Amboss Internal Medicine Questions

1. The most likely cause of an isolated oculomotor nerve palsy in a patient with
uncontrolled diabetes mellitus is diabetic mononeuropathy, which occurs as a result of
microangiopathic ischemia.
a. Ptosis occurs in patients with oculomotor nerve palsy levator palpebrae
superioris is innervated by the oculomotor nerve.
2. In obstructive sleep apnea (daytime sleepiness) in an obese patient, hypoxia triggers
EPO secretion and increased production of RBCs’ resulting in a characteristics red
discoloration of face (plethora).
3. Alzheimer’s neuroimaging – occurs in individuals >65 yrs of age, atrophy of the cortex.
Early (new memory loss) and progressive memory loss, and then personality changes.
Narrowing of the gyri and widening of the sulci.

4. Colles fractures – extension fracture of the distal radius. Complications of colles fracture
– fracture median nerve injury, compartment syndrome, and malunion or nonunion.
Treatment : closed reduction – conservative therapy,
severe: unstable, intraarticular, or open fractures –
surgical therapy.

5. Galeazzi fracture
a. Distal third radius fracture
b. Distal ulnar head dislocation
c. Fracture of the first metacarpal bone
6. Squamous cell carcinoma – white male, smoker, oral ulcers located in bottom lip,
outside worker. (keratin pearls)
7. Beta-2-agonist (terbutaline)  hypokalemia  stimulating Na+/K+ ATPase pump 
shifts potassium into the cell  causes hypokalemia. Clinical manifestations of
hypokalemia are fatigue, proximal muscle weakness, and decreased deep tendon
reflexes.
8.