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Step 2 CK > UW Notes 2 > Flashcards

UW Notes 2 Flashcards

1
Q

Treatment for Croup?

A

Corticosteroids, then add racemic epinephrin

Supplemental O2 and intbuation if needed…obviously

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2
Q

alcohol consumption recommendations for women?

A
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3
Q

What is the mechanism of anemia of prenaturity?

A

decreased EPO and shorter lifespan of RBCs

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4
Q

Baby with retinal hemorrhage and enlarging head circumference… you should think what?

A

shaken baby syndrome

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5
Q

child with arthralgia, purpura/petechia, and renal issues… what do you think of?

A

HSP

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6
Q

elevated protein and normal cell count in CSF. what is this called? what is it associated with?

A

Albuminocytologic dissociation. Associated with Guillain Barre

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7
Q

max serum sodium correction rate should be…by hour? …by day?

A
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8
Q

Lithium triggers central or nephrogenic DI?

A

nephrogenic

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9
Q

Treatment of lithium induced DI?

A

stop lithium,

salt restriction, amiloride

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10
Q

when is nasotracheal intubation contraindicated?

A

apneic/hypopneic patients

basilar skull fx patients

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11
Q

when is needle cricothyroidotomy preferred?

A

children

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12
Q

5 criteria of metabolic syndrome?

A
  1. abdominal obesity (men >40; women >35)
  2. fasting glucose >100
  3. BP >130/80
  4. Triglycerides >150
  5. HDL cholesterol
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13
Q

what’s different about Guillain barre and tick borne paralysis

A

tick borne is usually hours onset, asymmetric, no autonomic dysfunction
GBS is days to weeks onset, symmetric, with autonomic dysfunction

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14
Q

obstructive lung dz…FEV1/FVC ratio?

A
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15
Q

meralgia paresthetica sx?

A

lateral fem cutaneous nerve compression at waist. paresthesia of lat thigh

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16
Q

neuroleptic malignant syndrome is associated with what several classes of drugs that share what property?

A

all are dopamine antagonists

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17
Q

digoxin toxicity (acute)

A

GI symptoms (n/v/abd pain), weakness, confusion

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18
Q

digoxin toxicity chronic versus acute?

A

more neurological/visual symptoms and less GI

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19
Q

What medication can induce digoxin toxicity? how should dig be managed when starting this?

A

amiodarone. must decrease dig by 25-50%

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20
Q

does pregnancy make the pt more or less hypercoagulable? why?

A

more because of increased fibrinogen, decreased protein S, and increased resistance to protein C

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21
Q

McCune-Albright Syndromic features

A

polyostotic fibrous dysplasia;

precocious puberty, cafe au lait spots

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22
Q

intrahepatic cholestasis of pregnancy…treatment?

A

ursodeoxycholic acid

early delivery

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23
Q

treatment of x-linked agammaglobulinemia (Bruton’s)

A

IVIG, prophylactic antibiotics

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24
Q

OCD…treatment?

A

psychotherapy

high dose SSRI

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25
Q

how can you provoke absence seizure? diagnosis?

A

hyperventilation.

EEG you’ll see 3Hz spike waves.

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26
Q

how to calculate anion gap? what’s nl range?

A

Na-Cl-Bicarb

8-12

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27
Q

anion gap metabolic acidosis.

alcoholic with vision loss/hyperemic optic disc?

A

methanol

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28
Q

Pellegra 3 symptoms?

what deficiency causes it?

A

dermatitis, diarrhea, dementia

niacin deficiency

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29
Q

winter’s formula is used to do what? what is it?

A

assess appropriate pCO2 compensation for metabolic acidosis.

pCO2=1.5(HCO3)+8+/-2

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30
Q

treatment for fibromyalgia

A
  1. exercise an good sleep hygiene

2. TCA antidepressants

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31
Q

fever, abd pain, hematuria in a nephrotic patient…dx? why?

