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1
Q

Adequate Iron Stores in CKD4

A

Ferritin > 500 Transferritin sat > 30%

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2
Q

Locally Advanced Head/Neck w/ Positive margins or nodal mets w/ extracapsular extension

A

Surgery Radiation + Chemo

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3
Q

Locally Advanced Head/Neck w/ Positive margins or nodal mets w/ extracapsular extension

A

Surgery Radiation + Chemo

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4
Q

Inflammation & damage of cartilaginous tissues

A

Relapsing Polychondritis (ear, nose, trachea, joints)

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5
Q

Cogan Syndrome

A

Interstitial keratitis w/ cochlear and vestibular dysfunction

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6
Q

Who gets 2nd doses of MMR vaccines (4)

A

Health care workers Post-grad students Household contacts of immunocompromised patients International Travelers

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7
Q

Screening test for Cushings in night shift worker

A

24 hour urine free cortisol

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8
Q

Follow up for AAA < 4 cm

A

Repeat US in 2-3 years

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9
Q

Follow up for AAA 4-5 cm

A

Repeat US in 6 months

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10
Q

Management of AAA > 5.5 cm

A

CTA and surgical/endovascular planning

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11
Q

Pulmonary infection with exposure to livestock

A

Mild: Coxiella burnetti (Q Fever) - Doxy Severe: Anthrax spores from cattle/goat hides

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12
Q

Most common cause of primary adrenal insufficiency in the US?

A

Autoimmune - 21 hydroxylase antibodies

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13
Q

Red pruritic papules on chest, flanks and back associated with dry skin, heat and sweating

A

Transient Acantholytic Dermatosis - steroid cream or moisturizers

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14
Q

Transverse Myelitis Treatment

A

High Dose Steroids PLEX

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15
Q

Transverse Myelitis diagnosis

A

Cord symptoms Inflammation w/ leukocytosis on CSF Inflammation on MRI

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16
Q

TM vs GBS

A

TM: paresis, corresponds to cord level, bowel/bladder dysfunction GBM: ascending weakness/sensory loss, autonomic dysfunciton, isolated inc CSF protein

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17
Q

Screening tests for Incidental Adrenal-oma

A

24 hr urine metanephrines Dexamethasone suppression test

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18
Q

Pancytopenia and bloody diarrhea in transplant patient

A

CMV

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19
Q

Management of well-differentiated, low-grade, metastatic GI NET

A

Repeat CT in 3 months

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20
Q

Anti-aminoacyl-tRNA i.e. Anti-Jo-1

A

Antisynthetase Syndrome

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21
Q

ILD Myositits Raynaud Inflammatory arthritis Mechanics hands Low grade Fever

A

Antisynthetase Syndrome

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22
Q

Mepolizumab / Resolizumab

A

MAb IL-5 Moderate/Severe Asthma w/ eosinophilic phenotype

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23
Q

Omalizumab

A

MAb IgE Allergies to perennial aeroallergens IgE 30-700

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24
Q

Assess adequate quantities of sleep using _________ or __________ in patient w/ excessive sleepiness

