ABFM ITE 2018 with 100- correct answers.

ABFM ITE 2018 with
100% correct answers
pt who had recently been on CRUISE SHIP now has
productive COUGH- sometime bloody
HA, muscle aches.
Dx? how to diagnose?
Legionnaires disease
- urine testing for legionella antigen
What increases the risk of developmental dysplasia of the hip in
infants? (3)
- breech presentation in 3rd trimester (REGARDLESS OF DELIVERY
BEING C/S OR SVD)
- family history of breech
- hx of previous DDH
CARPET LAYER PT HAS LEFT KNEE SWELLING,
MINIMAL TTP

NO ERYTHEMA, WARMTH
NO TRAUMA

DIAGNOSE
TX?
PRE-PATELLAR BURSITIS
=
TX= REST ICE COMPRESSION

equiv of olecrenon aseptic bursitis
what is ABSOLUTE CONTRAINDICATION TO
USE OF TPA/FIBRINOLYTIC THERAPY
RECENT ISCHEMIC STROKE IN 3 MONTHS

OTHERS:
- ANY HISTORY OF INTRACRANIAL hemorrhage

,- Symptoms of subarachnoid hemorrhage
- ANY SORTS OF CONCERNS FOR BLEEDS
- Use of anticoagulant drug
- Aortic dissection
PT HAS SUDDEN LEFT HEARING LOSS
NO TRAUMA
NO PAIN, NO BLEEDING, DRAINAIGE, , FEVER
EAR EXAM COMPLETELY NORMAL

DIAGNOSE
TX
IDIOPATHIC
sudden sensorineural hearing loss
=
(SSNHL)

TX= PREDNISONE= ORAL
Weber test means that hearing lateralizes to:
Good ear
PT TWISTED ANKLE

Able to bear weight but with significant pain.

She reports pain across her right midfoot

.An examination reveals edema over the lateral malleolus and
diffuse tenderness,

but she does not have any pain OVER posterior distal lateral and
medial malleoli

SHOULD U DO XRAY OR NOT?
NO XRAY

ALTHOUGH LATERAL MALLEOLUS TTP,
DISTAL PART OF LATERAL/MEDIAL MELLEOLUS IS NOT TTP OR
PAINFUL

AND ALTHOUGH PT HAS PAIN,

,SHE IS ABLE TO BEAR WEIGHT (4 STEPS)
=
CONSERVATIVE MANAGEMENT
D) Lace-up ankle support, ice, compression, and clinical follow-up
Which one of the following factors would increase the risk of atrial
fibrillation in this patient?
A) Alcohol use
B) Treatment with lisinopril (Prinivil, Zestril)
C) Treatment with pioglitazone (Actos)
D) Use of a continuous positive airway pressure (CPAP) device
E) Physical stress3
ALCHOL USE
best way to assess the patient's response to oral iron?
RETICULOCYTE COUNT IN
JUST
1-2 WEEKS
PT WITH CHRONIC URTICARIA
ON LORATADINE= CLARITIN
STILL HAS HIVES

TX?
ADD ON H1 BLOCKER
=
RANITIDINE/CIMETIDINE

First- and second-generation H1 antihistamine receptor antagonists
are generally considered first-linetreatment for chronic urticaria
PT WHOSE BRO HAS ACTIVE TB
HIS PPD TEST= 8MM

NO SX, PE NORMAL
CXR NORMAL

SHOULD U TREAT THIS KID
IF SO WITH WHAT
YES TX DUE TO CLOSE CONTACT TO ACTIVE TB PT
AND
>5MM INDURATION

, TX FOR LATENT TX
=
INH FOR 9 MONTHS
TB TEST POSITIVE IF >5MM FOR WHICH POPULATION
An induration of 5 or more millimeters is considered positive in
-HIV-infected persons
-A recent contact of a person with ACTIVE TB disease
-Persons with fibrotic changes on chest radiograph consistent with
prior TB
-Patients with organ transplants
-Persons who are immunosuppressed
An induration of 10 or more millimeters is considered positive in
An induration of 10 or more millimeters is considered positive in
-Recent immigrants (< 5 years) from high-prevalence countries
-Injection drug users
-Residents and employees of high-risk congregate settings
===>
HEALTH CARE WORKERS
PRISONER/ JAIL
HOME LESS SHELTER
NURSING HOME
An induration of 15 or more millimeters is considered positive in
>An induration of 15 or more millimeters is considered positive in
any person, with no known risk factors for TB.
SHOULD PT WITH SHELLFISH ALLERGY NOT GOT ORAL OR IV
CONTRAST
NO SAFE TO GIVE CONTRAST
PAIN WITH INTERNAL ROTATION OF SHOULDER

WHAT MUSCLE AFFECTED