Aaron: Uworld IM Deck 2 Flashcards by Aaron Sircy

What drug can help acute heart failure exacerbation if no chest pain or ST elevations?

Nitroglycerin

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What HTN med has a photosensitivity reaction?

Hydrochlorothiazide

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Topical Fluocinonide 0.05% is the tx for what skin condition?

Psorasis

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CML, what is the best treatment choice?

Tyrosine Kinase Inhibitor

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Mono infection, persistent lymphadenopathy, what should be done?

Biopsy

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If a patient has a smoking history and left lung mass, what is a concerning sign?

Right Leg hyper-reflexia

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As a general rule of thumb, if a patient has a brain tumor, what is it most likely?

Metastatic cancer, individual brain tumors do happen, but #1 is metastasis

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DIC vs ITP what labs will be normal for ITP and not normal in DIC?

Ddimer, PT, and PTT

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Medullary Cancer s/p surgery 6 months and Calcitonin is still elevated, what is going on? What is the next step?

Metastasis, repeat CT scan of Neck and Chest

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If a patient has Hodgkin Lymphoma, (treatment or no treatment), what is most likely cause of an AKI?

Tumor Lysis Syndrome

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Iron Deficiency anemia in a 55 year old male, what is the next best test?

FOBT (I know)

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If a patient has HIT, should they avoid all Heparin products for the rest of their life?

YES!!!!

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Tumor Lysis Syndrome can cause Kidney Damage, what is the common stone type?

Calcium Phosphate Stones

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Does an IVC filter increase the risk of a DVT?

Yes! But it halves the risk of a PE

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A young male with a mom family history of clotting disorder. Patient develops a cold leg, no pulses. Sensation and ROM are intact. What is the most likely diagnosis?

Atrial Myxoma, i know.

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Microcytic Anemia, what is the next best step to evaluate?

Normocytic Anemia, what is the next best step to evaluate?

Iron Studies

Reticulocyte Count

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Once Multiple Myeloma is diagnosed, what is the next best step?

Whole Body CT scan w/out contrast

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If a patient has Autoimmune metaplastic atrophic gastritis, what is the most common endoscopic finding?

Absent Rugae in the fundus

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Elevated PSA and Shoulder Pain, what else should be done?

Should biopsy, concern for a metastatic prostate lesion

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CCL onset, what is a poor prognostic sign seen in the labs?

Thrombocytopenia

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A patient has a recent MVA, they have chest discomfort a day later with normal coronaries and troponins. What is another thing to think about?

Takotsubo CM

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All CHF potential patients need what?

Echo

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Bicuspid valve has an increased risk of what?

Aortic Aneurysm

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Patients with HOCM and asthma. If non-selective Beta blockers are not needed. What is the next best medication?

Calcium channel blocker, such as verapamil

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A young patient 30 years old, severe HTN recently, facial swelling, pulses equal throughout, family Hx of HTN, what is next place to look?

Renal Interstitial Disease

What is the number one risk factor for colon cancer?

Alcohol

What is the best Anemia of Chronic Disease treatment?

Treat the underlying cause, i.e. RA, give infliximab

Type 2 HIT occurs, Argotroban is started, if the platelets take a hit, eventually warfarin needs to be restarted. When should that happen?

After the platelet levels recover

Cryoprecipitate which contains what clotting products?

Factors VII and XII, vWF

FFP is used to replete what?

Multiple Clotting Deficiency factors

Platelet dysfunction can lead to decrease platelet aggregation due to uremia despite normal platelet numbers. What can help that problem?

Desmopressin and help improve vWF

Prostate metastasis to the spine, what is the treatment for that?

Radiation therapy, no Neurosurgery unless there is a structural problem

When HTN drugs are being handed out, what is one other test that has to be checked first?

Fasting Lipid Panel

Aortic Dissection, what is the drug of choice?

Esmolol

Peri-infarct pancreatitis, what is the next treatment step?

Aspirin

A stent is place s/p 3 days, inflation and scratchy heart sounds are heard, what is the most likely diagnosis?

Pericarditis

Trastuzumab can cause cardiotoxicity. Is the cardiotoxicity permanent?

No, it can be reversed

Severe HTN s/p cocaine use can cause elevated BP. If a patient has right arm and leg weakness. What is the next best step?

Scan Chest, concern for Dissection

Acute Paronychia is called what? What is the treatment?

Finger nailbed infection Tx: Warm Water soaking and abxs

Scaly and itchy skin, Ichthyosis Vulgaris, what is the treatment of choice?

Urea-containing lotion

Actinic Keratosis that leads to squamous cell carcinoma, what is the treatment of choice?

Topical 5-fluorouracil cream

Psoriatic arthritis is best treated with what?

Methotrexate

Rash in flexural surfaces, genitals, and mouth. Plus the patient is Hep C positive. What is the most likely rash cause?

Lichen Planus

Gingko Bilboa, what is the most common side effect?

Bleeding Disorder

If a young person has unilateral light sensitivity, blurry vision, sudden onset, no trauma, what is the most likely cause?

Anterior Uveitis

A-fib with structural heart disease, what is the best medication? A-fib without structural heart disease, what is the best medication?

Amiodarone Flecanide

What drug inhibits the tubular secretion of diogoxin?

Verapamil

In acute decompensated heart failure, what medication should be avoided?

