UWorld Assessment 2 Flashcards
Rside heart failure, treated with furosemide, now has AKI, d/t?
Intravascular depletion
Patient has 44 lb weight loss, BMI 19, amenorrhea
No bleeding on progesterone challenge
Cause?
Functional hypothalamic amenorrhea
No withdrawal bleeding d/t low endogenous levels of estrogen
Abdominal pain, nausea, vomiting, post op day 4 cholecystectomy
Elevated bilirubin
DX?
Biliary leak
CSF has increased protein level with normal cell count, dx?
Gillian-Barre syndrome
Rett syndrome gene
MECP2
Hemodynamics in cardiogenic shock
Increase CVP Increase PCWP Decrease CI Increase SVR Decrease SvO2
1 day old with petechiae, jaundice, hepatosplenomegally, microcephaly
Etiology?
CMV
Also hearing loss, periventricular calicifications
Management of threatened abortions
Observation and repeat ultrasound
Conjunctivitis, foreign body sensation, increased vascularity
Normal pupillary reflexes, visual acuity, fungus optic exam
Dx?
Ocular rosacea
How to decrease postop pneumonia?
Preop physical therapy
Smoking cessation >8 weeks
Spirometry postop
Watery diarrhea with blood and mucus
No response to cipro
LLQ tenderness
Philippines trip
Dx? How? Tx?
Entamoeba histolytica colitis by stool microscopy
Metronidazole
Treatment of severe hypercalcemia
Normal saline plus calcitonic, avoid loop diuretics
Long term: bisphosphonate
28 y/o with severe pneumonia, ICU for 4 days, now yellow sputum streaked with blood
Crackles in R lower lung and scattered wheezing
Dx? Pathophys?
Bronchiectasis d/t permanent destruction and dilation of the airways
68 y/o male, decreased hearing in R eye
Increased hat size over 2 years
Increased ALP
X-rays: sclerotic and lytic lesions
Dx? Pathophys?
Paget disease d/t disorganized bone remodeling
When to deliver in preeclampsia without severe features
> 37 weeks
When to deliver in preeclampsia with severe features
> 34 weeks
When to deliver in eclampsia
Immediately
What features define preeclampsia with severe features
Can have only 1
```
>160/>110
Scotoma
Headache
Thrombocytopenia
Elevate liver enzymes
Elevated Cr
End organ damage
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Steps of failure modes and effects analysis
Get an interdisciplinary team Define goals and process Process mapping Id failure modes Hazard analysis Action plain
Timing of RV failure after MI
What vessel
Acute
RCA
Timing of papillary muscle rupture after MI
What vessel
Acute or within 3-5days
RCA
Timing of interventricular septum rupture after MI
What vessel
Acute or within 3-5 days
RCA or LAD
Timing of free wall rupture after MI
What vessel
Within 5 days - 2 weeks
LAD
Timing of LV aneurysm after an MI
What vessel
Up to several months
LAD
HIV, several months of anal pain and bleeding, anal ulcer, painless lymphadenopathy
DX?
Anal cancer d/t HPV
In LGV d/t Chlamydia trachomatis, lymphadenopathy is…
The ulcer is…
Painful
Non tender
Pregnant patient with fever, chills, SOB, blank pain
Diffuse bilateral crackles
R flank tenderness
Cervix 1 cam, contractions q 5 min
Dx?
Acute pyelonephritis complicated by ARDS and preterm labor
Child comes in for acute mastoiditis, what’s next
IV ab’s
Do not need imaging unless complications
In antiphospholipid antibiody syndrome, PTT is (short/prolong)
What antibodies?
Prolonged (even though they are prothombotic)
Anti-beta-2-glycoproteins 1, antiphophatidylserine, anticariolipin
Painless ulcer on penis for months, inguinal lymphadenopathy, smoker
Dx?
Penile cancer
Loss of peripheral vision
Open angle glaucoma
Anticoagulation in pregnancy
LMWH
What is DRESS Syndrome?
Drug: MC allopurinol and anti epileptics
Reaction: morbiliform eruption, starts on face—> diffuse
Eosinophilia
Systemic symptoms: fever, malaise, diffuse lymphadenopathy, organ involvement
Latency of DRESS syndrome
Long, 2-8 weeks
Tx of DRESS syndrome
Stop drug, supportive care
Was in Panama
Took chloroquine for malaria
Now symptoms are back
Etiology, why? What additional therapy?
P. Vivax, dormant period, add primaquine to attack dormant hepatic phase
AUB, pelvic pressure, symmetrically enlarged uterus, friable vaginal lesion
Spontaneous abortion 6 months ago
DX?
Choriocarcinoma with vaginal metastasis
Time difference between MDD and GAD
MDD: >2 weeks
GAD: >6 mo
Palpable thrill accompanied by harsh holosystolic murmur in 4th L ICS
VSD
15 month old refusing to bear weight on R leg
URI 2 weeks ago, Born breech
Hip external rotated, cries when moved
T 102.6, 19,800 leukocyte, ESR 55
Dx? D/t?
Septic arthritis d/t hematogenous bacterial spread into joint space
MC etiology of septic arthritis
S. Aureus and GAS
Single most effective strategy to prevent acquiring HSV?
Consistent condom use
Patient took multiple meds for migraine, now can’t sit and needs to walk
Side effect d/t?
Prochlorperazine, akathisia
To start isotretinoin, what do you need and what does the patient need to do
2 negative pregnancy tests
And
2 forms of contraception
Initial approach to behavioral regression after birth of younger sibling
Spend 1-on-1 time
Patient on carbamazepine, now has nausea, forgetfulness
Na 125
Dx?
SIADH d/t side effect of carbamazepine
Serum osm, urine osm, urine Na in setting of SIADH
Low, high, high (>40)
Lung cancer with cavitary lesion
Squamous cell carcinoma
4 y/o has URI resolve 2 days ago
Now has ataxia, horizontal nystagmus for several hours
Dx?
Acute cerebellar ataxia
Pathophys of direct inguinal hernia
Weakening of inguinal canal floor
Pathophys of indirect inguinal hernia
Failure of processes vaginalis closure
First line tx for gentian warts for pregnant women
Topical trichloroacetic acid
