Test 29 - Created July 25

Question 1

observer bias

Answer 1

occurs when studies are qualitative; when observers misclassify data due to individual differences in interpretation or preconceived expectations regarding the tx

Question 2

effect modification

Answer 2

external variable differentially modifies effect of a risk factor on disease of interest in different groups

Question 3

sensitivity and negative result

Answer 3

negative result on a highly sensitive test, rules out the disease; snNout

Question 4

likelihood ratio facts

Answer 4

direct clinical significance; doesn’t change as dz prevalence does; can grade grade clinical significance btwn multiple tests

Question 5

verification bias

Answer 5

when a study uses gold standard testing selectively in order to confirm a preliminary test result; can affect sensitivity or specificity; avoid this by doing gold standard testing in random sample of pt’s

Question 6

contamination bias

Answer 6

when control group unintentionally receives treatment or intervention

Question 7

susceptibility bias

Answer 7

experimental and control groups differ from a prognostic standpoint; randomization helps this

Question 8

med to treat agitation in acute mania

Answer 8

antipsychotic; mood stabilizers will take weeks to work

Question 9

important thing to do with Rh(-) Mom and massive fetomaternal hemorrhage

Answer 9

increase the dose of anti-D Ig

Question 10

exam findings for severe aortic stenosis

Answer 10

1. soft, single S2
2. delayed/diminished carotid pulse (parvus et tardus)
3. loud/late peaking systolic murmur

Question 11

2 drugs to induce ovulation in PCOS pt

Answer 11

letrozole or clomiphene

Question 12

heart finding in baby who has mom with gDM

Answer 12

transient hypertrophic CMP

Question 13

meds for ventricular rate control in rapid A.fib

Answer 13

BB, verapamil, diltiazem

Question 14

tx and order of which to do them for kid with constipation

Answer 14

1. diet change
2. osmotic laxative (lactulose)
   E. stimulant laxatives or enemas

Question 15

child is lacking in vocabulary, next best step

Answer 15

audiology eval

Question 16

what to do in dialysis pt with long-term catheter and signs of infection

Answer 16

a. 2 sets of blood cultures (peripheral site and central catheter)
b. start vanc and cefepime
c. leave the catheter in unless pus at site, septic, unstable vitals, metastatic infection, sxs after 72h of Abx, or BCx shows S. aureus, Pseudomonas, or Candida

Question 17

how to prevent recurrent infeciton in dialysis pt with long-term catheter and history of CRBSI

Answer 17

change catheter over guidewire or do Abx lock therapy after each hemodialysis session

Question 18

prognosis of sarcoidosis

Answer 18

pt will need 12-24 months of steroids initially and most cases resolve over time; (only 25% have progressive lung dz, 10% organ dysfn, they need the fancy meds)

Question 19

tx of peripheral artery disease

Answer 19

1. antiplt/statin, modify RFs, supervised exercise
2. cilostazol
3. stent or bypass surgery

Question 20

Nelson’s syndrome

Answer 20

pituitary enlargement, hyperpigmentation, visual field defect after bilat. adrenalectomy

Question 21

diagnostic workup of pheo

Answer 21

1. 24h urinary metanephrines and catecholamines
2. MRI of abdomen
3. MIBG scan (if MRI failed)

Question 22

tx of surgery complications during pheo removal

Answer 22

1. HTN - nitroprusside or phentolamine
2. htn - NS bolus
3. hypoG - dextrose
4. arrhythmia - lidocaine or esmolol

Question 23

tx of priapism

Answer 23

urination/cold -> aspiration -> phenylephrine

Question 24

workup, dx, and tx of normal-pressure hydrocephalus

Answer 24

1. imaging
2. Miller Fisher test - gait, stride, verbal memory, and visual attn before/after removal of CSF
3. VP shunt if #2 helped

Question 25

heart defect in Down’s syndrome

Answer 25

endocardial cushion defect

Question 26

publication bias and the consequence

Answer 26

studies with significant (+) results are published or included in a systematic review or meta-analysis (may be all the studies with OR > 1); can overestimate the true effect size

Question 27

PE findings of ASD

Answer 27

wide and fixed splitting of S2; mid-systolic ejection murmur (P); mid-diastolic rumble (T)

Question 28

echo finding of ASD

Answer 28

can be RA or RV dilation

Question 29

echo finding for dilated CMP

Answer 29

dilated LV

Question 30

murmur of hypertrophic CMP and echo finding

Answer 30

harsh cres-decre systolic murmur at apex and LLSB; echo - LVH

Question 31

murmur of VSD and echo finding

Answer 31

harsh holosystolic murmur with maximal intensity over left 3rd/4th i.c. spaces; enlarged RV, LV, LA, pulm aa