Uworld Int. Med-7-26-2015

wumimimu's version from 2015-07-26 21:00


Question Answer
What is wells criteria?Criteria for PE likeliness: 3+ signs of DVT, or other dx less likely; 1.5+, recent immbolization, HR>100, hx of PE?DVT, 1+ cancer, or hemoptysis. ,<2, less likely, 2-6 mod likely, >7, very likely
What are the signs and sx of mesenteric ischemia?Chronic abd pain, worsened pain postprandially, food aversion, weight loss, atherosclerotic disease, pain out of proportion to exam, abd bruits
How do you diagnose mesenteric ischemic with imaging /Doppler US, or CT angiography
What are the series of tests used in diagnosing primary hyperaldosteronism?First, PAC/PRA, then adrenal suppression testing, imaging, if normal, then adrenal venous sampling
What are short actig and long acting tx for hyperkalemiashort: calcium, insulin +glucose, b2 agonists, and sodium bicarb; long acting: diuretics, kaexylate, and hemodialysis
What are the three mechanical complications that occur 3-7 days after MI?MR from papillary muscle rupture, free wall rupture, intravent septum rupture
WHat is the most effective non pharmocologic method to reduce BP?WEIGHT LOSS, also, DASH diet, exercise, limiting sodium intake, limiting alcohol
What happens to leukocyte alkaline phosphatase acitivty in CML?decreases
What are blast counts in 3 phases of CML?<9% = chronic, 10-19%,= accelerated, >20%,= blast crisis
WHich murmurs decrease in intensity with increased venous returnHCM and MVP
WHich murmurs get softer with increased afterload?AS and HCM
What are urine chloride levels in saline responsive and unresponsive met alkaloses?Saline responsive: (usually due to vomiting or prior diuretic use)low urine chloride; saline unresponsive: urine chloride >20
What drug should you avoid in cocacine induced mI?Beta blockers! can cause unopposed alpha vasocontriction: give calcium channel blockers and alpha antagonists like phentolamine to reduce vasospasm
What are the risk factors for developing NASH?Diabetes, obesity, and HTG/HLD, TPN, and certain medications
What is prophy for MAC in hiv patients?<50 cd4 counts, azithromycin
Which bacteria causes IE due to nosocomial UTIs?Enterococci!
Bitter almond odorCYanide poisoning
What are the sx of caustic ingestion?severe pain, cant swallow, heavy salivation, mouth burns: watch out for mediatinitis or perotinitis
What test do you use to compare two means? three or more means?T -test ;anova
What are complciations of hepatic adenoma?Malignant transformation and rupture (usually bx is not done)
What are the CT findings in acute diverticulitis?pericolic fat inflammation, diverticula, abscesses, bowel wall thickening, soft tissue masses
What test can be used to distinguish endogenous depression from other causes of forgetfullnes?DST= dexmethasone supression testing
What are the side effects of proacainamide?lupus, QT prolongation, agranulocytosis
What are the SE of quinidine?Tinnitus, QTprolong, Torsades, hemolytic anemia, thrombocytopenia
What other diseases are associated with Hep C?Cryoglobulinemia (arthalgias, MPGN, palpable purpura), Porphyria cutanea tarda, lichen planus, and leukocytoclastic vasculitis
WHat vasculitis is associated with hep B?polyarteritis nodosa
What is the best test of dx and evaluating for complications in diverticulitis?Ct scan of the abdomen
What are 2 common complications of ADPKD?UTIs and nephrolithiasis
WHat is the initial treatment for rosacea?Topical antibiotics such as metronidazole
What does damage to the lateral spinothalamic tracts cause?contralteral loss of pain and sensation two levels below the lesion
WHat imaging is characteristic of huntingtons disease?Atrophy of the caudate nucleus, seen as enlargement of the lateral ventriclers
WHat causes familial hypocalcuric hypercalcemia?defective calcium sensors on parathyroid gland and renal tubules. urine calcium/creatinine clearance ratio <0.01
What are the regions with choloroquine resistant p. falciparum?southeast and south asia, and subsaharan africa and the amazon rainforest
WHat can you prophy people who are going to regions endemic with p. falciparum?atovaquone-progaunil, doxy, and mefloquine (preferred in pregnancy)
WHat is the LP opening pressure in someone with IIH?>250
What is cushing reflex?worrisome for brainstem herniation: triad of hypotension, bradycardia, and resp depression