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Medicine > step 3 25 > Flashcards

step 3 25 Flashcards

1
Q

When external cephalic version is offered to patients for persistent breech presentation

A

37 or more weeks

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2
Q

alopecia areata prognosis

A

often self-limited, but may be relapsing and remitting or chronic and progressive

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3
Q

alopecia areata presentation

A
  • well-demarcated, non-scarred, round patches of hair loss, which may have “exclamation point” hairs
  • associated nail bed pitting
  • history of other autoimmune conditions
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4
Q

psoriatic arthritis treatment

A

methotrexate

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5
Q

pathophys of BPPV

A

canalithiasis, or the presence of calcium “rocks” within the posterior semicircular canal.

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6
Q

management of PCOS patient trying to conceive

A

1) weight loss

2) then ovulation induction with clomiphene citrate

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7
Q

TRALI prognosis

A

Long-term sequelae (eg, neurocognitive deficits, impaired muscle strength and lung function, psychiatric illness) are common following recovery from ARDS.

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8
Q

treatment of organophosphate poisoning

A

Atropine, which reverses muscarinic receptor effects, and pralidoxime, which reactivates cholinesterase.

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9
Q

management of symptomatic aortic stenosis

A

valve replacement

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10
Q

colchicine contraindication

A

renal failure

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11
Q

management of gout patient with renal failure

A

IF monoarticular – INTRAARTICULAR steroids

IF polyarticular – oral steroids

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12
Q

other acute HIV presentation

A
  • seborrheic dermatitis (eg, dandruff, scaly facial rash)

- mononucleosis like syndrome (fever, lymphadenopathy, weight loss, sore throat, myalgias, diarrhea, and headache)

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13
Q

intention to treat analysis + point of doing it

A
  • analyzes each subject based on randomization group (even if subjects stop the intervention or shift to a different intervention). This tends to provide a conservative but more valid estimate of the intervention effect. ITT is used to help preserve the benefits of randomization in superiority trials.
  • The rationale is that if subjects are doing so poorly as to switch interventions or to drop out of the study, then their outcome should be attributed to that intervention. Therefore, ITT analysis is usually conducted to avoid the effects of crossover (eg, noncompliance to assigned intervention) and attrition (eg, loss to follow-up, drop-out), which may disrupt the benefit of randomization and introduce bias in the estimation of the effect of the intervention.
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14
Q

per-protocol analysis

A

only data from subjects who completed the intervention originally allocated at randomization are analyzed. With as-treated analysis (a subtype of per-protocol analysis), subjects are evaluated based on the intervention they received rather than the intervention to which they were randomized. Therefore, the benefit of the randomization is lost. Usually, per-protocol analysis will overestimate the real effect of the intervention on the outcome.

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15
Q

what is a paradoxical emboli?

A

embolus originating in venous system that becomes arterial through shunt in heart

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16
Q

sjogren’s complications

A

Complications of dry mouth include dental caries, candidiasis (upto 70% patients), and chronic esophagitis.

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17
Q

mild asthma exacerbation management

A
  • albuterol, if symptoms persistent add oral steroids
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18
Q

best single item screening question to determine unhealthy drinking behavior

A

Asking how many times in the past year a patient has had 5 (4 for women) or more drinks in a day

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19
Q

first step after IDA diagnosis

A

FOBT x 3

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20
Q

blepharospasm presentation + management

A
  • periodic involuntary eye closure

- botox (generally safe for dystonic reactions)

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21
Q

management of patient in severe pain with opioid use disorder

A

Discuss risk of treatment, including OD’ing, and get informed consent

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22
Q

Protracted active phase of labor meaning + management

A
  • no change in cervical dilation

- oxytocin and amniotomy

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23
Q

femoral nerve injury presentation

A

inability to extend the knee, loss of knee jerk reflex, and sensory loss over the anterior and medial aspects of the thigh, medial aspect of shin, and arch of the foot.

24
Q

construction apraxia meaning

A

inability to copy line drawings

25
Q

localization of difficulty drawing

A

nondominant parietal lobe

26
Q

Gerstmann syndrome presentation + location

A
  • damage to the dominant parietal lobe
  • difficulty in performing simple arithmetic tasks (acalculia), inability to name individual fingers (finger agnosia), impaired writing (agraphia) and right/left confusion (difficulty in identifying or distinguishing the right or left side of the body).
27
Q

Constipation treatment in kids

A

first with dietary modification, and secondarily with osmotic laxatives.

