USMLEasy

Question 1

Test to determine Meniscal Tear?

Answer 1

McMurray test - palpate the joint line with one hand and internally/externally rotate while flexing and extending the knee. This maneuver elicits a catch with pain at the joint line

Question 2

Antibody positive in early Hep B infection, but negative in chronic infection?

Answer 2

IgM anti-HBc

Question 3

Criteria for IBS?

Answer 3

#12 weeks of symptoms in last year
 #Pain relieved by defecation
#onset with change in stool frequency
#onset with a change in the shape

Question 4

Drugs to relieve dyspnea in terminal lung cancer pt?

Answer 4

opiates

Question 5

Mechanism of bisphosphonates?

Answer 5

inhibit osteoclast activity

Question 6

Poor prognostic sign of exercise stress test?

Answer 6

#ST-segment depression at a heart rate less than 120 bpm 
#ST-segment depression greater than 2.0 mm 
#ST-segment depression lasting more than 6 minutes into recovery
#poor systolic blood pressure, angina, ventricular tachycardia with exercise
#ST-segment depression in multiple leads

Question 7

Extra-articular symptoms of RA?

Answer 7

#Vasculitis
#dry eyes
#dyspnea
#cough

Question 8

After cat bite, when to hospitalize?

Answer 8

bite involves:
#tendon
#joint capsule
#bone
#hand

Question 9

Environmental modifications to help people with allergies?

Answer 9

#low humidity
#Enclosing bedding with allergen impermeable covers
#laundering bedding in hot water
#no carpets
(#air filters not helpful)

Question 10

If BP over 160/90 and failure of lifestyle modifications, next step?

Answer 10

2 drug combination (Thiazide + something else)

Question 11

ASCUS on Pap smear - next step?

Answer 11

#Repeat in 5 months and 1 year OR
#HPV testing OR
#Colposcopy

(if HPV negative, low risk - just redo PAP smear in one year)

Question 12

Triggers for HSV outbreak?

Answer 12

#Fever
#Infection
#UV light exposure

Question 13

Primary HSV symptoms?

Answer 13

#gingivostomatitis with or without cutaneous or perioral lesions
#Fever, malaise, adenopathy

Question 14

First line therapies for smoking cessation?

Answer 14

#nicotine replacement 
#bupropion
#varenicline

Question 15

When not to use nicotine replacement for smoking cessation?

Answer 15

unstable angina

Question 16

When not to use bupropion for smoking cessation?

Answer 16

seizures

Question 17

Second line therapies for smoking cessation?

Answer 17

Clonidine

Question 18

Cocaine withdrawal symptoms?

Answer 18

depression and fatigue (no other physiologic withdrawal)

Question 19

patient with peripheral vestibular disorder - treatment? Mechanisms?

Answer 19

Antihistamines (suppress the vestibular end organ receptors and inhibit activation of the vagal response)

Question 20

Factors that decrease likelihood of UTI?

Answer 20

#absent dysuria
#absent back pain
#history of vaginal discharge
#history of vaginal irrittation

Question 21

Unilateral Edema - ddx?

Answer 21

DVT or cellulitis

Question 22

NYHA classes?

Answer 22

1. no limitation of activity
2. slight discomfort with ordinary activity
3. discomfort with less than ordinary activity
4. symptoms at rest

Question 23

Drugs for postherpetic pain?

Answer 23

Anticonvulsants (valproic acid, carbamazepine, gabapentin)

Question 24

Pt with hematuria with normal pyelogram and urine culture - when to test? what tests?

Answer 24

Over 40

cystoscopy or renal biopsy

Question 25

Drug to d/c before stress testing?

Answer 25

B-blocker

Question 26

Be careful giving St. Johns wart to patients with?

Answer 26

SSRI (can cause serotonin syndome)

Question 27

Be careful with giving Ginkgo boloba to patients with?

Answer 27

aspirin/antiplatelet agents (antiplatelet effects)

Question 28

Lab value that suggest chronic liver disease (as opposed to acute)?

Answer 28

low albumin

Question 29

Tx of WPW? When to treat?

Answer 29

radiofrequency ablation; symptomatic

Question 30

SIde effects of -glitazone?

Answer 30

Edema