Review

Question 1

Discussion of code status with pt admitted to hospital is what type of preventive care

Answer 1

Quaternary prevention

Question 2

What’s a type of primary prevention

Answer 2

Immunizations

Question 3

What type of prevention is a Pap smear screening

Answer 3

Secondary prevention- strategies to promote early detection of disease

Question 4

What type of prevention is mastectomy

Answer 4

Tertiary - aim to limit impact of established disease

Question 5

What are the components of an intervention for treating tobacco use

Answer 5

Ask,advise,assess,assist,arrange

Question 6

An immuno-compromised pt would like the pneumonia vaccine what is recommended

Answer 6

pCV 13 now and revaccinate with PPSV23 in 8 weeks

Question 7

Screening of a hepatitis panel results with negative HBsAg, positive anti-HBs,negative anti-HBc what does this mean

Answer 7

Pt had hep B in the past and has passive immunity

Question 8

Who should be screened for lung cancer

Answer 8

Adults 55-80 who have 30pk smoking history and currently smoke or quit with in past 15 years

Order Low dose CT chest

Question 9

Women 50-74 should get screened how often for breast cancer

Answer 9

Biennial mammogram

Question 10

Elevation in lead II, III and aVF indicate what type of MI

Answer 10

Inferior

Question 11

Elevation in lead v3&v4 what type of MI

Answer 11

Anterior

Question 12

Elevation in lead v1 V2and V3indicate MI where

Answer 12

Anteroseptal

Question 13

Hgb levels

Answer 13

14-18 males
12-16 femals

Question 14

HCT levels

Answer 14

Males: 40-54
Female 37-47

Question 15

TIBC what is it and levels

Answer 15

Binding capacity of iron- increased means higher need for iron
Normal 250-450

Question 16

Serum iron

Answer 16

50-150

Question 17

MCV

Answer 17

Volume and size of erythrocyte
80-100

Question 18

MCV

Answer 18

Mean corpuscular volume - average amount/weight of Hgb in a single erythrocyte
Normal 26-34

Question 19

MCHC

Answer 19

Mean corpuscular hemoglobin concentration-average Hgb concentration of each RBC more accurate then MCH
Normal 32-36%

Question 20

Low MCV anemias

Answer 20

Iron deficiency
Thalassemia

Microcytoc anemia

Question 21

High MCV anemia

Answer 21

Macrocytic anemia
B12 or folate deficiency,alcoholism,liver failure and drug effects

Question 22

Normocytic anemia

Answer 22

Anemia of chronic disease
Sickle cell
Renal failure
Blood loss
Hemolysis

Question 23

The most common cause of anemia

Answer 23

Iron deficiency anemia

Question 24

Causes of iron deficiency anemia

Answer 24

Blood loss
Inadequate iron intake
Impaired absorption of iron

Question 25

What anemia may cause Pica

Answer 25

Iron deficiency anemia

Question 26

Labs: low h/h, low serum ferritin, high TIBC and low MCV - what type of anemia

Answer 26

Iron deficiency

Question 27

Labs: low h/h, low MCV, low MCHC, normal TIBC and decreased a Hgb chain

Answer 27

Thalassemia

Question 28

Genetically inherited disorder in abnormal Hgb and microcytic and hypochromic anemia

Answer 28

Thalassemia

Question 29

Who gets thalassemia

Answer 29

Mediterranean African middle eastern Indian and Asian

Question 30

Most common type of thalassemia

Answer 30

Beta thalassemia

Question 31

An adult with thalassemia has which type most likely

Answer 31

Thalassemia minor One copy of beta chain Mild anemia

Question 32

A child has what type of thalassemia that is progressively severe

Answer 32

Thalassemia major/Cooleys Anemia 2 genes for beta

Question 33

Can you administer iron in thalassemia

Answer 33

No contraindicated

Question 34

Tx for thalassemia

Answer 34

No treatment for mild/moderate, RBC transfusion/splenectomy for severe forms

Question 35

Pt with fatigue, tachycardia and glossitis with out neuro changes has anemia what type do you expect

Answer 35

Folic acid deficiency

Question 36

Labs: low h/h, elevated MCV, normal MCHC, decreased serum folate Anemia?

