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Difference between prospective cohort vs cross sectional studies

Prospective cohort compares disease incidence
Cross sectional compares disease prevalence


Patients with celiac sprue who presents with GI sx (watery diarrhea) despite adherence to gluten free diet most likely has what disease?

Intestinal T cell lymphoma


oliguria, hypotension, elevated BUN and creatinine in hospitalized patient. Ddx?

Acute tubular necrosis (muddy brown cast, high FeNA)


Steps in evaluating impaired gastric emptying

1. first rule out mechanical obstruction; upper endoscopy
2. if nondiagnostic, and malignancy is a concern, obtain CT or MRI
3. then perform tests for gastric dysmotility, like scintigraphic gastric emptying tests


Treatment for pregnant TB infected patients

9 months of isoniazid, ethambutol, rifampin
unless drug resistant, avoid pyrazinamide due to teratogenicity


Causes of acute painless vision loss

- central retinal artery occlusion: sudden, cherry red spot, hx of amaurosis fugax, pale fundus
- central retinal vein occlusion: subacute, retinal hemorrhage, optic disc edema ("blood and thunder")
- retinal detachment: floaters, fundus with vitreous hemorrhage, marked elevation of retina
- vitreous hemorrhage: decreased red reflex, hemorrhage on funduscopy, bed rest with elevation


Characteristic lesions of cutaneous cryptococcus, confirmatory test?

small, reddish brown papules with central umbilication (like molluscum contagiosum)
- biopsy


Common fractures when you fall on an outstretched hand

colles fracture (distal radius)- at risk for acute CTS
scaphoid fracture
ulnar styloid fracture


Treatment of bacterial vaginosis (fishy odor, homongenous vaginal discharge)

oral metronidazole or clindamycin


Which diseases are related to multiple skin tags? dermatitis herpertiformis?

- skin tags: insulin resistance, pregnancy, crohn's dz (perinanal)
- derm. herp: celiac disease


catatonia treatment

-benzo, ECT


Management of pts with acute ischemic stroke who received TPA

- keep bp <185/105
- do not give antiplatelets, anticoagulation, invasive therapy in the first 24 hours


Initial diagnostic test of dermatomyositis (proximal muscle weakness, helitrope rash, gottron's papules, elevated muscle enzymes)? must needed screening test?

- ANA testing
- serum antibodies; anti Ro, La, anti Jo
- cancer screening test needed as it is associated with malignancy


Management of breast mass in women under 30 and above 30?

- <30: ultrasound +/- mammogram--> complicated cyst? then core biopsy, if not, elective needle aspiration1
->30: mammogram +/- ultrasound--> malignancy? then core biopsy


Autoimmune hepatitis (young to middle aged women, elevated AST/ALT and normal everything else) diagnosis test?

ANA, anti smooth muscle ab


opioid withdrawal management

- opioid antagonist: methadone, buprenorphine (preferred under supervised setting)
- nonopioid: clonidine, antiemetics, antidiarrheals, benzos


clinical presentation of nondominant parietal lesion vs dominant parietal lesion

- nondominant (right): construction apraxia---confusion, difficulty drawing lines, dressing issues
- dominant (left): Gerstmann syndrome---acalculia, finger agnosia, agraphia, left right confusion


strongest known risk factor for breast cancer in male

klinefelter's syndrome


first line treatment of severe bipolar mania in pregnant patients



Pernicious anemia shows what in gastric endoscopy?

- glandular atrophy
- intestinal metaplasia
- inflammation


best diagnostic test for sickle cell anemia

hemoglobin electrophoresis


Most common complication of cat scratch disease

suppuration of lymph nodes


Most common cause of pediatric pneumonia and treatment

- preschool or focal lung findings: strep pneumo, high dose amoxicillin
- older or b/l lung findings: mycoplasma, azithro


Primary prevention of esophageal varices? Management of acute esophageal bleeding?

- nonselective beta blockers- propanolol, nadolol
- banding with endoscopy at first attempt, at recurrence, try again. Then if that fails, try TIPS


Clinical presentation of acute mesenteric ischemia

- acute abdominal pain where physical exam does not match severity of pain.
- metabolic acidosis


presentation of esophageal perforation/boerhaave's syndrome

- acute chest pain with repeated vomiting
- tear in distal third of esophagus, leads to pleural effusion
- pneumomediastinum, pneumothorax can be seen


trimethoprim, methotrexate, and phenytoin can cause what kind of anemia through which mechanism? Tx?

- macrocytic anemia by inhibiting DHFR
- need folinic acid, not folic acid, as folinic acid is more potent


What can prevent febrile nonhemolytic transfusion reaction (occurs 1-6 hours after transfusion)

** washing cells is for IgA deficiency


Most common complication of patients admitted with acute variceal bleeding, what ppx treatment is needed?

need fluoroquinolone agent for 7-10 days


Which medication group contributes most to pulmonary edema?

pioglitazone/thiazolidinedione group