A

renal vein thrombosis; due to loss of antithrombin III

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32
Q

renal vein thrombosis is associated with what kind of nephrotic disease?

A

membranous glomerulonephropathy

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33
Q

what’s the genetic etiology of complete mole?

A

2 sperms fertilizing 1 ovum without any genetic info

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34
Q

abx classes for Legionnaire’s disease?

A

fluoroquinolones, macrolides

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35
Q

four types of sensation categories of focal seizures?

A

motor: jacksonian march
sensory: paresthesia, vertigo
autonomic: sweating
psychic: de javu

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36
Q

dx criteria of ADHD? (x3)

A
  1. > 6 months
  2. in 2 settings
  3. prior to 12 years
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37
Q

which glomerulonephropathy is associated with HepB?

A

membranous

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38
Q

centor criteria for strep pharyngitis? (4)

A

fever
anterior cervical lymphadenitis
tonsillar abscess
NO cough

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39
Q

who should get oseltamivir for flu? (4)

A
  1. pregnant
  2. > 65
  3. other chronic medical problems…
  4. withiin 48 hours
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40
Q

PROM is PPROM at what time? what’s the proper management?

A

34 weeks. baby should be delivered

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41
Q

pancreatitis diagnosis; is amylase or lipase better?

A

lipase

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42
Q

aortic regurg; describe the murmur? where is the murmur best heard? what position should the patient be?

A

early diastolic decrescendo at the3-4th L sternal border, best when pt is leaning forward

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43
Q

B12 is absorbed where?

A

ileum

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44
Q

hoarding behavior disorder. what’s the treatment?

A

cognitive behavioral therapy

can also add SSRI

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45
Q

what is psychodynamic psychotherapy?

A

psychotherapy based on the unconscious mind

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46
Q

how do you assess cervical length/competency in a woman with prior cervical surgery?

A

transvaginal US. (way better than digital examination)

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47
Q

DKA diagnostic criteria? (3)

A
  1. glucose >250

2. oH low

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48
Q

DKA initial management?

A
  1. IVF NS
  2. regular insulin
  3. Potassium correction
  4. treat precipitating factor (such as infection)
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49
Q

how to manage threatened abortion?

A

reassurance. may recommend bed rest and abstain from sex.

- no need to hospitalize

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50
Q

Beck’s triad for cardiac tamponade

A

distant heart sound, JVP elevated, hypotension.

suspicious of this when pt is s/p cardiac surgery with tachy/tachypnea

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51
Q

early cyanotic child with L axis deviation, and decreased pulmonary markings….what do you think of?

A

tricuspid atresia/hypoplastic R heart

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52
Q

Pts with Primary sclerosing cholangitis is at risk for what cancer?

A

colorectal

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53
Q

antimitochrondrial antibodies

A

primary biliary cholangitis

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54
Q

blood on initiating urination…where’s the bleed

A

urethra

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55
Q

terminal blood upon urination…with clots

A

bladder/trigone/posterior urethra bleeding.

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56
Q

sinusoidal fetal heart tracing means what

A

fetal anemia

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57
Q

variable decelerations on fetal heart tracing indicates what

A

compression of cord

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58
Q

enuresis is a problem after what age?

A

5 years

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59
Q

Enuresis. after behavioral modification and enuresis alarms…what is the first and second line pharmacotherapy

A

first line: desmopressin: (SE: relapse and hyponatremia)

Secondline: Imipramine

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60
Q

What are the recommendations regarding PSA screening for prostate CA?

A

USPSTF: recommends no screening…but other societies still recommends it…so TALK TO THE PATIENT on individual basis

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61
Q

Why is cefotaxime preferred over ceftriaxone in neonates (NOT infants)?

A

because ceftriaxone displaces albumin from bilirubin…can cause kernicterus

62
Q

acute limb ischemia… you should start immediate anticoagulation… and you should also perform what?

