192) Best initial screening test for renal artery stenosis?
193) Best noninvasive method to confirm renal art stenosis?
194) Best invasive method to confirm renal art stenosis?
195) Best initial tx for renal art stenosis?
196) Dx of primary hyperaldosternosim (Conn synd)?
197) Tx for Conn synd?
198) Tx for simple kidney cysts?
199) Dx of RTA type I (distal)?
200) Tx for RTA type I (distal)?
201) Dx of RTA type II (proximal)?
202) Tx for RTA type II (proximal)?
203) Dx of RTA type IV (hyporenin/hypoaldosteronism)?
204) Tx for RTA type IV?
205) EKG in hyperkalemia?
206) Tx of hyperkalemia?
207) What is Bartter synd?
208) EKG findings of hypokalemia?
209) Tx of hypokalemia?
210) Tx for hypernatremia? For CDI? For NDI?
211) Dx of hyponatremia?
212) Tx of hyponatremia? Mild (approx 120-130)? Moderate (approx 110-120)? Severe (<110 w/sx)? Chronic?
213) Tx of anemia in ESRD?
214) Tx of osteodystrophy (secondary hyperparathyroidism) in ESRD?
215) General tx of ESRD?
216) Indications of dialysis in ESRD?
217) Helpful in dx of post infectious GN?
218) Tx for Goodpasture synd?
219) Which nephritic synd is associated w/ Hep C?
220) Tx for Hemolytic Uremic Synd?
221) Tx for TTP?
222) TX for cryoglobulins IgM & IgG deposits?
223) Tx for HSP?
224) Tx for Wegner’s granulomatosis?
225) Dx of analgesic nephropathies?
226) Tx of choice for TSS?
227) Dx of blastomycosis?
228) Tx for blastomycosis? Severe? Mild?
229) Best dx test for toxoplasmosis?
230) Best initial test for CNS toxo lesion in AIDS pt?
231) Dx of RMSF? Tx?
232) When to start triple tx for HIV pt?
233) When to give AIDS pt prophylaxis for PCP? What? When to discontinue?
234) When to give MAI px to AIDS pt? What? How to dx MAI in HIV pt? Tx?
235) Prophylaxis for toxo in AIDS?
236) Tx for cryptococcus in AIDS?
237) Best dx test /specific dx for myocarditis?
238) Ultimate dx for gas gangrene?
239) Tx of gas gangrene?
240) Initial dx test for brain abscess?
241) Most accurate test for brain abscess?
242) Most common cause of encephalitis?
243) Most specific & sensitive test for HSV encephalitis?
244) What type of meningitits in pt w/hx of neurosurgery?
245) Best initial test for meningitis?
246) DIC associated w/ which leukemia type?
247) Tx for DIC?
248) Tx for hemophilia A?
249) Most common cause of congenital disorder of hemostasis?
250) Dx of vWD?
251) Tx for vWD?
252) Dx of ITP?
253) Tx of ITP?
254) Virus/bacteria associated w/ Non Hodgkin lymphoma?
255) % Location of cervical/supraclavicular nodes in NHL?
256) Initial dx for NHL & HL?
257) Tx for stage I A & II A of HL & NHL?
258) Tx for stages IB, IIB, III & IV of NHL?
259) Tx of relapses of NHL?
260) % Location to cervical/supraclavicular nodes in HL?
261) Tx for stages IB, IIB, III & IV of HL?
262) Which HL has good prognosis?
263) Dx of CML?
264) Tx of CML?
265) Confirmatory dx of acute leukemia?
266) Differentiation b/w different types of acute leukemia?
267) Tx of acute leukemia?
268) Common causes of death in PNH?
269) Defect in PNH?
270) Dx of PNH?
271) TX of PNH?
272) Defect in hereditary spherocytosis?
273) Dx of heredietary spherocytosis?
274) Tx of heredietary spherocytosis?
275) Specific dx for autoimmune, cold-agglutinin & drug induced hemolytic anemia?
276) Staging for HL & NHL?
277) Etiology of MGUS?
278) Dx of MGUS?
279) Sx of hyperviscosity synd associated w/MM?
280) Confirmatory dx for MM?
281) Tx for MM? Young pt? Old pt?
282) Staging & survival for CLL?
283) Dx of CLL?
284) TX of CLL?
285) Dx of aplastic anemia?
286) Tx of aplastic anemia?
