545A Final

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BillK
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308049
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545A Final
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2015-09-18 08:57:16
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Adult medicine
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Review for 545A final exam
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  1. R-sided H/A with facial pain, R eye tearing. What type of headache is this?
    Cluster headache
  2. What is the leading cause of blindness in the US
    Diabetic retinopathy
  3. What is the leading cause of death in women in the US?
    Cardiovascular disease
  4. Patients with Printzmetal’s angina often have a hx of which two disorders?
    Raynaud’s disease and migraine
  5. True or False. Patients with dyspnea from cardiac causes remain dyspneic much longer after cessation of exercise.
    True
  6. What is the most common cause of systolic ejection murmur in the elderly?
    Aortic sclerosis
  7. Elevated early morning blood glucose without hypoglycemia during the night is known as:
    Dawn Phenomenon
  8. How often should a stable diabetic patient monitor his blood glucose?
    3x per week
  9. Describe the relationship between diabetes and heart disease.
    Excess insulin decreases patency of blood flow by depositing vascular smooth muscle cells on the vessel walls
  10. Which hormone is secreted by the adrenal cortex?
    Aldosterone
  11. Which hormone is secreted by the anterior pituitary?
    Antidiuretic hormone
  12. What is the pathophysiology behind diabetic neuropathy?
    Demyelination of schwann cells
  13. Older adults often experience a delay in Dx of MI. Why?
    Symptoms are vague and atypical in presentation
  14. Auscultation of S3 heart sound is indicative of which two conditions?
    Early heart failure and mitral valve regurge
  15. Loss of interest, recent memory loss, increased appetite, and mood swings are symptoms of which drug?
    Marijuana
  16. Patient with increased anxiety, tremors, and visible perspiration, you suspect
    Alcohol withdrawal/detox
  17. What are the 3 cardinal symptoms of aortic stenosis?
    Dyspnea, angina, and syncope
  18. Define the cardinal symptoms of COPD?
    Dyspnea, excessive mucous production, fatigue
  19. Pathological U waves are associated with which two conditions:
    Hypocalcemia and Hypokalemia
  20. New patient s/p surgery is edematous, dusky blue of the upper extremities. You suspect:
    Superior Vena Cava Syndrome
  21. Most common cause of elevated LDL in the US is associated with what type of diet?
    High in saturated fats
  22. Patients taking high dose simvastatin are at risk for what?
    Myopathies/ rhabdo
  23. BP of 160/100 is which stage according to JNC 8?
    Stage 2
  24. Water hammer pulses are associated with which condition?
    Aortic regurgitation
  25. Pulsus Paradoxus is associated with which condition?
    • Superior vena cava obstruction
    • Pericardial effusion
    • Severe CHF
    • Constrictive pericarditis
  26. In hypertrophic cardiomyopathy, which 3 drugs would you avoid?
    Digoxin, ACEI, ARB
  27. Presence of thread pulse is indicative of which life-threatening condition?
    Cardiogenic shock
  28. Name the criteria for metabolic syndrome
    • Waist > 40” for males, >35” for females
    • HTN > 135/85
    • HDL < 40 for males, < 50 for females
    • Fasting BG > 100
    • Triglycerides > 150
  29. Prinzmetal’s angina is characterized by what on the EKG?
    ST elevation
  30. Smith needs a diuretic for new onsent HF. What must you NOT give due to his sulfa allergy?
    Bumex and HCTZ
  31. Keratitis is associated with which part of the eye?
    Cornea
  32. Treatment of mono?
    Symptomatic treatment
  33. Otitis externa with fuzzy discharge. Which two organisms would you suspect?
    Aspergillus & Candida
  34. AOM with ruptured TM. Which antibiotic would you use?
    Ofloxacin drops
  35. Which antihypertensive agent will result in a rebound crisis after sudden discontinuation?
    Clonidine
  36. True or False: Joe has been diagnosed with HTN 1 year ago. He has not been on medication. You should start him on metoprolol 25mg.
