Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Step 3 > UWorld c > Flashcards

UWorld c Flashcards

(93 cards)

Start Studying
1
Q

2 classes of calcium channel blockers

A

Dihydropyridines- used to reduce systemic vascular resistance and arterial pressure

  • amlodipine
  • nicardipine
  • nifedipine

Non-dihydropyridine- relatively select for the myocardium to reduce myocardial O2 demand and reverse coronary vasospasm

  • verapamil
  • diltiazem
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

3 top Ddx for vaginitis

(b) Tx for each

A

Vaginitis:
1. BV = bacterial vaginosis from gardnerella vaginalis
Tx- flagyl or clinda

  1. Trichomoniasis from trichomonas vaginalis
    Tx- flagyl, treat sexual partner
  2. Candida vaginitis from candida albicans
    Tx -fluconazole
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Distinguish 3 causes of vaginitis

(a) Discharge
(b) Lab findings

A

Vaginitis

  1. Gardnerella vaginalis (BV)
    (a) Thin, off white discharge w/ fishy odor
    (b) Clue cells, positive whiff test (amine odor w/ KOH)
  2. Trichomoniasis
    (a) Thin, yellow-green malodorous discharge w/ vaginal inflammation
    (b) Motile trichomonads
  3. Candida vaginitis
    (a) Thick cottage cheese discharge
    (b) Pseudohyphae
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Buzzwords for vaginitis

(a) Fish odor
(b) Clue cells
(c) Pseudohyphae
(d) Motile trichomonads
(e) Cottage cheese (thick) discharge
(f) Positive whiff test

A

(a) Fishy odor = off-white thin discharge of BV (gardnerella)
(b) Clue cells = BV, gardnerella
(c) Pseudohyphae = lab finding of candida vaginalis (cottage cheese thick discharge)
(d) Motile trichomonads = trichomoniasis = thin yellow/green malodorous (but not ‘fishy’) discharge
(e) Cottage cheese discharge = candida vaginalis
(f) Positive whiff test = amine odor w/ KOH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which type of vaginitis should you also treat the partner?

A

Tx pt and sexual partner for trichomoniasis (flagyl to both pt and partner): even for asymptomatic pts (for F if found incidentally on pap)

-don’t need to tx partner for BV (gardnerella) or candida vaginitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Clinical features of chronic adrenal insufficiency

A

Chronic adrenal insufficiency (MC cause Addison’s): weight loss, hyperpigmentation (brown spots on lip/face), abd pain, fatigue, myalgias, decreased axillary and pubic hair

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Lab abnormalities consistent with Addison’s disease

A

BMP abnormality in chronic adrenal insufficiency (autoimmune = Addison’s)

  • hyponatremia (85-90% of pts w/ Addisons): due to low aldo
  • hyperkalemia: due to low aldo (aldo stimulates urinary K secretion)
  • mild hyperchloremic metabolic acidosis (H+ retention by kidneys from low aldo)

Diagnostic = low cortisol w/ elevated ACTH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Clinical features of tabes dorsalis

A

Tabes dorsalis = treponeal spirochetes directly damage dorsal sensory roots

  1. sensory ataxia: positive Romberg, reduced sensation to pain/temp/vibration/proprioception
  2. lancinating pains: brief shooing or burning pain (ex: 45 y/oM shooting and burning pain in legs)

Argyll Robertson pupils = normal pupillary construction w/ accommodation but not to light

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Bacterial vs. viral meningitis

(a) Expected white count
(b) Expected protein

A

Bacterial meningitis

(a) WBC over 1,000
(b) Protein over 250 (high!)

Viral meningitis

(a) WBC 10-500
(b) Protein under 150 (viruses not all filled w/ proteins)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Define solitary pulmonary nodule

(b) First step in mgmt

A

Solitary pulmonary nodule= round opacity 3 cm or less in diameter surrounded by pulmonary parenchyma

(b) Compare to prior imaging, if no prior imaging or change in size/appearance => CT
- see other smaller nodules
- characterize (fully surrounded by pulmonary parenchyma? spiculated borders?)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Valgus vs. varus laxity of the knee

A

Valgus laxity = insability w/ lateral movement = damage to medial collateral ligament

Varus = instability w/ medial movement of the knee = damage to lateral collateral ligament

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Clinical features of tear in cruciate vs collateral ligaments of the knee

A 
Cruciate ligaments (anterior, posterior) come w/ anterior/posterior laxiety
-large effusion/hemarthrosis usually pressent

Collateral ligament (medial, lateral): instability w/ lateral vs. medial movement
-effusion uncommon
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Options to help pts w/ PCOS get pregnant

A

Can’t do OCPs to regulate menstruation if pt wants to get pregnant!

First line tx = weight loss, weight loss restores ovulation (b/c in PCOS infertility is 2/2 anovulation)
Then can use clomiphene citrate for ovulation induction (before having to go to IVF)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Paget’s disease

(a) What is it
(b) Lab values
(c) First line tx

A

Paget’s disease

(a) Disorder of increased bone turnover
(b) Elevated alk phos w/ normal calcium (and normal LFTs)
(c) Bisphosphonates- to reduce bone turnover

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Pseudohypertrophy of the calves

(b) Next lab test

A

= Gower’s sign
Buzzword for Duchenne’s muscular dystrophy = defective dystrophin gene on X-chromosome

(b) Elevated CK

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

First line tx for Raynaud’s phenomenon

A

Dihydropyridine (peripheral, not cardiac selective) calcium channel blocker = nifedipine or amlodipine

(not verapamil or dilt = non-dihydropyridine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

During surgery for pheochromocytoma removal, how would you manage

(a) Hypotension
(b) Acute severe hypertension

A

(a) Hypotension due to rapid removal of catecholamines- give fluids, maybe pressors if needed
- also preop alpha blockade may reduce vascular tone => need vaso

(b) Acute severe hypertension from high catecholamine release from adrenal gland handling => IV nitroprusside, phentolamine, or nicardipine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Age cutoff to watch and wait in cryptorchidism

A

Cryptorchidism = undescended tests

By 6 months of age (corrected for gestation) referral for surgery (orchiopexy = surgical fixation of testis to scrotal wall) is indicated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Name 3 things that increased the risk of bleeding diathesis in colonic angiodysplasias

A

Cherry-red lesions on endoscopy/colonoscopy = angiodysplasis (vascular ectasias or AV malformations)

More likely to bleed in

  1. ESRD
  2. Aortic stenosis: sheer stress of RBCs from turbulence
  3. von willebrand disease: vWF most active in vascular beds w/ high sheer stress
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Breast milk jaundice vs. breast feeding failure jaundice

(a) TIming
(b) Presentation
(c) Tx

A

Breast milk jaundice

(a) First 1-2 weeks
(b) Indirect hyperbili due to enzyme in breast milk, normal exam, adequate breastfeeding
(c) Nada, keep chillin and breastfeeding

Breast feeding failure jaundice

(a) Early, first week of life
(b) Losing weight, dehydrated
(c) Formula feed supplement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Key factors to distinguish migraines vs. cluster headache

A

Both unilateral, can have photophobia

Cluster- associated w/ trigeminal autonomic hyperactivity (lacrimation, conjunctival injection, rhinorrhea, nasal congestion)

Ex: 41 y/oM w/ h/o HA increasing in frequency, bad HA behind his left eye w/ sweaty forehead and watery L eye

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Cluster headaches tx

(a) Acute management/abortive measures
(b) Prophylaxis after more than 2 months

A

(a) 100% O2 via nonrebreather provides relief in over 70% pts
- second line: intranasal sumatriptan in nostril contralateral to side of headache

(b) Ppx- verapamil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

First line tx for persistent/severe RLS

A

Pramipexole = dopamine agonists

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Neurologic exam findings consistent with brain death

