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PAEA Internal Medicine EOR questions and answers rated A+ 2024/2025
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PAEA Internal Medicine EOR questions and answers rated A+ 2024/2025
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PAEA Internal Medicine EORBell's Palsy - ANScauses cranial nerve 7 disorder
S/S of Bell's Palsy - ANSHas brow involvement (while a stroke does now not have an effect on
forehead motion), facial weak point, inability to keep one eye closed
Treatment for Bell's palsy - ANSPrednisone 60mg x five days, Valcyclovir 1000mg TID x 7 days,
synthetic tears, lacri lube at night time
When can I use tPA? - ANSischemic stroke providing inside <3 hrs and CT head negative
How do you treat high BP with stroke? - ANSNitroprusside (short half life, easy to titrate) or IV
labetalol
What do you use for anticoagulation/antiplatelet therapy in stroke? - ANSASA (not in
hemorrhagic), heparin for thrombosis
What do you do differently to treat hemorrhagic stroke? - ANSGive prophylactic anticonvulsant
like phenytoin because of increased seizure risk, antiplatelet therapy contraindicated
Types of Hemorrhagic Stroke - ANS1. Intracerebral (10%): results from rupture of small
arterioles
2. Subarachnoid (3%): rupture of arterial aneurysms (hemorrhage into subarachnoid space)
Causes of Intracerebral hemorrhagic stroke are what? - ANSHTN, amyloidosis, iatrogenic
anticoagulation, vascular malformations, cocaine use
Causes of Subarachnoid hemorrhagic stroke are what? - ANSberry aneurysm rupture, vascular
malformation rupture
Signs and symptoms of Intracerebral hemorrhagic stroke are what? - ANSICP rises,
vasoconstriction-sweating
Signs and symptoms of Subarachnoid hemorrhagic stroke are what? - ANSmay be preceded by
warning headache, neck/back pain, "worst headache of my life," thunderclap, may have loss of
consciousness
Treatment of Subarachnoid hemorrhage - ANSsurgery, control hypertension, analgesics
What is Complex regional pain syndrome (CRPS) - ANSChronic arm or leg pain developing
after injury, surgery, stroke, or heart attack.
,Signs and symptoms of complex regional pain syndrome are what? - ANSPain out of proportion
to injury. ANS sx: swelling, extremity color changes, increased nail and hair growth.
Treatment for complex regional pain syndrome - ANSAmitriptyline, nortriptyline, gabapentin,
pregabalin, lamotrigine; NSAIDs; Calcitonin to reduce pain as adjunctive therapy;
Bisphosphonates, IVIG, regional nerve blocks, dorsal column stimulation
Vit C prophylaxis after fx
Imaging modality used to diagnose Subarachnoid Hemorrhage? - ANSCT without contrast. If
CT negative but still suspect SAH, do LP to look for RBC or xanthochromia (will not develop
until 12hrs after onset)
Delirium - ANStransient disorder characterized by impaired attention, perception, memory and
cognition. Sleep wake cycles interrupted ("sundowning"). Reduced alertness, activity levels
change rapidly.
Treatment of Delirium - ANStreat underlying cause, Haloperidol 5-10mg for agitation,
Lorazepam 0.5-2 mg
Dementia - ANSLoss of mental capacity. Psychosocial level and cognitive abilities deteriorate
and behavioral problems develop. Largest categories are Alzheimer dz and vascular dementia.
Hallucinations, delusion, depression, repetitive behavior are common.
Treatment of Dementia - ANSAntipsychotics to manage psychosis
Essential tremor does not occur at rest, occurs bilaterally, and has no indication of other neuro
signs. How do you treat essential tremor? - ANSPropranolol, Primidone (can combine these 2 if
needed)
Guillian Barre Syndrome - ANSIdiopathic polyneuropathy often following minor infections,
immunizations or surgical procedures. Most times no cause is identified.
How long does Guillian Barre Syndrome last? - ANSworst at 2-4 weeks after onset, plateaus
next 2-4 weeks, remits weeks-moats
Signs and symptoms of Guillian Barre Syndrome - ANSascending symmetric weakness and
loss of DTR's, proximal muscles affected more than distal. Sensory abnormalities, pain,
tachycardia, sweating, impaired pulmonary function, paralytic ileus
How do you diagnose Guillian Barre? - ANSno fever at onset, CSF protein >45 and coffee
WBC, MRI suggests selective enhancement of anterior spinal nerve roots
,Treatment of Guillian Barre Syndrome - ANSIVIG or plasmapheresis, may also want intubation.
