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Uworld Flashcards

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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
Hair growth phases
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
26
Metabolic effects of thiazide diruretics
``` Hyponatremia Hypokalemia Hypercalcemia Hyperglycemia Hypercholesterolemia Hyperuricemia ```
27
Urine albumin/creatinine ratio when ACEi should be started in diabetic pt
>30mg/g and HTN
28
Goal A1c in DM
less than or equal to 7.0%
29
What drugs affect the afferent and efferent arteriole of the kidney
Afferent: Natriuretic peptides, prostaglandins (NSAIDs can mess with this) Efferent: Angiotensin II causes vasoconstriction (ACEi/ARB prevent this)
30
What intervention will prolong survival and improve quality of life in patients with COPD?
long-term supplemental oxygen therapy (LTOT)
31
Criteria for starting long-term supplemental oxygen therapy in pts with COPD
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
Important diagnostic clues for psoriatic arthritis
Involvement of the distal interphalangeal joints (present in ~50%) and characteristic nail changes such as pitting (present in >90%)
33
Clinical presentation of exercise-induced hypothalamic amenorrhea
``` Strenuous exercise Relative caloric deficiency Stress fractures Amenorrhea Infertility ``` Athlete's triad: amenorrhea, osteoporosis, and an eating disorder
34
Clinical manifestations of TMJ disorder
Facial pain (worsens with jar motion) Ear pain, tinnitus Headache (unilateral, worse on awakening) Jaw dysfunction
35
Gold standard for diagnosis of acute angle-closure glaucoma
gonioscopy but tonometer can be used if ophthalmologic consultation is not available immediately
36
Treatment for allergic rhinitis
Allergen avoidance | Intranasal corticosteroids
37
Diagnosis of Fibromyalgia
>3 months of symptoms with widespread pain index or symptoms severity score Normal lab studies (elevated ESR, CRP in polymyalgia rheumatica)
38
Exam findings for Atelectasis
Decreased or absent breath sounds Decreased tactile fremitus Dullness to percussion Mediastinal shift toward atelectasis (towards decreased breath sounds)
39
Which vitamin reduces morbidity and mortality in patients with measles
Vitamin A
40
What mechanism leads to the development of a Zenker's diverticulum
Abnormal spasm or diminished relaxation of the cricopharyngeal muscles during swallowing
41
What are the Centor criteria?
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
Clinical features of patellofemoral pain syndrome
Running, negotiating stairs, and prolonged sitting aggravate pain, atrophy or weakness of quadriceps, tonic contraction of quadriceps with knee flexed causes pain
43
Recommended vaccines for patients with chronic liver disease
``` Tdap (q10y) Influenza (qy) Pneumococcal (at Dx and 65) Hep A Hep B ```
44
At what age can you stop paps if prior screens negative?
>65
45
Organism causing urethritis in men with no growth on gram stain and negative urine culture
Chlamydia trachomatis Gonorrhea shows gram-negative in 95% of cases
46
MCC of gastric outlet obstruction
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
What should you do in patient who develops measles after MMR vaccination?
Reassurance and should keep them away from immunocompromised or unvaccinated individuals
48
Mammogram interval and age range?
q2yrs for women age 50-74
49
Clinical manifestations of disseminated gonococcal infection
purulent mono-arthritis OR triad of tenosynovitis, dermatitis, migratory polyarthralgia
50
Clinical findings of Lichen planus
5 P's: pruritic, purple/pink, polygonal papules and plaques | Lacy, white network of lines (Wickham striae)
51
Indication for statin therapy in prevention of ASCVD
LDL >190 mg/dL Age >40 with DM Estimated 10-year risk of ASCVD >7.5-10% (provides most info for starting statin)
52
What disease is Lichen planus associated with?
Hep C
53
Complications of inadequate and excessive weight gain in pregnancy
Inadequate: low birth weight and preterm delivery Excessive: gestational DM, macrosomia, C section
54
Diagnostic criteria for acute bacterial rhinosinusitis
(1 of 3) Persistent symptoms >10 days without improvements Severe onset (fever > 102.2) >3 days Worsening symptoms following initial improvement
55
Characteristic findings of hypertensive nephrosclerosis
Elevated creatinine (decreased GFR) US showing small, atrophic kidneys Bland urinalysis with mild proteinuria
56
Clinical features and treatment of Lymphangitis
Tender, erythematous streaks proximal of wound Regional tender lymphadenopathy Systemic symptoms Treatment: cephalexin
57
Major modifiable risk factor for the progression of Crohn's dz
cigarette smoking
58
Most sensitive test to screen for nephropathy in diabetic patients
random urine albumin-to-creatinine ratio should be done annually starting at either diagnosis (DM2) or 5 years after diagnosis (DM1)
59
Differential based on DLCO (low, normal, increased)
Low: emphysema Normal: chronic bronchitis, asthma Increased: asthma
60
First step in evaluation of infective endocarditis
blood cultures from 3 different venipuncture sites. Get these before starting initiating antibiotics
61
What gene is affected in Ichthyosis vulgaris
loss of function in filaggrin gene
62
Clinical features of Ichthyosis vulgaris
Onset in infancy/early childhood Diffuse, scaly skin with mild pruritis Worse on extensor extremities, spares intertriginous areas
63
Mainstays of treatment for COPD
inhaled bronchodilators, especially anti-cholinergic medications like ipratropium and tiotropium Can be combined with SABAs
64
Heart abnormalities in Turner syndrome
bicuspid aortic valve, coarctation of the aorta, and aortic root dilation
65
Clinical features of CSF rhinorrhea
Unilateral watery rhinorrhea with salty or metallic taste | Possible complication: meningitis
66
Clinical features of primary dysmenorrhea
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
Management progression of Primary Nocturnal Enuresis
Treatment of comorbid conditions Behavioral modifications Enuresis alarm Desmopressin therapy
68
Clinical features of trachoma
conjunctival injection, tarsal inflammation, and pale follicles
69
CD4 cutoff for receiving live vaccines
CD4 >200
70
What classes of medications have been shown to improve long-term mortality in patients with heart failure with reduced injection fraction?
Angiotensin-neprilysin inhibitor (sacubitril-valsartan) ACE/ARB Beta blockers Mineralocorticoid receptor antagonists (spironolactone, eplerenone) SGLT-2 inhibitors (-gliflozins)

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