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MTBs Step 3 > Random Ass Qs (IM) > Flashcards

Random Ass Qs (IM) Flashcards

1
Q

Initial evaluation of HTN

A
  • urinalysis (protein, blood, glucose)
  • EKG
  • fasting lipids
  • BUN/creatinine
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2
Q

HRT effects

A
  • alleviate vasomotor instability
  • reduce risk of osteoporosis/fractures
  • reduce incidence of endometrial cancer
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3
Q

Labs that diagnose diabetes

A

Fasting glucose >126
Nonfasting glucose >200 with symptoms
OGTT >200 after 2 hours
A1C > 6.5

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4
Q

Cause of hip pain with long term glucocorticoid use?

A

Avascular necrosis of the femoral head

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5
Q

Initial pharmacotherapy for C dif?

A

ORAL metronidazole

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6
Q

First imaging in suspected gallstone pancreatitis?

A

Ultrasound

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7
Q

Treatment for common bile duct stone causing biliary obstruction?

A

Sphincterotomy and endoscopic removal

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8
Q

Depletion of what molecule leads to the hepatotoxicity of acetaminophen OD?

A

Glutathione

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9
Q

Indicators of poor prognosis in acetaminophen OD?

A
  • serum lactate >3.5
  • pH <7.3
  • renal failure
  • coagulopathy
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10
Q

Chronic diarrhea + pruritic vesiculopapular lesions on extensor surfaces……most likely dx?

A

Celiac sprue

***dermatitis herpetiformis

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11
Q

Diagnostic confirmation of celiac sprue?

A

Small bowel biopsy

**villous atrophy and crypt hyperplasia

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12
Q

Celiac sprue increases risk of what malignancies?

A

Adenocarcinoma and lymphoma of small bowel

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13
Q

Primary sclerosing cholangitis increases risk of what malignancy?

A

Cholangiocarcinoma

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14
Q

Diagnostic test for chronic pancreatitis?

A

CT

**duct dilation, calcifications, pseudocysts

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15
Q

What marker is frequently elevated in pancreatic cancer?

A

CA 19-9

**also seen in cholangiocarcinoma

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16
Q

Initial treatment for reactive arthritis?

A

NSAIDs (ie Indomethacin)

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17
Q

Patient does not respond to initial treatment for reactive arthritis, next step?

A

HIV test

***reactive arthritis may be first manifestation

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18
Q

As gout progresses how do frequency and duration of attacks change if untreated?

A

More frequent and last longer

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19
Q

What is initial long term therapy for gout with excessive urate excretion?

A

Allopurinol and colchicine

***allopurinol alone can precipitate attacks when first starting treatment

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20
Q

What is the long term treatment of gout with normal/low excretion?

A

Probenecid

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21
Q

What osteoporosis drug increases bone mass rather than just inhibiting reabsorption?

A

Teriparatide (recombinant PTH)

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22
Q

What is the first test when you suspect pseudotumor cerebri? Second?

A
  • CT/MRI to rule out mass

- LP to check opening pressure

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23
Q

What type of antidepressant can interact with the activity of warfarin?

A

SSRI

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24
Q

What causes cloudy corneas in angle closure glaucoma?

A

Edema

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25
Q

Does the presence of any epithelial cells in urinalysis make it invalid?

A

Nope

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26
Q

What type of medication is contraindicated in Alzheimer’s?

A

Anticholinergics or any drug with anticholinergic effect (ie TCAs)

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27
Q

What anxiolytic would you pick if nonsedation was important?

A

Buspirone

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28
Q

What are properties of anesthetics that have higher potency and longer duration of action?

A
  • higher lipid solubility/higher partition coefficient
  • higher protein binding
  • pKa closer to pH = 7.4
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29
Q

What will hyperkalemia show on EKG?

A

Peaked T waves and widened QRS

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30
Q

What effect can Cisplatin have on electrolytes?

A

Renal potassium and magnesium loss

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31
Q

HTN, abd pain, red-blue rash on extremities, eosinophils in urine and recent hx of MI……dx?

A

Atheroembolic disease from dislodging plaque during cardiac catheterization

32
Q

Why can’t you give NSAIDs with acute renal failure?

A

Potentially nephrotoxic and could prevent recovery of kidney function

33
Q

What would you see in the urine of a patient with lupus nephritis flare?

A

RBC casts

34
Q

What would be the mechanism of acute renal failure during chemotherapy?

A

Tumor lysis syndrome and renal tubular deposition of uric acid

35
Q

What blood labs are seen in nephrotic syndrome?

A
  • low calcium
  • low thyroxine
  • microcytic hypochromic anemia
36
Q

What type of nephropathy is seen in HIV?

A

Collapsing glomerulopathy (variant of focal segmental)

37
Q

What labs denote HBV “window period”?

A

Negative HBs antigen AND antibody

38
Q

Tongue fasciculation, brain inflammation, elderly diabetic…….dx?

A

West Nile virus

39
Q

What is first line medication for strep pharyngitis?

A

Penicillin

***erythromycin or 1st gen cephalosporin if allergic

40
Q

Fever, chills, myalgias and headache 3 hours after receiving penicillin for primary syphilis……dx?

