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9 Internal Medicine > UWorld > Flashcards

UWorld Flashcards

1
Q

Decrease in lower esophageal sphincter tone vs. increase in tone.

A

Decrease LES = Systemic sclerosis

Increase LES = Achalasia

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2
Q

Valganciclovir taken for _________

A

Cytomegalovirus (CMV)

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3
Q

Trimethorpim-sulfamethoxazole taken for ________

A

Pneumocystis pneumonia

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4
Q

First-line therapy for stable angina

A

Beta blockers

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5
Q

Treatment of lyme disease in pregnant women.

A 
NOT doxycycline (inhibits skeletal development)
Instead use Amoxicillin
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6
Q

Bernard-Soulier Syndrome

A

Autosomal recessive disorder of absent platelet glycoprotein 1b

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7
Q

Stridor - common DDx

A

Infectious epiglotitis (Haemophilus influenzae)

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8
Q

How to treat cyanide toxicity

A

Hydroxycobalamin - bind cyanide
Sodium thiosulfate - bind cyanide
Nitrates - induce methemoglobinemia (Fe3+), giving alternate binding site for cyanide

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9
Q

How to treat carbon monoxide toxicity

A

100% O2

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10
Q

Duodenal ulcer therapy

A

Proton pump inhibitor (e.g. omeprazole)

Antibiotics (amoxicillin + clarithromycin)

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11
Q

S3 DDx and treatment

A

Left Ventricle Failure

Initial treatment = intravenous diuretics

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12
Q

Absent CD55

A

Absent CD55 causes hemolytic anemia, which leads to proxysmal nocturnal hemoglobinuria.

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13
Q

Increased Hemoglobin A2

A

Beta thalassemia trait

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14
Q

Major complication of giant cell arteritis

A

Aortic aneurysm

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15
Q

Acromegaly cardiac complication

A

Concentric left ventricular hypertrophy

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16
Q

Drugs that cause hepatitis

A

Isoniazid
Halothane
Phenytoin
Alpha-methyldopa

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17
Q

Diagnosis for: Shoulder pain with decreased passive and active range of motion. More stiffness than pain.

A

Adhesive capsulitis (frozen shoulder)

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18
Q

Knee synovial fluid analysis shows rhomboid-shaped crystals.

A

Calcium Pyrophosphate Dihydrate (CPPD) are positively birefringent = Pseudogout

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19
Q

Heberden nodes

A

Osteoarthritis

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20
Q

Conjunctivitis + Knee pain

A

Reactive arthritis, usually following acute GI (Salmonella, Yersinia) or genitourinary (Chlamydia) infection.

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21
Q

Low Urine Osm, High Serum Sodium

A

Central Diabetes Insipidus

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22
Q

Subauricular systolic bruit and high BP in a young woman.

A

Fibromuscular dysplasia

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23
Q

Hemolytic anemia is G6PD pts is caused by what drugs?

A

Sulfa drugs
Antimalarials
Nitrofurantoin

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24
Q

Acne treatment

A 
Comedonal = topical retinoids
Inflammatory = antibiotics (erythromycin, clindamycin)
Severe Nodular (cystic) = oral isoretinoin
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25
Q

Lab differential of folate vs cobalamin deficiency

A

Folate defi has high Homocysteine, normal Methylmalonic acid

Cobalamin defi has high Homocysteine and HIGH Methylmalonic acid

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26
Q

def. asterixis

A

flapping hand tremor (implies underlying cirrhosis)

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27
Q

Aldosterone antagonists

A

Spironolactione, eplerenone

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28
Q

Aldosterne/renin >20

A

Primary hyperaldosteronism

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29
Q

Corneal vesicles and dendritic ulcers

A

Herpes simplex keratitis

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30
Q

The 2 most common causes of Acute pancreatitis

A

Chronic Alcohol Use (~40%)

Gallstones (~40%)

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31
Q

Alpha 2 agonists: examples and use

A

Clonidine, Methyldopa, Dexmedotomidine
Clonidine and Methyldopa are used to treat hypertension.
Dexmedetomidine is used for sedation in ICU.

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32
Q

Aortic stenosis triad

A

1) Syncope
2) Exertional dyspnea
3) Angina pectoris

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33
Q

Diastolic decrescendo murmur

A

Aortic insufficiency (regurg)

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34
Q

Tricuspid valve endocarditis - murmur type?

A

Holo-SYSTOLIC murmur

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35
Q

Red urine TB treatment

A

Rifampin

36
Q

Prenicious anemia mechanism

A

Anti-intrinsic factor antibodies cause B12 defi, causing megaloblastic anemia.

37
Q

Treatment of esophageal varices

A

Endoscopic variceal ligation (EVL)
OR
Nonselective beta blocker

38
Q

Antibiotic to treat Anaerobic above the diaphragm

A

Clindamycin

39
Q

Antibiotic to treat Anaerobic below the diaphragm

A

Metronidazole

40
Q

What is this diagnostic test used for?

24-hour urine cortisol

A

Cushing’s syndrome

41
Q

What is this diagnostic test used for?

Captopril radionucleotide renal scan

A

Renal artery stenosis

42
Q

What is this diagnostic test used for?

Plasma aldosterone/renal ratio

A

Primary aldosteronism

43
Q

What is this diagnostic test used for?

Urine metanephrines

A

Pheochromocytoma

44
Q

Positive tuberculin skin test induration size

A

More than 5mm

45
Q

Prophylaxis for HIV pt against Mycobacterium avium. CD4 count and antibiotic.

A

CD4 less than 50

Azithromycin

46
Q

Treatment of CMV in immunocompromised patients.

