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USMLE Step 2 > Uworld 3 > Flashcards

Uworld 3 Flashcards

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1
Q

chondrocalcinosis

A

pseudogout –> CPPD

evaluate for: hyper PTH, hypothyroid, hemachromatosis

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2
Q

hemachromatosis

A

diabetes
hepatomegaly
arthralgia (assoc with pseudogout/ chondrocalcinosis)

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3
Q

how do breath sounds/ tactile fremitus change in consolidate process vs effusion

A

consolidation: sound travels faster through solids/liquids, so breath sounds inc (crackles, etc) and tactile fremitus increases
effusion: liquid OUTSIDE lung compresses it and shelters breath soudns and fremitus

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4
Q

methemoglobinemia

A

cyanosis that does not correct with O2 –> likely after expsoure to oxidizing agents like dapsone, benzocaine, lidocaine

low SaO2 with normal PaO2

co-oximetry can decipher types of hemoglobin

tx= methylene blue

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5
Q

methylene blue

A

reduces methemoglobin back to regular hemoglobin

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6
Q

dimercarpol

A

tx for lead poisoning

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7
Q

fomepizole

A

ethylene glycol, methanol poisoning

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8
Q

pralidoxime

A

antidote given with atropine in cholinergic poisoning

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9
Q

cardiac anomaly in marfans

A

AORTIC root dilation, causes regurg
AORTIC aneuryms
AORTIC dissections

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10
Q

evaluatin of physiologic galactorrhea

A

pregnancy test, TSH, PRL, maybe MRI

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11
Q

appearnce of lichen planus vs sclerosis

A

Planus= brightly erythematous and involves labia and vagina + mucosal invovlement
(6 P’s-pruritic, purple, polygonar, plaques)

sclerosis= thin, cigarette paper, only involves vulva, perianal thickening

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12
Q

oral involvenet of lichen Planus

A

lacy, reticular = wickham striae

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13
Q

6 P’s of lichen planus

A

Purple, Polygonal, Planar, Pruritic, Papules

can involve skin, mucosa, nails

tx= bx to rule out vulvar carcinoma, high dose steroids

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14
Q

best test with LOWER extremity changes in sensation, hy[erreflexia and babinski

A

MRI of the spine

UMN signs point to CNS involvement, and lower extremity only= spinal cord.

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15
Q

presentation difference (thinking about the fever) that’s different between roseala and measles

A

roseala –> rash AFTER fever

measles–> rash with fever

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16
Q

mechanism of TD with antipsychotics

A

UPregulation and supersensitivty of DA receptors…

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17
Q

how does caricocele contribute to decreasd fertility

A

increased temperature

boys= tx with gonadal vein ligation
older men= nsaids and supportive therapy

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18
Q

congenital VZV

A

limb hypoplasia
blindness
dermatomal scarring

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19
Q

congential HSV

A

disseminated can present without skin findings –> look for encephalitis with TEMPORAL EDEMA AND HEMORRAGE

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20
Q

causes of magnesium toxicity in pre-E

A

Mg is 100% cleared by kidneys so look at Cr

*first line reversal is Calcium gluconate

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21
Q

factrial design

A

randomizatoin into two interventions with additional study of 2 variable

ie: randomize by treatment and then randomize by two BP goals

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22
Q

cross over design

A

each group does one treatment, after a set number of weeks they switch groups and do the other

