Step 3 Miscellaneous Flashcards by Aamir Hussain

Sputum acid-fast culture vs. Tuberculin skin test

culture can distinguish latent from active infection

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sensitivity of Sputum acid-fast culture for TB

Low (45-80%)

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dilated transverse colon with no free air, and mucosal edema

findings in acute ischemic colitis

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Synovial fluid findings for Reactive Arthritis

Elevated WBC, usually negative culture

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Physical exam difference between Ehlers-Danlos and Marfan

EDS with more skin changes (velvety skin, atrophic scars)

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Normal breast development but absent pubic hair

Androgen Insensitivity, XY but phenotype female

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Lack of menstruation up to this age is normal

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Most common complication of IVC filter

recurrent DVT, IVC thrombosis

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Priapism treatment

if >4 hours, inject a-agonist (phenylephrine), aspirate corpus cavernosum

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Risk factor for developing drug-induced Long QT

Bradycardia

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Treatment for benzo withdrawal

more benzos, lol

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Indications for steroids in PCP treatments (2)

Alveolar-arterial gradient >35, and PaO2 <70 on RA

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Management of pyloric stenosis in infants

Correct underlying electrolytes before surgery

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Risk factors for pyloric stenosis (3)

Azithro and Erythromycin, and bottle-feeding rather than breastfeeding, being 1st-born boy

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Treatment for PBC

Ursodiol

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Initial treatment for PAD

Statin + antiplatelet therapy

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Treatment for improvement of PAD

Supervised exercise program

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Normal amount of initial weight loss for baby within 2 weeks of life

10 percent

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Tests for Cushing’s Syndrome (2)

1) 24-hr urinary cortisol,

2) dexamethasone suppression

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Treatment for Paget’s Disease of Bone

Alendronate

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Side effect of nitroprusside

Cyanide toxicity –> sudden metabolic acidosis and altered mental status

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Best test for foot osteomyelitis

MRI

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Treatment for SIADH

water restriction

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Bicuspid aortic valve associated with risk for what (3)

Aortic dissection, aortic aneurysm, aortic dilation

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Management for ongoing pain after air enema for intussussception

Abdominal X ray to rule out perforation

When to do PCI in cocaine abuser

persistent ST elevation despite nitro/CCB/other therapy

Diagnosis of orthostatic proteinuria

Split day/night urinary protein collection

Ovarian hyperstimulation syndrome

bilateral enlarged ovaries, ascites, hemodynamic instability

main comorbidity for Dupuytren's Contracture

Diabetes

SPF recommended for outdoor activities

>30

Diagnosis of Hirschprung's Disease

Rectal suction biopsy

Risk factor for UTI's, especially in children

Chronic constipation

Dangerous side effect of SGLT2 inhibitors

Ketoacidosis (euglycemic)

Electrolyte risk for TPN

Hypophosphatemia

Cardiac exam findings in severe AS (3)

1) low-intensity, single S2 during inspiration 2) delayed and diminished carotid pulse 3) loud, and late-peak systolic murmur

Fetal hyperinsulinemia cardiac complication

transient hypertrophic cardiomyopathy, causing thickened Interventricular septum

Which pts with CAD diagnosed by stress test need elective cath?

High-risk features such as low exercise capacity, or ST depression with minimal exertion, or ST elevations

No symptoms preceding syncope - what type of syncope most likely?

Cardiogenic (vasovagal usually has prodrome that can persist after syncope)

EKG signs of prior MI

inverted Q and T waves in contiguous leads

Echo measurements of severe AS

aortic jet velocity >4 m/s or transvalvular gradient >40 mmHg

When to use injection sclerotherapy for varicose veins

failed 3-6 months of conservative therapy (compression stockings, etc.)

Goal INR for aortic valve replacement

2-3 if no risk factors

which valve replacement has INR 2.5-3.5 goal?

1) Any mitral valve | 2) Aortic valve + high risk factor (Afib, EF<30, prior thrombotic event or hypercoagulable state)

Time course for Dressler Syndrome

2-3 weeks following MI, presents similar to pericarditis

Treatment of viral pericarditis

NSAID + colchicine

Treatment of peri-infarction pericarditis

High dose aspirin (DIFFERENT THAN REGULAR PERICARDITIS)

Most effective lifestyle change for HTN

Weight reduction

Indications for biventricular pacing

1) symptomatic heart failure 2) EF <35 3) LBBB with QRS >150

Presentation of atrial myxoma

arterial embolization to an extremity, mitral valve obstruction, rapidly worsening HF

Why discontinue SERM's (raloxifene, etc.) before surgery?

Higher risk for VTE

CXR finding in pulm HTN

enlargement of main pulmonary arteries

Rate/rhythm control in AFib pts with LV systolic dysfunction

Amiodarone or Dofetilide

Adjust warfarin dose after adding amiodarone?

Decrease by 25-50%

First line ADHD treatment

behavioral

hungry bone disease

presents 2-4 days after parathyroidectomy, results in hypocalcemia

Renal consequence of seizures

Rhabdo --> treat with isotonic saline

Official way to diagnosis sarcoidosis

Excisional lymph node biopsy, or lung biopsy if no lymph nodes available

what is Immune Reconstitution Inflammatory Syndrome

HIV pts started on HAART get transient worsening of infectious symptoms. supportive care only

Post-exposure prophylaxis for HIV

within 1-2 hrs ideal, <72 hrs is cutoff

Treatment of lead toxicity

Mild (5-44) = no medication Moderate (45-69) = DMSA Severe (70+) = Dimercaprol + EDTA

Surgery decision for RCC

if confined to renal capsule = partial nephrectomy | if extends through capsule but NOT Gerota's fascia = radical nephrectomy

Most common cause of pediatric PNA and treatment

Strep pneumo - amoxicillin

Drug interactions with lithium

NSAID, thiazides, ACE. causes tremors/AMS

Facial plethora when arms raised

confirms enlarged thyroid as causing esophageal symptoms

Treatment of severe malnutrition

Oral rehydration >> IV

Management of incidentaloma

- functional studies | - if negative and mass <4cm, can observe

Endoscopy findings for pernicious anemia

atrophy of fundus (absent rugae), glandular atrophy, but normal antrum

Findings in traumatic LP

+RBC, high protein, high glucose, but negative xanthochromia

Renal consequence of compartment syndrome

AKI, secondary to rhabdo

Carotid artery dissection vs cluster headache

Dissection headache is ongoing Cluster headache - lasts 15 min-3 hrs, episodic pain both can have Horner syndrome

"frozen shoulder syndrome", contracture of joint capsule | restriction in BOTH passive and active ROM

Adhesive capsulitis

Treatment of chronic urticaria

2nd gen antihistamine (cetirizine, loratadine) | do NOT use topical steroids

Dyspepsia management

if <60 and no alarm features, test for H pylori

Treatment for bacterial prostatitis

6 weeks, FQ or TMP-SMX

Abx ok to use in pregnancy for bacteriuria

Cephalexin, Fosfomycin, Amox-Clav | not TMP-SMX or nitrufurantoin

Best test to confirm eradication of H pylori

Urea breath OR stool test, 4 weeks after treatment | do NOT use serology

Treatment for bleeding due to uremia

Desmopressin

Neuro complication of early syphilis

Strokes

Step 3 Miscellaneous Flashcards

Part 1 UWORLD questions (78 cards)