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Uworld Gaby > UW 15 > Flashcards

UW 15 Flashcards

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1
Q

Severe cancer related pain with no adequate dosing during the night

A

Add a long-acting opioid or extended release medication like a fentanyl patch or sustained released morphine

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2
Q

Elevated lactate meaning

A

Poor organ perfusion

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3
Q

New Left bundle branch block is suggestive of

A

Acute MI

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4
Q

Exercise and Cocaine hemodynamic monitoring profile

Preload, CO, Afterload

A

Exercise: low preload, high CO and afterload

Cocaine: normal preload and CO, elevated afterload. Normal CO is possible due to increased in contractility and HR.

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5
Q

How is the preload in:

Cardiogenic, Hypovolemic and septic shock

A

Cardiogenic: increased

Hypovolemic: decreased
Septic: decreased

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6
Q

Candiasis vs. Tinea on KOH

A

Candidiasi: Pseudohyphae with blastoconidia

Tinea: Septate hyphae

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7
Q

What to look for in acute gout when it comes to treatment

A

Look for clues of NSAIDs contraindications: anticoagulation (aspirin, clopidogrel, apixaban)

Indomethacin (fisrt line), naproxen

Colchicine: if the patient is taking anticoagulants. Do not use in eldery or renal failure

Corticosteroids: also good to use in patients with NSAIDs contraindication. Careful with diabetic patients

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8
Q

Z score corresponding to 95% and 99% confidence interval

A

95% = 1.96

99% = 2.58

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9
Q

How do you calculate confidence interval

A

mean +/- Zscore x standard error of the mean

Standard error of the mean = standard deviation/square root of the sample

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10
Q

Interpretation of confidence intervals

A

Wider confidence interval means higher variation in results

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11
Q

Overlapping or not in confidence intervals

A

If the CI of two groups do not overlap.. it means there is statistical significance

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12
Q

Rosacea presentations

A

Erythematotelangiectasic: erythema, flushing, burning, scaling

Pustular: small papules, pustules, looks like acne

Phymatous: rinophyma

Ocular: affects conjuntiva, cornea, sensation of foreing body. Common with skin manifestations not necesarily at the same time

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13
Q

Uveitis image

A

Look for irritation as close as possible to the iris.

Common with severe pain and photophobia

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14
Q

Diagnostic requirement for liver failure

A

ALT/AST >1000
INR > 1.5 (normalized value of PT)
Sings of encephalopathy (confusion, asterixys)

May also present with: anemia, thrombocytopenia, hypoglycemia, electrolyte imbalance

Renal failure can be present but it is not specific to liver failure

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15
Q

Specifics of liver failure due to Wilson or Acetaminophen toxicity

A

Acetaminophen: low bilirubin

Wilson: very low ALP

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16
Q

Serotonin sd. AAA

A

neurological Activity: clonus, tremors, hyperreflexia, hypertonia, seizure

Autonomic stimulation: fever, diaphoresis, flushing, diarrhea, midirasis

Agitation

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17
Q

Sings and symptoms of early diseminated Lyme

A 
erythema migrans
malaise, fatigue, arthralgias
CN palsy, bells palsy, radiculopathy, lymphocytic meningitis
Cardio: av block
Regional lymphadenopathies
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18
Q

Treatment of lyme and criteria for prophylaxis

A

Mild/ skin : oral doxycycline or amoxicilin in <8 yoa or pregnant

Neurologic/Cardio: IV ceftriaxone

Ixodes tick
Attached for >36hr
Treatment initiated before 72hrs of tick removal
Rate of infection is >20%

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19
Q

Fever + painful uterine fundus (postpartum)

A

Decidua infection

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20
Q

Empiric treatment for endometritis

A

clynda + genta

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21
Q

Empiric treatment for endometritis

A

clynda + genta

If no improvement after 48hrs, think abscess

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22
Q

Fever <24 hrs post partum

23
Q

Empiric treatment for Community acquired pneumonia

Study These Flashcards
A

Outpatient:
Macrolide, oral quinilone or betalatam + macrolide

Inpatient (not MICU)
Levofloxacin IV or betalactam + macrolide

MICU
betalactam + macrolide
belactam + fluoroquinolone

24
Q

Common mycoplasma pneumonia presentation and treatment

Study These Flashcards
A

Young patient in college, prison, military

Malaise, dry cough, faringeal erythema (not exudative)
Macular/vesicular rash

Normal leukocytes, subclinical hemolytic anemia (cold agglutins)

