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Step 2 Question Review > UWorld Assessment 1 > Flashcards

UWorld Assessment 1 Flashcards

1
Q

Patient’s on parenteral nutrition for >48 hours have an increased risk of developing what?

A

Central line-associated bloodstream infection

MC d/t coagulase-negative Staph and S. Aureus.

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2
Q

Antifreeze will cause what on ABG? What in urine?

A

Antifreeze=Ethylene glycol

Increased anion gap metabolic acidosis (low pH, low HCO3, compensated slightly low pCO2)

Calcium oxalate crystals

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3
Q

Reactive NST for > 32 weeks

A

> /= 2 FHR accelerations that peak at >/= 15 bpm above baseline and lasts >/= 15s

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4
Q

Progressive dyspnea on exertion for 6 months, can’t do ADLs, hx of HTN, 30 pack year hx

BP 130/80, pulse 82, RR 18, SpO2 92%, BMI 34

Lungs bibasilar fine crackles

FEV1 65%
FVC 58%
FEV1/FVC 85%

Dx? Pathophys?

A

Interstitial Lung Dz, lung stiffening due to fibrosis

Progressive dyspnea, nonproductive cough, fine crackles

Decreased FEV1, FVC, TLC; Normal FEV1/FVC

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5
Q

Restrictive Spirometry

A

Decreased FEV1, FVC, TLC (<80%)

Normal or increased FEV1/FVC

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6
Q

Obstructive spirometry

A

Decreased FEV1
Normal FVC
Decreased FEV1/FVC

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7
Q

What type of a molecule is ACTH

A

Polypeptide hormone

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8
Q

Tx of protracted active phase of labor

A

Oxytocin

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9
Q

What is protracted active labor in G1P0

A

<1 cm every 2 hours, inadequate contractions (ideal is 2-3 min)

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10
Q

Light criteria for pleural effusion

A

Transudate = 0.5 protein pleural/serum AND
= 0.6 LDH pleural/serum AND
Pleural LDH = 2/3 upper limit of normal serum LDH

Exudate >0.5 protein pleural serum OR
>0.6 LDH pleural/serum OR
Pleural LDH > 2/3 upper limit of normal serum LDH

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11
Q

Cause of exudate pleural effusions

A

Infection: parapneumonic, TB, fungal, empyema
Malignancy
PE

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12
Q

Cause of Transudative pleural effusions

A

Hypoalbuminemia d/t cirrhosis, nephrotic

CHF

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13
Q

What vaccines do you give adults with HIV

A

HAV, HBV, HPV, Influenze (inactivated), Meningococcus, Pneumococcus, Tdap

Only give Live is CD4>200

NOT BCG

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14
Q

Headaches worse when leaning forward
JVD
No peripheral edema
Facial and UE swelling

A

Superior vena cava syndrome

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15
Q

How to prevent aspiration pneumonia

A

Oral care, diet modification, elevating head of bed

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16
Q

Pathophys of SBP

A

Intestinal bacterial translocation

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17
Q

Patient has a history of neural tube defects, what is recommended for her next pregnancy?

A

Folic acid supplementation, 4 mg

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18
Q

Pathophys of tension pneumothorax

A

Allows air to enter pleural space but can’t escape
Increase intracellular pressure, compress mediastinal structures (SVC)
Impedes venous return to heart

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19
Q

Multiple episodes of unresponsive ness, fumbling hand movements

MCC?

A

Focal seizure with impaired awareness = Temporal lobe epilepsy

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20
Q

Tx of V tach

A

Amiodarone

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21
Q

Calcifications within the pancreas

A

Chronic pancreatitis

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22
Q

Early Complications of Roux-en-Y

A

Anastomotic leak, bowel ischemia

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23
Q

Late complications of Roux-en-Y

A

Anastomatic stricture
Marginal ulcer
Cholecystitis
Dumping syndrome

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24
Q

Neurogenic bladder tx

A

Cholinergic agents, bethanechol

25
Q

Urge incontinence tx

A

Muscarinic antagonist and beta agonist

26
Q

Metabolic acidosis in presence of septic shock, pathophys?

