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UWorld 2 Flashcards

1
Q

increased peak pressure a/w unchanged plateau pressure suggests…

A

some pathology causing increased airway resistance (bronchospasm, mucus plug, ETT obstruction)

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2
Q

increased peak pressure and plateau pressure suggests…

A

some pathology causing decreased pulmonary compliance (pulm edema, atelectasis, pneumonia, R mainstem intubation)

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3
Q

what is the plateau pressure

A 
elastic pressure (compliance) + PEEP
(since you set the PEEP, it's pretty much showing you compliance)
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4
Q

what is peak airway pressure

A

resistive P (flow x resistance) + plateau P (compliance + PEEP)

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5
Q

explain the hormones in primary ovarian insufficiency

A

(a type of hypogonadotropic hypogonadism)
ovaries stop functioning –> estrogen down
amps up feedback @ hypothalamus –> increased GnRH and FSH

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6
Q

explain the hormones in hypothalamic hypogonadism

A

usually they’re too skinny –> shuts down hypothalamus

less GnRH –> less FSH –> less estrogen

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7
Q

explain the hormones in PCOS

A

(i think)
the ovaries are crap and not really ovulating –> estrogen down
hypothalamus goes nuts trying to help –> GnRH up (but not pulsatile)
this makes LH go up more than FSH (which is low/normal)
then also you’re making a bunch of androgens and they get converted to estrone which is an estrogen but doesn’t help so you get high (unhelpful) estrogen
Total: GnRH up, LH up, FSH low/norm, E up

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8
Q

when do you get benzo withdrawal seizures

A

short acting benzos are more likely

24 hrs+ after abrupt stop

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9
Q

when can you turn a breech baby

A

37 weeks to onset of labor

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10
Q

what do leuk esterases and nitrates tell you

A

+ leuks = pyuria

+ nitrates = enterobacteriaceae (like E. coli)

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11
Q

AE of succinylcholine (who to avoid)

A

hyperkalemia –> cardiac arrhythmias

rhabdo, burns, guillain-barre

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12
Q

AE etomidate

A

adrenal insufficiency

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13
Q

AE nitrous oxide (who to avoid)

A

inactivates B12 –> neurotox (B12 def people)

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14
Q

AE propofol (who to avoid)

A

myocardial depression –> severe hTN

ventricular systolic dysfunction

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15
Q

who can’t breastfeed

A 
active TB
HIV
HSV breast lesions
varicella
meds/chemo/drugs
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16
Q

walk through the hypertension/hypokalemia workup

A

look at the renin-aldosterone ratio
both up –> secondary hyperaldosteronism (somethings making you make renin/is making renin)
aldo up, not renin –> primary hyperaldosteronism (you’re making too much aldo in adrenals)
both down –> something else is making trouble

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17
Q

tx: acute CHF exacerbation

A 
LMNOP
lasix/loops
morphine
NG
O2
position
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18
Q

evidence of cholecystitis vs choledocolithiasis

A

both can have similar sx, elevated LFTs or bilirubin

choledocolithiasis will have increased alk-phos + possibly very high bilirubin (> 4)

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19
Q

polymyositis vs polymyalgia rheumatica (sx)

A

polymyositis: proximal muscle weakness but mild pain

polymyalgia rheumatica: stiffness in same places + neck

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20
Q

polymyositis vs polymyalgia rheumatica (labs)

A

polymyositis: up CK, aldolase, AST, anti-Jo, ANA, up ESR?

polymyalgia rheumatica: up ESR, CRP

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21
Q

indication for HRT

A 
hot flashes (nothing else!)
women < 60 who meno'd in past 10 yrs
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22
Q

preterm labor definition

A

contractions (making cervical change!) before 37 wks

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23
Q

newborn CXR: egg on a string

A

transposition of great vessels

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24
Q

newborn CXR: snowman sign

A

total anomalous pulm venous return w/ obstruction

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25
Q

cyanotic newborn: single S2

A

transposition of great vessels
tricuspid atresia
truncus arteriosus

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26
Q

well circumscribed, round, dural-based mass on MRI

A

meningioma

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27
Q

tx: meningioma

A

resection

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28
Q

MSK effects of CF

A

osteopenia

kyphoscoliosis

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29
Q

tx: DM ileus

A

metoclopramide

erythromycin

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30
Q

drugs causing folate def

A

phenytoin
trimethoprim (TMP)
methotrexate
hydroxyurea? (–> macrocytosis)

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31
Q

why do you not CT infant meningitis first?

