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COMQUEST LEVEL2 Wrongs > 6/24 > Flashcards

6/24 Flashcards

1
Q

what complications are the first to occur in diabetes mellitus?

A

microvascular

  • diabetic retinopathy
  • nephropathy
  • neuropathy
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2
Q

______ marks the earliest manifestation of a microvascular complication associated with diabete mellitus

A

microalbuminuria

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3
Q
A
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4
Q

what are the 4 ways to diagnose diabetes?

A
  1. hemoglobin A1c of 6.5% or greater
  2. fasting serum glucose over 126 mg/dL
  3. serum glucose over 200 mg/dL two hours after 75g of oral glucose load
  4. random serum glucose over 200mg/dL with classic diabetes sx
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5
Q

which lab value will be abnormally elevated in hemophilia A (factor VIII deficiency)?

A

aPTT, defective intrinsic pathway

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6
Q

first line treatment for persistent allergic rhinitis

A

intranasal corticosteroids

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7
Q

list the major risk factors for suicide

A
  • personal hx of suicide attempts
  • sexual orientation
  • famliy history of suicide attempts
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8
Q

name some dopamine agonists used in treating Parkinsons

A

levodopa, pramipexole, ropinirole

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9
Q

COMT inhibitors end in what suffix?

A

-capone

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10
Q

MAO inhibitors end in what suffix?

A

-giline

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11
Q

types of drugs used to treat Parkinsonian resting tremors?

A

anticholinergic medications (benztropine, trihexyphenidyl)

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12
Q

what 3 things justify involuntary admittance to the psychiatric hospital?

A
  1. harm to self
  2. harm to others
  3. unable to take care of self due to psychiatric illness

*if pt is able to do thses things, even if acutely delusional, just schedule regular visits outpatient

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13
Q

who do you contact when you suspect child abuse?

A
  • law enforcement
  • Child Protective Services
  • or Department of Children and Family Services
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14
Q

pt with actively bleeding esophageal varices is undergoing EGD. best treatment?

A

treatment of choice for acute bleeding of esophageal varices during endoscopy is ligation

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15
Q

is L5 felxed or extended in forward torsions?

A

L5 is neutral in forward torsions and follows type 1 mechanics

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16
Q

pt with flu-like illness +lymphadenopathy+rash and you suspect acute HIV illness. what is the next step in diagnosing?

A
  • first: HIV 1/2 antigen/antibody immunoassay
    • if negative, no further testing.
    • if positive, get HIV 1/2 antibody differentiation assay
  • idk very confusing, OME says get viral load
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17
Q

cranial technique to address acute otitis media and temporal bone dysfunction is _____

A

V spread technique

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18
Q

what cranial dysfunction can lead to acute otitis media?

A

internal rotation of the temporal bone

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19
Q

St. Johns wort (used for depression) is a known cyp P450 _____

A

inducer; increases the metabolism of warfarin causing decrease in INR

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20
Q

goal INR for pts on anticoagulation for AFIB, PE, DVT

A

2-3

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21
Q

goal INR for pts on anticoagulation with mechanical heart valves

A

2.5-3.5

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22
Q

S-adenosyl methionine (SAMe) is used for depression and has an interaction with what drug?

A

SSRIs (can cause serotonin syndrome)

23
Q

pt with warfarin toxicity, active bleeding, and high INR . what should you give them?

A

fresh frozen plasma transfusion for immediate reversal (vitamin K alone will take hours to reach effect)

24
Q
A
25
Q

pt with warfarin toxicity and INR higher than 5 with no bleeding. What do you give?

A

vitamin K

26
Q

pt is overconcerned with a mild sx despite numerous negative tests. dx?

A

illness anxiety disorder

27
Q

development of several unrelated sx without a clear medical explanation

A

somatic sx disorder

28
Q

pt with thyroid nodule and decreased TSH. next step?

A

decreased TSH= hyperthyroidism

US, then thyroid scintigraphy (RAIU)

29
Q

pt with thyroid nodule and increased or normal TSH. next step?

A

increased TSH=hypothyroid (or euthyroid)

US, then FNA if nodule is 1cm or larger

if less than 1 cm, f/u US in 6-12 months

30
Q

where is the most common place to get an anal fissure?

A

posterior midline

31
Q

name the tumors commonly associated with MEN1 (MEN1 gene)

A
  • hyperparathyroidism (usually first tumor to show up and most common)
  • pancreatic islet cell tumor
  • pituitsry tumor (prolactinoma)
32
Q

tumors commonly associated iwth MEN2A

(RET mutation)

A

2 Ps

  • hyperparathyroidism
  • pheochromocytoma
  • medullary thyroid cancer (elevted calcitonin) (pts should undergo thyroidectomy in early childhood)
33
Q

tumors commonly associated with MEN2B

A
  • medullary thyroid carcinoma
  • pheochromocytoma
  • mucosal neuromas
  • intestinal ganglioneuromas
  • marfanoid habitus
  • developmental abnormalities
  • skeletal deformities
  • megacolon
34
Q

colon cancer marker for recurrent disease

A

carcinoembryonic antigen (CEA)

35
Q

first test to get when bacterial meningitis is suspected?

A

blood cultures

36
Q

pt presents with bacterial meningitis and signs of increased intracranial pressure. workup order?

A

blood draw–> steroids+abx–>CT

if CT normal, then do LP

37
Q

pt presents with bacterial meningitis and NO signs of increased intracranial pressure. workup order?

A

blood draw–>LP–> steroids+abx

38
Q

supraventricular arrythmia that is associated with pulmonary disease (long-standing asthma or COPD)

A

Multifocal atrial tachycardia; 3 or more P wave morphologies over 100 BPM

39
Q

treatment for asepctic bursitis

A

protdctive joint bracing and comservative management (RICE)

40
Q

lab values seen in hemochromatosis?

A
  • elevated iron
  • elevated ferritin
  • decreased TIBC
  • confirm with liver bx and genetic testing
41
Q

what is spodylolysis and how do you diagnose it?

A

pars interarticularis fracture, occurs in young athletes with radiation to butt.

diagnose with oblique lumbar radiograph

42
Q

what is spodylolisthesis and how do you diagnose it?

A

anterior displacement of a lumbar vertebral segment relative to the segment above or below

dx with lateral radiography

43
Q

what is spodylosis and how do you diagnose it?

A

degenerative narrowing of the joints of the spine (“osteoarthritis of the spine”)

44
Q

pt just had seizure and arm is internally rotated and abducted. injury?

A

posterior glenohumeral dislocation

45
Q

pt has abdominal pain after discharge for acute pancreatitis. what is it and what do you do next?

A

pancreatic pseudocyst; NPO and observation

46
Q

when do you need to give a pregnant pt betamethasone for fetal lung maturation?

A

if pt is delivering before 34 weeks

47
Q

pregnant pt comes in having seizure (eclampsia). what do you do?

A

airway management, IV mag sulfate, betamethasone, induction of vaginal delivery (you dont have to do a c-section)

48
Q

pt becomes acutely hypoxic during hospital stay. what test do you want to order to rule out ARDS vs cardiogenic pulmonary edema?

A

echocardiogram

49
Q

suspect pancreatic cancer in a patient. next step?

A

US

50
Q

most sensitive test for pancreatic CA? most specific?

A

sensitive=CT abdomen

specific=ERCP

51
Q

pt treated for UTI, but doesnt get better. what next?

A

send urine for culture and sensitivities; complicated UTI could be pyelo

52
Q
A
53
Q

murmurs that get louder with inspiration are on which side of the heart?

A

right side

COMQUEST LEVEL2 Wrongs (2 decks)

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