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Step 3 > UWORLD Qbank wrongs > Flashcards

UWORLD Qbank wrongs Flashcards

1
Q

Fluoxetine?

A

Tends to be more ACTIVATING (jitteriness, anxiety, insomnia), NOT good for GERIATRIC patients

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2
Q

Urethral Diverticulum

A

Dysuria
Postvoid dribbling
Stress urinary incontinence
Dyspareunia
ANTERIOR VAGINAL MASS (tender, bloody, purulent fluid on manipulation)
RECURRENT urinary infections
BEST NEXT STEP DX → MRI OF PELVIS

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3
Q

Hysterosalpinography

A

Used primarily for infertility
Evaluates fallopian tube patency

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4
Q

Idiopathic Premature Pubarche

A

ISOLATED pubic hair development
- NORMAL bone age
- NO additional signs of adrenarche (acne)

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5
Q

Central vs Peripheral precocious puberty

A

Central –> immaturity of HPG axis
Peripheral –> excess sex hormones from gonads, adrenals, or an exogenous source

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6
Q

Non classic congenital adrenal hyperplasia

A

Autosomal recessive
DECREASED 21-hydroxylase activity
NORMAL glucocorticoids and mineralocorticoids
Clinical:
- Early pubic/axillary hair development
- Severe acne
- Hirsutism, oligomenorrhea GIRLS
GROWTH VELOCITY UP, AND BONE AGE UP
ELEVATED 17 hydroxyprogesterone level

TX: Hydrocortisone

NOT detected in NEWBORN SCREENING
NO SALT WASTING

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7
Q

Medical conditions causing enuresis

A
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8
Q

Enuresis differentiation
Primary vs Secondary

A

Primary enuresis: Night time continence has not been established

Secondary enuresis: new onset bedwetting, after age >5, after prolonged period of continence (<6 months)

Secondary –> RAISED CONCERN FOR STRESSOR or MEDICAL CONDITION

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9
Q

Secondary Eneuresis

A

URINALYSIS and SERUM CHEMISTRIES

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10
Q

Bipolar disorder hypomania disorder
What to do if patient does not want to adhere to meds??

A

Inquire about the initial symptoms patient experiences during mood episodes
- INCREASE patients self awareness of symptoms
- Immediately inquiring about med adherence, increases patient risk of resistance
- Ask patient to compare symptoms of prior mood episodes to current episode

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11
Q

TERATOGENS

A

Valproic acid
retinoic acid

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12
Q

Oral Candidiasis (thrush)

A

Plaques that can be sraped off
- NYSTATIN

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13
Q

Myocardial Infarction

A

ST segment ELEVATION or DEPRESSION

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14
Q

PULMONARY EMBOLISM

A

Right heart straining pattern –> right bundle branch block, inferior and precordial T wave inversions

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15
Q

Pulmonary embolism flowchart

A
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16
Q

PE (MASSIVE, SUBMASSIVE, LOW RISK)

A

Low risk –> NO RV dysfunction
Submassive –> RV dysfunction, elevated biomarkers (Troponin I and/or BNP)
MASSIVE –> HYPOTENSION (SBP <90) + rv dysfunction

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17
Q

BEST for detection of pneumothorax in ACUTE setting?

A

USG
- HIGH RISK of pneumothorax

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18
Q

Test of CHOICE of pneumothorax in NON ACUTE setting?

A

Low risk of TENSION pneumothorax
- Upright posteroanterior chest xray,

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19
Q

Urinary Incontinence

A

Overflow –> neuropathy + antimuscarinic meds
Stress –> increased intraabdominal pressure, sneezing, coughing, valsalva), positive bladder stress test (coughing + leak)

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20
Q

Normal aging

A

1st rule out depression (PHQ-2) or delirium

next –> 6 item screener
5-6 points is NORMAL

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21
Q

What happens to RV and LV in massive PE?

A

RV failure –> (dilation, ischemia, hypokinesis) –> poor LV filling and loss of CO

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22
Q

Fibroadenoma

A

estrogen sensitive!

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23
Q

Physiologic changes during pregnancy

A

Plasma volume UP
RBC mass UP –> more EPO –> up 20/30%
Hb concentration DOWN

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24
Q

Fever

A

Less than <5 days –> Supportive Tx
More than >5 days –> reevaluation

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25
Q

Kawasaki disease
Risk factors for coronary artery aneurysm

A

Concerned for CORONARY ARTERY ANEURYSM FORMATION

Major risk factor for formation
- Age <1, >9
- DELAYED treatment after day 10
- FAILED response to IVIG –> persistent fever or fever recurrence within 2 weeks after original resolution

26
Q

Kawasaki disease TX

A

ONLY circumstance you give a child <6 ASPIRIN
IVIG –> decreases risk of aneurysms

27
Q

Bicuspid aortic valve

A

STRONG association –> TURNER

Current guidelines state that TEE for first degree family members upon DX
Uncomplicated: ejection murmur, sound or click best heard at lower left sternal border

28
Q

Viral Meningoencephalitis

A

altered mental status + meningeal signs

29
Q

Px with SGLT2 inhibitors can develop?

A

DKA with normal or minimally elevated blood glucose

30
Q

Confidence interval OVERLAP

A

CI means or proportions of >2 groups do NOT overlap –> important to establish statistical significant difference between the groups

CI OVERLAP –> may or may not be a statistical difference between the groups

31
Q

Type I error risk elevated when ?

