3/27

Question 1

indication for HRT in postmenopausal women

Answer 1

vasomotor symptoms

Question 2

treatment of psychosis from Parkinsons

Answer 2

low dose antipsychotic like quetiapine

Question 3

first line treatment for OCD

Answer 3

SSRI

Question 4

digoxin main use

Answer 4

rate control in supraventricular arrhythmias, especially in patients with hypotension and heart failure - can worsen ventricular arrhythmias

Question 5

treatment for sustained monomorphic ventricular tachycardia

Answer 5

amiodarone

Question 6

cause of neuroleptic malignant syndrome

Answer 6

antipsychotic medications

Question 7

volume of bladder cath that indicates urinary retention

Answer 7

over 150mls

Question 8

greatest risk factor for cerebral palsy

Answer 8

prematurity - insults to brain development

Question 9

symptoms of spastic cerebral palsy

Answer 9

hypertonia, hyperreflexia, equinovarus deformity of the feet, “commando crawl”

Question 10

most common bugs in CF

Answer 10

s aureus first, then psuedomonas later - may need MRSA coverage with frequent hospitalizations

Question 11

signs of elevated ICP in children

Answer 11

usually headache, but can be irritability with intractable vomiting and lethargy

Question 12

x ray signs of pleural fluid

Answer 12

obscuring costophrenic angle, layering fluid on lateral decubitus

Question 13

NF1

Answer 13

cafe au lait macules, freckles and Lisch nodules (hamartomas of the iris) - nerve sheath tumors

Question 14

melasma

Answer 14

hyperpigmentation in sun exposed areas in pregnancy

Question 15

mechanism for hypertension in thyrotoxicosis

Answer 15

primarily through ionotropic and chronotropic effects (actually decreases systemic vascular resistance - so pulse pressure widens)

Question 16

symptoms of fibular nerve compression

Answer 16

foot drop, numbness/tingling over dorsal foot and lateral skin, impaired dorsiflexion, preserved plantar flexion

Question 17

celiac disease and IgA anti-tissue antibodies

Answer 17

testing should be positive but may be negative with concurrent IgA deficiency - high high clinical suspicion, IgA levels should also be checked

Question 18

two main manifestations of Chagas

Answer 18

megacolon/esophagus and cardiac disease

Question 19

diseases associated with erythema nodosum

Answer 19

strep, sarcoid, TB, fungal disease, IBD and Bechets

Question 20

hallmark of carcinoid syndrome

Answer 20

episodic flushing

Question 21

normocytic anemia with osteolytic lesions

Answer 21

multiple myeloma

Question 22

early placenta previa

Answer 22

pelvic rest, no intercourse or digital exams - but most cases will resolve on their own - otherwise scheduled c-section at 36-37 weeks

Question 23

bleeding in kidney disease

Answer 23

uremic toxins cause platelet dysfunction

Question 24

possible treatments of alzheimers

Answer 24

donepezil, galantamine and rivastigmine (cholinesterase inhibitors)

Question 25

acute back pain with point tendeness

Answer 25

vertebral compression fracture

Question 26

pharm treatment for calcium stones

Answer 26

thiazide diuretics

Question 27

benzos to use in liver disease

Answer 27

ones that only undergo phase II glucuronidation - LOT - lorazepam, oxazepam, temazepam

Question 28

contents of Meckel's

Answer 28

ectopic gastric mucosa - high acid can cause bleeding

Question 29

rabies prophylaxis in pet

Answer 29

observe for 10 days, no prophylaxis needed unless you can't quarantine

Question 30

highest risk for preterm delivery

Answer 30

previous preterm delivery

Question 31

HCG in molar pregnancy

Answer 31

over 100,000

Question 32

decreasing HCG levels in first trimester

Answer 32

fetal demise

Question 33

JONES criteria of rheumatic fever

Answer 33

``` Joint arthralgias Heart - carditis Nodules - subcutaneous Erythema marginatum Sydenham chorea ```

Question 34

reactive attachment disorder

Answer 34

usually present in cases of childhood abuse

Question 35

key components of Korsakoff syndrome

Answer 35

retrograde and anterograde amnesia, confabulation, lack of insight and apathy

Question 36

brain anatomy affected in Korsakoff syndrome

Answer 36

anterior and medial thalami and corpus callosum - see mammillary body atrophy

Question 37

how TCAs can affect cardiac muscle

Answer 37

block sodium channels - give sodium bicarb to decreases drug avidity for sodium channels

Question 38

treatment of delrium

Answer 38

lose dose haloperidol

Question 39

potassium in HHS

Answer 39

may be high due to lack of insulin and high glucose, but total body stores are usually low due to osmotic diuresis

Question 40

cause of ARDS in pancreatitis

Answer 40

pancreatic enzymes leaking across lung vessels causing tissue damage

Question 41

kidney enlargement in pregnancy

Answer 41

physiologic hydronephrosis of pregnancy, requires no treatment

Question 42

urine dipstick with protein in kids

Answer 42

may be a false positive, may be orthostatic, retake 2 more measurements

Question 43

most common cause of isolated elevation of alk phos

Answer 43

Paget's disease, usually normal calcium and phos

Question 44

serum ascites albumin gradient

Answer 44

higher than 1.1 = portal hypertension, lower = other causes

Question 45

treatment for intusseception

Answer 45

air enema

Question 46

mechanism for increased insulin resistance in pregnancy

Answer 46

increase in HPL which causes islet cell hyperplasia and insulin resistence

Question 47

optimization of glycemic control is best for what type of diabetic complications

Answer 47

microvascular - nephropathy and retinopathy | - otherwise macrovascular should be controlled with hypertension and smoking cessation

Question 48

cause of plantar warts

Answer 48

HPV infection

Question 49

activity after low back injury

Answer 49

should be continued, with short course of NSAIDs

Question 50

thyroid hormones in liver disease

Answer 50

lower thyroid binding, lower total T3/T4, normal serum, normal TSH

Question 51

kidney problems with lithium

Answer 51

nephrogenic diabetes insipidus and tubulointerstitial nephropathy

Question 52

breast exam following cystic drainage

Answer 52

follow up in 2 months for repeat exam