Internal Med Qhz 6

Front 1

R/o obstruction in AKI c

Back 1

Renal U/S

Front 2

Reperfusion therapy of choice for pt c STEMI

Back 2

Door to balloon < 90min for PCI

Front 3

if cath lab < 90 min away

Back 3

Heparin, gp2b3a

Front 4

Spiculations on mammogram suggest

Back 4

breast CA

Front 5

What finding used for monitoring fluid overload in HF?

Back 5

JVD

Front 6

Anthrax scar

Back 6

Vesicular -> black painless eschar

Front 7

Occupational expo to anthrax 2

Back 7

tannery, wool factory

Front 8

Inhalation anthrax does what

Back 8

Flu-like -> fulminant pulm failure

Front 9

Brisk GI bleed from upper v. lower determined by

Back 9

NG lavage

Front 10

Drug of choice for Dressler's

Back 10

NSAIDs, steroids

Front 11

typical clinical presentation for primary TB

Back 11

Immunocompetent no Sx

Front 12

Chronic HCV, palpable purpura, infl arthritis, MPGN

Back 12

Mixed cryoglobinemia

Front 13

Most common cause aplastic anemia in immunocompromised

Back 13

Parvovirus B19

Front 14

Proposed mech for flushing from niacin use

Back 14

Prostaglandin & Histamine release

Front 15

Bernard-Souille characteristics

Back 15

Plt: giant
Bleeding time: incr <- impaired plt adhesion <- defective gp1b

Front 16

Which is more likely to be accompanied by thrombocytopenia, Bernard-Souille or Glanzmann's thombosthenia?

Back 16

Bernard-Souille

Front 17

Tx of choice for acute chest syndrome, acute stroke, and acute priaprism in sickle cell

Back 17

Exchange transfusion

Front 18

Goal of exchange transfusion in sickle cell

Back 18

Reduce Hb S in blood to <30%

Front 19

Recommended screening test for hemachromatosis for pt c suspected dz

Back 19

Transferrin saturation

Front 20

Ab-NL coag studies in vWD & why? 2

Back 20

PTT incr: relative factor VIII def
Bleeding time incr: vWD needed for plt adhesion

Front 21

more common hepatobiliary complications of parenteral nutrition 4

Back 21

sludging bile
acalculous cholecystitis
cholelithiasis
steatohepatitis -> cirrhosis

Front 22

polycythemia is paraneoplastic syndrome for which CA 3

Back 22

renal cell CA
HCC
Malig hemangioma

Front 23

Dubin-Johnson & Rotor's is what type of serum bilirubin

Back 23

conj bilirubin

Front 24

Dubin-Johnson show what on Bx

Back 24

Pigmented hepatocytes

Front 25

Pattern of transaminase level in shock liver 2

Back 25

acute AST/ALT elevation in thousands
Rapidly self-corrects

Front 26

Vit B12 def w/u 3

Back 26

intrinsic factor Ab
Homocysteine levels
Methylmalonate levels

Front 27

Dawn phenomenon v. somogei

Back 27

Dawn: hyperglycemic in am b/c cortisol pk (NL)

Somogei: hyperglycemic in am b/c rebound to hypoglycemia

Front 28

Shot for pt c high risk puncture wound 2

Back 28

Tetanus toxoid to stim immune response
If never vax, give Ig

Front 29

Homan's Sx

Back 29

phys exam finding for DVT: pain in calf on dorsiflexion of foot
not specific/not sensitive

Front 30

Types of renal calculi that can't be dissolved by medications

Back 30

Calcium containing

Front 31

Conservative mgmt of calculi acceptable if < what size

Back 31

< 5 mm

Front 32

When to start using DMARDs in RA? Which ones to use?

Back 32

Start within 1st 3m of Dx
MTX = 1st line
Sulfasalazine, hydroxychloroquine = 2nd line

Front 33

Mixed venous O2 sat changes in early septic shock? Goal? Late shock?

