonate help with treatment of TCA overdose?

A

Alleviates depressive action on Na channels by increasing extracellular Na

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

Patient’s with suspected ACS should be administered what ASAP?

A

Aspirin, decreases mortality

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

Why would someone who received multiple units of pRBC have parasthesia?

A

Blood products can have large amounts of citrate which chelates Ca and causes hypocalemia

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

A patient has leukocytosis following an asthma exacerbation- why?

A

Probably received glucocorticoids which mobilize the marginal pool of neutrophils

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

A patient with HTN and a fib comes in with dry skin, weight gain, fatigue, and difficulty concentrating. What medication could be responsible?

A

Amiodarone- it is inducing hypothyroidism

Also look out for pulmonary fibrosis and hepatotoxicity

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

How do you treat pseudotumor cerebri?

A

LP to let out some of the pressure- until opening pressure < 20

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

What 3 organs are typically affected by GVH disease?

A

Liver, skin, intestine

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

What are some signs of drug induced interstitial nephritis?

A

acute renal failure, arthralgia, rash, and WBC casts of eosinophils

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

What are causes of atrial fibrillation?

A

HTN, valvular disease, hyperthyroid, drugs, pulmonary embolism, CHF

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

What is the best treatment for someone with EKG changes and hyperkalemia?

A

IV Ca gluconate

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

A patient undergoes a CABG procedure and requires 10 units of pRBC and develops hypotension during the procedure. He then develops jaundice on POD 3- why?

A

Post-op cholestasis

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

What is the SAAG?

A

Serum ascites albumin gradient- serum albumin - fluid albumin
> 1.1 is consistent w/ portal HTN

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

What vaccine should people over 65 get who already had pneumovax?

A

Varicella

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

What one time screening should be done in patients >65 who have 10 year pack history?

A

Abdominal ultrasound to rule out AAA

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

What is the treatment for acute cocaine intoxication?

A

BZDs

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

What medication has been proven to decrease the frequency of relapse with alcoholics?

A

Naltrexone

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

A patient with prostate cancer now has low back pain- best diagnostic test?

A

MRI of thoracolumbar spine to look for bony metastasis

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

How to diagnose and treat chronic cough NOT caused by GERD, allergic rhinitis, or asthma?

A

Inhaled albuterol trial- any response could mean eosinophilic bronchitis
Tx of chronic cough is antihistamines and decongestants

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

A patient has unsuccessfully tried to lose weight with diet and exercise for 3 years- what is the next step in treatment?

A

Try orlistat before surgery

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

What is a possible treatment for heavy menstrual bleeding?

A

medroxyprogesterone acetate

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

A woman with amenorrhea has a positive progestin challenge- menses occurred after progestin- diagnosis?

A

Chronic anovulation with estrogen present

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

What is the proper screening test for hearing impairment in the elderly?

A

Whisper test

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

What is be best treatment for disequilibrium causing falls in the elderly?

A

Physical therapy

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

A patient comes in with a BP of 162/100- what is the best treatment?

A

Stage 2 HTN needs 2 DRUGS- HCTZ and ACEI

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

What are some lung parameters seen in neuromuscular respiratory failure?

A

Normal FEV/FVC ratio
Increased RV
Low maximum respiratory pressures

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

A patient with systemic sclerosis has normal lung volumes but worsening dyspnea on exertion- what lung pathology could be occurring?

A

Pulmonary arterial HTN

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

What constitutes a complicated pleural effusion and what is the treatment?

A

pH < 7.2, glucose < 60, LDH > 1000

Treat w/ chest tube b/c will respond poorly to antibiotics

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

A patient has a lymphocyte dominated pleural effusion- next step in management?

A

Pleural biopsy for TB

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

A patient’s well controlled asthma becomes much worse following a URI- what is the best treatment?

A

Short dose of oral corticosteroids to help patient regain control of asthma

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

A patient is having a COPD exacerbation- what can reduce the need for intubation?

A

Noninvasive positive pressure ventilation

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

When is lung transplant considered in COPD?

A

PCO2 > 50 during hospitalization, FEV not > 20%, DLCO < 20%

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

A 65 year old woman has back pain, acute kidney injury, and hypercalcemia- diagnosis?

