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Medicine Week 1 NCs > Week 5 UWorld > Flashcards

Week 5 UWorld Flashcards

1
Q

what is head imaging of tuberculosis meningitis?

A

basilar meningeal enhancement and hydrocephalus

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2
Q

what are sx of mitral stenosis?

A

dyspnea, swelling, pulm HTN

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3
Q

what is murmur of mitral stenosis?

A

diastolic rumble

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4
Q

what should be given with right heart MI to maintain CO of heart?

A

normal saline boluses

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5
Q

what large vessel can giant cell arteritis involve? wat does it cause?

A

aortic aneurysm

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6
Q

what is classic ECG finding of PE?

A

S1Q3T3

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7
Q

aside from ABX what are some other risk factors for C diff?

A

IBD, hospitalization, PPis chemo

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8
Q

what is rx of nocardia? and is it aerobic?

A

bactrim and yes

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9
Q

what is cause of elevated creatinine in cardiorenal syndrome?

A

basically get back pressure from elevated venous system pressure that leads to decrease in GFR and diuretics help decrease this

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10
Q

what happens to left atrium and ventricle size in acute versus chronic MR?

A

in chronic they will increase, in acute they dont have time to dilate

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11
Q

what are the cardiac findings in marfan syndrome?

A

aortic regurg, aortic dilation, aortic dissection, nd mitral valve prolapse

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12
Q

what protein is the problem in marfans?

A

fibrillin

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13
Q

what MSK issue can longstanding HIV cause?

A

peripheral neuropathy

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14
Q

what is rx for HIV peripheral neuropathy?

A

gabapentin or TCA, just like usual neuropathies

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15
Q

patient with hyperkalemic emergency should receive what in addition to calcium gluconate?

A

insulin and glucose

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16
Q

what is a bad side effect of propylthiouracil?

A

agrunlocytosis

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17
Q

if patient on PTU presents with fever and sore throat, what should be done? why?

A

stop PTU cause could be caused by agranulocytosis

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18
Q

HIT puts patients at risk for what two hematologic findings?

A

thrombocytopenia and thrombus formation

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19
Q

why does HIT cause thrombus formation?

A

because antibodies can activate platelets

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20
Q

what is a side effect of lisinopril in patients with CKD?

A

hyperkalemia

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21
Q

what can be done to treat hyperkalemia in patient’s with CKD on lisinopril?

A

start patiromer

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22
Q

3 common causes of acute pancreatitis

A

alcohol, biliary stones, lipids

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23
Q

contact lens keratitis is associated with what two bugs?

A

pseudomonas and serratia

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24
Q

what happens to blood flow to the heart when someone squats?

A

decreases

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25
Q

what happens to hypertrophic cardiomyopathy murmur when someone squats?

A

it increases

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26
Q

what metabolic issue does a pancreatic leak cause?

A

non anion gap metabolic acidosis

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27
Q

what are some common symptoms of carbon monoxide poisoning?

A

headache confusion nausea

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28
Q

what does carbon monoxide do to hgb levels?

A

causes high hematocrit

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29
Q

if a patient with myasthenia gravis comes in with difficulty swallowing and is acidotic, what is going on?

A

myasthenia crisis

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30
Q

what is a common cause of a myasthenia crisis?

A

infection

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31
Q

what should you do for a patient with a myasthenia crisis?

A

intubate

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32
Q

what malignancy is very common in those with HIV and why?

A

non hodgkin lymphoma because EBV can reactivate

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33
Q

if a patient with HIV has bloody diarrhea, what is likely cause?

A

CMV

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34
Q

if patient with HIV has watery diarrhea, what is the cause?

A

cryptosporidium

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35
Q

what is best therapy for single brain metastasis?

A

surgical resection if in accessible location

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36
Q

what are abx options for aspiration pneumonia?

A

zosyn or penems

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37
Q

what is treatment for frostbite?

A

rapid rewarming in warm water

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38
Q

what is an essential tremor?

A

one that worsens with activity, usually unilateral

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39
Q

what worsens physiologic tremors?

A

stress/anxiety and caffeine

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40
Q

describe a parkinsons tremor

A

unilateral, worse at rest and goes away with activity

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41
Q

if elderly patient has dry eyes and dry mouth, is it sjogrens>

A

probably not…more likely to be atrophy of exocrine glands

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42
Q

what cd4 count do you start bactrim ppx?

