ROSH review general | Que & Answ
1. Patients with acute HF should be given 1) loop diuretic and 2) to reduce
afterload: vasodilator (sodium nitroprusside eg)
2. How do osmotic laxatives work?: drawing water into the intestine
3. orbital cellulitis tx: vancomycin and ceftriaxone
4. bacterial diarrhea treatment: azithromycin or fluroquinolone
5. first line agents for IBS cramping/bloating: antispasmodic agents- dicyclomine or hyoscyamine
-antidepressants are next
6. Diarrhea type IBS management: 1-antidiarrheal agents (loperimide) 2-bile acid
sequestrants (cholestyramine)
7. Rome IV criteria: recurrent abdominal pain at least 1x/week for 3 months asso- ciated with 2
or more criteria
related to defecation
associated with change in stool frequency
associated with change in stool form
8. Treatment options for external hemorrhoids: 1) conservative- sitz baths, local anesthetics,
topical corticosteroids if this fails
2) hemorrhoidectomy
9. treatment options for internal hemorrhoids: rubber-band ligation sclerotherapy
if grade 4 needs surgery
10.internal hemorrhoids: proximal to dentate line
11.External hemorrhoids: located below the dentate line (painful)
12.Gold criteria group a: No moderate exacerbations (not needing hospitaliza- tion)- can be
treated with bronchodilator alone
13.gold criteria group B: 2+ acute exacerbation not needing hospitalization treatment is
LABA + LAMA
eg) fomoterol + tiotropium
anoo ellipta stiolto
14.gold criteria group E: 2 + moderate exacerbations, at least 1 leading to hospi- talization
LABA + LAMA +ICS
trelegy
15.SpO2 goal in COPD: 88-92%
16.foreign body aspiration s/sx: cough, stridor, regional variation in lung sounds,
hyperresonance to percussion over affected area
17.most common cause of appendicitis: fecalith
18.Quadruple therapy: PPI, bismuth, tetracycline, metronidazole
, ROSH review general | Que & Answ
19.Triple therapy: omeprazole, clarithromycin, amoxicillin
20.most common cause of upper GI bleed, most commonly caused by hpylori/ nsaid use: PUD
21.1st trimester/ initial prenatal visit labs: cbc, blood type, rh, UA, rubel- la/syphillis/GC
screening, HIV, hemoglobin electrophoresis
22.All prenatal visits need to look at: weight, blood pressure, fetal heart rate, and a urinalysis for
infection, protein, and glucose should be obtained and the presence of fetal movement or
vaginal bleeding evaluated
23.maternal quad screen includes: alpha-fetoprotein, hCG, estradiol, and inhibin A and may be
performed during the second trimester (typically between 16-20 weeks gestation) to test for
aneuploidy and spina bifida
24.When is chorionic villus sampling done?: 10-12 weeks
25.first line med for generalized epileptic seizures: valproate
26.generalized epilepsy medications: valproate lamotrigine levetiracetam
27.focal seizure medications: lamotrigine oxcarbazepine phenytoin
28.key finding in primary adrenal insufficiency (addisons): hyperpigmentation of the skin
-weakness fatigue and GI symptoms also common
29.Primary adrenal insufficiency diagnosis: morning serum cortisol and rapid ACTH stimulation
test
30.trichomonas findings: frothy green-yellow discharge ph>5
strawberry cervix mobile
trichomonads
31.in asymptomatic patients with positive TB screen a test is recommend- ed:
interferon gamma release assay blood test
32.rifampin causes fluids to turn : yellow/orange
33.most sensitive test for ischemic stroke: mri
34.Shigella transmission
presentation complications:
fecal-oral
fever, cramping, bloody-mucoid diarrhea
bacteremia, HUS, toxic megacolon, seizures, reactive arthritis
35.Coronary artery disease definitive treatment: revascularization using percu- taneous
transluminal coronary angioplasty (PTCA
, ROSH review general | Que & Answ
36.increased ferritin and transferrin saturation think: hemochromatosis
37.prolonged cough >3 weeks an no signs of pneumonia/copd think: bronchi- tis
38.acute bronchitis treatment: dextromethorphan,NSAIDs, and albuterol. Antibi- otic therapy
should be avoided.
