General Medicine

Question 1

Icosapent ethyl and omega 3 fatty acid usage

Answer 1

Decrease triglyceride

Question 2

Treatment chronic low back pain

Answer 2

Nonpharmacologic therapy, nsaid, duloxetine, and final is opioid but carefull

Question 3

Chronic noncancer pain, which opioid

Answer 3

Short acting opioid

Question 4

Opioid use in palliative care, manage pain from cancer or other conditions characterized by persistent pain or disabling pain with significant functional impairment

Answer 4

Extended release or long acting opioid

Question 5

Hip osteoarthritis: FADIR positive, flexion, adduction, internal rotation
Sacroiliitis joint dysfunction: FABER positive, flexion, abduction and external rotation

Question 6

Varenicline does not increase risk of cardiac event

Question 7

Nicotin replacement therapy includes short acting and long acting nicotin

Question 8

An abnormal result on any one of the three HINTS ( Head impulse, nystagmus, test of skew) examination component suggest a central vertigo

Question 9

Window for thrombolytic therapy for stroke

Answer 9

3 hours

Question 10

Olanzapine can cause weight gain, hyperglycemia and hyperlipidemia

Question 11

Clozapine can cause agranulocytosis

Question 12

Fluphenazine can increase liver enzymes

Question 13

Treatment of binge eating

Answer 13

Cbt, ssri and lidexamfentamine

Question 14

Absolute contraindication of compression therapy when abi is

Answer 14

0.5 or less

Question 15

Acute rehab requirement

Answer 15

Participate 3 hours of therapy on 5 days a week

Question 16

Treat nightmare related to ptsd

Answer 16

Prazosin

Question 17

Cbt in premenstrual dysphoric disorder is very limited and variable

Question 18

Risk factor for opioid overdose

Answer 18

More than 50 morphine mg equivalent per day and receiving opioid and benzo concurrently

Question 19

Haloperidol can lower the seizure threshold in pt with withdrawal seizures

Question 20

Treatment of vasovagal

Answer 20

Counterpressure measure, fludrocortisone, midodrine

Question 21

Bupropion contrandicate in seizure and do not cause weight gain or sexual dysfucntion

Question 22

Meclizine can cause fall in older adult

Question 23

Time up and go test if more than 12 seconds should intervene to reduce risk of fall

Question 24

Chronic cough causes step approach
Upper airway cough syndrome
Asthma
Non asthmatic eosinophilic bronchitis
Gerd with ppi
Then gerd with ph monitoring
Ct scan

Question 25

Treatment of stress incontinence

Answer 25

First line kegel excercise Second line vaginal estrogen

Question 26

Codeine metabolized with cyp p450 Thiopurine methyltransferase metabolite azathioprine and 6 mercaptopurine

Question 27

Presence of hla B 57:01 increase risk of hypersensitivity reaction when pt uses abacavir Presence of hla B58:01 increase risk for severe cutaneous adverse reaction with allopurinol

Question 28

Treatment of systemic exertion intolerance disease is

Answer 28

Pacing strategies

Question 29

Treatment of labyrinthitis

Answer 29

Prednisone

Question 30

Options for chronic neuropathic pain is pregabalin, gabapentin, duloxetine, capsaicin, topical lidocaine

Question 31

Contrandication of methylnatrexone

Answer 31

Bowel obstruction

Question 32

Urate lowering therapy for gout when

Answer 32

Stage 2 or greater ckd Two or more acute attack per year One or more tophi Uric acid nephrolithiasis

Question 33

Allopurinol can inhibit thiopurine methyltransferase so cant use allopurinol with azathioprine or 6 mercaptopurine

Question 34

Narrow band ultraviolet B phototherapy uses for psoriasis vulgaris, mycosis fungoides, atopic dermatitis, vitiligo

Question 35

Perioperation, can continue nonbiologic dmards but should stop biologic Except lupus, biologic should stop 1 dose before surgery Janus kinase inhibitor like tofacitinib should be held 3 days before. Resume when the wound heal at around 14 days

Question 36

Treatment of bacterial conjunctivitis

Answer 36

Trimethoprim polymyxin Erythromycine Bacitracin polymyxin

Question 37

Bacterial conjunctivitis with contact lense due to pseudomonas

Answer 37

Ofloxacin

Question 38

Bacterial vaginosis Vaginal ph greater than 4.5 Thin gray homogeneous vaginal discharge Positive amine whiff test, fishy odor 20% clue cells on wet mount

