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ZZ - step 3 - UWorld 2017 > Second pass deck 01 > Flashcards

Second pass deck 01 Flashcards

1
Q

erysipelas is most often caused by what organism?

A

group A strep (pyogenes)

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2
Q

how do you treat the severe tonsillar enlargement that could be a prelude to airway obstruction in infectious mononucleosis?

A

IV corticosteroids

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3
Q
  • hypo / hyperpigmentation
  • hyperkeratosis
  • stocking glove neuropathy

what type of poisoning?

A

arsenic (chronic)

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4
Q
  • vomiting
  • watery diarrhea
  • QTc prolongation
  • profound pancytopenia and hepatitis
  • garlic breath

what type of poisoning?

A

arsenic (acute)

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5
Q

what is the treatment for arsenic poisoning?

A
  • dimercaprol (first line)

- DMSA, succimer

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6
Q

mees lines (horizontal striations of fingernails) is characteristic of:

A

arsenic poisoning

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7
Q

what is susceptibility bias? how do you prevent it?

A
  • when the treatment regimen selected for a patient depends on the severity of the patient’s condition
  • prevent by random assignment, intention-to-treat analysis to avoid counting crossover patients
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8
Q

what is the treatment for symptomatic neonatal thyrotoxicosis from maternal graves disease?

A
  • methimazole

- beta blocker

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9
Q

what is the treatment for paroxysmal nocturnal hemoglobinuria?

A

eculizamab

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10
Q

what is the mechanism of trousseau syndrome in the context of latent visceral malignancy?

A

tumor release mucins that react with platelets to form platelet-rich microthrombi

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11
Q

elevation and equalization of intracardiac pressures is indicative of ________________

A

tamponade

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12
Q

which anti-seizure medication is associated with acute pancreatitis?

A

valproate

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13
Q

what is the a) initial and b) maintenance therapy for cryptococcal meningoencephalitis?

A
  • initial: amphotericin B and flucytosine

- fluconazole

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14
Q
  • fevers
  • headaches
  • increased intracranial pressure (papilledema)
  • HIV patient
A

cryptococcal meningitis

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15
Q

which vaccinations should HIV patients receive?

A
  • hep B
  • PCV13 then PPSV23 eight weeks later then five years later and at age 65
  • varicella if born after 1979 (CD4 must be over 200)
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16
Q

isoniazid causes what kind of liver damage?

A

hepatitis with panlobular mononuclear infiltration and hepatic cell necrosis

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17
Q

gonococcal conjunctivitis occurs within what time frame? chlamydial? what are the treatments?

A
  • gonococcal: 2-5 days (single IM dose 3rd gen ceph)

- chlamydial: 5-14 days (PO macrolide)

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18
Q

what is a potential GI side effect of erythromycin and azithromycin in infants?

A

pyloric stenosis

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19
Q

which medication should be given in the weeks to months following an MI to prevent dilation and remodeling of the ventricles?

A

ACE inhibitors

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20
Q

which type of heparin is CONTRAindicated in end stage renal disease?

A

LMWH

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21
Q

what is the preferred long-term oral anticoagulant in end stage renal disease?

A

warfarin

22
Q

the ice pack test is used for ____________

A

myasthenia gravis

23
Q

what are treatment medications for restless leg syndrome?

A
  • pramipexole
  • ropinirole
  • gabapentin if comorbid insomnia, chronic pain, or anxiety are present
24
Q

how long may surgery be delayed to address an unstable comorbidity?

A

72 hours

25
Q

what medication is used for mild tourettes? more severe cases?

A
  • mild: a2 agonists (clonidine, guanfacine)
  • severe: dopamine blocking antipsychotics (risperidone, haloperidol, pimozide)

*haloperidol and pimozide are FDA approved, but risperidone is the best studied of the second generation

26
Q

osteitis fibrosa cystica is most often seen with what conditions?

A
  • parathyroid carcinoma

- primary and secondary/tertiary (advanced renal disease) hyperparathyroidism

27
Q

buproprion and selegeline can cause false positives for what drug on tox screen?

