X

Question 1

Dx chronic pancreatitis

Answer 1

CT pancreas calcification

Question 2

delayed sleep phase syndrome

Answer 2

sleep onset insomnia and excessive morning sleepiness

Question 3

type of respiratory involvement in wegeners

Answer 3

lower respiratory

Question 4

respiratory involvement in good pastures

Answer 4

upper respiratory

Question 5

chronic liver disease Physical signs

Answer 5

new onset ascites, pedal edema, spider angiomata, plamar erythema, caput medusa, nail changes, gynecomastia, splenomegaly, testicular atrophy

Question 6

most important step in management of non ketotic hyperglycemic coma

Answer 6

fluid replacement- normal saline

Question 7

what acid base disorder is caused by aspirin toxicity

Answer 7

mixed respiratory alkalosis and metabolic acidosis

Question 8

which diuretic decreases tolerance to glucose

Answer 8

thiazides

Question 9

lectrolyte abnormalities from thiazides

Answer 9

hyponatremia, hypokalemia, hyperCa

Question 10

febrile neutropenia

Answer 10

EM
start early empiric antibiotic therapy
anti pseudomonals are good

Question 11

anti pseudomonals

Answer 11

cefepime, meropenem, piperacillin-tazobactam

Question 12

what cause respiratory alkalsosis

Answer 12

hyperventilation from pneumonia, high altitude or salicylate intoxication

Question 13

findings of coccidiomycosis

Answer 13

fever, fatigue, cough, weight loss, pleuritic chest pain, erythema multiforme and erythema nodosum

Question 14

where is histoplasmosis found

Answer 14

Southeastern, mid atlantic and central US

Question 15

where is blastomycosis found

Answer 15

south central and north central

Question 16

where does blastomycosis affect in the body

Answer 16

lungs, skin, bones, joints, prostate

usually immunosupressed

Question 17

what drugs can lead to invasive aspergillosis

Answer 17

cyclosporine

high dose glucocorticoids

Question 18

CT shows pulmonary nodules with halo sign or air crescent

Answer 18

invasive aspergillosis

Question 19

quickest way to correct hyperkalemia

Answer 19

insulin and glucose

Question 20

which drug can cause macrocytic anemia

Answer 20

MTX

Question 21

what to supplement with MTX

Answer 21

folic acid

Question 22

side effects of MTX

Answer 22

macrocytic anemia, nausea, stomatitis, rash, hepatotoxicity, interstitial lung disease, alopecia and fever

Question 23

what causea anaphylactic reaction in blood transfusions

Answer 23

recipient anti IgA Ab

Question 24

risk factors for adenocarcionm of esophagus

Answer 24

barretts, obesity, high dietary calorie, fat intake, smoking, medications that promote GERD

Question 25

major risk factors for squamous cell CA of esophagus

Answer 25

smoking, alcohol, dietary deficiency of beta carotene, vit B1, zinc, selenium, viral infections, toxin producing fungi, hot food and beverages, pickled vegetables and food rich in N nitroso compounds

Question 26

increased risk for what with hiatal hernia

Answer 26

barretts

Question 27

iron and ferritin levels in sideroblastic anemia

Answer 27

normal to high serum Fe | normal to high ferritin

Question 28

adverse effects of antithyoid drugs

Answer 28

agranulocytosis methimazole- 1st trimester teratogen and cholestasis propothiouracil- hepatic failure, ANCA-associated vasculitis

Question 29

tolvaptan

Answer 29

V2 vasopressin R antagonist that causes selective water loss in kidney w/o changing Na or K only used for significant hypervolemia in heart failure or euvolemic hyponatremia in SIADH

Question 30

differentiate mild/mod and severe C dif

Answer 30

mild/mod: WBC15,000 Cr >1.5x baseline serum albumin

Question 31

what are the Tx options for C dif

Answer 31

metronidazole for mild/mod oral vanco for severe super severe go for colectomy... that is if toxic megacolon like

Question 32

what can prevent febrile nonhemolytic reaction and reduce risk of HLA alloimmunization and CMV transmission

Answer 32

leukoreduction

Question 33

blood transfusion reactions timline

Answer 33

anaphylaxis- secs to minutes acute hemolytic- minutes to hours febrile nonhemolytic- 1-6 hours delayed hemolytic- 2 days to 10 days

Question 34

skin manifestations of cholesterol emboli from cardiac cath

Answer 34

blue toes, livedo reticularis, gangrene and ulcers

Question 35

whipples disease

Answer 35

trophyerma whippelii weight loss, diarrhea and abdominal pain, malabsorption, flatulence and steatorrhea migratory polyarthropathy, chornic cough and myocardial or valvular involvement

Question 36

PAS + material in lamina propria in small intestine

Answer 36

whipples disease

Question 37

bloody diarrhea primarily caused by what pathogens

Answer 37

E coli, Shigella, CAmpylobacter

Question 38

what to avoid in enterohemorrhagic e coli

Answer 38

empiric antibiotic therapy because can increase risk of HUS

Question 39

signs of acute angle closure galucoma

Answer 39

severe eye pain with n/v | red eye with steamy cornea and moderately dilated pupil that is non reactive to light

Question 40

if BP is greater in R arm than L

Answer 40

coarctation aorta

Question 41

BP hard to control despite many medications

Answer 41

secondary HTN | most likely renal artery stenosis

Question 42

appearance of pseudogout

Answer 42

rhomboid shaped crystals with + birefringence

Question 43

findings of lead poisoning

Answer 43

microcytic anemia | PBlood smear shows basophilic stippling

Question 44

in clinical trials what makes randomization successfull

Answer 44

when similar baseline characteristics of patients in treatment and placebo group are seen

Question 45

development of new conduction delay in someone with infective endocarditis

Answer 45

perivalvular abscess

Question 46

Tx for severe hypovolemic hypernatremia

Answer 46

0.9% saline

Question 47

Tx for mild hypovolemic hypernatremia

Answer 47

0.5% dextrose in .45% saline

Question 48

what type of lung cancer releases PTHrP

Answer 48

squamous cell

Question 49

what labs are elevated in Pagets disease

Answer 49

``` alk phos hydroxyproline deoxypyridinoline N telopeptide C telopeptide ```

Question 50

Xray of skull shows bone resoprtion and sclerosis | R leg pain for past year

Answer 50

pagets