Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Boards 2 > UWorld Step 2 Notes > Flashcards

UWorld Step 2 Notes Flashcards

(302 cards)

Start Studying
1
Q

Defect in b-cell tyrosine kinase

A

Bruton agammaglobulinemia

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

Skin infections
Mucosal infections
Poor wound healing
No pus

CBC lab?

A

Leukocyte adhesion deficiency

Neutrophilia

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

Increased C2b and bradykinin

A

C1 inhibitor deficiency

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

Low C1q

A

Acquired angioedema (over 30 y/o)

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

Causes of pericarditis

A

Cards surgery, TB, radiation, malignancy, uremia, virus, idiopathic, connective tissue disorders

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

Kussmaul’s sign

Sign of?

A

No decrease in JVP on inspiration

Defective/restricted RV

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

Systolic HTN, normal diastolic BP

A

Elderly w/ stiff vessels

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

Lipid lowering therapy guidelines

A
  1. Clinical atherosclerosis (moderate if over 75, high if under 75)
  2. LDL > 190 (high)
  3. 40-75 w/ DM (high if over 7.5% risk, moderate if under 7.5% risk)
  4. 10 year risk > 7.5%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

High intensity statins

A

Atorvastatin (high dose)

Rosuvastatin (high dose)

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

Risk factors for PACs (4)

A

Caffeine, smoking, EtOH, stress

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

Signs of AS + thrill above sternum

What else will they have? Why?

A

Supravalvular AS

Exercise-induced ischemia 2/2 coronary artery stenosis

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

Papillary muscle rupture…which infarct?

A

RCA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Free wall rupture…which infarct?

A

LAD

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

Endocarditis –> aortic regurg and AV block

A

Perivalvular abscess

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

Gross hematuria after sudden severe pain in upper abdomen + Hypotension

A

AAA rupture –> fistula w/ IVC –> retroperitoneal vein backup –> bladder vein rupture

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

Post-op…fever…cloudy fluid…widened mediastinum

Tx?

A

Acute mediastinitis

Surgery + Abx

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

Chest pain + stable…workup/tx?

A
  1. Aspirin (unless dissection)
  2. EKG
  3. CXR
  4. Treat problem
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

STEMI - tx?

A

Emergency cath or thrombolysis

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

NSTEMI - tx?

A

Anticoagulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Exertional syncope…cause?

A

Outflow obstruction

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

B/l hip, thigh, butt claudication + impotence + b/l LE atrophy

A

Occlusion at aortoiliac junction (Leriche syndrome)

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

Hypertrophic cardiomyopathy…genetic inheritence?

A

AD

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

Most common arrhythmias after an MI

A

V tach

V fib

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

A fib…assess what?

