ABFM ITE Real Exam Test Questions & Verified Solutions | Latest update

ABFM ITE Real Exam Test Questions & Verified Solutions | Latest update Which class of DM drugs are most likely to cause weight loss? - ANSWER GLP-1 inhibitors such as Byetta or Trulicity as they increase insulin secretion, decrease glucagon and increase satiety How is head lice treated? - ANSWER 1% permethrin shampoo applied twice, 7-10 days apart Nit combing Oral ivermectin can be used if no improvement with permethrin 1% or 5% When can a child with head lice return to school? - ANSWER No school restrictions even if nits are visualized due to very low likelihood of transmission!!!!! Are diverticular bleeding and angiodysplasia (small GI vascular malformation) painful or painless? - ANSWER PAINLESS Crampy abdominal pain + bloody diarrhea + low abdominal pain in a patient with HTN, vascular dementia, peripheral artery disease, HT and HLD. What diagnosis should you suspect? - ANSWER Ischemic colitis. PAINFUL, cramps and bloody The risk factors this patient has for vascular disease make this diagnosis even more likely How do you treat a patient with patellofemoral syndrome? - ANSWER Physical therapy and activity modification (reducing running distance, keeping leg straight by dragging it, etc.) Patellar taping can be used as an adjunct but the evidence is inconsistent so it should not be the primary approach When does JNC8 recommend <140/90 vs <150/90 for blood pressure goals? - ANSWER Less than 65yo, DM or HTN: <140/90 Greater than 65 yo: <150/90 Old and multiple problems you can be even more lenient What signs and symptoms would a child with transient synovitis present with? - ANSWER Hip pain, limping, prefers lying supine with knee bent or out to the side. Well appearing & afebrile No leukocytosis or elevation is ESR/CRP Normal x-ray How is transient synovitis treated? - ANSWER This is a self limited inflammatory disorder with no active infection or bony disruption. Treat with NSAIDs and rest How do you treat a patient found to be in SVT? - ANSWER If not stable --> synchronized cardioversion If stable --> Vagal maneuvers followed by med -Adenosine (SA node only, first line tx for SVT) -Beta blockers (Esmolol is SA only and IV, procainamide is SA and AV working by binding Na++ channels and widening QRS) -Calcium channel blockers (SA and AV node) Which class of medication can be used acutely to stop SVT and chronically for prevention of SVT? - ANSWER Calcium channel blockers such as verapamil Adenosine or beta blockers (amio, esmolol, procanimide) can be used acutely but are not first choice for long term treatment What is the pathophysiology of beta thalassemia? - ANSWER Beta globulin proteins are not formed properly (minor) or not at all (major) This leads to an excess of alpha globulins resulting in alpha tetramer formation The excess alpha units interact with the RBC cell wall leading to ovalocyte production and abnormal peripheral smear This leads to increased hemolysis and erythrocyte production in order to compensate and allow enough oxygen transport through the body. Diagnosis with with hemoglobin electrophoresis This is a MICROCYTOSIS with normal/high iron, normal TIBC/ferritin/ transferrin. Anemia may or may not be present. Name 4 diagnostic criteria/symptoms of delirium - ANSWER 1. ACUTE onset: "my husbands not like this at home" 2. Fluctuating: agitation at night but not in a