Instructions:

• Answer 50 questions in 15 minutes.
• If you are not ready to take this test, you can study here.
• Match each statement with the correct term.
• Don't refresh. All questions and answers are randomly picked and ordered every time you load a test.

This is a study tool. The 3 wrong answers for each question are randomly chosen from answers to other questions. So, you might find at times the answers obvious, but you will see it re-enforces your understanding as you take the test each time.

1. The most common cause of SAH.
Acute dystonia (oculogyric crisis). Treat with benztropine or diphenhydramine
Hypoparathyroidism
False. Patients may change their minds at any time. Exceptions to the requirement of informed consent include emergency situations and patients without decision - making capacity
Trauma; the second most common is berry aneurysm


2. A patient with a history of lithium use presents with copious amounts of dilute urine.
Renal cell carcinoma (RCC)
Both have ? hematocrit and RBC mass - but polycythemia vera should have normal O2 saturation and low erythropoietin levels
Nephrogenic diabetes insipidus (DI)
CML


3. Bilious emesis within hours after the first feeding.
Duodenal atresia
Diphenhydramine or epinephrine 1:1000
Huntington's disease
5- aminosalicylic acid +/- sulfasalazine and steroids during acute exacerbations


4. Name the organism:
Salmonella
Cirrhosis - CHF - nephritic syndrome
Oral or topical metronidazole
Charcot's triad plus shock and mental status changes - with suppurative ascending cholangitis


5. Hypercholesterolemia treatment that ? flushing and pruritus.
Femoral hernia
S. aureus
Immediate needle thoracostomy
Niacin


6. A 15-year - old pregnant girl requires hospitalization for preeclampsia. Should her parents be informed?
They can mask symptoms of hypoglycemia
Ulcerative colitis
Signs and symptoms of hypercalcemia
No. Parental consent is not necessary for the medical treatment of pregnant minors


7. An elderly male with hypochromic - microcytic anemia is asymptomatic. Diagnostic tests?
IV penicillin or ampicillin
Fecal occult blood test and sigmoidoscopy; suspect colorectal cancer
Hemophilia A or B; consider desmopressin (for hemophilia A) or factor VIII or IX supplements
Fever - heart murmur - Osler's nodes - splinter hemorrhages - Janeway lesions - Roth's spots


8. Treatment for opioid overdose.
Epidural hematoma. Middle meningeal artery. Neurosurgical evacuation
Renal artery stenosis - coarctation of the aorta - pheochromocytoma - Conn's syndrome - Cushing's syndrome - unilateral renal parenchymal disease - hyperthyroidism - hyperparathyroidism
1
Naloxone


9. Antihypertensive for a diabetic patient with proteinuria.
ACEI
Epidural hematoma. Middle meningeal artery. Neurosurgical evacuation
Respiratory alkalosis
S. aureus


10. 'Cradle cap.'
Isospora - Cryptosporidium - Mycobacterium avium complex (MAC)
Rett's disorder
Mycobacterium tuberculosis
Seborrheic dermatitis. Treat with antifungals


11. A 60-year - old African - American male presents with bone pain. Workup for multiple myeloma might reveal?

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12. A 20-year - old man presents with a palpable flank mass and hematuria. Ultrasound shows bilateral enlarged kidneys with cysts. Associated brain anomaly?
Cerebral berry aneurysms (AD PCKD)
Sulfonamides - antimalarial drugs - fava beans
Wernicke's encephalopathy due to a deficiency of thiamine
Cardiogenic shock


13. Treatment for mild and severe unconjugated hyperbilirubinemia.
Stasis - hypercoagulability - endothelial damage
68% - 95.5% - 99.7%
Phototherapy (mild) or exchange transfusion (severe)
Acanthosis nigricans. Check fasting blood sugar to rule out diabetes


14. Drowsiness - asterixis - nausea - and a pericardial friction rub.
Alzheimer's and multi - infarct
The likelihood of a disease among individuals exposed to a risk factor compared to those who have not been exposed
Osteoarthritis
Uremic syndrome seen in patients with renal failure