A

Clot risk via CHA2DS2 VASc

CHF
HTN
Age > 75 (2)
DM
Stroke/TIA/TE (2)
Vascular dz
Age 65-74
Sex category (female)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
CHADS-VASc...when to anticoagulate? Use what?
2+ Warfarin, NOT aspirin
26
S4 after severe chest pain
MI --> myocardial stiffening
27
DeGeorge symptoms
``` CATCH 22... Conotruncal cardiac defects (truncus arteriosus) Abnormal facies Thymic aplasia Cleft palate HYPOCALCEMIA ```
28
When to do surgery for carotid atherosclerosis (3)
1. Men > 50% w/ symptoms 2. Men > 60% 3. Women > 70%
29
Adenosine...used in what? Why?
SVTs Slows supraventricular and AV conduction, revealing P waves
30
Order of most important things to lower BP
1. Weight loss 2. DASH diet 3. Exercise 4. Sodium restriction 5. Alcohol restriction
31
Systolic murmur at lower sternal border that increases w/ respiration
Tricuspid regurg
32
Firm hyperpigmented nodule on lower extremity that dimples in the center when pinched
Dermatofibroma
33
Firm mobile cyst or nodule that recurs
Epidermal inclusion cyst
34
Chronic, relapsing skin condition w/ abscesses and sinus tracts and scarring
Hydradenitis suppurative
35
Red plaques w/ vesicles or pustules, Candida
Intertrigo
36
Furuncle = what?
Staph abscess
37
Pituitary mass + increased prolactin + decreased everything else
Non-secreting macroadenoma
38
Pituitary mass + decreased LH + increased prolactin
Prolactin-secreting microadenoma (Prolactin suppresses GnRH)
39
HTN, taking diuretic --> develops low K+ and still has HTN
Primary hyperaldosteronism (prone to diuretic-induced hypoK)
40
Cabergoline...MoA? Other one like it?
Dopamine agonist Bromocriptine
41
Sudden onset symptomatic hyperkalemia...think what?
Malignancy
42
2 Ab types in hypothyroidism Which one has large thyroid and recurrent pregnancy loss?
Anti-TPO TSH receptor-blocking Anti-TPO
43
Hyperthyroid drug major side effect Others?
Agranulocytosis
44
Child, distal extremity myotonia, testicular atrophy, baldness
Myotonic congenital myopathy (AR)
45
Diabetic gastroparesis...tx?
Metoclopramide
46
Small vs large fiber DM neuropathy
Small - pain, paresthesias | Large - numb, loss of prop/vib, loss of reflexes
47
How to calculate attributable risk?
(RR-1)/RR
48
Symptomatic bradycardia...Tx?
IV atropine IV epi or Dopamine if bad Pacing is worst case
49
Fusion/capture beats...rhythm?
V tach
50
Tx stable V tach
Amiodarone
51
Tx SVT stable
Carotid massage Rate control (esmolol, dig) Adenosine if super fast
52
Tx SVT unstable
Cardiovert
53
Best way to slow DM nephropathy
BP control (ACEI/ARB)
54
Intense glc control in DM...purpose?
Prevent nephropathy and retinopathy (MICROvascular issues)
55
CT contrast --> proptosis, lid lag, fever, delirium, vomiting
Thyroid storm precipitated by IV iodine in person w/ hidden hyperthyroidism
56
Corrected Ca for low albumin Low albumin = what for Ca?
Ca + (.8)(4-alb) Low TOTAL Ca++ but normal IONIZED Ca++
57
Secondary amenorrhea...workup?
1. Pregnancy test 2. TSH/Prolactin/FSH 3. Scope if prior surgery or infection
58
Hashimoto's vs. Painless vs. Grave's
Hashimotos - diffuse painless goiter Painless - brief hyperthyroid, small goiter, then recovery, DECREASED iodine uptake Grave's - INCREASED iodine uptake
59
Things that cause ox. stress in G6PD
``` Sulfa drugs Fava beans Nitrofurantoin Antimalarials Infections ```
60
Heinz body Seen in what? (4)
Damaged, clumped hemoglobin G6PD, Alpha thal, Chronic liver dz, NADPH deficiency
61
Prussian blue positive urine stain
Hemosiderin - G6PD
62
Atypical glandular cells on pap...workup?
Colp + ECC + EMB
63
McCune-Albright...symptoms (3)
Cafe-au-lait spots Polyostotic fibrous dysplasia Endocrine hyperfunction (precocious puberty, etc.)
64
Kallman syndrome...genetics?
X-linked
65
Indications for endometrial biopsy
