MKSAP quiz 1

Question 1

Rx of ILD in systemic sclerosis

Answer 1

Mycophenolate mofetil>cyclophosphamide

Question 2

Rx of laceration over a finger joint

Answer 2

sutures

Question 3

Risk with using GC in scleroderma

Answer 3

Renal crisis

Question 4

Rx of Raynaud’s

Answer 4

CCB, Sildenafil; losartan; prazosin, Topical nitrates; low-dose aspirin, Digital sympathectomy

Question 5

severe HTn, AKI, normal UA/mild pruria/no cells in pt with scleroderma

Answer 5

Scleroderma renal crisis

Question 6

Rx of scleroderma renal crisis

Answer 6

ACEI - preferably captopril, might need temporary dialysis

Question 7

Rx of gi dysmotility (pro-motility agents)

Answer 7

Metoclopramide (avoid long-term use); domperidone

Erythromycin; cisapride

Question 8

Px Scleroderma renal crisis

Answer 8

CCB

Question 9

Ab in scleroderma

Answer 9

Scl 70/topoisomerase 1, centromere, RNA polym III

Question 10

Scl 70 Ab in SS asso. with

Answer 10

lung fibrosis

Question 11

Ab giving protection from lung and kidney ds in SS

Answer 11

centromere

Question 12

Centromere ab in SS asso. with

Answer 12

pulm HTn, esoph ds

Question 13

RNA polymerase III in SS asso. with

Answer 13

renal, skin, malignancy

Question 14

Ab in limited SS

Answer 14

centromere

Question 15

MC pathogen in COPD exacerbation

Answer 15

H. influenzae

Question 16

SE of sodium polystyrene sulfate used for HK

Answer 16

gi tox - ulcerations, perforation

Question 17

reversal of dabigatran

Answer 17

idarucizumab, a monoclonal antibody fragment that binds free and thrombin-bound dabigatran/activated PCC

Question 18

NOAC not needing renal dosing

Answer 18

Betrixaban

Question 19

reversal of Xa agents

Answer 19

andexanet(only if life threatening bleeding)/4 factor PCC

Question 20

NOAC approved for pts undergoing dialysis

Answer 20

eliquis/apixaban

Question 21

tenofovir alafenamide is preferred over tenofovir disoproxil fumarate because

Answer 21

lower nephrotoxicity and risk of osteopenia

Question 22

ART alternative in ppl with chilbearing potential/not using contraception

Answer 22

Dolutegravir

Question 23

cutaneous sclerosis that involves only the skin in the absence of other systemic manifestations of systemic sclerosis

Answer 23

morphea

Question 24

Diffuse cutaneous SS characterized by

Answer 24

skin thickening that involves areas proximal to the elbows and/or knees.

Question 25

Limited cutaneous SS characterized by

Answer 25

skin disease that does not progress proximal to the elbows or knees but may include the face and neck.

Question 26

Linear scleroderma characterized by

Answer 26

skin thickening that follows a dermatomal distribution on one side of the body.

Question 27

linear morphea affecting face/scalp involving underlying subcutaneous tissues, muscle and bone.

Answer 27

En coup de sabre

Question 28

ABx of choice to px SSI

Answer 28

Cefazoline

Question 29

Rx opioid addiction

Answer 29

buprenorphine - reduces cravings

Question 30

MOA of buprenorphine

Answer 30

partial opioid agonist - binds strongly but minimum activation

Question 31

prevent relapse in patients with opioid and alcohol use disorders

Answer 31

Naltrexone

Question 32

Drug which decreases adenoma in FAP

Answer 32

Sulindac (NSAID), aspirin

Question 33

Attenuated FAP

Answer 33

<100 but >10 polyps, 80% risk of CRC

Question 34

Turcot syndrome

Answer 34

FAP with cns tumors

Question 35

Screening for FAP

Answer 35

If risk for classic: sigmoidoscopy/colonoscopy annually starting at 10-12 y.o If risk for attenuated: Every 1-2 y starting at 25 y

Question 36

Drugs preferred for HIV rx

Answer 36

Nrti: Tenofovir, emtiracitabine | Integrase inhib: dolutegravir

Question 37

Rx of prolactinoma

Answer 37

DA ag - cabergoline, bromocriptine

Question 38

Anti-HTn meds associated with hyperprolactinemia

Answer 38

Verapamil, methyldopa

Question 39

Ab in systemic sclerosis which increases risk of ILD

Answer 39

anti–Scl-70 (DNA topoisomerase-1)

Question 40

Rx of raynaud's

Answer 40

CCB, Sildenafil; losartan; prazosin, Topical nitrates; low-dose aspirin, Digital sympathectomy

Question 41

mild COPD exacerbation

Answer 41

when a change in the clinical condition is noted but no change in medication is necessary

Question 42

Severe COPD exacerbation

Answer 42

if ED eval/hospitalization needed or 2 offollowing symptoms: increased dyspnea, increased sputum volume, or increased sputum purulence

Question 43

Pseudomonas infection RF in COPD exacerbation

Answer 43

Frequent administration of antibiotics (four or more courses over the past year); recent hospitalization (two or more days duration in the past 90 days); isolation of Pseudomonas during a previous hospitalization; severe underlying COPD (FEV1 <50 percent predicted).

Question 44

Sodium polystyrene sulfate /Kayexalate SE

Answer 44

GI bleed/ulcerations/perforation

Question 45

STICH Trial

Answer 45

Surg rx for ischemic HF<35%: all cause mortality dec with cabg act medical

Question 46

Naloxone given to

Answer 46

Subs use ds, opioids+bdz, >50morphine meq/d, older, mental ds, osa

Question 47

Ca seen in FAP

Answer 47

CRC>duod/periampullary>gastric, papillary/follicular thyroid ca, cns tumors (turcot), desmoid

Question 48

Classic FAP

Answer 48

>100 polyps, 100%colon ca

Question 49

Metoclopramide should not be used for more than 12 weeks because (black box)

Answer 49

Tardive dyskinesia (maybe irrev)

Question 50

Lab monitoring in hypoparathyroidism

Answer 50

Ca, mg, P, urine ca, creat

Question 51

Most effective intervention to prevent pressure injuries

Answer 51

Advanced static mattress