Step 3

Question 1

infant of diabetic mother. CHF and fetal cardiomyopathy. common heart problem?

Answer 1

excess glycogen deposition in myocardium–> hyptertorphy of fetal hearth musculature. commonly intraventricular septum resulting in ventricular outflow obstruction (hypertrophic cardiomyopathy)

Question 2

diabetic with early satiety and postprandial fulness

Answer 2

diabetic gastroparesis

Question 3

diabetic gastroparesis associated with

Answer 3

autonomic symptoms, and labile glucose control

Question 4

confirm diabetic gastroparesis

Answer 4

nuclear gastric emptying study

Question 5

What antihypertensives ok to use with lithium?

Answer 5

calcium channel blockers (amlodipine, verapamil)

Question 6

chlamydia in preggers. what abx?

Answer 6

azithromycin

Question 7

priapism. simple intervention

Answer 7

urination, cold compresses

Question 8

priapism lasting >4 hours. intervention?

Answer 8

aspiration of corpora cavernosa and intracavernosal injection of an alpha agonist (phenylephrine)

Question 9

high risk HIV exposure screening test?

Answer 9

HIV antigen (P24) and HIV1/HIV 2 antibody. false negatives may occur in the first 4 weeks of infection due to low titers of antigen and antibody (window period)

Question 10

new HIV. before starting anti-retrovirals, check for what?

Answer 10

test for Hep B (some treatments can target both HIV and Hep B)

Question 11

tibial tuberosity avulsion

Answer 11

Osgood- Schlatter disease (overuse injury in pubertal children and causes chronic anterior knee pain). Physical exam shows tenderness or prominence of the tibial tubercle but range of motion and joint stability are preserved

Question 12

ruptured patellar tendon. what do you do?

Answer 12

surgical repair

Question 13

lichen planus

Answer 13

discrete, intensely pruritic, polygonal shaped violaceous papules or plaques involving the flexural surfaces of the extremities– wrists, buccal mucosa, and external genetalia. skin biopsy to confirm

Question 14

what is lichen planus associated with?

Answer 14

advanced liver disease due to hep C virus

Question 15

sound of mitral stenosis

Answer 15

soft, low pitched rumble best heard with the bell of the stethoscope at the heart apex

Question 16

lithium toxicity

Answer 16

hemdialysis