Test Bank for Principles of Internal Medicine
Self-Assessment 20th Edition
Nephrogenic systemic fibrosis (NSF) - answers A rare complication in severe renal
insufficiency caused by exposure to linear gadolinium contrast agents. It can manifest in
various body tissues, with reported onset between 5 and 75 days.
Ferromagnetic implants - answers Objects like aneurysm clips that can cause damage
or death if attracted into an MRI magnet, posing risks to patients and healthcare
personnel during MRI procedures.
Astrocytes - answers Cells in the central nervous system with various functions,
including regulating synaptic development, maintenance, and pruning, phagocytosing
synapses, and dynamically regulating vascular tone.
New-onset seizures - answers Seizures that occur at different ages, with causes
including alcohol withdrawal, cerebrovascular disease, brain tumor, autoantibodies,
neurodegenerative disease, and metabolic disorders.
Discontinuation of antiepileptic drugs - answers It is possible for 70% of children and
60% of adults to successfully discontinue antiepileptic drugs without recurrence,
typically over a 2- to 3-month period, with four predictive factors for remaining seizure-
free.
Status epilepticus - answers Continuous or repetitive seizures with impaired
consciousness, requiring prompt recognition and appropriate treatment to prevent
severe metabolic derangements, hyperthermia, cardiorespiratory collapse, and
irreversible neuronal injury.
Focal seizures - answers Seizures originating within limited brain regions, usually
associated with structural abnormalities, and capable of evolving into generalized
seizures.
Typical absence seizures - answers Characterized by sudden, brief lapses of
consciousness, often accompanied by subtle, bilateral motor signs, and associated with
genetically determined epilepsies usually in childhood or early adolescence.
Carotid endarterectomy - answers A surgical intervention for carotid stenosis, most
beneficial in symptomatic individuals with stenosis ≥70%, with a significant absolute risk
reduction of 17% favoring surgery.
Ischemic stroke - answers Requires brain imaging to determine the cause, with potential
benefits of recombinant tissue plasminogen activator or endovascular mechanical
thrombectomy in restoring cerebral perfusion.
, Metabolic encephalopathies - answers Produce fluctuating mental status changes
without focal neurologic findings, capable of unmasking prior deficits in the setting of
fever or sepsis.
IV recombinant tissue plasminogen activator (rtPA) - answers Shown to have a clear
benefit in selected patients with acute ischemic stroke within 3 hours of onset, with a
significant risk of symptomatic intracranial hemorrhage.
Endogenous hyperinsulinemia - answers Excessive insulin production within the body,
leading to potential low blood sugar levels (hypoglycemia).
Factitious hypoglycemia - answers Artificially induced low blood sugar levels, often
caused by surreptitious insulin use or ingestion of sulfonylurea drugs.
Sulfonylurea drug screen - answers A test to detect the presence of sulfonylurea drugs
in the body, used to confirm artificially induced hypoglycemia.
Whipple triad - answers A set of symptoms indicating hypoglycemia, including low
plasma glucose concentration, and relief of symptoms with increased blood glucose
levels.
Counterregulatory hormones - answers Hormones such as glucagon, epinephrine,
cortisol, and growth hormone, which help raise blood glucose levels in response to low
blood sugar (hypoglycemia).
HMG-CoA reductase inhibitors - answers Medications that lower cholesterol levels by
inhibiting the enzyme HMG-CoA reductase, including various drugs such as lovastatin,
pravastatin, simvastatin, fluvastatin, atorvastatin, rosuvastatin, and pitavastatin.
Cholesterol absorption inhibitor - answers A drug that reduces the absorption of
cholesterol in the intestine, exemplified by ezetimibe.
Bile acid sequestrants - answers Medications that bind to bile acids in the intestine,
reducing cholesterol reabsorption, including cholestyramine, colestipol, and
colesevelam.
PCSK9 inhibitors - answers Antibodies that bind to proprotein convertase
subtilisin/kexin type 9 (PCSK9) and reduce LDL cholesterol levels, such as evolocumab
and alirocumab.
MTP inhibitor - answers A substance that inhibits microsomal triglyceride transfer
protein, for instance, lomitapide.
ApoB inhibitor - answers A medication that inhibits apolipoprotein B, for example,
mipomersen.
