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UWorld Family Medicine > Weeks 4-5 > Flashcards

Weeks 4-5 Flashcards

1
Q

describe a keratocanthoma

A

rapidly growing nodule with ulceration and keratin plug

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2
Q

what is unique about a keratocanthoma

A

will regress on its own

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3
Q

what can a keratocanthoma turn into?

A

SCC

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4
Q

what is most effective medication for allergic rhinitis?

A

intranasal steroids like fluticasone

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5
Q

what are signs of allergic rhinitis on physical exam?

A

cobblestoning of posterior pharynx
clear drainage
pale turbinates

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6
Q

at what age should baby respond to name?

A

6 months

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7
Q

at what age should baby say dad or mom?

A

9 months

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8
Q

common SEs of aromatase inhibitors?

A

arthralgias and sexual dysfxn

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9
Q

what are features of back pain that are more concerning for malignancy?

A

worse at night, hx of cancer

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10
Q

what MSK issue can steroids cause?

A

glucocorticoid induced myopathy

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11
Q

describe issue in glucocorticoid induced myopathy

A

proximal muscle weakness, normal ESR and CK

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12
Q

who gets vasospastic angina?

A

ppl that are young

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13
Q

describe the sx in vasospastic angina?

A

sudden onset chest pain, lasts 15 minutes and goes away

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14
Q

how do you dx vasospastic angina?

A

ECG with ST elevations during pain

angiogram normal

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15
Q

what is rx for vasospastic angina?

A

Ca channel blocker

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16
Q

what is oftent the management of a struvite kidney stone?

A

removal

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17
Q

what is a secondary spontaneous pneumothorax?

A

spontaneous rupture of pleural bleb that causes a pneumothorax

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18
Q

who gets secondary spontaneous pneumothorax??

A

patients with known lung disease like COPD or CF

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19
Q

what is rx of secondary spontaneous pneumothorax?

A

ranges from oxygen to thoracostomy

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20
Q

what are the two types of contact dermatitis?

A

allergic or irritant

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21
Q

what causes irritant contact dermatitis?

A

usually stuff you put on hands over and over…chemicals

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22
Q

what type of infection can happen with MMR vaccine?

A

can get measles mild infxn

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23
Q

what does measles infxn after vaccine look like?

A

mild maculopapular rash on face and fever…not nearly as contagious

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24
Q

what are the symptoms of acute angle closure glacuoma?

A

HA, nausea, eye pain, diminished vision

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25
Q

what is physical exam sign of acute angle closure glacuoma?

A

non reactive and mid dilated pupil

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26
Q

what is initial therapy in acute angle closure glacuoma?

A

IV acetazolamide

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27
Q

what are some drugs that can cause acute angle closure glacuoma?

A

decongestants, and anticholinergics

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28
Q

define non allergic rhinitis

A

basically allergies without a specific allergen triggering it…can have behavioral triggers instead

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29
Q

what is first line therapy of non allergic rhinitis?

A

intranasal antihistamine or glucocorticoid

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30
Q

what can be triggers for non allergic rhinitis?

A

walking into cold air, eating

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31
Q

what is currently the only indication for HRT/

A

vasomotor symptom reduction

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32
Q

two groups with indication for weight loss surgery

A

40+ BMI

35+ BMI with weight related comorbidity

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33
Q

two first line options for medication for weight loss

A

orlistat and liraglutide

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34
Q

what is most common inheritied bilirubin disease?

A

Gilberts

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35
Q

what is issue in gilberts?

A

decreased UDP action, so decreased conjugation of bilirubin

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36
Q

when does gilbers flare up?

A

in times of stress..sick..fasting, dehydration, menstruation

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37
Q

what do liver labs do in gilberts?

A

only indirect bili is up, all else normal

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38
Q

what is alopecia areata?

A

autoimmune caused hair loss in patches

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39
Q

is alopecia areata ithcy or painful?

A

Neither

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40
Q

what is rx of alopecia areata?

A

topical corticosteroids

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41
Q

what is best test to determine if asthma or COPD?

A

bronchodilator then repeat FEV testing

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42
Q

what is female pattern hair loss?

A

vertex, center of scalp, spares hair line

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43
Q

what is rx of female pattern hair loss?

