Week 7 Uworld Flashcards
1
Q
what do you calculate in ascites to determine if from portal HTN or not?
A
SAAG
2
Q
what is equation for SAAG?
A
serum albumin minus ascites albumin
3
Q
what numbers signify what for SAAG?
A
> 1.1 means portal HTN
<1.1 means other causes
4
Q
what is cause of primary MR?
A
myxomatous degeneration or valvular issue
5
Q
what is cause of secondary MR?
A
often caused by heart failure and volume overload leading to displacement of papillary muscles
6
Q
cryptococcal meningitis has how many phases of treatment?
A
3 phases
7
Q
what is first phase of rx for cryptococcal meningitis?
A
amphotericin b and flucytosine
8
Q
what is second phase of rx for cryptococcal meningitis?
A
high dose fluconazol e
9
Q
what is third phase of rx for cryptococcal meningitis?
A
low dose fluconazole
10
Q
if patient has new red skin lesion that dimples when it is pinched, what is it?
A
dermatofibroma
11
Q
what bugs are associated with ventilator pneumonia?
A
pseudomonas, e coli, klebsiella mrsa and strep
12
Q
patient with ARDS on ventilator has low oxygen, what should you adjust?
A
increase PEEP
13
Q
what is a very common side effect of hodkin lymphoma when treated with radiation?
A
often leads to secondary malignancy (30%) of cases
14
Q
what are chronic symptoms of arsenic poisoning?
A
stocking and glove neuropathy, hypo ad hyperpigmentation and hyperkeratosis
15
Q
what are acute sx of arsenic poisoning?
A
nausea, garlic breath, vomiting and diarrhea
16
Q
what is rx of arsenic poisoning?
A
dimercaprol
17
Q
repetitive arm motions put baseball players at risk for what finding in their arms?
A
DVTs
18
Q
what do you monitor to assess treeatment of DKA?
A
anion gap
19
Q
what does hairy cell leukemia cause in bone marrow?
A
fibrosis leading to cytopenias
20
Q
what is given for MS flares that are refractory to steroids?
A
plasmapheresis
21
Q
what are the classic features of klinefelter syndrome?
A
tall, small testes, infertile, gynecomastia, minimal hair growth
22
Q
which of lambert eaton or MG is associated with lung cancer?
A
lambert eaton
23
Q
which of lambert eaton or MG is associated with diminished reflexes?
A
lambert eaton
24
Q
von hippel lindau syndrome is associated with what three things?
A
hemangioblastoma
renal cell carcinoma
pheochromocytoma
25
does low or high thyroglobulin mean exogenous thyroid intake?
low is exogenous, high is thyroiditis
26
what drugs can cause crystal induced AKI?
acyclovir, uric acid, methotrexate
27
what imaging is used to dignose bronchiectasis?
chest CT
28
brain abscesses are caused by what three bugs?
staph a, strep viridans, and anaerobes
29
what is effect of hyperthyroidism on heart?
high cardiac output due to low SVR, tachycardia, can go into a fib too
30
what endocrine issue can amiodarone cause
hypothyroid
31
what can amiodarone do to the liver?
hepatocellular injury
32
a cherry red spot on macula on eye exam is consistent with what?
retinal artery occlusion
33
what are sx of retinal artery occlusion?
sudden loss of vision in one eye, with curtain dropping vertically down
34
what is first and second line therapy of urge incontinence?
kegel exercises then antimuscarinics (oxybutynin)
35
what happens to levels of FSH/LH in hypothyroid?
they decrease
36
what happens to menstrual cycles in hypothyroidism?
can become irregular becasue decreased FSH and LH
37
what are some lab abnormalities in histoplasmosis?
elevated liver enzymes, pancytopenia
38
what are skin findings in histoplasmosis?
papules, nodules and ulcers
39
what is rx of severe histoplasmosis?
amphotericin b, itrconazole if mild
40
what opiates should be avoided in patients with kidney disease?
morphine, tramadol, codeine
41
when does a pericardial knock occur?
with constrictive pericarditis, it is mid diastolic
42
what is found on imaging in constrictive pericarditis?
calcifications of pheart
43
what is severe SE of trastuzamab?
cardiac toxicity,get echo before starting
44
if patient has bilateral nystagmus, where is issue in eye?
medial longitudinal fasciculus
45
bilateral internuclear opthalmoplegia is associted with what?
MS
46
/what is internuclear opthmoplegia
nystagmus of both eyes when looking laterally
47
when do you start therapy for hyperkalemia?
6.5m g
48
if patient with ongoing stemi has flash pulmonary edema, what should be given?
lasix...even if before reperfusion completed
49
what is rx of sporotrichosis?
itraconazole
50
aside from arterioocclusive symptoms, what other symptoms can be seen in takaysu arteritis?
blood pressure discrepancies, fever, fatigue, arthralgias
51
what is rx of takayasu arteritis?
systemic roids
52
what is imaging to diagnose takayasu?
CT angio
53
what are two heme complications of EBV that are pretty rare??
autoimmune hemolytic anemia and thrombocytopenia
54
aside from cardiac tamponade, what else can cause pulsus paradoxus?
asthma and COPD
55
two types of meningitis that cause low glucose?
fungal and bacterial
56
two types of meningitis that cause high lymphocytes?
viral and fungal
57
can bicuspid aortic valve cause aortic stenosis?
you bet
58
what lung cancer causes hypercalcemia? how?
squamous cell via PTHrp
59
what is imaging finding in acute cholangitis?
dilated bile ducts
60
what is rx of acute cholangitis?
abx and drainage of biliary tree
61
what is MoA of statin?
