Brainscape's Knowledge GenomeTM

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


See full index

USMLE Step 2 Saba > Amboss > Flashcards

Amboss Flashcards

You may prefer our related Brainscape-certified flashcards:
USMLE® Step 1 flashcards
1
Q

What kind of bacteria is associated with acute infective endocarditis in someone with prosthetics?

A

Coagulase-negative staphylococci like S.epidermidis which is found on prosthetics

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

What kind of bacteria is associated with subacute infective endocarditis in predamaged heart valves?

A

gram positive streptococci like strep viridians and enterococci.

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

What is the next step after seeing mediastinal widening on CXR?

A

Get a chest CT with contrast

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

Which drugs reduce mortality in CHF?

A

Beta blockers, ACE inhibitors, and aldosterone antagonists.

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

Which drugs only improve symptoms in CHF?

A

Digoxin and diuretics

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

Next management step in suspected chronic venous disease?

A

Duplex ultrasonography to help determine the underlying etiology (reflux, obstruction, or reflux and obstruction), specific sites involved (deep or superficial veins, perforators, or greater veins), the severity of the disease, and if the patient has a coexisting peripheral artery disease – all of which are needed to determine further management.

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

How could a cardiac myxoma present?

A

If in the LA, will have a plopping sound followed by a low-pitched rumbling mid-diastolic murmur heard best over the apex. Might present with syncope, orthostatic hypotension, constitutional findings (fever, weight loss, anemia)

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

Causes of hypomagnesemia.

A

Diarrhea, alcoholism, use of diuretics

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

What kind of murmur is heard with coarctation of the aorta?

A

A systolic ejection murmur over the left paravertebral region and/or a continuous murmur below the left clavicula and between the shoulder blades.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Symptoms of coarctation of the aorta in a child?

A

Chest pain, cold feet, and lower-extremity claudication on physical exertion, and variability in blood pressure in the upper and lower extremities

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

Symptoms of coarctation of the aorta in an adult?

A

HTN, variability in blood pressure in the upper and lower extremities, headache, epistaxis, tinnitus, and claudication of the lower extremities with exertion.

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

How do you diagnose pulmonary HTN?

A

Right-heart catheterization is the test of choice to confirm the diagnosis of pulmonary hypertension as well as the specific subgroup. Diagnosis is made when the mean pulmonary artery pressure is ≥ 25 mm Hg at rest and underlying pulmonary and left heart conditions (e.g., valvular heart disease, systolic dysfunction, diastolic dysfunction) are excluded

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

What is used to close a PDA in a preterm infant?

A

NSAIDS (e.g indomethacin)

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

What is used to close a PDA in a full term infant > 5 kg?

A

Procedural closure

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

Signs and Symptoms of symptomatic PDA?

A

Poor feeding, sweating, failure to thrive, and a characteristic continuous (“machinery”) murmur

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

What is used to close a PDA in a full term infant < 5 kg?

A

Digoxin and furosemide until they are >5kg and can get the procedure.

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

First line tx for acute PSVT?

A

Vagal maneuver

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

Second line tx for acute PSVT specifically AVNRT and orthodromic AVRT?

A

AV node blockade via adenosine. Second line: verapamil, diltiazem, and metoprolol

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

Second line tx for acute PSVT specifically antidromic AVRT (WPW)?

A

Procainamide

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

Which drugs are contraindicated in WPW?

A

AV node blockers like adenosine, verapamil, beta blockers, digoxin, and amiodarone.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Patient presents with a penetrating chest wound with foreign object still in. Next step?

A

Emergency surgery to remove object under controlled conditions.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

EKG findings of AVNRT?

A

Narrow QRS complexes and an invisible P wave (as it is “buried” in the QRS complex)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is associated with a split pleura sign?

A

Pleural empyema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How do you differentiate between a chylothorax and pseudochylothorax?

A

In chylothorax: cholesterol <200 and triglyceride >110 so ratio is <1. In pseudochylothorax, cholesterol >200 and triglyceride <110 so ratio >1. It will also have cholesterol crystals.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What causes pseudochylothorax? Examples?

A

Accumulation of cholesterol-rich fluid in the pleural cavity due to chronic inflammation like rheumatoid arthritis of pulmonary tuberculosis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Hemothorax tx and complications?

A

Chest tube w. evacuation. Blood left will clot and result in a trapped lung or an empyema.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Glucose < 30mg/dL in pleural fluid analysis suggests what?

A

Rheumatoid pleurisy or empyema.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Glucose 30-59 mg/dL in pleural fluid analysis suggests what?

A

Malignant effusion, TB, empyema, pneumonia, esophageal rupture, or lupus pleuritis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What kind of bacteria is associated with acute infective endocarditis?

A

Staph aureus, strep pyogenes, S. pneumoniae, N. gonorrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Tx of native valves in bacterial endocarditis?

List alternatives, preferred tx for pts >65 and for penicillin susceptible pathogens.

A

4 week: (preferred in pts >65) penicillin G.
alternatives: ampicillin, IV ceftriaxone, IV vancomycin.

2 week: (for pts with penicillin susceptible pathogen and rapid response to abx)

  • gentamicin + penicillin G
  • gentamicin + ceftriaxone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Tx of prosthetic valves in bacterial endocarditis?

A

Same as native valves except at least 6 weeks.

Penicillin G.
alternatives: ampicillin, IV ceftriaxone, IV vancomycin.

(for pts with penicillin susceptible pathogen and rapid response to abx)

  • gentamicin + penicillin G
  • gentamicin + ceftriaxone

Exceptions for staphylococci

  • Methicillin-susceptible: nafcillin (or oxacillin, cefazolin) + rifampin + gentamicin
  • Methicillin-resistant: vancomycin + rifampin + gentamicin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Tx of in bacterial endocarditis in IV drug users?

A

Intravenous empiric antibiotic treatment with vancomycin.
After confirmation of a susceptible pathogen:
- IV nafcillin (2 weeks)
- PO cloxacillin (2 weeks)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Endocarditis ppx?

In allergic pts?

A

Usually PO amoxicillin (administer 1 hour before procedure)
Patients who are unable to take oral medication: IV ampicillin
Patients with penicillin allergy: PO clarithromycin or azithromycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Diagnostic criteria for Kawasaki disease?

A

Fever for at least 5 days in combination with at least 4 of the symptoms listed: a polymorphous rash, conjunctivitis, cervical lymphadenopathy, and erythema or edema of the hands, feet, and tongue (strawberry tongue)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Hemolytic anemia is a very rare complication of which childhood exanthem?

A

Fifth disease (Parvo B virus)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Describe the phases of scarlet fever.

A

Initial phase: acute tonsillitis: fever, sore throat, cervical LAD

Exanthem phase: 12-48 hrs after fever

  • maculopapular sand-paper like erythematous rash that confluence in creases.
  • Tonsillar exudate
  • Strawberry tongue
  • Red face with perioral pallor

Desquamation phase: 7-10 days after rash resolution

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Digitalis toxicity symptoms?

A

Nausea, vomiting, diarrhea, abdominal pain, weakness, loss of appetite, and blurry vision with a yellow tint and halos.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Etiologies of digitalis toxicity?

A
  • Digoxin overdose
  • Hypokalemia
  • Renal failure
  • Volume depletion (e.g diuretics)
  • Treatment with verapamil, diltiazem, amiodarone, quinidine, propafenone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

List 2 drugs used for chemical conversion in afib?

A

Flecainide or propafenone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

List a drug that is contraindicated in afib?

A

Adenosine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What other cardiac abnormality should be assessed in a pt w/ afib?

A

Mitral valve involvement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What are the 1st line med for rate control in afib?

A

Beta blockers (esmolol, propranolol, metoprolol or nondihydropyridine calcium channel blockers (diltiazem, verapamil)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What are the 2nd line meds for rate control in afib?

A

Digoxin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What are the 3rd line meds for rate control in afib?

A

Amiodarone or dronedarone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What is the 2nd line tx for rate control in afib after medication?

A

AV nodal ablation and implantation of a permanent ventricular pacemaker

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What are the 1st line tx for rhythm control in afib?

A

Elective electrical cardioversion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What are the 2nd line tx for rhythm control in afib?

