Practice Exam topics Flashcards
1
Q
Inherited protein C deficiency predisposes you to what?
A
Thrombosis
2
Q
Preferred medication to decrease incidence of bed wetting episodes?
A
Imipramine/Tofranil
anticholinergic med that when given before bedtime can decrease incidence
3
Q
what can you use Hyocyamine to treat?
A
overactive bladder
4
Q
1st 2nd and 3rd line treatment for morton’s neuroma
A
1st- conservative metatarsal support, broad-toed shoes with firm soles
2nd- steroid injection
3rd- surgery if failed conservative tx (could have permanent numbness)
5
Q
positive endomysial IgA antibodies during screening is indicative of what disease?
A
celiac sprue
6
Q
when are face, scalp, trunk, and extremity sutures removed after placement?
A
face: 3-4 days
scalp: 5-7 days
trunk: 6-8 days
extremity: 7-14 days
7
Q
which diagnostic test is most sensitive for an AIDS pt with toxoplasmosis who presents with AMS/neuro deficits?
A
MRI
8
Q
which disease is diagnosed by an elevated sweat chloride test (TOC)?
A
cystic fibrosis
9
Q
what is the most common cause of death in a patient with cystic fibrosis?
A
pulmonary infection (terminal CHRONIC resp failure)
10
Q
CXR findings of “eggshell calcification of hilar lymph nodes” is suggestive of what disease?
A
silicosis
11
Q
CXR findings of hyperinflation and flat diaphragms is suggestive of what disease?
A
long-standing chronic disease
12
Q
which class of medications is contraindicated in pts using cocaine?
A
pure beta blockers (PROPRANOLOL)- can cause paradoxical hypertension (reverse effect causing more vasoconstriction and less blood flow to tissues)
13
Q
first immunoglobulin to respond during acute exposure? immunoglobulin that responds during 2nd exposure?
A
first- IgM
2nd- IgG
(mom is faster than grandma)
14
Q
what immunoglobulin responds during an allergic response or parasitic infection?
A
IgE
15
Q
where is IgA antibody found?
A
colostrums and GI secretions
16
Q
what is used to treat magnesium sulfate toxicity?
A
10% calcium gluconate
17
Q
positive ANCA (antineutrophil cytoplasmic antibodies) are indicative of what disease
A
ulcerative colitis
18
Q
positive ASCA (anti-saccharomyces cerevisiae antibodies) are indicative of what disease?
A
crohn’s disease
19
Q
puncture wound with sxs suggestive of acute osteomyelitis is most likely infected with what bug?
A
pseudomonas
20
Q
early and late XR findings of acute osteomyelitis
A
early- soft tissue swelling and PERIOSTEAL reaction
late- lucent areas of cortical destruction
21
Q
mucosal bleeding (gingival bleeding) is seen in what heme disease?
A
von willebrand
22
Q
migraines activate what nerve to cause pain sensation?
A
trigeminal
23
Q
pt with metabolic acidosis due to methanol ingestion is treated with what?
A
ethanol
24
Q
what are mild late decelerations on fetal non-stress test mostly likely due to?
A
uteroplacental insufficiency
25
variable decelerations on fetal non-stress test are most likely due to?
cord compression
26
early decelerations on fetal non-stress test are most likely due to?
head compression of fetus
27
deep late decelerations PLUS absent beat to beat variability on fetal non-stress test is most likely due to?
fetal hypoxia
28
which patient population is at highest risk to develop erythrasma?
people living in tropical climates
29
what is erythrasma?
superficial skin infection that causes brown scaly skin patches
30
sign for blue discoloration around umbilicus?
cullen's sign hemorrhagic pancreatitis)
31
sign for green/brown discoloration of bilateral flanks ?
turner's sign (acute pancreatitis)
32
what drug type is nedocromil and what can it help treat?
mast cell stabilizer (inhibits mast cell degranulation and can treat allergic rhinitis)
33
what are three lab findings typical for chronic renal failure pt?
hypocalcemia, metabolic acidosis and hyperkalemia
34
why are patients with chronic renal failure often anemic?
bc of low erythropoietin (broken kidneys cant make this anymore)
35
what are exudative pleural effusions due to?
increased production of fluid due to INFLAMMATION or MALIGNANT processes
36
what are transudative pleural effusions from?
increased hydrostatic or decreased oncotic pressures across normal capillaries
37
what is mittelschmerz
one-sided lower abdominal pain associated with OVULATION (occurs midway through cycle)
pain can alternate side to side
38
what is the organism for rocky mountain spotted fever?
rickettsia
39
what is the test to confirm diagnosis of rocky mountain spotted fever?
direct immunofluorescent assay (confirms antibodies to ricksettia)
40
what is test is used to detect antibodies to EBV?
heterophile agglutination
41
what does a prominent A wave of jugular venous pulsation represent?
atrial contraction against a closed tricuspid valve
42
how do you treat acute renal failure due to rhabdomyolysis/crush injury?
