uworld 11 Flashcards
Si/sx of rubella?
low grd fever, conjunctivitis, coryza, cervical LAD, head to body spread of blanching maculopapular rash, lasts less than 3 days
Risk fx of endocarditis?
Poor dentition, cardiac probs (congenital dx, valvular abnormalities/ repair), IV catheters, IV drug use
Lab/imaging findings w/ infective endocarditis?
+ blood cx, leukocytosis or nml WBC, glomerulonephritis signs on UA, septic emboli
What is gold standard for dx of infective endo?
TEE is gold std, 100% specific
How tx I.E.?
Start w/ vanc, then adjust based on cx
What is alternate test to dx vertebral osteomyelitis?
can do bone scan w/ gallium if MRI contraindicated
Causes of constrictive pericarditis?
idiopathic or viral pericarditis, cardiac surgery or radiation tx, TB pericarditis
Px of constrictive pericarditis?
fatigue + dyspnea, periph edema, JVD, ascites, may hear pericardial knock
JV wave signs of constrictive periccarditis?
prominent x and y descents
What are P/E findings of pulmo htn?
widely split s2 and incrsd intensity of P2
What is px of polymyositis?
slowly progressive prox muscle weakness of lower>upper extrem, cannot get out of chair, climb stairs, muscles of mastication and facial expession typically spared
How best diagnose polymyositis?
do muscle biopsy — get mononuclear infiltrate surrounding necrotic and regenerating muscle fibers
when should amiodarone be avoided?
Can cause pulm toxicity and should be avoided in pts w/ preexisting lung disease, can cause chronic interstitial pneumonia, organizing pneumonia, ARDS.
How empirically tx patient <50 y/o for meningitis?
vanc + 3rd gen cephalosporin
HOw empirically tx >50 y.o w. meningitis?
vanc + 3rd gen ceph + ampicillin. If immunocomp use cefepime instead of 3rd gen cephalo
What is INR goal of anticoag after unprovoked DVT?
want 2.0-3.0 for 6-12 mo if unprovoked
What is INR goal in pt w/ mechanical valve?
2.5-3.5
Lab findings with tumor lysis syndrome?
incrsd uric acid, incrsd PO4 and K, dcrsd Ca
Most common cause of hyperPTH?
80% due to parathyroid adenoma
Other effects of hyperPTH?
htn, arrhythmias, ventric hypertrophy, vascular/ valvular calcificiation
Causes of exudative pleural effusion?
infxn, malignancy, PE, connective tissue dx, iatrogenic
when do papillary muscle ruptures occur?
classically w/ posteroseptal MIs, can occur rarely w/ anteromedial MIs
SI/sx of Guillan Barre syndrome?
ascending lower extrem weakness, areflexia, can develop respiratory failure
How manage resp failure in GBS?
serial VC measurements, risk for resp failure when VC < 15
What is ddx for anterior knee pain?
patellofemoral syndrome, patellar tendonitis, osgood-schlatter syndrome
How diagnose PFS?
based on clinical sx, do PF compression test — reproduces pain of squatting
How chronic exposure of lead px?
same as acute but with fatigue, insomnia, htn, neuropsych sx, nephropathy, reproductive probs
Acute exposure of lead posioning sx?
ab pain, constipation, HA, periph neuropathy, joint pain, muscle aches, anemia, basophillic stippling, anorexia
What can cause cauda equina syndrome?
disc herniation, rupture, spinal stenosis, tumors, infxn, hemorrhage, iatrogenic
How does conus medullaris px?
sudden onset svr back pain, perianal hypo/anesthesia, symmetric motor reflexes, hyperreflexia, bowel and bladder dysfxn
What is sympathetic opthalmia?
immune mediated inflamm of one eye following injury to other eye, px w/ floating spots and blurred vision in non injured eye.
Si/sx of hereditary hemochromatosis?
lethargy, fatigue, malaise, skin pigmentation, joint probs/ arthralgia, incrsd LFTs, cirrhosis/ HCC risk, DM, hypogonadotropic hypogonadism, restrictive/dilated HF, cndxn probs
Infxns risk for hereditary hemochromatosis?
incrsd risk of listeria, vibrio, yersinia
Environ risk for pancreatic cancer?
smoking greatest, also chronic pancreatitis, obestiy, lack of physical activity
How does dipyramidole dx angina?
dilates coronary arts distal to obstructed arteies, already max dilated — other vessels dilate and pull blood from obstructed vessels— ischemia
How asses signs of adrenal insufficiency?
Do cosyntropin test
Cosyntropin findings w/ primary adrenal insufficiency?
basal cortisol low, ACTH high w/ minimal respons of cortisol to cosyntropin
