7/23

Question 1

55 yo p/w R sided weakness and HA, head CT w/ partial calcified extra axial mass compressing L frontal lobe. Dx and next step?

Answer 1

Meningioma (benign tumor)

txt: resection

Question 2

post-partum mother with delusions. dx and txt?

Answer 2

Post-partum psychosis (rare)

txt: HOSPITALIZE, anti-psychotics, antidepressants
- risk of infanticide

Question 3

post-menopause US w/ ovarian cyst. next?

Answer 3

CA-125?

• if elevated –> CT pan scan and surgery
• if not –> serial US and CA-125

Question 4

Rheumatic F criteria

Answer 4

2 major OR 1 major + 2 minor OR carditis or chorea

Major:
Joint - migratory arthritis
O- carditis
Nodules
Erythema marginatum
Syndeham chorea

Minor:
F, arthralgia, inc ESR/CRP, prolonged PR interval

Question 5

Decelerations mean?

Answer 5

variable
early
accelerations
late

cord compression
head compression (benign)
oxygenation (good)
placental insufficiency

Question 6

multi-drug resistant UTI treated then renal failure. what druge?

Answer 6

Amikacin (aminoglycoside)

Question 7

acute back pain txt?

Answer 7

early mobilization, muscle relaxant, and pain meds (NSAID)

if not better in 4-6 wks, MRI and CT

Question 8

GBS unknown management?

Answer 8

if intrapartum F, 18 hrs then penicillin

Question 9

PMS/PMDD txt

Answer 9

SSRI, caffeine reduction

Question 10

white vulvar plaques, dryness, intense pruritis, perianal “figure 8,” spares vagina - dx and txt?

Answer 10

lichen sclerosis

txt: topical steroids (clobetasol)
- dx by biopsy

Question 11

Hereditary angioedema due to?

Answer 11

deficiency of C1 inhibitor –> inc bradykinin and C2b (edema-producing factors)

Question 12

peresistent tachyarrhythmia with hemodynamic instability txt?

Answer 12

immediate synchronized direct current cardioversion

Question 13

treatment of primary/secondary syphilis in pt w/ penicillin allergy

Answer 13

doxycycline for 2 wks

Question 14

acute viral arthritis cause?

Answer 14

Parvo B19, hep B/C, HIV, rubella

Question 15

tachycardia mediated cardiomyopathy, txt?

Answer 15

rhythm and rate control

Question 16

Med overdose w/ tachycardia, seizures, prolonged QRS complex, ileus, dry skin, flushed, dilated pupils

Answer 16

TCA overdose

• best indicator is QRS duration (likelihood of seizures and ventricular arrhythmia)
  txt: bicarb

Question 17

elderly pt with lymphocytosis, HSM, anemia, thrombocytopenia and pneumonia - test? dx?

Answer 17

• flow cytometry

CLL

Question 18

cystic hepatic lesions with eggshell calcifications

Answer 18

Echinococcus granulosus
multiple - E. multilocularis
- from dogs
- txt: resection and albendazole

Question 19

Asian woman with acute unilateral frontorbital headache, eye pain, dilated pupil with poor light response, conjunctival infection - dx? cause?

Answer 19

acute angle glaucoma

• cause: anticholinergics
• if untreated, permanent loss of vision in 2-5 hours

Question 20

pt from Mexico w/ hepatic abscess, inc alk phos/ALT/AST, test? dx? treatment?

Answer 20

Amoebic (entamoeba histolytica)

• serologic testing
• txt: PO metronidazole and paromomycin (luminal)
• no drainage unless complications

Question 21

causes of asymmetric and symmetric fetal growth restriction

Answer 21

asymmetric (head sparing) = maternal factors

symmetric (head and body) = fetal factors (genetic dz, congenital heart dz, infection)

Question 22

cause of unilateral foot drop?

Answer 22

compression common peroneal neuropathy 
L5 radiculopathy (also weak inversion and plantar flexion)

Question 23

recent cardiac stent placement with MI. dx?

Answer 23

medication non-adherence –> stent thrombosis

- need to be on clopidogrel and aspirin