Internal Medicine Hint and Clues (Based of Kaplan
Questions and Answers 2023)with complete solution
Key Words are given and Quotations, try to figure out what they mean. Qs are
added too...
...
"Machinery Murmur"
Patent Ductus Arteriosus
"Best heard in the right sternal border" (loud systolic murmur)
Aortic valve stenosis
What is pulsus paradoxus?
define as fall in systolic blood pressure >10mmHg on inspiration Seen in Cardiac
tamponade
What is the first therapy for HTN in DM pt?
ACEi (eg. Lisinopril)
A class of drugs that decrease mortality for CHF and can control a. fib.
Beta Blocker
Drug that lowers BP by vasodilate
Nitroglycerin
An arrhythmia that is tachycardia and can be controlled with vagal maneuver?
Atrioventricular nodal reentry tachycardia
(AV nodal renetry)
What is the most frequent secondary cause to young children with HTN?
renal vascular disease
Why tPA over streptokinase for fibrinolytic therapy?
bc fibrinolytic therapy can cause allergic reaction bc it is a foreign protein as compare to
tPA.
Who is most likely to get a Mitral valve prolapse? Is antibiotic needed?
Pregnant Women.
No
"Musset sign, Austin Flint murmur, Corrigan pulse, Hill sign"
Aortic Regurgitation
"Opening Snap, Graham Steel Murmur"
Mitral Stenosis
Valvular disease associated with rheumatoid fever
Mitral Stenosis
Murmur is holosystolic, high pitch and best heard at the apex with diaphragm in
left lateral decubitus, radiates to the axilla.
Mitral regurgitation
The most common anatomic correlate seen in patients who have AF...
Enlarged left atrium
What happen after a severe hemorrhage or lost of blood?
↑Heart Rate, ↓ BP, ↓ GI motility, and dilation in pupil.
Pt who are hypothermic, will show what type of waves on the EKG?
Osborn waves
,Plavix is an anti-platelet that inhibits
adenosine diphosphate induced platelet aggregration and interact with platelet
glycoprotein IIB/IIIa
Chest pain w/ inspiration and recumbency
pericarditis
Pt comes in and has been coughing for the past five days.
Acute Bronchitis
URI can lead to
bronchitis (H. Influ., S. Pneumo.)
Chronic hypoxia is often to due to...
chronic bronchitis
Main complaint is chronic cough
chronic bronchitis
"Pt present with egophony, rales, dullness to percuss, wheezing, possible
productive cough, chest, night sweat, tachypnea"
Pneumonia
Cutaneous flushing is the hallmark sign of
Carcinoid Tumor
Pt. has wheezing, SOB, chest tightness, worse night, Increase Expiratory phase,
Cough...
Asthma
Pt. ha s chronic bronchitis, emphysema, Decrease elastic recoil of the ling, barrel
chest, SOB, wheezing, use of chest muscles
COPD
Chest x-ray shows hyperinflated lungs
COPD
Blue Bloaters
Chronic Bronchitis
Pt has wheezing, cough or no cough, decrease breath sounds, Dullness to
precussion, egophany,increase tactile fremitus, tachypnea
Pneumonia
Pt has cough, weight loss, hemoptysis, hoarseness, adenocarcinoma, Superior
vena cava syndrome: Facial/arm swelling
Lung Cancer (Neoplasm)
Classic symptoms of pneumonia; Non-productive cough
Viral pneumonia (Influ. A)
Classic symptoms of pneumonia; High fever, Pleutric pain, productive cough
Bacteria pneumonia (Stept. Pneumoniae)
Classic symptoms of pneumonia; Slow on-set
Bacteria pneumonia: H. Influenza
Classic symptomsof pneumoni; Abscess
Bacteria pneumonia: Staph A.
Classic symptoms of pneumonia; GI Symptoms
Fungal pneumonia: Pneumocystis carnini (fungal-like)
Subacute disease, for initial hx, traveler get these in caves in Central America,
South America
,Fungal pneumonia:
Symptoms of pneumonia; Currant-jelly sputum
Atypical bacteria pneumonia: Klebsiella pneumoniae
This tumor synthesize, store, release serotonin and bradykinin.
Carcinoid Tumor
Bronchiectasis mostly caused by
Cystic fibrosis
"Chronic cough accompanied by frequent bouts of yellow or green sputum
production, dyspnea, and possible hemoptysis and halitosis."
Bronchiectasis
Irreversible destruction of the muscle and elastic tissue of the bronchial tree
(scarring)
Bronchiectasis
Pt has weight loss, anemia, crackles on lung exam, rales, rhonchi, purulent
mucus, and occasional hemoptysis."
Bronchiectasis
"well-circumscribed nodule seen on CXR with no associated mediastinal or hilar
lymph node
involvement"
Pulmonary nodule
Pulmonary nodule
"Presents with nonproductive cough, shortness of breath, fatigue, and malaise;
she has bilateral hilar lymphadenopathy on chest radiography and elevated ACE
levels."
