9

Question 1

best initial test for hemoptysis

Answer 1

chest x-ray

Question 2

chronic myeloid leukemia ddx test and tx

Answer 2

• BCR-ABL test– philadelphia chromosome

- tx: tyrosine kinase inhibitor

Question 3

Diagnosic test for infectious mononucleosis

Answer 3

• monospot test for EBV IM

Question 4

Treatment difference between preseptal cellulitis (chemosis, eyelid swelling, erythema, fever, leukocytosis) vs postseptal cellulitis (sx of pre plus ophthalmoplegia, visual acuity changes, proptosis, diplopia)

Answer 4

• preseptal: oral abx

- post septal: IV abx (vac plus ampicillin-sulbactam)

Question 5

Management of diabetic ketoacidosis

Answer 5

• IV insulin, aggressive fluid support, potassium supplementation
• if anion gap is still there and blood glucose <200, half insulin and add dextrose to prevent hypoglycemia

Question 6

What should you watch out for in B 12 supplementation in megaloblastic anemia?

Answer 6

Hypokalemia, as you use potassium when making RBCs

Question 7

Anterior uveitis (iritis) clinical features and diagnostic test

Answer 7

• pain, redness, variable visual loss, constricted and irregular pupil
• leukocytes in anterior segment

Question 8

Management of HSV in pregnant pts, history vs no history of hsv

Answer 8

• if infected before, then needs antiviral therapy at 36 weeks, and needs c-section when delivering if infection is active
• if never exposed, no further testing needed
• if exposed to HSV infected partner, then needs HSV serology testing.

Question 9

Which ratio measures association between studies?

Answer 9

Odds ratio–> odds of 1 event/odds of 2nd event

odds: probabilty of an event/1- prob of event

Question 10

Clinical features of patellar tendon rupture

Answer 10

excruciating pain, swelling of the anterior part of the knee, inability to maintain passive extension of the knee against gravity

Question 11

enuresis (bedwetting) at age 5 and above management and treatment

Answer 11

• need UA
• urologic imaging if significant daytime sx and history of recurrent UTI
• Tx: behavior modification, then enuresis alarms, then meds (desmopressin)

Question 12

scaphoid fx diagnostic test and complication

Answer 12

• X-ray (can take upto two weeks for imaging to be positive), and if negative, MRI/CT, repeat x-ray, or bone scan
• nonunion and avascular necrosis

Question 13

which herbal supplement can cause hypertension?

Answer 13

licorice

Question 14

what side effect does ginko (dementia, neurological issue) have?

Answer 14

bleeding due to interaction with warfarin/aspirin

Question 15

Actinic keratosis (skin disease from increased sun exposure) has increased risk of which cancer?

Answer 15

squamous cell carcinoma

Question 16

Disease related to meconium ileus in peds

Answer 16

CF

Question 17

low pitched, rumbling diastolic murmur best heard in apex in left lateral decubitus position

Answer 17

mitral stenosis

Question 18

systolic crescendo decrescendo ejection murmur in left sternal border

Answer 18

pulmonary stenosis

Question 19

apical holosystolic murmur

Answer 19

mitral regurgitation

Question 20

mid-to-late systolic click followed by late systolic murmur

Answer 20

mitral valve prolapse

Question 21

Bacterial conjunctivitis (redness, purulent drainage) complication? treatment for uncomplicated bacterial conjunctivitis? for contact wearers?

Answer 21

• keratitis
• erythromycin ointment, sulfa drops
• fluoroquinolone (cipro, ofloxacin)

Question 22

proximal muscle weakness with increased CPK levels indicate primary muscle weakness. What other lab findings are present? Treatment for inflammatory myositis?

Answer 22

elevated ferritin levels in inflammatory myositis

tx: steroids

Question 23

treatment of choice in mammalian bites

Answer 23

amoxicillin/clavulanate as it provides coverage for both aerobic and anaerobic flora

Question 24

Initial test of choice to confirm pneumothorax

Answer 24

upright chest x-ray (PA view)

Question 25

Clinical features of acute bronchitis, diagnosis and tx

Answer 25

• preceding respiratory illness, cough lasts 5 days to 3 weeks
• can be productive sputum, but absent systemic signs
• chest wall tenderness, wheezing, rhonchi
• diagnosis: clinical, chest x-ray only if PNA is suspected
• tx: symptomatic

Question 26

patients with untreated acromegaly has increased mortality due to what?

Answer 26

• cardiovascular disease

- increased risk of colon cancer; need screening every 3-5 years

Question 27

diabetic gastroparesis (early satiety, postprandial fullness, autonomic sx, labile glucose control) is best diagnosed with what test? Management?

Answer 27

• nuclear gastric emptying study

- dietary modification, and if refractory, promotility agents (erythromycin, metoclopramide)

Question 28

antibiotics for meningococcus meningitis ppx

Answer 28

• rifampin
• ceftriaxone IM, can be used in pregnancy
• cipro, not for children

Question 29

When should you switch AED regimen in pregnant ladies?

Answer 29

6 months prior to pregnancy, should not switch once pregnancy is confirmed

Question 30

GBS ppx indication

Answer 30

• GBS bacteriuria or GBS UTI during current pregnancy
• GBS positive rectovaginal culture
• prior delivery complicated with GBS
• • positive GBS in prior pregnancy is not indication for GBS tx in current pregnancy
• unknown GBS status PLUS <37 weeks of gestation OR rupture of membranes >18 hours