2nd Uworld assessment Flashcards
What problem related to lactation?
subareolar, mobile, well circumscribed , nontender, SOFT mass; no fever. typically occurs a few weeks to months after cessation of breastfeeding
Galactocele
Size of galactocele
up to 5 cm in size
What problem related to lactation?
small, FIRM, TENDER palpable lump due to inadequate breast drainage. Erythema may be present, but not fever
Plugged duct
Size of a plugged duct mass
2 cm or less
Patients with right sided heart failure (maybe COPD) are preload dependent and require CAREFUL diuresis as what can happen?
Intravascular volume depletion . . . prerenal azotemia
Amenorrhea in Progestin-containing IUD?
Copper?
- typical side effect of Progestin-containing IUD
- A patient with a copper IUD should maintain regular menses
Patients with low-grade fever, RUQ tenderness, N/V, leukocytosis, obstructive appearing liver enzymes after a recently lap chole
Bile leak, one of the most common complications
imaging of a post lap chole bile leak?
normal-appearing biliary ducts or only mild dilation (which can be from the postop state alone)
Retained gallstone would show what on imaging in post lap chole?
significant biliary dilation
Neurologic manifestations of Lyme disease often occur within the first several weeks of infection and may include what?
- lymphocytic meningitis
- Cranial nerve palsies
- and/or radiculoneuritis
- Facial Nerve palsy is particularly common (about 8%)
Describe the facial nerve balsy that can occur in early Lyme disease?
Rapid onset facial weakness that is often bilateral
gene mutation in Rett syndrome
MECP2
Preload in cardiogenic shock?
increased
This is an inflammatory condition involving occluded skin surfaces such as the axillae, groin, inframammary folds, or abdominal folds. It is most commonly due to Candida species.
Intertrigo
The diagnosis of Intertrigo is mainly based on clinical features, but potassium hydroxide prep or fungal culture of skin scraping can confirm the diagnosis if need . . . how will it appear?
-pseudohyphae with budding yeast forms (blastoconidia)
This is a superficial skin infection that also affects intertriginal areas. It is caused by Corynebacterium minutissimum and presents with well-demarcated, thin, red-brown plaques with wrinkling and a fine scale
Erythrasma
Diagnostic “imaging” of Erythrasma
coral-red appearance under wood’s lamp
Tinea cruris presents as annular lesions with partial central clearing and a scaly-raised border. It can be caused by a number of dermatophytes, which appear on KOH prep as what?
septate hyphae
All congenital infections can present in neonatal period with IUGR, Hepatosplenomegaly, jaundice, and blueberry muffin spots . . what is the most common congenital infection?
CMV
Treatment of mild-moderate sunburn
- Topical: cool compresses, calamine lotion, aloe vera
- Oral: NSAIDS
Gout can be triggered by thiazide and loop diuretics due to decreased clearance of urate. What are acute treatment options
- NSAIDS
- Colchicine
- glucocorticoids
What is the preferred treatment for acute gout in patients taking anticoagulants?
Colchicine and glucocorticoids due to the risk of bleeding with NSAIDs
Patient presents with first trimester vaginal bleeding, closed cervix, and a fetus with a normal heart rate on US is consistent with threatened abortion. US can also reveal a subchorionic hematoma, an abnormal collection of blood between the placenta and the uterus. Risk factors for spontaneous abortion include advanced maternal age and a previous spontaneous abortion. Describe the management?
Patients with a threatened abortion frequently have uncomplicated pregnancies with normal outcomes. Therefore, management of a threatened abortion is expectant with outpatient observation
-Serial US can be performed until either the symptoms resolve or there is progression to a complete abortion
Acute liver failure is characterized by what triad?
