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World9 Flashcards

1
Q

Bypass surgery can cause symptomatic gallstones, but what causes the gallstones

A

rapid weight loss promotes gallstone formation

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2
Q

patient with hypocalcemia and hyperphosphatemia in the setting of CKD has what

A

secondary hyperparathyroidism

  • causes parathyroid hyperplasia
  • causes renal osteodystrophy on bone
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3
Q

when do you perform large-volume abdominal paracentesis

A

if patient is symptomatic

  • SOB
  • abdominal pain
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4
Q

first step in spontaneous bacterial peritonitis

A

abs not abdominal paracentesis

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5
Q

type II renal tubular acidosis

A

impaired renal bicarbonate
hypokalemia
non-anion gap metabolic acidosis

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6
Q

what causes constrictive pericarditis

A

result of acute pericarditis

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7
Q

Jaundice, decreased appetite with weight loss, abdominal discomfort, fullness in right upper quadrant … has?

A

pancreatic cancer

  • Elevation of bilirubin and alkaline phosphatase implies a cholestatic cause of jaundice, which can be caused by blockage of the common bile duct by a pancreatic mass.
  • gallbladder neoplasms –> less likely jaundice b/c bile can pass through the common bile duct.
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8
Q

What type of knee injury causes impairment of extension of the knee, instability, and exacerbation of pain with squatting

A

meniscal tears

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9
Q

valgus instability indicates

A

medial collateral ligament

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10
Q

Interleukin-1 receptor antagonists are useful in the treatment of

A

rheumatoid arthritis

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11
Q

pulsatile abdominal mass

A

abdominal aortic aneurysm

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12
Q

when do you repair an abdominal aortic aneurysm

A

size greater than equal to 5.5 cm

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13
Q

What is the only thing increased in hypovolemic shock

A

systemic vascular resistance

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14
Q

which type of shock only has elevated cardiac index

A

septic shock

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15
Q

hemodynamically stable patient with widened mediastinum

A

transesophaglea echo or

CT scanning

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16
Q

unstable patient with widened mediastinum

A

ex. thoracotomy

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17
Q

clinical feature of lymphatic obstruction

A

marked thickening and rigidity of skin

- uncommon cause of edema

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18
Q

hypovolemic hyponatremia triggers what

A

ADH secretion

  • decreased serum osmolality
  • decreased urine sodium (less 20)
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19
Q

Common cause of osteomyelitis/ septic arthritis in sickle cell

A

Staph aureus

salmonella

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20
Q

When is abs prophylaxis not recommended for dental procedure

A

mitral valve prolapse
rheumatic fever
ASD
bicuspid aortic valve

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21
Q

treatment for extrapyramidal symptoms from antipsychotic medications

A

anticholinergic

diphenhydramine

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22
Q

Dilated bowel can mean

A

small bowel obstruction

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23
Q

what statin medication adverse effect give you leukocytosis

A

no

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24
Q

the most effective treatment for benign paroxysmal positional vertigo

A

Epley maneuver

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25
Q

humeral midshaft fracture most like to damage what

A

radial nerve

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26
Q

treatment for advanced pancreatic cancer

A

endoscopic common bile duct stent

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27
Q

Large unilateral pleural effusion without evidence of infection

A

malignancy should be suspected

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28
Q

low acetylcholine activity–> neuro

A

alzheimer

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29
Q

Eosinophlic inclusions in neurons of the substantial nigra

A

Lewy body dementia

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30
Q

Loss of dopamine-producing cells

A

parkinsons

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31
Q

when does dementia occur in Parkinson’s

A

later in disease course

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32
Q

patient with a combination of renal failure, hypercalcemia,and anemia should be evaluated for?

