I

Question 1

Rx that can decrease hyperkalemia by causing intracellular shift

Answer 1

insulin, glucose, Na-bicarb, and albuterol

Question 2

type of urinary crystals seen in ethylene alcohol poisoning

Answer 2

rectangular envelope shaped

Question 3

lumbar puncture showing predominance of lymphocytes

normal opening pressure and normal glucose

Answer 3

herpes encephalitis

Question 4

suicide by drinking highly alkaline solution. what to do

Answer 4

secure airway
decontamination
CXR if respiratory Sx
endoscope in first 24 hrs to address severity of damage and need for more aggressive Tx

Question 5

HIV screening test

Answer 5

p24 Ag and Ab

Question 6

+ coombs test

Answer 6

autoimmune hemolytic anemia

Question 7

electrical alterans, varying QRS complexes

Answer 7

pericardial effusion. needs centesis

Question 8

screening for diabetic nephropathy

Answer 8

microalbumin/creatinine ratio

Question 9

murmur with aortic dissection

Answer 9

aortic regurg– early diastolic murmur

Question 10

lab key to heparin induce thrombocytopenia

Answer 10

platelets drop below 50% of what they were prior

risk now for arterial thrombosis

Question 11

prophylaxis for HIV CD4 count

Answer 11

azithromycin for MAC prevention

Question 12

riluzole

Answer 12

glutamate inhibitor used in ALS

Question 13

Acute Tubular necrosis findings

Answer 13

muddy brown casts of renal epithelial cells
urine osmol 300-350
urine Na >20
FeNa >2%

Question 14

preferred respiratory support for Acute exacerbation COPD

Answer 14

noninvasive positive pressure ventilation

Question 15

risk of the main antipsychotic medications

Answer 15

can develop extreme hypothermia

Question 16

showing of cutaneous larva migrans

Answer 16

ancylostoma braziliense- hookworm

serpinginous reddish brown lesions on skin in lower and upper extremities

Question 17

findings in adrenal insufficiency or addisons

Answer 17

mineralocorticoid deficiency
increased vasopressin secretion
hyperkalemia
hyponatremia

Question 18

risks for idiopathic intracranial hypertension

Answer 18

overweight women childbearing age

possible like to medications: tetracyclines and hypervitaminosis A

Question 19

Systemic Sclerosis findings

Answer 19

esophageal dysmotility, fibrotic lung disease, arthralgias

thickening or hardening, edema and pruritis

Question 20

diabetic pyelonephritis

Answer 20

parenteral antibiotics after 48-72 hours

TMP-SMX

Question 21

most common secondary solid tumor malignancies

Answer 21

lung, breast, thyroid, bone and GI

Question 22

presentation vitreous hemorrhage

Answer 22

sudden loss of vision and onset floaters
common cause is diabetic retinopathy
fundus is hard to visualize

Question 23

Primary biliary cirrhosis marker

Answer 23

anti mitochondrial Ab
will have inc alk phos
inc IgM and inc Cholesterol

Question 24

pericardial knock

Answer 24

early heart sound after S2

Question 25

pericardial calcifications JVP kussmaul sign sharp x and y descents

Answer 25

pericarditis

Question 26

cause of constrictive pericarditis in Africa India and China

Answer 26

TB

Question 27

difference of eythlyene glycol and methanol poisioning

Answer 27

ethylene glycol damages kidneys | methanol damages eyes

Question 28

findings sarcoidossi

Answer 28

erythema nodosum, anterior uveitis, acute polyarthritis, paratracheal adenopaty and reticulonodular infiltrates on CXR noncaseating granulomasACE increased

Question 29

Tx symptomatic sarcoidosis

Answer 29

glucocorticoids

Question 30

another name for vasovagal syncope

Answer 30

neurocardiogenic

Question 31

how to decrease CCB pedal edema with adjunct Rx

Answer 31

add ACEI

Question 32

acanthosis nigricans

Answer 32

insulin R | GI malignancy

Question 33

lung infection after bone marrow transplant

Answer 33

45 days ~ CMV

Question 34

TSH and LH levels in prolactinoma

Answer 34

low LH normal TSH

Question 35

what cause inc homocysteine

Answer 35

deficiency in folate or cobalamin

Question 36

inc blood in urine after tonic clonic seizure

Answer 36

rhabdomyolysis

Question 37

reaction with niacin

Answer 37

PG release cause peripheral vasodilation and pruritis-- give low dose aspirin

Question 38

polycythemia vera can cause what other condition

Answer 38

gout

Question 39

pulmonary physical findings for pleural effusion

Answer 39

decreased tactile fremitus, dullness to percussion, decreased breath sounds

Question 40

findings in carcinoid syndrome

Answer 40

skin: flushing, telangiectasias, cyanosis, diarrhea, cramping, valvular lesions, bronchospasms, niacin deficiency (dermatitis, diarrhea, dementia)

Question 41

presentation of post strep glomerulonephritis

Answer 41

periorbital swelling, hematuria, oliguria hypertension, RBC casts mild proteinuria

Question 42

signs thalamic hemorrhage

Answer 42

eye deviates towards hemiparesis

Question 43

signs basal ganglia hemorrhage

Answer 43

contralateral hemiparesis and hemisensory loss homonymous hemianopsia gaze palsy

Question 44

sign of stroke in anterior cerebral a

Answer 44

incontinence | contralateral somatosensory and motor in lower extremity

Question 45

Tx acute pancreatisis

Answer 45

conservative, 4-7 days with analgesics, IV fluids and no oral food