,
,
,
,generally underweight, or less than 18.5
QUESTION
Anti -u1-ribonucleoprotein antibody
Answer:
mixed connective tissue disease
QUESTION
Anti-Glomerular basement membrane antibody disease (goodpasture's syndrome)
Answer:
-autoimmune disease, antibodies directed against type 4 collagen that binds to GBM
- linear deposition of IgG along GBM
- Rx cyclophosphamide, steroids, plasmapharesis
QUESTION
Anticoagulation option in breastfeeding women
Answer:
warfarin
QUESTION
APTT in hemophilia A and B
,Answer:
Prolonged, corrects on mixing study
b-thalasssemia - Answer: slightly increased hg A2, residual hg F
Barrter syndrome - Answer: Mimics loop diuretics
Biologic DMARDS - Answer: Anakinra,Anti-TNF: Etanercept, Infliximab, Adalimumab
Non Anti-TNF: Rituximab, Abatacept
biphosphonates must be used in all newly diagnosed MM patients requiring therapy - Answer: e.g
zoledronic acid
breast cancer prophylaxis post-menopausal women - Answer: exemestane
breast cancer screening modality for women with high breast density - Answer: digital mamography
(MRI Breast and US breast have low validity)
Can pyrazinamide be used in active gout? - Answer: No. Also caution in chronic gout, as can exacerbate
symptoms
Cancer associated with cyclophosphamide - Answer: Bladder cancer, may present with hematuria
causes of oral iron malabsorption - Answer: achlorydia
h.pylori
celiac disease
Cervicitis Vs Vaginitis - Answer: Cervicitis- Inflamed, friable cervix, typically caused by
gonorrhea/chlamydia. Treatment is 1 dose of IM Ceftriaxone 250mg and Azithromycin 1g
,Vaginitis- Infection of the vagina, caused by trichomoniasis, candidiasis, etc.
check for EGFR mutation in patients with lung cancer due to better prognosis with medications -
Answer: EGFR tyrosine kinase inhibitors - erlotinib, afatinib)
Chigunkuya - Answer: Severe joint pain and stiffness, fever (which recurs after an afebrile period),
polyarticular and migratory joint pains
chlamydia, gonorrhea cervicitis/urethritis treatment - Answer: Chlamydia- one dose azithromycin
(preferred to 7-day doxycycline)
Gonorrhea - Give Ceftriaxone and Azithromycin,as there is usually concomittant chlamydia infection
CKD with hyperphosphatemia? - Answer: use phosphate binders, e.g sevelamer
Classical component pathyway deficiency - Answer: C1, C2, C4 - Rheumatoid arthritis, SLE, Vasculitis,
Scleroderma. Frequency of infection low
Complement component deficiency - Answer: C5,C6, C7, C8, C9 - recurrent invasive meningococcal or
gonoccocal infections
confirmation for cold agglutinin disease - Answer: direct antiglobulin (coombs) test
dx assoc. with cold agglutinin- ebv, mycoplasma pneu
continue colchicine even if uric acid <6 and asymptomatic if tOPHI are present - Answer: ...
Continuous renal replacement therapy - Answer: type of dialysis specifically designed for critically ill
patients with AKi who cannot tolerate traditional dialysis due to hemodynamic instability.
,CRRT is performed continously through a venovenous access
Criteria for Non-contagious TB - Answer: 1. 3 Negative AFB sputum
2. At least 2 weeks of therapy with RIPE
3. Demonstrate improvement in symptoms
Cryoglobulinemic vasculitis - Answer: Ear infarction (very common) as well as skin infarctions
Low C4 with normal C3 in presence of positive RF
about 90% are infected with hepatitis C
palpable purpura
CSF PCR in Herpes simplex encephalitis - Answer: Early CSF PCR may be falsely negative in early stage of
disease, and should be repeated in 3-7 days.
Cutaneous uncomplicated anthrax treatment - Answer: Ciprofloxacin (or flouroquinolone)
Dengue Fever - Answer: Sudden high fever, frontal headache, retororbitial eye pain, severe low back
pain, arhralgia+myalgia, maculopapular rash that appears as fever abates
describe uveitis - Answer: unilateral eye pain, photophobia, ciliary flush (Circumferential redness along
the border of the sclera and cornea), there may be miosis
Diabetes insipidus test - Answer: water restriction test
no rising urine osmolality despite rising plasma osmolality in water restriction
D.I is either caused by abscence of ADH (central) or resistance to ADH (nephrogenic)
Normal urine osm response >600
,in central D.I, increase in urine osm is seen with administration of desmopressin (no increase in
nephrogenic)
differentiate liver disease coagulopathy/DIC/vit.K def/coumadin overdose - Answer: In liver disease, PT,
aPTT and Factor VIII elevated (in DIC, factor VIII not elevated)
In Vit K def, Factor V normal (in liver failure, Factor V low)
diffuse alveolar hemorrhage associated with SLE - Answer: Hypoxia
New infiltrates
Dropping hct
only ~50% have hemoptysis
disease associated with collapsing form of FSGS - Answer: HIV
DISH (diffuse idiopathic skeletal hyperostosis) or Forestier disease - Answer: Flowing osteophytes seen
on radiography
dont use two biologic DMARDS together due to increased risk of infections - Answer: ....