A

Absence of cerebral and brainstem reflexes: non pupillary/corneal/gag reflexes in brain death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
35 y/o pilot p/w joint pain - trip 3 months ago had fever and malaise for several days, followed by pain in fingers/wrists/ankles - since then: severe joint pain Dx?
Chikungunya fever Illness script: mosquito (same one as Dengue and Zika) borne w/ 3-5 days of high fevers (102) followed by symmetric distal joint pains (wrists, hands, ankles) Then about 30% develop chronic joint pains, some so severe as requiring MTX
26
Typical lab abnormalities seen in malaria
Anemia and hyperbilirubinemia 2/2 RBC lysis -mosquito-borne protozoal illness
27
Illness script for typhoid fever
After incubation period of ingesting salmonella-infected food/water p/w stepwise increasing fever, relative bradycardia 2nd week- abdominal pain and rose spots (faint salmon colored 1-2mm macules on trunk and abdomen) 3rd week- HSM, intestinal bleeding, intestinal perf 2/2 ileocecal lymphatic hyperplasia of Peyer's patches
28
Upper vs lower motor neuron lesion would cause: (a) Atrophy (b) Absent DTRs (c) Flaccid paralysis (d) Hypertonia (e) Fasiculations
UMN lesion (a) no (minimal) atrophy (only due to disuse) (b) Hyperreflexia (c) Spastic paralysis (d) Hypertonic (e) No fasiculations LMN lesion (a) Marked atrophy (b) DTRs absent (c) Flaccid paralysis (d) Hypotonic (e) Yes fasiculations
29
How to distinguish ALS from brainstem tumor
Both can cause both UMN and LMN signs (ex: hyperactive knee jerk (UMN), R thigh atrophy and fasciculations (LMN)) In ALS: ocular motility, sensory, bowel, bladder, and cognitive fxns are preserved even in advanced disease Would expect pain, sensory changes, bowel/bladder dysfunction in brainstem tumor
30
What type of hypersensitivty reaction is: (a) Serum sickness (b) Autoimmune hemolytic anemia (c) PCN allergy (d) Contact dermatitis
HS reaction (a) Serum sickness = immune complex mediated = type III (b) AIHA = antibody mediated = type II (another ex: Goodpastures) (c) PCN allergy = fast IgE mediated = type I (like anaphylaxis) (d) Contact dermatitis = delayed, T cell mediated = type IV
31
What type of hypersensitivty reaction is: (a) Acute graft vs host (b) Chronic graft rejection
Hypersensitivity Rxn (a) Acute GVH = antibody mediated = type II (b) Chronic graft rejection = T cell mediated = type IV (another ex: contact dermatitis)
32
Drug of choice for mammal (including human) bites
Augmentin (amox/clavulanate) to cover for oral aerobes and abaerobes including Eikenella corrodens (anaerobe found in human mouth)
33
Post-stroke (a) Time window for tPA (b) BP goal with and w/o tPA
Post-stroke (a) If no contraindications (hemorrhagic conversion, intracranial mass, plts under 100k, INR over 1.7) can give if under 3-4.5 hours of symptom onset (b) BP goal under 220/110 if no tPA use if tPA used slightly stricter goal under SBP 185 to minimize risk of intracranial hemorrhage
34
MC bug caused by ear infection associated w/ (a) Following water exposure (b) Purulent unilateral ear drainage
(a) Pain on external ear manipulation = bacterial otitis externa MC bug pseudomonas usually following water exposure (b) Suppurative otitis media MC from group A strep middle ear cavity infected by bacteria from the nasopharynx
35
Differentiating features of pediatric neck masses (a) Thyroglossal duct cyst (b) Dermoid cyst (c) Brachial cleft cyst
(a) Thyroglossal duct cyst from embryologic failure of duct to atrophy normally (as thyroid forms as outpouching from the base of the tongue then descends via thyroglossal duct) Medial Displaces superiorly w/ protrusion of tongue (b) Dermoid cyst = midline, but no displacement w/ tongue protrusion Contain cutaneous structures (hair follicles, sebaceous glands) (c) Brachial cleft cyst = embryologic remnant anterior to SCM muscle. Neck mass is lateral Can have associated sinus tract or fistula
