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uworld gaby > Step3 21 > Flashcards

Step3 21 Flashcards

1
Q

First-line medications for migraine prevention

A

Beta-blocker

Valproate

TCAs

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2
Q

EHEC diarrhea presentation

A

Bloody diarrhea and abdominal pain without fever

Exposure to animals and /or undercook meat

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3
Q

Best strategy to prevent lung injury in an intubated patient with ARDS

A

Low tidal volume

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4
Q

Effects of mechanical ventilation on BP

A

Mechanical ventilation increases intrathoracic pressure
Collapses capacitance veins (inf. vena cava)
Decreases venous return
Decreases right heart preload
HYPOTENSION

Give IV fluids

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5
Q

Medications that cause pill esophagitis

Management

A 
Tetracyclines
NSAIDs
K
Fe
Biphosphonates

Stop medication

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6
Q

Risk factors for developing fetal neural tube defects

A

Low folic acid intake
Medications: methotrexate, antiepileptics
Diabetes
Previous pregnancy with NTD

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7
Q

Prevention of neural tube defects

A

FOLIC ACID *at least 1 month before pregnancy

Regular population: 0.4 mg/day

High risk: 4mg/day
Low folic acid intake
Medications: methotrexate, antiepleptics
Diabetes
Previous pregnancy with NTD
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8
Q

Screening for Neural tube defects

A

AFP

Second-trimester ultrasound (to check on elevated AFP or even as first test)

Amniocentesis: if ultrasound fails
Positive AFP and cholinesterase

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9
Q

Rheumatoid arthritis medications safe in pregnancy

A

Hydroxychloroquine

Stop methotrexate 3 months prior to trying pregnancy

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10
Q

Normal vitamin B level

A

200-900

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11
Q

Clinical presentation

HEMOCHROMATOSIS

Skin, GI, Endocrine, Infecto, Cardiac, Mus/Ske

A

Skin: bronze diabetes

GI: Elevated liver enzymes, hepatomegaly (early), cirrhosis (late). Risk for Hepatocellular carcinoma

Endocrine: diabetes, hypogonadism (low libido), hypothyroidism

Mus/Ske: arthrarlgias, chondrocalcinosis

Cardiac: dilated or restrictive cardiomyopathy, conduction abnormalities

Infection: increased risk for listeria, yersinia, Vibrio vulnificus

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12
Q

Classic vignette for a patient with Hemochromatosis

A

Patient with diabetes and decreased libido

Elevated iron, ferritin, and transferrin

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13
Q

Diagnosis of hemochromatosis

A

Iron panel (elevated)

LFTs: elevated (mild)

Definitive diagnosis: gene testing
HFE

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14
Q

Treatment for bulimia

A

Cognitive-behavioral therapy first

Fluoxetine

(Hospitalize if severe or risk for suicide)

Bupropion can cause seizure in a patient with Bulimia

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15
Q

Important complications of nephritic sd

A

Thromboembolic events

Infection caused by typical organisms (not opportunistic)

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16
Q

Fetal complications of maternal hyperglycemia

first trimester

A

Cardiac defects
Neural tube defects
Small colon syndrome
Spontaneous abortion

17
Q

Fetal complications of maternal hyperglycemia

second and third trimester

A

Macrosomia –> shoulder distosia –> injury

Organomegaly

Neonatal hypoglycemia

Polycythemia

Deliver before week 39 if hyperglycemia is under control; if not, deliver <39 weeks

C-section if >4.5kg

18
Q

Myopathies that elevate CK

A

Statin-induced
Inflammatory
Hypothyroid myositis

19
Q

Myopathies that elevate ESR

A

Inflammatory

Polymyalgia rheumatica

20
Q

Glucocorticoid-induced myopathies

A

Normal CK and ESR

Painless proximal muscle weakness (legs>arms)

21
Q

Description of Lichen Planus

A

Planar

Polyglonal

Purple

Pruritic

Papule

22
Q

Fetal complications of parvo infection in pregnancy

A

Hydrops
Anemia
Fetal demise

23
Q

Diagnosis of Parvo infection in a normal person and during pregnancy

A

Normal person:
B19 IgM (acute) or B19 IgG (passed) in immunocompetent
NAAT or B19 DNA in immunocompromised

Fetus:
B19 PCR of amniotic fluid

24
Q

Management of intrauterine parvo infection

A 
Doppler ultrasound (middle cerebral artery for anemia)
Serial ultrasound for hydrops

Look for fluid accumulation in >2 pockets (eg. ascites, pleural effusions)

25
Q

Management of COPD exacerbation (7)

A 
Oxygen: target 88-92
Steroids
Bronchodilators
Antibiotics (if >2 cardinal symptoms)
Oseltamivir if suspicious for Influenza
Non-invasive ventilation
Intubation if above fails

uworld gaby (77 decks)

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