STEP 2 - UWORLD part 3 Flashcards
1
Q
inspiratory strider in FBAO
A
extrathoracic - call GI
2
Q
expiratory wheeze in FBAO
A
intrathroacic - call pulm
3
Q
+ coin sign on lateral
A
its in the trachea
4
Q
stepwise asthma tx
A
SABA then ICS then increase the ICS then SABA (LTA at ICS or not)
5
Q
person who’s asthma is not controlled, what next
A
make sure they’re using inhaler correctly
6
Q
tx for bronchiolitis
A
nothign, SABA, steroids, abx doesn’t work - O2 and IVF if really bad
7
Q
child who is <2 with wheezing and dyspnea in the winter
A
bronchiolitis
8
Q
meconium ileus on day of birth is what disease
A
CF
9
Q
diverticulosis vs diverticulitis bleeding
A
none in -itis, only in -osis
10
Q
treatment for severe babiosis with anemia
A
exchange trasnfusion
11
Q
complex vs simple seizure
A
complex - LOC
simple - no LOC
12
Q
generalized simple seizure - what dx?
A
think pseudoseizure
13
Q
simple vs complex febrile seizures
A
simple - 1 per 24 hours, duration <15 mins, generalized (if any one absent, go to complex)
complex - probably not febrile (do EEG, LP, etc) treat as epilepsy
14
Q
treatment for febrile seizures - complex vs simple
A
simple - acetaminaphen
complex - bzd
15
Q
<1 yo symmetrical jerking with hypsarrhythmia on EEG with no fever
A
infantile spasm, tx with ACTH
16
Q
infantile spasm is most associated with what disease
A
tuberous sclerosis
17
Q
cosyntropin is also knonw as
A
ACTH
18
Q
sebasceous adenoma is connected with what peds disease
A
tuberous sclerosis
19
Q
blood disorders with SLE are what kind of hypersensitivity
A
type 2 - hemolytic anemia, thrombocytopenia, lymphopenia, leukopenia
20
Q
volar displaced radius fracture
A
smiths - fall on outstretched hand in volarflexion
21
Q
lab to monitor for spetic arthritis tx
A
CRP
22
Q
GI bacterial overgrowth in systemic sclerosis - tx
A
MTZ
23
Q
renal problems coocurring with septic arthritis
A
serum A amyloidosis (look for proteinuria or nephrotic syndrome)
24
Q
pt who has TRAP+, elevated alk phos and increased CKBB and decreased hemotocrit and hemoglobin
A
osteopetrosis
25
increased ESR, WBCs and decreased Hgb in a child with wht probable bone problem
Ewing sarcoma
26
who is predisposed to drug induced lupus
slow acetylators
27
night stick fracture
monteggia - strike up the proximal ulnar side of forearm
28
renal problem with "wire loop" lesions
SLE class 4 lupus nephritis
29
membranous glomerulonephritis in lupus
class 5
30
impaired delivery of NaCl to the macula densa results in what production and outcome
PGE2 -> stimulates renin release, electrolyte derangement
31
how do sulfonyureas work
increase insulin secretion by closing ATP-gated K channel in pancreatic beta cell membranes which causes Ca2+ channels to open and release insulin
32
trying to diagnose meckles in a teenager - what scan is best
CT > technetium-99
33
Apt test
fetal maternal blood swallowing
34
erisypelas is MCC by
s pyogenes
35
heart problem in infants where mom already had diabetes before conception
transposition of the great vessels
36
what does a VSD sound like
holosystolic murmur at the left sternal borner
37
increase what in ToF
SVR
38
MCC of erythema nodosum
strep pharyngitis
39
painful erythemetous nodules on the anterior portion of the tibia
erythema nodosum
40
clicky hip in newborn that is still there at 4 weeks
DDH - do u/s
41
treatment for developmental dysplasia of the hip
harness
42
6 year old with antalgic gait and doesn't want to put weight on a leg
Legg-Calve-Perthes
43
treatment for LCP disease
casting
44
13 year old with non-traumatic joint pain
slipped cap - get a frog leg XR
45
hip pain in a child after a viral illness
transient synovitis - supportive care, come back in 2 days
46
osteocondrosis other name
osgood slatter
47
pin point tenderness in a teenage athlete
osgood slatter/osteochondrosis
48
teenage girl with dyspnea and one shoulder is higher than the other
scoliosis
49
translocation of 11;22 with a an onion skin appearance on the mid shaft of the femur
Ewing sarcoma
50
sunburst pattern on the distal femur and Rb gene
osteosarcoma
51
leukocyte alkaline phosphate - CML vs leukemoid reaction
low in CML - because it shows neutophil activity and they aren't doing a whole lot in CML
52
BZD you should use in etoh withdrawl
Lorazepam becuase its good with Liver dysfunction
53
pt with profound hypotension after an OD - what to give
glucagon
54
cataracts day one vs not day one
day one - TORCH
| not day one - galactosemia
55
treatment for torsades de pointes
mg2+
56
dysmorphic RBCs or RBC casts
glomerular nephritis
57
imaging for reflux in peds
VCUG
58
imaging for kidney stones
non con CT
59
PUV is most similar to what adult condition
BPH
60
what will you see on u/s for UPJO
hydroureter not hydronephrosis
61
child with recurrent UTI and pyelo, u/s shows hydro
vesiculouretral reflex
62
no urine on day one
PUV
63
female child who is never dry, constant urinary leak
ectopic ureter
64
child pt has had 1 UTI vs 4?
