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USMLE Step 2 > UWorld form 1 > Flashcards

UWorld form 1 Flashcards

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USMLE® Step 1 flashcards
1
Q

when do you do amnioinfusion

A

Cord Compression –> repetitive variables

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2
Q

painless ulcer with black necrotic center in immunocomp patient

A

ecythma gangrenosum= pseudomonas

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3
Q

in brief, CSF in HSV meningitis

A

lymphocytic pleocytosis, inc protein, nl gluc

inc red cells= from hemorrheage of frontotemporal lobes

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4
Q

why do you get hyperpigmentation with AI and ectopic ACTH

A

because POMC gets cleaved to ACTH –> both have high ACTH

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5
Q

features of hypercortisolism

A

high BP, purple straie, easy bruising, easy fatiguability

**most common paraneoplastic in Small cell lung cancer!!

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6
Q

when do you consider a pt in labor “arrest” and move to section

A

no cervical change >4 hours WITH good contractions

no cervical change >6 hours with bad contractions

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7
Q

most common reason for “protracted” labor

A

inadequate contractions, give IV oxy

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8
Q

TB pleural effusion vs empyema

A

TB= very high protein (>4), Glucose <60, lymphocytic predom

Empyema= very low glucose <30, neutrophils, FEVER!!

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9
Q

headache worse with leaning forward, some JVD, but no peripheral edema….

A

SVC syndrome, most commonly due to malignancy

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10
Q

SBP

A

enteric bacteria from gut translocates and causes infection. Present with fever, abd pain, ascities,

  • empirics= cephalosporin
  • proph= FQ
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11
Q

age demographic and prodrome to bullous pempHigoid

A

elderly, presents with urticarial/eczematous prodrome

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12
Q

classic ALS

A

UMN + LMN (fasciulations/ atrophy are signs of denervation)

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13
Q

three biggest risks of ALL types of diabetic mothers

A

macrosomia
RDS
premature delivery

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14
Q

“serositis” in SLE

A

pleurisy
pericarditis –> effusion
peritonitis

(**migratory joint pains)

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15
Q

drug of choice in monomorphic Vtach (stable)

A

AMIODORONE

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16
Q

thin, shiny skin in a person with CVD is ALWAYS:

A

PAD –> evaluate with ABI

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17
Q

most common cause of primary hyperaldosteronism (2)

A

bilateral adrenal hyperplasa –> tx with SPIRONOLACTNE

aldo producing adenoma –> adrenalectomy

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18
Q

hypercalcemia in primary PTH vs malignancy

A

much higher in malignancy

<12 in PTH

Hyperthyroidism can also cause hypercalcemia from increased bone turnover

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19
Q

overflow incont classic presentation

A

urinary freq, NOCTURIA, frequent dribbling

high post void residual

  • men >50
  • women >150
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20
Q

how do you treat incontinence:

  • stress
  • urge
  • overflow
A

stress= kegels, pessary, urethral sling procedure, pelvic floor surgery

urge= bladder training, antimuscarinics

overflow= cholinergics (bethanecol), intermittent self cath (neurogenic bladder)

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21
Q

BUN:Cr that suggests hepatic encephalopathy is due to GI bleed

A

> 20:1

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22
Q

differentiate galbladder mass from pancreatic

A

Pancreatic has jaundice and elevated alk phos/bili because it is OBSTRUCTING the gb

GB cancer is (much more rare) but also would still be able to produce bile and it wouldn’t show obstructive signs

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23
Q

signs of acute iron toxicity

A
  • hemmoragic gastroenteriris (caustic to GI tract)
  • dark stools, can be green

deFEroxamine!!

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24
Q

t/f: chronic ESRD can reactivate TB?

A

true

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25
Q

reactivation TB vs primary TB

A

presents with fever, COUGH, NIGHT SWEATS, HEMOPTYSIS, weight loss, fatigue and EFFECTS UPPER LOBES PRIMARILY

primary TB is usually mild, often turns latent, and is in LOWER/MIDDLE LOBE

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26
Q

miliary TB

A

systemic spread of dz –> effects bone, liver, lymphatics mostly, but can really go anwhere

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27
Q

three types of infx that TB can decide to do

A
  1. parimary/latent –> heal by fibrosis, mostly in kids
  2. miliary
  3. reactivation
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28
Q

potts deisease

A

when TB effects the bones

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29
Q

prognostic factor of astrocytoma

A

differentiation!! Most common brain tumor in adults

I/II lack central necrosis and increased mitosis

GBM= grade Iv

30
Q

infections in sickle cell dz

A

ENCAPSULATED ORGS

  • sepsis/meningitis/bacteremia= strep pneumo, h flu
  • osteomyelitis= salmonella, (staph too)
31
Q

dysgerminoma/seminoma

A

adolescents

-secrete bHCG and LDH

32
Q

granulosa cell tumor: young girl vs postmenopausal women

A

sx are bsed on high estrogen expression, so precocious puberty or endometrial bleeding

33
Q

c diff

A

don’t forget about c diff with recent antibiotic use!! don’t forget it can turn into toxic megacolon

34
Q

AHIA like looking picture but add decreased fibrinogen and increased INR…

A

DIC

35
Q

pain with relief of teste elevation suggests…

A

epididymitis –> treat with antibiotics

36
Q

absent cremasteric reflex suggest….