A

echocardiogram to assess for L ventricular thrombus

63
Q

DOPAMINE RASH mneumonic of SLE?

A 
Discoid rash
Oral ulcer
Photosensitivity
Arthritis
Malar rash
Immunologic criteria
Neurologic sx
ESR
Renal
ANA
Serositis
Hematologic
64
Q

management of postpartum blues?

A

monitor beyond 2 weeks. should be self limited

65
Q

what acid base abnormalities are seen in Asprin overdose

A

metabolic acidosis
AND
respiratory alkalosis
(fever, tachypnea, tinnitius… are other sx)

66
Q

Zollinger Ellison is associated with what disease? what are some sx?

A

MEN1; due to elevated gastrin >1,000

reflux sx, abd pain, weight loss, diarrhea, GI bleeds, jejunal ulceration, refractory to PPIs

67
Q

parotid surgery complication?

A

facial droop 2/2 disruption of facial nerve

68
Q

what’s the neurologic connection between boca’s and wenicke’s areas?

A

arcuate faciculus

69
Q

acute therapy for gout?

A

indomethacin, colchicine, steroids

70
Q

what is contraction alkalosis?

A

loss of H+ due to effects of aldosterone in effort to conserve volume

71
Q

neurogenic claudication?

A

claudication-like pain produced in spinal stenosis.

spinal extension makes it worse
normal ankle brachial index

72
Q

Gottron papules are associated with what?

A

dermatomyositis

73
Q

psoriatic arthritis treatment?

A

NSAIDS, Methotrexate, TNF alpha inhibitors

74
Q

what’s nl QT interval?

A

450

75
Q

What is the autosomal recessive long QT conditions?

A

Jervell and Lang-Nielsen

76
Q

How do you treat prolonged QT?

A

Propranolol +/= pacemaker

77
Q

what is the autosomal dominant long QT condition?

A

romano ward

78
Q

What classes of drugs can cause long QT?

A 
Macrolides
Fluoroquinolones
antipsychotics
antiemetics
antiarrythmics
opioids
79
Q

how to treat bacterial endocarditis without heart failure?

A

IV antibiotics. DOn’t do surgery unless there’s heart failure

80
Q

buproprion is contraindicated in what populations?

A

bulimia/anorexia, seizure, recent monoamine oxidase inhibitor use

81
Q

What are the features of TTP?

A

renal failure, hemolytic anemia, thrombocytopenia, fever, and AMS

it’s like HUS without diarrhea + fever, CNS sx

82
Q

what are type A and type B adverse drug events?

A

Type A is dose dependent

Type B is dose independent/unpredictable: SJS, NMS…etc

83
Q

Tourrettes tx?

A

risperidone, behavioral therapy (and first gem antipsych)

84
Q

post nasal drip treatment?

A

antihistamines

85
Q

bradycardia (sick sinus syndrome). medical therapy

A

atropine (antimuscarinic)

86
Q

asymptomatic bacturia treatment in pregnancy

A

nitrofurantoin x7 days
amoxicillin x7 days
fosfomycin single dose

87
Q

should you give fluoroquinolones to pregnant women? why?

A

no, because of cartillage dysplasia

88
Q

how to manage varicocele?

A

depend on age and fertility desires…

scrotal support, NSAIDS, surgery

89
Q

new diagnosis of HTN in

A

chronic HTN

90
Q

new dx of HTN in >20 weeks of pregnancy is called?

A

gestational HTN (as long as there’s no proteinuria/edema/end organ damage)

91
Q

vesicoureteral reflux. how to diagnose?

A

voiding cystourethrogram

92
Q

TCA overdose; treatment?

A

sodium bicarb to shorten QRS interval

93
Q

What is the Dxylose test used to diagnose? How does it work? and what can it r/o?

A

Dxylose can be absorbed in the small intestines without pancreatic enzymes.
it is used to diagnose celiac disease since, absorption won’t occur due to damaged villi.
It r/o pancreatic causes of malabsoption

94
Q

triglyceride of >1,000, hx of MI, eruptive xanthomas…abd pain. dx?