A

Actigraphy (wrist) Sleep diary

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25
Q

Tumor marker to check for GE Junction Cancer

A

HER2 - Trastuzumab

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26
Q

Tumor marker to check for melanoma

A

BRAF - Tyrosine kinase inhibitors

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27
Q

Tumor marker for colorectal cancer

A

RAS - EGFR antibodies

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28
Q

HypoMag can cause

A

Hypocalcemia

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29
Q

How to treat early stage laryngeal cancer

A

Radiation alone

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30
Q

Treatment of MSSA OM in patient with hardware

A

Cefazolin + Rifampin

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31
Q

Prevent recurrent pneumonia’s in a patient with CLL

A

Check immunoglobulin levels - may benefit from IVIG

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32
Q

Resistant HTN and hypokalemia

A

Check for primary hyperaldo

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33
Q

Degree of stenosis need to treat asymptomatic carotid stenosis

A

> 80%

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34
Q

Anticoagulation for a patient with a mechanical valve who desires pregnancy

A

1st Trimester: Warfarin if <5mg daily (LMWH) 2nd-3rd Trimester: Warfarin

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35
Q

Which antiepileptic doesn’t worsen bone density

A

Lamotrigine

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36
Q

Follow up of 6-8mm subsolid (GG) lung nodules

A

Repeat CT at 6-12 months, then every 2 years for 5 years - slow growers

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37
Q

Management of newly diagnosed autoimmune pernicious anemia

A

EGD to look for gastric cancer - inc. gastrin secretion can predispose to cancer Gastric AdenoCA or Gastric Carcinoid

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38
Q

Tumor marker to look for in metastatic, Non-small cell lung cancer

A

PD-L1 - treat with pembrolizumab instead of Cisplatin

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39
Q

Who gets ASA for primary prevention (CAD and colon cancer)

A

Age 50-59 ASCVD risk ≥10% **no increased bleeding risk

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40
Q

Purpose and timing of colonoscopy after diverticulitis

A

Look for colon cancer 1-2 months after diagnosis

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41
Q

Manage a patient with fever & sore throat taking Methimazole

A

Check CBC for agranulocytosis and stop methimazole - usually occurs in the first few months after starting

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42
Q

When to repair asymptomatic biscuspid valve and aortic root dilation

A

>5.5 cm (5 cm if family hx of dissection or risk factors) **Otherwise TTE q6 months

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43
Q

Greater Trochanteric Pain Syndrome (Trochanteric Bursitis)

A

Pain over lateral hip radiating down leg NSAIDs/Tylenol PT

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44
Q

Surgical Mitral valve repair vs replacement - primary chronic severe MR

A

Repair is preferred

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45
Q

Treat Lynch Syndrome (mismatch repair) CRC with

A

Checkpoint inhibitor - Pembrolizumab

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46
Q

Meds to stop in a cirrhotic with ascites

A

Meds that decrease kidney perfusion ACE/ARB, NSAIDs

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47
Q

Survivors of ALL are at increased risk for ________.

A

Metabolic Syndrome

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48
Q

In patients with myxedema coma treat with _________.

A

IV Hydrocortisone prior to thyroid hormone

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49
Q

Management of asymptomatic hepatic adenoma < 5cm in size in women

A

Stop OCP Liver imaging q6 months for 2 years

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50
Q

Who gets hepatic adenonas surgically removed (3)

A

Men Symptomatic - bleeding Women > 5cm

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51
Q

Hypomag can cause __________.

A

Hypokalemia by exacerbating renal losses

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52
Q

Chronic silicosis patient with constitutional symptoms and hemoptysis

A

TB

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53
Q

What provides the best protection against hospital developed pressure ulcers

A

Advanced static mattress

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54
Q

Treat hypermag using ____________.

A

NS, Lasix IV Calcium (severe symptoms)

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55
Q

Cross-sectional studies are suscpetible to _________ (2)

A

Recall bias Confounding

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56
Q

How does Tylenol cause a gap acidosis

A

Pyroglutamic acidosis

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57
Q

F/u after treatment of ovarian cancer

A

None unless symptoms BRCA testing for all women

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58
Q

Treat Cyclospora with ________.

A

Bactrim

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59
Q

Drug induced pruritis w/o skin findings

A

NSAID HCTZ CCB Opiates **Stop drug**

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60
Q

Aseptic meningitis (Viral) between May-Nov

A

Enterovirus

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61
Q

Aseptic meningitis “year round” aka not May-Nov

A

HSV-2

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62
Q

Who gets G-CSF

A

PPX and Seoncdary PPX of neutropenia in patients undergoing chemo **give with day 2 of cycles of therapy**

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63
Q

Androgen Excess diagnostic study - High DHEAS

A

Adrenal tumor - Abdominal CT

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64
Q

Androgen Excess diagnostic study - High Testosterone (>150)

A

Pelvic Ultrasound

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65
Q

How to treat GBS

A

Plex vs IVIG

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66
Q

Treat low back pain with

A

ibuprofen - tylenol doesn’t help

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67
Q

Evaluate for suspected central vertigo with ____

A

MRI

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68
Q

Fingolimod monitoring (MS)

A

Eye exams - macular edema

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69
Q

Labs to check before starting Natalizumab (MS)

A

JC Virus antibodies high titers = high risk for PML

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70
Q

Who gets referred to a transplant center?

