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Medicine > uworld11 > Flashcards

uworld11 Flashcards

1
Q

what should you do if you find a pulm nodule- high malignancy risk vs low malignancy risk

A

high- resection

low-int: based on nodule size:
<8mm: serial CT
>8mm: PET –> resect

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2
Q

what makes a pulm nodule high risk for malignancy

A

nodule>2 cm and irregular
age >60
smoking

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3
Q

what is strongest predictor of stent thrombosis within first 12 months of stent placement?

A

premature dicontinuation of antiplatelet therapy

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4
Q

what to use for cancer staging

A

CT

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5
Q

how can a massive PE cause increased JVP?

A

inc pulm vascular resistance –> RV pressure increases –> Right sided heart failure

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6
Q

elevated retic count
increased LDH
decreased haptoglobin

A

intravascular hemolytic anemia

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7
Q

most common causes of secondary digital clubbing

A

lung malignancies, CF, right to left shunt

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8
Q

what is digital clubbing

A

enlargement and broadening of fingertips

d.t connective tissue prolif at nail bed and distal phalanyx

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9
Q

most common cause of AS in patient under 70

A

bicuspid aortic valve

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10
Q

what should you htink of when:

osteolytic lesions, recurrent infections, const. sympt

A

multiple myeloma

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11
Q

warfarin induced skin necrosis

A

within first few days of warfarin

in patients with underlying protein c def

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12
Q

which heart sound associated with MI

A

S4

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13
Q

should digoxin dose be changed with amiodarone addition

A

decrease digoxin by 25%-50%

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14
Q

how long does b12 vs folate deficiencies take to present?

A

b12-years

folate- 5-6 weeks

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15
Q

what byproducts are up in b12 vs folate deficiencies?

A

b12:
high homocysteine
high methylmalonic acid

folate:
high homocysteine
nl methylmalonic acid

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16
Q

can asthma be diagnosed in adults?

A

yes

more severe

17
Q

how much does post-bronchdilator FEV1 have to increase to be considered reversible

A

> 12%

18
Q

what is DLCO in asthma vs COPD

A

asthma: inc or nl

COPD: dec or nl

19
Q

young pt with chronic dyspnea on exertion and slight liver function test abnormalities with fam hx of cirrhosis should be suspected to have

A

alpha 1 antitrypsin deficiency

20
Q

hypertrophic osteoarthropathy

A

clubbing and joint arthropathy

associated with lung cancer

21
Q

what can prolong survival in patients with COPD

A

long term supp O2

22
Q

criteria for initiating long term supp O2

A

resting PaO2<55 or SpO2<88%

or PaO2<59 or SpO2<89 in patients with evidence of R HF or hematocrit >55% (secondary polycythemia)

23
Q

what murmur does bacterial endocarditis make

A

TR

systolic murmur, inc with inspiration

24
Q

what should you do if elderly woman with hx of CV risk factors presents with n/v, epigastric pain

A

EKG- r/u atypical MI

25
Q

should someone taking INH for TB who develops mild increases in ALT,AST (<100) discontinue the treatment?

A

no, only discontinue if hepatotoxicity

26
Q

does smoking cessation reduce BP

A

nah, but encourage it anyway

27
Q

best ways to reduce BP in which order

A 
lose weight- 
DASH diet
exercise
reduce salt
alcohol intake
28
Q

drugs associated with acute pancreatitis

A 
diuretics
anti seizure meds- valproic acid
azathioprine
HIV meds
abx- MTZ, tetracycline
29
Q

renal vein thrombosis is a complication with what and associated with what

A

nephrotic syn

membranous glomerupathy

30
Q

what causes widened mediastinum with pleural fluid containing amalyse

A

boorhaeave syndrome

31
Q

diagnose boorhaave

A

CT or gastrograffin esophagography

32
Q

most common complication of influenza

A

secondary bacterial pneumonia

33
Q

what most common cause of secondary bacterial pneumonia in young people

A

MRSA

34
Q

which masses found in anterior vs middle vs posterior mediastinum

A

anterior: thymoma
middle: bronchogenic cyst
posterior: neurogenic tumors, esophageal leiomyomas

35
Q

what constutitues as neurogenic tumor

A 
meningocele
enteric cysts
lymphomas
diaphragmatic hernias
esophageal tumors
aortic aneurysms
36
Q

infective endocarditis- most common bacteria on hospital vs community acquired

A

hospital: staph (aureus, epi)
community: strep (viridans, bovis)

37
Q

which infective endo bacterial strain associated with tooth extractions?

A

strep viridans- specifically S. sanguinis

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