Random Qs 2

Question 1

holosystolic murmur with thrill

Answer 1

VSD

Question 2

treatment of dermatomyositis

Answer 2

steroids and methotrexate or azathioprine

Question 3

treatment of acute cholecystitis

Answer 3

antibiotics and cholecystectomy prior to hospital discharge

Question 4

abnormal uterine bleeding in an obese woman who is <45

Answer 4

endometrial biopsy to eval for cancer

Question 5

treatment of IgG-4 disease

Answer 5

rituximab

Question 6

adjuvant therapy for localized breast CA after bilateral mastectomy

Answer 6

nothing, hormone therapy prevents new cancers, but only if breast tissue remains

Question 7

undulent fever after travel

Answer 7

brucellosis

Question 8

do you need to treat bacteruria prior to surgery?

Answer 8

Nope you and you shouldn’t check except urologis procedures

Question 9

work-up for bronchiectasis

Answer 9

immunoglobulins

Question 10

treatment of relapsed UC

Answer 10

infliximab & azathioprine

Question 11

treating early stage hodgkin’s lymphoma

Answer 11

combination chemo followed by radiation therapy

Question 12

scarring and blistering on sun exposed skin

Answer 12

porphyria cutanea tarda

Question 13

treatment for scleroderma renal crisis

Answer 13

IV ACE inhibitor

Question 14

treatment for GCA which is steroid sparing

Answer 14

tocilizumab (IL-6 blocker)

Question 15

treatment for refractory gout

Answer 15

anakinra

Question 16

How to treat prolactinemia in a patient taking risperidone

Answer 16

estrogen-progesterone replacement (let the prolactin stay)

Question 17

treatment for a chill cellulitis

Answer 17

if nonpurulent: cefazolin, if purulent: bactrim or doxy

Question 18

traveler’s diarrhea prophylaxis in immunocompromised patients

Answer 18

rifaximin

Question 19

low-normal blood pressure, hypokalemic metabolic alkalosis, and, frequently, hypomagnesemia and high-normal serum calcium levels

Answer 19

Gitelman syndrome

Question 20

how do you diagnose CTEPH (initial test)

Answer 20

VQ scan

Question 21

treatment for severe malaria

Answer 21

artesunate

Question 22

treatment for hypermagnesemia

Answer 22

calcium gluconate and dialysis

Question 23

when to screen for secondary causes of hypertension

Answer 23

must be on four BP meds including a diuretic, or have lab/exam abnormalities

Question 24

high fever, headache, retro-orbital pain, myalgia, arthralgia, and lower back pain (break-bone fever); a positive tourniquet test is characteristic

Answer 24

dengue fever

Question 25

insidious onset of distal and proximal muscle weakness in an older patient

Answer 25

inclusion body myositis

Question 26

renal disease in ankylosing spondylitis

Answer 26

causes renal amyloidosis

Question 27

anticoagulation in a pregnant patient with a mechanical valve

Answer 27

continue warfarin

Question 28

contraindications to exercise EKG

Answer 28

inability to exercise and baseline ECG abnormalities (e.g., ST-segment depression >1 mm, left bundle branch block, left ventricular hypertrophy, paced rhythm, or preexcitation)

Question 29

treatment of severe hypothermia

Answer 29

active internal rewarming

Question 30

work-up of hyperprolactinemia

Answer 30

TSH, hypothyroidism can cause mild hyperprolactinemia

Question 31

immunosuppressants and elective surgery

Answer 31

Nonbiologic disease-modifying antirheumatic drugs (DMARDs) can be continued throughout the perioperative period; biologic DMARDs should be discontinued and restarted after evidence of wound healing.

Question 32

side effects of montelukast

Answer 32

black box warning for depression!

Question 33

treatment of isopropyl alcohol ingestion

Answer 33

supportive care (fomepizole for ethylene glycol and methanol)

Question 34

treatment for anklosing spondylitis

Answer 34

etanercept (TNF inhibitor)

Question 35

roflumilast

Answer 35

a selective phosphodiesterase-4 inhibitor, can reduce symptoms and exacerbations in patients with severe COPD who have a chronic bronchitis phenotype or frequent exacerbations

Question 36

should you screen for TB in HIV patients?

Answer 36

Yes when CD4 reaches 200

Question 37

what should you screen for in a patient with dermatomyositis

Answer 37

colon cancer

Question 38

initial therapy for COPD

Answer 38

LABA or LAMA (or combo), ICS is added later

Question 39

treatment of dry mouth in Sjogren's

Answer 39

symptomatic tx, then pilocarpine or cevelimine - no DMARD for this

Question 40

treatment of familial Mediterranean fever

Answer 40

colchicine

Question 41

adjuvant therapy for GIST

Answer 41

imatinib

Question 42

reversal agent for dabigatran

Answer 42

Idarucizumab