Random1 Flashcards Preview

Uworld Buzz step2 > Random1 > Flashcards

Flashcards in Random1 Deck (130):
1

Onset of mild alcohol withdrawal?

6-24 hrs

2

Onset of Seizures from alcohol withdrawal?

12-48hrs

3

Alcoholic hallucinosis onset?

12-24 hrs, resolves w/in 48hrs

4

Delirium tremens onset?

48-96hrs

5

alcoholic hospitalized for operation, now 24 hrs later having visual hallucinations, stable VS and orientation. Dx?

alcoholic hallucinosis

6

Normal saline is a crystalloid or colloid?

Crystalloid

7

When are colloid solutions used?

In burns or conditions w/ hypOproteinemia

8

mainstay of dehydration treatment?

rehydration w/ IV sodium containing crystalloid solutions

9

acute onset unilateral weakness + positive Babinski sign = think?

acute ischemic stroke

10

tPA should be given to stroke pt w/o hemorrhage w/in?

3-4.5 hrs of symptom onset

11

what should be held and for how long should a stroke pt receive fibrinolytic therapy?

aspirin for 24hrs

12

fears of negative evaluation and embarrassment in social and performance situations = Dx?

Social anxiety disorder

13

poor eye contact + anxiety attacks when doing presentations = think?

social anxiety disorder

14

performance anxiety is included in what type of anxiety disorder?

social anxiety disorder

15

acute onset polyarticular and symmetric arthritis that resolves w/in 2mo, Dx?

Viral arthritis

16

monoarticular arthritis (4)?

- Osteoarthritis
- Septic arthritis
- Crystalline arthritis (gout)
- Seronegative spondyloarthropathies (+ back pain)

17

Symmetrical arthritis (2)?

- Rheumatoid arthritis
- Lupus

18

Effective treatment of cancer-related anorexia/cachexia syndrome? (2)

- Progesterone analogues (megestrol acetate)
- Corticosteroids (more side fx)

19

Effective treatment of advanced HIV cachexia?

synthetic cannabinoids

20

delayed treatment of appendix (>5days) may dev into?

Appendiceal rupture --> appendiceal abscess

21

What maneuvers are best for appendiceal abscess dx?

- Psoas sign (extension)
- Obturator sign (internal rotation)
- Rectal tenderness (esp on R rectal wall)

ant palpation may be less useful bc is deep tissue

22

Rx of appendiceal abscess if pt is stable?

- IV abx, bowel rest, and possibly percutaneous drainage of abscess
- return in 6-8 wks for appendectomy

immediate surgery has high complication rate so wait for it to calm down

23

arthralgias + psychosis + hematuria + proteinuria - concerning for?

Lupus

24

acute onset of psychosis in a child or adolescent --> psych rare, what else is on diff dx? (7)

- CNS injury, infx, dysfunction (epilepsy)
- Metabolic disturbances (urea cycle disorder, acute intermittent porphyria, wilson disease, renal/liver fail)
- Autoimmine (Lupus, Thyroiditis)
- Electrolyte disrturbances (glucose, Na, Ca, Mg)
- Illicit substances or withdrawal from them
- Medication intoxication (serotonin syndrome, steroids, abx, anticholinergics, etc)
- Medication withdrawal (baclofen, benzo's)

25

Prior gyn surgery esp a LEEP or cone biopsy puts pt at risk of?

cervical insufficiency/incompetence

26

gold standard for evaluating cervix for cervical incompetence/insufficiency?

transvaginal ultrasound

-abdominal u/s not accurate

27

Complications of diethylstilbestrol? (5)

- Clear cell adenocarcinoma of the vagina and cervix
- Structural anomalies of rep tract (hooded cervix, T shaped uterus, etc)
- Pregnancy problems (ectopic, preterm, etc)
- Infertility
- Males: Cryptorchidism, microphallus, hypospadias, & testicular hypoplasia

28

Clear cell adenocarcinoma of vagina and cervix --- maj risk factor?

