Shelf Review Round 1

Endocrinology

100

Most common cause of primary hyperparathyroidism

Parathyroid adenoma

200

First step in treatment of a patient in DKA

Give isotonic IV fluids!

300

Most common hormone produced from a pituitary adenoma 

Prolactin

400

Diagnosis in a pt with polyuria, polydipsia, hypernatremia, serum hyperosmolarity, and dilute urine 

Diabetes insipidus 

500

Name two screening tests for a patient with osteoporosis, central adiposity, violaceous stretch markings, and hyperglycemia 

Dexamethasone suppression test or 24 hour urine cortisol 

Will also accept salivary cortisol 

Cardiology

100

Name for chest pain that occurs at rest in patient with risk factors for CAD

Unstable angina 

200

Most common cause of death immediately after MI? 

Arrhythmias 

300

Pt with new systolic murmur presents for f/u 5-7 days post-PCI for NSTEMI. What is the diagnosis? 

Papillary muscle rupture

400

Diagnosis in a young woman with hx of migraines and transient ST elevation during episodes of chest pain that occur at night 

Prinzmetal's angina, treat with calcium channel blocker 

(coronary artery vasospasm)

500

The murmur associated with HOCM gets ____ with valsalva

LOUDER 

Renal and Electrolytes

100

First step in treatment of hyperkalemia with peaked T waves on EKG

IV calcium gluconate 

200

Feared complication of rapid sodium correction in hyponatremia 

Central pontine demyelination (or myelolinolysis)

or Locked-in Syndrome 

300

Name 3 indications for emergency dialysis

A - Ph < 7.1

E - Severe hyperkalemia with EKG changes

I - Overdose or intoxication (aspirin, ethylene glycol, etc)

O - Volume overload 

U - Uremia with altered mental status or pericarditis

400

Patient on cephalexin develops fever, rash, arthralgias, hematuria, sterile pyuria, and eosinophiliuria. WBC casts may be present. What is the condition? 

Drug induced interstitial nephritis

Cephalosporins, PCNs, sulfonamides, NSAIDs, rifampin, phenytoin, and allopurinol are common causes 

500

Name one lab abnormality that might be present in type IV RTA

Hyperkalemia 

Hypochloridemia 

High urine sodium

Hematology

100

Diagnosis in pt with Low hgb, low mcv, low ferritin, low retics, elevated RDW, elevated TIBC

Iron deficiency anemia 

200

Name one cause of secondary polycythemia AND state whether the EPO level is high or low 

Hypoxemia (COPD, OSA, high altitude)

EPO producing tumors (renal or hepatic)

Congenital (high affinity hemoglobin) 

Androgen supplementation 

Post-renal transplant 

EPO level is (inappropriately) normal or high

300

Name one genetic mutation that can cause primary polycythemia AND state whether the EPO level is high or low 

JAK2 mutation or EPO receptor mutation 

EPO level is LOW 

400

Splenomegaly, bilirubin gallstones, and elevated MCHC on CBC

Hereditary spherocytosis 2/2 AD loss of spectrin in RBCs. 

Treat with splenectomy 

500

Diagnosis in pt with blue discoloration of fingers, ear, nose, and recent atypical pneumonia infection with the following labs: 

Low hgb, normal MCV, high LDH, high bili, low haptoglobin

Cold agglutinins - IgM mediated RBC destruction that occurs in the liver 

Miscellaneous

100

One-time screening exam needed for male >65 years old who has ever smoked 

Ultrasound screening for AAA

200

Hypercalcemia, punched out lesions on xray, bone pain, elevated creatinine

Multiple myeloma 

CRaB (calcium, renal, and bone) 

300

Name one antibody that is positive in rheumatoid arthritis 

Rheumatoid factor (against Fc of IgG)

Anti-CCP (cyclic citrullinated peptide) 

Mutated citrullinated vimentin antibody

400

Patient presenting for OD is unconscious with 4 mm pupils. T 95.5 F, RR 12, HR 40/min, Po2 84%, glucose 52. What class of drugs likely caused her OD?

Beta-blockers 

500

Vitamin deficiency that can occur in carcinoid syndrome due to tryptophan depletion 

Niacin deficiency - dementia, dermatitis, diarrhea