IM samplex notes

Question 1

Most common pattern of diabetic neuropathy

Answer 1

Distal sensorimotor polyneuropathy

Question 2

Lab test to monitor hyperthyroidism

Answer 2

Free T4

Question 3

Chvostek sign (+)

Answer 3

hypocalcemia

Question 4

TB drug that may cause joint pain

Answer 4

pyrazinamide can also cause jaundice

Question 5

In what phase of pneumonia is there predominance of neutrophils and deposition of fibrin?

Answer 5

Grey hepatization

Question 6

prophylaxis against NSAID related mucosal injury

Answer 6

Bismuth

Question 7

Most potent medication for AR in providing relief of established rhinitis

Answer 7

ICS

Question 8

Daily maintenancedose of antithyroid drugs in the titration regimen

Answer 8

2.5 -10 mg of carbimazole or methimazole

50-100 mg of PTU

Question 9

Follow up for thyroid function

Answer 9

4-6 weeks after starting treatment, and the dose is titrated based on Free T4 levels.

Most do not achieve euthyroidism until 6-8 weeks after treatment is initiated.

Question 10

Anithyroid meds that must be avoided in children

Answer 10

propylthiouracil

Question 11

Antithyroid meds that can cause cholestasis (RARE)

Answer 11

methimazole and carbimazole

Question 12

Adverse effect of ferrous sulfate

Answer 12

• Epigastric pain
• Constipation
• darkening of stols
• GI irration
• Nausea
• Vomiting

Question 13

Alarm features of dyspepsia

• burning epigastic pain radiating to the retrosternal area
• exacerbated by meals and sometimes awakens him from sleep
• sour tatse in his mouth

Answer 13

• Unintentional weight loss
• Progressive dysphagia
• Odynophagia
• Unexplained IDA
• persistent vomiting
• Palpable mass or lymphadenopathy
• Family history of Upper GI

Question 14

Palpating in the left lower quadrant causes pain in the Right lower quadrant

Answer 14

Rovsing’s sign

Question 15

Internal rotation of the hip causes pain, suggeting the possibility of an inflamed appendix located in the pelvis

Answer 15

obturator sign

Question 16

Extending the right hip causes pain along posterolateral back and hip, suggesting retrocecal appendicitis

Answer 16

Iliopsoas sign

Question 17

Anemia in CKD

Answer 17

• Normocytic, normochromic anemia

Observed as early as Stage 3

Due to insufficient production of EPO by the diseased kidney

Question 18

Mechanism of Misoprostol as prophylaxis against NSAID-related mucosal injury

Answer 18

Inhibits basal and nocturnal gastric acid secretion

Question 19

Mechanism of Bismuth as prophylaxis against NSAID-related mucosal injury

Answer 19

antacid thought to work by coating the stomach and intestines

Question 20

Mechanism of proton pump inhibitor as prophylaxis against NSAID-related mucosal injury

Answer 20

reduce the production of acid by the stomach by irreversibly blcoking H+/K+ ATPase

Question 21

Drugs for HF that promote reverse remodelling

Answer 21

• beta Blocker
• ACE-i
• ARBs

Question 22

Laboratory Findings in newly identified CKD

Answer 22

• increased crea
• Increased BUN
• anemia
• Hyperphosphatemia
• hyperkalemia
• metabolic acidosis
• hypocalcemia
• elevated PTH

Question 23

Intervention that is proven to reduce motality in COPD

Answer 23

Oxygen

• the long term administration of oxygen (>15 hours per day) to patients with chronic respiratory failure has been shown to increase survival in patinets with sevre resting hypoxemia

Question 24

Peripheral vs Central Vertigo

Answer 24

• Peripheral Vertigo
  
  • combined horizontal and torsional
  • inhibited by fixation
  • fades after a few days
  • does not change direction with gaze
• Central Vertigo
  
  • ​Purely vertical, horizontal, or torsional
  • not inhibited by fixation of eyes onto object
  • may last weeks to months
  • may change direction with gaze towards fast phase of nysgtagmus

Question 25

three drugs focus priarily on reducing acute thrombotic events

Answer 25

* Aspirin * ACE-i * Statins * High intensity statin therapy should be given for patients with established IHD \<75 y/o)