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STEP 2 > UW5 > Flashcards

UW5 Flashcards

1
Q

What acid base disorder would a pt with cyanide toxicity have? Why?

A

Lactic acidosis (metabolic acidosis) because the cyanide inhibits the electron transport chain so everything goes into lactic acid fermentation

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1
Q

What is the most important prognosticator of TCA overdose?

A

Length of the QRS

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1
Q

What is the general mgmt of myasthenia crisis?

A

ABC’s then (plasmapheresis OR IVIG) + Steroids; HOLD anticholinesterases in this setting to prevent resp. secretions and worsening resp. status

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1
Q

Which renal syndrome is assoc with Hodgkin lymphoma? Which is assoc with solid organ tumors (carcinomas)?

A

Minimal change dz; membranous nephropathy

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2
Q

What is the treatment for cyanide toxicity?

A

Sodium thiosulfate and HYDROXYcobalamin (why give cyanocobalamin! It has cyanide!)

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2
Q

What is Charcot’s triad? Reynold’s pentad?

A

RUQ pain, Fever, jaundice; same + MS changes and shock

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3
Q

What if a person with AIDS has ring enhancing lesion with EBV in the CSF?

A

Primary CNS lymphoma (DLBCL) tx is CHOP or RCHOP (or in theory, EPOCH)

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3
Q

Allopurinol can be used prophylactically for urate nephropathy but what kidney issue can it cause?

A

Interstitial nephritis

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4
Q

When do pts with masked primary hyperaldosteronism often first develop hypokalemia?

A

When placed on diuretics

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4
Q

An abnormal D-xylose test (i.e. low serum and urine concentrations after ingestion) indicates what?

A

Malabsorption (small bowel) since it is absorbed in proximal small bowel via passive diffusion

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5
Q

What 2 antibodies are present in most pts with Hashimoto’s?

A

Anti-thyroid peroxidase and Anti-thryoglobulin

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6
Q

What is a major distinguishing factor between osteoporosis and osteomalacia in terms of symptoms?

A

Osteomalacia usually has bone pain whereas osteoporosis does not; osteomalacia also has pseudofractures (looser zones)

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7
Q

What is the number 1 form of drug induced CKD?

A

Analgesic nephropathy (tubulointersitial nephritis)

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7
Q

Aside from porphyria cutanea tarda, what other skin disorder is HCV assoc with?

A

Lichen planus

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8
Q

Why may dermatomyositis be “associated with malignancy”?

A

Because it can be a paraneoplastic syndrome

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9
Q

What is more common to see on renal bx of DM nephropathy, diffuse glomerular sclerosis or nodular glomerulosclerosis?

A

Diffuse is more common but nodular (Kimmelstiel Wilson nodules) are pathognomonic

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10
Q

For every 1 point drop in albumin how much does the serum calcium drop?

A

0.8 but recall that you need to correct the calcium

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11
Q

What is a reentrant ventricular arrhythmia?

A

Essentially ventricular fibrillation!

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12
Q

Why should you look for sx of fatigue, dry skin, and constipation in a pt just started on amiodarone?

A

It can cause hypothyroidism (note it can also cause hyperthryoidism)

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12
Q

Which valvular disease commonly has hemoptysis?

A

MS

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13
Q

How is Trichinella spiralis often transmitted?

A

From pork or bear meat; encysts in muscle causes myalgias with peripheral eosinophilia often preceded by intestinal sx; can have splinter hemorrhages

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14
Q

What is required in all pts with newly dx’d lupus nephritis and why?

A

Renal biopsy because the treatment is different by stage (Class I = minimal mesangial; Class IV = advanced sclerosis i.e. wire-looping)

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15
Q

If a person is on PDE-5 inhibitor and alpha blockers how would you advise the pt to take them?

A

Have at least a 4 HOUR INTERVAL to decrease the risk of hypotension; PDE5 inh are CI with nitrates though!

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17
Q

What pulmonary-renal syndrome may be associated with pyoderma gangrenosum?

A

Wegeners

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18
Q

What TB drug can cause interstitial nephritis? Describe the casts?

A

Rifampin; WBC casts with eosinophils

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19
Q

What is often the clinical scenario in which ascending cholangitis develops? Potential complication?

A

Choledocolithiasis since there is no where to go but up; Pyogenic liver abscess

20
Q

How do you treat exercise induced asthma?

A

B2 agonists 30 min prior to exercise NOT ipratropium

21
Q

Describe necrolytic migratory erythema and what else you’d expect them to present with

A

Erythematous papules and plaques often assoc with mild hyperglycemia (“DM II”) due to increased hepatic production from the glucagon stimulation; weight loss and diarrhea too

22
Q

Lynch Syndrome II increases the risk of which cancers?