Sarcoidosis
"Presents with dyspnea on exertion, fatigue, lethargy, syncope with exertion,
chest pain, and symptoms of right-sided CHF (edema, abdominal distention,
JVD)"
Pulmonary hypertension
>25mmHg in the lung
Pulmonary hypertension
Honeycomb appear on chest X-ray
Pulmonary fibrosis
"Pt present dry cough, fatigue, clubbing, malaise, inspiratory crackles, exertional
dyspnea"
Pulmonary fibrosis
What is being malaise?
A sense of disease, depression
Worker that are involved in brake lining, insulation, construction, demolition, ship
building. CXR shows linear opacities at lung, base and interstitial fibrosis.
Asbestosis Pneumoconiosis
Worker in the mines and quarries or with glass, pottery, silica. CXR shows
eggshell calcification.
Silicosis Pneumoconiosis
"Exertional dyspnea and a nonproductive cough.
Inspiratory crackles and/or clubbing on exam."
, Pneumoconioses
l. Decrease in exercise tolerance
2. Cyanosis and digital clubbing
3. Signs of right ventricular failure: hepatomegaly, edema, JVD
4. Parasternal lift
5. Polycythemia is often present if COPD is the cause of cor pulmonale.
Cor pulmonale
What is the most common cause of community acquired pyogenic bacteria
pneumonia?
Pneumococcus
What is the tx Pneumococcui
Class:Macrolides
Drug: Clarithromycin
Unilateral Chest Pain / dynea
Spontaneous Pneumothroax
Whooping cough=Severe paroxysm
Pertussis
Tx for Pertussis
Erythromycin
Lung present w/ hyperresonant and decreases tactile fremitus
Pneumothorax
"2 year old pt present w/ low grade fever, wheezing, and cough.
RSV
Infant who experience apneic episode and cyanotic...Tx
Caffeine citrate
Respiratory distress following ingestion of a piece of candy
Aphonia
Dx of sarcoidosis
Lymph node
Pt has chronic cough, cyanosis, distended neck vein, dysnea
Cor pulmonale
Lung cancer usually present with
Ptosis, miosis, anhidrosis (inability to sweat normally)
Which pneumoniae has a non productive cough?
Mycoplasma (Transmission is aerosolized droplet)
Tx for Mycoplasma pneumoniae
Macrolides
Peripheral "pruning" of the large pulmonary artery
Pulmonary HTN
Dx of PTE (pulmonary thromboendarterectomy)
Arteriography
Which of the pneumoconioses would show a decrease FEV?
Coal Work pneumoconiosis
Noncaseating granulomas
sarcodosis
Risk factor for acute respiratory distress syndrome
Questions and Answers 2023)with complete solution
Key Words are given and Quotations, try to figure out what they mean. Qs are
added too...
...
"Machinery Murmur"
Patent Ductus Arteriosus
"Best heard in the right sternal border" (loud systolic murmur)
Aortic valve stenosis
What is pulsus paradoxus?
define as fall in systolic blood pressure >10mmHg on inspiration Seen in Cardiac
tamponade
What is the first therapy for HTN in DM pt?
ACEi (eg. Lisinopril)
A class of drugs that decrease mortality for CHF and can control a. fib.
Beta Blocker
Drug that lowers BP by vasodilate
Nitroglycerin
An arrhythmia that is tachycardia and can be controlled with vagal maneuver?
Atrioventricular nodal reentry tachycardia
(AV nodal renetry)
What is the most frequent secondary cause to young children with HTN?
renal vascular disease
Why tPA over streptokinase for fibrinolytic therapy?
bc fibrinolytic therapy can cause allergic reaction bc it is a foreign protein as compare to
tPA.
Who is most likely to get a Mitral valve prolapse? Is antibiotic needed?
Pregnant Women.
No
"Musset sign, Austin Flint murmur, Corrigan pulse, Hill sign"
Aortic Regurgitation
"Opening Snap, Graham Steel Murmur"
Mitral Stenosis
Valvular disease associated with rheumatoid fever
Mitral Stenosis
Murmur is holosystolic, high pitch and best heard at the apex with diaphragm in
left lateral decubitus, radiates to the axilla.
Mitral regurgitation
The most common anatomic correlate seen in patients who have AF...
Enlarged left atrium
What happen after a severe hemorrhage or lost of blood?
↑Heart Rate, ↓ BP, ↓ GI motility, and dilation in pupil.
Pt who are hypothermic, will show what type of waves on the EKG?
Osborn waves
,Plavix is an anti-platelet that inhibits
adenosine diphosphate induced platelet aggregration and interact with platelet
glycoprotein IIB/IIIa
Chest pain w/ inspiration and recumbency
pericarditis
Pt comes in and has been coughing for the past five days.
Acute Bronchitis
URI can lead to
bronchitis (H. Influ., S. Pneumo.)
Chronic hypoxia is often to due to...
chronic bronchitis
Main complaint is chronic cough
chronic bronchitis
"Pt present with egophony, rales, dullness to percuss, wheezing, possible
productive cough, chest, night sweat, tachypnea"
Pneumonia
Cutaneous flushing is the hallmark sign of
Carcinoid Tumor
Pt. has wheezing, SOB, chest tightness, worse night, Increase Expiratory phase,
Cough...
