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USMLE Step 2 > Uworld > Flashcards

Uworld Flashcards

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1
Q

organophosphate poinsing t

A

atropine

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2
Q

bladder DOME rupture can cause…

A

diffuse chemical peritonitis

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3
Q

autism on the test

A

repetitive behaviors

behavioral regidity

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4
Q

management of SIADH

A

mild, no sx 130-135= fluid resus
OR –> if it is chronic and axymptomatic and lower, fluid restriction is okay

ACUTE,severe, symptomatic <120= hypertonic saline!! but go slowly

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5
Q

how to manage hypothyroid when someone becomes pregnant

A

T4 increases by bHCG, and estrogen by increasing TBG

TSH decreases due to feedback inhibition of above

SO, increase levothyroxine dose ~ 30 % and then adjust after first trimester

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6
Q

ethylene glycol poisoining

A

flank pain, hematuria, oliguira

  • hypocalcemia + calcium oxalate crystals
  • anion gap metabolic acidosis

tx with fomepazole

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7
Q

clinical features of methanol ingestion

A

central scotoma
APD
altered mentation

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8
Q

who should get washed RBC?

A

IgA defic
complement defic
repeated reactions despite antihistamine

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9
Q

how to prevent non hemolytic febriel transfusion reaction

A

leukoreduction

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10
Q

risk of testicular cancer in cryptorchidism after orchiopexy

A

remains elevated

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11
Q

murmur of pulmonic vlave stenosis

A

isolated congential finding

  • similar to AS but INCREASES WITH INSP and has a loud S2
  • can present as R heart failure signs in a child
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12
Q

differentiating sx in NMS vs SS

A

NMS= higher fever, rigidity

SS= hyperreflexia, myoclonus

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13
Q

atomoxetine

A

SNRI first line alternative to stimulants in ADHD

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14
Q

chanfges you’ll see on echo in hypovolemic shock

A

decreased size of LV (less blood) with INC ejection fraction

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15
Q

when do you use steroids with TMP-SMX in PCP pna

A

when PaO2 <70 or Aa >35

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16
Q

MRI vs XRAY for low back pain

A

XRAY- malignancy, AS, osteoporossis

MRI- neuro changes

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17
Q

management of GDM
1)
2)

A

1) dietary modifications

2) INSULIN!

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18
Q

community acquired MRSA pna

A

Staph A pna after influenze –> high fever, multilobular infiltrates and cavities on CXR

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19
Q

coagulability in pregnancy

A

hypercoag state –> dec prot S, inc fibrinogen

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20
Q

bruton agammglobulinemia

A

dec lymphoid tissue do to bad B cell development

-inc sinopulm and GI infections

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21
Q

ADA deficiency

A

SCID –> T cell immunity doesn’t develop

  • recurrent viral, fungal, bacterial infx
  • FTT
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22
Q

chronic granulomatous dz

A

recurrent skin and lung infx with CATALASE + organisms due to impaired oxidative burst