E. fecalis Vs E.faecium - Answer: E.fecalis
- infections more virulent than e.faecium
- bacteremia more likely to be associated with endocarditis than e.faecium
- e.fecalis more susceptible to b-lactams (e.g ampicillin), e.fecalis more resistant to b-lactams
- e.fecalis more resistant to quinupristin-dalfopristin (e.faecium vice-versa)
Effect of Trimethoprim on Cr - Answer: Trimethoprim affects Creatinine secretion without affecting the
GFR and can cause increase in serum Cr up to 0.5 without affecting kidney function
, Effectof dextrose containing fluids on phosphate level - Answer: further drops phosphate level, patient's
may dev respiratory failure is levels already low (e.g in alcoholics)
glucose stimulates insulin release, which promotes phosphate uptake
elevated homocysteine level is 90% sensitive for folate deficiency - Answer: homocysteine and
methylmalonic acid levels are elevated in Vit B12def
Empiric therapy for meningitis in ppl over the age of 50 - Answer: Ampicillin, Ceftriaxone and
Vancomycin (Ampicillin added for Listeria infection)
enteric hyperoxaluria and calcium oxalate nephrolithiasis adjunct management - Answer: bile salt
binders, e.g cholestyramine to descrease intestinal oxalate absorption
Eosinophilic granulomatosis with polyangiitis presentation - Answer: Eosinophilia
Migratory pulmonary infiltrates
mononeuritis multiplex
Purpuric skin rash
+in setting of antecedent atopy
example of central pain syndrome - Answer: fibromyalgia
Felty syndrome - Answer: RA
Splenomegaly
neutropenia
first line therapy for upper airway cough syndrome in patients with allergic rhinitis - Answer: intranasal
glucocorticoids
,
,
,generally underweight, or less than 18.5
QUESTION
Anti -u1-ribonucleoprotein antibody
Answer:
mixed connective tissue disease
QUESTION
Anti-Glomerular basement membrane antibody disease (goodpasture's syndrome)
Answer:
-autoimmune disease, antibodies directed against type 4 collagen that binds to GBM
- linear deposition of IgG along GBM
- Rx cyclophosphamide, steroids, plasmapharesis
QUESTION
Anticoagulation option in breastfeeding women
Answer:
warfarin
QUESTION
APTT in hemophilia A and B
,Answer:
Prolonged, corrects on mixing study
b-thalasssemia - Answer: slightly increased hg A2, residual hg F
Barrter syndrome - Answer: Mimics loop diuretics
Biologic DMARDS - Answer: Anakinra,Anti-TNF: Etanercept, Infliximab, Adalimumab
Non Anti-TNF: Rituximab, Abatacept
biphosphonates must be used in all newly diagnosed MM patients requiring therapy - Answer: e.g
zoledronic acid
breast cancer prophylaxis post-menopausal women - Answer: exemestane
breast cancer screening modality for women with high breast density - Answer: digital mamography
(MRI Breast and US breast have low validity)
Can pyrazinamide be used in active gout? - Answer: No. Also caution in chronic gout, as can exacerbate
symptoms
Cancer associated with cyclophosphamide - Answer: Bladder cancer, may present with hematuria
causes of oral iron malabsorption - Answer: achlorydia
h.pylori
celiac disease
Cervicitis Vs Vaginitis - Answer: Cervicitis- Inflamed, friable cervix, typically caused by
gonorrhea/chlamydia. Treatment is 1 dose of IM Ceftriaxone 250mg and Azithromycin 1g
,Vaginitis- Infection of the vagina, caused by trichomoniasis, candidiasis, etc.
