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how do you diagnose metabolic syndrome
3 or more of the risk factors: 1. waist circumfrence 2. fasting BS 3. decreaed HDL 4. BP 5. elevated TG
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what are the 2 major bacteria that causes subacute bacterial endocarditis
staph and alpha hemolytic strep (strep viridians and strep pneumo)
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PSA levels above what is worrisome for metastatic prostate ca
10
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how does metformin work
increasing insulin sensitivity
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what HLA is associated with RA
HLA-DR4
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what nerve is most affected in RA
median nerve
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what measuers direct pathway? Indirect pathway in caogulation?
PT and INR (indirect measurement); PTT
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what vaccines to avoid in egg allergies
"mmr, rabies, influenza, yellow fever"
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what vaccine do you give to asplenic patients
meningococcal vaccine and Hib vaccine (don't give pneumococcal because its encapsulated)
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what should ldl goal be for a diabetic
< 100
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what type of nystagmus do you see in lithium takers
downbeat nystagmus
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is uveitis in JIA patients more common in males or females
females
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what retrobulbar anesthetic has highest likelihood of respiratory arrest
bupivacaine
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what surgeries require bacterial ppx for endocarditis in prostethic haert valve
"NLD system repair, sinus surgery, orbital trauma"
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whats the most common thyroid cancer? Most malignant?
papillary carcinoma; anaplastic carcinoma
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what ocular structures are most sensitive to radiation? What's the latency between exposure and disease?
"lens > cornea > retina > optic nerve; 2-3 years before cataract, radiation retinopathy, 1 year before corneal changes"
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how much do you creased risk of retinopathy by lowering A1C by 1 point
30%
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what antihypertensive is CI in pregnancy
lisinopril
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"with an asymtopatic carotid bruit, what is the chance for stroke? MI?"
2%; 4%
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what syndrome can cause both venous AND arteriole thrombosis
antiphospholipid syndrome
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what hla with behcets
hla-b51
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what do you do for someone with high risk of clots on coumadin before blepharoplasty
"stop coumadin 5 days prior, start heparin when INR <2.0, stop heparin 12 hrs before surgery until 24 hours after surgery, start coumadin right after surgery"
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when should you stop coumadin and aspirin before surgery
4 days; 5 days
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what is the incidence of chlamydia in someone with gonoccocal urethritis
25-33%
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what antibiotic is used to prevent PCP in HIV
bactrim
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what patients likely has allergy with latex
"spina bifida patients, and patienst with allergies to BACK-P foods (bananas, avocados, chestnus, kiwis, passionfruit)"
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what type of bacteria is cdiff
gram positive anaerobe
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what is the mechanism of graves disease
antibodies to TSH receptors
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what is the most comon way to get toxo
eating undercooked meat
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what treatment for TB doesnt affect eyes
pyrazinamide
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what is the regimen for diabetics on morning of cat surgery
stop oral hypoglycemics and short acting insulin; take half dose of intermediate and long acting insulin
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what do you need for diagnosis of HIV
"ELISA must be positive twice, then confirmed by western blot"
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how do you calculate relative risk
taking the incidence in the non-treated arm divided by incidence in treated arm
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when should you get CEA for carotid disease
when stenosis > 70% and surgeon has a perioperative morbidity and mortaility rate < 6%
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what drug likely to cause angle closure glaucoma
SSRI
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what are side effects of SSRI
"angle closure glaucoma due to anticholinergic side effects, platelet dysfunction causing gi bleed, "
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"most likley cause of meningitis in patients living in close quarters (college, army)"
neisseria meningitidies
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what medication reduces the risk of chronic hep C in a patient with acute hep C
interferon alpha; also cotreat with ribavarin
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what is cidofovir used for and what is its side effects
CMV retinitis; SE is nephrotoxicity and 37% get secdonary ant uveitis
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what conditions can give false positive VDRL/RPR
"SLE, lyme, antiphospholipid antibody syndrome, liver disease, pregnancy"
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how shouyld you treat someone with syphillic ant uveittis
tx as if they have neurosyphillis: IV pcn g for 10-14 days
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what is the primary limiting SE that can lead to mortailtiy of AZT
"bone marrow supressoin; other SE include hepatotoxicity, cardiomyopathy, seizures"
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how does ITP present and how do you treat
"acute disease in children where antibodies to platelets are produced after viral infection -> gingival bleeding and petechia -> tx with steroids, danazol, rituximab"
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what is cause of TTP
diffuse intravascular coagulation and fibrinolysis
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what is best test for heparin therapy
PTT
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what cancer is increasing most in incidence
melanoma
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what is the most common cause of cardiopulmonary arrest in kids
respiratory blockage- check the airway!
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how do you calculate accuracy of a test
TP + TN/ (total number of people tested)
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what medications can you stop before surgery
"thyroid medication (has long half life), diuretics (so patient deosnt have to pee)"
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what are top 3 leading cause of death
1. cardiac 2. cancer 3. stroke
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how do you diagnose AIDS
"CD4 < 200 or AIDS defining illness (kaposi, PCP)"
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what percentrage of patietns with PCN allergy have cross allergy to cephalosporins
3-5%
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what is somogyi phenomenon
institution of medications causes hypoglycemia which subsequently leads to rebound hyperglycemia
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what are signs of neuroleptic malignant syndrome
extreme muscle rigidity and hyperthermia
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what is eye SE of ssri?
"angle closure glaucoma due to anticholinergic side effects, platelet dysfunction causing gi bleed, pts feel well enough to commit suicide now"
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what is SE of MAOI
hypertensive crisis after ingesting tyramine (wine and cheese)
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what are ocular findings of takayasu arteritis
mid peripheral CWS and AV anastomoses
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how do fluoroquinolones work
inhibition of DNA gyrase and topoisomerase II -> inhibits DNA transcription and replication
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most common cancer cause of death in women > 40
"lung (used to be breast, but advances have made it better)"
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what are early signs of malignant hyperthermia
tachycardia and icnrease in end tidal CO2
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what is most common type of cancer
skin
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which medication in tx of cmv retinitis does NOT have bonie marrow suppression
foscarnet
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