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Uworld Gaby > Step3 35 > Flashcards

Step3 35 Flashcards

1
Q

Extraintestinal manifestations of celiac disease

A

Skin: dermatitis herpetiform
Oral: enamel hypotropia, atrophic glossitis
M/E: rickets/osteomalacia due to Vit D deficiency
Neuro: peripheral neuropathy, depression, dementia: B12 def.
Hem: iron deficiency anemia

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2
Q

Risk factors for celiac disease

A

First-degree relative

Down sd.

Other autoimmune diseases

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3
Q

Features of Central hypothyroidism

A

Hypothyroid symptoms with low free T4 and low or inappropriately normal TSH

Other pituitary hormones are low (LH, FSH,)

Mass effect

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4
Q

Diagnosis and treatment of central hypothyroidism

A

DIAGNOSIS
Low free T4
Low or inappropriately normal TSH
MRI of pituitary

TREATMENT
Levothyroxine until free T4 is normal. TSH is not used for treatment adjustment

Perform an ACTH stimulation test before treatment. Thyroid hormone can precipitate an adrenal crisis by increasing cortisol metabolism

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5
Q

Risk factors for a rapid decline in CKD

A

Most significant:
Hypertension
Hyperglycemia
Proteinuria

Others:
Hyperuricemia
Metabolic acidosis
Anemia
Hyperphosphatemia
Hyperlipidemia
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6
Q

Expected response in Creatinine after ACEI initiation

A

Creatinine and K can raise

An increase in <30% is ok and treatment can stay as is

More severe increases warrant treatment discontinuation

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7
Q

Renal tubular acidosis type 1

Pathogenesis
Clinical presentation
Laboratory findings
Treatment

(Compare to type 2)

A

Pathogenesis:
Impaired excretion of Hydrogen (vs. impaired absorption of HCO3)

Clinical presentation:
Nephrolithiasis, nephrocalcinosis, bone demineralization

Laboratory findings:
Non-anion gap metabolic acidosis
Urine pH >5.5
Hypokalemia (K wasting), hypochloremia
Hypercalciuria

Treatment:
Bicarbonate
+/- Potassium supplementation

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8
Q

pH depending on the kind of stone and shape of the stone

A

Calcium: square
Calcium phosphate: pH is High
Calcium oxalate: pH is low

Struvite: paralelepidedo
pH is High

Uric acid: diamond
pH is Low

Cysteine: hexagon
pH is Low

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9
Q

Complications of Juvenile osteoarthritis

A

Joint destruction, deformities

Osteoporosis

+/- Uveitis

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10
Q

Painful vs. Painless genital lesions

A

Painful:
Herpes
Chancroid (H. ducreyi)

Painless:
Syphilis (Treponema pallidum)
Granuloma inguinale (Klepsiella granulomatis)
Lymphogranuloma venereum (Chlamydia trachomatis)

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11
Q

Clinical presentation of the Painful genital lesions and treatment

A 
Chancroid:
Large, deep, and well-demarcated ulcer
Gray-yellow exudate
Severe lymphadenopathy that may suppurate
Azithromycin or ceftriaxone
Herpes:
Small vesicles
Systemic symptoms
Painful lymphadenopathies
Acyclovir/valacyclovir
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12
Q

Clinical presentation of the Painless genital lesions

A

Syphilis:
Usually single ulcer, indurated border
Red, raised, non-purulent
Penicillin G

Lymphogranuloma venereum: (Chlamydia trachomatis)
Small ulcer, usually missed
Painful and fluctuant adenitis (bubones)
Azithromycin or ceftriaxone

Granuloma inguinale: (Klebsiella granulomatis)
Small, single, or multiple
Granulomatous ulcers
Doxy or azythro

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13
Q

Behcet syndrome

A

It’s a vasculitis that causes multiple and recurrent ulcers in the genitals, mouth, and other tisues similar to aphthous soar.

It may be in Dxx of genital ulcers

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14
Q

When do you vaccinate preterm babies

A

According to their chronological age, no need to correct

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15
Q

Treatment for SSRI-induced sexual dysfunction

A

Bupropion

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16
Q

General approach to erectile dysfunction

A
  1. Treat reversible cause
  2. Lyfe-style modifications

If erection… psychological
Cardiovascular
Endocrine: TSH,
Hypogonadism: slow onset, other signs
Neuropathic: diabetes, other neurological disorder
Medications: bp, depression, antiandrogenic

17
Q

Case-control vs. a cohort study

A

Case-control:
Selects the outcome (eg. patients with cancer) and compares the risk of exposure in people with cancer vs. people without it

Cohort:
Classifies people as exposed vs. unexposed and then looks for the outcome

18
Q

When do you start screening for ADPCKD?

A

After 18 years old

19
Q

Renal cyst: Simple vs. Malignant

A 
Simple:
Smooth, thin wall
Uniloculated
No septation
Homogenous filling
Usually asymptomatic
Absence of contrast enhancement on CT or MRI
No follow up needed
20
Q

ADPCKD diagnosis

A

Ultrasound after 18

15-40: >3 cyst uni or bilat
40-50: >2 cysts on each
>60: >4 cysts on each

If no family history:
>10 at any age

21
Q

Internal vs. external validity. How to increase or decrease it?

A

Internal validity: describes causality (a change in the independent variable causes a change in the dependent variable)
More tightly controlled = more validity
Threat to validity: confounding, measurement, maturation, regression, etc

External validity: is generalizability.
The tighter the study, the less generalizability
Threat to validity: artificial environment. measurement effects, the sample is not representative

22
Q

Explanatory trials vs. Pragmatic trials

A

Explanatory:
Usually, phases II and III of clinical trials
Small samples, tightly controlled,

Pragmatic: for external validity
Phase IV
Large samples, less controlled, more diverse enviroment

23
Q

Treatment for Anorexia vs. Bulimia

A

Both:
CBT
Nutritional support

Anorexia: Olanzapine if above fails
Bulimia: SSRI in combination with above

24
Q

Approach to menopause with vasomotor symptoms

A
  1. Mild or Moderate to severe?
    Mild: behavioral therapy
    Mod/Sev: step 2
  2. Strogen contraindication?
    Yes: SSRI
    No: step 3
  3. Does the patient have an intact uterus?
    No: Strogen only
    Yes; Strogen + progesterone
25
Q

What do you do next in a patient with molluscum contagiosum

A

Child: just treat (curetting, freezing, cantharidin)

Genital lesions: other STD screening

Severe infection: HIV screening

26
Q

Pyogenic granuloma

A

Small benign capillary hemangiomas (red papuples)

27
Q

Gingival bleeding in pregnancy

A

Normal

Due to gums hypertrophy and inflamation

28
Q

Endocarditis mnemonic

A

FROM JANE

Fever
Roth spots
Oslher node
Mumur

Janeway lesion
Anemia
Nail
Embolic phenomena

29
Q

Empiric treatment for infective endocarditis

A

Vanco genta

Uworld Gaby (77 decks)

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