A

minoxidil

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44
Q

what is rx of male pattern hair loss?

A

minoxidil or finasteride

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45
Q

what other endocrine abnormality can hypothyroid cause/

A

hyperlipidemia

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46
Q

what should you check in patient with newly found hyperlipidemia before starting on meds?

A

TSH

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47
Q

what is appearance of discoid lupus erythematous rash?

A

erythematous plaques with ulceration and central hypopigmentation with surrounding hyperpigmentation

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48
Q

how does olecranon bursitis present?

A

localized swelling over posterior elbow after microtrauma or overuse

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49
Q

which liver enzyme is highest elevated in NAFLD?

A

ALT>AST

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50
Q

what comorbidity is most commonly associated with a fib?

A

chronic HTN

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51
Q

how often should cholesterol screening be done? what age to start it?

A

3-5 years, starting ta age 40

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52
Q

what does otitis media have that otitis media with effusion doesnt?

A

fever and TM bulging

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53
Q

what liver labs are mainly elevated in autoimmune hepatitis?

A

AST/ALT

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54
Q

what is antibody elevated in AI hepatitis?

A

anti smooth muscle

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55
Q

what is rx for AI hepatitis?

A

prednisone

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56
Q

what are presenting symptoms of AI hepatitis?

A

fatigue anorexia nausea jaundice

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57
Q

what is a lifestyle risk factor for colon cancer?

A

diabetes/obesity

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58
Q

what is the only major risk factor for worsening crohns disease?

A

smoking

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59
Q

someone with suspected PCOS, what additional tests should be done?

A

oral glucose tolerance test

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60
Q

patient with skin abrasion, red streaks in skin and lymphadenopathy has what?

A

acute lymphangitis

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61
Q

what is rx for lymphangitis?

A

cephalexin

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62
Q

what is blepharitis?

A

inflammation at the eyelid margin

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63
Q

what are sx of blepharitis?

A

burning and itching of eyelids, crusting on eyelashes, discharge of eye

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64
Q

what is associated with blepharitis?

A

seborrheic dermatitis

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65
Q

what is rx of blepharitis?

A

warm compresses and supportive care

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66
Q

what is the test for lactose intolerance?

A

lactose breath test

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67
Q

how do the kidneys appear in hypertensive nephrosclerosis?

A

they appear normal but are small

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68
Q

what are the lab findings in hypertensive nephrosclerosis?

A

elevated creatinine, bland urinalysis with mild proteinuria

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69
Q

aside from SLE, what other rash can be on face and spare nasolabial folds?

A

melasma

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70
Q

how does the rash of melasma appear?

A

irregularly shaped hyperpigmented macules

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71
Q

what is rx of melasma?

A

sunscreen use

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72
Q

what medication is used to help pass kidney stones?

A

tamsulosin

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73
Q

how deos tamsulosin help pass kidney stones?

A

its an alpha 1 antagonist and will relax smooth muscle of the ureter

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74
Q

what two hand joints are commonly involved in OA?

A

1st carpometacarpal and DIPs

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75
Q

are bony enlargements of joints common in OA?

A

yes

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76
Q

what are the hematologic findings in JIA?

A

high white cells, high platelets, anemia, high inflammatory markers

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77
Q

what often precedes pityriasis rosea?

A

a viral illness

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78
Q

what does rash of pityriasis rosea start as?

A

herald patch on back

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79
Q

what does rash of pityriasis rosea progress to look like?

A

oval lesions in christmas tree pattern

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80
Q

is pityriasis rosea itchy?

A

yes

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81
Q

2 cardiac findings in turner syndrome

A

coarctation of aorta and bicuspid aortic valve

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82
Q

what is most significant risk factor for pancreatic cancer?

A

smoking

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83
Q

what is therapy that greatly increases survival for patients with COPD?

A

long term oxygen therapy

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84
Q

what can thiazide diuretics do to sugar levels?

A

cause hyperglycemia

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85
Q

what three electrolytes can be low on HCTZ?

A

K, Na and Mg

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86
Q

what electrolyte can be high on HCTZ?

A

Ca

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87
Q

patient with measles virus should receive what?

A

vitamin A

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88
Q

what is most common cause of travelers diarrhea?

