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USMLE Step 2 > Uworld 3 > Flashcards

Uworld 3 Flashcards

1
Q

chondrocalcinosis

A

pseudogout –> CPPD

evaluate for: hyper PTH, hypothyroid, hemachromatosis

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2
Q

hemachromatosis

A

diabetes
hepatomegaly
arthralgia (assoc with pseudogout/ chondrocalcinosis)

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3
Q

how do breath sounds/ tactile fremitus change in consolidate process vs effusion

A

consolidation: sound travels faster through solids/liquids, so breath sounds inc (crackles, etc) and tactile fremitus increases
effusion: liquid OUTSIDE lung compresses it and shelters breath soudns and fremitus

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4
Q

methemoglobinemia

A

cyanosis that does not correct with O2 –> likely after expsoure to oxidizing agents like dapsone, benzocaine, lidocaine

low SaO2 with normal PaO2

co-oximetry can decipher types of hemoglobin

tx= methylene blue

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5
Q

methylene blue

A

reduces methemoglobin back to regular hemoglobin

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6
Q

dimercarpol

A

tx for lead poisoning

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7
Q

fomepizole

A

ethylene glycol, methanol poisoning

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8
Q

pralidoxime

A

antidote given with atropine in cholinergic poisoning

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9
Q

cardiac anomaly in marfans

A

AORTIC root dilation, causes regurg
AORTIC aneuryms
AORTIC dissections

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10
Q

evaluatin of physiologic galactorrhea

A

pregnancy test, TSH, PRL, maybe MRI

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11
Q

appearnce of lichen planus vs sclerosis

A

Planus= brightly erythematous and involves labia and vagina + mucosal invovlement
(6 P’s-pruritic, purple, polygonar, plaques)

sclerosis= thin, cigarette paper, only involves vulva, perianal thickening

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12
Q

oral involvenet of lichen Planus

A

lacy, reticular = wickham striae

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13
Q

6 P’s of lichen planus

A

Purple, Polygonal, Planar, Pruritic, Papules

can involve skin, mucosa, nails

tx= bx to rule out vulvar carcinoma, high dose steroids

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14
Q

best test with LOWER extremity changes in sensation, hy[erreflexia and babinski

A

MRI of the spine

UMN signs point to CNS involvement, and lower extremity only= spinal cord.

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15
Q

presentation difference (thinking about the fever) that’s different between roseala and measles

A

roseala –> rash AFTER fever

measles–> rash with fever

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16
Q

mechanism of TD with antipsychotics

A

UPregulation and supersensitivty of DA receptors…

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17
Q

how does caricocele contribute to decreasd fertility

A

increased temperature

boys= tx with gonadal vein ligation
older men= nsaids and supportive therapy

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18
Q

congenital VZV

A

limb hypoplasia
blindness
dermatomal scarring

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19
Q

congential HSV

A

disseminated can present without skin findings –> look for encephalitis with TEMPORAL EDEMA AND HEMORRAGE

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20
Q

causes of magnesium toxicity in pre-E

A

Mg is 100% cleared by kidneys so look at Cr

*first line reversal is Calcium gluconate

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21
Q

factrial design

A

randomizatoin into two interventions with additional study of 2 variable

ie: randomize by treatment and then randomize by two BP goals

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22
Q

cross over design

A

each group does one treatment, after a set number of weeks they switch groups and do the other

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23
Q

feature of hypovolemic shock and septic shock in terms of heart/ pulm pressures

A

DEC RA, PA, wedge

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24
Q

vessel distribution assoc with thalamic pain syndrome

A

deep penetrates of posterior cerebral artery

**occurs weeks to mnths after, presents with contralateral sensory loss from lacunar strke

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25
Q

aspiration pneumonitis

A

HOURS after asp of stomach acid

compared to aspiration PNA which comes days later

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26
Q

what to test for with unexplained cytopenias, like isolated thrombocytopenia

A

HIV, HCV

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27
Q

heart involvement of amyloidosis

A

accumulation of insoluble protein firbrils that commonly affect heart as restrictive cardiomyopatyh –> progresses to dilated cardio myopathy

easy brusing
proteinuria
neuropathy
hepatomegaly

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28
Q

who gets NEC

A

premies AND congenital heart problems who arn’t perfusing the gut well

**look for signs abdominal distention, billious vomiting, bloody stools, signs of vital sign instability like hypothermia from insensible loses

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29
Q

oral or systemic tx for vaginal candida?

A

oral fluconazole is first line for comfort purposes

pseudo hyphae with normal pH!

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30
Q

pulmonary edema in pre E

A

due to arterial vasospasm in inc systemic vascular resistance

**rare complication. dist from amniotic fluid embolism by BP and whether or not they are in labor

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31
Q

calcium/ phos in lactose intolerance/ fat malabsorption disorders

A

don’t absorb D –> dec gut absorption of C/Phos –> dec Ca, dec Phos –> Inc PTH

**secondary hyperparathyroidism

32
Q

effect of Vit D on ca/phos

A

increased absorption of both at the gut

33
Q

most common cause of spinal stenosis

A

DJD –> osteophytes and stuff

relief when leaning forward, worse with extension

34
Q

gold standard dx for HIT? Classic features involved with injection site? Tx?

