UWorld Flashcards
(310 cards)
1
Q
Delirium tremens
A
alcohol withdrawal >48h after last drink
Delirium, hyperthermia, HTN, tachycardia
2
Q
Esophageal cancer subtypes
A
adenocarcinoma: distal esophagus, from Barretts
squamous cell carcinoma: proximal and mid esophagus
3
Q
pertussis post exposure prophylaxis
A
<1 month: azithromycin
>1mo: azithromycin, clarithromycin, erythromycin
4
Q
sigmoid volvulus
A
constipation, abd distension, no stool in rectal vault
colonic dilation, no air in rectum
elderly patient in nursing home
5
Q
jones criteria
A
rheumatic fever
Joints
O (heart)
Nodules
Erythema nodosum
Sydenham chorea
6
Q
acute rheumatic fever sx
A
Teen/young adult
fever, arthralgia, mitral regurgitation/stenosis
elevated ESR/CRP
prolonged QT interval
hx of recent URI
7
Q
disseminated gonococcal infection
A
purulent monoarthritis or triad (tenosynovitis, dermatitis, migratory polyarthralgia)
pustular rash on trunk or extremity including palms and soles
tx 3rd gen cephalosporin
8
Q
Abusive head trauma (shaken baby syndrome)
A
bilateral retinal hemorrhages
posterior rib fx
hx provided does not line of developmental age
9
Q
DIC
A
schistocytes
bleeding from venipuncture sites
10
Q
prolonged postoperative ileus
A
delayed return in bowel function >72h after surgery
conservative tx
11
Q
primary open angle glaucoma sx
A
old age, DM, HTN, FHx
disk cupping, peripheral vision loss
12
Q
HOCM presentation
A
Teenager syncope episode during sports game
systolic ejection murmur
LVH on EKG
13
Q
pulmonary arterial HTN
A
progressive dyspnea, angina/syncope
loud P2 of S2
RVH
14
Q
ethylene glycol poisoning
A
sudden flank pain, gross hematuria, oliguria
high ion gap metabolic acidosis
elevated osmolar gap
15
Q
Conjunctivitis contact lens tx
A
pseudomonas
ciprofloxacin drops
16
Q
rash in lyme disease
A
erythema migrans
17
Q
MC sinus in orbital sinusitis
A
ethmoid
18
Q
MC complication of Kawasaki dz
A
coronary artery aneurism
19
Q
sarcoidosis sx
A
AA, hx of iritis
malaise, dyspnea, low grade fever
nodules on anterior lower legs
hepatomegaly
bilateral hilar lymphadenopathy
20
Q
heart blocks that need pacemaker
A
2nd degree type 2 (mobitz)
3rd degree
21
Q
Normal PR interval
A
0.12-0.20s
less than one big block
22
Q
How to determine rate
A
300
150
100
75
60
23
Q
Normal body temperature
A
98.6F (37C)
24
Q
multifocal atrial tachycardia seen in
A
COPD
25
multifocal atrial tachycardia tx
CCB
26
WPW avoid
ABCD (adenosine, BB, CCB, digoxin)
27
WPW tx
Vagal
Procainamide
definitive: radio frequency ablation
28
ASD murmur
fixed split S2
crescendo decrescendo
systolic
29
ASD tx
surgery
30
coarctation of aorta seen in what condition
turners syndrome
31
when PDA becomes cyanotic
eisenmingers syndrome
32
tetralogy of fallot
pulmonary stenosis
RVH
VSD
overriding aorta
33
tetralogy of fallot sx
crescendo decrescendo holosystolic
LSB rad to back
tet spells
cyanotic
34
tetralogy of fallot dx and tx
boot shaped heart
IV PDE1 to keep open PDA
35
Cardiogenic shock sx
hypotension
tachycardia
cool extremities
36
niacin AE
flushing, HA
warm sensation, pruritus
Caution in gout and DM
37
Fibrate AE
myositis and myalgia
gallstones
38
endocarditis sx
Fever
roth spots
laneway lesions
splinter hemorrhages
osler nodes
39
pericarditis sx
pericardial knock
positional chest pain (better sitting up or leaning forward)
friction rub
40
pericarditis tx
NSAIDS (indomethacin, colchicine)
41
kussmaul sign seen in
cardiac tamponade
42
pulses alternans
cardiac tamponade
43
cardiac tamponade tx
pericardiocentesis
44
rheumatic fever presentation
Caused by GABHS
hx of strep pharyngitis
