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Step 3 Studying > Step 3 Miscellaneous > Flashcards

Step 3 Miscellaneous Flashcards

Part 1 UWORLD questions

1
Q

Sputum acid-fast culture vs. Tuberculin skin test

A

culture can distinguish latent from active infection

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2
Q

sensitivity of Sputum acid-fast culture for TB

A

Low (45-80%)

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3
Q

dilated transverse colon with no free air, and mucosal edema

A

findings in acute ischemic colitis

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4
Q

Synovial fluid findings for Reactive Arthritis

A

Elevated WBC, usually negative culture

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5
Q

Physical exam difference between Ehlers-Danlos and Marfan

A

EDS with more skin changes (velvety skin, atrophic scars)

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6
Q

Normal breast development but absent pubic hair

A

Androgen Insensitivity, XY but phenotype female

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7
Q

Lack of menstruation up to this age is normal

A

15

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8
Q

Most common complication of IVC filter

A

recurrent DVT, IVC thrombosis

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9
Q

Priapism treatment

A

if >4 hours, inject a-agonist (phenylephrine), aspirate corpus cavernosum

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10
Q

Risk factor for developing drug-induced Long QT

A

Bradycardia

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11
Q

Treatment for benzo withdrawal

A

more benzos, lol

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12
Q

Indications for steroids in PCP treatments (2)

A

Alveolar-arterial gradient >35, and PaO2 <70 on RA

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13
Q

Management of pyloric stenosis in infants

A

Correct underlying electrolytes before surgery

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14
Q

Risk factors for pyloric stenosis (3)

A

Azithro and Erythromycin, and bottle-feeding rather than breastfeeding, being 1st-born boy

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15
Q

Treatment for PBC

A

Ursodiol

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16
Q

Initial treatment for PAD

A

Statin + antiplatelet therapy

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17
Q

Treatment for improvement of PAD

A

Supervised exercise program

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18
Q

Normal amount of initial weight loss for baby within 2 weeks of life

A

10 percent

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19
Q

Tests for Cushing’s Syndrome (2)

A

1) 24-hr urinary cortisol,

2) dexamethasone suppression

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20
Q

Treatment for Paget’s Disease of Bone

A

Alendronate

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21
Q

Side effect of nitroprusside

A

Cyanide toxicity –> sudden metabolic acidosis and altered mental status

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22
Q

Best test for foot osteomyelitis

A

MRI

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23
Q

Treatment for SIADH

A

water restriction

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24
Q

Bicuspid aortic valve associated with risk for what (3)

A

Aortic dissection, aortic aneurysm, aortic dilation

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25
Q

Management for ongoing pain after air enema for intussussception

A

Abdominal X ray to rule out perforation

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26
Q

When to do PCI in cocaine abuser

A

persistent ST elevation despite nitro/CCB/other therapy

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27
Q

Diagnosis of orthostatic proteinuria

A

Split day/night urinary protein collection

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28
Q

Ovarian hyperstimulation syndrome

A

bilateral enlarged ovaries, ascites, hemodynamic instability

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29
Q

main comorbidity for Dupuytren’s Contracture

A

Diabetes

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30
Q

SPF recommended for outdoor activities

A

> 30

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31
Q

Diagnosis of Hirschprung’s Disease

A

Rectal suction biopsy

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32
Q

Risk factor for UTI’s, especially in children

A

Chronic constipation

33
Q

Dangerous side effect of SGLT2 inhibitors

A

Ketoacidosis (euglycemic)

34
Q

Electrolyte risk for TPN

A

Hypophosphatemia

35
Q

Cardiac exam findings in severe AS (3)

A

1) low-intensity, single S2 during inspiration
2) delayed and diminished carotid pulse
3) loud, and late-peak systolic murmur

36
Q

Fetal hyperinsulinemia cardiac complication

A

transient hypertrophic cardiomyopathy, causing thickened Interventricular septum

37
Q

Which pts with CAD diagnosed by stress test need elective cath?

A

High-risk features such as low exercise capacity, or ST depression with minimal exertion, or ST elevations

38
Q

No symptoms preceding syncope - what type of syncope most likely?

A

Cardiogenic (vasovagal usually has prodrome that can persist after syncope)

39
Q

EKG signs of prior MI

A

inverted Q and T waves in contiguous leads

40
Q

Echo measurements of severe AS

A

aortic jet velocity >4 m/s or transvalvular gradient >40 mmHg

41
Q

When to use injection sclerotherapy for varicose veins

A

failed 3-6 months of conservative therapy (compression stockings, etc.)