A

Pharmacologic cardioversion with antiarrhythmic drugs such as flecainide, propafenone, ibutilide, dofetilide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What procedure could be used as rhythm control in afib?

A

Catheter-based radiofrequency ablation of atrial tissue around pulmonary vein openings (pulmonary vein isolation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What is the tx for unstable afib?

A

Immediate cardioversion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Tx before cardioversion in stable AF?

A

Warfarin with bridging therapy for 3 weeks before and up to 4 weeks after cardioversion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

CHADS VASc score

A
  • CHF or left-sided HF
  • HTN
  • A2 age >75
  • DM
  • S2 Stroke or TIA or thromboembolism
  • Vascular disease: prior MI, PAD, or aortic plaque
  • Age 65-74
  • Sex - female
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Whats CHA2DS2 VASc score corresponds to what tx of nonvalvular atrial fibrillation?

A

Score of 1 no anticoagulation or tx w/ oral anticoagulants

Score of 2 oral anticoagulation with either warfarin or newer oral anticoagulants (dabigatran, rivaroxaban, apixaban)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Tx for valvular afib?

A

Anticoagulation with warfarin is required regardless of the CHA2DS2-VASc score

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

First tx after infant presents with CDH?

A

Intubation and mechanical ventilation then gastric decompression and surgery in 24-48 hrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Pre-renal BUN:creatinine? Causes?

A

> 20:1

  • Decreased renal perfusion (e.g peripheral vasodilation due to sepsis and cirrhosis, cardiac dysfunction)
  • Pre-renal uremia
  • high protein intake
  • After GI bleeding
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Renal BUN:creatinine? Causes?

A

<10:1

  • Acute tubular necrosis
  • Low protein intake
  • Starvation
  • Severe liver disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

High BUN:creatinine with raised creatinine? Causes?

A

Like a post-renal cause.

  • post renal obstruction
  • post renal uremia with renal disease
  • Prostate hyperplasia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Does type 4 RTA present with hyper or hypokalemia?

A

Hyperkalemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

How is RTA diagnosed?

A

With urine pH and anion gap

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

How is primary hyperaldosteronism diagnosed?

A

With a saline infusion test. Renin and aldosterone levels should be decreased (PAC <10 ng/dL) and if they don’t then diagnosis is confirmed.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

What is the ratio or aldosterone to renin in primary hyperaldosteronism?

A

> 20

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

What is the differential diagnosis of primary hyperaldosteronism?

A
  1. Secondary hyperaldosteronism:
    - Renal artery stenosis
    - Renin secreting tumor
    - CKD
  2. Pseudohyperaldosteronism:
    - Congenital adrenal hyperplasia
    - Exogenous minaerlocorticoid
    - Cushing’s syndrome
    - Liddle’s syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Symptoms of aortic stenosis?

A

Dyspnea on exertion, angina, or syncope.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Tx of symptomatic aortic stenosis?

A

Surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Pulmonary HTN tx?

A
  • Diuretics
  • Oxygen
  • Pulmonary vasodilator therapy:
    ~ Ca channel blockers
    ~ Long-acting prostacyclin analogs
    ~ Endothelin receptor antagonists, Bosentan
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Conditions where hypocomplementemia is seen?

A

Lupus, mixed cryoglobulinemia, membranoproliferative glomerulonephritis, hereditary angioedema, and cholesterol crystal embolism (atheroembolism).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Symptoms of Eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome)?

A
  • Severe allergic asthma attacks (chief complaint)
  • Allergic rhinitis/sinusitis
  • Skin nodules; palpable purpura
  • Pauci-immune glomerulonephritis
  • Mononeuritis multiplex
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Symptoms of Microscopic polyangiiti?

A

Similar to granulomatosis with polyangiitis, but without involvement of the nasopharynx!

  • Glomerulonephritis; hypertension
  • pulmonary vasculitis with hemoptysis
  • palpable purpura
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Symptoms of mixed cryoglobulinemia?

A
  • Nonspecific systemic symptoms: fatigue, malaise, myalgia, arthralgia
  • Skin lesions (nearly 100% of cases): palpable purpura, ulceration, necrosis
  • Raynaud’s phenomenon
  • Polyneuropathy
  • Hepatosplenomegaly
  • Glomerulonephritis (severe cases or late complication)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Symptoms of Behçet disease?

A
  • Recurrent painful aphthous ulcers
  • Recurrent genital ulceration
  • Ocular disease: uveitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

How is Behçet disease diagnosed?

A

Positive pathergy skin test: erythematous papule or pustule 24–48 hours after a; needle prick.
Autoantibodies (e.g., ANA, ANCA, rheumatoid factor) are usually absent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

Are lungs involved in polyarteritis nodosa?

A

No they are spared

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

What medication is contraindicated in Prinzmetal angina?

A

Beta blockers because they inhibit dilation of smooth muscle cells.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

Features of benign lung tumors?

A

“Popcorn” calcifications. Round, well-circumscribed nodules, lobulated by respiratory epithelium. 90% are peripheral, 10% are endobronchial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

Features of infectious granulomas like TB of histoplasmosis in lung?

A

Round, well-defined, calcified nodule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

Ddx of pulmonary edema?

A

Acute decompensated HF, ARDS, PE, transfusion-related acute lung injury, high altitude, asthma, or pneumonia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

What kind of arrhythmia is WPW syndrome?

A

A ventricular tachycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

What other defect could congenital long QT syndrome be associated with?

A

Deafness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

1st line tx of long QT syndrome?

A

Beta blockers; propranolol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

What kind of arrhythmia is torsade de pointes?

A

A ventricular tachycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

Is hematemesis present in Boerhaave syndrome?

A

Not usually

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

What is a pseudoaneurysm of the gastroduodenal artery associated with and how could it present?

A

Associated with recurrent pancreatitis. Pts usually have hx of pancreatic pseudocysts and can present with signs of upper GI bleed.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

Typical findings on ECG in atrial premature beats?

A
  • P-wave abnormalities or absent P waves
  • Altered PR interval in the premature beats (compared to the normal beats)
  • QRS complex may be normal, aberrant (widened), or absent
  • No full compensatory pause. aka if the interval b/w pre-extrasystolic and post-extrasystolic beat is less than 2x a normal RR interval.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

Next step after seeing atrial premature beats on ECG?

A

Get an echo to rule out structural heart disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

Tx of atrial premature beats in symptomatic pts?

A

Reduce triggers like caffeine, smoking, and alcohol.

Beta blockers or catheter ablation if symptoms persist.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

TCA overdose tx?

A

Activated charcoal within 2 hours of ingestion and sodium bicarbonate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

MOA of glucagon in beta blocker overdose?

A

It enhances myocardial contractility.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

Antidote for serotonin syndrome?

A

Cyproheptadine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

Which antidote is used in organophosphate poisoning?

A

Atropine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

What is ammonium chloride used for?

A

To acidify urine to help increase excretion of weak bases like amphetamines.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

1st diagnostic step after suspecting myocarditis?

A

Get an ECG. Might see sinus achy, arrhythmias, ST elevation w/ concave ascending S wave, heart block, or low voltage from pericardial effusion.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

Positive lab findings in myocarditis?

A

↑ Cardiac enzymes
↑ ESR
Leukocytosis
↑ BNP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

Hypotension and tachycardia that do not respond to fluid resuscitation should raise suspicion for what?

A

Cardiac contusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

Which beta blockers are cardioselective and white receptor do they block?

A

Metoprolol and atenolol. They block B1 receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

Which receptors does labetalol block? What other beta blocker has a similar MOA?

A

It blocks both beta1/2 and alpha 1 receptors. Carvedilol has a similar MOA.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

Which alpha blocker is given first in pheochromocytoma and why?

A

Phenoxybenzamine. Because it is irreversible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

How does cocaine serve as a local anesthetic?

A

Inhibition of Na+ channels causes local anesthetic action by blocking nerve action potential transmission.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

Drug of choice for afib in pts w/ decompensated HF?

A

Digoxin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

When is prednisone used to treat Raynaud’s?

