IM Shelf Quick Review

Question 1

LAD EKG territory

Answer 1

V1-V4

Question 2

RCA EKG territory

Answer 2

II, III, aVF

Question 3

LCx/Diagonal branch of LAD EKG territory

Answer 3

I, aVL, V5-V6

Question 4

Intermittent Asthma

Answer 4

ssx/SABA use
<2 days a week

Nighttime ssx
<2 times a month

Step 1 tx

Question 5

Mild Persistent Asthma

Answer 5

ssx/SABA use
>2 days week - not daily

Nighttime ssx
3-4 a month

Step 2 tx

Question 6

Moderate Persistent Asthma

Answer 6

ssx/SABA use
daily

Nighttime ssx
>1 time per week - not nightly

Step 3 tx

Question 7

Severe Persistent Asthma

Answer 7

ssx/SABA use
throughout the day

Nighttime ssx
4-7 times a week

Step 4 or 5 tx

Question 8

Asthma PFTs

Answer 8

FVC nl/decreased
FEV1 decreased
FEV1/FVC decreased
DLCO nl/increased

Reversible with bronchodilator

Question 9

COPD/Obstructive PFTs

Answer 9

RV increased
FRC increased
TLC increased
FVC nl/decreased
FEV1 decreased
FEV1/FVC decreased
DLCO nl/decreased

FEV1 decreases more than FVC

Not reversible with bronchodilator

Question 10

Restrictive PTFs

Answer 10

RV decreased
FRC decreased
TLC decreased
FVC decreased
FEV1 decreased
FEV1/FVC nl/increased
DLCO nl/decreased

FEV1 decreases proportional to FVC

Question 11

Asthma Tx Step 1

Answer 11

SABA prn

Question 12

Asthma Tx Step 2

Answer 12

low dose ICS
or
Cromolyn, LTRA, Nedocromil, theophyline

Question 13

Asthma Tx Step 3

Answer 13

low dose ICS + LABA
or
medium dose ICS

Question 14

Asthma Tx Step 4

Answer 14

medium dose ICS + LABA

Question 15

Asthma Tx Step 5

Answer 15

high dose ICS + LABA

Question 16

Asthma Tx Step 6

Answer 16

high dose ICS + LABA + oral corticosteroid

consider omalizumab if they have allergies

Question 17

increased 24 hr cortisol/ no suppression on low dose dexamethasone suppression test:

low ACTH

Answer 17

exogenous glucorticoids

adrenal adenoma

Question 18

increased 24 hr cortisol/ no suppression on low dose dexamethasone suppression test:

high ACTH

high dose dexamethasone suppression test:

No supression

Answer 18

Ectopic ACTH production

Get CT chest/abdomen/pelvis

Question 19

increased 24 hr cortisol/ no suppression on low dose dexamethasone suppression test:

high ACTH

high dose dexamethasone suppression test:

Adequate suppression

Answer 19

Cushings Disease

Get MRI of pituitary

Question 20

ANA

Answer 20

Lupus

Question 21

Anti-CCP

Answer 21

rheumatoid arthritis

Question 22

anti-RF

Answer 22

rheumatoid arthritis

Question 23

anti-histone

Answer 23

drug induced lupus

Question 24

anti-dsDNA

Answer 24

lupus (specific) renal involvement

Question 25

anti-centromere

Answer 25

scleroderma CREST

Question 26

anti-topoisomerase

Answer 26

systemic scleroderma

Question 27

anti-jo

Answer 27

polymyositis

Question 28

anti ro/la

Answer 28

sjorgrens

Question 29

anti-mitochondrial

Answer 29

primary biliary sclerosis

Question 30

anti smooth muscle

Answer 30

autoimmune hepatits

Question 31

MI Complications | hours -2 days

Answer 31

reinfarction

Question 32

MI Complications | hours- 1/2 weeks

Answer 32

ventricular septal rupture/free wall rupture

Question 33

MI Complications | 1 day- 3 months

Answer 33

pericarditis

Question 34

MI Complications | 5 days - 3 months

Answer 34

left ventricular aneyrysm

Question 35

MI Complications | 2 days - 1 week

Answer 35

papillary muscle rupture

Question 36

CAP tx

Answer 36

ceftriaxone + Azithromycin (IV) | Azithromycin PO

Question 37

HCAP tx

Answer 37

Vanc and pip/tazo

Question 38

Meningitis tx

Answer 38

ceftriaxone + Vanc + steroids +/- ampicillin (immunocompromised)

Question 39

Cellulitis tx

Answer 39

vanc-MRSA Clindamycin TMP-SMX

Question 40

UTI tx

Answer 40

``` amoxicillin- pregnant Nitrofurantoin- women TMP-SMX- no renal failure Ceftriaxone (IV)- septic with pyelo Ciprofloxacin- ambulatory pyelo ```

Question 41

Anaerobe coverage

Answer 41

clindamycin- non GI | Metronidazole- GI/GU

Question 42

Ulcerative Colitis

Answer 42

``` Ulcers Large intestine Continuous Colorectal CA Crypt abscesses Extends proximally Red diarrhea Sclerosing cholangitis ```

Question 43

Crohns Disease

Answer 43

``` cobble stone mucosa skip lesions rectal sparing creeping fat noncaseating granulomas ```

Question 44

AML

Answer 44

Auer Rods M3: tx Vit A- trans retinoic acid Myeloperoxidase

Question 45

ALL

Answer 45

Kids | Ppx to cns and scrotum

Question 46

CML

Answer 46

``` BCR-ABL T(9:22) Imatinib- tyrosine kinase Basophilia Assx with WBC >60k ```

Question 47

CLL

Answer 47

Smudge cells

Question 48

RBC Casts

Answer 48

Glomerulonephritis

Question 49

WBC Casts

Answer 49

Pyelo

Question 50

Muddy brown casts

Answer 50

ATN

Question 51

Waxy casts

Answer 51

CKD