28
Q

thyroglossal duct cyst managment

A

surgery (high risk for infection)

29
Q

thyroglossal duct cyst vs dermoid cyst

A

thyroglossal duct cyst moves up with protrusion of the tongue

30
Q

management of bleeding dysfunction due to uremic platelet dysfunction

A

desmopressin

31
Q

lab findings in bleeding dysfunction due to uremic platelet dysfunction

A

prolonged bleeding time

32
Q

common triggers of allergic contact dermatitis

A
  • topical antibiotic use
  • Other common causative allergens include topical antibiotics, fragrances, and a variety of chemicals used in rubber, plastic, and leather processing
33
Q

seborrheic dermatitis associations

A

HIV

Parkinsons

34
Q

seborrheic dermatitis description

A

pruritic, erythematous plaques with greasy scales and typically affects the scalp, central face, and ears

35
Q

sickle cell trait on electrophoresis

A

HbA and HbS in a 60:40 ratio

36
Q

sickle cell trait presentation

A

asymptomatic, not anemic

37
Q

Type II error

A

The failure to detect a difference between groups when it exists is referred to as type II error. The probability of type II errors (β) is related to the power of a study (calculated as 1 − β).

38
Q

Type I error

A

(false positives) occur when a study incorrectly rejects a null hypothesis that is true. The rate of type I errors is denoted by α and usually reflects the significance level of a test. A higher α increases the likelihood of a type I error and decreases the likelihood of a type II error. The main effect of a smaller sample size is to increase the probability of a type II error rather than a type I error.

39
Q

monitoring required when patients are on TPN

A
  • phosphate (high risk for hypophosphatemia) (Dextrose stimulates insulin secretion, and insulin drives serum phosphate into cells to be used for oxidative phosphorylation. The shift of serum phosphate into the intracellular space and the subsequent usage of phosphate to generate adenosine triphosphate can rapidly deplete serum phosphate levels and cause hypophosphatemia.)
40
Q

why you give sodium bicarb with TCA overdose

A

prevent arrhythmia (increased pH (goal 7.50-7.55) modifies TCAs to their neutral (non-ionized) form, making them less available to bind to the rapid sodium channels. The elevated extracellular sodium increases the electrochemical gradient across cardiac cells and also affects the ability of TCAs to bind to the fast sodium channels)

41
Q

management of any sharp object in the oropharynx

A

flexible endoscopy

42
Q

wall motion abnormality suggests

A

ischemia

43
Q

Pseudohypoparathyroidism means + lab findings

A
  • end-organ resistance to parathyroid hormone (PTH)

- chronic hypocalcemia, hyperphosphatemia, and elevated PTH

44
Q

difference between hypoparathyroidism and pseudohypoparathyroidism

A

Elevated PTH distinguishes pseudohypoparathyroidism from true hypoparathyroidism, which also causes hypocalcemia and hyperphosphatemia but is due to impaired PTH production

45
Q

first step in language delay of any child

A

audiology

46
Q

urinary schisto diagnosis

A

urine sediment microscopy

47
Q

urinary schisto clinical features

A

person from developing world + dysuria, urinary frequency, terminal hematuria, and peripheral eosinophilia

48
Q

initial labs for suspected lead poisoning

A

include CBC, serum iron and ferritin levels, and reticulocyte count. These tests will help detect the presence of anemia and iron deficiency.

49
Q

lead poisoning presentation

A

anorexia, decreased activity, irritability, vague abdominal pain and insomnia;

50
Q

Anomalous aortic origin of a coronary artery (AAOCA) presentation + how to differentiate from HOCM

A
  • common cause of sudden death in young athletes
  • premonitory symptoms of exertional angina, lightheadedness, or syncope
  • normal echo, as opposed to HOCM
51
Q

exam findings consistent with severe AS

A
  • low-intensity, single second heart sound during inspiration.
  • delayed and diminished carotid pulse “parvus et tardus”
  • loud and late-peaking systolic murmur
52
Q

iodine uptake in subacute thyroiditis

A

DECREASED. It is due to acute inflammation of the thyroid and release of stored thyroid hormone, leading to suppressed TSH and decreased radioactive iodine uptake

53
Q

First step with suspected lichen planus

A

skin biopsy

54
Q

association between confidence interval and statistical significance

A
  • IF CI includes null value (1), it is not considered statistically significant
55
Q

anticonvulsant women cannot be on while pregnant

A

valproate

56
Q

management of lithium during pregnancy

A

weigh risks, benefits (very low teratogenic risk) and for some people it’s more important to be on lithium than small teratogenic risk

Medicine (71 decks)

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