Answer 36

Folic acid deficient

Question 37

Tx for folic acid deficiency anemia

Answer 37

Folate acid 1mg every day High folate food/ bananas, peanut butter,fish, green leafy vegetables iron fortified breads and cereals

Question 38

Anemia caused by deficiency of intrinsic factor

Answer 38

Pernicious anemia (b12)

Question 39

Labs: low h:h, MCV increased, decreased b12 Anemia?

Answer 39

Pernicious anemia

Question 40

What type of anemia is pernicious anemia

Answer 40

Macrocyctic normochromic

Question 41

Tx for pernicious anemia

Answer 41

B12 100mcg IM daily x1 eeek (front load) then lifelong monthly

Question 42

Most common anemia in elderly and hospitalized patients

Answer 42

Anemia of chronic disease

Question 43

Labs: low h/h, MCV normal, MCHC normal, serum iron and TIBC low, high serum ferritin

Answer 43

Anemia chronic disease

Question 44

Pt reports pain in chest and aching joints, upon assessment appears dehydrated you suspect sickle cell what is the treatment

Answer 44

Fluids Analgesics Oxygen

Question 45

Genetic disorder results in deficiency of clotting factor VIII

Answer 45

Von willebrand disease

Question 46

Tx for von willebrand disease

Answer 46

Desmopreasin Recombinant von Willebrand factor/factor VIII concentration

Question 47

Acute leukemia in adults with long term survival of 40%

Answer 47

Acute myelogenous leukemia (AML)

Question 48

90% remission rate in children hallmark of disease is Pancytopenia with circulation of blasts

Answer 48

Acute Lymphocytic leukemia (ALL)

Question 49

Most common leukemia in adults

Answer 49

Chronic lymphocytic leukemia (CLL)

Question 50

Hallmark of this leukemia is lymphocytosis

Answer 50

CLL - chronic lymphocytic leukemia

Question 51

What leukemia is Philadelphia chromosome seen in

Answer 51

Chronic myelogenous leukemia (CML)

Question 52

Pt with fatigue weight loss and generalized lymphadenopathy - what do you suspect

Answer 52

Leukemia

Question 53

Pt presents with low h/h, fatigue, glossitis and parenthesis - what anemia do you suspect How do you treat

Answer 53

Pernicious anemia B12 IM daily x 1week then monthly

Question 54

How is leukemia confirmed

Answer 54

Bone marrow biopsy

Question 55

Why give allopurinol to a pt undergoing chemotherapy

Answer 55

To reduce tumor lysis syndrome

Question 56

Management of leukemia

Answer 56

Chemo Bone marrow transplant Control symptoms

Question 57

What stage is lymphoma if you have enlarged lymph in neck and groin

Answer 57

Stage III- lymph involved on both sides of diphragm

Question 58

Stage II lymphoma involves what

Answer 58

More than one lymph node group- confined to one side of diaphragm

Question 59

Stage I lymphoma is dx how

Answer 59

Disease localized to one single lymph node

Question 60

Pt has lymphoma that has spread to neck lymph nodes, the spleen and the liver - what stage is this

Answer 60

Stage III- involves liver or bone marrow

Question 61

20 year old male presents with advanced stage lymphoma - what type is this most likely

Answer 61

Non-hodgkins

Question 62

What finding would differentiate Hodgkin’s disease from non-hodgkins

Answer 62

Reed-stern berg cells

Question 63

Manager of lymphoma

Answer 63

Radiation Chemo Bone marrow transplant

Question 64

Management of ITP( idiopathic thrombocytopenia purpura)

Answer 64

May not need till PLT <20000 High dose corticosteroids IV gamma globulin (preferred for HIV pt) PLT transfusion

