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Uworld Gaby > UW 19 > Flashcards

UW 19 Flashcards

1
Q

Acute intermittent porphyria symptoms

A 
Painful abdomen
Port-wine urine
Precipitated: medications, stress
Polyneuropathy
Psychiatric symptoms
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2
Q

Peutz-Jegherz sd

A

GI hemartomatous polyps

1-5mm perioral mucocutaneous pigmented macules

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3
Q

Blood findings of defective prosthetic valves

A

Hemolytic anemia and thrombocytopenia can be found to due to mechanical damage

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4
Q

Rheumatoid arthritis treatment

A

NSAIDs (for acute pain/crisis)

First line:
Methotrexate

Others
CD 20 inhibitor: leuflonide
TNF inhibitor: rituximab

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5
Q

MOA of Rituximap

A

TNF inhibitor

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6
Q

Treatment for neuroleptic malignant sydrome

A

Dantroline or bromocriptine

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7
Q

Treatment of Serotonin sd

A

Cyproheptadine (antihistamine: blocks serotonin production)

Benzos: for altered mental status

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8
Q

Treatment of Bullous penphigoid vs. Pephigus vulgaris

A

Bullous penphigoid: topical corticosteroids (eg, clobetasol)

Pephigus bulgaris: systemic steroids +/- azathriopine, mycophenolate, IVGI, rituximab

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9
Q

Wilms Tumor

A

Embryonic glomerular structure.
Most common renal malignancy. 2-5 yoa

Asymptomatic
Palpable mass
+/- Hematuria, hypertension, absominal pain

WARG
Wilms tumor
Aniridia
Retardation
Genitourinary malformations
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10
Q

Neuroblastoma

A

Adrenal medulla tumor
Kids <2yoa
Tumor crosses mid line (vs. pheochromocytoma)
Periorbital echymosis (raccoon eyes)
Opsoclonus-myoclonus (dancing eyes and feet)

Diagnosis: catecholamine metabolites in blood, n-myc oncogene, small round blue cells on hystology

Dxx: Wills tumor
Hematuria, hypertension, WT-1 chromosome 11

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11
Q

Indication for systemic atb therapy of anal abscess after drainage

A
  1. Systemic illness (fever) or cellulitis

2. Diabetes or immunosupresion

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12
Q

Severe retinopathy of prematurity

A

Retinal detachment in infants born <30 weeks gestation

Causes leucokoria

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13
Q

Retinoblastoma red flags

A

White reflex
Strabismus
Nystagmus

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14
Q

ECG findings of pericardial efusion

A

Electrical alternans (QRS variation of amplitud)

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15
Q

Wolf-Parkinson-White treatment

A

Procainamide
Amiodarone
Ibutilde

(B-blockers and CCC are contraindicated)

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16
Q

Uterine atony management

A
  1. Bimanual massage
  2. High dose oxytocin, misoprostol
  3. Trenaxemic acid
  4. Carbapost (contraindicated in asthmatic patients), metergine (if not hypertensive)
  5. Intrauterine balloon
  6. Surgery
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17
Q

Dxx of foot pain

Stress fracture:
Arthritis
Morton neuroma
Tarsal tunnel sd

A

Stress fracture: localized pain, seen specially in runners, dorsal surface, 2nd, 3rd and 4th metatarsal

Arthritis: pain in the joints, not localized

Morton neuroma: pain between 3rd and 4th toe. Plantar surface, clicking sound on palpation

Tarsal tunnel sd: after anckle fractures. Burning sensation, aching and numbness on plantar surface

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18
Q

DIfference between intraparenchymal vs. subarachnoid hemorrhage

A

Intraparenchymal: focalization symptoms that worsen within a few hours. Blood is in the brain. (If hypertension: basal ganglia, av malformation in kids)

Subarachnoid: sudden headache without focalization. Blood is in between the sulci.