1 - do an u/s
| 2+ - do VCUG
65
pain after mass diuresis like first etoh consumption in teenager
UPJO - diagnose with u/s
66
B12 deficiency looks exactly like what chldhood genetic disease
friedrichs ataxia
67
normal hgb
alpha2 beta2
68
embyonic hgb
alpha2 delta2
69
fetal hgb
alpha2
70
acute chest is what
pulmonary embolism - give exchange transfusion
71
treatment for CVA in someone SS disease
exchange transfusion
72
recurrent sinopulmonary infections with no IgA, IgG
XLA - Brutons
73
anaphylaxis to a transfusion
IgA deficiency
74
XLA presentation but in a teenager, not a baby
CVID
75
child with frequent fungi and PCP infx with low set eats and small face
DiGeorge - give the missing thymus and Ca
76
Eczema and low platelets in a child
Wiskott Aldrich
77
cellular failure in CGD
macrophages
78
giant granules in neutrophils
chediak higashi
79
spontaneous non-drug related angioedema
C1esterase
80
type of cancer in cervical cancer
SCC
81
type of cancer in endometrial cancer
adenocarcinoma
82
treatment for endometrial cancer
total abdominal hysterectomy and bilateral salpingoophorectomy
83
types of chemo used in gyne cancers
platinum agents
84
young person with endometrial cancer - look for what
PCOS or granulosa-theca cell tumor
85
treatment for endometrial hyperplasia
progesterone therapy
86
type of cancer most likely in ovarian cancer
epithelial
87
how to track progress of dysgerminoma of ovary
LDH
88
MC occurence of germ cell tumors
adolescent female
89
treatment for germ cell tumor in female
unilateral salpingoophorectomy
90
serous, mucinous, endometriod and BRenners cancers are what
cystadenoma carcinoma of the ovarian epithelial cell
91
post menopausal woman with ascites with no liver disease
epithelial cell ovarian cancer
92
stromal cell tumors
granulosa theca and sertoli-leydig
93
granulosa cell tumor has what
estrogen
94
sertoli leydig tumor has what
testosterone
95
MC ovarian mass in adolescent/young girl
granulosa theca
96
grape like mass in uterus
DES in utero
97
MCC of sudden onset DOE in someone with COPD
ruptured alveolar bleb
98
symmetrically enlarged uterus that is tender, boggy and globular
adenomyosis
99
urine pH >8 suggests what
urease + bacteria like proteus or klebsiella
100
cancers associated with lynch syndrome
colorectal
endometrial
ovarian
101
cancers associated with FAP
colorectal, osteomas, brain
102
cancers associated with von Hippel Lindau
hemangioblastomas, RCC, pheo
103
cancers associated with MEN1
parathyroid, pituitary, pancreatic
104
cancers associated with MEN2
medullary thyroid, pheo, parathyroid hyperplasia
105
first line meds for hypertensive emergency in pregnancy
labetolol unless HR <60 then hydralazine
106
treatment for postpartum endometritis
clindamycin and gentamicin
107
child with cyanotic heart problem and seizures and sinusitis
brain abscess from hematogenous spread of sinusitis bacteria
108
earliest renal dysfunction in diabetes pts
glomerular hyperfiltration
109
mammary pagets disease is what kind of cancer
adenocarcinoma
110
next step in suspecting GBS
spirometry to assess lung function - even if it seems like breathing is fine, if breathing is not fine, intubate
111
ipratropium is what kind of medicaiton
antimuscarinic
112
Highest risk for LV thrombus post STEMI
large anterior ST elevation MI
113
limb ischemia after MI suggest what
arterial embolus from LV
114
increase the murmur of HOCM
valsalva
115
murmurs where decreasing preload (valsalva or abrupt standing) increases the murmur
HOCM and MVP
116
things that decrease preload
valsalva, abrupt standing, nitro
117
things that increase preload
squatting, passive leg raise
118
things that increase afterload
hand grip, squatting
119
what increases both afterloadand preload
squatting
120
why can you not give someone nitro with right MI
nitro decreases preload and right MI is preload dependant
121
prevention measures for migraine
topiramate, propranolol, amitriptylene
122
liver disease that is strongly associated with UC/IBS
PSC
123
ovaries are supplies by what (arterial)
directly from the aorta
124
ligament in ovarian torsion
suspensory ligament of ovary
125
uterine arteries come from where
iliac arteries
126
postpartum hemorrhage size
500cc in vaginal birth
| 1000cc in c-section
127
