Emily's Fcm Post-Exam Review

Front 1

Atypical Microbiology for endocarditis?

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HACEK, Bartonella, Coxiella, Brucella, Tropheryma whipplei

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HACEK, Bartonella, Coxiella, Brucella, Tropheryma whipplei require […] for Dx:

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All require PCR due to negative culture for diagnosis

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What is HACEK?

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Haemophilous spp., Actinobacillus actinomycetemcomitans, Cardiobacterium hominus, Eikenella corrodens, Kingella spp.

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2. Inflammatory Bowel Disease (IBD) --> Extra Intestinal Manifestations are:

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Musculoskeletal Disorders: Peripheral, large joint and Ankylosing spondylitis; Dermatological Disorders: Erthema Nodosum, Pyoderma Gangrenosum; Uveitis/episcleritis; Hepatobiliary problems

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3. Bloody Diarrhea low back pain (sacrolieac)?

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Inflammatory Bowel Disease

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4. Treatment for ulcerative colitis?

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mesalamine (5-ASA)

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5. Prolactinoma first treat with -->

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Bromocriptine medical therapy

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6. Adrenal Insufficiency – Metabolic Acidosis, Hyperkalemia, Hyponatremia-->

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oral cortical steroids

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GH tumor – measure […] hours after an oral glucose load

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GH tumor – measure 2 hours after an oral glucose load

Front 10

GH is diabetogenic- insulin […]

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GH is diabetogenic- insulin antagonist

Front 11

What hormones compete with insulin?

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Compete with insulin: epinephrine, cortisol, glucagon, GH.

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HBsAg indicates what?

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HBsAg active Hep B

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HBsAb indicates what?

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HBsAb indicates exposure

Front 14

HBeAg indicates what?

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HBeAg highly infectious

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IgG in hepatitis indicates what?

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IgG chronic

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IgM in hepatitis indicates what?

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IgM acute

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differentiating between Hep B & C -->

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Hep B sexually Transmitted; Hep C IV drug user, transfusion

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Hep B, low Blood Pressure -->

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10. High levels of viral load warrant therapy

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11. Persistent hyperglycemia makes […] worse

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11. Persistent hyperglycemia makes DM worse

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Type I DM most common group?

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Caucasian, Nordic, white European

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13. Longest Acting Insulin?

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Glargine insulin longest lasting 24hrs? (Need baseline insulin)

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T or F: 14. Corticosteroids NOT a risk factor for IE

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TRUE

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risk factors for infectious endocarditis?

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Pulmonary-systemic shunts, IV drug use, prosthetic valves, congenital abnormalities, rheumatic heart disease and previous endocarditis ARE

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Native Valve Endocarditis

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Streptococcus viridans

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16. **IV Drug (meth) abuser -->Endocarditis --> Staph aureus --> Seeding from Tricuspid into the Lungs

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--> Diffuse Embolic infections

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17. Painful swelling in the neck -->

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Subacute De Quervain’s Thyroiditis

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18. Graves Disease -->

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Increased uptake of radioactive iodine (low I23 uptake)

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19. Sick Euthyroid -->

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Increase reverse T3 uptake

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20. Cold Thyroid Nodule -->

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diagnosis with fine needle aspiration (biopsy)

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T3 and T4 uptake go […] in thyroid disease

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T3 and T4 uptake go in same direction in thyroid disease

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21. Smoker pneumonia?

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H. influenza, 2nd generation cephalosporin

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22. TB what do you do?

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place in isolation test for HIV, PPD, stain for acid fast

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23. Walking (Community) Pneumonia --> bad chest X ray, not that sick of a patient. Number one cause of walking pneumonia?

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#1 cause = viral

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23. Walking (Community) Pneumonia --> bad chest X ray, not that sick of a patient. Number two cause of walking pneumonia?

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#2 cause mycoplasma (No gram stain)

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24. PORT Score?

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pneumonia severity index the higher the score the poorer the prognosis

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25. Camping Diarrhea?

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Giardia Lambia

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26. Rota Virus?

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# 1 cause of Diarrhea in Kids

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27. Bilateral flank pain, pyelonephritis + Ab --> Clostridium diffeicle -->

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Pseudomembranous Colitis

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28. Pseudomembranous colitis drugs?

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clindamycin and cipro --> Clostridium diffecile -->Bacterial Toxins

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29. Stress + icteric sclerus, elevated serum + indirect bilirubin?

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Gilberts Syndrome

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30. **Heart Failure, Cirrhosis, and Nephrosis all cause […] Aldosterone states and Edematous states

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30. **Heart Failure, Cirrhosis, and Nephrosis all cause increase Aldosterone states and Edematous states

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31. Chronic (>1month) Herpes Simplex (mucocutaneous or esophageal infection) is diagnostic of

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AIDS

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32. Friend wants to know if he has HIV -->

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Saliva ELISA and Western blot NOT p24

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33. Mid 1990’s […] the big break through for AIDS

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33. Mid 1990’s Protease Inhibitors the big break through for AIDS

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34. Patient with Histoplasmosis and HIV is given treatment and pt. worsens -->

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Immune Reconstitution Syndrome, give steroids

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35. Liver Disease runs in the family, emphysema from what?

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alpha 1 anti trypsin deficiency (PiZZ haplotype)

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hemolysis = Risk Factor for what?

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36. Cholethithiasis

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37. ALCOHOL is the Number 1 cause of […] (Pancreatits)

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37. ALCOHOL is the Number 1 cause of Chronic (Pancreatits)

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38. Acute Pancreatitis =

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alcohol or gallstones

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39. Spontaneous Bacterial Peritonitis

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gram negative rods

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40. Serum-ascetic albumin gradient > 1.1. What is the cause of portal ascites?

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Portal HTN is the cause of ascites

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41. Elevated PT / INR, Impotence, PT hepatic encephalopathy:

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not due to portal HTN due to dead liver; not due to an increase in portal pressure, but due to hyperestrogen state

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Palmar Erythema due to […]

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Palmar Erythema due to estrogen

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Gynecomastia due to […]

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Gynecomastia due to estrogen

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Ways you get pneumonia…

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42.  answer: all of the above

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early morning sputum properly collected

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TB

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SAGG

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serum ascetic gradient