STEP 2 - UWORLD Flashcards
1
Q
how to prevent stones
A
increase fluids, decrease Na in diet, decrease protein in diet, normal Ca an duse thiazide diuretcs
2
Q
infections from joint replacements, < and > 3 months
A
< 3 months = s aureus
> 3 months = s epi
3
Q
post cholecystectomy syndrome - test
A
ERCP
4
Q
early diastolic murmur with hyperdynamic or water hammer pulse
A
AR
5
Q
next step for pt who is mildly hypercalcemic
A
check PTH first
6
Q
hormone produced in adrenal tumor in women
A
DHEAS
7
Q
why does DHEAS producing tumor also have decreased LH
A
negative feedback
8
Q
child with hip pain after URI
A
transient synovitis
9
Q
child with hip pain, negative XR, fixed, slightly abducted externally rotated limb
A
transient synovitis
10
Q
you suspect transient synovitis - what do you do next and what do you rule out
A
legg-calves-perth disease with XR of hip
11
Q
hyperoxaluria found in what dz
A
crohns
12
Q
recurrent candidiasis in older woman
A
check A1c
13
Q
pt has minor symptoms but also lung consolidation, what now
A
CXR and empiric abx - chance of bacterial conversion is high
14
Q
gene with MEN2a/b
A
RET proto-onco genes
15
Q
medullary thyroid CA and pheochromocytoma
A
MEN2a/b
16
Q
heart problems (3) with Turners
A
bicuspid aortic valve
aortic coarctation
aortic root dilation
17
Q
tumor in precocious puberty in female
A
granulosa cell
ovarian mass
18
Q
MCC of congenital hypothyroidism
A
thyroid dysgenesis
19
Q
type of dysfunction in Zenkers
A
motor - sphincter/esophageal dysmotility
20
Q
pathophysiology of Zenkers
A
posterior herniation bt fibers of cricothyroid muscle
21
Q
35 year old woman with infertility and hypothyroidism
A
premature ovarian failure
22
Q
hormone levels in premature ovarian failure
A
increased FSH, decreased estrogen, increased GnRH
23
Q
gross hematuria w/i 5 days of URI and normal complement levels
A
IgA nephropathy
24
Q
gross hematuria 2-3 weeks after URI with low C3 and C3 deposits on kidney bx
A
post infectious glomerulonephritis
25
MCC of glomerulonephritis
IgA nephropathy
26
sudden contralateral sensory loss with ballistic movements
thalamic stoke (proximity to BG)
27
burning pain on same side as sensory loss 4 weeks after stroke
thalamic pain syndromw
28
Bipolar pt with renal failure or BUN/Cr elevation - medication choice?
valproate
29
test of choice in suspected pancreatic CA
ab CT
30
pituitary necrosis from ischemia
Sheehan syndrome
31
hypotension, lethargy, weight loss 2/2 ACTH impairment
Sheehan syndrome
32
endometrial hyperplasia from medication
tamoxifen
33
effect of long term NPO on gall bladder
stasis >> gall stones
34
fever, leukoctosis, LUQ pain and chest pain
splenic abscess with left sided endocarditis
35
diagnostic reqs for acute liver failure
ALT/AST >1000
hepatic encephalopathy
INR >1.5
36
what can retropharyngeal abcess become that is worse and how
necrotizing mediastinitis, through alar fascia
37
Looks like pericarditis, you want to do pericardiocentesis, but make sure you check WHAT first
the fucking BUN, if it's >60 then it's uremic pericarditis
38
6 week old baby with some odd facial features has loud S2, systolic ejection murmur
AV septal defect
39
how to calculate TTKG
(urine K/serum K)/(urine osm/serum osm)
40
<2 vs >4 TTKG means?