Metoprolol

First line drug to slow down a-fib

Beta blocker or non-dihydropyr. calcium channel blocker

If the patient has a bicuspid valve, what should all 1st degree family members have?

Echo

CKD patients can have atypical symptoms for what kind of cardiac condition?

Myocardial Infarction

A patient has widened QRS complex after having chemotherapy, what is this heart arrythmia due to?

Severe Hyperkalemia

Edema, asicities, and hepatic congestion, what are the things to think about?

Constrictive Pericarditis

If a patient has elevated STs and no troponin increase, not to mention cocaine use, what is the next best test?

PCI

Number #1 thing that reduces blood pressure?

Weight loss

Loud first heart sound and mid-diastolic rumble best heard at cardiac apex and elevated right heart pressures, what could this be?

Mitral stenosis 2/2 Rheumatic Heart Disease

A patient on a statin that has elevated CK levels 2/2 injury or exertion should do what before the medication is restarted?

Recheck CK levels

Restless Leg Syndrome has what associated disease?

Iron Deficiency Anemia

What is the treatment for Restless Leg Syndrome?

Gabapentin

SLE patient's have a higher risk of what heart problems?

Coronary Atherosclerosis

If a patient aspirates, should they be empirically covered for anaerobes?

No, not unless they have an abscess or empyema

In order for patients to have Acute Interstitial Nephritis, what are a few other hallmark signs?

Fever and Rash, if not, think ATN

Back pain that wraps around the back to the front with marked weakness and numbness/tingling, decrease reflexes, and upgoing Babinksi reflexes is concerning for epidural spinal cord compression. What is the next treatment step?

High Dose Corticosteroids and MRI

If deciding breath death or no brain death, the patient took benzos and baclofen, what must be done first?

Wait 3-5 days, drugs have to wear off first before brain death can be pronounced

Are migraines associated with a runny nose and eye tearing?

Usually no, think about Cluster headaches

What is the Bromocriptine mechanism of action?

A dopamine agonist

Assuming a young kid has paralysis via tick bite, what is the next best step?

Look for and remove Tick

If a person may have Lyme disease with facial paralysis, what is the next best step? Steroids or Lyme Serology

Lyme Serology

Pregnant patients that have M.S. are more likely to have what problems with giving birth?

More likely to have C-Section or Vaginal Assitance during delievery

M.S. exacerbation what is the best treatment?

IV steroids

Xanthochromia has RBC breakdown, which means blood has been there a long time, if a patient has RBCs but Xanthochromia, what does this mean?

A blood vessel was hit on the way in, traumatic lumbar puncture

If a patient has Herpes Encephalitis, what is a common diagnostic feature as well?

AMS

Oromandibular Dystonia has sustained, involuntary muscle contractions, but they can be relieved by what?

A sensory trick, i.e. a water bottle pushing on the jaw

What lung function feature should be evaluated with GBS?

Bedside Vital Capactiy

Idiopathic Intracranial HTN is managed with Acetazolamide. What is the prescribed management with this drug?

Decreased CSF production by the choroid Plexus

When a patient has a symptomatic pituitary tumor, what is the next step in management? Assuming really high Prolactin level

Add dopamine agonist, first then potential surgery

Does Bell's palsy have a high recurrence rate?

Yes

What type of stroke has oculomotor palsy attached to it?

PCOM aneurysm

Bad vitamin B12 can lead to what?

Ineffective Erythropoesis

S/P Stroke diagnosis, should patients be given DVT prophylaxis?

Yes

What is a non-common stroke cause in young adults? Particularly with high risk sexual activity?

Syphillis Menioencephalitis

Reduced blood flow to the brain can cause vertigo symptoms, stocking-glove pattern, what is the name of this phenomenon?

Vertebrobasilar Insufficiency

Stocking and glove decrease in sensation bilaterally, what is the most common cause of this problem?

Diabetic neuropathy, also can have loss of cremasteric muscle.

If a patient is hemodynamically stable and has bright red rectal bleeding. What should the patient have done?

Emergent Colon

A high stool gap will show what? Chronic malabsorption syndrome, what will it be?

Celiac's Disease

SAAG score greater than 1.1 one indicates what? SAAG score lower than 1.1 one indicates what?

Portal Hypertension (CHF, Cirrhosis, and Alcoholic Hepatitis) Non-portal Hypertension (peritoneal carcinomatosis, TB, and nephrotic syndrome)

A patient has gastric reduction surgery and has constant diarrhea. We are concerned for dumping syndrome. What is the right diet?

High Protein

Transmural lymphocytic inflammation is code for what, in a GI patient? May also have crypt abscesses.

Crohn's Disease

Overweight patient with elevated Liver enzymes, no acute causes, infections, or drug use. What is the most likely cause?

NASH

If an admitted variceal bleeding patient is admitted to the hospital, what is the most common adverse advent that can happen, to them? Assume they are a heavy alcoholic

SBP

Young patient, with GERD, difficulty swallowing, what is the first thing to think about?

Stricture

What is a common finding with Celiac's Disease?

Iron Deficiency Anemia

If a woman has a positive AMA what does this mean?

PBC, will need a transplant

Hepatic adenoma, greater than 5 cm what should be done?

Surgery

Cherry red lesions in the colon can cause anemia, these lesions are associated with vW disease and Aortic stenosis, what is the name of the lesion?

Angiodysplasia

PSC, can damage the bile ducts, but is also associated with what?

Ulcerative Colitis