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Uworld Gaby > Step3 1 > Flashcards

Step3 1 Flashcards

1
Q

Clues to renal hypertension (5)

A

Resistant (>3 treatments with no improvement)
Malignant hypertension
Before 25 or after 55
Pulmonary edema with elevated BP
Elevation of creatinine after ACEI initiation

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2
Q

Prefered drugs for Hyperthyroidism

A

Methamizol > Propylthiouracil (less hepatotoxic)

In pregnancy:
Propylthiouracil due to teratogenic effect of methimazole.

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3
Q

Indications for pretreatment for hyperthyroidism before definite treatment

A

All patients before surgery

Older patients and those with high cardiovascular risk (diabetes, PAD, CAD,) before iodine

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4
Q

Thyroid nodule algorithm

A

Physical exam and ultrasound, history, risk factors
Pathologic? FNA
Normal: next step

TSH:
Normal or Elevated: FNA

Low: Iodine uptake

cold: FNA
hot: Treat hyperthyroidism

FNA results: 
No diagnosis: repeat FNA in 6 weeks
Bening: serial follow up
Suspicious for follicular neoplasm: complete thyroidectomy
Malignancy: Total thyroidectomy
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5
Q

Contraindications of exercise in pregnancy

A

Cervical insufficiency (preterm labor in current pregancy, PPRM)

Underlying conditions that can worsen with exercise: anemia, heart, Hypertensive disorders of pregnancy, restrictive lung disease, severe heart disease

Risk of bleeding: placenta previa, persistent 2nd or 3rd trimester bleeding

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6
Q

Adolescent pregnancy: maternal and fetal complications (10)

A 
Maternal: 
Preeclampsia
Hydatidiform mole
Anemia
Surgical vaginal delivery
Postpartum depression

Fatal:
Low birth weight, preterm labor
Gastroschisis, omphalocele
Perinatal death

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7
Q

Breech presentation: risk factor (4)

A

Oligohydramnios
Multiple gestations
Placenta previa
Advanced maternal age

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8
Q

Risk factors for gestational diabetes (5)

A 
Obesity
History of PGD
Family history
Multiple gestation
Maternal age >25
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9
Q

Risk factors for placenta previa (4)

A

Previous placenta previa
Hx of surgery
Multiple gestation
Advanced maternal age

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10
Q

What modifies predictive values on a test?

When can/cannot use predictive values on a test. Why?

A

Prevalence modifies predictive values

OK: cohort studies
NOT OK: case-control studies

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11
Q

Risk factors for iron deficiency in young children:

A

<1yoa
Late introduction of solid food
Exclusively breastfed after 6months
Soy, cow, goat milk

> 2yoa
24oz/d milk
Diet low in iron-rich food

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12
Q

Virus associated with aplastic anemia

A

Parvo 19

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13
Q

Management of pharyngitis

A

Centor criteria (exudates, lymphadenopaties, fever, no cough)

> 3: Test for ASTO
If 4: consider empiric treatment
<3: no test or treatment needed

If positive:
Treat with penicillin, azithromycin, or cephalosporin for people allergic to penicillin but not anaphylactic

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14
Q

Hypoglossal nerve injury during neck surgery

A

Deviation of the tongue towards the side of the lesion

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15
Q

Conditions associated with Down Sd. (6)

A 
Cardiac cushion defect
Alzheimer's disease
Leukemia
Depressives disorders
ADHD
Seizure disorders
Celiac disease
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16
Q

Treatment for Actinic Keratosis

A

5FU or Imiquimod

Liquid nitrogen works for single lesions

17
Q

Indication for biopsy in a patient with actinic keratosis (7)

A 
Unsure about diagnosis
Lesion >1cm
Tender
Indurated
Ulcerated
Fast-growing
Does not respond to treatment
18
Q

Indication for statin therapy

A

CAD or equivalent
>75: moderate intensity
<75: high intensity

LDL>190: high intensity

Diabetic >40:
>20% 10 year cardio risk: high intensity
<20% 10 year cardio risk: moderate intensity

10-year cardiovascular risk >7.5

Atorvastatin H: 40-80 M: 10-20
Rosuvastatin H: 20-40 M: 5-10
Sinvastatin M: 20-40
Pravastatin M: 40-80

19
Q

Risk Factors for Otitis Media in children (4)

A

Second-hand smoking
Absence of breastfeeding (even after 6months)
Daycare attendance
Pacifier use

20
Q

Contraindication of VZV vaccine (6)

A 
Anaphylactic reaction to neomycin
Anaphylactic reaction to gelatin
Immunocompromised:
   Hematologic or solid tumor
   Severe HIV infection
   Prolonged immunosuppressant therapy
   Congenital immunodeficiency
21
Q

Management of seronegative VZV patients with vaccine contraindication that had contact

A

Immunoglobulin administration

after 6months

22
Q

Risk factors for acute opioid intoxication (3)

A

Substance abuse
Hospitalization (especially for surgery)
Renal or liver failure

23
Q

Clinical manifestation of opioid intoxication (6)

A 
Somnolence, altered mental status
Miosis (1mm), pinpoint
Respiratory depression (shallow and bradycardia) 
Respiratory acidosis
Hypothermia 
Decreased bowel sound
24
Q

Management of Opioid overdose

A

Naloxone (repeat if necessary)
Airway management
Exclude other cause of altered mental status like hypoglycemia

25
Q

Opioid withdrawal

A

Anxiety, insomnia, anorexia, diaphoresis, mydriasis,
Flu-like symptoms (fever, rhinorrhea, piloerection,)
Yawning, myalgias

Super awful but usually not life-threatening

26
Q

Drug with life-threatening withdrawal

A

Bs

Benzos
Barbituric
Booze

27
Q

Indications for CT scan for minor head trauma

3 categories, 13 total

A

High-risk patients:
Coagulopathy
High energy injury mechanism

High-risk signs and symptoms:
   Vomiting, headache, seizure
   Signs of basilar fracture (racoon eye, mastoid ecchymosis, CSF leak)
   Retrograde amnesia >30min before the accident
   LOC or AMS
   Glasgow <14
   Suspicion of depressed skull fracture
   Neurological deficit
28
Q

Cancer associated with acromegaly. Screening recommendations

A

Colon cancer

Screen for polyps every 3-5years

29
Q

Sarcoidosis mnemonic

A 
Granulomas Non-caseating
aRthritis
Uveitis
Erythema nodosum/ ACE elevation
Lymphadenopaties
Idiopathic
Negative TB test
Gammaglobulinemia
D (Elevated calcium)
30
Q

Treatment and long term prognosis of sarcoidosis

A

Asymptomatic: no treatment

Symptomatic: corticosteroids for 12-24 months

Usually does not recur

31
Q

Management of shoulder dystocia

A

BE CALM

Breath, don't push
Elevate legs
Call for help
Apply suprapubic pressure
Large vaginal opening (episiotomy)
Maneuvers
32
Q

Common Pathogen in corneal foreign bodies

A

S. aureus

Also:
Strep
Haemophilus
Pseudomonas (especially in contact lenses)

Uworld Gaby (77 decks)

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