Test 11 - Created July 6

Question 1

meds to treat restless legs syndrome and their MOA

Answer 1

1. pramipexole or ropinirole - dopamine agonist
   2a. gabapentin - a-2-d Ca ch. ligand
   2b. benzodiazepines - GABA-R agonist; only for intermittent use

Question 2

auscultation locations of mitral versus tricuspid valves

Answer 2

M: 5th intercostal space at L mid-clavicular line
T: same space at L sternal border

Question 3

auscultation locations of pulmonic versus aortic valves

Answer 3

P: 2nd intercostal space at L sternal border
A: same space at R sternal border

Question 4

diagnostic findings on pt with malignant mesothelioma

Answer 4

pleural effusion, calcifications, thickening, mass on CXR; pleural fluid analysis shows low pH and G; cytology can be negative; need biopsy

Question 5

people affected by mesothelioma

Answer 5

cement, tile, car brake pad, or shipbuilding industries

Question 6

chronic silicosis findings on CXR

Answer 6

upper lobe nodules and lower lobe emphysema

Question 7

people affected by mesothelioma

Answer 7

miners, sandblasters, foundry workers, and masons

Question 8

pleural fluid analysis findings with rheumatoid pleural effusion

Answer 8

leukocytes < 5000, G < 60, pH < 7.3, high LDH; will see RA sxs too

Question 9

pleural fluid analysis findings with thoracic duct obstruction

Answer 9

TG level > 110 mg/dL

Question 10

labs to check with suspected fibromyalgia

Answer 10

1. CBC (anemia)
2. ESR or CRP (infl. arthropathy)
3. TSH (hypothyroid myopathy)

Question 11

best next step in stable pt with Wernicke encephalopathy (confused, LR palsy, gait ataxia)

Answer 11

IV thiamine; don’t give dextrose first even if malnourished, it can worsen sxs

Question 12

recommended dietary allowance

Answer 12

Ca: 1200 mg

Vit.D: 600-800 IU

Question 13

when to start bone density screening

Answer 13

age 65 (if no RFs, start sooner if present)

Question 14

quadruple therapy for H. pylori

Answer 14

PPI + bismuth + metro + tetracycline for 10-14 days

Question 15

tests to determine H.pylori eradication

Answer 15

urea breath testing and fecal antigen testing

Question 16

Wilms tumor versus neuroblastoma

Answer 16

both: abdominal mass, HTN
W: hematuria
N: flushing and sweating (from excess catecholamines)

Question 17

other clinical features of neuroblastoma

Answer 17

periorbital ecchymoses, spinal cord compression from epidural invasion, opsoclonus-myoclonus syndrome

Question 18

diagnostics of neuroblastoma

Answer 18

elevated catecholamine metabolites; small/round blue cells on histo; N-myc gene