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Medicine > step 3 20 > Flashcards

step 3 20 Flashcards

1
Q

porcelain gallbladder management

A

refer for prophylactic cholecystectomy

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2
Q

breast mass management

A
  • if under 30, US plus, minus mammogram. If simple cyst, FNA. If complex cyst, image-guided core biopsy
  • if over 30, US + mammogram, if suspicious then biopsy
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3
Q

bullous pemphigoid management

A

Mild cases are managed with topical high-potency glucocorticoids, but more severe cases require treatment with systemic glucocorticoids and steroid-sparing agents.

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4
Q

first step with bullous pemphigoid

A

skin biopsy and serum assay for basement membrane antibodies

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5
Q

bullous pemphigoid management

A

prodrome of itching and urticaria, which was followed by an outbreak of an erythematous rash with tense bullae

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6
Q

treatment of asymptomatic lead toxicity

A

identify and remove lead sources, children with

  • mild lead toxicity (5-44 µg/dL) – repeat venous blood lead level within 1 month
  • moderate 45-70– (Meso-2,3-dimercaptosuccinic acid (DMSA, succimer)
  • if over 70 – Dimercaprol (British Anti-Lewisite) + calcium disodium edetate (EDTA)
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7
Q

indications for bariatric surgery

A

BMI >40 kg/m2 OR obesity-related comorbidity (osteoarthrits) and BMI >35 kg/m2.

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8
Q

severe hip pain in obese patient management

A
  • conservative measures, then bariatric surgery

- joint replacement relatively contraindicated

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9
Q

ectopic pregnancy diagnosis

A

Positive hCG

Transvaginal ultrasound revealing adnexal mass, empty uterus

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10
Q

ectopic pregnancy management

A

Stable: Methotrexate
Unstable: Surgery

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11
Q

PMR presentation

A

elevated erythrocyte sedimentation rate and pain and stiffness in the neck, shoulders, and pelvic girdle.

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12
Q

PMR treatment

A

low dose prednisone

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13
Q

relatively risk conceptually

A

Risk of a certain outcome (eg, sudden cardiac death [SCD]) in a given group (eg, low-dose hydrochlorothiazide [HCTZ])
divided by

Risk of that same outcome in another group (eg, high-dose HCTZ).

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14
Q

most valid measure of central tendency in distributions

A
  • if normal distribution then mean

- if skewed distribution then median

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15
Q

mortality risk of smokers who quit

A

mortality risk falls below current smokers within 5 years of quitting

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16
Q

what to expect with cough when quitting smoking

A

can be an initial temporary increase in cough during the first few weeks after cessation

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17
Q

mammograms start at

A

40-50, depending on organization

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18
Q

population attributable risk calculation

A

PARP = (Risk in the total population – Risk in the unexposed) / Risk in the total population.

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19
Q

Pulmonary contusion presentation and CXR findings

A

chest pain and may develop respiratory distress and hypoxemia that is delayed up to 24 hours from the time of injury. Chest x-ray characteristically shows an irregular, localized lung opacification.

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20
Q

central venous sinus thrombosis

A
  • rare, potentially life-threatening condition characterized by the formation of a blood clot within the dural sinuses.
  • usually happens in pregnancy
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21
Q

anti-dsDNA test characteristics

A

sensitive for SLE

22
Q

antibody to use to monitor for SLE flare

A

anti-DSDNA

23
Q

how to assess for lupus nephritis

A

anti-DSDNA (immune complexes containing these antibodies are actually seen within the glomeruli of patients with lupus nephritis)

24
Q

management of arthralgias, serositis, and cutaneous symptoms in SLE

A

hydroxychloroquine

25
Q

dupuytren contracture presentation

A

progressive fibrosis of the palmar fascia. It presents with thickening and nodule formation along the flexor tendons near the distal palmar crease, leading to contractures with decreased extension.

26
Q

diagnostic relevance of ED

A

strong predictor of coronary artery disease

27
Q

first step in patient with ED and atherosclerotic disease

A

screen for cardiovascular disease – ankle-brachial index, cardiac stress testing) prior to initiating specific therapy for sexual dysfunction.