```
<2 = nonrenal reason for hypokalemia
>4 = renal reason for hypokalemia
```
41
renal bicarb secretion depends on
counter transport of Cl
42
calculate the osmolar gap
osmolarity - (2[Na] + glucose/18 + BUN/2.5)
43
what does a osmolar gap of >10 mean
toxic ethanol ingetsion
44
metabolic derangement in acetazolamide use
increased Cl and decreased K
45
lepirudin, dabigatran, argabatran are what
direct thrombin inhibitors
46
when can you use direct thrombin inhibitors
NV Afib, VTE prophylaxis, HIT
47
corrected anion gap
anion gap + (4 - [albumin] x 2.5)
48
metabolic changes with thiazide diuretics
decreased K, Na, H
| increased glucose, lipids, uric acid, Ca
49
treatment for CAP
IP: ceftriaxone + azithromycin OR moxifloxacin
OP: Azithroymcin
50
treatment for HAP
Vanc/Zosyn
51
treatment for PCP
Bactrim +/- steroids (decreased PaO2 or hypoxic)
52
treatment for bronchitis
macrolide/doxy/FQ or nothing
53
young man with knee catching after a game
meniscal tear - MRI >> surgery
54
ischemic colitis after what kind of surgery
vascular/AAA repar
55
CT shows thickening of bowel wall
ischemic colitis
56
stroke without hemiparesis or sensory loss
likely hemorrhagic
57
cerebellar hemorrhage
ipsilateral hemiataxia
58
atypical depression in a smoker not treated before
buproprion, not MAOI
59
if no fetal heart tones on doppler
U/S for fetal demise
60
next step for mom and baby after fetal demise
baby - autopsy for karyotype/genetics
| mom - antiphospholipid syndrome/fetomaternal hemorrhage
61
toxicity of trasztusamab
cardiotoxicity - do ECHO frequently
62
angular chelitis, glossitis, stomatitis, normocytic/chromic anemia, seborhic dermatitis
B2 riboflavin def
63
HZ on both eyes?
still fucking HZ even though it shouldn't be
64
water bottle shaped heart with no maximal impulse point
cardiac tamponade
65
pt with mono and really sore throat at risk for
acute airway obs, could be at risk for peritonsilar abscess but NEVER retropharyngeal abscess
66
pt is strep, 3 yrs old and has swallowing problems
retropharyngeal abscess
67
don't choose retropharyngeal abscess unless
pt is <4 or had recent trauma
68
DOE, orthopnea, choking on laying down, lower ext edema
diastolic dys with preserved EF
69
methimazole s/e
agranulocytosis
70
PTU s/e
liver failure
71
which Graves disease drug in 1st trimester
PTU
72
sore throat and fever while taking methimazole
agranulocytosis
73
pt with STEMI, give MONA BASH unless flash pulmonary edema then give
loop
74
difference bt seminomitous vs nonseminomatous tumors
semi - Bhcg
| non-semi - Bhcg and AFP
75
spider angiomas, palmar erythema, gynecomastia, testicular atrophy
hyperestinism in cirrhosis
76
vascular wall dilation in cirrhosis
estrinism
77
frequent watery nocturnal diarrhea
possible laxative abuse
78
malanosis coli/dark brown spots on proximal colon
laxative abuse
79
menarche should start during what tanner stage
4
80
postpartum with signs of PE
go straight to anticoag
81
painless episodes of GI bleeding
angiodysplasia
82
MC place for angiodysplasia
R colon
83
angiodysplasia often co-occurs with what other disorder
AS
84
treatments for PAD
exercise >> cilostozol >> revascularization
85
blood problems in scleroderma
schistocytes
86
schistocytes, AKI, thrombocytopenia, malignant HTN
scleroderma
87
mcc of second stage arrest of labor
fetal malposition
88
vaccines 2 year old sickle cell patients need
PPSV23 and MCV4
89
reason for hypoCa in pancreatitis
precipitation of calcium soaps
90
FAST scan cannot see what areas
retroperitoneal or other peritoneal bleeds - it's good for splenic but not kidney or aorta or pancreas
91
treatment for bacterial rhinosinusitis
augmentin (levo is as effective but has poorer s/e panel)
92
3 relatives, 2 generations, 1 before 50
Lynch, HNPCC
93
types of cancer in HNPCC
endometrial and colon
94
genetic failing in HNPCC
DNA mismatch repair with microsatelitte
95
tx for cholestasis of pregnancy
ursodeoxyacid, deliver at 36 weeks
96
CENTOR score
```
C - no cough (1 pt)
E - exudates (1 pt)
N - node involvement (1 pt)
T - temp over 39
OR - <14 (1 pt) or >44 (-1pt)
```
<1 = nothing
2-3 rapid strep
>4 = rapid strep and treat regardless
97
location of b/l nose bleed
posterior - use packing
98
major/minor Duke criteria for IE
Maj: bacteremia, new onset regurg, vegetations
Minor: RF, fever, vascular, rheumatological
99
Tx for IE/SBE
```
native valve: vanc ONLY
prosthetic valve <60d: vanc + gent + cefipime
61-364 days: vanc + gent
>365 days: vanc + gent + ceftriaxone
SBE: gent + ceftriaxone
```
100
Imaging modality for IE
TEE
101
when is surgery indicated for IE
florid CHF, veg >15mm, veg >10mm + embolism, stroke or MI, fungus, abscess
102
can't give vanc in IE?
