Uworld Int. Med 6-29

wumimimu's version from 2015-07-02 21:59


Question Answer
What does asbestosis present as?Type of pulmonary fibrosis: bibasilar end-inspiratory crackles, fingernail clubbing, bibasilar reticulonodular infiltrates with honeycombing around them, b/l pleural thickening, and pleural plaques
What is the most common cancer that forms after asbestos exposure?Bronchogenic carcinoma. smoking acts synergystically w/exposure to asbestos
What are lewy bodies?Eosinophilic cytoplasmic inclusions made of alpha-synuclein
What are the hallmarks of Lewy body dementua?Alterations in conciousness, visual hallucinations, extrapyrimdal symptoms
What are the WBC's in different arthritis conditions?normal: 0-200, OA: 200-2000, Inflammatory: 2000-50,000, infectious: >50,000
What are the sx of GBM?Nausea, vomiting, headaches that worsen with a change in position, coughing, and sneezing, papilledema (space occupying lesion)
What does GBM look like on CT scan?Usually in the frontal lobe, looks like a butterfly shaped lesion with central necrosis, and serpiginous contrast enhancement
What is the most common cause of impaired hemostasis in chronic renal failure patients?Uremic coagulopathy: causing platelet dysfunction (abn bleeding time): treated with DDAVP
How do we treat renal artery stenosis causing renovascular hypertension?Angioplasty with stent placement (for younger patients with fibromuscular dysplasia)
What are the clinical features of Steven Johnsons syndrome?4-28 days after exposure to drug, influenza like prodrome, rapid onset lesions, mucosal involvement, and necrosis and sloughing of the epidermis
What do we use to treat cellulitis with systemic symptoms ?IV nafcillin or cefazolin
What are the two common causes of syncope on exertionVtach and left ventricular outflow tract obstruction
When is pulsus parvus et tardus seen?Aortic stenosis
When are capillary pulsations of in the fingers and the lips seen?In aortic regurgitation
What are acute and chronic treatments of MS?Acute exacerbations are treated with IV steroids: Reduction in frequency of episodes is achieved by beta interferon and glatiramer acetate
What are symptoms of chronic primary adrenal insufficiency?Fatigue, weakness, borderline hypotension, electrolyte abn, hypoglycemia, and eosinophilia
What are some causes of primary adrenal insufficiency?Autoimmune, TB, histo, sarco, (etc), hemorrhage (meningococcemia/anticoagulant), metastatic cancer
What causes less levothyroxine absorption?Bile acid binding agents, calcium, iron, aluminum hydroxide, PPI's and sucralfate
What causes an increase in thyroid binding globulin?Estrogen, SERMs, heroin and methadone
What causes a decrease in thyroid binding globulin =?Glucocorticoids, anabolic steroids, testosterone, slow release nicotinic acid
CYP450 inducers do what to thyroid hormone? Reduce it
How does vascular dementia tend to present?A sudden or stepwise decline in executive function, usually after a stroke
What kind of kidney stones occur when there is fat malabsorption?Calcium oxalate kidney stones! Ca binds to fat in gut, not oxalate, so more is absorbed causing hyperoxaluria
What drugs are implicated in peripheral neuropahty?Vincristine, taxanes, cisplatin, amio, hydralazine, phenytoin, INH
What kind of emphysema does AAT def cause?panlobular
What is the approach to the solitary pulmonary nodule?>.8 cm, then high risk, surgical excision; intm risk, PET scan; if <0.8 cm, if btwn 5-7mm, then serial CTs,if <4mm, then low risk, nothing, int risk, serial CT
What are the four types of lacunar stroke and where do they occur?Dysarthria-clumsy hand: basal pons; pure motor: post limb of internal capsule; ataxia-hemiparesis: ant limb of internal capsule, pure sensory: VPL nucleus of thalamus
What medications should be held before exercise stress testing?B blockers, calcium channel blockers, and nitrates (48 hours prior)
What meds should be held before vasodilator stress test?dypyridamole (at least 48 hours) and caffeine (12 hours prior)
What is tennis elbow?lateral epicondylitis: presents with pain on supination and extension of the wrist, and point tenderness just distal to lateral epicondyle
What is the difference between retrospective cohort study and case control study?Case control: identifies outcome first, then assesses risk factors; retro cohort: identifies risk factors, and then assesses disease outcome
How does lupus predispose to heart attacks?Chronic steroid use and the disease itself causes accelerated coronary atherosclerosis
What should be checked in new-onset afib?Thyroid hormone levels and TSH
What are the features of AIHA?normocytic anemia, splenomegaly, reticulocytosis, jaundice with elevated indirect bili, increased LDH, and decreased haptoglobin
How do you treat AIHA?glucocorticoids, or splenectomy in unresponsive pateints
What are causes of AIHA?Drugs, viruses, lupus, immunodef states and lymphoproliferative disorders
When does rupture occur after MI?3-7 days after MI
What kind of MI produces Ventricular aneursym?Anterior wall MI: akinesis, arrythmias, and systemic embolization
What are sx of upper motor neuron lesions?Hyperreflexia, spasticity, and bulbar symptoms
What are sx of lower motor neuron lesions?Fasciculations
What are some causes of peptic/esophageal strictures?Radiation, systemic sclerosis, swallowing caustic agents, and GERD
What are the two most common manifestations of Chagas?Megacolon, megaesophagus, or heart disease *myocarditis
How do we test for peripheral sensory loss in diabetic neuropathy?10 g monofilament test
How do you treat tinea corporis?With topical antifungalterbinafine or systemic griseofulvin for extensive disease
In what kind of arthritis do you see pencil in cup deformity?Psoriatic arthritis
What is the WHO classification of pHTN?Group 1: idiopathic 2: left heart failure 3:chronic lung disease 4: Chronic PE 5: other
What is PHTN defined by?mean pulmonary arterial pressure >25 mm Hg
What are the findings with esophageal dismotility due to SSC?Atrophy of smooth muscle and fibrosis in lower esophagus, and decreased tone of LES; hypomotility. sx of dysphagia and heartburn
What are the two most common types of analgesic nephropathy?Papillary necrosis and Chronic tubulointerstitial nephritis
What is dacrocytitis?Infection of the lacrimal sac: inflammatory changes in the medial canthal regions of the eye; usually caused by staph aureus or beta hemolytic strep
What is a hordeolum and chalazion?Hordeolum: abscess of eyelid (stye); chalazion: chronic granulomatous inflammation of meibomian gland, presents as a hard, painless lid nodule
What is the diff in location between HOCM murmur and AS murmurHOCM: left sternal border (lower); AS: right second intercostal space