Diethylstilbestrol exposure in utero

29

Overriding aorta is? think?

- when the aorta is over a VSD rather than LV
- Tetralogy of Fallot

30

What are quad in tetralogy of fallot?

- Right ventricular outflow tract obstruction (ie pulm stenosis or atresia)
- RVH
- Overriding aorta
- VSD

31

Harsh systolic ajection murmur over L upper sternal border + single s2?

Tetralogy of Fallot

32

Right to L shunts? (5)

5 T's
1. Truncus arteriousis (1 vessel)
2. Transposition (2 switched vessels)
3. Tricuspid atresia (3 - tri)
4. Tetralogy of Fallot (4 - tetra, most common)
5. Total Anomalous Pulmonary Venous Return (5 words, TAPVR)

Early cyanosis (eaR-->Ly)

33

Eisenmenger syndrome?

Uncorrected L--> R shunt causing pulm HTN --> RVH --> shunt becomes R to L --> cyanosis, clubbing, polycythemia in KIDs (LateR)

34

cyanosis in a kid w/ clubbing and polycythemia - think?

Eisenmenger syndrome
(L--> R shunt that switches and causes cyanosis LateR)

35

Transposition of great vessels associated w/?

DM mom

36

Ebstein Anomaly associated w/?

Prenatal Li exposure

37

Ebstein anomaly is?

Atrialized RV

38

Supravalvular aortic stenosis associated w/?

Williams syndrome (deletion in elastin)

39

22q11 syndromes (ie DiGeorge) associated w/ what cardiac issues (2)?

- Truncus arteriosus
- Tetralogy of Fallot

40

Alcohol exppsure in utero (fetal alcohol syndrome) --> what cardiac issues (4)?

- VSD
- ASD
- PDA
- Tetralogy of Fallot

41

Boot shaped heart on xray think?

Tetralogy of Fallot

42

Low birth weight + closed fists w/ overlapping fingers + micrognathia + rocker-bottom feet - think?

Edward's syndrome (Trisomy 18)

43

Micrognathia?

Undersized jaw (mandibule hypoplasia)

44

Hypotonia + flat face + upward and slanted palpebral fissure + hypoplasia of middle phalanx of 5th finger + brushfield spots + high arched palate - think?

Down syndrome

45

cleft lip + flexed fingers w/ polydactyly + low set ears + large distance b/t eyes (ocular hypotelorism) + hypoplastic ribs - think?

Patau's syndrome (Trisomy 13)

46

microcephaly w/ protruding metopic suture - think?

Cri-du-chat syndrome

47

Obstructive lung disease FEV/FVC

DECREASED ---> FEV/FVC

48

Restrictive lung disease FEV/FVC?

Normalish --> FEV/FVC >70%

49

Mom w/ Graves disease + euthyroid during pregnancy --> neonatal tachy w/ low birth weight and irritable - think?

Neonatal thyrotoxicosis (hyperthyroid)

50

Neonatal thyrotoxicosis caused by?

Transplacental passage of maternal anti-TSH receptor Ab (Abs bind to infant's TSH receptors --> excessive thyroid hormone release --> hyperthyroid)

51

Dx neonatal thyrotoxicosis cause?

Test for ant-TSH receptor Ab

52

Rx of neonatal thyrotoxicosis?

- short term rx w/ methimazole + beta blocker
- self resolves over weeks - months

53

Does levothyroxine cross placenta?

NO

54

Trihexyphenidyl can cause what maj side fx?

Anticholinergic excess (blind as a bat...etc)
- headache, dizziness, tachy, acute glaucoma

55

Selegiline is? maj complication?

MAO-B inhibitor
Serotonin syndrome

56

GI perforation + pt on warfarin for afib --> best initial step (after fluids, abx, NG tube compression)?

