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Uworld questions > uworld deck 5 > Flashcards

uworld deck 5 Flashcards

1
Q

most effective tx for COPD?

A

smoking cessation

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2
Q

best way to dcrs risk of CV disease?

A

smoking cessation

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3
Q

What is common complication of gastric bypass?

A

stomal stenosis -> stricture of anastamosis of gastric pouch and jejunum

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4
Q

Systemic effects of COPD?

A

svr COPD can cause weight loss, skeletal muscle dysfxn, incrsd CV morbidity and mortality

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5
Q

How best eval secondary amenorrhea?

A

best to do progestin w/drawal challenge

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6
Q

How eval abnormal uterine bleeding?

A

do endometrial bx after pelvic exam and pap smear

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7
Q

si//sx of cellulitis?

A

rapidly spreading, dermal and subcu infxn, most freq caued by staph aureus or GAS. px w/ well demarcated area of warmth, swelling, tenderness, erythema

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8
Q

What is presentation of seborrheic dermatitis?

A

scalp/ face rash w/ erythematous lessions w/ dry or greasy scales or crusts.

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9
Q

How tx seborrheic dermatitis?

A

low potency steroids on face, ketoconazole cream, medicated shampoos

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10
Q

What is rosacea? Si/sx?

A

chronic inflamm of skin, usually on face. >30 y/o pt. px w/ erythema, telangiectasia, pustules, papules

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11
Q

How does tinea cruris px?

A

involves groin, rarely scrotum, may have central clearing w/ darker border

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12
Q

Most common cause of erthema multiforme?

A

most often infxs cause… esp herpes simplex

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13
Q

How does erythema multiforme px?

A

appears as targetoid lesions.

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14
Q

How tx acute herpes zoster?

A

oral famciclovir w/in 72 hrs of formation of herpetic rash.

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15
Q

How differentiate SLE malar rash from rosacea?

A

malar rash spares nasolabial folds and areas below nares and lower lip. Rosacea won’t have systemic SLE sx

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16
Q

How tx inflamm Acne?

A

tx w/ oral ABX

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17
Q

What are types of Acne?

A

non-inflamm acne -> open and closed comedones, inflamm acne -> papules, pustules, nodules

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18
Q

What are non-concerning signs w/ LAD?

A

yng pt, <2 cm, freely mobile, rubbery, recent infxn

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19
Q

best method for screening of hearing impairment in adults?

A

whispered voice test

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20
Q

Best wy to eval fall in elderly?

A

get up and go test - > asses balance and gait

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21
Q

How tx urge inconctinence?

A

tx w/ anticholinergic like oxybutinin, can also use tolterodine

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22
Q

How manage young pts w/ mild/ pre-htn?

A

begin w. lifestyle changes, Dash Diet

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23
Q

Si/sx of coarctation of aorta?

A

Lower pulse delayed cmprd w/ upper extrem pulse, lower bp in lower extrem, will see rib notching on cxr, systolic and diastolic murmurs over back due to collateral formation.

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24
Q

How tx stg 2 htn?

A

systolic >=160 or diastolic >=100, begin w. 2 drug therapy

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25
Q

Mostcommon paraneoplastic syndrome assoc w/ squam cell carcinoma of lung?

A

PTH related peptide - > hypercalciemia

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26
Q

Sis/sx of GVHD?

A

rash on face, hands, feeet blood diarrhea, Incrsd LFTs, jaundice

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27
Q

What is cause of GVHD?

A

activation of donor lymphocytes against recipients wbcs/ rbcs

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28
Q

What is significance of positive prussian blue stain of UA?

A

demonstrates hemosiderin presence in blood suggesting oxidative stress

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29
Q

Most common cause of myocarditis?

A

viral, esp coxsackie A&B

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30
Q

How manage variceal bleeding?

A

majority stop spontaneously, can tx w/ vasoconstrictors -> octreotide, somatostatin, terlipressin

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31
Q

What is one result of incrsd CO in blood?

A

dcrsd O2 delivery to tissues leading to anearobic metabolism and lactic acidosis

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32
Q

effect of steroids on acid-base state?

A

can cause hypokalemia w/ metabolic alkalosis

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33
Q

effect of OSA on acid base?

A

causes resp acidosis

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34
Q

first step in tx of acute decomp HF?

A

give lasix, do not give beta blockers as will cause exacerbation

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35
Q

Side effects of EPO use?

