U World 6 pick up sticks

Question 1

Anticholinergic toxicity

Answer 1

hyperthermia
mydriasis 
delirium 
urinary retention 
dry mouth
↓ bowel sounds

Question 2

TCA toxicity

Answer 2

Looks like anticholinergic
(dry, hot, red, mad)
+
CNS depression, arrhythmias, and hypotension

Question 3

Joint pain in a smoker

Answer 3

hypertrophic osteoarthropathy which is associated with lung cancer

digital clubbing, sudden arthropathy, often hands/fingers

Question 4

Multiple myeloma features

Answer 4

• osteolytic bone lesions
• frequent infection from hypogammaglobulinemia
• Hyper Ca
• Renal insufficiency

Question 5

What is “normal” hearing (bone vs air)

Answer 5

air> bone

Question 6

Pattern of hearing loss in sensorineual

Answer 6

air> bone

webber localizes to unaffected

Question 7

What is the pattern of hearing loss for conductive

Answer 7

bone> air

webber localizes to affected ear

Question 8

Antibiotics in EHEC

Answer 8

antibiotics ↑ hemolytic uremic syndrome and should be avoided

Question 9

Diarrhea in C. Perfringens

Answer 9

toxin mediated
food borne
non bloody

Question 10

What likely contributes to statin induced myopathy

Answer 10

statins ↓ coQ10 –> myopathy

Question 11

How do statins work

Answer 11

inhibit HMG-CoA reductase

Question 12

Masses in the mediastinum by location

Answer 12

anterior: thymoma, retrosternal thyroid, lymphoma
middle: bronchogenic cyst
posterior: neurogenic/ esophageal tumors

Question 13

Serology for lyme disease

Answer 13

very insensitive

if you suspect lyme disease, treat with doxy no need to confirm

Question 14

When do you not vaccinate in HIV

Answer 14

no live vaccines CD4 under 200

live= MMR, zoster, varicella

Question 15

When would you use high intensity statin

Answer 15

LDL > 190
ASCVD risk > 7.5
clinical symptoms in under age 75

Question 16

What are the high intensity statins

Answer 16

40 mg + atrovostaitin and 20 mg + rosuvostatin

Question 17

Polymyalgia rheumatica

Answer 17

pts > 50
↑ ESR
stiffness of: neck, shoulders, pelvis

Question 18

Hypersensitivity pneumonitis

Answer 18

inflammation of lung parenchyma from antigen exposure

chronic exposure–> honeycombing of lung

rx: antigen avoidance

Question 19

What classically alleviates pain from diffuse esophageal spasm

Answer 19

nitrates

Question 20

Most common cause of megaloblastic anemia in alcoholics

Answer 20

folate

Question 21

Contraction alkalsis

Answer 21

volume down –> ↑ aldosterone

aldosterone dumps K and acid into the urine

result= met alk and hypo k

Question 22

Case control study

Answer 22

a case and a control are selected

then determine previous exposures

Question 23

Acute digoxin toxicity

Answer 23

acute GI symptoms

Amiodarone–> ↑ digoxin

chronic s/s: neurological / visual

Question 24

How do you treat back pain from prostate mets to the spine

Answer 24

Radiation

bisphosphonates help, but less so

Question 25

Invasive aspergillosis

Answer 25

fever, chest pain, hemoptysis
CD4 under 50
cxr: focal lesions

Question 26

Rx for renal transplant rejection

Answer 26

High dose IV steroid

Question 27

Pellagra

Answer 27

dermatitis
diarrhea
dementia

long term isoniazid can cause this

Question 28

Acute intermittent porphyria

Answer 28

ab pain
NVD
paresthesias/ confusion

Question 29

Actinomyces

Answer 29

oral flora bacteria
anaerobic
drains sulfur granules
rx: penicillin

Question 30

Nocardia

Answer 30

wild west sketchy
bacteria
rx: tpm-smx

Question 31

Azithromycin drug class

Answer 31

macrolide

good for URIs

Question 32

CHF blood gas

Answer 32

CHF –> tachypnea –> resp alkalosis

Question 33

Where do most PEs come from?

Answer 33

The thigh

calf clots are less likely to move

Question 34

Acute aortic dissection rx?

Answer 34

IV beta blocker

↓ HR, contractility, and BP

Question 35

Herpes esophagitis

Answer 35

small well defined round ulcers
intranuclear inclusions on biopsy
rx: acyclovir

Question 36

CMV Esophagitis

Answer 36

large linear ulcers
intranuclear and intracytoplasmic inclusions
rx: ganciclovir

Question 37

What is an ideal FiO2

Answer 37

under 60%

should try to decrease FiO2 as soon as possible

Can ↑ PEEP if needed