Mksap 3

Front 1

Myasthenia gravis is associated with

Back 1

Thymoma

Front 2

Acetylcholine receptor binding antibody

Back 2

MG

Front 3

How can you tell apart MG from Lambert Eaton clinically?

Back 3

MG has a predilection for ocular, bulbar, resp mm while LE is more prox + autonomic dysfunction

Front 4

Can you cont HCTZ in pregnancy?

Back 4

Yes if they have already been on it

Front 5

Next step when a patient presents with lyme carditis (i.e. heart block)

Back 5

IV ceftriaxone until heart block resolves then 21 days of oral antibiotics and monitoring

Front 6

What happens with lyme carditis?

Back 6

it resolves spontaneously

Front 7

Which GOLD stage COPD is this?
FEV1/FVC = <70%
and
FEV1 >80% of predicted

Back 7

mild

Front 8

Which GOLD stage COPD is this?
FEV1/FVC = <70%
FEV1 50-80%

Back 8

moderate

Front 9

Which GOLD stage COPD is this?
FEV1/FVC = <70%
FEV1 30-50

Back 9

severe

Front 10

Management of PTSD

Back 10

CBT

Front 11

Management of close contacts of a patient with smallpox

Back 11

vacinnia vaccination

Front 12

Next step in work up of patients with known or suspected non small cell lung cancer?

Back 12

PET_CT for staging to see if thoracotomy is useful

Front 13

anti-Ro and anti-La

Back 13

Sjrogren syndrome

Front 14

What malignancy are patients with Sjrogren syndrome at increased risk for?

Back 14

Non Hodgkin lymphoma

Front 15

First test to do when you suspect Asherman syndrome (scar tissue after D&C that prevents menses)

Back 15

pelvic ultrasound

Front 16

A patient in cardio Enid shock requires

Back 16

Milrinone or dobutamine

Front 17

How do you tell apart esophageal stricture from pill esophagisitis in a patient with systemic sclerosis?

Back 17

Pill = odynophagia
Stricture = dysphagia

Front 18

Management of ankylosing spondylitis

Back 18

TNF alpha inhibitor enterecept

Front 19

A negative radioactive iodine uptake scan in a patient who has signs of thyrotoxicosis means (2)

Back 19

either exogenous thyroid hormone
or
thyroiditis

Front 20

What two lab measurements are low in someone taking exogenous thyroid hormone and high in thyroiditis?

Back 20

ESR and thyroglobulin level

Front 21

What is the radioactive iodine uptake in Grave's disease?

Back 21

high

Front 22

Management of claudication in patients who do not have severe disease

Back 22

a supervised exercise program

Front 23

The initial step in the evaluation of delayed gastric emptying is

Back 23

EGD to rule out a mechanical cause of obstruction

Front 24

Management of metastatic renal cell carcinoma

Back 24

Sunitinib or sorafenib

Front 25

Polycythemia secondary to OSA is called

Back 25

SECONDARY polycythemia

Front 26

CMV infection occurs in the first which months post transplant?

Back 26

2-6th

Front 27

Management of fertility in a woman on cyclophosphamide

Back 27

give concurrent lupron injections - will prevent pregnancy while on cyclophosphamide and protect the ovaries

Front 28

What do you do when someone has had longstanding heartburn? (i.e. five years)

Back 28

an EGD to see if they have Barretts Esophagus

Front 29

Diagnose spinal cord compression secondary to bony mets

Back 29

with an MRI!

Front 30

70 M with hx of prostate CA, mid back pain, worsening urinary incontinence, mild parasthesias in his feet

Back 30

spinal cord compression due to mets

Front 31

Best anticoagulation in pregnant patients with mechanical heart valves?

Back 31

Its controversial but MKSAP says Warfarin in spite of the fetal risks

Front 32

Can you have brief myoclonic jerking after losing conciousness with vasovagal syncope?

Back 32

yes

Front 33

Abnormal uterine bleeding in women 35+

Back 33

need an endometrial biopsy

Front 34

AFP levels in nonseminomas

Back 34

high

Front 35

manage a young man with nonseminomatous testicular cancer stage III (spread to lungs and lymph nodes in the mediastinum)

Back 35

radical orchiectomy and chemotherapy

Front 36

which is a better prognosis - seminoma or non seminoma?

Back 36

seminoma

Front 37

A patient is going to start a TNF alpha inhibitor and PPD is 5mm - what is next step?

Back 37

Treat with isoniazid - 5mm is the cut off for treating latent TB in pts starting biologics.

Front 38

COPD pt with ACS - ok to use selective beta blocker?

Back 38

In general yes unless the patient has severe or very severe COPD. Then you use a CCB like dilt.

Front 39

A patient with a crusted ulcerated papule and regional LAD after recently traveling to Africa and also systemic symptoms of fever, etc.

Back 39

African Tick Bite Fever (Ricketssia Africae)

Front 40

Does a leschmania flea bite cause patients to get systemic symptoms?

Back 40

NO

Front 41

Best way to diagnose chronic thromboembolic pulmonary hypertension?

Back 41

V/Q scan (becuase its organized differently than acute PE)

Front 42

Management of a cirrhotic patient with liver mass and elevated AFP?

Back 42

Liver transplant eval. No need to biopsy the liver.

Front 43

A patient going for hip replacement with no symptoms but severe AS seen on echo + nl LV fxn

Back 43

does NOT need prophylactic AVR.

Front 44

What type of blood to give to a patient with a history of stem cell transplant

Back 44

leukoreduced irradiated

Front 45

Management of a patient with advanced esophageal cancer

Back 45

stent

Front 46

What is the best question to ask a patient after offering treatment with marginal benefits that is also potentially burdonsome?

Back 46

Why they do or do not want it

Front 47

Management of advanced pancreatic cancer

Back 47

NO radiation
place a metal biliary stent for pain control

Front 48

Gram positive cocci in short chains

Back 48

strep pyogenes (necrotizing fasciitis)

Front 49

Antibiotic of choice for necrotizing fasciitis

Back 49

PCN and clinda

Front 50

elevated serum IgM
lymphoplasmacytic infiltrates of the bone marrow

Back 50

Waldrenstrom's Macroglobulinemia

Front 51

blurred vision
fatigue
mucosal bleeding
headache
heart failure
altered mentation

Back 51

hyperviscosity syndrome