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Uworld > Internal Medicine > Flashcards

Internal Medicine Flashcards

1
Q

Korsakoff syndrome is a potential complication of Wernicke encephalopathy that is characterized by __________, ________, ________, and _______.

A

retrograde and anterograde amnesia with preserved long term memory, confabulation, lack of sight and apathy

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2
Q

___________________ often cause feminization (eg, gynecomastia) due to the production of estrogen by tumor cells.

A

Leydig cell testicular tumors

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3
Q

In patients with alcoholic cirrhosis, ____________ can reduce liver inflammation, fibrogenesis, and portal pressure, which can lead to the resolution of ascites and, ultimately, improved survival.

A

Cessation of alcohol use

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4
Q

____, ______ and _______ accounts for >90% of chronic cough in non smokers who do not have pulmonary disease

A

Post nasal drip, GERD and asthma

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5
Q

For patients with suspected post nasal drip initial empiric treatment includes ___________ or _________

A

Oral first-generation antihistamine (eg chlorpheniramine) or combined antihistamine-decongestant (eg brompheniramine and pseudoephedrine)

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6
Q

_______ is characterized by a painful, red eye with tearing and decreased visual acuity.

A

Anterior uveitis

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7
Q

_______________ in children typically presents with an erythematous, tender, warm lymph node as well as possible fever and fluctuance

A

Acute, unilateral cervical lymphadenitis

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8
Q

________ is an intensely pruritic rash characterized by small erythematous papules and burrows in the axillae, periumbilical area, genitalia and interdigital web spaces

A

Scabies

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9
Q

The first line treatment of scabies is ________ or _______

A

Topical 5% permethrin or oral ivermectin

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10
Q

Hematuria in the setting of direct penile trauma concerning for _________ and should prompt ____________

A

Urethral injury

Retrograde urethrography

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11
Q

___________ is a small-vessel vasculitis that commonly presents with palpable purpura (leukocytoclastic vasculitis), arthralgias, fatigue, peripheral neuropathy, liver involvement and renal disease

A

Mixed cryoglobulinemia

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12
Q

____________ is the most common cause of dementia in the western world. It is characterized initially by gradual memory loss, language difficulties, and apraxia, followed by impaired judgment and personality and behavioral changes.

A

Alzheimer’s disease

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13
Q

Type 1 MEN

A
  • Primary hyperparathyroidism
  • pituitary adenoma
  • pancreatic tumors (especially gastrinomas)
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14
Q

Type 2A MEN

A
  • medullary thyroid cancer
  • pheochromocytoma
  • Primary hyperparathyroidism
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15
Q

Type 2B MEN

A
  • medullary thyroid cancer
  • pheochromocytoma
  • mucosal neuromas/ marfanoid habitus
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16
Q

Milk-alkali syndrome is caused by excessive intake of _____ and ____

A

excessive intake of calcium and absorbable alkali

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17
Q

clinical findings seen in milk-alkali syndrome include ______, _______ and ________

A

symptomatic hypercalcemia, metabolic alkalosis and acute kidney injury

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18
Q

_________ should be suspected in patients with AIDS who have CD4 counts<50/mm3; frequent small-volume, bloody stools and abdominal pain.

A

Cytomegalovirus colitis

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19
Q

The preferred initial treatment for uncomplicated BPH includes _________

A

alpha-1 blockers e.g. terazosin, tamsulosin

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20
Q

______ is characterized by hypertension, mild hypernatremia, metabolic alkalosis and suppressed plasma renin activity

A

Primary hyperaldosteronism

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21
Q

In patients with suspected stroke, ___________ is the initial diagnostic test of choice

A

noncontrast CT scan of the head

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22
Q

________ is an effective and rapid method used to abort an acute cluster headache without major side effects

A

providing 100% oxygen

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23
Q

______________ is a common manifestation of systemic sclerosis that typically presents with progressive dyspnea and often leads to right ventricular enlargement and right-sided heart failure.

A

Pulmonary arterial hypertension

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24
Q

________________ is a common manifestation of systemic sclerosis that results from intimal hyperplasia of the pulmonary arteries.

