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1

If patient is asymptomatic with actinomyces on pap smear and she has copper IUD, how do you manage?

observe, no abx needed as actinomyces is part of normal flora

2

Rapidly progressive weakness of b/l lower extremities followed by URI, with sensory loss and urinary retention. Ddx?

transverse myelitis

3

Types of diabetes screening test, and when to repeat these tests?

- A1C: >6.5
- random glucose >200
- oral glucose tolerance test- >200 (most sensitive test)
- fasting blood glucose >126
- if pt is asymptomatic with abnormal test, repeat same test on same day. If 2 tests are concordant, then no need to repeat

4

Lab values for thalassemia

low MCV
normal RDW (elevated in iron deficiency anemia)
high ferritin for increased RBC turnover (low in iron deficiency anemia)
normal RBCs

5

Features of sarcoidosis

- common in Af. Am
- b/l hilar adenopathy
- anterior and posterior uveitis
- hepatomegaly, splenomegaly
- arthritis, migratory polyarthralgia
- central diabetes, hypercalcemia (tx: responds to steroids)
- erythema nodosum

6

Clinical features, management and treatment of spinal epidural abscess

- fever, focal spinal tenderness, neurological dysfunction
- MRI, blood cx, inflammatory markers, CT guided aspiration and culture, abx
- Tx: emergency surgical decompression and drainage abscess

7

Treatment of group A streptopharyngitis

penicillin or amoxicillin

8

Treatment of skin abscess

- I& D
- abx needed if systemic signs are present or if size is >5cm, immunocompromised, multiple abscesses

9

most frequent complication of TURP

retrograde ejaculation

10

Features of neurosyphilis (usually has prodrome several days before)

early neurosyphilis: meningitis, ocular (posterior uveitis, decreased visual acuity), otosyphilis
late neurosyphilis: general paresis (dementia), tabes dorsalis

11

Treatment of latent TB infection

- isoniazid and rifapentine weekly for 3 months
- isoniazid monotherapy for 6-9 months
- rifampin for 4 months
- isoniazid and rifampin for 4 months

12

asymptomatic pulmonary sarcoidosis with erythema nodosum, treatment?

none needed, high rates of spontaneous recovery

13

pseudohypoparathyroidism lab values

low calcium, high phosphorus
high PTH (PTH increases calcium levels and lowers phosphate levels normally)

14

c.diff treatment

- mild to moderate: oral metronidazole
- severe (WBC >15000, creatinine >1.5x baseline, serum albumin <2.5): oral vanc, IV metronidazole
- toxic megacolon, severe ileus: subtotal colectomy, diverting loop ileostomy with colonic lavage

15

Treatment of lyme arthritis and primary diagnostic test

- doxycycline or amoxicillin if <8 yo
- enzyme linked immunosorbent assay, followed by confirmatory western blot

16

low T3, normal T4 and TSH. Ddx and treatment

- euthyroid sick syndrome/ low T 3 syndrome
- it is often present with other severe acute illnesses, treatment not recommended until baseline health returns

17

How often do HIV patients on/about to start HAART need HIV and CD4 counts checked?

3-4 months

18

RA-like sx with small joint involvement and weakly positive RF with less than six weeks of sx, with prior URI. Ddx and treatment

- viral arthritis- parvovirus infection
- self limited, symptomatic management

19

First test to differentiate between insulinoma and oral hypoglycemic agent use?

- hypoglycemic drug assay

20

Best treatment for borderline personality disorder

dialectical behavior therapy

21

Interpersonal therapy is effective for which psych disorder?

depression

22

diagnostic test for pheochromocytoma (headaches, diaphoresis, and tachycardia), and follow up tests when positive

- 24 hour urine collection for metanephrine and catacholamine
- CT or MRI of abdomen; if negative or has large tumor or extraadrenal disease, then MIBG scan

23

Diagnostic test for chronic lymphocytic leukemia

- flow cytometry
- severe lymphocytosis and smudge cells
- LN & BM biopsy not generally needed

24

rotator cuff tendonitis presents with what kind of shoulder pain? anterior vs posterior vs lateral

lateral
- anterior: biceps tendonitis, acromioclavicular or glenohumeral joint OA
- posterior: referred pain

25

Treatment of OCD

- exposure and response prevention/CBT and/or SSRI
- clomipramine or antipsychotic if refractory
- DBS for severe cases

26

First step in management in hyperosmolar hyperglycemic state (more likely in T2DM, no ketones)

1. aggressive fluid resuscitation
2. IV insulin

27

When is statin therapy recommended?

- age 40-75 with diabetes
- LDL >190
- calculated atherosclerotic coronary heart disease risk >7.5%
- clinically significant atherosclerotic disease

28

Diagnosis of SAH

- noncontrast CT >90% sensitive within 2-6 hours of onset
- lumbar puncture required to r/o definitely in pts with negative CT
- xanthochromia confirms ddx >6 hours from onset
- cerebral angiography to identify bleeding source

29

urethral diverticula ( three d's: postvoid dribbling, followed by dysuria and dyspareunia) ddx test

- transvaginal ultrasound
- MR

30

Molluscum contagiosum (transmitted by skin to skin contact)--> what screening test should be considered?

HIV testing