A

herniation is rare (fontanelles are open)

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32
Q

knee injury: people who kneel a lot

A

prepatellar bursitis

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33
Q

knee injury: people who jump/forcefully extend a lot

A

patellar tendinitis

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34
Q

knee injury: pain w/ active motion, normal passive ROM

A

think bursitis

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35
Q

tx: prostatitis

A

TMP-SMX or FQs (acute)

FQs (chronic)

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36
Q

MC orgs of bacterial rhinosinusitis

A

strep pneumo
H flu
moraxella catarrhalis (way less)

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37
Q

neck xray: widened prevertebral space

A

think retropharyngeal abscess

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38
Q

tylenol overdose, what ot expect

A

n/v
RUQ pain
LFTs up
–> liver failure

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39
Q

mgmt: PAD

A
  1. lifestyle (stop smoking), supervised exercise program, ASA, statins
  2. (if persists) Cilostazol or surgical stenting
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40
Q

emergency: can’t get an IV

A

IO

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41
Q

MCC pneumonia in CF pts

A

kids: staph aureus

> 20: pseudomonas

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42
Q

tx: pneumonia in CF pts

A

cefepime (staph + pseudomonas)

vanco (MRSA)

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43
Q

why is there increased CSF in NPH

A

decreased absorption (or obstruction)

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44
Q

tx: chronic LBP

A

exercise regimen

NSAIDs/tylenol intermittently

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45
Q

RFs for focal sclerosing GN

A 
MC nephrotic syndrome in adults
AA/Hispanic
HIV
heroin
obesity
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46
Q

lyme/RMSF vs ehrlichiosis

A

ehrlichiosis has no rash

ehrlichiosis has leukopenia +/- thrombocytopenia and increased LFTs and LDH

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47
Q

FeNA values

A

> 2% = acute tubular necrosis

< 1% = acute interstitial nephritis

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48
Q

mgmt: variceal hemorrhage

A
  1. IVF, octreotide, Abx
  2. EGD
    3a (stopped bleeding): start prophylaxis (BB, band 1-2 wks later)
    3b (bleeding/rebleed): balloon tamponade, eventual TIPS/shunt surg
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49
Q

multiple myeloma: sx

A

weight loss
fatigue
bone pain

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50
Q

multiple myeloma: labs

A

hypercalcemia
normocytic anemia
renal insufficiency
protein gap (TP 4+ > alb)

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51
Q

what do you do if you see a protein gap

A

get serum protein electrophoresis
polyclonal = infxn, CT d/os
monoclonal = MM, Waldenstrom’s

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52
Q

pneumococcal vs meningococcal meningitis

A

pneumococcal doesn’t have rapid onset shock or skin stuff

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53
Q

Ca forms in the body

A

ionized (45%) – only physiologically active form
alb-bound (40%)
bound to other crap (15%)

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54
Q

Ca changes w/ acid-base stuff

A

acidosis –> alb holds more H+ (and less Ca) –> up ionized Ca

alkalosis –> alb releases more H+ (and holds more Ca) –> down ionized Ca

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55
Q

HIV pt: painless retinitis

A

CMV

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56
Q

HIV pt: rapid b/l necrotizing retinitis

A

HSV

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57
Q

signs of cyanide toxicity

A

AMS, lactic acidosis, seizures, coma

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58
Q

chorioamnionitis aka

A

intraamniotic infection

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59
Q

criteria for chorioamnionitis

A

maternal fever plus 1:

  • uterine tenderness
  • maternal or fetal tachycardia
  • malodorous amniotic fluid
  • purulent vaginal discharge
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60
Q

tx: chorioamnionitis

A

broad spectrum Abx
deliver (accelerate w/ oxytocin)
antipyretics

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61
Q

tx: disseminated GC

A

IV ceftriaxone, switch to oral cefixime when clinically improved

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62
Q

mgmt: pap –> atypical glandular cells

A

could be cervical or endometrial adenocarcinoma

who: > 35 or < 35 w/ RFs (obese, anovulation)
mgmt: colp, endocervical curettage and EMB

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63
Q

signs of acute arsenic poisoning

A

garlic breath
vomiting
watery diarrhea
QTc prolongation

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64
Q

signs of chronic arsenic poisoning

A

hypo/hyperpigmentation
hyperkeratosis
stocking-glove neuropathy

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65
Q

eyes: acute onset discomfort, photophobia, watery discharge, bulbar conjunctival injection