medications to stop uterine hemorrhaeg
oxytocin (first choice)
128
surgical fixes for post partum hemorrhage
uterine artery ligamentum
or internal iliac ligation
finally TAH
129
ligament with ovarian vascular supply
suspensory ligament of ovary
130
ligaments that need to be cut in TAH
uterosacral ligaments (looks like ureters)
131
ligament that connects ovary to side wall
cardinal ligament
132
pelvic floor relaxation comes from what ligament problem
cardinal
133
anterior falling in vagina
cystocele
134
posterior falling in vagina
rectocele
135
cervix is way too close to vaginal opening
uterine inversion - TAH
136
size of small vs large ovarian cysts
<10/>10
137
HUGE ovarian cyst
teratoma
138
treatment for ovarian teratoma
cystectomy - they'll recur but don't BSO unless she's older
139
if you can't use OCP in endometriosis, use what
GnRH analog (lueprolide)
140
u/s should show uterine pregnancy at what bhcg
1500-2000
141
when can you use MTX for etopic
<5000 beta quant, <3cm GS and no heart tones
142
diagnosis for ovarian torsion
u/s with doppler to see arterial flow as well
143
WBC on wet prep with fever and pelvic pain
TOA/PID
144
in patient PID treatment
cefoxitin, doxy and MTZ is preferred
145
stress incontinenece is found only in who
women, you need a cardinal ligament for this
146
cystocele is associated with what type of incontinence
stress incontinence
147
overflow incontinece is also known as what
hypotonic/neurogenic bladder - absent detrusor contractions
148
bethanachol vs oxybutinin used for
bethanachol - hypotonic bladder
| oxybutinin - hypertonic bladder
149
what to give in an acute bleed of the uterus
IV estrogen
150
first diagnostic step in precocious puberty
xray of the wrist - if bone age is too great move to GnRH stim test
151
murmur of marfans
early diastolic (aortic regurg)
152
alcohol quitting drugs
acamprosate for when you've already set up camp in the abstinence dept
naltrexone for people still drinking but not opiod users
153
amphetamine vs anticholinergic poisoning
anticholinergic will have more consistent delirium not anger and will have dry mucous membranes
154
hormone that regulates periods
progesterone
155
absent uterus, normal ovaries
Mullerian agenesis
156
absent uterus, ovaries, top part of vagina with cryptorchic testes
androgen insensitivity
157
pt with UC and coexisting elevated alk phos
PSC
158
differentiate pt with hyperpigmentation of the skin and determine whethere addisons or hemochromotosis
hyperglycemia in hemo
| hypoglycemia in addisons
159
reentrant ventricular arrhythmia is aka
vfib
160
beta quant fails to double after not being seen on u/s
ectopic
161
LH/FSH ratio of greater than 3:1
PCOS
162
estrogen vs testosterone secreting tumors in women
estrogen - germ cell
| testosterone - sertoli-leydig
163
bone age is 2 or more years greater than actual age
precocious puberty
164
GnRH stim test shows increased LH in 7 year old girl with pubertal onset
get an MRI either tumor or constitutional - give leuprolide if constitutional
165
GnRH stim test is LH negative in 7 year old girl with pubertal changes
U/S abdomomen, check 17-OH, DHEAS, testosterone
166
FSH and LH elevated in 16 year old girl without menarche
hypergonadatropic look at karyotype
167
FSH and LH are not increased in 16 year old girl without menarche
look at proloactin, TSH, UPT, CBC, LFT, ESR, MRI - hypogonadatropic
168
LH and FSH very elevated in woman that doesn't have menarche
turners syndrome
169
difference between Mulerian agenesis and AIS
Same on the outside, on the inside AIS will have testes that need to be removed
170
increase in proloactin foes what to GnRH
shuts it off
171
progesterone challenge causes bleeding
PCOS
172
progesterone challenge does not cause bleeding
give estrogen and progesterone - if no bleeding - Ashermans
| if bleed - signal is missing
173
FSH/LH is increased after negeative progesterone syndrom
savage or menopause
174
Pt with chronic pancreatitis and pain in the epigastrum with jaundice
U/S - pancreatic cancer in head
175
pt with chronic pancreatitis with pain in epigastrum w/o jaundice
CT - pancreatic cancer in body or tail
176
Pertussis prophylaxisis
macrolide
177
abx associated with pyloric steonsis
erythromycin
178
slow rising weak carotid pulse - murmur?
