Challenge Bowl #1

Question 1

What are three antisecretory drugs that can be used to tx PUD?

Answer 1

PPI, H2RA, and sucralfate

Question 2

The existence of this hepatitis virus requires the coexistence of Hep B?

Answer 2

Hep D

Question 3

What are 2 tests used to dx the presence of H. pylori?

Answer 3

urea breath test

stool antigen

Question 4

Which rash has a Christmas tree distribution and is preceded by a Herald patch?

Answer 4

pityriasis rosea

Question 5

What is the first line tx for AOM in a 5 month old that is bilateral and without otorrhea?

Answer 5

Amoxicillin 90mg/kg in 2 divided doses

Pain management - APAP/ibuprofen

Question 6

What is the formula for CO?

Answer 6

CO = SV x HR

Question 7

A toddler presents who had scratched his lip, and now has a golden yellowish scab over the scratch. Dx?

Answer 7

impetigo

Question 8

Abd pain in the RLQ while palpating the LLQ is which sign?

Answer 8

Rovsing’s sign

Question 9

H. pylori tx should contain which key ingredients?

Answer 9

2 or more antibiotics + antisecretory drugs

Question 10

What is the study of the action of drugs on the body?

Answer 10

pharamcodynamics

Question 11

What is atelectasis?

Answer 11

Dependent collapse of the alveolar sacks.

MC when pt has been laying in bed too long

Question 12

What is a heave?

Answer 12

Pulsation felt due to distention of the underlying structure

Question 13

What is the most sensitive instrument for the detection of gallstones?

Answer 13

US

Question 14

What are 3 parenteral routes of drug administration?

Answer 14

IV, IM, sublingual, transdermal, rectal, intranasal

Question 15

What is a thrombus

Answer 15

A clot that is formed in the vessels

Question 16

What percent of the body has been burned if the anterior chest and entire left arm have been affected?

Answer 16

27%

Question 17

What generation of cephalosporins has the best gram negative coverage?

Answer 17

3rd/4th generation

Question 18

What FQ has the best activity against pseudomonas?

Answer 18

ciprofloxacin

Question 19

What skin CA is most likely to metastasize?

Answer 19

melanoma

Question 20

What initial therapy is recommended when sinusitis begins?

Answer 20

antipyretics
analgesics
nasal irrigation 
hydration
\+/- intranasal corticosteroids

Question 21

What is the best lab test to monitor long term nutritional status?

Answer 21

albumin

Question 22

What should you instruct your pt to take with metamucil and why?

Answer 22

8oz of water so it doesn’t get impacted

Question 23

When tx’ing anaphylaxis, which med has the fastest onset of action?

Answer 23

epinephrine - fastest
antihistamines - middle
corticosteroids - slowest

Question 24

What is one organism that causes walking pneumonia/

Answer 24

M. pneumo

Question 25

On which structure is an acoustic neuroma located?

Answer 25

CN VII

Question 26

What are two advantages of second generation antihistamines over first generation?

Answer 26

Second generation have fewer anticholinergic effects and less sedation

Question 27

Two MC nutritional deficiencies with alcohol dependence?

Answer 27

Thiamine and vit B12 | Also vit k and folic acid

Question 28

Why must you use caution when prescribing cimetidine to a pt using other medications?

Answer 28

CYP450 inhibitor; increasing the serum levels of other medications

Question 29

If a pt has a murmur from aortic stenosis, what will happen when they stand up?

Answer 29

Gets softer

Question 30

What is the recommended tx for uncomplicated HTN?

Answer 30

HCTZ

Question 31

What is the MC cause of death s/p AMI?

Answer 31

arrhythmias

Question 32

What can be used to tx AOM with an allergy to amoxicillin?

Answer 32

ceftriaxone, cefdinir, cefuroxime, and ceptidoxine

Question 33

What is the most effective drug for tx of persistent to moderate allergic rhinitis?

Answer 33

intranasal corticosteroid

Question 34

The rash of rubella starts on which part of the body?

Answer 34

Head or face

Question 35

Prochlorperazine and metoclopramide can cause what type of serious AE?

Answer 35

EPSE

Question 36

Are erosions primary or secondary lesions when describing derm findings?

Answer 36

secondary

Question 37

What is the tx of choice for acute constipation?

Answer 37

bisacodyl (Dulcolax)

Question 38

What is the atrial rate in a. flutter?

Answer 38

250-300

Question 39

Which lipid lower agent lowers LDL and TGL, significantly increases HDL, and causes flushing?

Answer 39

Nicotinic acid

Question 40

What is the MC sx associated with mitral valve prolapse?

Answer 40

asymptomatic

Question 41

What labs are used to monitor warfarin? heparin?

Answer 41

Warfarin: INR Heparin: aPTT

Question 42

How many half lives does it take to reach steady state?

Answer 42

5

Question 43

What is the major intracellular cation?

Answer 43

K

Question 44

What are 2 minor Jones criteria for rheumatic HD?

