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Uworld Gaby > Step3 8 > Flashcards

Step3 8 Flashcards

1
Q

Orthostatic proteinuria

Clinical presentation
Pathophysiology
Diagnosis
Treatment

A

Incidental finding of protein in urine.

Exaggerated response to the upright position. Increased glomerular capillary resistance

Protein/Creatinine ration supine vs. standing or
Split 24hr urine (day vs. night)

No treatment needed. Reassurance

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2
Q

Alopecia Areata

Clinical presentation
Management
Prognosis

A

Smooth and discrete areas of hair loss. No scaling or inflammation

High rate of recurrence

Intralesional or topical steroids

Patient education: Hair growths back to normal even without treatment. Can recur. Hair growth seen 4-6 weeks after treatment

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3
Q

Anticholinergic intoxication

Medication that causes (6)
Presentation (7)

A

Antihistamines, antipsychotics, atropine, jimson weed, scopolamine, TCAs

Hot as a hare, red as a beet, dry as a bone, mad a hatter, blind as a bat

Fever, flushing, dry mucus membranes, psychosis, mydriasis; also tachycardia and urinary retention

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4
Q

Cholinergic intoxication

Medication that causes (4)
Presentation (7)

A

Muscarine containing mushrooms, pilocarpine, pyridostigmine, organophosphates

DUMBELS
Diarrhea
Urination
Miosis
Bronchorrhea, Brocospasm, Bradycardia
Emesis
Lacrimation
Salivation
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5
Q

Indication for thrombolysis in PE

A

Hypotension (systolic <90)

AND

Low bleeding risk

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6
Q

Indication for thrombectomy in PE

A

Thrombus potentially causing deadly shock within hours

or

Failed thrombolysis with persistent hypotension

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7
Q

Marfan vs. Homocystinuria

A

Homocystinuria presents with venous thromboembolism and intellectual disabilities

Lens dislocation:
Down: Homocystinuria
Up: Marfan

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8
Q

Eye symptoms in Marfan vs. Homocystinuria

A

Lens dislocation:
Down: Homocystinuria
Up: Marfan

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9
Q

Allergic Bronchopulmonary Aspergillosis

History

A

Asthma

Cystic fibrosis

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10
Q

Allergic Bronchopulmonary Aspergillosis

Imaging

A

Recurrent fleeting infiltrates (transient infiltrates in different part of the lungs

Bronchiectasis

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11
Q

Allergic Bronchopulmonary Aspergillosis

Diagnosis

A

Positve Aspergillus skin test or IgE

Elevated serum IgE

Eosinophilia

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12
Q

Allergic Bronchopulmonary Aspergillosis

Treatment

A

Steroids

Itraconazol or variconazol

Others:
Omalizumab (monoclonal antibody against IgE)

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13
Q

Amiodarone effects on thyroid hormone (labs) and management (4)

A

1) Decreased conversion T4-T3
Normal/High TSH / Elevated T4 / Low T3
No treatment needed

2) Inhibition of thyroid hormone synthesis
High TSH / Low T4
Treat with Levothyroxine

3) Amiodarone induced thyrotoxicosis Type 1 (iodine-induced increased in levothyroxine)
Low TSH / High T4/T3 / Decreased iodine uptake / Increased vascularity on ultrasound
Treat with antithyroid medication

4) Amiodarone induced thyrotoxicosis Type 2 (Destructive thyroiditis)
Low TSH / High T3/T4 / Undetected iodine uptake Decreased vascularity on ultrasound
Treat with glucocorticoids

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14
Q

Pediatric septic arthritis pathogens and treatment

A

< 3 months:
S. aureus, GBS, anaerobes
vancomycin + cefotaxime

> 3 months
S. aureus, GAS
vancomycin

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15
Q

Clinical diagnosis of Pediatric septic arthritis (4)

A 
Criteria for diagnosis: (>3 is indication for aspiration)
Fever
No weight bearing
Leukocytosis
CRP >2 or ESR >40