A

episcleritis

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66
Q

eyes: localized red, tender swelling over eyelid

A

hordeolum (stye) - usually staph aureus

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67
Q

eyes: fever, proptosis, restricted EOM, red, swollen eyelids

A

orbital cellulitis

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68
Q

eyes: sudden onset pain and redness in medial canthal region

A

dacryocystitis

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69
Q

whats that benign red thing on the baby butt called

A

strawberry (or superficial) hemangioma

also, they aren’t always on the butt

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70
Q

whats the adult hemangioma called

A

cherry hemangioma

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71
Q

mgmt: minimal BRBPR

A

< 40, no red flags: anoscopy (then sigmoid/colonoscopy if don’t find anything)
40 - 49, no red flags: sigmoid/colonoscopy
50+ or red flags: colonoscopy

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72
Q

breast: peau d’orange

A

inflammatory breast carcinoma

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73
Q

breast: firm, mobile spherical, palpable mass (young woman)

A

fibroadenoma (benign)

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74
Q

breast: unilateral nipple discharge w/o skin changes or other sx

A 
intraductal papilloma (benign)
even if discharge is bloody
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75
Q

breast: fever, diffuse warmth, erythema

A

mastitis

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76
Q

breast: dimpling/contour changes

A

infiltrating ductal carcinoma or lobular breast carcinoma

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77
Q

breast: diffuse erythema, edema and dimpling

A

inflammatory breast carcinoma

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78
Q

breastfeeding failure jaundice

A

first week of life
baby or mom fail
signs of dehydration

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79
Q

breast milk jaundice

A

peak @ 2 weeks (start at day 3-5)
adequate feeding
normal exam (besides jaundice)

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80
Q

how does lung infxn –> pleural effusion

A

cytokines released

increase capillary permeability

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81
Q

HIV pt: fever, headache and signs of increased ICP

A

think cryptococcus meningitis

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82
Q

tx: frostbite

A

rapid rewarming in a water bath (98.6 - 102.2) with tons of pain meds

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83
Q

newborn: cutis aplasia

A

trisomy 13 (Patau)

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84
Q

newborn: cat like cry

A

5p deletion

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85
Q

newborn: clenched fists

A

trisomy 18 (Edwards)

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86
Q

newborn: microphthalmia

A

trisomy 13 (Patau)

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87
Q

newborn: rocker bottom feet

A

trisomy 18 (Edwards)

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88
Q

newborn: polydactyly

A

trisomy 13 (Patau)

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89
Q

nephropathy a/w hep B

A

membranous, membranoproliferative

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90
Q

nephropathy a/w hep C

A

membranoproliferative

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91
Q

nephropathy a/w lipodystrophy

A

membranoproliferative

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92
Q

nephropathy a/w lymphoma

A

minimal change dz

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93
Q

nephropathy a/w URI

A

IgA nephropathy

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94
Q

things for NF-1

A 
cafe-au-lait spots
freckles in axilla/inguinal
lisch nodules (iris hamartomas)
neurofibromas (peripheral nerve sheath tumors)
optic gliomas
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95
Q

daddy, where do PEs come from?

A 
usually from proximal deep veins of LEs (iliac, femoral, popliteal)
renal veins (in nephropathy)
R atrium (with pacemakers)
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96
Q

hematuria: glomerular vs non

A

glomerular: blood (RBC casts, dysmorphic RBCs) and protein

non glomerular: blood (normal RBCs), no protein

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97
Q

lactation suppression

A

avoid nipple stimulation
ice packs
NSAIDs
no binding (mastitis) no bromocriptine

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98
Q

MCC a sudden heart attack outside the hospital

A

sustained v tach or vfib

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99
Q

most important prognosis indicator for out of hospital heart attack

A

time to resuscitation (CPR, defibrillator)

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100
Q

what not to give people with AV block

A

adenosine
BB
digoxin

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101
Q

prenatal care: when do you type and screen

A

initial visit

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102
Q

prenatal care: when do you do HIV/HBsAg/RPR/Chlamydia

A

initial visit

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103
Q

prenatal care: when do you do the 1 hr GTTT

A

24 - 28 wks

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104
Q

prenatal care: when do you get the GBS culture

A

35 - 37 wks

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105
Q

prenatal care: when do you get the Ab screen if shes Rh negative

A

24 - 28 wks

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106
Q

prenatal care: when do you check her rubella/varicella immunity

A

initial visit

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107
Q

prenatal care: when do you do a UA

A

initial

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108
Q

ataxia, dysarthria, scoliosis, foot deformities, CM

A

Friedreich ataxia

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109
Q

MCC death in Friedreich ataxia

A

CM/respiratory complications

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110
Q

hereditary thrombophilias

A

factor V leiden
prothrombin mutation
antithrombin def
protein C/S def

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111
Q

talk through protein C/S

A

protein C and S stop you from making clots (by inhibiting factor V)
protein C/S def –> more clots
Warfarin stops production of C and S (not on purpose!) which is why you have to bridge therapy