A

testicular torsion of spermatic cord (pampiniform plexus)

37
Q

JME

A

progression from absence –> myoclonus –> GTC (in teens)

worse with sleep deprivation

38
Q

what features typlica of ACTH dependeant process are NOT typical of ACTH independant process (exogenous steroids, adrenal adenoma)

A

hyperpigmentation

androgen xs

39
Q

best way to relieve PAIN of ACS

A

nitrates: venous dilation –> decreased preload/RV volume/wall stress–> decreased O2 demand

40
Q

gout treatment

A

1st line= lifestyle
1st line acute= NSAIDs ( indomethacin)
–> next: steroids or colchicine if RENAL contraindications for NSAIDs

Chronic= allopurinol for >2 attack/ year but DO NOT start right away

41
Q

celiac is what type of disorder?

A

AI malabsorption due to villous atrophy

***lactose intol DOES NOT cause fat malabsoprtion of fe deficiancy anemia

42
Q

albuminocytologic dissociation

A

normal leukocyte count with ELEVATED PROTEIN seen in GBS

43
Q

factitious disorder

A

INTENTIONAL production of sx to assume sick role

44
Q

viral (cocksakie A) strep

A

runny nose, cough, vesicles on posterior pharynx/tonsiler pillars

45
Q

wegners (granulomatosis with polyangitis)

A

ANCA
small-medium necrotizing vasculitis

upper airway: ENT, saddle nose deformity
lower airyway
kidney: rapidly progressive GN
skin: urticaria, pyoderma gangrenosum, NON HEALING WOUNDS,

46
Q

malnutrition in elderly

A

common in dementia

  • hypoalbuminemia –> edema
  • brusing –> C/K
  • gums –> C?
47
Q

risk/dx of myelodysplastic syndrome

A

older people and peopel with previous chemo/rad

-ovalomacrocytes (messed up red blood cells) and neutrophil hyposegmentation/ hypergranulation

usually presents with cytopenias

dx= BM tgap with hypocellular marrow

48
Q

EKG signs of impending hyperkalemia

A

flattening of P wave and wiening of QRS –> in the clinical context of something like recent seizure or rhabdo where K is on the rise

49
Q

pheo

A

adrenal medulla (from neuro endocrine cells)

  • makes you pale
  • beta blockade can cause RISE in BP –> tx first with alpha block, then add beta
50
Q

genetic disorders associated with peho

A

RET
VHL
NF1

51
Q

what complication of GAS does impetigo progress into

A

PSGN

52
Q

glucocorticoids in COPD exacerbation

A

decrease length of hospital stay

53
Q

neutropenic fever!!!!

A

sepsis with abnormal immune response in someone getting chemo

54
Q

mechanism of ketosis in DKA

A

fatty acids transfered to liver, broken down by lipolysis

55
Q

how do you CONFIRM CLL?

A

flow –> looking for monoclonal B cells

*treat with rituximab

56
Q

test for aortic rupture/ dissection

A

CT with contrast or tEe

not TTE

57
Q

painful, unilateral, fluctuant swelling on medial aspect of labia majora that extends into the introitus

A

bartholin gland cyst- pain with sitting, walking, sex

*usually e. coli

58
Q

sx of Graves:

  • skin
  • nails
  • eyes
  • menstrual cycle
  • ltyes
A

Skin: pretibial myxedema

Nails: onycholysis (nail separating from bed), CLUBBING!!

Eyes: lid log, proptosis

Menstural cycle: ammenorrhea/ irregularity

Lytes: HYPERcalcemia, hyperglycemia, bone loss

59
Q

headache, GI distress, petechial rash

A

rocky mountain spotted fever

60
Q

inreasing “night blindness”

A

cataracts! also see loss of distance vision

  • mostly happens to older people but idabetes is a risk too
  • expect to see loss of red reflex due to increasing opacification
61
Q

secondary thrombocytosis

A

think of spelnectomy

62
Q

sterile pyuria

A

> 3 WBC with NO bacteria –> sign of chlamydia urethritis!

63
Q

order of tocolytics in pregnancy

A

INT

Indomethacin –> cox inhibitor –> can’t use past 32 week because risk closing ductus

Nifedipine –> 32-34 weeks –> can cause tachy, flushing, nasuea, headaches

Terbutaline (beta ag) –> used short term in patient

64
Q

use of Mg as “tocolytic”

A

neuroprotection for babe. it is a weak tocolytic

65
Q

types of cyanosis in a new born

A

CENTRAL: highly vascular things like lips, mm –> due to decreased O2 sat

PERIPHERAL: blue extremeties–> NORMAL O2 sat but INC O2 extraction

66
Q

striate palmar xanthomas

A

yellow streaks on palms indicative of high triglycerides like in dysbetalipoprteinemia

67
Q

differentiate rash of measles and rubella

A

both occur with fever and spread from face down

measles= “dark brick red”

rubella= lighter

68
Q

what do you see on UA in rhabdo

A

“blood” on dipstick but it is false positive because it thinks its hemoglobin

no casts!! unless ATN

69
Q

decreased cancer risk with OCPs

A

endometrial

ovarian

70
Q

class III antiarrythmics

A

can cause arrythmias –> look for precipitants like diarrhea to push someone into wide QRS –> into torsades

USMLE Step 2 (18 decks)

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