Uworld Int. Med 7-04-2015

wumimimu's version from 2015-07-05 15:10


Question Answer
How often should cirrhotic patients get liver US to assess for HCC?every 6 months
What is one major screen that all patients with cirrhosis should undergo?Screening for esophageal varices- major cause of morbidity and mortality
What should be done after diagnosis of hyperthyroidism is made?24 hour Radioiodine uptake scan to differentiate graves disease from other causes
What is the classic presentation of psoriatic arthritis?DIP joints, morning stiffness, dactylitis, deformity, nail changes
What is the treatment of psoriatic arthritis?NSAIDs, methotrexate, and TNF-alpha inhibitors
What is the major cardiac complication of marfan syndrome?Aortic dissection
What kind of mumur would be present in aortic dissection?aortic regurgitation
What is the major cause of morbidity and mortality in patients with PAD?Cardiovascular events
What is the most common extra auricular manifestation of Ankylosing spondylitis?anterior uveitis
How is ankylosing spondylitis definitively diagnosed?Plain film showing bilateral sacroillitis
How does polyarteritis nododa present?Skin symp: livedo reticularis and purpura, kidney disease, abdominal pain, muscle weakness and pain ; ESR is elevated
How do you diagnose fibromyalgia?Widespread pain index and symptom severity score
How should the pneumococcal vaccine be dosed?13 valent followed by 23 valent after 6-12 months >/= 65, if less than 65, then 23valent alone for at risk, and for very high risk, do sequential vaccine
What lobe of the brain does hemineglect involve?Right (non dominant) parietal lobe
What kind of murmurs increase on expiration?Left sided murmurs
WHat are the indications for Aortic valve replacment?Symptoms: SAD: syncope, angina, dyspnea,; getting another heart procedure anyway, asymptomatic but LV systolic dysfunction, really thick wall, valve area < 0.6, abnormal respnonse to exercise
HIV infected patient with bloody diarrhea and normal stool exam?CMV!!!
If CMV colitis is suspected, what should be the next step?Colonoscopy with biopsy
What is seen on colonoscopy in entameoba histolytica Flask shaped ulcers
What are the different therapies for PCP pneumoniae?Trimethoprim, IV pentamidine, trimethoprim-dapsone, atovoquone, clindamycin +_ primaquine
How should epidural spinal cord compression be initially managed?MRI and Glucocorticoids (to reduce inflammation)
What is leuprolide?GnRH agonist used in the treatment of met prostate cancer, and other reasons
What should you do before starting EPO?Check iron stores, and make sure pt has adequate amount, or supplement iron
IN who does nocardia cause infection and what are teh sx?Immunocompromised pts. systemic sx, can resemble TB, pulm infiltrates, and nodules which cavitate, can disseminate to the brain and skin most commonly
What is the treatment of aspergillosis?Voriconazole
How does excess thyroid hormones affect catecholamines?Increases sensitivity to them
What does thyroid hormone directly do to the heart?Increases ionotropy and chronotropy
What does hyperthyroidism do to SVR?Decreases it
What is tarsal tunnel syndrome?COmpression of tibial nerve at ankle: burning and numbness at distal plantar surface of foot
What is morton neuroma?mechanically induced degenerative neuropathy, that causes aching, burning, and numbness in the distal forefoot from the metatarsal heads to the thrid and fourth toes
N-acetyl cysteine uses?Antidote to acetaminophen toxicity and is nephroprotective aginst contrast induced nephropathy
How do we treat amphetamine overdose?Acidification of the urine!!
What is dystonia?INvoluntary sustained muscle contraction, and example would be torticollis
What is athetosis?Writing snake like movements of the hands and feet, often seen in huntingtons
What is akathisia?Feelin sensation of restlessness that causes the patient to move frequently
What are some common medications that induce dystonia?Metoclompramide, typical antipsychotics, and prochlorperazine
What is the imaging modality of choice for Abdom. aneurysm always?US!
What can MRI cause in renal insufficeincyNephrogenic dermatopathy- bc of the gadolimium
WHat is protocol for pap smear?Starting at age 21, and then every 3 years up to 29, then >30, continue every 3 years or do Pap + HPV testing every 5 years.
How long does it take for tardive dyskinesia to occur?1-6 months after starting therpay
What test can confirm primary hyperaldosteronism?Adrenal suppression testing after oral saline load
WHat is the aldo/renin ratio in primary hyperaldosteronism?>20
WHat is a normal result in bladder scan?<100 ml
How do you interpret PSA?>4 is elevated
What is the preferred method of ventilation support in AE of COPD?NPPV! not endotracheal intubation (non-invasive positive pressure ventilation)
What is hypercalcemia of immobilization?Elevated calcium due to immobility: occurs in patients with high bone turnover (young pts, pagets disease)
How do you treat hypercalcemia of immobilzation?BIsphosphonates and hydration
What antibiotic should be used for legionnaires disease?Macrolide or fluroquinolone
Why does hypotension occur in pancreatitis?Increased vascular permeability widespread
What predicts the developement of severe pandreatitis?AGE >75, alcoholism, obesity, Crp>150 at 48 hours, and elevated BUN/Cr at 48 hours
How is severe acute pancreatitis designated?Pancreatitis with at least one organ failure
What is the diff between Cauda equina and conus medullaris?CE: Unilateral radiculopathy, late onset bowel/bladder dysfn, Assymetric muscle weakness, saddle hypothesia, hyporeflexia; CM: low back pain, early onset bladder/bowel, symmetric
What is the treatment for cauda equina or conus medullaris?neurosurg consult, glucocorticoids, and emergency MRI
What are the risk factors for developing AAAWhite male, atherosclerosis, smoking, age >60, family history
What are the risk factors for AAA rupture?rate of expansion, size, and active smoking
What are some serologies found in PSC?Hypergammaglobulinemia, increased serum IgM, and sometimes, p-ANCA
What is chikangunya fever?Present in south america/tropical regions of Africa, Passed by aedes mosquito, malaise, fever, lymphadenopathy, maculopapular rash, severe polyarthalgias, thrombocytopenia, and leukopenia
What are the most common causes of acute epiddymitis?In older peopple: associated with UTI-- usually Ecoli; IN younger people: sexually transmitted, urethritis, chlamydisa and gonnorhea