Signs and Symptoms

Question 1

What can fatigue + darkening of the skin indicate?

Answer 1

Addisons disease

Question 2

Fever + Jaw claudication can indicate what?

Answer 2

Giant cell arteritits

Question 3

Fever + nocturia in a male could indicate what?

Answer 3

prostatitis

Question 4

what other signs are present w/ a vasovagal syncopal event?

Answer 4

nausea, warmth, pallor, lightheadedness, idahpresis

Question 5

What would an increase in an outflow murmur w/ valsalva manuevers?

Answer 5

Hypertrophic cardiomyopathy

Question 6

What can syncope and a postive stool guiac indicate?

Answer 6

Anemia, hypovomelia

Question 7

All patients w/ syncope shoudl ge twhat?

Answer 7

an EKG

Question 8

how long do migraines typically last?

Answer 8

4-27 hours

Question 9

Tx for nausea w/ migraine

Answer 9

compazine

metoclopramide

Question 10

ADRs w/ tripatans

Answer 10

paresthesias, tightness in throat or chest

Question 11

Drug used for prevention of migraines?

Answer 11

Propranolol or amitriptyline, topirimate

Question 12

Drug used for prevention of cluster HA

Answer 12

verapmail

Question 13

Tx for cluster HA

Answer 13

oxygen, (7-10 L/ min), triptans

Question 14

Drug used for prophylaxis of tension HAs

Answer 14

amitriptyline

Question 15

Idiopathic intracrnail HTN seen in young, obese women. Will hve papilledema and elevated CSF. Can have abducens nerve palsy

Answer 15

Pseudotumor cereberi

Question 16

Tx for pseudotumor cerebri

Answer 16

Acetazolamide (can add diuretic for additional benefit)

Question 17

With a SAH what will a lumbar puncture show?

Answer 17

Xanthochromia- yellow disolocratoin indicating a hemorrhage

Question 18

What manuever is treatment for BPPV?

Answer 18

Epley maneuver

Question 19

Presents with tinnitus, hearing loss and vertigo.

Answer 19

Meniere disease

Question 20

Tx for Meniere’s disease

Answer 20

Diuretics (acetazolamide of HCTZ), sal restriction

Question 21

Present with vertigo, is a tumor (schwannoma) that can compress the brainstem

Answer 21

Acoustic neuroma

Question 22

vertigo associated w/ a viral illness, if accompanied by hearing loss is called labrinthitis, typically goes away in 2-10 days

Answer 22

Vestibular neuritits

Question 23

Tx for vestibular neuritits

Answer 23

Meclizine, benadryl, antiemetis, benzos

Question 24

What meds can damage the 8th cranial nerve and cause vertigo?

Answer 24

Amingoglycosides, loop diuretics

Question 25

what does vertical nystagmus plus vertigo suggest?

Answer 25

Brainstem origin of vertigo

Question 26

If an MRI shows scattered demyelination and a patient has central vertigo what is suggested?

Answer 26

Multiple sclerosis

Question 27

what med can cause a chronic, non productive cough

Answer 27

ACEI

Question 28

what medication can exacerbate asthma

Answer 28

beta blockers

Question 29

Chronic use or nitrofurantoin can lead to a cough due to...

Answer 29

interstital fibrosis

Question 30

what 2 things present with chronic cough, weight loss, night sweats, hemoptysis

Answer 30

lung cancer, TB

Question 31

after D/Cing ACEI when should the cough go away

Answer 31

within 4 weeks

Question 32

What heart sound and lung finding indicates CHF?

Answer 32

S3 and pulmonary rales

Question 33

What is Beck's triad w/ cardiac tamponade?

Answer 33

JVD Muffled heart sounds decreased BP

Question 34

Signs of aortic dissection

Answer 34

HPOTN absence of peripheral pulses murmur of aortic insufficiency

Question 35

3 labs used for MI

Answer 35

CPK, troponin, myoglobin

Question 36

First enzyme to rise w/ MI and remains elevated for 5-14 days (most sensitive)

Answer 36

troponin

Question 37

What cardiac enzyme rises w/i 4 hours of MI and peaks at 24 hours after

Answer 37

CPK-MB

Question 38

what two drugs can be used to do a chemical stress test?