39.Lung cancer LESS likely to be smoking: adenocarcinoma
40.Non small cell lung cancer treatment: Tx depends on staging, may include surgical resection,
chemotherapy, or tyrosine kinase inhibitors if positive for ALK or EGFR mutations
41.retinal detachment presentation: - sudden onset
- painless loss of vision
-peripheral defect "curtain
moving across"
-increase in floaters/flashing lights
42.Primary ITP
etiology- clinical-
labs-
tx-: antiplatelet autoantibodies (hx recent viral illness) non
blanching petechia, gingival bleeding, menorrhagia platelets <100
000
rest, observation, IVIG
43.mcc acute pericarditis: viral (esp enteroviruses- coxsackie & echo)
44.pericarditis treatment: NSAIDs colchicine and steroids
45.retinal artery occlusion tx: -Emergent referral
-Lay pt flat
-Ocular massage
-High concentrations of O2
-IV acetazolamide
46.most common location anal fissure: posterior midline
47.lateral anal fissure think: chrons
, ROSH review general | Que & Answ
48.anal fissure treatment: fiber, stool softeners, protective ointments, sitz baths, topical
nitroglycerin or nifedipine
49.high intensity statins: atorvastatin 40-80 mg, rosuvastatin 20-40 mg
50.Most common lumbar radiculopathies
-what is it caused by?: Patients with a disc herniation present with pain dermatome of in
the affected nerve root, with L5 and S1 radiculopathies th common the e
-caused by spondylosis or disc herniation most
51.lesion in which vessel is indicated by ST elevations in leads V1, V2, V3, and V4?: LAD
52. Glans penis inflammation, uncircumcised men, inadequate hygeini
: balanitis e,
think-
53.Aspirin vs Dual antiplatlet therapy for TIA: Low-risk TIA (ABCD2 score < 4) or moderate to
major ischemic stroke (National Institutes of Health Stroke Scale (NIHSS) > 3)Treatment with
aspirin alone
High-risk TIA (ABCD2 score e 4) or minor ischemic stroke (NIHSS score d 3)Begin with dual
antiplatelet therapy (DAPT) for 21 days using aspirin plus clopidogrel
ABCD2 score: predicts likelihood of subsequent stroke within 2 days
54.Tinea versicolor
cause
worse with
KOH findings: malassezia worse
with sun
see spaghetti and meatballs
55.Tinea versicolor treatment: topical selenium sulfide 2.5% or topical ketocona- zole
56.Beginning of menstrual cycle GNRH is
FSH is and LH is : all increased
57.when does LH surge occur: mid cycle (14 day) --> ovulation
58.rise in progesterone, decrease in LH is seen with release of : oocyte
-may or may not be fertilized
1. Patients with acute HF should be given 1) loop diuretic and 2) to reduce
afterload: vasodilator (sodium nitroprusside eg)
2. How do osmotic laxatives work?: drawing water into the intestine
3. orbital cellulitis tx: vancomycin and ceftriaxone
4. bacterial diarrhea treatment: azithromycin or fluroquinolone
5. first line agents for IBS cramping/bloating: antispasmodic agents- dicyclomine or hyoscyamine
-antidepressants are next
6. Diarrhea type IBS management: 1-antidiarrheal agents (loperimide) 2-bile acid
sequestrants (cholestyramine)
7. Rome IV criteria: recurrent abdominal pain at least 1x/week for 3 months asso- ciated with 2
or more criteria
related to defecation
associated with change in stool frequency
associated with change in stool form
8. Treatment options for external hemorrhoids: 1) conservative- sitz baths, local anesthetics,
topical corticosteroids if this fails
2) hemorrhoidectomy
9. treatment options for internal hemorrhoids: rubber-band ligation sclerotherapy
if grade 4 needs surgery
10.internal hemorrhoids: proximal to dentate line
11.External hemorrhoids: located below the dentate line (painful)
12.Gold criteria group a: No moderate exacerbations (not needing hospitaliza- tion)- can be
treated with bronchodilator alone
13.gold criteria group B: 2+ acute exacerbation not needing hospitalization treatment is
LABA + LAMA
eg) fomoterol + tiotropium
anoo ellipta stiolto
14.gold criteria group E: 2 + moderate exacerbations, at least 1 leading to hospi- talization
LABA + LAMA +ICS
trelegy
15.SpO2 goal in COPD: 88-92%
16.foreign body aspiration s/sx: cough, stridor, regional variation in lung sounds,
hyperresonance to percussion over affected area
17.most common cause of appendicitis: fecalith
18.Quadruple therapy: PPI, bismuth, tetracycline, metronidazole
, ROSH review general | Que & Answ
19.Triple therapy: omeprazole, clarithromycin, amoxicillin
20.most common cause of upper GI bleed, most commonly caused by hpylori/ nsaid use: PUD