daptomycin
103
how long to treat IE/SBE for
4-6 weeks
104
increased Uosm and Una
SIADH
105
treatment for SIADH
demeclocycline to induce DI
106
Uosm is decreased and urine is dilute
DI
107
dx for DI
Deprive the Internal water
108
decreased serum Na and decreased serum Osm
SIADH from too much ADH
109
Not enough ADH
DI
110
euvolemic hypotonic hyponatremia causes
RATS
RTA, Addisons, thyroid, SIADH
111
how to deal with symp vs non symp SIADH
symp - water deprivation
| non-symp - CT scan
112
what to check in euthryroid sick syndrome
rT3
113
thyroglobulin differences bt biologic and medically induced hyperthyroid state
```
biologic = increased
induced = nonexistant
```
114
thyroid finding in recurrent miscarriage
antiTPO ab
115
most common factor in CP
prematurity
116
MCC of sepsis in fully vaccinated SS child
s pneumo
117
lesion of facial nerve: below vs above pons
below - Bell's palsy
| above - forehead sparing, may have hemiplegia, hemisensory loss
118
small for gestational age child with hearing loss and cataracts
congenital rubella
119
pt with HF and hx of MI
left ventricular aneurysm
120
deep Q waves and persistant ST elevation on EKG
left vent aneurysm
121
iron deficiency anemia and malabsorption
celiac
122
suspected celiac pt without IgA antiendomysial ab
could still be, maybe they're selective IgA deficiency
123
movement of blood from high pressure aorta to low pressure pulmonary artery results in this murmur
PDA
124
mildly accentuated peripheral pulse
PDA
125
s/e of ICD
TR
126
hormonal derangement in OSA
increased EPO
127
increased renin, increased aldo in hypoK and HTN
secondary hyperaldosteronism - probably renovasular
128
decreased renin, increased aldo in hypoK and HTN
primary hyperaldosteronism - probably adrenal hyperplasia or aldosterone secreting tumor
129
decreased renin and aldo with hypoK and HTN
non aldosterone cause - probably CAH, cushings, exogenous mineralocorticoid
130
HTN, mild increase in Na, decreased renin
primary hyperaldosteronism
131
tx for allergic rhinitis
intranasal glucocorticoids
132
gram positive filimentous acid fast bacteria with brain abscess and lung involvemnt
nocardia - use bactrim and carbapenam if brain involvement
133
cardiac arrest after intubation of a hypovolemic pt
loss of right ventricular preload because right heart is too weak without volume
134
why might you get cardiac arrest with PPV use in a hypovolemic pt
increase in intrathoracic pressure causes cardiac arrest b/c of no back pressure from right heart
135
hypocalcemia with increased PTH
renal failure, vitamin D deficiency, PTH resisitance
136
why do you see hypoCa in alkalosis
decreased number of charged sites on albumin that bind ca
137
hypoCa with decreased phos
vitamin D def
138
hypoCa with increased phos
renal failure
139
how to correct Ca
[Ca] + {0.8 (4.0 - [albumin]}
140
how does hypomag and hypermag cause hypoCa
by causing PTH resistance
141
definition of hypoCa
<8.4
| <4.2 ionized
142
hypoCa with low to normal PTH
hypoparathyroidism
143
holding all other variables constant, increased phos should do what to Ca
decrease
144
what happens in the first phase of ATN
urine output decreases
BUN increases
lasts 36 hours
145
MCC of intrarenal AKI
aminoglycosides
146
what are the 3 phases of ATN
1) initiation
2) maint - oliguric (WATCH FOR increased K!)
