R-sided H/A with facial pain, R eye tearing. What type of headache is this?
Cluster headache
What is the leading cause of blindness in the US
Diabetic retinopathy
What is the leading cause of death in women in the US?
Cardiovascular disease
Patients with Printzmetal’s angina often have a hx of which two disorders?
Raynaud’s disease and migraine
True or False. Patients with dyspnea from cardiac causes remain dyspneic much longer after cessation of exercise.
True
What is the most common cause of systolic ejection murmur in the elderly?
Aortic sclerosis
Elevated early morning blood glucose without hypoglycemia during the night is known as:
Dawn Phenomenon
How often should a stable diabetic patient monitor his blood glucose?
3x per week
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
Which hormone is secreted by the adrenal cortex?
Aldosterone
Which hormone is secreted by the anterior pituitary?
Antidiuretic hormone
What is the pathophysiology behind diabetic neuropathy?
Demyelination of schwann cells
Older adults often experience a delay in Dx of MI. Why?
Symptoms are vague and atypical in presentation
Auscultation of S3 heart sound is indicative of which two conditions?
Early heart failure and mitral valve regurge
Loss of interest, recent memory loss, increased appetite, and mood swings are symptoms of which drug?
Marijuana
Patient with increased anxiety, tremors, and visible perspiration, you suspect
Alcohol withdrawal/detox
What are the 3 cardinal symptoms of aortic stenosis?
Dyspnea, angina, and syncope
Define the cardinal symptoms of COPD?
Dyspnea, excessive mucous production, fatigue
Pathological U waves are associated with which two conditions:
Hypocalcemia and Hypokalemia
New patient s/p surgery is edematous, dusky blue of the upper extremities. You suspect:
Superior Vena Cava Syndrome
Most common cause of elevated LDL in the US is associated with what type of diet?
High in saturated fats
Patients taking high dose simvastatin are at risk for what?
Myopathies/ rhabdo
BP of 160/100 is which stage according to JNC 8?
Stage 2
Water hammer pulses are associated with which condition?
Aortic regurgitation
Pulsus Paradoxus is associated with which condition?
Superior vena cava obstruction
Pericardial effusion
Severe CHF
Constrictive pericarditis
In hypertrophic cardiomyopathy, which 3 drugs would you avoid?
Digoxin, ACEI, ARB
Presence of thread pulse is indicative of which life-threatening condition?
Cardiogenic shock
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
Prinzmetal’s angina is characterized by what on the EKG?
ST elevation
Smith needs a diuretic for new onsent HF. What must you NOT give due to his sulfa allergy?
Bumex and HCTZ
Keratitis is associated with which part of the eye?
Cornea
Treatment of mono?
Symptomatic treatment
Otitis externa with fuzzy discharge. Which two organisms would you suspect?
Aspergillus & Candida
AOM with ruptured TM. Which antibiotic would you use?
Ofloxacin drops
Which antihypertensive agent will result in a rebound crisis after sudden discontinuation?
Clonidine
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
Name the medication that could potentiate hyperglycemia
Corticosteroids
Niacin
Thiazides
BBs
Fluoroquinolones
A patient has GERD. What foods should she avoid?
Caffeine and chocolate
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
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
If a patient is allergic to ASA, what anticoagulant should you give instead?
Plavix
What is the first line of treatment for HTN?
Thiazide diuretic
Define asthma.
Chronic airway inflammation with superimposed bronchospasm.
What is a sandpaper rash indicative of?
Scarlet fever
What is the most important teaching point for a patient taking NSAIDS for chronic pain?
Stomach ulcers/bleeding
What preventative medications would you add to a patient on long-term NSAIDS?
H2 blockers/PPI
How would you treat shingles?
Acyclovir, steroids
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)
The ADA recommends that diabetic patients take ASA prophylactically. True/False?
True
A 33-year-old diabetic patient accidentally took too much insulin. What should she do next?
Drink 4 oz. of fruit juice
What is the first sign of renal dysfunction?
Proteinuria
In the presence of proteinuria, how much kidney function has been lost?
50%
Signs & Symptoms consistent with DKA?
Ketonuria, polyuria, hyperventilation
How often should a stable diabetic patient monitor his blood glucose?
3 times per week
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
How often do you do A1c on stable diabetic patient?
Twice a year
According to USPSTF, which age group should be screened for alcohol abuse?
All adults & adolescents
What preventative measures for colon/rectal cancers would you recommend for your patients?
Increased fiver intake, ASA, regular exercise
What should a patient with GERD avoid eating besides spicy foods?
Caffeine and chocolate
What is the most likely cause of nosebleeds in the elderly not taking anticoagulants?
Trauma/inflammation/dryness
Most common cause of decrease vision in the elderly is
Cataracts
Describe the sound of a murmur due to aortic stenosis.
Crescendo-decrescendo ejection type
Which class of antihypertensive is used to treat BPH?
Alpha-adrenergic blockers (Flomax)
What should the ideal LDL be for a patient with CAD?
< 100mg/dl
If an elderly patient presents with new onset A. fib, what lab test should be ordered?
TSH
How often do you monitor TSH levels when adjusting levothyroxine to euthyroid levels?
Every 6-8 weeks
Patient has low BP, blood glucose, sodium, but ELEVATED potassium. What emergency is this?
Addison’s Crisis
Primary adrenal insufficiency; which hormone are you deficient in?
Cortisol
What is the purpose of the parathyroid gland?
Maintain calcium levels
What is the most common cause of hyperthyroidism?
Grave’s disease
Which emergent condition is the opposite of thyroid storm?
Myxedema Coma
Thyroid Releasing Hormone (TRH) is produced where?