21.1st trimester/ initial prenatal visit labs: cbc, blood type, rh, UA, rubel- la/syphillis/GC
screening, HIV, hemoglobin electrophoresis
22.All prenatal visits need to look at: weight, blood pressure, fetal heart rate, and a urinalysis for
infection, protein, and glucose should be obtained and the presence of fetal movement or
vaginal bleeding evaluated
23.maternal quad screen includes: alpha-fetoprotein, hCG, estradiol, and inhibin A and may be
performed during the second trimester (typically between 16-20 weeks gestation) to test for
aneuploidy and spina bifida
24.When is chorionic villus sampling done?: 10-12 weeks
25.first line med for generalized epileptic seizures: valproate
26.generalized epilepsy medications: valproate lamotrigine levetiracetam
27.focal seizure medications: lamotrigine oxcarbazepine phenytoin
28.key finding in primary adrenal insufficiency (addisons): hyperpigmentation of the skin
-weakness fatigue and GI symptoms also common
29.Primary adrenal insufficiency diagnosis: morning serum cortisol and rapid ACTH stimulation
test
30.trichomonas findings: frothy green-yellow discharge ph>5
strawberry cervix mobile
trichomonads
31.in asymptomatic patients with positive TB screen a test is recommend- ed:
interferon gamma release assay blood test
32.rifampin causes fluids to turn : yellow/orange
33.most sensitive test for ischemic stroke: mri
34.Shigella transmission
presentation complications:
fecal-oral
fever, cramping, bloody-mucoid diarrhea
bacteremia, HUS, toxic megacolon, seizures, reactive arthritis
35.Coronary artery disease definitive treatment: revascularization using percu- taneous
transluminal coronary angioplasty (PTCA
, ROSH review general | Que & Answ
36.increased ferritin and transferrin saturation think: hemochromatosis
37.prolonged cough >3 weeks an no signs of pneumonia/copd think: bronchi- tis
38.acute bronchitis treatment: dextromethorphan,NSAIDs, and albuterol. Antibi- otic therapy
should be avoided.
39.Lung cancer LESS likely to be smoking: adenocarcinoma
40.Non small cell lung cancer treatment: Tx depends on staging, may include surgical resection,
chemotherapy, or tyrosine kinase inhibitors if positive for ALK or EGFR mutations
41.retinal detachment presentation: - sudden onset
- painless loss of vision
-peripheral defect "curtain
moving across"
-increase in floaters/flashing lights
42.Primary ITP
etiology- clinical-
labs-
tx-: antiplatelet autoantibodies (hx recent viral illness) non
blanching petechia, gingival bleeding, menorrhagia platelets <100
000
rest, observation, IVIG
43.mcc acute pericarditis: viral (esp enteroviruses- coxsackie & echo)
44.pericarditis treatment: NSAIDs colchicine and steroids
45.retinal artery occlusion tx: -Emergent referral
-Lay pt flat
-Ocular massage
-High concentrations of O2
-IV acetazolamide
46.most common location anal fissure: posterior midline
47.lateral anal fissure think: chrons
, ROSH review general | Que & Answ
48.anal fissure treatment: fiber, stool softeners, protective ointments, sitz baths, topical
nitroglycerin or nifedipine
49.high intensity statins: atorvastatin 40-80 mg, rosuvastatin 20-40 mg
50.Most common lumbar radiculopathies
-what is it caused by?: Patients with a disc herniation present with pain dermatome of in
the affected nerve root, with L5 and S1 radiculopathies th common the e
-caused by spondylosis or disc herniation most
51.lesion in which vessel is indicated by ST elevations in leads V1, V2, V3, and V4?: LAD
52. Glans penis inflammation, uncircumcised men, inadequate hygeini
: balanitis e,
think-
53.Aspirin vs Dual antiplatlet therapy for TIA: Low-risk TIA (ABCD2 score < 4) or moderate to
major ischemic stroke (National Institutes of Health Stroke Scale (NIHSS) > 3)Treatment with
aspirin alone
High-risk TIA (ABCD2 score e 4) or minor ischemic stroke (NIHSS score d 3)Begin with dual
antiplatelet therapy (DAPT) for 21 days using aspirin plus clopidogrel
ABCD2 score: predicts likelihood of subsequent stroke within 2 days
54.Tinea versicolor
cause
worse with
KOH findings: malassezia worse
with sun
see spaghetti and meatballs
55.Tinea versicolor treatment: topical selenium sulfide 2.5% or topical ketocona- zole
56.Beginning of menstrual cycle GNRH is
FSH is and LH is : all increased
57.when does LH surge occur: mid cycle (14 day) --> ovulation
58.rise in progesterone, decrease in LH is seen with release of : oocyte
-may or may not be fertilized
