S2 RR_1

Question 1

Classic ECG finding in atrial flutter

Answer 1

Sawtooth P waves

Question 2

Definition of unstable angina

Answer 2

Angina is new worsening or occurs at rest

Question 3

Antihypertensive for a diabetic patient with proteinuria.

Answer 3

ACEI

Question 4

Beck’s triad for cardiac tamponade.

Answer 4

Hypotension distant heart sounds and JVD

Question 5

Drugs that slow AV node transmission.

Answer 5

beta-blockers digoxin calcium channel blockers

Question 6

Hypercholesterolemia treatment that causes flushing and pruritus.

Answer 6

Niacin

Question 7

Treatment for atrial fibrillation.

Answer 7

Anticoagulation rate control cardioversion

Question 8

Treatment for ventricular fibrillation.

Answer 8

Immediate cardioversion

Question 9

Autoimmune complication occurring 2-4 weeks post-MI.

Answer 9

Dressler’s syndrome: fever pericarditis inc’d ESR

Question 10

IV drug use with JVD and holosystolic murmur at the left sternal border. Treatment?

Answer 10

Treat existing heart failure and replace the tricuspid valve

Question 11

Diagnostic test for hypertrophic cardiomyopathy.

Answer 11

Echocardiogram (showing thickened left ventricular wall and outflow obstruction)

Question 12

A fall in systolic BP of > 10 mmHg with inspiration.

Answer 12

Pulsus paradoxus (seen in cardiac tamponade)

Question 13

Classic ECG findings in pericarditis.

Answer 13

Low-voltage diffuse ST-segment elevation

Question 14

Definition of hypertension.

Answer 14

BP > 140/90 on three separate occasions two weeks apart

Question 15

Eight surgically correctable causes of hypertension.

Answer 15

Renal artery stenosis coarctation of the aorta pheochromocytoma Conn’s syndrome Cushing’s syndrome unilateral renal parenchymal disease hyperthyroidism hyperparathyroidism

Question 16

Evaluation of a pulsatile abdominal mass and bruit.

Answer 16

Abdominal ultrasound and CT

Question 17

Indications for surgical repair of abdominal aortic aneurysm.

Answer 17

> 5.5 cm rapidly enlarging symptomatic or ruptured

Question 18

Treatment for acute coronary syndrome.

Answer 18

Morphine O2 sublingual nitroglycerin ASA IV beta-blockers heparin

Question 19

What is the metabolic syndrome?

Answer 19

Abdominal obesity high triglycerides low HDL hypertension insulin resistance prothrombotic or proinflammatory states

Question 20

Appropriate diagnostic test? A 50-year-old male with angina can exercise to 85% of maximum predicted heart rate.

Answer 20

Exercise stress treadmill with ECG

Question 21

Appropriate diagnostic test? A 65-year-old woman with left bundle branch block and severe osteoarthritis has unstable angina.

Answer 21

Pharmacologic stress test (e.g. dobutamine echo)

Question 22

Signs of active ischemia during stress testing.

Answer 22

Angina ST-segment changes on ECG or dec’d BP

Question 23

ECG findings suggesting MI.

Answer 23

ST-segment elevation (depression means ischemia) flattened T waves and Q waves

Question 24

A young patient has angina at rest with ST-segment elevation. Cardiac enzymes are normal.

Answer 24

Prinzmetal’s angina

Question 25

Common symptoms associated with silent MIs.

Answer 25

CHF shock and altered mental status

Question 26

The diagnostic test for pulmonary embolism.

Answer 26

V/Q scan

Question 27

An agent that reverses the effects of heparin.

Answer 27

Protamine

Question 28

The coagulation parameter affected by warfarin.

Answer 28

PT

Question 29

A young patient with a family history of sudden death collapses and dies while exercising.

Answer 29

Hypertrophic cardiomyopathy

Question 30

Endocarditis prophylaxis regimens.

Answer 30

Oral surgerym amoxicillin; GI or GU proceduresampicillin and gentamicin before and amoxicillin after

Question 31

The 6 P's of ischemia due to peripheral vascular disease.

Answer 31

Pain pallor pulselessness paralysis paresthesia poikilothermia

Question 32

Virchow's triad.

Answer 32

Stasis hypercoagulability endothelial damage

Question 33

The most common cause of hypertension in young women.

