Week 4 Uworld Flashcards by Luke Hayek

what abx for meningitis in immunocompromised?

ampicillin, vancomycin and cefepime

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what abx for meningitis in someone 50+?

ampicillin vancomycin and 3rd gen cephalosporin

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what murmur is common in aortic dissection?

aortic regurgitation

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what can happen to kidneys in aortic dissection, why?

if it involves the renal arteries can have kidney injury…creatinine bump

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multiple long nodules with cavitation at periphery of lungs should make you think what?

septic emboli from infective endocarditis

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what are the sx of GVHD?

diarrhea, liver inflammation and maculopapular rash

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when does someone develop GVHD?

within 100 days of transplant

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what is rx of GVHD?

steroids

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what is pathogenecity of GVHD?

Cd8 cells from transplant against host

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is radioiodine uptake increased or decreased in graves disease?

increased

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is radioiodine uptake increased or decreased in painless thyroiditis?

decreased

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what are two reversal agents of warfarin

vit K and prothrombin complex concentrate

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what electrolyte conributes to hypocalcemia?

hypomagnesemia

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what is murmur of hypertrophic cardiomyopathy

crescendo decrescendo at LUSB

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what is murmur of bicuspid aortic valve?

aortic regurg, diastolic decrescendo at LUSB

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what are the symptoms of digoxin toxicity?

nausea anorexia weakness fatigue and confusion

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what medication often interacts with digoxin and causes toxicity?

amiodarone

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what common medication can cause interstitial nephritis?

analgesic nephropathy (pain pills)

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what should be given for anaerobic pneumonia as outpatient?

amox-clav

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if you have steroid induced adrenal insufficiency, what are levels of ACTH, cortisol and aldosterone?

low acth and cortisol, normal aldosterone

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if you have primary adrenal insufficiency, what are levels of ACTH, aldo and cortisol?

all low

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3 findings in wernicke encephalopathy

ataxia, encephalopathy and nystagmus

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two ppl that get wernickes encephalopathy?

alcoholics and severely malnourished

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rx of wernickes?

thiamine then glucose

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what rhythm agents are used in a fib initially?

diltiazem and verapamil

aside from lifestyle changes, what else can help patients with chronic pancreatitis?

pancreatic enzyme supplementation (included lipase)

what are signs of kidney transplant rejection?

proteinuria and worsening creatinine

when does kidney transplant rejection occur?

within 6 months of transplant

what is rx for kidney transplant rejection?

high dose IV steroids

what are ecg findings of hypokalemia?

flat T waves and U waves

what are symptoms of hypokalemia?

weakness, cramps, hyporeflexia, rhabdomyolysis

what are some causes of hypokalemia

diuretics, vomiting, diarrhea, hypomagnesemia, and loads of beta agonists

what is the main difference between a case control and cohort study?

in a cohort study, you take people with and without a risk factor and compare incidence of disease while in a case control you take cases of disease and controls without disease and compare if they had certain risk factors

isoniazid can cause what kind of anemia? how?

microcytic anemia...through pyrodoxine deficiency

is hemodynamic instability common in acute transplant rejection?

no, should make you think of bacterial infection

what abx for syphilis if you cannot give penicillin?

doxy

what will central venous pressure and capillary wedge pressure be in a PE?

CVP will be elevated and capillary wedge pressure will be normal or low

what blood cancer is associated with DIC?

APML

what is the A wave of JVP?

right atrial contraction

what is the C wave of JVP?

RV contraction against closed tricuspid

what is the V wave in JVP?

peak of right atrial filling

what can cause prominent A waves or cannon A waves?

atrioventricular disassociation leading to atrium contracting against closed ventricle

what is best malaria prophylaxis?

mefloquine for 2 weeks before and 4 weeks after

are bone infections from diabetic ulcers mono or polymicrobial?

usually polymicrobial

what is a pulmonary side effect of amiodarone?

chronic interstitial pneumonitis

renal vein thrombosis is most common with which nephrotic syndrome?

membranous nephropathy

if there is a concern for ACS but no diagnosis yet, what should patient be given right away/

aspirin

what can you give to diurese cirrhotic patient?

furosemide and spironolactone together

what is triad of gonnococemia?

dermatitis, tenosynovitis and polyarthralgia

straight lines looking wavy to someone is an early sign of what?

macular degeneration

what TB drug is associated with hepatitis?

