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Uworld Gaby > UW 16 > Flashcards

UW 16 Flashcards

1
Q

Glazman thrombastenia

A

Platelet aggregation deficit

Mucocutaneous bleeding

Normal platelet count. No clumping on peripheral blood smear

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2
Q

Cholangio carcinoma markers vs. Hepatocellular

A

Cholangio carcinoma: CA 19-9 and CAE

Hepatocellular: AFP

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3
Q

Systemic sclerosis antibodies

A

Limited cutanueos: Anticentromere

Difuse: anti polymerase 3 and ScL-70 (topoisomerase 1)

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4
Q

Delivery management of preeclampsia

A

Delivery at 37 weeks.

Severe features after 34 weeks: Delivery
Induction of labor preferred over C-section

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5
Q

Preeclampsia with severe features

A

BP: >160/110

Thrombocytopenia
> Creatinine
> LFTs
Headache or neurological symptoms
Pulmonary edema
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6
Q

Fetal fibronectin test

A

Done in patients <33+6 weeks gestation to predict preterm labor.

Positive test is good predictor of preterm labor within a week and an indication for IM corticosteroid injection

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7
Q

Pathology of Lewi body dementia

A

Deposition of alpha-synuclein bodies in the substantia nigra and brain stem

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8
Q

Examples of primitive relfexes and what do they suggest in an adult

A

Sucking, roting, glabelar

Frontotemporal dementia

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9
Q

Startle myoclonus definition and asssociation

A

Myoclonus/jerk with loud auditory stimulus

Prion disease (Creutzfeld-Jacob)

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10
Q

Dementia with Lewi bodies

A

Visual Hallucinations
Fluctuating cognition (may be describes as good moments and bad moments)
Parkinsonism
REM sleep behavior disorder

Other symptoms that might suggest:
Frequent falling
Sensitivity to antipsychotics

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11
Q

Dementia with Lewi bodies

A

Visual Hallucinations
Fluctuating cognition (may be describes as good moments and bad moments)
Parkinsonism
REM sleep behavior disorder

Other symptoms that might suggest:
Frequent falling
Sentivity to antipsychotics
syncope/near syncope
autonomic dysfuntion
SPECT or PET showing low dopapine transport in basal ganglia
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12
Q

Lewi body dementia management

A

Parkinsonism: levo/carvidopa

Cholinesterase inhibitor: rivastigmine for cognitive impairment

Anti psychotics for functional impeding hallucinations

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13
Q

FACT:

If GBS status is not mentioned on the question. Consider it unknown. What do you do?

A

Screening 36-38

IV penicillin if
1. GBS UTI during pregnancy regardless of treatment
2. Colonation of GBS (GU and/or rectum)
3. Hx of early onset neonetal sepsis
4. Unknown status and...
..... <37 weeks
.... Intrapartum fever
.... Rupture of membranes >18 hrs
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14
Q

Vit C deficiency pathological effect

A

Impaired wound healing due to poor collagen formation

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15
Q

Niacin deficiency

A

Pellagra

Dermatitis
Diarrhea
Dementia/Delusions

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16
Q

Livido reticularis associations

A

Vasculitis:
Polyarteritis nodosa, SLE

Vasocclusive
Fat embolism, Antiphospholipid sd, cryoglobulinemia

May be normal in some people specially in cold climates

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17
Q

Antiphosppholipid sd coagulation studies

A

Normal PT
Prolonged PTT

Mixing of patient blood with donor plasma will not correct PTT (unlike factor deficiency)

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18
Q

Elevated B2-microglobulin

A

Multiple Myeloma

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19
Q

Common dermal manifestation of Antiphospholipid sd

A

Livido reticularis

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20
Q

Specific antiphospholipid antibodies

A

Anticardiolipin
Antiphosphatidilserine
Anti beta2 glycoprotein

21
Q

Retained product of conception

Risk and complication

A

No placental expulsion after 30 min

Can cause post partum hemorrhage and infection

Increased risk if 24-27 weeks, still birth, placenta acreta, previous hx

22
Q

Chemo induced cardiac damege

A

Doxorubicin (and its family that end in rubicin): fibrosis. Not reversible

Trastuzumab: stunnin/dormant/hybernation cardiomyocytes. Asymptomatic ventricular systolic dysfunction

23
Q

Hystologic finding in hypertrophic cardiomyopathy

A

Cardiomyocyte hypertrophy and disarray

24
Q

Painless penile ulcer that has been present for a few months

A

Cancer (Usually SCC)

Syphilis self resolve in 2-6 weeks if left untreated

25
Q

Penile Cancer

A

Risk factors: VPH, smocking

Presentation: chronic painless ulcer + regional lymphadenopathies

Diagnosis: biopsy

Management: Excision

26
Q

Massive transfusion protocol

A

Packed RBC, FPP and platalets 1:1:1 ratio to avoid coagulopathy from delution of platelets and coagulation factors

Indicated in patients with hypovolemic shock that failed initial resuscitation efforts

27
Q

FACT

Always stabilize the patient first.. then do imaging studies

A

Unstable patients cant wait for blood matching.

