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Internal Medicine Board Exam > General Medicine > Flashcards

General Medicine Flashcards

1
Q

What is the treatment for urge incontinence?

A

Bladder Training for timed voiding

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2
Q

If a patient has statin resistance, no reduction despite statin max and eztimibe therapy. What is the next best step?

A

PCSK9

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3
Q

Patient has constant dizziness, 30 hours, multiple vascular risk factors, older patient, what should be done?

A

MRI brain

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4
Q

A patient has a high risk for breast cancer, mom and sister have breast cancer, what should be done?

A

Genetic Counseling

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5
Q

If a patient has sertraline and venlafaxine depression resistance, what is the next best step?

A

Intranasal esketamine

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6
Q

If a patient has routine dyspnea on exertion, with no cardio/pulmonary cause or reason, what is the next best step?

A

Cardiopulmonary Exercise Testing

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7
Q

Acute cough less than 3 months is typically what?

A

Viral infection

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8
Q

What is another name for code status evaluation?

A

Advance Care planning

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9
Q

Cervical Radiculopathy can be treated how?

A

Conservative management, exercises, will have a positive Spurling Test (Neck pain on the side of forced rotation)

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10
Q

Meclizine in the elderly can cause what problems after 4 weeks?

A

Ataxia, they can fall over easier, should d/c if able

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11
Q

Scaphoid fracture after an accident, what is the next best step?

A

MRI/CT scan, thumb splinting

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12
Q

PTSD, ex-Iraq soldier, what is the best medication?

A

SSRI, prazosin can help with sleep, but SSRI is much better

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13
Q

Cervical Radiculopathy is what?

A

Nerve Root Impingement, nerve off of the spinal cord

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14
Q

Cervical Myelopathy is what?

A

Spinal cord impingement, at that level, is usually worsened with neck flexion

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15
Q

Myofascial Neck Pain is what?

A

Point tenderness of a muscle

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16
Q

Left Hip pain, pain that radiates down the leg, worse with straight leg test, pain is sharp and shooting, pregnant, what is the most likely cause?

A

Sciatic nerve radiculopathy

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17
Q

Meniere’s disease does not present with what?

A

Constant Vertigo

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18
Q

If a patient recently had a URI, persistent vertigo, hearing loss, what is this?

A

Labrithyinitis, treat with steroids

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19
Q

Elevated triglycerides, ASCVD score is 4.3, drinks less than 2 drinks a day, what is the best recommendation?

A

Diet and exercise

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20
Q

If a patient has a chronic dry cough, greater than one month, no tobacco, seasonal rhinitis, what is the next best test?

A

Spirometry, think about asthma

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21
Q

Flexion, adduction, and internal rotation of the hip cause pain, 68 year old male, back pain, what else do you suspect?

A

Hip Osteoarthritis

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22
Q

Chronic Venous stasis ulcers, what should be given?

A

Compression Therapy

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23
Q

A paraplegic is bed bound, what is the best opition to decrease a pressure wound?

A

Static matress therapy

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24
Q

Sudden onset urinary incontinence, what is the first step for evaluation?

A

UA

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25
Q

Comfort care, patient has delirium and not responding with delirium and haldol, what is the treatment?

A

Give Lorazepam

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26
Q

Greater Trochanteric pain, what is the hallmark sign?

A

Laying on the affected side

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27
Q

A patient has Flexion, Abduction, and External rotation pain, what is this?

A

Sacroiliac Joint Pain

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28
Q

Chronic pain and treatment, what is the next best step?

A

Opiod Risk Assessment

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29
Q

Opioid induced constipation requires treatment, what is the treatment of choice?

A

Senna

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30
Q

A snuffbox fracture, the original xray is wnl, what is the next best step? (Patient and doctor do not want to wait two weeks to repeat an xray)

A

MRI hand

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31
Q

If a patient has a chronic cough, that can not be explained, what medication can be given for symptom relief?

A

Gabapentin

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32
Q

2 or more episodes of vertigo lasting 20 minutes to 12 hours and fluctuating or nonfluctuating hearing loss, tinnitus, or ear pressure, what could this be?

A

Meniere’s Disease

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33
Q

Asian patient with gout, what is the first initial step of treatment?