287) Genetic association of CML?


Ans:
192) Abd US & captopril renogram
193) Captopril renogram
194) Arteriogram
195) PC transluminal angioplasty
196) Inc aldosterone in urine & blood
197) If adenoma: surgical resection; If hyperplasia: spironolactone
198) If smooth walled w/ no debri in cyst: no further dx or tx; If cysts w/ irregular walls or debri inside cyst: aspirate (R/O malignancy)
199) Acid load test; give NH4Cl (should lower urine pH secondary to inc H+) but in type I, pH remains high. Serum HCO3-=10
200) PO HCO3- as HCO3- reabsorption still works. K+ replacement
201) Pts unable to absorb IV HCO3- load & have basic urine in presence of academia
202) K+ replacement, thiazide diuretics, very large amounts of HCO3-
203) High urine Na+ w/ PO salt restriction
204) Fludrocortisone
205) Peaked T waves, wide QRS, short QT or prolonged PR interval
206) CaCl, NaHCO3-, Glucose & insulin, diuretic, B agonist, Kayexalate (w/sorbitol), dialysis
207) Primary inability to reabsorb NaCl from loop of Henle-> High renin, high aldosterone, N BP
208) U wave, T wave flattening
209) Correct underlying dis, IV K+ max 10-20 mEq/hr, K+ PO 200-400 mg/point of K+ decrease gut regulates absorption, half N or NS
210) Isotonic IV fluids. For CDI: correct dis, give ADH. For NDI: correct dis, diuretics or NSAIDS
211) Urine Osmolality > Serum Osmolality w/U Na+>40
212) Mild: fluid restriction <1000ml/d; Mod: loop diuretic & NS; Severe: hypertonic saline; Chronic: Li & demeclocycline
213) Erythropoietin & transfusions
214) Vit D, phosphate binders (Amphojel), Ca rep
215) Restrict protein, K, PO4, Mg & give Vit D, CaCo3, DDAVP (for bleeding)
216) Hyperkalemia, acidosis, fluid OL, pericarditis, encephalopathy
217) After pharyngitis or strep skin infect-> smoky urine (hematuria, proteinuria) w/HTN & edema. Inc ASLO, AHT (antihyaluronidase) & dec C3
218) Plasmapheresis (remove circulating Ab) combined w/ steroids & cyclophosphamide
219) Membranoproliferative (immune deposits & dec complement)
220) None as self-limited. Sometimes steroids
221) Plasmapheresis & steroids
222) Plasma exchange
223) Non-specific tx. For refractory cases: steroids
224) Cytotoxics & steroids
225) Sterile pyuria, hematuria, flank pain, mild proteinuria, hx (need 1g/d for 1-3 yrs)
226) Naficillin/oxacillin, restoration of hypovolemic shock, removal of toxin
227) Isolation of fungus in sputum, pus, biopsy
228) Severe: prolonged amphotericin (8-12 wks); mild: itraconazole/ketoconazole (6-12 mo)
229) Visualize parasite in tissue & fluid (serology is the most common method used)
230) Contrast Head CT or MRI, pt is given 10-14 days of tx, then re-scan, if lesion shrinks->dx confirmed
231) Specific serology: biopsy of skin lesion. Doxycycline
232) CD4<350 or (on PCR-RNA) VL>55,000
233) CD4<200. TMP-SMZ (most effective), dapsone, atovaquone, aerolized pentamidine (breakthrough). Discontinue when antiretrovirals raise CD4>200 >6mo
234) CD4<50. Px: Azithromycin PO 1/wk or clarithromycin bid (rifabutin is an alternative) Dx: blood culture, bone marrow, liver, and other body tiss or fluids culture. Tx: clarithromycin & ethambutol
235) CD4<100. TMP/SMZ, dapsone/pyrimethamine
236) Amphotericin IV at least 10-14 days followed by fluconazole (life long)
237) Endomyocardial biopsy
238) Direct visualization (usually at surgery) of pale, dead muscle w/brownish, sweet smelling discharge
239) High dose pnc (24 million/d) or clindamycine (if pnc allergic), surgical debridment or amputation, hyperbaric oxygen
240) Head CT w/contrast
241) MRI
242) HSV
243) PCR for HSV has 98% sensitivity & >95% specificity
244) Staph aureus
245) Head CT
246) Promyelocytic leukemia (M3)
247) FFP & sometimes platelets, correct underlying dis
248) Desmopressin (DDAVP) pre-op for mild pts. Factor 8 for severe pts.