Question 65

Mtg if DIC

Answer 65

Treat underlying cause PLT Tx for thrombocytopenia, FFP to replace clotting factors, cryo for fibrinogen Use heparin

Question 66

Labs associated with DIC

Answer 66

Thrombocytopenia PLT <150000 Hypofibrinogenemia /fibrin <170 Decreased RBC Increased fibrin degradation products. (FDP) >45 mcg/ml Prolonged PT >19 seconds Prolonged PTT >42 seconds DDimer +

Question 67

Difference in acute vs chronic pain

Answer 67

Acute <6 months

Question 68

What to consider to treat bone pain with Mets

Answer 68

Biophosphonates

Question 69

What is neuroleptic malignant syndrome

Answer 69

Toxic on antipsychotic or antidepressant like SSRI

Question 70

Pt presents to ED with possible overdose he is vomiting with hyperthermia elevated LFTs and tinnitus what substance do you suspect

Answer 70

Aspirin

Question 71

Pt presents to Ed with possible overdose s/s include nausea excessive salivation blurred vision with kiosks and bradycardia. What substance do you suspect

Answer 71

Organophsphate insecticide

Question 72

Tx for insecticide (organophosphate) poisoning

Answer 72

Wash skin Activated charcoal if swallowed Atropine is drug of choice

Question 73

Tx for serotonin syndrome

Answer 73

Dantrolene sodium Clonazepan to treat rigor Cooling blankets

Question 74

What condition do you need to worry about developing with antidepressant toxicity

Answer 74

Seizures- treat with benzodiazepines IV

Question 75

S/s antidepressant toxicity

Answer 75

Confused Hallucinations Urinary retention Hypothermia Hypotension Tachycardia Seizure

Question 76

Tx for beta blocker overdose

Answer 76

Glucagon Atropine as needed Stabilize airway

Question 77

Tx of ethylene glycol overs OPO se

Answer 77

Fomepizole (antizol) Ethanol if fomepizole not AV

Question 78

What indicates compartment syndrome and what is treatment

Answer 78

Pressure >30 mmHG Delta pressure <=30 Fasciotomy

Question 79

What is delta pressure

Answer 79

Difference in Diastolic BP and the intra-compartmental pressure - if less then 30 need fasciotomy

Question 80

Pathogen and drug for endocarditis

Answer 80

Staphylococcus aureus Vanco + ceftriaxone

Question 81

Drug choice for peritonitis

Answer 81

Metronidazole plus 3rd gen. Cephalosporin or zosyn

Question 82

Common pathogen cause acute otitis media sinusitis and bronchitis

Answer 82

S. Pneumoniae

Question 83

Common pathogen of cellulitis and Tx

Answer 83

Staph. Aureus , group A strep Cefazolim, Vanco, clindamycin, linezolid and dapto

Question 84

Tx for transplant Pt that you think is rejecting organ

Answer 84

Immediate biopsy

Question 85

What is most effective anti-rejection regimen

Answer 85

Triple therapy Steriod- methyprednisolone or prednisone Antimetabolite Calcimeurin inhibitor or mTOR

Question 86

Who gets shingrix

Answer 86

Shingles vaccine Adults >=50- 2 doses with 2nd dose given 2-6 months after first

Question 87

Rough flesh colored pink patches in sun exposed parts of body

Answer 87

Actinic keratoses

Question 88

Firm irregular pPule or nodule that is keratitis and scaly bleedinh

Answer 88

Squamous cell carcinoma

Question 89

Benign non painful beige or black plaques that are “stuck on”

Answer 89

Sevorrheic kerToses No treatment or nitrogen removal

Question 90

Most common skin cancer

Answer 90

Basal cell carcinoma

Question 91

Tx of basal cell carcinoma

Answer 91

Shave/punch biopsy and surgical excision

Question 92

Highest mortality rate of all skin cancers

Answer 92

Malignant melanoma

Question 93

Most common type of headache

Answer 93

Tension headache

Question 94

Headache effecting middle age men and often at night and unilateral

Answer 94

Cluster headache

Question 95

Tx of cluster headache

Answer 95

100% oxygen Sumatriptan 6mg SQ

Question 96

Normal urine sodium

Answer 96

10-20 mEq/L

Question 97

Normal serum osmolality

Answer 97

275/285 (2x Na)