Hospitalized pt with close tracking. Recovery is sluggish but about 60% make complete
recuperation inside 1 yr.
What ailment is a systemic inflammatory situation of medium and massive vessels affecting
people over 50 years vintage, coexists with polymyalgia rheumatica and might cause blindness
if now not treated correctly? - ANSGiant cellular arteritis
Signs and symptoms of Giant Cell Arteritis - ANSheadache, scalp tenderness, jaw claudication,
throat pain, diplopia
Symptoms of polymyalgia rheumatica: pain of shoulder/pelvis
Giant Cell Arteritis Treatment - ANSSteroids right now, do now not watch for biopsy results. Give
low dose aspirin too.
Describe a Migraine Headache? - ANSunilateral vicinity, pulsatile nice, slight to severe intensity,
irritated by way of movement, nausea, vomiting, photophobia, phonophobia
lasting 4-seventy two hours
Migraine remedy - ANSNSAIDs, Triptans, antiemetics
What is a Cluster Headache? - ANSsevere, unilateral headache localized to periorbital/temporal
area followed by way of lacrimation, rhinorrhea, ptosis, myosis, nasal congestion, eyelid edema
-Occurs in clusters which means 1-eight daily assaults lasting 15-ninety mins for four-6 weeks...
Followed by means of pain unfastened c programming language 3-6 months
Cluster headache treatment - ANSOxygen, Sumatriptan 6mg SQ, begin preventive remedy as
quickly as headache onset to suppress attacks over expected length of cluster duration
Preventive therapies for cluster headache lasting extra than 2 months - ANSVerapamil
240-960mg given in 3 every day doses
What is a Tension Headache? - ANSmild to moderate depth, positioned bilateral-frontal regions,
stupid band like ache, lasting for hours, associated with stress. No nausea, vomiting, neuro
deficits.
Tension HA treatment - ANSNSAIDs or ASA combined with caffeine. APAP much less effective
however favored in being pregnant. 2nd line treatment plans are antidepressants (amitriptyline)
Huntington Disease - ANSinherited disorder, develops after 30 years antique, modern chorea
and dementia, commonly deadly inside 15-twenty years
Signs and symptoms of Huntington Disease - ANSmental modifications, stressed, dystonic
posturing, intense choreiform moves
, Empiric treatment for bacterial meningitis - ANSCeftriaxone 2g IV and Vancomycin =/-
Acyclovifr, Dexamethasone 10 mg IV; spupportive care
Bacterial meningitis establishing strain of LP - ANS>300mm
Viral meningitis establishing stress of LP - ANS<300mm
Bacterial and Viral meningitis WBC in CSF from lumbar puncture - ANSBacterial: >1000
Viral: <one thousand
Bacterial and Viral meningitis glucose in CSF from lumbar puncture - ANSBacterial: <40
Viral: >40
Bacterial and Viral meningitis protein in CSF from lumbar puncture - ANSBacterial: >two
hundred
Viral: <200
What is Myasthenia gravis? - ANSinvolves muscle weakness and fatigue improves with
relaxation. Common in young girls and old guys.
Signs and signs and symptoms of Myasthenia gravis? - ANSptosis, diplopia, issue chewing,
limb weak point, respiration difficulties
Parkinson's Disease - ANSnerve cellular damage in brain reasons dopamine degrees to drop
leading to sings and signs
Essential functions of Parkinson's Disease - ANSresting tremor, bradykinesia, stress, postural
instability
Treatment for Parkinson's Disease - ANSMainstay of tx are Levodopa and Carbidopa (whilst
using collectively can reduce Levodopa to reduce AE)
Convulsive (grand-mal or tonic-clonic) seizures - ANSassociated with postictal obtundation and
confusion lasting mins to hours. Tonic-clonic muscle contractions of all extremities, LOC,
incontinence, flaccid/unconscious after assault
Non-Convulsive (absence) seizures - ANSAssociated wtih most effective minor motor interest
inclusive of blinking or facial twitching. Begin in childhood typically subsiding before maturity.
Signs and signs and symptoms of non-convulsive (absence) seizures - ANSbrief, frequently
unnoticeable, episodes of impaired cognizance lasting seconds happening up to 100 instances
in step with day. Present as staring spells.
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