UWorld 8/24 Flashcards
What is the first sign of hypovolemia?
-increased pulse rate!
4 Red flags for orbital cellulitis?
- Decreased visual acuity
- Diplopia
- Opthalmolegia
- Proptosis
3 Ssx of chorioamnionitis?
- Uterine tenderness
- Maternal fever
- Tachycardia
4 Risk factors of chorioamnionitis?
- Prolonged rupture of membranes (> 24hrs)
- Prolonged labor
- Internal fetal/uterine monitoring devices
- Presence of genital tract pathogens (ex. UTI)
C-section for chorioamnionitis?
-only if fetus is in distress!
Corneal vesicles and dendritic ulcers?
-think: herpes simplex keratinitis
What is the pH, PCO2, and HCO3 usually in salicylate toxicity?
- AKA asprin OD
- pH = close to normal
- PCO2 = low = resp alkalosis
- HCO3 = low = also metabolic acidosis!
Lower pulse with MI?
- AV node involvement
- think: RV infarction
What type of fluid is typically seen in a pleural effusion due to CHF? What is the pH of the fluid?
- typically transudative
- pH 7.4-7.55
Tx for lyme dz when doxy cant be given?
-amoxicillin
Screening for Gonorrhea and chlamydia?
-urine screen all asymptomatic sexually active women younger than 24
Most common congenital cause of aplastic anemia? Genetics? More susceptible to? Physical features?
- fanconi anemia
- autosomal recessive or x-linked
- predisposition to developing cancer
- physical characteristics: short stature, microcephaly, abnormal thumbs, hypogonadism, hypo/hyperpigmented areas, cafe au lait spots, lg freckles, strabismus, low set ears, middle ear abnormalities (ear infections/deafness)
What is the most common transfusion rxn that happens within 1-6 hrs of transfusion? Ssx? What can be done to prevent this in the future?
- nonfebrile nonhemolytic transfusion rxn –> bc the leukocytes in the RBCs cause a release of cytokines
- ssx: transient fevers, chills, and malaise –> NO hemolysis
- can be prevented in the future by leukoreducing the RBCs
Initial workup in a postmenopausal women that has an adnexal mass (2)? What to do if they are both negative?
- CA 125 level
- Transvagina, ultrasound
- if both CA 125 level is low and ultrasound is normal, then pt can be monitored via transvag us
What congenital cardiac abnormality is most often seen in Down Syndrome?
-endocardial cushions defect = complete atrioventricular septal defect
Tx for neuroleptic malignant syndrome?
-Dantrolene!
Tx for EPS of antipsychotics?
-benztropine
3 mechanical complications of an MI that can occur in the first 3-7 days?
- Papillary muscle rupture
- Left ventricular free wall rupture
- Interventricular septum rupture
Pansystolic murmur that is loudest at the apex and radiates to the axilla?
- think: mitral valve regurgitation
- can be due to rupture of papillary m if it has new onset post MI
Bruit in AAA v renal artery stenosis?
- AAA = systolic
- RAS = systolic-diastolic
Pathogenesis of food borne botulism v infant botulism?
- food borne = ingestion of PREFORMED botulinum. Toxin
- infant botulism = ingestion of botulinum spores from environmental dust!
What 3 states have the highest concentration of botulinum spores in the soil?
- California
- Utah
- Pennsylvania
Descending flaccid paralysis in an infant?
- think: botulism!
- can be from toxin in food (honey) or spores in dust!
What is the most common area of a DVT that becomes a PE?
-illiofemoral vein clot!
Asplenic pt that develops hemolysis after a tick bite?
- think: babesiosis
- causes hemolytic anemia, jaunice, hemoglobinuria, renal failure, death
What is the mechanism of excess estrogen in obese women?
-conversion of adrenal androgens to estrogen by adipose tissue
Initial tx for osteoarthritis?
-acetaminophen
First line antibiotics that can be used for UTI during pregnancy (3)?
- Amoxicillin
- Nitrofurantoin
- Cephalexin
What test is recommended before giving a pt trasthzumabb
-echocardiogram –> bc the drug can be cardiotoxic!!
What 2 conditions can cause splinter hemorrhages?
- Endocarditis
2. Trichinelosis infection –> from undercooked pork
Periorbital edema, myositis, eosinophillia?
-think: trichinosis from eating raw pork!
3 Meds used for HTN in preg?
- Labetalol
- Methyl dopa
- Nifedipine
Bp control in eclampsia?
-hydralazine!
Organophosphate poisoning?
-atropine
First medication given for pulselessness?
-amioderone
Med given for SVTs?
-adenosine = blocks AV node
CCBs given for afib?
-verapamil and diltiazem
Atropine? Amioderone? Adenosine?
- atropine = for organophosphate poisoning –> blocks acetylcholine
- amoiderone = given first between shocks in cardiac arrest
- adenosine = for SVTs –> very short acting AV blocker
What is hyposthenuria? What genetic disease is it commonly seen in?
- impairment in kidneys ability to concentrate urine
- commonly linked with sickle cell anemia and trait, but can be seen in normals too
Another name for eczema?
-atopic dermatitis
What 3 infectious dz are pregnant women tested for no matter what their risk factors are?
- Syphilis
- HIV
- Hep B
When during preg should women be tested for syphilis?
-at first prenatal visit with rapid plasma regain (RPR)
Tx for lichen-sclerosis?
-high-potency topical steroids are first line
What does pulmonary capillary wedge pressure measure?
-preload