IV fluids and forced alkaline diuresis (IV sodium bicarb)
43
what is the common murmur associated with marfans syndrome
```
aortic regurgitation (connective tissue disorder or dilated aortic root)
-diastolic murmur heard on right intercostal
```
44
which pneumonia vaccine do kids get at 2, 4, 6, and 12-18 months?
PREVNAR (13)
45
what is the indication for pediatric pt to receive the 23 valent pneumo vaccine?
children 24-59 mo at high risk for invasive pneumo disease
46
treatment for polycythemia vera
phlebotomy
47
after starting synthroid, when do you recheck TSH level?
3-4 weeks
48
what lab test is best to determine immunity to Hep B?
Anti-HBs
| circulating antibody that develops to surface antigen in response to past Hep B infection or Hep B immunization
49
what does a positive HBsAg mean?
shows an acute Hep B infection and NOT immunity
50
persistent ST elevation in corresponding leads of old MI (usually anterior) is diagnosis for what?
ventricular aneurysm
51
percussion, tactile fremitus, and lung sounds for lobar pneumonia
dullness to percussion
increased tactile fremitus
late inspiratory crackles
52
mastitis is most commonly caused by what bacteria?
staph aureus
53
what is the main difference between brown recluse and black widow spider bites?
back widow bites typically produce systemic sxs (bradycardia, htn, tachyarrhythmias, fever)
54
optimal INR for pt with mechanical mitral valve prosthesis or aortic mechanical valve?
MV- 2.5 to 3.5
| AV- 2.0 to 3.0
55
leading cause of injury-related deaths in children between 1-15
motor vechicle injuries
56
a positive osmotic fragility test is seen in what disease?
hereditary spherocytosis
57
perfusion of the coronary arteries primarily occurs during what phase of heart activity?
diastole
58
what are three symptoms of a patient with interstitial lung disease?
progressive dyspnea on exertion, late inspiratory crackles, cough with minimal sputum production
59
four meds that are used for prophylaxis of traveler's diarrhea
FQ: norfloxacin, ciprofloxacin, ofloxacin
| bactrim
60
which two tests are specific tests for the diagnosis of syphilis?
FTA-ABS and MTA-TP
61
what is the initial study for a patient with amaurosis fugax?
carotid ultrasound
62
which trimester does maternal BP drop the lowest?
second
63
after insertion of a pacemaker, what is a common physical exam finding?
migratory ecchymosis: swollen, non tender arm with bluish discoloration along upper arm and forearm
64
what test do you do to confirm vitilago?
skin biopsy
65
pulmonary capillary wedge pressure indirectly measures what heart chamber pressure?
left atrial filling pressure
66
what disease can be caused by prescribing excessive doses of synthroid?
osteoporosis (increased bone turnover due to increased basal metabolic rate)
67
most effective tx for onychomycosis
terbinafine
68
which lifestyle recommendation most benefits a heart failure pt's quality of life?
regular exercise program
69
which leukemia is auer rods present in?
AML
70
extracorporeal shock wave lithotripsy is indicated in patients with kidney stones larger than what size?
>6 mm
71
which electrolyte should be most closely monitored when a pt is on loop diuretics?
potassium
72
what type of blood products do you have to give after 10 units of transfused packed RBCs?
fresh frozen plasma for clotting products
73
formications are associated with what two conditions?
delirium tremens from alcohol withdrawal and cocaine addiction
74
first line treatment for acute demyelinating polyneuropathy variant of guillain-barre syndrome?
IV immunoglobulin
75
most common PE finding for intestinal obstruction?
distention
76
which hormone inhibits GH secretion from pituitary?
somatostatin
77
first line medication for ankylosing spondylitis?
NSAIDS (indomethacin)
78
which bacteria causes diarrhea post ingestion of food contamination of dairy products, mayo, meats, eggs, salads?
S aureus
79
which medication class should be started to prevent progression of diabetic retinopathy?
ACEI
| *concern with microalbuminemia/proteinuria = improve glomerular hemodynamics by decreasing glomerular pressure
80
which antiarrhythmic drug can be associated with hyper- or hypothyroidism following long-term use?
amiodarone: structurally related to thyroxine and contains iodine
81
what treatment should be initiated for insect in auditory canal with poorly visualized TM
Two percent lidocaine solution will paralyze the insect and provide topical anesthesia for suction or forceps
removal
82
which skin condition is characterized by epidermal hyperplasia and an increase in the epidermal turnover?
psoriasis: leads to classic scale pattern
83
what lung disease: diminished breath sounds over the right lower lobe with decreased tactile fremitus
and dullness to percussion
pleural effusion
| pneumonia has increased tactile fremitus
84
what is ecthyma?
Ecthyma is a skin infection characterized by crusted sores beneath which ulcers form. It is a deep form of impetigo
85
what three medications are most useful in maintaining remission in a patient with ulcerative colitis?
Sulfasalazine, olsalazine, and mesalamine
86
treatment for child bitten by a black widow spider?
hospital admission for symptomatic care
87
What is the most accurate way to determine the exact degree of spinal curvature in a child with scoliosis?
the cobb angle
88
when would you use nebulized epi over oral dexamethasone in the treatment of croup?
