Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

IM Uworld > 5 > Flashcards

5 Flashcards

1
Q

HTN, tachy, cardiac arrhythmias, high fever, tremor, AMS, lid lag, think ?

A

thyroid storm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

isolated, symmetric LE symptoms including loss of sensation and UMN dysfunction (weakness, hyperreflexia, extensor plantar response) consider?

A

spinal cord compression, UMN presents distal to lesion

medical emergency, requires spinal MRI for diagnosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

acute Lyme presents with

A

erythema migraines, headache, arthralgias, myalgias

late disseminated disease: mos-yrs: subacute encephalopathy (men/encep) and axonal polyneuropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

von Willebrand will present with what derangements

A

prolonged bleeding time and aPTT

normal platelet counts typically

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Bernard-Soulier is due to absent ?

A

platelet glycoprotein 1b-IX-V (receptro for vW factor)

AR disease, mild thrombocytopenia, “big suckers”, platelet dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

recurrent episodes of UNILATERAL hearing loss and tinnitus with feeling of fullness in ear

A

Meniere

increased volume and pressure of endolymph due to defective resorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Meniere tx

A

restrict sodium, caffiene, nicotine, etOH
can use benzos, antihistamines, antiemetics for acute symptoms
diuretics for long-term management

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

when to give meningococcal vaccine

A

age 11-12, booster recommended at 16

esp. important for asplenia, complement deficiency, military recruits, college students, travelers to sub-Saharan Africa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

avoid live attenuated vaccines for

A 
allergy to eggs, AIDS with CD4 less than 200, immunodeficiencies (thymus related), recent stem cell transplant
immunosuppressive agents (anti-TNFs, systemic cortsteroids as in Crohns)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

arterial ulcers vs diabetic ulcers

A

arterial insufficiency ulcers will be at the tips of toes + other signs of arterial insufficiency (diminished pulses)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

causes of constrictive pericarditis

A

idiopathic/viral
cardiac surgery
radiation
TB in endemic areas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

hemorrhagic bullae, necrotizing fasciitis with signs of septic shock, think what organism?

A

Vibrio vulnificus
acquired through ingesting oysters or wound contamination in sea water or seafood handling
liver diz and hemochromatosis pts are at higher risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

pt presents with muscle weakness, arrhythmias after being treated for asthma exacerbation, think?

A

B-agonist (albuterol)-induced hypokalemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

hypoglycemia FOLLOWING meals in an insulin-dependent diabetic, consider

A

gastroparesis

tx: prokinetics (metoclopramide, erythromycin, cisapride)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

loss of peripheral vision and cupping of the optic disc, think ?

A

primary open angle glaucoma

more common in African Americans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

loss of central vision

A

macular degeneration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

poor night vision, floaters

A

diabetic retinopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

transient vision loss with changes in head position consider ?

A

papilledema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

b/l LE muscle weakness and diminished pain/temp (proprioception, vibratory sensation, light touch unaffected)

A

anterior cord syndrome (trauma to ASA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

decreaed sensation and motor function in arms with relative sparing of legs +/- bladder dysfunction

A

central cord syndrome

seen in whiplash injuries and underlying cervical spondylotic myelopathy

21
Q

myasthenia gravis may be precipitated by ?

A

infection, surgery, pregnancy, medications (FQs)

22
Q

tx for restless leg

A

iron for iron deficiency, dopamine agonists (pramipexole) alpha-2-delta calcium channel ligands (gabapentin)

23
Q

HIV screening involves ?

A

HIV p24 antigen and antibody testing

gonorrhea not recommended in men as they will have significant symptoms

24
Q

if lesion appears very different from others, or it itches, bleeds or develops new nodularity, suspect ?
what to do next ?

A

melanoma

excisional biopsy with 1-3mm margins

25
Q

tx of actinic keratosis

A

cryotherapy or topical fluorouracil

26
Q

unilateral vision loss, proptosis, esotropia, optic disc pallor with cafe-au-lair macules think ?

A

optic pathway glioma seen in NF1

27
Q

scabies tx

A

topical permethrin or oral ivermectin

28
Q

painless, rapid, transient “curtain descending” over visual field, think ?
how to dx?

A

amaurosis fugax
duplex US of neck as most commonly caused by retinal ischemia due to atherosclerotic emboli from ipsilateral carotid artery

29
Q

what to do in 1st 24 hrs after caustic ingestion

A

endoscopy to evaulate severity of damage and to guide therapy

30
Q

posterior knee/calf pain with arc of ecchymosis distal to medial malleolus (crescent sign) think?