check for EGFR mutation in patients with lung cancer due to better prognosis with medications -
Answer: EGFR tyrosine kinase inhibitors - erlotinib, afatinib)
Chigunkuya - Answer: Severe joint pain and stiffness, fever (which recurs after an afebrile period),
polyarticular and migratory joint pains
chlamydia, gonorrhea cervicitis/urethritis treatment - Answer: Chlamydia- one dose azithromycin
(preferred to 7-day doxycycline)
Gonorrhea - Give Ceftriaxone and Azithromycin,as there is usually concomittant chlamydia infection
CKD with hyperphosphatemia? - Answer: use phosphate binders, e.g sevelamer
Classical component pathyway deficiency - Answer: C1, C2, C4 - Rheumatoid arthritis, SLE, Vasculitis,
Scleroderma. Frequency of infection low
Complement component deficiency - Answer: C5,C6, C7, C8, C9 - recurrent invasive meningococcal or
gonoccocal infections
confirmation for cold agglutinin disease - Answer: direct antiglobulin (coombs) test
dx assoc. with cold agglutinin- ebv, mycoplasma pneu
continue colchicine even if uric acid <6 and asymptomatic if tOPHI are present - Answer: ...
Continuous renal replacement therapy - Answer: type of dialysis specifically designed for critically ill
patients with AKi who cannot tolerate traditional dialysis due to hemodynamic instability.
,CRRT is performed continously through a venovenous access
Criteria for Non-contagious TB - Answer: 1. 3 Negative AFB sputum
2. At least 2 weeks of therapy with RIPE
3. Demonstrate improvement in symptoms
Cryoglobulinemic vasculitis - Answer: Ear infarction (very common) as well as skin infarctions
Low C4 with normal C3 in presence of positive RF
about 90% are infected with hepatitis C
palpable purpura
CSF PCR in Herpes simplex encephalitis - Answer: Early CSF PCR may be falsely negative in early stage of
disease, and should be repeated in 3-7 days.
Cutaneous uncomplicated anthrax treatment - Answer: Ciprofloxacin (or flouroquinolone)
Dengue Fever - Answer: Sudden high fever, frontal headache, retororbitial eye pain, severe low back
pain, arhralgia+myalgia, maculopapular rash that appears as fever abates
describe uveitis - Answer: unilateral eye pain, photophobia, ciliary flush (Circumferential redness along
the border of the sclera and cornea), there may be miosis
Diabetes insipidus test - Answer: water restriction test
no rising urine osmolality despite rising plasma osmolality in water restriction
D.I is either caused by abscence of ADH (central) or resistance to ADH (nephrogenic)
Normal urine osm response >600
,in central D.I, increase in urine osm is seen with administration of desmopressin (no increase in
nephrogenic)
differentiate liver disease coagulopathy/DIC/vit.K def/coumadin overdose - Answer: In liver disease, PT,
aPTT and Factor VIII elevated (in DIC, factor VIII not elevated)
In Vit K def, Factor V normal (in liver failure, Factor V low)
diffuse alveolar hemorrhage associated with SLE - Answer: Hypoxia
New infiltrates
Dropping hct
only ~50% have hemoptysis
disease associated with collapsing form of FSGS - Answer: HIV
DISH (diffuse idiopathic skeletal hyperostosis) or Forestier disease - Answer: Flowing osteophytes seen
on radiography
dont use two biologic DMARDS together due to increased risk of infections - Answer: ....
E. fecalis Vs E.faecium - Answer: E.fecalis
- infections more virulent than e.faecium
- bacteremia more likely to be associated with endocarditis than e.faecium
- e.fecalis more susceptible to b-lactams (e.g ampicillin), e.fecalis more resistant to b-lactams
- e.fecalis more resistant to quinupristin-dalfopristin (e.faecium vice-versa)
Effect of Trimethoprim on Cr - Answer: Trimethoprim affects Creatinine secretion without affecting the
GFR and can cause increase in serum Cr up to 0.5 without affecting kidney function
, Effectof dextrose containing fluids on phosphate level - Answer: further drops phosphate level, patient's
may dev respiratory failure is levels already low (e.g in alcoholics)
glucose stimulates insulin release, which promotes phosphate uptake
elevated homocysteine level is 90% sensitive for folate deficiency - Answer: homocysteine and
methylmalonic acid levels are elevated in Vit B12def
Empiric therapy for meningitis in ppl over the age of 50 - Answer: Ampicillin, Ceftriaxone and
Vancomycin (Ampicillin added for Listeria infection)
enteric hyperoxaluria and calcium oxalate nephrolithiasis adjunct management - Answer: bile salt
binders, e.g cholestyramine to descrease intestinal oxalate absorption
Eosinophilic granulomatosis with polyangiitis presentation - Answer: Eosinophilia
Migratory pulmonary infiltrates
mononeuritis multiplex
Purpuric skin rash
+in setting of antecedent atopy
example of central pain syndrome - Answer: fibromyalgia
Felty syndrome - Answer: RA
Splenomegaly
neutropenia
first line therapy for upper airway cough syndrome in patients with allergic rhinitis - Answer: intranasal
glucocorticoids
