USMLE spaghetti night

Question 1

constrictive pericarditis s/s

Answer 1

pericardial calcifications

RV failure

mid diastolic pericardial knock

Question 2

Pneumococcal vaccine before age 65

Answer 2

before 65- PPSV23

After 65
PCV 13, then repeat PPSV23

Question 3

Renal failure and cocaine

Answer 3

20% cocaine OD has rhabdo

Rhabdo –> ↑ CPK –> ATN

Question 4

Hepatorenal syndrome

Answer 4

in end stage liver disease

↑ RAS –> ↓↓ GFR from splanchnic arterial dilation

Question 5

Stress induced cardiomyopathy

Answer 5

caused by emotional/ physical stress

s/s: CP, SOB

ECG abnormal w/ ↑ cardiac enzymes

Question 6

Prego w/ lyme disease rx

Answer 6

amoxicillin

Question 7

Waldenstrom macroglobulinemia

Answer 7

plasma cell neoplasm

monoclonal IgM

neuropathy, neuro findings, and anemia

Question 8

M spike in multiple myeloma

Answer 8

light chains (IgG or IgA)

Question 9

Hep C kidney problem

Answer 9

membranoproliferative glomerulonephritis

dymorphic red cells, RBC casts

Question 10

Crystals in pseudogout

Answer 10

Calcium pyrophosphate dihydrate crystals

Question 11

miotic means?

Answer 11

TINY pupil

little word little pupil

Tolerance rarely reduces the miotic effects of narcotic medications.

Question 12

Kitty bite bug

Answer 12

Pasteurella species are isolated from up to 50% of dog bite wounds and up to 75% of cat bite wounds

Question 13

PPD test size for positive test

Answer 13

normal peeps 15 mm
10 mm in high risk patients
HIV 5 mm

Question 14

The routine tests for a newly diagnosed hypertensive patient include:

Answer 14

CBC
potassium, calcium
creatinine
fasting glucose
a fasting lipid profile
urinalysis,
 resting electrocardiogram

Question 15

renal artery stenosis test

Answer 15

A captopril renal scan or renal magnetic resonance angiography would evaluate this.

Question 16

When to observe a pneumothorax

Answer 16

An initial pneumothorax of <20% may be monitored if the patient has few symptoms.

Follow-up should include a chest radiograph to assess stability at 24–48 hours.

Question 17

The cardiac toxicity of methadone is primarily related to _________

Answer 17

QT prolongation and torsades de pointes.

Question 18

Shingles RX

Answer 18

antivirals

Question 19

drug resistant CMV rx

Answer 19

foscarnet

Question 20

Initial step of cushing’s work up

Answer 20

Any of the 3

• late night salivary cortisol
• 24 hours urine cortisol
• overnight low dose dex suppression

Question 21

Cancer in pernicious anemia

Answer 21

2X risk of gastric cancer

Question 22

Pain- aginal equivalent

Answer 22

An aginal equivalent occurs when a patient has no chest pain, but has other symptoms of cardiac ischemia (e.g., dyspnea) that is predictably precipitated by exertion and relieved by rest

Question 23

Atypical angina

Answer 23

Atypical angina occurs when:

the patient experiences pain that has the quality and characteristics of angina
- or -
occurs with exertion

*but not both.

Question 24

DEXA stands for?

Answer 24

Dual energy x-ray absorptiometry (DEXA) scanning is most precise and is the test of choice for osteoporosis

Question 25

A T-score more than ____ standard deviations below the mean indicates osteoporosis.

Answer 25

2.5 aka a score of –2.5 or lower= osteoporosis.

Question 26

________ is the leading cause of cancer-related deaths in the United States

Answer 26

Lung cancer

Question 27

When do you add steroids in PCP

Answer 27

Adjunctive corticosteroids should also be started in any patient whose initial pO2 on room air is <70 mm Hg.

Question 28

Qualifying for hospice

Answer 28

life expectancy of less than 6 months to qualify for hospice services.

Question 29

The black box warning for thiazolidinediones (ex pioglitazone) specifically addresses __________

Answer 29

heart failure

Question 30

Otitis media rx

Answer 30

Amoxicillin, 80–90 mg/kg/day in two divided doses, which increases the concentration of amoxicillin in the middle ear fluid to help with resistant Pneumococcus.

Question 31

1st line allergy treatment

Answer 31

In multiple studies, intranasal corticosteroid sprays have proven to be more efficacious than the other options listed, even for ocular symptoms.

Question 32

Hypertensive emergencies, defined as severe blood pressure elevations to _________ warrant emergent treatment.

Answer 32

>180/120 mm Hg with evidence of impending or worsening target organ dysfunction,

Question 33

diagnostic imaging procedure for superior mesenteric artery embolization

Answer 33

celiac and mesenteric arteriography

Question 34

The threshold for prophylactic platelet transfusion is ________-

Answer 34

10,000/μL in pts not bleeding and not undergoing surgery

Question 35

First-line agents for ovulation induction and treatment of infertility in patients with PCOS include __________

Answer 35

metformin and clomiphene