Incorrects

Question 1

Severe respiratory distress
Cyanosis after Premature birth

Imaging: Didfuse reticulogranular appearance, air bronchograms, low long vol

Answer 1

Neonatal respiratory distress syndrome

Question 2

Pharmacological agents causing idiosyncratic reactions in the liver

Answer 2

ISONIAZID
Chlorpromazine
Halothane
Anti-retrovirals

Question 3

Panlobular mononuclear infiltration and hepatic cell necrosis = pathological state of?

Answer 3

Hepatitis

Use labs to differentiate causes
LFT’s for alcoholic
Viral titers for viral causes
Autoimmune is last resort Dx

Question 4

Age <1 year
Respiratory and/or esophageal symptoms
BIPHASIC STRIDOR
IMPROVES WITH NECK EXTENSION

Answer 4

Vascular rings

As opposed to laryngomalacia

Question 5

MCC of acute bacterial lymphadenitis in children

Violaceous color and sub acute time frame =

Answer 5

Staph aureus

Non tuberculous mycobacterium

Question 6

Patient over 40 with DM type II

Tx?

Answer 6

Lifestyle mod + statin

ASCVD >7.5 high intensity statin

<7.5 moderate intensity statin

Question 7

3 paraneoplastic syndromes affecting muscle and/or peripheral nerves

Answer 7

Myasthenia Gravis

Lambert-Eaton

Polymyositis/Dermatomyositis

Question 8

Severe side effect with anti-thyroid men’s PTU and methimazole?

First step?

Answer 8

Agranulocytosis

Stop med at first sign of fever

Question 9

Type I RTA

Defect?

Urine pH

Serum K

Causes

Answer 9

Poor Hydrogen secretion

> 5.5

Low normal K

Genetic, medications, autoimmune

Question 10

Type II RTA

Defect?

Urine pH

Serum K

Causes

Answer 10

Poor bicarbonate resorption

<5.5

Low normal K

Fanconi

Question 11

Type IV RTA

Defect

Urine pH

Serum K

Causes

Answer 11

Aldosterone resistance

<5.5

High K

Obstructive uropathy, CAH

Question 12

Lights Criteria- TRANSUDATE

Answer 12

Pleural protein: serum protein ratio

Question 13

Lights criteria - EXUDATE

Answer 13

Pleural protein: serum protein ratio >.5

Pleural LDH: serum LDH >.6

Pleural LDH >2/3 upper limit of nml

Causes - infection, malignancy, PE

Question 14

Mechanism of metabolic alkalosis in Conn Syndrome (hyperaldosterone)

Answer 14

Hypokalemia causes bicarbonate resorption

Combined with increased hydrogen secretion

= metabolic alkalosis

Question 15

Patient with TB

Develops fatigue, weakness, hypotension, electrolyte abnormalities

D.X?

Answer 15

Chronic primary adrenal insufficiency

Question 16

Rheumatoid arthritis

Tx algorithm

Answer 16

Methotrexate

MTX + Paralell (hydroxychloroquine, sulfasalazine)

Anti-TNF (infliximab, etanercept)

Question 17

Severe complication of ulcerative colitis

Answer 17

Toxic megacolon

Question 18

Diagnosis of CLL by?

Answer 18

Flow cytometry of peripheral cells

Question 19

Trigeminal neuralgia tx

Answer 19

Carbamazepine

Question 20

Nephrotic syndrome symptoms in patient with RA

Kidney biopsy findings?

Answer 20

Amyloid deposits

Congo red stain

Apple green birefringence

Question 21

Two physical findings in fibromuscular dysplasia

Answer 21

Renal artery stenosis

Internal carotid artery stenosis - subauricular systolic bruit

Question 22

Erythematous papules across back, neck, shoulders

On corticosteroids recently

Dx?

Answer 22

Drug induced acne

Question 23

Two main imaging modalities for kidney stone

Answer 23

Non con spiral ft of abdomen and pelvis

Abdominal ultrasound

Question 24

1st line treatment for alcohol abuse disorder (if not abstinent)

Medication once abstinence is obtained?

Answer 24

Naltrexone

Acamprosate

Question 25

Obesity hypoventilation syndrome HCO3- ? Chloride?

Answer 25

Bicarbonate resorption by kidneys increases Chloride decreases = hypochloremic metabolic alkalosis

Question 26

Dream enactment in the latter part of the night Transient confusion but becomes fully alert Dx

Answer 26

R.E.M. Sleep behavior disorder

Question 27

Turner Syndrome at increased risk of? Why?

Answer 27

Osteoporosis Ovarian dysgenesis = decreased estrogen

Question 28

Transient synovitis in children Differentiate between?

Answer 28

Septic arthritis If grossly stable and no evidence of severe infection - rest, ice, ibuprofen, f/u in 1 week

Question 29

Reddish purple pedunculated lesions Develop into friable lesions Dx?

Answer 29

Bacillary angiomatosis Bartonella Immunocompromised, usually HIV

Question 30

Dermatological manifestations of chronic hep c infection

Answer 30

Porphyria cutanea tarda Lichen planus

Question 31

Positive pronator drift specific for?

Answer 31

Upper motor neurons - Pyramidal/corticospinal tract lesions

Question 32

Secondary Raynauds >40, usually male Asymmetric attacks Work up?

Answer 32

ANA titers Rheumatoid factor ESR and complement titers

Question 33

Aspirin overdose lab findings pH = PaCO2 HCO3- Acid base status

Answer 33

Normal pH Low paCO2 Low bicarb Mixed metabolic acidosis and respiratory alkalosis

Question 34

Arrhythmia most specific for Dig toxicity

Answer 34

Atrial tachycardia with AV block

Question 35

``` Elderly Progressive LE edema Distended abdomen w/flank percussion Increased urine protein output Elevated EF Tired and SOB ``` Dx?

Answer 35

Restrictive cardiomyopathy Amyloidosis

Question 36

Fungal infection can cause disseminate disease in immunocompetent

Answer 36

Blastomyces dermatiditis SKIN - heaped up verrucous or nodular lesions with violaceous hue

Question 37

Positive NAAT for chlamydia tx?

Answer 37

Single - AZITHROMYCIN only

Question 38

Positive NAAT for gonorrhea Tx?

Answer 38

Dual Azithromycin + Ceftriaxone

Question 39

Underlying cause of isolated systolic HTN

Answer 39

Rigidity of arterial walls

Question 40

PCOS vs Cushings

Answer 40

Skin atrophy, muscle weakness, easy bruisability = CUSHINGS Not pcos.

Question 41

Precocious puberty symptoms Normal testicular volume Low LH baseline and no response to GNRH Dx

Answer 41

Non-classic CAH Secondary to 21 hydroxylase deficiency

Question 42

One of he most common neurological complications in AIDS patients Presents like B12 deficiency Dx?

Answer 42

Vacuolar HIV myelopathy