Under 45 w/ AUB and cause for extra estrogen OR failed medical management OR Lynch syndrome Over 45 w/ AUB or PMB
66
Ovarian torsion...abdominal exam?
MASS
67
Severe (sick) PID...tx?
Hospital IV cef + Oral Doxy (IV clinda + IV gent) Metro if TOA present
68
Why does estrogen cause HTN?
Increased angiotensinogen by liver --> increased aldosterone
69
Hirsutism vs. Virilization
Hirsutism - excess body hair Virilization - clitoromegaly, aggressive, deep voice
70
Endometriosis - Tx?
1. NSAIDs, OCPs | 2. Laparoscopy
71
Condyloma accum - Tx?
Topical acetic acid | Podophyllin resin
72
Genital lesion w/ broad base, velvety, lobulated or plaque like
Condyloma lata
73
Pt had Roux-en-Y bypass surgery --> 5-6x per day fatty diarrhea, abdominal pain, weight loss, anemia, vitamin deficiency, flatulence How to diagnose?
SIBO - Jejunal aspirate - Carbohydrate breath testing
74
High homocysteine | Normal methylmalonic acid
Folate deficiency
75
Microvesicular steatosis
Reye syndrome
76
Macrovesicular steatosis
EtOH hepatitis | NAFLD
77
Periportal eosinophilic inclusion bodies
A1ATD
78
Sinusoidal congestion, hemorrhagic necrosis
CHF liver
79
Bile plugs, portal edema, fibrosis
Biliary atresia
80
Pancreatic CA w/ jaundice...U/S or CT?
U/S
81
Pancreatic CA w/o jaundice...U/S or CT?
CT
82
3 requirements for acute liver failure diagnosis
Elevated LFTs Signs of hep enceph. INR > 1.5
83
3 requirements for ARDS diagnosis
B/l alveolar infiltrates PaO2/FiO2 < 200 PCWP < 18
84
PBC...tx?
Ursodeoxycholic acid
85
Autoimmune hep...ab? Tx?
Anti-smooth muscle Steroids
86
Causes of niacin deficiency
``` Prolonged INH Alcoholism Chronic illness Carcinoid syndrome Hartnum dz Nutritional def. ```
87
Cyclic vomiting syndrome...look for what?
FHx of migraines
88
Angiodysplasia...usually diagnosed in who?
vWD Renal failure Aortic stenosis
89
When will bilirubin be in the urine?
Conjugated hyperbilirubinemia (unconjugated is bound to albumin, not excreted)
90
Low vs. high stool osmotic gap
``` Low = secretory High = osmotic ```
91
Why do you get NAFLD in DM?
No insulin response --> peripheral lipolysis --> TG synthesis and hepatic uptake of FFAs --> oxidative stress on liver --> NAFLD
92
DES or Achalasia...Tx? Why do they work?
CCBs or Nitrates Relax smooth muscle (esophageal too)
93
Duodenal villous atrophy...dx? Look for?
Celiac dz Iron deficiency
94
When do you take the colon out in FAP?
Significant increase in polyps (20s) or malignancy
95
Fatty stools, weight loss, ulcers in duodenum and jejunum...why these symptoms?
Zollinger-Ellison Gastric acid inactivates pancreatic enzymes in duodenum
96
Impaired glucose control in DM...what vitamin deficiency?
Chromium
97
Brittle hair, skin depigmentation, neuro issues, sideroblastic anemia, osteoporosis...what vitamin deficiency?
Copper
98
Thyroid issue, cardiomyopathy, immune dysfunction...what vitamin deficiency?
Selenium
99
Alopecia, pustular rash, hypogonadism, impaired wound healing, impaired taste, immune dysfunction...what vitamin deficiency?
Zinc
100
Acalculous cholecystitis...what is it?
Trauma or illness or surgery --> stasis or ischemia of GB --> inflammation
101
Jaundice, fever, RUQ pain
Charcot triad -- cholangitis
102
Air-fluid level in GB, air in biliary tree, crepitus on palpation over GB Tx?
Emphysematous cholecystitis Emergent cholecystectomy + Unasyn abx
103
Reversible risks for pancreatic cancer
Smoking | Obesity
104
Hepatic hydrothorax
Peritoneal fluid passes through defects in R diaphragm into pleural space (cirrhosis)
105
3 reasons for physiologic jaundice
1. High RBC turnover 2. Slow hepatic UGT 3. Sterile gut = no bacteria to break down bilirubin = gets reabsorbed
106
C diff...tx for mild, severe, and horrible
``` Mild = Oral metro Severe = Oral vanc, IV metro Horrible = surgery ```