42
Q

Goal INR for aortic valve replacement

A

2-3 if no risk factors

43
Q

which valve replacement has INR 2.5-3.5 goal?

A

1) Any mitral valve

2) Aortic valve + high risk factor (Afib, EF<30, prior thrombotic event or hypercoagulable state)

44
Q

Time course for Dressler Syndrome

A

2-3 weeks following MI, presents similar to pericarditis

45
Q

Treatment of viral pericarditis

A

NSAID + colchicine

46
Q

Treatment of peri-infarction pericarditis

A

High dose aspirin (DIFFERENT THAN REGULAR PERICARDITIS)

47
Q

Most effective lifestyle change for HTN

A

Weight reduction

48
Q

Indications for biventricular pacing

A

1) symptomatic heart failure
2) EF <35
3) LBBB with QRS >150

49
Q

Presentation of atrial myxoma

A

arterial embolization to an extremity, mitral valve obstruction, rapidly worsening HF

50
Q

Why discontinue SERM’s (raloxifene, etc.) before surgery?

A

Higher risk for VTE

51
Q

CXR finding in pulm HTN

A

enlargement of main pulmonary arteries

52
Q

Rate/rhythm control in AFib pts with LV systolic dysfunction

A

Amiodarone or Dofetilide

53
Q

Adjust warfarin dose after adding amiodarone?

A

Decrease by 25-50%

54
Q

First line ADHD treatment

A

behavioral

55
Q

hungry bone disease

A

presents 2-4 days after parathyroidectomy, results in hypocalcemia

56
Q

Renal consequence of seizures

A

Rhabdo –> treat with isotonic saline

57
Q

Official way to diagnosis sarcoidosis

A

Excisional lymph node biopsy, or lung biopsy if no lymph nodes available

58
Q

what is Immune Reconstitution Inflammatory Syndrome

A

HIV pts started on HAART get transient worsening of infectious symptoms. supportive care only

59
Q

Post-exposure prophylaxis for HIV

A

within 1-2 hrs ideal, <72 hrs is cutoff

60
Q

Treatment of lead toxicity

A

Mild (5-44) = no medication
Moderate (45-69) = DMSA
Severe (70+) = Dimercaprol + EDTA

61
Q

Surgery decision for RCC

A

if confined to renal capsule = partial nephrectomy

if extends through capsule but NOT Gerota’s fascia = radical nephrectomy

62
Q

Most common cause of pediatric PNA and treatment

A

Strep pneumo - amoxicillin

63
Q

Drug interactions with lithium

A

NSAID, thiazides, ACE. causes tremors/AMS

64
Q

Facial plethora when arms raised

A

confirms enlarged thyroid as causing esophageal symptoms

65
Q

Treatment of severe malnutrition

A

Oral rehydration&raquo_space; IV

66
Q

Management of incidentaloma

A
  • functional studies

- if negative and mass <4cm, can observe

67
Q

Endoscopy findings for pernicious anemia

A

atrophy of fundus (absent rugae), glandular atrophy, but normal antrum

68
Q

Findings in traumatic LP

A

+RBC, high protein, high glucose, but negative xanthochromia

69
Q

Renal consequence of compartment syndrome

A

AKI, secondary to rhabdo

70
Q

Carotid artery dissection vs cluster headache

A

Dissection headache is ongoing
Cluster headache - lasts 15 min-3 hrs, episodic pain
both can have Horner syndrome

71
Q

“frozen shoulder syndrome”, contracture of joint capsule

restriction in BOTH passive and active ROM

A

Adhesive capsulitis

72
Q

Treatment of chronic urticaria

A

2nd gen antihistamine (cetirizine, loratadine)

do NOT use topical steroids

73
Q

Dyspepsia management

A

if <60 and no alarm features, test for H pylori

74
Q

Treatment for bacterial prostatitis

A

6 weeks, FQ or TMP-SMX

75
Q

Abx ok to use in pregnancy for bacteriuria

A

Cephalexin, Fosfomycin, Amox-Clav

not TMP-SMX or nitrufurantoin

76
Q

Best test to confirm eradication of H pylori

A

Urea breath OR stool test, 4 weeks after treatment

do NOT use serology

77
Q

Treatment for bleeding due to uremia

A

Desmopressin

78
Q

Neuro complication of early syphilis

A

Strokes

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