Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Uworld questions > Uworld deck 1 > Flashcards

Uworld deck 1 Flashcards

1
Q

What is req for dx of Type II DM?

A

a) fasting gluc >126, b) random gluc > 200 & sx of hyperglyc, c) 2 hrd GGT > 200

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is impaired fasting glucose?

A

Fasting glucose 100-125, in between state between normal and DM.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How tx impaired fasting glucose or impaired GGT?

A

tx with lifestyle changes, diet, exercise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

When is metformin contraindcated?

A

Dont use if renal insufficiency, Cr>1.4. Can lead to worsening lactic acidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How tx hospitalized pt with DM II?

A

Tx w/ basal + bolus insulin using long acting insulin (lantus, novolog) and short acting (reg insulin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How tx diabetic retinopathy?

A

laser ablation w/ pan retinal photocoag

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How does diabetic retinopathy px?

A

px w/ non prolif w/ hard exudates, microaneurysms, minor hemorrhages + cotton wool spots of neovascularization. Can lead to retinal detachment + vision loss.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is optimal basal insulin tx?

A

Should be peakless, 24 hr duration. Includes Lantus and Novolog

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Best tx for hyper and hypo episodes?

A

If having many episodes of either, do basal/bolus regimen w/ lantus and novolog, shouldn’t have peaks and troughs with this.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How best manage HHS?

A

1) replinish IV volume w/ fluids, 2)once volume replete start Insulin GGT, 3)Cont drip till Gluc=250.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How manage blood sugars in DKA?

A

use insulin drip, not SQ

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How do xanthomas appear?

A

yellow, orange, reddish, brown papules, nodules. If on eyelid then xanthelasma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How manage isolated low HDL?

A

tx with lifestyle modifications. No meds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is considered HLD?

A

Total fasting chol>200, LDL goal varies based on risk fx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are LDL goals?

A
  • 0 - 1 risk fx goal <160
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How tx high cholesterol and high TGs?

A

use fibrates if TG>200 + elevated non HDL cholest.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is colestipol?

A

colestipol and cholestyramine are bile binding resins that block absorption leading to decreased LDL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

LDL goal if hx of TIA/stroke?

A

LDL < 100

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How diagnose hypothyroidism?

A

Can diagnose based on labs and sx. Don’t need to ID any stimulating or inhibitory thyroid Ab.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How manage hypoythyroidism in pregnancy?

A

Need ot do repeated TSH and Total T4, free T4 can be misleading due to increased protein binding lipids in serum.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How tx Graves disease?

A

atenolol + methimazole. Can also use radioactive I- for first line.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

CV si/sx of thyrotoxicosis?

A

tachy, htn (esp elevated systolic), widened pulse pressure, lid retrxn.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How workup adrenal incidentaloma?

A

Get plasma metanephrines levels and overnight dexamethasone suppression test.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Diagnostic findings for hyperaldosterone

A

aldo/renin ratio >20:1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is stress level dosing of steroids required?

A

should be 10 x normal dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

When is pneumococcal vacc indicated?

A

use when 65 or older. Give second shot 5 years after.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

When do DEXA scan?

A

Indicated in all WOMEN > =65 y/o. Can do earlier if high risk.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

How tx osteoporosis?

A

first do oral bisphosphonates. If cannot tolerate due to pill esophagitis can do IV zolendronate shots.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is raloxifene?

A

Selective Estrogen Receptor modulator.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Cause of meningitis in neonates?

A

GBS, Listeria, E coli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Cause of meningitis in 3mo-18 y/o?

A

N. mening, Strept pneumo, H. influe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Cause of meningitis in adults (<50)?

A

Strept Pneumo, N. mening, H. influ

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Cause of meningitis in elderly?

A

S. pneumo, N. mening, L. monocytogenes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Cause of meningitis in immunocomp?

A

L. mono, G- rods, S. pneumo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

How tx meningitis?

A

Begin ABX immediately after LP findings. Tx empirically until can narrow based on gram stain. Also use steroids if concerned about swelling.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Close contacts receive what for meningitis?

A

Get dose of rocephin or rifampin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Usual cause of encephalitis?