A

worsenign of htn, HA, flu-like sx, red cell aplasia

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36
Q

tx of acute angle glaucoma?

A

timolol, acetazolamide, mannitol, pilocarpine

AVOID Atropine

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37
Q

Clinical fx of IBS?

A

recurrent abd pain/ discomfort for past 3 months + sx improvement w/ BM, chng in freq of stools, chng in form of stools, commonly px as chronic crampy ab pain.

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38
Q

Lab findings sugg of gallstone pancreatitis?

A

ALT>150, incrsd alk phos

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39
Q

What is most common cause of svr mitral regurg in developed nations?

A

mitral valve prolapse

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40
Q

How does anserine bursitis px?

A

pain centromedial just below joint line of knee, can occur due to abnormal gait, overuse trauma

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41
Q

What r risks of tamoxifen?

A

incrsd risk of endometrial cancer and VTE

42
Q

How does rubella present?

A

erythema/ maculopapular rash starts on face and moves to trunk and extrem, have fvr, LAD, arthralgia

43
Q

Risk w/ naficillin?

A

Can cause acute interstitial nephritis.

44
Q

What is tx for reactive arthritis?

A

1st line therapy is NSAIDS (NOT ABX)

45
Q

What is hiearchy of evidence?

A
  1. meta-analysis of RCT, 2. RCT 3. Cohort, 4. case-control, 5. case series.
46
Q

What are cross-sectional studies?

A

snapshot of population at given pt in time

47
Q

What is a case control study?

A

pts selcted cause they had specific outcome (like disease), and their hx is retrospectively reviewed to ID exposure or risk fx.

48
Q

What is cohort study?

A

subjects are slected because of exposre (like smoking, living in certain city), and followed over time to watch development of disease

49
Q

What is RCT?

A

type of cohort study w/ control group and study group. Pts randomly assigned to each group.

50
Q

What is sensitivity? Eqtn?

A

true +/ true (+) + false (-), essentially rate of false negative

51
Q

What is specificity? What eqtn?

A

true (-)/ true (-) + false (+), used for disease confirm, may have false (-) but no false (+)

52
Q

What is PPV?

A

if pt tests (+), what r odds pt has disease, true (+)/ true (+) + false (+), depends on prevalence and sensiti/specific

53
Q

What is NPV?

A

prob of having disease in pt who tests (-). true -/ true (-) + false (-). high NPV important screening test

54
Q

Concern in diabetic w/ upper motor neuron sx?

A

At risk for epidural abscess. Get MRI.

55
Q

How does diabetic neuropathy usually dx?

A

usually only dx based on clinical exam finding, no EMG studies needed.

56
Q

If positive for GC/CT, what w/u needed?

A

Do HIV serology, Pap smear, RPR, hep B

57
Q

What is concern w/ recent travel and pneumonia?

A

If nothing on gram stain and recent travel, esp w/ hotel/ cruise stay, concern for legionella.

58
Q

How tx legionella?

A

tx w. azithromycin

59
Q

Si/sx of legionella infxn?

A

high fvr >39, GI sx, neuro sx, rales, focal lobar consolidation on cxr, must cx on charcoal agar.

60
Q

How manage SIADH?

A

if as/mild - > do fluid restrxn, if mod or sx - > hypertonic saline in 1st 3-4 hrs. Want sodium >120.

61
Q

What are causes of acute epididymitis?

A

Sexually transmitted - > if associated w/ pain @ tip of penis & urethral dc. Non STD if assoc w/ UTI or UTI sx preceding episode

62
Q

What is primary biliary cirrhosis?

A

Chronic liver disease w/ autoimmune destrxn of intrahepatic bile duct and cholestasis.

63
Q

WHat are si/sx of PBC?

A

severe pruritis, fatigue, hsm, xanthomatous lesions

64
Q

WHat antibody assoc. w/ PBC? What associated disease occur w/ PBC?

A

Antimitochondrial AB, associated w. sjogrens, reynauds, scleroderma, autoimmune thyroid disease. hypothyroidism, celiac disease

65
Q

How tx PBC?

A

ursodeoxcholic acid - > slows progression & relieves sx. Only do liver xplant if having advanced liver damage or cirrhosis

66
Q

What is most common cause of primary adrenal insufficiency in developed nations?

A

autoimmune adrenalitis. Due to antibody against steroidogenic enzymes.