45
rheumatic fever tx
penicillin G
NSAID/ASA
46
MC valve rheumatic heart disease
mitral
47
systolic valve disorders
mitral regurg
aortic stenosis
tricuspid regurg
pulmonic stenosis
48
diastolic valve disorders
aortic regurgitation
mitral stenosis
49
meds that can be used in pregnancy
methyldopa
labetatol, hydralazine (acute)
nifedipine
50
folliculitis tx
topical mupirocin
51
Erythema multiforme reaction
type 4 hypersensitivity reaction
52
erythema multiforme etiology
HSV1
53
erythema multiforme major tx
PO prednisone
54
alopecia sx
exclamation mark hairs
55
paronychia nail biter tx
augmentin
56
hand foot and mouth disease complications
myocarditis
CNS dz
57
koplik spots
rubeola (measles)
58
MCC cellulitis
S. Pyogenes
59
erysipeloid tx
penicillin G or V
60
tinia capitus tx
griseofulvin PO
61
tinea versicolor tx
1st line: shampoo (selenium sulfide, ketoconazole)
2nd line: PO antifungals (fluconazole/itraconazole)
62
amphotericin B AE
nephrotoxic
cardiotoxic
63
condyloma acuminatum tx
TCA, podophyllin, imiquimod
64
verrucae tx
salicylic acid or cryotherapy
65
actinic keratosis sx
sandpaper
sum exposed areas (head, farmer, gardener)
easier to feel than see
66
seborrheic keratosis sx
benign
wart like
waxy greasy stuck on appearance
67
basal cell carcinoma sx
translucent pearly white shiny
pink papule or nodule w/ telanagiectasias
raised/rolled border
68
basal cell carcinoma tx
face: mohs
69
kaposki sarcoma etiology
HHV8
70
kaposki sarcoma sx
red/purple painless lesions
starts as oral lesion on feet/leg/hands and spread centripetally
71
kaposki sarcoma dx
skin bx: neoplastic spindle shaped cells
72
SCC of the skin sx
friable, bleeds w/ minimal trauma
firm, frequently ulcerates
73
pityriasis rosea sx
URI sx --> herald patch --> Christmas tree --> resolution
74
seborrheic dermatitis tx
anti dandruff shampoo
flares: TCS (desonide)
75
MC complication pressure ulcers
osteomyelitis
76
child with >6 cafe au lait spots
potential neurofibromatosis type 1
77
Jones criteria
acute rheumatic fever
Joint
O (heart)
Nodules
Erythema marginatum
Syndenham chorea
Minor: Fever, arthralgia, hx rheumatic fever, elevated ESR/CRP/Leukocytosis, prolonged PR interval
78
allergic conjunctivitis sx
cobblestone mucosa
bilateral
itching
79
MCC optic neuritis
MS
80
optic neuritis sx
swollen disk
Marcus gunn pupil
flame shaped hemorrhage
unilateral central vision loss
loss of color perception
81
optic neuritis tx
IV methylprednisolone
Oral CS
82
papilledema sx
flame hemorrhages
white cotton wool spots
blurred disc margins
83
periorbital cellulitis tx
no visual changes or EOM pain
augmentin or 1st gen cephalosporin
84
postseptal orbital cellulitis tx
hospital
IV ceftriaxone and vanco
85
retinopathy sx
hard exudates
cotton wool spots
flamed shaped, blot and dot
neovascularization
HTN: copper wiring, AV nicking
86
amaurosis fugax sx
curtain descending then goes back up
unilateral, lasts minutes
acute vision loss
87
primary open angle glaucoma sx
gradual loss of peripheral vision `
cupping of optic disk
88
tx open angle glaucoma
BB (timolol)
latanoprost
89
malignant otitis externa tx
IV high dose cipro
90
acoustic neuroma sx
unilateral sensorineural hearing loss
91
labyrinthitis tx
CS
92
labyrinthitis sx
vertigo (continuous)
hearing loss
nystagmus
Hx of URI
93
BPPV dx
dix hall pike
94
BPPV tx
employ
meclizine
95
vestibular neuritis sx
continuous vertigo
no hearing loss
96
menière dz sx
episodic vertigo
hearing loss
ear fullness
97
tx mastoiditis
IV vancomycin and/or tympanostomy
mastoidectomy
98
anterior epistaxis tx
direct pressure, sitting and leaning forward