Diffuse reticonudular opacities on xray

Treat with macrolide or resp. quinolone

25
Why are penicillins are cephalosporins inefective against mycoplasma
They inhibit cell wall synthesis and mycoplasma doesnt have one
26
Diagnosis criteria for narcolepsy
>3 episodes of lapses into sleep/naps >3month + >1 of the following 1. Catalepsy: brief loss of muscle tone precipitated by emotion (eg. laughing, exitment) 2. Low hypocretin level on CFS 3. Decreased REM latency Others: Hallucinations when falling asleep or waking up and/or sleep paralysis Specifics: decreased sleep latency, increased REM density
27
3hz spike wave activity on EEG
Absence seizure
28
Absence seizure EEG
3hz spike wave activity on EEG
29
Thromboangitis obliterans
Age <45, smoker, non occlusive limb ischemia, gangrene, ulceration, thrombosis Pulses and ankle/brachial index usually normal Treatment: smocking sesation
30
Aspergillosis 4 different presentations
Allergic bronchopulmonary aspergillosis: common in asthma and cystic fibrosis. Eosinophilia, bronchiectasis. Steroids + itraconazol Aspergilloma: usually asymptomatic. Common in patients with TB, sarcoidosis. Can cause fever, hemoptysis and cough. Solid mass in preexisting lung cavity. Itraconazol Chronic necrotizing pulmonary aspergillosis: common in alcoholics or steroid dependent COPD patients. fever, cough, sweating. Pneumonia that does not respond to antibiotics. Vorizonazole Invasive aspergillosis: fever, chest pain, hemoptysis. Exclusively in immunocompromised. CXR: nodules with sourounding ground glass opacities (halo sing). Voriconazol or caspofungin
31
Allergic bronchopulmonary aspergillosis:
Common in asthma and cystic fibrosis. Eosinophilia, bronchiectasis. Diagnose with skin test and specific IgG Steroids + itraconazol
32
Pharmacologic treatment for bulimia vs anorexia
Anorexia: olanzapine Bulimia: SSRI Binge eating disorder: SSRI or lisdexanfetamine
33
Major differences between bulimia and anorexia
Anorexia: BMI <18.5. Distorted views over weight and shape Bulimia: Binge eating with compensatory behaviors. Worry about weight and body shape.
34
Management of hypercalcemia
>14: Short term: IV Fluids + calcitonin, avoid diruretics unless fluid overload (patients are ussually volume depleted due to hypercalcemia induced neprhogenic diabetes insipidus) Long term: biphosphonate 12 -14 Short term: non if asymptomatic, same as above if symptomatic <12 or asymptomatic No treatment needed. Avoid diuretics, lithium, volume restriction or bed rest
35
Mechanic valve thrombosis
Mitral or Aortic Looks like a stenosis ==> CHF ==> Cardiogenic shock Due to inadequate anticoagulation: INR mitral 2.5-3.5. aortic 2-3 Diagnose with eco Anticoagulate (eg. heparine) Thrombolitics, avoid to the max Surgery for severe CHF
36
Patient with chronic cough with sputum production and +/- streacks of blood after an inciting event....
Bronchiectasis
37
Permanent destruction and dilation of airways
Bronchiectasis
38
Infantile hemangioma
May begin as a patch of telangiectasia Progreses to a red, raised nodule at age 0-1 Regresses at 1-9 yoa (gets darker and smaller) No treatment needed
39
Infantile hemangioma
May begin as a patch of telangiectasia Progresses to a red, raised nodule at age 0-1 Regresses at 1-9 yoa (gets darker and smaller) No treatment needed
40
Rett syndrom
Lost of motor and communicative skills (from 6-18months), gait disturbances, autism Deceleration of head growth Stereotypical hand movements Ataxia
41
Phenylketunuria
``` Mosty odor Eczema Microcephaly Albinism Impaired cognition ``` Screen at birth
42
Tay Sachs
Hexoaminidase A deficiency. Accumulation of ganglioside Neurodevelomental regretion staring at age 6 months Cherry red spot on macula, no heptosplenomegaly (vs. gaucher)
43
Congenital syphilis
Rinorrhea Desquamating rash in hans and soles Bone deformities (sadle nose/ teeth later in life)
44
Congenital CMV
Microcephaly Periventricular calcification Hepatosplenomegaly Jaundice
45
Rubella congenita
Catracts PDA (heart defects) Sensorineural deafness Bluberry muphin rash
46
Management of mild sunburn
Lotions | NSAIDs
47
Management of threatened abortion
Vaginal bleeding with closed cervix If fetal hr is normal and everything looks ok... Reassurance and follow up
48
Need to increased folic acid dosing in pregnancy
Previous neural tube defect pregnancy Patient taking anticonvulsants
49
Epstein anomaly presentation and association
Atrialization of the right ventricle Atrial septal defect Tricuspid valve defect Lithium
50
SSRI and pregnancy
Good to go except for paroxetine wich has been associated with cardiac defects
51
Most common location of hypertensive hemorrahages and potential complication
Basal ganglia Complication: Uncal herniation
52
Uncal herniation
IPSILATERAL CN III paralysis: dilated pupil with no response to light. Down and out Ipsilateral hemiparesis: compresion of contralat cruz cerebri Contralat homonimus hemianopia: compresion of ipsilateral posterior cerebral artery
53
Measures to prevent pulmonary complications after cardiac surgery
Stop smoking 8 weeks prior Physical therapy prior to surgery
54
Wiskott-Aldrich
Xlinked recesive (male patients) WIPE Wiskott-Aldrich Infections Purpura Eczema Elevated IgE/IgA, low IgM Increased risk for encapsulated bacteria) Clasic presentation: bleeding, eczema and recurrent otitis media

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