2019 ITE

Question 1

What 3 blood markers are the best predictors of the severity of acute pancreatitis?

Answer 1

BUN, Hct & Cr bc they show the degree of intravascular volume depletion. CRP will be elevated no matter what and amylase and lipase have no prognostic value.

Question 2

What would you check to monitor T2DM in patient with hemoglobinopathy(like SSD).

Answer 2

serum fructosamine level - correlates well with A1C which can be falsely low in pt with hemoglobinopathies.

Question 3

2/3 of these characteristics are needed to dx Fetal Alcohol Syndrome

Answer 3

• smooth philtrum
• shortened palpebral fissures
• thin vermilion border of the upper lip

Question 4

T/F Topiramate can cause increased formation of uric acid stones

Answer 4

false! Calcium phospate stones! 2/2 metabolic acidosis causing hypercalciuria

Question 5

Before what age do you need only 2 doses of HPV vaccine?

Answer 5

15

Question 6

Metatarsus adductus should resolve by age…

Answer 6

1

Question 7

When should you repeat TB testing on patient who is traveling to endemic area?

Answer 7

8-10 weeks after they return. no need for ppx or any of that shit

Question 8

When would you refer a patient with Dupuytren’s contracture for surgery?

Answer 8

30+ degrees of the metacarpophalangeal joint or any degree with the proximal interphalangeal joint

Question 9

Pityriasis Rosea in prego is associated with…

Answer 9

spontaneous abortion especially if within the first 15 weeks.
*otherwise benign

Question 10

Patients with asymptomatic sarcodosis in addition to regular screening will need yearly screening —- to look for extrapulmonary manifestations of the disease

Answer 10

eye exam

Question 11

T/F ADA states non-nutritive sweeteners are acceptable to use for ppl with DM

Answer 11

T

Question 12

CDC recommends perscribing naloxone to patients once MME reach —- per day. What MME should you never go over?

Answer 12

50, dnt go over 90 -.-

Question 13

Target fasting glucose in prego

Answer 13

<95

Question 14

Cut off for stage 1 HTN

Answer 14

130/80 = start non-pharm tx aka lose weight fatty

Question 15

Patients on 2.5mg + of steroids for >3 months should be started on —- for bone protection

Answer 15

Alendronate/Fosamax

Question 16

Define alcohol use in early remission

Answer 16

no alcohol use in 3 months+ but less than 12 months

Question 17

Best rx for somatic symptom disorder? (be specific)

Answer 17

Sertraline/Zoloft

Question 18

Treatment for EoE?

Answer 18

Budesonide oral suspension 1mg BID

Question 19

CXR findings suspicious for malignancy

Answer 19

> 6mm, non-calcified lesion, lesion doubling in size BETWEEN 1month - 1 year, irregular or spiculated boarders, non-solid ground glass apearance

Question 20

Most common infection in IV drug users?

Answer 20

cellulitis

Question 21

Someone who’s recently diagnosed with celiac disease what would you do you want to check lab wise six months later and why?

Answer 21

IGA tissue Transglutaminase antibody. Check the six months after diagnosis to see if patient is actually avoiding gluten and monitor disease levels. If this remains elevated would likely repeat biopsy to monitor for chronic inflammation

Question 22

Criteria for diagnosis of IBS

Answer 22

Three months with two of the following: pain related to defecation, change in stool form, change in stool frequency

Question 23

Patient with urinary retention after surgery. What should you do and for how long do you treat?

Answer 23

Start Flomax and place a Foley for three days

Question 24

Name two common anti-hypertensive medications that should be stopped prior to checking plasma adosterone/renin activity. How long prior to check in to do stop this medication?

Answer 24

Spironolactone – increases renin and aldosterone
ACE/ARB - increases renin
What medication should be stopped 4–6 weeks prior to checking levels

Question 25

Patient with an area of target erythema on my egg after a tick bite. What do you treat them with him for how long?

Answer 25

Doxycycline 100 mg twice daily for 10 days (7-21d)