A

Conducting multiple independant hypothesiswithout proper adjustment to alpha level increases rate of type I error

32
Q

Rabies

A

HYDROPHOBIA is pathognomonic of RABIES
Manifestations 1-3 months after transmission

if patient is symptomatic –> progression to coma and death

treatment is preventive or palliative only

33
Q

NNTT

A
34
Q

ODDS RATIO

A
35
Q

FACIAL PALSY

A

PREDNISONE
ARTIFICAL TEARS
EYE PATCH

36
Q

turner syndrome comborbidities

A

female px with turner wants to get pregnant
- evaluate aorta with TEE or MRI
hormonal changes in female with pregnancy can increase risk of aortic dissection

37
Q

Peak expiratory flow rate

A

used to evaluate COPD

38
Q

COMPARTMENT SYNDROME

A
39
Q

UTI in CHILDREN

A

FIRST febrile UTI
<2 years of age
- RBUS (renal and bladder USG)
- if ABNORMAL –> NEXT –> VOIDING CYSTOURETHROGRAM

40
Q

Meningococcal Meningitis PROPHYLAXIS indicated in?

A

High risk contacts
- Same HOUSE
- Prolonged contact <8 hours
- Close contact <3 feet or with patient’s SECRETIONS
- ALL health care workers in contact with direct exposure to patient’s respiratory secretions

PROHPYLAXIS
RIFAMPIN, CEFTRIAXONE, CIPROFLOXACIN

41
Q

Borderline personality disorder

A

Borderline personality disorder
- unstable relationships
- self image problems
- mood instability
- impulsivity
- recurrent suicidal behavior
- TRANSIENT MOOD SHIFTS VERY CHARACTERISTIC

TREATMENT DIALECTICAL BEHAVIOR THERAPY

42
Q

Postpartum thyroiditis

A
  • Anti-thyroid peroxidase antibodies
  • Elevated serum thyroglobulin
43
Q

BRAIN DEAD PATIENTS for ORGAN donation

A

managed in ICU (ideally)
- Maintain hemodynamic support with IV fluids or pressors if needed
- Mechanical ventilation should be continued to prevent hypoxia or hypercapnia
- Hormone replacement therapy –> methylprednisolone, thyroid hormone, vasopressin

44
Q

Eosinophilic esophagitis in adults

A

Esophageal food impaction –> via fibrotic strictures
TH2 mediated
ATOPIC conditions assocaited –> ASTHMA OR ECZEMA
Hx of heartburn refractory to high dose PPI
DX via ENDOSCOPY + BIOPSY

45
Q

CREST SYNDROME

A
46
Q

OSA treatments

A

PEDS –> TONSILLECTOMY/ADENOIDECTOMY
ADULTS –> change sleep position or CPAP

47
Q

Eosinophilic esophagitis

A
48
Q

Acute Bronchitis

A

5 days to 3 weeks (+/- sputum)
post viral

49
Q

Pelvic organ prolapse

A
50
Q

Antiarrhythmic therapy in patients with AF

A
51
Q

ASD vs VSD

A

ASD –> L-R shunt, with wide and fixed splitting of second heart sound, mid systolic ejection murmur x increased flow across pulmonic valve, mid-diastolic rumble x increased flow across tricuspid valve

VSD –> HARSH holosystolic murmur max intensity over 3/4 intercostal spaces + thrill
SMALL –> LOUDER murmur
LARGER –> SOFTER murmur

52
Q

BEST way to minimize ascertainment bias + internal validity

A

BLINDING (patients and physicians)

53
Q

ABO hemolytic disease

A

A+ or B+ blood type infants with O+ mothers
- Mother antibodies attack babies RBCs
- Hyperbilirubinemia

EXCHANGE transfusion
- SEVERE hyperbilirubinemia : >20-25 mg/dL
- failed phototherapy with rapidly rising levels
- bilirubin induced neurological damage (lethargy, hypotonia)

TRANSFUSION –> FAILED phototherapy or BILIRUBIN >20-25

PREVENT KERNICTERUS

53
Q

Hawthorne effect

A

impact on behavior from being OBSERVED in a study

53
Q

Validity
Threats to EXTERNAL and INTERNAL validity

A
53
Q

Neurofibromatosis

A

AD mutation in NF1 tumor suppressor gene, 17q11.2
- Cafe au lait spots
- Scoliosis
- Neurofibromas
- Axillary and inguinal freckling
- Pseudoarthrosis

YEARLY OPHTHALMOLOGIC evaluation –> OPTIC PATHWAY GLIOMAS

54
Q

Cytochrome P450 inducers

example antiepileptics ?

A

CAN lead to decreased effectivity of oral contraceptives

phenytoin, carbamazepine, ethosuximide, phenobarbital, topiramate

55
Q

Antiepileptics that do NOT cause P450 induction

A

GABAPENTIN, VALPROATE

56
Q

Breast Implants

A

DO NOT increase risk for new or recurrent breast cancer, and DO NOT affect breastfeeding or pregnancy

Complications: rupture, infection, exposure, distortion of breast shape, ALCL –> anaplastic large cell lymphoma

57
Q

Aspiration Pneumonia

A

Patients AFTER resolution of aspiration pneumonia REQUIRE –> FULL SPEECH AND SWALLOW EVALUATION

58
Q

Acute Kidney Injury

A
59
Q
A

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