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112
Q

lung exam: when do you get increased tactile fremitus

A

consolidation

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113
Q

lung exam: when do you get dullness to percussion

A

consolidation
pleural effusion
atelectasis

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114
Q

lung exam: when do you get a mediastinal shift (away)

A

pneumothorax

large pleural effusion

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115
Q

lung exam: when do you get hyperresonant percussion

A

pneumothorax

emphysema

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116
Q

lung exam: when do you get decreased tactile fremitus

A

pleural effusion
pneumothorax
emphysema
atelectasis

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117
Q

lung exam: when do you get a mediastinal shift (toward)

A

large atelectasis

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118
Q

ABI: PAD

A

< 0.90

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119
Q

ABI > 1.3

A

calcified or non compressible vessels – do more tests

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120
Q

GI sx/complications of HSP

A 
abdominal pain (nbd)
intussusceptions (bd)
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121
Q

bradycardia, AV block, hypotension, wheezing

A 
BB overdose
(consider CCB, digoxin or cholinergic agents w/o wheezing)
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122
Q

mgmt: BB overdoes

A

IVF
IV atropine
IV glucagon (if still hTN)
or try calcium, pressors, insulin/glucose

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123
Q

tx: anemia of prematurity

A

stop taking all their blood
iron supplement
transfusions if bad, but it doesn’t help long term

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124
Q

things that up warfarin (inhibit CYP450)

A 
tylenol/NSAIDs
abx/metronidazole
amiodarone
cimetidine/omeprazole 
SSRIs
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125
Q

things that down warfarin (induce CYP450)

A

carbamazepine/phenytoin
OCPs
phenobarbital
rifampin

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126
Q

CHF w/ LV hypertrophy but not HTN

A

think about amyloidosis

127
Q

waxy skin

A

amyloidosis

128
Q

niemann pick def

A

sphingomyelinase

129
Q

tay sachs def

A

beta hexosaminidase

130
Q

what to do when you suspect blunt aortic injury

A

CXR

131
Q

tx: mucormycosis

A

debridement and amphotericin B

132
Q

loud P2

A

think pulm HTN

133
Q

wedge shaped opacity on chest CT

A

think PE

134
Q

EKG: broad, notched P waves

A

mitral stenosis

135
Q

risk of cocaine in pregnancy

A

placental abruption

136
Q

fetal hydantoin syndrome

A

mom on anti-seizures (phenytoin, carbamazepine)

midfacial hypoplasia, microcephaly, cleft lip/palate, little fingers, hirsutism, developmental delay

137
Q

aplastic anemia vs aplastic crisis

A

aplastic anemia = pancytopenia

aplastic crisis is just RBCs, but super low (< 6)

138
Q

aplastic crisis vs splenic sequestration crisis

A

aplastic has low reticulocytes (< 1%)

splenic has higher + splenomegaly

139
Q

RFs for c. diff

A

abx, hospitalization, PPI

140
Q

MC meningitis in kids by age

A

< 3 mo: GBS, E. coli, listeria, HSV
3 mo - 10: strep pneumo, neisseria
> 11: neisseria

141
Q

PTU risks

A

liver injury/failure

142
Q

methimazole risks

A

teratogen (1st TM), agranulocytosis

143
Q

HIV screening test

A

assay for HIV p24 antigen and HIV Abs

confirmation w/ HIV-1/HIV-2 ab differentiation immunoassay

144
Q

ascending paralysis in hours/days w/o autonomic dysfunction

A

tick-borne paralysis (find that sucker)