AS
179
single soft S2
AS
180
hydatid liver cyst with septations in south american farmer
eichinococcus granulosus - dog tape worm from sheep
181
how to decrease calcium stones
increase liquid intake and decrease sodium
182
hypoglycemia, doll face, lactic acidosis, seizures in 4 months old child
von gierkes
183
mechanism of von gierkes
impaired glycogen to glucoseresulting in glycogen accumulatin in organs
184
antipsychotic least likely to cause TD
clozapine
185
treatment for early tremor in parkinsons
trihexaphenidyl
186
pt sees wavy lines
macular degeneration
187
mcc of constrictive pericarditis in developing countries
TB
188
pt with recent onset of wheezing and trouble breathing - takes ASA, ACE-i, statin, albuterol, never had wheezing befor
ASA induced
189
ASA induced asthma is what kind of reaction
non-IgE
190
initial management of PAH
ACE-i, loops
191
abdominal radiopgraph with free air under hte diaphragm in someone with abdominal pain
ruptured ulcer
192
what is the murmur in ToF
stenosis of the pulmonary artery - harsh crescendo decrescendo murmur
193
most common TEF
C type
194
fever during the surgery
malignant hyperthermia
195
fever right after suregry
bacteremia - probably an error in surgery
196
dx bacteremia
blood culture
197
fever post op day 1
atelectasis - get a CXR
198
fever post op day2
pneumonia - HAP
199
fever post op day 3
UTI - unless with white cell casts, probably had it before
200
fever post op day 5
DVT/PE - particularly ortho
201
treat a DVT/PE in hospital
heparin to warfarin bridge
202
post op day 7 fever
cellulitis from the wound - check u/s for abscess
203
post op day 10-14 fever
abscess - get an u/s or CT - incision and drainage
204
enzyme used for reinfarction for MI 18 hours later
CKMB
205
obstructive jaundice with heme positive stool
ampullary cancer
206
unilateral bloody nipple breast discharge with no lump
intraductal papilloma - usually benign
207
MRCP vs ERCP in choledocholithiasis
ERCP for stone removal, MRCP if transaminitis (w/o cholangitis)
208
can't give which anticoag in antithrombin deficiency or anticardiolipin in pregnancy
warfarin
209
soft S2, diminished carotid pulse, mid late systolic murmur
AS
210
crescendo decrecendo murmurover L second intercostal with wide split S2
pulmonic stenosis
211
best study for incidence
cohort
212
increased cap permeability - type of effusion
exudative
213
decreased oncotoic pressure or increased hydrostatic pressure - what kind of effusion
transudate
214
congenital cataracts day one vs not day one
day one - TORCH
| not day one - galactosemia
215
white thing at the front of eye vs back of eye
front - cataract
| back - retinoblastoma
216
dilated nonreactive hard pupil - sudden onset
closed glaucoma
| give alpha agonist and beta blocker (activate alpha, block beta)
217
orbital cellulitis in DM/DKA
give apmphoteriin B for mucor coverage
218
painless unilaterla loss of vision in 75 year old hypertensive man with no other FND
retinal artery occlusion
219
loss of central vision
macular degeneration
220
best first test for brain cancer suspect
MRI with contrast
221
posterior brain tumors
meduloblastoma and ependmoma
222
anterior brain tumors
glioblastoma and meningioma
223
ring enhancing lesion in bat wing formation in the brain
glioblastoma
224
nausea vomiting hearing loss and tinnitis if a brain tumor what is it
schwannoma
225
kid with headaches and fetal position relieves them
hydrocephalus caused by ependymoma or meduloblastoma
226
child with bent thumbs, WBC of 3000, platelets of 40k, and hypopigmentatioan
fanconi anemia
227
reason for increased cancer risk in fanconi anemia
DNA chromosomal breaks
228
lumbar step off and back pain in adolescent male child
spondylolisthesis
229
studies for first febrile UTI in child <24 months
renal and bladder ultrasound
230
metabolic derangement in Addisons disease (acid base)
non gap met acid
231