A

Think multiple myeloma until proven otherwise

Look for lytic lesions on X ray or Bence Jones protein in urine

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

A patient begins taking amitriptyline then comes to the ED with abdominal pain- what is happening and what is treatment?

A

Urinary retention due to anticholinergic effects of TCAs

Urinary cath is diagnostic and therapeutic

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

What is the initial treatment for agitation in the elderly?

A

Low dose haloperidol

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

A patient with hx of NSCLC has a new brain mass at gray-white matter junction- treatment?

A

Resect mass

Whole brain radiation

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

What is the treatment for inferior wall MI?

A

Fluid resuscitation to increase RV stroke volume

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

What will a right heart cath show in PE?

A

Increased RA pressure, increased pulmonary artery pressure, normal PCWP, RV dilatation

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

Which kidney disease is associated with HIV?

A

FSGS

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

A patient develops PNA after being intubated and is not responding to ceftriaxone- next step?

A

Zosyn to cover for pseudomonas

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

How do you treat someone with an area of erythema and induration that grows gram positive branching bacteria?

A

IV penicillin

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

What is the treatment for influenza?

A

Oseltamivir

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

Pleural effusion fluid has a very high amylase- what is the diagnosis?

A

Esophageal perforation

Look for subcutaneous emphysema, mediastinal widening

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

A patient with AML s/p bone marrow transplant has diarrhea and pneumonitis- diagnosis?

A

CMV infection most likely

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

What leads to edema in CHF?

A

Constriction of renal arterioles and renin angiotensin system activation

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

Both tacrolimus and cyclosporine cause nephrotoxicity- what is a side effect of cyclosporine that can help differentiate the two?

A

gum hypertrophy and hirtuism

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

What is the major toxicity of mucophenolate?

A

Bone marrow suppression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

What is the major toxicity of azathioprine?

A

diarrhea, leukopenia, hepatotoxicity

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

A patient comes in with CML what show treatment focus on?

A

Targeting abnormal tyrosine kinase activity- imatinib is one choice

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

What is the pathophysiology behind carpal tunnel syndrome?

A

Deposition of mucopolysaccharide protein complexes

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

What is seen in hereditary spherocytosis with respect to MCHC and RDW and why?

A

Increased MCHC and RDW due to membrane loss and RBC dehydration

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

An HIV patient has a bright red firm friable nodule- diagnosis and treatment?

A

Bacillary angiomatosis

Treat with erothromycin

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

How can acute pancreatitis cause hypotension?

A

Intravascular volume loss due to increased capillary permeability

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

A patient with HIV comes in with pain swallowing and substernal burning? Diagnosis and treatment

A

Esophagitis, most likely from candida
Therefore, treat with fluconazole
Candida»> than CMV

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

What is the classic scenario of dequervian’s synovitis?

A

Newborn mother having pain when she lifts her infant from a crib
Finklestein test: Passive stretching of tendons by moving flexed thumb into the palm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

What are 2 common side effects of EPO therapy?

A

Worsening of HTN

Headaches

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

A patient with a h/o radiation therapy presents with hepatomegaly, ascites and increased JVP- diagnosis?

A

Constrictive pericarditis

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

How can PCWP differentiate between cardiogenic and hypovolemic shock?

A

Will be high in cardiogenic shock and low in hypovolemic

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

What are some complications of acute pancreatitis?

A

Pleural effusion, ARDS, ileus, and renal failure

Typically caused by activation of pancreatic enzymes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

How can nephrotic syndrome cause hypercoaguability?

A

Increased loss of pro-coagulation proteins due to proteinuria

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

A patient was recently discharged from the hospital after having hallucinations and now presents with muscle rigidity, mental status changes, fever, and diaphoresis- diagnosis?

A

Neuroleptic malignant syndrome- patient was most likely taking anti-psychotics which have dopamine antagonist effects causing NMS

82
Q

What is first line treatment for chronic OA?

A

Tylenol

NSAIDs are for acute exacerbations

83
Q

Nikolsky’s sign is associated with what disease?