Fresh frozen plasma prior to surgery
- (to rapidly normalize PT by restoring vit K dependent clotting factors - don't want to bleed in surg)

57

Acute bleeding in pt w/ liver failure, best treatment?

Fresh Frozen Plasma
- to rapidly replace clotting factors that liver normally makes

58

Obstructive lung diseases? (4)

- COPD (Emphysema &Chronic Bronchitis
- Asthma
- Bronchiectasis
- CF

59

Pink puffers?

EmPhysema

60

Blue bloaters?

chronic Bronchitis

61

Obstructive lung disease causes inc in what and dec in what PFTs?

Inc: RV --> inc TLC, FRC
Dec: VC, FEV, FEV/FVC (

62

Restrictive lung disease causes inc in what and dec in what PFTs?

Inc:
Dec: FVC (a lot) --> FEV/FVC (>70%) + TLC, FEV

63

non caseating granulomas + cough + hyperCalcemia + uveitis + issues w/ saliva and lacrimal glands - think?

Sarcoidosis
(can mimic sjogren's syndrome, but has sarcoid has non-caseating granulomas which sjogren's doesn't)

64

Restrictive lung diseases? (2)

- interstitial lung diseases (fibrosis, pneumoconioses, sarcoid, hypersensitivity pneumonitis)
- wall abnormalities (ie obesity, ankylosing spondylitis)

65

Silicosis is found where and inc risk of what?

- Nodules upper lobe
- Inc risk of TB

66

noncaseating granulomas have what type of metabolic derangement?

hyperCalcemia

67

Lung disease + Aerospace industry or mining (specific type) - think?

Berylliosis

68

Lung disease + sand blaster work - think?

Silicosis

69

Lung disease + coal miners - think?

Coal worker pneumoconiosis or black lung

70

Lung disease + construction worker or plumber or shipyard worker - think?

asbestosis

71

Asbestos inc risk of what? (2)

- lung CA (most common)
- Mesothelioma

72

anthracosis think?

coal dust exposure

73

long golden brown fibers w/ associated iron think?

asbestos bodies

74

"reticular" or "reticulonodular" or "ground glass" or "honeycombing" -- think?

Interstitial lung disease (restrictive)

75

elevated serum findings in sarcoidosis? (2)

- ACE
- Ca

76

Main lung findings on xray in sarcoidosis?

Bilateral hilar adenopathy

77

Sarcoidosis treatment?

- usually spontaneously self resolves
- Symptomatic --> corticosteroids
- Refractory --> methotrexate

78

hemoptysis + dyspnea + kidney issues - think?

goodpasture's

79

Goodpasture what type of hypersensitivity?

type 2 (Ab mediated)

80

Type 3 hypersensitivity is caused by and ex (3)?

Immune complexes
- SLE, RA, HSP

81

treatment of goodpasture syndrome (3)?

- plasmapheresis
- cyclophosphamide
- coricosteroids

82

Antiglomerular basement membrane Ab?

Goodpasture syndrome

83

Ground glass appearance w/ bilateral alveolar infiltrates that resemble a bat shape?

Pulmonary alveolar proteinosis (restrictive lung disease)

84

Pulmonary alveolar proteinosis is?

accumulation of surfactant-like protein and phopholipids in alveoli --> restrictive lung disease

85

Pulmonary alveolar proteinosis looks like on CXR?

Ground glass appearance w/ bilateral alveolar infiltrates that resemble a bat shape

86

Pulmonary alveolar proteinosis treat?

lung lavage and Granulocyte colony-stimulating factor
- NO steroids

87

mesothelioma --> what in pleura?

pleural effusion

88

Light's criteria

Exudative effusions have at least one of the following:
- Pleural protein/Serum protein >0.5
- Pleural LDH/Serum LDH >0.6
- LDH > 2/3 upper limit of normal serum LDH ()

89

Budd chiari syndrome is?

thrombosis of hepatic vein --> infarction of liver

90

cyanosis w/ chocolate colored blood?

methemoglobinemia

91

methemoglobinemia treatment?

