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2011-03-23 20:35:27
step ck review

Review of step 2 questions
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  1. What is the most common complication associated with TPN?
    Catheter tip infection
  2. What is antifreeze made out of?
    Ethylene glycol and water
  3. What is windshield wiper fluid made out of?
  4. Elderly patient presents with systolic ejection murmur at right upper sternal border that radiates to carotids
    aortic stenosis
  5. What is the most common cause of aortic stenosis in younger patients?
    Bicuspid aortic valve
  6. What is the most common cause of aortic stenosis in older patients?
    Degenerative calcification of aortic valve leaflets
  7. What is the most common cause of infectious pericarditis or myocarditis?
  8. 67 y/o M complains with bilateral posterior thigh pain with walking and prolonged standing. Pain is much worse walking downhill as opposed to uphill
    Lumbar spinal stenosis
  9. What is the most common cause of spinal stenosis?
    • Osteoarthritis of the spine
    • - narrowing of spinal canal due to bone spurs for ex
  10. What is an empyema?
    Frank collection of pus within the pleural cavity
  11. 59 y/o smoker dx with small cell lung CA pw headache. Describes headaches as diffuse and says they get worse when he leans forward. PE: Abdomen soft and distended. No peripheral edema. What does this patient have and how is this treated?
    SVC syndrome (treated with radiation)
  12. 56 y/o caucasian male complains of increasing weakness for past 6 weeks. Noted difficulty climbing stairs at first, then trouble rising from chair. Recently, tired when using arms to do homework. Labs: TBili: 0.2, AST: 250, ALT: 140, Alk Phos: 90, LDH: 665, CPK: 4000
  13. What are neuro sx associated with ALS?
    • Motor - Upper (hyperreflexia) and lower (atrophy, fasciculations) motor neuron signs
    • Sensation - Preserved
  14. What is the age range of absence seizures?
    Typically occurs in children
  15. What is the difference between complex and simple seizures?
    Complex - loss of consciousness
  16. What is the most common region involved with complex partial seizures?
    Temporal lobe
  17. Treatment of STABLE ventricular tachycardia?
    Amiodarone (IV)
  18. Drug used for treatment of SUPRAventricular tachycardia?
  19. What are the two main causes of hyperaldosteronism?
    • Bilateral adrenal hyperplasia
    • Functioning adrenal adenoma
  20. What is ursodeoxycholic acid?
    • Secondary bile acid - helps digest fats
    • Reduces rate at which intestine absorbs cholesterol
  21. Proteinuria was noted - what is the source of this disease?
  22. 35 y/o F w h/o DM complains of pain in lower back, hips, and knees. Pt has ESRD and has been on HD for the last 2 years. Labs: Hb: 9.5, WBC: 6000, Platelets: 150K. Ca: 8.1, Phos: 6.1. What does she have and why?
    Renal osteodystrophy - reduced GFR leads to phosphate retention and poorly processed vit D leads to hypocalcemia. Parathyroids respond by hypertrophying (secondary hyperparathyroidism)
  23. Where are anti-centromere antibodies seen?
    Scleroderma (limited form) (CREST)
  24. What labs are useful for diagnosing SLE?
    • Anti DS DNA Antibodies - more specific for SLE
    • Anti-Smith Antibodies - more specific for SLE
    • Antinuclear Antibodies - nearly all SLE patients have
  25. What antibodies are associated with auto-immune hepatitis?
    Anti-smooth muscle antibodies
  26. In what disease are anti-mitochondrial antibodies (AMA) found?
    Primary Biliary Cirrhosis
  27. 52 y/o F w longstanding h/o DM and recurrent UTIs complains of urinary leaks. Has nagging sensation that her bladder is full and frequent low-volume leaks. Catheterization reveals PVR of 400 mL.
    Neurogenic bladder (overflow incontinence)
  28. 54 y/o M with alcoholic liver disease presents with coffee ground emesis. On day 3 of hospitalization, he develops progressive lethargy. What should be suspected and how to test this?
    Spontaneous Bacterial Peritonitis (SBP) - test with diagnostic paracentesis (look for high level of neutrophils)
  29. What is first line therapy for reducing risk of esophageal variceal hemorrhage?
    Beta blockers (non selective)
  30. What are common causes of restrictive cardiomyopathy?
    Amyloidosis, Sarcoidosis, Hemochromatosis