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Uworld Gaby > UW 25 > Flashcards

UW 25 Flashcards

1
Q

Idiopatic thrombocytopenic purpura vs TTP

A

ITP does not present with hemolysis

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2
Q

CO2 abdominal insufflation side effect

A

Bradycardia and AV block due to peritoneal streching and activitation of the parasympathic system

CO2 emolism: rare. Can present as obstructive shock or end organ infarction

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3
Q

Renal changes in diabetic neprhopathy

A

Mesangial nodules (Kameitel), tubolointerstitial fibrosis

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4
Q

Apearence of amniotic membrane juction at the placent if monochorionic or bichorionic

A

Monocorionic: T shape

Fusion bi chorionic: Lambda shape

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5
Q

Complication of monochorionic twins

A

Twin-twin transfusion

Donor twin: anemia, olygohydramnios, low output heart failure

Recipient twin: policythemia, polyhydramnios, high putput heart failure

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6
Q

Estreogen receptor modulators

A

Clomiphene: antagonist at estrogen receptor in hypothalamus. Prevent normal feedback inhibition, increasing LH and FSH release. Use to treat infertility due to anovulation

Tamoxifen: estrogen blocker in breast and stimulant in endometrium and bone. Use in breast cancer ER/PR +. Can cause endrometrial cancer. Increase risk of thromboembolic events

Raloxifene: antagonist at breast and uterus, agonist at bone. Increase risk of thromboembolic events but not cancer. Use primarily in osteoporosis

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7
Q

Rosacea

A

Erythema/flushing of face +/- telangiectasias
May be pustular

Ocular: Conjunctival iperemia, lid margin telangiectasia

Avoid triggers (spicy food, wine)
Sun protection
Soft emolients
Topical metronidazol for pustular type
Laser or brimonidine (topical alpha 2 agonist) for tlenagientacic type
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8
Q

Fanconi sd

A

Glucosuria, phosphaturia, aminoaciduria

Cafe au lait spots, short stature and radial, thumb hypoplasia/aplasia

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9
Q

Renal tubular acidosis

Primary difect
Urine pH
Serum K
Causes

A

Type 1: Poor hydrogen excretion (Distal)
pH: >5.5
Serum K: normal or low
Causes: medication, autoinmune (sjrogren or rheumatioid arthritis)

Type 2: excess bicarbonate secretion (proximal)
pH: <5.5
Serum K: normal or low
Causes: fanconi sd

Type 4: Aldosterone deficiency or resistance
pH: <5.5
Serum K: high
Causes: Obstructive uropathy, congenital adrenal hyperplasia

All: low serum HCO3, hyperchloremia, growth failure

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10
Q

Clostridium perfringes diarrhea

A

Brief limited watery diarrhea and fever

Associated with undercook or unrefrigerated food

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11
Q

Bloody diarrhea with no fever

A

E. coli

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12
Q

Euthyroid sick sd

A

Normal T4 and TSH. Low T3

In the setting of a severe illness

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13
Q

Desmopresin

A

ADH analogue

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14
Q

Treatment of primary adrenal insufficiency

A

Corticosteroid: hydrocortisone, prednisone

Mineralocorticoid: fludrocortisone

Hydrocortisone has both gluco and mineralo activity, but incresing the dose if patients is having symtoms of mineralocorticoid deficiency only, would increased risk of excess cortisol side effects (cushing like symptoms)

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15
Q

Midrodrine

A

Alpha adrenergic agonist use to treat orthostatic hypotension

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16
Q

Uric acid stone formation physiopathology

A
  1. Excess excretion: myeloproliferative disorders, gout
  2. Increased uric acid concentration: hot climates, dehydration
  3. Low urine pH: chronic diarreha (HCO3 loss), metabolic sd/ DM

Acidic urine favor uric acid crystal formation vs urate (soluble)

Treatment is urine alkalinization (Potasium citrate)

17
Q

Management of hyperglycemis

A

> 14:
Agressive IV fluids and calcitonin
Long term biphosponates
Avoid loop diuretics unless volume overload