107
At 1 year old, where should height and weight be?
``` Weight = tripled Height = 1.5x ```
108
Folic acid supplement --> progressive LE neuro damage What will be fixed?
SCD (need B12 too) Megaloblastosis
109
Hereditary spherocytosis --> cholecystitis...why?
RBC breakdown --> bilirubin collection --> pigment gallstones
110
Sideroblastic anemia, dimorphic RBC population Causes?
Low B6 ``` Low pyridoxine** Lead poisoning** Copper deficiency Antimicrobials Zinc excess ```
111
Unexplained thrombocytopenia...check what?
HIV
112
Factor V Leiden = what?
Protein C resistance
113
Causes of acquired AT deficiency? (3)
DIC Cirrhosis Nephrotic syndrome
114
Anabolic steroids...what to see for H/H, LDL, HDL, LFTs
High H/H High LDL Low HDL High LFTs (hepatotox.)
115
Aplastic anemia Ear problem Skin spots
Fanconi anemia
116
High metamyelocytes High myelocytes
Leukemoid reaction CML
117
Abnormal eosin-5 maleimide binding test
Hereditary Spherocytosis
118
Protein - Albumin > 4
Multiple myeloma until proven otherwise
119
Hydroxyurea side effect
Myelosuppresion (neutropenia, etc.)
120
Sounds like G6PD, G6PD assay is normal
G6PD Deficient RBCs are destroyed, reticulocytes have normal G6PD
121
What causes the destruction in G6PD?
RBCs cannot bind the oxidative metabolites --> membrane instability + Hgb denaturation
122
CO poisoning - risk factor?
Smoking - already higher carboxyHgb
123
Premie w/ low Hb/Hct and low retic count Why?
Anemia of prematurity Decreased EPO + short RBC life span + frequent phlebotomy in NICU
124
Transplant --> pruritic rash on face, hands, feet; diarrhea; abnormal LFTs Cause?
Acute graft-vs-host dz (skin, intestine, liver) Donor T cells vs. Host HLA antigens
125
ESRD - anticoagulation options
Warfarin ONLY (others are metabolized by kidneys)
126
On warfarin but struggle w/ dietary restrictions and/or anticoag appt's
Oral 10A inhibitors
127
Leukoreduced blood...for what?
Remove WBCs and cytokines -> prevent nonhemolytic febrile reaction
128
Washed blood...for what?
Remove IgA --> prevent IgA deficiency anaphylaxis
129
AKI (high BUN/Cr) Thrombocytopenia Hemolytic anemia (schistocytes)
HUS or TTP
130
Best way to confirm elevated lead level When to give a chelator?
VENOUS ``` Over 45 (DMSA) Over 70 (Dimercaprol + EDTA) ```
131
60 year old man w/ weight loss, nighttime cough, smoking history, difficulty swallowing solids and liquids.....Barium shows widened mediastinum w/ dilated esophagus and smooth tapering of distal esophagus Do what?
PSEUDOachalasia 2/2 cancer Endoscopic evaluation for differentiation from actual achalasia
132
Basophilic stippling, macrocytic megaloblastic anemia
B12 or folate
133
MCV over 110, anisocytosis, poikilocytosis...what type of anemia?
Macrocytic MEGALOBLASTIC (B12 or folate)
134
Acute HIV can present as a ____-like syndrome How to differentiated it by symptoms?
Mononucleosis HIV = painful oral ulcers, skin rash, prolonged diarrhea
135
Can chronic bronchitis have hemoptysis?
YES
136
Lumbar spinal stenosis...how to dx?
MRI (can see bone AND nerves)
137
Non-biologic DMARDs (5)
``` Methotrexate Hydroxychloroquine Sulfasalazine Leflunomide Azathioprine ```
138
Biologic DMARDs (5)
``` Etanercept Infliximab Adalimumab Tocilizumab Rituximab ```
139
In general, best drug for RA Not in who? Must do what before starting it?
Methotrexate Pregnant, planning, renal dz, liver dz, EtOH Test for Hep B, Hep C, TB
140
If Methotrexate does not cause symptom remission for RA...?
Add biologic after 6 months
141
Unconscious patient w/ weak pulse, elevated RAP, elevated PAP, normal PCWP
MASSIVE PE causing R-heart dysfunction and decreased preload to L heart --> obstructive shock
142
Todd paralysis
Complete or incomplete hemiplegia after a seizure
143
Endocarditis suspected...management?
