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Medicine > step 3 30 > Flashcards

step 3 30 Flashcards

1
Q

central hypothyroidism

A

low free T4 + low or inappropriately normal TSH

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2
Q

management of central hypothyroidism

A

ACTH stimulation test first, then give levo (levo can accelerate cortisol metabolism and precipitate adrenal crisis in patients with undiagnosed adrenal insufficiency).

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3
Q

biggest RF’s for CKD progression

A

hypertension
proteinuria
hyperglycemia

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4
Q

most effective way to ensure transition of care according to USMLE

A

oral communication, need to call PCP, provider-to-provider phone call, closed loop

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5
Q

normal bicarb

A

22

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6
Q

management of breast pain

A

If noncyclic, unilateral, or focal, imaging

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7
Q

quasi-experimental study design

A
  • nonrandomized study used when not feasible or ethical to conduct a randomized controlled trial
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8
Q

anorexia nervosa management

A

FIRST LINE: CBT + nutritional rehab

SECOND LINE: olanzapine

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9
Q

treatment of menopausal symptoms in patient contraindicated for estrogen

A

SSRI

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10
Q

anemia of pregnancy physiology

A

Pregnant women have mild dilutional anemia because plasma volume increases more rapidly than RBC mass

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11
Q

bleeding in pregnancy?

A

Gingival bleeding is common due to hyperplasia and inflammation from hormonal changes

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12
Q

meds causing AIN

A

NSAIDS
PPIs
Penicillins
Diuretics

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13
Q

other features of panic disorder

A
  • recurrent and unexpected panic attacks (often with no clear trigger)
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14
Q

immediate treatment of panic disorder

A

benzos

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15
Q

GI disorder associated with trisomy 21

A

Hirschsprung disease

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16
Q

transient synovitis vs. septic arthritis presentation

A

transient synovitis – Well-appearing kid with history of mild infection/URI, with effusion, and able to bear weight
septic arthritis – high fever, ill-appearing,

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17
Q

first step in pediatric hip pain workup

A

Ultrasound

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18
Q

transient synovitis management

A

NSAIDs

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19
Q

legg-calve-perthes

A

chronic condition, non-weight bearing

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20
Q

ADHD diagnosis

A

Need to evaluate for symptoms in 2 or more settings + symptoms present for 6 months + significant functional impairment

  • need to use ADHD-specific behavior scales by parent and teacher
  • symptom onset before age 12
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21
Q

First-line treatment for ADHD

A

stimulants

22
Q

hypercalcemia of malignancy management

A

Treat if calcium over 14 or severely symptomatic
long term = bisphosphonates (zoledronic acid)
short term = IV fluids + calcitonin (delay in effect of bisphosphonates)

23
Q

workup of hypercalcemia of malignancy

A

PTH + PTHrP + vitamin D (need to differentiate between hormonal induced and bone mets)

24
Q

most common fetal chromosomal abnormality

A

trisomy 16

25
Q

serosanguineous fluid means

A

bloody

26
Q

low pleural fluid/serum glucose ratio in pleural effusion suggests

A

TB
Malignancy (cancer cells use up glucose)
Rheumatologic (RA, SLE)
Esophageal rupture

27
Q

high pleural fluid/glucose ratio found n

A

transudative effusions
Infections
PE

28
Q

exudative in light’s criteria suggested by

A

The ratio of pleural fluid protein to serum protein is greater than 0.5
The ratio of pleural fluid LDH and serum LDH is greater than 0.6

29
Q

sarcoidosis pleural effusion features

A
  • exudative with very high lymphocyte predominase
30
Q

SLE pleural effusion features

A
  • exudative with low glucose level
31
Q

folliculitis with pool exposure + management

A

hot tub folliculitis

- stop swimming in pool, self-limiting

32
Q

COPD on flow-volume loop

A
  • scooped-out pattern on expiratory curve
33
Q

typical ILD presentation

A

dyspnea + chronic nonproductive cough

34
Q

sick sinus syndrome management

A
  • pacemaker
35
Q

olecranon bursitis initial management

A

aspiration with fluid analysis (septic bursistis is common)

  • if mild, treat with oral abx
  • if immunocompromised or severe, admit for IV abx
36
Q

When PCP ppx is indicated with chronic steroids

A

Greater than 1 month of pred greater than 20 mg and another source of immunocompromise (eg on another immunosuppressant)

37
Q

hypospadias management

A

surgery by 6 months

38
Q

caveat about acute otitis media in infants

A
  • presents with nonspecific symptoms (can be fever, vomiting, diarrhea, poor sleep, poor feeding, or decreased appetite) so always do otoscopy as part of full exam
39
Q

ITP other features

A
  • young women
  • mucocutaneous bleeding, epistaxis, gum bleeding, menorrhagia, petechiae
  • can have anemia due to chronic blood loss (eg, menorrhagia)
40
Q

other ITP causes

A

HIV, hep C, SLE

41
Q

TTP presentation

A

These patients are generally very sick. Life-threatening disorder
- Severe thrombocytopenia, hemolytic anemia, organ damage with confusion, neuro deficits, renal disease, GI problems.

42
Q

infant with watery diarrhea + vomiting?

A

rotavirus

43
Q

ovarian cancer workup

A

US, then surgical exploration (no transdermal biopsy)

44
Q

management of pregnant woman potentially exposed to parvovirus

A

serology (many immunocompetent people show no signs of previous infection so test IgG and IgM to test for immunity)

45
Q

how to reduce risk of ventilator-associated pneumonia

A
  • reduced sedation
  • put patient in semirecumbent position
  • drain subglottic secretions
46
Q

first line for PTSD

A

SSRI’s + CBT

47
Q

Common complication of lap chole’s

A

Retained CBD stone (choledocholithiasis)

48
Q

choledocholithiasis presentation

A

RUQ pain intermittent + N/V + mildly elevated aminotransferases, bili, and alkphos

49
Q

how to reduce risk of nephrolithiasis

A 
Increase fluids
Increase calcium intake (calcium binds oxalate in the GI system and prevents GI oxalate absorption)
Reduce oxalate (spinach/potatoes/nuts, animal protein (animal protein increases urinary calcium levels and reduces citrate) (citrate binds calcium and prevents stones), and sodium
50
Q

most common cause of stroke in pediatric patients

A

sickle cell disease

Medicine (71 decks)

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