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1

features of sicca syndrome and best initial and diagnostic test

- dry eyes, dry mouth
- secretory deficiency (Schrimer test) and autoantibody screen

2

positive biferengence test with rhomboid crystals is what? what disease is it related to?

pseudogout, seen in hemochromatosis

3

features of sarcoidosis

- erythema nodosum
- peripheral nerve disease
- hepatic compromise
- hilar lymph node enlargement--> need x-ray to diagnose
- young population

4

definite diagnosis of sarcoidosis

biopsy of:
- any palpable lymph node
- subq nodule except erythema nodosum
- enlarged parotid
- lacrimal gland

5

Drugs that affect lithium level

- diuretics
- NSAIDs except aspirin
- SSRI
- Ace-I and ARBs
- antiepileptics

6

Management of lobular carcinoma in situ (nonmalignant-- DCIS is worse)

- excisional biopsy then follow up surveillance
- alternative option: tamoxifen or raloxifene

7

Features and tests for chronic pancreatitis

- steatorrhea secondary to fat malabsorption (bulky foul smelling stool difficult to flush)
- epigastric pain with radiation to the back
- text: CT scan of abdomen, NOT serum lipase and amylase (more for acute pancreatitis)

8

Treatment of chronic pancreatitis

- first line: alcohol cessation and small meals with low fat
- pancreatic enzymes and possible opiate medications

9

Endometriosis treatment

- meds-- NSAIDs, GnRH analogs, danazol (synthetic androgen), oral contraceptives
- surgery

10

Medications in recent MI (q waves in lead II, III, avF)

- antiplatelets
- beta blocker
- statins
- Ace-I or ARB
- aldosterone antagonist (eplerenone) IF LVEF <40%, add to beta blocker and ace-i

11

when should EGD be considered instead of colonoscopy as first step in hematochezia?

- UGIB suspected
- hemodynamically unstable

12

How does biliary colic present?

constant epigastric or RUQ pain, can radiate to shoulder
- n/v/diaphoresis
- <6 hours

13

Management of gallstones w/ vs w/o stones on imaging

with: cholecystectomy, or ursodeoxycholic acid in poor surgical candidates or patients refusing surgery
without: CCK- stimulated cholesyntigraphy

14

How does amaurosis fugax present?

- transient monocular blindness
- carotid bruit

15

How does IgA nephropathy usually present?

- gross hematuria following acute URI
- flank pain
- dysmorphic RBCs in urine

16

How does acute post strep glomerulonephritis usually present?

-strep throat/skin infection, then 10 days later renal issues
- hypertensive
- urine cast shows RBCs and RBC casts
- decreased complement levels

17

Timing, pathophysiology and signs of breastmilk jaundice

- starts at 3-5 days, peaks at 2 weeks
- high beta-glucuronidase in breast milk deconjugates intestinal bili and increase enterohepatic circulation
- normal exam, spontaneous resolution

18

Best prognostic indicator of acute pancreatitis

APACHE II

19

Positive LR vs Negative LR

+= sensitivity/ 1- specificity
-= 1- sensitivity/specificity

20

Which antibodies correlate to disease activity in SLE?

anti-ds DNA (most sensitive marker for disease as well)

21

Treatment of SLE

hydroxychloroquine and prednisone

22

Initial management of adrenal masses?

- studies of hormonal production: dexamethasone suppression, 24 hr urine catecholamines, metanephrine, VMA, etc
- if >4cm, then surgical excision

23

Treatment of sunburn from doxy

NSAIDs, steroids if severe

24

SE of isotretinoin (acne med)

hyperglycemia, hyptertriglyceridemia, hepatotoxicity, mucocutaneous rxns, teratogen (females need 2 concurrent contraception methods)

25

Treatment of hypertrophic cardiomyopathy

- first line: beta blockers
- verapamil, disopyramide

26

how does traumatic LP present?

- high RBCs without xanthochromia (this presents with SAH)
- high protein, high glucose
- WBC 1 in 1000 when compared to RBCs

27

Risk factors for CRC

- family history, FAP
- IBS
- Af American
- alcohol intake, smoking >30 years
- obesity

28

What does paroxysmal supraventricular tachycardia look like on EKG?

- Abrupt onset
- unidentifiable P waves
- narrow and regular QRS complexes

29

4 Ts of HIT

- thrombocytopenia
- timing of drop (onset 5-10 days or <1 day if prior exposure in last 30 days for 2 points)
- thrombosis
- other causes

30

Treatment of HIT

discontinue all forms of heparin, including warfarin
start direct thrombin inhibitor (i.e. argatroban)
avoid all forms of heparin for life