- Elevated aminotransferases
- Hepatic encephalopathy
- Prolonged prothrombin time with INR > 1.5
- in a patient without underlying liver disease
Uncontrolled HTN is at risk for Hypertensive vasculopathy, the most common cause of spontaneous intracranial hemorrhage. Hypertensive cerebral vascular damage typically occurs near the branch points off of major intracerebral vessels; the basal ganglia is the most common (50%) site of hemorrhage. One potential consequence of basal ganglia hemorrhage is uncal herniation . . describe this and the PE findings?
- Mass effect pushes pare of the temporal lobe (uncus) laterally and downward against the tentorium cerebelli
- this compresses the 3rd cranial nerve and results in a dilated, nonreactive IPSILATERAL pupil
- Further displacement causes midbrain compression with CONTRALATERAL extensor posturing, coma, and respiratory compromise
Hypertensive hemorrhage can occur in the cerebellum and may push the cerebellum through the foramen magnum, resulting in cerebellar tonsillar herniation. Manifestations typically include what?
- neck tilt
- flaccid paralysis
- coma
- blood pressure instability
- respiratory arress
What analgesic has some serotonin activity and can potentially cause serotonin syndrome if used with another serotonergic med
Tramadol
Describe what Hypnagogic and hypnopompic hallucinations and cataplexy associated with narcolepsy are?
- Hypnagogic and hypnopompic hallucinations: Hallucinations that occur as the patient is going to sleep and waking up
- Cataplexy: Considered pathognomonic. sudden muscle weakness in response to intense emotion
pathology of narcolepsy
-decreased REM latency, with patients entering REM sleep within 15 minutes of sleep onset (normal is 90 minutes)
- Poorly controlled asthma with recurrent exacerbations
- severe: recurrent infiltrates, fever, cough productive of brownish sputum and hemoptysis
- Central BRONCHIECTASIS commonly results from a recurrent cycle of inflammation
- peripheral eosinophilia is typically present
Allergic bronchopulmonary aspergillosis
Allergic bronchopulmonary aspergillosis is typically diagnosed how?
skin testing and Aspergillus-specific IgE levels
The most frequent symptom of bronchiectasis is what?
a persistent cough with mucopurulent sputum that may be streaked with blood
-Dyspnea, fatigue, and weight loss are common
pathophysiology of Paget disease of bone
osteoclast dysfunction with disordered bone remodeling
Patients with pancreatitis often have hypocalcemia, possibly due to what?
calcium binding to free fatty acid complexes, calcium saponification, or cellular shifts
Management of Preeclampsia after 37 weeks gestation
- Labor induction for a vaginal delivery is preferred
- C section is indicated for obstetrical indications (eg, failed induction) or for a nonreassuring fetal status
Management of preeclampsia with severe features at < 34 weeks
conservative management with hospital admission and observation
Management for patients with preeclampsia without severe features at < 37 weeks
Outpatient management
This is the most common etiolog of persistent nasal obstruction during childhood. Affected patients have nasal congestion refractory to medical management. Hx may suggest chronic upper airway obstruction (eg, recurrent sinus and ear infections, mouth breathing, sleep disturbances/snoring due to apnea). Mucopurulent nasal discharge, postnasal drip, and elongated/flattened facial features (due to changes in the structure of the palate, jaw, and teeth) may suggest the diagnosis
Adenoid hypertrophy
The tunica albuginea is the fibrous tissue that immediately overlies the testicles and the corpora cavernosa of the penis. In this dz, excess collagen formation within the tunica albuginea can cause painful erections with curvature of the penis
Peyronie disease
Primitive reflexes (eg, rooting, sucking, glabellar) are frontal release signs that are generally more prevalent in what type of dementias?
frontally based like frontotemporal dementia
Vitamin C deficiency (Scurvy) causes impaired collagen synthesis with decreased connective tissue strength. Symptoms include what
- Petechial and perifollicular hemorrhages
- mucosal bleeding
- periodontal disease
Mechanism of Levonorgestrel IUD
- Thickens cervical mucus
- Impairs implantation
Mechanism of Copper IUD
- Cytotoxic endometrial inflammation
- Impairs sperm function
- Impairs implantation