Radiology

Question 1

Pneumonia with brown mucus plugs, eosinophilia, and hemoptysis
CXR: “tram lines”, “parallel lines”, “gloved finger shadow” from the hilus

Answer 1

Allergic bronchopulmonary aspergillosis (ABPA)

Question 2

Managment of symptomatic pancreatic pseudocyst

Answer 2

Percutaneous drainage

Usually occurs weeks after acute pancreatitis

Question 3

Tx for out pt CAP?

Answer 3

Azithromycin
Ceftriaxone
Most likely organisms - S. pneumo, Mycoplasma pneumo

Question 4

Tx for hospitalized CAP?

Answer 4

IV ceftriaxone OR cefepime, OR amp-sulbamctam
PLUS
Macrolide OR clarithromycin OR doxycycline

Question 5

What are the CURB-65 criteria?

Answer 5

If pt has 2 of the following they will require inpt management of CAP
Confusion
Urea >7mmol or 20mg/dL
Respiratory rate >30/min
BP <90/60 mmHg
65 or older

Question 6

Tx for neurocysticercosis

Answer 6

Albendazole + dexamethasone to reduce inflammation caused by dying cysts
Can also use praziquantel
Also give an antiepileptic

Question 7

HIV + man with low CD4 count and multiple ring-enhancing lesion on CT

Answer 7

Toxoplamsosis
Tx - Pyrimethamine and sulfadiazine (best for cerebral toxo, bactrim is a better prophylactic choice)
If single lesion - CNS lymphoma more likely

Question 8

Bamboo spine on Xray

Answer 8

Ankylosing spondylitis

Tx - Indomethacin

Question 9

Extrarenal complications of ADPKD?

Answer 9

Intracranial berry aneurysms
Cardiac valve dz
Hepatic cysts
Colonic diverticula

Question 10

How do you manage an incidental finding of asymptomatic porcelain gallbladder?

Answer 10

Prophylactic cholecystectomy

20% risk for progression to gallbladder carcinoma