A

Decompensated Cirrhosis MELD > 15

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71
Q

Evaluate a young patient with shingles for _____.

A

HIV

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72
Q

Treat end of life depression with __________. (weeks)

A

Methylphenidate

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73
Q

Treat comedomal Acne with

A
  1. Topical Retinoids
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74
Q

Treat inflammatory acne with

A

Topical antibiotics

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75
Q

Treat chronic HBV with (2)

A

Tenofovir or Entecavir

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76
Q

Who gets ppx cipro for travelers diarrhea

A

IBD Immune Compromised

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77
Q

Drugs that cause drug induced swelling

A

CCB, Pregabalin Minoxidil Alpha blockers

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78
Q

Who gets a kidney biopsy?

A

Glomerular hematuria Inc. Albuminuria Unknown AKI/CKD Transplant monitoring

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79
Q

1st line for EtOH use disorder

A
  1. Naltrexone - safe if CKD, watch for hepatotoxicity 2. Acamprosate - need to dose reduce
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80
Q

Treat cognitive dysfunction in MS with ________.

A

Cognitive Rehab - no meds!

81
Q

AC for mechanical heart valves

A

Warfarin + ASA 2.5 Aortic 3.0 Mitral

82
Q

Epilepsy drug for elderly

A

Lamotrigine

83
Q

Side Effect of Entresto

A

Hypotension - don’t start in someone who is orthostatic

84
Q

When to look for androgen secreting tumor?

A

Testosterone > 150 - Pelvic US DHEAS > 7 - Abd CT

85
Q

Dapto monitoring

A

CK and SCR - weekly

86
Q

Treat Cheyne Stokes breathing with _______

A

CHF optimization

87
Q

Barrets w/ Low Grade dysplasia treatment

88
Q

Acute generalized exanthematous pustulosis

A

1-2 days after antibiotics Pustules that start on face and spread

89
Q

Milaria

A

Heat rash - Fever & Occlusion Superficial clear vesicles or as multiple discrete red papules due to occlusion of eccrine sweat ducts

90
Q

Anti-androgen meds

A

Examastane & Anastrozole - less risk for VTE

91
Q

Anti-estrogen meds

A

Tamoxifen & Raloxifene

92
Q

Treate mild, non-purulent cellulitis with _________ (4)

A

Strep Coverage Cefalexin Clinda Dicloxacillin PCN

93
Q

Causes of hypoaldo hyperkalemia

A

Heparin/LMWH ACE/ARB CKD & DM2 - Type 4 RTA Aldo resistance: Sickle cell, urinary obstruction, transplant rejection, tubulointerstitial disease

94
Q

Treat ________ with fomepazole

A

Methanol Ethylene Glycol

95
Q

Treat chronic cervical stenosis with ________.

A

PT **Acute intervention if seeing progressive leg weakness, spasticity, bowel/bladder dysfunction, etc.

96
Q

Medication-induced enteropathy can be caused by _______. (Mimics celiac disease)

A

Olmesartan

97
Q

Empiric TB meningitis Treatment

A

Rifampin Isoniazid Pyrazinamide Ethambutol + Dexamethasone

98
Q

Skin finding in the head/neck in older person with frequent sun exposure

A

Melanoma in situ, lentigo malgina

99
Q

Who gets endocarditis ppx

A

Unrepaired cyanotic congenital heart disease 6 mo s/p repair of congentital heart defect

100
Q

Treat acute bacterial prostatitis

A

Bactrim or Cipro x6 weeks

101
Q

When can you start ppx heparin after hemorrhagic stroke

A

48 hours if no active bleed on imaging

102
Q

First line for hepatic encephalopathy, when to add 2nd agent?