A

200 or less

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43
Q

aside from bactrim, what other ppx is there for patients with HiV and low CD4 counts?

A

there isnt any

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44
Q

lacunar infarcts occur where?

A

internal capsule

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45
Q

what are often symptoms of lacunar infarcts?

A

motor symptoms only

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46
Q

what is felty syndrome?

A

RA with neutropenia

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47
Q

metoclopramide can cause what neurologic issue? why?

A

it is a dopamine antagonist so can cause acute dystonia

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48
Q

what are sx of PBC?

A

fatigue, itching, jaundice, hepatomegaly, xanthomas

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49
Q

what ab is + in PBC?

A

antimitochondrial

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50
Q

what are complications of PBC?

A

HCC, osteomalacia

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51
Q

what is rx for PBC?

A

ursodeoxycholic acid

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52
Q

what is an adverse effect of hydroxychloroquine?

A

retinopathy

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53
Q

intrnsic renal injury leads to what level of urine sodium?

A

often greater than 40

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54
Q

what are some signs of intrinsic kidney injury in electrolytes?

A

hyperkalemia and metabolic acidosis

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55
Q

what are two things to give for TCA overdose?

A

activated charcoal and sodium bicarb (for QRS protection)

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56
Q

what are pulmonary findings in blastomycosis?

A

acute or chronic pneumonia

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57
Q

what are skin findings in blastomycosi?

A

wart like lesions and ulcers

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58
Q

what are bone findings in blastomycosis?

A

osteomyelitis

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59
Q

what is rx of blastomycosis?

A

itraconazole if moderate disease, no treatment if mild, amphotericin B if severe

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60
Q

for a patient with myasthenic crisis, what can be given to help them?

A

plasmapheresis

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61
Q

does a varicocele or hydrocele transilluminate?

A

hydrocele

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62
Q

does a varicocele or hydrocele contribute to infetility?

A

varicocele

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63
Q

how does a varicocele change with position?

A

increases with valsalva, decreases with supine positioning

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64
Q

when do patients wih ADPKD present?

A

usually in 30-40s

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65
Q

what are sx of ADPKD?

A

flank pain, hematuria, hypertension

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66
Q

what are some extrarenal findings of ADPKD?

A

cerebrl anaurysms, hepatic and pancreatic cysts, diverticulosis

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67
Q

what can occur with heart in thyrotoxicosis?

A

a fib, tachycardia and hypertension

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68
Q

aside from ST elevations, what other ECG finding is associated with pericarditis?

A

PR segment depressions

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69
Q

the spleen does what in clearing infections?

A

antibody mediated phagocytosis

70
Q

eye redness at medial border of eye and nose is likely what?

A

dacrocystitis

71
Q

a diastolic murmur heard at left sternal border after aortic valve replacement is c/f what?

A

valve dysfxn

72
Q

what electrolytes go low in refeeding syndrome?

A

K, Mg and Phos

73
Q

what can happen in refeeding syndrome?

A

arryhtymias,heart failure, seizures, encephalopathy wernickes

74
Q

what is mc side effect of hydroxyurea?

A

myelosuppression

75
Q

erythropoetic stimulating agents come with what common side effect?

A

hypertension

76
Q

what is treatment of carbon monoxide posioning?

A

100% O2

77
Q

what are mild signs/symptoms of carbon monoxide poisoning?

A

headache confusion dizziness

78
Q

what ae severe signs of carbon monoxide poisoning?

A

heart attack seizures and coma

79
Q

does HIV have a rash?

A

it can…looks like pink red ovals thatoccur in acute infection phase

80
Q

does HIV have ulcers anywhere?

A

can have oral ulcers

81
Q

where does amiloride work in kidney for diuresis?

A

collecting duct (K sparing)

82
Q

what are two classic findings in carcinoid syndrome?

A

flushing and diarrhea

83
Q

what is cardiac finding in carcinoid syndrome?

A

tricuspid regurgitation

84
Q

what is rx of carcinoid syndrome?

A

octreotide

85
Q

what is lab test for carcinoid syndrome?

A

elevated urine 5-HIAA

86
Q

primary adrenal insufficiency AKA addisons leads to what two elctrolyte abnormalities?

