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UWORLD ABIM > Miscellaneous > Flashcards

Miscellaneous Flashcards

1
Q

T/F: Increased social isolation in elderly when hearing and vision loss present

A

true

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2
Q

Recurrent vertigo, tinnitus and sensorineural hearing loss

A

Meniere disease. Can experience ear fullness/pain in the affected ear

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3
Q

Common age-related hearing loss. Progressive, symmetrical and high-frequency

A

Presbycusis. Can be accompanied by bilateral tinnitus, vertigo, disequilibrium. Difficulty hearing in the presence of competing backgrounds but do well one-on-one.

Tx: hearing aids, implants

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4
Q

acute onset eye redness and tearing in young female without many disorders. foreign-body sensation. no pain, visual impairment or photophobia

A

Episcleritis. Usually self-limited, tx with topical lubricants

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5
Q

subacute eye diffuse redness and severe pain with movement/photophobia and patient with rheumatologic disease

A

Scleritis is SCARY (vs episcleritis is easy). Diffuse erythema and edema with dark red sclera. Eval for rheum dz and need systemic steroids and immunosuppressants

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6
Q

painless acute vision loss in 1 eye, complete or relative afferent pupillary defect, cherry red spot in macula

A

central retinal artery occlusion. Urgent optho consult, ocular massage to lower intraocular pressure, long term atherosclerosis risk factor mod. rare, seen in vasculopaths

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7
Q

vision loss, severe eye pain, HA, n/v. Light halos, conjunctival redness, poorly reactive and dilated pupil

A

acute angle-closure glaucoma

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8
Q

T/F: Perforated/ruptured tympanic membrane in AOM resolves completely with oral and topical abx

A

TRUE

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9
Q

acute rhinosinusitis

A

usually viral and tx with supportive care. clues for bacterial needing abx = sxs >10 days, severe sxs >3 days, worsening sxs >5 days after initially improving viral URI

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10
Q

Painful vs painless parotid gland enlargement

A

Painless: lymphoma

Painful: infection (sialedenitis, fever present) or parotid stone obstruction (sialolithiasis; recurrent)

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11
Q

How to interpret Weber and Rinne test

A

Sensorineural hearing loss (presbycusis, meniere, idiopathic):

  • Weber: lateralization to unaffected ear
  • Rinne: air conduction > bone conduction (better heard in front of the ear compared to placed on the mastoid)

Conductive:
(otitis, cerumen, TM perf)

  • Weber: lateralizes to affected ear
  • Rinne: bone conduction > air conduction
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12
Q

t/f: consider audiometry and MRI in acute idiopathic sensorineural hearing loss

A

true

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13
Q

mgmt of meniere disease (tinnitus, vertigo, sensorineural hearing loss)

A

sodium restriction +/- diuretics

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14
Q

ear fullness, decreased hearing and popping sounds after URI

A

eustachian tube dysfunction. need decongestants

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15
Q

new onset of floaters, flashing lights or vision loss

A

retinal detachment. if vision loss: see retinal specialist w/in 24 hours. if just floaters/flashes without vision loss, can see opthy more electively

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16
Q

t/f: central retinal a occlusion usually preceded by amaurosis fugax

A

true

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17
Q

Lichen planus 4 P’s and associated dz

A

Pruritic, purple, polygonal papules or plaques. associated with hep C. Topical steroids.

18
Q

tx after poison ivy exposure

A
  • wash skin with soap and water within 2 hours of exposure
  • topical mid to high potency cortisteroids since its a delayed hypersensitivity rxn. continue tx for 2-3 weeks because of rebound dermatitis
19
Q

skin blisters and changes in pigmentation in sun-exposued areas in IVDU

A

porphyria cutanea tarda. may see elevated liver enzymes, urine overload, elevated plasma/urine porphyrin levels. Tx: phlebotomy, HCV tx

20
Q

Which common skin condition (sebacous glands) occurs in all age groups but especially in Parkinson and HIV?

