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Uworld > 11.14 > Flashcards

11.14 Flashcards

1
Q

obese, 10-16, limp, chronic pain, waddling gait

weakening of femoral physis = anterior displacement of proximal femoral diaphysis w/ posterior slippage of femoral head

A

SCFE

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2
Q

screening 6 weeks post partum

A

edinburgh postnatal depressoin scale

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3
Q

decreased lung aeration
flattened facies
limb deformities
pulmonary hypoplasia

A

oligohydramnios leads to Potter sequences = any condition ass w/ inadequate amniotic fluid levels (urinary tract obstruct, renal agenesis, polycystic kidney disease, preterm rupture of membraneses)

abdominal distension + suprapubic mass = bladder distension resulting from obstruction

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4
Q

cervix <2.5cm at <24 weeks

prior preterm labor + <2.5 cm

A

vaginal progesterone

if prior preterm delivery: prophylactic cerclage

if prior preterm labor = IM 17 hydroxyprogesterone

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5
Q

MTC = medullary thyroid cancer

A

neuroendocrine malignancy from calcitonin parafollicular C cells = high serum calcitonin = increased risk of recurrence

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6
Q

acute heart failure + cardiogenic shock after ductus arteriosus closes

A

aortic coarctation

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7
Q

parallel circuits of systemic and pulmonary blood flow

A

TGA

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8
Q

what type of hypoxemia does not correct w/ supplemental oxygen

A

large IP shunt, large dead space ventilation

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9
Q

lightly brushing the skin to the right of th eumbilicis elicits pain

A

= VZV

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10
Q

tx for splenic abcess

A

abx + splenectomy bc most pts fail percutaneous aspiration

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11
Q

> 20mmhg difference in SBP between arms + sharp, severe tearing chest or back pain

A

acute aortic dissection

EKG normal or nonspecific ST/T wave changes

T: morphine, BBs, nitroprusside is SBP<120, emergent surgial repair if ascending

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12
Q

how to tx aortic dissection

A

if it causes: syncope stroke MI heart failure = surgical repair (means that it involves ascending aorta)

high mortality rate in absence of immediate surgical intervention

otherwise morphine, BB, nitroprusside if only if hypertension

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13
Q

dystonia
akathisia
parkinsonism
tardive dyskinesia

A

benztropine for the first three
benazines for the last one
benadryl good enough for the first one
xanax * propanalol okay for the second one

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14
Q

COPD causes dead space leading to V/Q mismatch and hypoxia/hypercapnia –> redirection of blood flow to better ventilated alveoli. What happens with o2 administration?

A

worsens hypercapnia because there is less redirection of blood flow so V/Q mismatch goes up, and the affinity of oxyhemoglobin for CO2 goes down and so does alveolar ventilation

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15
Q

Effect of hypercapnia

A

cerebral vasodilation = seizures

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16
Q

ureteral filling + dilated collecting system of cystourethrogram

A

VUR - leads to renal scar formation

tx w/ abx severity + maybe surgical correction

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17
Q

normal lipid panel

A

Total Cholesterol200mg/dL
TG 150
LDL Less than 100mg/dL
HDL 40mg/dL or higher

18
Q

DM management
if urine albumin/Cr ratio is <30, then add? Or if >130/80, add?
Lisinopril/arb

if >10 % stroke risk, add daily aspirin

A 
hgb a1c q3mo
annual alb/Cr ratio
regular screening/lipid panel
eye exam 1-3 years
annual foot exam
19
Q

ventricular enlargement + increase in intensity in the white matter diffusely

motor deficits (focal arm/leg weakness or hemiparesis, ataxia, vision abnormalities) + well delineating asymmetric lesions

A

HIV dementia

PML

20
Q

can’t fix low potassium

A

hypomagnesemia

21
Q

what drugs cause SIADH

A

carbamazepien SSRIs NSAIDs
pneumonia
Small cell lung cancer

22
Q

you see Na less than 135, then what?

A

edema, JVD = diurese
dry MM = saline
euvolemic = fluid restriction

23
Q

urine Na<20 =

Na>40 =

A

hypovolemia, bc if sodium is <20 then you are holding onto salt

SIADH, bc urine is concentrated due to ADH causing less water in pee

24
Q

LV systolic dysfunction leading to CHF

A

decreased CO/index
increased SVR
increase in LVEDV

25
Q

heparin induced thrombocytopenia

A

heparin exposre>5 days +

drop in platelets by 50%
arterial thrombosis
necrotic skin lesions at injection site
anaphylactoid rxn after heparin

serotonin release assay

26
Q

causes of thrombocytopenia in pregnancy

1) elevated AST/ALT: either A) AFLP if extremely high >1000 B) HELLP if hemolytic anemia C) Pre-ec w/ severe features if no hemolysis but HTN
2) chest pain, PE, leg pain = HIT
3) fever, weakness = TTP

A 
AFLP = low platelets + RUQ pain
HELLP = thrombocytopenia
27
Q

Vitamin K deficiency

A

increases PTT & PT

first give FFP acutely if bleeeding otherwise vitamin K in 10 hours

28
Q

damage to one eye after penetrating injury to the other eye

A

recognition of hidden antigens

29
Q

when does FH of breast cancer matter

A

if it is in first degree relative

30
Q

Rh negative mothers develop anti-D abs in prior pregnancy resulting in attack on Rh positive RBCs

A

fetal hydrops

31
Q

Tx for mucopurulent eye discharge >5 days post birth?

<5 days prior to birth?

A

> 5 days = chlamydia = PO azithromycin

<5 days = gonorrhea = IM CTX

32
Q

pale limb w/ inability to feel

A

comparmtnet syndrome

pulseless, paralysis, paresthesia, pain, pallor

33
Q

BL acidemic acid base status to mildly alkalemic acid base status

A

if high bicarb, and low potassium, consider contraction alkalosis

34
Q

irritable infant in the first few days of life = w/ sweating vomiting diarrhea high pitched cry

A

neonatal abstinence syndrome

35
Q

fetal hydantoin syndrome

A

nail digit hypoplasia intellectually disables due to phenytoin

36
Q

how to tx psychosis

A

1) second generation antipsychotics (short acting, then long acting only if med nonadherent): olanzapine, risperiodone, ariprazole
2) first generation antipsychotics = haloperidol
3) adjunctive xanax for agitation

37
Q

appendiceal signs w/ longer course to presenting sx

A

appendiceal abscess

percutaneous drainage w/ interval appy

38
Q

nonclassic CAH

A

hyperandrogenism + elevated 17 hydroxyprogesterone levels

partial deficiency in 21 hydroxylase

hyperandrogenism

39
Q

difference between virilization + hirsutism?

A

virilization = clitoromegaly, deepening of voice

40
Q

what causes virlization

A

androgen producing adrenal tumor = progressive hirsutism + virilization w/ high DHEAS

Uworld (6 decks)

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