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step 3 20 Flashcards

1
Q

porcelain gallbladder management

A

refer for prophylactic cholecystectomy

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2
Q

breast mass management

A
  • if under 30, US plus, minus mammogram. If simple cyst, FNA. If complex cyst, image-guided core biopsy
  • if over 30, US + mammogram, if suspicious then biopsy
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3
Q

bullous pemphigoid management

A

Mild cases are managed with topical high-potency glucocorticoids, but more severe cases require treatment with systemic glucocorticoids and steroid-sparing agents.

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4
Q

first step with bullous pemphigoid

A

skin biopsy and serum assay for basement membrane antibodies

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5
Q

bullous pemphigoid management

A

prodrome of itching and urticaria, which was followed by an outbreak of an erythematous rash with tense bullae

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6
Q

treatment of asymptomatic lead toxicity

A

identify and remove lead sources, children with

  • mild lead toxicity (5-44 µg/dL) – repeat venous blood lead level within 1 month
  • moderate 45-70– (Meso-2,3-dimercaptosuccinic acid (DMSA, succimer)
  • if over 70 – Dimercaprol (British Anti-Lewisite) + calcium disodium edetate (EDTA)
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7
Q

indications for bariatric surgery

A

BMI >40 kg/m2 OR obesity-related comorbidity (osteoarthrits) and BMI >35 kg/m2.

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8
Q

severe hip pain in obese patient management

A
  • conservative measures, then bariatric surgery

- joint replacement relatively contraindicated

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9
Q

ectopic pregnancy diagnosis

A

Positive hCG

Transvaginal ultrasound revealing adnexal mass, empty uterus

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10
Q

ectopic pregnancy management

A

Stable: Methotrexate
Unstable: Surgery

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11
Q

PMR presentation

A

elevated erythrocyte sedimentation rate and pain and stiffness in the neck, shoulders, and pelvic girdle.

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12
Q

PMR treatment

A

low dose prednisone

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13
Q

relatively risk conceptually

A

Risk of a certain outcome (eg, sudden cardiac death [SCD]) in a given group (eg, low-dose hydrochlorothiazide [HCTZ])
divided by

Risk of that same outcome in another group (eg, high-dose HCTZ).

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14
Q

most valid measure of central tendency in distributions

A
  • if normal distribution then mean

- if skewed distribution then median

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15
Q

mortality risk of smokers who quit

A

mortality risk falls below current smokers within 5 years of quitting

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16
Q

what to expect with cough when quitting smoking

A

can be an initial temporary increase in cough during the first few weeks after cessation

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17
Q

mammograms start at

A

40-50, depending on organization

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18
Q

population attributable risk calculation

A

PARP = (Risk in the total population – Risk in the unexposed) / Risk in the total population.

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19
Q

Pulmonary contusion presentation and CXR findings

A

chest pain and may develop respiratory distress and hypoxemia that is delayed up to 24 hours from the time of injury. Chest x-ray characteristically shows an irregular, localized lung opacification.

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20
Q

central venous sinus thrombosis

A
  • rare, potentially life-threatening condition characterized by the formation of a blood clot within the dural sinuses.
  • usually happens in pregnancy
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21
Q

anti-dsDNA test characteristics

A

sensitive for SLE

22
Q

antibody to use to monitor for SLE flare

A

anti-DSDNA

23
Q

how to assess for lupus nephritis

A

anti-DSDNA (immune complexes containing these antibodies are actually seen within the glomeruli of patients with lupus nephritis)

24
Q

management of arthralgias, serositis, and cutaneous symptoms in SLE

A

hydroxychloroquine

25
dupuytren contracture presentation
progressive fibrosis of the palmar fascia. It presents with thickening and nodule formation along the flexor tendons near the distal palmar crease, leading to contractures with decreased extension.
26
diagnostic relevance of ED
strong predictor of coronary artery disease
27
first step in patient with ED and atherosclerotic disease
screen for cardiovascular disease -- ankle-brachial index, cardiac stress testing) prior to initiating specific therapy for sexual dysfunction.
28
other major disease associated with breastcancer in men
klinefelter syndrome
29
central retinal artery occlusion presentation
acute, painless, monocular vision loss. Funduscopy shows diffuse ischemic retinal pallor and a cherry red macula
30
central retinal vein occlusion presentation
painless, acute, or subacute monocular vision loss. Central retinal vein occlusion is usually due to nonembolic causes. Examination can show tortuous and dilated veins, diffuse hemorrhages, disk swelling, and cotton wool spots.
31
central retinal artery occlusion management
urgent ophthalmology consultation and interventions to lower intraocular pressure
32
dyspepsia management
IF age ≥60, weight loss, gross or occult bleeding, anemia, dysphagia, or early satiety → EGD IF NSAID induced → stop NSAID + start PPI IF younger than 55 AND from endemic area treat empirically for Hpylori IF NSAID/COX-2 use → discontinue agent OR add acid suppression
33
deal with varenicline and neuropsych SE's
Despite initial concerns about depression and increased suicidality with varenicline, newer findings have not substantiated this, and the black box warning for these adverse effects was removed in 2016
34
osteoporosis and osteopenia on DEXA scans
Osteoporosis (T-score 20% or hip fracture >3% based on the fracture assessment tool (FRAX) risk calculator
35
bisphosphonate therapy indications
Low bone mass with a history of fragility fracture Osteoporosis (T-score 20% or hip fracture >3% based on the fracture assessment tool (FRAX) risk calculator
36
management of heavy alcohol use in young adults
screening and a brief counseling intervention
37
HPV age range for women
12-26
38
chronic urticaria presentation
well-circumscribed, raised erythematous plaques with central pallor and intense pruritus
39
chronic urticaria treatment
stepwise approach with an initial second-generation antihistamine (eg, loratadine) in addition to avoidance of aggravating factors (if identified). Refractory patients can try other therapies, including an H1 blocker, leukotriene receptor antagonist, H2 blocker, or a brief course of oral steroids.
40
chronic urticaria prognosis
self-limited condition that resolves spontaneously within 2-5 years
41
management of functional abdominal pain
- symptom diary is recommended to characterize the pain and guide treatment. - reassurance
42
other presentation of OSA in elderly
mild cognitive impairment (eg, irritability, poor concentration, decreased memory)
43
paget's treatment
Six months of treatment with oral alendronate and two months of treatment with oral risedronate
44
paget's workup
technetium bone scan
45
isolated gastric varices etiology
splenic vein thrombosis
46
splenic vein thrombosis cause
Thrombosis occurs as the splenic vein runs along the posterior surface of the pancreas and can become damaged or compressed due to pancreatic inflammation (or pancreatic masses/pseudocysts).
47
prognosis of trastuzumab-related cardiotoxicity
reversible after stopping trastuzumab
48
AKs increase risk for what?
squamous cell carcinoma (this is why all AK's need to be removed or destroyed)
49
leser-trelat sign + association
- acute onset of numerous seborrheic keratoses - The Leser-Trélat sign is associated with many internal malignancies, most commonly adenocarcinomas of the gastrointestinal tract.
50
consequence of recall bias
leads to misclassification of exposure.
51
disseminated gonorrhea presentation
- Patients with DGI are typically unaware of the urogenital infection and usually seek clinical attention with either mono- or oligoarthritis or a triad of manifestations including - mono- or oligoarthritis or a triad of symptoms including dermatitis (pustular lesions on the distal extremities), tenosynovitis (swelling and pain with passive extension of multiple tendons), and polyarthralgia

Medicine (71 decks)

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