Preventative Medicine
Dermatology
Pediatrics
Hypertension
Things you should know (Fun)
100
What is the USPSTF recommendation for colon cancer screening in adults age 76 to 85
The USPSTF recommends that clinicians selectively offer screening for colorectal cancer in adults aged 76 to 85 years. Due to the small net benefit. Consider the patient's overall health, prior screening history, and preferences.
100
What is this?
Herpetic Whitlow
HSV infection of the finger
100
8 yo male with lower abdominal pain without constipation. No surgical hx. History and physical consistent with likely appendicitis. What is the most appropriate imaging study?
Ultrasound is the preferred imaging modality in children to r/o appendicitis. It avoids radiation exposure and is useful for detecting many causes of abdominal pain, including appendicitis.
100
An African American male is being seen for follow up HTN. Despite lifestlye modification he remains hypertensive 150s/80s. He does not have other known medical conditions or drug allergies. Which class of antihypertensives would be the most appropriate initial antihypertensive treatment option for this patient?
For African-Americans, thiazide diuretics and calcium channel blockers, have been shown to be more effective in lowering blood pressure than ACE inhibitors, angiotensin II receptor blockers, or betablockers, and should be considered as first-line options over the other classes of antihypertensive drugs unless a comorbid condition is present that would be better addressed with a different class of drugs.
100
what should you order before calling a vascular consult in a patient with poor peripheral pulses or a cool extremity.
Bonus point: What do the acronyms stand for?
ABI : Ankle Brachial Index
PVR : Pulse Volume Recording
200
At what age does HPV testing start on screening pap smear in an otherwise healthy female.
Age 30
200
A child with a "port wine stain" in this distribution is at high risk for this condition.
Sturge Weber Syndrome is a neurocutaneous disorder with angiomas of the face known as nevus flames in the distribution of the trigeminal nerve.
Ocular and neural abnormalities are associated with this condition including seizures and glaucoma
200
A 4-year-old male with a history of sickle cell presents for a WCC. What screening test should be done?
A)CXR
B) A DXA scan
C) Abdominal U/S
D) Renal Artery U/S
E) Transcranial Doppler
There is in increased risk of stroke in patients with sickle cell disease. All children age 2–16 with SS should have screening transcranial Doppler .
200
A 42M presents for f/u HTN found to have BP 185/105 at the FMC. He is asymptomatic and is compliant with home medications. Physical is benign.
A) Send to the hospital
B) Send home
C) treat in office
C) Attempt to treat BP in office.
Follow the hypertensive urgency protocol posted on the wall at FMC in hypertension section.
Medications available include: Labetolol, Clonidine, Enalapril?
200
Interns only!
What is the extension for pharmacy
Bonus points if you know both!
What is the extension for pharmacy
6539
3990
300
58 yoM with 20 pack year hx presents for physical. Quit smoking 1 year ago. He has not been seen by a Doctor in 20 years.
U.S. Preventive Services Task Force recommends which of the following?
A) AAA screening
B) Fall prevention screening
C) Hep C screening
D) low-dose CT
Hepatitis C screening in adults born between 1945-1965
AAA screening in male smokers > 65
Fall screening in adults living in the community age > 65
Low dose CT for smokers > 30 pack years within 15 years of quitting.
300
50F with hx of seizure started on phenytoin. 10 days later she developed. Repeat labs show a rise in eosinophil count and LFTs > 1000. Name that rash!
DRESS syndrome
a delayed type 4 hypersensitivity reaction associated with morbilliform rash and delayed rise in eosinophils, liver or kidney dysfunction. Most commonly seen with anti epileptics, allopurinol, minocyclin (pulmonary manifestations). DRESS syndrome can be life threatening with mobility estimated to be 10%.
300
What labs should you order for work up of childhood obesity.
Hint these are needed before referral to Dr. Mather
Fasting
CBC, CMP, TSH, insulin level, lipid panel, A1C
300
Which one of the following antihypertensive classes may reduce the severity of sleep apnea?
A) calcium channel blocker
B) Thiazide
C) ACEi
D) beta blocker
E) aldosterone receptor antagonists
Aldosterone antagonists offer further benefit beyond that of traditional diuretics. Resistant hypertension is common in patients with obstructive sleep apnea. Resistant hypertension is also associated with higher levels of aldosterone, which can lead to secondary pharyngeal edema, increasing upper airway obstruction.