A

Used in patients with secondary Raynaud’s phenomenon due to an underlying condition (e.g., vasculitides, connective tissue diseases).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

What is the 1st and 2nd line tx for Raynaud?

A

1st: calcium channel blockers
2nd: Fluoxetine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

Which drugs are contraindicated in Raynaud’s phenomenon? why?

A

Beta blockers b/c they worsen the vasospasm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

Clinical differences b/w primary and secondary Raynaud?

A

Primary: usually symmetrical and no ulceration
Secondary: usually asymmetrical w/ ulceration/necrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

DDx of bluish/white or discoloration of fingers or toes?

A
  • Raynaud’s phenomenon
  • Acrocyanosis
  • Erythromelalgia
  • PAD
  • Acute arterial occlusion of an extremity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

Describe ECG findings of WPW?

A

Shortened PR interval w/ wide monomorphic QRS and a regular rhythm. A slurred upstroke of the QRS will also be seen.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

What is a common cause of Atrial tachycardia? What other ECG finding does it usually present with?

A

A common cause of AT includes digoxin poisoning which typically presents with concomitant AV block

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

ECG in AVNRT?

A

no P waves or atrial activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

ECG in AVRT?

A

P wave in the ST segment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
108
Q

Side effects of amiodarone (7)?

A 
Cardiac: QT prolongation, TdP
Pulmonary: interstitial pneumonitis
Endocrine: Hypo or hyperthyroidism
GI: elevated transaminases, hepatitis
Ocular: corneal micro deposits, optic neuropathy
Derm: blue-gray skin
Neuro: peripheral neuropathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
109
Q

Severes aortic stenosis criteria?

A
  • Aortic jet velocity > 4.0m/sec OR
  • mean transvalvular pressure gradient >40 mm Hg. OR
  • Vavlve area < 1 cm2
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
110
Q

Indications for AS valve replacement?

A

Severe AS and 1 or more of the following:

  • Onset of sx (angina, syncope)
  • Left EF <50%
  • Undergoig other cardiac surgery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
111
Q

Can oral contraceptives cause HTN?

A

Yes. Most pts’ HTN returns to normal after stopping it.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
112
Q

What is the 1st line medication for hypertrophic cardiomyopathy?

A

Beta blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
113
Q

First med to give for narrow QRS tachycardia? Why?

A

Amiodarone b/c it helps unmask any buried p waves and terminates PSVT?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
114
Q

How does constrictive pericarditis usually present?

A

R heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
115
Q

What is the timeline requirement for diagnosis of peripartum cardiomyopathy?

A

Diagnosed at >36 weeks or early postpartum period.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
116
Q

How do you diagnose a retroperitoneal hematoma?

A

non contrast abdomen and pelvis CT. May use abdominal ultrasound.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
117
Q

How does a retroperitoneal hematoma present after catheterization?

A

Sudden hemodynamic instability with ipsilateral flank and back pain.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
118
Q

When is synchronized cardioversion used?

A
  • Symptomatic or sustained monomorphic Vtach that is unresponsive to antiarrhythmics
  • Afib with RVR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
119
Q

Describe the intracardiac pressures as recorded by pulmonary artery catheter in cardiac tamponade?

A

Elevation and equalization of intracardiac diastolic pressures: R atrial, R ventricular, and pulmonary capillary wedge pressure (L atrium).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
120
Q

Syncope associated w/ prodrome of weakness, diaphoresis, nausea, pallor, warmth, or abdominal pain. What is it?

A

Vasovagal syncope

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
121
Q

Describe atrial premature beats on ECG?

A

Irregular rhythm with some of the p waves having abnormal morphology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
122
Q

Pediatric pt with hx of rheumatic fever. Next step in management?

A

Penicillin ppx against group A strep pharyngitis. Duration depends on severity of disease.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
123
Q

Complication in patients on TPN > 2 weeks?

A

Cholestasis leading to cholelithiasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
124
Q

What chemical is found in antifreeze?

A

Ethylene glycol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
125
Q

What are the s&s of ethylene glycol toxicity?

A

Metabolic acidosis, calcium oxalate crystals in urine (due to increased oxalic acid binding Ca), high osmolar gap, flank pain, hematuria, oliguria, and altered mental status.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
126
Q

Which organism is ecthyma gangrenous associated with?

A

Pseudomonas aerginosa bacteremia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
127
Q

What does pulses paradoxus look like clinically?

A

Loss of palpable radial pulse bilaterally during inspiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
128
Q

Describe pain from pericarditis?

A

Retrosternal pain that can radiate to the left arm or shoulder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
129
Q

Distinguishing feature of tamponade compared to myocarditis?

A

Pulsus paradoxus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
130
Q

CP + decreased CO + pulsus paradoxus following viral illness =? Describe lungs in this scenario?

A

Tamponade secondary to viral pericarditis. Clear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
131
Q

What are the HSV encephalitis CSF findings? Why?

A

Lymphocytic pleocytosis, elevated protein, normal glucose, elevated RBCs (due to hemorrhagic destruction of frontotemporal lobes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
132
Q

What are the tuberculous meningitis CSF findings?

A

Markedly low glucose, elevated protein, and lymphocytic pleocytosis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
133
Q

Alveolar hypoventilation is the pathophys behind which pulmonary disease?

A

Extrinsic restrictive lung disease like obesity hypoventilation or neuromuscular weakness.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
134
Q

Describe the pain of compression fx in a pt w/ osteoarthritis?

A

Typically starts after a minor trauma (fx) and decreases over time.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
135
Q

Back or lower extremity pain that improves with flexion of spine in someone >60?

A

Lumbar spinal stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
136
Q

Maneuvers that cause spinal flexion?

A

Leaning forward or walking uphill.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
137
Q

What is active phase protraction?

A

Cervical dilation of <1cm per 2 hours.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
138
Q

Characteristics of pleural effusion from TB?

A

High protein >4, low glucose, markedly elevated LDH > 500, low pH, and lymphocytic leukocytosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
139
Q

When are live vaccines contraindicated in HIV patients?

A

When CD4 is <200

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
140
Q

What are 2 examples of prophylactic abx in HIV? What organisms are they used for? and when are they used?

A
  • Azithromycin against Mycobacterium avium when CD4 <50

- Trimethoprim-sulfamethoxazole against toxoplasmosis and Pneumocystis pneumonia when CD4 <200

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
141
Q

Describe headaches associated with SVC syndrome?

A

They worsen with leaning forward due to decreased gravitational effects on the blood column

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
142
Q

How do you diagnose SBP?

A

Ascitic fluid must have neutrophil count >250

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
143
Q

How do you differentiate between bullous pemphigoid and pemphigus vulgaris?

A

The first is due to hemidesmosome autoantibodies with subepidermal blisters, liners IgG @ basement membrane and doesn’t have oral/mucosal involvement. Also blisters usually remain intact.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
144
Q

Describe the clinical presentation of polymyositis?

A

Symmetric proximal muscle weakness. Pain is mild or not present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
145
Q

What are the lab and biopsy findings of polymyositis?

A

Elevated muscle enzymes: creatine kinase, aldolase, AST, ALT, and LDH.
ANA and anti-Jo-1 antibodies.
Biopst shows endomysial infiltrate (macrophages and CD8) with itchy necrosis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
146
Q

Pt with both UMN and LMN signs. What do they have?

A

ALS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
147
Q

Fetal complications due to maternal DM especially new onset in the last trimesters?

A
  • Immature lungs –> respiratory distress syndrome
  • Macrosomia
  • Pre-term delivery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
148
Q

Which disease is antiendomysial antibodies associated with?

A

Celiac disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
149
Q

Describe lipase and liver enzyme levels in chronic pancreatitis?

A

They could be normal or elevated even if the etiology is alcoholic pancreatitis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
150
Q

How does hyperthyroidism causer hypercalcemia?

A

Via increased bone turnover

151
Q

Clinical features of iron overdose?

A

Abdominal pain, hematemesis, diarrhea (could be green or black), liver necrosis, shock, AGMA

152
Q

What imaging modality is used to diagnose a meniscal tear?

A

MRI

153
Q

Clinical features of meniscal tear?

A

Joint line tenderness, slow onset effusion, sensation of instability, locking or catching when joint is rotated or extended under load.