15. The most common causes of hypercalcemia.
The IR of a disease in a population exposed to a particular factor
IV benzodiazepine
Reye's syndrome
Malignancy and hyperparathyroidism


16. When should a vaginal exam be performed with suspected placenta previa?
Never
Treat existing heart failure and replace the tricuspid valve
Neuroleptic malignant syndrome
Angina - ST- segment changes on ECG - or ? BP


17. Shortest AP diameter of the pelvis.
Inhaled Beta- agonists and inhaled corticosteroids
Obstetric conjugate: between the sacral promontory and the midpoint of the symphysis pubis
DM - SLE - and amyloidosis
Streptococcus pneumoniae


18. Difference between Mallory- Weiss and Boerhaave tears.
RSV bronchiolitis
Patient on dopamine antagonist
Mallory- Weiss
Choriocarcinoma


19. Cross - sectional survey
Prevalence
Diphenhydramine or epinephrine 1:1000
Bladder rupture or urethral injury
Rate control with carotid massasge or other vagal stimulation


20. The most common cause of seizures in children (2-10 years).
Fluid restriction - demeclocycline
Fatigue and impending respiratory failure
ARDS
Infection - febrile seizures - trauma - idiopathic


21. Chronic diseases such as SLE
Membranous glomerulonephritis
Treat CO poisoning with 100% O2 or with hyperbaric O2 if severe poisoning or pregnant
When there is no rationale for treatment - maximal intervention is failing - a given intervention has already failed - and treatment will not achieve the goals of care
Higher prevalence


22. What is the immunodeficiency?
Chronic granulomatous disease
= 200 for PCP (with TMP); = 50-100 for MAI (with clarithromycin/azithromycin)
Fluid restriction - demeclocycline
Abdominal obesity - high triglycerides - low HDL - hypertension - insulin resistance - prothrombotic or proinflammatory states


23. When can a physician refuse to continue treating a patient on the grounds of futility?
Allergic interstitial nephritis
Think of leaky capillaries. Malignancy - TB - bacterial or viral infection - pulmonary embolism with infarct - and pancreatitis
Bruton's X- linked agammaglobulinemia
When there is no rationale for treatment - maximal intervention is failing - a given intervention has already failed - and treatment will not achieve the goals of care


24. Proteinuria - hypoalbuminemia - hyperlipidemia - hyperlipiduria - edema.
Nephrotic syndrome
Seborrheic keratosis
MCP and PIP joints; DIP joints are spared
1


25. Defect in an X- linked syndrome with mental retardation -
Lesch - Nyhan syndrome (purine salvage problem with
Type IV (distal) RTA
Think of leaky capillaries. Malignancy - TB - bacterial or viral infection - pulmonary embolism with infarct - and pancreatitis
Kl


26. Bone is fractured in fall on outstretched hand.

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27. Side effects of corticosteroids.
Neither
Acute mania - immunosuppression - thin skin - osteoporosis - easy bruising - myopathies
Pulsus paradoxus (seen in cardiac tamponade)
Immediate cardioversion


28. RTA associated with abnormal HCO3 - and rickets.
Elevated ICP - RBCs - xanthochromia
Factitious disorder (Munchausen syndrome)
Type II (proximal) RTA
Beta- blockers - digoxin - calcium channel blockers


29. Treatment of supraventricular tachycardia (SVT).
Rate control with carotid massasge or other vagal stimulation
No. Parental consent is not necessary for the medical treatment of pregnant minors
Developmental dysplasia of the hip. If severe - consider a Pavlik harness to maintain abduction
Nephrotic syndrome


30. Back pain that is exacerbated by standing and walking and relieved with sitting and hyperflexion of the hips.
HBV immunoglobulin
Conduct disorder
Duchenne muscular dystrophy
Spinal stenosis