3) recovery - polyuric (WATCH FOR decreased K!)
147
ATN with intratubular oxalate crystal deposits under polarized light
ethylene glycol
148
MCC of ischemic ATN
prerenal failure
149
compromises renal perfusion
```
decreased preload
hypovolemia
systemic vasodilation
cirrhosis
decreased CO
CHF
cardiogenic shock
NSAIDs
```
150
FeNa >3 and muddy brown casts
ATN
Watch for FeNa <1 in contrast or rhabdo
151
MCC of NHL
diffuse large B cell (25%)
152
atypical lymphocytes that look like immature B cells
NHL - DLBC type
153
types of cell markers in NHL - DLBC
CD19, 20, 22, 79a
154
levels of excretion in hypophos - <100mg in 24 hours
refeeding syndrome or respiratory alk
155
levels of excretion in hypophos - >100mg in 24 hours
hyperPTH or vitamin D deficiency
156
MCC of euvolemic hypernatremia
free water loss or DI
157
correct Na for high glucose
Na + 0.016 (glucose - 100)
158
PTH inhibits renal reabsorption of what
phos
159
how does vitamin D increase phos
through intestinal absorption
160
Calculate urine anion gap
Na(u) + K(u) - Cl(u)
161
positive UAG
RT dysfunction
162
negative UAG
GI loss
163
cell markers for PreT ALL
CD3, CD7
164
cell markers for Burkitts
IgM, CD10, HLADR, CD43,
| B antigens, CD19, 20, 22
165
most effective antivirals in HIV
tenofovir + emtricitabine
166
next best option if you can't use the best in HIV (because of renal failure)
abacavir-lamuvidine
167
preferred PIs to NRTI backbone
atazanavir or darunavir
168
integrase inhibitiors
dolutegravir, elvitegravir, relategravir
169
2/3 of sepsis cases are what kind of bacteria
gram positive
170
how does follicular thyroid cancer spread
hemotogenously
171
what is produced in the adrenal medulla
catecholamines - cats are the center of everything
172
how to diagnose the tupe of cushings
low then high
173
pt is hypotensive, N/V, coma
acute addisons
174
pt is orthostatic and darker than they should be
chronic addisons
175
consyntropin stim test shows increased cortisol
anterior pituitary problme
give prednisone only - MRI
176
cosyntropin stim test shows no change to cortisol
problem is in the adrenal gland
give prednisone and fludricortisone - CT/MRI
177
normal renin:aldo ratio
CAH or licorice OD
178
renin:aldo ratio of <10
renovascular disease
179
renin:aldo of >10
Conns test with salt suppression test and get MRI/CT if no suppression
180
pt with newly diagnosed DM has GAD or IA2 antibodies
only insulin will work
181
treatment for prediabetes
lifestyle and metformin
182
treatment succession for diagbetes
1) lifestyle and metformin
2) 2nd agent
3) insulin
183
A1c of >9%
go straight to insulin
184
best test for DM
fasting glucose of >125
185
breast feeding contraindications
TB, HIV, herpetic lesions, varicella, chemo/rads, substance abuse
186
w/i 3 months of a change or stressor
adjustment disorder
187
sausage digits + joint pain in the DIP
psoriatic arthritis
188
hypotension after an epidural
vasodilation and venous pooling from sympathetic blockage
189
pt has difficulty walking and cramping when sitting
PAD - >0.9 ABI is diagnositc
190
D-xylose test - urinary excretion is decreased
absorption problem, likely celiac
191
D-xylose test - urinary excretion is normal
pancreatic insufficiency
192
newborn with HR <100
PPV
193
newborn with HR <60
chest compressions
194
drug that can cause peripheral edema
CCBs like amlodipine
195
post parotid surgery complicaton
facial droop
196
suspected aortic aneurysm, need to image, Cr high vs normal
high - TEE
| normal - CT contrast
197
pt with signs of right heart failure and remote history of hodgkinds lymphoma
constrictive pericarditis from radiation
198
metabolic alkalosis + decreased urine Cl
vomiting
199
bilateral hemiparesis s/p trauma
anterior spinal cord (motor is at the front)
200
blunt trauma in pregnancy, and vaginal bleeding what do you do now
1) IVF
| 2) put the pt in L lat decubitus
201
pt with high BUN and normal platelet count is bleeding
uremic platelet dysfunction
202
most important thing s/p MI
restore blood flow
203
contralatral hemisensory deficit with greater LE weakness and urinary incontinence
ACA
204
medication other than abx that increases risk of c difficile
PPI
205
acute cholecystitis is wehre
cystic duct
common bile duct would have jaundice
206
NNRTIs
efavirenz - 1st gen
| rilpivirine and etravirine - 2nd gen
207
what lab should you always look for in sepsis
lactic acid!