A

Usually viral: arbovirus (Eastern Equine, West Nile) Enterov, polio. Can also be non viral- toxo, cerebral aspergillosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

CD4 count at risk for toxo?

A

If CD4 < 200

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

How dx viral enceph?

A

LP for CSF - > leukocytosis, can do PCR for viral DNA, MRI to r/o masses, frontotemporal enhancement as seen in HSV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

How diff types of viral Hep xmitted?

A

A & E xmitted fecal-oral, B is parenteral or sexual, C is parenteral, D requires BsAg.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What are si/sx of viral hep

A

jaundice, dark urine (conj bili only), RUQ pain, N/V, fvr, malaise, LFTS>500.

42
Q

What are possible complications of hepatitis?

A

can get hepatic enceph, bleeding diasthesis (uremic platelets), hepatorenal syndrome

43
Q

What is significance of HBeAg?

A

If present, then patient is infective.

44
Q

What is only antigen present during window period?

A

Only have Hbcore antigen.

45
Q

LFT patterns in viral hep?

A

ALT>AST, ALT commonly >1000 in acute cases

46
Q

How tx chronic HBV?

A

IFN-alpha or lamivudine

47
Q

How tx chronic HCV?

A

IFN-a or ribavirin

48
Q

How tx botulism?

A

admit and monitor respiratory state, do GI lavage if ingestion w/in last 2 hours, give toxoid after specimen ID’ed.

49
Q

Most common UTI causes?

A

E. coli, S. saprophyticus, enterococcus, less commonly proteus, klebs, enterobacter, P.A.

50
Q

What is considered asx bacteriuria?

A

2 succesive + cultures (>10^5 cfu) w/out sx.

51
Q

What are si/sx of UTI?

A

dysuria, polyuria, urgency, gross hematuria can be px

52
Q

How confirm UTI dx?

A

requires urine cx, if sx w/ 10^2-10^4 cfu, then + for UTI

53
Q

What is considered complicated UTI?

A

any UTI that spreads beyond bladder, or that is due to structural or fxnl problem

54
Q

Tx options for uncomplicated UTI?

A

Bactrim for 3 days, nitrofurantoin for 5-7 days, fosfamycin X 1 dose, cipro x 3 days

55
Q

How tx prego w/ UTI?

A

ampicillin, amoxicillin, or cephalosporin x 7-10 days

56
Q

How manage recurrent UTI?

A

need to do U/S to r/o structural cause, cont ABX x 2 weeks & do urine Cx to determine cure

57
Q

Bugs most freq causing pyelo?

A

E. Coli, proteus, klebs, enterobact, P.A., also G+s like entero, S. Aeurus

58
Q

UA findings with Pyelo?

A

Pyuria, bacteriuria, leukocyte casts

59
Q

How tx pyelo?

A

bactrim or levaquin x 10-14 days if G-rods, Amox if G+ cocci. Can adjust based on cxs after initial empiric tx

60
Q

Si/sx of diphenhydramine posioning?

A

anti-cholinergic sx, drowsiness, confusion

61
Q

What are some anticholinergic sx?

A

dry mouth, dilated pupils, blurred vision, dcrsd bowel sounds, urinary retention

62
Q

How tx diphenhydramine OD?

A

tx w/ physostigmine (cholinesterase inhibitor)

63
Q

What is most common cause of death after MI?

A

complex vent arrythmias due to reentry arrhthmias

64
Q

What is risk w/ digoxin toxicity?

A

glyocside intox leads to incrsd ventric automaticity

65
Q

Earliest finding of Diabetic renal damage?

A

glomerular hyperfiltration — first sign of renal DM involvement, leads to later DM glomerular disease

66
Q

When tx primary adnrelalism w/ meds?

A

If bilateral hyperplasia or if unilateral but not surgical candidate

67
Q

What is typical px of acute hemolytic xfusion rxn?

A

occurs in 1st hr after xfusion, fvr, flank pain, hemoglobinuria, renal failure, DIC, due to ABO incompatibiltiy

68
Q

What is IgA anaphylaxis px in infusion?

A

occurs in seconds to minutes + px w/ angioedema, hypotension, dyspnea — LOC, resp failure

69
Q

Signs on ecg of 3rd degree heart block?

