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Uworld questions > uworld 7 > Flashcards

uworld 7 Flashcards

1
Q

What meds can cause constipation?

A

numerous but esp anticholinergics. Hypothyroidism also can cause

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2
Q

How does amoxicillin type rash in EBV mono appear?

A

Occurs 24 hrs usually after taking drug, appears of polymorphous maculopapular rash.

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3
Q

How tx neutropenic fvr?

A

W/ broad spectrum ABX including P.A. coverage (i.e. cefepime, carbapenems, quinolones) usually quinolone + beta lactam

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4
Q

How prevent contrast induced nephropathy?

A

IV hydration needed, prevents renal vasoconstrxn and tubular injury, also nacetyl cysteine provides benefit

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5
Q

How differentiate asthma and COPD?

A

asthma reversible w/ bronchodilator while COPD is partially or non-reversible

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6
Q

Tx for asthma vs COPD?

A

inhaled steroids better for asthma but inhaled anticholinergics preferred for COPD.

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7
Q

Si/sx of sarcoidosis?

A

commonly AA women - > arthritis, lungs px w/ cough, dyspnea, fever, weight loss. Skin px w/ erythema nodosum, eyes px w. anterior uveitis,

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8
Q

CXR findings w/ sarcoidosis?

A

bilateral hilar adenopathy and reticular opacities

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9
Q

most common cause of hepatic cirrhosis?

A

ETOH abuse, viral hepatitis, NAFLD

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10
Q

Cause of wilson’s disease?

A

AR disease w/ deficiency of copper binding enzyme that fails to bind Cu or excretion onto ceruloplasmin

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11
Q

Lab finding w/ wilson’s?

A

low ceruloplasmin, low serum Cu, high urine Cu

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12
Q

What is hepatic whitlow?

A

self limiting viral infxn of hand due to HSV1 or HSV2 that px w/ redness, tenderness, vesicles.

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13
Q

Positive tzack smear px as?

A

multinucleated giant cells which suggests herpes infxn

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14
Q

Si/sx of disc prolapse?

A

unilateral radicular pain in dermatomal distrib., back spasm w/ inability to valsalva.

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15
Q

Si/sx of cauda equina syndrome?

A

bladder atony w/ overflow incontinence, bilateral sciatica, saddle anesthesia, loss of anal sphincter tone

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16
Q

Si/sx of acute bronchitis?

A

wheezing, afebrile, coag of acute onset, productive of yellow sputum, may be blood tinged

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17
Q

What is senile purpura?

A

ecchymosis in elderly in areas susc to trauma, due to atrophy of perivascular CT, no prior bleeding probs in hx

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18
Q

How does digoxin toxicity prx?

A

N/V, anorexia, confusion, weakness, visual abnormalities

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19
Q

What are indications for surgery w/ aortic stenosis?

A

syncope, angina, dyspnea, operation of choice is valve replacement

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20
Q

How w/u dysphagia?

A

If of solids + liquids- likely motility issue, do barium 1st, endo 2nd if inconclusive

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21
Q

What prophylaxis against malaria used in L.A. & Korea

A

Primaquine ( no falciparium in this region)

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22
Q

What prophylaxis used where falciparum resistant to chloroquine?

A

can use atovaquone-proguanil, doxy, mefloquine. Needed in subsaharin Afric, SE Asia, southern Asia

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23
Q

If noncaseating granuloma on lung biopsy? How tx?

A

sarcoidoiss most likely. tx w/ steroids

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24
Q

How does cyclosporine fxn?

A

inhibits IL-2 mainly, also inhibits other cytokines and helper T cells

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25
Q

Adv rxn of cyclophosphamide?

A

nephrotoxic - > htn, neurotoxic (HA, seziures, vision probs), hyperglyc, SCC + lymphoprolif malignancy, gingival hyperplasia, GI sx

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26
Q

Adv rxn of azathioprine?

A

dose-related diarrhea, leukopenia, hepatoxicity

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27
Q

How does obstructive PFT flow loop appear?

A

rapid incr in expiratory pressure with rapid fall, producing steep downward slope, like backwards J

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28
Q

How does restrictive PFT flow loop appear?

A

slower rise in expiratory pressure with slower linearly dcrs in pressure upon expiration< like upside down V.

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29
Q

What is BNP correlate w/?

A

level of circulating BNP - > severity of left ventricle filling pressure + mortality. Assoc w/ S3 when elevated.

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30
Q

How does HOCM murmur sound?

A

heard on left sternal border, cresc-descres murmur, due to interventrical septal hypertrophy

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31
Q

How differentiate HOCM from AS?

A

AS px on R sternal border and radiates to carotids, HOCM rare in young individuals w/out FMHX

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32
Q

Concerning signs for lymph node?

A

hard, immobile, non-rubbery, >2 cm

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33
Q

best tx for poor appetite in cancer pt?

