UWorld Facts 5 Flashcards
From where should lymph node biopsies be made to make a definitive diagnosis of sarcoidosis?
1) any palpable lymph node
2) subcutaneous nodule EXCEPT erythema nodosum
3) enlarged parotid
4) lacrimal gland
* *if there is no easily accessible lesion, fiberoptic bronchoscopy with transbronchial lung biopsy is the procedure of choice
* *nerve and liver biopsies are not recommended unless all other approaches fail
T/F: WPW is an uncommon cause of SCD in young athletes.
True (but anomalous origin of coronary artery, on the other hand…)
What is the side effect of gingko biloba? What is it used for?
used for “memory booster.” Side effects include seizures and increasing the risk of bleeding, including inhibiting platelet-activation factor
What is aconite?
an ingredient in Chinese herbal medicines used to treat pain or heart failure. Can cause fatal arrhthmias, including VT or SVT, first degree heart block, BBB, TdP
Tinea versicolor is a non-invasive fungal infection of the skin caused by
Malassezia species (rash is more prominent in the summer)
How do you treat tinea versicolor?
topical antifungal: selenium sulfide, terbinafine, clotrimazole, and ketoconazole
The risk of transverse limb abnormality, complication of CVS, is greatest when age of gestation is __ weeks
GREATEST RISK: 11 weeks
Asymptomatic subclinical hypothyroidism does not require treatment. Treatment is warranted when:
presence of:
1) antithyroid antibodies
2) abnormal lipid profile
3) sx of hypothyroidism
4) ovulatory and menstrual dysfunction
What types of viruses are the usual causes of viral meningitis or encephalitis in the pediatric population of the US?
enteroviruses or arboviruses (more common in the rural areas)
Urticarial plaques, papules and vesicles surrounding the umbilicus:
herpes gestationis
Papular urticarial papules and plaques of pregnancy is characterized by pruritic erythematous papules where?
within the striae gravidarum (abdominal striae; usually spares the periumbilical area)
What ist he Wolff-Chaikoff effect?
An impact of amiodarone on thyroid function – high iodine content in amiodarone inhibits thyroid synthesis, leading to primary hypothyroidism
**can also decrease peripheral conversion of t4 to 53 and nl or mildly elevated TSH. Can also induce thyrotoxicosis
What is ginseng used for? What is the side effect?
Ginseng is used for improved mental performance. Side effect is increased bleeding risk
What is saw palmetto used for? What are the side effects?
Saw palmetto is used for BPH. Causes mild stomach discomfort nad increased bleeding risk
What is black cohosh used for? What are the side effects?
Black cohosh is used for postmenopausal symptoms (hot flashes and vaginal dryness). Causes hepatic injury and increased bleeding (antiplatelet properties)
What is St. John’s wort used for? What are the side effects?
St John’s wort used for depression and insomnia.
Side effects are drug interactions with antidepressants (serotonin syndrome), OCP, anticoagulants (decreased INR), digoxin.
Can also cause HYPERTENSIVE crisis
What is kava used for? Side effects?
Kava is used for anxiety and insomnia. Can cause severe liver damage.
What is licorice used for? What can it cause?
Licorice can cause stomach ulcers, bronchitis/viral infections. Can cause hypertension, hypokalemia.
What does the hook of hamate contain? How does its fracture present?
Hook of hamate contains the ulnar artery and nerve. Pain and swelling of the hypothenar eminence and ulnar aspect of the wrist occur with fracture.
CPRS can occur as a complication of distal radius fracture and in patients with wrist fracture splinted with palmar flexion >__*
> 15*
A crescent-shaped hypoechoic region adjacent to the gestational sac (the most commonly identified source of first-trimester bleeding) is:
subchorionic hematoma
What is the most common congenital heart disease in children with Down’s syndrome?
What are other common malformations?
endocardial cushion defect
other malformations that are common in Down’s syndrome include duodenal atresia, Hirschsprung’s disease, atlanto-axial instability, and hypothyroidism
What is the most well known anatomical predisposing factor for Mallory-Weiss syndrome?
hiatal hernia (transmural pressure gradient is greater within the hernia than the rest of the stomach)
How long should people be on antidepressants?
6m to a year, then can be stopped.
But in those who have had two or more episodes, they should be on the med chronically
What is the treatment of chronic urticaria?
second generation antihistamine: loratadine or cetirizine
**if no improvement, then first gen H1 blocker (hydroxyzine), montelukast, or h2 blocker, or a brief course of oral steroids
Carotid endarterctomies should be performed with stenosis >__ %
70
What is a visual defect disorder with mitochondrial inheritance?
Leber hereditary optic neuropathy
All children age _____ months with UTI should undergo renal and bladder ultrasound to evaluate for anatomic abnormalities that might predispose the child to a UTI.
Which kids should undergo a voiding cystourethrogram?
Kids age 2m to 2y with Abnormal renal and bladder ultrasound (hydronephrosis, reflux, obstruction) or recurrent UTIs.
What is a serum-sickness like syndrome? What type of hypersensitivity reaction is it?
Fever, rash, arthralgias–usually resolves with onset of jaundice. Type III reaction.
What are the extrahepatic manifestations of hep B infxn that can be caused by circulating immune complexes?
polyarteritis nodosa, glomerulonephritis (usually membrane nephropathy, less often membranoproliferative glomerulonephritis), and serum-sickness
Autoimmune hemolytic anemia is explained by what type of hypersensitivity reaction?
Type II–mediated by cytotoxic antibodies
Contact dermatitis is what type of hypersensitivity reaction?
type IV
For which patients is dronedarone NOT recommended?
severe heart failure (NYHA class III or IV), those with hospitalized HF within the past 4 weeks, and/or those with LV systolic dysfunction w/ EF
What are causes of TdP?
1) PVCs with compensatory pause
2) bradyarrhthmias (sinus bradycardia, or frequent pauses)
3) electrolyte imbalances (hypoM, hypoK, hypoCa)
4) SSRIs, macrolides, antipsychotics, FLQs, antifungals, amiodarone/antiarrthymics
5) hypothermia
6) HIV infxn
What class of antiarrhthmic is amiodarone?
class III
What are classIB antiarrhthmics? How do they work?
lidocaine, phenytoin. Work by shortening the action potential duration
Which abx are most likely to causes seizurs?
penicillins, cephalosporins, monobactams, carbapenems, and FLQs
What should be suspected in patients with a history of Hashimoto’s who have a rapidly enlarging thyroid gland and subsequent obstructive symptoms?
thyroid lymphoma
Acute pericarditis (infarction pericarditis) can occur within \_\_\_\_\_\_\_\_ of a transmural How is it managed?
1-4 days
Manged with high dose aspirin
This complication of MI is not usually associated with chest pain, occurs as a late complication that develops over time, and is associated with persistent ST elevation.
Left ventricular aneurysm
When does papillary muscle rupture occur after MI? What does it cause?
occurs 2-7 days after infarction. Causes acute hemodynamic instability and acute pulmonary edema