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Flashcards in UWorld Step 2 Deck (51):
1

Baker (Popliteal)'s cyst
path
pt
Tx
looks like what?

path: intra-articular pathology
pt: rupture --> pain, swelling, warmth, eccymosis
looks like: aute DVT

2

Clinical assessment of Acromegaly:
pt, Dx, Tx

Pt:
- glucose intolerance (induced gluconeogenesis)
- cardiomegaly
- growth of hands, feet, face, visceral organs
Dx:
1. IGF-1 (somatomedin)
2. Glu suppression test fails to suppress
3. MRI
Tx:
1. surgery
2. octreotide (Residual tissue)

3

clinical syndromes of coxsackie virus

Coxsackie A & B
Hand Foot and Mouth disease
- herpetic gingivostomatitis (gray vesicles/ulcers on post pharynx)
- pharyngitis
- red vesicular rash
- fever
- kids
- summer
2. Aseptic meningitis
3. Dilated Cardiomyopathy
4. pleurodynia

(UWorld + sketchy)


4

cx: filamentous gram + rods with rudimentary branching
pt:
Clx findings:
Tx:

Actinomyces

pt:
dental infx, trauma
mandible
non-painful mass
sinus tracts w/sulfur granules

Tx: PCN for months

5

lifestyle tx of HTN (5, in order of greatest affect --> least)

1. wgt loss (5-20mmHg/10kg loss)
2. DASH diet
3. Excersice
4. Dietary Na
5. ETOH

6

most sensitive test to screen for diabetic nephropathy?

random urin for microalbumin/Cr ratio

7

painless hematuria in a sickle cell kid?
labs?

Renal papillary necrosis
labs: normal labs, normal appearing uRBC's but elevated (= extra glomerular)

8

Tx of clubfoot

immediate stretching, manipulation --> serial casting/splinting/taping --> surgery if necessary (at 3-6mo)

(UWorld)

9

enzyme deficiency in Lesch Nyhan syndrome

what does this lead to?

hypoxanthine-guanine phosphoribosyltransferase (HGPRT) in purine metabolism

--> gout

10

Clinical findings of Osteogenesis imperfecta and Tx

"brittle bone disease"
- pathologic fx at birth
- blue sclera
- hearing loss
- opalescent teeth (uworld)

Tx: bisphosphonates

11

man has chest pain + diaphoresis. Soon after he arrests - cause of arrest?

ventricular arrhythmia

12

Treatment for kids with lyme?

Amoxicillin

13

CYP450 inducers:

GC and PBR's induce chrOnic Alcoholism
Ginseng
Carbamazepine
Phenobarbital
Rifampin
St Johns Wort
OCP's
Chronic Alcoholism

14

CYP 450 inhibitors:
(ACGOS)

Acetaminophen
Abx + metronidazole
Amio
Cimetidine
Gingko
Omeprazole
SSRI's (fluoxetine)

15

What are the most significant RF for AAA?

Male
Smoking

16

Associations with FSGM:

AA, Hispanics
HIV
Heroin
Sickle Cell

17

Clinical findings of amyloidosis:
CV, Renal, Skin, Neuro

*uworld

CV: increased wall thickness + diastolic dysfx
Renal: proteinuria
Skin: bleeding/bruising
Neuro: peripheral neuropathy

18

Common clinical associations/RF of Temporal/GC Arteritis?

Polymyalgia Rheumatica
Aortic involvement (AAA, dissection)

19

IgA nephropathy vs. PSGN

IgA:
- adult
- within 5 days of URI

PSGN
- kid
- 10-14 days post infection
- low complement
- elevated Antitrypsinolysin O

20

Pt Dx with syphilis and 6-48 hrs post initiation of tx --> acute onset of fever, chills, myalgias and rash progression

What is is?
Tx?

Jerisch-Herxheimer reaction
Tx: supportive, self-limiting

21

Associations with membranoproliferative GN?

