UWorld Qs: Week of 02/11/18 Flashcards
Describe the management of actinic keratosis.
Lesions that are larger than 1 cm, have ulcerations, or appear indurated should be biopsied to rule out malignancy. Lesions without those features can be treated with cryotherapy.
Review the treatment of meningitis in adults (immunocompetent, immunocompromised, and older than 50).
- Immunocompetent: ceftriaxone, vancomycin, and steroids
- Immunocompromised: cefepime, vancomycin, ampicillin, and steroids
- > 50: ceftriaxone, vancomycin, ampicllin, and steroids
In treating DKA, add iV potassium when _____________.
potassium is less than 5.2 (hold insulin when it hits 3.3)
The two most common causes of hyperkalemia are _________________.
kidney disease (acute or chronic) and aldosterone-inhibiting drugs
What pattern of T3, T4, and TSH is typical of euthyroid sick syndrome?
- Normal T4 and TSH
* Low T3
After NSAIDs, the next treatment for RA is _______________.
methotrexate
Only progress to other agents (etanercept, infliximab, etc.) when methotrexate fails.
The best test for diagnosing chronic pancreatitis is _____________.
CT scan
Lipase and amylase can be elevated, but they are not in many cases.
Enlarging nodules or ulcers at the site of an injury (like a graft or burn) are likely ________________.
Marjolin ulcers (SCC)
A patient had a drug-eluting stent placed and developed a STEMI four months later. What likely happened?
Drug noncompliance
Dual-antiplatelet therapy is indicated in the setting of stenting. Discontinuing this therapy has been shown to precipitate CAD.
Review the presentation, workup, and treatment of paroxysmal nocturnal hemoglobinuria.
Presentation:
- Hematuria at night
- Fatigue
- Hypercoagulable state
Workup:
- CBC showing hemolysis (anemia, elevated LDH, and decreased haptoglobin)
- Flow cytometry showing absence of CD55 and CD59
Treatment:
- Eculizumab (antibody to complement)
A young man is involved in an MVC and develops respiratory distress afterward. CXR shows bilateral infiltrates. What is the likely diagnosis?
Pulmonary contusions with flail chest
_____________ can appear after an MVC and might look like a hemothorax on CXR.
Diaphragmatic tear
It is more common on the left side because the liver is protective. Look for the g-tube in the chest.
________________ are treated with topical lidocaine and topical nifedipine.
Anal fissures
Limiting what two perioperative things can help prevent prolonged postoperative ileus?
•Opiates
* Fluids (overuse of which can cause bowel edema)
What bacteria is the most common cause of prosthetic joint infection?
S. epidermidis
Note, however, that infections within 3 months of surgery or after 12 months of surgery are more likely to be S. aureus.
Supracondylar fractures frequently injure what nerves?
Median nerve and radial nerve
Explain the pathophysiology of dumping syndrome.
Loss of the pyloric sphincter (from gastric bypass surgery) leads to rapid dumping of hypertonic contents into the small intestine which pulls fluid from the vessels into the intestinal lumen.
