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UW Step 2 CK > part 4 > Flashcards

part 4 Flashcards

1
Q

year after cholecystectomy, 52 yo obese woman has gallstone pain, no jaundice, but elevated ALP and AST/ALT. mild common bile duct dilation. dx and next step?

A

post-cholecystect syndrome, do ERCP

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2
Q

hyperosmolar hyperketotic state, potassium is 4.8. given fluids and insulin. next step?

A

give IV potassium, if lower than 5.3

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3
Q

high-voltage QRS complexes, st depression at lateral leads, lateral T wave inversion. and nose bleeding and headaches, BP is high in 29 yo old. dx?

A

coarctation

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4
Q

cervical spinal cord atrophy and weakness in limbs, high arching foot. dx?

A

freiderich’s ataxia- trinucleotide repaet

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5
Q

16 yo boy with fever and sore throat, severe myalgia, mottling of skin of legs, non-suppurative pharyngitis, severe pain. dx?

A

meningococcemia

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6
Q

crohn’s disease, with fractures. what do you expect on calcium, phosphorus, PTH levels?

A

low low high. vitamin D def

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7
Q

HAGMA with envelope shaped urine crystals. dx?

A

ethylene glycol poisoing

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8
Q

hypocalcemia and hyper PTH. next step?

A

vitamin D levels

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9
Q

severe watery diarrhea and flushing and electrolyte abnormality (hypokalemia), 3 cm pancreatic tail mass. dx?

A

VIPoma

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10
Q

65 yo woman with low bone density, given alendronate then takes antacid for gERD. has hypercalcemia, high HCO3 and hypomagnesemia and hypophosphatemia., creatinine is slightly higher than before. what is cause of hyper Ca?

A

milk-alkali syndrome

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11
Q

empyema vs parapnuemonic (uncomplicated) effusion

A

WBC >50000, pH less than 7.2, glucose less than 60

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12
Q

46 yo man with severe MVA has RUQ pain, pericholecystic fluid, no stones, diestneded bowels. dx?

A

acalculous cholecystitis (severe injury/disease, presents like gallbladder obstruction/infectino)

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13
Q

baby with umbilical cord cut by kitchen scissors, DIY delivery, and honey mixed in formula. now is hyperreflexic and neck stiffness, and stridor. no vaccinations for mother and child. dx?

A

tetanus

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14
Q

PPROM is a/w what other obsetric complication?

A

placental abruptuion, infection, PTLabour

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15
Q

56 yo man has septic shock, critical condition. now has occult stool blood. dx?

A

stress ulcer

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16
Q

cervical spine injury and paralysis. respi distress. next step?

A

intubate

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17
Q

35 yo woman with dysphagia, episodic retrosternal pain that radiates to back, lasts 15 mins each time, triggered by hot and cold food or emotion. next step? and dx?

A

esophageal manometry for diffuse esophageal spasm

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18
Q

cancer related cachexia and HIV cachexia what to give to stimulate appetite

A

progesterone analog and synthetic cannabinoid, respectively

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19
Q

15 day old baby with bilious vomiting and abdo distension. abdo xray shows no gas. then next step? and dx?

A

malrotation and volvulus, do a UPPER GI series (barium swallow)

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20
Q

trastuzumab toxicity?

A

cardio

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21
Q

AFib, aflutter where are they generated in the heart

A

pulmonary vein ostia, tricuspid annulus

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22
Q

painful vesicular hand rash in sexually active person. dx?

A

herpetic whitlow

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23
Q

PCP pneumonia with o2 92% and PaO2 54, rx?

A

bactrim and corticosteroids (if below PaO2 below 70, o2 is below 92, or if AA gradient is greater than 35

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24
Q

pregnant woman 36 weeks, has had herpes simplex virus in the past. mx?

A

give acyclovir prophylaxis until delivery, even without symptoms. if vesicles, then CS

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25
Q

triphasic scratchy sound on heart auscultation and PR depression diffusely. rx? and dx

A

acute pericarditis, give colchicine and NSAID

26
Q

obese, breathless, hypercapnia acidosis, dx?