metabolic derangment in TB (acid base)
non gap met acidosis becuase of addisons disease
232
alanine is converted to waht during gluconeogenesis
pyruvate
233
diagnosis of subclinical hypothyoridism, what next
anti TPO ab titer
234
unexplained HF and proteinuria in someone with no HTN hx
amyloidosis
235
cause of TD
dopamine D2 receptor super sensitivity
236
what hormone is levonorgesterol
progesterone
237
best anticoagulant in someone with a low GFR <30
unfractionated heparin
238
who is most likely to have RTA 4
poorly controlled diabetics
239
low bicarb with hyperk (acid base)
metabolic acidosis
240
calc the gap
(Nackelbee) Na+Cl+bicarb
241
firm nodular prostate
cancer
242
how to bx a prostateq
transrectal
243
whole RBCs vs dysmophic RBCs in hematuria
whole - somewhere in the GU system after the kidneys
| dysmorphic - glomerular
244
X-ray 24 hours after pulmonary trauma with unilateral white out
Pulmonary contusion tx with colloids, PEEP
245
Diagnosis for aortic dissection
CT a bio maybe TEE or MRI
246
Treatment for flair chest
Binders and weights
247
ALT >150 in a woman with pancreatitis
gallstone pancreastitis
248
treatment for gallstone pancreatitis
cholecystectomy
249
mc disloactaton of the shoulder
anterior
250
external abducted shoulder
anterior dislocation
251
abducted internally roatated shoulder
posterior dislocation
252
dorslly displaced wrist fracture
colles
253
ulna breakage and radius dislocation (upward block of a downward blow)
monteggia
254
radius break, ulna dislocated (downward block of an upward blow)
galezzia
255
factue of the femoral head needs what
prosthesis
256
fracture of intrtrochanter needw what
plates
257
valgus stress is what
laterl injures the MCL
258
knee pain that clicks on extension
meniscus
259
tx for anion gap alcohol ingestion
fomepizole or etoh
260
anion gap alcohols
ethylene alcohol and methanol
261
alcohol with glowing woodlamps
ethylene glycol
262
Dilated loops of bowel on infant X-ray
Me onion ileum
263
Absent radius
Thrombocytopenia absent radius, fanconi anemia, holt oram
264
Bx of erythema toxicum
Eosinophils
265
Facial capillary malformation at V1 V2
Sturge weber
266
Port wine stain in newborn
Capillary malformations
267
Lung cancer screening
CT scan
| 55-80, 30 pack year, quit less than 15 years ago
268
more than a mg of acetaminophen
use NAC
269
tx for OD aspitin
alkalize the urine
270
pulse ox 100% in someone with n/v and HA after fire
carbon monixide poisoning, use ABG to diagnose
271
cherry red skin or cherry red blood after a fire
cyanide poisonng
272
treatment diff cyanide poisoning
fire - don't use amyl nitrate
| chemical - can use amyl nitrate or thisulfate
273
block organophospathae
atropine and praladoxime
274
Nausea vomiting and hypo active or absent bowel sounds
Paralytic ileum
275
Basilar predominant COPD
Alpha 1 antitrypsin
276
Peripheral edema, increased JVP, prominent a wave, loud s2, right sided heave, pulsatilla liver, tricuspid regurgitate
Cor pulmonale
277
Pulmonary hypertension with RBBB, and right axis deviation
Cor pulmonale
278
How to diagnose cor pulmonale
Right heart cath
279
Mitral problem in HOCM
Abnormal mitral leaflet motion from contacting the thickened septum from systolic anterior motion and leads to left ventricular outlet obstruction
280
Someone with fever and confusion after CTA
Thyrotoxicosis
281
Male child with antalgic gait
Legg calves perthes disease
282
Hematocrit of >65% in newborn with respiratory distress
Policy themes
283
When to prescribe a statin to a newcomer
>7.5% 10 year risk of ASCVD aged 40-75
284
Nausea vomiting decreased appetite diarrhea in someone with afib
Digoxin toxicity
285
Deceased lung volume, decreased diffusion lung capacity and normal FEV1/FVC ratio
Restrictive pattern
286
Pt with slurred speech, unsteady gait, drowsiness with 5mm reactive pupils
Benzo tox
287
Treatment for food borne botulism
Equine derived antitoxin
