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Shelf exams PK Edit > Medicine- Uworld > Flashcards

Medicine- Uworld Flashcards

1
Q

ATN vs AIN basics

A

ATN: hypotension, AGs –> BROWN muddy casts

AIN: drugs, abx (PCNs, cef, TMX) –> white blood cells, esopinophils, maculorpapular rash

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2
Q

dense intramembranous deposits that stain + for C3 on renal bx

A

membranoproliferative glom –> persistent activation of alternative complement pathway

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3
Q

most common kidney stone

A

calcium oxalate

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4
Q

when is increased fluid intake approp in nephrolithiasis?

A

when stones are <5mm

  • inc urinary flow
  • dec urinary solute concentration to prevent further stone formation
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5
Q

plan for hyperkalemia

A

Shift K out of serum into cells –> insulin/ glucose, inhaled beta ag, NaHCO3

Stabilize cardiac membrane –> calcium carbonate

Removal from body –> diuresis, HD, cation exchange resins

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6
Q

Renal vein thrombosis

A

complication of nephrotic syndrome (loss of AT III)

most commonly seen in mebranous glomerular nephropathy

RVT p/w: acute hematuria, abdominal pain, fever

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7
Q

aspirin toxicity sx triad

A

fever, tachypnea, tinnitus

***mixed metabolic acidosis with resp alkalosis, expect to see a relatively nl pH

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8
Q

learn contraction alkalosis

A

loss of fluid, ie from vomiting, triggers RAAS, which kicks in aldosterone –> inc Na reabsorption at the expense of K/H.

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9
Q

Chronic NSAID use can induce _________ anemia

A

Fe deficiecny

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10
Q

MEN1

A

1) Hyperparathyroid/ adenoma –> hypercalcemia
2) pancreatic islet cell neoplasia –> gastrinoma, VIPoma, insulinoma, glucagonoma
3) pituitary adenoma

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11
Q

MEN 2A vs 3B

A

RET protooncogene
both have: medullary thyroid carcinoma + pheo

2A= parathyroid hyperplasia

2B= mucosal and gastrointestinal neuromas

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12
Q

gastrinoma (ZES) diagnosis

A

fasting serum gastrin (off PPI one week)
<110 pg/ml= nl
>1000pg/ml= diagnostic

110-1000 –> secretin stimulation test. Secretin should inhibit normally functioning G cells

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13
Q

crunching sound on auscultation following esophageal rupture

A

hamman’s sign

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14
Q

sponteneous rupture of esophagus from vomiting

A

borehaav syndrome

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15
Q

offenders in pill induced esophagitis

A

KCl –> osmotic effect
NSAIDs
Bisphosphonates
Tetracyclines

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16
Q

primary proph for esophageal varices in cirrhosis?

A

nonselective beta blocker

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17
Q

precipitating factors of hepatic encephalopathy

A
  • low Na, K
  • hypovolemia –> diarrhea, too much diuresis
  • nitrogen load –> ex GI bleed
  • drugs
  • TIPS
  • infections
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18
Q

how does hypokalemia induce hepatic enceph?

A

dec K –> inc intracellular H+ to maintain neutrality –> so tublar cells inc NH3 production via glutamine progression

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19
Q

most common bugs isolated in ascites? treatment?

A

GNR –> e coli, klebsiella
staph

tx with 3rd gen ceph

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20
Q

symmetric circumfrential narrowing on barium swallow

A

esophageal stricture

  • -> progressive dysphagia to solids without weight loss
  • bx to ro adenocarcinoma

can be cause by sclerosis, irritants, reflux –> inflammation, or irritatnts

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21
Q

longitudinal tears in mucosal lining near GE junction. Contrasted to esophageal perf that presents with vomiting….

A

mallory weiss
supportive care generally

borheave

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22
Q

VHL associated cancers

A

renal cell
pheo
hemangioblastomas

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23
Q

two associations with PBC besides positive AMA antibody, hm, generalized pruritis are….

A

osetoporosis/ osteomalacia

hyperlipidemia –> xanthelasomas

24
Q

what is the charcot triad assoc with acute cholangitis?

reynolds pentad?

