Infectious Disease
If patients are allergic to penicillin, these groups need desensitization
Who are patients who have neurosyphillis, and pregnant women
Class of antiarrhythmic that causes sodium channel blockade.
What is class I?
Class I causes sodium channel blockade, class II are beta blockers, class III are potassium channel blockers, and class IV are calcium channel blockers.
Differentiating Factor Between DLB (Dementia with Lewy Bodies) and PDD (Parkinons Disease with Dementia)
In DLB, dementia precedes Parkinsonism; in PDD, Parkinsonism precedes dementia.
Tongue Movement
12
What is the diagnosis for a woman who is experiencing amenorrhea and galactorrhea in the absence of pregnancy.
What is prolactinoma?
What is the most common brain tumor in adults?
Metastasis
What is the best initial test for osteomyelitis of the skull?
What is CT scan or MRI?
Osteomyelitis of the skull is also called malignant otitis externa. It can lead to a brain abscess and destruction of the skull. Most accurate test is biopsy. Treatment is with surgical debridement and antibiotics active against Pseudomonas such as ciprofloxacin, piperacillin, cefepime, carbapenem, or aztreonam.
Valvular lesion that can be associated with dysphagia and/or hoarseness.
What is mitral stenosis?
Mitral stenosis can result in left atrial dilatation, resulting in dysphagia/hoarseness via compression of the esophagus and recurrent laryngeal nerve.
Most Common Brain Tumor in Children
Medulloblastoma
Smell
1
What condition is associated with necrolytic migratory erythema?
What is glucagonoma?
Other symptoms include diabetes, DVT, weight loss, and depression. Treatment is octreotide and surgery
What classical syndrome may be seen following a Thalamic Stroke
Thalamic Pain Syndrome
Name 3 groups of people that would need antimicrobial prophylaxis following Neisseria meningitidis exposure
- Roomates
- Innmates
- child care workers
- Persons directly exposed to respiratory or oral secretions
- Person seated next to an affected person for > 8 hours
Antimicrobial chemoprophylaxis should be administered as early as possible and within 24 hours of exposure. Prophylaxis has limited efficacy if exposure is > 14 days.
Medication prescribed for angina refractory to convention therapies that does not affect blood pressure
What is ranolazine?
Ranolazine inhibits the late phase of sodium current thereby reducing diastolic wall tension and oxygen consumption without affecting heart rate or blood pressure.
Which common AED is renally excreted, a factor which most be considered when dosing patients with AKI/CKD?
Keppra
Chewing
V
Which class of diabetes medications should you not use in CHF?
What are Thiazolidenediones?
Contraindicated in Class III or IV heart failure patients. They act on PPAR gamma, leading to increase sodium and fluid retention.
A pure sensory stroke most likely involves what region?
Thalamus (FYI, VPL Nucleus)
Jarisch- Herxheimer reaction is an acute febrile syndrome that can occur within 24 hours of initial treatment of a spirochete infection due to?
What is rapid lysis of the spirochetes?
Rapid lysis of the spirochetes releases bacterial proteins into the bloodstream and triggers an immunologic response. Manifestations include fever, chills, malaise, headache, and myalgias.
Syndrome that explains the mechanism of coronary vessel lesion identification with dipyridamole or regadenoson administration during a stress test.
What is coronary steal syndrome?
Distal to coronary stenosis, vessels are maximally dilated at baseline. Administration of vasodilators such as dipyridamole and regadenoson dilates normal vessels causing blood to be shunted toward well-perfused areas. This results in ischemia in myocardium perfused by stenosed vessels terms coronary steal syndrome.
How to differentiate Bell's Palsy from acute stroke?
Forehead sparing in acute stroke
Hearing
8
What hormone accumulates in patients with 11-beta hydroxylase deficiency contributing to hypertension in these patients?
What is 11-deoxycorticosterone?
11 beta hydroxylase converts 11-deoxycorticosterone to corticosterone which produces aldosterone.
A stroke in the internal capsule (posterior limb) is most likely to produce what deficit?
Pure Motor (Contra Hemiparesis)
Chemokine receptor 5 found on the CD4 cell attaches to this glycoprotein found on the HIV virus surface.
What is GP120?
CCR5 attaches to the GP120 glycoprotein of the HIV virus and this is how the virus begins replication. Maraviroc is a drug the inhibits entry by blocking CCR5 receptor.
Most common pathogen responsible for culture negative bacterial infective endocarditis in the US.
What is coxiella?
The HACEK group (haemophilus, aggregatibacter, cardiobacterium, eikenella, and kingella), coxiella, and bartonella are common causes of culture negative bacterial infective endocarditis. A study of 476 patients with culture negative infective endocarditis, 229 had coxiella, 86 had bartonella spp, 70 had a common bacterial agent, 12 had T. whipplei, and 8 had fungal endocarditis.
Best way to rule out SAH in the ER, in a patient with negative head CT, but high clinical suspicion (thunderclap headache)?
Spinal Tap
Motor Impulse to Pharynx
11
What is the autosomal dominant condition resulting in normal PTH, normal calcium and skeletal defects found in hereditary osteodystrophy?
What is Pseudopseudohypoparathyroidism?
It occurs when there is a defective GS protein alpha subunit inherited from the father that makes the kidneys unresponsive to PTH.
Stroke Syndromes: Name the 2 Clinical Features of Weber's Syndrome
3rd CN Palsy, Hemiplegia