Uworld Int Med 6-28-2015

wumimimu's version from 2015-06-28 23:28


Question Answer
How do you reduce the risk of infection in someone requiring catheterization for neurogenic bladder?Intermittent straight cath
What should be done to diagnose MG?Ach receptor antibody test + EMG + CT scan of the chest to look for thymoma once diagnosis is established
Anti-jo antibodies?Polymyositis
Mechanical ventilation for ARDS patients should include what?PEEP
What is the goal FiO2 in patients on mech vent?<40% to decrease the risk of pulmonary oxygen toxicity
What is the most common cause of bloody diarrhea without fever?E. coli
What do we treat restless leg syndrome with?Dopamine agonists
What therapies help improve survival in patients with COPD?Smoking cessation, lung reduction surgery, and supplemental O2
What is dexamedetomidine?Alpha- 2 agonist used for sedation in iCU patients
How are glucocorticoids useful during thyroid storm?Prevent conversion of T4 to T3
What is Ludwig angina?Bilateral cellulitis of the submandibular and sublingual glands; usually from infection of the second or third molar tooth. death from asphyxiation
What anticoagulant is preferred in patients with severe CKD (GFR<30)Unfractionated heparin, bc levels can be monitored with PTT (unlike others). There are increased anti Xa levels in CKD
What are the most common mets to the bone?BLT with a kosher pickle: breast, lung, thyroid, kidney, and prostate
Trihexyphenidyl?Anticholingeric med used to treat the extrapyrimidal signs of parkinsons disease; in the same class as bromocriptine
What is the mechanism of contrast induced nephropathy?Renal vessel vasoconstriction and direct tubular injury
Wht can be done to prevent contrast indueced nephropathy?IV hydration with isotonic bicarb or NS, acetylcysteine might also help
What should be done for patients w/first degree heart block and prolonged QRS?EP studies, bc conduction delay is below the AV node. THis can more easily progress into second or even complete heart block
What is the most common valve abn seen in patients with infective endocarditis?MVP with mitral regurgitation, aortic (BAV, or stenosis) is the second most common
How do you treat Infective endocardiits?Empirically with vancomycin and then based on cultures
How do we diagnose infective endocarditis definitively?Gold standard is TEE, but also can use serial positive blood cultures, and other signs and sx
WHat is seborrheic dermatitis?Fine greasy looking yellow scales, that occur in areas of sebaceous glands: usually seen more in pts with HIV and parkinsons disease
What are the distinguishing factors of primary reynauds?Usually occurs in women <30, no abn nail fold cap exam, no connective tissue, peripheral vasc disease, no tissue injury, no ESR or ANA
How do you treat primary reynauds vs secondary reynauds?Primary:CCB and avoid aggravating factors; seondary (usually men>40, tissue injury), CCB, and aspirin for risk of ulceration
Who is prone to getting pellagra?People eating corn based diets, alcoholics, carcinoid syndrome, or hartnup disease
What are the sx of pellagra?Dermatitis, dementia, and diarrhea (3 D;s)
What are the causes of macrocytic anemia?Megaloblastic (folate and B12 def) or nonmegaloblastic (alcohol. liver disese, drugs, and hypothyroidism )
What should be done for patient with septic emboli stroke from IE?IV antibiotics, and then careful observation and managment
What is the single most important lab value in determining prognosis in acute liver failure?PT
What two lab values give the best picture of acid base status?PAco2 and Ph
How is pagets disease treated?bisphosphonates
What diagnostic findings are seen in CJD?Sharp waves on EEG, 14-3-3 in CSF, mutations in the PRNP gene
How do you treat warfarin induced skin necrosis?Immediate cessation of warfarin and protein C infusion
What will fixed airway obstruction do to flow-volume loop?flatten both top and bottom part
What will pneumothorax and pulm edema do to flow volume loop?Cause restricitve pattern: low lung volumes
What will onbstructive disease do to flow-volume loop?Scooped out pattern
What are doxepin and hydroxyzine?Anticholinergic agents
What does forced hyperextension type of injury to neck cause?Central cord syndrome: burning and paralysis of upper ext
What do burst fractures typically cause?Anterior cord syndrome- loss of motor function and pain/temp sens in lower ext
WHat is the treatment for dehydration?IV sodium containing crystalloid solutions
What is the most common cause of post-influenza PNM>Staph aureus
How should you screen for HCC in cirrhotic patients?Liver US every 6 months
What should be done in hep c patients before starting antiviral drugs?Liver biopsy
WHen is succinylcholine contraindicated for rapid endotracheal intubation?When pt has risk of hyperkalemia: crush or burn injuries more than 8 hours old, tumor lysis syndrome, demyelinating syndromes
What is the strongest indicator of prognosis in STEMI?Door to balloon time, ideally less than 90 minutes; door to needle time should be less than 30 minutes
how do you treat cluster headaches?prophylactically- lithium, ergotamine, and verapamil; acute- 100% O2 and subcu sumitriptan
What should you be thinking of in recurrent PNM in same place?Aspiration and obstruction