Week 5 UWorld Flashcards
1
Q
what is head imaging of tuberculosis meningitis?
A
basilar meningeal enhancement and hydrocephalus
2
Q
what are sx of mitral stenosis?
A
dyspnea, swelling, pulm HTN
3
Q
what is murmur of mitral stenosis?
A
diastolic rumble
4
Q
what should be given with right heart MI to maintain CO of heart?
A
normal saline boluses
5
Q
what large vessel can giant cell arteritis involve? wat does it cause?
A
aortic aneurysm
6
Q
what is classic ECG finding of PE?
A
S1Q3T3
7
Q
aside from ABX what are some other risk factors for C diff?
A
IBD, hospitalization, PPis chemo
8
Q
what is rx of nocardia? and is it aerobic?
A
bactrim and yes
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
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
11
Q
what are the cardiac findings in marfan syndrome?
A
aortic regurg, aortic dilation, aortic dissection, nd mitral valve prolapse
12
Q
what protein is the problem in marfans?
A
fibrillin
13
Q
what MSK issue can longstanding HIV cause?
A
peripheral neuropathy
14
Q
what is rx for HIV peripheral neuropathy?
A
gabapentin or TCA, just like usual neuropathies
15
Q
patient with hyperkalemic emergency should receive what in addition to calcium gluconate?
A
insulin and glucose
16
Q
what is a bad side effect of propylthiouracil?
A
agrunlocytosis
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
18
Q
HIT puts patients at risk for what two hematologic findings?
A
thrombocytopenia and thrombus formation
19
Q
why does HIT cause thrombus formation?
A
because antibodies can activate platelets
20
Q
what is a side effect of lisinopril in patients with CKD?
A
hyperkalemia
21
Q
what can be done to treat hyperkalemia in patient’s with CKD on lisinopril?
A
start patiromer
22
Q
3 common causes of acute pancreatitis
A
alcohol, biliary stones, lipids
23
Q
contact lens keratitis is associated with what two bugs?
A
pseudomonas and serratia
24
Q
what happens to blood flow to the heart when someone squats?
A
decreases
25
what happens to hypertrophic cardiomyopathy murmur when someone squats?
it increases
26
what metabolic issue does a pancreatic leak cause?
non anion gap metabolic acidosis
27
what are some common symptoms of carbon monoxide poisoning?
headache confusion nausea
28
what does carbon monoxide do to hgb levels?
causes high hematocrit
29
if a patient with myasthenia gravis comes in with difficulty swallowing and is acidotic, what is going on?
myasthenia crisis
30
what is a common cause of a myasthenia crisis?
infection
31
what should you do for a patient with a myasthenia crisis?
intubate
32
what malignancy is very common in those with HIV and why?
non hodgkin lymphoma because EBV can reactivate
33
if a patient with HIV has bloody diarrhea, what is likely cause?
CMV
34
if patient with HIV has watery diarrhea, what is the cause?
cryptosporidium
35
what is best therapy for single brain metastasis?
surgical resection if in accessible location
36
what are abx options for aspiration pneumonia?
zosyn or penems
37
what is treatment for frostbite?
rapid rewarming in warm water
38
what is an essential tremor?
one that worsens with activity, usually unilateral
39
what worsens physiologic tremors?
stress/anxiety and caffeine
40
describe a parkinsons tremor
unilateral, worse at rest and goes away with activity
41
if elderly patient has dry eyes and dry mouth, is it sjogrens>
probably not...more likely to be atrophy of exocrine glands
42
what cd4 count do you start bactrim ppx?
200 or less
43
aside from bactrim, what other ppx is there for patients with HiV and low CD4 counts?
there isnt any
44
lacunar infarcts occur where?
internal capsule
45
what are often symptoms of lacunar infarcts?
motor symptoms only
46
what is felty syndrome?
RA with neutropenia
47
metoclopramide can cause what neurologic issue? why?
it is a dopamine antagonist so can cause acute dystonia
48
what are sx of PBC?
fatigue, itching, jaundice, hepatomegaly, xanthomas
49
what ab is + in PBC?
antimitochondrial
50
what are complications of PBC?
