Uworld10 Flashcards

1
Q

when do you give packed red blood cell transfusions

A

acute GI bleeding patients with Hb less than 7

unstable pt with Hb less than 9

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2
Q

what lobe is involved in Hemi-neglet syndrome

A

right (non-dominant) parietal lobe

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3
Q

difference in chronic mitral regurgitation and acute

A

chronic: change in left atrial or ventricular size and/or compliance
acute: excessive volume overload, elevated left atrial and ventricular filling pressures

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4
Q

penicillin treatment for syphlilis is someone is allergic to penicillin

A
  • give doxycycline, if allergic reaction is life threatening (throat swelling up)
  • desensitization to penicillin done in pregnancy or multiple treatment failures, or central nervous system syphilis
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5
Q

very very very first thing to do in infective endocarditits

A

blood cultures

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6
Q

Dilutional hyponatremia with appropriately suppressed ADH occurs in what syndrome

A

free water intake

psychogenic polydipsia

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7
Q

what are common but nonspecific findings for primary autoimmune adrenalitits

A

esosinophilia and hyperplasia of lymphoid tissue

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8
Q

An elderly patient with evidence of osteolytic lesions on X-ray indicate? screening test? diagnostic test?

A
  • multiple myeloma
  • Protein electrophoresis/ urine protein electrophoresis / free light chain analysis
  • bone marrow biopsy
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9
Q

Type 1 MEN

A

Primary hyperparathyroidism
Pituitary tumors
Pancreatic tumors

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10
Q

Type2A MEN

A

Medullary thyroid cancer (calcitonin)
Pheochromocytoma
Parathyroid hyperplasia

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11
Q

Type 2B MEN

A

Medullary thyroid cancer (calcitonin)
Pheochromocytoma
Mucosal neuromas/marfanoid habitus

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12
Q

HIV retinopathy

A

cotton-wool retinal lesions

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13
Q

toxoplasmic chorioretinitis

A

eye pain and decreased vision

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14
Q

really the only treatment for septic embolic events in patients with native valve infective endocarditis

A

antibiotics

Surgery if really bad or not getting better

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15
Q

underlying histopathologic lesion for sarcoidosis

A

noncaseating granulomas on tissue biopsy

Chronic granulomatous inflammation

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16
Q

necrotizing pulmonary vasculitis

A

Granulomatosis with polyangiitis

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17
Q

Does Myxomatous valve degeneration cause systemic systems?

A

no

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18
Q

S. Bovis and S. gallolyticus

A

colon cancer

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19
Q

Strep. sanguinis

A

infective endocarditis

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20
Q

most common cause of abnormal hemostasis in patients with chronic renal failure?

A

platelet dysfunction

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21
Q

progressive multifocal leukoencephalopathy

A
reactivation of JC virus
AMS
motor deficits 
ataxia 
vision abnormalities
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22
Q

HIV-associated neurocognitive disorder

A

chronic decline in multiple cognitive domains

mood and behavioral symptoms are common

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23
Q

Most common location for Ludwig anigna

A

mandibular molar

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24
Q

superficial unilateral hip pain that is exacerbated by external pressure to the upper lateral thigh (as when lying on the affected side in bed). Middle aged adult

A

trochanteric burisitis

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25
Q

role of femoral nerve

A

sensation to hip joint and skin of anterior and medial thigh and leg

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26
Q

What nerve gives sensation to the upper lateral thigh

A

lateral femoral cutaneous and/or iliohypogastric nerves

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27
Q

frist step in clavicular fracture

A

neuromuscular examination to rule out underlying bronchial plexus and subclavian artery
- get an angiogram

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28
Q

treatment for clavicular fracture

A

traditional: figure-of-eight device, wear sling

cosmetic reason: open reduction and internal fixation

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29
Q

triad of fat embolism

A

respiratory distress
neurologic dysfunction (confusion)
petechial rash

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30
Q

gamekeeper thumb

A

hyperextend the thumb

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31
Q

jersey finger

A

flexed finger is forcefully extended

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32
Q

Mallet finger

A

extended finger is forcefully flexed

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33
Q

felon

A

abscess in pulp of fingertip

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34
Q

bone locations where children may not have great bone remodeling

A
  1. supraconydlar fractures of humorous

2. fracture of any bone involving growth plate

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35
Q

Genu valgus

A

knock knee

normal between 4-8

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36
Q

Genu Varum

A

bow legs

normal up to age 3

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37
Q

Humoral mid-shaft fracture, what is likely injured

A

radial nerve

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38
Q

nerve damage at medial epicondyle

A

ulnar

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39
Q

nerve damage at supracodylar region of humorus

A

median nerve

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40
Q

electrolyte abnormality in Succinylcholine

A

hyperkalemia

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41
Q

adverse effect of halothane

A

acute liver function

42
Q

Adverse effect of nitrous oxide

A

inactivated vitamin B12

43
Q

clinical feature of tibial plateau fractures

A

unable to bear weight on knee

44
Q

drop arm test

A

rotator cuff injury

45
Q

nerve injury for fracture of surgical neck of humourous

A

axillary nerve injury

46
Q

inferior trunk of brachial plexus indicates

A

C8-T1

Klumpke palsy

47
Q

adhesive capsulitis

A

decreased passive and active range of motion

48
Q

tenderness in anatomic snuffbox

A

scaphoid fracture

49
Q

medial tibial stress syndrome

A

shin splits

no point tenderness

50
Q

treatment for stress fracture between 2-4 metatarsal

A

rest and analgesics

51
Q

treatment for stress fracture between 5metatarsal

A

casting or internal fixation

52
Q

causes of initial hematuria

A

urethritis

trauma (catheterization)

53
Q

causes of terminal hematuria

A

bladder or prostatic damage

54
Q

total hematuria damage causes

A

kidney or ureter damage

55
Q

what defines oliguria

A

less than 500 mL of urine in 24 hours

56
Q

Most common reason for newborn boy to not urinate during the first day of life? diagnostic workup

A

posterior urethral valves

voiding cystourethrogam

57
Q

size matters for urethral stone passage

A

less than 3 cm –> analgesics, fluids, watchful waiting

greater than. –> extracorporeal shock-wave lithotripsy

58
Q

blood in the urethral meatus and high riding prostate? next step?

A

posterior urethral injury

retrograde urethrogram

59
Q

arterial blood gas for atelectasis

A

hypoxemia
hypocapnia
respiratory alkalosis

60
Q

diaphragmatic rupture most commonly occurs on what side

A

left side

61
Q

what is the blood pressure in tension pneumothorax

A

hypotensive patient

62
Q

when do children present with diaphragmatic hernia

A

delayed presentation

63
Q

what is the first step in a bleeding lung

A

bronchoscopy

64
Q

potential complication of thoracentesis

A

hemothorax

65
Q

what is a common complication of blunt thoracic trauma?onset? compare it to something else

A

pulmonary contusion
develops in first 24 hours (unilateral)

ARDS
24-48 hours after trauma (bilateral)

66
Q

treatment for flail chest

A

positive airway pressure
adequate pain control should be prime objective
rib fractures heal without surgery

67
Q

treatment of circumferential burns

A

escharotomy

68
Q

baby with mass that is deep and immobile

A

Wilm’s or neuroblastoma

69
Q

baby with mass that moves up and down with respiration

A

liver tumor

70
Q

Cushing reflex

A

hypertension
bradycardia
respiratory depression

71
Q

Abducens nerve

A

CN 7

72
Q

Most common adult primary brain tumor

A

astrocytoma

73
Q

Tearing of middle meningeal artery

A

epidural hematoma

74
Q

what motor function does the femoral nerve do

A

knee extension

hip flexion

75
Q

Obturator nerve

A

medial compartment of thigh
adduction of thigh
sensation over medial thigh

76
Q

Tibial nerve

A

posterior compartment of thigh, leg and plantar muscles of foot

77
Q

After passive abduction of the right arm above the head, the patient is asked to slowly lower his arm; as he is lowering it below horizontal, the arm suddenly drops rapidly, associated with moderate, sharp pain.

A

rotator cuff problem

78
Q

clinical feature of deltoid wakness

A

extreme extension

79
Q

Tic douloureux

A

trigeminal neuralgia

80
Q

Hyperventilation would decrease this patient’s intracranial pressure by which of the following mechanism

A

cerebral vasoconstriction

81
Q

next step in management for acute epididmyitis

A

ultrasound to rule out testicular torsion

82
Q

The most common cause of urethral injury is

A

iatrogenic trauma during abdominal surgery

83
Q

treatment for testicular cancer

A

platinum based chemotherapy

84
Q

testicular “bag of worms”

A

varicocele

85
Q

pain relief on elevation of testis

A

epididymis

86
Q

collection of fluid between parietal and visceral tunica vaginalis

A

testicular hydrocele

87
Q

Management of undescended testicle

A

has not reached scrotum by age 1

Orchiopexy

88
Q

Adolescent kid drinks a lot of beer the first time and has colicky flank pain?

A

Ureteropelvic junction obstruction

89
Q

acute parotitis most common pathogen

A

staph aureus

90
Q

Most likely pathogen for prosthetic joint infection, less than 3 months

A

Staph aureus
gram negative rods
anaerobes

91
Q

Most likely pathogen for prosthetic joint infection, 3-13 months

A

coagulase-negative staph
enterococci
prpionibacterium species

92
Q

Most likely pathogen for prosthetic joint infection, greater than a year

A

Staphy aureus
gram-negative rods
beta-hemolytic strep

93
Q

What can happen to platelet count after splenectomy

A

thrombocytosis

94
Q

differential for extragonadal germ cell tumor

A

thymoma
teratoma
thyroid
terrible lymphoma

95
Q

lab values for seminomas

A

increase b-hCH

normal AFP

96
Q

lab values for nonseminomatous germ cell tumors

A

elevated AFP and b-hCG

97
Q

what are types of nonseminomatous germ cell tumors

A

yolk sac tumor
choriocarcinoma
embryonal carcinoma

98
Q

what type of heparin is not recommended in end-stage renal disease

A

low molecular weight heparin

99
Q

what do you do with amputated body parts

A

be wrapped in saline-moistened gauze
sealed in a plastic bag
placed on ice
brought to the emergency department with the patient.

100
Q

Most common intra-abdominal complication of blunt abdominal trauma?

A

splenic injury

101
Q

blunt abdominal trauma. Hemodynamically stable patients with a negative ultrasound evaluation but high-risk features (anemia, guarding) should undergo?

A

CT imaging