Uworld Int Med 6-06-2015

wumimimu's version from 2015-06-06 21:24


Question Answer
What are the other sx seen in those with aspirin induced asthma?Nasal polyps and allergic rhinitis
Which beta blockers are non selective?Propanolol, nadolol, sotalol, and timolol
What are physical exam signs of pleural effusion?Decreased movement of ipsilateral chest wall, dullness to percussion, and decreased breath sounds
What is the classic presentation of rotator cuff tear?Fall on an outstretched hand
How do you tell the diff between rotator cuff tendonitis and rotator cuff tearTendonitis gets better with lidocaine injection
What are the symptoms of rotator cuff injury?Pain and weakness upon mid-arc abduction and ext rotation
Multiple myeloma presents with what electrolyte and cbc abn?Hypercalcemia and anemia
The pain of multiple myeloma is usually located whereSpine, back, and ribs
What is bone scan used forMetastatic disease, osteomyelitis, and fractures
What are the side effects of methimazole?Agranulocytosis, 1st trimester teratogen, and cholestasis
What are the side effects of PTUAgranulocytosis, hepatotoxicity, and ANCA associated vasculitis
What elec abn can cause refractory hypokalemia?hypomagnesemia; mg is cofactor in K uptake and maintaining intracellular K levels
What are common electrolyte abd in alcoholics?Hypokalemia, hypomagnesmia, and hypophosphotemia
What are the sx of hypophosphotemia?Weakness, rhabdomyolysis, paresthesias, and resp failure
What can cause spurious hypocalcemiaHypoalbuminemia
What is the most common visual complication of GCA?Anterior ischemic optic neuropathy
What agent other than steroids can be used in GCA?Methotrexate, used as a steroid-sparing agent if pt cant tolerate steroids
What are the lab findings in GCAElevated ESR and CRP, normochromic anemia, and temporal artery biopsy
Where is the pain of anserine bursitis located?Anteromedial to the tibial plateau, just below the joint line.
What can cause anserine bursitis?abn gait, trauma, or overuse
How is anserine bursitis treated?Ice, rest, reduction of pressure on the bursa, also injection of corticosteroids
What is patellofemoral syndromeChronic overuse pain syndrome; pain localized to peripatellar area worsened by activity or prolonged sitting. may be some crepitus
Who is at risk for orthostatic hypotension? Hypovolemic, elderly, autonomic neuropathy (diabetes, parkinson's disease); those on vasodilators, adrenergic blocking agents, and diuretics q
What is the difference in MM vs MGUS?In MM, there is anemia, hypercalcemia, lytic bone lesions, and renal insufficiency; also, M-protein >3 g/dl and plasma cells in bone marrow >10%; beta-2 microglobulin may also be present
What would hyperviscosity syndrome present with?Blurry vision, headaches, nose bleeds
What is a gamma gap and when is it seen?Protein elevated but albumin normal: seen in MM, MGUS, amyloidosis, and Waldenstroms
What is the strongest risk factor for strokes?Hypertension
What is the most common cause of sideroblastic anemia?B6 deficiency (can be caused by medications, INH, alcoholism, etc)
What does the peripheral blood smear of sideroblastic anemia show?Microcytic hypochromic anemia; usually both normochromic and hypochromic will be present
What are the manifestations of exertional heat stroke?core body temp >104 (40), CNS dysfunction, and multiorgan dysfunction: DIC, ARDS, hepatic or renal failure
How do you manage Ex Heat Stroke?Ice water cooling, electrolyte corrections, fluid resuscitation, no use for antipyretics
Which drugs can predispose you to ex. heat stroke?anticholinergics (TCA's, 1st gen antihistamines, phenothiazines)
How should non-exertional heat stroke be treated?Evaporative coolong
What are the most common causes of esophagitis in HIV patients?Candida, HSV (Round/ovoid ulcers), CMV (deep linear ulcers), and apthous ulcers
How would you treat candida esophagitis?Oral flucanozole for 3-5 days
What are common sx of atheroembolism?Abd pain, intestinal ischemia, pancreatitis, acute kidney injury, GI bleed, blue toe syndrome, livido reitcularis, gangrene, ulcers, hollenhorst plaques in the retinal artery
How does a lateral frontal lobe lesion manifest?Contralateral ext and face weakness, and conjugate gaze deviation to the side of the lesion
What does temporal lobe lesion affect to cause pie in the sky?Meyer's loop, inferior optic tract radiations.
