Deck 42: Medicine Flashcards Preview

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Flashcards in Deck 42: Medicine Deck (55)
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1

3 common causes of aortic stenosis

1. senile calcific aortic stenosis
2. bicuspid aortic valve
3. rheumatic heart disease

2

cause of aortic stenosis in majority of patients under 70 years old

bicuspsid aortic valve

3

Myxomatous valve degeneration usually causes what problem

mitral valve prolapse

4

Most common cause of aortic stenosis in patients older than 70

senile calcific aortic stenosis

5

Initial imaging study of choice in patients with unprovoked first seizure to exclude acute neurologic problems

CT without contrast
- MRI if elective or nonemergency

6

What can noncontrast CT show of brain

intracranial or subarachnoid bleed

7

CT of brain with contrast can identify

structural abnormality or mass lesions

8

initial management of forstbite

rapid rewarming of affected tissues

9

Difference between hypopituitarism and primary adrenal insufficiency

Aldosterone is normal in central adrenal insufficiency due to hypopituitarism

10

3 things that characterize hypopituitarism

1. glucocorticoid deficiency
2. hypogonadism
3. hypothyroidism

11

what is not made in primary adrenal insufficiency? consequenses

- decrease aldosterone
- hyperkalemia and severe hypotension
- increase ACTH, hyperpigmentation

12

aburpt onset of regular tachycardia that resolves with col-water immersion, what do I have

paroxysmal supraventricular tachycardia

13

most common form of paroxysmal supraventricular tachycardia? who gets it?

atrioventricular nodal reentrant tachycardia
- young patients with a structurally normal heat

14

Vagal maneuver does what do the heart

increase parasympathetic tone
- slowing conduction in AV node
- increase in AV node refractory period

15

Atrial fibrillation with rapid ventricular response, initial treatment

- beta blockers
- calcium channel blockers

16

3 main goals for atrial fibrillation

1. control ventricular rate
2. restore normal sinus rhythm
3. asses need for anticoagulation

17

how do you determine if an Afib patient needs antithrombolytics

CHAD2DS2-VASc score

18

CHAD2S2-VASc

- congestive heart failure
- hypertension
- age 75 older
- diabetes mellitus
- stroke/TIA/thromboembolism
- vascular disease
- age 65-74
- sex

19

drug treatment for paroxysmal supraventricular tachycardia

adenosine: slows AV node to interrupt reentry pathway

20

what should be suspected in any patient with cirrhosis and ascites who presents with low-grade fever, abdominal discomfort, or altered mental status

spontaneous bacterial peritonitis

21

Reitain trail test

- timed connect-the-numbers test,
- detects subtle mental status changes

22

first step in evaluation for thyroid nodule

TSH and ultrasound

23

when do you use radionuclide scan in thyroid nodule

patients with low TSH

24

how do you treat hot thyroid nodules

most are benign, treated for hyperthyroidism

25

what happens in popliteal (baker) cyst

- extrusion of synovial fluid from knee joint into gastrocnemius or semimembranosus brusa

26

2 risk factors for popliteal (Baker) cyst

- trauma
- underlying joint disease

27

clinical presentation for popliteal (Baker) cyst

- chronic, painless bulge behind knee
- crescent sign: arc of ecchymosis visible distal to medial malleolus

28

anserine bursitis

subacute medial knee pain

29

Meningococcal vaccination should be given when ?

age 11-12
booster: 16

30

3 contraindications for yellow fever vaccine

1. allergy to egg
2. AIDS
3. immunosuppressive therapy