A

Seborrheic dermatitis. scalp (dandruff), face, chest etc. pruritic, greasy scales. tx with low-potency corticosteroids, antifungal creams

21
Q

dystrophic nails and funal appearing toes

A

confirm dx with KOH scrapings

if hyphae/fungus…ora terbinafine 12 weeks

22
Q

Tx of urticaria

A

Its chronic if >6 weeks.

Either way. start with 2nd gen antihistamine (loratidine). increase dose, if doesn’t work then first gen (benadryl, hydroxyzine) at night, etc

23
Q

30-60 year old with erythema and telangiectasias over cheeks, nose and chin. may have papules, pustules, flushing

A

rosacea. topical metronidazole or oral abx (doxycycline/minocycline/erythromycin)

24
Q

T/F: Molluscum contagiosum is caused by poxvirus, has umbilication and should probably have HIV testing

A

true

25
Q

Mild to moderate plaque psoriasis (most common) tx

A

topical steroids and emollients. Combo therapy with topical steroids + vitamin D is most effective.

If facial or intertigonous: topical tacolimus or pimecrolimus

Moderate to severe: phototherapy + methotrexate

26
Q

T/F: Common warts due to HPV are common in individuals who handle meat, poultry and fish, and those with atopic dermatitis. as well as HIV

A

true. tx with OTC salicylic acid or liquid nitrogen, many will self resolve over 2 years

27
Q

tx for discoid lupus

A

sunscreen
protective clothing
topical corticosteroids or calcineurin inhibitor (tacrolimus)

28
Q

pruritic lesions that can ulcerate and seen on flexor surfaces of extremities, especially wrists

A

lichen planus

29
Q

antimalarials differentiate btwn discoid lupus and?

A

they make discoid lupus better but worsen psoriasis. DLE may have negative or low titer ANA, can also have no other SLE findings . its very photosensitive . extends to follicles an dcauses permanent scarring alopecia

30
Q

T/F: Venous lakes are benign lesions commonly seen on lips and ears of elderly patients

A

true, disappear when compressed. can bleed sometimes. are gray/blue/purple

31
Q

what is vitiligo associated with

A

Thyroid disease and type 1 diabetes

32
Q

warty growths with stuck on appearance

A

Seborrheic keratoses (SK)

33
Q

T/F: Necrobiosis lipoidica is a skin condition frequently seen in diabetics, pretibial areas with annular lesions

A

true wtf

34
Q

meds for EtOH abuse help

A
  • Naltrexone (prevent relapse and dependence, and in patients actively drinking
  • Acamprosate (enhances abstinence, CI in CKD)
  • Use sx triggered regimen to treat withdrawal, i.e. sx-triggered benzos
  • thiamine before glucose
  • avoid antipsychotics (lowers seizure threshold)
  • disulfiram is second-line
35
Q

meds for tobacco cessation

A

Nicotine gum/patches etc: avoid in recent MI, arrythmia, unstable angina

Buproprion: avoid in seizure or eating disorder

Varenicline: Increases smoking cessation double than buproprion

36
Q

thickness for endometrial biopsy in postmenopausal AUB

A

> 4mm

37
Q

T/F: Medroxyprogesterone acetate used for second half o fmenstrual cycle will restore cyclic withdrawal bleeding and thus preserve fertility in anovulatory AUB

A

true

38
Q

HIV mother HIV >1000

A

if >1000, intrapartum zidovudine, need a c/section, postparum ART prophylaxis for the infant

if <1000, vaginal and no meds

39
Q

Suspect IgG4-related disorder in middle age man with:

A
  • autoimmune pancreatitis
  • lymphadenopathy
  • bilateral salivary/lacrimal gland enlargement
  • eosinophilia

Tx: steroids (can add mycophenolate, azathioprine or rituximab if refractory)

40
Q

low immunoglobulins and poor response to vaccination

A

CVID

41
Q

T/F: Myeloperoxidase deficiency can present with recurrent candida infections

A

true

UWORLD ABIM (10 decks)

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