Uworld Flashcards
1
Q
Supratherapeutic INR management
A
9 hold and give 2.5-5 mg PO vitamin K
2
Q
Before diagnosis of basilar migraine can be given, what imaging needs to be done?
A
MRI and MRA as need to exclude vascular lesions
3
Q
Screening u/s for hepatocellular carcinoma interval in active hep B?
A
6 months even in the absences of cirrhosis. Hep C needs to have progressed to cirrhosis
4
Q
Treatments for traveler’s diarrhea?
A
quinolones or azithromycin (good for SE Asia)
5
Q
Molluscum contagiousm associated illness?
A
Most common in children. It is also more prevelant in those who are immunosuppresed, so get HIV testing
6
Q
IBD releated rectovaginal fisutla
A
Mild treat with abx, if moderate then treat with more potent immunomodulators and if that fails then surgery
7
Q
Which pathogens causing catheter related infection necessitate removal?
A
Staph, Pseudomonas, fungi and myobacteria
8
Q
CCB induced peripheral edema?
A
ACEi can reduce the incidence, diuretics are not helpful
9
Q
Porpheria is associated with?
A
Hep C infection
10
Q
Cardiac complications of ankylosing spondylitis?
A
Can have aortic valve disease
11
Q
Side effects of linezolid?
A
Bone marrow suppression, peripheral neuropathy, and optic neuropathy
12
Q
Timing of pre-eclampsia
A
Usually after 20 weeks but can occur up to 4 weeks after delivery
13
Q
Headache with ADPKD?
A
Do not forget about their increased risk of intracranial aneurysms
14
Q
Non-motor symptoms of early parkinson disease?
A
- sleep issues (REM sleep behavior disorder), daytime sleepiness
- mood disturbances
- anosmia
- constipation
15
Q
Varicoceles and further workup?
A
- R sided obtain CT abdomen and pelvis
- L and does not improve when supine consider CT
16
Q
Rare colchincine side effect?
A
Can result in neuromyopathy, not just a simple myopathy like a statin. Think about in CKD patients on it.
17
Q
When to use calcitonin?
A
Ca>14
18
Q
Sensitivity =
A
TP/(TP+FN)
19
Q
Specificity =
A
TN/(TN+FP)
20
Q
PPV =
A
TP/(TP+FP)
21
Q
NPV =
A
TN/(TN+FN)
22
Q
Steroid induced osteoporosis?
A
Start bisphosphonate if >7.5 mg/day, man >50 or postmenopasual
T score between -1.0 and -2.5
23
Q
Location of lung adenocarinoma?
A
Periphery
24
Q
Dermatomyocytisis GI complications?
A
esophageal dysmotility, increased risk of aspiration PNA
25
Arthritis in sarcoid?
NO
26
Pelvic actinomyses, presents as?
Smouldering infection with multiple cystic pelvic masses
27
Iron on bone marrow biopsy in anemia of chronic disease?
Will be present in macrophages but absent in RBC precusors
28
Presentation of calciflyaxis?
PAINFUL subQ nodules that can progress to ulcers
29
Necrobiosis lipodica?
Asymptomatic indurated yellow plaques
30
Vitamin D causing hypercalcemia?
If taking >4000 units a day
31
Age cut off for relative with CRC to make high risk?
If it develops before the age of 60
32
Cause of gastric fundal varcies without esophageal?
Splenic vein thrombosis
33
Antihypertensives and DM2 risk?
Carvediolol does NOT, other BB do
| thiazides, esp cholorthalidone does INCREASE risk
34
If think there is a DVT but u/s negative?
Repeat in 5-7 days
35
Unvaccinated contacts of person with active hep A infection?
If non-immunosupressed give hep A vaccine within 14 days
| immunosuppressed give hep IvIG
36
ICU BG goal?
140-180
37
Screening need with new diagnosis of primary sclerosing cholangitis?
colonoscopy
| also at higher risk for GB and cholangiocarinoma
38
Cat bite abx treatment?
Augmentin
| if allergic doxy and metronidazole
39
Moderate aortic stenosis defined as?
Mean gradient of 25-40 mmHg, valve area of 1-1.5 cm
| Get echo every 1-2 years
40
Causes of spherocytes on peripheral smear?