Question 98

What does high urine sodium usually indicate

Answer 98

Renal salt wasting a problem with kidney

Question 99

What sodium defect usually occurs with extreme hyperlipidemia or hyperproteinemia

Answer 99

Isotonic hyponatremia

Question 100

normal CVP

Answer 100

0-6

Question 101

Normal PAP

Answer 101

15-25/5-15

Question 102

normal PCWP

Answer 102

6-12

Question 103

normal CO

Answer 103

4-8

Question 104

normal CI

Answer 104

2.5-4

Question 105

normal SVR

Answer 105

800-1200

Question 106

normal CV02

Answer 106

60-80%

Question 107

Shock state with low CO, LOW CVP and high SVR

Answer 107

hypovolemic

Question 108

type of shock with low CO, high CVP and high PCWP

Answer 108

cardiogennic

Question 109

shock state with high CO, low CVP, low PCWP and low SVR

Answer 109

septic shock

Question 110

shock with low CO, high CVP, high SVR and high SV02

Answer 110

obstructive shock

Question 111

shock with low CO, low CVP, low PCWP, low SVR

Answer 111

anaphylatctic neurogenic

Question 112

side effect of st johns wort

Answer 112

increase blood clotting serotonin syndrome wiht SSRI

Question 113

two herbs that help with premenstrual and menopausal discomfort

Answer 113

black cohosh evening primrose

Question 114

what is side effect of kava kava

Answer 114

hypertension long term alcohol increased toxic effects

Question 115

first drug to administer for anaphylactic shock

Answer 115

diphenhydramine (Benadryl) 25-75mg IV or IM

Question 116

elements of aSOFA

Answer 116

SBP <100 - 1 point RR >=22 - 1 point GCS <15, AMS - 1 point 2 or more points greater risk of death or prolonged ICU

Question 117

what is serum osmolality of hypotonic hyponatremia

Answer 117

<280

Question 118

Causes of hypovolomeic with urine NS <10

Answer 118

dehydration diarrhea (C-Diff) Vomiting / NGT suctioning

Question 119

causes of hypovolemic w/ urine Na > 20

Answer 119

-Low volume and kidneys cannot conserve Na Diuretics ACE inhibitors Mineralocorticoid deficiency

Question 120

causes of hypervolemic hypotonic hyponatremia

Answer 120

- Need to restrict water-most common edematous states CHF liver disease advance renal failure

Question 121

state of body wat´r excess diluting all body fluids , clinical signs arise from water excess

Answer 121

hypotonic hyponatremia

Question 122

usually due to excess water loss; always indicates hyperosmolality

Answer 122

hypernatremia - serum osmolality >295

Question 123

Mtg of hypernatremia

Answer 123

hypovolemic- NS IV followed by 1/2 NS euvolemia- free water (D5W) hypervolemia- free water and loop diuretic; may need dialysis

Question 124

pt has muscular weakness, fatigue and muscle cramps as well as prominentU waves and broad T waves - what do you suspect

Answer 124

hypokalemia -

Question 125

MTG of hypokalemia

Answer 125

oral replacement if >2.5 and EKG normal IV replacement if <2.5 or severe s/s - 40mEq/hour Check Mg!!!!

