Feb 2024

Question 1

Fecal elastase testing
indication?

Answer 1

pancreatic insufficiency
(level < 100)

Question 2

SeHCAT test indication

Answer 2

diagnose bile acid malabsorption
(e.g., pt post-ileal resection for CD)

Question 3

pyoderma gangrenosum Rx ?

Answer 3

PO steroids

Question 4

HIT type2
Dx ?

Answer 4

marked fall in PLT count post-heparin use in 5-10days.

Question 5

HIT type 1
Dx ?

Answer 5

direct PLT activation by Heparin
(not associated with increase risk of venous thrombosis)

Question 6

microscopic colitis cause ?

Answer 6

PPI or NSAIDs use

Question 7

Anemia of chronic disease
Dx ?

Answer 7

known case of RA
Low Hb plus MCV (at lower limit)

Question 8

WM
Dx ?
Rx ?

Answer 8

headache
features of hyperviscocity syn (increase thrombosis risk)
Dexa + Rituximab + cyclophosphamide

Question 9

IgA nephropathy
Rx ?

Answer 9

Observation
(if needed Rx - modefied release budesonide)

Question 10

achalasia
Dx ?

Answer 10

intermitent regugitation of solids and liquids

Question 11

Weil’s Dz
Dx ?
Rx ?

Answer 11

acute infection + severe liver damage + kidney damage
Rx: Benzylpenicillin IV

Question 12

Brugada syn
Dx ?

Answer 12

family member death in sleep

Question 13

Congenital long QT syn
Dx ?

Answer 13

Ventricular arrhythmia during extreme SNS activity (stress)

Question 14

Mirabegron use ?

Answer 14

Urge incontinence in old age with mild cognitive impairment

Question 15

Type 2 respiratory failure
(not improved with 1 hr NIV)
Next step ?

Answer 15

Elective intubation

Question 16

MM Rx with steroids - causing N/V, hyperK+, HypoNa+, low BP
Next step?

Answer 16

IV hydrocortisone
(Rx adrenal insufficiency)

Question 17

Number of PVCs - high risk level ?

Answer 17

> 10,000 per day

Question 18

neuroborreliosis
Dx ?
Rx ?

Answer 18

neuro menifestation of lyme Dz
caused by Borrelia burgdorferi with meningitis + 7th CN palsy
Rx: penicillin + doxy

Question 19

fludarabine related AIHA
Dx ?

Answer 19

Rx with CLL
Remission rates can be increased by adding fludarabine with rituximab

Question 20

Increase Cl- levels post-DKA Rx
cause ?

Answer 20

plasma volume expansion

Question 21

carbamazepine overdose Rx ?

Answer 21

activated charcoal

Question 22

1st Hemodialysis session. pt acute unweel. Rx ?

Answer 22

sodium modeling (manipulate sodium conc in dialyser machine)

Question 23

Liraglutide use ?

Answer 23

reduce weight, reduce HbA1C level, better CVS outcome

Question 24

ovarian teratoma associated antibodies ?

Answer 24

NMDA ab (autoimmune encephalitis - psychiatric and neuro symptoms)

Question 25

brachial neuritis Dx ?

Answer 25

pain + sensory + motor loss in upper trunk of brachial plexus. associated with trauma/exercise.

Question 26

Prolactinoma Rx ?

Answer 26

cabergoline > bromocriptine

Question 27

acromegaly Rx ?

Answer 27

octeriotide

Question 28

Bisphosphonate (check before start it) ?

Answer 28

dental examination (poor dental hygiene - risk factor for osteonecrosis of jaw)

Question 29

Granulomatosis with polyangitis Rx ? (young female plan to get pregnant)

Answer 29

methylprednisolone + rituximab

Question 30

Small cell lung Ca with limbic encephalitis. AutoAb ?

Answer 30

Hu

Question 31

paget dz Dx ?

Answer 31

High Alk phos Normal Ca++ bone pain

Question 32

histoplasmosis Rx ?

Answer 32

itraconazole

Question 33

acute dystonia Rx ?

Answer 33

Diphenhydramine

Question 34

Lambert-Eaton Myasthenia Syn (Small cell lung Ca association) Rx ?

Answer 34

3,4, Diaminopyridine (increase ACh release)

Question 35

Eosinophilic pneumonia Dx ? Rx ?

Answer 35

increase blood eosinophil increase alveolar eosinophil peripheral consolidation on CXR Rx - steroids

Question 36

Rx Raynaud's in Systemic sclerosis ?

Answer 36

Bosentan

Question 37

retroperitoneal fibrosis - causing B/L ureteric obstruction. Rx ?

Answer 37

B/L nephrostomy tube insertion

Question 38

70% stenosis in ICA with TIA stroke prevention ?

Answer 38

clopidogrel 75mg OD

Question 39

Lung volume reduction surgery mortality benefit ? C/I ?

Answer 39

predominant upper lobe emphysema C/I: FEV1 < 1.5

Question 40

CKD anti-coagulation ?

Answer 40

Unfractionated heparin

Question 41

pt with DM in pregnancy start Metformin ?

Answer 41

only if no improvement with diet and exercise (minor improvement means - continue diet and exercise)