A

Increased tissue metabolic acid (lactic acid) production

27
Q

Jaundice, decreased appetite, weight loss, abdominal discomfort, fullness in RUQ

A

Pancreatic cancer

28
Q

Best predictor of prognosis in astrocytomas in adults

A

Degree of Ana plasma

29
Q

Small hemorrhagic lesions on the retina

What are they? What causes from?

A

Roth spots

Infectious endocarditis

30
Q

MCC bactermia in sickle cell disease

A

Strep pneumoniae, HiB

31
Q

MCC osteomyelitis in sick cell dz

A

S. Aureus, salmonella

32
Q

MCC ovarian cancer

A

Epithelial ovarian cancer

33
Q

Large, non painful, unilateral pleural effusion
Cancer history
Rapid weight loss

Dx?

A

Malignant pleural effusion

34
Q

Acute pleuritic pain
Signs of infection
Painful effusion

Dx?

A

Parapneumonic effusion

35
Q

Septic shock, persistent hypotension after fluids

What do you give?

A

IV Norepinephrine

36
Q

What causes renal injury in multiple myeloma?

A

Renal tubular damage

renal insufficiency leading to intratubular cast formation and toxicity

37
Q

MC associated inherited syndrome to Autism?

Genetic mutation?

A

Fragile X syndrome

Tri nucleotide repeat of FMR1 gene

38
Q

Severe delirium tx

A

IM haloperidol, low dose

39
Q

Patient with RA develops septic arthritis, MC organism class?

Not sexually active, immune compromised or old

A

Gram + bacteria

40
Q

List the nephrotic syndromes

A 
Focal segmental glomerulosclerosis
Membranous nephropathy
Mambranoproliferative glomerulonephritis
Minimal change disease
IgA nephropathy
41
Q

Neonate with sudden onset, recurrent, forceful bilious vomiting

Upper GI series shows a corkscrew in the mid abdomen

Dx?

A

Malrotation with volvulus

Corkscrew is due to duodenum

42
Q

Risk factors for Listeria monocytogenes

Tx?

A

Pregnant, > 50, immune compromised, chronic glucocorticoids

Ampicillin

43
Q 
Shoulder pain
Horner syndrome
Neuro S/S in the arm (invasion of C8-T2 nerves)
Supraclavicular lymphadenopathy
Weight loss
A

Superior pulmonary sulcus tumor (Pancoast tumor)

44
Q

R heart cath of septic shock

A

Decreased SVR
Decreased PCWP
Elevated mixed venous oxygen saturation
Increased cardiac index

45
Q

Upper respirtoary tract involvement
Lower respiratory tract involvement
Kidney involvement
Cutaneous manifestations

Tx?

A

Granulomatosis with polyangiitis

Steroids and immunomodulators

46
Q

Patient who just had chemo now has leukocyte count of 600 and alt mental status

Dx?

A

Bacterial infection

47
Q

Pathophys of DKA

A

Without insulin, fatty acids break down to ketones in th liver, which leaks to acidosis

48
Q

Rouleaux formation

A

Multiple myeloma

49
Q

Pregnant women with high protest probability for PE but low probability V/Q scan, what next?

A

CTA

50
Q 
Conjunctivitis
Rash
Asian
Strawberry tongue
Hands and feet desquamation
Fever >/= 5 days
A

Kawasaki

51
Q

Causes of reactive thrombocytosis

A

Recent surgery, infection, malignancy, asplenia

Basically inflammation

52
Q

Dysuria but UA has WBC of 50+ only

Dx? Cause? Sequela?

A

Sterile pyruria

Chlamydia trachomatis

PIC and infertility

53
Q

Tocolytic for <32 weeks

A

Indomethacin

54
Q

Tocolytic 32-34 weeks

A

Nifedipine

55
Q

Tx of severe hypertriglyceridemia d/t familial dysbetalipoproteinemia

A

Fenofibrate

56
Q

Tx Raynaud

A

CCB

57
Q

Drank lots of alchohol, had 3 seizures, now dark urine

Dx?

A

Rhabdomyolysis

58
Q

Side effect of sotalol

A

Prolong QT, Torsades de pointes

59
Q

How to prevent torsades de pointe

A

Magnesium

Step 2 Question Review (5 decks)

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