Question 126

common drug cause of hyperkalemia

Answer 126

NSAID

Question 127

tx of K >6.5 with muscle paralysis (emergent treatment )

Answer 127

10 units insulin plus one amp D50

Question 128

what does total calcium vary with

Answer 128

albumin

Question 129

causes of hypocalcemia

Answer 129

hypoparathyroidism, hypomagnesemia, pancreatitis, renal failure, severe trauma and multiple blood transfusions

Question 130

ds/s of hypocalcemia

Answer 130

Trousseau's sign (carpopedal spasm) Chvostek's sign (increased irritability of the facial nerve, twitching with percussion of facial nerve) Prolonged Qt

Question 131

Mtg of hypocalcemia

Answer 131

if acute IV calcium gluconate

Question 132

pt presents with fatigue, muscle weakness, constipation and anorexia what electrolyte disturbance do you expect

Answer 132

hypercalcemia

Question 133

Tx of hypercalcemia

Answer 133

calcitonin if impaired cario/renal function NS with loop diuretic dialysis in severe cases

Question 134

what is the first ABG abnormality when in pt in distress

Answer 134

respiratory alkalosis - hyperventilation

Question 135

what do you usually see ketones with

Answer 135

Type I DM

Question 136

glutamic acid decarboxylase is associated with what

Answer 136

80% of Type I DM patients glutamic acid decarboxylase GAD -65

Question 137

what serum fasting blood glucose diagnostic of DM

Answer 137

8 hour blood glucose >=126 mg/Dl on more than one occasion

Question 138

A1C diagnostic of DM

Answer 138

glycated hemoglobin >= 6.5

Question 139

somogyi effect

Answer 139

nocturnal hypoglycemia pt is hypoglycemic at 0300 but rebounds with elevated BS at 0700

Question 140

tx of somogyi effect

Answer 140

reduce or omit the bedtime dose of insulin

Question 141

dawn phenomenon

Answer 141

BS becomes progressively elevated throughout night resutling in elevated BS at 0700

Question 142

tx of dawn phenomenon

Answer 142

add or increase bedtime dose of insulin

Question 143

criteria of metabolic syndrome

Answer 143

waist circumference >=40" men, >=35"women BP >= 130/85 Triglycerides >= 150 FBG >=100 HDL < 40 in men <50 in women Must have 3 to dx

Question 144

pt has had a frequent recurrent vaginitis as well as pruritus and now complains of blurred vision - what should you work her up for

Answer 144

DM II

Question 145

started drug for type II DM

Answer 145

biguanide- Metformin BLACK box : lactic acidosis c/o muscle pain

Question 146

types of GLP-1 and black box warning

Answer 146

trulicity byetta Victoza Ozemic Thyroid Ca REMS program-pancreatitis

Question 147

pt presents with increased appetite, weight loss, exophthalmos and tachycardia what do you suspect and associated labs

Answer 147

hyperthyroidism (overdrive) TSH low Elevated T3 T4 free thyroxine index

Question 148

pt presents with cold intolerance, puffy eyes, and edema of hands and face what do you expect and associated labs

Answer 148

hypothyroidism (sluggish) TSH elevated, low T4

Question 149

labs associated with hashimotos

Answer 149

elevated TSH low T4

Question 150

labs with Graves disease

Answer 150

decreased TSH elevated t3 & y4

Question 151

what med do you avoid in thyroid crisis

Answer 151

Acetylsalicylic acid

Question 152

pt presents with tachycardia and severe anxiety, tremors and has elevated T3 what do you worry about and how do you treat

Answer 152

thyroid crisis propylthiouracil 150-250 q 6 OR methimazole 15-25 mg every 6 hours

Question 153

pt presents hypothermic, unable to maintain airway and bradycardia TSH is elevated what do you suspect and how to treat

Answer 153

myxedema coma intubate if needed fluid replacment Synthroid 400mcg IV slow rewarming

Question 154

what is most common presentation of hyperthyroidism

Answer 154

Graves' disease

Question 155

Medication tx for hyperthyroidism

Answer 155

propranolol for s/s relief Thioruea drugs for patients with small goiters or fear of isotopes- - Methimazole every day in 3 doses - Propylthiourcia daily in 4 doses

Question 156

TX for thyroid storm

Answer 156

propylthiouracil every 6 hours OR methimaozle every 6 hours plus other tx avoid ASA

Question 157

what is the reason most people are non compliant with taking levothyroxine

Answer 157

initial hair loss

Question 158

management of myxedema coma *hypothyroidism crisis

Answer 158

protect airway fluid replacement levothyroxine 400mcg IV then daily slow rewarming with blankets