28
Q

other major disease associated with breastcancer in men

A

klinefelter syndrome

29
Q

central retinal artery occlusion presentation

A

acute, painless, monocular vision loss. Funduscopy shows diffuse ischemic retinal pallor and a cherry red macula

30
Q

central retinal vein occlusion presentation

A

painless, acute, or subacute monocular vision loss. Central retinal vein occlusion is usually due to nonembolic causes. Examination can show tortuous and dilated veins, diffuse hemorrhages, disk swelling, and cotton wool spots.

31
Q

central retinal artery occlusion management

A

urgent ophthalmology consultation and interventions to lower intraocular pressure

32
Q

dyspepsia management

A

IF age ≥60, weight loss, gross or occult bleeding, anemia, dysphagia, or early satiety → EGD
IF NSAID induced → stop NSAID + start PPI
IF younger than 55 AND from endemic area treat empirically for Hpylori
IF NSAID/COX-2 use → discontinue agent OR add acid suppression

33
Q

deal with varenicline and neuropsych SE’s

A

Despite initial concerns about depression and increased suicidality with varenicline, newer findings have not substantiated this, and the black box warning for these adverse effects was removed in 2016

34
Q

osteoporosis and osteopenia on DEXA scans

A

Osteoporosis (T-score 20% or hip fracture >3% based on the fracture assessment tool (FRAX) risk calculator

35
Q

bisphosphonate therapy indications

A

Low bone mass with a history of fragility fracture

Osteoporosis (T-score 20% or hip fracture >3% based on the fracture assessment tool (FRAX) risk calculator

36
Q

management of heavy alcohol use in young adults

A

screening and a brief counseling intervention

37
Q

HPV age range for women

A

12-26

38
Q

chronic urticaria presentation

A

well-circumscribed, raised erythematous plaques with central pallor and intense pruritus

39
Q

chronic urticaria treatment

A

stepwise approach with an initial second-generation antihistamine (eg, loratadine) in addition to avoidance of aggravating factors (if identified). Refractory patients can try other therapies, including an H1 blocker, leukotriene receptor antagonist, H2 blocker, or a brief course of oral steroids.

40
Q

chronic urticaria prognosis

A

self-limited condition that resolves spontaneously within 2-5 years

41
Q

management of functional abdominal pain

A
  • symptom diary is recommended to characterize the pain and guide treatment.
  • reassurance
42
Q

other presentation of OSA in elderly

A

mild cognitive impairment (eg, irritability, poor concentration, decreased memory)

43
Q

paget’s treatment

A

Six months of treatment with oral alendronate and two months of treatment with oral risedronate

44
Q

paget’s workup

A

technetium bone scan

45
Q

isolated gastric varices etiology

A

splenic vein thrombosis

46
Q

splenic vein thrombosis cause

A

Thrombosis occurs as the splenic vein runs along the posterior surface of the pancreas and can become damaged or compressed due to pancreatic inflammation (or pancreatic masses/pseudocysts).

47
Q

prognosis of trastuzumab-related cardiotoxicity

A

reversible after stopping trastuzumab

48
Q

AKs increase risk for what?

A

squamous cell carcinoma (this is why all AK’s need to be removed or destroyed)

49
Q

leser-trelat sign + association

A
  • acute onset of numerous seborrheic keratoses
  • The Leser-Trélat sign is associated with many internal malignancies, most commonly adenocarcinomas of the gastrointestinal tract.
50
Q

consequence of recall bias

A

leads to misclassification of exposure.

51
Q

disseminated gonorrhea presentation

A
  • Patients with DGI are typically unaware of the urogenital infection and usually seek clinical attention with either mono- or oligoarthritis or a triad of manifestations including
  • mono- or oligoarthritis or a triad of symptoms including dermatitis (pustular lesions on the distal extremities), tenosynovitis (swelling and pain with passive extension of multiple tendons), and polyarthralgia

Medicine (71 decks)

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