UWorld Q's Flashcards by Emily Damba

2 years post kidney transplant, now has resistant hypertension, dx?

Most likely transplant renal artery stenosis

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Woman has mullerian agenesis, also must check for what? By what?

Renal abnormalities by renal US

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Conservative tx of uncomplicated kidney stones

hydration, analgesics, alpha blockers

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AIDS patient with diffuse, non tender lymphadenopathy; night sweats
CD4 208, undetectable viral load, medication compliant
Vitals T 100.2, BP WNL, pulse 102
CXR enlarged cardiac silhouette

Dx? Etiology?

Non-Hodgkin lymphoma due to reactivation of EBV

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Otitis externa tx?

Topical cipro

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Aplastic anemia
Bleeding gums
Fatigue
Failure to thrive and short
Hypoplastic thumbs

Dx? D/t?

Fanconi anemia due to DNA repair defect

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CGD diagnostic tests

Dihydrorhodamine test

Nitro blue tetrazolium test

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Euthyroid sick syndrome features

What is it

Decreased peripheral conversion of T4 to T3
Initially only low T3
Prolonged/ severe: low T3, T4, TSH

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T1DM wants to run a marathon, how will you change his insulin?

Decrease

Exercise induced hypoglycemia

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Elevated AFP, what produces it?

Fetal liver and yolk sac

Look for those cancers

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Diagnostics for UTI in kids

Renal and bladder ultrasound THEN voiding cystourethrogram

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Acute epididymitis etiology:

<35 y/o
>35 y/o

<35: sexually transmitted (chlamydia, gonorrhea)

> 35: bladder outlet obstruction (E coli)

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Sounds like testicular torsion but patient is able to resolve without intervention, dx?

Intermittent torsion

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4 month hx of achy joint pain
Pain increases with activity
Excessive sweating, poly uric, erectile dysfunction
Macroglossia, increased interdental spacing
XR of hand: widening of the joint spaces, osteophytes, thickened soft tissues
Lab: low T, hyperglycemia

Dx?

Acromegaly

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Baby has erythematous popular rash on occluded and intertriginous areas

Dx? D/t?

Miliaria rubra due to overheating and overbundling

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Hx of poorly controlled T2DM, hypertension
Persistent hyperkalemia
BP 150/90
Na 136
Cl 108
Bicarbonate 18

Dx?

Type IV Renal Tubular Acidosis

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T1DM, what other autoimmune dz do they probably have?

Celiac

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14 y/o female presents with symmetric arthritis is ankles, knees, elbows, wrists for 3 months. Tx?

Naproxen, NSAIDS

May need immunomodulators like MTX later

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Prosthetic joint infection etiology

<3 month

S. Aureus, gram neg rods, anaerobes

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Prosthetic joint infection

3-12 months

Coagulate negative staph
Propionibacterium
Enterococcus

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Prosthetic joint infection

>12 months

S. Aureus
Gram negative rods
Beta hemolytic strep

Due to recent infection at a distal site

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Omphalocele
Macrosomia
Macroglossia

Dx?

Beck with-Weidemann syndrome

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What nonopioid can you give in opioid withdrawal?

Clonidine

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2 day old, not feeding or sleeping well
High pitched cry
Tremors/seizures
Autonomic dysfunction
Tachypnea, vomiting, diarrhea

Dx?

Neonatal abstinence syndrome

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What is a hepatic hydrothorax

Transudative pleural effusion, due to small defects in diaphragm, permits peritoneal fluid to pass into pleural space, Mc on right side

Absent uterus | No pubic or axillary hair

Androgen insensitivity syndrome

Absent uterus | Tanner stage 4 or 5 pubic hair, has axilliary hair

Mullerian agensis

Bad side effect of PTU and methimazole How will you know they have it Tx?

Agranulocytosis Sore throat, fever Stop drug ASAP

How to diagnosis psychogenic nonepileptic seizures

Video EEG

Renal biopsy of Alport syndrome

Longitudinal splitting of GBM

Primary polycythemia: EPO high or low

Low

Secondary polycythemia: EPO high or low?

