Tests 8 and 9 - Created July 4

Question 1

Mentzer index

Answer 1

MCV/RBC
iron def > 13
a/b thalassemias < 13

Question 2

iron studies results with thalassemias

Answer 2

normal or increased iron and ferritin

Question 3

evaluation of choriocarcinoma

Answer 3

TFTs, LFTs, renal fn, pelvic u/s, CXR, beta-quant

Question 4

presentation of tension-type headache

Answer 4

develop under stress, periodic, bifrontal, non-throbbing, band-like dull pain, can have phonophobia or photophobia (if pt has both, it’s not tension-type)

Question 5

central tendency in skewed patterns

Answer 5

right tail: mode -> median -> mean
left tail: mean -> median -> mode
mode is largest in both

Question 6

what to do with infants born to GBS(+) mothers

Answer 6

no matter the prophylaxis, observe in nursery for 48 hrs; if mom poorly treated AND baby preterm or prolonged ROM, then do CBC and BCx also

Question 7

warfarin pt with newly added amiodarone

Answer 7

decrease warfarin dose; amio will slow its metabolism, which increases overall amount; f/u INR closely

Question 8

what to do with person with chronic GERD and risk factors for Barrett’s (old, fat, white M, former smoker)

Answer 8

do upper GI endoscopy to look for dysplasia

Question 9

what to do in pt with IBD flare and toxic megacolon

Answer 9

bowel rest, NG tube, steroids, IVF, may need Abx; avoid steroids if infectious etiology

Question 10

treatment for condylomata acuminata

Answer 10

trichloroacetic acid or podophyllin (not internally or during pregnancy) -> interferon? -> surgery

Question 11

frequency of colonoscopies

Answer 11

annual: familial polyp syndromes
2-6 mo: removed large polyp
3y: removed advanced polyp; repeat good -> 5y
10y: if good

Question 12

hematochezia

Answer 12

bright red or maroon-colored stool; usually lower GI bleed; 15% = upper; consider EGD if they have hemodynamic instability and RFs

Question 13

anasarca

Answer 13

general swelling of whole body

Question 14

bodily fluids from HIV pt exposed to a person: when to give PEP

Answer 14

exposure to any fluid with blood in it

Question 15

2nd line therapy for atopic dermatitis (after conservative therapy)

Answer 15

topical glucocorticoids (hydrocortisone, triamcinolone, betamethasone) or calcineurin inhibitors (tacrolimus) for more sensitive areas

Question 16

presentation of TB meningitis

Answer 16

HA, low-grade fever, lassitude -> nuchal rigidity, V, confusion, CN palsies, coma, seizures

Question 17

findings of TB meningitis on optic disc and CT scan

Answer 17

disc: choroidal tubercles (yellow-white nodules)
CT: basilar meningeal enhancement

Question 18

CSF findings in TB meningitis

Answer 18

elev protein, low G, lymphocytes!, elev ADA

Question 19

therapy for TB meningitis

Answer 19

a) adjuvant glucocorticoids to reduce CNS infl.
b) 2 mo. of RIP + FQN or AG
c) 9-12 mo. of RI

Question 20

when to be concerned for latent TB with 5 and 10 mm induration

Answer 20

5 mm - HIV, recent contact, fibrosis on CXR, organ transplant, immunocompromised

10 mm - recent immigrant, IV drugs, lives in high-risk setting, kid < 4 yo

Question 21

tx for latent TB

Answer 21

3-4 months of rifampin or rifampin plus isoniazid

Question 22

induration size when BCG vaccine given and when it wears off

Answer 22

usually < 15 mm; induration effect decreases significantly after 15 years

Question 23

why subactue thyroiditis occurs

Answer 23

postviral infl. process

Question 24

presentation of subacute thyroiditis

Answer 24

fever, neck pain, tender goiter, elev ESR; decr. uptake on thyroid scintigraphy

Question 25

tx of subacute thyroiditis

Answer 25

NSAID and BB; +/- glucocorticoids

Question 26

mgt of Giardia outbreak

Answer 26

advise those with sxs to stay away from recreational water venues and to take metronidazole

Question 27

acute OE mgt

Answer 27

topical acetic acid -> topical Abx -> wick -> systemic Abx if invasive