Uworld3 Flashcards
unfractionated heparin or low-molecular-weight heparin which is preferred for PE
Unfractionated heparin
which heparin drugs do you not give in severe renal insufficiency
fondazparinux and rivaroxaban
What is the most common acid-base disturbance caused by PE
respiratory alkalosis
how do you check lung findings for sarcoidosis after chest-x ray
fiberoptic bronchoscopy with endobronchial and transbronchiaal biopsies
- mediastinal lymph node will be positive but bronchoscopy is safer
Clinical features of superior vena cava syndrome
headache worse with leaning forward
facial swelling
jugular venous engorgement without peripheral edema
What causes superior vena cava syndrome
lung cancer especially small cell carcinoma
how does systemic sclerosis appear in the lung?
pulmonary arterial hypertension
What has shown to decrease the risk of ventilator-acquired pneumonia
daily interruption to assess readinness for extubating
Major toxicity for mycophenolate
bone marrow suppression
Major toxicity for azathioprine is
dose related diarrhea, leukopenia and hepatoxicity
Difference between Tacrolumus and Cyclosporin toxicity
Cyclosporin has hirsituism and gum hypertrophy
Recurrent bacterial infections in an adult should raise suspicion for
common variable immunodeficiency
is irritant contact dermatitis immunologically mediated?
no
what type of response does a 23-valent pneumonococcal vaccine give
T-cell-independent B-cell response
what type of response does 13-valent pneumococcal vaccine give?
T-cell -dependent B-cell response
Liver transplant rejection < 1 week
hyperacute rejection
Liver transplant rejection <1 month
bacterial causes from operative complications or hospitlization
liver transplant rejection month 1-6
Opprotunistic pathogen (CMV, Aspergillus, Mycobacterium, TB).
Liver transplant rejection greater 6 months
community-acquired pathogen
when does acute cellular rejection occur and when does bacterial infection occur in liver tansplant
acute cellular: <90 days
bacterial: <60 days
Shows reduction of both passive and active range of motion?
adhesive capsulitis (frozen shoulder)
Defect in active range of motion but passive range of motion is perserved
rotator cuff tear
what is a common cardiac findnig in akylosing spondylitisis
aortic regurgitiaton
antiphospholipid syndrome need to have at least 1of what 3 antibodies
- anticardioplipin abs
- anti-beta2-glycoprotein-I abs
- lupus anticoagulant
when do you x-ray the low back
- osteoporosis/compression fracture
- suspected malignancy
- ankylosing spondylititis
when do you MRI the low back
- sensory /motor deficits
- cuada equina syndrome
- epidural abscess/infection
when do you do radionuclide bone scan or CT scan of low back
when patient cannot have MRI
positive straight leg raise
herniated nucleus pulposus/disk disease
pseudoclaudication
better with spine flexion
worse with extension
spinal stenosis
tenderness and induration at the medial head of the gastrocnemius. Moderate pitting edema at the ankle and a crescent-shaped path of achymosis at the medial malleolus
popliteal baker cyst
3 categories of clinical findings for Behcet’s disease
oral ulcers/genital ulcers
uveitis
thrombosis
pes anserinus pain syndrome? any tests and x-ray?
localized pain and tenderness over the anteriormedial part of the tibital plataeu just below the joint line of the knee.
valgus stress test will not aggravate the pain
x-rays will appear normal
what is Charcot joint?
complication of neuropathy and repeated joint trauma
what are symptoms of cryoglobulinemia syndrome
fatigue non-blanching palpable purpura arthralgias renal disease peripheral neuropathies
Cryoglobulinemia is associated with what
Hepatitis C.