BLOOD CULTURES, then echo and abx
144
Pt w/ ToF has "tet" spells during feeding or exertion or crying...why?
All of these cause increased pulmonary vascular resistance --> complete RVOT obstruction
145
Which is better in anaphylaxis...IM or IV epi? Why?
IM Less chance of adverse effects (arrhythmias, etc.)
146
Gilbert syndrome...genetic cause?
UDPGT mutation
147
Alcoholic, anion gap acidosis, vision loss, coma, hyperemic optic disc
Methanol poisoning
148
Alcoholic, anion gap acidosis, acute kidney failure
Ethylene glycol poisoning
149
MC cause of death in ESRD patient
Cardiovascular disease (many reasons AND common other predisposing medical conditions)
150
Reasons for CV disease in dialysis patient
1. ESRD in general 2. Anemia 3. Metabolic abnormalities 4. Increased homocysteine 5. Uremia-induced accelerated atherogenesis 6. Increased Ca uptake -> coronary calcification 7. Inhibition of N.O.
151
Unilateral motor impairment, no sensory or cortical deficits...what stroke?
Lacunar infarct
152
Unilateral sensory and motor deficit of face, arm, and leg; eye deviation away from affected side, homonymous hemianopia...what stroke?
MCA
153
Unilateral sensory and motor deficit, worse in lE, urinary incontinence, emotional disturbances, primitive reflexes...what stroke?
ACA
154
Ipsilateral CN dysfunction, Contralateral hemiplegia possible ataxia...what stroke?
Vertebrobasilar system
155
Why urinary incontinence in ACA stroke?
Cortical micturition centers in mesial frontal lobe
156
How do you diagnose toxic megacolon?
Abdominal XRAY
157
Meningococcal vaccination recommendations
1. First dose between 11-18 (11-12 is ideal) 2. Booster at 16 if initial was before that 3. Adult booster if high risk (immunodeficient, college, military, travel to endemic Africa/Saudi Arabia)
158
AIDS diarrhea... (4)
``` MAC = fever > 102, watery, CD4 under 50 CMV = intermittent bloody, CD4 under 50 Crypto = severe watery, low grade fever, CD4 under 180 Micro/Iso = watery, no fever, CD4 under 100 ```
159
Hyperthyroid (High T4, Low TSH), diffusely decreased iodine uptake...options? How to differentiate?
Thyroiditis or Exogenous thyroid hormone Serum thyroglobulin...LOW = exogenous, HIGH = endogenous
160
How to calculate A-a gradient in a person breathing room air How to calculate expected A-a gradient
150 - (PaCO2/0.8) (Age/4) + 4
161
AIDS, severe watery diarrhea, low fever
Cryptosporidium
162
AIDS, watery diarrhea, no fever
Isospora/Microspora
163
AIDS, watery diarrhea, high fever over 102.2
MAC
164
AIDS, intermittent bloody diarrhea
CMV
165
Pinworm...tx?
Albendazole, Pyrantel
166
Chagas...tx?
Benznidazole
167
Strongyloides...tx?
Ivermectin
168
Onchocerciasis...tx?
Ivermectin
169
Pneumonia symptoms Arthralgias Erythema nodosa
Valley fever - Coccidioides
170
Empiric abx for human bite Bugs?
Augmentin Strep, staph, anaerobes, other
171
Unilateral LAD...bugs?
Staph Strep MAC Bartonella
172
Empiric abx for baby w/ systemic bacterial sepsis (can't tell why yet) Workup?
Ampicillin + Gentamicin CBC, cultures, LP, U/A, urine culture
173
Why to hospitalize in pyelo? (5)
``` Vomiting Elderly Septic DM Obstruction ```
174
Thick and thin blood smears, giemsa stain
Malaria
175
Infection of upper dermis, warm tender red RAISED w/ SHARP BORDERS Classic location to differentiate from cellulitis
Erysipelas (GABHS) External ear (no lower dermis)
176
Possible disseminated gonococcal infection syndromes
Purulent monoarthritis, AND/OR | Tenosynovitis, dermatitis, migratory polyarthralgias
177
Vitamin A...functions besides in eye
Turnover of mucosal cells | B-cell production promotion
178
Young patient, post-viral bacterial pneumonia, multilobar w/ cavitary infiltrates, leukopenia, hemoptysis
CA-MRSA
179
Rash, elevated LFTs, thrombocytopenia, lymphopenia, polyarthralgias...recently traveled
