hammer9

Question 1

What are the symptoms of amphetamine intoxication?

Answer 1

Agitation, irritability, paranoia or delirium, chest palpitations and tachycardia, HTN, diaphoresis and mydriasis

Question 2

What are the symptoms of heroin withdrawal?

Answer 2

Muscle spasms, joint pain, nausea and vomiting, diarhea, abdominal cramps, rhinorrhea, lacrimation adn sweating

Question 3

What is the workup of acute bacterial prostitis? What is the treatment?

Answer 3

Do a mid stream urine sample. Tx - TPM-SMX or fluoroqunilones for 4-6 weeks

Question 4

What are the features of adenomysis?

Answer 4

Dysmenorrhea, heavy mesntrual bleeding with progression to chronic pelvic pain, boggy, tender, uniformly enlarged uterus

Question 5

What are findings in dermatomyositis/polymyositis?

Answer 5

Muscle fiber injury. Symmetrical and proximal muscle weakness. Interstitial lung disease, esophageal dysmotility, Raynaud phenomenon, polyarthritis, Skin findings like gottron papules and heliotrope rash

Question 6

What are findings in Lambert-Eaton syndrome?

Answer 6

Proximal muscle weakness, autonomic dysfunction, cranial nerve involvement, DIMINISHED or absent DTR

Question 7

Which nerve is damaged during parotid surgery? Which nerve causes jaw assymetry?

Answer 7

Facial nerve.V3 of trigeminal nerve

Question 8

What is the treatment for Paget disease of bone? What are clinical features?

Answer 8

Bisphosphonates. Spinal stenosis, radiculopathy, long bone bowing, fracture, arthritis Giant cell tumor, osteosarcoma.

Question 9

What are the indications to put patients on statin therapy?

Answer 9

Age 40 - 75 with diabetes, LDL > 190, 10 year ASCVD > 7.5, clincially significant atherosclerotic diseae

Question 10

What happens to elderly patients who are predisposed to prerenal azotemia?

Answer 10

Intravascular volume depletion, poor renal perfusion, worsening of GFR and renal function.

Question 11

What is the diference between trichomoniasis and bacterial vaginosis in terms of inflammation and erythema?

Answer 11

Trichomoniasis has inflammation. Both have pH > 4.5, only candida has normal pH.

Question 12

What are clinical findigns of hereditary hemochromatosis?

Answer 12

Chondrocalcinosisi pseudogout, chronic arthopathy, diabetes, liver disease.

Question 13

What are the inheritance mode and findings in osteogenesis imperfecta?

Answer 13

Blue sclerae, hearing loss, recurrent fractures, opalescent teeth. Autosomal dominant and norma intelligence

Question 14

What are lab findings (Ca, P, PTH) in osteomalacia 2/2 vitamin D deficiency?

Answer 14

low Ca, low P, increased PTH

Question 15

What are the risk factors for milk/soy protein induced colitis? Clinical features? Treatment and prognosis?

Answer 15

Family hx of allergies, eczema or asthma. Presents ate age 2 - 8 weeks with regurgitation or vomiting, +/- painless bloody stools, +/- eczema. Elimination, inititation of hydrolyzed formula in formula fed infants. Spontaneous resolution by age 1 year.

Question 16

Which organisms cause osteomyelitis in children with sickle cell?

Answer 16

Salmonella and staph aureus

Question 17

What is the workup of secondary hypogonadism in males?

Answer 17

Serum prolactin, transferrin, MRI

Question 18

What are the findings in optic neuritis?

Answer 18

Central scotoma, afferent pupillary defect, changes in color perception and decreased visual acuity.

Question 19

What are ECG, imaging and JVP findings in constrictive pericarditis?

Answer 19

nonspecific or afib or low voltage QRS, imaging shows pericardial thickening and calcification. JVP shows prominent x and y descents.

Question 20

What are teh CT brain findings in Alzhemier with MMSE

Answer 20

Diffuse cortical and subcortical atrophy which is greater in the temporal and parietal lobes

Question 21

What are teh symptoms and imaging findings in frontotemporal dementia?

Answer 21

Mute, immobile, incontinent. Marked atrophy of frontal and temporal lobes on CT.

Question 22

What is the murmur of tricuspid regurgitation and what makes it louder?

Answer 22

Holosystolic and gets louder with inspiration

Question 23

What are teh two major causes of acute pancreatitis and what is the first step in diagnosis?

Answer 23

Gallstones and chronic alcohol use. Abdominal ultrasound

Question 24

What is the etiology and treatment for patietns with febrile neutropenia (

Answer 24

Pseudomonas, pip-tazo

Question 25

What is the major cause of duodenal ulcers and how is it treated?

