Test 28 - Created July 24

Question 1

serious side effect of ginkgo biloba leaf extract

Answer 1

increased risk of bleeding (partly due to inhibition of platelet-activating factor

Question 2

presentatin of erysipelas

Answer 2

usually legs, possibly face; red, painful, edematous, elevated, sharp demarcation, butterfly rash across face; abrupt onset; fever, chills, malaise

Question 3

look of molluscum contagiosum and how it gets transmitted

Answer 3

small skin-colored papules with indented centers; obtain via skin-to-skin

Question 4

ways you can get toxoplasmosis

Answer 4

raw or undercooked meat, unwashed produce, cat feces

Question 5

tx of toxoplasmosis

Answer 5

pyrimethamine, sulfadiazine, folate

Question 6

nerve injuries during carotid endarterectomy

Answer 6

1. recurrent laryngeal - vocal cord paralysis
2. facial nerve, marginal mandibular branch - asymmetric smile
3. vagus (carotid sheath) - multiple issues
4. ansa hypoglossus - okay to chop
5. hypoglossal - tongue deviation to injured side

Question 7

what to do if H&P gives broad differential diagnosis

Answer 7

state in general terms the most likely possibilities and what testing is necessary

Question 8

features of Addison’s disease

Answer 8

1. sxs: wt loss, abd. pain, asthenia, amenorrhea, fatigue, weak, poor appetite
2. PE: tender mm, decr. axillary/pubic hair, tan
3. labs: hypoNa, hyperK, hyperCl

Question 9

possible thyroid complication after coronary angiography

Answer 9

iodine induced hyperthyroidism

Question 10

necrotizing fasciitis presentation

Answer 10

pain out of proportion to exam, swelling, erythema, fever, htn

Question 11

bug causing necrotizing fasciitis based on risk factors

Answer 11

1. healthy - group A strep
2. immunocompromised - Pseudomonas
3. PVD - polymicrobial
4. crepitus on exam - Clostridum

Question 12

tx of necrotizing fasciitis

Answer 12

pip/tazo + vanc + clinda

Question 13

signs that pneumothorax is not a “tension” ptx

Answer 13

normal BP, no JVD, no tracheal deviation

Question 14

tx of large pneumothorax in absence of tension physiology

Answer 14

chest tube

Question 15

bugs that cause AOM

Answer 15

Strep pneumo, nontypeable H. flu, Moraxella catarrhalis

Question 16

bug that causes otitis-conjunctivitis syndrome

Answer 16

nontypeable H. flu

Question 17

tic disorders

Answer 17

1. Tourette: multiple motor and vocal
2. chronic tic disorder: multiple motor OR vocal; not both
3. provisional tic disorder: tics < 1yr

Question 18

tx of Tourette’s

Answer 18

antipsychotics, clonidine, guanfacine, tetrabenazine

Question 19

what to do if pt has ST depression with minimal exertion on exercise stress testing

Answer 19

schedule percutaneous coronary angiography to evaluate need for revascularization

Question 20

Chikungunya fever presentation

Answer 20

high fevers for 3-5 days -> severe polyarthralgias in hands/wrists, ankles -> chronic joint pain; may have rash

Question 21

how to distinguish malignant versus nonmalignant pancreatic cyst

Answer 21

endoscopic U/S with aspiration

Question 22

common presentation of sickle cell disease in young kids

Answer 22

dactylitis (swelling of hands or feet) and hemolytic anemia (scleral icterus, jaundice)

Question 23

why valacyclovir is preferred over acyclovir for shingles

Answer 23

dosing; val 3x/day; acy 5x/day

Question 24

definition and tx of postherpetic neuralgia

Answer 24

persists >4 mo. from rash onset; TCA’s, gabapentin, pregabalin