ABFM BOARD REVIEW EXAM 2024 WITH 100% CORRECT ANSWERS, Exams of Nursing

Download ABFM BOARD REVIEW EXAM 2024 WITH 100% CORRECT ANSWERS and more Exams Nursing in PDF only on Docsity!

ABFM BOARD REVIEW EXAM 2024

WITH 100% CORRECT ANSWERS

76 yo is brought by her daughter who is concerned about her mother's memory. 6 months ago, daughter took over mom's checkbook after she failed to pay bills. Her mother seems unable to knit, something she enjoyed for years. She has difficulty finding the words to complete a thought. Dx? A. PT has dementia B. Pt is delirious C. The patient is depressed D. The pt has mild cog impairment - correct answer✔✔ The patient has dementia -Progressive impairment -Lead to loss of social and functional abilities Greatest risk factor for developing dementia? A. Family Hx B. Phys Activity C. Aging D. Lack of mental exercise - correct answer✔✔ Aging What is Mild Cognitive Impairment? - correct answer✔✔ -Complaint of memory impairment -Objective memory loss -Preserved general cog fnx -Intact activities of daily living -High risk of developing dementia 80 yo with 1yr becoming more sedentary w/difficulty completing ADLs, 2 falls. Stepwise progression of deficits, can't manage finances, no change in mood/personality. PMHx of diabetes, smoker, HTN. R grip is weaker vs L, no tremor. 1/5 on mini-cog test and the pt attempts to joke about not being able to perform word recall.

A. Alzheimer's B. Lewy Body C. Vascular D. Frontotemporal - correct answer✔✔ C. Vascular -Hint is that it is stepwise progression -Preserved personality, but emotional incontinence 69yo with rigidity, short-stepped gait, and masked facies. He also has become more forgetful (mini-cog 2/5). Family thinks he sees things that aren't real. What kind of dementia? - correct answer✔✔ Lewy Body -Dementia -Parkinsonism + visual hallucinations -Significant visuospatial deficits 64 yo brought in after exposing himself in public. He has also been urinating in the kitchen sink and refuses to bathe. MMSE 26/30. Has some word-finding difficulties - correct answer✔✔ Frontotemporal Key is this starts younger First thing is behavioral issues 76 yo, difficulty walking and his "feet seem stuck together." Gait is widened, but arm swing is maintained. Mild memory loss. Urge incontinence. - correct answer✔✔ Normal Pressure Hydrocephalus -Key here is that the arm swing is maintained (less likely Parkinson's) 84 yo rapidly progressive dementia over 4 months. Has low-grade fever, very rigid, and has myoclonic jerks when startled. EEG shows triphasic sharp wave complexes - correct answer✔✔ Creutzfeldt-Jakob Dz -Rapid with myoclonus -Tend to be younger, viral-like prions

Which is proven to be protective against dementia? A. Estrogen B. Educational attainment C. Vit E D Turmeric - correct answer✔✔ Educational Attainment USPSTF: Screening guideline for AAA - correct answer✔✔ Men ages 65-75 one time who have ever smoked You identify a AAA in your pt. At what size should you refer for surgical intervention? A. 3-3. B. 4-4. C. 5-5. D. 6-6.5 - correct answer✔✔ 5-5. How often should you monitor a 3-3.9 cm AAA? - correct answer✔✔ Every 36 months How often should you monitor a 4-4.9cm AAA? - correct answer✔✔ Every 12 months How often should you monitor a 5-5.4 cm AAA? - correct answer✔✔ Every 6 months Most common cause of AAA - correct answer✔✔ Atherosclerosis Most common cause of Aortic Dissection - correct answer✔✔ HTN (2 lumen problem) 68 yo M presents with aching pain in both thighs after walking 1 block. Pain subsides 1-2 mins after he stops ambulating. The best initial test is: A. ABI B. Bil leg US

