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Uworld Gaby > Step3 6 > Flashcards

Step3 6 Flashcards

1
Q

Location of lesion in a patient with constructional and dressing apraxia

A

Non dominant parietal lobe

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2
Q

Area of supply of the left anterior descending

A

Apex

Anterior 2/3 of the septum

Anterior wall of the left ventricle

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3
Q

Laboratory test for invasive fungal infections

A

Beta D-glucan

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4
Q

Etiology of Otitis media + conjunctivitis

A

Usually non-typeable H. influenzae

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5
Q

Common cause of otitis media

A

S. pneumonia

Nontypeable H. influenzae

Moraxella

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6
Q

Management of otitis media

A

Amoxicillin

Amoxiclav

Penicillin allergic:
azytrho or clinda

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7
Q

Treatment for bronchiolitis

A

Supportive care

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8
Q

Prevention of RSV

A

Palivizumab for selected infants
<29 weeks
Chronic lung disease of prematurity
Hemodynamically significant heart disease

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9
Q

Complications of Bronchiolitis

A

Apnea
Respiratory failure

Older infants:
Recurrent wheezing

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10
Q

Antipseudomonal antibiotics

A 
Cefepime / Ceftazidime
Amikacin / Tobramycin (aminoglicoside)
Carbapenem
Aztreonam
Colistin
Certain fluoroquinolones (eg. cipro)
Piperazilin-tazobactoan
Tricarcilin-clav.
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11
Q

Other symptoms (4) and laboratory results (7) that might be present in Kawasaki disease

A

Arthritis, scrotal swelling, pericarditis, and gallbladder inflammation

Labs:
Steril pyuria on clean catch (catheterization bypasses the urethral origin of the pyuria)
Thrombocytosis, Elevated WBC, decreased hemoglobin
Elevated LFTs
Hypoalbuminemia
Hyponatremia
(PCR/ESR)

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12
Q

Treatment of Kawasaki disease

A

High dose aspirin during the acute phase

IV immunoglobulin

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13
Q

Precautions to take after immunoglobulin therapy

A

Differ live vaccines for at 11 months

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14
Q

Lifestyle modification effect in hypertension

DASH diet

A

Drops 12 mmHg

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15
Q

Lifestyle modification effect in hypertension

Weight loss

A

6mmHg per 10 kg of weight loss

Target: BMI <25

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16
Q

Lifestyle modification effect in hypertension

Low Sodium Diet

A

< 1.5 - 2.3 g/day

Response vary

5-8 mmHg

17
Q

Lifestyle modification effect in hypertension

Alcohol intake

A

<2 drink/day for men and <1 for women

5 mmHg

18
Q

Lifestyle modification effect in hypertension

Exercise

A

> 30min a day >5 days a week

7mmHg

19
Q

Lobular carcinoma in situ

Diagnosis
Management
Surgery

A

Usually incidental

Needle biopsy ====> exicional biopsy

No radiation or chemo recommended because this is not malignant

May add tamoxifen or raloxifen

Patients may request mastectomy

20
Q

Management of Ductal Carcinoma In situ

A

Lumpectomy +/- radiation

Endocrine therapy for 5 years in ER/PR +

21
Q

Management of invasive breast cancer

A

With NEGATIVE lymph nodes:
Lumpectomy, breast-conserving surgery, and radiation may be considered depending on tumor size
Chemo to shrink tumor before surgery, adjuvant chemo, hormone therapy

With POSITIVE lymph nodes:
Breast-conserving surgery or modified radical mastectomy, axillary disection, adjuvant chemo, and endocrine therapy

22
Q

Paget disease of the bone

Clinical presentation
Management

A

Bone pain
Thicken cortex of the bone and sclerotic lesion on Xray
Hypercalciuria
Heart failure

Studies:
Bone scan: increased uptake

If symptomatic (pain or neuro symptoms) or affects weight bearing bones (eg. femur), treat with bisphosphonate

23
Q

Pathophysiology of hypercalcemia in Paget

A

Due to immobilization because of many painful lesions but not because of disease itself

24
Q

Hyperthyroidism in elderly patients

A

Apathetic hyperthyroidism:
Lethargy, apathy, decreased appetite. weight loss

Can present with A. fib without tachy due to medications or conductivity issues related to age

25
Q

Cardiovascular effects of hyperthyroidism

A

Hypertension
Tachycardia
Widened pulse pressure (increased cardiac output with decreased systemic vascular resistance)
A. fib

26
Q

Prognosis in COPD

A

FEV1 and age

After adjusting for age, FEV1 is the most important predictive factor for prognosis

27
Q

Diagnostic features of Dementia with Lewi Bodies

Core (4)

A

Fluctuating cognition

REM sleep disorders

Visual hallucinations

Parkinsonism

28
Q

Diagnostic features of Dementia with Lewi Bodies

Suggestive (2)

A

Severe antipsychotic sensitivity

SPECT or PET low dopamine transporter uptake in the basal ganglia

29
Q

Diagnostic features of Dementia with Lewi Bodies

Supportive (5)

A 
Repeated falls
Syncope or near syncope
Delusions
Autonomic dysfunction
Depression or anxiety
30
Q

Pharmachologic treatment for dementia with lewi bodies

A

Cholinestares inhibitors for cognitive impairment. Donepezil

Levodopa/carvidopa for parkinsonism

Melatonin for REM sleep behavior disorder

Antipsychotics for hallucinations (use low potency, second-generation eg. quetiapine, cloanzapine, )

31
Q

Predictors of 30 days mortalitye in PE

CLINICAL (8)

A 
Hypotension (Sistolic bp <90)
Tachycardia (>110)
Hypoxemia (O2 sat <90%)
Tachypnea (>30)
Hypothermia (36)
Age >80
Altered mental status
Cancer
32
Q

Predictors of 30 days mortality in PE

IMAGING

A

Right ventricular dysfuntion on eco or CT

33
Q

Predictors of 30 days mortality in PE

LABORATORY

A

Elevation of troponin or BNP

Uworld Gaby (77 decks)

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