Back 33

Decreases due to hyper-metabolism
Goal: > 70%
Late: paradoxical increase

Front 34

3 pain features of typical angina

Back 34

brought on by exertion
relieved by rest/nitro
duration > 20 min

Front 35

2 most common causes ring-enhancing lesions when immunocompromised

Back 35

Toxoplasmosis
CNS Lymphoma

Front 36

What screening technique do F Tx'd for Hodgkin's need earlier

Back 36

Mammogram

Front 37

ring-enhancing lesion in immunocompetent represent what? 2

Back 37

CA
Abscess

Front 38

Lung CA more common in asbestos (not mesothelioma)

Back 38

Bronchogenic CA

Front 39

Dx test for acute pyelo/acute PNA/susp bact meningitis/sepsis before empiric abx

Back 39

BCx

Front 40

Endocrine disturbance most likely seen in pt on long-term amiodarone

Back 40

Hypothyroidism

Front 41

Indication for infusing hypertonic saline 2

Back 41

Serum Na < 115
Pt c incr ICP

Front 42

NNRTI assoc c vivid hallucinations

Back 42

efivirenz

Front 43

test of choice of adult M/post-menopausal F for hypochromic microcytic anemia

Back 43

colonoscopy

Front 44

Most common cause of severe elevation of transaminases (>2000) 3

Back 44

acute viral hepatitis
acetaminophen OD
shock liver

Front 45

acute febrile rxn: flu-like, when give abx for spirochete or ricketsial inf

Back 45

Herx-Heimer rxn

Front 46

Mgmt for microcytic anemia + low ferritin

Back 46

Is bleeding? If no, then Fe supplement

Front 47

highest risk for transfusion-related inf with HCV, HBV, or HIV?

Back 47

HBV - 1/200,000

Front 48

Major serum protein other than alb

Back 48

Immunoglobulins

Front 49

most common cause retinitis in pt c AIDS

Back 49

CMV

Front 50

Tx of CMV retinitis

Back 50

Ganciclovir

Front 51

3 most common drugs assoc c warm autoimmune hemolytic anemia

Back 51

Methyldopa
PCN
Quinidine

Front 52

Bacteremia c. burnetti assoc c 2

Back 52

Q fever
Inf endocarditis

Front 53

only inhalable ricketssial spp

Back 53

C. burnetti

Front 54

Occupation expo assoc c Q fever

Back 54

animal handling

Front 55

Slowing of CKD facilitated by what measures 4

Back 55

Ctrl HTN: goal BP < 130/80
Glc control
?low-Pr diet
ACE/ARB

Front 56

Mech for how low Pr diet helps CKD

Back 56

Minimize albuminuria and filtration

Front 57

Dx suggested by pulm exudate c lymphocytes, cloudy, low glc level

Back 57

Rheumatoid arthritis or other autoimmune

Front 58

2 main MAHA

Back 58

TTP
DIC

Front 59

Differentiate TTP v DIC

Back 59

DIC - fibrinogen low, D-dimer high, PT/INR incr
TTP - fibrinogen NL, D-dimer NL

Front 60

electrolyte disturbances that cause hyperreflexia

Back 60

low Mg
low Ca

Front 61

S/S of hypertrophic osteoarthropy

Back 61

arthritis at joint
periosteal bone formation

Front 62

Primary indication for screening endoscopy in alcoholic

Back 62

Known cirrhosis/portal HTN on exam

Front 63

Tx of choice for Paget's dz of bone if symptomatic

Back 63

bisphosphonates

Front 64

Lab value for Paget's

Back 64

Very high ALP
NL Ca
NL PO4

Front 65

Dx suggested by anemia, incr Cr, and hypercalcemia

Back 65

MM

Front 66

Best initial screening test for vitamin B12/folate def

Back 66

homocysteine

Front 67

multifocal atrial tachycardia usu have what lung dz

Back 67

COPD's cor pulmonale

Front 68

fungal inf that present c
pulm dz,
verrucous skin lesions,
osteolytic bone lesions,
prostatits

Back 68

Blastomycosis

Front 69

M/A and indication for dobutamine

Back 69

agonist at beta-1mostly
ionotropic for cardiogenic shock

Front 70

drug of choice for mets papillary and follicular thyroid CA

Back 70

Radioactive iodine

Front 71

fluconazole PPx in neutropenia does not protect from what fungus

Back 71

aspergillus

Front 72

time frame for presentation of type II HIT? Exception?

Back 72

5-14 d after starting heparin
Exception: taking heparin in last 3 months

Front 73

Inhereditary tendency for hemorrhagic telangectasias that can cause fatal hemorrhage

Back 73

Osler-Weber-Rendu

Front 74

Chronic rejection of transplant mech

Back 74

Ab-mediated vasculopathy of organ

Front 75

HLA-matching in transplant pt for what purpose? 2

Back 75

prevent donor immune from attacking aloograft -> humoral
Prevent graft from attacking host