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ABIM - Practice Exam
Exam #1 - Things I got wrong
| Question | Answer |
|---|---|
| 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
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