misc. medicine

Question 1

54 y/o pt has several days of low grade fever, malaise and severe pain in the right side of the ribcage. Examination reveals an erythematous rash with clusters of tense vesicles, with clear content, on a belt distribution from the front of the chest to the back under the nipple, limited to the right side. Likely causal viral agent? (4x)

Answer 1

VARICELLA ZOSTER VIRUS

Question 2

17 y/o pt has an insidious onset of unusual behavior and argumentativeness. Exam, the mouth is held slightly open. Pt has mild dysarthria and hoarseness, generalized slowness, rigidity, and a mild resting tremor of the left arm and head. rule out drug and/or alcohol abuse. Liver function tests show elevated transaminases. An increase in which laboratory test is most likely to confirm Dx? (4x)

Answer 2

URINARY COPPER EXCRETION

Question 3

45 y/o M, with recurrent episodes of LOC while wearing a shirt with a tight collar, has feeling of faintness accompanied by pallor, followed by collapse and LOC, and several seconds later by a few bilateral jerks of the arms and legs. Entire episode lasted less than one minute. Most likely explanation? (2x)

Answer 3

CAROTID SINUS SYNCOPE

Question 4

Decreases in men during andropause

Answer 4

PENILE RIGIDITY

Question 5

Normal changes with motor fxn in aging?

Answer 5

STOOPED POSTURE AND SLOWED WALKING

Question 6

55 yo diplopia when looking right, drooping of left eyelid, and drooping L eye, symptoms better in the morning

Answer 6

MYASTHENIA GRAVIS

Question 7

19 y/o F has bouts of motor agitation, often followed by intense, seemingly meaningless writing; also mood lability, tactile & olfactory hallucinations. During the interview, patient abruptly stops paying attention and begins rapidly pacing around the room. What should be the next step?

Answer 7

WAIT 15 MINS, THEN OBTAIN PROLACTIN LEVEL

Question 8

Immunocompromised patient with confusion and mild headache, b/l papilledema and cerebellar ataxia. CSF stain shows pleocytosis, inc. protein, low glucose? India ink stain shown below. What is diagnosis?

Answer 8

CRYPTOCOCCUS

Question 9

45 y/o pt has recurrent episodes of LOC. A detailed description by family: pt reporting a feeling of faintness accompanied by pallor, followed by collapse and LOC, and several seconds later by a few bilateral jerks of the arms and legs. Prior to recovery, the pt’s face and chest are flushed. No precipitating factors are identified. Which of the following is the most likely explanation:

Answer 9

CARDIAC SYNCOPE

Question 10

43 y/o pt w/ memory loss x 8 months associated with abd pain, wt loss, joint distention/pain, fever, lymphadenopathy, hyperpigmentation of skin, decrease hemoglobin, and fat in stool. Which test result is likely to be found in this patient?

Answer 10

CEREBROSPINAL FLUID WITH PAS+ CELLS INFECTED WITH TROPHERYMA

Question 11

2 y/o child w/ hx of upper respiratory infections, most likely:

Answer 11

HAEMOPHILUS INFLUENZA

Question 12

22 yo female is hospitalized with paranoia, hallucinations, abdominal pain worse with periods, physical exam shows reduced strength in upper and lower extremities and reduced tendon reflexes. Which of the following lab values is likely to be elevated and explain her symptoms?

Answer 12

PORPHOPBILINOGEN

Question 13

Component of type A behavior most reliable risk factor for CAD

Answer 13

HOSTILITY

Question 14

50 y/o pt with myasthenia gravis and a 3-day hx of cough, low-grade fever and chills, presents with great difficulty breathing. The pt appears tired and anxious, and the pt’s skin is clammy and sweaty. Initial management?

Answer 14

MECHANICAL VENTILATION

Question 15

55 y/o M with changes in his voice, orthostatic hypotension and one immobile vocal cord on inspection suffers from:

Answer 15

SHY-DRAGER SYNDROME

Question 16

Neoplasms of the thymus are associated with:

Answer 16

MYASTHENIA GRAVIS

Question 17

A 25 yr old pt develops progressive hearing loss, has acoustic neuromas and cafe au lait spots, diagnosis?

Answer 17

NEUROFIBROMATOSIS TYPE 2

Question 18

Pediatric Autoimmune Disorder Associated with Streptococcus (PANDAS) is associated with what disorder?

Answer 18

OCD

Question 19

Children with pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection (PANDAS) often manifest:

Answer 19

CHOREIFORM MOVEMENTS AND OCD SYMPTOMS

Question 20

Age that corticospinal tract complete myelination

Answer 20

3 YEARS

Question 21

Alternative stimuli that can be used to overcome withdrawal response to Babinski reflex:

Answer 21

DOWNWARD SCRAPING OF THE SHIN

Question 22

This neuropsych symptoms is most commonly seen in mild neurocognititve disorder

Answer 22

DEPRESSION