QBankin' on doing well? Get after it! (mostly card/resp)

Question 1

A patient was recently started on a new drug and has developed edema, but NO other symptoms. What drug was this patient started on?

Answer 1

Amlodipine (or another dihydropyridine)

Question 2

A newborn has decreased pulmonary markings and left axis deviation (normally have right axis deviation). What is the likely cause?

Answer 2

Tricuspid valve atresia –> hypoplastic right ventricle

Question 3

In cardiac terms, what does standing or the valsalva maneuver do?

Answer 3

Decreases venous return

Question 4

Kid comes in with stridor that is better when she extends her neck. What does she have? What is it associated with?

Answer 4

Vascular ring

Cardiac anomalies

Question 5

Kid comes in with stridor that is worse with laying down. What is it?

Answer 5

Laryngomalacia

Question 6

Which arm has a higher BP in a coarctation?

Answer 6

Right greater than left

Question 7

A patient is unconscious and pulseless, but is found to have a electrical activity. What is the management?

Answer 7

CPR and vasopressor to treat PEA

Question 8

When does contrast induced nephropathy resolve?

Answer 8

3-5 days after contrast

Question 9

A patient has angiography done and like a week later has mottling of the skin on his feet, eosinophilia, and shitty renal labs. What happened?

Answer 9

Cholesterol embolization

Question 10

When should stenotic aorta be replaced?

Answer 10

SAD Left ventricle, or CABG

S-Syncope
A-Angina
D-Dyspnea

Question 11

Why do kids with ToF often squat/bring knees to their chest?

Answer 11

Increases vascular resistance –> increases LV pressure…no longer a R-to-L shunt

Question 12

An asthma patient comes in with an exacerbation. No new exposures. No sick contacts. Recently had headaches for which she took aspirin. What caused the exacerbation?

Answer 12

Aspirin…beta-blockers can do it too

Question 13

How does the dipyridamole stress test work?

Answer 13

Coronary steal…tries to dilate all vessels, but diseased are already maximally dilated…dilating other vessels further decreases perfusion to diseased

Question 14

A man from Wisconsin comes in with breathing issues, skin lesions, and bone pain. What does he have?

Answer 14

Blastomycosis

Question 15

How is inpatient community acquired pneumonia treated?

Answer 15

Fluoroquinolone; OR

beta-lactam + macrolide

Question 16

How do anti-muscarinics help with COPD?

Answer 16

Cause bronchodilation on top of reducing allergies

Question 17

What increases the risk of RDS?

Answer 17

Prematurity
Maternal diabetes
C-section

Question 18

A youngish woman keeps getting CAP. What could be going on?

Answer 18

IgG3 immunodeficiency

Question 19

What is the CHADS-VASc score calculated for? How?

Answer 19

Necessity of anticoag…consider w/ score of 1, give if 2

	C- CHF → +1
	H- HTN → +1
	A- Age > 75 → +2
	D- DM → +1
	S- Stroke/TIA/Thromboembolism → +2
	V- Vascular disease → +1
	A- Age 65-74 → +1
	Sc- Sex category (female) → +1

Question 20

Patient comes in after recently traveling with a high fever, likely pneumonia, headache, and watery diarrhea. What is the bug? What is the treatment?

Answer 20

Legionella (can get a piss test)

Fluoroquinolone
Newer macrolides

Question 21

A patient keeps getting sick and then it says something about really low CD-19 lymphocytes. What is the disease? What is the treatment?

Answer 21

X-linked agammaglobulinemia (Bruton’s agammaglobulinemia)

IV immunoglobulins (IVIG)

Question 22

A patient comes in with cardiac symptoms, so was started on nitroprusside. Later on, was talking nonsense and having seizures. Labs show lactic acidosis. What happened? What else is likely going on?

Answer 22

This is cyanide toxicity

Patient also likely has renal insufficiency