208
SIRS criteria
HR >90
T <36 or >38
WBC <4000 or >12000 or >10% bands
RR >20 or PaCO2 <32
209
Delta gap (what is it)
differnce bt anion and bicarb
210
how to calculate the delta gap
(AG - 10) - (24 - bicarb)
211
hypoPTH usually does what to phos
hypo
212
if saline admin doesn't work for metabolic alkalosis
acetazolamide
213
hyperNa with 800 mOsm/L excretion
renal etiology
214
non pharmaceutical intervention for symptomatic hypermag
ventilation
215
MC translocation in childhood pre B ALL
t(12;21)
216
MC translocation in adult pre B ALL
t(9;22) philidelphia chromosome
217
BM failure vs erythrocyte destruction or loss
reticulocytes will be down in BM failure
218
extra renal hypovolemia
U(Na) <15 or FeNa <1%
219
reticulocytes in hemolytic anemia
4-5%
220
increased protein in kaposi sarcoma
VEGF
221
angioproliferative disorder associated iwth HIV
kaposi sarcoma (HHV8)
222
CD4 count for toxo
<100
223
chorioretinitis + hydrocephalus + ring enhancing lesions + cortex and BG involvement
toxo
224
imaging for toxo
MRI
225
pneumonitis, myocarditis, necrotizing encephalitis
toxo
226
what drug must you give with pyrimethamine
leucovorin
227
MEN1 vs MEN2a vs MEN2b
MEN1 - Pituitary, Parathyrid (HyperCa), Pancreatic tumors (ZE and insulinoma)
MEN2a - Pheo, medullary thyroid CA, hyper PTH
MEN2b - Pheo, medullary thyroid CA, neuronal tumor
228
genes of the MEN syndromes
MEN1 - MEN
| MEN2a/b - RET
229
dysfunction with basilar or vertebral CVA
syncope
230
dysfunction with cerebellum CVA
ataxia
231
person on warfarin has brain bleed on CT
give FFP
232
causes of seizure
```
Vascular
Infection
Trauma
Autoimmune
Metabolic
Ingestion
Neoplasm
pSych
```
233
Pt is seizing and you can't get it to stop - order of drugs
BZDs >> fosfophenytoin >> Midozalam >> Propofol >> Phenobarb
234
how do you treat atonic or myoclonic seizures
valproate
235
treatment for parkinsons <70 vs >70
<70 dopamine agonists like promipexole or ropinarole
| >70 levo/carbidopa
236
difference between essential and intention tremor
both with movement
intention is worse closer to target
essential you can treat with propranolol
237
only headache you have to image
cluster
238
flaccid paralysis, UMN symptoms after, bladder or bowel incontinenece after a repair ofan AA
anterior spinal cord syndrome becuase of proximity to artery of Adamkiewicz
239
RA risks increase of what disease
osteoporosis
240
SAAG of >1.1 and PMNs of >250
SBP
241
child with macrocytic anemia, low reticulocytes, palor, congenital anomalies like webbed neck, cleft life and shield chest, with sporadic or AD/AR inheritance
Diamond Blackfan anemia
242
liver abscess, dysentary with travel to an endemic region or animal contact
amebic abscess (e histolytica)
243
treatment for liver abscess
metronidazole - don't drain
244
Fat person with restrictive pulmonary problem and respiratory acidosis
obesity hypoventilation
245
complex multiloculated adnexal mass with thick walls and debris
TOA
246
necrolytic migratory erythema with DM and GI symptoms like weight loss and diarrhea
glucagnoma
247
serum glucagon level in a glucagonoma
>500
248
dry eyes, raynauds, cuteous vasculitis, interstitioal lung dz, NHL
sjogrens
249
baby that is <28 days old with difficulty feeding and hypotonic and lethargic
suspect sepsis
250
type of infection in diabetic ulcer
polymicrobial with contiguous spread
251
HIV pt with CD4 <100 and small pustules on the face and groin
