Rx_Random Set #3

Question 1

Adverse effects of phenytoin

Answer 1

• gingival hyperplasia
• megaloblastic anemia
• teratogenesis
• SLE-like sx

Question 2

Infectious causes of dilated cardiomyopathy

Answer 2

coxsackievirus B

Question 3

Presentation of dilated cardiomyopathy

Answer 3

• S3 heart sound
• dyspnea
• fluid overload + CHF
• CHF ==>elevated b-type natriuretic peptide

Question 4

elevated b-type natriuretic peptide indicates?

Answer 4

CHF

Question 5

Most common cancer of bone

Answer 5

metastatic cancer >> primary cancer of bone

Question 6

Older man + back pain + elevated alkaline phosphatase + bone lesions: Dx (most likely)?

Answer 6

metastatic neoplasia

Question 7

Acute-phase cytokine

Answer 7

• IL-6
  
  • produced by T lymphocytes

Question 8

Common acute & chronic tx for Gout

Answer 8

• NSAIDs
• common acute: indomethacin
• common chronic: probenecid

Question 9

Common cause of this non-pruritic rash? + common patients w/condition?

Answer 9

• Poxvirus (Molluscum contagiosum)
• Patients:
  
  • children
  • immunosuppressed

Question 10

Tumor @ cerebellopontine angle w/spindle cells + pink cytoplasm forming whorls and palisades on histology

Answer 10

Schwannoma

Question 11

Common sx of schwannoma

Answer 11

• dizziness
• tinnitus
• poor balance
• hearing loss
• increasing ICP

Question 12

Characteristics of schwannoma

Answer 12

• third most common primary intracranial tumor
• often localized to cranial nerve VIII (acoustic neuroma)
• commonly seen @ cerebellopontine angle

Question 13

Muscular paraneoplastic syndrome derived from small cell lung cancer

Answer 13

• Lambert-Eaton myasthenic syndrome
  
  • facial muscle or proximal muscle weakness
  • weakness improves with muscle use

Question 14

Associations with Turner Syndrome

Answer 14

• short stature
• webbed neck
• wide-set nipples
• ovarian dysgenesis
• bicuspid aortic valve
• horseshoe kidney/renal abnormalities ==> WILMS TUMOR

Question 15

Infectious cause (+ class of pathogen): Genital ulcer + pain + erythematous base + bleeds w/manipulation

Answer 15

• Haemophilus ducreyi ==> Chancroid ulcers
  
  • H. ducreyi = gram-negative coccobacillus

Question 16

Characteristics of trichomoniasis

Answer 16

• STD
• sx:
  
  • vaginal itching
  • dysuria
  • foul-smelling green discharge
• histopath:
  
  • trophozoites in vaginal discharge

Question 17

Dx of Prerenal azotemia

Answer 17

• urine osmolality > 500 mOSm/kg
• urine Na⁺ < 20 mEq/L
• fractional excretion of Na⁺ < 1%
• serum BUN/Cr > 20

Question 18

Characteristics of Whipple’s disease

Answer 18

• cause: T. whipplei
• sx:
  
  • weight loss
  • diarrhea
  • arthralgias
• histopath:
  
  • PAS-staining macrophages @ lamina propria on intestinal biopsy

Question 19

Common complications of sickle cell trait

Answer 19

• episodic hematuria
• inability to concentrate urine
• autosplenectomy at high altititudes

Question 20

Tx of P. jiroveci infections in patients w/sulfa allergies

Answer 20

• aerosolized pentamidine

Question 21

Common diagnostic test for HIV

Answer 21

• western blot
  
  • protein-antibody hybridization

Question 22

Swimmer’s ear: cause & tx

Answer 22

• cause: Pseudomonas aeruginosa
• tx: aminoglycoside + extended-spectrum penecillin
  
  • amino = gentamicin
  • ext-spec pen = piperacillin-tazobactam

Question 23

Possible structural disruption w/surgical access to femoral artery

Answer 23

• most likely = deep inguinal lymph nodes
  
  • inguinal lymph nodes enclosed inside the femroal sheath which must be opened to access femoral artery

Question 24

Fetal vs. Adult Hemoglobin

Answer 24

• Fetal = HbF-a2y2
  
  • increased affinity for oxygen vs. adult hemoglobin
  • ==> left shift in hte oxygen-hemoglobin dissociation curve
• Adult = HbA

Question 25

Causes of right shift of oxygen-hemoglobin dissociation curve

Answer 25

• (Increase in) BAT ACE:
  
  • BPG (2,3 - BPG)
  • Altitude
  • Temperature
  • Acid
  • CO₂
  • Exercise