Question 159

Cushing syndroom is caused by what

Answer 159

to much steroid ACTH hyper secretion adrenal tumor chronic admin of glucocorticoids

Question 160

s/s of Cushing

Answer 160

central obesity moon face buffalo hump hypertension (vasoconstriction) Hyperglycemia Hypernatremia Hypokalemia elevated AM cortisol

Question 161

test for Cushing disease

Answer 161

dexamethasone suppression test

Question 162

Addisons disease caused by what

Answer 162

to little steroid , androgen and aldosterone deficient cortisol autoimmune metastatic cancer bilateral adrenal hemorrhage pituitary failure

Question 163

s/s of Addisons

Answer 163

hyperpigmentation of buccal mucosa and skin creases hypotension scant axially and pubic hair hypoglycemia hyponatremia hyperkalemia AM cortisoll <5mcg/dl

Question 164

test for Addison

Answer 164

cosyntropin stimulation test

Question 165

mtg of Addison

Answer 165

glucocorticoid and mineralocorticoid replacement - hydrocortisone -fludrocortisone acetate

Question 166

s/s of SIADH

Answer 166

neurologic changes from hyponatremia (mild headache, seizure, coma ) decreased DTRs hypothermia

Question 167

labs r/t SIADH

Answer 167

hyponatremia decreased serum osmolality <280 increased urine osmolality >100 increased urine sodium >20 increased urine specific gravity because urine osmosis is increased

Question 168

what is DI

Answer 168

diabetes inspires excessive urination and extreme thirst from to much vasopressin

Question 169

s/s of DI

Answer 169

thirst/cravings for water polyuria (2-20 L/day) hypotension weight loss, fatigue elevated temp

Question 170

labs r/t DI

Answer 170

hypernatremia increased serum osmolality >290 decreased urine osmolality <100 elevated BUN/creatinine low urine specific gravity

Question 171

how do you test for DI

Answer 171

Vasopressin challenge test (Desmopressin) - positive in central DI negative in nephrogenic DI

Question 172

management of DI

Answer 172

if NA >150 - give D5W to replace 1/2 volume deficit in 12-24 hours if Na <150 substitute 1/2 NS or 0.9 DDAVP IV or Sq in acute situations DDAVP maintenance intranasally

Question 173

management of SIADH

Answer 173

if Na <120 restrict fluids to 1000ml/24hours if Na <110 or neuro s/s replace with isotonic or hypertonic saline and Lasix at 1-2mEq/h

Question 174

a pt presents with liable BP, diaphoresis and severe headaches also notice postural hypotension TSH is normal what do you suspect

Answer 174

pheochromocytoma tumor of adrenal medulla

Question 175

how do you dx pheochromocytoma

Answer 175

plasma-free metanehines (blood_ Assay of urine catecholamines, metanephrines, vanillylmandelic acid (VMA) and creatine 24 hours urine >2.2 ug metanephrine per mg creatine and >5.5 VMA

Question 176

how do you CONFRIM pheochromocytoma

Answer 176

CT of adrenals

Question 177

what do you monitor post operatively in pheochromocytoma

Answer 177

hypotension adrenal insufficiency hemorrhage

Question 178

Younger people have what type of ulcer

Answer 178

Duodenal ulcer

Question 179

What type of ulcer typically occurs between 55-65

Answer 179

Gastric ulcer

Question 180

Who are ulcers more common in

Answer 180

Men

Question 181

This type of stomach pain feels better after eating

Answer 181

Duodenal ulcer

Question 182

This type of stomach pain gets worse after eating

Answer 182

Gastric ulcer

Question 183

Pt presents with severe epigastric pain, rigidity and quiet bowel sounds what do you suspect