decongestants (afrin)
cautery (silver nitrate)
packing (after 24h failure)
arterial embolization or ligation
99
posterior epistaxis tx
posterior nasal packs
embolization or ligation
100
Vincents angina tx
trench mouth
penicillin VK/ clindamycin
101
Ludwig angina sx
Hx of dental caries
swelling upper neck and chin
muffled voice
tongue displacement
pus on floor of mouth
102
sialadenitis tx
nafcillin + flagyl or clindamycin
103
gas gangrene (myonecrosis) sx
hx traumatic injury of UVDU
brown/blood tinged watery exudates
crepitus/gas in tissue
104
gas gangrene tx
IV penicillin + IV clindamycin
debridement
105
listeriosis tx
ampicillin IV
106
anthrax tx
ciprofloxacin tx and exposure
107
campylobacter jejuni sx tx
F, frequency bloody watery diarrhea
supportive, azithromycin if severe
108
chlamydia conjunctivitis tx
PO erythromycin
erythromycin ointment if neonate
109
neonatal chlamydia pneumonia sx tx
azithromycin
staccato cough
afebrile
110
cholera sx tx
rice water stools
fever rare
doxy or azithromycin if mod-severe
111
diphtheria tx
hospital and isolation
airway support, ASAP antitoxin
IM penicillin G or IV erythromycin
112
hemolytic uremic syndrome labs
triad: hemolytic anemia, renal failure, thrombocytopenia
113
HUS sx and tx
E. coli O157:H7
bloody diarrhea
supportive n
114
salmonellosis sx
fever
bloody diarrhea
115
typhoid sx
relative bradycardia
hepatosplenomegaly
rose colored rash
pea soup
116
shigella sx
high fever
watery blood mucoid diarrhea
seizures
dehydration
117
shigella tx
FQ/cipro
azithromycin in kids
bactrim
118
Q fever tx
doxy
119
plague tx
streptomycin/gentamicin
doxycycline
120
tetanus sx
joker smile
arched back
lock jaw
descending paralysis
121
tetanus tx
metronidazole + IM tetanus IG
122
CD4 <100
cryptococcus
amphotericin B/ fluconazole
123
histoplasmosis tx
itraconazole or amphotericin B
124
CD4 <200
pneumocystis (PCP)
125
pneumocystis
fever
dry cough, wheezing
bilateral diffuse infiltrates (bat wing)
bactrim
126
ehrlichiosis sx, lab, tx
ticks
7-10d sx start
high fever, myalgia, HA
no rash, splenomegaly
PBS: Buffy coat/ morale in WBC. mulberry shaped aggregates
tx w/ doxy
127
CD4 < 50
mycobacterium avium complex
128
mycobacterium avium complex tx
clarithromycin + ethambutol
129
Ghon complex
TB
Ghon focus (caseous necrosis) + hilarious lymph node
130
PPD
>5mm: HIV, recent TB contact, immunocomp
>10mm: immigrants, IVDU, healthcare workers
>15mm: anybody
131
TB XCR
capillary lesions apical
132
amebic liver abscess tx
metronidazole
133
malaria tx
chloroquine
complicated: quinidine + doxy
134
chloroquine AE
hemolytic anemia
G6PD
135
malaria sx
cyclic fevers
night sweats
splenomegaly
jaundice
PBS + trophozoites (diamond ring appearance)
136
ToRCH syndrome
toxoplasmosis
rubella
cytomegalovirus
HSV2
blueberry muffin rash (TTP)
137
toxoplasmosis dx
ring enhancing lesion
138
cytomegalovirus
CVM IgM
large atypical lymphocytes w/ owl eye appearance
tx w/ gancyclovir
139
cat scratch dz tx
mild: symptomatic
azithromycin or doxy
140
roseola sx
high fever w/ abrupt onset
rose colored rash starts on trunk
141
scarlet fever sx
pharyngitis, F, chills
sandpaper rash, "burn w/ goosebumps"
flushed face w/ circumoral pallor and strawberry tongue
pastia lines
142
tx scarlet fever
penicillin G/VK
macrolide if allergic
143
zona glomerulosa
outer layer of cortex
aldosterone (Na balance)
144
zona faciculata
cortisol
middle layer of cortex
145
zona reticularis
estrogen/androgen
inner layer of cortex
146
Primary adrenal insuffiency labs
CRH high
ACTH high
Cortisol low
CRH stim test: high ACTH
147
secondary adrenal insufficiency labs
