Uworld Int. Med 7-19

wumimimu's version from 2015-07-20 18:04


Question Answer
What 4 conditions should you think about with hypokalemia, alkalosis and normotension?Surrep vomiting, diuretic abuse, gittlemans, and Barterrs syndrome
DUring mech ventilation, how do calculcate peak airway pressure?Plateau pressure (PEEP + elastic pressure) + resistive pressure
What are the gradations of treatment for Cdiff colitis?WBC<15,000, Cr<1.5: oral metronidazole, WBC>15,000, or Cr>1.5: serum albumin <2.5: oral vanco; lactate>2.2, WBC>20,000, toxic megacolon, ileus: Surgery
What are the risk factors for c diff?Age, recent hospitilzation, recent antibiotic use
What are the manifestations of blastomycosis?Pulmonary disease, skin, bone, and prostate manifestations.
What is the treatment of dermatitis herpetiformis?gluten free diet and dapsone
What is the treatment for scabies?permethrin cream
What are the most common organisms associated with splenic abscess?Staph, strep, and salmonella
What are the risk factors for splenic abscesshemoglobinopathies, immunosuppresion, endocarditis (hematogenous spread), trauma, iv drug use
What does intrinsic renal failure do to the BUN/Cr ratio?Decreases it to <20:1 `
WHat are the indications for HPV vaccine?`men and women age 9-26
What are the recs on MMR vaccine in HIV patients?OK to give and should be given if CD4>200, and no history of AIDS defining infection
What is the primary treatment of viral/idiopathic pericarditis?NSAIDs and colchicine
What are the indications for urgent hemodialysis?AEIOU: Metabolic acidosis, electrolyte abn- hyperkalemia (ECG changes or >6.5, refractory), ingestions:salicylates, toxic alcohols, lithium, valproate, carbamazepine, volume overload refractory, uremia (pericarditis, encephalopathy, or bleeding)
What is the most common kidney disease in HIV?FSGS
What is post exposure prophylaxis for HIV?Serological studies immediately, at 6 weeks, 3 months, and then 6 months. Immediate triple drug therapy within first few hours continued for 28 days: consisting of 2 NRTIs + integrase, protease inhibitor, or NNRTI
How does vitamin K def occur?Inadequate dietary intake, intestinal malabsorption, hepatocellular disease causing loss at storage sites
What are the protocols for screening for osteoporosis?All women >65, and earlier if specific risk factors
What predisposes to OA of the glenohumeral joint?Trauma
What presdisposes to adhesive capsulitis?Diabetes mellitus, rotator cuff tendinopathy, subacromial bursitis, paralytic stroke,humeral head fracture
What are the most common kidney stones?Calcium oxalate stones
What predisposes to calcium oxalate stone formation?Small bowel disease, surgical resection, or chronic diarrhea (anything that impairs fat absorption)
What predisposes to forming calcium phosphate stones?RTA, and primary hyperparathyroidism
What shape are calcium oxalate stones?Envelope shaped q
What should be done to prevent urinary calcium stone formation?Adequate fluid intake, sodium and protein restriction, thiazide/amiloride diuretics, and maintaining normal level of calcium intake, increasing citrate in the diet (fruits and vegetables)
What do CPPD crystals look like/Rhomboid shaped and postively birefringent
What can trigger CPPD onset?Trauma, medical illness or surgery most commonly
Struvite is what?Magnesium ammonium phosphate
Which four drugs have mortality benefits in patient with acute mI?Statin, ACEi, aspirin, and beta blocker
When should clopidogrel be used?after UA/NSTEMI..for at least 12 months along with aspirin (indefinitely); after PCI (with aspirin), for 30 days or 1 year for drug eluting stents,or as an alternative for aspirin
How is NPH treated?large volume lumbar punctures, and if successful then ventriculoperitoneal shunt
What is a complication of norepinephrine use during an episode of hypotension?NE induced vasospasm causing reduced blood flow and duskiness of the fingertips and toes
What are the levels of findings in synovial joint fluid aspiration?OA: clear fluid, WBCs: 200-2000, 25% PMNs; inflammatory: clear to opaque, 2000-100,000, >50% PMNs, septic joint:opaque fluid, WBCs: 50,000-150,000, >80/90% PMNs
What predisposes to gout?high meat or alcohol consumption, diuretics, volume depletion
How do you differentiate psychogenic and organic causes of ED?nocturnal penile tumesence
What complciation commonly occurs after hemothorax?Empyema
How do we treat empyema?antibiotics, fibrinolytic therapy, chest tube to drain, if it has a thick peel you need decortication with surgery
What are the indications for hep A vaccineMSM, IVDU, chronic liver disease
What are the manifestations of entamoeba histolytica?Bloody diarrhea and can cause liver cysts (amebic cysts); usually in the right lobe
How do you treat entamoeba histolytica cysts?oral metronidazole, and luminal agent: paromyomycin? drainage is NOT recommeded
How do you distinguish uncong from cong hyperbilirubinemia by urine dipstick?Conjugated- positive urine bilirubin assay; unconjugated- positive urobilinogen assay