249) VWD
250) Abn Ristocetin platelet agg test, low vW factor (aka factor VIII), inc BT, maybe inc PTT
251) Pre-op DDAVP for mild pts, VWF replacement for severe cases
252) Superficial bleeding, thrombocytopenia, N spleen, Antiplatelet Ab (high sensitivity w/poor specificity), Bone marrow filled w/ megakaryocytes, N peripheral smear & creatinine (R/O HUS, TTP, DIC)
253) Initially prednisone (mostly). IF platelet<10,000-20,000 recur even w/ rep steroid course-> splenectomy. If platelet <10,000 & life threatening bleed-> IVIG or Rhogam initially. If no response to IVIG or steroids in life threatening condition-> platelet transfusion (very rare)
254) HIV, EBV, HTLV-1, H. pylori
255) Only 10-20%
256) Excisional lymph node biopsy
257) Radiation
258) Combination chemo; Initial CHOP (cyclophosphamide, hydroxy-adriamycin, oncovin (vincristine), prednisone)
259) Autologous bone marrow transplant
260) 80-90%
261) Combination chemo ABVD (adriamycin (doxorubicin), bleomycin, vinblastine, dacarbazine)
262) Lymphocyte predominant HL
263) Inc WBC (predominantly neutrophils), blasts absent or <5%, dec LAP, basophilia, association w/ polycythemia vera, inc B12
264) If <60 yrs w/ suitable donor->bone marrow transp (as 25%/yr convert to acute leukemia); If w/o donor-> IFA initially, if fails-> hydroxyurea (dec # of cells); specific tx: Gleevec (tyrosine kinase inhibitor)
265) Bone marrow biopsy: >30% blasts
266) Monoclonal Ab
267) Initially chemo-> 99.9% remission-> consolidate -> transplant; Initial chemo for AML: cytosine arabinoside & daunorubicin or idarubicin; Initial chemo for ALL: Daunorubicin, vincristine, prednisone & asparginase; Promyelocytic leukemia: Add Vit A derivative (ATRA); CNS px for ALL: intrathecal methotrexate
268) Thrombosis of hep veins (Budd Chiari)
269) RBC memb defect in PIG-A
270) Specific: Sugar water test, Ham test, decrease DAF (decay accelerating factor)
271) If severe blood loss: Fe rep; If severe for unclear reasons: steroids; For thrombosis: anticoagulation
272) AD loss of spectrin (splenomegaly, jaundice, anemia)
273) Sensitive: Osmotic fragility test, Inc MCHC, -ve Coombs test
274) Chronic folate rep; If more severe anemia: splenomegaly
275) Coombs test (smear will show spherocytosis)
276) Stage I: 1 lymphatic gp; Stage II: 2 lymphatic gp on same side of diaphragm; Stage III: lymphatic gp on both sides of diaphragm or inv of any extra lymphatic gp contiguous to primary nodal site; Stage IV: widespread dis w/ different extralymphatic sites as bone marrow or liver
277) Unknown cause. 1% of population>50 yrs & in 3% of those >70yrs
278) Inc monoclonal spike of SPEP (lower than MM), N creatinine, Ca, Hb, inc total protein, no lytic lesion, bone marrow: <5% plasma cells)
279) Blurry vision, confusion, mucosal bleeding
280) Bone marrow biopsy: >10% plasma cell
281) Pre-op chemo VAD (vincristine, adriamycin, dexamethasone). Young pts: autologous bone marrow transp; Older pts: melphalan & prednisone
282) Stage 0: lymphocytosis; Stage I: lymphadenopathy; Stage II: splenomegaly; Stage III: anemia; Stage IV: thrombocytopenia
283) Inc WBC (80-90% lymphocytes), CD19, smudge cells
284) None for stage 0-II if asx; If stage I-II w/sx: chemo; Initial tx: chlorambucil w/prednisone; if don’t work: fludarabine
285) CBC: pancytopenia; confirm w/bone marrow biopsy: hypoplastic fat filled w/no abn cells
286) When pt<50yr & healthy: allogenic bone marrow transp (cure 80-90%); if not possible: immunosuppresion (remission in 60-70% w/ anti thymocte globulin, cyclosporine & prednisone)
287) Philadelphia chromosome 9-22 (more specific)