HCC, osteomalacia
51
what is rx for PBC?
ursodeoxycholic acid
52
what is an adverse effect of hydroxychloroquine?
retinopathy
53
intrnsic renal injury leads to what level of urine sodium?
often greater than 40
54
what are some signs of intrinsic kidney injury in electrolytes?
hyperkalemia and metabolic acidosis
55
what are two things to give for TCA overdose?
activated charcoal and sodium bicarb (for QRS protection)
56
what are pulmonary findings in blastomycosis?
acute or chronic pneumonia
57
what are skin findings in blastomycosi?
wart like lesions and ulcers
58
what are bone findings in blastomycosis?
osteomyelitis
59
what is rx of blastomycosis?
itraconazole if moderate disease, no treatment if mild, amphotericin B if severe
60
for a patient with myasthenic crisis, what can be given to help them?
plasmapheresis
61
does a varicocele or hydrocele transilluminate?
hydrocele
62
does a varicocele or hydrocele contribute to infetility?
varicocele
63
how does a varicocele change with position?
increases with valsalva, decreases with supine positioning
64
when do patients wih ADPKD present?
usually in 30-40s
65
what are sx of ADPKD?
flank pain, hematuria, hypertension
66
what are some extrarenal findings of ADPKD?
cerebrl anaurysms, hepatic and pancreatic cysts, diverticulosis
67
what can occur with heart in thyrotoxicosis?
a fib, tachycardia and hypertension
68
aside from ST elevations, what other ECG finding is associated with pericarditis?
PR segment depressions
69
the spleen does what in clearing infections?
antibody mediated phagocytosis
70
eye redness at medial border of eye and nose is likely what?
dacrocystitis
71
a diastolic murmur heard at left sternal border after aortic valve replacement is c/f what?
valve dysfxn
72
what electrolytes go low in refeeding syndrome?
K, Mg and Phos
73
what can happen in refeeding syndrome?
arryhtymias,heart failure, seizures, encephalopathy wernickes
74
what is mc side effect of hydroxyurea?
myelosuppression
75
erythropoetic stimulating agents come with what common side effect?
hypertension
76
what is treatment of carbon monoxide posioning?
100% O2
77
what are mild signs/symptoms of carbon monoxide poisoning?
headache confusion dizziness
78
what ae severe signs of carbon monoxide poisoning?
heart attack seizures and coma
79
does HIV have a rash?
it can...looks like pink red ovals thatoccur in acute infection phase
80
does HIV have ulcers anywhere?
can have oral ulcers
81
where does amiloride work in kidney for diuresis?
collecting duct (K sparing)
82
what are two classic findings in carcinoid syndrome?
flushing and diarrhea
83
what is cardiac finding in carcinoid syndrome?
tricuspid regurgitation
84
what is rx of carcinoid syndrome?
octreotide
85
what is lab test for carcinoid syndrome?
elevated urine 5-HIAA
86
primary adrenal insufficiency AKA addisons leads to what two elctrolyte abnormalities?
hyperkalemia and hyponatremia
87
what are signs and symptoms of primary adrenal insufficiency AKA addisons?
weight loss, fatigue, low BP, hyperpigmentation, syncope, nausea, diarrhea, abdominal pain
88
what causes hyperpigmentation in primary adrenal insufficiency AKA addisons?
melanocyte stimulating hormone
89
what drugs are common in drug induced hemolytic anemia?
amoxicillin and cephalosporin
90
in addition to steroids and bronchodilators, what else should patients with copd exacerbation receieve? when?
antibiotics if >2 cardinal symptoms
91
if patient with hypothyroid is started on estrogen, what should be done to levothyroxine dose?
increased
92
what is the triad associated with cardiac tamponade?
hypotension, distended neck veins and muffled heart sounds
93
what antiarrythmics prolong the QRS?
NA channel blockers
94
what antiarrhythmics prolong the QT?
K+ channel blockers..AIDS
95
mixed connective tissue disease involves what 3 autoimmune diseases?
polymyositis, systemic sclerosis and SLE
96
what is ab in mixed connective tissue disordrr?
anti u1RNP
97
what is rx for central and nephrogenic DI?
central is desmopressin
| nephrogenic is HCTZ
98
what are levels of T4, T3 and TSH in euthyroid sick syndrome?
all are low
99
excessive intake of antacids can lead to what metabolic complication?
milk alkali syndrome
100
what is milk alkali syndrome?
too much calcium carbonate intake leads to hypercalcemia and metabolic alkalosis
101
milk alkali syndrome leads to what three metabolic/renal issues?
hypercalcemia, metabolic alkalosis and AKI
102
what is rx of milk alkali syndrome?
stop offending agent, often tums or
103
what is rx for paget disease?
bisphosphonates
104
what is a common complication of cardiac catheterization?
cholesterol emboli
105
if patient has cholesterol emboli from cardiac cath, what is most likely finding?
skin changes from where the emboi embedded
106
a systolic diastolic abdominal bruit means what?
renal artery stenosis
107
what is most common cause of splenic abscesS?
infective endocarditis
108
babesia can cause what heme issues?
anemia and thrombocytopenia
109
babesia is diagnosed by what?
blood smear with maltese cross
110
what labs are abnormal in babesia?