154
Q

What are the important prognostic factors in brain tumors?

A

Pt age, functionality and tumor grade (degree of anaplasia, neovascularity, or necrosis)

155
Q

Therapy in CLL targets what?

A

CD20 cell surface antigen

156
Q

Clinical features of vascular dementia?

A

Stepwise decline in function, early executive dysfunction, cerebral infarction and/or deep white matter changes on imaging.

157
Q

UA results in renal insufficiency in multiple myeloma caused by cast nephropathy?

A

Results will be normal

158
Q

Etiologies of renal insufficiency in MM other than cast nephropathy? What are the UA results?

A

Amyloidosis and monoclonal immunoglobulin deposition disease. They cause glomerular injury –> nephrotic syndrome that would be reflected in the UA.

159
Q

Gram positive cocci septic arthritis tx?

A

Vancomycin

160
Q

Gram negative rod septic arthritis tx?

A

3rd generation cephalosporin

161
Q

Is there increased LV end-diastolic pressure in tamponade?

A

No. Pressures are generally low and decreased LV preload is seen.

162
Q

What is the primary mechanism for reducing pain in acute MI?

A

Venous dilation to reduce preload –> reduce myocardial oxygen demand

163
Q

What is the typical lumbar puncture findings in GBS?

A

Elevated protein with normal leukocyte count and glucose

164
Q

Lab results in epidural abscess?

A

They could be normal including WBC count but ESR is always elevated

165
Q

How isa spinal epidural abscess diagnosis confirmed?

A

MRI of the spine

166
Q

Describe the CF of herpangia?

A

Sore throat, oral ulcers or vesicles on posterior oral mucosa like uvula, soft palate, and tonsillar pillars.

167
Q

What are the clinical manifestations of tumor lysis syndrome?

A

N/V, bowel disturbance, low urine output, acute renal insufficiency, seizures, tetany, or arrhythmias.

168
Q

Lab abnormalities associated with tumor lysis syndrome?

A

Hypocalcemia, hyperphosphatemia, hyperkalemia, and elevated uric acid levels.

169
Q

Describe the MOA of DKA that leads to its symptoms?

A

Insulin deficiency leads to increased lipolysis of peripheral fat secondary to high catecholamine levels. Those fatty acids are broken down in the liver to ketones which contribute to anion gap acidosis. Additionally, increased anaerobic metabolism releases lactic acid.

170
Q

Where are tear-dropped shaped RBC seen?

A

In myelofibrosis or beta thalassemia (especially after splenectomy)

171
Q

Which HIV drug causes neuropsychiatric effects like insomnia, vivid dreams, depression, and anxiety?

A

Efavirenz

172
Q

An endocrinopathic cause of clubbing and onycholysis?

A

Hyperthyroidism

173
Q

What migraine abortive should not be combined? Why?

A

Triptans and ergotamine because they both cause vasoconstriction and the combination could lead to HTN, MI, or stroke

174
Q

What are the symptoms of cataracts?

A

Painless blurring of vision, glare and halos around lights, and worsening of distance vision initially.

175
Q

What would be seen in ocular examination in a pt with cataracts?

A

Opacification and loss of red reflex and retinal details.

176
Q

Describe symptoms of herpes simplex keratitis? What triggers it? What would be seen on examination?

A

Pain, photophobia, blurred vision, redness, and tearing. It is often recurrent and triggered by sun exposure, immunodeficiency, or fever. Findings include corneal vesicles w/ branching ulcers and opacities.

177
Q

When is drusen deposits with patchy depigmentation seen in the macula? What are the features of that condition?

A

In dry macular degeneration which manifests with slowly progressive bilateral vision loss.

178
Q

Hard exudates, arteriovenous nicking, ‘silver wiring” of arterioles, cotton wool spots, and a flame shaped hemorrhage is seen in what condition?

A

Hypertensive retinopathy.

179
Q

Retinal aneurisms are associated with what condition?

A

Diabetic retinopathy

180
Q

Superolateral lens displacement (ectopia lentis) is associated with what condition?

A

Marfan syndrome

181
Q

What are the 3 drugs used as tocolytics? When are they used?

A

Indomethacin - before <32 weeks
Nifedipine - weeks 32-34
Terbutaline - short term in-patient use

182
Q

What are the side effects of indomethacin as a tocolytic?

A

Maternal: gastritis, platelet dysfunction
Fetal: oligohydramnios, closure of ductus arteriosus

183
Q

What are the side effects of nifedipine as a tocolytic?

A

Hypotension, tachycardia, palpitations, nausea, flushing, headache

184
Q

What are the side effects of terbutaline as a tocolytic?

A

Tachycardia, arrhythmia, hypotension, hyperglycemia, pulmonary edema

185
Q

What are the clinical feature differences between central and peripheral cyanosis?

A

Central cyanosis has a low arterial oxygen saturation. Extremities are warm and patients will have bluish discoloration of lips, tongue, nail beds etc.
Peripheral cyanosis has a normal arterial oxygen saturation w/ increased O2 extraction due to sluggish blood flow thru capillaries with cold and clammy extremities. Additionally, bluish discoloration is only seen in distal extremities.

186
Q

Striate palmar xanthomas (yellowish streaks) are associated with what condition? Other features? What is the 1st line tx?

A

Familial dysbetalipoproteinemia causing increased triglycerides. Blood appears milky and opalescent. 1st line tx is fenofibrate.

187
Q

Clinical features of roseola infantum and which organism causes it?

A

3-5 days of high fever followed by a non-itchy, non-painful erythematous and blanching maculopapular rash. Caused by HHV-6

188
Q

What is an absolute contraindication to OCP use?

A

Active liver disease

189
Q

Clinical features of amaurosis fugax?

A

Painless, rapid, and transient (<10 mins) monocular vision loss

190
Q

Fundoscopic findings in amaurosis fugax?

A

Often normal but may show embolic plaques and retinal whitening due to ischemia.

191
Q

Clinical features of posterior uveitis? Pathophys? Which conditions is it associated with?

A

Painless vision loss and floaters. Choroidal inflammation. Associated with systemic inflammatory disorders like IBD, ankylosing spondylitis or infection e.g CMV

192
Q

What is the Uhthoff phenomenon?

A

It is when neurological symptoms in MS worsen when the body overheats (e.g. exercise, hot shower, fever etc)

193
Q

Etiology of target cells?

A

Liver disease, asplenia, or thalassemia

194
Q

Pancreatitis is associated with which lipid disorder?

A

Hypertriglyceridemia >1000 md/dL

195
Q

Is diarrhea is C.diff bloody or not?

A

Bloody

196
Q

Clinical features of glucagonoma?

A

Weight loss, necrolytic migratory erythema (indurated pruritic erythematous plaques with central clearing), hyperglycemia/newly diagnosed DM, GI symptoms (diarrhea, pain, or anorexia)

197
Q

First line Benzo for alcohol withdrawal?

A

Lorazepam

198
Q

Side effects of lithium?

A

Hyperparathyroidism, thyroid dysfunction (usually hypo), diabetes insipidus, and CKD.

199
Q

Signs and symptoms of benzo and alcohol overdose? How is it different from benzo overdose alone?

A

Benzo alone would cause altered mental status, ataxia, and slurred speech. Addition of alcohol would cause vital sign derangement with respiratory depression, bradycardia, hypotension, and hyporeflexia.

200
Q

Which 2nd generation antipsychotics have the least metabolic effects?

A

Ziprasidone, aripiprazole, and lurasidone.

201
Q

Aspirin could be a trigger for what?

A

Bronchoconstriction in people with asthma

202
Q

How do glucocorticoids affect neutrophils and lymphocytes?

A

Decrease circulating numbers

203
Q

What is a normal JVP range?

A

6-8

204
Q

What is the nest tx after aspirin and a statin in a pt with claudication?

A

Exercise therapy

205
Q

Adverse effects of methotrexate? What should be checked prior to starting it?

A
  • Hepatotoxicity
  • Stomatitis
  • Cytopenias

Check liver enzymes before starting. Giving folic acid with it reduces side effects.

206
Q

What should be regularly checked for pts on hydroxychloroquine?

