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Uworld3 Flashcards

1
Q

unfractionated heparin or low-molecular-weight heparin which is preferred for PE

A

Unfractionated heparin

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2
Q

which heparin drugs do you not give in severe renal insufficiency

A

fondazparinux and rivaroxaban

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3
Q

What is the most common acid-base disturbance caused by PE

A

respiratory alkalosis

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4
Q

how do you check lung findings for sarcoidosis after chest-x ray

A

fiberoptic bronchoscopy with endobronchial and transbronchiaal biopsies
- mediastinal lymph node will be positive but bronchoscopy is safer

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5
Q

Clinical features of superior vena cava syndrome

A

headache worse with leaning forward
facial swelling
jugular venous engorgement without peripheral edema

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6
Q

What causes superior vena cava syndrome

A

lung cancer especially small cell carcinoma

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7
Q

how does systemic sclerosis appear in the lung?

A

pulmonary arterial hypertension

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8
Q

What has shown to decrease the risk of ventilator-acquired pneumonia

A

daily interruption to assess readinness for extubating

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9
Q

Major toxicity for mycophenolate

A

bone marrow suppression

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10
Q

Major toxicity for azathioprine is

A

dose related diarrhea, leukopenia and hepatoxicity

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11
Q

Difference between Tacrolumus and Cyclosporin toxicity

A

Cyclosporin has hirsituism and gum hypertrophy

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12
Q

Recurrent bacterial infections in an adult should raise suspicion for

A

common variable immunodeficiency

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13
Q

is irritant contact dermatitis immunologically mediated?

A

no

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14
Q

what type of response does a 23-valent pneumonococcal vaccine give

A

T-cell-independent B-cell response

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15
Q

what type of response does 13-valent pneumococcal vaccine give?

A

T-cell -dependent B-cell response

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16
Q

Liver transplant rejection < 1 week

A

hyperacute rejection

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17
Q

Liver transplant rejection <1 month

A

bacterial causes from operative complications or hospitlization

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18
Q

liver transplant rejection month 1-6

A

Opprotunistic pathogen (CMV, Aspergillus, Mycobacterium, TB).

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19
Q

Liver transplant rejection greater 6 months

A

community-acquired pathogen

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20
Q

when does acute cellular rejection occur and when does bacterial infection occur in liver tansplant

A

acute cellular: <90 days

bacterial: <60 days

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21
Q

Shows reduction of both passive and active range of motion?

A

adhesive capsulitis (frozen shoulder)

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22
Q

Defect in active range of motion but passive range of motion is perserved

A

rotator cuff tear

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23
Q

what is a common cardiac findnig in akylosing spondylitisis

A

aortic regurgitiaton

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24
Q

antiphospholipid syndrome need to have at least 1of what 3 antibodies

A
  1. anticardioplipin abs
  2. anti-beta2-glycoprotein-I abs
  3. lupus anticoagulant
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25
Q

when do you x-ray the low back

A
  1. osteoporosis/compression fracture
  2. suspected malignancy
  3. ankylosing spondylititis
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26
Q

when do you MRI the low back

A
  1. sensory /motor deficits
  2. cuada equina syndrome
  3. epidural abscess/infection
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27
Q

when do you do radionuclide bone scan or CT scan of low back

A

when patient cannot have MRI

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28
Q

positive straight leg raise

A

herniated nucleus pulposus/disk disease

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29
Q

pseudoclaudication
better with spine flexion
worse with extension

A

spinal stenosis

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30
Q

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

A

popliteal baker cyst

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31
Q

3 categories of clinical findings for Behcet’s disease

A

oral ulcers/genital ulcers
uveitis
thrombosis

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32
Q

pes anserinus pain syndrome? any tests and x-ray?

A

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

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33
Q

what is Charcot joint?

A

complication of neuropathy and repeated joint trauma

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34
Q

what are symptoms of cryoglobulinemia syndrome

A 
fatigue
non-blanching palpable purpura
arthralgias
renal disease
peripheral neuropathies
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35
Q

Cryoglobulinemia is associated with what

A

Hepatitis C.

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36
Q

what are lab values for cryoglobulinemia

A

hypocomplementemia
rheumatoid facor
elevated transminases
kidney injury

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37
Q

what is the pathology for thrombotic thrombocytic purpura

A

decreased ADAMTS13 activity

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38
Q

what muscles are impacted by De Quervian’s Tenosynotivitis

A

Abductor pollicus longus

Extensor pollicus brevis

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39
Q

what is the most common ocular manifestation for giant cell arthritis

A

anterior ischemic optic neuropathy

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40
Q

Subacute or chronic locking or popping sensation in knee is what type of tear

A

meniscal tear

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41
Q

what type of knee tear is associated with hemarthrosis

A

ALS

42
Q

what is an effective pharmacotherapy for fibromylagia

A

amitriptyline

43
Q

Disseminated gonococcal infection has what triad

A

polyarthralgias
tenosynovitis
vesiculopustular skin lesions

44
Q

anti-citrullinated abs

A

rheumatoid

45
Q

anti-smooth muscle ABS

A

autoimmune hepatitis

46
Q

Hereditary hemochromatosis is associated with what arthalgias

A
  1. chondrocalcinosis
  2. psuedogout
  3. chronic arthropathy
47
Q

what medicine do you not give to inflammatory disease arthalgias

A

NSAID

48
Q

What causes lateral epicondylitis

A

repetitive, forceful extension at the wrist

49
Q

numbness, aching and burning in distal forefoot from metatarsal heads to the 3rd and 4th toes

