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World Questions Flashcards

1
Q

2 week old female w/ ambiguous genitalia. Hyponatremia, hyperkalemia. Decreased cortisol, aldosterone. Increased testosterone. Increased 17-hydroxyprogesterone. Diagnosis?

A

21-hydroxylase deficiency

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2
Q

Acute medical management of aortic dissection?

A

IV beta-blockers. Reduce SBP to 100-120 and HR to <60

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3
Q

HIV patient with CD4 less than 200 should receive prophylaxis with what medication? To prevent what?

A

Trimethoprin/Sulfamethoxazole

To prevent PCP

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4
Q

HIV patient with CD4 less than 50 should receive prophylaxis with what medication? To prevent what?

A

Azithromycin or Clarithromycin

To prevent MAC

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5
Q

American Academy of Neurology recommends ruling out these 2 disorders before diagnosing dementia?

A

B12 deficiency
Hypothyroidism
(alcoholics should also have B1 levels checked)

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6
Q

First line agents for Alzheimer’s dementia?

A

Acetycholinesterase inhibitors (donepezil, tacrine)

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7
Q

Indications for bariatric surgery?

A

BMI >40 who have failed medical management

BMI >35 with obesity related comorbid conditions

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8
Q

Management of porcelain gallbladder?

A

Elective cholecystectomy. Risk of developing gallbladder carcinoma

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9
Q

What is Morrison’s pouch?

A

Space in the upper abdomen, hepatorenal space. Blood noted here means there may be up to 500 cc of blood in the abdomen

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10
Q

Respiratory distress, AMS, and petechial rash in a patient suffering from bone fractures. Diagnosis?

A

Fat embolism

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11
Q

Symptoms of benzo withdrawal?

A

Anxiety, agitation, confusion, seizures, psychosis, elevated blood pressure, tachycardia, and elevated body temperature

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12
Q

Philadelphia chromosome associated with?

A

Chronic Myeloid Leukemia

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13
Q

Chronic Myeloid Leukemia treatment?

A

Tyrosine Kinase Inhibitors (imatinib)

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14
Q

Arthrocentesis of gout patient shows?

A

Negatively birefringent needle shaped crystals

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15
Q

First line treatments for gouty attacks?

A

Indomethacin and Colchicine

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16
Q

Contrandication to colchicine use?

A

renal failure

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17
Q

Indications for treatment of subclinical hypothyroidism?

A
  • Antithyroid antibodies

- Abnormal lipid profile

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18
Q

Hypercalcemia, normal PTH, and urinary calcium less than 100. Diagnosis?

A

Familial Hypocalciuric Hypercalcemia

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19
Q

Treatment for Lyme disease?

A

28 day course of amoxicillin or doxycycline

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20
Q

Contraindications to MMR vaccine?

A

Anaphylaxis to neomycin
Anaphylaxis to gelatin
Pregnant
Immunodeficient

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21
Q

Most common anatomic risk factor for Mallory-Weiss tears?

A

Hiatal hernia

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22
Q

Clinical findings of Pick’s disease?

A

Speech abnormalities, Executive functioning impairment, irritable mood, hyper-oral behavior, disinhibition

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23
Q

CT brain findings in Pick’s disease?

A

Symmetric atrophy of frontal and temporal lobes

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24
Q

Vertical nystagmus in an awake or agitated patient, concern for?

A

PCP overdose

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25
Q

Children with constipation, after increased fiber-intake, next line agent?

A

Magnesium hydroxide (milk of magnesia)

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26
Q

Pediatric sepsis less than 1 month old. What organisms do you target? What antibiotics?

A

E. coli and GBS

Ampicillin + Gentamicin or Cefotaxime

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27
Q

Healthcare worker with needlestick from known HIV-patient. What do you do next?

A

Immediate HIV test and 2 NRTI drug regimen (Zidovudine, Lamivudine, Tenofivir, Emtricitibine)

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28
Q

What is the difference between Premenstrual Sydnrome and Premenstrual Dysphoric Disorder?

A

Premenstrual syndrome - Emotional and Physical symptoms that occur in the second half of the menstrual cycle and are relieved by menses.
Premenstrual Dysphoric Disorder - Severe form of PMS characterized by anger and irritabiilty

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29
Q

First-line and Second-line agents for treatment for Premenstrual Syndrome or Premenstrual Dysphoric Disorder?

A
  1. SSRI’s

2. Try a difference SSRI or OCPs

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30
Q

Cancers that most frequently metastasize to brain, in order of frequency?

A
  1. Lung
  2. Breast
  3. Unknown primary
  4. Melanoma
  5. Colon cancer
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31
Q

Earliest sign of phenytoin toxicity?

Other signs?

A

Earliest - Horizontal nystagmus on far lateral gaze
Other signs - Blurred vision, diplopia, ataxia, slurred speech, lethargy and decreased mentation which can progress to coma.

32
Q

Usual therapeutic range of phenytoin?

A

10-20 mcg/mL

33
Q

Anterior uveitis (iritis) characterized by?

A

Eye, pain, redness, variable vision loss, constricted irregular pupil, visualization of leukocytes in anterior segment on slit-lamp exam.

34
Q

How many weeks after a clavicle fracture can a patient return to non-contact sports?

35
Q

How do you differentiate diaper dermatitis from candidal dermatitis?

A

Candida dermatitis - tomato-red, satellite papules, involves crural folds, also may have history of recent antbiotic use.

36
Q

Hydrophobia (fear of drinking fluids because of pharyngeal spasms mimicking drowning) pathognomonic for?

