General medicine Flashcards

1
Q

Most likely vascular malformation responsible for SAH?

A

Arteriovenous malformation - AVM most likely to present with focal seizures, unilateral throbbing headache, and slowly progressive focal neurologic signs

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2
Q

Most common pituitary tumor

A

lactotroph adenoma (prolactinoma) 25%

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3
Q

47 yo F HA, weight gain in trunk, facial hair

A

corticotroph adenoma (Cushing syndrome)

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4
Q

Somatotroph adenoma

A

produce growth hormone and cause acromegaly in adults and gigantism in prepubertal patients

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5
Q

Hypertension with hypokalemia

A

hyperaldosteronism

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6
Q

secondary cause of HTN with flank mass

A

polycystic kidney disease

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7
Q

secondary cause of HTN with unilateral abdominal bruit in young aptient with marked HTN; new-onset HTN with severe end-organ disease

A

renovascular disease

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8
Q

markedly labile BP with tachycardia and headache

A

pheochromocytoma

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9
Q

persistent hypokalemia in absence of diuretic therapy or marked drop with low-dose diuretics

A

hyperaldosteronism

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10
Q

delayed or absent femoral pulses in a young patient

A

coarctation of the aorta

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11
Q

truncal obesity and abdominal striae

A

cushing syndrome

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12
Q

Treatment for uncomplicated gonococcal infection of cervix, urtehra or rectum

A

ceftriaxone 250 mg IM in single dose plus azithromycin 1 g orally in single dose

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13
Q

Study type to investigate a possible association between and exposure or potential risk factor and an outcome of interest

A

case-control study

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14
Q

Treat acute life-threatening staphylococcal infections with this agent

A

vancomycin

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15
Q

Subacute bacterial endocarditis (SBE) prophylaxis is recommended for what ophthalmic surgical procedure?

A

Dacryocystorhinostomy

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16
Q

perioperative modification that may worsen postoperative delirium

A

soft mechanical restraints

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17
Q

Subtype of systemic sclerosis (SSc) formerly known as scleroderma infrequently involves internal organs and has best prognosis?

A

limited SSc

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18
Q

Important lab for 32 year old woman with CVO

A

anticardiolipin antibodies to r/o antiphospholipid antibody syndrome

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19
Q

Medication used to treat mycobacterium tuberculosis causes pink-tinged tears and blepharoconjunctivitis

A

rifampin

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20
Q

What percentage of normal population has an antinuclear antibody (ANA) titer of >1:40

A

30% (high false-positive rate) Must also check anti-dsDNA, anti-smith, antiphospholipid which are highly specific

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21
Q

ANA titer in patient with true SLE

A

1:160 or higher

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22
Q

Nearly all isolates of Haemophilus influenzae are now resistant to what antibiotic class?

A

macrolides

current treatment - amoxicillin-clavulanate, trimethoprim-sulfamethoxazole, quinolone (ciprofloxacin) or third-generation cephalosporin (ceftriaxone or cefotaxime)

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23
Q

Most radiosensitive structure in the eye

A

lens > cornea > retina > optic nerve

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24
Q

Recommended screening for thyroid dysfunction?

A

TSH, free T4 (sensitivity of 99.5%)

TSH rise early in hypothyroidism and fall in hyperthyroidism even before free T4 are outside reference range

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25
Q

JNC 8 guidelines for BP

A

60 years and older systolic blood pressure target less than 150 mm Hg and/or diastolic blood pressure less than 90 mm Hg

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26
Q

Stage of treponema pallidum infection characterized by fever, lymphadenopathy, patchy hair loss, and malaise?

A

Secondary

resolve in 2 to 6 weeks with 25% relapse in first 2 to 4 years

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27
Q

Indication for prophylactic implantable cardioverter-defibrillators (ICDs)

A

survivors of hemodynamically unstable ventricular tachycardia

previous cardiac arrest

inducible ventricular arrhythmia

28
Q

Adverse effect of anticytokine drugs sucha as etanercept and infliximab

A

optic neuropathy

29
Q

Cyclosporine is associated with this ophthalmic finding

A

disc edema

30
Q

Ocular associations of bisphosphonates (pamidronate and alendronate)

A

conjunctivitis, scleritis, episcleritis and anterior uveitis

31
Q

Monoclonal antibody against interleukin-6 receptor (pro-inflammatory cytokine)

A

tocilizumab - FDA approved for treatment of moderate to severe rheumatoid arthritis and JIA