A

hypertriglyceridemia induced pancreatitis

95
Q

What does herpangina look like/where is it? what causes it? how is it different from herpetic gingivostomatitis?

A

herpangina–>small vesicles on pharyngeal pillars; due to coxackie virus in the late summer time. herpetic gingivostomatitis is on the lips

96
Q

smoking destroys which part of lung first? where does alpha 1 antitrypsin dz destroy first?

A

smoke=upper; alpha 1 antiptrypsin=lower

97
Q

abortive sx; no sac is seen in the uterus or outside on US… what should you do

A

get beta hCG and follow to determine if it’s ectopic or if it’s completed abortion

98
Q

at what bhCG level can you usually visualize gestational sac?

A

1,500-2,000

99
Q

constitutional growth delay
pattern of growth?
testosterone levels?
bone age?

A

pt born normal weight; falls off until puberty (which is delayed)
testosterone is normal
bone age is delayed

100
Q

mechanism of benztropine?

A

anticholinergic

101
Q

mechanism of trihexphenidyl?

A

anticholinergic

102
Q

most common osteomyelitis organism?

A

Staph aureus

103
Q

how to diagnose gallstone pancreatitis?

A

RUQ US, possible ERCP after

104
Q

When should you involuntarily commit a patient?x2

A

when they’re a danger to themselves/ others;

grave disability where they can’t care for themselves

105
Q

Atrophic vaginitis can be associated with urinary incontinence/UTIs. What’s first line of tx for atrophic vaginitis? second line?

A

first line is moisturizer/lubricants; then it’s low dose estrogen

106
Q

urinary incontinence 2/2 urethral hypermobility presents with incontinence when?

A

activity involving increased abd pressure

107
Q

myotonic dystrophy has what pattern of inheritance? what’s the mutation?

A

autosomal dominant; CTG repeat expansion

108
Q

whenever there’s postmenopausal bleeding and thickened endometrium on US…you should do what?

A

endometrial biopsy

109
Q

incidental finding of asymptomatic endometriosis what should you do?

A

observation

110
Q

how to treat symptomatic endometriosis?

A

OCP, progesterone IUD, or leuprolide (anti GnRH)

111
Q

what do you see on blood smear for thalassemia?

A

tear drop cells and target cells

112
Q

treatment for cyanide poisoning?

A

sodium thiosulfate

113
Q

what kind of compounds can cause cyanide toxicity?

A

carbon and nitrogen containing compounds… like nitroprusside

114
Q

symptoms of cyanide toxicity

A

N/V, flushing, CNS HA/confusion, arrhythmia, tachypnea followed by respiratory depression

115
Q

why is ACE I contraindicated in pregnancy?

A

ACE I can cause fetal renal damage

116
Q

informed consent. you must discuss what 4 topics?

A

indication, risk, benefit, alternatives

117
Q

bed wetting is normal until what age. Before this age you should NOT try to prescribe any help methods

A

5 years

118
Q

time requirement for chronic bronchitis?

A

> 3 consecutive months in 2 successive years

119
Q

what’s the most immediate intervention in acute liver failure?

A

liver transplant;

renal dysfunction will develop, but dialysis should NOT be done before liver transplant

120
Q

when should sclerotherapy be used in cirrhotic?

A

when there’s a bleeding varices

121
Q

what is the definitive way to diagnose Duchene’s MD?

A

genetic testing; biopsy will only support the dx

122
Q

pharmacotherapy for raynaud’s

A

CCB

123
Q

CT scan can induce thyrotoxicosis…why?

A

acute iodine influx via contrast

124
Q

Why might you see hematuria with no RBCs in a pt with heat stroke?

A

rhabdo

125
Q

pleural effusion. what happens to breathsounds, fremitus, percussion?