pituitary
CRH high
ACTH low
cortisol low
CRH stim test: absent/ low ACTH
148
tertiary adrenal insufficiency labs
hypothalamus
CRH low
ACTH low
cortisol low
CRH stim test: prolonged
149
primary adrenal insuffiency (Addisons) sx
hyperpigmentation
salt cravings
hypotension
hyperK, metabolic acidosis
hypoglycemia
loss libido
150
Addisons BIT
AM serum cortisol level
if low, adrenal insufficiency
151
GLP1 "tide" AE
pancreatitis
152
SGLT2 "flozin" AE
UTI/yeast
153
metformin AE
macrocytic anemia
renal impairment
metallic taste
154
hyperosmolar hyperglycemic state
blood glucose 600-2400
serum osmy >320
hyponatremia
little ketones
155
diabetic ketoacidosis
KETONURIA
blood glucose 250-600
fruity breath, kussmaul respiration
usually DMT1
hypokalemia, high anion gap
156
pheochromocytoma tx
phenoxygenzamine
propranolol
157
primary hyperaldosteronism (conn)
refractory HTN
hypokalemia, hypernatremia
158
conn syndrome tx
adrenalectomy if adenoma
spironolactone
159
SIADH labs
hyponatremia
high urine osmo
low serum osmo
160
SIADH tx
fluid restriction
sx: furosemide, admit to ICU
161
DI labs
increase volume dilute urine
decrease urine osmo
high serum osmo
162
Tx DI central
DDAVP
163
tx DI nephrogenic
thiazide
164
thyroid storm tx
ABC
BB
PTU/methimazole
iodine and steroids (dexamethasone)
165
hyperthyroidism tx
PTU
methimazole
166
de quervain thyroiditis (subacute thyroiditis)
hx URI
hyperthyroid then hypothyroid state
HLA B35
high ESR
167
subacute thyroiditis tx
self limiting
NSAIDS and BB
steroids
168
Basal long acting insulin
glargine
getemir
deluded
once daily
169
basal intermediate acting insulin
NPH
twice daily
170
preprandial short acting
Regular: best for IV use DKA. peak 2-5h
lispro, aspart, glulisine: peak 30m-3h. best for postal hyperglycemia
171
DM meds that cause hypoglycemia
sulfonylureas (glyburide, glipizide)
meglitinides (repaglinidide, nateglinidide)
insulin (regular, lispro, aspart, NPH, glargine)
172
cholecystitis sx
fat female fertile forty
murpheys sign
fever
173
cholangitis sx
charcots triad: F, RUQ pain, jaundice
Reynolds pentad: + septic shock, AMS
emergency
174
cholelithiasis sx
fat, forty, female, fertile, fair
pain after meal
no tx if asx
175
choledocholithiasis
jaundice, RUQ pain
176
primary biliary cholangitis
jaundice, RUQ pain, pruritus
+anti mitochondrial antibodies
tx w/ ursodiol. cholestyramine for pruritus
177
primary sclerosing cholangitis sx, lab
male w/ hx of IBS/UC
itchy hands, jaundice, hepatomegaly
increased ALK, increased GGT
+ pANCA
onion skin on liver bx
178
constipation tx
psyllium
Senna, bisacodyl
enema
179
diverticulosis sx
painless rectal bleeding
180
diverticulosis sx
fever, LLQ pain, leukocytosis
no bleeding
181
diverticulitis dx
CT w/ oral and IV contrast
CI: barium enema and colonoscopy (risk of perforation)
182
diverticulitis tx
zosyn, cipro, bactrim + metronidaozole
183
fecal impaction tx
digital disimpaction and evacuation
184
Hirschsprung dz sx
no passed meconium within 48h of birth
poor feeding, abd distention
185
hirschsprung dx
anorectal manometry BIT
xray: complete bowel obstruction
bx definitive
186
hirschsprung tx
surgery
187
hemorrhoids tx
2nd line: rubber band ligation (internal). elliptical excision (thrombosed)
3rd line: hemorrhoidectomy
188
smoking and IBD
Crohn: smoking harmful
UC: smoking protective
189
crohns
transmural, cobblestone appearance, skip lesions
RLQ, N/V/D, no gross blood
+ASCA, high ESR/CRP
string sign
190
Tx crohns
mesalamine
191
UC sx
continuous
LLQ pain, hematochezia, tenesmus
sigmoidoscopy/colonoscopy
+PANCA, stovepipe sign (dec haustral marking)
