Uworld Int Med 7-21-2015

wumimimu's version from 2015-07-26 02:04


Question Answer
High levels of homocyteine levels are treated how?B6 and folate supplementation
What is AERD?Aspirin or Nsaid exacerbated resp disease: nasal polyps, rhinosinusitis, asthma, bronchospasm, anosmia
What are common complications of acute pacreatitis?pleural effusion, ARDS, ileus, pancreatic necrosis, pseudocyst, abscess
cutaneous larva migrans?Skin lesion caused by cat/dog hookworm (ancylostoma); associated with sandboxes/tropical regions; pruritic, elevated, serpiginous lesions on skin
What are the CXR findings in CHF?Kerly b lines, cardiomegaly, pleural effusions, cephalization of the pulm vessels
What can excerbate pseudotumor cerebri?Corticosteroids and vitamin A
Does hepatorenal syndrome resolve in fluid resus/holding of diuretics?NO. can use splhanic vasoconstrictors: midodrine, NE, octreotide; liver transplantation is cure
What are the criteria for starting home O2 therapy in COPD patient?Sao2<88%, PaO2<55, or cor pulmonale, sig pulm HTN, hematocrit>55%, or if individual becomes hypoxic during sleep or exercise
What are the symptoms of menieres disease?Aural fullness, sensorineural hearing loss, and tinnitus, and recurrent episodes vertigo
Weber test results in sensorineural hearing loss?Lateralizes to the unaffected ear
Weber test results in conductive hearing loss?laterlizes to the affected ear
What is otosclerosis and how is it treated?Stapes footplate becomes fixed to the oval window; occurs in 20's, 30's, more in females, treated with stapedectomy and hearing amplification
WHat are the signs of sx of postoperative endoopthalmitis?Swollen conjuntiva and eyelids, hypopyon, infection, corneal edema; occurs within 6 weeks after surgery
How does herpetic whitlow present?infection in hand: Throbbing pain the distal pulp space, usually swollen soft and tender; nonpurulent vesicles on volar surface, fevers, and lympadenopathy
In who does herpetic whitlow occur?IN children with herpetic gingivostomatitis, women with genital herpes, healthcare workers, contact with saliva by broken skin
WHat is felon?Bacterial infection of hand in people who work with needles: present with tense abscess
WHen does dressler syndrome occur?1-6 weeks after mI
At what level of BUN does uremic pericariditis usually occur?>60
What serum marker should be checked in vit b12 def?Methylmalonic acid
WHat are the most common causes of thyrotoxicosis with reduced iodine uptakelymphocytic or granulomatous thyroiditis, levothyroxine overdose, struma ovarri, iodine-induced thyrotoxocosis
WHat is the difference between dead space and shunting?Dead space is when you have ventilation but not good blood flow; shunt is when you have good blood flow and bad ventilation
LYring on the affected side in pneumonia does what?Worsens shunt and makes you more hypoxic
What is mixed cryoglobulinemia?IgM to HepC IgG, causes deposition in vessels, and elsewhere: vasculitis of skin, kidneys, nerves, and joints
How do you test for cryo?Low complement, increased RF, increased cryos in blood, elevated liver enzymes
What test can use to diagnose BPPV?Dix-Hallpike testing... vertigo and nystagmus upon lying in supine position and angling head to 45 deg
What it stills disease?Recurrent high fevers, rash, and arthritis
What are the signs and sx of infective endocarditis?Oslers nodes, roth spots, janeway lesions, Glomerulonephritis, sytemic arterial emboli
How should patient with afib>48 hours be treated?Rate control w/beta blockers/calcium channel blockers, anticoagulation, 3-4 weeks, before attempting cardioversion
What arrythmias are adenosine and vagal maneuvers used to stop?PSVT
What is the most common complication of the treatment for hodgkins lymphoma?Secondary malignancy
What are the risk factors of fluroquinolone induced tendinopathy?age >60, female, concurrent steroid use, normal BMI, organ transplant
What do you measure to monitor resolution of DKA?beta-hydroxybutyrate, and anion gap
in DKA, when can you switch to subQ insulin from IV?when able to eat, serum glucose <200, anion gap<12, bicarb>15
Which electrolytes should you supplement inDKA?K, IV K when K<5,2, stop insulin if K<3.3, Bicarb if ph<6.9, phosphate <1.0, cardiac dysfucntion or resp depression q
How do you estimate serum osmalality?Na x 2 + glucose
What are the most common organs affected in GVHD?Skin liver and intestines
What are classic cytochemical features of hairy cell leukemia?TRAP + stain, and cd11c marker
What is one drug induced cause of SIADH?NSAIDs
What can cause a false positive d xylose test?small bowel bact overgrowth, delayed gastric emptying, renal dysfunction, urinary retention, ascites
Chronic scar that develops into painless, bleeding non healing ulcer?SCC
What is the first step with suspected SCC?Punch/shave/excisional bx
How do you treat actinic keratoses?flurouracil cream
What are senile purpura?Age related ecchymoses related to loss of elastic fibers in perivasc connective tissue
What is hepatic adenoma?beningn tumor, usually in right lobe, women who take OCPs for long time
What is hepatic angiosarcoma/?malignant vascular tumor of liver,usually in older men exposed to toxins like vinyl chloride, arsenic compounds, or thorium dioxide
WHat hormone is hypovolemic hyponatremia mediated through?ADH
WHen are antibiotics recommended in COPD exac?>1 cardinal sx, mod-severe exac, mechanical ventilation
What therapies are used on COPD exac?suppl O2, systemic corticosteroids, bronchodilators, antibiotics, NPPV
What is the SPIKES approach?A method used for breaking bad news