Uworld Int. Med 6-22-2015

wumimimu's version from 2015-06-23 23:48


Question Answer
What is optic glioma and in who does it occur?Tumor of the eye resulting in progessive unilateral vision loss with dyschromatopsia, occurs in NF1 patients usually younger than 6 years old
How does hypothyroidism cause hyperprolactinemia?TRH increases and can induce lactotrophs
What is the most common nephrotic syndrome associated with adenocarcinoma?Membranous nephropathy
What is the most common nephrotic syndrome associated with Hodgkin's lymphoma?Minimal change disease
What is FSGS associated with?HIV, obesity, heroin use, African americans and hispanics
What is membranoproliferative glomerulonephritis associated withi?Hep B and C infections, chronic bacterial infection, some leukemia and non-hodgkins lymphoma
What is the most common cause of purulent and non-purulent cellulitis?Purulent- staph; non-purulent-strep
What is erysipelas?Infection limited to the superficial dermis and epidermis
What causes flank pain and low volume voids?Obstructive uropathy usually due to renal calculi
What type of hypersens reaction is anaphylaxis?Type 1 hypersensitivity
What are the signs and sx of acute angle closure glaucoma?Dilated pupil non reactive to light, red eye with steamy cornea, severe sudden eye pain and blurred vision, and nausea and vomiting.
How do you treat angle closure glaucoma?WIth IV acetozolamide, and permanent treatment with peripheral laser iridotomy
What is the most common cause of back pain and how is it treated?Lumbosacral strain, treated with NSAIDs and early mobilization
How do you differentiate between neurogenic claudication and real claudication?Neurogenic which is result of lumbar spinal stenosis, is posture dependent, presents with weakness in LE and pain in the lower back, MRI is used to diagnose it and usually you have a normal ABI and LE pulses. For claudication, pain is with exertion and relieves with rest and is more crampy: no lower back pain
What is the first imgaging study for someone with a first time unprovoked seizure in emergency situation?Non contrast head CT ; MRI in elective situations
What are the signs of peritonsillar abscess?Muffled hot potato voice, unilateral lymphadenopathy, deviation of the uvula to one side.
How do you treat peritonsillar abscess?Peritonsillar aspiration and IV antibiotics
What are the main radiographic findings in hemochrom associated arthropathy?Squared offbone ends and hook like osteophytes in the second and third MCP joints
Who does ABPA occur in?Asthma and CF patients: presents with malaise, fever, productive cough, hemoptysis, and eosiniphilia
What is the most effective tx to abort a cluster headache?100% O2
What other treatments can be used to treat cluster headache acutely?NSAID's Ergots, indomethacin, triptan,
What can be used prophylactically in cluster headache?Verapamil, ergots, lithium, indomethacin, methysergide, cyproheptadine, prednisone
What are the characteristics of cluster headache?Men more than women; unilateral, eye pain, same time every day, usually at night, lacrimation, stuffy nose, etc, occur on same side
What is the most common neuropathy in diabetic patients?Symmetric distal sensorimotor polyneuropathy "stocking glove" pattern of sensory loss
Large fiber neuropathy causes what?More loss of sensation/numbness than pain
Pure small fiber neuropathy causes what?More pain, allodynia, paresthesias, than numbness
How does viral esophagitis present compared to candida?More odynophagia than dysphagia and no oral thrush, usually HSV or CMV
What are sx of eosinophilic esophagitis?dysphagia, heartburn, and refractory acid reflux; usually presents in those with atopic disease
What are common causes of pill esophagitis?Tetracyclines, bisphosphonates, NSAIDs, KCl
How does WIlson's disease present in kids vs young adults?Kids more liver disease, young adults more neuropsych sx first
How is wilson's disease diagnosed?Keyser fleishcer rings, urinary copper excretion increased, and low serum ceruloplasmin
WHat does MUDPILES stand for?gap acidosis: Methanol, uremia, dka, paraaldehyde, INH/iron, Lactic acid, ethylene glycol, salicylates
What are some typical causes of hyperventilation?High alt, PMN, and early salicylate intoxication
What considerations should be taken in prescribing sildenafil?It should not be taken with nitrates, careful in patients with conditions that predispose to priapism, careful with cimetidine/erythromycin as they lengthen half life, should be taken at 4 hour interval with alpha blockers bc risk of hypotension
How do you work up a solitary pulm nodule in low risk patients?If nodule is less than 3 cm and in mid-lateral third of lung surrounded by normal parenchyma, in a nonsmoker <40, ask for an old x-ray; work up by following w/ CXR every 3 months for 12 months;
How do you work up solitary pulm nodule in high risk patient?CT scan followed by final needle aspiration bx
Calcifcation of lung nodule suggest what?beningn lesion;; popcorn = hamartoma, bulls eye =granuloma
What is the main precipitant of myasthenic crisis in patients with MG?Usually some type of infection
How is myasthenic crisis treated?Intubation, followed by steroids, and IVIG or plasmapharesis
How can you tell the diff between myasthenic crisis and cholinergic criss?Edrophonium or tensilon test
What is supparative hidraadentiis?Chronic follicular occlusive disease, painful inflammatory nodule with draining sinus tract, usually in inframammary, axillary, and groin regions
What is lone afib?When patient has no evidence of cardiopulm or structural heart disease, by def they have CHADS-VASC of zero.
What is the best treatment for prostate cancer pts with bony mets for bone pain after orchiectomy?Radiation!
What are the most common causes of microcytic anemia?IDA, thallasemia, and ACD
what do iron studies look like in Thallasemia?low mCV, high iron, low transferrin(TIBC) high ferritin, high tranfs saturation
What do iron studies look like in ACDnormal/low MCV, low iron, low transferrin (TIBC), normal to high ferritin, normal to low transferin sat
What are some things that can cause spinal cord compression?Abscess, malignancy, and disc herniation
Lytic lesions +hypercalcemia + renal failure = multiple myeloma!
What are the criteria for treating HEp C?>18, compensated liver disease, stable CBC. liver bx showing fibrosis and hepatitis, and detectable HCV RNA; contraindications include drug and alcohol abuse or major depression
What do we use to treatHep C?Peginterferon and ribavirin; also protease inhibitor if genotype 1 tela- or boce-previr
Whre is the murmur of HOCM usually located?Lower left sternal border
Which drugs can be used for decreased appetite in cancer patients?Progesterone analogs, corticosteroids, and the TCA mirtazapine
What is the characteristic skin rash seen with a glucogonoma?Necrotic migratory erythema
What do non beta cell tumors that cause hypoglycemia produce?IGF-2
How does Acute HIV infection present?Mono like syndrome: fever, weight loss, arthalgias, lymphadenopathy, night sweats, and diarrhea: also mucocutaneous ulcers, skin rash, and prolonged diarrhea help to differentiate this from mono
How does optic neuritis present?blurring vision and retrobulbar pain