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Step 2 > UWorld Step 2 > Flashcards

UWorld Step 2 Flashcards

1
Q 
Baker (Popliteal)'s cyst
path
pt
Tx
looks like what?
A

path: intra-articular pathology
pt: rupture –> pain, swelling, warmth, eccymosis
looks like: aute DVT

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2
Q

Clinical assessment of Acromegaly:

pt, Dx, Tx

A

Pt:
- glucose intolerance (induced gluconeogenesis)
- cardiomegaly
- growth of hands, feet, face, visceral organs
Dx:
1. IGF-1 (somatomedin)
2. Glu suppression test fails to suppress
3. MRI
Tx:
1. surgery
2. octreotide (Residual tissue)

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3
Q

clinical syndromes of coxsackie virus

A 
Coxsackie A & B
Hand Foot and Mouth disease
- herpetic gingivostomatitis (gray vesicles/ulcers on post pharynx)
- pharyngitis
- red vesicular rash
- fever
- kids
- summer
2. Aseptic meningitis 
3. Dilated Cardiomyopathy 
4. pleurodynia

(UWorld + sketchy)

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4
Q

cx: filamentous gram + rods with rudimentary branching
pt:
Clx findings:
Tx:

A

Actinomyces

pt: 
dental infx, trauma
mandible
non-painful mass
sinus tracts w/sulfur granules

Tx: PCN for months

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5
Q

lifestyle tx of HTN (5, in order of greatest affect –> least)

A
  1. wgt loss (5-20mmHg/10kg loss)
  2. DASH diet
  3. Excersice
  4. Dietary Na
  5. ETOH
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6
Q

most sensitive test to screen for diabetic nephropathy?

A

random urin for microalbumin/Cr ratio

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7
Q

painless hematuria in a sickle cell kid?

labs?

A

Renal papillary necrosis

labs: normal labs, normal appearing uRBC’s but elevated (= extra glomerular)

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8
Q

Tx of clubfoot

A

immediate stretching, manipulation –> serial casting/splinting/taping –> surgery if necessary (at 3-6mo)

(UWorld)

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9
Q

enzyme deficiency in Lesch Nyhan syndrome

what does this lead to?

A

hypoxanthine-guanine phosphoribosyltransferase (HGPRT) in purine metabolism

–> gout

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10
Q

Clinical findings of Osteogenesis imperfecta and Tx

A

“brittle bone disease”

  • pathologic fx at birth
  • blue sclera
  • hearing loss
  • opalescent teeth (uworld)

Tx: bisphosphonates

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11
Q

man has chest pain + diaphoresis. Soon after he arrests - cause of arrest?

A

ventricular arrhythmia

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12
Q

Treatment for kids with lyme?

A

Amoxicillin

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13
Q

CYP450 inducers:

A 
GC and PBR's induce chrOnic Alcoholism
Ginseng
Carbamazepine
Phenobarbital
Rifampin
St Johns Wort
OCP's
Chronic Alcoholism
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14
Q

CYP 450 inhibitors:

ACGOS

A 
Acetaminophen
Abx + metronidazole
Amio
Cimetidine
Gingko
Omeprazole
SSRI's (fluoxetine)
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15
Q

What are the most significant RF for AAA?

A

Male

Smoking

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16
Q

Associations with FSGM:

A

AA, Hispanics
HIV
Heroin
Sickle Cell

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17
Q

Clinical findings of amyloidosis:
CV, Renal, Skin, Neuro

*uworld

A

CV: increased wall thickness + diastolic dysfx
Renal: proteinuria
Skin: bleeding/bruising
Neuro: peripheral neuropathy

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18
Q

Common clinical associations/RF of Temporal/GC Arteritis?

A 
Polymyalgia Rheumatica
Aortic involvement (AAA, dissection)
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19
Q

IgA nephropathy vs. PSGN

A

IgA:

  • adult
  • within 5 days of URI

PSGN

  • kid
  • 10-14 days post infection
  • low complement
  • elevated Antitrypsinolysin O
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20
Q

Pt Dx with syphilis and 6-48 hrs post initiation of tx –> acute onset of fever, chills, myalgias and rash progression

What is is?
Tx?

A

Jerisch-Herxheimer reaction

Tx: supportive, self-limiting

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21
Q

Associations with membranoproliferative GN?

