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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
DDx of myopathy:
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
Clinical assessment of Acromegaly: | Include pt, dx, and tx
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
Associations with membranous nephropathy?
*Hep B and C *SLE NSAIDS Penicillamine *also associated with membranoproliferative
28
Dx and Tx for SBP
PMN's > 250/mm3 + cx (70% GNR) Tx:Ceftriaxone Ppx: fluoroquinolone If polymycrobial: add MTZ
29
Lifestyle tx of HTN (5, in order of greatest affect --> least):
1. Wgt loss (5-20mmHg/10kg loss) 2. DASH diet 3. Execrise 4. Salt restriction 5. ETOH
30
Most sensitive test to screen for diabetic nephropathy?
Random urine for micralbumin/Cr ratio
31
Who gets minimal change dz?
Children | Hodgkins and Non-Hodgkins
32
Painless hematuria in a sickle cell kid? | What will labs look like?
Renal papillary necrosis | Labs: urine RBC's elevated but normal appearing. All other labs normal
33
Infection associated with MALT
H pylori
34
Relationship between Ca and Mg
Hypermag --> hypoca (d/t decreased PTH secretion) | SE of Mag tox
35
Associations with RPGN? (3)
PSGN SLE Vasculitises (Wegeners, Microscopic Polyangitis, Churg-Strauss)
36
S/sx of disseminated MAC infection ? CD4 count Tx
``` CD4 < 50 Weight loss Fever Anemia LAN Diarrhea ``` Tx: Clarithromycin + Ethambutol (UW - Azithromycin)
37
``` Common infections seen in the following CD4 counts: 200-500 <200 <100 <50 ```
``` 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
Pt with RA sx (joints etc.), splenomegaly and neutropenia?
Felty's syndrome
39
Pt with RA is going for surgery, what test should you do?
Cervical x-ray (RA can affect the cervical spine)
40
Marfan body habitus + 1. Aortic root dilation, upward lens dislocation 2. IDD, Thrombotic events at any age, fair complexion, megaloblastic anemia, downward lens dislocation
1. Marfan syndrome | 2. Homocystinuria - tx: B6, folate, B1
41
Angular cheilosis, stomatitis, glossitis, seborrheic dermatitis
B2 (Riboflavin)
42
Beriberi or Wernicke-Korsakoff syndrome | ? Vitamin deficiency?
B1 (thiamine)
43
Pellagra is what vitamin deficiency?
B3 (niacin)
44
Cheilosis, stomatitis, glossitis | Neuro sx - iritaability, confusion, depression
B6 (pyridoxine)
45
Gingivitis, punctate hemorrhages, corckscrew hair | Vitamin deficiency?
Vit C
46
Symptoms of serotonin syndrome:
``` Agitation, AMS Ataxia Diaphoresis Diarrhea Hyperreflexia Myoclonus Tremor Shivering Hyperthermia ``` (*did not recently start a neuroleptic med)
47
Lithium toxicity: Sx Causes
Sx: GI, confusion, ataxia, tremors Causes: Thiazides, NSAIDS, ACEi, Tetracyclines
48
Pathology of Reye's syndrome
Microvesicular steatosis on liver biopsy in the context of acute hepatic encephalopathy
49
Anti-mitochondrial antibodies
PBC
50
Pt w/ seizure and CT shows Cystic lesions in brain with surrounding edema
Neurocysticercosis - Taenia solium (pork tapeworm) - Tx: albendazole
51
Aspergillus
Check sketchy

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