A

morton neuroma

50
Q

Plantar surface of heel

worse when initiating running for first steps of the day

A

plantar fasciitis

51
Q

Diclofenac

A

NSAID

52
Q

narrowing of joint space and osteophytes

A

osteoarthritits

53
Q

periarticular osteopenia and joint margin erosions

A

rheumatoid arthritis

54
Q

What are lab values for Paget’s disease

A

increased: alkaline phosphatase and urine hydroxyproline
normal: serum calcium and phosphorous

55
Q

what will x-ray show for Paget’s disease

A

osteolytic mixed lytic-sclerotic lesions

56
Q

treatment for Paget’s disease

A

bisphosphonates

57
Q

clinical presentation for patellar tendonitis

A

athletes

episodic pain and tenderness at inferior petalla

58
Q

clinical presentation for petallofemoral syndrome

A

young women

subacute to chronic pain with squatting, running, prolonged sitting, using stairs

59
Q

Initial management of patellofemoral compression test

A

activity modification
NSAIDs
stretching
strengthening exercises

60
Q

antibodies associated with dermatomyositits

A

Anti-Jo-1 (antisynthetase antibody)

Anti-Mi-2 (antihelicase)

61
Q

what is the most definitive test for polymyositits

A

muscle biopsy

62
Q

Clinical feature of polymyalgia rheumatica

A

muscle stiffness

63
Q

Clinical feature of polymyositits

A

proximal muscle weakness

64
Q

first line treatment for reactive arthritis

A

NSAID

65
Q

adverse effect of hydroxychloroquine

A

retinopathy

66
Q

Felty syndrome

A

rheumatoid arthritis
neutropenia
splenomegaly

67
Q

Osteitis fibrosa cystica

A

bony pain, osteoclastic resporbtion of bone, leading to replacement with fibrous tissue (brown tumors)
- seen in parathyroid carcinoma

68
Q

Osteitis deformans

A

Paget disease

69
Q

clinical feature of rotator cuff tear

A

pain with abduction and external rotation

70
Q

Lofgren syndrome is associated with what?

A

sarcoidosis

71
Q

Initial management of sciatic neuropathy

A

NSAID or acetaminophen

72
Q

Allopurinol

A

decreases uric acid production by inhibiting xanthing oxidase
used for prevention of recurrent gout

73
Q

Colchicine

A

treats acute gout

74
Q

Schirmer test

A

see how wet/dry eyes are

75
Q

antibodies for Sjogrens

A

anti-Ro/SSA and Anti-La/SSB

76
Q

Pathology of Sjogrens

A

lymphatic infiltration

77
Q

what should be the first antibody test for SLE

A

ANA

78
Q

drug induced lupus abs

A

anti-histone

79
Q

anti=topoisomerase

A

systemic sclerosis

80
Q

Lumbar extension worsens back pain

A

lumbar disk herniation

81
Q

anticentromere abs

A

systemic sclerosis

82
Q

anti-smooth abs

A

autoimmune hepatitis

83
Q

Anti-neutrophil cytoplasmic abs

A

Wegner

84
Q

Ant-cyclic-citrullinated peptide abs

A

rheumatoid arthritis

85
Q

Muddy brown granular cast

A

acute tubular necrosis

86
Q

RBC casts

A

glomerulonephritis

87
Q

WBC casts

A

interstitial nephritis and pyelonephritis

88
Q

fatty casts

A

nephrotic syndrome

89
Q

broad and waxy casts

A

chronic renal failure

90
Q

Serology values for Systemic sclerosis

A

antinuclear antibody
anti-topoisomerase (ant-Scl-70) antibody
Anticentromere antibody

91
Q

Anti-cyclic citrullinated peptide antibodies

A

Rheumatoid factor

92
Q

What is Kussmaul’s sign and what do you see that in?

A

lack of decrease or increase in jugular venous pressure on inspiration
constrictive pericarditits

93
Q

what murmur do you hear with constrictive pericarditis

A

mid-diastolic sound = pericardial knock

94
Q

What is the differential if a pt has hypoxia but is worsened by intravascular volume exapnsion

A

pulmonary contusion

95
Q

what is a cause of cardiogenic shock

A

myocardial infarction

96
Q

Patients with long-standing ankylosing spondylitits can develop

A

bone loss due to increased osteoclast activity in the setting of chronic inflammation.

97
Q

what does equilibrated intracardiac diastolic pressures mean? next step?

A

cardiac tamponade

urgent echocardiography

98
Q

what are risk factors for vertebral compression fracture

A 
trauma 
osteoporosis/osteomalacia
osteomyelitis
MALIGNANCY WITH BONE METASTASES
hyperparathyroidism
99
Q

Patient with SLE what is the x-ray finding of joints

A

no evidence of joint destruction

100
Q

clinical finding for malignant hyperthermia

A

muscular rigidity

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