UWORLD facts Flashcards
What are anti-pseudomonal antibiotics?
zosyn, cefepime, ceftazidime, imipenem, amikacin, gentamicin, tobramycin, meropenem, ciprofloxacin, aztreonam, colistin
What is hungry bone syndrome? What is the timeline following parathyroidectomy?
Hungry bone syndrome is caused by the sudden withdrawal of parathyroid hormone in patients with severe hyperparathyroidism. This “relative” hypoparathyroidism causes an influx of calcium from the circulation into the bone. The serum calcium falls to its nadir between TWO TO FOUR DAYS after parathyroidectomy.
What is the characteristic finding on manometry for esophageal scleroderma? How is it different from achalasia?
absence of peristaltic waves in the lower two-thirds of the esophagus and a significant decrease in LES tone
In achalasia, there is an absence of waves but an INCREASED LES tone
Smoking cessation at of age 60 or older has been shown to lower the risk of all-cause mortality and cardiovascular events within ___ years of quitting.
After how long does cessation reverse the loss of bone density and decrease the risk of osteoporotic fracture?
within 5 years = decrease all cause mortality (but it will be less absolute decline than at younger ages).
10 years for bone loss
What are the treatments for ADHD? How long is an adequate trial at max dose? What is the tapering schedule when you switch?
methylphenidates (amphetamine), atomoxetine (NE reuptake inhibitor), clonidine (alpha2 adrenergic agonist)
Stimulant doses are titrated up weekly until max dose; for a couple weeks.
No need to taper or washout; can switch immediately
What is the difference between conjunctivitis and keratitis?
conjunctivitis is inflammation of the thin conjunctival membrane overlying the cornea, whereas keratitis is inflammation of the cornea. This complication is more common in patients with contact lenses. Patients with keratitis typically have a foreign body sensation (vs the grittiness that patients with conjunctivitis describe).
Keratitis also has photophobia and corenal opacity or ulcereration.
How is keratitis different from enophthalmitits?
Endophthalmitis involves the cornea but also deepr components of the eye including the vitreous and aqueous humors. It is usually acquired through an open wound to the eye or a systemic route, and not through conjunctivitis.
Viral conjunctivitis, often caused by ______, frequently has other systemic manifestations such as fever, pharyngitis, and upper respiratory symptoms.
Adenovirus
What are the most common causes of bacterial conjunctivitis? What is the treatment?
staph, strep pneumo, moraxella catarrhalis, and H flu.
Treat with erythromicin ointment, sulfa drops, or polymyxin/trimethoprim drops.
In contact lens wearers, use fluorquinolone drops (ciprofloxacin or ofloxacin) because pseudomonas is more common in those patients
How does cyclosporin cause gout?
decreases urate excretion from the kidneys causing hyperuricemia
What are the large coin-like particles you might see on joint aspiration (esp the shoulder joint)?
calcium phosphate crystals (“Milwaukee shoulder”)
Allopurinol decreases the activity of xanthine oxidase, which is responsible for the metabolism of which med?
azathioprine
Renal transplant patients should have gout treated by
systemic or intraarticular steroids (NSAIDs can reduce renal blood flow w/ cylosporin; colchicine with azathioprine can cause leukopenia)
Who are thei gh-risk cardiac disease patients who should have an assessment prior to advising on activity (like sex) after MI.
1) refractory angina
2) NYHA class IV heart failure
3) significant arrhythmias
4) severe valvular disease
Who are the high risk patients with mechanical valves who need a target INR of 2.5-3.5?
1) mitral mechanical valve
2) aortic with high risk features including afib
3) LV dysfunction (EF
