Uworld Flashcards
organophosphate poinsing t
atropine
bladder DOME rupture can cause…
diffuse chemical peritonitis
autism on the test
repetitive behaviors
behavioral regidity
management of SIADH
mild, no sx 130-135= fluid resus
OR –> if it is chronic and axymptomatic and lower, fluid restriction is okay
ACUTE,severe, symptomatic <120= hypertonic saline!! but go slowly
how to manage hypothyroid when someone becomes pregnant
T4 increases by bHCG, and estrogen by increasing TBG
TSH decreases due to feedback inhibition of above
SO, increase levothyroxine dose ~ 30 % and then adjust after first trimester
ethylene glycol poisoining
flank pain, hematuria, oliguira
- hypocalcemia + calcium oxalate crystals
- anion gap metabolic acidosis
tx with fomepazole
clinical features of methanol ingestion
central scotoma
APD
altered mentation
who should get washed RBC?
IgA defic
complement defic
repeated reactions despite antihistamine
how to prevent non hemolytic febriel transfusion reaction
leukoreduction
risk of testicular cancer in cryptorchidism after orchiopexy
remains elevated
murmur of pulmonic vlave stenosis
isolated congential finding
- similar to AS but INCREASES WITH INSP and has a loud S2
- can present as R heart failure signs in a child
differentiating sx in NMS vs SS
NMS= higher fever, rigidity
SS= hyperreflexia, myoclonus
atomoxetine
SNRI first line alternative to stimulants in ADHD
chanfges you’ll see on echo in hypovolemic shock
decreased size of LV (less blood) with INC ejection fraction
when do you use steroids with TMP-SMX in PCP pna
when PaO2 <70 or Aa >35
MRI vs XRAY for low back pain
XRAY- malignancy, AS, osteoporossis
MRI- neuro changes
management of GDM
1)
2)
1) dietary modifications
2) INSULIN!
community acquired MRSA pna
Staph A pna after influenze –> high fever, multilobular infiltrates and cavities on CXR
coagulability in pregnancy
hypercoag state –> dec prot S, inc fibrinogen
bruton agammglobulinemia
dec lymphoid tissue do to bad B cell development
-inc sinopulm and GI infections
ADA deficiency
SCID –> T cell immunity doesn’t develop
- recurrent viral, fungal, bacterial infx
- FTT
chronic granulomatous dz
recurrent skin and lung infx with CATALASE + organisms due to impaired oxidative burst
first step in acetaminophen OD with n signs of toxicity
activated charcoal, check levels –> nac
first step in dx infertility
semen analysis
when do you give steroids in neonatal meningitis?
when its H flu to prevent sensorineural hearing loss
drug induced acne
steroids most commonly –> monomorphic papular rash without pustules or comedones most commonly on back, shoudlers, arms
infective endocarditis that looks like PNA
IV drug use –> R heart –> rarely has audible murmur and shows less typical signs
throws septic emboli into lungs that cause cavitation lesions
most common reason fr arrested secnd stage of labor
fetal malposition
abnormal glandular cells on pap
cervical or endometrial cancer
if >35 –> endometrial bx!
t/f: oxalate absoprtion is inc in fat malabsorption disorders like chrons
true –> oxalate stones
chronic pancreatitis
epigastric pain that relieves with leaning forward
- can have long pain free intervals
- amylase/lipase can be NORAML!!
- dx with CT which can show calcifications
dx of intussuption
air/saline enema
decreased libido after Hsyt+ BSO
decreased androgens
(postmenopausal ovaries produce testosterone and androgens that peripherally convert to androgens in adipose tissue and are thought to be important for libido)
valvovaginal atrophy
aka –> atrophic vaginitis, aka menopausal genitouirnary syndrome
can present with:
- vaginal dryness
- urinary incontinence!
homemade alcohol
think lead poisoning! look fr vague GI, neuro complaints
**lead poisoning can increase uric acid and gout.
vitamin K deficiency
normal stores= 30 days, but sick person with underlying dz can loose in 7-10 days
**think alcoholic, surgery (NPO) on abx (killing gut flora)
how do you manage ACUTE organ rejection?
increase imunosuppressants/ steroids
when do you do bronchoscopy for hemoptysis? when do you do arteriography?
> 600ml of blood or 100ml/hr/ hemodynamic instability
bleeding can be visualized and treated by bronch interventions, but if you CANT LOCALIZE, then do arteriography
what is greatest risk to patient with massive hemoptysis?
asphyxiation from blood in the airway
-do a bronch to localize bleed and put them in dependent position
non stimulant, non addictive options for ADHD
1) atomoxetine
2) bruproprion and TCA
effect of anteverted/anteflexed uterus on bladder?
compresses it
define adenomyosis
endometrium WITHIN myometrium
how should you admin vaccines to premies? what is the exception?
by CHRONOLOGICAL age
-Hep b: wait til babe is >2kg
story like polymyositis but no ESR/CK in someone on high dose steroids?
glucocorticoid incuded myopathy
*begins weeks to months after induction
acute urinary retention in someone who is on antihistamines…
they have anticholinergic effects and can push someone with BPH over the line to AUR
triad presentation of aspergillosis
fever, pleuritic chest pain, hemoptysis
CT: halo sign= pulmonary nodules with surrounding ground glass opacities
management of stillborn
offer autopsy.
dx of perforated viscus
some hx of ulcer (ie NSAID use) with sudden onset peritonitis, rebound, decreased bowel sounds
dx= upright xray to show free air
tx of TCA overdose
bicarb–> use EKG to determine if necessary
explain secondary hyperparathyroidism in renal failure
renail failure –> decrease Vit D + phosphate retention –> dec CA ++ –> inc PTH (stilmulated by both low Ca and high Phos)
first line treatment in ideopathic intracranial hypertension
acetazolamide
–> can add furosemide if still symptomatic
**rememeber you can see a CN6 palsy with this
contact lens keratitis
usually gram negatives
osteogenesis imprefecta II
rare form –> infants die in utero or shortly after birth due to THORACIC HYPOPLASIA, short femurs, multiple fractures
bugs that raise vaginal pH
trich
gardnerella
adjustment disorder
maladaptive emotional/behavioral response to a stressor that last <6 mo
neiman pickk vs tay sachs
both are lysosomal storage disorders with cherry red spots
NP= Hepatomagaly + foam cells + areflexia
TS= hyperreflexia
Gauche presentation
HSPM, pancytopenia, avascular necrosis of femur, bone crisis
tx= recombinant glucocerebrosidase
selective IgA deficiency
Airway+ GI (inc giardiasis)
Atopy
Anaphylaxis (esp with foreign ag like blood transfusion)
x linked (Bruton) agammaglobulinemia
b for boys
no b cell MATURATIN = lymphoid tissue atrophy
- recurrent sinopulmonary infx after 6 months
- all Ig levels dc
- live vaccines CI
CVID
defect in B DIFFERENTIATION
-dec plasma cells and Ig
disseminated fungal or mycobacterial infx after BCG vaccine?
Il12 R deficiny –> decrease Th1 response
Jobs syndrme (hyper IgE)
impaired neutrophil recruitment with INC IgE and eos
- staph abscess
- retained primary teeth
- coarse facies
SCID
no thymus and no GCs
- recurrent diarrhea, thrush, FTT
- treatment is IVIG and BM transplant
ADA deficiency is common cause
wiskott Aldrich (WATER)
Wiskot-Aldrich
- Thrombocytopneia
- Eczema
- Recurrent pyogenic infx
dec IgG, IgM
inc IgE, IgA
chronic granulomatous dz
recurrent cat + infections due to problem with respiratory burst
