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Step 2 > Set 9 > Flashcards

Set 9 Flashcards

1
Q

Tx DVT/PE?

A

heparin bridge to warfarin. if 1st event, 6mo. If recurrent, lifelong anticoagulation

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2
Q

FSH, LH, FSH/LH expected in premature ovarian failure? confirmatory criteria?

A
  • dec FSH and LH
  • FSH:LH ratio >1 b/c FSH is cleared from circ slower.
    Dx = FSH very elevated in woman 3 mos of amenorrhea - confirms dx
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3
Q

SE of dihydropyrodine CCBs

A

peripheral edema (especially amlodipine)

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4
Q

When do you get a CT in head fall? what about admission/neuro checks?

A

no LOC or neuro findings –> no CT, send home
If vomiting, HA or LOC –> CT, if neg send home
if severe HA, prolonged LOC or seizures, admit

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5
Q

Abnormal bleeding in patient with CKD due to? Tx?

A

platelet dysfunction, tx = DDAVP (release stores of factor 8/vWF)

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6
Q

3rd trimester bleeding with uterine tenderness and increased tone, contractions. Ddx?

A

Placental Abruption* = a/w pain, dark red bleeding

placenta previa = NO pain, bright red bleeding

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7
Q

HIV patient with PCP, when do you add steroids to the tx?

A

when PaO2 35

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8
Q

smelly discharge and vaginal pH of 5.5, ddx and differentiate?

A

trichomonas vaginITIS = gray-green frothy d/c with INFLAMMATION PRURITIS, dysuria/dyspareunia
bacterial vaginOSIS = NO inflammation or pruritis

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9
Q

normal vaginal pH

A

3.5-4.5

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10
Q

secondary amenorrhea + galactorrhea. next tests?

A

pregnancy test, THEN TSH (hypothyroidism can elevate PRL level).
also, FSH to r/o ovarian failure, PRL for hyperprolactinemia.

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11
Q

2 complications (NOT PE findings) of nephrotic syndromes?

A

hypercoagulability and dyslipidemia (leads to atherosclerosis and strokes/MI!)

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12
Q

Fever, dysphagia, odynophagia and drooling in an alcoholic? MCC?

A

Ludwig Angina = progressive b/l cellulitis of the submandibular + sublingual sapces 2/2 tooth infxn. MCC strep or anaerobes

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13
Q

MCC mucolpurulent cervicitis

A

Chlamydia trachomatis

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14
Q

Feared consequence of whiplash injury

A

central cord syndrome. damage to central portion of ant SC - central parts of CST +/- decussating fibers of lat STT.
- weakness more pronounced in upper ext b/c motor fibers for arms are nearer to the central part of the CST. +/- loss of pain and temp (STT )
(similar to syringomyelia - expansion of central canal -> fibers of STT are affected first. cape-like loss of pain/temp)

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15
Q

18yo girl w/ primary amenorrhea, normal breasts and pubic hair, blind vagina and no uterus, 2 ovaries, 46 XX?

A

Mullerian agenesis

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16
Q

CI succinylcholine

A

hyperkalemia –> depolarizing NM blocker can cause further K+ release –> arrhythmias

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17
Q

SE acyclovir

A

renal tubule obstruction 2/2 crystalluria (poorly soluble drug in urine)

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18
Q

TSH and T4 levels in pregnancy, MoA?

A

TSH and free T4 normal, increased total T4 –> due to increased E2 causing increased TBG and stimulation of TSH receptors by BhCG

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19
Q

chromosome findings in Kallmann Syndrome

A

46 XX (GnRH deficiency, anosmia)

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20
Q

Tactile fremitus incr/decr in: PNA, Pleural E, COPD, pneumo

A

increased only in PNEUMONIA b/c fluid is INSIDE the lungs –> sound transmits faster.
all others have fluid outside the lungs, therefore decreased tactile fremitus)

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21
Q

Tx clavicular fx

A

middle 3rd–> check neuroarterial injury, if OK then brace and rest, no reduction
Distal 3rd –> may require ORIF

22
Q

what is plan B, how long afterwards can you take it, efficacy?

A

levonorgestrel, up to 120hrs, 7/8 won’t get preggers

23
Q

What is pseudocyesis?

A

false pregnancy –> woman displays psychophysical signs of pregnancy w/o actual pregnancy. NORMAL endometrial stripe on US and negative pregnancy test in the OFFICE (regardless of home test result)

24
Q

Tx duodenal hematoma 2/2 blunt trauma

A

NGTD and parenteral nutrition, resolves in 1-2wks

25
Q

Equation for respiratory compensation for either metabolic acidosis or alkalosis

A

acidosis –> PaCO2 = 1.5xHCO3 + 8, +/- 2

alkalosis –>PaCO2 = 0.9xHCO3 + 16, +/-2

26
Q

Causes of acute renal transplant dysfxn, dx tests?

