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ABIM - MKSAP Reviews(updated)questions n answers
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ABIM - MKSAP Reviews(updated)questions n answers
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ABIM - MKSAP ReviewsTumor lysis tx - correct answer ✔✔IV fluids (6L/day), loop diuretic to maintain UOP if needed, and
Rasburicase (preventative)
Tumor lysis labs: - correct answer ✔✔hyperkalemia, hyperuricemia, hyperphosphatemia, acute kidney
injury (d/t prior)
Acromegaly etiology - correct answer ✔✔Hypersecretion of of GH, d/t pituitary adenoma
GH --> liver --> IGF1-->acromegaly
Diagnosis of acromegaly - correct answer ✔✔IGF-1 level
NOT GH level b/c secreted in pulses
Chronic paroxysmal hemicrania definition - correct answer ✔✔- similar to cluster headaches
- trigeminal nerve pain with autonomic features (tearing, conjunctival injection, rhinorrhea)
- last 15 minutes, 8-40 times/day (cluster HA is 15-180 minutes and 1-8x/day)
Cluster headache treatment - correct answer ✔✔Indomethicin (NOT carbamazepine - that is trigeminal
neuralgia)
Treatment of prostate cancer - correct answer ✔✔Organ-confined dz: radical prostatectomy
Extension beyond prostate, PSA>20, high Gleason score (8-10): ADT + radiation
Brachytherapy - option for gleason <8, PSA<20
Drug induced lupus erythematosus - correct answer ✔✔- Drugs can induce auto-antibodies
- Can be d/t TNF-alpha inhibitors (etanercept)
- Most common drugs: procainamide, hydralazine, penicillamine
,- fever, rash, arthritis, blood count abnormalities
- Dx with + ANA, anti-SSDNA antibody, and anti-histone antibodies (TNF alpha associated with anti-
DSDNA)
Benign Recurrent Lymphocytic Meningitis - correct answer ✔✔- AKA Mollaret meningitis
- most comon cause HSV-2
- recurrent meningitis, lasting 2-5 days, spontaneous recovery
Characteristics of inflammatory anemia (anemia of chronic dz) - correct answer ✔✔- normal or low Fe
- low TIBC
- elevated ferritin
- smear is normal OR microcytic/hypochromic
- Retic low
Bullous pemphigoid - correct answer ✔✔- autoimmune
- older people
- treat with prednisone
Can persist months to years (if so, add azathioprine, cellcept)
Fulminant liver failure - correct answer ✔✔hepatic encephalopathy + jaundice without preexisting liver
dz.
Hyperacute: encephalopathy <1 wk after jaundice
Acute: encephalopathy 1-4 weeks after jaundice
Subacute: encephalopathy 4-12 weeks after jaundice
Etiology: meds (Tylenol), viral
,Indication for carotid artery stenosis intervention - correct answer ✔✔Stenosis >70% or symptomatic
Botulism Symptoms - correct answer ✔✔Triad:
- symmetric, descending flaccid paralysis with bulbar palsies (diplopia, dysarthrtis, dysphagia)
- normal body temperature
- clear sensorium
Diagnose with toxin detection in serum, stool
Treat with antitoxin
Recommendations for microalbumin testing - correct answer ✔✔Annually in patients with:
- DM I starting 5 years after diagnosis
- DM II starting at diagnosis
Measure by getting albumin-creatinine ratio
Diagnosis of microalbuminuria - correct answer ✔✔- albumin-creatinine ratio of 30-300
- requires elevated ratio on 2/3 random samples over 6 months
If diagnosed, use ACEi or ARB to delay progression
Patient with anterior uveitis requires w/u for systemic disease with: - correct answer ✔✔Chest xray first,
looking for sarcoidosis.
Secondary w/u: HLA-B27, ANCA, RPR
Worried for spondyloarthritis, sarcoidosis, Behcet, JIA, Wegener's.
, anti-dsDNA antibody - correct answer ✔✔Lupus
Anti-Ro antibody - correct answer ✔✔Sjogren
SSA antibody - correct answer ✔✔Sjogren
Indications for long-term oxygen therapy - correct answer ✔✔PO2 <55
O2 sat <88%
O2 in chronic respiratory failure, including COPD, improves survival.
Paroxysmal Nocturnal Hemoglobinuria features - correct answer ✔✔Primary acquired stem cell disorder
causing:
- unprovoked venous thrombosis
- hemolytic anemia
- pancytopenia
Diagnose with flow cytometry, looking for CD55 and CD59 + cells
Resistant Hypertension - correct answer ✔✔BP above goal despite optimal doses of three
antihypertensives, including a diuretic
If resistant HTN with CKD on HCTZ, change to loop diuretic. Those patients tend to be volume
overloaded.
Microscopic colitis - correct answer ✔✔- Commonly d/t lansoprazole, NSAIDs, sertraline, ranitidine
- Over age 40, more common women
- Sxs: watery diarrhea, relapsing/remitting, with abd pain and nausea
Bowel mucosa appears normal on cscope
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