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23
Q

first step in acetaminophen OD with n signs of toxicity

A

activated charcoal, check levels –> nac

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24
Q

first step in dx infertility

A

semen analysis

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25
when do you give steroids in neonatal meningitis?
when its H flu to prevent sensorineural hearing loss
26
drug induced acne
steroids most commonly --> monomorphic papular rash without pustules or comedones most commonly on back, shoudlers, arms
27
infective endocarditis that looks like PNA
IV drug use --> R heart --> rarely has audible murmur and shows less typical signs throws septic emboli into lungs that cause cavitation lesions
28
most common reason fr arrested secnd stage of labor
fetal malposition
29
abnormal glandular cells on pap
cervical or endometrial cancer if >35 --> endometrial bx!
30
t/f: oxalate absoprtion is inc in fat malabsorption disorders like chrons
true --> oxalate stones
31
chronic pancreatitis
epigastric pain that relieves with leaning forward - can have long pain free intervals - amylase/lipase can be NORAML!! - dx with CT which can show calcifications
32
dx of intussuption
air/saline enema
33
decreased libido after Hsyt+ BSO
decreased androgens (postmenopausal ovaries produce testosterone and androgens that peripherally convert to androgens in adipose tissue and are thought to be important for libido)
34
valvovaginal atrophy
aka --> atrophic vaginitis, aka menopausal genitouirnary syndrome can present with: - vaginal dryness - urinary incontinence!
35
homemade alcohol
think lead poisoning! look fr vague GI, neuro complaints **lead poisoning can increase uric acid and gout.
36
vitamin K deficiency
normal stores= 30 days, but sick person with underlying dz can loose in 7-10 days **think alcoholic, surgery (NPO) on abx (killing gut flora)
37
how do you manage ACUTE organ rejection?
increase imunosuppressants/ steroids
38
when do you do bronchoscopy for hemoptysis? when do you do arteriography?
>600ml of blood or 100ml/hr/ hemodynamic instability bleeding can be visualized and treated by bronch interventions, but if you CANT LOCALIZE, then do arteriography
39
what is greatest risk to patient with massive hemoptysis?
asphyxiation from blood in the airway | -do a bronch to localize bleed and put them in dependent position
40
non stimulant, non addictive options for ADHD
1) atomoxetine | 2) bruproprion and TCA
41
effect of anteverted/anteflexed uterus on bladder?
compresses it
42
define adenomyosis
endometrium WITHIN myometrium
43
how should you admin vaccines to premies? what is the exception?
by CHRONOLOGICAL age | -Hep b: wait til babe is >2kg
44
story like polymyositis but no ESR/CK in someone on high dose steroids?
glucocorticoid incuded myopathy | *begins weeks to months after induction
45
acute urinary retention in someone who is on antihistamines...
they have anticholinergic effects and can push someone with BPH over the line to AUR
46
triad presentation of aspergillosis
fever, pleuritic chest pain, hemoptysis CT: halo sign= pulmonary nodules with surrounding ground glass opacities
47
management of stillborn
offer autopsy.
48
dx of perforated viscus
some hx of ulcer (ie NSAID use) with sudden onset peritonitis, rebound, decreased bowel sounds dx= upright xray to show free air
49
tx of TCA overdose
bicarb--> use EKG to determine if necessary
50
explain secondary hyperparathyroidism in renal failure
renail failure --> decrease Vit D + phosphate retention --> dec CA ++ --> inc PTH (stilmulated by both low Ca and high Phos)
51
first line treatment in ideopathic intracranial hypertension
acetazolamide --> can add furosemide if still symptomatic **rememeber you can see a CN6 palsy with this
52
contact lens keratitis
usually gram negatives
53
osteogenesis imprefecta II
rare form --> infants die in utero or shortly after birth due to THORACIC HYPOPLASIA, short femurs, multiple fractures
54
bugs that raise vaginal pH
trich | gardnerella
55
adjustment disorder
maladaptive emotional/behavioral response to a stressor that last <6 mo
56
neiman pickk vs tay sachs
both are lysosomal storage disorders with cherry red spots NP= Hepatomagaly + foam cells + areflexia TS= hyperreflexia
57
Gauche presentation
HSPM, pancytopenia, avascular necrosis of femur, bone crisis tx= recombinant glucocerebrosidase
58
selective IgA deficiency
Airway+ GI (inc giardiasis) Atopy Anaphylaxis (esp with foreign ag like blood transfusion)
59
x linked (Bruton) agammaglobulinemia | b for boys
no b cell MATURATIN = lymphoid tissue atrophy - recurrent sinopulmonary infx after 6 months - all Ig levels dc - live vaccines CI
60
CVID
defect in B DIFFERENTIATION | -dec plasma cells and Ig
61
disseminated fungal or mycobacterial infx after BCG vaccine?
Il12 R deficiny --> decrease Th1 response
62
Jobs syndrme (hyper IgE)
impaired neutrophil recruitment with INC IgE and eos - staph abscess - retained primary teeth - coarse facies
63
SCID
no thymus and no GCs - recurrent diarrhea, thrush, FTT - treatment is IVIG and BM transplant ADA deficiency is common cause
64
wiskott Aldrich (WATER)
Wiskot-Aldrich - Thrombocytopneia - Eczema - Recurrent pyogenic infx dec IgG, IgM inc IgE, IgA
65
chronic granulomatous dz
recurrent cat + infections due to problem with respiratory burst

USMLE Step 2 (18 decks)

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