C. PVRs D MRA of LE - correct answer✔✔ A. ABI What is a normal ABI? - correct answer✔✔ 0.9-1. What if you have a very high ABI? - correct answer✔✔ Noncompressible arteries (calcified likely) When obtaining ABI, AHA/ACC recommends obtaining the systolic BP in both arms and using the higher of the readings. However, if a difference in systolic BP >20mmHg between the arms, what is the most likely dx? - correct answer✔✔ Subclavian Artery Stenosis What medication can be given to help with pain with claudication? - correct answer✔✔ Cilostazol 72 yo F comes with sudden, severe R leg pain from knees to toes. PMHx HTN, DB. Vitals 160/90, pulse 120 and irregular, afebrile. R leg is cool to touch, pale in color, you're unable to obtain a posterior tibial or dorsalis pedis pulse. At this point, you should A. Start heparin and immediately consult vasc sx B. Immediately obtain US of the lower extremity C. Immediately obtain an echo D. Immediately obtain an AA US - correct answer✔✔ A. Start heparin and immediately consult vasc sx What are the 5 Ps of acute arterial occlusion? - correct answer✔✔ Pain Pallor Paresthesia Pulselessness Paralysis TX: Heparin and consult vascular

What is the most common source of acute arterial occlusion? - correct answer✔✔ Thromboembolism from the heart! Think A Fib 76 yo M with Hx of HTN, HLD, and smoking presents with with blue painful toes in the setting of intact pulses. The most likely diagnosis is A. Acute Gout B. Raynaud's C. Cellulitis D. Blue Toe Syndrome - correct answer✔✔ Blue Toe Syndrome Raynaud's secondary disease association - correct answer✔✔ Scleroderma/Sclerosis SLE What is GDMT for HFrEF? - correct answer✔✔ RAAS Inhibitor (ARNI or ACE) BB (carvedilol, metoprolol succ) MRAs (spironolactone) SGLT2 Inhibitor (empagliflozin) How to treat LOW RISK, stable angina - correct answer✔✔ Stable Angina: pain only with exertion, alleviated at rest LOW RISK: Not LAD or multivessel disease (seen on stress) Tx: ASA, statin, BB/CCB. No PCI!! What is the appropriate first line test for hyperaldosteronism? - correct answer✔✔ -Aldosterone/renin ratio -Hypokalemia, HTN Benign Esophageal Varices Treatment A. Propanolol B. Octreotide

C. Ligation D. Repeat EGD 1-2yr E. Nothing - correct answer✔✔ Repeat EGD in 1-2 years Mod risk? (Red whale sign or moderate size) = propanolol or ligation High Risk/Bleeding = Octreotide (From ITE 2022 #3) What are the indications for dental antibiotic prophylaxis? - correct answer✔✔ -Infective endocarditis -Valve replacement -Hx of congenital heart defect (From ITE 2022) What is CDC guidelines for treatment of urethritis, NAAT for gonorrhea is positive and Chlamydia is negative? - correct answer✔✔ -Ceftriaxone 1g IM Gonorrhea: ceftriaxone once Chlamydia: doxy for 7 days (From ITE 2022) What is the Rotterdam Criteria for PCOS? - correct answer✔✔ - Oligomenorrhea -Hyperandrogenism -Presence of polycystic ovaries *You need 2/3 for diagnosis

What is the most common cause of unconjugated hyperbilirubinemia? - correct answer✔✔ -Elevated indirect bilirubin level -Hemolysis!

• #2 is Gilbert's According to AAP, what age should you start BP screening? - correct answer✔✔ -Start at age 3 When are triptans contraindicated? - correct answer✔✔ -Pts with established CAD, cerebrovascular disease, or peripheral vasc disease -Multiple cardiovascular risk factors -High-risk migraine sx (basilar and hemiplegic migraines) What is HS commonly associated with? - correct answer✔✔ Crohn's Disease DB Obesity PCOS Metabolic Syndrome What lab values would you expect in tumor lysis syndrome? - correct answer✔✔ High cell turnover --> acute kidney failure 2/2 high uric acid -High uric acid -High K+, Phosphorus (both because of the kidneys not filtering) -Low Calcium because of the high phos When is cardiac stress testing contraindicated? - correct answer✔✔ -After recent stroke or TIA -Severe symptomatic aortic stenosis