36
MC complication of transurethral resection of the prostate
TURP for mgmt of BPH | MC complication = retrograde ejaculation
37
Triad of symptoms in Meniere's (b) Differentiate from BPPV
Meniere's triad = periodic vertigo/dizziness, unilateral hearing loss, unilateral tinnitus (b) BPPV- no accompanied hearing loss
38
Clinical features of testicular torsion
Severe unilateral testicular pain, elevated and transverse testis (b/c spermatic cord is twisted on itself) * *absence of cremasteric reflex (testis should reflexively elevate on stroking of upper inner thigh) - no pain relief w/ scrotal elevation (seen in epididymitis)
39
Tx of bacterial conjunctivitis
First line = erythromycin ointment or polymyxin-trimethoprim drops BUTTT if contact wearers- first line is fluoroquinolone (ex: cipro) given higher risk for pseudomonas
40
When does a cleft lip get repaired?
Rule of 10 - 10 lbs of weight - 10 weeks old (3 months ish) - 10 g hemoglobin
41
Anterior uveitis (a) Clinical features (b) Pupil findings (c) Slit lam exam findings
Anterior uveitis = iritis (a) pain, redness, variable vision loss (b) Constricted and irregular pupil (c) Characteristic leukocytes in anterior segment confirms diagnosis
42
Ramsay Hunt Syndrome- clinical features
= herpes zoster oticus = reactivated VZV | -ear pain, external auditory vesicles, ipsilateral facial paralysis
43
72 y/oF w/ HTN/DM p/w R ear pain and drainage x2 days, tenderness w/ motion of R earlobe, purulent drainage and granulation tissue on external auditory canal (a) Dx (b) MC cause (c) Tx
(a) Malignant otitis externa- external otitis media that progressed to involve adjacent bones at base of the skull - marked pain - systemic signs (fever) common - granulation tissue pathognomonic but not always present (b) 95% due to pseudomonas (c) Tx w/ cipro
44
Testicular cancer (a) Typical clinical presentation (b) Workup (c) Typical treatment
(a) Young male (15-35), possible h/o cryptorchidism (undescended testes) p/w unilateral painless firm ovoid testicular nodule (b) Start w/ scrotal ultrasound- firm hard testicle that does not transilluminate. Then serum tumor markers (AFP, beta-hCG). (c) Radical orchiectomy- both remove and get tissue diagnosis, that + chemo gives 95% cure rate
45
How to distinguish viral from allergic conjunctivitis
Viral- commonly w/ prodrome, uni or bilateral, watery or mucoid discharge, pain w/o itchiness Allergic- always b/l, watery discharge only, itchiness is characteristic
46
Clinical presentation of keratitis
Keratitis = corneal inflammation Pain, impaired sight, photophobia, red eye, 'gritty' sensation So not painless (like central retinal artery/vein occlusion) Photophobia
47
Tx of foreign-body corneal abrasion (b) MC organism
Erythromycin or cipro eye drops or ointments | b) MC overal is coag negative staph (ex: staph epi MC in contact wearers = pseudomonas (so use cipro for them)
48
Mastoiditis (a) Clinical features (b) Treatment (c) MC organism
Mastoiditis = bacterial infxn of mastoid air cells, complication of acute otitis media Inflammation from middle ear extends to mastoid cavity, purulent material causes bony destruction (a) fever, ear pain, otorrhea (ear discharge), also w/ protrusion of auricle (ear sticking out of head) (b) Tx = IV abx (vanc) and drainage of mdidle ear (c) MC pathogens: strep pneumo, strep pyogenes, staph aureus
49
Cause of elevated PSA that aren't cancer
- urinary retention (so if pt admitted for urinary retention found to have elevated PSA, repeat in 6-8 weeks to see if real) - prostatitis - urologic procedure (ex: cystoscopy) - recent ejaculation - BPH
50
32 y/oF p/w tenderness at McBurney's point (a) Diagnosis (b) Possible consequence of inadequate treatment