Autoimmune hemolysis
| Heriditary spherocytosis
41
Causes of bite cells?
D/t macrophages removing denatured hemoglobin, see in alpha thalassemia and G6PD def
42
Treatment of MAC?
macrolide (clarithromycin/azithro) + ethambutol + rifampin
43
Testing in suspected multiple myeloma?
Need to get serum light chain or urine immunofixation in addition to serum protein electrophoresis as this will not get light chain variant MM
44
Metformin and vitamin def?
Reduces absorption of B12
45
Imaging for suspected pancreatic malignancy?
Start with CT scan before EUS
46
Causes of falsely low FeNa
Rhabdo
47
CXR in chronic eosinophilic pneumonia?
"photonegative" pulmonary edema
| Fever, nightsweats, and wt loss
48
CXR in pulmonary alveolar proteinosis?
Central infiltrates
49
Cause of cortical hemorrhage?
cerebral amyloid angiopathy
50
Hemorrhage in thalamus, pons, cerebellum?
HTN
51
Anti-coagulate with mitral stenosis if?
Afib (does not matter the CHADS score), LA >5.5 cm
52
Disease associated with pseudogout?
Hemochromatosis and hyperparaythyroidism
53
HSV PCR?
If clinical suspicion is high enough even if negative would repeat and continue to treat
54
CKD and prolactin?
CKD can result in elevations of prolactin
55
Testing with new dx of medullary thyroid cancer?
RET testing to look for MEN
56
Follicular thyroid cancer tumor marker?
thyroglobulin
57
Treatment of toenail fungus?
Only after confirming with scraping and then use terbinafine
58
Lab findings with rheumatoid pleural effusion?
very low pH and glucose
very high LDH
cell count
59
When is surgery indicated for hyperparathyroidism?
Ca >1 above normal
| GFR
60
Treatment of latent syphilis of unknown duration?
B penicllin weekly x3 weeks
61
Complications of unrepaired PDA?
pHTN and increased risk of endocarditis
62
Sjogren and renal involvement?
chronic interstitial nephritis
| tubular dysfunction with hypokalemia, RTA or diabetes incipidus
63
Size cut off for parapneumonic effusion on decubitus film?
>10 mm needs chest tube
64
CSF VRDL sensitivity?
Not great, can be negative!
65
Lichen planus is associated with what infection?
Hep C
66
CK in PMR?
NORMAL
67
Stool osm
stool osm - 2 (Na+K)
| 125 osmotic
68
Atypical antipsychotics with lowest rate of EPS?
Quetiapine and clozapine
69
Bacteria that cause struvite stones?
Klebsellia as well as proteus
70
DLCO in pHTN?
Can be pretty reduced, 50-60% of normal
71
COPD and oxygen for flying?
If SpO2 is >95% on RA do not need to test
72
Management of small corneal abrasion?
Topical abx
73
Treatment of psoriatic arthritis?
MTX is 1st line
TNF can be used
sulfasalazine is 3rd line
74
Early presentation of cataracts?
Trouble with distance vision before clouding
75
Appearance of toxo?
MULTIPLE ring enhancing lesions
76
Brain abscess versus met on MRI?
Abscess causes an area of restricted diffusion, met will NOT
77
Guttate psorasis?
Wide spread and frequently appears 2-3 weeks after strep infection
78
Characterization of ascities by total protein?
Total protein >2.5 (CHF, carcinomatosis, Tb, fungal)
| Total protein
79
Characterization of ascities by SAAG?
>1.1 cardiac or cirrhosis
80
Reactive arthritis occurs after?
Gi infection with salmonella, shigella or camplobacter
Chlamydia infection
NOT gonorrhea which is actually a disseminated infection if have arthritis
81
Treatment of alopecia areta?
Intralesional steroid injection
82
Cyclosporin renal toxicity findings?
```
hyperkalemia
low PO4
high uric acid
low mag
Oblierative arteriopathy and global and focal segmental glomerusclerosis
```
83
High risk ulcer?
```
Adherent clot
Arterial
non-bleeding visible vessel
oozing
Watch for 3 days!
```
84
Treatment of bipolar depression?
Can use quetapine
85
Dx Paget disease?
Bone scan
86
Isopropyl alcohol metabolic effect?