When would a stress test be indicated in preop optimization? - correct answer✔✔ Preop assessment when surgery is at least a moderate risk and the patient can't reach 4 METs of exertion (climbing a single flight of stairs) without cardiac symptoms Which medications when used in combination with statins increase your likelihood of statin-induced myopathy? - correct answer✔✔ -Statin --> liver clearance -CCBs, some anti-HIV meds, and some antifungals can increase complications such as statin-induced myopathy because they are liver metabolized! **D/c statin if CK >10x ULN What age do you start screening for Depression per the USPSTF? - correct answer✔✔ Age 12! Delirium vs Dementia - correct answer✔✔ Delirium: altered consciousness, major attention deficit, fluctuation, acute Dementia: appear to at least be making eye contact, less fluctuation When is delirium tremens onset? - correct answer✔✔ 48-96hrs 85 yo hospitalized, develops confusion post-operatively which is atypical. No hx of memory loss. Which tool should you use to assess? What can you do first-line? - correct answer✔✔ -CAM (confusion assessment method) -You can't use the normal dementia tools (MOCA, etc)

• Tx: Reorient!! What rash is associated with celiac disease? - correct answer✔✔ Dermatitis herpetiformis What is first line treatment for motor symptoms in Parkinson's? - correct answer✔✔ Carbidopa/levodopa Nothing to stop progression!

Which class of DB medicine is associated with ketoacidosis? - correct answer✔✔ SGLT- What do you need under the Clozapine Risk Evaluation and Mitigation Strategy? A. Signed consent B. Serum levels C. neutrophil counts D. Training in pych - correct answer✔✔ C. Neutrophil counts What is the most common cause of chronic cough in adults? - correct answer✔✔ Upper airway cough syndrome (postnasal drip) What is the most common location for cysts in ADPKD? - correct answer✔✔ Liver (outside the kidney) What is first-line treatment for IBS with best quality evidence? - correct answer✔✔ Soluble Fiber ****This is according to the American College of Gastroenterologists G2P2 delivered, had GDMA1 in pregnancy, here for 6wk f/u. How do you follow-up her diabetes? - correct answer✔✔ A 2hr, 75g glucose tolerance test should be performed 4-12wks post-partum following a preg in which gestational DB was diagnosed. What antihypertensive med is useful for both BP and OSA? - correct answer✔✔ Spironolactone! Aldosterone can play a role in HTN and disordered breathing 17 yo, normal PFTs, still having episodic SOB/chest tightness. PFTs revealed normal expiratory findings including normal FEV1 and FVC, but had a flattened inspiratory flow loop. What is going on? - correct answer✔✔ Vocal Cord Dysfunction! -Get nasolaryngoscopy -Tx with breathing techniques

What is first line tx for PTSD? - correct answer✔✔ Trauma-focused psychotherapy MED: Fluoxetine Heat stroke vs heat exhaustion vs Heat Injury - correct answer✔✔ Heatstroke: Neuro + > Heat Exhaustion: Neuro < Heat Injury: No neuro, >104. TX: Complete immersion to the neck in ice water (2-3C) What are the hormones for primary ovarian insufficiency? How would you tx? - correct answer✔✔ Elevated FSH and LH Tx: HRT as soon as possible (within a year of dx) UTERUS: estrogen/progesterone (IUD) What are the hormones for PCOS? - correct answer✔✔ LH >>>FSH What treatment is the most efficacious for Fibromyalgia? - correct answer✔✔ Exercise!! FDA approved med is cymbalta, but exercise is better. What is the vision loss pattern of glaucoma? - correct answer✔✔ Peripheral vision loss (increased pressure pushes on periphery of the ophthalmic) What is the vision loss pattern of macular degen? - correct answer✔✔ Central vision loss

How do you manage Levothyroxine in pregnancy? - correct answer✔✔ -Increase by 30% by taking an extra dose 2 days per week for a total of 9 weekly doses -Then monitor TSH every 4 wks In someone with stable angina and documentaed coronary atherosclerosis. positive stress test and underwent coronary angiography, which showed atherosclerotic dz without stenting..... What medications have been shown to decrease cardiac and all-cause mortality in pts with CAD? - correct answer✔✔ -Xarelto What is first line treatment for bacterial sinusitis? - correct answer✔✔ Tx: Augmentin for 5-7 days What should you monitor with SLE flare? - correct answer✔✔ Anti-dsdna, complement, ESR/CRP, UA (for lupus nephritis), WBC, BMP What do you need prophylaxis for HIV with CD4 <200? What do you need prophylaxis for HIV with CD4 <100? What do you need prophylaxis for HIV with CD4 <50? - correct answer✔✔ <200: Bactrim for PJP <100: Bactrim for Toxo <50: Azithro for MAC Pt sustains nondisplaced radial head fracture, how would you treat this? A. Immobilization for 3 days then ROM exercise B. Long arm posterior splint for 6 weeks C. Long arm cast for 6 weeks D. Referral to ortho for cast E. Referral to ortho for surgery - correct answer✔✔ A. Immobilization for 3 days with ROM What is the best approach to vaccine hesitancy? - correct answer✔✔ Presumptive approach rather than participatory What lab abnormalities would you expect in multiple myeloma?

