Step3 2

Question 1

Cardiovascular manifestations of TCAs intoxication

Answer 1

Tachycardia, hypotension

Prolonged QRS, PR, QT

Arrythmias: ventricular tachy/fib

Question 2

Evaluation for dysentery

Answer 2

Stool sample / culture
Blood work

CT: if suspicious for ischemic colitis
Endoscopy: if dx IBD

Question 3

Treatment for dysentery

Answer 3

Fluid resuscitation

For acute/severe with travel hxx: ciprofloxacin or azytromicyn

DO NOT USE ATB IN ECEH DUE TO RISK OF HEMOLYTIC UREMIC SYNDROME

Question 4

ESR and CRP in polymyalgia rheumatica, statin myopathies, inflammatory myopathies

Answer 4

No elevated in statin myopathy

Question 5

Disease associated with polymyalgia rheumatica

Answer 5

Giant cell artheritis

Question 6

Disease associated with Giant cell artheritis

Answer 6

polymyalgia rheumatica

Question 7

Risk factors for Metformin-associated lactic acidosis

Answer 7

Renal dysfunction
Liver dysfunction
Heart Failure
Hypotension (maybe due to diarrhea caused by metformin)

Question 8

Normal leg alignment with age

Answer 8

Genu varum: up to 2yoa
Normal 2-4
Genu valgum 4-6
Normal again

Question 9

HIV prophylaxis for Toxoplasma

Answer 9

TMP-SMX if CD4 < 100

Question 10

HIV prophylaxis for Pneumocystis

Answer 10

TMP-SMX if CD4 is <200

Question 11

When to treat asymptomatic bacteriuria

Answer 11

Pregnant women

Before urologic procedure

Question 12

Medical indications of pregnancy termination (6)

Answer 12

Ejection fraction: <40%

NYHA: III-IV

Pulmonary hypertension

Hx of peripartum cardiomyopathy in a previous pregnancy

Unstable aortic dilatation >40mm

Severe cardiac obstructive lesions

Question 13

Eisenmenger Sd.

Answer 13

Pulmonary hypertension due to uncorrected VSD

It reverses the blood flow and causes R-L shunt

Cyanosis and eventual heart failure

Question 14

Antibiotics used for the treatment of UTI and asymptomatic bacteriuria

Answer 14

Nitrofurantoin 5-7
Cephalexin 3-7 days
Amoxicillin 3-7
Fosfomycin single dose
Amoxicillin-clavulanic

TMP-SMX 1st and 3rd trimester only

Fluoroquinolones contraindicated all pregnancy

Question 15

Indication for Upper endoscopy in patients with dyspepsia (8)

Answer 15

> 60 yoa
or alarm symptoms

Progressive dysphagia, 
Anemia
Odynophagia
Palpable mass or adenopathy
Persistent vomiting
Fx of GI malignancy

Question 16

Polycythemia low vs. high erythropoietin

Answer 16

Low: polycythemia vera

High: Pulmonary or cardiac disease
Super high: EPO secreting tumor (eg. renal cell carcinoma)

Question 17

Polycythemia vera diagnosis

Answer 17

Low EPO

Bone marrow biopsy

or

JAK 2 test

Question 18

Cardiac arrest algorithm

Answer 18

Pg 61

Question 19

When do you use atropin?

What is it?

Answer 19

Symptomatic bradycardia (Hypotension, heart failure)

Anticholinergic medication

Question 20

Conditions that need an increase in levothyroxine

Answer 20

Malabsorptive: eg. celiac disease (common with other autoimmune conditions)

Medications that interfere with absorption: iron, calcium

Medications that increased metabolism: phenytoin, carbamazepine, rifampin

Other:
Hormones
Increase protein
Obesity

Question 21

How do you start treating hypothyroidsm?

Answer 21

Start: 75-125 mcg or 25-50 if elderly or cardiovascular risk

Follow up in 6 weeks. Adjust if needed until normal TSH

Follow up every 6-12 months

Question 22

What is a Type I error in statistics

Answer 22

Rejecting the null hypothesis when is actually true.

This is linked to the alpha value