37
Q

First line and second-line treatment for chronic prostatitis?

A

First-line - Quinolones (Cipro and Levaquin)

Second line - Bactrim

38
Q

First-line and second-line treatment for squamous cell carcinoma?

A

First-line - Surgical excision

Second-line - Radiation therapy

39
Q

Adverse effects of isoniazid?

A

Hepatotoxicity, peripheral neuropathy

40
Q

Spina bifida managemet after delivery?

A

Neurosurgical consult for surgery in 24-48 hours

41
Q

First-line treatment for condyloma accuminata?

A

Trichloroacetic acid application

42
Q

Treatment for post-partum endometritis?

A

Clindamycin and gentamycin

43
Q

Main risk factor for developing post-partum endometritis?

44
Q

Which form of hyperbilirubinemia is typically pathologic, conjugated or non-conjugated?

A

Conjugated hyperbilirubinemia. Most serious form is biliary atresia

45
Q

How high are CPK levels in rhabdomyelolysis?

A

At least 10,000

46
Q

Pseudomembranous colitis found on sigmoidoscopy or colonoscopy. Diagnosis?

47
Q

Antibiotics most commonly implicated in causing C diff?

A

Most common is Flouroquinolones (Cipro, levaquin) also, –Extended-spectrum penicillins

  • cephalosporins
  • clindamycin
48
Q

Best initial imaging of choice for pneumothorax?

A

Upright CXR PA view

49
Q

Gingko Biloba main adverse effect?

A

Bleeding and platelet dysfunction. Caution in patients taking anticoagulants

50
Q

Lacrimation, yawning, mydriasis. Withdrawal or overdose of what type of drug?

A

Opioid withdrawal

51
Q

Which antibiotics are most commonly associated with CNS adverse effects, including seizures?

A

Beta-lactams: Penicillins, cephalosporins, monobactams, Carbapenems, and fluoroquinolones

52
Q

MELD score for patients being considered for TIPS?

A

Less than 14 is most favorable outcome. Greater than 24 is contraindication.

53
Q

What is the 90 day mortality for patients with MELD score of <15, 30, and 40?

A

MELD <15 = 5% mortality
MELD 30 = 35% mortality
MELD 40 = 90% mortality

54
Q

Which 3 drugs interfere with folate metabolism and can lead to folate deficiency?

A

Trimethoprim
Methotrexate
Phenytoin

55
Q

Drug of choice for treating chronic folate deficiency anemia in patients on methotrexate?

A

Folinic acid (Leucovorin). Folic acid is helpful but still requires dihydrofolate reductase to convert it which is inhibited by methotrexate.

56
Q

First-line agents for pulmonary hypertension if vasoreactivity test shows favorable response? Second-line agents?

A
  1. Calcium Channel Blockers

2. Prostanoids, Endothelial receptor antagonists, or PDE-5 inhibitors

57
Q

Treatment for herpes zoster?

A

Acyclovir 800 mg PO 5x/day for 7-10 days

58
Q

Safe and rapid response treatment for Bipolar I disorder with a Manic episode with psychotic features during pregnancy?

59
Q

Average sized adult, 1 unit of platelets raises platelet count how much?

A

5,000/microL

60
Q

Average amount of time to see rate control response to diltiazem or metoprolol, or emsolol IV in a-fiv RVR patients?

61
Q

Tourrete syndrome associated with what other psychiatric comorbidities?

A

ADHD and OCD

62
Q

Treatment for relapsing or secondary progressive Multiple Sclerosis?

A

Beta-interferon or Glatiramer acetate

63
Q

Suspicious for Hashimoto’s thyroiditis, next diagnostic step?

A

Serum anti-TPO antibodies

64
Q

What dyslipidemia is often seen with hypothyroidism?

A

Increased LDL and Triglycerides

65
Q

6 week old infant with staccato cough, rales, and hyperinflated lungs on cxr. Diagnosis?

A

Chlamydial pneumonia

66
Q

Infant with cough, wheezes and fever. Diagnosis?

A

RSV bronchiolitis

67
Q

Infant chlamydial pneumonia presents at what age range? Treatment?

A

4-12 weeks. Treat with oral erythromycin for 14 days

68
Q

Infants receiving oraly erythromycin have higher risk of?

A

Hypertrophic pyloric stenosis

69
Q

Diarrhea and eosinophilia. Differential diagnosis?

A

Helminthic infection, eosinophilic gastroenteritis, Addison’s disease

70
Q

First and second line options for post-exposure chemoprophylaxis to meningococcus meningitis?

A
  1. Rifampin

2. Cipro

71
Q

Medication regimen for hyperthyroidism in pregnancy?

A

PTU in first trimester. Switch to Methimazole in 2nd and 3rd trimester. (Prolonged PTU has risk of liver failure)

72
Q

Management of asymptomatic, euthyroid, thyroid nodules based on size?

A

Less than 1 cm -> yearly ultrasounds

Greater than 1 cm -> FNA

73
Q

Hypomagnesemia caused by?

A

Aloholism, prolonged nasogastric suction, diarrhea, diuretic use

74
Q

Drugs that can cause digoxin toxicity if used with digoxin?

A

Amiodarone, verapamil, spironolactone, quinidine

75
Q

DKA patient develops fouls smelling nasal discharge, facial swelling, fever, maxillary tenderness, headache. Diagnosis?

A

Mucormycosis, rapidly invasive fungal disease caused by zygomycetes. Need amphotericin B and stat surgical debridement

76
Q

Unilateral headache and Horner’s syndrome, rule out?

A

Carotid dissection

Medicine (10 decks)

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