19 JAN 2017 0836 IM

Question 1

HIV patients with CD4 counts under ______ should not receive live vaccines

Answer 1

200

Question 2

in diabetic neuropathy small fibers cause what types of symptoms? large fibers?

Answer 2

• small fibers: POSITIVE symptoms (pain, paresthesias)

- large fibers: NEGATIVE symptoms (sensory loss)

Question 3

what types of medications can cause acute angle closure glaucoma?

Answer 3

• decongestants
• antiemetics
• anticholinergics

Question 4

hordoleums (styes) are usually caused by what bacterium? what is the treatment?

Answer 4

• staph aureus

- warm compress

Question 5

patients with HIV who develop progressive disseminated histoplasmosis require what treatment medication?

Answer 5

• IV amphotericin B (liposomal): 1-2 weeks

- oral intraconazole: for 1 year maintenance

Question 6

what do lab studies show in a VIPoma? what are the reasons for each?

Answer 6

• hypokalemia: increased intestinal potassium secretion
• hypercalcemia: increased bone resorption
• hyperglycemia: increased glycogenolysis
• Low stool osmotic gap < 50 mosm/kg (OG = 290 - 2*Na - K)

Question 7

what is confirmatory for diagnosing a VIPoma?

Answer 7

VIP level over 75

Question 8

what are the treatment options for a VIPoma?

Answer 8

• volume repletion

- octreotide to decrease diarrhea

Question 9

an anaphylactic reaction can potentially be delayed up to how long?

Answer 9

several hours

Question 10

patients with syphilis who have PCN allergy receive alternate treatment with _____________

Answer 10

oral doxycycline

Question 11

when is PCN desensitization indicated for syphilis treatment?

Answer 11

• CNS involvement (ocular, neuro)
• multiple treatment failures with other agents
• pregnancy

Question 12

what is the treatment of choice for early syphilis?

Answer 12

IM benzathine PCN G

Question 13

definition: observer bias

Answer 13

when investigator’s decision is adversely affeected by knowledge of the exposure status

Question 14

what is the first step when encountered with a painless hard testicular mass and suggestive US?

Answer 14

orchiectomy (remove testicle and cord) - remove first and investigate later!

Question 15

how can polymyositis be differentiated from lambert eaton?

Answer 15

in polymyositis:

• reflexes are preserved
• elevated creatine kinase

Question 16

patients with ankylosing spondylitis can develop what type of pulmonary disease? why?

Answer 16

• restrictive lung disease

- diminished chest wall and spinal mobility

Question 17

optic glioma is a well known complication of ___________________

Answer 17

neurofibromatosis type I

Question 18

definition: enthesitis

Answer 18

inflammation at sites of ligamentous insertion

Question 19

what is the mainstay of therapy for Dressler’s syndrome?

Answer 19

NSAIDs (corticosteroids if NSAIDs are contraindicated)

Question 20

what are the symptoms of wallenberg syndrome?

• vestibulocerebellar
• sensory
• bulbar
• autonomic

Answer 20

• vestibulocerebellar: vertigo, falling to side of lesion, diplopia and nystagmus (horizontal and rotational), ipsilateral limb ataxia
• sensory: loss of pain and temperature on ipsilateral face and contralateral trunk / limbs
• bulbar: dysphagia, aspiration, dysarthria, dysphonia, hoarseness (ipsilateral vocal cord paralysis)
• autonomic: ipsilateral horners, hiccups

Question 21

wallenberg syndrome (lateral medullary infarct) occurs due to occlusion of what artery(ies)?

Answer 21

PICA or vertebral

Question 22

after ____ hours, gluconeogenesis represents the sole source of glucose production

Answer 22

24

Question 23

what is the main cause of hypercapnia in COPD?

Answer 23

increased dead space ventilation

Question 24

minute ventilation is the product of:

Answer 24

tidal volume and respiratory rate