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MCCEE Questions > Wrong Question > Flashcards

Wrong Question Flashcards

1
Q

what over the counter medication can cause hepatotoxcitiy

A

NIACIN tablet

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2
Q

Red yeast rice what blood should be moinotored

A

LIVER ENZYMS

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3
Q

ovarian cancer screening

A

No recommendation is recommended

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4
Q

Tx wandering in a patient with ALZIEMERS

A

anticohlinergics

DO not give benzos unless agitated incoming etc

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5
Q

Zollinger Ellison syngrome

A

peptic ulcers increase GASTRIN SECRETION and a tumour in the pancreas (gastronome) also get HYPERCALCEMIA

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6
Q

Dx Zollinger Ellison syngrome

A

measure gastrin levels

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7
Q

most frequent cause of ventricular rupture

A

Necrosis due to artery obstruction

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8
Q

Increase PTT, normal INR , bleeding from nose and bruising both male and female members of the family

A

von Hillebrand disease

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9
Q

hypoglycemic agent that acts on both alpha and beta blockers used with Metformin

A

SITAGLIPTIN

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10
Q

prophylaxis for meningococcus for close contacts and pregnant women

A

Close contact - 4 doses of rifampin every 12 hours

Pregnant women - IM ceftriaxone

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11
Q

inability to birng teeth together properly, visual disturbances and clear nasal discharge due to what fracture

A

MAXILLARY FRActure

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12
Q

Perioperative ventricular arrhythmia GREATEST risk factor

A

congestive heart failure

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13
Q

feeling of dread and apprehensive expectations

A

ANXIety

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14
Q

Treatment of acute gout

A

Indometocin (DO NOT TAKE IF ON WAFARIN)

OR

Colchicine

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15
Q

herpes gential infection transmission

A

Suppressive therapy can REDUCE transmission to sexual partner (acyclivir, famciclovir)

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16
Q

tennis elbow dx

A

lateral epicondylitits best DX PHYSICAL EXAM AND HISTORY

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17
Q

no lactation after birth

A

SHEEHAN SYNDROME
- all pituitary hormones decreased

Aldosterone = uneffective

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18
Q

Megestrol what is it?

A

it is a progesterone analogue
USED In breast cancer and ALSO can be used as an appetite stimulant
MOA: results in adrenal SUPPRESION

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19
Q

COMMON risk factor for retinal detachment

A

Posterior detachment of the virtuous

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20
Q

what eye condition will NOT require ophthalmology appointment

A

BACTERIAL CONGUnctiVITIS

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21
Q

type of nonthrombocytopenia purpura

A

hSp

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22
Q

MOST common cause of fistula in an

A

Rectal absecess

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23
Q

treadmill arterial flow study showing a 20 mmHG decrease in ankle systolic blood pressure immediately following exercise

A

PVD

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24
Q

decrease in ABI

A

PVD

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25
Q

LOUD SOUNDS without ear protection clinical

A

Sensory hearing loss and tinnitus

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26
Q

How many hours or days will antibiotics help prevent thematic fever after having Group a strep throat