Hep B and C
Lupus
Syphilis
Low C3
Cryoglobulins

22

S/sx of sarcoid:
Gen
HEENT
Resp
CV
Msk
Neuro
Skin

Malaise, fever, anorexia, wgt loss
Anterior uveitis
Dry cough, SOB
Arrhythmias, heart block
Arthralgias and arthritis
Bells palsy
Erythema nodosum

23

Clinical syndromes of coxsackie virus

1. Hand Foot and Mouth Disease
- herpetic gingivostomatitis (grey vesicles on erythem base)
- pharyngitis
- red vesicular rash
- fever
- kids
- summer time

2. Aseptic Meningitis
3. Dilated Cardiomyopathy
4. Pleurodynia

24

Screening that should be done in a pt with myositis (Poly/Dermato)

Ca screening (d/t increased incidence of malignancy)

25

DDx of myopathy:

1. Steroid induced - progressive proximal weakness, no pain
2. Polymyalgia Rheumatica - pelvis and shoulder pain and stiff
3. Inflammatory myopathies - skin rash
4. Statin induced
5. Hypothyroid myopathy

26

Clinical assessment of Acromegaly:
Include pt, dx, and tx

Pt:
- glucose intolerance
- cardiomegaly
- growth of hands, face, visceral organs

Dx:
1. IGF-1
2. Glu suppression test fails to suppress
3. MRI

Tx:
1. Resect
2. Octreotide (residual tissue)

27

Associations with membranous nephropathy?

*Hep B and C
*SLE
NSAIDS
Penicillamine

*also associated with membranoproliferative

28

Dx and Tx for SBP

PMN's > 250/mm3
+ cx (70% GNR)

Tx:Ceftriaxone
Ppx: fluoroquinolone

If polymycrobial: add MTZ

29

Lifestyle tx of HTN (5, in order of greatest affect --> least):

1. Wgt loss (5-20mmHg/10kg loss)
2. DASH diet
3. Execrise
4. Salt restriction
5. ETOH

30

Most sensitive test to screen for diabetic nephropathy?

Random urine for micralbumin/Cr ratio

31

Who gets minimal change dz?

Children
Hodgkins and Non-Hodgkins

32

Painless hematuria in a sickle cell kid?
What will labs look like?

Renal papillary necrosis
Labs: urine RBC's elevated but normal appearing. All other labs normal

33

Infection associated with MALT

H pylori

34

Relationship between Ca and Mg

Hypermag --> hypoca (d/t decreased PTH secretion)

(SE of Mag tox)

35

Associations with RPGN? (3)

PSGN
SLE
Vasculitises (Wegeners, Microscopic Polyangitis, Churg-Strauss)

36

S/sx of disseminated MAC infection
? CD4 count
Tx

CD4 < 50
Weight loss
Fever
Anemia
LAN
Diarrhea

Tx: Clarithromycin + Ethambutol (UW - Azithromycin)

37

Common infections seen in the following CD4 counts:
200-500
<200
<100
<50

200-500:
Oral leukoplakia
Pulm TB
Pneumococcal pna
Thrush

<200:
PCP
Crypto meningitis
Eso candida

<100: HSV/CMV esophagitis
Toxo

<50:
MAC
CMV retinitis

38

Pt with RA sx (joints etc.), splenomegaly and neutropenia?

Felty's syndrome

39

Pt with RA is going for surgery, what test should you do?

Cervical x-ray (RA can affect the cervical spine)

40

Marfan body habitus +
1. Aortic root dilation, upward lens dislocation
2. IDD, Thrombotic events at any age, fair complexion, megaloblastic anemia, downward lens dislocation

1. Marfan syndrome
2. Homocystinuria - tx: B6, folate, B1

41

Angular cheilosis, stomatitis, glossitis, seborrheic dermatitis

B2 (Riboflavin)

42

Beriberi or Wernicke-Korsakoff syndrome
? Vitamin deficiency?

B1 (thiamine)

43

Pellagra is what vitamin deficiency?

B3 (niacin)

44

Cheilosis, stomatitis, glossitis
Neuro sx - iritaability, confusion, depression

B6 (pyridoxine)

45

Gingivitis, punctate hemorrhages, corckscrew hair
Vitamin deficiency?

Vit C

46

Symptoms of serotonin syndrome:

Agitation, AMS
Ataxia
Diaphoresis
Diarrhea
Hyperreflexia
Myoclonus
Tremor
Shivering
Hyperthermia

(*did not recently start a neuroleptic med)

47

Lithium toxicity:
Sx
Causes

Sx: GI, confusion, ataxia, tremors
Causes: Thiazides, NSAIDS, ACEi, Tetracyclines

48

Pathology of Reye's syndrome

Microvesicular steatosis on liver biopsy in the context of acute hepatic encephalopathy

49

Anti-mitochondrial antibodies

PBC

50

Pt w/ seizure and CT shows Cystic lesions in brain with surrounding edema

Neurocysticercosis
- Taenia solium (pork tapeworm)
- Tx: albendazole

51

Aspergillus

Check sketchy