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Questions Flashcards

1
Q

What is the next best step after establishing the diagnosis of myasthenia gravis?

A

Chest X-ray to r/o thymoma

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2
Q

Who always gets a statin accoring to current guidelines?

A

Diabetic ages 40-75

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3
Q

Shiny tongue with vitalligo

A

Pernicious anemia– Ab against intrinsic factor

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4
Q

HIV pts with a CD4 of <50 require prophylaxis for what infection? With What Abx?

A

Mycobaterium Avium Complex (MAC)

Azithromycin

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5
Q

Loss of the gallbladder ducts is commonly seen in what disorder?

A

Primary biliary cirrhosis

Chemotherapy

GVHD

CMV

Hodgkin disease

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6
Q

Treatment for ethylene glycol poisoning

A

Ethanol or fomepazole (alcohol dehydrogenase inhibitor)

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7
Q

Explain type II HIT

A

Type II HIT is the result of heparin binding to platelet factor 4.

The heparin-PF4 complex then binds IgG. This leads to activation of platlets and sequestion of the patelets by the spleen.

This causes thrombosis and thrombocytopenia

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8
Q

Most common cause of PNA in nursing homes

A

S. pneumonia

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9
Q

Equation to calculate osmolar gap

A

2xNa + BUN/2.8 + Glucose/18

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10
Q

How much fluid given to burn patient

A

4mL per 1% burn

(rule of 9s)

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11
Q

Most common EKG abnormality seen in hypothermia

A

J point elevation

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12
Q

Common side effect of hydroxychloroquine

A

retinopathy

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13
Q

Causes of AKI with acyclovir treatment

A

Acyclovire when given IV can chrystallize in the urine causing obstructive uropathy

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14
Q

Give this to treat epiglottitis…what to give close contacts

A

Ceftriaxone

give close contacts Rifampin

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15
Q

Gray highly vascular membrane on the pharynx of a sick child…dx? Tx?

A

Diptheria

Tx with antitoxin

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16
Q

Signs of vitamin B2 (riboflavin) deficiency

A

Chelosis

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17
Q

Arrythmia most specific for digoxin tox

A

atrial tachycardia with AV block

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18
Q

Combination of nephrotic syndrome, hepatomegaly, palpable kidneys and ventricular hypertrophy is suggestive of…

A

Secondary amyoldosis (AA)

tx: colchicine

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19
Q

Vitamin B3 (niacin) deficiency

A

4D’s

Dermatitis

Diarrhea

Dementia

Death

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20
Q

Which type of dementia is associated with alterations in level of consciousness and EPS

A

Lew body dementia

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21
Q

Calculation to adjust Ca for albumin

A

Serum Ca - ( 0.8 (4 - albumin))

22
Q

Mnemonic to remember gravity and parity

A

F-PAL

Full term

Pre term

Abortions

Living Children

23
Q

Most commonly induced HIV nephropathy

A

Focal segmental glomerulosclerosis

24
Q

Commone side effect of statin

A

elevated transaminases

Myositis

25
Q

Side effects of niacin

A

elevated glucose, uric acid and pruritis

26
Q

Side effects of fibrates

A

Elevated rate of myositis when used with statins

27
Q

Side effects of cholestyramine

A

flatus and abdominal cramping

28
Q

Common side effects of CCB

A

Edema

Constipation

29
Q

ST elevation in V2-V4 corresponds to ischemia here

A

Anterior wall MI= high mortality

30
Q

Which leads correspond to inferior wall MI?

A

ST elevations in II, III, aVF

31
Q

Ho long does CK-MB stay elevated in a patient post MI? Why is this important to know?

A

1-2d

It is most specific for re-infarction because Tropnins stay elevated for 10-14d

32
Q

Describe the S4

A

Late diastolic murmur heard when an atria contracts against a stiffened ventricle

33
Q

Describe S3

A

Low frequency

Early Diastole, just after the S2 in early diastole

Normal in young people

Indicates elevated ventricular diastolic filling pressures

may be first clinica sign of CHF

34
Q

Initial teo drug therapy in CHF

A

ACEi or ARB with a diuretic (loop)

Spironolactone is given for anti-aldosterone effect not diuretic effect

35
Q

What treatments are shown to have a mortality benefit in systolic dysfunction?

A

ACEi/ARB

B-blocker

Spironolactone

Hydralazine/nitrate

implatable defib

36
Q

This drug shows clear benefit in CHF with diastolic dysfunction

A

B-blocker

37
Q

Best INITIAL therapy for CHF with pulmonary edema

A

Loop diuretic

38
Q

All left sided murmurs will increase on expiration except for these two

A

HOCM

Mitral valve prolapse

39
Q

Pulsations in the nail bed, BP in legs 40mmHg higher than arms, and a wide pulse pressure are all signs of this

A

Aortic regurgitation

40
Q

Which manuveurs improve MVP murmur? Why?

A

Anything that increases LVEDV becuase the valve will be more stretched out and less likely to “snap” backwards

41
Q

Most commom cause of hypertrophic cardiomyopathy

A

Hypertention

42
Q

Erythematous papules and plaques that are present on the face, extremities and perineum in patients with glucagonomas

A

Necrolytic migratory erythema

43
Q

Treatment of choice for uncomplicated cystitis in a female

A

Nitrofurantoin or tmp/smx

44
Q

Treatment of choice for complicated UTI in female

A

Fluroqinnolones

45
Q

Abx of choice for a neonate <1yo for pertussis prophylaxis

A

Azithromycin

NOT erythromycin due to pyloric stenosis

46
Q

Best choice Abx for human bite patient

A

Amoxicillin-clavulanate

47
Q

Isloated alk phos incidentally discovered in elderly patient. Most like Dx?

A

Paget disease of bone

48
Q

Early 20s African American female with slow onset dry scaly skin diffusely with horns and plaques

A

Icthyosis Vulgaris

49
Q

Hosimoto patients are at high risk for this malinancy

A

Thyroid lymphoma– rapidly enlarging gland with donut sign

Needs core bopsy for dx

50
Q

Discuss CAH

A
51
Q

Durring which week is external eversion indicated in a patient with a breech presentation?

A

Not until the 37th week

52
Q

An HIV patient presents with non-specific symtoms of malaise, fever, cough, abdominal pain and aches. Their alkphos is elevated. CD4 is <50.

Most likely Dx?

What prophylactic drug would have prevented this?

A

MAC- Disseminated mycobaterium complex

Axitromycin would have prevented

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