bartonella - bacilliary angiomatosis
252
AMS, ataxia, diploplia, motor deficits with non ring enhancing brain lesions in HIV pt
progressive multifocal leukoencephalopathy (JC virus)
253
pt with cirrhosis what next
EGD to r/o varicies
254
deciding factors on a liver transplant 2/2 acetaminaphen tox
Cr >3.4
stage 3/4 encephalopahty
prothromin >100ms/INR 1.5
255
first treatment for BPH
alpha blockers like terazosin or terazosin
5alpha reductase inhibitors comes second (finasteride)
256
moderate to severe croup treatement
neb epi
257
CAI tox
hyperchloremic metabolic acidosis and hypokalemia
258
quickSOFA
RR >22
AMS
SBP <100
>2 for sepsis
259
signs and symptoms of metabolic alk are similar to what
hypocalcemia (tetany, confusion, cramps)
260
normal role of antithrombin III
inhibits coagulation by lysing Xa and IXa
261
pt in the ICU with BUN of 96 suddenly has increased diuresis and hypernatremia
increased in urea causes osmotic diuresis and therefore hypernatremia
262
why does hypovolemic hypernatremia happen
more water than Na loss
263
Imaging for portal vein thrombosis
contrast MRA, contrast CT but best initial is doppler u/s
264
why is there increased urine sodium in hypovolemic alkalotic pt
Na is excreted to keep it, Urine Cl should be <20 in this case
265
Pentad of TTP/HUS
```
microangiopathic hemolytic anemia
thrombocytopenia
AKI
AMS
Fever
```
266
Urine Cl of <10 suggests what
Cl responsive met alk and volume depletion
267
How to treat moderate lead poisoning
45-69 level
| succimer
268
How to treat severe lead poisonign
>70 level
| EDTA
269
Cancer with CD63, CD11c and CD25 and Anhexin-A1
hairy cell leukemia
270
hypocloride makes alkolosis
worse
271
hyperCa on EKG
short QT and block
272
how to diagnose bladder CA
florescence cytoscopy
273
casues of AIN
PCN, NSAIDs, allopurinol, sulfa, cephalosporins, PPI and rifampin
274
cancerous progression of polycythemia vera
AML
275
Ranson's criteria
```
WBC >16000
AST >250
glucose >200
Age >55
LDH >350
```
276
what is in HgH
4 beta chains, missing 3 alphas
277
met alk and hypoK becuase of increased aldo from hypovolemia, also H and K are secreted at alpha intercalated
Barters
278
causes of normal gap hypoK met acid
RTA 1 - DCT can't secrete
| RTA 2 - decreased bicarb resorption in PCT
279
normal gap hyperK met acid
RTA 4 - hypoaldo
280
MCHC in spherocytosis
increased because of membrane loass
281
increased proliferation of mesangial cells immune complexes on EM
IgA nephropathy
282
mutation in gittlemans
AR mutation of NCCT in DCT
283
gonadal dysgenesis, nephrotic syndrome, wilms tumor, mutation of WT1
Denys Drash
284
vision loss, myocarditis, respiratory failure, encephalitis, seizures
toxocara canis
285
prophylaxis for tension HA
TCAs - amitriptylene
286
MOA of valproic acid
inhibit Na channels and enhance GABA
287
MOA of topiramate
inhibit NMDA glutamate and enhance GABA
288
how does s typhii get into the body
through Peyer's patches in the TI and is taken up by macrophages
289
how does tetanus work
cleaves synaptobrevin and inhibits release of glycine and GABA
290
treatment for Meniere's diesease
salt restrcition and meclizine
291
cold water calorics - which direction
COWS
| cold opposite, warm same
292
in MS how to treat urinary retention, incontinence, spasms, neurogenic pain
retention - bethanachol
incontinence - amitriptyelene
spasms -baclofen
neuro - gabapentin
293
