VII

Question 1

sympathetic opthalmia

Answer 1

spared eye injury
immune mediated inflammation of one eye after penetrating injury to other eye
manifests as anterior uveitis- can progress to papillary edema and blindness
mechanism– hidden antigens that are “uncovered”

Question 2

cause of compresstion fracture

Answer 2

osteoporosis

loss of bone mineral density

Question 3

tinea versicolor

Answer 3

malasseiza globosa
hypopigmented and hyperpigmented lesions
fine scale and pruritis
KOH show hyphae and yeast cells
buzz= spaghetti and meatballs pattern

Question 4

Tx for tinea versicolor

Answer 4

topical ketoconazole, terbinafine or selenium sulfide

Question 5

presentation and lab values of VIPoma

Answer 5

watery diarrhea, flushing, lethargy, n/v, hypokalemia, hyperCa, hyperglycemia

Question 6

where are VIPomas usually found

Answer 6

pancreatic tail

localized with abdominal CT or MRI

Question 7

Tx for VIPoma

Answer 7

IV volume repletion, ocreotide, and hepatic resection if mets to liver

Question 8

if patient has positive urine bilirubin then is buildup conj or unconj

Answer 8

conj

Question 9

+ bilirubin in UA

normal ALT AST and AlkPhos

Answer 9

rotors syndrome

defect in hepatic secretion of conjugate bilirubin into the biliary sytem

Question 10

labs of nonseminomatous germ cell tumor

Answer 10

increased bhcg and increased AFP

Question 11

labs of seminomatous germ cell tumor

Answer 11

increased b-hcg but not increased AFP

Question 12

Tx for meningitis in immunocompromised patients

Answer 12

Vanco, ampicillin plus cefepine or ceftazidime

Question 13

Tx goodpastures

Answer 13

emergency plasmaphoresis

Question 14

Tx wegeners

Answer 14

cyclophosphamide and steroids

Question 15

what can cause nonalcoholic fatty liver disease

Answer 15

peripheral insulin resistance that leads to increased peripheral lipolysis, triglyceride synthesis and hepatic uptake of fatty acids

Question 16

CBC in crohns

Answer 16

anemia and reactive thrombocytosis

Question 17

signs of toxic shock syndrome

Answer 17

fever, myalgias, marked hypotension and diffuse erythematous macular rash

Question 18

most common source of DVT

Answer 18

proximal deep leg veins

Question 19

symptoms of intracranial HTN, pseudotumor cerebri

Answer 19

holocranial HA, vision changes, pulsatile tinnitus “whooshing sound to ears”

Question 20

progression of malignant otitis externa

Answer 20

osteomyelitis of the skull base and destruction facial nerve

Question 21

pathogen that causes post viral URI necrotizing pulmonary bronchopneumonia with multiple nodular infiltrates that can cavitate to cause small abscesses

Answer 21

staph aureus

Question 22

primary polydipsia occurs with what otehr condition

Answer 22

schizophrenia

Question 23

Tx of hep B

Answer 23

interferon
lamivudine
entecavir
tenofovir

Question 24

hep C Tx

Answer 24

pegylated interferon + ribavirin

Question 25

those with menieres disease should avoid what food

Answer 25

salt, alcohol, caffeine and nicotine because all can increase endolymphatic retention

Question 26

symptoms of menieres

Answer 26

vertigo, ear fullness, tinnitus, hearing loss

Question 27

initial drug of choice for hypercalcemia of malignancy

Answer 27

bisphosphonates: zoledronic acid, pamidronate

Question 28

CV effects of thyrotoxicosis

Answer 28

tachy cardia, systolic HTN, widened pulse P | afib/flutter and atrial and ventricular ectophy

Question 29

what causes the systolic HTN in thyrotoxicosis

Answer 29

increased myocardial contractility and HR

Question 30

what pathogens cause pulmonary cavitation in HIV patient

Answer 30

m tb, atypical mycobacteria, nocardia, gram neg rods and anaerobes

Question 31

Tx choice for nocardia

Answer 31

TMP SMX

Question 32

acid fast, filamentous branching rods

Answer 32

nocardia

Question 33

pathophys of ARDS

Answer 33

impaired gas exchange decreased lung compliance pulmonary HTN all caused by leakage of bloody and proteinaceous fluid into the alveoli

Question 34

when do you use physostigmine

Answer 34

reverse life threatening anticholinergic agents

Question 35

pulsus paradoxus

Answer 35

aortic dissection

Question 36

labs of TTP

Answer 36

hemolytic anemia and thrombocytopenia, schistocytes on peripheral smear altered mental status, renal failure and fever

Question 37

Dx of TTP

Answer 37

based on ADAMTS13 activity

Question 38

all patients with presumed ITP should be screened for what

Answer 38

HIV and Hep C

Question 39

ITP labs

Answer 39

isolated thrombocytopenia without anemia or leukopenia

Question 40

Schilling test

Answer 40

determine B12 deficiency due to pernicious anemia or malabsoprtive

Question 41

drug used for diabetic gastroparesis

Answer 41

metoclopramide,

Question 42

empiric Ab therapy for acute prostatitis

Answer 42

TMP SMX or fluoroquinolone

Question 43

which side is more likely to have varicocele

Answer 43

Left because the left gonadal vein enters left renal vein at a right angle get compression between SMA and aorta

Question 44

if patient has right sided varicocele what should you look for

Answer 44

IVC compression (renal cell carcinoma) or obstruction in IVC causing compression of the R gonadal vein and backup

Question 45

bupropion

Answer 45

most common used for smoking cessation

Question 46

conservative management for kidney stone

Answer 46

hydration, analgesics and alpha blockers

Question 47

cause of senile purpura aka bruising of old people

Answer 47

perivascular CT atrophy

Question 48

skin lesions of blastomycosis

Answer 48

heaped up cerrucous or nodular lesions with violaceous hue that may evolve into microabscesses

Question 49

Achalasia vs stricture

Answer 49

achalasia presents with dysphagia for solids and liquids! heartburn, regurg and weight loss will have dilated esophagus and distal narrowing in achalasia

Question 50

before starting Tx for achalasia what should you do

Answer 50

endoscopy to exclude esophageal malignancy