Things I need to know better...day 3

Question 1

History of cervical spine issues + trauma –> bilateral arm weakness. What happened?

Answer 1

Central cord syndrome (decussating lateral spinothalamic tracts obstructed)

Question 2

How is impetigo treated?

Answer 2

Topical antibiotic…like mupirocin

Question 3

Patient has pain and swelling over coccyx. What is likely going on?

Answer 3

Pilonidal disease

Question 4

What is seen on MRI with MS?

Answer 4

Multiple, bilateral, and asymmetric hyperintensive lesions in the periventricular white matter

Question 5

What is enthesitis? What is associated with it?

Answer 5

Enthesitis is inflammation/tenderness of tendon/bone junctions

HLA-B27 arthropathies…like ankylosing spondylitis

Question 6

Patient presentation makes you go “Tay-Sachs”…then it says hepatosplenomegaly. Now what do you think?

Answer 6

Niemann-Pick disease (sphingomyelinase deficiency)

Question 7

What is chronic HBV treated with?

Answer 7

Tenofovir

Question 8

A study loses a lot of its participants. What kind of bias is this?

Answer 8

Attrition bias…a form of selection bias

Question 9

What drug that is used to treat benign essential tremors can cause colicky abdominal pain, confusion, headaches, hallucinations, and dizziness?

Answer 9

Primidone

Question 10

Youngish patient has recurrent hematuria 4 days after a URI starts. What is going on?

Answer 10

IgA nephropathy

Post-infectious GN starts 10-21 days after infection…usually in kids

Question 11

What causes Graft Versus Host Disease?

Answer 11

Donor T lymphocytes

Question 12

Patient had right-sided weakness and is now comatose…exam finds a constricted, non-reactive right pupil and decreased right-sided reflexes. What is going on?

Answer 12

Left basal ganglia hemorrhage

Question 13

What is seen on funduscopy of diabetic retinopathy?

Answer 13

Microaneurysms
Dot and blot hemorrhages
Hard exudates
Macular edema

Question 14

Patient has history of rheumatic fever and has mitral stenosis. What should be done?

Answer 14

Penicillin G every 4 weeks

Question 15

Young kid has conjunctivitis, oral mucosa (or mouth) changes, and cervical lymphadenopathy. What is going on?

Answer 15

Kawasaki…palm/sole desquamation is a late finding

Question 16

What can be used to treat syphilis in penicillin allergic patients?

Answer 16

Doxycycline

Question 17

What can aid in the passing of a kidney stone?

Answer 17

Fluids
Analgesics
Alpha-blocker (tamsulosin)

Question 18

Person has step-wise dementia and cerebral symptoms. What is going on?

Answer 18

Vascular dementia

Question 19

What can make it so potassium won’t replenish despite supplementation?

Answer 19

Hypomagnesemia

Question 20

A person is found after traveling and doesn’t know who they are, where they are, or what they are doing. What is going on?

Answer 20

Dissociative fugue

Question 21

Person has chronic fatty stools…later has bleeding issues. What is going on?

Answer 21

Vitamin K deficiency –> II, VII, IX, X, C, and S defciency

Question 22

Malnutrition + angular cheilosis, stomatitis, glossitis, normocytic anemia, and seborrheic keratitis. What is deficient?

Answer 22

B2…riboflavin

Question 23

How is dermatitis herpetiformis treated?

Answer 23

Dapsone

Question 24

Patient has GBS based off of clinical presentation. What should be done next?

Answer 24

PFTs

Question 25

What can maternal hyperglycemia in the first trimester cause?

Answer 25

Congenital heart defects Neural tube defects Small left colon syndrome Spontaneous abortion

Question 26

What can maternal hyperglycemia in the 2nd/3rd trimester cause?

Answer 26

Increased metabolic demand --> hypoxia Organomegaly Macrosomia Neonatal hypoglycemia

Question 27

A patient is going to be intubated. What should be checked BEFORE giving succinylcholine?

Answer 27

Potassium...hyperkalemia contraindicates succinylcholine use

Question 28

How is sinus bradycardia treated?

Answer 28

Atropine

Question 29

Postpartum woman has fever, uterine tenderness, foul-smelling lochia (vaginal discharge after birth), and leukocytosis. Labor was complicated by use of forceps. What is likely going on?

Answer 29

Endometritis...polymicrobial infection treated with clindamycin and gentamicin (aminoglycoside)

Question 30

A croup patient is not doing well...so you think intubation might be in order. What should be tried first?

Answer 30

Racemic epinephrine

Question 31

How often should UC patients have a colonoscopy?

Answer 31

Every year

Question 32

Patient has recurrent dark urine with RUQ pain. Labs show increased bilirubin, decreased Hgb, and decreased haptoglbin. US shows hepatic vein thrombosis. What is going on?

Answer 32

Paroxysmal Nocturnal Hemoglobinuria

Question 33

How is long-QT treated?

Answer 33

Beta-blocker and a pacemaker

Question 34

What is diagnostic of neonatal polycythemia?

Answer 34

Hct > 65% Causes respiratory distress

Question 35

Severe dizziness + cannot walk + stabbing pain on right side of face + can't sit w/o restraints + constricted, nonreactive right pupil + horizontal and rotational nystagmus + diminished gag reflex + diminished pain and sensation to right face and left trunk/limbs. What is going on?

Answer 35

Wallenberg syndrome...lateral medulla infarct...diagnosed via MRI