Set 1

Question 1

Tx RLS

Answer 1

DA agonist (pramipexole, ropinerole) or Levadopa

Question 2

DDx low calcium AND low phopshate (3)

Answer 2

Vit D deficiency, malabsorption, pancreatitis

Question 3

3 causes HIV retinitis, differences

Answer 3

CMV= painLESS, no conjunctivitis or keratitis
HSV/VZV= retinal necrosis, pain, keratitis/uveitis

Question 4

skin AND organ lesions with hemorrhage in HIV patient? Dx, Tx?

Answer 4

Bacillary angiomatosis (Bartonella)
Dx careful bx
Tx oral erythromycin

Question 5

Screening and Confirmation of acute cholycystitis

Answer 5

screening = US, labs
confirm = ERCP/HIDA

Question 6

Causes of Erythema Nodosum (6)

Answer 6

Infxn = strep, TB, histoplasmosis

systemic d/s= sarcoidosis, IBD, Behcet’s

Question 7

Oral ulcers, genital ulcers AND uveitis

Answer 7

Behcet’s vasculitis (+ erythema nodosum and other SYSTEMIC sx)

Question 8

atypical lymphocytes but NEGATIVE heterophile antibody test

Answer 8

CMV monoucleosis

Question 9

Infertility, recurrent URI/sinusitis +/- situs inversus

Answer 9

Kartagener’s Syndrome (immotile cilia 2/2 dynein arm defect)

Question 10

ABRUPT fever with AMS and + babinski? Dx, Tx?

Answer 10

HSV encephalitis (temporal lobes)
FIRST start IV acyclovir if high suspicion
THEN dx with CSF PCR (not cx)

Question 11

Northeastern tick-borne disease with fever AND hemolytic anemia? Tx?

Answer 11

Babesiosis, Tx quinine

Question 12

hemoptysis and normal CXR in young, non-smoker? MCC?

Answer 12

Acute bronchitis. MCC viral > bacterial
IF bacterial:
non-smokers = MYCOPLASMA
smokers = pneumococcus or H. influ

Question 13

Anti-smooth muscle Ab’s

Answer 13

Mother F-ing AI Hepatitis

Question 14

If COPD patient is hypercapnic after initiating tx for acute exacerbation, tx?

Answer 14

NIPPV if ~stable, otherwise intubate

Question 15

Tx hyperkalemia

Answer 15

1. Calcium gluconate (stabilizes membranes)
2. Insulin AND glucose (drive K+ intracellularly)
3. Na polysterene sulfonate (kayexalate)

Question 16

Electrolyte disturbance caused by multiple blood transfusions

Answer 16

hypocalcemia (ionized) 2/2 binding with citrate

Question 17

External validity

Answer 17

Generalizability (to other studies/populations)

Question 18

Nausea, dizziness, HA, polycythemia

Answer 18

HIGH suspicion of CO poisoning

Question 19

complication of cardiac catheterization? S/s?

Answer 19

cholesterol emboli (any organ, BLUE TOE syndrome, livedo reticularis*)
labs = eosinophils, decreased complement levels

Question 20

patient with acute exacerbation of COPD develops AMS or seizures? Tx?

Answer 20

hypercapnia / CO2 narcosis; can be induced by TOO MUCH O2 (decreases body endogenous response to hypoxia, decreased affinity of Hb for O2 in acute-on-chronic COPD).
Tx = O2 sat b/w 90-94%

Question 21

malacia

Answer 21

softening of tissues

Question 22

4 causes of osteomalacia

Answer 22

Vit D def, Ca2+ def, hypophosphatemia/hyperPTH, RTA

Question 23

non-resolving pneumonia with hyponatremia and GI symptoms? Dx, Tx?

Answer 23

Legionella (+/- elevated LFTs)
Dx = urine antigen test + cx
Tx = fluoroquinolone or macrolide

Question 24

fluoroquinolones

Answer 24

clindamycin, ofloxacin, gatifloxacin

Question 25

Macrolides

Answer 25

erythromycin, azithromycin, clarithromycin

Question 26

doughy, sweaty hands, carpel tunnel syndrome, HTN, skin tags? Dx, Tx?

