Uworld 8/19 Flashcards
What is reye syndrome?
- encephalopathy +/- liver disease caused by giving aspirin to a child for influenza or varicella infection
- pathophysiology: microvesicular fatty infiltration & hepatic mitochondrial dysfunction
What can aspirin cause in a child when given to them for influenza or varicella infection?
-reye syndrome = encephalopathy and/or liver failure
What is the only time aspirin should be given to a child?
-kawasaki disease!!
What is more common in blunt trauma: esophageal or tracheobronchial rupture?
-tracheobronchial rupture!
When does false labor usually occur?
-last 4-8 wks of pregnancy
Describe the contractions of false labor?
- they are lower in the abdomen
- irregular
- interval does not shorten or increase in intensity
- NO cervical changes
- relieved by sedation
What is the best initial test to do with any complaints of trouble swallowing?
-barium swallow study!
What is the best way to help prevent kidney damage when a contrast CT scan is needed?
-use non-ionic contrast agent
Microbio of pseudomonas?
-gram-neg rod
Dx of malaria?
-thick and thin blood smears
2 non-vasculitis conditions that have positive p-ANCA too!
- Ulcerative colitis
- Ankylosing spondylitis
* *both HLA-B27
Can relative risk be calculated from case-control studies?
- NO!
- only the odds ratio can be determined
4 Common drugs that are ototoxic?
- Aminoglycoside antibiotics
- Chemotx
- Aspirin
- Loop diuretics (ex furosemide)
What tx of graves dz can cause a worsening of opthalmopathy?
- radioiodine ablation –> bc releases more TH at first
- these effects are usually mild and transient, but can be given glucocorticoid tx prophylactically
What is the only tx that is effective in reducing the risk of early reccurance of an ischemic stroke?
-aspirin!
What 3 things can trigger vasovagal syncope?
- Emotional stress
- Painful stimuli
- Prolonged standing
Dx of vasovagal stroke?
- usually a clinical dx, with no other testing needed
- tilt test if clinical presentation is unclear
Tx of mucormycosis?
-surgical debridement + amphotericin
What type of bias is it when you lose a lot of subjects to follow-up?
-attrition bias = a selection bias
Recurrent nose bleeds, oral lesions, and clubbing?
- think: osler-weber-rendu syndrome = hereditary telangiectasia
- develop multiple av malformations
- these pts can develope pulmonary AVMs that cause R–>L shunts
What grade is a “flow murmur”? What should be done for murmurs that are > grade?
- grade I/II = innocent flow murmur of childhood, usually from VSD that will close on their own
- higher than grade II should have echo to determine size, severity, and location of defect
“Stuck on” skin lesion?
-seborrheic keratosis!!!!!!
Potassium in DKA and Hyperosmolar Hyperglycemic State (HHS)?
- serum levels might measure as normal or even high, but ther is actually a total body defecit
- bc insulin def and hyperosmolarity cause the mvmnt of potassium OUT of the cells and into the extracellular space
What is a marker of poor prognosis in CLL?
-thrombocytopenia!
A baby with vomiting, bloody stools, and abdominal distention?
-think: necrotizing entercolitis!
Tx of choice for duodenal hematoma?
-NG suction + parenteral nutrition
When are duodenal hematomas commonly seen?
-with blunt abdominal trauma, esp in kids
When does a febrile non-hemolytic rxn to a blood transfusion usually occur?
-within 1-6 hrs of transfusion
Tx for viral myocarditis?
-diuretic + inotropes
What are 2 specific signs of CHF and increased cardiac filling pressures?
- Elevated BNP
2. Audible S3
Etiology if sudden vision changes in a diabetic?
- hyperosmolarity
- diabetic retinopathy is a chronic gradual change
What is one love vaccine that is not contraindicated in an HIV pt?
- MMR!
- as long as CD4 is > 200 and no-AIDS defining illnesses are present
What disease used to be the most common cause for adrenal insufficiency?
-tuberculosis!
What is the bronchoalveolar lavage test best at diagnosing?
- Suspected malignancy
2. Opportunistic infections
Best dx test for PCP?
-bronchiolar lavage
What is the most common cause of cor pulmonale in the the US?
-COPD
Tx for supraventricular tachy?
-tx: adenosine = interrupts AV nodal reentry circuit
Atrophic (glossy) tounge, vitiligo, thyroid dz, and neurologic abnormalities?
-think: pernicious anemia
Arthritis in a pt with hemophilia?
- called: hemophilic arthropathy
- consequence of recurrent hemarthroses
- hemosiderin deposition leads to synovitis and fibrosis within the joint