A

9 DAYS

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27
Q

what symptom is not produced with antipsychotic drugs

A

tremor at rest

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28
Q

pauci articular juvenille arteritis is ass. w/

A

UVEITIS

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29
Q

Tx SVT

A

Verapamil

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30
Q

What headache is ALWAYS UNILATERAL

A

cluster headache

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31
Q

MOA respiradone

A

Dopamine receptor antagonist

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32
Q

hypertrophic cardiomyopathy

A

cause of sudden death

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33
Q

Flumazenil used for

A

Benzodiazepine

Overdose is acute and there is NO chronic dependance in alcoholic

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34
Q

treatment RSV

A

OXYGEN

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35
Q

what do you give to prevent contrast induced nephropathy

A

isotonic bicarbonate infusion

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36
Q

SOB and cough HTN digital clubbig , fine bisilar inspiratory crackles

A

Idiopathic pulm fibrosis

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37
Q

1 treatment of PVD

A

STRICT EXERCISE PROGRAM

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38
Q

What is NOT a Dx of viral labyrinths

A

Otorrhea

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39
Q

Guttate psoriasis

A

You get after Group A beta streptococcal infection

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40
Q

dark urine and foot edema THINK

A

GN - therefore red blood cell cast

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41
Q

Starvation anionion gap

A

INCREASE ANION GAP

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42
Q

Diarhearra anion gap

A

metabolic acidosis

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43
Q

asthma - uses SABA once per week - what treatment should she get now

A

NO CHANGE IN MEDS - only mild asthma

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44
Q

multiple tender shotty nodules that are immovable in the breast

A

Fibrocystic disease of the breast

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45
Q

highly movable non tender masses in breast

A

FIRBOADENOMA

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46
Q

1 cm ulceration on exocervix - What treatment do u do

A

punch biopsy

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47
Q

feeding tube in Alzhiemers - benefit

A

NONe has been shown

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48
Q

what test do you do for the initial test for ALzhiemers

A

TSH

- b/c hyper or hypo thyroids can mimic alshimers in elderly patients

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49
Q

duration of anticoagulant treatment in each case :
First DVT w/ transient risk factor
First episode DVT with ongoing risk factor such as cancer pr antiphosphlipid antibiody or more than one risk factor
recurrent DVT
first episode with no identifiable risk factors or inherited risk factor (FVL)

A

First Dvt w/ transient risk factor - 3 month
First episode DVT with ongoing risk factor such as cancer pr antiphosphlipid antibiody or more than one risk factor - LIFELONE
recurrent DVT - idenfinite
first episode with no identifiable risk factors or inherited risk factor (FVL) - 6-12 month

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50
Q

leading cause of eyrsipela

A

GROUP A SSTREP PYROGEN

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51
Q

initial dose of Ldopa in Parkinsons

A

100mg tablet THREE times a day = 300mg per day

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52
Q

best test to determine if patient has denentia or not

A

Mini mental state exam

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53
Q

2.5-15 hypoechoic cyst

A

NORMAL _ recheck 8 months

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54
Q

flashing lights in one eye - 74 year old healthy man what does he have?

A

Retintal detachment

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55
Q

when do you get mirgraine syndrome

A

8th decade - where you get virtuous floaters and ARE referred to as SPOTS (not lights - cause that would be retinal detachment )

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56
Q

meripenime

A

decreases 5HT release

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57
Q

suspect an MI

A

get EKG and troponin levels

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58
Q

Dx of renal agenesis

A

Renal doppler US

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59
Q

Smoking withdrawal symptoms

A

Insomnia

impaired conecntration

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60
Q

testies pain improves when elevated

A

epididymis

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61
Q

extensor tendon injury

A

patient can not actively extended the joint but passive extension is possible

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62
Q

treatment of extensor tendon injury

A

Splinting for 6 weeks

If not treated correctly or delayed then a boutonniere deformity can result

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63
Q

After treatment of H.pylori how many months does it take for the results of urea breath test to be negative

A

6-12 months to turn negative

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64
Q

Phaeochromocytome usually occurs in …

A

THIN PATIENTS

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65
Q

xerosis

A

Pathological dryness of the skin
In elederly
worse in winter time , low humidity and low temperature

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66
Q

PAIN IN BIG TOE BUT NOT GOUT THINK

A

Sesamoid bone fracture

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67
Q

verterbal compression fracture

A
  1. measured conservatively - DECREASE IN ACTIVITY until pain is gone
  2. IF PAIN does not go in 2 weeks… then you want to do vertebroblast
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68
Q

Side effect of timolol for glaucoma

A

BRONCHOSPASM

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69
Q

respiratory use

A

Some medical conditions are adversely affected by respiratory use

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70
Q

ISOLATED SYSTOLIC HTN TX

A

hydrochlorothiazide

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71
Q

cotyledons - how to Dx

A

inspect maternal placenta

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72
Q

How to Dx succenturiate placenta

A

inspect the fetal placenta aide (this means an entire lobe

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73
Q

buckle fractures have a high incidence of on union

A

FALSE

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74
Q

OCP with continuous bleeding

A

ADD NSAID

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75
Q

hypertenssion secondary to pseudoephedrine and MAO inhibitor how go treat

A

STOP PSEUDOEPHEDRINE

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76
Q

patient that remains hypotensive after fluids are administered

A

YOU wANT TO TREAT WITH NOREPINEPHRINE infusion then correct whatever clinically is causing it (ex. PE)