Answer 183

Acute abdomen- perforation

Question 184

Treatment for suspected PUD

Answer 184

pPI -prazole

Question 185

What is the treatment for H Pylori

Answer 185

Two antibiotics + PPI with or with out bismuth x 10-14 days

Question 186

What is a precursor for esophageal cancer

Answer 186

Barrett’s esophagus

Question 187

How do you dx Barrett’s esophagus

Answer 187

EGD

Question 188

Hepatitis related to IV drug use

Answer 188

Hep C

Question 189

Pt has anti-HAV and IgM what do you suspect

Answer 189

Active Hep A iGm-immediate

Question 190

Pt has HBsAg, anti-HBc, HBeAG and IgM what it’s this

Answer 190

Active hep b

Question 191

Pt has HBsAg, anti HBc, anti HBe IGM IGH what is this

Answer 191

Chronic Hep B

Question 192

Pt has anti-HBc, antiHBs what is this

Answer 192

Recovered hep B

Question 193

Pt presents with LLQ tenders ness and pain along with loose stools and nause what do you suspect

Answer 193

Diverticulitis

Question 194

Dietary risk for diverticulitis

Answer 194

Low dietary fiber

Question 195

Pt presents with abdominal pain and has deep pain while breathing in when fingers placed under right rib cage What do you suspect

Answer 195

Murphy sign Cholecystitis

Question 196

How dx cholecystitis

Answer 196

US is gold standard

Question 197

Most common complication of ERCP

Answer 197

Pancreatitis

Question 198

Causes of acute pancreatitis

Answer 198

Gallbladder disease -#1 cause cholelythisis HEAVY alcohol use

Question 199

Pt presents with upper abdomen tenderness severe epigastric pain that is improved by sitting forward you note flank discoloration what do you suspect

Answer 199

Grey turner sign Hemorrhagic pancreatitis

Question 200

Ransom criteria

Answer 200

Greater than 55 W- WBC >16000 G- glucose >200 L- LDH > 350 A- AST >250 George Washington Got Lazy After

Question 201

Treatment for autonomic dysreflexia

Answer 201

Remove stimulus - cath cause bladder full - straighten sheet - move fan

Question 202

Parkinson’s is deficient of what

Answer 202

Dopamine

Question 203

What is Murphys sign

Answer 203

Deep pain on inspiration while fingers are placed under right rib cage - indicates cholecystitis

Question 204

How do you dx cholecystitis

Answer 204

Ultrasound - gold standard

Question 205

Major complication associated with ERCP

Answer 205

Pancreatitis

Question 206

What is ransoms criteria used for

Answer 206

Evaluate prognosis with pancreatitis

Question 207

Pt presents with cramping periumbilical pain , afebrile, unable to pass stool and high pitched tinkling BS what test do you order

Answer 207

KUB- dilated loops of bowel and air fluid levels with bowel obstruction

Question 208

Pt had pain with right thigh extension what do you suspect

Answer 208

Appendicitis -psoas sign

Question 209

Pt had RLQ pain with pressure applied to LLQ what do you suspect

Answer 209

Appendicitis Positive rovsings sign

Question 210

How do you dx appy

Answer 210

CT or US

Question 211

RIFLE is used for what

Answer 211

Assess AKI R- risk I- injury F-failure L- loss E- end stage

Question 212

Pt has AKI with BUN ratio of 20:1 FENa <1 and urine sodium <20, what type of renal cause do you suspect and how to Tx

