board review

MALT lymphoma is associated with

H. pylori infection

Celiac disease dx with

IgA anti-endomysial antibodies

Celiac disease assoc with

dermatitis herpetiformis

Pt with ascitis develops sudden onset fevers, chills, and generalized

abd pain Paracentesis to r/o spontaneous

bacterial peritonitis

Pts with late compliment deficiencies are prone to

Gonococcal infections.

Herpes simplex virus CNS infection will see

Temporal lobe lesions with mass effect/edema.

Start acyclovir ASAP

m/c inherited bleeding disorder, associated with bleeding symptoms

from nose or gingival. Factor V Leiden

65 yo male with headache and fever, spinal tap with decreased

glucose, increased protein, lymphocytosis and gram positive

bacilli best treated with Ampicillin plus Gentamycin.

Loop diuretics act on

the Na+-K+-2Cl- symporter (cotransporter) in the thick ascending

limb of the loop of Henle to inhibit sodium and chloride reabsorption

What is associated with severe phosphatemia (<1.0)?

Vitamin D deficiency

65 yo male with h/o recurrent calcium urolithiasis has anion gap 13

with bicarb of 15 and urine pH 6, potassium 3.2.

Type I RTA

45 yo female with nl BUN/Cr, sodium 120 with urine sodium 40

and urine osm 240

Psychogenic Polydypsia

Dirty brown casts are characteristic of

acute tubular necrosis

44 yo male with psych history found comatose with anion gap and calcium oxalate crystals in UA,

diagnosis is

Ethylene glycol intoxication.

16 yo male with asymptomatic hematuria, nl blood pressure, no edema, UA with 60-80 RBCs/HPF

and C3 nl, m/l dx is:

IgA Nephropathy

What drug may cause hyperkalemia by decreased renal tubular secretion

of potassium?

Bactrim (I don’t think this is right)

30 yo male with acute nephroureterolithiasis, calcium 9.8,

phos 3.6, creatinine 0.8, urine calcium 320/24h, urine uric acid

500/24h, urine pH 6.8, the m/l dx is:

Idiopathic hypercalciuria

55 yo with painless hematuria with UA has RBCs but no proteinuria, no red cell dysmorphia or no RBC casts;

what should next test be:

Cystoscopy

28 yo WM with hematuria, proteinuria, nephritic syndrome, b/l

cataracts, high frequency hearing loss =

Alport’s Syndrome

48 yo alcoholic has sodium 105 what is initial tx:

10 gram Regular Diet

32 yo male construction worker treated for heat stroke has renal

insufficiency m/l secondary to: with BUN 35 and Cr 3.5 and UA with

protein and 2-3 RBCs:

ATN secondary to hypovolemia or myoglobulinuria

42 yo female with adult polycystic kidney disease with flank pain and

fever with infected cyst in right kidney, should be treated

empirically with:

LEVAQUIN Gram negative bacteria are most common

36 yo male with creatinine of 3.0 has a GFR of ~24, STAGE?

Stage 4 CKD.

64 yo black female with HTN and DM2 has increased BUN/Cr, K 5.2; what is the cause for her increased

K:

RTA 4

60 yo with h/o CHF, systolic dysfunction and CKD presents with

heart palpitations, K 6.5, Dig 3.5; what is relatively contraindicated:

CALCIUM GLUCONATE - The injection of calcium preparations is strictly

contraindicated in digitalized patients.

What can cause decreased anion gap

HypoalbuminemiaIncreased immunoglobulins (MYELOMA, gammopathies)

Increased unmeasured cations (hyperkalemia, hypercalcemia, hypermagnesemia)

Lithium therapy

40 yo WF with ARF, sinus infection, pulmonary infiltrate, conjunctivitis, hemoptysis, positive c-ANCA; most

likely dx:

Wegener’s

What factor places patient at greatest risk to develop

osteoporosis:

Long-term corticosteroids

Patient presenting with headache, nausea, vomiting, hypotension,

blurred vision, diplopia, impaired consciousness; most likely has:

Pituitary apoplexy – know diagnosis/treatment

Schmidt’s syndrome :

consists of Adrenal insufficiency, gonadal failure, hypoparathyroidism, lymphocytic

thyroiditis and Diabetes

Solitary thyroid nodule most likely malignant if:

Serum thyroglobulin (papillary or follicular) or calcitonin (medullary) elevated

What diagnostic test would prove self-induced hyperthyroidism?

Thyroglobulin level low

46 yo hypertensive male with acute nephrolithiasis and h/o PUD and

constipation; nephrolithiasis most likely d/t:

HYPERPARATHYROIDISM

Goal of LDL-C in patients with CKD stage IV is

< 100.

18-hydroxysteroid measurements and postural stimulation used to

differentiate

Aldosterone deficiencies

Subacute granulomatous (DeQuerveins) thyroiditis is

characterized by:

DECREASED UPTAKE OF IODINE

What causes low total T4PREGNANCY OR INCREASED THYROGLOBULIN

Craniopharyngioma Empty sella syndrome

Metastases to the pituitary Pituitary irradiation

Pituitary tumor Post cranial irradiation

Post surgery Sheehan's syndrome

48 yo asymptomatic female with elevated AST and ALT with

ultrasound showing fatty infiltration; what would predispose her to abnl LFTs with nl alk phos and albumin

DIABETES MELLITUS

MEN IIa:

Pheochromocytoma, medullary thyroid carcinoma, and parathyroid hyperplasia

Patient with easily palpable 1.5 cm thyroid nodule; what is best next

approach?

Fine needle aspiration

36 yo nurse with repeated bouts of palpitations, sweating, anxiety,

hunger, dizziness and blurred vision; glucose in ER 20; confirm dx by

checking:

C-Peptide level will be low

34 yo WM with hypercalcemia on routine physical exam, calcium 11, urinary calcium <200/24h; patient

most likely has:

Familial Hypocalciuric Hypercalcemia

76 yo female obtunded with glucose 1200 and sodium 126:

She is in hyperosmolar coma requiring aggressive fluid rehydration with

normal saline

30 yo obese female with hirsutism, irregular menses, LH/FSH 2:1,

TSH/Prolactin nl; what else would be expected:

ACANTHOSIS NIGRICANS – know other PCOS criteria

58 yo female diagnosed with osteoporosis by DEXA with t-score -

3 SD with increased PTH and nl serum calcium, 24h urine calcium 200; she should be treated with:

vitamin D plus calcium supplements for osteomalacia

Complication of RA:

Splenomegaly

Patient with pain/redness of both ears, arthritis of hands and knees,

b/l conjunctivitis, and diastolic decrescendo murmur has:

Relapsing Polychondritis

49 yo female with Raynaud’s and pains in both hands/wrists,

dysphagia, sclerodactyly, ANA 1:160, anticentromere antibodies, neg

rheumatoid factor, negative antiribosomal antibodies; most

likely has:

Scleroderma

Lymphoma + stocking glove purpura + arthralgias + Raynaud’s +

glomerulonephritis; most likely has:

MCTD – what lab is diagnostic ANTI-RNP

#1 cause of death in SLE is

INFECTION

negative birefringent crystals

GOUT

36 yo male from upper Midwest presents with rash + Bell’s palsy +

photophobia + headache and 4 months later heart block:

Lyme disease