EOC End of Curriculum Exam Prep With Questions And Complete Solutions

EOC End of Curriculum Exam Prep With Questions And Complete Solutions abnormal laboratory tests with ______________ include -- increased LFT, NH4+ -- decreased Glucose - Answer Reye syndrome tx- Treatment is aimed at reducing intracranial pressure and supportive care. SE- cerebral edema and fulminant heptitis mechanical mitral valve replacement on warfarin presents to the office for routine management of his anticoagulant medication. What is the target international normalized ratio range for this patient? - Answer INR 2.5 to 3.5 (mechanical valve) INR 2.0 to 3.0 (organic valve) LBP worse with walking, radiating to both legs, + paresthesia, +weakness + worse pain with spine extension - Answer Spinal Stenosis - LBP worse with extension better with forward flexion/bending patho: degeneration of intervertebral disc, decrease in height with bulging into the spina l canal dx- MRI Tx- PT and surgery Decreased light touch and vibration sensation*** - Answer nerve compression neuropathy IVDU (heroin use), conjunctival hemorrhages, small red macular lesions on B/L palms and soles, new murmur on left sternal border - Answer infective endocarditis dx based on: -Two Major (+blood cx, +echo, +valve regurg) -one major - three minor - 5 minor (F, IVDU, *Most often elevated lab marker- rheumatoid factor* Rash starting at the face spreading to B/L knee and wrist rash. + fever, + posterior cervical and posterior auricular lymphadenopathy - Answer Rubella -- maculopapuar rash - pinpoint, pink - posterior cervical/ auricular and suboccipital lymph nodes - low grade fever - JOINT pain - Complications: hearing loss (congenital) Dx- IgM antibodies, enzyme immunoassay Tx- supportive, vaccinations SUPER HIGH fever (104F) --> FEVER resolves --> RASH (blanching, maculopapular rash) begins on chest then spread to face and extremities - Answer RoSeola (Super High F, and sixth dz) HHS 6 *roses that start in chest and bloom to face/ extremities* LOW grade fever, coryza (aka runny nose/ congestion), cough, conjunctivitis, malaise, koplik spots - Answer rubeola / measles dx- mesles IgM serum antibody recommendations- isolate tx- supportive constipation, what medication could safely be added - Answer Bulk forming laxatives --note that osmotic stimulants and surfactants don't help. Which medication causes a rapid eye movement sleep behavior disorder in patients with Parkinson disease or Lewy body dementia? - Answer SSRI and antidepressants (common) --- rare--BB, cholinesterase inhibitors (donepezil, rivastigmine, mimentamine), suvorexant (rare) --- benzodiazepine withdrawal, barbiturate withdrawal. --- use melatonin or low dose clonazepam SEVERE HA, _ conjunctival inject + tearing, occuring one minute --- Oxygen does NOT help! - Answer short lasting unilateral neuralgiform headache attack Note - no n/photophobia/ phonophobia = no alcohol triggers tx- Lidocaine prophylaxis persisitent rhinorrhea, frequent sneezing, itching, watering eyes - Answer allergic rhin itis wash bed lining weekly tx- antihistamine glucocrticoid nasal sprays cromolyn sodium montelukast intense stabbing along the jaw. Aggrevated by chewing and brushing teeth. -- - Answer trigeminal neuralgia through foramen ovale (facial nerve, V3 mandibular a nd maxillary branch (V2) -- presence of facial muscle spasm tx- carbamazepine gabapentin lamotrigine, phenytoin What is the most common dislocation in the body? - Answer shoulder _MC ante rior / ABDucted / externally rotated/ axillary nerve Second MC is elbow Knee dislocations are rare complications: axillary nerve damage, bankar lesion/ hill sachs deformity. MC symptom for eosinophilic esophagitis - Answer dysphagia to solid foods c/o fatigue, slugginesh, numbness, glossitis, jaundiced, macrocytic anemia. INstrinsic factor antibodies, what is the treatment? - Answer IM cynocobalamin (for autoimmune intrinsic factor) Methylmalonic acid is elevated. note: PO vit b12 good for diet def in vit b12 PO folate for high dose methotrexate therapy