8-18

Question 1

afib in a younger pt from developing country

Answer 1

sequela of rheumatic heart dz (from mitral stenosis -> dilated LA)

Question 2

testing for cushing syndrome

Answer 2

24hr urine cortisol vs late night salivary vs low-dose dex suppression -> ACTH level

Question 3

tx for malignant hypercalcemia

Answer 3

bisphosphonates

Question 4

warfarin reversal

Answer 4

IV vit K and prothrombin complex concentrate

Question 5

tamoxifen vs raloxifene

Answer 5

tam: for breast cancer
ral: for osteoporosis

Question 6

serum to ascites albumin gradient

Answer 6

> 1.1 = portal HTN

Question 7

AIDS malignancies assoc w/ EBV

Answer 7

non-hodgkin lymphoma + primary CNS lymphoma

Question 8

pt >50yo w/ pain + stiffness in neck/shoulders/pelvic girdle + elevated ESR

Answer 8

polymyalgia rheumatica - tx w/ prednisone

Question 9

saline responsive metabolic alkalosis

Answer 9

low urine chloride (<20)

Question 10

cafe au lait macules + axillary/inguinal freckling

Answer 10

NF1 - assoc w/ seizures, optic gliomas

Question 11

nonstimulant tx for ADHD

Answer 11

atomoxetine

Question 12

delusional disorder

Answer 12

1+ delusions for 1+ months, no other psychotic sxs

Question 13

progressive bilateral loss of central vision

Answer 13

age-related macular degeneration

Question 14

bacteremia assoc w/ colon cancer

Answer 14

clostridium septicum + strep bovis

Question 15

tx for female pattern hair loss

Answer 15

topical minoxidil (vasodilator)

Question 16

infant with widened wrists and depressible skull bones

Answer 16

nutritional rickets

Question 17

next steps for child w/ transient proteinuria

Answer 17

first morning void prot:Cr ratio

Question 18

lab findings assoc w/ RMSF

Answer 18

hyponatremia, thrombocytopenia, inc LFTs

Question 19

lung cancer screening

Answer 19

low dose chest CT age 55-80, 30 pack year hx + current smoker/last 15 yrs

Question 20

AAA screening

Answer 20

one time for men 65-75 w/ smoking hx

Question 21

sickle cell RBCs

Answer 21

howel-jolly bodies (nuclear remnants, usually removed by functional spleen)

Question 22

heinz bodies

Answer 22

RBC inclusions, seen in G6PD and thalassemia -> turn into bite cells