11/3's practice

Question 1

murmur associated with rheumatic fever?

Answer 1

mitral regurgitation

Question 2

What is the definitive test result for polycystic ovary?

Answer 2

LH:FSH ratio of 2:1 or greater

Question 3

What cancer is associated with pheochromocytoma?

Answer 3

Medullary thyroid CA

Question 4

What is the diagnostic test for amoebiasis?

Answer 4

indirect hemagglutination test for amoebiasis

Question 5

A 30-year-old man presents with a 1-year history of watery diarrhea. He has lost 5 kg. He has joint pains of 1-month duration. His stool examination for occult blood is negative. Stool culture is negative. No ova and cyst are seen in the stool. Laboratory tests fail to reveal rheumatoid factor or anti-nuclear antibodies. Serum calcium, phosphorous and alkaline phosphatase is 9.2 mg/dl, 4 mg/dl and 110 U/L respectively. A biopsy taken from the upper intestine shows distended macrophages in the lamina propria, which is found to be positive with PAS stain. What is the most likely diagnosis in this case??

Answer 5

Whipple disease - macrophages indicate infection

Question 6

What demographic factors influence one’s risk for SCC?

Answer 6

male gender, caucasian, light eyes

Question 7

What lab test is ordered in an adolescent female to assess when she may begin menses?

Answer 7

FSH

Question 8

What is the APC genetic test for?

Answer 8

familial adenomatosis polyposis syndrome

Question 9

What is the MSH2 genetic test for?

Answer 9

hereditary non-polyposis colon cancer syndrome

Question 10

What is the RET genetic test for? Associated conditions (3)?

Answer 10

multiple endocrine neoplasia syndrome type II (MEN-II), which is typically associated with medullary thyroid cancer, parathyroid adenomas, and pheochromocytomas

Question 11

What do ACE inhibitors do to oral hypoglycemics?

Answer 11

Increase their activity, increasing the risk of hypoglycemia

Question 12

Patient with diarrhea, dermatitis, and dementia, diagnosis? Treatment?

Answer 12

Niacin deficiency - diet high in tryptophan

Question 13

What is the most common location of an anal fissure?

Answer 13

Posterior

Question 14

What is the first line treatment for an acute Meniere’s disease flare of symptoms?

Answer 14

Benzos (valium)

Question 15

What is the threshold of outbreaks/year for beginning prophylactic herpes therapy?

Answer 15

> = 6/year

Question 16

At what point after an acetaminophen overdose do LFTs start to rise?

Answer 16

12 hours

Question 17

What medication is given to decrease the size of fibroids?

Answer 17

Lupron

Question 18

What is preferred management for SVC syndrome?

Answer 18

stenting/radiation

Question 19

A 20 yo woman p/w malodorous vaginal discharge. Physical examination reveals a homogeneous gray discharge. Some of the vaginal discharge is obtained and mixed with 10% KOH, whereupon a fishy amine odor is produced. A Gram stain of the vaginal discharge reveals diagnostic “clue” cells. Diagnosis?

Answer 19

Bacterial vaginosis

Question 20

A 72-year-old man presents with double vision, weakness, fatigue, nausea, and abdominal discomfort. Med list: Digoxin, Furosemide, Potassium, Acetylsalicylic acid, Amoxicillin. What is the culprit?

Answer 20

Digoxin

Question 21

Infant with a loud systolic ejection murmur is ascertained at the left upper sternal border. An EKG reveals normal sinus rhythm and the chest X-ray reveals a “boot shaped” cardiac shadow. Diagnosis?

Answer 21

Tetralogy of Fallot

Question 22

child with fever then rash

Answer 22

roseola

Question 23

floppy newborn of a mother with a mono-like illness at some point in pregnancy, bulging fontanelles. Normal CSF. Diagnosis?

Answer 23

Toxoplasmosis

Question 24

Patient with encephalopathy has an MRI scan of the brain demonstrates low-density lesions in the brain; they represent areas of gross demyelination. What is the most likely diagnosis??

Answer 24

HSV encephalitis

Question 25

What's the first blood test to change in anemia?

Answer 25

Red Cell Distribution Width (RDW)

Question 26

A patient presents with multiple angular, mildly pruritic, flat-topped violaceous papules on both shins as well as Wickham's striae. Diagnosis?

Answer 26

Lichen planus

Question 27

Pt has a superficial form of cellulitis caused by B-hemolytic streptococci. It most typically occurs on the cheek. Diagnosis? Lab finding?

Answer 27

Erysipelas, lymphocytosis

Question 28

A 19-year-old college student presents with numerous mildly erythematous oval lesions with fine scaling over her chest and trunk which appear to follow the cleavage lines of the skin. A week prior to the outbreak of her rash, she noticed a single, similar but larger lesion below the right clavicle. Diagnosis?

Answer 28

Pityriasis Rosea

Question 29

A patient complains of severe itching on the wrists and hands. Examination reveals pinpoint vesicles and pustules, some arranged in an irregular linear fashion. Diagnosis?

Answer 29

Scabies

Question 30

In severe contact dermatitis, what is the treatment?

Answer 30

Prednisone for 12-14 days with a taper

Question 31

An adult presents with diffuse, raised, target-like lesions with two zones of color change. Lesions affect approximately 50% of body surface. He has a recent history of sulfonamide treatment. What is the most likely diagnosis?

Answer 31

Toxic epidermal necrolysis denotes >30 % BSA skin loss with lesions as observed. A drug reaction is the most common cause in adults.

Question 32

What is the treatment for TTP?

Answer 32

Plasma exchange

Question 33

49. A 4-year-old is brought to the clinic with a bright red rash on his face. He had a fever and was irritable for two days prior. Exam reveals a deep red macular facial rash with circumoral pallor. A fine lacy rash is visible on the trunk and shoulders. He is currently afebrile. What is the most likely cause?

Answer 33

erythrovirus aka parvovirus B19 is responsible for erythema infectiosum, also known as "slapped cheek" or "5th disease."

Question 34

A 23-year-old female at 26 weeks gestation presents with myalgias, headache, and fatigue 10 days after returning from a camping trip in the mid-Atlantic US. Exam reveals a nontender, slightly raised, red lesion with central clearing on the lower posterior left thigh. Diagnosis? What is the recommended treatment?

Answer 34

Lyme disease: amoxicillin

Question 35

Pt has a positive geimsa-stained blood smear, dx?

Answer 35

Giemsa-stained blood smears are diagnostic for malaria. The density of parasitemia may correlate with severity of infection.

Question 36

Which class of antibiotics work by inhibiting cell wall synthesis?

Answer 36

PCNs

Question 37

Which of antibiotics class is most strongly associated with an increased risk of prolonged QT syndrome?

Answer 37

macrolides

Question 38

Sulfonamides are antibacterial due to their ability to inhibit what?

Answer 38

folic acid