145
Q

kidney stone: primary hyperPTH

A

calcium phosphate

146
Q

kidney stone: small bowel dz/resection

A

calcium oxalate

147
Q

kidney stone: recurrent UTIs

A

struvite

148
Q

kidney stone: RTA

A

calcium phosphate

149
Q

target cells

A

thalassemias

150
Q

alpha vs beta thalassemia minor

A

Hgb electrophoresis:
alpha = normal
beta = increased Hgb A2

151
Q

tx: inducible ischemia on nuclear stress test

A

BB and anti-platelet

152
Q

measles vs rubella

A

rubella doesn’t have Kopliks spots and rash doesn’t darken and its milder/shorter

153
Q

fundoscopy: pallor of optic disc, cherry red fovea

A

central retinal artery occlusion

154
Q

fundoscopy: grey, elevated retina

A

retinal detachment

155
Q

“curtain coming down over my eyes”

A

retinal detachment

central retinal artery occlusion

156
Q

CSF: herpes encephalitis

A

lymphocytes
RBCs
elevated protein

157
Q

where do you get colonic ischemia

A 
splenic flexure (SMA/IMA watershed)
rectosigmoid jxn (sigmoid/superior rectal watershed)
158
Q

when do you use unfractionated vs LMWH

A

ESRD

159
Q

ages for HPV vaccine

A

female: 11 - 26
males: 9 - 21 (9 - 26 for MSM or HIV)

160
Q

tx: PCP pneumonia

A

TMP-SMX

if PaO2 < 70 or A-a gradient > 35: add corticosteroid

161
Q

12 month old: how much should they weigh/be tall

A

weight x 3

height x 1.5

162
Q

MC location for HTN hemorrhagic strokes

A

BG (putamen)
cerebellar nuclei
thalamus
pons

163
Q

BG stroke –>

A

contra hemiparesis
contra sensory loss
conjugate gaze to side of lesion

164
Q

CF infections by age

A

< 20: staph

> 20: pseudomonas

165
Q

pneumo vaccine, who gets what + immune responses

A

polysaccharide (23) (< 65 w/ predisposing problems): T cell independent

conjugate (13) (kids): T-cell dependent

people > 65 and all immunocompromised get both

166
Q

psych med –> infertility

A

dopa blockers

167
Q

what else do you check when you have hypocalcemia

A

alb and Mg

low-> hypocalcemia

168
Q

hepatojugular reflux

A

failing right ventricle (can’t deal with the increase in venous return)

169
Q

Kussmaul’s sign

A

increase in jugular venous pressure on inspiration

a/w constrictive pericarditis

170
Q

pregnancy liver d/os

A

intrahepatic cholestasis of pregnancy
HELLP
acute fatty liver of pregnancy

171
Q

3rd TM: itchy papular rash around umbilicus

A

pruritic urticarial papules and plaques of pregnancy

172
Q

pregnancy: general pruritus, worse at night, worse on palms/soles

A

intrahepatic cholestasis of pregnancy

173
Q

acute otitis media vs otitis media w/ effusion

A

OMWE: middle ear effusion w/o inflammation

turns out acute otitis media has an effusion anyway

174
Q

drugs a/w photosensitivity

A 
tetracyclines
chlorpromazine
furosemide
HCTZ
amiodarone
promethazine
175
Q

anti-endomysial abs

A

celiacs

176
Q

anti-cardiolipin abs

A

antiphospholipid syndrome

177
Q

DM med that helps lose weight

A

GLP-1 receptor agonists (-atides)

178
Q

tx: OCD

A

SSRI

CBT (exposure and response prevention)

179
Q

definition of preeclampsia

A

new onset HTN (>140/+/- >90) @ > 20wks

proteinuria +/- end organ damage

180
Q

RFs for pubic symphysis diastasis

A

macrosomia
multiparity
precipitous labor
operative delivery

181
Q

McRoberts maneuver complication

A

mom femoral nerve damage

182
Q

tx: postpartum endometritis

A

clindamycin + gentamicin

183
Q

tx: impetigo

A

limited: topical mupirocin

extensive or bullous: oral cephalexin or clinda

184
Q

HCM murmur

A

systolic

improved w/ more blood

185
Q

murmur with dual upstroke of carotid pulse

A

HCM

186
Q

CN responsible for corneal reflex

A

CN V (trigeminal)

187
Q

indications for carotid endarterectomy

A

males: > 60% (asx); > 50% sx
females: > 70 %

188
Q

dx: hemorrhagic stroke

A

CT w/o contrast

189
Q

tx: TCA overdose

A

supportive: O2/IVF
1st 2 hrs: activated charcoal
wide QRS: IV bicarb (alleviate depression of Na channels)

