UWorld Flashcards by Ernst Fattakhov

Decrease in lower esophageal sphincter tone vs. increase in tone.

Decrease LES = Systemic sclerosis

Increase LES = Achalasia

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Valganciclovir taken for _________

Cytomegalovirus (CMV)

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Trimethorpim-sulfamethoxazole taken for ________

Pneumocystis pneumonia

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First-line therapy for stable angina

Beta blockers

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Treatment of lyme disease in pregnant women.

NOT doxycycline (inhibits skeletal development)
Instead use Amoxicillin

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Bernard-Soulier Syndrome

Autosomal recessive disorder of absent platelet glycoprotein 1b

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Stridor - common DDx

Infectious epiglotitis (Haemophilus influenzae)

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How to treat cyanide toxicity

Hydroxycobalamin - bind cyanide
Sodium thiosulfate - bind cyanide
Nitrates - induce methemoglobinemia (Fe3+), giving alternate binding site for cyanide

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How to treat carbon monoxide toxicity

100% O2

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Duodenal ulcer therapy

Proton pump inhibitor (e.g. omeprazole)

Antibiotics (amoxicillin + clarithromycin)

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S3 DDx and treatment

Left Ventricle Failure

Initial treatment = intravenous diuretics

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Absent CD55

Absent CD55 causes hemolytic anemia, which leads to proxysmal nocturnal hemoglobinuria.

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Increased Hemoglobin A2

Beta thalassemia trait

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Major complication of giant cell arteritis

Aortic aneurysm

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Acromegaly cardiac complication

Concentric left ventricular hypertrophy

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Drugs that cause hepatitis

Isoniazid
Halothane
Phenytoin
Alpha-methyldopa

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Diagnosis for: Shoulder pain with decreased passive and active range of motion. More stiffness than pain.

Adhesive capsulitis (frozen shoulder)

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Knee synovial fluid analysis shows rhomboid-shaped crystals.

Calcium Pyrophosphate Dihydrate (CPPD) are positively birefringent = Pseudogout

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Heberden nodes

Osteoarthritis

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Conjunctivitis + Knee pain

Reactive arthritis, usually following acute GI (Salmonella, Yersinia) or genitourinary (Chlamydia) infection.

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Low Urine Osm, High Serum Sodium

Central Diabetes Insipidus

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Subauricular systolic bruit and high BP in a young woman.

Fibromuscular dysplasia

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Hemolytic anemia is G6PD pts is caused by what drugs?

Sulfa drugs
Antimalarials
Nitrofurantoin

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Acne treatment

Comedonal = topical retinoids
Inflammatory = antibiotics (erythromycin, clindamycin)
Severe Nodular (cystic) = oral isoretinoin

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Lab differential of folate vs cobalamin deficiency

Folate defi has high Homocysteine, normal Methylmalonic acid | Cobalamin defi has high Homocysteine and HIGH Methylmalonic acid

def. asterixis

flapping hand tremor (implies underlying cirrhosis)

Aldosterone antagonists

Spironolactione, eplerenone

Aldosterne/renin >20

Primary hyperaldosteronism

Corneal vesicles and dendritic ulcers

Herpes simplex keratitis

The 2 most common causes of Acute pancreatitis

Chronic Alcohol Use (~40%) | Gallstones (~40%)

Alpha 2 agonists: examples and use

Clonidine, Methyldopa, Dexmedotomidine Clonidine and Methyldopa are used to treat hypertension. Dexmedetomidine is used for sedation in ICU.

Aortic stenosis triad

1) Syncope 2) Exertional dyspnea 3) Angina pectoris

Diastolic decrescendo murmur

Aortic insufficiency (regurg)

Tricuspid valve endocarditis - murmur type?

Holo-SYSTOLIC murmur

Red urine TB treatment

Rifampin

Prenicious anemia mechanism

Anti-intrinsic factor antibodies cause B12 defi, causing megaloblastic anemia.

Treatment of esophageal varices

Endoscopic variceal ligation (EVL) OR Nonselective beta blocker

Antibiotic to treat Anaerobic above the diaphragm

Clindamycin

Antibiotic to treat Anaerobic below the diaphragm

Metronidazole

What is this diagnostic test used for? | 24-hour urine cortisol

Cushing's syndrome

What is this diagnostic test used for? | Captopril radionucleotide renal scan

Renal artery stenosis

What is this diagnostic test used for? | Plasma aldosterone/renal ratio

Primary aldosteronism

What is this diagnostic test used for? | Urine metanephrines

Pheochromocytoma

Positive tuberculin skin test induration size

More than 5mm

Prophylaxis for HIV pt against Mycobacterium avium. CD4 count and antibiotic.

CD4 less than 50 | Azithromycin

Treatment of CMV in immunocompromised patients.

