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Flashcards in UWORLD Deck (30):
1

patient falls down 10 feet off tree, has left sided abdominal pain with guarding and anemia

splenic injury

after FAST, if HDS, proceed to CT abdomen to r/o splenic injyry

2

how to calc serum osmol

2Na + glucose/18 + BUN/2.8 = 280 nml

3

3 side effects of thiazide diuretics (hyper/hypo)

hyperuricemia
hypercalcemia
hypokalemia

4

pregnant lady PAP shows high grade squamous lesion, what to do next

immediate colposcopy (ok in pregnancy)

if Pap shows ASCUS or low grade, do HPV cotesting to confirm

5

DM patient with anorexia, nausea, vomiting, early satiety, postprandial fullness, hypoglycemic after meals
dx and rx

gastroparesis 2/2 autonomic neuropathy
rx with metclopramide

6

it pt positive for gonorrhea, what else to test for?

chlamydia
HIV
hep B
syphillis


NOT HSV, not recommended

7

management DKA

1. 0.9% normal saline to restore intravascular volume
2. correct hyperglycemia with regular IV insulin
3. serial assessment of electrolytes (watch out because insulin can cause hypoK)
4. treat underlying cause if any

once glucose gets under 200 may add on dextrose

8

painful tender goiter, fever/hyperthyroid symptoms (elevated T4, low TSH), elevated ESR/CRP, recent viral infection

subacute/ Dequervain thyroiditis
low radioiodine uptae

rx beta blockers for hyperthyroid symptoms and NSAIDs

9

positive TPO antibody, predominately hypothyroid feaetures, diffuse goiter,

chronic autoimmune thyroiditis (hashimoto)

10

postive TPO antibody, low radioiodine uptake, small goiter, brief hyperthyroid phase, spontaneous recovery

painless thyroiditis/silent

11

patient in labor presents with severe abdoinal pain, vaginal bleeding, fetalheart decels, palpable fetal parts on abdominal exam/loss of fetal station

uterine rupture

immediately deliver/surgically explore

risk increases from prior uterine surgery (i.e. c section), induction of prolonged labor

12

pancytopenia, hyperpigmentation, neck, cafe au lait spots, short stature, initially thrombocytopenia, then neutropenia, then anemia.
4-12 years of age

fanconi anemia

13

3 month old, presents with pallor poor feeding. CBC shows pure red cell aplasia, normocytic/macrocytic. WBC and plt counts normal

diamond blackfan anemia

14

what conditions can cause acquired aplastic anemia

bone marrow injury (radiation, drugs/chemo), insecticides, infections

15

mildy deranged Ca and Phos, nml PTH, family hx of hypercalcemia

what to do next

check urine Ca

r/o familial hypercalcemic hypocalciuria

16

When to check 1-25 vit D for hypercalcemia

if you suspect CKD

17

elevation in PTH, hypercalcemia, low phosphorus, parathyroid gland scan shows multiple small adenomas on several parathyroid glands

tertiary hyperparathyroidism

one parathyroid adenoma = primary hyperparathyroidism

18

5 month old infant, recurrent infections (viral/fungal/opportunistic), hypogammaglobulinemia, low T cell count, chronic diarrhea

dx rx

SCID (XLRecessive or AD)
rx stem cell transplant (also check for absent thymos)

19

recurrent sinopulmonary/gi infections, absent B cells, low serum immunoglobulin, NORMAL T CELL, no lymphoid tissue

Bruton/Xlinked agammaglobulinemia

20

recurrent sinopulmonary/GI bacterial infections 2/2 hypogammaglobulinemia, presents later in age (less severe than Bruton's)

combined variable immuniodeficiency

21

early infancy,, eczema, bleeding 2/2 thrombocytopenia

wiskott-aldrich (WATER)
"wasp gene"
anemia
thromboycytopenia purpura
eczema
recurrent infections

22

when to offer BRCA1/2 testing

first degree relative with breast cancer dx< 50....if mother dx with breast cancer 67, don't need to screen!

23

modifiable risk factors breast cancer (4)

HRT
nulliparity
increased age at firs tlive birth
ALCOHOL CONSUMPTION! (smoking protective)

anything that increases estrogen

24

recent URI turns into persistent dry cough for 10 days. Yellow tinged sputum and scant hemoptysis, chest xray clear., afebrile..dx rx

acute bronchitis
symptomatic rx with NSAIDs, bronchodilators

NO ABX
self limiting

25

rx uremic coagulopathy (commmon cause abnormal hemostasis in patients with chronic renal failure)

DDAVP
(increases release of factor VIII/Vwf multimers from endothelium)

DO NOT GIVE PLATELETS
(they will quickly become inactive in uremia)

26

how to rx hypercalcemia 2/2 granulomatous dx or excessive vit D intake

steroids (i.e. prednisone, methylprednisolone)

27

2 ways ACEI contribute to cough

1. leads to accumulation of kinins, substance P
2. activates arachadonic pathway->increased thromboxane->bronchoconstriction

28

most sensitive screening test for diabetic nephropathy

random urine microalbumin/Cr ratio

29

acute episodic fever, malaise, cough, breathlessness in bird handler or farmer/mold handler

dx and rx

hypersensitivity pneumonitis
rx AVOID ANTIGEN

30

although Hodgkin lymphoma is fairly responsive and treatable with chemo, what to look out for

develop second malignancy from chemo!!! (lung, breast, thyroid, bone, GI) can occur within 20-30 years