IV

Question 1

tamoxifen is used for what breast CA

Answer 1

estrogen and P positive

Question 2

when is trastuzumab used in breast CA

Answer 2

when + for Her2neu

Question 3

risk of combining trastazumab with chemo

Answer 3

cardiac toxicity

Question 4

cervical mucus is produse clear and thin that stretches 6 cm when lifted vertically, what phase?

Answer 4

ovulatory

Question 5

scant opaque thick cervical mucus

Answer 5

post and pre ovulatory phases

Question 6

spinnbarkeit

Answer 6

when the cervical mucus stretches vertically

Question 7

ferning cervical mucus

Answer 7

ovulatory phase

pH is 6.5 or greater

Question 8

after MVA, CXR show alveolar opacities over both lower lobes and hours later complains of CP and SOB

Answer 8

pulmonary contusions

Question 9

signs of fat embolism

Answer 9

respiratory distress, mental status changes and petechiae

Question 10

what leads to hepatic encephalopathy

Answer 10

livers inability to convert ammonia to urea

Question 11

what can precipitate hepatic encephalopathy

Answer 11

sedatives, hypovolemia, infection or excessive nitrogen load

patients develop diurnal sleep pattern disturbances (insomnia and hypersomnia)

Question 12

treatment hepatic encephlopathy

Answer 12

nonabsorbable disaccharides like lactulose and lactitol

Question 13

what is added to lactulose if patient with hepatic encephalopathy does not improve within 48 hours

Answer 13

rifaximin

Question 14

chlordiazepoxide is used to treat what

Answer 14

alcohol withdrawal

Question 15

triad of wernickes

Answer 15

altered mental status, ataxia and nystagmus

Question 16

signs of opioid intoication

Answer 16

miosis and decreased respirations

Question 17

major risk factors for pancreatic cancer

Answer 17

first degree relative with it
hereditary pancreatitis
germline mutations like the BRCAs and peutx jeghers
cigarette smoking
obesity
nonhereditary chronic pancreatitis

Question 18

where are majority pancreatic CA

Answer 18

head of pancreas

Question 19

patient with epigastric pain, weight loss but no jaundice

imaging?

Answer 19

CT with contrast

Question 20

what test is used for diagnosing chronic pancreatitis

Answer 20

secretin test that measure ability of pancreatic ductal cells to produce HCO3

Question 21

urine crystals that are envelope shaped

Answer 21

Ca oxalate

Question 22

what predisposed to Ca oxalate stones

Answer 22

small bowel disease, surgical resection or chronic diarrhea

Question 23

when do struvite stones form

Answer 23

when urine is alkaline because of infection with urease producing bacteria

Question 24

what are the indications for ECT for depression

Answer 24

treatment resistance, psychotic features, emergency conditions like refusal to eat or drink and imminent risk for suicide

Question 25

what are the postoperative measures to decrease risk of pneumonia after surgery

Answer 25

incentive spirometry, deep breathing exercises, continuous positive airway pressure, intermittent positive pressure breathing

Question 26

clinical features of aortic regurg

Answer 26

diastolic decrescendo murmur, widened pulse pressure, water hammer pulse heart failure symptoms

Question 27

most common cause of aortic regurg in developed countries

Answer 27

aortic root dilation or congenital bicuspid valve

Question 28

corrigan pulse

Answer 28

rapid abrupt upstroke followed by rapid collapse of peripheral pulse

Question 29

which patients are at increased risk of molluscum contagioiusm

Answer 29

those with cellular immunodeficiency

Question 30

C5-C8 deficiencies predispose to what

Answer 30

nisseria infections

Question 31

impairment phagocytosis leads to what diseases

Answer 31

chronic granulomatous disease chediak higashi disease jobs syndrome defective leukocyte adhesion proteins

Question 32

hypersensitivity rashes are caused by what

Answer 32

circulating Ab type II or III

Question 33

radiolucency like along the costodiaphragmatic curves suggests what

Answer 33

free air under diaphragm, ruptured peptic ulcer

Question 34

what type of HS reaction is scabies

Answer 34

type IV

Question 35

Tx scabies

Answer 35

topical permethrin cream

Question 36

Tx polymyalgia rheumatica

Answer 36

glucocorticoids

Question 37

signs polymyalgia rheumatica

Answer 37

``` age >50 subacute-chronic pain in shoulder an dhip girdles morning stiffness>1 hour constitutional symptoms elevated ESR>40 mm/h ```

Question 38

polymyalgia rheumatica is associated with what other condition

Answer 38

giant cell arteritis

Question 39

signs of giant cell arteritis

Answer 39

HA, jaw claudication, vision loss, tenderness over temporal artery

Question 40

fibromylagia

Answer 40

young-middle aged women with widespread pain, fatigue, and cognitive/mood distrubances

Question 41

what causes lumbar spinal stenosis

Answer 41

enlarging osteophytes at the facet of joints and hypertrophy of ligamentum flavum

Question 42

what occurs with lumbar spinal stenosis

Answer 42

back pain that radiates to buttocks and thighs, numbness and paresthesias worse during walking and lumbar extension

Question 43

how to confirm spinal stenosis

Answer 43

MRI

Question 44

signs of ankylosing spondylitis

Answer 44

progressive limitation of back motion most often in young men back pain and stiffness are typically worse in the morning and improve as the day progresses

Question 45

Hx recent URI followed by cardiac failure suggests what

Answer 45

dilated cardiomyopathy secondary to viral myocarditis

Question 46

what virus canc ause myocarditis

Answer 46

``` Coxsackie B parvo HSV6 adeno entero ```

Question 47

echo of dilated cardiomyopathy

Answer 47

diffuse hypokinesia from low ejection fraction

Question 48

eccentric hypertrophy

Answer 48

chronic volume overload seen in valvular regurg

Question 49

risk factors for descending aortic aneurysms

Answer 49

atherosclerosis, HTN, hypercholesterolemia and smoking

Question 50

risk factors for ascending aortic aneurysms

Answer 50

cystic medial necrosis or CT disorders