A
  1. Lactulose 2. Add rifaximin after 2nd episode of HE
103
Q

Diagnose TTP

A

Symptoms: Fever, AMS Labs: Hemolytic anemia, thrombocytopenia **Need peripheral smear with schistocytes**

104
Q

Treat TTP

105
Q

Causes of TTP

A

ADAMTS13 deficiency

106
Q

Treat Invasive Candidiasis

A

Resistant UTI - candida on culture Amphotericin (CNS) vs micaFUNGIN x 14 days then oral azole based on susceptibility

107
Q

Psoriasis can flare to erythroderma following use of ____________.

A

Systemic glucocorticoids (steroids)

108
Q

Who gets a parathyroidectomy for hyperCa

A

Ca > 1 mg/dL above ULN CrCl < 60 24 hr urine Ca >400 Increased stone risk or stones DEXA < -2.5 at any site Fracture Age <50 **Monitor q6 months until surgery is indicated**

109
Q

When to get parathyroid sestamibi scan

A

Primary hyperparathyroid once surgery is indicated

110
Q

Medical managment of Type 1 NSTEMI

A

DAPT (ASA and ticagrelor) x1 year

111
Q

Antipseudomonal least likely to trigger seizure

112
Q

Evaluate __________ when evaluating a patient for occupation lung disease.

A

Material Safety Data Sheet

113
Q

Treat cardioembolic stroke not given tPA with _______.

A

Aspirin, short term therapy **Can start long term warfarin 24 hours to 2 weeks after hospitalization depending on size of infarct**

114
Q

Thrombolytic therapy (full dose tpa) is indicated for STEMIs when symptom onset is within ________ and PCI is not available with in _______ of first medical contact

A

12 hours 120 minutes

115
Q

Isolated right sided colonic ischemia can be due to _______. Evaluate with ______.

A

Acute mesenteric ischemia from emoblism or thrombus. CTA

116
Q

Treat Aeromonas Nec Fasc with (GNR)

A

Cipro + Doxy surgery/supportive care

117
Q

When to use Erlotinib

A

EGFR mutation cancer

118
Q

Treat severe poison ivy with ____________.

A

Prednisone taper x3 weeks

119
Q

Neck Radiation in childhood increases your risk of

A

Papillary Thyroid Cancer

120
Q

Best first step for Lyme disease w/ neuro sytmpoms

A

LP - give CTX if infection in CSF

121
Q

Topamax causes what type of kidney stone

A

Calcium Phosphate

122
Q

Stress test modality for pt with LBBB

A

Adenosine (vasodilator) nuclear

123
Q

Mild hyponatremia and Pregnancy

124
Q

Treat immune-mediated necrotizing myopathy (statin-induced)

A

Prednisone

125
Q

Treat Pyoderma gangrenosum in an IBD patient with

126
Q

Xanthomas (yellow) are associated with __________.

A

Hyper-triglyceridemia

127
Q

Reversal Agent of Dabigatran

A

idarucizumab

128
Q

Treat high risk GIST tumors with (2)

A

Surgery Imatinib x3 years

129
Q

__________________________ should be suspected in black patients >50 years who have left ventricular wall thickening that is not explained by loading conditions

A

Cardiac Amyloid - TTR Pseudo Septal infarct Low voltage EKG

130
Q

Acrochordons

131
Q

Best treatment for pressure injury

A

Hydrocolloid dressing - foam dressing **Better than gauze**

132
Q

Evaluate patietns with non-cyclic focal breast pain with

A

Ultrasound!