A

enterotoxigenic E coli

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89
Q

what is type of diarrhea with enterotoxigenic E coli?

A

watery, non bloody

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90
Q

what abx for acute rhinosinusitis?

A

augmentin

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91
Q

what is the appearance of intertrigo

A

beefy red plaques within inguinal folds

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92
Q

what is common cause of intertrigo?

A

candida

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93
Q

is intertrigo itchy?

A

YES

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94
Q

what is rx for intertrigo?

A

topical azole

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95
Q

2 common problems aside from muscle issues with Duchennes?

A

dilated cardiomyopathy and scoliosis

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96
Q

what endocrine issue can cause myopathy?

A

hypothyroid

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97
Q

strict glycemic control decreases risk of macrovascular, microvascular or both types of complication?

A

just microvascular, risk of stroke and MI same with good control

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98
Q

what causes a varicocele?

A

dilation of pampiniform plexus on top of testes

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99
Q

what does varicocele feel like?

A

bag of worms

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100
Q

does varicocele change with valasalva?

A

yes…enlarges

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101
Q

what is difference in varicocele and inguinal hernia?

A

hernia is reducible

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102
Q

four causes of erythema nodosum

A 
abx
sarcoidosis
malignancy
infection
crohns
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103
Q

if patient has diffuse scaling of skin, think what?

A

ichthyosis vulgaris

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104
Q

a patient with itchy red rash around anterior part of wasteline, most likely has what?

A

contact dermatitis from belt buckle

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105
Q

what is test to confirm tinea pedis?

A

KOH scrape

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106
Q

what abx class for otitis externa?

A

fluoroquinolone

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107
Q

MOA of meds to treat ED?

A

PDE5 inhibitors

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108
Q

name the pde5 inhibitors?

A

tildanafil

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109
Q

what can you not give PDE5 inhibitors with? why?

A

alpha blockers…risk of hypotension

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110
Q

what are the symptoms of fibromyalgia?

A

chronic widespread pain with fatigue and impaired concentration

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111
Q

are any labs abnormal in fibromyalgia?

A

No will be norml

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112
Q

what is a PE finding in fibromyalgia?

A

tenderness at trigger points

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113
Q

what is classic symptom of polymyositis?

A

proximal muscle weakness

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114
Q

what labs are abnormal in polymyositis/

A

CK and anti Jo `

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115
Q

what is the triad of herpes zoster oticus?

A

ear pain
facial weakness
vesicular rash in ear canal

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116
Q

1st line treatment for lateral epicondylitis?

A

counterforce bracing

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117
Q

most common bug that causes bacterial conjunctivitis?

A

Staph Aureus

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118
Q

what are the two types of neuropathy in Dm?

A

large and small fiber neuropathy

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119
Q

large fiber neuropathy of DM has what sx?

A

loss of proprioception and vibration sense, numbness, poor balance, reflex loss

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120
Q

small fiber neuropathy of DM has what sx?

A

loss of pain and temp sense, burning and stabbing pain

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121
Q

which of large or small fiber neuropathy of DM has loss of reflex?

A

large

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122
Q

which of large or small fiber neuropathy of DM has loss of proprioception?

A

large

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123
Q

what anti HTN med is preferred for patients with osteoporosis?

A

thiazides bc increase calcium reabsorpton

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124
Q

what med for bipolar can cause hypothyroidism?

A

lithium

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125
Q

how long does cough last in acute bronchitis?

A

5 days to 3 months

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126
Q

what is proctalgia fugax?

A

recurring intermittent rectal pain

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127
Q

what causes proctalgia fugax?

A

pudendal nerve compression

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128
Q

is proctalgia fugax associated with pooping?

A

no

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129
Q

what is rx for proctalgia fugax?

A

nothing

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130
Q

what is meralgia paresthetica?

A

paresthesia and decreased sensation at lateral thigh

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131
Q

what is cause of meralgia paresthetica

A

compression of lateral cutaneous nerve

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132
Q

what are causes of meralgia paresthetica?

A

obesity, tight clothing, seat belts

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133
Q

what is rx of meralgia paresthetica?

A

nothing, change things that may be causing it

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134
Q

what lifestyle change has the largest impact on BP?

A

weight loss

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135
Q

where does oral leukoplakia occur on tongue?