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77
Q

saddle shaped extension into both pulmonary arteries with widen mediastinum TX

A

think its a PE

want to do an embolectomy

78
Q

bright light therapy is good for what sleep disorder

A

shift night insomnia

79
Q

tourettes

A

is a tic disorder that begins in childhood

80
Q

what has the greatest risk of endometrial carcinoma

A

THINK PCOS

81
Q

what vitamin is produced endogneously

A

VIT D and K

82
Q

what cardiac cause can chronic alcohol abuse lead to

A

DILATED CARDIOPMYOPATHY

83
Q

what drug can cause a false decrease PSA level

A

finasteride

84
Q

recurrent pneumonia in 3 year old … think

A

CYSTIC FIBROSIS

85
Q

Fournier gangrene Tx

A

THIS IS an example of necrotizing facts of the perineal peianal or genital area best treatment with IV CIPROFLOXACIN

86
Q

loss of vaiablitiy on CTG .. what next

A

DO A biophySIcAL PROFILE

87
Q

IBS tx

A

Loperamide

88
Q

past Hx of schizophrenia … what makes u re-evaluate the patient

A

ELATED MOOD

89
Q

Long term complication of heamochromatosis leads to cirrhosis which leads to

A

PORTAL HTN Schistosomiasis and hepatic vascular abnormalitis

90
Q

Mode of adheradace of Huntigtons

What % will male children will be affected if dad has

A

ADOSOMAL DOMINANT

50% chance they will have sons and then a 50% chance they will get the disease
0.5X 0.5 = 25%

91
Q

How to distinguish depressive symptoms from metastatic disease

A

WITHDRAWAL FROM FAMILY

92
Q

grandmother has TB and dies… what test do you do in family

A

PPD testing in rest of family

93
Q

Flattening of inspiratory loop of the flow volume loop but NORMAL expiratory phase

A

THINK vocal cord disfunction

94
Q

treatment hypercalcemia

A

normal saline iV

95
Q

postpartum urinary retension

A

discharge with caterer in place and close follow up

96
Q

what is not ass. w/ psychogenic amnesia …

A

Moderate to devere anterograde amnesia

97
Q

opisthotonus in newborn - is when the body is held in an abnormally extended position how do you tx

A

this is due to pathological jaundice - UCB - and therefore you want to initial exchange transfusion

98
Q

Does Conjugated (direct) bilirubin cause BIND - bilirubin induced neurologic dysfunction - >340 mol/l known as vigitiphobia because of its concerning association with neurologic disorder

A

NO

BIND is tx with exchange transfusion (caused by UCB )

99
Q

what antibiotic causes esophagitis in elderly

A

TETRACYCLINE

100
Q

what animal do you not need to protect against if concerned about rabies

A

any small rodents (rats, mice or squirls)

101
Q

Chronic adominal pain is ass. w/

A

type A personality with chronic ado pain - stress related

102
Q

lower limb deem, bilateral basilar lung crackles, SOB and diaphoresis Hx of diabetes and 2 MI what do you treat him with

A

He is having pulmonary oedema - due to the increase capillary hydrostatic pressure secondary to the elevated pulmonary venous pressure
tx with nitroglycerin - preload reduction, after load reduction and ionotropic support

103
Q

Never give what during an acute exacerbation of negative ionotropism

A

BETA BLOCKERS

104
Q

toddlers diarrhea is NOT ass. w/

A

failure to thrive

105
Q

Marphans - what screening

A

ECHO - every 6 months

placed on a b-blocker

106
Q

history of shingles 3 weeks ago… and the patient has recurrent pain how do you t

A

think it is postherpetic neuralgia and therefore tx with nortriptyline

107
Q

sleep problem that occurs in second half of sleep

A

NIGHTMARES

108
Q

When are tears produced …

A

tears are not produced till 3 months of age and therefore a blocked nasolacimal duct usually becomes apparent after 1 month of age