what are lab values for cryoglobulinemia
hypocomplementemia
rheumatoid facor
elevated transminases
kidney injury
what is the pathology for thrombotic thrombocytic purpura
decreased ADAMTS13 activity
what muscles are impacted by De Quervian’s Tenosynotivitis
Abductor pollicus longus
Extensor pollicus brevis
what is the most common ocular manifestation for giant cell arthritis
anterior ischemic optic neuropathy
Subacute or chronic locking or popping sensation in knee is what type of tear
meniscal tear
what type of knee tear is associated with hemarthrosis
ALS
what is an effective pharmacotherapy for fibromylagia
amitriptyline
Disseminated gonococcal infection has what triad
polyarthralgias
tenosynovitis
vesiculopustular skin lesions
anti-citrullinated abs
rheumatoid
anti-smooth muscle ABS
autoimmune hepatitis
Hereditary hemochromatosis is associated with what arthalgias
- chondrocalcinosis
- psuedogout
- chronic arthropathy
what medicine do you not give to inflammatory disease arthalgias
NSAID
What causes lateral epicondylitis
repetitive, forceful extension at the wrist
numbness, aching and burning in distal forefoot from metatarsal heads to the 3rd and 4th toes
morton neuroma
Plantar surface of heel
worse when initiating running for first steps of the day
plantar fasciitis
Diclofenac
NSAID
narrowing of joint space and osteophytes
osteoarthritits
periarticular osteopenia and joint margin erosions
rheumatoid arthritis
What are lab values for Paget’s disease
increased: alkaline phosphatase and urine hydroxyproline
normal: serum calcium and phosphorous
what will x-ray show for Paget’s disease
osteolytic mixed lytic-sclerotic lesions
treatment for Paget’s disease
bisphosphonates
clinical presentation for patellar tendonitis
athletes
episodic pain and tenderness at inferior petalla
clinical presentation for petallofemoral syndrome
young women
subacute to chronic pain with squatting, running, prolonged sitting, using stairs
Initial management of patellofemoral compression test
activity modification
NSAIDs
stretching
strengthening exercises
antibodies associated with dermatomyositits
Anti-Jo-1 (antisynthetase antibody)
Anti-Mi-2 (antihelicase)
what is the most definitive test for polymyositits
muscle biopsy
Clinical feature of polymyalgia rheumatica
muscle stiffness
Clinical feature of polymyositits
proximal muscle weakness
first line treatment for reactive arthritis
NSAID
adverse effect of hydroxychloroquine
retinopathy
Felty syndrome
rheumatoid arthritis
neutropenia
splenomegaly
Osteitis fibrosa cystica
bony pain, osteoclastic resporbtion of bone, leading to replacement with fibrous tissue (brown tumors)
- seen in parathyroid carcinoma
Osteitis deformans
Paget disease
clinical feature of rotator cuff tear
pain with abduction and external rotation
Lofgren syndrome is associated with what?
sarcoidosis
Initial management of sciatic neuropathy
NSAID or acetaminophen
Allopurinol
decreases uric acid production by inhibiting xanthing oxidase
used for prevention of recurrent gout
Colchicine
treats acute gout
Schirmer test
see how wet/dry eyes are
antibodies for Sjogrens
anti-Ro/SSA and Anti-La/SSB
Pathology of Sjogrens
lymphatic infiltration
what should be the first antibody test for SLE
ANA
drug induced lupus abs
anti-histone
anti=topoisomerase
systemic sclerosis
Lumbar extension worsens back pain
lumbar disk herniation
anticentromere abs
systemic sclerosis
anti-smooth abs
autoimmune hepatitis
Anti-neutrophil cytoplasmic abs
Wegner
Ant-cyclic-citrullinated peptide abs
rheumatoid arthritis
Muddy brown granular cast
acute tubular necrosis
RBC casts
glomerulonephritis
WBC casts
interstitial nephritis and pyelonephritis
fatty casts
nephrotic syndrome
broad and waxy casts
chronic renal failure
Serology values for Systemic sclerosis
antinuclear antibody
anti-topoisomerase (ant-Scl-70) antibody
Anticentromere antibody
Anti-cyclic citrullinated peptide antibodies
Rheumatoid factor
What is Kussmaul’s sign and what do you see that in?
lack of decrease or increase in jugular venous pressure on inspiration
constrictive pericarditits
what murmur do you hear with constrictive pericarditis
mid-diastolic sound = pericardial knock
What is the differential if a pt has hypoxia but is worsened by intravascular volume exapnsion
pulmonary contusion
what is a cause of cardiogenic shock
myocardial infarction
Patients with long-standing ankylosing spondylitits can develop
bone loss due to increased osteoclast activity in the setting of chronic inflammation.
what does equilibrated intracardiac diastolic pressures mean? next step?
cardiac tamponade
urgent echocardiography
what are risk factors for vertebral compression fracture
trauma osteoporosis/osteomalacia osteomyelitis MALIGNANCY WITH BONE METASTASES hyperparathyroidism
Patient with SLE what is the x-ray finding of joints
no evidence of joint destruction
clinical finding for malignant hyperthermia
muscular rigidity
