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USMLE Step 2 CK > More Step 2 Ck > Flashcards

More Step 2 Ck Flashcards

1
Q

Mom at 27 weeks gestation is now in labor. She had routine prenatal care during pregnancy.

How do you manage?

A

šŸ”‘ 27w gestation = pre-term labor (āˆ“ anything less than 34w is preterm labor)

šŸ”‘ The aim of preterm labor management is to delay DELIVERY and protect fetusā€” so give tocolytics
Also must give
1. IM betamethasone (prevent NRDS)
2. Magnesium (neuro protect)

ā¦™ no required intrapartum GBS prophylaxis because she has prenatal care (so GBS status is NOT unknown)

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2
Q

Mom at 27 weeks gestation is now in labor. She did not have routine prenatal care during pregnancy.

How do you manage?

A

šŸ”‘ 27w gestation = pre-term labor (āˆ“ anything less than 34w is preterm labor)

The aim of preterm labor management is to delay DELIVERY and protect fetusā€” so give tocolytics
Also must give
1. IM betamethasone (prevent NRDS)
2. Magnesium (neuro protect)
3. Intrapartum PENICILLIN prophylaxis (no prenatal care = unknown GBS status)

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3
Q

Mgmt spinal cord compression

A

IV glucocorticoids first
Then to MRI

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4
Q

Age of presentation of CVID

A

Normally age 20-40
But possible in anyone 10+

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5
Q

Management for ITP

A

1Ė¢įµ— IVIG (for 2-3d)
2į“ŗįµˆ prednisone
3Ź³įµˆ splenectomy

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6
Q

Sheā€™s for types of leukemia

A

Lymphoid leukemias ā€” extreme ages old/young

Myeloid ā€” middle age (40-60)

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7
Q

Auer rods

A

AML (specifically APML)

[note: t(15;17) translocation)

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8
Q

Leukemia treated with tyrosine kinase inhibitor

A

CML

[Note: Philadelphia chrom t(9;22) ā€”> BCR-ABL fusion protein ā€”> ā†‘s tyrosine kinase activity)

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9
Q

Leukocyte alkaline phosphatase (LAP)

A

ā†“ in CML

Compare
to

ā†‘ in leukemioid reaction

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10
Q

CML

A
  • middle age
  • ā†“ LAP
  • Philadelphia chromosome t(9;22) translocation ā€”> BCR/ABL fusion protein ā€”> ā†‘ tyrosine kinase activity
  • tx with tyrosine kinase inhibitor
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11
Q

Possible cardiac manifestations of Turners (4)

A

1) aortic dissection (severe CP)
2) aortic-root dilation (aortic regurgitation)
3) bicuspid aortic valve (aortic stenosis)
4) coarctation of the aorta,

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12
Q

MCC meningitis in a neonate (first 28 days of life)

A

Group b strept (s. Agalactiae)

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13
Q

Too 3 bugs causing meningitis in someone 60+ yo

A

1) s.pneumoniae
2) haemophilus influenziae
3) Listeria

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14
Q

Mechanism of celiacs to secondary hypeR-parathyroidism

A

Celiacs ā€”> malabsorption of vits ADEK ā€”> vitD deficiency ā€”> impaired calcium absorption (ā†“ serum calcium) ā€”> ā†‘ PTH (compensatory)

(Note: final calcium level will be mildly ā†‘ or normal, due to compensation)

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15
Q

Causes of secondary hyperparathyroidism

A

Chronic renal failure or other causes of vit D deficiency (like malabsorption: celiacs, chronic pancreatitis, cystic fibrosis, sprue)

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16
Q

Lab values in secondary hyperparathyroidism

A

Calcium ā€” mildly raised or normal
Phosphate ā€” high if CKD, low if other vitD deficiency
Vitamin D ā€” low (primary disturbance)