A

HLAB*58:01 genotyping

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34
Q

If a patient has dementia and inability to get to the toilet in time, what is the best recommendation?

A

Prompted Voiding

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35
Q

What is the best treatment for cervical radiculopathy?

A

Neck Exercises

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36
Q

If you are over 40 years old and have DM, what should most people be placed on?

A

Statin

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37
Q

Swelling and pain in the patient’s elbow, works as a Gardner, what would be the treatment recommendations?

A

Rest, Ice, and protection

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38
Q

Positive Dix Hall Pike manuever, what is the next best step?

A

Canalith repositioning manuever

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39
Q

Receiving Benzos and Opiods at the same time has an increased risk of what?

A

Death

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40
Q

First line treatment for geratic insomnia patients, what is the best treatment?

A

Behavior related therapy

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41
Q

All syncope patients should have what test done?

A

Orthostatic BP

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42
Q

If taking Olanzapine, what blood test should be ordered as well?

A

Lipid Panel

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43
Q

A patient has a URI, he is given codeine-guaifenesin, then he borderline codes, what is the underlying problem?

A

Polymorphism of his CYP 450 gene

44
Q

Severe COPD, oxygen saturation is stable with rest and ambulation, what is the next best step?

A

Pulmonary Rehabilitation

45
Q

Statin treatment that shows resistance, what should be given?

A

PCSK9 monoclonal antibody

46
Q

Lateral Femoral Condyle pain that is worse with palpitation to the area, runner that has pain, what is the most likely scenario?

A

IT band syndrome

47
Q

Calcaneal stress fracture, what is the proper treatment?

A

Walking boot

48
Q

When a seasonal disease occurs, test that detects this disease will have what?

A

Increased PPV

49
Q

Besides doxycycline, what other treatment can help with hidradenitis suppurativa?

A

Adalimumab

50
Q

Biotin, Fish Oil, Beta Carotene, and vitamin E in an A-fib patient should be continued or stopped?

A

Stop all supplements, no cardiovascular benefit

51
Q

Bacterial Conjunctivas should be treated with what?

A

Trimethoprim-polymyxin

52
Q

A young patient without any past medical history has dysmenorrhea, what would be the first line treatment?

A

Oral OCPs

53
Q

A young 30 year old patient with a 1cm non-tender breast lump should receive what treatment?

A

Ultrasound

54
Q

A Rheumatoid Arthritis patient would like to go for knee surgery. She takes methotrexate and adalimumab. What should be done with her medications?

A

Adalimumab can be given, hold methotrexate

55
Q

Post operative ilieus after a hysterectomy, air fluid levels are seen on the xray, the patient is asymptomatic, what is the next best step?

A

Decrease opioid use

56
Q

A patient has Vitiligo, what should be tested?

A

TSH

57
Q

Patient does not take all his medications as prescribed, what should be done?

A

Patient Education

58
Q

Seborrheic Keratoses can be treated in what way?

A

Cryotherapy

59
Q

Tinea Pedis, can be best treated, how?

A

Terbinafine

60
Q

Chronic Bacterial Prostatitis is treated with what?

A

4-6 weeks of antibiotics

61
Q

Low Testosterone levels need to have what evaluated?

A

Repeat 8:00am serum total testosterone measurement, need two measurements

62
Q

After a patient has a PCV23 vaccine what should they have next?

A

The PCV20 vaccine or another PCV vaccine

63
Q

Acute otitis externa, is seen how?
Treatment?

A

Tenderness upon pulling on the ear
Ciprofloxacin-dexamethasone otic drops

64
Q

Melasma, skin darkening during pregnancy, what is the most likely cause?

A

Sun light, limit exposure

65
Q

Hepatitis C is associated with what rash?

A

Lichen Planus

66
Q

Rheumatoid arthritis patient, takes prednisone daily, is going to have elective surgery, what is the best steroid treatment?

A

Give an increased prednisone dose on day of surgery only, this will help avoid an adrenal crisis

67
Q

Allergic contact dermatitis, what should be given?

A

Triamcinolone Cream

68
Q

A small missing patch of hair is called?

A

Alopecia Areta, exclamation point hairs

69
Q

Rivaroxaban should be held until how far in advance of the patient’s surgery?