A 
Hep B and C
Lupus
Syphilis
Low C3
Cryoglobulins
22
Q 
S/sx of sarcoid:
Gen
HEENT
Resp
CV
Msk
Neuro
Skin
A 
Malaise, fever, anorexia, wgt loss
Anterior uveitis
Dry cough, SOB
Arrhythmias, heart block
Arthralgias and arthritis
Bells palsy
Erythema nodosum
23
Q

Clinical syndromes of coxsackie virus

A
  1. Hand Foot and Mouth Disease
    - herpetic gingivostomatitis (grey vesicles on erythem base)
    - pharyngitis
    - red vesicular rash
    - fever
    - kids
    - summer time
  2. Aseptic Meningitis
  3. Dilated Cardiomyopathy
  4. Pleurodynia
24
Q

Screening that should be done in a pt with myositis (Poly/Dermato)

A

Ca screening (d/t increased incidence of malignancy)

25
Q

DDx of myopathy:

A
  1. Steroid induced - progressive proximal weakness, no pain
  2. Polymyalgia Rheumatica - pelvis and shoulder pain and stiff
  3. Inflammatory myopathies - skin rash
  4. Statin induced
  5. Hypothyroid myopathy
26
Q

Clinical assessment of Acromegaly:

Include pt, dx, and tx

A

Pt:

  • glucose intolerance
  • cardiomegaly
  • growth of hands, face, visceral organs

Dx:

  1. IGF-1
  2. Glu suppression test fails to suppress
  3. MRI

Tx:

  1. Resect
  2. Octreotide (residual tissue)
27
Q

Associations with membranous nephropathy?

A

*Hep B and C
*SLE
NSAIDS
Penicillamine

*also associated with membranoproliferative

28
Q

Dx and Tx for SBP

A

PMN’s > 250/mm3
+ cx (70% GNR)

Tx:Ceftriaxone
Ppx: fluoroquinolone

If polymycrobial: add MTZ

29
Q

Lifestyle tx of HTN (5, in order of greatest affect –> least):

A
  1. Wgt loss (5-20mmHg/10kg loss)
  2. DASH diet
  3. Execrise
  4. Salt restriction
  5. ETOH
30
Q

Most sensitive test to screen for diabetic nephropathy?

A

Random urine for micralbumin/Cr ratio

31
Q

Who gets minimal change dz?

A

Children

Hodgkins and Non-Hodgkins

32
Q

Painless hematuria in a sickle cell kid?

What will labs look like?

A

Renal papillary necrosis

Labs: urine RBC’s elevated but normal appearing. All other labs normal

33
Q

Infection associated with MALT

A

H pylori

34
Q

Relationship between Ca and Mg

A

Hypermag –> hypoca (d/t decreased PTH secretion)

SE of Mag tox

35
Q

Associations with RPGN? (3)

A

PSGN
SLE
Vasculitises (Wegeners, Microscopic Polyangitis, Churg-Strauss)

36
Q

S/sx of disseminated MAC infection
? CD4 count
Tx

A 
CD4 < 50 
Weight loss
Fever
Anemia
LAN
Diarrhea

Tx: Clarithromycin + Ethambutol (UW - Azithromycin)

37
Q 
Common infections seen in the following CD4 counts:
200-500
<200
<100
<50
A 
200-500: 
Oral leukoplakia
Pulm TB
Pneumococcal pna
Thrush

<200:
PCP
Crypto meningitis
Eso candida

<100: HSV/CMV esophagitis
Toxo

<50:
MAC
CMV retinitis

38
Q

Pt with RA sx (joints etc.), splenomegaly and neutropenia?

A

Felty’s syndrome

39
Q

Pt with RA is going for surgery, what test should you do?

A

Cervical x-ray (RA can affect the cervical spine)

40
Q

Marfan body habitus +

  1. Aortic root dilation, upward lens dislocation
  2. IDD, Thrombotic events at any age, fair complexion, megaloblastic anemia, downward lens dislocation
A
  1. Marfan syndrome

2. Homocystinuria - tx: B6, folate, B1

41
Q

Angular cheilosis, stomatitis, glossitis, seborrheic dermatitis

A

B2 (Riboflavin)

42
Q

Beriberi or Wernicke-Korsakoff syndrome

? Vitamin deficiency?

A

B1 (thiamine)

43
Q

Pellagra is what vitamin deficiency?

A

B3 (niacin)

44
Q

Cheilosis, stomatitis, glossitis

Neuro sx - iritaability, confusion, depression

A

B6 (pyridoxine)

45
Q

Gingivitis, punctate hemorrhages, corckscrew hair

Vitamin deficiency?

A

Vit C

46
Q

Symptoms of serotonin syndrome:

A 
Agitation, AMS
Ataxia
Diaphoresis
Diarrhea
Hyperreflexia
Myoclonus
Tremor
Shivering
Hyperthermia

(*did not recently start a neuroleptic med)

47
Q

Lithium toxicity:
Sx
Causes

A

Sx: GI, confusion, ataxia, tremors
Causes: Thiazides, NSAIDS, ACEi, Tetracyclines

48
Q

Pathology of Reye’s syndrome

A

Microvesicular steatosis on liver biopsy in the context of acute hepatic encephalopathy

49
Q

Anti-mitochondrial antibodies

A

PBC

50
Q

Pt w/ seizure and CT shows Cystic lesions in brain with surrounding edema

A

Neurocysticercosis

  • Taenia solium (pork tapeworm)
  • Tx: albendazole
51
Q

Aspergillus

A

Check sketchy

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