A

Pemphigus vulgaris

84
Q

What is the most common cause of nephrotic syndrome in patients with Hodgkin’s lymphoma?

A

Minimal change disease

FSGS can also occur

85
Q

What effects can digitalis have on EKG and how?

A

Can cause atrial tachycardia and AV block

Caused by increased vagal tone and decreased conduction through AV node

86
Q

What are some exacerbating and relieving factors in lumbar stenosis?

A

Exacerbated by narrowing of spinal canal via extension- standing and downhill walking
Relieved by widening of spinal canal via flexion- sitting and walking uphill

87
Q

What is an effective treatment for fibromyalgia?

A

TCAs such as amitriptyline

88
Q

A 70 year old woman has femoral bowing and hearing loss- diagnosis and pathophysiology?

A

Paget’s disease via osteoclast dysfunction

89
Q

What can cause pain and tenderness over anteromedial tibia?

A

Anserine bursitis

Prepatellar bursitis causes swelling below patella

90
Q

A 30 year old male has positive P-ANCA and bloody diarrhea. Also has painful erythematous nodules over his shins- diagnosis?

A

He has IBD- UC can be P-ANCA positive!

91
Q

A patient following a major surgery requiring 10 units of RBC has hypotension and hyperbilirubinemia- diagnosis?

A

post-op cholestasis

92
Q

How does portal HTN cause ascites?

A

Increased capillary hydrostatic pressure

93
Q

A patient has isolated shoulder pain and a normal shoulder exam- next step?

A

CXR to look for etiology of referred shoulder pain

94
Q

What is the best treatment for gout acute attacks?

A

NSAIDs

95
Q

What is the best treatment for chronic gout?

A

Allipurinol and low dose colchicine

Give colchicine to avoid flare up after initiating uric acid lowering therapy

96
Q

What is more diagnostic of rheumatoid arthritis- imaging or rheumatoid factor?

A

Imaging of bony or cartilage erosions more specific than rheumatoid factor

97
Q

A patient with rheumatoid arthritis refuses to stop drinking two glasses of wine a day but needs medication beyond NSAIDs- what DMARDs should be avoided?

A

Methotrexate due to hepatotoxicity

98
Q

A 30 year old man has rapid onset of psoriatic arthritis- what could be an underlying problem?

A

HIV can cause explosive onset psoriasis

99
Q

What is the diagnostic criteria for SBP?

A

PMN count> 250 in ascites fluid

100
Q

A patient without alcohol use presents with elevated lipase. U/S for gallstones are negative. He has crops of yellow papules on his arms- diagnosis?

A

Pancreatitis via hypertriglyceridemia- eruptive xanthomas on his arm

101
Q

A patient presents four weeks after d/c for pancreatitis diagnosis with palpable abdominal mass and elevated lipase- diagnosis?

A

Pancreatic pseudocyst

102
Q

A CT scan shows dilated central bronchi and thickened bronchial walls- diagnosis and most common complication?

A

Bronchiectasis

Can cause hemoptysis

103
Q

What is the treatment for diabetic retinopathy with macular edema?

A

Photoanticoagulation

104
Q

LDL goal for patient with 0 risk factors?

A

<190

105
Q

How do you manage hypothyroid in pregnancy?

A

Monitor TSH levels- levo doses may need to be increased

106
Q

What is the treatment for Graves disease?

A

Atenolol and methimazole

107
Q

What diuretic can cause severe hyponatremia?

A

HCTZ

108
Q

How can pancreatitis cause hypocalcemia?

A

Generation of free fatty acids chelate insoluble calcium salts resutling in hypocalcemia

109
Q

A patient with rheumatoid arthritis has a ferritin of 50 on iron studies- what type of anemia?

A

Iron deficiency w/ anemia of chronic disease

Ferritin< 100 is suspicious for mixed anemia w/ iron deficiency

110
Q

What is the best test for osteonecrosis when X ray is normal?

A

MRI»> radionuclide bone scan

111
Q

What is the triad of TTP?

A

hemolytic anemia, thrombocytopenia, CNS symptoms

112
Q

A patient prefers colon cancer screening by FOBT x3 annually. One is positive- what is next step?

