UWorld Self Assessment Flashcards
What 2 chemicals should come to mind for a pt who drank windshield washer fluid or anti-freeze? One main sx of each to tell them a part?
- Methanol = visual disturbances
2. Ethylene glycol = acute kidney injury (hematuria or renal failure)
Most common and feared complication of TPN?
-infection of cath tip
Acid-base disturbance caused by ethylene glycol ingestion?
-severe anion-gap metabolic acidosis
What is considered a reactive nonstress test? When is this test done? What does it assess?
- 2 or more heart rate accelerations of 15 bpm above the baseline –> last for 15 sec
- within the 20 min of observation
- *this test is usually done in high risk pregnancies to assess for fetal hypoxemia
Nontender skin nodules with centeral necrosis: what is it? What is it caused by? Who is it usually seen in?
- ecthyma gangrenosum
- caused by pseudomonas aeruginosa bacteremia
- can be seen in immunocomp pts
What is pulsus paradoxus typically a sx of?
- pericardial tamponade
- cardiac filling can only occur during deep inhalation bc thats when the neg pressure allows for the pressure difference btwn the vena cava and RA
Loss of palpable pulse during inspiration?
-pulsus paradoxus
Fever, headache, seizures, confusion, and stupor that develops over a few days?
-think: herpes simplex encephalitis
HSV encephalitis on CT/MRI and in CSF?
- CT/MRI will show abnormalities in the frontotemporal region of brain
- CSF = ^proteins, ^RBC, normal glucose
What is heard on exam in pulmonary fibrosis?
- basilar, fine, dry crackles
- “velcro”
FVC and FEV1/FVC ratio in pulmonary fibrosis?
- FVC = decreased
- FEV1/FVC = normal (or even increased) –> bc both will decrease the same!
What is one key feature of the pleural fluid in the pleural effusion caused by TB?
-very high total protein, > 4 g/dL
What is spontaneous bacterial peritonitis? Who is it commonly seen in? Ssx?
- bacterial infection of the ascitic fluid
- thought to be caused by bacteria that translocates across the intestinal wall and seeds into the ascitic fluid w/ in the peritoneal cavity
- non-specific ssx: abdominal pain and fever –> dont always see rebound tenderness and gaurding
- ascitic fluid neutrophil count > 250
What is the most common primary brain tumor seen in adults?
-gliomas
Polymyositis v polymyalgia rheumatica?
- polymositis = proximal muscle wkness + ^LDH + ^CPK
- polymyalgia rheumatica = proximal muscle tenderness w/out increase in LDH or CPK
Tx for Conn’s syndrome?
-spironolactone = inhibits aldo
What 2 markers are most specific for SLE?
- anti-DS DNA
- ant-Smith antibodies
What type of pain is sharp and localized?
-somatic pain!
What should diabetics do with their insulin when they are going to engage in intense exercise?
-decrease their dose! To avoid hypoglycemia!
Medical tx of overflow incontinence?
-cholinergic agonists
Tx for proteinuria?
-ACEi or ARBs
What should be given if steroids don’t work for tx of some kidney diseases?
-cyclophosphamide!
What cardiac problem can coxsackie B virus cause?
-dilated cardiomyopathy!
What should be thought of as the cause of painless jaundice unless proven otherwise?
-pancreatic cancer!
What is bacteremia in sickle cell pts most commonly caused by?
-strep pneumo!
Tx of acute dystonia?
-antihistamine = diphenhydramine
Tx for extrahepatic cholestasis?
-endoscopic stent placement
Tx of vasoocclusive crises in sickle cell anemia?
- Hydration
- Pain control
- Supplemental oxygen
First thing to do when septic shock is suspected?
- fluid bolus, since there is inadequate perfusion of tissues due to the vasodilation
- continue boluses until bp normalizes
Diarrhea, abdominal pain, bloating, and eosinophilia?
-think: parasite infection
Most common cause of renal dysfunction in multiple mylenoma?
-renal tubular damage from light chain casts
What lab abnormalities are usually seen with only one alpha globin gene abnormality? What is this condition called?
- Usually no symptoms and no lab normalities
- known as alpha thalassemia minima
Hemiparalysis w/contrlateral facial wkness: where is the lesion?
-pons!
Hemiparalysis + contralateral occulomotor dysfunction: where is the lesion?
-midbrain
What does a positive 99m-Tc-pertechnetate scan mean? What sx is usually seen?
- means there is ectopic gastric mucosa within a Meckel’s diverticulum
- sx: painless GI bleed in a kid
Shortly after thoracentesis a pt has rapid reaccumulation of pleural effussion, dificulty breathing, and hemodynamic instability?
-think hemothorax, which is a potential complication of a thoracentesis
Most common cause of idiopathic nephrotic syndrome in adults?
- focal segmental glomerulosclerosis
- AKA: membranous glomerulonephritis
What is the mechanism of nitrates in the relief of chest pain?
-venodilate = reduces preload = decrease myocardial oxygen demand
Bug that causes Meningitis in a transplant pt?
-think: listeria!
Decreased vibratory sense in an elderly patient?
-can be normal in an elderly pt
2 Causes of aortic stenosis in developed countries?
- Bicuspid aortic valve
2. Aortic root dilation
What is the protein and WBC levels in CSF of Guillian-Barre Syndrome?
- ^^protein
- normal WBC
What portion of the adrenal gland does a pheo arise from?
-chromaffin cells of the medulla
Calculation for anion gap?
- Na-(Cl + bicarb)
- normal: 8 - 12
How are ketones made?
-fatty acid breakdown by the liver
What should be given to a pt in DKA before insulin and after resuscitation?
-potassium!!