never use what in GBS
steroids
294
use what drug in MG
cholinesterase inhibitors
295
How to diagnose ALS
EMG
296
lateral knee injury - with or without crepitus
wo crepitus - MCL
| with crepitus - medial meniscus
297
how to treat acalculus cholecystitus
percutaneous cholesystotomy
298
dermatophyte of tinea capitus
t. tonsurans
299
treatment for tinea capitus
oral griseofulvin, terbinafine
300
social vs generalized anxiety
social - people, nothing else
| generalized - things, events, abstract worries
301
lichen sclerosis vs atrophic vaginits
lichen sclerosis is like AV but will involve the anus as well and ther will be white skin or cigarette paper skin
302
hypoNa in someone with decompenssated HF
severe sign of HF
caused by increased renin/norepi/ADH
tx: fluid restric, ACE-i, loop
303
other name for strawberry hemangioma
superficial hemangioma
304
what can you give in a complicated childhood hemangioma
propranolol
305
other risk factors for osteoporosis
malabsorption, hypercortisolism, hyperthyroid, hyperPTH, RA, liver/renal, estrogen (early meno/hysterectomy)
306
if you can't give doxy in lyme disease
amoxicillin
307
increased thrombosis risk in PNH where
cerebral and abdominal
308
increased bili, LDH and low hapto
hemolytic anemia
309
tx for neurocystercosis
albendazole
310
imaging for kidney stone
u/s or non con CT
311
radiopaque hexagonal crystals with familial hx
cysteine stones
312
screening test for cystein stones
cyanide nitroprusside
313
disorder of sickle cell disease/trait wehre kidney can't concentrate urine
hyposthenuria
314
renal problem where blood sickles in the vasa recta of the inner medulla
hyposthenuria
315
drugs that increase/don't increase survival in HF
increase: ACE, ARB, Beta, spironolactone
| don't increaes: digoxin and loops
316
45 year old pt with cirrhosis - which pneumococal vax?
give 23-valnt and then 13 and 23 at 65
317
perihilar linear opacities in newborn
respiratory distress syndrome give continuous PPV
318
HTN and ambiguous female genitalia or precocious puberty in male
11-OH def
319
HTN and failure of secondary sex charachteristics at puberty
17-OH def
320
low urine/serum osm
psychogenic polydipsi
321
low urine osm high serum osm
DI - diagnose through water deprivation test
322
symptomatic managemet of nephrogenic DI
HCTZ, indomethacin, amilioride
323
what will DDAVP do to osm in central DI
increase osm
324
drugs that cause nephrogenic DI
lithium, demeclocycline, cidofovir, foscarnet, amphotericin B
325
before starting insulin in someone with DKA what do you need to check firsts
K
326
most common cause of death in DKA in children
cerebral edema
327
overactive aldosterone and RAAS suppression - what kind of adrenal problem
primary hyperaldosteronism
328
primary hyperaldosteronism from an aldosterone producing tumor
COnns
329
adrenal adenomas - aldosterone producing? cortisol producing? androgen producing? Doesn't produce?
aldo - Conns
cortisol - cushings
androgen - hyperandrogen
no hormone - incidentaloma
330
overproduction of aldo, excess water retention, HTN, H/K wasting with metabolic alk and decreased K
Conn's
331
increased RAAS activity and low volume state
secondary hyperaldo - probably from CHF, cirrhosis, renal failure, nephrotic syndrome, (increased renin and aldo)
332
difference between primary and secondary hyperaldo
primary - decreased renin and increaed aldo
| secondary - increaed renin and aldo
