step 3 16

Question 1

chikungunya presentation

Answer 1

high fever and severe polyarthralgia

Question 2

complications of untreated chlamydia during pregnancy

Answer 2

preterm premature rupture of membranes, preterm labor, postpartum endometritis) and neonatal complications (eg, blindness, pneumonia)

Question 3

biggest predictor of coronary heart disease risk

Answer 3

diabetes

Question 4

cross sectional study design

Answer 4

individuals are assessed at a specific point in time to determine whether or not they have a certain risk factor and a certain disease of interest.

Question 5

case control study design

Answer 5

categorizes patients with and without a specific disease (eg, ischemic heart disease) and compares the risk factor frequency (eg, CAC score) between the 2 groups.

Question 6

prospective cohort study design

Answer 6

follow individuals who do not have the disease/outcome of interest (eg, ischemic heart disease) and who may or may not have a certain risk factor (eg, elevated CAC scores) over time.

Question 7

next step after lobular carcinoma in situ diagnosis

Answer 7

excisional biopsy (no sentinal because nonmalignant)

Question 8

HPV vaccine benefits

Answer 8

prevents genital warts and anogenital cancer in both sexes.

Question 9

HPV vaccine age range

Answer 9

The recommended time for the first dose is age 11-12, but the HPV vaccine series can be started at age 9-26.

Question 10

cat scratch disease treatment

Answer 10

azithromycin

Question 11

adhesive capsulitis management

Answer 11

rest and gentle range of motion exercises. Glucocorticoid injection is recommended for patients with more severe symptoms and those who do not improve with conservative measures.

Question 12

sequela of comparment syndrome

Answer 12

ARF – may develop rhabdomyolysis and release of myoglobin. Heme pigment from myoglobin is nephrotoxic; patients may develop acute renal failure

Question 13

epistaxis management

Answer 13

Nostril pinching is the first step in management, and a topical vasoconstrictor can be applied if direct compression alone is not effective.

Question 14

bedside echo findings with massive PE

Answer 14

pulmonary hypertension –> acute right ventricular dysfunction, tricuspid annulus dilation, and functional tricuspid valve regurgitation

Question 15

massive PE on EKG

Answer 15

new right bundle branch block, atrial arrhythmias, and Q-waves or ST-segment changes in the inferior leads.