Aaron: Uworld IM Deck 2 Flashcards
What drug can help acute heart failure exacerbation if no chest pain or ST elevations?
Nitroglycerin
What abx has a photosensitivity reaction?
Hydrochlorothiazide
Topical Fluocinonide 0.05% is the tx for what skin condition?
Psorasis
CML, what is the best treatment choice?
Tyrosine Kinase Inhibitor
Mono infection, persistent lymphadenopathy, what should be done?
Biopsy
If a patient has a smoking history and left lung mass, what is a concerning sign?
Right Leg hyper-reflexia
As a general rule of thumb, if a patient has a brain tumor, what is it most likely?
Metastatic cancer, individual brain tumors do happen, but #1 is metastasis
DIC vs ITP what labs will be normal for ITP and not normal in DIC?
Ddimer, PT, and PTT
Medullary Cancer s/p surgery 6 months and Calcitonin is still elevated, what is going on? What is the next step?
Metastasis, repeat CT scan of Neck and Chest
If a patient has Hodgkin Lymphoma, (treatment or no treatment), what is most likely cause of an AKI?
Tumor Lysis Syndrome
Iron Deficiency anemia in a 55 year old male, what is the next best test?
FOBT (I know)
If a patient has HIT, should they avoid all Heparin products for the rest of their life?
YES!!!!
Tumor Lysis Syndrome can cause Kidney Damage, what is the common stone type?
Calcium Phosphate Stones
Does an IVC filter increase the risk of a DVT?
Yes! But it halves the risk of a PE
A young male with a mom family history of clotting disorder. Patient develops a cold leg, no pulses. Sensation and ROM are intact. What is the most likely diagnosis?
Atrial Myxoma, i know.
Microcytic Anemia, what is the next best step to evaluate?
Normocytic Anemia, what is the next best step to evaluate?
Iron Studies
Reticulocyte Count
Once Multiple Myeloma is diagnosed, what is the next best step?
Whole Body CT scan w/out contrast
If a patient has Autoimmune metaplastic atrophic gastritis, what is the most common endoscopic finding?
Absent Rugae in the fundus
Elevated PSA and Shoulder Pain, what else should be done?
Should biopsy, concern for a metastatic prostate lesion
CCL onset, what is a poor prognostic sign seen in the labs?
Thrombocytopenia
A patient has a recent MVA, they have chest discomfort a day later with normal coronaries and troponins. What is another thing to think about?
Takotsubo CM
All CHF potential patients need what?
Echo
Bicuspid valve has an increased risk of what?
Aortic Aneurysm
Patients with HOCM and asthma. If non-selective Beta blockers are not needed. What is the next best medication?
Calcium channel blocker, such as verapamil
A young patient 30 years old, severe HTN recently, facial swelling, pulses equal throughout, family Hx of HTN, what is next place to look?
Renal Interstitial Disease
What is the number one risk factor for colon cancer?
Alcohol
What is the best Anemia of Chronic Disease treatment?
Treat the underlying cause, i.e. RA, give infliximab
Type 2 HIT occurs, Argotroban is started, if the platelets take a hit, eventually warfarin needs to be restarted. When should that happen?
After the platelet levels recover
Cryoprecipitate which contains what clotting products?
Factors VII and XII, vWF
FFP is used to replete what?
Multiple Clotting Deficiency factors
Platelet dysfunction can lead to decrease platelet aggregation due to uremia despite normal platelet numbers. What can help that problem?
Desmopressin and help improve vWF
Prostate metastasis to the spine, what is the treatment for that?
Radiation therapy, no Neurosurgery unless there is a structural problem
When HTN drugs are being handed out, what is one other test that has to be checked first?
Fasting Lipid Panel
Aortic Dissection, what is the drug of choice?
Esmolol
Peri-infarct pancreatitis, what is the next treatment step?
Aspirin
A stent is place s/p 3 days, inflation and scratchy heart sounds are heard, what is the most likely diagnosis?
Pericarditis
Trastuzumab can cause cardiotoxicity. Is the cardiotoxicity permanent?
No, it can be reversed
Severe HTN s/p cocaine use can cause elevated BP. If a patient has right arm and leg weakness. What is the next best step?
Scan Chest, concern for Dissection
Acute Paronychia is called what? What is the treatment?
Finger nailbed infection
Tx: Warm Water soaking and abxs
Scaly and itchy skin, Ichthyosis Vulgaris, what is the treatment of choice?
Urea-containing lotion
Actinic Keratosis that leads to squamous cell carcinoma, what is the treatment of choice?
Topical 5-fluorouracil cream
Psoriatic arthritis is best treated with what?
Methotrexate
Rash in flexural surfaces, genitals, and mouth. Plus the patient is Hep C positive. What is the most likely rash cause?
Lichen Planus
Gingko Bilboa, what is the most common side effect?
Bleeding Disorder
If a young person has unilateral light sensitivity, blurry vision, sudden onset, no trauma, what is the most likely cause?
Anterior Uveitis
A-fib with structural heart disease, what is the best medication?
A-fib without structural heart disease, what is the best medication?
Amiodarone
Flecanide
What drug inhibits the tubular secretion of diogoxin?
Verapamil
In acute decompensated heart failure, what medication should be avoided?
Metoprolol
First line drug to slow down a-fib
Beta blocker or non-dihydropyr. calcium channel blocker
If the patient has a bicuspid valve, what should all 1st degree family members have?
