Medicine Misc.

Question 1

Pulsatile tinnitus cause

Answer 1

Most common cause dural AV fistula, can be reduced by compression of the occipital artery over the mastoid process

Question 2

Primary vs secondary hyper aldosterone test

Answer 2

Aldo-Renin-ratio is the most sensitive

Can also use captopril testing

Question 3

Clinical manifestations of thoracic aortic dissection

Answer 3

Horner’s, dysphagia, murmur, wide pulse pressure, stroke (secondary to carotid obstruction)

Question 4

CT scan with brain mass + progressive headache and confusion

Answer 4

Glioblastoma multiforme - usually presents sx

Question 5

Nasal sx, neck swelling, fullness/ effusion in the ear

Answer 5

Nasopharyngeal carcinoma

Question 6

Risk factor for nasopharyngeal carcinoma

Answer 6

EBV, Smoking

Question 7

Biggest risk for mortality post transplant?

Answer 7

Infection

Question 8

Tx for angular chelitis

Answer 8

Mupirocin and anti-fungal agents

Question 9

Lots of RBCs in the LP?

Answer 9

Bleed or HSV encephalitis

Question 10

Tamoxifen vs Raloxifene risk factors

Answer 10

Tamoxifen is associated with a risk of endometrial CA

Raloxifene decreases risk of osteoporosis and thromboembolic events

Question 11

Cocaine chest pain is caused by

Answer 11

Vasospasm, beta-blockers are contraindicated

Question 12

Findings in labs for diabetes insipidus

Answer 12

Drop in vasopressin/ADH - will find high serum sodium, low urine sodium, low extracellular fluid, and low ADH

• You lose the ability to concentrate your urine - and lose lots of water.

Question 13

Homonymous hemianopsia - what artery has stroke?

Answer 13

PCA

Question 14

What heart finding should you not give digoxin?

Answer 14

AV block

Question 15

Advice to help jet lag

Answer 15

Take melatonin 0.5-5mg nightly for 2-5 nightly starting on the first night in the destination

Question 16

Tx for alopecia

Answer 16

Can try topicals with added oral corticosteroids- nothing really works

Question 17

Pentad of microangiopathic hemolysis (low RBC/ high bili), thrombocytopenia, neurologic abnormalities, fever and renal impairment

Answer 17

Thrombotic Thrombocytopenia Purpura

Question 18

Triad of normal pressure hydrocephalus

Answer 18

Wet (urine incontinence), wacky (motor disturbance), weird (mental impairment)

Question 19

Common sx in temporal lobe epilepsy?

Answer 19

Aura of rising episgastric sensation, can also have unease - with feeling of deja-vu

Question 20

Tx for VWF deficiency

Answer 20

Desmopressin (induces the release of VWF from inside cells) and transfusion therapy

Question 21

Hypothermia ECG finding

Answer 21

J wave

Question 22

Sx of Sjogrens

Answer 22

Dry mouth, eyes, painful mouth + anti-ro/ la

Question 23

Tx Sjogrens

Answer 23

Pilocarpine and topical cyclosporine to help with the sx

Question 24

Hyperthyroid types how to differentiate

Answer 24

Grave - increased iodine uptake, other autoimmune thyroid - decreased

Question 25

What can look like breast cancer on exam but is in fact benign (fixed, spiculated mass)

Answer 25

Fat necrosis of the beast - path will show foam macrophages

Question 26

Tx for cardiogenic pulmonary edema

Answer 26

Nitroglycerin

Question 27

Non healing lesion on site of prior skin graft/scarring?

Answer 27

Concern for SCC

Question 28

Triad of sweating, headache and tachycardia in a young otherwise healthy person

Answer 28

Pheochromoxytoma - look for unexplained HTN and hyperglycaemia too (take a plasma or urine metanephrine)

Question 29

Epstein-Barr risk factor for which cancer?

Answer 29

Nasopharyngeal carcinoma

Question 30

Common drugs causing drug-induced pancreatitis?

Answer 30

Diuretics - lasix, Hydrochlorothiazide

Question 31

NPH sx

Answer 31

Wet, wobbly, wacky - urinary incontinence, gait changes, cognitive impairment

Question 32

Stopping clonidine suddenly?

Answer 32

Reflex HTN

Question 33

Tx for ALS?

Answer 33

It is fatal but riluzole can help improve survival

Question 34

Mild respiratory sx, diarrhea and increasing Ha/ confusion from an LTC/ hospital

Answer 34

Legionella

Question 35

Best test for legionella?

Answer 35

UAT + sputum culte on charcoal yeast agar

Question 36

Xanthanchromia on LP?

Answer 36

SAH - csused by lysis of RBCs

Question 37

Cardiac implication of ankylosing spondylitis

Answer 37

Aortic regurgitation