109
Q

what gender is at higher risk of developing tardive dyskinesia

A

FEAMLE GENDER (males can get it to though just at lower risk)

110
Q

empirical treatment of osteomylitits

A

IV VANCOMYCIN (not naficillin)

111
Q

solitary node in lung - next step

A

take biopsy

112
Q

acute bronchitis how long does cough last for

A

2 weeks and up to 20 days

113
Q

1 test for urolithiasis

A

unenhanced helical CT scan of the abdomen and pelvis

114
Q

acceptable chemoprophylaxis indicated for n.mennigitids

A

Ciprofloxacin (not okay if

115
Q

in elderly what is the number one cause of incontinence

A

DETRUSOR INSTABILITY

116
Q

77 year old man with urinary incontinence - no change with cough sneeze, has a smooth large prostate without irregularity what is the cause of incontinince

A

detrusor instability

117
Q

most serve sign of pancreatitis is

A

HYPOCALCEMIA - because means saponification is caused by release of fatty acids

118
Q

treatment of condylomata acuminated

A

CRYOTHERAPHY

119
Q

PPD test without clinical X-ray finding tx with

A

menas latent TB

treat with 9 months of isoniazid

120
Q

PSA test

A

best used for seeing disease progression and recurrence after post-operatively

121
Q

Short stature case that may need further evaluation

A

prepubescent testicular soze

122
Q

peak level of BHCG

A

Week 8-10

123
Q

cray of neonate RSV

A

Air broncograms

124
Q

absolute contraindication to HRT

A

Acute / severe liver disease

125
Q

elevate levels of what is ass. w/ increase risk of atherosclerosis

A

homocysteine

126
Q

what drug can cause hyperthyroidism

A

Amiodarone

127
Q

tx of ankle sprain

A

semi rigid stirup brace

128
Q

MIBI scan what is it

A

Thallium and technetium Tc 99 sestamibi scan that - GOOD FOR PATIENTS WITH LIMITATIONG IN EXERCISE with normal ECG and chest pain

129
Q

why treat strep pharyngitis

A

want to decrease risk of getting scalet fever

130
Q

bite by someone who suspected to have HIV

A

you should draw blood and test HIV

131
Q

nicotine leads to an increase in

A

GLUCOSE

HDL

132
Q

nicotine tends to lover

A

serum cholesterol LDL serum TG

133
Q

What Sx has a highest risk of MI post sx

A

FEMOROPOPLITEAL Bypass

134
Q

if patient has high calcium… what lab value would diagnose a cause other than hyperparathyroidism

A

Low 24 hour urine calcium

this would be a finding in familial hypocalciutic hypercalcemia

135
Q

What test does not need to be done for turners

A

MRI of brain

136
Q

IV oral chelation

A

only wheh >70

137
Q

ORAL CHELATION

A

45-69

138
Q

WHEN DOES VIRAL SHEEDING occur in norwalk

A

viral sheeding occurs long after acute illness

139
Q

suspected pneumonia in neonate 1st test

A

Oxygen saturation by pulse oximetry

140
Q

crying fussy child

A

flurescein strip should be performed to exclude corneal abration

141
Q

anxiety towards strangers happens at what age

A

6 months

142
Q

proteinuria and puffy eyes kids

A

NEPHROTIC SYNDROME

they will also have high cholesterol

143
Q

MCC of neonatal death if mom had diabetes before pregnancy

A

Congenital abnormalitis

144
Q

tx celiac skin problem

A

Daspone

145
Q

What should injury is most serious and life threatening

A

SC joint

146
Q

1 cause of pneumonia in 6 month old

A

RSV

147
Q

when is tocolysis contraindicatied

A

when the cervix is dilated 3cm

148
Q

after delivery when does a mother get her menstrual cycle if she is not breast feeding