total colectomy curative
192
toxic megacolon
fever, tachycardia, leukocytosis
bloody diarrhea, vomiting
Xray: >6cm loss of haustral markings
ICU: colectomy if >24h
193
boerhaave syndrome
severe retrosternal chest pain
crunching (hammens sign)
XR: widened mediastinum, pleural effusion, emphysema)
contrast esophogram definitive
NPO, surgical
194
diffuse esophageal spasm tx
nitrates, CCB, TCA
195
Zenker diverticulum
halitosis
barium swallow
surgery 1st line
196
tx esophageal varices
vasopressin
banding and IV octeotide
chronic: BB and ligation
197
H. pylori tx
clarithromycin
amoxicillin
PPI
198
duodenal atresia
bilious vomiting first 2 days of life
double bubble sign
199
gastroporesis dx and tx
upper endoscopy BIT
confirm: scintigraphic gastric emptying study
metoclopramide
200
direct inguinal hernia
hesselbachs triangle
medial to inferior epigastric vessels
201
indirect inguinal hernia
lateral to inferior epigastric vessels
202
travelers diarrhea tx
cipro
azithromycin (preg/child)
bismuth
203
C. diff tx
metronidazole
vancomycin
204
hemolytic uremic syndrome caused by
shiga toxin
E. coli 1057:H7
205
HUS sx
bloody diarrhea, petechiae, oliguria
schistocytes
thrombocytopenia, AKI
Tx fluids, transfusion, dialysis
206
phenylketonuria
excessive phenylalanine
light complexion, musty/mousey urine
tx w/ tyrosine, avoid high proteins and phenylalanine
207
MC gastric cancer
adenocarcinoma
208
colorectal cancer
CEA
209
cholangiocarcinoma
tumor of intra extra hepatic bile duct
clay colored stool, dark urine, jaundice
210
pancreatic cancer
Ca 19-9
CEA
painless jaundice, pale stools
palpable gallbladder
211
thiamine deficiency
B1
from alcoholism
wernicke encephalopathy
212
Beriberi sx
dry: peripheral neurologic deficits from B1 deficiency. stocking glove distribution
wet: myocardial dz due to B1 deficiency
213
Riboflavin
B2
oral ocular genital syndrome
magenta tongue, angular chelitis
214
niacin deficiency
B3 (pellagra)
raw skin
4Ds: diarrhea, dementia, dermatitis, death (if not tx)
tx: meat, fish, liver, whole grains, green leafy veggies
215
scurvy
vitamin C deficiency
3H: hyperkeratitis, hemorrhage, hematologic
216
vitamin D deficiency labs
loser lines
low Ca, low P, high ALP
217
acute pancreatitis sx
epigastric pain rad to back
N/V/F leukocytosis, hypotension
Cullen sign, grey turner sign, fox sign
218
acute pancreatitis labs
CT
Xray/US: colon cut off sign, sentinel loop
high serum amylase, lipase (specific), low calcium
219
chronic pancreatitis
triad: calcifications, steatorrea, DM
CT, ERCP (gold)
amylase lipase normal
220
acute mesenteric ischemia
pain out of proportion
lactic acidosis, metabolic acidosis
CTA BIT, mesenteric angiography gold
barium enema (thumb printing)
221
intussusception sx, dx, tx
palpable sausage shaped mass
currant jelly stool
XR BIT (target sign)
reduction via enema (stable)
surgical if unstable
222
SBO labs
XR: ladder pattern, string of pearls
223
paralytic ileus
RF: opioids, post op
abscent/no Bowel sounds
resolves w/ time
224
volvulus
bilious vomiting, blood streaked stools
double bubble sign
corkscrew/beaked appearance
225
Kayser Fleischer ring
Wilsons dz
decreased ceruloplasmin
tx w/ D. penicillamine, zinc
226
compartment syndrome 5 Ps
pulselessness
pallor
paresthesia
paralysis
pain out of proportion
poikilothermic
227
OA tx
NSAIDs
acetaminophen for elderly w/ bleed risk
228
osteomyelitis sx tx
Codman's triangle (CT)
high WBC, high ESR/CRP
bone aspiration gold
tx: ampicillin-sublbactam, surgery to remove dead bone
229
avascular necrosis xray
joint space narrowing, subchondral sclerosis
