deck 22

Question 1

syncope with exercise?

Answer 1

manifestation of organic heart disease in which cardiac output is fixed and does not rise (or even fall) with exertion. Syncope, commonly on exertion, is reported in up to 42% of patients with severe aortic stenosis.

Question 2

preferred treatment for scabies

Answer 2

topical permethrin (5%)

Question 3

management of hep B exposure

Answer 3

hep B immune globulin + hep b vaccine

Question 4

strong RF for dupuytren’s disease

Answer 4

diabetes

Question 5

stool character in c diff colitis

Answer 5

• semiformal rather than watery stool + **
  fecal leukocytes (not seen in viral gastroenteritis)
• CAN BE SEEN outside abx use

Question 6

conservative management of unstable angina/NSTEMI

Answer 6

clopidogrel + aspirin

Question 7

granuloma annulare treatment

Answer 7

• self-limited

- can be treated with topical corticosteroids

Question 8

use of probiotics

Answer 8

• reduce incidence, duration, and severity of antibiotic-associated and infectious diarrhea.

Question 9

when to screen for GDM

Answer 9

24-28 weeks

Question 10

normal EF

Answer 10

55-75%o

Question 11

management of asymptomatic uterine fibroids

Answer 11

observation

Question 12

cognitive therapy

Answer 12

helps patients correct false self-beliefs that can lead to negative moods and behaviors.

Question 13

RF’s for delirium in hospitalized patients

Answer 13

vision impairment, hearing impairment, dehydration, immobility, cognitive impairment, and sleep
deprivation

Question 14

best method for estimating gestational age

Answer 14

crown-rump length

Question 15

treatment for latent TB

Answer 15

isoniazid monotherapy

Question 16

treatment for latent TB in HIV positive person

Answer 16

isoniazid monotherapy

Question 17

best imaging procedure for hematuria

Answer 17

CT urography

Question 18

initial treatment of neurogenic bladder (i.e. with DM)

Answer 18

strict voluntary urination schedule
then bethanechol
many need to self-cath

Question 19

treatment of cocaine-associated chest pain

Answer 19

BENZOS

- HTN, tachycardia, and CP will often respond to IV benzos

Question 20

when to give fibrinolytics for ACS

Answer 20

only to patients who clearly have an STEMI and can’t get PCI

Question 21

amount of exercise necessary to begin burning fat stores

Answer 21

• at least 30 minutes (glycogen is primary energy source fro muscles during the first 20 minutes of exercise)

Question 22

management of herpes zoster opthalmicus

Answer 22

Systemic antiviral + ophthalmology referral

Question 23

supplement that can cause hepatotoxicity

Answer 23

niacin

Question 24

most common cause of hypoglycemia in a previously stable, well-controlled diabetic patient

Answer 24

renal disease

Question 25

value of chest films in ACS

Answer 25

While they do not confirm or rule out the presence of myocardial ischemia, other causes of chest pain may be evident, such as pneumothorax, pneumonia, or heart failure. The chest film may also provide clues about other possible diagnoses, such as pulmonary embolism, aortic disease, or neoplasia.

Question 26

management of exercise-related oligomenorrhea

Answer 26

increased caloric intake

Question 27

influenza vaccine for fetus?

Answer 27

some protective effect up to age of 6 months

Question 28

diet and when to initiate in pancreatitis

Answer 28

- low-fat solid diet has been shown to be safe compared with clear liquids, providing more calories and shortening hospital stays

Question 29

recommended test to confirm eradication of h pylori

Answer 29

1) urea breath test OR stool antigen

Question 30

vaccine diabetics need if not previously vaccinated

Answer 30

hepatitis B

Question 31

recommended treatment for OCD

Answer 31

CBT

Question 32

confirming PD diagnosis

Answer 32

positive response to levodopa

Question 33

management of postpartum urinary retention

Answer 33

discharge with a catheter in place and close follow-up

Question 34

diagnosis of gastroparesis

Answer 34

gastric emptying scintigraphy

Question 35

mgmt of low back and pelvic pain in pregnant women

Answer 35

core stability exercise

Question 36

mgmt of patient who doesn't want to know prognosis

Answer 36

ask pt to designate someone with whom you can discuss the results and prognosis

Question 37

skin tags are associated with...

Answer 37

DM + obesity

Question 38

flu shot for pt with egg allergy?

Answer 38

give inactivated + observe for at least 30 minutes afterward

Question 39

Etiology of DI

Answer 39

Caused by a deficiency in the secretion or renal action of arginine vasopressin (AVP). AVP, also known as antidiuretic hormone, is produced in the posterior pituitary gland and the route of secretion is generally regulated by the osmolality of body fluid stores, including intravascular volume. Its chief action is the concentration of urine in the distal tubules of the kidney. Both low secretion of AVP from the pituitary and reduced antidiuretic action on the kidney can be primary or secondary, and the causes are numerous.

Question 40

treatment of choice for PSVT

Answer 40

IV adenosine

Question 41

pernio

Answer 41

localized inflammatory lesion of the skin, usually found in the extremities following exposure to nonfreezing cold temperatures. It is generally a benign condition, and is not associated with any systemic diseases. These lesions are red-purple plaques with deep swelling, and are accompanied by itching or burning. They are not associated with infections or connective tissue disease.

Question 42

rule about release of patient information

Answer 42

always has to be in writing

Question 43

alternative medication with best evidence for anxiety

Answer 43

kava

Question 44

tarsal tunnel syndrome

Answer 44

Entrapment of the posterior tibial nerve or its branches as the nerve courses behind the medial malleolus results in a neuritis known as tarsal tunnel syndrome. Causes of compression within the tarsal tunnel include varices of the posterior tibial vein, tenosynovitis of the flexor tendon, structural alteration of the tunnel secondary to trauma, and direct compression of the nerve. Pronation of the foot causes pain and paresthesias in the medial aspect of the ankle and heel, and sometimes the plantar surface of the foot. - leads to paresthesias

Question 45

usual site for a stress fracture

Answer 45

2nd, 3rd, 4th metatarsals

Question 46

loss of smell think...

Answer 46

vitamin A, B6, b12 deficiency, brain tumors