USMLE March on!

Question 1

_________ stones are the most common of all renal calculi.

Answer 1

Calcium oxalate

rx: potassium citrate should be taken at mealtime to increase urinary pH and urinary citrate (SOR B).

Question 2

Fomepizole (Antizol) is?

Answer 2

Ethylene glycol poisoning antidote

once severe acidosis and renal failure have occurred hemodialysis is necessary

Question 3

In patients with a drug-eluting stent, _________________- is needed because of the increased risk of late stent thrombosis

Answer 3

combined therapy with clopidrogel and aspirin is for 12 months

Question 4

Primidone in essential tremor

Answer 4

Primidone has been effective in the treatment of essential tremor, and in head-to-head studies with propranolol has been shown to be superior after 1 year.

Question 5

First-line therapies for urge urinary incontinence include

Answer 5

issue of detrusor instability.

behavioral therapy, such as pelvic muscle contractions, and anticholinergic therapy.

Question 6

a hemoglobin A 1c of __________ signifies impaired glucose tolerance.

Answer 6

5.7%–6.9%

Patients meeting these criteria have a significantly higher risk of progression to diabetes and should be counseled about lifestyle modifications such as weight loss and exercise.

Question 7

Pain from spinal stenosis is relieved by sitting and aggravated by standing, whereas the opposite is true for pain from a __________.

Answer 7

herniated disk

Question 8

↑ insulin sensitivity in peripheral tissue. Binds to PPAR-γ nuclear transcription regulator

Answer 8

Glitazones/ thiazolidinediones

Pioglitazone, rosiglitazone

Question 9

Ethylene glycol poisoning antidote

Answer 9

Fomepizole (Antizol)

once severe acidosis and renal failure have occurred hemodialysis is necessary

Question 10

Insulin, rapid acting

Answer 10

Lispro,
Aspart,
Glulisine

Binds insulin receptor (tyrosine kinase activity) rapidly, no LAG

Question 11

Glitazones/ thiazolidinediones
Pioglitazone, rosiglitazone
side effects

Answer 11

Weight gain
 edema
Hepatotoxicity
HF
 ↑ risk of fx

Question 12

Insulin, long acting

Answer 12

Detemir, glargine

Question 13

Stimulate postprandial insulin release by binding to K+ channels on β-cell membranes (site differs from sulfonylureas).

Answer 13

Meglitinides- Nateglinide, repaglinide

Question 14

inpatient insulin to outpatient therapy

Answer 14

determine the total amount of insulin used while hospitalized
divide that dose during the day.
2/3 am, with 1/3 pm.

Each time the patient receives insulin, 75% of the dose
should be NPH, and 25% should be regular.

Question 15

Adding NPH in DM

Answer 15

estimating 0.1 unit/kg of body weight in addition to the current regimen

NPH= Insulin, intermediate acting

Question 16

____________- should be withheld before a procedure with radiocontrast dye, as contrast-induced nephropathy may predispose to developing lactic acidosis

Answer 16

Metformin

Question 17

Of all the lipid values, _____ is the single best predictor of an adverse outcome (like CAD).

Answer 17

HDL

Question 18

Smoking and cholesterol

Answer 18

Smoking cessation increases HDL by 5–10 mg/dL, but does not affect LDL, VLDL, or triglycerides

Question 19

___________ blocks much of the flushing that is associated with sustained release niacin preparations

Answer 19

Aspirin

Question 20

Fibrates

Answer 20

Upregulate LPL–> ↓ TG

Gemfibrozil, bezafibrate, fenofibrate

Myopathy (↑risk with statins), cholesterol gallstones

Question 21

Prevent cholesterol absorption at small intestine brush border

Answer 21

Ezetimibe

Question 22

Prevent intestinal reabsorption of bile acids; liver must use cholesterol to make more

Answer 22

Bile acid resins

Cholestyramine, colestipol, colesevelam

Question 23

Inhibits lipolysis (hormone sensitive lipase) in adipose tissue; reduces hepatic VLDL synthesis

Answer 23

Niacin (vitamin B3)

Question 24

_________ lowers cholesterol by interfering with the absorption of cholesterol in the gut.

Answer 24

Ezetemibe (Zetia)

Question 25

Ranolazine

Answer 25

CLINICAL USE Angina refractory to other medical therapies.

Question 26

Hypertension with heart failure rx

Answer 26

Diuretics, ACE/ARBs, β-blockers (compensated HF), aldosterone antagonists.

β-blockers must be used cautiously in decompensated HF and are contraindicated in cardiogenic shock.

Question 27

Ezetemibe (Zetia)

Answer 27

lowers cholesterol by interfering with the absorption of cholesterol in the gut.

Question 28

Hypertension with diabetes mellitus rx

Answer 28

ACE inhibitors/ARBs, Ca2+ channel blockers, thiazide diuretics, β-blockers.

ACE inhibitors/ARBs are protective against diabetic nephropathy.

Question 29

Hypertension in pregnancy rx

Answer 29

Hydralazine, labetalol, methyldopa, nifedipine