UWorld_7.26 Flashcards
Lacunar stroke presentation
- common syndromes include:
- pure motor hemiparesis
- pure sensory stroke
- ataxic hemiparesis
- dysarthria-clumsy hand
Lacunar stroke lesions
- basal ganglia
- subcortical white matter (internal capsule, coronoa radiata)
- pons
Timing for alcohol withdrawal seizures
12-48 hours after last drink
Cyanide toxicity presentation
- AMS
- lactic acidosis
- seizures
- coma
Anterior mediastinal mass ddx
- “4 Ts”:
- thymoma
- teratoma (mixed germ cell tumor)
- thyroid
- terrible lymphoma
Evaluation of suspected androgen-producing tumor
DHEA-S (hehydroepiandrosterone-sulfate)
First trimester anomaly screening options
-@ 9-13 weeks: triple test (PAPP A, bHCG, nucal translucency) 10 wks: cell free fetal DNA 35 yo)
ipratropium MOA, use
- MOA: anti-muscarinic (anti-cholinergic)
- use = sx of COPD
Tx of young cystic fibrosis pt. w/PNA
vancomycin
Most severe mutation types
- nonsense
- frameshift
Tx of PCP pneumonia in HIV pt.
TMP-SMX + corticosteroids
First line therapy for angina pectoris
- ASA
- B-blockers (metoprolol)
- sublingual nitro PRN
Cause of ED after pelvic fracture
nerve injury and disruption of arterial supply
Morton neuroma presentation
- MN = mechanically induced degenerative neuropathy
- numbness, aching, burning @ distal forefoot from metatarsal heads to third/fourth toes
Tarsal tunnel syndrome presentation
- 2/2 compression of tibial n. as it passes through ankle (usually 2/2 fractures around ankle)
- burning, numness, aching @ distal plantar surface of foot/toes +/- radiation to calf
Prevent progression of diabetic nephropathy
-strict BP control w/target = 130/80
Characteristics of dipyridamole cardiac testing
- injected during myocardial perfusion scanning
- reveals areas of restricted myocardial perfusion
- “steal syndrome” = redistribution of blood to non-diseased areas induced by injection
Tx of reactive arthritis
NSAIDs
Reactive arthritis
“can’t pee, can’t see, can’t climb a tree”
urethritis, conjunctivitis, arthritis
OCD tx
- SSRIs
- CBT/exposure therapy
Patau’s syndrome
xx
Cause of osteomylitis 2/2 nail puncture wound
pseudomonas
Complication of uncontrolled infection of facial skin
cavernous sinus thrombosis
Presentation of cavernous sinus thrombosis
- can occur in setting of uncontrolled infection of face, sinuses, orbit
- H/A
- periorbital edema
- binocular palsies
Dx/Tx of cavernous sinus thrombosis
- MRI
- IV abx/prevent herniation
UGI bleed unusual lab findings
- low Hb
- elevated BUN and BUN/Cr ration
Cooling in heat stroke
ice water immersion preferred
Thiazide diuretic SEs
- hyperglycemia (worse in pt.s w/DM)
- increased LDL/TGs
- hyperuricemia
- electrolytes: hyponatremia, hypokalemia, hypomg, hyperca
Ovarian torsion tx
- laparoscopy w/detorsion
- ovarian cystectomy
- oophorectomy if necrosis/malignancy
Behcet disease presentation
- recurrent, painful oral apthous ulcers
- genital ulcers
- eye lesions/uveitis
- skin lesions
- thrombosis
Dx of Behcet disease
- pathergy = skin ulceration w/minor trauma (e.g. needlestick)
- biopsy ==> nonspecific vasculitis of different-sized vessels
Pulmonary nodule w/halo sign ==> dx?
aspergillosis
Steroids skin SE
steroid-induced folliculitis ==> monomorphous, erythematous follicular papules
Management of solid testicular mass
- ochiectomy
- avoid FNAB/transscrotal biopsy to avoid spillage of cancer cells
Blastomycosis presentation
- Great Lakes, Mississippi river, Ohio river (WI is highest)
- pulmonary: productive cough
- skin and bone lesions
- broad budding yeast from sputum
Cause of calcium phosphate stones
- primary hyperparathyroidism
- renal tubular acidosis
Most common kidney stones
calcium oxalate
cysteine stones cause
- congenital error of metabolism
- fhx of stones
struvite stones cause
- proteus infection (urease-producing)
- assoc. w/hx of recurrent UTIs
Types of conditions that lead to digital clubbing
- intrathoracic neoplasms
- intrathoracic suppurative diseases (e.g. CF, abscessn bronciectasis)
- lung disease (except COPD)
- cyanotic congenital heart disease
RA typical joint involvement
- MCP and proximal PIPs initially
- MTPs of toes
- wrists
- cervical spine ==> spinal sublux/cord compression
