USMLE 2 Flashcards
Patient with low-grade fever, RUQ tenderness, nausea, vomiting s/p cholecystectomy, mild abdominal distension and non-dilated biliary ducts on imaging likely has what?
Biliary Leak
Signs of mineralcorticoid deficiency
Hypotension, Hyperkalemia, Hyponatremia, increased renin activity
tx= fludrocortisone
Work up of secondary amenorrhea
(progesterone challenge)
What does a wide confidence interval indicate?
A wider range of effects
Sxs early lyme disease
Presentation of testicular cancer
unilateral painless ovoid testicular nodule/swelling–> can present after groin injury or during sexual activity
-
How does candida present
Psuedohyphae and budding yeast (blastoconidia)
CMV- most common congenital infection worldwide
- most asymptomatic, but when symptomatic can have:
- Jaundice, petechiae, hepatosplenomegaly
- microcephaly
- periventricular calcifications on imaging
- sensorineural hearing loss
Treatment of acute gout
NSAIDs (naproxen, indomethacin) unless contraindicated- then colchicine
- Contraindication= heart failure, patietnts on anticoagulants
- don’t use colchicine in elderly or renal dysfunction
Urge incontinence vs. Overflow incontinence
Urge- caused by overactive bladder (involuntary detrusor contractions)
- tx= kegel exercises, bladder training, oxybutynin
Overflow- bladder outlet obstruction or neurogenic bladder (urine leakage)
-post void residual volume >150 ml
Signs of Acute liver failure
Elevated aminotransferases, hepatic encephalopathy, prolonged prothrombin time with INR>1.5
Is folate a vitamin?
Yes- vitamin B9
Presentation of hypertensive hemorrhage in basal ganglia
Uncal herniation–> mass effect compresses 3rd cranial nerve= ipsilateral dilated nonreactive pupil
- contralateral extensor posturing, coma, respiratory compromise
Tx postpartum endometritis
Clindamycin + gentamicin
Fever, malaise, headache, cough, scattered wheezes, subclinical hemolytic anemai (cold agglutinins), diffuse reticulonodular opacities (interstitial infiltrate)
Mycoplasma pneumoniae
- treat with macrolide (azithromycin)
- or respiratory fluoroquinolone
How to reduce risk of postoperative pneumonia
Preoperative PT (aerobic exercise, inspiratory muscle training)
Narcolepsy
Shortened REM latency
- shortened sleep latency
- increased REM density
45 year old man with 1 day history nausea, vomiting, epigastric pain with relief when leaning forward
Acute pancreatitis
When to deliver for preeclampsis with and without severe features
With severe features: at greater than or equal to 34 weeks
Without: at term (37 weeks)
Severe complicatino (eclampsia, fetal demise): immediate delivery
Signs of left ventricular aneurysm causing thrombus in leg post MI
- persistent ST segment elevation after recent MI with deep Q waves in the same leads
- progressive LV enlargement leads to angina, heart failure, mitral regurg. (holosystolic murmur)
Vitamin deficiencies
Presentation of anal cancer
HIV, receptive anal cancer, HPV
- chronic pain due to anal ulcer and painless lymphadenopathy
- rectal bleeding
Pyelonephitis in pregnancy
Presents like pyelo but can be complicated by acute respiratory distress syndrome and preterm labor
Livedo reticularis is seen in what conditions?
vasculitic (polyarteritis nodosa, SLE) or vasoocclusive (cholesterol embolization, antiphospholipid antibody syndrome, cryoglobulinemia)
– in APL- prolongation of PTT can be seen due to lupus anticoagulant interaction
Deposition of calcium in the basal ganglia accompanied by hypocalcemia and hyperphosphatemia is indicative of what condition?
Hypoparathyroidism
- can result from injury to parathyroids during thyroid surgery
Chemo-induced cardiotoxicity
Anthracyclines (doxorubicin)- fibrosis
Trastuzumab- myocardial stunning
chalazion vs. hordeolum
Chalazion= non-painful blocking of meimobian gland
Hordeoum= bacterial infection of eyelash follicle (typically staph aureus)
Group 2 pulmonray hypertension (due to left heart disease) is due to what?
Pulmonary VENOUS congestion
Primary PAH is due to pulmonary arterial HTN
Incisional hematoma presentation
increasing pain and dark red sanguinous discharge from incision site with intact fascia
Tx of choice for DVT in pregnant patient without contraindications to anticoagulants
Heparin/LMWH
IVC if risk for bleeding (recent surgery/hemorrhage)
DRESS syndrome
Drug reaction - allopurinol and antiepileptics
- morbiliform eruption starting on face/trunk and spreading
- Eosinophilia
- systemic sxs: fever, malaise, lymphadenopathy
Presentation fo choriocarcinoma
Can be after ANY type of pregnancy i.e. spontaneous abortion
- abnormal vaginal bleeding, pelvic pressure, enlarged uterus
- commonly metastatic to lungs and vagina
- vaginal metastasis presents as friable, red lesion
Tx of legionella
Respiratory fluoroquinolone or newer macrolide
Clindamycin= skin/dental infections
Rules for taking isotretinoin
2 negative pregnancy tests and commitment to using 2 forms of contraception
How would chronic diarrhea lead to uric acid stones?
Chronic diarrhea can cause urine to be acidic/hyper-concentrated due to loss of bicarbonate/dehydration–> uric acid stone formation
Malignant cavitary lesion of lung with air fluid level
Squamous cell carcinoma
(adenocarcinoma= nodule, small cell= central mass
Hernias - relation to inferior epigastric vessels
Indirect= lateral (patent processus vaginalis)
Direct= medial (weakness of fascia)