230
salter Harris fx
I: Slipped epiphysis
II: Above fx
III: L below fx
IV: Through fx
V: ERasure of growth plate
231
pes anserinus pain syndrome
pain medial knee just below joint line
tenderness over medial tibial condyle
232
medial ankle injury gold
screw fixation
233
osteosarcoma presentation
young adult, adolescent
long bones
hair on end, starburst
Codman triangle
234
Ewing sarcoma sx, dx
children
+ fever, palpable mass
lytic lesion, onion peel, moth eaten, codman triangle
235
fibromyalgia tx
amitriptyline or duloxetineor pregabalin
236
1st line gout tx
NSAIDs
237
juvenile RA
uveitis, salmon colored macular rash, joint pain
high CRP, high ESR, + ANA
opthalmologic exams
NSAID, MTX
238
starburst livedo
polyarteritis nodosa: skin ulcers, nodules on lower legs,
high ESR/CRP
definitive: deep wedge bx of nodules
-ANCA
prednisone, cyclophosphamide
239
polymyalgia rheumatica
assoc w/ giant cell arteritis
morning stiffness better throughout the day (proximal)
high ESR/CRP
low dose prednisone w/ taper
240
eosinophilic granulomatosis w/ polyangitis
triad: asthma, hypereosinophilia, chronic rhino sinusitis
eosinophilia hallmark, + panca, high ESR/CRP, inc BUN/Cr
CS
241
polymyositis markers and tx
anti-jo-1
anti SRP
high dose CS
242
dermatomyositis
anti MI 2 ab
heliotrope (blue/purple eyelid discoloration)
gottrons papules: knuckles raised violaceous scaly eruptions
malar rash
shawl/ V sign
243
reactive arthritis tx
NSAID
supportive
244
RA
+RF
anti CCP
245
sjrogens
+ ANA, + RF
schemer test
antiSSa (ro)
anti SSb (la)
tx: pilocarpine
246
+ anticardiolipin ab
antiphospholipid syndrome
247
SLE tx
hydroxychloroquine
248
scleroderma markers
anti SCL 70
anticentromere ab
249
ankylosing spondylitis tx
NSAIDS, PT
TNF
250
brown sequared syndrome
ipsilateral hemiplegia
ipsilater loss of motor, vibratory, and proprioception
contralateral loss of pain and temp sensation
251
anterior cord syndrome
loss of motor, pain, temp below injury
proprioception and vibratory maintained
252
MC clavicle fx
middle 1/3
253
humeral head fx avascular necrosis
axillary nerve
brachial plexus
axillary artery
254
fat pad sail sign
radial head fx
255
galeazze fx
distal radius fx
radioulnar joint dislocation
256
Monteggia fx
ulna fx
radial head dislocation
257
MC mandibular fx
body
condyle
angle
258
lateral rectus palsy
SO4, LR6: abducens nerve
horizontal diplopia, estropia
259
trigeminal neuralgia tx
carbamazepine
260
pseudotumor cerebri tx
acetazolamide
261
alzheimers tx
anticholinergics (donepezil, rivastigmine)
memantine late stages
262
Creutzfeldt-Jakob disease
dementia at early age
seizures, myoclonic jerks
LP: 14-3-3 proteins in CSF
no current tx
263
frontotemporal dementia
+ palmomental and palmar grasp reflexes
personality changes
tx: SSRI, supportive
264
normal pressure hydrocephalus
wet, weird, wobbly: urinary incontinence, dementia, shuffling/wide based gait
MRI: ventriculomegaly
Tx w/ shunt
265
vascular dementia
sudden or stepwise decline
temporal: memory problems
parietal: loss of speech (aphasia)
frontal: personality changes
Tx by preventing another stroke: anticoagulant (ASA, clopidogrel, statin, ACE)
266
cerebral palsy sx
spastic: increase muscle tone, high DTR
267
MS tx
exacerbation: Methylpred
plasmapheresis
maintenance: Beta interferon
268
myasthenia gravis dx
AChr ab test, MuSK ab
tension test
269
myasthenia gravis tx
pyridostigmine
thymectomy if thymoma
270
GBS tx
high dose IVIG, plasmapheresis, CS
271
central cord syndrome
upper extremities more affected than lower
272
subarachnoid hemorrhage gold standard
LP: xanthochromia
273