A

3 months

149
Q

tc hirtuisim in PCOS

A

spirolactone

150
Q

left lower ado pain, pelvic US best diagnosis what

A

Adnexal torsion

151
Q

if last period was April 17 when is the patient due

A

negate rule = 9 months + 7 days =- JANUARY 24

152
Q

treatment of pyelonephritis in pregnancy

A

IV Ceftriaxone

153
Q

AGUS - most likely what

A

CIN

154
Q

unilateral varoceile on the right

A

requires more investigation

155
Q

high INR slightly high aPTT with normal bleeding time

A

vit K disorder

INR always slightly higher

156
Q

perforation of the apendendix ten days later fever, pain

A

pelvic absess

157
Q

tenderness of radial head without swelling - FOSH

A

radial fracture - put in posterior split and rex-ray 1-2 weeks

158
Q

patient with a previous postoperative venous thromboembolism is at risk of another after another Sx therefore what do u do

A

Start subcutaneous enoxaparin (Lovenox) 1-2 hour prior to surgery and once a day after surgery

159
Q

4mm stone but the patient is vomitting what do you do

A

Admit and hospital medical management

160
Q

fluroscenin staining is negative with tearing and blurry vision

A

Think intraocular foreign body

not corneal abrasion - would have a positive fluroscein test

161
Q

treatment of choice for massive heamatesis

A

Ensocopic ligation

162
Q

nissen fundoplication is the treatment of choice for

A

GERD

163
Q

extensor tendon injury when do you recommend sx

know as mallet finger

A

if they lack passive extension of DIP joint

164
Q

flexor tendon injury - unable to flex at distal IPJ - what do you do
(know as jersey finger)

A

splint the finger

slightlu flexed position and urgerly refer hi to a hand surgery

165
Q

treatment of ankle sprain

A

early range of motion exercise to maintain flexibility

166
Q

best screening test for hemochromatosis

A

serum transferrin saturation

167
Q

varicella vaccine recommendation

A

in anyone >60 to prevent PAIN and RECURRENCE of Shingles

168
Q

what is the purpose of randimization in trails

A

to minimize bias between 2 groups

169
Q

16 year old girl … does not live with her parents and has no contact with them who does consent

A

the girl does

170
Q

hyperplastic polyp when to screen

A

10 years - they are concidered to have a normal colposcopy finding and therefore normal .

171
Q

3 or more adenomatous polyps > 1cm how many years

A

3 years

172
Q

1-2 adenomatous polyps

A

5 years

173
Q

if sessile adenoma removed piecemeal should be re-examined when

A

6-12 month

174
Q

face to face time with patients

A

concelling and coordinating care

175
Q

age 50 – went to doctor for routine screening what test should he get first

A

stool for occult blood - every year
colposcopy 10 years
sigmoidotomy 5 years

176
Q

screening at age 40

A

diabetest

177
Q

screening at age 30

A

cholesterol

178
Q

diverticulitis is recommended to increase fiber what other recommendations

A

NONE

179
Q

relapses

A

usually recurrent and part of the change process

180
Q

who should be screened for hepC

A

individuals with recurrent abnormal ALT

181
Q

somatiziation disorder does not need to include

A

hx of depression or anxiety

182
Q

what tx should be avoided in panic symptoms

A

buporpion

183
Q

hx of narcolepsy what do you ass. w/ it

A

hallucination

184
Q

what is the least likely hx of having in conversion disorder

A

childhood of stammering disorder

185
Q

if patient is on benzo and she stops them

A

educate her on the importance of taking medication as percibed

186
Q

buying impulsively plus history of depression

A

bipolar 11

187
Q

acute delrium is treatmed with

A

IV haloperiodol in increasing doses every 30 mintues

188
Q

recent hanging themself then get a history of long and short term memory loss think..

A

cerebral anoxia

189
Q

bipolar diosry has psychosis despite treatment for depression or mania what is the dx

A

schizoaffective disorder

190
Q

depression in elderly what do you have to do first

A

rule our secondary cause of depression

191
Q

treatment of delirium

A

haloperiodol - may lessen agitation or pschyotic symptoms

MCCEE Questions (4 decks)

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