A

fever, jaundice, RUQ
+
hypotension, AMS

25
Q

rotors syndrome shows bilirubin on urinalysis because it has a build up of _________ which is _________

A

CONJUGATED bili which is WATER SOLUBLE

26
Q

d-xylose test

A

NOT broken down by pancreatic enzymes = normal absorpotion in pancreatic insuf

ABSORBED by intestinal brush –> abnormal test in celiac disease

27
Q

how do vagal manuevers help in AVNRT

A

they trigger parasympathetic tone which slows conduction at AV node an increase in AV node refractory period to restore rythm

cold water (dive reflex), valsalva, carotid massage

28
Q

with super high BP you generally want to decrease slowly except for in……..

A

dissection! Decrease rapidly within 20 minutes. IV labetalol

29
Q

first line for torsades

A

IV mag

30
Q

first line for symptomatic brady or heart block

A

atropine

31
Q

causes of pericarditis

A 
Infx= most common
iatrogenic
connective tissue= RA, SLE
Uremic = BUN>60 usu
cardiac= dressler
malignant= hodgkin, lung, breast, RADIATION
32
Q

first line aortic dissection for BP

A

IV beta blocker, ie labetolol, to decrease BP as well as Hr and contractility

**hydral can cause reflex tachy

33
Q

Hyponatermia in CHF?

A

independent predictor of poor prog

mech: low CO –> inc renin, ADH, norepi –> all lead to increased water retention –> hyponatremia

34
Q

reversible causes of complete heart block

A

myocardial ischemia
inc vagal tone –> pain, sleep
metabolic –> hyperK
AV nodal blocking agents –> bb, ccb

35
Q

cause of aortic dissection before 40? after 60?

A

<40= marfans

> 60= HTN

36
Q

becks triad

A

hypotension
distended neck veins
muffled heart sounds

37
Q

medications to withhold before exercise stress test

A

beta blockers
CCB
nitrates

***anything that is antianginal

38
Q

norepinephrine induced vasospasm

A

norepi has alpha 1 agonist properties –> vasoconstriction –> can see dusky cool fingers and toes in someone on pressors

39
Q

how do you respond to PEA

A

pressors and CPR

40
Q

how do you treat SIADH?

A

fluid restrict

41
Q

what is gold standard for cor pulmonale diagnosis? And what is the def?

A

right heart cath showing RVH and PH

42
Q

most common Superior sulcus tumor (pancoast tumor)

A

squamos cell and small cell of lung

-can cause parasthesias of 4th, 5ht, medial arm, forearm

43
Q

secondary spontaneous pneumothorax in someone with COPD

A

bleb rupture –> bleb is cause by chornic destruction of alveolar sacs –> creates “bleb” –> can rupture and allow air to flow into intrapleural space

44
Q

digital clubbing with sudden onset joint arthropathy in wrists in smoker

A

COPD –> hypertrophic osteoarthropathy

45
Q

signs of impending respiratory failure

A

decreased breath sounds
absent wheeze
change/dec mental status
hypoxia and cyanosis

46
Q

clinical findings in wegeners?

upper resp, lower resp, heme, renal, skin

A

UR: chronic sinusitis, saddle nose deformitry –> tracheal ulceration
LR: cavitation, nodules
heme: anemia of chronic dz
renal: RPGN
skin: livedo reticularis, nonhealing ulcers

47
Q

lights criteria

A

fluid prot/serum prot >0.5
fluid LDH/serum LDH >0.6
fluid LDH >2/3 ULN

48
Q

indications that a pleural effusion is “complicated”

A

low pH, low glucose (<60), high protein (>50kWBC)

49
Q

most common cap bugs

A

strep
legionella
mycoplasma
h flu?

50
Q

what are CURB65 crit and what does it mean?

A

confusion
BUN > 20
>65 yo
*should be admitted to hospital for managment of PNA

51
Q

type of shock seen in massive PE?

A

obstructive! increased right heart and pulm pressures with decrease wedge pressures

52
Q

3 things that PROLONG survival in COPD?

A
  1. supp O2
  2. quit smoking
  3. lung reduction surgery
53
Q

type of lung process that has INC breath sounds and tactile fremitus

A

consolidation

54
Q

t/f: afib is associated with PE?

A

true

irregular RR intervals with no p waves on EKG

55
Q

vent settings for ARDS

A

low TV

high PEEP, FiO2

56
Q

epigastric pain that radiates to interscapular region, relieved by CCB or sublingual nitroglycerin

A

diffuse esophageal spasm

dx with manometry –> intermittment peristalsis with simultaneous contractions –>”corkscrew”

57
Q

stool pH in lactose intolerance

A

ACIDIC –> test with hydrogen breath test
inc stool osmotic gap
positive stool reduction test

Shelf exams PK Edit (40 decks)

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