A

Ganciclovir or Valganciclovir

47
Q

Hyperresonance to percussion of lung - diagnosis

A

Pneumothorax OR Emphysema
Determine which one by mediastinal shift.
Pneumothorax shift away from tension pneumothorax.
Emphysema no shift

48
Q

Decreased breath sounds, decreased tactile fremitus and dull percussion - diagnosis

A

Pleural effusion OR Atelectasis (e.g. mucus plugging)
Determine which one by mediastinal shift.
Pleural effusion shift away from effusion.
Atelectasis shift toward atelectasis (if large)

49
Q

What type of mediastinal shift occurs toward the side of decreased breath sound?

A

Atelectasis (mucus plugging)

50
Q

Dx: widespread pain and normal lab

A

Fibromyalgia

51
Q

Dx: difficulty climbing stairs and elevated creatine kinase.

A

Polymyositis

stairs = proximal muscle weakness

52
Q

Dx and Tx: elevated CRP, muscle stiffness

A

Dx: Polymyalgia rheumatic
Tx: rapid improvement with glucocorticoids

53
Q

Dx: triad of periorbital edema, myositis, eosinophelia

A

Trichinellosis

54
Q

Treatment of unstable sinus bradycardia in pt with STEMI

A

Intravenous atropine to treat the unstable sinus bradycardia.

55
Q

Treatment of pulmonary edema in pt with STEMI

A

Furosemide to treat pulmonary edema, if pt is NOT hypotensive/hypovolemic.

56
Q

Dx: HIV pt with cavitary upper lung lesion

A

Reactivation TB

57
Q

Central renal artery occlusion treatment.

A

Ocular massage and high-flow oxygen

58
Q

Dx:
Early peaking systolic murmur
vs
Late peaking systolic murmur

A

Early peak = mild./moderate aortic stenosis

Late peak = Severe aortic stenosis

59
Q

Drug overdose Dx:

Hypertension, tachycardia, hyperreflexia, clonus, agitation

A

Serotonin Syndrome

60
Q

Drug overdose Dx:
Slurred speech, unsteady gait, drowsiness
No Respiratory Depression
Normal Pupils

A

Benzodiazepine overdose

61
Q

Drug overdose Dx:

Tremor, hyperreflexia, ataxia, seizures, vomiting and diarrhea

A

Lithium overdose

62
Q

Drug overdose Dx:
Slurred speech, unsteady gait, drowsiness
Respiratory Depression
Miosis

A

Opioid intoxication

63
Q

Drug overdose Dx:

Horizontal nystagmus, Cerebellar ataxia, confusion

A

Phenytoin toxicity

64
Q

Tx: Torsades de pointes

A

Immediate defibrillation
AND
Intravenous magnesium

65
Q

When to use emergency

Adenosine

A

proxysmal supraventricular tachycardia (PSVT)

66
Q

When to use emergency

Amiodarone

A

atrial/ventricular tachycardia

67
Q

When to use emergency

Calcium Gluconate

A

Hyperkalemia

68
Q

When to use emergency

Sodium Bicarbonate

A
  • Torsades de pointes due to quinidine
  • Metabolic Acidosis
  • Hyperkalemia
  • TCA overdose
69
Q

When to use emergency

Magnesium sulfate

A

Torsades de points due to:

congenital or acquired long QT

70
Q

Hidradenitis suppurativa

A 
"Hidra-" = sweat
"-aden-" = gland
"-itis" = inflammation
Hiradenitis = inflammation of the sweat glands
suppurativa = which opens to the skin surface
71
Q

Furuncle

A

Skin abscess, usually due to staph aureus

72
Q

Intertigo

A

Infection with Candida species

Well-defined erythematous plaques

73
Q

Positive antimitochondrial antibody assay

Dx and Tx

A

Dx: Primary Billiary Cholangitis
Tx: Ursodeoxycholic Acid (UDCA)

74
Q

Dx, complications, Tx:
Young obese female with headache.
Normal CT
Papilledema

A

Dx: Benign Intracranial Hypertension (Pseudotumor cerebri)
Complication: blindness
Tx: weight reduction, acetazolamide, shunting, optic nerve fenestration

75
Q

Top choice antibiotic for human bite wound

A

Amoxicillin-Clavulanate

76
Q

Agents that injury gastric mucosa

A
  • Aspirin (inhibit prostaglandin)
  • Cocaine (vasoconstriction - decrease gastric blood flow)
  • Alcohol (mucosal injury)
77
Q

Dx:

  • History of AAA
  • prior GI surgery
  • hematemesis
A

Abdominal antoenteric fistula

78
Q

What antibodies do you look for in the window phase of HBV?

A

Positive IgM Anti-HBc

Positive for HBV DNA

79
Q

What antibodies do you look for in chronic HBV?

A

Positive HBs-Ag

Positive IgG Anti-HBc

80
Q

Bile salt diarrhea

A

Caused by poor absorption of bile salts in the ileum. Caused by ileal resection OR Crohns ileitis

81
Q

How to monitor heparin levels?

A

aPTT

82
Q

Dx:

Free air under diaphragm

A

Perforated peptic ulcer

83
Q

How to diagnose chronic pancreatitis

A

CT scan is the test of choice

ERCP is the most sensitive test, but highly invasive

84
Q

How to diagnose pancreatic cancer

A

(just like chronic pancreatitis)
CT scan is the test of choice
ERCP is the most sensitive test, but highly invasive

85
Q

Most common cause of sudden cardiac arrest in the immediate post-MI period

A

Reentrant ventricular arrhythmias (Ventricular fibrillation)

9 Internal Medicine (7 decks)

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