Answer 38

adenosine, dobutamine

Question 39

Immediated tx for MI

Answer 39

Morphine O2 Nitroglycericn ASA (or clopidrogel if allergic)

Question 40

bulky, greasy stools that are often caused by some sort of malabsoprtion. Improves w/ fasting

Answer 40

Osmotic diarrhea

Question 41

Tx for osmotic diarrhea

Answer 41

D?C consumption of food. MIld, low residue diet, maintain electrolytes

Question 42

What type diarrhea has blood or w/ leukocytes

Answer 42

INflammatory

Question 43

What type of drug can't you use with inflammatory diarrhea

Answer 43

antimotiligy agents

Question 44

as osmolality >50 mOsm/kg indictes what?

Answer 44

osmotic diarrhea

Question 45

what type antibody titers r/o celiac disease

Answer 45

ntiendomysial antibody titers

Question 46

Antimotiligy agent used to treat acute diarrhea

Answer 46

loperamide (Imodium)

Question 47

C/I w/ lopermaide

Answer 47

Temp >1010, UC, C. Diff, age <2

Question 48

2 absobents that are used to treat acute diarrhea

Answer 48

CHolestyrmaine | bismuth subsalicylte

Question 49

C/I and ADRs w/ bismuth subsalicylate

Answer 49

Kid <12 | blackened stools, ryres syndrome, gout

Question 50

What criteria is used to evaluate IBS?

Answer 50

Rome III

Question 51

What type ulcers are more common in dyspepsia

Answer 51

duodenal ulcers

Question 52

what is long term metaplastic transformation in the esopagus due to GERD?

Answer 52

Barett esophagus

Question 53

what foods decrease the pressure of LES

Answer 53

``` coffee chocolate mints fatty foods alcohol ```

Question 54

Tx for H PYlori

Answer 54

2 abx + PPI or H2 blocker for 7-14 days (Abx- clairthyromyxin, amoxicillin, metronidazole)

Question 55

Most common herniation in LBP

Answer 55

L5-S1

Question 56

Red flags w/ LBP

Answer 56

Fever night pain weight loss bone pain

Question 57

LBP with difficulty urniating, fecal incontinence, progressive weakness, saddle anesthesia

Answer 57

cauda equina (surgical emergency!)

Question 58

what are concerning signs for neoplasm causing LBP

Answer 58

insidious night pain not relieved w/ supine position

Question 59

Mornign spinal stiffness hx of IBD sacroilitits bamboo spin on x-ray

Answer 59

Ankylosing spondylitits

Question 60

young age, trigger – fatigue, sx – round back, vertebral wedging, end plate irregularity per x-ray

Answer 60

Scheuermann disease

Question 61

straight leg raise produces pain at <__ degrees with sciatica

Answer 61

<60 degreees

Question 62

When should x-rays be done w/ LBP

Answer 62

``` persists for >6 weeks Age >50 hx of trauma, systemic symptoms neuro deficiet chronic steroid use ```

Question 63

Tx for mechanical back pain

Answer 63

APAP COX-2 inhibitors narcotics- shrot term muscle relaxants

Question 64

muscles in the rotator cuff

Answer 64

Supraspinatus infraspinatus teres minor subscapularis

Question 65

muscles that stabilize the scaupla

Answer 65

trapezius serratus anterior rhomboid muscles

Question 66

what is characteritistc of rotator cuff tendonitits

Answer 66

Discomfort abducting arm past 90 degrees

Question 67

– chronic pain and stiffness w/limited should motion; middle age; follows period of immobilization from injury or medical condition

Answer 67

Adhesive capsulitits (frozen shoulder)

Question 68

passively abducting pt’s shoulder and observe lowering of hand to waist level (sudden drop = rotator cuff tear)

Answer 68

drop off test

Question 69

what does erythema migrans indicate?

Answer 69

lyme disease

Question 70

What are nodes at the DIP called?

Answer 70

Heberden

Question 71

What are nodes at the PIP called?

Answer 71

Bouchard

Question 72

1st line treatment with osteoarthritits

Answer 72

APAP

Question 73

ADRs w/ methotrexate

Answer 73

bone marrow toxicity hepatitis stomatitits

Question 74

ADR w/ hydroxychloroquine

Answer 74

retinopathy

Question 75

what hormones can hypothyroidism suppress?

Answer 75

GnRH, FSH, LH