A

amphetamines

28
Q

in patients with cirrhosis, both spider angiomas and palmar erythema arise due to __________ because ____________

A
  • hyperestrinism

- impaired hepatic metabolism of circulating estrogens (which begins in the cyp450 system)

29
Q

what is the treatment for patients with tinea capitis? what about for contacts?

A
  • patients: oral griseofulvin or terbinafine

- contacts: selenium sulfide or ketoconazole shampoo

30
Q

copper or rust colored nipple discharge?

A

intraductal papilloma

31
Q

normal pleural fluid pH is:

A

7.6

32
Q

transudative pleural fluid has a pH of:

A

7.4 - 7.55

33
Q

exudative pleural fluid has a pH of:

A

7.3 - 7.45

34
Q

patients at moderate to high risk of thromboembolic events due to systemic embolization should get what treatment?

A

non-vitamin K antagonist oral anticoagulation (apixaban, dabigatran, rivaroxaban, edoxaban)

35
Q
  • sclerotic, cortical lesion on imaging with a central nidus of lucency
  • pain worse at night and unrelated to activity
  • pain relieved by NSAIDs
A

osteoid osteoma

36
Q
  • pain, swelling, and decreased ROM at involved site
  • osteolytic lesions with “soap bubble” appearance
  • epiphyseal region of long bones
A

giant cell tumor

37
Q

what is the cushing reflex with respect to intracranial HTN? what is it indicative of?

A
  • HTN
  • bradycardia
  • respiratory depression
  • indicative of brainstem compression
38
Q

what are the CHADS-2-VASc criteria?

A
  • C = CHF (1)
  • H = HTN (1)
  • A = Age over 75 (2)
  • D = DM (1)
  • S2 = Stroke / TIA / thromboembolism (2)
  • V = Vascular disease (1)
  • A = Age 65-74 (1)
  • Sc = Sex category (female) (1)

Max score = 9
Score 2 or greater = anticoagulation

39
Q
  • a normal A-a gradient is under ____

- what is the equation for A-a gradient?

A
  • under 15

- PAO2 - PaO2

40
Q

a non-diagnostic gastrin level (between 110 and 1000) in the setting of suspected zollinger-ellison syndrome requires follow up with what test?

A

secretin stimulation test

41
Q

why isnt PTU the preferred drug for hyperthyroidism?

A

black box warning for liver injury and acute liver failure

*however, it is preferred during the first trimester of pregnancy due to the teratogenicity of methimazole

42
Q

what is the most common side effect of anti-thyroid drugs? what is the most serious?

A
  • most common: allergic reaction

- most serious: agranulocytosis

43
Q

a patient is on an anti-thyroid drug and develops sore throat and fever - what is happening?

A

agranulocytosis

44
Q

when are antibiotics indicated for patients with COPD?

A
  • MODERATE TO SEVERE (not mild) COPD exacerbation (two or more cardinal symptoms) especially with increased sputum purulence
  • mechanical ventilation requirement
45
Q

which empiric abx are used for COPD exacerbations?

A
  • macrolides
  • respiratory fluoroquinolones
  • penicillin / beta lactamase inhibitors
46
Q

how does hypokalemia exacerbate hepatic encephalopathy?

A

intracellular acidosis (excreted intracellular potassium replaced by hydrogen ions to maintain electroneutrality) causes increased NH3 production (glutamine conversion) in renal tubular cells

47
Q

how does metabolic alkalosis exacerbate hepatic encephalopathy?

A

promotes conversion of ammonium (NH4), which cannot enter the CNS, to NH3, which can

48
Q

how does succinylcholine cause cardiac arrhythmias?

A
  • severe hyperkalemia

- triggers influx of sodium ions and efflux of potassium ions - depolarization ensues

49
Q

patients with recurrent renal calculi should be advised to restrict ____________

A

sodium

50
Q

what sail sign on pediatric CXR references the ____

A

thymus

ZZ - step 3 - UWorld 2017 (61 decks)

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