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ABIM > Random Qs > Flashcards

Random Qs Flashcards

1
Q

aprepitant and olanzapine

A

For patients receiving high-emetic-risk chemotherapy, standard antiemetic treatments include a four-drug combination of an NK1 receptor antagonist, a 5-hydroxytryptamine-3 receptor antagonist (zofran), dexamethasone, and olanzapine.

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2
Q

levothyroxine treatment of med-high risk thyroid cancer

A

Treatment of intermediate- to high-risk differentiated thyroid cancer includes thyroid-stimulating hormone (TSH) suppression with daily levothyroxine

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3
Q

aspirin in a GI bleed

A

aspirin for secondary prevention should not be held unless life-threatening bleed - risk of stroke or MI within 7-10 days of holding - and should be restarted as soon as hemostasis is achieved

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4
Q

treatment of functional dyspepsia

A

TCAs (amitriptyline, nortriptyline)

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5
Q

Follow-up of indeterminate pulmonary nodule

A

Repeat CT 6mos, if it persists but is unchanged in size, CT should be repeated at 2-year intervals for 5 years

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6
Q

Vaccines in well-controlled HIV

A

Live vaccines, including varicella, measles-mumps-rubella, and influenza are not recommended for patients who are severely immunocompromised, but well-controlled HIV can get everything except live flu vaccine

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7
Q

exemestane

A

an option for chemoprevention of breast cancer in postmenopausal women with a previous history of VTE. Exemestane is not associated with an increased risk of VTE

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8
Q

Fundic Gland Polyp treatment

A

fundic gland polyps are the most common benign epithelial gastric polyp and require no endoscopic follow-up.

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9
Q

aristolochic acid nephropathy

A

chinese herbal medications –> chronic tubulointerstial nephritis and is associated with urothelial cancer.

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10
Q

Adjuvant Chemo Management for early breast CA

A

Increasingly, the use of adjuvant chemotherapy for early breast cancer is based more on tumor biology rather than on stage. For hormone receptor–positive, HER2-negative breast cancers with zero to three positive axillary nodes, the use of multigene assays (e.g., the 21-gene recurrence score assay) will help guide management.

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11
Q

Management of cancer survivors who received chest irradiation between age 10-30

A

For women survivors of Hodgkin lymphoma who received chest irradiation, annual breast cancer screening with mammography and breast MRI is recommended to begin 8 to 10 years posttherapy or at age 40 years, whichever comes first.

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12
Q

malignant hyperthermia

A

Malignant hyperthermia is an autosomal dominant condition resulting from deranged intracellular calcium metabolism in response to inhaled anesthetic agents and succinylcholine. Treat with dantrolene

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13
Q

Recurrent UTIs in a man

A

chronic bacterial prostatitis even without other findings - treat with abx x6 weeks, only need massage if no organism identified

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14
Q

Management of a high-risk gastric ulcer

A

high-dose IV proton pump inhibitor (PPI) therapy for 72 hours while hospitalized, followed by an oral PPI twice daily for a total of 2 weeks following the therapeutic endoscopy.

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15
Q

Textured breast implant -> pain/swelling

A

Anaplastic T-cell lymphoma. Although uncommon, there are increasing reports of non-Hodgkin lymphoma, typically anaplastic T-cell lymphoma, arising around breast implants.

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16
Q

treatment for SLE with nephritis

A

prednisone + HCQ + MMF

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17
Q

alectinib

A

chemo for lung cancer with ROS1 or ALK driver mutations

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18
Q

HER2 positive breast cancer

A

Be aggressive! At risk for local recurrence -> endocrine therapy, radiation, chemo (paclitaxel), and trastuzumab (ab against HER2)

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19
Q

osteomalacia

A

prolonged and severe vitamin D deficiency; diffuse bone pain, pathologic fractures, rise in alk phos, widespread uptake on whole-body bone scan

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20
Q

apple-green birefringence and congo red stain under polarized light

A

amyloidosis

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21
Q

Goal BP in pregnancy

A

<160/110

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22
Q

at what point do you treat a PDA

A

When there is L sided cardiac chamber enlargement as long as there is no severe pulmonary hypertension

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23
Q

leflunomide in pregnancy

A

absolutely contraindicated (demonstration of undetectable blood levels needed prior to conception)

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24
Q

when is a tuberculin skin test positive?

