Uworld 3 Flashcards
chondrocalcinosis
pseudogout –> CPPD
evaluate for: hyper PTH, hypothyroid, hemachromatosis
hemachromatosis
diabetes
hepatomegaly
arthralgia (assoc with pseudogout/ chondrocalcinosis)
how do breath sounds/ tactile fremitus change in consolidate process vs effusion
consolidation: sound travels faster through solids/liquids, so breath sounds inc (crackles, etc) and tactile fremitus increases
effusion: liquid OUTSIDE lung compresses it and shelters breath soudns and fremitus
methemoglobinemia
cyanosis that does not correct with O2 –> likely after expsoure to oxidizing agents like dapsone, benzocaine, lidocaine
low SaO2 with normal PaO2
co-oximetry can decipher types of hemoglobin
tx= methylene blue
methylene blue
reduces methemoglobin back to regular hemoglobin
dimercarpol
tx for lead poisoning
fomepizole
ethylene glycol, methanol poisoning
pralidoxime
antidote given with atropine in cholinergic poisoning
cardiac anomaly in marfans
AORTIC root dilation, causes regurg
AORTIC aneuryms
AORTIC dissections
evaluatin of physiologic galactorrhea
pregnancy test, TSH, PRL, maybe MRI
appearnce of lichen planus vs sclerosis
Planus= brightly erythematous and involves labia and vagina + mucosal invovlement
(6 P’s-pruritic, purple, polygonar, plaques)
sclerosis= thin, cigarette paper, only involves vulva, perianal thickening
oral involvenet of lichen Planus
lacy, reticular = wickham striae
6 P’s of lichen planus
Purple, Polygonal, Planar, Pruritic, Papules
can involve skin, mucosa, nails
tx= bx to rule out vulvar carcinoma, high dose steroids
best test with LOWER extremity changes in sensation, hy[erreflexia and babinski
MRI of the spine
UMN signs point to CNS involvement, and lower extremity only= spinal cord.
presentation difference (thinking about the fever) that’s different between roseala and measles
roseala –> rash AFTER fever
measles–> rash with fever
mechanism of TD with antipsychotics
UPregulation and supersensitivty of DA receptors…
how does caricocele contribute to decreasd fertility
increased temperature
boys= tx with gonadal vein ligation
older men= nsaids and supportive therapy
congenital VZV
limb hypoplasia
blindness
dermatomal scarring
congential HSV
disseminated can present without skin findings –> look for encephalitis with TEMPORAL EDEMA AND HEMORRAGE
causes of magnesium toxicity in pre-E
Mg is 100% cleared by kidneys so look at Cr
*first line reversal is Calcium gluconate
factrial design
randomizatoin into two interventions with additional study of 2 variable
ie: randomize by treatment and then randomize by two BP goals
cross over design
each group does one treatment, after a set number of weeks they switch groups and do the other
feature of hypovolemic shock and septic shock in terms of heart/ pulm pressures
DEC RA, PA, wedge
vessel distribution assoc with thalamic pain syndrome
deep penetrates of posterior cerebral artery
**occurs weeks to mnths after, presents with contralateral sensory loss from lacunar strke
aspiration pneumonitis
HOURS after asp of stomach acid
compared to aspiration PNA which comes days later
what to test for with unexplained cytopenias, like isolated thrombocytopenia
HIV, HCV
heart involvement of amyloidosis
accumulation of insoluble protein firbrils that commonly affect heart as restrictive cardiomyopatyh –> progresses to dilated cardio myopathy
easy brusing
proteinuria
neuropathy
hepatomegaly
who gets NEC
premies AND congenital heart problems who arn’t perfusing the gut well
**look for signs abdominal distention, billious vomiting, bloody stools, signs of vital sign instability like hypothermia from insensible loses
oral or systemic tx for vaginal candida?
oral fluconazole is first line for comfort purposes
pseudo hyphae with normal pH!
pulmonary edema in pre E
due to arterial vasospasm in inc systemic vascular resistance
**rare complication. dist from amniotic fluid embolism by BP and whether or not they are in labor
calcium/ phos in lactose intolerance/ fat malabsorption disorders
don’t absorb D –> dec gut absorption of C/Phos –> dec Ca, dec Phos –> Inc PTH
**secondary hyperparathyroidism
effect of Vit D on ca/phos
increased absorption of both at the gut
most common cause of spinal stenosis
DJD –> osteophytes and stuff
relief when leaning forward, worse with extension
gold standard dx for HIT? Classic features involved with injection site? Tx?