31. The coagulation parameter affected by warfarin.
Reactive (Reiter's) arthritis. Associated with Campylobacter - Shigella - Salmonella - Chlamydia - and Ureaplasma
PT
ST- segment elevation (depression means ischemia) - flattened T waves - and Q waves
Diphenhydramine or epinephrine 1:1000


32. Risk factors for pyelonephritis.
Pregnancy - vesicoureteral reflux - anatomic anomalies - indwelling catheters - kidney stones
Neisseria meningitidis
Diverticulosis
Pregnant women. Treat this group aggressively because of potential complications


33. Treatment for bacterial vaginosis.
Group B strep - E. coli - Listeria. Treat with gentamicin and ampicillin
Allergic interstitial nephritis
Oral or topical metronidazole
Treat CO poisoning with 100% O2 or with hyperbaric O2 if severe poisoning or pregnant


34. The most common cause of female infertility.
50 cc/hour
Distal radius (Colles' fracture)
Wernicke's encephalopathy due to a deficiency of thiamine
Endometriosis


35. An antidiabetic agent associated with lactic acidosis.
Iron overload; use deferoxamine
Erythema multiforme
Metformin
Endometriosis


36. A burn patient presents with cherry- red flushed skin and coma. SaO2 is normal - but carboxyhemoglobin is elevated. Treatment?
Anemia of chronic disease
A patient's family cannot require that a doctor withhold information from the patient
Treat CO poisoning with 100% O2 or with hyperbaric O2 if severe poisoning or pregnant
Polymyalgia rheumatica


37. How to diagnose and follow a leiomyoma.
Isospora - Cryptosporidium - Mycobacterium avium complex (MAC)
46 -XX
Charcot's triad plus shock and mental status changes - with suppurative ascending cholangitis
Ultrasound


38. Medication to avoid in patients with a history of alcohol withdrawal seizures.
Diffuse interstitial pulmonary fibrosis. Supportive care. Steroids may help
Neuroleptics
Kl
? protein intake - lactulose - neomycin


39. Birth rate?
Mycoplasma
Asymmetry - border irregularity - color variation - large diameter
Number of live births per 1000 population
Highly sensitive for TB


40. Attributable risk?
Hereditary spherocytosis
The incidence rate (IR) of a disease in exposed - the IR of a disease in unexposed
Widened mediastinum (> 8 cm) - loss of aortic knob - pleural cap - tracheal deviation to the right - depression of left main stem bronchus
False. Patients may change their minds at any time. Exceptions to the requirement of informed consent include emergency situations and patients without decision - making capacity


41. Treatment for acute coronary syndrome.
DM - SLE - and amyloidosis
Morphine - O2 - sublingual nitroglycerin - ASA - IV Beta- blockers - heparin
Legionella pneumonia
MAOIs


42. What is the immunodeficiency?

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43. Fertility rate?
Number of live births per 1000 women 15-44 years of age
Clomiphene citrate
Reactive (Reiter's) arthritis. Associated with Campylobacter - Shigella - Salmonella - Chlamydia - and Ureaplasma
Uterine massage; if that fails - give oxytocin


44. Reynolds' pentad.

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45. Treatment for TTP.
Emergent large - volume plasmapheresis - corticosteroids - antiplatelet drugs
Choriocarcinoma
Varicella zoster
Parvovirus B19


46. Classic ultrasound and gross appearance of complete hydatidiform mole.

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47. The most common type of tracheoesophageal fistula (TEF). Diagnosis?
Pulsus paradoxus (seen in cardiac tamponade)
Lichen sclerosus
ARDS
Esophageal atresia with distal TEF (85%). Unable to pass NG tube


48. Glomerulonephritis with hemoptysis.

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49. HUS triad?
Headache
Biliary tract obstruction
Anemia - thrombocytopenia - and acute renal failure
Cohort studies can be used to calculate relative risk (RR) - incidence - and/or odds ratio (OR). Case - control studies can be used to calculate an OR


50. A 10-year - old boy presents with fever - weight loss - and night sweats. Examination shows anterior mediastinal mass. Suspected diagnosis?

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