Answer 26

Acromegaly 2/2 elevated GH --> IGF-1 screening = IGF-1 (indirect GH measure) Dx = GH after ORAL GLUCOSE LOAD + MRI Tx= pituitary tumor removal +/- octreotide

Question 27

abnormally enlarged uterus 3mo post-partum with lung sx / findings on CXR? Dx?

Answer 27

choriocarcinoma (either after normal or molar preg) | dx = quantitative BhCG and imaging?

Question 28

#1 RF for stroke

Answer 28

HTN >> smoking or DM

Question 29

2 conditions associated with episcleritis

Answer 29

RA and IBD

Question 30

anti-topoisomerase Ab's

Answer 30

AKA anti-scl 70 = Scleroderma

Question 31

post-gastrectomy complication? Tx?

Answer 31

dumping syndrome. Tx diet mod +/- octreotide

Question 32

SE of primidone

Answer 32

acute intermittent porphyria (abd pain, neuro and psych sx) | check urine porphobilinogen

Question 33

5 causes post-op fever / timeline

Answer 33

``` wind (atalectasis, pneumonia) 1-2d water (UTI) 3-5d wound (infxn) 4-7d walking (DVT/PE) 7-10d wonder drug >7d ```

Question 34

transplant patient prophylaxis (4)

Answer 34

bactrim for PCP, toxo, UTI, pneumo | Flu, pneumococcus, hep B

Question 35

Middle mediastinal mass DDx (6)

Answer 35

bronchogenic cyst, pericardial cyst, tracheal tumor, lymphoma, lymph node, aortic arch aneurysm

Question 36

Early tx of influenza A vs B

Answer 36

infl A = rimantadine or amantadine | infl B = zanamivir, oseltamivir

Question 37

Amylodisis manifestations of affected organs (5)

Answer 37

``` heart = restrictive cardiomyopathy / arrhythmias kidney = nephrotic syndrome GI = hepatomegaly, malabsorption/dysmotility musculoskeletal = pseudohypertrophy CNS = peripheral and/or autonomic neuropathy ```

Question 38

Only Tx for ALS

Answer 38

Riluzole (Glutamate inhibitor) prolongs survival

Question 39

Polyarthritis, tenosynovitis and rash

Answer 39

Gonoccocal septic arthritis

Question 40

abdominal rose-spots, fever, HA and diarrhea

Answer 40

Typhoid fever --> can remain latent in gallbladder, "carrier state"

Question 41

Broad, waxy casts in urine

Answer 41

chronic renal failure

Question 42

antimitochondrial Ab

Answer 42

Primary biliary cirrhosis

Question 43

galactorrhea and amenorrhea? how does it present in males? Tx?

Answer 43

Prolactinoma; hypogonadism in males. | Tx DA agonists (cabergoline > bromocriptine), +/- surgery +/- radiotherapy

Question 44

Tx lead poisoning

Answer 44

low levels = retest to confirm moderate levels = succimer high levels = EDTA and succimer VERY high levels = IM dimercaprol and IV EDTA

Question 45

MCC HIV esophagitis? 2 ddx? Dx/Tx

Answer 45

MCC candida, tx fluconazole. | no resolution 3-5d, EGD + cytology to look for HSV (acyclovir) or CMV (ganciclovir)

Question 46

Cushing syndrome vs disease

Answer 46

``` Syndrome = silly (adrenals/ectopic) Disease = dire (CNS ACTH pituitary adenoma) ```

Question 47

Electrolytes in cushing SYNDROME, tx

Answer 47

hyperglycemia and natremia hypokalemia Tx = spironolactone (aldosterone antagonist)

Question 48

Hashimoto's Ab's and HLA type

Answer 48

anti-TPO>>anti-thyroglobulin Ab | HLA-DR5

Question 49

Fatty casts

Answer 49

Nephrotic syndrome

Question 50

oral/facial abscesse w/ yellow drainge from sinus tracts (gram + bacteria)? Tx?

Answer 50

Actinomyces israelii | Tx penicillin 6-12wks