Test 32 - Created July 28

Question 1

advantage of long-acting insulin analogs over NPH

Answer 1

less risk of hypoglycemia

Question 2

what does overlapping standard error of measurement error bars indicate

Answer 2

non-statistically significant difference

Question 3

standard deviation rule

Answer 3

1SD = 68%
2SD = 95%
3SD = 99.7%

Question 4

pain pattern for rotator cuff tendonitis

Answer 4

lateral shoulder pain

Question 5

presentation of late neurosyphilis

Answer 5

impaired vibration/proprioception, sensory ataxia, instability during Romberg, decreased pain/temp, areflexia, lancinating pains, Argyll Robertson pupils (constricts w/ accommodation but not w/ light)

Question 6

hyperbilirubinemia exchange transfusion level

Answer 6

> 25 mg/dL

Question 7

tx of auricular hematoma

Answer 7

immediate I and D; pressure dressing; Abx that cover skin flora and Pseudomonas

Question 8

complications of auricular hematoma

Answer 8

cauliflower ear, bacterial superinfection, re-accumulation of hematoma

Question 9

what to suspect with apical diastolic murmur and possible arterial embolus

Answer 9

left atrial myxoma

Question 10

signs of arterial occlusion in a limb

Answer 10

acute-onset pain, diminished pulses, pale/cool

Question 11

common presentation of hypothyroidism in elderly

Answer 11

impaired cognition, hyponatremia, macrocytosis

Question 12

what predicts prognosis in chronic lymphocytic leukemia

Answer 12

thrombocytopenia, anemia, multiple chain LAP, hepatosplenomegaly

Question 13

presentation of tick paralysis

Answer 13

brief prodrome of fatigue and paresthesias, gait ataxia and ascending paralysis that develops over hours, absent DTRs; look for the tick!!!

Question 14

difference btwn tick paralysis and Guillain-Barre

Answer 14

source; GBS occurs days/weeks after GI or respiratory infection

Question 15

tx of botulism

Answer 15

equine serum heptavalent antitoxin

Question 16

initial evaluation for tuberous sclerosis

Answer 16

skin exam, CNS imaging, abdominal imaging (renal), EEG if seizures suspected

Question 17

leading cause of death in tuberous sclerosis patients

Answer 17

neuro impairment, predominantly caused by seizures

Question 18

what labs are used to assess thyroid fn during tx with PTU or methimazole

Answer 18

total T3 and free T4; (TSH may be suppressed for months)

Question 19

pregnancy reference range for TSH

Answer 19

1st: 0.1-2.5
2nd: 0.2-3.0
3rd: 0.3-3.0

Question 20

tx of hypothyroidism in pregnancy

Answer 20

increase levothyroxine 30%, monitor TSH q4w, adjust dose based on trimester reference ranges

Question 21

what test can help distinguish diabetes insipidus from primary (psychogenic) polydipsia

Answer 21

water deprivation test; urine Osm is unchanged in DI but increases in primary polydipsia

Question 22

next step with agitated delirious elderly person

Answer 22

usually reorientation, but if pt is a threat to themselves or staff, low dose haloperidol is needed