A

usually on sides

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136
Q

can oral leukoplakia be scraped off?

A

no

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137
Q

what are two risk factors for oral leukoplakia ?

A

smoking and alcohol use

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138
Q

what is risk with oral leukoplakia ?

A

can be pre cancerous like squamous cell

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139
Q

what is rx of oral leukoplakia /

A

biopsy and monitor closely

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140
Q

two risk factors for male breast cancer?

A

klinefelter and obesity

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141
Q

what is common presentation of male breast cancer?

A

firm subareolar mass

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142
Q

what is used to treat scabies?

A

permethrin

143
Q

what is used to treat tinea pedis?

A

terbinafine or azole cream

144
Q

what bug causes endocarditis from dental procedure?

A

strep sanguins

145
Q

what is rx for polymyalgia rheumatica?

A

glucocorticoids

146
Q

how does polymyalgia rheumatica present?

A

rapid onset pain in shoulders and hips

147
Q

what labs are elevated in polymyalgia rheumatica?

A

ESR/CRP

148
Q

what 3 meds to give for acute asthma exacerbation/.

A

beta agonist, muscarinic antagonists and oral steroid

149
Q

what are the main differences between benign renal cyst and malignant?

A

benign are usually unilocular without septae and uniform

150
Q

what do you do for benign renal cyst?

A

nothing

151
Q

what level AV block indicated placement of permanent pacemaker?

A

at least Mobitz type II

152
Q

what two meds should patients with carotid atherosclerotic stenosis be placed on?

A

statin and aspirin

153
Q

what percent block of carotids do you revascularize?

A

80%

154
Q

curtain falling over eye indicative of what diagnosis?

A

retinal artery occlusion

155
Q

what is usual cause of retinal artery occlusion

A

atheroembolic plaque in ipsilateral carotid

156
Q

how will eye exam look in retinal artery occlusio?

A

normal

157
Q

do basal or squamous cell carcinomas lead to ulcers?

A

squamous

158
Q

what type of skin cancer more common to develop in scars?

A

squamous cell carcinoma

159
Q

what is the main sx of pill esophagitis?

A

sudden onset of odynophagia and severe pain in esophagus

160
Q

what meds commonly cause pill esophagitis?

A

KCL
doxycycline
aspirin
alendronate

161
Q

another word for stye

A

hordeolum

162
Q

what is a hordeolum (stye)?

A

erythematous tender nodule at eye lid margin from inflammation in tear duct

163
Q

what is rx for stye?

A

warm compress

164
Q

rx for bells palsy?

A

steroids

165
Q

when does CVID onset>

A

20-20s

166
Q

what is low in CVID?

A

IgG and IgA and IgM

167
Q

what are sx of CVID?

A

recurrent pulm and GI infxns

168
Q

what is rx for CVID?

A

Ig replacement

169
Q

when should you not use bisphosphonate for osteoporosis?

A

renal impairment

170
Q

euvolemic hyponatremia is associated with what?

A

SiADH

171
Q

what is first line rx to see if euvolemic hyponatremis truly from SIADH?

A

fluid restriction

172
Q

corneal vesicles and dendritic ulcers are characteristic of what?

A

herpes simplex keratitis

173
Q

what are sx of herpes simplex keratitis?

A

redness, photophobia, tearing and pain

174
Q

wat is rx for herpes simplex keratitis?

A

valcyclovir

175
Q

four sx of lead poisoning in adults

A

GI issues, cognitive deficit/neuropathy, microcytic anemai

176
Q

what is rx for lead poisoning in adults?

A

calcium EDTA

177
Q

what are the three common sx of primary hyperparathyroid?

A

hypercalcemia, neuropsych issues and kidney stones

178
Q

what is assoc with prmary hyperparathyroid?

A

secondary HTN

179
Q

if patient has HFpEF, what is likely reason?

A

diastolic dysfxn secondary to HTN

180
Q

3 reasons to repair aortic valve for stenosis?

A

EF less than 50,
symptomatic,
undergoing other cardiac surgery

181
Q

are periarticular erosions more common in OA or RA?

A

RA

182
Q

asx mediastinal and axillary lymphadenopathy in elderly is concerning for what?