32
Q

Class of infliximab

A

tumor necrosis factor alpha antagonist

33
Q

Class of rituximab

A

B-cell depleting monoclonal antibody used primarily as chemotherapy in treating non-Hodgkin’s lymphona and CLL, RA, graves ophthalmopathy, neuromyelitis optica, and IgG4-related diseases

34
Q

MOA of cyclosporine

A

inhibits transcription of interleukin-2 -> decreases production of inflammatory cytokines by T-lymphocytes (transplant rejection)

35
Q

Risk of myopathy while taking simvistatin

A

Gemfibrozil

36
Q

arthritis, urethritis, and conjunctivitis

A

reactive arthritis

63%-95% positive for HLA-B27

37
Q

M/c vector-borne illness in the US

A

Borrelia burgdorferi

38
Q

Most frequent cause of death of patients suffering shock

A

respiratory failure

39
Q

Workup for Sjogren syndrome

A

anti-SS-A antibody, Anti-SS-B antibody, and minor salivary gland biopsy

40
Q

Criteria for metabolic syndrome

A
3 of the following
HDL <40 men <50 women, 
abdominal obesity >40 men
elevated TGA >150
HTN >130/85
Elevated fasting glucose >100 mg/dL
41
Q

Large vessel vasculitidies

A

GCA

Takayasu

42
Q

Medium-sized vasculitis

A

Polyarteritis nodosa

Kawasaki

43
Q

Small vessel vasculitis

A

Granulomatosis with polyangiitis

44
Q

Size vasculitis of Behcet

A

All sizes!

45
Q

What systemic condition increases the risk of latex allergy?

A

spina bifida or myelodysplasia

46
Q

Treatment for chronic, active hepatitis C virus

A

peginterferon alpha-2b + ribavirin

47
Q

M/c type of thrombosis that occurs in patients with antiphospholipid antibody syndrome (APS)

A

DVT (occurs in 1/3)

48
Q

Last resort immunosuppressant medication in 15 yo with DM2 and bilateral vision threatening HLA B27 associated panuveitis

A

cyclophosphamide - causes sterility

49
Q

Gene that confers immunity to HIV

A

CCR5

50
Q

Gene a/w Leber congenital amaurosis and RP

A

RPE65

51
Q

Only antiplatelet agent shown to be effective in early treatment of ischemic stroke

A

aspirin

52
Q

Preferred treatment for Toxoplasma chorioretinitis

A

pyrimethamine, folic acid (leukovorin), sulfadiazine

53
Q

Somatoform disorder

A

symptoms that includes a preoccupation with fear of having a serious disease

54
Q

Study that showed intensive glycemic control in patients with DM2 reduced complicatoins

A

United Kingdom Prospective Diabetes Study (UKPDS)

55
Q

MOA moxifloxacin

A

inhibits bacterial DNA replication

56
Q

CEA recommended for what percentage of ipsilateral carotid artery stenosis?

A

70%-99%

57
Q

Patients with TMVL (transient monocular vision loss), retinal infarcts (artery occlusions) or TIAS have an annual stroke rate of…

A

TMVL - 2%
Retinal infarcts - 3%
TIA - 8%

58
Q

first-line treatment for ocular syphilis

A

intravenous penicillin G

59
Q

acceptable colorectal cancer screening

A

3 fecal occult blood cards from home
CT colonography q5 years
Double-contrast barium enema or colonoscopy every 10 years

60
Q

Recommendation after MI

A

ACE inhibitor such as captopril or lisinopril in combination with a second antiplatelet agent for at least 1 year after placement of a drug-eluting stent

61
Q

Clinical feature that would suggest the diagnosis of relapsing polychondritis?

A

saddle-nose deformity from nasal chondritis

62
Q

M/c inherited bleeding disorder

A

von Willebrand disease (VWD)

found in 1% of population

63
Q

Standard antiviral treatment for CMV retinitis

A

oral valganciclovir and intravitreal ganciclovir

64
Q

Most commonly elevated auto-antibody found in patients with Graves hyperthyroidism (TED)

A

thyroid-stimulating hormone TSH receptor antibody (90%)

65
Q

Found in more than 95% of Hashimoto thyroiditis and in 55% of Graves patients and 10% with no thyroid disease

A

Thyroid microsomal antibody

66
Q

Most effective treatment for pseudomonal infections

A

ceftazidime