A 
urethral obstruction --> US
acute rejection --> bx
cyclosporine toxicity --> blood levels
vascular obstruction --> radioisotope scan
ATN
27
Q

rash, arthralgias, ARF, eosinophils in urine?causes?

A

Drug-induced interstitial nephritis

Causes = cephalosporins, PCN, sulfonamides, NSAIDS, rifampin, phenytoin, allopurinol

28
Q

H pylori is a/w what cancers?

A

gastric ADENOCARCINOMA

MALT lymphoma

29
Q

Tx pre-eclampsia (3)?

A

MgS –> prevents FURTHER seizures (not abortive)
hydralazine or labetolol for HTN
deliver the baby!

30
Q

clear cell carcinoma of the vagnia

A

DES expsoure

31
Q

Bronchiectasis vs. chronic bronchitis?

A

bronchiectasis = irreversible dilation + destruction of bronchi leading to recurrent respiratory infxn and chronic mucopurulent daily cough

chronic bronchitis = productive cough for 3+mo in 2+yrs. PE with crackles, rhonchi, wheezing

32
Q

painless blisters, hypertrichosis, hyperpigmentation. Dx? A/w?

A

porphyria cutanea tarda

a/w Hep C, often triggered by ethanol or E2

33
Q

Endometritis, causes? Tx?

A

POLYMICROBIAL! MC anaerobes E coli, GBS, bacteroides

Tx = gentamicin and clindamycin until afebrile for 48hrs

34
Q

2 extrarenal complications of ADPKD?

A

berry aneurysms and HEPATIC cysts

35
Q

Role and natural history of BhCG

A

maintains corpus luteum (produces progesterone until placenta can)
begins 8d after fertilization, doubles every 48hrs until peaks at 6-8wks

36
Q

SJS and TEN are what type of hypersensitivity reaction?

A

type 3 = immune-complex mediated

37
Q

lightly pigmented patches on upper back that don’t tan? Tx?

A

tinea versicolor

Tx = topical selenium sulfide + ketoconazole shampoo

38
Q

McMurrys sign indicates? what is a positive test? Tx?

A

Dx for meniscal tears –> positive if “snapping” upon extending leg with full knee flexion and applying tibial torsion.
Tx = NSAIDs 1st, then arthroscopic repair if necessary

39
Q

When do you remove gonads in androgen insensitivity syndrome? what is the Tx needed afterwards?

A

AFTER puberty, decreases the risk of testicular carcinoma. MC done in 20-30s.
Tx = E2 needed to maintain female features afterwards (no progesterone bc no uterus)

40
Q

When do you remove gonads in Swyer syndrome (XY gonadal dygenesis)?

A

IMMEDIATELY bc malignant change can occur at any time

41
Q

progressive SOB, clupping and pleural plaques on CXR? Dx?

A

absestosis (restrictive)
decreased TLC and DLCO.
FEV1/FVC is normal (equally reduced)

42
Q

immunosuppressants that can cause BM supression? (5)

A

mcyophenolate, 5-FU, 6-MP, methotrexate and vinBLASTine

43
Q

IUFD. fibrinogen low/normal. platelets low/normal. normal PT, PTT. POA?

A

deliver fetus. fibrinogen levels are higher in preg, so low/normal should raise suspicious of consumptive coagulopathy due to retnetion of fetus. other signs: dec platelets, inc in PT and PTT, presence of fibrin split products.

44
Q

Tx vaginal candidiasis

A

topical antifungals = clotrimazole, miconazole, nystatin)
OR
oral fluconazole

45
Q

Tx CAP (mild vs severe)

A 
mild = outpatient = azithro or doxy
severe/inpatient = levofloxacin moxifloxacin to cover atypicals (NOT CIPROFLOXACIN)
46
Q

syphilis vs granuloma inguinale vs chancroid?

A
  • chancroid is painful. no LAD.
  • syphilis - painless ulcerated chancre with punched out base and raised margins. LAD. ulcer will resolve without abx.
  • granuloma inguinale (donovanosis) - painless. ulcer with red, beefy base. no LAD. req ABX to resolve!
47
Q

MoA and CI of Raloxifene?

A

mixed E2 agonist(breast, vagina) -antagoinst(bone)

1st line Tx prevent osteoporosis and decreasing risk of BCA, but INCREASED risk of thromboembolism, CI h/o DVT/PE

48
Q

post-BMT patient with lung and GI complaints?

A

CMV –> causes pneumonitis and GI ulcers/esophagitis

49
Q

Tx precocious puberty? MoA?

A

GnRH AGONIST!! = leuoprolide

prevents premature fusion of epiphyseal plates

50
Q

Big cyst with daughter cysts w/in it? a/w? Tx?

A

echinococcal cysts = liver > lung
A/w sheep and dog exposure
Tx = albendazole

51
Q

immunosuppressant drug causing nephrotox, gum hypertrophy, hirsutism, tremor? similar drug?

A

Cyclosporine; tacrolimus does NOT have gum hypertrophy or hirsuitism tho

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