General Medicine

Question 1

If nystagmus with Dix-Hallpike maneuver is vertical what type of vertigo is it? Peripheral or central?

Answer 1

Central

Question 2

What is the triad for Meniere Disease?

Answer 2

1. Vertigo
2. Low frequency hearing loss
3. Tinnitus

Question 3

What is cause of shoulder pain if Apley scratch test (touch superior and inferior aspects of opposite scapula) is positive?

Answer 3

Rotator cuff problem

Question 4

What is cause of shoulder pain is Neer test is positive (forced flexion of pronated arm)?

Answer 4

Subacromial impingement

Question 5

What is cause of shoulder pain if Hawkins test is positive (forward flexion of the shoulder to 90 degrees and internal rotation)?

Answer 5

Supraspinatous tendon impingement

Question 6

What is cause of shoulder pain if patient has positive drop-arm test (attempted slow lowering of arm to waist)?

Answer 6

Rotator cuff tear

Question 7

What is the cause of shoulder pain if positive cross-arm test (forward elevation to 90 degrees and active adduction)?

Answer 7

Acromioclavicular joint arthritis

Question 8

What is the cause of shoulder pain if positive Spurling test (spine extended with head rotated to affected shoulder while axially loaded)?

Answer 8

Cranial nerve root disorder

Question 9

What is the cause of shoulder pain if positive apprehension test (anterior pressure on the humerus with external rotation)?

Answer 9

Anterior glenohumeral instability

Question 10

What is the cause of shoulder pain if positive relocation test (posterior force on the humerus while externally rotating the arm)?

Answer 10

Anterior glenohumeral instability

Question 11

What is the cause of shoulder pain if positive sulcus sign (pulling down on elbow or wrist)?

Answer 11

Inferior glenohumeral instability

Question 12

What is the cause of shoulder pain if positive yergason sign (elbow flexed to 90 degrees with forearm pronated)?

Answer 12

Biceps tendonitis or instability

Question 13

What is the cause of shoulder pain if positive speed maneuver (elbow flexed to 20 to 30 degrees and forearm supinated)?

Answer 13

Biceps tendonitis or instability

Question 14

What is the cause of shoulder pain if positive “clunk” sign (rotation of loaded shoulder from extension to forward flexion)?

Answer 14

Label tear/disorder

Question 15

Do testicular torsion or epididymal pain improve with raising the affected testicle?

Answer 15

Epididymitis

Question 16

What is the length of treatment for epididymitis?

Answer 16

21 days

Question 17

Do varicoceles occur more on the right or left?

Answer 17

Left

Question 18

What is diagnostic test of choice for breast mass if age

Answer 18

Ultrasound

Question 19

What is diagnostic test of choice for breast mass if woman > age 35?

Answer 19

Diagnostic mammogram

Question 20

What form of biopsy is best for solid breast lesions?

Answer 20

Core needle biopsy

Question 21

What is only medication approved for treatment of cyclic mastalgia?

Answer 21

Danazol

Question 22

What are contraindications to using OCPs?

Answer 22

H/o thrombosis
Liver disease
Breast cancer
Migraine with aura
Uncontrolled hypertension

Question 23

A copper IUD can be implanted within how many days to act as emergency contraception?

Answer 23

5 days

Question 24

How far after intercourse can Plan b (levonorgestrel) be taken for emergency contraception?

Answer 24

72 hrs, may be efficacious up to 5 days

Question 25

How long after sexual intercourse call Ella (ulipristal) be used for emergency contraception?

Answer 25

120 hrs (5 days)

Question 26

Which SSRIs are potentially teratogenic?

Answer 26

Fluoxetine | Paroxetine

Question 27

How long should a person have amenorrhea to be considered to have gone through menopause?

Answer 27

12 months

Question 28

What are absolute contraindications to hormonal therapy for menopausal symptoms?

