Test 22 - Created July 22

Question 1

what meds need to be taken 3-4 hours separated from levothyroxine

Answer 1

cholestyramine, Fe, Ca, aluminum hydroxide, PPIs, sucralfate

Question 2

workup for urethral diverticulum

Answer 2

U/A, UCx, pelvic MRI, TVUS

Question 3

risk with subclinical hypothyroidism in females

Answer 3

recurrent miscarriages, especially if anti-TPO Ab’s are present

Question 4

early signs of compartment syndrome

Answer 4

tightness of area, muscle weakness, and pain with passive stretching of mm

Question 5

underlying pathology and result of type 2 HIT

Answer 5

autoAb’s against heparin-plt factor 4 complexes; thrombocytopenia -> thrombosis

Question 6

underlying pathology and result of type 1 HIT

Answer 6

heparin-induced plt clumping; plt nadir around 100k; no tx needed

Question 7

when to suspect cardiac syncope due to V. tach

Answer 7

abrupt onset w/o prodrome and h/o structural heart dz; admit, do tele/echo

Question 8

tx of neonatal polycythemia

Answer 8

IVF and G; if that fails, partial exchange transfusion

Question 9

tx of acute chest syndrome in SCD

Answer 9

ceftriaxone, azithromycin, pain meds, IVF

Question 10

med of choice for prophylaxis of Pneumocystic jiroveci Pna

Answer 10

TMP-SMX

Question 11

what to consider in pt with scleroderma and HTN

Answer 11

scleroderma renal crisis

Question 12

tx of scleroderma renal crisis

Answer 12

1. captopril (watch renal fn!)

2. nitroprusside if CNS sxs present (HA, BV, papilledema)

Question 13

initial tx for hyperkalemia and EKG changes (peaked T -> lost P wave and wide QRS)

Answer 13

calcium gluconate or chloride; followed by beta-agonists or combo of G/insulin to lower serum K

Question 14

initial tx of aortic dissection

Answer 14

pain meds and IV BB; add in nitroprusside if HTN remains

Question 15

in setting of likely pretest probability for PE, interpret V/Q results

Answer 15

normal: NO PE
high: confirms it
low to moderate: indeterminate and needs further testing or empiric tx

Question 16

stress urinary incontinence: intrinsic sphincter def. versus urethral hypermobility

Answer 16

ISD: neuromuscular damage from pelvic surgery or vaginal delivery
UH: pelvic trauma, loss pelvic CT, or high-impact activity

Question 17

if narcolepsy is a possible dx, what’s the next step

Answer 17

sleep study

Question 18

tx of narcolepsy

Answer 18

1. modafinil

2. methylphenidate if 1 fails

Question 19

tx of cataplexy (m. weakness triggered by intense emotional episodes)

Answer 19

SNRI (venlafaxine)

Question 20

Centor criteria for strep

Answer 20

tonsillar exudate, tender ant. cervical LAP, fever, no cough; < 3 is viral