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MALT lymphoma is associated with H. pylori infection

Board review

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Page 1: Board review

MALT lymphoma is associated with

H. pylori infection

Page 2: Board review

Celiac disease dx with

IgA anti-endomysial antibodies

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Celiac disease assoc with

dermatitis herpetiformis

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

abd pain Paracentesis to r/o spontaneous

bacterial peritonitis

Page 5: Board review

Pts with late compliment deficiencies are prone to

Gonococcal infections.

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Herpes simplex virus CNS infection will see

Temporal lobe lesions with mass effect/edema.

Start acyclovir ASAP

Page 7: Board review

m/c inherited bleeding disorder, associated with bleeding symptoms

from nose or gingival. Factor V Leiden

Page 8: Board review

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.

Page 9: Board review

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

Page 10: Board review

What is associated with severe phosphatemia (<1.0)?

Vitamin D deficiency

Page 11: Board review

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

Page 12: Board review

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

and urine osm 240

Psychogenic Polydypsia

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Dirty brown casts are characteristic of

acute tubular necrosis

Page 14: Board review

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

diagnosis is

Ethylene glycol intoxication.

Page 15: Board review

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

Page 16: Board review

What drug may cause hyperkalemia by decreased renal tubular secretion

of potassium?

Bactrim (I don’t think this is right)

Page 17: Board review

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

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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

Page 19: Board review

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

cataracts, high frequency hearing loss =

Alport’s Syndrome

Page 20: Board review

48 yo alcoholic has sodium 105 what is initial tx:

10 gram Regular Diet

Page 21: Board review

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

Page 22: Board review

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

Page 23: Board review

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

Stage 4 CKD.

Page 24: Board review

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

Page 25: Board review

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.

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What can cause decreased anion gap

HypoalbuminemiaIncreased immunoglobulins (MYELOMA, gammopathies)

Increased unmeasured cations (hyperkalemia, hypercalcemia, hypermagnesemia)

Lithium therapy

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

likely dx:

Wegener’s

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What factor places patient at greatest risk to develop

osteoporosis:

Long-term corticosteroids

Page 29: Board review

Patient presenting with headache, nausea, vomiting, hypotension,

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

Pituitary apoplexy – know diagnosis/treatment

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Schmidt’s syndrome :

consists of Adrenal insufficiency, gonadal failure, hypoparathyroidism, lymphocytic

thyroiditis and Diabetes

Page 31: Board review

Solitary thyroid nodule most likely malignant if:

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

Page 32: Board review

What diagnostic test would prove self-induced hyperthyroidism?

Thyroglobulin level low

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

constipation; nephrolithiasis most likely d/t:

HYPERPARATHYROIDISM

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

< 100.

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18-hydroxysteroid measurements and postural stimulation used to

differentiate

Aldosterone deficiencies

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Subacute granulomatous (DeQuerveins) thyroiditis is

characterized by:

DECREASED UPTAKE OF IODINE

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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

Page 38: Board review

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

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MEN IIa:

Pheochromocytoma, medullary thyroid carcinoma, and parathyroid hyperplasia

Page 40: Board review

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

approach?

Fine needle aspiration

Page 41: Board review

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

Page 42: Board review

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

most likely has:

Familial Hypocalciuric Hypercalcemia

Page 43: Board review

76 yo female obtunded with glucose 1200 and sodium 126:

She is in hyperosmolar coma requiring aggressive fluid rehydration with

normal saline

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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

Page 45: Board review

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

Page 46: Board review

Complication of RA:

Splenomegaly

Page 47: Board review

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

b/l conjunctivitis, and diastolic decrescendo murmur has:

Relapsing Polychondritis

Page 48: Board review

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

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

glomerulonephritis; most likely has:

MCTD – what lab is diagnostic ANTI-RNP

Page 50: Board review

#1 cause of death in SLE is

INFECTION

Page 51: Board review

negative birefringent crystals

GOUT

Page 52: Board review

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

photophobia + headache and 4 months later heart block:

Lyme disease