(a) Appendicitis (b) Pylephebitis = infective suppurative portal vein thrombosis- rare but devastating complication of intraabdominal infections (pelvic infections, diverticulitis)
51
At what part of the pathway (UMN, peripheral nerve, NMJ, muscle fiber) do the following act (a) Vit B12 deficiency (b) Guillain-Barre (c) Hypothyroidism (d) Organophosphate poisoning (e) Botulism (f) Lead poisoning (g) Myasthenia gravis
(a) Vit B12 affects UMN (b) Guillain-Barre = autoimmune demyelination of peripheral nerves (c) Hypothyroidism- level of the muscle (d) Organophosphate poisoning- level of NMJ (inhibits achetylcholinesterase => cholinergic toxicity) (e) Botulism- level of NMJ (neurotoxin inhibits presynaptic ACh release into NMJ) (f) Lead poisoning- peripheral nerve (g) MG- NMJ, ACh-receptor antibodies
52
Paralysis seen in (a) Botulism (b) Guillain-Barre
(a) Botulism = descending paralysis | (b) Guillain-Barre = ascending paralysis
53
MC clinical symptoms of (a) PBC (b) Wilson's disease (c) Hemochromatosis
(a) PBC- fatigue and pruritis (b) Neuropsych features: depression, dysarthria, gait issues, chorea/parkinsonism (c) men, hyperpigmentation, diabetes (bronze diabetes)
54
NF1 clinical features
NF1: cafe au lait spots in childhood, inguinal freckling | neurofibromas = benign tumors of peripheral nerves of the skin
55
PBC (a) Treatment (b) Nutritional complication
(a) Tx- urosdeoxycholic acid slows progression and improves transplant free survival (b) Progressive bone loss- associated w/ metabolic bone disease (osteopenia and osteoporosis)
56
Clinical features of organophosphate poisoning
Organophosphates (farms) inhibits ACh-ase => cholinergic toxicity ``` Muscarinic effects = DUMBELS Defecation Urination Miosis (pinpoint pupils) Bronchospasm/bradycardia Emesis Lacrimation Salivation ``` ex: 22 y/o farm hand p/w cough and SOB, pinpoint pupils, copious airway secretions, clothes spoiled w/ stool and urine
57
How to diagnose carbon monoxide poisoning
Dx by carboxyhemoglobin level on ABG (pulse ox will be 100% b/c it cannot distinguish carboxyHb and oxyHb) NOT methemaglobin which is from oxidation of iron molecules in Hb preventing O2 binding
58
MEN2a vs. MEN2b
Both: medullary thyroid cancer and pheochoromocytoma MEN2a: + parathyroid hyperplasia MEN2b: + mucosal neuromas/marfanoid habitus
59
Kussmal breathing
Rapid and deep breathing pattern ex: respiratory compensation to severe metabolic acidosis
60
Antifreeze (a) Compound name (b) Tx of antifreeze
Antifreeze = (a) Ethylene glycol (b) Fomepizole = alcohol dehydrogenase competitive inhibitor - Ethanol use (AD has greater affinity for ethanol than other alcohols) not suggested in fomepizole (more potent ADH inhibitor) is available
61
MC blood transfusion reaction (b) Mechanism (c) How to treat/prevent
MC = febrile nonhemolytic rxn 1-6 hrs after starting transfusion (b) Reaction to cytokines released by leukocytes while blood parts are in storage (c) Prevent next time by using leukoreduced blood products for the next transfusion - leukoreduced = reduce number of transfused leukocytes, also reduces HLA
62
Type of specialized RBC treatment that should be used in (a) Pts who have had previous febrile nonhemolytic transfusion reactions (b) Pts w/ IgA deficiency (c) Bone marrow transplant recipients
(a) Use leukoreduced (aka reduced number of leukocytes) in pts w/ febrile rxns b/c fever is thought to be 2/2 cytokines released by leukocytes while blood products are in storage (b) Washed RBCs in IgA deficiency b/c these pts have anti-IgA antibodies which would react w/ IgA in donor blood => anaphylaxis (c) BMT recipients- irradiated
63
Oral chelation agent used in (a) Moderate asymptomatic lead poisoning (b) Wilson's
