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Medical Knowledge & Clinical Science Flashcards

7 cards from real ECFMG practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 7 Medical Knowledge & Clinical Science flashcards as text

  1. A 68-year-old man with COPD has PaO2 55 mmHg and PaCO2 58 mmHg on ABG. What is the primary acid-base disorder?

    Answer: Respiratory acidosis with metabolic compensation

    Chronic CO2 retention (respiratory acidosis) in COPD is accompanied by renal bicarbonate retention (metabolic compensation), reflected by an elevated serum HCO3.

  2. A 30-year-old woman is found unconscious. ABG: pH 7.24, PaCO2 20 mmHg, HCO3 8 mEq/L. Serum glucose is 540 mg/dL with ketonuria. What drives the respiratory response?

    Answer: Kussmaul breathing as compensation for metabolic acidosis

    Kussmaul breathing (deep, rapid respirations) is the compensatory hyperventilation that reduces PaCO2 in response to severe metabolic acidosis in DKA.

  3. A 55-year-old woman presents with a palpable thyroid nodule. Fine needle aspiration shows follicular neoplasm. What is the NEXT best step?

    Answer: Thyroidectomy or hemithyroidectomy

    Follicular neoplasm on FNA cannot distinguish adenoma from carcinoma cytologically; surgical excision is required for definitive diagnosis.

  4. A 4-year-old boy presents with periorbital edema, proteinuria of 4 g/day, hypoalbuminemia, and hyperlipidemia. Kidney biopsy shows effacement of foot processes on electron microscopy. What is the treatment of choice?

    Answer: Prednisone

    Minimal change disease (nephrotic syndrome in children with foot process effacement) responds to corticosteroids as first-line therapy in over 90% of cases.

  5. A 45-year-old woman develops proximal muscle weakness, heliotrope rash around the eyes, and Gottron's papules over the knuckles. Which malignancy is MOST commonly associated with this condition in adults?

    Answer: Ovarian cancer

    Dermatomyositis in adult women is most commonly associated with ovarian cancer, making gynecologic malignancy screening essential.

  6. A patient takes warfarin and is started on fluconazole. His INR rises to 6.5 without bleeding. What is the mechanism of this drug interaction?

    Answer: CYP2C9 inhibition reducing warfarin metabolism

    Fluconazole inhibits CYP2C9, the primary enzyme metabolizing the more potent S-warfarin enantiomer, leading to elevated warfarin levels and INR.

  7. A 72-year-old man with a history of atrial fibrillation on warfarin suddenly develops left hemiplegia and right gaze deviation. CT head is negative. What is the NEXT most appropriate step?

    Answer: Check INR before deciding on thrombolysis

    In patients on warfarin, INR must be checked before thrombolytics because an INR >1.7 is a contraindication to IV tPA.