A

Colon and Endometrial

22
Q

How is the treatment of stomach CA guided?

A

By stage; limited stage gets surgical resection and more widespread gets chemo and palliative surgery; so after dx get a CT

24
Q

What is the difference between interstitial nephritis and chronic tubulointerstitial nephritis?

A

Interstitial nephritis is essentially an allergic rxn; chronic tubulointerstitial is a form of CKD due to analgesics both have WBC casts (not to confuse with pyelonephritis)

26
Q

What are the PTH levels in hypercalcemia of malignancy?

A

Suppressed (unless of course, the cause was parathyroid carcinoma)

27
Q

What is DOC for cat bites? Human bites? Dog bites?

A

AMOXICILLIN-CLAVULANATE

29
Q

What are the contraindications for radioactive iodine ablative tx?

A

Pregnancy is the main one (severe ophthalmopathy but don?t read too much into this)

31
Q

What kind of study is best for studying the incidence of a disease?

A

Cohort study

32
Q

What is removed in radical orchiectomy?

A

Testis and spermatic cord not just testis; via high-inguinal incision

33
Q

What is the study of choice for Zenker’s

A

Barium esophagogram

35
Q

What are 3 interventions that can help with uremic bleeding?

A

DDAVP, Cryoprecipitate, and CONJUGATED ESTROGENS

37
Q

HCV is classically assoc with blood products from before what year?

A

1992

38
Q

What is the MC cause of mitral regurgitation in developed countries?

A

MVP

39
Q

How do you treat central retinal artery occlusion in first 4-6 hours? After?

A

tPa; Ocular massage (dislodge the thrombus) and High flow O2

40
Q

In a pt with pleural plaques from asbestosis what would be the cause of breathing problems?

A

Interstitial lung disease, the plaques are just there not the cause of the dyspnea

41
Q

What should be suspected in a pt with post-cholecystectomy syndrome in which no stones are found on ERCP? Tx?

A

Sphincter of Oddi dysfunction; tx is sphincterotomy during the ERCP

42
Q

What is the most likely group to develop emphysematous cholecystitis?

A

Elderly diabetics; often the bugs are clostridial

43
Q

Name 2 common causes of drug induced esophagitis

A

Potassium chloride (PO) and Bisphosphonates, I believe Iron tablets can do it too

43
Q

What is porphyria cutanea tarda assoc with? What does it present like?

A

HCV; Vesicles and photosensitivity

44
Q

A young woman with anterior knee pain when climbing stairs probs has what? Tx?

A

Patellofemoral syndrome; Exercises to strengthen thigh muscles

45
Q

What is the tx of PML?

A

None the pts die in about 6 months

47
Q

Why would a pt with ankylosing spondylitis for several years possibly develop restrictive lung dz?

A

Diminished chest wall and spinal mobility

48
Q

What is the corrected calcium equation?

A

(Measured total calcium + 0.8(4 - serum albumin)

49
Q

What is a big thing to consider when the ddx includes RA and paravoviral arthritis?

A

TIME; RA needs to be present for 6 weeks whereas parvovirus is more acute

51
Q

When someone is diagnosed with hereditary hemochromatosis? What is an important clinical question to ask?

A

IS THERE END ORGAN DAMAGE?? i.e. cardiomyopathy, diabetes, etc.

52
Q

What do progressive multifocal leukencephalopay lesions look like on MRI or CT?

A

THEY ARE NON CONTRAST ENHANCING

53
Q

Why does alcohol precipitate gout?

A

Metabolized to lactate and competes with urate in kidney (pct)

54
Q

Why does AS cause exertional syncope?

A

Because you cannot increase your cardiac output to meet the demands of exercise

55
Q

What electrolyte abnormality should you watch out for in a pt being treated for severe asthma attack?

A

Hypokalemia (B2 agonists pull K into the cell)

56
Q

What is the mechanism by which bence jones proteins cause CKD

A

Tubular obstruction of distal tubules

57
Q

What ist he pathophys of presbyopia?

A

decreased elasticity of the lens

58
Q

Describe the vision loss in age related macular degeneration

A

Central vision loss mostly

59
Q

What may be seen on CXR for LA enlargement?

A

Elevation of L mainstem bronchus

60
Q

What is the eponym for multiple myeloma?

A

Kahlers dz

62
Q

What causes NPH?

A

Decreased CSF absorption by arachnoid granulations; do CT first then LP

63
Q

What is the temporizing treatment of constrictive pericarditis? Permanent?

A

Diuretics; Pericardiectomy

64
Q

What is the worst prognosticator in HAV infection

A

Increasing PT – this can be an indicator of fulminant hepatic failure (development of encephalopathy within 8 d of acute liver injury)

STEP 2 (13 decks)

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