UPDATED PRACTICE QUESTIONS AND
SOLUTIONS
◉ 6 drugs with narrow therapeutic index. Answer: 1. Warfarin:
monitor INR
2. Digoxin: Monitor dig level, electrolytes
3. Theophylline: monitor blood levels
4. Carbamazepine / phenytoin: monitor blood levels
5. Levothyroxine: monitor TSH
6. Lithium: monitor blood levels and TSH (can cause
hypothyroidism)
◉ TZDs black box warning. Answer: Can cause or exacerbate CHF in
some patients. Do not use if NYHA class III or IV HF
◉ L4 neuro tests. Answer: Motor: Foot dorsiflexion
Reflex: Knee jerk
Sensory: Medial calf
◉ L5. Answer: Motor: Great toe dorsiflexion
Reflex: NONE
,Sensory area: Medial foot
◉ S1. Answer: Motor: Foot eversion
Reflex: Ankle jerk
Sensory area: Lateral foot
◉ high-Ca non-dairy foods. Answer: Spinach tofu almonds sardines
◉ acral letiginous melanoma. Answer: most common melanoma in
AA and Asian patients. Dark spots on nailbeds (longitudinal
black/brown bands), palmar and plantar surfaces
◉ Result of maternal Vitamin D deficiency. Answer: infantile rickets
(brittle bones, skeletal abnorms)
◉ Koebner phenomenon. Answer: new psoriatic plaques form over
areas of skin trauma
◉ Auspitz sign. Answer: removal of scaling causes pinpoint bleeding
seen in psoriasis
◉ topical tacrolimus BBW. Answer: Rare cases of malignancy.
,◉ Meds for atopic dermatitis. Answer: Mild: Hydrocortisone 1%-
2.5%
Medium: Triamcinolone cream
◉ Characcteristics of superficial candidiasis. Answer: red and shiny
skin
◉ Ramsay Hunt Syndrome. Answer: Herpes zoster facial neuritis.
Ear pain, facial paralysis, vesicular eruption about the ear. MR may
reveal increased enhancement of facial nerve. Herpes zoster oticus:
CN 8.
◉ Diseases caused by S.pneumoniae and H.influenzae. Answer:
COMPS:
Conjunctivitis
Otitis Media
Meningitis
Pneumonia
Sinusitis
◉ S.pneumoniae: + or -. Answer: Gram positive. Most common cause
of fatal CAP
◉ H.influenzae: + or -. Answer: Gram negative. Smokers are high risk
, ◉ Atypical strains causing CAP. Answer: M.pneumoniae
C.pneumoniae
Legionella spp.
◉ Osler nodes. Answer: painful erythematous nodules on the pads
of the fingers and toes
Associated with endocarditis
◉ Janeway lesions. Answer: nontender hemorrhagic lesions -
fingers, toes, nose, earlobes - associated with endocarditis
◉ Signs of bacterial endocarditis. Answer: FROM JANE P
fever, roth spots (cornea), Osler (ouch) nodes, murmur, Janeway
lesions (palm), anemia of chronic disease, nail bed hemm (Splinter),
emboli, petechiae on the palate
◉ When is an S3 considered abnormal?. Answer: Always after 35 yo
◉ Which murmur is best heard with the bell. Answer: S4 heart
sound
Mitral stenosis (rumble)