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PAEA Internal Medicine EOR Questions and Answers (100% Correct Answers) Already Graded A+

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PAEA Internal Medicine EOR Questions and Answers (100% Correct Answers) Already Graded A+

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PAEA Internal Medicine EOR Questions
and Answers (100% Correct Answers)
Already Graded A+
Bell's Palsy [ ANS: ] causes cranial nerve 7 dysfunction

S/S of Bell's Palsy [ ANS: ] Has forehead involvement (whereas a
stroke does not affect forehead movement), facial weakness,
inability to keep one eye closed

Treatment for Bell's palsy [ ANS: ] Prednisone 60mg x 5 days,
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Valcyclovir 1000mg TID x 7 days, artificial tears, lacri lube at night

When can I use tPA? [ ANS: ] ischemic stroke presenting within <3
hrs and CT head negative
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How do you treat high BP with stroke? [ ANS: ] Nitroprusside (short
half life, easy to titrate) or IV labetalol

What do you use for anticoagulation/antiplatelet therapy in
stroke? [ ANS: ] ASA (not in hemorrhagic), heparin for thrombosis

What do you do differently to treat hemorrhagic stroke? [ ANS: ]
Give prophylactic anticonvulsant like phenytoin because of
increased seizure risk, antiplatelet therapy contraindicated

Types of Hemorrhagic Stroke [ ANS: ] 1. Intracerebral (10%): results
from rupture of small arterioles

2. Subarachnoid (3%): rupture of arterial aneurysms (hemorrhage
into subarachnoid space)

Causes of Intracerebral hemorrhagic stroke are what? [ ANS: ]
HTN, amyloidosis, iatrogenic anticoagulation, vascular
malformations, cocaine use

, 2
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Causes of Subarachnoid hemorrhagic stroke are what? [ ANS: ]
berry aneurysm rupture, vascular malformation rupture

Signs and symptoms of Intracerebral hemorrhagic stroke are
what? [ ANS: ] ICP rises, vasoconstriction-sweating

Signs and symptoms of Subarachnoid hemorrhagic stroke are
what? [ ANS: ] may be preceded by warning headache,
neck/back pain, "worst headache of my life," thunderclap, may
have loss of consciousness

Treatment of Subarachnoid hemorrhage [ ANS: ] surgery, control
hypertension, analgesics
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What is Complex regional pain syndrome (CRPS) [ ANS: ] Chronic
arm or leg pain developing after injury, surgery, stroke, or heart
attack.
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Signs and symptoms of complex regional pain syndrome are
what? [ ANS: ] Pain out of proportion to injury. ANS sx: swelling,
extremity color changes, increased nail and hair growth.

Treatment for complex regional pain syndrome [ ANS: ]
Amitriptyline, nortriptyline, gabapentin, pregabalin, lamotrigine;
NSAIDs; Calcitonin to reduce pain as adjunctive therapy;
Bisphosphonates, IVIG, regional nerve blocks, dorsal column
stimulation



Vit C prophylaxis after fx

Imaging modality used to diagnose Subarachnoid Hemorrhage? [
ANS: ] CT without contrast. If CT negative but still suspect SAH, do
LP to look for RBC or xanthochromia (will not develop until 12hrs
after onset)

Delirium [ ANS: ] transient disorder characterized by impaired
attention, perception, memory and cognition. Sleep wake cycles

, 3
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interrupted ("sundowning"). Reduced alertness, activity levels
change rapidly.

Treatment of Delirium [ ANS: ] treat underlying cause, Haloperidol
5-10mg for agitation, Lorazepam 0.5-2 mg

Dementia [ ANS: ] Loss of mental capacity. Psychosocial level and
cognitive abilities deteriorate and behavioral problems develop.
Largest categories are Alzheimer dz and vascular dementia.
Hallucinations, delusion, depression, repetitive behavior are
common.

Treatment of Dementia [ ANS: ] Antipsychotics to manage
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psychosis

Essential tremor does not occur at rest, occurs bilaterally, and has
no indication of other neuro signs. How do you treat essential
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tremor? [ ANS: ] Propranolol, Primidone (can combine these 2 if
needed)

Guillian Barre Syndrome [ ANS: ] Idiopathic polyneuropathy often
following minor infections, immunizations or surgical procedures.
Most times no cause is identified.

How long does Guillian Barre Syndrome last? [ ANS: ] worst at 2-4
weeks after onset, plateaus next 2-4 weeks, remits weeks-moats

Signs and symptoms of Guillian Barre Syndrome [ ANS: ] ascending
symmetric weakness and loss of DTR's, proximal muscles affected
more than distal. Sensory abnormalities, pain, tachycardia,
sweating, impaired pulmonary function, paralytic ileus

How do you diagnose Guillian Barre? [ ANS: ] no fever at onset,
CSF protein >45 and low WBC, MRI shows selective enhancement
of anterior spinal nerve roots

Treatment of Guillian Barre Syndrome [ ANS: ] IVIG or
plasmapheresis, may need intubation. Hospitalized pt with close

, 4
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monitoring. Recovery is slow but approximately 60% make full
recovery within 1 year.

What disease is a systemic inflammatory condition of medium and
large vessels affecting people over 50 years old, coexists with
polymyalgia rheumatica and can cause blindness if not treated
appropriately? [ ANS: ] Giant cell arteritis

Signs and symptoms of Giant Cell Arteritis [ ANS: ] headache,
scalp tenderness, jaw claudication, throat pain, diplopia

Symptoms of polymyalgia rheumatica: pain of shoulder/pelvis
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Giant Cell Arteritis Treatment [ ANS: ] Steroids immediately, do not
wait for biopsy results. Give low dose aspirin too.

Describe a Migraine Headache? [ ANS: ] unilateral location,
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pulsatile quality, moderate to severe intensity, aggravated by
movement, nausea, vomiting, photophobia, phonophobia

lasting 4-72 hours

Migraine treatment [ ANS: ] NSAIDs, Triptans, antiemetics

What is a Cluster Headache? [ ANS: ] severe, unilateral headache
localized to periorbital/temporal area accompanied by
lacrimation, rhinorrhea, ptosis, myosis, nasal congestion, eyelid
edema

-Occurs in clusters meaning 1-8 daily attacks lasting 15-90 minutes
for 4-6 weeks... followed by pain free interval 3-6 months

Cluster headache treatment [ ANS: ] Oxygen, Sumatriptan 6mg
SQ, start preventive therapy as soon as headache onset to
suppress attacks over expected duration of cluster period

Preventive therapies for cluster headache lasting more than 2
months [ ANS: ] Verapamil 240-960mg given in 3 daily doses

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