12-14:
Same as above if symptomatic, If not, no treatment needed

<12
No immediate intervention needed
Avoid thiazide, lithium, volume depletion, excesive bed rest

18
Q

Dobutamine MOA

A

beta 1 adrenergic agonist: Increases heart contractility and heart rate (decreases end systolic volume). Also causes mild vasodilation (b2 agonist) decreasing afterload

Used in patients with cardiogenic shock

19
Q

Hallucinations in a patient with parkinsons

A

Due to disease itself or due to medication (levo/carvidopa or pramipixole)

Start reducing the dose, if meassure fails… try seconde generation antipsychotic

20
Q

Paroxysmal nocturnal hemoglubinura

A

Complement mediated hemolysis
CD55/CD59 deficiency (RBC not protected agianst complement attachment)

Iron deficiency anemia, pancytopenia, episodic dark urine, throbosis (most common hepatic or mesenteric)

Treat with prednisone

21
Q

G6PD deficiency triggers

A

Sell FAVA BEANS in INDIA

Sulfa drugs
Fava beans
Infection
Nitrofurantoin
Dapsone
Isoniazid
Antimalarials
22
Q

Physical findings in endometriosis

A

Normal size uterus

Dysuria, pain with defecation
FIxed uterus (retroverted position)
Cervcal pain with mobilization
Adnexal mass (endometrioma)
Rectovaginal nodularity (due to tussiue in cul de sac)
23
Q

ATB prophylaxis for patients undergoing clean surgery

A

Cardia or neurologic procedures

Covarage angaisnt skin pathogens (gram +)

Cefazoline first line

Vanco or clinda for penicillin allergic

24
Q

Migratory superficial thromboflebitis

A

Trousseau sd

Eryhtmeatpus palpable cord-like veins

Associated with pancreas, lung, prostate, cplon

25
Q

Hodking lymphoma

A

Bimodal presentation: 15-35 and >60

Painless lymphadenopathy
B symptoms
Pruritus
Pel-ebstein fever: 2weeks on, 2 weeks off

Excisional biopsy: red stimberg cell (owels eye) Bcell with bipolar nuclei and huge eosinophil inclusions

Treatment: adriamycin (doxorubicin), bleomaycin, vinplastine, dacarbazine (ABVD)

26
Q

AVBD treatment for Hodking lymphoma

A

Adriamycin
Vinplastine
Bleomycin
Dacarbazine

27
Q

Why is not necessary imaging before LP in infants with open fontanel

A

There is no risk for herniation

28
Q

Empric treatment of meningitis according to age pg 224

A

pg 224

29
Q

Elevated GGT and ALP

A

Suggest biliary compression or obstruction

30
Q

Uterine tachysystole

A

> 5 contractions in 10 min

Place patient in latral decubitus
Stop oxytocin
Give tocholytics

31
Q

Trearment for adult vs. infant botulism

A

Infant: human immunoglobulin

Adult: equine derived antitoxin

32
Q

Cholesterol crystal embolism

Risk factors (2)
Clinical features (7)
Lab findings (5)
Diagnosis (2)
A

Hypercholesterolemia, hypertension DM

Livido reticularis
Renal (acute or subacute injury)
Stroke, amauross fugax, plaques on retina
Intestinal ischemia, pancratitis

Laboratory findings:
Elevated creatinine, eosinophilia, hypocomplementenemia
Urine: few cells or cast, eosinophiluria

Skin or renal biopsy:
Biconvex, neddle shape cleft within ocluded vassels
Perivascular inflamation with eosinophils

33
Q

Cocaine chest pain management

A 
O2
Aspirin
Bezos
CCB and Nitrates are safe
Do not use beta blockers

Immediate catheterization and reperfusion

34
Q

Labial adhesions

A

Fused labia minora

Due to poor hygiene, infection or trauma

Usually asymptomatic or require treatment with estrogen

Dxx with lichen sclerous: hypopigmentation

Uworld Gaby (77 decks)

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