Things Rosh Humbled me on

Question 1

…..are the only medications that manage CHF diuresis in the presence of impaired renal function.

Answer 1

loop diuretics

Question 2

BP and HR in neurogenic shock

Answer 2

hypotension and bradycardia

Question 3

Asthma treatment

Answer 3

• mild int asthma = SABA PRN
• mild pers asthma = Low ICS
• Mod pers asthma = Low ICS + LABA or High ICS
• Severe = High ICS + LABA

Question 4

Normal ABG values

Answer 4

• PaCO2 - 35-45
• PaO2 - 80-95
• pH 7.35-7.45

Question 5

ABG in COPD exacerbation

Answer 5

compensatory respiratory acidosis (normal pH, borderline high/normal CO2, low pO2.)

Question 6

Hypovolemic shock treatment

Answer 6

1. NS or LR.
2. dopamine if SBP <90, dobutamine if >90.

Question 7

tx pericarditis

Answer 7

NSAIDS or colchicine

Question 8

pnuemonia + verrusous skin leasion is probs what diagnosis? how do you treat it

Answer 8

Blastomycosis, tx with amphotercin B. (from great lakes. moist because its a fungus). HIV patients MC.

Question 9

Trigger: bence jones protein

Answer 9

Multiple Myeloma. Causes Pathologic fractures = MC in rib, pelvis, femoral neck and vertebre.

Question 10

high serum protein and Rouleaux formation on smear suggests what

Answer 10

multiple myeloma

Question 11

blunting of the costophrenic angles or complete opacification of hemithorax on CXR suggests what

how would it present

Answer 11

plaural effusion.
would present with decreased chest expansion, breath sounds and tactile fremitus. also dullness to percussion.

Question 12

trigger: BCR-ABL1 gene

Answer 12

CML

Question 13

active TB tx

Answer 13

“RIPE” rifampin, isoniazid, pyrazinamide, ethambutol.

Question 14

Latent TB tx

Answer 14

Isoniazid for 9 months + pyridoxine
OR
rifampin alone for 4 motnhs

Question 15

MC valve abnormality in MI is …

Answer 15

Mitral regurg (“M” i for “mitral”)

Question 16

WPW EKG presentation

Answer 16

short PR and slurred upstroke of QRS (delta wave)

tx w procainamide

Question 17

Rheumatoid arthritic pleural effusions show what on pleural effusion testing

Answer 17

high protein, low glucose, low compliment level.

Question 18

MC SE of CCB

Answer 18

constipation

Question 19

Stable Ventricular Tachycardai tx

Answer 19

1. procainamide
2. amiodarone and lidocaine second line

Question 20

unstable VT tx

Answer 20

1. synchronized cardioversion.
2. amiodarone.

Question 21

pulseless VT tx

Answer 21

1. defibrillation + CPR. then follow cardiac rescusitation algorithm

Question 22

Acute (<48hrs) hyponatremia tx

Answer 22

3% hypotonic saline/10min

Question 23

Chronic (>48hrs) hyponatremia tx

Answer 23

3% hypotonic saline over 24 hrs.

Question 24

DVT w kidney failure treatment

Answer 24

Unfrac heparin bridged to warfarin.

Question 25

if on warfarin, avoid what foods

Answer 25

leafy green veggies

Question 26

chronic purulent sputum prod. High resolution CT scan with tram tracks.

Answer 26

bronchiectasis tx w abx based on culture, chest physiotherapy and bronchodilators

Question 27

Hypertensive urgency tx

Answer 27

clonidine or captopril

Question 28

hypertensive emergency tx

Answer 28

nicardipine aor labetelol.

Question 29

MC underlying cause for torsades de pointes.

Answer 29

Prolonged QT interval

Question 30

MVP can cause what as a complications

Answer 30

MR

Question 31

anti-histidyl-transfer RNA synthetase antidodies are seen when

Answer 31

polymyositis

Question 32

greatest immediate risk reduction for abdominal aortic aneurysm.

Answer 32

smoking cessation

Question 33

DM diagnostic criteria

Answer 33

1. DM symptoms + random BG >200 2. fasting BG >125 3. BG>200 2 hours after 75g glucose load 4. HbA1C>6.5 any of these 2 times

Question 34

gout treatment

Answer 34

Indomethacin (NSAID), colchicine, glucocorticoids. allopurinol for PREVENTION

Question 35

treatment of bells palsy

Answer 35

glucocorticoids. add antiviral if vesicles present in ear or if super severe.

Question 36

reactive arthritis presentation

Answer 36

swelling, warm, painful joint several weeks after infection.

Question 37

septic arthritis presentation

Answer 37

fever and chills with swelling/pain in joint. synovial fluid will show 50-150k WBCs and have a positive culture.

Question 38

how to diagnose PE in person w renal fialure

Answer 38

ventilation perfusion scan

Question 39

Cor pulmonale can result in what valvular disorder

Answer 39

tricuspid regurgitation

Question 40

HFE gene =

Answer 40

hereditary hemachromatosis

Question 41

atrophy of caudate nucleus and putamen is seen with...