intracranial hemorrhage tx
nitroprusside
274
ACA
feet and legs
275
MCA
hands
arms
face
language center in dominant hemisphere
276
PCA
visual
blindness
277
lacunar CVA
hemiparesis (contralateral)
278
basilar CVA
CN abnormalities
vertigo
279
TPA/Alteplase
w/in 4.5h of onset
280
vertebral CVA
vertigo, nystagmus, diplopia
281
MC CVA
MCA
282
outpatient tx pneumonia
amoxicillin
doxycycline
283
inpatient tx pneumonia
ceftriaxone and azithromycin
FQ (levo)
pseudomonas: piperacillin tazo
284
MCC atypical pneumonia
mycoplasma (young college)
285
CXR atypical pneumonia
mycoplasma: reticulonodular infiltrates
286
blastomycosis
east of Mississippi
F, cutaneous papules
pulmonary sx
round broad budding yeast w/ thick double walls
itraconazole
287
coccidiomycosis
California
mild lung infx, bone granulomas, meningitis, erythema nodosum
self limiting, itraconazole
288
histoplasmosis
Mississippi River valley, Ohio
dimorphic oval yeast
289
cryptococcosis
encapsulated budding yeast on India ink stain
USA, MC fungal meningitis
290
aspergillosis sx tx
soil
mold grow in lungs
septa hyphae w/ regular branching, wide angle
fungus ball on xray
need surgery, itraconazole
291
rifampin AE
orange discoloration of urine/tears
hepatotoxic
292
isoniazid + pyroxidine AE
peripheral neuropathy (combo w/ B6)
hepatotoxic
293
pyrazinamide AE
hepatotoxic
hyperuricemia
photosensitive dermatologic rash
can use on pregnancy
294
ethambutol AE
optic neuropathy
red/green color blindness
hyperuricemia
gout
295
superior vena cava syndrome
complication of lung cancer
SVC obstructed by tumor, venous congestion to head, neck and UE
facial fullness, face/arm edema, dilated veins anterior chest/arm/face JVD
296
horners syndrome
apical tumor presses on cervical sympathetic chain
ptosis
miosis
anhidrosis
297
lung cancer nerve compression
recurrent laryngeal nerve: hoarseness
phrenic nerve: diaphragmatic elevation and dyspnea
298
small cell lung cancer location
central
299
mesothelioma dx
pleural thickening
bx of tumor definitive
immunostained w/ calretinin: fried egg shape
300
pulmonary carcinoid tumor
dysfunction of neuroendocrine cells leading to tumor production
serotonin synthesis
diarrhea, skin flushing, asthma-like attacks, hemoptysis
well vascularized central tumor (pink/purple)
best: 24h urine w/ 5-HIAA: high serotonin levels
TOC: surgery, octreotide
301
pulmonary HTN sx
dyspnea, chest pain, and syncope on exertion
tricuspid regurgitation (holosystolic murmur)
loud P2 during S2
right heart Cath gold, echo BIT
tx underlying
302
coal worker pneumoconiosis CXR
small apical opacities upper lobs
303
berylliosis
aerospace, dental, lightbulbs
berrylium lymphocyte upper lobe
noncaseating granulomas on bx
glucocorticoid therapy for acute and chronic
MTX if nonresponsibe
304
byssinosis sx
cotton dust, textile
Monday chest tightness
305
ARDS sx and xray
failure to respond to 100% O2
bilateral infiltrates, spares costophrenic angles
306
Stages of asthma tx
Intermittent: <2d/wk, night sx <2/mo (SABA prn)
Mild persistent: >2d/wk, night sx 4x/mo (SABA + low dose ICS, fluticasone)
moderate persistent: daily sx, night sx >1/wk (SABA + low ICS +LABA)
severe persistent: multiplex/d night >7x/wk (SABA+med/hi ICS+LABA)
307
bronchiectasis
MCC CF
chronic cough, mucopurulent foul smelling sputum
Chest CT: tram track, signet ring sign
zosyn for pseudomonas coverage
308
MC site FB lung
main right bronchus
309
hyaline membrane dz
insuffiency of surfactant
diffuse ground glass appearance
antenatal CS for mom 24h before
310
3 auditory ossicles
malleus
incus
stapes: smallest bone in body
