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uworld Flashcards

1
Q

main cause of zenker diverticulum

A

motor dysfunction

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2
Q

mucosal tear at the Gastroesophageal junction

A

mallory-Weiss tear

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3
Q

nonunion (bone dont grow back together) of fracture. pt had acute osteomyelitis 6 months ago and treated. pt has sinus tract with a persistently draining wound strongly suggests?

A

chornic osteomyelitis: xray shows fragmentation of the bone and ragged, irregular fracture lines. Question: Next best step: Immediate surgical debridement + ABX

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4
Q

tinea versicolor is the same as

A

malassezia globosa

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5
Q

what drug can you give >65 yo with acute delirium?

A

haloperidol

wrong answer: BENZO, memantine (used for alzh chronic dementia)

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6
Q

acute lymphoblastic leukemia is diagnosed via:

Pt can have: bone pain and lymphadenopathy

A

bone marrow biopsy:

> 25% lymphoblast

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7
Q

pt with BLUNT ABD TRAUMA, hypotension, right chest/abdominal wall injury and free intraperitoneal fluid. DX

A

HEPATIC LACERATION. one the most common solid organ injuries (along with splenic lacerations due to BAT).

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8
Q

young child with episodic inconsolable crying (lying with legs drawn to abdomen) thinking possible intussussception. Best next step

A

ultrasound-guided air contrast enema.

= procedure of choice for dx and tx.

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9
Q

pt complain of gait disturbance and constant sensation of objects moving around him. an abnormal HEAD THRUST test can help detect vestibular dysf due to?

A

gentamicin

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10
Q

what can cause BILATERAL trigeminal neuralgia (its usually unilat) and whats the cause?

A

MS

causes ** demyelination of the nucleus of the trig nerve or nerve roots.

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11
Q

most common cause of lobar hemorrhage in adults usually > 60

A

amyloid angiopathy.

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12
Q

pt on pallative care for cancer. has lumbar spine metastases = worsening low back pain. significant pain. ibuprofen isnt working anymore. next step for pain?

A

short-acting opioid

not: transdermal fentanyl patch.

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13
Q

intention tremor

A

cerebellar dysfunction

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14
Q

ct scan shows *numerous punctate hemorrhages with blurring of the gray-white interface.. pt was in MVA. diagnosis?

A

diffuse axonal injury

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15
Q

pt in status epilepticus. pt is given iv benzo to terminate sz. best next step?

A

start nonbenzo antiepileptic med to prevent sz recurrence (fosphenytoin, phenytoin, levetiracetam, valproate).
not monitor w/ continuous EEG

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16
Q

if you suspect MS. orderr?

A

MRI of brain and head

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17
Q

idiopathic pseudotumor cerebri. if untreated which complication is likely to develop?

A

blindness

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18
Q

trihexyphenidyl (anticholinergic) can be used to treat?

A

parkinsonism

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19
Q

cisplatin, taxanes (paclitaxel) and vinca alkaloids (vincristine) can cause chemo induced pripheraly neuropathy that presents as?

A

symmetric, distal sensory neuropathy that spreads in a stocking-glove pattern.

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20
Q

pt has myasthenia gravis. after ACH receptor AB confirmation. what should you get.

A

CT scan of chest

look for thymoma

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21
Q

pt with involuntary head turning and head fixation to one side. hypertrophied left SCM

A

dystonia

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22
Q

pt with lead toxicity. give?

A

calcium disodium EDTA

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23
Q

diabetic pt with CN3 palsy. ptosis down and out gaze, diplopia. but NORMAL pupillary response. cause?

A

nerve ISCHEMIC.

if it was blown (dilated) ( no pupillary response) = nerve compression.

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24
Q

kid with Henoch schonlein purpura is at increased risk of developing?

A

intussception

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25
Q

emergent tx of central retinal artery occlusion is done with

A

an ocular massage and high flow oxygen administration.

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26
Q

1 month old with VSD. most appropriate course of action

A

echocardiography

not reassurance, no further workup.

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27
Q

acute rheumatic fever. tx

A

penicillin.

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28
Q

prior to prescribing SSRI. you tell pt about what early side effects

A

HA, Nausea, insomnia/sedation, anxiety, dizziness.

29
Q

initial management of uncomplicated hemorrhoids?

A

high fiber diet and follow up.

inc intake of fluid and fiber, reduction of fat and alcohol, exercise

30
Q

anal fissure (“posterior mucosal tear of the anus and a skin tag”). in addition to stool softeners and sitz baths, BNS?

A

topical lidocaine and nifedipine

31
Q

abd US reveals gallstones, thickened gallbladder wall w/ edema and normal common bile duct. BNS management? A. HIDA scan. B. Cholecystectomy w/in 72 hours?

A

laparoscopic cholecystectomy within 72 hours.

32
Q

pt with HIT. stop heparin and start?