LFTs and LDH and bili up
111
what are symptoms of babesia?
like flu...malaise, body aches, fever, sweats and weight loss
112
what is rx of babesia?
atovaquone and azithromycin
113
beta agonist cause what with potassium?
low potassium
114
a person with stable ventricular tachycardia should receive what?
iv amiodarone
115
a person with unstable ventricular tachycardia should receive what?
cardioversion
116
how do you know if it is ventricular tachycardia?
wide based QRS
117
ulcerated skin lesions and lytic bone lesions with history of long time infection should make you think about what bug?
blastomycosis
118
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?
go ahead and start 4 drug therapy
119
what are the two general problems in tumor lysis syndrome?
AKI and electrolyte abnormalities
120
what are the electrolyte abnormalities in TLS?
high phsophate and potassium, low calcium
121
what is prophylaxis for TLS?
normal saline and allopurinol
122
what is rx of TLS?
rasburicase and normal saline
123
mild cancer related pain should be managed with what?
nsaids and tylenol
124
moderate to severe cancer pain should be managed with what?
short acting opioids
125
what is cornerstone of NSTEMI medications?
dual antiplatelet therapy with aspiring and clopidogrel
126
if patient has EBV like symptoms but has negative monospot, what could be considered as cause? what would prove this?
cmv especially if abnormal lymphocytes on smear
127
factor V leiden leads to what? how?
hypercoagulable state through activated protein C resistance
128
most common hereditary thrombophilia?
factor V leiden
129
rapid correction of hyponatremia can cause what?
osmotic demyleination
130
rapid correction of hypernatremia can cause what?
cerebral edema
131
patient receiving blood starts to go hypotensive, what is most likely cause?
anaphylaxis to IgA
132
how does PCP present?
progressive shortness of breath, cough and fatigue and fever over multiple weeks
133
a positive ice pack test indicates what diagnosis?
MG
134
what is an ice pack test?
patient with ptosis gets ice put on eyes and ptosis will improve some
135
what is the goal PaO2 in ARDS?
60-90
136
if PaO2 is too high in ARDS, what can you do?
lower Fi)2
137
what are findings in behcet syndrome?
oral and genital ulcers, uveitis, erythema nodosum
138
who gets behcet syndrome?
middle aged ppl from turkey middle east and asia
139
what bug causes bacteremia that can be associated with colon cancer?
clostridium septicum and strep bovis
140
what are the differences between TRALI and TACO?
taco is overload so high bnp, JVD, and decreased EF all present, none of these present in TRALI
141
when does TRALI onset?
within 6 hrs of transfusion, can be during
142
can RA involve the spine? if so what level?
yes..cervical even atlantoaxial
143
esophageal perforation presents how?
with chest and back pain and fevers
144
what can happen to lungs with esophageal perforation?
pleural effusion
145
patient who has symmetric joint pain in hands that sounds like RA but has normal ESR has what?
parvovirus B19 arthralgias
146
how long after contrast is given do you see AKI?
24-48 hours
147
what are two things you can do to help prevent contrast associated AKI?
give fluids and hold nsaids
148
what are symptoms of methemoglobinemia?
cyanosis and respiratory depression
149
what is rx of methemeglobinemia?
methylene blue
150
what are sx of ethylene glycol ingestion?
anion gap acidosis, kidney stones, hypocalcemia, heamturia, flank pain
151
what is rx of ethylene glycol ingestion?
fomepizole
152
what are serum phosphorus levels in hypoparathyroidism and vitamin d deficiency?
high in hypoparathyroid and low in vitamin D deficiency
153
nodules with surrounding ground glass opacity is consistent with what on CT scan of chest?
invasive aspergillosis
154
what is triad of invasive aspergillosis?
fever, pleuritic chest pain, hemoptysis
155
what is rx of invasive aspergillosis?
voriconazole and capsofungin
156
d-xylose test is used for diagnosing what GI disease/
celiacs
157
beta blockers can do what to sugar?
cause increase in sugar and weight gain
158
what two abs are + in systemic sclerosis?
anti centromere and topoisomerase
159
what is characteristic murmur with tricuspid regurg?
holosystolic murmur that increases with inspiration
160
rhabdomyolysis leads to what electrolyte changes?
high potassium and phosphorus, low calcium
161
what is livedo reticularis?
reticular purple discoloration that blanches
162
what is a common cause of livedo reticularis?
cholesterol emboli
163
what ar findings of cholesterol emboli?can===
abdominal pain, renal failure, livedo reticularis, eosinophilia
164
what can happen to the scrotum with renal vein thrombosis?
can become swollen due to backing up of blood
165
what is availability bias?
when you allow recently seen or available things to sway current diagnostic approaches
166
what happens to cardiac index in an MI?
decreases
167
what happens to PCWP in MI?
increases
168
what happens to SVR in MI?
increaes
169
an older person with graves should get what rx for hyperthyroid?
should get methimazole, not thyroidectomy or iodine
170
how do antipsychotics cause orthostatic syncope?
a1 blockade, same with antihistamines and TCAs
171
what meds increase risk of getting CAP in elderly?
antipsychotics, sedatives, acid suppressants