A

multiple myeloma

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33
Q

ER, physical violent person, next step

A

physical restraints and emergency haloperidol or Benz

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34
Q

Cardiac tamponade causes equilibration of what pressures

A

diastolic pressures

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35
Q

pathology in Meckel diverticulum

A

ectopic gastric mucosa

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36
Q

difference between autoimmune hemolysis and DIC

A

DIC will have elevated fibrinogen and increase INR.

DIC = microangiopathic hemolytic anemia

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37
Q

how often do you get a lipid profile

A

every 5 years

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38
Q

potential compilation of thoracentesis

A

hemothorax

- decreases left ventricular preload

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39
Q

clinical findings for testicular torsion

A

acute scrotal pain
tenderness
bell-clapper deformity
loss of the cremasteric reflex

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40
Q

transient inguinal bulge on Valsalva maneuver

A

hernia

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41
Q

most common cause of nephrotic syndrome in adults, particularly African Americans

A

focal segmental glomerulosclerosis

42
Q

When do seizures typically occur in juvenile myoclonic epilepsy

A

occur upon awakening

43
Q

lab values for complicated effusions

A

low glucose
low pH
high protein

44
Q

2 most common organism for brain abscess are

A

viridian’s streptococci

Staphylococcus aureus

45
Q

renal vein thrombosis is most commonly associated with what nephrotic syndrome?

A

membranous glomerulopathy

46
Q

define oliguria

A

<250 mL urine in 12 hours

47
Q

what should be performed in all patients with oliguria and acute renal failure due to suspected bladder outlet obstruction

A

urgent bladder scan and catheterization

48
Q

what causes heat exhaustion

A

inadequate fluid and salt replacement

49
Q

what causes extensional heat stroke

A

thermoregulation failure

50
Q

what is the difference between heat exhaustion and exertional heat stork

A

Exertional heat stroke has CNS dysfunction (altered mental status)

51
Q

What is the most common cause of abnormal hemostasis in patients with chronic renal failure? treatment?

A

platelet dysfunction

DDAVP

52
Q

clinical features of minimal change disease

A

NSAIDs

lymphoma

53
Q

elevated endolymphatic pressure

A

Meniere disease

54
Q

bitter almond breath

A

cyanide poisoning

55
Q

bony pain mets from cancer. treatment?

A

radiation therapy is faster

bisphonates (Etidronate disodium) has a slower onset

56
Q

can you get a macular skin rash with mycoplasma pneumonia

A

yes

57
Q

first line treatment for beta blocker overdose

A

IV fluids and atropine

IV glucagon if refractory hypotension

58
Q

what are the 3 categories of lead toxicity

A

nonspecific (fatigue, irritability, insomnia)
neuropsychiatric (peripheral neuropathy, neurocognitivie deficits)
GI manifestations

59
Q

Damage of one eye (the sympathetic eye) after a penetrating injury to the other eye? pathophysiology of this?

A

Sympathetic ophthalmia

immunologic mechanism involving the recognition of ‘hidden’ antigens

60
Q

Reagin-mediated disease

A

IgE-mediated

61
Q

circulated immune complexes can affect the eye in what disease

A

SLE

62
Q

Elbow held in extension, passive flexion of the wrist reproduces the patient’s pain?

A

lateral epicondylitis (tennis elbow)

63
Q

when you see first degree AV block, what should you do?

A

CHECK QRS duration
normal = observation
prolonged = electrophysiology testing

64
Q

how do you treat bradycardia with hypothermia

A

hypothermia correction should correct heart

65
Q

most common cause of bloody diarrhea in absence of fever is?

A

E. coli

66
Q

targeted INR value for Warfarin

A

between 2-3

67
Q

is Sporothrix Schenichkii purulent?