Ganciclovir or Valganciclovir

Hyperresonance to percussion of lung - diagnosis

Pneumothorax OR Emphysema Determine which one by mediastinal shift. Pneumothorax shift away from tension pneumothorax. Emphysema no shift

Decreased breath sounds, decreased tactile fremitus and dull percussion - diagnosis

Pleural effusion OR Atelectasis (e.g. mucus plugging) Determine which one by mediastinal shift. Pleural effusion shift away from effusion. Atelectasis shift toward atelectasis (if large)

What type of mediastinal shift occurs toward the side of decreased breath sound?

Atelectasis (mucus plugging)

Dx: widespread pain and normal lab

Fibromyalgia

Dx: difficulty climbing stairs and elevated creatine kinase.

Polymyositis | stairs = proximal muscle weakness

Dx and Tx: elevated CRP, muscle stiffness

Dx: Polymyalgia rheumatic Tx: rapid improvement with glucocorticoids

Dx: triad of periorbital edema, myositis, eosinophelia

Trichinellosis

Treatment of unstable sinus bradycardia in pt with STEMI

Intravenous atropine to treat the unstable sinus bradycardia.

Treatment of pulmonary edema in pt with STEMI

Furosemide to treat pulmonary edema, if pt is NOT hypotensive/hypovolemic.

Dx: HIV pt with cavitary upper lung lesion

Reactivation TB

Central renal artery occlusion treatment.

Ocular massage and high-flow oxygen

Dx: Early peaking systolic murmur vs Late peaking systolic murmur

Early peak = mild./moderate aortic stenosis | Late peak = Severe aortic stenosis

Drug overdose Dx: | Hypertension, tachycardia, hyperreflexia, clonus, agitation

Serotonin Syndrome

Drug overdose Dx: Slurred speech, unsteady gait, drowsiness No Respiratory Depression Normal Pupils

Benzodiazepine overdose

Drug overdose Dx: | Tremor, hyperreflexia, ataxia, seizures, vomiting and diarrhea

Lithium overdose

Drug overdose Dx: Slurred speech, unsteady gait, drowsiness Respiratory Depression Miosis

Opioid intoxication

Drug overdose Dx: | Horizontal nystagmus, Cerebellar ataxia, confusion

Phenytoin toxicity

Tx: Torsades de pointes

Immediate defibrillation AND Intravenous magnesium

When to use emergency | Adenosine

proxysmal supraventricular tachycardia (PSVT)

When to use emergency | Amiodarone

atrial/ventricular tachycardia

When to use emergency | Calcium Gluconate

Hyperkalemia

When to use emergency | Sodium Bicarbonate

- Torsades de pointes due to quinidine - Metabolic Acidosis - Hyperkalemia - TCA overdose

When to use emergency | Magnesium sulfate

Torsades de points due to: | congenital or acquired long QT

Hidradenitis suppurativa

``` "Hidra-" = sweat "-aden-" = gland "-itis" = inflammation Hiradenitis = inflammation of the sweat glands suppurativa = which opens to the skin surface ```

Furuncle

Skin abscess, usually due to staph aureus

Intertigo

Infection with Candida species | Well-defined erythematous plaques

Positive antimitochondrial antibody assay | Dx and Tx

Dx: Primary Billiary Cholangitis Tx: Ursodeoxycholic Acid (UDCA)

Dx, complications, Tx: Young obese female with headache. Normal CT Papilledema

Dx: Benign Intracranial Hypertension (Pseudotumor cerebri) Complication: blindness Tx: weight reduction, acetazolamide, shunting, optic nerve fenestration

Top choice antibiotic for human bite wound

Amoxicillin-Clavulanate

Agents that injury gastric mucosa

- Aspirin (inhibit prostaglandin) - Cocaine (vasoconstriction - decrease gastric blood flow) - Alcohol (mucosal injury)

Dx: - History of AAA - prior GI surgery - hematemesis

Abdominal antoenteric fistula

What antibodies do you look for in the window phase of HBV?

Positive IgM Anti-HBc | Positive for HBV DNA

What antibodies do you look for in chronic HBV?

Positive HBs-Ag | Positive IgG Anti-HBc

Bile salt diarrhea

Caused by poor absorption of bile salts in the ileum. Caused by ileal resection OR Crohns ileitis

How to monitor heparin levels?

aPTT

Dx: | Free air under diaphragm

Perforated peptic ulcer

How to diagnose chronic pancreatitis

CT scan is the test of choice | ERCP is the most sensitive test, but highly invasive

How to diagnose pancreatic cancer

(just like chronic pancreatitis) CT scan is the test of choice ERCP is the most sensitive test, but highly invasive

Most common cause of sudden cardiac arrest in the immediate post-MI period

Reentrant ventricular arrhythmias (Ventricular fibrillation)

UWorld Flashcards

(85 cards)