Self-Assessment 20th Edition
Nephrogenic systemic fibrosis (NSF) - answers A rare complication in severe renal
insufficiency caused by exposure to linear gadolinium contrast agents. It can manifest in
various body tissues, with reported onset between 5 and 75 days.
Ferromagnetic implants - answers Objects like aneurysm clips that can cause damage
or death if attracted into an MRI magnet, posing risks to patients and healthcare
personnel during MRI procedures.
Astrocytes - answers Cells in the central nervous system with various functions,
including regulating synaptic development, maintenance, and pruning, phagocytosing
synapses, and dynamically regulating vascular tone.
New-onset seizures - answers Seizures that occur at different ages, with causes
including alcohol withdrawal, cerebrovascular disease, brain tumor, autoantibodies,
neurodegenerative disease, and metabolic disorders.
Discontinuation of antiepileptic drugs - answers It is possible for 70% of children and
60% of adults to successfully discontinue antiepileptic drugs without recurrence,
typically over a 2- to 3-month period, with four predictive factors for remaining seizure-
free.
Status epilepticus - answers Continuous or repetitive seizures with impaired
consciousness, requiring prompt recognition and appropriate treatment to prevent
severe metabolic derangements, hyperthermia, cardiorespiratory collapse, and
irreversible neuronal injury.
Focal seizures - answers Seizures originating within limited brain regions, usually
associated with structural abnormalities, and capable of evolving into generalized
seizures.
Typical absence seizures - answers Characterized by sudden, brief lapses of
consciousness, often accompanied by subtle, bilateral motor signs, and associated with
genetically determined epilepsies usually in childhood or early adolescence.
Carotid endarterectomy - answers A surgical intervention for carotid stenosis, most
beneficial in symptomatic individuals with stenosis ≥70%, with a significant absolute risk
reduction of 17% favoring surgery.
Ischemic stroke - answers Requires brain imaging to determine the cause, with potential
benefits of recombinant tissue plasminogen activator or endovascular mechanical
thrombectomy in restoring cerebral perfusion.
, Metabolic encephalopathies - answers Produce fluctuating mental status changes
without focal neurologic findings, capable of unmasking prior deficits in the setting of
fever or sepsis.
IV recombinant tissue plasminogen activator (rtPA) - answers Shown to have a clear
benefit in selected patients with acute ischemic stroke within 3 hours of onset, with a
significant risk of symptomatic intracranial hemorrhage.
Endogenous hyperinsulinemia - answers Excessive insulin production within the body,
leading to potential low blood sugar levels (hypoglycemia).
Factitious hypoglycemia - answers Artificially induced low blood sugar levels, often
caused by surreptitious insulin use or ingestion of sulfonylurea drugs.
Sulfonylurea drug screen - answers A test to detect the presence of sulfonylurea drugs
in the body, used to confirm artificially induced hypoglycemia.
Whipple triad - answers A set of symptoms indicating hypoglycemia, including low
plasma glucose concentration, and relief of symptoms with increased blood glucose
levels.
Counterregulatory hormones - answers Hormones such as glucagon, epinephrine,
cortisol, and growth hormone, which help raise blood glucose levels in response to low
blood sugar (hypoglycemia).
HMG-CoA reductase inhibitors - answers Medications that lower cholesterol levels by
inhibiting the enzyme HMG-CoA reductase, including various drugs such as lovastatin,
pravastatin, simvastatin, fluvastatin, atorvastatin, rosuvastatin, and pitavastatin.
Cholesterol absorption inhibitor - answers A drug that reduces the absorption of
cholesterol in the intestine, exemplified by ezetimibe.
Bile acid sequestrants - answers Medications that bind to bile acids in the intestine,
reducing cholesterol reabsorption, including cholestyramine, colestipol, and
colesevelam.
PCSK9 inhibitors - answers Antibodies that bind to proprotein convertase
subtilisin/kexin type 9 (PCSK9) and reduce LDL cholesterol levels, such as evolocumab
and alirocumab.
MTP inhibitor - answers A substance that inhibits microsomal triglyceride transfer
protein, for instance, lomitapide.
ApoB inhibitor - answers A medication that inhibits apolipoprotein B, for example,
mipomersen.
