Clinical Medicine - Internal Medicine Flashcards

A patient with chronic kidney disease has a serum potassium of 6.8 mEq/L and peaked T waves on EKG. First-line immediate treatment is:

Answer: IV calcium gluconate

IV calcium gluconate immediately stabilizes the cardiac membrane in hyperkalemia, preventing arrhythmia, though it does not lower potassium levels.

Which finding on pulmonary function tests is characteristic of obstructive lung disease such as COPD?

Answer: Reduced FEV1/FVC ratio (<0.70)

Obstructive disease (COPD, asthma) is defined by an FEV1/FVC ratio <0.70, reflecting air trapping and increased expiratory resistance.

The most common cause of community-acquired pneumonia (CAP) in otherwise healthy adults is:

Answer: Streptococcus pneumoniae

Streptococcus pneumoniae remains the most common bacterial cause of CAP in adults across all age groups and severity levels.

A patient presents with symmetric proximal muscle weakness, elevated CK, and Gottron's papules. The diagnosis is:

Answer: Dermatomyositis

Dermatomyositis presents with proximal muscle weakness, elevated CK, and pathognomonic skin findings including Gottron's papules (knuckles) and heliotrope rash.

In the diagnosis of systemic lupus erythematosus (SLE), which antibody is most specific (though not most sensitive)?

Answer: Anti-Sm

Anti-Smith (anti-Sm) antibody is highly specific for SLE (~99% specific) though present in only ~25% of patients; ANA is most sensitive.

Which complication of cirrhosis involves bacterial translocation causing spontaneous infection of ascitic fluid?

Answer: Spontaneous bacterial peritonitis (SBP)

SBP occurs when gut bacteria translocate into ascitic fluid; diagnosed by PMN count >250 cells/mm³ in ascites; treated with cefotaxime.