Rosh Review Internal Medicine EOR Questions and answers 2023

Rosh Review Internal Medicine EOR Questions and answers 2023 Bronchiectasis Bronchiectasis is characterized by abnormal, permanent dilation and destruction of bronchial walls. Multiple etiologies can contribute to the development of bronchiectasis, including airway obstruction, cystic fibrosis (CF), recurrent infections, primary ciliary dyskinesia, rheumatic and systemic diseases, humoral immunodeficiency, and cigarette smoking. Central diabetes insipidus ADH deficiency due to hypothalamic or psoterior pituitary pathology (tumor, trauma, infection, inflammation) Nephrogenic diabetes insipidus Kidneys dont respond correctly to ADH Wolfram syndrome DIDMOAD Diabetes Insipidus Diabetes Mellitus Optic Atrophy Deafness What is the most common heart valve affected by rheumatic fever? Mitral followed by aortic and tricuspid Exposure to what metal can predispose individuals to essential tremor? Lead What describes the etiology of jaundice seen with thyroid storm? Hepatic tissue hypoxia due to increased peripheral consumption of oxygen Why is iodine used to treat thyroid storm It inhibits the conversion of T3 and T4 and inhibits the organification of iodine WHat is often the presenting feature of aortic stenosis? SYncope due to fixed stroke volume despite vasodilation with a subsequent decline in systolic blood pressure Austin flint murmur diastolic murmur caused by regurgitation on anterior mitral valve leaflet -> sign of severe aortic regurgitation -> need to replace aortic valve Debakey type 1 dissection ascending and descending aorta and aortic arch In what areas of the ureter can a stone less than 4 mm still cause obstructive symptoms? The ureterovesicular and ureteropelvic junction make passage of even small stones difficult What is the leading cause of mortality in patients diagnosed with scleroderma? Lung disease: pulmonary hypertension and interstitial pulmonary fibrosis. Crest syndrome (limited scleroderma) C - calcinosis of the fingers R - Raynaud's E - Esophageal dysmotility S - Sclerodactyly T - Telangiectasia ** Primary hypertension ** Doesn't have joint pain, heart/lung/kidney involvement What tool is used to estimate probability of death or hospitalization in patients with COPD? The BODE index which used BMI, FEV1, dyspnea, and exercise capacity Antiphospholipid antibody syndrome an acquired autoimmune disorder that causes a hypercoagulable state. Individuals with this disorder are known to have recurrent venous or arterial thrombosis at an early age, although not all patients are symptomatic. Any patients with the following presentations should be tested for antiphospholipid syndrome: history of thrombosis in the absence of known risk factors, miscarriage (especially if in the late trimester or recurrent), history of heart murmurs or cardiac valvular vegetations, history of hematologic abnormalities, and pulmonary hypertension Treatment for antiphospholipid syndrome that has antithrombotic properties Hydroxychloroquine What is the mode of genetic transmission for hemophilia B? X linked recessive What does hemophilia prolong? PTT How much of blood volume is typically lost before hypotension is seen in hemorrhagic shock? (Percentage) 30-40%