Answer 33

OCPs

Question 34

The most common cause of hypertension in young men.

Answer 34

Excessive EtOH

Question 35

Stuck-on appearance.

Answer 35

Seborrheic keratosis

Question 36

Red plaques with silvery-white scales and sharp margins.

Answer 36

Psoriasis

Question 37

The most common type of skin cancer; the lesion is a pearly-colored papule with a translucent surface and telangiectasias.

Answer 37

Basal cell carcinoma

Question 38

Honey-crusted lesions.

Answer 38

Impetigo

Question 39

A febrile patient with a history of diabetes presents with a red swollen painful lower extremity.

Answer 39

Cellulitis

Question 40

+ Nikolsky's sign.

Answer 40

Pemphigus vulgaris

Question 41

- Nikolsky's sign.

Answer 41

Bullous pemphigoid

Question 42

A 55-year-old obese patient presents with dirty velvety patches on the back of the neck.

Answer 42

Acanthosis nigricans. Check fasting blood sugar to rule out diabetes

Question 43

Dermatomal distribution.

Answer 43

Varicella zoster

Question 44

Flat-topped papules.

Answer 44

Lichen planus

Question 45

Iris-like target lesions.

Answer 45

Erythema multiforme

Question 46

A lesion characteristically occurring in a linear pattern in areas where skin comes into contact with clothing or jewelry.

Answer 46

Contact dermatitis

Question 47

Presents with a herald patch Christmas-tree pattern.

Answer 47

Pityriasis rosea

Question 48

A 16-year-old presents with an annular patch of alopecia with broken-off stubby hairs.

Answer 48

Alopecia areata (autoimmune process)

Question 49

Pinkish scaling flat lesions on the chest and back. KOH prep has a spaghetti-and-meatballs appearance.

Answer 49

Pityriasis versicolor

Question 50

Four characteristics of a nevus suggestive of melanoma.

Answer 50

Asymmetry border irregularity color variation large diameter

Question 51

Premalignant lesion from sun exposure that can lead to squamous cell carcinoma.

Answer 51

Actinic keratosis

Question 52

Dewdrop on a rose petal.

Answer 52

Lesions of 1Á varicella

Question 53

Cradle cap.

Answer 53

Seborrheic dermatitis. Treat with antifungals

Question 54

Associated with Propionibacterium acnes and changes in androgen levels.

Answer 54

Acne vulgaris

Question 55

A painful recurrent vesicular eruption of mucocutaneous surfaces.

Answer 55

Herpes simplex

Question 56

Inflammation and epithelial thinning of the anogenital area predominantly in postmenopausal women.

Answer 56

Lichen sclerosus

Question 57

Exophytic nodules on the skin with varying degrees of scaling or ulceration; the second most common type of skin cancer.

Answer 57

Squamous cell carcinoma

Question 58

The most common cause of hypothyroidism.

Answer 58

Hashimoto's thyroiditis

Question 59

Lab findings in Hashimoto's thyroiditis.

Answer 59

High TSH low T4 antimicrosomal antibodies

Question 60

Exophthalmos pretibial myxedema and dec'd TSH.

Answer 60

Graves' disease

Question 61

The most common cause of Cushing's syndrome.

Answer 61

Iatrogenic steroid administration. The second most common cause is Cushing's disease

Question 62

A patient presents with signs of hypocalcemia high phosphorus and low PTH.

Answer 62

Hypoparathyroidism

Question 63

Stones bones groans psychiatric overtones.

Answer 63

Signs and symptoms of hypercalcemia

Question 64

A patient complains of headache weakness and polyuria; exam reveals hypertension and tetany. Labs reveals hypernatremia hypokalemia and metabolic alkalosis.

Answer 64

1Á hyperaldosteronism (due to Conn's syndrome or bilateral adrenal hyperplasia)

Question 65

A patient presents with tachycardia wild swings in BP headache diaphoresis altered mental status and a sense of panic.

Answer 65

Pheochromocytoma

Question 66

Should alpha- or beta-antagonists be used first in treating pheochromocytoma?

Answer 66

alpha-antagonists (phentolamine and phenoxybenzamine)

Question 67

A patient with a history of lithium use presents with copious amounts of dilute urine.

Answer 67

Nephrogenic diabetes insipidus (DI)

Question 68

Treatment of central DI.

