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USMLE Step 2 > Uworld > Flashcards

Uworld Flashcards

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USMLE® Step 1 flashcards
1
Q

organophosphate poinsing t

A

atropine

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2
Q

bladder DOME rupture can cause…

A

diffuse chemical peritonitis

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3
Q

autism on the test

A

repetitive behaviors

behavioral regidity

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4
Q

management of SIADH

A

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

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5
Q

how to manage hypothyroid when someone becomes pregnant

A

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

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6
Q

ethylene glycol poisoining

A

flank pain, hematuria, oliguira

  • hypocalcemia + calcium oxalate crystals
  • anion gap metabolic acidosis

tx with fomepazole

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7
Q

clinical features of methanol ingestion

A

central scotoma
APD
altered mentation

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8
Q

who should get washed RBC?

A

IgA defic
complement defic
repeated reactions despite antihistamine

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9
Q

how to prevent non hemolytic febriel transfusion reaction

A

leukoreduction

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10
Q

risk of testicular cancer in cryptorchidism after orchiopexy

A

remains elevated

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11
Q

murmur of pulmonic vlave stenosis

A

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
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12
Q

differentiating sx in NMS vs SS

A

NMS= higher fever, rigidity

SS= hyperreflexia, myoclonus

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13
Q

atomoxetine

A

SNRI first line alternative to stimulants in ADHD

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14
Q

chanfges you’ll see on echo in hypovolemic shock

A

decreased size of LV (less blood) with INC ejection fraction

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15
Q

when do you use steroids with TMP-SMX in PCP pna

A

when PaO2 <70 or Aa >35

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16
Q

MRI vs XRAY for low back pain

A

XRAY- malignancy, AS, osteoporossis

MRI- neuro changes

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17
Q

management of GDM
1)
2)

A

1) dietary modifications

2) INSULIN!

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18
Q

community acquired MRSA pna

A

Staph A pna after influenze –> high fever, multilobular infiltrates and cavities on CXR

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19
Q

coagulability in pregnancy

A

hypercoag state –> dec prot S, inc fibrinogen

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20
Q

bruton agammglobulinemia

A

dec lymphoid tissue do to bad B cell development

-inc sinopulm and GI infections

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21
Q

ADA deficiency

A

SCID –> T cell immunity doesn’t develop

  • recurrent viral, fungal, bacterial infx
  • FTT
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22
Q

chronic granulomatous dz

A

recurrent skin and lung infx with CATALASE + organisms due to impaired oxidative burst

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23
Q

first step in acetaminophen OD with n signs of toxicity

A

activated charcoal, check levels –> nac

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24
Q

first step in dx infertility

A

semen analysis

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25
Q

when do you give steroids in neonatal meningitis?

A

when its H flu to prevent sensorineural hearing loss

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26
Q

drug induced acne

A

steroids most commonly –> monomorphic papular rash without pustules or comedones most commonly on back, shoudlers, arms

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27
Q

infective endocarditis that looks like PNA

A

IV drug use –> R heart –> rarely has audible murmur and shows less typical signs

throws septic emboli into lungs that cause cavitation lesions

28
Q

most common reason fr arrested secnd stage of labor

A

fetal malposition

29
Q

abnormal glandular cells on pap

A

cervical or endometrial cancer

if >35 –> endometrial bx!

30
Q

t/f: oxalate absoprtion is inc in fat malabsorption disorders like chrons

A

true –> oxalate stones

31
Q

chronic pancreatitis

A

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
32
Q

dx of intussuption

A

air/saline enema

33
Q

decreased libido after Hsyt+ BSO

A

decreased androgens

(postmenopausal ovaries produce testosterone and androgens that peripherally convert to androgens in adipose tissue and are thought to be important for libido)

34
Q

valvovaginal atrophy

A

aka –> atrophic vaginitis, aka menopausal genitouirnary syndrome

can present with:

  • vaginal dryness
  • urinary incontinence!
35
Q

homemade alcohol

A

think lead poisoning! look fr vague GI, neuro complaints

**lead poisoning can increase uric acid and gout.

36
Q

vitamin K deficiency

A

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)

37
Q

how do you manage ACUTE organ rejection?