133
Q

BP goal for post ICH stroke patients

134
Q

Post-treatment surveillance for cervical cancer

A

H&P & Gyn exam q3 months

135
Q

Treatment of T3 Breast Cancer in a pre-menopausal woman

A

Neoadjuvent Chemo, Surgery, Radiation **Leuprolide and Aromatase inhibitor**

136
Q

Management of Pagets findings on imaging

A

Check Alk Phos If elevated give bisphosphonate (Zoledronic Acid)

137
Q

Treat VAscular dementia with

A

Donepezil (off label AChE-inhibitors)

138
Q

Moderate/Severe Psoriasis

A

30% BSA involvement Treat w/ MTX **Topical agents for <10%**

139
Q

Treat symptomatic anemia in a patient with Eisenmenger’s

140
Q

GN coccobacilli with bipolar staining causing pneumonia

A

Yersinia pestis - Pneumonic plague Gentamicin or Streptomycin

141
Q

Sporulating GPR Low grade fever, malaise, myalgia, HA Cough, dysnpnea, CP

A

Anthrax = B. anthracis Treat w/ Cipro, Levo, Moxi or Doxycycline **Mediastinal widening from hemorrhagic lymphadenitis

142
Q

Treat Calcium Oxalate stones in a patient with malabsorption

A

Fluids & Potassium citrate

143
Q

Lab to check before starting bisphosphonate

A

Vitamin D level

144
Q

Who is high flow not appropriate for

A

Hypercapnic RF or mixed RF

145
Q

Indiactions Mohs surgery

A

Tumors with aggressive histiologic subtypes (micronodular, morpheaform, infiltrative, perineural involvement) High risk and cosmetically sensitive locations (face, genitals)

146
Q

Who typically gets Rheumatoid Vasculitis

A

Old, Male, smokers with long standing RA or high titers Small or Medium sized vasculitis - nodules, ulceratoins, livedo reticularis, digital infarcts

147
Q

Palpable purpura with the involvement of ears in a cocaine user

A

Levamisole - leukocytoclastic vasculitis

148
Q

Risk factors associated with Vanc induced nephrotoxicity

A

CKD Prolonged therapy Doses > 4g/d Trough > 15 Concomitant use of loop diuretics

149
Q

Management of Stage 1 Sarcoid (LAD only)

A

Observation

150
Q

West Nile presents as __________.

A

Encephalitis / AMS

151
Q

CN 7 palsy and lyme possible exposuure =

A

Lyme disease

152
Q

True or False: ASA should be continued in patients with stents prior to surgery, unless the bleeding risk is prohibitively high.

153
Q

Weight loss is best achieved with _______________.

A

A high intensity behavioral program

154
Q

Cardiac X Syndrome

A

Angina & stress test abnormalities w/o angiographic evidence of CAD

155
Q

Evaluate erythema nodosum with____. Why?

A

CXR To look for: Lymphoma, Sarcoid, TB, and Fungal infection (Cocci)

156
Q

What can trigger Erythema Nodosum (4)

A

Lymphoma Sarcoid TB Fungal infection (Cocci) Strep infections OCP Pregnancy IBD

157
Q

Indication for BIV ICD (3)

A

EF < 35% Class II-IV symptoms LBBB w/ QRS > 150

158
Q

Treat all patients with classic Hodgkin Lymphoma regardless of stage iwth

A

Chemo: Doxorubicin, bleomycin, vinblastine and dacarbazine

159
Q

Treat Carbon Monoxide poisioning from not a fire with

A

Hyperbaric oxygne

160
Q

Treat smoke inhalation with

A

Hyperbaric O2 if < 90 +Hydroxycobalabmin (cyanide toxicity)

161
Q

Treat adv ovarian +BRCA cancer with

A

Olaparib Oral Poly ADP inhibitor

162
Q

Most common cause of infection relation GN

A

Staph Aureus

163
Q

When do post-strep GNs occur

A

7-10 days after oropharyngeal 2-4 weeks after skin infections

164
Q

Vasoreactivity testing to inhaled nitric oxide for PAH indicates what?