Give O type blood

28
Q

Cortical bone loss

A

Primary hyperparathyroidsm

29
Q

McCune albright sd

A

Constant activated G protein

Elevated TSH: thyrotoxicosis
Elevated LH/FSH: precosious buberty (breast and pubic hair development)
Elevated ACTH: cushing sd

Caffe aulit spots, fibrous dysplasia of the bone

30
Q

Fibrous dysplasia of the bone association

A

McCune albright sd

31
Q

Defective mineralization of osteoid

A

Osteomalasia/osteoporosis

32
Q

Bipolar I vs II diagnosis

A

I:
One manic episode (need for hospitalization)

II:
Hx of hypomanic episodes (lasting over 4 days)
At least one MDD episode

33
Q

Clasic triad of Hemochromatosis

A

Cirrhosis
Diabetes
Skin pigmentation

Found only late in the disease

34
Q

Hemochromatosis

Skin
Gastro
M/E
Cardio
Endocrine
Infection
A

Skin: hyperpigmentation
Gastro: elevated LFTs and hepatomegaly (early), cirrhosis (late), risk for hepatocellular carcinoma
M/E: arthritis, chondrocalcinosis, arthralgias
Cardio: dilated or restrictive cardiomyopathy, conduction abnormalities
Endocrine: DM, hypogonadism (low libido, impotence in men), hypothyroidsm
Infection: Yersnia, vibrio,

35
Q

Asymptomatic patient with LFTs

A

Hemochromatosis in dxx

36
Q

Hemochromatosis

Skin
Gastro
M/E
Cardio
Endocrine
Infection

Diagnosis

A

Skin: hyperpigmentation
Gastro: elevated LFTs and hepatomegaly (early), cirrhosis (late), risk for hepatocellular carcinoma
M/E: arthritis, chondrocalcinosis, arthralgias
Cardio: dilated or restrictive cardiomyopathy, conduction abnormalities
Endocrine: DM, hypogonadism (low libido, impotence in men), hypothyroidsm
Infection: Yersnia, vibrio,

DIagnosis: genetic HFE mutation

37
Q

Initial management of acute pancreatitis

A

Aggressive IV fluids
Pain management
Monitoring complications (infection, renal failure, ARDS)

Empiric ATB not indicated unless CT evidence of necrosis

38
Q

Dxx of erectyle dysfunction

A

Absence of nocturnal erections:
Neurologic: diabetic neuropathy, MS, spinal injury
Cardiovascular: smocking, claudication, DM, hypertension

Nocturnal erections:
Psycologic: specific to a person, situation, sudden onsent

Hypogonadism:
Decreased libido, testicular atrophy, gynecosmastia, gradual onset, low testotorone

Endocrine: hypothyroidsm, prolatinoma

Hemochromatosis

Medications: antidepresants, SSRI, antiandrogenic medication

39
Q

Clues for masotiditis

A

Inflammation of mastoid lowers ear

40
Q

Suction splash on physical examination

How do you produce it?
What does it mean

A

Stethoscope on epigastric region, rock the patient back and forth at the hip

Associated with gastric outlet obstruction

41
Q

Calcium-phosphorous product

A

Ca x PO4 = >55 risk for tissue calcification

Can cause basal ganglia calcification and symptoms of parkinsonism

Low Ca and high PO4 is seen in secondary hyperparathyroidsm

42
Q

Good or bad pronostic factor of schizofrenia

A 
GOOD:
Female
Late onset
Mostly positive symptoms
Identifiable precipitant /acute onset
BAD:
Early onset (childhood, adolescence)
Family hx
Long duration of symptoms without treatment
Presence of negative symptoms
Gradual onset
43
Q

Good or bad prognostic factor of schizophrenia

A 
GOOD:
Female
Late onset
Mostly positive symptoms
Identifiable precipitant /acute onset
BAD:
Early onset (childhood, adolescence)
Family hx
Long duration of symptoms without treatment
Presence of negative symptoms
Gradual onset
44
Q

Auer rods

A

AML

45
Q

Brief psychotic disorder

A

> 1d and <1month

Sudden onset
Return to baseline

46
Q

Schizophreneiform disorder

A

> 1 month <6 months
Same symptos as schizofrenia.
Functional decline not requiered

47
Q

Schizophrenia

A

> 6 month of symptoms
With funtional decline
1 month of active symptoms

48
Q

Schizoafective

A

2 years
Mood episode (depresion or bipolar) + schizophrenia
> 2weeks episode of schizophrenia without mood symptoms

49
Q

Delusional disorder

A

> 1 delusion >1 months without any other symptom

Uworld Gaby (77 decks)

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