UWORLD Flashcards
(30 cards)
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
how to calc serum osmol
2Na + glucose/18 + BUN/2.8 = 280 nml
3 side effects of thiazide diuretics (hyper/hypo)
hyperuricemia
hypercalcemia
hypokalemia
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
DM patient with anorexia, nausea, vomiting, early satiety, postprandial fullness, hypoglycemic after meals
dx and rx
gastroparesis 2/2 autonomic neuropathy
rx with metclopramide
it pt positive for gonorrhea, what else to test for?
chlamydia
HIV
hep B
syphillis
NOT HSV, not recommended
management DKA
- 0.9% normal saline to restore intravascular volume
- correct hyperglycemia with regular IV insulin
- serial assessment of electrolytes (watch out because insulin can cause hypoK)
- treat underlying cause if any
once glucose gets under 200 may add on dextrose
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
positive TPO antibody, predominately hypothyroid feaetures, diffuse goiter,
chronic autoimmune thyroiditis (hashimoto)
postive TPO antibody, low radioiodine uptake, small goiter, brief hyperthyroid phase, spontaneous recovery
painless thyroiditis/silent
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
pancytopenia, hyperpigmentation, neck, cafe au lait spots, short stature, initially thrombocytopenia, then neutropenia, then anemia.
4-12 years of age
fanconi anemia
3 month old, presents with pallor poor feeding. CBC shows pure red cell aplasia, normocytic/macrocytic. WBC and plt counts normal
diamond blackfan anemia
what conditions can cause acquired aplastic anemia
bone marrow injury (radiation, drugs/chemo), insecticides, infections
mildy deranged Ca and Phos, nml PTH, family hx of hypercalcemia
what to do next
check urine Ca
r/o familial hypercalcemic hypocalciuria
When to check 1-25 vit D for hypercalcemia
if you suspect CKD
elevation in PTH, hypercalcemia, low phosphorus, parathyroid gland scan shows multiple small adenomas on several parathyroid glands
tertiary hyperparathyroidism
one parathyroid adenoma = primary hyperparathyroidism
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)
recurrent sinopulmonary/gi infections, absent B cells, low serum immunoglobulin, NORMAL T CELL, no lymphoid tissue
Bruton/Xlinked agammaglobulinemia
recurrent sinopulmonary/GI bacterial infections 2/2 hypogammaglobulinemia, presents later in age (less severe than Bruton’s)
combined variable immuniodeficiency
early infancy,, eczema, bleeding 2/2 thrombocytopenia
wiskott-aldrich (WATER) "wasp gene" anemia thromboycytopenia purpura eczema recurrent infections
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!
modifiable risk factors breast cancer (4)
HRT
nulliparity
increased age at firs tlive birth
ALCOHOL CONSUMPTION! (smoking protective)
anything that increases estrogen
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