(a) Serum Pb 45-69 = moderate, treat w/ DMSA, succimer to chelate- binds Pb in blood to increased urinary secretion (b) D-penicillamine- primary chelating tx for copper removal in Wilsons
64
Venous lead levels associated with (a) Requiring chelation therapy (b) Seizures
Venous lead levels over 5 is abnormal 5-44 is mild, requires removal of exposure and repeat venous level in 1 month (a) Over 45 is moderate and severe => chelation with DMSA, EDTA (b) Acute encephalopathy (AMS, seizures) in very severe w/ venous levels over 100
65
65 y/oF in workup pre-CABG is found to have hypothyroidism w/o symptoms of myxedema coma- go ahead w/ surgery? Start levothyroxine?
Go ahead w/ surgery w/o starting synthroid Synthroid can increase myocardial O2 demand => start low and go slow in pts w/ CAD
66
What is achalasia? (b) Finding on esophagram (b) Infectious cause of secondary achalasia
Achalasia- failure of lower esophageal sphincter relaxation due to degeneration of ganglia in Auerbach plexus (b) Dilated esophagus w/ birds beak narrowing distally (c) Typanosoma cruzi (chagas)
67
Plummer-Vinson syndrome (b) Tx
Plummer-Vinson = triad of 1. iron deficiency anemia 2. dysphagia 3. esophageal web (b) Iron repletion- generally improves esophageal web
68
Iron deficiency anemia vs. thalassemia (a) MCV (b) Peripheral smear (c) Ferritin
(a) Both microcytic (b) Microcytosis and hypochromia for IDA. Target cells for thal (c) Ferritin low in IDA, normal or high in thal
69
Thalassemia vs. physiologic anemia of pregnancy
Thal- microcytic, hypochromic Physiologic of pregnancy- normocytic, normal RDW, just diluted essentially
70
Renal ultrasound w/ multiple b/l cysts (a) Diagnosis, clinical features (b) Next step in management (c) Neurologic complication (d) Cardiac complications
(a) Autosomal dominant PCKD. Hematuria, flank pain, HTN, palpable abdominal masses, proteinuria (b) ACEi for good BP control (c) Cerebral berry aneurysms (d) Valvue disorders- mitral valve prolapse, aortic regurg
71
ADPCKD (a) How to make diagnosis (b) How to screen in ppl w/ fam Hx
Autosomal dominant polycystic kidney disease (a) Clinically (palpable kidney masses, HTN, renal disease, flank pain, proteinuria) then renal ultrasound - dont need expensive genetic testing for dx (b) Screen pts over age 18 w/ family history w/ renal ultrasound (not more expensive genetic testing)
72
32 y/oF p/w tenderness at McBurney's point (a) Diagnosis (b) Possible consequence of inadequate treatment
(a) Appendicitis (b) Pylephebitis = infective suppurative portal vein thrombosis- rare but devastating complication of intraabdominal infections (pelvic infections, diverticulitis)
73
(a) Anti-smooth muscle Ab (b) Antimitochondrial Ab (c) Anti-citrullinated peptide Ab
(a) Anti-smooth muscle = autoimmune hepatitis, expect transaminitis (b) Antimitochondrial = PBC, highly sensitive (95%) and specific for PBC, expect higher alk phos than transaminitis (c) Anti-citrullinated peptide Ab = high specificity for RA, so in pt w/ polyarthritis it can help differentiate RA
74
Typical clinical presentation of Wilson disease (b) Blood test for diagnosis
Pt before age 35 p/w hepatomegaly and transaminitis, frequent neuropyschiatric symptoms (depression, movement d/o) (b) Low ceruloplasmin - due to abnormal transport and metabolism of copper
75
MC clinical symptoms of (a) PBC (b) Wilson's disease (c) Hemochromatosis
(a) PBC- fatigue and pruritis (b) Neuropsych features: depression, dysarthria, gait issues, chorea/parkinsonism (c) men, hyperpigmentation, diabetes (bronze diabetes)
76
Antimitochondrial Ab+ (a) Diagnosis (b) Mechanism of disease
(a) PBC | (b) Progressive autoimmune disease: fibrosis and obliteration of intrahepatic ducts leading to cirrhosis
77
PBC (a) Treatment (b) Nutritional complication
(a) Tx- urosdeoxycholic acid slows progression and improves transplant free survival (b) Progressive bone loss- associated w/ metabolic bone disease (osteopenia and osteoporosis)
