Misc

Question 1

before starting IV fluids, make sure to r/o

Answer 1

pulmonary edema from heart failure
pleural effusion
(done with CXR)

Question 2

indications for PPSV23 before 65

Answer 2

chronic heart, lung, liver disease

diabetic, alcoholic, current smoker

Question 3

indications for PCV13 + PPSV23 before 65 (very high risk patients)

Answer 3

immunocompromised
CKD
CSF leaks
cochlear implants

Question 4

pneumonia vaccines after turning 65

Answer 4

PCV13 then PPSV23 6-12 months later

Question 5

Cushings electrolyte abnormality and reasoning

Answer 5

hypernatremia, hypokalemia

cortisol has mineralocorticoid activity, binds aldosterone receptors, causes K wasting

Question 6

causes of Charcot joint / neurogenic arthropathy

- tx

Answer 6

diabetes
B12 deficiency
tertiary syphilis
peripheral nerve damage

tx underlying disease, special shoes

Question 7

management of mild, drug induced hypersensitivity reaction (urticaria, no systemic sxs)

Answer 7

antihistamine and d/c offending drug

Question 8

positive FAST

equivocal FAST

Answer 8

positive: ex lap
equivocal: diagnostic peritoneal lavage

Question 9

shock within a few minutes of transfusion

• dx
• mechanism

Answer 9

anaphylactic reaction

recipient preformed IgA Ab

Question 10

respiratory distress and pulm edema within 6 hours of transfusion

• dx
• mechanism

Answer 10

TRALI

donor’s leukocyte Ab

Question 11

transient hypotension in patient taking ACEi, and given transfusion

• dx
• mechanism

Answer 11

primary hypotension reaction

bradykinin in blood products

Question 12

fever, chills, septic shock, DIC within minutes of transfusion
- dx

Answer 12

bacterial sepsis

Question 13

splenectomy vaccinations

Answer 13

Meningococcal
PCV13
Hib
all either at least 2 weeks before or 2 weeks after splenectomy

Question 14

complications of heat stroke

Answer 14

rhabdo
renal failure
ARDS
coagulopathic bleeding

Question 15

abd pain, constipation, polydipsia

Answer 15

hypercalcemia

Question 16

dry skin
HA
abd pain
blurry vision

Answer 16

vit A toxicity

Question 17

straight lines actually appear wave. dx?

Answer 17

macular degeneration

Question 18

indication for using IV sodium bicarb

Answer 18

pH less than 7.2

Question 19

prophylaxis post splenectomy

Answer 19

daily PCN 3-5 years after splenectomy

Question 20

people at risk for thiamine deficiency

Answer 20

alcoholics

bariatric surgery

Question 21

timeline of febrile non hemolytic reaction

what to do to blood in future

Answer 21

1-6 hours after transfusion

leukoreduction

Question 22

acute hemolytic reaction

• time frame
• sxs
• complications

Answer 22

within 1 hour of transfusion
fever, chills, flank pain, hemoglobinuria
renal failure, DIC

Question 23

patients with IgA deficiency should get what type of blood transfusion

Answer 23

washed blood

Question 24

what diseases increase production of vitamin D / calcitriol and result in kidney stones and renal failure?

Answer 24

sarcoidosis

TB

Question 25

tx of renal transplant rejection

Answer 25

IV corticosteroids

Question 26

scrotal bulge that increases when standing and decreases when lying down - tx

Answer 26

varicocele (dilated pampiniform plexus) gonadal vein ligation if want kids scrotal support and ligation if don't want kids

Question 27

characteristics of milk alkali syndrome

Answer 27

hypercalcemia renal insufficiency metabolic alkalosis

Question 28

qualities of McCune Albright syndrome

Answer 28

precocious puberty light brown cafe au lait spots bone defects

Question 29

patient ingested foreign object.. what are indications for surgical removal instead of endoscopic removal?

Answer 29

hematochezia melena extreme abd pain

Question 30

screening test for primary ciliary dyskinesia

Answer 30

exhaled nasal NO