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Uworld Flashcards

1
Q

Clinical features of basal cell carcinoma

A
  • Skin colored, pearly nodule +/- rolled borders
  • Telangiectatic vessels
  • +/- central ulceration, local invasion
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2
Q

Clinical features of keratoacanthoma

A
  • Rapidly growing nodule with ulceration and keratin plug

* Often shows spontaneous regression/resolution

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3
Q

Lab testing for initial workup of suspected cognitive impairment

A

Routine: CBC, B12, TSH, CMP
Selective: folate, syphilis, Vit D
Atypical: CSF

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4
Q

Mnemonic for clinical diagnosis of Parkinson

A 
TRAP:
Tremor
Rigidity
Akinesia/bradykinesia
Postural instability
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5
Q

Clinical features and treatment of septic bursitis

A

Manifests as worsening pain, redness, swelling, and systemic symptoms several days after steroid injection

Image guided aspiration when infection is suspected

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6
Q

Clinical features of post corticosteroid injection flare

A

occurs rapidly and resolves within 48 hours

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7
Q

How is the initial evaluation of HTN directed?

A

Directed to rule out common secondary causes, end-organ damage complications, and additional risk factors that may influence management

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8
Q

Clinical features of nonalcoholic fatty liver disease

A
  • Mostly asymptomatic
  • Metabolic syndrome
  • +/- steatohepatitis (AST/ALT ratio <1)
  • Hyperechoic texture on US

Look for pt with DM2, obesity, and elevated liver enzymes

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9
Q

Clinical features of cervical spinal cord compression

A

gait unsteadiness, shock sensation in the spine, atrophy/weakness in the upper extremities (LMN) and increased tone/reflexes in the lower extremities (UMN)

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10
Q

Pathogen involved in Tinea versicolor

A

Malassezia globosa skin flora which grows in exposure to hot and humid weather

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11
Q

Treatment of Tinea versicolor

A

topical ketoconazole, terbinafine, or selenium sulfide

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12
Q

Clinical features of Mycoplasma pneumonia

A
  • Indolent headache, malaise, fever, persistent dry cough
  • Pharyngitis (nonexudative)
  • Macular/vesicular rash
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13
Q

Comorbidities that encourage Afib

A 
Chronic HTN (MCC)
Advanced age
Mitral valve dysfunction
Left ventricular failure
CAD
Obesity and OSA
COPD
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14
Q

Clinical features of cellulitis

A

Deep dermis and subq fat
Flat edges with poor demarcation
Indolent (over days)
Localized (fever later in course)

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15
Q

Clinical features of erysipelas

A

Superficial dermis and lymphatics
Raised, sharply demarcated edges
Rapid spread and onset
Fever early in course

Opposite features of cellulitis

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16
Q

Treatment for Kawasaki disease

A

IVIG and aspirin

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17
Q

What is the null value of RR

A

1

If it does not fall in the range, then the P-value is <0.05

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18
Q

First line treatment for asymptomatic bacteriuria in pregnant pts

A

Cephalexin
Amoxicillin-clavulanate
Nitrofurantoin
Fosfomycin

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19
Q

Clinical features of Epidermolysis bullosa (EB)

A

Friction induced blisters at the palms and soles
Thickening of the skin of the feet
Oral blisters with bottle feeding as an infant

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20
Q

Percent blockage cut off for Carotid Revascularization

A

Asymptomatic: 80-99%
Symptomatic: 70-99%

50% up to cut off CEA can be done in men but women likely benefit more from intensive medical therapy (Aspirin, Statin, BP control)

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21
Q

Most effective intervention to treat HTN

A

DASH diet

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22
Q

Pathogenesis of Giardia infection

A

villous blunting, disruption of epithelial tight junctions, loss of brush border enzymes –> malabsorption

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23
Q

Treatment for radial head subluxation

A

Hyper pronation of forearm

Supination of forearm and flexion of elbow

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24
Q

Clinical features of adhesive capsulitis

A

Gradual onset, poorly localized shoulder pain and stiffness

Decreased passive and active ROM

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25
Q

Hair growth phases

A
  1. ) Anagen phase: linear growth of the hair shaft associated with proliferation of hair follicles (affected by chemotherapy)
  2. ) Catagen phase: transition phase characterized by regression and apoptosis of follicular cells
  3. ) Telogen phase: resting phase of variable duration
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26
Q

