Day 7 Review - Epi/Ethics, GI1, GI2

Question 1

50 yo M w/ 25 pack year 2nd PNA in 6 mo, CXR lobar consolidation same location as previous

Answer 1

Tx PNA; CT scan (r/o cancer)

Question 2

Imaging study dx DVT

Answer 2

Compressive venous ultrasound

Question 3

Radiographic study dx injury to urethra

Answer 3

Retrograde cystourethrogram; E.g., blood at the meatus, high-riding prostate, ballotable prostate

Question 4

Sx basilar skull fracture

Answer 4

Racoon’s eyes - periorbital bruising, Battle’s sign - bruising mastoid process, Bleeding behind tympanic membrane, CSF out of nose/ears

Question 5

Tx Trigeminal neuralgia

Answer 5

Carbamazepine

Question 6

Tx normal pressure hydrocephalus

Answer 6

Ventriculoperitoneal shunt

Question 7

Tx pseudotumor cerebri

Answer 7

Weight loss, Acetazolamide; Serial Lumbar punctures or shunting of CSF

Question 8

Tx Guillain-Barre syndrome

Answer 8

IVIg or Plasmapharesis; Supportive care

Question 9

Distinguish somogyi effect versus dawn

Answer 9

Both cause high AM glucose; Check 2 or 3 AM glucose level to distinguish - Somaji low => stress hormone release, Dawn (insufficient NPH) high

Question 10

Type of immunodeficiency increase risk of transfusion deficiency

Answer 10

IgA deficiency

Question 11

First-line antihypertensives: No comorbidities

Answer 11

Thiazides (HCTZ, Chlorthiadone)

Question 12

First-line antihypertensives: DM

Answer 12

ACEi/ARB

Question 13

First-line antihypertensives: Heart failure

Answer 13

ACEi/ARB + Beta blocker + Aldosterone antagonist (e.g., spironolactone)

Question 14

First-line antihypertensives: BPH

Answer 14

Alpha blockers

Question 15

First-line antihypertensives: LVH

Answer 15

(precursor to LV failure) ACEi/ARB

Question 16

First-line antihypertensives: Hyperthyroid

Answer 16

Beta blocker (e.g., propanolol)

Question 17

First-line antihypertensives: Osteoporosis

Answer 17

Thiazide (Recall: loops loose calcium, Thiazides do not)

Question 18

First-line antihypertensives: benign essential tremor

Answer 18

Beta blocker

Question 19

First-line antihypertensives: post-menopausal female

Answer 19

Thiazide (again, decreases osteoporosis risk - loops loose calcium, Thiazides do not)

Question 20

First-line antihypertensives: Migraines

Answer 20

Beta blocker

Question 21

HACEK bacteria

Answer 21

Culture-negative endocarditis; Haemophilus, Actinobacteria, Cardiobacterium, Eikenella, Kingella

Question 22

Indications for home O2 in COPD pts

Answer 22

O2 sat =

Question 23

Initial tx for localized non-small cell lung CA

Answer 23

Surgical resection (can give chemotherapy after that)