UW 9

Question 1

Rhabdomyolysis effect on kidney

Answer 1

Acute renal failure

Excessive filtered myoglobin when CPK > 20,000 causes acute tubular necrosis

Question 2

Workup for BAT

Hemodynamically unstable

Answer 2

Bedside US or FAST

- if inconclusive, do DPL

Question 3

When do we do DPL

Answer 3

IF FAST is inconclusive

Question 4

BAT for hemodynamically unstable patient and Negative FAST exam - next step?

Answer 4

Look for sings of extraabdominal hemorrahge

Question 5

Presentation of Paroxysmal Nocturnal Hemoglobinuria

Answer 5

Fatigue (Hemolysis)
Cytopenias - fatigue and dyspnea from anemia
Venous thrombosis

Question 6

What are labs for intravascular hemolysis?

Answer 6

Anemia
Low haptoglobin
High BR
High LDH

Question 7

Presentation of Acute Intermittent Porphyria

Answer 7

Abdominal pain

Dark red/brown urine

Question 8

Renal abnormality in Diabetic patients - earliest change

Answer 8

Glomerular hyperfiltration

Question 9

First quantifiable change in diabetic renal dz
2nd
Later finding

Answer 9

Thickening of glomerular basement membrane
Next - mesangial expansion
Nodular sclerosis later

Question 10

Mutation in neurofibromatosis - severe variant

Answer 10

Nonsense (and frameshift) = more severe than missense

Question 11

When do we see Low DLCO

Answer 11

Emphysema - obstructive
Interstitial Lung dz - Restrictive
Sarcoidosis - R
Asbestosis - R
Heart Failure - R

Question 12

When do we see normal DLCO

Answer 12

Chronic bronchitis - O
Msuculoskeletal deformity - R
Neuromuscular - R

Question 13

When do we see increased DLCO

Answer 13

Asthma - O

Morbid Obesity - R

Question 14

Tx for V fib

Answer 14

Defibrillation

Question 15

Tx for pulseless V tach

Answer 15

Defibrillation

Question 16

Serum C3 complement level in Post-strep GN

Answer 16

Low

Question 17

Complement level in Membranoproliferative GN

Answer 17

Low

Question 18

Severe LLQ abdominal pain radiating to groin + vomiting is what
Workup

Answer 18

Obstructive ureterolithiasis

Noncontrast spiral CT of abdomen and pelvis

Question 19

What is Acute dystonia and TX

Answer 19

EPS sx’s: muscle spasm, stiffness, torticollis, lip smacking
Benztropine
Diphenhydramine

Question 20

Tx for Neuroleptic Malignant Syndrome

Answer 20

Dantrolene

Question 21

Presentation of NMS

Answer 21

High very
Muscle rigidity
Rhabdomyolysis

Question 22

What is akathisia and what is the tx

Answer 22

Feeling of restlessness/inability to sit still

Tx: Beta blokers

Question 23

What heme change is seen in Chronic Renal Failure

Answer 23

Abnormal hemostasis - Platelet dysfunction that causes increased BT
Uremic toxins involved
TX: DDAVP

Question 24

Loss of peripheral vision - gradual + cupping of optic disc + Increased IOP

Answer 24

Primary open angle glaucoma

Question 25

Tx for primary open angle glaucoma

Answer 25

Timolol | Laber trabeculoplasty

Question 26

Non proliferative diabetic retionopathy presentation

Answer 26

``` Dilated veins Microaneurysms Retinal hemorrhages Edema Hard exudates ```

Question 27

Proliferative diabetic retinopathy presentation

Answer 27

Neovascularization Poor night vision Curtain falling = vitreous bleed floaters

Question 28

Presentation of angle closure glaucoma

Answer 28

Sudden onset blurred vision, severe eye pain N/V Red eye w hazy cornea Fixed, dilated pupil

Question 29

Loss of central vision

Answer 29

Macular degeneration

Question 30

What is the MOA of dipyridamole and adenosine

Answer 30

Coronary Vasodilators = increase blood flow 3-5x above baseline

Question 31

What electrolyte abnormalities are seen with pts undergoing major surgery requiring extensive transfusions

Answer 31

Hypocalcemia = hyperactive DTRs | Other sx's muscle cramps, convulsions

Question 32

Galactosemia Presentation

Answer 32

``` FTT BL cataracts Jaundice Hypoglycemia Deficiency of galactose-1-phosphate uridyl transferase deficiency ```

Question 33

Presentation of galactokinase deficiency

Answer 33

Cataracts only

Question 34

What is the relation b/t PPV and Prevalence

Answer 34

The more common the disease (prevalent), the greater the probability that a patient from that population with have a true positive result

Question 35

Workup for secondary amenorrhea w no sx's or findings

Answer 35

1. B-HCG 2. PRL to r/o prolactinoma TSH to r/o primary hypothyroid 3. If normal, serum FSH and LH

Question 36

Astrocytomas

Answer 36

MC pediatric tumor

Question 37

Medulloblastoma | Location

Answer 37

2nd MC pediatric tumor | Location: posterior fossa, 90% from vermis

Question 38

Exudative pleural effusion causes

Answer 38

Infxn AI Neoplasm

Question 39

Pathophysiology of exudative pleural effusion

Answer 39

Increased capillary permeability allows protein and LDH to pass into pleural fluid

Question 40

Causes of transudative pleural effusions

Answer 40

Decreased plasma oncotic - liver failure | Elevated hydrostatic pressure - CHF

Question 41

Molluscum contagiosum Presentation

Answer 41

Single or multiple Rounded Dome-shaped papules Central umbilication

Question 42

Cause of molluscum contagiosum

Answer 42

Poxvirus STD Common in AIDS CD4<100

Question 43

Lichen planus presentation

Answer 43

Inflammatory Pruritic Violaceous Flat topped papules