A

hyperkalemia and hyponatremia

87
Q

what are signs and symptoms of primary adrenal insufficiency AKA addisons?

A

weight loss, fatigue, low BP, hyperpigmentation, syncope, nausea, diarrhea, abdominal pain

88
Q

what causes hyperpigmentation in primary adrenal insufficiency AKA addisons?

A

melanocyte stimulating hormone

89
Q

what drugs are common in drug induced hemolytic anemia?

A

amoxicillin and cephalosporin

90
Q

in addition to steroids and bronchodilators, what else should patients with copd exacerbation receieve? when?

A

antibiotics if >2 cardinal symptoms

91
Q

if patient with hypothyroid is started on estrogen, what should be done to levothyroxine dose?

A

increased

92
Q

what is the triad associated with cardiac tamponade?

A

hypotension, distended neck veins and muffled heart sounds

93
Q

what antiarrythmics prolong the QRS?

A

NA channel blockers

94
Q

what antiarrhythmics prolong the QT?

A

K+ channel blockers..AIDS

95
Q

mixed connective tissue disease involves what 3 autoimmune diseases?

A

polymyositis, systemic sclerosis and SLE

96
Q

what is ab in mixed connective tissue disordrr?

A

anti u1RNP

97
Q

what is rx for central and nephrogenic DI?

A

central is desmopressin

nephrogenic is HCTZ

98
Q

what are levels of T4, T3 and TSH in euthyroid sick syndrome?

A

all are low

99
Q

excessive intake of antacids can lead to what metabolic complication?

A

milk alkali syndrome

100
Q

what is milk alkali syndrome?

A

too much calcium carbonate intake leads to hypercalcemia and metabolic alkalosis

101
Q

milk alkali syndrome leads to what three metabolic/renal issues?

A

hypercalcemia, metabolic alkalosis and AKI

102
Q

what is rx of milk alkali syndrome?

A

stop offending agent, often tums or

103
Q

what is rx for paget disease?

A

bisphosphonates

104
Q

what is a common complication of cardiac catheterization?

A

cholesterol emboli

105
Q

if patient has cholesterol emboli from cardiac cath, what is most likely finding?

A

skin changes from where the emboi embedded

106
Q

a systolic diastolic abdominal bruit means what?

A

renal artery stenosis

107
Q

what is most common cause of splenic abscesS?

A

infective endocarditis

108
Q

babesia can cause what heme issues?

A

anemia and thrombocytopenia

109
Q

babesia is diagnosed by what?

A

blood smear with maltese cross

110
Q

what labs are abnormal in babesia?

A

LFTs and LDH and bili up

111
Q

what are symptoms of babesia?

A

like flu…malaise, body aches, fever, sweats and weight loss

112
Q

what is rx of babesia?

A

atovaquone and azithromycin

113
Q

beta agonist cause what with potassium?

A

low potassium

114
Q

a person with stable ventricular tachycardia should receive what?

A

iv amiodarone

115
Q

a person with unstable ventricular tachycardia should receive what?

A

cardioversion

116
Q

how do you know if it is ventricular tachycardia?

A

wide based QRS

117
Q

ulcerated skin lesions and lytic bone lesions with history of long time infection should make you think about what bug?

A

blastomycosis

118
Q

in patients with high pretest probability of TB who have no gram stain showing acid fast, what should you do with treatment while waiting on culture?

A

go ahead and start 4 drug therapy

119
Q

what are the two general problems in tumor lysis syndrome?

A

AKI and electrolyte abnormalities

120
Q

what are the electrolyte abnormalities in TLS?

A

high phsophate and potassium, low calcium

121
Q

what is prophylaxis for TLS?

A

normal saline and allopurinol

122
Q

what is rx of TLS?

A

rasburicase and normal saline

123
Q

mild cancer related pain should be managed with what?

A

nsaids and tylenol

124
Q

moderate to severe cancer pain should be managed with what?

A

short acting opioids

125
Q

what is cornerstone of NSTEMI medications?

A

dual antiplatelet therapy with aspiring and clopidogrel

126
Q

if patient has EBV like symptoms but has negative monospot, what could be considered as cause? what would prove this?

A

cmv especially if abnormal lymphocytes on smear

127
Q

factor V leiden leads to what? how?

A

hypercoagulable state through activated protein C resistance

128
Q

most common hereditary thrombophilia?