Metabolic effects of thiazide diruretics

A 
Hyponatremia
Hypokalemia
Hypercalcemia
Hyperglycemia
Hypercholesterolemia
Hyperuricemia
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27
Q

Urine albumin/creatinine ratio when ACEi should be started in diabetic pt

A

> 30mg/g and HTN

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28
Q

Goal A1c in DM

A

less than or equal to 7.0%

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29
Q

What drugs affect the afferent and efferent arteriole of the kidney

A

Afferent: Natriuretic peptides, prostaglandins (NSAIDs can mess with this)
Efferent: Angiotensin II causes vasoconstriction (ACEi/ARB prevent this)

30
Q

What intervention will prolong survival and improve quality of life in patients with COPD?

A

long-term supplemental oxygen therapy (LTOT)

31
Q

Criteria for starting long-term supplemental oxygen therapy in pts with COPD

A
  1. ) resting arterial oxygen tension (PaO2) less than or equal to 55mmHg or pulse oxygen saturation (SaO2) less than or equal to 88% on room air
  2. ) PaO2 less than or equal to 59mmHg or SaO2 less than or equal to 89% in patients with cor pulmonale, evidence of right heart failure, or hematocrit >55%
32
Q

Important diagnostic clues for psoriatic arthritis

A

Involvement of the distal interphalangeal joints (present in ~50%) and characteristic nail changes such as pitting (present in >90%)

33
Q

Clinical presentation of exercise-induced hypothalamic amenorrhea

A 
Strenuous exercise
Relative caloric deficiency
Stress fractures
Amenorrhea
Infertility

Athlete’s triad: amenorrhea, osteoporosis, and an eating disorder

34
Q

Clinical manifestations of TMJ disorder

A

Facial pain (worsens with jar motion)
Ear pain, tinnitus
Headache (unilateral, worse on awakening)
Jaw dysfunction

35
Q

Gold standard for diagnosis of acute angle-closure glaucoma

A

gonioscopy but tonometer can be used if ophthalmologic consultation is not available immediately

36
Q

Treatment for allergic rhinitis

A

Allergen avoidance

Intranasal corticosteroids

37
Q

Diagnosis of Fibromyalgia

A

> 3 months of symptoms with widespread pain index or symptoms severity score
Normal lab studies (elevated ESR, CRP in polymyalgia rheumatica)

38
Q

Exam findings for Atelectasis

A

Decreased or absent breath sounds
Decreased tactile fremitus
Dullness to percussion
Mediastinal shift toward atelectasis (towards decreased breath sounds)

39
Q

Which vitamin reduces morbidity and mortality in patients with measles

A

Vitamin A

40
Q

What mechanism leads to the development of a Zenker’s diverticulum

A

Abnormal spasm or diminished relaxation of the cricopharyngeal muscles during swallowing

41
Q

What are the Centor criteria?

A

Fever by history
Tender anterior cervical lymphadenopathy
Tonsillar exudates
Absence of cough

2-4 get rapid strep test give Penicillin or amoxicillin if positive

42
Q

Clinical features of patellofemoral pain syndrome

A

Running, negotiating stairs, and prolonged sitting aggravate pain, atrophy or weakness of quadriceps, tonic contraction of quadriceps with knee flexed causes pain

43
Q

Recommended vaccines for patients with chronic liver disease

A 
Tdap (q10y)
Influenza (qy)
Pneumococcal (at Dx and 65)
Hep A
Hep B
44
Q

At what age can you stop paps if prior screens negative?

A

> 65

45
Q

Organism causing urethritis in men with no growth on gram stain and negative urine culture

A

Chlamydia trachomatis

Gonorrhea shows gram-negative in 95% of cases

46
Q

MCC of gastric outlet obstruction

A

80% of cases occur due to malignancy, with the most common cancer being pancreatic adenocarcinoma

should also suspect this in a patient with unexplained hyperglycemia

47
Q

What should you do in patient who develops measles after MMR vaccination?