A

argatroban.

(safe in HIT) not LMWH

33
Q

mammary paget disease is associated with?

A

adenocarcinoma (carcinoma that starts in glandular tissue, generally mc type of breast cancer).

34
Q

components of Glasgow coma scale assessment?

A

answer: EYE OPENING

also VERBAL RESPONSE, MOTOR RESPONSE

35
Q

hypothyroidism.

A

hyperlipidemia

36
Q

16 yo w/ ITP. platelet count 10,000. IVIG and steriods arent helping. BNS?

A

splenectomy.

if actively bleeding can try anti-D immunoglobulin if bleeding and pt is RH+.

37
Q

Turner syndrome pt has inc risk for?

A

osteoporotic fracture.

TS pt has dec Estrogen thus no inhibition of osteoclast bone reabsorption

38
Q

empirical tx for epiglottis?

A

Ceftriaxone (H. Influ, and streptococcus species) vancomycin (staph a)

39
Q

variocele. pt should consider surgery bc what complication?

A

inferitlity

40
Q

scleroderma renal crisis typically presents w/ acute renal failure (w/out previous kidney disease_ and malignant htn (blurry vision, ha, nausea. what will be seen on blood smear?

A

schistocytes.

from microangiopathic hemolytic anemia, and thrombocytopenia.

41
Q

preterm infant with anemia dx and cause?

A

anemia of prematurity

due to diminshed erythropoietin levels, shortened RBC life span and blood loss. will see loss H and H and low RC.

42
Q

HIV pt with CD <90. pain on swallowing and substernal burning for wk. white plaques on buccal mucosa and palate. tx

A

oral fluconazole.

43
Q

PCP (p jirovecii) dx will be made with

A

bronchoalveolar lavage.

44
Q

dx of endometriosis is done by?

A

laparscopy

45
Q

meniscal tear.

xray looks normal of knee. bns

A

*MRI of the knee = DX.

also chart says arthroscopy.

46
Q

most effective nonpharmacologic measure to dec BP

A

wt loss (10% wt loss)

47
Q

chronic granulomatous disease. cause of inc susceptibility to fungal and catalase + bacteria?

A

decreased superoxide production (no respiratory burst)

48
Q

reyes syndrome

A

MICROvesicular fatty infiltration

not macro

49
Q

Henoch-schonlein purpur is an IgA mediated vasculitis. what lab finding is most likely seen in this pt

A

hematuria***

not in creatinine.

50
Q

stress urinary incontinence is caused by weak pelvic floor muscles that cause

A

urethral hypermobility.

51
Q

aplastic crisis in sickle cell

A

hemoglobin (4.5) and reticulocytes (0.1)are low only

52
Q

downs syndrome pt can have atlantoaxial instability leading to

A

spinal cord compression (not ischemia)

53
Q

untreated shoulder dislocation can lead to

A

*shoulder abduction weakness. bc axillary nerve damage.

54
Q

edwards syndrome trisomy 18

A

micrognathia**
closed fists w/ OVERLAPPING fingers.
prominent occiputk,, rocker bottom feet

55
Q 
osteogenesis imperfecta
(blue sclera, freq fx, conductive hearing loss, dentinogenesis imperfecta, joint hypermobility)
A

type 1 collagen gene (COL1A1) defect

56
Q

5yo kid exposed to Varicella zoster virus (chickenpox). he hasnt received vaccines after 1 yr. BNS

A

administer varicella vaccine.

57
Q

topiramate can be used for

A

migraine prophylaxis

58
Q

upslanting palpebral fissures, mouth is open w/ a protruding tongue, palate narrow, but intact. no hepatosplenomegaly

A

downs syndrome.

59
Q

postmenopausal bleeding. 1st step

A

TVUS or endometrial bx.
TVUS shows <= 4mm –> stop
> 4 –> get bx.

60
Q

RIGHT sided varicocele. BNS

A

get abd US to look for secondary cause (renal or retroperitoneal tumor).

61
Q

LEFT sided varicocele BNS

A

observation

62
Q

gastric cancer (wt loss, chronic mid epigastric pain worsens with eating). initial test of choice

A

EGD

not ct scan of abdomen

63
Q

what two infections can worsen psoriasis symp

A

HIV***

also strept pharyngitis (Guttate psoriasis)

64
Q

36 week pregnant women. w/ hx of HSV. what to do.

A

begin antiviral (acyclovir**) supp at 36 wks until delivery. if lesion/prodromal symptoms during labor –> C section

65
Q

dash diet or smoking cessation lower BP more?

A

DASH

66
Q

prinzmetal angina tx

A

CCB (*DILTIAZEM, amlodipine)

67
Q

first line pharmacotherapy for nocturnal enuresis

A

DESMOPRESSIN

68
Q

Hypotension

JVD

New onset RBBB

A

Acute MASSIVE Pulm Embolism

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