What is the difference between MGUS and MM? - correct answer✔✔ MM LABS: -Elevated globulin -Hypercalcemia -Renal Insufficiency (monoclonal light chains toxic to kidney) "CRAB" findings hyperCalcemia, Renal insuff, Anemia, Bone lytic lesions *MGUS is premalignant WITHOUT any CRAB findings, <10% clonal plasma cells When thinking of multiple myeloma, what test would you get after high globulin-to-albumin ratio? - correct answer✔✔ -Serum and urine immunoelectrophoresis In an old person with depression, what class of meds is the best when considering adverse effects? - correct answer✔✔ SSRIs! Better than SNRIs What is guideline-directed therapy for PAD? - correct answer✔✔ -Low dose ASA -Statin -ACE inh -Exercise -Smoking cessation When is too late to start Rotavirus series? - correct answer✔✔ 15 weeks!! (If you see a 4 month old, DON'T DO IT) -Must complete the series by 8 months

What is the USPSTF recommendation for statin therapy? - correct answer✔✔ For primary prevention of CVD for adults aged 40 to 75 years who have 1 or more CVD risk factors (i.e. dyslipidemia, diabetes, hypertension, or smoking) and an estimated 10-year risk of a cardiovascular event of 10% or greater. What is the goal A1C in T2DM? What about in the elderly? - correct answer✔✔ <7 for younger patients <8 for older pts with comorbidities What is the recommendation for statins in DB tx? - correct answer✔✔ Moderate intensity for primary prevention for CVD in all pts with db age 40- High Intensity for known multiple atherosclerotic risk factors What are the USPSTF guidelines for DB screening? - correct answer✔✔ Screen age 35-70 for those overweight or obese (BMI>25) Diagnosis for Diabetes....

1. A1C
2. Oral GTT
3. Fasting glucose
4. Sx plus glucose lvl - correct answer✔✔ 1. A1C>6.
5. 2hr GTT >
6. Fasting glucose >
7. Sx of db + random glucose > What DB medication puts you at higher risk of DKA with not as high sugars? - correct answer✔✔ SGLT- What DB medication is associated with Fournier's? - correct answer✔✔ SGLT- What DB medication is associated with increased HF? - correct answer✔✔ TZDs

What percent weight reduction was found to lower the risk of developing diabetes? - correct answer✔✔ 5-10% What is the most common cause of AKI? - correct answer✔✔ ATN What are pigmented, muddy brown casts associated with? - correct answer✔✔ ATN What are the indications for urgent dialysis? - correct answer✔✔ -Fluid Overload refractory to diuresis -K+ >6. -Uremic pericarditis or uremic encephalopathy -Severe met acidosis (pH <7.1) and hypervolemia -Acute poisoning In what cases do you want K+>4? - correct answer✔✔ Known heart disease, arrhythmias, How does CKD change your potassium? - correct answer✔✔ Increases! Kidney is responsible for excretion What are causes of Hypokalemia? - correct answer✔✔ 1. GI Losses (Diarrhea, vom, bowel prep)

2. Renal Losses (hypomag, RTAs, mineralocorticoid excess)
3. Transcellular shift (refeeding syndrome, alkalosis, thyrotoxicosis, hypothermia) What meds cause low K+? - correct answer✔✔ Thiazides, loops Corticosteroids Laxatives Causes of hyperkalemia - correct answer✔✔ -Transcellular shift (insulin resistance or deficiency) -Excessive intake -Impaired excretion

-Medications -Crush injuries (muscular injuries, rhabdo) When do you need to limit potassium? - correct answer✔✔ AFTER CKD3b What are some meds responsible for Hyperkalemia? - correct answer✔✔ ACE/ARB Bactrim Heparin BB DIg NSAIDs Physical exam of Hyperkalemia? - correct answer✔✔ -Muscle weakness -Ascending paralysis What tests do you need for Hyperkalemia? - correct answer✔✔ -BMP -EKG (peaked T earliest sign) -Acid/base status What medication stabilizes the cardiac membrane with K+? What meds used to shift? What meds used to eliminate? - correct answer✔✔ Stabilize: calcium gluc Shift: Insulin (10U insulin followed by 25g glucose unless the glucose >250 you don't need it) Eliminate: lokelma, kayexylate *Lasix will help you excrete K+ If you have a pt who you are concerned is experiencing ACS, what do you do? - correct answer✔✔ *Give O2, aspirin, and nitro

*Repeat trop in 2-3 hours DAPT duration after stent placement:

1. ACS Patients (DES or BMS)
2. Stable CAD (DES)
3. Stable CAD (BMS) - correct answer✔✔ ACS PTs: tx for at least 12 months! Then you may stop P2Y12, but continue ASA indefinitely STABLE CAD: -BMS: tx for at least 1 month -DES: tx for at least 6 months *DAPT is aspirin + P2Y12 inhibitor (clopidogrel, ticagrelor, prasugrel) What are the symptoms/findings in pericarditis? - correct answer✔✔ -Pleuritic chest pain -Fever -Scratchy systolic and diastolic auscultatory findings (pericardial rub) You have a pt with acute STEMI.... how do you decide whether to perform PCI vs fibrinolytic? - correct answer✔✔ If PCI can't be performed within 120 mins of first medical contact, fibrinolytic therapy (alteplase, tenecteplase, or reteplase) should be given -THEN after fibrinolytic therapy, transfer to a center where PCI can be performed within 24 hrs -Also make sure to give heparin and aspirin What is first line therapy for chronic stable angina? - correct answer✔✔ Beta Blocker What is second line therapy for chronic stable angina after maximizing BB? - correct answer✔✔ A long- acting nitrate (isosorbide mononitrate) or a CCB

How do you reduce the risk for contrast-induced nephropathy in someone with reduced renal fnx? - correct answer✔✔ Volume expansion with isotonic fluid (NS from 3hrs before cath to 6hrs after) What is first-line lipid management for pts <75yrs with established CAD? - correct answer✔✔ High- intensity statin! Atorva 40-80mg Rosuva 20-40mg Which of the following is true with regard to screening for depression? A. Brief, 2-question screens for depression are equivalent to longer ones B. The Edinburgh Postnatal Dep Scale should not be routinely used at the 1st pp visit C. There are few standardized scales that can be used for screening D. USPSTF does NOT rec screening adults and adolescents for depression - correct answer✔✔ A PHQ-2 Qs:

1. Over the past 2 wks, have you ever felt down, depressed, or hopeless?
2. Have you felt little interest or pleasure in doing things? What are the two questions from the PHQ-2? - correct answer✔✔ 1. Over the past 2 wks, have you ever felt down, depressed, or hopeless?
3. Have you felt little interest or pleasure in doing things? Which of the following is true about depression and Persistent Depressive Disorder (dysthymia)? A. Depression assoc w/ dysthymia is as severe as that of MDD B. Lifetime risk is equal for women and men C. Depression is more common in medically ill pts

D. Dysthymic pts may have periods of "normal" mood taht can last >1yr - correct answer✔✔ C. Depression is more common in medically ill patients What is the timeline of symptoms to diagnose with Major Depression? - correct answer✔✔ 2 weeks!!!! (5 or more symptoms from DSM-5) How does persistent depressive disorder (dysthymia) compare to major depressive disorder? - correct answer✔✔ Depressed mood for at least 2 years with no symptom-free period lasting longer than 2 months!!! Which is true about treatments for depression? A. If pt doesn't respond to an SSRI within 2 weeks of starting it, a second should be added B. Med of choice in pt with seizures is bupropion C. Memory loss caused by ECT is reversible D. Antidepressants are contraindicated if pt is breastfeeding - correct answer✔✔ C Memory loss caused by ECT is reversible What would entail medical screening for depression? - correct answer✔✔ -CBC -CMP -TSH -Vit D -RPR Which SSRIs are safe in pregnancy? - correct answer✔✔ Citalopram, Escitalopram, Sertraline Which SNRI is also indicated in fibromyalgia? - correct answer✔✔ Duloxetine What is the most effective treatment in pts with severe resistance (with medicine for depression) or psychotic depression? - correct answer✔✔ ECT

What medications are FDA approved for depression in pediatric populations? - correct answer✔✔ Fluoxetine and escitalopram Fluoxetine (age 8 or greater) Escitalopram (age 12 or greater) Age 6-17yrs *****Zoloft (sertraline): age 6 (for OCD, not depression) *****Prozac (Fluoxetine): age 7 for OCD What's the timeline difference in baby blues vs postpartum depression? - correct answer✔✔ Baby Blues: First 1-2 weeks PPD: >2 weeks, normally within first 3 mo after delivery *Pts should be screened for a minimum of 1year for postpartum depresson A 36 yo woman with bipolar I has been on lithium for 17 years. Which is most likely irreversible SE from tx? A. Polyuria B. Renal insuff C. Hypothyroidism D. Resting tremor - correct answer✔✔ B. Renal insufficiency -This one is irreversible! The rest are reversible. What is the most common cause of encephalitis in children? What is the best test? - correct answer✔✔ Viral pathogens! VIP is HSV and enterovirus. Test with viral PCR of CSF for both HSV and enterovirus. Viral culture is low sensitivity

What medication should you use to treat bacterial meningitis in a kid >1 month? - correct answer✔✔ Vanc + 3rd gen cephalosporin (such as cefotaxime) What is empiric treatment for bact meningitis in an immunocompromised host? - correct answer✔✔ Ceftriaxone, Vanc, and ampicillin What are the MCC of symmetric distal polyneuropathy? - correct answer✔✔ -DM!! Then get CBC, b12, mma What constitutes a constitutional delay of growth and puberty? - correct answer✔✔ -Height & Weight <5th percentile -Normal linear growth velocity -Delayed bone age -FHx of delayed puberty What heart condition is associated with Turner syndrome? - correct answer✔✔ Bicuspid aortic valve What is the difference of a massive vs submassive PE? - correct answer✔✔ Massive: high-risk, hemodynamically UNSTABLE Submassive: Int risk, hemodynamically stable w/ R ventricular strain How long do you treat 1st provoked PE? How long do you treat 1st provoked DVT? - correct answer✔✔ At least 3 months (unless hemodynamically unstable, then consider 6-12mo) How long do you treat unprovoked or recurrent PE? How long do you treat unprovoked DVT? - correct answer✔✔ Lifelong Which degree burns have blanching? - correct answer✔✔ 1st degree (rapid refill)

2nd degree superficial (slow refill) ***2nd degree deep and beyond do not blanch What is one of the biggest benefits of weight loss surgery in regards to coexisting comorbities? - correct answer✔✔ -T2DM! -Will have remission in 60-80% of pts How do you dx hypogonadism in males? What labwork do you need to obtain when supplementing testosterone? - correct answer✔✔ Dx: 2 separate AM fasting total testosterone levels LABS: Hematocrit Stop the med if HCT >54% increase What is the most common cause of septic arthritis? - correct answer✔✔ Staph Aureus (#1), followed by strep species If you treat diverticulitis with antibiotic, which ones would you choose? - correct answer✔✔ -Augmentin OR -FQ + MTZ What is a contraindication to cilostazol? - correct answer✔✔ Heart Failure What is the triad for ruptured AAA? - correct answer✔✔ Abdominal Pain Pulsatile Mass/Abd distention Hemodynamic instability Complicated Diverticulitis --> hospital treatment IV - correct answer✔✔ IV: pip-tazo OR cephalosporin/levoflox + MTZ

-If there is an abscess, drain it (if >4cm) After diverticulitis, once resolved, when should you undergo colonoscopy? - correct answer✔✔ -In 6- 8weeks after! -Especially in complicated What is the most common cause for lower GI bleed? - correct answer✔✔ Diverticular Bleed -MC on R side What is considered overweight in kids? Obese? - correct answer✔✔ Overweight= >85%tile Obese= >95%tile What link between obesity and cancer has been shown? - correct answer✔✔ Increase in 7% of "obesity cancers" -Large increase: uterine, gallbladder, kidney At what age does USPSTF recommend screening for obesity? - correct answer✔✔ At age 6 and greater (SOR-B) A 27 yo F with BMI of 39 requests help wtih a diet. You tell her: A. There is no weight loss diet that is better than others B. Mediterranean diet is the best C. Decrease intake by 500 calories a day will results in 2lb a week D. Avoid commercial weight loss programs - correct answer✔✔ A! Mediterranean is not better for weight loss (it is good for CVD, diabetes) -there are ~3500 calories in a pound.

Fact: Fasting is safe in T2DM, but not in T1DM - correct answer✔✔ How much exercise should adults get? Kids? - correct answer✔✔ Adults: 150 min/week Kids: 1 hr a day *Exercise is moderately effective for weight loss (even when added to diet) How often should you monitor weight when trying to lose weight? - correct answer✔✔ Weekly! Your pt just got a sleeve gastrectomy. What should you tell her is the most likely complication in the first 6 months? - correct answer✔✔ GERD --Dumping syndrome is much less common --Roux-en-Y gastric bypass would be preferred in those with Hx of GERD What is the #1 cause of death following bariatric surgery? - correct answer✔✔ Pulmonary Embolism What is the most common nutritional deficiency after bariatric surgery? - correct answer✔✔ Iron When you find TSH/T4 levels indicative of hyperthyroidism, what is your next step? - correct answer✔✔ Radioactive Uptake Scan 60Yo 6wk hx of neck mass, confirmed on PE. What is the initial diagnostic test? - correct answer✔✔ Get a TSH first!!! You notice a thyroid nodule and obtain a TSH. What would you do if the TSH was low? - correct answer✔✔ 1. Get an US as well

2. Get I-123 scan a. HOT: surgery b. COLD: FNA

You notice a thyroid nodule and obtain a TSH. What would you do if the TSH was normal/high? - correct answer✔✔ 1. Get an US in addition

2. FNA!!! All of the following are common symptoms of hyperparathyroidism EXCEPT: A. Bone Pain B. Increased app C. Depression D. Renal Stones - correct answer✔✔ Increased Appetite Bones, stones, and moans, psych groans LABS: elevated PTH, elevated Ca, normal Vit D TX: Parathyroidectomy if you can, cinacalcet if unable What diuretic can cause hypercalcemia? - correct answer✔✔ Thiazides (they also lose K) *May be helpful in calcium oxalate renal stones to decrease urine calcium levels What is the best test for diagnosing prolactinoma? - correct answer✔✔ MRI brain w/ What is the normal progression of Subacute Thyroiditis of labs? - correct answer✔✔ Initial thyrotoxicosis followed by a 4-6 month transient hypothyroidism What antibody level is most often elevated in Hashimoto Thyroiditis? - correct answer✔✔ Hashimoto Thyroiditis= form of hypothyroidism -Elevated antithyroid peroxidase antibody in 99% of patients

The presence of a thyroid bruit and chronic symptoms in a patient with thyrotoxicosis is highly suggestive of... - correct answer✔✔ Graves Dz -Bruit: reflects increased blood flow to the thyroid You have a pt who has amenorrhea and is on risperidone. What lab abnormalities could you see and what is the cause? - correct answer✔✔ -Antipsychotics and other meds with dopamine antagonistic properties can cause clinically significant elevations in prolactin What are the symptoms of Addison's disease? - correct answer✔✔ ANDRENAL INSUFF -Fatigue, depression, lightheadedness upon standing, muscle weakness, weight loss, hyperpigmentation What are the first two steps for evaluation of male infertility? - correct answer✔✔ 1. Semen analysis

2. Oligozoospermia? Endocrine eval with FSH and early morning total testosterone What is the DSM-5 criteria for ODD? - correct answer✔✔ Occurring over 6 months... -Losing temper -Easily annoyed -Antagonism toward authority figures -Deliberately annoying others -Placing blame on others -Being spiteful or vindictive What is treatment of croup in A. Mild Cases B. Mod/Severe - correct answer✔✔ A. Oral dexamethasone B. Addition of epinephrine