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0 - Step 2 CK > Uworld - Medicine > Flashcards

Uworld - Medicine Flashcards

1
Q

Which important complication of end-stage liver disease is characterized by a significant decrease in glomerular filtration in the absence of another clear cause of renal dysfunction, minimal hematuria (< 50 erythrocytes/hpf) and lack of improvement with volume resuscitation?

A

Hepatorenal syndrome (HRS)

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2
Q

List 3 ways to treat hepatorenal syndrome?

A
  • Address precipitating factors i.e., hypovolemia, anemia, infection
  • Splanchnic vasoconstrictors i.e., midodrine, octreotide, NE + albumin
  • Liver transplantation
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3
Q

What are 3 indications for giving HAV vaccine to patient with HIV?

A
  • Chronic liver disease
  • Men who have sex with men
  • IV drug users
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4
Q

Renal injury typically causes hypocalcemia; the presence of hypercalcemia suggests what?

A

Multiple myeloma cast nephropathy

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5
Q

Which drugs have ben shown to increase appetite and weight gain in pt’s with cancer-related anorexia/cachexia syndrome?

A
  • Progesterone analogues i.e., megestrol acetate and medroxyprogesterone acetate

OR

  • Corticosteroids
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6
Q

Transmural intestinal inflammation is seen in what?

A

Chron’s disease

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7
Q

What is the preferred initial DMARD in pt’s with moderately to severely active RA?

A

Methotrexate

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8
Q

What are 3 potential complications of primary biliary cholangitis?

A
  • Malabsorption
  • Metabolic bone disease i.e., osteoporosis or osteomalacia
  • Hepatocellular carcinoma
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9
Q

What is the most likely cause of occult GI hemorrhage days after being admittd to the ICU for septic shock?

A

Stress-induced ulcer

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10
Q

TTP must be treated emergently with what?

A

Plasma exchange (most important) + glucocorticoids

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11
Q

What are 3 effective first-line tx’s for uncomplicated cystitis in non-pregnant women?

A
  • Oral TMP-SMX
  • Nitrofurantoin
  • Fosfomycin
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12
Q

Pt’s with clinical signs of HTN but normal BP readings should be tested for what?

A

Masked HTN w/ ambulatory BP monitoring

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13
Q

Cupping of the optic disc with loss of peripheral vision is characteristic of what?

A

Open angle glaucoma

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14
Q

What is the preliminary investigation of choice in the managment of pleural effusion; exception?

A
  • Diagnostic thoracentesis
  • EXCEPT in pt’s w/ classic signs and sx’s of CHF, where a trial of diuretic is warranted
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15
Q

Which 2 markers are the most appropriate diagnostic tests for acute hepatitis B infection?

A
  • HBsAg
  • anti-HBc
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16
Q

What should be recommended as part of the initial tx regimen in all pt’s with intermittent claudication?

A
  • Low-dose aspirin + statin therapy
  • Exercise therapy
17
Q

Hyperkalemia with EKG changes needs immediate tx with what?

A
  • IV Calcium
  • Although this does not affect the serum K+ concentration, Ca2+ does ↓ cardiac membrane excitability and provide short-term cardioprotection from the membrane depolarizing effects
    of hyperkalemia.
18
Q

Pt’s with Turners Syndrome often present with rib notching and on cardiac auscultation have a short 2/6 midsystolic murmur heard at the left paravertebral interscapular area which is consistent with what?

A

Coarctation of the aorta

19
Q

What are the 2 classic autoantibodies most often assoc. w/ Dermatomyositis?

A

anti-Jo-1 (antisynthetase antibody) and anti-Mi-2 (against helicase)

20
Q

How is Dermatomyositis managed clinically and what type of regular screening is essential for these pt’s?

A
  • High-dose glucocorticoids PLUS glucocorticoid-sparing agent
  • Regular, age-appropriate cancer screening
21
Q

Why is there an increased risk of non-Hodgkin lymphoma in pt’s with chronic autoimmune diseases (i.e., SLE, Sjogren’s)?

A
  • Persistent B-cell stimulation
  • Immune dysregulation
  • Exposure to immunosuppressive agents
22
Q

What is the mainstay pharmacotherapy for Bell’s palsy?

A

Oral glucocorticoids (i.e., prednisone)

23
Q

In a pt with chronic liver disease, such as with chronic HCV infection, what are the strategies recommended to prevent further liver damage?

A
  • Alcohol avoidance
  • Hepatitis A and B vaccination
24
Q

Which 2 infectious agents are responsible for severe, acute retinal necrosis with pain, keratitis, uveitis, and funduscopic findings of peripheral pale lesions and central necrosis in HIV patients?

A

Both HSV and VZV

25
Q

Which cause of retinitis is painless and has findings of hemorrhages and fluffy or granular lesions around the retinal vessels?

A

CMV

26
Q

What laboratory value is often elevated in pt’s with upper GI bleeding; why?

A
  • BUN/creatinine ratio
  • Increased urea production from intestinal breakdown of hemoglobin
  • Increased urea reabsorption in the prox. tubule due to assoc. hypovolemia
27
Q

What are some underlying conditions which can increase thyroid binding globulin (TBG)?

A
  • Estrogens i.e., pregnancy and OCPs + estrogenic drugs i.e., tamoxifen
  • Acute hepatitis
28
Q

Which features of peritonsillar abscesses can be helpful in distinguishing from epiglottitis?

A

Deviation of the uvula and unilateral LAD

29
Q

Which DMARD sometimes used for RA is associated with retinopathy as an AE?

A

Hydroxychloroquine

30
Q

Which 2 pro-motility drugs can be used to tx diabetic gastroporesis?

A

Metoclopramide and Erythromycin (for short intervals <4 weeks)

31
Q

A patient with nephrotic syndrome develops sudden onset abdominal pain, fever, and hematuria; what is the most likely complication?

A

Renal vein thrombosis: most commonly see with membranous glomerulopathy

32
Q

Mixed connective tissue disease is an autoimmune disorder characterized by variable clinical features of what 3 autoimmune disorders?

A
  • SLE
  • Systemic sclerosis
  • Polymyositis
33
Q

Which serological marker has both high specificity and sensitivity for mixed connected tissue disease?

A

anti-U1 RNP

34
Q

What is the first-line drug therapy during the acute phase of reactive arthritis?

A

NSAIDs

35
Q

What are 6 common etiologies of crystal-induced AKI?

A
  • Acyclovir
  • Sulfonamides
  • Methotrexate
  • Ethylene glycol
  • Protease inhibitors (-navir)
  • Uric acid (tumor lysis syndrome)
36
Q

What are the preferred pharmacologic agents for treating vasospastic angina?

A

Calcium channel blockers i.e., diltiazem, amlodipine

37
Q

Why is IgA antibody testing often negative in pt’s with biopsy confirmed celiac disease?

A

Many have an associated selective IgA deficiency, which is common in celiac disease

38
Q
A

0 - Step 2 CK (2 decks)

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