190
Q

dx: lactose intolerance

A

hydrogen breath test

stool: increased stool osmotic gap, low stool pH

191
Q

talk about K levels in DKA/HHS

A

insulin deficiency and hyperosmolarity take K out of the cells (up K)
but you’re peeing out a million everything (down K)
so even though levels look normal, the total is low

192
Q

tx: central retinal artery occlusion

A

ocular massage and high flow O2

193
Q

when do you bx a mole (even if it’s good by ABCDE)

A
  • person has lots, but one is diff from the others (ugly duckling)
  • nodularity
  • itch or bleed
194
Q

contraindications to rota vaccine

A

past intussusception

hx of Meckel’s (or other GI malformation)

195
Q

newborn CXR: diffuse reticulogranular pattern

A

respiratory distress syndrome

196
Q

when do strawberry hemangiomas go away by

A

5 - 8 yo

197
Q

digoxin causes what arrhythmia

A

atrial tachycardia w/ AV block

198
Q

pain along tendon sheaths

A

tenosynovitis

199
Q

polyarthralgia, tenosynovitis, painless vesiculopustular skin lesions

A

disseminated GC

200
Q

workup: precocious puberty

A

central or peripheral?

central: high FSH/LH from high GnRH
peripheral: low FSH/LH w/ gonads or adrenals going wild

201
Q

sausage digits

A

dactylitis

psoriatic arthritis

202
Q

arthritis + nail stuff

A

think psoriatic arthritis

203
Q

rash in fat embolism

A

petechiae

204
Q

fat embolism time frame

A

12 - 24 hrs after injury

205
Q

complications of SAH

A

rebleed (first 24 hr)
vasospasm (3 days +)
seizures
SIADH/hNa

206
Q

when will you see xanthochromia

A

6 hr after onset

207
Q

mammography: microcalcifications

A

ductal carcinoma in situ

208
Q

breast: diffuse nodularity with b/l mastalgia

A

fibrocystic changes

209
Q

breast: fixed, palpable mass with irregular borders

A

lobular breast carcinoma

210
Q

corkscrew esophagram

A

diffuse esophageal spasm

211
Q

which do you use for number needed to treat: RRR or ARR

A

ARR

212
Q

recurrent, predictable vomiting w/ no sx between episodes

A

cyclic vomiting syndrome

213
Q

CD4 count for HIV associated dementia

A

< 200

214
Q

where is 0 station

A

midway btwn ischial spines

215
Q

quick loss of fetal station

A

think uterine rupture

216
Q

painless vaginal bleeding upon rupture of membranes

A

think vasa previa

217
Q

tx: post nasal drip

A

antihistamine or antihistamine + decongestant

218
Q

categories of DM retinopathy

A

simple
pre-proliferative
proliferative/malignant

219
Q

fundoscopy for DM retinopathy (categories)

A

simple: microaneurysms, hemorrhages, exudates, edema
pre-proliferative: cotton wool spots
proliferative/malignant: newly formed vessels

220
Q

workup: primary amenorrhea

A

uterus?

yes –> FSH (increased –> karyotyping; decreased –> MRI)

no –> karyotype, serum T (XX, normal –> abnormal mullerian; XY, normal –> androgen insensitivity syndrome)

221
Q

tx: ringworm

A

local: topical clotrimazole

extensive/refractory: oral griseofulvin

222
Q

infant: webbed neck, cleft lip, thumb things, macrocytic anemia

A

Diamond-Blackfan syndrome

223
Q

infant: cafe-au-lait, microcephaly, no thumbs, pancytopenia, macrocytosis

A

Fanconi anemia

224
Q

big, tender lymph node in kids (+ MC org)

A

lymphadenitis
staph aureus
GAS

225
Q

lymphadenitis in older kid w/ periodontal dz

A

think peptostreptococcuss

226
Q

skin things in cushing syndrome

A

striae
dermal atrophy
easy bruisability
(apparently all because CT breaks down)

227
Q

what does the D-xylose test show you

A

shows if intestines are absorbing properly (if they are, most of it is absorbed and peed out)

only for small intestine mucosal dz (not enzymatic activity since you don’t need any enzymes to absorb D-xylose)

228
Q

HMB +/- dysmenorrhea: get the uterus stuff straight

A

adenomyosis: HMB and dysmen
fibroids: more HMB, less dysmen
PID: no HMB yes dysmen
endometriosis: no HMB, yes dysmen

