Test 33 - IM GI/GU/Hepato/ENT

Question 1

Major side effect of acyclovir and prevention of it:

Answer 1

Severe Nephrotoxicity in 5-10% of patients, prevent by aggressive IV hydration

Question 2

How ong does it take to deplete folic acid stores? B12 stores?

Answer 2

Folate - 4-5 months B12 - 4-5 years

Question 3

Patient w diet of canned foods, hot tea and toast. What dietary deficiency do they have?

Answer 3

Folate - found in green leafy vegetables and liver. Depleted in cooked foods due to heat sensitivity

Question 4

Risk factors for rhabdomyolysis? What do you worry about with rhabdo?

Answer 4

Risk factors: immobility, cocaine

Worry about acute renal failure (AKI)

Question 5

What is winter’s formula? What is it good for?

Answer 5

Winter’s formula: arterial PaCO2 = 1.5 [HCO3] + 8 +/-2

Is used to help determine respiratory compensation when the body is in metabolic acidosis or alkylosis.

Question 6

Fever, chills, sore throat, muffled voice, and deviation of the uvula. What is dx? trt? What are complications?

Answer 6

Dx:Peritonsillar abcess probably secondary to tonsilitis.Patients typically have prominent unilateral lymphadenopathy.

Trt: Needle aspiration of the abcess and IV antibiotics. Surgery if recurrence.

Comp: Can cuase airway obstruction or spread of infection to the carotid sheat

Question 7

What is the most common and serious complication of peptic ulcer disease?

Answer 7

Hemorrhage: Upper GI bleeding. Vomitting blood.

Other complications: perforation, penetration, gastric outlet obstruction.