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Question 1

Can lactose intol pt have yogurt?

Answer 1

Yea! Fermented milk with live cultures have b galactosidase which is well tolerated in pts

Question 2

What are the most common adverse inhospital events?

Answer 2

In surgery pts- wound inf, bleed, dvt

In medicine pts- most common is adverse DRUG event like hypoglycemia, abx, narcotics 5-7% hospitalized
Falls only make up 1-2%
Hospital inf makes up 4%
Pressure ulcers up to 5%

Question 3

Restless leg syndrome needs only one lab test. What is it?

Answer 3

Ferritin bc often assoc w IDA

Question 4

Tx of restless leg syndrome

Answer 4

If mild then decr caffeine and alcohol, incr mentally stim activities

If severe then dopamine agonists like pramiprexole or ropinorole

Question 5

Main side effect of GINGKO? Why is it used?

Answer 5

Bleeding and plt dysfunction by inh platelet activating factor.

Used as memory booster bc incr cerebral blood flow and may be effective for alzheimers and claudication

Question 6

Medicare coverage- parts a to d?

Answer 6

A- inpt, SNF, hospice
b- outpt, obs
C - medicare advantage allows u to also enroll in private insurance
D - prescriptions

Question 7

When to refer to bariatric surgery?

Answer 7

Failed diet, behavior, medical therapy

Bmi>35 and comorbidies or bmi>40

Question 8

Antidote to organophosphate poisoning (cholinergic receptor) causing constricted pupil, salivation, wheezing,sweats, drooling

Answer 8

Atropine (antimuscarinic) and pralidoxime (cholinesterase inh)

Question 9

Injestion of fish causing flushing, headache, palpitations, abd cramps, diarrhea

Answer 9

Scromboid poisoning due to improperly stored seafood causing histamine release

Vs pufferfish causing neuro symp

Question 10

Acute vision loss in one eye without pain? What do u see on eye exam?

Answer 10

crao

On exam with pale fundus and a cherry red spot. Tx to decr intraocular pressure with massage and acetazolamide

Va optic neuritis- vision loss with eye pain that worsens with movement. On exam with optic disc edema

Vs crvo similar but not due to embolism. On exam w dilated veins, diffuse hemorrhage, sic swelling

Question 11

Ams, basilar crackles, bradypnea, pupils 2 mm

Answer 11

Opioid intox esp in setting of renal injury. Normal pupil size 4 mm

Question 12

Ams, basilar crackles, bradypnea, pupils 2 mm

Answer 12

Opioid intox esp in setting of renal injury. Normal pupil size 4 mm

Question 13

Narcolepsy treatment

Answer 13

Modafinil (nonaddicting stimulant) . Take scheduled naps during day.

Question 14

Daytime sleeping, cataplexy (lows of muscle tone with stress or argument), hypnagogic hallucination.

How do u tx the cataplexy?

Answer 14

Snri like venlafaxine or ssri or tca to treat cataplexy

Question 15

Primary amenorrhea, bl inguinal hernias, breasts without pubic hair

Answer 15

Androgen insensitivity - XY. vagina ends in blind pouch.

Va klinefelter is XXY looks like male with small testes and gynecomastia

Question 16

A drug test is a urine what test? Immunoassay or chromatography?

Answer 16

Immunoassay

Question 17

Uses and side effects of:
Gingo and gingseng
Saw palmetto
St johns worts
Kava
Licorice!
Black cohosh
Horse chestnut

Answer 17

Gingo and gingseng for memory but incr risk of bleed
Saw palmetto for bph but incr risk bleed
St johns wort for depression/insomnia but interefere w lots drugs and also cause htn crisis
Kava for anxiety and insomnia causes severe liver dmg!!!
Licorice cause htn
Black cohosh for pms and menopause cause hypotension
Horse chestnut for venous stasis cause bleed

Question 18

The best predictor of a pt suffering from back pain returning to work is:
Depreasion
Job satisfaction
Stress
Patients expected recovery time

Answer 18

Pts expected recovery time which doctors should help pts figure out!

Question 19

Sudden onset hyperglycemia in setting of TPN is due to

Answer 19

Sepsis

Question 20

Injestion causing bradycardia, miosis, wheezing, skin flushing? What is best way to dx?
Utox
Rbc cholinesteraae

Answer 20

Organophos poisoning - dx w rbc cholinesterase

Question 21

Bacterial conjunctivitis untreated can lead to..

Tx? And for how long?

Answer 21

Keratitis!! Inflammation of cornea which is more srs and in contact lense wearers

Vs endopthalmitis is more serious and deep inf in vitreous and aqueous humor- maybe due to eye injury or surgery

Tx is erythromycin ointment! Only reserve oxacin for contact lens wearer!! Tx for 24 hrs before pt returns to school to decr transferring

Question 22

How long before a viagra taking pilot can drive a plane?

Answer 22

6 hrs due to blue green color distortion

Question 23

Before can start peritoneal dialysis in pt with apckd, need additional img. What kind?

Answer 23

Cscope be incr risk of diverticulosis

Question 24

Could have prevented fall in >65 yo on klonipin and exercises regularly if: stength training/gait exercise vs avoid benzo

Answer 24

Avoid benzo. This pt is active and no instability.

Question 25

Which is most common cancer w sjogrens disease?

Answer 25

B cell nonhodgkin lymphoma

Question 26

How to preserve donor organ?

Answer 26

Euvolemic NORMOTENSIVE and normothermic!!! Not hypothermic

Question 27

Overdose accidental on antifreeze. Antidote?

Answer 27

Fomepizole only!! Dont need to combine w ethanol!
Antifreeze is ethylene glycol. Also methanol can receive fomepizole.

If homeless person is intoxicated on thay then u can give just ethanol

Question 28

Are you allowed to precribe ur friends adderall? What do u say?

Answer 28

Altho id like to help i am UNCOMFORTABLE prescribing for someone i am not treating

It is generally unethical BUT not always ie if emergency and thus u r allowed to!!

Question 29

Opioid withdrawal tx

Answer 29

Methadone - only if pt adherent and will be monitored outpt

Clonidine is alpha agonist good too

Question 30

Laser or dermabrasion to remove tattoo from 10 yrs ago side effect

Answer 30

Scar or skin discoloration

Removing it doesnt matter on how long ago it was placed

Question 31

If woman says sex life not pleasurable ask

Does ur hubs have erectile dysf?
Or tell sometimes menopause can make more difficult

Answer 31

Menopause bc of vag dryness and dyspareunia