Answer 212

Prerenal Expand intravascular volume

Question 213

Most common cause of intrarenal AKI that effects renal cortex

Answer 213

Nephrotoxic agents

Question 214

Initial Tx of nephroliyhiasis

Answer 214

Morphine Toradol Metoclopramide

Question 215

Pt has a “Kentucky” sound upon assessment what is this and what does it indicate

Answer 215

S3 Fluid overload- CHF, pregnant

Question 216

Pt has developed. New heart sound after an MI what is this

Answer 216

S4 “ten-ne-ssee “

Question 217

Murmur that is loud with thrill

Answer 217

IV/VI

Question 218

Murmur heard at 5th ICD and in diastole

Answer 218

Mitral stenosis

Question 219

Murmur heard at base and in systolic

Answer 219

Aortic stenosis

Question 220

Where are mitral murmurs

Answer 220

5th ICS, apex

Question 221

Where are aortic murmurs

Answer 221

2nd or 3rd ICS, base

Question 222

Stage I HTN

Answer 222

130-139 or 80-89

Question 223

Stage 2 HTN

Answer 223

>=140 or >=90

Question 224

Elevated Bp

Answer 224

120–129 and <80

Question 225

Typical first line Tx for HTN

Answer 225

Thiazide diuretic

Question 226

Tx for HTN in DM

Answer 226

Acei or Arb

Question 227

Normal cholesteroL Normal LDL Normal HDL Normal VLDL/triglycerides

Answer 227

<200 <100 >40 <150

Question 228

Goals for lipids for DM or CAD

Answer 228

LDL <70 hDL >40 triglycerides <150

Question 229

Elevation in lead I and aVl is MI where

Answer 229

Lateral

Question 230

Elevation on leads II,III and aVF

Answer 230

Inferior MI

Question 231

Elevation in V leads

Answer 231

Anterior MI

Question 232

Pt had PRI that gets longer then drops qrs is what type of heart block

Answer 232

Type I second degree /mobitz type I

Question 233

Atrial rate is regular PRI is constant but ventricular rhythm is irregular and has dropped QRS

Answer 233

Type 2 Heart block

Question 234

No relationship between P wave and QRS complex

Answer 234

Type 3 block

Question 235

Normal INR

Answer 235

0.8-1.2

Question 236

Normal PT

Answer 236

11-16 seconds

Question 237

Who enforces HIPAA

Answer 237

Office of civilian rights

Question 238

What dx must be reported

Answer 238

Gonorrhea Chlamydia Syphilis HIV TB Covid

Question 239

Nonmaleficence

Answer 239

Duty to do no harm

Question 240

Utilitarianism

Answer 240

Right act is one thag produces the greatest good for the greatest number

Question 241

Beneficence

Answer 241

Duty to prevent harm and promote good

Question 242

Justice

Answer 242

Duty to be fair

Question 243

Fidelity’s

Answer 243

Duty to be faithful

Question 244

Veracity

Answer 244

Duty to be truthful

Question 245

Autonomy

Answer 245

Duty to respect individual thoughts and actions

Question 246

Cross sectional research

Answer 246

Type of observational study, designed to find relationships between variable at specific point in time or “surveys” Examines population with similar attributes but differ in specific variable such as age

Question 247

Cohort

Answer 247

Nonexperemtal Compares particularl outcome in groups that are alike but differ by certain characteristic

Question 248

Longitudinal study

Answer 248

Nonexperimental Taking multiple measures of group over attended period of time to find relationship between variables

Question 249

Useful frame work to answer clinical based question

Answer 249

P-patient I- intervention C- comparison O- outcome T- timing

Question 250

What is a type 1 error

Answer 250

False positive Incorrectly rejecting the true null hypothesis

Question 251

Type 2 error

Answer 251

False negative Failing to reject a null hypothesis which if false

Question 252

What does CN XII do

Answer 252

Move the tongue

Question 253

What nerve shrugs the shoulders

Answer 253

CN XI spinal accessory

Question 254

What is function of CN VIII

Answer 254

Acoustic- hearing

Question 255

What does CN VI do

Answer 255

Abducens - lateral eye movement

Question 256

CN that does pupillary construction

Answer 256

CN III ovulomotor

Question 257

Pneumonic for CN

Answer 257

Oh- olfactory Oh- optic Oh- oculomotor To- trochlear Touch- trigeminal And- abducens Feel- facial A- acoustic Girls- glossopharyngeal Vagina - vagus So - spinal accessory Heavenly -hypoglossal

Question 258

heart sounds in S1

Answer 258

aortic/pulmonic open - mitral/tricuspic close

Question 259

heart sounds in S2

Answer 259

aortic/pulmonic close- mitral/tricuspid open