Set 30

Question 1

What organisms are particularly known for causing infective endocarditis?

Answer 1

Staphylococcus aureus (30%)
Viridans strep (20-30%) = strep mutans
Enterococci (10%)
Coagulase-negative staph (5-10%) = staph epidermidis
HACEK organisms if nothing grows on culture
(Haemophilus, Actinobacillus, Cardiobacterium, Eikenella, Kingella)

Question 2

A 60-year-old male long-time patient of yours comes to your office complaining of sexual dysfunction. What is the differential diagnosis? What drugs are known for causing sexual dysfunction?

Answer 2

DDX:
Hormonal disturbance (low testosterone, hyperprolactinemia)
Depression
Diabetes
Psych (performance anxiety)
Meds: antihypertensives (BB), neuroleptics, SSRIs, ethanol

Question 3

A 44-year-old woman is seen in the ER for shortness of breath, malaise, and high fever. CXR reveals a right-sided consolidation and her labs reveal a WBC count of 12,000. Which organism is overall the most common cause of lobar pneumonia? What organisms are the most common causes of interstitial (walking) pneumonia?

Answer 3

Lobar: Streptococcus pneumoniae (pus fills lobe)

Walking: Mycoplasma, chlamydophila, legionella

Question 4

Which type of lymphoma has a presentation that is very similar to CLL and fewer constitutional signs/symptoms?

Answer 4

Small lymphocytic lymphoma

Question 5

A 30-year-old man is at an inpatient facility for opioid addiction. What symptoms might this patient experience while discontinuing opioids?

Answer 5

Tremor
Chills
Muscle and bone pain
Perspiration
Flu-like symptoms
Yawning
Vomiting/Diarrhea
Restless leg syndrome

Question 6

What is the difference between a promoter region and an enhancer region?

Answer 6

Promoter = site on the DNA where RNA polymerase binds, just upstream from the gene locus itself. TATA box or CAAT box. Promotes gene expression and transcription

Enhancer = section of DNA that enhances gene expression by binding transcription factors (doesn’t have to be upstream)

Question 7

What medications are considered first-line in the treatment of ADHD?

Answer 7

Methylphenidate
Dextroamphetamine
Atomoxetine (selective NE re-uptake inhibitor)

Question 8

What are the signs of right-sided heart failure? What are the signs of left-sided heart failure? What is most often the cause of right-sided heart failure?

Answer 8

R: JVD, peripheral edema, hepatic congestion

L: pulmonary edema (orthopnea), dyspnea on exertion, paroxysmal nocturnal dyspnea (PND)

MCC of R sided HF is left sided HF

Question 9

What abnormal lab values would lead you to suspect alcoholic hepatitis?

Answer 9

AST > ALT (2:1)

Question 10

How many umbilical vessels are there? Which umbilical vessel has the highest oxygen content?

Answer 10

2 Umbilical arteries

1 Umbilical vein (highest O2 concentration)