Answer 44

``` fever prolonged PR interval arthralgia inc'd CRP/ESR evidence of + strep culture antigen test elevated antibody titer ```

Question 45

A pt has COPD and has received the pneumo vaccination. When should they be revaccinated?

Answer 45

If they are 5yrs since their previous dose.

Question 46

What is the pathological process causing appendicitis?

Answer 46

obstruction of the lumen

Question 47

What medication should someone with persistent asthma be on?

Answer 47

scheduled inhaled CS | prn SABA

Question 48

Massive hemoptysis in a pt with advanced liver dz is most likely associated with what condition?

Answer 48

esophageal varices

Question 49

Tx for moderate acne?

Answer 49

PO antibiotics +/- benzoyl perioxide

Question 50

T or F? Psoriasis MC'ly affects the flexor surfaces of the elbows and knees.

Answer 50

F

Question 51

What three bacteria must be tx'd with more than one antibiotic?

Answer 51

H. pylori Pseudomonas Enterococcus

Question 52

What lipid lowering agent is best at lowering TG's?

Answer 52

Fibric acid (gemofibrozil)

Question 53

What is the best tx for pityriasis rosea?

Answer 53

Time

Question 54

What generation of FQ has the best gram positive coverage?

Answer 54

4th

Question 55

Name the drugs classes used to tx GERD from most ot least aggressive?

Answer 55

PPI, H2RA, antacids

Question 56

What is herpetic whitlow?

Answer 56

Herpes infx of the finger

Question 57

Which common GI procedure should not be used in a pt with acute diverticulitis?

Answer 57

Colonoscopy

Question 58

What is the appropriate first line tx of paroxysmal supraventricular tachycardia (SVT)?

Answer 58

valsalva or carotid massage

Question 59

What is the recommended tx for anticipatory N/V?

Answer 59

lorazepam

Question 60

What are three conditions that can cause symmetric enlargement of the abdomen?

Answer 60

Gas, fluid and fat

Question 61

What are three possible AE of topical corticosteroids?

Answer 61

acne, striae, atrophy, purpura

Question 62

Modifiable RF's for heart disease?

Answer 62

exercise, diet, smoking, EtOH, hypercholesterolemia, HTN

Question 63

What drug decreases gastric pH the most?

Answer 63

PPI

Question 64

What physical exam finding would you expect to find in a pt with an atrial septal defect?

Answer 64

a fixed split S2

Question 65

Which lab test confirms active infx and infectivity of the hepatitis b virus?

Answer 65

Hep B surface antigen

Question 66

What is the recommendeded drug tx for COPD management for a pt in group B?

Answer 66

SA + LA agent | Influenze and pneumococcal vaccine

Question 67

What are the major Jones criteria for RHD?

Answer 67

``` carditis polyarthritis chorea nodules erythema marginatum ```

Question 68

Tx of choice for chemo induced N/V?

Answer 68

Zofran | Dexamethasone

Question 69

Three sxs of end organ damage from HTN?

Answer 69

``` Arterial venous leaking ventricular hypertrophy AV nicking renal failure carotid dz TIA ```

Question 70

Which GI drug is CI in pg?

Answer 70

Misoprostol because it is a prostaglandin which induces labor and causes uterine contractions

Question 71

S2 is caused by the closure of what valves?

Answer 71

aortic and pulmonic valves

Question 72

What should you start at the same time you prescribe a narcotic?

Answer 72

Fluids, physical activity, fiber +/- bisacodyl (stimulant laxative)

Question 73

Which electrolyte imbalance causes flattening of the T waves on an EKG?

Answer 73

hypokalemia

Question 74

What is the LDL goal in a pt with DM?

Answer 74

<70

Question 75

What outcomes do ACEI have in CHF tx?

Answer 75

Slow progression of ventricular remodeling | BB reverse

Question 76

What is the name of the criteria used to predict morbidity and mortality in pt with pancreatitis?

Answer 76

Ranson's criteria

Question 77

What agent can be used in diabetic gastroparesis and GERD?

Answer 77

metoclopramide (Reglan)

Question 78

What is the tx of choice for C. diff?

Answer 78

metronidazole

Question 79

What are Osler's nodes?

Answer 79

Osler's nodes are painful, red, raised lesions found on the hands and feet in endocarditis

Question 80

What ENT condition is a true medical emergency?

Answer 80

epiglottitis

Question 81

What is the tx for pg induced N/V

Answer 81

pyridoxine | doxylamine

Question 82

What part of the artery do atherosclerotic lesions affect?

Answer 82

intima

Question 83

What is used to tx severe acne?

Answer 83

isotretinoin

Question 84

Which two hepatitis viruses are transmitted in the blood?

Answer 84

B and C

Question 85

What are three MC causes of PUD?

Answer 85

H. pylori, NSAID, and stress induced (from most to least)

Question 86

Ludwig's angina affects what space?

Answer 86

Between the hyoid bone and floor of mouth