Where in the lungs are adenocarcinomas located?Usually peripherally, can present as single lesions
What determines the prognosis of adenocarcinoma?Stage and resectabliity
Which joints are most commonly affected by lupus arthritis?MCP and PIP of the hand. but non-deforming unlike RA
What is the main measure of association in a case-control studyOdds ratio
What is the main measure of association in a cohort study?Relative risk
What are the complications of SAH?Hydrocephalus/increased ICP, Rebleed in the first 24 hours, vasospasm 3-10 days later, Seizures, and SIADH
What should be done after an SAH?Patient should have endovascular stenting/coiling of aneurysm, and nimodipine should be given to prevent vasospasm
What can cause unresponsiveness to antihypertensive meds?NSAIDs, glucocorticoids, decongestants, and alcohol; patients sH hould be counseled if they partake in excessive alc use
When should testing be pursued for 2 causes of HTN?non-responsive to >3 meds, nonobese, Non AA, young <30
Jejunal ulcers are almost pathognomic for what condition?Zollinger ellison
What would BUN/Cr be in prerenal azotemia>20:1
What can cause crystal induced AKIAcyclovir, sulfonamides, methotrexate, ethylene glycol, and protease inhibitors
What is seen on UA in crystal induced AKI?Hematuria, pyuria, and crystals seen in polarized light
What can cause acute interstitial nephritis?Beta lactams and PPI's
What findings are seen along with AIN?Pyuria, eosinophillia, eosinophiluria, and skin rashes; usually occurs 7-10 days after drug exposure
When should a flail chest be considered?Multiple rib fractures, overlying a pulmonary contusion; resp distress
How should flail chest be treated?Postive airway pressure (mech vent) if severe, pain control, and supplemental oxygen
When should you treat hyperkalemia?K>7, rapidly rising, or ECG abnormalities (peaked t waves, shortened QT, QRS widening_
WHat drugs can cause hyperkalemia?K sparing diuretics, nonselec beta blockers, Arbs, ACEi's, and NSAIds. heparin, digitalis, cyclosporine, succinylcholine
What are the manifestations of PNH?Anemia, Cytopenias, and hypercoagulability (portal vein thrombosis or cerebral vein)
How do you treat PNH?Eculizumab, iron and folate supplementation
Elevated LDH, biliriubin, and low haptoglobin w/anemia suggests?Intravascular hemolysis
How is gastrin measurement used to dx ZES?<110 can rule out; >1000 is diagnostic; Also, pH of stomach acid must be <4
How can ZES be diagnosed if gastrin levels are btwn 110-1000?Secretin stimulation test; secretin normally inhbits G cells, but enhances gastrinoma cells
What does albuterol do to potassium?Drives it intracellularly?
What are the renal effects of trimethoprim?Causes hyperkalemia and artificial rise in creatinine (no decrease in GFR)
What are the SE of macrolide Abs?Prologation of QT and cholestasis
Why is hypokalemia seen in Cushings?Cortisol can act like a mineralocorticoid and activate aldosterone receptors
Is cardiomyopathy due to hemochromatosis reversible?Yes. phlebotomy
What is the initial treatment for hepatic hydrothorax?Salt restriction and diuretics, and then TIPS if all else fails
What are the SE of cyclophosphomide?Hemorrhagic cystitis, bladder carcinoma, sterility, and myelosupression
What are indicators of severe asthma attack?Cyanosis, silent lungs, sweating, normal or increased pCo2, speech difficulty, altered sensorium
Other than the lungs, where does sarcoidosis attack?Skin (erythema nodosum) and uveitis (eyes)
What other metabolic abn can hypothyroidism causeHyponatremia, hyperlipidemia, elevations in CK, serum transaminases,, hyperTG
When should people with UC be screened for colon cancer?8-10 years after dx
What are the sx of adrenal insufficiency?GI troubles, N/V/D, fatigue, anorexia, weight loss
What is the pharmoco treatment of HOCM?Beta blockers or calcium channel blockers (slow diastole down)
Inclusions in CMV vs HSV?HSV-intranuclear inclusions; CMV--intranuclear and intracytoplasmic inclusions
What is electrical alternans and when is it seen?EA is when the QRS amplitude varies with every other beat; it is seen in pericaridal effusion/tamponade
What is becks triad for tamponade and effusionhypotension, JVD, and muffled heart sounds

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