3/22

Question 1

MS vision thing

Answer 1

optic neuritis

Question 2

kidney stone management by size

Answer 2

< 5: toradol
5 - 10: flomax
> 10 mm: urology; >8 unlikely to pass

Question 3

hemochromatosis screen

Answer 3

transferrin sat (>60 in men, >50 in women)

Question 4

what gives you xanthelomas

Answer 4

familial hypercholesterolemia (not TGs)

Question 5

tx primary adrenal insuff

Answer 5

prednisone

fludrocortisone (mineralicorticoid)

Question 6

ups and downs in primary adrenal insuff

Answer 6

cortisone, aldosterone down
sodium, glucose down
potassium up

Question 7

age for CT screen (smoking)

Answer 7

50 to 80 + 20 pack year + smoked in past 15 yrs

medicare 55-77, 30 pack year

Question 8

acute onset fever, LAD, w/o pharyngitis

Answer 8

think toxo?

Question 9

condyloma

Answer 9

lata: secondary syphilis
acuminata: HPV

Question 10

rash with rheumatic fever

Answer 10

erythema marginatum

Question 11

lyme bullseye

Answer 11

erythema migrans

Question 12

erythema multiforme

Answer 12

think HSV, sulfa drugs, autoimmune

Question 13

orthostats

Answer 13

SBP drop >20

DBP > 10

Question 14

spondylolysis vs spondylolisthesis

Answer 14

thesis has ant displacement

lysis breaks pars

Question 15

INR for afib coumadin folk

Answer 15

2-3

Question 16

pneumotosis intestinalis

Answer 16

mesenteric ischemia

Question 17

other screening in chronic urinary retention

Answer 17

renal U/S

Question 18

obstructive vs restrictive FEV1/FVC

Answer 18

obstructive decreased

restrictive increased

Question 19

empiric outpt CAP tx

Answer 19

amox + azithro

Question 20

sever dz

Answer 20

heel pain age 8 - 12, sports

inflammation of growth plate

Question 21

kids w/ fever, rash, arthritis, LAD

Answer 21

stills (systemic juvenile idiopathic arthritis )

Question 22

complications of stills dz in kids

Answer 22

macrophage activation syndrome, osteoporosis, growth stunting

Question 23

pimples on a newborn

Answer 23

erythema toxicum

Question 24

when is it infantile acne

Answer 24

3-4 mo

Question 25

OSA neck circumfrence RF

Answer 25

16 in females, 17 in males

Question 26

ankle brachial index number

Answer 26

< 0.9 = PAD 0.4 - 0.9 = claudication < 0.4 = gangrene/tissue loss

Question 27

hutchinson sign (zoster)

Answer 27

vesicles on nose, worry about ocular

Question 28

next step shock refractory Vfib

Answer 28

amiodarone (300 mg) or lidocaine

Question 29

afib vs multifocal atrial tachycardia

Answer 29

MAT has 3+ p wave morphologies, afib has no p waves

Question 30

chlamydia screening

Answer 30

fucking stupid, no men, only girls < 24

Question 31

IBS pathophys

Answer 31

apparently serotonin (too much --> diarrhea, too little --> constipation)

Question 32

meds to avoid in sick sinus syndrome

Answer 32

CCBs, BBs, digoxin

Question 33

kiddo with grey exudate on tonsils that bleeds when scraped

Answer 33

diphtheria

Question 34

diphtheria tx

Answer 34

erythromycin (antitoxin if severe only)

Question 35

severe hypercalcemia

Answer 35

> 14

Question 36

hypercalcemia tx

Answer 36

calcitonin, loops, bisphos, glucocorticoids, dialysis

Question 37

adjustment d/o timeframe

Answer 37

< 3 mo from stressor

Question 38

morton neuroma

Answer 38

btwn 3rd and 4th toe, squeeze metatarsals to test , > 5 mm is bad

Question 39

IV for etoh withdrawal

Answer 39

Glucose, thiamine

Question 40

Mcc bacterial meningitis

Answer 40

N. Meningitis Strep pneumoniae Listeria

Question 41

Long qt w/ palpitations tx

Answer 41

Propranalol

Question 42

contraception for transplant pts

Answer 42

IUD

Question 43

unilateral HA w/ conjunctival injection and rhinorrhea

Answer 43

variant of cluster HA: chronic paroxysmal hemicrania. Tx with indomethacin

Question 44

tx IBS

Answer 44

SSRIs/TCA fiber miralax if constipated

Question 45

causes of low DLCO with normal spirometry

Answer 45

heart failure, chronic PEs, CT d/o, primary pulm HTN

Question 46

dental abx prophy for prosthetic heart valves

Answer 46

1. amoxicillin | 2. PCN allergy: clinda or azithro (or keflex if just rash)