Test 45 - Created Aug 10

Question 1

STI screen in an otherwise low risk adult

Answer 1

HIV p24 Ag and Ab screen; add on other based on risk factors and sxs

Question 2

main side effect of isoniazid

Answer 2

hepatotoxicity (neurotoxicity also but less likely in setting of vitamin B6); monitor LFT’s

Question 3

L5 radiculopathy

Answer 3

LBP that radiates down leg; sensory loss over lat. thigh, calf, dorsal foot; weak great toe extension, foot dorsiflexion/inversion/eversion

Question 4

lab findings with acute mesenteric ischemia

Answer 4

leukocytosis; elevated amylase, phosphate, lactate

Question 5

next step when pt presents with chronic daily HA and evidence of raised ICP

Answer 5

MRI with contrast

Question 6

pulmonary cachexia syndrome

Answer 6

when pt with severe lung disease has BMI < 20 or wt loss > 5%. Loss of lean muscle mass due to energy imbalance and systemic inflammation.

Question 7

tx of pulmonary cachexia syndrome

Answer 7

optimization of lung fn, exercise, and nutritional supplementation

Question 8

tx of OCD (therapy wise)

Answer 8

CBT aka exposure and response prevention

Question 9

next step with thyroid nodule and no thyroid sxs

Answer 9

TSH level and u/s

Question 10

after TSH level and u/s done on thyroid nodule, what is next?

Answer 10

nl/elev TSH OR suspicious findings on u/s - do FNA

low TSH - do radionuclide thyroid scan

Question 11

tx of “dumping syndrome”

Answer 11

high protein diet; smaller, more frequent food portions

Question 12

hot versus cold nodules on thyroid scan

Answer 12

hot - treat like benign hyperthyroidism

cold - do FNA

Question 13

what is done after surgery for papillary or follicular thyroid cancer

Answer 13

radioactive iodine

Question 14

serious adverse effect associated with kava kava

Answer 14

hepatoxicity and liver failure

Question 15

adverse effect with Gingko

Answer 15

increased risk of bleeding

Question 16

adverse effects of ginseng

Answer 16

HA, insomnia, GI sxs, vaginal bleeding, hypoglycemia

Question 17

obstetric and fetal complications of chlamydia in pregnancy

Answer 17

pPROM, PTL, postpartum endometritis

neonatal conjunctivitis, neonatal pneumonia

Question 18

presentation of early neurosyphlis which occurs during secondary stage of syphilis

Answer 18

2* stage - rash on palms/soles and LAP

early neurosyphilis - symptomatic meningitis, ocular syphilis, and otosyphilis

Question 19

what absent or reversed umbilical artery end-diastolic flow indicates

Answer 19

impending fetal hypoxia -> time to deliver! (may also see oligohydramnios, no accelerations on NST)

Question 20

true statement of a negative exercise stress test

Answer 20

patients have < 1% risk of cardiovascular events within the next year

Question 21

odds ratio w/o contingency table

Answer 21

(odds of exposure in case)/(odds of exposure in controls)

a/c)/(b/d) or (ad)/(bc

Question 22

primary purpose of treating bacterial vaginosis in pregnancy

Answer 22

symptom relief