A

progesterone analog megestrol acetate and medroxyprogesterone, also steroids

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34
Q

ACLS protocol for vfib, vtach?

A

first defib, then epi w/ 3 min CPR, repeat defib, give antiarryhtmics

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35
Q

how does OD on beta blockers px? How tx?

A

bradycardia, AV block, hypotension, diffuse wheezing. Tx w/ glucagon (incrs cAMP levels)

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36
Q

Risk of TCA OD and how tx?

A

can cause QRS prolongation leading to ventric arrythm, tx w/ Na bicarb - > depresses action of sodium channels preventing QRS prolong

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37
Q

What is source of bleed in mallory weiss tears?

A

Ruptured submucosal arteries

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38
Q

Px of cluster headaches?

A

tearing, pain of ipsilateral eye, horner’s syndrome, runny nose

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39
Q

How tx w/ ppx against cluster HA?

A

Can do verapamil, lithium, ergotamines

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40
Q

How does warfarin skin necrosis appear?

A

get pain then bullae then skin necrosis 2/2 to warfarin admin

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41
Q

Lab findings w/ low vitamin D?

A

get low Ca, low Phos, high PTH

42
Q

What do low complement levels most often suggest w/ renal disease?

A

PSGN, lupus nephritis, MPGN, mixed cryoglobulinema (2.2 to hep C)

43
Q

Effect of beta blocker admin in presence of pheo?

A

rapid incr in bp due to reflexive vasoconstrxn due to excessive alpha receptor activation, alpha receptor catechol are then unopposed (vasoconstrxn)

44
Q

Most likely murmur w/ IV drug use?

A

tricuspid regurg which px w/ systolic murmur that incrs w/ inspiration

45
Q

What is hazard rate?

A

chance of an event occuring in either tx arm or control arm over set period.

46
Q

What is hazard ratio?

A

chance of event in tx arm cmprd to chance in control arm.

47
Q

What does hazard ratio # mean?

A

If 1 then more likely in tx arm

48
Q

Best tx for worsening pain in pt w/ prsotate cancer + metastasis?

A

best to use prophylactic radiation

49
Q

Another tx for bone pain 2/2 to metastisis esp in prostate cancer?

A

can use bisphosphonates to dcrs bone dstrxn.

50
Q

Si/sx of spinal cord compression?

A

worsening of local back pain, pain worse laying down, symmetric LE weakness, dcrsd reflexes, early bilateral babinski, incrsd dtr w/ sensory loss late.

51
Q

How tx spinal cord compression?

A

emergent MRI, IV steroids

52
Q

Risk w/ recurrent vomiting?

A

mallory weiss tear can form — ruptured submucosal arteries of distal esoph and prox stomach

53
Q

How tx mallory weiss tear?

A

usually bleed stops spont., can tx w/ vasopressin, edoscopic injx, electrocautery

54
Q

Si/sx of adrenal failure?

A

anorexia, fatigue, N/V/D, ab pain, weight loss, hyperpigmentation, dcrsd BP, dcrsd Na, incrsd K

55
Q

How does reactivation of TB appear on CXR?

A

upper lobe infiltrate w/ cavitation

56
Q

How does PCP penumonia appear on CXR?

A

diffuse granular opacities

57
Q

How does otitis externa px typically?

A

Ear discharge and pain w/ pulling on Pinna

58
Q

Most common organism w/ endocarditis 2/2 IV drug abuse?

A

staph aureus most common

59
Q

What does an S4 heart sound signify?

A

heard over cardiac apex in left lateral decubitus position in pts w/ reduced ventricular compliance. Caused by htn, HD, AS, HOCM

60
Q

Si/sx of syncope due to arrhythmia?

A

sudden nset w/ no preceding clues, presence of HD (post MI, MR), presence of arrythmia/ ectopic beats

61
Q

What is flutamide?

A

non-steroidal antiandrogen that blocks androgen stimulation on prostate. Prolongs survival in pts w/ prostate cancer

62
Q

Common cause of ascites?

A

cirrhosis, acute liver failure, ETOH hepatitis, budd-chiari, HF, hypoalbuminemia, nephrotic syndrome

63
Q

Peritoneal cause of ascites?

A

malignancy or infxn

64
Q

What is pathophys of goodpastures?

A

Ab agaisnt alpha 3 chain of type IV collagen — expressed most in alveoli and glomeruli

65
Q

Si/sx of aortic regurg?

A

water hammer pulse — wide pulse pressure felt by pt as pounding heart

66
Q

Typical cause of nec fasc

A

usually occurs after trauma

67
Q

How does nec fasc px?

A

bullae, serosang in area of edema & purpulish discoloration, exquisit tenderness, si/sx of shock also may be px

68
Q

Painless hard mass in testes?