HMG coa reductase inhibitor
62
what are characteristics of tularemia?
single rapidly progressive ulcer with supporative lymphadenitis
63
what are sx of anterior uveitis?
painful red eye with photophobia and loss of visual acuity
64
what is first line therapy of chemotherapy induced nausea dn vomiting?
ondansetron
65
what is rash of leprosy?
macular hypopigmented skin lesions with raised borders
66
what can happen to nerves in leprosy?
painful nerves with loss of sensation
67
how do you diagnose leprosy?
full thickness biopsy
68
what is rx of leprosy?
dapsone and rifampin
69
what lab can be elevated in non hodgkin lymphoma?
LDH
70
what is the most common cause of pancytopenia
idiopathic
71
what are some known causes of pancytopenia?
infection, autoimmune, drugs and toxins
72
what is necrolytic migratory erythema?
erythematous papules that coalesce to form large plaques with central clearing
73
what is necrolytic migratory erythema associated with?
glucagonoma
74
what are sx of glucagonoma?
diarrhea, diabetes, weight loss, necrolytic migratory erythema
75
do blockers cause hyper or hypokalemia?
hyperkalemia
76
what abx causes hyperkalemia?
bactrim
77
what kidney stone is radiolucent?
uric acid stones
78
what is rx of uric acid kidney stone?
potassium citrate
79
name three common side effects of tacrolimus
nephrotoxicity, tremor and glucose intolerance
80
what are common SEs of azathioprine?
hepatotoxicity and bone marrow suppression
81
what is prodrome of vasovagal syncope?
warmth and nausea
82
how do vagal maneuvers stop AVNRTs?
slow AV nodal firing
83
what is cor pulmonale?
right heart failure due to pulm Htn
84
what are signs of cor pulmonale?
elevated JVP, ascites, liver enlargement, edema
85
what heart murmur may be found in cor pulmonale?
tricuspid regurgitation
86
how do you diagnose CLL?
flow cytometry
87
how does CLL present?
can be asymptomatic, but will have lymphocytosis with anemia and thrombocytopenia
88
what is post exposure prophylaxis for rabies?
vaccines and IVIG
89
if patient is bitten by a pet, but not sure about rabies, what do you do?
observe animal for 10 days and treat patient if animal shows signs. If you cannot observe animal then treat patient
90
if patient bitten by wild animal and unknown if animal has rabies, what do you do?
give post exposure prophylaxis
91
what two meds should be started for patient with peripheral arterial disease?
aspirin and statin
92
superior vena cava syndrome causes what to happen?
impeded venous return to heart from head neck and arms...so swelling there
93
what is mc cause of superior ven cava syndrome?
malignancy
94
what is imaging for superior vena cava syndrome?
cxr
95
what medication is used to treat hypertriglyceridemia from 100-999?
statins only
96
what medications for hypertriglyceridemia above 1000?
statin and fenofibrate
97
what else should patient with hypertriglyceridemia do to help lower aside from medication therapy?
weught loss, limit saturated fat and sugar, limit alcohol
98
what are two mainstay medications for acute exacerbation of COPD?
inhaled bronchodilators and oral steroids
99
what are two test options for PJP?
sputum culture or bronchial lavage
100
increased stroke volume and cardiac output in sepsis can lead to what physical exam finding?
bounding pulses
101
inferior MI is what vessel?
RCA
102
what is treatment of spinsal cord compression from cancer?
steroids
103
erysipelas is commonly caused by what bug?
strep a pyogenes
104
what does erysipelas look like?
erythematous rash with well demarcated raised borders
105
what are other symptoms of erysipelas?
early onset of fevers and regional lymphadenitis
106
what is common abx for eryisipelas?
ceftriaxone or ampicillin
107
what is therapy for urethreal chlamydia infection of man?
single dose of azithromycin
108
what are the two main lights criteria?
fluid/serum protein >0.5
| fluid/serum LDH >0.6
109
what are sx of RMSF?
headache, fatigue, arthralgias fever
110
what labs can be abnormal in RMSF?
hyponatremia, elevated liver enzymes and thrombocytopeni a
111
what is 1st line rx of renal artery stenosis due to non occlusive atherosclerosis?
ACE inhibitor
112
what blood cancer commonly causes white counts above 100000?
CML
113
what does luekocyte alk phos help differentiate?
leukocyte reaction versus CML
114
what is leukocyte alk phos in reaction vs CML?
low in CML high in reaction
115
patient with hiv has single ring enhancing lesion and EBV noted in CSF, what is cause?
CNS lymphoma
116
EBV causes increased risk for what two cancers in HIV patients?
non hodgkin lymphoma and CNS lymphoma
117
what is a very common MSK side effect of hemodialysis? does it improve or worsen with dialysis?
carpal tunnel syndrome...worsens
118
when can odds ratio be considered the same thing as relative risk?
if disease is very rare
119
what are calcium, phosphate and PTH levels in osteomlacia?
low ca and phos, high PTH
120
what is initial therapy for BPH?
tamsulosin or prazosin
121
what is moa of tamsulosin?
alpha adrenergic antagonist
122
amyloidosis is associated with what class of diseases?
autoimmun e
123
medullary echogenicity is consistent with what on renal US?
papillary necrosis
124
what happens to PCWP and central venous pressure in obstrictive shock?
PCWP normal and CVP high
