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Uworld Gaby > Step3 10 > Flashcards

Step3 10 Flashcards

1
Q

Lab test for Rheumatoid Arthritis

A

Rheumatoid factor
Cyclic citrulinated peptide antibody
ESR/CRP

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2
Q

Palpable breast mass algorithm

A

<30: Ultrasound +/- mammogram
Cystic: aspirate if patient wants
Complex cyst/solid mass: Core biopsy

> 30: Mamogram +/- ultrasound
Suspicious for malignancy? Core biopsy

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3
Q

Lab workup for lupus

A
  1. ANA: highly sensitive
  2. anti-dsDNA: highly specific
  3. anti-Sm: highly specific

Antihistone may be positive in drug induced lupus and primary SLE
Antiphospholipid (anticardiolipin)
Decreased C3, C4, CH50 during flare-up

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4
Q

Diagnosis criteria for SLE

A 
4 out of 11  DOPAMINE RASH
Discoid rash
Oral Ulcers
Photosensitivity rash
Arthritis
Malar rash
Immunologic criteria (Anti-Sm, anti-dsDNA)
NEurologic or psychiatric symptoms
Renal disease
ANA +
Synovitis
Hematologic disorders (thrombocytopenia, hemolytic anemia, leukopenia)
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5
Q

Disease-modifying anti-rheumatoid drugs

A 
Methotrexate
Sulfasalazine
Hydroxychloroquine
Leuflonide
Azathioprine
anti-TNF (etanercept, infliximab, adalimumab)
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6
Q

Significance of elevated inflammatory markers in rheumatoid arthritis

A

Active disease

Needs disease-modifying drugs

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7
Q

Other clinical manifestations of Rheumatoid arthritis outside de M/E system

A

Pleuritis, pulmonary fibrosis, pericarditis, myocarditis, vasculitis

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8
Q

Diagnostic criteria for rheumatoid arthritis

A

Arthritis >3 joints

Rheumatoid nodules (mostly on ankle)

Labs: Elevated ESR/CRP. Rheumatoid factor, Anti-cyclic citrullinated peptide

Xray: symmetrical joint space narrowing, osteoporosis near the joint

Aspiration: inflammatory fluid

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9
Q

Vitamin deficiency caused by Isoniazid

A

B6

Pyridoxine

Peripheral neuropathy, irritability, convulsion

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10
Q

Methotrexate side effects

A

Folate deficiency

Pneumonitis, pulmonary fibrosis

Myelosuppression “High dose)

Pancreatitis

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11
Q

Awake intubation

A

For people with difficult airway access like anaphylactic shock

Ketamine: provides dissociation, amnesia, analgesia while maintaining airway tone and protective reflexes

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12
Q

Dxx of painless hematochezia in children

A

Meckel diverticulum

Vascular malformation

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13
Q

Clinical presentation of ehrlichiosis

A

Flu-like symptoms: fever, myalgias, chills
Confusion
Rash uncommon (Rocky Mountain spotted fever without the spots)

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14
Q

Labs in ehrlichiosis

A

Leukopenia, thrombocytopenia
Elevated LFTs, LDH
Intracytoplasmic morula
PCR for Ehrlichia

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15
Q

Labs in Rocky Mountain spotted fever

A

Leukopenia, thrombocytopenia
Serum antibodies

Like erlichia

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16
Q

Prenatal first visit labs (11)

A 
Rh(D) and antibody
Hemoglobin/hematocrit, MCV
HIV, HBV, Syphilis
Rubella/Varicella immunity
Urine culture
Urine protein
Pap smear if necessary
Chlamydia if high risk
17
Q

Second-trimester prenatal labs

When to get them

A

24-28 weeks

Hemoglobin/hematocrit, MCV
Rh(D) antibody (if patient is negative)
Glucose tolerance test

18
Q

Diagnosis of gestational thrombocytopenia (6)

A 
Asymptomatic
PLT 70000-150000
2nd-3rd trimester
No hx of thrombocytopenia
No associated hx of thrombocytopenia
Resolves after delivery

NO TREATMENT NECESsARY

19
Q

When is an epidural contraindicated in patients with low platelet count

A

<70000

If rapidly decreasing (Severe preeclampsia)

If evidence of platelet dysfunction (easy bruising, bleeding)

20
Q

Uterine neoplasia associated with tamoxifen use

A

Premenopausal
Endometrial polyps

Postmenopausal
Edometrial hyperplasia/carcinoma
Endometrial sarcoma

21
Q

Net clinical benefit

A

Compare best possible outcome minus worst

22
Q

Important features of randomized clinical trials

A

Randomization
Blinding
Intention to treat

23
Q

Cocaine use

Cardiovascular Physiologic effects (4)

A

Coronary vasoconstriction

Hypertension and tachycardia

Increased platelet activity and thrombus formation

24
Q

Cocaine use

Cardiovascular clinical presentation (3)

A

Myocardial ischemia/infarction

Aortic dissection

Neurologic ischemia/stroke

25
Q

Cocaine use

Treatment for cardiovascular manifestations

A

Benzos and nitroglycerin

CCBs for persistent chest pain

Phentolamine for presistent hypertension

PCI for Myocardial infarction

26
Q

Sjogren sd. antibodies

A

Anti Ro-SSA

Anti La-SSB

27
Q

Clinical Manifestations of Sjogren sd. (5)

A

Dry mouth, dry skin, dry eye
Salivary gland hypertrophy
Vasculitis

28
Q

Complications of Sjogren Sd.

A

B cell non-Hodgkin lymphoma

Dental caries

29
Q

Management of dumping sd

A

Small frequent meals
High protein - low carb diet
Octreotide if everything fails

30
Q

Why not metoclopramide use in dumping sd

A

Metoclopramide increases contraction of the lower esophageal sphincter and increases gastric emptying

31
Q

Name of NRTIs and side effects (6)

A

Tenofovir: renal toxicity

Zidovudine: myopathy, bone marrow suppression

Lamivudine: diarrhea, nausea, headache
Emtricitabine: diarrhea, nausea, headache

Abacavir: hypersensitivity reactions (fever, chills. dyspnea)

Didanosine: pancreatitis

32
Q

Hospice care criteria

A

<6 months prognosis

Patient’s or surrogate’s decision to forgo medical treatment

33
Q

Cardiac and vascular causes of hemoptysis

A

Mitral stenosis, acute pulmonary edema

Pulmonary embolism

Arteriovenous malformation

34
Q

Management of carotid art. stenosis

A

70%-99% and symptomatic… surgery

Uworld CK: asymptomatic and 80-90%… surgery

PLUS: life expectancy >5 years

Aspirin and statins

35
Q

Preterm birth prevention

A

Hx of preterm labor?

NO: TVUS-CL

  • –Cervix
  • —-Normal: Regular prenatal care
  • —-Short: intravaginal progesterone

YES:

    • Progesterone injection + TVUS-CL
  • —- Normal: Serial TVUS until week 24
  • —- Short: cerclage + serial ultrasound until week 24

Uworld Gaby (77 decks)

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