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USMLE Step 2 > UWorld_6.29 > Flashcards

UWorld_6.29 Flashcards

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USMLE® Step 1 flashcards
1
Q

Bloody ascites ==> ?

A
  • Trauma
  • malignancy
  • rarely TB
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2
Q

Milky ascites ==> ?

A
  • chylous

- pancreatic

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3
Q

Turbid ascites ==> ?

A

possible infxn

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4
Q

PMNs in ascites indications

A

no peritonitis

> 250 PMNs @ ascites ==> peritonitis (secondary vs. SBP)

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5
Q

Total protein @ ascites indications

A
  • > ## =2.5 albumin = “high protein ascites”; CHF, peritoneal cancer, TB, Budd-Chiari, fungal
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6
Q

SAAG calculation/indication @ ascites

A
  • SAAG = serum alb. - ascites alb.
  • SAAG >=1.1 ==> portal HTN (cirrhosis, Budd-chiari, CHF)
  • SAAG no portal HTN
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7
Q

Cyanosis @ rest, relieved by crying and worsened by feeding ==> dx?

A

choanal atresia

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8
Q

Common bacterial causes of brain abscess

A
  • 50% spread from sinusitis/head&neck infection
  • Viridans strep
  • anaerobic bacteria (prevotella, peptostrep, bacteroides)
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9
Q

Tx for brain abscess

A
  • drainage if possible

- prolonged abx (4-8 wks)

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10
Q

Methanol intoxication presentation

A
  • H/A, N/V, epigastric pain
  • visual problems/optic disc hyperemia
  • anion gap metabolic acidsos
  • osmolar gap
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11
Q

blood cancer w/strong PAS staining ==>

A
  • ALL

- TdT also positive in almost all pt.s

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12
Q

Cyclosporine: MOA, SE

A
  • MOA: calcineurin-inhibitor
  • SE:
  • nephrotoxicity
  • hyperkalemia
  • HTN
  • gum hypertrophy
  • hirsutism
  • tremor
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13
Q

Tacrolimus: MOA, SE

A
  • MOA: calcineurin-inhibitor
  • SE:
  • nephrotoxicity
  • hyperkalemia
  • HTN
  • tremor
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14
Q

Azathioprine: use, SE

A
  • use: immunosuppressant
  • SE:
  • diarrhea
  • leukopenia
  • hepatotoxicity
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15
Q

Mycophenolate: use, SE

A
  • use: immunosuppressant

- SE: marrow suppression

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16
Q

Salmeterol: MOA

A

long-acting B2 adrenergic agonist

17
Q

Management of ventilator-associated PNA

A
  • CXR
  • lower respiratory tract sampling for gram stain/culture
  • empiric abx
18
Q

Complication of acute pancreatitis

A
  • hypotension 2/2 intravascular volume loss b/c of local and systemic vascular endothelial injury
  • ==> vasodilation, increased vascular permeability, plasma leak into retroperitoneum ==> systemic hypotension
  • hypotension ==> multi-organ failure
19
Q

Tests for CGD

A
  • dihydrorhodamine 123 test

- nitroblue tetrazolium

20
Q

CH50 assay use

A

determine total complement concentration

21
Q

XR in stress fx

A
  • may show nothing on XR
  • stress fx = clinical dx w/TTP @ site of pain + local swelling
  • can be seen on MRI/bone scan
22
Q

Wells Criteria

A
  • +3 points: Signs of DVT; alt. dx less likely
  • +1.5 points: previous PE or DVT; HR>100; recent surgery/immobilization
  • +1 points: hemoptysis; cancer
  • PE Unlikely ==> d-dimer
  • > 4 points total ==> PE likely ==> CT pulmonary angiography
23
Q

Metatarsus adductus management

A
  • Type I = corrects passively/actively into abduction ==> spontaneous correction
  • Type II = corrects passively/actively into neutral ==> orthosis vs. casting if needed
  • Type III = no correction ==> serial casting
24
Q

Entamoeba histolytica illness

A
  • develops after prolonged exposure to native areas: SE Asia, Africa, Central/South America
  • abdominal pain + bloody diarrhea
25
Q

Hypokalemia presentation

A
  • weakness, fatigue
  • m. cramps; hyporeflexia
  • ECG w/broad, flat T waves, U waves, ST depression, PVCs
26
Q

DDx in pt. w/HTN & Hypokalemia

A
  • Primary hyperaldosteronism
  • Secondary hyperaldosteronism
  • Non-aldosterone causes
27
Q

Primary hyperaldosteronism presentation

A
  • ELEVATED aldosterone & LOW renin
  • HTN
  • hypokalemia
  • metabolic alkalosis
  • caused by aldo-producing tumor or bilateral adrenal hyperplasia
28
Q

Secondary hyperaldosteronism presentation

A
  • ELEVATED aldosterone & ELEVATED renin

- 2/2 renovascular HTN; malignant HTN; renin-secreting tumor; diuretic use

29
Q

Non-aldosterone causes of HTN + hypokalemia

A
  • p/w LOW aldosterone & LOW renin
  • CAH
  • deoxycortico-producing adrenal tumor
  • cushing syndrome
  • exogenous MCs
30
Q

Hyperestrinism characteristics

A
  • occurs in pt.s with cirrhosis 2/2 impaired hepatic metabolism of circulating estrogens
  • spider angiomata
  • palmar erythemia
  • gynecomastia
  • testicular atrophy
  • decreased body hair
31
Q

OCPs benefits/risks

A
  • benefits: decreased benign breast dz; decreased endometrial/ovarian cancer
  • risks: VTE, HTN, hepatic adenoma, rarely MI/stroke
32
Q

Most common presenting sx of multiple myeloma

A

bone pain

33
Q

Elderly pt. w/osteolytic lesion ==> ?

A

suspect multiple myeloma

34
Q

Gonococcal vs. Chlamydial urethritis in men

A
  • Gonococcal ==> gram stain: gram (-) cocci

- Chlamydia ==> gram stain negative; (+) nucleic acid testing

USMLE Step 2 (38 decks)

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