Sings and symptoms
Fever, limited range of motion, refuse to bear weight,

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16
Q

Cervical cancer screening

IMMUNOCOMPROMISED

A

At onset of sexual activity

Pap + HPV co testing

17
Q

Cervical cancer screening according to age

A

<21 no testing

> 21-29: Cytology every 3 years

> 30-65:
Cytology every 3 years
Pap + co-test every 5 years
Primary HPV test every 5 years

> 65:
No screening if negative on previous screens and low risk

Hysterectomy:
No screening if negative on previous screens and low risk

18
Q

Acute Epididymitis

Etiology
Presentation
Work up
Treatment

A

<35: chlamydia, gonorrhea
>35: bladder outlet obstruction (coliform bacteria)

Pain (posterior), swelling, erythema
Pain improves with elevation
Dysuria/polyuria if coliform bacteria

Urinalysis and culture
NAAT for chlamydia and gonorrhea

Doxy +/- ceftriaxone for gonorrhea
Levo if no high risk for gonorrhea

19
Q

Preeclampsia prevention

High risk (6)
Moderate (3)
A

Aspirin in high risk patients after week 12

High risk
Chronic Kidney disease
Chronic Hypertension
Preeclampsia in previous pregnancy
Diabetes
Autoimmune disease
Multiple gestation

Moderate:
Obesity
Advanced maternal age
Nulliparuty

20
Q

Unilateral benign breast disorder

A

Fibroadenoma rubery
Usually upper quadrant
Cyclic

Breast cyst
+/- tenderness

They are both well-circumscribed, firm, mobile

21
Q

What would get injured if you try to grab a knife?

A

Tendons

Arteries and veins run on the side of the hand

22
Q

Pathophysiology of pernicious anemia (4)

A

Antibodies against parietal cells and intrinsic factor

AMAG: Autoimmune metaplastic atrophic gastritis
Atrophy of parietal cells (mainly in body and fundus see as absent rugae)
Intestinal metaplasia
Inflammation

23
Q

Diagnosis of pernicious anemia

A

Low B12

Antibodies against intrinsic factor (first line)
Antibodies against parietal cells (not too specific)

Shilling test: more complicated, second line if Ab IF is negative

24
Q

A. fib mnemonic

A

PIRATES

Pulmonary disease
Ischemia
Rheumatic heart disease
Anemia / Atrial myxoma
Thyrotoxicosis
Ethanol
Sepsis
25
Q

Management of Afib

A

Stable
Rate control: B-blocker, CCB (diltiazem, verapamil) digoxin
Anticoagulation with warfarin or NOVAC (apixaban, dabigatran, rivaroxaban, edoxaban)

26
Q

Intussusception age of presentation

A

<2 years

27
Q

Risk factors for stress hyperglycemia (5)

A 
Fever >39
ICU
Severe illness
Sepsis
CNS infection
28
Q

Urinary incontinence in the elderly (4)

GENITOURINARY

A

Detrusor malfunction (hyperactivity or decreased tone)
Obstruction (prostate/cancer)
Weakness of urethra or pelvic floor
Fistula

29
Q

Urinary incontinence in the elderly (4)

NEUROLOGIC

A

Multiple sclerosis
Dementia
Spinal cord injury
Disc herniation

30
Q

Urinary incontinence in the elderly

POTENTIALLY REVERSIBLE (8)

A 
Delirium
Infection (UTI)
Atrophic (urethritis/vaginal)
Pharmacological (a-blockers)
Psychologic (depression)
Excessive urine output (Diabetes, CHF)
Restricted mobility
Stool impaction
31
Q

McCune-Albright

Pathophysiology
Clinical presentation

A

Continued activation of G proteins

Elevated TSH: thyrotoxicosis
Elevated ACTH: Cushing sd.
Low LH/FSH

Precousios puberty
Cafe Au lait spots
Fibrous dysplasia of the bone
Breast and axillary and pubic hair development

32
Q

Precocious puberty algorithm

A

Advanced bone age

Basal LH

If High: central

If LOW
GnRH Stimulation test

LH high: Central… Brain MRI
LH low: peripheral… Abdominal ultrasound

Uworld Gaby (77 decks)

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