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23
Q

feature of hypovolemic shock and septic shock in terms of heart/ pulm pressures

A

DEC RA, PA, wedge

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24
Q

vessel distribution assoc with thalamic pain syndrome

A

deep penetrates of posterior cerebral artery

**occurs weeks to mnths after, presents with contralateral sensory loss from lacunar strke

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25
aspiration pneumonitis
HOURS after asp of stomach acid compared to aspiration PNA which comes days later
26
what to test for with unexplained cytopenias, like isolated thrombocytopenia
HIV, HCV
27
heart involvement of amyloidosis
accumulation of insoluble protein firbrils that commonly affect heart as restrictive cardiomyopatyh --> progresses to dilated cardio myopathy easy brusing proteinuria neuropathy hepatomegaly
28
who gets NEC
premies AND congenital heart problems who arn't perfusing the gut well **look for signs abdominal distention, billious vomiting, bloody stools, signs of vital sign instability like hypothermia from insensible loses
29
oral or systemic tx for vaginal candida?
oral fluconazole is first line for comfort purposes pseudo hyphae with normal pH!
30
pulmonary edema in pre E
due to arterial vasospasm in inc systemic vascular resistance **rare complication. dist from amniotic fluid embolism by BP and whether or not they are in labor
31
calcium/ phos in lactose intolerance/ fat malabsorption disorders
don't absorb D --> dec gut absorption of C/Phos --> dec Ca, dec Phos --> Inc PTH **secondary hyperparathyroidism
32
effect of Vit D on ca/phos
increased absorption of both at the gut
33
most common cause of spinal stenosis
DJD --> osteophytes and stuff relief when leaning forward, worse with extension
34
gold standard dx for HIT? Classic features involved with injection site? Tx?
Serotonin relase assay HIT skin necrosis at injection site on belly STOP and start argatroban or fondoparinaux
35
hazard ration <1, 1, >1
``` <1= more likely in control 1= similar >1= more likely treatment ```
36
how do you dx HepC
2 steps: - 1) ab - 2) PCR 50% of patients spontaneously clear so you have to confirm it
37
meconium ileus vs hirschsprung in terms of consistency and location
MI= inspissated, ileum HS= normal consistency, rectosigmoid
38
CMV colitis
immunocompromised patient with CD4 <50 presenting with small volume, frequent bloody stool and low grade fever dx= colonoscopy looking for eso/baso internuclear inclusions
39
triad presentation of spinal epidural abscess
fever, back pain, focal neuro deficit *these rarely all present. Staph a is most common organism
40
steps in caustic ingestion
1) ABC 2) remove clothing 3) EGD = diagnostic and should be done withn 24 hours. Too soon wont show full extent, too late is risk for perf
41
negative predictive value
probablitiy of being free of dz if a test result is negative (high pretest probability= low NPV)
42
ROM that causes pain in rotatr cuff
abduction and external rotation
43
prader wili
loss of Paternal 15q11-q13
44
meds that cause iICH
tetracyclines vit A derivatives GH
45
aderenoleukodystrophy
congenital cause of AI characterized by build up of very long chain fatty acids
46
when to suspect a cholesteatoma
continued ear drainage for several weeks despite abx in a kid, granulation tissue and skin debris within retraction pockets of TM - congenital or acquired from chronic OM - think about with new onset hearing loss - can lead to bad things
47
classic triad of resp signs in CF? why do they have bruising? differentiate from primary ciliary dyskinesia
- recurrent sinopulm infx, clubbing, nasal polyps - impaired vit K asoprtions PCD has all similar sx but NOT pancreatic insufficiency
48
primary ciliary dyskinesia
mucociliary clearnace problem | 50% have situs inversus
49
management of neonatal hydrocele
conservative, should resolve in a year | -can be communicating or non communicating
50
how does succs work
depolarizing agent that binds post synaptic Ach receptors --> Na in, K out
51
how does etomidate lead to adrenal insufficiency
blocks 11b-OH
52
"diabetic neuropathy"
somatic nerves are central/ more susceptible to ischemia--> ptosis and down and out pupil parasymp are outside--> preserved light rxn
53
alcohol/ sleep/ anxiety
someone who is only anxious at night...consider mild alcohol withdrawal
54
ACA stroke
- contralateral weakness/sensory loss mostly LOWER extremities - urinary incontinence
55
refeeding syndrome
introduction of cards --> insulin spike --> uptake of Phos, Mg, K Phos used up the most for ATP K and Mg cause arrythmias --> can lead to fast volume overload and heart failure signs
56
mech of xs estrogen in obesity
androgens converted into estradiol
57
why do anovulatory cycles not produce progesterone
no development of corpus lutem normal= corpus luteum secretes prog --> cnverst proliferative endometrium to secretory endometrium --> corpus lutem sheds --> period
58
hypercalcemia in quadriplegic?
immobilization
59
why/ when do you take out testes in AIS
after puberty, allow pt to reach maximum hiehg tand secondary development, but take them out because inc risk of cancer
60
in laryngomalacia, when is stridor exacerbated?
crying or stress
61
difference between mono presentation and acute HIV
similar, flu like illness HIV- diarrhea, rash Mono- tonsilar exudate
62
preE at <20 weeks
hydatidaform mole
63
risk for mole. presentation?
extremes of age, hx of mole preE, hyperemesis gravidum, hyperthyroid, uterus>age
64
vitreous hemorrhage
sudden loss of vision with floaters --> common in diabetic neuropathy
65
central retinal vein occlusion
- sudden painless loss of vision - disk swelling, retinal hemmorhage, venous dilation, ctton wool spots **hypertension and atherosclerosis
66
retinal artery occlusion
sudden painless loss of vision with cherry red fovea
67
why are HSP kids at risk for intussusception
ileoedema and bleeding **IgA vasculitis presents with palpable purpura, arthralgias, hematuria, abd pain
68
precipitators of thyroid storm
surgery, trauma, childbirth, infx, contrast load (iodine) look for hyperthermia, tremor, agitation, delerium, LID LAG tx with BB, PTU, glucocorticoids
69
feature of malignant hyperthermia you probably wouldn't see in thyroid storm
presents with hypercarbia
70
hepatohydrothorax
transudative effusion through muscular defect in diaphgram (usu right) in liver failure patients
71
hepatopulmonary syndrome findings
intrapulmonary vascular dilations - dyspnea while sitting up - decrease SpO2 while sitting up
72
how does prevelance relate to PPV/NPV
inc Prevelance = inc PPV dec prevelance= inc npv
73
tabes dorsalis presentation
romberg, sensory ataxia, neurogenic incontinence, argyll robertson pupils (don't respond to light but do respnd to accomodation
74
what type of cancer is paget's
adenocarcinoma
75
dangerous complications in mono
splenic rupture airway compromise AHIA --> IgM, coombs, inc retics ****happens about 2-3 weeks later
76
how do you address fixing refractory hypokalemia in alcoholic?
replete mag

USMLE Step 2 (18 decks)

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