Answer 41

huntingtons

Question 42

lewy bodies in substantia nigra is seen with..

Answer 42

parkinsons

Question 43

how do labs appear in anemia of chronic disease.

Answer 43

High ferritin + normal MCV + low hbg

Question 44

EKG reading w 3 different P wave morhpologies is called ........ and is usually seen in COPD exacerbation and other hypoxic states

Answer 44

multifocal atrial tachycardia

Question 45

Hypercalcemia >14 tx

Answer 45

IV saline FIRST, then IV bisphosphonates and calcitonins

Question 46

how do you diagnose PAD

Answer 46

ankle brachial index

Question 47

Epididymitis with bacterial growth on blue agar

Answer 47

E. coli

Question 48

patient has CHICKENS. lives in Missouri or ohio. farming. with pneumonia now.

Answer 48

histoplasmosis

Question 49

increased JVP, peripheral edema, ascites, hepatomegaly. AND accenuation of the pulmonic component of S2

Answer 49

pulmonary hypertension

Question 50

dx of septic shock

Answer 50

sepsis + Lactate >2 despite fluid rescusitation

Question 51

gross hematuria 1-2 days after upper respiratory infectin.

Answer 51

IgA nephropathy

Question 52

acute interstitial nephritis can be caused by....

Answer 52

drugs, like NSAIDS!!!

Question 53

MC area for acute arterial occlusion

Answer 53

COMMON femoral artery. becuase its most COMMON its the COMMON femoral artery

Question 54

what drug is used to provoke vasospasms for prinzmetal angina in coronary angiography

Answer 54

argovine

Question 55

what drug is used to produce bronchospasm

Answer 55

methacoline

Question 56

Treatment of hypoglycemia

Answer 56

give fast acting oral carbs UNLESS unconcious or unable to ingest food! then use dextrose or glucagon

Question 57

pleural criteria that is TRANSUDATIVE

Answer 57

LOW pleural serum protein and LDH and LOW plerual fluid LDH caused by HF, PE, nephrotic syndrome or cirrhosis

Question 58

anal fistulas, perirectal abscesses, anal ulcers all are commonly caused by....

Answer 58

chrons disease

Question 59

opening Snap

Answer 59

mitral Stenosis

Question 60

presents with linear erythematous induration that is palpable and tender to palpation.

Answer 60

superficial thrombophlebitis dx w venous duplex, tx w NSAIDS

Question 61

MC SE of metformin

Answer 61

GI upset (diarrhea and nuasea)

Question 62

first line tx for hemroidectomy

Answer 62

ubber band ligation UNLESS the patient is on anticoags (sclerotherapy indicated) or if hemorroids have accutely thrombosed (excision indicated)

Question 63

Acute diverticulitis dx

Answer 63

CT abdomen

Question 64

Carcinoid syndrome

Answer 64

flushing wheezing diarrhea sweating hypotension

Question 65

when is carotid endartectomy indicated

Answer 65

if patient is symptomatic OR stenosis is >70%

Question 66

if TIA is suspected and CT is normal what isthe next step

Answer 66

get diffusion MRI

Question 67

Prinzmetal Angina tx

Answer 67

CCB, nitrates or ACEI DO NOT USE BB

Question 68

Pulsatile liver, Large pulsatile neck veins + heart failure s/s

Answer 68

tricuspid regurg. Everythings TRYing to REGURGITATE the fluids. (idk bear w me ok)

Question 69

lyme disease vector

Answer 69

Ixodes scapularis = deer tick

Question 70

PREVENTION of cluster headaches

Answer 70

short term steroid and CCB (tx of current is 100% o2 on nonrebreather)

Question 71

change in skin color, varicose veins, ulcers all on lower extremities

Answer 71

chronic venous insufficiency tx = compression socks and elevation

Question 72

CREST is the pneumonic for what diagnosis?

Answer 72

scleroderma! Calcinosis Cutis Raynauds esophagyl dysmotility Sclerodactyly Telangiectasia

Question 73

anticentromere antibody

Answer 73

scleroderma

Question 74

what flu treatment is used with pregnancy

Answer 74

oseltamivir (tamiflu)

Question 75

which hepatitis infections present with a lacey reticular rash (livedo reticularis)

Answer 75

Hep B and C

Question 76

1st line treatment for ascites

Answer 76

loop diuretics (furosemide) and salt restriction

Question 77

tx for hyperkalemia.

Answer 77

1. calcium gluconate or calcium chloride 2. insulin, albuterol, sodium bicarb 3. loops

Question 78

orthostatic hypotension definitions

Answer 78

fall in systolic >20 or diastolic >10 within 2-5 minutes of quiet standing after 5 minutes of supine rest.

Question 79

Tx of acute myocarditis

Answer 79

furosemide for fluid overload ACEI for cardiac remodeling BB if EF<40%

Question 80

harsh systolic murmur radiating to carotids

Answer 80

aortic stenosis

Question 81

what is the MC risk factor for Aortic dissection

Answer 81

Hypertension