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Uworld Step 2 > Deck 77: Internal Medicine > Flashcards

Deck 77: Internal Medicine Flashcards

1
Q

what causes markedly impaired alveolar ventilation in acute pneumonia? What does this result in?

A

alveolar consolidation

  • hypoxemia
  • intrapulmonary shunting
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2
Q

Dead space ventilation

A

ventilation of ares of lung that are not perfused with blood

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3
Q

headache that manifests as constant pressure in the temporal and occipital regions without nausea or visual symptoms and that are unchanged of quality from prior

A

tension-type headache

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4
Q

what can cause tension headaches

A

stress

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5
Q

what can cause cluster headaches

A

sleep

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6
Q

Unilateral recurrent periorbital headache pain that resolves and recurs with associated ipsilateral miosis and ptosis

A

Cluster

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7
Q

Headaches that are pulsatile and throbbing in character, often unilateral

A

Migraine

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8
Q

what is often associated with migraine without arura

A

nausea, vomiting, and photophobia

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9
Q

how is leprosy diagnosed

A

biopsy from active edge of lesion

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10
Q

symptoms for leprosy

A

chronic, anesthetic, hypopigmented lesions with peripheral nerve involvement

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11
Q

Ichthyosis vulgaris

A

diffuse dermal scaling

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12
Q

coarsening of facial features, pharyngeal crowding, and enlargement of hands and feet

A

acromegaly

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13
Q

heart problem in acromegaly

A

concentric myocardial hypertrophy
diastolic dysfunction
left ventricular dilation
global hypokinesis

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14
Q

typical presentation of anaphylaxis

A

hypotension
tachycardia
urticarial rash
wheezing

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15
Q

fat embolism that occurs following a long-bone fracture has what clinical symptoms

A

dyspnea
neurological impairment ( confusion, seizure)
petechial rash

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16
Q

Timing difference between fat embolism from bone fracture and anaphylaxis reaction

A

anaphylaxis: quickly

fat embolism: 12-24 hours

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17
Q

Acanthosis nigricans is associated with what

A

younger patients: insulin resistance states

Older: GI malignancy

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18
Q

characterize laxative abuse

A

frequent, watery, nocturnal diarrhea

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19
Q

how do you diagnose positive laxative abuse

A

positive laxative screen

colonoscopy: melanosis coli ( dark brown discoloration with pale patches of lymph follicles)

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20
Q

characterize VIPoma diarreha

A

tea-colored

hypokalemia with hypochlorhydria

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21
Q

What distinguished peritonsillar abscess from epiglottis

A

Pertonsillar abscess: deviation of uvula and unilateral lymphadenopathy

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22
Q

what cancers are associated with lynch syndrome

A

colorectal cancer
endometrial carcinoma for female carriers
ovarian cancer

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23
Q

associated cancer with familial adenomatous polyposis

A

colorectal
desmoid and osteomas
brain tumors

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24
Q

cancer associated with von Hippel-Linau syndrome

A

Hemangioblastomas
Clear cell renal carcinoma
pheochromocytoma

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25
Q

MEN1

A

parathyroid ademona
pituitary adenoma
pancreatic adenomas

26
Q

MEN2

A

Meduallary thyroid cancer
pheochromocytoma
Parathyroid hyperplasia

27
Q

BRCA1 and BRCA2

A

breast and ovarian cancer

28
Q

X-ray finding for osteomalacia due to vitamin D deficiency

A

decreased bone density with thinning of cortex

pseudofractures (Looser zones)

29
Q

absence of identifiable bacteria on culture or gram stain, a mucopurulent urethral discharge in a patient who is sexually active suggests? what tests confirms diagnosis

A

chlamydial urethritis

Nucleic acid amplification

30
Q

which drugs have survival benefit in CHF ? which help symptoms

A

survival: ACE inhibitors, ARB, beta blockers, spironolactone
symptomatic: Digoxin, furosemide

31
Q

treatment for papillary thyroid cancer?

A

surgical resection

if high recurrence rate: radioiodine and thyroid replacement to suppress TSH

32
Q

what is performed for initial evaluation of thyroid nodules

A

thyroid scintigraphy

33
Q

thyroid peroxidase is marker for

A

hashimoto thyroiditis

34
Q

presentation of cyanide toxicity

A

altered mental status
lactic acidosis
seizures
coma

35
Q

what causes cyanide toxicity

A

nitroprusside

36
Q

how does respiratory alkalosis impact Calcium

A

Hydrogen ions dissociate from albumin

calcium binds albumin

37
Q

PE causes what acid base disturbance

A

respiratory alkalosis

38
Q

Most effective intervention in overweight patients for controlling hypertension

A

weight control

other ideas: DASH diet

39
Q

when can an abnormal S4 be heard in a person with CAD

A

acute phase of myocardial infarction due to ischemia induced Myocardial dysfunction

40
Q

when should an HIV patient get the live attenuated varicella vaccine

A

CD4 count greater than 200

41
Q

patient outstretch arms with palms up and eyes closed. Arm drifts downward and palm turns (pronates) toward the floor

A

Pronator drift

Upper motor neuron or pyramidal tract disease

42
Q

what is romberg test and what does it test for

A

stand with feet together, arms to the sides and eyes closed.
propioception

43
Q

Treatment for Dressler syndrome

A

NSAID

44
Q

what lab value is elevated in pneumocysitis pneumonia

A

lactate dehydrogenase

45
Q

is a lupus patient what is the difference ebtween pneumocysitis and pulmonary fibrosis

A

same except timing

pulmonary fibrosis shows up later

46
Q

Common cause of cyclic breast pain in women of reproductive age? PE?

A

fibrocystic breast: nodular breasts with non-focal tenderness, no nipple discharge or lymphadenopathy

47
Q

Treatment for costochondritis

A

reassurance and symptomatic pain management

48
Q

What will cause decrease airflow rate during inspiration and expiration, flattening both the top and bottom of the flow-volume loop

A

fixed upper-airway obstruction

49
Q

Mild persistent asthma? treatment

A

2 day per week
3-4 nightly awakenings per month

inhaled corticosteroid
short-acting beta-2 agonist

50
Q

exaggerated fall in systemic blood pressure (10 or more) during inspiration

A

Pulsus paradoxus

51
Q

when can you find pulsus paradoxus

A

cardiac tamponade
severe asthma
COPD

52
Q

how does aortic regurgitation prevent pulsus paradoxus

A
  • increase left ventricular end-diastolic pressure

- precludes interventricular septum to shift left

53
Q

Light criteria

A

exudative if

  • pleural fluid protein/ serum protein .5 or more
  • pleural fluid LDH/ serum LDH .6 or more
  • pleural fluid LDH greater 2/3 of upper limit of normal for serum LDH
54
Q

heart failure and hypoalbuminemia are associated with what type of effusion

A

transudative

55
Q

most common cause of liver mass in the US

A

matastatic disease

56
Q

what is Beck’s triad? and what is it associated with

A

hypotension, distended neck veins, muffled heart sounds

- cardiac tamponade

57
Q

What causes symptoms in cardiac tamponade

A
  • exaggerated shift of interventricular septum toward left

- reduces left ventricular preload, stroke volume and cardiac output

58
Q

Strongyloides stercoralis causes

A

mild intermittent skin, GI, and pulmonary symptoms

59
Q

Immediate treatment for frostbite

A

WATER bath rewarming

60
Q

most common cause of constrictive pericarditis in developing countries

A

TB

Uworld Step 2 (30 decks)

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