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STEP 2 CK Frequently Missed > UWSA 1= 262 > Flashcards

UWSA 1= 262 Flashcards

1
Q

What is the greatest risk to parenteral nutrition?

A

Central Line Associated blood stream infections

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2
Q

Reactive fetal NSt

A
  • BL FHR: 110-160
  • Mod Variable: 6-25/min
  • > =2 accelerations lasting >= 15 seconds, >=15 beats above normal
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3
Q

Pt with loss of palpable radial pulse during inspiration. Had recent syncope following 2 weeks ago having URI and vague retrosternal chest pain that radiated to left arm shoulder.

A

Cardiac Tamponade, pulsus paroxodus. Virus –> Viral pericardidis –> Cardiac Tamponade

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4
Q

Viral Encephalitis, what does the LP show?

A

increased protein (90), increased RBC (700), NL glucose, 125 WBC with only 5% neutrophils

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5
Q

Neurogenic claudication (Psuedocladication), pain with extension of spine, walking down hill, relieved by flexing spine, waling uphill. What is it, how to diagnose?

A

Lumbar spinal stenosis, 2/2 degenerative OA, dx with MRI. Narrowing of lumbar canal and compression of lumbar nerve roots.

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6
Q

Paraneoplastics ACTH production, what is it?

A

A polypeptide hormone (ACTH). How? By Small cell lung carcinoma, have severe hypercortisolism, also hyperpigmentation bcus of MSH receptors being bound by ACTH and MSH

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7
Q

Most common cause of labor protraction? (cervical change slower than expected +/- inadequate contractions). Arrest = no cervical change >= 4 hours with adequate contractions or >=6 hours with inadequate contractions.

A

Contraction inadequacy. Should be forceful q2-3min. Tx with oxytocin.

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8
Q

Effective measures to prevent aspiration PNA?

A

Oral care, diet modification for patients with dysphagia, elevating bed to 30-45 degrees. Only J tube, post pyloric feeding has been shown to reduce the risk or aspration. (NG tube/G tube/trachial tube all predispose to ASA PNA) Tx. With Clinda.

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9
Q

Adult stares blankly for several minutes and engages in automatisms such as lip smaking or chewing, then confusions, and leg dragging for 30 minutes (transient post seizure state)

A

Partial Complex Seizure 2/2 temporal lobe epilepsy DX RMi or RRG (absense no post ictal confusion)

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10
Q

Tx of wide complex Vtach

A

Amiodarone

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11
Q

Tx SVT

A

Adenosine

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12
Q

Ca 14, severe neuro sxs, low phos

A

Malignancy, 2/2 PTHrP

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13
Q

Hypocalcemia, hyperphosphatemia w/CKD

A

Secondary hyperparathyroidsm. Increased PTH, renal osteodystrophy, pain, increased risk of fracture. Can lead to autonomous adenomas, tertiary hyperparathyroidsm, high CA and PTH.

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14
Q

Precipitating factors for hepatic encephalopathy

A

Drugs, Hypovolemia, electrolyte changes (low K), increased Nitrogen (GI bleed), infection, TIPS

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15
Q

Young Pt with recent viral illness presents with heart failure, chest pain, arrhythmias

A

Dilated CM 2/2 viral myocarditis (Cox B)

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16
Q

Back pain, fevers, night sweats, immunosuppressed, back pain, Xray shows cavity infiltrate in left upper lung

A

Active TV (spread hematogenously)

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17
Q

Twist knee, impaired extension of the knee, instability, and exacerbation of pain with squatting. Joint line tenderness, effusion, locking or catching when extended while under load.

A

Meniscal tear

18
Q

Most important prognostic factors for astrocytomas

A

patient age, functional status, tumor grade (degree of anaplasia)

19
Q

Chronic Lymphocytic Leukemia

A

LAD
HSM
Mild Thrombocytopenia, anemia
Severe lymphcytosis and smudge cells, dx with flow cytometry
Tx with monoclonal antiboty against CD20 antigen expressed on B lymphocytes 1st line. Also at high risk infections, #cause M&M.

20
Q

High risk cardiac procedures that need abx prophylaxis for specific invasive procedures

A

Prosthetic heart valve, previous hx IE, structurally abnormal valve in transplated heart, certain CHD

21
Q

Most common underlying condition that increases risk of IE from transient bacteremia

A

MVP

22
Q

Tx acute dystonia

A

Anticholinergic (Benztropine/trihexyphenidyl) or diphenhydramine

23
Q

6 year old delayed milestones, autistic behavior, ID, elongated face, large testes, macrocephaly, hypotonia

A

Fragile X, CDD FMRI gene X chromosome

24
Q

3-5 days after MI, hypotension, tachycardia, holosystolic murmur LLB, oxygen gradient between RA (65%) and RV (79%), and increased right sided heart pressures

A

VSD

25
Q

Metastatic BC, thrombocytopenia, decreased fibrinogen, increased INR

A

DIC, most common coagulopathy in pts with malignancies (microangiopathi hemolytic anemia)

26
Q

Murmur or mitral stenosis

A

Mid diastolic murmur at cardiac apex (low pitched, openin snap)

27
Q

Hemothorax after thoracentesis of L PE, then SOB, MOA

A

Decreased Left Ventricular preload tx with chest tube

28
Q

Loss of cremasteric reflex with testicular pain

A

testicular torsion

29
Q

Cisplatin tox

A

Renal tox, electrolyte abnormalities, tinnitus, hearing loss, N/V, neurotox

30
Q

Quickest way to relieve pain with MI

A

reduce preload with nitrates

31
Q

First line medicine with spinal epidural abscess

A

Abx (vanc + ceftriazone), ASA or surgical decompression (glucorticoids better for reducing compression with epidural mets)

32
Q

CLL

A

Smudge cells

33
Q

Pregnant patio with high Pre test probability for PE has a low or mod prob PE on V/Q

A

CTA, only normal V/Q scan can r/o PE

34
Q

HIV tx that causes anxiety, dizziness, impaired concentration, and vivid dreams, depression

A

Efavirnez

35
Q

1st line tx for urge incontinence

A

bladder training, then antimuscarinic oxybutnin

36
Q

Blunt trauma, CXR shows widened mediastinum, what next? HDS.

A

CT with contrast (Or TEE)

37
Q

Ergot + triptan

A

severe elevation in BP 2/2 prolonged vasospasm due to over-activation 5HT receptors

38
Q

painless blurring of vision, glare, halos, worsening distance vision (myopic shift), red flex lost

A

CATARACT

39
Q

Splenectomy

A

thrombocytosis for months years

40
Q

Sterile pyuria (WBC w/out bacteria in clean urine sample) and urethritis in sexually active pt in non monogamous relationship 2/2

A

Chlamydia

41
Q

Very high TG and pancreatitis bouts tx with

A

fenofibrate

42
Q

Tx torsades with

A

magnesium

STEP 2 CK Frequently Missed (5 decks)

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