A

Jarisch Herxheimer reaction

**self limiting

41
Q

You suspect a patient has histoplasmosis PNA, what test do you do?

A

ABG to determine hypoxia severity

42
Q

Health care worker gets a needle stick injury. Assuming the patient is positive what is the risk of HBV? HCV? HIV?

A

HBV - 6-30%
HCV - 1.8%
HIV - 0.3%

43
Q

What two drugs have the largest reduction in triglycerides?

A

Nicotinic acid and fibrates

44
Q

What abx treatment is first line in V vulnificus sepsis?

A

Doxycycline + 3rd gen cephalosporin

45
Q

What abx treatment is used for E faecalis sepsis?

A

Ampicillin + aminoglycoside

46
Q

Patient on clozapine develops agranulocytosis…..tx?

A

Granulocyte colony stimulating factor

*****decreasing/discontinuing drug does NOT always prevent progression

47
Q

What labs are seen in primary hyperparathyroidism?

A
  • increased serum calcium
  • decreased serum phosphate
  • increased urine calcium
48
Q

Patient complains of “curtain coming down over visual field”…..dx?

A

Retinal detachment

49
Q

Patient has symptoms of a “hot” thyroid nodule, what is the next diagnostic step?

A

Thyroid nuclear scan

**FNA not needed since hot nodules are rarely malignant

50
Q

What treatment has the lowest recurrence rate for basal cell carcinoma?

A

Mohs micrographic surgery

51
Q

What is the best oral agent for MRSA?

A

TMP-SMZ

52
Q

What is the dilution strength of epinephrine used in an allergic reaction?

A

1:1000

53
Q

How are most cancers staged?

A

0 - carcinoma insitu
1/2 - local (depends on depth)
3 - spread to nodes
4 - metastasized

54
Q

What serum lab is suggestive of metastatic melanoma?

A

Elevated LDH

55
Q

After surgery for colon cancer what’s the schedule for follow up colonoscopies?

A

1 year post op
3 years later
Every 5 years after

56
Q

What asthma medication is the best for prevention of symptoms?

A

Inhaled steroid

57
Q

What type of antihypertensive is contraindicated with quinidine use and why?

A

Thiazide diuretics

Quinidine SE is torsade de pointes; thiazides cause hypokalemia which increases the risk of torsade

58
Q

Patient tells you the nitroglycerin he takes for angina makes his heart speed up. How should his treatment be modified?

A

Add propranolol to his nitroglycerin

59
Q

How is polymyositis diagnosed?

A

Elevated muscle enzymes (CPK, aldolase)

60
Q

Patient being monitored in ER for MI converts to ventricular tachycardia. What’s the next step?

A

Defibrillation

61
Q

Patient being monitored in ER for MI converts to asystole. What’s the next step?

A

Check a second monitor lead to confirm asystole

62
Q

What’s the most common cause of diastolic heart failure?

A

Hypertension

63
Q

Patient with hx of HTN, CAD and smoking complains of pain/cramping in thighs/buttock for 2 months that worsens with ambulation and relieves when sitting down…….dx?

A

Peripheral arterial disease

64
Q

What labs will be seen in tumor lysis syndrome?

A
  • hyperuricemia
  • hyperkalemia
  • hyperphosphatemia
  • hypocalcemia
  • lactic acidosis
65
Q

What imaging should be done in suspected lung cancer?

A

Spiral CT

66
Q

Biopsy of a lung mass confirms small cell carcinoma, what’s the next step?

A

Staging including MRI of brain, CT abd/pelvis, bone scan and bone marrow aspirate/biopsy

67
Q

Patient with pmh of urinary frequency and muscle weakness is being treated for acute pancreatitis. Labs at the time and follow up reveal hypercalcemia…….dx?

A

Hyperparathyroidism

68
Q

What antibody can cross the placenta and cause neonatal lupus?

A

Sjögren syndrome antibodies (SSA/SSB)

69
Q

Patient presents with joint pain, low positive ANA and elevated ALT/AST. What lab needs to be done?

A

Hep C antibody……..rule out cryoglobulinemia

70
Q

Patient presents with muscle weakness and elevated AST/ALT. What test needs to be run?

A

GGT, determines if liver or muscle origin

71
Q

List cues that back pain may be due to cord injury

A
  • worse with recumbency
  • worse with valsalva
  • electric sensation down back/extremities with extension or flexion of neck/spine
72
Q

What is initial therapy for SVC syndrome due to lung tumor?

A

Elevate head and monitor for airway obstruction

**not emergency, don’t treat cancer before biopsy

73
Q

What is the most appropriate treatment for micro-invasive cervical carcinoma (stage Ia)?

A

Simple hysterectomy

74
Q

What virus can contribute to hepatocellular carcinoma?

A

Hep B & Hep C

75
Q

How do you diagnose hereditary spherocytosis?

A

Osmotic fragility

76
Q

High calcium is an indication of what type of thyroid cancer? What needs to be done before treatment?

A
  • Medullary

- evaluate for pheochromocytoma (MEN)

77
Q

Sickle cell patient presents in crisis with low reticulocyte count. What could be causing the crisis?

A

Parvovirus B19 (aplastic crisis)

MTBs Step 3 (30 decks)

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