A

do radical orchiectomy w/out other studies, dont do FNA as risk for seeding of tumor cells.

69
Q

What is post-chole syndrome?

A

persistent abd pain/ dyspepsia that happens postop or years later after cholecystectomy

70
Q

What are causes of PCS?

A

can be biliary or extrabiliary cause… due to retained stone or biliary dyskinesia

71
Q

Important side effects of HIV therapy?

A

Indinavir causes crystal induced nephropathy, didanosine — pancreatitis, abacavir - hypersen syndrome, NRTIs – lactic acidosis, neviropine – liver failure, NNRTIs- SJS

72
Q

How does nocardia px? How tx?

A

acid fast G+ branching rods. tx w/ TMP-SMX

73
Q

How does nocardiosis px?

A

usually in immunocomprom pts, px w/ weight loss, fvr, night sweats, cough w/ productive sputum

74
Q

How does nocardia appear on cxr?

A

lobar or multilobar consolidation, can px w. solitary mass or nodules

75
Q

What is confounding?

A

when exposure disease relationship is combined w/ another factor skewing or confusing results

76
Q

What is selection bias?

A

refers to method w/ which ppl are picked in study or if particular groups fail to follow up

77
Q

Si/sx of complication of infective endocarditis?

A

arterial emboli - focal neuro probs, visceral organ infarcts, mycotic aneurysms,

78
Q

Si/sx of infective endocarditis?

A

conjunctival hemorrhages, GMN, janeway lesions — rash on palms soles, osler nodes- painful vesicles on fingers, toes

79
Q

Main CSF finding w/ MS?

A

oligoclonal bands, mainly IgG, altho may be IgA, IgM

80
Q

Where would pure motor stroke px?

A

most likely internal capsule - > lacunar stroke

81
Q

What causes of reanl insufficiency in multiple myeloma?

A

likely obstrxn of distal & collecting ducts by laminated casts of bence jones proteins

82
Q

What is klebs penumonia?

A

G- capsulated bacilli, usually affects infants, elderly, alcoholics, neutropenic/immunocomp pts, most common cause of CAP in ETOH

83
Q

how does syringomyelia appear on CT/MRI?

A

cord cavity usually in upper thoracic/ lower cervical spine

84
Q

Px of CMV retinitis?

A

painless w fluffy or granular retinal lesions located near the retinal vessels.

85
Q

How does HSV infxn in eye px?

A

eye pain, conjunctivitis, rapid visual loss, fundo shows nuemrous pale perih retinal lesions w/ central retinal necrosis

86
Q

CHF findingins on ABG?

A

hypoxia, hypocarbia, respiratory alkalsosis

87
Q

what testing should be done to asses HF?

A

BNP and PCWP

88
Q

How does aspirin cause gastritis?

A

inhibits protective prostacycline prodxn, can lead to hemorrhagic erosive lesions

89
Q

How does subarrachnoid hemorrhage px?

A

svr HA, dcrsd level of conciousness, no focal findings

90
Q

What is px of cerebellar hemorrhagic stroke?

A

ataxia, vomiting, occipital HA, gaze palsy, facial weakness, no hemiparesis

91
Q

What is hepatic hydrothorax?

A

pleural effusion, assoc w/ portal htn usually on R side w/ no underlying cardiac or pulmonary issue

92
Q

How tx hepatic hydrothorax?

A
  1. pleurodesis + diuresis, 2. if fails do xplntation or TIPS
93
Q

How does cerebellar tumor usually px?

A

ipsilateral ataxia!!!, nystagmus, intention tremor, problems w/ repetitive movements

94
Q

What genetic findinings alter tx for breast cancer?

A

If oncogene px (HER2) can tx w/ trastuzumab

95
Q

What is lumbar spinal stenosis?

A

degen condition w/ narrowing of canal. Due to enlarging osteophyte and hypertrophy of ligamentum flavum.

96
Q

Px of lumbar spinal stenosis?

A

pain in butt/thigh, worse w/ extension, walking, improvement w/ flexion of spine, if was due to lumbar disc herniation, flexion worse not better

97
Q

How w.u likely PE based on sx?

A
  1. start anticoag on heparin. 2. do CT or V/Q scan to confirm. 3. If + do thrombolytics +/- surgry, if - stop anticoag.
98
Q

Waht is risk w/ chronic alcoholism?

A

recurrent gout. If get gout should abstain, avoid purine in diet, avoid diuretics and pyrazinamide

99
Q

WHat drugs precipitate renal damage?

A

NSAIDS, ACEI, cyclosporine

100
Q

WHat is cause of AKI?

A

renal blood flow dcrsd to point that toxins like BUN, Cr build up and cause damage

101
Q

What are vascular causes of AKI?

A

Renal artery occlusion, TTP, HUS

Uworld questions (13 decks)

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