Random Facts

Question 1

What is metabolic syndrome?

Answer 1

1) Elevated waist circumference: [(Men > 40 inches (102 cm); women > 35 inches (88 cm)]
2) Elevated triglycerides: Equal to or greater than 150 mg/dL (1.7 mmol/L)
3) Reduced HDL (“good”) cholesterol: [(Men 130/85 mm Hg or use of medication for hypertension
5) Elevated fasting glucose: =/> 100 mg/dL (5.6 mmol/L) or use of medication for hyperglycemia

Question 2

How is diabetes diagnosed?

Answer 2

By demonstrating any one of the following:

1) Fasting plasma glucose level ≥ 126 mg/dl
2) plasma glucose ≥ 200 mg/dl two hours after a 75 g oral glucose load as in a glucose tolerance test
3) symptoms of high blood sugar and casual plasma glucose ≥ 200 mg/dl
4) HbA1c ≥ 6.5

Question 3

What is a positive PPD test?

Answer 3

> 5 mm induration in patients with HIV
10 mm induration in high-risk patients (recent immigrants from endemic areas, IVDU, children 15 mm induration in all patients (no risk factors)

Question 4

What are the nodes in the hands of OA patients?

Answer 4

Heberden (DIP) nodes

Bouchard (PIP) nodes

Question 5

What is Virchow’s triad of DVT?

Answer 5

1) endothelial damage
2) immobilization
3) hypercoaguable state (OCPs, preganncy, lupus anticoagulant, inherited deficiencies)

Question 6

QT is prolonged in (hypo/hyper)calcemia.

Answer 6

HYPOcalcemia = prolonged
HYPERcalcemia = QT shortening

Question 7

Prolongation of patient survival in patients with congestive heart failure has been documented with:

Answer 7

diuretics, beta blockers, ACE inhibitors, ARBs, hydralazine plus nitrate, and aldosterone antagonists (added in NYHA class II

Question 8

What is the sequelae of liver failure?

Answer 8

coagulopathy that can’t be fixed with vit K, jaundice/hyperbilirubinemia, hypoalbuminemia, ascites, portal hypertension, hyperammonemia/encephalopathy, hypoglycemia, DIC

Question 9

What is the guideline for HPV screening?

Answer 9

If just Pap, then EVERY YEAR for women >21 until 3 negative tests and over 30

If HPV serology AND Pap, then every 3 years

Question 10

RADIAL NERVE

Motor function, sensory function, and clinical scenario in which it can be injured!

Answer 10

Motor: wrist extension (watch for wrist drop)

Sensory: back of forearm, back of hand (first 3 digits)

Clinical: humeral fracture

Question 11

ULNAR NERVE:

Motor function, sensory function, and clinical scenario in which it can be injured!

Answer 11

Motor: finger abduction (watch for “claw hand”)

Sensory: front and back of last 2 digits

Clinical: elbow dislocation

Question 12

MEDIAN NERVE

Motor function, sensory function, and clinical scenario in which it can be injured!

Answer 12

motor: pronation, thumb opposition
sensory: palmar surface of hand (first 3 digits)
clinical: carpal tunnel syndrome, humeral fracture

Question 13

AXILLARY NERVE

Motor function, sensory function, and clinical scenario in which it can be injured!

Answer 13

motor:
abduction, lateral rotation

sensory: lateral shoulder
clinical: upper humeral dislocation or fracture

Question 14

PERONEAL NERVE

Motor function, sensory function, and clinical scenario in which it can be injured!

Answer 14

motor: dorsiflexion, eversion (watch for foot drop)
sensory: dorsal foot and lateral leg
clnical: knee dislocation

Question 15

What is the management of carotid artery stenosis?

Answer 15

70-99%: endarterectomy

Question 16

What are the adverse metabolic effects of thiazide diuretics?

Answer 16

calcium retention, hyperglycemia, hyperuricemia, hyperlipidemia, hyponatremia, hypokalemic metabolic alkalosis, hypovolemia
(PS are also sulfa drugs)

Question 17

What are the adverse metabolic effects of loop diuretics?

Answer 17

hypokalemic metabolic alkalosis, hypovolemia, ototoxicity, and calcium excretion
(w/ the exception of ethacrynic acid, are also sulfa drugs)

Question 18

What are the adverse metabolic effects of carbonic anhydrase inhibitors?

Answer 18

metabolic acidosis

Question 19

What is an adverse metabolic effect of spironolactone?

Answer 19

potassium-sparing diuretics can cause hyperkalemia

Question 20

What is the antidote for beta blocker poisoning?

Answer 20

glucagon

Question 21

What is the antidote for quinidine or TCA overdose?

Answer 21

sodium bicarbonate (cardioprotective)

Question 22

increased hemoglobin A2 and anemia

Answer 22

thalassemia

Question 23

rash develops after administration of ampicillin or amoxicillin for sore throat:

Answer 23

EBV infection

Question 24

port-wine stain and seizures:

Answer 24

Sturge-Weber syndrome

Question 25

What is Beck’s triad?

Answer 25

1) JVD distension
2) muffled heart sounds
3) hypotension

= cardiac tamponade

Question 26

What is Chvostek sign?

Answer 26

tapping on the facial nerve elicits tetany (hypocalcemia)

Question 27

What is Courvoisier sign?

Answer 27

painless, palpable gallbladder plus jaundice

= pancreatic cancer

Question 28

What is Cullen sign?

Answer 28

bluish discoloration of periumbilical area (= pancreatitis with retroperitoneal hemorrhage)

Question 29

What is Cushing reflex

Answer 29

hypertension, bradycardia, irregular respirations

=high intracranial pressure

Question 30

What is Grey Turner sign?

Answer 30

Bluish discoloration of flank (=pancreatitis with retroperitoneal hemorrhage)

Question 31

What is Kehr sign?

Answer 31

pain in the left shoudler (2/2 ruptured spleen)

Question 32

What is Leriche syndrome?

Answer 32

claudication and atrophy of the buttocks with impotence (=aortoiliac occlusive disease)

Question 33

What is Tinel sign?

Answer 33

tapping on the volar surface of hte wrist elicits paresthesias (=carpal tunnel syndrome)

Question 34

What is Trousseau sign?

Answer 34

pumping up a blood pressure cuff causes carpopedal spasm (=tetany from hypocalcemia)