A

Ophthalmologic evaluation for potential retinal injury

207
Q

What are the contraindications for a contraction stress test?

A

The same as ones for labor: placenta previa, prior myomectomy, etc

208
Q

What is a normal amniotic fluid volume?

A

Single fluid pocket of >2cm x 1cm or amniotic fluid index >5

209
Q

What is the preferred diagnostic study for aortic dissection in a pt w/ hemodynamic compromise?

A

TEE

210
Q

After thyroidectomy due to medullary thyroid cancer what should be monitored? why?

A

Calcitonin because of its positive correlation with recurrence.

211
Q

Previously healthy child with 3 days fever, runny nose, cough, and visual hallucinations. Only took OTC antihistamines and decongestants. Vitals stable, physical and near exam normal. What is causing his hallucinations and agitation?

A

Medication side effect from antihistamines (have anticholinergic properties) and decongestants (alpha adrenergic and NMDA. antagonist)

212
Q

Clinical features of Reye syndrome? When does it occur?

A

Hepatic failure, altered mental status, vomiting, seizure, and coma that develop a few days after resolution of a viral illness and risk is increased with salicylate use.

213
Q

What are common areas of enthesitis (tenderness at tendon insertion sites) presentation? What conditions is it associated with?

A

Achilles heel, costosternal junction, elbows, shoulders, hips, iliac crests, tibial tuberosities, etc.
It can occur alone but is also associated with the spondyloarthropathies (ankylosing spondylitis, psoriatic arthritis, and reactive arthritis)

214
Q

Features of medulloblastoma? Which population is it common in?

A

Nocturnal or morning headaches and vomiting. Incoordination and ataxia.This a pediatric tumor.

215
Q

Indications for H. pylori screening?

A

Active PUD, hx of PUD, atrophic gastritis, or gastric MALT lymphomas. It is NOT indicated for GERD.

216
Q

Clinical features of hereditary angioedema?

A
  • Swelling of face, extremities, or genitalia without urticaria
  • Laryngeal edema
  • Colicky abdominal pain, vomiting, diarrhea (GI sx due to bowel wall edema)
217
Q

When does hereditary angioedema usually present?

A

Late childhood or adolescence after a dental procedure, stress, or trauma

218
Q

Which drugs can cause idiopathic intracranial hypertension?

A
  • Retinoids
  • Tetracyclines
  • Growth hormone
219
Q

What are the extra-hepatic manifestations of hepatitis C?

A
  • Mixed cryoglobulinemia
  • Membranoproliferative glomerulonephritis
  • Prophyria cutanea tarda
220
Q

Pt w/ sickle cell disease presents with macrocytic anemia and reticulocyte count on 1%? What is the cause?

A

Folate deficiency

221
Q

Femoral nerve motor and sensory innervation?

A

Hip flexion and knee extension. Patellar reflex will be weaker with injury due to. involvement of quadriceps.
Provides sensation to anterior thigh and medial leg.

222
Q

Common peroneal nerve motor and sensory innervation? Damage caused by which injury?

A

Usually caused by fx or compression at the proximal fibula. Involved in foot eversion, dorsiflexion, and toe extension. Damage causes foot drop.
Sensory includes posterolateral leg and dorsolateral foot.

223
Q

Tibial nerve motor and sensory innervation? Caused by damage where?

A

Caused by injury at the popliteal fossa which results in weak plantar flexion. Compression of the nerve at the medial ankle can cause numbness and paresthesia in the sole and distal toes (Tarsal tunnel syndrome)

224
Q

What are the lab findings in Gilbert syndrome?

A

Mildly elevated indirect hyperbilirubinemia. Normal CBC, no evidence of hemolysis, normal Alk phos, AST, ALT, blood smear, and reticulocytes.

225
Q

What causes Felty syndrome?

A

It is a complication of long standing erosive rheumatoid arthritis.

226
Q

Clinical features of Felty syndrome?

A 
- Rheumatoid arthritis:
~ erosive joint disease and deformity
~ Rheumatoid nodules
~ Vasculitis (mononeuritis multiplex, necrotizing skin lesions)
~ LAD
- Neutropenia
- Splenomegaly (due to antibody-coated neutrophils trapped in spleen)
-
227
Q

Causes of primary adrenal insufficiency?

A
  • Autoimmune
  • Infectious (TB, HIV, disseminated fungal)
  • Hemorrhagic infarction (meningococcemia, anticoagulants)
  • Metastatic cancer (lung)
228
Q

Lab values associated with primary adrenal insufficiency?

A
  • Hyponatremia
  • Hyperkalemia
  • Hypercalcemia
  • Eosinophilia
229
Q

What are the three categories of hyponatremia?

A
  1. Hypotonic
  2. Isotonic
  3. Hypertonic
230
Q

What are the 3 categories in hypotonic hyponatremia and list the causes of each?

A
  1. Hypovolemic:
    - Renal: diuretic, aldosterone deficiency
    - Extrarenal: pancreatitis, vomiting, diarrhea, burns, bleeding
  2. Euvolemic:
    - SIADH
    - Psychogenic polydipsia
    - Hypothyroidism
    - Rarely alcoholism
  3. Hypervolemic:
    - CHF
    - Cirrhosis
    - Nephrotic syndrome
231
Q

Causes of isotonic hyponatremia?

A
  • Psuedohyponatremia
    ~ Hyperlipidemia
    ~ Paraproteinemia (e.g multiple myeloma)
232
Q

Causes of hypertonic hyponatremia?

A
  • Hyperglycemia

- Use of mannitol

233
Q

What are the three categories of hypernatremia?

A
  1. Hypovolemic
  2. Euvolemic
  3. Hypervolemic
234
Q

What are the causes of hypovolemic hypernatremia?

A
  1. Dehydration: poor oral intake, diarrhea

2. Diuretics: usually loop and osmotic diuretics

235
Q

What are the causes of euvolemic hypernatremia?

A
  1. Diabetes insipidus (central and renal)

2. Lack of access to water

236
Q

What are the causes of hypervolemic hypernatremia?

A
  1. Primary hyperaldosteronism
  2. Cushing syndrome
  3. Iatrogenic
  4. Drinking sea water
237
Q

Three main categories of hyperkalemia causes? List the different causes of each

A
  1. Potassium excess
    - Reduced excretion: acute and chronic kidney disease
    - Endo: hypocortisol, hypoaldosterone
    - Drugs: aldosterone antagonists, ACE, ARB, NSAIDS, TMP-SMX
    - RTA IV
    - Release from cells: myolysis, tumor lysis, hemolysis
  2. Extracellular shifts
    - Acidosis
    - Insulin deficiency
    - Drugs: succinylcholine, digoxin
  3. Pseudohyperkalemia
    - Blood draw error
    - Prolonged tourniquet
238
Q

What are the two categories of hypokalemia? List the causes under each?

A
  1. Renal loss:
    - Endo: hyperaldosterone, hypercortisol
    - Drugs: diuretics, glucocorticoids, licorice (aldosterone-like)
    - Hypomagnesemia
    - RTA I and II
  • GI loss: vomiting, diarrhea, laxatives
  1. Intracellular shift:
    - Alkalosis
    - Insulin
    - Beta agonist
239
Q

Eosinophilia with liver cyst? Tx? Common cause?

A

Hydatid cyst. Albendazol if uncomplicated cyst. Petting animals or eating soiled food.

240
Q

Clinical features of HSV retinitis (esp in HIV pts) and funduscopy findings? What other virus can cause a similar condition?

A

Acute retinal necrosis characterized by keratitis, uveitis, conjunctivitis followed by rapidly progressive visual loss. Funduscopy reveals widespread, pale peripheral lesions and central necrosis of the retina.
VZV.

241
Q

How does CMV retinitis present?

A

Typically painless and not associated with keratitis or conjunctivitis. Funduscopy reveals fluffy or granular lesions near the retinal vessels and associated hemorrhages.

242
Q

Chondrocalcinosis in an inflammatory joint is most likely what diagnosis?

A

Calcium pyrophosphate arthritis aka pseudogout

243
Q

What is the next medication after stimulants for ADHD in children and adolescents?

A

Atomoxetine a selective norepinephrine reuptake inhibitor.

