UWORLD6 Flashcards
Dysphagia initially involving bot hsolids and liquids suggests
neuromuscular disorder
Structural lesions that lead to dysphagia in the pharynx and upper esophagus are visualized with
nasopharyngeal laryngoscopy
Cancers in the upper esophgaus are more likely to be
squamous cell carcinoma (vs adenocarcinoma, found primarily in the lower esophagus)
Trastuzumab is an antibody against
HER2
While anthracycline-associated cardiotoxicity may not be reversible after tx discontinuation (due to myocyte necrosis and replacement by fibrous tissue), that due to __________ is reversible
trastuzumab
A positive straight-leg raising test at a ___ degree angle or less is characteristic for nerve root irritation.
60
While scombroid poisoning symptoms include flushing, throbbing headache, palpitations, abdominal cramps, diarrhea, and oral burning; pufferfish poisoning is associated with
prominent neuro symptoms, including perioral tingling, incoordination, weakness
Red to flesh colored papules with slight central umbilication in HIV patient. Think this (in addition to Molluscum):
cutaneous cryptococcosis
Apple-jelly nodules with central atrophy and progression by peripheral extension:
cutaneous TB (lupus vulgaris)
How do you diagnose cutaneous crypto?
histopathologic examination
In whom is the warfarin INR goal 2.5-3.5?
MV replacement; AV replacement with presence of risk factors (afib, EF less than 30, prior VTE, hypercoagulable state)
Which tests are highly suggestive of patellofemoral pain syndrome?
pain elicited by extending the knee while compressing the patella; reproduction of pain with squatting
Episodic pain and tenderness at the inferior patella:
patellar tendonitis (jumper’s knee; seen in volleyball, basketball)
Localized pain and tenderness at the medial aspect of the knee joint distal to the joint line. Symptoms are usually acute/episodic (vs chronic) and not felt at the anterior knee, usually:
anerine bursitis
What is “housemaid’s knee”?
Common cause of anterior knee in patietns who work on their knees. Typically acute and HIGHLY localized with visible swelling anterior to the patella. Frequently complicated by secondary infection (septic arthritis) due to S aureus
T/F: Women less than age 30 should not be screened wit HPV
True; infection is transient
What are the features of ACL tear?
rapid deceleration or direction changes; pivoting with planted foot. Rapid onset severe pain; a “popping sensation” and significant swelling (effusion/hemarthrosis), jointinstability. Anterior laxity of tib relative to femur. Dx with MRI.
T/F: MCL injuries are not typically associated with significant hemarthrosis.
True.
Positive valgus stress test is consistent
T/F: Patients with a meiscal tear have effusions that develop slowly.
True
Hemarthrosis is rare
What comprises the latent stage of labor?
Stage 1. 0-6 cm cervical dilation
What comprises active stage of labor?
Stage 1. 6-10 cm cervical dilation
What is the 2nd stage of labor?
10cm (complete) cervical dilation to delivery
What is stage 3 of labor?
delivery of baby to expulsion of placenta
What is arrest of labor in the first satge?
Greater than 6 cm dilation, ruptured membranes, and
1) no cervical change for 4 hours despite ADEQUATE contractions; OR
2) no cervical change for 6 hours with INADEQUATE contractions
What is “adequate labor” in terms of Montevideo units?
200-250 units or greater
Which drug is used for cervical ripening and labor induction? What class of drug is it?
misoprostol! a prostaglandin
What are the indications for parathyroidectomy in patients with 2* or 3* hyperparathyroidism?
1) calcium levels over 10.5 not responding to conservative management
2) mod to severe hyperphos
3) PTH greater than 1000
4) intractable bone pain
5) intractable pruritus
6) episode of calciphylaxis
7) soft tissue calcification
Patients with alarm symptoms or older than age ___ should undergo endoscopy.
55
alarm symptoms = abdominal mass or LAN, unexplaind anemia, FH of gastric cancer, worsening dysphagia or odynophagia, persistent vomiting or hematemesis, unintentional weight loss
The major problem that leads to difficulties finding cross-matched blood in patients with a history of multiple transfusions is:
alloantibodies
Though premixed insulins (eg 70/30) can provide sometimes larger declines in hemoglobin a1c compared to long-acting basal insulins, they are also more likely to cause these two negative side effects:
1) higher risk of hypoglycemia
2) weight gain
Bile-salt induced diarrhea occurs in 5-10% of patients following cholecystectomy and in patients with short bowel syndrome. What is the treatment?
cholestyramine
What is the treatment of choice in cases of ethylene glycol and methanol intoxication?
Fomepizole
How does DIC affect D-dimer, PT, PTT, and fibrinogen?
D dimer = elevated (accelerated fibrinolysis)
PT and PTT: prolonged (depletion of clotting factors)
fibrinogen: low (due to consumption)
Which diabetes meds can cause nasopharyngitis?
DPP4 inhibitors, like sitagliptin or saxagliptin
Which diabetes meds cause diarrhea/flatulence?
a-glucosidase inhibitors, like acarbose and miglitol
Which diabetes meds cause weight gain and hypolgycemia?
sulfonylureas (like glyburide, glipizide, glimepiride) and meglitinides (nateglinide, repaglinide)
FLexible kyphosis is normal or slightly increased thoracic kyphosis seen on lateral radiographs, from which angles?
20-40
The radiographic finding of a “collar on the neck of the Scotty dog” is typical of
spondylolisthesis: an anterior slippage of the vertebral body, usually in the lower lumbar vertebrae