Answer 25

H.pylori or NSAIDS. Acid suppression and antibiotic eradication therapy.

Question 26

What is the progression of acne treatment?

Answer 26

1. Topical retinoids, salicylic 2. topical antibiotics 3. Oral antibiotics 4. oralisotretinoin

Question 27

Who should get tetanuspdipteria toxoid vaccine? tetanus immune globulin?

Answer 27

Severe or dirty wounds who received a booster > 5 years and those with minor clean wounds who received a booster > 10 years ago. TIG for dirty wound and unclear/incomplete immunization history

Question 28

Where do neuroblastomas arise adn what are teh imaging and lab findings?

Answer 28

Neural crest cells. Most commonly in abdomen, calcifications and hemorrhages are seen and elevated serum adn urine catecholamines adn their metabolites (HVA and VMA)

Question 29

What is the best way to prevent prenatal conjuctivitis from chlamidya?

Answer 29

Maternal prenatal testing.

Question 30

What is the presentation adn imaging findings of progressive multifocal leukoencephalopathy?

Answer 30

HIV patints with focal neurological signs and multiple non-enhancing lesions with no mass effect. Stroke in HIV patinets

Question 31

What is the most common congenital GI tract anomaly in children and what does it usually present with? Tx?

Answer 31

Meckel diverticulum presentign between epidodes of telescoping. Surgical resection.

Question 32

What sign is specific for renovascular hypertension? What are other signs implicated?

Answer 32

Presence of an abdominal bruit. Resistant HTN and diffuse atherosclerosis, assymetic kidney size, recurrent flash pulmonary edema and elevation in serum creatinine > 30%

Question 33

What are teh best treatment for cancer induced anorexia/cachexia?

Answer 33

Progesterone analogues such as megesterol acetate and medroxyprogesterone acetate

Question 34

What is the presentation of prepatellar bursitis? which organism is implicated?

Answer 34

Anterior knee pain, tenderness, erythema and localized swelling in repetitive kneeling. 2/2 staph aureus

Question 35

What are early findings in Alzheimer?

Answer 35

memory loss, visuospatal deficits (getting lost), landuage difficulties, cognitive impairement

Question 36

What are late findings of Alzhemier disease?

Answer 36

Neuropsychiatric halluciations, dyspraxia, lack of insight regarding deficits, non cognitive neurologic deficits, urinary incontinence

Question 37

What is the imaging findings of advanced ovarian cancer and what is the management?

Answer 37

Pelvic mass and ascites. Exploratory laparotomy.

Question 38

What are nasal polyps often associated with and what kind of symptoms do they cause?

Answer 38

Chronic rhinosinusitis, asthma, aspirin induces bronchospasm. Cause symptoms of bilateral nasal obstruction, nasal discharge and anosmia.

Question 39

Which meds are used to treat acromegaly and what are their mechanisms?

Answer 39

Cabergoline to inhibit GH release Octeorotide to inhibit GH release Pegvisomant inhibits IGF release from the liver, is a GH receptor antagonist

Question 40

What hormone is usually cosecreted with Growth hormone? Which CCB increases its level?

Answer 40

Prolactin. Verapamil

Question 41

Which medications cause hyperprolacintoma?

Answer 41

Antipsychotics, methyl dopa, metoclopromide, opioids, TCAs and Verapamil

Question 42

What is the presentation in men and women with high prolactin?

Answer 42

Women have galactorrhea, amenorrhea, infertility and men have ED and decreased libido

Question 43

What four tests are done prior to getting an MRI for prolactin? Treatment?

Answer 43

TFT, pregnancy test, BUN/Creatinine, LFTs. Treatment is with Cabergoline preferred over bromocriptine

Question 44

Which process is elevated during hypothyroidism?

Answer 44

Menstrual flow

Question 45

When do you replace thyroid hormone? When do you test for antithyroig per oxidase/antithyroglobulin?

Answer 45

When TSH is very high more than double with normal T4. When TSH is less than double

Question 46

Which is the only case in hyperthyroidism where TSH is elevated and where RAIU is elevated?

Answer 46

Pituitary adenoma. Graves.

Question 47

What is the treatment for acute hyperthyroidism or thyroid storm?

Answer 47

Propranolol to block peripheral conversion. Methimazole and PTU. Iodinated contrast material to block peripheral conversion and release. Steroids.

Question 48

What is the treatment for Graves opthalmopathy?

Answer 48

Steroids, radiation for those not responding, de compressive surgery for severe cases.

Question 49

What is the management of a thyroid nodule?

Answer 49

Perform TFT, if tests are normal biopsy. If nodules are greater than 1 cm, biopsy. If TSH is low, do iodine 123 scintigraphy and if nodule is hot, treat, if it is cold FNA.