244
Q

Chronically inflamed, scarred, or wounded skin can cause which skin cancer?

A

Squamous cell carcinoma

245
Q

How does cutaneous T cell lymphoma appear?

A

Scaly, pruritic patches or plaques

246
Q

Angiodysplasia is associated with which conditions?

A
  • Advanced renal disease
  • von Willebrand disease
  • Aortic stenosis (likely due to acquired vW deficiency from shearing of vW multimers)
247
Q

Diagnostic criteria for chorioamnionitis?

A

Maternal fever plus one of the following:

  • Fetal tachycardia >160
  • Maternal leukocytosis
  • Purulent amniotic fluid
248
Q

Signs and symptoms of rubella (German measles)?

A

May start with low grade fever and lymphadenopathy (especially suboccipital and posterior auricular), cephalocaudal spread of maculopapular rash. May have petechiae or erythematous papules on the soft palate.

249
Q

1st line tx for stable angina? What is the MOA? What is an alternative?

A

Beta blockers. Can use non-dihydropyridines instead.

Both medication classes work by reducing heart rate and contractility

250
Q

Describe EPO in an infant after birth?

A

Circulating EPO decreases due to increased oxygen concentration in tissue. A physiologic dip in RBCs occurs at age 2-3 months. In pre-term infants this phenomenon is exacerbated and causes anemia of prematurity.

251
Q

Herpes simplex ultrasound and fetal findings?

A

Placental and umbilical cord calcifications. temporal lobe involvement in the fetus.

252
Q

Congenital defects associated with varicella zoster infection?

A
  • Club foot
  • Hypoplastic limbs
  • Hydrops fetalis
253
Q

Indications for urgent dialysis?

A

AEIOU
A: acidosis, pH <7.1
E: electrolyte imbalance, severe or symptomatic hyperkalemia
I: ingestion: toxic alcohols (methanol, ethylene glycol), salicylate, lithium, valproate, carbamazepine
O: overload refractory to diuretics
U: uremia symptomatic (encephalopathy, pericarditis, and bleeding)

254
Q

Causes of asterixis?

A
  • Hepatic encephalopathy
  • Uremic encephalopathy
  • Hypercapnia
255
Q

What stain is used to visualize Howell-Jolly bodies? Heinz bodies?

A
  • Wright staining = Howell-Jolly

- Crystal violent = Heinz bodies

256
Q

Ddx of hypokalemia, alkalosis, and normotension (4)?

What is the urine finding 3 of them have in common?

A
  • Surreptitious vomiting
  • Diuretic abuse
  • Bartter syndrome
  • Gitelman’s syndrome

Diuretic abuse and Bartter/ Gitelman results in high urine chloride concentration whereas bulimia might result in low urine chloride

257
Q

Septic arthritis us usually caused by a gram + organism and treated with vancomycin, however some people do not improve and need additional gram - coverage. Which abx would be used?

A

A 3rd generation cephalosporin e.g ceftriaxone

258
Q

CXR findings in transient tachypnea of the newborn?

A

Increased pulmonary vascular markings or fluid in the fissures.

259
Q

How does Freidreich ataxia present?

A

Presents in adolescence with progressive ataxia, dysarthria, scoliosis, hypertrophic cardiomyopathy, and loss of vibratory/prioprioceptive sensation.

260
Q

Which diseases are associated with erythema nodosum?

A
  • Strep infection
  • Sarcoidosis
  • TB
  • Endemic fungal disease (e.g histoplasmosis)
  • IBD
  • Behcet disease
261
Q

How is catatonia treated?

A

Benzodiazepines or ECT for severe cases

262
Q

What is a hazard ratio?

A

It indicates the chance of an event occurring in the treatment group compared to the chance of the event occurring in the control group.
Ratio >1 means the event is more likely to occur in the tx group
Ratio <1 = event is more likely to occur in the control group
A ratio close to 1 implies little difference between the groups.

263
Q

Symptoms of central cord syndrome and first diagnostic test?

A

Usually occurs in cervical spine after trauma and causes loss of pain/temperature in upper limbs and trunk with weakness, and loss of DTR. Symptoms are usually more prominent in the hands.
First diagnostic test is MRI of the spine without contrast as well as a non contrast CT

264
Q

When should TCAs be avoided as tx for neuropathic pain?

A

If a pt has hx of a cardiac condition b/c they might prolong QRS/Qt interval and causes arrhythmias.
It should also be avoided in patients with epilepsy and glaucoma.

265
Q

How does cortisol affect ADH?

A

It inhibits it

266
Q

What is the pH status in adrenal insufficiency related to corticosteroid withdrawal?

A

It is not associated with normal anion gap metabolic acidosis because aldosterone secretion is preserved.

267
Q

What is the status of K in adrenal insufficiency due to corticosteroid withdrawal?

A

There is no hyperkalemia because aldosterone secretion is preserved.

268
Q

What would be seen in peripheral blood smear in a pt with scleroderma renal crisis?

A

Schistocytes

269
Q

Where are Burr cells (echinocytes) seen?

A

Liver dz and ESRD.

270
Q

Where are spur cells (acanthocytes) seen?

A

Liver disease

271
Q

How does scleroderma renal crisis present?

A

Presents with acute renal failure (w/o previous kidney dz), malignant HTN (HA, blurry vision, nausea), UA may show mild proteinuria, microangiopathic hemolytic anemia (schistocytes) and thrombocytopenia.

272
Q

Clinical presentation of exztraperitoneal bladder injury and what other injury does it usually occur with?

A

Localized pain in lower abdomen and pelvis (due to spill of urine), gross hematuria, urinary retention, and it usually occurs with pelvic fractures.

273
Q

What does organophosphate poisoning do and how does it present?

A

It inhibits acetylcholinesterase. It presents with sx of cholinergic excess like bradycardia, miosis, bronchorrhea, muscle fasciculation’s, salivation, lacrimation, diarrhea, and urination.
Remove the person’s clothing, wash them, and give atropine.

274
Q

What test should be obtained in a TCA overdose?

A

An ECG to assess for for QRS prolongation.

275
Q

Retinal hemorrhage in a baby is most likely due to what?

A

Abuse head trauma aka shaken baby syndrome

276
Q

Which abx is most commonly used to treat UTIs in children?

A

3rd generation cephalosporins like cefixime.

277
Q

What is the tx for primary CNS lymphoma?

A

Methotrexate and brain radiation

278
Q

Clinical features of Legionella pneumonia?

A

Slowly evolving, fever, and has GI symptoms (vomiting and diarrhea).

279
Q

What CSF findings suggest cryptococcal meningitis?

A
  • Elevated opening pressure
  • low WBC count <50
  • Low glucose
  • Elevated protein
280
Q

Increase in creatinine by 30% after starting an ACE or an ARB is most likely due to what underlying cause?

A

Renal artery stenosis

281
Q

The question is about psoriasis and mentions lymphoma or risk factors for lymphoma. What do you do?

A

Biopsy the lesion

282
Q

How does tethered cord syndrome present and what condition is it associated with?

A

Presents with weakness, decreased sensation, urinary incontinence, and hyporeflexia. Because the cord is affected below T12/L1 UMN signs are not present. It is associated with spina bifida.

283
Q

Tumor lysis syndrome prophylaxis?

A
  • IV fluids

- Allopurinol or rasburicase

284
Q

What are the electrolyte abnormalities in tumor lysis syndrome and what causes them?

A
  • Hyperuricemia: nucleic acids are released and metabolized into uric acid
  • Hyperkalemia and hyperphosphatemia: these are released intracellular ions
  • Hypocalcemia: precipitated by increased phosphate
285
Q

Clinical features of sporotrichosis? Tx?

A

Subacute skin papule that ulcerates with nonpurulent odorless drainage and proximal lesions along the lymphatic chain. LAD is rare.
Tx is 3-6 mo of itraconazole.

286
Q

Murmur that doesn’t change with valsalva?

A

Systolic flow murmur

287
Q

Causes of high output cardiac failure?

A
  • AVF
  • Thyrotoxicosis
  • Paget disease
  • Anemia
  • Thiamine deficiency
288
Q

Acute MS exacerbation? Next step if that doesn’t work?

