- MALT lymphoma is associated with H. pylori infection. Celiac disease can be diagnosed with IgA anti-endomysial antibodies. Patients with late complement deficiencies are prone to gonococcal infections. - Herpes simplex virus CNS infections will see temporal lobe lesions with mass effect/edema. Ampicillin plus gentamicin is best for treating a 65 yo male with decreased glucose, increased protein and lymphocytosis in spinal fluid along with gram positive bacilli. - Vitamin D deficiency is associated with severe phosphatemia (<1.0). Type I renal tubular acidosis is diagnosed in a 65 yo male with recurrent calcium kidney stones, anion gap of 13, b

1. MALT lymphoma is associated with H. pylori infection

2. Celiac disease dx with IgA anti-endomysial antibodies

3. Celiac disease assoc with dermatitis herpetiformis

4. Pt with ascitis develops sudden onset fevers, chills, and generalized abd pain Paracentesis to r/o spontaneous bacterial peritonitis

5. Pts with late compliment deficiencies are prone to Gonococcal infections.

6. Herpes simplex virus CNS infection will see Temporal lobe lesions with mass effect/edema. Start acyclovir ASAP

7. m/c inherited bleeding disorder, associated with bleeding symptoms from nose or gingival. Factor V Leiden

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. 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. What is associated with severe phosphatemia (<1.0)? Vitamin D deficiency

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. 45 yo female with nl BUN/Cr, sodium 120 with urine sodium 40 and urine osm 240 Psychogenic Polydypsia

13. Dirty brown casts are characteristic of acute tubular necrosis

14. 44 yo male with psych history found comatose with anion gap and calcium oxalate crystals in UA, diagnosis is Ethylene glycol intoxication.

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. What drug may cause hyperkalemia by decreased renal tubular secretion of potassium? Bactrim (I don’ t think this is right)

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. 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. 28 yo WM with hematuria, proteinuria, nephritic syndrome, b/l cataracts, high frequency hearing loss = Alport’s Syndrome

20. 48 yo alcoholic has sodium 105 what is initial tx: 10 gram Regular Diet

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. 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. 36 yo male with creatinine of 3.0 has a GFR of ~24, STAGE? Stage 4 CKD.

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. 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. What can cause decreased anion gap Hypoalbuminemia Increased immunoglobulins ( MYELOMA , gammopathies) Increased unmeasured cations (hyperkalemia, hypercalcemia, hypermagnesemia) Lithium therapy

27. 40 yo WF with ARF, sinus infection, pulmonary infiltrate, conjunctivitis, hemoptysis, positive c-ANCA; most likely dx: Wegener’s

28. What factor places patient at greatest risk to develop osteoporosis: Long-term corticosteroids

29. Patient presenting with headache, nausea, vomiting, hypotension, blurred vision, diplopia, impaired consciousness; most likely has: Pituitary apoplexy – know diagnosis/treatment

30. Schmidt’s syndrome : consists of Adrenal insufficiency, gonadal failure, hypoparathyroidism, lymphocytic thyroiditis and Diabetes

31. Solitary thyroid nodule most likely malignant if: Serum thyroglobulin (papillary or follicular) or calcitonin (medullary) elevated

32. What diagnostic test would prove self-induced hyperthyroidism? Thyroglobulin level low

33. 46 yo hypertensive male with acute nephrolithiasis and h/o PUD and constipation; nephrolithiasis most likely d/t: HYPERPARATHYROIDISM

34. Goal of LDL-C in patients with CKD stage IV is < 100.

35. 18-hydroxysteroid measurements and postural stimulation used to differentiate A ldosterone deficiencies

36. Subacute granulomatous (DeQuerveins) thyroiditis is characterized by: DECREASED UPTAKE OF IODINE

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. 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. MEN IIa: Pheochromocytoma, medullary thyroid carcinoma, and parathyroid hyperplasia

40. Patient with easily palpable 1.5 cm thyroid nodule; what is best next approach? Fine needle aspiration

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. 34 yo WM with hypercalcemia on routine physical exam, calcium 11, urinary calcium <200/24h; patient most likely has: Familial Hypocalciuric Hypercalcemia

43. 76 yo female obtunded with glucose 1200 and sodium 126: She is in hyperosmolar coma requiring aggressive fluid rehydration with normal saline

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. 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. Complication of RA: Splenomegaly

47. Patient with pain/redness of both ears, arthritis of hands and knees, b/l conjunctivitis, and diastolic decrescendo murmur has: Relapsing Polychondritis

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. Lymphoma + stocking glove purpura + arthralgias + Raynaud’s + glomerulonephritis; most likely has: MCTD – what lab is diagnostic ANTI-RNP

50. #1 cause of death in SLE is INFECTION

51. negative birefringent crystals GOUT

52. 36 yo male from upper Midwest presents with rash + Bell’s palsy + photophobia + headache and 4 months later heart block: Lyme disease