A

HIV, immunosuppression, known contact: 5mm
immigrants, IVDU, health care workers: 10mm
no risk factors: 15mm

25
Q

calcium phosphate arthritis in the shoulder

A

can cause progressive destruction of the glenohumeral joint and rotator cuff

26
Q

prevention of cardiovascular disease in pts with PAD

A

aspirin and very low-dose rivaroxaban (2.5mg BID) lowers risk by 2%, only use if no risk of bleeding

27
Q

first step to work-up female infertility

A

midluteal phase serum progresterone level (tests ovulatory function), if normal would evaluate tubal patency and uterine abnormalities

28
Q

treatment of exercise induced asthma

A

budesonide-formoterol (LABA/ICS) prior to exercise

29
Q

Statin in CKD

A

atorvastatin is preferred because rosuvastatin is renally excreted

30
Q

When to screen for AAA

A

one time for men 65-75 who have smoked five packs of cigarettes in their lifetime

31
Q

acute reaction to zoledronic acid

A

low-grade fever, myalgias, headaches in the first 1-3 days in 30% patients; usually improves with subsequent infusions

32
Q

contraindication to flecanide?

A

absolutely contraindicated in patients with ischemic heart disease due to risk for ventricular arrhythmias

33
Q

treatment of CMV

A

oral valganciclovir or IV ganciclovir

34
Q

when do you need angiography in PAD

A

Only for surgical planning for symptomatic disease, no need if asymptomatic

35
Q

treatment of nonmetastatic castrate-resistant prostate cancer

A

apalutamide (androgen receptor blocker)

36
Q

stress testing in patients with LBBB

A

vasodilator single-photon emission CT (others may be complicated in interpretation due to LBBB)

37
Q

PMR puts you at risk for ….

A

giant cell arteritis (headache, jaw claudication, vision changes)

38
Q

Acute painful knee in someone with psoriatic arthritis

A

Likely gout! PsA flares are usually less painful and slower

39
Q

treatment of gonorrhea alone

A

ceftriaxone (add doxycycline if chlamydia has not been ruled out)

40
Q

w/u of marked elevation in DHEAS

A

abdominal CT to locate likely adrenal tumor

41
Q

when should a HF patient get a CRT-D?

A

New York Heart Association functional class II to IV symptoms despite guideline-directed medical therapy who have an ejection fraction of 35% or less, sinus rhythm, and left bundle branch block with a QRS duration of 120 ms or longer.

42
Q

viral meningitis in the winter

A

most likely HSV-2

43
Q

treatment of Behcet’s syndrome

A

prednisone, colchicine, and alpremilast (PDE-4 inhibitor)

44
Q

when to treat renovascular hypertension

A

short duration of hypertension; refractory to medical therapy; recurrent flash pulmonary edema; progressive impaired kidney function; or unilateral stenosis affecting a solitary functioning kidney

45
Q

treatment of limited-stage small cell lung cancer includes:

A

chemo, radiation of the tumor, and prophylactic brain radiation

46
Q

at what size gallbladder polyp should you treat?

A 
>1cm = cholecystectomy
<1cm = 6 or 12 month US monitoring
47
Q

treatment of ANCA vasculitis

A

high-dose steroids and rituximab

48
Q

treatment of salicylate toxicity

A

Intravenous sodium bicarbonate administration is used to treat patients with salicylate toxicity, as it increases urinary elimination of salicylate (goal urinary pH >7.5), would only do HD if this is failing

49
Q

how do you diagnose GPA

A

kidney biopsy

50
Q

treatment of edema related to nephrotic syndrome

A

loop diuretics, and add thiazides or potassium-sparing diuretics if not effective; treatment of the underlying etiology with steroids can take 12-16 weeks

51
Q

how to evaluate for mitral regurg if echo seems insufficient?

A

cardiac MRI

52
Q

indications for parathyroidectomy in primary hyper-PTH

A

fragility fractures, vertebral fractures, and a dual-energy x-ray absorptiometry T-score of less than -2.5 or less at lumbar spine, total hip, femoral neck, or distal one-third radius.

53
Q

winter’s formula

A

predicted pCO2 = 1.5 x [HCO3-] + 8

54
Q

treatment of interstitial lung disease in systemic sclerosis

A

MMF

55
Q

increased activation of vitamin D (with hyperCa)

A

think fungal infections, tuberculosis, sarcoidosis, and lymphoma

56
Q

treatment for dermatitis herpetaformis

A

dapsone (test for G6PD before using)

57
Q

treatment of brain abscess

A

aspiration first, then CTX/metronidazole +/- Vanc if risk factors

58
Q

How long to wait for elective surgery after CVA

A

At least 6mos, but ideally 9

ABIM (4 decks)

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