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1
Q

big toe is innervated by `

A

sciatic nerve

2
Q

best test to confirm ascending cholangitis

A

ERCP

3
Q

young adult with “atypical” pneumonia s/s, think?

A

Mycoplasma pneumonia

4
Q

sympathetic innervation to the head and neck

A

T1-4

5
Q

pain onset in duodenal vs gastric ulcers

A

gastric ulcers: pain is worst right after a meal

duodenal ulcers: pain worse a few hours after meal (acidic bolus travels down)

6
Q

pH, pCO2, pO2, HCO3- in chronic COPD

A

pH: 7.30, pCO2: ^60, pO2: 90 HCO3: ^30

chronic respiratory acidosis, low pH, ^pCO2 and HCO3-

7
Q

when to use myocardial perfusion imaging

A

uses radioactive tracer to assess function of the myocardium, compares perfusion during resting and stressed states
indications: wall abnormalities found on echo, active CP and no EKG changes

8
Q

renal stone specific treatments

A

uric acid stones: alkalinize the urine with citrate
thiazides: help retain calcium so good for calcium oxalate/phosphate
cystine stones: penicillamine

9
Q

posterior radial head shows restriction in ?

A

restricted supination of forearm and anterior glide of the radial head

10
Q

hypotension, polydipsia, GI complaints, w/l, hyperpigmentation, think?

A

Addisonian crisis

11
Q

PPD is considered +if more than 10mm in what populations

A

IVDU, nursing home residents, prisoners, homeless, those living in developing countries, kids less than 4 or exposed to high-risk adults, health care workers

12
Q

when PPD is + if less than 5mm

A

HIV, abnormal CXR, close contact with person with active TB, immunosuppressed

13
Q

second MCC of hyperthyroidism after Graves

A

Plummer’s disease: toxic multinodular goiter

see patchy uptake on thyroid scan

14
Q

ankylosing spondylitis may have ? which are bony growths in the ligaments

A

syndesmophytes

15
Q

most appropriate tx for post-herpatic neuralgia?

A

nortriptyline?

pregabalin: 2nd line

16
Q

levels of evidence

A

level 1: best: RCT

level 3: case reports, case series

17
Q

what can precipitate AIN

A

meds: NSAIDs, PPIs, rifampin, PCN, cephs

infections, collagen vascular disease, AI

18
Q

what can precipitate ATN

A

renal ischemia, sepsis, nephrotoxins: contrast, ampB, sulfa, ACE/ARBs, NE/EPI
rhabdo, MM, crystal disease

19
Q

depolarizing NM blocker with 2 phases

A

succinylcholine:
phase 1: membrane potential above threshold, constantly depolarized
phase 2: non-depol. blockade, ACh antagonized
(involved K+ efflux, rapid, no refractory period)

20
Q

angiodysplasia (AVM) of colon may be associated with ?

A

aortic stenosis

Heyde’s syndrome

21
Q

proximal muscle weakness with Gottron’s papules (knuckles), and rash over eyes (heliotrope) +/- calcifications in the subQ fatty tissue, think?

A

dermatomyositis
^CK and aldolase
dx: muscle biopsy
tx: steroids

22
Q

pleural effusion after pneumonia refractory to tx, what to do?

A

thoracentesis: dx and tx

23
Q

definitive tx for DeQuervain’s tenosynovitis (after conservative- NSAIDs)

A

surgical release of abductor polices longs tendon

24
Q

most common risk factor for ectopic pregnancy

A

PID

25
Q

CA-125?
CA-19-9?
AFP?
CEA?

A

CA-125: ovarian cancer
CA-19-9: parncreatic, biliary cancer
AFP: nonseminomatous testicular cancer, hepcell cancer
CEA: colorectal cancer

26
Q

back pain in pt with known malignancy + bowel/bladder control problems suggests?
how to dx/tx?

A

spinal cord compression

dx: MRI of spine
tx: dexamethasone to save motor function

27
Q

neonatal tetanus may be from?

A

tentanus spores infecting umbilical cord of poorly immunized mother

28
Q

lab derangements in Kawasakis

A

^WBCs, ^PLTs, ^acute phase reactants (ferritin), ^WBCs in CSF, normocytic anemia

29
Q

other hyperkalemia findings with hyperK+ besides cardiac arrhythmias

A

muscle weakness and depressed DTRs

30
Q

hypothermia, AMS, respiratory depression, edema +/- desquamating rash, think?

A

myxedema coma in the setting of hypothyroidism (body is unable to compensate for hypothyroidism, typically elderly females with undx hypothyroidism)

dx: TSH
tx: thyroxine (synthroid) and cortisol (check levels 1st) in case of adrenal insufficiency

31
Q

oral ferrous iron salts utilize what transporter?

A

divalent metal transporter-1 (DMT-1)

32
Q

carpal tunnel 1st line diagnosis

A

electrophysiology studies

33
Q

polymyositis labs

A

^CK, ^aldolase, +anti-Jo

34
Q

restrictive cardiomyopathy with endomyocardial fibrosis with eosinophilic infiltrate, think?

A

Loeffler’s endocarditis

35
Q

too much calcium carbonate may lead to milk-alkali syndrome, most common complication?

A

acute renal failure not CV collapse

tx: lasix

36
Q

what causes symptoms in lead toxicity?

A

generation of reactive oxygen species