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ABIM - Practice Exam

Exam #1 - Things I got wrong

QuestionAnswer
Does beta blocker therapy reduce the risk of sudden cardiac death in patients with HOCM? No. Only used to treat symptoms in HOCM.
Which patients with HOCM should be considered for an implantable cardioverter defibrillator? ICD if they have risk factors for sudden cardiac death: 1. Myocardial wall thickness >= 30 mm, 2. Previous cardiac arrest due to vent arrhyth, 3. Blunted BP response or hyPOTN w exercise, 4. Unexplained syncope, 5.NSTV on EKG, 6. fam ho SCD 2/2 HCM
What is the treatment for a patient with HOCM who does not respond to drug therapy? Septal reduction therapy with either alcohol septal ablation or surgical myectomy.
What are the indications for mitral valve surgery? 1. Symptomatic severe mitral regurgitation with LV EF >30%, 2. Asymptomatic severe MR with mild to mod LV dysfxn (EF 30-60% OR LV end systolic diameter >= 40 mm)
In what circumstances is mitral valve replacement preferred over repair? 1. Extensive calcification of valve leaflet or annulus, 2. Prolapse of more than one third of the leaflet tissue, 3. Extensive destruction of the chordal apparatus
What is the treatment for pitted keratolysis? Clindamycin lotion or erythromycin lotion in conjunction with keeping the feet dry
What is the blood pressure goal for people who are 60 years or older? less than 150/90
What is the treatment for toxic epidermal necrolysis? Supportive care and discontinuation of the causative medication
In a patient with polycystic ovary syndrome, what is the treatment the patient has irregular menses and hirsutism? Combined oral contraceptive pills. The estrogen increases hepatic production of sex hormone binding globulin, which decreases the circulating free testosterone--> dec androgen activity to hair follicles. OCP will also provide predictable menses.
how to treat chronic neurogenic neck pain? Gabapentin
A patients with diffuse cutaneous systemic sclerosis start having weight loss, abdominal pain, and loose stools. What does she have? How to diagnose? Pt has malabsorption to bacterial overgrowth syndrome. Diagnosis with hydrogen breath test.
Primary progressive aphasia is associated with what two diseases? Frontotemporal dementia, Alzheimer's disease
How often should those with ankylosing spondylitis get imaging studies? Every two years
How are nocturnal blood pressures different from daytime blood pressures? Nocturnal blood pressure is 15% lower than daytime.
What study to diagnose chronic thromboembolic pulmonary hypertension? VQ scan
Define localized zoster and what type of precautions to prevent spread? Localized zoster is a rash in one or two dermatomes that does not cross the midline. In an immunocompetent patient, this can be managed with contact precautions alone.
When is a patient with localize zoster no longer infectious? after all the lesions have crusted over.
Define disseminated zoster Zoster that affects three or more dermatomes.
What are the contact precautions for disseminated zoster in and immunocompromise patients? Airborne and contact precautions because in an immuno compromised patient, zoster could affect the respiratory tract.
Name the anterior mediastinal masses Thymomas (age 40 to 50), Hodgkin lymphoma (age 20-30), lymphoblastic lymphoma, primary mediastinal diffuse large B cell lymphoma, germ cell tumors (teratomas)
What are the precautions for pertussis or mumps? Droplet precautions
Where can you find bronchogenic cysts? Middle mediastinal in the second decade, found as rounded lesions.
Name some middle mediastinal masses Bronchogenic cysts, pericardial cysts, esophageal duplication cysts
Name some posterior mediastinal masses Neuroblastomas in children, Shwannomas in adults
How to calculate the Duke treadmill score Exercise time in minutes − (5 × ST-segment depression) − (4 × angina score). (Angina score: 0 = asymptomatic; 1 = nonlimiting angina; 2 = exercise-limiting angina.) Scores below −11 are high risk, and those above 5 are low risk.
How to treat a patient with ongoing stable angina pectoris and a low-risk exercise stress test result (that is, a Duke treadmill score of +5 or above) Long acting nitrates and beta blockers
In a patient with immune thrombocytopenia purpura, how to manage if asymptomatic? If the pt is not bleeding, and platelet counts are greater than 30,000 to 40,000, then manage with careful observation and a repeat blood count in one week
When should you treat a patient with immune thrombocytopenic purpura? What do you treat with? When platelet counts are less than 40,000 or if they are bleeding. Treat with glucocorticoids. If no response to glucocorticoids, can give intravenous immune globulin or rituximab.
How does contrast induced nephropathy a present? What is the timeline? Presents with acute tubular necrosis with granular casts and peaks 24 to 72 hours after getting contrast dye. Improves within 5 to 7 days.
for whom would u do a urine culture if symptoms of cystitis? urine culture is indicated if pyelonephritis, complicated UTI, recurrent UTI, multiple antibiotic allergies, or a resistant organism is suspected; in pregnant women with asymptomatic bacteriuria; and for patients undergoing urologic procedures.
Created by: christinapham