Isoniazid

what should you do if patient wiht Tb has mild liver enzyme elevation while on isoniazid?

continue treatment

how does dobutamine help decompensated heart failure?

beta agonist and leads to decrease in end systolic LV volum e

does heart failure cause respiratory alkalosis or acidosis?

alkalosis

does COPD cause respiratory alkalosis or acidosis?

acidosis

what coag test can be abnormal in VWD?

PTT

what is rx of cryptococcal meningitis?

amphotericin B

what are CSF signs of cryptococcal meningitis?

high opening pressure, low glucose, high protein and low WBCs

what is cause of AKI in cardiorenal syndrome?

increase in central venous pressure

what is post exposure prophylaxis for HIV?

immediate test and start triple therapy

does IgA nephropathy have to have significant amount of protein in urine?

NO will be blood and protein mixed

what is test for ITP?

there isnt one...test for causes of ITP like autoimmune diseases

what are three requirements for acute liver failure diagnosis?

high liver enzymes, poor fxn and hepatic encephalopathy

can lupus cause seizures?

YEs

what is first line therapy of BPH?

alpha antagonists

what is first line therapy of patient with torsades?

magnesium

ring enhancing lesions on brain MRI are suggestive of what in HIV patient?

toxoplasmosis

what CD4 count makes you worried about toxo? what is ppx?

bactrim at <100 cells

what are three meds to use for dementia?

rivastigmine, donepezil and galantamine

what med is used for a fib in patient with wolf parkinson white?

procainamide

why should you not give beta blockers or caclcium channel blockers to patients in afib who have WPW?

can promote conduction across accessory pathways

what are two lung volume changes in pregnancy

decreased residual volume and FRC and increased minute ventilation

why will patient with OSA have low chloride?

because of metabolic alkalosis compensation leading to high bicarb and low Cl

heroin use and HIV put you at risk for what kidney disease?

FSGS

if worried about acromegaly, what is first lab to check?

insulin like growth factor

what are signs and symptoms of acromegaly?

skin tags, enlarged facial features, enlarged hands, arthralgia, carpal tunnel,

patients with nephrotic syndrome have increased risk of what two things with blood vessels?

hypercoagulation and hyperlipidemia

what do ppl usually pick up histoplasma from?

bat/bird droppings

what imaging to diagnose budd chiari?

US of abdomen

how soon after MI does papillary muscle rupture occur?

3-5 days

how soon after MI does free wall rupture happen?

5 days to weeks

how soon after MI does ventricular aneurysm develop?

weeks to months

what is imaging for chronic mesenteric ischemia?

Ct angio

what is mononeuritis multiplex?

neuropathy of more than 3 non contiguous nerves

what is mononeuritis multiplex a feature of?

polyarteritis nodosa

what are systemic sx of polyarteritis nodosa?

fever, weight loss and fatigue

what are renal sx of polyarteritis nodosa?

HTN and renal insufficiency

what are skin findings in polyarteritis nodosa?

nodules and livedo reticularis

what is GI sx in polyarteritis nodosa?

mesenteric ischemia

what are neuro sx ofpolyarteritis nodosa?

headache, seizure and mononeuritis multiplex

pt with suicide attempt has oral ulcers and drooling and is in severe pain, what did they do?

caustic ingestion

what LVEF supports mitral valve repair in MR? why?

30-60% and because it actually isnt this high bc part of cardiac output going into right atrium

what are two types of mitral regurg? which one gets surgery?

primary and secondary (primary gets operated on)

what is a common cause of secondary MR?

what is most common cause of primary MR?

myxomatous degeneration of valve

what is difference between SJS and TEN?

TEN is more of body involved like greater than 30%

what happens to cardiac output, SVR and BP in hypovolemic shock?

CO down due to loss, BP down and SVR up due to those being down

what are some signs of RCC?

hematuria, flank pain, varicoceles

what can happen to RBCs and platelets in RCC?

can have anemia or erythrocytosis and thrombocytosis

what are levels of alk phos, calcium and phosphate in paget disease?

alk phos up, other normal

what is rx of paget disease?

bisphosphonate s

hammer and claw toes are classic findings of what?

T2DM neuropathy

what causes BPPV?

often due to debris in canals