UW 8

Question 1

Chondroma

Answer 1

Benign cartilaginous tumor

MC location - hands and feet

Question 2

Do reactive nasal polyps cause bony erosions

Answer 2

Not commonly

Question 3

Crescendo-Decrescendo murmur heart at left sternal border without carotid radiation

Answer 3

HOCM = Interventricular septal hypertrophy

Question 4

Diff b/t HOCM and AS murmur

Answer 4

AS radiates to carotid
AS is right second IC space
HOCM does NOT radiate to carotid
HOCM Is at left sternal border

Question 5

Lung Abscess v Empyema

Answer 5

Lung Abscess - discrete abscess cavity typically seen on CXR

Empyema - Loculated, abnormally contoured effusion w adjacent pulmonary consolidation

Question 6

MCC Empyema

Answer 6

Bacterial seeding of parapneumonic effusion in w bacterial pneumonia

Question 7

Erythema toxic neonatorum Presentation

TX

Answer 7

Asymptomatic 
Blotchy
Erythematous papules and pustules 
Spares palm and soles
TX: Resolves w/in 2 weeks after birth

Question 8

Nephrotic syndrome ass’d with lymphoma

Answer 8

Minimal Change

Question 9

Nephrotic syndrome ass’d with Hep B

Answer 9

Membranous

MembranoProliferative

Question 10

Nephrotic syndrome ass’d with Adenocarcinoma of lung and breast

Answer 10

Membranous

Question 11

EKG of Ventricular Aneurysm

Answer 11

Persistent ST elevation after recent MI

Deep Q waves in same leads

Question 12

EKG of Pericardial Effusion

Answer 12

Low voltage QRS complexes

Electrical alternans = large effusions

Question 13

CT of Alzheimer’s

Answer 13

Cortical and subcortical Atrophy
Temporal and Parietal Lobes
Enlargement of Lateral Ventricles

Question 14

Presentation of posterior urethral injury

Answer 14

Blood at urethral meatus
Inability to void
High-riding prostate on DRE

Question 15

Assn’s with posterior urethral injury

Answer 15

Perineal or scrotal hematoma

Pelvic Fracture

Question 16

Why are beta blockers used in HOCM

Answer 16

Slow the heart and prolong diastole which leads to more time for heart to fill and lessen outflow obstruction

Question 17

What maneuver makes HOCM worse

Answer 17

Those that decrease preload since smaller ventricular volumes lead to higher degrees of obstruction

Question 18

What sound is a harsh shrill

Answer 18

Stridor

Question 19

MCC of Epiglottis (2)

Answer 19

Hib

Strep pyogenes

Question 20

TX for MALT

Answer 20

1. H.pylori tx - if ineffective ->

2. CHOP

Question 21

What is CHOP

Answer 21

Cyclophosphamide
Adriamycin
Vincristine
Prednisone

Question 22

When do we NOT treat HTN

Answer 22

Immediately after ischemic stroke IF Less than 220/120
OR
If pt has CAD
in order to maintain cerebral perfusion

Question 23

Drugs that cause depression

Answer 23

Methyldopa
a-IFN (tx for viral hep)
Haloperidol - 1st G APs
Sedatives: Alcohol, benzos, barbs
Stimulant Withdrawl
Anti-emetics - metoclopromide, prochlorperazine
Glucocorticoids - can cause mania, insomnia

Question 24

Diff bt MDD with psychotic features and Schizoaffective

Answer 24

MDD w psychotic features - Mood disorder always present - psychosis develops, may come and go. Never have psychosis w/out mood disorder

Schizoaffective - Psychosis is always present, mood disorder comes and goes. Never have mood disorder w/out psychosis

Question 25

TX for Serotonin Syndrome

Answer 25

1. Withdraw offending agent 2. Supportive Care 3. Agitation despite benzo's = Cyproheptadine = Serotonin Antagonist

Question 26

Do we use phenytoin for TCA OD seizures? Reasoning?

Answer 26

No. Ineffective for toxin induced seizures Use benzos, barbs, propofol

Question 27

Comorbidities with Dysthmia

Answer 27

MDD | Bipolar Disorder

Question 28

TX for Lithium induced NDI? | Reasoning?

Answer 28

HCTZ + Amiloride | Amiloride closes the Na+ channels at the collecting tubules where Lithium acts

Question 29

Difference bt MDD and Adjustment Disorder

Answer 29

Adjustment disorder 1. Occurs w/in 3 mo's of stressor 2. Disappears w/in 6 mo's of absence of stressor 3. Does not meet criteria for MDD

Question 30

Difference bt Bereavement and Adjustment Disorder

Answer 30

Bereavement impairs patient's ability to function normally. | Adjustment - does not impair

Question 31

Assn's with Panic Disorder

Answer 31

1. MVP | 2. Agoraphobia

Question 32

Difference bt Acute stress disorder and PTSD

Answer 32

Acute stress < 30 days - Can progress to: PTSD > 30 days

Question 33

Which APs have less anticholinergic AE's: Hi or Low potency | Which are they?

Answer 33

Hi Potency Haloperiodol, Droperidol, Fluphenazine, thiothxene Good for + sx's of schizophrenia

Question 34

Presentation of Acute Dystonia | TX?

Answer 34

Torticollis, neck spasm TX: Diphenhydramine, Benztropine Drugs that have Anticholinergic Activity

Question 35

Presentation of Tardive Dyskinesia | TX?

Answer 35

Choreoathetosis, writhing of face, tongue, neck, limbs TX: D/C or reduce offending agent (Neuroletptic). Switch to Atypical AP, i.e. risperidone, clozapine

Question 36

Time frame for Parkinsonian SX AEs in pts taking APs | TX?

Answer 36

4 days --> 4 months TX: Diphenhydramine Benztropine Da Agonist = Amantadine

Question 37

Presentation of NMS

Answer 37

``` AMS Muscular rigidity Hyperthermia - High Fever Autonomic instability Rhabdomylosis Within days of starting AP ```

Question 38

TX for NMS

Answer 38

``` Cooling blankets, ice packs in axilla Reduce HTN - clonidine, nitroprusside DVT prevention - heparin, Lovenox Benzos for agitation Dantrolene Bromocriptine, Amandatine to increase Dopamine ```

Question 39

DOC for Bipolar in Renal Failure

Answer 39

Valproate Carbamezapine CI = Lithium