300
Where is the handheld doppler located in the hospital?
Medicine Room in top cupboard on each flood.
**If you can't find it ask a nurse
400
A 54F presents for physical exam. Last mammo 10 years ago showed dense breasts but was otherwise normal.
A history of which one of the following is an indication for MRI of the breasts?
A) Very dense breasts
B) Morbid obesity
C) Combination estrogen/progesterone therapy for the last 3 years
D) Chest radiation for Hodgkin’s disease
E) Radioiodine treatment for Graves disease
MRI of the breasts should be reserved for women at very high risk for breast cancer such as those with
genetic mutations, a history of breast irradiation, or a very high-risk family history. Women who had chest
radiation therapy during childhood or adolescence, generally for Hodgkin’s disease, are at an extremely
high risk for breast cancer.
BONUS question!!!!
what test do you always need to order alongside a bilateral screening mammogram????
400
45F with itchy palms presents with this rash. What class of medications is used as the initial treatment for this dermatologic finding
initial treatment with Topical Azole antifungals
This is Tinea Manuum a superficial dermatophyte infection which occurs in both healthy and immunocompromised hosts.
400
7F with asthma presents with 4th exacerbation in 3 months a/w increased use of albuterol inhaler. Which class of medications should be added to reduce the frequency of asthma exacerbations?
Treatment for persistent asthma requires the use of inhaled corticosteroids, with short-acting beta-agonists PRN.
400
50F here for follow up HTN 1 month ago you started lisinopril 10 for BP 158/92. She does not take any other. Today BP is 140/82
Repeat BMP shows rise in BUN from 12 to 25 and Cr from 0.7 to 1.5
Which one of the following would be most appropriate at this time?
A) Continue lisinopril
B) Increase lisinopril
C) Continue lisinopril and add amlodipine
D) DC lisinopril and begin amlodipine
E) DC lisinopril and begin losartan
D:
This patient has more than a 30% rise in creatinine and has no other factors, such as diabetes mellitus,heart failure, or chronic kidney disease, that would indicate a need for ACE or ARB therapy for her hypertension.
Options include thiazide diuretics and calcium channel blockers.
400
who do you call to get walking oximetry done
Pulm Lab
500
Which of the following is NOT an indication to start pneumococcal vaccinations at age 19-64 years
A) Diabetes
B) Malignancy
C) cochlear implant
D) Alcohol dependence
E) IV drug users
E) IV drug users
1 dose of PPSV23 age 19-64 followed by second dose after age 65 and 5 years after first dose for patients with chronic heart, lung or liver diseases, diabetes, alcohol dependence and smokers
1 dose of PCV13 age 19-64 and 1 or 2 doses of PPSV23 age 19-64
CSF leak, cochlear implants, SS or other hemoglobinopathies, asplenia, immunodeficiencies, HIV, chronic renal failure, nephrotic syndrome, leukemia, lymphoma, hodgkin disease, generalized malignancies, solid organ transplant, iatrogenic immunosuppression, multiple myeloma
500
Name that rash 
Pitrriasis Rosea
A benign rash, pityriasis rosea usually begins as a single scaly, pink patch with a raised border known as a herald patch. Days to weeks later, it starts to itch and spread. Resolves in 6-8 weeks without intervention.
500
3yoF brought in for evaluation of intoeing.
What are the 3 most common causes
Metatarsus adductus
internal tibial torsion
Femoral anteversion
500
55F with hx of bipolar disorder and HTN presents for follow up BP. She recently attempted lifestyle changes with successful 10b weight loss. Her BP remains elevated 155/80 despite these changes.
Which is the best initial agent
A) Calcium channel blocker
B) HCTZ
C) ACE inhibitor
A) Calcium channel blocker
Bipolar disorders are chronic conditions treated with lithium, which exerts deleterious effects on the kidney, among which nephrogenic diabetes insipidus, tubular acidosis and ultimately chronic kidney disease. Conversely, drugs that alter renal function can modify its serum levels and lead to the potentially fatal lithium intoxication.
500
name 1 of Dr. Nurena's dogs
More points if you know more!
Shakespeare
Phoenix
Indiana