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19
Q

Patophysiology of hyper IgM sd

A

CD 40 ligand on T cells deficiency… prevents Ig class switching because it cant bind to CD40 receptor on B cells

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20
Q

CT findings of High grade astrocytoma

A

High grade astrocytoma = glioblastoma multiforme

Butterfly appearance with central necrosis. Serpentiginous, well defined enhancing

Vs. abseces: enhancing is thicker and diffuse

21
Q

Systemic symptos of anorexia

A

Hypotension, bradycardia, hypothermia
Gastroparesis, constipation
Cardia atrophy, arryhtmias

22
Q

Systemic symptos of anorexia

A

Hypotension, bradycardia, hypothermia
Gastroparesis, constipation
Cardia atrophy, arryhtmias

vs. hypothyrioidsm: diastolic hypertension

23
Q

Alvarado score for apendicitis

A 
1 point each
RLQ migratory pain
Fever
Anorexia
Nausea and vomiting
RLQ rebound tenderness

2 points each
RLQ tenderness
Leukocytosis (>10.000)

24
Q

Patient with 1 amenorrhe, 2nd sexual characters developed.

A

Amenorrhea normal <15 yoa if secondary characters are developing

Women have a rapid growth spurt right before menarche. If patient is growing “fast” then reassure

25
Q

Universal screening for pregnant patients

A

HIV
Hep B
Syphilis
Chlamydia

26
Q

Language disorder

A

Deficit in understanding and/or producing language

Presentation:
Limited vocabulary
Inadecuate structure
Difficulty ussing language to communicate, explain cocepts, create stories

Other symptoms:
Frustration, look for attention in other ways (biting, hitting,)

27
Q

Concussion symptoms

A

Headache (predominant symptom) can worsen with sounds, concentrating, eye movements

Irritability, sleep disturbances

28
Q

What do you need to remember about parvo19 in adults

A

Patients with kid contacts are at risk of viral arthitis

29
Q

Fibular neuropathy

A

Foot drop
Impaired dorsiflexion
Preserve plantar flexion (walk on toes)
Sensory deficit on lat aspect of dorsal foot an shin

30
Q

Aortic dissection and hoarness

A

Expansion of the intima compresess the laringial nerve

31
Q

Diagnosis of aortic disection

A

CT angiography (for stable patients)

TEE if not stable

32
Q

Diagnosis of Adrenal insuficiency

A

Consytropin stimulation test (ACTH analogue)

Normal response: rise in cortisol

No rise in cortisol = AI

33
Q

Adrenal insuficiency labs

A

Hyperkalemia, hyponatremia
Eosinophilia
Normal to low glucose
Low cortisol, high ACTH

34
Q

AD Polycystic Kidney disease

Presentation and extra renal features

A

Asymptomatic until 30-40
Flank pain, palpable mass
Hematuria

Others: polyuria (cant cocnentrate urine), hypertension, progresive renal dysfunction)

Extrarenal manifestations: 
Brain aneurism
Colonic diverticulos
Hepatic/pancreatic cyst
Mitral valve prolapse, aortic regurge
35
Q

Location of appendicitis in pregnant women

A

RUQ

36
Q

Auscultation findings in pulmonary contusion

A

Rales or decrease breath sounds do to pulmonary edema (from hemorrhage that is later worsen by IV fluids)

37
Q

Time frame of pulmoary contusion vs fat embolism

A

Pulmonary contusion: <24hrs

Fat embolism: 12-72 hrs

38
Q

Triad of gonoccocal arthritis

A

Tenosinovitis
migratory Arthritis
Maculo/papular discharge

39
Q

TRALI

A

Non cardiogenic pulmonary edema
Pulmonary infiltrates

Within 6 hrs

40
Q

Acute hemolytic reaction

A 
<1hr
Fever, flank pain, hemoglobinuria, pain at catheter insertion site
Low BP, tachycardia
Normal O2 sat
Positive coombs

Management:
Aggressive IV fluids

41
Q

Management con complicated diverticulitis

A

Abscess <3cm: ATB

Abscess >3cm: CTpercutaneous draingage

If no improvement after a few days… surgery

42
Q

Medications associated with neurotoxicity

A

Calcineurin inhibitors

Cyclosporin and tracolimus

43
Q

Anti Jo antibodies

A

Polymyositis/dermato

44
Q

Treatment of Bells palsy

A

Prednisone

45
Q

Management of edema secondary to Calcium channel blockers

A

ACEI

46
Q

When to administer Hep B vaccine in a premature baby

A

When it >2kg

47
Q

Contraindication for faxtor Xa inhibitor

A

Renal failure

DVT/PE due to malignancy

48
Q

Drugs related to Folate deficiency

A

Phenytoin
Methotrexate
Pyrimethamine
TMP-SMX

49
Q

Indication for IECAs in diabetic patient

A

Hypertensive patien

Albumin/creatine ratio >30

Uworld Gaby (77 decks)

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