USMLE World 1/28/15

Question 1

What drug is indicated in BPH + htn?

Answer 1

alpha-1 blocker (e.g. prazosin, doxazosin)

Question 2

Why are alpha-1 blockers also good for diabetics?

Answer 2

↓ insulin resistance, ↓LDL, ↑HDL

Question 3

What therapy (beyond optimal medical mgmt) of CHF is recommended for pts w/ EF<35% w/ LBBB?

Answer 3

cardiac resynchronization therapy (biventricular pacing)

Question 4

A patient started on androgens may have to _______ their synthroid dose because androgens _______.

Answer 4

decrease; decrease serum thyroid-binding globulin

Question 5

A patient started on glucocorticoids may have to _______ their synthroid dose because glucocorticoids _______.

Answer 5

decrease; decrease circulating TBG

Question 6

What is the appropriate imaging study for avascular necrosis of the femoral head?

Answer 6

MRI hip

Question 7

Sjogren’s syndrome increases the risk of what cancer?

Answer 7

B-cell lymphoma

Question 8

Vertigo, dysarthria, diplopi, and numbness in a pt w/ risk factors for emboli, thrombi, or arterial dissection.

Answer 8

vertebrobasilar insufficiency

Question 9

Name a cause of hypervitaminosis D.

Answer 9

granulomatous disease

Question 10

Aside from dextrose, what should be given in sulfonylurea (e.g. glyburide) overdose?

Answer 10

octreotide

Question 11

Pts w/ typical cholecystitis Sx who can’t have surgery should be given _______.

Answer 11

ursodeoxycholic acid (UDCA)

Question 12

What is the purpose of cholecystokinin-stimulated cholescintigraphy?

Answer 12

evaluate for functional gallbladder disease (in pt’s w/ typical biliary colic, but no stones)

Question 13

Pt w/ choledocholithiasis confirmed or suspected by US should under go _______.

Answer 13

ERCP

Question 14

What syndrome causes decreased sensation over anterolateral thigh without weakness or DTR abnormalities.

Answer 14

meralgia paresthetica

Question 15

What is the cause of meralgia paresthetica?

Answer 15

entrapment of lateral femoral cutaneous nerve

Question 16

What is the conservative Tx of meralgia paresthetica?

Answer 16

weight loss and avoidance of tight-fitting garments

Question 17

What is the cutoff time from onset of ischemic stroke symptoms to fibrinolytic therapy?

Answer 17

4 hrs

Question 18

Htn up to a BP of ___ is generally permitted in pts w/ ischemic stroke who do not receive thrombolytic therapy.

Answer 18

220/120

Question 19

Is full dose heparin used to treat ischemic stroke? Why?

Answer 19

No! Risk of hemorrhagic transformation.

Question 20

Why does octreotide help in sulfonylurea overdose?

Answer 20

It inhibits insulin release from the pancreas. (Opposite effect of sulfonylureas.)