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1

Initial evaluation of chronic diarrhea

microscopic stool exam for leucocytes, parasites, ova, and occult blood

2

If patient develops rapid myelopathy (paresthesias, flaccid paralysis), what is best next step in management if they have bladder/bowel dysfunction? if they do not have bladder dysfx?

- w/ bladder/bowel dysfx or sensory deficit, then MRI. Otherwise, it is GBS-- nerve conduction study
- If MRI is normal and gadolinum enhancement is absent, then lumbar puncture.

3

Treatment for nonfunctioning pituitary adenoma (increased alpha subunits, low gonadotropin levels)? For prolactinomas (prolactin >200)?

- trans-sphenoidal surgery
- prolactinomas: cabergoline (dopaminergic meds)

4

Treatment of dumping syndrome (complication of gastrectomy, causes n/v, abdominal pain, diarrhea, neurovegetative sx like dizziness, sweating etc)

high protein diet, smaller more frequent meals

5

multiple brain metastasis treatment

whole brain radiation

6

Salmonella treatment

- supportive- fluids and electrolytes

7

Plantar warts, usually due to HPV, treatment options

- topical salicylic acid for at least 2-3 weeks

8

Surgical management options for renal cell carcinoma

- if stage 1 (confined within renal capsule), then partial nephrectomy
- if stage 2 (beyond renal capsule but not beyond Gerota's fascia), then radial nephrectomy
- if metastatic, then chemo/immunotherapy

9

Complications of multiple myeloma

- hypercalcemia
- renal insufficiency
- infections (PNA, UTI)
- hyperviscosity syndrome
- lytic bone lesions- need skeletal survey, bisphosphonates for prevention
- thrombosis

10

How does esophageal dysmotility present in scleroderma

- absent peristalsis in lower two thirds of esophagus
- decreased LES tone (as opposed to achalasia, which has increased LES tone)

11

Indications for ICU admission in diabetic ketoacidosis

- pH <7.1
- bicarb < 5
- AMS

12

Management of nonsuicidal self injury (scratching, superficial cuts)

- screen for suicidal ideation
- comprehensive psych eval but no need to be admitted

13

Post partum thyroiditis vs Graves disease lab values for TSH, thyroglobulin, anti-TPO, RAIU, T4

- both low TSH
- post partum: high thyroglobulin--> occurs when thyroid gland destroyed
- low RAIU vs high RAIU in graves
- may have increased anti TPO in post partum

14

Clinical features of MCL tear

- pain with valgus stress test
- instability with lateral movement
- effusion uncommon

15

When does type II error (beta) occur?

when study is too small
power= 1-beta
- when a study fails to reject a null hypothesis that is false

16

acute asthma exacerbation management

- o2
- short acting beta agonist (albuterol)
- systemic steroids, NOT inhaled steroids (this is more for long term ppx)

17

Treatment of metoclopramide induced acute dystonia

- diphenhydramine IV- anticholinergic

18

Initial evaluation of tuberous sclerosis (hypopigmented lesions/ashleaf spots, CNS lesions, seizures, autism, behavior problems, rhabdomyoma)

- skin examination
- MRI of brain for hamartomas
- EEG if seizures are present (seizures most predominant cause of death)

19

Risk factors and screening for iron deficiency anemia in children <2

- exclusive breastfeeding after 6 months
- lead exposure
- prematurity
- low iron diet, exposure to milk before age 1
- screening test: CBC when 9-12months old

20

What test should women with elevated AFP receive? (AFP measurements occur 16-20 weeks)

Ultrasound

21

Clinical features of Chagas disease (leading cause of dilated cardiomyopathy in Central and South America)

- Left ventricular apical aneurysm
- embolic complications
- arrhythmias

22

Kava kava side effect (used for anxiety)

hepatic injury

23

Side effect of licorice (used for stomach ulcers, bronchiolitis/viral infection)

hypertension, hypokalemia

24

Prevention for acute rheumatic fever (usually after untreated streptococcal meningitis; joints, cardiac issue, nodules, erythema marginatum, syndemham chorea)

IM penicillin for group A strep until adulthood

25

Med choice during pregnancy in hyperthyroidism patients

- in first trimester: propylthiouracil
- in second and third, can use methimazole due to liver toxcity of ptu

26

In blunt cardiac injury in MVA, what are initial tests that should be ordered?

- chest x-ray; if abnormal, then CT chest or FAST
- ECG

27

Treatment of adhesive capsulitis (frozen shoulder; decrease in both passive and active movements)

- ROM exercises
- glucocorticoid injection

28

What is Nelson's syndrome?

- pituitary enlargement, hyperpigmentation, visual field defect following bilateral adrenalectomy

29

First line treatment for prolactinomas?

dopaminergic receptor agonist, including large prolactinomas