A

Glucocorticoids. Use plasmapheresis if refractory.

289
Q

What kind of hormones does a Leydig tumor secrete?

A

Estrogen or testosterone

290
Q

Seminoma features?

A

Painless testicular mass that does not produce hCG, AFP, or estrogen

291
Q

Sertoli tumor features?

A

Occasionally secretes excessive estrogen

292
Q

Tx for acute cocain intoxication with symptoms of sympathetic hyperactivity?

A

Benzodiazepines

293
Q

Which medication is contraindicated in cocaine toxicity?

A

Beta blockers

294
Q

Periumbilical pain that is disproportionate to physical exam findings?

A

Acute mesenteric ischemia

295
Q

CSF findings in Creutzfeldt-Jakob disease? EEG findings?

A

Positive 14-3-3 CSF assay.

Sharp wave complexes on EEG

296
Q

What is. dermatofibroma?

A

It is a benign fibroblast proliferation that appears as a firm, hyperpigmented nodule, most often on the lower extremities. They have a fibrous component that causes dimpling in the center when the area is pinched (dimple or buttonhole sign)

297
Q

What is an epidermal inclusion cyst?

A

A benign nodule containing epithelium that produces keratin. It presents as a dome-shaped firm and movable cyst with a central punctum. It usually regresses on its own.

298
Q

Congenital rubella symptoms?

A
  • Hearing loss
  • Heart defects (PDA)
  • Microcephaly
  • Cataracts
  • Blueberry muffin rash
299
Q

Referred pain felt in the ear is coming from where?

A

Dental disease, TMJ, Head and neck squamous cell carcinoma like: CN IX (base of tongue tumor) and X (posterior pharyngeal wall tumor)

300
Q

How does L5 radiculopathy present?

A

Back pain radiating to the foot with weakness of foot inversion and plantar flexion.

301
Q

Dorsiflexion of the foot is caused by injury to what nerve? Where does this nerve run?

A

Common Peroneal nerve that runs along the lateral fibula.

302
Q

Causes of hyperandrogenism in pregnancy and how to differentiate between them?

A
  • Placenta aromatase deficiency: no ovarian masses
  • Luteoma: uni/bilateral solid ovarian masses
  • Theca lutein cyst: bilateral cystic ovarian masses. Low fetal virilization
    Sertoli-Leydig tumor: solid unilateral mass. Surgery required 2nd trimester or postpartum
303
Q

What physiologic changes happen to the kidneys during pregnancy?

A

Bilateral hydronephrosis with dilation of the pelvises and proximal ureters. It requires no additional management.

304
Q

Tx of Lyme disease in pregnant and lactating women and children under <8?

A

Amoxicillin

305
Q

Clinical features of osteoid osteoma and tx?

A

Benign bone tumor that is common in adolescent boys and occurs in the proximal femur. Pain is worse at night, unrelated to activity, and is relieved by NSAIDs.
Tx is NSAIDS and monitoring for spontaneous resolution.

306
Q

Clinical features of Ewing sarcoma?

A

Typically occurs in the pelvis and femur diaphyses with pain and swelling. Pain is worse with activity and not relieved by NSAIDS. X-ray shows onion skinning.

307
Q

Osteosarcoma presentation?

A

Chronic localized pain and a soft tissue mass. X-ray shows bony destruction with a “sunburst” pattern

308
Q

Features of laxative abuse?

A

10-20 watery diarrhea per day that also occurs at night and has abdominal cramps. Metabolic alkalosis (usually) and melanosis coli (dark brown discoloration of the colon)

309
Q

Causes of macrocytic anemia?

A
  • Folate/Vit B12 deficiency
  • Myelodysplastic syndromes
  • AML
  • Drug-induced (hydroxyurea, zidovudine, chemo)
  • Liver disease
  • Alcohol abuse
  • Hypothyroidism
310
Q

Peripheral smear findings in megaloblastic anemia?

A
  • Hypersegmented neutrophils
  • Anisocytosis
  • Poikilocytosis
  • Low reticulocyte count
311
Q

Basophilic stippling can occur in which anemias?

A
  • Lead poisoning
  • Alcoholism
  • Thalassemias

Basophilic stippling is a nonspecific finding

312
Q

What does a pericardial knock sound like?

A

A mid diastolic sound

313
Q

Imaging results of constrictive pericarditis?

A

Pericardial thickening with calcifications.

314
Q

Echo results of cardiac amyloidosis?

A

Increased ventricular wall thickness with a normal or non dilated left ventricular cavity.

315
Q

What can be done to reduce pain due to chronic pancreatitis? What is the next step if that doesn’t work?

A

Pancreatic enzyme supplementation to reduce pancreatic stimulation.
Gabapentin, pregabalin, or amitriptyline.

316
Q

Clinical presentation of thyroid lymphoma? What is a risk factor for it?

A

Hashimoto’s is a risk factor. It presents with a rapidly enlarging diffuse firm goiter with compressive symptoms (dysphagia, hoarseness, Pemberton sign (raising arms causes distended neck veins and red face), pts also have B symptoms.

317
Q

How does infectious cavernous venous thrombosis occur and how does it present?

A

It is caused by uncontrolled infection of the skin, sinuses, and orbit. It presents with HA, intracranial HTN symptoms, periorybital edema, CN II, IV, V, VI deficits, facial pain, and a low grade fever.
Features often become bilateral.

318
Q

6 year old girl with precocious puberty, irregular cafe au lait macules, polyostotos foibrous dysplasia (recurrent long bone fractures). What does she have? What other things could this condition cause?

A

McCune -Albright Syndrome.

This syndrome causes overproduction of pituitary hormones so it could also cause thyrotoxicosis (TSH), acromegaly (GH) and Cushing syndrome (ACTH)

319
Q

How is neurofibromatosis 1 different from McCune-Albright syndrome?

A

NF 1 also causes precocious puberty, and long-bone dysplasia (fractures), however, its cafe au lait macules are more numerous with regular borders, and is associated with axillary/inguinal freckling.

320
Q

How does Sturge-Weber syndrome present?

A
  • Intellectual disability
  • Seizures
  • Visual impairment (due to capillary-venous malformations)
  • A port wine stain in the trigeminal nerve distribution
321
Q

What do the skin lesions associated with tuberous sclerosis look like?

A

Hypopigmented ash leaf spots and shagreen patches.

322
Q

Fat embolism pulmonary artery filling test results?

A

Arterial filling defect will not be seen because the emboli obstruct the pulmonary capillaries which are too small to be detected on CT

323
Q

Chest imaging findings in pulmonary contusion?

A

Localized pulmonary edema not a diffused scattered pattern.

324
Q

What is Langerhans cell histiocytosis and how does it present?

A

A rare disorder seen in children < 3 years. Presents with single or multiple punched out lytic bone lesions.

325
Q

Possible UA findings in Wilms tumor?

A

Gross hematuria and RBCs on UA

326
Q

UA and clinical features of post streptococcal glomerulonephritis?

A

UA: hematuria and proteinuria

HTN and edema

327
Q

How does erysipelas present?

A

This is a group A strep infection that presents with a well-demarcated warm, tender area of erythema. Overlying bullae can develop in severe cases, and pts often have constitutional symptoms (fever, chills). Diffuse rash and shedding do not occur.

328
Q

What is another name for erythroderma and how does it present?

A

Exfoliative dermatitis. Pts have erythema and scaling in >90% of the body. Bright red patches coalesce and gradually peel.

329
Q

How does salicylate intoxication present and what is the tx?

A
  • Tinnitus
  • N/V
  • Fever
  • Altered menta status
  • Metabolic acidosis then respiratory alkalosis

Tx includes alkalization of the urine with sodium bicarbonate

330
Q

How does graft-versus-host disease manifest?

A

Donor T lymphocytes attack the host’s skin (macuopapular rash involving the face, palms, and soles), intestines (blood positive diarrhea), and liver (abnormal LFTs)

331
Q

Describe the presentation of Ehrlichiosis?

A

A tick borne infection that starts with flu like symptoms (high fever, HA, myalgia, chills). Lab findings include luekopenia and /or thrombocytopenia, elevated liver enzymes and LDH, and neurologic symptoms.