A

no assoc btwn QRS and P wave. P waves occur at rate of 90-120, QRS occur @ rate of about 30 bpm.

70
Q

How tx 3rd degree heart block?

A

pacemaker placement

71
Q

Si/sx of pulmo infrxn due to P/E?

A

prolong immobility, hemopytsis, dyspnea, tachy, chest pain w/ inspiration (pleuritic pain)

72
Q

What is risk w/ OCP use?

A

incrsd risk of thromboembolic event

73
Q

What is result of excess NSAID use on kidneys?

A

can get papillary necrosis, tubulointerstitial nephritis, px w/ polyuria and sterile pyuria

74
Q

How does acute/chronic GMN px?

A

hematuria, RBC casts, edema, htn, proteinuria

75
Q

What is cause of immune thrombocytopenia?

A

platelet destrxn due to IgG Ab against platelet membrane glycoproteins

76
Q

What is bernard Soulier syndrome?

A

AR defect on platelet glycoprotein — mild dcrs in platelets, giant platelets on smear, svrr platelet dysfxn, bleeding out

77
Q

Electrolyte abnm w/ legionella pneumonia?

A

can get hypoNa (only seen in this pneumonia), can also see incrsd LFTs

78
Q

What prolongs survival in COPD?

A

long term supplemental O2 therapy the major cause of improvement. Beta agonist important in tx too for exacerbations.

79
Q

What is risk fx w/ amitryptilione and other TCAs?

A

can get urinary retention due to anticholinergic side effect

80
Q

How does urinary retention resent?

A

Abd pain w/ midline tenderness below umbilicus

81
Q

What bugs typically cause aspiration pneumonia px due to impaired cough reflex?

A

aerobic oral flora (viridians strept) and anaerobes

82
Q

What is greatest risk fx for SCC of skin?

A

sunlight exposure

83
Q

What is erysipelas?

A

type of cellulitis px w/ priminent swelling w/ demarcated border, tender skin lesion

84
Q

WHat bug causes contact-lens associated keratosis?

A

pseudomonas and serratia. CAn also be due to G+ or fungi

85
Q

What is episcleritis?

A

red eye w/ patchy distribution, mild pain, no vision abnormalities

86
Q

What is risk of TPN? How manage?

A

hyperosmolar fluid can damage veins leading to thrombosis. If occurs, 1st remove catheter, short term of anticoag until resolves

87
Q

Where do pressure ulcers most often occur?

A

usually on boney prominences esp at risk if patient immobile.

88
Q

When are beta blockers contraindicated following MI?

A

if pt has subsequent decomp HF and pulmo edema

89
Q

Si/sx of liver failure?

A

telangiectasia, caput medusa, gynecomastia, terry nails, clubbing

90
Q

Prereqs for brain death?

A

need clinical/ radiologic signs of brain death w/ no evidence of drug/ ETOH intox, core temp must be >32, brain death must be confirmed by 2 docs

91
Q

Si/sx of tropica sprue?

A

chronic diarrhea — defic folate, B12 — MCV>100, glossitis, cheilosis, cramps, gas, weight loss

92
Q

CXR signs of Booerhaves?

A

widened mediastinum with unilateral pleural effusion

93
Q

What is effect of hypovolemic hemorrhage shock on CO?

A

dcrsd preload leads to dcrsd CO

94
Q

What is contraindication to succinocholine use?

A

hyperK — drug causes signif K release leading to arrhythm. includes pts w. crush injuries, pts w. demyelinatng syndrome (GBS), tumor lysis syndrome

95
Q

First test to confirm suspicion for DKA?

A

FSBS to determine

96
Q

Serious complication of aortic dissection?

A

can lead to cardiac tamponade

97
Q

What is problem w. extensive Beta agonist use?

A

dries K into cells and can lead to significant hypoK

98
Q

Signs of hyperestrogenism in men?

A

palmar erythema, spider angiomata, gynecomastia, testicular atrophy, dcrsd body hair

99
Q

What is cause of asterixis?

A

hyperammonemia 2/2 to liver failure

100
Q

Most common cause of osteomyelitis following puncture wound?

A

most often pseudomonas. If bone not involved more likely staph

Uworld questions (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions