UWorld Flashcards
Decrease in lower esophageal sphincter tone vs. increase in tone.
Decrease LES = Systemic sclerosis
Increase LES = Achalasia
Valganciclovir taken for _________
Cytomegalovirus (CMV)
Trimethorpim-sulfamethoxazole taken for ________
Pneumocystis pneumonia
First-line therapy for stable angina
Beta blockers
Treatment of lyme disease in pregnant women.
NOT doxycycline (inhibits skeletal development) Instead use Amoxicillin
Bernard-Soulier Syndrome
Autosomal recessive disorder of absent platelet glycoprotein 1b
Stridor - common DDx
Infectious epiglotitis (Haemophilus influenzae)
How to treat cyanide toxicity
Hydroxycobalamin - bind cyanide
Sodium thiosulfate - bind cyanide
Nitrates - induce methemoglobinemia (Fe3+), giving alternate binding site for cyanide
How to treat carbon monoxide toxicity
100% O2
Duodenal ulcer therapy
Proton pump inhibitor (e.g. omeprazole)
Antibiotics (amoxicillin + clarithromycin)
S3 DDx and treatment
Left Ventricle Failure
Initial treatment = intravenous diuretics
Absent CD55
Absent CD55 causes hemolytic anemia, which leads to proxysmal nocturnal hemoglobinuria.
Increased Hemoglobin A2
Beta thalassemia trait
Major complication of giant cell arteritis
Aortic aneurysm
Acromegaly cardiac complication
Concentric left ventricular hypertrophy
Drugs that cause hepatitis
Isoniazid
Halothane
Phenytoin
Alpha-methyldopa
Diagnosis for: Shoulder pain with decreased passive and active range of motion. More stiffness than pain.
Adhesive capsulitis (frozen shoulder)
Knee synovial fluid analysis shows rhomboid-shaped crystals.
Calcium Pyrophosphate Dihydrate (CPPD) are positively birefringent = Pseudogout
Heberden nodes
Osteoarthritis
Conjunctivitis + Knee pain
Reactive arthritis, usually following acute GI (Salmonella, Yersinia) or genitourinary (Chlamydia) infection.
Low Urine Osm, High Serum Sodium
Central Diabetes Insipidus
Subauricular systolic bruit and high BP in a young woman.
Fibromuscular dysplasia
Hemolytic anemia is G6PD pts is caused by what drugs?
Sulfa drugs
Antimalarials
Nitrofurantoin
Acne treatment
Comedonal = topical retinoids Inflammatory = antibiotics (erythromycin, clindamycin) Severe Nodular (cystic) = oral isoretinoin
Lab differential of folate vs cobalamin deficiency
Folate defi has high Homocysteine, normal Methylmalonic acid
Cobalamin defi has high Homocysteine and HIGH Methylmalonic acid
def. asterixis
flapping hand tremor (implies underlying cirrhosis)
Aldosterone antagonists
Spironolactione, eplerenone
Aldosterne/renin >20
Primary hyperaldosteronism
Corneal vesicles and dendritic ulcers
Herpes simplex keratitis
The 2 most common causes of Acute pancreatitis
Chronic Alcohol Use (~40%)
Gallstones (~40%)
Alpha 2 agonists: examples and use
Clonidine, Methyldopa, Dexmedotomidine
Clonidine and Methyldopa are used to treat hypertension.
Dexmedetomidine is used for sedation in ICU.
Aortic stenosis triad
1) Syncope
2) Exertional dyspnea
3) Angina pectoris
Diastolic decrescendo murmur
Aortic insufficiency (regurg)
Tricuspid valve endocarditis - murmur type?
Holo-SYSTOLIC murmur
Red urine TB treatment
Rifampin
Prenicious anemia mechanism
Anti-intrinsic factor antibodies cause B12 defi, causing megaloblastic anemia.
Treatment of esophageal varices
Endoscopic variceal ligation (EVL)
OR
Nonselective beta blocker
Antibiotic to treat Anaerobic above the diaphragm
Clindamycin
Antibiotic to treat Anaerobic below the diaphragm
Metronidazole
What is this diagnostic test used for?
24-hour urine cortisol
Cushing’s syndrome
What is this diagnostic test used for?
Captopril radionucleotide renal scan
Renal artery stenosis
What is this diagnostic test used for?
Plasma aldosterone/renal ratio
Primary aldosteronism
What is this diagnostic test used for?
Urine metanephrines
Pheochromocytoma
Positive tuberculin skin test induration size
More than 5mm
Prophylaxis for HIV pt against Mycobacterium avium. CD4 count and antibiotic.
CD4 less than 50
Azithromycin
Treatment of CMV in immunocompromised patients.
Ganciclovir or Valganciclovir
Hyperresonance to percussion of lung - diagnosis
Pneumothorax OR Emphysema
Determine which one by mediastinal shift.
Pneumothorax shift away from tension pneumothorax.
Emphysema no shift
Decreased breath sounds, decreased tactile fremitus and dull percussion - diagnosis
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)
What type of mediastinal shift occurs toward the side of decreased breath sound?
Atelectasis (mucus plugging)
Dx: widespread pain and normal lab
Fibromyalgia
Dx: difficulty climbing stairs and elevated creatine kinase.
Polymyositis
stairs = proximal muscle weakness
Dx and Tx: elevated CRP, muscle stiffness
Dx: Polymyalgia rheumatic
Tx: rapid improvement with glucocorticoids
Dx: triad of periorbital edema, myositis, eosinophelia
Trichinellosis
Treatment of unstable sinus bradycardia in pt with STEMI
Intravenous atropine to treat the unstable sinus bradycardia.
Treatment of pulmonary edema in pt with STEMI
Furosemide to treat pulmonary edema, if pt is NOT hypotensive/hypovolemic.
Dx: HIV pt with cavitary upper lung lesion
Reactivation TB
Central renal artery occlusion treatment.
Ocular massage and high-flow oxygen
Dx:
Early peaking systolic murmur
vs
Late peaking systolic murmur
Early peak = mild./moderate aortic stenosis
Late peak = Severe aortic stenosis
Drug overdose Dx:
Hypertension, tachycardia, hyperreflexia, clonus, agitation
Serotonin Syndrome
Drug overdose Dx:
Slurred speech, unsteady gait, drowsiness
No Respiratory Depression
Normal Pupils
Benzodiazepine overdose
Drug overdose Dx:
Tremor, hyperreflexia, ataxia, seizures, vomiting and diarrhea
Lithium overdose
Drug overdose Dx:
Slurred speech, unsteady gait, drowsiness
Respiratory Depression
Miosis
Opioid intoxication
Drug overdose Dx:
Horizontal nystagmus, Cerebellar ataxia, confusion
Phenytoin toxicity
Tx: Torsades de pointes
Immediate defibrillation
AND
Intravenous magnesium
When to use emergency
Adenosine
proxysmal supraventricular tachycardia (PSVT)
When to use emergency
Amiodarone
atrial/ventricular tachycardia
When to use emergency
Calcium Gluconate
Hyperkalemia
When to use emergency
Sodium Bicarbonate
- Torsades de pointes due to quinidine
- Metabolic Acidosis
- Hyperkalemia
- TCA overdose
When to use emergency
Magnesium sulfate
Torsades de points due to:
congenital or acquired long QT
Hidradenitis suppurativa
"Hidra-" = sweat "-aden-" = gland "-itis" = inflammation Hiradenitis = inflammation of the sweat glands suppurativa = which opens to the skin surface
Furuncle
Skin abscess, usually due to staph aureus
Intertigo
Infection with Candida species
Well-defined erythematous plaques
Positive antimitochondrial antibody assay
Dx and Tx
Dx: Primary Billiary Cholangitis
Tx: Ursodeoxycholic Acid (UDCA)
Dx, complications, Tx:
Young obese female with headache.
Normal CT
Papilledema
Dx: Benign Intracranial Hypertension (Pseudotumor cerebri)
Complication: blindness
Tx: weight reduction, acetazolamide, shunting, optic nerve fenestration
Top choice antibiotic for human bite wound
Amoxicillin-Clavulanate
Agents that injury gastric mucosa
- Aspirin (inhibit prostaglandin)
- Cocaine (vasoconstriction - decrease gastric blood flow)
- Alcohol (mucosal injury)
Dx:
- History of AAA
- prior GI surgery
- hematemesis
Abdominal antoenteric fistula
What antibodies do you look for in the window phase of HBV?
Positive IgM Anti-HBc
Positive for HBV DNA
What antibodies do you look for in chronic HBV?
Positive HBs-Ag
Positive IgG Anti-HBc
Bile salt diarrhea
Caused by poor absorption of bile salts in the ileum. Caused by ileal resection OR Crohns ileitis
How to monitor heparin levels?
aPTT
Dx:
Free air under diaphragm
Perforated peptic ulcer
How to diagnose chronic pancreatitis
CT scan is the test of choice
ERCP is the most sensitive test, but highly invasive
How to diagnose pancreatic cancer
(just like chronic pancreatitis)
CT scan is the test of choice
ERCP is the most sensitive test, but highly invasive
Most common cause of sudden cardiac arrest in the immediate post-MI period
Reentrant ventricular arrhythmias (Ventricular fibrillation)