Echo
CKD patients can have atypical symptoms for what kind of cardiac condition?
Myocardial Infarction
A patient has widened QRS complex after having chemotherapy, what is this heart arrythmia due to?
Severe Hyperkalemia
Edema, asicities, and hepatic congestion, what are the things to think about?
Constrictive Pericarditis
If a patient has elevated STs and no troponin increase, not to mention cocaine use, what is the next best test?
PCI
Number #1 thing that reduces blood pressure?
Weight loss
Loud first heart sound and mid-diastolic rumble best heard at cardiac apex and elevated right heart pressures, what could this be?
Mitral stenosis 2/2 Rheumatic Heart Disease
A patient on a statin that has elevated CK levels 2/2 injury or exertion should do what before the medication is restarted?
Recheck CK levels
Restless Leg Syndrome has what associated disease?
Iron Deficiency Anemia
What is the treatment for Restless Leg Syndrome?
Gabapentin
SLE patient’s have a higher risk of what heart problems?
Coronary Atherosclerosis
If a patient aspirates, should they be empirically covered for anaerobes?
No, not unless they have an abscess or empyema
In order for patients to have Acute Interstitial Nephritis, what are a few other hallmark signs?
Fever and Rash, if not, think ATN
Back pain that wraps around the back to the front with marked weakness and numbness/tingling, decrease reflexes, and upgoing Babinksi reflexes is concerning for epidural spinal cord compression. What is the next treatment step?
High Dose Corticosteroids and MRI
If deciding breath death or no brain death, the patient took benzos and baclofen, what must be done first?
Wait 3-5 days, drugs have to wear off first before brain death can be pronounced
Are migraines associated with a runny nose and eye tearing?
Usually no, think about Cluster headaches
What is the Bromocriptine mechanism of action?
A dopamine agonist
Assuming a young kid has paralysis via tick bite, what is the next best step?
Look for and remove Tick
If a person may have Lyme disease with facial paralysis, what is the next best step? Steroids or Lyme Serology
Lyme Serology
Pregnant patients that have M.S. are more likely to have what problems with giving birth?
More likely to have C-Section or Vaginal Assitance during delievery
M.S. exacerbation what is the best treatment?
IV steroids
Xanthochromia has RBC breakdown, which means blood has been there a long time, if a patient has RBCs but no Xanthochromia, what does this mean?
A blood vessel was hit on the way in, traumatic lumbar puncture
If a patient has Herpes Encephalitis, what is a common diagnostic feature as well?
AMS
Oromandibular Dystonia has sustained, involuntary muscle contractions, but they can be relieved by what?
A sensory trick, i.e. a water bottle pushing on the jaw
What lung function feature should be evaluated with GBS?
Bedside Vital Capactiy
Idiopathic Intracranial HTN is managed with Acetazolamide. What is the prescribed management with this drug?
Decreased CSF production by the choroid Plexus
When a patient has a symptomatic pituitary tumor, what is the next step in management? Assuming really high Prolactin level
Add dopamine agonist, first then potential surgery
Does Bell’s palsy have a high recurrence rate?
Yes
What type of stroke has oculomotor palsy attached to it?
PCOM aneurysm
Bad vitamin B12 can lead to what?
Ineffective Erythropoesis
S/P Stroke diagnosis, should patients be given DVT prophylaxis?
Yes
What is a non-common stroke cause in young adults? Particularly with high risk sexual activity?
Syphillis Menioencephalitis
Reduced blood flow to the brain can cause vertigo symptoms, stocking-glove pattern, what is the name of this phenomenon?
Vertebrobasilar Insufficiency
Stocking and glove decrease in sensation bilaterally, what is the most common cause of this problem?
Diabetic neuropathy, also can have loss of cremasteric muscle.
If a patient is hemodynamically stable and has bright red rectal bleeding. What should the patient have done?
Emergent Colonoscopy
A high stool gap will show what?
Chronic malabsorption syndrome, what will it be?
Celiac’s Disease, osmotic diarrhea (high)
Secretary Diarrhea: low gap
SAAG score greater than 1.1 one indicates what?
SAAG score lower than 1.1 one indicates what?
Portal Hypertension (CHF, Cirrhosis, and Alcoholic Hepatitis)
Non-portal Hypertension (peritoneal carcinomatosis, TB, and nephrotic syndrome)
A patient has gastric reduction surgery and has constant diarrhea. We are concerned for dumping syndrome. What is the right diet?
High Protein
Transmural lymphocytic inflammation is code for what, in a GI patient? May also have crypt abscesses.
Crohn’s Disease
Overweight patient with elevated Liver enzymes, no acute causes, infections, or drug use. What is the most likely cause?
NASH
If an admitted variceal bleeding patient is admitted to the hospital, what is the most common adverse advent that can happen, to them? Assume they are a heavy alcoholic with a large belly
SBP
Young patient, with GERD, difficulty swallowing, what is the first thing to think about?
Stricture
What is a common finding with Celiac’s Disease?
Iron Deficiency Anemia
If a woman has a positive AMA what does this mean?
PBC, will need a transplant
Hepatic adenoma, greater than 5 cm what should be done?
Surgery
Cherry red lesions in the colon can cause anemia, these lesions are associated with vW disease and Aortic stenosis, what is the name of the lesion?
Angiodysplasia
PSC, can damage the bile ducts, but is also associated with what?
Ulcerative Colitis