A

follicular lymphoma

183
Q

after 5 years of metformin, what is something to worry about?

A

b12 deficiency

184
Q

does a syphilis rash include the palms and soles?

A

yes

185
Q

does a syphilis rash include the mouth?

A

yes

186
Q

how do nitrates relieve angina?

A

lessen cardiac LV wall stress, decrease O2 demand

187
Q

two drugs that commonly induce acne flares

A

steroids and androgens

188
Q

four symptoms of zinc deficiency

A

alopecia
loss of taste
delayed wound healing
pustular skin rash (perioral)

189
Q

what is hyposthenuria?

A

kidneys arent able to concentrate urine

190
Q

who gets hyposthenuria?

A

sickle cell trait

191
Q

what tract is affected in ALS?

A

corticospinal tract

192
Q

MEN type 1 includes:

A

hyperparathyroid
pituitary tumor
pancreatic tumor

193
Q

MEN type 2a includes

A

medullary thyroid cancer
pheochromocytoma
hyperparathyroid

194
Q

MEN type 2b includes

A

medullary thyroid
pheochromocytoma
mucosal neuromas

195
Q

what is elevated in medullary thyroid cancer?

A

calcitonin

196
Q

what are the sx of rhino-orbital-cerebral mucormycosis?

A

fever, congestion, sinus pain, necrosis of local tissues

197
Q

who is at risk for rhino-orbital-cerebral mucormycosis?

A

those with uncontrolled DM

198
Q

what bug causes rhino-orbital-cerebral mucormycosis?

A

rhizopus

199
Q

what is rx of rhino-orbital-cerebral mucormycosis?

A

surgical debridement and amphotericin B

200
Q

what joint in hands is often involved in psoriatic arthritis?

A

DIP

201
Q

what are some other hand findings in psoriatic arthritis?

A

nail involvement, sausage digit (dactylitis), hand swelling

202
Q

gout can cause what three things with joints

A

acute bursitis
chronic bursitis
bursal tophus

203
Q

of acute bursitis
chronic bursitis
bursal tophus
which is painful?

A

acute bursitis

204
Q

what change can happen that can be seen on imaging in bursal tophus?

A

bone erosions with overhanging edges of cortical bone

205
Q

what medication is used to treat aspergillosus?

A

azoles

206
Q

three classes of meds used for migraine prevention

A

beta block
TCA
topiramate

207
Q

what virus can cause arthritis that looks like RA?

A

parvo B19

208
Q

what are some risk factors for osteomalacia?

A

gastric bypass
celiacs
chronic liver and kidney disease

209
Q

what are some sx of osteomalacia?

A

bone/muscle pain, waddling gait

210
Q

what are levels of PTH, Alk phos, calcium and vit d in osteomalacia?

A

PTH and alk phos up

CA and vit d down

211
Q

what is a porcelain gallbladder?

A

calcium ridden GB

212
Q

what is porcelain gallbladder at increased risk for?

A

gallbladder adenocarcinoma

213
Q

what is imaging used to diagnose pancreatic cancer?

A

CT scan

214
Q

what are the sx of chronic prostatitis?

A

pain in pelvis and genitalia, urgency/hesitancy, and pain with ejaculation

215
Q

what are the two meds to treat chronic pancreatitis?

A

alpha blockers and ciprofloxacin

216
Q

how does prostate feel and what are levels of PSA in chronic prostatits?

A

prostate feels normal and PSA wnl

217
Q

patients with recurrent kidney stones can be put on what med?

A

if calcium stones, HCTZ will help reabsorb calcium

218
Q

what dietary adjustment should patient with recurrent calcium stone do?

A

decrease dietary sodium

219
Q

dietary changes to help with gout

A

decrease red meat, no beer or liquor, low fat diet

220
Q

are most parotid gland masses benign or malignant?

A

benign

221
Q

what is a feature of parotid gland mass that is concerning for malignancy?

A

if it involves any cranial nerves..like trigeminal or facial

222
Q

what is finding on eye exam of open angle glaucoma?

A

atrophy of optic nerve head (cupping)

223
Q

what is first sx of open angle glaucoma?

A

loss of peripheral vision

224
Q

what is first line rx for open angle glaucoma?