A

Responsivity to CCB Dilt

165
Q

Male patients with urinary urge incontinence and no response to behavioral therapy give _______

A

Mirabegron (anti-chol)

166
Q

Treat BPH and ED with

167
Q

Treat symptomtaic prolactinomas with

A

Dopamine Agonists: Cabergoline and bromocriptine

168
Q

Medication induced tubulointerstitial nephritis

A

Omeprazole

169
Q

HIV meds can cause

170
Q

What is the most common type of AKI from Multiple Myeloma

A

Light chain cast nephropathy

171
Q

What is this and what causes it

A

Chronic Paronychia

wet work and candida

Treat with topical steroids & minimize wet work

172
Q

How do you treat patients with primary membranous

A

6-12 months of steroids

ACE

Statin

**allow time for possible spontaneous remission**

173
Q

Treat latent TB with

A

INH for 9 months

INH + Rifapentine x 3 months (directly observed)

174
Q

Bleeding issues

Prolongation of Platelet function analyzer

Mechanical heart valve

A

Acquired VWF

175
Q

Calcineurin inhibitor

A

Tacrolimus and Cyclosporine

**HTN & Hyperkalemia**

Treat w/ HCTZ or Chlorthalidone

176
Q

Parkinson’s Plus Syndromes

A

Progressive Supranuclear Palsy

Multiple system atrophy - autonomic, early falls

Cortical-basal ganglionic degeneration - unilateral

Dementia with Lewy Bodies

177
Q

Avoid Adenosine (vasodilator) stress tests in __________.

A

COPD w/ active wheezing

178
Q

Treat old man epididymitis with _________.

vs

young man epididymitis with _________.

A

Ceftriaxone and Levaquin - E coli, pseudomonas

Ceftriaxone and Doxy - CT, NG

179
Q

Who shouldn’t get pregnant

A

Marfan’s (<4 cm safe)

Pulmonary HTN

Cardiomyopathy

180
Q

How does minimal change present?

A

Full-blown Nephrotic Syndrome!

181
Q

How to treat primary adrenal failure

A

HC BID (hydrocortisone)

MC QD (fludrocortisone)

182
Q

Normal labs in ESRD patient with bone pain/fracture

A

Adynamic bone disease

183
Q

Treat Toxic Adenoma with _______________

A

Radioactive Iodine

184
Q

Vulvar itching, vaginal dryness, and dyspareunia

Pale shiny vaginal walls, decreased rugae and petechiae

A

GU Syndrome of Menopause

185
Q

Patient with bruising and proteinuria and this skin finding

186
Q

Safe platelet count for pregnant women with ITP

187
Q

Side Effects of Bevacizumab (Anti-VEGF)

A

Hypertension (significant but reversible)

188
Q

Side Effect of Paclitaxel + Doxorubicin

A

Higher incidence of cardiomyopathy

189
Q

CV Side Effects of Cisplatin

A

VTE

SVT

MI

Cardiomyopathy

190
Q

22 yo w/ LDL 200

A

High-Intensity Statin

191
Q

Metformin is safe with GFR > ***

and contraindicated if < ***

A

>45 = safe

<30 = no!

192
Q

Treatment of localized impetigo

A

Topical Mupirocin

193
Q

Management of pulmonary nodules >8 mm

A

PET for risk stratification

Wedge resection if highly active

194
Q

Labyrinthitis vs Vestibular Neuritis

A

Labyrinthitis - Hearing loss + continuous vertigo

Vestibular Neuritis - continuous vertigo

195
Q

Itching that persists after scabies treatment with permethrin cream

A

Post-scabies itching

Treat with steroid cream and oral antihistamine

196
Q

Low vitamin D, high PTH, low Ca can cause

A

Osteomalacia

197
Q

Photo-sensitive rash occurred after starting TNF-alpha, ACE, NSAID, HCTZ or terbinafine

A

Drug-induced lupus

198
Q

Greasy/flaky rash with the scale on head and neck that started abruptly

A

HIV associated Seborrheic Dermatitis

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