A

Colonoscopy

113
Q

A patient has a breast mass with BIRADs score of 2 on mammography?

A

US to see if fluid filled or solid mass

114
Q

A man with a history of prostate cancer reports for check up. denies symptoms, but bone scan shows multiple metastases- best treatment?

A

Leuprolide- GnRH agonist

115
Q

A patient with history of cancer and metastasis has moderate pain not controlled by NSAIDs- next step?

A

Short acting opioids first

Long acting are used once pain is controlled and dose is calculated

116
Q

A patient with sepsis and a platelet count less than 30 should receive what treatment to improve mortality?

A

Protein C

117
Q

A patient presents with acute prostatitis and does not respond to IV fluoroquinolones- next step?

A

Look for abscess- transrectal US

118
Q

A pregnant woman has asymptomatic bacturia- next step?

Is the next step different for non-pregnant woman?

A

Pregnant- Amoxicillin! do NOT observe

Non-pregnant- Observe

119
Q

What is standard outpatient treatment for women with pyelonephritis who are not pregnant?

A

FQ for 7-10 days

120
Q

A 25 year old sexually active woman comes to the dr for a checkup. She has no symptoms but has not been to the drs for 3 years. What STD screening should be done?

A

HIV, G, C

Syphilis only if she is at risk

121
Q

What is the best way to prevent ventilator associated pneumonia?

A

Semi-erect positioning of the patient- 45 degrees

122
Q

A patient has N. meningitidis- next step in precautions?

A

Face mask- nasopharynx is the reservoir

123
Q

A 66 year old patient presents for a check up. PMH significant for severe pneumonia 4 years ago where he was given pneumovax prior to discharge. Does he need pneumovax again?

A

Yes- should receive 2nd dose of vaccine 5 years after initial dose if initial dose < 65 years old

124
Q

A patient has suspected vertebral osteomyelitis after getting MRI and X ray- what is next step?

A

Get blood cultures before antibiotics

Typically- ceftriaxone is good coverage EXCEPT for MRSA, hence blood cultures

125
Q

A patient is going to the dentist…Prophylaxis?
Has a heart murmur without vegetations
Has a heart murmur with vegetations
Has a heart murmur with vegetations and allergic to penicillin

A

No vegetations means NO prophylaxis
Penicillin is 1st choice
If allergic- clindamycin

126
Q

A patient presents with diarrhea and tenesmus within 6 weeks of radiation therapy- diagnosis and test?

A

Radiation proctitis- diagnose with flex sigmoidoscopy

127
Q

What the treatment of salmonella causing bloody diarrhea

A

Supportive unless immunocompromised

128
Q

How do you diagnose HUS?

A

Blood smear

129
Q

What are the 2 most likely causes of painless rectal bleeding in elderly patients?

A

Diverticulosis and vascular ectasia

130
Q

Anti smooth muscle antibodies are associated with what?

A

Autoimmune hepatitis

131
Q

What is the triad of hypotension, clear lung fields, and elevated central venous pressure indicative of? Treatment?

A

R ventricular failure

Tx is normal saline

132
Q

A patient with history of CAD and angina presents with increasing symptoms, still only with exercise. What is the next step?

A

Coronary angiography- no need for stress test

133
Q

A patient has new onset heart failure, confirmed low EF by echo- what is the next step?

A

Coronary angiography to assess for potential revascularization

134
Q

A sex worker presents with elevated transaminases and normal PT. On day 3 of hospitalization transaminases are decreasing but PT is markedly increased- what is happening?

A

Progression to fulminant liver failure- very few functioning hepatocytes
Without rising PT, could just be recovery from liver injury

135
Q

What CBC finding is a poor prognostic indicator in CLL?

A

Thrombocytopenia

136
Q

What side effect of Ca channel blockers could be mistaken for heart failure?

A

Edema

137
Q

What is first line treatment for MALT lymphoma?

A

Treat H pylori first, then possibly chemotherapy

138
Q

What are two signs that BPH should be evaluated further?