Nebulized racemic epinephrine is only indicated in the treatment of croup in cases of moderate to severe
rest stridor, respiratory distress, or hypoxia
89
describe what drusen bodies look like and what disease they are from
Drusen are tiny to small yellowish round spots with hard or soft edges that are often seen in age-related
macular degeneration
90
```
Which class of diuretics is considered the treatment of
choice as first-line therapy in a failing kidney due to its improved sodium clearance in pts with heart failure?
```
Loop diuretics remain active in severe renal insufficiency and are the most effective type of diuretics used in the management of heart failure symptoms. These agents have a rapid onset and result in natriuresis due to their activity in the ascending limb in the Loop of Henle.
91
two most common treatments for neuroleptic malignant syndrome
dantrolene (Dantrium) and bromocriptine (Parlodel)
92
Which finding on CXR would most likely be seen in a patient with hypersensitivity
pneumonitis?
diffuse nodular densities
93
What is the recommendation for primary prevention of stroke in a patient under sixty years of age with atrial
fibrillation?
no therapy
94
what side of the penis does epispadias occur on?
THE DORSAL side (top of penis)
| hypospadias is the ventral side (bottom of penis)
95
what is the next medication to add to asthma therapy after PRN albuterol?
ICS
| after that is the long acting bronchodilator
96
difference between schizophrenia and schizophreniform disorder
Schizophrenia is greater than six months duration.
Schizophreniform disorder is characterized by the same features except the total duration of the illness is at least one month and less than six months
97
A patient with adrenal insufficiency is taking hydrocortisone 25 mg daily. What should the patient do with the hydrocortisone dose when they develop a minor illness such as a cold?
To better mimic the normal physiologic response the baseline dose should be doubled for the duration of the illness. Doses should be increased 5-10 fold with major events such as surgery
98
Common symptoms of fatigable weakness, ptosis, diplopia, and proximal muscle
weakness are found in what disease?
myasthenia gravis
99
two ABX used for treatment of bacterial conjunctivitis in contact lens wearers
Topical aminoglycoside or fluoroquinolones are indicated in contact lens wearers to cover Pseudomonas infection
100
What laboratory test must be monitored frequently in patients who are taking clozapine (Clozaril)?
white blood count: Leukopenia, granulocytopenia, and agranulocytosis occur in approximately 1% of patients on this medication
101
what is IgA nephropathy due to?
IgA nephropathy presents after an upper respiratory illness with deposition of IgA within the mesangium of the glomerulus
102
what is considered a risk factor for retinopathy of prematurity?
low birth weight
103
what medication inhibits prostaglandin synthesis in a patient with rheumatoid arthritis
aspirin
104
Which disease state results from hypersecretion of growth hormone in a 27 year-old patient?
acromegaly
105
what three medications can be used to tx absence seizures?
Ethosuximide, valproic acid, and clonazepam
106
what is a tzanck smear used for?
herpes simplex
107
next step in treatment for patient with allergic rhinitis who is not responsive to allergy avoidance or medical therapy of antihistamines and nasal steroids
immunotherapy
108
What laboratory test should be followed routinely every six to twelve months in patients taking lithium?
TSH
109
Which of the following conditions is most closely associated with an increased intensity of the P2 heart sound?
ASD
110
what test should be done to evaluate the urinary system in a pt with blood at the urethral
meatus and suspected of having a pelvic fracture?
urethrogram is the only procedure that should be done to evaluate this type of injury as urethral integrity may have been compromised secondary to the pelvic fracture
111
which medication should be used for a hypertension control in a pt with pheochromocytoma?
Phenoxybenzamine is an alpha-blocker
112
A 21 year-old male with a diagnosis of type 1 von Willebrand disease undergoes dental extraction of his wisdom teeth. The patient comes to the clinic with continued oozing of the dental sockets despite packing. Treatment should begin with which of the following?
DDVAP = causes the release of vWF and factor VIII from storage sites significantly which is needed to complete
hemostasis
(vWF used in patients with type 2 or 3)
113
what is treatment of choice for posterior nose bleed?
posterior nasal packing
114
which med class is contraindicated in pts with CAD to treat migraines?
triptans
115
what is the cause of syncope brought on by change in positions?
atrial myxomas
116
which heme disease is caused by a disorder in the red blood cell membrane
cell membrane defect of spherocytosis leads to hemolysis due to trapping of the cells by the spleen
117
Patients who undergo percutaneous angioplasty or who have coronary artery revascularization often are treated with glycoprotein IIb/IIIa inhibitors. What is the major side effect associated with these agents?
bleeding
118
medication to treat PCP in HIV + pts?
bactrim (also used for prophylactic PCP when CD4 is less than 200)
119
what elevated lab value is associated with sarcoidosis?
ACE
120
imaging findings that suggest mesothelioma?
pleural thickening and plaque formation (doesn't involve parenchyma)
pleural effusion
121
medication type that should not be given in pts with hyperparathyroidism?
thiazides (increase serum calcium)