    False
  37. Name the medication that could potentiate hyperglycemia
    • Corticosteroids
    • Niacin
    • Thiazides
    • BBs
    • Fluoroquinolones
  38. A patient has GERD. What foods should she avoid?
    Caffeine and chocolate
  39. Matching
    1. Byetta          a. Monitor LFTs               
    2. Glyburide      b. Administer at night
    3. Lantus          c. Risk of pancreatitis
    4. Metformin     d. Risk of hypoglycemia
    5. TZD             e. PCOS
    • 1. c
    • 2. d
    • 3. b
    • 4. e
    • 5. a
  40. Matching
    1. COPD                                              a. Cardiac origin
    2. Common cause of CHF                  b. Non-cardiac
    3. Submammary CP                           c. Chronic bronchitis
    4. Widow maker                                d. Coronary atherosclerosis
    5. Chest heaviness, tight, dull pain    e. Left anterior descending
    • 1. c
    • 2. d
    • 3. b
    • 4. e
    • 5. a
  41. If a patient is allergic to ASA, what anticoagulant should you give instead?
    Plavix
  42. What is the first line of treatment for HTN?
    Thiazide diuretic
  43. Define asthma.
    Chronic airway inflammation with superimposed bronchospasm.
  44. What is a sandpaper rash indicative of?
    Scarlet fever
  45. What is the most important teaching point for a patient taking NSAIDS for chronic pain?
    Stomach ulcers/bleeding
  46. What preventative medications would you add to a patient on long-term NSAIDS?
    H2 blockers/PPI
  47. How would you treat shingles?
    Acyclovir, steroids
  48. If diet, exercise, and oral antidiabetic meds are insufficient for control of T2DM, what would you add?
    Long-acting insulin at HS (i.e. Lantus)
  49. The ADA recommends that diabetic patients take ASA prophylactically. True/False?
    True
  50. A 33-year-old diabetic patient accidentally took too much insulin. What should she do next?
    Drink 4 oz. of fruit juice
  51. What is the first sign of renal dysfunction?
    Proteinuria
  52. In the presence of proteinuria, how much kidney function has been lost?
    50%
  53. Signs & Symptoms consistent with DKA?
    Ketonuria, polyuria, hyperventilation
  54. How often should a stable diabetic patient monitor his blood glucose?
    3 times per week
  55. Secondary causes of hyperglycemia include the use of all the following medications EXCEPT. (Niacin, Corticosteroids, Thiazide diuretics, Angiotensin Receptor Blockers)
    Angiotensin receptor blockers (ARBs) all others above cause hyperglycemia
  56. How often do you do A1c on stable diabetic patient?
    Twice a year
  57. According to USPSTF, which age group should be screened for alcohol abuse?
    All adults & adolescents
  58. What preventative measures for colon/rectal cancers would you recommend for your patients?
    Increased fiver intake, ASA, regular exercise
  59. What should a patient with GERD avoid eating besides spicy foods?
    Caffeine and chocolate
  60. What is the most likely cause of nosebleeds in the elderly not taking anticoagulants?
    Trauma/inflammation/dryness
  61. Most common cause of decrease vision in the elderly is
    Cataracts
  62. Describe the sound of a murmur due to aortic stenosis.
    Crescendo-decrescendo ejection type
  63. Which class of antihypertensive is used to treat BPH?
    Alpha-adrenergic blockers (Flomax)
  64. What should the ideal LDL be for a patient with CAD?
    < 100mg/dl
  65. If an elderly patient presents with new onset A. fib, what lab test should be ordered?
    TSH
  66. How often do you monitor TSH levels when adjusting levothyroxine to euthyroid levels?
    Every 6-8 weeks
  67. Patient has low BP, blood glucose, sodium, but ELEVATED potassium. What emergency is this?
    Addison’s Crisis
  68. Primary adrenal insufficiency; which hormone are you deficient in?
    Cortisol
  69. What is the purpose of the parathyroid gland?
    Maintain calcium levels
  70. What is the most common cause of hyperthyroidism?
    Grave’s disease
  71. Which emergent condition is the opposite of thyroid storm?
    Myxedema Coma
  72. Thyroid Releasing Hormone (TRH) is produced where?
    Hypothalamus

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