78
Typical clinical presentation of myasthenia gravis
Progressive weakness, worsens throughout the day, most commonly of ocular and bulbar muscles => ptosis and intermittent dysphagia
79
29 yoF w/ h/o GIB due to large gastric ulcer p/w hypercalcemia. Mother has h/o syptomatic hypercalcemia and pituitary tumor Suspected diagnosis?
MEN1: 3 P's 1. Pituitary adenoma 2. Primary hyperparathyroidism- most common manifestation 3. Pancreatic tumor- gastrinoma (recurrent peptic ulcers), glucagonoma, insulinoma, VIPoma
80
MEN2a vs. MEN2b
Both: medullary thyroid cancer and pheochoromocytoma MEN2a: + parathyroid hyperplasia MEN2b: + mucosal neuromas/marfanoid habitus
81
Clinical features of Sturge-Weber syndrome
Facial port-wine stain and leptomeningeal angiomatosis
82
Ocular manifestation of sarcoidosis
Anterior uveitis -erythema around cornea, constricted pupil, blurred vision, moderate eye pain
83
What age is considered delayed for children to walk
Walking normally occurs 9-16 months, consider eval if not walking by age 16
84
Lead time bias vs. length time bias
Both problems w/ screening tests Length-time bias = false increase in survival due to increased detection of less aggressive cases (slowly progressive) cases ex: PSA found prostate cancers that wouldn't have killed ppl anyway Lead time bias- test diagnoses diseases earlier, so time from diagnosis from death appears prolonged despite no improvement in survival
85
Hawthorne effect
= Observer effect Alteration of behavior of subjects of a study due to their awareness of being observed
86
MC clinical features of lead toxicity
Neuropsych- behavioral disturbances, cognitive impairment Then very severe (lead levels over 100) can be assocaited w/ acute encephalopathy- seizures, AMS
87
Symptoms of organophosphate poisoning (b) Tx
``` Organopshophate poisoning = Cholinergic toxicity = DUMBELS Diarrhea Urination Miosis (pinpoint pupils) Bradycardia Emesis Lacrimation Sweaing ``` (b) Atropine = anticholinergic
88
Mechanism of pyridostigmine (b) Uses
Pyridostigmine = inhibits ACh breakdown (b) Use in myasthenia gravis
89
Baby born w/ Turner's syndrome, why do they need (a) TTE (b) Renal ultrasound
Newborn w/ webbed neck (a) TTE to r/o coarctation of aorta - also BP measurements on all 4 extremities (b) Renal ultrasound to screen for horseshoe kidney- increases risk of UTIs
90
Explain the mechanism of hypophosphatemia in refeeding syndrome
Dextrose stimulates insulin secretion which drives phosphate into cells to be used for oxidative phosphorylation, rapidly depleting serum levels to make ATP
91
Mechanism of TRALI (b) What to watch out for in future transfusions?
TRALI = transfusion-related lung injury = form of ARDS from factor in the transfused blood that triggers recipient neutrophils to release inflammatory cytokines (b) Recipient is not at increased risk of transfusion reactions in the future, it is more a component of the donor blood (so pt should not receive blood from that same donor again)
92
ABPA (a) 2 main risk factors (b) Findings on chest imaging (c) Lab abnormalities
Allergic bronchopulmonary aspergillus (a) Asthmatics and cystic fibrosis- intense IgE and IgG mediated immune response after recurrent exacerbations (b) Upper lobe opacities, bronchiectasis (bronchial wall thickening) on CT chest (c) Eosinophilia (ex: 10% eos), +skin test for aspergillus
93
ABPA (a) Typical clinical manifestation (b) Tx
Allergic bronchopulmonary aspergillus (a) When pt w/ asthma or CF has recurrent exacerbations w/ fever, malaise, cough w/ brown sputum, symptoms of bronchial obstruction (b) Steroids to reduce inflammation, then can consider antifungals but mainstay is steroids

Step 3 (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions