MALT lymphoma is associated with  H. pylori infection
Celiac disease dx with  IgA anti-endomysial antibodies
Celiac disease assoc with  dermatitis herpetiformis
Pt with ascitis develops sudden onset fevers, chills, and generalized abd pain  Paracentesis to r/o spontaneous bacterial ...
Pts with late compliment deficiencies are prone to  Gonococcal infections.
Herpes simplex virus CNS infection will see  Temporal lobe lesions  with mass effect/edema. Start acyclovir ASAP
m/c inherited bleeding disorder, associated with bleeding symptoms from nose or gingival.   Factor V Leiden
65 yo male with headache and fever, spinal tap with decreased glucose, increased protein, lymphocytosis and gram positive ...
Loop diuretics  act on  the  Na + -K + -2Cl -  symporter  (cotransporter) in the  thick ascending limb of the loop of Henl...
What is associated with severe phosphatemia (<1.0)?  Vitamin D deficiency
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...
45 yo female with nl BUN/Cr, sodium 120 with urine sodium 40 and urine osm 240  Psychogenic Polydypsia
Dirty brown casts are characteristic of acute tubular necrosis
44 yo male with psych history found comatose with anion gap and calcium oxalate crystals in UA, diagnosis is  Ethylene gly...
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 Nep...
What drug may cause hyperkalemia by decreased renal tubular secretion of potassium?  Bactrim (I don’ t think this is right)
30 yo male with acute nephroureterolithiasis, calcium 9.8, phos 3.6, creatinine 0.8, urine calcium 320/24h, urine uric aci...
55 yo with painless hematuria with UA has RBCs but no proteinuria, no red cell dysmorphia or no RBC casts; what should nex...
28 yo WM with hematuria, proteinuria, nephritic syndrome, b/l cataracts, high frequency hearing loss =  Alport’s Syndrome
48 yo alcoholic has sodium 105 what is initial tx: 10 gram Regular Diet
32 yo male construction worker treated for heat stroke has renal insufficiency m/l secondary to:  with BUN 35 and Cr 3.5 a...
42 yo female with adult polycystic kidney disease with flank pain and fever with infected cyst in right kidney, should be ...
36 yo male with creatinine of 3.0 has a GFR of ~24, STAGE? Stage 4 CKD.
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
60 yo with h/o CHF, systolic dysfunction and CKD presents with heart palpitations, K 6.5, Dig 3.5; what is relatively cont...
What can cause decreased anion gap  Hypoalbuminemia Increased immunoglobulins ( MYELOMA , gammopathies) Increased unmeasur...
40 yo WF with ARF, sinus infection, pulmonary infiltrate, conjunctivitis, hemoptysis, positive c-ANCA; most likely dx:  We...
What factor places patient at greatest risk to develop osteoporosis:  Long-term corticosteroids
Patient presenting with headache, nausea, vomiting, hypotension, blurred vision, diplopia, impaired consciousness; most li...
Schmidt’s syndrome  :  consists of Adrenal insufficiency, gonadal failure, hypoparathyroidism, lymphocytic thyroiditis and...
Solitary thyroid nodule most likely malignant if:  Serum thyroglobulin (papillary or follicular) or calcitonin (medullary)...
What diagnostic test would prove self-induced hyperthyroidism?  Thyroglobulin level low
46 yo hypertensive male with acute nephrolithiasis and h/o PUD and constipation; nephrolithiasis most likely d/t:  HYPERPA...
Goal of LDL-C in patients with CKD stage IV is  < 100.
18-hydroxysteroid measurements and postural stimulation used to differentiate  A ldosterone deficiencies
Subacute granulomatous (DeQuerveins) thyroiditis is characterized by:  DECREASED UPTAKE OF IODINE
What causes low total T4 PREGNANCY OR INCREASED THYROGLOBULIN Craniopharyngioma  Empty sella syndrome  Metastases to the p...
48 yo asymptomatic female with elevated AST and ALT with ultrasound showing fatty infiltration; what would predispose her ...
MEN IIa:  Pheochromocytoma, medullary thyroid carcinoma, and parathyroid hyperplasia
Patient with easily palpable 1.5 cm thyroid nodule; what is best next approach?  Fine needle aspiration
36 yo nurse with repeated bouts of palpitations, sweating, anxiety, hunger, dizziness and blurred vision; glucose in ER 20...
34 yo WM with hypercalcemia on routine physical exam, calcium 11, urinary calcium <200/24h; patient most likely has:  Fami...
76 yo female obtunded with glucose 1200 and sodium 126:  She is in hyperosmolar coma requiring aggressive fluid rehydratio...
30 yo obese female with hirsutism, irregular menses, LH/FSH 2:1, TSH/Prolactin nl; what else would be expected:  ACANTHOSI...
58 yo female diagnosed with osteoporosis by DEXA with t-score -3 SD with increased PTH and nl serum calcium, 24h urine cal...
Complication of RA:  Splenomegaly
Patient with pain/redness of both ears, arthritis of hands and knees, b/l conjunctivitis, and diastolic decrescendo murmur...
49 yo female with Raynaud’s and pains in both hands/wrists, dysphagia, sclerodactyly, ANA 1:160, anticentromere antibodies...
Lymphoma + stocking glove purpura + arthralgias + Raynaud’s + glomerulonephritis; most likely has:  MCTD – what lab is dia...
#1 cause of death in SLE is  INFECTION
negative birefringent crystals  GOUT
36 yo male from upper Midwest presents with rash + Bell’s palsy + photophobia + headache and 4 months later heart block:  ...
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Board review

  1. 1. MALT lymphoma is associated with H. pylori infection
  2. 2. Celiac disease dx with IgA anti-endomysial antibodies
  3. 3. Celiac disease assoc with dermatitis herpetiformis
  4. 4. Pt with ascitis develops sudden onset fevers, chills, and generalized abd pain Paracentesis to r/o spontaneous bacterial peritonitis
  5. 5. Pts with late compliment deficiencies are prone to Gonococcal infections.
  6. 6. Herpes simplex virus CNS infection will see Temporal lobe lesions with mass effect/edema. Start acyclovir ASAP
  7. 7. m/c inherited bleeding disorder, associated with bleeding symptoms from nose or gingival. Factor V Leiden
  8. 8. 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.
  9. 9. 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
  10. 10. What is associated with severe phosphatemia (<1.0)? Vitamin D deficiency
  11. 11. 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
  12. 12. 45 yo female with nl BUN/Cr, sodium 120 with urine sodium 40 and urine osm 240 Psychogenic Polydypsia
  13. 13. Dirty brown casts are characteristic of acute tubular necrosis
  14. 14. 44 yo male with psych history found comatose with anion gap and calcium oxalate crystals in UA, diagnosis is Ethylene glycol intoxication.
  15. 15. 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
  16. 16. What drug may cause hyperkalemia by decreased renal tubular secretion of potassium? Bactrim (I don’ t think this is right)
  17. 17. 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
  18. 18. 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
  19. 19. 28 yo WM with hematuria, proteinuria, nephritic syndrome, b/l cataracts, high frequency hearing loss = Alport’s Syndrome
  20. 20. 48 yo alcoholic has sodium 105 what is initial tx: 10 gram Regular Diet
  21. 21. 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
  22. 22. 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
  23. 23. 36 yo male with creatinine of 3.0 has a GFR of ~24, STAGE? Stage 4 CKD.
  24. 24. 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
  25. 25. 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.
  26. 26. What can cause decreased anion gap Hypoalbuminemia Increased immunoglobulins ( MYELOMA , gammopathies) Increased unmeasured cations (hyperkalemia, hypercalcemia, hypermagnesemia) Lithium therapy
  27. 27. 40 yo WF with ARF, sinus infection, pulmonary infiltrate, conjunctivitis, hemoptysis, positive c-ANCA; most likely dx: Wegener’s
  28. 28. What factor places patient at greatest risk to develop osteoporosis: Long-term corticosteroids
  29. 29. Patient presenting with headache, nausea, vomiting, hypotension, blurred vision, diplopia, impaired consciousness; most likely has: Pituitary apoplexy – know diagnosis/treatment
  30. 30. Schmidt’s syndrome : consists of Adrenal insufficiency, gonadal failure, hypoparathyroidism, lymphocytic thyroiditis and Diabetes
  31. 31. Solitary thyroid nodule most likely malignant if: Serum thyroglobulin (papillary or follicular) or calcitonin (medullary) elevated
  32. 32. What diagnostic test would prove self-induced hyperthyroidism? Thyroglobulin level low
  33. 33. 46 yo hypertensive male with acute nephrolithiasis and h/o PUD and constipation; nephrolithiasis most likely d/t: HYPERPARATHYROIDISM
  34. 34. Goal of LDL-C in patients with CKD stage IV is < 100.
  35. 35. 18-hydroxysteroid measurements and postural stimulation used to differentiate A ldosterone deficiencies
  36. 36. Subacute granulomatous (DeQuerveins) thyroiditis is characterized by: DECREASED UPTAKE OF IODINE
  37. 37. What causes low total T4 PREGNANCY OR INCREASED THYROGLOBULIN Craniopharyngioma Empty sella syndrome Metastases to the pituitary Pituitary irradiation Pituitary tumor Post cranial irradiation Post surgery Sheehan's syndrome
  38. 38. 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
  39. 39. MEN IIa: Pheochromocytoma, medullary thyroid carcinoma, and parathyroid hyperplasia
  40. 40. Patient with easily palpable 1.5 cm thyroid nodule; what is best next approach? Fine needle aspiration
  41. 41. 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
  42. 42. 34 yo WM with hypercalcemia on routine physical exam, calcium 11, urinary calcium <200/24h; patient most likely has: Familial Hypocalciuric Hypercalcemia
  43. 43. 76 yo female obtunded with glucose 1200 and sodium 126: She is in hyperosmolar coma requiring aggressive fluid rehydration with normal saline
  44. 44. 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
  45. 45. 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
  46. 46. Complication of RA: Splenomegaly
  47. 47. Patient with pain/redness of both ears, arthritis of hands and knees, b/l conjunctivitis, and diastolic decrescendo murmur has: Relapsing Polychondritis
  48. 48. 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
  49. 49. Lymphoma + stocking glove purpura + arthralgias + Raynaud’s + glomerulonephritis; most likely has: MCTD – what lab is diagnostic ANTI-RNP
  50. 50. #1 cause of death in SLE is INFECTION
  51. 51. negative birefringent crystals GOUT
  52. 52. 36 yo male from upper Midwest presents with rash + Bell’s palsy + photophobia + headache and 4 months later heart block: Lyme disease

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