cases

Question 1

uti

Answer 1

“upreg

bactrim ua ucx”

Question 2

pregnancy

Answer 2

“ectopic labs, bmp, then pap u/a+cx rubellaAb HBsAg RPR/HIVelisa/Chlamydia
q4w visits until 28w, then q2w
vitamins iron folate counseling”

Question 3

ibd

Answer 3

“esr, sigmoidoscopy with biopsy, stool op/whites/cx, lfts, coags, cbc, bmp
then topical mesalamine=5-asa with immodium, dietary consult”

Question 4

ectopic

Answer 4

“get coags, ct/ng, lft’s too

mtx or surgery”

Question 5

ibs

Answer 5

“cbc bmp tsh fobt esr stool-op/wbc/cx+FAT pap

lactose/fiber/loperamide/biofeedback/reassure”

Question 6

depression

Answer 6

“cbc bmp tsh b12

ssri excercise education”

Question 7

vaginitis

Answer 7

vaginal ph, wet mount, gram stain, pap, ct/ng, u/a

Question 8

alzheimers

Answer 8

“donepezil/rivastigmine/galantamine +memantine
vitE if not heart disease
atypical antipsychotic
+-fluoxetine/buspirone”

Question 9

copd excacerbation

Answer 9

“head of bed up
PEFR, basic labs, EKG
counseling
flu and pneumoccal vaccines”

Question 10

fibroadenoma

Answer 10

“mammography, fna, maybe ultrasound

counseling, pap smear”

Question 11

hypertensive emergency

Answer 11

"iv, pulse ox, cardiac and bp monitor
ekg, head ct, cbc/bmp/ua cxr-pa stat
npo
nitroprusside, a-line
icu
lipids"

Question 12

foreign body aspiration

Answer 12

“iv, o2, pulse ox
neck and cxr, cbc
scope”

Question 13

panic attack

Answer 13

“ekg and Dstick
CXR, U/A, Utox in addition to basic’s
benzo, repeat psych exam
counseling, follow-up”

Question 14

tia

Answer 14

“aspirin after negative HCT
diabetic diet, a1c, lipids, echo, carotid doppler’s, mri’s
pre-op cefazolin”

Question 15

pid

Answer 15

“wet mount, cervical gram stain and gc cultures, pap, esr, vrdl, hiv
cefoxitin/doxy or clinda/gent, morphine, promethazine, tylenol, NS
NPO, admit!
repeat gential exam, advance diet”

Question 16

hemophilia

Answer 16

“pt/ptt/bleeding time, then 8/9/11 levels +- LFTs/BMP
give 8 or 9 (hemophilia A or B)
desmopressin, txa
counsel genetics/patient/family, no sports/aspirin”

Question 17

unstable angina

Answer 17

“LFTs too, PTTs with heparin drip
early metop, fobt
non-emergent angiography if no ongoing pain
GP2b/3a=eptifibatide=integrilyn prior to cath
then echo, lipids, tsh, counsel inc smoking/alcohol, excercise, compliance, diet
aspirin, metop, statin, plavix, nitro”

Question 18

croup

Answer 18

“cbc, bmp
neck xr, humid air, racemic epi, oral dex
counsel”

Question 19

asthma

Answer 19

“abg, peak-flow

albuterol, pred -> ipratropium -> fluids, bedrest”

Question 20

constipation

Answer 20

“cbc bmp mg phos tsh a1c fobt
colonoscopy
metamucil
1w f/u”

Question 21

appy

Answer 21

“NS, LFTs, UA, ultrasound first, npo
morphine and phenergan
cefoxitin before OR
lap appy”

Question 22

septic arthritis

Answer 22

“basic labs, ESR, full synovial studies

iv fluids morphine, vanc and ceftri”

Question 23

dysfunctional uterine bleeding

Answer 23

“preg cbc tsh prolactin coags pap

iron low/low-ocp”

Question 24

pericarditis

Answer 24

trop, esr, bcx, advil colchicine

Question 25

splenic contusion

Answer 25

"spine immobilization type and cross, lipase, etoh, utox, upreg, surg consult counsel"

Question 26

cellulitis

Answer 26

"cbc, bmp, x-ray, bcx, wound cx iv clinda, admit compliance counseling"

Question 27

gout

Answer 27

"esr, x-ray | indomethacin"

Question 28

pcp pna

Answer 28

"bactrim, pred pneumocystis stain, ldh, g6pd, elisa cd4 + vl efv/tenofovir/emtricitabine, flu and pneumococcus vaccine"

Question 29

renal cell carcinoma

Answer 29

"serum iron, tibs, ferretin | u/a, abdominal ct -> chest ct, admit labs, nephrectomy, pain mgmt"

Question 30

perfed peptic ulcer

Answer 30

"iv, npo, stop ibuprofen ng tube morphine, phenergan, protonix advance diet after laparotomy"

Question 31

turner

Answer 31

"karyotype, fsh/lh full labs, renal+pelvic us, skeletal survey, hearing test gh therapy, hrt, vitD+Ca, dietary consult, psych consult for IQ"

Question 32

hypertension

Answer 32

cbc, bmp, ua, ekg, lipids but lifestyle before meds

Question 33

diverticulitis

Answer 33

npo, unasyn then home with cipro/flagyl

Question 34

child abuse

Answer 34

bleeding time, chest physio, cps+psych

Question 35

menopause

Answer 35

"hrt + vitD/Ca | +- pap/mammography/colonoscopy/lipids"

Question 36

dvt

Answer 36

initial coags and fobt, f/u INR checks

Question 37

pe

Answer 37

"cbc, trop, abg stop ocp check INRs until 2-3"

Question 38

colon cancer

Answer 38

"LFTs, ESR, miralax CEA, iron, pre-op labs and abx=cipro/flagyl counsel smoking/etoh"

Question 39

mania

Answer 39

"cbc, bmp, tsh, uds | olanzapine, lithium, psych, suicide contract"

Question 40

pneumococcal meningitis

Answer 40

"head ct before LP, head elevation | stop antiHTN, dex, vanc, ceftri"

Question 41

cns crypto

Answer 41

"labs, serum crypto antigen lp w/ cell glucose protein gramstain crypto india fungal culture antigen afb amphotericin flucytosine for 2w cd4"

Question 42

hsv encephalitis

Answer 42

csf hsv too

Question 43

temporal arteritis

Answer 43

"cbc esr vitD+Ca and protonix with prednisone aspirin also f/u dexa scan"

Question 44

polymyalgia rheumatica

Answer 44

"cbc bmp esr crp rf ana tsh cpk cxr | pred and adjuncts"

Question 45

ovarian torsion

Answer 45

laparoscopy, ua

Question 46

ovarian cancer

Answer 46

"cbc, us, ca125, colonoscopy, mammogram, pap | cefazolin, heparin, diet"

Question 47

sigmoid volvulus

Answer 47

gi consult, colonoscopy prior to laparotomy

Question 48

cholecystitis

Answer 48

lipase, zosyn, toradol ok

Question 49

sinusitis

Answer 49

augmentin, tylenol, mometasone

Question 50

aaa

Answer 50

"stop metop, aspirin | cefazolin"

Question 51

intusussception

Answer 51

"npo, fluids, ng, labs, axr | barium enema, counsel"