17
Q

Placental abruption

A
  • present with 3rd trimester vag bleeding (only 80%) āŽ®šŸ“šŸŒŸ20% have a concealed abruption (NO visible bleeding)
  • risk factors: cocaine, šŸ“ tobacco, HTN/šŸ“ preeclampsia
  • šŸ“ high frequency contractions (< every 2-3 min apart)
  • šŸ“ tender firm uterus!
18
Q

CMV treatment

A

Ganiciclovir

19
Q

Intussusception

A
  • age 6-36 months old
    -preceding viral infection ā€”> cause inflammation of intestinal lymphoid tissue (Peyers Patches) serve as lead point
    -pain abdomen ā€” (pain is intermittent/episodic and colicky)
    -šŸ“draws legs up to chest.
  • May vomit (first non-bilious, may become bilious with further obstruction)
  • gross bloody currant jelly stool
  • Possible palpable sausage shaped abdo mass.
    -U/S: shows ā€œTarget sign ā€ (this confirms the dx) & prompts immed tx with *AIR (or water-sol contrast/barium) ENEMA!
20
Q

Indications that a chronic ulcer is complicated by osteomyelitis (6)

A

-(1)chronic (present for *4+ weeks), or treatment-resistant (nonhealing) ulcer
-(2) local signs of infection (erythema, pus
-(3) large size *(šŸ“2-cm), or deep (depth >3cm)
-(4) exposed bone tissue, or able to touch bone on bone-to-probe test
- (5) systemic signs (fever)
- (6)markā†‘ESR

21
Q

Ulcer at the lateral malleolus and shin

A

Arterial ulcer

22
Q

Which ulcer is exudative, arterial or venous?

A

Venous

23
Q

Which ulcer (arterial or venous) has irregular borders and which looks ā€œpunched-outā€

A

Irregular borders (venous)
ā€œPunched-outā€ (arterial)

24
Q

Pathophysiology of amenorrhea during breastfeeding

A
25
Q

Lipid screening

A
  • start at age 35 (for men) & 40/45 (women)ā€”> continue to monitor every 3-5y ā€” until reach age 75
  • Consider earlier screening if family history of dyslipidemia or early MI, šŸš¬
26
Q
A

TCA toxicity

27
Q

TCA toxicity management

A
28
Q

Acute dystonia treatment

A

Benztropine or diphenhydramine

29
Q
A

Pityriasis Rosea

30
Q

NBS for a new thyroid nodule with ā†“TSH

A

Radioactive iodine uptake/ iodine 131 scintigraphy

31
Q

Prochlorperazine

A

Antiemetic with D2 blocking activity (significance: can cause NMS)

32
Q

Promethazine

A

Antiemetic with D2 blocking activity (significance: can cause NMS)

33
Q

Antiemetics that can cause NMS (D2 blocking activity)

A

Metoclopramide
Prochlorperazine
Promethazine

34
Q

Which is seen in Crohns vs UC for the following:

Fissure
Stricture
Abscess
Fistula

A

Crohns ā€” fissure, stricture, fistula

UCā€” abscess

35
Q

Tx for BPH

A

(1) alpha-1 blockers (tamsulosin, prazosin, dozazosin)
- quickly improves urine flow by relaxing smooth muscle
-Note: caution prazosin/doxazosin cause orthostatic hypOten

Long termā€” 5-alpha-reductive inhibitor (finesteride, dudasteride)
- for those with enlarged prostate experiencing urinary sx
- improves sx over several months by shrinking prostrate over time!

36
Q

Ogood shlatter

A
  • adolescent athlete
  • anterior knee pain
  • tibial tubercle traction apophysitis
37
Q

Which leukemia is contrasted with leukemiod reaction.
How?

A

CML ā€” has ā†“LAP

38
Q

Pre-renal AKI values for the following:

FeNa+
Urine Na+

A

FeNa+ (<1)

Urine Na+ (<20)

USMLE Step 2 CK (3 decks)

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