229
Q

acanthosis nigricans

A 
insulin resistance (young, fat)
GI malignancy (older)
230
Q

indications for parathyroidectomy

A

sx hypercalcemia

asx hypercalcemia w/ complications (osteoporosis, stones) or young < 50

231
Q

mid diastolic sound

A

think pericardial knock

232
Q

enzyme def: ambiguous genitalia in girls and HTN/fluid/salt retention

A

11 beta-hydroxylase
(low cortisol and aldo, but increased 11 stuff (which acts like a mineralocorticoid))
high T

233
Q

enzyme def: ambiguous genitalia in girls and hTN/salt wasting

A

21-hydroxylase
low cortisol and aldo
high T

234
Q

enzyme def: low cortisol, high mineralocorticoids, high T

A

17 alpha hydroxylase

235
Q

conjunctival edema

A

allergic conjunctivitis

236
Q

gritty feeling in eye

A

viral conjunctivitis

237
Q

dementia w/ hallucinations

A

lewy body dementia

238
Q

fluids (+ insulin) in DKA/HHS

A 
initially NS (+ IV insulin)
add dextrose 5% when glucose < 200 (+switch to SQ insulin)
239
Q

healthy people w/o RF PPD

A

> 15 mm

240
Q

blunt trauma: when do you FAST vs serial abd exams/CT

A

FAST it they’re awake/alert

241
Q

contraindications for exercise in preg

A 
amniotic fluid leak
cervical incompetence
multis
placenta abruption/previa
preeclampsia/gest HTN
severe heart/lung dz
also no hot yoga
242
Q

MC orgs sickle cell sepsis (apparently this just like, happens)

A

strep pneumo
H flu
neisseria meningitidis

243
Q

prevention: sickle cell sepsis

A

vaccinations
PCN till age 5
folic acid supplementation

244
Q

tx: lichen sclerosus

A

topical clobetasol

245
Q

MC childhood cancer

A

ALL

246
Q

preseptal cellulitis vs orbital cellulitis

A

orbital has ophthalmoplegia and pain with EOM

orbital can have proptosis or vision impairment

247
Q

tet spells

A

ToF

248
Q

cohort vs case control

A

cohort = start with RFs, compare dz incidence

case control = start w/ dz, look at past RFs

249
Q

tx: celiacs

A

dapsone and gluten free

250
Q

epigastric pain + vomiting 24-36 hrs post abdominal trauma

A

think duodenal hematoma

251
Q

tx: minimal change dz

A

corticosteroids

252
Q

tx: uric acid stones

A

hydration
alkalinization of urine (K citrate)
low purine diet
recurrent –> add allopurinol

253
Q

posterior MI: LCX or RCA

A

both have ST depression in V1 - V3
LCX: ST elevation in I and aVL
RCA: ST depression in I and aVL

254
Q

ST elevations in some/all V1 - V6: MI (+ vessel)

A

anterior MI (LAD)

255
Q

ST elevation in I, aVL, V5, V6: MI (+ vessel)

A

lateral MI (LCX, diagonal)

256
Q

ST depression in II, III, aVF

A

lateral MI (LCX, diagonal)

257
Q

water hammer pulse

A

AR

258
Q

mass in anterior mediastinum

A

thymoma

259
Q

mass in middle mediastinum

A 
bronchogenic cyst
tracheal tumors
pericardial cysts
lymphoma
LN enlargement
arch aortic aneurysms
260
Q

mass in posterior mediastinum

A 
all neurogenic tumors:
meningocele
enteric cysts
lymphomas
diaphragmatic hernias
esophageal tumors
aortic aneurysms
261
Q

muddy brown casts

A

ATN

262
Q

waxy casts

A

chronic renal failure

263
Q

RBC casts

A

glomerular dz or vasculitis

264
Q

fatty casts

A

nephrotic syndrome

265
Q

broad casts

A

chronic renal failure

266
Q

WBC casts

A

interstitial nephritis

pyelonephritis

267
Q

hyaline casts

A

nephrotic syndrome

268
Q

increased breath sounds

A

consolidation

269
Q

tx: pagets

A

bisphosphonates

270
Q

dx: amyloidosis

A

fat pad bx

271
Q

tests before starting Li

A

UA
BUN, Cr
thyroid fxn

272
Q

transplant a tylenol overdose?