A

Increased Cr or abnormal UA- signs of kidney damage

Get renal US

139
Q

A 30 year old patient presents with headaches and right sided renal bruit- best treatment?

A

Stent placement&raquo_space;> medical management

140
Q

What abnormal lab value is caused by lupus anti-coagulant but what is the clinical presentation?

A

Prolonged PTT

Presents with clots- miscarriages are common

141
Q

What is terminal hematuria indicative of?

A

Prostae or bladder disease

142
Q

What is the best medication for anorexia associated with cancer?

A

Progesterone analog&raquo_space;» cannabanoids

143
Q

A diabetic presents with foot pain and X ray shows loss of cartilage, osteophyte formation, and loose bodies- diagnosis?

A

This is charcot’s joint- due to nerve damage

144
Q

What three veins form the most DVTs

A

Femoral, iliac, and popliteal

145
Q

Rank the ways to lower BP by greatest effect: reduce alcohol intake, DASH diet, weight loss, exercise, decreased sodium intake?

A

Weight loss»DASH»exercise»Na restriction»alcohol

146
Q

A smoker presents with a palpable neck lymph node positive for squamous carcinoma- next step?

A

Pan-endoscopy to find tumor

147
Q

A patient presents with a malar rash, proximal muscle weakness causing difficulty rising from a chair- diagnosis?

A

Dermatomyositis- NOT SLE

DM associated with ovarian and breast cancer

148
Q

Rheumatoid arthritis increases risk for what?

A

Osteoporosis

149
Q

A 35 yo woman with chronic headaches presents with painless hematuria- diagnosis?

A

Analgesic nephropathy–> papillary necrosis

She is probably using a lot of NSAIDs

150
Q

HIV drug side effect- didanosine?

A

Pancreatitis

151
Q

HIV drug side effect- abacavir

A

Hypersensitivity

152
Q

HIV drug side effect (drug class)- NRTIs

A

Lactic acidosis

153
Q

HIV drug side effect- NNRTIs?

A

SJS

154
Q

HIV drug side effect- nevirapine?

A

Liver failure

155
Q

HIV drug side effect- indinavir?

A

Crystal induced nephropathy

156
Q

How is MPGN different than other glomerulopathies?

A

Activation of complement in MPGN

Others are mostly immune complex mediated damage

157
Q

What should be performed before starting trastuzumab?

A

Echocardiography

Cardiotoxicity

158
Q

How can diabetic neuropathy cause urinary incontinence?

A

denervated bladder–> detrusor muscle weakness

159
Q

Why are people with multiple myeloma at increased risk for infection?

A

Inability to produce functioning antibodies

160
Q

A patient has a MI then 3 days later develops a cold leg–> next step?

A

Get Echo to look for LV thrombus

161
Q

What is a particular extra-colonic tumor to look out for in Lynch syndrome?

A

Endometrial cancer in women

162
Q

What is the treatment for stroke in a sickle cell patient (acutely)?

A

Exchange transfusion

163
Q

What is the treatment for acetaminophen overdose if patient comes in 1 hour after ingestion (3 steps)?

A

Activated charcoal
Test levels at 4 hours
Decide if N-acetylcysteine is necessary

164
Q

What part of the spine is most likely involved in RA?

A

Cervical spine

165
Q

A patient with a recent URI comes in with symptoms of CHF- what will be seen on Echo?

A

Dilated ventricles w/ hypokinesia

Patient has virus induced dilated cardiomyopathy

166
Q

What are two symptoms seen in mononucleosis NOT seen in strep pahryngitis?

A

Splenomegaly and cervical lymphadenopathy

167
Q

What are patients with HIT more prone to- hemarthrosis or arterial thrombosis?

A

Thrombosis! Platelets are activated by antibody!

168
Q

What are two risks of nephrotic syndrome unrelated to kidneys?

A

Accelerated atherosclerosis

Hypercoaguable

169
Q

What is the most likely finding on renal biopsy in a patient with SLE and proteinuria?

A

Amyloidosis- deposits under polarized light

170
Q

A patient with CKD is in EPO therapy for chronic anemia but not improving- what else can be done?

A

Iron supplement- EPO can use up iron stores quickly

171
Q

What is the preferred antifungal treatment for histo?