A

decreased breathsounds, decreased fremitus (bc fluids insulate around the lung), and dull to percussion

126
Q

pulmonary infiltrate/consolidation. what happens to breathsounds, fremitus, percussion?

A

decreased breathsounds/crackles, increased fremitus, dullness to percussion

127
Q

most common cause of bacterial pneumonia in HIV

A

strep pneumo

128
Q

conservative treatment for renal stones?

A

hydration, pain control, and alpha blockers (tamsulosin)

129
Q

drug of choice for cat bite prophylaxis?

A

amoxicillin-clavulanate

130
Q

arterial thrombosis versus embolus in the extremity…what’s the difference in presentation

A

thrombosis is slower onset

embolus is sudden…and if there’s afib then it’s obvious

131
Q

acute stress disorder versus post traumatic stress disorder. what’s the difference

A

acute stress is 1 month

132
Q

post concussive syndrome sx?

A

mild TBI;

HA, confusion, amnesia, difficulty concentrating, anxiety, mood alteration, vertigo

133
Q

early decel’s FHT. causes

A

fetal head compression. normal

134
Q

late decel FHT. causes

A

placental insufficiency

135
Q

variable decel FHT. what is it? causes?

A

quick deceleration

136
Q

atypical squamous cells of undetermined significance. what should you do if pt is 25?

A

under 25=repeat pap in 1 year

over 25=test HPV; if positive do colpo; if negative f/u with pap+HPV testing in 3 years

137
Q

3 bacteria of bloody diarrhea

A

shigella, e coli, and campy

138
Q

strep pharyngitis how do you test?

A

rapid strep. culture is gold standard

139
Q

tumor lysis syndrome can have what effects on serum potassium, calcium, phosphate?

A

potassium and phosphate will increase

phosphate will bind calcium thus calcium will decrease

140
Q

pt with appendicitis for >5 days. you should be worried about what?

A

appendiceal abscess

141
Q

why should you not restrict calcium with renal stones?

A

calcium binds oxalate. therefore decreased calcium will result in more oxalaturia and possibly worse stones

142
Q

what is recommended in terms of sodium and potassium intake in the face of renal calculi?

A

low sodium diet as calcium is excreted with sodium

high potassium diet as potassium increases urinary citrate excretion and lessens stone formation

143
Q

what’s the most sensitive marker of CHF? what’s the most specific marker of CHF?

A

sensitivity is high with BNP

specificity is high with third heart sound

144
Q

pts with high risk of thromboembolic events 2/2 afib (aka CHA2DSVASc2 score is high); then you should put the pt on prophylactic what?

A

anticoagulation. via warfarin or Xa inhibitors

145
Q

what’s the difference between aplastic crisis and aplastic anemia?

A

aplastic anemia is a pancytopenia due to bone marrow failure (fanconi anemia, autoimmune)
versus
aplastic crisis is a sudden drop in red count due to things like parvo B19

146
Q

total calcium in the body exist in what 3 ways?

A

ionized, bound to albumin (thus hypoalbuminemia–>hypocalcemia), and bound to phosphate

147
Q

platelet dysfunction with uremia…what’s the treatment of choice?

A

DDAVP to increase von willebrand factor

DO NOT transfuse platelet because it doesn’t work +platelet count is generally normal

148
Q

drugs of choice for post exposure prophylaxis to HIV? duration?

A

tenofovir, emtricitabine, raltegravir

start it immediately and stay on it for 4 weeks

149
Q

child with first episode of UTI under

A

renal/bladder US

150
Q

acute decompensated heart failure. what should you give the patient first?

A

loop diuretics and vasodilators (nitro)

then add on betablocker later on…acutely it can decrease cardiac output and should NOT be given

151
Q

Meniere’s disease. triad of sx

A

vertigo, tinnitus, and neuro sensory hearing loss

152
Q

Meniere’s treatment?

A

avoid sodium, caffeine, nicotine, alcohol

long term diuretics

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