A

apparently yes

273
Q

head MRI: numerous minute punctate hemorrhages

A

think diffuse axonal injury

274
Q

CT: crescentic collection

A

subdural

275
Q

CT: biconvex collection

A

epidural

276
Q

post MVA: pt loses consciousness instantly then –> vegetative state

A

think diffuse axonal injury

277
Q

definition abnormal uterine bleeding

A 
heavy
> 7 days
more often than every 21 days
less often than every 35
any post meno bleeding
278
Q

when do you do an EMB: > 45 yo

A

any abnormal uterine bleeding

279
Q

when do you do an EMB: < 45 yo

A

abnormal uterine bleeding + (any of following)

  • unopposed estrogen exposure
  • failed medical mgmt
  • lynch syndrome (HNPCC)
280
Q

MCC megaloblastic anemia in alcoholics

A

folate def

281
Q

mgmt: eclampsia

A

mg sulfate
anti-HTN (hydralazine, labetalol…)
deliver

282
Q

when do you treat moms for GBS

A

+ test: during labor

unknown and < 37 wks: during labor

283
Q

nephrotic syndrome complications

A

edema (hypoalbuminemia)
hypercoagulability (–> renal vein thrombosis, PE)
hyperlipidemia
microcytic hypochromic anemia (iron resistant)
decreased thyroxin
vit D def
infection

284
Q

white reflex (aka + dz)

A

leukocoria

retinoblastoma

285
Q

premie: lethargy, hypotonia, rapidly increasing head circumference, bulging fontanelle

A

intraventricular hemorrhage

286
Q

why do serial head U/S in premies

A

screening for intraventricular hemorrhage (up to half are asx)

287
Q

complications of temporal arteritis

A

aortic aneurysm (get serial CXRs)

288
Q

vaccines for chronic liver dz

A

Tdap/Td
flu
pneumo (23, then 13+23 @ 65)
hep A/B

289
Q

workup: low TSH, high T3/T4

A
  1. RAIU (unless clearly graves)
    2a. high uptake –> graves (diffuse pattern) or toxic adenoma/multinodular (nodular)
    2b. low uptake –> 3
  2. measure thyroglobulin
    4a. high –> thyroiditis (spills pre-formed)
    4b. low –> exogenous hormone, struma ovarii?
290
Q

ALL cell levels

A

+/- leukocytosis

anemia and or thrombocytopenia

291
Q

skin rash worsened by hot drinks, EtOH, sun or emotion

A

rosacea

292
Q

what do you transfuse with for severe hemorrhage (trauma)

A

whole blood

293
Q

what do you transfuse with for acute GI bleed

A

PRBCs

294
Q

early onset HTN and bilateral abdominal masses

A

ADPKD

295
Q

bilateral flaccid paralysis, loss of pain/temp, vibration/proprio in tact

A

anterior spinal cord syndrome (disruption of anterior spinal artery)

296
Q

prophylaxis post organ transplant

A

TMP-SMX (PCP)

-cyclovir (CMV)

297
Q

paraneoplastic lung cancers

A

squamous cell: PTHrP

small cell: SIADH, ACTH

298
Q

MC orgs brain abscess

A

viridans strep
staph aureus
gram negs

299
Q

CT: hypodense lesions in temporal lobe

A

think HSV

300
Q

CT: single ring enhancing lesion w/ central necrosis

A

think brain abscess

301
Q

signs it was prob just a febrile seizure

A

return to mental baseline (after post-ictal)

normal neuro exam

302
Q

why do you get tardive dyskinesia

A

dopa receptor supersensitivity

303
Q

mgmt: inevitable abortion

A

hemo stable: misoprostol, nothing or D&C

hemo unstable: D&C

304
Q

why can’t you use oxytocin for 1 TM/2 TM abortions

A

there aren’t many oxytocin receptors on uterus yet

305
Q

baby with retinal hemorrhages and bulging fontanelle

A

abusive head trauma –> subdural bleeding

306
Q

sx of hypercalcemia

A

abdominal pain
constipation
polydipsia

307
Q

tx: pinworm (+aka)

A 
enterobius vermicularis (butthole guy)
albendazole or pyrantel pamoate (esp preggers)
308
Q

tx: strongyloides

A

ivermectin

309
Q

tx: amebiasis

A

metronidazole

310
Q

tx: chagas

A

benznidazole

311
Q

tx: river blindness (+aka)

A

onchocerciasis

ivermectin

312
Q

urticaria, abdominal pain, resp problems

A

think strongyloidiasis

313
Q

thyroid and bones

A

hyperthyroid –> up osteoclast activity –> bone loss, osteoporosis, hypercalcemia

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