deck 21

Question 1

HIV presentation

Answer 1

• weight loss, oral thrush, lymphadenopathy, and ulcerative esophagitis
• esophageal disease with advanced infection

Question 2

nunbullous impetigo treatment

Answer 2

topical mupirocin

Question 3

treatment of conjunctivitis

Answer 3

• viruses cause 80% (usually adenovirus) so usually requires no treatment.

Question 4

how to tell conjunctivitis is bacterial

Answer 4

• mattering and adherence of the eyelids

Question 5

location of fibromyalgia trigger points

Answer 5

medial scapula borders + posterior neck + upper outer quadrants of gluteal muscles + medial fat pads of the knees

Question 6

alopecia areata etiology

Answer 6

localized autoimmune reaction to hair follicles

Question 7

alopecia areata course

Answer 7

Spontaneous recovery usually occurs within 6–12 months, although areas of regrowth may be pigmented differently. Recovery is less likely if the condition persists for longer than a year, worsens, or begins before puberty.

Question 8

alopecia areata treatment

Answer 8

triamcinolone

Question 9

preferred abx for young adult with CAP who is not sick enough to be hospitalized

Answer 9

azithromycin (mycoplasma coverage)

Question 10

nicotine replacement + varenicline?

Answer 10

• leads to increase Nausea, HA, dizziness, fatigue

Question 11

group for which you don’t need to treat HSIL with ablation or excision

Answer 11

• adolescents (HPV infection common and transient in most young women so can be observed)

Question 12

risk of adenocarcinoma from Barrett’s esophagus

Answer 12

less than 1%

Question 13

only HA type that is always unilateral

Answer 13

cluster

Question 14

lateral epicondylitis management

Answer 14

• self-limiting, usually resolves within 12-18 months.

- no benefit from NSAIDS or steroids, it’s degeneration of the tendon, not inflammation

Question 15

pleurisy treatment

Answer 15

NSAID

Question 16

pleuritic chest pain workup

Answer 16

CXR + EKG (could be pericarditis)

Question 17

use of BNP in acute heart failure

Answer 17

Differentiates cardiac and pulmonary disease

Question 18

hemoptysis can also be due to…

Answer 18

effusions

Question 19

catch with allopurinol

Answer 19

Used for prophylaxis, Can worsen acute attacks since fluctuating levels of uric acid can actually worsen inflammation

Question 20

management of DVT during pregnancy

Answer 20

• risk of PE continues in the postpartum period

- continue treatment for 6 weeks after delivery with warfarin or LMWH

Question 21

only approved DM drugs for kids

Answer 21

metformin and insulin

Question 22

more effect on reducing HTN – dash diet or smoking?

Answer 22

dash diet

Question 23

most effective intervention for HTN if obese

Answer 23

weight loss

Question 24

double effect concept

Answer 24

• relieving suffering when death is unintended but foreseeable consequence

Question 25

orthostatic proteinuria

Answer 25

- benign condition occurring in young people in which protein excretion is increased in the upright position but normal when patient is supine. - diagnosed with split urine collections

Question 26

test most people need for syncope workup

Answer 26

EKG

Question 27

high risk angina features

Answer 27

* Angina at rest with dynamic ST-segment changes ³1 mm * Angina with hypotension * Angina with a new or worsening mitral regurgitation murmur * Angina with an S3 or new or worsening crackles * Prolonged (>20 min) anginal pain at rest * Pulmonary edema most likely related to ischemia

Question 28

USPSTF recommendation for aspirin in women

Answer 28

- more effective in preventing stroke than MI | - recommended for women 55-79 when benefit of stroke risk reduction outweighs GI hemorrhage

Question 29

aspirin and stroke prevention evidence for men?

Answer 29

- low dose decreases risk of first MI, but not stroke

Question 30

management of men with mild BPH

Answer 30

watchful waiting

Question 31

spinal cord injury as VTE RF?

Answer 31

induces immobility

Question 32

ottawa ankle rules criteria

Answer 32

Inability to take four steps, either immediately after the injury or when being evaluated; localized tenderness of the navicular bone or the base of the fifth metatarsal; or localized tenderness at the posterior edge or tip of either malleolus.

Question 33

management of urosepsis with renal failure

Answer 33

1) aggressive IV fluid resuscitation | 2) abx

Question 34

best single angle for empiric treatment of nursing home CAP

Answer 34

levofloxacin (levaquin)

Question 35

requirements for proxy to decide on life-sustaining therapy

Answer 35

A patient’s condition does not need to be terminal or irreversible to allow the removal of life-sustaining therapy. So if on ventilator, proxy can tell you to stop it.

Question 36

supplement that can have negative interaction with aspirin

Answer 36

ginkgo biloba (associated with serious intracereberal bleeding)

Question 37

NSAIDS and MI

Answer 37

- all oral NSAIDS increase the risk of MI | - EXCEPT for naproxen

Question 38

causes of secondary osteoporosis in men

Answer 38

Excessive alcohol use, hypogonadism, vitamin D deficiency, and decreased body mass index

Question 39

management of RBB + left anterior hemiblock

Answer 39

Heart monitoring study

Question 40

positive result on second but not first of 2 step TST suggests...

Answer 40

long-standing latent TB infection

Question 41

most common cause of skin and soft-tissue infections among patients presenting to metropolitan

Answer 41

MRSA

Question 42

nutritional intervention shown to accelerate pressure ulcer healing

Answer 42

adequate protein intake | - increased caloric intake will promote healing

Question 43

for release of patient info, authorization must be in WRITING except for

Answer 43

(1) coordination of care between providers and those involved in the patient’s case (i.e., caretakers, nurses, consulting physicians); (2) arranging payment for medical services rendered; and (3) health-care operations such as evaluating a provider or system’s competency or quality.

Question 44

problem with corticosteroids for obstructive lung disease

Answer 44

increased risk for pneumonia

Question 45

med most commonly known to cause hyperthyroidism

Answer 45

amiodarone

Question 46

DHEA efficacy as performance enhancer?

Answer 46

doesn't enhance performance or muscle strength

Question 47

lab to order for milky discharge from breast

Answer 47

prolactin

Question 48

patellofemoral stress syndrome (runner's one)

Answer 48

patella deviates laterally with knee extension

Question 49

patellofemoral stress syndrome (runner's one) treatment

Answer 49

PT

Question 50

postpartum visit testing

Answer 50

screen fro depression

Question 51

preferred initial test for patient with painless postmenopausal bleeding

Answer 51

1) transvaginal ultrasonography | 2) if unavailable, endometrial biopsy