A

increase imunosuppressants/ steroids

38
Q

when do you do bronchoscopy for hemoptysis? when do you do arteriography?

A

> 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

39
Q

what is greatest risk to patient with massive hemoptysis?

A

asphyxiation from blood in the airway

-do a bronch to localize bleed and put them in dependent position

40
Q

non stimulant, non addictive options for ADHD

A

1) atomoxetine

2) bruproprion and TCA

41
Q

effect of anteverted/anteflexed uterus on bladder?

A

compresses it

42
Q

define adenomyosis

A

endometrium WITHIN myometrium

43
Q

how should you admin vaccines to premies? what is the exception?

A

by CHRONOLOGICAL age

-Hep b: wait til babe is >2kg

44
Q

story like polymyositis but no ESR/CK in someone on high dose steroids?

A

glucocorticoid incuded myopathy

*begins weeks to months after induction

45
Q

acute urinary retention in someone who is on antihistamines…

A

they have anticholinergic effects and can push someone with BPH over the line to AUR

46
Q

triad presentation of aspergillosis

A

fever, pleuritic chest pain, hemoptysis

CT: halo sign= pulmonary nodules with surrounding ground glass opacities

47
Q

management of stillborn

A

offer autopsy.

48
Q

dx of perforated viscus

A

some hx of ulcer (ie NSAID use) with sudden onset peritonitis, rebound, decreased bowel sounds

dx= upright xray to show free air

49
Q

tx of TCA overdose

A

bicarb–> use EKG to determine if necessary

50
Q

explain secondary hyperparathyroidism in renal failure

A

renail failure –> decrease Vit D + phosphate retention –> dec CA ++ –> inc PTH (stilmulated by both low Ca and high Phos)

51
Q

first line treatment in ideopathic intracranial hypertension

A

acetazolamide
–> can add furosemide if still symptomatic

**rememeber you can see a CN6 palsy with this

52
Q

contact lens keratitis

A

usually gram negatives

53
Q

osteogenesis imprefecta II

A

rare form –> infants die in utero or shortly after birth due to THORACIC HYPOPLASIA, short femurs, multiple fractures

54
Q

bugs that raise vaginal pH

A

trich

gardnerella

55
Q

adjustment disorder

A

maladaptive emotional/behavioral response to a stressor that last <6 mo

56
Q

neiman pickk vs tay sachs

A

both are lysosomal storage disorders with cherry red spots

NP= Hepatomagaly + foam cells + areflexia

TS= hyperreflexia

57
Q

Gauche presentation

A

HSPM, pancytopenia, avascular necrosis of femur, bone crisis

tx= recombinant glucocerebrosidase

58
Q

selective IgA deficiency

A

Airway+ GI (inc giardiasis)
Atopy
Anaphylaxis (esp with foreign ag like blood transfusion)

59
Q

x linked (Bruton) agammaglobulinemia

b for boys

A

no b cell MATURATIN = lymphoid tissue atrophy

  • recurrent sinopulmonary infx after 6 months
  • all Ig levels dc
  • live vaccines CI
60
Q

CVID

A

defect in B DIFFERENTIATION

-dec plasma cells and Ig

61
Q

disseminated fungal or mycobacterial infx after BCG vaccine?

A

Il12 R deficiny –> decrease Th1 response

62
Q

Jobs syndrme (hyper IgE)

A

impaired neutrophil recruitment with INC IgE and eos

  • staph abscess
  • retained primary teeth
  • coarse facies
63
Q

SCID

A

no thymus and no GCs

  • recurrent diarrhea, thrush, FTT
  • treatment is IVIG and BM transplant

ADA deficiency is common cause

64
Q

wiskott Aldrich (WATER)

A

Wiskot-Aldrich

  • Thrombocytopneia
  • Eczema
  • Recurrent pyogenic infx

dec IgG, IgM
inc IgE, IgA

65
Q

chronic granulomatous dz

A

recurrent cat + infections due to problem with respiratory burst

USMLE Step 2 (18 decks)

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