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ismailalmokyad's version from 2018-01-22 14:57


Question Answer
1-what test is good to diagnose latent TB?Interferon-gamma release assay (for vaccinated) and tuberculin skin test. both can diagnose latent TB but not the active one.
2-what is the test that diagnose active TB.sputum smear and cx should obtain 3 samples, 8 hours apart, and at least one sample early in the morning.
3-who to know if active TB pt is infectious or not3 negative smears ar considered noninfectious of TB.
4-what is the features of lewy body dementia?1-fluctuating cognition
2-visual hallucinations
3-parkinsonism features,
4-vivid dreams
5-sever neuroleptic sensitivity(haloperidol)
6-pet or spect showing low dopamine transporter uptake in basal ganglia
7-repeated falls, syncope or near
8-sever autonomic dysfunction
5-How to diagnose lewy body dementia ?dementia plus 2 out of 3 core clinical features:
1-cognitive fluctuations
2-visual hallucinations
6-parkinson vs lewy body dementia ?parkinson disease has tremor and parkinson symptoms starts early and dementia starts late, the opposite with LBD and tremor is rare with LBD.
7-frontotemporal dementia c/p ?presents earlier usually 50s, starts as personality changes before cognitive dysfuction. typically will present with disinhibition, personality changes, extreme agitation and **urinary incontinence**
8-What is the classic triad of NPH?dementia, urinary incontinence, and abnormal gait.
9-How to confirm dx of NPHHead CT.
10-What Lewy BD medication can exacerbate visual hallucination?dopamin agonist > levodopa
11-What is the features of pineal gland tumor?parinaud's syndrome, which is
1-loss of pupillary reaction
2-vertical gaze paralysis
3-loss of optokinetic nystagmus
5-headache due to obstructive hydrocephalus.
6-some are germinomas and secret HCG which can cause precocious puberty in prepubertal males.
12-wt is craniopharyngiomas and what is the most common associated disease ?- brain tumor derived from pituitary gland embryonic tissue, that occurs most commonly in children but also in adults in their 50s and 60s

-Diabetes insipidus and deficiency of one or more anterior pituitary hormones
13-wt is foster kennedy syndrome ?optic atrophy on the side of frontal lobe tumor and papilledema on the contralateral side.
14-wt is the use of inferior petrosal sinus sampling?used to differentiate the sours of ACTH production(pituitary vs ectopic)
15-how to prevent bone loss 2/2 chronic prednisone use ?treat with calcium and vit D.
16-how does glucocorticoids cause low bone massmultiple mechanisms.
1-decrease calcium absorption
2-increase renal calcium wasting
3-direct anti-anabolic effect on bone.
4-suppress the release of GnRH leading to central hypogonadism with aggravate bone loss.
17-how to treat glucocorticoid induced osteoprosisalendronate or risedronate, treatment could be warranted if bone mineral density studies reveal a t score of <-1.5 that continues to rapidly deteriorate, or if hx of fracture after minor fall
18-who is candidate for lung cancer screening ?smoker >30 years who currently smoker or quite within the past 15 years. start at age 55 to 80.

-stop screen after 15 years of smoking free or age 80.

screen with CT
19-how does quit smoking affect risk of cancer?cancer risk increase 10 to 30 fold than non-smokers, if quit >15 year risk decrease by 80-90%. however lung cancer risk remains elevated by 10-80% in former smokers
20-Wt is bronchiolitis and how does it presentit is infection occur in kids in the winter caused by RSV,

-pt typically have
1-nasal congestion
3-corse breath sound
5-with or without crackles.
6-may be increase work of breath, nasal flaring, and grunting.
21-who should be admit because of brochiolitis RSVthe following patient should be hospitalized on contact droplet precautions.
1-resp destress
22-how to ttt bronchiolitis RSVsupportive only
23-who should get palivizumab as prevention of RSVinfant with the following
1-preterm birth<29
2-chronic lung disease of prematurity(defined as gestational age <32 weeks, 0 days and a requirement for >21% oxygen for at least the first 28 days after birth.)
3-hemodynamically significant congenital heart disease.
24-Indication of nasal or pulmonary secretion testing for nucleic acid amplification testing to detect RSV infectionin infant who is in prophylaxis with palivizumab to detect breathrough rsv which provid active immunity and protection and palivizuman can be discontinued
25-wt is the long term complication of rsvrecurrent wheezing in 30%

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