UWorld Q Bank: Final Stretch! Flashcards
______________ presents like Henoch-Schonlein purpura in an adult who has a history of IV drug use.
Mixed cryoglobulinemia
They both present with purpura, arthralgias, malaise, hematuria, and proteinuria. Other than a history of HCV, the only big difference is that MC presents with low complement.
____________ may present after rhinoplasty.
Septal perforation
Rigors after pregnancy may signify ___________.
nothing
While they could be a sign of fever, rigors in the postpartum period are common. They are thought to occur secondary to poor thermal regulation.
In addition to hirsutism, those with PCOS can actually have ______________.
male-pattern baldness
Those with IBD are at increased risk of what ophthalmologic concern?
Anterior uveitis
What is the uvea?
The tissue between the cornea and the retina
Hereditary spherocytosis can present as early as ____________.
the neonatal period
Postprandial hypoglycemia in a long-time diabetic can indicate what disorder?
Gastroparesis
If someone gives themselves a preprandial bolus of insulin and then their meal is stalled in their stomachs, then they will become hypoglycemic.
Which antibiotics are CYP inhibitors?
- Ciprofloxacin
* Clarithromycin / erythromycin
What synthetic cannabinoid is often given for weight gain in those with HIV cachexia?
Dronabinol
Note: it has not been shown to be effective in other types of anorexia, so megesterol is preferred for non-HIV cachexia.
Explain how severe B12 deficiency can cause hemolytic anemia.
B12 deficiency leads to megaloblastosis. Those large RBCs can actually break when leaving the bone marrow, leading to intramedullary hemolytic anemia.
Upper-lobe cavitation, hyponatremia, and hyperkalemia indicate _________________.
tuberculosis with adrenal destruction
How can you prevent uric acid stones?
- Hydration
* Potassium citrate (this alkalinizes the urine and prevents stone formation)
True or false: the best initial diagnostic in those with suspected diverticulitis is x-ray.
False
Abdominal CT with oral and IV contrast is the proper initial diagnostic.
Untreated, genital herpes has what usual course?
Decreasingly frequenty relapses
In the first year after infection, those with genital herpes will typically have five relapses. Frequency usually decreases after that.
Diagnose diabetes with ___________ in those with PCOS.
oral glucose tolerance test
It is more sensitive than the A1c.
Describe the presentation of sporotrichosis.
- Starts at distal extremities
- Papule that then ulcerates into non-purulent, odorless vesicle
- Spreads along lymphatics
- Vital signs normal
Atrial fibrillation most commonly arises from which site in the heart?
Pulmonary veins
The dermatitis of pellagra is ______________.
sun-sensitive (look for malar rash and rash on forearms)
Minimal change disease is seen in children and those with _______________.
Hodgkin lymphoma
Recall the association with cytokines.
Membranous nephropathy is seen in those with HBV, HCV, and ___________.
solid malignancies
Although many people think that OCPs cause ____________, several studies have shown this not to be true.
weight gain
Describe the differential for fetal growth restriction.
•Note if it has occurred throughout pregnancy or started later.
- Early FGR is either infectious (with multiple anomalies on US) or aneuploidy (fewer anomalies).
- Late FGR is likely due to maternal HTN or uteroplacental insufficiency.
In addition to diarrhea, dementia, and dermatitis, pellagra can also cause ______________.
glossitis
How does contraction alkalosis affect the urinary chloride?
It leads to high urinary chloride. The increased bicarb absorption leads to a need for another anion to be peed out.
Discuss how vitamin D can be used to differentiate between hyperparathyroidism and PTHrp.
PTHrp does not lead to as much conversion of vitamin D, so 1,25-Vitamin D will be normal or even low in hypercalcemia of malignancy.
A young woman has pulsatile tinnitus. What is the likely cause?
Fibromuscular dysplasia of the internal carotid
Discuss how the choice to do US for DVT differs based on presentaiton.
Those with suspected DVT only (that is, no PE symptoms) should have compression US done prior to anticoagulation. Those with PE symptoms go straight to anticoagulation.
“Pain out of proportion to the abdominal exam” is Step 2 code for ________________.
mesenteric ischemia
Hypoplastic thoracic cavity and multiple fractures at birth are consistent with _____________.
osteogenesis imperfecta
Matching patients to similar controls (like neighbors or those with the same comorbidities) controls for ____________.
confounding
Not selection bias!
Doing ______________ can trigger a thyroid storm in someone with Graves disease.
a contrast CT
The iodine load can induce a surger of thyroid hormone.
“Straight lines that appear wavy” on a visual exam are consistent with _______________.
macular degeneration
An enlarging blind spot is suggestive of _____________.
papilledema
Low levels of __________ can cause severe hypocalcemia.
magnesium
In addition to HOCM, murmurs from ____________ may increase with squatting.
MVP
In addition to macrosomia, babies who are post-term are at risk for ______________.
oligohydramnios (thought to be due to placental fatigue)
Although women give urine at each prenatal visit, culture is done only on ___________.
the initial one
Although it is recommended that the 13-valent PNA be given first in those 65 and older, the ___________ is given first in those with medical comorbidities.
23-valent
Although SCC more commonly ulcerates, BCC can, too. How can you tell them apart?
BCC has a pearly ring around its ulcer.
People with profuse watery diarrhea and recent travel hiking in streams may have _____________.
Cryptosporidium infection
Parasitic infections like Strongyloides usually present with additional symptoms (like pulmonary and derm stuff), so think of Crypto if all they have is diarrhea.
Distal neuropathy, hypo- and hyperpigmentation, transaminitis, and anemia are features of which toxidrome?
Arsenic poisoning
Look for the exposure to antique wood!
Remember, you need to wait ______________ before testing for G6PD.
3 months after the hemolytic attack
Testing during the attack will show up as normal.
True or false: give doxycycline for someone with headache and fatigue from Lyme.
True
Ceftriaxone is reserved for cardiac involvement (myositis or AV block), encephalitis, or nerve palsy. Fatigue and headache don’t count.
Osteitis deformans is seen in _______________.
Paget disease of the bone
Those with RA are at elevated risk for what orthopedic problem?
Osteoporosis
The chronic inflammation seen in RA stimulates increased bone resorption.
Discuss the three groups of therapy for hyperthyroidism and how to decide which to do.
- Mild disease: PTU, methimazole
* Moderate/severe disease: RAI, thyroidectomy