Serotonin relase assay
HIT skin necrosis at injection site on belly
STOP and start argatroban or fondoparinaux
hazard ration <1, 1, >1
<1= more likely in control 1= similar >1= more likely treatment
how do you dx HepC
2 steps:
- 1) ab
- 2) PCR
50% of patients spontaneously clear so you have to confirm it
meconium ileus vs hirschsprung in terms of consistency and location
MI= inspissated, ileum
HS= normal consistency, rectosigmoid
CMV colitis
immunocompromised patient with CD4 <50 presenting with small volume, frequent bloody stool and low grade fever
dx= colonoscopy looking for eso/baso internuclear inclusions
triad presentation of spinal epidural abscess
fever, back pain, focal neuro deficit
*these rarely all present. Staph a is most common organism
steps in caustic ingestion
1) ABC
2) remove clothing
3) EGD = diagnostic and should be done withn 24 hours. Too soon wont show full extent, too late is risk for perf
negative predictive value
probablitiy of being free of dz if a test result is negative
(high pretest probability= low NPV)
ROM that causes pain in rotatr cuff
abduction and external rotation
prader wili
loss of Paternal 15q11-q13
meds that cause iICH
tetracyclines
vit A derivatives
GH
aderenoleukodystrophy
congenital cause of AI characterized by build up of very long chain fatty acids
when to suspect a cholesteatoma
continued ear drainage for several weeks despite abx in a kid, granulation tissue and skin debris within retraction pockets of TM
- congenital or acquired from chronic OM
- think about with new onset hearing loss
- can lead to bad things
classic triad of resp signs in CF? why do they have bruising? differentiate from primary ciliary dyskinesia
- recurrent sinopulm infx, clubbing, nasal polyps
- impaired vit K asoprtions
PCD has all similar sx but NOT pancreatic insufficiency
primary ciliary dyskinesia
mucociliary clearnace problem
50% have situs inversus
management of neonatal hydrocele
conservative, should resolve in a year
-can be communicating or non communicating
how does succs work
depolarizing agent that binds post synaptic Ach receptors –> Na in, K out
how does etomidate lead to adrenal insufficiency
blocks 11b-OH
“diabetic neuropathy”
somatic nerves are central/ more susceptible to ischemia–> ptosis and down and out pupil
parasymp are outside–> preserved light rxn
alcohol/ sleep/ anxiety
someone who is only anxious at night…consider mild alcohol withdrawal
ACA stroke
- contralateral weakness/sensory loss mostly LOWER extremities
- urinary incontinence
refeeding syndrome
introduction of cards –> insulin spike –> uptake of Phos, Mg, K
Phos used up the most for ATP
K and Mg cause arrythmias –> can lead to fast volume overload and heart failure signs
mech of xs estrogen in obesity
androgens converted into estradiol
why do anovulatory cycles not produce progesterone
no development of corpus lutem
normal= corpus luteum secretes prog –> cnverst proliferative endometrium to secretory endometrium –> corpus lutem sheds –> period
hypercalcemia in quadriplegic?
immobilization
why/ when do you take out testes in AIS
after puberty, allow pt to reach maximum hiehg tand secondary development, but take them out because inc risk of cancer
in laryngomalacia, when is stridor exacerbated?
crying or stress
difference between mono presentation and acute HIV
similar, flu like illness
HIV- diarrhea, rash
Mono- tonsilar exudate
preE at <20 weeks
hydatidaform mole
risk for mole. presentation?
extremes of age, hx of mole
preE, hyperemesis gravidum, hyperthyroid, uterus>age
vitreous hemorrhage
sudden loss of vision with floaters –> common in diabetic neuropathy
central retinal vein occlusion
- sudden painless loss of vision
- disk swelling, retinal hemmorhage, venous dilation, ctton wool spots
**hypertension and atherosclerosis
retinal artery occlusion
sudden painless loss of vision with cherry red fovea
why are HSP kids at risk for intussusception
ileoedema and bleeding
**IgA vasculitis presents with palpable purpura, arthralgias, hematuria, abd pain
precipitators of thyroid storm
surgery, trauma, childbirth, infx, contrast load (iodine)
look for hyperthermia, tremor, agitation, delerium, LID LAG
tx with BB, PTU, glucocorticoids
feature of malignant hyperthermia you probably wouldn’t see in thyroid storm
presents with hypercarbia
hepatohydrothorax
transudative effusion through muscular defect in diaphgram (usu right) in liver failure patients
hepatopulmonary syndrome findings
intrapulmonary vascular dilations
- dyspnea while sitting up
- decrease SpO2 while sitting up
how does prevelance relate to PPV/NPV
inc Prevelance = inc PPV
dec prevelance= inc npv
tabes dorsalis presentation
romberg, sensory ataxia, neurogenic incontinence, argyll robertson pupils (don’t respond to light but do respnd to accomodation
what type of cancer is paget’s
adenocarcinoma
dangerous complications in mono
splenic rupture
airway compromise
AHIA –> IgM, coombs, inc retics
**happens about 2-3 weeks later
how do you address fixing refractory hypokalemia in alcoholic?
replete mag