A

Pulmonary arterial hypertension

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25
Q

First-line treatment for essential tremor is ________________, especially if the patient is also hypertensive.

A

propranolol

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26
Q

__________ causes pruritic, erythematous plaques with a greasy scale that predominantly affect the scalp and face.

A

Seborrheic dermatitis

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27
Q

_____________ is the initial treatment of choice.in patients with persistent tachyarrhythmia (narrow or wide complex) associated with clinical or hemodynamic (hypotension, cardiogenic shock, signs of ischemia, acute heart failure)

A

Immediate synchronized cardioversion

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28
Q

A pt after gastric bypass procedure presents with bloating, flatulence and watery diarrhea; malabsorption and nutritional deficiencies most likely as__________

A

Small intestinal bacterial overgrowth

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29
Q

Methamphetamine use is associated with cardiomyopathy. T/F

A

True

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30
Q

Dobutamine is a potent inotropic agent with a strong affinity for _________ receptors and a weak affinity for _____ and _____ receptors.

A

Strong affinity for beta 1 receptors and weak affinity for beta 2 and alpha 1 receptors

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31
Q

Dobutamine stimulates increased myocardial contractility leading to _____, _____ and ____

A

Improved EF, reduced Left ventricular ESV and symptomatic improvement of decompensated HF

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32
Q

Initial test for a patient with suspected acute stroke is ______

A

Head CT Scan without contrast

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33
Q

____________ is characterized by a recurrent, pruritic, vesicular rash that primarily affects the palms, soles, and sides of the digits.

A

Dyshidrotic eczema (acute palmoplantar eczema)

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34
Q

______ is a large artery vasculitis that I’d most common in young Asian women

A

Takayasu arteritis

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35
Q

A young Asian woman presents with c/o initial symptoms of fever, arthralgias and weight loss and later features of blood pressure discrepancies and claudicationof upper extremities. Diagnosis?

A

Takayasu arteritis

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36
Q

Abortive treatment for migraine

5

A
  • NSAIDs eg, naproxen
  • Acetaminophen
  • Ergotamine eg, dihydroergotamine
  • Triptans eg, sumtriptan
  • Antiemetics eg, metoclopramide, prochloperazine
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37
Q

Preventives therapy for migraines

A
  • Topiramate
  • Divalproex sodium
  • Tricyclic antidepressants
  • Beta blockers (eg, propanolol)
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38
Q

_______ and ______ are indicated in patients with severe asthma unresponsive to maximal medical therapy and who have signs of impending respiratory arrest

A

Endotracheal intubation and mechanical ventilation

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39
Q

Signs of ________ includes altered mental status, minimal aeration, hyoercarbia and worsening hypoxemia

A

Respiratory failure

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40
Q

Patients with cocaine-associated chest pain should be treated initially with ________________

A

Intravenous benzodiazepines

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41
Q

A personal history of recurrent kidney stones from childhood, a positive family history for nephrolithiasis and a positive cyanide-nitroprusside test raises suspicion for diagnosis

A

Cystinuria

42
Q

Ecthyma gangrenosum is a rapidly progressive cutaneous disorder seen most commonly in immunocompromised patients with __________________.(pathogen) Lesions begin as painless red macules, quickly progress to pustules/bullae, and then form “punched-out” gangrenous ulcers.

A

Pseudomonas aeruginosa bacteremia/sepsis.

43
Q

Suspect____________ in a young woman with obesity who comes with a headache that is suggestive of a brain tumor, but with normal neuroimaging and elevated CSF pressure.

A

idiopathic intracranial hypertension (pseudotumor cerebri

44
Q

The most significant complication of pseudotumor cerebri is _____________

A

Blindness

45
Q

Treatment of idiopathic intracranial hypertension includes ______ and _______

A

Weight reduction and acetazolamide

46
Q

________ or _________ may be performed to prevent blindness in idiopathic intracranial hypertension

A

Shunting or optic nerve sheath fenestration

47
Q

Differential diagnosis for polyuria and dilute urine…….. (3)

A

Central or nephrogenic diabetes insipidus or primary polydipsia

48
Q

wernicke encephalopathy triad

A

encephalopathy
gait ataxia
ocular dysfunction

49
Q

________test can differentiate between DI and primary polydipsia

A

The water deprivation test

50
Q

___________ should be suspected in patients with conjunctival erythema and thick, purulent eye discharge that reaccumulates within a few minutes after wiping.

