Other

Question 1

What does HIPAA require to disclose PHI to a third party?

Answer 1

Verbal or written authorization, and only minimal necessary information is disclosed. It is not required to require proof of identify of the third party per HIPAA.

Question 2

First step if metastatic SCC of unknown primary is identified in a neck lymph node?
Next step if this is negative?

Answer 2

First: CT chest
Next: Panendoscopy (esophagoscopy, bronchoscopy, laryngoscopy)

Question 3

Anterior mediastinal masses

Answer 3

4 T’s: Thymoma, retrosternal Thyroid, Teratoma, (Terrible) lymphoma

Question 4

Middle mediastinal masses

Answer 4

Bronchogenic or pericardial cysts, tracheal tumors, lymphoma

Question 5

Posterior mediastinal masses

Answer 5

Neurogenic tumors, esophageal tumors, enteric cysts, lymphoma

Question 6

Treatment of hypothermia by temperature:

Answer 6

32-35 C: Passive external rewarming
28-32 C: Active external rewarming
<28 C: Active internal rewarming
In all, if need fluids for hypotension, give warmed crystalloid

Question 7

Empiric treatment of smoke inhalation injury

Answer 7

For CN: Hydroxycobalamin, sodium thiosulfate, or nitrites for methemglobinuria
For CO: 100% O2 via non-rebreather

Question 8

Treatment of frostbite

Answer 8

Rapid rewarming in water bath (37-39 C), with aggressive pain control

Question 9

Thick skin with changes in pigmentation, with painful stocking-glove neuropathy

Answer 9

Chronic arsenic poisoning (treat with dimercaprol)

Question 10

Garlic breath, N/V, and long QT

Answer 10

Acute arsenic poisoning (treat with dimercaprol)

Question 11

Congo red stain and apple-green birefringence

Answer 11

Amyloid

Question 12

Nephrotic syndrome with enlarged, palpable kidneys

Answer 12

Secondary amyloidosis (may also see restrictive cardiomyopathy, HSM, big tongue, waxy thick skin, easy bleed/bruising, neuropathy, CVA)

Question 13

Cause of primary amyloidois?

Secondary?

Answer 13

Primary is AL: Light chains in MM or WM
Secondary is AA: Acute phase reactant in chronic autoimmune (e.g. RA), infectious (e.g. TB, osteomyelitis), or malignant disease

Question 14

Cyclosporine toxicity

Answer 14

Nephrotoxicity, neurotoxicity, with gingival hypertrophy and hirsuitism
(Tacrolimus is similar but does not cause gingival hypertrophy and hirsuitism)

Question 15

Tacolimus toxicity

Answer 15

Nephrotoxicity and neurotoxicity

Does not lead to gingival hypertrophy or hirsuitism like cyclosporine does

Question 16

Mycophenolate toxicity

Answer 16

Bone Marrow suppression

Mycophenolate suppresses the Marrow