Test 39 - Created Aug 4

Question 1

effect modification

Answer 1

when external variable has (+) or (-) impact on observed effect of a risk factor on disease status

Question 2

what can detect effect modification

Answer 2

stratification; if e.m. present, publish separate measures of outcome at each level

Question 3

presentation of subphrenic abscess

Answer 3

h/o abd. surgery, swinging fever, leukocytosis, cough, shoulder-tip pain

Question 4

best imaging for abdominal abscess

Answer 4

abdominal ultrasound

Question 5

factorial study design or fully crossed design

Answer 5

utilizes more than 2 interventions and all combinations of these

Question 6

causes of primary ovarian insufficiency

Answer 6

Turner, Fragile X, autoimmune oophoritis, anticancer drugs, pelvic radiation, galactosemia

Question 7

next step once primary ovarian insufficiency diagnosed with elevated FSH and low estrogen

Answer 7

adrenal antibodies, TSH, and karyotype analysis

Question 8

how to intubate unstable pt with significant hypoxemia

Answer 8

rapid-sequence intubation with etomidate and succinylcholine

Question 9

lab findings of Rocky Mountain spotted fever

Answer 9

decreased plt’s and sodium; increased AST and ALT

Question 10

PE findings of endometriosis

Answer 10

pelvic pain, rectovaginal nodularity, ovarian mass

Question 11

tx of peri-infarction pericarditis

Answer 11

high-dose aspirin

Question 12

tx of idiopathic or viral acute pericarditis

Answer 12

NSAID + colchicine

Question 13

tx of symptomatic high-grade (70-99%) carotid lesions in pt with life expectancy >5 yrs

Answer 13

carotid endarterectomy

Question 14

what to do in pt with elevated calcitonin levels post-total thyroidectomy for medullary thyroid cancer

Answer 14

CT scan of neck and chest to look for mets

Question 15

mgt of supratherapeutic INR with warfarin

Answer 15

Hold warfarin with all plus
< 4.5: do for 1-2 days
4.5-10: low dose Vit.K if risk of bleed
>10: high dose Vit.K
serious bleed risk: very high dose Vit.K and PCC

Question 16

how does plasma exchange help in TTP

Answer 16

removes the autoAb against ADAMTS13 and replenishes the enzyme with ADAMTS13 from donor serum

Question 17

isolation of hospitalized patients with shingles

Answer 17

localized - standard precautions

disseminated - contact and airborne

Question 18

stress hyperglycemia

Answer 18

transiently elevated bG in patients w/o known diabetes; usually occurs in setting of severe illness

Question 19

what to do in pt with URI for awhile but then has worsening sxs including fever/chills and productive cough

Answer 19

send them to the ER for evaluation, especially if CURB-65 criteria dictates it

Question 20

CURB-65 criteria

Answer 20

Confusion
Urea > 20
Respirations > 30
BP (SBP < 90 or DBP < 60)
Age > 65

Scores:
0-1 - outpatient
2 - hospital
3/+ - ICU

Question 21

pearly penile papules

Answer 21

more than 1 row of small, flesh-colored, dome-topped or filiform papules positioned circumferentially around corona or sulcus of glans penis; no tx necessary

Question 22

labs that indicate drug induced lupus

Answer 22

ANA and anti-histone Ab’s

Question 23

when steroids need to be tapered

Answer 23

more than 3 wks daily use; Cushingoid appearance

Question 24

advance directives

Answer 24

patient preference should always prevail in case of any family conflict regarding withdrawal of life support