A

topical prostaglandin like latanoprost

225
Q

where is nasopharyngeal carcinoma endemic? what is it associated with?

A

china and EBV

226
Q

what are some sx of nasopharyngeal carcinoma

A

headaches, nose bleeds, congestion, facial nerve palsy

227
Q

pemphigus vulgaris is against what?

A

desmosomes

228
Q

which of pemphigus or bullous pemphigoid includes mouth?

A

pemphigus

229
Q

which of pemphigus or bullous pemphigoid has tense bullae? and which has erosive bullae?

A

pemphigus is erosive

230
Q

what can BPH cause with kidneys?

A

obstructive uropathy…so rising creatinine

231
Q

what should you do to assess for obstructive uropathy from BPH?

A

renal US

232
Q

when do ACE inhibitors cause creatinine rise?

A

3-5 days after starting

233
Q

what antibiotic for a bite wound?

A

augmentin

234
Q

name some symptoms of acute interstital nephritis

A

can have fever rash and arthralgias

235
Q

what appears in urine with interstitial nephritis?

A

eosinophils, hematuria and WBCs

236
Q

what may be elevated in hepatocellular carcinoma/

A

AFP

237
Q

if patient has hepatomegaly, high ferritin and high liver enzymes, what is dx?

A

hereditary hemochromatosis

238
Q

what do you do for someone with hereditary hemochromatosis?

A

phlebotomy

239
Q

how does ankylosing spondylitis present?

A

<40 years old, morning bakc pain and spinal tenderness

240
Q

what is first line rx for ankylosing spindylitis?

A

nsaids

241
Q

what can happen to lung function tests in sarcoidosis?

A

restrictive pattern, FEV and FVC about normal and DLCO will decrease `

242
Q

does amyloid cause nephritic or nephrotic syndrome?

A

nephrotic syndrome

243
Q

what is the triad of aspirin exacerbated respiratory disease

A

asthma, chronic sinusitis, and worsening of sx with NSAIDs

244
Q

what is toxicity of tacrolimus?

A

can have kidney injurty

245
Q

a mechanical aortic valve can cause what heme issue?

A

macrovascular hemolysis leading to anemia

246
Q

what labs are elevated in primary sclerosing cholangitis?

A

Alk phos and bilirubin

247
Q

what is primary sclerosing cholangitis associated with?

A

UC

248
Q

what is imaging finding of primary sclerosing cholangitis?

A

stricturing and dilation if intrahepatic and extrahepatic bile ducts with onion skinning

249
Q

what abx used to treat pyelonephritis can cause kidney injury?

A

any of the aminoglycosides

250
Q

RTAs cause what kind of metabolic issue?

A

non anion gap metabolic acidosis

251
Q

what is vitiligo associated with?

A

hashimotos thyroiditis

252
Q

in diabetic nephropahty, what is abnormal on Urinalysis?

A

protein present

253
Q

what causes loss of protein in diabetic nephropathy?

A

damage to basement membrane

254
Q

what lung cancer is most common in kids?

A

bronchial carcinoid tumor

255
Q

what are sx of bronchial carcinoid tumor ?

A

hemoptysis, recurrent pneumonia, mass

256
Q

how to calculate attributable risk?

A

RR-1/RR

257
Q

patient with incompressible veins has what?

A

DVT

258
Q

what should you screen for in patient with DVTs?

A

cancer screenings

259
Q

prior to ablation, what therapy should patients with atrial flutter be on?

A

anticoag…DOAC

260
Q

patient with diabetic foot ulcer…what should be done for starting abx?

A

bone biopsy

261
Q

what type of rash can occur with interstitial nephritis?

A

maculopapular rash

262
Q

what is the most common cause of adrenal insufficiency?

A

autoimmune adrenalitis

263
Q

what are common symptoms of adrenal insufficiency?

A

weight loss, abdominal pain, nausea vomiting and hyperpigmentation of skin

264
Q

what is the most common lab finding in adrenal insufficiency

A

hyponatremia, hyperkalemia

265
Q

what can be found on CBC with patient who has adrenal insufficiency?

A

eosinophilia

266
Q

what rx should be given to patient who cant have doxy for lyme disease?

A

amoxicillin

267
Q

what is a contraindication to using SERMs?

A

previous DVT

268
Q

describe dermatitis herpetiformis and what disease it is associated with

A

pruritic erythematous papules associated with celiac

269
Q

how is hep a transmitted?

A

fecal oral mainly

270
Q

inflammatory back pain has what characteristics?

A

improves with activity and worsens with rest

271
Q

what are levels of alk phos, calcium, PTH and phosphorus in osteomalacia?

A

PTH and alk phos up, calcium and phos down

272
Q

two symptoms of osteomalacia?

A

fatigue and bone pain

273
Q

what type of ulcer gets better with eating?

A

duodenal

274
Q

what is rx for duodenal ulcers? what is usual cause?

A

amox and PPI and H pylori

275
Q

what test is positive if patient has corneal abrasion?

A

fuorescein stain

276
Q

what can happen to patient with corneal abrasion?

A

slight loss of vision

277
Q

what nerve is affected in a corneal abrasion that leads to small vision loss?

A

trigeminal

278
Q

what is first line drug for fibrmyalgia?

A

TCAs

279
Q

what are the first two therapies for COPD?

A

SABA and SAMA

280
Q

what can you add to saba/sama as symptoms and COPD get worse?

A

LAMA and LABA

281
Q

if LAMA and LABA dont work for COPD what is next step

A

ICS

282
Q

what does PPI use put you at increased risk for?

A

c diff

283
Q

are breath sounds increased or decreased with lobar pneumonia?

A

increased

284
Q

what is egophony associated with?

A

lobar pneumonia

285
Q

bloody ascites should make you think of what?

A

hepatocellular carcinoma

286
Q

what is triad of cardiac tamponade?

A

distant heart sounds, increased JVP, and hypotension

287
Q

what is common finding on cardiac exam of pericardial effuson?

A

no PMI

288
Q

what are the symptoms of primary biliary cholangitis?

A

cholestasis fatigue pruritis and elevated alk phos

289
Q

what ab is + in primary biliary cholangitis?

A

anti mitochondrial

290
Q

what disease has + anti smooth muscle antibody/

A

AI hepatitis

291
Q

what is cause of presbyopia?

A

loss of lens elasticity

292
Q

what are the rules for transudate versus exudate pleural effusion?

A

pleural fluid protein/serum protein >0.5

pleural fluid LDH>2/3 serum normal LDH

293
Q

will glucose be high or low in exudate pleural effusion?

A

low

294
Q

does fever have to be present in vertebral osteomyleitis?

A

NO

295
Q

if patient is healthy and has positive PPD, what do you do?

A

only treat if induration >15mm

296
Q

which of lambert eatong, MG or dermatomyositis causes rash?

A

dermatomyositis

297
Q

what does rash of dermatomyositis look like?

A

erythematous papules on dorsum side of hand

298
Q

what is most common cause of severe mitral regurgitation?

A

MVP from myxomatous degeneration

299
Q

how does isoniazid cause neuropathy?

A

pyridoxine B6 deficiency

300
Q

B12 deficiency can cause what with tongue?

A

glossitis

301
Q

what is a hepatic hydrothorax?

A

pleural effusion due to small defects in diaphragm that allow ascites to leek into pleural space

302
Q

what drug decreases cardiac remodeling in post MI patients?

A

ACE inhibitors

303
Q

what systemic disease is associated wit hdialysis?

A

amyloidosis

304
Q

what are issues with dialysis related amyloidosis?

A

bone cysts, carpal tunnel syndrome and arthritis

305
Q

does baroreceptor sensitivity increase or decreas with age? what can this cause?

A

decrease…orthostatic hypotension

306
Q

how do beta blockers decrease angina?

A

decrease cardiac contractility

307
Q

where does arthropathy from hereditary hemochromatosis occur?

A

2nd and 3rc MCP joints

308
Q

what is rx for arthropathy from hereditary hemachromatosis?

A

phlebotomy

309
Q

what are the diagnostic features of acute bronchitis?

A

cough fo rmore than 5 days without systemic signs and can have wheezing

310
Q

what is rx for acute bronchitis?

A

supportive, can give bronchodilator

311
Q

if you are concerned about cushings/hypercortisolism, what test should you do?

