STUDY GUIDE | PRACTICE QUESTIONS &
ANSWERS, COMPREHENSIVE EXAM
PREP & REVIEW MATERIALS
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,Trauma to Kiesselbachs plexus: Will result in an anterior nosebleed
The diagnostic or gold standard test for sickle cell anemia, Hemoglobin electrophoresis
G6PD anemia, and alpha or beta thalassemia:
Erythromycin "allergy" vs adverse reaction: Adverse reaction-symptoms of nausea or GI upset
allergy -hives, angioedema
Acute mononucleosis: Pt will most likely be a teen presenting w classic triad of sore throat, prolonged fatigue,
and enlarged cervical nodes.
Alpha thalassemia: More common among Southeast Asians such as, Indian, Chinese, or Filipino descent
Lupus Malar rash(butterfly rash)Pts need to avoid or to minimize sunlight
exposure(photosensitivity)
Tx polymyalgic rheumatica(PMR) 1st line tx for PMR includes long-term steroids. Long term steroids are commonly used to
control symptoms(pain, stiffness on shoulders, and hip girdle). PMR pts have higher risk
for temporal arteritis.
Gold standard exam for temporal arteritis: Biopsy of the temporal artery. refer pt to opthalmologist for mgt
Finkelstein's test: Positive in De Quervains tenosynovitis
Anterior Drawer maneuver and Lachman maneuver: Positive if anterior cruciate ligament (ACL) of knee damaged. The knee may also be
unstable
McMurray's sign: Positive in meniscus injuries of the knee
Damaged Joints: Order X-ray first, but MRI is the Gold Standard
Diabetic retinopathy: Neovascularization, hard exudates, cotton wool spots, and micoaneurysms
Hypertensive retinopathy: AV nicking, silver and or copper wire arterioles
,Checking deep tendon reflexes: absent(0),
hypoactive (1)
normal(2)
hyperactive(3)
clonus(4)
Clonus: Clonus is typically seen in patients with stroke, multiple sclerosis, spinal cord damage and
hepatic encephalopathy.
Clonus has also appeared after ingesting potent serotonergic drugs, where ingestion
strongly predicts imminent serotonin toxicity (serotonin syndrome).
Clonus is a series of involuntary, rhythmic, muscular contractions and relaxations.
Clonus is a sign of certain neurological conditions, particularly associated with upper
motor neuron lesions involving descending motor pathways, and in many cases is,
accompanied by spasticity (another form of hyperexcitability).Unlike small, spontaneous
twitches known as fasciculations (usually caused by lower motor neuron pathology),
clonus causes large motions that are usually initiated by a reflex.
A rare but serious adverse effect of ACE inhibitors is: Angioedema
A common side effect of ACE inhibitors is a Dry cough(10%)
1st line drug to tx htn in DM & pts w mild renal dz bc of their ACE inhibitors or ARBS
renal protective properties:
Penicillin: Amoxicillin(broad-spectrum PCN) Penicillin VK
Macrolide: Erythromycin, azithromycin(Z-Pack), or clarithromycin(Biaxin)
Cephalosporins: 1st generation(Keflex), 2nd generation(Cefaclor, Ceftin, Cefzil)3rd generation(Rocephin,
Suprax, Omnicef)
Quinolones w gram positive coverage: Levofloxacin(Levaquin), moxifloxacin(Avelox), gatifloxacin(Tequin)
Quinolones: Ciprofloxacin(Cipro), ofloxacin(Floxin)
Sulfa: Trimethoprim/sulfamethazole(Bactrim, Septra), nitrofurantoin(Macrobid),
Tetracyclines: Tetracycline, doxycycline, minocycline(Minocin)
, NSAID: Ibuprofen, naproxen(aleve, Anaprox)
Cox-2 inhibitors: Celecoxib (celebrex)
Antitussives: Dextromorphan(Robitussin), benzonate(Tessalon Perles)
Drugs allowed for pregnant or lactating women: Category B
Pregnancy in pain: Tylenol instead of Ibuprofen
Avoid nitrofurantoin & sulfa drugs during 3rd trimester: Increase the risk of hyperbilirubinemia
Best way method of spreading viruses or bacteria: Making them airborne or nebulized
Tx cutaneous anthrax: Ciprofloxacin 500mg orally BID for 60 days or 8 weeks. If pt allergic to ciprofloxacin , use
doxycycline 100mg BID
Good communication rules: Ask open ended questions, do not reassure patients, avoid angering the patient, and
respect the patients culture.
Primary vs secondary: "Will performing this action prevent the disease or the social condition from happening?
If it does, then it is considered as primary prevention(if it doesn, then it is secondary)
Breast self exam and genital self exam: Considered secondary prevention
Tertiary prevention: Involves not only rehabilitation, but also includes actiivities that will help to prevent
complications from disease treatment, such as patient education about medication side
effects or the proper use of equipment such as cane. Support groups for a disease
/condition are all considered as part of a tertiary prevention activity.
Primary prevention: (Prevent disease.injury/condition)-youth violence prevention, bullying prevention,
presonal safety promotion, disease prevention-immunization, using suncreen, healthy
lifestyle promotion, promotion of OSHA lawas-workplace safety, EPA laws-clean water,
anipollution laws