Test 30 - Created July 26

Question 1

test to confirm dx of posterior urethral valve

Answer 1

VCUG - dilated bladderk, maybe ureter reflux/dilation, dilated proximal urethra

Question 2

tx of posterior urethral valve

Answer 2

ablation of the valve during cystoscopy

Question 3

tx of keratosis pilaris

Answer 3

emollients and topical keratolytics (salicylic acid or urea)

Question 4

presentation of lactose intolerance

Answer 4

periumbilical abd. pain, flatulence/bloating, and D

Question 5

dx of lactose intolerance

Answer 5

sxs resolve on lactose-restricted diet or do lactose breath hydrogen test

Question 6

PE maneuver to test for complete rupture of Achilles tendon

Answer 6

Thompson test - pt lying down, squeeze pt’s calf mm and observe for plantar flexion of foot; not damaged if it happens

Question 7

tx of RA anemia

Answer 7

anti-TNF-a antibody (infliximab)

Question 8

associated PE finding with amaurosis fugax

Answer 8

carotid bruit (atherosclerotic dz present in carotid artery)

Question 9

primordial prevention

Answer 9

prevention of RFs themselves; encourage children to NOT adopt harmful lifestyles

Question 10

primary prevention

Answer 10

action taken before a pt develops a dz; try to prevent occurrence of dz itself

Question 11

secondary prevention

Answer 11

action that halts or delays progression of a disease at its initial stage and prevents complications

Question 12

tertiary prevention

Answer 12

dz has advanced beyond early stages; taking actions to limit impairments and disabilities

Question 13

quaternary prevention

Answer 13

set of health activities that limit consequences of unnecessary or excessive intervention by health system

Question 14

prevention of preeclampsia in pt’s who are at high risk (h/o renal dz, DM, HTN, prior PreE)

Answer 14

start aspirin at 12 wks GA

Question 15

prevention of preterm delivery in pt’s with short cervix

Answer 15

vaginal progesterone

Question 16

tx of asthma exacerbation in pregnant female

Answer 16

duo-neb -> systemic steroids -> mag or terbutaline; oxygen if need be

Question 17

tx of acute hepatitis B virus when pt has icterus, elevated LFTs, and stable vitals

Answer 17

close outpt f/u for serial labs

Question 18

next best step once neuro exam and CT or EEG indicates brain death

Answer 18

apnea test to confirm dx of brain death, plus any local legal requirements

Question 19

in a pt w/ HIV and PCP Pna, what ABG criteria needs to be met for steroid therapy?

Answer 19

A-a oxygen gradient > 35 mmHg and/or PaO2 tension < 70 mmHg on room air

Question 20

paranoid personality disorder

Answer 20

pervasive pattern of distrust and suspiciousness in a variety of settings - work, partner; holds grudges, benign comments are threats

Question 21

paranoid versus borderline personality disorder

Answer 21

both can have suspiciousness and angry reactions; BPD has self-destructive behavior and impulsivity

Question 22

presentation and locations of lichen planus

Answer 22

discrete, intensely pruritic, polygonal-shaped violaceous papules or plaques on flexural services of arms/legs, buccal mucosa, or external genitalia; mouth may have erosive lesions or lacelike, reticular Wickham striae

Question 23

screen to do in pt with lichen planus

Answer 23

hepatitis C antibodies (with presence of risk factors)

Question 24

tx of pediatric pneumonia outpatient

Answer 24

preschool or lobar: amoxi (strep pneumo)

older or bilateral: azithro (mycoplasma)

Question 25

empiric tx of septic arthritis that’s likely bacterial

Answer 25

vanc; add cefotaxine if < 3 mo. old

Question 26

lab findings of nonfunctioning pituitary adenoma

Answer 26

low LH and FSH; elevated a-subunit levels; (gonadotrophs is what makes up the tumor and it normally secretes LH and FSH)

Question 27

tx of nonfunctioning pituitary adenoma

Answer 27

trans-sphenoidal surgery

Question 28

hint in question stem that will lead you to prolactinoma versus nonfunctioning pituitary adenoma

Answer 28

prolactinoma has prolactin levels >200

Question 29

what do with new-onset A.fib pt

Answer 29

besides a rate control med… do CHA2DS2-VASc score assessment to determine need for anticoagulation; 2/+ needs it