XI

Question 1

diastolic murmur in 20 y.o

Answer 1

investigate with echo

Question 2

main cause of orthostatic hypotension

Answer 2

hypovolemia

Question 3

how to confirm hypovolemia with CMP

Answer 3

elevated BUN/Cr ration because it is prerenal azotemia

Question 4

acute epididymis in elderly population

Answer 4

non STD related

E coli

Question 5

autoimmune conditions associated with vitiligo

Answer 5

pernicious anemia, autoimmune thyroid disease, type 1 DM, primary adrenal insufficiency, hypopituitarism, alopecia areata

Question 6

actinic keratosis on light microscopy

Answer 6

areas of acanthosis, parakeratosis, dyskeratosis and hyperkeratosis

Question 7

lung CA that realses ADH

Answer 7

small cell

Question 8

What are small cell lung cancer assoc paraneoplastic synromes

Answer 8

ectopic ACTH leading to Cushing
Lamber Eaton syndrome
SIADH

Question 9

mass in middle of mediastinum

Answer 9

bronchogenic cysts

Question 10

main step when suspect acromegaly

Answer 10

measure IGF-I

Question 11

glucose does what to GH

Answer 11

suppress it

Question 12

characteristics of nephrosclerosis

Answer 12

hypertrophy and intimal medial fibrosis of renal arterioles

Question 13

DM nephropathy characteristics

Answer 13

increased extracellular matrix, basement membrane thickening, mesangial expansion and fibrosis

Question 14

upper lobe cavitations

Answer 14

suspect TB

Question 15

increased LDHa nd bilirubin

decreased haptoglobin

Answer 15

hemolytic anemia

Question 16

antibiotics for human bite or dog bite

Answer 16

augmentin

amox-clavulanate

Question 17

management of DKA

Answer 17

1 restore volume with normal saline
correct hyperglycemia with regular insulin
correct electrolytes- potassium
treat precipitating factors like infecitons

Question 18

most useful intervention for peripheral arterial claudication

Answer 18

supervised graded exercise program

Question 19

Good Pastures

Answer 19

nephritic proteinuria, acute renal failure, urinary sediment with dysmorphic RBC and casts
pulmonary– SOB, cough, hemoptysis
fever, weight loss, arthralgias

Question 20

udnerlying cause of goodpastures

Answer 20

Ab to alpha 3 chain type IV collagen

Question 21

microscopy of goodpastures

Answer 21

linear IgG deposition along the glomerular BM

Question 22

common causes of nephrotic syndrome

Answer 22

focal segemental glomerulosclerosis, minimal change disease, membranous nephropathy, DM, primary amyloidosis, IgA nephropathy

Question 23

causes of nephritic syndrome

Answer 23

IgA nephropathy, lupus nephritis, thin BM disease

Question 24

Dx mixed cryoglobulniemia

Answer 24

serum cryos, low Complement levels

Question 25

most common cause of cyroglobulinemia

Answer 25

chronic Hep C

Question 26

empyema

Answer 26

intrapleural colleciton pus usually from bacterial pneumonia

Question 27

bacteria that cause empyema

Answer 27

strep pneumo staph aureus klebsiella pneumo

Question 28

signs of empyema

Answer 28

fever cough, SOB and pleuritic chest pain

Question 29

radiograph findings in empyema

Answer 29

free flowing or loculated pleural effusion with lung consolidations with air bronchograms

Question 30

when to suspect gastrinoma

Answer 30

when endoscopy shows multiple stomach ulcers and thickened gastric folds

Question 31

which syndrome is zolinger ellison syndrome apart of

Answer 31

MEN1

Question 32

secretin test

Answer 32

secretin stimulates gastrin in gastrinoma | usually gastic G cells are inhibited by secretin so usually should not cause an increase in gastrin

Question 33

most common extrapulmonary sites for nocardia

Answer 33

brain and skin

Question 34

Tx nocardia

Answer 34

TMP SMX

Question 35

Tx uncomplicated cystitis

Answer 35

nitrofurantoin tMP SMX fosfomycin

Question 36

Tx complicated cystitis

Answer 36

fluoroquinolones for 5-14 days

Question 37

outpatient Tx pyelonephritis

Answer 37

fluoroquinolone

Question 38

inpatient Tx pyelnephritis

Answer 38

IV fluoroquinoones, aminoglycoside +/- ampicillin

Question 39

Tx hemophilia A or B

Answer 39

factor VIII or Ix | desmopressin for mild hemophilia A

Question 40

what is elevated in hemophilia: PT or PTT

Answer 40

PTT

Question 41

Dx C dificile

Answer 41

stool sample

Question 42

murmur in mild AR vs severe

Answer 42

mild has a early diastolic murmu | severe has holosystolic

Question 43

bounding pulses

Answer 43

seen with aortic regurg from increased SV

Question 44

pneumonia in right lower lobes is usuallyd ue to what

Answer 44

local obstruction or recurrent aspiration

Question 45

mitral stenosis is most commonly due to what

Answer 45

rheumatic fever

Question 46

what heart pressures are elevated in mitral stenosis

Answer 46

left atrial and pulmonary vasculature | also get an elevation of the L main bronchus

Question 47

most cmmon cause of nephrotic syndrome in the US

Answer 47

FSGS

Question 48

non inflammatory chronic prostatitis

Answer 48

afebrile with irritative voiding Sx | PE unremarkable and UA normal

Question 49

most cmmon cause of adhesive capusltiis

Answer 49

rotator cuff tendinopathy

Question 50

signs of cocaine intoxication

Answer 50

``` psychomotor agitation dilated pupils atrophic nasal mucosa HTN acute myocardiacl sichemia ```

Question 51

CV effects of cocaine

Answer 51

coronoary vasoconstriciton, inc HR, inc BP inc myocardial oxygen demand increase thrombus formation by promotoing platelet activation and aggregation