Step3 29

Question 1

Complication for women renal donor

Answer 1

Gestational complications:
Fetal loss
Preeclampsia
Gestational Diabetes
Gestational hypertension

Question 2

Pharmacologic treatment option for stress incontinence

Answer 2

Duloxetine

Question 3

DIverison and misused of drugs

Answer 3

Diversion:
Give it to someone else

Misuse:
Use of higher dose or with other substance to achieve “high:

Question 4

Family medical leave act

Benefit
Qualifying employee
Covered conditions

Answer 4

Benefit:
Up to 12 weeks of unpaid leave (continuous or intermittent)
Job is secure

Qualifying employee
> Half-time
> 1 year employed
The employer has >50 employees

Covered condition
Serious health problem
Childbirth and newborn care
Care of child, spouse or parent

Question 5

Maneuvers that can worsen the pain of Carpal Tunel sd.

Answer 5

Phalen test: hyperflexion of the wrist

Tinel test: tapping over the nerve

Hand elevation

Reverse phalen: hyperflexion

Question 6

Management of Carpal tunnel syndrome

Diagnostic studies

Answer 6

Splint
Steroids
Surgery

Nerve conduction studies and Electromyography to see if there is nerve damage, usually reserve for patient refractory to treatment where surgery is being considered

Question 7

Management of preeclampsia with severe features

Answer 7

Deliver if >34 weeks

Control BP
Start magnesium drip
Deliver (vaginal or c-section depends on the state of the mother and/or baby

Question 8

Preeclampsia severe features (6)

Answer 8

Systolic BP >160 Diastolic >110 (2 time in 4 hrs)

Change in:
Platelets
LFTs
Creatinine

Visual changes

Pulmonary edema

Question 9

Work up for a solid testicular mass

Answer 9

Bilateral ultrasound…

Markers: B-hCG, AFP
CT
Orchiectomy + biopsy. (Do not perform trans scrotal biopsy as it increases the risk for lymphatic cancer disemination)
Chemotherapy

Question 10

Mentzer index

Answer 10

MCV/RBC

Mentzer index >13 indicates Iron deficiency anemia

<13: Thalassemia

Question 11

Antibiotic treatment for mastitis

Answer 11

S. aureus

Dicloxacillin
Cephalexin

Question 12

Management of suspected breast abscess

Answer 12

Ultrasound
Fine needle aspiration

Incision and drainage are not indicated because increases the risk of fistulas, longer recovery time, and lower cosmetic desire

Question 13

Managment of incidentaloma

Answer 13

Dexamethasone supresion test
Urine: 
Metanephrine: pheochromocytoma
Catecholamines
Venilmandelic, homovanilic acid: neuroblastoma
17-ketosteroid

Surgical excision if:
Malignant impression
Secreting tumor
> 4cm (even if cold)

Question 14

Ocular melanoma

Clinical presentation
Management

Answer 14

Clinical presentation:
Usually asymptomatic
Blurry vision, floaters

Management

If asymptomatic and small (<10mm diameter and <3 thickness), follow up in 3 months and every 6 months there after

If not, chemotherapy

Surgery (enucleation) is reserved for bigger tumors