Set 2

Question 1

Descending paralysis

Answer 1

C. botulinum

Question 2

Transfusion reaction ABO mismatch vs. IgA deficiency

Answer 2

IgA deficiency happens in SECONDS-MINUTES

ABO takes longer to develop but can result in hemolysis, shock, DIC and ARF

Question 3

SIADH diagnostic criteria (2)

Answer 3

plasma osm 150 (100-150)

Question 4

Screening age for DM if no RF, cutoffs (4)?

Answer 4

45yo
A1c >6.5
Fasting BG >125
Random BG >200 + sx
OGTT >200 (75g at 2 hrs)

Question 5

radial-side wrist pain worsened by thumb movement

Answer 5

DeQeurvain’s tenosynovitis (common postpartum)

Question 6

partially acid fast gram + branching rods, Tx

Answer 6

Nocardia, Bactrim

Question 7

“SNAP” for atypical gram + bugs (2)

Answer 7

Sulfa for Nocarida, Actinomyces use Penecillin

Question 8

Tx diabetic nephrophathy

Answer 8

Improve BP control! also gabapentin

Question 9

Bilateral hilar and paratracheal adenopathy with reticualr opacities/infiltrates

Answer 9

Sarcoidosis

Question 10

MCC organism associated with Reiter’s Syndrome (reactive arthritis)?

Answer 10

Chlamydia

Question 11

muddy brown casts

Answer 11

ATN!! (they are renal epithelial cells)

Question 12

statistics test to compare means? proportions?

Answer 12

2 means –> T-test “T for 2”
3 means –> ANOVA (3 syllables)
Proportions –> Chi-squared

Question 13

Tx TCA overdose?

Answer 13

sodium bicarbonate –> improves SBP, narrows the QRS and decreases ventricular arrhythmias

Question 14

3 causes of post-cholecystectomy pain?

Answer 14

Functional
Spincter of Odi dysfxn
CBD stone
If alk phos elevated / biliary tree dilation –> ERCP to distinguish 2 and 3

Question 15

3 RF for osteosarcoma

Answer 15

Chemo, radiation, Paget’s disease

Question 16

Hazard Ratio

Answer 16

Experimental/control relative occurance of outcome
higher in CONTROL group
>1 –> higher in EXPERIMENTAL group

Question 17

4 criteria to dx brain death

Answer 17

absent CNS reflexes
fixed,dilated pupils
no spontaneous respiration
2 physicians MUST agree

Question 18

Painful bullae and necrosis on breasts, butt, thighs abd

Answer 18

Warfarin-induced skin necrosis

Question 19

Pathogenesis warfarin-induced skin necrosis, Tx?

Answer 19

Protein C deficiency –> Tx vitamin K and switch to heparin

Question 20

Ca, Phos, PTH levels in 2ndary hyperPTH

Answer 20

increased Phosphrous and PTH

decreased calcium

Question 21

Sinusitis in a diabetic

Answer 21

Mucormycosis (rhizopus)

Question 22

p-ANCA and HLA-B27 (2)

Answer 22

either ankylosing sponylitis or ulcerative colitis

Question 23

2 MI complications wks–>months later

Answer 23

Ventricular aneurysm (CHF, MR and persistent ST elevations) or Dressler’s snydrome (fibrinous pericarditis)

Question 24

Asymptomatic pulmonary nodule, must consider?

Answer 24

histoplasmosis (MS, OH central america)

Question 25

3 test w/u of galactorrhea

Answer 25

Pregnancy test, TSH and PRL

Question 26

2 conditions ass. with cystic hygromas

Answer 26

Turners and Downs

Question 27

Etiology and pathogenesis of osteitis fibrosis cystica

Answer 27

hyperPTH from replacement of normal bone architecture with fibrous tissue (brown tumors)

Question 28

HIV patient with bloody diarrhea, suspect...

Answer 28

CMV colitis, tx ganciclovir

Question 29

Tx rosacea

Answer 29

topical metronidazole

Question 30

NNT equation

Answer 30

``` NNT = 1/ARR ARR = incidence in control - incidence in experimental group ```

Question 31

normal pleural pH? what does a low pH imply?

Answer 31

7.6 = normal 7.35 = transudate <7.2 = requires chest tube to prevent empyema formation

Question 32

Vertigo, vomiting, occipital HA and HTN?

Answer 32

cerebellar hemorrhage

Question 33

Tx fibromyalgia

Answer 33

TCAs and exercise

Question 34

HTN <20wks gestation (2)

Answer 34

chronic HTN or hydatiform mole

Question 35

increased WBCs with bands and segs, increased platelets, decreased RBCs

Answer 35

chronic MYELOGENOUS leukemia = increased MATURE granulocytes

Question 36

Tx SVT

Answer 36

``` unstable = DC cardiovert stable = try carotic massage/vagal maneuvers, if fails then adenosine (blocks AV node) ```

Question 37

kid with short stature, pancytopenia, cafe au lait spots, thumb abnormalities

Answer 37

Fanconi's anemia (Fanconi's has Fucked up thumbs)

Question 38

Tx hepatic encephalopathy

Answer 38

Lactulose (acidifies colon to decr. ammonia) neomycin/rifaximin (decr. ammonia producing bacteria) Laxative

Question 39

depigmentation

Answer 39

ALWAYS consider vitiligo, AI destruction of melanocytes

Question 40

MC site of HTN hemorrhage

Answer 40

Putamen +/- internal capsule

Question 41

Aspirin use causing nasal blockage and SOB/wheezing? Tx?

Answer 41

ASA sensitivity syndrome = pseudoallergic rxn causing bronchoconstriction and nasal polyps Tx leukotriene receptor antagonists (--lukast or zileuton).

Question 42

Risk of treating Hodgkn's Lymphoma with chemoradation

Answer 42

development of secondary malignancies (Lung or BCA) ~20 yrs later

Question 43

Pathogenesis and Tx of scleroderma?

Answer 43

Connective Tissue thickening (myelofibroblasts and collagen) --> in kidneys, cause HTN in lungs, cause pulmonary arterial HTN and RIGHT heart failure GI, cause eosphageal and gastric dysmotility / GERD

Question 44

FEV1 <85%

Answer 44

Restrictive lung disease (pulmonar fibrosis)

Question 45

Dx malignant HTN

Answer 45

>180/120 AND evidence of end-organ damage (retinal hemorrhage, exudate, papilledema)

Question 46

Immune response induced by toxin vaccines

Answer 46

T-cell dependent B-cell response

Question 47

NT derrangements in Parkinson's

Answer 47

decreased DA | increased ACh

Question 48

Tx WPW in setting of Afib?

Answer 48

cardioversion or procainamide (NOT AV nodal blockers like normal tx)

Question 49

Tx Tourette's

Answer 49

TYPICAL antipsychotics = pimozide, fluphenazine or haldol

Question 50

Projection psychological response

Answer 50

projecting YOUR unacceptable thoughts/behaviors on others (cheater accuses his wife of cheating)