06 APR 2017 1948 MIX

Question 1

how can primary hyperparathyroidism be differentiated from familial hypocalciuric hypercalcemia?

Answer 1

in primary hyperPTH there is increased urinary calcium excretion (due to bone resorption)

Question 2

what is the treatment for major depressive disorder with psychotic features?

Answer 2

• antidepressant and antipsychotic OR

- antidepressant and ECT

Question 3

how does the levonorgestrel IUD prevent pregnancy?

Answer 3

releases levonorgestrel (a progestin) which creates a physical barrier by thickening cervical mucus and impairing implantation through decidualization of the endometrium

Question 4

why is the levonorgestrel IUD a good choice for women with heavy periods and / or are anemic?

Answer 4

side effect is amenorrhea

Question 5

in addition to colon cancer, patients with lynch syndrome are at extremely high risk for what other cancer?

Answer 5

endometrial (also ovarian)

Question 6

the development of a new conduction abnormality in patients with infective endocarditis should raise suspicion for:

Answer 6

perivalvular abscess (extending into adjacent cardiac conduction pathways)

Question 7

what enzymes are elevated even before manifestation of weakness in duchenne muscular dystrophy?

Answer 7

• serum CPK

- serum aldolase

Question 8

acute kidney rejection is best treated by:

Answer 8

IV steroids

Question 9

what is the use for chlordiazepoxide?

Answer 9

long acting benzo for alcohol withdrawal

Question 10

what are the baseline tests before starting lithium therapy?

Answer 10

• UA
• BUN
• creatinine
• thyroid function tests
• ECG in patients with coronary risk

Question 11

what is the treatment for warm agglutinin autoimmune hemolytic anemia?

Answer 11

high dose glucocorticoids

Question 12

how do TCAs cause cardiac toxicity?

Answer 12

• inhibit fast sodium channels in the His Purkinje system and myocardium
• decreases conduction velocity, increases duration of repolarization, and prolongs absolute refractory periods
• result: hypotension, prolonged QRS, ventricular arrhythmias

Question 13

how does sodium bicarbonate reverese TCA toxicity?

Answer 13

• NaHCO3 increases serum pH and extracellular sodium
• increased pH (7.5-7.55) decreases avidity for sodium channels
• elevated extracellular sodium concentration increases the electrochemical gradient across cardiac cells and affects the ability of TCAs to bind to fast sodium channels

Question 14

how does sodium bicarbonate reverse salicylate toxicity?

Answer 14

urine alkalinization