Answer 28

``` Pregnancy Thrombosis CVA Coronary artery disease Unexplained vaginal bleeding Breast or endometrial cancer Hypertriglyceridemia Immobilization ```

Question 29

What defines oligomenorrhea?

Answer 29

> every 35 days

Question 30

What defines polymenorrhagia?

Answer 30

Bleeding more frequent that every 24 days

Question 31

What endometrial stripe thickened requires further eval for endometrial cancer?

Answer 31

5 mm

Question 32

How many candidal vaginitis infections in a year is considered recurrent?

Answer 32

>4 in a year - treat with topical imidazole x 7-14 days or PO fluconazole q3 days x 3 followed by weekly x 6 months

Question 33

What is the most common viral etiology of conjunctivitis?

Answer 33

Adenovirus

Question 34

What is the most common bacterial etiology of conjunctivitis?

Answer 34

S aureus

Question 35

What is severe complication of Neisseria gonorrhea conjunctivitis?

Answer 35

Corneal perforation

Question 36

What underlying conditions are associated with scleritis?

Answer 36

Rheumatoid arthritis Tuberculosis Syphilis

Question 37

What antibiotic should be used for blepharitis with associated rosacea?

Answer 37

Oral tetracycline

Question 38

What eye condition has deposits of drusen?

Answer 38

Dry macular degeneration

Question 39

What type of macular degeneration is more vision threatening - wet or dry?

Answer 39

Wet

Question 40

What is treatment of dry macular degeneration?

Answer 40

Antioxidants - vit C or E and beta carotene Zinc Laser therapy VEGF inhibitor

Question 41

What is leading cause of irreversible blindness in the world?

Answer 41

Primary open angle glaucoma

Question 42

What cup to disc ratio is a finding of glaucoma?

Answer 42

>0.5

Question 43

What complication occurs if acute angle closure glaucoma is not treated?

Answer 43

Optic nerve atrophy

Question 44

What is leading cause of blindness globally (reversible)?

Answer 44

Cataracts

Question 45

What is epiphora?

Answer 45

Excessive tearing of eyes due to impaired drainage of the lacrimal duct system

Question 46

What eye disorder presents with sudden unilateral vision loss, cotton wool spots, tortuous retinal veins?

Answer 46

Central retinal vein occlusion (CRVO)

Question 47

What eye condition presents with sudden loss of vision in one eye, pale retina, cherry red fovea and afferent pupillary defect?

Answer 47

Central retinal artery occlusion

Question 48

What is endophthalmitis?

Answer 48

Inflammation of the aqueous and vitreous humors - usually from infection or after eye surgery

Question 49

What is Hutchinson sign?

Answer 49

Herpes zoster infection that involves the tip of the nose - usually indicates corneal involvement

Question 50

What dietary change can precipitate worsening of Ménière's disease?

Answer 50

High salt intake

Question 51

Which tuning fork is used for Rinne test - 256 or 512 hz?

Answer 51

512 Hz

Question 52

Which hearing test places a 512 hz running fork against the mastoid?

Answer 52

Rinne test - if sound can be heard better on the mastoid then likely conductive hearing loss

Question 53

Which type of hearing loss (conductive vs sensorineural) in the Weber test be louder in the affected ear?

Answer 53

Conductive

Question 54

What conditions can cause pulsatile tinnitus?

Answer 54

AV malformation Carotid artery stenosis Paraganglioma (glomus tumor)

Question 55

What are the 2 most common bacterial causes of acute otitis externa?

Answer 55

Pseudomonas | Staph aureus

Question 56

Acute otitis externa with presence of white or black fungal balls indicate what organism?

Answer 56

Aspergillus

Question 57

What post strep complication can NOT be caused by group C or G streptococci?

Answer 57

Acute rheumatic fever

Question 58

What bacteria is know to cause lemierre syndrome (septic thrombosis of IJ)?

Answer 58

Fusobacterium necrophorum

Question 59

What vitamin deficiency is associated with atropic glossitis?

Answer 59

B12

Question 60

Which type of vertigo, central or peripheral, habituates with Dix-Halpike maneuver?

Answer 60

Peripheral

Question 61

What is Russell sign?

Answer 61

Scarring on dorsum of the hand from recurrent purging in bulimia

Question 62

What MMSE score is mild dementia?

Answer 62

19-24

Question 63

What pharmacological therapy can help with stress incontinence if pelvic floor exercises don't work?

Answer 63

Duloxetine

Question 64

What pressure ulcer stage has full thickness breakdown with visible subq fat but no tendons, bone or ligament seen?

Answer 64

Stage 3

Question 65

Which lipid lowering agent needs to be held prior to surgery?

Answer 65

Cholestyramine

Question 66

What dose of steroids a patient is taking requires stress dosing?

Answer 66

If taking >10 mg/day for 3 weeks or more

Question 67

When should estrogen be discontinued before surgery?

Answer 67

Several weeks- increased risk of thrombosis

Question 68

What psychiatric medication class needs to be discontinued prior to surgery?

Answer 68

MAOIs

Question 69

Which patients require DVT prophylaxis for 5 weeks after surgery?

Answer 69

Orthopedic surgeries Abdominal or gynecological surgery for malignancy History of VTE

Question 70

What CHADS2 score for a fib requires bridging therapy for surgery?

Answer 70

>4

Question 71

What medication can be given for platelet dysfunction due to underlying kidney/liver disease prior to surgery to decrease bleeding?

Answer 71

Desmopressin 1 hr prior to surgery

Question 72

Which hormone LH or FSH is responsible for ovulation?

Answer 72

LH

Question 73

What vitamin deficiency presents with skin pigmentation cracking and crusting?

Answer 73

Niacin

Question 74

What vitamin deficiencies present with glossitis?

Answer 74

Niacin folate and vitamin b12

Question 75

What condition should be considered if a person faints while doing upper extremity exercise?

Answer 75

Subclavian steal syndrome

Question 76

What is Ramsey hunt syndrome?

Answer 76

Zoster infection of the external ear canal of facial nerve. May also have facial paralysis and sensorineural hearing loss

Question 77

What cause of conjunctivitis is associated with giant papillary conjunctivitis with itchy, watery discharge and preauricular LAD?

Answer 77

Chlamydial conjunctivitis