IV methylene blue

92

Room temp, room air, sea level A-a gradient formula?

(150 - 5/4PCO2) - PaO2

93

estimated nL A-a gradient by age?

Aa gradient

94

normal PaO2/FiO2 ratio?

>300

95

Acute Respiratory Distress Syndrome
- mild: 200- 300
- Mod: 100-200
- Severe:

96

PCWP

ARDS

97

PCWP >18 + pulm edema - think?

cardogenic pulm edema

98

Hypoxemia is?

PaO2

99

Main line of treatment in ARDS?

high PEEP w/ low tidal volumes

100

middle mediastinal mass? (6)

- bronchogenic cyst
- tracheal tumor
- pericardial cyst
- lymphoma
- lymph node enlargement
- aortic aneurysm of arch

101

anterior mediatstinal masses? (5)

- thymoma
- restrosternal thyroid
- teratoma
- lymphoma
- nonseminomatous germ cell tumor

102

Posterior mediastinal masses? (6)

- meningocele (all neurogenic tumors are posterior)
- enteric cysts
- lymphomas
- diaphragmatic hernias
- esophageal tumors (ie leiomyomas)
- aortic aneurysms

103

Priority of treatment for rib fracture?

- pain management and respiratory support in order to prevent hypoventilation --> atelectasis and PNA

104

Treatment options for rib fracture?

- NSAIDs
- Opiates
- Intercostal nerve block (if oral meds not sufficient)

105

Exudative effusion - main 2 types?

- Compicated parapneumonic effusion
- Empyema

106

Findings in pleural fluid of exudative effusion?

- Low glucose (

107

Distinguish b/t complicated parapneumonic effusion from empyema how?

- Pleural fluid gram stain usually NEG in CPE and POS in empyema
- Pleural fluid cx usual NEG in CPE and POS in empyema

108

Continued fever post abx treatment + loculation in CXR - think? (2)

- complicated paranpeumonic effusion
- empyema

109

Pulmonary contusion is?

parenchymal bruising of the lung

110

pulmonary contusion dev in what time frame?

minutes - 24hrs

111

ARDS manifest how soon post trauma?

24-48hrs

112

How to distinguish b/t ARDS and pulmonary contusion?

1) Timeframe: Pulm contusion sooner (

113

Recurrent pneumonias in the same anatomic region of the lung suggests?

Bronchial obstruction due to an underlying abnormality (ie CA, foreign body, bronchial stenosis)

114

bronchiolitis caused by what virus?

respiractory syncytial virus

115

prophylaxis for RSV and to what category pts?

- Palivizumab (monoclonal Ab)
- kids

116

bronchiolitis has inc risk of what?

Otitis media

117

Lymphoma and nasopharyngeal CA associated w/ what virus?

EBV

118

EBV associated w/ what CAs? (2)

- lymphoma
- nasopharyngeal CA

119

who do you give palivizumab to?

kids

120

elevated AFP and B-hCG - think? (2)

- Endodermal sinus tumor (ie nonseminomatous germ cell tumor)
- Teratoma

121

tell difference b/t seminoma and nonseminomaotus germ cell tumor?

NSGCT has elevated AFP, seminoma does not

- both elevated B-hCG

122

dysgerminomas are equivalent to what male tumor?

seminoma

123

panacinar emphysema caused by?

alpha-1 antitrypsin deficiency

124

panacinar emphysema located where usually?

lower lobes

125

AAT deficiency --> where emphysema useuall?

panacinar emphysema descruction in lower lobes

126

Pt w/ COPD at young age (

AAT deficiency

127

COPD w/ minimal or no smoking hx - consider?

AAT deficiency

128

Basilar-predominant COPD - consider?

AAT deficiency

129

PE can --> what lung abnl?

small Pleural effusion (due to hemorrhage or inflammation) --> pain

130

What type of effusion generally seen w/ PE?

exudative
- potentially bloody