A

Reassurance and should keep them away from immunocompromised or unvaccinated individuals

48
Q

Mammogram interval and age range?

A

q2yrs for women age 50-74

49
Q

Clinical manifestations of disseminated gonococcal infection

A

purulent mono-arthritis OR triad of tenosynovitis, dermatitis, migratory polyarthralgia

50
Q

Clinical findings of Lichen planus

A

5 P’s: pruritic, purple/pink, polygonal papules and plaques

Lacy, white network of lines (Wickham striae)

51
Q

Indication for statin therapy in prevention of ASCVD

A

LDL >190 mg/dL
Age >40 with DM
Estimated 10-year risk of ASCVD >7.5-10% (provides most info for starting statin)

52
Q

What disease is Lichen planus associated with?

A

Hep C

53
Q

Complications of inadequate and excessive weight gain in pregnancy

A

Inadequate: low birth weight and preterm delivery
Excessive: gestational DM, macrosomia, C section

54
Q

Diagnostic criteria for acute bacterial rhinosinusitis

A

(1 of 3)
Persistent symptoms >10 days without improvements
Severe onset (fever > 102.2) >3 days
Worsening symptoms following initial improvement

55
Q

Characteristic findings of hypertensive nephrosclerosis

A

Elevated creatinine (decreased GFR)
US showing small, atrophic kidneys
Bland urinalysis with mild proteinuria

56
Q

Clinical features and treatment of Lymphangitis

A

Tender, erythematous streaks proximal of wound
Regional tender lymphadenopathy
Systemic symptoms

Treatment: cephalexin

57
Q

Major modifiable risk factor for the progression of Crohn’s dz

A

cigarette smoking

58
Q

Most sensitive test to screen for nephropathy in diabetic patients

A

random urine albumin-to-creatinine ratio should be done annually starting at either diagnosis (DM2) or 5 years after diagnosis (DM1)

59
Q

Differential based on DLCO (low, normal, increased)

A

Low: emphysema
Normal: chronic bronchitis, asthma
Increased: asthma

60
Q

First step in evaluation of infective endocarditis

A

blood cultures from 3 different venipuncture sites. Get these before starting initiating antibiotics

61
Q

What gene is affected in Ichthyosis vulgaris

A

loss of function in filaggrin gene

62
Q

Clinical features of Ichthyosis vulgaris

A

Onset in infancy/early childhood
Diffuse, scaly skin with mild pruritis
Worse on extensor extremities, spares intertriginous areas

63
Q

Mainstays of treatment for COPD

A

inhaled bronchodilators, especially anti-cholinergic medications like ipratropium and tiotropium

Can be combined with SABAs

64
Q

Heart abnormalities in Turner syndrome

A

bicuspid aortic valve, coarctation of the aorta, and aortic root dilation

65
Q

Clinical features of CSF rhinorrhea

A

Unilateral watery rhinorrhea with salty or metallic taste

Possible complication: meningitis

66
Q

Clinical features of primary dysmenorrhea

A

Pain 1 to 2 days prior to menses
Pain first 2-3 days of menses
N/V and diarrhea
Normal pelvic examination

Endometriosis will have pain that starts 1 to 2 prior to menses and lasts for the entire cycle

67
Q

Management progression of Primary Nocturnal Enuresis

A

Treatment of comorbid conditions
Behavioral modifications
Enuresis alarm
Desmopressin therapy

68
Q

Clinical features of trachoma

A

conjunctival injection, tarsal inflammation, and pale follicles

69
Q

CD4 cutoff for receiving live vaccines

A

CD4 >200

70
Q

What classes of medications have been shown to improve long-term mortality in patients with heart failure with reduced injection fraction?

A

Angiotensin-neprilysin inhibitor (sacubitril-valsartan)
ACE/ARB
Beta blockers
Mineralocorticoid receptor antagonists (spironolactone, eplerenone)
SGLT-2 inhibitors (-gliflozins)

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