A

obesity hypoventilation syndrome

27
Q

47 yo wth facial nerve palsy, parotid sweeling bilaterally and hypercalcemia and enlarged cervical LAD, fatigue and low grade fevers. dx?

A

sarcoidosis

28
Q

anterior mediastinal mass, AFP and B-HCG elevated. dx?

A

mixed germ cell tumor, not seminoma (AFP normal in seminoma)

29
Q

mild UC, rx?

A

mesalamine enema. oral mesalamine for more extensive. then infliximab for moderate to severe

30
Q

rheumatic fever a year ago. rx?

A

give penicillin prophylaxis for 5 years

31
Q

13 yo girl starting to get nodulocystic acne and clitoral protrusion and bilateral masses in the labia majorum. dx?

A

5-alpha reductase deficiency

32
Q

alcoholic who came in for GTC, has discrepancy between urnialyasis and urine microscopy (blood is 2 plus but no RBC on UFEME), hyperkalemia. acute renal injury. dx?

A

rhabdomyolysis

33
Q

dizziness episodes. taking amitryptiline. dx?

A

orthostatic

34
Q

malnoursihed kid has NCNC anemia, angular chelitis and dermatitis. dx?

A

riboflavin (B2) def

35
Q

HIV and IVDU, nodular infiltrates in lungs on Ct. dx?

A

staph aureus from IE emboli

36
Q

Td or TdaP in adults?

A

give Td then Tdap at least once as an adult. as in alternate between these two

37
Q

constricve pericarditis or amyloidosis?

A

latter has LV thickness, and nephrotic range proteinuria

38
Q

HIV prophylactic drugs?

A

give bactrim if CD4 below 200. for PCP and toxo. azithro for MAC and itraconazole for histo no need anymore. acyclovir also no need

39
Q

cholecystitis. surgery when?

A

wihtin 72 hours

40
Q

MG with preeclampsia and GBS. what should you not give.

A

mag sulf. give valproic acid instead

41
Q

depression and diabetic neuropathy. rx?

A

duloxetine (SNRI

42
Q

known vasa previa has bloody show, fetal heart rate 100. mother is fine. next step?

A

crash C/S

43
Q

postpartum endometritis rx?

A

clinda and gentamycin

44
Q

lithium toxicity. symptomatic. rx?

A

dialysis

45
Q

graves disease what treatment option makes the opthalmopathy worse?

A

RAIU

46
Q

pancreatitis and hypotension. what is cause?

A

panc enzymes leading to increased vascular permeability

47
Q

claw hand and horners syndrome from shoulder dystocia. where is the lesion?

A

C8 and T1- klumpke

48
Q

alternative to doxycycline in lyme disease (pregnant, lactating, or under 8 years old)

A

amox

49
Q

preeclampsia in patient under 20 wks gestation. dx?

A

hydatitidform mole

50
Q

acute angle closure glaucoma in PD tremor. what is culprit drug?

A

trihexyphenidyl (anticholinergic)

51
Q

precocious puberty and LH is low, dx?

A

peripheral precocious puberty –> non-classic CAH

52
Q

LLQ pain, sterile pyuria, subacute onset. dx?

A

diverticulitis

53
Q

catatonia rx

A

benzo

54
Q

marfans and fair hair and stroke. dx?

A

homocysteienuria

55
Q

grey mucous patches, sore throat and malaise, epitroclear LAD, genital LAD. dx?

A

secondary syphylliss

56
Q

mild rash and fever, posterior LAD, rash from face to body, erythematous papules on soft palate. dx?

A

rubella

57
Q

exogenous hyperthyroid how do you confirm?

A

low serum thyroglobulin

58
Q

MG, dx made by AchR antibodies. then what?

A

CT scan of chest, to look for thymoma

59
Q

GA 8weeks, no fetal pole and decreasing b-hcg. dx?

A

missed abortion

60
Q

leukocyte greater than 50000, and leukocyte alkaline phosphatase score is high. dx?

A

leukemoid reaction

61
Q

fever, thrombocytopenia, MAHA, neurologic changes renal failure, in a young guy dx?

A

TTP

UW Step 2 CK (4 decks)

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