67
Q

What is px of primary hypoaldosteronism?

A

hoTN, pigmentation, hypoNa, hyperK, eosinophilia, incrsd ACTH, low cortisol

68
Q

What Ab cause hashimotos?

A

anti-TPO and anti-thyroglobulin Ab

69
Q

What causes graves Dx?

A

thyroid stimulating immunoglobulins

70
Q

What is equation of absolute risk redxn?

A

Arr- RRR grp 1 - RRR grp 2

71
Q

What is equation for NNT?

A

NNT = 1/ARRR

72
Q

To Incrs sensitivity whwat must be incrsd?

A

must incrs true negative value

73
Q

How does giant cell tumor px?

A

expansile and eccentric lytic area of bone on xray. px w/ pain, swelling, dcrsd ROM, pathologic fx

74
Q

How does osteoid osteoma px?

A

sclerotic cortical lesion w/ central lucency (soap bubble appearence), px w/ pain that’s worse @ night and unrelated to activity.

75
Q

WHat is effect of pulmonary edema on lungs?

A

leads to V/Q mismatch, incrsd A-a gradient, nl or incrsd PaCO2, can correct w/ supplemental O2

76
Q

What diseases cause V/Q mismatch?

A

obstructive lung disease, atelectasis, pulmo edema, pneumonia

77
Q

What is nl A-a gradient?

A

<15, but increases with age.

78
Q

What is medical treatment for essential tremor?

A

beta blocker or primidonee

79
Q

What are adv rxns w/ primidone?

A

can lead to acute intermitten porphyria, ab pain, neurologic, psychiatric

80
Q

What causes blood at beginning of urination?

A

lesion in urethra (urethritis)

81
Q

Waht causes blood @ end of urination?

A

prostatic or bladder cause, can px w/ clots in urine.

82
Q

Blood during entire cycle of urine?

A

usually ureter or kidney cause, will not have any clots

83
Q

What is px of mixed essential cryoglobulinemia?

A

Presents w/ hematuria, RBC casts, proteinuria, and palpable purpura in hep C pt?

84
Q

Px of allergic conjunctivitis?

A

watery d/c, itchiness, hx of allergies, diffuse conjunctival infxn, follicular or bumpy conjunctival edema.

85
Q

How does viral conjunctivitis px?

A

usually unliateral, watery d/c, burning, sandy sensation.

86
Q

How manage peripheral arterial embolism?

A

Initiate heparin & if limb salvageable then start embolectomy

87
Q

How differentiate DI and psychogenic polydypsia?

A

DI is hypernatremic where psychogenic polydip px w/ hyponatremia

88
Q

How work up recurrent pneumonia?

A

If in some anatomic region, then likely underlying anatomic prob or obstrxn, Do CT to further ID

89
Q

Causes of recurrent pneumonia?

A

If same region - > bronchial compression, obstrxn (FOB, bronchial stenosis, bronchiectasis).

90
Q

How tx svr or sx hypercalcemia?

A

If w/ sx or > 14 -> NS infusion, no loop diuretics unless HF px. Long term tx w/ bisphosphonates

91
Q

Clinical si/sx of cushing?

A

prox muscle weakness, skin thinning, central obesity, htn, hypergluc, skin hyperpigmentation

92
Q

Si/sx of diverticulitis?

A

fvr, N/Vconstip, leukocytosis, LLQ pain

93
Q

How does sideroblastic anemia px?

A

microcytic hypochromic anemia w/ nml or incrsd Fe, w/ dimorphic RBCs. Tx by giving pyridoxine.

94
Q

How manage antiphospholipid syndrome?

A

give LMWH if prego to dcrs risk of spontan abortion

95
Q

What must be done if having radiating acute epigastric pain?

A

Must do ecg to r/o MI

96
Q

What are muscarinic antagonists used for COPD?

A

ipratropium and tiotropium

97
Q

How manage prego women w/ hep C?

A

vaccinate against A and B, can breast feed following delivery. Do not need to do C-section

98
Q

What is definitive tx for Graves? Contraindications?

A

radioactive iodine tx. Dont do if prego or have svr opthalmopathy

99
Q

Si/sx of UC?

A

bloody diarrhea, tenesmus, cramping, weight loss, anemia

100
Q

Extraintestinal manifestations in UC?

A

sclerosing cholangitis, uveitis, eryhtema nodosum, spondyloarthropaty.

Uworld questions (13 decks)

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