Symptoms

Question 1

Fatigue that is loner than ____ months and fluctuates in severity is usually functional and the patient may have identifiable stressors

Answer 1

6 months

Question 2

Fatigue associated w/ psychiatric causes is frequently worse when? and alleviated by what?

Answer 2

worse in the morning and may be alleviated by activity

Question 3

Who is physiologic fatigue common in

Answer 3

mothers of newborns
shift workers
athletes who overtrain

Question 4

when is fatigue worsened w/ organic dz?

Answer 4

with activity

Question 5

Darkening of the skin + fatigue points to what?

Answer 5

Addison’s

Question 6

pale appearance + fatigue points to what?

Answer 6

anemia

Question 7

Diagnosis with persistent or relapsing fatigue not previously present

Answer 7

chronic fatigue syndrome

Question 8

Lab tests for fatigue with no obviously PE finding

Answer 8

CBC, ESR< comprehensive metabolic profile, UA< thyroid, pregnancy testing, HIV (if suspected) 
creatinine kinase (if muscle weakness)

Question 9

A nonanemic patient with low serum ferritin can receive what to help relieve symptoms of fatigue?

Answer 9

Iron

Question 10

what is considered a fever?

Answer 10

temp above 38.3ºC (101 F)

Question 11

when are fevers typically the highest?

Answer 11

evening

Question 12

when are fevers typically the lowest?

Answer 12

morning

Question 13

antipyretic meds supress what?

Answer 13

prostaglandin formation

Question 14

why do many patients with fever experience myalgia

Answer 14

hypothalamus increases muscle tone to generate heat and raise body temperature

Question 15

what fevers can produce convulsions

Answer 15

104-106 F

Question 16

what conditions can cause reucrrent or intermittent fever?

Answer 16

malaria
hepatitis B
leptospirosis
brucellosis
disseminated fungal infections

Question 17

a cyclic pattern of high fevers for 1-2 weeks alternating with afebrile periods are pathognomonic for what?

Answer 17

PelEbstein fever ogf Hodgkin’s disease

Question 18

Fevers persisting for 3 weeks, exceeding temp of 101 F and eluding 1 week of intensive diagnostic study

Answer 18

fever of unknown origin (FUO)

Question 19

Fever plus petechial eruptions on teh skin can suggest what?

Answer 19

meningococcemia or Rockyu Mountain supotted fever

Question 20

Petechiae at the juntion of the hard and soft palate and fever occur w/ what

Answer 20

mononucleosis

Question 21

Splinter hemorrhages and conjunctival petechiae suggest what?

Answer 21

endocarditis

Question 22

what is an important sign of Lyme disease?

Answer 22

erythema chronicum migrans

Question 23

common causes of increased metabolic rate

Answer 23

chronic infection
hyperthyroidism
excessive exercise
malignancy

Question 24

what is unintended weight loss

Answer 24

> 5% in 1 month

>10% in 6 months

Question 25

what test measures the absorptive capacity of the proximal small intestine [19] and is used to determine whether defects in the intestinal epithelium are responsible for malabsorption.

Answer 25

D-xylose test

Question 26

what is the leading cause of unexplained weight loss

Answer 26

major depression (especially in elderly)

Question 27

what is the prototypical occult neoplasm associated w/ dramatic weight loss?

Answer 27

carcinoma of the pancreas

Question 28

sudden, transient loss of consciousness and postural tone followed by spontaneous recovery

Answer 28

syncope

Question 29

sensation of impending syncope w/o loss of consciousness

Answer 29

presyncope

Question 30

what type of syncope is always sudden in onset w/ little prodrome

Answer 30

cardiac

Question 31

most common cause of syncope. have a prodrome of weakness, light-headedness, diaphoresis and nausea

Answer 31

vasovagal

Question 32

reflux (neurally-mediated) syncope that occurs during or immediately after provocative stimuli such as coughing, swallowing, warm places, pain, urinating

Answer 32

situational syncope

Question 33

what is orthostatic hypotension

Answer 33

decrease in systolic BP of >20 mmHg and in diastolic BP >10 within three minutes of standing

Question 34

type of vertigo due to abnormalitites in the vestibular end organs

Answer 34

peripheral vertigo

Question 35

vertigo due to the abnormalitites in the central nervous system

Answer 35

central

Question 36

most common type of peripheral vertigo

Answer 36

BPPV

Question 37

what type vertigo is usually sudden w/ onset and severity and only lasts for a few minutes

Answer 37

peripheral

Question 38

what type vertigo is more gradual in onset with mild intesntiy but can be chronic

Answer 38

central vertigo

Question 39

type of vertigo that starts w/ movement

Answer 39

peripheral

Question 40

what test is used to illict BPPV

Answer 40

Dix-Hallpike

Question 41

what is a positive test w/ the Dix Halpike test?

Answer 41

patient will report vertigo and exhibition a mixed torsional and vertical nystamgus w/ upper pole of eye beating toward the affected ear

Question 42

what manuever is done to treat BPPV

Answer 42

Epley manuver

Question 43

what type ulcer is formed because of high acid

Answer 43

duodenal

Question 44

when does pain occur w/ a duodenal ulcer?

Answer 44

2-3 hours after a meal

Question 45

what relieves pain w/ a duodenal ulcer?

Answer 45

food

Question 46

what may aggreavate a gastric ulcer

Answer 46

food

Question 47

main way to see peptic ulcers

Answer 47

radiographic studies- barium swallow and endoscopy

Question 48

How can GERD be documented

Answer 48

esophageal mamometry and pH monitoring

Question 49

tx for H pyloria

Answer 49

pepto bismol, PPI and tetracycline for 2 weeks