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Flashcards in UWorld Deck (20)
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When TPN has to be given in central line

TPN risks to know

TPN must be given in central line if >48h

central line infection--highest risk
Cholestasis--risk if >2 weeks of TPN. higher risk of cholelithiasis then.


ecthyma gangrenosum

lesion, often foot, of Pseudomonas

progress from small erythematous macule to large, NONTENDER, necrotic nodule

Suspect when immunocompromsed (eg radiation)


pulsus paradoxus
-indicates what
-how to measure bedside without BP cuff

tamponade. inspiration causes increased preload to R side, pushing into L side's filling

Loss of palpable radial pulse during inspiration
(or >10mmHg lower BP during inspiration)


AFib risk score, nonvalv anticoag
-what scores to give what tx

CHA2DS2VASc score
Age >75
Vascular (PAD, MI, aortic plaque)
Age 65-74
Sex (female)

1--none, aspirin, or oral anticoag
2--oral anticoag


New baby of diabetic mother
-most likely complication after birth?

respiratory distress (RDS from low surfactant from lung immaturity)

also: limb, cardiac issues


ABI values for PAD
-severe ischemia

what can cause possible false elevation

normal: 1.0-1.3
PAD: 0.4-0.9
severe ischemia: <0.4

Diabetics with calcified noncompressible vessels


What if you see hyperCa to 14.0?

If hyperCa >12, then think malignancy, esp PTH-rp of squamous cell of lung
You also see low phosphate

Primary hyperparathyroidism would go up to 12 usu, and not severely sx.


Gastric bypass and RUQ pain
-think what, do what

Higher risk (40% chance) of gallstones soon after surgery/ b/c of concentration of bile

-ppx with Urso acid 6 mo
-or take out gallbladder if sxs before surgery


How does GI bleed cause hepatic encephalopathy?
-how to know by labs?

High nitrogen state. Digested blood is source of urea, and it reabsorbed in intestine during Upper GI Bleed.

You will see elevated BUN/Cr ratio (>20)


Iron toxicity
-how present

Initially N/V/Diarrhea. Upper GI bleed. Hematemesis and melena. Then hypovolemic shock

can occur with 10 tablets only


Knee injuries:
ACL vs meniscus

Meniscal tear: twisting on uneven ground.
-immediate pain, but usu not severe enough to limit mobility
-Effusion on 2nd day, common
-locking, instability sensation, painful squatting, can limit joint extension.
-Tenderness at joint line, and locking/clicking

rapid onset hemarthrosis, does not limit joint extension


How to use urine Na for determining dehydration

Decrase urine Na (Urine Na <20) supports hypovolemia in pt


Sickle cell pt in septic shock
-what bug most likely

Strep pneumo (encapsulated)
which is why must get pneumococcal vaccine, ad


Who needs abx ppx for dental procedures? (3)
who doesn't?

high risk: prosthetic heart valves, hx of IE, unreparied congenital heart dz
Give single dose Amox (or azithro)

No ppx for: bicuspid aortic valve, acquired aortic valve dz, acquired mital valve dz (including MVP)


Hookworm (or other worm) infection:
typical vignette to know

Chronic diarrhea, recently came from poor country
Had an unexplained dry cough for a while, resolved
CBC shows eosinophilia (>3%)
Fe deficiency anemia


Hemoptysis in children
DDx (3)
which is MCC

1. Bronchiectasis, usu from CF
2. Resp infection (local trauma, inflamm). Usu small-volume blood
3. Foreign body

CF Bronchiectasis MCC


OCPs reduce risk of what cancer(s)?

increase risk of what 2 things?

Ovarian and Endometrial
not Breast

DVT, hepatic adenoma


Diarrhea and heart arrythmia, think what

Diarrhea can cause HypoK and hypoMg. If pt already long QT, then can cause torsades

Remember Mg for Torsades


Long QT: what values

men: 0.44
women: 0.46


MS: what activity can exacerbate sxs?

Heat, Hot showers. Uhthoff phenomenon