Asthma
Pt. ha s chronic bronchitis, emphysema, Decrease elastic recoil of the ling, barrel
chest, SOB, wheezing, use of chest muscles
COPD
Chest x-ray shows hyperinflated lungs
COPD
Blue Bloaters
Chronic Bronchitis
Pt has wheezing, cough or no cough, decrease breath sounds, Dullness to
precussion, egophany,increase tactile fremitus, tachypnea
Pneumonia
Pt has cough, weight loss, hemoptysis, hoarseness, adenocarcinoma, Superior
vena cava syndrome: Facial/arm swelling
Lung Cancer (Neoplasm)
Classic symptoms of pneumonia; Non-productive cough
Viral pneumonia (Influ. A)
Classic symptoms of pneumonia; High fever, Pleutric pain, productive cough
Bacteria pneumonia (Stept. Pneumoniae)
Classic symptoms of pneumonia; Slow on-set
Bacteria pneumonia: H. Influenza
Classic symptomsof pneumoni; Abscess
Bacteria pneumonia: Staph A.
Classic symptoms of pneumonia; GI Symptoms
Fungal pneumonia: Pneumocystis carnini (fungal-like)
Subacute disease, for initial hx, traveler get these in caves in Central America,
South America
,Fungal pneumonia:
Symptoms of pneumonia; Currant-jelly sputum
Atypical bacteria pneumonia: Klebsiella pneumoniae
This tumor synthesize, store, release serotonin and bradykinin.
Carcinoid Tumor
Bronchiectasis mostly caused by
Cystic fibrosis
"Chronic cough accompanied by frequent bouts of yellow or green sputum
production, dyspnea, and possible hemoptysis and halitosis."
Bronchiectasis
Irreversible destruction of the muscle and elastic tissue of the bronchial tree
(scarring)
Bronchiectasis
Pt has weight loss, anemia, crackles on lung exam, rales, rhonchi, purulent
mucus, and occasional hemoptysis."
Bronchiectasis
"well-circumscribed nodule seen on CXR with no associated mediastinal or hilar
lymph node
involvement"
Pulmonary nodule
Pulmonary nodule
"Presents with nonproductive cough, shortness of breath, fatigue, and malaise;
she has bilateral hilar lymphadenopathy on chest radiography and elevated ACE
levels."
Sarcoidosis
"Presents with dyspnea on exertion, fatigue, lethargy, syncope with exertion,
chest pain, and symptoms of right-sided CHF (edema, abdominal distention,
JVD)"
Pulmonary hypertension
>25mmHg in the lung
Pulmonary hypertension
Honeycomb appear on chest X-ray
Pulmonary fibrosis
"Pt present dry cough, fatigue, clubbing, malaise, inspiratory crackles, exertional
dyspnea"
Pulmonary fibrosis
What is being malaise?
A sense of disease, depression
Worker that are involved in brake lining, insulation, construction, demolition, ship
building. CXR shows linear opacities at lung, base and interstitial fibrosis.
Asbestosis Pneumoconiosis
Worker in the mines and quarries or with glass, pottery, silica. CXR shows
eggshell calcification.
Silicosis Pneumoconiosis
"Exertional dyspnea and a nonproductive cough.
Inspiratory crackles and/or clubbing on exam."
, Pneumoconioses
l. Decrease in exercise tolerance
2. Cyanosis and digital clubbing
3. Signs of right ventricular failure: hepatomegaly, edema, JVD
4. Parasternal lift
5. Polycythemia is often present if COPD is the cause of cor pulmonale.
Cor pulmonale
What is the most common cause of community acquired pyogenic bacteria
pneumonia?
Pneumococcus
What is the tx Pneumococcui
Class:Macrolides
Drug: Clarithromycin
Unilateral Chest Pain / dynea
Spontaneous Pneumothroax
Whooping cough=Severe paroxysm
Pertussis
Tx for Pertussis
Erythromycin
Lung present w/ hyperresonant and decreases tactile fremitus
Pneumothorax
"2 year old pt present w/ low grade fever, wheezing, and cough.
RSV
Infant who experience apneic episode and cyanotic...Tx
Caffeine citrate
Respiratory distress following ingestion of a piece of candy
Aphonia
Dx of sarcoidosis
Lymph node
Pt has chronic cough, cyanosis, distended neck vein, dysnea
Cor pulmonale
Lung cancer usually present with
Ptosis, miosis, anhidrosis (inability to sweat normally)
Which pneumoniae has a non productive cough?
Mycoplasma (Transmission is aerosolized droplet)
Tx for Mycoplasma pneumoniae
Macrolides
Peripheral "pruning" of the large pulmonary artery
Pulmonary HTN
Dx of PTE (pulmonary thromboendarterectomy)
Arteriography
Which of the pneumoconioses would show a decrease FEV?
Coal Work pneumoconiosis
Noncaseating granulomas
sarcodosis
Risk factor for acute respiratory distress syndrome