NO elevation in AG
87
NPPV after extubation?
Only if for COPD and do it right away, if intubated for other causes and failing again re-intubate
88
GBS and findings on LP?
NO WBC
89
IgG4 related disease?
Autoimmune pancreatitis, but also lymphadenopathy, salivary gland involvement
90
Treatment of hypertriglyceridemia causing acute pancreatitis?
If patient is hemodynamically stable can do plasmapharesis, if NOT can do insulin and glucose
91
Other symptoms with secondary syphilis
Can have generalized lyphadenopathy and patchy alopecia
92
Management of acute bone met pain?
Need IV bisphosphonates or denosumab.
| CANNOT use PO bisphosphonates as onset is too slow
93
Exposed to Tb and negative skin test?
Repeat in 8-12 weeks
94
DM1 antibodies?
islet cells or glutamic acid decarboxylase
95
Testing in PCOS?
Cortisol, prolactin, TSH, IGF-1, DHEAS and 17-hydroxyprogesterone to r/o other causes
96
Asbestosis effusion characteristics?
High in eosinophils
97
Myasthenia exacerbation and respiratory monitoring?
Vital capacity (
98
Statins with lowest potential for myopathy?
Rosuvastatin, pravastatin and fluvastatin
99
Last line agent in osteoprosis?
Teriparatide (recombinant PTH)
100
Appearance of calcium oxalate crystals?
Envelope shaped
101
Appearance of uric acid crystals?
rhomboid
102
Appearance of cystine crystals?
Hexagonal
103
c-ANCA is?
PR3
104
p-ANCA is?
MPO
105
Cancer and acromegaly?
increased risk of colon cancer
106
+LR =
sensitivity/ (1-specificity)
107
-LR =
1-sensitivity/specificity
108
Cell counts for peritonitis on PD?
only need WBC>100 or >50% neutrophils and treat with IP vanco and cephalsporin
109
Antibody in primary biliary cirrhosis?
anti-mitochondrial antibody
110
Antibody in systemic sclerosis?
anti-DNA topoisomerase 1 (SCL-70)
111
Cut off for LV wall thickness in atheletes heart?
>15 mm then it is likely HOCM
112
BP goals in ischemic stroke if NOT getting TPA?
Systolic
113
Causes of malignancy induced hypercalcemia?
PTHrP 80%
| 20% d/t bone mets
114
Cluster headache prophylaxis?
Verapamil
115
Unusual cause of elevated LFTs?
Do not forget to screen for celiac disease
116
Management of asplenic patients with fever?
Should be given abx prophylaxis and seek urgent evaluation
117
Treatment of charcot joint?
Casting with non-wt bearing
118
Blasto can cause?
Skin ulcers/plaques
Bone lesions
and GU involvement as well
119
Histo can cause?
hilar lymphadenopathy, hepatosplenomegaly, pancytopenia and adrenal insuffiency
120
Coccido can cause?
skin (including erythema nodosum), lymph node enlargement and osteoarticular involvement
121
LVEDP and RVEDP are equal
constrictive pericarditis
122
Methylglobinemia
Suspect with clinical cyanosis but normal arterial Po2, pulse ox reading of 85%
Dapsone, nitrates, topical local anesthetics
123
Colon cancer screening for patient with ulcerative colitis?
Start annually 8-10 years after diagnosis
124
In acute HIV infection wait for resistance tests?
No need, tailor therapy later
125
Pitutary mass and visual fields?
If >10 mm check them and look for hypofunction
126
Pharmacologic treatment of anorexia?
Olanzapine
127
Cervical cancer screening?
21-29 cytology every 3
| 30-65 cytology every 3 OR cytology + HPV every 5
128
For PTH to cause epo resistance?
Must be >150
129
Most common cause of epo resistance?
Iron def
130
Measure of dialysis adequacy?
Calc by machine Kt/V >1.3
131
Treatment of paroxysmal hemicrania?
Indomethicin
132
Pitutary the cause of prolactin elevation?
>200
133
Folic acid def?
Besides anemia causes stomatitis, must replace when on MTX
134
Speed healing of venous stasis ulcers?
ASA and compression
135
Gram + rods on blood culture?
Listeria, corynbacterim, clostridium and nocardia
