Uworld Int Med 6-17-2015

wumimimu's version from 2015-06-18 02:17


Question Answer
What is Courvosier's sign?Palpable but nontender gallbladder at the right costal margin in a jaundiced patient
What are common lab findings in pancreatic cancer?Elevated ALP, total bilirubin, and and mild anemia
What are the major risk factors for pancreatic cancer?Diabetes, chronic pancreatitis, hereditary disposition, smoking
What are the manifestations of TCA overdose?Mental status changes, anticholinergic SE, and cardiotoxicity(sinus tach, hypotension, vent arrythmias)- most common cause of death
What are the indications of using bicarb in TCA overdose?when QRS interval >100 msec or pt having ventricular arrhythmias.
How are seizures induced by TCA overdose treated?Benzodiazepines
How does pancoast tumor present?Shoulder pain radiating into the arm in an ulnar distribution. compression of the brachial plexus
What are CXR findings in cryptogenic organizing PMN?Bilateral ground glass infiltrates
What type of cirrhosis is most associated with hypogonadism>Alcohol and hemochromatosis related cirrhosis
What are the side effects of metformin?Weight loss; also can cause lactic acidosis in setting of AKI, liver failure and sepsis (we usually hold this med in those settings)
What is the target blood glucose for acutely ill patients with hyperglycemia?140-180
What are common presenting sx of ankylosing spondylitis?Morning stiffness and progressive back pain >3 months, sacroilliac tenderness and reduced range of motion
What is the most common extraauricular complication of ankylosing spondy?anterior uveitis
What is the vaccine dosing schedule for Td/Tdap?Patients should receive one admin of Tdap as an adult, and then adults over the age of 18, Td every ten years
What are the guidelines for pneumococcal vaccine?the 13 valent then 6-12 mo later the 23-valent should be give to all adults >65; <65, severely sick pts should get the sequential vaccines, and <65 chronic medical issues should get just the 23 valent vaccine
Hyperglycemia after meals can be seen in diabetic patients bc?Insulin admin before meals + delayed gastric empyting
What are medication options for diabetic gastroparesis?Metoclopramide, erythromycin, cisapride (risk of cardiac arrhythimias)
What are progesterone analogs like medroxyprogesterone acetate used for?They improve appetite and weight gain in chachetic cancer patients
How does HbA1C correlate to blood gluocse levels?It reflects the blood glucose on average over last 3 months. Every 1% increase in HbA1C, represents 35 mg/dl increase in mean blood glucose
What is ursodeoxycholic acid?Medical treatment to dissolve gallstones for poor surgical candidates
What is the risk of reoccurence for symptomatic gallstones?70% of patients will have reoccurrence
What is a hazard ratio?The ratio of an event occurring in the treatment group vs the non-treatment group
What is a factorial design study?The randomization of 2 or more experimental interventions with each with 2 or more variables studied independently
What should be done for someone with unknown immunity who is exposed to hep B virus?HBIG and HBV recombinant vaccine
A ulcerating cancer of the lower lip is most likely ?squamous cell carcinoma
What is winter's formula and what is it used for?1.5(HCO3-) +8 +/- 2; this formula is used to determine adequate resp compensation for metaboic acidosis (RCMA)
Where are bronchogenic cysts found? middle mediastinum: they are benign
Where are neurogenic tumors in the mediastinum found?posterior!
What are common anterior mediastinal masses?A reterosternal thyroid, lymphoma, thymoma, teratoma
How does polymyositis present?Proximal muscle weakness of the lower ext first, then upper ext, and sometimes dysphagia; no skin findings: muscle bx is diagnostic- mononuclear cell infiltrate surrounding necrotic muscle fibers
What is the triad seen in NPH?Incontinence, gait disturbances, and dementia
What are the initial presenting sx in alzheimer's vs. frontotemporal dementia?In alzheimer's memory is usually first, while on frontotemporal personality changes and social disinhibition are seen first
What kind of cortical changes are seen in alzheimer's diffuse cortical atrophy but particularly in the parietal and temporal regions
What score do you have to have on MMSE to be dx with dementia?24 or lower out of 30
What does reliable mean?Precision
How are diabetic patients with pyelo managed?First 48-72 hours, iv antibiotics, then switch to orals (TMP-SMX or fluoroquinolones) if responding well. Therapy should be maintained for 10-14 days
How is simple comedone acne treated?Initially with topical retinoids, and with organic acids/benzoyl peroxide
How is inflammatory acne treated?Can add topical antibiotic or oral if severe
How is nodulocystic acne treated?oral Isotretinoin and oral antibiotics can be added on
What is fluphenazine and what are its side effects?typical antipsychotic that inhibits body's shivering mechanism. and can cause severe hypothermia
What happens to ACTH and aldosterone, cortisol in secondary adrenal insufficiency ACTH is low and so is cortisol, Aldosterone is normal
What are the diagnostic criteria for PCOS?2/3 of the following: hyperandrogenism, polycystic ovaries on ultrasound, and oligo/anovulation
What kind of cancer are patients with PCOS more prone to getting?Endometrial cancer
What method is preferred for screening for glucose intolerance and T2DM?OGTT
What are the amsterdam criteria?to diagnose lynch syndrome: At least three relatives with CRC, involvement of 2 or more generations,at least one case dx before age 50, FAP has been excluded
What extracolonic cancer is lynch syndrome associated with?Lynch type 2 is associated with endometrial cancer in women
How are nocardia different from actinomyces?They are branching filamentous rod bacteria, that are AEROBES, and partially ACID_FAST, and you treat with TMP-SMX
What are the manifestations of nocardiosis?They have pulmonary sx, (nodules, cavitation, fevers, chills, weight loss), and can disseminate to the skin and the brain
What are the treatments of IIH?Acetozolamide and furosemide, lumboperitoneal shunting or optic nerve sheath decompression, bridge to surgery with corticosteroids and serial lumbar punctures
What are the most important factors in improving patient survival in SCA?adequate bystander CPR, prompt rhythm analysis, and defibrillation (elapsed time to effective resusicitation)
How do you treat MALT lymphoma without mets?First try triple antibiotic therapy to eradicate H. Pyori and cancer should regress; if not, then try chemo (CHOP)q
What is triple therapy for H. pylori?Omeprazole, clarithromycin, and amoxicillin
What is Behcet's syndrome?Inflammatory condition characterized by recurrent oral and genital ulcers, erythema nodosum, uveitis, positive pathergy test, seen in middle eastern, turkish, and asian populations. ,
How do you control/treat Behcet's?Corticosteroids