May 9th

Question 1

What kind of HF is seen in thiamine def?

Answer 1

High output HF with dilated cardiomyopathy

Question 2

Left hemineglect syndrome is caused by a lesion where?

Answer 2

Right, (Nondominant) parietal lobe

Question 3

When is screening abdominal ultrasound indicated?

Answer 3

Men age 65-75 with a history of smoking

Question 4

What are the risk factors for rhino-orbital-cerebral mucormycosis?

Answer 4

DM, hematologic malignancy, solid organ or stem cell transplant

Question 5

Where is trypanosoma cruzi endemic?

Answer 5

South America

Question 6

What is the classic triad of congenital rubella syndrome?

Answer 6

Machine like systolic murmur (PDA), snesorineural hearing loss, leukocoria (while pupillary reflex) from cataracts

Question 7

What antibody is seen in Hashimoto thyroiditis?

Answer 7

TPO antibody

Question 8

What statistical test is used to compare two means?

Answer 8

Two sample t - test

Question 9

When is ANOVA used in stats?

Answer 9

To compare three or more means

Question 10

A SAAG of what indicates portal HTN?

Answer 10

SAAG > 1.1

Question 11

How is SAAG calculated?

Answer 11

Serum albumin - peritoneal fluid albumin

Question 12

Antibodies to what structure are part of the pathogenesis of bullous pemphigoid?

Answer 12

Antibodies to IgG

Question 13

Acyclovir can lead to what type of kidney injury?

Answer 13

Esp IV acyclovir can see crystal induced acute kidney injury

Question 14

How is cryptosporidium diagnosed on stool examination?

Answer 14

Modified acid-fast stain reveals cryptosporidial oocytes

Question 15

What are the contraindications to rotavirus vaccine?

Answer 15

Anaphylaxis to vaccine, h/o intussusception, h/o uncorrected congenital malformation of the GI tract, SCID

Question 16

What type of vaccine is rotavirus?

Answer 16

Live attenuated virus vaccine

Question 17

Young boy with bone pain worse at night, relieved by NSAIDs

Answer 17

Osteoid osteoma

Question 18

What is pulsus paradoxus?

Answer 18

Systolic BP fall >10 mmHg during inspiration; commonly seen in cardiac tamponade, COPD/asthma

Question 19

What do you see pulsus paradoxus?

Answer 19

seen in cardiac tamponade, COPD/asthma

Question 20

How does acute arsenic poisoning manifest?

Answer 20

Nausea, vomiting, watery diarrhea, garlic breath, QTc prolongation

Question 21

How does chronic arsenic poisoning manifest?

Answer 21

Hypo- / hyperpigmentation, hyperkeratoses, stocking-glove neuropathy

Question 22

How is arsenic poisoning treated?

Answer 22

Dimercaprol, DMSA, succimer

Question 23

What is the treatment for amyloidosis (AA)?

Answer 23

Secondary amyloidosis (AA) can be treated / prevented with colchicine

Question 24

What is the pathophysiology of hyperoxaluria in Crohns disease?

Answer 24

CD leads to fat malabsorption, calcium binds to the fat and leaves oxalate available for absorption (usually calcium binds oxalate and prevents absorption)

Question 25

How is a hydatid cyst treated?

Answer 25

Aspiration if needed to prevent cyst spillage and anaphylactic shock; otherwise surgical resection under the cover of albendazole

Question 26

What are the indications for clozapine treatment?

Answer 26

Treatment-resistant schizophrenia; schizophrenia associated with suicidality

Question 27

What are the contraindications to methylergonovine use in postpartum hemorrhage?

Answer 27

HTN/history of hypertension

Question 28

What is the contraindication to carboprost use in postpartum hemorrhage?

Answer 28

Causes bronchoconstriction and thus is CI in asthma

Question 29

How is postpartum hemorrhage treated?

Answer 29

First: uterine massage + oxytocin; if fail give methylergonovine (watch for HTN) or carboprost (watch for asthma/bronchoconstriction)

Question 30

What is the cause of infertility in primary ciliary dyskinesia?

Answer 30

Immotile spermatozoa (vs CF due to absent vas deferens)

Question 31

What are the clinical features of TTP?

Answer 31

Hemolytic anemia (incr LDH, low haptoglobin) with schistocytes, thrombocytopenia (increased BT, normal PT/PTT), renal failure, neuro stuff, fever

Question 32

What is the cause of TTP?

Answer 32

Def in protease ADAMTS13 - leads to long chains of vWF

Question 33

How is TTP treated?

Answer 33

Plasma exchange

Question 34

Why are ACEi effective in diabetic nephropathy?

Answer 34

Reduces intraglomerular HTN

Question 35

What is the prophylaxis for toxoplasmosis? And when is it started?

Answer 35

TMP-SMX at CD4 <100

Question 36

What is the prophylaxis for MAC? And when is it started?

Answer 36

Azithromycin, CD4 <50

Question 37

Antibodies found in polymyositis?

Answer 37

Anti-Jo 1 and ANA