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Uworld Gaby > UW 7 > Flashcards

UW 7 Flashcards

1
Q

Hepatorenal Syndrome

A

Acute renal failure in the setting of liver disease. (Prerenal)
Cause by splanic vasodilation and decresed blow flow to the kidneys
“Healthy kidneys in an unhealthy enviroment”

Midodrine, octreotide to decrese splanic circulation

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2
Q

Amyloidosis types

A

AL: plasma cell dyscrasia (Multiple myeloma and Waldenstrom macroglobulinemia) due to monoclonal light chain fragments

AA: chronic disease/infections (AR, Chrons, Lymphoma, vasculitis, TB). Amyloid A is an acute phase reactant

Dialysis: B2-microglobulin deposition

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3
Q

Crioglublinemia vs Cold agglutins disorder

A

Both caused by increased levels of IgM

Crioglobulinemia: Hep C patients with articular pain and renal involvement

Cold aglglutins: finger and toe numness, hemolytic anemia on cold expossure, reynaud phenomenon. Seen on EBV, mycoplasma and waldestrom macroglobulinemia

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4
Q

Secondary amyloidosis clinical manifestations

A 
Neprhotic sd or asymptomatic proteinuria
Cardiomegaly with CHF
Hepatomegaly
Organomegaly (eg. macroglosia)
Peripheral neuropathy (mixed motor and autonomic dysfunction)
Bleeding diathesis
Waxy skin and easy brusing
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5
Q

Hypertensive neprhosclerosis

A 
Patients with HTN
Ritinopathy
Left ventricular hypertrophy
Progresive renal failure
Mild proteinuria (<1gr/day)
Usually small kidneys
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6
Q

Risk factors for 1 dysmenorrhea (6)

A 
BMI <20
Age >30
Menarche <12
Heavy/long menstrual periods
Sexual abuse
Tobacco use
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7
Q

Non anion gap metabolic acidosis

A

HARDASS

Hyperalimentation
Adisons
Renal tubular acidosis
Diarrhea
Azetazolamide
Spirnolactone
Saline infusion
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8
Q

Renal tubular acidosis type IV

A

Low aldosterone or resistance

High potasium. Metabolic acidosis

Etiologies: hypoaldosteronism, agiontensin II inhibition (ACEI, ARA II i), urinary tract obstruction, heparine

Old people have decrease function of the juxtaglomerular aparatus… low renin.. low aldosterone

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9
Q

Acid base disorder in diarrhea vs. laxative abuse

A

Normally causes Metabolic acidosis

Laxative abuse===> loss of K in stool
High aldosterone due to volume loss worsens hypokalemia
Imparied HCO3 excretion and CL reabsorption

MATABOLIC ALKALOSIS

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10
Q

Biobsy of Reye sd.

A

Microvesicular fatty infiltration

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11
Q

Ottawa ankle rules

A

When to do ankle xray

a. Pain in malleolar area + tendernes in posterior margin/tip of lat or med malleolus OR unable to bear weight 4steps 2each.
b. Pain in mid foot area + tendernes in navicular (medial) OR 5th metatarsal (lat) OR unable to bear weight.

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12
Q

Howell-Jolly bodies

A

Persistance of RBC precursor nuclei.
Present in patients with funtional/surgical asplenectomy

Sickle cell disease patient have functional asplenia by age 5

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13
Q

Schystocyte significance and other name

A

Helment cell

Mechanical hemolisis

DIC, TTP/HUS

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14
Q

Heinz body

A

Hb precipitation in G6PD deficiency…. bite cells

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15
Q

Complications of Sickle cell (2)

A

Splenic secuestration: severe acute anemia. tachycardia, pallor, shock (pool of blood into the spleen resulting in hypovolemia) (low hematocrit and low platelets)

Aplastic crisis: usually secondary to Parvo infection.

Both present with anemia but aplastic crisis has a low reticulocyte count

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16
Q

Complication in patients with sickle cell trait

A

Renal complications:

a. Hematuria: renal papilary necrosis
b. hypostenuria: inability to concentrate urine
c. increased risk of UTI

17
Q

HELLP syndrome (clinical presentation, labs, management)

A

a. Headache, nausea, vomiting; RUQ pain (liver capsule distention), preclampsia
b. Hemolitic anemia, elevated liver enzimes, low platelet count
c. Lower BP, Mg drip, delivery

18
Q

Spinal stenosis presentation

A

Most common in neck and lumbar region.
Pain that radiates to the arms or legs
Numbness and weakness

Lumbar stenosis:
Worse with extension: going down the stairs, standing, walking
Better with flexion: going up the stairs, sitting

MRI of the spine is gold standard

19
Q

Most common cause of lumbar spinal stenosis

A

Degenerative joint disease

20
Q

Managment of an agitated patient

A

Benzo +/- antispychotic (usually haloperidol)

21
Q

Multiple sclerosis findings on CSF (PL)

A

Oligoclonal bands

Normal opening pressure
Normal proteins. Relative elavation of IgG

22
Q

14-3-3 protein on PL (CSF)

A

Prion disease (Creuztfeld-Jacob)

23
Q

Albumincytologic dissociation on PL (CSF)

A

Finding of Guillian Barre.

High proteins, normal cells

24
Q

Possible complications of occlusion of the right coronary artery

A 
SA and AV node dysfunction (bradycardia, heart block)
Papillary muscle rupture
Ventricular septum (posterior 1/3)
25
Q

Presentation of papillary muscle rupture

A

Acute mitral regurge (holcystolic murmur)
Pulmonary edema

It does not cause structural changes (increase atrial/ventricular size or compliance)

26
Q

Number needed to treat

A

1/absolute risk reduction

ARR: difference between % in not treated group minus treated group vs. %

27
Q

Erythematous tender nodule at the lid marging

A

Hordeolum (stye)

28
Q

Lichen planus

A

pg. 80

29
Q

ECG of a ventricular aneurysm

A

persistent ST elevation, deep Q waves

30
Q

Management of penile fracture

A

Surgery (its an emergency

Retrograde cystography before surgery if:
Hematuria
Dysuria
Urinary retention
Blood at the meatus
31
Q

Creanial hematomas that cross suture lines

A

Caput sucedaneum

Subgaleal hemorrhage: massive hemorrhage that can cause anemia, pallor and shock. Can reach the neck. Due to scalp traction

32
Q

Complications of ulcerative colitis

A 
Toxic megacolon
Primary sclerosing cholangitis
Erythema nodoso
Pyoderma gangrenoso
Spondyloarthritis
Colon cancer
33
Q

Age of onset of IBD

A

bimodal
15-40

50-80

34
Q

Target cells

A

Thalasemia

Uworld Gaby (77 decks)

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