Chikungunya fever (Aedes)
180
Gray lesions on posterior oropharynx, summer or fall
Coxsackie herpangina/HFM
181
Arthralgias, porphyria cutanea tarda, fatigue
Hep C
182
Lung cavitation w/ TB/staph/fungus, IV drug user, no murmur
Tricuspid endocarditis (no murmur b/c low flow)
183
TB symptoms, ulcerated skin lesions, lytic bone lesions
Blasto
184
Meningitis...normal glc, normal lymphocytes, low protein
Viral (enteroviruses - coxsackie or echo)
185
What do you do for rabies PEP for a pet bite vs low risk animal bite vs high risk animal bite?
Pet - wait 10 days, observe pet LR - nothing HR - kill animal and test, or rabies PEP if no access to animal
186
Adult: Pharyngitis + other symptoms...how to know how to treat/test?
Centor criteria...fever, anterior LAD, tonsillar exudates, NO cough ``` 0-1 = treat like viral 2-3 = tb test 4+ = treat as strep ```
187
Child w/ pharyngitis...how to test?
Rapid strep antigen...follow negative result w/ throat culture
188
Child under 20 w/ CF + pneumonia...bug?
Staph aureus
189
Adult over 20 w/ CF + pneumonia...bug?
Pseudomonas
190
Child has pertussis...what to do about family?
Prophylax (Z-pack) EVERYONE
191
Pain on gentle palpation of spine, chronic and slowly progressing back pain
Vertebral osteomyelitis
192
Echinococcus tx?
Metro + luminal paromomycin
193
Umbilical stump infection, hypertonicity
Neonatal tetanus
194
Rash in neck/axillae/groin, then spreads everywhere, then desquamates from head down
Scarlet fever
195
Terazosin, Tamsulosin...MoA?
Alpha blockers
196
Finasteride, Dutasteride...MoA?
5-alpha reductase blockers
197
When to test for chlamydia and gonorrhea if not symptomatic
Under 24, sexually active
198
Parkinsonism, autonomic symptoms, widespread other neuro symptoms
Multiple system atrophy (Shy-Drager syndrome)
199
T-wave inversion...causes?
MI, myocarditis, old pericarditis, myocardial contusion. digoxin toxicity
200
Friedreich ataxia...genetics?
AR
201
Carbamazepine...what to monitor?
Leukopenia, aplastic anemia (CBC)
202
Cataracts only...what type of galactosemia
Galactokinase deficiency
203
Cataracts + HSM + jaundice + seizures...what type of galactosemia
G1PUT deficiency
204
Cataracts + HSM + jaundice + deafness + hypotonia...what type of galactosemia
UDG4E deficiency
205
Chronic alcoholic w/ wide-based gait and postural instability, no anemia...cause?
"Alcoholic cerebellar degeneration" - purkinje cell degeneration in cerebellar vermis
206
Solitary met to brain...cancer?
Breast, colon, renal
207
Multiple mets to brain...cancer?
Lung, melanoma
208
Central scotoma, washed-out color appearance, dilation on direct light stimulation
Optic neuritis (MS)
209
Pain after lacunar infarct
Thalamic pain syndrome
210
Tay Sachs vs Neimann Pick...differences?
Tay Sachs - Hex A - HYPERreflexia NP - Sphingomyelinase - HYPOreflexia, HSM
211
Time frame for tPA in ischemic stroke
3 hours, no contraindications
212
HSV vs. CMV retinitis
HSV - CORNEA... keratitis/conjunctivitis 1st, then retinal necrosis w/ many peripheral lesions CMN - RETINA... fluffy/granular lesions near vessels w/ hemorrhages, only 1 phase
213
Contact-lens associated keratitis...bugs?
Pseudomonas, Serratia
214
Sudden loss of vision, floaters, dark red glow on exam, obscured fundus on exam
Vitreous hemorrhage
215
Periorbital burning, itching, vesicles, conjunctivitis, dendriform corneal ulcers
Herpes zoster ophthalmicus
216
What does NaHCO3 do to the CV system? (2)
Increased BP | Decreased QRS duration
217
Abdominal pain, N/V, diarrhea, hematemesis, anion gap acidosis...radiopaque tablets in stomach
Iron poisoning
218
Explain iron poisoning
Iron is vasodilator and toxic to cellular processes, causing hypotensive shock and AGMA
219
Long-term risk of iron poisoning