A

Bacterial conjunctivitis

51
Q

_______ is the most common etiology of bacterial conjunctivitis in adults.

A

Staph aureus

52
Q

one of the earliest findings in macular degeneration is ___

A

distortion of straight line such that they appear wavy

53
Q

______ is the most common cause of blindness in industrialized nations

A

macular degeneration

54
Q

on ophthalmology examination _________ is a common lesion seen in the macula

A

drusen deposit

55
Q

CSF analysis (WBC, Glucose, protein) for normal:

A

WBC: 0-5
Glucose: 40-70
Protein: <40

56
Q

CSF analysis (WBC, Glucose, protein) for bacterial meningitis

A

WBC count: >1000
Glucose: <40
Protein: >250

57
Q

CSF analysis (WBC, Glucose, protein) for tuberculosis meningitis

A

WBC count: 5-1000
Glucose: <10
Protein: > 250

58
Q

CSF analysis (WBC, Glucose, protein) for viral meningitis

A

WBC count: 10-500
Glucose: 40-70
Protein: <150

59
Q

______ is commonly characterized by mental status changes, respiratory depression and mioisis

A

Opioid Intoxication

60
Q

Topical glucocorticoid eyedrops and systemic glucocorticoids can raise____________, leading to open-angle glaucoma (OAG).

A

intraocular pressure (IOP)

61
Q

________ is usually characterized by insidious loss of peripheral vision, and some patients with steroid-induced ________ may develop central blurriness due to corneal edema.

A

Open-angle glaucoma (OAG)

OAG

62
Q

Intracranial Pressure can be measured with_________

A

Tonometry

63
Q

______________ is characterized by inflammation and degeneration of the plantar aponeurosis (deep plantar fascia), a thick, fibrous band that extends from the calcaneus to the toes and supports the longitudinal arch of the foot. It presents with chronic pain at the sole of the foot that is worse with weight bearing.

A

Plantar fasciitis

64
Q

Indication for cervical spine imaging: (6)

A
  • high-energy mechanism of injury
  • neurologic deficit
  • spinal tenderness
  • altered mental status
  • intoxication
  • distracting injury
65
Q

The presence of a single vertebral fracture in a patient with blunt trauma is an indication to image the entire spine. T/F

A

True

66
Q

___ is sensitive and accurate for diagnosing thoracolumbar spine injury

A

CT scan

67
Q

__________ is an endemic mycosis of the desert southwest that causes community-acquired pneumonia (fever, chest pain, cough, lobar infiltrate) often accompanied by arthralgias, eythema nodosum and erythema multiforme

A

Coccidioides

68
Q

_______ is characterized by the acute onset of hypertension and acute kidney injury in a patient with systemic sclerosis

A

scleroderma renal crisis

69
Q

The mainstay therapy of a patient with systemic sclerosis who presents with acute onset of hypertension and acute kidney injury is ____

A

ACEi eg, typically captopril

70
Q

patients with _______ typically have pleuritic chest pain, a pericardial friction rub, and diffuse ST-segment elevations on ECG < 4 days post MI

A

peri-infarction pericarditis

71
Q

_____ is the best form of photoprotection

A

sun avoidance

72
Q

sunscreen with sun protective factor______ should be applied how?

A

> /= 30 should be applied liberally 15=30 minutes prior to sun exposure and reapplied every 2 hours or after swimming

73
Q

_____________ is a complication of mediastinal irradiation and an important cause of right heart failure. It should be suspected in patients with progressive peripheral edema, elevated jugular venous pressure, hepatomegaly, and ascites.

A

constrictive pericarditis

74
Q

___________ causes injury to the upper aerodigestive tract and most commonly presents with pain, dysphagia, and oropharyngeal erythema and ulcerations. It does not cause alterations in consciousness.