It does not typically have a rash.

332
Q

What is a 2nd line abx to tx Rocky Mountain spotted fever and Ehrlichiosis?

A

Chloramphenicol

333
Q

What medications are used for Tourette syndrome?

A
  • Antidopaminergic agents:
    ~ Tetrabenazine (dopamine depleter)
    ~ Antipsychotics
  • Alpha 2 adrenergic receptor agonists like guanfacine
334
Q

At what hCG level should an intrauterine pregnancy be found on intravaginal ultrasound?

A

> 1500 IU/L

335
Q

How does disseminated gonococcal infection present?

A

Triad of polyarthralgia, tenosynovitis, and painless vesiculopustular skin lesions (2-10)

336
Q

Complications of cryptorchidism that is unfixed or fixed late?

A
  • Testicular torsion
  • Subfertility
  • Testicular cancer
  • Inguinal hernia
337
Q

Lab findings in legionella pneumonia?

A
  • Hyponatremia
  • Hepatic dysfunction
  • Hematuria and proteinuria
  • Gram stain that shows many neutrophils but few or no microorganisms
338
Q

Does COPD cause clubbing?

A

No. Its presence in patients with COPD should prompt a search for malignancy

339
Q

Neurological deficits in uncal herniations?

A

Ipsilateral CN III palsy and hemiparesis

340
Q

What kind of screening is needed for patients with cirrhosis?

A

Screening abdominal ultrasound every 6 months to evaluate for new-onset HCC

341
Q

Side effects of methotrexate?

A
  • Hepatitis
  • Stomatitis
  • Cytopenias
342
Q

How do glucocorticoids affect the different WBCs?

A

They increase neutrophil concentration but decrease lymphocytes, eosinophils, and monocytes.

343
Q

What other infection is Babesiosis similar to? Where is it common?

A

It presents similarly to Malaria but is common in northeastern and midwestern US.

344
Q

Describe presentation of Dengue fever?

A

Symptoms develop 4-7 days (almost never >2 weeks) after mosquito bite. Patients present with fever, HA, marked muscle ad joint pain, retroorbital pain, rash, and leukopenia.

345
Q

How does hepatitis A present?

A
  • Fever
  • Jaundice
  • Hepatomegaly
  • Dark urine
  • Acholic stool
  • Pruritus
346
Q

How does typhoid fever present?

A

HA, GI symptoms, salmon rose spots, and relative bradycardia.

347
Q

What is the timeframe for acute renal transplant rejection? What are the biopsy results?

A

Occurs within the 1st 6 months.
Biopsy shows lymphocytic infiltration of the intima with swelling and inflammatory tubular disruption.

Patients will also have an asymptomatic rise in creatinine.

348
Q

What is bilateral nontender swelling of the submandibular glands called and what is it associated with?

A

Sialadenosis. It is associated with advanced liver disease (both alcoholic and non-alcoholic cirrhosis)

349
Q

How does lichen planus present?

A

Pruritic purple plaques that are sometimes associated with thin white striae around the labia and vulva.

350
Q

What is lichen simplex chronicus?

A

It occurs secondary to repetitive scratching. Patients develop a hyperplastic response that causes thickened leathery skin.

351
Q

Clinical presentation and lab findings in staphylococcal toxic shock syndrome?

A

Fever, n/v, myalgias, widespread peeling rash involving the palms and soles as well, shock (hypotension and tachycardia), altered mental status (lethargy, coma, confusion)
Lab: decreased platelets, elevated transaminases and bilirubin

352
Q

What are the contraindications to the use of the following uterotonics in postpartum hemorrhage:methylergonovine, carboprost, and tranexamic acid?

A
  • Methylergonovine (methergine): HTN
  • Carboprost (hemabate): asthma
  • Tranexamic acid: hypercoagulability state
353
Q

What is a unique feature of Lambert-Eaton syndrome?

A

Diminished or absent deep tendon reflexes

354
Q

Cause of painless gross hematuria in someone with sickle cell trait? UA results?

A

Renal papillary necrosis.

Blood with normal RBC morphology

355
Q

UA results in acute interstitial nephritis?

serum creatinine?

A

Abundant WBCs many of which are neutrophils.

Serum creatinine will be elevated

356
Q

UA and serum findings in acute tubular necrosis?

A

UA: granular casts, hematuria, renal tubular epithelial cells.

Serum creatinine will be elevated

357
Q

How do you monitor resolution of ketonemia in DKA?

A

By measuring anion gap or direct assay of beta-hydroxybutyrate (BH)

358
Q

When can you switch to basal bolus insulin in DKA or HHS management?

A
  • Able to eat
  • Glucose <200 mg/dL
  • Anion gap <12
  • Serum HCO3 = or > 15 mEq/L
359
Q

Symptoms of posterior urethral injury? How do you diagnose?

A
  • Blood at urethral meatus
  • Inability to void
  • Perineal or scrotal hematoma
  • High-riding prostate on DRE

Diagnose with aa retrograde urethrogram

360
Q

Varicocele that fails to empty when patient is recumbent in addition to painless hematuria should raise suspicion for what?

A

Renal cell carcinoma

361
Q

How do you diagnose renal cell carcinoma?

A

Abdominal CT

362
Q

Symptoms of renal cell carcinoma?

A
  • Flank pain and mass
  • Hematuria
  • Left sided varicocele (that fails to empty)
  • Anemia or erythrocytosis
  • Thrombocytosis
  • Fever
  • Fatigue, weight loss
  • Hypercalcemia
363
Q

Tx for strep viridans infective endocarditis that is sensitive to penicillin?
What if they have a penicillin allergy?

A

4 weeks of IV penicillin G or ceftriaxone.

If allergic use vancomycin.

364
Q

Next step in patients with significant sternal wound drainage with or without systemic symptoms?

A

Chest and sternal imaging to look for fluid collections or pneumomediastinum

365
Q

Describe primary infection presentation in disseminated gonococcal infection?

A

It is usually silent

366
Q

UA results of cystinuria? Name a diagnostic test. What is the MOA of this disease?

A

Hexagonal crystals on UA

Cyanide-nitroprusside will detect elevated cystine in the urine

This condition is due to impaired transport of cystine and other amino acids like ornithine, lysine, and arginine.

367
Q

Urine chloride level is metabolic alkalosis secondary to vomiting/nasogastric aspiration?

A

Low urine chloride

368
Q

What are the acid-base findings in aspirin toxicity?

A
  • Near normal or normal pH
  • Metabolic acidosis
  • Respiratory alkalosis

HCO3 and PaCO2 will both be low

369
Q

Causes of hematuria throughout the urinary stream? Which parts of the urinary tract are involved?

A

Upper collecting system (kidney and upper ureters)

  • Renal mass (benign/malignant)
  • Glomerulonephritis
  • Urolithiasis
  • Polycystic kidney disease
  • Urothelial cancer
  • Trauma
370
Q

Causes of hematuria at the end of the urinary stream? Which parts of the urinary tract are involved?

A

Lower ureter, bladder up to right below the prostatic urethra

  • Urothelial cancer
  • Cystitis (infectious or post-radiation)
  • Urolithiasis
  • Benign prostatic hyperplasia
  • Prostate cancer
371
Q

Causes of hematuria at the beginning of the urinary stream? Which parts of the urinary tract are involved?

A

Urethra below the prostate

  • Urethritis
  • Trauma (catheterizations)
372
Q

What is the mnemonic for papillary necrosis and what does it stand for?

A 
NSAID:
N: NSAIDs
S: sickle cell
A: analgesic abuse
I: infection (pyelonephritis)
D: diabetes mellitus
373
Q

What would cause refractory (difficult to correct) hypokalemia in a chronic alcoholic?

A

Hypomagnesemia.
Intracellular magnesium inhibits K secretion by the renal outer medullary potassium (ROMK) channels in the collecting tubules.

374
Q

Renal vein thrombosis (RVT)is a complication of nephrotic syndrome. How does it present and which of the nephrotic syndrome is it more commonly associated?

A

Usually presents with side abdominal pain, fever, and gross hematuria.

Associated with membranous glomerulopathy

USMLE Step 2 Saba (1 decks)

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