Answer 38

Treatment Metronidazole oral or cream Clindamycin vaginal cream Clindamycin oral Secnidazole oral Tinidazile oral

Question 39

Herpes zoster and involve first division on the trigeminal nerve (forehead extending over upper eyelid or nasal tip involvement

Answer 39

Refer to eye doc because of herpes zoster ophthalmicus and blindness

Question 40

Herpes zoster and vesicle in the external ear canal

Answer 40

Facial paralysis and auditory vestibular symptoms can occur Ramsay Hunt syndrome

Question 41

Percutaneous balloon aortic valvulotomy uses for severe aortic stenosis and pulmonary edema or cardiogenic shock unresponsive to standard therapy

Question 42

Zinc containing intranasal product can cause permanent anosmia

Question 43

Lichen planus is treated by glucocorticoid and ultraviolet light

Question 44

Dx scabies uses mineral oil preparation of skin scraping Dx fungal infection uses potassium hydroxide preparation of skin scraping

Question 45

Dx tinea capitis, skin fluorescence seen in erythrasma, vitiligo uses wood lamp examination

Question 46

Vitiligo associate with hashimoto thyroiditis, graves disease, alopecia areata, t1dm, pernicious anemia rheumatoid arthritis, polyglandular autoimmune syndrome

Question 47

Hep c related to lichen planus, porphyria cutanea tarda, leukocytoclastic vasculitis

Question 48

Hiv associates with pruritus, molluscum contangiosum, seborrheic dermatitis

Question 49

Indication for treating osteoporosis

Answer 49

Bmd t score -2.5 or less Bmd t score -2.5 to -1 and 10 year risk of 3% or greater for hip fracture or 20% risk or greater for major osteoporosis related fracture as estimated by FRaX tool

Question 50

Ct scan is more sensitive for appendicitis

Question 51

We should give influenza vaccine two weeks before and one week after chemotherapy

Question 52

Biotin should stop 2-5 days before testing thyroid function because it can increase t3,t4 and decrease tsh

Question 53

Biotin can cause low troponin

Question 54

Beta caroten can cause lung cancer on smoker

Question 55

Fish oil and vitamin e can increase risk of bleeding if use anticoagulation

Question 56

Treatment of rosacea is topical metronidazole cream

Question 57

Copper iud prevent pregnancy by 99% if placed within 5 days of unprotected sex

Question 58

For emergent conteaception levonogestrel is not effective with bmi more than 26, but ulipristal acetate is effective with bmi more than 26

Question 59

Acid transnexamic inhibit melatonin synthesis can can use off label to treat refractory melasma

Question 60

Anyone younger than 15 years old should receive two dose series of hpv vaccine Older than 15 should receive three dose series of hov vaccine

Question 61

Orlistat contraindication in malabsorption syndrome and cholestasis

Question 62

Phentermine topiramate contraindicated in glaucoma hyperthyroidism and nephrolithiasis

Question 63

Naltrexone bupropion contraindication in insomnia seizures, eating disorder opiate use or withdrawal alcohol use

Question 64

Uspstf recommend aspirin in aldult 40-59 with ascvd 10 year risk of 10% or higher and no increase risk of bleeding

Question 65

Treatment of seborrheic keratoses

Answer 65

Cryotherapy

Question 66

Treatment of actinic keratosis

Answer 66

Topical 5 fluorauracil

Question 67

Fusobacterium necrophorum causes Lemierre syndrome

Question 68

Danazol is onlu fda approved drug for cyclic breast pain

Question 69

Treatment of onychomycosis

Answer 69

Systemic terbinafine or fluconazole

Question 70

Should stop clopidogrel 5 day, prasugel 7 days, ticargrelor 3-5 days before surgery

Question 71

Erythrasma use wood lamp evaluation and treated by oral or topical erythromycin

Question 72

Copper iud last 10 years Levonogestrel iud last 3-5 years

Question 73

To diagnose androgen deficiency, will need two test of morning serum total testosterone

Question 74

Obtaining free testosterone level if alteration in sex hormone binding globulin like obesity, liver disease, diabetes, insulin resistance, glucocorticoid use

Question 75

Using tacrolimus cream can cause viral skin infection hsv and vzv and skin cancer and cutaneous lymphoma

Question 76

Calcipotriene cream use to treat psoriasis

Question 77

Treatment of porphyria cutanea tarda

Answer 77

Phlebotomy or twice weekly hydroxychloroquine

Question 78

Hyperacute bacterial conjunctivitis caused by neisseria gonorrhea