A 
ruptured popliteal (Baker) cyst
US can r/o DVT and confirm popliteal cyst
31
Q

in acute glaucoma, avoid agents that cause ? such as ?

A

mydriatic (dilating) agents like atropine

32
Q

refeeding syndrome manifests as ?

how to tx

A

edema, heart failure, seizures
may be associated with thiamine deficiency
tx with IV phosphate

33
Q

supplemental O2 in COPD pts can worsen ? due to ?

A

hypercapnia due to increased dead space perfusion causing V/Q mismatch, decreased affinity of oxyhemoglobin for CO2 and reduced alveolar ventilation
goal oxyhgb sat: 90-93%

34
Q

progressive proximal muscle weakness and atrophy WITHOUT pain/tenderness, think ?

A

steroid-induced myopathy
may be associated with weight gain, bone loss, hypertension, hirsutism (Cushing)
most commonly from exogenous steroids
cortisol has direct catabolic effects on skeletal muscles–>atrophy

35
Q

eye exam reveals micro aneurysms, dot/blot hemorrhages, hard exudates, macular edema, think ?

A

(diabetic) retinopathy
this presentation is background/simple retinopathy
pre-proliferative: cotton wool spots
proliferative: new vessels

36
Q

tx for DM retinopathy

A

argon laser photocoagulation

37
Q

macular degeneration presentation and eye exam

A

affects central vision, distorted vision, central scotoma
atrophic: sores in the macula
exudative: new blood vessels that may leak/bleed/scar the retina
smoking increases the risk

38
Q

Who should get a statin?

A

clinically significant athersclerotic disease (ACS, MI, angina, revascularization, CVA, TIA, PAD)
LDL 190+
all diabetics age 40-75
estimated 10-yr ASCVD risk 7.5%+

39
Q

low testosterone and low/normal LH/FSH, think ?

A

secondary (central) hypogonadism; as LH/FSH should be increased when testosterone is low so it is a hypothalamic/pituitary problem (not gonadal)
i.e. from mass lesions, hyperprolactinemia (suppresses GnRH), steroid/opiate use, severe systemic illness

40
Q

what does use dependence refer to in the context of cardiac medications

A 
enhanced effects of a drug during faster HR
Class IC (i.e. Flecainide): decrease impulse conduction with faster HR-->^QRS duration
Class IV (CCBs: verapimil, diltiazem): prolong refractory period of the AV node-->^PR interval
B-blockers also increase the refractory period of the AV node, do not display use dependence
41
Q

well-circumscribed verrucous nodules and plaques that progress to microabscess, think what fungus?

A

blastomycosis

42
Q

why is a MM pt is at increased risk of infection?

A

BM infiltration by neoplastic cells alters normal lymphocyte population–>ineffective Ab production, hypogammaglobulinemia–>respiratory infections and UTIs

43
Q

secondary hyperparathyroidism:

vitamin D deficiency vs CKD

A

vitamin D deficiency: low/normal phosphate, normal Ca2+ (dx by measuring 25, OH-vitamin D)
CKD: ^phosphate, low Ca2+, low 1,25-OH vit D; magnitude of PTH^ corresponds to renal failure

44
Q

who should get tamiflu (oseltamivir)?

A

65+, pregnant, chronic medical problems

OR consider if present less than 48 hrs of onset, may shorten duration of illness

45
Q

common organs affected in GVHD

A

skin (rash), intestine (blood+ diarrhea), liver (LFT abnormal, jaundice)
donor T cells against host HLA antigens (CMI)

46
Q

most beneficial therapy to reduce progression of DM nephropathy

A

strict BP control: less than 130/80

47
Q

levels in Paget disease of bone

A

^alk phos, ^bone turnover markers: urine hydroxyproline, procollagen type 1 N propeptide (PINP)
Ca2+ and phosphorus typically NORMAL unless underlying condition

48
Q

most common valvular abnormality in infective endocarditis

A

mitral regurgitation (rarely stenosis) “MAT”
aortic stenosis 2nd (rarely regurg)
tricuspid regurg 3rd (IVDU)

49
Q

GBS precipitants besides campy

A

herpes viruses, mycoplasma, H. flu

more common in pts with lymphoma, sarcoid, SLE, recent HIV, immunization

IM Uworld (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions