UW 18

Question 1

Medication that can cause SIDAH

Answer 1

Carbamazepine, SSRI, NSAIDs

Question 2

Mechanism of uric acid stone formation

Answer 2

Excess uric acid production:
Gout, tumor lysis sd

Acidic urine pH
Chronic bicarbonate loss (eg. chronic diarrhea due to Chrons) cause acidic hyperconcentrated urine

Question 3

Chrons + renal stone

Answer 3

Ca oxalate: increased oxalate absorption

Urate: chronic HCO3 loss, acidic urine

Question 4

ECG evidence of right heart strain

Answer 4

ST depresion of V1 - V3

Question 5

Lung cancer with cavitary lesion

Answer 5

SCC

Usually central but can be located in the periphery

Question 6

MIcroscopic colitis

Answer 6

Common in women >50

Nocturnal watery diarrhea

All possible diarrhea wokup are normal

Biopsy: monuclear infiltrate

Question 7

MIcroscopic colitis

Answer 7

Common in women >50, smocking, NSAIDs

Nocturnal, watery diarrhea

All possible diarrhea workup are normal

Biopsy: mononuclear infiltrate

Question 8

Biopsy of Chrons and UC

Answer 8

Chrons: non caseating granulomas

Crypt abscesses: UC

Question 9

Treatment for legionella

Answer 9

Resp fluoroquinolone or macrolide. Treat as empiric community acquired pneumonia

Question 10

Aortic valve replacement indication for AS

Answer 10

Severe AS criteria
Flow velocity >4mm/sec
Transvalvular gradient >40
Diameter <1 cm

Indications for replacement
Severe AS + 1 
... Symptomatic (angina, syncope)
... LVEF < 50%
... Undergoing cardiac surgery

Question 11

If you formula feed your new born.. When do you get your period again?

Answer 11

8-14 weeks

Question 12

Omental caking

Answer 12

Sign of carcinomatosis

Question 13

CT sign of bowel ischemia

Answer 13

Wall thickening

Fever and leukocytosis

Question 14

Waldenstrom macroglobulinemia major manifestations

Answer 14

Hyperviscosity sd (dizzines, confusion, blury vision, ataxia)
Neurologic symptoms: mental status changes, peripheral neuropathy
Hepatosplenomegaly
Lymphadenopaties
Cytopenas

Plasma exchange for symptomatic hyperviscosity

IgM, clonal Bcell malignancy (vs. MM IgG)

Question 15

Waldenstrom macroglobulinemia major manifestations

Answer 15

Hyperviscosity sd (dizzines, headache, confusion, blury vision, ataxia)
Neurologic symptoms: mental status changes, peripheral neuropathy
Hepatosplenomegaly
Lymphadenopaties
Cytopenas

Plasma exchange for symptomatic hyperviscosity

IgM, clonal Bcell malignancy (vs. MM IgG)

Question 16

Acute postviral cerebellar ataxia

Answer 16

Viral symptoms1-3 weeks prior

Cerebellar symptoms: dysmetria, ataxia, nystagmus, intention tremor, staggering gate

Question 17

Ataxia telangiectasia

Answer 17

Ataxia
Infections (immunoglobulin deficiency)
Telangiectasia

Develops before age 2

Question 18

Management of hyporthyroidsm in pregnancy

Answer 18

Increased levothyroxin dose 30%
Monitor TSH levels every 2 weeks
Adjust dose to be accordant to pregnancy levels (lower then normal people)

Question 19

Management of genital warts in pregnancy

Answer 19

Trichloroacetic acid, podophylin resin

Imiquimod contraindicated

Surgery: wait after pregnancy is over