Answer 68

Administration of DDAVP decreases serum osmolality and free water restriction

Question 69

A postoperative patient with significant pain presents with hyponatremia and normal volume status.

Answer 69

SIADH due to stress

Question 70

An antidiabetic agent associated with lactic acidosis.

Answer 70

Metformin

Question 71

A patient presents with weakness nausea vomiting weight loss and new skin pigmentation. Labs show hyponatremia and hyperkalemia. Treatment?

Answer 71

1Á adrenal insufficiency (Addison's disease). Treat with replacement glucocorticoids mineralocorticoids and IV fluids

Question 72

Goal hemoglobin A1c for a patient with DM.

Answer 72

< 7.0

Question 73

Treatment of DKA.

Answer 73

Fluids insulin and aggressive replacement of electrolytes (e.g. K+)

Question 74

Why are beta-blockers contraindicated in diabetics?

Answer 74

They can mask symptoms of hypoglycemia

Question 75

Bias introduced into a study when a clinician is aware of the patient's treatment type.

Answer 75

Observational bias

Question 76

Bias introduced when screening detects a disease earlier and thus lengthens the time from diagnosis to death.

Answer 76

Lead-time bias

Question 77

If you want to know if race affects infant mortality rate but most of the variation in infant mortality is predicted by socioeconomic status then socioeconomic status is a what?

Answer 77

Confounding variable

Question 78

The number of true positives divided by the number of patients with the disease is what?

Answer 78

Sensitivity

Question 79

Sensitive tests have few false negatives and are used to rule (in or out?) a disease.

Answer 79

Out

Question 80

PPD reactivity is used as a screening test because most people with TB (except those who are anergic) will have a +PPD. Highly sensitive or specific?

Answer 80

Highly sensitive for TB

Question 81

Chronic diseases such as SLEhigher prevalence or incidence?

Answer 81

Higher prevalence

Question 82

Epidemics such as influenzahigher prevalence or incidence?

Answer 82

Higher incidence

Question 83

Cross-sectional surveyincidence or prevalence?

Answer 83

Prevalence

Question 84

Cohort studyincidence or prevalence?

Answer 84

Incidence and prevalence

Question 85

Case-control studyincidence or prevalence?

Answer 85

Neither

Question 86

Describe a test that consistently gives identical results but the results are wrong.

Answer 86

High reliability low validity

Question 87

Difference between a cohort and a case-control study.

Answer 87

Cohort studies can be used to calculate relative risk (RR) incidence and/or odds ratio (OR). Case-control studies can be used to calculate an OR

Question 88

Attributable risk?

Answer 88

The incidence rate (IR) of a disease in exposed - the IR of a disease in unexposed

Question 89

Relative risk?

Answer 89

The IR of a disease in a population exposed to a particular factor … the IR of those not exposed

Question 90

Odds ratio?

Answer 90

The likelihood of a disease among individuals exposed to a risk factor compared to those who have not been exposed

Question 91

Number needed to treat?

Answer 91

1 / (rate in untreated group - rate in treated group)

Question 92

In which patients do you initiate colorectal cancer screening early?

Answer 92

Patients with IBD; those with familial adenomatous polyposis (FAP)/hereditary nonpolyposis colorectal cancer (HNPCC); and those who have first-degree relatives with adenomatous polyps (< 60 years of age) or colorectal cancer

Question 93

The most common cancer in men and the most common cause of death from cancer in men.

Answer 93

Prostate cancer is the most common cancer in men but lung cancer causes more deaths

Question 94

The percentage of cases within one SD of the mean? Two SDs? Three SDs?

Answer 94

68% 95.5% 99.7%

Question 95

Birth rate?

Answer 95

Number of live births per 1000 population

Question 96

Fertility rate?

Answer 96

Number of live births per 1000 women 15-44 years of age

Question 97

Mortality rate?

Answer 97

Number of deaths per 1000 population

Question 98

Neonatal mortality?

Answer 98

Number of deaths from birth to 28 days per 1000 live births

Question 99

Postnatal mortality?

Answer 99

Number of deaths from 28 days to one year per 1000 live births

Question 100

Infant mortality?

Answer 100

Number of deaths from birth to one year of age per 1000 live births (neonatal + postnatal mortality)