A

Itraconazole»»fluconazole

172
Q

What EKG finding is specific for pericarditis?

A

Electrical alternans- QRS complex amplitudes vary from beat to beat

173
Q

What is pulsus paradoxus and what are 3 conditions where it is seen?

A

> 10mg drop in systolic blood pressure during inspiration

Tamponade, COPD, asthma

174
Q

A patient with chronic HCV comes in with elevated ALT and detectable HCV RNA- treatment?

A

Interferon and ribavirin

175
Q

What is the most rapid acting medicine to relieve dyspnea associated with cardiogenic pulmonary edema?

A

Nitroglycerin

176
Q

Why would a patient taking benadryl have trouble urinating?

A

Anticholinergic effects causing detrusor inactivity

177
Q

Why is sodium level important in heart failure?

A

Hyponatremia can signify worsening HF

178
Q

What risk factor is most associated with AAA expansion and rupture?

A

Smoking!

Not HTN

179
Q

A patient with COPD has new onset of clubbing in his fingernails- diagnosis?

A

Lung cancer

180
Q

What are three commonly prescribed drugs that potentiate warfarin’s effects?

A

Acetaminophen, NSAIDs, amiodarone

Some antibiotics too

181
Q

A patient has CAD and PAD and is resistant to a mutli-drug regimen for HTN- what other finding is likely?

A

Renal artery stenosis and abdominal bruit

182
Q

What dictates the treatment in polymyalgia rheumatica? Will present with stiffness in neck, shoulders, and pelvic girdle.

A

Presence of giant cell arteritis means high dose prednisone

No GCA then low dose

183
Q

What does a positive straight leg raise test signify?

A

Likely herniated disc

treat with NSAIDs and returning to normal activities

184
Q

A patient with HSV meningitis develops renal failure in the hospital during treatment- why?

A

Crystalluria causing obstruction due to acyclovir

185
Q

What response does pneumococcal vaccine produce?

A

B cell response independent of T cells

due to polysaccharide

186
Q

What is the treatment for PVCs post MI?

A

NOTHING

Unless symptomatic- then beta blockers

187
Q

A patient withe anemia has a hepatic venous thrombosis- what is the likely cause of anemia?

A

PNH is known for causing venous thrombosis

188
Q

What nephrotic syndrome most commonly causes renal vein thrombosis?

A

Membranous glomerulonephritis

189
Q

How do histamine blockers help with post-nasal drip?

A

Decrease secretions

190
Q

A mobile mass in the lung with intermittent hemoptysis is indicative of what?

A

Aspergilloma

191
Q

Which pneumonia causing bacteria can cause erythema multiforme?

A

Mycoplasma pneumo.

192
Q

What is the treatment for uric acid stones?

A

Potassium citrate to alkalinize the urine

193
Q

Hemochromatosis increases risk for what type of infection?

A

Listeria

194
Q

What is the most frequent ectopic foci for A fib?

A

Pulmonary veins

195
Q

A patient with metastatic prostate cancer to the bone has balance issues- what is the first step?

A

Give steroids in attempt to preserve neurologic function via reduced swelling
Imaging would be MRI

196
Q

An HIV patient with bloody diarrhea gets a colonic biopsy showing cells with eosinophilic intranuclear and basophilic intracytoplasmic inclusions- diagnosis

A

CMV

197
Q

What is the most common cause of death in acute MI

A

reentry arrhythmia

198
Q

What mitral valve abnormality is seen with HOCM?

A

Anterior leaflet motion

199
Q

A patient with cirrhosis wants to follow medical advice after years of drinking. He has a US of the liver and it shows no masses. What is next step?

A

Endoscopy to look for varices- major cause of morbidity and mortality

200
Q

What is the treatment for TTP

A

Plasma exchange

201
Q

An elderly patient with fatigue and lymphadenopathy has anemia- treatment?

A

Prednisone
Has NHL and autoimmune hemolytic anemia
If prednisone fails–> splenectomy

202
Q

In RA, what causes a Baker’s cyst?

A

Inflamed synovium

Internal Medicine (1 decks)

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