High

Earliest sign of burn wound infection

Change in appearance Partial thickness to full thickness

Burn wound sepsis systemic findings

T <36.5 C or >39 C Progressive tachycardia Progressive tachypnea Refractory hypotension

``` Painless lymphadenopathy Mediastinal mass Pruritus Eosinophilia Elevated LDH ``` Dx?

Hodgkin lymphoma

How to confirm neonatal abstinence syndrome

Urine drug screen

Tx for toxic shock syndrome

Clindamycin and Vancomycin

How to prevent febrile nonhemolytic transfusion reaction

Leukoreduction of blood products

Diagnostic work up of proteinuria; initial step

First morning urine protein/Cr ratio

Most common cause of newborn with 46 XX and ambiguous genitalia

Congenital adrenal hyperplasia

Confirmation test for disseminated histoplasmosis

Serum or urine Histoplasma antigen immunoassay

Felty syndrome

RA + neutropenia + splenomegaly

Do you need antibiotics for campylobacter gastroenteritis?

No Unless severe: >7 days, bloody stools, high fevers or i/c, pregnant

Metaphysical widening wit cuppping and fraying on X-ray | Dx?

Nutritional rickets

History of gastrectomy Glossitis Now has anemia, increase LDH, increase indirect bilirubin

B12 deficiency

Holly stolid murmur and thrill along left stern along border, what is the heart defect?

VSD

Which way shunting in VSD early on?

Left to Right

Mom had VZV at delivery, what to do for infant?

Isolate and give VZV Ig

``` Old Weight loss Constant epigastric pain Smoking hx Recent dx of DM ``` Dx?

Pancreatic cancer

HepB is associated with what kidney thing

Membranous nephropathy

What class of anti arrhythmic drugs cause PR prolonged

CCB and beta blockers

What class of antiarrhythmics cause QRS prolong

Class IA and IC (Na channel blockers)

What class of antiarrhythmic drugs cause QT prolong

Class IA and III, K channel block

What study to get in restless leg syndrome

Iron studies

Risk for PACs

Tobacco, alcohol, caffeine, stress

What should you empirically treat in a patient with a smoke inhalation injury

Cyanide toxicity

What does ANOVA compare?

>3 independent groups

Define Absolute risk reduction

Percentage indicating actual difference in event rate between control and treatment

Define relative risk reduction

Percentage indicating relative reduction in the treatment event rate compare to control group

Define relative risk

Ratio of probability of an event occurring in the treatment group compared to the control group

Ways to calculate RRR

RRR=ARR/Risk control Or RRR=1-RR

Define response bias

In cross-sectional students, participants purposely give desirable responses to questions about topics perceived to be sensitive

Definite admission rate bias

Occurs when a distortion in the risk ration exists due to hospitals’ differing admission rates for certain cases Ex: hospital has a specialized cardiology service, so they get more cardio patients

Define attributable risk percentages

Percentage of disease in an exposed group that can be attributes to expose

2 Calculation for ARP

(Risk exposed -Risk non exposed) / Risk exposed Or ARP = (RR-1)/RR

Define attrition bias

Unequal loss of participants from study in follow-up

What is Type 1 error (alpha)

Probability of rejecting a null hypothesis that is true False positive You say there is a difference when there isn’t

What is Type 2 error (beta)

Not rejecting the null hypothesis when it’s actually false False negative You said there was no difference, when there was

What analysis technique should you use for 1 quantitative dependent (outcome) variable >/=1 independent (explanatory) variable

Linear regression | Or correlation

What analysis technique should you use for Qualitative dependent variable Qualitative independent variable

Chi square Or Logistic regression

What analysis technique should you use for Qualitative dependent variable Quantitative independent variable

Logistic regression

What analysis technique should you use for Quantitative dependent variable Qualitative independent variable

T test ANOVA Linear regression

What is the dependent variable

The outcome

What is the independent variable

The explanatory

Define Berkson bias

Disease studied using only hospital-based patients may lead to results not applicable to target population

Define Neyman bias

AKA Prevalence bias Exposures that happen long before disease assessment can cause study to miss deceased patients that die early or recover

Define attrition bias

Significant loss of study participants may cause bias if those lost to follow up differ significantly from remaining subjects

Types of selection bias

``` Ascertainment (sampling) nonresponse Berkson Neyman (prevalence) Attrition ```

Types of Observational bias

Recall Observer Reporting Surveillance

What is a per-protocol analysis

Compadres treatment groups by including ONLY those participants who STRICTLY ADHERED AND COMPLETED THE PROTOCOL

What is the intention-to-treat principle

Analysis includes all participants as initially allocated after randomization regardless of what happens (dropouts)