A

3 days before the procedure

70
Q

What can be used to treat atopic dermatitis?

A

Topical Tacrolimus and Pimecrolimus, can help patients, do not have the skin atrophy, striae, and telangiectasia that steroids have

71
Q

Plavix and ASA before an elective surgery, what should be done?

A

Hold Plavix, keep Aspirin

72
Q

High risk of CVD disease between 40 to 70 years old, what is the best treatment?

A

Aspirin may be given for treatment

73
Q

All patients over the age of 50 should have what vaccine spaced 6 months apart?

A

Herpes Zoster Vaccine

74
Q

Young woman with acne, what are two good treatment options?

A

OCPS and Spironolactone

75
Q

Scleritis is inflammation of the eye, and what is a hallmark sign?

A

Eye pain

76
Q

Treatment of Genitourinary syndrome of menopause is what?

A

Topical Vaginal Moisturizers

77
Q

How long should warfarin patients be without their warfarin? How long s/p surgery should they wait to restart?

A

Withhold 5 days, restart in 12 hours

78
Q

What is a great way to prevent COPD s/p surgery issues?

A

Perioperative prophylatic respiratory therapy

79
Q

A patient needs an Aortic Valve replaced and aortic-femoral bypass surgery performed, which should be done first?

A

Aortic Valve Surgery

80
Q

Suspected Epiglotittis, a young patient, what is the next best step? Severe Salivation, what should be done next?

A

ICU admission

81
Q

Urticarial Vasculitus is characterized by urticarial lesions that last longer than how long?

A

24 hours

82
Q

Exthanemous drug reaction happen low long after a new drug starts?

A

1-2 weeks

83
Q

A patient has menopause and not feeling well. She has HTN, and moderate cardiac risk factors. What should be given?

A

Transdermal Estrogen

84
Q

Porphyria Cutanea Tarda has what disease associated with it?

A

Hepatitis C

85
Q

Erythema covering 80% of the body, is what?

A

Erythroderma

86
Q

Superficial Fungal Infection, what is the best diagnostic test?

A

Potassium Hyroxide Preparation of skin scrapping

87
Q

What oral endocrine medications can help a patient lose weight?

A

Liraglutide

88
Q

Seborrheic Dermatitis, what should be given?

A

Zinc pyrithone

89
Q

Two or more centor criteria, what should be done?

A

Rapid Group A strept antigen testing

90
Q

If a woman is considering pregnancy, what should she be assessed for?

A

Varicella Antibody Risk

91
Q

Women with a history of gestational diabetes, what should be screened, even if no acute complaints?

A

HbA1c

92
Q

Acute epididymitis, older male, no STD concerns, what is the next best test?

A

Oral Levofloxacin

93
Q

Trichomonas positive, not pregnant, what should be given?

A

Oral Metronidazole

94
Q

When a patient wants to improve their life, what should be done?

A

Behavioral Counseling

95
Q

After a patient has bariatric surgery, what should be withheld if the patient’s diabetes is being evaluated?

A

Hold the patient’s lantus

96
Q

A patient has superficial skin infection that has mild puritis, what should be done for evaluation?

A

Wood’s lamp

97
Q

What vitamin or supplement has show Cardiovascular benefits?

A

None

98
Q

A patient with known CAD and CAGB x 4, what should be given to help Erectile Dysfunction?

A

Slidenafil, Phosphodiesterase-5 inhibitors

99
Q

Patient with blistering rash, oral/mucosal involvement, no new antibiotic, what should be considered?

A

Pemphigus Vulgaris

100
Q

When a patient has new vaginal discharge concerns, what should be done?

A

Saline and Potassium Hydroxide Wet mounts

101
Q

What should be done for AC s/p uterine surgery? Assuming no problems

A

LMWH for 30 days

102
Q

After a stroke, how long should patients wait before surgery?

A

9 months

103
Q

What is emergency contraception for a young women, without any big concerns?

A

Ulipristal Acetate

104
Q

Increased screening for prostate cancer can lead to what kind of problem?

A

Overdiagnosis

105
Q

What shot be considered in patients, ages 18-26, especially if TDAP and Flu are given?

A

HPV vaccine

Internal Medicine Board Exam (15 decks)

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