A

Serotonin relase assay

HIT skin necrosis at injection site on belly

STOP and start argatroban or fondoparinaux

35
Q

hazard ration <1, 1, >1

A 
<1= more likely in control
1= similar
>1= more likely treatment
36
Q

how do you dx HepC

A

2 steps:

  • 1) ab
  • 2) PCR

50% of patients spontaneously clear so you have to confirm it

37
Q

meconium ileus vs hirschsprung in terms of consistency and location

A

MI= inspissated, ileum

HS= normal consistency, rectosigmoid

38
Q

CMV colitis

A

immunocompromised patient with CD4 <50 presenting with small volume, frequent bloody stool and low grade fever

dx= colonoscopy looking for eso/baso internuclear inclusions

39
Q

triad presentation of spinal epidural abscess

A

fever, back pain, focal neuro deficit

*these rarely all present. Staph a is most common organism

40
Q

steps in caustic ingestion

A

1) ABC
2) remove clothing
3) EGD = diagnostic and should be done withn 24 hours. Too soon wont show full extent, too late is risk for perf

41
Q

negative predictive value

A

probablitiy of being free of dz if a test result is negative

(high pretest probability= low NPV)

42
Q

ROM that causes pain in rotatr cuff

A

abduction and external rotation

43
Q

prader wili

A

loss of Paternal 15q11-q13

44
Q

meds that cause iICH

A

tetracyclines
vit A derivatives
GH

45
Q

aderenoleukodystrophy

A

congenital cause of AI characterized by build up of very long chain fatty acids

46
Q

when to suspect a cholesteatoma

A

continued ear drainage for several weeks despite abx in a kid, granulation tissue and skin debris within retraction pockets of TM

  • congenital or acquired from chronic OM
  • think about with new onset hearing loss
  • can lead to bad things
47
Q

classic triad of resp signs in CF? why do they have bruising? differentiate from primary ciliary dyskinesia

A
  • recurrent sinopulm infx, clubbing, nasal polyps
  • impaired vit K asoprtions

PCD has all similar sx but NOT pancreatic insufficiency

48
Q

primary ciliary dyskinesia

A

mucociliary clearnace problem

50% have situs inversus

49
Q

management of neonatal hydrocele

A

conservative, should resolve in a year

-can be communicating or non communicating

50
Q

how does succs work

A

depolarizing agent that binds post synaptic Ach receptors –> Na in, K out

51
Q

how does etomidate lead to adrenal insufficiency

A

blocks 11b-OH

52
Q

“diabetic neuropathy”

A

somatic nerves are central/ more susceptible to ischemia–> ptosis and down and out pupil

parasymp are outside–> preserved light rxn

53
Q

alcohol/ sleep/ anxiety

A

someone who is only anxious at night…consider mild alcohol withdrawal

54
Q

ACA stroke

A
  • contralateral weakness/sensory loss mostly LOWER extremities
  • urinary incontinence
55
Q

refeeding syndrome

A

introduction of cards –> insulin spike –> uptake of Phos, Mg, K

Phos used up the most for ATP
K and Mg cause arrythmias –> can lead to fast volume overload and heart failure signs

56
Q

mech of xs estrogen in obesity

A

androgens converted into estradiol

57
Q

why do anovulatory cycles not produce progesterone

A

no development of corpus lutem

normal= corpus luteum secretes prog –> cnverst proliferative endometrium to secretory endometrium –> corpus lutem sheds –> period

58
Q

hypercalcemia in quadriplegic?

A

immobilization

59
Q

why/ when do you take out testes in AIS

A

after puberty, allow pt to reach maximum hiehg tand secondary development, but take them out because inc risk of cancer

60
Q

in laryngomalacia, when is stridor exacerbated?

A

crying or stress

61
Q

difference between mono presentation and acute HIV

A

similar, flu like illness

HIV- diarrhea, rash

Mono- tonsilar exudate

62
Q

preE at <20 weeks

A

hydatidaform mole

63
Q

risk for mole. presentation?

A

extremes of age, hx of mole

preE, hyperemesis gravidum, hyperthyroid, uterus>age

64
Q

vitreous hemorrhage

A

sudden loss of vision with floaters –> common in diabetic neuropathy

65
Q

central retinal vein occlusion

A
  • sudden painless loss of vision
  • disk swelling, retinal hemmorhage, venous dilation, ctton wool spots

**hypertension and atherosclerosis

66
Q

retinal artery occlusion

A

sudden painless loss of vision with cherry red fovea

67
Q

why are HSP kids at risk for intussusception

A

ileoedema and bleeding

**IgA vasculitis presents with palpable purpura, arthralgias, hematuria, abd pain

68
Q

precipitators of thyroid storm

A

surgery, trauma, childbirth, infx, contrast load (iodine)

look for hyperthermia, tremor, agitation, delerium, LID LAG

tx with BB, PTU, glucocorticoids

69
Q

feature of malignant hyperthermia you probably wouldn’t see in thyroid storm

A

presents with hypercarbia

70
Q

hepatohydrothorax

A

transudative effusion through muscular defect in diaphgram (usu right) in liver failure patients

71
Q

hepatopulmonary syndrome findings

A

intrapulmonary vascular dilations

  • dyspnea while sitting up
  • decrease SpO2 while sitting up
72
Q

how does prevelance relate to PPV/NPV

A

inc Prevelance = inc PPV

dec prevelance= inc npv

73
Q

tabes dorsalis presentation

A

romberg, sensory ataxia, neurogenic incontinence, argyll robertson pupils (don’t respond to light but do respnd to accomodation

74
Q

what type of cancer is paget’s

A

adenocarcinoma

75
Q

dangerous complications in mono

A

splenic rupture
airway compromise
AHIA –> IgM, coombs, inc retics
**happens about 2-3 weeks later

76
Q

how do you address fixing refractory hypokalemia in alcoholic?

A

replete mag

USMLE Step 2 (18 decks)

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