A

A caustic ingestion

75
Q

__________ can manifest as central nervous system stimulation (eg, headache, insomnia, seizures), gastrointestinal disturbances (eg, nausea, vomiting), and cardiac toxicity (arrhythmia).

A

theophylline toxicity

76
Q

sudden death post MI. CAUSE?

A

fatal arrhythmia—V.fib

77
Q

new systolic murmur 2-7 days after MI

A

Papillary muscle rupture

78
Q

The most severe consequences of methanol intoxication are

A

Vision loss and coma

79
Q

Post concussive syndrome

A

Headache, confusion, amnesia, difficulty concentrating or with multitasking, mood alteration, vertigo, sleep disturbance and anxiety following traumatic brain injury of any severity

80
Q

What should be given to patients that present to the ED with chest pain and suspected ACS?

A

Aspirin ASAP

81
Q

Painful sensorimotor polyneuropathy, skin lesions (hypo- and hyperpigmented, hyperkeratotic), pancytopenia and mild transaminase elevation in a pt with possible environmental exposure warrants suspicion of

A

Arsenic toxicity

82
Q

Difference between autoimmune hemolytic anemia and hereditary spherocytosis

A

Negative family history and positive Coombs test suggests AIHA while positive family history and negavitice Coombs test suggest HS

83
Q

Typical lab findings seen in osteomalacia

A

Hypocalcemia
Hypophosphatemia
Elevated alkaline phosphatase

84
Q

Define orthostatic hypotension

A

Defined as a postural decrease in blood pressure by 20mmHg systolic or 10mmHg diastolic that occurs on standing.

85
Q

_______________ is the most common end-organ complication of CMV in those with advanced AIDS

A

Cytomegalovirus (CMV) retinitis

86
Q

First line therapy for chemotherapy related diarrhea

A

Oral hydration and anti diarrheal eg, loperamide

87
Q

Reversal of warfarin toxicity

A

Vitamin K
Prothrombin complex concentrate
Fresh frozen plasma

88
Q

A type of optic neuropathy characterized by loss of peripheral vision associated with enlarged optic cup and increased cup/disc ratio (> 0.6)

A

Open-angle glaucoma

89
Q

6 causes of normal anion gap metabolic acidosis

A 
Diarrhea 
Fistulas (eg, pancreatic, ileocutaneous, etc.)
Carbonic anhydrase inhibitors 
Renal tubular acidosis
Ureteral diversion ( eg, ideal loop)
Iatrogenic
90
Q

initial therapy of patients with pulmonary edema and hypoxemia due to acute decompensated heart failure includes

A

aggressive intravenous diuresis, oxygen supplementation, and possibly assisted ventilation.

91
Q

How does obstructive uropathy presents

A

Flank pain
Low volume voids with or without occasional high-volume voids
And if bilateral renal dysfunction

92
Q

Define acute liver failure

A

Acute onset of severe liver sever liver injury with encephalopathy and impaired synthetic function (defined as INR >/= 1.5) in a patient without cirrhosis or underlying liver disease

93
Q

Transport proteins that thyroid hormone is bound to

A

Thyroxine-binding protein
Transthyretin
Albumin

94
Q

_____________ are the most appropriate diagnostic tests for acute hepatitis B infection as they are both elevated during initial infection and ___________ will remain elevated during the window period.

A

HBsAg and anti-HBc

anti-HBc

95
Q

Treatments of Graves’ disease

A

Anti thyroid drugs
Radioactive iodine
Thyroidectomy

96
Q

Peri-infarction pericarditis can be prevented by

A

Early coronary reperfusion therapy

97
Q

First line treatment of mycoplasma pneumonia is

A

Azithromycin

98
Q

Preferred therapy for symptomatic Paget disease of bone

A

Bisphosphonates

99
Q

Bone loss associated with anemia, renal insufficiency and hypercalcemia suggests _________

A

Multiple myeloma

100
Q

First line treatment of mycoplasma pneumonia is

A

Azithromycin

101
Q

Preferred therapy for symptomatic Paget disease of bone

A

Bisphosphonates

102
Q

Bone loss associated with anemia, renal insufficiency and hypercalcemia suggests _________

A

Multiple myeloma

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