Miscellaneous

Question 1

Drugs associated with increased risk of CAP in elderly?

Answer 1

Atypical antipsychotics (ie quetiapine)

Question 2

Normal platelet level?

Answer 2

150,000 to 450,000

Question 3

Normal K level?

Answer 3

3.5-5.2

Question 4

Diagnosis for a guy who moves into a new apartment building
with a hot tub and gets bilateral chest infection

Answer 4

inhalation of fumes with
Mycobacterium avium complex (MAC) = hot tub lung

Question 5

Lithium toxicity presents with what syptoms

Answer 5

Neurologic (AMS, tremor, seizures, fasciculations)
And
GI (vomitting, diarrhea)

Question 6

Lithium toxicity is treated with

Answer 6

Hemodialysis

Question 7

Side effects of benzos in the elderly

Answer 7

Cognitive impairment
Falls
Paradoxical agitation

Question 8

Drowned patient often require respiratory support to correct hypoxia. Under what circumstances is endotracheal intubation (intubation with mechanical ventilation) required

Answer 8

Patient unable to protect their airway or hypoxic despite supplemental oxygen

Question 9

Innocent cardiac murmurs (resulting from physiologic blood flow across structurally normal heart) present as

Answer 9

Grade 1-2 in intensity
Vibratory or musical in quality
Early or midsystolic

Question 10

What is Stills murmurs and how is it treated?

Answer 10

Innocent, vibratory systolic ejection murmur

Treatment is reassurance

Question 11

Drugs that can cause urinary retention?

Answer 11

Those with anticholinergic properties, such as TCAs (ie Amitriptyline)

Question 12

Treatment for drug-induced urinary retention?

Answer 12

Urinary catherization plus discontinue drug

Question 13

What is a venous hum?

Answer 13

A murmur in the neck that abates when the kid is laid supine and the neck is rotated.

It is typically a benign finding.

Question 14

How does a venous hum change with position?

Answer 14

It abates when the child is laid supine and the neck is rotated.

This positional change is key to identifying the murmur as a venous hum.

Question 15

Treatment for a venous hum?

Answer 15

No, it is benign and does not require treatment.

Understanding that it is a benign condition helps in managing parental concerns.

Question 16

Acanthosis nigricans presents as

Answer 16

Velvety, symmetrical, hyperpigmented plaques in neck, groin, axilla

Question 17

Acanthosis nigricans association in younger patients?

Answer 17

Insulin-resistant states (DM, obesity, PCOS)

Question 18

Acanthosis nigricans association in older patients?

Answer 18

Gastrointestinal malignancy

Question 19

A-a oxygen gradient in PE

Answer 19

High alveolar-arterial oxygen gradient

Question 20

Cycle vomiting syndrome presentation

Answer 20

In children, recurrent self-limiting episodes of profuse vomiting or nausea without an apparent cause

Question 21

Cycle vomiting syndrome key historical factors

Answer 21

Identifiable trigger (stress, infection)
Personal/family history of migraine

Question 22

Benefit of circumcision:

Answer 22

• Decreased risk UTIs in first year of life
• Decreased risk of penile phimosis, cancer and inflammatory conditions in adulthood
• Decreased risk of some STI

Question 23

Mechanical or severely calcified aortic valve can cause

Answer 23

Hemolytic anemia due to mechanical shearing of RBCs (frequently also have mildly low platelets due to concurrent mechanical platelet injury)

Question 24

NBS for Hemolytic anemia due to Mechanical or severely calcified aortic valve

Answer 24

Echo to assess valve function

Question 25

PE classically present with

Answer 25

Sudden onset Pleuritic chest pain Dyspnea Cough (hemoptysis can also occur due to pulmonary infarction)

Question 26

Classic PE finding on imaging

Answer 26

Peripheral Wedge shaped infarct

Question 27

Patients who inject drugs into the femoral vein can develop

Answer 27

Iliofemoral dvt (unilateral leg erythema, edema, warmth with evidence of dilated superficial veins and increased calf/thigh diameter)

Question 28

Answer 28

ichthyosis vulgaris, chronic inherited disorder characterized by rough dry skin with fish like scales

Question 29

ichthyosis vulgaris treatment

Answer 29

Topical keratolytics (alpha hydroxy acid (lactic acid), urea, salicylic acid to help remove scales, (frequent bathing and moisturizer)

Question 30

Fecal impaction is common in older patients with impaired mobility, chronic constipation, or decreased sensation of stool in the rectal vault. Presentation?

Answer 30

Obstruction of fecal flow in the rectum can cause backup of stool; passage of liquid stool around the impaction can lead to incontinance. Initial management is manual disimpaction and enema to clear the rectal vault.

Question 31

Normal pulm changes in pregnancy: feeling of breathing

Answer 31

Progesterone induced feeling of dyspnea

Question 32

Normal pulm changes in pregnancy: minute ventilation and tidal volume

Answer 32

Increased minute ventilation driven mostly by increased tidal volume

Question 33

Normal pulm changes in pregnancy: residual volume and functional residual capacity

Answer 33

Basilar lung compression by gravid uterus results in decreased residual volume and decreased functional residual capacity

Question 34

Normal pulm changes in pregnancy: FEV1 and vital capacity

Answer 34

FEV1 and vital capacity unchanged