USMLE cray cray

Question 1

meds to prevent lyme disease

Answer 1

a single 200-mg dose of doxycycline given within 72 hours after an Ixodes scapularis tick bite can prevent the development of Lyme disease.

Question 2

It is recommended that _____________ receive the pneumococcal vaccine before the age of 65

AND receive an additional dose at age 65 or 5 years after the first dose, whichever is later.

Answer 2

institutionalized individuals > 50
chronic cardiac or pulmonary disease
 diabetes mellitus
 anatomic asplenia
 chronic liver disease
AKI 
health-care workers.

Question 3

Prevention traditionally has been divided into three categories: __________

Answer 3

primary, secondary, and tertiary

Question 4

Primary prevention targets?

Answer 4

individuals who may be at risk to develop a medical condition and intervenes to prevent the onset of that condition

e.g., childhood vaccination programs, water fluoridation, antismoking programs, and education about safe sex

Question 5

Pain in central retinal vein occlusion?

Answer 5

painless

fundoscope: blood and thunder

Question 6

Secondary prevention targets

Answer 6

individuals who have developed an asymptomatic disease and institutes treatment to prevent complications

e.g., routine Papanicolaou tests; screening for hypertension, diabetes, or hyperlipidemia

Question 7

Amaurosis fugax (and vision)

Answer 7

emboli in carotid

temp vision loss

Question 8

Tertiary prevention targets ?

Answer 8

individuals with a known disease, with the goal of limiting or preventing future complications

e.g., screening diabetics for microalbuminuria and post–myocardial infarction prophylaxis with β-blockers and aspirin

Question 9

Initial presentation of MS (often)

Answer 9

optic neuritis

unilateral vision loss, pain, afferent pupillary defect

Question 10

Most common cause of congenital adrenal insufficiency

NOT autoimmune aka addisons

Answer 10

adrenoleukodystrophy

Question 11

Goodpasture antibody

Answer 11

anti-GBM

Question 12

_____________ colonize the mouth and frequently lead to infective endocarditis

Answer 12

viridans streptococci

mutans, mitis, oralis, sanguinis

Question 13

Caused by persistent activation of complement –> proteinuria and hematuria

Answer 13

membranoproliferative glomerulonephritis type 2

Dense deposits of C3 nephritic factor

Question 14

this can cause hypotension that is resistant to intravenous fluid resuscitation in atients suffering from a critical illness with an exaggerated inflammatory response

Answer 14

cortisol deficiency

survival is increased if these patients are treated with intravenous corticosteroids during acute management.

Question 15

The “rule of twos” is useful in assessing asthma control: in children under the age of 12

Answer 15

Asthma is NOT well-controlled if

• they have had symptoms or used a β-agonist for symptom relief more than twice per week
• had two or more nocturnal awakenings due to asthma in the past month
• or had two or more exacerbations requiring systemic corticosteroids in the past year.

Question 16

__________ reduces the risk of subsequent seizures in women with eclampsia compared with placebo

Answer 16

Intravenous magnesium sulfate

Question 17

smudge cells are pathognomonic for ?

Answer 17

CLL

*most common leukemia in US

onset usually 70 yo

Question 18

2 most common nephrotic syndromes in adults

Answer 18

1- FSGS- common with africans- americans, obese, HIV, and heroin use

2- membranous nephropathy-

Question 19

Rx for latent TB

Answer 19

+ TB test but with no s/s

use isoniazid and pyridoxine x 9 months

Question 20

IgA nephropathy, more blood or protein?

Answer 20

More blood (50%)

Question 21

Screening for AAA

Answer 21

males who ever smoked age 65- 75

one time screen

Question 22

Heat exhaustion

Answer 22

body does not maintain CO due to inadequate salt and water replacement

Question 23

Heat stroke

Answer 23

body doesn’t thermoregulate

high fever, ams

Question 24

LAD MI

Answer 24

V1- V6

anterior MI

Question 25

__________ is rx for uterine atony but should not be used in patients with asthma

Answer 25

Carboprost

Question 26

________ is rx for uterine atony but contraindicated in hypertensive patients

Answer 26

Methylergonovine

Question 27

Cardiovascular changes associated with aging include

Answer 27

↑ systolic and diastolic blood

↓ CO
↓ maximum heart rate
↓ stroke volume pressure

Question 28

Centor criteria

Answer 28

most reliable clinical predictors of streptococcal pharyngitis

These include:
 tonsillar exudates
 tender anterior cervical LAD
absence of cough
 hx of fever.

Question 29

WHich NSAID is on Beers list

Answer 29

Indomethacin is on the list due to its propensity to produce more central nervous system adverse effects than other NSAIDs.