A

factor V leiden

129
Q

rapid correction of hyponatremia can cause what?

A

osmotic demyleination

130
Q

rapid correction of hypernatremia can cause what?

A

cerebral edema

131
Q

patient receiving blood starts to go hypotensive, what is most likely cause?

A

anaphylaxis to IgA

132
Q

how does PCP present?

A

progressive shortness of breath, cough and fatigue and fever over multiple weeks

133
Q

a positive ice pack test indicates what diagnosis?

A

MG

134
Q

what is an ice pack test?

A

patient with ptosis gets ice put on eyes and ptosis will improve some

135
Q

what is the goal PaO2 in ARDS?

A

60-90

136
Q

if PaO2 is too high in ARDS, what can you do?

A

lower Fi)2

137
Q

what are findings in behcet syndrome?

A

oral and genital ulcers, uveitis, erythema nodosum

138
Q

who gets behcet syndrome?

A

middle aged ppl from turkey middle east and asia

139
Q

what bug causes bacteremia that can be associated with colon cancer?

A

clostridium septicum and strep bovis

140
Q

what are the differences between TRALI and TACO?

A

taco is overload so high bnp, JVD, and decreased EF all present, none of these present in TRALI

141
Q

when does TRALI onset?

A

within 6 hrs of transfusion, can be during

142
Q

can RA involve the spine? if so what level?

A

yes..cervical even atlantoaxial

143
Q

esophageal perforation presents how?

A

with chest and back pain and fevers

144
Q

what can happen to lungs with esophageal perforation?

A

pleural effusion

145
Q

patient who has symmetric joint pain in hands that sounds like RA but has normal ESR has what?

A

parvovirus B19 arthralgias

146
Q

how long after contrast is given do you see AKI?

A

24-48 hours

147
Q

what are two things you can do to help prevent contrast associated AKI?

A

give fluids and hold nsaids

148
Q

what are symptoms of methemoglobinemia?

A

cyanosis and respiratory depression

149
Q

what is rx of methemeglobinemia?

A

methylene blue

150
Q

what are sx of ethylene glycol ingestion?

A

anion gap acidosis, kidney stones, hypocalcemia, heamturia, flank pain

151
Q

what is rx of ethylene glycol ingestion?

A

fomepizole

152
Q

what are serum phosphorus levels in hypoparathyroidism and vitamin d deficiency?

A

high in hypoparathyroid and low in vitamin D deficiency

153
Q

nodules with surrounding ground glass opacity is consistent with what on CT scan of chest?

A

invasive aspergillosis

154
Q

what is triad of invasive aspergillosis?

A

fever, pleuritic chest pain, hemoptysis

155
Q

what is rx of invasive aspergillosis?

A

voriconazole and capsofungin

156
Q

d-xylose test is used for diagnosing what GI disease/

A

celiacs

157
Q

beta blockers can do what to sugar?

A

cause increase in sugar and weight gain

158
Q

what two abs are + in systemic sclerosis?

A

anti centromere and topoisomerase

159
Q

what is characteristic murmur with tricuspid regurg?

A

holosystolic murmur that increases with inspiration

160
Q

rhabdomyolysis leads to what electrolyte changes?

A

high potassium and phosphorus, low calcium

161
Q

what is livedo reticularis?

A

reticular purple discoloration that blanches

162
Q

what is a common cause of livedo reticularis?

A

cholesterol emboli

163
Q

what ar findings of cholesterol emboli?can===

A

abdominal pain, renal failure, livedo reticularis, eosinophilia

164
Q

what can happen to the scrotum with renal vein thrombosis?

A

can become swollen due to backing up of blood

165
Q

what is availability bias?

A

when you allow recently seen or available things to sway current diagnostic approaches

166
Q

what happens to cardiac index in an MI?

A

decreases

167
Q

what happens to PCWP in MI?

A

increases

168
Q

what happens to SVR in MI?

A

increaes

169
Q

an older person with graves should get what rx for hyperthyroid?

A

should get methimazole, not thyroidectomy or iodine

170
Q

how do antipsychotics cause orthostatic syncope?

A

a1 blockade, same with antihistamines and TCAs

171
Q

what meds increase risk of getting CAP in elderly?

A

antipsychotics, sedatives, acid suppressants

Medicine Week 1 NCs (6 decks)

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