A

24 hour urine cortisol, or low dose dexamethasone cortisone test

312
Q

what abx should a person without a spleen take if they get a fever?

A

augmentin

313
Q

what can methotrexate cause to the lungs?

A

hypersesnitivty pneumonitit s

314
Q

which of lambert eaton and myasthenia gravis has abnormal reflexes?

A

lambert eaton

315
Q

prominent V waves are specific for what in JVP?

A

tricuspid regurgitation

316
Q

what medication class is notorious for causing secondary hypogonads?

A

Opioids

317
Q

what imaging should be done for normal pressure hydrocephalus?

A

MRI

318
Q

what can lithium cause in the kidneys?

A

nephrogenic DI

319
Q

patients with CF that have involvement of pancreas can develop what endocrine issue?

A

diabetes

320
Q

what must you be extra careful about with CF diabetes and why?

A

low sugars…because pancreas probably not making glucagon either

321
Q

what is initial rx of hemorrhoids, even if they are internal?

A

high fiber, goo dhydration, limited BMs and limit straining

322
Q

what is therapy for idiopathic pulmonary fibrosis/

A

antifibrotic therapy

323
Q

what endorcrine issue can celiac cause?

A

secondary hyperparathyroid, because vitamin D not absorbed and Ca lost in stool

324
Q

what is most common cause of Aoritc Regrg in USA?

A

bicuspid valve

325
Q

what are sx of chronic AR?

A

pounding heartbeat, shortness of breath, widened pulse pressure

326
Q

is methotrexxate beneficial for patients with reactive arthitiidies?

A

NO

327
Q

if patient with ankylosing spondylitis is not well treated with NSAIDS, what do you try?

A

TNF- a inhibitors

328
Q

what are sx of systemic sclerosis

A

sceradactyly, arthralgias, raynauds, GERD, interstitial lung disease

329
Q

what is cause of GERD in systemic sclerosis?

A

atrophy and fibrosis of smooth muscl e

330
Q

when are PDE5 inhibitors contraindicated?

A

if patient taking nitrites

331
Q

what is rx of papulopustular rosacea?

A

topical metronidazole

332
Q

what are characteristics of rosacea?

A

erythematous skin that comes and goes with sun exposure and spicy foods, mainly in women, can be papulopustular

333
Q

what cancer most commonly moves to liver?

A

colon

334
Q

if you see multiple liver tumors, what is likely cause?

A

metastasis

335
Q

what is main risk factor for prostate cancer?

A

AGE

336
Q

explain a cross sectional study

A

determine if group has risk factor or not and compare prevalence of disease at present time

337
Q

what heme issue can patients with OSA have?

A

polycythemia

338
Q

what virus commonly causes viral arthritis?

A

parvovirus

339
Q

patients on PPIs are at risk of developing what neuro issue?

A

B12 deficiency neuropathy

340
Q

what is rx of actinic keratosis?

A

cryo or 5 fluorouracil

341
Q

what can contirbute to development/worsening of AAA

A

smoking

342
Q

what is given for prophylaxis of variceal bleeding?

A

beta blockers

343
Q

what leukemia is associated wiht 9:22 issue? who gets it?

A

CML and adults

344
Q

what is rx for CML?

A

imatinib targeting tyrosine kinase

345
Q

if patient has thyroid nodule, what should initial imaging test be?

A

US

346
Q

when do you do a FNA of thyroid nodule after an US?

A

if US shows calcifications or vascularity

347
Q

firm dry and thickened skin is indicative of what issue?

A

chronic lymphedema

348
Q

what is a risk for chronic lymphedema?

A

recurrent cellulitis

349
Q

what is most common cause of acute urinary holding in older men?

A

bladder outflow obstruction from BPH

350
Q

what is a common side effect of niacin therapy? why does it happen?

A

flushing and itching because of prostaglandin induced vasodilation

351
Q

what do you give niacin for?

A

high triglycerides

352
Q

is diastolic or systolic murmur more worrisome?

A

diastolic, should get full work up

353
Q

if patient has new bleeding with poops and is young without risk factors, what should be done to work up the bleeding?

A

anoscopy

354
Q

in addition to bactrim, what should be given to patient with severe PJP?

A

corticosteroids to tame immune response

UWorld Family Medicine (3 decks)

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