Board Review Questions And Answers 2022

What are the 5 P's and what rash do they represent Lichen Planus Purple Pruritic Planar Polygonal Papular with fine white streaks A full term male infant is delivered by cesarean section because of dystocia due to macrosomia. Apgar scores are 8 and 10. An hour after delivery he begins to have tachypnea without hypoxemia. A chest radiograph shows diffuse parenchymal infiltrates and fluid in the pulmonary fissures. The symptoms resolve without treatment within 24 hours. What is the most likely diagnosis? Transient tachypnea of the newborn m/c cause of neonatal respiratory distress It is a benign condition due to residual pulmonary fluid remaining in the lungs after delivery. What is respiratory distress syndrome? Respiratory distress syndrome is an acute lung disease caused by surfactant deficiency Primarily seen in premature infants younger than 32 weeks' gestation. CXR reveals bilateral, diffuse, or ground-glass appearances What is the most common ECG finding in hypokalemia? U waves You are evaluating a patient with polyneuropathy. His nerve conduction study reveals a predominantly demyelinating injury process. Which of the following laboratory serum tests would best delineate this patient's diagnosis? -Creatinine -Hemoglobin A1C -Hepatitis B panel -TSH Hepatitis B panel Predominantly demyelinating neuropathy: -Hepatitis B and C -Guillain Barre -CIDP -Charcot-Marie-Tooth Disease Predominantly axonal neuropathy: -DM -Uremia/CKD -Hyperthyroidism -B12 and folate deficiency -Toxins -Multiple myeloma What laboratory abnormalities would be expected on urinalysis of a patient with diabetes? Glucose, ketones, and low specific gravity. Diagnosis of DMII Diagnosis is made by ADA Diagnostic Criteria: -Random plasma glucose of 200 mg/dL in a patient with classic symptoms -Fasting plasma glucose of 126 mg/dL on two separate occasions -Hemoglobin A1C of 6.5 % -Plasma glucose of 200 mg/dL two hours after a 75-g glucose load during an OGTT Usually confirm these with 2 tests on different days (unless it's super classic or obvious) What is the most common cause of an intracranial neoplasm? Metastatic disease (primarily from lung cancer) is the most common cause of an intracranial neoplasm. Other cancers that commonly metastasize to the brain include breast and colon carcinoma. m/c primary brain tumor meningioma m/c malignant brain tumor Glioma 23-year-old woman presents with dysuria, frequency and urgency that began three days ago. The patient denies fever, chills, nausea or flank pain. Physical exam reveals suprapubic tenderness. There is no costovertebral angle tenderness. A urinalysis reveals leukocytes and nitrites. The patient denies chronic health conditions and has not been on antibiotics recently. Which of the following is the most appropriate treatment for this patient? Nitrofurantoin This patient has an uncomplicated UTI. She does not exhibit symptoms that would suggest pyelonephritis such as fever, chills or flank pain. She is not at risk for antibiotic resistance as she has not been on antibiotics recently. The most appropriate antibiotic for her is nitrofurantoin. Nitrofurantoin concentrates in the urine, leading to higher and more effective levels in the urinary tract than in other tissues or compartments. Because of extremely poor tissue penetration and low blood levels, it is NOT used in the treatment of pyelonephritis. Which of the following is the most common type of prostate cancer? Adenocarcinoma (95%) Other types of cancer including small cell carcinoma and squamous cell carcinoma make up the remaining 5% of cases of prostate cancer. Tx of perichondritis? Fluoroquinolone (to cover Staph and Pseudomonas) Pseudomonas is commonly the cause of infections resulting from transcartilaginous piercings. Oral ciprofloxacin is the recommended agent since it covers against pseudomonas, strep., and staph. spp., and has adequate cartilage penetration. A 72-year-old man presents to the Emergency Department with chest pain. During triage, he collapses and nursing staff cannot feel his pulse. The patient is taken to a treatment room where cardiopulmonary resuscitation is initiated and the above cardiac rhythm is noted (V Fib). What is the next best step? Defibrillation In a witnessed cardiac arrest, if the initial rhythm is amenable to defibrillation, a shock should be administered as soon as possible. Defibrillation is the best chance of recovering a perfusing rhythm from a nonperfusing rhythm. The longer a heart is in a nonperfusing rhythm, the less likely it is to respond to defibrillation and cardiac life support. Note: Shock IS indicated in V fib/pulseless VT but NOT in PEA A 1-year-old boy presents unconscious to the emergency department with multisystem trauma after he was a passenger in a motor vehicle accident. He is placed in a cervical collar. Which of the following, can definitively clear the cervical spine? -CT -MRI -XR -Clinical clearance MRI A cervical spine MRI scan is the definitive way to diagnose and clear a cervical spine injury on patients of all ages. This diagnostic study allows for clear visualization of the ligaments, intervertebral disc spaces, spinal cord, and bones. A 40-year-old man with HIV presents with two weeks of progressive headache, malaise, and fever. On examination, he has mild nuchal rigidity, confusion, and a temperature of 38.2C. CSF analysis shows a white blood cell count 360 cells/mL with a monocyte predominance, glucose 28 mg/dL, and protein 220 mg/dL. What is the treatment of choice? Amphotericin B Cryptococcal meningoencephalitis is an opportunistic infection that occurs primarily in patients with advanced AIDS, usually when the CD4 count is 100 cells/mm3. CSF will show a mildly elevated WBC count with a monocyte predominance, decreased glucose, and mildly elevated protein.