Hepatic necrosis, pyloric stenosis
220
Aspirin vs. Iron on abd XRAY
Aspirin - radiolucent | Iron - radiopaque
221
Hyperemesis gravidarum...labs to see?
Ketonuria Hypokalemia Met. alkalosis
222
Hypoplastic thoracic cavity, limb fractures, growth restriction
Type 2 OI
223
Pregnancy + b/l ovarian masses + hirsutism and acne Risk?
Luteoma Virilization of baby
224
Pregnancy + b/l ovarian masses + molar pregnancy or twins
Theca luteum cyst
225
Pregnancy + b/l ovarian masses + weight loss
Krukenberg tumor
226
Methylergonovine...use? Risk?
Uterotonic HTN
227
Carboprost...use? Risk?
Uterotonic Bronchoconstriction
228
Symmetric growth restriction
Chromosomal or infection
229
Asymmetric growth restriction
Utero-placental insufficiency or malnutrition
230
Pregnant woman w/ previous transvaginal myomectomy...labor trial?
NO - not after uterine cavity entry
231
ECV - when can you try it?
After 37 weeks
232
When should you induce for a dead fetus?
Over 24 weeks
233
When is an MMSE score very specific for dementia/delirium?
Under 23
234
Timeline for EtOH withdrawal shit
Day 1 = withdrawal s/s Day 1-2 = seizures/hallucinosis Day 3 = DTs
235
Tourette's...tx?
Alpha 2 agonists (guanfacine, clonidine) | Antipsychotics
236
Intubation --> BP drop and CVP rise...cause?
Pneumothorax (mediastinal compression)
237
Intubation --> atelectasis of L lung
R main bronchus
238
SIADH tx
Fluid restriction + salt tablets | Hypertonic saline if super severe
239
Pulmonary nodule w/ high risk for malignancy...tx?
Resection right away
240
Why is a PE painful?
Causes small pleural effusion (exudative) which irritates the pleura
241
Recurrent pneumonia in same lung region...test?
CT - look for bronchial obstruction or compression
242
PE highly likely...first thing?
Anticoagulation (heparin, etc.)
243
Best thing to do in COPD for mortality
Stop smoking
244
COPD + O2 sat under 88%...best thing to do for mortality
Home O2 therapy
245
Ankylosing spondylitis...FRC and RV
Ribs stuck UP --> increased FRC and RV
246
Asthma exacerbation + increased PaCO2...do what?
INTUBATE
247
Positive bronchodilator response in asthma means what?
12%+ increase in FEV1
248
HTN, nephrotoxicity, gum hypertrophy, hyperkalemia, hirsutism, tremor...what drug?
Cyclosporin toxicity
249
Diarrhea, leukopenia, hepatotoxicity...what drug?
Azathioprine toxicity
250
HTN, nephrotoxicity, hyperkalemia, tremor, normal gums and skin...what drug?
Tacrolimus
251
Causes of clubbing
Malignancies CF R->L shunts
252
Bronchiectasis w/ upper lung infections...cause
CF
253
High Ca, high-normal PTH
Familial hypocalciuric hypercalcemia
254
Treatment ladder for enuresis
1. Behavior mod and non pharma 2. Desmopressin 3. TCA
255
AKI 2/2 obstruction (BPH, etc.)...next?
Look for other causes and hydronephrosis (CT)
256
Post-URI glomerulonephritis...5 days after, young adult 10-21 days after, child
IgA nephropathy PSGN
257
Kidney stone...med management?
Alpha blockers (Tamsulosin) -- alpha receptors on ureter and bladder and urethra
258
Fat malabsorption --> kidney stones...why?
Increased oxalate absorption --> stone formation
259
Chronic use of aspirin or NSAID --> renal failure
Analgesic nephropathy (TIN or papillary necrosis)
260
Hyperkalemia on ECG
Peaked T waves, prolonged PR, prolonged QRS
261
Vomiting/diarrhea --> metabolic alkalosis...why?
Contraction alkalosis (RAAS --> H+ loss and HCO3 reabsorption)
262
Treating PCP pneumonia --> hyperkalemia...why?
Trimethoprim blocks collecting duct Na channels
263
Metabolic acidosis...how to judge CO2
1.5(HCO3) + 8 +/- 2
264
Metabolic alkalosis...how to judge CO2
Add 0.7 for every 1 HCO3 rise
265
Respiratory acidosis...how to judge HCO3
Add 1 for every 10 CO2 rise
266
Respiratory alkalosis...how to judge HCO3
Subtract 2 for every 10 CO2 fall
267
Osteitis fibrosa cystica
