UWorld_6.26 (week 1 make-up) Flashcards
Management of aortic dissection
- Type A: IV b-blockers (labetalol) + surgery
- Type B (descending only): IV b-blockers (labetalol)
- avoid vasodilators and heparin
Leydig cell tumors ==> ?
- increased testosterone +/- estrogen production (2/2 aromatase action)
- inhibition of FSH and LH also ==> additional estrogen ==> gynecomastia
Teratomas ==> ?
+/- elevated AFP or beta-hcg
Endodermal sinus tumor ==> ?
- aka “yolk sac tumor”
- ==> elevated AFP
DLCO in COPD (chronic bronchitis vs. emphysema)
- DLCO normal in chronic bronchitis
- DLCO low in emphysema
Babesiosis presentation
- Ixodes tick (NE US)
- can ==> hemolytic anemia w.jaundice, renal failure, death
Several days w/out BM + N/V + abdominal pain ==> ?
SBO
Risk factors for endometrial cancer
- age >45
- obesity
- DM
- unopposed estrogen (e.g. periods of ammenorrhea)
- PCOS
- early menarche/late menopause
DKA management
- NS
- correct hyperglycemia, electrolytes, acidosis (insulin, glucose, potassium)
- tx of any precipitating causes (i.e. infections)
Prevention of vasospasm s/p SAH
nimodipine initiation
Medical tx for acute abnormal uterine bleeding
- high dose IV or oral estrogen
- high-dose combined OCPs
- high-dose progestin pill
- tranexamic acid
Routine meds to hold before cardiac stress testing
- beta blockers
- ca-channel blockers
- nitrates
- dipyridamole
- no caffeine for 12 hours before
Fanconi anemia presentation
- AR
- congenital marrow failure
- poor growth (short)
- morphologic abnormalities (abnormal thumbs, pigmentation abnormalities, ear problems)
- macrocytic anemia
- caused by chromosomal breaks
Acquired causes of aplastic anemia
- Drugs (NSAIDs, sulfa)
- toxins (benzene, glue)
- idiopathic
- viral (HIV, EBV)
- immune disorders
- thymoma
Nephrotic syndrome associated with HIV, heroin use
focal segmental glomerulosclerosis
FSGS associated w/…
- African American
- Obesity
- Heroin use
- HIV
Membranous nephropathy associated w/…
- adenocarcinoma (lung, breast)
- NSAIDs
- Hep B
- SLE
Membranoproliferative nephropathy associated w/…
- Hep B & C
- lipodystrophy
Characteristics of epidermal inclusion cyst
- benign nodule that produces keratin
- dome-shaped, mobile cyst w/small central punctum
- can be stable, resolve, or increase in size
Most common cause of sudden CHF in young, healthy person
viral myocarditis
Tx of acute glaucoma
- narcotics for pain
- increased IOP: mannitol, acetazolamide, timolol, pilocarpine
Med to avoid in acute glaucoma
-atropine b/c can ==> pupil dilation and worsened glaucoma
red, maculopapular rash @ face, then trunk/extremities + preceeding cough, tearing, rhinorrhea, sneezing ==> dx?
measles
Vitamin that reduces morbidity/mortality in measles
vitamin A
Nephrotic syndrome associated w/RA
- amyloidosis
- @ renal biopsy: amyloid deposits will stain w/congo red
Characteristics of hypopituitarism
- glucocorticoid deficiency ==> hypoglycemia, hypoNa
- Testosterone deficiency (low/normal FSH/LH) ==> low libido, ED
- hypothyroidism
Clopidogrel MOA
P2y12 receptor blocker
Eval of suspected BPH
- rectal exam
- UA
- PSA if >10yr. life expectancy
Management of neonatal clavicular fx
- reassurance; gentle handling, pain management
- no surgery needed
Characteristics of WPW
- accessory pathway that bypasses AV node
- short PR interval (
WPW pic
Wolff-Parkinson-White syndrome
Aromatase deficiency presentation
- decreased conversion of androgens to estrogens
- ==> gestational maternal virilization and virilization of XX fetuses
- girls with normal internal genitalia and ambiguous external genitalia
Rx antibiotics for UTI in pregnancy
- Nitrofurantoin
- Amox
- Amox-Clav
- Cephalexin
Contraindicated antibiotics for UTI in pregnancy
- Tetracyclines
- Fluoroquinolones
- TMP-SMX
Cervicofacial actinomycosis presentation
- mandibular region as slow-growing, nontender mass
- yellow granular pus
- gram stain: gram + branching rod
Tx of cervicofacial actinomycosis
- penicillin x 12 weeks
- clindamycin if allergic to PCN
- surgical excision if not cured by abx
Age-related hearing loss = ?
- “presbycusis”
- bilateral, symmetric sensorineural hearing loss
- tinnitus may develop
Number needed to treat =
1/ARR
Complications of nephrotic syndrome
- hypercoagulability ==> PE, renal vein thrombosis
- protein malnutrition
- microcytic, hypochromic anemia
- increased infections
- vit D deficiency
Cause of LFTs in thousands
- meds
- acute viral hepatitis
- ischemia
LFTs in acute alcoholic hepatitis
rarely exceed 500
Nitrate MOA for reduced cardiac pain/demand
-systemic vasodilation ==> decreased cardiac preload ==> decreased LV walls stress and O2 demand