A

nope

68
Q

Post-op patient with unexplained fever, diffuse RUQ abdominal pain, leukocytosis, normal liver/alk phos levels

A

Acalculous cholecystitis

69
Q

What is contraindicated in lye (sodium hydroxide) ingestion

A

activated charcoal

70
Q

What has low Leukocyte alkaline phosphatase levels

A

CML

71
Q

First line pharmacotherapy options for alcohol use disorder

A

acamprosate and naltrexone

acamprsate is better if the patient has liver disease

72
Q

Treatment for body dysmorphic disorder

A

SSRI

CBT

73
Q

old lady on Benzo for sleep, next step

A

stop Benz then reassess, no need to start another drug just yet

74
Q

Patient’s psychiatric symptoms (anxiety, psychosis, insomnia), autonomic instability (hyperthermia, hypertension, tachycardia), short-term memory impairment, rigidity, dystonia, and focal seizure following a flu-like prodrome

A

autoimmune encephalitits

75
Q

difference between meningitis and encephalitis

A

encephalitis has cognitive dysfunction

76
Q

alcohol withdrawal, what type of benzodiazepines

A

short acting ATOM

77
Q

Someone who presents with PCOS type symptoms with myopathy and bruising has what

A

Cushing syndrome

78
Q

Upper GI series shows a crockscrew-shaped and rightward displaced deodenum

A

midgut volvulus (intestinal malrotatio)

79
Q

first-line interventions for initial gout attack

A

alcohol cessation and weight loss

80
Q

What is the strongest risk factor for superior pulmonary sulcus

A

smoking (not family history)

81
Q

What murmur is best heard with the patient sitting up, leaning forward, and holding the breath in full expiration

A

aortic regurgitation

82
Q

most likely diagnosis? child with cough, runny nose, and oral vesicles

A

viral pharyngitits

reassurance and observation

83
Q

which type of shock has mixed venous oxygen saturation

A

septic shock

84
Q

Patient has a impaired wound healing and kidney failure?

A

Granulomatosis with polyangiitis (necrotizing vasculitis)

85
Q

Peripheral blood smear shows signs of dysplasia, including oval macrocyte and hypo segmented/hypogranulated neutrophils? how to make diagnosis

A

myelodysplastic syndrome

bone marrow biopsy is required for diagnosis

86
Q

fevers, chronic diarrhea, abdominal pain, weight loss, been passing gas, and malordorerous discharge from vagina?

A

Crohn’s with fistula formation

87
Q

Tumor lysis syndrome

A

hypocalcemia
hyperphosphatemia
hyperkalemia
elevated uric acid levels

88
Q

bad side effect of chemotherapy

A

neutropenia

signs of sepsis is much more subtle

89
Q

pathophys for diabetic ketoacidosis

A

fatty acids breaks down to ketones in the liver

90
Q

Are focal neurologic deficits common in subarachnoid hemorrhage

A

nope

Thunderclap headache

91
Q

When do you use Pentamide with steroids for PCP

A

allergies to TMP-SMX

92
Q

What complication occurs 5days to 2weeks after acute MI

A

rupture of ventricular free wall

  • profound shock
  • rapid progression to pulseless electrical activity and death
93
Q

clinical feature of theophylline toxicity

A

central nervous system (headache, insomnia, seizure)
GI (nausea, vomiting)
cardiac toxicity (arrhythmia)

94
Q

what type of gait is found in Parkinson’s

A

Hypokinetic gait

suffering gait

95
Q

pharmacotherapy for patients who have recurrent stroke already on aspirin therapy

A

aspirin plus dipyridamole OR clopidogrel

96
Q

conductive hearing loss

A

Rhine: bone conduction is greater than air conduction
Weber: lateralizes to affected ear

97
Q

Sensorineural hearing loss

A

Rhine: air conduction is greater than bone (normal)
Weber: lateralizes to unaffected ear

98
Q

2 things to thing about in a house fire

A

hydrogen cyanide toxicity (more worried about, more fatal)

carbon monoxide

99
Q

Treatment for cyanide toxicity

A

hydroxocobalamin or sodium thiosulfate

100
Q

What causes methemoglobinemia?

A

exposure to oxidizing agents (dapsone, topical/local anesthetics)

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