High PTH
268
Polyostotic fibrous dysplasia
McCune-Albright
269
Osteitis deformas
Paget's dz of bone
270
Spondyloarthropathies...symmetric or asymmetric arthritis?
Asymmetric
271
Who is more prone to vitamin D deficiency?
Dark skin, indoors
272
Felty syndrome Look for what?
RA Neutropenia Splenomegaly Extra-articular manifestations (vasculitis, ulcers, etc)
273
Ways to reduce gout risk
``` Stop EtOH Stop red meat and seafood Lose weight Stop refined sugars Low-fat diet Low-fat dairy and veggie products for protein ```
274
Woman w/ DM has pain in inner knee for a few weeks, worse in morning or overnight
Anserine bursitis
275
Blood/urine markers for Paget's dz of bone (3)
Procollagen 1N propeptide Urine hydroxyproline Alk phos
276
Drugs w/ ototoxicity
Aminoglycosides | Platinum chemo drugs
277
Drug w/ retinopathy
Hydroxychloroquine
278
1º vs 2º Reynauds
``` 1º = symmetric, no damage 2º = asymmetric, damage ```
279
Crepitus btwn 3rd and 4th toes
Morton neuroma (Mulder sign)
280
Fracture of middle metatarsal...do what?
Nothing, will be held in place by surrounding tissue
281
Prepatellar bursitis...cause? Do what?
Staph aureus Aspirate for cell count and gram stain
282
1st attack of gout...tx? Recurrent...tx?
NSAIDs, colchicine, steroids Allopurinol
283
Chondrocalcinosis Look for what?
Pseudogout 2º cause - hyperPTH, hypothyroid, hemochromatosis
284
SLE criteria
``` Serositis Oral ulcers Arthritis (non-destructive) Photosensitivity Blood (penias, hem anem) Renal (protein and blood) ANA Immunologic (markers) Neurologic Malar rash Discoid rash ```
285
Acute stroke...dx steps?
``` CT w/o contrast EKG CXR CBC PT, PTT Electrolytes Glucose level B/l carotid U/S Echo ```
286
Acute ischemic stroke..tx steps?
W/in 3 hours = tPA (UNLESS contraindication) Aspirin or Clopidogrel (unless getting tPA) Control BP IF significantly elevated OR severe need OR receiving tPA
287
How to prevent a stroke
Control HTN, DM, smoking, cholesterol, obesity Aspirin Carotid surgery if over 70% and symptomatic
288
Do you use warfarin and heparin in ischemic strokes?
NO - no proven benefit
289
How to treat hemorrhagic stroke?
Supportive - ABCs, control BP if very high (nitroprusside), reduce ICP if elevated
290
Intracerebral hemorrhage...where is the lesion: - Pinpoint pupils - Poorly responsive pupils - Dilated pupils
Pons Thalamus Putamen
291
Excruciating H/A, LP shows yellow CSF...dx?
Subarachnoid hemorrhage - yellow is broken down RBCs, so you know it's not a traumatic tap
292
When do you NOT do an LP?
Papilledema (cerebral edema) (repeat CT instead)
293
After dx of SAH, what next?
Cerebral angiogram (see where to clip)
294
How to prevent a vasospasm after a SAH?
Nifedipine (CCB)
295
Like parkinson's but w/o tremor and w/ ophthalmoplegia
Progressive supranuclear palsy
296
HIV, dull hypomobile TM, u/l hearing loss
Serous OM - MC middle ear issue in HIV - 2/2 obstruction of auditory tube from LAD or obstructing lymphomas
297
Akathisia tx
Decrease antipsychotic dose + benzo/propranolol/benztropine
298
TCA toxicity...think what (symptoms)?
- Neuro - Cardiac - Anticholinergic
299
How to treat really bad TCA OD? Why?
Sodium bicarb - TCAs block fast Na+ channels - Na+ causes increased gradient for Na+ channels - HCO3 raises pH and decreases drug affinity for channel
300
Risk factors for NEC (4)
Premature Low birth weight Low perfusion to gut Formula feeding
301
Low total T3 and T4 Normal TSH Gynecomastia and impotence in male Why?
Cirrhosis - decreased TBG = normal TOTAL T3/T4, and associated w/ high estrogen from circulating androgens
302
Why hypercalcemia/hypercalcuria in sarcoidosis?
Granulomatous inflammation --> increased 1-ALPHA HYDROXYLASE --> increased 1,25-vit D

Boards 2 (2 decks)

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