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step 2 uworld > april 20 > Flashcards

april 20 Flashcards

1
Q

clinical features of a hypermetabolic state following severe burn?

A
  • increased gluconeogenesis & insulin resistance
  • increased basal metabolic rate/body temp
  • increased protein & lipid catabolism - lean muscle wasting
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2
Q

oliguria = < ____ ml of urine over 24 hours

A

500

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3
Q

management of a duodenal hematoma?

A
  • bowel rest, nasogastric decompression, and parenteral nutrition
  • drainage/surgery only required if hematoma persists after a few weeks
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4
Q

what is emphysematous cholecystitis?

A

cholecystitis caused by gas forming organisms such as clostridium

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5
Q

complications of emphysematous cholecystitis?

A

hemolysis, gangrene, necrosis, perforation and septic shock

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6
Q

treatment of emphysematous cholecystitis?

A
  • emergency cholecystectomy

- broad spectrum antibiotics

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7
Q

presentation of emphysematous cholecystitis?

A
  • rever, RUQ pain, nausea/vomiting

- crepitus in abdominal wall adjacent to gallbladder

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8
Q

when the head of the humerus is anteriorly displaced, the deltoid appears…

A

flattened

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9
Q

which nerve is commonly injured in antierior dislocation injuries?

A

axillary nerve

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10
Q

how do you treat a malignant pericardial effusion?

A

Acute: pericardiocentesis, cytologic fluid analysis
Chronic: prolonged drainage (pericardial window)

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11
Q

do varicoceles transilluminate?

A

no

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12
Q

does an inguinal hernia transilluminate?

A

no

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13
Q

does a spermatocele transilluminate?

A

yes

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14
Q

do hydroceles transillluminate?

A

yes

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15
Q

why can mechanical ventilation in a hypovolemic patient cause decreased cardiac output?

A

increase in intrathoracic pressure can collapse venous capacitance and cutoff venous return to the heart

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16
Q

treatment of adhesive capsulitis?

A

gentle range of motion exercises

  • NSAIDS
  • corticosteroid injection
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17
Q

unilateral bloody discharge with no masses found =

A

intraductal papilloma

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18
Q

serous/bloody nipple discharge + a palpable mass =

A

invasive ductal carcinoma

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19
Q

XRAY shows free air under the diaphgram suggesting ulcer rupture… next step?

A

EMERGENCY SURGICAL EXPLORATION

20
Q

what type of scan should be used to assess for a cervical spine injury?

A

CT scan

21
Q

why is XRAY not the recommended scan for assessing for a cervical spine injury?

A

not sensitive enough

22
Q

Patients with high risk injury for cervical spine injury always require…

A

imaging

23
Q

A patient has a low risk type injury for cervical spine injury. What criteria indicate that they require a scan?

A
  • intoxicated
  • alterations in mental status
  • spinal tenderness
  • neurological
  • distracting injury
24
Q

what conditions predispose patients to small intestinal bacterial overgrowth?

A
  • anatomical abnormalities such as surgery/strictures

- motility disorders (scleroderma, diabetes)

25
Q

presentation of SIBO?

A
  • diarrhea, weight loss, bloating, flatulance

- anemia, malabsorption, etc

26
Q

diagnostic tests for SIBO?

A

jejunal aspirate OR carbohydrate breath testing (lactulose, glucose)

27
Q

Dumping syndrome is a complication of..

A

gastric bypass

28
Q

path of dumping syndrome ?

A

carbohydrate rich foods are rapidly emptied into the small bowel, -> osmotic fluid shift from plasma to intestine ->abdominal pain and diarrhea

29
Q

symptoms associated with dumping syndrome?

A
30
Q

hyperechoic breast mass on ultrasound is usually…

A

benign

31
Q

what causes a complicated parapneumonic effusion?

A

bacterial invasion of pleural space

32
Q

pH of a complicated parapneumonic effusion?

A

low (<7.2)

33
Q

glucose of a complicated parapneumonic effusion?

A

low (<60)

34
Q

WBCs in a complicated parapneumonic effusion?

A

> 50 000

35
Q

protiein in a complicated parapneumonic effusion?

A

high

36
Q

is CMV pneumonitis acute or indolent in onset?

A

acute

37
Q

is pneumocystitis pneumoniia acute or indolent in onset?

A

insidious

38
Q

crescent sign is seen in…

A

ruptured popliteal cyst

39
Q

what is crescent sign?

A

an arch of bruising

40
Q

symptoms of a ruptured popliteal cyst?

A

posterior knee and calf pain, tenderness and swelling of the calf, crescent sign

41
Q

Whats an infectious complication of steroid injection into a joint?

A

septic bursitis

42
Q

diagnosis of septic bursitis?

A

bursal fluid aspiration (xray if suspected fracture or foreign body)

43
Q

treatment of septic bursitis

A

systemic antibiotics / drainage

44
Q

pain on medial / lateral squeezing of the calcaneous =

A

stress fracture

45
Q

zone of lucency or sclerosis in the poster calcaneous on XRAY =

A

calcaneous stress fracture

step 2 uworld (57 decks)

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