UWorld_6.6 Flashcards

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1
Q

Afib: 1st line tx

A
  • unstable pt: cardioversion

- stable pt: 1. b-blockers vs. ca-chan blockers 2. anticoag based on CHADS-VASC score

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2
Q

Determination of need for anticoagulation in Afib

A
  • CHA2DS2-VASc score
  • CHF = +1
  • Hyptertension = +1
  • Age >75 = +2
  • DM = +1
  • Stroke (prior) = +2
  • Vasc. dz = +1
  • Age 65-74 = +1
  • Sc (sex category) = +1 if female
  • anticoagulation advised if score >= 2
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3
Q

Duodenal hematoma management

A
  • occurs with blunt abdominal trauma
  • bowel rest + parenteral nutrition + NG suction
  • surgery considered second line if conservative tx fails
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4
Q

Characteristics of lateral medullary infarct

A
  • ipsilateral loss of pain/temp @ face + contralateral loss of pain/temp @ body
  • ipsilateral Horner’s syndrome (miosis, ptosis, anhidrosis)
  • vertigo to side of lesion + nystagmus
  • ipsilateral bulbar m. weakness ==> choking, hoarseness
  • motor fxn is spared
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5
Q

Cause of lateral medullary infarct/wallenberg syndrome

A

occlusion of posterior inferior cerebellar artery or vertebral artery

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6
Q

Deficits in medial mid-pontine infarct

A

contralateral ataxia and hemiparesis

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7
Q

Deficits in medial medullary infarct + cause

A
  • contralateral paralysis of arm/leg + tongue deviation towards the lesion
  • caused by occlusion of vertebral or anterior spinal artery
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8
Q

BG goals in gestational DM

A

-Fasting

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9
Q

Newborn/fetal consequences of maternal hyperglycemia

A
  • congenital malformations
  • macrosomia
  • neonatal hypoglycemia
  • hyperviscosity 2/2 polycythemia`
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10
Q

Thyroid hormone production during pregnancy

A
  • increased thyroid hormone production ==> increased total T4 & T3
  • increased thyroxine-binding globulin
  • overall: slightly elevated free T4/T3 and decreased TSH
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11
Q

Adenosine deaminase deficiency ==>

A
  • impaired T cells

- viral, fungal, bacterial infections

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12
Q

X-linked agammaglobulinemia ==>

A
  • impaired B cell development
  • absent lymphoid tissue
  • recurrent sinopulmonary and GI infections
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13
Q

Complement deficiency ==>

A
  • risk for disseminated bacterial infections

- esp. w/encapsulated bacteria: s. pneumo, n. menigitidis

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14
Q

Impaired oxidative burst ==>

A
  • chronic granulomatous disease

- recurrent skin & pulm infections w/catalase + organisms: s.aureus, serratia marcescens

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15
Q

Niemann-Pick vs. Tay Sachs

A
  • both: AR, 2-6 mo., loss of motor milestones, hypotonia, feeding difficulties, “cherry-red” macula
  • NP: sphingomyelinase deficiency, HSM, arreflexia
  • TS: B-hexosaminidase A deficiency, no HSM, hyperrflexia
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16
Q

Characteristics of nasal polyps

A
  • assoc. w/chronic sinusitis, asthma, aspirin/NSAID-induced bronchospasm in condition = aspirin-exacerbated respiratory disease
  • sx = bilateral nasal obstruction, nasal discharge, anosmia
17
Q

Common toxic exposure in house fire

A

cyanide toxicity

18
Q

Cyanide toxicity tx

A
  • hydroxocobalamin
  • sodium thiosulfate
  • IV fluids for support
  • if no antidote: nitrates to induce methemoglobinemia
19
Q

Tx of legionnaires dz

A
  • macrolides

- fluoroquinolones